Madhumeha (Diabetes) Management
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Madhumeha (Diabetes) Management

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Apart from many classifications - Susruta 7 fold classification has much importance to understand the disease Madhumeha.

Apart from many classifications - Susruta 7 fold classification has much importance to understand the disease Madhumeha.

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Madhumeha (Diabetes) Management Madhumeha (Diabetes) Management Presentation Transcript

  • In the Memory of VVS Sastry 20-11-1932 to 12-08-1999Prof. Dr. K. Shiva Rama PrasadDept. of Kayachikitsa (PG)PGARC, DGMAMC, Gadag+91-9448746450doctorksrprasad@gmail.com
  • A step towards healing Sharing of the information of Madhumeha in front of many intellectuals of Ayurveda is a Herculean Task Gnosis of Diabetes makes ones to attend it either curative or prophylaxes forms. Nosology of Madhumeha is necessary to manage it full length. Apart from many classifications - Susruta 7 fold classification has much importance to understand the disease Madhumeha.13-8-2007 doctorksrprasad@gmail.com 2
  • 7 fold classification of Madhumeha Adibala Pravrutta Janmabala Pravrutta Doshabala Pravrutta Sanghatabala Pravrutta Kalabala Pravrutta Daivabala Pravrutta Swabhavabala Pravrutta VÉx¨É¤É±É |É´ÉÞkÉÉ: nùÉä¹É¤É±É |É´ÉÞkÉÉ: ºÉÆPÉÉiÉ¤É±É |É´ÉÞkÉÉ: EòÉ±É¤É±É |É´ÉÞkÉÉ: nèù´É¤É±É |É´ÉÞkÉÉ: º´É¦ÉÉ´É¤É±É |É´ÉÞkÉÉ: <ÊiÉ - ºÉÖ¸ÉÖiÉ ºÉÚjÉ 24/413-8-2007 doctorksrprasad@gmail.com 3
  • Adibala Pravrutta Matruja Madhumeha – probably developed because of Matruja beeja avayava Medo vikruti – kostanga – kloma (Pancreas-?) Pitruja Madhumeha – Asthi beeja avayava – Acetylcholine – citrus acid cycle disturbance – neo glycolysis - ketone bodies Genetically influenced Madhumeha – where Beeja – Beeja bhaaga avayava are influenced to give rise MM child The genetics and involvement of Genes are even though not new – medically to treat a patient of Shisava MM is not possible. But “Eugenics” – is provided by the Ayurveda to combat the disease to eradicate or to avoid “predominance” of Beeja – Pumsavana - sadvrutta etc. Apart from this the colonial prophylaxis management as – Atulya Grotriya is followed. iÉjÉ +ÉÊnù¤É±É|É´ÉÞkÉÉ ªÉä ¶ÉÖGò¶ÉÉäÊhÉiÉ nùÉä¹ÉÉx´ÉªÉä: EÖò¹`öɶÉÇ|ɦÉÞiɪÉ:, iÉä +Ê{É ÊuùÊ´ÉvÉÉ: ¨ÉÉiÉÞVÉÉ: Ê{ÉiÉÞVÉɶSÉ -ºÉÖ¸ÉÖiÉ ºÉÚjÉ 24/513-8-2007 doctorksrprasad@gmail.com 4
