Main Thesis

INTRODUCTION
Human civilization has reached to an ultra-advanced era where it can

solve all its problems by modern means. Human being is the supreme
most creature in the universe made by God. He granted an intellect as
a boon to human being. It is necessary that everybody should
channelize this boon for ethical things & in turn for the maintenance
of physical & mental health.
But in today’s era, it is observed that goals of life are changed. Society
is becoming materialistic. People are adopting unhealthy life style.
Dietary habits, daily activities, earning sources all these things are
changed. This unwanted & unhealthy change gives momentary
happiness but its constant use results into Dhātuvaishamya & people
suffer through the vicious chain of disorders. These disorders are
caused by two modes
1. Santarpana (due to over nourishment)
2. Apatarpana (due to lack of nourishment)
Among these two, the Scholar has selected Santarpanajanya Vyādhi
for research work. Because diseases due to over nourishment are
found in large percentage in today’s era. This over nourishment leads
to Sthaulya & Sthulya is prime cause of almost all Santarpanjanya
Vyādhis. Hence there is a need of proper solution for above severe
problem.
Causative factors for Santarpanajanya Vikāras are,
saMtp-yait ya: isnagQaOma_QaurOgau-$ipicClaO: |
navaannaOna-vamaVOSca maaMsaOScaanaUpvaairjaO:
|
gaaorsaOgaaO-iDkOScaannaO:
pOiYTkOScaaitmaa~aSa: |
caoYTavdoYaI idvaasvaPnaSayyaasanasauKo rt: | ca.
saU. 23.3,4
All the above factors result into various types of diseases as explained
in ca. saU. 23.6.7
 p`maoh
 ipDka
 kuYz
 kaoz
 paNDu
 jvar
 Aamap`daoYaja ivakar
(Dept. of Samhita and Siddhant 2014-2015) Page 1
 maU~kRcC/
 Araocak
 saMnyaasa
 kasa
 Saaof
 ivasap-
 BagaMdr
 ]dr
 ApcaI
 @laObya
 sqaaOlya
Considering the role of obesity in the pathogenesis of
Santarpanajanya Vyādhi, more focus was given to Sthaulya.
According WHO 2010 report,
1. Worldwide obesity has more than doubled since 1980.
2. 65% of the world's population live in countries where overweight &
obesity kills more people than underweight.
3. More than 40 million children under the age of five were
overweight in 2010.
4. So obesity is gaining more & more attention at the globally. That’s
why so many countries are making an effort to find out the perfect
remedy for this burning problem.
Need of study:
1. sqaaOlya kaSyao- var kaSyao-…| ca.saU.21.20

Ācārya Caraka has clearly mentioned that, treating Sthaulya is
a challenging task, as compared to treating Kārsya. In today’s
era, percentage of overweight & obesity is increased in all age
groups. So it is primly considered for research work.
2. In today’s era, the disorders like diabetes, skin diseases, urinary
problems, infertility, etc. are observed in huge percentage. They
are mainly Santarpanajanya & caused due to obesity. They are
certainly cured after treating obesity. Same thing is stated by
Caraka Ācārya with following quotation,
saMtp-NakRtdao-YaO: sqaaOlya mau@%vaa

ivamaucyato | ca.saU.23.25

This quotation states that, treatment prescribed for
Santarpanajanya disorders works by following method. In first
step, it treats obesity & then breaks the vicious chain of
pathogenesis of Santarpanajanya disorders. Hence it is clear
that, the treatment of Sthaulya is important measure in all
Santarpanajanya disorders. Untreated Sthaulya provides the
platform for so many hazards like Hyper Tension, Chronic Heart
Diseases, Diabetes Mellitus, Osteoarthritis, Infertility,
Impotency as well as psychological disorders like stress,
anxiety, depression etc. Thus, the mortality & morbidity is more
in obese person as compared to others.
3. t~ maodaoinalaSlaoYmanaaSanaM sava-imaYyato |
A.).saU.14.20
In the pathogenesis of Sthaulya, Vata & Kapha Dosha along
with Meda Dhātu are vitiated. Hence line of treatment which
distructs above three abnormal factors is necessary & same
principle is given in benefits of Vatsakādi Gana.
Maximum drugs existing in Vatsakādi Gana are found in
treatment given for various Santarpanajanya Vyādhis. This
indicates that these drugs work in obesity.
Previous work done:-

Before starting this study, all previous work done on the subject i.e
information was gathered and further study was conducted to avoid
the repetition of monotonous work. Previous work done also helps to
preced the previous researches.
A) Jamanagar.
1. Medovaha Srotas – Ek Adhyayan 1966 D.L. Dixit
2. Sthaulyata – Ek Adhyayan 1968 Suryakant Tilak
3. A conceptual and applied aspects of “Harsh Hetu- Visheshascha” in
contest of Sthaulya 2004 Ritesh Gujarathi
Department Of Kaya Chikitsa
1. A Clinical study on the role of Pathya and medohar yoga
in the management of Sthaulya (Obesity) 1994 Amrish Pandya
2. A Clinical study on the management of Sthaulya by
Panchatikta and Lekhan Basti 2001 Rekha Savjani
3. Etiopathological study of Sthaulya (Obesity) and assessment of
effect of Devdarvadi Vati and Virechan Karma 2003 Sarika Mehta
Department Of Dravyaguna
1. Study of katusigru for its Lekhan Karma in the management of
obesity (Sthaulya) 1994 R.M. Parmar
B. Government Akhandanand Ayurvedic College Dept.
Of K.C.& Panchkarma (P.G.), Ahmemdabad

1. Assessment of the efficacy of Lekhan Basti and Narak Guggul yoga
in case of obesity (Sthaulya) 1991 Sonal Bhatt
2. Lekhan Basti Evam Varunadi Ghana Vati Ka Sthaulya roga me
tulnatmak Adhayan 1996 Bindu Vora
3. A Role of Bhadradi Asthapan Basti in the Management of Sthaulya
with Special Reference to Obesity” 2010 Vibhash Chhipa
C. Department Of Kaya Chikitsa, Ahmadnagar

1. Triphala – Effect on Medovaha Srotas 1991 G.J. Patil
2. A clinical study on the concept of lipid group of drugs (Charaka) in
the management of lipidemic & ischaemic heart disease 1993 C.S.
Pandey
3. Study on interrelationship between Medoroga andPrameha 1999
Priya Darshini
E. Department Of Kayachikitsa, Calcutta

1. Clinical Study of Medoroga (Obesity) and its treatment with piper
nigrums compound.
F. Department Of Kayachikitsa, Hyderabad

1. A study of Vidangadi Lauh on Medoroga 1987 Prakash Chandra
2. The effect of Agni-manth Quath bhavit Shilajeet on Medoroga
1991 V. Murlikrishna
G. National Institute Of Ayurveda, Jaipur Deparment Of Kaya

Chikitsa
1. Sthaulya Roga par Vyoshadya satelu ka prayog 1979 B.L. Sharma
2. Sthaulya roga ke pariprekshya me Lekhan vati evam Lekhan Basti
ka chikitsatmak Adhyna 1997 M.K. Swami
Department Of Panchakarma
1. Clinical evaluation of Tab. Lipodieresis and Phalatribadi Lekhan
Basti (both Kalpit yoga) in the management of Sthaulya 2008 Seetha
Madhavi
2. A clinical evaluation of Medohar Basti & Fat-0-Nil tab (Kalpita yoga)
in the management of medoroga WSR to obesity 2009 Gyan Prakash
Sharma
H.Department Of Kaya Chikitsa, Lakhnow

1. The effect of Arogya Vardhini in Medoroga in relation to obesity and
blood cholesterol 1975 Ramchandra Mishra
2. Role of Arogyavardhini in blood cholestrol & Medoroga with
anupam with stharangadha-rakta maha manjisthali kwath 1978 Shail
Bala
I. Govt. Ayurveda Medical College & Hospital, Mysure

1. Sthaulya and its management with Madhujala 1982 Ramanand Rao
N.R.

2. Clinical study on effect of Vyoshadi guggul in Sthaulya 1998 Patil
B.G.
3. Effect of Lekhan Vati in management of Sthaulya 2001
Ramchandra S.
4. A clinical study on Sthaulya (obesity) W.S.R. to its management
through Lekhana Vasti & Amritadya Guggulu 2002 Kareer Prasanna
J. Govt. Ayurveda Mahavidhyalaya, Nagpur

1. Agnimanth bhavita shilajeet ki Sthaulya rog me Karmvkata, Ek
Savikalp Adhyayan1992 Thatere S.
2. Sthauly oparaka hetuon me Madhur Rasatma Ahara – Ek
vishleshatmak adhyayan 2003 Khot R.S.
3. A Clinical study of Vatasakadi yoga in the management of obesity in
ref. to lipid profile 2007 Viswakarma Vandana
K. Tilak Ayurveda Mahavidhyalaya, Pune

1. Guggul ka Sthaulyah ara parinma 1987 Godigil (Ku.J.M.)
2. Clinical evaluation of Vidangadi choorna on Sthaulya 1998
Masurkar N.P.
3. To study the efficiency of lekhan basti on Sthaulya 2000 Sabde
M.S.
L. S.D.M. College Of Ayurveda (Karnataka), Hassan

Swasthvrit Department
1. A clinical study on effect of Yavamalaka Churna in prevention of
Sthaulya
2003 Sajjanar Shrikanth
M. College Of Ayurveda & Research Centre Pune

University, Pune
1. Effect of Guduchhyadi yoga on Sthaulya (K.C.) 2005 Dhus Mahesh
N. Ayurveda Mahavidhyalaya (K.C.), Nasika

1. To define the deciding factors of Sthaulya W.S.R. to Navak guggul
2005 Wagh Kapil Kumar.
Interpretation: - from above data it is revealed that, though many

research works have been carried out for Santarpanajanya Vyādhi &
Sthaulya as well. The study of Vatsakādi Gana & its role in Sthaulya
is not conducted. Hence this topic is selected for research work.
Aim and objectives
AIM:-
To study role of Vatsakādi Gana in Sthaulya (obesity) as a
Santarpanajanya Vyādhi.

OBJECTIVES:-
 To study the concept of Santarpanajanya Vyādhi.
 To study pathogenesis of Sthaulya Vyādhi & mode of treatment.
 To study role of Vatsakādi Gana in Sthaulya.
Materials:-
 Caraka Samhitā with Cakrapānī commentary
 Susruta Samhitā with Dalhan commentary.
 Aşhţāñga Hŗdaya.with hemadri & Arūņdatta commentary.
 Other allied literature.
 30 patients of overweight & obesity.
METHODOLOGY:-
A. LITERARY STUDY:-
1. References of Santarpanajanya Vyādhi were compiled &
studied from Bŗhattrayī & allied literature.
2. References of Sthaulya have been studied in detail &
categorised with the help of Brihattrayī & allied literature.
3. All drugs from Vatsakādi Gana were studied on the basis of
their Guna & Karma.
B. CLINICAL STUDY:-
1. According to literary review primary case paper was revised.
2. Written consent was taken before the treatment.
2. Authantication of all drugs existing in Vatsakādi Gana was

done by standard source.
3. Tablets of Vatsakādi Gana were prepared in the pharmacy of

College of Āyurveda Bharati Vidyapeeth Deemed University,
Pune.
4. Tablets were prepared following the guidelines given by the

Ayurvedic Pharmacopoeia of India- first edition (2010).
5. 30 patients of Sthaulya (obesity) were selected on the basis of

inclusion criteria. Role of Vatsakādi Gana in Sthaulya were
studied. Dose, Duration & Anupan was as follows,
a. Dose:- 2 tablets (Each of 500 mg.)×vyaanaaodana
b. Duration:- 60 days (8 weeks)
c. Anupana:- Hot water (Ushnodaka)

6. Total 4 Follow-ups were taken with the gap of 15 days.
7. Laboratory investigation ie lipid profile of each patient was
done before treatment & after treatment.
8. Observations depending upon assessment criteria were
studied at each follow up.
9. After observation of clinical data of 30 patients, all hetu and
lakshana were analysed.
10. Statical analysis was done according to data obtained.
11. Place of clinical work-Bharati Vidyapeeth Medical
Foundation’s Bharati Āyurved Hospital, Pune Satara Road,
Dhankawadi, Pune-43.
DESIGN OF DISSERTATION
 INTRODUCTION
 CHAPTER 1- CONCEPT OF SANTARPANA
 CHAPTER 2-CONCEPT OF STHAULYA
 CHAPTER 3- DISEASE REVIEW OF OBESITY FROM MODERN
SCIENCE
 CHAPTER 4- DRUG REVIEW OF VASTAKADI GANA.
 CHAPTER 5- CLINICAL STUDY
 DISCUSSION – OBESERVATIONS
 CONCLUSION
 SUMMERY
 BIBLIOGRAPHY
 ANNEXURE

CONCEPT OF SANTARPAN
Part A: - Santarpan as Chikista:-
The term Santarpan is found in Brihattrayi. Acharyas have explained
Santarpan as therapy.
]pËmyasya ih iW%vaai%WQaOvaaopËmaao mat: |

ek: san%ap-Nast~ iWtIyaEcaptp-Na: | 1 | A.).14.1
Accoding to Aşhţāñga Hŗudaya Santarpan explained as one of the

therapies. People suffer from the diseased condition by two types of
diatery causative factors. Either due to over nourishment or less
nourishment. Hence they are treated accordingly by two ways 1)
Santarpana 2) Apatarpana.
1. Definition:-
Santarpan is also called as a Bruhan.
baRMh<vaM yacCrIrsya janayao<acca baRMhNama\ |

ca.saU.22.10
According to Acharya Caraka the drug which nourishes the body is
called as a Bruhan.
baRMhNaao doho vaRdQaIkr | DlhNa TIka sau.saU. 46.518

Acharya Dalhan states that Bruhan is responsible for nourishment of
body. Santarapan is treatment explained for k aSya_.
santp-Na ina$i> :
The word Santarpan is derived from root “sama\” + ‘tRp\” with iNaca\
which stands for satiating, refreshing.
na santUPya<yanaona sama\ +tRp\ krNao laRT\ |
sama +tRp\ ¹ iNaca\ lyau | vaacasptyama\ 6.5211

2. Meaning of Santarpan:-
Ref (Monier Willams). Page no: - 1142).
1) Santarpaka= Satiating, Refreshing

2) Tarpan = Refreshing or vigorating.
3) Tarpaniya = Treating of restoratives.
Thus Santarpan means nourishment which is refreshing and

restorative in nature.
3. Synonyms of Santarpan:-
1. tRiPtkrma\ pÌNanama\ | sau saU 46.34
According to Acharya Sushrut, the word Santarpan means to

satisfy and to nourish the body.
2. baMRhNama\ … | ca saU 23.30
According to Acharya Caraka, the word Santarpan means

nourishment.
3. inaima<a baRMhNahotuk |
According to Ayurvediy Shabdkosh, the word Santarpan means

nourishment.
4. santp-NaIya … ca saU 23.1

According to Caraka Santarpan means nutritious.
Considering above meanings, it is clear that Santarpaka drugs work

at physical and mental both levels. They increase strength of
Dhatus. They are restorative in nature and refresh the mind but
their improper and excess use causes Vyādhis like Sthaulya.
4. Santarpan bheda:-
toYaaM saMtp-NaM tj~O punara#yaatmaaOYaQama\ |

ya<ada%vao samaqa-M syaadByaasao vaa tidYyato |
saV:xaINaao ih saVao vaO tp-NaonaaopcaIyato |
nato- saMtp-NaaByaasaaiccarxaINastu puYyait |È
ca.saU.23.30.31
The refreshing therapy can be given in two ways
1) Administration of refreshing regimen
2) Habitual intake of refreshing regimen
One suffering from fresh attack of emaciation can soon be cured
by the administration of refreshing regimen but one suffering

from chronic type of emaciation would require habitual intake of
refreshing therapy.
5. Importance of Santarpan chikista:

1. naIlaItulyaM %vagaolaM ca tOis~vaR%saisataoplaa |
caUNa-M saMtp-NaM xaaOd`flaamlaM sainnapatnaut\ |
22 |sau.saU. 44.22
Nili (fruits), Tvak and Ela, each one part, Trivrt three parts
mixed with sugarcandy this powder taken with honey and sour
fruit juice is satiating and allivates sannipata.
2. nao~M ivarokaityaaogao syandto caaitmaa~Sa: |

t~ saMtp-NaM kaya-M ivaQaanaM caainalaaphma\ | 77 |
sau.].18.77
When there is excessive evacuation, the eyes becomes crooked,
hard, with abnormal colour, drooping, too rough and discharges
excessively in this case Santarpan should be applied along with
other Vata allivating measures.
3. bauBauxaap`Bavao SaUlao laGau saMtp-NaM ihtma\ |

]YNaO: xaIrOya-vaagaUiBa: isnagQaOmaa-
MsarsaOstqaa | sau.]. 42.100
In pain caused by hunger, light food with warm milk, gruel and
unctuous meat – soup is beneficial.
4. duba-lao caOva $xao ca tp-NaM ihtmaucyato |

jaa=galaaorBa`jaOmaa-MsaOranaUpaOvaa- sausaMsÌtO: |
sau.].51.54
In case the patient is debilated and having Rukshata in the

body, he should be treated with processed meat of wild or
marshy animals and sheep.
5. sqaUla: p`maohI balavaainahOk:ÌSastqaOk: pirduba-laSca

|
saMbaRMhNaM t~ ÌSasya kaya-M saMSaaoQanaM
daoYabalaaiQaksya |

}Qva-M tqaa|QEca malao|pnaIto maohoYau saMtp-
Namaova kaya-ma\ | 16 | ca.ica. 6.15.16
Patients suffering from Prameha can be classified into two

categories, viz 1) those who are obese and strong, and 2) those
who are emaciated and weak. Patients belonging to the latter
category should be given nourishing therapy. Patients of the
former category who are strong and who have more doshas in
the body should be administerd elimination therapy. For this
perpose, the oleated patient should be given various Yoga
described in Kalpa Sthan with view to eliminating excreta
through both upword and downward. After the excreta are
eliminated from his body, the patient should be given Santarpan
or Refreshing therapy because Apatarpan therapy in this
condition may produce Vatajanya Prameha.
6. yaVt\ saMtp-NaM SaItmaivadaih ihtM laGau |

AnnapanaM inaYaovyaM t%xatxaINaO: sauKaiqa-iBa: |
ca.ica.11.93
Kshatshin treatment: In Kshatkhin patients, food and drinks
which are nourishing, cooling, avidahi, wholesome and light,
should be used by the patient suffering from Kshatshin and who
is desire to regain health.
7. Vipluta yoni vyapad treatment :-

kaya-stt: snaohipcaustt: saMtp-NaM Bavaot\ |
SallakIijai=ganaIjambaUQava%vak\pc~valklaO: |
ca.ica.30.108|
Oil should be boiled with the decoction of sallaki jingini and the
barks of jambu, dhava, nyagrodha, udumbara, asvatta, parisa
and plksa. Tampon soked with this medicated oil should be kept
inserted into the genital tract which cures Vipluta type of
Gynecological disorder.
8. Ardit treatment:-
Aid-to naavanaM maUinQa-tOlaM tp-Namaova ca |
ca.ica. 28.99
For the treatment of facial paralysis, nourishing type of
inhalation therapy should be administered and head should be
anointed with medicated oil.
Part B:-SANTARPANA AS A CAUSATIVE FACTOR:

I) According to Caraka Samhitā -
The Santarpan is one of the chikista upakaram. It is also called as

bruhan. In Emaciated weak patient it is best choice of treatment. But
if this chikista is given to an improper person, it leads to various
disorders.
The causative factors of Santarpanajanya Vyādhis are given in Caraka

Samhitā as follows-
saMtp-yait ya: isnagQaOma_QaurOgau-$ipicClaO: |

navaannaOna-vamaVOSca maaMsaOScaanaUpvaairjaO:
|
gaaorsaOgaaO-iDkOScaannaO:
pOiYTkOScaaitmaa~aSa: |
caoYTavdoYaI idvaasvaPnaSayyaasanasauKo rt: | ca.
saU. 23.3,4
If an improper person over refreshes himself with unctuous, sweet,

heavy, and slimy substance, newly harvested rice, fresh wine, meat of
marshy and aquatic animals, cow milk and its products, food items
made of jaggery, pastry but is averse to physical activities, indulge in
sleep during day time, and keeps lying on the bed or sitting at ease at
all-time falls to victim of Santarpanjanya Vyādhis.
Above causative factors are categorised as follow’s,
1) Aharaj hetus
2) Viharaj hetus
3) Manas hetus
1) Aharaj hetus
sr no. Aaharja hotu cark A. h.
1 isnagQa Aahar + -
2 maQaur Aahar + -
3 gau$ Aahar + -
4 ipicCla + -

5 navaanna + -
6 navamaV + -
7 vaarIja maaMsa + +
8 AanaUp maaMsa + -
9 gaaOiDk + -
10 pOiYTk + -
11 xaIr - +
12 saip- - +
13 maQaur isnagQa bastI - +
14 isata - +
Aaharja hotu :- Excess consumption of following Ahar results into

Santarpanajanya disorders .
These causative factors is again categarised according to there Guna,

Rasa properties and Nava (fresh articles), Desha etc .
A) Guna:-
The following Snigdha, Guru, and Picchila Guna Pradhan Ahar leads
to Santarpanajanya Vyādhis as follows:-
Guru
Snigdha Picchila
Āhār
1) isnagQa :-
yasya @laodnao Sai@t: sa isnagQa: | homaaid`

The quality of elements or diet increases & produces the softness and
smoothness in the body is called as Singdha.
snaoh maad-vakRt\ isnagQaao balavaNa-kr stqaa |

sau.saU.46.518
The term ‘Snehan’ is used for lubricating, greasing, and unctuousness.
paMcaBaaOitk%va¹
snaohao|paMivaSaoYagauNa: | vaOSaoiYakdSa-na
According to Vaisheshika system it is special attribute of Aapa
mahaBaUta.
isnagQa vaathr SlaoYmakarI vaRYyaM balaavahma\ |

Baa.p`. 1
The food articles like Shali, Shashtik, wheat, cow milk, Mrudvika are
Singdha gunatmak promote and nourish tissue, alleviate Vata Dosha and
aggravate Kapha dosha.
Most of the Snigdha Dravyas are cold in potency and Madhur Vipaki.
Effects on Doshas are – Snigdha alleviate Vata ,Pitta & increases

Sleshma.
Effects on Dhatus are – Snigdha gunatmak articles do Bruhan , Tarpan ,

Lepan.
Excess consumption of Snigdha gunatmak Ahar leads to

overnourishment of Dhatus and increase Kapha dosha in the body. As
Aap Mahabooth is pridominatly seen in Snigdha guna, Aap does Vikruti
in bodyfluids. It leads to following types of diseases.
No Snigdha guna – References

Santarpanajanya Vyādhis
1. Prameha (su ni 6/3), (va ni 10/2)
2. Kushtha (ch chi 7/4)
3. Granthi visarp (ch chi 21/39)
4. Kaphaj shoth (ch su 18/7)
5. Kaphaj jwar (ch ni 1/25)
6. Kaphaj kas (ch chi 18/17)
7. Sthaulya (chsu.21/4)
2) gau¯ :¹

yasya d`vyasya baRhNao kma_iNa Saikt sa gau¯ | homaaid`
The element having capacity to digestion and also nourishment is called
as Guru.
paMcaBaaOitk%va: ¹
gaaOrvaM paiqa-vaM AaPyaM ca | r.vaO.saU.3.116
It is special attribute of Pruthvi and Aap Mahabhoot.
gau¯þ vaathr puYTISlaoSmakRt\ icarpakIca | Baa p` 1

According to Bhavmishra the substance bearing the attribute of
heaviness, decreases Vata Dosha and increases Kapha Dosha.
saadaoplaop balakRt gau¯þtp_Na baRhNa | sau saU .46.518
According to Sushruta, the Guru Guna provides lassitude or depression

of mind, increases tissue Kaphaj Visarp hetu.
Effect on Doshas are –Vatashamak, Kaphavardhak.
Effect on Dhatus are- Bruhan, Tarpan, Vardhan.
Excess consumption of elements which are heavy to digest like wheat,
buffalo milk, colostrum, etc produces heaviness in the body. Excess
consumption of Guru gunatmak Dravyas does over nourishment in all
Dhatus and increases heaviness in the body and leads to Santarpanjanya
Vyādhis.
No Guru – References
Santarpanajanya
Vyādhis
1. Pandu (ch16/125),
2. Kaphaj kas (ch chi 18/17), (ch chi 21/33)
3. Kushta (ch chi 7/4), (su ni 5/3),
4. Tandra (ch si 9/21),
5. Granthi visarp (ch chi 21/39),21/33)
6. Klaibya ch (chi 30/163),
7. Aama ch (vi 2/8)
3) ipaicCla :-
yasya laopnao Sa@tI sa ipicCla | homaaid`
It acts as wound healer. Hemadri states that Picchila Guna has the
power of coating or covering.
paMcaBaaOitk%va ¹

ipicCla%vamaaPyama\ | r.vaO.saU.3.112
Picchila substances are predominated by Jala Mahabhoot.
ipicClaao jaIvanaao balya sanQaana SlaoYmalaao gau$ |
sau.saU.46.517
The attribute by which drugs and diet contain the power of
maintaining pran strengthens body, help in joining the broken
bones are called Picchila or sliminess. It softens the body tissue
and has nature to make covering on skin or mucus membrane.
pOicClyaadgaaOrvaad\ d`vyaM ÉQdvaa rsavaha: isara: |
Qa%to yaWaOrvaM tt syaadiBaYyaind yaqaa diQa ||
SaarMgaQar
Excessive intake of Picchila Ahar heaviness in the body.
As Jala Mahabhoot is pridominat in Picchila, the articles have
thred like qualities. The milk and milk cream are the example of
picchila attributes, due to quality of sliminess the circulatory
channels are obstructed and it results in feeling like heaviness.
Some Picchila articles like dadhi are Abhishyandi. This will result
in storage of fat in the body and dullness.
Effect on Doshas –Vatapittashamak, Kaphavardhak.
Effect on Dhatu- Bruhan, Vardhan, Balya, Vrushya.
Excess use of Pichhila results in following disorder.
No Picchila References
1. Kaphaj jwar (ch ni 1/25)
2. Prameha (va ni 10/2)
B) Rasa :- Madhur Rasa
Santarpanjanya
Rasa vyadhis
Madhur
Over consumption of maQaur rsa.
t~ maQaurao rsa: isnagQa: SaItao gau$Sca | ca.saU. 26

t~ maQaurao rsa: isnagQa: SaItao maRdugau$Sca |
A.saM.saU.18
paMcaBaaOitk%va¹
pRqvaIsaaomagauNaitrokat\ maQauraorsa: | ca.saU.26.40
The Pruthvi and Jal mahabhoot pridomintly found in Madhur rasa.
snaohnapÌNanaa)admaad-vaO$plaByato |
mauKasqaao maQaurEcaasyaM vyaaPnava^MillamptIva ca |
ca.saU.26.74
The elements and diets having sweet taste are wholesome to the body
and such they add to the growth of body fluids.
Snigdha dravyas are Shitviryatmk and Madhurvipaki
Effect on Doshas are –Vatashamak, Pittashamak, Kaphavardhak.
Effect on Dhatus are- Bruhan, Tarpan, Vardhan.
As the Madhura ras does Bruhan, Tarpan and Vardhan of dhatus it
increases Medodhatu in the body which leads in to following disorders.
sqaaOlyaaignasaadsaMnyaasamaohgaMDabau-daidkana ||
A.).saU.10.9
Madhur rasatmak daiet articles like Rasala, ghee, goat milk, Kharjur, etc.
are soothing and nourishing. When only excess of it is used, causes
vitiation of Kapha, resulting in Sthaulya, tenderness, laziness,
hypersomnia, loss of power of digestion, cough, etc.
According to Aşhţāñga Hŗdaya excess consumption of Madhur rasa leads
to Sthaulya, Agnimandya, Prameha etc disorders.
No Madhur Rasa- Vyādhis References

