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Description of Sahaja prameha and role of genetic predisposition in the development of disease clears all the dout about the scientific validity of Ayurveda.
Description of Sahaja prameha and role of genetic predisposition in the development of disease clears all the dout about the scientific validity of Ayurveda.
===Sanskrit text, Transliteration and English Translation===
अथातः प्रमेहचिकित्सितं व्याख्यास्यामः||१||
अथातः प्रमेहचिकित्सितं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
इति ह स्माह भगवानात्रेयः||२||
iti ha smAha bhagavAnAtreyaH||2||
iti ha smAha bhagavAnAtreyaH||2||
We shall now expound the chapter on the treatment of Prameha. Thus, said Lord Atreya. [1-2]
We shall now expound the chapter on the treatment of Prameha. Thus, said Lord Atreya. [1-2]
निर्मोहमानानुशयो निराशः पुनर्वसुर्ज्ञानतपोविशालः|
निर्मोहमानानुशयो निराशः पुनर्वसुर्ज्ञानतपोविशालः|
कालेऽग्निवेशाय सहेतुलिङ्गानुवाच मेहाञ्शमनं च तेषाम्||३||
कालेऽग्निवेशाय सहेतुलिङ्गानुवाच मेहाञ्शमनं च तेषाम्||३||
nirmohamAnAnushayo nirAshaH punarvasurj~jAnatapovishAlaH|
nirmohamAnAnushayo nirAshaH punarvasurj~jAnatapovishAlaH|
kAle~agniveshAya sahetuli~ggAnuvAca Meha~jshamanaM ca teShAm||3||
kAle~agniveshAya sahetuli~ggAnuvAca Meha~jshamanaM ca teShAm||3||
Punarvasu who is free from delusion, ego, hatred and attachment, and who has attained magnanimity because of his knowledge and penance, described the etiology, signs and symptoms, and treatment of meha (prameha) to Agnivesha at proper time (when query was asked).[3]
Punarvasu who is free from delusion, ego, hatred and attachment, and who has attained magnanimity because of his knowledge and penance, described the etiology, signs and symptoms, and treatment of meha (prameha) to Agnivesha at proper time (when query was asked).[3]
Etiology of prameha:
==== Etiology of prameha ====
आस्यासुखं स्वप्नसुखं दधीनि ग्राम्यौदकानूपरसाः पयांसि|
आस्यासुखं स्वप्नसुखं दधीनि ग्राम्यौदकानूपरसाः पयांसि|
नवान्नपानं गुडवैकृतं च प्रमेहहेतुः कफकृच्च सर्वम्||४||
नवान्नपानं गुडवैकृतं च प्रमेहहेतुः कफकृच्च सर्वम्||४||
navAnnapAnaM guDavaikRutaM ca PramehahetuH kaphakRucca sarvam||4||
navAnnapAnaM guDavaikRutaM ca PramehahetuH kaphakRucca sarvam||4||
Over-indulgence in the pleasure of sedentary habits, excess sleep, curds, soup of the meat of domesticated and aquatic animals and animals inhabiting marshy land, milk and its preparations, freshly harvested food articles, freshly prepared drinks, preparations of jaggery and all kapha- aggravating factors are responsible for the causation of prameha. [4]
Over-indulgence in the pleasure of sedentary habits, excess sleep, curds, soup of the meat of domesticated and aquatic animals and animals inhabiting marshy land, milk and its preparations, freshly harvested food articles, freshly prepared drinks, preparations of jaggery and all kapha- aggravating factors are responsible for the causation of prameha. [4]
Dushya (vitiated factors) and pathogeneis:
==== Dushya (vitiated factors) and pathogeneis ====
मेदश्च मांसं च शरीरजं च क्लेदं कफो बस्तिगतं प्रदूष्य|
मेदश्च मांसं च शरीरजं च क्लेदं कफो बस्तिगतं प्रदूष्य|
करोति मेहान् समुदीर्णमुष्णैस्तानेव पित्तं परिदूष्य चापि||५||
करोति मेहान् समुदीर्णमुष्णैस्तानेव पित्तं परिदूष्य चापि||५||
क्षीणेषु दोषेष्ववकृष्य बस्तौ धातून् प्रमेहाननिलः करोति|
क्षीणेषु दोषेष्ववकृष्य बस्तौ धातून् प्रमेहाननिलः करोति|
दोषो हि बस्तिं समुपेत्य मूत्रं सन्दूष्य मेहाञ्जनयेद्यथास्वम्||६||
दोषो हि बस्तिं समुपेत्य मूत्रं सन्दूष्य मेहाञ्जनयेद्यथास्वम्||६||
mēdaśca māṁsaṁ ca śarīrajaṁ ca klēdaṁ kaphō bastigataṁ pradūṣya|
mēdaśca māṁsaṁ ca śarīrajaṁ ca klēdaṁ kaphō bastigataṁ pradūṣya|
karōti mēhān samudīrṇamuṣṇaistānēva pittaṁ paridūṣya cāpi||5||
karōti mēhān samudīrṇamuṣṇaistānēva pittaṁ paridūṣya cāpi||5||
kShINeShu doSheShvavakRuShya bastau dhAtUn pramehananilaH karoti|
kShINeShu doSheShvavakRuShya bastau dhAtUn pramehananilaH karoti|
doSho hi bastiM samupetya mUtraM sandUShya Meha~jjanayedyathAsvam||6||
doSho hi bastiM samupetya mUtraM sandUShya Meha~jjanayedyathAsvam||6||
Aggravated Kapha vitiates medas, mamsa and kleda of the body located in basti (bladder and urinary system) and causes different types of kapha dominant meha.
