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“A CONCEPTUAL STUDY ON PATHYA IN MADHUMEHA W.S.R. TO TYPE-2 DIABETES MELLITUS.”
By
Dr. K.L. RAMESH KUMAR B.A.M.S.,
Dissertation submitted to the Rajiv Gandhi University of Health Sciences,
Karnataka, Bangalore.
In partial fulfillment of the requirements for the degree of
DOCTOR OF MEDICINE (AYURVEDA)
In
AYURVEDA SIDDHANTA
Under The Guidance of Dr. K. NASEEMA AKHTAR M.D. (Ayu)
Professor & HOD, Department of Post-Graduate Studies in Ayurveda Siddhanta,
G.A.M.C., Mysore.
Co-Guide DR. K.S.SHANTHARAM M.D. (Ayu)
Asst.professor & HOD, Department of Basic Principles for UG,
Govt Ayurveda Medical College, Mysore - 570021
DEPARTMENT OF POST GRADUATE STUDIES IN AYURVEDA SIDDHANTA,
GOVERNMENT AYURVEDA MEDICAL COLLEGE,
MYSORE.
2010
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ACKNOWLEDGEMENT
I bow to the sacred feet of Almighty, without the blessings of whom this study would
not 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, Former. Professor and HOD, Department of PG
Studies in Ayurveda Siddhanta, Government Ayurveda Medical College, Mysore,
Dr.N.Anjaneya Murthy.Joint Director, Department of Ayush, Karnataka. For his
constant guidance, continuous supervision and help to take up this study. Also, for his
thoughtful provoking concepts and constructive criticism, which have catalysed my work.
Without his guidance with regards to publication via media sources it would not have
been possible to reach out to the society and attract the patients to volunteer for this
study. I owe my heartfelt gratitude for the same.
I sincerely express my indebtedness and profound gratitude to my Guide Dr. Naseema
Akhtar, Professor, Department of PG Studies in Ayurveda Siddhanta, Government
Ayurveda Medical College, Mysore for her valuable guidance & encouragement
throughout my PG studies
First of all it was my privilege that i had the chance to work under the one whom, i
admired since 2002, the year when i started my under graduation. I sincerely
acknowledge my reverend teacher and Co- guide Dr.K.S.Shantharam sir,
Assistant.professor, Department of Kayachikitsa, Government Ayurveda Medical
College, Mysore. He is the one, who has made a great influence on me as a teacher, as a
well wisher and as a source of vibrant energy. Without his encouragement and support
this work could not have become possible. I am very much greatful for his valuable
guidance and support throughout my student life.
I owe my deep sense of gratitude and my heartfelt thanks to my respected teacher and
my well wisher Late.Dr.G.N.Shakunthala, Former.Professor& HOD, Department of
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PG Studies in Ayurveda Siddhantha, Government Ayurveda Medical College, Mysore.
She was the one who supported and encouraged me in all aspects since my under
graduation.
I am grateful to Principal Dr.Ashok D.Satpute, Professor and Head, Department of
Rasashastra and Bhaishajya Kalpana, Government Ayurveda Medical College, Mysore
for his support and encouragement.
I owe my deep sense of gratitude and my heartfelt thanks to my respected teachers
Dr.T.D.Ksheera sagar, Dr.V.Rajendra and Dr.Shreevathsa, for their patient
observations, valuable suggestions and corrections throughout 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.V.A.Chate, Dr. Anand Katti and all other teachers for their
support in this study.
I sincerely express my indebtedness and profound gratitude to
Mr.M.C.Narasimhamurthy, Scientist, Defense food Research laboratories (DFRL),
Mysore. For providing me the valuable text books and scientific journals from the
Library, DFRL, Mysore.
I express enormous amount of thanks to my colleague’s Dr. Kalyani Ashok Bhusane,
Dr.Ranjit kumar shetty and Dr.Geetha, and my seniors Dr.Yogesh Mukund
Jirankalgikar, Dr.Savitha shenoy, Dr.Soubhagya, Dr.Abdul khader patel,
Dr.Annapoorani, Dr.Aparna, Dr.Pankaj pathak and Dr.Rajesh Bhat for their help
and overall support and for making my stay in the college very joyful and educative.
I express my heartfelt gratitude to Mr.Sampath, senior research scholar and Lecturer,
Department of Bio-technology, Maharani’s college, Mysore. and Ms.Girijamba.R.
Senior Research scholar, department of Bio-Technology, University of mysore, mysore.
For guided me in clarifying and identifying the taxonomical features of the
Pathyaaharas.
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I express my heartfelt gratitude to my friend Mohan Kumar. A.P for his strong support
and encouragement throughout my student life.
I wish to convey my thanks to U.G. and PG Librarian Varalakshmi and Somasundar
for 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 my
Patients and I would fail in my duties if I do not express deep sense of gratitude to each
and every one of them.
I am thankful to Dr. Lancy D’Souza for helping in statistical analysis and
interpretation.
I could not be able to come up in my life up to this level without the blessings of my
Parents, Lingaiah and Gayathri, friends and well wishers. I convey my gratitude to all
of them who supported me in all ways.
Last but not the least, I express my thanks to all persons who helped me directly or
indirectly in my studies with apologies for my inability to identify and thank them
individually.
Date: Dr. K.L.Ramesh Kumar
Place: Mysore
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ABSTRACT
Background of the Study
Diabetes was considered to have prevalence in the developed world and higher
classes. Recent studies reveal that it is an increasing problem even in the developing
countries and in lower economical strata.
Diabetes mellitus is a leading cause of morbidity and mortality world over. It is
estimated that approximately 1% of population suffers from DM. The incidence is rising
in the developed countries of the world at the rate of about 10% per year, especially of
type 2 DM, due to rising incidence of obesity and reduced activity levels.
The present study is intended to evaluate the anti-diabetic efficacy of the pathya
aharas in the management of type-2 diabetes. In Sthoulya. Thus, this study is intended to
device a convenient, cost effective and specific treatment for Sthoulya
Objectives of the Study
To compile the available literature on pathya in madhumeha.
To develop a module of pathya for madhumeha.
To evaluate the efficacy of the developed module of pathya in the management of
madhumeha w.s.r.to Type-2 diabetes mellitus.
Method
A Single group Observational Study with pre and post design.
Intervention
As it is a Observational study, the patients are assigned in to single group of 30
patients.
The Module of Pathya ahara & vihara was advised to the patients for duration of 30
days. Followed by a follow-up period of 30 days.
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Statistical Analysis to assess Individual and comparative effects of the groups was
done using Chi- Square test, One Sample t- test, and Repeated Measures ANOVA.
Results
All the patients with newly detected diabetes, considered for the study showed
mild improvement during the first two visits of the study, which is statistically
significant. But there was no overall improvements interms of the normal glucose level of
all the patients, statistically there is no significance in the overall improvement.
Interpretation and Conclusion:
Statistically it shows no significance result in the overall results. The declining values in
FBS & PPBS in the beginning of the dietic advice shows the definite effect action of the
diet on the hyperglycemia, but the consistency in following the diet is not maintained by
the patients regularly, It results in the failure of the overall result.
Keywords
Pathya.
Madhumeha
Diabetes mellitus
Hyperglycemia
Anti-diabetic efficacy
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CONTENTS
Introduction 1
Objectives 3 Pathya Derivation Definition Historical Review Synonym Classification Classification of individual food articles Ashtavidha ahara vidhi visheshayatana Ahara vidhi vidhana Dwadasha ashana vichara Sada Pathyas Pathyatama & Apathyatama aharas Importance of Pathya
5
6 8
10 15 16 17 18 19 20 21 21
Review of Literature
Madhumeha Introduction Derivation Definition Synonyms Classification Nidana Poorvaroopa Roopa Samprapti Roga nirnaya Sadhya asadhyata Upadrava Chikitsa siddhanta Diabetes mellitus
26 27 27 28 29 29 30 32 33 35 39 39 40 41 46
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Pathya aharas in Madhumeha Dhanya varga Shakha varga Harita varga Phala varga Taila varga
57 60 78 88 109117
Pictures of Pathya aharas Review of Previous works 122
Methodology 123
Observation 128Results 138Discussion 154General observations 182Recommendations 183Conclusion 184Summary 185Bibliography 187Master Chart Annexure i-xviii
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No. LIST OF TABLES P .no
1. Classification of Ahara according to Charaka 16 2. List of Pathyatama and Apathyatama aharas 21 3. Classification of vataja prameha 29 4. Classification on the basis of prognosis 30 5. Specific Madhumeha Nidana 32 6. List of Poorva roopas in Brihatrayees 32 7. Prameha pidakas 41 8. ADA recommended diagnostic criteria of Diabetes mellitus 52 9. List of Pathya aharas in Madhumeha 57
10. List of foods used in Diabetes mellitus 126
11. The assessment criteria’s 127 12. Distribution of sex 128 13. Distribution of Age group 128 14. Distribution of Religion 129 15. Distribution of Location 129 16. Distribution of Family History 129 17. Distribution of Occupation 130 18. Distribution of Exercising Practice 130 19. Distribution of Socio Economic Status 131 20. Distribution of Education 131 21. Distribution of Nature of Work 132 22. Distribution of Diet 132 23. Distribution of Hours of Day Sleep 133 24. Distribution of Hours of Night Sleep 133 25. Distribution of Habits 134 26. Distribution of Prakruti 134 27. Distribution of Saara 135 28. Distribution of Samhanana 135 29. Distribution of Satmya 135 30. Distribution of Sattva 136 31. Distribution of Abhyavaharana Shakti 136 32. Distribution of Jarana Shakti 137 33. Distribution of Vyayama Shakti 137 34. Results showing Mean PU values on 0th ,14th, 30th &60th days 138 35. Results showing Mean PP values on 0th ,14th, 30th and 60th days 138 36. Results showing Mean PD values on 0th ,14th, 30th and 60th days 139 37. Results showing Mean BFP values on 0th ,14th, 30th and 60th days 139 38. Results showing Mean FBS values on 0th ,14th, 30th and 60th days 140
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39. Showing the results of repeated measure ANOVA for mean FBS 140 40. Results showing Mean PPBS values on 0th ,14th, 30th and 60th days 141 41. Showing the results of repeated measure ANOVA for mean PPBS 141 42. Shows the distribution of overall results 142 43. Showing the results of repeated measure ANOVA for overall
results 142
No. LIST OF ILLUSTRATIONS P. no
1 Showing Distribution Of Age 143 2 Showing Distribution Of Sex 143 3 Showing Distribution Of Religion 144 4 Showing Distribution Of Occupation 144 5 Showing Distribution Of Education 145 6 Showing Distribution Of Socio-Economic Status 145 7 Showing Distribution Of Location 146 8 Showing Distribution Of Family History 146 9 Showing Distribution Of Diet 147 10 Showing Distribution Of Nature Of Work 147 11 Showing Distribution Of Exercising Habit 148 12 Showing Distribution Of Hours Of Day Sleep 148 13 Showing Distribution Of Hours Of Night Sleep 149 14 Showing Distribution Of Habits 149 15 Showing the Distribution of Mean values of Polyurea 150 16 Showing the Distribution of Mean values of Polyphagia 150 17 Showing the Distribution of Mean values of Polydypsia 151 18 Showing the Distribution of Mean values of BFP 151 19 Showing the Distribution of Mean values of FBS 152 20 Showing the Distribution of Mean values of PPBS 152 21 Showing the Distribution of Overall improvements 153
No. LIST OF FLOW CHARTS P.no
1 Synthesis and releas e of Insulin 54 2 Schematic representation of pathogenesis of Type-2 dm: 55 3 Pathophysiological basis of common signs and symptoms 56 4 Prameha nidanas
No. LIST OF PICTURE P.no
1 Pthya aharas of Madhumeha 121.a 2 Annexure i-
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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
C.S - Charak Samhita
S.S - Shusruta Samhita
A.H - Astanga Hridaya
A.S - Astanga Samgraha
S.K.D - Shabda Kalpa Druma
R.N - Raja nighantu
K.N - Kaiyadeva nighantu
N.R - Nighantu ratnakara
D.N - Dhanvantari Nighantu
B.P - Bhava Prakash
M.N - Madhava Nidana
Sh.S - Sharangadhara Samhita
Ka.S - Kasyapa Samhita
ABBREVIATION
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 1
INTRODUCTION
Diabetes is a disease known from the dawn of civilization. Sedentary life style,
lack of exercise, faulty food habits and improper medication and urbanization
precipitate the disease. Diabetes mellitus is a common chronic metabolic disorder
prevalent all over the world. Although diabetes has been a known morbidity since
time immemorial, its incidence has been growing notably in recent years. It has turned
out to be the biggest “silent killer” today in the world. The mortality rate due to
Diabetes mellitus is very high and is ranked fifth amongst the ten major causes of
death in southern part of India.
The rising prevalence of diabetes is closely associated with industrialization
and socio-economic development. It will soon become the first incommunicable
disease whose severity will be endorsed by the United Nation. Forecasts of soaring
rates of diabetes in the next two decades may be wildly underestimated, a new study
suggests. Evidence from Canada indicates that the diabetes "time-bomb" may be a far
worse global health threat than anyone imagined. The World Health Organization
(WHO) predicts that the prevalence of diabetes among adults will reach 6.4% by 2030
- a 60% increase since 1995.
In spite of tremendous advancement of modern system of medicine i. e. oral
hypoglycemic agent and insulin till date, an ideal drug which can cure diabetes is not
yet available and still scientists are struggling to search an effective and harmless
therapy.
The ancient Ayurvedic classical texts, namely the Samhitas of Charaka,
Sushruta, Vagbhata and the subsequent treatises have invariably given detailed
description of the disease diabetes, its causes, types, pathology and the line of
management and treatment both preventive and curative.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 2
Madhumeha is mainly caused due to Apathya ahara and vihara sevana, while
describing the chikitsa for Madhumeha all scholars have focussed on Pathya aharas in
the management of madhumeha with a greater importance.
Well known Cikitsa Grantha of medieval period “Vaidhya Jivanam” by Lolimbaraja
has stated the importance of Pathya-Apathya in Cikitsa as ,
mÉjrÉãxÉÌiÉ aÉSÉiÉïxrÉ ÌMüqÉÉæwÉkÉ ÌlÉwÉãuÉhÉæ: ?
mÉjrÉå AxÉÌiÉ aÉSÉiÉïxrÉ ÌMüqÉÉæwÉkÉ ÌlÉwÉãuÉhÉæ: ?
If a person follows the dietary rules for particular disease there is very little
significance of drug treatment and when a person is exposed to Apathya the drug
treatment has not value because taken drug can’t cure the disease1.
Ahara is said to be Mahabhaisajya by Kasyapacarya, hence no any other
medicament just like diet is not available. In other words, one is capable to make man
disease free only with the cereals (congenial diet).One is not able to sustain life
without diet even of endowed with medicine that is why the diet is said to be the great
medicament by physician2.
Madhumeha is basically a disease of metabolic derangement of carbohydrayte
metabolism. The fualty food itself is being a cause of the disease, it can be managed
by the administration of the suitable food which is wholesome to the body channels. It
is not yet become possible to frame an ideal diabetic diet for the effective
management of the disease. In ayurveda, pool of information is available in scattered
form. In the present day scenario there is need to collect the scattered matter and it is
to be reproduced with a scientific data base in front of the ultra modern world. Hence
this work was undertaken to find a better dietic management for the management of
Type-2 diabetes mellitus.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 3
This study is a single observational Study with Pre and Post‐test design. The
patients are assigned in to single group. Diet and Regimen proforma was given to all
patients.
This dissertation comprises of two parts, Part I and II. The First Part deals
with the Review of the literature on the concept of Pathya, Madhumeha and Pathya
aharas in madhumeha, which are carried out, by thoroughly reviewing Ayurvedic
Literature and also modern literature regarding Madhumeha and Pathya. The
Second Part deals with Materials and methods, Observation, Results, Discussion,
Conclusion and Summary. This part is based on a Observational trial organized on
30 patients of newly detected diabetes selected from OPD, IPD of Government
Ayurveda Medical College and Hospital, Mysore and special camps conducted in and
around Mysore.
OBJECTIVES OF THE STUDY
To compile the available literature on Pathya in madhumeha.
To develop a module of pathya for madhumeha.
To evaluate the efficacy of the developed module of pathya in the management of
madhumeha w.s.r.to Type‐2 diabetes mellitus.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 4
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 5
CONTENTS
1. Introduction
2. Derivation
3. Definition
4. Historical Review
5. Synonym
6. Classification
7. Classification of individual food articles:
8. Ashtavidha ahara vidhi visheshayatana
9. Ahara vidhi vidhana
10. Dwadasha ashana vichara
11. Sada Pathyas
12. Pathyatama & Apathyatama aharas
13. Importance of Pathya
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 6
REVIEW ON PATHYA
INTRODUCTION
Pathya is one which is very much wholesome to the srotases (channels of
body) and it is very specific according to the different conditions of the body.
Wholesome diet is the prime cause for the growth and development of the body, on
the contrary, unwholesome diet causes several diseases. Caraka samhita emphasizes
that, the ideal diet is that which maintains the equilibrium of the body constituents.
Irrational diet acts otherwise, producing disease3.
In Ayurvedic classics for the regular usage, some of the Pathyas have been
told. They are called as Sadaa Pathyas and the specific foods which are designed for
the specific diseases are avastika pathyas. In the management of disease Pathya is
having equal and even more importance than that of Beshaja or Treatment. Hence to
advice the suitable Pathya for the diseased as well as healthy individual, it is very
important to understand the concept of Pathya in detail.
DERIVATION:
The word pathya is a streelinga shabdha, it is derived from the root of pathin i.e.,
“mÉÍjÉlÉç+kÉiqÉmÉjrÉjÉïlrÉÉrÉÉSlÉmÉãiÉã |
ÍcÉÌMüixÉÉSÉæ ÌWûiÉMüÉUMüqÉç iÉimÉrÉÉïrÉ: MüÉUlÉqÉç ÌWûiÉqÉç || (zÉ.Mü.SìÓ) – means hitakara in the chikista4.
The word Pathya is made up of two words, mÉjÉç+AcÉç mÉëirÉrÉ.ã çmÉjrÉÇ ÍcÉÌMüixÉÉlÉÑxÉÉËU qÉÉaÉÉïrÉ
ÌWûiÉqÉç|�
Means which is hitakaraka to the srotomargas according to the chikista”5.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 7
DEFINITIONS:
mÉjrÉÇ mÉjÉÉãlÉmÉãiÉÇ rÉkrÉŠÉã£üqÉç qÉlÉxÉ: ÌmÉërÉqÉç |
rÉŠÉÌmÉërÉqÉmÉjrÉÇ cÉ ÌlÉrÉiÉã iÉ³É sÉYzÉrÉãiÉç ||
In Caraka samhita, Pathya is defined as, the wholesome Àhàra, which do not
adversely affect the body channels i.e Patha, and which is very pleasant to the mind 6.
ÍcÉÌMüixÉÉSÉæ ÌWûiÉMüÉUMüqÉç iÉimÉrÉÉïrÉ: MüÉUlÉqÉç ÌWûiÉqÉç ||
That which is good for chikitsa is called Pathya 7
qÉÉaÉïxÉÉkÉÉæ mÉjÉÉãlÉmÉãiÉ: rÉiÉç |
ÌWûiÉã ÍcÉÌMüixÉÉSÉ, æ ÌWûiÉ MüÉUMü pÉÉãerÉSìurÉpÉãSã
Which is, good for the sroto margas and does not harm the sroto margas, Hitakaraka
ahara is one among the Bhojya dravya bheda.8
mÉjÉÉãlÉmÉãiÉç rÉiÉç |
ĘɹqÉÉlÉxiÉÑ mÉUÉã lÉÉãmɤÉrÉ : mÉjrÉÍqÉŠiÉ |
Which does not makes harm to the sroto margas is called as Pathya & that which is
having the compatibility, wholesomeness & comfortness with marga, is called Pathya.
9
ÌWûiÉã ÍcÉÌMüixÉÉSÉæ ÌWûiÉMüÉUMãü ||
LãiɲÉã qÉlÉuÉ; mÉjrÉÇ ÎxlÉakÉÇ AsmÉÇcÉ pÉÉãeÉlÉÇ.
ÌuÉlÉÉÌmÉpÉãwÉeÉæurÉïÍkÉ: mÉjrÉÉSãuÉÌlÉuÉiÉïiÉã |
That which is good for chikitsa is called Pathya, one should eat Snigdha and alpa
ahara. And the disease can be cured only by following Pathya even without
medicines.10
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 8
ÌuÉ,mÉjÉÉãlÉmÉãiÉqÉç, xuÉxjÉxrÉ xuÉÉxjrÉ U¤ÉhÉqÉÉiÉÑU urÉÉÍkÉ urÉÍkÉmÉËUqÉÉã¤É¶ÉãÌiÉ mÉljÉÉxiÉxqÉSè AlÉmÉãiÉqÉç | qÉlÉ: ÌmÉërÉqÉç
|
That which is very wholesome to the body channels, maintains the health and cures
the disease & which is very pleasant to the mind is called Pathya.11
mÉjÉÇ ÍcÉÌMüixÉÉlÉÑxÉÉËU qÉÉaÉÉïrÉ ÌWûiÉqÉç |
ÍcÉÌMüixÉÉãmÉrÉÉãÌaÉÌlÉ UÉãÌaÉxÉãurÉ uÉxiÉÑÌlÉ | ÌWûiÉMüUMãü cÉ |
That which is good to the channels of chikitsa , and it is very good for the diseased
person to get cured from his Vyadhis.12
Meaning of the word Pathya:
Path., pathati, to go, move, to fly
Patha: away, path, road, course, reach.
Pathin: in a way, Path, road, course.
Pathya: Belonging to the way, suitable, fit proper, wholesome, salutary, and
especially said of diet in a medical science.
Pathyaasin: Eating or an eater of wholesome diet 13
Modern Dictionary meaning of word Ahara:
Collins dictionary defined the word food as “Any substance that can be ingested by a
living organism and metabolized into energy and body tissue is known as food”.
According to TABER’s dictionary food is defined as “any material that provides the
nutritive requirements of an organism to maintain growth and physical well being.
Major B. N. Khan – Nutrition: “Food is a substance which, when taken in the body,
is able to build up or repair tissue, protect against ill health (disease) and supply
Material for the production of health and energy”.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 9
HISTORICAL REVIEW
Veda kala
In Yajurveda, Ahara has been praised as “oh! God, Give us food which does not
cause any diseases and also gives us strength. And also, Lord Agnideva is called
annaswami.
Upanishad kala:
Chandogyaopanishad Bhashyartha: 7th chapter, Anna is called as Brahma. And
also it is described that, the food that we consume gets separated in to three parts. The
sthula or exterior gets converted into pureesha, Madhyama or the middle one is
converted into mamsa and Sukshma or intrinsic part is converted into mind or mana.
Taittiryopanishad: while explaining the Importance of Ahara, it is told that,
All human beings are made of anna, all living creatures which are living on the earth
are made up of anna, and anna is the very basic need of all living creatures on the
earth. So it is called as Sarvaushada.
Purana kala
In Vishnu purana: An important rule has been told for Ahara sevana, One should
take half part of stomach with solid foods; one fourth part of liquids and remaining
part should be kept empty for vata.
In Brihadhyajnavalkya Smriti: The food which we consume should be considered
as amrita. If we took the food through ‘Prana agnihotra vidhana’, then it destroys all
the diseases.
In Ramayana: Diet has been classified into two groups by Valmeeki viz, Satvika
Ahara & Tamasika Ahara.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 10
In Mahabharata: The one who wants to be healthy should take food such as easily
palatable, well digestible and will be helpful for the body after digestion. And it also
told that, the one who takes food on proper quantity lives long life without any
diseases, get strength and alertness of mind. And also he will get healthy progenies.
In Bhagavat geeta: All living beings are made out of food, the purpose of food is to
increase the duration of life, purify the mind and to aid bodily strength. The
description of three different types of food has been told viz, Satvika, Rajasika
&tamasika.
In Chanakyasutra: mÉjrÉqÉmrÉmÉjrÉÉeÉÏhÉãï lÉÉÎzlÉrÉÉiÉç | (cÉÉhÉYrÉ xÉѧÉ)
If somebody is suffering from indigestion due to unwholesome food and over diet, he
should not take any kind of food.
In Buddhist literature: it has told that, the food should be consumed with due
respect and mercy along with the sanga bikkhus. Buddhagosha says that, the one who
takes one meal in a day will not be suffered by any illness.14
SAMHITA KALA:
In Charaka Samhita: The concept of Pathya is scattered everywhere in charaka
samhita. In Sutrasthana only we can get many references regarding the concept of
Pathya. In the first chapter Dirganjeevitiya adhyaya, the concept of hita ahita has been
told. In 5th chapter Matrashitiya, sada Pathya is told. In 6th ch tasyashitiya. In Charaka
Sutrasthana 22, 23, 25, 27, 28, 29 and 30th chapters we can get various references
related to the concept of pathya. In Ca.Vi 5th chapter the importance of Pathya has
been told. In Ca.Ci 1st chapter Pathya has been told as synonym for beshaja. In
Ca.Ci.30th chapter importances of Pathya have been told.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 11
In Sushruta Samhita: The Concept of Pathya is also found scattered throughout the
Susruta Samhita, In Sutra sthana 1st ch Vedotpatti adhyaya, the importance of Ahara
& Aushada is told. In 20th ch Hitahitiya adhyaya the concept of Hita ahara and Ahita
ahara is explained in 35th ch, the concept of satmya and asatmya has been explained.
In Uttara tantra 64th chapter, dwadasha ashana vichara has been told according to the
different conditions of body.
SANGRAHA KALA:
In Ashtanga Samgraha: The concept of Pathya is found in various chapters &
Sthanas of Ashtanga samgraha, in sutra sthana 3,4,10 and 11th chapters the scattered
information related to pathya is available. And also the description of pathya is found
scattered in various sthanas.
In Ashtanga Hridaya:In Sutra sthana 3rd ch Ritu charya, Seasonal dietic regimen has
been told. In 8th ch Matrashitiya adhyaya, Sada Pathyas, Ahara matra and diseases
caused due to atimatra and amatra, has been told. And the related concepts are also
found in other sthanas of Ashtanga hridaya.
SYNONYMS:
Atmaneena, Ayushya and Hita (D.N.Mishraka varga.77)
Chikitsitam, Vyadhiharam, Pathyam, Sadhanam, Oushadham, Prayaschitam,
Prashamanam, Prakruti Sthapanam, Hitam, these are synonyms for the bheshaja.
(ch.chi.1/3)
TERMS RELATED WITH PATHYA
In the Ayurvedic classics, the terms Hita, Satmya, Pathya, Upashaya are used
to impart the perception of wholesomeness. Even though these technical terms of
Ayurveda imparts similar meaning, these terms along with there antagonisms must be
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studied to get a proper understanding of the concepts of wholesome and unwholesome
food/diet, dietary regimens.
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Satamya- Asatamya:
A substance conductive to an individual is called Satmya and the use of such
substances results in the well being of that individual. This is of three types, viz.
superior, inferior and mediocre. According to another mode of classification, it is of
seven types, depending upon the administration of individual Rasas (six types) and
the use of Rasas jointly (seventh type). Use of all the Rasas is of the superior type of
Satmya; use of only one Rasa is of an inferior type and in between the superior and
the inferior types is the mediocre type of Satmya. The inferior and mediocre types
should be slowly changed over to the superior types of Satmya. 15
Chakrapani opines that, the term Satmya is used to convey the idea of Oka
Satmya (i.e. to make a substance conducive to the body by its habitual intake.) (Ca.Vi.
1/20 Ck.) Satmya or homologation stands for such factors which are wholesome to the
individual even when continuously used. 16
In Susruta samhita: Satmya (habituation, a customization) is the use of such
things which do not cause harm to the body even though they are opposite of /
different from ones own constitution, habitat, time, caste(family) season, disease,
exercise (physical activities) water, day sleep, taste and such others.
The taste (substance of such tastes) which consumed makes for happiness
(health) only, apart from that (health) produced by exercises and others (season,
habitat etc.) should be considered as Satmya .17
Upasaya and Anupasaya
Upasaya is also one of the synonyms of satmya. Upasaya means that which gives
happiness eventually. Though upasaya is a synonym of satmya it helps mainly in
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diagnosis of hidden diseases. Chakrapani comments, Upashaya is that which helps to
diagnose the invisible diseases. 18
Upasaya is the suitable use of drug, diet, and behavior which are contrary to the cause
of diseases or the disease itself or which produce effects contrary to
them(A.S.Ni.1/6).19 Such medicines, diets, regimens bring about happiness either by
acting directly against the cause of the disease and or the disease itself or by
producing such effects indirectly are called upasaya.
Upashaya is the explanatory theory that provides diagnostic aid for disease which is
otherwise difficult for diagnosis. Most of the commentators called upasaya as
vyadhisatmya.20 Upasaya is divided into the following two broad groups:
1. Drugs, diet, and regimens which are actually antagonistic to the cause of the
disease or disease itself. (Hetu vyadhi vipareeta )
2. Drugs, diets, and regimens which are actually not antagonistic either to the cause of
the disease or to the disease itself but when employed, they actually alleviate the
condition by counteracting either the disease or the cause of the disease.( Hetu vyadhi
vipareetharthakari) 20
Hita and ahita
The food articles, which maintain the equilibrium of bodily Dhàtus and help in
eliminating the disturbance of their equilibrium, are to be regarded as Hitakara Àhàra
otherwise they are Ahitakara to body. In Caraka, it is stated that Hitakara diet is the
only cause of growth and development of body and Ahitakara diet is the only cause of
disease.21
Wholesome and unwholesome food articles bring out opposite effects,
depending upon the variations in dose, time, method of preparation, habitat, and
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constitution of the body, disease and the age of the individual. The bodies as well as
diseases are caused by food; wholesome and unwholesome food is responsible for
happiness and misery respectively.22
Chakrapani comments on the following factors to be considered,
Matra: By the Improper dosage the pathya becomes Apathya and vice versa. Ex. Pathya
ahara Raktha shali, if given atimatra or heena matra it becomes apathya.
Kala: Raktashali is laghu ahara, if it is given in hemanta kala where agni is very much
predominant then it will become Ahita.
Samskara: By the proper methods of processings like swinna, prasrutva etc, the odana or rice
will become Hita. And in relation with Bhumi, it becomes Apathya in Anupa desa.
Avastha: The tikta rasa is Pathya in balyavasta, because of the predominance of kapha in
balyavastha, where in vriddhavasta it becomes Apathya because the vata will be more
dominant in this age.23
The body is constituted of food, hence one should take wholesome (Hita) Ahara only
after careful examination and should not indulge in unwholesome (Ahita) ones out of
greed or ignorance.24
As Susruta stated in Sutra 20, there are 3 types of dravya.
1] Ekanta Hita(always/totally wholesome): Those which do not harm the body even
though used always (routinely) are called as Ekanta Hitakara e.g. given in classics as
water, milk, ghee and audana (boiled rice), which are always suitable and accustomed
to man by birth
2] Ekanta Ahita: (Absolutely unsuitable): It means those which harm the body
quickly and so can not be used even for short period, which are always unsuitable and
perform actions like Dahana, Pacana and Marana such as Agni, Ksara and Visa etc.
3] Hitahita Ahara: (conditional wholesome /Suitable- conditional /unsuitable): those
which do not harm in certain conditions (proper quantity, time, season, admixture,
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processing etc.) but cause harm in certain other conditions (improper quantity, time,
season, admixture, processing etc.) are said to be Hitahita Ahara. Due to their nature
and result of combination they become absolutely suitable, absolutely unsuitable or
suitable –unsuitable. Thus substances are of three kinds.
Therefore, conditional unwholesome is called Apathya e.g. Milk is always
Hitakari in healthy state of body but when one individual is suffering from
Navajwara, milk is not Hitakari in this condition. So milk is called Apathya in
Navajwara. Another point is that Hitakari term is used mostly in healthy state of
individuals while Pathya term is used mostly in ill conditions.25
According to Sushruta, the meal processed by the special methods appropriate
to the patha and desired taste etc and which is pleasant to manas, clean, not too hot,
and is fresh, is considerd as hita.26
PATHYA AND APATHYA:
The drugs and regimen which do not adversely affect the body channels and
which are pleasant to mind are regarded as Pathya or wholesome; those which
adversely affect them are considered to be Apathya or unwholesome27, but this cannot
be accepted as a general rule in absolute terms. The drugs and regimen in fact change
their qualities, depending on the dosage, season, and method of preparation, habitat
and combination with other useful and harmful substance.28 So the natural qualities of
regimen and drugs as well as the conditions like dosage etc. are required to be well
ascertained before the administration of the requisite therapy in order to achieve the
desired effect.29
Chakrapani opines that, The Patha here is to be considered as shareera margas
i.e. srotas, the food which do not harm the body and mind is regarded as Pathya and
clarifies with an Ex. Ghee is generally regarded to be Pathya ahara but intake of ghee
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in excessive quantity or its intake during spring or when it is prepared with drugs of
opposite qualities or its intake by an individual of marshy land or by an individual
having corpulent body or the one in whom Kapha is aggravated is considered to be
Apathya.30
Conversely even an unwholesome drug like poison becomes wholesome, if
taken in proper quantity. For the purpose of rejuvenation poison is said to be given in
the quantity of a sesame seed.31 generally, wholesome nature of a drug may however
be defined. But the definition of wholesomeness relates only to its natural form & also
about unwholesomeness. For example red variety of Sali rice is wholesome by nature
and Yavaka etc are unwholesome. 31
Gańgàdhara in Jalpakalpataru Tika of Caraka Samhita has given a very clear cut
explanation. A drug and diet not causing harmful effects to any channel of body and
which is comfortable to Mana is granted as ‘Pathya’. Although pungent and bitter
cause discomfort at a time to mind but, it is ultimately comfortable for body, so it is
taken as ‘Pathya’. Thus anything producing discomfort to mind initially or later on is
granted as ‘Apathya’ otherwise taken under ‘Pathya’.32
From the above descriptions it is clear that hita, satmya, upasaya, and pathya, are
almost conveying the same meaning. The hita when applied for diagnostic purpose is
called as upasaya and for therapeautic purposes as pathya, and for the conducive
purpose it is known as satmya.
CLASSIFICATION OF PATHYA (Ahara):
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For the proper understanding of any subject a systematic classification is necessary.
Pathya is also considered as hitakara bhojya dravya, hence the classification of ahara
can be considered for Pathya.
Table.No.1 Classification of Ahara according to Charaka 33
Sr no Classified By Type Name 1 Aharatva(Edible) 1 Ahara 2 Yoni(Origin) 2 Sthavaram(Vegetable products)
Jangama (Animal products) 3 Prabhava 2 Hitam (wholesome)
Ahitamn (unwholesome) 4 Virya 2 Sita
Usna 5 Upayogat (Nature
of intake) 4 Pana (Beverages), Ashana (Eatables),
Bhakshya (Masticable food), Lidhyam (Linctuses)
6 Mahabhuta 5 Parthiva, Apya, Tejasiya,Vayaviya, Akasiya
7 Rasa 6 Madhura, Amla, Lavana, Katu, Tikta, Kasaya
8 Virya 8 Guru, Laghu, Sita, Usna,Snigdha, Ruksha, Manda, Tiksna
b. Considering the effect of Ahara on mental faculties Srimad Bagavat Geeta
classifies ahara in to three groups.
1. Satvika, 2. Rajasika and 3. Tamasika:
c. According to effect of Ahara Susruta Acarya has classified it in to three
groups34
Ekanta Hitakara, Ekanta-Ahitkara and Hita –Ahitkara
d. Classification of Ahara according to various Acaryas:
Bhavamishra, Yogaratnakar, Kasyapa, Sarangdhar has classified Ahara in six
categories by the nature of intake.
1. Chusya (which are sucked)
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2. Peya (liquids which are drinkable)
3. Lehya (which are licked)
4. Bhojya (solid food)
5. Bhaksya (eatable food)
6. Carvya (which require mastication)
Except the above classification Kashyapacarya has mentioned twelve types of Ahara
as Ahara Pravicarana and 24 types of Ahara as per Kaladinam. 35
Factors responsible for the Pathya Dravyas
The Wholesomeness (Pathya) and unwholesomeness (Apathya) of Ahara dravyas
depends upon these following factors like, Matra, Kala, Kriya, Bhoomi, Deha, Dosha,
guna. All these factors are to be taken into consideration before advising Pathya.36
Ashtavidha ahara vidhi viseshayatana
In Charaka Sutrasthana it is explained that, there are eight factors37 to be considered
in dietetics. They are responsible for causing happiness or misery. These factors are
to be examined before taking any food.38
Definition:
Ahara Vidhi Viseshayatanani consists of three different words. Here, Visesha relates
to both word - Ahara and Vidhi as, Ahara Visesha, Vidhi Visesha and Ayatana.
Ahara Visesa: means – Speciality, special property, distinguished effect (of Ahara).
Vidhi Visesa: means – Special system, Special method, Special manner, Special way,
Special arrangement, Special rule, Special command or Special statement for diet
intake.
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Ayatana: Cause, support, Hetu etc. Thus Ahara Vidhi Vishesayatanani means the
causative factors which are responsible for the wholesome and unwholesome effect of
the food or the method for the diet intake.
The eight factors which determine the utility or otherwise of various types of food are:
1) Prakrti - Nature of substances
2) Karana - Processing of substances
3) Samyoga - Combination of different substances
4) Rasi - Quantum of substances to be taken
5) Desa - Habitat of substances
6) Kala - Time as age, seasons and conditions
7) Upayoga Samstha - Dietetic rules
8) Upayoktra - The individual
AHARAVIDHI VIDHANA:
These are the dietetic rules which are to be followed while taking the food.39
One should consume only that in proper quantity which are,
Ushna
Snigdha
Matravat
is consumed after the digestion of previously ingested food
Virya Aviruddha Ahara
Is to be taken in Ishte desha, where it is provided with Ista Sarvopakarana
Not to be taken speedily
Not to be taken too slowly
Taken without talking with others
Taken without laughing
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Taken with the concentration of the mind
Taken after paying due regard to oneself or own self.
This description given by the Caraka is mainly for the healthy and unhealthy persons
and Sushruta has described it for Unhealthy persons and called it as Dwadasa
Asanavicara.
DWADASHA ASHANA VICHARA: 40
1. Shita Anna: Persons afflicted with thirst, heat, alcoholism, burning sensation,
Rakta-Pitta, poisoning and epileptic fits as well as those suffering from the effects of
sexual excess should be treated with cold food.
