ISSN 2277-4289 | | International, Peer ...gjrmi.com/Upload/June2015/Nishteswar K et al., (2015)_ GJRMI 4(6... · Bibhitaki, Guduchi, Haridra, Kiratatikta, Karavellaka, Asana, Meshashringi,

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 6 | June 2015 | 111–124

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

ISSN 2277-4289 | www.gjrmi.com | International, Peer reviewed, Open access, Monthly Online Journal

MEHAHARA DASHEMANI- A NOVEL GROUP DEVELOPED BASED ON

SUSHRUTA’S MEHAHARA DRUGS WITH SPECIAL REFERENCE TO

DIABETES

Nishteswar K1, Sushama Bhuvad

2*

1Prof. & HOD of Dravyaguna department, I.P.G.T. & R.A, Jamnagar-361008, Gujarat, India

2Ph.D scholar, Dravyaguna department, I.P.G.T. & R.A, Jamnagar-361008, Gujarat, India

*Corresponding author: E-mail: [email protected];, Contact: +91-9737037392

Received: 06/05/2015; Revised: 30/05/2015; Accepted: 15/06/2015

ABSTRACT

The cardinal signs of Prameha are Prabhuta and Avilamutrata (excessive and turbid urination).

When Pramehi suffers from boils and had severe complications can be called as Madhumehi.

Uncomplicated diabetes mellitus may be referred as Kshudrameha. WHO estimated 1.5 million

deaths in 2012 making it the 8th

leading cause of mortality. It is a life style disorder which cannot be

cured completely, but life span of an individual can be made worthy by palliative treatment.

Synthetic oral hypoglycemic agents are very popular to lower the blood sugar level but it’s

prolonged use may lead to Vit. B12 deficiency. Therefore the need of an hour is to find out a natural

hypoglycemic source for palliative treatment of Prameha. Sushruta’s therapeutic classification can

be explored for the Mehahara activity. In total 62 drugs have been incorporated under Mehahara

activity categorized under 7 groups of drugs i.e. Aragvadhadi, Salasaradi, Mushkakadi, Trapvadi,

Triphala, Vallipanchamoola, and Kantakapanchamoola. Among these drugs 55 are herbal in origin

and 7 are mineral in origin. In total 42 herbal and 2 mineral drugs have been evaluated for their anti-

diabetic property. These drugs act through different mechanism of action. Based upon the analysis of

62 drugs compiled from seven ganas and 43 drugs enlisted for the treatment of 20 varieties of

Prameha, a broad spectrum formulation known as “Mehaharadashemani” (Haritaki, Amalaki,

Bibhitaki, Guduchi, Haridra, Kiratatikta, Karavellaka, Asana, Meshashringi, and Shatavari) can be

used as palliative formulation for all types of Prameha

KEY WORDS: Mehahara dashemani, Madhumeha, Prameha

Review Article

Cite this article:

Nishteswar K, Sushama Bhuvad (2015), MEHAHARA DASHEMANI- A NOVEL GROUP

DEVELOPED BASED ON SUSHRUTA’S MEHAHARA DRUGS WITH SPECIAL REFERENCE

TO DIABETES, Global J Res. Med. Plants & Indigen. Med., Volume 4(6): 111–124

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 6 | June 2015 | 111–124

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

INTRODUCTION:

The epidemiological survey regarding

Diabetes suggests that it is 8th

leading cause of

mortility. As of 2013, 382 million people have

diabetes worldwide. In 2014, the International

Diabetes Federation (IDF) estimated that

diabetes resulted in 4.9 million deaths. The

greatest increase in rates was expected to occur

in Asia and Africa, where most people with

diabetes will probably live in 2030 (World

Health Organization fact sheet, 2013)

Acharya Charaka described about a

pathogenesis of Prameha as “the birds are

attracted towards the trees where their nests lie,

similarly, Prameha affects people who are

voracious eaters and have aversion to bath and

physical exercises.” There are two types of

Pramehi (suffering from Prameha) i.e. Sthoola

(obese) and Krisha (lean) pramehi. The

cardinal sign of Prameha is Prabhuta and

Avilamutrata (Excessive turbid urination).

Doshika dominance in the disease can be

categorized basing on colour of urine.

Objective assessment for doshas can be done

by boiling the urine to the stage of

solidification and the ratio of residual content

should be estimated. If residual content as

compared to its supernatant liquid is 1/5th

portion, it is Vataja; 1/7th

portion indicates

Pittaja and 1/9th

represents Kaphajadosha(K.

