E-ISSN:2456-3110

Review Article

Nidanpanchaka

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 7 JULY
Publisherwww.maharshicharaka.in

Nidanpanchaka of Madhumeha Vyadhi - A Review Article

Kumar A1*, Shukla S2, Chandrakar R3
DOI:10.21760/jaims.9.7.20

1* Ashutosh Kumar, Post Graduate Scholar, Dept of Roga Nidan Evam Vikriti Vigyana, Shri Npa Govt Ayurveda College, Raipur, Chhattisgarh, India.

2 Sanjay Shukla, Reader, Dept of Roga Nidan Evam Vikriti Vigyana, Shri Npa Govt Ayurveda College, Raipur, Chhattisgarh, India.

3 Rupendra Chandrakar, Reader, Dept of Roga Nidan Evam Vikriti Vigyana, Shri Npa Govt Ayurveda College, Raipur, Chhattisgarh, India.

Nidanpanchak is subjective as well as objective tool for diagnosis of disease. Nowadays, eating junk food and leading a sedentary lifestyle is a prestige symbol. It is responsible for many different kinds of diseases. One of the main diseases driving this way of living is diabetes mellitus. There is plenty of knowledge about the disease's pathogenesis, symptoms, and available treatment options in the classical Ayurvedic literature. To determine the precise pathophysiology of Madhumeha, a variety of pathological processes pertaining to Dosha and etiological components are available in the classics. This metabolic condition causes a person to pass honey-like (sweet) urine and is associated with abnormalities. Diabetes mellitus is similar to Madhumeha. It is a particular kind of Vataj Prameha. Presented by Acharya Charak. The Ayurvedic approach to treating Madhumeha can only be more successful if its etiopathogenesis, or Nidan Panchaka, is fully established.

Keywords: Madhumeha, Nidan Panchaka, Vataj Prameha, Diabetes mellitus

Corresponding Author How to Cite this Article To Browse
Ashutosh Kumar, Post Graduate Scholar, Dept of Roga Nidan Evam Vikriti Vigyana, Shri Npa Govt Ayurveda College, Raipur, Chhattisgarh, India.
Email: 		Kumar A, Shukla S, Chandrakar R, Nidanpanchaka of Madhumeha Vyadhi - A Review Article. J Ayu Int Med Sci. 2024;9(7):143-147.
Available From
https://jaims.in/jaims/article/view/3602

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-05-08 2024-05-17 2024-05-27 2024-06-07 2024-06-17
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 14.47

© 2024by Kumar A, Shukla S, Chandrakar Rand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

India is the global centre for diabetes.[1] Due to People don't have time for exercise in current disturbed and hectic lifestyle, and poor eating habits are the root cause of a lot of diseases. Among the diseases caused by the aforementioned circumstances is Madhumeha. Madhumeha is a Vataja Prameha[2] one of the 20 varieties of Prameha that different Acharyas have described. She exhibits symptoms like Kashaya (astringent), Madhura (sweet), and pale and unctuous urine.[3]

Initially Madhumeha was identified as a Kapha Dosha condition; all three Doshas were involved, and ten Dushya (Abaddha Meda, Mansa, Rakta, Shukra, Oja, Ras, Majja, Lasika, Vasa, Ambu) were displayed.[4]

Later in the illness Vata is predominant and the condition progressively progresses to Ashadya. Over the previous thirty years, Due to changes in the environment and lifestyle brought about by industrialization and the migration of people from rural to urban regions, the prevalence of diabetes mellitus has sharply increased in countries across all income levels. Diabetes mellitus affects 545 million individuals globally, the bulk of whom are low- and middle-income.[5] It is anticipated that there would be over 165 million in India.[6]

Madhumeha is becoming more and more significant on a global scale as a non-infectious pandemic or epidemic. It is frequently called a "silent killer." Based on Prabhut-Avila Mutrata, (Excessive and Turbid Urination). Prameha is classified into twenty categories.

Knowing the Samprapti of Madhumeha is crucial since, among these twenty categories, Madhumeha is the most common nowadays.

The current investigation is an effort to expand upon the Nidana Panchaka of disease Madhumeha, which includes Granthokt Hetu (Aetiology from classical sources), Purvroopa (Prodroma), Roopa (Symptoms), Samprapti (Pathogenesis), and Upashaya-Anupashaya (Therapeutic).

Aim and Objective

To study and understand the Nidanpanchka of Madhumeha Vyadhi an Ayurvedic aspect.

Materials and Methods

This Article is based on review on Nidanpanchaka of Madhumeha Vyadhi from Ayurvedic Samhitas and texts available in the library of Govt. Ayurved college Raipur (C.G). The text books referred are Charak Samhita, Sushruta Samhita, Ashtang Hridya, Ashtang Sangrah Madhava Nidana, Bhavprakasha, Yogratnakara and Vangsen Samhita. And modern review of diabetes mellitus is taken from an authorized modern textbook. Internet data and various research papers were also explored.

