Diabetes description in Ayurveda
Described in Ayurveda as madhumeha kshaudrameha which
literally means “excessive urine with sweet taste like honey”, or dhatupak
janya vikriti, which means a disease caused by a defective metabolism leading
to derangement in body tissue transformation process. Historically, ayurvedic
texts have described 20 types of urinary disorders (pramehas) based on
predominant dosas and physical characteristics of urine. The urine is
discharged in excessive quantities and is generally turbid. DM is one of these
pramehas that may occur in any of the three (vata, pitta, kapha) body
constitutions.
The Ayurvedic approach to DM management includes life style
dietary interventions, exercise and variety of hypoglycaemic herbs and herbal
formulas depending upon the predominant dose. Cleansing procedures are unique
to the Ayurvedic approach to DM. However, the Ayurvedic clinical description of
DM, etiology, diagnosis, prognosis and recommended life style changes are
basically similar to those described in western medicine.
Clinical description and Etiology
The major signs and symptoms of DM described in classic
Ayurvedic texts consists of honey like sweetness of urine, thirst, polyphagia,
lassitude, tiredness, obesity, dysgeusia, constipation, burning sensation, in
the skin , seizures, insomnia, and numbness of the body. Boils , wounds and
abscesses are often difficult to heal in a diabetic patient and are recognised
in Ayurveda.
The etiology of DM in Ayurveda is multifactorial. DM may be
a familial trait and overweight patients with this diagnosis may be engaged in
a lethargic lifestyle and unhealthy diet. All these factors are understandable
because they all can lead to type 2 DM. Ayurveda divides DM into two categories
(1) genetic or sahaja, occuring in young age from the very beginning of life
that has some similarities with the juvenile diabetes or insulin dependent
diabetes and (2) aquired or apathyaja due to an unhealthy lifestyle that occurs
in old age and obese people and has similarities with type 2 DM . In addition,
Charaka Samhita described two types of DM; one that occurs in very underweight
people and one that occurs in obese people. The former DM requires restorative
treatment along the line of insulin treatment and the latter requires fat
reducing treatment.
Pathogenesis
According to Ayurveda, DM and all pramehas start with the
derangement of kapha that spreads throught the body and mixes with fat that is
similar in physical properties to kapha. Kapha mixed with fat passes with
urinary system, thereby interfering with normal urine excretion. Vitiated
pitta, vata and other body fluids may also be involved in their blockage.
Pramehas left untreated may lead to deranged development of bone marrow , body
tissue, nutritional materials and hormones. The incurable stage of pramehas is
madhumeha, which is insulin dependant DM. Madhumeha may not be described
presicely in Ayurveda , but it points in the direction of the current knowledge
we have about the disease w.r.t neurological damage and insulin(ojas) levels.
The involvement of tissues leading to blood vessels,, kidney, eye and nerve
damage is also described in Ayurveda as major complication. DM is described not
only as a condition of madhumeha but also as a condition of ojameha in Ayurveda
for the purpose of treatment.
Clinical course and prognosis
According to classical Ayurveda, all pramehas have the
potential to become incurable if left untreated. The kaphaja urinary disorders
are curable because the causative dosa and the affected tissues have same
properties, thus requiring same type of therapy. Although te pittaja urinary
disorders are controllable the resulting disorder may persist for life because
the causative doas is pitta, but the tissues and waste products are different, requiring a different type of
therapy. Vataja urinary disorders are considered incurable because tissues and
hormones undergo deterioration.
In Ayurveda the major complication of kaphaja urinary
disorder are believed to be poor digestion., anorexia, vomiting, drowsiness,
coughing, and nasal catarhh. Pittaja urinary disorder patients tend to exhibit
a pricking pain in the urinary bladder, penis and scrotum, as well as fever,
burning sensation, thirst, sourness of the throat, fainting and loose bowel
movements. Vata urinary disorders patients often experience tremors, pain in
the cardiac region, abdominal tenderness, insomnia, and dryness of the
mouth.The major complication of vata DM most commonly include ulcers over
joints, muscles, skin, blood vessels, as well as damage to the kidneys and
retina.
Clinical Examination and Diagnosis
Ayurvedic classification of DM into vataja, kaphaja, pittaja
pramehas are as follows
Kaphaja pramehas
Udaka meha-the urine is clear; is in large resemble water,
sometimes with slight turbidity and slimy
Iksu meha-the urine is like sugarcane juice and is very
sweet
Sandra meha-the urine becomes thick when kept overnight
Sura meha-the urine resembles beer with a clear top and a
cloudy bottom portion
Pishta meha-the urine is white and thick similar to a
solution of corn flour
Sukra meha-the urine is like semen or mixed with semen
Sita meha-the urine is sweet and very cold
Sikata meha-the urine contains sand like particles
Sanair meha-the urine is passed very slowly
Lala meha-the urine is slimy and contains threads like that
of saliva
Pittaja pramehas
Ksara meha-the urine is like a solution of alkali in smell,
colour, taste
Kala meha-the urine is black
Nila meha-the urine is bluish
Haridra meha-the urine is yellowish, similar to turmeric
Manjishta meha-the urine is foul smelling resembling
manjishta a slightly red solution
Rakta meha-the urine is foul smelling, slightly salty and
blood red
Vataja prameha
Majja meha-the urine looks like marrow or marrow mixed
Ojas meha-the urine looks like honey
Vasa meha-the urine looks like liquid muscle fat and may be
passed frequently
Hasti meha-the urine is like that of an elephant , being
discharged continuously without force, mixed with lymph and without
obstruction.
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