Nishteswar, 2003).

Acharya Sushruta has allocated separate

chapter for Madhumeha, keeping in view its

prognosis. One who is suffering from boils and

has severe complications is called madhumehi

and that is considered incurable (Sushruta

Nidana 6/24) (Trikamaji Yadavaji, 2008).

Diagnostic criteria for Madhumehi was quoted

as one who prefers to stand rather than move

from place to place, prefers sitting to standing,

lying down to standing, desires to sleep rather

than lie down in bed. This observation portrays

the extreme weakness of Madhumehi and refers

to extreme weakness or asthenic which may be

considered as bad prognostic sign. All types of

urinary abnormalities if not treated in time

develop Madhumeha and then become

incurable (Sushruta nidana 6/25, 27) (Trikamaji

Yadavaji, 2008). Uncomplicated diabetes

mellitus (DM) should not be referred with the

term Madhumeha. It is to be categorized under

Kshaudrameha.

Modern science classified Diabetes as Type

I and Type II. Type I DM It is due to beta cell

islet destruction by autoimmune process, and

these patients are prone to Ketoacidosis. Type

II occurs over 40 years of age. It is associated

with Hypertension, Dyslipidemia and

Atherosclerosis. This is the most prevalent

form and results from insulin resistance, mainly

caused by visceral obesity, with a defect in

compensatory insulin secretion (Harsh Mohan,

2010).

All oral hypoglycemic agents have side

effects on their prolonged use. Sulfonylureas

are associated with weight gain and

hypoglycemia. It’s not proved to be safe in

pregnancy. Metformin's major side effects are

seen in the gastrointestinal tract, with nausea,

cramps and diarrhea. Vitamin B12 deficiency

may occur after 1 year of drug administration

(Bell DSH, 2002). To find out natural sources

of hypoglycemic agent, one can make use of

drugs mentioned in classics. Acharya Sushruta

had classified drug basing on its pharmaco-

therapeutic implications. Some of the groups

like Aragvadhadi, Salasaradi, Mushkakadi,

Trapvadi, Triphala, Vallipanchamoola, and

Kantakapanchamoola do possess Mehaghna

(anti-diabetic) property. In the present study, an

attempt is made to generate the general

formulation which can be used in the

management of 20 types of Prameha by

reviewing these 62 drugs compiled from

therapeutic classification of Sushruta. For

analysis, the simple recipes quoted for 20 types

Prameha by Sushruta were also taken into

consideration. And drug’s review had been

carried out according to their Rasa (Taste),

Veerya (Potency), Vipaka (Bio-transformation),

Guna (Attributes) and Prabhava (principle

responsible for specific action), action and

indications mentioned in the classical texts and

research works related to anti-diabetic activity.

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 6 | June 2015 | 111–124

Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||

MATERIAL AND METHOD:

The compilation of drugs had been done

from Sushrutasamhita along with its

commentary “Nibandhasamgraha” by

Dalhana. Rasapanchaka (Rasa, Guna, Veerya,

Vipaka, and Prabhava) action and indication of

drugs were compiled from

Bhavaprakashanighatu and Rajanighantu.

Recent research studies were downloaded from

Google scholar.

OBSERVATIONS

Sushruta had described total 62 drugs in 7

groups of drugs. Among them 55 are herbal and

7 are mineral in origin. These drugs are

tabulated below (Table 1):

Table 1. List of the drugs mentioned in therapeutic classification of Sushruta having Mehahara

(anti-diabetic) activity N

o

Drug Botanical

source

Rasa,

Veerya,

Vipaka

Indication Part

Used

Experimental study

Herbal

1. Aguru Aquilaria

agallocha

Roxb.

Rasa:

Katu,

Veerya:

Ushna

Karna-

Akshiroga

Leaf The drug acts through increased glucose

uptake by adipocytes and contained

antioxidant activity (Pranakhon Ratree et

al., 2011)

2. Ajakarna Dipterocarpus

turbinatus

Gaertn. f.

Rasa:

Katu,

Tikta,

Kashaya

Veerya:

Ushna

Meha,

Kushtha,

Visha, Vrana

Not yet evaluated for anti-diabetic activity

3.

Ajashrungi

Pistacia

integrrima

Stew.ex.Brandis

Shwasa,

Trishna,

Hikka, Kasa

Gall Pistagremic acid, triterpenic acid, has a

glycosidase inhibitory activity (Uddin Ghias

et al., 2012)

4.

Amalaki

Phyllanthus

emblica Linn.

