Whats App Discussion series 31: 'Cardiomyopathy' due to excessive intake of Soda as an 'Oksatmya' by Vaidya Rangaprasad ji Bhat, Dr. Ashwini Kumar Sood, Dr. Subhash Sharma and Dr. Praveen Kumar Madokonda and others
[1/5, 18:26] S A Soni: 
C/o dilated cardiomyopathy
Pt. Had *oksatya* of *ksharatisevan* throughout his life until the signs and symptoms occurred in 2012 as per the sequence mentioned by Charak.....!
First visual symptoms followed by marked weakness and onward up to the condition of *Hridayapakartan* or cardiomyopathy.
Just the history of excessive soda intake give enough ground to make diagnosis.
Superb Acharya Agnivesh / Charak !!
३ विमानस्थानम्
१ रसविमानम्
क्षारः पुनरौष्ण्यतैक्ष्णयलाघवोपपन्नः क्लेदयत्यादौ पश्चाद्वि१शोषयति, स पचनदहनभेदनार्थमुपयुज्यते; सोऽतिप्रयुज्यमानः केशाक्षिहृदयपुंस्त्वोपघातकरः सम्पद्यते । ये ह्येनं ग्रामनगरनिगमजनपदाः सततमुपयुञ्जते त आन्ध्यषाण्ढ्यखालित्यपालित्यभा
आयुर्वेददीपिका व्याख्या
हृदयापकर्तिन इति हृदयपरिकर्तनरूपवेदना
[1/5, 18:41] pawan madan Dr:
Wonder observations.....
Thats the need of.the hour to learn for ayurveda students.
Thanks ...
[1/5, 19:21] Ashwini Kumar Sood Dr:
Deep observation 
.
Please advise relevant treatment too .
[1/5, 19:33] Vd. Dhanvantari Pancholi MD: 
[1/5, 19:36] Gururaja Bose Dr:
Nice observation.
[1/5, 19:37] S A Soni:
Simple Brinhan ojovardhan .
[1/5, 19:37] S A Soni: Dr Ashwani Ji
[1/5, 20:16] Ashwini Kumar Sood Dr:
As LVEF is 15% pt must be having severe breathlessness , orthopnea and a chronic smoker resulting in PAH might be in need of प्राणवह दुष्टि चिकित्सा।
[1/5, 20:18] S A Soni:
Yes Sir !
Rightly pointed out.
[1/5, 20:32] Dr. Hemant Kalita KC Assam:
Please enlighten me in some details of your treatment of cardiomyopathy in Ayurveda
[1/5, 20:40] S A Soni:
Treating ksharatisevan with Simple Brinhan ojovardhan ...
Not cardiomyopathy....
[1/5, 21:04] Ashwini Kumar Sood Dr:
As Soni sir has first dealt with the cause and then he has pointed out the treatment.
Similarly if one has focused on cause half of the treatment is done.
Restricted,hypertrophic, dialated , arrhythmias,diabetic cardiomyopathy are some of the known causes and rx depends on the cause.
Makardhwaj plus hridyarnav is effective in ischemic type of cardiomyopathy. Cardiomyopathy caused by valvular heart disease and others are difficult to treat in my opinion.
[1/5, 21:07] Ashwini Kumar Sood Dr:
Others opinion is welcome on different aspects of the disease as it is becoming a geriatric problem now a days.
[1/5, 21:17] Chulet Sir Nia:
हृद्य ओजस्य एवम् स्रोतो प्रसादन तीनों एक साथ परस्पर सम्पूरक ,प्राथमिक रूप से ज़रूरी होगा !
[1/5, 21:33] S A Soni:
Perfect !!
Actually I missed snap of op slip. I shall post when pt. Will come next time.
I started will opd available drugs
Ajmodadi churn chandra prabha arogyavardhini draksha siddha ksheer arjunarishta Javahar
Mohara Rasayan Arjunarishta.
[1/5, 21:36] Ashwini Kumar Sood Dr:
Very convincing rx
[1/5, 21:40] Anupma Patra AIMS AYU:
Nice observation. As per my opinion, as the nidaan sevan is kshar then amla rasa may be advised because it is having hridya property,along with hridya medicines .if there is specific manifestation of symptoms then I think proper doshic differentiations of disease may be done and treatment may be followed accordingly. Sir what may be the appropriate ayurvedic diagnosis of that disease? If hridrog ,any doshic differentiation ......?
[1/5, 21:54] Manu Vats Dr Patiala:
Very well observed reference....Hats of Sir....As per echo.....pathological damage is much more on larger extent.....and though kshar May be the core cause of disease......at this stage ischemia is very difficult to rule out as Angio may prove fatal with 15% EF......and as rightly said by Dr Sood other factors are too difficult to adress....Sir.... USG abdomen is also required to know renal liver spleen status ....low Ef leads to slow Death of all organs......So to conclude other affected damage is much more heavier on main cause I.w. kshar sevan
..
