Critical review on Sushruta

contribution of the urology

D.SASHIKUMARAN
G.SAHAYAPRAGASH
E.P.C.PRIYADARSHANI
L.A.A.C.SUBHASHINI
KAVIDU KARUNARATHNA

INTRODUCTION
Urologyisthebranchofmedicinethatfocusesonthe
surgical and medical diseases of the male and
femaleurinarytractsystemandthemalereproductive
organs.
Theorgansunderthedomainofurologyinclude The
Kidney
Ureters
Urinary bladder
Urethra and the male reproductive organs (testes,
epididymis,vasdeferens,seminalvesicles,prostateand
penis).

Urology-associated issues

Benignprostatichyperplasia
Bladderstones
Kidneystone
Urolithiasis
Prostitis(prostateglandinfection)
Prostatecancer
Bladdercancer
Cystitis
Epididymitis
Kidneycancer
Retrogradeurethra
Testicularcancer

ANATOMY OF URINARY SYSTEM

ACCORDING TO SUSHRUTHA SAMHITHA

KIDNEYS (jDlal&
jDlafl! udxi msKa oajhx tafld jdu mdYj
ia:s;#
oa;fhd olaIsK
mdYj ia:s;# - iq$ks 9$7 v,ayk rla; fo# m%idod;aufl! jDlafl! - iq$Yd 4$31
Kidneysareoriginatedfromprasadabhagaofraktha
andmeda.

Bladder( jia;sh)
1. Originatedfromrakthaandkaphaanditboilfrompitta.
(Su.Sha.4/26)
2' kdNs mDIag lG uqIal .=o jxlaIKfYAMidx
taloajdria;kq;ajDlafl! ufOH jia;srfOdauqL#
basthiissituatedinthemidstofumbilicus,back,waist,scrotum,
rectum, groins and penis and it has one orifice and place with its
facedownwards.
3' w,jd bj rEfmk isrd iakdhq mrs.%y#
uq;%dYfhdau,dOdr# m%dKdh;kuq;a; iq$ks 3$18-24
the shape of the bladder is looks like alabu(pitcher gourd) and
supportedbysiraandsnayu.

PHYSIOLOGY OF THE URINARY SYSTEM

Overview of kidney functions:
Regulating blood ionic composition: Thekidneyshelpregularthebloodlevelsof
several ions, most importantly sodium ions (Na+) potassium ions (K+) calcium
ions(Ca2+)chlorideions(CI-)andphosphateions(HPO42)
Regulating blood Ph: The kidneys excrete a variable amount of hydrogen ions
(H+)intotheurineandconservebicarbonateions(HCO3)whichareanimportant
bufferofH+intheblood.BothoftheseactivitieshelpregulatebloodpH
Regulating blood volume: The kidneys adjust blood volume by conversing or
eliminating water in the urine.Also, an increase in blood volume increase blood
pressurewhereasadecreaseinbloodvolumedecreasebloodpressure.

Regulating blood pressure: Beside adjusting blood volume, the kidneys help
regulate blood pressure by secreting the enzyme renin, which activates the renin
angiotensin - aldosterone pathway Increased renin causes an increase in blood
pressure.

 Maintaining blood osmolality: By separately regulating loss of

water and loss of solutes in the urine, the kidneys maintain a
relatively constant blood osmolality close to 290 milliosmoles per
liter.
Producing hormones: The kidneys produce two hormones.
Calcitol the active form of vitamin D, helps regulate calcium
homeostasisanderythropoietinstimulatesproductionofredblood
cells.
Regulating blood glucose level : Like the liver, the kidneys can
use theamino acid glutamineingluconeogenesis,thesynthesisof
new glucose molecules. They can then release glucose into the
bloodtohelpmaintainanormalbloodglucoselevel.

 Excreting wastes and foreign substances: By forming

urinethekidneyshelpexcretewastessubstancesthathave
no useful function in the body. Some wastes excreted in
urineresultfrommetabolicreactionsinthebody.
Theseincludeammoniaandureafromthedeaminationof
aminoacids;bilirubinfromthecatabolismofhemoglobin;
creatine from the breakdown of creatine phosphate in
musclefibers;anduricacidfromthecatabolismofnucleic
acids. Other wastes excreted in urine are foreign
substancesfromthediet,suchasdrugsandenvironmental
toxins.

