“A STUDY TO EVALUATE THECHIKITSA SIDDHANTA‘GURU CHA ATARPANA’ IN STHOULYA”ByDr. K. SAVITHA R SHENOY B.A.M.S.,Dissertation ...
iiRAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNME...
iiiRAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNM...
ivRAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNME...
vRAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNMEN...
viRAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNME...
viiDedicated . . .To my Parents, Teachers, Family, Friends andAll my PatientsFor their hope in destiny & faith in Ayurveda
viiiACKNOWLEDGEMENT“KNOWLEDGE IS PROUD THAT HE HAS LEARNED SO MUCH; WISDOM ISHUMBLE THAT HE KNOWS NO MORE.”I bow to the sa...
ixI owe my deep sense of gratitude and my heartfelt thanks to my respected teacherDr.V.A.Chate, for his patient observatio...
xI also owe my heart felt gratitude to my teachers of under graduation, ShriSubramanya Bhat, Dr.Prabhakar Upadhyaya Renjal...
xiI am thankful to Dr. Lancy D’Souza for helping in statistical analysis andinterpretation. I also thank Sri. M.V.Prasad, ...
xii Ch - Charak Samhita SU - Shusruta Samhita A.H - Astanga Hridaya A.S - Astanga Samgraha S.K.D - Shabda Kalpa Druma...
xiiiABSTRACTBackground of the StudyObesity was considered to have prevalence in the developed world and higherclasses. Rec...
xivFor Group B‘Lekhaneeya Gana Churna’ with Madhu Anupana in the dose of 6g, twice aday (in empty stomach morning and even...
xvCONTENTSIntroduction 1Objectives 3Review of LiteratureSrotas 4Medovaha srotas 10Medo dhatu 26Sthoulya Historical review...
xviNo. LIST OF TABLES Pg. no1 Synonyms of Srotas 52 Bahirmukha Srrotas 63 Abhyantaramukha Srotas 64 Sroto Moola 75 Medovah...
xvii43 Distribution of Age Group 8044 Distribution of Religion 8145 Distribution of Location 8146 Distribution of Occupati...
xviii86 Effect of Intervention On Sweda 9787 Significance of Change in Sweda 9788 Effect of Intervention On Waist Circumfe...
xix8 Showing Distribution Of Family History 1119 Showing Distribution Of Nature Of Work 11210 Showing Distribution Of Exer...
xxNo. LIST OF FLOW CHARTS Pg. no1 Mode Of Formation Of Medo Dhatu 272 Classification Of Sthaulya 363 Samprapti - Schematic...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A...
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K. SAVITHA R SHENOY, A STUDY TO EVALUATE THE CHIKITSA SIDDHANTA ‘GURU CHA ATARPANA’ IN STHOULYA, DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA, GOVERNMENT AYURVEDA MEDICAL COLLEGE, MYSORE. 2008

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  1. 1. “A STUDY TO EVALUATE THECHIKITSA SIDDHANTA‘GURU CHA ATARPANA’ IN STHOULYA”ByDr. K. SAVITHA R SHENOY B.A.M.S.,Dissertation submitted to theRajiv Gandhi University of Health Sciences,Karnataka, Bangalore.In the partial fulfillment of the requirements for the degree ofDOCTOR OF MEDICINE (AYURVEDA)inAYURVEDA SIDDHANTAUnder The Guidance ofDr.K.NASEEMA AKHTAR M.D. (Ayu)Professor,Department of Post-Graduate Studies in Ayurveda Siddhanta,G.A.M.C., Mysore.Co-GuideDR.H.M.CHANDRAMOULI M.D. (Ayu)Professor,Govt Ayurveda Medical College,Mysore - 570021DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNMENT AYURVEDA MEDICAL COLLEGE,MYSORE.2008
  2. 2. iiRAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNMENT AYURVEDA MEDICAL COLLEGEMYSORE.DECLARATIONI hereby declare that this Dissertation entitled “A Study To Evaluate TheChikitsa Siddhanta ‘Guru Cha Atarpana’ in Sthoulya” is a bonafide and genuineresearch work carried out by me under the guidance of Dr.K.Naseema Akthar,Professor, Department of Post Graduate Studies in Ayurveda Siddhanta,Government Ayurveda Medical College, Mysore.Date: Signature of the CandidatePlace: Mysore Name: Dr. K. SAVITHA R SHENOY
  3. 3. iiiRAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNMENT AYURVEDA MEDICAL COLLEGEMYSORE.CERTIFICATEThis is to certify that the dissertation entitled “A Study To Evaluate TheChikitsa Siddhanta ‘Guru Cha Atarpana’ in Sthoulya”is a bonafide researchwork done by Dr. K. SAVITHA R SHENOY in partial fulfilment of therequirement for the degree of Doctor of Medicine (Ayurveda).Date : Signature of the GuidePlace : Mysore DR. NASEEMA AKTHAR M.D. (Ayu).Professor,Department of Post Graduate Studiesin Ayurveda Siddhanta,Government Ayurveda Medical College,Mysore.
  4. 4. ivRAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNMENT AYURVEDA MEDICAL COLLEGEMYSORE.CERTIFICATEThis is to certify that the dissertation entitled “A Study To Evaluate TheChikitsa Siddhanta ‘Guru Cha Atarpana’ in Sthoulya” is a bonafide researchwork done by Dr. K. SAVITHA R SHENOY in partial fulfilment of therequirement for the degree of Doctor of Medicine (Ayurveda).Date: Signature of the Co-GuidePlace: Mysore DR.H.M.CHANDRAMOULI M.D. (AYU)Professor & H.O.D,Department of Dravyaguna,Govt Ayurveda Medical College,Mysore - 570021
  5. 5. vRAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNMENT AYURVEDA MEDICAL COLLEGEMYSORE.ENDORSEMENT BY THE HOD, PRINCIPAL /HEAD OF THE INSTITUTIONThis is to certify that the dissertation entitled “A Study To Evaluate TheChikitsa Siddhanta ‘Guru Cha Atarpana’ in Sthoulya” is a bonafide researchwork done by Dr. K. SAVITHA R SHENOY under the guidance of Dr.NaseemaAkhtar Professor, Department of Post Graduate Studies in Ayurveda Siddhanta,Government Ayurveda Medical College, Mysore.Seal & Signature of the HOD Seal & Signature of the PrincipalDr. N.Anjaneya Murthy Dr. Ashok D.SatputeDate: Date:Place: Mysore Place: Mysore
  6. 6. viRAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA,DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,GOVERNMENT AYURVEDA MEDICAL COLLEGE, MYSORE.COPY RIGHTDeclaration by the CandidateI hereby declare that the Rajiv Gandhi University of Health Sciences,Karnataka shall have the rights to preserve, use and disseminate thisdissertation /thesis in print or electronic format for academic / research purpose.Date : Signature of the CandidatePlace : Mysore Dr. K. SAVITHA R SHENOY© Rajiv Gandhi University of Health Sciences, Karnataka
  7. 7. viiDedicated . . .To my Parents, Teachers, Family, Friends andAll my PatientsFor their hope in destiny & faith in Ayurveda
  8. 8. viiiACKNOWLEDGEMENT“KNOWLEDGE IS PROUD THAT HE HAS LEARNED SO MUCH; WISDOM ISHUMBLE THAT HE KNOWS NO MORE.”I bow to the sacred feet of Almighty, without the blessings of whom this study wouldnot have been completed. He is the possessor of the ocean of knowledge and wisdom –to which I would like to contribute a drop in the form of my dissertation.I am highly thankful to my beloved, Professor and HOD, Department of PG Studies inAyurveda Siddhanta, Government Ayurveda Medical College, Mysore, Dr.N.AnjaneyaMurthy (Murthy sir) for his constant guidance, continuous supervision and help atevery stage of this study. Also, for his thoughtful provoking concepts and constructivecriticism, which have catalysed my work. Without his guidance with regards topublication via media sources it would not have been possible to reach out to the societyand attract the patients to volunteer for this study. I owe my heartfelt gratitude for thesame.I sincerely express my indebtedness and profound gratitude to my Guide Dr. NaseemaAkhtar, Professor, Department of PG Studies in Ayurveda Siddhanta, GovernmentAyurveda Medical College, Mysore for her valuable guidance & encouragementthrough out my PG studiesI sincerely acknowledge my reverend teacher and Co- guide Dr.H.M.Chandramouli,Professor & Head, Department of Dravya Guna, Government Ayurveda MedicalCollege, Mysore for his valuable guidance and support throughout my study.I am grateful to Principal Dr.Ashok D.Satpute, Professor and Head, Department ofRasashastra and Bhaishajya Kalpana, Government Ayurveda Medical College, Mysorefor his support and encouragement.
  9. 9. ixI owe my deep sense of gratitude and my heartfelt thanks to my respected teacherDr.V.A.Chate, for his patient observations, valuable suggestions and correctionsthroughout my study without which my dissertation would not have taken this shape.Also, I owe my deep sense of gratitude to all my teachers Dr. Anand Katti,Dr.T.R.Shantala Priyadarshini, Dr. Gopinath, Dr. Shantaram, Dr. Shashirekhaand all other teachers for their support in this study.I sincerely express my indebtedness and profound gratitude to Dr. K. S. Umashankar,Assistance Professor, Department of PG Studies in Kayachikitsa, GovernmentAyurveda Medical College, Mysore for his valuable guidance & for helping me toprocure Ativisha Choorna from N.K.C.A. Pharmacy.I convey my special thanks to the Teachers from J.S.S Ayurveda College, Mysore, Dr.Venkat Shivudu and Dr. Sudhakar Reddy for their valuable guidance and inputs forthis study and also through out my P.G. Studies.I express enormous amount of thanks to my colleague’s Dr.K.S Dutta Sharma,Dr.Soubhagya Bilagi, Dr.Yogesh Mukund Jirankalgikar, Dr. H.D.Vijayalakshmi,Dr.Puspalatha, Dr.Moose Beary, Dr.L.N.Shenoy, Dr.Beena, Dr.Savita Hiremath andmy junior P.G. Colleagues Dr.Pankaj, Dr.Rajesh, Dr.Annapooorani, Dr.Aparna, Dr.Kavitha, Dr. Ranjith, Dr. Kalyani, Dr.Ramesh & Dr.Geetha for their help and overallsupport and for making my stay in the college very joyful and educative.I would like to place on record my heartfelt thanks to my Best friend Dr. AbdulKhadar Patel for his patient hearing during times of my frustration and for offeringvaluable suggestions and inspiration from time to time during both my U.G. and P.Gstudies.I express my heartfelt gratitude to my friend (more a younger brother) Dr.Naveen, forbeing such huge a support through out my P.G. Studies.