1. Sthaulya hetu ( su su 15/32).
2. Kushth (sa ni 14/48)
3. Prameha (suni 6/3)
4. Pandu (ch chi 16/27) (sa ni 13/14)
5. Granthi visarp (ch chi 21/39)
C) New Food articles:-
Excess consumption of following Āhār leads to Santarpanajanya

Vyādhis.
1) navaanna :
Freshly harvested crop up to 1 year is called as Navanna.

navaM QaanyamaiBaYyandI laGau saMva%saraoiYatma\ |
sau.saU.46.51
QaanyaM sava- navaM svaadu: gau$ SlaoYmakrM smaRtma\
| Baa.p`.88
Newly harvested crop are Abhishyandi. They secrete excess
secretions in the body and increases Aap Mahabhoot. Aap
Mahabhoot is responsible to increase Kapha Dosha in the body.
New cereals are slimy while those kept for more than one year or
thereafter it loses its qualities.
According to Sushrut and Bhavpraksh newly harvested crop

having age below 1 year is called as Navanna and it is sweet and
Kapha Vardhak in nature. These two properties do over
nourishment of Dhatus, and its excess use in daily routine results
in Santarpanajanya Vyādhis.
No Navanna References
1. Prameha (ch chi 6/4 ch ni4/5), v ni 10/3)
2. Nijshotha (ch su 18/6)
3. Kushtha ( ch ni 7/7)
2) navamadya:
Fresh wine is having property Abhisyandi, it vitiates Kapha dosha in
the body and result in santarpanjanya Vyādhis. According to Caraka
Navmadya is a causative factor for Prameha and Urusthambha.
No Navamadya Referances
1. Urusthambha (Ch chi 27/9)
2. Prameha (ch ni 4/5)
3) gaaOiDk :
The Sweets made from Jaggery is called as Gaudik. As newly prepaired
Sweets are heavy to digest and results in disorders like Shwas, Krimi etc.
so this causative factor included in new food articles.
gauDao vaRYyaao gau$:isnagQaao vaatGnaao

mau~SaaoQana: naaitip%thrao maod:kfiËimabalap`d: | Baa.p`.
The Gaudik is having properties like Vrushya, Guru, Pittashamak,
Vatghna, it increases Meda and Kapha in body.

gauDao nava: kfSvaasa kasa iËimakrao|ignaÌt\ |Baa.p`.
Sweets made from Jaggery which is new will leads to vitiation of Meda
and Kapha, and excess comsumption causes increase in calories in the
body. Excess consumption causes following disorders. Shwas, Kasa, and
Krimi rog
No Gaudik References
1. Prameha (ch chi 6/4), (v ni 10/3) .
2. Kushtha (ch chi 7/7)
D) Food articles according to Desha:-
1) AanaUp maaMsa :¹
SlaoYmalaa: ipicClaaScaaip maaMsapuiYTp`da
BaRSama\ |
tqaa|iBaYyaindnasto ih pàya: pqyama:smaRta || Baa.p`.
The meat of animals living in AanaUpdoSa. The meat of such animals is
Kaphavardhak, Picchil gunatmak , and which does Mamsa pushti. It is also
Abhishyandi in property . Mamsa is Pruthavi Mahabhoot dominant element.
maaMsaM maQaurSaIt%vaad\gau$ baRMhNamaaivakma\

|62 |
baRMhNaa: SauËlaaEcaao>a hMsaa maa$tnaaSanaa: |
isnagQaaEcaaoYNaaEca vaRYyaaEca baRMhNaa:
svarbaaoQanaa: |66 |
snaohnaM baRMhNaM vaRYyaM
EamaGnamainalaaphma\ | 78 |
varahipiSatM balyaM raocanaM svaodnaM gau$ |
gau$YNaa maQaura balyaa baRMhNaa: pavanaapha: | 81 |
ca.saU.27.62Ê66Ê78Ê81
According to above referances Type of Mamsa which does nourishment

are goat, pig, fish, hen, hippopotamus are called as Brumhaniya.
isaQda varahinayaU-ho yavaagaUbaR-MhNaI mata |

ca.saU.2.25
Yavagu prepared by Varah Mamsa is called as Brumhaniya. These type of
meat responsible for Kapha and Pichhila guna. Which result in increase in

Mamsa, Meda. Excess use leads to deposition of fat in the body and results
in following disorders.
No Anup mamsa - Vyādhis References

1 Visarp (ch chi 21/19)
2 Mutrakruchha (ch chi 26/32)
3 Klaibya (ch chi 30/164)
4 Nija shotha (ch su 18/6,su chi 23/4),
5 Prameha (V ni 10/3, ch ni 4/5)
2) vaarIja maaMsa :
The food artcles like fish comes under the Varija Mamsa.
ma%syaa : isnagQaaoYNa maQaura gaurva : kfip%%alaa |

vaatGnaa baRMhNaa vaRYyaa raocaka balavaQa-naa : | Baa.
p`.
According to Bhavprakasha fish are having properties like Snigdha,

Madhura, which is Kaphavardhak, Pittavardhak Vataghna. Fishes
does Brumhan, and Balavardhan. Due to these properties, excess
consumption of Varija mamsa may leads to Kaphaj disorders. There is
no any reference found that states fish is causative factor for a
disease.
E) gaaorsa :
gavyaM dugQa ivaSaoYaoNa maQaur rsa pakyaao |
daoYa Qaatu mala s~aotsa ikiccaMlaodkrM gau$ | Baa.p`.

The milk of cow is called as Goras, it is having properties like Madhur
rasa and Vipak. It is heavy in digestion. The goras forms Kleda in the
body, and vitiate Kapha Dosha. Excessive secretions in the body, results
in to Shaithilya. It results in vitiatation of Mamsa, Meda Dhatus and
Malas. Excess use of it may lead in Santarpanjanya Vyādhis.
F) paOiYTk :
Food prepared from fine wheat (like maOda) such as pizza, burger etc.
ipYTanna naOva BaujjaIt maa~yaa vaa bauBauixat: |

iWgauNaM ca ipbao%taoya sauK samyak p`jaIya-it ||
sau.saU. 49
One should not consume of rice flour or in case of hunger, should take in
small quantity followed by intake of double quantity of water, thus it is
digested well.
No Pishtanna Vyādhis
1. Prameha (ch ni 4/5)
2. Shotha ( ch su 18/6,su chi23/4)
3. Klaibya (ch chi 30/163)
2) Viharaj hetus:-
The Vihara like Asanasukha, Shayyasukha etc are responsible to

increase Kapha Dosha in the body. Acharya charaka and A.H both
states that Shayyasukha, and Swapnasukha are Viharaja nidan for
Santarpanjanya disorders. These causative factors are as follows
sr. no ivaharja hotu cark A. h.

1 AasanasauK + -
2 SayyaasauK + +
3 svaPnasauK + +
4 caoYTaWoYa + -
5 idvaasvaap + -
7 AByaMga - +
8 snaana - +
1. AasanasauK : Tendency of happiness in sitting posture is called as

Asansukha. According to Caraka, aasansukha is a causative factor for
prameha.
No Aasansukha Referances
1 Prameha (Ch chi 6/4)
2. SayyaasauK : Tendency of happiness in lieng down postur is called as

Shayyasukha. Excessive use of Shayyasukha leads to Santarpanjanya
Vyādhis.

3. svaPnasauK : Excessive sleep a is called as Swapnasukha.
No Swapnasukha Referances
1 Prameha (ch chi 6/4)
4. caoYTaWoYaI : Lazy for any movement. Increased kapha dosh in the

body causes heaviness which results in Cheshtadvesha and habitual
following of this will leads to saturation of fat in the body parts.This hetu
is seen in following disorders.
No Cheshtadvesha Referances
1 Shotha Ch su 18/6, su chi 23/4
2 Kaphaj Gulma Ch ni 3/10
5. idvaasvaap :
ra~aaO jaagarNaM Éxa ,isnagQaM p`svapnaM idvaa |
AÉxamanaiBaYyaind %vaasaInap`calaaiyatma | ca.saU.
21.53
Keeping awake at nights produces dryness in the body, while day sleep is
responsible for increase in Snigdha property.
Vata accumulates during grishma. Dryness is more during this season

due to aadan kal, nights are short and days are long one can take sleep
in grishma. But persons who are fat, who take fatty food/heavy food
daily, they should not sleep during grishma.
No Divaswapna Referances
1 Prameha Ch ni 6/4
2 Pandu (ch chi 16/27) (sa ni 13/14)
3 Jwara ( ch ni 1/25)
4 Kasa (Ch su 18/17)
5 Visarpa
3. Manas hetus
Sr no. hotu cark A. h.
1 AicaMta + -
2 hYa-Na - +

Achintana is psychological factors mentioned by Acharya Charaka.
which is responsible for Medavriddhi. This is Kapha aggravating
factor. Which leads to Meda deposition.
1. Achintana:-
Aicantnaacca kayaa-NaaM QaùvaM saMtp-Naona ca |
svaPnap`sa=gaacca narao varah [va puYyait ||34 ||
cau.saU. 21.34
According to Acharya Caraka, freedom from anxiety about work,
intake of nourishing diet and adequate sleep makes man fatty like a
pig. Achintana is hetu of santarpanjanya Vyādhis and Sthaulya,
Arsha.
No Achintan Referances
1 Sthaulya (ch su 21/4)
2 Arsh (ch chi 14/19)
The other causative factors maintioned in charts are discussed under

Ashtang Hrudaya.
II) The causative factors of Santarpanajanya Vyādhis are given in

Aşhţāñga Hŗdaya as follows:-
maaMsaxaIrisatasaip-ma-QaurisnagQabastIiBa |
svaPnaSayyaasauKaByaM=gaasnaanainavaR-i%t
hYa-NaO |
³A.).sau.14.9´
According to Aşhţāñga Hŗdaya Basti prepaired from meat, milk, sugar,

ghee and sweet and oily properties will lead in Santarpanjanya
Vyādhis. Calm sleep, abhyang, bath, psychological wellbeing and
jolliness are hetus given in Aşhţāñga Hŗdaya.
1. Anuvasan basti ( Mamsa+ Kshira+Sita+Sarpi+Madhur+Snigdha)

2. Swapnasukha
3. Shayyasukha
4. Abhyang
5. Snan
6. Nivrutti
7. Harshn.
1. Anuvasan basti:-
BaoYajaxaipto pqyamaaharOrova baRMhNama\ |

GaRtmaaMsarsaxaIr)VyaUYaaosaMihtO: |
ABya=gaao%saadnaO: snaanaOina-$hO:
saanauvaasanaO: |
tqaa sa laBato Sama- yaujyato caayauYaa icarma\ ||
ca.saU. 16.22
Elimination therapy reduces dhatus as well. In order to dhatus get

restored to their normalcy, one should take nourishing diet together
with ghee, meat, soup, milk and vegetable soup which are good for
heart.
For the sake of restoring the dhatus reduced by elimination therapies,

nourishment with Anuvasan Basti is prescribed rather than diet as
nourishment.
2. Swapnasukha:-
svaPnap`sa=gaao ina%yaM svaPnamaitmaa~M ca | TIka

ca. saU. 21.34
Tendency of excessive sleep is called as Swapnsukha. It leads to
vitiation of Kapha Dosha.
No Swapnasukha Referances
1. Prameha (ch chi 6/4)
3. Shayyasukha:-
Tendency of happiness in lieng down postur is called as
Shayyasukha. Excessive use of Shayyasukha leads to
Santarpanjanya Vyādhis.
4. Abhyanga:-
AByanga karyaoina%yaM savao-YvaDgaoYau puiYTp`dma\
| Baa. p`.
Abyangya should be resorted to daily, it is Pushtikarak. But if there
is Kapha aggravation patient should avoid Abhyang.there is no any
reference found that stats Abhyang is responsible for disease.
5. Snan: - Snan is daily activity. It keeps body clean and healty. But
there is no any reference for Snan A cusative factor.
6. Nivrutti:- It is states as free from all tensions.
7. Harshanitya:- With this type of psychological wellbeing and
jolliness those people indulge more in worldly pleasure and excess

calories stored in the form of Meda. It is hetu for Santarpanjanya
Vyādhis like
No Harshan Referances
1 Sthaulya (ch su 21.3,4)
2 Prameha ( ch chi 6/4)
3 Klaibya (ch chi 30/163)
III) Comparative Study on Causative factors of Santarpanjanya

Vyādhis:-
a) The above all causative factors leads to vitiation of Kapha
dosha, Meda and Mamsa dhatu.
Aicantnaacca kayaa-NaaM QaùvaM saMtp-Naona ca |
b)
svaPnap`sa=gaacca narao varah [va puYyait ||34 ||
cau.saU. 21.34
According to Acharya charak the Aharaj, viharj, and manasik
type of causative factors togtherly leads to Santarpanjanya
Vyādhis, and makes man fatty like pig.
c) The Causative factor for Santarpanjanya disorder are given

in charak Samhitā and Ashtang Hrudaya. Viharaj factors like
Swapnaprasang, Shayyasukha, are similar in both Samhitās.
d) Physcological factors like Achintan and harshan having
similar function.
e) Effect of Santarpan on Dosha, Dhatu, and Mala:-
i) Dosha:- Santarpan vitiats Kapha Dosha,

In Santarpanjanya Vyādhis jala and Pruthvi Mahabooth get
vitiated. Jal Mahabooth dominat drugs having properties like
liqudity, unctuousness, cold, dullness, softness, slimy,
compactness, and happiness.
Foolowing are the normal properties of Aapya Dravya.
d`vaisnagQaSaItmandmaRduipaicClarsagauNa
bahulaanyaapyaainaÊ
tanyaup@laodsnaohbanQaivaYyandmaad-
vap`)adkraiNa |³ca saU .26.11´
If such drugs are consumed by improper person and in
excess Quaantity then it leads to various disorders.
ii) Dhatu:- Pruthavi Mahabooth dominant drugs are heavy,
tough, hard, dull, stable, non-slimy, dence, gross and
abounding in the quality of smell, they promote plumpness,
compactness, heaviness, and stability. These properties with
jal mahabhoot vitiate Rasa, Meda, and Mamsa dhatus.

Dhatu Mahabhoot Properties
Rasa Jal mahabhoot Liquidity, dullness,
Meda Jal and Dence, plumpness, compactness,
Pruthavi heaviness
Mamsa Pruthavi Plumpness, heaviness.
iii) Upadhatu: - Vasa.
iv) Mala:- Sweda, Mutra, Purisha.

The Jal and Pruthavi mahabhoot are responsible to increase
Mutra and Sweda in the body. Increased Mutra hampers
elimination of kleda.
]plaopao malavaRiQd: DlhNa TIka sau.saU. 46.518

The Guru Guna of Pruthavi Mahabhoot may causes digestive
disterbances, and malavridhhi in patients. Thus Santarpanjanya
Vyādhis affect all three Malas.
C) SANTARPANJANYA VYĀDHIS:-
The above all are hetus of Santarpanjanya Vyādhis and diseases

caused due to Santarpanjanya Vyādhis are as follows-
raogaastsyaaopjaayanto saMtp-Nainaima<ajaa: |
p`maohipDkakaozkNDUpaND\vaamayajvara: | 5 |
kuYzanyaamap`daoYaaEca maU~kRcC/maraocak: |
tndà @laObyamaitsqaaOlyamaalasyaM gau$gaa~ta
|6|
[ind`yasaaotsaaM laopao bauQdomaao-h: p`maIlak: |
SaaofaEcaOvaMivaQaaEcaanyao
SaIGnamapìtkuva-ta: | 7 |³ca.saU.23.5Ê6Ê7´
Disorders like Prameha, Pidaka are Kapha and Meda dominant
Santarpanjanya Vyādhis. While Pandu, Mutrakruchha, Kandu, Koth,
Kushta are due to vitiation of Meda dhatu, the lakshanas like Tandra,
Budhhirmoh, Pramilak, Alasya are due to vitiation of kapha dosha in
the body.
AitsqaaOlyaapcaImaohjvaraodrBagandrana\ |
kasasannyaasaÌcC/amakuYzadInaitda$Naana\ |20 |
³A.).saU.14.20´

Excess of brmhana therapy produces profound Sthaulya, Apachi,
Prameha, Udar, Bhagandar, due to vitiation of Kapha and Meda in the
body. Kasa, Sanyas are causes due to mainly Kapha dosha vitiation.
Sr
no
Raoga cark A. h.
1 p`maoh + +
2 ipDka + -
3 kuYz + +
4 Kaoz + -
5 paNDu + -
6 Jvar + +
Aamap`daoYaja
7 + +
ivakar
8 maU~ÌcC/ + +
9 Araocak + -
10 saMnyaasa - +
11 Kasa + -
12 sqaaOlya + +
13 Saaof + -
14 ivasap- + -
15 BagaMdr - +
16 ]dr + -
17 ApcaI - +
18 @laObya + -
C-I) Disorders:-
The all above Santarpanjanya disorders explained by Acarya Caraka
are detailed discussed as below:-
a) Prameha:
Almost all causative factors of Santarpanjanya diseases have been

found in Prameha. They are as follows-
Sr Santarpanjanya Santarpaneta a/c a/c a/c

no hetus r hetus Carak sushrut ashtang
hrudya
1 Aasysukha + - +
2 Swapnasukha + -
3 Divaswapna + - +

4 Aanupa + -
mamasa
5 Payas + - +
6 Navanna + -
7 Gudavaikrut + - +
8 Aatimatra + - +
Navdhanya
9 Ghee + - -
10 Pishtanna + - -
11 Kshir + - -
12 Navmadya + - +
13 Madhur + - +
14 Guru - - +
15 Snigdha - + +
16 Pichhila - + +
17 Aalasya -- +
18 Avyayam - +
19 Medya ahar -- + +
20 Aamla - - +
21 Kaphaj ahar + - +
22 Sheet - + +
23 Lavan - - +
24 Dadhi + - +
25 Ikshu - - +
bahud`va SlaoYmaa daoYa ivaSaoYa: | ca.ina.4.6

Prameha is generated by vitiated Kapha Dosha having dominance of
Drava Guna. Dushyasangrah of prameha is 1) Meda, 2) Mamsa,3)
Vasa, 4) Majja, 5) Kleda 6) Sukra, 7) Rakta, 8) Lasika 9) Rasa 10) Oja.
Nidans of Prameha like navaanna, gudvikruti, pishtanna, and guru

are guru in nature in which Pruthavi mahabhoot is dominant. And the
nidan like kshir, kaphaj ahar, with viharaj aasansukha divaswapn are
responsible for aggravation of Kapha. The lavan and amla ahar have
results in shithilatwa in the body.
Santarpan as Chikista in Prameha:-
isnagQasya yaaogaa ivaivaQaa: p`yaaojyaa:

klpaopidYTa malaSaaoQanaaya |
}Qva-M tqaa|QaEca malao|pnaIto maohoYau saMtp-
Namaova kaya-ma\ | 16 | ca.saU. 6.16

Though Prameha is developed by over use of Santarpan i.e. maximum
causative factors of Prameha creates Santarpan in the body, still
Santarpan is treatment prescribed for Prameha in specific condition
for specific purpose. It is as follows.
In Vataj Prameha, when patient is weak, Bruhan Chikista is adviced

in Caraka . After proper virechan, patients become weak hence to
regain the strength of Dhatus, Santarpan is adviced. If Apatarpan
given in such patient it will cause more weakness in the body and
results in Vataj Prameha.
b) Pidaka :-
No Santarpanjanya hetu Santarpanetar hetu

1. Guru Amla
2. Snigdha Lavan
3. Navanna Atinidra
4. Asyasukha Avyayam
5. Achinta Not doing any Vaman
virechanadi karma
Guru, Snigdha, Navanna, these hetus are responsible for

aggravation of Kapha and vitiation of Meda. Amla, lavan are have
responsible for Shaithilya in the body. lack of Vaman Virechan adi
karma, results in increase Pitta dosha. Pitta and Kapha Dosha
cause Pidaka at Mamsa, joints, and at place of Marma.

c) Kushta :-
No Santarpanjanya Santarpanetar
1 Snigdha Sheet- Ushna vyatyas
2 Guru Ahar Santarpan –Apatarpan
vyatyas
3 madhu phanit
4 fruits with milk
5 satat ajirna
6 Lavan
7 Amla
8 Maithun after having food
9 Dhupasevan
10 Vidagdha, vidahi
annasevan
11 Vaman vegavrodha
12 Vyayam
13 Srama
14 Bhaya
Kushta is one of the Santarpanjanya Vyādhi. Snigdha, Guru ahar

sevan, Navanna, Pishthanna, Gud etc sevan increase kapha in the
body. While other hetus like Sheet- Ushna vyatyas, Santarpan –
Apatarpan vyatyas, Madhu phanit, fruits with milk, satat ajirna,
Lavan, Amla etc are aggravate pitta in the body. Increased pitta
does raktadushti, thus rakta, pitta, kapha vitiated at skin and
leads to Kushtha.
d) Pandu :-
No Santarpanjanya hetus Santarpanetar hetus

1. Divaswapna Kshar
2. Amla
3. Lavan
4. Atiushna
5. Virudhha ahar
Asatmya ahar
Nishpav, mash
Adhik vyayam
Adhik maithun
Vegadharan
Kama krodha, bhaya, shoka, etc
manasik vikaras
Pandu is also Santarpanjanya Vyādhi. But in hetus of pandu only

viharaj hetu ie divaswap is Santarpanjanya. Due to Divaswapna,

Kapha Dosha gets aggravated in the body. Due to Snigdha & Drava
property of Kapha, Dhatus loses their normal consistency and
Shaithilya is generated. Other hetus of Pandu like Kshar, Lavan,
Atiushana Ahar, Virodhi Asatmya Ahar, excessive exercise, Mala
Mutra Vega dharan, Kama, Krodha, Bhaya, Shok, etc hetus are
responsible for the aggravation of Pitta. In this way Pitta Dominant
Doshas with Shaithilya are responsible for Pandu.
e) Mutrakruchha :-
No Santarpanjanya hetus Santarpanetar hetus

1. Madyapan Adhik vyayam
2. Anup Mamsa Tikshana aoushdh
3. Ruksh
4. Walking with speed
5. Excessive use og horse etc for
travlling
6. Masya
7. Adhyashan
8. Ajirn
In mutrakruchha also only two hetus are Santarpanjanya. Madya

and Aanupa Mamsa sevan. Aanupa mamsa is pichhila gunatmak
and abhishyandi it increase kapha and meda in the body.
Excessive madyapan increases heat in the body which leads to
Shopha in urinary track results in dribbling micturition.
f) Jwara :-
No Santarpanjanya hetus Santarpnetar hetus

Snigdha Sheet
Guru Amla
Picchila Lavan
Divaswap Avyayam
Harsh Lack of work
Kaphaj Jwara only shows features of Santarpan. Above causative

factors of Santarpanottha disorders have dominance of Pruthvi &
Aap. Hence all they vitiate Mamsa & Meda Dhatu along with the
vitiation of Kapha. In these pruthavi mahabhooth is dominant,
pichhila guna increase the Kapha and Meda. While Amla & Sheeta
causes Shaithilya in the body.

g) Aamapradoshaj Vyādhis:-
No Santarpanjaya Santarpanetar hetus Manasik

hetus nidan
1. Guru Ruksha Kama
Sheeta Krodha
Shushka Lobha
Dvishta Moha irsha
Vidahi Lajja
Virudhaanna Shok
Abhiman
Udveg
Bhaya
Amapradoshaj Vikar are Santarpanjanya but here also only one

hetu is seen as Santarpanjanya, ie Guru. The food which is
heavy to digest is called as Guru. It hampers digestive power
and generate Aama. Properties of Aama and Kapha are almost
same. Hence it also vitiate Kapha. Other mental causative
factors as mentioned in the chart also destruct the digestive
capacity and helps for the derivation of Aama.
h) Arochak:-
1 Guru Ushana Ahar vihar
2 Snigdha Shok
3 Bhaya
4 Krodha
5 Lobha
6 Atimatra Bhojan
7 Atisheeta
In Santarpanjanya disorders Arochak causes due to manasik hetus

like Shok, Bhaya, Krodha, Lobha. This is disorder which causes
due to rasavahasrotodushti. Hence among the causes of rasavaha
srotodushti, excess consumption of Guru, Atisnigdha and Atimatra
Ahar sevan are considered as Santarpanothha hetu of Arochak.
i) Kasa:-
No Santarpanjanya Nidan Santarpanetar Nidan

