Sthulta (obesity) an Agnijanya vyadi and its management through Ayurveda-A...

[Full title: Sthulta (obesity) an Agnijanya vyadi and its management through Ayurveda-A Review]

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Review Article This work is licensed under a CC BY 4.0 License International Research Journal of Ayurveda & Yoga Vol. 5 (12),86-89, Dec,2022 ISSN: 2581-785 X; https://irjay.com/ DOI: 10.47223/IRJAY.2022.51214 Sthulta (obesity) an Agnijanya vyadi and its management through Ayurveda-A Review Anita Bhardwaj 1 , Sunita Kukkal 2 1 Associate Prof. (Kriya Sharir), Govt Ayurveda Yog Avm Prakitik Chikita Maha Vidhyalaya, Jaipur, Rajasthan, India, 2 Department of AYUSH, Municipal Corporation of Delhi, India INTRODUCTION Sthulta (obesity) is the reason of various other systemic illness and is the major cause behind escalated morbidity and mortality. It seriously affects physical and mental health of the sufferer by impacting his personal and social life. Acharya Charka has mentioned it under Ashtaunindaniya purusha (eight serious disorders) 1 . Unnaturally over accumulation of Meda (fat) and Mamsa (muscles) cause to deform buttocks, abdominal region, and breast so they become heavy, descended and loose, beside these morphological features improper nourishment of other organ and low level of energy is also notice in sthula (obese) 2 . Various factors are responsible to cause sthulata (obesity) considered as nidana for instance inappropriate practices of Ahar (diet), Vihar (life style), and other issues. Ahar includes excess intake of S hleshmic (fatty) food, Vihar (life style) categorized on the basis of cessation in physical and mental activities, other issues include genetic factors, physical ailments, age, gender, socio economic status and side effect of some medicine. These causes tend to generate and accumulate excess amount of Meda Dhatu (fat) , consequently others dhautus remains under nourished. Furthermore, excessive Vayu tends to upsurge Article Info Article history: Received on: 10-09-2022 Accepted on: 12-12-2022 Available online: 31-12-2022 Corresponding author- Anita Bhardwaj, Associate Prof. (Kriya Sharir), Govt Ayurveda Yog Avm Prakitik Chikita Maha Vidhyalaya, Jaipur, Rajasthan, India, Email: dr.animahi@gmail.com ABSTRACT: Sthulta (Obesity) critical impacted on physical, mental and social wellbeing of a sufferer, could complicate mild diseases and a major reason of high mortality of a serious illness. Improper practicing of Ahar (diet) and Vihar (life style) are responsible to alter normal functioning of Agni consequently in place of Prasad bhag (nourishment) , Ama (raw or toxin) is produced which has potency to disturb normal functioning by variating the Dosha , Dhatu and Mala thus cause various ailments. Three major forms of Agnis i.e., Jathragni , Bhutagni and Dhatuagni have potential to execute all bodily functions from cellular and systemic level. Dhatuagnis responsible for regular successive dhatu formation get power from Jathragni through bhutagni . Disturbing state of Agni may be of hypoactive, hyperactive or improper/disturbed type. In Sthulta hypoactive Medoagni cause to produce Ama meda which tend to accumulate and obstruct the Medovah strotas , which pollute internal environment Sthulta is considered as chronic and hardly to cure type of ailment, therefore it has to be managed. Nidan parivarja , Aptarpana techniques, and Lekhaniya mahakashya help to assimilate Ama and normalise Meda dhatu . This article presents elaborated description of Sthulta , its causative factor Agni and details of management is explained through fundamentals mentioned in Ayurveda. Keywords : Sthulyta, Agni, Ama, Medoagni, Aptarpana, Lekhaniya mahakashaya

