Madhumeha is an Ayurvedic disorder very similar to Diabetes Mellitus. Ayurveda has grouped Madhumeha under one of the 20 Prameha urinary disorders. Madhumeha is considered primarily a vata disorder, with kapha and pitta secondary. It manifests overtime, usually 3 – 5 years and very rarely manifests in a short timeframe. There are some exceptions like pregnancy, injury, surgery, psychological conditions, and infection that may cause faster onset.
Pathogenesis of Madhumeha
Acharya Vagbhata explains Madhumeha as the following. Ojas is the essence of all dhatus (tissues) and the main supplier of immunity and is spread throughout the body. Its appearance is frothy, clear, unctuous, sweet, thick, heavy, cold, and slimy in nature. Due to the relative nature of the disorder, Madhumeha is an imbalance of three dosas, especially kapha and pitta blocking vata. This blocks the channels related to mamsa (muscle tissue) and meda (adipose / fat tissue).
Due to the obstruction of vata, the taste of sweet ojas is altered into a sweet, astringent taste. The taste is similar to honey and is discharged through the urine. Madhumeha is a urinary disorder where the urine becomes sweet like honey, and quantity greatly increases, quality is more astringent, pale color, and turbid. The whole body becomes Madhumehi or sweet and if left untreated leads to Madhumeha which is an uncurable stage of the prameha urinary disorders.
The essence of ojas in all the bodily tissues, and plays an active role in the manifestation of Madhumeha. Ojas is excreted through the urine leading to oja kshaya (bodily depletion). Vata becomes aggravated in an individual whose body is pre-conditioned and exposed to the following vata-provoking factors.
- Excessive intake of astringent, pungent, bitter, rough, light, and cold foods
- Excessive indulgence in sex and/or physical exercise
- Excessive administration of vasti, virechana, and nasya purgation
- Suppression of the natural urges
- Excessive fasting
- Trauma due to assault or accident
- Exposure to the sun
- Chronic anxiety
- Prolonged grief
- Excessive bloodletting
- Staying awake at night
- Irregular bodily posture
The aggravated vata spreads throughout the body, and along with vasa (muscle fat), enters the ureter leading to the manifestation of vasameha. When it carries majja (marrow) to the urinary bladder, it results in majjameha.
Due to a large quantity of lasika (lymph) in the body and the ability of vata to dissipate things, lasika entering the urinary bladder produces a large quantity of urine, causing a continuous urge for micturition and the passing of copious amounts of urine. Ojas by nature, is of sweet taste, however due to vata’s roughness causes it to turn astringent.
If the person’s ahara and vihara continues to provoke vata it vitiates meda even more and leads to a complex transfer of vasa, majja, lasika, and ojas to the Mutravaha srotas (urine channel). When ojas due to influence of vata adopts kshaya and rukshaguna and gets into the urinary bladder, it causes Madhumeha.
Western Medicine Causative Factors for Diabetes Mellitus
- Obese / overweight
- Family history
- Lack of exercise
- High triglycerides with low HDL
- High blood pressure
- Gestational diabetes
- High fat and carbohydrate diet
- High alcohol intake
- Women with PCOS
Ayurvedic Causative Factors for Madhumeha
- Asyasukham – luxury lifestyle, lack of physical activity
- Svapnasukham – excessive sleeping
- Kapha krut cha sarvam – kapha provoking foods and lifestyle
- Sahaja – inherited family trait
- Chinta – excess stress
- Shoka – grief
- Bhaya – fear
- Deergha roga – long term illness
- Alasya – sedentary lifestyle
Foods Causing Madhumeha
- Dadheeni – excessive intake of curds or yogurt
- Gramya-oudaka-anupa mamsa – meat of animals in water or marshy regions
- Payamsi – excessive intake of milk, its derivatives, and preparations
- Navaanna panam – foods prepared from newly harvested grains
- Guda vaikruti – excessive intake of jaggery, or other sugars
- Madhura ahara – excessive intake of sweet substances
- Pishta ahara – excessive intake of carbohydrates
- Adyashana – eating too often
- Adhikashana – eating in excess
- Ahitashana – eating unwholesome food
- Guru ahara – eating foods that are heavy
- Samashana – eating improper for prakriti/vikriti
Kriya Kala Samprapti
Sanchaya
1st Kriya kala – Sanchaya avastha
In this stage the samhathi rupa vriddhi of kapha occurs in the amashaya, presenting the following mild symptoms.
- Agnimandya – weak agni
- Gaurava – heaviness
- Alasya – laziness
The symptoms are as a result of guru and manda guna of kapha. The occurrence of these symptoms has been inferred after studying the purva rupa and rupa of Madhumeha.