  10. 10. xI also owe my heart felt gratitude to my teachers of under graduation, ShriSubramanya Bhat, Dr.Prabhakar Upadhyaya Renjal, Dr.G.S.Acharya,Dr.Muralidhara Sharma, Dr.K.Ramachandra Rao, Dr.B.V.Prasanna, Dr.PrasannaMogasale, Dr.Nagaraj, Dr.Niranjan Rao, Dr.A.R.Acharya, Dr.Shrilatha,Dr.J.K.Nayak, Dr.Jonah, Dr.Subramanya Bhat, Dr.Mallika, and all others whoinitiated and instilled in me the knowledge of this holy science.I convey my heartfelt thanks to Dr.Md.Rafik, M.S.Health services, Udupi who gave metimely guidance and helped me in procuring the drug for my thesisThis acknowledgement would not be complete without paying obeisance to my parentsShri.K.Ramesh Shenoy and Smt.Asha.R. Shenoy, who are living examples of selflesslove and immense patience. Their constant encouragement and guidance propelled me toachieve my goal. Their Support during my Periods of frustration due to workload helpedme fight all barriers.I would fail in my duty if I forget to mention my elder sister Smt. Anitha Shenoy andmy Brother-in-law Shri. Vinayak Shenoy for their abounding love, for being a sourceof Inspiration in every moment of my life and keeping me always charged. . I conveymy special thanks enveloped with affection to my beloved younger sister Ms. AkshathaR Shenoy for her valuable timely help and support.I wish to convey my thanks to U.G. and PG Librarian Varalakshmi and Somasundarfor providing library facilities and also thank the Lab Technicians, Hospital Staff,Physicians and other staff for their timely help.My doctoral study could not have been possible without the co-operation of myPatients and I would fail in my duties if I do not express deep sense of gratitude to eachand every one of them.
  11. 11. xiI am thankful to Dr. Lancy D’Souza for helping in statistical analysis andinterpretation. I also thank Sri. M.V.Prasad, , Microdot Creators, Mysore for their effortin bringing out the dissertation in such an excellent way.I owe my sincere thanks to CCRAS Officials for funding my research work.Last but not the least, I express my thanks to all persons who helped me directlyor indirectly in my studies with apologies for my inability to identify and thank themindividually.Date: 15thOct 2008 Dr. K. Savitha R ShenoyPlace: Mysore
  12. 12. xii Ch - Charak Samhita SU - Shusruta Samhita A.H - Astanga Hridaya A.S - Astanga Samgraha S.K.D - Shabda Kalpa Druma Ud - Udbhata Am - Amara Med - Medini Dh.Ni - Dhanvantari Nighantu B.P - Bhava Prakash M.N - Madhava Nidana Sh.S - Sharangadhara Samhita Ka.S - Kasyapa Samhita Bh.S - Bhela Samhita Y.R - Yoga Ratnakar Cd - Chakradatta Su - Sutra Sthana Sha - Shareera Sthana Vi - Vimana Sthana Ni - Nidana Sthana Chi - Chikitsa Sthana Si - Siddhi Sthana U - Uttara Tantra Pu - Purva Khanda B.M.I- Body Mass Index W : H- Waist Hip RatioABBREVIATION
  13. 13. xiiiABSTRACTBackground of the StudyObesity was considered to have prevalence in the developed world and higherclasses. Recent studies reveal that it is an increasing problem even in the developingcountries and in lower economical strata.Statistics shows that 58 million are overweight, 40 million are obese & 3million are morbidly obese around the world. 75% of Indian females and 58% ofIndian males are Obese.The present study is intended to evaluate the Chikitsa Siddhanta –‘Guru ChaAtarpanam’ in Sthoulya. Thus, this study is intended to device a convenient, costeffective and specific treatment for SthoulyaObjectives of the Study To review the literature on Sthoulya. To analyse the available literary data regarding the Siddhanta “GURU CHAATARPANAM” with regards to Sthoulya. To evaluate the efficacy of Guru Atarpana Ahara and Vihara in Sthoulya. To evaluate the efficacy of the ‘Lekhaneeya Gana Churna’ in the managementof Sthoulya along with Madhu Anupana. To evaluate the efficacy of the combined effect of ‘Lekhaneeya Gana Churna’with Madhu Anupana and Guru Atarpana Ahara and Vihara in Sthoulya.MethodA Comparative Single Blind Clinical Study with pre and post design.InterventionAs it is a comparative study, the patients are divided in to three Groupsconsisting of 15 patients in each Group.For Group AThe Module of Ahara Vihara was advised to the patients to be followed forduration of 60 days. Followed by a follow-up period of 30 days.
  14. 14. xivFor Group B‘Lekhaneeya Gana Churna’ with Madhu Anupana in the dose of 6g, twice aday (in empty stomach morning and evening), for duration of 60 days was given asoral administration. Followed by a follow-up period of 30 days.For Group CThe Module of Ahara Vihara along with ‘Lekhaneeya Gana Churna’ withMadhu Anupana in the dose of 6g, twice a day (in empty stomach morning andevening), was advised to the patients for duration of 60 days. Followed by a follow-upperiod of 30 days.Statistical Analysis to assess Individual and comparative effects of the groupswas done using Chi- Square test, One Sample t- test, Contingency Co-efficient Testand Repeated Measures ANOVA.ResultsAll the patients with Sthoulya considered for the study showed improvementin all the Parameters in all three Groups, which is statistically highly significant. Butthere was no significant difference between the Results of the three Groupsindividually.Interpretation and Conclusion:During the period between Before and After best result was seen in Group C(Mixed), followed by Group B (Lekhana Gana Choorna), then Group A(Pathya-Apathya).During this period best result was seen in Group A (Pathya- Apathya),followed by Group B (Lekhana Gana Choorna), then Group C (Mixed).During the period of complete treatment best result was seen in Group C(Mixed), followed by Group B (Lekhana Gana Choorna), then Group A (Pathya-Apathya).Keywords Sthoulya and medas. Obesity Lekhaneeya Gana Choorna Guru Atarpana Pathya-Apathya
  15. 15. xvCONTENTSIntroduction 1Objectives 3Review of LiteratureSrotas 4Medovaha srotas 10Medo dhatu 26Sthoulya Historical review Nidana Panchaka Nidana Poorvaroopa Roopa Upashaya Samprapti Upadrava Sadhya asadhyata Arista lakshana Modern parlance303137374041434447484950Chikitsa siddhanta 58Pathya apathya 65Drug review 68Review of Previous works 72Methodology 73Observation and Results 80Discussion 129Conclusion 160Summary 161Master Chart 163Bibliography 168References 182Annexure 186
  16. 16. xviNo. LIST OF TABLES Pg. no1 Synonyms of Srotas 52 Bahirmukha Srrotas 63 Abhyantaramukha Srotas 64 Sroto Moola 75 Medovaha Sroto Moola 106 Synonyms of Kati 127 Utpatti of Mamsa 138 Karma of Mamsa 139 Medo Vriddhi Lakshana 1610 Medo Kshaya Lakshana 1611 Medo Pradoshaja Vikara 1612 Synonyms of Guru 1813 Gunas of Guru Dravya 1914 Karma of Guru Dravya 1915 Synonyms of Laghu 2016 Synonyms of Santarpana 2217 Gunas of Santarpana Dravya 2218 Karma of Santarpana Dravya 2219 Synonyms of Apatarpana 2320 Synonyms of Medas 2621 Pramana of Medo Dhatu 2822 Gunas of Medas 2823 Karma of Medas 2824 Sthana of Medas 2925 Synonyms of Sthoulya 3026 Aahaaraatmaka Nidana for Sthoulya 3727 Vihaaraatmaka Nidana for Sthoulya 3828 Maanasika Nidana for Sthoulya 3929 Apachaaraja Nidana for Sthoulya 3930 Anya Nidana for Sthoulya 3931 Roopa of Sthoulya 4132 Upadrava of Sthoulya 4733 Saadhya Asaadhyata of Sthoulya 4834 Pathya Aahaara for Sthoulya 6535 Pathya Vihaara for Sthoulya 6636 Pathya Maanasika Bhaava for Sthoulya 6637 Apathya Aahaara for Sthoulya 6738 Apathya Vihaara for Sthoulya 6739 Apathya Maanasika Bhaava for Sthoulya 6740 Description of Lekhaneeya Gana Dravya with Madhu Anupaana 7041 Review of Previous Works 7242 Distribution of Sex 80
  17. 17. xvii43 Distribution of Age Group 8044 Distribution of Religion 8145 Distribution of Location 8146 Distribution of Occupation 8147 Distribution of Socio Economic Status 8248 Distribution of Education 8249 Distribution of Family History 8250 Distribution of Nature of Work 8351 Distribution of Exercising Practice 8352 Distribution of Diet 8453 Distribution of Hours of Day Sleep 8454 Distribution of Hours of Night Sleep 8455 Mean Hours of Night Sleep 8556 Significance of Hours of Night sleep 8557 Distribution of Habits 8558 Distribution of Number of Children 8659 Distribution of Marital Status 8660 Distribution of Number of Children v/s Marital Status 8761 Distribution of Prakruti 8762 Distribution of Dushya 8863 Distribution of Sara 8864 Distribution of Samhanana 8865 Distribution of Satmya 8966 Distribution of Sattva 8967 Distribution of Poorvatana Abhyavaharana Shakti 8968 Distribution of Adyatana Abhyavaharana Shakti 9069 Distribution of Poorvatana Jarana Shakti 9070 Distribution of Adyatana Jarana Shakti 9071 Distribution of Vyayama Shakti 9172 Distribution of Agni 9173 Distribution of Koshtha 9174 Effect of Intervention On Weight 9275 Significance of Weight Change 9276 Effect of Intervention On BMI 9377 Significance of Change in BMI 9378 Effect of Intervention On W: H 9379 Significance of Change in W: H 9480 Effect of Intervention On Shwasa Krucchrata 9481 Significance of Change in Shwasa Krucchrata 9582 Effect of Intervention On Utsaaha Haani 9583 Significance of Change in Utsaaha Haani 9584 Effect of Intervention On Sarvakriyaasu Asamarthata 9685 Significance of Change in Sarvakriyaasu Asamarthata 96