Similarly, pitta aggravated by hot things vitiates those elements and causes different types of pitta dominant meha.
Similarly, pitta aggravated by hot things vitiates those elements and causes different types of pitta dominant meha.
When other two doshas are in a relatively diminished state, the aggravated vayu draws tissues elements (viz. ojas, majja, and lasika) into the urinary tract and vitiates them to cause vata dominant pramehas. Different doshas having entered the urinary tract in vitiated condition give rise to the respective types of meha with their own dominance. [5-6]
==== Classification and Prognosis ====
साध्याः कफोत्था दश, पित्तजाः षट् याप्या, न साध्यः पवनाच्चतुष्कः|| समक्रियत्वाद्विषमक्रियत्वान्महात्ययत्वाच्च यथाक्रमं ते||७||
साध्याः कफोत्था दश, पित्तजाः षट् याप्या, न साध्यः पवनाच्चतुष्कः|| समक्रियत्वाद्विषमक्रियत्वान्महात्ययत्वाच्च यथाक्रमं ते||७||
sādhyāḥ kaphōtthā daśa, pittajāḥ ṣaṭ yāpyā, na sādhyaḥ pavanāccatuṣkaḥ|
sādhyāḥ kaphōtthā daśa, pittajāḥ ṣaṭ yāpyā, na sādhyaḥ pavanāccatuṣkaḥ|
Kaphaja pramehas are of ten types and they are curable because of their compatibility of the therapies meant for their cure (samakriyatvat). Pittaja pramehas are of six types and they are only palliable (yapya) because of their incompatibility of the therapies meant for their treatment. Vatika pramehas are of four types and they are incurable because of their incompatibility with therapies and dreadful nature of vata leading to complications. [7]
Kaphaja pramehas are of ten types and they are curable because of their compatibility of the therapies meant for their cure (samakriyatvat). Pittaja pramehas are of six types and they are only palliable (yapya) because of their incompatibility of the therapies meant for their treatment. Vatika pramehas are of four types and they are incurable because of their incompatibility with therapies and dreadful nature of vata leading to complications. [7]
Vitiating factors involved in pathogenesis:
==== Vitiating factors involved in pathogenesis ====
कफः सपित्तः पवनश्च दोषा मेदोऽस्रशुक्राम्बुवसालसीकाः|
कफः सपित्तः पवनश्च दोषा मेदोऽस्रशुक्राम्बुवसालसीकाः|
मज्जा रसौजः पिशितं च दूष्याः[१] प्रमेहिणां, विंशतिरेव मेहाः||८||
मज्जा रसौजः पिशितं च दूष्याः[१] प्रमेहिणां, विंशतिरेव मेहाः||८||
kaphaH sapittaH pavanashca doShA medo~asrashukrAmbuvasAlasIkAH|
kaphaH sapittaH pavanashca doShA medo~asrashukrAmbuvasAlasIkAH|
majjA rasaujaH pishitaM ca dUShyAH pramehiNAM, viMshatireva MehaH||8||
majjA rasaujaH pishitaM ca dUShyAH pramehiNAM, viMshatireva MehaH||8||
Doshas like kapha, pitta and vata, and dushyas like medas, rakta, shukra, ambu (body fluid), vasa (muscle fat), lasika (lymph), majja, rasa, ojas and mamsa are responsible for the causation of prameha which is of twenty types. [8]
Doshas like kapha, pitta and vata, and dushyas like medas, rakta, shukra, ambu (body fluid), vasa (muscle fat), lasika (lymph), majja, rasa, ojas and mamsa are responsible for the causation of prameha which is of twenty types. [8]
Twenty types of dosha dominant prameha:
==== Twenty types of dosha dominant prameha ====
जलोपमं चेक्षुरसोपमं वा घनं घनं चोपरि विप्रसन्नम्|
जलोपमं चेक्षुरसोपमं वा घनं घनं चोपरि विप्रसन्नम्|
शुक्लं सशुक्रं शिशिरं शनैर्वा लालेव वा वालुकया युतं वा||९||
शुक्लं सशुक्रं शिशिरं शनैर्वा लालेव वा वालुकया युतं वा||९||
Diminution of other dhatus or tissue elements (besides those described above) is responsible for the causation of the above mentioned four varieties of vatika prameha. [9-11]
Diminution of other dhatus or tissue elements (besides those described above) is responsible for the causation of the above mentioned four varieties of vatika prameha. [9-11]
