Asthanindita purusha.pptx

This presentation deals with description of Astanindita purusha and its correlation with hormonal disorders

1. ASTHANINDITA PURUSHA Dr Akshay Shetty Associate Professor SSRAMC & H Inchal

2. CONTENTS 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 2

3. OBJECTIVES 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 3

4. ASTHANINDITA इह खलु शरीरमधिकृत्याष्टौ पुरुषा निन्दिता भवन्ति; तद्यथा- अतिदीर्घश्च, अतिह्रस्वश्च, अतिलोमा च, अलोमा च, अतिकृष्णश्च, अतिगौरश्च, अतिस्थूलश्च, अतिकृशश्चेति||३|| Ca.Su 21 Eight types of physical abnormalities were explained by Ayurveda. People with these malformations are considered to be difficult to treat, and they are prone to a wide range of diseases. 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 4

5. Ati-hrasva (Dwarfism/ short statured/ Excessive small person) Ati-dirgha (Excessive tall person Gigantism and Acromegaly) Ati-loma (Hairy body) A-Loma (Hairless body). Ati-krishna (Tanned body) Ati - Gaur ( Albine body) Ati-sthula (Obesity) Ati - krusha (Emaciated body) 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 5

6. सततं व्याधितावेतावतिस्थूलकृशौ नरौ| सततं चोपचर्यौ हि कर्शनैर्बृंहणैरपि||१६|| स्थौल्यकार्श्ये वरं कार्श्यं समोपकरणौ हि तौ| यद्युभौ व्याधिरागच्छेत् स्थूलमेवातिपीडयेत्||१७|| Ca.Su 21 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 6

7. Among above said undesirable persons, Atisthula and Atikrisha purusha are more commonly found. Ayurveda further stated that Atisthula and Atikrisha person are more despised among all eight despised persons. These two people are more favorable to get any kind of diseases easily. Therefore they are described in details. According to Acharya Charak , people who are Atisthula are more liable to be at a health risk than Atikrisha 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 7

8. Atihriswa As the name suggests, the person suffering from this disorder has short body proportions as compared to normal. This, also does not have any treatment and is socially unacceptable. Few complications that are normally faced by ati-hrasva person are as follows- • Any work that needs strength, these people will not be able to perform it. • Due to small body proportions, these people will also not be able to consume and tolerate the teekshna virya aushadh . • Their mental and physical growth may be hindered May suffer from manda-agni . 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 8

9. Dwarfism Dwarfism is the medical terminology for short-stature. It is defined as height-vertex below two standard deviations (-2SD) or in the third percentile for a given age and sex. The standing height is measured from ground to the vertex when the head is in the Frankfurt-horizontal plane. Most people have an aversion to the term dwarf and identify themselves as "Little people" and also have a community under the name -'Little People of America' 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 9

10. Dwarfism is broadly categorized into two types based on the patient's physical appearance  Proportionate Short Stature (PSS) - means that the limbs and the trunk are proportionately small. Disproportionate Short Stature (DSS) implies that the individual has a significant difference in their sitting and standing height, and either their trunk or extremities are small 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 10

11. 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 11

12. Aetiology Familial Short Stature (FSS):  The child's genetic height potential can be measured by measuring the mid-parental height, which is a child's projected adult height based on parental height measurements. A positive family history, and the absence of underlying pathological etiologies of dwarfism, can be diagnosed as a case of familial short stature Constitutional delay of growth and puberty (CDGP):  The child presents with short height in childhood, but attain their target height until adulthood, also known as a 'late bloomer'. They even enter puberty at later ages. 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 12

13. Idiopathic Short Stature (ISS):  Short stature is said to be idiopathic when no other etiology like endocrine/metabolic can be determined. Endocrine disorders:  Growth hormone deficiency is a frequent cause of dwarfism. The hypothalamic-pituitary axis maintains the levels of growth hormones in the body, which then directly or indirectly, through Insulin-like growth factor-1 (IGF-1), stimulates bone elongation, and growth of soft tissue and cartilage. Genetic disorders : Many genetic conditions that are associated with short stature are- Down's, Turner's, Noonan's, 3-M, Prader-Willi, Russell-Silver, Aarskog , and short stature homeobox gene deficiency syndrome. Bone diseases Systemic illness 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 13

14. Atidheerga Just as the name suggests, Ati-dirgha is the disorder in which the body is over- grown as compared to normal dimensions of the body.in this over- growth the main reason is considered as vata since for growth and movement purposes in body vata is held responsible, thus such as person is also called as “ vatal pursh ” 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 14

15. Acromegaly is a rare disorder caused by excessive growth hormone production (GH), most commonly from an adenoma of the anterior pituitary gland. The resulting production of insulin-like growth factor 1 (IGF-1) causes the characteristic overgrowth of certain tissues resulting in coarsening of facial features, enlarging hands and feet, as well as effects on multiple systems throughout the body, including cardiovascular, rheumatologic, neurologic, pulmonary, neoplastic, and metabolic. 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 15