  18. 18. xviii86 Effect of Intervention On Sweda 9787 Significance of Change in Sweda 9788 Effect of Intervention On Waist Circumference 9789 Significance of Change in Waist Circumference 9890 Effect of Intervention On Hip Circumference 9891 Significance of Change in Hip Circumference 9992 Effect of Intervention On Mid Arm Circumference 9993 Significance of Change in Mid Arm Circumference 9994 Effect of Intervention On Wrist Circumference 10095 Significance of Change in Wrist Circumference 10096 Effect of Intervention On Thigh Circumference 10197 Significance of Change in Thigh Circumference 10198 Effect of Intervention On Kshudha 10199 Significance of Change in Kshudha 102100 Effect of Intervention On Pipaasa 102101 Significance of Change in Pipaasa 102102 Clinical improvement BT-AT in Group A 103103 Clinical improvement BT-AT in Group B 104104 Clinical improvement BT-AT in Group C 104105 Clinical improvement AT-FU in Group A 104106 Clinical improvement AT-FU in Group B 105107 Clinical improvement AT-FU in Group C 105108 Clinical improvement BT-FU in Group A 106109 Clinical improvement BT-FU in Group B 106110 Clinical improvement BT-FU in Group C 106111 Properties of Medya Aahaara 131112 Dietary Calorie value 135113 Calorie Requirement According to Body Weight 137114 Calorie Requirement According to Age 137115 Energy Need for everyday Activity 138116 Rasa Panchaka of Pathya Aahaara 144117 Rasa Panchaka of Apathya Aahaara 145No. LIST OF ILLUSTRATIONS Pg. no1 Showing Distribution Of Sex 1082 Showing Distribution Of Age 1083 Showing Distribution Of Religion 1094 Showing Distribution Of Location 1095 Showing Distribution Of Occupation 1106 Showing Distribution Of Socio-Economic Status 1107 Showing Distribution Of Education 111
  19. 19. xix8 Showing Distribution Of Family History 1119 Showing Distribution Of Nature Of Work 11210 Showing Distribution Of Exercising Habit 11211 Showing Distribution Of Diet 11312 Showing Distribution Of Hours Of Day Sleep 11313 Showing Distribution Of Hours Of Night Sleep 11414 Showing Distribution Of Habits Sleep 11415 Showing Distribution Of Number Of Kids 11516 Showing Distribution Of Marietal Status 11517 Showing Distribution Of Number Of Kids In Married 11618 Showing Distribution Of Prakruti 11619 Showing Distribution Of Dushya 11720 Showing Distribution Of Sara 11721 Showing Distribution Of Samhanana 11822 Showing Distribution Of Satmya 11823 Showing Distribution Of Sattva 11924 Showing Distribution Of Abhyavaharana Poorvatana And Adyatana 11925 Showing Distribution Of Jarana Poorvatana And Adyatana 12026 Showing Distribution Of Vyayama Shakti 12027 Showing Distribution Of Agni 12128 Showing Distribution Of Koshtha 12129 Showing Effect Of The 3 Interventions On Weights 12230 Showing Effect Of The 3 Interventions On B.M.I 12231 Showing Effect Of The 3 Interventions On Waist Hip Ratio 12332 Showing Effect Of The 3 Interventions On Shwasa Krucchruta 12333 Showing Effect Of The 3 Interventions On Utsaaha Haani 12434 Showing Effect Of The 3 Interventions On Sarvakriyasu Asamarthata 12435 Showing Effect Of The 3 Interventions On Sweda 12536 Showing Effect Of The 3 Interventions On Waist Circumferance 12537 Showing Effect Of The 3 Interventions On Hip Circumferance 12638 Showing Effect Of The 3 Interventions On Mid-Arm Circumferance 12639 Showing Effect Of The 3 Interventions On Wrist Circumferance 12740 Showing Effect Of The 3 Interventions On Thigh Circumferance 12741 Showing Effect Of The 3 Interventions On Kshudha 12842 Showing Effect Of The 3 Interventions On Pipaasa 12843 Showing Energy Balance 139
  20. 20. xxNo. LIST OF FLOW CHARTS Pg. no1 Mode Of Formation Of Medo Dhatu 272 Classification Of Sthaulya 363 Samprapti - Schematic Representation 454 Summarized Samprapti - Schematic Representation 142No. LIST OF PICTURE Pg. no1 Ingredients Of Lekhaneeya Gana Choorna With Madhu Anupana 69
  21. 21. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-20091INTRODUCTIONThe Nature has taught the man how to be healthy before the science hasdiscovered the laws of health. But, it is an irony of the fate that on this earth on onehand Millions do not get enough food and roam in a skeletal appearance while on theother hand, there are many more who, besides over eating lead a sedentary life tomarch towards an untimely death.Sthoulya (Obesity) is one among the major diseases of Modern era. In Modernera with continuous changing life styles and environment, changed diet habits, manhas become the victim of many disease caused by unwholesome dietary habits andObesity is one of them.Obesity is a blessing of the Modern age of Machines and Materialism. Itoccurs as a result of lack of physical activity with increased intake of food. Theindustrialization, stress during the work dietary habits, lack of exercise & variousvarieties among the daily diet e.g. fast food, Freezed fruits, increased amount of softdrinks and beverages, canned foods results into the clinical entity which we can callas Obesity.Obesity is a disease, which is gaining more and more attention of scientists atglobal level. Many institutions and Medical schools are making efforts to find aperfect remedy for this burning problem. Curiosity is one of the noblest instincts ofman, the endless desire of man for his knowledge. By this time, many countries aremaking an effort into this field of research. Many theories have been put forward withmany new hypotheses describing the exact aetiopathogenesis of Sthoulya or Obesity.As it is said that " wherever is the carcass there will be vultures gatheredtogether" in the similar fashion, the Obesity is such a physical state whereHypertension, Osteoarthritis, Diabetes Mellitus, Cardio Vascular accidents impotencyand many other grave complications are the Vultures invited. The long-term dangersof Obesity are like a sword hanging over ones head tied in a weak thread, which canstrike at any time and create numerous difficulties and boundless miseries.The definition of Swashta purusha as given by Cha.Su.21/18-19 andSu.Su.15/48, A healthy body is the only one media to achieve the ultimate goalamong the Chaturvidha purushartha. Acharya Sushruta also said that Madhyama
  22. 22. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-20092Sharira is the best but Ati Sthoola and Ati Krisha are always affected with somecomplaints,“Atyanta Garhitaauvetau” (Su. 15/42). Acharya Charaka has thrown lighton the eight varieties of impediments, which are designated as Nindita Purusha; AtiSthoulya is one of them.Since the inception of postgraduate education in India, several theses havebeen submitted on various aspects of this disease. In Charaka Samhita most of thequalities of Tikta Rasa has been described which are very suitable for themanagement of Sthoulya Roga.Lekhaniya Gana Choorna is the effective remedy, which has been mentionedby Charaka that is useful in the management of Sthoulya.Thus the current study is intended to seek better remedy for Sthoulya byapplying the Chikitsa Siddhanta Guru Cha Atarpana and a Clinical trial withLekhaneeya Gana Choorna on the same.This study is a Single clinical Study with Pre and Post-test design. ThePatients are divided into three groups A, B and C. Group A was given Diet andRegimen proforma, Group B was given the Lekhaneeya Gana Choorna with MadhuAnupana and the third group was given both.This dissertation comprises of two parts, Part I and II. The First Part dealswith the Review of the literature on Srotas, Medovaha Srotas, Medo Dhatu andSthoulya, which are carried out, by thoroughly reviewing Ayurvedic Literature andalso modern literature regarding Obesity. The Second Part deals with Materials andmethods, Observation, Results, Discussion, Conclusion and Summary. This part isbased on a Clinical trial organized on 45 patients suffering from Sthoulya selectedfrom OPD, IPD of Government Ayurveda Medical College and Hospital, Mysore andspecial camps conducted in and around Mysore.
  23. 23. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-20093OBJECTIVES OF THE STUDY To review the literature on Sthoulya. To analyze the available literary data regarding the Siddhanta “GURU CHAATARPANAM” with regards to Sthoulya. To evaluate the efficacy of Guru Atarpana Ahara and Vihara in Sthoulya. To evaluate the efficacy of the ‘Lekhaneeya Gana Churna’ in the managementof Sthoulya along with Madhu Anupana. To evaluate the efficacy of the combined effect of ‘Lekhaneeya Gana Churna’with Madhu Anupana and Guru Atarpana Ahara and Vihara in Sthoulya.
