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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, ...

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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  • “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
  • 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
  • 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.
  • 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
  • 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
  • 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
  • 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 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.
  • 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.
  • 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.
  • 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
  • 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
  • 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.
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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.
  • 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.
  • 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
  • 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 -- + -- --
  • 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 -- + --
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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:
  • 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 - + -
  • 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
  • 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 + -- -- --
  • 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.
  • 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:
  • 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|”
  • 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 + -- -- --
  • 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 -- -- +
  • 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.
  • 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.
  • 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).
  • 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.
  • 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 + --
  • 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)
  • 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 -- + -- -- -- -- -- -- --
  • 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.
  • 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.
  • 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.
  • 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.
  • 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.
  • 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
  • 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) + -- + -- -- -- --
  • 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)-- + -- -- -- + --
  • 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)+ -- -- -- -- -- --
  • 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.
  • 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 -- + -- -- + + +
  • 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 -- + -- + -- -- --
  • 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.
  • 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
  • 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
  • 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.
  • 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 - - + - - -
  • 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) + +
  • 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.
  • 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.
  • 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.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200952Etiology of Obesity:Though the molecular pathways regulating energy balance are beginning to beilluminated, the causes of obesity remain elusive. In part, this reflects the fact thatobesity is a heterogeneous group of disorders. Role of Genes vs. Environment: Obesity is commonly seen in families.Inheritance is usually not Mendelian, however, and it is difficult to distinguish therole of genes and environmental factors. Here genetic effects appear to relate toboth energy intake and expenditure. Whatever the role of genes, it is clear that theenvironment plays a key role in obesity, as evidenced by the fact that famineprevents obesity in even the most obesity-prone individual. Cultural factors arealso important these relate to both availability and composition of the diet and tochanges in the level of physical activity. Specific Genetic Syndromes: Obesity in rodents has been known for many yearsto be caused by a number of distinct mutations distributed through the genome.Most of these single-gene mutations cause both hyperphagia and diminishedenergy expenditure, suggesting a link between these two parameters of energyhomeostasis. Identification of the ob gene mutation in genetically obese (ob/ob)mice represents a major breakthrough in the field. The ob/ob mouse developssevere obesity, insulin resistance, and hyperphagia, as well as efficientmetabolism (e.g., it gets fat even when given the same number of calories as leanlittermates). The product of the ob gene is the peptide leptin, a name derivedfrom the Greek root leptos, meaning thin. Leptin is secreted by adipose cells andacts through the hypothalamus. Its level of production provides an index ofadipose energy stores. High leptin levels decrease food intake and increase energyexpenditure. Another mouse mutant, db/db, which is resistant to leptin, has amutation in the leptin receptor and develops a similar syndrome. The ob gene ispresent in humans and expressed in fat. Central hypothyroidism and growthretardation are seen in the mouse model, but their occurrence in leptin-deficienthumans is less clear. To date, there is no evidence to suggest that mutations orpolymorphisms in the leptin or leptin receptor genes play a prominent role incommon forms of obesity. Mutations in several other genes cause severe obesity
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200953in humans; each of these syndromes is rare. A number of complex humansyndromes with defined inheritance are associated with obesity.Pathogenesis of Common Obesity:Obesity can result from increased energy intake, decreased energyexpenditure, or a combination of the two. Thus, identifying the etiology of obesityshould involve measurements of both parameters. However, it is nearly impossible toperform direct and accurate measurements of energy intake in free-living individuals.The level of energy expenditure differs in established obesity, during periods ofweight gain or loss, and in the pre- or post obese state. There is increased interest inthe concept of a body weight "set point." This idea is supported by physiologicmechanisms centered on a sensing system in adipose tissue that reflects fat stores, anda receptor, or "adipostat," that is in the hypothalamic centers. When fat stores aredepleted, the adipostat signal is low, and the hypothalamus responds by stimulatinghunger and decreasing energy expenditure to conserve energy. Conversely, when fatstores are abundant, the signal is increased, and the hypothalamus responds bydecreasing hunger and increasing energy expenditure. The recent discovery of the obgene, and its product leptin, provides a molecular basis for this physiologic concept.Complications of Obesity:Obesity is a type of disease, which invites many major and minor diseases.Significantly it shortens the life span. Consideration of health, the simplest statistics isthat, a middle-aged man who is 10 kg overweight can expect to die roughly 4 yearsearlier than a normal person. The most common metabolic syndrome is Diabetes,which also leads to Kidney failure. In the presence of overweight, there is anincreased tendency to develop a variety of disease, which are all classified infollowing mentioned systems.(1) Cardio vascular system:(a) Hypertension(b) Coronary Heart disease(c) Myocardial infarction(d) Left ventricular hypertrophy(e) Generalized Atherosclerosis
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200954(f) Peripheral vascular disease(g) Atheroma(h) Premature cardiovascular death.(2) Respiratory system:(a) Chronic bronchitis(b) Hypoxaemia(c) Alveolar hypoventilation(d) Obesity hypoventilation syndrome(e) Pulmonary hypertension(f) Pulmonary embolism(g) Obstructive sleep apnoea(3) Gastro Intestinal system:(a) Gall stone(b) Hiatus hernia(c) Cholecystitis(d) Pancreatitis(e) Dyspepsia(f) Diverticulosis of colon(g) Reflux oesophagitis(4) Endocrine and Metabolic system:(a) Diabetes mellitus(b) Hyperlipidaemia(c) Hypercholesterolaemia(d) Fatty liver(e) Gout(f) Polycystic ovarian syndrome(5) Musculo Skeletal :(a) Osteoarthritis(b) Backache(6) Skin:(a) Ulceration(b) Fungal infection
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200955(c) Erythema intertigo(d) Acanthosis Nigricans(7) Miscellaneous:(a) Varicose Veins(b) Delayed wound healing(c) Technical difficulty in surgery(d) Risk in general AnaesthesiaTreatment:Obesity is a chronic medical condition. Successful treatment, defined as thesustained attainment of normal body weight without producing unacceptabletreatment-induced morbidity, is rarely achieved in clinical practice. Many approachesproduce short-term weight loss, and this has clear benefits for associated morbiditiessuch as hypertension and diabetes. Despite the fact that sustained weight loss isuncommon, enormous resources are expended in pursuit of this goal. Behavior Modification: The principles of behavior modification provide theunderpinnings for many current programs of weight reduction. Typically, thepatient is requested to monitor and record the circumstances related to eating,and rewards are designed to modify maladaptive behaviors. Diet: Reduced caloric intake is the cornerstone of obesity treatment. Thefundamental goal is the sustained reduction of energy intake below that ofenergy expenditure. The difficulty in achieving this goal has led to a widearray of suggested diets that vary in recommended calorie content (from totalfasting to mild reductions), as well as specific food content and form (e.g.,liquid vs. solid). The rate of weight loss on a given caloric intake is related tothe rate of energy expenditure. Because obese individuals have a highermetabolic rate than lean individuals, and because men have a higher metabolicrate than women (due to their greater lean body mass), the rate of weight lossis greater among the more obese and among men (relative to women Exercise: Exercise is an important component of the overall approach totreating obesity. Increased energy expenditure is the most obvious mechanismfor an effect of exercise. Exercise appears to be a valuable means to sustain
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200956diet therapy. Even if exercise had no such salutary effect, it would be valuablein the obese individual for its effects on cardiovascular tone and bloodpressure. Drugs: Unfortunately, drug treatment of obesity is rarely efficacious. Despiteshort-term benefits, medication-induced weight loss is often associated withrebound weight gain after the cessation of drug use, side effects from themedications, and the potential for drug abuse. Given the need for effectivetherapies, many possible compounds have been evaluated.o Amphetamine and related compounds like Fenfluramine,Dextroamphetamine, Mazindol, Phentamine, Diethylpropion etc.Contraindication: These drugs must not be given to patients with a history ofpsychiatric illnessAdverse effects: Nausea, Confusion, Restlessness, Irritability, Agitation,Visual Hallucinations, Diarrhea, ErraticBehavior, Headache, Addiction,Psychosis, Tremors, Lethargy, Palpitationo Bulk anorexient: Methylcellulose: It is digestible when ingested, it swells and adds to the bulkin the diet. Though it is used as a appetite satiater in the treatment of obesity ithas proved no more effective, than the high residue low caloric diet. Phenyl Tert putylamine, in the form of a resin complex, was of anoretic agentused.o Miscellaneous: Thyroxin: The administration of thyroxin to Euthyroid patients is not onlyuseless but is potentially dangerous, especially if heart disease is present. Itshould be prescribed only if hypothyroidism co-exists with obesity. Biguanides – (Anti-diabetic drugs) Metformin, phenoformin because ofanorexic effect, reduction in carbohydrate absorption and hypoinsulinemiceffect. It may produce serious hypoglycemia hence not used. Surgery: In response to ineffective treatment using diet, exercise, andavailable drugs, surgical approaches have been tried. The potential benefits ofsurgery include major weight loss and improvement in hypertension, diabetes,
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200957sleep apnea, CHF, angina, Hyperlipidaemia, and venous disease. Manydifferent approaches have been used, often without adequate assessment ofefficacy and complications. Jejuno-ileal bypass surgery has largely beenabandoned because of complications, which have included electrolytedisturbances, nephrolithiasis, gallstones, gastric ulcers, arthritis, and hepaticdysfunction, with cirrhosis occurring in as many as 7% of patients. Twoprocedures in common use today are The vertical-banded gastroplasty The Roux-en-Y gastric bypass.Following the National Institutes of Health Consensus Conference onGastrointestinal Surgery for Severe Obesity in 1991, it was recommended thatsuitable patients be selected using the following criteria: The presence of 45 kg (100 lb) or 100% above ideal body weight, or oneor more severe medical conditions related to refractory obesity Repeated failures of other therapeutic approaches At eligible weight for 3 to 5 years Capability of tolerating surgery Absence of alcoholism, other addictions, or major psychopathology Prior clearance by a psychiatrist.It is recommended that an appropriately experienced surgeon work together withnutritionists and other support personnel; evaluation and follow-up programs shouldbe monitored closely.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200958CHIKITSAChikitsa is that procedure / entity which brings the bodily components to a state ofnormalcy. 68In general, Chikitsa for any rogas is told in three headings: 69 Nidaana parivarjana Samshodhana SamshamanaThe Chikitsa for Sthoulya can be explained as: General line of treatment Specific line of treatmentTHE GENERAL LINE OF TREATMENT:Nidana Parivarjana:It is the first line of treatment of any disease and it is most important line oftreatment for Sthoulya also. SU.U.1/25 indicates that the root of Samprapti process isNidana must be avoided for best management of the disease. In Sthoulya, the factorsi.e. Ahaaraatmaka Viharatmaka, Maanas and others which are mentioned as Nidanasof the disease should be avoided.Samshodhana:The therapy in which the aggravated doshas or the excretory product ofdigetion are eliminated after mobilising them from their respective sites, by Urdhva orAdhah marga from the body is known as Shodhana. It is also termed as Apakarshana.There are two main parts of Shodhana:1. Bahya Samshodhana2. Abhyantara Samshodhana Bahya Samshodhana:Many Acharyas have mentioned external purification therapy for management ofSthoulya. In all classical texts, Udavartana is mentioned as part of Dincharya andfor Sthoulya ‘Udavartan’ is recommended by Acharyas. The benefits ofUdavartan is also mentioned i.e. Kaphahara, Medasah Pravilayanm, Sthirikaranam
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200959Anganam, Tvaka Prashadakar (A.H. Su. 2/15). In Sthoulya Udavartan processremoves the foetid odour, heaviness of the body, stupour, pruritis, dirt in skinpores, excessive sweating.(Ch.Su.5/14)Ch.Su.21/21 specifies ‘Teekshna Rooksha Udvartana’ for Sthoulya. Abhyantara Samshodhana:Being a syndromic entity (bahudosha avashta) Samshodhan therapy is highlyrecommended for Sthoulya management by Charak. According to Vagbhat,patients with Ati Sthoulya, Adhika Dosha and Adhika Bala should be treated withSamshodhana therapy including Vamana, Vireachana, Ruksha Niruha,Raktamokshana and Shirovirechana.(A.H.Su.14/12). Charak has recommendedVamana and Virechana Karmas for all Santarapanajanit Vyadhies. (Ch.Chi.6/47)As Sthoulya too comes under the same category; Vamana, Virechana therapiescan be tried in Sthoulya.Though Purvakarma like Snehana, Svedna and PradhanaKarma including Vamana, Virechana, Anuvasan Basti has been contraindicated toAtisthula patients by most of the Ayurvedic texts, specifications could beunderstood as below:o Snehana Karma is always restricted for the patients of Sthoulya (Ch.Su. 13/53).However on exigency usage of Taila is recommended (Ch.Su. 13/44-46) Lekhanaand Medahara properties (SU.Su.45/112) and Sthulatvahara action (SU.Chi.31/16,A.S.Su.6/100) of Taila are described in Ayurveda and advised to use particularlyTaila of Sharsapa (SU.Su. 45/11-7) Tuvarak,Bhallataka (SU.Su.45/112) andYavatikta (SU.Su.45/125). Among them Sharsapa Taila can be used for internal aswell as external snehana.o Another important Purva Karma Svedana is also restricted for the patient ofSthoulya by most of the Ayurvedic texts except Sushruta Samhita (Chi.32/15),Kashyapa Samhita (Su.23/19-20) and Sharangdhar (U. 2/11-12). Although onexigency Mridu Sveda is advised for Sthoulya patients (B.P.Pu.34/11-12).Especially Nirangni Sveda Viz. Guru pravarana, Bahupana, Kushdha Nigraha,Atap sevan, Vyayama, Ahava, Krodha, Bhaya and Upanaha (Ch.Su.14/64,SU.Chi.32/15) are advocated. Vagbhatt has indicated the use of pindasveda onextreme requirement (A.S.Su. 26/8).
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200960o Most of the texts prohibit the use of Vamana and Virechana Karma due toinability of the patient to bear the potency of medicine and therapy causingPraanaparodha (Life threatening Condition (Ch.Si.2/8-9,11-12). Moreover, AtiBruhmana and Meda Mamsa Ativruddhi are mentioned as predisposing factors forVamana and Virechana Vyapada (Ka.Si.3). However Vamana is indicated fortreatment of Medo Roga (SU.Chi. 33/18). Further more, similar line of treatmentis advised for disorders of Shleshma and Meda (A.S. Su. 19/13, Y.R- DoshaSamana-3) and Vamana is considered as the best for alleviation of Kapha dosha(Ch.Su.25/40). Hence, Vamana can be used for the treatment of Sthoulya, but onlyin uncomplicated patients.o Though Virechana has been forbidden for patients of Sthoulya (Ch.Si.2/11-12,SU.Chi.33/29-3/5, Ka.Si.7), mild Verechana is indicated for Pittadhikyacondition. In Sushruta Samhita, while describing Virechana Karma, SthulaPramehi is considered as Durvirechya due to aggravation and dominance of Meda.Tikshna Sodhana (Virechana) is insisted (Su. Chi. 12/6). Line of treatment forAtinidra has been descried by Charak has been included for the management ofSthoulya by Bhava Mishra (BP.Ma. 39/11-26) and Virechana karma is indicatedfor treatment of Atinidra symptom and thereby for AtiSthoulya. AmongVirechaka dravyas mentioned in Ayurvedic Materia medica, Haritaki, Katuki,Aragvadha, Trivruta, Danti-Dravanti, Snuhi etc. are attributed to have additionalMedanasaka property. Hence Virechana Karma could be applied to the patients ofSthoulya with suitable drugs among these. Practically, also Vamana andVirechana karma seems to be fruitful in the management of Sthoulya.o Bruhmana Karma of Anuvasan Basti is well established and so its application isunanimously contraindicated for patients of Sthoulya (Ch.Si. 1/36, Su.Chi. 35/21).It is considered as one of the etiological factor of Sthoulya and always restrictedfor the patient of Sthoulya. But Ashtapana Basti particularly Lekhana Basti ishighly recommended for the management of Sthoulya by ancient Ayurvedicphysicians. (Su.Su. 15/38, Chi.35/22). Rooksha and Tikshna Basti is considered asmost suitable for chronic and complicated disorder like Sthoulya (Ch.Si.10/17).The role of ruksha, Ushna and Tikshna Basti in management of Sthoulya isindicated by Charaka (Ch.Su.21). Sushruta also recommends Basti therapy and
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200961emphasizes to consider patients Agni, Bala etc, while administering Lekhanadravya is combination of Vata and Teja Mahabhuta dominance (SU.Su.41/10). Afurther characteristic of Lekhan Basti is given by Sharangdhara (Sh.U.6/23).According to him, the Basti prepared with Triphala Kwath is termed as LekhanaBasti. Lekhana or Karshana Basti helps to remove obstruction of Meda, Kaphaand Kleda from Srotas by its veerya and helps to alleviate vitiated Vata andnormalize the function of Agni and Vayu.Basti prepared with Taila, Gomutra,Kanji, and Saindhava (Ch.Si.10/13-14), Erandamuladi Niruha (Ch.Si.3/41),Kaphanasaka Basti (Ch.Si.10/23-24), Lekhana Basti (AH.Ka.4/7-10, Sha.U.6/23),Madhutailik Basti (Sha.U.6/3-33, BP/29-30) etc. can be practised for managementof Sthoulya. By going through this reference, it can be said that Ashtapan Basti,especially Lekhan Basti is most essential part of treatment for Sthoulya. Sushrutahas also pointed out this importance of Basti in (Su. Chi.35/22).o Raktamokshna along with Urdhva and Adhah Samsodhana is mentioned as oneof the best therapy for Sthoulya patients especially for Medasvi Dhatri (Ka. DhatriChikitsa Adhikar). Bhavaprakasha has also indicated Raktamokshana as line oftreatment for Sthoulya (Ma. 39/12). Rakta Mokshana may be applied for patientsof Sthoulya, more specifically in the patient with Rakta Gat Medo Vruddhi.O Though, none of the Ayurvedic texts have specified the benefits ofShirovirechana in Medo Roga. Avapida Shirovirechana is mentioned as line oftreatment for Abhishyanna Meda Vyaapta Sharira especially Sirah i.e. excessiveaccumulation of Meda in body especially in upper body (SU.Chi.40/44).Moreover Karshana Nasya is indicated in the disorders of Kapha Dosha (Ka. Si.2) and Sthoulya is enumerated as one of the twenty-kapha nanatmaja disorder. SoShirovirechana Nasya can be applied to patients of Sthoulya. Besides that,Triphaladya taila has been indicated for Nasya Karma in patients of Sthoulya (BP.Ma.39/55-56, YR - Medoroga Chi.) Shirovirechana can be used in patients ofSthoulya to alleviate aggravation of kapha and its related symptoms like Moha,Glani, Jadya, Alasya, Krathana, Gadgadatva, Atinidra etc.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200962SAMSHAMANA THERAPY:Among Sad Upakrama (Six types of therapies), Langhana and Rukshana canbe administrated for Samshaman purpose in Sthoulya (Cha. Su. 22/4). ShamanaChikitsa can be implemented throughseven different ways: Deepan, Pachana,Kshudha Nigraha, Trisha Nigraha, Vyayamaa, Aatapasevan, Marutasevan.Langhana is administrated in Santarpanajanya Vyadhi, in Amashayothavikara,in Shleshmika Vikara, in Rasaja Vikara and it is best remedy advised in Saama Roga.According to general principle of management (SU.Chi.33/3) for themanagement of Sthoulya alleviation of Vata, Pitta and Kapha along with depletion ofMedodhatu increasing Medo dhatvagni is main aim of treatment in Sthoulya. Deepana and Panchana: The Deepana dravyas are dominated by Agni and VayuMahabhutas which are anti to the constitution of Meda and Kapha i.e. Jala andPrithvi Mahabhuta. Deepana therapy is efficacious in Sthoulya because apart fromdigesting Ama and Apakva Meda, it has the additional property to potentiateJatharagni, Bhutagni and Dhatvagni. Kshudha Nigraha: The food is the main source of Nutrition for Meda Dhatu.Fasting controls the over production of Meda dhatu. Fasting first of all halts thenutrition of Ama and thus activates the Agni and digests the Ama. As a result,Agni functions are restored and Dhatvagni gets stimulated which resists furthernourishment to Medadhatu. The digestive power absorption of the food, both arestimulated in Sthoola Purusha. So the person digests food quickly, but if he isdeprived of the food, at the time of his need, the Margavarodhajanya aggravatedVayu and Agni may lead to serious complications. Looking to this possibility it isadvisable to give small quantity of Laghu and Ruksha Aahara in place of completeor severe starvation, so that the Tikshnagni gets fuel in the form of food andultimately checks the over production of Meda. Trisha Nigraha: Excessive thirst is a symptom and also a cause of Sthoulya.Drinking of cold water in large quantities depresses the Jatharagni by adding tothe liquidity of Pitta. It also increases the metabolic by product, Kleda. So a SthulaPurusha should take lukewarm water in small quantities. Thus, he should controlhis thirst, which aids in the phenomenon of deepan and panchana. From the word
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200963control of thirst we can arrive to the conclusion that obese person should avoidsweet and soft drinks, nutritious fruit juice and cold water. Vyayamaa: Importance of Vyayama or physical exercise has been describedsince centuries in Sthoulya. Most of the Acharyas described Avyayama as thecause of obesity and in the management of Sthoulya all have given moreimportance to Vyayamaa. So, Vyayama works as Nidana Parivarjan as well as itmelts the excessive fat, deposited in the fat depots. In all classical texts,Vyayamaa is also mentioned as a Routine (Dincharya) by various Acharyas."Sharira Ayasajanka Karma" is Vyayama, benefits of Vyayama is also mentionedi.e. Laghava, Karmasamrthya, Agnidipti, Medakshya, Vibhakta Ghangatratva.Indication and contraindication and quality and quantity of Vyayama are alsomentioned. "Sharir Ardha Saktya" Vyayama in routine is beneficial for goodhealth. There is also mention that vyayama is the best remedy for obesity(A.Hr.Su.1/44, Cha.Su.7/31-35). Atapa Sevan: Atapa sevan enhances Ushma in the body. This raised body heatreduces Meda by Vibhajana and Vilayan. It potentiates Kleda Vilayana. Marut Sevan: The word Maruta is a synonym of Vata. By the Vata sevana, theRuksha Guna of Vata reduces Kleda and Kapha by Shoshana and Stimulates theJatharagni.Some Samsamana yoga like Guduchi - Bhadra Musta, Triphala, Takrarista,Makshika, Vidangadi Lauha, Bilvadi panchmula and Silajatu with Agnimanthsvarasa are adviced to practise for prolonged period (Cha.Su. 21/ 21-24). Apartfrom that, varied treatment of Sthoulya is depicted at different places in Charaka.Drugs and preparation like Karsana Yavagu of Gavedhuka (Su. 2/25), Lekhaniya Mahakashaya (Su. 4/3(3)), Venuyava (Su. 27/20), Bibhitaka (Su. 27/148) Dhana and Virudha Dhana (Su. 27/266) Madhudaka (Su. 27/323)These are advocated as Medanashaka and Lekhana. Akasa and VayavyaMahabhuta dominant dravyas are attributed to have laghavakara action
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200964(Su.26/11), So Akasa and Vayavya Mahabhuta dominant articles can be useful formanagement of Sthoulya. Katu and Kashaya Rasa are attributed to have Karsanaand Upachayahara action and TiktaRasa is attributed to have Lekhana and Meda Upashoshana Karma (Su.26/44);hence, Katu, Tikta and Kashay Rasa can be used for treatment of Sthoulya andDasavidha Langhana therapy is mentioned for the same (Su. 23/8, 25).Administration of Virukshana and Chhedaniya Dravya especially Silajatu,Guggulu, Gomutra, Triphala, Loha Raja, Rasanjana and Madhu in proper doseand duration is adviced.THE SPECIFIC LINE OF TREATMENT:Charaka Samhita has been given treatment as- Administration of Guru andAtarpana articles which possess additional Vata, Slesma and Meda Nashakaproperties is considered as an ideal for Samasaman therapy.Chakrapani has explained that Guru property is sufficient to alleviate vitiated agni andthereby Atikshudha. The Atarpana property provides non nourishment and thus leadsto depletion of Meda. For example Madhu possess Guru and Ruksh properties, henceit is ideal for management for Sthoulya. Gangadhara has interpreted it as Guruproperty is suitable to alleviate Tikshnagni and vitiated vata especially Kosthagatavata and thereby Ati Kshudha. The Atarpan property is that which can not provideTarpana (Trupti) and cause reduction of Meda due to under nourishment(Aposhakatvat).