16. 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 16

17. 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 17

18. ATILOMA Ati-loma as the name suggests, a person suffering from this disorder has more body hairs( loma ) on body than normal this excess can be in many forms such as thicker than normal or presence of more than one loma from single lomakoopa . The normal amount of loma that is assumed by acharyas are three and a half crores of loma , more than this is called as atiloma . The complications faced by a person suffering from this disorder are as follows - Since loma koop are the minute openings on skin that becomes the passage for the mala “ sweda ” or sweat so that it can escape the body, now in case of ati-loma the sweat that releases cannot dry off properly and becomes sticky and thus can lead to skn disorders or bad smell etc 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 18

19. Hypertrichosis Hypertrichosis is defined as excessive hair growth anywhere on the body in either males or females. It is important to distinguish hypertrichosis from hirsutism, which is a term reserved for females who grow an excessive amount of terminal hairs in androgen-dependent sites. 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 19

20. 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 20

21. Aloma A- loma as the name suggests, this is a condition where body is devoid of hair follicles throughout the body, In this condition the person suffering has to face many complications as Due to less amount of loma on body there is low amount of loma-koopa on body as well, which results in blockages/presence of low amount of outlets for sweda , Thus creating a complication as this means that due to reduced amount of loma-koopa the sweda and thus the mala- bhaga that excretes out of body through this pathway is not able to excrete properly that can lead to various complication in body. Other than that, these loma are responsible for perception of temperature on body or any other sudden touch, thus reducing the sensing ability of sparshendriya as it is also a part of twacha ( aashraya of sparshendriya ) 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 21

22. Alopecia universalis (AU) Alopecia universalis (AU) is a condition characterized by the complete loss of hair on the scalp and body. It is an advanced form of alopecia areata , a condition that causes round patches of hair loss. Although the exact cause of AU is unknown, it is thought to be an autoimmune condition in which the person's immune system mistakenly attacks the hair follicles. 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 22

23. Atikrishna & Ati Gaura Susruta Acharya describes the formation of Garbha varna from the combination of different Panchamahabhuta . Tejo Mahabhuta + Pritvi Mahabhuta = Krishna varna Tejo Mahabhuta + Ap Mahabhuta = Gaura varna TejoMahabhuta + Pritvi Mahabhuta + Akasha Mahabhuta = Krishna Shyava Tejo Mahabhuta + Jala Mahabhuta + Akasha Mahabhuta = Gaura shyava So, any change in this permutation and combination of Mahabhuta can cause changes in garbhavarna which shows the formation of congenital, inherited, hormonal pigmentation disorders. 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 23

24. 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 24

25. Hyperpigmentation Hyperpigmentation may be localized, as in the case of post-inflammatory hyperpigmentation or melasma, or more diffuse in its presentation. Diffuse hyperpigmentation tends to be associated with metabolic causes, certain medications, malignancy, or autoimmune or infectious aetiologies 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 25

26. Albinism Albinism is a group of heritable conditions associated with decreased or absent melanin in ectoderm-derived tissues (most notably the skin, hair, and eyes), yielding a characteristic decrease in skin pigmentation. Oculocutaneous albinism (OCA) is a group of phenotypically similar genetic disorders derived from errors in melanin synthesis. As the name implies, the most dramatic effects are in the eyes and skin. To date, seven types of nonsyndromic albinism (OCA1 to OCA7) have been described. These are all due to isolated genetic mutations  04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 26

27. Atisthaulya मेदोमांसातिवृद्धत्वाच्चलस्फिगुदरस्तनः| अयथोपचयोत्साहो नरोऽतिस्थूल उच्यते||९|| Ca.Su 21 The person is considered too obese when there is an excessive increase in fat and muscle tissue in the regions of buttocks, abdomen, and breasts, which become pendulous and suffer from deficient metabolism and energy. 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 27

28. तदतिस्थौल्यमतिसम्पूरणाद्गुरुमधुरशीतस्निग्धोपयोगादव्यायामादव्यवायाद्दिवास्वप्नाद्धर्षनित्यत्वाद-चिन्तनाद्बीजस्वभावाच्चोपजायते I Ca.Su 21 Excessive obesity is caused due to over-nourishment as a consequence of the intake of a heavy, sweet, cold and fatty diet, lack of physical exercise, abstinence from sexual intercourse, sleeping during the day, uninterrupted cheerfulness, lack of mental activities, and hereditary/genetic defects 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 28