2. Ushna Anna: Persons afflicted with the aggravation of bodily Kapha and Vayu as
well as those already treated with purgatives of Sneha and those whose bodies are full
of Kleda (physical moisture) should be treated with warm food.
3. Snigdha Anna:Persons suffering from the aggravation of bodily Vayu and from a
parched (Ruksa) condition of the body as well as those suffering from the effects of
sexual excess and those accustomed to physical exercise should be treated with
Snigdha food.
4. Ruksha Anna: Persons with an excess of bodily Medas and Kapha as well as those
suffering from Meha and those previously treated with a Sneha should be treated with
Ruksa food.
5. Drava Anna: Weak, parched and thirsty persons should be given Drava food.
6. Shushka Anna: Those suffering from Meha and ulcers as well as those whose
bodies are full of Kleda should be given dry food.
7. Eka-Kala Anna: Persons with impaired digestion should be given only one meal
every day, so that the digestive fire may have opportunities to be rekindled.
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8. Dwi-Kala Anna: Persons with the proper amount of digestion should be given two
meals a day.
9. Matra Hina: Food and drink in smaller quantity would be beneficial to persons
suffering from impaired digestion or any other disease.
10. Aushadha Yukta: Medicine should be given with food and drink to a person,
having aversion to it.
11. Dosha Prasamana: Foods consumed appropriate- suitable to season is Dosha
Prasamana
12. Vrityartha:All foods consumed by the healthy person is meant to maintain health
and life. Considering these twelve aspects ingestion of food should be planned. In
order to prevent the unmanifested diseases and to cure the manifested ones, an
individual desirous of happiness, should follow the prescribed regimen.
Daily indicated pathya ahara
Shasthika shali,Mudga, Saindhava, Amalaki,Rain water collected before falling on the
ground, Ghrita, Meat of animals dwelling in arid climate (jangala) and Madhu. All
these foods to be practiced for the regular usage, but in the proper dosage and
management.41 By the usage of these food articles, it maintains the health and it
prevents the person from getting sick.
In Ashtanga hridaya it is told, Shali, Godhuma, Yava, Shashtika, Jangala mamsa,
Jivanti shaka, mulaka, Vastuka, Amalaka, Mridvika, Mudga, Sharkara, Ghrita,
Vyodaka, Ksheera, Kshoudra, Dadima and Saindhavas are to be use habitually.42
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Table.No.2 THE LIST OF PATHYATAM AND APATHYATAMA AHARAS IN
VARIOUS CATEGORIES.43
Sl.no. Ahara Dravya HitamAhara Dravya AhitamAhara Dravya
1 Shukadhanya Shali Yavaka
2 Shamidhanya Mudga Masha
3 Udaka Toya ambu Nadi jala
4 Lavana Saindhava Ushara
5 Saka Jivanti Sarshapa
6 Mriga mamsa Ena Gomamsa
7 Pakshi mamsa Lava Kana kapota Mamsa
8 Vilesaya Godha Bheka
9 Matsya Rohita Cilcima
10 Sarpi Goghrita Avi sarpi
11 Milk Godugdha Avi dugdha
12 Sthawara Sneha Tila taila Kusumbha oil
13 Anupa mriga vasa Varaha vasa Mahisha vasa
14 Matsya vasa Chuluki vasa Kumbhira vasa
15 Jalcara Vihanga vasa Pakahamsa vasa Kakamadgu vasa
16 Vishkira Sakuni vasa Kukkuta vasa Chataka vasa
17 Sakhada Medsam Aja medas Medas of hasti/ Gaja
18 Kanda shaka Shringavera Nikucha
19 Phala Mridvika Aluka
20 Iksu Vikara Sharkara Phanita
IMPORTANCE OF PATHYA:
The main aim of Àyurveda is to preserve the health of a healthy person and to
treat the disease of diseased one. Àhàra, Swapna (Nidra) and Brahmacarya play an
important role in the maintenance of “Swasthya” of an individual. That is why these
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are called as Trayopastambha of life. Àhàra plays an important role in healthy and in
diseased. It is more important than the medicine itself. The body can be nourished and
maintained in good health status, by adopting suitable diet and full benefits of life can
also be reaped by adherence to proper mental hygiene. 44
Wholesome diet is the prime causes for the growth and development of the
body, on the contrary, unwholesome diet causes several diseases. Caraka emphasizes
that the ideal diet rebuilds the worn out systems, nourishes the Dhàtus and maintains
the equilibrium of the body constituents. Irrational diet acts otherwise, producing
disease.45
Food sustains the life of living beings. All living beings in the universe require
food. Complexion, clarity, good voice, longevity, geniuses’ happiness, satisfaction,
nourishment, strength and intellect are all conditioned by food. Professional activities
leading to happiness in the world, Vedic rituals leading to abode in heaven and
observance of truth, Brahmacarya leading to salvation are all based on food.
Only the individual having a healthy body can afford to perform all activities
leading to happiness, heaven and salvation, and for the preservation of health intake
of food is essential. Hence food is the basic factor for the attainment of all of them.
In Chakrapani commentary of Ca.Vi.5/4, he has said that which causes dosha
prakopa is Apathya, in contrary to this that causes dosha prashamana is Pathya.46
Pathya is being considered as the ideal Ahara (dietic regimen) which suits for the
different conditions of the body, to maintain the normal state of Dosha-Dhatus & to
bring back the imbalanced Dosha-Dhatus of body.
Well known Cikitsa Grantha of medieval period “Vaidhya Jivanam” by Lolimbaraja
has stated the importance of Pathya-Apathya in Cikitsa as ,
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Dr.Ramesh Kumar.K.L 25
mÉjrÉãxÉÌiÉ aÉSÉiÉïxrÉ ÌMüqÉÉæwÉkÉ ÌlÉwÉãuÉhÉæ: ?
mÉjrÉå AxÉÌiÉ aÉSÉiÉïxrÉ ÌMüqÉÉæwÉkÉ ÌlÉwÉãuÉhÉæ: ?
If a person follows the dietary rules for particular disease there is very little
significance of drug treatment and when a person is exposed to Apathya the drug
treatment has no value because the drug taken can’t cure the disease. 47
In Charaka Sutrasthana 27th chapter, the importance of Pathya has been quoted
as , Paying the due consideration to the quantity and time, a self controlled man
should regularly intake such useful food & drinks as are conducive to the internal
power of digestion including metabolism. Like a man who performs ‘yajna’. The
proper consumption of Pathya is compared to the ‘Yajna’ or ‘Homa’. Fuel like wood
or coal is required to keep the fire continuously or enlighten. Similarly the Àhàra acts
as the Indhana (fuel) for the Jatharagni and other Agnis in the body. 48
Who takes the diet conducive to the power of digestion being aware of the
wholesomeness of food and drinks, who resort to meditation of ‘Brahma’ and charity,
enjoys the bless without any disease during the present as well as future lives.49
Chakrapani: During the present life, man becomes free from diseases due to the
intake of Pathya ahara. And in the future life due to the influence of the invisible
effect occurred as a result of the righteous acts of the present life. Sinful acts and
apathya ahara , these two are the important factors for the causation of diseases. In
the absence of these factors, the individual becomes free from all the diseases.50
A self controlled man, blessed by noble man lives for 100 years free from diseases by
the intake of Hita ahara (Pathya). 51
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The Relation of food with Body and diseases.
Diseases are a result of the food taken in four fold manner via eating, drinking,
licking and masticating. Intake of wholesome and unwholesome food is responsible
for the maintenance of health and production of diseases respectively. 52
The body is constituted of food; hence one should take wholesome food only
after careful examination and should not take unwholesome ones out of greed or
ignorance.
Chakrapani: Out of greed some individuals indulge in unwholesome food even
though they are fully aware of its harmful effects. Some others out of ignorance treat
unwholesome food as useful one and take it. Both of them are subjected to misery. 53
Need for the consideration of Pathya.
The wise who always avoid the intake of Apathya food are held in high esteem by
saints. It means the one who is habitually taking Pathya aharas will be praised by the
saints. The Shareera as well as the diseases is caused by food. Wholesome and
unwholesome foods are responsible for Sukha and Dukha. 54
Chakrapani: The compactness of doshas (caused by chaya prakopa) which are
aggrevated internally (Anta: kupita) become soft (mridu) and the non-compact doshas
which take gross form (mahan kupita) become reduced in quantity by the
administration of Pathya aharas.
Pathya can be modified according to the Palatability:
Because of the regular intake of the same Pathya, if the Pathya is disliked & it is not
palatable to the eater, then it should be modified to the form of palatable one.55
Due to the favorableness of the sense object (taste of food) one attains satisfaction,
energy, relish, strength, happiness and consequent loss of severity of diseases.56
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The relish which appears due to greediness, diminution of dosha, disorder or
contrariness should be managed with Pathya ahara processed with drugs if necessary.
57
Diet is the greatest medicament.
The food is said to be cause of stability for all living beings. There is nothing else
except diet for sustaining the life of living beings. Ahara is said to be Mahabhaisajya
by Kasyapacarya, hence no any other medicament just like diet is not available. In
other words, one is capable to make man disease free only with the cereals (congenial
diet).One is not able to sustain life without diet even of endowed with medicine, that
is why the diet is said to be the great medicament by physician.58 and Pathya has been
considered as one of the Ashtavidha chikitsa in hareetha samhita. 59
Pathya can be ultimately understood as the food which suits any condition of the
body. It may be in the form of satmya, hita, upashaya, that which ultimately provides
health to the individual. To have a healthy life one should have the awareness
regarding proper diet, its dose, time, place, and wholesomeness, .etc. the food having
all these qualities, which becomes hita to the mind, body through its srotases and thus
produces health.
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CONTENTS
1. Introduction
2. Derivation
3. Definition
4. Synonyms
5. Classification
6. Nidana
7. Poorva Roopa
8. Roopa
9. Samprapti
10. Roga nirnaya
11. Sadhyasaadhyata
12. Upadrava
13. Chikitsa
14. Diabetes mellitus
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Dr.Ramesh Kumar.K.L 30
INTRODUCTION:
Madhumeha is one of the varieties of vataja meha. It is the last variety of vataja meha.
Much importance is being given to the management of the disease. The disease is to
be managed with very much caution. If it is neglected it may lead to life threatening
complications. So there are many advancements happening regarding, understanding
the pathology and management of the disease. In spite of tremendous advancement of
modern system of medicine i. e. oral hypoglycemic agent and human insulin till date,
an ideal drug which can cure diabetes is not yet available and still scientists are
struggling to search an effective and harmless therapy. Along with the current
knowledge, it is very much important to redefine the available ancient knowledge of
the disease for the benefit of diabetic community.
AYURVEDIC REVIEW
In Ayurveda, Madhumeha has been described as one among the 20 types of Prameha
& is a sub-type of Vatik Prameha in which patient passes excessive amounts of urine
that tastes & looks like honey. To understand the iatrogenecity, pathophysiology,
complications and management first it is merely necessary to emphasize the disease
Prameha as whole.
Derivation of the word madhumeha:
The word ‘Prameha’ is pullinga shabdha, it consist of two sub-words. i.e. ‘Pra’ and
‘Meha’. The word Meha is derived from the root “Mih Secane” by adding ‘Lue’
Pratyaya to it "Mehati, Sinchati Mutraretansi" which means to excrete
(Halayudhakosha).64
In Sanskrita literature, The 'Mih' is used to denote, to make water, to wet, to emit
semen. So this root 'Mih' is added to prefix 'Pra' the word becomes 'Prameha'.
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mÉëqÉãWû: = mÉë+ÍqÉWèû= qÉãWûÌiÉ qÉÔ§ÉrÉÌiÉ CìiÉ AjÉï:|60
The word Madhumeha consists of two words:
Madhu and Meha
The word ‘Madhu’is also pullinga shabdha, it is derived from the root “qÉÉlrÉiÉã ÌuÉzÉãwÉãhÉ
eÉÉlÉÉÌlÉ eÉlÉÉ rÉÎxqÉlÉç “(Manyante Viseshena Jananti Jana Yasmin.) In Sanskrit literature,
Madhu word is used in various contexts like PushpaRasa, Makarandah, Makshikam,
Madhy, Ama, Kshiram, Jalam, Madhura Rasa61 etc. It is termed as Mutra roga and
Mutraatisaara.62
qÉkÉÑUÇ rÉŠ qÉãWãûwÉÑ mÉëÉrÉ qÉÎkuÉuÉ qÉãWûÌiÉ | xÉuÉãïÌmÉ qÉkqÉãWûÉZrÉÉ qÉÉkÉÑrÉÉïŠ iÉlÉÉãUiÉ: ||
mÉëMüwÉãïhÉ qÉãWûÌiÉ ¤ÉUÌiÉ uÉãrÉÉïÌSUlÉãlÉãÌiÉ | qÉÉkÉÑrÉïÇ rÉŠ xÉuÉãïwÉÑ qÉkÉÑÌuÉuÉ qÉåWãûÌiÉ || 63
So’ it can be defined, that the disease in which the excretion is having quality
concordant with Madhu (honey) in its colour, taste, smell, and consistency called
Madhumeha.63
Definition of madhumeha:
MüwÉÉrÉ qÉkÉÑUÇ mÉÉhQÒû äÉÇ qÉãWûÌiÉ rÉÉã lÉU:| uÉÉiÉMüÉãmÉÉSxÉÉkrÉÇ iÉÇ mÉëÌiÉrÉÉlqÉkÉÑqÉãÌWûlÉÉÇ ||64
qÉkÉÑqÉãWûÏ qÉkÉÑxÉqÉÇ 65
qÉkÉÑqÉãWûÏ qÉkÉÑxÉqÉÇ mÉëqÉãÌWû 66
The clinical entity in which patient voids the urine having concordance with Madhu
i.e. of Kashaya and Madhura taste, Ruksha (dry) texture and honey like colour and
body acquires sweetness called Madhumeha.
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Dr.Ramesh Kumar.K.L 32
¤ÉÉæSìqÉãWûÉã qÉkÉÑqÉãWûÉ:67
uÉÉiÉÉixÉÌmÉïuÉïxÉɤÉÉæSìqÉãWûÉxcÉiuÉÉUÉã AxÉÉkrÉiÉqÉÉ: qÉWûirÉÉÌrÉMüiuÉÉiÉç ||68
Sushruta has term narrated the term Kshaudra Meha in place of Madhumeha.
Kshaudra is nothing but variety of Madhu (honey), which is Kapila (tawny) in colour.
So it is clear that Kshaudrameha resembles with Madhumeha. Further, he asserted that
when all the Pramehas are ill-treated or neglected, it is converted into Madhumeha
and especially he emphasized that the disease Prameha along with Pidaka should
termed as Madhumeha.
SYNONYMS:
These are the few synonyms mentioned in the ancient treatise, which are as follows:
Paushpa Meha:69
Ojo Meha: 70
Kshaudra Meha.71
CLASSIFICATION OF PRAMEHA:
Three important Ayurvedic ancient treatises elaboratively classified the disease
Prameha on the basis of dosha dominance, as shown below in tabular form:-
A.CLASSIFICATION ON THE BASIS OF DOSHA
Table.No.3 VATAJA MEHA:
Charaka samhita Sushruta Vagbhata Vasameha Vasameha Vasameha Majjameha Sarpimeha Majjameha Hastimeha Hastimeha Hastimeha Madhumeha Kshaudrameha Madhumeha
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B.Table.No.4 CLASSIFICATION ON THE BASIS OF PROGNOSIS:
SADHYA YAAPYA ASAADHYA Kaphaja Pittaja Vataja Obese Usually not much obese Asthenic Acquired Acquired Hereditary Early stage Acute stage Advance stage Without complications With complications With complications
C.CLASSIFICATION ON THE BASIS OF BODY CONSTITUTION. 72
Sthula and Krisha:
D. CLASSIFICATION ON THE BASIS OF THE ETIOLOGICAL FACTORS.
73
Sahaja (Hereditary) and Apathyanimittaja (Acquired)
E. CLASSIFICATION ON THE BASIS OF SAMPRAPTI.74
Avaranajanya and Dhatuapakarsanjanya:
Vagbhata has clearly mentioned the two types of Madhumeha. (A.H.NI. 10/18-19)
Dhatukshyajanya Madhumeha and Avaranajanya Madhumeha
NIDANA (ETIOLOGY)
All ancient treaties mentioned the common etiological factors of Prameha but
Charaka samhita mainly narrated the specific etiological factors according to dosha,
and also mentioned the specific etiological factors of Madhumeha. This is the unique
contribution of Charaka samhita. Etiological factor can be classified according to the
type ie. Sahaja and Apathyanimittaja.75
1) Sahaja (Hereditary)
Charaka samhita has clearly narrated that Madhumeha is a Kulaja Vikara which
results due to the defect in the Beeja. As per Chakrapani it can be caused by father,
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Dr.Ramesh Kumar.K.L 34
mother or grand parents, which means that, disease may be inherited from generation
to generation.76 Charaka samhita narrated that Sahaja type of diseases can occur due
to defect in Beeja, Beejabhaga or Beejabhagavayava.77 Chakrapani explained that this
defect may be caused due to the indulgence of faulty foods at the time of pregnancy.
Charaka samhita narrated that indulgence in excessive use of Madhura Rasa by
mother at the time of pregnancy causes Madhumeha and Sthaulya.78
Thus, genetic predisposition and the over indulgence of etiological factors at the time
of pregnancy by mother helps to precipitate the disease Madhumeha.
2) Apathyanimittaja: (Acquired)
Charaka samhita has narrated etiological factors according to Dosha predominance in
Nidana Sthana and common etiological factors in Chikitsa Sthana.
SPECIFIC ETIOLOGY OF MADHUMEHA:
On the basis of causative theory, Madhumeha have been subdivided into two
etiological types by Vagbhata. The specific factors which lead to excessive tissue
depletion (Dhatukshaya) cause Dhatukshayajanya Madhumeha.
The specific factors which increase Kapha, Pitta, Meda and Mamsa in turn lead to
obstruction (Avarana) of Vata causing Avaranajanya Madhumeha.
Specific etiology of Madhumeha79
Ahara: Kashaya, Katu, Tikta, Sheeta, and Laghu, Ruksha guna ahara sevana.
Vihara: Vyavaya,Vyayama,Vishama ashana, Vamana, Virechana Atiyoga,Atapa
sevana,Shirovirechana Atiyoga, Vega Sandharana, Anashana, Abhighata and
Asthapana Atiyoga.
Manasika: Chinta, Shoka and Bhaya.
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Table.No.5. Specific Madhumeha nidana
AHARA VIHARA Excessive intake of Excessive indulgence in
Guru
Snigdha
Amla
Lavana
Navannapana
Nidra
Asyasukha
Tyakta Vyayama Chinta
Sanshodhana Akurvatam
PURVARUPA
In Ayurvedic treatises common premonitory symptoms of Prameha are mentioned in
detail, but special premonitory symptoms of Madhumeha are not mentioned.
Table.No.6. List of Poorva roopas in Brihatrayees.8o, 81, 82
Purvarupa C.S S.S A.S A.H M.N Kesheshu Jatilabhava + + + - - Asya Madhurya + - + + + Karapada Daha + + + + + Karapada Suptata + - - - - Mukha Talu Kantha Shosha + - + + - Pipasa + + + - + Alasya + - + - - Kaye Malam + - + - - Kaya Chhidreshu Upadeha + - + - - Paridaha Angesu + - + - - ShatpadaPipilakabhi Mutrabhisaranam + - + + - Mutra Cha Mutra Doshan + - - - - Visra Sharira Gandha + + + + - Nidra Sarva Kalam + - + - - Tandra Sarva Kalam + + + - - Sweda + - + + - Shithilangata + - - + - Shaiyya Asana Swapneshu Sukhe Ratischa + - - + - Hridaya-Netra-Jihva-shravana- Upadeha + - - + - Ghanangata + - - + -
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Kesha Nakha Ativriddhi + + - + - Sheeta Priyata + - + + - Shatpada Pipilika Sharirabhisaranam + - + + - Snigdha Gatrata - + + - - Picchila Gatrata - + - - - Guru Gatrata - + - - - Madhura Mutrata - + - - - Shukla Mutrata - + + - - Sada - + - - - Shwasa - + + - - Deha Chikkannata - - - - + Dantadinam Maladhyatvam - - - - + Gala Talu Shosha - - + + -
RUPA
All acharya have focused specifically on character of Urine in Rupa, Madhumeha
patient excretes urine having Kashaya and Madhura taste, Panduta in colour and of
Ruksa quality. Sushruta has clearly mentioned that the diagnosis of Prameha should
be made when complete or partial prodromal symptoms of Prameha accompanied by
Polyuria get manifested.83
In this regard Gayadasa opined that, in this disease all prodromal symptoms get
converted into Rupa due to specific nature of the disease i.e. Vyadhi Prabhava. The
Rupa as described in Ayurveda includes both, signs and symptoms of the disease.
GENERAL SYMPTOMATOLOGY: URINE CHARACTERISTICS:
xÉÉqÉÉlrÉsɤÉhÉÇ iÉãwÉÉÇ mÉëpÉÔiÉÉÌuÉsÉqÉÔ§ÉiÉÉ | SÉãwÉSÕwrÉÌuÉzÉãwÉãÌmÉ iÉixÉqrÉÉãaÉÌuÉzÉãwÉiÉ: ||
qÉÔ§ÉuÉhÉÉïÌSpÉãSãlÉ pÉãSÉã qÉãWãûwÉÑ MüsmrÉiÉã |84
iɧÉÉÌuÉsÉ mÉëpÉÔiÉqÉÔ§ÉsɤÉhÉ: xÉuÉïÇ LãuÉ mÉëqÉãWûÉã pÉuÉÎliÉ || 85
(1) Prabhutamutrata:
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This is the main cardinal sign described by all acharayas. Vagbhata mentioned
Prameha as the disease of Mutraatipravrtija.86 Patient voids urine more in quantity.
Gayadasa, opined that this excess urine quantity is because of liquification of the
dusyas and their amalgamation.87
(2) Avilamutrata:
Patient voids urine having hazy consistency or having turbidity. Gayadasa and
Dalhana both opined that, this characteristic feature of urine is because of the nexus
between mutra, dusya and dosha.88 Vagbhata also emphasized that this turbidity of
the urine is because of its annexation with the dhatus.89
(3) Picchila mutrata :
Charaka samhita has mentioned this character of urine especially at the time of
diagnosis of the Prameha.
Kashaypa mentioned following symptoms of Prameha to be observed in pediatric
patients90
Akasmat Mutra Nirgama: Child excretes urine suddenly with no intention.
Makshika Akrant: Flies get attracted towards the urine.
Shweta and Ghana Mutra : Child excretes urine having Shweta colour
And solid consistency i.e. turbidity.
Associated signs and symptoms:
In ChikitsaSthana, Sushruta before profounding the treatment of Prameha, asserted
two types of Prameha along with their features as follows:
Sahaja Pramehi: Krisha (Asthenic) 91
Ruksha (dry body)
Alpashi (consumes less food)
Bhrisha Pipasa (Excessive thirst)
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Parisaranshila (restless always want to wonder)
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Apathyanimittaja: Sthula (obese) 92
Bahuashi (consumes excessive food)
Snigdha (unctuous body texture)
Shayyasanswapnasheela (like to sit down and sleep always)
Psychophysiological feature (Characteristic) or manifestation:
xÉ cÉÌmÉ aÉqÉlÉiÉç xjÉÉlÉÇ xjÉÉlÉÉSxÉÍqÉdcÉÎliÉ || AéxÉlÉÉSèSìÓhÉÑiÉã zÉrrÉÉÇ zÉrÉlÉÉiÉç xuÉmlÉÍqÉdcÉÌiÉ ||
QûsWûhÉ: cÉiÉÑÌuÉïkÉ Ì¢ürÉÉ´ÉrÉÇ ÍsÉÇaÉÇ SzÉïrɳÉÉ: xÉ cÉÉÌmÉ aÉqÉlÉÌSirÉÉÌS:|93
This special manifestation related to behavioural pattern is enumerated by
Sushruta that, Madhumehi prefer to stand still than walking, sitting than standing,
lying down than sitting and sleeping than lying down. This manifestation mainly
because of the Alasya (indolence).93 this feature mentioned as 'Pancavidhakriya-
Srayalinga' by Dalhana in contenxt to above quotation.
SAMPRAPTI:
The process of manifestation of disease is called Samprapti or pathogenesis. It
includes various stages as disease progresses.
According to Sushruta, the excessive indulgence of the etiological factors related to
Prameha results into Aparipakva Vata, Pitta, Kapha and Meda, which further proceed
downward through the Mutravaha Srotasa to get localized at Basti Mukha and thus
leading to disease Prameha.94
Dalhana interprets the term Aparipakva as Ama. Again he asserts that along
with Aparipakva Vata, Rasa, Mamsa etc. should also be considered.95 Sushruta also
asserted that, if all the Pramehas are treated improperly or ignored they get terminated
into Madhumeha. 96
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Vataja Prameha:
Vata gets provoked due to its own etiological factors and draws out Vasa-adi Dhatus
from the body towards Basti resulting into four types of Vataja Prameha. When Oja is
drawn towards Basti due to vitiation of Vata, the natural Madhura Swabhava of Oja
due to the Ruksha Guna of Vata gets transformed into Kashaya Rasa leading to the
manifestation of Madhumeha.97 Sushruta narrated the typical Dushya Sangraha
according to Dosha. He explained that, in Vataja Prameha, Kapha, Pitta, Meda, Vasa
and Majja take part in pathogenesis.98
SAMPRAPTI OF MADHUMEHA
According to Vagbhata two types of pathogenesis get precipitated.99
(a) Dhatukshayata
(b) Avritapathata
The different types of Samprapti which are mentioned by various Acharyas are being
described below.
Sampraptivishishta Anilatmaka Madhumeha:
This type of Samprapti of Vataja Prameha occur in the persons who have the specific
body tendency for Prameha onset i.e. Tathavidha Sharire. These persons have the
specific Abadhdhatva Meda Bahulyata. It may be due to genetic predisposition,
Prakriti manifestation or sedentary habits. Due to excessive indulgence of Aharaja and
viharaja nidana vata gets vitiated in these person. This vitiated Vata further gets
implicated by Meda. Now this provoked Vata – Meda complex spreads through out
the body and leads to transfer of either of Vasa, Majja, Lasika, or Oja in to basti.
When Oja due to influence of Vata changes to Kashaya and Ruksha Guna and is
excreted through urinary tract then this disorder is called Madhumeha.100
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Tathavidha Sharire (Genetic predisposition) can also be correlated to Sahaja
Prameha. Sushruta narrated that Sahaja Prameha precipitates because of defect in
Beeja.101 Charaka samhita says that Sahaja Madhumeha is a Kulaja Vikara, because of
the defect in Beeja (sperm/ovum)/ beeja bhaga avayava.102
Madhumeha due to Shuddha Vata: 103
Due to kshaya (depletion) of Kapha and Pitta, Vata gets provoked and causes the
excretion of Dhatus (like Vasa, Majja, Oja and Lasika) through urinary tract resulting
into Madhumeha.104 in this category of Madhumeha is Asadhya due to Vata as
Arambhaka Dosha and its further consequential provocation due to Dhatukshaya.
Dhatukshayajanya Madhumeha: 105
The Kshaya of Gambhira and Sarabhuta Dhatus like Vasa, Majja, Oja and Lasika lead
to Vata provocation. The expulsion of Sarabhuta Dhatus through urine occurs in such
excess amount that this Kshaya itself again acts as nidana for Vata Prakopa. Hence
this vicious cycle goes on and on, but due to Ashukaritva property of Vata all the
stages of Samprapti proceed so fast that it leads to Asadhya stage of disease very
quickly.
Avritapathata (Avaranjanya) Madhumeha:
The etiological factors of Avaranjanya Madhumeha have been described by Vagbhata
but he has not explained the pathogenesis of this type of Madhumeha. 106
Charaka samhita has fully illustrated this type of Samprapti in detail.107 Due to
excessive indulgence in the etiological factors mentioned above, Kapha and Pitta get
provoked and vitiates Meda and Mamsa. All are in excess quantity. They in turn cause
obstruction to the normal pathway of Vata. This obstructed Vata get provoked and
draws out the Apara Oja from all over the body and carries it towards Basti causing
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Madhumeha.108 The Kricchrasadhyata of this Avaranajanya Madhumeha is due to
provocation of Vata by Kapha-Pittakara etiological factors.
Kala Prabhavaja Madhumeha:
This type of Madhumeha is described by Sushruta & Vagbhata.109 Though direct
pathogenesis is not mentioned but it is said that when all types of Prameha are ignored
or not treated properly, they get transformed into Madhumeha. We can say that this is
the last stage or further progression of Kaphaja and Pittaja Prameha110 or complicated
stage of the diseases.
SAMPRAPTI GHATAKA OF MADHUMEHA:
On the basis of various references the Samprapti Ghataka of Madhumeha are
illustrated below:-
Dosha: Disease is Tridoshakopanimittaja.111
Dushya: Rasa, Rakta, Mamsa, Meda, Majja, Shukra, Vasa, Oja, Lasika, Kleda112
and Sweda.113
Srotodushti: Sanga & Ati Pravritti
Srotas:
- Medovaha, Mutravaha,Udakavaha and Mamsavaha
Agni: Vaishamya of all Agnis (or Dhatvagnimandya)
Ama: Medogata Ama produced due to Jatharagnimandya and Dhatvagnimandya.
Adhishtana: Basti
UdbhavaSthana: Amashaya
Bhedavastha: Occurrence of Upadravas such as Puti Mamsa and Prameha Pidika etc.
Nature: Chirakari114
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ROGA NIRNAYA (Differential diagnosis of madhumeha)
It has been mentioned in Charaka samhita Chikitsa Sthana regarding diagnosis of
Prameha that:
In Charaka samhita Samhita –Chikitsa 6/54 it is told,
Until and unless Haridra and Rudhira coloured Mutrapravritti is not associated
with the premonitory symptoms of Prameha, the disease cannot be diagnosed as
Prameha, but it goes more in favour of RaktaPitta. Here more importance is given to
Purvarupa of Prameha and not only to Mutra Pravritti. Regarding Madhumeha, it is to
be specially emphasized that instead of only Mutra Madhurya, ‘Shareera Madhurya’
is also found which is not present in other types of Pramehas. Apart from
Mutramadhurya, other characters of urine are also helpful in differential diagnosis
among various Doshika varieties of Prameha.115
In Charaka samhita chikitsa 6/12, the description has been given to describe
Varna, Rasa, Sparsha and Gandha of whole body, so it may be applied to Mutra
Pravritti also viz. in IkshuMeha, Mutra Pravritti is Atimadhura in Rasa, Sheeta-
Picchila by Sparsha, Turbid and like sugarcane juice in Varna. In SheetaMeha,
Mutrapravritti is Atimadhura, Bhrusha and Sheeta. While in Madhumeha, the
Mutrapravritti is116 i.e. Rasataha Mutrapravritti is not only Madhura but it is Kashaya
– Madhura due to Vata dominance, Ruksha by Sparsha instead of Picchila and also
Pandu in Varna.117
SADHYA ASADHYATVA (Prognostic criteria for madhumeha):
Krichhrasadhya (Difficult to treat)
Madhumeha resulted because of Avaranjanya pathogenesis is difficult to treat i.e.
Krichhrasadhya. Here the provocation of Vata results, but the etiological factors
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mainly related to the Kapha and Meda. So it should have been considered for both of
them. There are very few therapeutic measures, which act against the Vata and Kapha
combinely.118
Asadhya (Incurable):
Vataja Prameha is incurable because there is involvement of vital Dhatus like Majja,
Oja in the pathogenesis and the treatment modalities quite opposite to Dosha and
Dushya.119 Sushruta mentioned that if Kaphaja and Pittaja Prameha or If all types of
Pramehas are not treated properly or ill treated they become asadhya.120
Charaka samhita mentioned that Madhumeha because of the BeejaDosha i.e.
genetic predisposition is incurable.121 Sushruta mentioned that Madhumeha in
association with complication i.e. Pidaka is incurable.122
UPADRAVA (COMPLICATIONS)
Charaka samhita enumerated the general complications while Sushruta and Vagbhata
described according to the Dosha predominance.
General Complications: These are Trishna, Atisara, Jwara, Daha, Daurbalya,
Arochaka, Avipaka, Putimamsapidaka, Alaji and Vidradhi.123 Chakrapani opined that
these complications manifest because of the long term Anubandha of Prameha
disease.
Specific Complications:
Vataja Meha Janmanam:
Hridagraha, Laulyam, Anidra, Stambha, Kampa, Shula, Badhapurishatvam, Shosha,
Kasha and Shwasa. 124
Complications specifically related to Madhumeha:
Charaka samhita mentioned the 'Sapta Pidaka' as complication, because of the
negligence of the Madhumeha125 while Sushruta mentioned that Madhumeha along
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with Pidaka is Asadhya. He quoted that these Pidaka are caused by the tridosha and
because of the vitiated Meda and Vasa. 126
Sushruta and Vagbhata mentioned 10 Pidaka while Charaka samhita
mentioned only 7 Pidaka. These are also follows:
Table.No.7. Prameha pidakas
Sl No Pidaka Charaka Sushruta Vagbhata1 Saravika + + + 2 Kacchapika + + + 3 Jalini + + + 4 Vinitha + + + 5 Jalaji + + + 6 Masoorika - + + 7 Sarshapika + + + 8 Putrini - + + 9 Vidharika - + + 10 Vidhradhika + + +
CHIKITSA (TREATMENT)
Following are the treatment modalities we can apply in the Madhumeha to alleviate
the disease.
Nidana parivarjana.
Treatment according to Dosha & Dushya.
Treatment according to Complications.
This is the prime treatment principle narrated by every Acharya before describing the
treatment of every disease. Charaka samhita enumerated that we should avoid these
etiological factors which are causing the disease Prameha. Avoidance of the
etiological factors is the prime treatment.127
Chakrapani opined that this avoidance of etiological factors in Prameha is
prime concern because; this disease is Chirakari having long impact on the body.
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Treatment According to Body Constitution
Krishapramehi:
In Krisha patient, such foods should be used which are going to increase the strength
of patient without increasing the vitiation and after proper strength gaining, mild
purificative measures can be used along with herbal medicine.128 For the krisha
pramehi patient the Brimhana therapy is to be done with aushadha and ahara.129
Sthulapramehi: 130
In Sthula patient we have to apply apatarpana Chikitsa along with powerful
purificative measures to be done. Again the treatment modalities described for Medo
Roga can be applied here too.
TREATMENT ACCORDING TO DOSHA PREDOMINANCE:
Though the disease is of Tridosha predominant, but individual Doshika consideration
for the treatment is important for good prognosis.
KAPHAJAPRAMEHA:
I) Vamana and Virechana: Dalhana further commented that after Vamana Karma,
Virechana is essential to alleviate the Prameha and also to reduce the Kleda
vitiation.131, 132
ii) Basti: After vamana and virechana, Basti can be administered specially Asthapana.
Arundatta especially commented133 that after completion of Vamana and Virechana, if
patient has strength then Asthapana Basti can be administered.
iii.Udavartana: This procedure helps to reduce the excess of Kapha and Meda by
performing Shoshana.134
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Iv.Snana and Jalavaseka: This will help to eliminate the waste products by
absorption from skin and also effective in excessive sweating and bad smell, it will
also help to regain strength. 135
v.Vilepana: Various herbs can be used for the external application all over the
body.136
Vi.Lekhana and Apatarpana Chikitsa: Charaka samhita mentioned that the
treatment principle of Lekhana can be applied by means of purification.
Charaka samhita also mentioned that we can apply the treatment principles
which are described for Santarpanajanya Vyadhi like in MedoRoga.137, 138
vii.Shamana
There are lot of herbs and decoctions described by eminent Acharya. Sushruta
specifically mentioned the decoctions according to the type.
Pittaja prameha:
Pitta is one of the prominent Dosha in the pathogenesis. Acharya mentioned following
measures to alleviate its vitiation.
Shodhana: Vamana and Virechana along with Para-procedures like, Snana,
Jalavaseka and Vilepana with the help of described herbs.
Shamana: By the use of decoctions and Ghrita mentioned by Acharyas.
Vataja prameha:
Before treating the patient of Vataja Prameha following points should be carefully
observed.
(1) Type of Madhumeha i.e. either Kevala Vataja or Avaranjanya.
(2) Strength of the patient according to Doshabala, Agnibala and Vyadhibala.
(3) Involvement of genetic predisposition.
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Dr.Ramesh Kumar.K.L 48
After observing the patient carefully we can profound the following treatment
modalities.
Shodhana: Vamana and Virechana can be performed if possible according to strength
of patient. In Madhumeha, Vata Dosha is dominant so Basti therapy is ideal treatment
for it.
Shamana: Various decoctions and some Arishta for vataja meha were described for
the treatment.
Special food regimen is required for Krisha Pramehi.139
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Dr.Ramesh Kumar.K.L 49
CONTENTS:
1. DEFINITION AND EPIDEMIOLOGY
2. CLASSIFICATION AND ETIOLOGY
3. PATHOGENESIS
4. CLINICAL FEATURES
5. COMPLICATIONS
6. DIAGNOSIS
7. MANAGEMENT
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Dr.Ramesh Kumar.K.L 50
DIABETES MELLITUS 225
1. Definition and Epidemiology:
As per WHO, diabetes mellitus (DM) is defined as heterogeneous metabolic disorder
charecterised by common feature of chronic hyperglycemia with disturbance of
carbohydrate, fat and protein metabolism.
DM is a leading cause of morbidity and mortality world over. It is estimated
that approximately 1% of population suffers from DM. The incidence is rising in the
devoloped countries of the world at the rate of about 10% per year, especially of type
2 DM, due to rising incidence of obesity and reduced activity levels. DM is expected
to continue as a major health problem owing to serious complications, especially end
stage renal disease, IHD, gangrene of the lower extremities, and blindness in the
adults. It is anticipated that the number of diabets will exceed 250million by the year
2010.
2. Classification and Etiology:
Etiologic classification of Diabetes Mellitus as per American Diabetes
Association-2007
I. TYPE-1 DIABETES MELLITUS (10%)
(Earlier called insulin –dependent or juvenile onset diabetes )
Type-1ADM: Immune mediated
Type-1B DM: Idiopathic
II. TYPE-2 DIABETES MELLITUS (80%)
(Earlier called non-insulin dependent or maturity onset diabetes.