Criteria for diagnosis:
==== Criteria for diagnosis ====
वर्णं रसं स्पर्शमथापि गन्धं यथास्वदोषं भजते प्रमेहः|
वर्णं रसं स्पर्शमथापि गन्धं यथास्वदोषं भजते प्रमेहः|
श्यावारुणो वातकृतः सशूलो
श्यावारुणो वातकृतः सशूलो
majjAdisAdguNyamupaityasAdhyaH||12||
majjAdisAdguNyamupaityasAdhyaH||12||
Different types of prameha are characterized by the colour, taste, touch and smell of the respective dosha. Vatika varieties of prameha are characterized by grayish or reddish colouration of the urine, pain and attributes of majja etc. These types of vatika prameha are incurable. [12]
Different types of prameha are characterized by the colour, taste, touch and smell of the respective dosha. Vatika varieties of prameha are characterized by grayish or reddish colouration of the urine, pain and attributes of majja etc. These types of vatika prameha are incurable. [12]
Premonitory signs and symptoms:
==== Premonitory signs and symptoms ====
स्वेदोऽङ्गगन्धः शिथिलाङ्गता च
स्वेदोऽङ्गगन्धः शिथिलाङ्गता च
शय्यासनस्वप्नसुखे रतिश्च|
शय्यासनस्वप्नसुखे रतिश्च|
Mehagadasya rUpaM mUtre~abhidhAvanti pipIlikAshca||14||
Mehagadasya rUpaM mUtre~abhidhAvanti pipIlikAshca||14||
Sweating, body odour, flabbiness of the body, liking for constantly lying on the bed, sitting, sleeping and leading an easy life, a feeling as if the cardiac region is covered with extraneous material, exudation of excreta from eyes, tongue and ears, corpulence of the body, excessive growth of hair and nails, liking for cold things, dryness of throat and palate, sweet taste in the mouth, burning sensation in hands and legs and swarming of ants on the urine- these are the premonitory signs and symptoms of prameha. [13-14]
Sweating, body odour, flabbiness of the body, liking for constantly lying on the bed, sitting, sleeping and leading an easy life, a feeling as if the cardiac region is covered with extraneous material, exudation of excreta from eyes, tongue and ears, corpulence of the body, excessive growth of hair and nails, liking for cold things, dryness of throat and palate, sweet taste in the mouth, burning sensation in hands and legs and swarming of ants on the urine- these are the premonitory signs and symptoms of prameha. [13-14]
Principles of management:
==== Principles of management ====
स्थूलः प्रमेही बलवानिहैकः कृशस्तथैकः परिदुर्बलश्च|
स्थूलः प्रमेही बलवानिहैकः कृशस्तथैकः परिदुर्बलश्च|
सम्बृंहणं तत्र कृशस्य कार्यं
सम्बृंहणं तत्र कृशस्य कार्यं
snigdhasya yogA vividhAH prayojyAH kalpopadiShTA malashodhanAya|
snigdhasya yogA vividhAH prayojyAH kalpopadiShTA malashodhanAya|
UrdhvaM tathA~adhashca male~apanIte meheShu santarpaNameva kAryam||16||
UrdhvaM tathA~adhashca male~apanIte meheShu santarpaNameva kAryam||16||
gulmaH kShayo MehanabastishUlaM mUtragrahashcApyapatarpaNena|
pramehiNaH syuH, paritarpaNAni kAryANi tasya prasamIkShya vahnim||17||
pramehiNaH syuH, paritarpaNAni kAryANi tasya prasamIkShya vahnim||17||
Patients suffering from prameha are classified into two categories, viz. (1) those who are obese and strong, and (2) those who are emaciated and weak.
Patients suffering from prameha are classified into two categories, viz. (1) those who are obese and strong, and (2) those who are emaciated and weak.
Patients belonging to the latter category should be given nourishing therapy. Patient of the former category who are strong and who have more doshas in the body should be treated with elimination therapy.
Patients belonging to the latter category should be given nourishing therapy. Patient of the former category who are strong and who have more doshas in the body should be treated with elimination therapy.