  • Janmabala Pravrutta Rasakruta (Apatarpanajanaya MM) & Douhrudapacharaja (Santarpanajanya MM) Rasakruta MM is, where mother irregular food habits or lack of food or incapacities of taking food leaves an impression over the baby to develop accumulation of food for future use habituated to develop as Juvenile DM. – 2nd World war impression over German population Douhrudapacharaja literally mother’s deviated habits influence the baby for deranged segregations of Shareera Kleda (Blood Sugar) to develop JDM as result of impaired metabolic functions VÉx¨É¤É±É |É´ÉÞkÉÉ ªÉä ¨ÉÉiÉÖ®úÉ{ÉSÉÉ®úÉiÉ {ÉRÂóMÉÖVÉÉiɺlÉ ¤ÉÊvÉ®ú ¨ÉÚEò ʨÉÎx¨ÉxÉ ´ÉɨÉxÉ |ɦÉÖiɪÉÉä: VÉɪÉxiÉäiÉä +Ê{É ÊuùÊ´ÉvÉÉ: ®úºÉEÞòiÉÉ: nùÉè¾þnùÉ{ÉSÉÉ®úEÞòiÉɶSÉ - ºÉÖ¸ÉÖiÉ ºÉÚjÉ 24/513-8-2007 doctorksrprasad@gmail.com 5
  • Doshabala Pravrutta Amashaya Samutha MM & Pakwashaya Samutha MM We always behind the Dosha and Dhatu, which are altering all the time to target for any illness in the body. Off course the Dosha are dependent over the food and digestion. The pre digestive manifested MM and post digestive manifested MM has to be differentiated before treatment nùÉä¹É¤É±É |É´ÉÞkÉÉ ªÉä +ÉiÉÆEòºÉ¨ÉÖi{ÉzÉÉ Ê¨ÉvªÉɽþÉ®úÉSÉÉ®ú EÞòiÉɶSÉ iÉä +Ê{É ÊuùÊ´ÉvÉÉ, +ɨɶɪɺɨÉÖilÉÉ: {ÉC´ÉɶɪɺɨÉÖilÉɶSÉ {ÉÖxɶSÉ ÊuùÊ´ÉvÉÉ: ¶É®úÒ®ú ¨ÉÉxɺÉɶSÉ - ¨ÉÉxɺÉÉÊ{É ÊuùÊ´ÉvÉÉ: ®úÉVɺÉÉ: iÉɨɺÉɶSÉ iÉ BiÉä +ÉvªÉÉÎi¨ÉEòÉ: - ºÉÖ¸ÉÖiÉ ºÉÚjÉ 24/513-8-2007 doctorksrprasad@gmail.com 6
  • Sanghatabala Pravrutta Shastra (armed fight) and Vyala (animal) should be concerned to exogenous causes of MM Viral DM is said to be a new invention in contemporary but the Krimija MM even though not classified, its existence is proved through usage of Anti retroviral management in MM. ºÉÆPÉÉiÉ¤É±É |É´ÉÞkÉÉ ªÉä +ÉMÉxiÉ´ÉÉä nÖù¤ÉDZɺªÉ ¤É±É´ÉÊuùOɽþÉiÉ iÉä +Ê{É ÊuùÊ´ÉvÉÉ: ¶ÉºjÉEÞòiÉÉ: ´ªÉɱÉEÞòiÉɶSÉ BiÉä +ÉÊnù¦ÉÉèÊiÉEòÉ: - ºÉÖ¸ÉÖiÉ ºÉÚjÉ 24/6 ºÉÆPÉÉiÉ¤É±É |É´ÉÞkÉÉ <ÊiÉ ºÉÆPÉÉiÉÉä +jÉ +iªÉʪÉEò: ºÉƺÉMÉÇ: - ºÉÖ¸ÉÖiÉ ºÉÚjÉ 24/6 ½þÉ®úhÉSÉÆpù13-8-2007 doctorksrprasad@gmail.com 7
  • Kalabala Pravrutta Seasonal influences are common in manifestation of disease. This cause Agni disturbances. The MM of seasonal variations dependent on food habits which are of external causes implies influence on shareera kleda to cause Amashaya samutha MM with apakwa rasa kleda. In some seasons sugar levels alters to high and low even – as we see in summer hypoglycemia – so as the usage of madhura rasa EòÉ±É¤É±É |É´ÉÞkÉÉ ªÉä ¶ÉÒiÉÉä¹hÉ´ÉÉiɴɹÉÉÇiÉ{É |ɦÉÞÊiÉ ÊxÉʨÉkÉÉ: iÉä +Ê{É ÊuùÊ´ÉvÉÉ: ´ªÉÉ{ÉzÉ @ñÊiÉEÞòiÉÉ: +´ªÉÉ{ÉzÉ @ñiÉÖEÞòiÉɶSÉ - ºÉÖ¸ÉÖiÉ ºÉÚjÉ 24/713-8-2007 doctorksrprasad@gmail.com 8