Overview of renal physiology according to Sushruta Samhitha

Su.Ni.3/18-24
Mutravaha nadi, fill the bladder by bringing
urine continuously just like the rivers
satisfying the ocean.
The urine, fill the bladder by oozing through
its wall, both during waking and sleeping
status, just as a fresh earthen pot kept
immersed in water up to its mouth gets filled
with water through its sides.

wdydr

wdydr mrsmpkh

wdydr rih

m%ido

lsg
ksIHkaokh
iafjo

uq;%dYh

iqlaIu fida;%ia

j uq;% >k mqrI

REVIEW ON MUTRA ROGA

The disease pertaining to Mutravaha srotas are
considered as Mutraroga. The Vasti- urinary
bladderisconsideredasmainseatofthemutraroga.
(S.S.Ni.3/28)
Variation of Tridosha leads to the pathology of the
urinarysystemandproducevariousmutravikara.
Normal physiology of the urinary system is
maintained by theApana vayu one among the five
typesofVayu.
(S.S.NI.3/27)

 AccordingtoSushruta,derangementofvayuitself
isthechief causesforthepathologicalconditions
oftheMutrapravrathi.
Actofurinationofvoidingvitiationofvatadosha
and sthana-samshraya in basti leads to various
urinarydiseases.
Eg:Prameha
20
Ashmari
04
Mutraghata 13
Mutrakriccha 08
(Su.Su.21/33)

NIDANA AND SAMPRAPTHI

i. Basiccauseformutrarogaaremutravega dharana
(suppressionofurgeofmicturition)andmithyahara
vihara(Unadvisablefoodandactivities).
ii. Vata dosha is the main dosha responsible for the
functionslikenishkarmanaof(expulsionorexecration
of ) shukra (semen), arthava (menstrual flow) shakrit
(stool/feces)andmutra(voiding).
The Pathology attains at different stages like
sanchaya,prakopa, prasasa, sthanasamshraya, vyakta
and bheda. When vitiated dosha takes seat in Basti
producesobstructiveuropathyetc,urinarydiseases.

Pathology
Mithyahara Vihara / Abhighataja
Vata vaishamya
Basti desha sthana samshraya

Mutravikara or Mutraroga

CLASSIFICATION
General Classification:
A. Diseases of Urinary tract.
i. Mutraghataii. Mutrakricchra
iii. Ashmari iv. Prameha

1.

B. Systemic diseases presenting urinary symptoms:

i. Rakta pitta ii. Atisara
iii. Kamala iv. Jwara

iii.Miscellaneous :
i. Mutrashukra
ii. Bastishula
iii. Mutraudavarta
iv. Mutrakta
v. Niruddha prakasha

2. According to Cardinal features:

i. With Obstruction:
In this group of disorders, obstruction to the free passage
of urine.
There will be mechanical cause leads to
obstruction:
Eg. Ashmari(urolithiasis), Ashtila (BPH), Niruddha
prakasha (pinhole meatus) (Su.Ni. 13/52,53,5).
ii. Disease with Dysuria : Painful micturition is the
dominant symptoms in this group. ( Su.Ut.59)
iii. Diseases with Urinary abnormalities : Change in
the characteristics of urine Eg. Prameharoga ( Su.Ni.
6/4)

3. According to Urinary Flow (Mutra Pravritthi)

i. Atipravrittaja: Prameha roga
Kapaja

Udakameha
Ikshumeha

Pittaja

Vataja

Ksharameda

Vasameha

Neelameha

Sarpimeha

Sandrameha

Shonitameha

Hastimeha

Surameha

Manjistameha

Kshoudrameha

Pishtameha

Haridrameha

Shukrameha
Sikatameha
Shanairmeha
Lavanameha
Phenameha
Shitameha
Alalameha

Amlameha
Kalameha

Madhumeha

ii Apravrittaja Mutra Roga

Mutraghata
1.

Vatakundalika

Mutrakricchra

Miscellaneous

1.

Vataja

1.

Tuni

2.

Vatashtila

2.

Pittaja

2.

Pratituni

3.

Vatabasti

3.

Kapaja

3.

Mutravruta vata

4.

Mutratita

4.

Sannipataja

4.

Pratyastila

5.

Murajatara

5.

Abhighataja

5.