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Anita et al “ Sthulta (obesity) an Agnijanya vyadi and its management through Ayurveda-A Review” : 2022; 5 (12):86-89 87 Agni which evident through Medoagni vaikriti (irregularity). So, this imbalance state of Agni is the reason behind various complications and abnormalities Literary Review Concept of Agni Agni along with optimal state of Dosha , Dhatu and Mala plays a vital role to govern bodily functions smoothly and considered as basic essential of life, so acquired earliest place under Dwadash Prana . It is the foundation of healthy life 3 , in appropriate condition it is the reason to healthy long-life span, attractive complexion, strength, health, nourishment, immunity, appearance, immunity and intelligence otherwise is prime factor to cause systemic illness 4 . And symbolised by Pitta Dosha in body, in equilibrium state is accountable for quantity and quality of health 5,6 . Doshas have peculiar role in physiology and pathology as Doshas (vital factors) are evident characteristic features of universal Panchmahbhutik module, responsible to conduct all functional and physiological purposes in body. As Kapha dosha is prepared by Pritvi with Jala Mahabhut , Pitta by Agni with Jala and Vata through Vayu with Aakash Mahabhut thus inner and outer world looks aligned. Inside the body Agni is the symbol of warmth and radiant appearance and is categories from three to thirteen types on the basis of its site i.e., Jathragni (related to digestion) is the chief fire or macro fire, Bhootikagni (related to five elements) and Dhatuagni (related to tissue system) 7,8 . According to Ayurveda, being chief fire of body Jathragni nourishes both the remaining Agnis or micro fires 8 .It helps in proper metabolism to nourish body tissues its deprived state is the reason for improper formation of Dhatu (tissue system) 9 . On the basis of its digestive strength and appetite pattern is found in four styles Visham Agni (irregular), Tikshana Agni (moderate), Manda Agni (mild), and Sama Agni (balanced/ proper). Dhatuagni get the share of chief Agni via Bhootagni hence, fire exists systemic to cellular level Food is initially digested by foremost Jathragni , further Bhutagnis helps to assimilate it by evaluating its Panchmabhutik (major elemental) content, subsequently progressive Dhatu formation occur through involvement of Dhatuagnis(cellular fire). Following Bhutagni relates to five elements i.e., Prithavi Agni (related to earth), Apya Agni (related to water), Tejas Agni (related to fire), Vayu Agni (related to air), Akash Agni (related to ether). Finally last category of Dhatuagni is comes which have seven functional and physiological components entitled as Rasagni (related to plasma tissue) , Raktagni (related to blood tissue) , Mamsagni (related to muscles or flesh tisuue ) , Medagni(related to fat or adipose tissue) , Asthiagni(related to bone tissues) , Majjagni(related to bone marrow tissue) , and Shukragni(related to semen or reproductive tissue , Dhatu formation is a gradual process where previous one after being digested properly produced three materials Prasad Bhaga (best part) is the source to generate subsequent one, second part entitled as Dhatu Ansh / Poshya Rasa helps to nourish another Dhatus so is supposed to get continuous nourishment and third part is the Kittansha (unwanted/excretory). Disturbed functioning of Dhatuagnis followed by improper Jathragni cause various related ailments by disturbing the normal function and physiology. There are three pattern of functioning 1. Dhatuagni Mandata (mild form/ hypoactive) causes Ama Dhatu Vridhi (excess accumulation of intermediate product of digestion) 2. Dhatuagni Tivrta (moderate form/hyper active) causes Dhatu Kshaya (deprivation)(Hemadri) 3. Dhatuagni Vaishmyata (irregular). This law is universal for entire range of Dhatu system and there is possibility to develop associated disorders. Concept of Sthulta (Obesity) Sthulta is considered Ahar Rasa Nimitaja (causative factor) 10 and disturbed Medoagni. Improper practices of Ahar, Vihar and other factors responsible for all process to produce Amameda (deformed fat) subsequently improperly excess fat get deposited in body and termed as S tulta (obesity). Sleshama part of Meda causes Strotorodh (channels get obstructed) consequently body does not get proper nourishment so merely unnatural over accumulation of Meda (fat) and Mamsa (muscles) occur. Ahar (diet) includes excess intake of shleshmic (fatty) food, vihar (life style) considered on the basis of cessation in physical and mental activities. And other factors could be genetic, due to other physical ailments, age, gender, socio economic status and side effect of some medicine are also accountable. In early stage of Stulta signs and symptoms are so mild only obvious indications of Kapha could be noticeable. Avoidance at initial stage results into evident symptoms as excess accumulation of fat on various part like abdomen, buttocks, breast, Aruchi (dysphagia), Kshudhadhikya (high appetite) Shwaskrichha (dyspnoea), Trishadhikya (excess thirst), Nidradhikya (excess sleepiness), Guruta (heaviness), Durbalta (weakness), Swedadhikya (excessive sweat), and Aangamard (body ache) Eight complications related to these ailments are Ayushohras (short of life span), Javoprodha (less active), Krichvyavata (sexual dysfunction), Durbalyta (weakness),

