Changes

sarva ēva tē yāpyāḥ saṁsr̥ṣṭadōṣamēdaḥsthānatvādviruddhōpakramatvāccēti||27||  

sarva ēva tē yāpyāḥ saṁsr̥ṣṭadōṣamēdaḥsthānatvādviruddhōpakramatvāccēti||27||  

tatra ślōkāḥ pittapramēhaviśēṣavijñānārthā bhavanti-||28||  

tatra ślōkāḥ pittapramēhaviśēṣavijñānārthā bhavanti-||28||  

gandhavarṇarasasparśairyathā kṣārastathāvidham|  

gandhavarṇarasasparśairyathā kṣārastathāvidham|  

pittakōpānnarō mūtraṁ kṣāramēhī pramēhati||29||  

pittakōpānnarō mūtraṁ kṣāramēhī pramēhati||29||  

masīvarṇamajasraṁ yō mūtramuṣṇaṁ pramēhati|  

masīvarṇamajasraṁ yō mūtramuṣṇaṁ pramēhati|  

pittasya parikōpēṇa taṁ vidyāt kālamēhinam||30||  

pittasya parikōpēṇa taṁ vidyāt kālamēhinam||30||  

cāṣapakṣanibhaṁ mūtramamlaṁ mēhati yō naraḥ|  

cāṣapakṣanibhaṁ mūtramamlaṁ mēhati yō naraḥ|  

pittasya parikōpēṇa taṁ vidyānnīlamēhinam||31||  

pittasya parikōpēṇa taṁ vidyānnīlamēhinam||31||  

visraṁ lavaṇamuṣṇaṁ ca raktaṁ mēhati yō naraḥ|  

visraṁ lavaṇamuṣṇaṁ ca raktaṁ mēhati yō naraḥ|  

pittasya parikōpēṇa taṁ vidyādraktamēhinam||32||  

pittasya parikōpēṇa taṁ vidyādraktamēhinam||32||  

mañjiṣṭhōdakasaṅkāśaṁ bhr̥śaṁ visraṁ pramēhati|  

mañjiṣṭhōdakasaṅkāśaṁ bhr̥śaṁ visraṁ pramēhati|  

pittasya parikōpāttaṁ vidyānmāñjiṣṭhamēhinam||33||  

pittasya parikōpāttaṁ vidyānmāñjiṣṭhamēhinam||33||  

haridrōdakasaṅkāśaṁ kaṭukaṁ yaḥ pramēhati|  

haridrōdakasaṅkāśaṁ kaṭukaṁ yaḥ pramēhati|  

pittasya parikōpāttaṁ vidyāddhāridramēhinam||34||  

pittasya parikōpāttaṁ vidyāddhāridramēhinam||34||  

ityētē ṣaṭ pramēhāḥ pittaprakōpanimittā vyākhyātā bhavanti||35||

ityētē ṣaṭ pramēhāḥ pittaprakōpanimittā vyākhyātā bhavanti||35||

sarva eva te yApyAH saMsRuShTadoShamedaHsthAnatvAdviruddhopakramatvAcceti||27||

sarva eva te yApyAH saMsRuShTadoShamedaHsthAnatvAdviruddhopakramatvAcceti||27||

tatra shlokAH pittapramehavisheShavij~jAnArthA bhavanti-||28|| gandhavarNarasasparshairyathA kShArastathAvidham|  

 

tatra shlokAH pittapramehavisheShavij~jAnArthA bhavanti-||28||  

 