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200965PATHYA – APATHYAPracticing appropriate Pathya-Apathya along with the treatment of disease isone of the unique characteristics of Ayurvedic science. Classical texts emphasize thatsuccess or failure of the treatment depends to a large extent on the practice of Pathyaand Apathya. The food articles, drugs and regimens that do not affect the body andmind adversely are regarded as Pathya and in the same way, which adversely affectsthe body, are considered to be Apathya.Acharya Lolimba Raj has highlighted the importance of Pathya Apathya byregistering that "What is the need of the medicine, if the person is following thePathya - Apathya rules and there is no effect of medicine for the one who is notfollowing the Pathya Apathya rules.”Keeping view the Pathological factors, the ancient Acharyas have listed numerousPathya, Apathya for Sthoulya.The Pathya-Apathya is tabulated under 3 heads: Aahaara, Vihaara and maanasika.Table 34: Pathya AahaaraSl.No AAHAARA Ch SU Vag Y.R B.P Cd1 Madhu + + + + + +2 Shunti + -- + -- -- --3 Yava + + + + + +4 Aamalaki + -- + -- -- --5 Prashaatika + -- -- -- -- --6 Shyaamaka + + + + + +7 Yavaka + -- -- -- -- --8 Joornaahva + -- + -- -- --9 Kodrava + -- -- + -- --10 Mudga + + + + + --11 Kulattha + -- + + + --12 Chakramudgaka + -- -- -- -- --13 Aadhaki beeja + -- -- -- -- --14 Patola + -- -- -- -- --15 Koradooshaka -- + -- -- + --16 Uddalaka -- + -- + -- --17 Mastu -- -- + -- -- --18 Dandahata(takra) -- -- + -- + --19 Shigru -- -- + -- -- --
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-20096620 Hingu -- -- + -- -- --21 Dhaanyaka -- -- + -- -- --22 Haridra -- -- + -- -- --23 Puraana shaali -- -- -- + + --24 Pratapta neera -- -- -- -- + --25 Dagdha vaartaka -- -- -- -- + --26 Chingata matsya -- -- -- + + --27 Sura -- -- -- + -- --28 Neevara -- -- -- + -- --29 Priyangu -- -- -- + -- --30 Chanaka -- -- -- + -- --31 Masoora -- -- -- + -- --32 Tuvari -- -- -- + -- --33 Laajha -- -- -- + -- --Table 35: Pathya VihaaraSl.No VIHAARA Ch SU Vag Y.R B.P Cd1 Rookshodvartana + -- -- -- + --2 Prajaagara + -- + + + +3 Vyaayaama + -- -- + + +4 Vyavaaya + + -- + + +5 Shrama -- -- -- + + +6 Adhwa -- -- -- + + +7 Aatapa -- -- -- -- + --8 Langhana -- -- -- -- + --9 Hasti-ashvayaana -- -- -- -- + --10 Bhramana -- -- -- -- + --11 Vireka -- -- -- -- + --12 Pracchardana -- -- -- -- + --13 Apatarpana -- -- -- -- + --14 Prabhojana vaaripaana-- -- -- -- + --Table 36: Pathya - Manasika BhavasSl.No MANASIKA BHAVAS Ch SU Vag Y.R B.P Cd1 Chintana + -- + + + +
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200967Table 37: Apathya AahaaraSl.No AAHAARA Ch SU Vag Y.R B.P Cd1 Mamsa -- -- + -- + --2 Sarpi -- -- + -- -- --3 Payaamsi -- -- + -- + --4 Ikshu vikruti -- -- -- -- + --5 Maasha -- -- -- -- + --6 Godhuma -- -- -- -- + --7 Sita -- -- + -- -- --8 Matsya -- -- -- -- + --Table 38: Apathya VihaaraSl.No VIHAARA Ch SU Vag Y.R B.P Cd1 Atisampoorana + -- -- -- --2 Avyaayaama + + -- + -- --3 Avyavaya + -- -- -- --4 Diwaswapna + + -- + + --5 Abhyanga -- -- + -- -- --6 Snaana -- -- + -- + --7 Sraggandha -- -- -- -- + --8 Shayyasukha -- -- + -- -- --9 Adhyashana -- + -- -- -- --10 Svapna -- -- + -- -- --11 Pashchaat paanam jalasya -- -- -- -- -- --Table 39: Apathya-Manasika BhavasSl.No MANASIKA BHAVAS Ch SU Vag Y.R B.P Cd1 Harshanityatva + -- + -- -- --2 Achintana + -- -- -- -- --3 Nirvrutti -- -- + -- -- --
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200968DRUG REVIEWIn Ayurveda, the success of Chikitsa depends totally upon four importantfactors analogous to the four legs that support a table. They are termed aschikitsapada. Among these four fold factors of treatment; Ausadha has been awardedthe second place. The selection of a proper drug in the management of disease is veryimportant because proper drug will never deceive the physician in the path of success.The selected drug should act on disease as well as dosha involved.SELECTION OF DRUGS:In pathogenesis of Sthoulya, Agni and Meda dhatu are two main responsiblefactors, so the drug should be selected in such a way that it affects on the pathogenesisof the disease. The substance, which can cause absorption or extirpation of Dosha,Dhatu, Mala and emaciation of body, is called as Lekhana. (Sha.Pu.4/10). In thisresearch comparative study is done on Diet and regiman, Lekaneeya gana choornawith Madhu anupana, and both combined in three groups A, B, C respectively.INGREDIENTS OF LEKHANEEYA GANA CHOORNA: Musta Kushtha Haridra Daruharidra Ativisha Vacha Katukarohini Chitraka Haimavati (Shweta Vacha) Chirabilva
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200969DRUGS PICTURE
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200970Drug name Bot.Name Rasa Guna Veerya Vipaka Doshaghnata Karma1. Musta CyperusrotundusTikta,Katu,KashayaLaghu,RookshaSheeta Katu Kapha PittaShamakaTruptighna, Trushna nigraha, Lekhana,Kandughna, Grahi, Deepana, Pachana2. Kushtha SaussurealepaTikta,Katu,MadhuraLaghu,Rooksha,TeekshnaUshna Katu Kapha PittaShamakaShukra shodhana, Lekhana,Ashtapanopaga3. Haridra CurcumalongaTikta,KatuRooksha,LaghuUshna Katu TridoshaShamakaKushtaghna, Lekhana, Kandughna,Vishaghna, Pramehaghna4. Daruharidra BerberisaristataTikta,KashayaLaghu,RookshaUshna Katu Kapha PittaShamakaArshaghna,Kandughna, Lekhana, Pramehaghna5. Vacha AcoruscalamusKatu,TiktaLaghu,TeekshnaUshna Katu Kapha RaktaShamaka,Pitta VardhakaLekhana, Arshaghna,Truptighna,Ashtapanopaga,Sangnya sthapaka6. Ativisha AconitumHeterophylumTikta,KatuLaghu,RookshaUshna Katu TridoshaShamakaArshaghna,Lekhana7. Katukarohini PicrorhizakurroaTikta Rooksha,LaghuSheeta Katu Kapha PittaShamakaBhedaneeya, Lekhana, Stanya shodhana8. Chitraka PlumbagozeylanicaKatu Laghu,Rooksha,TeekshnaUshna Katu Kapha VaataShamaka,Pitta VardhakaDeepaneeye,Truptighna, Bhedaneeya, Lekhana9. Chirabilva HolopteleaintegrifoliaTikta,KashayaLaghu,RookshaUshna Katu Kapha PittaShamaka,Kushthaghna,Pramehaghna,Raktashodhaka,Lekhana10. Madhu -- Madhura,KashayaLaghu,RookshaSheeta Madhura Kapha VaataHara,MedaghnaLekhana, Yogavahi, Chedana, Deepana,SrotovishodhanaTable 40: DESCRIPTION OF LEKHANEEYA GANA DRAVYA WITH MADHU ANUPANA
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200971Aushadha Dana Kala (Time of Administration of Drug)According to Ashtanga Samgraha, Prag Bhakta Kala i.e. administration ofmedicine before meal is insisted for Krishikarana purpose (A.S.Su.23/14). It has beenfurther elaborated by Sharangadhara and advised to take Lekhana drug on emptystomach in early morning and before a meal (Sh.Pu.4/10). So for the treatment ofSthoulya medicine should be administered before meal and ideally in the morning andempty stomach.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200972REVIEW OF PREVIOUS WORKTable No.41 Review on previous worksNo Year Author Subject College1 2002 Dr.BuchakeAnandAn assessment of theactivities of Ruksha gunaw.s.r. to SthoulyaIPGRA, Jamnagar2 2003 Dr. RajputAnurag SinghA Pharmaceutico-Pharmaco-Clinical StudyOn Guggulu W.S.R. ToIt’s Medohar Effect”IPGRA, Jamnagar3 2003 Dr.Sarika MehtaAetiopathological Studyof Sthoulya (Obesity)And Assessment of TheEffect of DevadarvyadiVati And VirechanaKarmaIPGRA, Jamnagar4 2003 Dr. Chinmayi C.ShahClinical Study on theAetiopathogenesis ofSthoulya and itsManagement withGomutra arka bhavitaagnimanthaIPGRA, Jamnagar5 2004 Dr.GujarathiRitesh .AA Conceptual and appliedaspects of ‘Hrasa hetuvisheshashcha’ in thecontext of SthoulyaIPGRA, Jamnagar
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200973MATERIALSThe Materials are classified as:1. Literary2. Drugs3. InstrumentsCollection of Material1. LiteraryLiterary source for the present study was obtained from Vedic scriptures,classical texts of Ayurveda, Sanskrit dictionaries, modern texts, published articlesin reputed journals and also from the various media like Internet etc followed byretrospective study of related research works.2. Drugsa) Sookshma choorna of Musta, Kushtha, Haridra, Daruharidra, Vacha,Katukarohini, Chitraka and Chirabilva were obtained fromM.S.HEALTH SERVICES, UDUPI.b) Sookshma choorna of Shodhita Ativisha was obtained from N.K.C.A.Pharmacy, Mysore.c) Unprocessed honey (Puraana) was obtained from VivekanandaGirijana Kalyana Kendra, B.R.Hills, Mysore.3. Instrumentsa) Weighing Machineb) Measuring Tapec) Scale for measuring height (Plotted on wall)Preparation of Medicine3 kg each, of Sookshma choorna of Musta, Kushtha, Haridra, Daruharidra,Katukarohini, Chitraka, Chirabilva and Shodhita Ativisha and 6 kg of VachaSookshma choorna were obtained from pharmacies and were mixed in a largecontainer to get 30 kg of the trial drug i.e; Lekhaneeya Gana Choorna.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200974Methodology1. Measurement of WeightPatient was asked to remove the slippers and was asked to stand on theweighing machine devoid of any accessories (like hand bag, mobiles etc). Thereading was observed on the weighing machine. (The readings were takenwith cloths on).2. Measurement of CircumferencesMeasurements were taken in cms using a measuring tape at different levelslike:a) Mid- armb) Wristc) Waistd) Hipe) Mid- thigh.3. Measurement of HeightHeights were taken by asking the patient to stand bare foot with their heel,back and head touching the wall. In that position a metal scale was placed over thehead perpendicular to the wall and the corresponding reading on the wall wasnoted.MethodsAimTo evaluate the Chikitsa Siddhanta “Guru Cha Atarpana” in Sthoulya.Objectives 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 prepare a module of Ahara and Vihara, which are antagonistic to Sthoulya,as a representative of Guru Atarpana, based on available literary informationin the Ayurvedic classics.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200975 To evaluate the efficacy of Guru Atarpana Ahara and Vihara in Sthoulya. To evaluate the efficacy of the ‘Lekhaniya Gana Choorna’ in the managementof Sthoulya along with Madhu Anupana. To evaluate the efficacy of the combined effect of ‘Lekhaniya Gana Choorna’with Madhu Anupana and Guru Atarpana Ahara and Vihara in Sthoulya. To compare the individual efficacies of Guru Atarpana Ahara and Vihara, ofLekhaniya Gana Choorna and to know the combined effect of the both onSthoulya.Source of Data A minimum of 45 patients coming under inclusion criteria approaching theOPD, IPD of Government Ayurveda Medical College and Hospital, Mysoreand special camps conducted in and around Mysore were selected for thestudy.Inclusion Criteria Patients of either sex between the age group of 20-45 years with DiagnosticCriteria were selected for the study. BMI > 30 Patients having weight more than the recommended Weight for specificHeight.Exclusion Criteria Obesity due to Hormonal imbalance were excluded Patients with Hypertension and Diabetes Mellitus were excluded. Any other systemic disorder, which interferes with the course of treatment,was excluded.Diagnostic CriteriaPatient with Signs and Symptoms of Sthoulya like Excess Adiposity (Pendulousness)of Breast, Abdomen and Buttocks, fulfilling any three of the below said criteria wasdiagnosed as obese: BMI.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200976 Ideal weight for specific height (Blackburn et al), 70(a) Waist measurement, Waist: HipSampling MethodFor the clinical trial 45 patients were randomly selected based on ‘LotteryMethod’, a type of random sampling from O.P.D.and I.P.D. of Government AyurvedaMedical College and Hospital, Mysore, and from medical camps in and aroundMysore.Research DesignAfter the Diagnosis, the selected patients were assigned to identical group of15 patients in each of the 3 Groups. This is a Single Blind Comparative ClinicalStudy.All the Patients were treated on O.P.D basis only and Pre- Treatment, Post-treatment and Post Follow-Up readings were recorded to assess various parameters ofthis study.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. Analysis was considered by SPSS for windows(Statistical presentation system software) version 14 developed by SPSS, New York(2005).INTERVENTIONFor Group A The 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.For Group B ‘Lekhaniya Gana Churna’ with Madhu Anupana in the dose of 6g, twice a day(in empty stomach morning and evening), for duration of 60 days was given asoral administration. Followed by a follow-up period of 30 days.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200977For Group C The Module of Ahara Vihara along with ‘Lekhaniya Gana Churna’ withMadhu Anupana in the dose of 6g, twice a day (in empty stomach morningand evening), was advised to the patients for duration of 60 days. Followed bya follow-up period of 30 days.Assessment CriteriaAssessment was made based on a clinical grading given to the parametersrelated to Sthoulya. The parameters are classified into three:I. Objective criteriaII. Subjective CriteriaIII. Observational CriteriaGrading for Objective criteria1. Weight:Grade 1: normal weight for specific heightGrade 2: 1-15%>normal weightGrade 3: 15-30%> normal weightGrade 4: 30-45%>normal weight2. B.M.I:Grade 1: <=30Grade 2: 30-33Grade 3: 33-36Grade 4: 36-393. Waist: Hip:For Males For FemalesGrade 1: 0.73 – 0.9 0.43 – 0.66Grade 2: 0.9 – 1.07 0.66 – 0.89Grade 3: 1.07 – 1.24 0.89 – 1.12Grade 4: >1.24 >1.12
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200978Grading For Subjective Criteria1. Shwasa Kruchruta:Grade 1: No shwasa kruchrutaGrade 2: After heavy/ moderate workGrade 3: After mild workGrade 4: Even at rest2. Utsaaha Hani:Grade 1: No utsaaha haniGrade 2: alpa utsaaha hani(does work half heartedly)Grade 3: madhyama utsaaha hani (does work only on being initiated to)Grade 4: ati utsaaha hani (doesn’t work even after being initiated)3. Sarvakriyasu Asamarthata:Grade 1: Able to do all workGrade 2: Able to do routine & some additional workGrade 3: Able to do routine work independentlyGrade 4: Able to do routine work also, only with assistance4. Sweda:Grade 1: No swedaGrade 2: After heavy or moderate workGrade 3: After mild workGrade 4: At restGrading For Observational Criteria1. Kshudha: Normal or excess2. Pipaasa: Normal or excess3. Waist measurement: At the level of umbilicus (or mid point between coastalmargin & iliac crest)4. Hip measurement: At the level of the highest distention of buttocks
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009795. Mid arm circumference: At the level of midway between shoulder joint &elbow joint.6. Wrist circumference: At the base of the Palm.7. Thigh circumference: At level mid way between hip and knee joint.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200980OBSERVATIONSObservations during Intervention: Most patients had constipation as the presenting symptom. Medicine given was accepted with difficulty due to non-palatability. Also, someadverse effects like Nausea, vomiting, abdominal discomfort and tightness in chestwas observed and reported by patients on intake of Lekhaneeya Gana Choorna. Medicine relieved patients off constipation and there was even an increasedfrequency of urination. Lightness of the body was the earliest reported change by most of the patients.Other Observations:Table No. 42: Distribution of Sex among the 45 patients taken for StudyFrequency PercentMale 6 13.3Female 39 86.7SEXTotal 45 100.0Out of 45 samples, 6 were Males (13.3%) & 39 were Females (86.7%).Table No. 43: Distribution of Age Group among the 45 patients taken for StudyFrequency Percent20-29 14 31.130-39 20 44.440 and above 11 24.4AGETotal 45 100.0Out of 45 samples, 14 patients (31.1%) were in the age group of 20-29; 20 patients(44.4%) were in the age group of 30-39 and 11 patients (24.4%) were in the age group of40 and above.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200981Table No. 44: Distribution of Religion among the 45 patients taken for StudyFrequency PercentHindu 31 68.9Muslim 14 31.1RELIGIONTotal 45 100.0Out of 45 samples, 31 patients (68.9%) were Hindus and 14 patients (31.1%) wereMuslims.Table No. 45: Distribution of Location among the 45 patients taken for StudyFrequency PercentRural 12 26.7Urban 33 73.3LOCATIONTotal 45 100.0Out of 45 samples, 12 patients (26.7%) were belonging to Rural area and 33patients (73.3%) were belonging to Urban area.Table No. 46: Distribution of Occupation among the 45 patients taken for StudyFrequency PercentHouse wives 24 53.3Teacher 4 8.9Business 5 11.1Administration 6 13.3Student 2 4.4Manual work 4 8.9OCCUPATIONTotal 45 100.0Out of 45 samples, 24 patients were House wives (53.3%), 4 patients wereTeacher (8.9%), 5 patients were into Business (11.1%), 6 patients were intoAdministration (13.3%), 2 patients were Students (4.4%) and 4 patients were Manualworkers (8.9%).
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200982Table No. 47: Distribution of Socio-Economic Status among the 45 patients takenfor StudyFrequency PercentLower middle class 12 26.7Middle class 22 48.9Upper middle class 11 24.4SOCIO-ECONOMICSTATUS Total 45 100.0Out of 45 samples, 12 patients belonged to Lower middle class(26.7%),22 patientsbelonged to Middle class(48.9%) and 11 patients belonged to Upper middle class(24.4%).Table No. 48: Distribution of Education among the 45 patients taken for StudyFrequency PercentUneducated 1 2.2Primary 3 6.7Middle school 7 15.6High school 16 35.6Graduate 16 35.6Post graduate 2 4.4EDUCATIONTotal 45 100.0Out of 45 samples, 1 patient was uneducated (2.2%), 3 patient had studied tillPrimary (6.7%), 7 patient had studied till Middle School(15.6%), 16 patient had studiedtill High School (35.6%), 16 patient were Graduates (35.6%) and 2 patient were Postgraduates (4.4%).Table No. 49: Distribution of Family History among the 45 patients taken for StudyFrequency PercentAbsent 16 35.6Paternal 5 11.1Maternal 16 35.6Paternal & Maternal 8 17.8FAMILYHISTORYTotal 45 100.0
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200983Out of 45 samples, 16 patients (35.6%) did not have a Family history of Sthaulya, 5patients (11.1%) had Paternal history of Sthaulya, 16 patients (35.6%) had Maternalhistory of Sthaulya and 8 patients (17.8%) showed presence of both Paternal andMaternal history of Sthaulya.Table No. 50: Distribution of Nature of Work among the 45 patients taken forStudyFrequency PercentSedentary 7 15.6Mild 4 8.9Moderate manual 32 71.1Hard manual 2 4.4NATUREOFWORKTotal 45 100.0Out of 45 samples, 7 patients were doing Sedentary work (15.6%), 4 patients were doingMild work (8.9%),32 patients were doing Moderate manual work(71.1%) and 2 patientswere doing Hard Manual work(4.4%).Table No. 51: Distribution of Exercising Practice among the 45 patients taken forStudyFrequency PercentNo exercise 34 75.6Does exercise 11 24.4EXERCISINGPRACTICE Total 45 100.0Out of 45 samples, 34 patients did not involve in Exercise (75.6%) and 11 patientsinvolved in Exercise (24.4%).
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200984Table No. 52: Distribution of Diets among the 45 patients taken for StudyFrequency PercentVeg 17 37.8Mixed 28 62.2DIETTotal 45 100.0Out of 45 samples, 17 patients were Vegetarians (37.8%) and 28 patients werehaving Mixed diet (62.2%).Table No. 53: Distribution of Hours of Day Sleep among the 45 patients taken forStudyFrequency PercentNo day sleep 32 71.1Day sleep 13 28.9HOURS OF DAYSLEEP Total 45 100.0Out of 45 samples, 32 patients (71.1%) were in the habit of Day sleep and 13patients (28.9%) were not.Table No. 54: Distribution of Hours of Night Sleep among the 45 patients taken forStudyFrequency Percent6-6.9 8 17.777-7.9 20 44.448-8.9 14 31.119-9.9 3 6.66HOURS OF NIGHTSLEEPTotal 45Out of 45 samples, 8 patients slept for 6-6.9 hrs at night (17.7%), 20 patients sleptfor 7-7.9 hrs at night (44.44%), 14 patients slept for 8-8.9 hrs at night (31.11%)and 3patients slept for 9-9.9 hrs at night (6.66%).
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200985Table No. 55: One-Sample Statistics- Mean Hours of Night Sleep among the 45patients taken for StudyN Mean Std. Deviation Std. Error MeanHONS 45 7.5111 .76492 .11403In the sample size of 45, 7.5 hrs was the average sleeping hour at night.Table No. 56: One-Sample Test- Significance of Hours of Night sleep taking 6Hours as the Test Value among the 45 patients taken for StudyTest Value = 6t df Sig. (2-tailed) Mean DifferenceHONS 13.252 44 .000 1.5111Out of 45 samples, 6hrs was minimum sleeping hours at night. Based on this testvalue significance of night sleeping hour was calculated. The night sleeping hours had asignificant effect on Sthoulya (.000)Table No. 57: Distribution of Habits among the 45 patients taken for StudyFrequency PercentNo habits 1 2.2Tea 16 35.6Coffee 18 40.0Tea & Coffee 9 20.0Tea, Cigarette& Alcohol 1 2.2HABITSTotal 45 100.0Out of 45 samples, 1 patient (2.2%) had no Habits, 16 patients (35.6%) had theHabit of taking tea, 18 patients (40%) had the Habit of taking coffee, 9 patients (20%)had the Habit of taking both tea and coffee, 1 patient (2.2%) had the Habit of taking tea,cigarette and alcohol.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200986Table No. 58: Distribution of number of Children among the 45 patients taken forStudyOut of 45 samples, 12 patients (26.7%) had no kids, 8 patients (17.8%) had 1 kid,15 patients (33.3%) had 2 kids, 5 patients (11.1%) had 3 kids, 3 patients (6.7%) had 4kids and 2 patients (4.4%) had 5 kids.Table No. 59: Distribution of Marital status among the 45 patients taken for StudyFrequency PercentUn married 7 15.6Married 38 84.4MARITAL STATUSTotal 45 100.0Out of 45 samples, 7 patients were unmarried (15.6%) and 38 patients were married(84.4%).Frequency PercentNo kids 12 26.71 8 17.82 15 33.33 5 11.14 3 6.75 2 4.4NUMBEROF CHILDRENTotal 45 100.0
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200987Table No. 60: Distribution of number of Children V/S Marital status among the 45patients taken for StudyMARITALSTATUSUnmarried Married TotalCount 7 5 12No kids% within MARITAL_ 100.0% 13.2% 26.7%Count 0 8 81.00% within MARITAL_ .0% 21.1% 17.8%Count 0 15 152.00% within MARITAL_ .0% 39.5% 33.3%Count 0 5 53.00% within MARITAL_ .0% 13.2% 11.1%Count 0 3 34.00% within MARITAL_ .0% 7.9% 6.7%Count 0 2 2OB-HTRY5.00% within MARITAL_ .0% 5.3% 4.4%Count 7 38 45Total% within MARITAL_ 100.0% 100.0% 100.0%Of the 38 married patients, 13.2% i.e. 5 patients did not have issues.Table No. 61: Distribution of Prakruti among the 45 patients taken for StudyFrequency PercentVata 3 6.7Pitta 2 4.4Kapha 2 4.4Vata+pitta 15 33.3Vata+Kapha 10 22.2Pitta+Kapha 13 28.9PRAKRUTITotal 45 100.0Out of 45 samples, 3 patients (6.7%) were of Vata Prakruti, 2 patients (4.4%) wereof Pitta Prakruti, 2 patients (4.4%) were of Kapha Prakruti, 15 patients (33.3%) were ofVata Pitta Prakruti, 10 patients (22.2%) were of Vata Kapha Prakruti, 13 patients (28.9%)were of Pitta Kapha Prakruti.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200988Table No. 62: Distribution Of Dushya Among The 45 Patients Taken For StudyFrequency PercentMeda 44 97.8Meda & Shukra 1 2.2DUSHYATotal 45 100.0Out of 45 samples, Dushya involved in 44 patients is Meda (97.8%), and in 1patient it is Meda and Sukra (2.2%).Table No. 63: Distribution of Sara among the 45 patients taken for StudyFrequency PercentAvara 3 6.7Madhyama 41 91.1Pravara 1 2.2SARATotal 45 100.0Out of 45 samples, 3 patients had Avara Sara (6.7%), 41 patients had MadhyamaSara (91.1%) and 1 patient had Pravara Sara (2.2%).Table No. 64: Distribution of Samhanana among the 45 patients taken for StudyFrequency PercentAvara 1 2.2Madhyama 44 97.8SAMHANANATotal 45 100.0Out of 45 samples, 1 patient had Avara Samhanana (2.2%) and 44 patients hadMadhyama Samhanana (97.8%).
