Metabolic Disorders in Ayurveda: A Comprehensive Review of Prameha, Madhumeha, and Sthaulya

Metabolic Disorders in Ayurveda: A Comprehensive Review of Prameha, Madhumeha, and Sthaulya

Abstract:
Metabolic disorders are extensively discussed in Ayurveda, with Prameha and its subtype Madhumeha (diabetes mellitus) forming the core. These conditions are linked to doshic imbalances, especially Kapha and Meda dhatus, along with disturbances in Agni and Ojas. This article presents an in-depth analysis of Prameha, Madhumeha, and obesity (Sthaulya), including their etiology, symptomatology, pathogenesis, treatment, and supportive Panchakarma protocols.

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1. Introduction
Ayurveda classifies diabetes and related metabolic disorders under the umbrella term Prameha. It encompasses twenty types caused by derangement in Kapha, Pitta, and Vata, with Madhumeha being the most critical Vataja variety. Sthaulya, or obesity, is another major metabolic condition resulting from Meda dhatu vriddhi.

2. Nidana (Etiological Factors)

• Excessive intake of heavy, oily, sweet, and cold food

• Sedentary lifestyle and day sleep

• Genetic predisposition and mental stress

• Suppression of natural urges and lack of exercise

3. Major Metabolic Disorders

• Prameha – Includes 20 types (10 Kaphaja, 6 Pittaja, 4 Vataja)

• Madhumeha – Vataja subtype of Prameha with glucose loss in urine

• Sthaulya – Obesity due to excessive accumulation of Meda dhatu

4. Samprapti (Pathogenesis)

• Kapha and Meda vitiation leads to obstruction in Medovaha and Mutravaha Srotas

• Dhatwagni mandya results in improper transformation and accumulation of Meda

• In Madhumeha, ojas becomes vitiated and gets excreted through urine

5. Rupa (Clinical Features)

• Prameha: Frequent urination, excessive thirst, turbidity and heaviness of urine

• Madhumeha: Sweet urine, dry mouth, fatigue, blurred vision

• Sthaulya: Excess fat accumulation, breathlessness on exertion, laziness

6. Prognosis (Sadhya-Asadhyata)

• Kaphaja Prameha is Sadhya with diet and lifestyle correction

• Madhumeha is Yapya or Krichrasadhya

• Sthaulya is generally Sadhya but needs long-term management

7. Chikitsa Sutra (Treatment Principles)

• Shodhana: Vamana, Virechana, and Basti for dosha shodhana

• Medohara, Mutrala, Rasayana dravyas

• Ahara-Vihara regulation is crucial

8. Ayurvedic Medicines

• Prameha/Madhumeha: Nishamalaki Churna, Chandraprabha Vati, Vasant Kusumakar Rasa, Shilajatu, Gudmar (Meshashringi)

• Sthaulya: Medohara Guggulu, Triphala, Trikatu Churna, Mustadi Kwatha

9. Panchakarma Therapies

• Vamana: In Kapha-dominant Prameha

• Virechana: In Pitta and Meda dushti

• Lekhana Basti: In Sthaulya and Madhumeha

10. Diet and Lifestyle

• Avoid sweets, dairy, red meat, fried and fermented food

• Include barley, green gram, amalaki, bitter gourd, methi

• Regular exercise, walking, yoga, and meditation

• Avoid day sleep and late-night meals

11. Conclusion
Ayurveda treats metabolic disorders holistically with a combination of Shodhana, Shamana, dietary correction, lifestyle regulation, and Rasayana support. Personalized therapies and ongoing monitoring are crucial for sustainable management of Prameha, Madhumeha, and Sthaulya.

12. References

1. Charaka Samhita Chikitsa Sthana – Prameha Chikitsa (Chapter 6)

2. Ashtanga Hridaya Chikitsa Sthana – Prameha and Sthaulya Chikitsa

3. Sushruta Samhita – Nidana and Chikitsa Sthana on Prameha

4. Bhavaprakasha Nighantu – Meshashringi, Haridra, Shilajit

5. CCRAS Ayurvedic Formulary Vol I & II