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Dr.Ramesh Kumar.K.L 51
III.OTHER SPECIFIC TYPES OF DIABETES (10%)
A.Genetic defect of beta-cell function due to mutations in various enzymes ( earlier
called maturity onset diabetes of young or MODY).(eg.hepatocyte nuc;lear
transcription factor HNF, Glucokinase)
B.Genetic defect in insulin action (eg.Type A insulin resistance)
C. Diseases of exocrine pancreas (Eg.chronic pancreatitis, pancreatic tumours, post
pancreatectomy)
D.Endocrinopathies (Eg. Acromegaly, Cushing’s syndrome, pheochromacytoma)
E.Drug or chemical induced (Eg.steroids, thyroid hormone, thiazides, beta-blocker
etc.)
F.Infections (Eg. Congenital rubella, cytomegalo virus.)
G.Un common forms of immune mediated DM (stiffman’s sundrome, anti-insulin
receptor antibodies).
H.Other genetic syndrome (Eg. Down’s syndrome, klinfelter’s syndrome, Turner’s
syndrome)
IV. GESTATIONAL DIABETES MELLITUS
American Diabetic Association -2007 has identified major risk factors for type-2
diabetes mellitus.
1. Family history of type-2 DM
2. Obesity
3. Habitual physical inactivity
4. Race and Ethnicity (Blacks, Asians, Pacific islanders)
5. Previous identification of impaired fasting glucose or impaired glucose tolerance
6. History of gestational DM or delivery of baby heavier than 4kgms.
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Dr.Ramesh Kumar.K.L 52
7. Hypertension.
8. Dyslipedaemia ( HDL level <35mg/dl or Triglycerides > 250mg/dl)
9. Poly cystic ovary diseases and acanthesis nigricans.
10. History of vascular diseases.
3. PATHOGENESIS:
Depending upon Etiology of DM hyperglycemia may result from the following.
Reduced insulin secretion.
Decreased glucose use by the body.
Increased glucose production.
PATHOGENESIS OF TYPE-2 DIABETES MELLITUS:
The basic metabolic defect in type-2 DM is either a delayed insulin secretion relative
to glucose load( Impaired insulin secretion), or the peripheral tissues are unable to
respond to insulin (Insulin resistance).
INSULIN RESISTANCE:
One of the most prominant metaboplic features of type-2 DM is the lack of
responsiveness of pheripheral tissues to insulin, especially of the skeletal muscle and
liver. Obesity, in particular is strongly associated with insulin resistance and hence
type-2 DM. Mechanism of hypergycemia in these cases is explained as under.
I.Resistance to action of insulin impairs glucose utilisation and hance hyperglycemia.
ii. There is increased hepatic synthesis of glucose.
iii. Hyperglycemia in obesity is related to high level of free fatty acid and cytokines(
eg.TNF-alpha and adeponectin) affect peripheral tissue sensitivity to respond to
insulin.
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Dr.Ramesh Kumar.K.L 53
IMPAIRED INSULIN SECRETION:
In type-2 DM, insulin resistance and insulin secretion are interlinked.
i).Early in course of disease, In response to insulin resistance there is compemnsatory
increased secretion of insulin (hyoer insulinaemia) in an attempt to maintain normal
blood glucose level.
ii) Eventually, however , there is failure of beta cell function to secrete adequate
insulin, although there is some secretion of insulin i.e. cases of type-2 DM have mild
to moderate deficiency of insulin (which is much less severe than that in type-1 DM )
but not its total absence.
INCREASED HEPATIC GLUCOSE SYNTHESIS:
One of the normal roles played by insulin is to promote hepatic storage of glucose as
glycogen and suppress gluconeo genesis. In type-2DM as a part of insulin resistance
by pheripheral tissues , the liver also shows insulin resistance i.e. inspite of hyper
insulinaemia in the early stages of disease, gluconeogenesis in the liver is not
suppressed. This results in increased hepatic synthesis of glucode which contributes to
hyperglycemia In these cases.
CLINICAL FEATURES:
It can be appreciated that hyperglycemia in DM does not causes single disease but it
is associated with numerous diseases and symptoms, especially due to complications.
Two main type of DM can be distinguished clinically. However overlapping of
clinical features occurs as regards the age of onset, duration of symptoms and family
history. Pathophysiology in evolution of clinical feature is schematically shoen in the
following figure.
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Dr.Ramesh Kumar.K.L 54
CLINICAL FEATURES OF TYPE-2 DM:
I.This form of diabetes generally manifests in middle life or beyond, usually above
the age of 40yers.
ii. The onset of symptoms in type-2 Dm is slow and insidious.
iii. Generally the patient is asymptomatic when the diagnosis is made on the basis of
glucosuria or hyperglycemia during physical examination, or may present with
polyuria and polydipsia.
iv. The patients frequently obese and have unexplained weakness and loss of wait.
v. Metabolic complications such as ketoacidocis are infrequent.
COMPLICATIONS OF DIABETES MELIITUS:
As a consequence of hyperglycemia of diabetes, every tissue and organ of the body
undergoes biochemical and structural alterations which account for the major
complication in diabetics which may be acute matabolic or chronic systemic. Both
type of diabetes mellitus may develop complications which are broadly divided into
two major groups:
A.ACUTE METABOLIC COMPLICATIONS:
Diabetic ketoacidocis
Hyperosmolar non ketotic coma and
Hypogycemia.
B.LATE SYSTEMIC COMPLICATIONS:
Artherosclerosis,
Diabetic microangiopathy,
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Dr.Ramesh Kumar.K.L 55
Diabetic nephropathy,
Diabetic neuropathy,
Diabetic retenopathy and
Infections
- Skin infections
- Pulmonary tuberculosis
- Urinary tract infections
- Vaginal monoliasis etc.
DIAGNOSIS OF DIABETES:
Hyperglycaemia remains the fundamental basis for the diagnosis of diabetes mellitus.
In symptomatic cases, the diagnosis is not a problem one can be confirm by finding
glycosuria and a random plasma glucose concentration above 200mg/dl.
The severity of clinical symptoms of polyuria and polydipsia is direcly related to the
degree of hyperglycaemia.
In a symptomatic cases, when there is persistantly eleveted fasting plasma glucose
level, diagnosis again posses no difficulty.
The problem aeises in asymptomatic patients who have normal fasting glucose level
in the plasma but are suspected to have diabetes on other grounds and are thus
subjected to oral GTT. If abnormal GTT values are found, these subjects are said to
have “chemical diabetes”.
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Dr.Ramesh Kumar.K.L 56
Table.No.8. the American Diabetes Association (2007) has recommended definite
diagnostic drieteria for early diagnosis of diabetes mellitus.
Revised Criteria for Diagnosis of Diabetes by oral GTT(American Diabetes Association (2007)
PLASMA GLUCOSE VALUE DIAGNOSIS
FASTING ( for > 8 hours) VALUE
Below 100mg/dl Normal fasting value
100‐125mg/dl Impaired fasting glucose (IFG)
126mg/dl or more Diabetes mellitus
TWO-HOUR AFTER 75GM ORAL GLUCOSE LOAD
Less than 140mg/dl Normal post prandial GTT
140‐199mg/dl Impaired post prandial glucose tolerance(IGT)
200mg/dl or more Diabetes mellitus
RANDOM VALUE
200mg/dl or more in asymptomatic
patient
Diabetes mellitus
THE FOLLOWING INVESTIGATIONS ARE HELPFUL IN ESTABLISHING
THE DIAGNOSIS OF DIABETES MELLITUS.
1. Urine testing: Glucosuria and Ketonuria
2. Single Blood Sugar estimation
3. Screening by fasting glucose test
4. Oral glucose tolerance test.
5. Glycosylated haemoglobin (HbA1c) test.
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Dr.Ramesh Kumar.K.L 57
6. Glycated albumin
7. Extended GTT
8. Intravenous GTT
9. Cortisone primed GTT
10. Insulin Assay
11. C-Peptide assay
12. Islet Auto antibodies
13. Screening for diabetes associated complications
7. MANAGEMENT:
Diabetes mellitus requires ongoing medical care as well as patient and family
education both to prevent acute illness and to reduce the risk of long term
complications. The therapeutic objective is to restore known metabolic
derangements towards normal in order to prevent and delay progression of
diabetic complications.
The goals of therapy for type 1 or type 2 DM are to:
(1) Eliminate symptoms related to hyperglycemia,
(2) Reduce or eliminate the long-term microvascular and macrovascular
complications of DM, and
(3) Allow the patient to achieve as normal a life-style as possible.
(4)Education of the patient about DM, Nutrition, and Exercise
Oral Drugs for Treating Hyperglycemia: Oral drugs are used to lower Blood
glucose level by achieving following goals.
1. Drugs that primarily stimulate insulin secretion
2. Drugs that alter insulin action.
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Dr.Ramesh Kumar.K.L 58
3. Drugs that principally affect absorption of glucose.
A. Pathway of normal insulin synthesis and release in beta cells of pancreatic islets.
B. Chain of events in action of insulin on target cell.
A.SYNTHESIS AND RELEAS E OF INSULIN
Altered ion channel Activity
Betacell
Outflow of K+
Influx of Ca+ ATP
A&B chains with C‐peptide
Pro‐insulin
GLU‐6 Ph
Nucls GLUTPre‐pro‐insulin
Release
of insulin Hypoglycaemia(<70mg/dl)
Insulin receptor
TARGET CELL
Irs1
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Dr.Ramesh Kumar.K.L 59
B.ACTIONS OF INSULIN
SCHEMATIC REPRESENTATION OF PATHOGENESIS OF TYPE-2 DM:
Irs2NUC
LEUS
Concordance in
identical twins
Both parents
Diabetic, 50% risk to
the child
Obesity
Hypertension
Low physical activity
DECREASED INSULIN INSULIN RESISTANCE
Amylin ?
Glucose Toxicity of islets ?
Receptor and post
receptor defects
INCREASED HEPATIC GLUCOSE SYNTHESIS
HYPERGLYCAEMIA
GENETIC FACTORS CONSTITUTIONAL
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Dr.Ramesh Kumar.K.L 60
PATHOPHYSIOLOGICAL BASIS OF COMMON SIGNS AND SYMPTOMS DUE TO UNCONTROLLED HYPERGLYCEMIA IN DIABETES MELLITUS:
TYPE-2 DM
HYPERGLYCAEMIA
GLYCOSURIA
Fatigue
Vulvitis, Balanitis
Hunger Polyphagia
Weight loss
Wasting
Increased catabolism
Lipolysis (in adipose)
Free fatty acids (in plasma) & Oxidation (liver)
Decreased anabolism
Osmotic diuresis
Dehydration & Loss of Elecrolytes
Poluuria, polydipsia
Tachycardia
Hypotension
DIABETIC COMA KETOACIDOCIS
INSULIN DEFICIENCY
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Dr.Ramesh Kumar.K.L 61
CHAPTER-3
PATHYA AHARAS IN MADHUMEHA:
The description of pathyaaharas for madhumeha is found in many classical text books
under the chapter Prameha. As madhumeha is one of the varieties of prameha, the
pathyas mentioned in prameha should be considered for the management of
madhumeha too (Su.Ci.13/3). For the convenience of understanding, the pathyas are
categorised in to Dhanya varga, Shimbhi varga, Shaaka varga, Hareeta varga, Phala
varga and Taila varga.
Table.No.9. List of Pathya aharas in Madhumeha
A.Dhanyavarga(Cereals&Millets ) B.Shimbhi varga(Pulses) 1. Yava 1. Chanaka 2. Godhuma 2. Adaki 3. Shastika Shali 3. Kulattha 4. Kangu 4. Mudga 5. Shyamaka 5. Masura 6. Kodrava 7. Joorna 8. Madhulika
C. Shaka varga (Vegetables) D. Harita varga (Leafy vegetables)1.Kushmanda 1. Katillaka 2. Karavellaka 2. Shigru patra
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Dr.Ramesh Kumar.K.L 62
3. Patola 3. Lonika 4. Shobhanjana 4. Drona pushpi patra 5. Brihati/ Vartaki 5. Guduchi patra 6. Bimbi 6. Kakamachi patra 7. Indravaruni 7. Vastuka 8. Karkotaka 9. Palandu 10.Rasona 11.Katutumbi 13.Koshataki 14. Kadali kaccha phala
E.Phala varga (Fruits)
F.Taila varga (Oils)
1.Karjura 1. Sarshapa 2. Aruka 2. Tila 3. Kapittha 4. Jambu G. Others
5. Udumbara 1. Aja mamsa 6. Kalinga 2. Takra
References of food articles found in various classical text books.
A.Shuka dhanya varga (Cereals)
Sl.no
Shuka dhanyas
C.S S.S A.S A.H B.P Y.R B.R B.N.R
1 Yava + + - - + - + + 2 Godhuma + + - - + + + + 3 Puranashali + + - - + + + + 4 Kangu + - - + - - + - 5 Shyamaka + - + + + + + - 6 Kodrava + + - + + + - + 7 Joorna - - - + - - - - 8 Madhulika - - - + - - + +
B.Shimbi dhanya varga (Pulses)
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Dr.Ramesh Kumar.K.L 63
Sl.no
Shuka dhanyas
C.S S.S A.S A.H B.P Y.R B.R B.N.R
R.N
1 Chanaka - + + - + + + + + 2 Adaki - + + - + + + + 3 Kulattha - + + + + + + + 4 Mudga + + - + + + + + 5 Masura - - - - - - + +
C.Shakavarga: (Vegetables)
Sl.n
Shakavarga
C.S
S.S
A.S
A.H
B.P
Y.R
B. R
B.N.R
K.N
R.N
D.N
1 Kushmanda - + - - - - - - + + - 2 Karavellaka + + + + + + - - + - - 3 Patola + + + + - + - - - - - 4 Shigru phala - - - - - - + + - - + 5 Brihati/Vartaki - + - - - - + - - - - 6 Bimbi + + + + + + - - + - - 7 Indravaruni + - - + + + + - + - - 8 Karkotaka - - - - - + + + + - - 9 Palandu - - - - - - - + - - - 10 Rasona - - - - - + + + + - - 11 Koshataki - - - - - - - - + - - 12 Katutumbi - - - - - - - - + - + 13 Kadali kaccha
phala - - - - - - - - + - -
14 Trapusa - - - - - - - - - - +
D.Harita varga: (Leafy vegetables)
Sl.no
C.S S.S A.S A.H B.P Y.R B.R B.N.R
K.N
1 Katillaka - + + + - - - + 2 Shigru patra - - - - - - - + + 3 Lonika - - - - + - - - + 4 Vastuka
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Dr.Ramesh Kumar.K.L 64
5 Dronapushpi - - - - + - - - 6 Guduchi + + - + + - + + 7 Kakamachi - - - - + - - +
E.Phalavarga: (Fruits)
Sl.n
Phalavarga
C.S
S.S A.S
A.H
B.P
Y.R
B. R
B.N.R
K.N
R.N
D.N
1 Karjura - - - - + - + - - - 2 Aruka - - - - + - - + + + 3 Kapitha + + + - + - + - - - 4 Jambu + + + - + - + - - - 5 Udumbara + + - - + - + - - - 6 Kalinga + - - + - - + + - - -
F.Others:
Sl.no Others C.S S.S A.S A.H B.P Y.R B.R B.N.R1 Sarshapa taila + + + + - + - + 2 Tila taila - - - + - - + + 3 Takra - - - - - - + -
A.Shuka dhanya varga:
1. Yava: 140
Latin name: Hordeum vulgare
Family: Graminae
Syn: Akshata, Sita shuka, Divya, Kanchuki, Teekshna shuka (K.N) 141
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Dr.Ramesh Kumar.K.L 65
Eng: Barley
Hin: Jeve, Jan, Jo
Kan: Jave godi
Tam: Barli arisi
Tel: Paccha yavulu
Habitat: This cereal is largely cultivated in several varieties in sindh, Bombay
presidency, and other provinces in India.
Parts used: Dried decorticated grain called pearl barley and the seeds of yava.
Guna karma: Guna:Ruksha,eshat guru; Rasa:Madhura,Kashaya; Veerya: Sheeta;
Vipaka: Madhura; Doshakarma:Kapha shamaka, Vata vardhaka; Karma:Pureesha
janaka, Balya and Sthairyakrita.
Constituents: Fixed oil or Fat, starch, proteoid compound ( gluten albumin) ;
cellulose , other nitrogenous principles and Ash containing salicilic acid, phosphoric
acid, Iron and lime. Fixed oil or fat contains glycerine mixed with palmitic and lauric
acids. Hypoxanthine (sarcine) is found to occur in this cereal.
Energy 1,474 kJ (352 kcal) Carbohydrates 77.7 g Sugars 0.8 g Dietary fiber 15.6 g Fat
1.2 g Protein 9.9 g Thiamine (Vit. B1) 0.2 mg ,Riboflavin (Vit. B2) 0.1 mg, Niacin (Vit. B3)
4.6 mg, Pantothenic acid (B5) 0.3 mg, Vitamin B6 0.3 mg, Folate (Vit. B9) 23 μg,
Vitamin C 0.0 mg Calcium 29.0 mg,Iron 2.5 mg, Magnesium 79.0 mg, Phosphorus 221
mg, Potassium 280 mg, Zinc 2.1 mg per 100g and Amino acids like Alanine-4.60,
Arginine-5.15, Asparic acid-5.56, Cysteine-2.01, Glutamic acid- 22.35, Glycine-4.55,
Hisidine-1.87, Isoleusinee-4.26, Lysine- 3.38, Methionine- 1.44, Phenylalanine-5.16,
Proline- 9.02, serine- 4.65, Threonine—3.38, Tryosine-3.64 and Valine—5.02
p.c.respectively by weight.
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Dr.Ramesh Kumar.K.L 66
Action: Yava is nutritive; Seed or grain is demulscent. Decoction of seeds is bitter
tonic & astringent.
2. Godhuma: 142
Latin name: Triticum Sativum lam
Family: Graminae
Syn: Bahu dugdha, Apupa, Mleccha bhojana, Yavana, Nishtuva, Ksheeri (K.N)
Eng: Wheat
Hin: Gehun
Kan: Godhi
Tam: Godumai
Tel: Godumulu
Mal: Godhuma
Habitat: Wheat is extensively cultivated in various forms or varieties, in punjab, in
the united and the central provinces, sind, central India, Rajputana and the Bombay
presidency and in the Deccan platue.
Varieties: There are four principle divisions, 1.Hard white, 2.Hard red, 3. Soft white
and 4. Soft red.
Parts used: Dried decorticated grain
Guna karma: Guna: Guru snigda guna; Rasa: Madhura kshaya; Veerya: sheeta;
Vipaka: madhura; Doshakarma: Vata pitta shamaka; Karma: Sandhanakara,
Jivaniya, Brimhana, Sthairyakara and Vrishya.
Constituents: Wheat contains all the elements necessary for the support of human
frame; hence it is that bread is often and very properly called the “Staff of Life”. A
grain of wheat can be divided in to six parts, viz (1) outer skin; (2) middle skin; (3)
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Dr.Ramesh Kumar.K.L 67
inner skin or cerealin cells containing cerealin; (4) germ; (5) gluten cells; (6) starch
granule. The first or outer skin contains chiefly Fibre. The second and third skin
contains a quantity of salts and acids. These are the most essential as food, being
bone, hair and teeth procedures. In wheat nitrigenous substances are in large
proportion and the starchy substances with the sugar, are also in large proportions.
Wheat germ crude Nutritional value per 100 g (3.5 oz) Energy 1,506 kJ (360 kcal)
Carbohydrates 51.8 g Dietary fiber 13.2 g Fat 9.72 g Protein 23.15 g Thiamine (Vit. B1)
1.882 mg, Riboflavin (Vit. B2) 0.499 mg, Niacin (Vit. B3) 6.813 mg, Pantothenic acid
(B5) 0.05 mg, Vitamin B6 1.3 mg, Folate (Vit. B9) 281 μg, Calcium 39 mg, Iron 6.26
mg, Magnesium 239 mg, Phosphorus 842 mg, Potassium 892 mg, Zinc 12.29 mg,
Manganese 13.301 mg per 100gm respectively and Amino acids like Alanine‐3.50,
Arginine‐4.79, Asparic acid‐5.46, Cysteine‐2.19, Glutamic acid‐ 31.25, Glycine‐6.11,
Hisidine‐2.04, Isoleusinee‐4.34, Lysine‐ 2.82, Methionine‐ 1.29, Phenylalanine‐4.94,
Proline‐ 10.44, serine‐ 4.61, Threonine—2.88, Tryosine‐3.74 and Valine—4.63
p.c.respectively by weight.
3. Shaali143
Latin name : Oryza sativa, Linn
Family: Graminae
Syn: Vrihi, Tandula, Dhanya (K, N) 144
Eng: Rice (husked); Paddy (Un husked)
Hin: Chaval (grain), Dhan (Paddy)
Kan: Akki (grain), Bhatta (paddy)
Tam: Arisi (grain), Nellu (paddy)
Tel: Biyyam (grain), Vadlu (paddy)
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Dr.Ramesh Kumar.K.L 68
Mal: Ari (grain), Nellu (paddy)
Habitat: This is a principal food crop in India, Ceylon, Burma, China, Japan and
Siam, and is spread over the tropical and sub tropical regions of both hemispheres.
Varieties: In Ayurveda many varieties of shali have been explained like, rakta shali,
maha shali, kalama, sugandhika, shakunahrit, deergha shuka, goura and maha shali.
There are hundreds of varieties of rice i.e., bhura, hemdi, rata, Gudhya, Varanga,
Raybag, etc. Ambemohor, kamod, jiresal, pankhali are a few of the scented
varieties.(Bombay Govt. Agri dept.)
Parts used: Dehusked Grain
Guna Karma: Guna:Snigdha; Rasa:Madhura rasa; Vipaka: madhura; Veerya:
sheeta, Doshakarma: Pitta shammaka, tridoshagna,; Karma: :mutra, pureesha
karaka, chskshushya, balya, vrishya amnd Mutrala.
Constituents; Rice contains more starch than any other starchy grains, but no
appreciable Fat, a very small quantity of proteins and a trace of mineral matter. In rice
there is an alkaloid ‘oridine’ (anti neuritic when impure) As-7mg in 100gr. Ash of
corn. Bran from the rice mills contains a considerable amount of oil. Oil extracted
from bran is highly acid, the acid value being 34.75p.c. Approximate composition of
total Fatty acids is palmitic 20, oleic 45 and Isolinolic 35p.c. Natural or unmilled rice
contains three times the food value of white rice. Milled rice is found to be the cause
of beri-beri among Indians living on such rice.
Rice, white, long‐grain vegetable, raw Nutritional value per 100 g(3.5 oz), Energy
1,527 kJ (365 kcal), Carbohydrates 79 g, Sugars 0.12 g, Dietary fiber 1.3 g, Fat 500
mg, Protein 7.12 g, Water 11.62 g, Thiamine (Vit. B1) 0.0701 mg, Riboflavin (Vit. B2)
0.0149 mg, Niacin (Vit. B3) 1.62 mg, Pantothenic acid (B5) 1.014 mg, Vitamin B6 0.164
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Dr.Ramesh Kumar.K.L 69
mg, Calcium 28 mg, Iron 0.80 mg, Magnesium 25 mg, Manganese 1.088 mg,
Phosphorus 115 mg, Potassium 115 mg, Zinc 1.09 mg and Amino acids like Alanine‐
3.56, Arginine‐5.76, Asparic acid‐4.72, Cysteine‐1.36, Glutamic acid‐ 13.69, Glycine‐
6.84, Hisidine‐1.68, Isoleusinee‐4.69, Lysine‐ 3.95, Methionine‐ 1.80, Phenylalanine‐
5.03, Proline‐ 4.84, serine‐ 5.08, Threonine—3.92, Tryosine‐4.57 and Valine—6.99
p.c.respectively by weight.
4. Kodrava: 145
Latin name: Paspalum scrobiculatum, Linn
Family: Graminae
Syn: Koradusha, Kuchala, kuddhala, madanagraja (K.N)
Eng: Kodomillet
Hin: Kodo, Kodava, Kodo dhan
Kan: Haraka
Tam: Varugu, Kiraruga
Tel: Arugu
Mal: Varugu
Habitat: This is a native of India; mostly grown in Gujarat, Konkan and over the
Deccan platue.
Parts used: dried decorticated grain
Guna karma: Guna:Laghu ruksha; Rasa: Kashaya madhura; Veeraya: sheeta;
Doshakarma: vata vardhaka, kapha pitta shamaka; Karma: shoshaka and graahi.
Constituents: Two cleaned samples of kodra-one from poona and one from ratnagiri
district gave the following results. Poona: Moisture 8.0; Ether extract 3.36;
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Dr.Ramesh Kumar.K.L 70
Albuminoids 5.8 (Containing nitrogen 0.93) soluble carbohydrates 70.06; woody
Fibre 8.43; and Ash 4.29 p.c.
Ratnagiri: Mosture 9.07; Etherextract 3.34; Albuminoids 5.46 (Containing nitrogen
0.87), soluble carbohydrates 70.77; woody Fibre 9.37; and Ash 1.99 p.c. respectively.
Uses: The new grain is said to be powerfully narcotic and is eaten only by th poor
who prepare it in various ways and from use, are able to use it with impunity.
5. Shyamaka146
Latin name : Panicum frumentaceum
Family: Graminae
Syn: Shyama, Tribeeja, Avipriya, Sukumara, raja dhanya, Trina beeja, Uttam (R.N)
Eng: Barnyard millet
Hin: Saamva, sama
Kan: Syame akki
Tam: shane, Kudurai valli pullu
Tel: Shyamulu
Habitat: It is almost cultivated in the deccan platue of India, most parts of the south
Indian states like Tamil nadu, Karnataka and Andhra pradesh are the major producers
of shyamaka.
Guna karma: Guna:Ruksha; Rasa: Kashaya, Madhura; Veerya:sheeta, Vipaka:
madhura Doshakarma: vatakaraka, kapha pitta hara; Karma: shoshana,sangraahi
and vishaghna.
Parts used: dried decorticated grain
Constituents: Moisture: 11.6; Protein 6.2; Carbohydrate 65.5; minerals 4.4; Calcium
0.02; posphorous o.28; and Iron 2.26 mg per 100 gm grains. Traces of vit-A ans vit-B
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Dr.Ramesh Kumar.K.L 71
are also found. It also contains a small amount of Protein called prolemin, in which
lysine, custine and histidine.
6. Kangu: 147
Latin name : Sertaria italica, Linn
Family: Graminae
Syn: Kanguni, kangani, Pita tandula, Vatala, and Sukumara (R.N)
Eng: Italian millet, Deccan grass, Fox tail millet
Hin: Kanguni, kangni
Kan:Navane akki
Tam: Tinnai
Mal: Tina
Tel: Korralu
Habitat: Depending on its country of origin, it is also known as Italian, German,
Hungerian and Siberian millet. In Europe it was used for human food, but presently it
is cultivated for fodder. Fox tail millet probably originated in Asia. In India it is
cultivated in the plains of Deccan platue and in dry agricultural lands.
Parts used: dried decorticated grain
Guna karma: Guna:Ruksha shitala; Rasa:Kashaya,Madhura;
Doshakarma:Pittagna; Karma: Ruchikaraka, daha shamaka, Bhagna
sandhanakaraka.
Constituents: Moisture 11.2; Protein 12.3; Fat 4.3; Minerals 3.3; Carbohydrate 60.6
p.c respectively. Ca 31; Mg 120; P 260; Fe 12.6 mg per 100 gm of grains. It also
contains Vit-A and B, and some amounts of prolein, a Protein.
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Dr.Ramesh Kumar.K.L 72
7. Madhulika: 148
Latin name : Eleusine coracana / Eleusine indica
Family: Graminae
Syn: Soma, Krishna, Madhuli, Ragika, Nartaka, Nrityakundala (N.R)
Eng: Indian millet, Finger millet, Bird’s foot millet and African millet.
Hin: Makra, Mandua
Kan: Raagi
Tam: Raagi, Iragi
Mal: Ragi
Tel: Ragulu, Tamidalu
Habitat: It originated in India and is grown in all parts of India. The countries like
China, Malaya and parts of central Africa are also cultivating the grain.
Parts used: dried decorticated grain
Gunakarma: Guna: Laghu ruksha; Rasa: Tikta, madhura, Kashaya, Veerya: sheeta;
Vipaka: madhura; Doshakarma: tridosha shamaka, especially pitta shamaka:
Karma: triptikaraka,
Constituents: Albuminoids, starch, oil, Fibre and Ash; phosphoric acid 0.4p.c.
‘Poona ragi on the analysis shows the following composition’. Moisture 14.3p.c,
Ether extract 1.34p.c, Albuminoids 6.4 (Nitrogen 1.03) p.c., Soluble carbohydrates
73.34 p.c.,
woody Fibre 1.83p.c., Ash 2.69p.c., Mysore ragi, Moisture 13.22 p.c., Ether extract
1.20p.c., Albuminoids 5.39 ( Nitrogen o.86) p.c., Soluble carbohydrates 75.13 p.c.,
woody Fibre 2.10p.c Ash 2.98 (sand nil) p.c.
Action & Uses: Raagi is highly protenaceous and nourishing food stuff. It is most
suitable to hard working classes and to the poorer classes. The population of the
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Dr.Ramesh Kumar.K.L 73
Mysore platue, especially the lower classes eat a great deal of this nutritious food stuff
in addition to rice, and as such that keep better health and have better physique than
the rice eaters of south India. Ragi kanji with buttermilk in the morning is a diet in
diabetes. (Bombay Govt. Agri Dept).
8. Vajranna/ Sajja149
Latin name: Pennisetum typhoideum
Family: Graminae
Syn: Vajranna, Sajaka
Eng: Pearl millet, Spiked millet, Bull rush millet, cat tail millet
Hin: Bajra, Bajda
Kan: Kambina akki, Sajje
Tam: Kambu
Tel: Sajja, Saddulu
Habitat: Pearl millet is probably originated in tropical Africa. It is Largely cultivated
in africa and India especially in Bombay presidency and the Deccan platue.
Parts used: dried decorticated grain
Gunakarma: Guna:Ruksha; Rasa:Madhura, Kashaya; Veerya: Ushna;
Doshakarma: Kapha vata nAshaka ; Karma: balya.
Varieties: Deshi of gujarat or nadiad bajri; Bhavnagiri; Jabalpuri; Poona bajri and
Deccan bajri.
Uses: This grain constitutes the principal food of the working classes of the Sind,
Punjab, Bombay ptresidency and the Deccan.
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Dr.Ramesh Kumar.K.L 74
Constituents: It contains moisture 60.0; Ether extract (oils 0.4; Albuminoids,
nitrogen 0.21.p.c.) digestible carbohydrate 20.0; woody Fibre 15.8; Ash 2.5 p.c. per
100 percent. Bajri contains about 10% of proteids and 70% starch.
Action: On account of the millets heating qualities, this is largely consumed by the
tribes of Northern India during the cold weather.
9. Joorna150
Latin name: Sorghum vulgare/Andropogon sorghum
Family: Graminae
Syn: jurna, Jurnahva, Yavanala
Eng: Great millet
Hin: Jinor, Jondhari, Jwaar
Kan: Jola
Tam: Cholam
Mal: Cholam
Tel: Jonnalu
Habitat: Sorghum belongs to the tribe Andropogonae and was known cereal crop in
ancient Egypt by 2200B.C. It was probably domesticated in Africa then it spread
through India and china. These are drought tolerant. It is cultivated in almost all parts
of India in the dry agricultural land.
Parts used: dried decorticated grain
Gunakarma: Guna:Laghu, ruksha; Rasa: Kashaya,Madhura; Veerya:Sheeta;
Doshakarma: kapha pitta shamaka ; Karma: kledahara.
Constituents: Sorghum Nutritional value per 100 g (3.5 oz) Energy -1,418 kJ (339
kcal) Carbohydrates -74.63 g and Fibre1-.7g /100gm. Dietary fiber- 6.3 p.c., Fat- 3.30
p.c., Protein- 11.30 p.c., Nitrogen-1.7.p.c.,; Fibre -2.2 p.c., Ash -1.6 p.c., Amino acids
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Dr.Ramesh Kumar.K.L 75
like Arginine -3.79 Cysteine -1.66 Glutamic acid- 21.92 Histidine- 1.92 , Leucine-
16.o6 , Lysine- 2.72, Methionine-1.73, Phenylalanine- 4.97, Serine- 5.05, Threonine -
3.58 , Tryptophan- 1.12, Tryosine- 2.75, Valine- 5.71 p.c. respectively. Minerals like
Ca.-4o mg, fe- 4 mg, Mg- 170mg, P- 310mg, K- 340 mg, Cu-0.96mg, Mn-1.45 mg
and Zn- 1.37mg/ 100gm of dry sorghum. Vitamins like, Thiamine- o.38 mg,
Riboflavin-0.15mg, Niacin-3.9 mg/ 100g.
B.Shimbi dhanya varga
1. Mudga: 151
Latin name: Phaseolus mungo, Linn.
Family: Papillionaceae
Syn: Harita mudga, mangalya, Balishta, Mada.
Eng: Green gram
Hin: Moong,Mung
Kan: Hesaru Kaalu
Tam: Pachai payiru, Pasi parupu
Mal: Cherupayar
Tel: Pachai payulu, Pesalu
Habitat: Extensively cultivated for its seed, in all parts of India especially in south
India, to which it is a native. It is also grown in africa. There is a yellow-seeded
variety also.
Parts used: Whole seed and dehusked pulses.
Varieties: In Ayurvedic literature ther are four varieties of mudgas has been
mentioned. viz, 1.Harita mudga, 2.Peeta mudga, 3. Krishna mudga and 4.Vanya
mudga (R.N) 152
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Dr.Ramesh Kumar.K.L 76
Gunakarma: It is considered as the best among the shimbi dhanya varga, it also
mentioned as sadapathya. Guna: Laghu, Ruksha, Vishada; Rasa:KAshaya, madhura;
Vipaka:Katu; Veerya:Sheeta; Doshakarma: Kapha pitta hara; Karma:
Chakshushya.
Constituents: Church gives the following analysis of mung with husk: Water-10.8,
Albuminoids- 22.2, Starch- 54.1, Oil-2.7, Fibre-5.8 and Ash-4.4 p.c. respectively.
Raw mung bean:
Energy-1,452 kj (347 kcal), Carbohydrates-62.62 g, Sugars-6.60 g, Dietary fiber-16.3 g,
Fat-1.15 g, Protein-23.86 g, Vitamin C-4.8 mg (8%), Calcium-132 mg
(13%),Magnesium-189 mg (51%), Sodium-15 mg (1%) .
boiled mung beans:
Energy- 441 kcal, Carbohydrates- 19.15 g, Sugars- 2.00 g, Dietary fiber- 7.6 g, Fat-
0.38 g, Protein- 7.02 g, Vitamin C- 1.0 mg (2%), Calcium- 27 mg (3%),Magnesium-0.
298 mg ( 0%), Sodium- 2 mg ( 0%) (Percentages are relative to US recommendations for
adults ;Source: USDA Nutrient database,).
2. Adaki 153
Latin name: Cajanus indicus
Family: Papillionaceae
Syn: Adaki, Tuvari, Varyya, Karaveera beeja, Peeta pushpa, Vritta bija (R.N) 154
Eng: Pigeon pea
Hin: Arahar
Kan: Togari kaalu, Togari bele
Tam: Adagi, Tovarai
Mal: Tuvara
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Dr.Ramesh Kumar.K.L 77
Tel: Kandulu
Habitat: Extensively cultivated throughout India, especially southern India, as an
article of food. White seeded variety extensively cultivated in Gujrat, and red or
brown seeded variety generally cultivated in other parts of the bombay presidency.
Parts used: Seeds or beans and leaves.
Variety: In Ayurveda there are three types, 1. Shwetha, 2.Raktha, and
3.Shyama.(R.N)
Khadesh red, Nadiad red, Baramati white, Bangalore red, Salem red, Bangalore
varigated, sambalpur Ash.
Gunakarma: Guna: Laghu, Ruksha; Rasa: Kashaya, madhura; Veerya: Sheeta;
Doshakarma:Vata vardhaka, Kapha pitta shamaka; Karma:Graahi.
Constituents: This pulse which has three varieties, viz. Yellow, Red and White,
contains food elements: nitrogenous matter, oil, Fatty matter, starch or Carbohydrate,
nutritive salts and watery matter. Analysis of Deccan unsplit grains with husk
contains these following constituents.
Moisture-6.96, Ether extract-2.50, Albuminoids-19.57, Soluble carbohydrate- 6o.77,
woody Fibre- 6.70, Ash-3.50.percents respectively.
Analysis of split tuvar grain with husk removed.
In Deccan tur: Moisture-6.00, Ether extract-1.60, Albuminoids-21.12(nitrogen-
3.38), Soluble carbohydrate- 66.88, woody fibre- 1.10, Ash-3.30.percents
respectively.
In Tur white: Moisture-10.87, Ether extract-1.46, Albuminoids-14.25(nitrogen-2.28),
Soluble carbohydrate- 63.68, woody fibre- 6.22, Ash-3.50.(containing sand 0.05)
percents respectively.
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Dr.Ramesh Kumar.K.L 78
In Tur Red: Moisture-10.94, Ether extract-1.03, Albuminoids-19.62, (nitrogen-2.
66), Soluble carbohydrate- 62. 92, woody fibre- 4.76, Ash-3.50.(containing sand 0.05)
percents respectively. General analysis of the two seeds for Proteins, Fats,
Carbohydrates, fibre and Ash contents were carried out and the results were given in
g/100 g dry seeds. Pigeon pea contained Protein-25.2 g, Calcium-170 mg and Iron-8.9
mg.
3. Kulatha: 155
Latin name: Dolichos biflorus, Linn.
Family: Papiliionaceae
Syn: Kulattha, Tamrabeeja, Shwetha beeja, Sitetara
Eng: Horse gram, Kidney bean
Hin: Koolathee
Kan: Huruli kaalu
Tam: Kollu
Mal: Kullu
Tel: Ulavalu
Habitat: A common twining plant growing all over India, especially in bombay ,
madras and Deccan regions.
Parts used: Dry seeds
Guna karma: Guna:Ruksha, Teekshna; Rasa:Kashaya, Madhura; Veerya:Ushna;
Vipaka: Amla (Katu vipaka in susrutha); Doshakarma: Kapha vata shamaka;
Karma: Bhedana, Graahi, Vidahi, Ashmarigna, Shukrashmarigna, Shwasa kasa,
Shopha, Arsha and Peenasagna.