1. Guru -
2. Madhur
3. Snigdha

4. Divaswap
5. Acheshta
Kaphaj Kasa is good example of Santarpanjanya disorders.
gauva-
iBaYyaindmaQaurisnagQasvapàivacaoYTnaO : |
vaRQd: ElaoYmaa|inalaM $d\Qvaa kfkasaM kraoit
ih | ca.saU. 18.17
Here all hetus of kaphaj kasa are Santarpanjanya. Guru, Snigdha,

Madhur ahar, daysleep, Acheshta. These are jala and pruthavi
mahabhoot dominant which increase Kapha. In pathogenesis of
Kasa there is no role of Mamsa and Meda Dhatu. Only vitiated
Kapha bloks the channels of Vayu. Hence normal direction and
proper functioning of Vayu gets hampered.
j) Visarp:-
1 Pishthanna Lavan
2 AanupaMamsa Amla
3 Divaswapna Katu Rasa
4 Guru Ati Ushna Ahar
5 Snigdha Dadhi
6 Madhur Sura
7 Souvira
8 Vikrut madya
9 Vidahi Ahar
10 Kulathi, kilat, Mandak
11 Audak mamsa
12 Decayed fish
13 Adhyashan
14 Ajirna
15 Shastraghat
In visarpa excessive intake of pishtanna, aanupamamsa, and

daysleep aggravate kapha dosha, while other hetus like lavan,
amla, katu rasatmak ahar, ushna anna, sura, souvir, vidahi anna,
kilat, etc vitiate pittha in the amashaya. This results in vitiation of
following seven types of dushyas Vata, Pitta, Kapha, Rakta, Lasika,
Twak, Mamsa. After stuying all hetus of Santarpan disorders it is
observed that Snigdha, Guru, Madhur, Aanupa Mamsa, causes
Abhisyand in the body. Which does Srotorodha and leads to

Granthi Visarpa. Granthi Visarpa is Vata- Kapha dominat type of
Visarpa and it comes under Santarpanjanya disorders.
k) Shotha:
1 Guru Jwaradi roga
2 Snigdha Vaman-virechan upadrav
3 Aanupamamsa Upawas
4 Divaswap Lavan
5 Navdhanya Kshar
6 Tikshna
7 Ushna
8 Mrudbhakshan
9 Vegadharan
10 Virudha ahar vihar sevan
11 Walking
12 Unstrayan
Shotha is causes due Santarpan hetus like guru, navanna, aanup

mamsa sevan. And other hetus like vaman, virechan, aasthapan,
anuvasan, mithyayog, vegdharan, excessive walking, amla, lavan,
ahar vitiate kapha and pitta results in shotha.
l) Bhagandar:-
Bhagndar is Santarpanjanya disorder given in Ashtang Hrudaya.
The parisravi type of Bhagandar is cause due to vitiation of Kapha.
1 - Mithya Ahar- Vihar
Mithya Ahar vihar vitiates Kapha and Pitta Dosha in the body.
Excess increased Kapha and pitta at the Anal region forms Shotha
which results in Bhagandar.
m) Udrara :- in kaphaj Udara there are all causative factors are
Santarpanjanya.
1 Diwaswap Avyayam
2 Madhura Dadhisevan
3 Snigdha
4 Picchila
5 Varija(Jaliya)
6 Aanupa Mamsa
7 Kshira

n) Sanyas:-
The Sanyas is next Stage of Mada, and Murcha. Vitiation of Kapha
Dosha results in heaviness in the body and blocks the channels
leads to Sanyas.
o) Klaibya:- The Klaibya is of two types

1) Bijopaghtaj 2) Dvajbhangkruta
1 Aanupa mamsa Amla
2 Kshira Lavan
3 Guru Ahar Kshar
4 Pishtanna Virudha Ahar
5 Atijal secvan
6 Sheeta, Ruksha, Virudha Ahar
7 Shoka, Bhaya,
8 Maithunadhikya
9 Dushtayoni maithun
10 Vamanadi ayog
11 Shukravegdharan
In above all causative factors Aanup Mamsa, Kshira, Guru Ahar,
Pishtanna are the Santarpanjanya and other Amla, Lavana, etc
vitiate Kapha, Pitta and Vata. Aggravated Kapha forms pustular
eruption at the urinary track.
p) Sthaulya:-
A separate chapter designed on Sthaulya.
C-II ) Lakshanas:-
A.Ë laxaNa cark A .=

1 Aalasya + -
2 gau$gaa~ta + -
[Mind`ya s~aotsaaM
3 + -
laopao
4 baudQaI-maaoh + -
5 p`maIlak + -
6 kNDu + -
7 tndà + -
The above are lakshanas which cause due to over nourishment.

a) Alasya:- The alasya is lakshan casues due to vitiation of Kapha
Dosha. Excess consumption of Snigdha, Picchila, Guna will result
in aalasya.
b) Gurugatrata:- Heaviness in the body is due to consumption of
Guru property. Pruthavi mahabhoot is dominat in guru Guna
c) Indriya srotasan lepo:-Vitiation of Kapha Dosha

d) Budhirmoha: Vitiation of Kapha dosha.
e) Pramilaka:
f) Kandu: Ahar like Gudik, fish vitiate Kapha Dosha and results in to
Kandu.
g) Tandra: Vitiated Kapha Dosha will result in tandra.
CONCEPT OF STHAULYA
Etymology (Vyutpatti): The word “Sthaulya” derived from Mula

Dhatu “Sthu” with the adition of “Ach” Pratyaya respectively which
means “Sthaulya”.Ācārya Charaka has been mentioned the disease
“Sthaulya” in context of Ashtaunindita Purusha. He has described
“Sthaulya” in detail and explained from etiology to treatment with
utmost care.
A) Vyutpatti :-
1. sqaUlasya Baava :* sqaUlata laxaNa
2. sqaUlasya Baava sqaaOlyama : | vaacasp%yama\ 6 / 5358

3. sqaUlayait to ca At sqaaOlyama | vaacasp%yama\ 6 / 5358
According to Amarakosha, it stands for excessive unwanted
growth of the body.
4. sqaUla pirbaRhNao | AmarkaoYa naanaaqa_ vaga_ 204
The world "Sthulata" means largeness or bigness or bulkiness of
body.
B) Nirukti :
sqaUlayait vaQa-to ]draid vaRQdyaa ya: sa sqaUla: |
Baa.p`.ma.KM. ivamaSa- 39
According to Ācārya Bhavamishra, a person having heaviness and
bulkiness of the body due to excessive growth, especially in
abdominal region is termed as Sthula and the state of Sthula is
called as Sthaulya.
C) SYNONYMS:
ivapulapaInapaInvaIna sqaUla pIvaro | AmarkaoSa
ivaSaoYyainaGna vaga_ 1.61
Pyaayato pIna * AmarkaoYa

Amarkosh Has Given Synonyms Of Sthula As Vipula, Pina, Pinvin,
Pivara Which Indicates Overnutritional Condition Of The Person.
D) Definition OF Sthaulya :
maodaomaaMsaaitvaRQd%vaaccalaisfgaudrstna: |
Ayaqaaopcayaao%saahao narao|itsqaUla ]cyato || ca.saU.
21.9
A person having pendulous appearance of Sphika (Hip), Udara
(Abdomen) and Stana (Chest) due to excess deposition of Meda
along with Mamsa dhatu, there is also unequal distribution of
Meda in the body. Ati Sthula is defined as a person who is owing to
inordinate increase of fat and flesh which is distinguished with
pendulous buttocks, belly and chest and whose increased bulk
does not match with corresponding increase in working capacity.
E) Classification of Sthaulya:
t~ saMSaaoQanaO: sqaaOlyabalaip<akfaiQakana\ |
AamadaoYajvarcCid-rtIsaar)damayaO: |
ivabanQagaaOrvaaogdar)llaasaaidiBaraturana\ |
maQyasqaaOlyaaidkana\ pàya: pUva-M pacanadIpanaO: |
13 |
Direct classification of Sthaulya is not given by sages. But to treat

Sthaulya Langhan is priscribed and to design the pattern of Langhan
Sthaulya is Categarised by Ashtang Hrudaya as depending on
strength of a person.1. Adhika 2. Madhya 3. Hina
F) NIDANA-
a) tditsqaaOlyamaitsaMpUrNaagdu$maQaurSaItisnaQaaopy
aaogaad¹
vyaayaamaadvyavaayaai_vaasvaPnaaQdYa-ina%ya
%vaadicantnaabdIjasvaBaavaa¹ccaaopjaayato |
ca.saU. 21.4
b) t~ ElaoYmalaaharsaoivanaao|
QyaSanaSaIlasyaavyaayaaimanaao idvaasvaPnartsya
caama evaannarsaao
maQaurtrEcaSarIrmanauËamannaitsnaohanmaodao
janayaitÊ tditsqaaOlyamaapadayait |
³sau.saU.15.37´

Sthaulya is explained in brihattrayi. Ashtang hridaya states that
Atisampuran is only causative factor for Santarpanjanya Vyādhis,
while other two given Madhur, sheeta, adyashan, diwaswapna,
Avyayam, Avyavaya as common factors. These are categarised as
bellow-
A.Ë sqaaOlya hotu cark sauEa A.h

ut
1 AitsaMpurNa + + +
2 isnagQa Aahar + - -
3 maQaur Aahar + + -
4 gau$ Aahar + - -
5 SaIt Aahar + + -
6 AQyaSana + + -
7 SlaoYmavaRiQdkr Aahar - + -
8 idvaasvaap + + -
9 AicaMta + - -
10 hYa- ina%ya%va + - -
11 Avyaayaama + + -
12 Avyavaaya + + -
13 baaIjasvaBaava + - -
14 Aama - + -
1. Atisampurnata:-
Ati Sampurna and Adhyasana can be considered as faulty eating
habits. Ati Sampuranat means Atibhojana (excess food intake in a
single meal),
In Sthaulya, Atimatrabojana provocate the Tridosha (Ch.Vi.2/7) as
well as Ama formation.
2. Snigdha Ahara:
Jala Mahabhoot is pridominat in Snigdha guna.
isnagQa vaathr SlaoYmakarI vaRYyaM balaavahma\
| Baa.p`. 1
Excess consumption of Snigdha gunatmak ahar leads to
overnourishment of Dhatus and increase Kapha Dosha in the
body. As Aap Mahabooth is pridominatly seen in Snigdha guna,
Aap does Vikruti in bodyfluids. It leads to Sthaulya.
3. Madhura Rasa Sevana:
Madhura Rasa is having pridominacy of pruthavi and aap
mahabhoot.
sqaaOlyaaignasaadsaMnyaasamaohgaMDabau-daidkana ||
A.),.saU.10.9

Madhur rasatmak daiet articles like Rasala, ghee, goat milk,
Karjur, etc. are soothing and nourishing. When only excess of it is
used, causes vitiation of Kapha, resulting in Sthaulya, tenderness,
laziness, hypersomnia, loss of power of digestion, cough, etc. So,
excessive consumption of these substances leads to Sthaulya.
4. Guru Ahara:-
gau$ vaathr puYTISlaoSmakRt\ icarpakIca | Baa p` 1
According to Bhavmishra the substance bearing the attribute of
heaviness, decreases Vata dosha and increases Kaphadosh. Guru
are the properties of Meda. Meda is the seat of Kapha Dosha and
moreover Meda and Kapha possess similar properties. So, Guru-
Snigdha Guna dominant Ahara can increase Kapha as well as
Meda Dhatu. Excess consumption of elements which are heavy to
digest like wheat, buffalo milk, colostrum, etc produces heaviness
in the body. Excess consumption of guru gunatmak dravyas does
over nourishment in all dhatus and increases heaviness in the
body and leads to Sthaulya.
5. Sheeta Ahara:-
The food items which are cold like icecream, cold cakes are having
property to increase Kapha Dosha. Jala Mahabhoot is predominant
in these items, which vitiate Kapha dosha in the body. Vitiated
Kapha produce Alasya, heaviness in the body.
6. Adhyasana:
Adhyasana means frequent food intake before digestion of a
previous meal. Adhyasana cause Ama formation in the body.
7. Divaswapana:-
ra~aO jaagarNaM Éxa ,isnagQaM p`svapnaM idvaa |
AÉxamanaiBaYyaind %vaasaInap`calaaiyatma | ca.saU.
21.53
Divaswapana is Kapha aggravating factor and particularly possess
Abhishyandi property, which leads to blockage in all body
channels. During Nidra and Divaswapana physical activity
diminishes which further provokes Kapha leading to Meda
deposition.
8. Achintana:- Achintana is a psychological factors mentioned by
Acharya Charaka, which is responsible for Medavriddhi. This factor
is Kapha aggravating factors lead to Meda deposition.
9. Harshnityatwa:-

With this type of psychological well being and jolliness those people
indulge more in worldly pleasure and excess energy stored in the
form of Meda
10. Asana Sukha:-
Tendency of happiness in sitting posture is called as Asansukha.
According to Caraka, aasansukha is a causative factor for
prameha. Continuesly sitting postue vitiate Kapha dosha in the
body, as there is less work less energy loss. And thus excess
consumed calories stored in the form of fat.
11. Avyayama:-
Lack of daily Excersise leads to less utilisation of energy in the
form of calories. If person is having siting type of work and he avoid
daily exercise he will become victim of disease Sthaulya.
12. Avyavaya:-
According to Acharya Charak Avyavaya is one of the causative
factors for Sthaulya. In modern scince also it is explained that
libido is type of excersise, so lack of libido will leads to Sthaulya.
13. Ama Annarasa (Ama Dosha):-
rsainaima<amaova sqaaOlyaM kaSya-M ca | sau.saU. 15.32

Ama Anna Rasa is mentioned as root cause of Sthaulya in
Su.Su.15/32. Rasa has been considered as a causative factor for
Sthaulya and Karsya. In the presence of Ama Anna rasa, further
intake of Madhura rasa tends to convert in Madhur Ama Rasa
which leads to formation of Meda due to similarity and specific
action of food it leads to Sthaulya.
14. Beeja Svabhava (Genetic Factor):
Only Charaka Samhitā has defined Beejadosha as one of the cause
besides other. According to Charaka, defect in Beejabhagavayava
i.e. part of Beeja, which resembles with chromosomes and genes
may lead to defective development of that organ.
G) SAMPRAPTI:-
Charaka and Sushruta have different opinion about Samprapti of
Sthaulya. Charaka has accentuated “Ahara” as most common
pathogenic factor for Medovridhhi in Sthaulya, while Sushruta
accepted “Ama Dosha”.
According to Charaka –
maodsaa||vaRtmaaga-%vaaWayau: kaoYzo
ivaSaoYat: |
carna\ saMQauxaya%yaignamaaharM SaaoYaya
%yaip | 5 |
tsmaat\ sa SaIGa`M jarya%yaharM caaitka=\xaait |

ivakaraMEcaaEauto Gaaorana\ kaMiEca
%kalavyaitËmaat\ |6 | ³ca.sau.21. 5¹6´
Due to obstruction of Srotas by Meda, the Vata moving mainly into
stomach, augments the Agni and absorbs the food. Thus the obese
person digests food speedily and craves for food tremendously. Over
eating produces over growth of Meda Dhatu, this leads to Sthulata.
According to Sushruta –
Aama Rasa is produced due to Kapha Vardhaka Ahara, Adhyasan,

Avyayama, Divaswapna. The Madhur Bhava Ama Rasa moves about
within the body. The Snigdhansha of that Ama Rasa causes Medo
Vriddhi, which produces excessive tubbiness
1. DOSHA:
Sthaulya is a Kapha predominant Vyādhi but involvement of Vata –
Pitta cannot be overlooked. So, collaboration of three Dosha
propagates the process of pathogenesis in Sthaulya.
a) KAPHA: Acharya Charaka has counted Sthaulya under Kapha

Nanatmaja Vyādhi.
slaoSma ivakaraSca.... AitsqaaOlyaMca | ³ca.sau.20.17´
As per view of Acharya Sushruta, excessive intake of Madhur, Amla,
Snigdha, Guru, Picchila and Abhishyandi Ahara and Vihara like
Diwasvapna, Avyayama leads to vitiation of Kapha (Su.Su.21/23).
c) VATA: Vata has been mentioned in the state of Avrita in Sthaulya

and this Avrita Vata provocates the Agni ultimately increasing
Abhyavaharan Shakti. Thus, vitiated cycle of pathogenesis starts.
The process of circulation, digestion and proper distribution of
Dhatu, these functions are controlled by Samana and Vyana Vayu.
Hence, involvement of Samana vayu can be clearly pastulated with
the evidence of Agni Sandhukshana.
2. DUSHYA:
Primarily Meda Dhatu is vitiated in Sthula. As Kapha is the prime
Dosha in Sthaulya. The involvement of Rasa dhatu as it is vitiated
Jathargnidushti. Aama pachan is hammperd, and it vitiate
medodhatwagni dushti will occur. It leads to Meda Dhatu Vrudhi.
3. SROTASA:
Medovaha Srotasa is primarily involved in Sthaulya.
Avyaayaamai_vaasvaPnaaonmaoVanaaM caaitBaxaNaat\ È
maodaovahIina duYyaint vaa$NyaaEcaaitsaovanaat\ ÈÈ 16
ÈÈ ³ca.iva.5À16´

The Medovaha Srotasa gets vitiated in consequences of lack of
exercise, daysleep, excessive consumption of fatty diet and over
indulgence in Varuni.
4. SROTODUSHTI:
In Sthaulya, the Srotodushti is Sanga type. Medavaha srotas get
vitiated in Sthaulya
5. AGNI:
There are 13 types of Agni as per Ayurvedic texts.
They are
a) Jatharagni (1)
b) Dhatvagni (7)
c) Bhutagni (5)
a) Jatharagni: – Agni is covered by Meda and digestive power is

increased to Snehan property of Meda .Agni is hyperactive in
Sthaulya. Time required for digestion is very less.
b) Dhatvagni – After the digestion of food by Pachakagni Annarasa

is produced which enters the circulation to be acted by the
Dhatvagni and Bhutagni. The excessive production of Annarasa
may lead to Sthaulya if the Medodhatvagni is hypoacting. This
Dhatvagnimandhyata may be due to the medodhatvagni
Poshakansha Dushti by Beeja Dosha or due to the Srotavarodha by
increased Kapha and Meda.
c) Bhutagni: The action of Bhutagni is to convert food partical into

the respective Mahabhutas in the celluler level. The Medodhatu is
made of Prithvi and Jala Mahabhuta. The foods and drinks taken
as the Nidana of Sthaulya are also Prithvi and Jala Mahabhuta
Pradhana. So Bhutagni transforms them into Prithvi and Jala
Mahabhuta in the cell. In Sthaulya mainly Apyagni and Parthivagni
should be considered which are either normal or underacting.
6. Aama:-
rsainaima<amaova sqaaOlyaM kaSya-M ca È
Ama is defined by Ayurveda for Apakva Ahara Rasa. There are two
types of Ama- Jatharagnimandhya janita and Dhatvagnimandhta
Janita. In Sthaulya, Jatharagni is Tikshna and Vata is vitiated in
Kostha. So, patient eats frequently. The Adhyasana leads to Ama
formation and this Ama formation causes Jatharagnimandya by a
chain process. Ama traversing in the body channels, accumulates
and obstructs the Medovaha Srotasa owing to the Khavaigunya
due to Bijaswabhava and/or Dhatu Shaithilya (Nidanasevana). It
combines with Kapha and Meda decreasing the Medodhatvagni,
which consecutively give rise to augmentation of Meda means
Sthaulya.

7. Adhishthana:
In initial stage the disease Sthaulya is manifested on Sphika,
Udara, Stana and Gala. The Meda particularly deposits on
Vapavahana and other Medodhara Kala. Ultimately whole body get
affected.

NIDANA
AHAR VIHAR MANASIKA
GURU MADHUR
ATISAMPURAN AYAYAM HARSHNITYATA
SHEETA
AVYAVAYA ACHINTAN
SNIGDHA
DIVASWAPNA
KAPHAVRIDHI
EXCESS PRESSURE ON
JATHARAGNI,
AVARAN OF VAYU JATHARAGNI DUSHTI
AMA ANNARASOTPATTI
MEDO DHATWAGNIDUSHTI
MEDOVAHA SROTODUSHTI
Medasa Vayuavaranam
Agnisandukshan
Shighrapachan
Kshudhadhanirmi
ti
Adhyashan
Medanirman Ayathopchit
STHAULYA Medovruddhi

H) SIGN & SYMPTOMS OF STHAULYA AS PER CHARAKA:-
maodaomaaMsaaitvaRQd%vaaccalaisfgaudrstna: È
Ayaqaaopacayaao%saahao narao|itsqaUla ]cyato ÈÈ 9 ÈÈ
³ca.sau.21À9´
Means the inordinate increase of fat & flesh is disfigured by
pendulous buttocks, abdomen & breast and that increased bulk
reduces the corresponding increase in energy. So the person has less
enthusiasm in his physical activity.
Besides these cardinal symptoms, disabilities of Sthaulya are –
1. Ayushorhasa :- Formation of only Medodhatu.
2. Javoparodha :- Due to Shaithilya, Gurutwa and Sukumarta.
3. Kriccha Vyavaya:- Due to Aavrutta Margatva Alpa Shukratva.
4. Daurbalya :- Due to Dhatu Asamatwa.
5. Daurgandhya :- Due to Medo Dosha.
6. Swedabadha:- Due to Meda and Kapha Sansarga causes Meda
vileyan.
7. Kshudhatimatra :-Due to Tikshna Agni and prabhut Vayu in
Koshta.
8. Pipasatiyoga :- Due to Tikshna Agni and prabhut Vayu in koshta.
Elaborated pathogenesis of occurrence of Ashta Dosha of Sthaulya
has been described in Ch.Su.21/4 which is as follows:-
tsmaadsyaayauYaa (asa:Ê SaOiqalyaat\ saaOkumaayaa-gdu$
%vaacca maodsaao javaaopraoQa:Ê
SauËabahu%vaanmaodsaa||vaRtmaaga-%vaacca
ÌcC/vyavaayataÊ daOba-lyamasama%vaaQdatUnaaMÊ daOga-
nQyaM
maodaodaoYaanmaodsa: svaBaavaat\ svaodna%vaaccaÊ
maodsa: ElaoYmasaMsagaa-iWYyaind%vaaWhu%vaa
ndu$%vaadvyaayaamaasah%vaacca svaopdabaaQa:Ê
tIxNaaigna%vaat\ p`BaUtkaoYzvaayau%vaacca xauditmaa~M
ippasaaityaaogaEcaoit ÈÈ 4 ÈÈ ca. saU. 21.4
(1) Ayushorhasa – Diminition of life span is due to excessive growth of
Medadhatu, which inhibits the nourishment of further Dhatu.
(2) Javoparodha - Due to Sukumarya, Guru& Shaithiliya properties
of Meda Dhatu, it causes Javoparodha.
(3) Kricchavyavaya – Excess of Meda Dhatu leads to Shukra Kshaya
due to Margavarodha which is also a cause of Aharsha (Ch.Chi.6/13).
Sexual intercourse cannot be performed properly due to excessive
deposition of fat in the abdomen.
(4) Daurbalya – Due to disequilibrium / malnourishment of other
dhatu and excess formation of Meda Dhatu, the general debility
occurs.