  24. 24. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-20094IntroductionIn Ayurveda, the entity, which is of fundamental importance in swashta1,Atura, and in Chikitsa, is termed as SROTAS.These Srotases play a fundamental role in all the activities of life; for e.g.Breathing, Ingestion, Digestion, Nutrition, Sequential formation of Sapta Dhatu,Formation of malas and its excretion.Due to Ahita Nidana Sevana there is Vigunata of Srotas2, which is termed as“Kha- Vaigunya”. Once there is Kha- Vaigunya or loss of quality in the Srotasas, theDoshas get vitiated and give rise to Diseases. Even if vitiated doshas are circulating inthe body, they are not in a position to result into a disease, unless they get afavourable place and find a foothold to give rise to a condition known as “Sthana-Samshraya”3, without which the occurrence of a disease isn’t possible.In chikitsa too both Shamana and Shodhana are based on rectifying the Doshaslodged in Kha- Vaigunya and purifying the Srotasas respectively. Both these areaimed at pacifying the vitiated doshas from Srotasas respectively.The word Pathya-Apathya too is derived from the word “Patha” which meansPathway i.e. nothing but the Srotas.Thus, be it Swashta, Atura or Chikitsa including Pathya-Apathya, SROTAS isof utmost Importance.Derivation“Srotam- kree srotah sravateeti|” 4Srota is derived from kriya pada “sravati” which means ‘that which has exudationwithin’ (flow).“Sru gatau + sruribhyaam tut cha|” 5It is derived from “sru gatau” dhatu.“Sroto ambu saranam|” 6Srotas is one in which sarana (flow)of ambu(water/liquid) occurs.“Vegena jalavahanam srota| Svatah svayamambunah saranam gamanam srotahityanvayah||”““7
  25. 25. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-20095The one which carries jala, which is flowing with speed. The one within whichthe ambu (water/liquid) sarana (flow) or gamana (movement) occurs by itself(Swatah/Svayam) is known as Srotas.“Srotasah nah, sru- tasi| Vegena svato jalanihsarane amarah| Retasi chaoorngasrotaa| Dehaasyachidre cha||” 8The one through which fluid flows at high speed. Also means the openings or poresof the body.DefinitionThe channels in which Sravana i.e. transudation. The channels or place wherethis process of transudation occurs is termed as Srotas.9On this chakrapani commentsThe nutrient materials are supplied to the tissues through the process oftransudation occurs is termed as Srotas.10The channels for transudation/transportation that arise from “moola” made upof Akashiya amsha, which are spread throughout the body are called as Srotas. Theseare entities separate from Sira and Dhamani.11Table 1: SynonymsSl.No Synonyms Ch SU A.H A.S1 Srotamsi + -- -- +2 Sira + -- -- +3 Dhamani + -- -- +4 Rasayani + -- -- _5 Rasavahini + -- -- +6 Naadi + -- -- +7 Panthaana + -- -- +8 Maarga + -- -- +9 Shareerachidra + -- -- +10 Samrutaasamruta + -- -- +11 Sthaana + -- -- +12 Aashaya + -- -- +13 Niketa + -- -- +14 Shareera Dhaatvaavakaasha + -- -- +15 Khaani -- + -- --16 Chidraani -- + -- --17 Kalakhanda -- + -- --
  26. 26. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009618 Jeevaayatana -- -- + +19 Kshaya -- -- -- +Types/SankhyaThe varieties of the channels of circulation in the human body are the same innumber of structural entities.12Some scholars hold the view that the human body isnothing but the conglomeration of Srotasas only.13Broadly, though Srotasas are classified as1. Bahirmukha Srotas2. Abhyantara Srotas / Antah SrotasTable 2: Bahirmukha SrotasBahirmukha Srotas Ch SU VagShrotra + + +Naasaputa + + +Akshi + + +Mukham + + +Guda + + +Linga + + +Stana -- + +Raktavaha -- + +Table 3: Abhyantara SrotasAbhyantara Srotas Ch SU VagPraanavaha + + +Udakavaha + + +Annavaha + + +Rasavaha + + +Raktavaha + + +Maamsavaha + + +Medovaha + + +Asthivaha + -- +Majjavaha + -- +Shukravaha + + +Mootravaha + + +Pureeshavaha + + +Svedavaha + -- +Artavavaha -- + --
  27. 27. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-20097Table 4: Sroto-MoolaSl.No Srotas Moola Ch SU VagHrudaya + + +MahaSrotas + -- +1 PraanavahaRasavaahini Dhamani -- + --Taalu + + +2 UdakavahaKloma + + +Aamaashaya + + +Vaama Paarshva + -- +3 AnnavahaAnnavaahini Dhamani -- + --Hrudaya + + +Dasha Dhamani + -- +4 RasavahaRasavaahini Dhamani -- + --Yakrut + + +5 RaktavahaPleeha + + +Snaayu + -- +Twak + -- +Snaayutwacha -- + --6 MamsavahaRaktavaha Dhamani -- + --Vrukka + + +Vapaavahana + -- --Kati -- + --7 MedovahaMamsa -- -- +Medas + N.A +8 AsthivahaJaghana + N.A +Asthi + N.A +Sandhi + N.A --9 MajjavahaParvaani -- N.A +Vrashana + + +Shepha + -- --Sthana -- + +10 ShukravahaMajja -- -- +Pakvaashaya + + +Sthoolaguda + -- --Guda -- + --11 PureeshavahaSthoolaantra -- -- +Basti + + +Vankshana + -- +12 MootravahaMedhra -- + --Meda + N.A +13 SvedavahaLomakupa + N.A +Garbhaashaya N.A + N.A14 AartavavahaAartavavahini Dhamani N.A + N.A
  28. 28. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-20098ANATOMICAL AND PHYSIOLOGICAL ASPECTS OF SROTASAnatomy of SrotasThe Srotas are Sthoola (Gross) or Anu (Minute) in size; and they could bechannel like or pore like opening in the body.14The Srotasas have colour similar tothat of the Dhatus that they carry. They are tubular, either large or small in size andeither straight or reticulated in shape.15Size: Anu or SthoolaForm: Pore like opening or Channel like.Colour: Similar to the Dhatu that they carry.Shape: Straight or ReticulatedPhysiology Of SrotasThe Srotas are the one, which carry the Dhatus (Tissues elements or theirconstituents) undergoing transformation, to their destination.16Sroto Dusti (Vitiation Of Srotas)Nidana:The improper food, drinks and actions, which vitiate doshas, same causes areresponsible for disturbing the functional and anatomical integrity of the Srotasas.Similarly, the foods drinks and actions, which are deleterious to the Dhatus, are alsocapable of vitiating the Srotasas.17The Sroto Dusti/Vaigunya is essential for manifestation of diseases. Thedoshas which are in an inequilibrium state and moving through out the body getlocated at sites of Kha-vaigunya and lead to diseases.18When the integrity of Srotas is impaired, both Sthanaga(Sthayi) and Margaga(Poshaka) Dhatus are also involved; the morbidity spreads from one Dhatu vitiatingthe other Dhatu and a Srotas to another Srotas.19
  29. 29. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-20099Types:The types of Sroto dusti are as follows20:1. Atipravrutti: Increased flow of contents2. Sanga: Obstruction to the flow3. Siragranthi: Dilatation with hardening4. Vimaargagamana: Flow of contents in abnormal path or direction throughchannels other than its own.Sroto Viddha LakshanaSroto vaigunya may also develop due to Abhighata (injury, trauma). The followingare the signs and symptoms caused by trauma to Srotas21:1. Delusions2. Tremors3. Flatulence4. Vomiting5. Fever6. Delirium7. Pain8. Retention of urine and faeces9. DeathSushruta has mentioned the signs and symptoms produced by the injury of eachindividual Srotas.22
  30. 30. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200910IntroductionMedovaha Srotas is one among the abhyantara, dhatuvaha Srotas.Thediseases are nothing but the outcome of srotovigunata. The vigunata of medovahaSrotas too leads to several diseases, Sthoulya too being one among them.The medhodhaatu gets nutrition from its preceding dhatu i.e mamsa (poshaka) though it’s ownSrotas called medovaha Srotas.DefinitionThe srotas, which transports the medo dhatu, which is in transformatory state,is known as medovaha Srotas.Table 5: Medovaha Sroto MoolaSl.No Moola Ch SU Va1 Vrukka + + +2 Vapavahana + - -3 Kati - + -4 Mamsa - - +VrukkaDefinition:Rounded masses in abdominal cavity.23Number:These are 02 in number.24Sthana:One is placed on the left flank and the other on right flank.25Utpatti:They are produced out of the essence of rakta and Medas.26Karma:Sharngadhara says they nourish the Medo dhatu inside the abdominal cavity.27Parlance:Based on the above, it should be a structure that must be directly related withfat metabolism. But, there is no exact evidence in modern science if the two structures
  31. 31. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200911above the two kidneys, i.e., super renal glands as Vrukka then it fulfills the role in fatmetabolism.Suprarenal glands: A pair of endocrine glands situated over the upper pole of thekidneys behind the peritoneum. Two parts visible on cross section: Outer cortex: 1. zona glomerulosa(minerelocorticoid)2. zona fasiculata (glucocorticoid)3. zona reticulosa(sex hormones) Inner medulla: It consists of chromaffin cells which in turn is divided into twoadrenaline and non adrenaline.The action of Hormones produced by the Adrenal gland on Fat Metabolism:Glucocorticoids: they stimulate the fat absorption from the intestines, mobilize the fatfrom depots and disintegrates to form ketone bodies in the Liver.Cortisol, a Glucocorticoid produced by the cortex of the Adrenal gland thatcauses moderate degree of fatty acid mobilization from adipose tissue but personswith excess cortisol secretion frequently develops obesity.Vapavahana:Derivation:It is made up of two words Vapaa + vahana“Vapaa stree, upyate atreti|”“Vap+bhidaadyang| Taap||”Definition:It is unctuous varti covering the udara bhaga,it is also known taila vartika.28Synonyms:Chakrapani mentions the below synonyms: Vapa Vapavahana TailavartikaSthana:Abdominal region.29It is one among Matruja Avayava. 30
  32. 32. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200912Parlance:It can be considered as omentum in modern parlance. Greater and lesseromentum → folds of peritoneum, which extend from greater and lesser curvature ofstomach. Greater omentum extends over the intestines as an apron lesser omentumextends over 2cm of the duodenum to liver.Kati:Derivation:“Pum, Stree”“ Katyate vastraadinaa vreeyate asau sarva dhaatubhya in iti| Kat + In ||”Definition: It is one of the parts of the body.31 It is one among the vatashtanas.32 Made of union of bones also known as shroni, which attains union withurunalaakaasthi that is femur.33Synonyms:Table 6: SynonymsSl.No Synonym A.H S.K.D1 Shroni + +2 Kaankali -- +3 Kataha -- +4 Shroniphalakam -- +5 Kakudhmati -- +6 Kati + +7 Kalatram -- +8 Kateeram -- +9 Kaancheepadam -- +10 Karabhaha -- +Pramana:It is 18 angula in circumference.34
  33. 33. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200913Parlance:May be considered as the hip region where generally fat deposition occursspecially in obese.Mamsa:Derivation:“Klee manyate iti| mana jnaane + manedeerghancha||”Definition:It is one among the Saptadhatus.35Synonyms:Shabda Kalpa Druma mentions the following Synonyms: Pishitam Tarasam Palalam Kravyam Amisham Palam Asrajam Jaangalam KeeramUtpatti:Table 7: UtpattiSl.No Utpatti from Ch SU Vag1 Raktasya saaramshat - - +2 Mamsavaha Srotassu mamsa dhatwagnina (mamsaathMedaha)+ - -3 In order after rasotpatti,on third day according to someand 10thday according to some other.- + -Swaroopa: 36Color: Slightly redQualities: Slim, thick, smooth
