ROLE OF GAUMUTRA IN THE MANAGEMENT OF OBESITY W . S . R TO STHAULYA : A REVIEW STUDY

Obesity is a common and preventable disease of clinical and public health importance. It is often a major risk factor for the development of several non-communicable diseases, significant disability and premature death. In Ayurveda, Sthaulya is described in all the literatures. Acharya Charaka has described Sthaulya Purusha among one of the AshtaNinditaPurusha. Sthaulyais caused due to Medovriddhi which includes abnormal and excessive accumulation of medadhatu in the body. This is caused by frequent and excessive intake of madhur and snigdhaaahar , lack of physical and mental exercises. These all results into the increase in kaphadoshaand medodhatu results in the sthaulya. In modern science, Sthaulya can be compared to the obesity. Obesity is one of the metabolic disorders. WHO considers obesity as a Global epidemic and a public health problem. It is estimated that more than 300 million adults are obese and many are overweight. Sthaulya (obesity) is discouraged by the society for social as well as on the medical grounds. Three main causes have been described in modern literature viz. 1) Dietetic, 2) Genetic, 3) Hormonal. Person of every age and sex is suffering by this widely spreaded epidemic i.e obesity. It is the major chronic disease in developing as well as in developed countries. The line of treatment includes the treatment of Dhatvagnimandya. In pathogenesis of Sthaulya, KledakaKapha, Samana&Vyana Vayu, Meda (fat /lipid) and Medodhatvagni Mandyata are main responsible factors


Introduction:
In modern era every person is very busy in his daily routine.No body has time to think for the healthy life.None of us follow Dinacharya and Ritucharya even after knowing the importance of it.Due to this artificial living life-style, person is suffering from various life style disorders.Sthaulya is one of them.Sthaulya is a condition where there will be distribution of Meda with reduced enthusiasm towards life is called Atisthula.[1] According to the modern science, Obesity is defined as increase in body weight beyond the limitation of skeletal and physical requirements as the result of excessive accumulation of body fat.
Classification: Vagbhata has mentioned three types of Sthaulya i.e.Adhika, Madhyama and Hina with management point of view.1. HinaSthaulya: (B.M.I. 25-30 kg/m2 -Over Weight) -Mild degree of overweight, without any complication or secondary disease, with less than four undesirable symptoms and with duration of less than 1 year -can be considered as HinaSthaulya.
3. AdhikaSthaulya: (B.M.I. > 40 kg./m2 -Very Obese) -Excessive degree, with complication and secondary disease with all 8 undesirable symptoms and duration of more than 5 years can be considered as AdhikaSthaulya.According to Ayurveda: There are 7 basic tissue elements in the human body Known as Dhatus.These are present in every human body in a particular proportion and any change in the equilibrium leads to diseases.Fat or the Meda is one of the Dhatus.

Agni and
According to modern: Obesity can be assessed by following tools: 1.Body Mass Index 2.Waist circumference 3. Waist / Hip ratio 4. Relative Weight (Rw) 5. Skin fold thickness .In Ayurveda, there are many medicines made from cow urine, milk, dung, ghee, curds.This purifies, and clears all blocks in bodily channels (Shroto-shodhaka).It enhances the therapeutic actions of medicines taken along with it.It has been found to be very effective in worm infestations, skin diseases, urticaria and allergic rashes, pain abdomen due to indigestion, constipation, and ascitis etc. Cow's urine is widely used in the Ayurvedic pharmaceuticals for enhancing the properties of many drugs, by giving Bhavana (repeated trituration).In Shodhana (purification) of metals, cow urine was extensively used.Charaka, Sushruta and all other ancient physicians have given prime importance to cow's urine.Milk or urine of cow of particular has been mentioned for a specific therapeutic use.Even though urine of many animals is used in preparing medicines, cow's urine has been found to be the best among all.Gomutra Rasa: Katu, Tikta, Kashaya, Lavana (Anurasa) Guna: Tikshna, Ushna, LaghuVirya: UshnaVipaka: KatuDoshghanta: KaphavataShamaka Action and Uses: Deepana, Lekhana, Pachana, Anulomana, MalshodhakAmapachana, it is also used in Virechana and Basti.Thus the biochemical analysis of cow's urine also indicates that by virtue of nitrogen and copper it helps to excreted out fat in the form of Kleda through urine by increasing kidney functions and diuretic action.Copper don't allow the fat to deposit in the body and organs.

2.
Dushya: Acharya Sushruta[2] has mentioned Sthaulya as a Dusya dominant disease and in this disease the excessive production of abnormal MedaDhatu is clearly visualized.Kapha is seated in Meda along with other Dhatus.In Sthaulya excessive In the Sthoulya, involvement of MedovahaSrotasa is the main factor along with the involvement of other Srotasa.According to Acharya Charaka,[1] Avyayama, Divaswapa excessive intake of MadhuraDravyas and Varuni, are the Nidana of Medovahastrotodushti.[1] It indicates clear involvement of Medovahasrotasa along with Rasavahasrotasa.Atisweda and Daurgandhya indicate the involvement of Swedavahasrotasa.

Nidana: Ahararasa plays
According to W.H.O.Obesity is listed under the 10 top selected risks to the health disorders.ViharatmakaNindana like Divaswapna having Abhishyandi property leads to blockage of the micro channels of the body, specifically in Medovahasrotas.During sleep, metabolic rate is reduced.Sthaulya is also considered under the group of psychosomatic diseases Acharya Charaka, mentioned two psychological factors: Harshantya (Excessive pleasure) and Achintana (Jolliness).[1]Withthistype of psychological well being and jolliness that person indulges more in worldly pleasure and leads to the accumulation of excess fat.Acharya Charaka has described that Beejadosha plays a major role in Medovriddhi.Defect of Beejabhagavayava i.e. part of Beeja, which resembles with Genes, may lead to defective development of that organ.[1]Bhavamishraalsomentionedthat increased proportionate of Meda and decreased proportion of Shukra in Beeja at the time of conception predisposes towards development of fleshy but weak body.This indicates role of hereditary factor in genesis of Sthaulya.In this disease, Vata has been mentioned in the state of Avrita in Kostha, which makes the Agnivaishamya, ultimately increases the demand of food.The involvement of SamanaVayu[1] can be clearly postulated with the evidence of Agni Sandhukshana and improper distribution of fat in the body proves the involvement of Vyana Vayu.In Pitta Vriddhi as well as in Sthaulya, the symptoms like Atikshudha, Atipipasa, Swedadhikya,Daurgandhya[2]have also been mentioned.Pachaka Pitta is mainly involved in the aetiopathogenesis of the disease.SthulaAnga by nature and also they have more pleasure and less tension -anxiety, so KaphaPrakriti persons are more prone to become obese (Sthula).
b) Pitta: Ama: According to Vagbhata,[3] Mandagni is considered as root cause of all disease.Due to Mandagni, formation of Ama occurs.Sthaulya results from derangement of Dhatvagni.In Sthaulya, due to vitiation of Vata by obstruction of Meda, Tikshnagni is a prominent feature.According to 'DhatuParinama concept', (at Dhatvagni level) Vriddhi of previous Dhatu and Kshaya of further Dhatu take place.In cases of Sthaulya, excessive consumption of Guru, Madhura, Snigdhaguna dominant diet produces excessive and inferiority Medodhatu Poshaka Annarasa, this makes Medodhatvagni-mandya.So as per above concept in the state of