gandhavarNarasasparshairyathA kShArastathAvidham|  

pittakopAnnaro mUtraM kShAramehI pramehati||29||  

pittakopAnnaro mUtraM kShAramehI pramehati||29||  

masIvarNamajasraM yo mUtramuShNaM pramehati|  

masIvarNamajasraM yo mUtramuShNaM pramehati|  

pittasya parikopeNa taM vidyAt kAlamehinam||30||

pittasya parikopeNa taM vidyAt kAlamehinam||30||

cAShapakShanibhaM mUtramamlaM mehati yo naraH|  

cAShapakShanibhaM mUtramamlaM mehati yo naraH|  

pittasya parikopeNa taM vidyAnnIlamehinam||31||

pittasya parikopeNa taM vidyAnnIlamehinam||31||

  visraM lavaNamuShNaM ca raktaM mehati yo naraH|

  visraM lavaNamuShNaM ca raktaM mehati yo naraH|

pittasya parikopeNa taM vidyAdraktamehinam||32||  

pittasya parikopeNa taM vidyAdraktamehinam||32||  

ma~jjiShThodakasa~gkAshaM bhRushaM visraM pramehati|  

ma~jjiShThodakasa~gkAshaM bhRushaM visraM pramehati|  

pittasya parikopAttaM vidyAnmA~jjiShThamehinam||33||

pittasya parikopAttaM vidyAnmA~jjiShThamehinam||33||

haridrodakasa~gkAshaM kaTukaM yaH pramehati|  

haridrodakasa~gkAshaM kaTukaM yaH pramehati|  

pittasya parikopAttaM vidyAddhAridramehinam||34||  

pittasya parikopAttaM vidyAddhAridramehinam||34||  

ityete ShaT pramehAH pittaprakopanimittA vyAkhyAtA bhavanti||35||

ityete ShaT pramehAH pittaprakopanimittA vyAkhyAtA bhavanti||35||

All these types of prameha are palliable (but not fully curable) because the loci of vitiated medas in the pathogenesis of this disease are closer to those of the affected doshas and the treatment of pitta and medas is in mutual contradiction. The specific features of diffent types of prameha caused by pitta are given below:

All these types of prameha are palliable (but not fully curable) because the loci of vitiated medas in the pathogenesis of this disease are closer to those of the affected doshas and the treatment of pitta and medas is in mutual contradiction. The specific features of diffent types of prameha caused by pitta are given below:

1. In ksharameha the patient passes urine having the smell, colour, taste and touch similar to those of alkalies.

1. In ksharameha the patient passes urine having the smell, colour, taste and touch similar to those of alkalies.

2. In kalameha the patient passes large quantities of black or dark urine.

2. In kalameha the patient passes large quantities of black or dark urine.

Thus, six varieties of prameha due to vitiation of pitta are explained. [27-35]

Thus, six varieties of prameha due to vitiation of pitta are explained. [27-35]

Etio-pathogenesis of vataja prameha:

==== Etio-pathogenesis of vataja prameha ====

 

कषायकटुतिक्तरूक्षलघुशीतव्यवायव्यायामवमनविरेचनास्थापन-शिरोविरेचनातियोगसन्धारणानशनाभिघातातपोद्वेगशोकशोणितातिषेक-  

कषायकटुतिक्तरूक्षलघुशीतव्यवायव्यायामवमनविरेचनास्थापन-शिरोविरेचनातियोगसन्धारणानशनाभिघातातपोद्वेगशोकशोणितातिषेक-  

जागरणविषमशरीरन्यासानुपसेवमानस्यतथाविधशरीरस्यैवक्षिप्रंवातः

जागरणविषमशरीरन्यासानुपसेवमानस्यतथाविधशरीरस्यैवक्षिप्रंवातः

प्रकोपमापद्यते||३६||

प्रकोपमापद्यते||३६||

सप्रकुपितस्तथाविधेशरीरेविसर्पन्यदावसामादायमूत्रवहानिस्रोतांसिप्रतिपद्यतेतदावसामेहमभिनिर्वर्तयति; यदापुनर्मज्जानंमूत्रबस्तावाकर्षतितदामज्जमेहमभिनिर्वर्तयति; यदातुलसीकांमूत्राशयेऽभिवहन्मूत्रमनुबन्धंच्योतयतिलसीकातिबहुत्वाद्विक्षेपणाच्चवायोःखल्वस्यातिमूत्रप्रवृत्तिसङ्गं[१]करोति, तदासमत्तइवगजःक्षरत्यजस्रंमूत्रमवेगं, तंहस्तिमेहिनमाचक्षते; ओजःपुनर्मधुरस्वभावं, तद्यदारौक्ष्याद्वायुःकषायत्वेनाभिसंसृज्यमूत्राशयेऽभिवहतितदामधुमेहंकरोति||३७||