  • Daivabala Pravrutta In it Vidud-ashanikruta – is said to be any external shock referred to execute electrical impulses that disturb the body environment and cause Hyper or Hypoglycemia Pishacha once again fingers towards the infectious origins - which could be sudden or communicated viral or Bacterial origins could occur either by contact or epidemiological or transfusion nèù´É¤É±É |É´ÉÞkÉÉ ªÉä näù´ÉpùÉä½þnùʦɶÉ{iÉEòÉ: +vÉ´ÉÇhÉEÞòiÉÉ ={ɺÉMÉÇVÉɶSÉ iÉä +Ê{É ÊuùÊ´ÉvÉÉ: Ê´ÉtÖnù¶ÉÊxÉEÞòiÉÉ: Ê{ɶÉÉSÉÉÊnùEÞòiÉɶSÉ - {ÉÖxɶSÉ ÊuùÊ´ÉvÉÉ: - ºÉƺÉMÉÇVÉÉ: +ÉEòκ¨ÉEòɶSÉ - ºÉÖ¸ÉÖiÉ ºÉÚjÉ 24/713-8-2007 doctorksrprasad@gmail.com 9
  • Swabhavabala Pravrutta In this the diseases manifested during the un time/time schedule routine course pathological conditions are discussed – like gestational DM etc which may ultimately leads to precipitate MM/DM permanently as marker In the old age hypoglycemia (Vata) and children with hyperglycemia (Kapha) are common º´É¦ÉÉ´É¤É±É |É´ÉÞkÉÉ ªÉä IÉÖÎi{É{ÉɺÉÉVÉ®úɨÉÞiªÉÖ ÊxÉpùÉ |ɦÉÞiɪÉ:, iÉä +Ê{É ÊuùÊ´ÉvÉÉ: - EòɱÉVÉÉ: +EòɱÉVÉɶSÉ iÉjÉ {ÉÊ®ú®úIÉhÉ EÞòiÉÉ: EòɱÉVÉÉ: +{ÉÊ®ú®úIÉhÉEÞòiÉÉ: +EòɱÉVÉÉ: - ºÉÖ¸ÉÖiÉ ºÉÚjÉ 24/713-8-2007 doctorksrprasad@gmail.com 10
  • Sahaja MM Sahaja MM is Krusha – Rooksha – Alpashi – Always Parisarana sheela (hyperactive) - is not indicated with any elimination but to treat with “Samskruta Annpana” pathya – transformed food regulations and Samshamana chikitsa – palliative management – along with diseases or conditions associated to even treat is indicated. iÉjÉ ºÉ½þVÉÉä ¨ÉÉiÉÉÊ{ÉiÉÞ ¤ÉÒVÉnùÉä¹ÉEÞòiÉ: - - - iɪÉÉä {ÉÚ´ÉæhÉÉä{ÉoùiÉ: EÞò¶ÉÉä°üIÉÉä,+±{ÉɶÉÒ Ê{É{ÉɶÉɺÉÖ¦ÉÞǶÉÆ {ÉÊ®úºÉ®úhÉ ¶ÉұɶSÉ ¦É´ÉÊiÉ - iÉjÉ EÞò¶É¨ÉzÉ{ÉÉxÉ |ÉÊiɺÉƺEÞòiÉÉʦÉ: ÊGòªÉÉʦÉζSÉÊEòiºÉäiÉ ºÉÖ¸ÉÖiÉ ÊSÉÊEòiºÉ - 11/3-4 ºÉƶÉÉävÉxÉÆ xÉɽÇþÊiÉ ªÉ: |ɨÉäʽþ iɺªÉ ºÉƶɨÉxÉÒ |ɪÉÉäVªÉÉ - SÉ®úEò ÊSÉÊEòiºÉ 6/18 iÉiÉÉä%xÉÖ¤ÉÆvÉ ®úIÉxÉÉlÉÈ ¶É¨ÉxÉɽÇþºªÉ ¶É¨ÉxÉÉxªÉ´ÉSÉÉ®úªÉäiÉ - +¹]õÉÆMÉ ºÉÆOɽþ ÊSÉÊEòiºÉ 14/413-8-2007 doctorksrprasad@gmail.com 11
  • Apathyanimittaja MM Apathya nimitta MM is Sthoola – snigdha – wants comforts of food and sleep – is to be treated with Apatarpana Chikitsa – Samshodhana following the “Samutha Vishesha” as either with Vamana in case of Amashaya samutha and Virechana fro Pakwashaya samutha MM +ʽþiÉɽþÉ®úVÉÉä%{ÉlªÉ ÊxÉʨÉkɶSÉ - =kÉ®äúhÉ ºlÉÚ±ÉÉä ¤É¼´ÉɶÉÒ ÎºxÉMvÉ: ¶ÉªªÉɺÉxÉ º´É{xɶÉұɶSÉ |ÉɪÉähÉäÊiÉ - - - - ºlÉڱɨÉ{ÉiÉ{ÉÇhɪÉÖHòÉʦÉ: - ºÉÖ¸ÉÖiÉ ÊSÉÊEòiºÉ - 11/3-4 ºlÉÚ±É|ɨÉäʽþ ¤É±É´ÉÉxÉèEò: - - ºÉƶÉÉävÉxÉ nùÉä¹É¤É±ÉÉÊvÉEòºªÉ - SÉ®úEò ÊSÉÊEòiºÉ 6/113-8-2007 doctorksrprasad@gmail.com 12