[1/5, 21:56] Manu Vats Dr Patiala:
Even some cases report suddenly increase in blood sugar due to insufficient blood supply to pancreas.
[1/6, 16:05] Praveen Medi Dr:
It's very interesting point sir.
I am keen to know which type of kshara he was habituated to ?
I am keen to know which type of kshara he was habituated to ?
[1/6, 16:19] Tapan Vaidya ADI:
All preservatives additives fertilizers chemicals extracts and taste enhancers are of kshar properties.
Why you are interested in one patient 's Kshar consumption ?
[1/6, 16:35] S A Soni:
Carbonated Beverage Soda like bagpiper etc. That he used to consume around 7 to 10 glasses a day.
It is very popular here in Gujarat.
@pravin sir
[1/6, 16:43] Praveen Medi Dr:
[1/6, 16:45] Praveen Medi Dr:
Thank you sir for indicating both vihara and Ahara aspects of kshara Sevana
.................................................................................
[1/6, 18:33] S A Soni:
[1/5, 23:02] Vd Ranga Prasad Ji Chennai:
Just one doubt..
Is CO2 falling under kshAra ?
Because aerated water is soda.
Where in Co2 is being used hein na?
[1/5, 23:03] Vd Ranga Prasad Ji Chennai:
Why is carbon dioxide present in cold drinks?
2 ANSWERS

Joshua Engel, worked at The Rude Mechanicals
Written 14 Oct 2012
It's there because they put it there. *Dissolved carbon dioxide* is *carbonic acid,* which adds a pleasantly *acidic flavor* and an interesting mouth-feel. When it's not present, the drink tastes flat.
Originally, the CO2 was provided by yeast. Now they get it in tanks and pump it in under pressure before bottling.
It stays there because water-soluble gases dissolve more easily in cold than in hot water. Things that are gas at room temperature can easily escape the liquid, given enough energy. The lower the temperature, the less energetic the molecules are, and the longer they stay in solution. When beverages get warm, the gas molecules have more energy and leave more quickly, and the soda gets flat faster.
[1/5, 23:04] Vd Ranga Prasad Ji Chennai:
Source :
[1/5, 23:06] Vd Ranga Prasad Ji Chennai:
Only because of this doubt, I didn't participate in that posting. Because, I myself is not sure about accepting SODA DRINK as kshAra. Since it is a acidic in medium, as per my understanding.
[1/5, 23:08] Vd Ranga Prasad Ji Chennai:
But any way, your Rx is perfect brother.
It syncs with the condition.
It would be further more effective, if it be given as complimentary medicine along with allopathy medication, since the clinical status of the pt is bad, and prognosis too will bad with just either of one system of medicine.
[1/5, 23:10] Vd Ranga Prasad Ji Chennai:
Placing these views over forum, I felt was not good on my part. Hence divulging the details to you in person.
[1/5, 23:29] S A Soni:
Co2 is chilling or making a sensational agent. This is not an only substance in liquid as per my understanding. The use sodium bicarbonate along with as base.
So I think that substance is alkaline solution. I never increase acidity but subsides.
[1/5, 23:35] Vd Ranga Prasad Ji Chennai:
So the *Soda* referred in the context of the case is not, *aerated drink aka soda* , but *sodium bicarbonate*.
If so, then your observation is cent percent perfect brother.
I thought it is aerated drink. 
[1/5, 23:58] S A Soni:
Soda is always mixed in Alcohol to decrease the acidic reaction .
*Bagpiper soda*
.................................................................................
[1/6, 18:35] S A Soni:
Praveen Sir!
An interaction with Ranga Sir.
This is for you.
[1/6, 18:35] S A Soni:
Requesting guidance for respected members too.
[1/6, 18:37] Praveen Medi Dr:
Much needed discussion. Thank you sir
[1/6, 18:39] Janardan Hebbar Dr:
Acidic or alkaline, whichever does ksharana (scraping / melting away) is kshara 
[1/6, 18:39] Janardan Hebbar Dr:
Scraping/ corroding/ melting
[1/6, 18:40] S A Soni:
These 2 r just opposite to each other.
So I think it matters a lot.
[1/6, 18:46] Janardan Hebbar Dr:
Almost all plant based ksharas have pH above 8 and
Almost all sodas have pH below 6.
*Drinks for thought.
[1/6, 18:49] pawan madan Dr:
Interesting....
Need discussion...
[1/6, 19:51] S A Soni:
This is what happens when you drink soda....