सप्रकुपितस्तथाविधेशरीरेविसर्पन्यदावसामादायमूत्रवहानिस्रोतांसिप्रतिपद्यतेतदावसामेहमभिनिर्वर्तयति; यदापुनर्मज्जानंमूत्रबस्तावाकर्षतितदामज्जमेहमभिनिर्वर्तयति; यदातुलसीकांमूत्राशयेऽभिवहन्मूत्रमनुबन्धंच्योतयतिलसीकातिबहुत्वाद्विक्षेपणाच्चवायोःखल्वस्यातिमूत्रप्रवृत्तिसङ्गं[१]करोति, तदासमत्तइवगजःक्षरत्यजस्रंमूत्रमवेगं, तंहस्तिमेहिनमाचक्षते; ओजःपुनर्मधुरस्वभावं, तद्यदारौक्ष्याद्वायुःकषायत्वेनाभिसंसृज्यमूत्राशयेऽभिवहतितदामधुमेहंकरोति||३७||

kaṣāyakaṭutiktarūkṣalaghuśītavyavāyavyāyāmavamanavirēcanāsthāpana-śirōvirēcanātiyōgasandhāraṇānaśanābhighātātapōdvēgaśōkaśōṇitātiṣēka-jāgaraṇaviṣamaśarīranyāsānupasēvamānasya tathāvidhaśarīrasyaiva kṣipraṁ vātaḥ prakōpamāpadyatē||36||  

kaṣāyakaṭutiktarūkṣalaghuśītavyavāyavyāyāmavamanavirēcanāsthāpana-śirōvirēcanātiyōgasandhāraṇānaśanābhighātātapōdvēgaśōkaśōṇitātiṣēka-jāgaraṇaviṣamaśarīranyāsānupasēvamānasya tathāvidhaśarīrasyaiva kṣipraṁ vātaḥ prakōpamāpadyatē||36||  

sa prakupitastathāvidhē śarīrē visarpan yadā vasāmādāya mūtravahāni srōtāṁsi pratipadyatē tadā vasāmēhamabhinirvartayati; yadā punarmajjānaṁmūtrabastāvākarṣati tadā majjamēhamabhinirvartayati; yadā tu lasīkāṁ mūtrāśayē'bhivahanmūtramanubandhaṁ cyōtayati lasīkātibahutvādvikṣēpaṇācca vāyōḥkhalvasyātimūtrapravr̥ttisaṅgaṁ [11] karōti, tadā sa matta iva gajaḥ kṣaratyajasraṁ mūtramavēgaṁ, taṁ hastimēhinamācakṣatē; ōjaḥ punarmadhurasvabhāvaṁ, tadyadā raukṣyādvāyuḥ kaṣāyatvēnābhisaṁsr̥jya mūtrāśayē'bhivahati tadā madhumēhaṁ karōti||37||  

sa prakupitastathāvidhē śarīrē visarpan yadā vasāmādāya mūtravahāni srōtāṁsi pratipadyatē tadā vasāmēhamabhinirvartayati; yadā punarmajjānaṁmūtrabastāvākarṣati tadā majjamēhamabhinirvartayati; yadā tu lasīkāṁ mūtrāśayē'bhivahanmūtramanubandhaṁ cyōtayati lasīkātibahutvādvikṣēpaṇācca vāyōḥkhalvasyātimūtrapravr̥ttisaṅgaṁ [11] karōti, tadā sa matta iva gajaḥ kṣaratyajasraṁ mūtramavēgaṁ, taṁ hastimēhinamācakṣatē; ōjaḥ punarmadhurasvabhāvaṁ, tadyadā raukṣyādvāyuḥ kaṣāyatvēnābhisaṁsr̥jya mūtrāśayē'bhivahati tadā madhumēhaṁ karōti||37||  

KaShAyakaTutiktarUkShalaghushItavyavAyavyAyAmavamanavirecan AsthApana shirovirecanAtiyogasandhAraNAnashanAbhighAtAtapodvegashokashoNitAtiSheka-