For this purpose, the oleated patient should be given various recipes described in kalpa section with a view to eliminating metabolic waste products through both upward and downward tracts. After the waste products (excess metabolic bi-products) are eliminated from his body, the patient should be given santarpana or nourishment therapy. Because apatarpana (depletion) therapy in this condition may produce gulma, consumption, pain in phallus and urinary bladder including kidneys and retention of urine. Such patients should be given santarpana therapy depending upon their power of digestion. [15-17]
Samshamana ( pacification therapy):
==== Samshamana ( pacification therapy) ====
संशोधनं नार्हति यः प्रमेही तस्य क्रिया संशमनी प्रयोज्या|
संशोधनं नार्हति यः प्रमेही तस्य क्रिया संशमनी प्रयोज्या|
मन्थाः कषाया यवचूर्णलेहाः प्रमेहशान्त्यै लघवश्च भक्ष्याः||१८||
मन्थाः कषाया यवचूर्णलेहाः प्रमेहशान्त्यै लघवश्च भक्ष्याः||१८||
Barley soaked in the decoction of triphala and kept overnight should be mixed with honey. It is a refreshing (tarpana) diet. It should be taken by the patient suffering from prameha regularly to overcome the disease. Barley should be soaked separately with each of decoctions prescribed for the treatment of kaphaja prameha and taken by the patient in the form of saktu (roasted flour), apupa (pan-cake), dhana (roasted barley) and other types of eatables along with jaggery.
Barley soaked in the decoction of triphala and kept overnight should be mixed with honey. It is a refreshing (tarpana) diet. It should be taken by the patient suffering from prameha regularly to overcome the disease. Barley should be soaked separately with each of decoctions prescribed for the treatment of kaphaja prameha and taken by the patient in the form of saktu (roasted flour), apupa (pan-cake), dhana (roasted barley) and other types of eatables along with jaggery.
Various eatables prepared from the barley or bamboo seed or wheat previously eaten by asses, horses, cows, swans and deer and collected from their dung should be given to the patient suffering from prameha. [18-24]
Various eatables prepared from the barley or bamboo seed or wheat previously eaten by asses, horses, cows, swans and deer and collected from their dung should be given to the patient suffering from prameha. [18-24]
Specific Therapies:
==== Specific Therapies ====
संशोधनोल्लेखनलङ्घनानि काले प्रयुक्तानि कफप्रमेहान्|
संशोधनोल्लेखनलङ्घनानि काले प्रयुक्तानि कफप्रमेहान्|
जयन्ति पित्तप्रभवान् विरेकः सन्तर्पणः संशमनो विधिश्च||२५||
जयन्ति पित्तप्रभवान् विरेकः सन्तर्पणः संशमनो विधिश्च||२५||
jayanti pittaprabhavAn virekaH santarpaNaH saMshamano vidhishca||25||
jayanti pittaprabhavAn virekaH santarpaNaH saMshamano vidhishca||25||
Purificatory therapies including specifically emesis and fasting therapies, administered at the appropriate time, cure kaphaja types of prameha. Similarly, pittaja types of prameha are overcome by purgation, santarpana (refreshing therapy) and alleviation therapies. [25]
Purificatory therapies including specifically emesis and fasting therapies, administered at the appropriate time, cure kaphaja types of prameha. Similarly, pittaja types of prameha are overcome by purgation, santarpana (refreshing therapy) and alleviation therapies. [25]
Various recipes:
==== Various recipes ====
दार्वीं सुराह्वां त्रिफलां समुस्तां कषायमुत्क्वाथ्य पिबेत् प्रमेही|
दार्वीं सुराह्वां त्रिफलां समुस्तां कषायमुत्क्वाथ्य पिबेत् प्रमेही|
क्षौद्रेण युक्तामथवा हरिद्रां
क्षौद्रेण युक्तामथवा हरिद्रां
The patient suffering from prameha should take the decoction of darvi, surahva, triphala and musta mixed with honey. He may also take haridra along with the juice of amalaki. [26]
The patient suffering from prameha should take the decoction of darvi, surahva, triphala and musta mixed with honey. He may also take haridra along with the juice of amalaki. [26]
Decoctions for kaphaja prameha:
===== Decoctions for kaphaja prameha =====
हरीतकीकट्फलमुस्तलोध्रं पाठाविडङ्गार्जुनधन्वनाश्च|
हरीतकीकट्फलमुस्तलोध्रं पाठाविडङ्गार्जुनधन्वनाश्च|
उभे हरिद्रे तगरं विडङ्गं कदम्बशालार्जुनदीप्यकाश्च||२७||
उभे हरिद्रे तगरं विडङ्गं कदम्बशालार्जुनदीप्यकाश्च||२७||
(9) Decoction of yavani, ushira, abhaya and guduchi; and
(9) Decoction of yavani, ushira, abhaya and guduchi; and
(10) Decoction of cahvya, abhaya, chitraka and sapta parna.
(10) Decoction of cahvya, abhaya, chitraka and sapta parna.