Basti shula

6.

Murtasanga

6.

Shakritjanya

6.

Mutraviddha

7.

Mutrakshaya

7.

Ashmari- janya

7.

8.

Sharkarajanya

8. Vitiation of mutravaha
srotus

8.

Mutragranthi

9.

Mutrashukra

10.

Mutroutasada - Pittaja

11.

Mutroutasada - Kaphaja

12.

Vitvighata - Caraka

13.

Bastikundala

9.

Parivartika

Niruddha Prakasha

10. Complication of pittaja

premeha

Sushruta Samhita mentioned

12 Mutraghata +8 Mutra kruchra -4 Ashmari
= 24
Mutraghata :
Sushruta Samhita Uttaratantra 58 (Mutraghata
pratisheda adhyaya)
Mutrakruchra:
Sushruta Samhita Uttara Tantra 59 (Mutrakruchra
Pratisheda adyaya)
Ashmari :
Sushruta Samhita Nidana stana 3 (Ashmari Nidana
adhyaya)
Sushruta Samhita Chikitsa sthana 7 (Ashmari
Chikitsa adhyaya)

Treatment of Mutraroga
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uq;% fodaIdP fh floa jia;sfuj
Njka;sys#
iq$ks 3$27
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ys;x

According to Treatment (Chikitsa) :

AMedical
Ashmari All varieties in early stage
Mutrakricchra Vataja, pittaja, kapaja,
sannipatana, abhighataya
Mutraghata all variety of Mutraghata
BSurgical
Ashmari all varieties except Shukra
Ashmari in later stage
Mutrakricchra Ashmari and sharkara janya

MUTRAKRUCHCHA
(uq;% lDP)

REVIEW ON MUTRARICCHA
NIDANA
Dietary Causes :
Tikshna oushadha sevana (Taking powerful/strong drugs)
Ruksha anna (Dry meal)
Atimadyapana (Excess intake of alcohol)
Anupa mamsa sevana (meat of marshy place animals)
Atimatsya sevana (Excess fish intake)
Adyashana (Over indulgence or intake of food)
Ajirna (Indigestion)

Physical strains:
Ativyayama (Excess Exercise)
Atimaithuna ( over indulgence in coitus)
Ati nritya karma ( Dancing)
Atidrita ( Fast riding)
Prishtayana ( riding vehicles, animals etc...)

SAMPRAPTI
The various mala (doshas) of the
body vitiates due to their own
vitiating causes. This vitiated dosha
singly or in combination vitiates
vasti, three by peedana (functional
derangement) of mutramarga, leads
to difficulty in micturition.

BHEDA

Vata
Pitta
Kapha
Sannipata
Ashmari
Shakrit
Sharkara
Abhighataja

VISHISTA LAKSHANA (SPECIAL SYMPTOMS):

VATAJA
MUTRAKRICCHRA(Su.U.59/4,PN.529)
Alpam alpam ( less quantity)
Vedana is mushka mehana and vasti (pain
in scrotum, penis and suprapublic
region)
Phalat bhiriva kricchrena ( difficulty
micturition)
Vataghanena mehati (all types of vata
vedana manifests).

PITTAJA MUTRAKRICHRA
(Su.U.59/5,PN 579)
Haridra mutra ( Yellowish urine)
Ushna mutra ( feeling hot during
urination)
Rakta mutrata ( blood in urine)
Agni dahayamana iva daha in mushka,
mehana and vasti (severe burning
sensation in scrotum, penis and
bladder area)

KAPHAJA MUTRAKRICCHRA
(Su.U.59/6,PN.580)
Snigdha (oil like/consistency of
urine)
Shukla (whitish urine)
Mushka, mehana, basti gurutva,
(heaviness in scrotum, penis and
suprapublic area)

SHALYAJA MUTRAKRICCHRA
(Su.U. 59/7, PN 580)
Due to injury to mutravaha srotas (urinary system)
it produces symptoms similar to mutraghata.
Injury to the uinary tract produces symptom
similar to vataja variety where severe pain,
frequency micturition, difficulty micturition,
pain in groin and scrotal area are common.
Above said symptoms appears in trauma of the
urinary system.
But the manifestation of
classically said symptoms depends on the type of
injury, site of injury.

