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→Sanskrit text, Transliteration and English Translation
अथातः प्रमेहचिकित्सितं व्याख्यास्यामः||१||
अथातः प्रमेहचिकित्सितं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
इति ह स्माह भगवानात्रेयः||२||
athātaḥ pramēhacikitsitaṁ vyākhyāsyāmaḥ||1||
athātaḥ pramēhacikitsitaṁ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātrēyaḥ||2||
iti ha smāha bhagavānātrēyaḥ||2||
athAtaH cikitsitaM vyAkhyAsyAmaH||1||
athAtaH cikitsitaM vyAkhyAsyAmaH||1||
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||
nirmōhamānānuśayō nirāśaḥ punarvasurjñānatapōviśālaḥ|
nirmōhamānānuśayō nirāśaḥ punarvasurjñānatapōviśālaḥ|
kālē'gnivēśāya sahētuliṅgānuvāca mēhāñśamanaṁ ca tēṣām||3||
kālē'gnivēśāya sahētuliṅgānuvāca mēhāñśamanaṁ ca tēṣām||3||
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||
āsyāsukhaṁ svapnasukhaṁ dadhīni grāmyaudakānūparasāḥ payāṁsi|
āsyāsukhaṁ svapnasukhaṁ dadhīni grāmyaudakānūparasāḥ payāṁsi|
navānnapānaṁ guḍavaikr̥taṁ ca pramēhahētuḥ kaphakr̥cca sarvam||4||
navānnapānaṁ guḍavaikr̥taṁ ca pramēhahētuḥ kaphakr̥cca sarvam||4||
AsyAsukhaM svapnasukhaM dadhIni grAmyaudakAnUparasAH payAMsi|
AsyAsukhaM svapnasukhaM dadhIni grAmyaudakAnUparasAH payAMsi|
navAnnapAnaM guDavaikRutaM ca PramehahetuH kaphakRucca sarvam||4||
navAnnapAnaM guDavaikRutaM ca PramehahetuH kaphakRucca sarvam||4||
==== Dushya (vitiated factors) and pathogeneis ====
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 ====
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||
kṣīṇēṣu dōṣēṣvavakr̥ṣya bastau dhātūn pramēhānanilaḥ karōti|
kṣīṇēṣu dōṣēṣvavakr̥ṣya bastau dhātūn pramēhānanilaḥ karōti|
dōṣō hi bastiṁ samupētya mūtraṁ sandūṣya mēhāñjanayēdyathāsvam||6||
dōṣō hi bastiṁ samupētya mūtraṁ sandūṣya mēhāñjanayēdyathāsvam||6||
Medashca mAMsaM ca sharIrajaM ca kledaM kapho bastigataM pradUShya|
Medashca mAMsaM ca sharIrajaM ca kledaM kapho bastigataM pradUShya|
karoti Mehan samudIrNamuShNaistAneva pittaM paridUShya cApi||5||
karoti Mehan samudIrNamuShNaistAneva pittaM paridUShya cApi||5||
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.
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.
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]
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 ====
==== 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|
samakriyatvādviṣamakriyatvānmahātyayatvācca yathākramaṁ tē||7||
samakriyatvādviṣamakriyatvānmahātyayatvācca yathākramaṁ tē||7||
sAdhyAH kaphotthA dasha, pittajAH ShaT yApyA, na sAdhyaH
sAdhyAH kaphotthA dasha, pittajAH ShaT yApyA, na sAdhyaH
pavanAccatuShkaH|
pavanAccatuShkaH|
samakriyatvAdviShamakriyatvAnmahAtyayatvAcca
samakriyatvAdviShamakriyatvAnmahAtyayatvAcca
yathAkramaM te||7||
yathAkramaM te||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]
''Kaphaja pramehas'' are of ten types and they are curable because of their compatibility of the therapies meant for their cure (''samakriyatvata'').
''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||
kaphaḥ sapittaḥ pavanaśca dōṣā mēdō'sraśukrāmbuvasālasīkāḥ|
kaphaḥ sapittaḥ pavanaśca dōṣā mēdō'sraśukrāmbuvasālasīkāḥ|
majjā rasaujaḥ piśitaṁ ca dūṣyāḥ [3] pramēhiṇāṁ, viṁśatirēva mēhāḥ||8||
majjā rasaujaḥ piśitaṁ ca dūṣyāḥ [3] pramēhiṇāṁ, viṁśatirēva mēhāḥ||8||
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|