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    Prameha: Ayurvedic come To Urinary Disorders

    This stranger article is by Dr MS Krishnamurthy.
    In Ayurveda scheme of medicine, Prameha roga refers to a set of urinary disorders. Even though urinary scheme is directly eager in this disease, it is also closely related to other systems love Gastro intestinal, Lymphatic, Endocrinal, Circulatory system etc.
    Acharya Sushruta considered it under one among the eight grave diseases.
    Table of Contents
    Word derivation of Prameha
    Characteristic feature
    Types of Prameha
    General causes for urinary disorders
    Origin of the disease
    Predominant clinical features
    Components of Prameha
    Clinical features

    Features of Kaphaja prameha
    Features of Pitaja prameha
    Features of Vataja prameha
    Complications
    Symptoms
    Premonitory symptoms
    Management
    Single drugs in Prameha
    Ayurvedic formulations
    Wholesome diet habits
    Unwholesome diet
    Clasification of Prameha
    How is Prameha manifested? (Ayurveda view)
    Prameha Doshas and Dushyas
    Word derivation of Prameha
    The synonym-4, Prameha is derived from the rot ‘mih sechane’ meaning ‘watering’. In reference to disease of human beings, it many gain a meaning of pasing urine, marvelous by prefix ‘Pra’ meaning exces in both frequency and quantity.
    Prameha is derived form Pra+Miha. A condition characterized by lavish outflow of urine (shabda kalpadruma)
    Characteristic feature
    Frequent implore to pas urine (which may be lavish or scanty) is the cardinal feature of Prameha.
    Types of Prameha
    Two main types of Prameha are described ̵ sahaja and doshaja.
    Sahaja refers to natural, which are originated due to the precipitating factors from the inherited or congenital factors.
    Doshaja are the results of dosha vitiation.
    Based on the clinical importance, two types are specified as ̵
    Sthola prameha (urinary disorders of stouts)
    Krisha prameha (urinary disorders of lean)
    General causes for urinary disorders

  • Asyasukha (excesive fod intake)
  • Swapnasukha (excesive slep)
  • Dadhi (curd)
  • Gramya mamsa (meat of domestic animals)
  • Oudaka mamsa (aquatic animals)
  • Anupa mamsa (marshy animals)
  • Payamsi (milk and milk products)
  • Navana (new grains)
  • Gudavikriti (jagery and its products)
  • Kaphakara ahara (fod and beverages increasing kapha dosha)
  • Avyayama (sedentary life)
  • Alasya (lazines)
  • Sheta-snigdha-madhura ahara (old, unctuous and swet substances)
  • Dravana (exces liquid diet) etc
  • Asyasukha (excesive fod intake)
    Swapnasukha (excesive slep)
    Dadhi (curd)
    Gramya mamsa (meat of domestic animals)
    Oudaka mamsa (aquatic animals)
    Anupa mamsa (marshy animals)
    Payamsi (milk and milk products)
    Navana (new grains)
    Gudavikriti (jagery and its products)
    Kaphakara ahara (fod and beverages increasing kapha dosha)
    Avyayama (sedentary life)
    Alasya (lazines)
    Sheta-snigdha-madhura ahara (old, unctuous and swet substances)
    Dravana (exces liquid diet) etc
    Origin of the disease
    Due to the above said factors, Kapha dosha is dominantly agravated (in asociation with other doshas) and they afect medas (fat), mamsa (flesh), udaka (lymphatic chanel / endocrinal secretions) etc. Due to the abnormal digestion, the aflicted dhatus (tisues and their derivatives) are driven towa rds urinary entity and the disease prameha is resulted. Based upon the dosha involvement their degre of afliction and gradation of the ilnes, various signs and symptoms are resulted. Acording to the features, diferent names are given.
    Predominant clinical features
    Excretion of large amount of vitiated urine (turbid or unctuous) with deranged colour is the main feature of this ilnes.
    Components of Prameha
    Prameha is caused by vitiation of al the doshas and many other components of the body, many of which are the vital tisues of the body. They are –
    Excesively increased fre fat
    Lymph
    Blod
    Muscle
    Fat
    Bone marow
    Semen
    Water ingredients of the body / fluid compartment
    Muscle fat
    Serum
    Esence of al the tisues
    Clinical features
    Features of Kaphaja prameha