SHARKARAJANYA MUTRAKRICCHA
(Su.U. 59/12 -14, PN 580)
Hrupida (chest pain)
Vepathu ( tremors)
Kukshishula ( pain in pelvic region)
Vahnidurbalala ( vitiation of agni)
Murcha ( fainting)
Mutraghata ( difficulty micturition)
If sharkara flushed out them vedanashanti.
(Subsidence of symptoms)
During passage of fresh sharkara, vedana
utpatti. (Appearance of symptoms).

TREATMENT OF MUTRAKRICHHRA

Swedana
Avagaha
Abhyanga
grita avapidana
trividha vasti karma (anuvasana,
asthanpana and uttara vasti) are
common procedures used for urinary
disorders (Su.Su.7/7)

MUTRAGHATHA
(uq;%d>d;)

MUTRAGHATA
NIDANA SAMPRAPTI (ETIOPATHOGENESIS)
Nidana :
(i) Vega avrodha ( suppression of natural urge
for micturition)
(ii) Vata vriddhikara ahara and vihara
( alteration of diet and activities which
vitiates vata dosha).
Dosha : Tridosha, pridomineatly vata dosha
Dushya : Mutra
Adhistana vasti

Samprapti
Vega avarodha
Vitiation of vata
Vitiation of mutra

Mutraghata

Classification
1. Types of mutraghata according to

sustrutha
Vatashtila
Vatabasti
Mutratita

Murajatara
Murtasanga
Mutrakshaya
Mutragranthi
Mutrashukra

Ushnavata
Mutrouksada - Pittaja
Mutroukasada
Kaphaja
Mutratita

2. ACCORDING TO FLOW OF URINE

3. ACCORDING TO DOSHA
:
Vataja
Pittaja
01.Vatakundal Pittaja
ika
Mutrouksada
02.Vatastila
03.Vatabasthi
04. Mutratia
05.
Mutrajatara
06.
Mutrasanga
07.
Mutrashukra
08. Vitighata
09.

kaphaja
Kaphaja

Vatakaphaja Vatapittaja
Raktagranthi Ushnavata

Mutsouksada

Mutrakshaya

4. ACCORDING TO CAUSE
NIJA ( Intrinsic)

AGANTUJA (Extrinsic)

1.Vatakundalika

1. Ushnavata

2. Vatastila

2. Mutrasanga

3. Vatabasti

3. Bastikundala

4. Mutratia

4. Vitvighata

5. Mutrajatara
6. Mutrakshaya
7. Mutrashukra
8. Mutrouksada
9.Mutrouksanda pittaja
10.Mutrokasada kaphaja
11. Vitvighata

5. ACCORDING TO
ETIOPATHOGENESIS
Inflammatory

Metabolic

Traumatic

Neoplastic

Neurogenic

1. Ushanavat
a

1. Mutagrant
hi

1. Mutrasang
a

1.Vatashtila

1.Bastikundali
ka

2.

2. Mutrakshay 2. Vivighata
a
3.
3. Pittaja
Bastikundal
a

Mutrasang
a

Mutrouksada
4. Kaphaja
Mutroukasada

2.
Mutragranthi

2. Vastabasti
3. Mutrajatara
4. Mutratita

6. ACCORDING TO LESION
Functional

Organic

i. Vatakundalika

i.

Mutragranthi

ii. Vatabasti

ii. Mutrashukra

iii.Mutratita

iii. Vitvighata

iv.Mutrajatara

iv. Vitastila

v. Mutrakshaya

v. Mutrasanga

vi.Mutrouksada pittaja

vi. Mutragranthi

vii.Mutrouksada kaphaja

vii.Ushnavata
viii Bastikundal

7.ACCORDING TO SPECIAL
SYMPTOMS
Mutraghata

Obstruction

Pain
+

Frequency

Burning

Haematuria

Vatakundalika

Vatashtila

Vatabasti

Mutratita

Murajatara

Murtasanga

Mutrakshaya

Mutragranthi

Mutrashukra

Ushnavata

Mutrouksada - Pittaja

Mutroukasada Kaphaja

Bastikundala

VATASHTILA
The vitiated apanavayu when takes seat in
the space between rectum ( guda) and
urinary bladder (basti)
produces, firm
(sthira) elevated (unnata), stone like
(astilavatgranthi) growth . This growth in
turn produces obstruction to passage of
faces, urine and flatus (Mala, Muta and
Anila Sanga) andAdhmana.
it leads to
intense pain (vedana) in suprapubic region.
(Su.U.59/7-9)

CHIKITSA (TREATMENT)

Abhyanga
swedana
vasti etc,
to be adopted along with these
measures, dashamula kashaya,
shilajitu along with sharkara to be
given orally ( for pana).

