Diabetes- what it means to you ?

Everyone has glucose in their blood, whether or not they have diabetes. This glucose comes from food. When we eat, the digestive process breaks down food into glucose, which is absorbed into the blood in the small intestine. People who don't have diabetes rely on insulin, a hormone made in the pancreas, to move glucose from the blood into the body's billions of cells. But people who have diabetes either don't produce insulin or can't efficiently use the insulin they produce. Without insulin, they can't move glucose into their cells.

Glucose accumulates in the blood -- a condition called hyperglycemia ("hyper" = too much, "glycemia" = glucose in the blood) -- and over time, can cause very serious health problem. Although there are various types of diabetes but everyone with diabetes has one thing in common that they have little or no or reduced ability to move glucose/sugar from the blood stream into the cells which is essential because glucose is body's primary fuel

Types of Diabetes :



Idiopathic diabetes mellitus --- IDDM
NIDDM­­­----Secondary diabetes
Gestational diabetes




Symptoms :

Cases of mild to moderate Diabetes are usually diagnosed on a routine health check-up or during pre operative investigations done for fitness for surgical procedures. Patients may go to a physician for some chronic non-healing problem like itching, cough, or a non-healing wound. The patient may be asked for a routine sugar check-up and is diagnosed as a case of diabetes. The classical symptoms of diabetes may not be essentially present. At times diabetes may be suspected by observing the following symptoms:

When one looks for the symptoms of diabetes the common symptoms found are

For Type 1:

Excessive urination

Excessive thirst

Excessive hunger

Episodes of extreme weakness or even fainting




Type 2:

The need to urinate more than usual

Excessive thirst

Unusual weight loss

Feeling of being un-well/weak or tired

Blurred vision

Tingling or numbness in hands or feet


Frequent and recurring infections such as urinary tract infections, boils, and fungal infections

Difficulty with erections in men, and unusual vaginal dryness in women





Causes Of Diabetes :




An elaborate description of the causative factors of diabetes is done in the Ayurvedic texts. More stress has

been laid on sedentary habits, lack of exercise and the consumption of diets having high calorie value The

causative factors from Ahara (diet) includes the use of new grains (of recent time) of less than one year, use of

new peas, the use of sugar-cane juice, frequent use of milk and milk products, fresh wine, curd preparations,

meat soups of different animals residing near or in water. These causative factors are responsible for the

increase of the humor Kapha (Kapha dosha). Vihara (Behavioral patterns) includes excessive sleep during day

and night, lack of exercise, laziness etc. Even worry, grief, anger and anxiety are said to be among the

causative factors of Prameha in susce­ptible individuals.





Modern Views



According to the modern science though the exact cause of diabetes is not known but there are some

predisposing/risk factors which increase the chances of occurrence of the disease. These can be listed as:


Age: Increasing age.

Genetic or heredity factor: diabetes is one of the known diseases that runs in families.

Viral infections affecting especially the pancreas.

Poor diet (Malnutrition related diabetes).

Excessive and long-term consumption of sweet products (like Milk products) as per Ayurveda.

Being overweight or obese.

Leading a sedentary lifestyle. Lack of exercise, especially in those who are overweight, increases risk.

Stress.

Drug induced.




Modern management of diabetes:


The principles of management of diabetes in the modern medicine are basically to achieve an optimum control

of blood sugar levels. The measures that are commonly employed are three fold and can be listed below:

Diet control

Exercise

Drug management

Patient Education

1) The role of Diet in Diabetes:

Whatever diet may be prescribed or recommended for a patient of diabetes the common principles to follow are:

Reduction of weight.

Eating fewer sugary or fatty foods.

Reducing blood pressure.

Do not skip a meal.

Do not eat too often of outside food (Fast food etc) .

2) Exercise in therapy of diabetes:



In NIDDM patients, regular exercise forms an important component of therapy along with dietary regulation

and oral hypoglycemic agents. Appropriate monitoring should be done to avoid complications. Exercise should

not be recommended in all IDDM patients but efforts should be made to make it possible for those who want to

exercise to be able to do so as safely as possible.



General Principles for exercise in Diabetics:

To be effective exercise must be performed regularly. Choose an exercise that one enjoys and which suits the

needs of individual patients. Daily exercise is preferable, however for the desired metabolic effect it should be

undertaken for at least 3-5 days per week. The duration should be 15-60 minutes. The ideal time is on an

empty stomach in the morning or evening. Any exercise should have a warming up and cooling down period of

5-10 minutes. Most diabetics may need to reduce the dose of insulin and oral drugs when they exercise

regularly.