(5) Daurgandhya – Sweda is the Mala of Meda. So, excessive sweating
is seen in Sthaulya. According to Chakrapani Meda is
„Amagandhitwen durgandham‟ due to Swabhava.
(6) Swedabadha – Due to association of Meda with Kapha (Kledaka),
its oozing nature, abundance, heaviness & intolerance to physical
exercise there is Swedabadha.
(7-8) Kshudhatimatra & Pipasatiyoga – Due to increased Agni in
Kostha & vitiation of Vata by obstruction of Meda it results in
excessive appetite & thirst.
I) UPADRAVA:-
The disease which occurs in the later phase of the main disease
with same Dosha is known as Upadrava. (Ch.Ni.8, Su. Su.35)
Acharya Charaka has not described the Upadrava separately but
he has reported that if Sthaulya is not treated, many diseases may
be arisen out.
According to Charaka,
tsmaat\ sa SaIGa`M jarya%yaharM caitka=\xaait È
ivakaraMEcaaEauto Gaaorana\ kaMiEca%kalavyaitËmaat\
ÈÈ 6 ÈÈ
evaavaupd`vakraO ivaSaoYaadignamaa$taO È
etaO ih dht: sqaUlaM vanadavaao vanaM yaqaa ÈÈ 7 ÈÈ
³ca.sau.21À6¹7´
tditsqaaOlyamaapadayaitÊ
tamaitsqaUlaMxaudÈvaasaippasaaxausvaPna
svaodgaa~daOga-nQyaËqanagaa~saadgdd%vaaina
ixap`maovaaivaSaintÊ saaOkumaayaa-naodsa: sava--
iËyaasvasamaqa-:Ê
kfmaodaoina$Qd¹ maaga-%vaaccaalpvyavaayaao BavaitÊ
AavaRtmaaga-%vaadova SaoYaa Qaatvaao
naaPyaayanto|%yaqa-matao|lppàNaao BavaitÊ
p`maohipDkajvarBagandrivadìQavaativakaraNaamanyatmaM
pàPya
pajca%vamaupyaaitÊ sava- eva caasya raogaa balavantao Bavan
%yaavaRtmaaga-%vaat\ s~aotsaama\ È
sau.saU.15.32
Acharya has said that due to chronic consistence of Sthaulya
complications occurs like have occur due to the two complicating
elements Agni and Vata. Acharya Charaka has not mentioned another
specific Upadravas, but othe Updravas mentioned by other Acharyas
are as below-
1. Prameha: Prameha and Mutrakriccha Upadrava occur due to
vitiated Meda, particularly Abaddha Meda. Due to similarity of

Nidana and Dosha Dushya Prameha is most frequent
complication of Sthaulya.
2. Mutrakriccha: Mutrakriccha ocures in Sthula person due to loss
of water in the body due to sweating.
3. Jvara: Jvara in Sthaulya is mainly due to the involvement of
Production of Ama in Sthaulya person.
4. Ajirna, Atisara, Bhagandara, Arsha and Udara roga: Upadrava
like Ajirna, Atisara, Bhagandara, Arsa, and Udararoga etc. can
emerge due to malfunctioning of Agni and formation of Ama
owning to Adhyasana aan Shleshmavardhaka Ahara in Sthaulya.
5. Vatavikara: Excessive production of Meda causes
Maragavarodha in Srotasa which may lead to Anuloma Kshaya of
Uttar Dhatu. As a result of Asthidhatukshaya, Vatavikara
manifests.
6. Urustambha: Urustambha may occur due to excessive
production of Meda and Kapha along with vitiation of Vata in
patient of Sthaulya.
7. Vidradhi, Shlipada, Pramehapidika and Visarpa: Apachi,
Vidradhi, Slipada, Pramehapidika, Visarpa etc. may result due to
vitiated Meda particularly Abaddha Meda.
8. Krimi and Kustha: According to Bhavaprakasha excessive
perspiration and fetid odour caused by Meda is the main
pathology in genesis of Krimi which is one of the cause of Kustha.
9. Kasa and Shwsa: Elevated Meda and Ama obstruct the Srotasa.
As a result other Dhatus do not get Poshana from Ahara Rasa. So
Alpa prana (low vitality power) results.
10. Sanyas: Sanyas may occur due to Dushti of Prana and Oja
caused by excessive formation of Ama in Sthaulya.
11. Mrityu: According to charak- Due to Ati kshudha and Atipipasa
and manifestation of severe complication and even death due to
negligence of Sthaulya.
J) Sadhyasadyata:-
Most of the Acharyas have described that Sthaulya is having bad

prognosis and Sahaja Sthaulya are considered incurable. Charaka
also emphasized the fact that the treatment of Sthaulya is more
difficult than Karshya.
Acharya Charaka has mentioned the bad prognosis of Sthaulya as if
an obese person is not duly managed; he is prone to death due to
excessive hunger, thirst and complications (Ch. Su. 21/8). Again
Charaka has mentioned in Chi. 6/57 bad prognosis for Sahaja
(hereditary) disease. Hence Sahaja Sthaulya can be considered as
Asadhya.
K) PATHYA – APATHYA
AHARA
Ahara Varga Pathya Apathya

Shuka Dhanya Yava,Venuyava,Kodrava Godhuma, Navanna,
Nivar, Jurna Shali
Shami Dhanya Mudga, Rajmasha, , Masha, Tila
Adhaki
Kulattha, Chanak,
Masur
Shaka Varga Vruntak, Patrashaka, Madhurshaka, Kanda
Patola
Phala Kapitha, Jamun, Madhuraphala
Amalak
Dravya Takra, Madhu, Dugdha, Ikshu,
Ushnodaka Navnit,
Til Tail, Sarshap Tail, Ghrita, Dadhi
Arishtha Asava,
Jirnamadya
Mamsa Rohit Matsya Anupa, Audaka,

Gramya
VIHARA
Pathya Apathya
Shrama Sheetala Jala Snana
Jagarana Divaswapa, Svapna Prasanga,
Sukha Shaiya
Vyavaya Avyayama, Nitya Bhramana,
Avyavaya
Chintana Achintana
Shoka Nityaharsha
Krodha Mansonivritti
L) STHAULYA CHIKITSA
yaaiBa: iËyaaiBajaa-yanto SarIro Qaatva: samaa: È
saa icaik%saa ivakaraNaaM kma- tiBdYajaaM smaRtma\
ÈÈ 34 ÈÈ
³ca.sau.16À34´
According to Acharya Charaka, Such actions, which bring the
equilibrium of Dhatu, constitute the treatment of diseases. Acharya
Charaka has further amplified the scope of the term Chikitsa.
According to him, the aim of Chikitsa is not only at the radical
removal of the causative factors of the disease, but also at the
restoration of the Doshika equilibrium” (Ch.Su. 9/5). As per view of
Acharya Charaka the main line of treatment of any disease is
saMSaaoQanaM saMSamanaM inadanasya ca vaja-nama\
ÈÈ

etavaiBdYajaa kaya-M raogao raogao yaqaaivaiQa ÈÈ 30
ÈÈ ³ca.iva.7À30´
So, the first line of treatment for Sthaulya is to avoid those factors
which are responsible for the causation of Sthaulya. All the factors,
having Snigdha Guna dominance in general should be avoided. Nitya
Langhana therapy & Langhana even in Shishir Ritu is advised for the
patients of Sthaulya by Vagbhatta (A.S.Su.24/13, A.H.Su.14/13).
Then types of Langhana therapy i.e. Vamana, Virechana etc. are
advised for practice according to Vyādhibala & Dehabala by Charaka
(Ch.Su.22/18). Amongst Sadavidha Upakramas, Langhana &
Rukshana therapies are more suitable for the management of
Sthaulya. Vagbhatta included all therapies under two main headings
i.e. Langhana & Brimhana. Langhana, the line of treatment for
Sthaulya has been further divided into Samsodhana & Samshamana.
(A.S.Su.24/13-16, A.H.Su.14/14).
SAMSODHANA :
All Sthula patients with Adhika Dosha & Adhika Bala should be
treated with Samsodhana therapy, including Vamana, Virechana,
Niruha, Raktamoksana & Sirovirechana (A.H.Su.14/14). Being a
syndromic condition (Bahudoshasya Laksanam) Samsodhana therapy
is highly recommended for Sthaulya patients possessing stamina &
strength (Ch.Su.16/13-16). Ruksha, Ushna & Tikshna Basti are also
suggested by Acharya Charaka (Ch.Su.21/21-23). Ruksa Udvartana is
the Bahya Sodhana indicated for the management of Sthaulya
(A.S.Su.25/65-66). Snehana Karma is always restricted for the
patients of Sthaulya (Ch.Su.13/53); however on exigency usage of
Taila is recommended. (Ca.Su.13/44-46).
SHAMANA :
The therapy which neither expels the Dosha from body nor disturbs
the homeostasis of Dosha is called Shamana & is of seven types i.e.
Pachana, Dipana etc. (A.S.Su.24/9). Among the Shat Upakramas,
Langhana & Rukshana can be administered in them (Ch.Su.22/4).
Alleviation of Vata, Pitta & Kapha especially Samana Vayu, Pachaka
Pitta & Kledaka Kapha along with reduction of Medo Dhatu by
increasing Medodhatvagni is the main goal of treatment in Sthaulya.
Management of Sthaulya is quite difficult because both Agni and Vayu
are in aggravated state. If Apatarpana is done Vayu gets Vriddhi and
Agni starts burning other Dhatus and if Santarpana is done the
disease will be aggravated. So, the principle for the treatment of
Sthaulya is:
gau$ caatp-NaM caoYTM sqaUlaanaaM kSa-naM pìt È

ÌSaanaaM baRMhNaaqa-M ca laGau saMtp-NaM ca yat\ ÈÈ
ca.saU. 21.20

Heavy and non- nourishing diet is prescribed for sliming in case of the
over corpulent & light and nourishing diet for the nourishment of the
slim. In order that the over corpulent ones are brought to normal
health, heavy but non – nourishing diet like honey may be given. By
virtue of their heaviness such diets would minimize the force of the
aggravated power of digestion and due to their non – nourishing
nature they would help to reduce fat.
Sthaulya= Guru + Apatarpan.
Karshya= Laghu+ Santarpan.
In above mentioned two therapies for emaciating and nourishing the

over corpulent and emaciated persons respectively are no doubt the
most effective ones but if given to baRhNaAh_ person and in proper
quantity. But Nourishment if given in excess to a person and if given
to baRhNaAnah_ person, he might suffer from number of different
diseases caused by over nourishment.

OBESITY A MODERN VIEW
History:-
The Greek were the first to recognize obesity as a medical disorder.

Hippocrates (460-377) – The great Greek clinical genius and the father
of modern medical science haddiscussed causative factors,
complication, prognosis, and treatment of corpulence very lucidly. He
states that “Corpulence is not only a disease itself, but the precursor
of others.”
Ancient Greek medicine recognizes obesity as a medical disorder,

and records that the Ancient Egyptians saw it in the same way.
Hippocrates wrote that "Corpulence is not only a disease itself, but the
harbinger of others". The Indian surgeon Sushruta (6th century BCE)
related obesity to diabetes and heart disorders. He recommended
physical work to help cure it and its side effects. For most of human
history mankind struggled with food scarcity. Obesity has thus
historically been viewed as a sign of wealth and prosperity. It was
common among high officials in Europe in the Middle Ages and the
Renaissance as well as in Ancient East Asian civilizations.
With the onset of the industrial revolution it was realized that the
military and economic might of nations were dependent on both the
body size and strength of their soldiers and workers. Increasing the
average body mass index from what is now considered underweight to
what is now the normal range played a significant role in the
development of industrialized societies. Height and weight thus both
increased through the 19th century in the developed world. During
the 20th century, as populations reached their genetic potential for
height, weight began increasing much more than height, resulting in
obesity. In the 1950s increasing wealth in the developed world
decreased child mortality, but as body weight increased heart and
kidney disease became more common. During this time period
insurance companies realized the connection between weight and life
expectancy and increased premiums for the obese.
Many cultures throughout history have viewed obesity as the result of

a character flaw. The obesus or fat character in Greek comedy was a
glutton and figure of mockery. During Christian times food was viewed
as a gateway to the sins of sloth and lust. In modern Western culture,
excess weight is often regarded as unattractive, and obesity is
commonly associated with various negative stereotypes. People of all
ages can face social stigmatization, and may be targeted by bullies or
shunned by their peers. Obesity is once again a reason for
discrimination.

Public perceptions in Western society regarding healthy body weight
differ from those regarding the weight that is considered ideal – and
both have changed since the beginning of the 20th century. The
weight that is viewed as an ideal has become lower since the 1920s.
This is illustrated by the fact that the average height of Miss America
pageant winners increased by 2% from 1922 to 1999, while their
average weight decreased by 12%. On the other hand, people's views
concerning healthy weight have changed in the opposite direction. In
Britain the weight at which people considered themselves to be
overweight was significantly higher in 2007 than in 1999. These
changes are believed to be due to increasing rates of adiposity leading
to increased acceptance of extra body fat as being normal.
Obesity is still seen as a sign of wealth and well-being in many parts

of Africa. This has become particularly common since the HIV
epidemic began. (Ref -Encyclopedia)
ETYMOLOGY:-
Obesity is from the Latin obesitas, which means "stout, fat, or plump".
Ēsus is the past participle of edere (to eat), with ob (over) added to it.
The Oxford English Dictionary documents its first usage in 1611 by
Randle Cotgrave.
SYNONYMS:
Synonyms for Obesity: Adiposity, Overweight, Corpulence,
Stoutness, Bulkiness, Turgidity, Clumsiness etc.
Synonyms for Obese: Fat, Corpulent, Stout, Clumsy, Chubby,

Adipose etc.
DEFINITION:
 Obesity describes a weight of 120% or above.(Medicine for
Student)
 Obesity is a state of excess adipose tissue mass.(Harrison)
 Obesity is usually easily diagnosed using what has been called
the eye ball test. “If a person looks fat, the person is fat.” ( API
text book of medicine 7th Ed.)
 An abnormal growth of adipose tissue due to an enlargement of
fat cell size or an increase in fat cell number or both is called
obesity.(PERK)
 Obesity is body weight more than 20% above a desirable
standard due to an excessive accumulation of adipose tissue.
 Obesity means excess deposition of fat in the body.(Gyton)
 BMI between 25 and 29.9 kg/m2 is called overweight and a BMI
greater than 30 kg/m2 is called obese.

CLASSIFICATION:
a. According to severity
i. Mild
ii. Moderate
iii. Severe
b. According to mode of onset:
i. Gradual
ii. Rapid
iii. Incidious
c. According to Stage of onset
i. Juvenile onset obesity
ii. Adult onset obesity
d. According to BMI( Body mass index):
Overweight BMI ≥ 25 kg/m2
Pre obese BMI 25-29.9 kg/m2
Obese class I BMI 30-34.9 kg/m2
Obese class II BMI 35-39.9 kg/m2
Obese class III BMI ≥ 40 kg/m2
e. According to surgical literature (categories of class III obesity):
i. Severe: BMI > 40 kg/m2
ii. Morbid: BMI > 40-49.9 kg/m2
iii. Super: BMI > 50 kg/m2
f. According to histopathology:
i. Hypertrophic obesity
ii. Hyper plastic obesity
iii. Combination of both
g. According to Etiological factors:
(a) Physiological – Observed temporarily during puberty, pregnancy
(b) Pathological – It is again divided into 3 viz.
(i) Exogenous – caused due to overeating & physical inactivity
(ii) Endogenous – Due to endocrine disorders i.e. Causing’s Syndrome
Hypothyroidism, Polycysctic ovarian syndrome, Hypoglyceamia,
Frohlich’s
Syndrome.
(iii) Idiopathic – When every possible causative factors of obesity has
been investigated and ruled out.
h. According to distribution of fat:
(a) Generalized: - Generalised accumulation of fat in the body and
usually seen in exogenous obesity
(b) Central (Android Obesity):- Storage of fat mainly in the abdomen.
(c) Superior (Buffalo type):- Involving the face, neck, arms and upper
part of trunk, common in Cushing’s syndrome or hypothyroidism.
(d) Inferior type: - Involving lower part of trunk and legs.
(e) Girdle type (Gynoid Obesity):- Involving hips, buttock, abdomen
found in
Pituitary or hypothalamic lesions.
(f) Breaches (Trochanteric type):- Involving only the buttocks found in
Hypogonadal syndrome.

(g) Lipomatous type:- Multiple Lipomatosis with localized depositions
of fat over the body.
i. According to Degree of obesity:
1. Mild degree obesity: 25% excess body weight than normal.
2. Moderate degree obesity: 50% excess body weight than normal.
3. Severe degree obesity: 75% excess body weight than normal
4. Very sever degree obesity: 100% excess body weight than normal.
Measurement:
The methods of assessment of obesity are as follows:
1. BMI
2. Waist Circumference
3. Waist Hip ratio
4. Skin fold thickness ( Anthropometry )
5. Hydrometry
6. Computed tomography (CT scan) and Magnetic Resonance
Image(MRI).
7. Broka’s index
1. BMI : ( Body Man Index )

BMI is calculate by taking an individual weight (in kg) and dividing it
by his or her height (in meters square). It is inexpensive and measures
an individual total weight, relative to their height.
Height (in m )
Weight (in kg)
This index provides a satisfactory measure of obesity in people who

are not
hypertrophied athletes. The classification of obesity as per B.M.I:
Under weight - <18.5 kg/m2
Normal weight - 18.5 - 24.9 kg/m2
Over weight - 25 - 29.9 kg/m2
Obesity (Class-I) - 30 - 34.9 kg/m2
Obesity (Class-II) - 35 - 39.9 kg/m2
Morbid Obesity (Class-III) - > 40 kg/m2
2. Waist circumference:
Waist circumference measurement becomes helpful to assess the risks
associated with obesity. The waist circumference is easily measured
by using a simple measuring tape, which is placed at the midpoint
between the lowest part of the ribs and the highest point of the iliac
chest and centrally positioned 1cm below the umbilicus .
A waist circumference is > 102 cm in men and > 88 cm in female
called obesity.
3. Waist Hip ratio:

Waist circumference is the minimum circumference between the
costal margin and iliac crest, measured in the horizontal plane, with

the subject standing. Hip circumference is the maximum
circumference in the horizontal plane, measured over the buttocks.
The ratio of the former to the latter provides an index of the proportion
of intra abdominal fat.
Average value of waist hip ratio is as follow:
In men, average value is 1.
In women, average value is 0.8.
From studies, it is evident that men and women, who have a high
waist/hip ratio circumference, have increased risk of death, blood
pressure and serum lipid levels.
4. Skin fold thickness:

It is also known as Anthropometry. This method is carried out by with
the help of venier caliper
The thickness of the adipose tissues which is lying in subcutaneous
layer is
measured by skinfold thickness. The four most commonly site used
for skinfold measurement are Biceps, Triceps, subscapular and
suprailiac. The method is inexpensive, but requires a skilled observer
and is not applicable to very obese people whose skinfolds would not
fit between the jaws of the measuring caliper. This is not a reliable
method for estimating intraabdominal fat.
5. Hydrometry:
Also known as underwater weighing or densitometry. In this method
isotope labeled water is being used. This method is the most accurate
method for assessment in the very obese (>200 kg) person, but these
are unsuitable of routine practice.
6. Imaging Techniques –
Images of cross sections of the body can be obtained by computed
tomography using either X-rays or magnetic resonance techniques in
principle, the entire body can be visualized by serial transverse scans.
It gives accurate results and having capacity to capture specific organ
adipocity levels but very expensive and time consuming.
7. Broca’s index: This measurement is easy to calculate and

accurate.
The formula for broka index
1)( Height in centimeters- 100= normal weight)
2)(Normal weight – 10%= ideal weight)
The broca formula, named after the inventor paul broca, a French
army doctor. Paul broca had to examine military capability of young
men. (Ref – encyclopaedia)
Fat:-
Obesity is condition in which excess deposition of fat takes place in
the body. The fat also recognised as lipids. The fat present in the
blood known as blood lipids and when stored in the adipose tissue

known as triglyceride. Thus, the storage of excessive amount of
triglycerides in the adipose tissue as body fat is responsible for
Obesity. These triglycerides are derived from dietary fat along with
cholesterol, phospholipids and cholesterol esterase.
This dietary fat is classified into two types:
Types of fat:
1. Saturated fat
2. Unsaturated fat
1. Saturated fat: A fat mainly consist of saturated fatty acid is called
saturated fat. Fatty acid that contains single covalent bond between
two carbon atoms of hydrocarbon chain called saturated fatty acid.
2. Unsaturated fat: A fat contain unsaturated fatty acid known as
unsaturated fat. In unsaturated fatty acid, there is one or more double
bond between two carbon atoms of hydrocarbon chain. Unsaturated
fatty acid further classified into two types:
a. Monounsaturated fat: There is only one double between two carbon
atoms of hydrocarbon chain fatty acid.
b. Polyunsaturated fat: Polyunsaturated fat contains more than one
double bond between carbon atoms of hydrocarbon chain fatty acid.
Digestion and absorption of fat:

When fat is ingested in the form of diet, a small amount of triglyceride
is digested in the stomach by lingual lipase and gastric lipase. Most of
digestion occurs in the small intestine through the action of
pancreatic lipase. About 80% of fat is digest by pancreatic lipase. In
the presence of bile salt and lecithin, pancreatic lipase broken down
triglyceride, into monoglyceride and fatty acid. These monoglycerides
and fattyacids than transported by miscells from intestinal lumen to
absorptive cells of intestinal mucosa, via simple diffusion. Inside
absorptive cells, monoglyceride and fatty acid are recombining to form
triglyceride. Along with cholesterol and phospholipids, triglycerides
are coated with protein and make large spherical mass called
chylomicrons .Chylomicrons are very large so they are unable to enter
in blood capillaries but can enter in peripheral blood circulation
through lymphatic vessels. While chylomicrons pass through blood
capillaries of liver and adipose tissue, the enzyme lipoprotein lipase,
present in the apical surface of capillary endothelium of hepatocytes
and adipocytes, break down triglyceride in chylomicron and other
lipoprotein into fatty acid and glycerol. These fatty acid and glycerol
absorbed by hepatocyte and adipocyte and stored as fat in the form of
triglyceride.
Lipoprotein:
Lipoproteins are small spherical particles produced by liver and small
intestine. These particles consist of an inner core of triglycerides and
other lipids, and an outer shell of protein, phospholipids and
cholesterol. Lipoprotein transports some non-polar and hydrophobic
lipids such as triglycerides and cholesterol in watery blood plasma.

Lipoproteins are categorised and named mainly according to their
density. There are four major types of lipoprotein as below:
1. Chylomicrons
2. Very low density lipoprotein
3. Low density lipoprotein
4. High density lipoprotein
Lipogenesis:
Synthesis of triglyceride from carbohydrate and amino acid is called
lipogenesis.
1. Synthesis of triglyceride from carbohydrate:
When carbohydrate rich diet consumed in large quantity and if there
is no immediate requirement for energy, it converted into glycogen and
stored in the hepatocytes and skeletal muscle cells. About 75% of
glycogen stored in skeletal muscle fibres and rest amount in liver
cells. When liver cells and muscle cells are saturated with glycogen,
additional carbohydrate in the form of glucose, transported by
hepatocytes to adipose cells. In adipocyte, this glucose is used to
synthesize minute amount of fatty acid and large amount of glycerol.
This glycerol molecule combines with three molecules of fatty acid and
forms triglyceride that is ultimately stored in the adipose cells as body
fat.
2. Synthesis of triglyceride from amino acids:
During digestion, proteins are broken down into amino acids. In
hepatocytes, amino acids are converted into deaminated amino acids
by removal of amino group(-NH2).Certain deaminated amino acids like
alanine are converted into acetyl co-A .Ultimately This acetyl co-A
converted into fatty acid that can be used by hepatocytes to
synthesize triglyceride.
Storage of fat:
Excess dietary carbohydrate, proteins, and fat converts into
triglycerides and deposits in adipose tissue and liver. The fat stored in
adipose tissue is called neutral fat or tissue fat. When the
chylomicrons are travelling through capillaries of adipose tissue or
liver, the enzyme called lipoprotein lipase hydrolysis of triglycerides of
chylomicrons into free fatty acid and glycerol. Free fatty acid and
glycerol enter the fat cells of adipose tissue or liver cells. Than FFA
and glycerol are again converted into triglycerides and stored in these
cells as body fat. The lipase also cause hydrolysis of phospholipids
and release fatty acids to be stored in the fat cells.
Adipose tissue:
Large quantities of fat are stored in the adipose tissue in the form of
triglyceride. The adipose tissue also called fat deposits, tissue fat, or
body fat. Adipose tissue is loose connective tissue compose of
Adipocytes.
Adipocyte: Adipocytes also known as fat cells that store triglyceride.
Adipocyte stores about 80-95% of triglycerides of the entire cell

volume. Triglycerides deposited inside the fat cell, are generally in
liquid form.
Obesity or being overweight in humans and most animals does not
depend on body weight but on the amount of body fat, to be specific,
adipose tissue.
In human body, adipose tissue located as below:
a. Beneath the skin (Subcuteneus fat)
b. Around internal organs (Visceral fat)
c. In the bone merrow (Yellow bone merrow)
Fat depot:
Adipose tissue found in specific location of the body called fat depot or
adipose depot. These depots are as below:
 Subcuteneous layer : 50%
 Around kidney: 12%
 In the omenta: 10-15%
 In genital area: 15%
 Between muscles: 5-8%
 Behind the eyes, In the sulci of the heart, &outside of large
intestine: 5%
Function of adipose tissue:

1. To store energy in the form of fat.
2. To produce hormone such as leptine, resistine, cytokine and TNF
alpha 1
3. 98% of total body energy reaserve as Triglycerides in adipose tissue
4. Fat serves as vehicles for fat-soluble vitamins.
5. Fat in the body supports viscera such as heart, kidney and
intestine.
6. Fat beneath the skin provide insulation against heat and cold.
7. Vegetable fats are rich source of essential fatty acids, which have
been used by the body for growth, for structural integrity of the cell
membrane and decreased platelet adhesiveness.
8. Diets rich in EEF are effective on reduction of serum cholesterol
and LDL.
9. Polyunsaturated fatty acid are precursor of prostaglandins that play
major role in controlling physiological function such as vascular
homeostasis, acid secretion in stomach, gastro-intestinal mortality,
lung physiology and reproduction.
10. Cholesterol is essential as a component of membrane and nervous
tissue and a precursor for the synthesis of steroid hormones.
PATHOGENESIS OF OBESITY
In accordance with the general principle that increased functional
demand
stimulates enlargement (hypertrophy) and / or proliferation of
(hyperplasia) the cells concerned, grossly obese humans having an
increase in number and/or size of adipose cells suggest hypertrophy
and/or hyperplasia of adipocytes either due to functional demand in

particular age or sex or due to genetic, endocrine, behavioral,
psychological or iatrogenic factors. After reduction in weight the
adipose cells shrink in size but hyperplasia remains fixed.
Accumulation of excessive amounts of adipose tissue, is a subject in
which it is difficult if not impossible, to draw a sharp diving line
between the physiological and pathological stages. However, there is
no doubt that gross obesity is harmful and must be regarded as
pathological. Adult onset obesity is characterized predominantly by
adipose cell hypertrophy with minimum hyperplasia. Apart from the
increase in size of normal depot. e.g. the subcutaneous tissue, the
omentum, retroperitoneal tissues and epicardium adipose tissue in
obesity may extend to the tissue where it is normally absent. There
are three main factors in the pathogenesis of obesity:
1) Excessive lipid deposition
2) Diminished lipid mobilization and
3) Diminished lipid utilization.
1. Excessive lipid deposition is due to either increased food intake or
hypothalamic lesions. Increased food intake in form of carbohydrates,
proteins and fats by metabolic process lastly converts in fat and get
stored at fat depots.
2. Diminished lipid mobilization is due to either decrease lypolytic
hormones or defective cells or abnormality of autonomous innervation.
Thyroxin and adrenaline stimulate mobilization of unsaturated fatty
acids from adipose tissue, abnormality of these two causes diminished
lipid mobilization and excessive lipid deposition ultimately leads to
obesity.
3. Diminished lipid utilization is due to either ageing, defective lipid
oxidation, defective theromogenesis or physical inactivity. It is the
main pathology in middle age obesity.
AETIOLOGY:
Obesity is a complex multifactorial chronic disease developing from
interactive influence of numerous factors; social, behavioural,
psychological, metabolic, cellular and molecular (genetics).
Age: Obesity is most prevalent in middle age but can occur at any
stage of life. Adolescent obesity is common in prosperous communities
and countries due to the lack of physical activity. Obesity in childhood
and adolescence is likely to be followed by obesity in adult life. Fat
increases in both sexes after puberty and during adult. Hyperplastic
obesity in adult is extremely difficult to treat with conventional
methods. Between age 20 and 50, fat content of men approximately
doubles and those of women increase by about 50 percent.
Sex: In general, the women are more prone to be obese than men. The
young women contain fat approximately 15% of body weight and it is
about more than young man. In that phase of puberty, pregnancy,
Menopause and cyclic oedema are the predominating factors, which
cause obesity in females. In adolescent due to hormonal changes,
more fat accumulates in
body, particularly in females.