Constituents: The grain with husk contains the following contents. Moisture:4.30-
10.25 p.c., Ether extract:0.65-1.84 p.c., Albuminoids: 20.75-22.25 ( Containing
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Dr.Ramesh Kumar.K.L 79
nitrogen 3.32-3.56) p.c., Soluble carbohydrates: 56.04-63.20 p.c., woody Fibre-:4.85-
5.50 p.c., and Ash: 4.20- 7.5 p.c.( Containing sand 0.72-1.70) and Energry (cals) 321
kcal, Moisture-12 gm , Protein-22 gm , Fat-0 gm, Minera- 3 gm, Fibre-5 gm,
Carbohydrates-57 gm, Calcium-287 mg ,Phosphorous-311 mg, Iron-7 mg. The Protein
content of kidney bean was 23 g, while Calcium and Iron contents were 134 mg and
8.02 mg respectively.
4. Chanaka 156
Latin name: Cicer Arietinum
Family: Papillionaceae
Syn: Harimantha, Vaji mantha, Hari jivana (K.N) 157, Chana, Sugandha, Bala bhojya,
Vaji bhaksha, Krishna kanchuka (R.N) 158
Eng: Bengal gram, Chicken- Pea, Chick- Pea,
Hin: Chana
Kan: Kadle kaalu
Tam:Kadalai
Mal: Kadala
Tel: Senagalu
Habitat: A pulse cultivated in sindh, Bombay region and growing wild in all parts of
south India.
Varieties: There are two varieties mentioned in Raja nigantu viz, 1.Krishna chanaka
2. Goura chanaka.
There are four varieties of gram which differ obviously in the colour of the seed viz,
1.Black, 2.Red or brown, 3.Yellow and 4.White.
Parts used: Seeds or peas and leaves.
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Dr.Ramesh Kumar.K.L 80
Guna karma: Guna: Laghu Ruksha; Rasa: Kashaya, madhura; Veerya: Ushna;
Vipaka: Katu; Doshakarma: Vata karaka, Kapha nashala; Karma: Vishtambhaka,
Rakta, Pitta and Kapha vikara nashaka.
Constituents: Chick peas are a helpful source of Zinc, Folate and Protein.They are
also very high in dietary fiber and hence a healthy source of Carbohydrates for
persons with insulin sensitivity or diabetes. Chickpeas are low in Fat and most of this
is polyunsaturated. Nutrient profile of desi chana (the smaller variety) is different,
especially the Fibre content which is much higher than the light coloured variety. One
hundred grams of mature boiled chickpeas contains 164 calories, 2.6 grams of Fat (of
which only 0.27 grams is saturated), 7.6 grams of dietary fiber and 8.9 grams of
Protein. Chickpeas also provides dietary Calcium (49–53 mg/100 g).
Nutritional value per 100 g (3.5 oz), Energy 686 kJ (164 kcal), Carbohydrates
27.42 g, Sugars 4.8 g, Dietary fiber 7.6 g,Fat 2.59 g, saturated 0.269 g, monounsaturated
0.583 g, polyunsaturated 1.156 g, Protein 8.86 g, Water 60.21 g, Vitamin A equiv. 1 μg,
Thiamine (Vit. B1) 0.116 mg, Riboflavin (Vit. B2) 0.063 mg, Niacin (Vit. B3) 0.526 mg,
Pantothenic acid (B5) 0.286 mg, Vitamin B6 0.139 mg, Folate (Vit. B9) 172 μg, Vitamin
B12 0 μg, Vitamin C 1.3 mg, Vitamin E 0.35 mg, Vitamin K 4 μg, Calcium 49 mg, Iron
2.89 mg, Magnesium 48 mg, Phosphorus 168 mg, Potassium 291 mg, Sodium 7 mg, Zinc
1.53 mg, (value per 100 g. Source: USDA National Nutrient data base )
5. Masurika 159
Latin name: Lens esculenta/ Ervum lens/ Cicer lens
Family: Papillionaceae
Syn: Mangalya, Pandura, Masura (K.N)160, Ramadali, Pruthu bijaka, Shura, Kalyana
bija, Guru bija,Masura, Masuraka, Mangalya (R.N)161
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Dr.Ramesh Kumar.K.L 81
Eng: Lentils
Hin: Masur
Kan: Channangi
Tam: Misur-paruppu
Tel: Misur-pappu
Habitat: Grown in all parts of India.
Parts used: Pulses
Guna karma: Guna: Laghu, Ruksha; Rasa: Kashaya, madhura; Vipaka: Madhura;
Veerya: Sheeta; Doshakarma:Kapha hara; Karma: Bala vardhaka, Graahi, Useful in
Rakta pitta, Kapha vikaras and Mutrakruccha.
Constituents: Lentils contain high levels of Proteins, including the essential amino
acids isoleucine and lysine, and are an essential source of inexpensive Protein in many
parts of the world for those who adhere to a vegetarian
diet.http://en.wikipedia.org/wiki/Masoor_dal ‐ cite_note‐3 Lentils are deficient in two
essential amino acids, methionine and cystine. However, sprouted lentils contain
sufficient levels of all essential amino acids, including methionine and cystine.
Apart from a high level of Proteins, lentils also contain dietary fiber, Folate, Vitamin
B1, and minerals. Red (or pink) lentils contain a lower concentration of fiber than
green lentils (11% rather than 31%).http://en.wikipedia.org/wiki/Masoor_dal ‐ cite_note‐
6 Health magazine has selected lentils as one of the five healthiest foods . Lentils are
often mixed with grains, such as rice, which results in a complete Protein dish.
Lentils also have "anti‐nutritional factors" such as trypsin inhibitors and relatively
high phytate content. Trypsin is an enzyme involved in digestion and phytates reduce
the bioavailability of dietary minerals.http://en.wikipedia.org/wiki/Masoor_dal ‐
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Dr.Ramesh Kumar.K.L 82
cite_note‐8 The phytates can be reduced by soaking the lentils in warm water
overnight.
Nutritional value per 100 g (3.5 oz) Energy 1,477 kJ (353 kcal) ,Carbohydrates- 60 g,
Sugars -2 g , Dietary fiber-31 g , Protein -26 g, Iron-7.5 mg (60%) . Fat total-0.75 g,
saturated Fat-0.10 g, Vitamin A IU-15.84 IU, Thiamin B1-0.33 mg, Riboflavin B2-
0.14 mg, Niacin B3-2.10 mg, Vitamin B6-0.35 mg, Vitamin B12-0.00 mcg , Vitamin
E mg-1.16 mg, Folate- 357.98 mcg, Vitamin K-3.37 mcg, Pantothenic acid- 1.26 mg,
Calcium-37.62 mg, Copper-0.50 mg, Magnesium-71.28 mg, Manganese-0.98 mg,
Phosphorus-356.40 mg, Potassium-730.62 mg, Selenium-2.51 m,Sodium-3.96 mg,
Zinc- 5.54 mcg. omega 3 Fatty acids-0.07 g, omega 6 Fatty acids-0.27 g (value per
100 g. Source: USDA National Nutrient data base )
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C.Hareeta varga
1. Katillaka 162
Latin name: Boerhaavia diffusa, Linn.
Family: Nyctagineae
Gana: Vayasthapana, Kasa hara, Swedopaga, Anuvasanopaga (C.S), Vidarigandhadi
(S.S)
Syn: Punarnava, punarbhu, Sada(Sthayi), Mandala patraka, Shweta mula,
Vrishcheeva, Varshabhu, Shophagni, Jatila, Sadhyo vishoshi and Deerga patraka.
(K.N)
Eng: Spreading hog weed
Hin: Beshakapore, Thikri
Kan: Sanadika, Gonajali, Bagarotte soppu
Tam: Mukkaratai keerai
Tel: Attatamamidi
Mal: Tamilama
Habitat: Boerhavia diffusa It is found growing in waste lands, it also found in the
tropical, subtropical and temperate regions of the world. This plant is indigenous to
India and U.S.A. In India it is found in the warmer parts and up to an altitude of
2000m.
Varieties: It is of two kinds, White and Red flower. In the Tibetian literaturea third
variety with blue flowers has also been described. In Ayurveda there are two varieties
of Punarnava has been explained they are, Shwetha punarnava and Rakta
punarnava(B.P)
Parts used: Leaves along with stems.
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Dr.Ramesh Kumar.K.L 84
Guna karma: Guna:Laghu Ruksha; Rasa:Tikta Kashaya Madhura,Kshareeya;
Vipaka: Madhura ; Veerya: Ushna; Doshakarma: Vata kapha nashaka ;
Karma:Saraka,Agni deepaka, Shotagna.
Constituents: The plant extract contains a large number of biochemicals like
alkaloids, flavonoides, steroids, triterpenoides, lipids, lignins, Carbohydrates,
Proteins, glycoproteins and Punarnavine and Boerhavinone (Agarwal and Dutt, 1936,
Basu et al.,1947,1968; Surange and Pendse, 1972, Laxmi et al., 1990,92),
hypoxanthine 0-L-arabinofuranoside, lirodendrin(Jain and Khanna,1998 and Aftab et
al., 1996). Some workers have reported that the plant extract contains good quantities
of Potassium nitrate. Mishra and Tiwari (1971) in an important study reported that the
plant extract contains ursolic acid. Studies reveal that the plant – root contains six
essential amino acids where as root system contains 14 amino acids.
moisture -82.22% , carbohydrate -10.56% , Vitamin C -44.80mg /100g dry
weight, Vitamin B1 -97.00 mg/100g and Vitamin B2 -22.00 mg/100g respectively.
The mineral contents of the defatted leaf extracts were found to be Na -162.50
mg/100g, Ca -174.09 mg/100g and Mg -8.68 mg/100g, Iron 0.012, Manganese 0.43,
Aluminum 0.46, Iodine 0.002mg/100gm.
2. Shigru 163
Latin name: Moringa olifera/ M.Pterogosperma
Family: Moringaceae
Gana: Swedopaga, Krimigna, Shirovirechanopaga, Katuskanda, Haritaka varga
(C.S), Varunadi, Shirovirechana (S.S)
Syn: Shobhanjana, Krishna gandha, Murangi, Shalanakshama, Ghanacchada,
Teekshna gandha, Bahalacchada, Avadamsha, Mulaparni, Mukha banga, Haricchada,
Subanjana, Vidhradhigna, Akshiva and Mulakacchada. (K.N) 164
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Dr.Ramesh Kumar.K.L 85
Eng: Horse-radish tree, Drum stick tree.
Hin: Sahinjan, Soanja, Segve
Kan: Nugge soppu
Tam: Muranga keerai
Tel: Mulaga aku
Mal: Murina
Habitat: A beautiful tree wild in all parts of India and burma.
Parts used: Leaves, flowers, immature capsules and root are eaten as vegetables in
curries.
Guna karma: Guna: Laghu, Ruksha, Teekshna; Rasa:Katu(Kshariya),
Tikta,madhuram; Vipaka: Katu; Veerya:Ushna; Doshakarma: Kapha vata nashaka;
Karma: Agni deepaka, Rochaka, Sangraahi, Vidahakari, Hrudhya, Netrya, Shotagna
and usefull in Medoroga and visha.
Constituents: The main constituents of Moringa plant are palmitic and stearic acid,
saponins, glycoside, gum, Protein Vitamin: A (8855 IU per 100g), B1, B2, B3,
C Minerals: Calcium, Iron, Phosphorus and Magnesium. The leaves, flowers and pods
are used as significant sources of Vitamins A, B and C, Riboflavin, nicotinic acid,
folic acid, pyridoxine, ascorbic acid, beta-carotene, Calcium, Iron, and alpha-
tocopherol (Dahot, 1988). The pods are considered good sources of the essential
amino acids. A compound found in the flowers and roots of the moringa tree,
pterygospermin, has powerful antibiotic and fungicidal effects (Das et al., 1957)
Leaves: The Moringa oleifera leaves are highly nutritious, being a significant source
of beta-carotene, Vitamin C, Protein, Iron, and Potassium.
Moisture content was 74.42%, Protein 16.7%, fibre 3.5%, Ash 8%, and oil 1.7%. Also
the minerals content were determined and they were found that the Calcium content
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Dr.Ramesh Kumar.K.L 86
was 0.20 mg/100g, Magnesium 0.13mg/100g, Potassium 0.075mg/100g, and
Phosphorus 0.031 mg/100g
3. Lonika 165
Latin name: Portulaca oleracea, Linn
Family: Portulacaceae
Eng: Common Indian purselane, garden purselane
Hin: Khursa
Kan: Duda-gorai, guni soppu
Tam: Paruppu keerai
Tel: Peddapavila kura
Mal: Neela keera
Habitat: it is found throught India in all warm climates, it is an abundant weed in
cultivated ground throughout Cylone.
Parts used: Leaves and whole plant
Guna karma: Guna:Ruksha, Guru; Rasa:Katu,amla; Veerya:Ushna; Vipaka:Katu;
Doshakarma: Vata nashaka, Pitta vardhaka; Karma: Agni deepaka and it is useful in
Vrana, Shotha, Kasa, Shwasa, and Netra vikara.
Constituents: Purslane contains large amounts of l-norepinephrine (l-noradrenaline;
0.25% in fresh herb), a neurohormone that has vasopressor and antihypotensive
activities and reduces haemorrhage at the tissue level. It also contains numerous
common nutrients (varying from low to high concentrations depending on report),
including: Vitamins (A, B1, B
2, C, niacinamide, nicotinic acid, α-tocopherol, β-
carotene, etc.); minerals (especially Potassium); Fatty acids, especially omega-3 acids
whose concentration in purslane is the highest found in leafy vegetables; glutathione;
glutamic acid; and aspartic acid. Other constituents include a mucilage composed of
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Dr.Ramesh Kumar.K.L 87
an acidic and a neutral fraction with structure determined, Calcium oxalate, malic and
citric acids, dopamine and dopa, coumarins, flavonoids, alkaloids, saponins, and urea
among others used [Leung & Foster, 1996].
Recent research has shown that P. oleracea is a rich source of omega-3 Fatty
acids, which are thought to be important in preventing heart attacks and strengthening
the immune system [Bown, 1995].
Oxalates and noradrenalin have been isolated from the plant. The plant also contains
saponins [Iwu, 1993]. The plan contains tannin, phosphates, urea, and various
minerals with a large amount of Magnessium [Keys, 1976]. The whole plant contains
carotene, Vitamins C, B1, B
2, Ca, Mg, Na, K salts; organic acids, nicotinic and oxalic;
nor adrenaline, and the bioflavonoid liquiritin [World Health Organisation, 1990].
4. Drona pushpin 166
Latin name: Leucas cephalotes/ Indicus/ Linifolia
Family: Labiatae
Syn: Kumba yoni, Drona, Chatra kutumbaka, Koundinyotha, Maha drona, Drona
kutumbaka, (K.N) 167 Chitra patrika, Deerga patra, Kumba yoni, Kurambika, Chitra
kshupa, Kuramba, Supushpa (R.N) 168
Hin: Gooma madhupati
Kan: Tumbe soppu
Tam: Tumbay keerai
Tel: Tumni
Mal: Tumba
Habitat: It found throughout India, It usually grown as a common weed wildly.
Parts used: Flowers,and leaves
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Dr.Ramesh Kumar.K.L 88
Gunakarma: Guna: Guru, Ruksha,Kshareeya,Teekshna ; Rasa: Katu, Lavana and
Madhura; Veerya:Ushna; Vipaka:Katu; Doshakarma:Vata pitta vardha ,Kapha
shamaka; Karma:useful in Baddha mala, Kamala, Shopha, Kasa, Tamaka shwasa and
in Agni mandya.
PHYSICALCONSTITUENTS
Total Ash: not more than 17%, acid insoluble Ash: not more than 6%, alcohol soluble
extractive: not less than 5%, water soluble extractive: not less than 14 %.
CHEMICALCONSTITUENTS
Plant :- β-sitosterol & its glycoside new labdane, nor labdane , and abietone‐type
diterpenes named leucasdins A,B,and C respectively and two protostane – type
triterpenes named leucastrins A and B, oleonolic acid, 7‐ oxositosterol, 7‐
oxostigmasterol,7alpha ‐hydroxysitosterol,7 alpha‐ hydroxystigmasterol,sigmasterol,
5‐hydroxy‐7,4‐dimethoxyflavone, pillion,gonzali‐ tosin 1, tricin,cosmosin,a pigenin 7‐
o‐beta‐D{6‐0‐p‐caumaroyl glucopyranoside, anisofolin A and luteolin 4‐0‐beta ‐D –
glucurono pyranoside, Seedoil: Laballenic acid { octadeca ‐ 5, 6‐dienoic acid }lauric
acid, glutanic acid ,tridecanonic acid , adipic acid.(IMM, Nadakarni & NIN,Hbd, India)
5. Guduchi patra 169
Latin name: Tinospora cordifolia
Family: Menispermaceae
Syn: Guduchi, Kundali, Soma, Chinna, Chinnodbhava, Amruta, Madhuparni, Chinna
ruha, Vayastha, Chandra hasa, Amrita latha, Dhara,Vatsadhani and Varaye.(K.N) 170
Guduchi, Amritavalli, Dhara, Naga kumari, Chinnangi, Tantrika, Devanirmita,
Soumya, Vishalyamrutha sambhava, Bhishagjita, Kanya, Kandodbhava and
Kandamrutha kanda. (R.N)
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Dr.Ramesh Kumar.K.L 89
Gana: Vaya sthapana, Daha prashamana, Trishna nigrahana, Sthanya shodana,
Truptigna, (C.S), Guduchyadi, Patoladi, Aragvadadhi, Kakolyadi, Vallipanchamula
(S.S)
Eng: Heart leaved moonseed
Hin: Gulancha, Giloya
Kan: Amrutha balli soppu
Tam: Sindilkodi, Amrudavalli keerai
Tel: Tippatega
Mal: Chittamrutam
Habitat: A common climbing shrub growing on neem and other trees in trophical
western ghats and grows wild all over India, it also grows wildly in the farm lands.
Parts used: Stem and fecula (starchy extract of guduchi), leaves as a curry with meals
and root for medicinal purpose.
Guna karma: Guna: Guru ,snigdha and laghu; Rasa: Tikta, Kashaya and Madura ;
Vipaka:Madhura; Veerya:Ushna; Doshakarma:Trodoshagna; Karma: Useful in
Kushta, Krimi, Chardhi, Daha, Pandu, Kamala, Trishna and Vatarakta.
Constituents: Different constituents reported include a glucoside, alkaloids, bitter
principles, crystalline components etc. The bitter principles have been identified as
columbin, chasmanthin and palmarin. The alkaloid tinosporin has also identified.
The active adaptogenic constituents are diterpene compounds including
tinosporone, tinosporic acid, cordifolisides A to E, syringen, the yellow alkaloid,
berberine, Giloin, crude Giloininand, a glucosidal bitter principle as well as
polysaccharides, including arabinogalactan polysaccharide (TSP). Picrotene and
bergenin were also found in the plant. The active principles of Tinospora cordifolia, a
traditional Indian medicinal plant were found to possess anticomplementary and
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Dr.Ramesh Kumar.K.L 90
immunomodulatory activities. Main chemical components are tinocordifolin,
tinocordifolioside, tinosponone, tinocordioside, cordioside, picroretine, colombine,
and columbin.
A large number of compounds have been isolated from the aerial parts and
roots of T. cordifolia . In the early 1900s, giloin, gilenin, and gilosterol, as well as the
bitter principles columbin, chasmanthin, and palmarin, were identified in the plant.
http://www.drugs.com/npp/tinospora.html ‐ ref6In addition, syringin, cordiol,
cordioside, and the phenylpropene disaccharides cordifoliosides A and B were
identified as the active principles with anticomplement and immunomodulatory
activities. (National institute of Nutrition, Hybd, India)
6. Kakamachi 171
Latin name: Solanum nigrum /S. americanum
Family: Solanaceae
Gana: Tiktaskanda (C.S)
Syn: Dhwankshamachi, Kakahva, Vayasi, Katvi, Katu phala, Rasayanavara (R.N)172
, Kakasahva, Kamata, Jaghanephala, Sarva tikta, Bahuphala, Swadhupaka phala,
Kamachi, Kakini, Gudaphala, Katu and Kushtaghni. (K.N)
Eng: Black night shade
Hin: Makoi, Gurkamai
Kan: Ganake soppu, Kakamunchi
Tam: Man thakkali keerai, Milagu takkali, Mann thakkali palam
Tel: Kamanchi chettu, Kanchi-pundu, Kachi
Mal: Tudavalam
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Dr.Ramesh Kumar.K.L 91
Habitat: Black nightshade is a fairly common herb or short-lived perennial shrub,
found in many wooded areas, as well as disturbed habitats. It grows wildly throught
India.
Parts used: Leaves and fruits, leaves are used as a vegetable curry very commonly in
India.
Guna karma: Guna:Lagu,Ruksha; Rasa:Katu, Tikata; Vipaka:Katu;
Veerya:Ushna; Doshakarma:Tridoshaghna; Karma: Hrudya, Rasayana and it is
used in Kushta, Shota, Arsha, Shwasa, Kasa, Aruchi and Jwara.
Constituents: Leaves contain quercetin glycosides, Immature fruits contain gluco
alkaloids, Leaves and fruits contain solasodine type compounds, Fruits contain
steroidal glycosides, glycoalkaloids, α – solamargine & α – solasonine,Seeds contain
a Fatty oil. Protein - 5-6% , Fat - 1% , Minerals - 2% , Carbohydrates - 8-9% ,
Calcium - 410mg , Riboflavin - 0.5mg ,Nicotinic acid - 0.92mg , Vitamin C - 11mg ,
β Carotene - 0.74mg , Iron - 20.5mg and Alkaloids like Solanine ,Solanorine
,Solamargine ,Solanigrine – A & B ,Total alkaloids - 0.101 to 0.43% . In fruits
:Glucose and fructose - 15 to 20% , Vitamin C and β - Carotene . Seeds :Yellow oil -
15 to 20% , Leaf is rich source of Riboflavin. Seeds : Yellow oil - 15 to 20% , Leaf is
rich source of Riboflavin. (National institute of Nutrition, Hybd, India)
7.Vastuka/ Chilli shaka 173
Latin name: Chenopodium album
Family: Chenopodiaceae
Syn: Palasalohita, Vastuka, Chillika, Mrudupatri, Ksharadala, Kshara patri and
Vastuki (R.N)174 Shaka veera, Pranalaka, Tanka vastuka, Prasadaka, Chandrila, Tanka
vastuka and Veera shaka.(K.N)175
Eng: Goose foot
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Dr.Ramesh Kumar.K.L 92
Hin: Chandan betu
Kan: Bayi basale soppu
Tam: Paruppu keerai
Tel: Pappu keera
Habitat: Usually grown in gardens, but sometimes in corners of early grain fields all
over India.
Parts used: The plant is much esteemed as a pot herb. Leaves are taken in the form of
infusion or decoction, as a laxative and anti helmenthic, Seeds are consumed by hill
tribes as an article of food.
Gunakarma:Guna:Lagu,Saraka,Ruksha,Teekshna;Rasa:Madhura,Katu,Ksharayukta
;Vipaka:Katu;Veerya:Ushna;Doshakarma:Pittavardhaka,Kaphavatanashaka;
Karma:Ruchikaraka, Agni deepaka, Medhya and useful in Prameha, Krimi,
Pleeharoga and Mutrakricha. (R.N)
Constituents: Water-84.300 g, Energy-43.000 kcal, Energy-180.000 kj,Protein-
4.200 g, Total lipid (fat)0-0.800 g, Ash- 3.400 g, Carbohydrate, by difference-
7.300 g, Dietary Fiber- 4.000 g, Calcium, Ca- 309.000 mg, Iron, Fe- 1.200 mg,
Magnesium, Mg- 34.000 mg, Phosphorus, P- 72.000 mg, Potassium, K- 452.000 mg,
Sodium, Na- 43.000 mg, Zinc, Zn- 0.440 mg, Copper, Cu- 0.293 mg, Manganese,
Mn-0.782 mg, Selenium, Se- 0.900 mcg, Vitamin C, total ascorbic acid- 80.000
mg, Thiamin-0.160 mg, Riboflavin-0.440 mg, Niacin- 1.200 mg, Pantothenic acid-
0.092 mg, Vitamin B-6-0.274 mg, Folate, total-30.000 mcg, Folate, food-30.000
mcg, Folate, DFE-30.000 mcg_DFE, Vitamin A, IU-11600.000 IU, Vitamin A,
RAE-580.000 mcg_RAE, Fatty acids, total saturated-0.059 g, Saturated Fatty
acids 16:0-0.047 g, Fatty acids, total monounsaturated-0.150 g, Fatty acids, total
polyunsaturated-0.351 , Polyunsaturated Fatty acids 18:2 undifferentiated-0.313
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Dr.Ramesh Kumar.K.L 93
g, Polyunsaturated Fatty acids 18:3 undifferentiated- 0.036 g, Polyunsaturated
Fatty acids 20:4 undifferentiated- 0.002 g, Cholesterol- 0, Tryptophan-0.038 g,
Threonine-0.163 g, Isoleucine-0.253 g, Leucine-0.350 g, Lysine-0.354 g,
Methionine-0.049 g, Cystine-0.089 g, Phenylalanine-0.166 g, Tyrosine-0.175 g,
Valine-0.226 g, Arginine-0.253 g, Histidine-0.116 g, Alanine-0.322 g, Aspartic
acid-0.431 g, Glutamic acid-0.521 g, Glycine-0.249 g, Proline-0.223 g, Serine-
0.200 g.
(value per 100 g. Source: USDA National Nutrient data base )
D.Shakavarga
1. Kushmanda 176
Latin name: Benincasa hispida
Family: Cucurbitaceae
Varga: Valli phala
Syn: Kushmandika, Kumbhaphala, Sthiraphala, Somasrushta, Peetaka, Bruhat phala,
Suphala and Kumbandi (R.N). Mahaphala, Pushpa phala, Somagrushtika, (K.N) 177
English: Ash gourd, White gourd melon, White pumpkin
Hin: Golkaddu, Peta, Rakasa and Bhatua
Kan: Boodigumbala, Sandhigumbala
Tam: Kalyan-pooshini
Tel: Boodi gummadi
Mal: Kumpalam
Habitat: Cultivated in gardens throught India
Parts used: Seeds, Fruits and fruit juice.
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Dr.Ramesh Kumar.K.L 94
Gunakarma: Guna: Laghu, Snigdha; Rasa:Madhura; Vipaka:Madhura;
Veerya:Sheeta; Doshakarma:Vata-pitta shamaka, Kapha vardhaka; Karma:
Shukrala, Hrudya, Ashmari chedanam, Pushtidayaka, Vrushya, Balya and Thisha
shamaka.
Constituents: Water-96.100 g, Energy-13.000 kcal, Energy-54.000 kj, Protein-
0.400 g, Total lipid (fat)- 0.200 g, Ash-0.300 g, Carbohydrate, by difference-3.000
g, Dietary Fiber- 2.900 g, Calcium, Ca -19.000 mg, Iron, Fe- 0.400 mg,
Magnesium, Mg -10.000 mg, Phosphorus, P- 19.000 mg, Potassium, K- 6.000 mg,
Sodium, Na- 111.000 mg, Zinc, Zn - 0.610 mg, Copper, Cu -0.023 mg, Manganese,
Mn-0.058 mg , Selenium, Se-0.200 mcg , Vitamin C, total ascorbic acid- 13.000
mg, Thiamin-0.040 mg , Riboflavin-0.110 mg , Niacin-0.400 mg , Vitamin B-6-
0.035 mg , Folate, total- 5.000 mcg, Pantothenic acid- 0.133 mg , Fatty acids,
total saturated- 0.016 g, Fatty acids, total polyunsaturated-0.087 g, Tryptophan-
0.002 g, Lysine-0.009 g, Methionine- 0.003 g. (Source: USDA: Nutrient Data base
for Average amount in 100g )
2. Karavellaka178
Latin name: Momordica charantia
Family: Cucurbitaceae
Gana: Tiktaskanda (C.S)
Syn: Kandiram, Kanda katukam, Sukandam, Karavellakam, Ugra kandam and Katilla
(K.N) 179
Eng: Bitter gourd
Hin: Karela
Kan: Hagala kayi
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Dr.Ramesh Kumar.K.L 95
Tam: Pavakkai, Pagal
Tel: Kakara
Mal: Paval, Kaipavalli
Habitat: This climbing plant is cultivated all parts of India in the gardens, for its
fruits.
Varieties: There are two varieties, one with a small roundish or ovoid fruit and the
other longer and more cucumber like (kerula-in bengal)
Parts used: Fruits, seeds and leaves.
Gunakarma: Guna: Laghu, Ruksha; Rasa:Tikta, katu; Vipaka:Katu; Veerya:Ushna
; Doshakarma:Kapha pitta shamaka, Kinchit vata vardhaka ; Karma: It is useful in
Aruchi, Rakta pitta, Pandu, Vrana, Krimi roga, Shwasa, Kasa, Rakta vikara, Kota,
Kushta and Jwara.
Constituents: Water-94.030 g, Energy-17.000 kcal, Energy- 71.000 kj, Protein-
1.000 g, Total lipid (fat)- 0.170 g, Ash-1.100 g, Carbohydrate, by difference-
3.700 g, Dietary Fiber-2.800 g, Calcium, Ca- 19.000 mg, Iron, Fe-0.430 mg,
Magnesium, Mg-17.000 mg, Phosphorus, P- 31.000 mg, Potassium, K- 296.000 mg,
Sodium, Na-5.000 mg, Zinc, Zn-0.800 mg, Copper, Cu-0.034 mg, Manganese, Mn-
0.089 mg, Selenium, Se-0.200 mcg, Vitamin C, total ascorbic acid-84.000 mg,
Thiamin-0.040 mg, Riboflavin-0.040 mg, Niacin- 0.400 mg, Pantothenic acid-0.212
mg, Vitamin B-6-0.043 mg, Folate, total- 72.000 mcg, Folate, food- 72.000 mcg,
Folate, DFE-72.000 mcg_DFE, Vitamin A, IU-471.000 IU, Vitamin A, RAE-
24.000 mcg_RAE, Carotene, beta- 190.000 mcg, Carotene, alpha- 185.000 mcg,
Lutein + zeaxanthin-170.000 mcg. (Source: USDA: Nutrient Data base for Average
amount in 100g )
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Dr.Ramesh Kumar.K.L 96
3. Bimbi 180
Latin name: Coccina grandis/ C.Indicus
Family: Cucurbitaceae
Gana: Mulini (C.S), Urdhwa bhaga hara (S.S)
Syn: Bimbi, Rakta phala, Tundi, Tundikeri, Oshtopama phala, Gohla, Piluparna and
Tundika. (D.N) Tikta tundi, Katuka, Katu tundika, Tikta tundi (R.N), Raktaphala,
Ushna phala, vidhruma pakya,Dantacchada, Tundikeri, Tundi, Golha, Tundiki and
Piluparnika (K.N)181
Eng: Ivy gourd
Hin: Kanduriki bel, Kunduru
Kan: Tonde kayi
Tam: Kovai kai
Tel: Dondatiga, Kakidonda
Habitat: Grows in a wild state abundantly in bengal and most parts of India.
Parts used: Leaves, root, fruit and bark
Varieties: It is of two varieties, first one is Katu bheda, its all parts are very much
bitter in taste and used as vegetable and medicine. The second one is sweet fruit
variety, used as vegetable.
Guna karma: Guna:Laghu, ruksha, teekshna; Rasa:Tikta, Katu; Vipaka:Katu;
Veerya: ushna; Doshakarma: Kapha pitta nashaka, Vatakara; Karma:
Ruchikaraka, vishahara and useful in shota, rakta vikara and in pandu.
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Dr.Ramesh Kumar.K.L 97
4. Patola182
Latin name: Trichosanthes anguina
Family: Cucurbitaceae
Gana: Triptighna, Trishna nigrahana (C.S) Patoladi, Aragvadadi (S.S)
Syn: Patola, Kulaka, Panduke, KarekAshacchada, Raji phala, Panduphala, amrita
phala (R.N) Raji phala, Pandu phala, Jaali, Jyotsna, Rajimana, Tiktottama, Raja
patolika and Bija garbha.(K.N)183
Eng: Snake gourd
Hin: Chichonda, Chachinda
Kan: Padavala kayi
Tam: Podalangai
Tel: Potla kaya
Mal: Patolam
Habitat: It is a creeper, the fruit resembles like snake and cultivated throughout India.
Variety: It is of twokinds 1. Gramya veriety which is not too much bitter 2. Wild
variety, it is very much bitter in taste.
Parts used: Fruits
Guna karma: Guna:Laghu, ruksha; Rasa:Tikta, katu; Veerya:Ushna; Vipaka:Katu;
Doshakarma: Tridoshashamaka; Karma: Agni deepaka, Pachaka, Ruchikaraka and
useful in Shwasa, Jwara, Kushta, Rakta vikara and in Krimi.
Constituents: Tricosanthes anguina is a rich source of nutrition. It is highly
constituted with Proteins, Fat, Fibre, Carbohydrates,Vitamin A and E. The total
phenolics and flavonoids content is 46.8% and 78.0% respectively. The fruit is rich in
Vitamin C and E. The crude Protein content is 30.18%8. The predominant mineral
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Dr.Ramesh Kumar.K.L 98
elements were Potassium (121.60mg 100-1g) and Phosphorus (135.0mg 100-1g).
Other elements found in fairly high amounts are Sodium, Magnesium and Zinc. The
triterpenes found are 23, 24-dihydrocucurbitacin D, 23,24-dihydrocucurbitacin B,
cucurbitacin B, 3β-hydroxyolean- 13(18)-en-28-oic acid, 3-oxo-olean-13(18)-en-30-
oic acid and the sterol 3-O-β-D-glucopyranosyl-24ξ-ethylcholest- 7,22-dien-3β-ol.
The percentage free Fatty acid and acid values were low suggesting increased stability
and usefulness in nutritional and industrial applications.The chemical constituents
present in T. anguina are cucurbitacin B, cucurbitacin E, isocucurbitacin B, 23,24-
dihydroisocucurbitacin B, 23,24-dihydrocucurbitacin E, sterols 2 β-sitosterol
stigmasterol 11. Low amount of chemical substances like oxalate, phytates and
tannins are also present. Analysis showed that the seed of T. cucumerina have high oil
content up to 42.5±5%. The ascorbic acid content found was 24.8 – 25.7 mg/100g
fresh weight and lycopene content was16.0 and 18.1 mg/100g.
5. Shigru phala: 184
Latin name: Moringa olifera/ M.Pterogosperma
Family: Moringaceae
Gana: Swedopaga, Krimigna, Shirovirechanopaga, Katukaskanda, Haritaka varga
(C.S), Varunadi, Shirovirechana (S.S)
Syn: Shobhanjana, Krishna gandha, Murangi, Shalanakshama, Ghanacchada,
Teekshna gandha, Bahalacchada, Avadamsha, Mulaparni, Mukha banga, Haricchada,
Subanjana, Vidhradhigna, Akshiva and Mulakacchada. (K.N) 185
Eng: Horse-radish, Drum stick
Hin: Sahinjan, Soanja, Segve
Kan: Nugge kaayi
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Dr.Ramesh Kumar.K.L 99
Tam: Muranga kai
Tel: Mulaga
Mal: Murina
Habitat: A beautiful tree wild in all parts of India and burma.
Parts used: Leaves, flowers, immature capsules and root are eaten as vegetables in
curries.
Guna karma: Guna: Laghu, Ruksha, Teekshna; Rasa:Katu(Kshariya),
Tikta,madhuram; Vipaka: Katu; Veerya:Ushna; Doshakarma: Kapha vata nashaka;
Karma: Agni deepaka, Rochaka, Sangraahi, Vidahakari, Hrudhya, Netrya, Shotagna
and usefull in Medoroga and visha.
Constituents: Water-78.660 g, Energy-64.000 kcal, Energy- 268.000 kj, Protein-
9.400 g, Total lipid (fat)-1.400 g, Ash-2.260 g, Carbohydrate, by difference -8.280
g, Dietary Fiber- 2.000 g, Calcium, Ca- 185.000 mg, Iron, Fe-4.000 mg,
Magnesium, Mg- 147.000 mg, Phosphorus, P- 112.000 mg, Potassium, K- 337.000
mg , Sodium, Na-9.000 mg, Zinc, Zn -0.600 mg, Copper, Cu- 0.105 mg, Manganese,
Mn- 1.063 mg, Selenium, Se-0.900 mcg, Vitamin C, total ascorbic acid- 51.700
mg, Thiamin- 0.257 mg, Riboflavin-0.660 mg, Niacin- 2.220 mg, Pantothenic acid-
0.125 mg, Vitamin B-6-1.200 mg, Folate, total-40.000 mcg, Folate, food-40.000
mcg, Folate, DFE-40.000 mcg_DFE, Vitamin A, IU-7564.000 IU, Vitamin A, RAE-
378.000 mcg_RAE, Tryptophan- 0.144 g, Threonine -0.411 g, Isoleucine-0.451 g,
Leucine-0.791 g, Lysine-0.537 g, Methionine-0.123 g, Cystine- 0.140 g,
Phenylalanine-0.487 g, Tyrosine-0.347 g, Valine-0.611 g, Arginine- 0.532 g,
Histidine- 0.196 g, Alanine-0.705 g, Aspartic acid-0.920 g, Glutamic acid- 1.035 g,
Glycine-0.517 g, Proline-0.451 g, Serine- 0.414 g. ( Nutrient in 100g: Source,
USDA Nutrient Data Base )
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Dr.Ramesh Kumar.K.L 100
6. Indravaruni186
Latin name: Citrullus colocynthis
Family: Cucurbitaceae
Gana: Virechana, Mulini (C.S), Adobhagahara, Shyamadi (S.S)
Syn: Aendri, Indrahva, Surendrahva, Gavakshi, Suravaruni, Aendrervaru,
Kshudraphala, Vrishabakshi, Vrishadani, Mrigabhaksha, Mrugairvaru, Vishala,
Atmaraksha, Chitraphala, Chitravedi, Mahaphala, Dhanushreni, Trapusi, Gajachirbati,
Hastidanti, Surpahva and Marusambhava (K.N)187, Aendri, Varuni, Indrahva,
Kshudraphala, Vrishabhakshi (D.N)188, Mrigadani, Kshudra sahendra, Chirbita,
Surya, Vishagni, Gunakarnika, Suvarna, Suphala,Indra vallari, Hemapushpi,
Balakapriya and Taraka(R.N)
Eng: Bitter apple, Indian wild gourd
Hin: Indrayan
Kan: Mekke kayi, Tamate kayi
Tam: Tumbikkai, Vasi-tummatti, Attu-tummatti, Peyt-tummatti
Tel: Eti-puccha, Paperabudama, Verri-puccha
Mal:Paikummatti, Kattuvelleri
Habitat: Common weed found wild in the sandy lands of north west, the punjab,
Sindh, Central and Southern India, and on the coromandal coast, Colocynth isnot
symmetrically grown anywhere in India.
