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While treating ''santarpanajanya vyadhis'' like ''sthulata'' (obesity) and ''madhumeha'' (diabetes), consumption of ''dravyas'' that have ''guru'' and ''ruksha'' properties is advised. Along with medicines, the diet must also be ''ruksha''. For skin ailments, applying powders of medicinal plants all over the body which can provide relief from ''kandu'' (itching) and ''kotha'' (pre-gangrenous condition) are advised. So the food must be ''guru'' and ''apatarpaka'', i.e., it should induce catabolic activities. Applying these powders on the lesions may improve blood circulation which may consequently improve the increased hydroxylysine and glucose disaccharide content, decrease in proteoglycan and heparin sulfate and decrease in lysine content towards the lesion. The effects of honey, a food rich in antioxidants, on diseases such as cancer, coronary diseases, inflammatory disorders, and aging, has helped it gain lot of attention among nutritionists<ref> Jaganathan et al. Antiproliferative Effects of Honey and of Its Polyphenols: A Review. 2009 Journal of Biomedicine and Biotechnology. Article ID 830616</ref>.  Properties of honey are ''ruksha, guru,'' and ''kashaya''. Food and medicine having these properties enhance ''akasha'' and ''vayu mahabhuta'' which tends the person towards ''apatarpana''.  

While treating ''santarpanajanya vyadhis'' like ''sthulata'' (obesity) and ''madhumeha'' (diabetes), consumption of ''dravyas'' that have ''guru'' and ''ruksha'' properties is advised. Along with medicines, the diet must also be ''ruksha''. For skin ailments, applying powders of medicinal plants all over the body which can provide relief from ''kandu'' (itching) and ''kotha'' (pre-gangrenous condition) are advised. So the food must be ''guru'' and ''apatarpaka'', i.e., it should induce catabolic activities. Applying these powders on the lesions may improve blood circulation which may consequently improve the increased hydroxylysine and glucose disaccharide content, decrease in proteoglycan and heparin sulfate and decrease in lysine content towards the lesion. The effects of honey, a food rich in antioxidants, on diseases such as cancer, coronary diseases, inflammatory disorders, and aging, has helped it gain lot of attention among nutritionists<ref> Jaganathan et al. Antiproliferative Effects of Honey and of Its Polyphenols: A Review. 2009 Journal of Biomedicine and Biotechnology. Article ID 830616</ref>.  Properties of honey are ''ruksha, guru,'' and ''kashaya''. Food and medicine having these properties enhance ''akasha'' and ''vayu mahabhuta'' which tends the person towards ''apatarpana''.  

Since ''ruksha dravyas'' are ''akasha'' and ''vayu'' dominant, medicines and food articles of this property are advised. Of the three properties of honey, the most important one is ''guru''. Since ''jatharagni'' is vitiated in obesity (since agni plays an important role in causing or aggravating anabolic disorders), ''guru'' and ''ruksha'' substances are used to pacify it, and thus honey is recommended for obesity. However, the use of honey in diabetes is controversial since honey is full of fructose and it imparts hyperglycaemic properties on diabetic patients. In diseases like obesity, lipid abnormality and diabetes mellitus, gut microbiota plays an important role in carbohydrate metabolism.  

Since ''ruksha dravyas'' are [[akasha]] and [[vayu]] dominant, medicines and food articles of this property are advised. Of the three properties of honey, the most important one is ''guru''. Since ''jatharagni'' is vitiated in obesity (since [[agni]] plays an important role in causing or aggravating anabolic disorders), ''guru'' and ''ruksha'' substances are used to pacify it, and thus honey is recommended for obesity. However, the use of honey in diabetes is controversial since honey is full of fructose and it imparts hyperglycaemic properties on diabetic patients. In diseases like obesity, lipid abnormality and diabetes mellitus, gut microbiota plays an important role in carbohydrate metabolism.  

Pericarp of ''haritaki'' showed cardiotonic activities in frog hearts, increasing the force of contraction and cardiac output without altering the heart rate<ref> Reddy VRC, Kumari SVR, Reddy BM, Azeem MA, Prabhkar MC, Rao AVN (1990) Cardionic activity of the fruits of Terminalia chebula. Fitotera- pia 41, 517-52 </ref>. ''Haritaki'' extracts administered before initiating any treatment showed signs of reduced myocardial damage caused by isoproterenol in rats. ''Haritaki'' reduced lipid peroxidation and significantly reduced cholesterolemia, aortic sudanophilia, and cholesterol content of the aorta and liver<ref> The Ayurvedic medicines Haritaki, Amala and Bahira reduce cholesterol-induced atherosclerosis in rabbits. Int J Cardiol. 1988 Nov;21(2):167-75.Thakur CP, Thakur B, Singh S, Sinha PK, Sinha SK.Patna Medical College, India. </ref>.  