  • Vamana – Virechana – Vasti with Alpa sneha and preferably with Ghruta (Medo- Kapha-Vata hara Chikitsa) Sneha pacifies Vata and Medohara Kaphahara Kashaya are releave MM In all MM methods of management are – Baddhamootrani – Amedaskarani –Brumhana – Agni deepana – Bala janana annapaana – Kleda prashamana dravya– Medoprahsmana dravya - ´ÉɨɪÉäiÉ - |ÉMÉÉføÊ´É®äúSɪÉäSSÉ - Eò¡ò¨Éä½äþ ´ÉɨɪÉäiÉ - Ê{ÉkɨÉä½äþ Ê´É®äúSɪÉäiÉ - +ɨɶɪɺlÉä Eò¡òÊ{ÉkÉä ´ÉɨɪÉäiÉ - {ÉC´ÉɶɪɺlÉä Ê´É®äúSɪÉäiÉ - - - +ɺlÉÉ{ɪÉäiÉ ÊxɺiÉè±ÉäxÉäÊiÉ ´ÉSÉxÉÉnù±{ÉPÉÞiÉɦªÉxÉÖYÉÉxɨÉ - +±{ɺxÉä½þÉlÉǨÉxªÉä - ºÉÖ¸ÉÖiÉ ÊSÉÊEòiºÉ 11/7 b÷±½þhÉ ÊºÉrùÉÊxÉ iÉè±ÉÉÊxÉ PÉÞiÉÉÊxÉSÉè´É näùªÉÉÊxÉ ¨Éä½äþ¹´ÉÊxɱÉÉi¨ÉEäò¹ÉÖ ¨Éänù: Eò¡ò¶SÉè´É Eò¹ÉɪɪÉÉäMÉè: ºxÉä½èþ¶SÉ´ÉɪÉÖ: ¶É¨ÉªÉäÊiÉ iÉä¹ÉɨÉ - SÉ®úEò ÊSÉÊEòiºÉ 6/34 ¨ÉÚjÉɪɨÉänùºÉäSÉ Ê´É{ÉÊ®úhɨÉiÉä - iɺ¨ÉnùºªÉ iÉäVÉÉävÉÉiÉÖ ´ÉÞqùªÉä C±Éänù¨Éänù: |ɶɨÉxÉɪÉSÉ ¤ÉʱÉxÉ: ºÉƶÉÉävÉxÉÉÊxÉ |ɪÉÖÆVÉÒiÉ - - - - ºÉ´ÉǺªÉSÉ ¤Érù¨ÉÚjÉÉhªÉɨÉänùºEò®úÉhªÉ ¤ÉÞƽþhÉÉxªÉÎMxÉnùÒ{ÉxÉÉÊxÉ ¤É±ÉVÉxÉxÉÉÊxÉ +zÉ{ÉÉxÉÉÊxÉ -+¹]õÉÆMÉ ºÉÆOɽþ ÊSÉÊEòiºÉ 14/213-8-2007 doctorksrprasad@gmail.com 13
  • Murphys Fourth Law states that - If there is a possibility of several things going wrong, the one that will cause the most damage will be the one to go wrong. “Management” rather than “treatment”, is the appropriate term in MM/DM, and involves diet, regulations, exercise, insulin, oral hypoglycemic, patient education and counseling.13-8-2007 doctorksrprasad@gmail.com 14
  • Points of observation @ MM Sahaja meha (Beejadosha) - krusha MM Apathyanimittaja - sthula MM Amashaya Samutha MM indicated with Vamana even (Kapha or Kapha Pitta MM) Pakwashaya samutha MM indicated with Virechana (Pitta MM) Avruta Vata janaya MM Dhatu kshaya Janya MM Krimija MM Garbhini MM Chintajanya MM, etc. nùÉè|ɨÉä½þÉè¦É´ÉiÉ: ºÉ½þVÉÉä%{ÉlªÉÊxÉʨÉkɶSÉ - - ºÉÖ¸ÉÖiÉ ÊSÉÊEòiºÉ - 11/3-413-8-2007 doctorksrprasad@gmail.com 15
  • Prabhoota (more than 4 Anjali - Dushya dravibhootata) – Avila (Samala) - Madhura (Kleda- Ojas) Mootra as common symptoms are developed due to – Shareera kleda (blood sugar) added to urine as – glycosuria is “Pratyatma Niyata Lakshana” requires management Usually the MM patient is with – impaired Agni where in pathology has transformed meda as mootra and the tejas of it augment Kleda with Abhishyanna Deha – Drava Pradhana deha |ÉɪÉähÉʽþ |ɨÉäʽþhÉÉä%ʦɹªÉhhÉnäù½þi´ÉÉnÖù{ɽþiÉÉMxÉä - ¨ÉÚjÉɪɨÉänùºÉäSÉ Ê´É{ÉÊ®úhɨÉiÉä - iɺ¨ÉnùºªÉ iÉäVÉÉävÉÉiÉÖ ´ÉÞqùªÉä C±Éänù¨Éänù: |ɶɨÉxÉɪÉSÉ ¤ÉʱÉxÉ: ºÉƶÉÉävÉxÉÉÊxÉ |ɪÉÖÆVÉÒiÉ - +¹]õÉÆMÉ ºÉÆOɽþ ÊSÉÊEòiºÉ 14/2 +ʦɹªÉhhÉ: pù´É |ÉvÉÉxÉ ¶±É乨ÉÊ´ÉEòÉ®úÒ - SÉGò{ÉÉÊhÉ13-8-2007 doctorksrprasad@gmail.com 16