Genetic factors: Genetics inheritance probably influence 50-70 per
cent a persons, chance of becoming fat more than any other factor.
Within families, the chance is 80 per cent if both parents are obese
and 50per cent if one parent is obese. A mutation of some particular
genes i.e. mutations of leptine receptor, malanocortine-4 receptor
increases the risk of obesity.
Physical inactivity: Obesity found in people who lead sedentary lives
and pay less importance to physical activity. Sedentary lifestyle may
play the dominant role in many obese people. Obesity can occur at
any age; this is more common during middle age when physical
activity decreases without corresponding decrease in food
consumption. Regular physical activity and physical exercise known
as increase muscle mass and decreased body fat mass, whereas
inadequate physical activity is typically associated with decreased
muscle mass and increased adiposity.
Socio-economic status: there is a clear inverse relationship between
socio-economic status and obesity. In the developing world women,
men and children from high social class had greater rates of obesity
because of availability of surplus food, high-energy diet (especially
fatty food) and sedentary life style.
Eating habit: certain type of eating habits may lead to obesity
Nibbling between meals is common among housewives and is a
potential cause for obesity in them. Eat faster and taking less time for
chewing, is the reasons for consume more food. Business executives
who frequently attend business lunches have more chance to
becoming obese. People who eat more junk food ( high fat, high
carbohydrate) may become obese. Non-inclusion of fruits and
vegetables and non-vegetarian diet favour weight gain. People who like
eat processed, concentrated and high fat foods are susceptible to
obesity.
Psychological factors: There is involvemrnt of some psychological
factors as the aetiology of obesity in some people. Overeating may be a
symptom of depression, anxiety, frustration and loneliness in
childhood as it is in adult life. Self gratification, self punishment,
depression, anxiety and stress may lead to excess caloric intakes.
People often gain large amount of weight during or after stressful
situation such as the death of a parent, a severe
illness.
Endocrine factors: There may be involved in occasional cases such
as hypothyroidism, hypogonadism, cushing’s syndrome. Obesity is
common at puberty, pregnancy and menopause; suggesting
attachment of endocrine factors in obesity.
Trauma: obesity may follow due to damage to hypothalamus after
head injury because it is not able to regulate appetite or satiety. The
lesion in the ventromedial nuclei of the hypothalamus causes an
animal to eat excessively and become obese. Abnormalities of
neurotransmitters or receptors mechanism in the neural pathways of
the hypothalamus that control feeding cause obesity.

Drug: Use of certain drug e.g. corticosteroids, contraceptives, insulin,
beta-blocker, anticonvulsant, anti-depressants etc. can promote
weight gain.
MENIFESTATION OF OBESITY
In the modern medical science, the sign and symptoms of obesity are
given
also. Obesity has paucity of sign and symptoms and most of them are
because of its complications.

Sign of obesity:
1. Weight gain- more than 20% of normal body weight.
2. Body mass index- >30 kg/m2 called obese
3. Skin fold thickness - More than 20 mm in a man and 28 mm in a
woman.
4. Waist hip ratio –Waist hip ratio >1 in males and >0.8 in females
known as Obese.
5. Waist circumference- >102cm in man and >88 cm in female
Symptoms of obesity
1. General lassitude
2. Day time hypersomnalism
3. Protuberant abdomen
4. Dyspnoea on exertion
5. General lassitude
6. Menstrual disturbance and sterility in fatty female
7. Depression
8. Snoring
9. Sleep apnoea
10. Low self esteem
11. Poor self emage
12. Backache and knee joint pain
13. Fungal infection in skinfold area
14. Vericose vein and ankle oedeama
15. Development skinfold around the axilla below the breast,
peritoneal region
COMPLICATIONS:
Obesity is defined as an excess of adipose tissue that imparts health
risk, a
body weight of 20% excess over ideal weight for age, sex and height is
considered a health risk.
Obesity increase the risk of many physical and mental conditions.

Physiological and biochemical mechanisms associated with obesity
affect every system of the body. Obesity is closely associated with a
variety of comorbidities that can occur alone or concomitantly.
National Center for Health Statistics reveal that 65% of overweight or
obese adults have at least one and 27% have two or more obesity
related complications.

The complications associated with obesity are as below:
1. Cardiovasculer system:
 Coronary heart disease
 Myocardial infarction
 Congestive heart failure
 High blood pressure
 Deep vein thrombosis
2. Respiratory system:
 Asthma
 Bronchitis
 Obstructive sleep apnoea
3. Gastro intestinal system:
 Fatty liver disease
 Cholelithiasis
4. Reproductive system:
 Menstrual disorders
 Infertility
 Polycystic ovarian syndrome
 Complication during pregnancy
5. Muscle and skeletal system:
 Osteoarthritis
 Backache
 Gout
6. Oncology:
 Cancer of colon, rectum and prostate in men
 Cancer of endometrium, breast, ovary, cervix in female
7. Psychiatry:
 Depression
 Social stigmatization
 Low self-esteem
PROGNOSIS
The prognosis is poor, untreated, it tends to progress. It is easy for an
obese person to lose upto 5 kgs of weight, (these accounts How
different it is to achieve further loses is not generally realized,
Experience in many clinics have shown that it is difficult for patients
to maintain their reduced weight. Since this requires some restriction
of energy intake on a long-term basis.
MANAGEMENT:-
1. Diet therapy
2. Physical exercise
3. Stress management
4. Behaviour therapy
5. Pharmacotherapy
6. Surgery

1. Diet therapy:
Dietary treatment is fundamental to the management of obesity. The
best and successful diet is for obesity is low calorie, normal protein,
vitamin and mineral (except sodium) , low carbohydrate low fat and
high fibre . By the help of diet, an ideal reduction in weight is 500 –
1kg.
Principals of dietetic management in obesity.

Energy: For a sedentary worker , 20kcl / kg of body weight is
preferred .while 25 kcal for Moderately active worker .
Protein: There is about 0.8 – 1 gm /kg is prescribed for tissue repair
and for
specific dynamic function .
Carbohydrates: The Carbohydrate reach foods like potatoes, rice,
sugar in
empty stomach and fruits like banana should be avoided in meal.
Fat: For reduced weight, low fat less, should be given while nuts oil
seed rich in fat should be avoided. Skimmed milk should be preferred
as diet.
Vitamins: There is supplementation of fat-soluble vitamin – A and D
is necessary.
Minerals: Restriction of sodium as common salt is helpful in weight
reducing diet. As excess sodium predisposes to retention on of fluid.
Diet rich in calcium helps in reducing weight owning to it may depress
obesity related hormones.
Fluid: A glass of water before meals helps to cut down food intake.
High fibre: The High fibre and low calorie foods like green leafy
vegetable, fruits, vegetables salads , whole grain cereals and pulses
can be included in the diet. Is effective for weight reduction because it
have some advantages related to obesity. They are some advantages
related to obesity. They are
1. Low in calorie
2. Food like green vegetable provides vitamines and minerals.
3. Decreased blood cholesterol.
4. Give safiety.
5. Regulates the bowel movement.
6. Promote chewing and decrease rate of ingetion.
Type of Diet
1. High – fiber diets.
2. Low – colorie diet.
3. Very – low calorie diet.
4. Low carbohydrate and high protein diet ( Athin diet )
1. High – fiber diety:
In High fibre diets the food like green leaves vegetable. fruits,
vegetables salad, whole grains , cereals and pulses are included .High
fibre diet is effective in obesity because of it have many advanges
related to obesity . They are
1. Low in calorie

2. Foods like green vegetables provided vitamins and minerals
3. It decreased blood cholesterol level
4. Give satiety
5. Regulates the bowel
6. Promote chewing and decrease rate of ingestion.
2. Very low caloriediets: (VLCD)

Very low calorie diets are extreme forms of weight loss diets. It is also
known as modified fasts. This type of diet is usually in liquid form and
provides 400-800 kcal per day. This type of diet can be used in
extremely obese person (Body weight>50%) under supervision of
physician.
3. Low – calorie diet:
Low calorie diet means the calorie intake is < 1200 kcal / day. This
can result in a 0.5 kg weight loss per week.
4. Low carbohydrate, High fat and high protein diet: (Atkin’s diet)
This types of diet is extremely low in carbohydrate, which helps to
regulate insulin production and decrease circulating insulins lead to
decrease in storage of fat and food cravings. In this diet, foods are rich
in protein and fat such as bread, pasta, potatoes, cereals, sugars and
fruits and usually alcohol are restricted. In obesity, calorie restriction
is most important and most effective method for weight reduction . In
general one pound of body fat is equivalent to 3500 kcal. There for
reduction of 500 kcal per day produce loss of one pound of body
fat/week whereas reduction of 1000 kcal / day may decrease two
pound of body fat per week.
2. Physical exercise: Most obese patients lead sedentary lives. A low
calorie diet accompanied by moderate exercise will be effective in
causing weight loss. Aerobic exercise directly increases the daily
energy expenditure and is particularly useful for long-term weight
maintenance. The simplest and most popular form of stimulating
exercise is walking. The muscle consumed energy derived from both
fat and glycogen. In human, the leg muscle are the longest muscles
and naturally they burns the most calories during most effective
exercise like swimming, running, jogging, bicycling, dancing, walking
etc. Exercise is extremely beneficial in weight management because it
help to regulate appetite, increase the basal metabolic rate and
reduces the fat deposit level. Exercise also helps to reduce stress
related eating.
Stress management: Stress is a major reason for overeating and
relapse. Patients can reduce stress related overeating by learning
implement method other than eating to reduce stress. These include
diaphragmatic breathing, deep muscle breathing, meditation, yoga
and physical activity like dancing, listening music, rearing pet. These
techniques provide a distraction to the stressful event and may be
helpful in alleviating myride health related problems.
4. Behavioral Therapy: Behavioral therapy is the collective name for
the various methods and scheme, which create change in lifestyle.
Long-term changes in eating behavior are necessary to loss and

maintain weight. In behavioural therapy, patients can be skilled to
plan menus and exercise session and to record their actual behavior.
The availability of record helps to plane treatment and suggestion for
problem. Patients also educated to recognize the ‘eating cues’
(emotional, situational) and how to avoid or control them.
5. Pharmacotherapy: People with BMI ≥30 or in the presence of
comorbidities, should be counselled on diet, exercise and other
relevant behavioural intervention and set realistic goal for weight loss.
If these goals not achieved, pharmacotherapy should beused.
This therapy may be used as part of a comprehensive weight loss
programme including dietary therapy and physical exercise for
patients with a BMI>=30 with or without the presence of complication.
Weight loss drugs should never be used without life style
modifications. Antiobesity drugs should be use in following
circumstances:
 If a patient has failed to achieve 10% loss of body weight
 To enhance further reduction in symptomatology, such as
breathlessness or weight bearing joint pain.
 To achieve further improvements in markers of comorbidity,
such as hyperlipidaemia or raised blood pressure.
 To improve exercise tolerance and promote increased physical
activity
 To improve diabetic control, lower fasting blood glucose and
other diabetes indices.
Now a day, several anti-obesity agents are available and used by
medical practioners, between them only two agents recommended for
the long- term treatment of obesity, they are Orlistate and
Sibutramine.
1. Orlistate (Xenical): Orlistate was first available in Europe in 1999.
It is classified as an intestinal lipase inhibitor, act locally to block the
action of pancreatic and gastric lipase enzyme and thus it prevents
absorption of fats from the small intestine, and so it decreases an
individual’s total calorific intake.
Side effects: Although, Orlistate is very effective in weight reducing, it
has some side effect due to its local mode of action, they are oil
spotting, flatus, faecal urgency anal leakage and malabsorption of fat
soluble vitamins.
Contraindication: It is contraindicated in patients with Cholestasis
and
malabsorptive syndrome.
2. Sibutramine: Another drug is Sibutramin, was developed in U.K. It
is centrally acting, Serotonin and noradrenaline reuptake inhibitor. Its
central action on neurotransmitters causes an enhancement of filling
of fullness after eating, which results in a 20% reduction in overall
calorific intake.
Side effect: The most common side effects of Sibutramine are
Headache, dizziness, sweating, palpitation, constipation and dry
mouth.

Contraindication: It should not be used in patients of CHD, cardiac
arrhythmias, uncontrolled hypertension, stroke, heart failure, eating
disorders, psychiatric illness, currently treated with antipsychotics
and antidepressant. Remonabent is a recently developed antiobesity
drug, which acts centrally in the brain and decreasing appetite. It also
acts peripherally by increasing thermogenesis and therefore
increasing energy expenditure.
6. Surgery:
Surgical treatment of obesity is vital facet for weight management and,
in many patients, is the only effective method for losing weight. The
surgical option is limited to few extremely obese people but for such
patients it is an important mean of significant long-term weight loss,
and a huge improvement in health and quality of life. Surgery is only
recommended in that suitable patients who has a BMI >35 with an
associated comorbidity or a BMI> 40 or who failed to lose weight with
dietary modification, physical exercise and pharmacological
treatments. Currently, Obesity surgery is remarkably safe and
straightforward with very few risks.
Surgical methods for obesity are as follow:

1. Bariatric surgery: The term ‘bariatric surgery’ refers to surgical
intervention and techniques that lead directly to weight loss and
which are used for the treatment of obesity. There are two commonly
used categories of bariatric surgery:
a. Restrictive surgery: It reduces the size of stomach so less food is
ingested before a feeling of fullness occurs. This include following
methods:
i. Vertical banded gastroplasty: This performed by partitioning a
pouch of between 15 and 40 mL, at the top of the stomach.
ii. Laproscopic gastric banding: It involves wrapping an adjustable
band around the outside of the stomach.
b. Malabsorptive surgery: It reduces the length of bowel through
which the food passes, so that a smaller amount will be adsorbed. It
include following methods:
i. Roux-en-Y bypass: It is widely used as a first line procedure. A 10
mL segment is surgically isolated from the body of the stomach and
anastomosed to the proximal jejunum, bypassing most of the stomach
and entire duodenum.
ii. Jejunoileal bypass: In this method, more than 90% of the small
bowel was bypassed by attaching the beginning of the jejunum to the
end of the ileum, leaving a total of only 18 functional inches.
2. Implantable gastric stimulation: A small implantable gastric
stimulation device leproscopically placed in a subcutaneous pocket in
the abdomen. It provide gastric stimulation to the smooth muscle of
the wall of the stomach. The gastric stimulation produces an increase
in satiety levels and results in decreased calorific intake.
3. Liposuction: Liposuction involves the suction of fatty material from
under the skin by way of a trochar. Approximately 3 L of fat is
removed by this method, but in extreme cases, elimination is 10-12 L.

It has no influence on visceral or abdominal adiposity and hence it
has no significant physiological effects on insulin resistance and other
comorbid disease markers. This technique has been attempted in the
morbid obese people as a cosmetic procedure.
4. Jaw wiring: This procedure is no longer commanding. Weigh
regained following the wireremoval.
5. Apronectomy: Apronectomy is not a treatment for obesity but is
helpful for patients who have lost large quantities of weight and have
overhanging folds of excess skin. (Ref medicine book of Harrison’s and
encyclopaedia) Body cholesterols, and triglycerides are calculated by
the test lipid profile-
Lipids –
Lipids (fats, oils, waxes etc.) are being organic substances mostly
insoluble in water and having better solubility in organic solvents like,
benzene, chloroform and ether. In the body fat serves as thermal
insulator to fasten the message send along with myelinated nerves.
Important cellular constituents like cell membrane and mitochondria
are made up of a combination of fat and proteins (phospholipids)
containing the various fat soluble vitamins A,D,E,K and essential fatty
acid, it is one of the necessary dietary constituent.
Classification
Lipids are classified as follows.
A. Simple lipids: -
a) Neutral Fats, b) Waxes
B. Compound lipids: -
a) Phospholipids, b) Glycolipids, c) Lipoproteins and other
C. Derivative lipids: -
a) Fatty acid, b) Glycerol, c) Sterols and others (Cholesterol)
Fatty Acids:-
Fatty acids are essential lipids having physiological significance and
their esters are triglycerides, phospholipids cholesterol and other
steroids.Lipids in the form of phospholipids are transported in the
plasma. Fatty acids occur mainly as esters of natural fats and oils,
but they also occur in the unesteriform as free fatty acids in the
plasma. Fatty acids are chains of hydrocarbons which may be
saturated or unsaturated. More the degree of insaturation of fatty acid
will cause lowering of its melting power while more and more of its
chain length will cause increase in the melting points. Membrane
lipids having liquid consistency are more unsaturated than storage
lipids.
Non-esterified Fatty Acids – (NEFA)

These are very important source of energy though their presence
isquantitatively very less in total plasma lipids. Several gms of rapidly
turning over NEFA complexes with albumin are transported in the
plasma every day.
Triglycerides

These are esters of long chain fatty acids with glycerol. Usually there
is presence of different fatty acids in the triglycerides. 95% of adipose
tissue is constituted by triglycerides and most of the lipid storage
takes place in the body in the form of triglycerides. Transportation of
triglycerides takes place mainly in the form of chylomicrons and VLDL
and minor in LDL and HDL also.
Phospholipids
Two important phospholipids found present in the humans are
glycerophospholipids and sphingophospholipids. Most of the tissue
synthesizes phospholipids but plasma phospholipids are derived
mainly from liver. Phospholipids are integral part of cell membrane
and their fatty acid composition in markedly influenced by nature of
fat in the diet consumed. They constitute about 25% of LDL mass
(Lecithin: sphingomyelin ration 2:1) and about 30% of HDL (Lecithin:
sphingomyelin ration 5:1).
Cholesterol
Cholesterol is an unsaturated steroid alcohol and important
structural component of cell membranes also. It is a precursor for the
bio-synthesis of important steroids including bile acids, adrenocortical
harmones, sex vitamins, D vitamins, cardiac glycosides, sitosterols of
plants and some alkaloids. Two third of plasma cholesterol is
esterified with long chain saturated and unsaturated fatty acids as
cholesteryl esters and one third exists as unesterified cholesterol. 60%
– 70% of it is transported by LDL in human beings, 20% -35% by HDL
and 5% – 12% by VLDL.
Metabolism of Cholesterol
Cholesterol content of the diet is absorbed from proximal small
intestine (Borgstron 1960). Bile acids are the major metabolites of the
cholesterol, which are synthesized exclusively in the liver. Dietary
cholesterol takes several days to equilibrate with cholesterol in plasma
and several weeks to equilibrate with cholesterol in tissues.
Cholesterol in company with other lipids is incorporated into
chylomicrons and also to some extent to VLDL. 80% - 90% of
absorbed cholesterol is found in LDL which carries cholesterol to
tissues and also in HDL, which takes cholesterol
to liver from tissues for degradation.
Cholesterol Synthesis
Except brain tissues rest of the tissues have the capacity to
synthesizecholesterol but most of the synthesis of the new cholesterol
takes place in the liver and in distal part of small intestine (Dietschy
and Wilson, 1970).Endoplasmic reticulum is mainly responsible for
cholesterol synthesis.
Cholesterol Synthesis
1) Major Classes of Lipoproteins
our major classes of lipoproteins can be identified on their particle
size, chemical composition, physico-chemical and flotation
characteristics and electro-phoretic mobility.
Regulation of Cholesterol Synthesis

Cholesterol
2) Cholesterol synthesis is also inhibited by LDL-cholesterol taken up
via LDL receptor.
3) Diurnal variations are also known to occur both in cholesterol
synthesis and reductase activity.
4) Insulin and thyroid hormone increase the reductase activity,
whereas glucagons and corticosteroids decrease the reductase activity.
5) The amount of cholesterol in diet influences in the endogenous
Synthesis of cholesterol and when dietary intake of cholesterol is
raised the endogenous hepatic production of cholesterol falls.
6) Intra luminal concentration of bile acids regulates the intestinal
synthesis (Dietschy et al, 1970). While the absorption of biliary
cholesterol limit the rate of hepatic cholesterol synthesis (Grundy et
al,1969).
7) Substitution of poly-unsaturated and mono-unsaturated fatty acids
(naturally occurring oils) for some of the saturated fatty acids in the
diet lowers the blood cholesterol level.
Factors influencing the cholesterol balance in tissues –
a) Increase
1) Uptake of cholesterol containing lipoproteins by receptors e.g. LDL
receptor or the scavenger receptor.
2) Uptake of free cholesterol from cholesterol rich lipoproteins to the
cell membrane.
3) Increased cholesterol synthesis.
4) Hydrolysis of cholesteryl esters by the enzyme ‘Cholesteryl ester
hydrolase’.
Plasma lipoproteins
b) Decrease
1) Efflux of cholesterol from the membrane to lipoproteins of low
cholesterol potential, particularly to HDL3, discoidal HDL, or B HDL
promoted by L CAT.
2) Esterification of cholesterol by the enzyme acyl co-A-cholesterol acyl
transferase (ACAT).
3) Utilization of cholesterol for synthesis of other steroids such as
hormones, or bile acids in the liver.
Chylomicrons
These are mainly of intestinal origin and their quantity is increased in
plasma following a fatty meal. The plasma becomes opalescent. The
protein component is mainly Apo-B. They are very rich in triglycerides
of exogenous origin and poor in free cholesterol and phospholipids
and contain about 1-2% (by weight) of protein. Because of very high
lipid; protein ration, the chylomicrons are considerably less dense
than water and float even without centrifugation. The apoproteins in
chylomicrons include Apo-B-48, Apo A, Apo C, Apo E.Lipolysis occurs
after the chylomicrons combine with the enzyme on the capillary
endothelium. After the removal of triglycerides from the chylomicrons
(and VLDL) the molecular size and the triglyceride content of
remnants decrease. These remnanats are called IDL (Intermediate
Density Lipoproteins). They are finally converted to LDL.

VLDL (Very Low Density Lipoproteins)
The bulk of VLDL is secreted by liver in a manner similar to
chylomicrons by intestine. The protein component in them is also
mostly Apo-B. The fatty acids are derived from hepatic synthesis from
acetyl Co-A in a well fed individual and from the fatty acids coming
from peripheral tissue through plasma in all ill fed individual. The
fatty acids are incorporated into triglycerides and then into VLDL. The
clearing factor acts on VLDL in a manner similar to its action on
chylomicrons and helps in removing the fatty acids from them.
LDL (Low Density Lipoproteins)
They seem to be a product of degradation of VLDL and chylomicrons.
This fraction is rich in cholesterol and is taken by all the cells
including liver cells and metabolized. The LDL are taken up in Toto at
specific binding sites on the cells.
HDL (High Density Lipoproteins)
These are synthesized and secreted by both the liver and intestinal
mucosa. The HDL secreted by intestine contain only Apo-A, whereas
those from liver contain Apo-C also. The lipids are mainly cholesterol
and phospholipids. As enzyme lecithin: cholesterol acyltransferase
(LCAT), transfers a fatty acid from lecithin to cholesterol and forms
cholesterol ester and lysolecithin. The cholesterol ester then gets
transferred from HDL to VLDL and LDL. This transfer is facilitated by
a protein called “Chlesteryl ester transfer protein”.
Lipid Transport in Lipoproteins
Fat absorbed from the diet and lipids synthesized in the liver and
adipose tissue have to be transported between various tissues and
organs for utilization and storage. Since lipids are insoluble in water,
non-polar lipids (triglycerides and cholesteryl esters) are combined
with amphipathic lipids (phospholipids and cholesterol) and proteins
to make water miscible lipoproteins for transport between the tissues
in aqueous blood plasma. Transportation of triglycerides takes place
from intestine in chylomicrons and from the liver in VLDL.
Chylomicrons are found in chyle formed only by the lymphatic
systems, draining the intestine. They are responsible for the transport
of all the dietary lipids in to the circulation. Chylomicron formation
increases with the load of triglycerides absorbed. Most of the plasma
VLDL is of hepatic origin. They are the vehicles of transport of
triglycerides from the liver to the extra hepatic tissue.
Metabolism of Lipoproteins
There are many similarities in the mechanism of formation of
chylomicrons by intestinal cells and of VLDL by hepatic parenchymal
cells. Apolipoprotein B is synthesized by ribosomes in the rough
endoplastic reticulum and is incorporated into lipoproteins in the
smooth endoplasmic reticulum, which is the main site of synthesis of
triglycerides. Lipoproteins pass through the Golgi apparatus, where
carbohydrate residues are added
to the lipoproteins. The chylomicrons and VLDL are released from
either the intestinal or hepatic cells by fusion of secretary vacuole with
the cell membranes (reverse pinocytosis). Chylomicrons pass into the

spaces between the intestinal cells, eventually making their way into
the lymphatic system (lacteals) draining the intestine. VLDL are
secreted by hepatic parenchymal cells into the space of disease and
then into the hepatic sinusoids through fenestrae in the endothelial
lining. Chylomicrons and VLDL are rapidly catabolized. Triglycerides
of chylomicrons and VLDL are hydrolyzed by lipoprotein lipase. Both
phospholipids and apolipoprotein C-II are required as co-factors for
lipoprotein lipase activity. The triglyceride is hydrolyzed progressively
through a diglyceride to monoglyceride that is finally hydrolyzed to
free fatty acid and glycerol. Some of the released FFA return to the
circulation, attached to albumin, but the bulk is transported into the
tissue. Reaction with lipoprotein lipase results in the loss of
approximately 90% of the triglycerides of chylomicrons and in the loss
of the aco C (which returns to HDL) but not apo E, which is retained.
Chylomicrons and VLDL are thereby converted to chylomicron
remnants and IDL (Intermediate Density Lipoproteins) in circulating
blood respectively. Liver is responsible for the uptake of these remnant
lipoproteins. Most LDL appears to be formed
from VLDL. The half-life of disappearance from the circulation of apo
B-100 in LDL is approximately 2 days. LDL is metabolized via the LDL
receptor. Catabolism of LDL occurs in addition to liver, principally in
peripheral tissues viz fibroblasts, lymphocytes, arterial smooth muscle
cells. HDL is synthesized & secreted from both liver and intestine.
However, nascent (newly secreted) HDL from intestine does not
contain apo C or E but only apo A. Thus apo C and apo E are
synthesized in the liver and transferred from liver HDL to intestinal
HDL, when the latter enters the plasma. HDL acts as a repository for
apo C and apo E that are required in the metabolism of chylomicrons
and VLDL. HDL interacts with lecithin cholesterol acyl transferease
((LCAT) to from cholesteryl esters and lysolecithin. HDL is assumed to
account for reverse cholesterol transport. It accumulates cholesterol
from cell membranes and other lipoproteins and is converted to a
spherical particle in the circulation through the action of LCAT &the
movement of the cholestryl esters formed into the core of HDL particle.
HDL cholesteryl esters are then transferred to VLDL & IDL are
subsequently metabolized via remnanat & LDL receptors. Some of the
cholesterol esters may also be delivered directly to the liver from HDL.
Factors Affecting HDL and LDL Concentration in Blood
HDL levels are comparatively higher in females than males. Estrogen,
moderate alcohol intake and nicotinic acid increase the HDL level
whereas progesterone, obesity, high carbohydrate consumption,
sedentary life habits, type II diabetes (NIDDM), hypertriglyceridaemia,
heavy cigarette smoking decrease the HDL levels. LDL levels can be
strikingly altered by thyroid, renal or liver diseases and consumption
of saturated fats and to a lesser extent by total calories, dietary
cholesterol and fibers. Diabetes and hypothyroidism can elevate LDL
levels by suppressing LDL receptor activity. The nephritic syndrome
raises LDL levels by stimulating hepatic synthesis of lipoproteins.

