A CASE STUDY OF MADHUTAILIKA BASTI AND UDVARTANA IN MEDOROGA WITH SPECIAL REFERENCE TO OBESITY

 

Dr. Shriram Shivajirao Ragad ¹

 

¹ MD (Panchakarma), Assistant Professor, Panchakarma Department, S. C. Mutha Aryangla Vaidyak Mahavidyalay, Satara-415002, India

 

1. INTRODUCTION

Sthaulya is described by Acharya Charaka in Ashtaunindita Purusha Mayashankar (1981) and also listed in Shleshma Nanatmaj. Santarpan Nimmittaja, Atinindita, Ati Brimhana Nimmittaja and Bahu Dosha Janita Vikara. Acharya Charak listed eight defects underlying Sthaulya Purusha, Ayurhasa, Javoparodha, Alpa-Vyavayitva, Daurbalya, Daurgandhya, Swedbadha, Ati-Trisha, Ait-Kshudha Mayashankar (1981). Moreover, Acharya Sushruta has emphasized on metabolic disturbances (Dhatwagnimandya) in the etiopathogenesis of Sthaulya. In modern medical science Sthaulya is compared with Obesity.

Obesity is a state of excess adipose tissue mass. Obesity should not be defined by body weight alone, as muscular individuals may be overweight by arbitrary standards status and risk of disease is the body mass index (BMI), which is equal to weight/ height2 in kg/m2. Book-Dennis et al. (2021) A person with a BMI of 30 or more is generally considered obese Joshi and Seth (2021). Obesity in India has reached epidemic proportions in the 21st century, with morbid obesity affecting 5% of the country's population Obesity (2021). According to ICMR-INDIAB study 2015, prevalence rate of obesity and central obesity are varying from 11.8% to 31.3% and 16.9%-36.3% respectively. Ahirwar and Mondal (2019) Guru & Aptarpana Chikitsa & Shodhana is mentioned as line of treatment for Sthoulya in Ayurveda alongside varied formulations like Udwartana, Basti Murth  (2001) A present article about a case study of a female patient of sthaulya was treated with madhutailik basti and Udvartana got relief within 15 days.

 

2. CASE REPORT          

History of personal illness

The present case study is successful Ayurvedic management of a case of Sthaulya (Obesity). A 44-year-old female patient came to us with chief compliant of – 

Table 1

Table 1: Showing symptoms & duration of patient
SR.NO	CHIEF COMPLAINTS	DURATION
1	Kshudrashwas (difficulty in respiration)	30 days
2	bharvrudhdhi (increase in weight)	2 months
3	Trushna (thrust)	2 months
4	Daurbalya (general weakness)	2 months
5	Kshudha	2 months

 

History of past illness

 patient was not a known case of hypertension, diabetes mellitus, hypothyroidism, PCOS. no any history of drug allergy hysterectomy done before 6 months

 

History of personal illness

The patient was normal 2 month back.  Increasing in weight, dourabalyanubuti (general weakness) in primary stage after that patient have symptoms like Kshudrashwas (difficulty in respiration). To overcome this, she came to our hospital for the treatment.

 

3. ASTAVIDHA PARIKSHA

 

 

 

 

Dashavidha pariksha

 

1.      Prakruti – Vatkaphj                              

2.      Vikruti –medodhatu drushti

3.      Sara –Madhya             

4.      Samhanana – Pravara

5.      Pramana – Adhik              

6.      Satmya – Madhyama

7.      Satva – Madhyama                      

8.      Aharashakti– Madhyama

9.      Vyayamashaki – Madhyama                                                  

10.  Vaya- Madhyama

 

Srotas parikshan

 

                        

Hetu Sevana

 

