A review of Ayurvedic alcoholic fermentation products used in Prameha Chikitsa

Ayurveda, one of the oldest medical systems, has long recognized diabetes (Prameha) as a significant health concern. This is evident from ancient texts, particularly the Charaka Samhita, where Nidana Sthana (Chapter 4) and Chikitsa Sthana (Chapter 6) provide detailed discussions on its etiology, classification, and treatment. These classical references highlight the historical understanding of diabetes and its management within the Ayurvedic framework. The primary cause of diabetes (Prameha) is an excess of Kaphadosha in the body, which leads to an imbalance in the dhatus (tissues) and upadhatus (sub-tissues). Diabetes (Prameha) presents a significant treatment challenge, as drug therapy must be individualized based on a patient’s body constitution and the stage of disease progression. While numerous antidiabetic medications are currently in use, the steady increase in diabetes prevalence over the years suggests the need for a more refined and innovative treatment approach through the development of novel therapeutic agents. Alcoholic fermented decoctions (Madyajanak Sandhana Kalpana) a process involving controlled alcohol formation within medicinally permissible limits, have been widely recommended in Ayurveda for managing complex diseases. These formulations continue to play a crucial role in Ayurvedic medical practice today. A critical analysis of the broad therapeutic potential of fermented decoctions has led to the hypothesis that they may hold promise in the management of Prameha. Given that diabetes (Prameha) has been recognized as a leading cause of mortality among non-communicable diseases, there is an urgent need to explore novel remedies that not only alleviate symptoms but also modify the disease progression and its harmful effects, offering a more comprehensive and effective approach to diabetes management.