Decoctions for pittaja prameha:
===== Decoctions for pittaja prameha =====
उशीरलोध्राञ्जनचन्दनानामुशीरमुस्ता मलकाभयानाम्|
उशीरलोध्राञ्जनचन्दनानामुशीरमुस्ता मलकाभयानाम्|
पटोलनिम्बामलकामृतानां
पटोलनिम्बामलकामृतानां
(9) Decoction of ashvattha, patha, asana and vetasa; and
(9) Decoction of ashvattha, patha, asana and vetasa; and
(10) Decoction of katankateri (daruharidra), utpala and mustaka. [30-32]
(10) Decoction of katankateri (daruharidra), utpala and mustaka. [30-32]
Decoctions for all types of prameha:
===== Decoctions for all types of prameha =====
सर्वेषु मेहेषु मतौ तु पूर्वौ कषाययोगौ विहितास्तु सर्वे|
सर्वेषु मेहेषु मतौ तु पूर्वौ कषाययोगौ विहितास्तु सर्वे|
मन्थस्य पाने यवभावनायां स्युर्भोजने पानविधौ पृथक् च||३३||
मन्थस्य पाने यवभावनायां स्युर्भोजने पानविधौ पृथक् च||३३||
Medicated oils and medicated ghee prepared by cooking with these decoctions should be administered to patients suffering from vatika prameha. These decoctions correct the vitiated medas and kapha, and the aggravated vayu in these patients gets alleviated by the unctuous ingredients (viz., oil and ghee) included in these recipes. [33-34]
Medicated oils and medicated ghee prepared by cooking with these decoctions should be administered to patients suffering from vatika prameha. These decoctions correct the vitiated medas and kapha, and the aggravated vayu in these patients gets alleviated by the unctuous ingredients (viz., oil and ghee) included in these recipes. [33-34]
Formulations for kaphaja and pittaja prameha:
===== Formulations for kaphaja and pittaja prameha =====
कम्पिल्लसप्तच्छदशालजानि बैभीतरौहीतककौटजानि|
कम्पिल्लसप्तच्छदशालजानि बैभीतरौहीतककौटजानि|
कपित्थपुष्पाणि च चूर्णितानि क्षौद्रेण लिह्यात् कफपित्तमेही||३५||
कपित्थपुष्पाणि च चूर्णितानि क्षौद्रेण लिह्यात् कफपित्तमेही||३५||
rasairjA~ggalajairmanoj~jaiH||36||
rasairjA~ggalajairmanoj~jaiH||36||
Powder of kampillaka, barks of saptacchada, bibhitaka, rohitaka and kutaja and flower of kapittha should be added with honey, made to a linctus and taken by patients suffering from kaphaja and pittaja prameha. One aksha of the paste of above mentioned drugs should be mixed with the juice of amalaki and given at the appropriate time to patients suffering from kaphaja and pittaja types of prameha. After the digestion of this potion, the patient should be given to eat old rice cooked and mixed with the delicious soup of the meat of animals living in arid land.[35-36]
Powder of kampillaka, barks of saptacchada, bibhitaka, rohitaka and kutaja and flower of kapittha should be added with honey, made to a linctus and taken by patients suffering from kaphaja and pittaja prameha. One aksha of the paste of above mentioned drugs should be mixed with the juice of amalaki and given at the appropriate time to patients suffering from kaphaja and pittaja types of prameha. After the digestion of this potion, the patient should be given to eat old rice cooked and mixed with the delicious soup of the meat of animals living in arid land.[35-36]
Formulations for vata association in kaphaja and pittaja prameha:
===== Formulations for vata association in kaphaja and pittaja prameha =====
दृष्ट्वाऽनुबन्धं पवनात् कफस्य पित्तस्य वा स्नेहविधिर्विकल्प्यः|
दृष्ट्वाऽनुबन्धं पवनात् कफस्य पित्तस्य वा स्नेहविधिर्विकल्प्यः|
फलत्रिकं दारुनिशां विशालां मुस्तां च निःक्वाथ्य निशां सकल्काम्|
फलत्रिकं दारुनिशां विशालां मुस्तां च निःक्वाथ्य निशां सकल्काम्|
पिबेत् कषायं मधुसम्प्रयुक्तं सर्वप्रमेहेषु समुद्धतेषु||४०||
पिबेत् कषायं मधुसम्प्रयुक्तं सर्वप्रमेहेषु समुद्धतेषु||४०||
dr̥ṣṭvā'nubandhaṁ pavanāt kaphasya pittasya vā snēhavidhirvikalpyaḥ|
tailaṁ kaphē syāt svakaṣāyasiddhaṁ pittē ghr̥taṁ pittaharaiḥ kaṣāyaiḥ||37||
tailaṁ kaphē syāt svakaṣāyasiddhaṁ pittē ghr̥taṁ pittaharaiḥ kaṣāyaiḥ||37||
trikaṇṭakāśmantakasōmavalkairbhallātakaiḥ sātiviṣaiḥ salōdhraiḥ|
trikaṇṭakāśmantakasōmavalkairbhallātakaiḥ sātiviṣaiḥ salōdhraiḥ|
If vayu is secondarily aggravated along with either kapha or pitta, then the patient should be administered unctuous preparations. For the kapha aggravation, medicated oil should be processed with the decoction of kapha alleviating drugs. .For the pitta aggravation, medicated ghee should be processed with the decoction of pitta alleviating drugs. Trikantaka, ashmantaka, somavalka, bhallataka, ativisha, lodhra, vacha, patola, arjuna, nimbi, musta, haridra, padmaka, dipyaka, manjishtha, aguru and chandana- all these drugs together should be used in the preparation of medicated oil for the treatment of kaphaja prameha which is associated with secondarily aggravated vayu. In case of pitta dominance, ghee shall be processed with abovementioned drugs.
