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Treatment of Alpa-Artava –
Acharya Sushruta has devoted one chapter to emphasize the importance of ‗Shuddha-Artava, known as ‗Shukra-Shonita Shuddhi Sharir‘. He has categorically mentioned in this chapter that the remedy described for the treatment of ‗Nashta-Artava‘ is also applicable to the treatment of ‗Kshina-Artava‘ or ‗Alpa-Artava‘. He has described certain principles for the treatment of ‗Nashta- Artava‘. The principles laid down by him are as follows
(1) Sanshodhana therapy. (2) The use of Agneya dravyas.
(3) Maharshi Sushruta has advised treatment for ‗Alpa-Artava‘ similar to ‗Nashtaraktavata‘. (4) The use of Swayoni dravyas i.e. having the same qualities on the basis of dravyas‘ gunas and karmas. Acharya Sushruta has mentioned certain dravyas for the oral use viz. fish, tila, masha, sura, mutra (cow's), udashchita, curd, chukra or shukta. etc. In Bhava Prakasha the same type of dravyas have been described. Ashtangasangrahakar has advised Pittavruddhikar ahar. Acharya Kashayapa suggested use of Lasuna, Shatavari and Shatapushpa in the disorders of Artava .
Different Acharyas have mentioned the following drugs for the treatment of Alpa-artava for oral use.
Oral Use :
1) In Yogaratnakara, the following drugs in the form of decoction for the remedy of ‗Anartava‘ as well as ‗Alpartava ‗have been described. Krishna Tila, Sailu, Karavi, and Guda(Jaggery) in the form of decoction for oral use.
2) By Vagbhatta, the oral use of Jivaniya gana dravyas with milk has been mentioned. 3) According to Charaka, in condition of amenorrheoea, the blood of deer, goat, sheep or
the hog should be drunk mixed with curd, juice of acidic fruits or ghee or the milk prepared with the life promoter group of drugs may be taken.
4) Avaleha, or Kanji, Japapuspa, Jyotishmati dalam and durva has been mentioned by Govindadasa. He has also mentioned certain other recipes which run as follows: 5) Sitakalyanak Ghrita
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8) Kumar Kalyana Ghrita 9) Nashtapuspantaka rasa
10) Shatapuspa kalpa has been mentioned by Maharishi Kashyapa
11) In Ayurvigyan, the use of drug named Kumari has been mentioned in anartava.
Yoni Varti – in Bhava Prakasa and Yoga Ratnakara, the following drugs in the form of ‗Yoni Varti‘ have been described – Danti, Chapala, Ikswaku, Madanaphala, Kinwa, Yavsuka and Snuk Kshira. All these drugs perform the samsodhana action.
Uttar-Basti – The decoction of Kasmari and Kutaja as a vaginal douche is beneficial in ‗Arajaska Yoni Vyapada‘ (Amenorrhoea) according to Charak
Discussion-
The niddan-panchak of Artava-kshaya helps in the diagnosis and to treat it. Samprapti-ghatak imparting in disease pathogenesis, also help to breakdown pathogenesis. Ayurved- science gives new approach to the etiological factors and also provides other treatment remeady than hormones itself.
Conclusion-
Conceptual study of Artava-kshaya helps to diagnosis Vandhyatva-Hetu. Its Nidan-panchak study is beneficial to treat Artava-kshaya as vyadhi which is one of complex etiological factor of Vandhyatva. Treating Artava-kshaya also helps to treat Vandhyatva and its vicious process References-
1. Vaidya Yadavaji Trikamaji Acharya, Dr. Gangasahaya Pandeya, editor. The Charaka Samhita of Agnivesha revised by Charaka and Drudhabala with the Ayurved –Dipika Commentary of Chakrapanidatta and with Vidyotini Hindi commentary by Pt.Kashinath Shashtri and introduced by Acharya Priyavrata Sharma Part-I, 7th edition. Chaukhambha Sanskrit Sansthan, Varanasi: Chaukhambha Publications; 2002.