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200989Table No. 65: Distribution of Satmya among the 45 patients taken for StudyFrequency PercentAvara 12 26.7Madhyama 27 60.0Pravara 6 13.3SATMYATotal 45 100.0Out of 45 samples, 12 patients had Avara Satmya (26.7%), 27 patients hadMadhyama Satmya (60%) and 6 patients had Pravara Satmya (13.3%).Table No. 66: Distribution of Sattva among the 45 patients taken for StudyFrequency PercentAvara 1 2.2Madhyama 40 88.9Pravara 4 8.9SATTVATotal 45 100.0Out of 45 samples, 1 patient had Avara Sattva (2.2%), 40 patients had MadhyamaSattva (88.9%) and 4 patients had Pravara Sattva (8.9%).Table No. 67: Distribution of Poorvatana Abhyavaharana Shakti among the 45patients taken for StudyFrequency PercentMadhyama 29 64.4Pravara 16 35.6POORVATANAABHYAVAHARANA SHAKTI Total 45 100.0Out of 45 samples, 29 patients had Madhyama Poorvatana Abhyavaharana Shakti(64.4%) and 16 patients had Pravara Poorvatana Abhyavaharana shakti (35.6%).
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200990Table No. 68: Distribution of Adhyatana Abhyavaharana Shakti among the 45patients taken for StudyFrequency PercentMadhyama 19 42.2Pravara 26 57.8ADHYATANAABHYAVAHARANA SHAKTI Total 45 100.0Out of 45 samples, 19 patients had Madhyama Adhyatana Abhyavaharana Shakti(42.2%) and 26 patients had Pravara Adhyatana Abhyavaharana shakti (57.8%).Table No. 69: Distribution of Poorvatana Jarana Shakti among the 45 patientstaken for StudyFrequency PercentMadhyama 32 71.1Pravara 13 28.9POORVATANAJARANA SHAKTI Total 45 100.0Out of 45 samples, 32 patients had Madhyama Poorvatana Jarana shakti (71.1%)and 13 patients had Pravara Poorvatana Jarana shakti (28.9%).Table No. 70: Distribution of Adhyatana Jarana Shakti among the 45 patientstaken For StudyFrequency PercentMadhyama 33 73.3Pravara 12 26.7ADYATANAJARANA SHAKTI Total 45 100.0Out of 45 samples, 33 patients had Madhyama Adhyatana Jarana shakti (71.1%)and 13 patients had Pravara Adhyatana Jarana shakti (28.9%).
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200991Table No. 71: Distribution of Vyayama Shakti among the 45 patients taken forStudyFrequency PercentAvara 10 22.2Madhyama 33 73.3Pravara 2 4.4VYAYAMA SHAKTITotal 45 100.0Out of 45 samples, 10 patients had Avara Vyayama Shakti (22.2%), 33 patients hadMadhyama Vyayama Shakti (73.3%) and 4 patients had Pravara Vyayama Shakti (4.4%).Table No. 72: Distribution of Agni among the 45 patients taken for StudyFrequency PercentTeekshna 27 60.0Vishama 18 40.0AGNITotal 45 100.0Out of 45 samples, 27 patients had Teekshna Agni (60%) and 18 patients hadVishama Agni (40%).Table No. 73: Distribution of Koshta among the 45 patients taken for StudyFrequency PercentMadhyama 16 35.6Kroora 29 64.4KOSHTATotal 45 100.0Out of 45 samples, 16 patients had Madhyama Koshtha (35.6%) and 29 patients hadKroora Koshtha (64.4%).
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200992RESULTSTable No. 74: Effect of the 3 Interventions on Weights of 45 patients BeforeTreatment, After Treatment and After Follow upGROUP Mean Std. Deviation NPathya Apathya 3.4667 .51640 15Lekhaneeya Gana choorna 3.5333 .51640 15PA & LGC 3.5333 .51640 15WT_BTTotal 3.5111 .50553 45Pathya Apathya 3.2667 .45774 15Lekhaneeya Gana choorna 3.3333 .48795 15PA & LGC 3.1333 .35187 15WT_ATTotal 3.2444 .43461 45Pathya Apathya 3.3333 .48795 15Lekhaneeya Gana choorna 3.3333 .48795 15PA & LGC 3.2000 .41404 15WT_FUTotal 3.2889 .45837 45Table No. 75: Significance of Weight Change – in accordance to duration oftreatment and among three GroupsSourceType III Sum ofSquares df Mean Square F Sig.CHANGE 1.837 2 .919 13.053 .000CHANGE * GROUP .252 4 .063 .895 .471Error (CHANGE) 5.911 84 .070The change in Weight before treatment, after treatment and after follow up issignificant in all three groups but there is no significant difference in change of Weightbetween the groups.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200993Table No. 76: Effect of the 3 Interventions on B.M.I of 45 patients BeforeTreatment, After Treatment and After Follow upGROUP Mean Std. Deviation NPathya Apathya 2.2667 .45774 15Lekhaneeya Gana choorna 2.4667 .63994 15PA & LGC 2.4000 .73679 15BMI_BTTotal 2.3778 .61381 45Pathya Apathya 1.8000 .77460 15Lekhaneeya Gana choorna 1.8000 1.08233 15PA & LGC 1.8000 .67612 15BMI_ATTotal 1.8000 .84208 45Pathya Apathya 1.6667 .81650 15Lekhaneeya Gana choorna 1.8667 1.06010 15PA & LGC 1.8667 .83381 15BMI_FUTotal 1.8000 .89443 45Table No. 77: Significance of Weight change – in accordance to duration oftreatment & among three groupsSourceType III Sum ofSquares df Mean Square F Sig.CHANGE 10.015 2 5.007 46.392 .000CHANGE * GROUP .252 4 .063 .583 .676Error (CHANGE) 9.067 84 .108The change in B.M.I. before treatment, after treatment and after follow up issignificant in all three groups but there is no significant difference in change of B.M.I.between the groups.Table No. 78: Effect of the 3 interventions on Waist Hip ratio of 45 patients Beforetreatment, After treatment and After follow upGROUP Mean Std. Deviation NPathya Apathya 2.7333 .45774 15Lekhaneeya Gana choorna 2.6667 .48795 15PA & LGC 2.6000 .50709 15W: H_BTTotal 2.6667 .47673 45Pathya Apathya 2.8000 .41404 15Lekhaneeya Gana choorna 2.8000 .41404 15W: H_ATPA & LGC 2.4667 .51640 15
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200994Total 2.6889 .46818 45Pathya Apathya 2.6667 .48795 15Lekhaneeya Gana choorna 2.6667 .48795 15PA & LGC 2.5333 .51640 15W:H_FUTotal 2.6222 .49031 45Table No. 79: Significance of change in Waist Hip ratio – in accordance to durationof treatment & among three groupsSource Type III Sum of Squares df Mean Square F Sig.CHANGE .104 2 .052 1.032 .361CHANGE * GROUP .341 4 .085 1.695 .159Error (CHANGE) 4.222 84 .050The change in Waist Hip Ratio before treatment, after treatment and after follow upis significant in all three groups but there is no significant difference in change of WaistHip Ratio between the groups.Table No. 80: Effect of the 3 interventions on Shwasa krucchruta of 45 patientsBefore treatment, After treatment and After follow upGROUP Mean Std. Deviation NPathya Apathya 1.8000 .67612 15Lekhaneeya Gana choorna 2.2000 .77460 15PA & LGC 2.2000 .86189 15SK_BTTotal 2.0667 .78044 45Pathya Apathya 1.4667 .63994 15Lekhaneeya Gana choorna 1.5333 .51640 15PA & LGC 1.5333 .51640 15SK_ATTotal 1.5111 .54864 45Pathya Apathya 1.2000 .41404 15Lekhaneeya Gana choorna 1.4667 .51640 15PA & LGC 1.5333 .51640 15SK_FUTotal 1.4000 .49543 45
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200995Table No. 81: Significance of change in Shwasa krucchruta – in accordance toduration of treatment & among three groupsSource Type III Sum of Squares df Mean Square F Sig.CHANGE 11.481 2 5.741 60.955 .000CHANGE * GROUP .607 4 .152 1.612 .179Error(CHANGE) 7.911 84 .094The change in Shwasa Krucchrata parameter before treatment, after treatment andafter follow up is significant in all three groups but there is no significant difference inchange of Shwasa Krucchrata parameter between the groups.Table No. 82: Effect of the 3 interventions on Utsaaha haani of 45 patients Beforetreatment, After treatment and After follow upGROUP Mean Std. Deviation NPathya Apathya 1.2000 .41404 15Lekhaneeya Gana choorna 1.2667 .59362 15PA & LGC 1.4000 .50709 15UH_BTTotal 1.2889 .50553 45Pathya Apathya 1.1333 .35187 15Lekhaneeya Gana choorna 1.2000 .41404 15PA & LGC 1.3333 .48795 15UH_ATTotal 1.2222 .42044 45Pathya Apathya 1.0667 .25820 15Lekhaneeya Gana choorna 1.0667 .25820 15PA & LGC 1.0667 .25820 15UH_FUTotal 1.0667 .25226 45Table No. 83: Significance of change in Utsaah haani – in accordance to duration oftreatment & among three groupsSource Type III Sum of Squares df Mean Square F Sig.CHANGE 1.170 2 .585 9.294 .000CHANGE * GROUP .207 4 .052 .824 .514Error(CHANGE) 5.289 84 .063The change in Utsaaha Haani parameter before treatment, after treatment and after
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200996follow up is significant in all three groups but there is no significant difference in changeof Utsaaha Haani parameter between the groups.Table No. 84: Effect of the 3 interventions on Sarva kriyasu asamarthata of 45patients Before treatment, After treatment and After follow upGROUP Mean Std. Deviation NPathya Apathya 1.0000 .00000 15Lekhaneeya Gana choorna 1.0667 .25820 15PA & LGC 1.2667 .45774 15SA_BTTotal 1.1111 .31782 45Pathya Apathya 1.0000 .00000 15Lekhaneeya Gana choorna 1.0000 .00000 15PA & LGC 1.0667 .25820 15SA_ATTotal 1.0222 .14907 45Pathya Apathya 1.0000 .00000 15Lekhaneeya Gana choorna 1.0000 .00000 15PA & LGC 1.1333 .35187 15SA_FUTotal 1.0444 .20841 45Table No. 85: Significance of change in Kriya saamarthya – in accordance toduration of treatment & among three groupsSource Type III Sum of Squares df Mean Square F Sig.CHANGE .193 2 .096 3.500 .035CHANGE * GROUP .163 4 .041 1.481 .215Error(CHANGE) 2.311 84 .028The change in Sarva Kriyaasu Asamarthata parameter before treatment, after treatmentand after follow up is significant in all three groups but there is no significant differencein change of Sarva Kriyaasu Asamarthata parameter between the groups.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200997Table No. 86: Effect of the 3 interventions on Sweda of 45 patients Beforetreatment, After treatment and After follow upGROUP Mean Std. Deviation NPathya Apathya 2.0000 1.19523 15Lekhaneeya Gana choorna 1.6667 1.04654 15PA & LGC 1.8000 1.01419 15SW_BTTotal 1.8222 1.07215 45Pathya Apathya 1.5333 .63994 15Lekhaneeya Gana choorna 1.3333 .48795 15PA & LGC 1.4000 .63246 15SW_ATTotal 1.4222 .58344 45Pathya Apathya 1.5333 .63994 15Lekhaneeya Gana choorna 1.3333 .48795 15PA & LGC 1.4000 .63246 15SW_FUTotal 1.4222 .58344 45Table No. 87: Significance of change in Sweda– in accordance to duration oftreatment & among three groupsSource Type III Sum of Squares df Mean Square F Sig.CHANGE 4.800 2 2.400 20.618 .000CHANGE * GROUP .089 4 .022 .191 .943Error(CHANGE) 9.778 84 .116The change in Sweda parameter before treatment, after treatment and after followup is significant in all three groups but there is no significant difference in change ofSweda parameter between the groups.Table No. 88: Effect of the 3 interventions on Waist circumference of 45 patientsBefore treatment, After treatment and After follow upGROUP Mean Std. Deviation NPathya Apathya 107.8533 10.16330 15Lekhaneeya Gana choorna 110.3260 8.60997 15PA & LGC 108.6867 10.07336 15WCIR_BTTotal 108.9553 9.47729 45Pathya Apathya 105.9333 9.59514 15WCIR_ATLekhaneeya Gana choorna 107.4200 7.77544 15
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200998PA & LGC 106.4200 10.00230 15Total 106.5911 8.98637 45Pathya Apathya 105.5333 8.60122 15Lekhaneeya Gana choorna 107.0073 7.26074 15PA & LGC 106.5333 9.70726 15WCIR_FUTotal 106.3580 8.40726 45Table No. 89: Significance of change in Waist circumference – in accordance toduration of treatment & among three groupsSource Type III Sum of Squares df Mean Square F Sig.CHANGE 185.850 2 92.925 42.799 .000CHANGE * GROUP 7.374 4 1.844 .849 .498Error(CHANGE) 182.383 84 2.171The change in Waist Circumference before treatment, after treatment and afterfollow up is significant in all three groups but there is no significant difference in changeof Waist Circumference between the groups.Table No. 90: Effect of the 3 interventions on Hip circumference of 45 patientsBefore treatment, After treatment and After follow upGROUP Mean Std. Deviation NPathya Apathya 114.4267 5.26626 15Lekhaneeya Gana choorna 114.7460 6.59317 15PA & LGC 113.5000 5.90702 15HCIR_ATTotal 114.2242 5.83468 45Pathya Apathya 113.5067 5.08098 15Lekhaneeya Gana choorna 113.4267 7.53236 15PA & LGC 112.3133 5.64306 15HCIR_BTTotal 113.0822 6.05825 45Pathya Apathya 113.2867 5.10922 15Lekhaneeya Gana choorna 113.4600 8.46327 15PA & LGC 112.1000 5.65117 15HCIR_FUTotal 112.9489 6.45222 45
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200999Table No. 91: Significance of change in Hip circumference – in accordance toduration of treatment & among three groupsSource Type III Sum of Squares df Mean Square F Sig.CHANGE 44.226 2 22.113 13.344 .000CHANGE * GROUP .792 4 .198 .119 .975Error(CHANGE) 139.204 84 1.657The change in Hip Circumference before treatment, after treatment and after followup is significant in all three groups but there is no significant difference in change of HipCircumference between the groups.Table No. 92: Effect of the 3 interventions on Mid-arm circumference of 45 patientsbefore treatment, after treatment and after follow upGROUP Mean Std. Deviation NPathya Apathya 30.7667 1.07282 15Lekhaneeya Gana choorna 32.8287 3.43004 15PA & LGC 33.2867 1.71667 15MAC_BTTotal 32.2940 2.50519 45Pathya Apathya 30.1867 1.07296 15Lekhaneeya Gana choorna 32.0800 3.54163 15PA & LGC 32.0800 2.14049 15MAC_ATTotal 31.4489 2.57485 45Pathya Apathya 30.1533 1.05347 15Lekhaneeya Gana choorna 31.9360 3.18402 15PA & LGC 32.0800 2.13882 15MAC_FUTotal 31.3898 2.41241 45Table No. 93: Significance of change in Mid-arm circumference – in accordance toduration of treatment & among three groupsSource Type III Sum of Squares df Mean Square F SigCHANGE 23.030 2 11.515 60.989 .000CHANGE * GROUP 1.989 4 .497 2.634 .040Error(CHANGE) 15.860 84 .189The change in Mid-Arm Circumference before treatment, after treatment and after
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009100follow up is significant in all three groups. There is also a significant difference in changeof Mid-Arm Circumference between the groups. The reduction is maximum in Group C,Moderate in Group B and Minimum in Group ATable No. 94: Effect of the 3 interventions on Wrist circumference of 45 patientsBefore treatment, After treatment and After follow upGROUP Mean Std. Deviation NPathya Apathya 15.9800 .65814 15Lekhaneeya Gana choorna 16.8300 1.41141 15PA & LGC 16.8533 1.54035 15WRCR_BTTotal 16.5544 1.30209 45Pathya Apathya 15.8133 .71301 15Lekhaneeya Gana choorna 16.6667 1.36783 15PA & LGC 16.7200 1.56214 15WRCR_ATTotal 16.4000 1.30767 45Pathya Apathya 15.8133 .71301 15Lekhaneeya Gana choorna 16.5787 1.39580 15PA & LGC 16.7400 1.53846 15WRCR_FUTotal 16.3773 1.30455 45Table No. 95: Significance of change in Wrist circumference – in accordance toduration of treatment & among three groupsSource Type III Sum of Squares df Mean Square F Sig.CHANGE .836 2 .418 20.370 .000CHANGE * GROUP .085 4 .021 1.033 .395Error(CHANGE) 1.724 84 .021The change in Wrist Circumference before treatment, after treatment and after follow upis significant in all three groups but there is no significant difference in change of WristCircumference between the groups.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009101Table No. 96: Effect of the 3 interventions on Thigh circumference of 45 patientsBefore treatment, After treatment and After follow upGROUP Mean Std. Deviation NPathya Apathya 61.4667 25.68840 15Lekhaneeya Gana choorna 57.8853 6.98755 15PA & LGC 57.0667 4.10499 15TC_BTTotal 58.8062 15.31656 45Pathya Apathya 54.0000 3.09377 15Lekhaneeya Gana choorna 56.4933 6.50510 15PA & LGC 55.9133 3.86169 15TC_ATTotal 55.4689 4.73449 45Pathya Apathya 53.3133 2.88861 15Lekhaneeya Gana choorna 56.0867 6.24578 15PA & LGC 55.7400 3.76939 15TC_FUTotal 55.0467 4.59835 45Table No. 97: Significance of change in Thigh circumference – in accordance toduration of treatment & among three groupsSource Type III Sum of Squares df Mean Square F Sig.CHANGE 381.755 2 190.877 2.566 .083CHANGE * GROUP 274.035 4 68.509 .921 .456Error (CHANGE) 6247.917 84 74.380The change in Thigh Circumference before treatment, after treatment and afterfollow up is neither significant in the three groups nor the difference is significantbetween the groups.Table No. 98: Effect of the 3 interventions on Kshudha of 45 patients Beforetreatment, After treatment and After follow upKSNormal Excess TotalCount 20 25 45Before treatment% within KS 20.8% 64.1% 33.3%Count 34 11 45After treatment% within KS 35.4% 28.2% 33.3%CHANGEFollow up Count 42 3 45
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009102% within KS 43.8% 7.7% 33.3%Table No. 99: Significance of change in Kshudha – in accordance to duration oftreatment & among three groupsValue Approx. Sig.Nominal by Nominal Contingency Coefficient .407 .000There is significant change in Kshudha before treatment, after treatment and afterfollow up. Initially only 20 patients were having normal Kshudha, which was made 34after treatment and was 42 after follow up.Table No. 100: Effect of the 3 Interventions on Pipaasa of 45 Patients BeforeTreatment, After Treatment and After Follow upPINormal Excess TotalCount 38 7 45Before treatment% within PI 31.4% 50.0% 33.3%Count 41 4 45After treatment% within PI 33.9% 28.6% 33.3%Count 42 3 45CHANGEFollow up% within PI 34.7% 21.4% 33.3%Table No. 101: Significance of change in Pipaasa – in accordance to duration oftreatment & among three groupsValue Approx. Sig.Nominal by Nominal Contingency Coefficient .123 .355There is no significant change in Pipaasa before treatment, after treatment and afterfollow up. Initially 38 patients were having normal Kshudha, which was made 41 aftertreatment and was 42 after follow up.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009103ASSESSMENT OF CLINICAL IMPROVEMENT IN THE THREE GROUPSINDIVIDUALLYTo find the Clinical Improvement by each intervention (Group A, Group B &Group C) individually and to know which of the three is a better intervention anotherscale is used and efficacies during various durations of treatment i.e. the period betweenbefore treatment and after treatment, after treatment and follow up, and for efficacy of thetotal treatment i.e. the period between before treatment and after follow up are calculated.The scale is as follows: CD – Deterioration by one grade. (-1) CS – Stable i.e. neither deterioration nor improvement. (0) C1 – Clinical improvement by one grade. (+1) C2 – Clinical improvement by two grades. (+2) C3 -- Clinical improvement by three grades. (+3)Clinical Improvement = [C1 + C2 + C3] - CDAssessment of Clinical Improvement in the three groups individually: BeforeTreatment to After TreatmentTable No. 102: GROUP A:Parameter CD CS C1 C2 C3Weight 00 12 3 00 00B.M.I 00 08 7 00 00W:H 01 14 0 00 00Shwasa Krucchrata 00 10 5 00 00Utsaaha Haani 00 14 1 00 00Sarva Kriyaasu Asamarthata 00 15 0 00 00Sweda 00 09 5 01 00Total Score 01 82 21 02 00Clinical Improvement = 21 + 2 + 0 – 1 = 22
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009104Table No. 103: GROUP B:Parameter CD CS C1 C2 C3Weight 00 12 03 00 00B.M.I 00 05 10 00 00W:H 02 13 00 00 00Shwasa Krucchrata 00 05 10 00 00Utsaaha Haani 00 14 01 00 00Sarva Kriyaasu Asamarthata 00 14 01 00 00Sweda 00 11 03 01 00Total Score 02 64 28 02 00Clinical Improvement = 28 + 2 + 0 – 2 = 28Table No. 104: GROUP C:Parameter CD CS C1 C2 C3Weight 00 09 06 00 00B.M.I 00 06 09 00 00W:H 00 13 02 00 00Shwasa Krucchrata 00 05 10 00 00Utsaaha Haani 00 14 01 00 00Sarva Kriyaasu Asamarthata 00 12 03 00 00Sweda 00 09 06 00 00Total Score 00 68 37 00 00Clinical Improvement = 37 + 0 + 0 – 0 = 37During this period best result was seen in Group C (Mixed), followed by Group B(Lekhana Gana Choorna), then Group A (Pathya- Apathya).Assessment of Clinical Improvement in the three groups individually: Aftertreatment to After Follow – UpTable No. 105: GROUP A:Parameter CD CS C1 C2 C3Weight 01 14 00 00 00B.M.I 00 13 02 00 00W:H 00 13 02 00 00Shwasa Krucchrata 00 11 04 00 00
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009105Utsaaha Haani 00 14 01 00 00Sarva Kriyaasu Asamarthata 00 15 00 00 00Sweda 00 15 00 00 00Total Score 01 95 09 00 00Clinical Improvement = 9 + 0 + 0 –1= 8Table No. 106: GROUP B:Parameter CD CS C1 C2 C3Weight 00 15 00 00 00B.M.I 01 14 00 00 00W:H 00 13 02 00 00Shwasa Krucchrata 00 14 01 00 00Utsaaha Haani 00 15 00 00 00Sarva Kriyaasu Asamarthata 00 15 00 00 00Sweda 00 15 00 00 00Total Score 01 101 03 00 00Clinical Improvement = 3 + 0 + 0 – 1= 2Table No. 107: GROUP C:Parameter CD CS C1 C2 C3Weight 01 14 00 00 00B.M.I 01 14 00 00 00W:H 01 14 00 00 00Shwasa Krucchrata 00 15 00 00 00Utsaaha Haani 00 11 04 00 00Sarva Kriyaasu Asamarthata 01 14 00 00 00Sweda 00 15 00 00 00Total Score 04 97 04 00 00Clinical Improvement = 4 + 0 + 0 – 4 = 0During this period best result was seen in Group A (Pathya- Apathya), followed byGroup B (Lekhana Gana Choorna), then Group C (Mixed).