29. अतिस्थूलस्य तावदायुषो ह्रासो जवोपरोधः कृच्छ्रव्यवायता दौर्बल्यं दौर्गन्ध्यं स्वेदाबाधः क्षुदतिमात्रं पिपासातियोगश्चेतिभवन्त्यष्टौ दोषाः| Reduced lifespan, Constricted or limited movement, Reduced sexual activities or impotence Debility Emit bad smell Profuse sweating, Excessive hunger Excessive thirst 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 29

30. Obesity Obesity is a heterogeneous complex disorder of multiple etiologies characterized by excess body fat that threatens or affects socioeconomic, mental or physical health Sharma 2007 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 30

31. The international classification of overweight and obesity according to BMI as per WHO Sl.no Classification BMI(kg/m2) 1 Normal Range 18.50-24.99 2 Over weight >25.00 3 Pre-obese 25.00-29.99 4 Obese >30.00 5 Obese class 1 30.00-34.99 6 Obese class 2 35.00-39.99 7 Obese class 3 >40.0 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 31

32. Diabetes mellitus Hypertension Dyslipidaemia Coronary heart disease Heart failure Atrial fibrillation Cerebrovascular disease Respiratory disease Hepatobiliary disease Osteoarthritis Cancer Gynaecological complications Surgical & anaesthetic complications Chronic kidney disease 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 32

33. AtiKarshya शुष्कस्फिगुदरग्रीवो धमनीजालसन्ततः| त्वगस्थिशेषोऽतिकृशः स्थूलपर्वा नरो मतः||१५|| Ca.Su 21 The excessively lean person has dried up buttocks, abdomen and neck, the prominent vascular network is mostly “skin and bones” with thickened nodes 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 33

34. Nidana of Atikarshya सेवा रूक्षान्नपानानां लङ्घनं प्रमिताशनम्| क्रियातियोगः शोकश्च वेगनिद्राविनिग्रहः||११|| रूक्षस्योद्वर्तनं स्नानस्याभ्यासः प्रकृतिर्जरा| विकारानुशयः क्रोधः कुर्वन्त्यतिकृशं नरम्||१२|| Ca.Su 21 Indulgence in the intake of dry diets and drinks, fasting, intake of food in inadequate quantity, overuse of therapeutic purificatory measures, grief, suppression of natural urges, inadequate sleep or sleep deprivation, dr powder massage, indulgence in baths, heredity, old age, continued illness and anger make a person too lean. 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 34

35. Laxana of Atikarshya व्यायाममतिसौहित्यं क्षुत्पिपासामयौषधम् | कृशो न सहते तद्वदतिशीतोष्णमैथुनम्||१३|| प्लीहा कासः क्षयः श्वासो गुल्मोऽर्शांस्युदराणि च| कृशं प्रायोऽभिधावन्ति रोगाश्च ग्रहणीगताः||१४|| Ca.Su 21 The excessively lean person does not tolerate physical exercise, intake of food in large quantities, hunger, thirst, diseases, and drugs. They also cannot tolerate too much cold, heat and sexual intercourse. Such a person is often associated with splenic diseases, cough, wasting, dyspnoea, gulma , piles, abdominal disorders and disorders of grahanі . 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 35

36. Mal -nutrition Ati-krusha can be correlated to mal-nutrition as it is a condition where due to absence of essential nutrients in daily diet leads to loss of weight or this may as well be related to eating disorders as well, that depends on the condition. 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 36

37. Hyperthyroidism:  An overactive thyroid develops when your thyroid gland makes too much thyroid hormone Type I DM Irritable bowel Syndrome (IBS)/Sprue Inflammatory Bowel Disease Addison Disease Depression Tuberculosis HIV/AIDS 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 37

38. Summary 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 38

39. REFERENCES Charaka Samhita Dongre S M,Daulatkar K.A Review on the Ashtonindita , the reason they are included in Ashtonindita and their co-relation with Modern Sciences. International Journal of Indian Medicine, 2022; 3(2):28-35 Namrata Shrivastav , A SCIENTIFIC REVIEW OF ASTHANINDITA PURUSHA. World Journal of Pharmaceutical and Life Science Megha Jain; Ahmed Y. Saber , Dwarfism https://www.ncbi.nlm.nih.gov/books/NBK563282/ Oluwaseun O. Adigun;  Minhthao Nguyen;  Tamaryn J. Fox; Catherine Anastasopoulou.Acromegaly https://www.ncbi.nlm.nih.gov/books/NBK431086/ Dahlia Saleh; Siva Naga S. Yarrarapu ; Christopher Cook. Hypertrichosis https://www.ncbi.nlm.nih.gov/books/NBK534854/ Justin R. Federico; Karthik Krishnamurthy.Albinism https://www.ncbi.nlm.nih.gov/books/NBK519018/ 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 39

40. THANK YOU 04/11/2023 ASTHANINDITA PURUSHA (Dr Akshay Shetty) 40