Dr.SeethaChandran PhD Scholar ROLE OF MAKSHIKA AND SHILAJATU IN THE MANAGEMENT OF PRAMEHA - A SUSRUTA’S PERSPECTIVE Dr.SeethaChandran PhD Scholar Dept. of Rasasastra & Bhaishajya Kalpana IPGT&RA, GAU, Jamnagar Dr.B.J.Patgiri Prof & HOD Dept. of Rasasastra & Bhaishajya Kalpana IPGT&RA, GAU, Jamnagar

INTRODUCTION Prameha - A general systemic disease caused by derangement of tridosha & manifest through the urinary symptoms. Diabetis - Under the broad concept of Prameha

Diabetis mellitus(DM) - A global problem A metabolic disorder of multiple etiologies 1. Insulin resistance, 2. Relative insulin deficiency, and 3. Hyper glycemia with disturbance of carbohydrate, fat and protein metabolism

SAMPRAPTI GHATAKAS Main morbid element- Bahu drava shleshma Dashavidha dhooshyas (slackened and increased state) Medas, mamsa,shareeraja kleda, shukra, shonitha, vasa, majja, lasika, rasa and oja

SAMANYA LAKSHANA Prabootha avila mootratha Medodushti lakshanas

Madumeha A multifactorial disease – due to the abnormal interacion of 3 doshas and 10 dushya predominantly vatadosha and ojas All Prameha - Madhumeha in its chronicity Refers - all type of Prameha and also one among the 20 types

SHILAJATU AND SWARNA MAKSHIKA

DISCUSSION

Santharpana and Apatharapana SAMANYA CIKITSA Shodana vs Shamana Santharpana and Apatharapana Kledomeda prashamana Tejodhatu Vardhana

OPTION OF DRUGS Medohara Rookshana Shoshana Srothoshodana Agnideepana Amootrala Balya Kushtahara Anulomana Yogavahitwa

PHARMACOLOGICAL PROPERTIES Types Rasa Guna Veerya Karma Shilajatu (exudate from rock) 6 types Tikta katuka Laghu, rooksha Ushna/ Anushna sheetha Kaphavata hara Saram Medochedakara Shoshana Chedana Yogavahi Makshika bhasma(Copper pyrite/ iron pyrite) 2 types MaduraTikta Sheetha Kaphapithahara Agnideepana Chakshushya yogavahi

MODE OF ADMINISTRATION Mode of administation of both drugs mentioned are same Administered - early morning with sarodaka after dehashudhi After digestion of medicine, advised to take jangala rasa

Dosage of shilajatu - 1 tulam( 4 Dosage of shilajatu - 1 tulam( 4.800 kg) in this context, patient will attain bala, varna and become Madumeha varjitha Acharya remains silent about the dosage of makshika dhatu Kapotamamsa and kulatha are varjya

MODE OF ACTION

SHILAJATU It is Well known for its naimittika rasayana effect, ojovardhaka and Pramehagna property Being a rasayana Act primarily at the level of rasadhatu (improves nutritional status) Improves the quality of dhatu production Improves agni Clears srothorodha

SWARNA MAKSHIKA Best rasayanas -Dehavada and dhatuvada Tikta rasa and katu paka: Purifies rakta dhatu Madura rasa: corrects the provocation of vata Rasayana property - strengthens the ojas and decreases the dhatu shaithilya

According to vyadhi avastha we have to eliminate the improperly manifested soumyabhava mala and then go for santharpana treatment. Both these rasayanas are of tridosha shamana, agnideepana, medohara, balya, cakshushya srothoshodana and vrishya with yogavahi property.

The best way for eliminating this saumyabhava adhika mala is soshana or rookshana karma. Rooksha guna of thiktha rasa – eliminates the drava roopa vrdha mala by it shoshana karma and there by removes the mandatha of dhatwagni Its laghu guna may activate the dhatwagni. As the drugs cause shoshana in the body, usage of mamsa rasa is advised.

As these drugs possess different virya and dosha hara property - It can be wisely selected based on the vyadyavastha of the patient. Kushta hara property helps to cure the Madumeha pitaka. Above all, the synergetic action (yogavahithwa) of these drugs will help to increase the potency of adjuvant many times.

Mineral drugs always remain superior to herbal and animal products in Ayurvedic therapeutics Swarnamakshika and shilajatu are such minerals which after proper processing, become highly potent and utilised for diseases like Prameha etc

Shilajatu consists of humic substances like DBP, Fulvic acid, Humic acid etc. Shilajathu is also rich in micronutrients like Fe, Mn, Mg,V, k, Zn, Ni etc Gupta et al  suggested that long-term treatment with shilajit increases the number of β -cells of pancreas The hypoglycemic effect of shilajatu (100 mg/kg) is significantly higher than that of metformin (500 mg/kg).

The main three elements in Swarna makshika are Copper, iron and sulphur. XRD of different samples of Swarna Makshika Bhasma reveales the presence of compounds like Fe3O4, Fe2O3, FeS2, FeSO4, and Cu2S. Trace elements like Mg, K, Si, and Al were also found.

Homeostasis of trace elements – disrupted by DM Disturbance in trace element status in DM - insulin resistance and development of diabetic complications. Tight glycemic control -preventing or decreasing these complications. This can be easily achieved with the help of some minerals and vitamins

SOME RESEARCH FINDINGS Both type 1and type 2 Diabetis are associated with low levels of Cr, Mn, Ni, Pb and Zn. Cr - Appears to increase the number of insulin receptors. Mn - Normalise insulin synthesis and secretion. Zn - Insulinomimetic effect and prevent oxidative damages. Cu - prevent STZ-induced type 1 Diabetis through the suppression of oxidative stress

Vanadium - Facilitate glucose uptake and metabolism, enhance insulin sensitivity. Age-Related macular degeneration Study–based micronutrients inhibit the development of diabetic retinopathy in rodents by inhibiting oxidative and nutritive stress. In spite of all the merits excessive accumulation of metals may adversely affects the situation.

Susrutacharya has mentioned 2 maharasas, shilajatu and makshika dhatu in madhumeha cikitsa. These drugs will provide the effect of shodana, without hampering the bala of the patient. Moreover the rasayana property of these drugs helps to maintain the roga in its yapya stage, preventing further complications.

 These rasayanas can produce a better glycemic control along with improvement in the lipid profile. As these minerals are rich in many micronutrients, it can normalise metal imbalance in the body preventing many complications. It can offer a new and promising approach in the long-term management of maturity onset Diabetis mellitus, because of its multifaceted action. So swarna makshika and shialajatu can be considered as the best available treatment modalities for Madumeha

Thank you