A Compendious Study on Santarpanotta Vikara vis-a-vis to Metabolic Diseases

INTRODUCTION

Ayurveda gives foremost importance to the concept of Trayopasthambha. Which areAhara, Nidra & Bramhacharya these become essentials for individual health¹ . Ahara is the most important factor for substance of life. According to acharya Kashyapa, ahara is considered as the Mahabhaishajya² . For the transformation of ahara into Dhatus the agniis the key factor³ . Agni (Jatharagni, Bhutagni & Dhatwagni) plays an important role in all the Metabolic activities. When there is any impairment in functions of agniit leads to the formation of ama.⁴

Ama is usually conjugated with doshas & dhatus⁵ . As ama accumulates in the body, it clogs the channels of the body & disrupts tissue nutrition. This ama can disturb physiologoical process at the cellular level as well. Whenamafinds its way into deeper tissues, it clogs the individual membranes inhibiting cellular communication & weakening of the immune response So that, the diseases which are originated from the improper metabolism of food are broadly categorized under the Santarpanavikaras. And these can be compared with the Metabolic syndrome/ Diseases.

The varied and complex process involved in utilization andstorage of macros and micronutrients either assimilatedfrom diet or metabolites, generated de novo as well as eliminationof undesirable by-products by the organism is called as metabolism. Most of the metabolic disorders are consequent to defects atenzymatic levels, either intracellular or at plasma tissue interface. Metabolic disorders can be classified by mode of inheritance or by abnormal metabolites produced or deficiency on any specific protein or metabolite necessary for that particular metabolic event⁶ .

Definition : Santarpana the word meaning “San tarpayatisantarpanamacharati”i.e Gratifying or Satisfying the desires⁷ .

Nidana: Nidana includes the Excessive intake of Snigdha, Madhura, Guru, Pischilaaharasevana. Then over consumption of Navanna, Nootanamadira, anupa & Jaleeyamamsa, Gorasa, Guda, Pishta etc.. aharapadarthaswhichnourishesthedhatusexcessively⁸ . These all foods are having the predominance of the Prithvi & aapmahabhoota quality.

Excessive intake of Madhura rasa ahara does over nourishment of the body, as it increases the sthoulata, mardavata, alasya ,gouravata etc.. along with this it does the agnimandhyata. And also the madhuravipaka increases the Kapha⁹ . The functional property of Snigdhaguna is sneha, mruduta&ardata. It stimulateskapha & increases mala¹⁰ .

Viharadiwaspana, Shayyasana & avyayamaetc.. also leads to santarpanajanya vikaras¹¹ .

SAMPRAPTI

These all the above nidanas leads to formation of Aparipakwaamarsa & Tridoshaprakop. And gets lodges in the Rasadidhatus& takes sthanasamshraya in the amashaya. From there it spreads into respective srotas and leads to various vyadhis.

Some of the sampraptis have been mentioned which are listed under the heading of santarpanajanyavikara which are…

1. In Medoroga, Medasavrittavata is one of the samprapti. Which is explained in the context of the Astouninditiyaadhyaya of Acharya Charaka and Medorogaprakarana of Madhavanidana.

The first and fore most nidana is explained as the Atisampuranati.e excessive intake of food¹² . It is co related with the “medasavrittamargat wadvayuhukostevisheshataha” here, the increased medadhatu obstruct the pathways of the srotas¹³ . At this time the vataenters into thekoshta and ignite the agni. Along with this absorption of the food takes place. Therefore, the digestion of food takes place instantly. Thus, the person eats food again and again in more quantity. Like this if food habits are continued for long time which leads to many chronic conditions of the vata and pitta associated diseases. This vitiated agni along with vata increases inturn leads to many complications as like the increased agni destroy the whole forest. This condition can be co-related with the complication of the medoroga like pakshaghata, hridroga etc¹⁴ ..

Other than this aharas like guru, madhura, sheeta, snigdhaguna, viharas like avyayama, avyavaya, diwaswapna and manasikabhavas like achinta, ashoka etc.. Also the beejaswabhava of mata-pita also a causative factor for the medoroga.

The medoroga symptoms includes the Ashaktahasarvakarmasu, Gurugatrata, Atisweda, Atitrishna, Krichrashwasa, Alpamaithuna¹⁵ etc..

2. Prameha - As the causative factors for the Prameha are similar to that of the Santarpanaahara and viharas.

“Shlemapittam cha medaschamamsam cha atipravardhate |tairavratagatirvayorojaadaya gacchati”||¹⁶

The nidana factors leads to theKapha, Pitta, Meda and Mamsaativriddhi, this forms the avrittaof vayu. This prakupitavayu take out the oja to the mutrashaya and leads to Madhumeha.

The symptoms includes the Avilamutrata, Hastapadadaha, Gurugatrata, Tandra, Avasada¹⁷.