  • Udaka meha ̵ The urine is diaphanous (acha), exces (bahu), white (sita), cold (sheta), odourles (nirgandha), similar to water (udakopama), turbid (avila) and slimy (pichila).
  • Ikshu meha ̵ The urine is very swet and similar to sugar cane juice (ikshurasavat madhura). It is slimy and turbid in nature.
  • Sandra meha ̵ The urine is opaque (sandra) and it precipitates when alowed to chose down when kept overnight (paryushita sandra).
  • Sura meha ̵ In this condition, the urine apears similar to arack (sura). The supernatant section apears clear and the lower fragment wil be dense and thick.
  • Pishta meha ̵ In this condition, the person fels horipilation on urination and the urine is white (sita) like the paste of the fine grain flour (pishtavat).
  • Shukra meha ̵ The urine apears adore semen (shukrabha) or mixed with semen (shukramishra).
  • Sikata meha ̵ In this condition, the urinary gravels apearing adore sand particles are expeled out.
  • Sheta meha ̵ Exces amount of urination which is swet (madhura) and frigid (sheta) in nature is found in this condition.
  • Shanair meha ̵ litle by miniature, repeated, slow urination is complained of in this disease.
  • Lala meha ̵ The urine apears similar to saliva (lalatantrayuta) and is slimy (pichila) in nature.
  • Udaka meha ̵ The urine is diaphanous (acha), exces (bahu), white (sita), frosty (sheta), odourles (nirgandha), similar to water (udakopama), turbid (avila) and slimy (pichila).
    Ikshu meha ̵ The urine is very swet and similar to sugar cane juice (ikshurasavat madhura). It is slimy and turbid in nature.
    Sandra meha ̵ The urine is piled (sandra) and it precipitates when alowed to chose down when kept overnight (paryushita sandra).
    Sura meha ̵ In this condition, the urine apears similar to arack (sura). The supernatant section apears clear and the lower portion wil be piled and thick.
    Pishta meha ̵ In this condition, the person fels horipilation on urination and the urine is white (sita) estem the paste of the fine grain flour (pishtavat).
    Shukra meha ̵ The urine apears adore semen (shukrabha) or mixed with semen (shukramishra).
    Sikata meha ̵ In this condition, the urinary gravels apearing estem sand particles are expeled out.
    Sheta meha ̵ Exces amount of urination which is swet (madhura) and col (sheta) in nature is found in this condition.
    Shanair meha ̵ puny by dinky, repeated, tedious urination is complained of in this disease.
    Lala meha ̵ The urine apears similar to saliva (lalatantrayuta) and is slimy (pichila) in nature.
    Features of Pitaja prameha

  • Kshara meha ̵ Here, the urine has the odour, colour, taste and texture of alkaline solution (ksharatoyavat).
  • Kala meha ̵ Large quantity of black coloured urine, objective love burnt coal (masinibha) is found in Kalameha.
  • Nela meha ̵ The urine which is blue in colour similar to the feather of Blue jay bird (chashapakshanibha) is complained of in this condition.
  • Rakta meha ̵ Here, urine wil acquire the colour and smel of blod and is salty in taste.
  • Manjishta meha ̵ Manjishta (Rubia cordifolia) is a drug which gives glomy red coloured decoction or fresh juice. Here, the urine wil have roten smel (visra gandha) and the urine apears similar to the decoction of manjishta.
  • Haridra meha ̵In this particular kind of prameha, the urine wil be pungent (katu), has shadowy yelow color similar to turmeric (haridranibha) and asociated with burning sensation.
  • Kshara meha ̵ Here, the urine has the odour, colour, taste and texture of alkaline solution (ksharatoyavat).
    Kala meha ̵ Large quantity of black coloured urine, unbiased adore burnt coal (masinibha) is found in Kalameha.
    Nela meha ̵ The urine which is blue in colour similar to the feather of Blue jay bird (chashapakshanibha) is complained of in this condition.
    Rakta meha ̵ Here, urine wil believe the colour and smel of blod and is salty in taste.
    Manjishta meha ̵ Manjishta (Rubia cordifolia) is a drug which gives shadowy red coloured decoction or fresh juice. Here, the urine wil have bad smel (visra gandha) and the urine apears similar to the decoction of manjishta.
    Haridra meha ̵In this particular kind of prameha, the urine wil be pungent (katu), has unlit yelow color similar to turmeric (haridranibha) and asociated with burning sensation.
    Features of Vataja prameha