Parts used: Fruit deprived of its rind, root, dried pulp of the fruit free from seeds and
oil from seeds.
Gunakarma: Guna:Laghu, Ruksha, Teekshna; Rasa:Katu Tikta; Vipaka:Katu;
Veerya:Ushna ; Doshakarma:Kapha pitta shamaka; Karma: Agni deepaka and
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Dr.Ramesh Kumar.K.L 101
useful in Kasa, Shwasa, Apachi, Galaganda, Anaha, Vrana, Krimi, Kushta, Kamala,
Ashmari, Granthi and visha.
Constituents: Active drug contains an ether-chloroform soluble resin, a phytosterol
glycoside (citrullol), other glucosides (elaterin, elatericin B and dihydro-elatericin B),
pectins and albuminoids. Bitter substance is colocynthin and colocynthetin. Roots
contain a-elaterin, hentriacontane, and saponins. Per 100 g, the seed is reported to
contain 556 calories, 6.7 g H2O, 23.6 g Protein, 47.2 g Fat, 19.5 g total Carbohydrates,
1.5 g fiber, 3.0 g Ash, 46 mg Ca, and 580 mg P. The oil contains oleic, linoleic,
myristic, palmitic, and stearic acids. Seeds contain the phyto sterolin (ipurand), 2
phytosterols, 2 hydrocarbons, a saponin, an alkaloid, a polysaccharide or glycoside,
and tannin.
7. Katu tumbi189
Latin name: Lagenaria vulgaris
Family: Cucurbitaceae
Gana: Vamana, Phalini (C.S) Urdwa bhaga hara (S.S)
Syn: Tumbi, Lamba, Pinda phala, Rajanya, Pravara, tikta bija, Tiktalabu, Mahaphala,
Raja putri, Gugdhinika and Dugdhika.(K.N)190, Katukalambini, Tumbi, Lamba,
Pindaphala, Ikshuvaku, Kshatriyavara, Tikta bija and Mahaphala (D.N)191
Eng: Bitter bottle gourd, long white gourd
Hin: Lauki, Jangli lauki, Khaddu.
Kan: Kahi sorekayi
Tam: Sorakkai
Tel: Chiti-Anab, Sorakaya, Anap kaya
Mal:Anapa-kai, Katuchuram
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Dr.Ramesh Kumar.K.L 102
Habitat: This climbing plant is found wild and cultivated nearly all over India.
Parts used: Fruit pulp, Seeds and Seed oil.
Gunakarma: Guna:Laghu, Ruksha; Rasa:Tikta; Vipaka:Katu; Veerya:Ushna;
Doshakarma:Vata pitta nashaka; Karma: Useful in Shitala, Kasa, Shwasa, Jwara
and Visha.
Constituents: The fruit is reported to contain the triterepeniode cucurbitacins B, D,
G, H and 22-deoxy cucurbitacin the bitter principle of cucurbitaceae. Two sterols i.e.,
fucosterol and campesterol, aerpene byonolic acid (an allergic compound), flavone-C
glycosides, a ribosome inactivating Protein), Lagenin, (antiproliferative,
immunosuppressive, antifertility . The edible portion of fruits is fair source of
ascorbic acid, beta carotene and good source of Vitamin B complex, pectin dietary
soluble fibers and contains highest source of choline level-a lipotropic factor, a healer
of mental disorders. It is also reported to have content more proportion of Soluble
Dietary Fibers (SDF) than insoluble fibers. SDF are having profound effect in
lowering serum cholesterol, which also reveals that the pectin is predominant
component of soluble fibers in Lagenaria vulgaris fruits. Carbohydrate and dietary
constituents:Total sugar-5.870g, Reducing sugar-5.220g, Starch-1.310g,
Hemicellulose-6.450g , Cellulose- 16.070g , Legnine-0.193g , Mineral : fe-11.87mg ,
P- 240.33mg, K- 3320mg, Na-27.88 , zn-3.77mg , Mg-162.33mg , Mn- 0.26mg, Cu-
0.19mg. Amino acids: Tryptophan-0.003 , Threonin-0.018 , Isoleucine-0.033 ,
Leucine-0.036 , Methionine-0.004, Phenylalanine-0.015, Valine-0.027, Arginine-
0.014, Histidine- 0.004, Vitamins content: Vit C- 10.100mg, Thiamine-0,029mg,
Riboflavin-0.022mg , Niacin-0.320mg, Vit B6-0.040mg, Pantothenic acid-0.152mg,
Vit E-16.02mg. (dietary content of Bottle gourd mg/100 g dry weight basis).
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8. Karkotaka192
Latin name: Momordica dioica
Family: Cucurbitaceae
Varga: Mulakadi (R.N)
Syn: Swadhupala, Manogna, Kumarika, Avandhya, Devi and Vishaprashamani
(D.N)193 Manasvini, Bhodana, Vandhya karkoti, Kantaphala, VishaprAshamani (R.N)
Kumarika, Nagaripu, Vishakantakini, Nishpala and Majjadamani (K.N)194
Eng: Wild gourd
Hin: Khekasa, Kakoda
Kan: Mada hagala kayi, Giddahagala, Kartikayi
Tam: Aegaravalli, Pallephagil, Palupaghel-kalung.
Tel: Karkotaki
Habitat: This climbing creeper is generally met with in Bengal and in the forests of
South India.
Parts used: Fruits and tuberous root.
Gunakarma: Guna: Laghu, Ruksha; Rasa: Tikta; Vipaka: Katu; Veerya: Ushna;
Doshakarma: Tridoshahara; Karma: Useful in Kushta, Gulma, Kasa, Jwara and in
Visha.
Constituents: It contains Lectins, Proteins, triterpenes and Vitamins.The fruit
contains a high amount of Vitamin C.The fruit is rich in ascorbic acid and contain
iodine. The fruit also contain alkaloid, flavonoids, glycosides and amino acids.
Momordica dioica also contains an alkaloid, a fragrant extractive matter and Ash 3 to
4 p.c. Ash contains a trace of Manganese. Momordica dioica as the average
nutritional value per 100 g edible fruit was found to contain 84.1% Moisture, 7.7 g
carbohydrate, 3.1 g Protein, 3.1 g Fat, 3.0 g fiber and 1.1 g minerals. It also contained
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Dr.Ramesh Kumar.K.L 104
small quantities of essential Vitamins like ascorbic acid, carotene, Thiamin,
Riboflavin and niacin. It also content Protein in the leaves and dry weight of aerial
plant parts remained higher in male as compared to female defruited, and monoecious
plants.From Momordica dioica fruit isolated 6-methyl tritriacont-50on-28-of and 8-
methyl hentracont- 3-ene along with the known sterol pleuchiol. Momodicaursenol,
an unknown pentacylic triterpene isolated from the seeds, had been identified as urs-
12, 18(19)-dien-3 beta-ol on. Phytochemical investigations have revealed the presence
of traces of alkaloids and ascorbic acid in fruits. Lectins, sitosterol, saponin
glycosides, triterpenes of ursolic acid, hederagenin, oleanolic acid, spiranosterol,
stearic acid, gypsogenin, two novel aliphatic constituents.From the dry root of
Momordica dioica isolated three triterpenes and two steroidal compounds. These
were alphaspinasterol octadecanonate(I), alphaspinasterol- 3-O-beta-D-
glucopyranoside(II), 3- O-beta-D-glucuronopyranosyl gypsogenin(III), 3-O-beta-D-
glucopyranosyl gypsogenin(IV) and 3-O-beta-D-glucopyranosyl hederagenin(V).
Constituent III was a new compound.
9. Bruhati/ (Vartaki) 195
Latin name: Solanum melongena
Family: Solanaceae
Gana: Kantya, Hikka nigraha, Shothahara, Angamardha prashamana (C.S),
Brihatyadi, Laghu panchamula (S.S)
Syn: Vartaki, Bruhati, Simhi, Sthulakanta, Mahoshtrica, Kantaki, Vishada, Kranta,
Mahati, Kuli, Bhantaki, Bahupatra and Vidhavika (K.N), Kanta, Vartaki, Simmhi,
RAshtrika, Vishada, Mahati and Mahotika (D.N) Bahupatri, Kantalu, Katphala,
Dorali and Vana vrintaki.(R.N)
Eng: Egg plant, Brinjal
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Dr.Ramesh Kumar.K.L 105
Hin: Baigun, Begun
Kan: Badanekayi
Tam: Katterikayi
Tel: Vankayi, Vankaya, Vanga
Mal: Valutina, Mulukutakali
Habitat: This is a common plan in India, It is extensively cultivated in India for its
fruit.
Parts used: Fruits and Seeds
Gunakarma: Guna: Laghu, Ruksha, Teekshna; Rasa:Tikta, Katu; Vipaka:Katu ;
Veerya:Ushna; Doshakarma:Kapha-Vata nashaka; Karma: It is useful in Shwasa,
Kasa, Shula, Aruchi and Mukhavairasya.
Constituents: Eggplant is an excellent source of dietary Fibre. It's a very good
source of Vitamins B1, B6 and Potassium. It’s a good source of Copper, Magnesium,
Manganese, Phosphorus, niacin, and folic acid. Nasunin, an anthocyanin from
eggplant peels, is a potent antioxidant and free-radical scavenger, and has
protective activity against lipid peroxidation.
Energy-24 Kcal, Carbohydrates-5.7g, Protein-1 g, Cholesterol-0 mg, Dietary Fiber-
3.40 g, Total Fat- 0.19 g, Vitamins: Folates-22 mcg, Niacin-0.649 mg, Pantothenic
acid- 0.281 mg, Pyridoxine-0.084 mg, Riboflavin-0.037 mg, Thiamin-0.039 mg,
Vitamin A-27IU, Vitamin C- 2.2mg, Vitamin E-0.30 mg, Vitamin K-3.5 mcg.
Electrolytes: Sodium-2 mg, Potassium-230 mg. Minerals: Calcium-9 mg, Copper-
0.082mg, Iron-0.24 mg, Magnesium-14 mg, Manganese-0.250 mg, Zinc-0.16 mg.
(Nutritive value per 100 g. Source: USDA National Nutrient data base)
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Dr.Ramesh Kumar.K.L 106
10. Koshataki 196
Latin name: Luffa acutanggula
Family: Cucurbitaceae
Gana: Vamana, Phalini (C.S) Urdhwabhagahara, Ubhayotobhagahara (S.S)
Syn: Shweta gosha, Krimicchidra, Ghantali, Krutavedana, Mridangavat, Koshavati,
Mrudanga phalini, Koshataki, Karkoti, Jalini, KarkAshacchada, Kshwela, Tikta,
Jyotsna, Jali and Ghoshaka.(K.N), Kritichidra, Kritavedhani, Kshweda, Sutikta,
Ghantali and Mrudanga phalika.(D.N), Dharaphala, Karkotaki, deergha phala, Peeta
pushpa, Sukosha and Dhamargava (R.N)
Eng: Ridged gourd, ribbed luffa, Sharp corned cucumber.
Hin: Torai, Jinga
Kan: Heere kayi
Tam: Pikumkai, Peerakai
Tel: Beerakaya, Burkai
Mal: Peecchakam, Cheru-peeram
Habitat: Cultivated in all parts of India.
Parts used: Fruit, Fruit juice, Seeds, root and leaves.
Gunakarma: Guna: Laghu, Ruksha, Teekshna; Rasa: Tikta, Katu; Vipaka: Katu;
Veerya: Ushna; Doshakarma: Kapha pitta shamaka; Karma: Agni deepaka and
useful in Vatarakta, Aruchi, Kasa, Shwasa, Jwara, Kushta, Pleeha roga and in Arsha.
Constituents: Dried fruit deprived of seeds contains a principle allied to Colocynthin
and a gelatinous bitter principles nameed luffin. Seeds contain a bland fixed oil. Fresh
vegetable contains Moisture-91.77 p.c., and the completely dried material contains
Ether extract 2.98 p.c., Albuminoids -0.87 p.c.(Containing Nitrogen 0.14 p.c.),
Soluble carbohydrates -73.47 p.c., woody Fibre 16.56 p.c. and Ash-6.12p.c.
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Dr.Ramesh Kumar.K.L 107
(containing sand-0.17 p.c.) respectively.(IMM,Nadakarni), The following research
shows the chemical analysis of luffa acutangula, The seed oils containing
Acylglycerol classes were estimated to be monoacylglycerols -1.6-1.9% ,
diacylglycerols -4.0-4.6%, and triacylglycerols -84.6-86.7% .whereas lipid classes to
be neutral lipids -92.5-94.2% , glycolipids -2.8-3.2%, and phospholipids -1.9-2.4%.
GLC analysis showed the presence of only four Fatty acids from series C16:0 to C18:2.
Linoleic acid was the major ranging from 49.5% to 51.0%. It also contains
considerable amounts of lipid -26.8-28.2% , Protein -20.8-23.1%. and other essential
nutrients.
11. Trapusa197
Latin name: Cucumis sativus
Family: Cucurbitaceae
Syn: Sudhavasa, Mutrala, Katuka, Katutikta, Vipandu, Mutraphala, Panduputra and
Mukha priya (K.N), Hasti parnini, Deerga parni, Lata, Karkatika (D.N), Peetapushpi,
Kantalu, Karkati, Bahuphala, Kosha phala and Tundi phala.( R.N)
Eng: Cucumber
Hin: Khira
Kan: Savate kayi
Tam: Velleri kai
Tel: Dosekaya
Mal: Vellari
Habitat: Found wild in the farm lands, it is cultivated all over India.
Parts used: Seeds, Leaves, Fruits and Pulp.
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Dr.Ramesh Kumar.K.L 108
Gunakarma: Guna:Laghu, Ruksha; Rasa:Tikta, Madhura; Veerya:Sheeta;
Vipaka: Madhura; Doshakarma: Pitta shamaka; Karma: Atyanta mutrala and useful
in Bastivikaras, Mutra kruccha and Rakta pitta.
Constituents: Water-95.230 g, Energy- 15.000 kcal, Energy- 65.000 kj, Protein-
0.650 g, Total lipid (fat)- 0.110 g, Ash- 0.380 g, Dietary Fiber-0.500 g, Sugars,
total-1.670 g, Sucrose-0.030 g, Glucose (dextrose)-0.760 g, Fructose-0.870 g,
Maltose-0.010 g, Starch-0.830 g, Calcium, Ca- 16.000 mg, Iron, Fe- 0.280 mg,
Magnesium, Mg- 13.000 mg, Phosphorus, P- 24.000 mg, Potassium, K- 147.000 mg,
Sodium, Na-2.000 mg, Zinc, Zn-0.200 mg, Copper, Cu- 0.041 mg, Manganese, Mn-
0.079 mg, Selenium, Se-0.300 mcg, Fluoride, F-1.300 mcg, Vitamin C, total
ascorbic acid- 2.800 mg, Thiamin-0.027 mg, Riboflavin-0.033 mg, Niacin-0.098 mg,
Pantothenic acid- 0.259 mg, Vitamin B-6-0.040 mg, Folate, total-7.000 mcg,
Choline, total- 6.000 mg, Betaine-0.100 mg, Vitamin A, IU-105.000 IU, Vitamin
A, RAE-5.000 mcg_RAE, Vitamin E (alpha-tocopherol)-0.030 mg, Tocopherol,
beta-0.010 mg, Tocopherol, gamma-0.030 mg, Vitamin K (phylloquinone)-16.400
mcg, Fatty acids, total saturated - 0.037 g, Fatty acids, total polyunsaturated-
0.032 g, Phytosterols-14.000 mg, Tryptophan- 0.005 g, Threonine-0.019 g,
Isoleucine-0.021 g, Leucine-0.029 g, Lysine-0.029 g, Methionine-0.006 g, Cystine-
0.004 g, Phenylalanine-0.019 g, Tyrosine-0.011 g, Valine-0.022 g, Arginine- 0.044
g, Histidine- 0.010 g, Alanine-0.024 g, Aspartic acid-0.041 g, Glutamic acid-0.196
g, Glycine-0.024 g, Proline-0.015 g, Serine-0.020 g. (Nutritive value
per100g. Source: USDA National Nutrient data base)
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Dr.Ramesh Kumar.K.L 109
12. Kadali (Kaccha Phala) 198
Latin name: Musa sapientum/ M.paradisiaca
Family: Musaceae/ Scitaminacea
Syn: Kalirasa, Hastibusa, Ramba, Veera, Amshumatphala, Charmanvati, Kanuphala,
Mocha, Hastivishanika, Bruhatpushpa, Mukta sara, Granthini, Sukumarika,
Kashtalika, Palashika, Mrutyupushpa, Hastivisha, Deerga patrika and
Palashika.(K.N), Sakrutphala, Guccha phala, Guccha dantika, Koshti rasa, Nissara,
Rajeshta, Balaka priya, Urusthambha, Bhanuphala, Vana lakshmi and ShodAsha.
Eng: Plantain or Banana
Hin: Kela
Kan: Bale kayi
Tam: Vazhai kai, Vazhai palam
Tel: Kadalamu, Arati pandu/ Arati kaya
Mal: Vala
Habitat: This plant is cultivated throughout India; it is a very delicious and nutritious
fruit.
Parts used: Raw Fruit as a vegetable, Ripen fruit as a fruit, Flowes and stem stalk.
Varieties: In Raja nigantu there are three varieties of kadali has been explained viz, 1.
Kashta kadali, 2. Giri kadali and 3.Suvarna kadali (R.N.Amr Vrga-111-114). In
Kaiyyadeva nighantu three varieties has been explained viz, 1. Sugandha kadali,
2.Krishna kadali, 3.Shailkadali. (K.N.Osh.Vrg.261)
Gunakarma: Guna: Laghu ruksga; Rasa: Tikta, Kashaya; Veerya: Ushna; Vipaka:
Katu; Karma: Samgrahaka and it is useful in Thrishna, Rakta pitta, Netraroga,
Prameha and Raktatisara.
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Dr.Ramesh Kumar.K.L 110
Constituents: Nutrients value of raw banana per 100gms; Water- 74.91g, Energy- 89
kcal, Energy-371kj, Protein- 1.09g, Total lipid (fat) 0.82g, Ash- 0.33g, Carbohydrate,
by difference- 22.84g, Fiber, total dietary- 2.6g, Sugars, total- 12.23g, Sucrose-2.39g,
Glucose (dextrose)-4.98g, Minerals: Calcium, Ca- 5mg, Iron, Fe-0.26mg,
Magnesium, Mg- 27mg, Phosphorus, P-22mg, Potassium, K-358mg, Sodium, Na-
1mg, Zinc, Zn- 0.15mg, Copper, Cu- 0.078mg, Manganese, Mn-0.270mg, Fluoride,
F-2.2mg, Selenium, Se- 1.0mg. Vitamins: Vitamin C, total ascorbic acid- 8.7mg,
Thiamin- 0.031mg, Riboflavin- 0.073mg, Niacin- 0.665mg, Pantothenic acid-
0.334mg, Vitamin B-6- 0.367mg, Folate, total-20mcg, Folate, food-20mcg, Folate,
DFE-20mcg DFE, Choline, total- 9.8mcg, Betaine- 0.1mcg, Vitamin A, RAE- 3mcg,
Carotene, beta-26mcg, Carotene, alpha- 25mcg, Vitamin A, IU- 64mcg, Lutein +
zeaxanthin- 22mcg, Vitamin E (alpha-tocopherol)- 0.10mg, Tocopherol, gamma-
0.02mg, Tocopherol, delta- 0.01mg, Vitamin K (phylloquinone)- 0.5mcg, Lipids:
Fatty acids, total saturated -0.112g, Fatty acids, total monounsaturated- 0.032g, Fatty
acids, total polyunsaturated- 0.073g, Cholesterol- 0mg, Phytosterols-16mg. Amino
acids: Threonine- 0.028g, Isoleucine- 0.028g, Leucine- 0.068g, Lysine-0.050g,
Methionine-0.008g, Phenylalanine-0.049g, Valine- 0.047g, Arginine- 0.049g,
Histidine-0.077, Alanine-0.040g, Aspartic acid-0.124g, Glutamic acid-0.152g,
Glycine- 0.038, Proline- 0.028g, Serine-0.040g. (value per 100 g. Source: USDA
National Nutrient data base )
13. Palandu 199
Latin name: Alium cepa
Family: Liliaceae
Varga: Mulakadi (R.N)
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Dr.Ramesh Kumar.K.L 111
Syn: Mukhadushi, Sukanda, Latarka, Dudruma, Dhavalakshaka and Ksheera palandu
(K.N),Haritonya, Latarko, Yavaneshta (D.N), Teekshnakanda, Ulli, Shudrapriya,
Krimighna, Deepano and Mukhagandhaka.(R.N)
Eng: Onion
Hin: Piyaz
Kan: Neerulli, Eerulli, Ullegaddi
Tam: Vengayam
Tel: Yerragadda, Ulligadda
Mal: Eerulli, Bavang
Habitat: Cultivated all over India
Parts used: Bulb and Seed
Gunakarma: Guna: Snigdha, Teekshna, Guru; Rasa: Katu, Madhura; Veerya: Eshat
ushna; Vipaka: Madhura; Doshakarma: Kaphavardhaka, Kinchit pittakaraka, Vata
hara; Karma: Vrishya and useful in Aruchi, Agnimandya and Krimi.
Constituents: Water-89.110 g, Energy-40.000 kcal, Energy-166.000 kj, Protein-
1.100 g, Total lipid (fat)-0.100 g, Ash-0.350 g, Carbohydrate, by difference-9.340
g, Dietary Fiber-1.700 g, Sugars, total-4.240 g, Sucrose-0.990 g, Glucose
(dextrose)-1.970 g, Fructose-1.290 g, Calcium, Ca- 23.000 mg, Iron, Fe-0.210 mg,
Magnesium, Mg-10.000 mg, Phosphorus, P-29.000 mg, Potassium, K-146.000 mg,
Sodium, Na-4.000 mg, Zinc, Zn-0.170 mg, Copper, Cu- 0.039 mg, Manganese, Mn-
0.129 mg, Selenium, Se-0.500 mcg, Fluoride, F-1.100 mcg, Vitamin C, total
ascorbic acid- 7.400 mg, Thiamin-0.046 mg, Riboflavin- 0.027 mg, Niacin-0.116
mg, Pantothenic acid-0.123 mg, Vitamin B-6-0.120 mg, Folate, total-19.000 mcg,
Folate, food- 19.000 mcg, Choline, total- 6.100 mg, Betaine- 0.100 mg, Vitamin A,
IU- 2.000 IU, Vitamin E (alpha-tocopherol)- 0.020 mg, Vitamin K
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Dr.Ramesh Kumar.K.L 112
(phylloquinone)- 0.400 mcg, Fatty acids, total saturated- 0.042 g, Fatty acids, total
monounsaturated- 0.013 g, Phytosterols- 15.000 mg, Tryptophan- 0.014 g,
Threonine- 0.021 g, Isoleucine- 0.014 g, Leucine- 0.025 g, Lysine-0.039 g,
Methionine-0.002 g, Cystine-0.004 g, Phenylalanine-0.025 g, Tyrosine-0.014 g,
Valine-0.021 g, Arginine-0.104g, Histidine-0.014 g, Alanine-0.021 g, Aspartic
acid-0.091 g, Glutamic acid- 0.258 g, Glycine- 0.025 g, Proline-0.012 g, Serine-
0.021 g, Carotene, beta-1.000 mcg, Lutein + zeaxanthin-4.000 mcg. (Nutritive
value per100g. Source: USDA National Nutrient data base)
14. Lashuna 200
Latin name: Alium Sativum
Family: Liliaceae
Varga: Mulakadi (R.N)
Syn: Rasona, Mlecchakanda, Jugupsita, Ugraganha, Mlecchagandha, Yavaneshta and
Mahoushada (K.N) Grunjana, Deerga patrika (D.N), Bhutaghna, Sheeta mardhaka
(R.N)
Eng: Garlic
Hin: Lasun
Kan: Bellulli
Tam: Vella pundu
Tel: Vellulli, Tellagadda
Mal: Vellulli
Habitat: Cultivated all over India
Parts used: Bulb and oil
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Dr.Ramesh Kumar.K.L 113
Gunakarma: Guna:Snigdha, Guru, Saraka, Teekshna; Rasa:Katu, madhura;
Vipaka: Katu; Veerya:Ushna; Doshakarma: Kapha vata shamaka; Karma:
Agnideepaka, Bala karaka, Medhya, Varnya, Keshya, and Useful in Kasa, Shwasa,
Jwara, Kushta, Ama, Pinasa, Shwitra, Arsha, Gulma, Hridroga, Shula and Shopa.
Constituents: Water-58.580 g, Energy-149.000 kcal, Energy-623.000 kj, Protein-
6.360 g, Total lipid (fat)-0.500 g, Ash-1.500 g, Carbohydrate, by difference-33.060
g, Dietary Fiber-2.100 g, Sugars, total-1.000 g, Calcium, Ca-181.000 mg, Iron, Fe-
1.700 mg, Magnesium, Mg-25.000 mg, Phosphorus, P-153.000 mg, Potassium, K-
401.000 mg, Sodium, Na-17.000 mg, Zinc, Zn-1.160 mg, Copper, Cu-0.299 mg,
Manganese, Mn-1.672 mg, Selenium, Se-14.200 mcg, Vitamin C, total ascorbic
acid-31.200 mg, Thiamin- 0.200 mg, Riboflavin-0.110 mg, Niacin-0.700 mg,
Pantothenic acid-0.596 mg, Vitamin B-6-1.235 mg, Folate, total-3.000 mcg, Folate,
food-3.000 mcg, Folate, DFE-3.000 mcg_DFE, Choline, total-23.200 mg, Vitamin
A, IU-.000 IU, Vitamin E (alpha-tocopherol)-0.080 mg, Vitamin K
(phylloquinone)-1.700 mcg, Fatty acids, total saturated-0.089 g, Fatty acids, total
monounsaturated-0.011 g, Fatty acids, total polyunsaturated- 0.249 ,
Tryptophan-0.066 g, Threonine-0.157 g, Isoleucine-0.217 g, Leucine-0.308 g,
Lysine-0.273 g, Methionine-0.076 g, Cystine-0.065 g, Phenylalanine-0.183 g,
Tyrosine-0.081 g, Valine-0.291 g, Arginine-0.634 g, Histidine-0.113 g, Alanine-
0.132 g, Aspartic acid-0.489 g, Glutamic acid-0.805 g, Glycine-0.200 g, Proline-
0.100 g, Serine-0.190 g, Carotene, beta-5.000 mcg, Lutein + zeaxanthin- 16.000
mcg. (Nutritive value per100g. Source: USDA National Nutrient data base)
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Dr.Ramesh Kumar.K.L 114
Phalavarga
1. Kharjura 201
Latin name: Phoenx dactylifera
Family: Palmae
Gana: Shramahara, Virechanopaga, Madhraskanda, Kashayaskanda, Phalasava (C.S)
Syn: Simhi, Shroni, Kharaskanda, Nishroni, Dridakanta, Madhura, Kashaya,
Swaadvi, Duraroha, Bhumikharjurika, Kaka karkati, Kharjurika, Swaduphala,
Suphala, Swadumastaka, Sukantaka and Pinda karjurika (K.N), Madhuragraja, Swadu
mastaka (D.N), Haripriya, Yavaneshta (R.N)
Eng: Edible date, Date fruit
Hin: Pinda khejur
Kan: Gijjira hannu, Khajjuri hannu, Uttatti hannu
Tam: Perichchangayi, Perichchambalam
Tel: Karjura kaya
Habitat: This is a tall palm, a native of North Africa, Egypt, Syria and Arabia, but
now cultivated in Sindh and the Punjab, chiefly in the multan
district.(Bomb.Agri.Dept)
Varieties: Grown in Rohri of Sind province:- 1.Lahore, 2.Assuli, 3.Thottair,
4.Idulshali, the first two are very superior.
Parts used: Fruits and Dry fruits
Gunakarma: Guna: Snigdha, Guru; Rasa: Kashaya, Madhura; Vipaka: Madhura;
Veerya: Sheeta; Doshakarma: Vata shamak; Karma: Hrudya, Pushti karaka and it is
useful in Daha, Jwara, Trushna, Kasa and Shwasa.
Constituents: Water- 22.50g, Energy- 275kcal, Energy- 1151 kj, Protein-1.97 g,
Total lipid (fat)- 0.45 g, Ash- 1.58 g, Carbohydrate, by difference- 73.51 g, Dietary
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Dr.Ramesh Kumar.K.L 115
Fiber- 7.5 g, Minerals: Calcium, Ca- 32mg, Iron, Fe- 1.15 mg, Magnesium, Mg-
35 mg, Phosphorus, P- 40mg, Potassium, K- 652mg, Sodium, Na- 3 mg, Zinc, Zn-
0.29mg, Copper, Cu- 0.288mg, Manganese, Mn- 0.298 mg, Selenium, Se- 1.9mcg,
Vitamins : Vitamin C, total ascorbic acid- 0.0mg, Thiamin- 0.090 mg, Riboflavin-
0.100mg, Niacin- 2.200mg, Pantothenic acid- 0.780mg, Vitamin B-6- 0.192mg,
Folate, total- 13 mcg, Folate, food- 13 mcg, Folate, DFE- 13mcg_DFE, Vitamin A,
IU-. 50 IU, Vitamin E (alpha-tocopherol)- 0.100mg, Vitamin B-12-0.00, Lipids:
Fatty acids, total saturated-0.191g, Fatty acids, total monounsaturated-0.149g, Fatty
acids, total polyunsaturated- 0.031g, Cholesterol-0, Amino acids: Tryptophan-
0.050 g, Threonine- 0.052 g, Isoleucine-0.047 g, Leucine- 0.088g, Lysine- 0.060 g,
Methionine- 0.022 g, Cystine- 0.045 g, Phenylalanine- 0.056 g, Tyrosine- 0.030g,
Valine- 0.066 g, Arginine- 0.066 g, Histidine- 0.030 g, Alanine- 0.100g, Aspartic
acid- 0.126 g, Glutamic acid- 0.213g, Glycine- 0.095g, Proline- 0.106 g, Serine-
0.066g, Phyto-nutrients : Carotene, beta- 89 mcg, Lutein + zeaxanthin- 23mcg.
Crypto-xanthin-ß- 0 mc. .(Nutritive value per100g. Source: USDA National Nutrient
data base)
2. Aruka 202
Latin name: Prunus communis, Huds.
Family: Rosaceae
Syn: Veerasena, China, Chinaruka (K.N), Veram, Veeranakam, (D.N),
Eng: Pear fruit, Peach fruit
Hin: Alubhokara
Tam: Pichchees palam, Alpagodam palam
Tel: Alpagoda pundu
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Dr.Ramesh Kumar.K.L 116
Habitat: This is a small tree usually grows in high altitude places, this fruit was
migrated from the west. In India it is growing in North east region hill stations. In
South India it is grown in Udagamandalam (Ooty) , Kodaikkanal, Munnar etc.
Parts used: Unripen fruit is used for chutney and ripen fruit.
Gunakarma:Guna:Guru,teekshna;Rasa:Madhura,Kashaya;Veerya:Ushna;Doshaka
rma: Kapha Pitta kara; Karma: Mala bedakaand useful in Arsha, gulma and
Asradosha.(R.N, K.N )
Constituents: Wonderfully delicious peaches are low in calories and contain no
saturated Fats; but contain numerous health promoting compounds, minerals and
Vitamins. Fresh peaches are a very good source of antioxidant Vitamin C.
Fresh peaches are also good source of Vitamin A and beta carotene. Beta carotene is
a pro-Vitamin which converts into Vitamin A in the body. Peaches contain many
health promoting flavonoid poly phenolic antioxidants such as lutein,
zeaxanthinand beta cryptoxanthin. Energy- 39 Kcal, Carbohydrates-9.54 g, Protein-
0.91 g, Total Fat- 0.25 g, Cholesterol-0 mg, Dietary Fiber-1.5 g. Vitamins: Folates-4
mcg, Niacin- 0.806 mg, Pantothenic acid- 0.153 mg, Pyridoxine-0.025 mg,
Riboflavin-0.031 mg, Thiamin-0.024 mg, Vitamin A- 326 IU, Vitamin C- 6.6 mg,
Vitamin E-0.73 mg, Vitamin K- 2.6 mcg. Electrolytes: Sodium-0 mg, Potassium-190
mg, Minerals: Calcium-6 mg, Copper- 0.068 mg, Iron-0.25 mg, Magnesium-9 mg,
Manganese-0.61 mg, Phosphorus-11 mg, Zinc-0.17 mg, Phyto-nutrients: Carotene-
ß-162 mcg, Crypto-xanthin-ß-67 mcg, Lutein-zeaxanthin- 91 mcg.(Nutritive value
per100g. Source: USDA National Nutrient data base)
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Dr.Ramesh Kumar.K.L 117
3. Kapittha 203
Latin name: Feronia elephantum
Family: Rutaceae
Syn: Dadittha, Takrachid, Surabhicchada, Akshisasya, dadhipala, graahi,
Graahiphala, Dadhi, Hridya, Kashayamlaphala, Chirapaki and Kapipriya (K.N),
Gandhaphala (D.N), Mangala, Neelamallika, Granthiphala, Karabavallabha (R.N)
Eng: Wood apple, Elephant apple
Hin: Kavath, Kavitha
Kan: Belada hannu
Tam: Vilappalam, Vila, Nelavilam, Vilakpittam
Tel: Velaga
Mal: Vilav
Habitat: Grows throughout India, Cultivated for its fruit.
Parts used: Fruit, gum, leaves, bark and pulp
Gunakarma: Apakva phala Guna: Lekhana, Rukshana, Laghu; Rasa: Kashaya,
Amla, Madhura; Veerya: Ushna; Vipaka: Katu; Doshakarma: Vata-Pittakara,
Kaphashamaka, Karma: Trishna shamaka. Swarabedaka, Vishanashaka
Pakwa phala: Guna: Guru; Rasa: Kashaya, Amla, Swadishta, Doshakarma:
Tridosha hara; Karma: Kanta shodana, Sangraahi, ruchikara, Hridhya, Hikka nigraha,
it alleviates vamana, Kasa, Shwasa, and trishna.
Constituents: The bael fruit pulp contains a large quantity of citric acid, mucilage
and refrigerant. A hundred gm of bael fruit pulp contains 31 gm of carbohydrate and
two gm of Protein, which adds up to nearly 140 calories. The ripe fruit is rich in beta‐
carotene, a precursor of Vitamin A; it also contains significant quantities of the B
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Dr.Ramesh Kumar.K.L 118
Vitamins Thiamine and Riboflavin, and small amounts of Vitamin C. Wild bael fruit
tends to have more tannin than the cultivated one. (IMM, Nadakarni & Wkipaedia)
4. Jambu 204
Latin name: Syzygium cumuni
Family: Myrtaceae
Gana: mutra sangrahaniya, Pureesha virajaniya, Chardhi nigrahana (C.S) Nyagrodadi
(S.S)
Syn: Mahajambu, Shyamapatra, Mahaskanda, Maharasa, Kumarika, Gandha patra,
Jambu, Neelanjanacchada, Bruhatphala, raja jambu, suphala and supratishtita. Are the
synonym for Shtula jambu and Neelapatra, Meghaba, Shita pallava, Vaideshi,
Megavarni and Alpaka are the synonym for kshudra jambu.(K.N).; Surabhi patra,
Surabhi (D.N),; Shyamala, raja priya, Shukra phala and mega modini (R.N).
Eng: Jambu fruit, Jaman
Hin: Jamun
Kan: Nerale hannu
Tam: Navala palam, Naga palam
Tel: Neredu pallu
Mal: Naval
Habitat: A native of East indies, Cultivated in India . It is a big tree grows wildly all
over India. This especially grows over the bank of the river and lake shores.
Parts used: Leaves, fruits and seeds
Gunakarma: Guna:Laghu, Ruksha; Rasa:Madhura, Amla, Kashaya;
Veerya:Sheeta; Vipaka:Katu; Doshakarma:Kapha Pitta shamaka; Karma:it is
vishtambi, Lekhana, Vibandha, admanakara and useful in medoroga and Atisara.
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Dr.Ramesh Kumar.K.L 119
Constituents: The ripe fruit is widely eaten in India. The edible pulp forms 75% of
the whole fruit. Analysis of the edible part shows the following composition:
Moisture-83%, Protein-0.7%, Fat-0.3%, Fibre-0.9%, Carbohydrate- 14.0%, Ash-
0.4%, Calcium- 15mg, Phosphorus-15mg, Magnesium-35mg, Iron-1.2mg, Vitamin
A- 80IU, Vitamin B1- 0.03mg, VitaminB2-0.01mg, Neotinic acid- 0.2mg, Vitamin C-
18mg, Choline -7mg, Folic acid- 3mg, Glucose and fructose are the principal sugars
found in ripe fruit; not even a trace of cane sugar is found. Mallic acid is the major
acid (0.5% of the weight of the fruit) a small quantity of oxalic acid is also reported.
Garlic acid and tannins account for the astringency of the fruit. The purplecolour of
the fruit is due to the presence of flavours and anthocyanin pigments occuring as plant
diglycosides.228
5. Udumbara 205
Latin name: Ficus glomerata
Family: Moraceae
Gana: Mutra sangrahaniya, Kashayaskanda (C.S) Nyagrodadi (S.S), Ksheerivruksha
(B.P)
Syn: Hemadugdha, Haritaksha, Vasudruma, Sachakshu, MAshaki, Ksheeri,
Ksheeradru, Sheeta valkala, Yajnanga, Jantu vriksha, supratishta, Sadaphala, Apushpa
phala, Kanchana and Jantu phala.(K.N) Kalaskanda, Yajniya, Pushya shunya,
Pavitraka, Soumya and Madhu sanjna.(R.N)
Eng: Country fig tree, Cluster fig
Hin: Gular, Paroa, Lelka, Umar, Dimeri
Kan: Atti hannu
Tam: Atti palam
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Dr.Ramesh Kumar.K.L 120
Tel: Patti pandu
Mal: Atti
Habitat: A native of India, Cultivated all over the country. It is a big tree grows
wildly all over India.
Parts used: Fruits and galls.
Gunakarma: Apakva phala: Guna: Ruksha; Rasa: Kashaya Madhura; Veerya:
Sheeta; Vipaka: Katu; Doshakarma: Kapha Pitta shamaka; Karma: Stambana
useful in Trishna, Vamana, Moorcha and rakta srava.