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009106Assessment of Clinical improvement in the three groups individually: BeforeTreatment to After Follow – upTable No. 108: GROUP A:Parameter CD CS C1 C2 C3Weight 00 13 02 00 00B.M.I 00 07 07 01 00W:H 00 14 01 00 00Shwasa Krucchrata 00 07 08 00 00Utsaaha Haani 00 13 02 00 00Sarva Kriyaasu Asamarthata 00 15 00 00 00Sweda 00 09 05 01 00Total Score 00 76 25 04 00Clinical Improvement = 25 + 4 + 0 – 0 = 29Table No. 109: GROUP B:Parameter CD CS C1 C2 C3Weight 00 12 03 00 00B.M.I 00 06 09 00 00W:H 01 13 01 00 00Shwasa Krucchrata 00 04 11 00 00Utsaaha Haani 00 12 03 00 00Sarva Kriyaasu Asamarthata 00 14 01 00 00Sweda 00 11 03 01 00Total Score 01 72 31 02 00Clinical Improvement = 31 + 2 – 1= 32Table No. 110: GROUP C:Parameter CD CS C1 C2 C3Weight 00 19 05 00 00B.M.I 00 06 08 00 00W:H 00 14 01 00 00Shwasa Krucchrata 00 05 10 00 00Utsaaha Haani 00 10 05 00 00Sarva Kriyaasu Asamarthata 00 13 02 00 00Sweda 00 09 06 00 00Total Score 00 76 37 00 00
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009107Clinical Improvement = 37 + 0 + 0 - 0 = 37During 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).
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009108GRAPHS ON OBSERVATIONSIllustration No.1: Showing distribution of Sex among the 45 patients takenfor study:MaleFemaleIllustration No.2: Showing distribution of Age among the 45 patients taken forstudy:20-2930-3940 above
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009109Illustration No.3: Showing distribution of Religion among the 45 patients takenfor study:0 10 20 30 40No.ofpatientsHinduMuslimReligionIllustration No.4: Showing distribution of Location among the 45 patients takenfor study:0 5 10 15 20 25 30 35No. of patientsRuralUrbanLocation
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009110Illustration No.5: Showing distribution of Occupation among the 45 patientstaken for study:House wifeTeacherBusinessAdministrationStudentManual workIllustration No.6: Showing distribution of Socio-Economic Status among the 45patients taken for study:0510152025No.ofpatientsLMC MC UMCSES
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009111Illustration No.7: Showing distribution of Education among the 45 patients takenfor study:UneducatedPrimaryMiddle schoolHigh schoolGraduatePGIllustration No.8: Showing distribution of Family history among the 45 patientstaken for study:0 5 10 15 20No. of patientsAbsentPaternalMaternalPaternal and MaternalFamilyhistory
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009112Illustration No.9: Showing distribution of Nature of work among the 45 patientstaken for study:SedentaryMildModerate manualHard manualIllustration No.10: Showing distribution of Exercising habit among the 45patients taken for study:0 5 10 15 20 25 30 35No. of patientsNoDoesExercise
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009113Illustration No.11: Showing distribution of Diet among the 45 patients taken forstudy:VegMixedIllustration No.12: Showing distribution of Hours of Day Sleep among the 45patients taken for study:0 5 10 15 20 25 30 35No. of patientsNoYesDaysleep
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009114Illustration No.13: Showing distribution of Hours of Night Sleep among the 45patients taken for study:Hours of night sleep6-6.97-7.98-8.99-9.9Illustration No.14: Showing distribution of Habits among the 45 patients takenfor study:NILTeaCoffeeTea & CoffeeTea cigarette alcohol
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009115Illustration No.15: Showing distribution of Number of Kids among the 45patients taken for study:0 2 4 6 8 10 12 14 16No. of patientsNo kidOneTwoThreeFourFiveObstretrichistoryIllustration No.16: Showing distribution of Marital status among the 45 patientstaken for study:UnmarriedMarried
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009116Illustration No.17: Showing distribution of number of kids in married among the45 patients taken for study:Married vs No. of Kids No kids1 Kid2 Kids3 Kids4 Kids5 KidsIllustration No.18: Showing distribution of Prakruti among the 45 patients takenfor study:VataPittaKaphaVata PittaVata KaphaPitta Kapha
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009117Illustration No.19: Showing distribution of Dushya among the 45 patients takenfor study:0 5 10 15 20 25 30 35 40 45No. of patientsMedaMeda &shukraDushyaIllustration No.20: Showing distribution of Sara among the 45 patients taken forstudy:AvaraMadhyamaPravara
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009118Illustration No.21: Showing distribution of Samhanana among the 45 patientstaken for study:0 10 20 30 40 50No. of patientsAvaraMadhyamaSamhananaIllustration No.22: Showing distribution of Satmya among the 45 patients takenfor study:AvaraMadhyamaPravara
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009119Illustration No.23: Showing distribution of Sattva among the 45 patients takenfor study:AvaraMadhyamaPravaraIllustration No.24: Showing distribution of Abhyavaharana poorvatana andadyatana among the 45 patients taken for study:Past Present051015202530AbhyavaharanaM adhyam a Pravara
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009120Illustration No.25: Showing distribution of Jarana poorvatana and adyatanaamong the 45 patients taken for study:05101520253035No.ofpatientsPast PresentJaranaMadhyama PravaraIllustration No.26: Showing distribution of Vyayama Shakti among the 45patients taken forstudy:A v a r aM a d h y a m aP r a v a r a
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009121Illustration No.27: Showing distribution of Agni among the 45 patients taken forstudy:TeekshnaVishamaIllustration No.28: Showing distribution of Koshtha among the 45 patients takenfor study:0 5 10 15 20 25 30no. of patientsMadhyamaKruraKoshta
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009122RESULTSIllustration No.29: Showing effect of the 3 interventions on weights of 45 patientsBefore treatment, After treatment and After follow up2.933.13.23.33.43.53.6MeanweightBT AT FUDurationPathya ApathyaLekhaneeya gana churnaMixedIllustration No.30: Showing effect of the 3 interventions on B.M.I of 45 patientsBefore treatment, After treatment and After follow up00.511.522.5BMIBT AT FUDurationPathya ApathyaLekhaneeya gana churnaMixed
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009123Illustration No.31: Showing effect of the 3 interventions on Waist Hip ratio of 45patients Before treatment, After treatment and After follow up2.32.352.42.452.52.552.62.652.72.752.8W:HBT AT FUDurationPathya ApathyaLekhaneeya gana churnaMixedIllustration No.32: Showing effect of the 3 interventions on Shwasa krucchruta of 45patients Before treatment, After treatment and After follow up00.511.522.5Shwasa KruchrataB T AT F UDurationP athya Apathya Lekhaneeya gana churna  Mixed
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009124Illustration No.33: Showing effect of the 3 interventions on Utsaaha haani of 45patients Before treatment, After treatment and After follow up00.20.40.60.811.21.4Utsaaha haaniBT AT F UDurationPathya Apathya Lekhaneeya gana churna  MixedIllustration No.34: Showing effect of the 3 interventions on Sarvakriyasuasamarthata of 45 patients Before treatment, After treatment & After follow-up0.920.940.960.9811.021.041.061.081.11.121.14Sarvakriyasu asamarthataB T AT F UDurationP athya Apathya Lekhaneeya gana churna  Mixed
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009125Illustration No.35: Showing effect of the 3 interventions on Sweda of 45 patientsBefore treatment, After treatment and After follow up00.20.40.60.811.21.41.61.82SwedaBT AT F UDurationPathya Apathya Lekhaneeya gana churna  MixedIllustration No.36: Showing effect of the 3 interventions on Waist circumference of45 patients Before treatment, After treatment and After follow up103104105106107108109110111Waist circumferanceBT AT F UDurationPathya Apathya Lekhaneeya gana churna  Mixed
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009126Illustration No.37: Showing effect of the 3 interventions on Hip circumference of 45patients Before treatment, After treatment and After follow up111111.5112112.5113113.5114114.5115Hip CircumferanceB T AT F UDurationP athya Apathya Lekhaneeya gana churna  MixedIllustration No.38: Showing effect of the 3 interventions on mid-arm circumferanceof 45 patients before treatment, after treatment & after follow up28.52929.53030.53131.53232.53333.5Mid Arm CircumferanceBT AT F UDurationPathya Apathya Lekhaneeya gana churna  Mixed
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009127Illustration No.39: showing effect of the 3 interventions on Wrist circumference of45 patients Before treatment, After treatment and After follow up15.215.415.615.81616.216.416.616.817Wrist CircumferenceB T AT F UDurationP athya Apathya Lekhaneeya gana churna  MixedIllustration No.40: Showing effect of the 3 interventions on Thigh circumference of45 patients Before treatment, After treatment and After follow up4850525456586062Thigh CircumferenceB T AT F UDurationP athya Apathya Lekhaneeya gana churna  Mixed
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009128Illustration No.41: Showing effect of the 3 interventions on kshudha of 45 patientsBefore treatment, After treatment and After follow up051015202530354045KshudhaBT AT F .UDurationNormalE xces sIllustration No.42: Showing effect of the 3 interventions on Pipaasa of 45 patientsBefore treatment, After treatment and After follow up051015202530354045PipaasaBT AT F .UDurationNormalE xcess
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009129DISCUSSIONDiscussion on title:Sthoulya, one of the eight despicable persons has gained a lot of momentumsince long time, both in Ayurveda and also in Modern. The research on this diseasehas been a challenge since times immemorial in both these systems. Sthoulya is acomplex disease, which invites various other life threatening diseases as well.The title “A STUDY TO EVALUATE THE CHIKITSA SIDDHANTA‘GURU CHA ATARPANA’ IN STHOULYA” has been taken for the Study so as toestablish its utility in present era and to find substantiate to the applicability ofPathya-Apathya and Lekhaneeya Gana Choorna as being Sthoulyahara and having“Guru Atarpana” property.DISCUSSION ON REVIEW OF LITERATURE:Discussion on Sroto Moola:Each of the Srotas is having a moola, which is termed as Srotomoola. This termcan be interpreted in 5 ways:1. Storage Depot / Site: Example the Medovaha Sroto moola.2. Site of Production: Example the raktavaha Sroto moola.3. Sites of Occurrence of symptoms: Example the Udakavaha Sroto moola.4. Site of Excretion: Example the Swedavaha Sroto moola.5. Site of Stimulation / Initiation: Example the Shukravaha Sroto moola asmentioned by Sushruta.Discussion on Medovaha sroto moola:As explained above, the Medovaha Srotas too has Moola sthana. All the threeAcharyas have mentioned Vrukka as one of the Moolas, but the other moola variesi.e. Vapavahana, Kati, and Mamsa according to Charaka, Sushrutha and Vagbhatarespectively.The cause for this may be explained as follows: Charaka mentions Vapavahana: as Storage Depot / Site for Medas. Sushruta mentions Kati: Site of Occurrence of symptoms of Medo Vriddhi. Vagbhata mentiona Mamsa: Site of Production. Maamsaat Medah.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009130Though there are many fat depots in the body, Vrukka (Perinephric fat) andVapavahana (Omental fat) has been mentioned as moola, as these two sites not onlyhave maximum fat deposited but also the fat in these regions are not depleted evenafter severe starvation.The modern parlance for Vrukka is a matter of discussion. It could be correlated to Kidneys Perinephric Fat Supra Renal GlandsKidneys could be easily excluded, as there is no definite role of Kidneys inrelation to fats or Fat metabolism.The Perinephric Fat can be understood as a Site of Fat deposition and theSupra Renal Gland has role to play in fat Metabolism by means of its Hormonalsecretions. Cortisol, a Glucocorticoid produced by the Adrenal cortex when in excessproduces Obesity. This Obesity results from excess stimulation of “Food intake” suchthat it is at a rate even more than Fat mobilized and Oxidized.Discussion on Poshana of Medovaha Srotas:Just as in pathological proceeding i.e. Nidana sevana → Dosha dushti→ Dhatudushti→ Sroto Dushti, shows that the Dhatu dushti leads to Sroto dushti.Also, the Srotas are said to be “sva dhatu sama varna” showing intimate effect of thedhatu on the Srotas.Based on the above two it can be inferred that the Srotas derives its nutrition from theDhatu that flows through it.An additional support to the same hypothesis is the “Ek Kaalika PoshanaKrama” wherein it shows that all entities in the body attain Poshana simultaneously.Hence, the Medovaha Srotas derives Poshana at the same time as Medas from thesame source.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009131Discussion on Nidanas for Medovaha sroto dushti: Medya Aahaara Sevana:The Medya Ahaara are attributed with below said properties:Table No.111Showing properties of Medya AaharaRasa Guna Virya Karma Panchabhautika CompositionMadhura GuruSheetaSnigdhaSthiraSandraSthulaSlakshnaPicchilManda`Sheeta BrimhanaSantarpanaRasayanVrishyaAbhishyandiPrithvi &Jala MahabhutaThese cause increase in Meda by virtue of Dravya Saamaanyataa, gunaSaamaanyataa and Karma Saamaanyataa. Of the above properties: 1) TheMahabhoota composition acts by Dravya Saamaanya, 2) The Rasa, Guna and Veeryaact by Guna Saamaanya, and 3) The Karma acts by Karma Saamaanya as medoVardhaka. Avyayama:The voluntary and rhythmical body movements which promotes physicalfitness and body strength is termed as Vyayama i.e. physical exercise.70 (b)Sushrutahas defined Vyayama as the body movements which can cause tiresomeness (Ayasa)in body.71Vagbhat has mentioned the benefits of Vyayama as, the one which bringslightness, able to work, stimulation of Agni, loss of Meda and proper nutrition of eachdhatu. Due to Avyayama, opposite actions are produced in the body like heaviness,sluggishness, hypofunction of Agni and vitiation of Doshas etc. Also Avyayamacauses aggravation of Kapha and stores the energy in the form of Meda therebyproduces aetiopathogenesis of Sthoulya.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009132Avyayama can also be understood as Inactivity which causes reduction inenergy expenditure hence the calorie expended is low the leading to accumulation ofCalories in the body in the form of Fats. Thus leading to Sthoulya. Divaswapna and Atinidra:Divasvapna causes Kapha vriddhi and its Abhishyandi property leads toblockage in whole body micro channels, specifically in Medovaha Srotas.72Becauseof excessive sleep at night and day, physical activity diminishes which aggravatesKapha leading to Meda deposition. Moreover reduced metabolic rate during sleep isan important factor for genesis of excess fat. Vaaruni atisevana:Different types of Madya like Varuni73, Sura and Gaudika74are described ascausative factors of Sthoulya. As Madya acts as an appetizer, the person eats moreand excess energy gets converted into fat. Moreover excess intake of alcohol disturbsthe liver metabolism and liver plays an important role in fat metabolism. The chiefclaim of alcohol as a food is due to the fact that it helps to support life when givenalong with other food. Acharya Charaka mentions the same thing.75Thus, Madya not only causes increase of Meda by its attributes but also leads toincrease in Meda Indirectly by increasing the Food intake.Discussion on Pramana of Medo Dhatu:The point of discussion here is, whether to include Vasa under the pramana ofMedo dhatu or not. The total quantity of Meda is two Anjali and the Vasa (Musclesfat) is three Anjalies. The major part of fats according to modern physiology remainsstored in the so-called fat depots.Distribution of Fat in Body tissue:(i) Subcutaneous tissue - 50%(ii) Peripheral tissue - 15%(iii) Mesentery - 20%(iv) Omentum - 10%(v) Intramuscular connective tissue - 05%
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009133These can be accepted as general considerations only. According to SushrutaSamhita, this equation may vary from person to person and exact measurement ofbody humors is not possible due to unpredictable and ever changing nature of body.76In Sthoulya, this proportion may found raised.Of the above sites of Fat Deposition the intramuscular connective tissue can beconsidered as Vasa, as Vasa is defined as “Maamsagata Sneha”.Udara, Sphik, Stana, Gala are the general depots of Meda.77 (a)It is also foundin Mamsa as Vasa.Hence by the above we can say that though Vasa is used as a synonym of Meda infew places, Vasa is not same as Meda. But Vasa can be considered under Meda itself.Discussion on Medoroga and Sthoulya:In relation to Medo Vriddhi, Medoroga and Sthoulya are the two terms used.There are two different views; one supporting the thought the Sthoulya & Medorogais one and the same. The other differs this thought & proposes that they are twodifferent entities.Supporting views for Sthoulya as equivalent to Medoroga (Saadharmya):1. Chakrapani in his book “Chakradutta” has followed the sequence adopted byMadhavakara in “Madhava Nidana” for the description of various diseases. But,Chakrapani has described Sthoulya under the heading of Sthoulya Chikitsa, whereas in M.N., this is described under Medoroga. So, for the same Medorogadescribed by Madhava, Chakrapani advises treatment under Sthoulya chikitsa.This proves that both diseases are one and the same.2. Acharya Charaka has used the term Medasvi, Medovruddhi in the context ofSthoulya to describe a Sthoola person.Reasons to say that Sthoulya and Medoroga are different (Vaidharmya):1. Sushruta & Vagbhata has listed Medoroga among Vamana arha Vyadhi andSthoulya is listed under Vamana anarha vyadhis by the same authors. ButVagbhata himself opines to adopt Samshodhana roopi langhana in case ofAtisthoola.2. None of the Acharyas or commentators has used Medoroga as synonym forSthoulya.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-20091343. Sthoulya & Medoroga are described in the same chapter under two separateheadings in Basavarajeeyam.4. CCRAS has co-related Medoroga to lipid disorders in the book “Studies onGuggulu”. It suggests that Medoroga & Sthoulya are two different diseases.Though there are conflicting views on this topic, both Medoroga and Sthoulyahave Medovikruti and based on the Saadharmya and Vaidharmya we may infer thatMedoroga is Lipid disorders and Sthoulya is Obesity.Discussion on Sthoulya:The disease Sthoulya is defined as Sthoolata bhaava, in modern Science tooObesity is defined in similar terms as a state of excess adipose tissue mass.Sthoulya is of three types i.e. Hina, Madhya and Ati Sthoulya. This could beinterpreted in relation to B.M.I. as follows: 25 – 30 : Over Weight : Hina Sthoulya 30 – 40: Obese : Madhyama Sthoulya >40 : morbid Obesity : Ati Sthoulya.Discussion on Nidana Panchaka of Sthoulya:1. Nidana (Causative Factors / Aetiology) Ahaaraatmaka Nidana -The quantitative (Ati bhojana & Adhyashana – excessive intake) & qualitativedefects (Ati guru, Snigdha, Sheeta, Madhura, amlarasa, sleshmala Aahara, navanna,navamadhya, Mamsa, gorasa, ikshu vikruti sevana – excessive intake of carbohydrate& fat rich food) can be known as the Ahaaraatmaka Nidana for Sthoulya.It is an established fact that under many circumstances the body convertscarbohydrates into fat through intermediary process. Most of the long chain fattyacids are derived or synthesized from glucose & glucose in turn is the ultimatebreakdown of carbohydrates. Thus, there is a close relationship between thetransformation of carbohydrates & synthesis of fat.The food components like oils & fats are popularly known as lipid formsnotable dietary constituents which results in increased Medas.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009135Obesity arises only when the intake of food is in excess quantity with respectto physiological requirement of the body. Hence an understanding of calorific valuesof the dietary ingredients could help to plan a balanced diet.A chart of dietary calorie value per 100 g is given below, which will be veryhelpful in planning diet schedule for an obese person.Table 112: Dietary Calorie ValueFoodstuffs CalProMg.FeMg.Vit AMg.Vit B1Mg.Vit B2Mg.NiacinMg.Vit CMg.1 2 3 4 5 6 7 8 9CerealsMaizeRagiRice (milled)Rice (Parboiled)WheatRice(hand ounded)Wheatflour(refined)JowarBajraPulsesPeas (dry)Red gram dhalBlack gram dhalGreen gram dhalBengal gram, wholeSoyabeanLeafy VegetablesSpinachCabbageRadish leavesBathua leavesMustard leavesCoriender leavesAmaranthOnion topsCauliflower leavesDrum stick leavesRoot & TubersRadishTurnipCarrotPotatoSweet potatoOther VegetableTomato GreenBrinjalPumpkinDrumsticksPapaya GreenCauliflowerLadies fingersMango, rawFrench beansIndian gooseberry1253283453453463463483493613153353473483604322627283034444661669217294897120232425262730354448584.77.36.86.411.87.511.010.411.619.722.324.024.517.143.22.01.83.83.74.03.34.04.75.96.70.70.50.91.61.21.91.41.42.50.72.61.90.73.80.51.117.43.14.04.03.22.55.813.35.15.89.18.510.211.510.90.83.64.216.318.525.5--40.07.00.40.42.20.70.81.80.90.75.30.91.51.55.41.71.2547000108443792206622064833164269.3002.0005.2951.7402.6226.9189.200----11.300503150401019212484184005188150221150.110.420.060.210.450.210.120.370.330.470.450.420.720.300.730.030.060.180.010.030.050.03----0.060.060.040.040.100.080.070.040.060.050.010.040.070.040.080.030.110.190.040.050.170.040.080.130.250.190.150.200.210.150.390.260.090.800.14--0.060.30----0.050.020.040.020.010.040.010.110.040.070.010.100.100.010.060.010.61.11.93.85.03.90.92.83.21.92.62.02.42.13.20.50.40.80.6--0.81.0----0.80.50.40.61.20.70.40.90.50.20.11.00.60.20.30.2600000000000030281208135313599----2201542317243112021201256130314600
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009136Cluster beansField beansNuts & Oil seedsGroundnutCoconut dryFruitsWater melonTomato, ripePapaya, ripeFigsLime sweets(Musambi)PineappleMango, ripeApricot (fresh)Orange (loosejacketed)Cashew fruitAppleGrapes (blue variety)LimeLichiPomegranateSeethaphalSapotaWood, appleDates (fresh)RaisinsMilk and MilkprodctsCurdsBreast milkCows milkGoats milkBuffalo milkCheeseOther Flesh FoodsLiver goatPork, muscleGoat Meat, MuscleLiver, SheepEgg, henEgg, duckMutton60158549662162032374346515353535558596165104110134144308606567721173481071141181501731811943.27.426.706.80.20.90.61.30.80.40.61.00.90.80.30.61.51.11.61.60.87.11.21.83.11.13.23.34.324.120.018.721419.313.513.518.54.52.61.62.77.90.40.51.00.71.20.32.20.40.21.00.50.30.70.31.50.10.6--7.70.39.10.20.30.22.1--2.2--6.32.13.02.533057630005851.1101620.0304.8002.1603263903.0260.000.0117102--2.4102137174182160273--0--22.3001.2001.200310.090.340.900.080.020.120.040.06--0.200.040.040.120.020.120.04--0.020.060.33--0.04--0.070.050.020.050.050.04----0.54--0.360.100.120.180.030.190.130.010.040.060.250.05--0.120.250.130.060.050.030.03--0.060.100.44--0.17--0.190.160.020.190.040.10----0.09--1.700.180.280.270.60.014.10.60.10.40.20.60.00.10.20.60.30.40.20.2--0.40.31.30.10.8--0.70.1--0.10.30.1----2.8--17.60.10.26.84927000712757550395766818021--31143763--113211----2--170----Based on the above, an individual can plan his / her diet as per his / her dailycalorie requirement as shown below: 77(b)
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009137Table No. 113: Calorie Requirement According to Body WeightBODY WEIGHT(Kg)MEN(Kcal)WOMEN(Kcal)35 - 171140 2036 195545 2290 220050 2545 244455 2800 268860 3054 293365 3309 317770 3663 3422Table No. 114 Calorie Requirement According to AgeAGE(Yrs)MEN 55 Kg(Kcal)WOMEN 45 Kg(Kcal)20-39 2800 220040-49 2660 209050-59 2520 198060-69 2240 176070-79 1960 1540In this study Atisampoorana, Ati Madhura, Sheeta, Snigdha Ahara,Adhyashana were elicited in majority of cases. Viharatmaka Nidana:Avyayama, Avyavaya, Cheshta dwesha etc i.e. an extreme degree of inactivityoften leads to Sthoulya. Excessive calorie intake more than energy expenditure leadsto Sthoulya. The energy expenditure by daily activities could be known as below:
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009138Table No. 115: Energy need for everyday activitiesActivitiesCaloryconsumptionper minuteActivitiesCaloryconsumptionper minuteSelf-Care ActivitiesRest, lying faceupwardsSittingStanding (easy posture)EatingTalkingDressing, UndressingWashing hands, FaceWalking to verifyShower BathWaliking downstairsHouse Hold Worksewing by handFloor SweepingFurniture PolishingSmall cloth washingScrubbing FloorsMaking BedsIroningHanging washedclothes1.01.21.41.41.42.32.53.64.25.21.41.72.43.03.63.94.24.5Recreational ActivitiesPainting sittingCar drivingSlowhorse ridingVolleyballBowlingCycling to verifyGolfingSwimming 18 mts./ min.DancingGardeningTennis PlayingHorse TrottingSkiingSquashProfessional ActivitiesSewing by machineBrick placingPlasteringTractor PloughingCarpentryHand mowing of lawnShovelling2.02.83.03.54.44.55.05.05.55.67.18.09.910.22.94.04.14.26.87.38.0In this study Avyayama, Divasvapna and Bhojonottara jalapana was elicited inmajority of Patients.The two Nidanas i.e. Aahaaraatmaka and Vihaaraatmaka acts hand in hand incausation of Sthoulya or otherwise. When energy intake in the form ofAahaaraatmaka Nidana is greater than the energy output in the form of physicalactivity, then they become a causative factor for obesity. This can be betterunderstood by the illustration below:
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009139Illustration 43: Showing Energy BalanceRequirementIntakeEnergy intake < energy requirement, therefore weight lossRequirementIntakeEnergy intake = energy requirement, therefore weight stableRequirementIntakeEnergy intake > energy requirement, therefore weight gain
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009140 Maanasika Nidana:In this study no Maanasika Nidanas like Harshanityatva could be elicited. Thisera being a competitive one, no individuals were found who were free from tensionand stress. Beeja swabhavaja:Acc to William boyd, the genetic phenomenon plays a vital role in thecausation of metabolic disorder. The error is the result of an enzymatic defect, whichmay involve protein, carbohydrates, lipids & pigments. A deficiency or absence of anenzyme may lead to an accumulation of substances that normally or intermediates inthe metabolic process. So, combining all i.e. absence of physical activity, sleepingduring day time & intake of foods which increase Kapha etc, makes the end productof digestion to become (abnormally) sweet which in turn causes increase of Medas.This obstructs the nutrient channels of the remaining tissues depriving them ofnutrition. So only fat accumulates in large quantities in the body making the personincapable of all activities.This can be understood as: Vikruti in Beejabhaaga and Beejabhaaga Avayavaof the obese parents leading to Khavaigunyata in relation to Medovaha Srotas by birthin the offspring, making the individual prone to Sthoulya even on slightest indulgencein Nidanas and sometimes even in absence of Ahaaraatmaka, Vihaaraatmaka andMaanasika nidanas. Such Sthoulya can be understood as being due toBeejaswabhaava.Discussion on Poorva roopa of Sthoulya:Though Sthoulya Poorva-Roopa has not been mentioned in the classics, basedon the observation of the prodromal symptoms of the patients included in this studyfew Poorva-Roopas were elicited like Nidradhikya and Alasya. In others it was AlpaVyakta avashta or Avyakta avashta of Roopa.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009141Discussion on Roopa of Sthoulya:In the patients following Roopa were elicited.Highest elicited Roopa were: Chala Sphik, Chala Udara / Udara Parshva Vriddhi,Chala Stana.Moderate Cases showed: Ayathopachaya, Anutsaaha, Aalasya, Alpa vega, Shrama,Sarvakkriyaasu Asaamarthyata, Alpa Bala, Alpa Praana, Nidraadhikya, KshudraShwaasa, Saukumaaryata, Anga Shaithulya, Snigdhangata.Least / non-elicited Roopa were: Moha, Alpa vyavaaya, Gacgadavaani.In Men fat deposition was maximum in Udara region and in Females fat depositionwas maximum in Sphik and Stana region.The Javoparodha symptom, which is one among the Ashta doshas can beinterpreted in two ways: Reduced Zeal / Enthusiasm Java also means Vega. Hence Javoparodha could mean Vega avarodha.Constipation was observed in most patients, which was relieved by the intervention,also there was increase in frequency of Urination.Discussion On Upashaya-Anupashaya In Sthoulya:Rather than Apathya food, producing obesity, Apathya Vihara was observed tobe a stronger Anupashaya / Nidana in Sthoulya.Diwasvapna, Bhojanottara Jalapana, Avyaayaama are Anupashaya.Bhojanapoorva Jalapana, Vyaayaama are Upashaya.Discussion on Samprapti in Sthoulya: Charaka mentions Samprapti as Nidanas→ Medo Vriddhi→ Obstruction toSrotas and thus obstruction to movement of vata→ Increased Vata in Koshtha→Increased Agni→ Increased Food Intake→ Sthoulya. Sushruta mentions as Nidanas →Kapha Vardhana→ Aama→ Madhura Bhavataof Aama Rasa Spreads through out the body→ Medo Vriddhi→ Sthoulya. The Samprapti can be summarized as follows:
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009142Nidanas↓Kapha Vardhana↓Aama↓Madhura Bhavata of Aama Rasa Spreads through out the body↓Medo Vriddhi↓Obstruction to Srotas↓Obstruction to movement of vata↓Increased Vata in Koshtha↓Increased Agni↓Increased Food Intake↓SthoulyaDiscussion on Chikitsa of Sthoulya: This Chikitsa Sootra is nothing but Chikitsa Siddhanta. As known Siddhanta isthe principle which is tested by several Examiners in different angles usingdifferent testing techniques and confirmed to be right at all times. Hence, theChikitsa Siddhanta Guru cha Atarpana is equally true for Sthoulya. The Specific Chikitsa Sootra for Sthoulya i.e. “Guru Cha Atarpanam ChestamSthoolaanaam Karshanam Prati|” is not on applicable for Sthoulya Chikitsa butalso applicable for the Chikitsa of Medo Dhatu and Medovaha Srotas. This can besubstantiated as follows:
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009143 While telling the Chikitsa for Medo Pradoshaja Vikara in Ch.Su.28/26, it hasbeen told to look back to the Ch.Su.21 Chapter. This is nothing but the SootraGuru Cha Atarpanam. The Chikitsa for Medovaha Srotas is mentioned in Ch.Vi.5 where in again ithas been told to refer back to the chapter where Medo Pradoshaja VikaraChikitsa is told that turns out to be nothing but same as the above i.e. GuruCha Atarpana.Thus, this Sootra is told for all the three. In the above we see that Charaka has used Ateetaavekashana Tantrayukti to reachto the exact Chikitsa. The reason why the Chikitsa is told in this pattern is: The same Chikitsa Sootra is applicable in three contexts and it would be“Punarukti Dosha” if repeated at all places. Hence, the actual Sootra has beenmentioned first in the initial instance and in later instances an indication hasbeen given to refer back to the same that is nothing but Ateetaavekshana(Ateeta means past/precedent, Aavekshana means to see i.e. to refer to theprecedent). Also, it gives the reader an opportunity to revise and also to find links betweenmatters described at various places. The Sootra literally means that the desired treatment to make the corpulent to slimdown is the usage of Guru i.e. Heavy and Atarpana i.e. Non-Nourishing Dravyas. The word “Cheshtha” in the Sootra can be understood in different ways- 1. ChaIshtha i.e. the Desired (Treatment for Sthoulya), 2. Chestha as Activity(Exercising etc), 3. To be done (Cheshtham Kaaryam). In this context the first oneholds good and is most suitable. The Atarpana Dravyas are Laghu in property and usage of Guru and Atarpana,which is Laghu, is mentioned in Sthoulya. Hence, a doubt arises as to how can asubstance be both Guru and Laghu at the same time. An effort could be made tounderstand this: Laghuta of Atarpana Dravya is undoubtedly the guna as there is a directmention. Guruta can’t be a guna in this context as a dravya can’t be both Guru andLaghu at the same time. Guru can be understood in general as : 1. Gunatah
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009144Guru, 2. Maatravat Guru. In this context therefore maatravat Guru appears tobe more applicable. In modern parlance these two terms i.e. Guru and Atarpana can be bestinterpreted as Heavy in terms of bulk and Non- Nourishing in terms of LowerCalories. Of the dietary ingredients Fibre rich foods, Vitamin and Mineral richfoods and Water best fit into this description. Carbohydrates, Proteins and Fatsare of higher Calorific value and hence are to be restricted. Analyzing the Dravyas of Pathya-Apathya based on the attributes like Rasa,Guna, Veerya, and Vipaka could help to some extent.Pathya Apathya Rasa PanchakaTable 116: PathyaSl.No NAME RASA GUNA VEERYA VIPAKA1 Madhu Madhura,KashayaGuru, Rooksha Sheeta Madhura/Katu2 Shunthi Katu Teekshna,Guru, RookshaUshna Madhura3 Yava Madhura Rooksha,Sheeta, LaghuSheeta Madhura4 Amalaki Lavana varjitapanchaMrudu Sheeta Madhura5 Prashaatika Madhura,KashayaSnigdha, Laghu Sheeta Madhura6 Shyaamaka Madhura,KashayaSnigdha, Laghu Sheeta Madhura7 Yavaka Madhura,KashayaLaghu, Snigdha Sheeta Madhura8 Joornahva Madhura Rooksha,Sheeta, Guru,MruduSheeta Madhura9 Kodrava Madhura Sheeta Sheeta Madhura10 Mudga Kashaya,MadhuraRooksha,SheetaSheeta Katu11 Kulattha Kashaya, Katu Rooksha Ushna Amla12 Aadhaki beeja Kashaya,MadhuraLaghu Sheeta Katu13 Patola Tikta Rooksha, Laghu Ushna Katu14 Koradooshaka Madhura Sheeta Sheeta Madhura15 Uddalaka Madhura Sheeta Sheeta Madhura16 Mastu Kashaya, Amla Laghu, Sara Sheeta17 Takra Kashaya, Amla Laghu Sheeta Madhura
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200914518 Sigru Katu, Tikta Teekshna,Rooksha, LaghuUshna Katu19 Hingu Katu Teekshna,Laghu, SnigdhaUshna Katu20 Dhaanyaka Kashaya, Tikta,Katu, MadhuraLaghu, Snigdha Ushna Madhura21 Haridra Tikta, Katu Rooksha, Laghu Ushna Katu22 Puraana shaali Madhura,KashayaLaghu, Snigdha Sheeta Madhura23 Pratapta neera Avyakta Laghu, Rooksha Ushna Avyakta24 Dagdhavaartaaka- Laghu - -25 Sura Amla Guru, Snigdha Ushna Amla26 Neevara Madhura Snigdha, Laghu Sheeta Madhura27 Priyangu Madhura, Tikta,KashayaGuru, Rooksha Sheeta Katu28 Chanaka Madhura,KashayaRooksha, Laghu Sheeta Madhura29 Masura Madhura/Kashaya,MadhuraLaghu, Rooksha Sheeta Madhura30 Tuvari Kashaya,MadhuraLaghu Sheeta Katu31 Laajhaa Kashaya,MadhuraLaghu Sheeta MadhuraTable No. 117: ApathyaSl.No Name Rasa Guna Veerya Vipaka1 Mamsa Madhura Guru Naatisheeta Madhura2 Sarpi Madhura Snigdha Sheeta Madhura3 Payaamsi Madhura Mrudu, Snigdha,Shlakshna, Picchila, Guru,MandaSheeta Madhura4 IkshuvikrutiMadhura Sara Sheeta Madhura5 Maasha Madhura Snigdha, Guru Ushna Madhura6 Godhooma Madhura Guru, Sara, Snigdha Sheeta Madhura7 Sita Madhura Guru, Snigdha Sheeta Madhura8 Matsya Madhura,KashayaGuru, Snigdha UshnaIn the Pathyas the Main Rasa is Madhura and Kashaya, Guna is LaghuRooksha, Veerya is Sheeta and Vipaka is Madhura.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009146In the Apathyas the Main Rasa is Madhura, Guna is Guru Snigdha, Veerya isSheeta and Vipaka is Madhura.Hence the Gunas of Pathya and Apathya give a clear picture odf having the effectof Atarpana and Santarpana respectively. The term Atarpana and Apatarana though synonymous and are opposite toSantarpana, there is a slight difference between the two. If we consider the presentstate of body as “0” then a Santarpana dravya would take the body to “+1” level.An Apatarpana dravya will take the body to “-1”. But an Atarpana Dravya beingNon- nourishing neither takes the body to “+1” state nor deplenishes it to “-1”state i.e. Santarpana Dravya is Nourishing, Apatarpana Dravya is Deplenishing,and Atarpana Dravya is Non- Nourishing. The Tantrayuktis used in the Review are: Viparyaya: In context of Medovaha Sroto Dudhti Nidana Avyaayaama isconsidered as a Nidana based on reversed opinion of the Statement that “NaVyaayaama Samam Kinchit Sthoulya Apakarshanam” Hetvartha: The extension of a Principle enunciated at one place to many othrplaces as well. In this study the General Chikitsa for Sthoulya and NidanaParivarjana in Sthoulya are arrived at, by the use of this Tantrayukti. Ateetaavekshana: The Chikitsa Sootra for Medovaha Sroto Dushti and MedoPradoshaja Vikara is got by referring to the previous chapters, which isnothing but Ateetaavekshana. Many other Tantrayuktis too are involved, as “they are the Methodology thatis implied to the writing of any Scientific Works”. This Study too being onesuch work it’s but natural that most Tantrayuktis find their usage andapplicability.Discussion on Drug Review: Of the Ten Drugs of Lekhaneeya Dashemani, Haimavati i.e. Shwetha Vachaaccording to Chakrapani, is not available. Hence, Vacha is used as a substitute. On analyzing the Rasa Panchaka, the drugs mainly are of Tikta Kashaya Rasa,Ushna Veerya, Laghu, Rooksha, Teekshna Guna and Katu Vipaka. Hence, theAtarpana effect is proved beyond doubt. The Guru Guna as discussed is with
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009147respect to Matra but these being medicines can’t be administered in large dose.Hence, Madhu, which is Guru and Atarpana Dravya and is endowed withYogavahi Guna, is used as Anupana, making the combination fit into thedefinition of Guru Cha Atarpana, Thus, applicable in Sthoulya.Discussion on Materials and Methods:Present study is a Controlled Clinical Single Blind study with pre and postdesign where there are three groups. The Group A was treated with a Diet & RegimenProforma Group B was Treated with Lekhaneeya Gana Choorna with MadhuAnupana and the Group C was treated with a combination of both.Reason for Selection of Lekhaneeya Gana Choorna: The Lekhaneeya GanaChoorna is selected as it helps in Lekhana of the body. This is taken to mean“Pattaleekarana” according to SU.Su.46/519, which is nothing but Krishikarana,which is required in Sthoulya.Reason for Selection of Unprocessed Honey: During processing, Honey is exposedto heat. Madhu and Ushnata are viruddha and is said to cause visharoopata. Though itis uncertain whether heated honey is poisonous only when hot or even after it cools, toavoid any ill effects unprocessed honey (Puraana) was procured.Puranata of Madhu was decided based on the reference in Bhava Prakasha, whichsays “Ek samvatsare vrutte puraanatvam” i.e. Honey which is one year old isconsidered Puraana.Inclusion criteria: Reason for Selecting the age group between 20 – 45 years: obesity other thanbeing a health hazard is even give importance due to its cosmetic effects. This agegroup is both health conscious and also gives importance to the Cosmetic effect.Also, age group below twenty being School going Children continuation oftreatment could be a problem and above 45 years specially females could put onweight due to hormonal causes, so were excluded.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009148 BMI more than 30 was included as that group comes under Obese. Below 30BMI are Overweight and above 40 are morbidly Obese. Thus BMI 30-40 wasincluded for the study.Exclusion criteria: Hormonal Causes were excluded as their treatment could require otherconsiderations and there would be need of a different line of treatment altogether. Diabetes and Hypertension were excluded, fore seeing the possible risk ofadverse effects. The Systemic illnesses were excluded, as they would interfere with the course oftreatment.Discussion on Sampling Method and Research Design:Reason for Random Sampling: This type of sampling is used so as to avoid any typeof bias in the study.Lottery method is used in Specific because of small sample size, unavailability of allthe patients at a time and due to the convenience by this method.Reasons for using specific Statistical tests:t-test: This test is used as the sample size is small and so as to find significance of theQualitative data.Chi-square test: This test is used so as to quantify the qualitative data.ANOVA: This test is used as there are multiple variants involved in the study.Repeated measures ANOVA: This test is used as in the study the same sample issubjected to statistical analysis repeatedly at different phases of studyIntervention:Reason for making 3 Groups in the study: This was done so as to get a clear pictureregarding individual efficacies of the interventions and also to know their combinedeffects. This design even would help to compare the efficacies of the three Groups.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009149DISCUSSION ON OBSERVATIONS & RESULTS:After the completion of the study, the data recorded during the study periodwere analysed to get a clear picture of demographic observations and results of thepresent study. The Observations and results have been presented in the previouschapter and this chapter deals with discussion on Observation and Results.Discussion on Observations:The observations are based on the clinical trail of 45 patients classified intothree Groups with 15 Patients in each.Sex:In the present study, 6 were Males (13.3%) & 39 were Females (86.7%). Thisis statistically significant (P value = .000) indicating more prevalence of Sthoulya inFemales, which coincides with the Worldwide Statistics.Age:In the present study, 14 patients (31.1%) were in the age group of 20-29; 20patients (44.4%) were in the age group of 30-39 and 11 patients (24.4%) were in theage group of 40 and above. This observation does not have much significance (Pvalue = .247).Religion:In the present study, 31 patients (68.9%) were Hindus and 14 patients (31.1%)were muslims. Statistical Significance (P value = .011) though indicates that Hindusare seen to have more incidence, clinically the observations are different. Hence alarger sample would give a better picture.Location:In the present study, 12 patients (26.7%) were belonging to Rural area and 33patients (73.3%) were belonging to Urban area. This Value is significant (P value =.002) as the urban population uses more of ready to eat foods, bakery foods, fast foodsetc. which cause Sthoulya and also due to advent and availability of easy transport
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009150and other facilities, the urban population involves least in walking and other physicalactivities adding on to the further causation of Sthoulya.Occupation:In the present study, 24 patients were House wives (53.3%), 4 patients wereTeacher (8.9%), 5 patients were into Business (11.1%), 6 patients were intoAdministration (13.3%), 2 patients were Students (4.4%) and 4 patients were Manualworkers (8.9%). This value is significant(P value = .000) and shows that housewivesare most prone to Sthoulya. The reason though is not easy to comprehend.Socio-Economic Status:In the present study, 12 patients belonged to Lower middle class (26.7%), 22patients belonged to Middle class (48.9%) and 11 patients belonged to Upper middleclass (24.4%). This observation does not have much significance (P value = .085).Education:In the present study, 1 patient was uneducated (2.2%), 3 patients had studiedtill Primary (6.7%), 7 patients had studied till Middle School (15.6%), 16 patients hadstudied till High School (35.6%), 16 patients were Graduates (35.6%) and 2 patientswere Post graduates (4.4%).Though the observation is statistically significant (P value = .000), the findingcan’t be clinically established.Family History:In the present study, 16 patients (35.6%) did not have a Family history ofSthoulya, 5 patients (11.1%) had Paternal history of Sthoulya, 16 patients (35.6%) hadMaternal history of Sthoulya and 8 patients (17.8%) showed the presence of bothPaternal and Maternal history of Sthoulya. This observation is statistically significant(P value = .038) and may be supported by the view that the main culprit in Sthoulyai.e. “Medo Dhatu” its moola Sthanas i.e. “Vapavahana” and “Vrukka”, all three are“Matruja Avayavas”. Hence by Beeja Swabhava Main inheritance could be from themother.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009151Nature Of Work:In the present study, 7 patients were doing sedentary work (15.6%), 4 patientswere doing Mild work (8.9%), 32 patients were doing Moderate manual work(71.1%) and 2 patients were doing Hard Manual work (4.4%). Statistically theObservation is highly significant (P value = .000) and it points to the fact thatSthoulya is more in the patients involved in Moderate Physical activity. But,“classics” point more towards higher incidence of Sthoulya in people with SedentaryLife style. The Sample size of this study is small hence; a larger sample size may helparrive at definite conclusion.Exercising Practice:In the present study, 34 patients did not involve in Exercise (75.6%) and 11patients involved in Exercise (24.4%). This finding is statistically significant (P value= .001) and also coincides with the Ayurvedic classics, which mention Avyayama asa cause for Sthoulya.Diet:In the present study, 17 patients were Vegetarians (37.8%) and 28 patientswere having Mixed diet (62.2%). Though the diet is statistically non significant (Pvalue = .101), clinically it is observed that incidence of Sthoulya is more in peoplehaving Mixed Diet.Hours of day Sleep:In the present study, 32 patients (71.1%) were in the habit of Day sleep and 13patients (28.9%) were not. The observation shows Significant value(P value = .005)pointing to the fact that Sthoulya is more in people not involving in Day sleep, whichis contradictory to the fact that day sleeping contributes to the disease (Seen bothClassically and Clinically).Hours Of Night sleep:In the present study, 8 patients slept for 6-6.9 hrs at night (17.7%), 20 patientsslept for 7-7.9 hrs at night (44.44%), 14 patients slept for 8-8.9 hrs at night(31.11%)and 3 patients slept for 9-9.9 hrs at night (6.66%).
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009152In the sample size of 45, 7.5 hrs was the average sleeping hour at night. 6hrswas minimum sleeping hours at night. Based on this test value, significance of nightsleeping hours was calculated. The night sleeping hours had a significant (P value =.000) effect on Sthoulya (.000) i.e. more the hours of sleep more is the incidence ofSthoulya, which coincides the clinical observation too.Habits:In the present study, 1 patient (2.2%) had no Habits, 16 patients (35.6%) hadthe Habit of taking tea, 18 patients (40%) had the Habit of taking coffee, 9 patients(20%) had the Habit of taking both tea and coffee, 1 patient (2.2%) had the Habit oftaking tea, smoking cigarette and drinking alcohol. The observation is statisticallysignificant (P value = .000) wherein; incidence of Sthoulya is high in patients havingthe habit of taking coffee followed by tea. The reason for this finding is difficult tocomprehend.Number of children:In the present study, 12 patients (26.7%) had no kids, 8 patients (17.8%) had 1kid, 15 patients (33.3%) had 2 kids, 5 patients (11.1%) had 3 kids, 3 patients (6.7%)had 4 kids and 2 patients (4.4%) had 5 kids. The finding is Significant statistically (Pvalue = .003) but it is clinically irrelevant. An effort is therefore, made to findrelevance by interlinking the number of married patients with number of issues infollowing discussion.Marital Status:In the present study, 7 patients were unmarried (15.6%) and 38 patients weremarried (84.4%). The finding is Significant statistically (P value = .000) and indicateshigher incidence of Sthoulya in married. The reason is difficult to comprehend.Of the38 married patients, 13.2% i.e. 5 patients did not have issues which points towards theincidence of infertility in the patients of Sthoulya. Study using larger sample wouldput better light on this finding.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009153Prakruti:In the present study, 3 patients (6.7%) were of Vata Prakruti, 2 patients (4.4%)were of Pitta Prakruti, 2 patients (4.4%) were of Kapha Prakruti, 15 patients (33.3%)were of Vata Pitta Prakruti, 10 patients (22.2%) were of Vata Kapha Prakruti, and 13patients (28.9%) were of Pitta Kapha Prakruti. The observation is statisticallysignificant (P value = .000) and indicates higher incidence of Sthoulya in the patientshaving Vata Pitta Prakruthi followed by patients of Pitta Kapha Prakruti. The reasonis not evident.Dushya:In the present study, Dushya involved in 44 patients is Meda (97.8%), and in 1patient it is Meda and Shukra (2.2%). The observation is statistically significant (Pvalue = .000) showing the main Dushya involved in Sthoulya is Meda which is wellestablished beyond doubts.Sara:In the present study, 3 patients had Avara Sara (6.7%), 41 patients hadMadhyama Sara (91.1%) and 1 patient had Pravara Sara (2.2%) The observation isstatistically significant (P value = .000) indicating most patients of Sthoulya hadMadhyama Sara.Samhanana:In the present study, 1 patient had Avara Samhanana (2.2%) and 44 patientshad Madhyama Samhanana (97.8%) The observation is statistically significant (Pvalue = .000) indicating most patients of Sthoulya had Madhyama Samhanana.Satmya:In the present study, 12 patients had Avara Satmya (26.7%), 27 patients hadMadhyama Satmya (60%) and 6 patient had Pravara Satmya (13.3%). Theobservation is statistically significant (P value = .000) indicating most patients ofSthoulya had Madhyama Satmya.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009154Sattva:In the present study, 1 patient had Avara Sattva (2.2%), 40 patients hadMadhyama Sattva (88.9%) and 4 patient had Pravara Sattva (8.9%). The observationis statistically significant (P value = .000) indicating most patients of Sthoulya hadMadhyama Sattva.Abhyavaharana Shakti:In the present study, 29 patients had Madhyama Poorvatana AbhyavaharanaShakti (64.4%) and 16 patients had Pravara Poorvatana Abhyavaharana shakti(35.6%).19 patients had Madhyama Adhyatana Abhyavaharana Shakti (42.2%) and26 patients had Pravara Adhyatana Abhyavaharana shakti (57.8%).In past, higher percent of patients had Madhyama Abhyavaharana Shakti but, at timeof approaching, higher percent of them had Pravara Abhyavaharana shakti provingthat, Ati Matra Bhojana leads to Sthoulya.Jarana Shakti:In the present study, 32 patients had Madhyama Poorvatana Jarana shakti(71.1%) and 13 patients had Pravara Poorvatana Jarana shakti (28.9%).33 patients had Madhyama Adhyatana Jarana shakti (71.1%) and 13 patients hadPravara Adhyatana Jarana shakti (28.9%). There was no difference in Jarana shaktibetween Past and Present.Vyayama Shakti:In the present study, 10 patients had Avara Vyayama Shakti (22.2%), 33patients had Madhyama Vyayama Shakti (73.3%) and 4 patients had PravaraVyayama Shakti (4.4%). The observation is statistically significant (P value = .000)indicating most patients of Sthoulya had Madhyama Vyayama Shakti.Agni:In the present study, 27 patients had Teekshna Agni (60%) and 18 patients hadVishama Agni (40%). The observation is statistically non significant (P value = .180).
