1. 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

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

3. 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

4. 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

5. SAMANYA LAKSHANA
Prabootha avila mootratha
Medodushti lakshanas

6. 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

7. SHILAJATU AND SWARNA MAKSHIKA

8. DISCUSSION

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

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

11. 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

12. 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

13. Dosage of shilajatu - 1 tulam( 4
Dosage of shilajatu - 1 tulam( 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

14. MODE OF ACTION

15. 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

16. 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

17. 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.

18. 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.

19. 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.

20. 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

21. 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).

22. 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.

23. 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

24. 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

25. 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.

27. 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.

28.  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

29. Thank you