DRUG REVIEW
Chikitsa Chatuspada.
iBaYagd`vyaaNyaupsqaata raogaI padcatuYTyama\ È
gauNavat\ karNaM &oyaM ivakarvyauSaantyao È ³ca.saU.9À3´
Among these four fold factors of treatment, the drug is second
important factor after physician. This highlights the significance of the
drug. The efficacy of the treatment depends upon proper drug
administration; hence the selection of a proper drug in the
management of disease is very important.
A) Selection of drugs:
In the pathology of Sthaulya, Kapha is main vitiated Dosha and Meda
is main vitiated Dushya. So, that type of drug should be selected
which have Kapha and Medanashaka property and have efficacy to
correct the function of Vata and Kapha.
t~ maodaoinalaElaoYmanaaSanaM sava-imaYyato È ³A.).saU.
14À20´
In the pathogenesis of Sthaulya, Vata & Kapha Dosha along with
Meda Dhātu are vitiated. Hence line of treatment which correct above
three abnormal factors is necessary & same principle is given in
benefits of Vatsakādi Gana. It is as follows,
va%sakmaUvaa-Baa=gaI-kTuka marIcaM GauNaip`yaa ca

gaNDIrma\ È
elaa paz|jaajaI kT\va=gaflaajamaaodisaQdaqa-vacaa: ÈÈ 33 ÈÈ
jaIrkih=gauivaD=gaM pSauganQaa pjcakaolakM hint È
calakfmaod: pInasagaulmajvarSaUladunaa-nma: ÈÈ 34 ÈÈ
³A.).saU.15À33Ê34´
Maximum drugs existing in Vatsakādi Gana are found in treatment
given for various Santarpanajanya Vyādhis. This indicates that these
drugs work in obesity.
In this study Drugs used is vati prepared from Vastakadi Gana.
B) Description of Drug:
1. Drug Schedule:
Patients were selected randomly
from BHARATI AYURVED
HOSPITAL AND RESARCH
CENTER DHANKAWADI PUNE 43.
DRUG:- Vastakadi Gana Vati.
Dose, Duration and Anupana for
both groups:
Dose: 500mg/Tab - Two Tab at
time twice in a day.
Duration: 8 weeks

Anupana: Ushnodaka.
Source and Preparation of Drugs Under Trial:

Manufacturing of the above drugs, according to the procedure
described in classics, was done by Bharati Ayurved Rasashala.
c) Drug Profile:
Vastakadi gana:-
va%sakmaUvaa-Baa=gaI-kTuka marIcaM GauNaip`yaa ca

gaNDIrma\ È
elaa paz|jaajaI kT\va=gaflaajamaaodisaQdaqa-vacaa: ÈÈ 33 ÈÈ
jaIrkih=gauivaD=gaM pSauganQaa pjcakaolakM hint È
calakfmaod: pInasagaulmajvarSaUladunaa-nma: ÈÈ 34 ÈÈ
³A.).saU.15À33Ê34´
It contains following drugs:
Drugs Part
1. Kutaj-Holarrhena Antidysenterica 1 Part
2. Murva - Maesdenia tenacissima 1 Part
3. Bharangi -Celerodendeum serratum 1 Part
4. Katuka -Picrorrhiza kurro 1 Part
5. Maricha-Piper nigram 1 Part
6. Ativisha-Aconitum heterophylum 1 Part
7. Gandir- Euphorbia trigona 1 Part
8. Ela- Amomum subulatum 1 Part
9. Patha- Cocculus hirsutus 1 Part
10. Shyonak- Oroxylum indicum 1 Part
11. Madanphala- Randia spinosa 1 Part
12. Ajamoda- Carum roxburghianum 1 Part
13. Sarshap- Brassica camprstis 1 Part
14. Vacha- Acorus calomus 1 Part
15. Jeerak- Cuminum cyminum 1 Part

16. Hingu- Ferula narthex 1Part
17. Vidang- Embelia ribes 1 Part
18. Pashugandha- Ocimum santum 1Part
19. Pippali- Piper longum 1Part
20. Pippalimoola- Piper longum radix 1 Part
21. Chavya- Piper retrophylum 1 Part
22. Chitrak- Plumbago zeylanica 1 Part
23. Shunthi- Zingiber officinale 1 Part
1. Kutaj :-
Latin name: Holarrhena Antidysenterica
Family: Apocyanaceae
Properties:
Rasa: Katu, Tikta, Kashay.
Guna: Laghu, Ruksha.
Virya: Sheeta
Vipaka: Katu
Doshaghnata: Kapha, Pitta Shamaka
Part used: Bark, leaves, seeds, flowers.
Dosage:- Powder 3-6 g, decoction.
Karma: Dipana, Grahi, Pittahar, Kaphaghna,
Rogaghnata: Jvara, Pittatisar, Kushta
Chemical composition: H.antidysenterica, W.tinctoria.
2. Murva:-
Latin name: Maesdenia tenacissima
Family: Asclepiadaceae
Properties:
Rasa: Tikta, Kashay
Guna: Guru, Ruksha.
Virya: Ushna
Vipaka: Katu
Doshaghnata: Kapha, Pitta, Vata Shamaka
Part used: Root
Dosage :- Powder 3-5g , decoction 50-100ml
Karma: Kapha, Vata hara, Jvaraghna.
Rogaghnata: Pandu, Chardi.
Chemical composition:- Marsdenin, D-cymarose, asclepobiose, D-
canarose, cissogenin etc.

3. Bharangi:
Latin name: Celerodendeum serratum

Family: Euphorbiaceae
Properties:
Rasa: Katu, Tikta
Virya: Ushna
Vipaka: Katu
Doshaghnata: Kapha Vata hara
Part used: Root
Dosage :- 3-6 gm
Karma: Kaphaghna, Jvaraghna, Kasahara.
Rogaghnata: VataVyādhi, Kasa, Svasa,
Chemical composition: hispidulin, 7-0glucuronides, scutellarein,
uncinatone, pectolinarigenin.
4. Katuka:-
Latin name: Picrorrhiza kurro.
Family: Scrophalariaceae
Properties:
Rasa: Tikta
Virya: Sita
Vipaka: Katu
Doshaghnata: Kapha Vata Shamaka
Part used: Root
Karma: Dipana, Bhedan, Hridya, Kaphaghna, Svasahara, Jvaraghna
Rogaghnata: Kushta, Krumi, Arochaka, Rakta vicar, Daha, Visham
jvara,
Kasa, Svasa, Amavata
Chemical composition: D- mannitol, kutkiol, kutikisterol, apocyanin,
phenol Glucoside, Androsim, and Picein iridoid glycosides, Kutkin,
Picroside I, II,III, kutkoside, minecoside, picrorhizin, arvenin III.
5. Maricha:-
Latin name: Piper nigrum
Family: Piperaceae
Properties:
Rasa: Katu
Guna: Laghu, Tikshna
Virya: Ushna
Vipaka: Katu
Part used: Fruit

Dosage:- 0.5-1 gm
Karma: Dipana, Pramathi, Vathara, Hrdroga, Kaphaghna,
Rogaghnata: Pinasa, Pravahika, Hrdrog, shula, Krumi, Kasa, Svasa,
Chemical composition: Piperene, piperethine, piperolein A&B,
feruperine, dihydroferuperine, citronellol, cryptone, dihydrocarveol,
α ∧β pinene, piperonal, camphene, β -caryophyllene, β – alanine,
pipecolic acid, carotene, ascorbic acid, pipercide etc.
6. Ativisha:-
Latin name: Aconitum heterophylum
Family: Ranunculaceae
Properties:
Rasa: Katu Tikta.
Guna: Laghu, Ruksha
Virya: Ushna
Vipaka: Katu
Doshaghnata: Tridoshahara.
Part used: Root
Dosage:- Powder 1-3 gm/ day
Karma: Dipana, Pachana Grahi,Tridoshhara, Shothara, Vishaghna,
Krimighana, Arshoghana, Kasahara, Jvaraghna
Rogaghnata: Atisara, jvara, Bala roga, Amadosha, Chardi, Krimi rog,
Agnimandya, Raktapitta, Yakrud roga, Trishna, Pinasa, Arsha,
pittodar
Kasa, Svasa, etc
Chemical composition: A heterophylum, A. palmatum.
7. Gandir :
Latin name: Euphorbia trigona haw.
Properties:
Rasa: Katu,
Guna: Ruksha, tikshana.
Virya: Ushna
Vipaka: Katu
Doshaghnata: Kapha Vata
Part used: Leaves, Steam, Root.
Dosage:- 3-5 gm
Karma: Kaphaghna
Rogaghnata: Tridosha vranashotha.
Chemical composition:

8. Ela:
Latin name: Amomum subulatum

Family: Zinziberaceae
Properties:
Rasa: Katu, Tikta
Guna: Laghu, Sukshma.
Virya: Ushna
Vipaka: Katu
Part used: Root
Karma: Dipana, Pachana,Vatanulamana,Shoolaprashaman, Hridya,
Kaphaghna,
Amapachana, Srotorodhnivaraka, Vrishya, Svasahara, Jvaraghna
Rogaghnata: VataVyādhi, Aruchi, Agnimandhya, Ajirna, Arsha,
Hriddaurbalya,
Kasa, Svasa, Amavata
Chemical composition: Oleo-resin- 6.5%, Gingerol, Shogaol,
Zingerone, Ragine
9. Patha:
Latin name: Cocculus hirsutus
Family: Minispermaceae
Properties:
Rasa: Tikta
Guna: Laghu, Tiksan
Virya: Ushna
Vipaka: Katu
Part used: Root
Dosage: 1-3 gm, 50-100 ml
Karma: Grahi, Vishaghna, Balya.
Rogaghnata: Atisara, Chardi, Sula, Jvara, Kushta,Kandu, Krimi,
Hrudrog, Gulma, Yoniroga.
Chemical composition: C.pareira,c.peltata.
10. Shyonak:
Latin name: Oroxylum indicum
Family: Bignonaceae
Properties:
Rasa: Tikata, Kashaya.
Guna: Laghu, Ruksha
Virya: Ushna
Vipaka: Katu

Part used: Root
Dosage: 3-6gm, decoction 40-80 ml
Karma: Dipana, Grahi
Rogaghnata: Atisara, Aruchi, Kasa, Basti vikaras, Vataroga, Amavata
Chemical composition: Baicalein, tetulin, oroxidin, aloe-emodin,
chrysin, 6 methylether of baicalein= oroxylium A, p coumaric acid,
scutellarein-7-rutinoiside, prunetin, β sistosterol
11. Madanphala:
Latin name: Randia spinosa
Family: Rubiaceae
Properties:
Rasa: Madhura, Tikata
Guna: Laghu, Ruksha
Virya: Ushna
Vipaka: Katu
Part used: Fruits and seeds.
Dosage: 1-3 gm,emesis 3-6 gm.
Karma: lekhan, chardan.
Rogaghnata: visha rog, pratishyay, soth, kushta, vrana, vidradhi,
gulma, javara.
Chemical composition: citric acid, and tartaric acid, randianin,
randia acid, ursosaponin, dumetoronins A,B,C,D,E & F , randoside A,
arachidics, lignoceric, linoleic, oleic, palmitics & stearic acids etc.
12. Ajamoda:
Latin name: Carum roxburghianum
Family: Umbelliferae
Properties:
Rasa: Katu, Tikta
Guna: Laghu, Ruksha, Tikshn
Virya: Ushna
Vipaka: Katu
Part used: Fruit
Karma: Dipana, Vidahi, hrdya, balya, Vrishya,
Rogaghnata: sula, Adhman, Hikka, chardi, Vasti-ruk, Krimi
Chemical composition: anthxanthins, Graveobioside A&B, luteolin,
apisoeglycosider, myristicic acid, aprumetien umbelliferene,
chrysoriol,apiin, luteolin, d- limonene, d- selinene, sepquiterpene
alchohols, apigravin, sedanolide & sedanomics acid anhydride.
13. Sarshap:
Latin name: Brassica camprstis
Family: Cruciferae
Properties:
Rasa: Katu, Tikta.

Guna: Laghu, Snigdha
Virya: Ushna
Vipaka: Katu
Part used: Seeds
Dosage: 2-4 gm
Karma: Vidahi, Vamak.
Rogaghnata: krimi Kushta, Kandu.
Chemical composition: Rutin, arabinogalactan
14. Vacha:
Latin name: Acorus calomus
Family: Araceae
Properties:
Rasa: Katu, Tikta
Guna: Laghu, Tikshn
Virya: Ushna
Vipaka: Katu
Part used: Rhizome
Dosage: 125-500 mg
Karma: Lekhaniya, Medhya.
Rogaghnata: Unmad, Apasmar, Jvara.
Chemical composition: Acolamone, Acorenone, Acoragermacrone,
acoramone, acorone, cis & trans- asarone β & of asarone, azulene,
cadalene, calacone, calacorene, calamine, calamenol, calamine,
calamenone, calamenene, calarene, β gurjunene, camphene, eugenol,
telekin, preisocalamendiol, acoric acid, calamen diol, calamenone etc.
15. Jeerak:
Latin name: Cuminum cyminum
Properties:
Rasa: Katu
Guna: Laghu, Ruksha
Virya: Ushna
Vipaka: Katu
Part used: Fruits
Karma: Dipana, Pachana, Vrishya, Grahi, Garbhashaya shodhak,
balya, Svasahara, Jvaraghna
Rogaghnata: Krimi, Jirna Jvara, Adhmana, Kustha, Grahani, Atisara,
Gulma, Visha roga, Netra roga.
Chemical composition: Cuminin, diacyl, glycerol, imperatorin,
isoimperatorin, isoimpinellin, oxypeucedanin, apigenin and apiin,
oxalic, cuminaldehyde, p-cymene etc.

16. Hingu:
Latin name: Ferula narthex
Properties:
Rasa: Katu
Guna: Laghu, Snigdha, Tiksna
Virya: Ushna
Vipaka: Katu
Part used: Resin
Dosage:125-500mg
Karma: Hridya, Artavjanan, Sulahara, caksusya, Bhedaniya,
Anulomaniya, Balya.
Rogaghnata: Krimi, Artavadosha, murcha, Apasmara, sula, Gulma,
Udar, Agnimandya
Chemical composition: Gum- a-pinene, phellandrene, see, butyl
propenyl, disulphide, a trisufide, asaresinotannol, faresiferol A,
gummosin, Kamolonol, mogoltadone, polyanthinin, polyanthin,
undecylsulfonyl acetic acid, umbelliferone, root- foetidin, luteolin,
whole plant- assafoetidin, ferocolicin.
17. Vidang-
Latin name: Embelia ribes
Family: Myrsinaceae
Properties:
Rasa: Katu
Guna: Laghu, Ruksha, Tiksna.
Virya: Ushna
Vipaka: Katu
Part used: Fruit, Roots.
Dosage: 3-5 gm powder.
Karma: Dipana, Vishgan, Krimigna
Rogaghnata: Krimi, Udara, Adhman, sula, kushta
Chemical composition: Embelin, christembine, homoembelin,
homorapanone, vilangine, quercitol etc.
18. Pashugandha-
Latin name: Ocimum santum
Family: Lamiaceae
Properties:
Rasa: Katu, Tikta
Virya: Ushna
Vipaka: Katu

Part used: Leaf, Root, Seed
Dosage: 10-20ml fresh juice, Root decoction 50-100ml, powder 3-6 gm
Karma: Dipana, Krimigna, Putigandhahara
Rogaghnata: Hikka, visharog, parvshula, krimi, visham jvara, Kasa,
Svasa, Amavata
Chemical composition: Bornyle acetate, cadinene, camphene,
camphor, carvacrol, β –caryophellene, eugenol, eugenol methyl ether,
humelene, methyl chavicol, limonene etc
19. Pippali-
Latin name: Piper longum
Family: Piperaceae.
Properties:
Rasa: Katu
Virya: Ushna
Vipaka: Madhura
Doshaghnata: Kapha Vata hara.
Part used: Fruit, Root.
Dosage: Powder 0.5-1 gm
Karma: Dipana, Vrishya, Rasayan.
Rogaghnata: Udar, pliharog, Jvara, kushta, prameha, gulma, arsha,
sula, Amavata.
Chemical composition: essential oil, mono and sequiterpenes,
caryophyllene, piperine, piplartine, piperlongumine, pipernonaline,
piperundecalidine, pipercide, sesamin, β sitosterol, four aristolactmus,
( cepharanone B, aristolactum AII, piperlactum A and piperlactum B)
five 4,5 dioxoaporphines etc.
20. Pippalimoola-
Latin name: Piper longum radix
Family: Piperaceae
Properties:
Rasa: Katu
Virya: Ushna
Vipaka: Katu
Part used: Root
Dosage: 0.5-1 gm
Karma: Dipana, Pachana, Bhedan,
Rogaghnata: Udara, Anaha, pliha rog, Gulma, Krimi, Kasa, Svasa,
Chemical composition: essential oil, piperine, β sitosterol
cepharadiones etc

21. Chavya-
Latin name: Piper retrophylum
Family: Piperaceae
Properties:
Rasa: Katu
Guna: Laghu, Ruksa.
Virya: Ushna
Vipaka: Katu
Part used: Root
Dosage: powder 1-2 gm
Karma: Dipana, Pachana,
Rogaghnata: Agnimandya, Udara, arsas, Krimi, Kasa, Svasa.
Chemical composition: Steam piperine, sitosterol, piplartine
(alkolide) new amides- retrofractamide A,B,C,&D isolated from aerials
parts.
22. Chitrak-
Latin name: Plumbago zeylanica
Family: Plumbaginaceae
Properties:
Rasa: Katu
Guna: Laghu, Ruksha, tiksna.
Virya: Ushna
Vipaka: Katu
Part used: Root bark
Dosage: powder 1-2 gm
Karma: Dipana, Pachana, Grahi.
Rogaghnata: Grahani, Udara, Krimi, sula, pandu, Arsha, Kasa,
Chemical composition: chitranone, plumbagin, 3- chloroplumbagin,
droserone, elliptinone, isozeyline, isozeylan –one, zeylanone and
zeylinone, maritone, plumbagic acid, dihydrosterone and zeylinone,
maritone, plumbagic acid, dihydrosterone β – sitosterol etc.
23. Sunthi (Dry ginger):

Latin name: Zingiber Officinale
Properties:
Rasa: Katu
Virya: Ushna
Vipaka: Madhura
Part used: Dried rhizome

Karma: Dipana, Pachana,Vatanulamana,Shoolaprashaman, Hridya,
Kaphaghna,
Amapachana, Srotorodhnivaraka, Vrishya, Svasahara, Jvaraghna
Rogaghnata: VataVyādhi, Aruchi, Agnimandhya, Ajirna, Arsha,
Hriddaurbalya, Kasa, Svasa, Amavata
Chemical composition: Oleo-resin- 6.5%, Gingerol, Shogaol, Zingerone,
Ragine
Comparative study of drugs:-

The above all 23 drugs given in Vastakadi Gana was studied as
bellow:-
1. Study of Rasa:-
The all above drugs are Katu, Tikta, Kashay, and Madhur. There is
no any drug which is having Lavan and Amla Rasa. Madhur is
Pruthavi and Aap Mahabhoot dominat Rasa. According to Ashtang
Hrudaya excessive use of Madhur Rasa leads to Sthulya. In this
Vatskadi Gana out of 23 drugs 20 number of drugs are Katu Rasa
Pradhan. Katu and Madhura are having opposite properties, so
Katu is useful for treating Sthulya.
Table no 1- Rasa distribution-
Rasa No of drugs % of Rasa

Tikta 14 37%
Katu 20 52%
Kashay 3 8%
Madhur 1 3%

RASA WISE DIS-
TRIBUTION
Ka
sh
ay
8 Madhur
% 3%
Tikta
37%
Katu
53%
2. Study of Guna:-
Guru and Snigdha Guna are also main causative factor in
Santarpanjanya Vyādhis and Sthulya. In this Gana drugs are
having properties Laghu Ruksh 50%, Laghu Tikshna 27% ie 13
and 7 respectively out of 23 drugs. Laghu is opposite to Guru
Guna, while Ruksha is opposite to Snigdha Guna. So that this
Gana is having exactly allivating properties for aggravating
factors.
Table no 2 - Guna distribution-
Guna of drugs No of drugs % of Guna

Laghu- Ruksha 13 50%
Laghu- Tikshna 7 27%
Laghu – Sukshma 1 4%
Laghu-Snigdha 4 15%
Guru-Ruksh 1 4%

GUNA WISE DISTRIBUTION
laghu- guru-ruksh
snigdha 4%
laghu –
15%
suk-
shma
4%
Laghu- Ruksha
50%
Laghu- Tikshna
27%

3. Study of Virya :-
Ushna virya is having Kapha allivating Properties. In vatskadi
Gana 19 drugs are ushna vryatmak which is benifictial for
treating Sthulya.
Table no-3 Virya distribution-
Virya No of drugs % of Virya

Ushana 19 79%
Sheeta 4 17%
Anushana 1 4%
VIRYA WISE DISTRIBUTION

Anushana
4%
Sheeta
17%
Ushana
79%

4. Study of Vipaka:-
The 21 drugs given under Vatskadi Gana are having Katu Vipaka and
only two are Madhura Vipaki. But The Drugs Having Madhur Vipak is
having Katu Rasa ie Shunthi and Pippali. Katu Vipaka does Lekhan of
Meda Dhatu with Ruksha and Laghu Properties. It also does
Srotoshodhan, so useful to treat Sthulya.
Table no 4- Vipaka Distribution-
Vipaka No of drugs % of Vipaka

Katu 21 91%
Madhur 2 9%
VIPAK WISE DISTRIBUTION

Madhur
9%
Katu
91%

5. Study of Doshghnata:- In dosha allivation also 19 drugs out of 23 are
Kapha-Vata allivating. As given bellow in table no 5-
Table no. 5- Doshghnata wise distribution-
% of Doshghnata
Doshaghnata of drugs No of drugs
Kapha- Vata 19 83%
Kapha 1 4%
Kapha- Pitta 1 4%
Tridosha 2 9%
DOSHGHNATA WISE DIS-

TRIBUTION
Kapha- Tridosha
Pitta 9%
4%
Kapha
4%
Kapha- Vata
83%

CLINICAL STUDY
Clinical research is the back bone of any medical science. It is the
most important among any research because in clinical research there
is direct interaction with patients.
Acharya Charaka has mentioned in Vimana Sthana that there are
several types and methods of examination (Ch. Vi. 8/81). It is
absolutely essential to select the method which one is easy, possible
and most suitable practically in all respects with least flows. For that
Charaka has advised Dashavidha Pariksha. Planning for research
should be based on these guidelines.
To come across the certain burning problems in the society by
providing the perfect solution is an ideal duty of the physician and
clinical researcher.
Now a day Sthaulya (obesity) has become a burning problem in the
world. It has been noted that this disease with its complications like
Hyperlipidaemia, Atherosclerosis and Degenerative Heart Disease is a
major cause for mortality and morbidity in all over the world.
Despite of so many researches have been carried out in modern
as well as Ayurvedic field, Sthaulya is yet a troublesome and
problematic disorder for patient as well as physician. The regimen of
modern science is effective but has troublesome side effects like
Headache, Faecal urgency, Constipation etc.. Hence the study entitled
“ROLE OF VATSAKĀDI GANA IN STHAULYA (OBESITY) AS A
SANTARPANAJANYA VYĀDHI.” was undertaken.
Clinical work was conducted in following way.

1. Authentication of drugs.
2. Standardization of medicine.
3.30 patients of Sthaulya were selected on the basis of inclusion
criteria.
4. Dose, Duration & Anupan Was as follows,
Dose: - 2 tablets twice a day. (Each of 500 mg.)

Duration:- 60 days (8 weeks)
Anupana:- Hot water (Ushnodaka)
Inclusion criteria-
1. Patients having BMI =25 and above.
2. Age group- 18yrs to 50yrs.
3. Either sex.
Exclusion criteria-
1. Obesity with severe complications like coronary heart disease.
2. Obesity with Pregnancy.

