Ayurvedic Management of Kaphaja Prameha Through Rutu Shodhana With Reference to Anusangitva – A Case Study

Prameha is a chronic metabolic disorder described in Ayurvedic classics in which derangement of Dosha, Dushya, Agni and Kleda plays an important role in its pathogenesis. Among the various types, Kaphaja Prameha is predominantly associated with Bahudrava Kapha, Meda, Mamsa and Kleda Dushti and is particularly related to sedentary lifestyle and excessive intake of Guru, Snigdha and Madhura Ahara. Although Kaphaja Prameha is considered Sadhya, its tendency for recurrence or Anusangitva makes long-term management challenging. Ayurveda emphasizes repeated and appropriately timed Shodhana according to Dosha predominance and seasonal variation. The present case study was undertaken to assess the role of Rutu Shodhana in the management of Kaphaja Prameha with special reference to Anusangitva. A 45-year-old male patient presented with Prabhuta Mutrata for six months, increased sweating for two months, decreased appetite for two months and generalized weakness for one month. Patient was newly diagnosed case of prameh and was not on any OHA. On investigation, fasting blood sugar was 150 mg/dl, post-prandial blood sugar was 180 mg/dl and HbA1c was 8.1%. Based on Nidana, Lakshana, Dosha-Dushya involvement and Samprapti, the case was diagnosed as Kaphaja Prameha. Sequential seasonal Shodhana was planned according to the predominance of Dosha. Vamana Karma was performed in March 2024, followed by internal medication. Basti Karma was administered in July 2024. Virechana Karma was performed in November 2024. The patient subsequently received supportive Ayurvedic formulations and was followed up clinically. Following the sequential Shodhana approach, fasting blood sugar decreased from 150 mg/dl to 99 mg/dl, post-prandial blood sugar from 180 mg/dl to 136 mg/dl and HbA1c from 8.1% to 6.4%. The sequential seasonal elimination of aggravated Dosha may help in reducing Kleda, correcting Agni, improving metabolic function and potentially reducing the tendency towards recurrence. This case highlights the possible clinical relevance of Rutu Shodhana as a preventive and therapeutic strategy in Anusangi Kaphaja Prameha.