  34. 34. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200914Karma:Table 8: KarmaSl.No Karma SU Vag1 Shareera pushti + -2 Lepana - +Abhivyakti:In 8thmonth of intra-uterine life, the Mamsa dhatu gets fully formed in aperson.37Parlance:Mamsa can be considered as the muscle tissue in the body.Medovaha Srotas – PoshanaThough there isn’t a direct reference to say, where the Srotas derives itsnutrition, it can be inferred based on the quotation of Definition of Samprapti:“Yatha dushtena doshena yatha chaanuvisarptah|Nirvruttiraamayasya asau sampraaptih jaatiraagatih||”It indicates that by nidanasevana, doshas are the first to be vitiated, they vitiatedhatus and dhatus inturn cause vitiation of the Srotas leading to vyadhi.This is a description of pathological stage. The same when applied tophysiology we can arrive at an hypothesis that the poshana of Srotas occurs by thedhatu that they carry.Medovaha Srotas – KarmaThough in specific karma hasn’t been told for individual Srotas, based on thegeneral karma of Srotas, the medovahasroto karma can be known. Thus, karma ofmedovaha Srotas is Abhivahana (transportation) of meodhatu, which is in itstranformatory phase.38Medovaha Srotodushti NidanaSpecific Nidana for Medovaha Srotodushti is mentioned in Charaka VimanaSthana 5thchapter. 39Also, in general Nidana for dushti of any Srotas too has beenmentioned in the same chapter i.e; all the aharas and viharas that are samaana guna of
  35. 35. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200915dosha and viguna (not vipareeta guna but the guna that vitiates) to dhatus is the causefor srotodushti. 40Combining both, the nidanas for Medovaha Srotodushti can be tabulated as follows: Ahara viguna to Medas Vihara viguna to Medas Avyayama Diwa swapna Medyanam atibhakshana Vaaruni atisevana1. Medya Ahara:The one, which brings about increase in Medas, increases the productionof Medas can be understood as medya.412. Avyayama:It is said, “Vyayama is best to relieve Sthoulya.”42Hence Avyayama canbe inferred to cause Sthoulya.3. Diwaswapna:It is said to be shleshma peeda kaaraka. By aashrayaaashrayi bhaava it canbe known to cause vitiation of Medas too which is the main culprit inSthoulya.4. Vaarunimadya: 43Vaaruni is hridya, laghu, teekshna and pacifies shoola, kaasa, etc. diseases.Its properties are same as that of sura, that is,Rogaghnata: gulma, udara, arsha, grahani, shophaGuna: snehani, guru, vaataharaEffect: Causes increases if Meda, asrak, ashtanya, mootra and kapha.Medovahasrotodushti LakshanaThere is no direct reference of Medovahasrotodushti lakshana. The belowreference is an indirect reference. The lakshanas related to Medodhatu itself are tobe considered as Medovahasrotodudhti lakshana. 44The Medo dhatu dushti may be seen as:
  36. 36. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009161. Medovriddhi2. Medokshaya3. Medopradoshaja vikaraTable 9: Medovriddhi LakshanaSl.No Medovriddhi lakshana Ch SU Vag1 Gandamala - - +2 Arbudha - - +3 Granthi - - +4 Galaganda - - +5 Uruvriddhi - - +6 Udaravriddhi - + +7 Adhimamsa in kantha etc - - +8 Shrama (on alpa cheshta) - - +9 Shwasa (on alpa cheshtha) - + +10 Spik lambana - - +11 Stana lambana - - +12 Udara lambana - - +13 Paarshwa vriddhi - + -14 Snighdhangata - + -15 Kasa - + -16 Daurgandhya - + -Table 10: Medokshaya LakshanaSl.No Medokshaya lakshana Ch SU Vag1 Sandheenam sphutanam + - -2 Glaanirakshno + - -3 Aayasa + - -4 Udara tanutva + - -5 Swapanam katya - - +6 Pleehno vriddhi - + +7 Krishaangata - - +8 Sandhi shoonyata - + -9 Raukshya - + -10 Medura mamsa prarthana - + -
  37. 37. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200917Table 11: Medo Pradoshaja VikaraSl.No Medo pradoshaja vikara Ch SU Vag1 Jatiri bhavata of kasha + - -2 Aasya madhurata + - -3 Suptata of kara + - -4 Suptata of paada + - -5 Daaha of kara + - -6 Daaha of paada + - -7 Mukha taalu kantha shosha + - -8 Pipasa + - -9 Aalasya + - -10 Malam kaaye + - -11 Kaaya chhidreshuupadehaha+ - -12 Angeshu paridahaha + - -13 Angeshu suptata + - -14 Shatpada pippilikabhihishareera abhisarana+ - -15 Shatpada pippilikabhihimootrabhisarana+ - -16 Mootradosha + - -17 Visra shareera gandha + - -18 Nidra sarwakaala + - -19 Tandra sarwakaala + - -20 Granthi - + -21 Vriddhi - + -22 Galagandha - + -23 Arbudha - + -24 Medoja oshtha prakopa - + -25 Madhumeha - + -26 Sthoulya - + -27 Atisweda - + -Medovaha Srotoviddha LakshanaOnly Sushruta mentions Medovaha srotoviddha lakshanas:1. Swedaagamana2. Snigdhangata3. Taalushoshaha4. Sthoola shophata
  38. 38. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009185. PipasaThe chikitsa of Medovaha Srotodusti Chikitsa Medovaha sroto dusti inCharaka Vimana 5thchapter isn’t a direct reference. It hints towards another referencein Charaka Sootra 28thchapter, which again gives indication to refer back to chapter21 of Charaka sootra sthana. This pattern of arriving at the actual direct reference byreferring to the prior references is known as “Ateetavekshana”. Thus, the Chikitsa canbe known as heavy and non-nourishing diet is prescribed for slimming in the case ofthe over-corpulent. Light and nourishing diet for the nourishment of the slim.45Here in we see 2 types of treatment modalities: GURU ATARPANA IN STHOOLA LAGHU SANTARPANA IN KRUSHABased on the treatment modalities the dravyas used could be grouped into 4: GURU LAGHU SANTARPANA ATARPANAGURUIntroduction:It is one among the Vimshati gunas.Derivation:“Gra + Krugroruccha unaam|1|24| iti ut||”“Pullinga shabda, granaati updishati vedadi shaastraani indraadi devebhyah iti|Yadvaa geeryate stooyate devagandharva manushyaadibhih||”Definition:That which brings about stoutening in the body or stoutening effect is known asguru.46Synonyms:Table 12: SynonymsSynonyms Ch SU Vag S.K.DMahan-great -- -- + --Adhyapakaha + -- -- --
  39. 39. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200919Upadeshakaha + -- -- --Brihaspatihi -- -- -- +Bhootadhipatihi -- -- + --Matrupitruprabrhitayaha -- + -- --Types:Basically the guru guna could be of two types471. Gunataha guru2. Paakataha guruThe gunataha guru dravya too could beA. Swabhavataha guruB. Samskaarataha guruMahabhuta Sanghatana:Every dravya and hence it’s guna is paanchabhautika. Guru guna has predominance ofptithivi and jalamahabhuta.Guna:Table 13: GunaSl.No Properties SU Vag1 Agniguna vipareeta -- +2 Chirapaki + --Karma:Table 14: KarmaSl.No Karma Ch SU Vag1 Brumhana -- + +2 Agnimaandyakara -- + +3 Upalapa -- + --4 Bala -- + --5 Upachaya -- + --6 Tarpana -- + --Importance: Dravyas used in chikitsa are used due to their actions, which are the result oftheir guna.
  40. 40. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200920 Guru guna by its paanchabhautika sanghatana, its properties and actions givesfollowing effects:o Vaatahara, kaphakara (B.P)o BrumhanaThis is for gunataha guru dravya. But the maatravat guru dravya needn’t have theabove properties. Even a laghu dravya (gunataha) when taken is large amount willbecome maatravat guru hence chirapaki.Examples: Maasha, mushali – gunavat guru: Maatravat guru – any dravya taken inlarge amount.LAGHUIntroduction:This is also one among the vinshatigunaha.Derivation:Klee, langhate aneneti| langh + “Langhivanhyornalopascha|” una 1/30/ iti kuh|Dhaatonalopancha| Sheeghram|| Iityamara||”“Stree, prakka naama aushadhi| iti medina| Ghe.Pu”“Tri (langh + kuh| nalopancha) aguruh ityudbhatah|”Definition:The one that causes ematiation is termed as laghu.48Synonyms:Table 15: SynonymsSl.No Synonyms Ch Ud Am Med1 Gurutva rahita + -- -- --2 Aguru -- + -- +3 Manognyaha -- -- + --4 Nissaaraha -- -- -- +Types:Based on types of guru guna, similar classification can be done for laghu guna Gunataha laghuhu Pakataha laghuhuAnd gunataha laghuhu intern could be:
  41. 41. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200921A. Swabhavataha laghuB. Samskaarataha laghuMahabhuta Sanghatana:Though paanchabhautika in constitution, it shows predominance of akasha,vaayu, and Agni mahabhuta.Guna:Charaka mentions the following gunas: Guru viruddhguna SheeghrapaakiKarma:Sushrutha mentions the following Karma:1. Anusaadakara2. Anupalepakrit3. Kaphahara4. Lekhana5. Ropana6. AgnisandhuukshanaImportance:The dravya used for laghu guna is used for: Lekhana Rogapana Pacifying Kapha doshaExamples:Mudga, Laajha – gunataha laghuMaatravat laghu – Any dravya taken in smaller quantity.SANTARPANAIntroduction:Chikitsa is basically of 2 types- santarpana and ApatarpanaDerivation:“Klee, santarpayateendriyaani iti| sam+ trup+ nich+ lyuh|”
  42. 42. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200922Definition:That which causes stoutening of the body is called Brumhana (synonymous tosantarpana).49Synonyms:Table 16: SynonymsSl.No Synonyms Ch SU Vag1 Triptikara -- + --2 Preenanam -- + --3 Brumhana + + +Types:It is mainly of two types: Sadya santarpana Abhyaasa santarpana (santarpanaabhyaasa)Mahabhuta Sanghatana:Mainly pradhaana in jala mahabhuta and prithivi mahabhuta.Guna:Table 17: GunaSl.No Properties Ch Dh.Ni1 Snigdha + --2 Madhura + --3 Guru + --4 Picchila + --5 Sheeta + +6 Mrudu + --7 Bahala + --8 Sthula + --9 Manda + --10 Sthira + --11 Shlakshna + --Karma:Table 18: KarmaSl.No Karma Dh.Ni SU Ch Vag1 Balya + -- -- --
  43. 43. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009232 Rasayana + -- -- --3 Hrdya + -- -- --4 Veeryavriddhikara + -- -- --5 Netrarogahara + -- -- --6 Brumhana -- + + +7 Triptikara -- + -- --8 Preenana -- + -- --Importance: Mainly applied where there are apatarpanothavyaadhi. It is cause for Santarpanoth Vyaadhi when taken in excess, like,Pramehapeedaka, paandu, Sthoulya etc.APATARPANA:Introduction:One among the major treatment modalities is Santarpana and Apatarpana.Derivation:“Klee, (aya+ trup+ bhaave lyut| langhanam)”Definition:The absence of food intake seen in the case of diseased condition.50Lack of nourishment, is known as apatarpana. Loss of desire for food, lack of tripti orits absence is called as apatarpana.51Note:Atarpana: Though used synonymous to apatarpana it is defined as:‘Pushti -kshayakara’ and ‘Medo- haanikara’ i.e non-nourishing and the onecausing depletion of Medo Dhatu respectively.Synonyms:Table 19: SynonymsSl.No Synonyms S.K.D Hemachandra Gangadhara1 Tripti shoonya + -- --2 Gatalobhaha + -- --3 Langhana -- + --4 Atarpana -- -- +
  44. 44. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200924Types:Apatarpana is of three types: 52 Langhana Langhana paachana DoshaavasechanaMahabhuta Sanghatana:Apatarpana dravya mainly constitutes of Agni, Vaayu and Aakash.53Guna:Being Synonymous to langhana, the properties of langhana are considered here.Charaka mentions the following gunas:1. Laghu2. Ushna3. Teekshna4. Vishada5. Rooksha6. Sookshma7. Khara8. Sara9. KathinaKarma:Sushrutha mentions the following Karma:1. Paachana of anavasthitadosha2. Deepana3. Jvaranaashana4. Aahaarecchakaram5. Ruchikaram6. LaghavakaramImportance: Mainly applied where there are santarpanothvyaadhi. It is a cause for apatarpanotha vyaadhi when taken in excess, likeMoodhavaata, Arsha, and Pleeha etc.