Rasa:

Amla

Vipaka:

Madhura

Veerya:

Sheeta

Prameha,

Raktapitta

Leaves,

Seed

The maximum fall of 27.3% (p<0.001) in

the blood glucose level of normal rats was

observed at 6h during fasting blood glucose

studies, with the dose of 300mg/kg

identified as the most effective dose of seed

extract (Mehta Shikha et al., 2009).

5. Aragvadha Cassia fistula

Linn

Rasa:

Madhura,

Veerya:

Sheeta

Jwara,

Hridroga,

Udavarta,

Shoola,

Kushtha

Flower

petals,

bark

The significant anti-hyperglycemic activity

at a dose level of 400 mg/kg by inducing

insulin secretion (E. E. Jarald et al., 2013)

Catechin have insulin mimetic effect

(Pitchai Daisy et al.,2012)

6. Arjuna Terminalia

arjuna (Roxb.)

W. & A

Rasa:

Kashaya

Veerya:

Sheeta

Hridya, Meda,

Meha,

Kshatakshaya

Bark Ethanolic extract of bark exert

hypoglycemic activity by inhibiting glucose

absorption through intestine and

regenerating beta cells (Barman Sarajita et

al., 2012)

7. Asana Pterocarpus

marsupium

Roxb.

Rasa:

Kashaya

Kushtha,

Visarpa,

Shwitra,

Meha, Krimi

Heart-

wood

The four out of five phenolic C-glycosides

isolated from n-butanol fraction of ethanolic

extract of P. marsupium enhanced glucose

uptake by skeletal muscle cells (C2C12) in a

dose dependent manner (Mishra A et al.,

2013)

8. Bhoorja Betula utilis D.

Don.

Rasa:

Kashaya

Medahara,

Vishahara;

Bhutagraha,

Karnaroga

- Yet to be evaluated for anti-diabetic activity

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9. Vibhitaka Terminalia

bellirica Roxb.

Rasa:

Kashaya

Vipaka:

Madhura

Veera:

Ushna

Krimi,

Trishna,

Chhardi, Kasa

Fruit

rind

Octyl gallate isolated from the fruit rind of

T. bellerica has potential anti-diabetic effect

as it augments insulin secretion and

normalizes the altered biochemical

parameters in diabetic rat models (Latha RC

et al., 2013)

10. Chandana Santalum

album Linn

Rasa:

Tikta

Veerya:

Ushna

Shrama,

Shosha,

Trishna, Daha

Heart-

wood

S.album pet ether fraction has potential anti-

hyperlipidemic activity that can help in

overcoming insulin resistance (Kulkarni CR

et al., 2012)

11. Chitraka Plumbago

zeylanica Linn

Rasa:

Katu

Veerya:

Ushna

Grahani,

Kushtha,

Shotha, Arsha,

Krimi, Kasa,

Root, The results indicated that plumbagin

enhanced GLUT4 translocation and

contributed to glucose homeostasis (C Sunil

et al., 2012)

12. Dasikuruntaka (Neelapushpa)

Barleria

strigosa Willd.

Kushtha,

Kandu;

Vishahara

– Yet to be evaluated

13. Dhava Anogeissus

latifolia

Wall. ex Bedd.

Rasa:

Kashaya,

Madhura

Veerya:

Sheeta

Prameha,

Arsha, Pandu

Bark The bark administration, altered lipid

profiles and antioxidants level were

reversed to near normal than diabetic

control rats (Subramaniam Ramachandran

et al., 2012)

14. Gopaghanta (Karkoti)

Momordica

dioica Roxb

Kushtha,

Aruchi,

Shwasa, Kasa;

Deepana

Fruit Aqueous extract of fruit increased sr. insulin

level by 31.3% by stimulating beta cells of

pancreas (Singh Rambir et al., 2011)

15. Gridhranakhi Capparis

sepiaria Linn.

- Leaves Leaves exhibit hypoglycemic activity by

stimulating beta cells of pancreas (P.

Selvamani et al., 2008)

16. Guduchi Tinospora

cordifolia

(Willd.) Miers

ex Hook. f.

&Thoms.