Pericarp of ''haritaki'' showed cardiotonic activities in frog hearts, increasing the force of contraction and cardiac output without altering the heart rate<ref> Reddy VRC, Kumari SVR, Reddy BM, Azeem MA, Prabhkar MC, Rao AVN (1990) Cardionic activity of the fruits of Terminalia chebula. Fitotera- pia 41, 517-52 </ref>. ''Haritaki'' extracts administered before initiating any treatment showed signs of reduced myocardial damage caused by isoproterenol in rats. ''Haritaki'' reduced lipid peroxidation and significantly reduced cholesterolemia, aortic sudanophilia, and cholesterol content of the aorta and liver<ref> The Ayurvedic medicines Haritaki, Amala and Bahira reduce cholesterol-induced atherosclerosis in rabbits. Int J Cardiol. 1988 Nov;21(2):167-75.Thakur CP, Thakur B, Singh S, Sinha PK, Sinha SK.Patna Medical College, India. </ref>.  

    

    

Local application by rubbing of certain herbal powders on the skin reduces ''kapha dosha'' and regulates ''vata dosha'' at that level and inhibits samprapti of ''kandu'' and ''kotha''. Regular rubbing of the powders over the skin increases peripheral circulation of the capillaries supplying the skin and also reduced inflammation at dermal level. Rubbing of dry powders over the body is called ''udvartana''. This softens the skin leaving it with a lustrous glow. The stimulating massage helps revitalize skin, removes fat deposits and improve circulation and digestion. ''Udvartana'' helps open the circulatory channels, facilitating metabolic activities, eliminating excessive perspiration and body odor and improving the complexion of the skin.   

Local application by rubbing of certain herbal powders on the skin reduces [[kapha dosha]] and regulates [[vata dosha]] at that level and inhibits samprapti of ''kandu'' and ''kotha''. Regular rubbing of the powders over the skin increases peripheral circulation of the capillaries supplying the skin and also reduced inflammation at dermal level. Rubbing of dry powders over the body is called ''udvartana''. This softens the skin leaving it with a lustrous glow. The stimulating massage helps revitalize skin, removes fat deposits and improve circulation and digestion. ''Udvartana'' helps open the circulatory channels, facilitating metabolic activities, eliminating excessive perspiration and body odor and improving the complexion of the skin.   

   

   

'''''Triphala''''' is one of the oldest used polyherbal preparations. It is comprised of Terminalia chebula, Terminalia bellerica and Emblica officinalis. Some of the positive qualities of ''triphala'' in-vivo and in-vitro are that it is an antioxidant, anti-hypercholesterolemic, anti-diabetic, anti-obesity, and possesses chemo-preventive potential and anti-mutagenic activities, anti-inflammatory, antimicrobial, radioprotective effect, immunomodulatory, improving wound healing, enteroprotective efficacies, anti-gastric ulcers and nitric oxide scavenging properties. This herbal combination can have profound healing benefits in multi-organ systems.  It is rich in Mg, K, Ca, Fe, Se and Zn, which enhance their bioavailability. Low molecular weight tannins, gallic acid and other important phytochemicals are responsible for the above effects <ref> A systematic review of the antioxidant, anti-diabetic, and anti-obesity effects and safety of triphala herbal formulation Kamali Seyed Hamid et al Journal of Medicinal Plants Research Vol. 7(14), pp. 831-844, 10 April, 2013  DOI: 10.5897/JMPR12.352  ISSN 1996-0875 ©2013 Academic Journals  http://www.academicjournals.org/JMPR  </ref>.   

