1) Panchakarma therapies like Vamana, Virechana, and Basti can play an important role in the management of Sthoulya (obesity) according to Ayurveda texts, though Sthoulya patients are generally not recommended for strong Panchakarmas due to risks. 2) Specifically, mild Vamana and Virechana may be performed if necessary, but Basti is considered the safest and least risky of the Panchakarmas for Sthoulya patients. 3) Repeated and regular use of appropriate Panchakarmas along with dietary control and exercise is needed for effective management of Sthoulya according to

1. Centre for Innovation in Science and Social Action 1

2. ROLE OF PANCHAKARMA THERAPIES IN
THE MANAGEMENT OF THE STHAULYA
Centre for Innovation in Science and Social Action
PRESENTED BY GUIDED BY
Dr.Kaushal sinha Dr.Lohith BA
2nd year PG scholar Associate professor
Department of Panchakarma
SDM college of Ayurveda and Hospital
Hassan
2

3. • Sthaulya is an burning problem in the world scenario
and has acquired the status of an EPIDEMIC.
• Indiscriminate dietary habits, sedentary life styles,
stress etc, which are the gifts of modern world, are
predisposing factors for Stoulya (Obesity).
• Due to economical, industrial and astonishing progress
in science & technology quality of life is deteriorating.
Centre for Innovation in Science and Social Action
INTRODUCTION
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4. • In Dec 1997; WHO declared Obesity as a global epidemic, giving rise
to a new term ‘GLOBESITY’
• 5000 yrs back, Ayurveda had identified this state as Sthaulya and
grouped it among the Santarpaṇotta vyādhi
• Obesity is basically a behavioral disorder.
Centre for Innovation in Science and Social Action 4

5. NIDANA
1.AHARAJ
•Gunapradhana-Guru,Sheeta, Pichila, Snigdha
•Rasapradhana – Madhura
•Dravyapradhana- Navanna, Gorasa, Dadhi,
Goudika, Varuni, Anupa Varija Mamsa.
•Vidhipradhana-Adhyasana,Atisampoorna,Atimatra
Ahara.
Centre for Innovation in Science and Social Action 5

6. 2.VIHARAJ
• Shayyasana Sukha
• Diwaswapna
• Chesta Dwesha.
3.MANSIK
• Achinta
• Harshanityatwa
Centre for Innovation in Science and Social Action 6

7. Centre for Innovation in Science and Social Action
SAMPRAPTI GHATAK
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Dosha : Kapha Pradhana Vata Pittanubandhi Udhbhava sthana: Amashaya
Dushya: Rasa, Mamsa, Meda vyakta sthana : sarvasharir
Agni : Jataragni, Medodhatvagni Rogamarga : bahya abhyantra
Ama : Jataragnimandyajanita, Medo
dhatvagnimandyajanita Ama
Srotodusti : Medovaha Srotas
Srotodusti Prakara :Sanga
Adhisthana : Medoharakala,vapavahan
Roga swabhava:chirakari

8. Centre for Innovation in Science and Social Action
STHAULYA ROOPA
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• Ayushohrasa (Diminution of life span)
• Javoparodha (Lack of enthusiasm)
• Kriccha Vyavaya
• Daurbalya (General debility)
• Daurgandhya (Foul smelling of body)
• Swedabadha (Distressful sweating)
• Kshudhatimatra (Excessive hunger)
• Pipasatiyoya (Excessive thirst)

9. TYPE OF STHAULYA
 Acc to Charaka: Sthoola & Atisthoola
 Acc to Sushruta: Sthoulya & Medoroga
 Acc to Vagbhata: Adhika, Madhyama & Heena
Centre for Innovation in Science and Social Action 9

10. Centre for Innovation in Science and Social Action
BODY MASS INDEX
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•Body mass index (BMI) weight (kg)/ height squared (m2).
•BMI is significantly correlated with total body fat content.