1.      Aharatmak– Atibhojana (Overeating), Guru Aharasevana (excessive consumption of heavy food) like non-veg eating Motton, chicken, Madhura Aharasevana (Sweet food), Sheeta Aharasevana (Excessive consumption of cold diet) like ice-cream, Snigdha Aharasevana (Excessive oily food), Gramya Rasa sevana (Usage of domestic animal’s meat & soups), Sarpi, Ikshu, dadhi seven etc

2.      Viharatmak– Avyayama (no exercise), Avyavaya, Divasvapa, Sukha Shaiya, Snana Sevana, Gandhamalyanu Sevana, Svapna Prasangat

3.      Mansik- Harshanityavat, Achintan, Mansonivrti, Priyadarshana, Saukhyena

 

Samprapti: Mayashankar (1981)

 

 

4. SAMPRAPTI GHATAKA

 

 

5. MATERIALS AND METHODS

5.1. METHODS

Centre of study: I.P. D of panchkarma dept. Of Ayurvedic hospital.

Method of sampling& study design: Simple Clinical Single case study.

 

5.2. MATERIALS

basti and udavartana treatment given to the patient

Table 2

Table 02. Showing Ingredients of Madhutailika basti:
sr/no	Dravya	Matra
1	Madhu	2-Prasruta ,1-karsha
2	Saindhava	1-Karsha
3	Taila	2-Prasruta,1-karsha
4	Shatapushpa choorna	1/2-Pala
6	Erandamoola kwatha	4Prsruta,2-karsha

 

Methods

Basti chart –

Sr No	Date	Basti Dana kala	matra	Praty agama	Lakshanas
1	18/09/2018	11AM	60Ml	after 1hr	Savat sasneha purish nirgamana
2	19/09/2018	9.30 AM	320Ml	after 5min	savat sakwatha purish nirgamana
3	20/09/2018	9.30 AM	60Ml	after 3 hrs	savat sasneha purish nirgamana
4	21/09/2018	10:00 AM	320Ml	after 15min	savat sakwatha purish nirgamana
5	22/09/2018	10.30 AM	60Ml	after 3hrs	savat sasneha purish nirgamana
6	23/09/2018	9.30 AM	320Ml	after 5min	savat sakwatha purish nirgamana
7	24/09/2018	10.30 AM	60Ml	after 6hrs	savat sasneha purish nirgamana
8	25/09/2018	11:00 AM	320Ml	after 15min	savat sakwatha purish nirgamana
9	26/09/2018	10.30 AM	60Ml	after 5hrs	savat sasneha purish nirgamana
10	27/09/2018	10:00 AM	320Ml	after 5min	savat sakwatha purish nirgamana
11	28/09/2018	9.30 AM	60Ml	after 2hrs	savat sasneha purish nirgamana
12	29/09/2018	10:00 AM	320Ml	after 15min	savat sakwatha purish nirgamana
13	1/10/2018	9.30 AM	60Ml	after 3hrs	savat sasneha purish nirgamana
14	2/10/2018	11AM	60Ml	after 4hrs	savat sasneha purish nirgamana
15	3/10/2018	9.30 AM	60Ml	after 5hrs	savat sasneha purish nirgamana

 

6. OBSERVATION AND RESULTS

After the treatment of 15 days, there was significant decrease in sign and symptoms of sthaulya Clinical examination of the patient’s revealed regression of        

·        No Kshudrashwas 

·        bharvruddhi less

·        No Trushna

·        No Daurbalya

·        Kshudha less

 

Criteria for assessment: -

Subjective criteria

Lakshanas	0 day	7th day	15th day	30th day
1)Kshudrashwas	++	+	+	-
2) bharvruddhi	++	+	+	+
3) Trushna	++	+	-	-
4)Daurbalya	+++	++	+	-
5)Kshudha	++	++	+	+

 