  45. 45. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200925Thus the treatment is - To reduce the obese, heavy and de-saturating diet should begiven. On the contrary, the lean should be managed with light and saturating diet.Here the treatment is told based on two presentations of medo drishti1. Medo vridhhi seen in the form of Sthoulya where in karshana is to be attainedby means of guru and atarpana.2. Medo shreya seen as karshana where in bramhana is to be done by means oflaghu santarpana.On this Chakrapaani comments:1. Guru Cha ataparnam cha yatha madhu- a dravya having both guru andatarpana guna like madhu is to be given.2. Gurutvaat vridhham agnim yaapayati – due to gurutva, it pacifies increasedagni.3. Apatarpanaat cha medohanti – Due to apatarpana guna it brings aboutreduction in Meda.4. So, the prashaatikaadi dravyaha could be made guru by samskaara and given,they are atarpana by nature.5. For krisha, laghu tarpana is to begiven.6. By laaghava, there is agni vriddhi and by tarpana there is pushti.7. The Laaghava or gaurava in these cases need not be by nature, it could bebroght about by samskaara.Gangaadhara too holds similar views.Yogeendranaatha elaborates it with further examples. He adds that “ In the lean thedigestive power is also mild and in this condition if heavy food is given it may causefurther mildness of fire.
  46. 46. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200926IntroductionMedas is one among the sapta dhatus and it is meant to support and nourishthe body. It is responsible for lubrication function in the body. Sthoulya being adushya pradhana vyadhi, Meda, plays a major role in its pathogenesis and hencereceives equal importance as that of dosha.Derivation“Medyati snihyati| Mit+ sarvadhaatubhyo asun||”Meda stands for Sneha, fat, oil etc.It is originated from the root word ‘mid’ with an addition of ‘asoon’ and ‘ach’pratyaya for Medas and medo respectively.DefinitionIt is the fourth dhatu among the sapta dhatus. It is Sneha predominant, dravadhatu having mainly guru-snigdha guna and prithvi- jala- teja mahabhutasdominance.54SynonymsTable 20: SynonymsSl.No Synonym Am Previou work1 Vapa + --2 Vasa + --3 Mamsaja -- +4 Mamsatej -- +5 Asthikrut -- +UtpattiThe Medo dhatu is originated from its preceding dhatu Mamsa. (Accepted byCharaka, Sushrutha. Also mentioned in Shabda Kalpa Druma).
  47. 47. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200927Flow Chart 1: Mode of Formation of Medo DhatuAHARAJATHARAGNISARA KITTARASADHAATVAAGNISTHAYI DHATU POSHAKA DHATURAKTAADHAATVAAGNIUPADHATU RASA DHATUSARA KITTASTHAYI DHATU POSHAKA DHATUMAMSADHAATVAAGNIUPADHATU RAKTA DHATUSARA KITTASTHAYI DHATU POSHAKA DHATUMEDODHAATVAAGNIUPADHATU MAMSA DHATUSARA KITTASTHAYI DHATU POSHAKA DHATUASTHIDHAATVAAGNIUPADHATU MEDO DHATUSARA KITTA. . . . . And So on till Shukra Dhatu.
  48. 48. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200928Pramana of Medo DhatuTable 21: Pramana of Medo DhatuTotal fat content may be therefore considered as 5 Anjali in total.Vasa:The snehamsha of Shuddha Maamsa is called Vasa. It is the upadhatu, whichis formed after the dhaatvagni paka of the Mamsa dhatu.55Medo Dhatu GunaTable 22: Medo Dhatu GunaSl.No Guna S.K.D SU1 Guru + +2 Snigdha + --3 Madhura -- +Medo Dhatu KarmaTable 23: Medo Dhatu KarmaSl.No Karma SU S.K.D A.S1 Snehana + + --2 Balakrut -- + --3 Vataghna + + --4 Pittakrut -- + --5 Kaphakrut -- + --6 Brahmana -- + --7 Sweda + -- --8 Drudhatva + -- --9 Asthipushti + -- --10 Netra snigdhata -- -- +11 Gatra snigdhata -- -- +Sl.No Pramana Ch SU1 2 Anjali + --2 Variable(from person to person) -- +3 3 anjali of vasa + --
  49. 49. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200929Sthaana of Medas:Table 24: Sthaana of Medas:Sl.No Sthaana B.P M.N1 Udara + +2 Asthi -- +Ashrayaashrayee Bhava:Meda is the ashraya for Kapha dosha (ashrayee) and hence MEDA plays amajor role in nutrition or vitiation of kapha and vice versa.(As.Hr.Su.11/27). The Medovriddhi, kshaya, pradoshaja vikara and the chikitsa are same as that for medovahaSrotas. (Ch.Vi.5/27)
  50. 50. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200930IntroductionIt is a disease, which is associated with Sthoola, who is one among theAshtanindita Purusha.Derivation“Sthoolayati Sthoola brumhanenach, Sthoola peene jade iti hemachandrah|”The word Sthoulya is derived from moola dhatu “sthu” with “ach” pratyaya.According to amarakosha it stands for excessive growth of the body.56Definition:The disease entity characterized by stoutness is called Sthoulya.57Over-nourished can be considered as sthoola.58Charaka defines sthoola as “a person in whom excessive and abnormal increase ofmedodhatu is found, it results in pendulous appearance of buttocks, belly and breasts; andwhose increased bulk is not matched by corresponding increase in energy. Hence there isreduced zeal towards life. ” 59A person having heaviness and bulkiness in body due to extensive growthespecially in udaraadi region is termed as “sthoola” and the state (bhaava) of beingsthoola is called as Sthoulya.60Synonyms:Table 25: SynonymsSl.No Synonym Ch SU As.S As.H M.N Sh.S Ka.S B.P Y.R1 Sthoulya + + + + -- -- + + +2 AtiSthoulya + + + + -- -- -- + +3 Sthoolata -- + + + -- -- -- -- --4 Sthoolatva -- -- + + -- -- -- -- --5 Sthavima -- -- + + -- -- -- -- --6 Medoroga -- + + + + + -- + +7 Medodosha + -- -- + -- + -- + +8 Medovriddhi -- -- -- -- -- -- -- + +9 Medovikara -- -- -- -- -- -- -- + --10 Medogada -- -- -- -- -- + -- + --11 Medapushti -- -- -- -- -- -- -- -- +12 Medadushti -- -- -- -- -- -- -- -- +13 Atipushti -- + -- -- -- -- + --14 Pushti + + + -- -- + + + +15 Upachaya + + + + -- + + + +16 Jaatharya -- + -- -- -- -- -- -- --
  51. 51. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-20093117 Brimhatva + -- + -- -- -- + -- --18 Shoolodora -- -- -- -- -- -- -- + --19 Tundika -- -- -- -- -- -- -- -- +HISTORICAL REVIEWVEDIC KALA (10,000 TO 500 B.C.):Veda are known as dawn of the sciences and considered as the oldest authenticmanuscripts ever found. Veda narrates medical science very lucidly. Though adetailed description regarding Sthoulya (Obesity) is not available, some scatteredreferences can be found:ATHARVAVEDA:1. Medas - 1/11/42. Medini - 4/27/53. Pivasi - 8/7/74. Detailsof anthropology and anthropometry is found in 10/2.5. Medini and Pivasi are used as synonyms of herbs in Atharvaveda, and thatprobably stands for largeness of quantum or having substance like Meda.6. 1/2/2 - Advise to strengthen and hardened the body like a stone, in other wordsindicates hazards of flabbiness of the body and obesity.RIGVEDA:1. 25th chap - Meda and Vapa are mentioned.2. 8/12/18, there is referance as to appreciate exercise and hard work, whichslashes laxity.YAJURVEDA:1. 25th chap - Meda and Vapa are mentioned.2. 12/97 - A disease named "Upachita" has also been described.AIYTAREYA BRAHMANA:1. 33 - exercise and hard work are appreciated and laxity is slashed, in thecontext of health.
  52. 52. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200932SAMHITA KALA : (200 B.C. - 400 A.D.):CHARAKA SAMHITA (2 B.C.):Sthoulya has been mentioned under “Ashtanindita Purusha” in Ch. Su. 21. Itscausative factors (exogenous and hereditary component), its pathology, sign andsymptoms, prognosis and management have been narrated in detail. Ch.Su.21/3-4 - Ashta Dosha of Sthoulya and its aetiopathogenesis. Ch.Su.21/18-19 - Madhyam pramana sharira i.e. well built and dualproportionate physique is considered as the best. Ch.Su.13/5 - Taila sevan yogya. Ch.Su.14/17 - Svedana ayogya Ch.Su.16/13-16 - Roga having Bahudoshaavashta Ch.Su.20/17 - As a Shleshma nanatmaja vikara Ch.Su.23/6 - As a Santarpananimittaja Vyadhi Ch.Su.22/24 - As a Brimhananimittaja Vyadhi Ch.Vi.8/117 - Detailed Anthropometry is described under the captionof Pramana Pariksha.SUSHRUTA SAMHITA: (2 A.D.):In Sushruta Samhita (Su.Su.15) he has narrated the aetiopathogenesis ofSthoulya Roga on the basis of an endogenous entity being caused due to "DhatvagniMandya".Further, the course and complication of the disease with some different line oftreatment are discussed at various places in Sushruta Samhita. SU.Su.35/40 - Sthoulya is considered as the physical condition of the body. SU.Su.24/13 - Result of vitiated Meda Dhatu. SU. Sha. 9/12 - As symptom of disrupt (Viddha) Medovaha Srotas. SU.Su.15/37 - Rasa Nimittaja vikara. SU.Chi.12/11 - Sushruta added a new synonym Jatharya. SU.Chi.24/40&79 - Further elaboration of line of treatment many remediesdescribed for the management of Sthoulya at different places.