The best exercise recommended to a diabetic stepwise increasing exercise plan of aerobic exercise. Plain brisk

walking is the simplest and safest of all excises. It can be started by anyone. Aerobic (isotonic) exercises like

walking, running cycling, jogging, swimming, skipping and games like badminton, tennis and basketball

stimulate the cardio respiratory system and increase the utilization of glucose to a great extent. Isometric

exercises like weight lifting, sustained handgrip must be avoided in diabetics as they increase the arterial

pressure.



The Ayurvedic mode of management of Diabetes


Since thousands of years the ancient physicians of this great nation have been successfully treating Prameha

with the Ayurvedic measures and drugs. Many drugs have already been screened for the their anti-diabetic

property/blood sugar lowering property. The importance of diet and exercise is also stressed in Ayurveda. The

Ayurvedic diet regimens and the recipes may serve as a good replacement for the Diabetic patient. Though

many of the diabetic drugs that are used today have a good sugar lowering (Hypoglycemic property they

essentially act at the basic pathology. This helps in controlling the diabetes and not only the blood sugar. The

management modalities can be categorized as:



Vyaayam (Exercise),

Pathya (dietary regulation),

Panchakarma (Bio-purification procedures) and

The use of therapeutic measures (Medicines).

The herbal drugs used in the management of Prameha are bitter, astringent and pungent in taste.

Individual herbs that are extensively used in the management of diabetes:



1. Eugenia jambolana:(Jamun beej churna) Dry seed powder of Jamun fruits have to be used in a dose of one-

teaspoon twice/thrice daily with lukewarm water.



2. Gymnema sylvestre: (Gudmar patra churna) Dry leaves of this plant have to be used one teaspoon daily with

lukewarm water. The leaves when chewed render the mouth tasteless to sweet for 45 min to one hour.



3. Pterocarpus marsupium (Vijaysar kashtha churna) Bark of this plant is available in the form of powder.

Cubicals or Vijaysaar glasses are also very popular. The piece of Vijaysaar is kept in water overnight or water

is kept in the glass is consumed early morning on empty stomach. One should discard these cubicals or glasses

once there is no colour change observed in water.



4.Ficus bengalensis (Nyagrodha twaka churna) This is banyan tree bark. A decoction of bark is to be prepared

and consumed twice daily in a dose of 40 to 80ml. The decoction is prepared by taking around 25-50gms of bark

to which 4 cups of water are to be added. It is heated to make one cup, which has to be consumed.



5. Shilajeet Popularly known as Rock salt, various reputed companies have Granular or powdered form of

Shilajeet available. Though not very useful in reducing the blood sugar it is an excellent remedy to for loss of

libido in males and in case of generalized weakness.



6. C. Tamal (Tejpatra) This is very commonly used as a spice in preparing food products. A diabetic patient

may make a point to add the leaves of this plant in his food. Also the powder of leaves may be consumed.



7. Fenugreek seeds (Methi churna) Seeds of Methi have to be soaked in warm water overnight and chewed

early in the morning with warm water. One may take powder of these seeds with warm water twice daily.

Methi powder may be added to the wheat flour to prepare chapattis.



8. Momordica chirantia Karvellaka (Karella) Juice of Karela should be taken early in the morning in a

quantity of 20 ml. The dried whole fruit powder can also be consumed in the dose of ½ to 1 teaspoon twice

daily.



9. Embelica officinalis (Amala) When fresh Amla are available one may take Amla juice 20 ml daily or

otherwise powder of Amla fruits may be taken twice daily.



10. Curcuma longa (Haridra) Haldi powder along with Amla juice is a very good combination in patients of

Diabetes. It is especially useful in prevention as well as treatment of patients of Diabetic eye disease. Haldi can

be put in milk as well.



11. Kirat tikata (Chirayata) A decoction of this plant is to be taken daily early morning. It is a very popular

remedy used in all parts of the country for various skin disorders and hence forms a perfect remedy for skin

infections in Diabetics .




An ayurvedic physician may advice some good Ayurvedic drugs even in patients who do not respond

to the oral hypoglycemic drugs or even insulin. These are then termed as adjuvant ayurvedic drugs. Not only

do these help in lowering the blood sugar but also prevent the long-term complications of diabetes. We shall

name some of these combinations/preparations:



Chandraprabha vati: In a dose of 500 mg twice or thrice daily. This is specially used in patients having

Diabetes with Urinary tract infection or in females having leucorrhoea. This can be used along with
Gorshuradi guggul in the same dose.


Trivang Bhasma: This is a combination of three bhasmas namely Naga, Vanga and Yashaha Bhasma. It is to be

taken in a dose of 125mg twice daily available in the form of powder. It is very useful in conditions where there

is excessive urination, Male sexual problems as well as to treat generalized weakness.