If vayu is secondarily aggravated along with either kapha or pitta, then the patient should be administered unctuous preparations. For the kapha aggravation, medicated oil should be processed with the decoction of kapha alleviating drugs. .For the pitta aggravation, medicated ghee should be processed with the decoction of pitta alleviating drugs. Trikantaka, ashmantaka, somavalka, bhallataka, ativisha, lodhra, vacha, patola, arjuna, nimbi, musta, haridra, padmaka, dipyaka, manjishtha, aguru and chandana- all these drugs together should be used in the preparation of medicated oil for the treatment of kaphaja prameha which is associated with secondarily aggravated vayu. In case of pitta dominance, ghee shall be processed with abovementioned drugs.
If the signs and symptoms of all the three doshas are manifested, then with all the above mentioned drugs together, ghee and oil both in a mixed form should be cooked and given to the patient.
If the signs and symptoms of all the three doshas are manifested, then with all the above mentioned drugs together, ghee and oil both in a mixed form should be cooked and given to the patient.
Recipe for all types of prameha
Recipe for all types of prameha
The decoction of triphala, darunisha, vishala and musta should be mixed with the paste of haridra and honey. Intake of this potion cures all types of prameha even when these are manifested in acute form. [37-40]
The decoction of triphala, darunisha, vishala and musta should be mixed with the paste of haridra and honey. Intake of this potion cures all types of prameha even when these are manifested in acute form. [37-40]
Madhvasava:
==== Madhvasava ====
लोध्रं शटीं पुष्करमूलमेलां मूर्वां विडङ्गं त्रिफलां यमानीम्|
लोध्रं शटीं पुष्करमूलमेलां मूर्वां विडङ्गं त्रिफलां यमानीम्|
चव्यं प्रियङ्गुं क्रमुकं विशालां
चव्यं प्रियङ्गुं क्रमुकं विशालां
पाण्ड्वामयार्शांस्यरुचिं ग्रहण्या
पाण्ड्वामयार्शांस्यरुचिं ग्रहण्या
दोषं किलासं विविधं च कुष्ठम्||४४|| इति मध्वासवः|
दोषं किलासं विविधं च कुष्ठम्||४४|| इति मध्वासवः|
lōdhraṁ śaṭīṁ puṣkaramūlamēlāṁ mūrvāṁ viḍaṅgaṁ triphalāṁ yamānīm|
lōdhraṁ śaṭīṁ puṣkaramūlamēlāṁ mūrvāṁ viḍaṅgaṁ triphalāṁ yamānīm|
cavyaṁ priyaṅguṁ kramukaṁ viśālāṁ kirātatiktaṁ kaṭurōhiṇīṁ ca||41||
cavyaṁ priyaṅguṁ kramukaṁ viśālāṁ kirātatiktaṁ kaṭurōhiṇīṁ ca||41||
kali~ggakan kesharamindrasAhvAM nakhaM sapatraM maricaM plavaM ca||42||
kali~ggakan kesharamindrasAhvAM nakhaM sapatraM maricaM plavaM ca||42||
droNe~ambhasaH karShasamAni paktvA pUte caturbhAgajalAvasheShe|
droNe~ambhasaH karShasamAni paktvA pUte caturbhAgajalAvasheShe|
rase~ardhabhAgaM madhunaH pradAya pakShaM nidheyo ghRutabhAjanasthaH||43|| madhvAsavo~ayaM kaphapittaMehan kShipraM nihanyAddvipalaprayogAt|
rase~ardhabhAgaM madhunaH pradAya pakShaM nidheyo ghRutabhAjanasthaH||43||
madhvAsavo~ayaM kaphapittaMehan kShipraM nihanyAddvipalaprayogAt|
pANDvAmayArshAMsyaruciM
pANDvAmayArshAMsyaruciM
grahaNyA doShaM kilAsaM vividhaM ca kuShTham||44|| iti madhvAsavaH|
grahaNyA doShaM kilAsaM vividhaM ca kuShTham||44|| iti madhvAsavaH|