  53. 53. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200933KASYAPA SAMHITA: (6 A.D.):Present available Kasyapa Samhita is incomplete and many chapters aremissing. On the basis of scattered reference about Sthoulya available in this text, itcan be presumed that there might be detailed description of this disease. Kashyapa has given some new aspects of management while narrating MedasviDhatri Chikitsa and suggested Raktamoksana (blood letting) as one of the besttreatment for Medasvi Dhatri i.e. obese frostier mother. Sthula and Ati Sthula word are frequently used at different places especially whiledescribing Anthropology, which stands for largeness, bigness, bulkiness etc, inSutra sthana. Ka.S.Su 28/6 - Sthula is classified under eight censurable physique whiledescribing the anthropology. Ka.S.Su.22/55 - Sthoulya is one of the disorders where Snehana Karma iscontraindicated, as it increases the severity of the disease. Despite that, in someconditions it can be used in combination with Triphala, Lavana, and Vyosa.BHELA SAMHITA (7TH A.D.): Bh.S.Su.2 – Bhela has described Sthoulya as a disorder of vitiated Meda inchapter on Samasana Paridhaniya.HARITA SAMHITA (10-12TH A.D.): Description regarding Sthoulya is not found in Harita Samhita.SAMGRAHA KALA:ASTANGA SAMGRAHA (6 A.D.) AND HRIDAYA (7 A.D.):Vruddha Vagbhata and Vagbhata have elaborated aetiopathogenesis of Sthoulyaon the basis of formation of Ama and disturbance of the process of DhatuParinamana. A.H.Su.14 and A.S.Su.24 - they have mentioned various therapeutic andprophylactic measures to cure and prevent this disease and considered Rasanjanaas a drug of choice for Sthoulya.
  54. 54. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200934 A.H.Su.14/31 – After observing relapse and challenging nature of the disease theyconcluded that there is no treatment of excessive obesity. A.H.Ni.6/11-12- Comparatively less side effects of excessive alcohol intake inMedadhika Purusha is noted. A.H.Ni.7/2- Vitiation of Meda in pathogenesis of Arsha. A.H.U.31/5 - In pathogenesis of Mukhadusika vitiation of Meda is 1st timeobserved by Vagbhata A.H.Su.14 /31- Karshya is better than Sthoulya. A.S.Su.19/26 - Sthoulya is counted as a disorder of Shleshma Dosha seated inmedo dhatu A.S.Su.19/28- Jathara Unnati i.e. abdominal adiposity is stated as the result ofplacement of shlesma in Koshtha A.S.Su.24/23 - Flabbiness of Dhatu caused by Ama is main pathogenesis ofSthoulya as highlighted. A.S.Su.24/26,27 - Patho physiology of Atisveda symptom and Medo vriddhi A.S.Su.24/13 - Use of Langhana therapy is indicated. A.S.Su.24/14-16 - Types of Sthoulya and their management has been first timementioned by Vagbhata.OTHER LITERATURE DURING MEDIEVAL PERIOD:MADHAVA NIDANA (7 A.D.): M.N. 4/4 - The patho physiology of this disease on the basis of fat tissue and fatdepot site and mentions natural tendency towards android obesity. M.Ni 34/3 - Madhavakara has elaborated the symptomatology of Sthoulya andnew symptoms of the disease like Moha have been included.SHARANGADHARA SAMHITA (13TH CENTURY): Sh.S.Pu.7/65 - Sthoulya is described by the name of Medo Dosa, which is of onlyone type. Sh.S.Pu. 5/15 - In this text Sweda has been mentioned as Upadhatu of Meda. Sh.S.Pu. 5/12 - Mala of Rasana, Danta, Kaksha, Medhruadi as Mala of Meda.
  55. 55. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200935 Sh.S.Pu. 5/35 - Vrukka nourishes Jatharashta Meda. Sh.S.Pu 6/10 - Sequential Dhatupaka Kala of one month for seven Dhatu ismentioned in. Sh.S.U. 5/35-38 - As Seventh Basti in Sequence is mention as MedaVardhana. Sh.S.Pu. 6/21Sthoulya is narrated as a characteristic of shlesma prakriti.BHAVA PRAKASHA (16TH CENTURY): 39th Chap of Madhya Khanda - Bhavamishra has given more emphasis on riskfactors, morbidity and other additional regimes and behavioral therapies. Furthermore, he has described various maladies to combat distressing symptoms likeSwedabadha, Gatradaurgandhya, and abdominal adiposity.OTHER LITERATURES:The disease was well established during Gupta and post Gupta Kala and thusmentioned at many places in Sanskrit literature like Bhagwat Mahapuran (5/10/10), Agnipurana (281/16/19) Kadambari (4/2/9) Harshcharit (88) Caturbanai(Srngarhata-208) Kalyan karaka (K/6/1/101) Sakuntala (215) - Fat alleviating property and girth reducing action of Mrgayahave been described by Kalidas. Dasakumar Charita (265) - Fat alleviating property and girth reducing action ofMrgaya have been described by Dandi in Dashakumar Charita. Some remedies like Sivagutika advocated by lord Siva and Methimodaka byKamadeva are attributed to have Medahara and Sthaylyahara properties. Sthoulya is also highlighted by various commentators like Chakrapani, Dalhana,Indu, Arundatta, Vijayarakshita etc.
  56. 56. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200936TYPES OF STHOULYAFlow Chart 2: Classification of SthoulyaCLASSIFICATIONACC. TO CHARAKA ACC. TO A.SANGRAHA ACC. TO A.HRUDAYAALPA MADHYAMA ATISTHOULYA STHOULYA STHOULYAADHIKA MADHYA HINASTHOOLA STHOOLA STHOOLASTHOOLA ATI STHOOLA
  57. 57. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200937NIDANA PANCHAKA OF STHOULYANIDANA:The causative factors, known for a disease is called as Nidana.Many Acharyas have mentioned various Nidanas, which can be, classified under fiveheadings: Aharatmaka Viharatmaka Manasika Apacharaja AnyaTable 26: Aharatmaka NidanaSl.No Aharatmaka Nidana Ch SU A.H A.S M.N B.P Y.R1 Atibhojana (Overeating) + + + + -- -- --2 Guru Aharasevana (excessiveconsumption of heavy food)+ -- -- -- -- -- --3 Madhura Aharasevana (Sweetfood)+ -- + + -- + --4 Sheeta Aharasevana(Excessive consumption ofcold diet)+ -- -- -- -- -- --5 Snigdha Aharasevana(Excessive consumption ofunctuous food)+ -- + + -- + --6 Navanna Sevana (Usage offresh grains)+ -- -- -- -- -- --7 Nava Madhyasevena (Usageof fresh alcoholic preparation)+ -- -- -- -- -- --8 Gramya Rasa sevana (Usageof domestic animal’s meat &soups)+ -- -- -- -- -- --9 Paya Vikara Sevana(Excessive usages of milk andits preparations)+ -- + + -- -- --10 Dadhi Sevana (Excessive useof curd)+ -- -- -- -- -- --11 Sarpi Sevana (Excessive useof ghee)+ -- + -- -- -- --12 Sleshmala Aharasevana(Kapha increasing food)+ + -- -- + + +13 Ikshu Sevana (sugarcane) + -- + -- -- -- --
  58. 58. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-20093814 Guda Vikara Sevana (Usageof Jaggery’s preparation)+ -- -- -- -- -- --15 Mamsa Sevana (Excessiveuse of meat)+ -- -- -- -- -- --16 Shali sevana (Excessive useof rice)+ -- -- -- -- -- --17 Masha Sevana (Excessive useof Phasiolus munga)+ -- -- -- -- -- --18 Godhuma Sevana (Excessivewheat)+ -- -- -- -- -- --19 Audak Rasa Sevana (Usagesof aquatic animal’s meat &soups)+ -- -- -- -- -- --20 Santarpana + -- + + -- -- --21 Adhyashana -- + -- -- -- -- --22 Rasayan Sevana + -- -- -- -- -- --23 Vrushya Sevana + -- -- -- -- -- --Table 27: Viharatmaka NidanaSL.NO Viharatmaka Nidana Ch SU A.H A.S M.N B.P Y.R1 Avyayama (Lack of physicalexercise)+ + -- + + + +2 Avyavaya (Lack of sexual life) + -- -- + -- -- --3 Divaswap (Days sleep) + + -- + + + +4 Asana Sukha (Luxurioussitting)+ -- + + -- -- --5 Swapnaprasangat (Excessivesleep)+ -- + + -- -- --6 Gandhamalyanu Sevana(Using of perfumes garlands)+ -- -- -- -- -- --7 Bhojanotar snana(Bathing after taking the meals)+ -- -- -- -- -- --8 Bhojanottar Nidra (Sleeping aftermeal)-- -- -- -- -- + --9 Bhojanottar Aushadha sevana(Drugs after meal)-- -- -- + -- -- --10 Chesta Dwesha (Aversion tophysical activity)+ + + + + + +11 Shrama (Tiresome work) + -- -- -- -- -- --12 Nitya tailabhyanga (Habitual oilmassage)+ -- + + -- -- --13 Bhojanottar jalapana (drinkingwater)-- + -- -- -- + --
  59. 59. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200939Table 28: Manasika NidanaSL.NO Manasika Nidana Ch SU A.H A.S M.N B.P Y.R1 Harshnityatvat(Uninterupted cheerfulness)+ -- + + -- -- --2 Manasonivritti(Relaxation from tension)+ -- + + -- -- --3 Achintanat (Lack of anxiety) + -- + + -- -- --4 Priyadarshana(Observations of belovedthings)+ -- -- -- -- -- --5 Saukhyena (Mentally atpeace)+ -- -- + -- -- --Table 29: Apacharaja NidanaSL.No Apacharaja Nidana Ch SU A.H A.S M.N B.P Y.R1 Snigdha Madhura BastiSevana (Administration ofunctuous & Sweet enema)+ -- + + -- -- --2 Snigdha Udvartana(Unctuous unction)+ -- -- -- -- -- --Table 30: Anya NidanaSL.NO Anya Nidana Ch SU A.H A.S M.N B.P Y.R1 Amarasa -- + -- -- -- + --2 Bijadoshaswabhavat(Genetic)+ -- -- -- -- -- --
  60. 60. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200940POORVA-ROOPAPoorva-roopa of Sthoulya has not been described by any Ayurvedic text.Therefore, the Avyakta or Alpa Vyakta lakshanas of Sthoulya itself can be consideredas the Poorvaroopa.