2. Vaidya Yadavaji Trikamaji Acharya, Dr. Gangasahaya Pandeya, editor. The Charaka Samhita of Agnivesha revised by Charaka and Drudhabala with the Ayurved –Dipika Commentary of Chakrapanidatta and with Vidyotini Hindi commentary by
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4. Maharshi Sushruta, Kaviraja Ambikadutta Shastri, editor. Sushruta Samhita edited with Ayurved- Tattva-Sandipika Hindi Commentary and forwarded by Dr.Pranajivana Manekchanda Mehta Part-II (Uttaratantra), 17th edition. Chaukhambha Sanskrit Sansthan, Varanasi: Chaukhambha Publications; 2003.
5. Dr. Ganesh Krushna Garde, Sartha Vagbhata Introduced by Prof. Subhash Ranade and Dr. S. S. Vaidya. 6th edition. Pune: M.D.Nandurkar, Anamol Prakashana; 2003.
6. Nepal Rajaguru Pandit Hemaraja Sharma, The Kashyapa Samhita OR Vruddhajivakiya Tantra by Vruddha Jivaka revised by Vatsya with Sanskrut Introduction and with Hindi Translation of Sanskrit Introduction by Ayurvedalankar Shrisatyapala Bhishagacharya. 7th edition. Chaukhambha Sanskrit Sansthan, Varanasi: Chaukhambha Publications, New Delhi; 2000.
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8. Prof. (Km.) Premavati Tewari, Ayurvediya Prasutitantra Evam Striroga Part-II Striroga (Gynaecology). 2nd edition. Chaukhambha Orientalia, Varanasi: Chaukhambha Orientalia, Golghar, Varanasi; 2000.
9. Miss. Jayashree D. Korante, Artavakshaya- Ek Adhyayana (M.D. Dissertation). Anandabava Chaklo, Sarvoday Book-Binding Works, Book Binder, Jamnagar: Gujarat Ayurved University, Jamnagar; 1976.
10. Vd. Anuja P. Taware, Exploratory Study of Kulattha Siddha Taila Matrabasti In Artavakshaya (M.D. Dissertation). M.A.M.‘s S.S.A.M.Pune:M.U.H.S.; 2017.
11. Neeraja Bhatala, Jeffcoate‘s Principles Of Gynaecology International Edition Revised and Updated. 6th edition. 338 Euston Road,London NW1 3BH: Arnold A Member of the Hodder Grpoup; 2001.
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edition.4596/1-A,11 Darya Ganj, New Delhi-110002:Satish Kumar Jain For CBS Publishers & Distributers; 2000.
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14. Shri. Madhavakara, Madhavanidanam with The Madhukosha Sanskrit Commentary by Shrivijayarakshita and Shrikanthadatta with The Vidyotini Hindi Commentary and Notes by Shri. Sudarshana Shastri. Prof. Yadunandana Upadhyaya Part-I, II. 21st edition. Gopal Mandir Lane, Varanasi-221001: Chaukhamba Sanskrit Sansthan; 1993. 15. Kaviraj Nagendra Natha Sena, Vaidyaka-Shabdasindhuh. Revised and Enlarged2nd edition by Kaviraja Nagendra Natha Sena editior. 5th edition. Golghar, Varanasi- I:Chowkhamba Orientalia, A House of Oriental andAntiquarian Books Varanasi;2005.
16. Vaidya Jayamini Pandey editor and translator, Harita Samhita text with Nirmala Hindi commentary.Gopal Mandir Lane Varanasi-221001: Chaukhambha Visvabharati Oriental Publishers and distributors; Va2010.
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Available from http://Shodhaganga.inflibnet.ac.in
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(DIABETES MELLITUS)
Dr. Pawankumar Godatwar
Professor, PG Dept of Roga Nidana, National Institute of Ayurveda, Jaipur
According to ICMR-INDIAB study the prevalence of diabetes is reported to be as high as 13.6% in Chandigarh to 5.3% in Jharkhand.i The risk factors for diabetes identified in this study are age, male sex, family history of diabetes, urban residence, abdominal obesity, generalized obesity, hypertension and socio-economic status. In other words this epidemic of diabetes is related to increasing body fat, particularly the central fat due to life-style factors inherent in urbanization in genetically predisposed individuals.