  • In a nut shell - Ahara consumed Absorbed from Amashaya (Madhura rasa ahara) = Amashaya samutha MM = Vamana indicated Food absorbed and transformed at Pakwashaya (Madhura vipaka ahara) = Pakwashaya samutha MM = Virechana indicated Rasa nimittaja or santarpana janya or Apathya nimittaja MM is pathological state of excess rasa in shareera as (Dhatu vruddhi) understood as intracellular glucose excess (many times we are not considering this condition) Excess is mala always – so the excess rasa from the dhatu is brought in to system (interstitial glucose excess) to name as – Shareera Kleda (Blood glucose) Shareera kleda along with “Apdhatu” is filtered by Mootravaha srotas to get Madhura Mootra where the re-absorption capacities of “Vrukka” or Shareera is failed Excess kleda (glucose) attracts 16 molecules of water so as to get Prabhoota and Avila Mootra in MM – thus the Baddhamootra drvaya along with Amedaskara as palliative management13-8-2007 doctorksrprasad@gmail.com 17
  • Preparations Used In Prameha Swarasa – Churna : Amalaki Triphaladi Haridra Mustadi Gokshuradi Nimbapatra Arkadi Bilwapatra Guduchi Kwatha : Ghrita: Vidangadi Dhanvantar ghrita Phalatrikadi Trikantakadi ghrita Sinhamrita ghrita Mustadi Dadimadi ghrita Manjishthadi Shalmali ghrita Pathadi13-8-2007 doctorksrprasad@gmail.com 18
  • Avleha kushavleha Bangavleha Gugglu Gokshuradi Guggulu Gutika : Modaka Chandraprabha Kastur Modaka Indravati Paka Pramehantak Vati Pugapaka Ashwagandhadi paka Draksha Paka. Asava Arishta: Rasaushadhi: Lodhrasava Vasant kusumakar Rasa Dantyasava Mehamudgar Rasa Madhukasava Brihat Vangeshwar Rasa Devdarvyadiarishta Prameha gajkesri Rasa Trivanga Bhasma Lodhrarishta. Vasant tilaka Rasa.13-8-2007 doctorksrprasad@gmail.com 19
  • Pathya in Madhumeha(Low caloric diet) Shook Dhanya: Jeerna Shali, Shashtika, Kodrava, Yava, Godhuma, Uddalaka,Shyamaka Shimbi Dhanya:Chanaka, Adhaki, Kulattha, Mudga Shaka Varga: The leafy vegetables with a predominance of tikta-kashaya rasa, Patola, Karvellaka, Shigru Phala Varga: Jambu, Dadima, Shringataka, Amalaki, Kapittha, Tinduka, Kharjura, Kalinga, Navina Mocha.13-8-2007 doctorksrprasad@gmail.com 20
  • Mamsa Varga:Vishkira mamsa,Pratuda, Jangala mamsa Taila Varga: Danti, Ingudi, Sarshapa , Atasi Udaka Varga: Sarodaka,Kushodaka,Madhudaka Kritanna Varga: Apupa,Saktu,Yavodana,Vatya,Yusha Others: Madhu, Hingu, Saindhava, Maricha, Lasuna13-8-2007 doctorksrprasad@gmail.com 21