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Anita et al “ Sthulta (obesity) an Agnijanya vyadi and its management through Ayurveda-A Review” : 2022; 5 (12):86-89 88 Durgandhyata (unpleasant body odour), Swedabadha (reduced sweating), Kshuda atimatra (high appitite) and Pipasa Atimatra (excess thirst) 1 Description of Samprapti sanghtana of Sthulta (Obesity) ❖ Dosh ( vital factor ) : Mainly Kapha Dosha along Vata and Pitta ❖ Strotas (chennals: Medovah Strotas ❖ Dushya : Meda ❖ Strotodushti (pattern of disturbance): Sanga (occlusion) ❖ Adhishtha (site): Whole body ❖ Udbhav Sthan ( causation site ) : Amashyothoth (digestive system) ❖ Vyaktisthan (apparent site): Buttocks, Abdomen and Breast ❖ Agni ( state of fire ) : Agni Mandya , Dhatuagni Mandya ❖ Swarup (conduct): Chirkari (chronic/ long lasting) ❖ Prabhav (impact/ affect): D aruna (difficult to treat) Because body is a complex structure therefore, single pathological condition could interrupt its normality and cause various Upadrav (complications). In Sthul (obese) Madumeha (diabetes mellitus), Bhagandar (fistula), Jwara (fever), Pidika (skin disorders), Vidradhi ( abscess ) and Vatavyadhi (c. s.) etc. are detected as chief complication. Management through applying Ayurveda fundamentals Line of treatment depends on strength of involved Doshas and Dushyas , quantity of symptoms, existence of complication and time duration. In general, two methods are applied to treat any ailments depending on the tendency of influencers Santarpan (proliferating) or Aptarpana (depleting). Although it is also mentioned that Sthulta is not treatable 11 but after analysing the predisposing factors it is considered as Rasaj (diet) therefore, Nidana parivarja (abstinence) by sensible practice of Ahar (diet) and Vihar (life style) changes have been advised. As this ailment belongs to Amashya (digestive system), Langhanam (starvation therapy) and Lekhanam / Karshan (scraping techniques) are another methods 12 . Acharya Charak has mentioned ten Lekhaniya Mahakashay attributing Tikta rasa (bitter in taste) Ushana virya (hot potency), Laghu (light)and R uksha (dry), Katu vipaka (intensive), so act as Medoghna (reduce fat/ lipid), Kaphagna and Vataghna and helps to intensify Mandta (mild/hypoactive) Medoagni (fire to digest fat/ lipid) Lekhaniya Mahakashya 13 1 Nagarmotha (Cyprus rundus) 2 Kushtha (Saussurea leppa) 3 Haridra (Curcuma longa) 4 Daruharira (Berberis aristata DC.) 5 Vacha (Acorus Calamus Linn) 6 Ativisha (Aconitum heterophyllum Wall.ex.Royle ) 7 Kutukui (Picrorrhiza kurroa Royle. Ex Benth.) 8 Chitraka (Plumbago zeylanica Linn.) 9 Chirbilva (Holoptelia interifolia) 10 Haimvati (Iris aristata) Beside this additional fascinating technique is also mentioned Guruchaptaroana (heavy diet which cause depletion) 14,15 . Aptarpana (depleting therapy) includes Langhanam (starvationtherapy), Swedanam (sudation therapy)and Rukshana (dehydrating therapy),it either effective through Shaman (pacifiers) methods like Pipasa (thirst therapy), Marut (wind/breeze therapy), Atap (sun bath therapy), Pachan (digestion of Ama), Deepan (enhancing digestive power), Kshut (hunger therapy), Vyayam (physical excercises) and Shodhan methods like Vaman (induced vomiting), Virechana , (therapeutic purgation) Niruha (enema therapy), Nasya ( inhalation therapy), Raktmokshan (blood-letting technique). These wholesome approaches systematically strengthen the Agni to improve balance among all internal factors responsible for healthy living, later their actions help to manage ailments and their complication finally health began to establish through stable internal environment. DISCUSSION Sthulta (obesity) is a consequence of disturbed Agni by involvement of various factors which initially disturb the food digestion further alter Dhatu production 16 From cellular to systemic level all functions are impacted resulting in enormous range of symptoms. Medoagni actively works on Medo Dhatu