Pakva phala: Guna: Guru; Rasa: Madhura; Doshakarma: Kapha Kara, pitta
shamaka; Karma: useful in Trishna, Aruchi and Rakta vikara.
Constituents: Fresh fig is a delicious fruit with high nutritive value. It consists of
84% of pulp and 16% skin. The chemical composition varies with type. The avg
composition of edible part of the fresh Indian fig is as follows (per 100gms).
Moisture- 80.03%, Protein-1.3%, Minerals total-0.6%, Carbohydrates- 17.1%,
Calcium-0.06mg, Phosphorus- 0.03mg, Iron- 1.2mg, B-Carotene-270 I.U., Nocotinic
acid-0.6mg, Riboflavin (B2)-50 mcg, Ascorbic acid-2mg. It is richer in Iron and
Copper than nearly all fruits.The principle acids in fresh figs are citric and acitic.
Small amounts of malic, boric and oxalic acids are also present. The content ranges
from 0.1 to 0.44%. A phosphatide with nitrogen: Phosphorus ratio at 1:2 and
containing palmitic acid and oleic acids is reported to be present.and Fruitalso contains
the phytochemicals like, glauanol, hentriacontane, β sitosterol, glauanolacetate,
glucose, tiglic acid, esters of taraxasterol, lupeolacetate, friedelin, higher
hydrocarbons and other phytosterol. Analysis of fig skin gave the following
composition (Per 100gms): Moisture-76%, Protein-1.5%, Fat-0.5%, Fibre-2.3%,
Carbohydrate-18.7%, Ash-0.7%, Calcium-162mg, Phosphorus-233mg, sugar-5.4%,
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Dr.Ramesh Kumar.K.L 121
Gum-mucilage-2.74%, sugar in fig juice-20.7%. Fig seeds contain both unsaturated
and Saturated Fatty acids , oleic acid 18.99; linoleic acid 33.72 and linolenic acid
32.95 (unsaturated); palmitic acid 5.23; stearic acid 2.18%.(Source: Fruits &Veg
theraphy By, Dr.S.A.ahmed, Dr.S.C.Sharma)
6. Kalinga 206
Latin name: Citrulus vulgaris
Family: Cucurbitaceae
Syn: Kalinda, Kaalinga and Krishna bija
Eng: Water melon
Hin: Tarbuz
Kan: Kallangadi hannu
Tam: Pitchapalam
Tel: Darbuje, Kallangadi pandu
Mal: Mandeki-patak
Habitat: Cultivated throught India. The best water melons are found at Garhi-Yasin
in sukkur dist of Sind in India.
Parts used: Seeds, Juice and Pulp of the fruit.
Gunakarma: Guna: Guru, Ushna, Grahi; Rasa: Madhura, Kinchit kshareeya;
Veerya: shita; Doshakarma: Pitta karaka and Kapha vata shamaka; Karma: Balya,
Mutrala, Vrushya and Saraka. (B.P)
Constituents: This sweet, crunchy, cooling fruit is exceptionally high in citrulline, an
amino acid our bodies use to make another amino acid, arginine, which is used in the
urea cycle to remove ammonia from the body, and by the cells lining our blood
vessels to make nitric oxide. Nitric oxide not only relaxes blood vessels, lowering
high blood pressure, it is the compound whose production is enhanced by Viagra to
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Dr.Ramesh Kumar.K.L 122
prevent erectile dysfunction. Arginine has been shown to improve insulin sensitivity
in obese type 2 diabetic patients with insulin resistance.
Calories-48.64, calories from Fat- 5.88, calories from saturated Fat- 0.66, Protein-
0.94 g, Carbohydrates- 10.91 g, dietary fiber- 0.76g, soluble fiber-0.49 g, insoluble
fiber-0.27 g, sugar – total-10.15 gm, onosaccharides-5.47 g, disaccharides-4.68 g, Fat
total- 0.65 g, saturated Fat- 0.07 g, mono Fat- 0.16 g, poly Fat- 0.22 g, water- 139.10
g, Ash- 0.40 g, Vitamins: Vitamin A IU- 556.32 IU, Vitamin A RE-56.24 REA,
carotenoid- 56.24 REA, beta carotene- 336.83 mcg, Thiamin – B- 10.12 mg,
Riboflavin B- 20.03 mg, niacin B- 30.30 mg, niacin equiv- 48 mg, Vitamin B6- 0.22
mg, biotin-1.52 mcg, Vitamin C- 14.59 mg, Vitamin D IU-0.00 IU, Vitamin E alpha
equiv- 0.23 mg, Vitamin E IU- 0.34 IU, Vitamin E -0.23 mg, Folate- 3.34 mcg,
Pantothenic acid- 0.32 mg, Minerals: Calcium- 12.16 mg, Copper- 0.05 mg, Iron-
0.26 mg, Magnesium- 16.72 mg, Manganese- 0.06 mg, Phosphorus- 13.68 mg,
Potassium- 176.32 mg, Selenium-0.15 mcg, Sodium- 3.04 mg , Sodium- 0.11 mg. ,
omega 6 Fatty acids-0.22 g, Amino Acids: alanine-0.03 g, arginine-0.09 g, aspartate-
0.06 g, cystine- 0.00 g, glutamate-0.10 g, glycine-0.02 g, histidine-0.01 g, isoleucine-
0.03 g, leucine-0.03 g.(value per 100 g. Source: USDA National Nutrient data base )
Taila varga
1. Sarshapa taila 207
Latin name: Brassica campestris
Family: Cruciferae
Syn: Katu sneha, Rajika phala, Grahagna, BhutanAshana, Siddhartha (D.N)
Teekshnaka, Kushta nAshana, Siddha prayojana, Siddha sadana, Sita sarshapa (R.N);
Dumbara, Bhogi, Rakshoghna, Tantubha, Teevra, Suteevra, Krishnika , Krishna
sarshapa (K.N)
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Dr.Ramesh Kumar.K.L 123
Eng: Mustard seeds
Hin: Sarso, shulgum
Kan: Sasive
Tam: Kadugu
Tel: Avalu
Mal: Sarasum
Habitat: Belongs to the cabbage species. Two varieties are grown in India; one is
White seeds and other has black seeds and hairy leaves. The variety sarson; oil yield
by seeds of this on pressure is largely used in cookery.
Parts used: Seeds and thick fleshy stems.
Gunakarma: Guna: Teekshna, Ruksha (Shaka), Kshariya, Snigda (Bija); Rasa:
Katu, Tikta, Lavana; Veerya: Ushna; Vipaka: Katu; Doshakarma: Tridosha karaka;
Karma: Mutrala, Pureeshajanaka, Swadishta.
Taila: Guna: Laghu, Lekhana, Teekshna; Rasa: Katu; Vipaka: Katu; Veerya:
Ushna; Doshakarma: Rakta, Pitta dushaka, Kapha hara; Karma: Medo hara,
Arshagna an useful in Meha, Karna roga, Shororoga, Kandu, Kota, Krimi, shwetha
kushta, Kushta and Dushta vrana.
Constituents: Water - 6.86 g, Energy - 1964 kj, Energy - 469 kcal, Carbohydrate, by
difference - 34.94 g, Total Fat: 218g; 335%Saturated Fat: 25.2g ;126%, Fiber, total
dietary - 14.7 g , Total Omega-3 Fatty acids-12862mg, Total Omega-6 Fatty
acids:33424mg, Protein - 24.94 g, Ash - 4.51 g, Fatty acids, total monounsaturated -
19.830 g, Fatty acids, total polyunsaturated - 5.390 g, Fatty acids, total saturated -
1.460 g, , Folate, total - 76 mcg, Fructose - 0.02 g, Galactose - 0.20 g, Glucose
(dextrose) - 2.88 g, Minerals: Potassium, K - 682 mg, Iron, Fe - 9.98 mg, Calcium,
Ca - 521 mg,Copper, Cu - 0.410 mg,Phosphorus, P - 841 mg,Magnesium, Mg - 298
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Dr.Ramesh Kumar.K.L 124
mg, Manganese, Mn - 1.767 mg, Selenium, Se - 133.6 mcg, Sodium, Na - 5 mg.
Amino acids: Alanine - 1.187 g, Arginine - 1.750 g ,Cystine - 0.582 g,Glycine -
1.312 g, Histidine - 0.762 g,Isoleucine - 1.081 g, Leucine - 1.783 g, Methionine -
0.480 g, Niacin - 7.890 mg, Phenylalanine - 1.067 g, Phytosterols - 118 mg, Lutein +
zeaxanthin - 448 mcg, Lysine - 1.519mg, Proline - 1.944 g, , , Serine - 1.081 g,
Threonine - 1.095 g, Tocopherol, beta - 0.01 mg, Tocopherol, delta - 0.71 mg,
Tocopherol, gamma - 18.76 mg, Tryptophan - 0.526 g, Tyrosine - 0.744 g, Valine -
1.325 g, Vitamins: Vitamin A, IU - 62 IU, Vitamin A, RAE - 3 mcg_RAE, Vitamin
B-6 - 0.430 mg, Vitamin C, total ascorbic acid - 3.0 mg, Riboflavin - 0.381 mg,
Vitamin E (alpha-tocopherol) - 2.89 mg, Vitamin K (phylloquinone) - 5.4 mcg, ,
Thiamin - 0.543 mg, Zinc, Zn - 5.70 mg. (value per 100 g. Source: USDA National
Nutrient data base )
2. Tila taila 208
Latin name: Sesamum indicum
Family: Pedaliaceae
Syn: Homa dhanya, Pavitra, Pitru tarpana, Papaghna, Puta dhanya, Vanodbhava
(D.N); Taila phala, Puta, Sneha pura phala (K.N)
Eng: Gingelly seed, Sesamum, Sesame
Hin: Til, Tir / Til tel
Kan: Yellu, uru ellu/ Ellenne
Tam: Yellu/ Nallennai
Tel: Nuvvulu, Nuvvu, Pollanuvullu, Guvvulu/ Manchinune
Mal: Karuellu/ Nallennai
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Dr.Ramesh Kumar.K.L 125
Habitat: This small bush is indigenous to India and extensively cultivated in warmer
regions.
Parts used: Seeds snd the fixed oil expressed from the seeds
Varieties: Three varieties of sesamum seeds are found: Black, White and Red or
Brown. The black variety is the most common and yields the best quality of oil and is
also the best suited for medicinal purposes. But the white variety is a rich container of
oil.
Gunakarma: Guna: Guru, Kashya; Rasa: Madhura, Tikta and Katu; Vipaka: Katu;
Veerya: Ushna; Doshakarma: Vata hara, Kapha pitta Kara; Karma: Balakaraka,
Medhya, Keshya, agnivardeepaka and It is good for Danta, Twacha and Vrana.
Taila: Guna: Sukshma, Ushna; Rasa: Kashya, Madhura; Doshakarma: Pittala,
Kapha vata shamaka; Karma: Medo hara, Triptikaraka, Agni deepaka, Vibandha
karaka, and Snehottama. It is very much useful in Snana, karna, akshi purana, Nasya
and abhyanjana.
Constituents: Water- 0.00 g, Energy- 884 kcal, Energy- 3699kj, Protein-0.00 g,
Total lipid (fat) 0-100.00g, Ash- 0.00g, Carbohydrate, by difference- 0.00g, Fiber, total
dietary- 0.0g, Sugars, total-0.00 g. Minerals: Calcium, Ca- 0mg, Iron, Fe-0.00mg,
Magnesium, Mg- 0.00mg, Phosphorus, P-0mg, Potassium, K-0mg, Sodium, Na-0mg,
Zinc, Zn- 0.00mg, Copper, Cu-0.00 mg, Selenium, Se-0.0mg. Vitamins: Vitamin C,
total ascorbic acid-0.0mg, Thiamin- 0.000mg, Riboflavin- 0.000mg, Niacin- 0.000mg,
Pantothenic acid- 0.000mg, Vitamin B-6- 0.000mg, Folate, total-0 mcg, Folate, food-
0mcg, Folate, DFE-0mcg DFE, Choline, total- 0.2mcg, Vitamin A, RAE- 0mcg,
Carotene, beta-0mcg, Carotene, alpha- 0mcg, Vitamin A, IU- 0mcg, Lutein+
zeaxanthin- 0mcg, Vitamin E (alpha-tocopherol)- 1.40mg, Tocopherol, gamma- mg,
Vitamin K (phylloquinone)- 13.6mcg, Lipids: Fatty acids, total saturated-14.200g,
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Dr.Ramesh Kumar.K.L 126
Fatty acids, total monounsaturated-39.700 g, Fatty acids, total polyunsaturated-
41.700g, Cholesterol- 0mg, Phytosterols-865mg. Amino acids: Threonine-0.000 g,
Isoleucine- 0.000g, Leucine-0.000 g, Lysine-0.000g, Methionine-0.000g,
Phenylalanine-0.000g, Valine- 0.000g, Arginine-0.000g, Histidine-0.000, Alanine-
0.000g, Aspartic acid-0.000g, Glutamic acid-0.000g, Glycine- , Proline-0.000 g,
Serine-0.000g. (value per 100 g. Source: USDA National Nutrient data base )
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 127
PREVIOUS WORKS DONE
Kavishvar. K.D‐Ayurvediya samhita granthon mein pathyapathya‐ek anusheelan‐
,Dept of Basic principles,Shri Ayurveda Mahavidhyalaya, Nagpur university;NAGPUR‐
1994
V.A.Shah ‐A conceptual study of pathya and its clinical application in the
management of Amlapitta‐ –Dept of Basic Principles, GUJARAT AYURVEDIC
UNIVERSITY, JAMNAGAR 1999.
Navel Ajay‐ Comparitive study of Charaka’s dietary principles with modern dietics‐
NATIONAL INSTITUTE OF AYURVEDA, JAIPUR‐2000.
Vargeese Anita‐An Evalution of Pathya‐Apathya w.s.r to Desha and Kala, Dept of
Basic principles,Govt Ayurvedic College, KERALA UNIVERSITY, THIRUVANANTA
PURAM‐2000.
Prashant gokhale‐Role of Triphala bhavita yava in the management of madhumeha –
Dept of Kaya Chikitsa‐Govt. Ayurvedic Medical College, Mysore‐2006.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 128
METHODOLOGY
After the completion of review of literature the actual procedures which were
undertaken in this study are dealt here.
MATERIALS: This study was an observational study, No medicines were used in
this study. The prepared diet module was given to the newly detected Type-2 Diabetes
patients.
Method of Collection of Pathyas and Diet module Preparation
The specific pathyaaharas were collected from different classical text books
and a diet module was prepared as per the modern diabetic diet chart for the
convenience & need of the present day population.
METHODS
Objectives of the study
1. To compile the available literature on Pathya in Madhumeha.
2. To develop a module of Pathya for Madhumeha.
3. To evaluate the efficacy of the developed module of pathya in the management of
madhumeha w.s.r.to Type-2 diabetes mellitus.
SOURCE OF DATA:
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 129
Literary: Literary data was collected from the Vedic scriptures ,Upanishads,
darshana shastra, Ayurvedic classical texts, Modern texts , Reputed journal,
retrospective study conducted on related Works from different Universities ,internet
etc.
Sample: Minimum of 30 patients coming under inclusion criteria approaching OPD,
IPD of Govt.Ayurvedic medical college& Hospital, Mysore, Special Camps
conducted in and around Mysore, and other referrals from in and around Mysore was
selected for the Study.
METHODS OF COLLECTION OF DATA
1. Patients of either sex between the age group of 30-60 years was selected on the
basis of diagnostic criteria of Diabetes mellitus.
2. They were assigned to a single group consisting of 30 patients.
3. The results of the present study was analyzed statistically
INCLUSION CRIETERIA:
1. Patients of either sex between the age group of 30-60 years with the signs and
symptom s of Diabetes mellitus were selected for the study.
2.Patients of Non insulin dependent Diabetes mellitus (NIDDM) or Type-2 DM were
salected
3.Patients with Fasting blood sugar more than 110mg/dl & below 150mg/dl were
selected
4. Patients with Post prandial Blood sugar more than 140 mg/dl & below 200mg/dl
were selected.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 130
5. In this study, only fresh/ Newly detected type-2 DM patients was selected.
EXCLUSION CRITERIA
1. Patients of Insulin dependent Diabetes mellitus (IDDM)/ Type-1
2. Patients with Fasting Blood sugar above 150 mg/dl & Post prandial Blood sugar
more than 200mg /dl
3.Multisystem involved complicated diabetic Patients.
Patients with any other systemic ailments which interferes with the study.
DIAGNOSTIC CRIETERIA
Based on the signs and symptoms of Diabetes Mellitus (Polyuria,
Polydypsia, Polyphagia) / Madhumeha and laboratory findings shows FBS
>120mg/dl & <150mg/dl, PPBS >140 mg/ dl & < 200mg/dl.
INVESTIGATIONS
1. Fasting Blood sugar
2.Post prandial Blood sugar
3. Urine Sugar
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 131
Research Design – Total 30 patients were assigned into single group.
INTERVENTION
The developed module of Pathya was given to each patient, it includes the list of diets
and Diabetic diet menu for 5 days, and the patients were adviced to repeat the diabetic
menu chart for one month after completing each cycle.
Table.No. 10. The List of Diabetic Foods used in madhumeha:
Cereals &Millets / zsÁ£Àå UÀ¼ÀÄ Pulses/ ¨ÉÃ¼É PÁ¼ÀÄUÀ¼ÀÄ 1. Barley/¨Á°Ãð CQÌ 1.Green gram / ºÀ¹gÀÄ PÁ¼ÀÄ 2. Wheat/ UÉÆâ 2. Tuvar dal/ vÉÆUÀj PÁ¼ÀÄ 3. Old rice/ PÉA¥ÀÅ CQÌ 3. Horsegram/ ºÀÄgÀĽ PÁ¼ÀÄ 4. Fox tail millet/£ÀªÀuÉ CQÌ 4. Bengal gram/ PÀqÀ¯É PÁ¼ÀÄ
5. Barnyard millet/¸ÁåªÉÄ CQÌ 5. Lentils/ ZÀ£ÀßAV/ «Ä¸ÀÄgï ¨ÉüÉ
6. Kodo millet/ ºÁgÀPÀ D.Leafy vegetables/ ¸ÉÆ¥ÀÅöàUÀ¼ÀÄ 7. Jowar/ eÉÆüÀ 1.Hog weed/ §UÀgÉÆmÉÖ ¸ÉÆ¥ÀÅöà
8. Raagi/Finger millet/ gÁV 2.Drum stick leaves / £ÀÄUÉÎ ¸ÉÆ¥ÀÅöà 9. Pearl millet/ PÀA©£À CQÌ, ¸ÀeÉÓ CQÌ 3.Purselane/ UÉÆÃt ¸ÉÆ¥ÀÅöà
C. Vegetables/ vÀgÀPÁjUÀ¼ÀÄ 4.Tumbe / vÀÄA¨É ¸ÉÆ¥ÀÅöà
1. Ash gourd/ §ÆzÀÄUÀÄA§¼À 5.Heart leaved moonseed/ CªÀÄÈvÀ §½î ¸ÉÆ¥ÀÅöà
2. Bitter gourd/ ºÁUÀ® PÁ¬Ä 6.Black night shade / UÀtPÉ ¸ÉÆ¥ÀÅöà 3.Snake gourd / ¥ÀqÀªÀ® PÁ¬Ä 7.Goose foot / ¨Á¬Ä §¸À¼É ¸ÉÆ¥ÀÅöà
4.Drum stick/ £ÀÄUÉÎ PÁ¬Ä E. Fruits/ ºÀtÄÚUÀ¼ÀÄ 5.Brinjal / §zÀ£É PÁ¬Ä 1. Date fruit/ RdÆðgÀ 6.Ivy gourd/ vÉÆAqÉ PÁ¬Ä 2.Peaches / ¦ÃZï ºÀtÄÚ
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 132
7.Bitter apple/ ªÉÄPÉÌ PÁ¬Ä/vÀªÀÄmÉ PÁ¬Ä 3. Wood apple/ ¨ÉîzÀ ºÀtÄÚ 8.Wild gourd/ ªÀÄqÀ ºÁUÀ® PÁ¬Ä 4.Indian fig/ CwÛ ºÀtÄÚ 9.Onion/ FgÀĽî 5. Jamun / £ÉÃgÀ¼É ºÀtÄÚ 10.Garlic/ ¨É¼ÀÄî½î 6.Water melon / PÀ®èAUÀr ºÀtÄÚ
11.Bottle gourd/ ¸ÉÆÃgÉ PÁ¬Ä G. Others/ EvÀgÉ ¥ÀzÀxÀðUÀ¼ÀÄ 13.Ridge gourd/ »ÃgÉà PÁ¬Ä 1. Goat meat/ Dr£À ªÀiÁA¸À
14.Raw Banana / ¨Á¼É PÁ¬Ä 2. Butter milk /¨ÉuÉÚ vÉUÉ¢gÀĪÀ ªÀÄfÓUÉ
F. Oils/ JuÉÚ ¥ÀzÁxÀð
1. Mustard oil/ ¸Á¹ªÉ JuÉÚ
2. Sesame oil/ J¼ÀÄî JuÉÚ
ASSESSMENT CRITERIA
The assessment was done on a single group of 30 patients. Assessment was done at the 0th day, 14th day, and 30th day followed by one month follow up at 60th day.
Duration-30 days.
Follow up-30 days.
The following parameters were considered, graded and scores were given.
Table.No.16. the assessment criterias
(A)Polyuria:PolyureaPU(In12hrs) (B)Polyphagia-PP
0-3 times Normal-0 Normal-0 3-5 times-1 Mild-1 5-7 times-2 Moderate-2 More than 7 times-3 Excess-3
(C)Polydypsia-PD (D)Burning foot &Palm-BFP
Normal-0 No Burning sensation -0 Mild-1 Mild -1 Moderate-2 Moderate -2 Excess-3 Severe -3 (E) Urine sugar (F)Over all result Nil- 0 Very good improvement-1
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 133
O.5%- 1 Mild improvement-2 1%- 2 Poor improvement-3 1.5%- 3 Very poor improvemenet 2%- 4 2.5%- 5
Assessment of blood glucose level both FBS,PPBS& Urine Sugar was done at the 0th day, 14th day, and 30th day followed by one month follow up at 60th day.
Statistical analysis by Chi square test and Student Pair ‘t’test.
OBSERVATIONS
In the present study 59 patients were registered, and the study was conducted on 30
patients.
Other Observations:
Table No. 17: Distribution of Sex among the 30 patients taken for Study
Frequency Percent
Male 21 70
Female 9 30
SEX
Total 30 100.0
Out of 30 samples, 21 were Males (70 %) & 9 were Females (30 %).
Table No. 18 : Distribution of Age Group among the patients taken for Study
Frequency Percent
30-40 5 16.7
AGE 41-50 11 36.7
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 134
51-60 14 46.7
Total 30 100.0
Out of 30 samples, 5 patients (16.7%) were in the age group of 30-40; 11 patients
(36.7%) were in the age group of 41-50 and 14 patients (46.7%) were in the age group
of 51-60.
Table No.19. Distribution of Religion among the 30 patients taken for Study
Frequency Percent
Hindu 26 86.7
Muslim 4 13.3
RELIGION
Total 30 100.0
Out of 30 samples, 26 patients (86.7%) were Hindus and 4 patients (13.3%) were
Muslims.
Table No. 20: Distribution of Location among the 30 patients taken for Study
Frequency Percent
Rural 8 26.7
Urban 22 73.3
LOCATION
Total 30 100.0
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 135
Out of 30 samples, 8 patients (26.7%) were belonging to Rural area and 22 patients
(73.3%) were belonging to Urban area.
Table No. 21: Distribution of Family History among the 30 patients taken for
Study
Frequency Percent
Absent 19 63.3
Paternal 5 16.7
Maternal 6 20.0
FAMILY
HISTORY
Total 30 100.0
Out of 30 samples, 19 patients (63.3%) did not have a Family history of Madhumeha,
5 patients (16.7%) had paternal history of Madhumeha, 6 patients (20.0%) had
maternal history of Madhumeha.
Table No. 22: Distribution of Occupation among the 30 patients taken for Study
Frequency Percent
House wives 7 23.3
Retiered employee 3 10.0
Farmer 1 3.3
Teacher 3 10.0
Police 2 6.7
Business 6 20.0
Office work 4 13.3
Manual work 4 13.3
OCCUPATION
Total 30 100.0
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 136
Out of 30 samples, 7 patients were House wives (23.3%), 3 patients were Retired
employees (10.0%), Only 1 patient was a farmer (3.3%), 3 patient were Teacher
(10.0%), 2 patients were Police (6.7%), 6 patients were into Business (20.0%), 4
patients were into office work (13.3%), and 4 patients were Manual workers
(13.3%).
Table No. 23: Distribution of Exercise among the 30 patients taken for Study
Frequency Percent
No exercise 8 26.7
Does exercise 22 73.3
EXERCISING
PRACTICE Total 30 100.0
Out of 30 samples, 8 patients did not involve in Exercise (26.7%) and 22 patients
involved in Exercise (73.3%).
Table No. 24: Distribution of Socio-Economic Status among the 30 patients taken
for Study
Frequency Percent
Below poverty line 1 3.3
Lower middle class 9 30.0
Middle class 18 60.0
Upper middle class 2 6.7
SOCIO-
ECONOMI
C STATUS
Total 30 100.0
Out of 30 samples,1 patient belongs to BPL(3.3%), 9 patients belonged to Lower
middle class(30.0%), 18 patients belonged to Middle class(60.0%) and 2 patients
belonged to Upper middle class(6.7%).
Table No. 25: Distribution of Education among the 30 patients taken for Study
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 137
Frequency Percent
Uneducated 3 10.0
Primary 2 6.7
High school 7 23.3
PUC 9 30.0
Graduate 8 26.7
Post graduate 1 3.3
EDUCATION
Total 30 100.0
Out of 30 samples, 3 patient was uneducated (10.0%), 2 patient had studied till
Primary (6.7%), 7 patient had studied till High School (23.3%), 9 patient had studied
till PUC (30.0%), 8 patient were Graduates (26.7%) and 1 patient was Post graduate
(3.3%)
Table No. 26: Distribution of Nature of Work among the 30 patients taken for
Study
Frequency Percent
Sedentary 1 3.3
Mild 19 63.3
Moderate manual 10 33.3
NATURE
OF
WORK Total 30 100.0
Out of 30 samples, 1 patients was doing Sedentary work (3.3%), 19 patients were
doing Mild work (63.3%) and 10 patients were doing Moderate manual work
(33.3%).
Table No. 27: Distribution of Diets among the 30 patients taken for Study
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 138
Frequency Percent
Veg 10 33.3
Mixed 20 63.3
DIET
Total 30 100.0
Out of 30 samples, 10 patients were Vegetarians (33.3%) and 20 patients were having
Mixed diet (63.3%).
Table No. 28: Distribution of Hours of Day Sleep among the 30 patients taken for
Study
Frequency Percent
No day sleep 15 50.0
0-1 hour 12 40.0
1-3hour 3 10.0
HOURS OF
DAY
SLEEP Total 30 100.0
Out of 30 samples, 15 patients (50.0%) were not having the habit of day sleep,
12 Patients(40.0%) were having the habit of sleeping in day times for about 0-1 hour
and 3 patients (10.0%) were having the habit of day sleep for about 1-3 hours.
Table No. 29: Distribution of Hours of Night Sleep among the 30 patients taken
for Study
Frequency Percent
5 hours 2 6.7
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 139
6 hours 17 56.7
7 hours 10 33.3
8 hours 1 3.3
HOURS OF
NIGHT SLEEP
Total 30 100
Out of 30 samples, 2 patients slept for 5 hrs at night (6.7%), 17patients slept for
6 hrs at night (56.7%), 10 patients slept for 7 hrs at night (33.3 %)and 1 patient slept
for 8 hrs at night (3.3%).
Table No.30: Distribution of Habits among the 30 patients taken for Study
Frequency Percent
No habits 1 3.3
Tea 4 13.3
Tea & Coffee 17 56.7
Alchohol 3 10.0
All above 5 16.7
HABITS
Total 30 100.0
Out of 30 samples, 1 patient (3.3%) had no Habits, 4 patients (13.3%) had the
Habit of taking tea, 17 patients (56.7%) had the Habit of taking both Tea& coffee, 3
patients (10%) had the Habit of taking Alchohol, and 5 patients (16.7%) had the
Habit of taking all above.
Table No. 31: Distribution of Prakruti among the 30 patients taken for Study
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 140
Frequency Percent
Vata+pitta 20 66.7
Vata+Kapha 6 20.0
Kapha+ Pitta 4 13.3
PRAKRUTI
Total 30 100.0
Out of 30 samples, 20 patients (66.7%) were of Vata Pitta Prakruti, 6 patients (20.0%)
were of Vata Kapha Prakruti and 4 patients (13.3%) were of Kapha Pitta Prakruti.
Table No.32: Distribution of Sara among the 30 patients taken for Study
Frequency Percent
Pravara 4 13.3
Madhyama 24 80.0
Avara 2 6.7
SARA
Total 30 100.0
Out of 30 samples, 4 patients had Pravara Sara (13.3%), 24 patients had Madhyama
Sara (80.0%) and 2 patient had Avara Sara (6.7%).
Table No. 33: Distribution of Samhanana among the 30 patients taken for Study
Frequency Percent
Pravara 1 3.3
SAMHANANA Madhyama 26 86.7
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 141
Avara 3 10.0
Total 30 100.0
Out of 30 samples, 1 patient had Pravara Samhanana (3.3%) , 26 patients had
Madhyama Samhanana (86.7%) and 3 Patients had Avara samhanana(10.0%).
Table No. 34: Distribution of Satmya among the 30 patients taken for Study
Frequency Percent
Pravara 1 3.3
Madhyama 23 76.7
Avara 6 20.0
SATMYA
Total 30 100.0
Out of 30 samples, 1 patient had Pravara Satmya (3.3%), 23 patients had Madhyama
Satmya (76.7%) and 6 patients had Avara Satmya (20.0%).
Table No. 35: Distribution of Sattva among the 30 patients taken for Study
Frequency Percent
Pravara 3 10.0
Madhyama 19 63.3
Avara 8 26.7
SATTVA
Total 30 100.0
Out of 30 samples, 3 patients had Pravara Sattva (10.0%), 19 patients had Madhyama
Sattva (63.3%) and 8 patients had Avara Sattva (26.7%).
Table No. 36: Distribution of Abhyavaharana Shakti among the 30 patients
taken for Study
Frequency Percent
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 142
Pravara 6 20.0
Madhyama 23 76.7
Avara 1 3.3
ABHYAVAHARANA
SHAKTI
Total 30 100.0
Out of 30 samples, 6 patients had Pravara Abhyavaharana shakti (20.0%), 23
patients had Madhyama Abhyavaharana Shakti (76.7%) and 1 patient had Avara
Abhyavaharana shakti (3.3%).
Table No. 37: Distribution of Jarana Shakti among the 30 patients taken for
Study
Frequency Percent
Pravara 3 10.0
Madhyama 23 76.7
Avara 4 13.3
JARANA SHAKTI
Total 30 100.0
Out of 30 samples, 3 patients had Pravara Jarana Shakti (10.0%), 23 patients had
Madhyama Jarana Shakti (76.7%) and 4 patients had Avara Jarana Shakti (13.3%).
Table No. 38: Distribution of Vyayama Shakti among the 30 patients taken for
Study
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Dr.Ramesh Kumar.K.L 143
Frequency Percent
Pravara 1 3.3
Madhyama 22 73.3
Avara 7 23.3
VYAYAMA SHAKTI
Total 30 100.0
Out of 30 samples, 1 patient had Pravara Vyayama Shakti (3.3%), 22 patients
had Madhyama Vyayama Shakti (73.3%) and 7 patients had Avara Vyayama Shakti
(23.3%).
RESULTS
Table No. 39: Showing the results of Mean Polyurea values of 0th, 14th , 30th and
60 Days.
Polyurrea Mean Std.deviation N
PU1 2.0667 .78492 30
PU14 1.8667 .43417 30
PU30 1.8333 .59209 30
PU60 2.1333 .57135 30
In the selected cases before the diet advice Polyurea mean on the 0th day it was 2.0667
which reduced to 1.8667 on 14th day, and still decreased to 1.8333 on 30th day. And
again it increased to 2.1333 on the 60th day.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 144
Table No. 40: Showing the results of Mean Polyphagia values of 0th, 14th , 30th
and 60 Days
Polyphagia Mean Std.deviation N
PP1 1.6667 .54667 30
PP14 1.4333 .50401 30
PP30 1.5333 .57135 30
PP60 1.7667 .62606 30
In the selected cases before the diet advice Polyphagia mean on the 0th day it was
1.6667 which reduced to 1.4333 on 14th day, and still decreased to 1.5333 on 30th
day. And again it increased to 1.7667 on the 60th day.
Table No. 41: Showing the results of Mean Polydypsia values of 0th, 14th , 30th
and 60 Days
Polydypsia Mean Std.deviation N
PD1 1.5667 .67891 30
PD14 1.4667 .50742 30
PD30 1.3333 .54667 30
PD60 1.7000 .59596 30
In the selected cases before treatment Polydypsia mean on the 0th day it was 1.5667
which reduced to 1.4667 on 14th day, and still decreased to 1.3333 on 30th day. And
again it increased to 1.7000 on the 60th day.
Table No. 42: Showing the results of Mean Burning foot and palm values of 0th,
14th, 30th and 60 Days.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 145
BFP Mean Std.deviation N
BFP1 .2000 .40684 30
BFP14 .0000 .00000 30
BFP30 .0667 .25371 30
BFP60 .2000 .40684 30
In the selected cases before the diet advice Burning foot and palm, mean on the 0th
day it was 1.5667 which reduced to 1.4667 on 14th day, and still decreased to 1.3333
on 30th day. And again it increased to 1.7000 on the 60th day.
Table No. 43: Showing the results of Mean FBS values of 0th, 14th , 30th and 60
Days.
FBS Mean Standard Deviation N
0th Day 129.4000 11.88914 30
14th Day 123.8000 10.43998 30
30th Day 121.4333 8.71655 30
60th Day 136.4333 14.42623 30
Table No. 44: Showing the results of repeated measure ANOVA for mean FBS
values of fresh cases before, during and after treatment (0th, 14th, 30th & 60
Days).
Source of variation
Type III
Sum of
Squares
df Mean
Square F value P value
CHANGES 4008.733 3 1336.244 12.596 .000
Error(CHANGES) 9229.267 87 106.084
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 146
Note: Change refers to change from before to after treatment.
In the selected cases before the diet advice FBS mean was129.4000 which reduced to
123.8000 on 14th day, and still decreased to 121.4333 on 30th day. And again it
increased to 136.4333 on the 60th day. Statistically it gives significant reduction in
the FBS during the observation period, But the FBS level once again increased very
significantly at the follow up time.
Table No. 45: Showing the results of Mean PPBS values of 0th, 14th, 30th and 60
Days.
PPBS Mean Standard Deviation N
0th Day 166.0667 10.90692 30
14th Day 154.4333 11.72878 30
30th Day 151.2000 20.30186 30
60th Day 160.6333 10.60411 30
Table No. 46: Showing the results of repeated measure ANOVA for mean FBS
values of fresh cases before, during and after treatment (0th, 14th, 30th & 60
Days).
Source of variation Type III Sum
of Squares df
Mean
Square F value
P
value
CHANGES 3928.167 3 1309.389 8.280 .000
Error(CHANGES) 13757.333 87 158.130
Note: Change refers to change from before to after treatment
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 147
In seleceted cases before the Diet advice, PPBS mean was 166.0667 which decreased
to 154.4333 on 14th day, and still decreased to 151.2000 on 30th day. On the 60th day
again the mean value icreased to 160.6333. Statistically it shows slight significance
was observed in PPBS values, but the values during the whole observational period
was not under the actual control level.
OVER ALL RESULT
The subjective and Objective assesment of all 30 patients are graded in to Very good
improvement-1, Mild improvement-2, Poor improvement-3 and Very poor
improvement-4 and the results are given below.
Table.No.47. shows the distribution of overall results
Grades frequency Percentage(%)
Very good improvement 0 0
Mild improvemenet 6 20
Poor improvemenet 12 40
Very poor improvement 12 40
Total 30 100
In the selected 30 no of Diabetic diet adviced cases none of the patients were having
very good improvement, 6 Patients were having mild improvement(20%), 12 patients
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 148
were having (40%) Poor improvement and 12 patients were having very poor
improvement (40%).
Table No.48: Showing the results of repeated measure ANOVA of the overall
treatment.
Chi-Square 2.4
df 2
Asymp. Sig.(P value) 0.301194
The over all treatment Result shows the P value 0.301194, it is not significant.
Graph No.1 Showing the Distribution of the sample by Age
Graph No.2 Showing the Distribution of the sample by Sex
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 149
Graph No.3 Showing the Distribution of the sample by Religion
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 150
Graph No.4 Showing the Distribution of the sample by occupation
Graph No.5 Showing the Distribution of the sample by Education
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 151
Graph No.6 Showing the Distribution of the sample by Socio-Economic status
Graph No.7 Showing the Distribution of the sample by Location
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 152
Graph No.8 Showing the Distribution of the sample by Family history
Graph No.9 Showing the Distribution of the sample by Diet
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 153
Graph No.10 Showing the Distribution of the sample by Nature of work
Graph No.11 Showing the Distribution of the sample by Excercise
Graph No.12 Showing the Distribution of the sample by HODS
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Graph No.13 Showing the Distribution of the sample by HONS
Graph No.14 Showing the Distribution of the sample by Habits
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Graph No.15 Showing the Distribution of Mean values of Polyurea
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Graph No.16 Showing the Distribution of Mean values of Polyphagia
Graph No.17 Showing the Distribution of Mean values of Polydypsia
Graph No.18 Showing the Distribution of Mean values of Burning foot and Palm
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Graph No.19 Showing the Distribution of Mean values of FBS
Graph No.20 Showing the Distribution of Mean values of PPBS
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Graph No.21 Showing the over all results of Improvements
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DISCUSSION
Discussion on Satmya and Pathya
A Substance which is conducive to an individual is called Satmya and the use of such
substances result in the well being of that individual.209 Chakrapani opines to the
above verse, the term satmya which is used to convey okasatmya i.e, by the prolonged
usage of the particular subject it becomes very much wholesome to the body. By the
above description it can be understood that the termed as satmya. Chakrapani
commentary on charaka vimana 5/4 opines that the food substance which causes
dosha prakopa is apathya and in contrary to this that causes dosha prashamana. In
sushrutha samhita it is said that satmya is the use of such things which do not cause
harm to the body even though they are opposite or different form to once own
constitution, habitat, season, disease etc. while formulating pathya for a particular
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disease we consider the opposite qualities to that of prakriti, desha, kala, jati, ritu &
roga in order to bring back the vitiated doshas to their normal state. By observing the
modalities of satmya and pathya we can understand that, pathya can be satmya always
but not the satmya.