11.  Adhika Sthaulya : (BMI> 40 Kg/m2) - Very Obese
 Madhyama Sthaulya : (BMI 30-40 kg/m2) – Obese
 Hina Sthaulya : (BMI 25-30 kg/m2) - Over weight
 The international classification of BMI which is widely accepted is as
follows :
• Below 20 kg m2 Under weight
• 20-25 Kg/m2 Normal
• 25-30 Kg/m2 Over weight
• 30-40 kg/m2 Obese
• Above 40 kg/m2 Very obese
Centre for Innovation in Science and Social Action 11

12. COMPLICATIONS OF OBESITY
• Metabolic disorders (DM, Gall stones, Gout, Hyperlipidaemia)
• Mechanical disabilities (OA, Hernia, Varicosity, Dysnoea, Accidents).
• Respiratory Complications (Dysnoea, Apnoea, Pickwickian syndrome,
OHS, Resp. infections).
• Cardiovascular complications (Stroke, Venous stasis, CCF etc.).
Centre for Innovation in Science and Social Action 12

13. Centre for Innovation in Science and Social Action
STHAULYA CHIKITSA
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NIDANA
PARIVARJANA
GURU
ATARPANA
LANGHANA
CHIKITSA
SATATA
KARSHANA
CHIKITSA
PATHYAPATH
YA

14. SHODHANA
• Charaka & Vagbhata both have very clearly mentioned Sthoulya in
Bahudoshavastha, hence Shodhana can be performed.
• Charaka considered Sthoulya as
Shlesma Nanatmaja Vyadhi in Cha.Su.20/17
Santarpana Nimitaja Vyadhi in Cha.Su.23/6
• There are two main parts of Shodhana
Bahya Samshodhana
Abhyantara Samshodhana
Centre for Innovation in Science and Social Action 14

15. BAHYA SHODHANA
• Many Acharyas have mentioned external
purification therapy for management of
Sthoulya.
• In all classical texts, Udvartana is mentioned
as part of Dincharya and for Sthoulya
‘Udvartan’ is recommended.
• Because it is Kaphahara, Medasah
Pravilayamanam, Sthirikaranam anganam.
• Charaka specifies ‘Teekshna Rooksha
Udvartana’ for Sthoulya. (Ch.Su.21/21)
Centre for Innovation in Science and Social Action 15

16. Centre for Innovation in Science and Social Action
ABHYANTARA SHODHANA
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VAMANA
VIRECHANA
NIRUHASHIROVIREC
HANA
RAKTAMOK
HSANA
• Charak has recommended Vamana and Virechana Karmas for all
Santarpanotta Vyadhis. (Ch.Chi.6/47).
• As Sthoulya too comes under the same category; Vamana, Virechana therapies
can be tried in Sthoulya.

17. Centre for Innovation in Science and Social Action
SNEHANA
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• Snehana Karma is always restricted for the patients of Sthoulya
(Ch.Su. 13/53).
• However on exigency usage of Taila is recommended (Ch.Su.
13/44-46).
• For Snehapana & Abhyanga following preparations can be used.
 Tila Taila (Su.Su45/112)
 Sarshapa Taila (Bhai.Rat)
 Triphaladi Taila (Bha.pra,Cha.dat,Yog.rat)
 Panchatiktakaguggulughrita (Cha.dat,Bha.pra)

18. Centre for Innovation in Science and Social Action
SWEDANA
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• In Cha.Su.23/8 it is told Svedana as one of the Chikitsa for Santarpana
Janya Roga.
• In A.Sa.Su 24/15 for Sthoulya, Svedana is essential.
• Vagbhata has indicated the use of Pinda sweda on extreme
requirement (A.S.Su. 26/8).
• Sagni sweda- Nadi Sveda, Parisheka Sveda, Drava Sveda, Ushna Jala
Snana
• Niragni sweda- Guru pravarana, Bahupana, Kushdha Nigraha, Atapa
sevana, Vyayama, Ahava, Krodha, Bhaya and Upanaha (Ch.Su.14/64,
SU.Chi.32/15)

19. Centre for Innovation in Science and Social Action
VAMANA
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• Sthoulya is Kaphaja Nanatmaja Vikara .Hence Vamana is the first line
of measure.
• However Vamana is indicated for treatment of Medo Roga (SU.Chi.
33/18)
• Also similar line of treatment is advised for disorders of Shleshma and
Meda (A.S. Su. 19/13, Y. R. 3)
• Vamana is considered as the best for Kapha dosha (Ch.Su.25/40).
• Hence, Vamana can be used for the treatment of Sthoulya, but only in
uncomplicated patients.