3. Raktagatavata - The vata along with raktadhatu leads to a condition called as Raktagatavata(Hypertension). Due to the nidanasevana,Sharirika&manasikatrido sha gets vitiated, leading to Kapha and medavriddhi&mana kshobha18. These dosha gets lodge in the dhamanis causing margavarodha, inturn leading to vataprakopa (vyanavata). This vyanavata combine with Rakta alters the raktasamhanana. This condition is called as Raktagatavata (Uccharaktachapa).

The symptoms includes the Padadaha,Twakshota, Shwayathu, Klama, Raktasrava& Spandana¹⁹.

Along with above diseases, pidaka, kotha, kandu, panduroga, mutrakrichra, aruchi, tandra, klaibhya, atisthoulya, alasya, gurugatrata, indriyapradoshajavikara, moha, pralapa like many disorders comes under the metabolic syndrome²⁰.

SAMPRAPTI GHATAKA :-

Dosha – Kapha predominant pitta&vata

Dushya- Rasa, Rakta, Mamsa, Meda, Majja, Shukra & Oja

Agni- Jatharagnimandhya

Srotas - Rasa, Rakta, Mamsa, Meda, Majja, Shukra

Srotodushti – Srotosanga, vimargagamana

Followed byAtipravritti

Udbhavasthana – Amashayotthavyadhi

Vyaktasthana– Sarvasharira /avayavavisesha

Sancharasthana – Sarvasharira

Swabhava- Chirakari

Sadhyasadhyata– Krichrasadhyavyadhi

CHIKITSA KRAMA

As Santarpanavikaaras are Bahudoshapradhanavyadhis, along with Shamana, Samshodhana are the necessary treatment modalities. In whichsamshodhana measures are most drastic effect in the metabolic syndrome.

For Santarapanajanyavyadhi, Apatarpana is the treatment modality. Apatarpana includes the Langhana, Swedana & Rukshana karmas.

For Medoroga the line of treatments²¹ are

1. As nidanaparivarjana is first line of treatment, the person should avoid vata, shleshmamedakaraahara & vihara.

2. Rooksha, Teekshna & ushnabasti like lekhanabasti are advised. Rookshaudwartana are indicated. As udwartanadoes the kaphamedapravilayana it helpful in the srotoshodhna & doshavilayana.

3. Guduchi, bhadramusta, triphala, takrarishta & madhu are prescribed. Administration of Vidanga, nagara, kshara, lohabhasma along with madhu can be given. Yava & amalakachurna can be given.

4. Administration of Bilwadipanchamoola along with madhu.

5. Administration of Agnimantha along with shilajatu.

Prameha: It has been explained that in Balavan & sthoolapramehi conditions the samshodhana is the main line of treatment. As prameha is a bahudoshajavyadhi, here mainly the pramanatahavriddhi of dosha & gunataha the combination of kapha & meda will occur. So that the shodhana (Langhana) is one of the treatment modality in the prameha²². It has been also explained that shodhana, Virookshanalekhana & langhana therapies are helpful treatment in the Kaphaja & Pittajaprameha²³. Asvamana karma is effective in pacifying symptoms like prabhutamutrata & avilamutrata, because both symptoms are mainly due to kaphaprakopa & abadha medas²⁴. In pittajapramehavirechana is best line of treatment. As karapadadaha, atisweda etc..arepitta predominant charactersticsvirechana is indicated. And than in madhumeha all dravadhatus gets lodges in the basti because of apana & vyanavigunata, Bastichikitsa is prime treatment modality here²⁵ .

In samprapti of prameha as it is bahudra vashleshma & abaddhameda are important. Among the dosha & dushyas, indicating excessive aapdhatu in the body. In this main line of treatment is Shoshana, that is done by rookshana. That is by pragadhaudwartana with triphaladichurna, kolakulatthadichurna etc²⁶ ..

Swedana does utkleshana & vilayana of doshas adhered to the dushya, but in pramehadoshas are already in utlhklishtaavastha,swedana is contraindicated. As it is necessary to give swedana before shodhana, it could be done by Nadisweda or seka.

Raktagatavata: In this condition advised to take laghu, supachya, sneharahita, lavanarahitaahara. The aharawhich does not increases the kapha&meda.

As samshodhana Lekhnabasti, virechana & raktamokshana are suggested with suitable drugs as langhana therapy²⁷ .

Nityavyayama, Jirnantebhojana, yavagodhuma bhojana etc. are recommended.

CONCLUSION

Modern life style can be treated as an indicator of social attitudes, as it has introduced many changes in the way of living. The tremendous development and innovation in all aspects of life in general and in field of technology in particular, which has made living much more comfortable on one side but on the other side, gifted many lifestyle related diseases. These disorders are included under the metabolic syndrome. The metabolic syndromes are having the nearer correlation with the pathology of the Ama & Avarana concept of Ayurveda. Ayurveda is having the unique and efficient treatment modalities in controlling these diseases. And prevent the further complications. Thus Ayurveda can improve the health and increases the longevity of patients with metabolic syndrome.