KaShAyakaTutiktarUkShalaghushItavyavAyavyAyAmavamanavirecan AsthApana shirovirecanAtiyogasandhAraNAnashanAbhighAtAtapodvegashokashoNitAtiSheka-

jAgaraNaviShamasharIranyAsAnupasevamAnasya tathAvidhasharIrasyaiva kShipraM vAtaH prakopamApadyate||36||

jAgaraNaviShamasharIranyAsAnupasevamAnasya tathAvidhasharIrasyaiva kShipraM vAtaH prakopamApadyate||36||

sa prakupitastathAvidhe sharIre visarpan yadA vasAmAdAya mUtravahAni srotAMsi pratipadyate tadA vasAmehamabhinirvartayati; yadA punarmajjAnaM mUtrabastAvAkarShati tadA majjamehamabhinirvartayati; yadA tu lasIkAM mUtrAshaye~abhivahanmUtramanubandhaM cyotayati lasIkAtibahutvAdvikShepaNAcca  vAyoH khalvasyAtimUtrapravRuttisa~ggaM karoti, tadA sa matta iva gajaH kSharatyajasraM mUtramavegaM, taM hastimehinamAcakShate; ojaH punarmadhurasvabhAvaM, tad yadA raukShyAdvAyuH kaShAyatvenAbhisaMsRujya mUtrAshaye~abhivahati tadA madhumehaM karoti||37||

sa prakupitastathAvidhe sharIre visarpan yadA vasAmAdAya mUtravahAni srotAMsi pratipadyate tadA vasAmehamabhinirvartayati; yadA punarmajjAnaM mUtrabastAvAkarShati tadA majjamehamabhinirvartayati; yadA tu lasIkAM mUtrAshaye~abhivahanmUtramanubandhaM cyotayati lasIkAtibahutvAdvikShepaNAcca  vAyoH khalvasyAtimUtrapravRuttisa~ggaM karoti, tadA sa matta iva gajaH kSharatyajasraM mUtramavegaM, taM hastimehinamAcakShate; ojaH punarmadhurasvabhAvaM, tad yadA raukShyAdvAyuH kaShAyatvenAbhisaMsRujya mUtrAshaye~abhivahati tadA madhumehaM karoti||37||

Vata gets immediately aggravated in an individual whose body is pre-conditioned by above mentioned (verse 5) factors and exposed to the following factors:  

Vata gets immediately aggravated in an individual whose body is pre-conditioned by above mentioned (verse 5) factors and exposed to the following factors:  

1. Excessive intake of astringent, pungent, bitter, rough, light and cold things;

1. Excessive intake of astringent, pungent, bitter, rough, light and cold things;

2. Excessive indulgence in sex and physical exercise.

2. Excessive indulgence in sex and physical exercise.

3. Excessive administration of emesis, purgations, asthapana type of enema and shirovirechana (elimination of doshas from the head) ,and

3. Excessive administration of emesis, purgations, asthapana type of enema and shirovirechana (elimination of doshas from the head) ,and

4. Suppression of the manifested urges, fasting, trauma due to assault, exposure to sun, anxiety, grief, excessive bloodletting, staying awake at night, and irregular posture of the body.

4. Suppression of the manifested urges, fasting, trauma due to assault, exposure to sun, anxiety, grief, excessive bloodletting, staying awake at night, and irregular posture of the body.

The aggravated vata spreads throughout the body, and along with vasa (muscle fat), enters the ureter leading to the manifestation of vasameha. When it carries marrow to the urinary bladder, it results in majjameha.

The aggravated vata spreads throughout the body, and along with vasa (muscle fat), enters the ureter leading to the manifestation of vasameha. When it carries marrow to the urinary bladder, it results in majjameha.

Due to the large quantity of lasika (lymphs) in the body and also due to the property of vata to dissipate things, lasika entering the urinary bladder produces large quantity of urine, causing a continuous urge for micturition and, thus, passing copious amounts of urine continuously (even) without any pressure, like an elephant (hasti) gone amuck. Thus, this is also known as hastimeha.  

Due to the large quantity of lasika (lymphs) in the body and also due to the property of vata to dissipate things, lasika entering the urinary bladder produces large quantity of urine, causing a continuous urge for micturition and, thus, passing copious amounts of urine continuously (even) without any pressure, like an elephant (hasti) gone amuck. Thus, this is also known as hastimeha.  