'''''Triphala''''' is one of the oldest used polyherbal preparations. It is comprised of Terminalia chebula, Terminalia bellerica and Emblica officinalis. Some of the positive qualities of ''triphala'' in-vivo and in-vitro are that it is an antioxidant, anti-hypercholesterolemic, anti-diabetic, anti-obesity, and possesses chemo-preventive potential and anti-mutagenic activities, anti-inflammatory, antimicrobial, radioprotective effect, immunomodulatory, improving wound healing, enteroprotective efficacies, anti-gastric ulcers and nitric oxide scavenging properties. This herbal combination can have profound healing benefits in multi-organ systems.  It is rich in Mg, K, Ca, Fe, Se and Zn, which enhance their bioavailability. Low molecular weight tannins, gallic acid and other important phytochemicals are responsible for the above effects <ref> A systematic review of the antioxidant, anti-diabetic, and anti-obesity effects and safety of triphala herbal formulation Kamali Seyed Hamid et al Journal of Medicinal Plants Research Vol. 7(14), pp. 831-844, 10 April, 2013  DOI: 10.5897/JMPR12.352  ISSN 1996-0875 ©2013 Academic Journals  http://www.academicjournals.org/JMPR  </ref>.   

Cyperus rotundus has antioxidant and anti-atherosclerotic effects due to the presence of flavanoids, polyphenols and terpenes which reduce absorption of total cholesterol and triglycerides. Cyperus rotundus, in the form of a fine powder or an aqueous solution, exhibits lipolytic properties and showed mobilization of fats from adipose tissues. Cyperus rotundus is supposed to have activators of beta adreno receptors<ref> Bhambhole V.d.et al Effect of some medicinal plant preparation on adipose tissue metabolism. Ancient Science of life 1998 117-124 </ref>.   

Cyperus rotundus has antioxidant and anti-atherosclerotic effects due to the presence of flavanoids, polyphenols and terpenes which reduce absorption of total cholesterol and triglycerides. Cyperus rotundus, in the form of a fine powder or an aqueous solution, exhibits lipolytic properties and showed mobilization of fats from adipose tissues. Cyperus rotundus is supposed to have activators of beta adreno receptors<ref> Bhambhole V.d.et al Effect of some medicinal plant preparation on adipose tissue metabolism. Ancient Science of life 1998 117-124 </ref>.   

'''''Madanaphala''''' (Randia dumentorum) has ''madhura, tikta rasa, katu vipaka'' and ''ushna veerya''. It is a widely used herb for induction of vomiting used for ''vamana'' procedure. It has ''lekhana'' properties.

'''''Madanaphala''''' (Randia dumentorum) has ''madhura, tikta rasa, katu vipaka'' and ''ushna veerya''. It is a widely used herb for induction of vomiting used for [[vamana]] procedure. It has ''lekhana'' properties.

Clearly, the pharmacological action of the above ''dravyas'' all have been proven to have anti-diabetic and anti-hyperlipidimic properties. The interesting thing to note is that although these ''dravyas'' ultimately work for metabolic disorders, they have different modes of action. Anti-diabetic properties of ''triphala, neem, musta'' and ''saptaparna'' are different. The ''rasa'' of the above mentioned ''dravyas'' is ''tikta kasahaya'' or ''tikta katu'' which is ''akasha, teja'' and ''vayu mahabhuta'' dominant. As we have seen that ''santarpaniya vyadhis'' are due to excess consumption of ''prithvi'' and ''apa mahabhuta,'' those of opposing properties, i.e., ''akasha, teja and vayu'' are used in treating such ailments.  

Clearly, the pharmacological action of the above ''dravyas'' all have been proven to have anti-diabetic and anti-hyperlipidimic properties. The interesting thing to note is that although these ''dravyas'' ultimately work for metabolic disorders, they have different modes of action. Anti-diabetic properties of ''triphala, neem, musta'' and ''saptaparna'' are different. The ''rasa'' of the above mentioned ''dravyas'' is ''tikta kasahaya'' or ''tikta katu'' which is [[akasha]], [[teja]] and [[vayu mahabhuta]] dominant. As we have seen that ''santarpaniya vyadhis'' are due to excess consumption of [[Prithvi]] and [[jala mahabhuta]] those of opposing properties, i.e., [[akasha]], [[teja]] and [[vayu]] are used in treating such ailments.  

'''''Devadaru''''' (Cedrus deodara or Himalayan Cedar) is a herb that is very effective in improving the functions of liver and in maintaining cholesterol levels in healthy limits. ''Devadaru'' pacifies the ''kapha dosha'' by ''tikta, katu'' and ''ushna'' properties, and ''vata dosha'' by ''snigdha'' and ''ushna'' properties so it is useful in disorders induced by ''kapha'' and ''vata doshas''.