Objective Criteria: -

Parameters	0 day	7th day	15th day	30th day
1) Body Weight	77 kg	75 kg	74.5 kg	74 kg
2) Body Mass Index	28.5	27.7	27.5	27.4
3) Waist to Hip ratio	108/114	107.5/113	107/112	106/111
4) Skin fold Thickness	4 cm	4 cm	3.5 cm	3.5 cm
5) Mid Arm circumference	38 cm	37 cm	37 cm	36.5 cm
6) Chest circumference	99 cm	98cm	98cm	97.5cm
7) Abdominal Girth	105cm	104cm	104cm	103.5cm
8) Thigh circumference	63cm	62cm	62cm	61.5cm

 

7. DISCUSSION

Acharya Sharangadhra has mentioned madhutailik basti as dipana, bruhana, vrushaya, balavanakara, it is mentioned that madhutailik basti can be given in disease like gulma, medovrudhhi, krumi, pliha and udavarta. Basti is not only best for Vata disorders it also equally effective in correcting the morbid Pitta, Kapha and Rakta. Murthy (2001) Charaka has considered, Basti therapy as half of the treatment of all the diseases, while some authors consider it as the complete remedy for all the ailments. Mayashankar  (1981) Sushruta describes that Udvartana helps to restore the deranged Vayu of the body to its normal condition. It liquefies Kapha and Meda, Shashtri (2009) gives smoothness and cleanness to the skin and imparts firmness to the limb. Triphala also having Medakaphahar properties along with it enhances agni and ultimately it helps in increasing lekhan and dhatwagni so the samprapti is broken for further meda preparation.

 

8. CONCLUSION

Panchakarma eliminates vitiated Doshas, improves power of digestion and enhance metabolism. Panchakarma treatment like Udwartana, along with Basti best way to manage such condition. In above case this therapy resulted in the marked relief in all the criteria’s of Sthoulya. So, we can say that Panchakarma treatment diet control and regular exercise can give best results in obesity (Sthoulya).

 

REFERENCES

Ahirwar, R., Mondal, P.R. (2018).  Prevalence of obesity in India : A systematic review.   

Book-Dennis, L. Kasper et al. (2021).   Harrison’s Manual of Medicine, Obesity, chapter 172, 19th edition, McGraw Hill Companies, 901.

Obesity (n.d.).  https://en.wikipedia.org/wiki/Obesity

Mayashankar, S. G. (1981).  Acharya Charaka,Charak Samhita, (3rd edition) Sutrastan: Chapter 21, Verse 03 . Ahmedabad:SastuSahitya Vardhaka Karyalaya, 164.

Murthy, K.R.S. (2001).  Sushruta Samhita,Sutrasthan,Chapter 15, Verse 32.  Varanasi:Chaukhamba Orientalia, Sharirsthana, 230.

Mayashankar, S. G. (1981).  AcharyaCharaka,CharakSamhita, (3rd edition) Sutrastan:Chapter21, . Ahmedabad:SastuSahitya Vardhaka Karyalaya, 176. https://10.29121/jahim.v1.i1.2021.2

Murthy, K.R.S. (2001).  Sushruta Samhita Chikitsa Sthana, Chapter 35, Verse 34.  Varanasi : Chaukhamba Orientalia, 345.

Mayashankar, S. G. (1981).  Acharya Charaka,Charaka Samhita, (3rd edition) Siddhisthan: Chapter 1, Verse 40. Ahmedabad : Sastu Sahitya Vardhaka Karyalaya, 654.  https://10.29121/jahim.v1.i1.2021.2

Mayashankar, S. G. (1981).  Acharya Charaka,Charak Samhita, (3rd edition) Sutrastan:Chapter 21, Verse 04 . Ahmedabad:SastuSahitya Vardhaka Karyalaya,164. https://10.29121/jahim.v1.i1.2021.2

Shashtri, A.D. (2009). Sushrut Samhita of sushrut,Chikitsasthan:Chapter 24, Verse 51. Varanasi : Chowkhambha Sanskrit Series, 452.  https://10.29121/jahim.v1.i1.2021.2

World Health Organization (n.d.).