Prakopa
2nd Kriyakala – Prakopa avastha
In the event of the patient continuing with the nidana sevana, the progression of the disorder proceeds to prakopa avastha where the kapha undergoes vilayana rupa vriddhi (increase of dosha through liquification)and can be understood as presenting with the following symptoms
- Annadvesha – aversion to food
- Hridayoklesha – nausea
Prasara
3rd Kriyakala – Prasara avastha
If unhindered the prakupitha (aggravated) dosas attain prasaravastha (stage of overflow or spread) where the unmarga gamana (regurgitation) of kapha, along with the other two doshas from the svasthana (own place) occurs. The doshas pervade the body and it can be inferred that the following symptoms are presented.
- Arochaka – anorexia
- Avipaka – dyspepsia
- Angasada – malaise
The importance of the first 3 kriya kalas in preventing Madhumeha is the disorder in these stages often goes unrecognized, as these symptoms are mild enough for the patient to ignore.
Moreover, the symptoms are so vague and varied that it becomes difficult to relate them to early development of Madhumeha. If suitable modifications of laghu ahara sevana (kapha pacifying foods) and vyayama (exercise) are taken then one can control as well as prevent the onset of Madhumeha.
Sthanasamsraya
4th Kriyakala – Sthanasamsraya avastha
By repeating the nidana sevana, prakupita dosa lodges in the srotas where kaivaguna (weakness or defect) exists. The medovaha sroto vaigunya (defective adipose tissue channels) in the vapavahana (peritoneum) due to apathya sevana (indulging unwholesome) or beeja upatapa (trouble in seeds) causes the dusti (vitiation) of kapha and vata and attains sthana samsraya (stage of localisation of vitiated doshas) initiating the process of dosa dushya sammurchana (amalgamation of dosha and dusya). The purva rupas manifest in this kriyakala.
Vyakta
5th Kriyakala – Vyakta avastha
Dosa dushya sammurchana takes place actively during this kriyakala. The pratyatma laksanas of Madhumeha, prabhuta mutrata (excess urination) and avila mutrata (turbid urine) along with sarvadaihika laksanas (entire body symptoms) manifest during this stage.
Prabhuta mutrata is a result of vriddhi (aggravated) svarupa (own qualities) kleda (moisture) dushti (vitiation) and avila mutrata is one of the symptoms of kleda dushti.
Bheda
6th Kriyakala – Bheda avastha
In this stage Madhumeha is now subacute or chronic and the disorder proceeds into more severe forms in the event of increasing dhatukshaya. It also starts manifesting the pittaja and vataja laksanas (symptoms of pitta and kapha) rendering the disorder yapya (uncurable). The disease essentially attains asadhyatha (incurable) in this stage. Hence forth, upadrava (complications) and arishta laksanas (signs of death) start appearing.
Madhumeha Purvarupa
Prodromal Symptoms of Madhumeha Purvarupa
- Sveda – excess sweating
- Angagandha – excess body odor
- Anga shaitilya – lack of stability in body
- Anga sada – malaise
- Sayya sukherati – feeling comfort in bed
- Svapna sukherati – feeling comfort in sleep
- Asana sukherati – feeling comfort in inactivity
- Hrudayopadeha – feeling as if heart is heavy
- Netropadeha – vision problems
- Jihwopadeha – coated tongue
- Shravanopadeha – hearing problems
- Taluni malotpathi – coated palate
- Danteshu malotpathi – coated teeth, caries
- Ghana gatra – heaviness in the body
- Kesha ativruddhi – excessive hair growth
- Nakha ativruddhi – excess nail growth
- Kesha jathilee bhava – brittle hair
- Sheeta priyatvam – person likes cold foods and season
- Gala talushosha – dryness of throat and palate
- Asya madhurya – sweetness in mouth
- Kara pada daha – burning sensation in feet and palm
- Mutra pipeeliha abhisarana – urine attracts ants
- Madhura mutrata – sweetness of urine
- Shukla mutrata – white discoloration of urine
- Snigdha gatra – excess oiliness of body
- Picchila gatrata – stickiness of body
- Pipasa – excess thirst
- Shvasa dourgandhya – bad breath
- Tandra – fatigue
- Karapada suptata – numbness of hand and feet
- Anga suptata – numbness
- Alasya – lethargy
- Mukha shosha – dryness of mouth
- Kaya chitropadeham – heaviness of body
- Sarvakala nidra – person wishes to sleep all the time
- Shatpada abhisarana on shareera – feeling as if ants are crawling on body
- Pipeelika shareera abhisarana – ants crawl on body
Clinical Features of Madhumeha Purvarupa
- Atimutrata – excess urination
- Avila mutrata – turbid urine
- Madhu tulya – urine like honey, sweet/astringent
- Panduta – pallor of the body
- Rukhsata – dryness of the body
- Dourbalya – debility
- Ratisu anasakti – loss of sexual urge
- Dourgandhya – bad body odor
- Dhatu kshaya – emaciation
Complications of Madhumeha Purvarupa
- Hridroga – cardiac disorder
- Loulya – urge to have food
- Anidra – loss of sleep
- Stambha – stiffness of the body
- Kampa – shivering
- Shoola – body ache
- Baddha purishata – constipation
- Udavarta – regurgitation
- Shosha – emaciation
- Kasa – cough
- Shwasa – dyspnea
Curability of Madhumeha Purvarupa
Madhumeha is a palliative disorder and cannot be completely cured; however, it can be controlled by food and medicine. Depending on the physical constitution or body type (prakriti), and the health status of an individual, ayurvedic classics advocate two different paths for therapy. They are Apatarpana or non-nourishing treatment – useful in obesity or kapha conditions, and Santarpana or nourishing treatment – useful in emaciation or pitta/vata conditions. When to offer a palliative or combination of treatments requires knowledge and experience.