By Lindsay Maxfield | Posted Mar 28th, 2013 @ 8:32pm
101
SALT LAKE CITY —
It's no news flash that soda — diet or otherwise — is bad for health; even those who happily indulge in a can-a-day (or more) habit can rattle off at least two or three negative effects of soda consumption. But when it comes to the effects of soft drink consumption on the human body, the total picture is downright scary.
With high levels of sugar, acids, preservatives and other harmful ingredients, soda causes more damage to the body than just expanding the waistline. From stroke to kidney stones to dementia, here’s a look at what can happen to the body long-term for those who regularly drink soda.
Brain
A 2002 UCLA study found that consuming excessive amounts of sugar reduces the production of the brain chemical called brain-derived neurotrophic factor, or BDNF. “Without BDNF, our brains can’t form new memories and we can’t learn (or remember) much of anything,” according to an article in Forbes magazine.
Infographic
Another study from the University of Copenhagen found that low BDNF levels are linked to depression and dementia. What’s more, when BDNF levels are reduced, the body begins to become resistant to insulin, which kicks off a cascade of other health problems.
But there’s a more immediate problem from consuming too many sweets: According to a 2010 study from the University of Minnesota, chronic sugar consumption dulls the brain’s mechanism for knowing when to stop eating.
Teeth
Sugar is not the only harmful substance in soda that affects dental health. A 2006 study published in the Academy of General Dentistry journal found that drinking soda is nearly as harmful for your teeth as drinking battery acid. That’s because soda actually contains acid (most commonly citric and/or phosphoric), which corrodes tooth enamel. And with a pH of 3.2, diet sodas are even more acidic than regular sodas.
According to the Colgate Oral and Dental Health Resource Center, soft drinks are among the most significant dietary sources of tooth decay. “Acids and acidic sugar byproducts in soft drinks soften tooth enamel, contributing to the formation of cavities. In extreme cases, softer enamel combined with improper brushing, grinding of the teeth or other conditions can lead to tooth loss.”
Heart
Recent research has shown a correlation between soda consumption and heart disease. Most recently, a 2012 Harvard study found that one daily 12-ounce serving of regular soda “was linked to a 19 percent increase in the relative risk of cardiovascular disease,” according to the New York Times.
Some researchers say the blame can be placed on high fructose corn syrup, which has been linked to an increased risk of metabolic syndrome, a condition associated with an elevated heart disease risk.
However, others say diet sodas with artificial sweeteners are much worse on the heart. A study from the University of Miami found that those who had a daily diet soda habit had a 61 percent increased risk of “cardiovascular event,” including heart attack and stroke, than those who drank no soda — even when factors such as smoking, physical activity, alcohol consumption and diet were controlled.
Lungs
A recent study by the University of Adelaide found that drinking too much soda can increase the risk for developing asthma or chronic obstructive pulmonary disorder, or COPD. The more soda a person consumes, the greater the risk of developing those diseases. Other studies suggest sodium benzoate, a preservative in soda, may directly affect the lungs: It increases the amount of sodium in the body while reducing the availability of potassium, causing asthma as well as eczema.
[1/6, 19:51] shekhar singh MP:
Drinking "Soda" to relieve Gas/Indigestion has been quite old prectice.
Though it is supposed to be an acidic drink now, on the basis of ph.
[1/6, 19:54] Janardan Hebbar Dr:
It is only useful in hyperchlorhydria. Phosphoric acid in soda is known to suppress HCl production in stomach over time.
[1/6, 19:56] shekhar singh MP:
Over time ? For instant relief sir ji !
[1/6, 19:58] shekhar singh MP:
Recently a habitual alcoholic told me, soda is not good with wine 
[1/6, 19:59] Janardan Hebbar Dr:
Instantly, it neutralises HCl hence may give temporary relief from gastritis.
[1/6, 20:56] Praveen Medi Dr:
Kshara Gutika is indicated in sodha...also chitraka gritam which also has kshara as important ingredient...sodha is one of the important symptom of cardiac disorders
At the same time ati yoga of kshara is implicated in Hridayaapakartina ( chest pain).
Here Hridayapakartana of atikshara Sevana is referring cardiac anomaly or Acidity ?
[1/6, 21:07] Vd Ranga Prasad Ji Chennai:
Thank you Soni brother. Hope to get the doubts cleared.
[1/6, 21:32] Vd Ranga Prasad Ji Chennai:
Bro', for your perusal 
"This increased distension can causethe reflux where the acid within the stomach is forced back into the esophagus. Second, carbonated sodas are acidic themselves. Studies have shown that consuming approximately one can of soda (350 ml) increasesthe acid level in the stomach for a period of 53.5 minutes."