Lodhra, shati, pushkaramula, ela, murva, vidanga, triphala, yamani, chavya, priyangu, kramuka, vishala, kiratatikta, katurohini, bharngi, nata, chitraka, pippalimula, kushtha, ativisha, patha, kalingaka, keshara, indravaruni, nakha, patra, maricha and plava- one karsha of each of these drugs should be boiled in one drona of water till one fourth remains. This decoction along with half its quantity of honey should be kept inside a ghee smeared jar for a fort night. This is called madhvasava. It instantaneously cures kaphaja and paittika types of meha when administered in a dose of two palas. It also cures pandu, arsha, aruchi, grahani dosha, kilasa and different types of kushtha.[41-44]
Lodhra, shati, pushkaramula, ela, murva, vidanga, triphala, yamani, chavya, priyangu, kramuka, vishala, kiratatikta, katurohini, bharngi, nata, chitraka, pippalimula, kushtha, ativisha, patha, kalingaka, keshara, indravaruni, nakha, patra, maricha and plava- one karsha of each of these drugs should be boiled in one drona of water till one fourth remains. This decoction along with half its quantity of honey should be kept inside a ghee smeared jar for a fort night. This is called madhvasava. It instantaneously cures kaphaja and paittika types of meha when administered in a dose of two palas. It also cures pandu, arsha, aruchi, grahani dosha, kilasa and different types of kushtha.[41-44]
Dantyasava and bhallatakasava
==== Dantyasava and bhallatakasava ====
क्वाथः स एवाष्टपलं च दन्त्या भल्लातकानां च चतुष्पलं स्यात्|
क्वाथः स एवाष्टपलं च दन्त्या भल्लातकानां च चतुष्पलं स्यात्|
सितोपला त्वष्टपला विशेषः क्षौद्रं च तावत् पृथगासवौ तौ||४५||
सितोपला त्वष्टपला विशेषः क्षौद्रं च तावत् पृथगासवौ तौ||४५||
sitopalA tvaShTapalA visheShaH kShaudraM ca tAvat pRuthagAsavau tau||45||
sitopalA tvaShTapalA visheShaH kShaudraM ca tAvat pRuthagAsavau tau||45||
In the above mentioned decoction, eight palas of danti, eight palas of sugar and the same quantity of honey should be added and processed. Similarly, in the above mentioned decoction four palas of bhallataka, eight palas of sugar and the same quantity of honey should be added and processed. These two asavas [namely dantyasava and bhallatokusava] are useful in the treatment of prameha. [45]
In the above mentioned decoction, eight palas of danti, eight palas of sugar and the same quantity of honey should be added and processed. Similarly, in the above mentioned decoction four palas of bhallataka, eight palas of sugar and the same quantity of honey should be added and processed. These two asavas [namely dantyasava and bhallatokusava] are useful in the treatment of prameha. [45]
Beneficial diet and drinks:
==== Beneficial diet and drinks ====
सारोदकं वाऽथ कुशोदकं वा मधूदकं वा त्रिफलारसं वा|
सारोदकं वाऽथ कुशोदकं वा मधूदकं वा त्रिफलारसं वा|
सीधुं पिबेद्वा निगदं प्रमेही माध्वीकमग्र्यं
सीधुं पिबेद्वा निगदं प्रमेही माध्वीकमग्र्यं
Spit- roasted meat of animals and birds and different eatables prepared of barley should be given to the patient to eat. Different types of prameha caused by over- nourishment should be alleviated by the administration of elimination therapies, arishtas (a type of wine), decoctions and various types of linctus.
Spit- roasted meat of animals and birds and different eatables prepared of barley should be given to the patient to eat. Different types of prameha caused by over- nourishment should be alleviated by the administration of elimination therapies, arishtas (a type of wine), decoctions and various types of linctus.