Dhatri Nisha: A combination of Haldi powder and Amla Rasa and has to be taken early morning and is

especially useful in Diabetic eye condition.



Vasant kusumakar rasa: A very useful tonic for diabetics especially useful in the stage of complications it has

to be consumed in a dose of 125 mg twice daily. Along with having a general tonic effect it also helps in

Diabetic eye condition and in preventing various conditions developing due to Nerve weakness.


Many of the well-known pharmaceutical companies have also come up with good Anti diabetic herbal

combinations. These preparations have been extensively clinically and scientifically studied at various centers

and have proven their efficacy. They are easy to administer and their dose may be well regulated. These

preparations have to be preferably consumed as per the advice of the physician. The well-known combinations

available today include :


Hyponidd (Charak Pharma)

Diabecon (Himalaya Drugs Co)

Asanad (Arka Shala)

Cogent Db

Glucomap (Map)

Karnim (Universal Medikit)

Debix (Sandu Brothers)

Ilogen Excel (Pankaj Kasturi)

Madhunshini Vati ( Patanjali Pharmacy)




Other associated conditions with diabetes and its management:


Diabetes is a long lasting and a chronic disease. A patient of diabetic may suffer from some very distressing

symptoms so much so that he even forgets of his diabetic in agony of this complain. A physician has to look for

the safe management of these symptoms that shall not affect the diabetic status as well as not have a long-term

complication.


We shall discuss some of these complaints and try to see how they can be managed.

1) Diabetes with Arthritis: Yograj guggul, freshly prepared decoction of Dasamoola, Rasna saptak, a paste

of sunthi or Dasang lepa may be applied on the affected joint.


2) Diabetes with constipation: Powders like Gandharva haritaki, Isabgool, Panchaskar, Hingvastak can be

used to relieve constipation.


3) Diabetes with burning sensation in the soles and palms: this can be well managed with Mangista Ghana

vati, chandrakala rasa, Chandraprabha vati, pravaal pisti, Guduchi satva etc


4) Diabetes with cough: Diabetic patient suffering of chronic cough may given powders of Yasti madhu,

Kantakari, Vasa, Shati etc. Ayurvedic cough syrups available in the market are not safe to be taken by a

diabetic patients


5) Diabetes with excessive thirst: Excessive thirst may be managed with the use of cold infusions (heema) of

Dahayanak, usheera, Chandan etc. Praval, Guduchi, may also be used


6) Diabetes with excessive urination: excessive urination can be treated with the use of Trivang bhasma,

jasad bhasma, etc


7) Generalised weakness and fatigue are the usual symptoms that can be treated with the use of herbs like

shatavari, Ashvagandha, Bala Yastimadhu. Complications like tapyadi loha, Vasant kusumakar rasa are also

very effective


8) Impotency is a very distressing symptom of a diabetic patient. By assessing the age of the patient they may

be advised Ashwagandha, Kaucha beeja, musali etc.

Scientific back-up of some extensively researched herbs


GUDMAR (Gymnema sylvestre)



Gymnema sylvestre stimulates insulin release in vitro by increased membrane permeability.
Persaud SJ, Al-Majed H, Raman A, Jones PM.

It appears to correct the metabolic derangements in diabetic rabbit liver, kidney and muscle.

This herbal therapy appears to bring about blood glucose homeostasis through increased serum insulin levels

provided by repair/regeneration of the endocrine pancreas.

Gymnema therapy appears to enhance endogenous insulin, possibly by regeneration/revitalisation of the

residual beta cells in insulin-dependent diabetes mellitus.. This is supported by the appearance of raised

insulin levels in the serum of patients after Gymnema supplementation.

Studies suggest that the component of Gymnema sylvestre inhibits the increase in the blood glucose level by

interfering with the intestinal glucose absorption process




Jamun & Nyagrodha

Hypoglycemic activity of Eugenia jambolana and Ficus bengalensis: mechanism of action.
Achrekar S, Kaklij GS, Pote MS, Kelkar SM.
Biochemistry Division, Bhabha Atomic Research Centre, Bombay, India.



Karella (Momordica charantia)

Ahmed I, Lakhani MS, Gillett M, John A, Raza H

Diabetes Res Clin Pract 2001 Mar;51(3):155-61

Hypotriglyceridemic and hypocholesterolemic effects of anti-diabetic Momordica charantia (karela) fruit extract

in streptozotocin-induced diabetic rats. . These results suggest that M. charantia fruit extract exhibits

hypolipidemic as well as hypoglycemic effects in the STZ-induced diabetic rat.

