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Panchakarma Approach to Sthoul Pproach to Sthoulya INTERNATIONAL AYURVEDIC MEDICAL JOURNAL International Ayurvedic Medical Journal, (ISSN: 2320 5091) (September, 2017) 5(9) PANCHAKARMA APPROACH TO STHOULYA ShruthiS1, VinayKumar.K.N2, Swati.S.Deshpande3 1PG Scholar, 2Reader, Professor & HOD3, Dept. of PG Studies in Panchakarma, SKAMCH & RC, Bangalore, Karnataka, India Email:[email protected] ABSTRACT Obesity has become an important public health problem in industrialized countries throughout the world scenario and has acquired the status of an epidemic. Indiscriminate dietary habits, sedentary life styles, stress, lack of mental and physical exercise. Sthoulya can also occur due to Beejadosha i.e hereditary causes. In Western medical science Sthoulya can be compared to Obesity. It is chronic disease, prevalent in both developed and developing countries and affecting children as well as adults which can act as a root cause for several diseases. Sthoulya is a Santarpanajanyavikara and being counted under the eight varieties impediments which are designated as Astaninditapurusha. Ayurveda has given much more consideration for the treatment of obesity. The main line of treatment explained is Apatarpana. Sthoulya is being identified in the category of BahuDoshavastha, where the Panchakarma procedure for detoxification to clear Kapha-Medhara from the body and prevents its further accumulation. Keywords: Sthoulya, Panchakarma, Obesity, Diet INTRODUCTION Obesity is defined as an abnormal or excessive population. The prevalence of obesity has accumulation of fat in the body that which increased threefold within the last 20 years & pose a risk to health. Obesity has increased at it continues to rise. It is considered as a an alarming rate in recent years & has become lifestyle disorder in which a complex interplay one of the major health hazards globally. In of Genetic, Environmental & Psychological many countries 50% of the adults are factors play a major role, especially primary overweight. Obesity has reached epidemic obesity wherein no obvious cause exists other proportions in India in the 21st century with than an imbalance in energy intake & morbid obesity affecting 5% of the country’s expenditure such a disease which provides the Swati. S. Deshpande Et Al: Panchakarma Approach To Sthoulya platform for so many hazards like Hridroga, Vidhipradhana – adhyasana, Madhumeha, Vandhyatva, Klaibya, etc as well atisampoorna, Atimatraahara. as psychological disorders like stress, Ahara plays a major role in increasing depression, anxiety etc. So to say the mortality Medodhatu in Sthoulya. AcharyaSushruta and morbidity are more in obese person mentioned Sthoulya and Karshya depend compared to others. upon the quality and quantity of Ahara. 2) VIHARAJA – Sthoulya is a condition wherein there will be Avyayama, Avyavaya, Diwaswapna, Asana Ayatopachaya of shareera associated with Sukha, Bhojanotarasnana, abnormal increase in MedhaDhatu. Swapnaprasgnata, chetadwesha. Charakasamhita gives one of the best All the Vivartmakanidana indicates decreased definitions of Sthoulya as – physical activity, which aggravates the kapha “Medhomamsaativrudhatvatchalaspikudarast and leads toMeda deposition. Diwasapna hana having Abhishyandi property leads to blockage Ayathopachayautsahonaroatisthulauchyate.” of the micro channels of the body especially in The aetiological factors mainly vitiate Medovahasrotas. kaphadosha and MedaDhatu and Vata gets Avrita by excessive Meda. Thus if Apatarpaka 3) MANASIKA – Dravyas are used alone, it increases the Achinta, Harshanityatwa, Priyadarsana, vitiated Vata. Hence treatment should be Manasonivrutti, Saukhya. planned considering vitiated Vata, Meda and Acharya Charaka mentions that these factors Kapha. In Ayurveda, Panchakarma includes are Kapha aggravating and hence lead to Sodhana therapies and by this it cures the Meda Sanachaya. disease from its root, leaving no chance for recurrence. 4) BEEJA DOSHA NIDANA – Over nutrition particularly with NIDANA – MadhuraRasa during pregnancy is 1) AHARAJA – mentioned as a causative factor for birth of Gunapradhana- Guru, sheeta, pichila, obese child. Snigdha Rasapradhana – Madhura TYPES OF STHOULYA – Dravyapradhana- Navanna, navamadhya, According to Charaka – Sthula,Atisthula gramya rasa, gorasa, payavikara, According to Sushrutha- Asthoulya, Medaroga godhika, Dadhi,varuni, Mashasevana, According to Vagbhata- Adhika, Madhyama, godhuma, guda. Heena IAMJ: SEPTEMBER, 2017 3535 Swati. S. Deshpande Et Al: Panchakarma Approach To Sthoulya SAMPRAPTI – Nidanasevana (Kaphamedovardhakaahara) Jataragnimandya Saamaanna rasa Utpatti Predominance of Apaand Pruthvibhuta Dhatvagnimandya Medhovahasrotodushti(sanga) Vataprakopa Sanchya of Apachitameda in Spik, UdaraSanchaya of Vata in Koshta