Persons habitually taking roasted barley, dry corn- flour, mudga and amalaka do not suffer from prameha, Shvitra (leucoderma), mutrakrucchra (dysuria) and kaphaja kushtha. [46-48]
Persons habitually taking roasted barley, dry corn- flour, mudga and amalaka do not suffer from prameha, Shvitra (leucoderma), mutrakrucchra (dysuria) and kaphaja kushtha. [46-48]
Indications of above treatment:
==== Indications of above treatment ====
सन्तर्पणोत्थेषु गदेषु योगा मेदस्विनां ये च मयोपदिष्टाः|
सन्तर्पणोत्थेषु गदेषु योगा मेदस्विनां ये च मयोपदिष्टाः|
विरूक्षणार्थं कफपित्तजेषु सिद्धाः प्रमेहेष्वपि ते प्रयोज्याः||४९||
विरूक्षणार्थं कफपित्तजेषु सिद्धाः प्रमेहेष्वपि ते प्रयोज्याः||४९||
Effective formulations for producing drying effect on obese patients while describing the management of diseases caused by over- nourishment are useful in the treatment of pramehas caused by kapha and pitta dominance. [49]
Effective formulations for producing drying effect on obese patients while describing the management of diseases caused by over- nourishment are useful in the treatment of pramehas caused by kapha and pitta dominance. [49]
Various external applications:
==== Various external applications ====
व्यायामयोगैर्विविधैः प्रगाढैरुद्वर्तनैः स्नानजलावसेकैः|
व्यायामयोगैर्विविधैः प्रगाढैरुद्वर्तनैः स्नानजलावसेकैः|
सेव्यत्वगेलागुरुचन्दनाद्यैर्विलेपनैश्चाशु[१] न सन्ति मेहाः||५०||
सेव्यत्वगेलागुरुचन्दनाद्यैर्विलेपनैश्चाशु[१] न सन्ति मेहाः||५०||
Pramehas get immediately cured by different types of exercises, unction, bath, sprinkling of water over the body and application of ointment made of sevya (ushira), tvak, ela, aguru, chandana etc. [50]
Pramehas get immediately cured by different types of exercises, unction, bath, sprinkling of water over the body and application of ointment made of sevya (ushira), tvak, ela, aguru, chandana etc. [50]
Indication of apatarpana treatment:
==== Indication of apatarpana treatment ====
क्लेदश्च मेदश्च कफश्च वृद्धः प्रमेहहेतुः प्रसमीक्ष्य तस्मात्|
क्लेदश्च मेदश्च कफश्च वृद्धः प्रमेहहेतुः प्रसमीक्ष्य तस्मात्|
वैद्येन पूर्वं कफपित्तजेषु मेहेषु
वैद्येन पूर्वं कफपित्तजेषु मेहेषु
vaidyēna pūrvaṁ kaphapittajēṣu mēhēṣu kāryāṇyapatarpaṇāni||51||
vaidyēna pūrvaṁ kaphapittajēṣu mēhēṣu kāryāṇyapatarpaṇāni||51||
kledashca medashca kaphashca vRuddhaH pramehahetuH prasamIkShya tasmAt|
kledashca medashca kaphashca vRuddhaH pramehahetuH prasamIkShya tasmAt|
vaidyena pUrvaM kaphapittajeShu meheShu kAryANyapatarpaNAni||51||
Aggravated kleda (liquid element of the body), medas (adipose tissue) and kapha are responsible for the causation of prameha. Keeping this in view, the physician, in the beginning, should administer depletion therapies to patients suffering with kapha and pitta dominant types of prameha. [51]
Aggravated kleda (liquid element of the body), medas (adipose tissue) and kapha are responsible for the causation of prameha. Keeping this in view, the physician, in the beginning, should administer depletion therapies to patients suffering with kapha and pitta dominant types of prameha. [51]
Vata dominant prameha:
==== Vata dominant prameha ====
या वातमेहान् प्रति पूर्वमुक्ता वातोल्बणानां विहिता क्रिया सा|
या वातमेहान् प्रति पूर्वमुक्ता वातोल्बणानां विहिता क्रिया सा|
वायुर्हि मेहेष्वतिकर्शितानां कुप्यत्यसाध्यान् प्रति नास्ति चिन्ता||५२||
वायुर्हि मेहेष्वतिकर्शितानां कुप्यत्यसाध्यान् प्रति नास्ति चिन्ता||५२||
Formulations described earlier for the vatika prameha are actually meant for vata dominant prameha where vayu is secondarily (subsequently) aggravated. If the Vayu is primarily aggravated in prameha because of excessive depletion of tissue elements, then it is incurable and the physican need not make efforts to treat. [52]
Formulations described earlier for the vatika prameha are actually meant for vata dominant prameha where vayu is secondarily (subsequently) aggravated. If the Vayu is primarily aggravated in prameha because of excessive depletion of tissue elements, then it is incurable and the physican need not make efforts to treat. [52]
Prevention of prameha:
==== Prevention of prameha ====
यैर्हेतुभिर्ये प्रभवन्ति मेहास्तेषु प्रमेहेषु न ते निषेव्याः|
यैर्हेतुभिर्ये प्रभवन्ति मेहास्तेषु प्रमेहेषु न ते निषेव्याः|
हेतोरसेवा विहिता यथैव जातस्य रोगस्य भवेच्चिकित्सा||५३||
हेतोरसेवा विहिता यथैव जातस्य रोगस्य भवेच्चिकित्सा||५३||
vihitA yathaiva jAtasya rogasya bhaveccikitsA||53||
vihitA yathaiva jAtasya rogasya bhaveccikitsA||53||
Etiological factors responsible for the causation of different types of prameha should be avoided even after prameha are manifested. The causative factors described shall be avoided during the treatment of those particular diseases (even after its manifestation). [53]
Etiological factors responsible for the causation of different types of prameha should be avoided even after prameha are manifested. The causative factors described shall be avoided during the treatment of those particular diseases (even after its manifestation). [53]
Differentiation between rakta-pitta and prameha:
Differentiation between rakta-pitta and prameha:
हारिद्रवर्णं रुधिरं च मूत्रं विना प्रमेहस्य हि पूर्वरूपैः|
हारिद्रवर्णं रुधिरं च मूत्रं विना प्रमेहस्य हि पूर्वरूपैः|