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009155Koshtha:In the present study, 16 patients had Madhyama Koshtha (35.6%) and 29patients had Kroora Koshtha (64.4%). The observation is statistically non significant(P value = .053).DISCUSSION ON RESULTS:Weight:The change in Weight before treatment, after treatment and after follow up issignificant in all three groups but there is no significant difference in change ofWeight between the groups. But comparing the mean values, overall effect of GroupC is best.Body Mass Index:The change in B.M.I. before treatment, after treatment and after follow up issignificant in all three groups but there is no significant difference in change of B.M.I.between the groups. But comparing the mean values, overall effect of Group B is best.Waist Hip Ratio:The change in Waist Hip Ratio before treatment, after treatment and afterfollow up is significant in all three groups but there is no significant difference inchange of Waist Hip Ratio between the groups. But comparing the mean values,overall effect of Group A & C is better.Shwasa Krucchrata:The change in Shwasa Krucchrata parameter before treatment, after treatmentand after follow up is significant in all three groups but there is no significantdifference in change of Shwasa Krucchrata parameter between the groups. Butcomparing the mean values, overall effect of Group B is best.Utsaaha Haani:The change in Utsaaha Haani parameter before treatment, after treatment andafter follow up is significant in all three groups but there is no significant difference in
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009156change of Utsaaha Haani parameter between the groups. But comparing the meanvalues, overall effect of Group C is best.Sarvakriyaasu Asamarthata:The change in Sarva Kriyaasu Asamarthata parameter before treatment, aftertreatment and after follow up is significant in all three groups but there is nosignificant difference in change of Sarva Kriyaasu Asamarthata parameter betweenthe groups. But comparing the mean values, overall effect of Group C is bestSweda:The change in Sweda parameter before treatment, after treatment and afterfollow up is significant in all three groups but there is no significant difference inchange of Sweda parameter between the groups. But comparing the mean values,overall effect of Group A is bestWaist Circumference:The change in Waist Circumference before treatment, after treatment and afterfollow up is significant in all three groups but there is no significant difference inchange of Waist Circumference between the groups. But comparing the mean values,overall effect of Group B is bestHip Circumference:The change in Hip Circumference before treatment, after treatment and afterfollow up is significant in all three groups but there is no significant difference inchange of Hip Circumference between the groups. But comparing the mean values,overall effect of Group C is bestMid arm Circumference:The change in Mid-Arm Circumference before treatment, after treatment andafter follow up is significant in all three groups. There is also a significant differencein change of Mid-Arm Circumference between the groups. The reduction is maximumin Group C, Moderate in Group B and Minimum in Group A. Thus, comparing themean values, overall effect of Group C is best.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009157Wrist Circumference:The change in Wrist Circumference before treatment, after treatment and afterfollow up is significant in all three groups but there is no significant difference inchange of Wrist Circumference between the groups. But comparing the mean values,overall effect of Group B is bestThigh Circumference:The change in Thigh Circumference before treatment, after treatment and afterfollow up is neither significant in the three groups nor the difference is significantbetween the groups. But comparing the mean values, overall effect of Group A isbest.Kshudha:There is significant change in Kshudha before treatment, after treatment andafter follow up. Initially only 20 patients were having normal Kshudha, which wasmade 34 after treatment and was 42 after follow up. Thus, 22 patients hunger wasbrought back to normalcy.Pipaasa:There is no significant change in Pipaasa before treatment, after treatment andafter follow up. Initially 38 patients were having normal Pipaasa, which was made 41after treatment and was 42 after follow up. Thus, 4 patients hunger was brought backto normalcy.Clinical Improvement:Based on the Clinical Improvement Grading following is reasons could begiven for the below findings: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).This may be due to the fact that the Group C is showing Combined effect and theCombination may therefore be said to have Synergism. During the period of administration of treatment modality best result was seenin Group C (Mixed), followed by Group B (Lekhana Gana Choorna), then
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009158Group A (Pathya- Apathya). The reason for this is same as the above. During the period of follow up best result was seen in Group A (Pathya-Apathya), followed by Group B (Lekhana Gana Choorna), then Group C(Mixed). Hence, reversal of lost weight was minimum in Group A (Pathya-Apathya). This may be due to the fact that in Groups B & C there iswithdrawal of the Medicine but Group A though a follow up period thepatients tend to follow the specific diet and regimen which is nothing bur thecontinuation of the treatment itself. Hence its effect continues even in thefollow up period.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009159RECOMMENDATION FOR FURTHER STUDY: The same study could be done with a larger sample for a more accurate resultsand conclusions. The Lekhaneeya Gana Choorna, being highly non-palatable, it could be usedin capsule form or any other palatable form (according to convenience). Lipid profile could be another investigation, which could be included for studyso as to find correlation between obesity and hyperlipedemia.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009160CONCLUSIONOn the basis of conceptual Analysis and Observations made in this clinical Study, thefollowing conclusion can be drawn: The disease Sthoulya effectively represents Obesity. Medoroga and Sthoulya are similar as both are medovikruti but are not sameand hence can be compared to lipid disorder and obesity respectively. The Guru Atarpana can be best understood as Maatraavat Guru and Atarpanaas Non- Nourishing. The Pathya given to the groups as intervention is undoubtedly Atarpana, butthe Guruta attribute is made available by consumption in larger quantity/ The Lekhaneeya Gana Choorna is Atarpana and the Guruta attribute isattained by the samyoga of Madhu Anupana which is Guru and Yogavahi. The symptom of Javoparodha is effectively managed by Lekhaneeya GanaChoorna as seen by its effect of relieving constipation and increasingfrequency of micturation. Individual effect of Group A(Pathya-Apathya) is best during follow up period. Individual effect of Group B(Lekhaneeya gana Choorna) is moderate in all thephases of treatment. Individual effect of Group C(Mixed) is best during the phase of treatment andduring overall intervention. Guru cha Atarpana being a Chikitsa Siddhanta is proved beyond doubts for alltimes and its utility and applicability is proved in this era too as being effectivein Sthoulya by this study.
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009161SUMMARYIn spite of technological advances & breakthrough in modern medicine we arewitnessing a renewed interest in the alternate therapies. Ayurveda is one such Science,which is increasingly taking its place along side the modern forms of treatment.The present study finds its place in providing a safe and efficaciousintervention with regards to Sthoulya. Being a Single Blind comparative study, threegroups were made- Group A, Group B & Group C. Hence the study was designed tocompare & understand the effect of the 3 Groups i.e. Pathya- Apathya, LekhaneeyaGana Choorna and the combined Effect of both.The present dissertation work is divided into 2 parts. The first part deals withthe Introduction, Nirukti, Paribhasha, Concept of Srotas, Medovaha Srotas, MedoDhatu & Nidana, Poorva Roopa, Roopa, Upashaya-Anupashaya, Samprapti,Upadrava, Sadhyasadhyata, Arista Lakshana, Chikitsa, and Pathya- Apathya ofSthoulya. In the same part modern review on Obesity was also dealt. Drug review isdealt at the end of first part.In the second part, Materials & Methods, Observation of clinical trials,Results, Statistical tables & graphs, Discussion, Summary, and Conclusions are dealt.A total of 45 Patients were selected for the study.The Module of Ahara Vihara (Constructed) was advised to the patients ofGroup A, ‘Lekhaneeya Gana Choorna’ with Madhu Anupana in the dose of 6g, twicea day (in empty stomach morning and night), was given as oral administration toGroup B. The Module of Ahara Vihara (Constructed) along with ‘Lekhaneeya GanaChoorna’ with Madhu Anupana in the dose of 6g, twice a day (in empty stomachmorning and night), was advised to the patients of Group C. The Interventions werefollowed for duration of 60 days. Followed by a follow-up period of 30 days.The different parameters of the study were observed and recorded Beforetreatment, After treatment and After the follow-up. The Observations and Resultswere statistically analyzed for better interpretation.During the period of complete (Overall) treatment best result was seen inGroup C (Mixed), followed by Group B (Lekhana Gana Choorna), then Group A(Pathya- Apathya). During the period of administration of treatment modality bestresult was seen in Group C (Mixed), followed by Group B (Lekhana Gana Choorna),
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009162then Group A (Pathya- Apathya). During the period of follow up best result was seenin Group A (Pathya- Apathya), followed by Group B (Lekhana Gana Choorna), thenGroup C (Mixed). Hence, reversal of lost weight was minimum in Group A (Pathya-Apathya).The conclusion derived on the basis of detailed observation & deep study issubmitted under the chapter on Conclusion. Future perspective of the study ishighlighted as an aid for the future research workers.
  • 163Sl.No. Pt.No Pt.Name OP.No Age Sex Rel M.S L Occ SES Edu FH NOW Ex Diet HODS HONS H Ob.Htry Pra Dushya Sara SamhananaGROUP A 1 6 Shamila Banu 29524 27 2 2 2 1 1 1 2 1 3 0 2 0.75 8 1 1 5 1 2 22 7 Sona 29640 40 2 2 2 2 6 3 4 2 3 1 1 0 7.5 2 1 6 1 1 23 8 Asma 29843 28 2 2 2 2 1 2 4 2 3 0 2 3.5 8 2 2 6 1 2 24 9 Amattu Salim 29889 28 2 2 2 1 1 1 4 2 3 0 2 0 9.5 5 4 4 2 2 25 11 Shamantha 30208 45 2 1 2 2 1 2 5 2 3 1 1 1.25 7 2 2 5 1 2 26 16 M.C.Shamantakaratna 27704 35 2 1 2 2 2 2 5 0 3 0 1 0 7 5 1 6 1 2 27 18 Uma 27733 36 2 1 2 2 1 2 4 0 3 1 2 0 7.5 2 3 3 1 2 28 19 Vasanthamani 27841 35 2 1 2 2 1 2 3 0 3 1 1 0 6.5 2 2 4 1 2 29 25 Shilpa 27310 28 2 1 2 1 1 3 5 1 3 0 1 I 7 1 1 5 1 2 210 26 Usha 27926 26 2 1 2 1 1 2 3 2 3 0 2 0 8 5 1 5 1 2 211 28 Farhana begum 28353 38 2 2 2 2 1 2 3 1 1 0 2 0.5 6.5 1 5 5 1 2 212 34 Veena 28091 31 2 1 2 2 4 2 5 0 3 1 2 0 8 1 2 4 1 2 213 35 Leelavathi 28097 44 2 1 2 2 6 1 3 2 4 0 2 0 8 2 2 1 1 3 214 44 Usha Rajanna 28524 42 2 1 2 2 4 2 6 0 3 1 1 0 6.5 2 2 2 1 2 215 45 Savitha 30169 25 2 1 2 1 1 1 4 1 3 0 2 0.75 8 2 2 6 1 2 2GROUP B 1 4 ShobhaBN 25964 30 2 1 2 2 1 2 4 2 3 0 2 0 8 5 1 4 1 2 22 5 Anuradha Nayak 26467 45 2 1 2 2 1 3 5 3 3 1 1 1 7.5 5 2 6 1 1 23 10 Dakshayini 28770 28 2 1 2 2 2 2 5 0 3 0 2 0 7.5 2 1 4 1 2 24 17 Roopa B N 28417 37 2 1 2 2 1 3 4 3 3 1 1 0 6.5 5 2 4 1 2 25 20 Chandrakumar 29384 31 1 1 1 2 3 1 4 0 2 0 2 0 8 6 0 2 1 2 26 21 Nagkiran 29433 31 1 1 2 2 4 3 5 3 1 0 1 0 7.5 2 0 3 1 2 27 23 Tasneem Taj 8303 31 2 2 2 1 1 1 3 3 3 0 2 0 7.5 5 3 5 1 2 28 27 Mujjassum Sultana 27967 21 2 2 1 2 1 1 4 2 3 0 2 3 7 2 0 4 1 2 29 29 Teeen 30369 35 2 2 2 1 1 2 3 3 3 0 2 0 9 1 4 6 1 2 210 30 Shahajahan 25724 45 2 2 1 2 1 1 1 3 1 0 2 1 8 0 0 31 1 2 211 31 Vaishali 29020 35 2 1 2 2 3 3 5 0 1 0 2 0 7.5 1 2 6 1 2 212 38 Seeja 30090 28 2 1 2 2 3 2 4 2 3 0 2 1 7.5 2 1 1 1 2 213 40 T M Shwetha 1435 20 2 1 1 2 5 3 5 0 1 0 1 2 8 1 0 31 1 2 214 41 Narasimha Raju 28381 37 1 1 2 2 4 2 5 0 3 0 2 0 7 2 0 4 1 2 215 43 Roopa 30435 25 2 1 2 2 1 2 4 0 3 0 2 0 8 1 2 31 1 2 2GROUP C 1 1 Vijay 28522 21 1 1 1 2 3 2 4 0 1 0 2 3 7.5 2 - 6 1 2 22 2 Nazeema Begum 28379 38 2 2 2 2 1 1 2 0 2 0 2 0 8 1 4 6 1 1 13 3 Sharada 28742 44 2 1 2 2 1 2 4 2 3 0 1 0 6 2 2 5 1 2 24 12 Hemalatha 28760 26 2 1 2 2 5 2 5 3 2 0 2 0 7 1 0 4 1 2 25 13 Bagyakakshmi 27610 45 2 1 1 2 4 2 5 2 3 1 1 0 6 5 0 5 1 2 26 14 Rajendra 27610 39 1 1 2 1 6 2 5 0 4 1 1 0 7.5 1 0 6 1 2 27 15 Chaayaraani 29451 30 2 1 2 1 1 2 5 0 3 1 1 0 8 2 3 1 1 2 28 22 Yasmin Taj 8302 30 2 2 2 1 1 1 3 3 3 0 2 0 7.5 1 3 5 1 2 29 24 Vajeeha Banu 27644 45 2 2 2 2 2 3 5 2 3 0 2 1 9 5 5 6 1 2 210 32 Saroja 28050 40 2 1 2 2 4 3 4 0 1 0 2 0 8 1 2 6 1 2 211 33 Lakshmi 28074 36 2 1 2 2 2 3 6 2 3 0 1 0 6.5 1 2 6 1 2 212 36 Choodamani 28075 30 2 2 2 1 1 2 4 2 3 0 1 0 6 2 2 5 1 2 213 37 Mahadevamma 28555 38 2 1 2 1 1 1 2 2 3 0 1 0 8 1 3 31 1 2 214 39 Sameera 9045 21 2 2 1 2 3 3 5 1 2 0 2 0 8 1 0 31 1 2 215 42 M Kumar 28408 45 1 1 2 2 6 1 4 2 3 0 2 0 7.5 2 0 4 1 2 2
  • 164Sl.No.Pt.NoPt.NameOP.NoSatmyaSattvaAbhyavaharan BTAbhyavaharanATJaranaBTJaranaATVyayamashaktiAgniKoshtaHeightDate BT Date ATGROUP A1 6 Shamila Banu 29524 1 2 3 3 2 2 2 1 1 147 11-Nov-07 15-Jan-082 7 Sona 29640 1 2 3 3 3 3 2 1 2 154.5 12-Nov-07 12-Jan-083 8 Asma 29843 1 2 3 3 3 3 1 1 1 150 13-Nov-07 13-Jan-084 9 Amattu Salim 29889 2 2 2 2 2 2 2 2 2 147 13-Nov-07 13-Jan-085 11 Shamantha 30208 1 2 2 3 3 3 2 1 2 155 16-Nov-07 15-Jan-086 16 M.C.Shamantakaratna 27704 1 2 3 3 2 2 2 1 1 151 24-Oct-07 24-Dec-077 18 Uma 27733 2 2 2 2 2 2 3 2 2 158 24-Oct-07 23-Dec-078 19 Vasanthamani 27841 2 2 3 3 2 2 2 1 2 157 23-Oct-07 24-Dec-079 25 Shilpa 27310 2 2 2 2 3 3 2 1 2 151 24-Oct-07 24-Dec-0710 26 Usha 27926 1 2 2 2 2 2 2 2 2 163 26-Oct-07 24-Dec-0711 28 Farhana begum 28353 2 2 3 3 3 3 1 1 1 150 26-Oct-07 03-Jan-0812 34 Veena 28091 2 2 2 3 2 2 2 1 2 147 27-Oct-07 26-Dec-0713 35 Leelavathi 28097 2 2 2 3 2 2 2 1 2 159 27-Oct-07 25-Dec-0714 44 Usha Rajanna 28524 2 2 3 3 2 2 2 1 1 158 29-Oct-07 27-Dec-0715 45 Savitha 30169 2 2 2 2 2 2 2 2 1 158 16-Nov-07 13-Jan-08GROUP B1 4 ShobhaBN 25964 1 2 2 2 2 2 2 2 1 156 05-Oct-07 05-Dec-072 5 Anuradha Nayak 26467 1 3 3 3 3 3 2 1 1 160 17-Oct-07 12-Dec-073 10 Dakshayini 28770 2 2 2 3 3 3 2 1 2 150 31-Oct-07 28-Dec-074 17 Roopa B N 28417 3 2 2 2 2 2 2 2 2 158 01-Nov-07 31-Dec-075 20 Chandrakumar 29384 1 2 2 2 2 2 2 2 1 162 07-Nov-07 07-Jan-086 21 Nagkiran 29433 2 2 3 3 3 3 2 1 1 180 07-Nov-07 07-Jan-087 23 Tasneem Taj 8303 2 2 3 3 2 2 2 1 2 151 24-Oct-07 23-Dec-078 27 Mujjassum Sultana 27967 1 2 2 2 2 2 2 2 2 147 03-Nov-07 14-Jan-089 29 Teeen 30369 2 2 3 3 2 2 2 1 2 154 03-Nov-07 04-Jan-0810 30 Shahajahan 25724 2 2 3 3 2 2 1 1 2 151 24-Oct-07 25-Dec-0711 31 Vaishali 29020 3 2 2 2 2 2 1 2 2 152 03-Nov-07 03-Jan-0812 38 Seeja 30090 3 2 2 2 2 2 2 2 2 147 15-Nov-07 15-Jan-0813 40 T M Shwetha 1435 1 1 2 2 2 2 1 2 2 174 21-Nov-07 17-Jan-0814 41 Narasimha Raju 28381 2 2 2 3 2 2 2 1 2 161 29-Oct-07 27-Dec-0715 43 Roopa 30435 3 2 2 3 2 2 2 1 2 149 05-Nov-07 07-Jan-08GROUP C1 1 Vijay 28522 3 2 3 3 3 3 1 1 1 179 29-Oct-07 26de20-72 2 Nazeema Begum 28379 3 2 2 3 2 2 1 1 2 156 30-Oct-07 30-Dec-073 3 Sharada 28742 2 2 2 3 3 3 2 1 1 149.5 30-Oct-07 30-Dec-074 12 Hemalatha 28760 2 3 2 2 2 2 2 2 2 145 30-Oct-07 30-Dec-075 13 Bagyakakshmi 27610 2 2 2 2 2 2 2 2 1 142 23-Oct-07 24-Dec-076 14 Rajendra 27610 2 3 2 2 2 2 3 2 2 167 23-Oct-07 24-Dec-077 15 Chaayaraani 29451 2 2 2 2 2 2 1 2 2 153 07-Nov-07 07-Jan-088 22 Yasmin Taj 8302 2 2 3 3 3 3 2 1 2 148 24-Oct-07 23-Dec-079 24 Vajeeha Banu 27644 2 2 2 2 2 2 2 2 1 154 24-Oct-07 27-Dec-0710 32 Saroja 28050 2 2 3 3 2 2 1 2 2 168 27-Oct-07 27-Dec-0711 33 Lakshmi 28074 2 2 3 3 3 2 2 1 2 160 27-Oct-07 27-Dec-0712 36 Choodamani 28075 2 2 2 3 3 3 2 1 1 157.5 28-Oct-07 29-Dec-0713 37 Mahadevamma 28555 2 2 2 2 2 2 2 2 2 151 28-Oct-07 27-Dec-0714 39 Sameera 9045 1 3 2 2 2 2 1 1 1 163 15-Nov-07 19-Jan-0815 42 M Kumar 28408 2 2 2 3 2 2 2 1 2 167 29-Oct-07 25-Dec-07
  • 165Sl.No.Pt.NoPt.NameOP.NoDate FUWt.BTWt.ATWt.FUBMIBTBMIATBMIFUW:HBTW:HATW:HFUSKBTSKATSKFUUHBTUHATUHFUSABTSAATGROUP A1 6 Shamila Banu 29524 10-Feb-08 3 3 3 2 2 2 3 3 3 1 1 1 1 1 1 1 12 7 Sona 29640 12-Feb-08 4 3 4 2 2 2 3 3 3 1 1 1 1 1 1 1 13 8 Asma 29843 13-Feb-08 4 4 4 3 3 3 3 3 3 2 1 1 1 1 1 1 14 9 Amattu Salim 29889 13-Feb-08 4 4 4 3 3 3 3 3 3 2 1 1 1 1 1 1 15 11 Shamantha 30208 15-Feb-08 4 3 3 3 2 1 3 3 2 2 2 1 2 1 1 1 16 16 M.C.Shamantakaratna 27704 28-Jan-08 3 3 3 2 1 1 2 2 2 3 2 2 1 1 1 1 17 18 Uma 27733 24-Jan-08 3 3 3 2 1 1 2 2 2 1 1 1 1 1 1 1 18 19 Vasanthamani 27841 23-Jan-08 3 3 3 2 1 1 2 2 2 2 2 2 1 1 1 1 19 25 Shilpa 27310 24-Jan-08 3 3 3 2 1 1 2 3 2 1 1 1 1 1 1 1 110 26 Usha 27926 26-Jan-08 4 3 3 2 2 2 3 3 3 2 1 1 1 1 1 1 111 28 Farhana begum 28353 13-Feb-08 4 4 4 2 2 2 3 3 3 3 3 2 1 1 1 1 112 34 Veena 28091 28-Jan-08 4 4 4 3 3 3 3 3 3 1 1 1 1 1 1 1 113 35 Leelavathi 28097 28-Jan-08 3 3 3 2 1 1 3 3 3 2 2 1 1 1 1 1 114 44 Usha Rajanna 28524 27-Jan-08 3 3 3 2 1 1 3 3 3 2 1 1 2 2 1 1 115 45 Savitha 30169 16-Feb-08 3 3 3 2 2 1 3 3 3 2 2 1 2 2 2 1 1GROUP B1 4 ShobhaBN 25964 08-Jan-08 3 3 3 2 1 1 3 3 3 1 1 1 1 1 1 1 12 5 Anuradha Nayak 26467 15-Jan-08 4 4 4 4 4 4 3 3 2 3 2 2 1 1 1 2 13 10 Dakshayini 28770 30-Jan-08 4 4 4 3 3 3 3 3 3 2 2 1 1 1 1 1 14 17 Roopa B N 28417 01-Feb-08 4 3 3 2 1 1 3 3 3 2 1 1 1 1 1 1 15 20 Chandrakumar 29384 07-Feb-08 3 3 3 2 1 1 2 2 2 1 1 1 1 1 1 1 16 21 Nagkiran 29433 07-Feb-08 3 3 3 2 1 1 2 2 2 1 1 1 1 1 1 1 17 23 Tasneem Taj 8303 24-Jan-08 4 3 3 3 2 2 3 3 3 2 1 1 1 1 1 1 18 27 Mujjassum Sultana 27967 13-Feb-08 3 3 3 2 1 1 2 3 2 2 1 1 1 1 1 1 19 29 Teeen 30369 04-Feb-08 3 3 3 2 1 1 3 3 3 3 2 2 1 1 1 1 110 30 Shahajahan 25724 23-Jan-08 4 4 4 3 3 3 2 2 2 3 2 2 1 1 1 1 111 31 Vaishali 29020 04-Feb-08 3 3 3 2 1 1 3 3 3 3 2 2 2 2 1 1 112 38 Seeja 30090 13-Feb-08 4 4 4 3 3 3 2 3 3 2 1 1 2 2 1 1 113 40 T M Shwetha 1435 29-Feb-08 4 3 3 2 1 1 3 3 3 2 2 2 3 2 2 1 114 41 Narasimha Raju 28381 27-Jan-08 4 4 4 3 3 3 3 3 3 3 2 2 1 1 1 1 115 43 Roopa 30435 18-Feb-08 3 3 3 2 1 2 3 3 3 3 2 2 1 1 1 1 1GROUP C1 1 Vijay 28522 29-Jan-08 3 3 3 2 1 1 2 2 2 3 2 2 2 2 1 2 12 2 Nazeema Begum 28379 30-Jan-08 4 4 4 4 3 4 3 3 3 3 2 2 2 2 1 2 13 3 Sharada 28742 30-Jan-08 4 3 3 2 2 2 3 3 3 2 2 2 1 1 1 2 14 12 Hemalatha 28760 30-Jan-08 3 3 3 2 1 1 2 2 2 1 1 1 2 2 1 1 15 13 Bagyakakshmi 27610 21-Jan-08 3 3 3 2 2 2 3 2 3 1 1 1 1 1 1 1 16 14 Rajendra 27610 25-Jan-08 3 3 3 2 2 2 2 2 2 2 1 1 1 1 1 1 17 15 Chaayaraani 29451 07-Feb-08 4 3 3 3 2 2 3 2 2 1 1 1 1 1 1 1 18 22 Yasmin Taj 8302 24-Jan-08 3 3 3 2 1 1 3 3 3 3 2 2 2 2 2 1 19 24 Vajeeha Banu 27644 25-Jan-08 4 4 4 4 3 3 3 3 3 3 2 2 2 1 1 1 110 32 Saroja 28050 27-Jan-08 3 3 3 2 1 1 3 3 3 3 2 2 1 1 1 2 211 33 Lakshmi 28074 27-Jan-08 4 3 3 2 2 2 2 2 2 2 1 1 1 1 1 1 112 36 Choodamani 28075 28-Jan-08 4 3 3 2 2 2 3 3 3 2 1 1 1 1 1 1 113 37 Mahadevamma 28555 27-Jan-08 4 3 3 2 2 2 2 2 2 3 2 2 2 2 1 1 114 39 Sameera 9045 18-Feb-08 4 3 4 3 2 2 3 3 3 3 2 2 1 1 1 1 115 42 M Kumar 28408 27-Jan-08 3 3 3 2 1 1 2 2 2 1 1 1 1 1 1 1 1