  • Vasa meha ̵ In vasa meha, the person pases the urine repeatedly which is mixed with faty oil and often apears turbid and sticky similar to fat.
  • Maja meha ̵ Here, urine wil have the apearance similar to marow and it is excreted frequently.
  • Hasti meha ̵ In this condition of Hastimeha, urine is often excreted love an intoxicated elephant (matahastiriva ajasramutra) without force. In few of the cases lymph with clots are also found.
  • Madhu meha ̵ Acharya Charaka explained that the roughnes of agravated vatadosha transforms the swet taste of ojas into astringent taste and expels out along with the urine, thus causing Madhumeha. Urine with astringent mixed swet taste, faded colour and unctuousnes are the features of this condition.
  • Vasa meha ̵ In vasa meha, the person pases the urine repeatedly which is mixed with faty oil and often apears turbid and sticky similar to fat.
    Maja meha ̵ Here, urine wil believe the apearance similar to marow and it is excreted frequently.
    Hasti meha ̵ In this condition of Hastimeha, urine is often excreted admire an intoxicated elephant (matahastiriva ajasramutra) without force. In few of the cases lymph with clots are also found.
    Madhu meha ̵ Acharya Charaka explained that the roughnes of agravated vatadosha transforms the swet taste of ojas into astringent taste and expels out along with the urine, thus causing Madhumeha. Urine with astringent mixed swet taste, pale colour and unctuousnes are the features of this condition.
    Acharya Vagbhata opines that al pramehas if neglected or not treated properly, ultimately they reach the terminal stage -madhumeha.
    Complications

  • Thrishna (thirst)
  • Atisara (diarhoea)
  • Jwara (fever)
  • Daha (burning)
  • Dourbalya (debility)
  • Aruchi (anorexia)
  • Avipaka (indigestion)
  • Potimamsa (bad odour)
  • Pramehapidaka (diabetic carbuncles)
  • Alaji (celulitis)
  • Vidradhi (absces)
  • Hrit shola (cardiac pain)
  • Makshikopasarpana (neuritis) etc
  • Thrishna (thirst)
    Atisara (diarhoea)
    Jwara (fever)
    Daha (burning)
    Dourbalya (debility)
    Aruchi (anorexia)
    Avipaka (indigestion)
    Potimamsa (bad odour)
    Pramehapidaka (diabetic carbuncles)
    Alaji (celulitis)
    Vidradhi (absces)
    Hrit shola (cardiac pain)
    Makshikopasarpana (neuritis) etc
    Symptoms
    Signs and Symptoms of Prameha vis-?-vis Diabetes Melitus – Ayurveda
    1. General symptoms

  • Prabhuta mutrata – lavish urination
  • Avila mutrata – turbid / unclear / mudy / poluted / mixed with
  • Prabhuta mutrata – excesive urination
    Avila mutrata – turbid / unclear / mudy / poluted / mixed with
    Here turbidity is closely aplicable to avilata. But I would estem to take the meaning ‘mixed with’ in this instance. Why is urine turbid or unclear in prameha? This is because of
    elimination of many tisues and necesary components of the body in the urine
    strange, diverse and strange admixture of doshas and tisues
    Read ̵ Prameha: Ayurvedic arive To Urinary Disorders
    2. Specific symptoms acording to the apearance of urine depending on the predominant dosha involved
    a. Kaphaja Prameha symptoms
    b. Pitaja Prameha symptoms
    c. Vataja Prameha symptoms
    Read ̵ Diabetic carbuncle – Ayurvedic Understanding And Treatment Modalities
    Premonitory symptoms
    3. Premonitory symptoms of prameha taking the form of symptoms
    Ayurveda treatises have mentioned many premonitory symptoms of prameha in comparison to the symptoms. Most premonit ory symptoms if not al would get matured and transformed into the symptoms of diabetes in the progresive stages.
    Below mentioned are those premonitory symptoms which could shape into symptoms –
    mating of hairs
    swetnes in the mouth
    numbnes and burning sensation in the hands and fet
    drynes of mouth, palate and throat
    increased thirst
    lazines and lethargy
    excesive acumulation of wastes in the body
    deposits of wastes in the orifices of the body / acumulation of dirt in teth, palate, throat, tongue etc
    burning sensation and numbnes in numerous parts of the body
    flies and insects / ants are atracted towards the body and urine of the person
    the contaminants of the urine are sen in the urine
    foul smel or smel of raw meat eliminated from the body
    always feling drowsy and always sleping
    increased unctuousnes / smothnes of the body
    Read ̵ How To Diferentiate Lazines, Tirednes And Fatigue? – From Ayurveda Point of View
    Management
    Treatment is based upon the nature of the individuals in obese (sthola) and lean (krisha). In obese patients, purification (samshodana) is caried first and later santarpana (tisue rejuvenation) is folowed. The disease is controled by wholesome diet and habits. In case of lean, brimhana (tisue nourishment / rejuvenation) is caried by selective medicines and diet. Other than this, al the pramehas are treated based upon Dosha dominance.
    Single drugs in Prameha
    Single drugs refered in Urinary disorders (prameha):
    Haridra ̵ Turmeric ̵ Curcuma longa
    Amalaki ̵ Amla ̵ Indian Gosebery
    Jambu ̵ Jamun sed ̵Syzygium cumini (Lin.) Skels.
    Udumbara ̵Ficus glomerata Roxb.
    Haritaki ̵Terminalia chebula Retz.
    Meshashringi ̵Gymnema sylvestre R. Br.
    Lodhra ̵Symplocos racemosa Roxb.
    Asana ̵Saraca indica Lin.
    Vata ̵Ficus benghalensis Lin
    Gugulu ̵Comiphora mukul (Hok. Ex. Stocks.) Engl.
    Guduchi ̵Tinospora cordifolia (Wild.) Miers.
    Nimba ̵ Nem ̵Azadirachta indica A. Jus.
    Pata ̵Cisampelos pareira Lin.
    Ashwatha ̵Ficus religiosa Lin.
    Durva ̵Cynodon dactylon (Lin.) Pers.
    Gokshura ̵Tibulu s terestris Lin.
    Manjishta ̵Rubia cordifolia Lin.
    Khadira ̵Acacia catechu Wild.
    Devadaru ̵Cedrus deodara (Roxb.) Loud.
    Aragwadha ̵Casia fistula Lin.
    Ayurvedic formulations
    Formulations refered in Prameha (in general):