Assessment criteria:-
a) Subjective Criteria:
Sign & symptoms of obesity according to Bŗhattrayī.
The details of the scores adopted for the main signs and
symptoms of Sthaulya in present study were as follows :
1. javaaoparaoQa :
i. Normal physical activity -0
ii. Less physical activity -1
iii. Physical activity with difficulty -2
iv. Can’t perform physical activity -3
2. daOba-lyama\ :
i. Feeling no weakness at the end of the day -0
ii. Weakness in performing daily work – 1
iii. Weakness in performing normal physical activity (walking / running )
2
iv. Needs to rest after every small activity -3
3.daOga-nQyama\ :
i. No foul smell of sweat - 0
ii. Normal smell of sweat – 1
iii. Persistent bad smell bearable with deodorant– 2
iv. Persistent bad smell not even suppressible with deodorants/bath – 3
4.svaodabaaQa:
(At normal temperature in normal condition)
i. Normal Sweats as per season - 0
ii. Sweats Profusely during moderate work – 1
iii. Sweats on doing routine work and movement – 2
iv. Sweats Profusely even doing his personal work or no work – 3
5. xauditmaa~ma\ :
i. Normally hungry after every 2hrs but can bear up to 3hrs -0
ii. Hungry ≤ 2hrs but relives with small amount of food – 1
iii. Hungry ≤ 2hrs, requires large amount of food to relive -2
iv. Hungry ≤ 1hrs, not relived even after having large amount of food – 3
6. ippasaaityaaoga:
i. Requires ~ 1 ½-2 lit of water /day -0
ii. Requires ~2- 2 ½ litre of water /day – 1
iii. Requires ~2 ½ -3 litre of water /day-2
iv. Feels Very thirsty drinks >3 litre liquid /day – 3

7. Aalasyama\ :
i. Can perform routine activity comfortably – 0
ii. Prefer to perform only unavoidable work – 1
iii. Tries to minimise unavoidable work -2
iv. Can’t perform routine activity independently -3
8. ÌcC/vyavaayata:
i. Unimpaired libido and sexual performance - 0
ii. Decrease in libido but can perform sexual act – 1
iii. Decrease in libido but can perform sexual act with difficulty – 2
iv. Loss of libido and cannot perform sexual act – 3
Objective Criteria:
The details of the scores adopted for the BMI and body
Measurments of Sthaulya in present study were as follows :
1. Body Mass Index: BMI

B M I= Weight (kg) ÷ (Height in meter)2
Below – 20 under Weight
20 – 25 Normal Weight
25– 30 Overweight
30 – 40 Obese
Above 40 Very obese/Morbid obese
The value of BMI>25 was considered as obese.
2. Measurement of circumference:
Body Girth Measurement
1. Chest: At the level of nipple
2. Abdomen: At the level of umbilicus.
3. Hip: At the level of highest point of distension of buttock.
4. Mid thigh: Mid of thigh between pelvic and knee joint.
5. Mid calf: At the highest level of calf region
6. Mid arm: Mid of arm from shoulder joint to elbow joint.
Follow up-
Total 4 Follow-ups were taken with the gap of 15 days depending
upon assessment criteria (mentioned below) was noted at each follow
up.
Place of clinical work-Bharati Vidyapeeth Medical Foundation’s
Bharati Āyurved Hospital, Pune Satara Road, Dhankawadi, Pune-43.
Laboratory findings: lipid profile were done before and after

treatment.
Stastical Analysis:
Clinical data gathered from patients was subjected for statistical
analysis. Data was analyzed statistically in terms of Mean score,
Percentage of relief, Standard Deviation (S.D.), Standard Error (S.E.)

and„ t test., Paired t test was carried out at the level of 0.05, 0.01,
0.001 of „P value. Results were interpreted as
Insignificant : p>0.1
Significant : P<0.05
Highly significant : P<0.01& P<0.001
Presentation of data:
Data collected from the patients was tabulated under following two
sections-
1. General observations like age, sex, marital status etc.
2. Results of therapy on the basis of changes in signs-symptoms and
disease specific biochemical investigations.
General Observations:-
Table No.1 Gender wise distribution
Gender Total
Male 11
Female 19
Grand Total 30
Gender wise distribution
Male; Series1; 11; Male

37% Female
Female; Series1;
19; 63%
Observations: From above table and graph, we see that there are
majority of the patients i.e. 63% were females and 37% patients were
males.

Table No.2 Age wise distribution
Age Total
20-30 10
30-40 14
40-50 6
Grand total 30
Agewise disribution
40-50; Se- 20-30;
ries1; 6; 20% Series1;
10; 33%
20-30
30-40
40-50
30-40;
Series1;
14; 47%
majority of the patients i.e. 47% were having age group 30-40 years,
and only 20% observed in age group 40-50 years.

Table No.3 Marital status:-
Marital status PATIENT % of patient

Married 26 87%
Unmarried 4 13%
MARITAL WISE WISE

DISTRIBUTION
Unmarried
13%
Married
87%
Observations:- In the present study, maximum numbers of

patients were found to be married i.e. 87% and 13% were unmarried
as shown in this table: 4.

Table No.4 Proffesion wise Distribution:-
WORK WISE PATIENT % of Patients

HOUSEWIFE 7 23%
SITING WORK 18 60%
STUDENT 5 17%
WORK WISE DISTRIBUTION

STUDENT
17%
HOUSEWIFE
23%
SITING WORK
60%
Observation :- Maximum i.e.60% patients were doing siting type of

work, 23% were house wives, and 17 % are student as per above data
of table-4

Table No.5. Addiction wise Distribution:-
ADDICTION WISE PATIENT % of Patients

TEA 18 53%
COFFEE 6 17%
TEA-COFFEE 6 18%
ALCOHOLE 4 12%
ADDICTION WISE DISTRI-

BUTION
ALCOHOLE
12%
TEA-COFFEE
18%
TEA
53%
COFFEE
18%
Observations:- Study of addiction reveals that 53% of patients

were found to be habituated tea followed by 17% were taking coffee.
And those who are having habit to drink both are about 18%. Alcohole
drinkers are 12%.

Table No.6. Āhār wise distribution:-
Aahar FOOD ITEMS % Of

Patients
gau¯þ Aahar Maggii, Noodles, Burger, Pizza, Bread 76.66
maQaur Aahar Bakery products, fruit Salad, 63.33
Shrikhand.
SaIt Soft Drinks, Ice cream, Pastries, Cold 33.33
Cake, Juice etc.
isnagQa Aahar Bread Pattice, Noodles, Butter, 90
Cheese,Oily food
ipaicCla Pasta, Butter etc 23.33
navaanna New harvested crop 26.66
navamaV 3.33
payasa ivakar Curd, paneer, Milk Shake etc. Salty 73.33
food with Milk etc
maaMsa Aquatic & meat of animals from 60
Marshy land etc.
.
Aaharajhetu wise distri-

bution
% of patients
Aahar
majority of the patients i.e. 76.66% were taking Snighdha Āhār a, and
only 3% taking Navmadya Āhār a. Hence we said that if people taking
Snighdha, Guru ,and Payas vikar Āhār a become obese.

Table No.7.Vihar wise distribution:-
ivahar % of patients
Vyaayaama 13.3
Vyavaaya 23.3
AasanasauK 90
caoYTavdoYa 83.3
idvaasvaap 63.3
svaPnap`saMga 10
Vihar wise distribution

% of patients
vihar
majority of the patients i.e. 90% were follows aasansukh vihar, and
83.33% were follows cheshtadvesh vihar .Hence as we see if people
having following type of vihar they may become obese.

Table No.8.Psychological examination wise distribution
PSYCHIOLOGICAL EXAMINATION % of patients
hYa- ina%ya%va 80
AicaMta 20
PSYCHIOLOGICAL EXAMINATION
wise distribution
% of patients
PSYCHIOLOGICAL EXAMINATION
majority of the patients i.e. 80% were having habit of harshanityatva
and only 20% having achintan, Hence we said that if people having
follows in this type of habit i.e. harshanityatva they become obese.

Results of therapy:-
A) Paired t test: Paired test is carried out for following data.

Hypothesis:
Ho: Vatsakādi Gana is not significantly effective in Sthaulya.
H1: Vatsakādi Gana is significantly effective in Sthaulya.
1. Weight
p
Paramete Interpretatio
N Mean SD SE t value Df valu
r n
e
BT AT 1.065876 17.12902
Weight 30 1
0.1946015
5 29 0 Significant
74.7 71.36
Here, mean of weight slightly decreases after treatment .Also p value<

0.05 .So it can be said that given drug has significant result to reduce
weight in Sthaulya
2. BMI
p
Parameter N Mean SD SE t value df Interpretation
value
BT AT
BMI 30 31.6 1.82 0.33 5.89 29 0 Significant
29.69
5
Here, mean of BMI slightly decreases after treatment & also p

value< 0.05 .So it can be said that given drug has significant result to
reduce BMI in Sthaulya
3. Chest circumference
t p Interpretatio
Parameter N Mean SD SE df
value value n
Chest BT AT
3.5 0.6
circumferenc 30 99.4 94.2 7.94 29 0 Significant
7 5
e 5 6
Here, mean of CH slightly decreases after treatment .Also p value<

Chest circumference in Sthaulya.
4. Waist circumference
t p Interpretatio
value value n
Waist 3 BT AT 3.0 0.5 11.08 2 0 Significant

circumferenc 100.5 94.3
0 8 6 9
e 6 3
Here, mean of Waist circumference slightly decreases after

treatment .Also p value< 0.05 .So it can be said that given drug has
significant result to reduce Waist circumference in Sthaulya.
5. Hip circumference:-
p
Parameter N Mean SD SE t value df Interpretation
value
Hip BT AT
circumferenc 30 4.49 0.82 9.22 29 0 Significant
e 111.53 103.96
Here, mean of Hip circumference decreases after treatment .Also p

value< 0.05 .So it can be said that given drug has significant result to
reduce Hip circumference in Sthaulya.
6. Thigh circumference:-
t p Interpretatio
value value n
Thigh BT AT
3 1.4 0.2 2
circumferenc 7.04 0 Significant
0 56.9 55.0 7 6 9
e
3 3
Here, mean of RTH decreases after treatment .Also p value< 0.05 .So
it can be said that given drug has significant result to reduce Right
Thigh circumference in Sthauya. LTH slightly decreases after
significant result to reduce Left Thigh cercumference in Sthaulya.
7. Arm circumference:-
t p Interpretatio
value value n
arm BT AT
1.5 1.0
circumferenc 30 8.06 29 0 Significant
34.2 32.6 8 7
e
1 3
Here, mean of arm circumferance decreases after

significant result to reduce arm circumference in Sthaulya

B) Wilcoxon test:- For signs and symptoms wilcoxan test is
carried out.
1. daOba-lyama\ :
Positive
Parameter N Negative rank Tie Z value P value Interpretation
rank
daOba-
30 0 29 1 -5.01 0 Significant
lyama\
Here p value<0.05 hence we said that dorbalyam in decreasing after

treatment i.e. given drug has significant result to reduce dorbalyam
in Sthaulya
2. daOga-nQyama\ :
Positive Negative Ti Z P Interpretat
Parameter N
rank rank e value value ion
daOga-nQyama\ 30 0 27 3 -4.68 0 Significant
Here p value<0.05 hence we said that dourgandhya in decreasing after

treatment i.e. given drug has significant result to reduce
dourgandhya in Sthaulya
3. svaodabaaQa :
Positive Negative Ti Z P Interpretatio
Parameter N
rank rank e value value n
svaodab 3
0 27 3 -4.86 0 S
0
aaQa
Here p value<0.05 hence we said that swedhabadh in decreasing

after treatment i.e. given drug has significant result to reduce
swedhabadh in Sthaulya
4. xauditmaa~ma\ :
Paramete Positive Negative Ti Z P Interpretatio
N
r rank rank e value value n
xauditm 30 0 27 3 -5.03 0 Significant
aa~ma\
Here p value<0.05 hence we said that kshudhtrimatram in decreasing

after treatment i.e. given drug has significant result to reduce
kshudhtrimatram in Sthaulya
5. ippasaaityaaoga:

Parameter N
ippasaait 3
0 30 0 -4.91 0 Significant
0
yaaoga
Here p value<0.05 hence we said that pipasatiyog in decreasing after

treatment i.e. given drug has significant result to reduce
pipasatiyog in Sthaulya
6. Aalasyama\ :
Paramete Positive Negative Ti Z P Interpretatio
N
r rank rank e value value n
Aalasya
30 0 30 0 -5.2 0 Significant
ma\
Here p value<0.05 hence we said that alasayam in decreasing after

treatment i.e. given drug has significant result to reduce alasayam
in Sthaulya.
7. ÌcC/vyavaayata :
Parameter N
ÌcC/
vyavaayat 4 0 4 0 -2 0.046 Not significant
a
Here p value>0.05 hence we said that kuchyavyavayata in increasing

after treatment i.e. given drug has no significant result to reduce
kuchyavyavayata in Sthaulya.
C) BIOCHEMICAL ANALYSIS:-
Lipid profile
1. CHOLESTEROL
Mean of
t Interpretatio
Parameter N Mean SD difference df p value
value n
s
BT AT
CHOLESTERO 3 22.0652
0.1946015 6.13 29 0.0121 Significant
L 0 196.9 169.033 9
3 3
Here, mean of CHOLESTEROL decreases after treatment .Also p value< 0.05.

So reject Ho i.e.it can be said that given drug has significant result to reduce
CHOLESTEROL in Sthaulya.

2. TRIGYSERIDES
Mean of t p
Parameter N Mean SD df Interpretation
differences value value
BT AT
2
TRIGYSERIDES 30 64.6667 10.7 1.008 0.3221 Not significant
9
128.10 117.4
Here, mean of TRIGYSERIDES decreases after treatment .but p value >

0.05 .So accept Ho i.e.it can be said that given drug has no significant result
to reduce TRIGYSERIDES in Sthaulya
3. S.HDL
Mean of t p
BT AT
S.HDL 30 5.97307 2.19 1.83 29 0.076 Significant
40.15 37.95667
Here, mean of S.HDL decreases after treatment .Also p value< 0.05 .So
reject Ho i.e.it can be said that given drug has significant result to
reduceS.HDL in Sthaulya
4. S.LDL
Mean of t p
BT AT 2
S.LDL 30 25.7153 24.83 4.9 0 Significant
9
133.64 108.8167
Here, mean of S.LDL decreases after treatment .Also p value< 0.05 .So reject
Ho i.e.it can be said that given drug has significant result to reduce S.LDL
in Sthaulya
5. V.L.D.L
Mean of
t p
Parameter N Mean SD difference df Interpretation
value value
s
BT AT 12.952
V.L.D.L 30 2.147 1.012 29 0.32 Not significant
1
25.62 23.47333
Here, mean of V.L.D.L . Decreases after treatment .Also p value< 0.05 .So
accept Ho i.e.it can be said that given drug has significant result to reduce
V.L.D.L in Sthaulya

DISCUSSION
Any research work without being discussed about its nature, utility
and importance is said to be incomplete, any hypothesis becomes
principle only after discussed from all the angles (Ch. Vi.8/37).
Success in treatment signifies the correct application of all
therapeutics measures.
Shastra Sahita Tarka is essential for any research work.
1. The facts established by proofs after careful investigations,
observations and experiments and supported by accurate data and
convincing reasoning can convince the people about validity and
even the facts require support of statistics.
2. Shastra based discussion over any conceptual and practical
oriented study definitely gives one or other fruitful conclusions.
3. Therefore, discussion is the main substratum of any type of
research work.
The study was: “ROLE OF VATSAKĀDI GANA IN STHAULYA

(OBESITY) AS A SANTARPANAJANYA VYĀDHI.”
1. Santarpan as therapy:-
 The word Santarpan is found in Bruhattrayi mainly as a
chikista upakrama. But if it is given to improper person it works
as a cause of Santarpanottha Vyādhi.
 Etiological factors of Santarpanjanya Vyādhis have a dominace
of Pruthvi and Aapa Mahabhoot. Hence they mainly increses
Kapha, Mamsa, and Meda and further develop respective
Vyādhis namely Prameha, Kushtha, Sthulya etc.
 Charaka Acharya has mentioned a list of causative factors of
Santarpanjanya Vyādhis along with their names. But it is not
mentioned that which causative factors produce which
Santarpanjanya Vyādhi. Schollar has tried to focus this point in
this chpter.
 Patient Suffering from Prameha can be Classified into two
1.balavaana & sqaUla 2. ÌSa & duba-la
Patients belonging to the second category should be given
Santarpan chikista and Apatarpan chikista for first one. but
after the Sanshodhan chiksta Santarpan chikista indicated for
balawan pramehi because apatarpan therapy in this condition
may produce Vatajanya Prameha.
 Maximum causative factors of Santarpanjanya Vyādhis are
found in Prameha.
 Pidaka- In Pidaks Guru, Snigdha, Navanna, these hetus are
responsible for aggravation of Kapha and vitiation of Meda.
Amla, lavan are responsible for Shaithilya in the body. lack of
Vaman Virechan adi karma, results in increase Pitta dosha.

Vitiated Pitta and Kapha Dosha cause Pidaka at Mamsa,
Sandhi, and Marma.
 Kushta- Kushta is one of the Santarpanjanya Vyādhi. Snigdha,

Guru ahar sevan, Navanna, Pishthanna, Gud etc sevan increase
kapha in the body. While other hetus like sheet- ushna vyatyas,
Santarpan –Apatarpan vyatyas, madhu phanit, fruits with milk,
satat ajirna, lavan, amla etc are aggravate pitta in the body.
Increased pitta does raktadushti, thus rakta, pitta, kapha
vitiated at skin and leads to kushtha
 Pandu- Pandu is also Santarpanjanya Vyādhi. But in hetus of
pandu only viharaj hetu ie divaswap is Santarpanjanya. Due to
Divaswapna, Kapha Dosha gets aggravated in the body. Due to
Snigdha & Drava property of Kapha, Dhatus loses their normal
consistency and Shaithilya is generated.
 Mutrakruchha-In mutrakruchha also only two hetus are

Santarpanjanya. Madya and aanupa mamsa sevan. Aanupa
mamsa is pichhila gunatmak and abhishyandi it increase kapha
and meda in the body. Excessive madyapan increases heat in
the body which leads to shopha in urinary track results in
dribbling micturition.
 Kaphaj jwara shows features of Santarpan. Above causative
factors of Santarpanottha disorders have dominance of Pruthvi
& Aap. Hence all they vitiate Mamsa & Meda Dhatu along with
the vitiation of Kapha. In these pruthavi mahabhooth is
dominant, pichhila guna increase the Kapha and Meda. While
Amla & Sheeta causes Shaithilya in the body.
 Amapradoshaj vikaras-Amapradoshaj Vikar are Santarpanjanya
but here also only one hetu is seen as Santarpanjanya, ie Guru.
The food which is heavy to digest is called as Guru. It hampers
digestive power and generate Aama. Properties of Aama and
Kapha are almost same. Hence it also vitiate Kapha. Other
mental causative factors as mentioned in the chart also destruct
the digestive capacity and helps for the derivation of Aama.
 Arochaka- In Santarpanjanya disorders Arochak causes due to
manasik hetus like Shok, Bhaya, Krodha, Lobha. This is
disorder which causes due to rasavahasrotodushti. Hence
among the causes of rasavaha srotodushti, excess consumption
of Guru, Atisnigdha and Atimatra Ahar sevan are considered as
Santarpanothha hetu of Arochak.
 Kasa- Kaphaj kasa is a Classical example of Santarpanjanya
disorders.

Here all hetus of kaphaj kasa are Santarpanjanya. Guru,
Snigdha, Madhur ahar, daysleep, Acheshta. These are jala and
pruthavi mahabhoot dominant which increase Kapha. In
pathogenesis of Kasa there is no role of Mamsa and Meda
Dhatu. Only vitiated Kapha bloks the channels of Vayu. Hence
normal direction and proper functioning of Vayu gets hampered
 In visarpa excessive intake of pishtanna, aanupamamsa, and
daysleep aggravate kapha dosha, while other hetus like lavan,
amla, katu rasatmak ahar, ushna anna, sura, souvir, vidahi
anna, kilat, etc vitiate pittha in the amashaya. This results in
vitiation of following seven types of dushyas Vata, Pitta, Kapha,
Rakta, Lasika, Twak, Mamsa. After stuying all hetus of
Santarpan disorders it is observed that Snigdha, Guru, Madhur,
Aanupa Mamsa, causes Abhisyand in the body. Which does
Srotorodha and leads to Granthi Visarpa. Granthi Visarpa is
Vata- Kapha dominat type of Visarpa and it comes under
Santarpanjanya disorders.
 Shotha- Shotha is causes due Santarpan hetus like Guru,
Navanna, Aanup mamsa sevan. And other hetus like vaman,
virechan, aasthapan, anuvasan, mithyayog, vegdharan,
excessive walking, amla, lavan, ahar vitiate kapha and pitta
results in Shotha.
 Bhagandar- In Bhagandar disease is given under Santarpanjaya
Vyādhis. But there is no any Santarpanjanya causative factor
found. Mithya Ahar Vihar leads to aggravation of Kapha, Pitta,
and Vata, and results in Bhagandar.
2. Sthaulya a disease review:-

 Acharya Charaka who first ever mentioned this disease in the
description of eight disgraceful personalities.
 Acharya Sushrut given aama annaras as main causative factor
for Sthaulya. Increased Kapha dosha result in increase in
Samata in the body. Singdhasha of that aam rasa causes
Medovridhhi.
 Acharya charaka stated Bijadosha as causative factor for
Sthulya.
 Maximum Santarpanjanya Vyādhis like Pidaka, Prameha etc are
found in Upadrava of Sthulya.
 Sthaulya is caused due to Medovridhi along with Kapha dosha
vitiation, so to treatment of Sthaulya allivation of these Dushyas
required.
3. Modern science :- obesity-
According to modern science, obesity precipitates some other
disease like Hypertension, Osteoarthritis, Coronary heart

disease, Diabetes mellitus etc. Research works were done
worldwide on obesity, but still there enough scope to rejuvenate
the management of Sthaulya.
4. Drug review:-
 In present study, Vatsakādi Gana was selected for the
management of Sthaulya. The 23 drugs given under this gana
are Katu, Tikta rasatmak, Katu vipaki, ushna viryatmak, which
are responsible to karshan in the body, eliminate Kapha dosha,
and Meda dhatu.
 In this Vatskadi Gana out of 23 drugs 20 number of drugs are
Katu Rasa Pradhan. Katu and Madhura are having opposite
properties, so Katu is useful for treating Sthulya.

Tikta 14 37%
Katu 20 52%
Kashay 3 8%
Madhur 1 3%
 Vipaka:- 21 Drugs in Vastakadi Gana are Katu. Only two drugs

are Madhura Vipaki but having Katu Rasa ie Shunthi and
Pippali.

Katu 21 91%
Madhur 2 9%
OBSERVATIONS :-
The end result of each therapy was assessed individually on various
parameters and then finally inferences were drawn and are presented
here.
30 patients were randomly selected from O.P.D. of B.V.D.U. Bharati
Ayurved Hospital and research centre.
1. Age:
In this present study maximum number of patient i.e.47%
belonged to age group of 30-40 yrs while 20 % each were of age
group of 40-50 and 33% of 20-30 yrs because of sedentary life
style, excessive food intake and inappropriate life style.
Age Total
20-30 10
30-40 14

40-50 6
Grand total 30
2. Sex:
Maximum patients i.e. 63 % were female because of having a
tendency to develop fatty mass. Moreover, some feminine factors
like menstrual disorder, post operating condition, pregnancy,
menopause etc. are predominant factors, which makes female
obese .
Gender Total
Male 11
Female 19
Grand Total 30
3. Occupation:
In present study, maximum patients were the one who always in
siting type of work and house wives, while other were having business
and student. The reason behind this might be light nature of work,
advancement of new techniques, tool And the common cause of
obesity in housewife is day time sleep.

HOUSEWIFE 7 23%
SITING WORK 18 60%
STUDENT 5 17%
4. Marital status:
In this study maximum patients are recorded as Married , Obesity is
common in married females in comparison to unmarried , owing to
hormonal imbalance occurring after marriage and pregnancy
5. Aharaj hetu :-
Observations: There are majority of the patients i.e. 90% were

taking snighdha Āhār a, and 76.6% were having Guru Ahar. there is
73.3% patients consuming milk products.

Aahar FOOD ITEMS % Of Number
Patients of
Patients
gau¯þ Aahar Maggii, Noodles, Burger, 76.66 23
Pizza, Bread
maQaur Bakery products, fruit 63.33 19
Aahar Salad, Shrikhand.
SaIt Soft Drinks, Ice cream, 33.33 10
Pastries, Cold Cake, Juice
etc.
isnagQa Bread Pattice, Noodles, 90 27
Aahar Butter, Cheese,Oily food
ipaicCla Pasta, Butter etc 23.33 7
navaanna New harvested crop 26.66 8
navamaV 3.33 1
payasa Curd, paneer, Milk Shake 73.33 22
ivakar etc. Salty food with Milk etc
maaMsa Aquatic & meat of animals 60 18
from Marshy land etc.
6. Viharaj hetu: Observations: There are majority of the patients

i.e. 90% were follows aasansukh vihar, and 83.33% were follows
cheshtadvesh vihar .Hence as we see if people having following
type of vihar they may become obese.
ivahar % of Patients Number of Patients

vyaayaama 13.33 4
vyavaaya 23.33 7
AasanasauK 90 28
caoYTavdoYa 83.33 26
idvaasvaap 63.33 19
svaPnap`saMga 10 4
7. Manasik hetu: There are majority of the patients i.e. 80% were
having habit of harshanityatva and only 20% having achintan,
Hence we said that if people having follows in this type of habit
i.e. harshanityatva they become obese.
PSYCHIOLOGICAL % of patients Number of

EXAMINATION patients
hYa- ina%ya%va 80 18
AicaMta 20 8
8. Weight:
Paramete p
N Mean SD SE t value df Interpretation
r value
BT AT
0.194601 17.12902
Weight 30 1.0658761 29 <0.05 Significant
5 5
74.7 71.36
p value< 0.05 .So it can be said that given drug has significant result
to reduce weight in Sthaulya
9. Body mass index:
Parameter N Mean SD SE t value df p value Interpretation

BT AT
BMI 30 1.82 0.33 5.89 29 <0.05 Significant
31.65 29.69
Here, mean of BMI slightly decreased after treatment & also p value<
BMI in Sthaulya.
10. There was reduction observed in various body circumferences i.e

in Chest circumference, in waist, in hips circumference P<0.01.
The result was highly significant at p<0.001.
11. Effect of therapy on sign and symptoms:
Effect on Chalatva: only one patient got relief from
javoparodha
Effect on Daurbalya: improvement in Daurbalya was in
significant at p<0.05,
Effect on Daurgandhya: improvement in Daurgandhya , which
are significant at p<0.05,
Effect on Swedadhikya: Patient got relief in swedadhikya.
Effect on Kshudhadhikya: Improvement in Kshudhadhikya
which are significant at the level (<0.05)
Effect on Trishadhikya: The responce in vastakadi vati was
better which has significant result (p<0.05).