Ojas is, by nature, of sweet taste. However, its roughness causes vata to convert it into an astringent tasting element.  This vata-afflicted ojas, when gets into the urinary bladder, causes madhumeha. [36-37]

Ojas is, by nature, of sweet taste. However, its roughness causes vata to convert it into an astringent tasting element.  This vata-afflicted ojas, when gets into the urinary bladder, causes madhumeha. [36-37]

Incurability of vataja prameha and its other characteristics:

 

==== Incurability of vataja prameha and its other characteristics ====

 

इमांश्चतुरः प्रमेहान् वातजानसाध्यानाचक्षते भिषजः, महात्ययिकत्वाद्विरुद्धोपक्रमत्वाच्चेति||३८||  

इमांश्चतुरः प्रमेहान् वातजानसाध्यानाचक्षते भिषजः, महात्ययिकत्वाद्विरुद्धोपक्रमत्वाच्चेति||३८||  

तेषामपि पूर्ववद्गुणविशेषेण नामविशेषा भवन्ति; तद्यथा- वसामेहश्च, मज्जमेहश्च, हस्तिमेहश्च, मधुमेहश्चेति||३९||  

तेषामपि पूर्ववद्गुणविशेषेण नामविशेषा भवन्ति; तद्यथा- वसामेहश्च, मज्जमेहश्च, हस्तिमेहश्च, मधुमेहश्चेति||३९||  

इत्येते चत्वारः प्रमेहा वातप्रकोपनिमित्ता व्याख्याता भवन्ति||४५||  

इत्येते चत्वारः प्रमेहा वातप्रकोपनिमित्ता व्याख्याता भवन्ति||४५||  

एवं त्रिदोषप्रकोपनिमित्ता विंशतिः प्रमेहा व्याख्याता भवन्ति||४६||  

एवं त्रिदोषप्रकोपनिमित्ता विंशतिः प्रमेहा व्याख्याता भवन्ति||४६||  

imāṁścaturaḥ pramēhān vātajānasādhyānācakṣatē bhiṣajaḥ, mahātyayikatvādviruddhōpakramatvāccēti||38||  

imāṁścaturaḥ pramēhān vātajānasādhyānācakṣatē bhiṣajaḥ, mahātyayikatvādviruddhōpakramatvāccēti||38||  

tēṣāmapi pūrvavadguṇaviśēṣēṇa nāmaviśēṣā bhavanti; tadyathā- vasāmēhaśca, majjamēhaśca, hastimēhaśca, madhumēhaścēti||39||  

tēṣāmapi pūrvavadguṇaviśēṣēṇa nāmaviśēṣā bhavanti; tadyathā- vasāmēhaśca, majjamēhaśca, hastimēhaśca, madhumēhaścēti||39||  

4. In madhumeha, the patient passes urine sweet and astringent in taste, pale in colour and ununctuous. It is incurable and caused by the aggravation of vata.

4. In madhumeha, the patient passes urine sweet and astringent in taste, pale in colour and ununctuous. It is incurable and caused by the aggravation of vata.

Thus explained are the four variants of vataja prameha and twenty types of prameha (due to vitiation of the three doshas).[38-46]

Thus explained are the four variants of vataja prameha and twenty types of prameha (due to vitiation of the three doshas).[38-46]

General prodromal features of prameha:

 

==== General prodromal features of prameha ====

 

त्रयस्तुखलुदोषाःप्रकुपिताःप्रमेहानभिनिर्वर्तयिष्यन्तइमानि

त्रयस्तुखलुदोषाःप्रकुपिताःप्रमेहानभिनिर्वर्तयिष्यन्तइमानि

पूर्वरूपाणिदर्शयन्ति; तद्यथा- जटिलीभावंकेशेषु, माधुर्यमास्यस्य, करपादयोःसुप्ततादाहौ, मुखतालुकण्ठशोषं, पिपासाम्, आलस्यं, मलंकाये,कायच्छिद्रेषूपदेहं, परिदाहंसुप्ततांचाङ्गेषु, षट्पदपिपीलिकाभिश्चशरीरमूत्राभिसरणं, मूत्रेचमूत्रदोषान्, विस्रंशरीरगन्धं, निद्रां, तन्द्रांचसर्वकालमिति||४७||