Bangladesh Med Res Counc Bull 1999 Apr;25(1):11-3



Effect of Momordica charantia (Karolla) extracts on fasting and postprandial serum glucose levels in NIDDM

patients.
Ahmad N, Hassan MR, Halder H, Bennoor KS.



Department of Pathology, Sher-e-Bangla Medical College, Barisal.

wThis hypoglycaemic action was observed in 86 (86%) cases. The results indicated that there was a significant

(Student's t-test, P < 0.004) increase in the number of beta cells in M. charantia-treated animals when

compared with untreated diabetics, however, their number was still significantly less than that obtained for

normal rats.






NEEM

Indian J Physiol Pharmacol 2000 Jan;44(1):69-74 A study of hypoglycaemic effects of Azadirachta indica

(Neem) in normaland alloxan diabetic rabbits.

Khosla P, Bhanwra S, Singh J, Seth S, Srivastava RK.

Hypoglycaemic effect was observed with Azadirachta indica when given as a leaf extract and seed oil, in

normal as well as diabetic rabbits The data suggests that A. indica could be of benefit in diabetes mellitus in

controlling the blood sugar or may also be helpful in preventing or delaying the onset of the disease KIRAT

TIKTA

Swerchirin induced blood sugar lowering of streptozotocin treated hyperglycemic rats.
Saxena AM, Bajpai MB, Mukherjee SK.
Central Drug Research Institute, Lucknow, India.

It has a very significant blood sugar lowering effect in fasted, fed, glucose loaded, and tolbutamide pretreated

albino rat models.





FENUGREEK

Effect of Trigonella foenum graecum (Fenugreek) on blood glucose in normal and diabetic rats.
Khosla P, Gupta DD, Nagpal RK.
Department of Pharmacology, Pt. B. D. Sharma Medical College, Rohtak.

Trigonella foenum graecum (Fenugreek) was administered at 2 and 8 g/kg dose orally to normal and alloxan

induced diabetic rats. It produced a significant fall (P < 0.05) in blood glucose both in the normal as well as

diabetic rats and the hypoglycemic effect was dose related.

Abdel-Barry JA, Abdel-Hassan IA, Al-Hakiem MH.
Department of Chemistry, College of Science, University of Basrah, Iraq.

Hypoglycaemic and antihyperglycaemic effects of Trigonella foenum-graecum leaf in normal and alloxan

induced diabetic rats.





GUDUCHI

Antioxidant activity of Tinospora cordifolia roots in experimental diabetes.
Prince PS, Menon VP.
Department of Biochemistry, Annamalai University, Tamil Nadu, India.



The research is concluded in The effect of Tinospora cordifolia was as effective as glibenclamide. It may be

concluded that extracts of the leaves of Tinospora cordifolia have an insulin-like action and can significantly

reduce the blood glucose in normal rabbits and in alloxan-induced diabetic rabbits.





VIJAYASAR

Indian J Med Res 1998 Jul;108:24-9

An active constituent of Pterocarpus marsupium, (-)-epicatechin (1) in,low doses, has been reported to reverse

hyperglycemia in alloxan diabetic rats when given before or within 24 hr after the dose of alloxan. The

antihyperglycemic activity of ethanolic extract of Vijaysara bark at the dose of 0.25 g/kg b.w. was found to be

more effective than that of glibenclamide and metformin.

Vijayasar is useful in the treatment of newly diagnosed or untreated mild NIDDM patients



HONEY

1) JPMA 39: 107, 1989).

Acta Diabetol Lat 1988 Jul-Sep;25(3):197-203

Oral administration of pure small or large-bee honeys in 5 ml/kg/doses could not produce a significant (P

greater than 0.05) increase in glucose levels in normal and alloxan-diabetic rabbits (Akhtar MS, Khan MS.)

pure natural honeys in low doses may be recommended as a source of carbohydrates and even as a sweetening

agent in place of sucrose to the human patients suffering from diabetes mellitus

Metabolic effects of honey (alone or combined with other foods) in type II diabetics. 1) honey and bread produce

similar degrees of hyperglycemia in type II diabetics. 2) Fat-rich foods added to honey do not alter the total

hyperglycemic effect but result in higher triglyceride and insulin serum concentrations.

2) Samanta A, Burden AC, Jones GR Diabet Med 1985 Sep;2(5):371-3

It is suggested that honey may prove to be a valuable sugar substitute in diabetics, and that both the GI and PI

should be used in the analysis of food.