Rasa:

Tikta,

Kashaya,

katu

Vipaka:

Madhura

Veerya:

Ushna

Trishna, Daha,

Meha, Kasa,

Pandu,

Kamala,

Kushtha,

Vatarakta,

Prameha,

Hridroga

Stem It may be through some peripheral

mechanisms, such as increasing the

glycogen storage in the liver or decreasing

the glucose release from the liver (Puranik

Nagaraja et al., 2010)

17. Haritaki Terminalia

chebula Retz

Rasa:

Kashaya

Veerya:

Ushna

Vipaka:

Madhura

Prameha,

Arsha,

Kushtha,

Shotha,

Udara, Krimi,

Shwasa, Kasa,

Hridroga

Fruit Pet ether extract fruit showed hypoglycemic

activity by stimulating beta cells of

pancreas, Reducing Lactate dehydrogenase

activity, at liver site- inhibiting glycolysis

and gluconeogenesis, and decreasing level

of glycosylated hemoglobin (Gandhipuram

Periasamy et al.,2006)

18. Kadara Acacia suma

Buch.-Ham.

Rasa:

Kashaya,

Tikta

Veerya:

Sheeta

Mukharoga - Yet to be evaluated

19. Kalaskandha Diospyros

embryopteris

Pers

Rasa:

Madhura

Veerya:

Sheeta

Prameha Fruit The activities of SOD, CAT, and GSH were

found to be increased in extract treated

diabetic rats in selected tissues.

The increased level of lipid peroxidation

(thiobarbituric acid reactive substances and

hydroperoxide) in diabetic rats was also

found to be reverted back to near normal

status in extract treated groups (Dewanjee S

et al., 2009)

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20. Kaliyaka Santalum

album

Rasa:

Tikta

Veerya:

Ushna

Vyanga - Same as 10

21. Kantaki

(Vikankata)

Flacourita

indica (Burm.

f.) Merr

Rasa:

Tikta

Veerya:

Sheeta

- Leaf

and

stem

Yet to be evaluated for anti-diabetic activity

22. Karamarda Carissa

carandas Linn.

var. congesta

(Wt.) Bedd.

Rasa:

Madhura

Veerya:

Ushna

Trishna,

Raktapitta

Leaves The doses of 500 and 1000 mg/kg of the

extract did significantly (p<0.05)

decrease the blood glucose levels of alloxan

diabetic Wistar rats at 4, 8 and 24 h.

(Swami Gaurav et al., 2010)

23. Karanja Pongamia

pinnata Pierre

Rasa:

Katu

Veerya:

Ushna

Yonidoshahara,

Kushtha,

Gulma, Arsha,

Vrana, Krimi

Leaves It could be due to potentiation of the insulin

effect of plasma by increasing the

pancreatic secretion of insulin from existing

β-cells or its release from bound insulin. Or

may be due to enhanced glucose utilization

by peripheral tissues (Sikarwar Mukesh S.et

al., 2010)

24. Lata-

karanja

Caesalpinia

bonduc

(L.) Roxb.

Dandy & Exell.

Rasa:

Katu

Veerya:

Ushna

- Seed

extract

The anti-hyperglycemic action of the

extracts may be due to the blocking of

glucose absorption (D.M. Kannura et al.,

2006)

25. Khadira Acacia catechu

(Linn. f.) Willd.

Rasa:

Kashaya,T

ikta

Veerya:

Ushna

Kandu, Kasa,

Aruchi, Meha,

Jwara, Krimi,

Shwitra,

Kushtha

Heart-

wood

It may have insulin secretaceous or insulin

sensitizing activity that lower down the

blood glucose level (Srivastava Swayam

Prakash et al., 2013)

26. Kiratatikta Swertia

chirayita

(Roxb. ex

Flem.) Karst.

Rasa:

Tikta

Veerya:

Sheeta

Jwara,

Shwasa, Kasa,

Shotha,

Trishna,

Kushtha,

Vrana, Krimi

Whole

plant

It is suggested that hexane fraction of S.

chirayita possibly acts through its insulin

releasing effect (Chandrasekar Bet al.,

1990)

27. Kramuka Areca catechu

Linn.

Rasa:

Kashaya

Veerya:

Sheeta

Aruchi,

Asyavairasya

Nut,

leaf

Hypoglycemic activity through alpha

glucosidase inhibition (M Senthil Amudhan

et al., 2008)

28. Kuchandana Caesalpinia

sappan Linn.