  61. 61. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200941ROOPAThe Sthoola is one among Ashtha-Nindita and is characterized by Ashtha-Doshas.These can be considered as main Roopa of Sthoulya: 611. Aayushohraasa: Diminished life span.2. Javoparodha: Lack of enthusiasm.3. Kricchra vyavaaya: Difficulty in sexual act.4. Daurbalya: Debility.5. Daurgandhya: Foul smelling body.6. Swedaabaadha: Distressful sweating.7. Kshudhatimaatra: Excessive hunger.8. Pipaasaatiyoga: Excessive thirst.Other features related to Sthoulya can be tabulated as below:Table 31: Roopa of SthoulyaSl.No ROOPA Ch SU A.H A.S M.N B.P Y.R1 Chala Sphik (PendulousButtock)+ -- + + + + --2 Chala Udara (PendulousAbdomen)+ -- + + + + --3 Chala Stana (PendulousBreast)+ -- + + + + --4 Ayatha Upachaya (Abnormalgrowth of the body)+ - -- + + + --5 Udara parshva Vriddhi(Enlargement of Abdomen)-- + + -- + + --6 Anutsaha (Lack ofEnthusiasm)+ -- -- + + + --7 Alasya (Jadyam) (Dullness) -- -- -- + -- -- --8 Moha -- -- -- -- + + --9 Alpa Vega -- -- -- + -- -- --10 Shrama -- -- -- + -- -- --11 Sarvakriyasu Asamrthata(Unable to bear the anyphysical exercise.)-- + -- -- + + --12 Alpa Bala -- -- -- + -- -- --13 Alpa Prana (Low vitalitypower)-- + -- + + + --14 Alpa Vyavaya (Lack of -- + -- -- + + +
  62. 62. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200942sexual life)15 Nidradhikya (ExcessiveSleep)-- + -- + + + +16 Kshudra Swasa (Dyspnoea onexertion)-- + + + + + +17 Krathana -- + -- -- + + +18 Gadgadvani (Indistinctness ofSpeech)-- + -- + -- -- --19 Gatrasada (Prostration of theBody)-- + -- -- + + +20 Saukumarata (Delicacy) + + -- -- -- -- --21 Anga saithilya + + -- -- + + --22 Snigdhangata -- + -- + -- -- --
  63. 63. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200943UPASHAYAThe Ahara-Vihara-Aushadha, which helps to relieve disease symptoms, iscalled as Upashaya and that which causes aggravation of the symptoms is calledAnupashaya.In the context of Sthoulya no direct reference as such is available aboutUpashaya & Anupashaya. Hence, all the Apathyas and Nidanas can be considered asAnupashaya and all those, which relieve symptoms of Sthoulya, can be considered asUpashaya.
  64. 64. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200944SAMPRAPTISamprapti means the knowledge of the way in which a disease occurs(Ch.Ni.1/11) and it deals with the process of manifestation of disease by the vitiatedDoshas. (Ma.Ni.1/10) Charaka mentions the Samprapti as: 62Due to obstruction of Srotas by Meda, the vaata moves towards the Koshtha,whips up the Agni and digests the food quickly. The corpulent man therefore, digeststhe food speedily and craves for food inordinately. Over-eating produces over growthof Medo-Dhatu leading to Sthoulya.According to Sushruta, Aama is produced due to Kapha-Vardhaka aahaara,Adhyashana, Avyaayaama, and Diwaswapna etc. The Madhura bhaava Aama rasamoves within the body, snigdhaamsha of this anna-rasa cause Medo-Vriddhi whichproduces excessive stoutness.63
  65. 65. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200945Flow Chart 3: Samprapti Schematic RepresentationNIDANAKAPHAVRIDDHI KHAVAIGUNYA MEDO DHAATVAAGNIMAANDYAMEDOVAHA SROTO DUSTIMEDO VRIDDHI STHOULYAOBSTRUCTION TO SROTASINCREASED VAATA IN KOSHTHAINCREASED JAATHARAAGNIINCREASED FOOD INTAKE
  66. 66. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200946SAMPRAPTI GHATAKAThe following factors play an important role in Samprapti of Sthoulya. Dosha: Kapha, Vaata. Dushya: Rasa Dhatu, Medo Dhatu. Srotas: Medovaha. Sroto-Dushti: Sanga. Adhisthana: Sarva-shareera. Udbhava Sthana: Amashaya. Sanchara- Sthana (Prasara): Rasayani. Rogamarga: Bahya. Aama: Saama. Vyakta-sthana: Sarvaanga, specially sphik, udara, Sthana.
  67. 67. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200947UPADRAVAAcharya Charaka has not described the Upadrava separately but he hasreported that if Sthoulya is left untreated, many diseases may be arisen out. Upadravamentioned by other Acharyas are as follows: 64Table 32: Upadrava of SthoulyaSl.No Updrava Ch. SU A.H. M.N. B.P. Y.R.1 Prameha - + + + + -2 Pramehapidika + + - - - +3 Jvara + + + + + +4 Bhagandara + + + + + +5 Vidradhi + - - - - +6 Vatavikara + - - - - +7 Udara roga - + + - - -8 Urustambha - + - - - -9 Shwasa - + - - - -10 Apachi - - + + + -11 Kasa - - + + + -12 Sanyasa - - + - - -13 Kushtha - - + + + -14 Visarpa - - - + + -15 Atisara - - - + + -16 Arsha - - - + + -17 Shlipada - - - + + -18 Kamala - - - + + -19 Mutrakricchra - - + - - -20 Ajirna - - + - - -
  68. 68. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200948SAADHYAASAADHYATAAs per the criteria about the knowledge of Saadhyaasaadhyata, Sthoulya is aKrucchasaadhya Vyadhi. Acharya Charaka has mentioned the bad prognosis ofSthoulya as follows: 65If an obese person is not duly managed, he is prone to death due to excessivehunger, thirst and complications. Again Charaka has mentioned in Chi.6/57, badprognosis for Sahaja (hereditary) disease. Hence Sahaja Sthoulya can be considered asAsadhya.According to Vagbhata Medogata diseases are curable only in uncomplicatedpatients with more bala and less chronicity.66So, Vagbhat has mentioned Sthoulya asAsaadhya Vyadhi due to its relapsing and challenging natureTable 33: Showing Saadhyaasaadhyata of SthoulyaSl.No Saadhyaasaadhyata Ch A.H1 Saadhya (if Anupadrava, balavaan, alpakaala) -- +2 Krucchasaadhya + --3 Asaadhya (If Sahaja) + +
  69. 69. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200949ARISHTA LAKSHANASudden drastic weight reduction is considered as Arishta lakshana.67Yogaratnakara has mentioned that sudden weight loss or gain could be fatal within sixmonths.
  70. 70. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200950MODERN PARLANCE: OBESITYDefinition:Obesity is a state of excess adipose tissue mass. Although often viewed asequivalent to increased body weight, this need not be the case in lean but verymuscular individuals may be overweight by arbitrary standards without havingincreased adiposity. Obesity is therefore more effectively defined by assessing itslinkage to morbidity or mortality.Physiologic Regulation of Energy Balance:Substantial evidence suggests that body weight is regulated by both endocrineand neural components that ultimately influence the effector arms of energy intakeand expenditure. This complex regulatory system is necessary because even smallimbalances between energy intake and expenditure will ultimately have large effectson body weight.Alterations in stable weight by forced overfeeding or food deprivation inducephysiologic changes that resist these perturbations: with weight loss, appetiteincreases and energy expenditure falls; with overfeeding, appetite falls and energyexpenditure increases. This latter compensatory mechanism frequently fails, however,permitting obesity to develop when food is abundant and physical activity islimited. A major regulator of these adaptative responses is the adipocyte-derivedhormone leptin, which acts through brain circuits (predominantly in thehypothalamus) to influence appetite,energy expenditure, and neuroendocrine functionAppetite is influenced by many factors that are integrated by the brain, mostimportantly within the hypothalamus. Signals that impinge on the hypothalamiccenter include neural afferents, hormones, and metabolites. Vagal inputs are particularly important, bringing information from viscera,such as gut distention. Hormonal signals include leptin, insulin, cortisol, and gut peptides such ascholecystokinin, which signals to the brain through the vagus nerve. Metabolites, including glucose, can influence appetite, as seen by the effect ofhypoglycemia to induce hunger; however, glucose is not normally a majorregulator of appetite.
  71. 71. Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200951These diverse hormonal, metabolic, and neural signals act by influencing theexpression and release of various hypothalamic peptides [e.g., neuropeptide Y(NPY), Agouti-related peptide (AgRP), melanocyte-stimulating hormone (MSH), andmelanin concentrating hormone (MCH)] that are integrated with serotonergic,catecholaminergic, and opioid signaling pathways. Psychological and cultural factorsalso appear to play a role in the final expression of appetite. Apart from raresyndromes involving leptin, its receptor, and the melanocortin system, the defects inthis complex appetite control network that account for common causes of obesity arenot well understood.Energy expenditure includes the following components: Resting or basal metabolic rate. The energy cost of metabolizing and storing food. The thermic effect of exercise. Adaptive thermogenesis, which varies in response to chronic caloric intake(rising with increased intake).Basal metabolic rate accounts for about 70% of daily energy expenditure,whereas active physical activity contributes 5 to 10%. Thus, a significant componentof daily energy consumption is fixed.Adaptive thermogenesis occurs in brown adipose tissue (BAT), which plays animportant role in energy metabolism in many mammals. In contrast to white adiposetissue, which is used to store energy in the form of lipids, BAT expends stored energyas heat. A mitochondrial uncoupling protein (UCP-1) in BAT dissipates the hydrogenion gradient in the oxidative respiration chain and releases energy as heat. Themetabolic activity of BAT is increased by a central action of leptin, acting through thesympathetic nervous system, which heavily innervates this tissue. In rodents, BATdeficiency causes obesity and diabetes; stimulation of BAT with a specificadrenergic agonist ( 3 agonist) protects against diabetes and obesity. Although BATexists in humans (especially neonates), its physiologic role is not yet established.Homologues of UCP-1 may mediate uncoupled mitochondrial respiration in othertissues.

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