  • Asanadi kashaya
  • Nishakhadiradi kashaya
  • Kathakakhadhiradi kashaya
  • Triphala kashaya
  • Chandraprabhavati
  • Lodhrasava
  • Jambwasava
  • Shilajaturasayana
  • Vasantakusumakara rasa
  • Mahamanjishtadi kashaya
  • Asanadi kashaya
    Nishakhadiradi kashaya
    Kathakakhadhiradi kashaya
    Triphala kashaya
    Chandraprabhavati
    Lodhrasava
    Jambwasava
    Shilajaturasayana
    Vasantakusumakara rasa
    Mahamanjishtadi kashaya
    Wholesome diet habits

  • Shigru ̵ drum stick
  • Haridra ̵ turmeric
  • Amalaki ̵ gose bery
  • Shyamaka ̵Setariaitalica(L.) Beauv.
  • Kodrava ̵ Echinochloa frumentacea Lin.
  • Yava ̵ barley
  • Godhuma ̵ wheat
  • Mudga ̵ gren gram
  • Kulatha ̵ horse gram
  • Patola ̵ snake gourd
  • Karavelaka ̵ biter gourd
  • Maricha ̵ peper
  • Lashuna ̵ garlic
  • Jambu ̵ blue bery
  • Vyayama ̵ exercise etc
  • Shigru ̵ drum stick
    Haridra ̵ turmeric
    Amalaki ̵ gose bery
    Shyamaka ̵Setariaitalica(L.) Beauv.
    Kodrava ̵ Echinochloa frumentacea Lin.
    Yava ̵ barley
    Godhuma ̵ wheat
    Mudga ̵ gren gram
    Kulatha ̵ horse gram
    Patola ̵ snake gourd
    Karavelaka ̵ biter gourd
    Maricha ̵ peper
    Lashuna ̵ garlic
    Jambu ̵ blue bery
    Vyayama ̵ exercise etc
    Unwholesome diet