Ayurvedic Mentoring for Practitioners
Whether Madhumeha is in the early stages of kriya kala or later stages, helping your client to preserve their ojas is the highest importance. An Ayurvedic mentoring consultation is like a second opinion and offers you a fresh look at your client’s condition. You will learn the correct ahara, vihara, and the best products to prescribe, along with the dosages and times to administer Arya Vaidya Sala’s classically formulated products.
If you would like a mentoring consultation, visit our website to meet Vaidya Vishwanath and schedule your consultation now.
Products for Madhumeha
Katakakhadiradi Kwatham is high antioxidant herbal compound. It is useful in diabetes and managing the complications. It balances vata and kapha dosa and removes excess kleda (accumulated moisture) from the body.
Varanadi Kwatham is useful for Diabetes which is predominantly kapha dominant dosa and this herbal compound helps to reduce kapha dosa. Apart from reducing blood sugar level it helps in obesity and digestive health.
Glysikot Granule is a proprietary herbal formula, which helps in diabetes conditions and detoxification of channels of the body. It also helps in prameha pidaka (diabetic carbuncles) and reduces excess kapha and pitta dosa.
Chandraprabha Vati – According to Ayurveda, the pathophysiology of diabetes conditions occurs in urinary system. This herbal compound helps to correct the imbalances in the urinary system. It also helps in burning sensation in urinary system and the removal of kidney stones.
Amritamehari Churnam is an antidiabetic and antihyperglycemic in action. It normalizes the blood sugar level, stimulates pancreas, and prevents diabetic complications. It reduces increased cholesterol level. It also helps to reduce symptoms of diabetes.
Varavisaladi Kashayam is an herbal compound suggested in diabetes condition associated with mental health issues. Due to high blood sugar nerves gets impacted. This will help to reduce sugar level as well as nourishes nervous system.
Two Ayurvedic Studies from the US National Library of Medicine, National Institute of Health demonstrate the efficacy of Ayurvedic methods.
Concept of Prameha//Madhumeha (Contradictions and Compromises) by A.R. V Murthy and R.H. Singh.
Conclusion: Western approach for Diabetes is based on wrong footings. Treating hyperglycemia with hypoglycemic drugs without caring to correct the metabolic impairment is something like applying dye to the grey hair which though helps to look younger does not reverse the fundamental process of senescence. Under the present circumstances Ayurvedic approach for Etiopathogenesis and treatment would be of great use. Separating 19 Mehas from the chapter of pramehas ad attributing the whole description to Madhumeha identifies Ayurvedic concept of this most deadly disorder – Diabetes mellitus. It also answers all those doubts raised about the contradictions and confusions about the disease.
Role of diet and lifestyle in the management of Madhumeha (Diabetes Mellitus) by Gyaneshwarsing Guddoye and Mahesh Vyas
Conclusion: The specially prepared Ayurvedic diet and lifestyle plan in the present study has all the potential to be used as a standard Ayurvedic model protocol for Madhumeha (DM) patients. According to the effect of therapy, Varadi Kwatha with Ayurvedic Ahara and Vihara (group A) has proved to be a better remedy than only Varadi Kwatha (group B) by relieving most of the cardinal symptoms as well as improving the biochemical parameters. Thus, it can be used to help to correct the condition of Madhumeha (DM). The effect of Ayurvedic diet and lifestyle plan along with Varadi Kwatha can be further studied on many patients to substantiate the results of the present study.
Original source: Dr JV Hebbar, EasyAyurveda.com
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