Rasa:

Madhura

Veerya:

Sheeta

Vrana, Daha Heart-

wood

Brazilein, active component of sappan

wood, decreases blood glucose in diabetic

animals. Brazilein inhibits hepatic

Gluconeogenesis by elevating the F-2, 6-BP

level in hepatocytes, possibly by elevating

cellular F-6-P/H-6-P levels and PFK-2

activity. Increased pyruvate kinase activity

may also play a role in the anti-

gluconeogenic action of brazilinv (You EJ

et al., 2005)

29. Kuruntaka Barleria

prionitis Linn

Kushtha,

Vatarakta,

Kandu, Visha

Leaf

and root

The extract has the potential to enhance the

glucose-dependent insulin release from the

pancreatic beta cells and thereby decrease the

blood glucose level only in alloxan-induced

diabetic rats (Reema Dheer et al., 2010)

30. Kutaja Holarrhena

antidysenterica

(Linn.) Wall.

Rasa:

Katu,

Kashaya

Veerya:

Sheeta

Arsha, Atisara,

Trishna,

Kushtha

Seed It may be the potentiating the insulin effect

of plasma by increasing either the

pancreatic secretion of insulin from the

existing beta cells or by its release from the

bound insulin (ManaSupriya et al., 2010)

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31. Madana Catunaregam

spinosa

(Thunb.)

Tirveng.

Rasa:

Madhura,

Tikta

Veerya:

Ushna

Vidradhi,

Pratishyaya,

Vrana,

Kushtha,

Shotha,

Gulma, Vrana

Fruit Exhibit hypoglycemic activity by

stimulating insulin secretion (Mishra Piyush

Ranjan et al., 2012)

32. Meshashringi Gymnema

sylvestre B. Br.

Rasa:

Tikta,

Vipaka:

Katu

Kushtha,

Meha, Krimi,

Vrana, Visha,

Shoola

Leaves It not only produces blood glucose

homeostasis but also increased the activities

of the enzymes affording the utilization of

glucose by insulin dependent pathways

(K.R. Shanmugasundaram et al., 1983)

33. Moorva Marsdenia

tenacissima

Wight & Arn.

Rasa:

Madhura,

Tikta

Meha,

Hridroga,

Kandu,

Kushtha,

Jwara

Root M. tenacissima has been evaluated by using

in vitro methods namely glucose oxidase

method and o-toluidine method (Nayak

Arabinda, 2014)

34. Mushkaka Schrebera

swientenioides

Roxb.

Medahara,

Grahi; Gulma,

Visha, Kandu,

Bastiroga,

Krimi

Fruit S. swietenioides and Glibenclamide

exhibited remarkable blood glucose

lowering effect in glucose tolerance test.

This indicates that the extract has capacity

to block glucose absorption (Rajkumar S.

Bagali et al., 2010)

35. Nimba Azadirachta

indica A. Juss.

Rasa:

Tikta

Vipaka:

Katu

Veerya:

Ushna

Kushtha,

Chardi,

Aruchi, Kasa,

Shwasa,

Krimi, Meha,

Arsha

Leaves,

oil

A significant hypoglycaemic effect was also

observed by feeding neem oil to fasting

rabbits. Recently, hypoglycemic effect was

observed with leaf extract and seed oil, in

normal as well as alloxan-induced diabetic

rabbits (Kausik Biswas et al., 2002)

36. Palasha Butea

monosperma

(Lam.) Taub

Rasa:

Kashaya,

Katu,

Tikta

Veerya:

Ushna

Grahani,

Arsha, Krimi,

Gudaroga,

Meha, Kushtha

– Yet to be evaluated

37. Patala Stereospermum

suaveolens DC

Rasa:

Kashaya,

Tikta

Veerya:

anushna

Aruchi,

Shwasa,

Shotha,

Chardi, Hikka,

Trishna

– Yet to be evaluated.

38. Patha Cissampelos

pareira Linn.

Rasa:

Katu

Veerya:

Ushna

Kushtha,

Atisara,

Hridroga,

Daha, Kandu,

Krimi, Gulma

Leaves This study unveils that the decrease in blood

glucose level may be attributed to the

stimulation of glucose uptake by peripheral

tissues and/or decrease in the

gluconeogenesis (Yadav Kuldeep Singh et

al., 2013)

39. Patola Trichosanthes

dioica Roxb

Rasa:

Tikta

Veerya:

Ushna

Kasa, Jwara,

Krimi

Unripe

fruit

It is able to decrease blood sugar level by

increasing the pancreatic secretion of

insulin from beta cells (Prashant Kumar Rai

et al., 2013)

40. Pootika Holoptelea

integrifolia

Planch

Rasa:

Tikta,

Katu

Veerya:

Ushna

Arsha, Krimi,

Prameha

Leaves H.integrifolia works by inhibiting ATP-

sensitive potassium channels in pancreatic

beta cells. This inhibition causes cell

membrane depolarization, which causes

voltage-dependent calcium channels to

open, which causes an increase in

intracellular calcium in the beta cell, which

stimulates insulin release (Sharma Sonu et

al., 2009)

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41. Rajani Coscinium

fenestratum

Colebr. or

Rubia

cordifolia

Rasa:

Katu,

Tikta

Veerya:

Ushna

Visha, Shotha,

Kushtha,

Visarpa,

Vrana, Meha,

Raktatisara

Root Alcoholic extract of R. cordifolia

(100,200,400mg/kg) significantly decreased

blood glucose level by increasing plasma

corticoids level (Patil Rupali et al., 2006)

42. Salasara Shorea robusta

Gaertn. f.

Rasa:

Kashya

Vrana, Sweda,

Krimi,

Bradhna,

Vidradhi, Karnabadhirya

– Yet to be evaluated.

43. Saptaparna Alstonia

scholaris R. Br.

Rasa:

Kashaya

Veerya:

Ushna

Kushtha,

Krimi,

Shwasa,

Gulma

Leaves,

bark

It produced a highly significant decrease in

blood glucose and a mechanism of this

action was upon insulin triggering and

direct insulin-like effects (B Deepti et al.,

2011)

44. Sariva Hemidesmus

indicus (L.) R.

Br.

Rasa:

madhura

Veerya:

Ushna

Aruchi,

Shwasa, Kasa,

Visha,

Pradara,

Jwara, Atisara

Root It acts by decreasing lipid peroxidation

index by antioxidant activity (Mahalingam

Gayathri et al., 2008)

45. Shaka Tectona

grandis Linn. f.

Raktaprasadana Root The effect may be due to presence of

flavonoid compound is reported to promote

regeneration of β cells (Pooja et al., 2011).

46. Shangreshta (Kakajangha)

Peristrophe

bicalyculata

Nees

Jwara, Krimi,

Kandu, Vrana,

Visha

– Yet to be evaluated

47. Shatavari Asparagus

racemosus

willd

Rasa:

Madhura,

Tikta

Veerya:

Sheeta

Grahani,

Arsha,Shotha

Root It acts by inhibition of carbohydrate

digestion and absorption, together with

enhancement of insulin secretion and action

in the peripheral tissue (Hannan JM et al.,

2012).

48. Shimshapa Dalbergia

sissoo Roxb ex

DC.

Rasa:

Katu,

Tikta,

Kashaya

Veerya:

Ushna

Shosha,

Kushtha,

Shwitra,

Chardi, Krimi,

Bastiroga,

Vrana, Daha

Leaves By providing a regenerative modification ag

ainst damage caused by alloxan to

endocrine cells of the pancreas (Niranjan

Pankaj Singh et al., 2010).

49. Shirisha Albizia lebbeck

(Linn.) Willd

Rasa:

Madhura,

Tikta,

Kashaya

Veerya:

Ushna

Shotha,

Visarpa, Kasa,

Vrana

Bark Effect may be due to by promoting the

insulin release from the undestroyed β-cells

or its action may be insulin like (Digbijay

Kumar et al., 2013)

50. Sushavi (karavellaka)

Momordica

charantia Linn.

Rasa:

Tikta

Veerya:

Sheeta

Jwara, Pandu,

Meha, Krimi

Fruit M.charantia protects pancreatic β-cells

through down-regulation of MAPKs and

NF-κB in MIN6N8 cells.

These include insulin secretagogue like

effect, stimulation of skeletal muscle and

peripheral cell glucose utilization, inhibition

of intestinal glucose uptake, inhibition of

adipocyte differentiation, suppression of

key gluconeogenic enzymes, stimulation of

key enzymes, HMP pathway and

preservation of pancreatic islet cells and

their functions (Baby Joseph et al., 2013)

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51. Tala Borassus

flabellifer Linn.

Rasa:

Madhura

Veerya:

Sheeta

Shukrala,

Madakara

Flower Attributed due to the potentiation of the

insulin effect of plasma by increasing the

pancreatic secretion of insulin from existing

β cells or its release from bound insulin

(Goyal Pradeep et al., 2014).

52. Tinisha Ougeinia

dalbergioides

Benth

Rasa:

Kashaya

Meda,

Kushtha,

Meha,

Shwitra, Daha,

Vrana, Krimi

- Yet to be evaluated.

53. Trikantaka Tribulus

terrestris Linn.

Rasa:

Tikta,

Madhura

Veerya:

Sheeta

Ashmari,

Prameha,

Shwasa, Kasa,

Hridroga

- Yet to be evaluated.