  • Pathya Vihara To have walk as much as possible traveling on elephants, horses different plays and games different forms of marshal arts practice roaming in different places other than temples using umbrella Following “Sadvrutta”13-8-2007 doctorksrprasad@gmail.com 22
  • Apathya in Madhumeha(High caloric diet) Aahara: Jala, Milk, Ghee, Oils, Curd, Sugar, Different types of rice preparations, anupa, gramya and audaka mamsa, Ikshurasa, Pishtanna, Navanna. Vihara: Eksthana asana, Divaswapa, Dhoompana, Sweda, Raktamoksha, Mutravega dharana.13-8-2007 doctorksrprasad@gmail.com 23
  • Madhumeha Chikitsa Baladi Churnam – Kshaya - Harita Samhita Gokantkadyavaleha – Bhava Prakasha Kharpara rasayanam – Rasa Ratna samucchyaya Manjisthadyam Ghrutam – Gada Nigraha Sinhamrut Ghrutam – Chakradutta Khadirradi Kashaya – Gadanigraha Pashanbhed Kashaya – Sahasra Yoga Pashanbhed Pak – Yoga Ratnakara Asanadi Yoga - Bhava Prakasha13-8-2007 doctorksrprasad@gmail.com 24
  • Indravati – Rasendrasara sangraha Vedvidya vati – Bharata Bhaishajya Ratnakara Vol 4 Bahumootrantaka ras – Sahasrayoga Maskmruganka ras – Rasaraja sundaram Meha Kesari ras – Rasendra sara Sangraha Pramadananda ras – Bruhat yoga Tarangini Sarweshwar ras – Bhaishajya Ratnavali Somanath ras – Rasendra Chintamani Vangeshwara ras – Yoga Ratnakara Taala Maranam – Bharata Bhaishajya Ratnavali vol-2 Umashambhu Ras – Rasa Ratna samucchya 283 Rasa yogas act on Prameha among 686 yogas Exclusive Madhumeha hara yogas are 2113-8-2007 doctorksrprasad@gmail.com 25
  • MadhumehaShareerika Manasika Anya •DouhrudaSahaja Apathya Chinta doshaBeeja Nimittja janya Sthuladosha •KrimijaKrusha Pakwashaya Amashaya Samutha Samutha13-8-2007 doctorksrprasad@gmail.com 26
  • Revalidation of Management Two entities viz. Shareera Kleda Vruddhi (Hyperglycemia) and Madhura Mutra (Glycosuria) are specific w.s.r. to Madhumeha management. Increase in blood glucose depends upon the tolerance and threshold of body and the action counter depends upon the Vikara vighata bhava in the body Urine out put with sugar is lack of re absorption capacity of kidney The management is proposed - based upon the level of pathology embedded in Amashaya (Pancreatic) or Pakwashaya (Renal) influence13-8-2007 doctorksrprasad@gmail.com 27