Nidana (causes)

Aharaj (dietary factors), Viharaj (habitual factors)

Aharaj Nidan (dietary factors)[7,8,9]

Frequent and excessive intake of-

  • Newly harvested grains like Hayanaka, Yavaka, Chinaka, Uddalaka, Naishadha, Itkata, Mukundaka, Mahavrihi, Promodaka, and
  • Newly harvested pulses like Harenu (Pisum sativum) and Masha (Phaseolus radiates Linn.), consumed with ghee.
  • Vegetables, Tila (Sesamum indicum) oil, cakes of Tila, pastries, Payasa (milk-based pudding), Krisara (gruel prepared of Tila, rice, and black gram), Vilepi (a type of thick gruel), and sugarcane-based food preparations.
  • Aquatic and wet-land animals, Milk, new wine, immature curd (curd which is mostly liquid and sweet).
  • Excessive intake of astringent, pungent, bitter, rough, light and cold things
  • Meat of domesticated, marshy & aquatic animals
  • Products of Jaggery and all things that increase Kapha
  • Various dietary regimen that produces excess Kapha, fat, and urine.

Viharaj (habitual factors)[7,8,9]

Lifestyle related activities, including

  • Avoidance of physical exercise
  • Excessive administration of emesis, purgations, Asthapana type of enema and Shirovirechana
  • Suppression of the manifested urges, fasting, trauma due to assault

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  • Exposure to sun, anxiety, grief, excessive bloodletting
  • Staying awake at night,
  • Excessive sleep, bed rest and sedentary habits
  • Addiction to pleasures of lounging and sleeping

Purvaroopa (pre-monitory signs and symptoms):[10-13]

Symptoms appearing after Dosha-Dushya Sammurchana of disease, while initiating process of manifestation of various types of Prameha, produce following premonitory symptoms-

  • Kar Paad Daaha (Numbness and burning sensation in hands and feet)
  • Jatilibhav Kesheshu (Matting Of hairs)
  • Kesha, Nakha Ati Vrudhhi (excess growth of hairs, nails)
  • Madhuryam Aasyasyam (sweetness in mouth)
  • Mukh Taalu Kanth Shosh Pipasa (Thirst)
  • Shwas - Talugal - Jiwha - Danteshu - Malo - Utpatti (Slimy mucous deposit on tongue, palate, pharynx and tongue)
  • Vistra-Mutra Madhurya (sweetness-and whitishness of urine)
  • Chikkanata Dehe (slimy mucous on body)
  • Malam Kaaye (accumulation of mala in body)
  • Kaaychidreshu Updeham (smearing in body orifices)
  • Suptata Changeshu (burning sensation and numbness in body parts)
  • Shatpad-Pipilika Sharir Mutra Abhisaranam (crawling of bees and ants on body and urine)
  • Vistram Sharirghandhi (Fleshy smell in body)
  • Nidra and Tandra (sleep and drowsiness)
  • Swedoanga Gandha (excess sweating)
  • Sheetpriyatwam (liking of cold)
  • Shudhadhikya (Excess Of appetite)

Roopa (Symptoms):[14-16]

  • In Madhumeha, patient passes urine sweet and astringent in taste, pale in color and ununctuous.
  • Increased frequency of urine (Polyuria)
  • Prabhuta Avila Mutra - Excessive passage of turbid urine.
  • Excessive thirst (Polydypsia)
  • Increased appetite (Polyphagia)
  • Hyperglycaemia
  • Having slow-healing sores / non-healing ulcer
  • Always tried / Debility
  • Heaviness in body
  • Stiffness in body
  • Constipation
  • Having slow-healing sores / non-healing ulcer

Samprapti (Pathogenesis):[17-20] Madhumeha can originate in two ways

Avaranjanya (By the obstruction of Vata caused by Doshas covering it)

Dhatukshayajanya (Depletion in body tissues causes aggravation of Vata)

Samprapti of Avaranjanya Madhumeha

In Prameha diagnosis, Kapha and Pitta aggravation is present. Because of the imbalance of the Kapha Dosha, the Meda and Mansa Dhatus are affected. The imbalanced Kapha, Pitta and Meda-Mansa tissues block the channels and disrupt the flow of Vata. The Vayu, with its Rukhsa Guna, transforms Madhura Ojas into Kasaya Rasa before entering the Mutra Vaha Srotas (urinary system). This mixture becomes concentrated in the bladder, resulting in frequent, excessive urination that resembles honey.

Samprapti of Dhatukshayajanya Madhumeha

Exposure to the factors causing Vata vitiation leads to early Vata Prokopa, this vitiated Vata having Ruksa properties leads to Vihsamagni. Vishamagni causes Dhatu Kshaya, because of Kshaya of all the Dhatus, Vata turns the Ojas in the body to Kasaya Rasa. These get mixed and enter the Mutra-Vaha-Srotas, get localised at Vasti-Mukha manifesting Madhumeha. The urine is sweet as honey, whitish, Sheeta and Ruksa. This type of patient is Krisa.