54. Vajravriksha (Snuhi)

Euphorbia

neriifolia auct.

Non Linn.

Rasa:

Katu

Veerya:

Ushna

Shoola,

Gulma, Udara,

Kushtha,

Unmada,

Medaroga,

Vrana, Visha,

Arsha

- Yet to be evaluated.

55. Vidari Pueraria

tuberosa DC.

Rasa:

Madhura

Veerya:

Sheeta

Shukrala,

Mutrala,

Jivaniya,

Rasayana

- Yet to be evaluated.

Mineral

1. Krishna-

loha

Iron Rasa: Tikta,

Madhura

Veerya:

Sheeta

Kshaya, Kushtha,

Gulma, Pleeha,

Meda, Meha,

Shwasa

- Yet to be evaluated

2. Lohamala (Mandoora)

Rust Rasa: Tikta,

Madhura

Veerya:

Sheeta

Pandu, Kamala,

Halimaka, Shosha

- Yet to be evaluated

3. Rajata Silver Rasa:

Kashaya

Vipaka:

Madhura

Veerya:

Sheeta

Hridya, Balya’

Daha, Trishna,

shosha, Jwara,

Prameha, Visha

- Yet to be evaluated

4. Seesa Lead Prameha, Grahani,

Vrana

Graded doses of Naga bhasma (100 and

200mg/kg) were administered orally with

suspension of milk using oral feeding

needle to control and experimental diabetic

rats. Treatment with Naga bhasma showed

no change in blood glucose level in normal

rats but normalized the impaired glucose

tolerance and alloxan-induced

hyperglycemia on long-term treatment

(Deshmukh Smita M et al., 2013).

5. Suvarna Gold Rasa:

Madhura,

Tikta,

Kashaya

Veerya:

Sheeta

Unmada, Apsmara,

Hridvepana, Kasa,

Shwasa, Atisara,

Grahani

- Yet to be evaluated.

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6. Tamra Copper Rasa:

Kashaya,

Madhura

Veerya:

Ushna

Kushtha, Krimi,

Kasa, Shwasa,

Kshaya, Sthaulya,

Grahani, Udara

- Yet to be evaluated

7. Trapu Tin Rasa:

Veerya:

Ushna

Medahara, Vrishya,

Balya; Prameha,

Vrana, Kshaya,

Kasa, Shwasa

Graded dose of Vanga Bhasma (25 and

50 mg/kg) were administered

intragastrically to normal and experimental

rats. Vanga bhasma treatment did not

influence the blood glucose level in normal

rats but normalized the impaired glucose

tolerance on long term treatment (Soni

Chandan et al., 2011)

DISCUSSION

Among 55 herbal drugs of ganas, in total 42

drugs had been screened for their anti-diabetic

activity. Still 13 drugs i.e. Tinisha, Gokshura,

Snuhi, Vidari, Kakajangha, Salasara, Patala,

Palasha, Vikankata, Kadara, Dasikurunta,

Bhoorja, Ajakarna are yet to be evaluated for

their anti-diabetic activity. Among mineral

drugs only two drugs i.e. Naga (Lead) and

Vanga (Tin) do possess anti-diabetic activity.

Analysis of these 62 drugs through various

lexicons showed that in total 23 drugs has

Mehahara activity. Among them 19 are herbal

and 4 are mineral in origin. Acharya Sushruta

had mentioned simple recipes in the

management of 20 types of Prameha. In total

43 drugs are enlisted in its management. After

comparing these two groups (Group of drugs

incorporated by Sushruta for the management

of 20 Prameha and another group of drugs

drawn from therapeutic classification), there

are 20 drugs common to both the groups. They

are Aguru, Amalaki, Aragvadha, Vibhitaka,

Chandana, Chitraka, Guduchi, Haritaki,

Kadara, Karanja, Khadira, Kramuka, Kutaja,

Moorva, Nimba, Palasha, Patha, Saptaparna,

Shimshapa, and Shirisha. Sushruta developed a

broad spectrum pramehahara formulation

consisting of Amalaki juice and Haridra mixed

with honey (Sushrutachikitsa11/8) (Trikamaji

Yadavaji, 2008). Based on this observation

Vagbhata included Dhatri (Amalaki) and Nisha

(Haridra) in the list of prime drugs

(Agryaushadhi) for the management of

Prameha (Vagbhata Uttara 40/48) (Paradakar

Hari Shashtri, 2010).