in abnormal state is refer as Medoagnimandya (Mild form/ hypoactive) which is the reason to produce and accumulation Ama (toxin) or Amameda and obstruction in Strotus 17 Excessive accumulation of Dosha , Dhatu and Mala successively treated by Aptarpana (subtraction). Nidana Parivarjan , Langhanan (starvation therapy) regular Lekhanam (scraping techniques) and management through guru (heavy) and Aptarpana (deprivation therapy) are the procedures for management of Sthulyata 18 CONCLUSION Obesity affects women more than men. Life style changes based on classical texts, such as following dinacharya and ruksha udavrtana in the context of sthaulya , can be beneficial in avoiding sthaulya. Shodhana techniques such

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Anita et al “ Sthulta (obesity) an Agnijanya vyadi and its management through Ayurveda-A Review” : 2022; 5 (12):86-89 89 as vamana in vasanta rItu performed according to traditional methods will undoubtedly aid in the prevention of obesity. Acknowledgments- Nil Conflicts Of Interest- Nil Source of finance & support – Nil ORCID Anita Bhardwaj , https://orcid.org/ 0000-0001-6694-8441 REFERENCES 1 Shastri K, editor. Charak Samhita of Agnivesh, Sutra Sthan, Chapter 21, verse 4, Chaukhamba Sanskrit Sansthan, Varanasi, reprint 1998.pp.409 2 Shastri K, editor. Charak Samhita of Agnivesh, Sutra Sthan, Chapter 21, verse 9, Chaukhamba Sanskrit Sansthan, Varanasi, reprint 1998.pp.411 3 Shastri AD editor. (eleventh edition) Sushruta Samhita, Sutra Sthan, chapter 15, verse 48, Chaukhamba Sanskrit Sansthan, Varnasi, 1997.pp.64 4 Shastri K, editor. Charak Samhita of Agnivesh, Chikita Sthan, Chapter 15 verse 3-4, Chaukhamba Sanskrit Sansthan, Varanasi, reprint 1998.pp.452-453 5 Shastri AD, editor. (eleventh edition) Sushruta Samhita, Sutra Sthan, Chapter 21, verse 9, Chaukhamba Sanskrit Sansthan, Varnasi, 1997.pp.88 6 Shastri K, editor. Charak Samhita of Agnivesh, Sutra Sthan, Chapter 12, verse 11, Choukhamba Sanskrit Sansthan, Varanasi, reprint 1998.pp.251 7 Tripathi B, editor. Astanga Hrdayam of Srimadvagbhats, Sharir Sthan, chapter 3, verse 59, Chaukhamba Sanskrit Pratishthan, Delhi, 1998.pp.377 8 Shastri K, editor. Charak Samhita of Agnivesh, Chikita Sthan, Chapter 15, verse 38, Choukhamba Sanskrit Sansthan, Varanasi, reprint 1998.pp.459 9 Shastri K, editor. Charak Samhita of Agnivesh, Chikita Sthan, Chapter 15, verse 5, Chaukhamba Sanskrit Sansthan, Varanasi, reprint 1998.pp.453 10 Shastri AD editor. (eleventh edition) Sushruta Samhita, Sutra Sthan, chapter 15, verse 37, Chaukhamba Sanskrit Sansthan, Varnasi, 1997.pp.62 11 Tripathi B, editor. Astanga Hrdayam of Srimadvagbhats, Sutra Sthan, chapter 14, verse 31, Chaukhamba Sanskrit Pratishthan, Delhi,2009.pp.195 12 Shastri K, editor. Charak Samhita of Agnivesh, Sutra Sthan, Chapter 21, verse 16, Chaukhamba Sanskrit Sansthan, Varanasi, reprint 1998,.pp. 412 13 Shastri K, editor. Charak Samhita of Agnivesh, Sutra Sthan, Chapter 4, verse 3, Chaukhamba Sanskrit Sansthan, Varanasi, reprint 1998.pp.72 14 Tripathi B, editor. Astanga Hrdayam of Srimadvagbhats, Sutra Sthan, chapter 14, verse 32, Chaukhamba Sanskrit Pratishthan, Delhi, 1998.pp.195 15 Shastri K, editor. Charak Samhita of Agnivesh, Sutra Sthan, Chapter 21, verse 20, Chaukhamba Sanskrit Sansthan, Varanasi, reprint 1998.pp.414 16 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC 3221079/ 17 https://www.easyayurveda.com/2016/11/08/medo-dhatuvruddhi-kshaya/ 18 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC 5822981/ How to cite this article: Bhardwaj A, Kukkal S “Sthulta (obesity) an Agnijanya vyadi and its management through Ayurveda-A Review ” IRJAY.[online]2022;5(12); 86-89.Available from: https://irjay.com DOI linkhttps://doi.org/10.47223/IRJAY.2022.51214

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Dhatu, Dosha, Vayu, Agni, Ayurveda, Kapha, Mala, Agnimandya, Vishamagni, Mandagni, Samagni, Bhutagni, Dushya, Vatavyadhi, Dhatukshaya, Vataghna, Medoghna, Pittadosha, Kaphadosha, Prabhav, Mental health, Physical health, Mortality, Morbidity, Aptarpana, Jathragni, Strotodushti, Langhanam, Ahar (diet), Lekhaniya Mahakashaya, Swedabadha, Kaphagna, Dhatuagni, Strotorodh, Javoprodha, Prasad bhaga, Meda (fat), Medoagni, Jwara (fever), Meda Dhatu (fat), Poshya Rasa, Bhagandar (fistula), Mamsa (muscles), Kshuda Atimatra, Shodhan method.