[1/6, 21:45] S A Soni:
Taking as a whole I understand that dhatu kshay reached up to the level of cardiac muscles leading to cardiomyopathy. Probably Shandya caused by kshar in initial stage played a Major psychological role in occurrence of massive damage.
[1/6, 21:50] Vd Ranga Prasad Ji Chennai:
This study supports your observation.
An excerpt from it....
"A 58-year-old previously healthy male was admitted with a history of worsening dyspnea and palpitations [55]. The patient admitted that he had recently been working extended hours and consumed one bottle (1000 mL) per week of a highly caffeinated (caffeine content 4.04 mg/mL) commercially available ED for six months. He was noted to be in atrial fibrillation with rapid ventricular response at 169 beats per minute. Echocardiography revealed a globally dilated heart with a globally reduced ejection fraction of 45%. Coronary angiography showed normal coronary arteries. After treatment with digoxin, ramipril, and warfarin, his heart rate returned to normal. Six months after discontinuing the ED, he was clinically improved and a repeat echocardiogram confirmed normal left ventricular dimensions and ejection fraction (65%)."
[1/6, 21:52] S A Soni:
Thanks Sir for great example.
[1/6, 21:53] Vd Ranga Prasad Ji Chennai:
Uttejana of नाड़ी संस्थान causing changes in hemodynamics results in हृत्स्थम् structural and pathological changes as per the last study posted.
[1/6, 21:53] pawan madan Dr:
Ranga bro....
[1/6, 21:56] Vd Ranga Prasad Ji Chennai:
Thought it might come in handy for you, hence shared.
P.S: It was handy and helpful to me. Read and registered the imp points.
Thanks to you Soni bro' for bringing up the निदान highlighted for the discussion.
[1/6, 21:56] Vd Ranga Prasad Ji Chennai:
[1/6, 22:19] Praveen Medi Dr:
[1/6, 22:25] shekhar singh MP:
This is what i wanted to say
[1/7, 00:36] Vd. Subhash Sharma Ji Delhi:
RO water also creates acidic reaction.RO water after being purified does become acidic because Reverse Osmosis filtration removes the alkaline mineral atoms from salt molecules, for example the Calcium atom from the molecule of Calcium Bicarbonate is removed. What remains is Carbon Dioxide which forms H₂CO₃ or Carbonic acid, which is the same as soda water. All carbonated drinks like Pepsi or Coca Cola contains much more H₂CO₃ or Carbonic acid, than in the water produced by an RO water purifier.
[1/7, 07:46] radheshyam soni dr:
सुप्रभातं
जब सोडा वाटर में कार्बोलिक एसिड होता है तो फिर ये क्षारीय नहीं अम्लीय हुआ।
और डॉ सुरेंद्र सोनी जी ने जो ह्र्दरोग के मरीज का प्रस्तुतीकरण किया उसे अतिक्षार जन्य माना और निदान में अत्यधिक सोडा वाटर का सेवन ही बताया।
ये 2 बाते एक दूसरे के प्रति विरोधाभाषी प्रतीत होती हैं।
कृपया विद्वत जन मार्गदर्शन करें।
[1/7, 09:08] Shital Joshi Dr. Vdo:
I agree with you sir.
Corrosion is more suitable word for it.
[1/7, 09:46] Ashwini Kumar Sood Dr:
Soni sir rightly detected the NIDAN of the pt with cardiomyopathy. The sequence of events in this pt were he suffered from RHEUMATIC VASCULAR DISEASE long back because of RF . He is just 54yrs of age and developed complications because of overindulgence in NIDAN resulting in PAH and CARDIOMYOPTHU in my opinion.
[1/7, 13:37] S A Soni:
Though the carbonated water is acidic in reaction in the presence of CO2 but it's more degerous in sugar contained drink where base is not added while in soda co2 is added as chilling as well as sensational agent with a tendency to be released from solution.
We can say a temporary loose bonding.... In the presence of base.
Probably this process is continue in GIT after inake resulting as udgar-apan-pravritti.
As we see soda drinks have to be consumed within seconds.
Thus we can say that acidic reaction with loose bonding doesn't affect the *ksharatva* of soda that is absolutely water dissolved. Thus we could observe signs and symptoms in said case.
There is a possibility of neutralisation of small part of base in the presence of co2.
Not a chemistry expert just put my understanding.
[1/7, 14:03] radheshyam soni dr:
************************************************************************
Above discussion held on 'Kaysampraday" a Famous WhatsApp group of well known Vaidyas from all over the India.
Compiled & edited by
Dr.Surendra A. Soni
M.D.,PhD (KC)
Associate Professor
Dept. of Kaya-chikitsa
Govt. Ayurveda College
Vadodara Gujarat, India.
Email: surendraasoni@gmail.com
Mobile No. +91 9408441150
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