3) Ionescu-Tirgoviste C, Popa E, Sintu E, Mihalache N, Cheta D, Mincu I.iabetologia 1983 Feb;24(2):80-4

Counting the blood glucose increase after glucose as 100%, the corresponding increases in glycaemia for other

carbohydrates were: fructose, 81.3%; lactose, 68.6%; apples, 46.9%; potatoes, 41.4%; bread, 36.3%; rice, 33.8%;

honey, 32.4% and carrots, 16.1%.



What stages one should expect Ayurvedic Medicines to be effective?


Newly diagnosed mild to moderate diabetic mellitus.

Non-Insulin Dependant Diabetes.

Postprandial Blood sugar should not be very high (below 450-mgm%).

Obese Diabetics.

Uncomplicated Diabetes mellitus.

Those in whom there is a secondary failure: in such cases Ayurvedic drugs can be combined to their regular

allopathic hypoglycemic medicines.

In case of Diabetic Complications some good remedies are available for early nephropathies, neuropathies and

retinopathies. Research is on to find solution to many of these problems of Diabetes.

HOME REMEDIES FOR SOME COMMON PROBLEMS




URTICARIA


Ayurvedic Synonym : - Shitapitta

Main symptoms : –
1. Rash all over the body.

2. Itching.

3. Reddish patches.

Remedies :-
1. Piper nigrum (Marich) with cow’s ghee.

2. Curcuma longa (Haridra) powder with milk or hot water.

3. Application of bark of (Kapitha).

Ayurvedic Medicines : -
1. Brihat Haridra Khand Yoga.

2. Khadirarishta.

3. Mahamanjishthadi kwath.

4. Arogyavardhini.






CONSTIPATION


Ayurvedic Synonym : - Malavashtambha

Main symptoms : –
1. Irregular bowel evacuation.

2. Passage of hard stool in less quantity.

3. Flatulence.

Remedies :-
1. 10-15 pieces of Vitis vinifera (Black Grapes) kept over night in a glass of water and used at morning can relive constipation permanently.

2. Decoction of Zingiber officinale (Ardrak) added with 2 or three teaspoon of castor oil, taken at bedtime can be useful for chronic constipation.

3. Powdered Terminalia.chebula (Haritaki) processed in cow’s ghee in the dose of 1 teaspoon followed by lukewarm water is also proved as equal effective.

Ayurvedic Medicines : -
1. Avipattikar churna.

2. Gandharva Haritaki churna.

3. Argwadh kapila vati.

4. Abhayadi Modak







VOMITTING


Ayurvedic Synonym : - Chhardi

Main symptoms : –

1. Nausea

2. Ejection of stomach contents.

Remedies :-
1. Glycyrrhiza glabra (Yashtimadhu) + Pterocarpus santalinus(Raktachandan } paste prepared in milk.
2. Santalum album (Chandan) + Emblica officinals (Amalki) } with honey
3. Fresh juice of Punica granatam(Dadim)

4. Decoction of Coriandrum sativum (Dhanyak) with honey mixed.

5. Fresh juice of Zingiber officinale (Ardrak)+ Allium cepa (Palandu).

Ayurvedic Medicines : -
1. Sutshekhar ras

2. Pravalpanchamrit

3. Mayur-pichhamashi

4. Chandanadi loha.

5. Dadimavaleham.






INDIGESTION


Ayurvedic Synonym : - Ajirna

Main symptoms : –
1. Loss of appetite

2. Nausea with /without vomiting.

Remedies :-
1. Citrus acida (Nimbuk) + Zingiber officinale (Adrak) + Salt (Saindhav) + Allium sativum (Rason) } Mixture - before meals

2. Tea of Syzygium aromaticum (Lavang) is effective when there is nausea and loss of appetite.
3. Ferula narthex (Hingu) with cow’s ghee.

4. Carum roxburghianum (Ajmoda) and salt (Saindhav) with hot water.

5. Drinking of Hot water intermittently.

6. Cuminum cyminum (Jirak) with Buttermilk.

Ayurvedic Medicines : -
1. Hingvashtak churna.

2. Panchakolasav

3. Shankhavati

4. Lavanbhaskar churna.





HAIR LOSS


Ayurvedic Synonym : - Khalitya

Main symptoms : –
1. Progressive hair fall with or without dandruff.

Remedies : -
1. Gentle massage with

coconut oil.
Sesamum oil processed with Emblica officinals (Amalaki) and Bacopa monnieri (Brahmi).

2. Emblica officinals (Amalki) Cyperus rotundus (Musta) Sapindus trifoliatus (Arishtak) } Rinsing hairs with decoction of these herbs.
3. Triphala churna + Black Sesamum + Eclipta alba (Bhringaraj) } powder with hot water of internal use.