पूर्वरूपाणिदर्शयन्ति; तद्यथा- जटिलीभावंकेशेषु, माधुर्यमास्यस्य, करपादयोःसुप्ततादाहौ, मुखतालुकण्ठशोषं, पिपासाम्, आलस्यं, मलंकाये,कायच्छिद्रेषूपदेहं, परिदाहंसुप्ततांचाङ्गेषु, षट्पदपिपीलिकाभिश्चशरीरमूत्राभिसरणं, मूत्रेचमूत्रदोषान्, विस्रंशरीरगन्धं, निद्रां, तन्द्रांचसर्वकालमिति||४७||

The three vitiated doshas, while causing prameha, produce the following prodromal symptoms:

The three vitiated doshas, while causing prameha, produce the following prodromal symptoms:

1. Matting of hair;

1. Matting of hair;

2. Sweet taste in the mouth;

2. Sweet taste in the mouth;

12. Excessive sleep and continuous drowsiness. [47]

12. Excessive sleep and continuous drowsiness. [47]

General complications and principles of treatment:

==== General complications and principles of treatment ====

 

उपद्रवास्तुखलुप्रमेहिणांतृष्णातीसारज्वरदाहदौर्बल्यारोचकाविपाकाः

उपद्रवास्तुखलुप्रमेहिणांतृष्णातीसारज्वरदाहदौर्बल्यारोचकाविपाकाः

पूतिमांसपिडकालजीविद्रध्यादयश्चतत्प्रसङ्गाद्भवन्ति||४८||

पूतिमांसपिडकालजीविद्रध्यादयश्चतत्प्रसङ्गाद्भवन्ति||४८||

तत्रसाध्यान्प्रमेहान्संशोधनोपशमनैर्यथार्हमुपपादयंश्चिकित्सेदिति||४९||

तत्रसाध्यान्प्रमेहान्संशोधनोपशमनैर्यथार्हमुपपादयंश्चिकित्सेदिति||४९||

upadravāstu khalu pramēhiṇāṁ tr̥ṣṇātīsārajvaradāhadaurbalyārōcakāvipākāḥ pūtimāṁsapiḍakālajīvidradhyādayaśca tatprasaṅgādbhavanti||48||  

upadravāstu khalu pramēhiṇāṁ tr̥ṣṇātīsārajvaradāhadaurbalyārōcakāvipākāḥ pūtimāṁsapiḍakālajīvidradhyādayaśca tatprasaṅgādbhavanti||48||  

tatra sādhyān pramēhān saṁśōdhanōpaśamanairyathārhamupapādayaṁścikitsēditi||49||  

tatra sādhyān pramēhān saṁśōdhanōpaśamanairyathārhamupapādayaṁścikitsēditi||49||  

UpadravAstu khalu pramehiNAM tRuShNAtIsArajvaradAhadaurbalyArocakAvipAkAH pUtimAMsapiDakAlajIvidradhyAdayashca

UpadravAstu khalu pramehiNAM tRuShNAtIsArajvaradAhadaurbalyArocakAvipAkAH pUtimAMsapiDakAlajIvidradhyAdayashca

tatprasa~ggAdbhavanti||48||

tatprasa~ggAdbhavanti||48||

tatra sAdhyAn pramehAn

tatra sAdhyAn pramehAn

saMshodhanopashamanairyathArhamupapAdayaMshcikitsediti||49||

saMshodhanopashamanairyathArhamupapAdayaMshcikitsediti||49||

Of all these variants, the curable types of prameha should be treated with the appropriate elimination and alleviation therapies on time. [48-49]

Of all these variants, the curable types of prameha should be treated with the appropriate elimination and alleviation therapies on time. [48-49]

Consequences of prameha:

==== Consequences of prameha ====

 

भवन्तिचात्र-  

भवन्तिचात्र-  

गृध्नुमभ्यवहार्येषुस्नानचङ्क्रमणद्विषम्|

गृध्नुमभ्यवहार्येषुस्नानचङ्क्रमणद्विषम्|