The person who get indulges constantly in

day sleep, absence of physical activities and

laziness, consumes foods and drinks which are

cold, unctuous and sweet etc. should be

understood as prone to Prameha. In such a

person, vitiated Vata, Pitta and Kapha dosha

(Bio-humours), when get mixed with Meda

dhatu (adipose tissue) travel downward along

with channels of urine and get localized in the

the urinary bladder and begin to flow out

through urine and give rise to Prameha.

(Sushruta Nidan 6/4, pp) (Trikamaji Yadavaji,

2008). In prameha, all three doshas and

dushyas like Meda, Rakta (Blood), Shukra

(Semen), Ambu, Vasa (Muscle fat), Lasika

(Lymph), Majja (Bone marrow), Rasa, Ojas

and Mamsa (Muscle) are responsible for the

pathogenesis. (Charaka Chikitsa 6/8,pp).

The drugs used for the management of the

20 types of Prameha should be of Katu

(Pungent), Tikta (Bitter) and Kashaya

(Astringent) Rasa; Katu Vipaka (Bio-

transformation) and Ushna Veerya (Hot

potency) and should have Laghu (easy to

digest), Ruksha (Rough), Vishada (Clear) etc.

gunas, so that they can alleviate the vitiated

Kapha dosha and dushya.

Majority of the drugs mentioned above are

having Katu, Tikta, Kashaya Rasa; Ushna

Veerya; Laghu, Ruksha guna which can able to

Global J Res. Med. Plants & Indigen. Med. | Volume 4, Issue 6 | June 2015 | 111–124

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alleviate vitiated doshas and dushyas of

Prameha

The above mentioned drugs act through

different mode of action. Some of them act by

increasing activity of pancreatic cells,

increasing insulin sensitivity, exhibiting insulin

like activity, maintaining glucose homeostasis

(increase of peripheral utilization of glucose,

increasing synthesis of hepatic glycogen or

decrease in gluconeogenolysis), inhibiting the

intestinal glucose absorption, reducing

glycemic index of carbohydrate, reducing the

effect of glutathione, increasing glucose uptake

of adipocytes, enhancing glucose uptake by

skeletal muscles, decreasing insulin resistance,

increasing glycogen storage, reducing lactate

dehydrogenase, increasing activity of enzymes

for utilization of glucose, and inhibiting

carbohydrate digestion.

Majority of drugs may act by increasing

insulin secretion or as insulinmimmetics. E.g.

Aragvadha, Vibhitaka, Gopaghanta,

Gridhranakhi, Haritaki, Karanja, Khadira,

Kiratatikta, Kuruntaka, Kutaja, Madana,

Patola, Chirabilva, Shatavari, Shirisha,

Karavellaka, Tala. Some drugs like Arjuna,

Latakaranja, Mushkaka, Karavellaka, Shaka,

Shimshapamay produce their action by

inhibiting glucose absorption from intestine and

regenerating beta cells of Langerhans.

Out of 78 drugs (a combined list of

Ganadravyas and drugs mentioned for 20 types

of Pramehas), ten drugs are selected to

formulate Mehahara dashemani based on its

significant anti-diabetic and antihyperglycemic

activities reported during recent research

studies. The drugs included in Mehahara

dashemani are Haritaki, Amalaki, Vibhitaki,

Guduchi, Haridra, Kiratatikta, Karavellaka,

Asana, Meshashringi, and Shatavari.

CONCLUSION:

Acharya sushruta had mentioned various

groups of drugs for different disease conditions

in his therapeutic classification. There are in

total 62 drugs are mentioned for Mehahara

activity among them 55 are of herbal origin and

7 are mineral in origin. Majority of drugs are

screened for their anti-diabetic, hypoglycemic

or anti-hyperglycemic activity. Vataja Prameha

is not curable, due to contradiction in the

treatment by Dosha and Dushya. Therefore, a

lifelong treatment has to be taken for the

palliation of disease. The need of an hour is to

generate a potent herbal origin formulation

with fewer side effects on its prolonged use. A

potent broad spectrum formulation, Mehahara

Dashemani, (Consisting of Haritaki, Amalaki,

Bibhitaki, Guduchi, Haridra, Kiratatikta,

Karavellaka, Asana, Meshashringi, and

Shatavari) can be used as palliative treatment

for all types of Prameha to reduce the side

effects of prolonged use of synthetic anti-

diabetic drugs as well as to improve the life

span of the patients.

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Source of Support: NIL Conflict of Interest: None Declared