4. Massage with pulp of Aloe vera (Kumari) and Hibiscus rosa-sinensis (Japa-kusum).

Ayurvedic Medicines : -
1. Bhringaraj ghan vati

2. Asthiposhak vati

3. Arogyavardhini

4. Praval panchamrit.

5. Tikta ghrit.






JOINT PAIN


Ayurvedic Synonym : - Sandhigata Vata

Main symptoms : –
1. Painful joints with or without inflammation

2. Restricted movements of joints.

3. Increased local temperature in inflamed joints.

Remedies :-

Inflamed joints :-
1. Dry fomentation.

2. Apply poultice of smashed leaves of Allium sativum (Rason), Ricinus communis (Erand), Vitex negundo (Nirgundi) Mixed with salt.

3. Zingiber officinale (Ardrak) ,Curcuma longa (Haridra) in paste form for Local Application.

Non Inflamed joints :-
1. Gental massage with Sesamum oil followed by hot water fomentation.

2. Smashed Allium sativam (Rason) boiled in milk.

Ayurvedic Medicines : -

Inflamed joints :-
1. Sinhanad guggul

2. Punarnava guggul

3. Dashamularishta

4. Rasnasaptak kwath

5. Mahavishagarbha tail for Local application

Non inflamed joints :-
1. Mahayograj guggul.

2. Mahanarayan tail for Local Application

3. Ashwagandharishta.

Zingeber Officinale
Nux Vomica
Lycopodium
Apis
Withania Somnifera

Vitiligo (often called as leucoderma) is a disorder where the skin loses its color in patches of irregular shapes and sizes. This is a pigmentation disorder which means that melanocytes (the pigment producing cells) in the skin get destroyed. This results in development of white patches on the skin.
The hairs which are growing in that area may loose their color and turn gray. This disorder also leads to psychological issues relating to appearances and at times in certain individuals (mainly the adolescents and the young) this stress can take enormous proportions particularly if Vitiligo develops on visible areas of the body, such as the face, hands, arms, feet, or on the genitals. They develop very strong emotions of being embarrassed, depressed, or worried about how others will react.
What causes Vitiligo?
The cause for Vitiligo is not very clear but doctors and researchers are beginning to believe that Vitiligo resembles an autoimmune disorder. Which means that the pigment (the matter that gives colour to our skin) producing cells of the skin are destroyed by the body?s own antibodies (defense cells).
In some cases it has been observed that the onset of Vitiligo is related to a psychologically stressful event in the patient?s life. People with a family history of Vitiligo are more prone to develop these white patches. Ninety five percent of all those who develop Vitiligo, start developing symptoms before their 40th year of their life.
Other factors that have been found to be more common with those suffering from Vitiligo are presence of other autoimmune disorders, history of sunburns, rashes and other skin disorders and hair turning grey before the age of thirty five.
What are the symptoms and how does it spread?
People with Vitiligo develop white patches on their skin of irregular shapes and sizes. Vitiligo is more common on the exposed areas for example hands face, neck and arms. It also occurs on covered areas too: - like genitals, breast and legs. In some patients the hair may also turn grey early and in the inside of the mouth, white discoloration may also occur.
The spread of Vitiligo cannot be determined. It may stop completely after the first patch but often these patches do spread. For some patients further development may takes years and for others the large areas can be covered in months. In some patients mental stress has been seen to increase the growth of these white patches.
How effective is homoeopathy?
Homoeopathy is able to give wonderful and miraculous cures in many cases of Vitiligo. This is due to the fact that homoeopathic treatment enhances the natural production of pigments. According to homoeopathic philosophy Vitiligo not a disease in itself but an expression of an inner disturbed state of the body. Thus, the cure should occur at a level where things have gone wrong. In order to archive this, the patient is analyzed on various aspects of mental and physical and familial attributes and also a complete study is done on the psychological-environment that the patient has gone through in his life. The prescription is then based at the deepest level of understanding of the patient?s disturbed inner force. Although many homoeopathic medicines Arsenic Sulph Falvus, Arsenic Album , Baryta Mur and Baryta Carb are known to give good results in Vitiligo; I would again reiterate the fact that real cure of Vitiligo occurs when the prescription is made according to the true principles of homoeopathic philosophy i.e. treating that ?deep causative factor ? which caused this inner disturbance. Also remember that Vitiligo is a chronic disorder and can take considerable time even with the best of the homoeopathic treatment, for it to be completely cured.

Introduction

Respiratory Disease will afflict every human being at some time in their life. Whether it’s a cough associated with the common cold or respiratory distress associated with allergies and asthma, respiratory challenges are a constant source of irritation and misery for the afflicted.