Indians when compared to Caucasians and African Americans were found to have higher percentage body fat (particularly visceral fat), high insulin resistance and relatively lower body mass index (so called ―lean fat phenotype‖).ii, iii, iv
In recent studies, it was found that diabetics belonging to Jaipur have typical ―lean-sick fat phenotype‖ characterized by comparable, BMI, overall body composition on DEXA, excepting lower fat mass in limbs and high Insulin resistance, therefore suggesting qualitative adipose tissue defects.v
‗Adiposopathy‘ (adipose-opathy) is a term used to describe the adverse anatomical and pathophysiologic consequences of pathogenic adipose tissue. The term adiposopathy can be translated as representing ‗sick fat‘. These terms and this approach emphasize that adipose tissue has as much pathogenic potential to result in ill health as the pathologic dysfunction of other body tissues. Thus, ‗adiposopathy‘ represents a ‗disease‘ similar to other organopathies.vi Adiposopathy seems to be a conceptual translation of Medo-dushti (Ca. Su. 21/2-4).vii
The current epidemic of diabetes in India is the tip of iceberg and the problem of Medodushti (adiposopathy) is much larger in magnitude. As Medodushti (adiposopathy) is a chronic phenomenon, its early recognition and treatment with life-style modification, which include Ayurvedic diet, medicines and lifestyle measures and practice of yoga, can significantly reduce the burden of not only Medodushti but also the consequent burdens of diabetes mellitus and atherosclerotic vascular disease.viii, ix
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iPrevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired
glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research–INdiaDIABetes (ICMR–INDIAB) study: ;Diabetologia (2011) 54:3022–3027
ii McKeigue PM, Shah B, Marmot MG. Relation of central obesity and insulin
resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet 1991; 337: 382.
iii Mohan V, Sharp PS, Cloke HR, Burrin JM, Schumer B, Kohner EM. Serum
immunoreactive insulin responses to a glucose load in Asian Indian and European type 2 (non-insulin-dependent) diabetic patients and control subjects. Diabetologia. 1986; 29: 235-237
iv Abate N, Chandalia M, Snell PG and Grundy SM. Adipose Tissue Metabolites and
Insulin Resistance in Nondiabetic Asian Indian Men. J. ClinEndocrinol Meta2004; 89 (6): 2750-2755.
v Sandeep Kumar Mathur, Poonam Punjabi, Nitish Mathur, Deepak Kumar Gupta,
Prashant Mathur, JyotiThanvi and Rati Mathur. A study of body composition in North Indian type-2 DM patients by DEXA and it's relation with insulin resistance. Endo-13 san Francisco poster: Mon - 859.
vi Bays HE, González-Campoy JM, Henry , Bergman DA, Kitabchi AE, Schorr AB,
Rodbar HW. Is adiposopathy (sick fat) an endocrine disease? Int J ClinPract. 2008; 62(10): 1474–1483. viiतस्य ह्यततमािमेदन्स्ळनो [२] मेद एळोऩिीयते न तथेतरे धातळ् , तस्मादस्यायुवो ह्राश्; ऴैचथल्यात् शौिुमायामद्गुरुत्ळा्ि मेदशो जळोऩरोध् [३] ऴुक्रािषुत्ळान्मेदशाऽऽळृतमागमत्ळा्ि िृ्रव्यळायता , दौिमल्यमशमत्ळाद्धातूनां, दौगमन्ध्यं मेदोदोवान्मेदश् स्ळर्ाळात् स्ळेदनत्ळा्ि , मेदश् श्चऱेष्ट्मशंशगामद्वळष्ट्यन्न्दत्ळाद्िषुत्ळाद्गुरुत्ळाद्व्यायामाशषत्ळा्ि स्ळेदािाध् , तीक्ष्णान्ग्नत्ळात् प्रर्ूतिोष्ट्िळायुत्ळा्ि सुदततमािं वऩऩाशाततयोगश्चिेतत||४|| (Ca. su. 21/2-4)
viii Iyer A, Panchal S, Poudyal H, Brown L. Potential benefits of Indian spices in
symptoms of metabolic syndrome: A review. Indian J BiochemBiophys. 2009 Dec;46(6):467-81
ix A systematic review on yoga : Journal of American Board of Family Practitioners