'''''Devadaru''''' (Cedrus deodara or Himalayan Cedar) is a herb that is very effective in improving the functions of liver and in maintaining cholesterol levels in healthy limits. ''Devadaru'' pacifies the ''kapha dosha'' by ''tikta, katu'' and ''ushna'' properties, and [[vata]] [[dosha]] by ''snigdha'' and ''ushna'' properties so it is useful in disorders induced by [[kapha]] and [[vata]] [[dosha]].

Investigation demonstrate that extracts of C. deodara shows reduction in body weight in treated groups in a dose dependent manner. The major chemical constituents of C. deodara are sterols, poly-phenols, flavanoids such as taxifolin, quercetin and saponins<ref> Agarwal PK, Agarwal SK, Rastogi RP. A new neolignan and other phenolic constituents from Cedrus deodara. Phytochemistry. 1980;19:1260–1.</ref>. It is well established that saponins are useful in treatment of obesity<ref> George Francis, Zohar Kerem, Harinder P.S. Makkar, Becker Klaus. The biological action of saponin in animal systems: A review. Brit J Nutr. 2002;88:587–605. [PubMed] </ref>. Phytosterols have beneficial effects on hyperlipidemia<ref> David JA, Cyril WC. Plant sterols, health claims and strategies to reduce cardiovascular disease risk.J Am Coll Nutr. 1999;18:559–62.  </ref> and poly-phenols and flavanoids have potential antioxidant properties. Therefore, it could be possible that presence of these compounds is responsible for observed glucose and lipid lowering properties.

Investigation demonstrate that extracts of C. deodara shows reduction in body weight in treated groups in a dose dependent manner. The major chemical constituents of C. deodara are sterols, poly-phenols, flavanoids such as taxifolin, quercetin and saponins<ref> Agarwal PK, Agarwal SK, Rastogi RP. A new neolignan and other phenolic constituents from Cedrus deodara. Phytochemistry. 1980;19:1260–1.</ref>. It is well established that saponins are useful in treatment of obesity<ref> George Francis, Zohar Kerem, Harinder P.S. Makkar, Becker Klaus. The biological action of saponin in animal systems: A review. Brit J Nutr. 2002;88:587–605. [PubMed] </ref>. Phytosterols have beneficial effects on hyperlipidemia<ref> David JA, Cyril WC. Plant sterols, health claims and strategies to reduce cardiovascular disease risk.J Am Coll Nutr. 1999;18:559–62.  </ref> and poly-phenols and flavanoids have potential antioxidant properties. Therefore, it could be possible that presence of these compounds is responsible for observed glucose and lipid lowering properties.

Above are all the important reasons why ''sattu'' is recommended as one of the important food in ''santarpaniya vyadhi''.

Above are all the important reasons why ''sattu'' is recommended as one of the important food in ''santarpaniya vyadhi''.

Those individuals who consume these type of formulations can have normalization of ''agni, smriti'' (memory) and ''buddhi'', that is the power of forming and retaining concepts and general notions, intelligence, reason, intellect, discernment, judgment which gets deranged in ''santarpaniya vyadhis'' in latter stages gets normalised.

Those individuals who consume these type of formulations can have normalization of [[agni]], [[smriti]] (memory) and [[buddhi]], that is the power of forming and retaining concepts and general notions, intelligence, reason, intellect, discernment, judgment which gets deranged in ''santarpaniya vyadhis'' in latter stages gets normalised.

Those individuals who exercise regularly, who do not eat until the previous meals are completely digested, who do not indulge in overeating, who regularly consume barley and wheat in diet get relief from all the diseases due to ''santarpana'' and obesity. This is how all the ''santarpanjanya vyadhis'' are treated with ''apatarpana'' medicines.  

Those individuals who exercise regularly, who do not eat until the previous meals are completely digested, who do not indulge in overeating, who regularly consume barley and wheat in diet get relief from all the diseases due to ''santarpana'' and obesity. This is how all the ''santarpanjanya vyadhis'' are treated with ''apatarpana'' medicines.  

If we observe the herbs mentioned in the management of ''santarpaniya vyadhis'' it is evident from the following table that most of the herbs are ''tikta, katu, kashaya rasa'' dominant having ''katu vipaka'' and ''ushna veerya''. These properties are attributed to ''akash'' and ''vayu mahabhuta''.   

If we observe the herbs mentioned in the management of ''santarpaniya vyadhis'' it is evident from the following table that most of the herbs are ''tikta, katu, kashaya rasa'' dominant having ''katu vipaka'' and ''ushna veerya''. These properties are attributed to [[akasha]] and [[vayu]] [[mahabhuta]].   

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