Classical Ayurvedic Medicine categorizes respiratory challenges into two main categories. These are Kasa (cough) and Swasa ( dyspnea or difficulty breathing). From an understanding of ayurvedic knowledge, common conditions such as the common cold, asthma and bronchitis can be understood and managed. This article address the condition of kasa (cough).

Kasa (Cough)

In the Allopathic medicine, Cough are understood to be the result of either infection or irritation of the bronchial tissue and are known as bronchitis. Infectious bronchitis commonly accompanies the common cold but may occur separately and may or may not be associated with fever. Cough may be dry or productive. Irritative bronchitis is usually the result of pollutants, smoke, or chemicals and may have an allergic component.

Samprapti (Pathology)

Kasa occurs when apana vayu is obstructed resulting in an increase in upward motion. Vitiation of udana vayu propels the air upward and out of the body. Vata may however lodge in the chest, back, or head resulting in pain and repeated coughing.

All disease has its physicial origins in the digestive system. This is the site of accumulation and aggrevation of the doshas. Kasa begins with vitiation of apana vayu in the purishavaha srota (large intestine). Vata eventually overflows into circulation (raktavaha srota) and relocates to the pranavaha srota (respiratory system.) Additional doshas may mix with vata or become dominant in the pathology.

Purvarupa (Prodomal symptoms)

Cough are often preceeded by symptoms of the common cold such as a sore throat, and a decrease in appetite. Proper early management of the prodromal symptoms can prevent the onset of bronchitis.


Types of Kasa

Kasa (cough) is of five types; vata, pitta, kapha, ksataja and ksaya. Those of a vata, pitta and kapha nature represent different doshic manifestations of a cough. Ksataja type are due to chest injuries while ksaya type is due to disease that results in wasting of the bodily tissues such as tuberculosis.


Rupa (symptoms)

Cough due to vitiation of vata are called “vataja kasa”. They present as a dry cough with little mucous production. While small amounts of hard mucous may occasionally accompany a cough, the condition is for the most part dry. Examination of the mucous reveals it to be gray in color and ununctuous (not very sticky). The cough may be accompanied by a loss of voice and severe chest pain. The frequency of the cough is episodic and may occur in fits.

Cough due to pitta vitiation are called “pittaja kasa”. They present with a greater amount of mucous. Examination of the mucous reveals a yellow color and possible blood within the mucous giving it a “rusty” appearance. This latter appearance indicates that the infection has penetrated deeper in the respiratory system as is seen in pneumonia. Pittaja kasa is accompanied by fever. The cough is more continuous than that of vata type.

Cough due to kapha vitiation are called “kaphaja kasa.” They present with the greatest amount of mucous. Examination of the mucous reveals a cloudy, white color and the mucous is thick and sticky. The condition is often accompanied by a runny nose, nausea, and vomiting. Actual pain in the chest and head is mild. Kaphaja kasa is not associated with fever. Coughing is continuous.



Comparative Rupa (symptomatology) of Vataja, Pittaja and Kaphaja Kasa
Vataja Pittaja Kaphaja
Minimal mucous, hard mucous, grey in color Moderate mucous, sticky, yellow in color Large amounts of mucous, sticky, cloudy and white in color


Cough due to trauma, called “ksataja kasa” reveal a combination of symptoms related to vata and pitta types. Sputum may be red, yellow or black indicating infection and bleeding. While the mucous is abundant, it is ununctuous. Fever is probable and there may be joint pains as well. Due to trauma, blood may simulatanously appear in the urine. Cough due to trauma are described as resembling the cooing of a pigeon.

Cough due to ksaya occur with wasting disease such as tuberculosis. Tuberculosis is called “rajayaksmadi” literally the “kind of diseases” in the Ayurvedic literature. The condition results in a drying up and loss of tissue (ksaya). While vata dosha plays the most important role in this condition, the condition is sannipattika in nature (due to the vitiation of all three doshas).


Chikitsa: Treatment and Management

The management of kasa (cough) requires an understanding of the state of the patients agni, ama, and ojas as well as an appreciation of the doshic pathology present. In addition to treatment at the site of relocation in the pranavaha srota (respiratory system), treatment should also be directed toward the mahavaha srota (digestive system) as this is the physical root of the condition and the raktavaha srota (circulatory system) as the pathway of overflow.