Samprapti Ghatak

  • Dosha - Vata, Pitta, Kapha
  • Dushya - Meda, Mamsa, Kleda, Rakta, Vasa, Majja, Lasika, Rasa and Ojas
  • Srotas - Mootravaha, Medovaha

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  • Srotodusti - Atipravrutti
  • Agni - Dhatvagni
  • Adhisthtan - Basti
  • Udhbhavasthana - Kostha
  • Sadhyata Asadhyata - Yapya

Upashaya-Anupashaya[21-23]

Upashaya (Pathya)Anupashaya (Apathya)
Shooka Dhanya (Grains): Shashtika, Shali, Yava, Godhuma, Kodrava, Shyamak
Shami Dhanya (Pulses): Chanaka, Adhaki, Kulattha, Mudga.
Shaka (Vegetables): Fresh herbs described under Tikta-varga and Kashaya- Varga
Mamsa (Non-Veg): Jangala mamsa which is Laghu in nature e.g., Mriga, Dvija Mamsa which is Jangala in origin, Vishkira and Pratuda Mamsa. These Mamsa must be Shulya i.e., roasted with the help of Shulya [Tandoor]. Mamsa of Kapota, Shash,Tittir, Lava, Bahir, Bhringraj, Vartak, Shuk
Taila (Oils): Nikumbha, Ingudi, Sarshapa, Atasi to prepare different food preparations
Pana (Drinks): Sarodaka, Kushodaka, Madhudaka, Triphala Rasa, Sidhu, Sura, properly prepared Madhvika which is having premium quality and has fermented for a long time.		Shooka Dhanya (Grains): Hayanaka, Chinaka, Yavaka, Naishadha, Itkata, Mukunda, Pramodaka, Sugandhaka
Shami Dhanya (Pulses): Harenu, Masha- must not be freshly harvested and must not be taken with ghee.
Mamsa (Non-Veg): Gramya Mamsa, Anupa Mamsa, Audaka Mamsa
Milk preparations: Payasa, Ksheera, Manaka and Dadhi.
Alcoholic preparations: Recently prepared Madya and other drinks which are sweets
Others: Tila, Palala, Pishtanna, Krishara, Vilepi, Kushmanda, Ikshu and Ikshuvikara, Shaka which are not mentioned in Pathya group.

Conclusion

Since ancient times, Madhumeha has been a widely recognized disease. Evidence as well as occurrence is increasing day by day and bounces with their complications and complexes. A subtype of Vataja Prameha, diabetes mellitus is the same as Madhumeha. Four out of Hundred adults in India suffer from it. The number of cases reported daily in routine medical procedures is still increasing.

There is plenty of information about this disease in our Ayurveda classics. The Busy and worried life of modern era has opened the door for the predisposition of Madhumeha. Madhumeha (Diabetes Mellitus) can be managed conservatively with changes in diet, exercise, medications and lifestyle. In the successful treatment of type 2 diabetes, all these factors have been incorporated into ancient India's Ayurvedic medicines for patients with Madhumeha.

a physician must have complete knowledge of different aspects of Madhumeha like Nidana, Roopa, Poorvaroopa, Samprapti, Sadhyaasadhyta and Arishtalakshan etc. from all Samithas, Nighantu, and other literature.

References

1. Rakesh Malik. India is the Diabetic Capital of World. Mumbai Mirror. 2016 Jun.28 [cited 2020 Jun. 10] In: The Economy Times [internet].

2. Bramhanand Tripathi. Charaka Nidana Sthana, 4/39, Varanasi, Chaukhamba Surbharati publications, 2019, P.619

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5. lobal Burden of Disease Collaborative Network. Global Burden of Disease Study 2019. Results Institute for Health Metrics and Evaluation. 2020 (https://vizhub.healthdata.org/gbd-results/)

6. Indian J Opthalmol. 2021 Nov 69(11): 2932 -2938. Published online oct 2021

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8. Bramhanand Tripathi. Charaka Chikitsa Sthana, 6/4, Varanasi, Chaukhamba Surbharati publications, 2012, P.279

9. Ambika Dutta Shastri. Sushrut Samhita Nidan Sthana 6/3, Varanasi, Chaukhamba Sanskrit Academy2012 P.326

10. Bramhanand Tripathi. Charaka Nidana Sthana, 4/47, Varanasi, Chaukhamba Surbharati publications, 2019, P.629

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13. Yadunandan Upadhyay, Madhav Nidanam 2 Chaukhamba publications 2019 P.9


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14. Brahmanand Tripathi, Ashtang Hridaya, Chaukhamba Sanskrit Academy delhi 2012 P.495

15. Bramhanand Tripathi. Charaka Nidana sthana, 4/44, Varanasi, Chaukhamba Surbharati publications, 2019, P.620

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