  • 166Sl.No.Pt.NoPt.NameOP.N0SAFUSwBTSwATSwFUKsBTKsAT KsFU PiBT PiATPiFUWCBTWCATWCFUHCBTHCATHCFUMACBTMACATGROUP A1 6 Shamila Banu 29524 1 3 2 2 2 2 1 1 1 1 105 102 102 104 106 106 32 312 7 Sona 29640 1 3 2 2 2 2 1 1 1 1 115.5 114 113 115.5 114 114 29 293 8 Asma 29843 1 2 2 2 1 1 1 1 1 1 109.4 110 109 118 118 118 31 314 9 Amattu Salim 29889 1 1 1 1 1 1 1 1 1 1 109.4 110 109 118 118 118 31 315 11 Shamantha 30208 1 1 1 1 2 2 1 1 1 1 110 108 106 122.8 121 120 29.5 296 16 M.C.Shamantkaratna 27704 1 1 1 1 2 2 1 1 1 1 104 101 102 118.5 115.8 115.5 31.5 30.87 18 Uma 27733 1 4 2 2 1 1 1 1 1 1 85.5 84 85 107 105 105 31.5 318 19 Vasanthamani 27841 1 3 2 2 1 1 1 1 1 1 93 92 93 113 110 109 30.2 309 25 Shilpa 27310 1 1 1 1 2 1 1 1 1 1 96 96 97 108.5 108 107 30.5 3010 26 Usha 27926 1 1 1 1 1 1 1 2 2 1 109 105 106 116 115 115 32 3211 28 Farhana begum 28353 1 4 3 3 2 2 1 1 1 1 118 115 114 114 113 113 28.5 2812 34 Veena 28091 1 1 1 1 2 2 1 1 1 1 124 119 116 121.5 121.8 121.8 30.8 2913 35 Leelavathi 28097 1 3 2 2 2 2 1 1 1 1 118 115 113 110 110 110 32 3114 44 Usha Rajanna 28524 1 1 1 1 2 2 1 1 1 1 108 106 106 114 112 112 31 3015 45 Savitha 30169 1 1 1 1 1 1 1 1 1 1 113 112 112 115.6 115 115 31 30GROUP B1 4 ShobhaBN 25964 1 1 1 1 1 1 1 1 1 1 104.5 103 103.5 116.5 115 114 34.5 342 5 Anuradha Nayak 26467 1 3 2 2 2 2 2 2 1 1 129.7 120.5 113.4 129.7 132.4 136.3 43.23 42.63 10 Dakshayini 28770 1 3 2 2 2 1 1 1 1 1 118.2 117 116 116 115 115 35.8 354 17 Roopa B N 28417 1 1 1 1 1 1 1 1 1 1 110 108 107 115 113 113 31.5 315 20 Chandrakumar 29384 1 4 2 2 1 1 1 1 1 1 105 100 102 107 106 105 31 306 21 Nagkiran 29433 1 1 1 1 2 1 1 1 1 1 110 107 109 116 116 115 33.5 33.57 23 Tasneem Taj 8303 1 1 1 1 2 1 1 1 1 1 110 107 108 115 112 110 31 308 27 Mujjassum Sultana 27967 1 2 2 2 1 1 1 1 1 1 97 93.2 90.8 110 102 102.8 29 28.69 29 Teeen 30369 1 1 1 1 2 1 1 1 1 1 114 111 110 112 112 112 31 3010 30 Shahajahan 25724 1 1 1 1 2 1 1 2 2 2 122 118 119 124.5 124 125 32 30.511 31 Vaishali 29020 1 1 1 1 1 1 1 2 1 1 100.5 97.6 97.2 106 105.8 105.3 31.5 29.812 38 Seeja 30090 1 1 1 1 1 1 1 1 1 1 106 105 106 120.5 115.2 116.8 33.4 3313 40 T M Shwetha 1435 1 3 2 2 1 1 1 1 1 1 117 115 114 116 116 115 32.5 3214 41 Narasimha Raju 28381 1 1 1 1 2 1 1 1 1 1 104 103 104 107 107 106 33.5 3315 43 Roopa 30435 1 1 1 1 2 1 1 1 1 1 107 106 105.2 110 110 110.7 29 28.2GROUP C1 1 Vijay 28522 2 1 1 1 2 2 1 1 1 1 110 108.3 108.5 116 114.7 114.5 33 30.22 2 Nazeema Begum 28379 1 4 3 3 2 1 2 1 1 1 126 123 122 127 125 125 37.5 373 3 Sharada 28742 1 2 2 2 2 1 1 1 1 1 111.5 111 110 114 113 113 35.5 354 12 Hemalatha 28760 1 1 1 1 1 1 1 1 1 1 86 86 85 107 105 104 31.5 315 13 Bagyakakshmi 27610 1 1 1 1 1 1 1 2 1 1 100 94 96 106 106 105 32 286 14 Rajendra 27610 1 3 2 2 1 1 1 1 1 1 112.5 110 111 113 112 112 33 327 15 Chaayaraani 29451 1 2 1 1 1 1 1 1 1 1 108.5 105 105 118.5 117 118 34.8 338 22 Yasmin Taj 8302 1 1 1 1 2 1 1 1 1 1 107 103 104 109 113 113 31 319 24 Vajeeha Banu 27644 1 1 1 1 1 1 1 2 2 2 124 123 122 118 115 115 34 3310 32 Saroja 28050 2 2 1 1 1 1 1 1 1 1 113 110 111 115 113 113 32 3111 33 Lakshmi 28074 1 3 2 2 2 2 1 1 1 1 96.5 95 96 116 115 113 33 3212 36 Choodamani 28075 1 1 1 1 2 1 2 1 1 1 112 110 110.5 115 115 114 34.5 3413 37 Mahadevamma 28555 1 1 1 1 1 1 1 1 1 1 101 100 100 115 113 112 32.5 3214 39 Sameera 9045 1 1 1 1 2 1 1 1 1 1 114.3 112 112 110 105 107 33 3115 42 M Kumar 28408 1 3 2 2 2 1 1 2 2 2 108 106 105 103 103 103 32 31
  • 167Sl.No.Pt.NoPt.Name OP.N0MACFUWrCBTWrC AT WrC FU TC BT TC AT TC FUGROUPA1 6 Shamila Banu 29524 1 3 2 2 2 2 12 7 Sona 29640 1 3 2 2 2 2 13 8 Asma 29843 1 2 2 2 1 1 14 9 Amattu Salim 29889 1 1 1 1 1 1 15 11 Shamantha 30208 1 1 1 1 2 2 16 16 M.C.Shamantkaratna 27704 1 1 1 1 2 2 17 18 Uma 27733 1 4 2 2 1 1 18 19 Vasanthamani 27841 1 3 2 2 1 1 19 25 Shilpa 27310 1 1 1 1 2 1 110 26 Usha 27926 1 1 1 1 1 1 111 28 Farhana begum 28353 1 4 3 3 2 2 112 34 Veena 28091 1 1 1 1 2 2 113 35 Leelavathi 28097 1 3 2 2 2 2 114 44 Usha Rajanna 28524 1 1 1 1 2 2 115 45 Savitha 30169 1 1 1 1 1 1 1GROUP B1 4 ShobhaBN 25964 1 1 1 1 1 1 12 5 Anuradha Nayak 26467 1 3 2 2 2 2 23 10 Dakshayini 28770 1 3 2 2 2 1 14 17 Roopa B N 28417 1 1 1 1 1 1 15 20 Chandrakumar 29384 1 4 2 2 1 1 16 21 Nagkiran 29433 1 1 1 1 2 1 17 23 Tasneem Taj 8303 1 1 1 1 2 1 18 27 Mujjassum Sultana 27967 1 2 2 2 1 1 19 29 Teeen 30369 1 1 1 1 2 1 110 30 Shahajahan 25724 1 1 1 1 2 1 111 31 Vaishali 29020 1 1 1 1 1 1 112 38 Seeja 30090 1 1 1 1 1 1 113 40 T M Shwetha 1435 1 3 2 2 1 1 114 41 Narasimha Raju 28381 1 1 1 1 2 1 115 43 Roopa 30435 1 1 1 1 2 1 1GROUPC1 1 Vijay 28522 2 1 1 1 2 2 12 2 Nazeema Begum 28379 1 4 3 3 2 1 23 3 Sharada 28742 1 2 2 2 2 1 14 12 Hemalatha 28760 1 1 1 1 1 1 15 13 Bagyakakshmi 27610 1 1 1 1 1 1 16 14 Rajendra 27610 1 3 2 2 1 1 17 15 Chaayaraani 29451 1 2 1 1 1 1 18 22 Yasmin Taj 8302 1 1 1 1 2 1 19 24 Vajeeha Banu 27644 1 1 1 1 1 1 110 32 Saroja 28050 2 2 1 1 1 1 111 33 Lakshmi 28074 1 3 2 2 2 2 112 36 Choodamani 28075 1 1 1 1 2 1 213 37 Mahadevamma 28555 1 1 1 1 1 1 114 39 Sameera 9045 1 1 1 1 2 1 115 42 M Kumar 28408 1 3 2 2 2 1 1
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  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009168BIBILIOGRAPHIC REFERENCES:1. Vagbhata, Angavibhagam Shareeram Adhyayam, Shaareera sthana, AshtangaHridayam with Vidyotini Hindi commentary by Kaviraj Atrideva Gupta, edited byVaidya Yadunandana upadhyaya, reprint edition, Varanasi, Chaukhambha SanskritSansthana, 2006. PP: 187. (A.H.Sha.3/41)2. Vagbhata, Angavibhagam Shareeram Adhyayam, Shaareera sthana, AshtangaHridayam with Vidyotini Hindi commentary by Kaviraj Atrideva Gupta, edited byVaidya Yadunandana upadhyaya , reprint edition, Varanasi, Chaukhambha SanskritSansthana, 2006. PP: 187. (A.H.Sha.3/42)3. Susruta, Ashtavidhashastrakarmiya Adhyayam, Sutra Sthana, Susruta Samhita withNibandha Sangraha commentary of Dalhanaacharya & Nyayachandrika Panjika of ShriGayaadasa on Nidanastana edited by Vaidya Yadavji Trikamji Acharya & NarayanramAcharya ‘Kavyatirtha’, VII edition, Varanasi, Chaukhambha Orientalia, 2002. PP: 116.(SU.Su.25/10)4. Syaar Raajaaraadha kaantadeva, V Part, Shabdakalpadruma, Enhanced by ShriVaradhhhaaprasaada and shri Haricharana, Chaukhamba Sanskrit Granthamala, IIIEdition, 1967, PP 4675. Syaar Raajaaraadha kaantadeva, V Part, Shabdakalpadruma, Enhanced by ShriVaradhhhaaprasaada and shri Haricharana, Chaukhamba Sanskrit Granthamala, IIIEdition, 1967, PP 4676. Syaar Raajaaraadha kaantadeva, V Part, Shabdakalpadruma, Enhanced by ShriVaradhhhaaprasaada and shri Haricharana, Chaukhamba Sanskrit Granthamala, IIIEdition, 1967, PP 467
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-20091697. Syaar Raajaaraadha kaantadeva, Shabdakalpadruma, V Part, Enhanced by ShriVaradhhhaaprasaada and shri Haricharana, Chaukhamba Sanskrit Granthamala, IIIEdition, 1967, PP 4678. Tarka Vaachaspati Shri Taranath Bhattacharya, Vaachaspathyam, VI part,Chaukhamba Sanskrit Granthamala, III Edition, 1970, PP 53759. Agnivesha, Arthedashamahamuliyam Adhyayam, Sutrasthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, V edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP:185(Ch.Su.30/12)10. Agnivesha, Arthedashamahamuliyam Adhyayam, Sutrasthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, V edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 185(Chakrapaani, on Ch.Su.30/12).11. Susruta, Dhamanivyakaranam Shaareeram Adhyayam, Shaareera Sthana, SusrutaSamhita with Nibandha Sangraha commentary of Dalhanaacharya & NyayachandrikaPanjika of Shri Gayaadasa on Nidanastana edited by Vaidya Yadavji Trikamji Acharya &Narayanram Acharya ‘Kavyatirtha’, VII edition, Varanasi, Chaukhambha Orientalia,2002. PP: 387 (SU.Sha.9/13)12. Agnivesha, Ashtoninditioyam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, V edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 249(Ch.Vi.5/3)13. Agnivesha, Srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji Trikamji
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009170Acharya, V edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP:250(Ch.Vi.5/4-5)14. Venimadhavashastri Joshi and Narayanahari Joshi, Ayurvediya Mahaakosha/Ayurvediya shabdakosh, Prathama Khanda, Maharastra rajya sahitya and sanskritimandala ,1968 edition, PP : 949.15. Agnivesha, Srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, V edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 252 (Ch.Vi5/25)16. Agnivesha, Srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, V edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 249 (Ch.Vi5/3)17. Agnivesha, srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, V edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 252(Ch.Vi5/23)18. Susruta, Vyadhisamuddeshiyam Adhyayam, Sutra Sthana, Susruta Samhita withNibandha Sangraha commentary of Dalhanaacharya & Nyayachandrika Panjika of ShriGayaadasa on Nidanastana edited by Vaidya Yadavji Trikamji Acharya & NarayanramAcharya ‘Kavyatirtha’, 7thedition, Varanasi, Chaukhambha Orientalia, 2002. PP: 116(SU.Su 24/10)19. Agnivesha, Srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji Trikamji
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009171Acharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 251 ((Ch.Vi5/9)20. Agnivesha, Srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 252 (Ch.Vi5/24)21. Vagbhata, Angavibhagam Shareeram Adhyayam, Shaareera sthana, AshtangaHridayam with Vidyotini Hindi commentary by Kaviraj Atrideva Gupta, edited byVaidya Yadunandana upadhyaya , reprint edition, Varanasi, Chaukhambha SanskritSansthana, 2006. PP: 188 (A.H.Sha. 3/47)22. Susruta, Dhamanivyakaranam Shaareeram Adhyayam, Shaareera Sthana, SusrutaSamhita with Nibandha Sangraha commentary of Dalhanaacharya & NyayachandrikaPanjika of Shri Gayaadasa on Nidanastana edited by Vaidya Yadavji Trikamji Acharya &Narayanram Acharya ‘Kavyatirtha’, 7thedition, Varanasi, Chaukhambha Orientalia,2002. PP: 386 (SU.Sha.9/12)23. Venimadhavashastri Joshi and Narayanahari Joshi, Ayurvediya Mahaakosha/Ayurvediya shabdakosh, Prathama Khanda, Maharastra rajya sahitya and sanskritimandala, 1968 edition, PP: 78124. Venimadhavashastri Joshi and Narayanahari Joshi, Ayurvediya Mahaakosha/Ayurvediya shabdakosh, Prathama Khanda, Maharastra rajya sahitya and sanskritimandala, 1968 edition, PP: 781.25. Susruta, Vidradhinaam Nidanam Adhyayam, Nidana Sthana, Susruta Samhita withNibandha Sangraha commentary of Dalhanaacharya & Nyayachandrika Panjika of ShriGayaadasa on Nidanastana edited by Vaidya Yadavji Trikamji Acharya & Narayanram
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009172Acharya ‘Kavyatirtha’, 7thedition, Varanasi, Chaukhambha Orientalia, 2002. PP: 303(SU.Ni.9/12)26. Susruta, Garbhavyakaranam Shaareeram Adhyayam, Shaareera Sthana, SusrutaSamhita with Nibandha Sangraha commentary of Dalhanaacharya & NyayachandrikaPanjika of Shri Gayaadasa on Nidanastana edited by Vaidya Yadavji Trikamji Acharya &Narayanram Acharya ‘Kavyatirtha’, 7thedition, Varanasi, Chaukhambha Orientalia,2002. PP: 358 (SU.Sha.4/31)27. Sharngadhara, Sharngadhara Samhita, translated by Prof. K. R Srikanta MurtyPrathama Khanda, kaladikaakhyana Shaareeram, Chaukhambha Orientalia PP: 24(Sh.S.Pu.5/45)28. Agnivesha, Srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 251(Chakrapaani on Ch.Vi. 5/8)29. Agnivesha, Srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 251(Chakrapaani on Ch.Vi. 5/8)30. Agnivesha, Ashtoninditioyam Adhyayam, Shaareera sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 310(Ch.Sha.3/6)
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200917331. Syaar Raajaaraadha kaantadeva, II Part, Shabdakalpadruma, Enhanced by ShriVaradhhhaaprasaada and shri Haricharana, Chaukhamba Sanskrit Granthamala, IIIEdition, 1967, PP: 932. Agnivesha, Ashtoninditioyam Adhyayam, Sutrasthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 113(Ch.Su.20/8)33. Vagbhata, Doshabhediyam Adhyayam, Sutra sthana, Ashtanga Hridayam withVidyotini Hindi commentary by Kaviraj Atrideva Gupta, edited by Vaidya Yadunandanaupadhyaya, reprint edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2006. PP: 90(A.H.Su.12/1)34. Susruta, Aaturopakramaniyam Adhyayam, Sutra Sthana, Susruta Samhita withNibandha Sangraha commentary of Dalhanaacharya & Nyayachandrika Panjika of ShriGayaadasa on Nidanastana edited by Vaidya Yadavji Trikamji Acharya & NarayanramAcharya ‘Kavyatirtha’, 7thedition, Varanasi, Chaukhambha Orientalia, 2002. PP: 150(SU.Su.35/12)35. Vagbhata, Ayushkameeya Adhyayam, Sutra sthana, Ashtanga Sangraha, withShashilekha commentary of Indu Edited by K.P. Shrikumari amma, Govt. of KeralaPublication, 1982. PP: 9 (A.S.1/31)36. Venimadhavashastri Joshi and Narayanahari Joshi, Ayurvediya Mahaakosha/Ayurvediya shabdakosh, Prathama Khanda, Maharastra rajya sahitya and sanskritimandala, 1968 edition, PP: 616
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200917437. Venimadhavashastri Joshi and Narayanahari Joshi, Ayurvediya Mahaakosha/Ayurvediya shabdakosh, Prathama Khanda, Maharastra rajya sahitya and sanskritimandala, 1968 edition, PP: 61638. Agnivesha, Srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 249(Ch.Vi.5/3)39. Agnivesha, Srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 251(Ch.Vi.5/16)40. Agnivesha, Srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 252(Ch.Vi.5/23)41. Susruta, Prameha Nidhanam Adhyayam, Nidana Sthana, Susruta Samhita withNibandha Sangraha commentary of Dalhanaacharya & Nyayachandrika Panjika of ShriGayaadasa on Nidanastana edited by Vaidya Yadavji Trikamji Acharya & NarayanramAcharya ‘Kavyatirtha’, 7thedition, Varanasi, Chaukhambha Orientalia, 2002. PP: 289(SU.Ni.6/3)42. Susruta, Anaagathabaadha Pratishedam Adhyayam, Chikitsa Sthana, Susruta Samhitawith Nibandha Sangraha commentary of Dalhanaacharya & Nyayachandrika Panjika ofShri Gayaadasa on Nidanastana edited by Vaidya Yadavji Trikamji Acharya &Narayanram Acharya ‘Kavyatirtha’, 7thedition, Varanasi, Chaukhambha Orientalia,2002. PP: 489 (SU.Chi.24/41)
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200917543. Vagbhata, Dravadravya Vijnaneeyam Adhyayam, Sutra sthana, Ashtanga Hridayamwith Vidyotini Hindi commentary by Kaviraj Atrideva Gupta, edited by VaidyaYadunandana upadhyaya , reprint edition, Varanasi, Chaukhambha Sanskrit Sansthana,2006. PP: 48 (A.H.Su.5/68)44. Agnivesha, Srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 250(Ch.Vi.5/8)45. Agnivesha, Ashtoninditioyam Adhyayam, Sutrasthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 117(Ch.Su.21/20)46. Vagbhata, Ayushkameeyam Adhyayam, Sutra sthana, Ashtanga Hridayam withVidyotini Hindi commentary by Kaviraj Atrideva Gupta, edited by Vaidya Yadunandanaupadhyaya , reprint edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2006. PP: 5(Hemadri on A.H.Su.1/8)47. Susruta, Hikkapratishedam Adhyayam, Uttara Sthana, Susruta Samhita withNibandha Sangraha commentary of Dalhanaacharya & Nyayachandrika Panjika of ShriGayaadasa on Nidanastana edited by Vaidya Yadavji Trikamji Acharya & NarayanramAcharya ‘Kavyatirtha’, 7thedition, Varanasi, Chaukhambha Orientalia, 2002. PP: 761(SU.U.50/30)48. Vagbhata,Ayushkameeyam Adhyayam, Sutra sthana, Ashtanga Hridayam withVidyotini Hindi commentary by Kaviraj Atrideva Gupta, edited by Vaidya Yadunandanaupadhyaya , reprint edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2006. PP: 5(Hemadri on A.H.Su.1/8)
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200917649. Vagbhata, Dwividhopakramaniyam Adhyayam, Sutra sthana, Ashtanga Hridayamwith Vidyotini Hindi commentary by Kaviraj Atrideva Gupta, edited by VaidyaYadunandana upadhyaya , reprint edition, Varanasi, Chaukhambha Sanskrit Sansthana,2006. PP: 100 (A.H.Su.14/2)50. Tarka Vaachaspati Shri Taranath Bhattacharya, Vaachaspathyam, I part, ChaukhambaSanskrit Granthamala, III Edition, 1970.51. Syaar Raajaaraadha kaantadeva, I Part, Shabdakalpadruma, Enhanced by ShriVaradhhhaaprasaada and shri Haricharana, Chaukhamba Sanskrit Granthamala, IIIEdition, 1967, PP 6352. Agnivesha, Ashtoninditioyam Adhyayam, Shadvirechanashataasritiya Adhyayam,Sutrasthana, Charaka Samhita with Ayurveda Deepika commentary by Chakrapanidattaedited by Vaidya Yadavji Trikamji Acharya, 5thedition, Varanasi, ChaukhambhaSanskrit Sansthana, 2001. PP: 246 (Ch.Vi.3/43)53. Vagbhata,Dwividhopakramaniyam Adhyayam, Sutra sthana, Ashtanga Hridayamwith Vidyotini Hindi commentary by Kaviraj Atrideva Gupta, edited by VaidyaYadunandana upadhyaya , reprint edition, Varanasi, Chaukhambha Sanskrit Sansthana,2006. PP: 101 (A.H.Su.14/3)54. Agnivesha, Grahanidoshachikitsitam Adhyayam, Chikitsa sthana, Charaka Samhitawith Ayurveda Deepika commentary by Chakrapanidatta edited by Vaidya YadavjiTrikamji Acharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP:515 (Ch.Chi.15/29-32)55. (a) Agnivesha, Shareerasankhya Shareeram Adhyayam, Shaareera sthana, CharakaSamhita with Ayurveda Deepika commentary by Chakrapanidatta edited by Vaidya