20. Centre for Innovation in Science and Social Action
VIRECHANA
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• Clear indication of Virechana in Sthaulya is mentioned.
• Though Virechana has been forbidden for patients of Sthoulya (Ch.Si.2/11-12,
SU.Chi.33/29, Ka.Si.7), as Virechana is indicated for Pittadhikya condition.
• In Sushruta Samhita, while describing Virechana Karma, Sthula Pramehi is
considered as Durvirechya due to aggravation and dominance of Medas.
• However, Tikshna Sodhana (Virechana) is insisted (Su. Chi. 12/6) line of
treatment for Sthaulya.
• It has been included for the management of Sthoulya by Bhava Mishra
(B.P.Ma.39/11-26)

21. Centre for Innovation in Science and Social Action
CONT...
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Virechana Yogas like Triphala, Aragvadha, Katukarohini can be used.
• Pippalyadichoorna (Cha.Datt.Virechanadhikara)
• Hareetakyadichoorna (Cha.Datt.Virechanadhikara)
• Trivrutadigutika/ Leha (Cha.Datt.Virechanadhikara)

22. BASTI
 As it is told by Sushruta and almost in all the classics we will get reference
regarding Lekhana Basti especially for Sthaulya.(Su .chi.38/82)
• Other Basti’s like:
– Bhadradi Asthapana Basti, Aragvadhadi Niruha Basti (Su.chi.38/60-63,79)
– Dvipanchamooladi Basti, Kaphamayaghna Niruha, Anuvasana (A.Sa.Kal.5)
– Erandamooladi Niruha (Ash.Hru.kal.4)
– Gomutra Basti (Cha.Datt)
Centre for Innovation in Science and Social Action 22

23. SHIROVIRECHANA
• Ayurvedic texts have specified the benefits of Shirovirechana in Medo Roga,
Avapida Shirovirechana is mentioned as line of treatment for Abhishyanna
Meda Vyaapta Sharira. (SU.Chi.40/44).
• Moreover Karshana Nasya is indicated in the disorders of Kapha Dosha (Ka.
Si.2) and Sthoulya is enumerated as one of the twenty-kapha nanatmaja
disorder.
• According to Bhavprakash Triphaladya taila has been indicated for Nasya
Karma in patients of Sthoulya (BP.Ma.39/55-56, YR - Medoroga Chi.)
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24. DISCUSSION
• Even though all the Panchakarmas are described in the
Chikitsa principle of Sthaulya, but during the indication of
each Karma, Sthoulya is Ayogya for each Panchakarma-why?
• In A.Sa.Su.24/15, Indu commentry & Cha.Su 23/8 mentioned
Rakta mokshana can be done in Sthaulya?
• In Yo.Ra, Cha.Datt, Bha.Pra (39/58-60) said that Triphaladi
Taila can be used for Nasya Karma in Sthaulya. How it will be
helpful? 24

25. CONCLUSION
• Based on the Avastha & Dosha Bahulyata suitable Shodhana can be adopted.
• If necessary Mridu Vamana & Virechana can be performed so as to avoid
complications in Sthaulya.
• Among all these Shodhana modalities Basti Karma is more ideal and do not
produce much complications compared to Vamana & Virechana Karma.
• Repeated & regular Shodhana followed by controlled diet, regular exercise
along with Shamana medications should be carried to combat STHAULYA an
Epidemic.
• Thus it can be concluded that Shodhana measures have very important role in
management of Sthoulya.
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