Management of Vataja Kasa

The management of vataja kasa, at the site of relocation focuses on the application of oils and heat to the pranavaha srota (respiratory system). Sesame oil massaged into the chest followed by fomentation is recommended. Fomentation may be performed simply using hot water bottles, a heating pad or locally applied steam as in nadi svedana. Popular cough relieving herbs from India include kantakari (solanum xanthocarpum; VK-P+) and vamsa rochana (bamboo manna; VP-K+) . These are commonly used and may be prepared as ghrita (medicated ghee). Popular herbs used in the West include licorice (glycyrrhiza glabra; VP-K+) and wild cherry bark (prunis virginiana, prunia serotina; VP-K+).
Care of the digestive system requires dietary modification and the use of anuvasana basti (oil enema) or niruha basti (decoction enema). The diet, though nourishing should be taken in small quantities at first until the agni becomes strong. Nourishing soups are most beneficial. Patients should receive plenty of rest.

For both vataja and pittaja kasa, the classical formulation, Sitopaladi churna is commonly used. It may also be prepared in warm water or with honey. Sitopaladi churna is a combination of many herbs and spices with vamsa rochana as the chief herb in the formulation.


Management of Pittaja Kasa

The management of pittaja kasa, at the site of relocation focuses on herbal therapies. Oil and heat are not recommended. Medicated ghrita (ghee) may be prepared with cough relieving, expectorant herbs such as vamsa rochana (bamboo manna; VP-K+) and vasa (adhatoda vasica; PK- V+). Western herbal alternatives include licorice (VP-K+), mullein (verbascum thapus; PK-V+) and wild cherry bark (prunis virginiana, prunia serotina; VP-

K+). The classical Indian formulation, sitopaladi churna may also be used.
Virechana performed early in the condition is most beneficial to allieviate pitta at its root. The diet should emphasize a greater amount of the bitter taste as the bitter taste is cooling and purifies the rasa and rakta dhatu helping to destroy the infection. The diet should be light and and consist of easy to digest foods until improvement is noted. Stronger antimicrobial bitter herbs may be given to accompany the cooling, cough reducing herbs. These include kutki (Gentiana kuroo; PK- V+) and neem (Azadirachta indica; PK-V+) as well as well as Western alternatives such as goldenseal (Hydrastis Canadensis; PK-V+) and echinecea (Echinecea augustifolia, echinecea purpura; PK-V+). Patients should receive plenty of rest.



Management of Kaphaja Kasa

In the management of kaphaja kasa, treatment focuses on strong purification and may include vamana, virechana and niruha basti. Nasya is also recommended to purify the nasal passages and sinuses. An important herb from India is kantakari (solanum xanthocarpum; VK-P+). Kantakari alleviates cough and is a bronchodilator. Kantakari is one of the herbs in the famous ten roots formulation, dashmoola. Along with kantakari, additional herbs may be added to formulations such as vidanaga (embelia ribes; KV-P+) and chitrak (plumbago zeylancia; K-VP+). Dry, expectorant herbs may also be added to formulation or prepared for inhalation. Clove (caryophyllus aromatica) and bayberry (myrica nagi, myrica sapida, myrica cerifera) are commonly prepared in cigarette form or simply burned and inhaled. Western herbs that are beneficial include elecampane (inula helinum), eucalyptus (eucalyptus globulis) and black pepper (piper nigrum).

The diet of patients with kaphaja kasa should be very light and patients may fast for several days according to their strength. The diet emphasizes the pungent taste to support drying the lung tissues. Patients who are not experiencing great fatigue should remain active but should not overly exert themselves.



Managing Cough due to trauma requires referral to a medical specialist as the lung may be punctured. Until medical care can be administered, patients should take hemostatic herbs such as the Indian herbs manjishta and praval pisthi . Patients should also stay well hydrated.

Cough associated with wasting disease are difficult to treat and careful management is required. Weak patients usually require tonification to combat weight loss and increase strength. Medicated ghees with demulcent herbs such as bala rejuvenate the body and support repair of respiratory tissues. The dosage of the herbs is dependent upon the state of the patient’s agni. Anuvasana basti should also be administered to improve strength and can be prepared with nourishing herbs such as bala and ashwaganda in a sesame oil base. The diet should be nourishing. Meat and bone soups may be required to prevent continued weight loss.

Vegetarian patients may object, however they are strongly recommended if the patients life is in danger. The quantity of food taken should be proportional to the bodies abililty to digest it. Hence, dipanas to strengthen agni are required.


Sadhyasadhyata (Prognosis)

Doshic disturbances resulting in kasa are relatively easy to treat with vataja considered the easiest and kaphaja the most difficult. Those of mixed dosha pathology such as ksataja type are more difficult. Ksaya kasa is the most difficult of all. Ayurvedic texts state that kasa of any kind, if not treated properly can progress to ksaya type.