Difference between satmya and Pathya
Sl no: SATMYA PATHYA 1 Satmya is a thing, which gives
pleasure to individual, it varies from person to person and it is generally due to long experience of that particular substance
It may or may not be the same with Pathya.
2 Kala, Desa etc. are the types of Satmya.
It has to be framed according to kala,desha,.etc. which are favorable to Pathya.
3 Satmya may be beneficial or harmful
Pathya is always beneficial according to situation.
4 Satmya can be categorized as superior (Pravara), mediocare (Madhyama) & inferior (Avara) Depending upon the administration of Rasa.
Pathya can never be graded in that way, it is always designed according to the condition.
5 Satmya is the Substance of pleasure of one self. May or may not have the beneficial effect o the body.
Pathya has beneficial effect for related condition.
Upashaya and Pathya:
The definition of Upashaya states that, the medicines, diet and the regimens which
instantaneously relieve the diseased condition by which the person will get
sukhanubandha. The suitable use of drug, diet and behavior which are contrary to the
cause of the disease or the disease itself or which produce effects contrary to them.
Such medicines, diets and regimens bring about happiness either by acting directly
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against the cause of the disease and or the disease itself or by producing such effects
indirectly are called upashaya. Even the administration of pathya also acts against to
the disease, by which it relieves the diseased condition. If the Aushada, ahara and
vihaaras are used for the diagnostic purpose, then it is Upashaya and if the same is
continued for long time in order to manage the disease it becomes Pathya. Even the
pathya can also be made according to hetuviparita, vyadhiviparita and
hetuvyadhiviparita.
Hita and Pathya:
The food articles which maintain the equilibrium of the dathus and help in
maintaining the equilibrium state are to be regarded as hitakara aharas otherwise they
become ahitakara to body. Here hitakara to the body is actually hitakara to the body
channels via the tissues being nourished, in caraka samhita the definition of pathya
has been stated as, the food articles which are wholesome to the body channels and it
doesn’t causes any harm to the channels. Chakrapani opines certain factors like matra,
kala, samskara and avastha are to be considered prior to the formulation of diet to
anykind of personalities. The hitaahara if administered by considering the above
factors it becomes pathya and hita is said as a synonym of pathya in Dhanvantari
Nigantu & Charaka samhita.
Difference between Pathya and Hitakara:
Sl no:
Hita Ahara Pathya
1 Hitakara term is used generally for all human beings or mass.
Pathya is mostly related to the conditions like disease, prakriti,Bala, Vrddha, Madya Vaya,Etc.
2 It is good for all people.
It is good for specific people.
3 Some foods which are commonly used have been told as hitahara based on the concept of ‘ Jatisatmya’
The specific foods have been told for each diseases based on the Dosha, dhatu and sroto satmyata.
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. 4 It is useful in Dosha samyavastha
It is useful in Doshavaishamyavastha
Ahara and pathya
Ahara is the food substance which is swallowed through throat after mastication
(SKD). In vachaspatyam it is mentioned that, the one which is good for the
srotomargas and does not harm the srotomargas is called as hita ahara and it is a
variety of bhojya dravya. By the above description we can understand pathya is also
an invariable form of ahara only, because generally when a food substance passes
through the throat it becomes the ahara dravya and when the same food substance is
advised after the assessment of the sarira srotases it becomes hita ahara and it is
nothing but pathya. Even the pathya can also be taken in any form as per the
palatability. Because of these similarities the classification of ahara can also be
considered for pathya also.
Importance of pathya in the management of chirakaleena vyadhis
Diseases manifests as a result of the food taken in fourfold manner via eating,
drinking, licking and mastication. Intake of wholesome and unwholesome food is
responsible for the maintenance of health and production of diseases respectively.
(ca.su.28/5). The factors like, the usage of apathya ahara, state of dosha and the state
of vyadhikshamtva in the sharira determines the acute or chronic onset of diseases.
Where in the the person who is consuming apathya ahara, having dosha vaishamya
and avyadhikshamatva (Lack of body’s defence mechanism), in such conditions he
will get acute (Sheegra) onset of diseases and the one who is consuming pathya
aharas, aprabala doshas (Not having too much aggravated doshas) and very good
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body defence mechanism (Vyadhi kshamatva shareera) will have mild (mridu) and
delayed onset of diseases.
Individuals whose body is sthooa or Krisha, or having shithila mamsa, rakta,
asthi , durbala and who is indulged in apathya ahara( unwholesome ) or accustomed to
take alpa ahara or having feeble mind, are unable to resist diseases. On the other hand
individuals having opposite type of physical constitution are capable of resisting
diseases. The factors like intake of apathya ahara, vaishamya dosha and physical
constitution of above description gives rise to diseases of many types via, mild or
severe and acute or chronic. 210
The body is constituted by food; hence one should take wholesome food only
after careful examination and should not take unwholesome ones out of greed or
ignorance.
Chakrapani opines that, out of greed some individuals indulge in unwholesome food
even though they are fully aware of its harmful effects. Some others out of ignorance
treat unwholesome food as useful one and take it. Both of them are subjected to
misery. 211
Pathyas to be advised after the assessment of the state of accumulation of doshas
inside the body via unabhava and khatinyata. 212 The above verses can be explained
in a different way also. Khatinyata or compactness and unabhava or noncompactness,
both may occur by the union of doshas and dhatus. But the former ie, khatinyata or
compactness takes place when this union is stablised. Both this events takes place in
the interior of the body(antaha) and both of them are of serious nature(mahan).
Because of deep seated as well as the serious nature of the morbidity, the condition
does not get alleviated completely. By the administration of pathya ahara and
aushadha both of these morbidities continue to be manifested in a milder form.
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Having ascertained this(Jnatvaivam), the pathya ahara and aushadha are to be
administered in a required dose continuously for a long time.213 From the above
description it can be stated that, by the regular intake of pathya aharas, the chronic
and severe diseases can be managed without detoriating the general health of the
patient.
Discussion on Madhumeha
The clinical condition where as the patient voids the urine which is similar to that of
honey is called madhumeha. The word Madhu is like honey and meha is excessive
urination. By analyzing the clinical condition we can understand it as Diabetes
mellitus.
Discussion on Title
Madhumeha is metabolic derangement state of Carbohydrates, in the management of
diabetes the folloing modalities are followed like; Pathya alone, Pathya with Exercise,
Hypoglycemic rugs with pathya and Insulin with pathya. In all types of management
Pahya is the invariably associated. In Ayurveda there is pool of information is
available regarding diets in the management of madhumeha. Hence to rule out the anti
diabetic efficacy of the pathya aharas mentioned in ayurvedic classics, this study was
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undertaken under the title, “A Conceptual Study of Pathya in madhumeha with special
reference to Type-2 Diabetes mellitus.
Discussion on synonym
Paushpa Meha: Narrated in Anjana Nidana. Paushpa Rasa is again resembles with
Madhu.
Ojo Meha: This is enumerated as a subtype of Vataja Prameha amongst thefour.
Therefore, the depletion of Oja through the urine along with changing its taste and
texture by vitiated Vata resulting OjoMeha. Change in qualities of Oja is because of
'Vata Prabhava'.
Kshaudra Meha: This synonym narrated by Sushruta because of its close
resemblance with Madhu. From above synonyms, we can postulate that anonymously
all Acharyas mentioned the urine culture concordant with Madhu. Some scholar also
opines that the another meaning of the madhu is liquor, when the liquor is kept for
long it is fermented just like that the urine of the diabetic person gets fermented.
Discussion on classification
From the above classification it is very necessary to find out the basic ideology behind
this. Vagbhata clearly narrated that these types result because of the nexus between
Dosha, Dushya and their specific combination according to concordance. That’s why
in each subtype specific type of urine is voided.214
Charaka put forth his theory that all these types and their nomenclature is
because of the specific qualities and their combinations with each other but, the
nomenclature is mainly based upon the predominance of one quality. 224 Chakrapani
also explained that the nomenclature is because close resemblance of urine with
particular quality (guna) i.e. Shitameha, Shuklameha, etc.
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While going through the details of this classification it can be easily
understood the Dosha predominance, Dushya involvement, nature of urine voiding
and can also find out the etiological factors, state of the disease and progression.
Discussion on etiology
Knowledge of etiological factor and their role in the pathology is very much
necessary to find out the constituents like dosha, dushya, mala, progression of the
disease and their role in diagnosis and prognosis.
Charaka samhita narrated that sahaja type of diseases can occur due to defect in
Beeja, Beejabhaga or Beejabhagavayava which can be correlated to ovum and sperm,
to chromosomes and to genes respectively. 215 Chakrapani explained that this defect
may be caused due to the indulgence of faulty foods at the time of pregnancy.
Charaka samhita narrated that indulgence in excessive use of Madhura Rasa by
mother at the time of pregnancy causes Madhumeha and Sthaulya. 216
From above Nidana we can highlight the following points:
(1) All the etiological factors having qualities like Snigdha, Sheeta, Guru, Madhura
and Picchila.
(2) All the etiological factors mainly causes excessive burden over digestion and form
aparipakva dhatus.
(3) All the etiological factors causes deposition of excess and unwanted matter in the
body i.e. Excess of vitiated Meda, Kleda, Lasika etc.
(4) All the etiological factors leads to the formation of excessive mala i.e. Mutra and
Sweda.
(5) The viharas which are mentioned above are exclusively the habits of sedentary
lifestyle
Prameha Nidana
Sahaja (Hereditary) Apathya Nimittaja (Acquired)
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Discussion on purvarupa
Discussion on Purva rupa
Purvarupa are valuable signs & symptoms to predict the nature of disease and a way
to check the full blown symptoms by timely management. As a matter of fact,
prodromal symptoms are produced at the stage of Sthana Samshraya and it is a kind
of caution to the person to stop the ingestion of etiological factors of Prameha.
By clean observation of above prodermal sign and symptoms we can postulate the
opinion that the disease having wast field of etiopathology and the patient shows very
few prodromal sign and symptoms. So it is very hard to diagnose Prameha by means
of above description but Sushruta makes it easy by narrating that a man with slight
increase in the urine output along with the premonitory symptoms should be consider
as the patient of Prameha. Here ‘Dantadinam Maladhyatvam’ is due to Meda dhatu
dusti. ‘Deha chikkannata’ is due to Meda and Kapha dusti.The signs like Kesha
Mainly causes Vitiation of Kapha (Bahudrava), Meda (Bahu & Abadhdha), Mamsa (Shaithilya) Kleda, Lasika, Rasa,
Vitiates mainly Pitta, Shonita Mamsa, Increases Mutra and Sweda Quantity.
Mainly vitiates Vata, Causes severe depletion of Vasa Majja and Oja.
Kaphakara Pittakara
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Nakha Ativriddhi and Kesheshu Jatilabhava is not due to any single dosha and dushya
dusti but it is the results of specific type of samyoga between specific Dosha and
anukula dushya.
Discussion on Rupa
(1) Prabhutamutrata:
This is the main cardinal sign described by all scholars. Vagbhata mentioned Prameha
as the disease of Mutraatipravrtija.217 Patient Voids urine more in quantity. Gayadasa
opined that this excess urine quantity is because of liquification of the dushyas and
their amalgamation.218
(2) Avilamutrata:
Patient voids urine having hazy consistency or having turbidity. Gayadasa and
Dalhana both opined that, this characteristic feature of urine is because of the nexus
between mutra, dushya and dosha.219 Vagbhata also emphasized that this turbidity of
the urine is because of its annexation with the dhatus.220
(3) Picchila mutrata:
Charaka samhita has mentioned this character of urine especially at the time of
diagnosis of the Prameha.
Kashaypa mentioned the following symptoms of Prameha to be observed in pediatric
patients 221
Discussion on Samprapti
The process of manifestation of disease is called Samprapti or pathogenesis. It
includes various stages as disease progresses. Madhumeha is the disorder mainly
tridoshaja. Classics emphasized its Pathophysiology by two ways, either
Dhatukshayaja or Avaranajanya. Though Datukshayaja pathogenesis leads to
incurability while Avaranjanya pathogenesis can be disrupted. Here in the
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pathogenesis etiological factors mainly vitiates Kapha, Pitta and Meda. They in turn
obstruct the path of Vata. Vyana the sub-component of Vata mainly perform the
functions related to gati and transportation of various vital essence at required place.
Obstruction to the path of Vata leads its aggravation causes severe depletion of vital
dhatu. Oja carried out towards Basti.. Along with this, vitiation of various body
elements like Meda, Mamsa, Kleda, Vasa and Lasika occurs which causes various
symptom and signs. Medo dosha were also manifests as the disease progress.
The disease Diabetes mellitus is caused because of disrupted carbohydrate and Fat
metabolism. Sedentary life, faulty foods and lack of exercise precipitate the disease.
Various metabolic changes involved in the pathogenesis here, genetical inheritance is
one of the major etiological factor.
The main Patho-physiology behind Diabetes mellitus is the disturbed metabolism of
the carbohydrates, fats and proteins due to either absolute or relative lack of Insulin.
The Diabetes mellitus has been broadly classified as type I and type II. The type I
Diabetes mellitus patients are usually asthenic in body constitution and suffer from it
in the early years of life, while the type II Diabetes mellitus patients are usually obese
and suffer from it in their 40’s. The type II Diabetes mellitus patients can be managed
easily by hypoglycemic drugs whereas in type I Diabetes mellitus patients the Insulin
therapy is obscure. So, the type I Diabetes mellitus is nearer to
Dhatuapakarshanajanya Madhumeha while the type II Diabetes mellitus resembles to
Avaranajanya Madhumeha.
Major dosha involved in the manifestation of Madhumeha
Vata is the main prime Dosha in the pathogenesis of Madhumeha. Here Vata get
aggravated either because of its own etiological factors or because of Avarana caused
by Kapha Pitta and Meda. This provoked Vata carries the vital constituents of the
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body like Vasa, Majja, and Oja towards Basti and excretes them outside through urine
resulting
in depletion of the Dhatus. Thus due to severe depletion of Dhatus, the symptom
manifests are Karshya, Daurbalya, Angasuptata and Parisarana shila nature.
In Su.Ni.1/20, it is described that Vyana and Apana are the main culprits in
Prameha. Here mainly the function of Vyanavayu gets hampered because of the
accumulation of vitiated Dushya at macro and microcellular level. Thus in all the
Samprapti of Pramehas Vyana acts as the gatherer of Kleda and Apana as excretor.
The function of Apana Vayu gets aggravated resulting excretion of vital Dhatus
through the urine outside the body.
Srotas Involvement:
Madhumeha is the disease mainly of systemic consideration. In the pathogenesis there
is involvement of each and every constituent of the body.In the pathogenesis there is
reference of Srotodushti only related to Mutravaha Srotasa. But when, we observe the
pathogenesis and symptomatology, it can be easily understood that the involvement of
Medovaha, Mamsavaha, Swedavaha and Udakavaha Srotas occurs.
In the pathogenesis we can find the two types of Srotodushti:
Atipravritti
Vimargagamana
Thus we can find out the Srotas involvement according to the symptoms as follows
Purvarupa of Prameha Medovahasrotodushti. Putimamsapidaka Mamsavaha Srotodushti Trishna, Mukha Talu Kanthashosha
Udakavaha Srotodushti.
Atisrishta Abhikshana Mutrapravrriti
Mutravaha Srotodushti.
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Agni:
All the metabolic activities (Paka, Parinamana) are governed by agni and its mandata
leads to so many metabolic disorders and madhumeha is one of them. In madhumeha,
dhatvagnimandya is a major etiological component. It has been mentioned that
dhatvagnimandya leads to dhatu Vriddhi and dhatvagni – Tikshnata causes
Dhatukshaya.222
In the Samanya Samprapti, Agnimandya develop due to Ajirna
Bhojana, Atibhojana, Asatmya, Guru, Sheeta Bhojana leads to Bahudrava Kapha and
Bahubadhdha Meda as well as excessive quantity of Mamsa and Kleda. But in case of
avaranajanya madhumeha due to kaphakara Nidana a, Dhatvagnimandya develops
and due to this agnimandya excessive dhatu cannot be assimilated properly leading to
more vitiation of specific dhatu. Such vitiated dhatu obstruct the gati of vata leading
to its provocation. But due to this provocation of vata, Jatharagni gets stimulated
demanding more food. This cycle goes on. Therefore, in Madhumeha the dushya
dushti mostly occurs in the form of vriddhi and not in the form of kshaya reflecting
dhatvagnimandya. Kshaya Lakshana of Majja and Shukra Dhatu may be due to
Medodhatvagnimandya there is less nourishment to further Dhatus.
So the role of Dhatvagni in the Samprapti of Madhumeha is important. One
may observe the difference between two types of Agnimandya. In Samanya
Samprapti one may get symptoms like Kshudhamandya due to Jatharagnimandya, but
in Avrita Vata Samprapti, Kshudhadhikya will be prominent.
Discussion on Chikitsa:
Following are the treatment modalities we can apply in the Madhumeha to alleviate
the disease.
Nidana parivarjana.
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Treatment According to Dosha.
Treatment According to Dushya.
Treatment According to Mala.
Treatment According to Complications.
Nidana parivarjanam :
This is the prime treatment principle narrated by every Acharya before describing the
treatment of every disease.
Charaka enumerated that we should avoid these etiological factors which are
causing the disease Prameha, Avoidance of the etiological factors is the prime
treatment.223
Chakrapani opined that this avoidance of etiological factors in Prameha is prime
concern because; this disease is Chirakari having long impact on the body.
Only Nidanaparivarjana is not the aim but along with that proper diet
management is necessary. This diet management should be according to body
constitution.
Discussion on Chapter 3
In Charaka chikitsa prameha adhyaya it is told that, the prime treatment principle is to
avoid the apathya aharas and one should regularly take the pathya aharas. The
excessive indulgence in nidana sevana of guru, snigdhadi ahara and avyayamadi
vihara leads to kaphadosha sanchaya.224 In prakrita avastha the kapha will be in
baddha form i.e, solid or binded form but due to nidana sevana the baddha form
changes to dravatwa leading to bahudravatwa and thus vitiated kapha gets provoked.
The provoked kapha having affinity towards meda due to their similar properties
binds along with other dushyas like kleda, mamsa and lasika resulting in Sthoulya.
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Always the treatment should have the counteraction against either the cause of the
disease or disease itself or the both. In all major classics the greater importance has
been given to pathya aharas in the management of Madhumeha. By observing the
qualities of pathya aharas mentioned in the prameha chapter, we can reveal that the
pathya aharas are having the qualities opposite to that of the disease and its
components.
Discussion on Dhanya varga
The Dhanyas like Yava, Godhuma, Purana shali, and Rakta shali and truna dhanyas
have been told as the major source of food. Most of the Dhanyas are laghu, ruksha,
sara gunas, tikta Kashaya madhura rasa, ushna virya, katu vipaka, kaphahara,
medohara, lekhana, sthairyakara, soshana, kledahara properties which are antagonistic
to the dosha and dushyas of madhumeha. While explaining the shali variety Purana
shali is advised as the best one. And it is not same for Trina dhanya; it can be
consumed immediately after harvesting. The biochemical change from New to old
shali reduces the moisture content significantly and the simple sugar compounds will
be converted into cellulose, hemicellulose and pectin or complex sugar compounds.
When these foods consumed in the older state it delays the absorption of glucose into
the blood and thus reduces the hyperglycemia and it is not same for the Trina dhanyas
because they have the similar properties of purana shali in their fresh state only. And
these Trina dhanyas are rich contents of soluable fibres, a vital component of Diabetic
diet.
The pulses like Mudga, Chanaka, Aadaki, Kulatha and Masurika are having
laghu, ruksha, vishada, tikshna gunas, Kashaya madhura rasas, ushna virya, katu and
amla vipaka, kapha vata shamaka, bhedhana, grahi properties. And these pulses are
the rich source of vitamin B complex, high levels of proteins and essential aminoacids
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and have low glycemic index, which are the essential factors in the management of
Diabetes mellitus.
Discussion on Harita and Shaka varga
The shakas are mainly having gunas like laghu, ruksha, tikta Kashaya madhura rasas,
ushna virya, katu vipaka, vata kaphanashaka, agni dipaka, hrudya, netrya, shothagna,
medohara, trushna nigraha etc are antagonistic to the doshas and dushyas of
Madhumeha. These also contains highest amount of dietary fibres, rich sources of
minerals and vitamins, low caloric energy level, essential amminoacids and some
amminoacids are also having hypoglycemic effect which in turn helps to bring back
the impaired metabolic activity. Most of the vegetables from cucurbitaceae family are
having the bitter principle, cucurbitin. It is known to have the stimulatory effect on the
islets of langerhans cells of pancreas and also increases the insulin sensitivity on the
cells of peripheral tissues.
Discussion on Phala varga
The phalas described in madhumeha mainly having Kashaya pradhana madhura rasa,
ushna virya, madhura vipaka, trishnahara, mutrala, kanthashodhaka, lekhana,
medohara, and malabhedaka properties. When these fruits are consumed in a divided
doses it will have continuous antagonistic effect on the samprapti and these fruits are
rich sources of vitamin B complex, vitamin C, Carotenoids, antioxidents, soluble
fibres and micronutrients like calcium, selenium, zinc, copper, magnesium, potassium
etc, these ionic compounds plays a very significant role in the trans cellular absorption
of insulin by the ionic exchanges between calcium influx and potassium outflux.
Discussion on Tailas
In prameha adhyaya the tailas like atasi, danti, ingudi, sarshapa and tilatailas have
been mentioned. But in the present study only tila and sarshapa tailas have been
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selected because of the availability and palatability to the patients. These tailas have
tikshna, ruksha and sara guna, katu tikta Kashaya, and madhura rasa, ushna virya,
katu vipaka, lekhana, karshana and medohara properties. These oils having
considerable amount of polyunsaturated fatty acids and traces of cholesterol and rich
amount of omega 3 and 6 fattyacids. These vital components reduces the LDL and
VLDL in considerable amount and thus prevents the formation of plaques inside the
arteries and prevents the chances of heart attack a later complication of Diabetes
mellitus.
Discussion on Nutrient components in Diabetes mellitus 227
Several revolutions in the dietary management of diabetes have not resolved all the
dilemmas conserning balanced diabetic diets. The progress in the evaluation of the
most appropriate diet for diabetes has been rather slow, partly because of large
variation among diabetics with regard to insulin resistence, body size and insulin
secretion. The education and dietic management of type 2 diabetes depend on their
individual needs. The basic aim in all patients is to relieve the symptoms of diabetes
and to minimize its impact on micro and macrovascular complications. The traditional
methods used a sequence of treatments to manage type 2 diabetes. Dieting is first used
to reduce weight and intake of quickly absorbed carbohydrates. Diet is aimed to limit
the saturated fat intake to prevent cardiovascular disease associated with type-2
diabetes. Among all, prescribing the right amount of energy has always remained a
central issue in the dietic management of type 2 diabetes. The total intake of calories
is more important for a diabetic than the exact proportion of proteins, fats and
carbohydrates in the diet.
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Dr.Ramesh Kumar.K.L 176
A diabetic should be kept on a well balanced diet providing just enough
calories to maintain ideal body weight. For the same calorie intake it is advisable to
take 5 small meals a day, it includes morning breakfast, midmorning snack, lunch, tea
time snack and dinner rather than usual three or even one meal. The usual distribution
of the nutrients in the diet is carbohydrate, 50-75% of calories ; protein 10-14%
(usually 1g per body weight) and the remaining energy to be drawn by fat.
CARBOHYDRATES
Carbohydrates are deposited as glycogen in the muscles and liver by the action of
insulin. In diabetes, due to deficiency of insulin this metabolism is disturbed. The rise
of blood sugar after a meal does not depend only on the amount of carbohydrate
ingested, but also on the rapidity of absorption. This varies with the fibre content
phytate. Lactins, tannins, saponins, and enzyme inhibitors. The ability of a food item
to rise the blood sugar is measured in terms of glycemic index. In diabetic patient
usually the low GI value foods are appreciated.
Fibre rich foods slow stomach emptying and delay intestinal transit and so
reduce the rate of glucose absorption, lower blood sugar rise and decrease urinary
glucose excretion. Fibre also contributes to satiety and the consequent decreased food
intake helps reduce weight. Thus fibre containing food such as barley, wheat, millets,
pulses etc will produce less rise in blood sugar and less excretion of urine sugar. The
inclusion of high fibre food in diets has improved control of both blood glucose and
lipids. Diabetics should therefore eat more fibres. Phytic acid, usually contain in
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 177
cereals and pulses, may have a dominant role in decrease in the blood sugar rise than
fibre. The blood glucose response becomes less with the increasing content of phytic
acid in food. Inclusion of food with low glycemic index (GI) decreases the
requirement for antidiabetic drugs. Sorbitol an alcohol of fructose is less sweet,
natural sorbitol occurs in pears, peech and cherries. Unlike the sugar, sorbitol is
absorbed very slowly in the intestine and so does not appreciably alter the blood sugar
level during absorption, though it supplies as many calories as sugar.
PROTEINS
A diet high in protein is good for the health of diabetics because (I). it supplies the
essential aminoacids needed for tissue repair. (2). Does not rise blood sugar during
absorption as much as carbohydrates. (3). Does not supply as many calories as fats.
(4).Proteins has stimulating and satiating effect. One gram of protein per kg body
weight is adequate, more proteins may be given if necessary and the amount of fats
and carbohydrates reduced proportionately.
FATS
Fats should provide about 20-25% of calories. They cannot be oxidized has readily as
carbohydrates. The normal end products of oxidation of fats are CO2 and H2O. When
carbohydrate metabolism is normal fats are metabolized to a relatively small extent,
and the small quantity of ketone bodies produced is completely utilized by the tissue
to supply energy. In a neglected diabetic, carbohydrates cannot be utilized because of
the deficiency of insulin, and so the energy requirements have to be met with fats. The
ensuing excessive breakdown of fats results in accumulation of ketone bodies which
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Dr.Ramesh Kumar.K.L 178
are then excreted in the urine. Daily metabolism of about 100gm carbohydrates
prevents accumulation of ketone bodies.
VITAMINS
Carbohydrates are not completely metabolized when there is a deficiency of vitamin
B. it is postulated that products of partial carbohydrate metabolism like pyruvic acid,
accumulate in such situations and damange the nerves resulting in pheripheral
neuropathy. The diabetic requires the supplementation of Vitamin B. it is also
advisable to supply vitamain A, as the liver which is store house of these Vitamins,
may be damaged in diabetes.
EXERCISE
Exercise is a very useful measure in the management of diabetes. It utilizes
carbohydrate for energy and reduces the requirement for insulin or antidiabetic
tablets. Uniform and regulated exercise like brisk walk, swimming, or a suitable game
for middle aged patients. Exercise benefits the cardiovascular risk factors namely high
blood pressure, lipids (it raises HDL and decreases LDL) and obesity. Physically
active middle-aged men who participate regularly in sports have lower plasma
concentration of insulin when fasting as well as after a meal. Exercise increases
insulin sensitivity, but this disappears within a few days of stopping exercise. Good
attention of feet diminishes the occurance of diabetic feet ulcer.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 179
DISCUSSION ON METHODOLOGY
After completion of the study and collecting the data at regular intervals the
obtained data were analyzed to give a better picture of demographic observations and
results. The interpretation of the observations is discussed in this chapter along with
discussion of methodology.
Discussion on Materials
The study was an observational study, The newly detected Type-2 diabetic patients
were adviced to follow the prepared dietic module specially devoloped for the
management of diabetic patients.The diabetic diet module contains the list of foods
and daily diet menu, the foods which are mentioned in the chapter prameha were
selected on the basis of their present day availability and affordability.The selected
foods were first identified Taxonomically and Botanically under the guidance of
Botanists, Department of Botany, University of Mysore, then the habitats of each food
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Dr.Ramesh Kumar.K.L 180
was identified geographically. The regional names of the each food item were
clarified by the Departments of Dravyaguna, Horticulture and Botany, and also by the
traditional vegetable sellers and Farmers. Finally all patients were informed regarding
the place of availability of all food items.
Discussion on Methods
Patients were assigned in a single group because of the study was
observational. The patients aged between 30 to 60 years of having newly detected and
less than one year chronicity without treatment were selected. as Type-2 Diabetes
(NIDDM) is more common in the middle aged people, and it is also called as Maturity
onset of Diabetes in Young (MODY). The patients of uncontrolled diabetes and
chronic patients with other systemic complications were excluded from the study,
because they need Oral Hypoglycemic agents and Insulin therapy along with the
diabetic diet.The diabetic diet menu has been prepared as per the standards of
American diabetes associations general guidelines, that a diabetic diet menu should
include three meals a day along with light snax inorder to provide the required energy
and Nutrition. The patients were also adviced to do Physical excercise for one hr or a
brisk walk for about 4km a day.
Discussion on Intervention
As per the objective, the present study was undertaken on the newly detected Type-2
DM patients. The prepared diet module was adviced to the patients to evaluate the
Anti-Diabetic efficacy of prepared diet module. The changes in the Polyurea,
Polyphagia, Polydipsia and Burning foot & Palm, FBS, PPBS and Urine sugar was
assessed on 0th day, 14th day and 30th day followed by a follow up after 60 days.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 181
Discussion on Observations
Availability
Most of the cases reported to GAMC hospital OPD directly. Special camp is
conducted in GAMC for the same time and the cases were also selected
Age
Majority of the patient in this study i.e. 46.7% belonging to the age group 51 to 60
yrs. this reveals that maximum prevalence of the disease at Madhyama Avastha.
These findings were concordant to the recent statistical data which shows that the
onset of Type II Diabetes mellitus after the forties is most common. While 36.7%
patients belonging to the age group between 41-50 years. A strong predisposing
factor in middle age diabetes is obesity. Middle aged diabetes is due to increase in the
size of fat cells. With weight reduction, the fat cells decrease in size and the glucose
tolerance test may return to normal.
Sex
In this series, maximum number of patients i.e. 70.0 % were male (21) and 30.0%
were female (9). Nothing specific can be derived from this. This may be due to the
demographic facts.
Religion
In this study 26 patients were Hindus (86.7% )and Muslims were only 4 patients(
13.3%) which again indicative of demographic situation of this region.
Education
Out of 30 patients, 3 was uneducateds, 2 had studied upto primary level, & had
studied upto high school, 9 upto PUC, 8 were graduates and only one was post
graduate. Chi square test reveals no difference between these frequencies noting
education is independent of DM for the selected sample.
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Dr.Ramesh Kumar.K.L 182
Occupation:
In the present study maximum number of patients were housewives(7) i.e. 23.3next to
this 20.0% of the patients were business mens(6) .These figure shows that disease
occurs in those classes who, usually lead sedentary life style and eat more than their
requirement.
Location
Majority of the patients i.e. 73.3% were living in urban area and 26.7% patients from
rural area. This data is concordant with the recent W.H.O. Annual Report (2009) that
the prevalence of Diabetes mellitus is greater in urban than in rural areas. This shows
the effect of fast foods, decreased levels of physical activity, sedentary life, and
sudden change in life style in urban areas.
Socio economic status
Majority of the patients’ i.e.60.0% belonged to middle socioeconomic status. This
finding reflects the pattern of patients coming to the hospital of this institute
according to their socio-economic conditions and also the increasing substantial
sedentary habits among them.
Family history
In this study 36.7% people were having the family history of Type-2 diabetes
mellitus. Heredity plays the most important role in confering susceptibility to
diabetes. The closer the blood relationship of a person to a diabetic, the greater the
chances of developing the disease. When both parents are diabetic, the chances of the
children getting diabetes are considerably increased. Insulin dependent diabetes is
more likely to be transmitted to the offspring by a diabetic father than a diabetic
mother.
Nature of work
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 183
Majority of the patients in this study were doing Mild work i.e, 63.3% (19) and 33.3%
(10) of the patients were doing moderate manual work. As it well known the people
who doesnot involved in more physical activity they are more prone to become obese
and thus lead to diabetes.
Diet
Majority of the patients i.e. 63.3% of this series were mixed type of food, whereas
33.3% patients had vegetarian diet pattern. It is mentioned in the recent studies that
people eating mixed diet are more likely to get excess fat deposition in their body
causes obesity, and then it leads to diabetes.
Habits
Observations of addiction in the present study revealed that majority of the patients
were addicted to some or other things. Maximum number of patients i.e. 56.7% were
addicted to Tea& Coffee followed by 10 % of the people were alchohol consumers
and 16.7% Alchohol, Tea, Coffee and smoking. All these addictions decreased the
natural immunity and also provoke the Vata to manifest the disease Madhumeha
earlier and with severity.
Chronicity
In this all patiens were newly detected diabetics and having the history of diabetes
within one year, it was selected because the newly detected diabetes patients intially
have impaired glucose absorption, and during this stage if the proper diet is adviced
the oral hypoglycemic drugs can be avoided. It is also recommended by WHO.
Hours of day sleep
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 184
In this study totally 50.0% of the people were having the habit of sleeping during
day times in which 40.0% of the patients were sleeping upto 1 hour daily and 10.0%
of the patients were sleeping upto 3 hours daily. It shows that day sleep is one of the
major features of sedentary life style, the major cause of Type-2 diabetes mellitus.
Divasvapna causes Kapha vriddhi and its Abhishyandi property leads to blockage in
whole body micro channels, specifically in Medovaha Srotas. Because of excessive
sleep at night and day, physical activity diminishes which aggravates Kapha leading
to Meda deposition. Moreover reduced metabolic rate during sleep is an important
factor for genesis of excess fat.
Prakrityadi pareeksha
All the patients were having Dwandvaja Prakriti with maximum number of patients
i.e. % were Vataj-Pittaaja Prakriti followed by Vata-kaphaja prakriti 20.0%, Majority
of the patients i.e. 80.0% were having Madhyama Sara, Madhyama Samhanana 86.7%
and Madhyama Satva 63.3 %.
Abhyavarana shakti
Most of the patients i. e. 76.7% were found to have Madhyama Abhyavaharana Shakti
and also maximum patients having Madhyama jarana Shakti 76.7%.
Discussion on Results
Polyuria
In 30 patients participated in the study had mean values of the polyurea was 2.0667
on the 0th day, then it reduced to the mean of 1.8667 on the 14th day and still reduces
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 185
to 2.1333 on the 30th day, but it again increased to 2.1333 on the 60th day. But the
poly urea observed in this study was almost in the normal level, when the blood
glucose exceeds more than 180mg/dl then only it crosses the renal thresh hold
capacity.
Polyphagia
In 30 patients participated in the study had mean values of the polyurea was 1.6667
on the 0th day, then it reduces to the mean of 1.4333 on the 14th day and still reduces
to 1.5333 on the 30th day, but it again increased to 1.7667 on the 60th day. It shows no
significance changes from before to after the dietic therapy.
Polydypsia
In 30 patients participated in the study had mean values of the polyurea was 1.5667
on the 0th day, then it reduces to the mean of 1.4667 on the 14th day and still reduces
to 1.3333 on the 30th day, but it again increased to 1.7000 on the 60th day. It shows no
significance changes from before to after the dietic theraphy.
Burning foot and Palm
In this study only 6 patients were having very mild burning foot before the Dietic
advice and it decresed gradually during the course of the study, and rest of the patients
was not having the complaint of Burning foot and palm. Usually in the course of the
disease, burning foot and palm is associated with peripheral neuropathy, a later
complication of diabetes in chronic patients.
FBS
In all patients after the advice of diabetic diet the mean value of the FBS was
significantly reduced for a milder extent. The mean FBS on 0th day was 129.4000, it
reduced to 123.8000 on 14th day, and still reduced to 121.4333 on 30th day but after
the followup period it again shoot up to 136.4333, and the ‘P’ value shows little
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 186
significance (0.000). Even though the FBS reduced to a milder extent, still it is more
than the normal limit of FBS i.e, 70-110mg/dl. Generally the patients follow the
instructions of the doctor very punctually in the begining, later because of the
ignorance of the patient to maintain the prescribed diet the variation in the FBS
occurs. The declining trend in mean value of FBS shows hypoglycemic action of the
diet in the early stage of diabetes.
PPBS
In all patients after the advice of diabetic diet the mean value of the PPBS
was significantly reduced for a milder extent. The mean PPBS on 0th day was
166.0667, it reduced to 154.4333 on 14th day, and still reduced to 151.2000 on 30th
day but after the followup period it again shoot up to 160.6333 and the ‘P’ value is
.000 which is significant. Even though the PPBS reduced significantly, still it is more
than the normal limit of PPBS i.e, 100-140mg/dl. The major aspect to be observed
here is, the PPBS will done two hours after the breakfast.In south indian culture the
breakfast is always very light food when compared to the Mid day heavy lunch.
Obviousely the mean content of the PPBS after morning breakfast will always lesser
than the PPBS after the mid day lunch.
Urine sugar
In the present study only 5 patients had traces of urine sugar in the begining,
as this study was mainly taken on the newly detected diabetic patients the level of
blood glucose was not that much to break the renal thresh hold of glucose. The urine
sugar test will become positive only when the blood glucose is more than 180mg/dl.
As most of the patients were not having urine sugar, it shows no statistical
importance.
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Dr.Ramesh Kumar.K.L 187
Discussion on overall Result
After assessing the individual assessment criterias, the overall results of both
subjective and objective parameters of all patients were graded in to very good
improvement-1, mild improvement-2, poor improvement and very-poor improvement.
None of the patients were having very good improvement (FBS.70-110mg/dl &
PPBS100-140mg/dl), 6 patients (20%) had mild improvement (FBS.110-130 & PPBS
140-160mg/dl), 12 patients (40%) had poor improvement (FBS.130-150 & PPBS
160-180mg/dl) and 12 patients(40%) had very poor improvement (FBS > 150 &
PPBS 180mg/dl). And the ‘P’ value is 0.301194, statistically it shows no significance.
The declining values in FBS & PPBS in the begining of the dietic advice shows the
definite effect action of the diet on the hyperglycemia, but the consistancy in
following the diet is not maintained by the patients regularly, It results in the failure of
the overall result.
GENERAL OBSERVATION
1. The study shows the definite effect of the Pathyaaharas in decreasing the
hyperglycemia, but it is practically very much difficult to monitor the patients very
closely.