  • In Amashaya Samutha MM – Excess glucose absorption from Amashaya because of – Navanna, Guda vikruti etc. makes initially temporary increase of glucose levels there by the Santarpanotha vikara MM develops. The MM from Amashaya is combated from regulating food – use of Pathya Ahara and medicines that inhibit the absorption of glucose from stomach Best example to block glucose absorption is “Indrayava” and “Apamarga Tandula” Here the importance of Vata regulation plays an important role in terms of regulating the pancreas. We should not only see that the shareera kleda is re absorbed from Henleys loop but also re absorption from gut – which could be controlled by controlling the Vyanavata13-8-2007 doctorksrprasad@gmail.com 28
  • Pakwashaya Samutha MM is a condition which is developed because of the post digestive metabolism or protein/fat transformation or at the interference of Citrus acid cycle which in turn excreted through kidney Mainly the action which regulate the fat metabolism and additional glucose release in to the blood as “Shareera Kleda” has to be controlled by either burning it or eliminating it. Here the management which is said is – Virechana – Mootra virechana. Such as Asana – Pashanabheda – Punarnava etc. along with Anulomana – Virechana for Vata13-8-2007 doctorksrprasad@gmail.com 29
  • Krimija Madhumeha – a uncommon name – practically observed should be treated by the Krimihara – pramehahara – medohara – Brumhana – Amedskara such as – (used in Prameha & Madhumeha management) Nisha – Amalaki – Akuli combination The drugs such as – Vidanga etc. The drugs acting on skin – Manjista etc ºÉ´ÉǺªÉSÉ ¤Érù¨ÉÚjÉÉhªÉɨÉänùºEò®úÉhªÉ ¤ÉÞƽþhÉÉxªÉÎMxÉnùÒ{ÉxÉÉÊxÉ ¤É±ÉVÉxÉxÉÉÊxÉ +zÉ{ÉÉxÉÉÊxÉ -+¹]õÉÆMÉ ºÉÆOɽþ ÊSÉÊEòiºÉ 14/213-8-2007 doctorksrprasad@gmail.com 30
  • Dhatukshaya janya MM managed with the Dhatu Pusti kara bhavas Avaranajanya MM treated by controlling Vata Chintajanya MM pacified by controlling Vata, counseling and relieving from causative factors Vastijanya MM (Hexosis) (defect of Hexose transport or active Na+-glucose co-transporters (SGLT) and the facilitative glucose transporters) even though not new a condition, where the glycosuria is observed with out rise of blood sugar – shareera kleda because of filter disturbances in the kidney In the management of MM the role of Vanga and Vatsaka are memorable13-8-2007 doctorksrprasad@gmail.com 31
  • Present trends of utilising hypoglycemic agents to regulate the disease may give temporary hypoglycemic conditions but the understanding of the “Vikara Vighata Bhava” and utilising them in right way offers the MM management in full length. Much to confer on Madhumeha and Diabetes and to unveil – a never end saga It is my privilege to speak on this topic at “World Diabetic Capital” - Hyderabad13-8-2007 doctorksrprasad@gmail.com 32