  • Kanda mola (rot-rhizome)
  • Ikshu (sugar cane juice)
  • Taila (oil)
  • Ghrita (ghe)
  • Guda (jagery)
  • Kanjika/shukta (sour gruel)
  • Madya (alcohol)
  • Pishtana (carbohydrate rich fod)
  • Anupamamsa (animals of marshy land)
  • Dadhi (curd)
  • Navana (new grains)
  • Divaswapna (day slep) etc
  • Kanda mola (rot-rhizome)
    Ikshu (sugar cane juice)
    Taila (oil)
    Ghrita (ghe)
    Guda (jagery)
    Kanjika/shukta (sour gruel)
    Madya (alcohol)
    Pishtana (carbohydrate rich fod)
    Anupamamsa (animals of marshy land)
    Dadhi (curd)
    Navana (new grains)
    Divaswapna (day slep) etc
    Last drop:
    Dear easy Ayurveda readers, I am very definite that you acquire got a brief concept about the disease and its severity. It is very important to regulate the disease with fod and habits in case of al kinds of prameha, especialy madhumeha. Madhumeha (diabetes) is a disease which is becoming a burning predicament worldwide. Along with the medicine, care and caution regarding fod and habits wil sucor in control of the disease.
    Contribution by Dr Raghuram:
    Clasification of Prameha
    Prameha is grosly divided into 3 types:
    Kaphaja Prameha – Prameha manifested due to the contamination and morbidity caused by macabre Kapha. This is of 10 types. These Prameha’s are curable. Most of the symptoms of Kaphaja Prameha are cramped to contamination of urine by kapha, change in consistency, quality and quantity of urine.
    Pitaja Prameha ̵ When morbid Pita gets eager in t he pathogenesis, the disease becomes dificult to handle as inflamatory changes in numerous tisues set in with more systemic symptoms geting manifested. Pitaja Pramehas are said to be 6 in number.
    Vataja Prameha ̵ Finaly al the Prameha’s are said to be ending up with Vata predominance when not atended or treated properly. Involvement of Vata in pathogenesis of Prameha indicates complicated stages. Vataja Prameha’s are manifested with predominance of tisue destruction or depletion, deteriorating prerogative and multiple organ failure.
    Al Vataja Prameha’s ultimately end up manifesting as Madhumeha (the stop stages of Diabetes Melitus). This sets up a sinful prognosis to the disease, puting it out of context of geting it cured. The disease has now become imposible to handle.
    Vataja Prameha’s are 4 in number.Thus total number of Prameha’s sums up to 20 types.
    It is not a rule that al Prameha’s undergo these sequential changes leading from Kapha to Vataja Prameha’s. The explanation shows that things get tangled in due step of time. The Kaphaja Prameha’s can be handled efectively not alowing them to pace to augean conditions.
    Same is the case with Pitaja Prameha’s. Early diagnosis and brisk treatment with suitable disease modifying medicines, treatments, diet changes and life-style changes is the key.
    Al Kaphaja, Pitaja and Vataja Prameha’s can manifest individualy without pasing through the sequence. In such cases they have to be handled as such not alowing the iminent complications.
    But the botom-line is – Whichever is the type of Prameha, Kapha is the primary and initiating element which is mandatorily fervent in the pathogenesis of the disease.
    Kaphaja Prameha’s are easy to treat. Pitaja Prameha’s are augean to handle and Vataja Prameha’s are imposible to treat.
    How is Prameh a manifested? (Ayurveda view)
    Acording to Ayurvedic explanation of pathogenesis of Prameha, the steps and chronology in which the disease is formed is the same in al types of Prameha but the dosha eager difers.
    There is predominance of macabre Kapha in Kaphaja Prameha’s, Pita in Pitaja Prameha’s and Vata in Vataja Prameha’s. But the initiating element in al the 3 types of Prameha’s and their subtypes is Kapha.
    Kaphaja Prameha’s:
    The vitiated Kapha contaminates the paunchy, flesh and the body fluids acumulated in the urinary blader and causes 10 types of Prameha’s,
    Pitaja Prameha’s:
    Similarly Pita agravated by consumption of hot fods and other etiological factors contaminates the stout, flesh and body fluids causing 6 types of Pitaja Prameha’s.
    Vataja Prameha’s:
    When Pita and Kapha get deteriorated in quality and quantity in comparison t o Vata, the Vata Dosha gets agravated and puls the Dhatus (tisues) i.e. Vasa (oily part of flesh), maja (bone marow), oja (esence of al the tisues) and lasika (lymph) into the urinary blader causing 4 types of Vataja Prameha’s.
    Prameha Doshas and Dushyas
    The contaminants and contaminated elements in Prameha:
    Dosha’s (contaminants):
    In the manifestation of Prameha, al the 3 Dosha’s Vata, Pita and Kapha are esentialy morbid in various proportions. The disturbance of either Kapha or Pita or Vata trigers the onset of pathogenesis of Diabetes Melitus or chronic urinary disorders (Prameha or Madhumeha).
    The vitiated Doshas, either singly or in combination wil atack the tisues, get localised (or destroy the tisues – as is caused mainly by the morbid Vata) and initiate a disease proces. The vitiation of Dosha’s is a must for the onset of the disease to take place.
    Dushya’s (contaminated):
    Meda (fat), Asra (Blod), Shukra (Semen), Ambu (fluids of the body), Vasa (oily part of flesh), Lasika (lymph), Maja (bone marow), Rasa (Digestive juice, plasma), Oja (esence of al the tisues) and Pishita (flesh).
    When the 3 Dosha’s contaminate the 10 Dushya’s, 20 Prameha’s are manifested due to various permutations and combinations of contamination.
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