2. There are many possibilities for the error results in the assessment criterias like
FBS, PPBS and Urine sugar. Because the glucose in the blood is always not satble, the
changes in the blood glucose level is influenced by many factors like physical activity,
pattern of food, type of food, state of mental stress and hormonal influences. Along
with the above tests, HbA1c can also be included in the stydy to asses the three
month average maintenance of blood sugar level.
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Dr.Ramesh Kumar.K.L 188
3. Even though the patient is not following the prescribed diet, he fasts over night
prior to the doctors visit on the regular intervals, obviously the FBS will be reduced
because of either over night fast or less food intake on the last night.
4. If the Diabetic diet is provided either by the researcher or by the institution, the
possible errors can be avoided.
RECOMMENDATIONS FOR FURTHER STUDY
1. Because of the practical difficulties in the present study to monitor the scattered
diabetic patients very closely, the study can be conducted in the Ashramas, Old
age homes or as in‐patient in the hospitals.
2. The study will be one of the best suitable Research work for the Animal
experimental study in Alloxan induced Type‐2 diabetic rats.By this it can give the
very accurate biochemical, endocrinal and histopathological changes.
3. The raw diabetic diet can also be made availabe in a redaymade form.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 189
4. To rule out the geographical influence on diet, the study can be conducted in a
major sample from different geographical areas.
CONCLUSION
On the basis of conceptual Analysis and Observations made in this Study, the
following conclusion can be drawn
Madhumeha can be considered as Diabetes mellitus.
Madhumeha is more a metabolic derangement, than a disease
Faulty food habits and sedentary life style is the core cause of the majority of
patients.
The dietic management difinitely plays a central role in the management of diabetes.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 190
Along with the diet the physical activity is also very much important in diabetes.
The diets which are told for madhumeha in Ayurvedic classics are having the exact
antagonostic effect on the disease.
The content of blood glucose is having a direct relation with the type of food
consumed by a diabetic.
The people, who are well educated and know the causes of the disease are, followed
the diet regimen very punctually.
Pathya may the central key to open the blocked channels of a diabetic patient.
Pathya ahara is a Mahabeshaja, is proved beyond doubts for all times and its utility
and applicability is proved in this era too as being effective in Madhumeha by this
study.
SUMMARY
The tremendous development in the modern medicine has made a revolution
in health care system. Inspite of so many latest advancements, still the science has
not yet succeeded in all aspects of medicine. There is a continous flow of newer
discoveries are happening all over the world. In the path of research, the ancient
sciences are also moving along with the main stream.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 191
Ayurveda being ancient system of medicine has dealt all kinds of disease and their
managements. As madhumeha being a lifestyle disease, it is found since time
immemorial.
The study “A Conceptual study on Pathya in Madhumeha with special
reference to Type-2 Diabetes mellitus”. Was undertaken to gather the scattered
information of Pathya aharas told in madhumeha, and to make a module of pathya to
evaluate its anti-diabetic efficacy by FBS and PPBS.
In this observational study total 30 patients under a single group were incidentally
selected by confirming clinical features, Urine routine, FBS & PPBS. The developed
module of the Pathya aharas was adviced to all patients. And the assessment was done
regularly on the 0th day, 14th day and 30th day followed by a 30 days of followup
period.
The observations done on the factors like age, sex, occupation, religion,
educational status, marital status, socio-economic status, locality, chronicity, akruti,
along with general observation during treatment was also done.
The scores of polyuria, polyphagia, polydypsia, burning foot and palm was
collected before, during and after the treatment were subjected for Contingency
Coefficient test.
In the observation of results, the result was significant in the first two visits
and again it goes back to the Non-significant level at the follow up period. The
statistical data shows the result as significant according to the mean values of Poly
uria, Polu phagia, Poly dipsia and Burning foot and Palm, FBS and PPBS. But the
over all assessment on the basis of the general observations in terms of standard data
base the result of this study shows non-significant result. It is because the patient does
not follow the strict diet regimen regularly for a long time.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 192
By observing the intial decrease of the assessment parameters, it can be
concluded that, the pathya mentioned in madhumeha has got the property
hypoglycemic activity and thus prevents the hyperglyce.mia.
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107.
180. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 300.
181. Acharya Priya vrata Sharma and Dr.Guruprasad Sharma, Kaiyyadeva
nighantu, Pathyapathya vibhodaka, Varanasi, Choukamba orientalaia, 1999, PP:
106.
182. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 1234.
183. Acharya Priya vrata Sharma and Dr.Guruprasad Sharma, Kaiyyadeva
nighantu, Pathyapathya vibhodaka, Varanasi, Choukamba orientalaia, 1999, PP:
103.
184. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 811.
185. Acharya Priya vrata Sharma and Dr.Guruprasad Sharma, Kaiyyadeva
nighantu, Pathyapathya vibhodaka, Varanasi, Choukamba orientalaia, 1999, PP:
137.
186. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP:335.
187. Acharya Priya vrata Sharma and Dr.Guruprasad Sharma, Kaiyyadeva
nighantu, Pathyapathya vibhodaka, Varanasi, Choukamba orientalaia, 1999,
PP:189.
188. Vinayaka Ganesh Apte, Rajanighantu sahita Dhanvantari nighantu,
Sikandarabad, Anandashrama mudranalay, 1925, PP:427.
189. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 721.
190. Acharya Priya vrata Sharma and Dr.Guruprasad Sharma, Kaiyyadeva
nighantu, Pathyapathya vibhodaka, Varanasi, Choukamba orientalaia, 1999,
PP:99.
191. Vinayaka Ganesh Apte, Rajanighantu sahita Dhanvantari nighantu,
Sikandarabad, Anandashrama mudranalay, 1925, PP:431.
192. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 807.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 205
193. Vinayaka Ganesh Apte, Rajanighantu sahita Dhanvantari nighantu,
Sikandarabad, Anandashrama mudranalay, 1925, PP:423.
194. Acharya Priya vrata Sharma and Dr.Guruprasad Sharma, Kaiyyadeva
nighantu, Pathyapathya vibhodaka, Varanasi, Choukamba orientalaia, 1999,
PP:106.
195. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 1149, 1151.
196. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 751.
197. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 403.
198. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 822.
199. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 63.
200. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 65.
201. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 943.
202. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 1014.
203. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP:535.
204. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 518.
205. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP:548.
206. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 338.
207. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 1140.
208. Dr.K.M.Nadakarni’s, Indian Materia medica, volume-1, Bombay, Popular
prakashan limited, 1999, PP: 1126.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 206
209. Acharya Y.T, Charaka Samhita of Agnivesha, 5th Edition, Varanasi,
Chaukhambha Prakashan, 2007, PP: 236.
210. Acharya Y.T, Charaka Samhita of Agnivesha, 5th Edition, Varanasi,
Chaukhambha Prakashan, 2007, PP: 178.
211. Acharya Y.T, Charaka Samhita of Agnivesha, 5th Edition, Varanasi,
Chaukhambha Prakashan, 2007, PP: 181.
212. Acharya Y.T, Charaka Samhita of Agnivesha, 5th Edition, Varanasi,
Chaukhambha Prakashan, 2007, PP: 649.
213. Acharya Y.T, Charaka Samhita of Agnivesha, 5th Edition, Varanasi,
Chaukhambha Prakashan, 2007, PP: 649.
214. Vaidhya Harishatri Paradakara, Ashtanga Hrudaya of Vagbhata, Nidana
sthana, 10/8, 9th Edition, Varanasi, Chaukhambha Orientalia, 2009, PP: 504.
215. Acharya Y.T, Charaka Samhita of Agnivesha, 5th Edition, Varanasi,
Chaukhambha Prakashan, 2007, PP: 212.
216. Acharya Y.T, Charaka Samhita of Agnivesha, 5th Edition, Varanasi,
Chaukhambha Prakashan, 2007, PP: 322.
217. Acharya Y.T, Charaka Samhita of Agnivesha, 5th Edition, Varanasi,
Chaukhambha Prakashan, 2007, PP: 344.
218. Vaidhya Harishatri Paradakara, Ashtanga Hrudaya of Vagbhata, Nidana
sthana, 9/40, 9th Edition, Varanasi, Chaukhambha Orientalia, 2009, PP: 401
219. Acharya Y.T, Acharya NR, Sushruta Samhita of Sushruta, Varanasi,
Chaukhamba Surabharati Prakashan, Reprinted 2008, PP: 291.
220. Shivprasad Sharma, Ashtanga Sangraha of Vagbhata, Nidana sthana 10/9, 1st
edition, Varanasi, Choukhamba Sanskrit Series Office, 2006, PP:34
221. Kashyapa samhita, Sutra sthana, 25/22.
222. Vaidhya Harishatri Paradakara, Ashtanga Hrudaya of Vagbhata, Nidana
sthana, 10/8, 9th Edition, Varanasi, Chaukhambha Orientalia, 2009.PP: 188
223. Acharya Y.T, Charaka Samhita of Agnivesha, 5th Edition, Varanasi,
Chaukhambha Prakashan, 2007, PP: 448.
224. Acharya Y.T, Charaka Samhita of Agnivesha, 5th Edition, Varanasi,
Chaukhambha Prakashan, 2007, PP: 212.
225. Harsh mohan’s, Text book of Pathology, Sixth edition, Jay pee brothers
medical publication, 2010, PP: 818.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”.
Dr.Ramesh Kumar.K.L 207
226. Baba sahib B.Desai, Hand book of nutrition and diet, New York, Marcel
dekker, 2000, PP:582
227. F.P. Antia, Clinical Dietics and Nutriton, New delhi, Fourth Edition, Oxford
university press, 2007, PP:347
228. Dr.Syed Aziz Ahmed, Dr.S.C.Sharma, Fruit and Vegetable therapy, Delhi,
Pustak mahal, 2006.
229. Narendranath shasthri, Madhava nidana of Acharya Madhavakara pranita,
Delhi, Motilal banarasidas publications, 2005: PP: 460.
230. Narendranath shasthri, Madhava nidana of Acharya Madhavakara pranita,
Delhi, Motilal banarasidas publications, 2005: PP: 479.
1.Yava (Barley)
2.Godhuma (Wheat)
3. Rakta shali
4.Kangu ( Fox tail millet)
5.Shyamaka (Barnyard millet)
6.Kodrava (Kodo millet)
7. Bajra/ Sajja ( Pearl millet)
8. Madhulika ( Finger millet/ Raagi)
9. Joornahva ( Great millet/ Jowar)
Shimbi dhanya varga
1.Mudga ( Green gram) 2. Chanaka (Chick pea)
3. Adaki ( Pigeon pea) 4.Kulatha ( Horse gram/ Kidney bean)
5. Masura ( Lentils)
Harita varga
1.Katillaka( Punarnava/ Hog weed) 2. Shigru patra( Moringa leaves)
3. Lonika( Indian Purselane) 4. Drona pushpi patra( Tumbe soppu)
5.Gduchi (Heartleaved moonseed) 6. Kakamachi (Black night shade)
7. Vastuka( Goose foot)
Shaka varga
1.Kushmanda ( Ashgourd) 2.Karavellaka (Bitter gourd)
3. Patola ( Snake gourd) 4. Bimbi (Ivy gourd)
5.Shigruphala( Drum stick) 6.Indravaruni ( Bitter apple)
7. Katutumbi ( Bottle gourd) 8. Karkotaka ( Wild gourd)
9. Vartaki ( Egg plant) 10.Koshataki ( Ridge gourd)
11.Trapusa ( Cucumber) 12. Kadali kaccha phala ( Raw Banana)
13. Palandu (Onion) 14. Lashuna ( Garlic)
Phalavarga
1.Karjura ( Dates) 2. Aruka ( Peaches)
3.Kapitha ( Wood apple) 4. Jambu ( Jamun)
5.Udumbara ( Indian Fig) 6. Kalinga ( Watermelon)
Taila varga
1.Tila ( Sesame/ Gingelly) 2. Sarshapa ( Black mustard seeds)
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2DM”
Dr.Ramesh Kumar. K.L 2
KEY TO MASTER CHART
Sex
Male – 1 Female –2
Age – Age
Religion – Rel
Hindu – 1 Muslim – 2
Marital Status – M.S.
Unmarried – 1 Married – 2
Locality – L
Rural – 1 Urban – 2
Occupation – Occ
House Wife – 1 Retiered emloyee-2 Farmer-3 Teacher – 4 Police-5 Business – 6 Office work-7 Manual work – 8 Socio Economical Status – SES
Below Poverty Line-0 Lower Middle Class (LMC) – 1 Middle Class -- 2 Upper Middle Class (UMC) – 3
Education – Edu
Uneducated – 0 Primary – 1 High School – 2 PUC-3 Graduate – 4 Post Graduated – 5
Family History – F.H.
Absent – 0 Paternal -1 Maternal – 2 Paternal & Maternal – 4
Nature of Work – NOW
Sedentary work – 1 Mild Work – 2 Moderate Manual Work– 3 Hard Manual Work – 4
Exercise – Ex
No Exercise – 0 Does Exercise – 1
Diet – D
Vegetarian – 1 Mixed – 2
Hours of Day Sleep – HODS
Hours of Night Sleep – HONS
Habits – H
None – 0 Tea – 1 Coffee– 2 Smoking – 3 Alcohol – 4 Tea & Coffee– 5 All above – 6
Prakruthi – Pr
VataPitta – 1 VataKapha – 2 PittaKapha – 3
Fresh/Treared Fresh-1 Treated-2
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2DM”
Dr.Ramesh Kumar. K.L 2
Polyphagia-PP
Normal-0 Mild-1 Excess-3 Moderate-2
Burning foot &Palm-BFP No Burning sensation -0 Mild -1 Severe -3 Moderate -2 Urine sugar Nil- 0 2.5%- 5 1%- 2 1.5%- 3 2%- 4 O.5%- 1
Over all result Very good improvement-1 Very poor improvemenet Poor improvement-3 Mild improvement-2
Sara - Sa
Samhanan - Sam
Satmya - Sat
Sattva – Satt
Abhyavaharana – Abhy
Jarana – Jar
Vyayamashakti – Vy
Pravara – 1 Madhyama – 2 Aavara – 3
Polyuria: Polu urea-PU 0-3 times Normal-0 3-5 times-1 5-7 times-2 More than 7 times-3
Polydypsia-PD Normal-0 Mild-1 Excess-3 Moderate-2
Case no
OP No Age
Sex
Rel
Occu
Edu
M.S
SES
Loc
F.H
Fr/Tr
Chr Diet
NoW
Exc
HODS
HONS
Hab
Pra
Sara
Sam
Sat Satt
Ab.Sh
Jrn.Sh
Vym.S
Desha
1 25664 59 1 1 4 3 2 3 2 0 1 1 2 2 1 0 7 5 4 2 2 1 1 2 3 1 3
2 27889 49 2 1 1 4 2 3 2 2 1 1 1 2 1 1 7 1 4 1 2 3 1 2 2 3 3
3 28475 46 2 1 1 0 2 0 1 0 1 1 2 3 0 0 6 1 6 2 2 2 3 2 2 2 3
4 28663 54 2 1 1 3 2 2 2 1 1 1 1 2 1 1 6 0 6 2 2 2 1 2 2 2 3
5 4143 55 1 1 4 5 2 2 1 0 1 1 2 2 1 1 6 4 4 2 2 3 2 2 3 3 3
6 6745 56 1 1 6 3 2 2 1 0 1 1 2 2 1 0 6 5 4 2 2 2 2 2 2 2 3
7 9565 49 1 1 5 2 2 2 2 2 1 1 2 3 1 0 6 4 4 2 2 2 2 2 2 2 3
8 10575 58 1 1 7 3 2 2 2 0 1 1 1 2 1 0 8 5 6 2 2 2 2 1 2 2 3
9 11748 37 1 1 6 4 2 2 2 1 1 1 1 2 1 0 6 1 4 2 2 2 2 2 2 2 3
10 11960 50 2 1 7 4 2 2 2 0 1 1 2 2 1 0 7 1 5 3 3 3 3 2 2 2 3
11 13407 59 1 1 7 3 2 1 2 0 1 1 2 2 1 0 7 6 5 3 3 3 3 3 2 3 3
12 14635 32 1 1 6 4 2 2 1 2 1 1 1 2 0 0 6 5 5 1 2 2 2 2 2 3 3
13 12101 51 1 1 5 2 2 1 1 0 1 1 2 3 1 0 6 5 4 2 2 2 2 2 2 2 3
14 15984 60 1 1 6 3 2 2 2 0 1 1 1 1 1 0 6 5 4 2 2 2 2 2 2 2 3
15 16003 60 1 1 2 2 2 2 2 0 1 1 2 2 1 1 6 6 4 2 2 2 2 2 2 2 3
16 16037 48 1 1 6 4 2 2 2 0 1 1 2 3 1 3 5 5 4 2 2 2 2 2 2 2 3
17 16030 39 1 1 8 3 2 1 1 1 1 1 1 3 1 0 6 5 4 2 2 2 2 2 2 2 3
18 15980 45 1 1 8 2 2 1 2 1 1 1 1 2 1 3 6 5 4 2 2 2 2 2 2 2 3
19 15981 49 1 1 7 2 2 1 2 2 1 1 2 3 1 1 6 4 4 2 2 2 2 2 2 2 3
20 15982 49 1 1 8 2 2 2 2 0 1 1 2 3 1 1 7 6 4 1 2 2 3 1 1 2 3
21 16158 60 1 1 2 4 2 2 2 0 1 1 1 3 1 1 7 5 6 2 1 3 3 2 2 2 3
22 16149 46 1 1 6 4 2 2 2 0 1 1 1 2 0 1 7 5 4 2 2 2 2 2 3 2 3
23 17894 33 2 2 1 3 2 1 2 1 1 1 2 2 1 3 7 5 4 1 2 2 2 1 2 3 3
24 17896 39 2 2 4 3 2 2 2 2 1 1 2 2 1 1 6 5 4 2 2 2 3 2 2 3
25 17897 55 2 2 1 1 2 1 2 0 1 1 2 2 0 1 7 5 4 2 2 2 2 2 2 3 3
26 17898 41 2 2 1 2 2 1 2 2 1 1 2 2 0 1 6 5 4 2 2 2 2 2 2 2 3
27 19337 60 1 1 2 4 2 2 2 0 1 1 2 2 1 1 5 5 5 2 2 2 2 1 1 2 3
28 20072 60 1 1 3 0 2 2 1 0 1 1 2 3 0 0 7 6 4 2 2 2 3 1 1 2 3
29 20073 55 2 1 1 0 2 2 1 0 1 1 2 2 0 0 6 5 5 2 3 3 3 2 3 3 3
30 21951 50 1 1 8 1 2 1 2 0 1 1 2 3 0 0 6 6 5 2 2 2 2 1 2 2 3
Polyurea Poly phagia Polydipsia BFP FBS PPBS Urine Sugar FR
0 14 30 60 0 14 30 60 0 14 30 60 0 14 30 60 0 14 30 60 0 14 30 60 0 14 30 60
1 2 2 2 3 2 1 1 2 2 2 1 2 0 0 0 0 126 108 115 120 180 135 158 170 0 0 0 0 2
2 3 2 2 2 2 1 2 2 3 2 1 2 1 0 0 0 148 131 120 117 189 174 153 158 1 0 0 0 2
3 2 2 1 3 2 2 2 3 1 1 1 2 0 0 0 0 134 123 111 118 156 144 150 154 1 0 0 0 3
4 3 2 2 3 2 1 2 2 1 1 1 2 0 0 0 0 128 132 118 115 160 166 136 141 2
5 1 2 1 2 1 2 1 2 1 2 1 2 0 0 0 0 128 120 126 138 164 150 144 158 0 0 0 0 3
6 3 2 2 2 2 2 3 3 2 2 2 2 0 0 0 0 104 114 108 126 156 144 138 162 0 0 0 0 3
7 3 2 2 2 2 2 2 2 2 2 2 2 0 0 0 0 130 116 128 121 165 160 143 151 0 0 0 0 2
8 2 2 2 2 2 1 1 1 1 1 1 1 0 0 0 0 123 134 119 127 167 154 143 158 0 0 0 0 3
9 2 2 1 2 2 2 2 3 2 2 2 2 0 0 0 0 134 126 134 128 170 162 165 170 0 0 0 0 3
10 3 3 3 3 2 1 2 2 2 2 1 2 0 0 0 1 138 96 128 136 170 148 144 168 0 0 0 1 3
11 2 2 2 2 1 1 1 1 1 1 1 1 0 0 0 0 118 132 117 163 153 159 145 171 0 0 0 0 4
12 2 2 2 2 1 1 1 1 2 1 1 1 0 0 0 0 140 128 119 162 172 166 170 146 0 0 0 0 4
13 1 1 1 1 2 1 1 2 1 1 1 1 0 0 0 0 103 116 131 158 161 138 155 170 0 0 0 0 4
14 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 0 132 126 123 160 180 154 136 145 0 0 0 0 4
15 3 2 2 3 2 2 2 2 2 2 2 2 1 0 0 0 146 140 134 156 176 162 158 182 1 0 0 1 4
16 2 2 2 2 1 1 1 1 1 1 1 1 0 0 0 0 124 126 118 116 142 154 136 146 0 0 0 0 2
17 1 2 2 2 1 1 1 1 1 1 1 1 0 0 0 0 140 128 135 144 168 144 238 176 0 0 0 1 4
18 2 2 2 2 1 1 1 1 1 1 1 1 0 0 0 0 136 108 112 134 172 166 142 160 0 0 0 0 3
19 1 2 2 2 1 1 1 2 1 1 1 2 0 0 0 0 131 108 119 140 159 132 140 168 0 0 0 0 4
20 3 2 2 2 2 2 2 2 2 2 2 2 1 0 1 1 144 132 138 148 181 162 174 178 1 0 0 1 4
21 2 2 2 2 1 1 1 1 1 1 1 2 0 0 0 0 128 139 111 134 158 165 143 152 0 0 0 0 4
22 1 1 2 2 2 2 2 2 1 1 1 1 0 0 0 0 100 124 131 128 172 169 156 164 0 0 0 0 3
23 2 2 2 2 2 1 1 2 1 1 1 1 0 0 0 0 129 131 109 136 164 158 130 153 0 0 0 0 3
24 2 2 1 2 1 1 1 1 1 2 1 2 0 0 0 0 124 129 114 134 156 148 132 154 0 0 0 0 3
25 1 1 2 2 2 2 2 2 1 1 1 1 0 0 0 0 121 128 118 132 153 162 146 148 0 0 0 0 3
26 3 2 3 3 2 2 2 2 3 2 3 3 1 0 1 1 134 116 128 136 153 138 160 174 0 0 0 1 4
27 1 1 1 1 1 1 1 1 2 1 1 2 0 0 0 0 127 116 108 126 161 134 130 158 0 0 0 0 2
28 3 2 2 2 3 2 2 2 2 2 2 2 1 0 0 1 146 138 130 156 186 171 168 160 1 0 0 1 4
29 2 2 1 2 2 2 2 2 2 2 2 2 0 0 0 1 136 131 117 146 174 161 143 158 1 0 0 0 4
30 3 2 3 3 2 2 2 2 3 2 2 3 1 0 0 1 130 118 124 138 164 153 160 166 0 0 0 0 3
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar i
PROFORMA OF CASE STUDY OF
A CONCEPTUAL STUDY ON PATHYA IN MADHUMEHA WITH SPECIAL REFERENCE TO TYPE-2 DIABETES
MELLITUS
Head of the Department : Dr. G.N.Shakunthala
Guide : Dr. K. Naseema Akhthar
Co-guide : Dr. K. S. Shantharam
Researcher : Dr. K. L. Ramesh Kumar
PART – A
HISTORY AND EXAMINATION
Sl.No:
Name : O. P. No.:
Age : I. P. No.:
Sex : Date of commencement:
Religion : Date of completion :
Occupation :
Marital status :
Married ( ) Unmarried ( ) Widow ( ) Widower ( )
Educational :
Socio-Economic Status:
High ( ) Middle ( ) BPL ( )
Address : Ph:
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar ii
Pradhana Vedana:
Known case of Diabetes Mellitus Avadhi (Duration)
General symptoms
Polydypsia Yes/No Avadhi (Duration)
Polyurea Yes/No Avadhi (Duration)
Polyphagia Yes/No Avadhi (Duration)
Weight Loss Yes/No kgs Avadhi (Duration)
Weight gain Yes/No kgs Avadhi (Duration)
Any other specify with duration: Anubandhi Vedana:
a. Trishna ( ) Avadhi (Duration) b. Atisweda ( ) Avadhi (Duration)
c. Angagandha ( ) Avadhi (Duration)
d. Keshanakhativriddha ( ) Avadhi (Duration)
e. Angamaduryata ( ) Avadhi (Duration)
f. Sheetapriyatva ( ) Avadhi (Duration)
g. Any other ( ) Specify with duration:
Poorva Vyadhi Vrittanta:
Known case of Diabetes Mellitus ( ) Avadhi (Duration)
History of Asthma ( ), HTN ( ), Epilepsy ( ) Any other diseases:
Specify :
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar iii
Vayaktika Vrittanta:
a. Ahara - Veg/ non-veg
Particular type of food- -
Predominantly used
Any change in food habit -
If so reason and duration -
b. Nidra: Night : hours/day Sound sleep ( ) Disturbed
sleep ( )
Diwaswapna : hours/day Sound sleep ( ) Disturbed
sleep ( )
c. Shareera bhara: Weight gain: Spontaneous ( ) Duration
Gradual ( ) Duration
Weight loss: Spontaneous ( ) Duration
Gradual ( ) Duration
d. Desha:
At Birth: Jangala ( ) Anoopa ( ) Sadharana( )
Presently Residing at: Jangala ( ) Anoopa ( ) Sadharana( )
Vyadhi at: Jangala ( ) Anoopa ( ) Sadharana( )
e. Vritti: Nature of work: Period: hrs/day Annual income:
Physical worker ( )
Farmer ( )
Office work ( )
Teacher ( )
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar iv
Business ( )
Any change in occupation: Yes/No
If Yes, Duration:
f. Vyayama: Yes/No
If Yes, Nature of vyayama: Duration hrs/day
Yoga ( )
Walking ( )
Jogging ( )
Aerobics ( )
Gym ( )
g. Vyasana: i. Alcohol: ( )
Type: Beer ( ), Vodka ( ) Brandy ( ) Whisky ( ) Rum ( ) Arrack ( ) Toddy ( )
Quantity: ml/day Age when started: Age when stopped:
ii. Smoking: Beedi ( ) /day Age when started:
Cigarette ( ) Age when stopped:
iii. Tobacco ( )
iv. Betel leaves & nuts ( )
v. Gutka ( )
h. Arthava & Prasava Vrittanta:
G ( ) P ( ) D ( ) A ( ) L ( )
Age of menarche: Age of Menopause:
Kulavrittanta:
a. Any member in family suffering from Diabetes mellitus: Yes/No
b. Type ( )
c. If Yes, relation with the patient:
d. Duration:
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar v
Chikitsa Vrittanta:
Any previous treatment for Madhumeha?
Ayurveda: Homeopathy:
Allopathic: Oral hypoglycemic Agents ( )
Insulin ( ) units/day any other:
II. Rogi pareeksha:
Samanya pareeksha:
Akriti : krisha ( ) Madhyama ( ) Sthoola ( )
Upachaya: Pravara ( ) Madhyama ( ) Avara ( )
Pramana Ht……..cm’s, weight………..kgs
Varna Prakrita ( ), Vikrita ( ) specify:
Naadi: ……./min, V ( ), P ( ), K ( ), VP ( ), VK ( ), PK ( )
Shwasagati………/min
Dehoshma…….F
Twacha: Colour:…………… Pigmentation: , Eruptions:
Jihwa: Lipta ( ) / Alipta ( )
Drik: Prakrita( ) / Vikrita ( )
Nakha: Prakrita ( ) Ativriddha ( ) Anyother:
B P: ………mm of hg
Lymphadenopathy:
Oedema: Absent ( ), General ( ), Facial ( ),Limb- pitting ( ), Non-pitting ( )
Other finding:
Dashavidha pareeksha
a) Prakruti : Shareera: V / P / K / VP /VK / PK Manasika: Pravara / Madhyama / Avara
b) Sara: Pravara / Madhyama / Avara c) Satmya: Pravara / Madhyama / Avara
d) Satwa: Pravara / Madhyama / Avara e) Samhanana: Pravara / Madhyama / Avara f) Aharashakti: Abhyavarana shakti: Pravara / Madhyama / Avara
Jarana shakti: Pravara / Madhyama / Avara
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar vi
g) Vyayama shakti: Pravara / Madhyama / Avara h) Pramana: Pravara / Madhyama / Avara
i) Vayatah
j) Desha: Anupa ( )/ Jangala ( ) / Sadharana ( ) Vishesha Pareeksha (Systemic Examinations):
a) Cardio- Vascular System:
b) Respiratory System:
c) Gastro Intestinal System:
d) Central Nervous System:
Specific enquiry in the following heads:
Mootra:
a) Frequency: Day Night
b) Quantity: Below1000ml ( ) 1000- 1500ml( ) more than 1500ml( )
c) Varna: At Beginning: At End:
d) Turbidity:
e) Approximate quantity in 24 hours:
f) Any other:
Malapravritti:
a) Frequency:
b) Consistency:
c) Colour:
d) Constipated:
e) Any other:
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar vii
Trishna: Ati ( ) Alpa ( ) Samyak ( )
Approximate fluid intake per day:
Laboratory Investigations:
a) Urine: Sugar: b) Blood: Hb:
Albumin: FBS:
Micro: PPBS:
Any other: Any other (if done):
PART – B - INTERPRETATION
Single group of 30 Known case of Type-2 Diabetes mellitus patients aged between 30- 60 yrs of either sex will be selected. Madhumeha pathya (Diabetic diet) i.e. strict diet regimen will be given for 30 days to single group of Known case of Type-2 Diabetes mellitus patients aged between 30- 60 yrs of either sex will be selected. (Diet module enclosed) Pathyapathya: Module enclosed.
PART – C – OBSERVATIONS AND ASSESSMENTS
ASSESSEMENT
For the assessment of the management following parameters were considered & they were graded and scores are given as follows; assessment will be done on 7th, 14th, 21st, 31st days.
Polyurea---- PU 0 0 to 1 times (normal nocturnal Micturation)
PU 1 2 to 3 times
PU 2 4 to 5 times
PU3 more than 5 times
Polydypsia--- PD 0 Normal
PD 1 Mild
PD 2 Moderate
PD3 Excess
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar viii
Polyphagia---- PP 0 Normal appetite
PP 1 Mild (can tolerate appetite up to one hour)
PP 2 Moderate (can tolerate appetite up to three hour)
PP3 Excess (cannot tolerate appetite)
Burning feet -- BFP 0 No burning sensation
& palm BFP 1 Mild
BFP 2 Moderate
BFP3 Severe
Observations:
Subjective Before 7th Day 14th Day 21st Day 31st Day
Polydypsia
Polyurea
Polyphagia
Burning feet & palm
Objective Before 7th Day 14th Day 21st Day 31st Day
FBS
PPBS
Urine Sugar
Signature of the Researcher Signature of the Co- Guide
Signature of the Guide Signature of the HOD
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar ix
Diabetic diet menu chart
DIABETIC DIET CHART
DAY-1
Patient:
Age:
N
o
t
e
:
F
o
r
The Preparations of Roti, Dosa, Raagi ball the following millets are to be taken in equal
proportion and Make it Atta powder (flour). Millets: Raagi(finger millet), Navane( wild
rice), Kambina akki ( fox tail millet), Syame akki ( Barnyard millet)
Time
Diet / Recipes
1
Morning :7.00-7.30 AM
Raagi Ganji/ Amblee: 200 ml ( Raagi atta+Onion+ pinch salt)
2
Breakfast:8.00- 9.00 AM
Wheat Upma – 200 gm, ( Wheat Coarse powder+Onion+ Coriander Leaves+ Curry leaves) Raw Cucumber pieces
3
Mid After noon:11.30 – 12.00
Elephant apple juice( Beleda hannina panaka) (Elephant apple, Cardamom, pepper)
4
Lunch: 1.00 - 1.30 PM
Chapathi ( Wheat+ Barley) 2 no, Vegetable+ Pulses sambar, Leafy vegetable Curry ½ Bowl old cooked rice
5
Evening Snacks :5 .00- 5.30 PM
Ginger Tea 1cup( Sugar less) Wheat buiscuts( sugar free) 2 no
6
Dinner : 8.00 – 8.30 PM
Raagi Ball (medium size) 1 no Vegetable+ Pulses sambar, Leafy vegetable Curry ½ Bowl old cooked rice
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar x
DIABETIC DIET CHART
DAY-2
Patient name:
Age:
Note: For The Preparations of Roti, Dosa, Raagi ball the following millets are to be taken
in equal proportion and Make it Atta powder (flour). Millets: Raagi(finger millet),
Navane( wild rice), Kambina akki ( fox tail millet), Syame akki ( Barnyard millet).
Time
Diet / Recipes
1
Morning : 7.00 -7.30 AM
Oat soup 200 ml (Oats, Green gram, pepper, pinch of salt)
2
Breakfast : 8 .00- 9.00 AM
Raagi rotti 2 no (Raagi flour, onion, pinch salt, coriander leaves) Onion Chutney
3
Mid After noon :11.30 – 12.00
Churned Butter milk ( fat less) (Butter milk, ginger, garlic, onion, coriander leaves)
4
Lunch: 1.00 - 1.30 PM
Roti 2 no Cucumber salad ( kosambari) Leafy vegetable curry, vegetable + Pulses sambar ½ Bowl old cooked rice
5
Evening Snacks:5.00 - 5.30 PM
Corn soup 200ml (corn flakes, onion, garlic, pepper, pinch of salt)
6
Dinner : 8 .00– 8.30 PM
Raagi Ball (medium size) 1 no Vegetable+ Pulses sambar, Leafy vegetable Curry ½ Bowl old cooked rice
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar xi
DIABETIC DIET CHART
DAY-3
Patient name:
Age:
Note: For The Preparations of Roti, Dosa, Raagi ball the following millets are to be taken
in equal proportion and Make it Atta powder (flour). Millets: Raagi(finger millet),
Navane( wild rice), Kambina akki ( fox tail millet), Syame akki ( Barnyard millet).
Time
Diet / Recipes
1
Morning : 7.00-7.30 AM
Bitter guard soup ( Bitter gourd,moong dal, Onion, Pepper, pinch of salt)
2
Breakfast: 8.00 - 9.00 AM
Barley Pongal ( Barley, moong dal, ginger, pepper, pinch of salt)
3
Mid After noon:11.30 – 12.00
Lemon juice ( Lemon, pepper, Ginger, pinch of salt)
4
Lunch: 1.00 - 1.30 PM
Raagi Ball (medium size) 1 no Vegetable+ Pulses sambar, Leafy vegetable Curry ½ Bowl old cooked rice
5
Evening Snacks:5.00 - 5.30 PM
Raagi amblee-200ml
6
Dinner : 8.00 – 8.30 PM
Chapathi ( Wheat+barley) 2 no Vegetable curry Leafy vegetable + Pulses sambar ½ Bowl old cooked rice
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar xii
DIABETIC DIET CHART
DAY-4 Patient name:
Age:
Not Note: For The Preparations of Roti, Dosa, Raagi ball the following millets are to be taken in equal proportion and Make it Atta powder (flour). Millets: Raagi(finger millet), Navane( wild rice), Kambina akki ( fox tail millet), Syame akki ( Barnyard millet).
Time
Diet / Recipes
1
Morning : 7.00 -7.30 AM
Barley soup ( Coarse powdered barley, Ginger, Pepper, pinch of salt)
2
Breakfast:8.00 - 9.00 AM
Dosa 2 no Horse gram chutney Leafy Vegetable curry
3
Mid After noon :11.30 – 12.00
Watermelon juice ( Watermelon, Cardamom, Pepper, Ginger)
4
Lunch : 1.00 - 1.30 PM
Roti 2 no Cucumber salad 1cup Leafy vegetable curry, Vegetable + Pulses sambar ½ Bowl old cooked rice
5
Evening Snacks :5.00 - 5.30 PM
Vegetable soup 200ml (Vegetables, Pepper, Ginger, Pinch of salt)
6
Dinner : 8.00 – 8.30 PM
Raagi Ball (medium size) 1 no Leafy vegetable Curry, Vegetable+ Pulses sambar, ½ Bowl old cooked rice
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar xiii
DIABETIC DIET CHART DAY-5
Patient name: Age:
Note: For The Preparations of Roti, Dosa, Raagi ball the following millets are to be taken in equal proportion and Make it Atta powder (flour). Millets: Raagi(finger millet), Navane( wild rice), Kambina akki ( fox tail millet), Syame akki ( Barnyard millet).
Time
Diet / Recipes
1
Morning : 7.00 -7.30 AM
Vegetable soup (Vegetables, Pepper, Ginger, Pinch of salt)
2
Breakfast : 8.00- 9.00 AM Barley upma ( Barley Coarse powder+Onion+ Coriander Leaves+ Curry leaves)
3
Mid Afternoon: 11.30 – 12.00
Cucumber salad ( kosambari)
4
Lunch : 1.00 - 1.30 PM
Chapathi (Barley+ Wheat) 2 no Vegetable curry Leafy vegetable + Pulses sambar ½ Bowl old cooked rice
5
Evening Snacks :5.00 - 5.30 PM
Moong dal soup ( moong dal, Ginger, Pepper, Pinch of salt)
6
Dinner : 8.00 – 8.30 PM
Raagi Ball (medium size) 1 no Vegetable+ Pulses sambar, Leafy vegetable Curry ½ Bowl old cooked rice
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar xiv
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“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar xv
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“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar xvi
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“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar xvii
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“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr.Ramesh Kumar xviii
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“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr. Ramesh Kumar. K.L 1
BIBLIOGRAPHY
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Maharashtra rajya sahitya and Samskrita mandal, 1968, PP:472.
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Varanasi, The Choukamba prakashana, 1967, PP: 258
13. Williams M.M, Sanskrit-English Dictionary, Varanasi, Motilal Banarsidass,
Reprinted 1990, PP: 122.
“A Conceptual study on Pathya in Madhumeha with special reference to Type-2 DM”
Dr. Ramesh Kumar. K.L 2
14. Shree.Y.B. Nandana, Bouddha nityacharana’s, Buddha vachana trust, Bangalore,
Printed at The corporate Body of the Buddha Educational Foundation, Tai pei,
Taiwan, 2004, PP: 35.
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PART-3
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