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==([[Nidana Sthana]] Chapter 4, Chapter on Chronic Urinary Disorders, or ''Prameha'')==
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=== Abstract ===
 
=== Abstract ===
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The fourth chapter in the [[Nidana Sthana]], dealing with the diagnosis of prameha, follows the diagnosis of gulma disease associated with the mamsa dhatu. Twenty known types of prameha, including diabetes mellitus (madhumeha), have been described here. However, there could be innumerable variations of a disease based on the presence or absence of disease (provoking or mitigating) factors in the body. The manifestation of the disease depends upon the interaction between causative factors, dosha, dushya and the defense mechanism of the body.  Some of these factors can also help determine if there could be a delayed or an early onset of the disease, the severity of the disease, etc. Various etiological factors of prameha are described here that lead to vitiation of kapha, meda, and mutra. A vitiated kapha affects ten fluid-predominant body tissues, resulting in the production of excessive kleda (moisture/excess discharge of body fluids) that, when intermixed with meda (lipid)and mamsa (muscle protein), further vitiates mutra (urine) and results in prameha. A patient afflicted with diabetes mellitus, on an initial visit to the physician, may complain of numbness, tingling, burning sensation in feet, fatigue, dryness of mouth, drowsiness, etc. It is highlighted these signs and symptoms for an early diagnosis and management of prameha.Ten types of curable kaphaja prameha, six variants of yaapya (palliative) and four variants of incurable vataja prameha, totaling twenty types of prameha have been described here in this text. Prodromal symptoms, complications, treatment procedures (enumerated briefly), and some rules (do’s and don’ts) have been included in the course of this chapter.
 
The fourth chapter in the [[Nidana Sthana]], dealing with the diagnosis of prameha, follows the diagnosis of gulma disease associated with the mamsa dhatu. Twenty known types of prameha, including diabetes mellitus (madhumeha), have been described here. However, there could be innumerable variations of a disease based on the presence or absence of disease (provoking or mitigating) factors in the body. The manifestation of the disease depends upon the interaction between causative factors, dosha, dushya and the defense mechanism of the body.  Some of these factors can also help determine if there could be a delayed or an early onset of the disease, the severity of the disease, etc. Various etiological factors of prameha are described here that lead to vitiation of kapha, meda, and mutra. A vitiated kapha affects ten fluid-predominant body tissues, resulting in the production of excessive kleda (moisture/excess discharge of body fluids) that, when intermixed with meda (lipid)and mamsa (muscle protein), further vitiates mutra (urine) and results in prameha. A patient afflicted with diabetes mellitus, on an initial visit to the physician, may complain of numbness, tingling, burning sensation in feet, fatigue, dryness of mouth, drowsiness, etc. It is highlighted these signs and symptoms for an early diagnosis and management of prameha.Ten types of curable kaphaja prameha, six variants of yaapya (palliative) and four variants of incurable vataja prameha, totaling twenty types of prameha have been described here in this text. Prodromal symptoms, complications, treatment procedures (enumerated briefly), and some rules (do’s and don’ts) have been included in the course of this chapter.
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=== The chapter ===
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===Sanskrit text, transliteration and english translation===
    
अथातःप्रमेहनिदानंव्याख्यास्यामः||१||
 
अथातःप्रमेहनिदानंव्याख्यास्यामः||१||

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