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009177Yadavji Trikamji Acharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana,2001. PP: 339 (Ch.Sha.7/15)(b) Susruta, Garbhavyakaranam Shaareeram Adhyayam, Shaareera Sthana, SusrutaSamhita with Nibandha Sangraha commentary of Dalhanaacharya & NyayachandrikaPanjika of Shri Gayaadasa on Nidanastana edited by Vaidya Yadavji Trikamji Acharya &Narayanram Acharya ‘Kavyatirtha’, 7thedition, Varanasi, Chaukhambha Orientalia,2002. PP: 356 (SU.Sha.4/13)56. Tarka Vaachaspati Shri Taranath Bhattacharya, Vaachaspathyam, VI part,Chaukhamba Sanskrit Granthamala, III Edition, 1970, PP 535857. Venimadhavashastri Joshi and Narayanahari Joshi, Ayurvediya Mahaakosha/Ayurvediya shabdakosh, Prathama Khanda, Maharastra rajya sahitya and sanskritimandala, 1968 edition, PP: 93958. Venimadhavashastri Joshi and Narayanahari Joshi, Ayurvediya Mahaakosha/Ayurvediya shabdakosh, Prathama Khanda, Maharastra rajya sahitya and sanskritimandala, 1968 edition, PP: 93759. Agnivesha, Ashtoninditioyam Adhyayam, Sutrasthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 116-117(Ch.Su.21/8-9)60. Shri Bhava Mishra, Bhava Prakasha, Hindi commentary by Brahma Shankar Mishra,2ndedition, 1949, Chaukhambha Sanskrit Sansthana, Varanasi.61.Agnivesha, Ashtoninditioyam Adhyayam, Sutrasthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji Trikamji
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009178Acharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 117(Ch.Su.21/9)62. Agnivesha, Ashtoninditioyam Adhyayam, Sutrasthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 116(Ch.Su.21/5-6)63. Susruta, Doshadhatumalakshayavriddhi Vijnaniyam Adhyayam, Sutra Sthana,Susruta Samhita with Nibandha Sangraha commentary of Dalhanaacharya &Nyayachandrika Panjika of Shri Gayaadasa on Nidanastana edited by Vaidya YadavjiTrikamji Acharya & Narayanram Acharya ‘Kavyatirtha’, 7thedition, Varanasi,Chaukhambha Orientalia, 2002. PP: 74 (SU.Su.15/37)64. (a)Susruta, Doshadhatumalakshayavriddhi Vijnaniyam Adhyayam, Sutra Sthana,Susruta Samhita with Nibandha Sangraha commentary of Dalhanaacharya &Nyayachandrika Panjika of Shri Gayaadasa on Nidanastana edited by Vaidya YadavjiTrikamji Acharya & Narayanram Acharya ‘Kavyatirtha’, 7thedition, Varanasi,Chaukhambha Orientalia, 2002. PP: 73 (SU.Su.15/ 32)(b) Vagbhata,Dwividhopakramaniyam Adhyayam, Sutra sthana, Ashtanga Hridayamwith Vidyotini Hindi commentary by Kaviraj Atrideva Gupta, edited by VaidyaYadunandana upadhyaya , reprint edition, Varanasi, Chaukhambha Sanskrit Sansthana,2006. PP: 102 (A.H.Su.14/ 20)65. Agnivesha, Ashtoninditioyam Adhyayam, Sutrasthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 116-117(Ch.Su.21/8)
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-200917966. Vagbhata, Vaatashonita Chikitsitam Adhyayam, Chikitsa sthana, AshtangaHridayam with Vidyotini Hindi commentary by Kaviraj Atrideva Gupta, edited byVaidya Yadunandana upadhyaya , reprint edition, Varanasi, Chaukhambha SanskritSansthana, 2006. PP: 423 (A.H.Chi.22/5)67. Vagbhata, Vikruti Vijnaniyam Adhyayam, Sutra sthana, Ashtanga Hridayam withVidyotini Hindi commentary by Kaviraj Atrideva Gupta, edited by Vaidya Yadunandanaupadhyaya , reprint edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2006. PP: 202(A.H.Sha.5/12)68. Agnivesha, Ashtoninditioyam Adhyayam, Sutrasthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 98(Ch.Su.16/34)69. Agnivesha, Srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, 5thedition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 261(Ch.Vi.7/30)70(a) Harrison’s, Nutrition; Malnutrition and Nutritional Assessment, Table No. 74-3,Ideal Weight for Height, Source – Blackburn Et al, Principles Of Internal Medicine, 16thedition 2005,McGrawHill publications.(b). Agnivesha, Navegaan Dhaaraniyam Adhyayam, Sutrasthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, V edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 50(Ch.Su.7/32).71. Susruta, Anaagatabadhaa Pratishedha Adhyayam, Sutra Sthana, AnaagatabadhaaPratishedha Adhyayam, Chikitsa sthana, Sushruta Samhita with Nibandha Sangraha
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009180commentary of Dalhanaacharya & Nyayachandrika Panjika of Shri Gayaadasa onNidanastana edited by Vaidya Yadavji Trikamji Acharya & Narayanram Acharya‘Kavyatirtha’, VII edition, Varanasi, Chaukhambha Orientalia, 2002. PP: 118, 489(SU.Su.25/10) (SU.Chi.24/50)72. Agnivesha, Srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, V edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 251(Cha.Vi.5/16).73. Agnivesha, Srotovimanam Adhyayam, Vimana sthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, V edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 185(Ch.Vi.5/16)74. (a)Susruta, Ashtavidhashastrakarmiya Adhyayam, Drava Dravyavidhim Adhyayam,Sutra Sthana, Sushruta Samhita with Nibandha Sangraha commentary of Dalhanaacharya& Nyayachandrika Panjika of Shri Gayaadasa on Nidanastana edited by Vaidya YadavjiTrikamji Acharya & Narayanram Acharya ‘Kavyatirtha’, VII edition, Varanasi,Chaukhambha Orientalia, 2002. PP : 118, 210 ( SU.Su.25/10) (SU. Su. 45/175)(b) Shri Bhava Mishra, Bhava Prakasha, Hindi commentary by Brahma ShankarMishra, 2ndedition, 1949, Chaukhambha Sanskrit Sansthana, Varanasi. B. P. Pu. 6/20-24)75. Agnivesha, Madaatyaya Chikitsitam Adhyayam, Chikitsa sthana, Charaka Samhitawith Ayurveda Deepika commentary by Chakrapanidatta edited by Vaidya YadavjiTrikamji Acharya, V edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP:585 (Ch.Chi.24/62-65).76. Susruta, Ashtavidhashastrakarmiya Adhyayam, Doshadhaatumala Kshaya Vriddhivijnaaniyam,Sutra Sthana, Sushruta Samhita with Nibandha Sangraha commentary of
  • Dr.K. Savitha R Shenoy⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯A Study to Evaluate the Chikitsa Siddhanta ‘Guru cha Atarpana’ in Sthoulya.PG Studies, Ayurveda Siddhanta, GAMC, Mysore. 2006-2009181Dalhanaacharya & Nyayachandrika Panjika of Shri Gayaadasa on Nidanastana edited byVaidya Yadavji Trikamji Acharya & Narayanram Acharya ‘Kavyatirtha’, VII edition,Varanasi, Chaukhambha Orientalia, 2002. PP : 118, 74 ( SU.Su.25/10) (SU.Su.15/37).77. (a)Agnivesha, Ashtoninditioyam Adhyayam, Sutrasthana, Charaka Samhita withAyurveda Deepika commentary by Chakrapanidatta edited by Vaidya Yadavji TrikamjiAcharya, V edition, Varanasi, Chaukhambha Sanskrit Sansthana, 2001. PP: 185(Ch.Su.21/8).(b) M. Swaminathan, Energy Value of Fods and Energy Requirements, Essentials ofFood and Nutrition Vol 1, 2nd Edition, Bappco Publications, Reprint Edition 1995. PP:121-122
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  • 186CASE SHEETDEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDASIDDHANTAGOVERNMENT AYURVEDA MEDICAL COLLEGE,MYSORE.“A STUDY TO EVALUATE THE CHIKITSA SIDDHANTA –‘GURU CHA ATARPANAM’ IN STHOULYA”.HEAD OF THE DEPARTMENT : Dr. Anjaneya Murthy M.D., (Ayu)GUIDE : Dr. Naseema Akthar M.D., (Ayu)CO-GUIDE : Dr. H.M.Chandramauli M.D., (Ayu)RESEARCHER : Dr. K. Savitha. R. ShenoySl.No :I. ATURA VIVARANA:Aatura naama : Date :Linga : M / F I.P.No :Vaya : yrs. O.P.No :Vaivahika vrittanta : M / UM / W / D. Ward :Jaati : H / M / C / Others. Bed No. :Saaksharata : UE / PS / MS / HS / G / PG. Date of adm :Samajika sthiti : VP / P / LM / M / UM / R. Date of discharge :Vilasa : Result :Phone No :
  • 187II. VEDANA VRITTANTA:A. PRADHANA VEDANA: DURATION Bhara vriddhi Breathlessness Fatigability Excess sweating OthersB. ANUBANDHI VEDANA: Excess sleep Excessive thirst Excessive hunger Difficulty in sexual intercourse OthersIII. ADYATANA VYADHI VRITTANTA:IV. POORVA VYADHI VRITTANTA:V. CHIKITSA VRITTANTA:VI. PAARIVARIKA VRITTANTA :A. MATERNAL : Present / AbsentB. PATERNAL : Present / Absent
  • 188VII. VAYAKTIKA VRITTANTA:A. Nature of work: Hard manual work / Moderate manual work / Mildwork/ Sedentary workB. Duration of exercise:C. Diet: Veg/ Non-vegIf Non-veg : Regular / OccasionalD. Nature of food: Heavy as usual meals : Yes / No Small quantity with increased frequency: Yes / No Use of snacks between meals: Yes / No Predominant tastes: Sw / So / Sa / Pu / Bi / As / All Predominant guna : Sn / Ru / Us / Sh / AnyE. Appetite: Poor / Moderate / Good / SevereF. Sleep: Sound / Disturbed / ExcessDuration of sleep : Day :Night :G. Habits: Beedi / Cigarette / Beetle leaf / Tobacco chewing / Supari /Alcohol / Drugs / Tea / Coffee / OthersH. Sexual intercourse: Days per week :Erectile dysfunction / ImpotenceVIII. A. GYNAECOLOGICAL HISTORY :Menstrual Cycle: Regular / IrregularintervalsFlow: Normal / Scanty / Excess / AbsentB. OBSTETRIC HISTORY: G P D A LPregnancies:Deliveries:Abortions:IX. SAMANYA PAREEKSHA:Height : H.R: Hip circumference :Weight: P.R: Waist circumference :B.M.I : R.R: Mid-arm circumference :B.P: Wrist circumference :Mid-thigh circumference :
  • 189X. ASHTASTHANA PAREEKSHA: Nadi: V / P / K / VP / PK / KV /VPK Mutra: times per day , times at night Mala: Drava / Baddha / Samyak / Others Jihva: Alipta / Alpa Lipta / Lipta / Others Shabda: Praakruta / Vikruta Sparsha: Praakruta / Vikruta Druk: Praakruta / Vikruta Akruti: Asthenic / Normoesthenic / HypersthenicXI. DASHAVIDHA PAREEKSHA: Prakriti: V / P / K / VP / VK / PK / VPK Vikriti: a. Dosha : V / P / K / VP / PK / KV / VPKb. Dushya : R / Ra / Ma / Me / As / Mj / Sh / Other Sara: Avara / Madhyama / Pravara Samhanana: Avara / Madhyama / Pravara Pramana: Ht: Wt: Satmya: Avara / Madhyama / Pravara Sattva: Avara / Madhyama / Pravara Aharashakti:a. Abhyavaharana1. purvatana: Avara / Madhyama / Pravara2. adyatana: Avara / Madhyama / Pravarab. Jarana:1. purvatana: Avara / Madhyama / Pravara2. adyatana: Avara / Madhyama / Pravara Vyayamashakti: Avara / Madhyama / Pravara Vayah: Yrs. Baalya / Yauvana / Vaardhakya
  • 190XII. A. KOSHTHA PAREEKSHA: Mr / M / KrB. SAMPRAPTI GHATAKA:i. Dosha : V / P / K / VP / PK / KV / VPKii. Dushya : R / Ra / Ma / Me / As / Mj / Sh / Otheriii. Srotasiv. Srotodushti : Ap / Sa / Vg / Grv. Agni : S / T / M / Vvi. Ama : Saama / Niraamavii. Udbhava sthana : Aamashaya / Pakvaashaya /Aamapakvaashayaviii. Sanchara sthana :ix. Vyakta sthana :C. NIDANA PANCHAKA:i. Nidana Aharaja Viharaja Manasaii. Poorva Roopaiii. Roopaiv. Upadhaya Anupashayav. SampraptiIX. VYADHI VINISCHAYA :
  • 191ASSESSMENT CRITERIA:I. OBJECTIVE PARAMETERS :SerialnumberParameter Before tt After tt Follow up1. Weight2. BMI3. Waist hip ratioII. SUBJECTIVE PARAMETERS :SerialnumberParameter Before tt After tt Follow up1. Shwasa kruchrata2. Utsaha hani3. Sarvakriyasuasamarthata4. SwedaIII. OBSERVATIONAL PARAMETER :SerialnumberParameter Before tt After tt Follow up1. Kshudha2. Pipaasa3. Waistcircumference4. Hip circumference5. Mid armcircumference6. Wristcircumference7. ThighcircumferenceGRADINGI. For objective criteria:1. Weight:Grade 1: normal weight for specific heightGrade 2: 1-15%>normal weightGrade 3: 15-30%> normal weightGrade 4: 30-45%>normal weight
  • 1922. B.M.I:Grade 1: <=30Grade 2: 30-33Grade 3: 33-36Grade 4: 36-393. Waist: Hip:For Males For FemalesGrade 1: 0.73 – 0.90 0.43 – 0.66Grade 2: 0.90 – 1.07 0.66 – 0.89Grade 3: 1.07 – 1.24 0.89 – 1.12Grade 4: >1.24 >1.12II. For subjective criteria:1. Shwasa Kruchruta:Grade 1: No shwasa kruchrutaGrade 2: After heavy/ moderate workGrade 3: After mild workGrade 4: Even at rest2. Utsaaha Hani:Grade 1: No utsaaha haniGrade 2: alpa utsaaha hani(does work half heartedly)Grade 4: madhyama utsaaha hani (does work only on being initiated to)Grade 3: ati utsaaha hani(doesn’t work even after being initiated)3. Sarvakriyasu Asamarthata:Grade 1: Able to do all workGrade 2: Able to do routine & some additional workGrade 3: Able to do routine work independentlyGrade 4: Able to do routine work also, only with assistance4. Sweda:Grade 1: No swedaGrade 2: After heavy or moderate workGrade 3: After mild workGrade 4: At restIII. Observational crireria:1. Kshudha: Normal or excess2. Pipaasa: Normal or excess
  • 1933. Waist measurement: At the level of umbilicus (or mid point between coastalmargin & iliac crest)4. Hip measurement: At the level of the highest distention of buttocks5. Mid arm circumference: At the level of midway between shoulder joint &elbow joint.6. Wrist circumference :7. Thigh circumference : At level mid way between hip and knee joint .Intervention:INTERVENTION :Group A:Treatment: Pathya apathya as advisedDate of commencement of tt:Date of completion of tt:Date of completion of follow up:Group B:Treatment: Lekhaneeya gana choornaDose: 6g bd (morning: empty stomach, night: 1 hour before food)Anupana: MadhuDate of commencement of tt:Date of completion of tt:Date of completion of follow up:Group C:Treatment: Lekhaneeya gana choorna with module of pathya apathya (combined)Dose: 6g bd (morning on empty stomach, night 1 hour before food)Anupana: MadhuDate of commencement of tt:Date of completion of tt:Date of completion of follow up:SIGNATURE OF OBSERVER SIGNATURE OF RESEARCHERSIGNATURE OF H.O.D.
  • 194DIET AND REGIMEN PROFORMAPATHYAS / DO’S / ¥ÀxÀå :Cereals / zsÁ£ÀåUÀ¼ÀÄ :1. Old rice / ºÀ¼É CQÌ2. Barley / ¨Á°ð3. Parched rice / CgÀ¼ÀÄ4. gÁV*5. eÉÆüÀ*6. Millet / £ÀªÀuÉ*Pulses / ¨ÉÃ¼É UÀ¼ÀÄ1. Green gram / ºÉ¸ÀgÀÄ ¨ÉüÉ2. Horse gram / ºÀÄgÀĽ3. ªÀÄlQà PÁ¼ÀÄ4. Bengal gram / PÀqÀ¯É ¨ÉüÉ5. Lentil / PÉøÀjà ¨É¼ÉÃ6. Tovar dal / vÉÆUÀjà ¨ÉüÉGreen leafy vegetables and fruits1. Snake guard /¥ÀqÀªÀ®2. Drum stick /£ÀÄUÉÎPÁ¬Ä3. Burnt brinjal /¸ÀÄlÖ§zÀ£É4. Bitter guard / ºÁUÀ®PÁ¬Ä*5. Cucumber /¸ËvÉPÁ¬Ä*6. Cauliflower / ºÀÆPÉÆøÀÄ*7. Cabbage / PÁå¨ÉÃdÄ*8. Mosambi / ªÉÆøÀA©*9. Orange / QvÀÛ¼É*10. Grapes / zÁæQë*11. Apple /¸ÉçÄ*
  • 195Spices, Condiments, others1. Whey / ªÀÄfÓUÉ w½2. Butter milk / ªÀÄfÓUÉ3. Asafetida / EAUÀÄ4. Coriander seeds or leaf / PÉÆvÉÆÛA§jà ©Ãd, ¸ÉÆ¥Àåöà5. Turmeric / ºÀ¼À¢Ã6. Warm water / ©¹Ã ¤ÃgÀÄ7. Sesame oil / J¼ÉîuÉÚ*8. Phoenogrek / ªÉÄAvÀå*9. KCL / ¸ÉÊAzÀÄ¥ÀÅöà*10. Dried red chillies / ªÉÄt¸ÀÄ*11. Saesamum / ¸Á¹ªÉ12. Milk(cows) without cream / PÉ£É gÀ»vÀ ºÀ¸ÀÄ«£À ºÁ®Ä*Regimen1. Massaging with wheat flour / PÉÊ EAzÀ ªÉÄÊ GdÄÓªÀÅzÀÄ2. Reducing duration of night sleep / gÁwæ ¤zÉÝ PÀrªÉÄ ªÀiÁqÀĪÀÅzÀÄ3. Sexual indulgence / ªÉÄÊxÀÄ£À ¸Éë¸ÀĪÀåzÀÄ4. Exercise / ªÁåAiÀiÁªÀÄ5. Thinking / AiÀiÁªÀÅzÁzÀgÀÄ «μÀaiÀÄzÀ §UÉÎ UÁqsÀªÁV aAw¸ÀĪÀÅzÀÄ6. Indulge in work / ºÉZÀÄÑ PÉ®¸À PÁAiÀÄð ªÀiÁqÀĪÀÅzÀÄ7. Walking / ªÁQAUï8. Sun bath / ©¹®Ä ¸Éë¸ÀĪÀÅzÀÄ9. A day or two of Fasting per week / ªÁgÀPÉÌ MAzÀÄ CxÀªÀ JgÀzÀÄ ¢£À Hl©qÀĪÀÅzÀÄ, ®WÀÄ DºÁgÀ ¸Éë¸ÀĪÀÅzÀÄ10. Water intake before food / HlzÀ ªÀÄÄAavÀªÁV ¤ÃgÀÄ ¸Éë¸ÀĪÀÅzÀÄ
  • 196APATHYA / DON’TS / C¥ÀxÀå : **Cereals1. Wheat / UÉÆâ2. New rice / ºÉƸÀ CQÌ *Pulses1. Black gram / G¢Ý£À ¨ÉüÉOthers1. Ghee / vÀÄ¥Àà2. Milk / ºÁ®Ä3. Sugarcane products / PÀ©â¤AzÀ vÀAiÀiÁåj¹zÀ ¥ÀzÁxÀðUÀ¼ÀÄ4. Meat / ªÀiÁA¸À5. Fishes /«ÄãÀÄ6. Curds / ªÉƸÀgÀÄ*7. Sour buttermilk / ºÀĽ ªÀÄfÓUÉ *8. Cheese *Regimens1. Over eating / CUÀvÀåQÌAvÀ ºÉZÁÑV DºÁgÀ ¸Éë¸ÀĪÀÅzÀÄ2. Day sleep / ªÀäzsÁåºÀßzÀ°èß, ¢£ÀzÀ°è ¤zÉÝ ªÀiÁqÀĪÀÅzÀÄ3. Oil massage / JuÉÚ C¨sÀåAUÀ4. Having bath for more number of times / §ºÀ¼À ¨Áj ¸ÁߣÀ ªÀiÁqÀĪÀÅzÀÄ5. Sedentary habits / PÀĽvÀ¯Éè EgÀĪÀÅzÀÄ, PÉ®¸À ªÀiÁqÀzÉà EgÀĪÀÅzÀÄ6. Using scent etc /¸ÉAmï EvÁå¢ UÀAzsÀ zÀæªÀåzÀ ¥ÀæAiÉÆÃUÀ7. Drinking water after food / HlzÀ£ÀAvÀgÀ ¤ÃgÀÄ ¸Éë¸ÀĪÀÅzÀÄ* Not told in classics included based on similar quantities and seen by experience**Some food articles can’t be completely avoided so their quantity is reduced(limited use).
  • 197GROUPING – LOTTERY METHODDATE: 21STAUG 2007 TIME: 11.00 amGROUP A - PATHYA GROUP B - MEDICINE GROUP C - MIXED06 04 0107 05 0208 10 0309 17 1211 20 1316 21 1418 23 1519 27 2225 29 2426 30 3228 31 3334 38 3635 40 3744 41 3945 43 42SIGNATURE OF GUIDE SIGNATURE OF CO-GUIDE(Dr.Naseema Akhthar) (Dr.H.M.Chandramouli)SIGNATURE OF WITNESS SIGNATURE OF RESEARCHER(Dr.V.A.Chate & Dr.Anand Katti) (Dr.K.Savitha R Shenoy)SIGNATURE OF H.O.D(Dr.N.A.Murthy)
  • 198KEY TO MASTER CHARTGroupsGROUP AGROUP BGROUP CSexMale – 1Female –2Age – AgeReligion – RelHindu – 1Muslim – 2Marital Status – M.S.Unmarried – 1Married – 2Locality – LRural – 1Urban – 2Occupation – OccHouse Wife – 1Teacher – 2Business – 3Administrator – 4Student – 5Manual work – 6Socio Economical Status– SESLower Middle Class (LMC) – 1Middle Class -- 2Upper Middle Class (UMC) – 3Education – EduUneducated – 1Primary – 2Middle School – 3High School – 4Graduate – 5Post Graduated – 6Family History – F.H.Absent – 0Paternal -1Maternal – 2Paternal & Maternal – 4Nature of Work – NOWSedentary work – 1Mild Work – 2Moderate Manual Work– 3Hard Manual Work – 4Exercise – ExNo Exercise – 0Does Exercise – 1Diet – DVegetarian – 1Mixed – 2Hours of Day Sleep – HODSHours of Night Sleep – HONSHabits – HNone – 0Tea – 1Coffee– 2Smoking – 3Alcohol – 4Tea & Coffee– 5Tea, Cigarette & Alcohol – 6Obstretic History – Ob.Htry(No. of Kids)Prakruthi – PrVata – 1Pitta – 2Kapha -- 3VataPitta – 4VataKapha – 5PittaKapha – 6
  • 199Ht – HeightBT – Before TreatmentAT – After TreatmentFU – After Follow UpWt – WeightBMI – Body mass IndexW:H – Waist Hip RatioSK – Shwasa KrucchrataUH – Utsaaha HaaniSA –Sarvakriyaasu AsaamarthyamSw – SwedaKs – KshudhaPi – PipaasaWC – Waist CircumferenceHC – Hip CircumferenceMAC – Mid arm CircumferenceWrC – Wrist circumferenceTC – Thigh CircumferenceDushya - DuMeda – 1Meda & Shukra – 2Sara - SaSamhanan - SamSatmya - SatSattva – SattAbhyavaharana – AbhyJarana – JarPast – PaPresent – PrVyayamashakti – VyAvara – 1Madhyama – 2Pravara – 3Agni – AgTeekshna – 1Vishama -- 2Koshtha – KoMadhyama – 1Kroora – 2
  • MUSTA HARIDRAKUSHTHADARUHARIDRA VACHA ATIVISHACHITRAKAKATUKAROHINI CHIRABILVAMADHUFig 1: INGREDIENTS OF LEKHANEEYA GANA CHOORNA WITHMADHU ANUPANAFINAL DRUG