Effect on Alasya: significant
Kruchravyavayata: Not significant results as p value 0.046.
12. Biochemical investigation:

In present study, biochemical investigation viz.
S. cholesterol, S. Triglyceride and HDL were carried out before
and after treatment.
a. S.Cholesterol: Maximum numbers of patients shows significant

reduction in cholesterol ie 25, and 5 patients have no effect in
cholesterol levels.
b. HDL: HDL level increased in 8 patients that is significant result.
And 19 patients show reduction in HDL after treatment.
c. S. Triglyceride: Maximum patients shows reduction in
trigycerides ie 20. Results are significant in biochemical
examination

CONCLUSION
On the basis of the Literary and clinical study, following conclusions

chas been drawn.
A) Literary :-
1. Santarpan is one of the main type of treatment but if given to
improper person then vitiated Kapha, Mamsa, and Meda produces
various over nutritive disorders.
2. Maximum causative factors of Santarpanjanya Vyādhi are found in
prameha as compare to other disorders.
3. Sthaulya is the main over nutritive disorder which futher causes
other Santarpanjanya Vyādhi if not cured properly
4. Maximum Drugs given in Vastakadi Gana are Katu, Tikta Rasa
Pradhan. 21 drugs are Katu Vipaki And two are Madhura Vipaki. And
Katu Rasa Pradhan ie Shunthi and Pippali.
B) Clinical evaluation:-
1. Obesity occurs more in female than male and specially increases
after marriage, light nature of work, contraceptive pills, after delivery
and in menopausal period etc.
2. Majority of patients were suffering from Trushna atimatra,
Svedadhikya, Alasya, Kshudhadhikya. From above observation it can
be concluded that these to conclude that these classical symptoms are
generally present in obese persons.
3. Apart from all Aharaj, Viharj, and Manasik hetus given in Samhitā,
it has been observed that Stress, use of Oral Contraceptive pills,
changed Diatery habits, Consuming Snaks instead of meal etc are also
responsible for Sthulya now days.
4. Vastakadi vati has shown highly significant result on cholesterol
and decrease in body girth. Reduction in waist circumference and hip
circumference is more significant. Average weight reduction in
patients is 3kg.
5. Effect of Vatsakādi Gana on Lakshanas:-
a) Maximum reduction is seen in Daurbalya, Alasya and Trishna.
b) There is moderatly relif from Kshudhaadhikya, and Swedadhikya
after treatment.
c) As Javoparodha was seen in only one patient but marginal result is
seen in Javoparodha.
d) In kruchravyvayata there is no any significant result. It may be
because of drugs in Vatsakādi Gana are Katu Rasa Pradhan, and
having Ushna Virya.

SUMMERY
Title – ROLE OF VATSAKĀDI GANA IN STHAULYA (OBESITY) AS A
SANTARPANAJANYA VYĀDHI.”
Aim:-
To study role of Vatsakādi Gana in Sthaulya (obesity) as a
Santarpanajanya Vyādhi.
OBJECTIVES:-
To study the concept of Santarpanajanya Vyādhi.
To study pathogenesis of Sthaulya Vyādhi & mode of treatment.
To study role of Vatsakādi Gana in Sthaulya.
MATERIALS:-
Caraka Samhitā with Cakrapānī commentary
Susruta Samhitā with Dalhan commentary.
Aşhtang hruday & A ūņ commentary.
Other allied literature.
30 patients of overweight & obesity.
METHODOLOGY:-
A. LITERARY STUDY:-
1. References of Santarpanajanya Vyādhi were compiled &
studied from Bŗhattrayī & allied literature.
2. References of Sthaulya have been studied in detail &
categorised with the help of Brihattrayī & allied literature.
3. All drugs from Vatsakādi Gana were studied on the basis of
their Guna & Karma.
B. CLINICAL STUDY:-
1. According to literary review primary case paper was revised.
2. Written consent was taken before the treatment.
2. Authantication of all drugs existing in Vatsakādi Gana was

done in Botony dept Pune Vidyapeeth .
3. Tablets of Vatsakādi Gana were prepared in the pharmacy of

College of Āyurveda Bharati Vidyapeeth Deemed University,
Pune.
4. Sanderdisation of Vatsakādi Gana is done in Bhide lab.
4. Tablets were prepared following the guidelines given by the

Ayurvedic Pharmacopoeia of India- first edition (2010).

5. 30 patients of Sthaulya (obesity) were selected on the basis of
inclusion criteria. Role of Vatsakādi Gana in Sthaulya were
studied. Dose, Duration & Anupan was as follows,
a. Dose:- 2 tablets (Each of 500 mg.)×vyaanaaodana
b. Duration:- 60 days (8 weeks)
c. Anupana:- Hot water (Ushnodaka)
6. Total 4 Follow-ups were taken with the gap of 15 days.

7. Laboratory investigation ie lipid profile of each patient was
done before treatment & after treatment.
8. Observations depending upon assessment criteria were
studied at each follow up.
9. After observation of clinical data of 30 patients, all hetu and
lakshana were analysed.
10. Statical analysis was done according to data obtained.
11. Place of clinical work-Bharati Vidyapeeth Medical
Foundation’s Bharati Āyurved Hospital, Pune Satara Road,
Dhankawadi, Pune-43.
Inclusion criteria-
1. Patients having BMI =25 and above.
2. Age group- 18yrs to 50yrs.
3. Either sex.
Exclusion criteria-
1. Obesity with severe complications like coronary heart disease.
2. Obesity with Pregnancy.
Assessment criteria:-
a) Subjective Criteria:
Sign & symptoms of obesity according to Bŗhattrayī.
The details of the scores adopted for the main signs and
symptoms of Sthaulya in present study were as follows :
1. javaaoparaoQa :
i. Normal physical activity -0
ii. Less physical activity -1
iii. Physical activity with difficulty -2
iv. Can’t perform physical activity -3
2. daOba-lyama\ :
i. Feeling no weakness at the end of the day -0
ii. Weakness in performing daily work – 1

iii. Weakness in performing normal physical activity (walking/running )-2
iv. Needs to rest after every small activity -3
3. daOga-nQyama\ :
i. No foul smell of sweat - 0
ii. Normal smell of sweat – 1
iii. Persistent bad smell bearable with deodorant– 2
iv. Persistent bad smell not even suppressible with deodorants/bath – 3
4.svaodabaaQa:
(At normal temperature in normal condition)
i. Normal Sweats as per season - 0
ii. Sweats Profusely during moderate work – 1
iii. Sweats on doing routine work and movement – 2
iv. Sweats Profusely even doing his personal work or no work – 3
5.xauditmaa~ma\ :
i. Normally hungry after every 2hrs but can bear up to 3hrs -0
ii. Hungry ≤ 2hrs but relives with small amount of food – 1
iii. Hungry ≤ 2hrs, requires large amount of food to relive -2
iv. Hungry ≤ 1hrs, not relived even after having large amount of food – 3
6.ippasaaityaaoga:
i. Requires ~ 1 ½-2 lit of water /day -0
ii. Requires ~2- 2 ½ litre of water /day – 1
iii. Requires ~2 ½ -3 litre of water /day-2
iv. Feels Very thirsty drinks >3 litre liquid /day – 3
7. Aalasyama\ :
i. Can perform routine activity comfortably – 0
ii. Prefer to perform only unavoidable work – 1
iii. Tries to minimise unavoidable work -2
iv. Can’t perform routine activity independently -3
8. ÌcC/vyavaayata:
i. Unimpaired libido and sexual performance - 0
ii. Decrease in libido but can perform sexual act – 1
iii. Decrease in libido but can perform sexual act with difficulty – 2
iv. Loss of libido and cannot perform sexual act – 3
Objective Criteria:
The details of the scores adopted for the BMI and body
Measurments of Sthaulya in present study were as follows :
1. Body Mass Index: BMI
B M I= Weight (kg) ÷ (Height in meter)2
Below – 20 under Weight

20 – 25 Normal Weight
25– 30 Overweight
30 – 40 Obese
Above 40 Very obese/Morbid obese
The value of BMI>25 was considered as obese.
2. Measurement of circumference:
Body Girth Measurement
1. Chest: At the level of nipple
2. Abdomen: At the level of umbilicus.
3. Hip: At the level of highest point of distension of buttock.
4. Mid thigh: Mid of thigh between pelvic and knee joint.
5. Mid calf: At the highest level of calf region
6. Mid arm: Mid of arm from shoulder joint to elbow joint.
3. Follow up-
Total 4 Follow-ups were taken with the gap of 15 days depending
upon assessment criteria (mentioned below) was noted at each follow
up.
4. Place of clinical work-Bharati Vidyapeeth Medical Foundation’s
Bharati Āyurved Hospital, Pune Satara Road, Dhankawadi, Pune-43.
5. Laboratory findings: lipid profile were done before and after

treatment.
6. Conseptual study:-
Santarpan as therapy:-
 The word Santarpan is found in Bruhattrayi mainly as a
chikista upakrama. But if it is given to improper person it works
as a cause of Santarpanottha Vyādhi.
 Itiological factors of Santarpanjanya Vyādhis have a dominace
of Pruthvi and Aapa Mahabhoot. Hence they mainly increses
Kapha, Mamsa, and Meda and further develop respective
Vyādhis namely Prameha, Kushtha, Sthulya etc.
 Charaka Acharya has mentioned a list of causative factors of
Santarpanjanya Vyādhis along with their names. But it is not
mentioned that which causative factors produse which
Santarpanjanya Vyādhi. Schollar has tried to focus this point in
this chpter.
 Patient Suffering from Prameha can be Classified into two
1.balavaana & sqaUla 2. ÌSa & duba-la
Patients belonging to the second category should be given
Santarpan chikista and Apatarpan chikista for first one. but
after the Sanshodhan chiksta Santarpan chikista indicated for
balawan pramehi because apatarpan therapy in this condition
may produce Vatajanya Prameha.
 Maximum causative factors of Santarpanjanya Vyādhis are
found in Prameha.
Sthaulya a disease review:-

 Acharya Charaka who first ever mentioned this disease in the
description of eight disgraceful personalities.
 Acharya Sushrut given aama annaras as main causative factor
for Sthaulya. Increased Kapha dosha result in increase in
Samata in the body. Singdhasha of that aam rasa causes
Medovridhhi.
 Acharya charaka stated Bijadosha as causative factor for
Sthulya.
 Maximum Santarpanjanya Vyādhis like Pidaka, Prameha etc are
found in Upadrava of Sthulya.
 Sthaulya is caused due to Medovridhi along with Kapha dosha
vitiation, so to treatment of Sthaulya allivation of these Dushyas
required.
Modern science: - obesity-
According to modern science, obesity precipitates some other
disease like Hypertension, Osteoarthritis, Coronary heart
disease, Diabetes mellitus etc. Research works were done
worldwide on obesity, but still there enough scope to rejuvenate
the management of Sthaulya.
Drug review:-
 In present study, Vatsakādi Gana was selected for the
management of Sthaulya. The 23 drugs given under this gana
are Katu, Tikta rasatmak, Katu vipaki, ushna viryatmak, which
are responsible to karshan in the body, eliminate Kapha dosha,
and Meda dhatu.
 In this Vatskadi Gana out of 23 drugs 20 number of drugs are
Katu Rasa Pradhan. Katu and Madhura are having opposite
properties, so Katu is useful for treating Sthulya.

Tikta 14 37%
Katu 20 52%
Kashay 3 8%
Madhur 1 3%
 Vipaka:- 21 Drugs in Vastakadi Gana are Katu. Only two drugs

are Madhura Vipaki but having Katu Rasa ie Shunthi and
Pippali.

Katu 21 91%
Madhur 2 9%
7. OBSERVATIONS :-
The end result of each therapy was assessed individually on
various parameters and then finally inferences were drawn and are
presented here.

30 patients were randomly selected from O.P.D. of B.V.D.U.
Bharati Ayurved Hospital and research centre.
Age:
In this present study maximum number of patient i.e.47%
belonged to age group of 30-40 yrs while 20 % each were of age
group of 40-50 and 33% of 20-30 yrs because of sedentary life
style, excessive food intake and inappropriate life style.
Age Total
20-30 10
30-40 14
40-50 6
Grand total 30
Sex:
Maximum patients i.e. 63 % were female because of having a tendency
to develop fatty mass. Moreover, some feminine factors like menstrual
disorder, post operating condition, pregnancy, menopause etc. are
predominant factors, which makes female obese .
Gender Total
Male 11
Female 19
Grand Total 30
Occupation:
In present study, maximum patients were the one who always in
siting type of work and house wives, while other were having business
and student. The reason behind this might be light nature of work,
advancement of new techniques, tool And the common cause of
obesity in housewife is day time sleep.

HOUSEWIFE 7 23%
SITING WORK 18 60%
STUDENT 5 17%
Marital status:
In this study maximum patients are recorded as Married , Obesity is
common in married females in comparison to unmarried , owing to
hormonal imbalance occurring after marriage and pregnancy.

Aharaj hetu :-
Observations: There are majority of the patients i.e. 90% were taking
snighdha Āhār a, and 76.6% were having Guru Ahar. there is 73.3%
patients consuming milk products.
Aahar FOOD ITEMS % Of Number

Patients of
Patients
gau¯þ Aahar Maggii, Noodles, Burger, 76.66 23
Pizza, Bread
maQaur Bakery products, fruit 63.33 19
Aahar Salad, Shrikhand.
SaIt Soft Drinks, Ice cream, 33.33 10
Pastries, Cold Cake, Juice
etc.
isnagQa Bread Pattice, Noodles, 90 27
Aahar Butter, Cheese,Oily food
ipaicCla Pasta, Butter etc 23.33 7
navaanna New harvested crop 26.66 8
navamaV 3.33 1
payasa Curd, paneer, Milk Shake 73.33 22
ivakar etc. Salty food with Milk etc
maaMsa Aquatic & meat of animals 60 18
from Marshy land etc.
Viharaj hetu: Observations: There are majority of the patients i.e.

90% were follows aasansukh vihar, and 83.33% were follows
cheshtadvesh vihar .Hence as we see if people having following type of
vihar they may become obese.
ivahar % of Patients Number of

Patients
vyaayaama 13.33 4
vyavaaya 23.33 7
AasanasauK 90 28
caoYTavdoYa 83.33 26
idvaasvaap 63.33 19
svaPnap`saMga 10 4
Manasik hetu: There are majority of the patients i.e. 80% were having
habit of harshanityatva and only 20% having achintan, Hence we said

that if people having follows in this type of habit i.e. harshanityatva they
become obese.
PSYCHIOLOGICAL Number of
EXAMINATION % of patients patients
hYa- ina%ya%va 80 18
AicaMta 20 8
Weight:
p
Paramet Interpretatio
N Mean SD SE t value df valu
er n
e
BT AT
1.065876 0.194601 17.12902 <0.0
Weight 30 29 Significant
74. 71.3 1 5 5 5
7 6
p value< 0.05 .So it can be said that given drug has significant result
to reduce weight in Sthaulya
Body mass index:
Parameter N Mean SD SE t value df p value Interpretation

BT AT
BMI 30 1.82 0.33 5.89 29 <0.05 Significant
31.65 29.69
Here, mean of BMI slightly decreased after treatment & also p value<
BMI in Sthaulya.
There was reduction observed in various body circumferences i.e in

Chest circumference, in waist, in hips circumference P<0.01. The
result was highly significant at p<0.001.
There was reduction observed in various body circumferences i.e in

Chest circumference, in waist, in hips circumference P<0.01. The
result was highly significant at p<0.001.
Effect of therapy on sign and symptoms:

Effect on Chalatva: only one patient got relief from javoparodha
Effect on Daurbalya: improvement in Daurbalya was in significant at
p<0.05,

Effect on Daurgandhya: improvement in Daurgandhya , which are
significant at p<0.05,
Effect on Swedadhikya: Patient got relief in swedadhikya.
Effect on Kshudhadhikya: Improvement in Kshudhadhikya which
are significant at the level (<0.05)
Effect on Trishadhikya: The responce in vastakadi vati was better
which has significant result (p<0.05).
Effect on Alasya: significant
Kruchravyavayata: Not significant results as p value 0.046.
Biochemical investigation:
In present study, biochemical investigation viz.
S. cholesterol, S. Triglyceride and HDL were carried out before and
after treatment.
b. S.Cholesterol: Maximum numbers of patients shows significant
reduction in cholesterol ie 25, and 5 patients have no effect in
cholesterol levels.
b. HDL: HDL level increased in 8 patients that is significant result.
And 19 patients show reduction in HDL after treatment.
c. S. Triglyceride: Maximum patients shows reduction in
trigycerides ie 20. Results are significant in biochemical
examination.
DISCUSSION:-
Santarpanjanya Vyādhis are developed due to vitiation of Kapha

dosha, Meda, Mamsa. After study of all causative factor of
Santarpanjanya disorders have predominance of Pruthavi and Aap
mahabhoot. Sthaulya is caused due to vitiation of Kapha dosha and
Medo, Mamsa dhatu. So the treatment should require which stabilise
these vitiated dushyas. Vastakadi Gana is selected for treatment as in
benefits of it given that it cures Vata, Kapha, and Meda. Observation
was made after the follow up and final result is obtained.
CONCLUSION:
On the basis of the Literary and clinical study, following conclusions
chas been drawn.
A) Literary:-
1. Santarpan is one of the main type of treatment but if given to
improper person then vitiated Kapha, Mamsa, and Meda produces
various over nutritive disorders.
2. Maximum causative factors of Santarpanjanya Vyādhi are found in
prameha as compare to other disorders.
3. Sthaulya is the main over nutritive disorder which futher causes
other Santarpanjanya Vyādhi if not cured properly
4. Maximum Drugs given in Vastakadi Gana are Katu, Tikta Rasa
Pradhan. 21 drugs are Katu Vipaki And two are Madhura Vipaki. And
Katu Rasa Pradhan ie Shunthi and Pippali.

B) Clinical evaluation:-
1. Obesity occurs more in female than male and specially increases
after marriage, light nature of work, contraceptive pills, after delivery
and in menopausal period etc.
2. Majority of patients were suffering from Trushna atimatra,
Svedadhikya, Alasya, Kshudhadhikya. From above observation it can
be concluded that these to conclude that these classical symptoms are
generally present in obese persons.
3. Apart from all Aharaj, Viharj, and Manasik hetus given in Samhitā,
it has been observed that Stress, use of Oral Contraceptive pills,
changed Diatery habits, Consuming Snaks instead of meal etc are also
responsible for Sthulya now days.
4. Vastakadi vati has shown highly significant result on cholesterol
and decrease in body girth. Reduction in waist circumference and hip
circumference is more significant. Average weight reduction in
patients is 3kg.
5. Effect of Vatsakādi Gana on Lakshanas:-
a) Maximum reduction is seen in Daurbalya, Alasya and Trishna.
b) There is moderatly relif from Kshudhaadhikya, and Swedadhikya
after treatment.
c) As Javoparodha was seen in only one patient but marginal result is
seen in Javoparodha.
d) In kruchravyvayata there is no any significant result. It may be
because of drugs in Vatsakādi Gana are Katu Rasa Pradhan, and
having Ushna Virya.

BIBLIOGRAPHY
1. Caraka Smhita, Ayurveda Dipika Commentry of Sri

Cakrapanidatta. By Yadavji Trikamji Acharya. Chowkhamba
Sanskrit Sansthan, Varanasi, Reprint 2009
2. Caraka Samhitā hindi Commentry part 1 & 2, by Dr.
Bramhanand Tripathi, Chwkhamba surbharti Prkashan,
Varanasi reprinted edition 2006.
3. Caraka Samhitā (Text with English Translation & Critical
Exposition Based on Cakrapani Datta’s Ayurveda Dipika),
Chowkhamba Sanskrit Series Office, Varanasi, Reprint 2013
4. Susruta Samhitā (Dalhan & Gayadas Tika) by Vaidya Yadav ji
Trikam ji and Narayan Ram acarya, Chwkhamba Surbharti
Prakashn, Varanasi Reprint Edition 2012.
5. Susruta Samhitā with English Translation of text and Dalhana’s
Commentry along with critical notes by Prof. P.V. Sharma,
Chwkhamba Vishvabharati Varanasi Reprint 2010.
6. Vagbhat’s Aşhţāñga Hridayam (Arundatta and Hemadri
commentary) by Dr. Kunte and Dr. Navare, Chowkhamba
Sanskrit Samsthan, Varanasi Reprint 2010.
7. Vagbhata’s Ashtang Hrdayam (Text English Translation, Notes,
Appendix and Indices) by Prof. K.R. Srikantha Murthy
Chwkhamba Krishnadas Acedamy, Varanasi. 6th Edition 2012
(Reprint).
8. Bhavprakasha Nighantu of sri Bhavmishra by Dr. Krishna
Chandra Chunekar and Dr. Gangasahay Pandey chowkhamba
Bharati Acadmey, Varanasi 2010.
9. DravyaGuna Vigyan Vol I & II by Prof. P.V. Sharma,
Chwkhamba Bharati Acedamy, Varanasi, Reprint Edition 2006
10. Ayurvediya Sarirkriya Vijnana by Prof. Vaidya Y.G.Joshi
Chowkhamba Vishvabharati Varanasi,1st Edition year 2010
11. Padartha Vijnana by Prof. Dr. Yogesh Chandra Mishra,
Chowkhamba Sanskrit Sansthan , Reprint 2007
12. A Sanskrita English Dictionary by Sir M. Monier Williams
Motilal Banarasidas Publishers pvt ltd, Dhelhi 1 st Edition 1899
reprint 1995
13. Hetukosh (A part of Ayurvediyah Triskandhakosh) vol I, by
Vaidya Gadgil Dilip Prabhakar, Maharshtra Sahakari
Mudranalaya Pune, 1st Edition 2004,

ANNEXURE


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INTRODUCTION

Human civilization has reached to an ultra-advanced era where it can

1. sqaaOlya kaSyao- var kaSyao-…| ca.saU.21.20

saMtp-NakRtdao-YaO: sqaaOlya mau@%vaa

(Dept. of Samhita and Siddhant 2014-2015) Page 2

Previous work done:-

(Dept. of Samhita and Siddhant 2014-2015) Page 3

C. Department Of Kaya Chikitsa, Ahmadnagar

E. Department Of Kayachikitsa, Calcutta

F. Department Of Kayachikitsa, Hyderabad

G. National Institute Of Ayurveda, Jaipur Deparment Of Kaya

H.Department Of Kaya Chikitsa, Lakhnow

I. Govt. Ayurveda Medical College & Hospital, Mysure

(Dept. of Samhita and Siddhant 2014-2015) Page 4

J. Govt. Ayurveda Mahavidhyalaya, Nagpur

K. Tilak Ayurveda Mahavidhyalaya, Pune

L. S.D.M. College Of Ayurveda (Karnataka), Hassan

M. College Of Ayurveda & Research Centre Pune

N. Ayurveda Mahavidhyalaya (K.C.), Nasika

Interpretation: - from above data it is revealed that, though many

Aim and objectives

(Dept. of Samhita and Siddhant 2014-2015) Page 5

2. Written consent was taken before the treatment.

2. Authantication of all drugs existing in Vatsakādi Gana was

3. Tablets of Vatsakādi Gana were prepared in the pharmacy of

4. Tablets were prepared following the guidelines given by the

5. 30 patients of Sthaulya (obesity) were selected on the basis of

(Dept. of Samhita and Siddhant 2014-2015) Page 6

(Dept. of Samhita and Siddhant 2014-2015) Page 7

]pËmyasya ih iW%vaai%WQaOvaaopËmaao mat: |

Accoding to Aşhţāñga Hŗudaya Santarpan explained as one of the

baRMh<vaM yacCrIrsya janayao<acca baRMhNama\ |

baRMhNaao doho vaRdQaIkr | DlhNa TIka sau.saU. 46.518

na santUPya<yanaona sama\ +tRp\ krNao laRT\ |

sama +tRp\ ¹ iNaca\ lyau | vaacasptyama\ 6.5211

Ref (Monier Willams). Page no: - 1142).

1) Santarpaka= Satiating, Refreshing

(Dept. of Samhita and Siddhant 2014-2015) Page 8

3) Tarpaniya = Treating of restoratives.

Thus Santarpan means nourishment which is refreshing and

1. tRiPtkrma\ p`INanama\ | sau saU 46.34

According to Acharya Sushrut, the word Santarpan means to

2. baMRhNama\ … | ca saU 23.30

According to Acharya Caraka, the word Santarpan means

According to Ayurvediy Shabdkosh, the word Santarpan means

4. santp-NaIya … ca saU 23.1

Considering above meanings, it is clear that Santarpaka drugs work

toYaaM saMtp-NaM tj~O punara#yaatmaaOYaQama\ |

(Dept. of Samhita and Siddhant 2014-2015) Page 9

5. Importance of Santarpan chikista:

2. nao~M ivarokaityaaogao syandto caaitmaa~Sa: |

3. bauBauxaap`Bavao SaUlao laGau saMtp-NaM ihtma\ |

4. duba-lao caOva $xao ca tp-NaM ihtmaucyato |

In case the patient is debilated and having Rukshata in the

5. sqaUla: p`maohI balavaainahOk:ÌSastqaOk: pirduba-laSca

(Dept. of Samhita and Siddhant 2014-2015) Page 10

Patients suffering from Prameha can be classified into two

6. yaVt\ saMtp-NaM SaItmaivadaih ihtM laGau |

7. Vipluta yoni vyapad treatment :-

Part B:-SANTARPANA AS A CAUSATIVE FACTOR:

(Dept. of Samhita and Siddhant 2014-2015) Page 11

The Santarpan is one of the chikista upakaram. It is also called as

The causative factors of Santarpanajanya Vyādhis are given in Caraka

saMtp-yait ya: isnagQaOma_QaurOgau-$ipicClaO: |