Changes

Thus, ends the fourth chapter on the diagnosis of ''prameha''.

Thus, ends the fourth chapter on the diagnosis of ''prameha''.

=== Tattva Vimarsha ===

=== ''Tattva Vimarsha'' ===

1. Nidana (etiological factors), dosha, and dushya are three major factors that cause any disease. Besides these, there are temporal influences, pre-existing conditions, genetic predispositions, as well as the presence or absence of resisting factors in the host body that decide the propensity of the affliction of a disease, including prameha.

#''Nidana'' (etiological factors), ''dosha'', and ''dushya'' are three major factors that cause any disease. Besides these, there are temporal influences, pre-existing conditions, genetic predispositions, as well as the presence or absence of resisting factors in the host body that decide the propensity of the affliction of a disease, including ''prameha''.

2. The onset of disease pathology, its severity and progress depend upon the cumulative effect of interaction between above-mentioned factors. If the disease resisting factors in the host body are stronger than the disease provoking factors, then the disease doesn't occur or occurs with less severity or with fewer symptoms. On the contrary, the disease is severe, acute, and fully manifested in the case of stronger disease provoking factors.   

#The onset of disease pathology, its severity and progress depend upon the cumulative effect of interaction between above-mentioned factors. If the disease resisting factors in the host body are stronger than the disease provoking factors, then the disease doesn't occur or occurs with less severity or with fewer symptoms. On the contrary, the disease is severe, acute, and fully manifested in the case of stronger disease provoking factors.   

3. Prameha is a type of pathogenesis or a syndrome and not one disease entity. The manifestation of each of the twenty types of prameha depends upon the dominant dosha, as well as a host of etiological factors and dushya at play. A common theme applicable to all the types, though, is prolonged exposure to the etiological factors (excess consumption of specific dietary articles and a sedentary lifestyle). Genetic predisposition also increases the propensity of an individual getting afflicted with prameha.

#''Prameha'' is a type of pathogenesis or a syndrome and not one disease entity. The manifestation of each of the twenty types of ''prameha'' depends upon the dominant ''dosha'', as well as a host of etiological factors and ''dushya'' at play. A common theme applicable to all the types, though, is prolonged exposure to the etiological factors (excess consumption of specific dietary articles and a sedentary lifestyle). Genetic predisposition also increases the propensity of an individual getting afflicted with ''prameha''.

4. Prognosis of prameha depends on the quantity and quality of doshas and the resistance capacity of dhatus. If they have similar site and properties, the prognosis is good due to the similarity in treatment principles. If they are dissimilar, the prognosis is bad because of contradiction in treatment principles.

#Prognosis of ''prameha'' depends on the quantity and quality of ''doshas'' and the resistance capacity of ''dhatus''. If they have similar site and properties, the prognosis is good due to the similarity in treatment principles. If they are dissimilar, the prognosis is bad because of contradiction in treatment principles.

5. Vitiated kapha dosha and medadhatu form the basis of pathogenesis for prameha. Further, the vitiation of pitta and vata dosha is observed as per their etiological factors to manifest respective types.

#Vitiated ''kapha dosha'' and ''meda dhatu'' form the basis of pathogenesis for ''prameha''. Further, the vitiation of ''pitta'' and ''vata dosha'' is observed as per their etiological factors to manifest respective types.

6. The excessive abaddha meda (loose fat), mamsa (muscle proteins), kleda (body fluids), shukra (reproductive tissues), shonita (blood), vasa (muscle fats), majja (bone marrow), rasa (body fluid with plasma), oja (vital essence of all tissues) are important factors involved in pathogenesis of prameha. Hence the treatment is targeted to correct the imbalances in these tissue components.  

#The excessive ''abaddha meda'' (loose fat), ''mamsa'' (muscle proteins), ''kleda'' (body fluids), ''shukra'' (reproductive tissues), ''shonita'' (blood), ''vasa'' (muscle fats), ''majja'' (bone marrow), ''rasa'' (body fluid with plasma), ''oja'' (vital essence of all tissues) are important factors involved in pathogenesis of ''prameha''. Hence the treatment is targeted to correct the imbalances in these tissue components.  

7. To treat prameha, the abovementioned factors with the loci in urinary system of the bladder, kidneys shall be treated well.

#To treat ''prameha'', the abovementioned factors with the loci in urinary system of the bladder, kidneys shall be treated well.

8. The quality and specific characteristics observed in urine are biomarkers in diagnosis and assessment of prameha.  

#The quality and specific characteristics observed in urine are biomarkers in diagnosis and assessment of ''prameha''.

=== Vidhi Vimarsha ===

=== Vidhi Vimarsha ===