SthoulyaAtiaharasevana SAMPRAPTI GHATAKA Srotodusti – Medovasrotas Dosha – Srotodustiprakara – Sanga KaphapradhanaVatapittanubandhi Adhisthana – Sarvanga, especially in Dushya-Rasa, Mamsa ,meda Sphik, Udara, stana. Agni – Jataragni, Medodhatwagni Udbhavasthana –Amasaya Ama- Jataragnimandyajanita, Rogamarga – Bhaya,Abhyantara Medodhatvagnimandyajanitaama Swabhava –Chirakari Table 1: The International classification of BMI which is widely accepted as follows; WHO classification BMI Risk of Death Under weight Below 18.5 Low Healthy weight 18.5 - 24.9 Average Over weight (grade 1 ) 25.0 - 29.9 Mild Increase Obese (grade 2 ) 30.0 -39.0 Moderate/ severe Morbid / Severe obesity (grade 3 ) 40.0 and above Very severe STHOULYA CHIKITSA IN AYURVEDA 2) Santarpananimitajavyadhi – SHODHANA – There are two main parts of Shodhana– Charaka and Vagbhata both have very clearly 1) BahyaSamshodhana mentioned Sthoulya in Bahudosavastha, 2) AbyantaraSamsodhana Hence Shodhana can performed. According to Charaka– BAHYA SHODHANA– 1) Shelsmanantmajavyadhi IAMJ: SEPTEMBER, 2017 3536 Swati. S. Deshpande Et Al: Panchakarma Approach To Sthoulya Shodhana should be always preceded by management of dominant diseases particularly Rukshana. Udwartana is a Vataand Kapha Dosha origin is the best Bahirparimarjanachikitsa, it is identified as treatment told by Acharyacharaka. Swedana is one among the Rukshana Karma and the same done to liquefy the vitiated Dosha which are can be adopted in Sthoulyaas a Purvakarma of spread through the body. Snehana is an Shodhana in order to bring about Rukshana important Poorvakarma which is administered effect which is exerted by its Kaphahara, prior to Samshodhana procedure. Because of MedasahPravilapanam and application of Swedana, the vitiated Doshas SthireekaranamAnganam, Twakprasadhakara are expelled out with the help of Pradhana properties. In SthoulyaUdvartana possess karma. Swedana is one of the Chikitsa for removes the fortid odor, restricts the process Santarpanajanyaroga. of excessive sweating, and alleviates the Vagabhata indicated Pinda Sweda in aggravated Doshas by function. Charaka Santarpanaroga. specifies the TeekshnaRooksha Udvartana for Sagnisweda-Nadisweda, Parishekasweda, Sthoulya. Drava sweda, Ushnajalasnana. Niragnisweda- Guru Pravarana, ABHYANTARA SHODHANA – Bahupana, Kushdha Nigraha, Being a syndrome entity Shodhana therapy is Atapasevana, Vyayama, Ahava, Krodha highly recommended for Sthoulya are recommended in the patient of management. According to texts, Sthoulya. withAtisthoulya, AdhikaDosha, AdhikaBala should be treated with Shodhana therapy VAMANA IN STHOULYA – Including Vamana, Virechana, RukshaNiruha, Sthoulya is the KaphajaNanatmajaVikara. Raktamokshana, shirovirechana can be given. Vamana is the first line of measure. It is indicated in Shelshma and MedaRogas. SNEHANA IN STHOULYA – Vamana karma is considered as the best for Sneha denotes oily substance and the therapy KaphaDosha. Vamana karma is in which oily substances are used to oleate the contraindicated in Atisthoulya told by Charaka body is known as Snehana Therapy. Acharya. Judiciously considering the Bala of Snehana karma is always restricted in the individual Vamana karma can be Sthoulya. In increase of kapha and meda on performed. It can be used for treatment in exigency usage of Taila is recommended. Sthoulya but in uncomplicated conditions. For Snehapana and Abhyanga following preparations can be used–TilaTaila, VIRECHANA IN STHOULYA – Sarsapataila, Triphaladitaila. Virechana karma is the expelling Doshas through Adhobhaga, specifically on SWEDANA IN STHOULYA – Pittadhikya condition and expels them out of Swedana is an important preparatory measure the body through anal route. In Sushrutha before Shodhana therapy and after Snehana, it Samhita, while describing Virechana karma, is an independent therapeutic measure for the SthulaPramehi is considered as Durvirechya IAMJ: SEPTEMBER, 2017 3537 Swati. S. Deshpande Et Al: Panchakarma Approach To Sthoulya due to aggravation and dominance of Medas. Kaphamayaghna Niruha, Anuvasana, However, Tikshna Sodhana (Virechana) is Erandamoladibasti, Madhutailikabasti, insisted the line of treatment in Sthoulya. Bruhatpanchamuladibasti, Pippalyadi According to Rutu, Bala, Ausadhi the Gomutrabasti. procedure of the Virechana karma can be done. Virechanayogas like Triphala, Aragvadha, SHIROVIRECHANA IN STHOULYA– katukarohini are used. Formulations like – Ayurvedic texts have specified the benefits of Pippalyadichoorna, Hareetakyadichoorna, Shirovirechana in MedoRoga, Avapida Trivruttadigutika /Leha are using in daily Shirovirechana is mentioned as line of practicing. treatment for Abhishyanna Meda Vyaptasharira. BASTI IN STHOULYA– Karshana Nasya is indicated in the disorders Basti has got an important place in
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