VATA KUNDALIKA

Etiology : Dryness and suppression of urge of

urination
Pathology : Aggravated vata begins to move
inside the urinary bladder along with urine
accumulates and moves in a circular manner.
Symptoms: Patient eliminates urine in small
quantity often, accompanied with pain.
Prognosis: It was considered as grave disease.
(Su.U.58/5-6 )

VATAVASTI
Etiology : Suppressing the urge of
urination
Pathology : Vata residing
in the
bladder gets aggravated, blocks the
mouth of the bladder
Symptoms: Retention of urine inside
the bladder and causing pain in the
bladder and abdomen
Prognosis :Difficult cure
(Su.U.58/9 10)

MUTRATITA
Etiology :Suppressing the urge of urine ( for a
long time) and then desires to eliminate it.
Pathology: Vitiation of vata
Symptoms: The urine does not come out or
comes out in little quantity after training, with
mild pain, less quantity, increased frequency.
(Su.U.58/3 4)

MUTRAJATARA
Etiology : Suppression of urge of urination
Pathology : Apana vata getting aggravated and
moving in upward directions and accumulates in
great amount inside the abdomen
Symptoms :Distention below the umbilicus,
severe pain, and obstruction of lower passages (
urethra and rectum)
(Su.U.58/13-14)

MUTRASANGA

Etiology : Aggravation of vata

Pathology: Obstruction of flow of urine at the
level of bladder, urethral canal or Glans
penis
Symptoms : Urine flows out mixed with blood
after straining or in little quantities again and
again, either with pain or without pain.
(Su.U.58/15 16)

MUTRAKSHAYA
Etiology :Persons who are dry and
fatigued
Pathology: Aggravation of pitta and
Vata located in the urinary bladder
Symptoms: Burning sensation, pain
in the bladder and difficulty for
urination
(Su.U. 58/17)

MUTRAGRANTHI AND RAKTAGRANTHI

(Acute Prostitis)

Aetiopathogenesis : A small , round

and immovable tumor developing
quickly at the level of bladder neck.
Symptoms: Severe pain, obstruction
of urinary passage and other
symptoms of Ashmari ( urinary
calculus).
(Su.U. 58/18 19)

MUTRASHUKRA
Etiology : Indulging in copulation when
the urge of urination pronounced
Pathology: The semen mixed with urine
Symptoms: Semen mixed urine comes
out either before or some times after
urination and urine resembles solution
of ash.
Semen mixed urine may be compared
to retrograde ejaculation.

USHNAVATA
Etiology : Indulging in physical activities,
walking for long time or exposure to sunlight.
Pathology: Pitta gets aggravates and obstructs
by vata.
Symptoms: Burning sensation in the bladder,
penis and rectum during flow of urine. Urine
is yellow, mixed with blood or blood itself
comes out with difficulty.
(Su.U. 58/22-23)

PITTAJA MUTRAUKASADA
Aetiopathology: Vitiation of pitta
Symptoms: Urine becoming nonslimy, yellow, thick and dry flows out
accompanied with burning sensation
and resembling powder of ox gall in
color ( Yellow)
(Su.U.58/25)

KAPHAJA MUTRAUKASADA
Aetiopathogenesis
: Vitiation
of
kapha.
Symptoms: Urine being dry, thick,
white in color, eliminated with
difficulty. becomes dry resembling
powder or conch or very white.
(Su.U. 58/25)

VITVIGHATA
Vitvighata was explained in Caraka Samhita
was not mentioned in Sushruta Samhita.
Etiology: Vitiation of vayu in dry, debilitated
person.
Pathology: Leading to abnormal upward
movement of faecess.
This is nothing but colo-vesical or rectovesical fistula of various etiologies

TREATMENT OF MUTRAGHATA
Kashaya, Kalka, Sarpi (Ghritha), Bakhshya, Leha,
Payasa, Kshara, Mastu, Swedana, Basti and Uttar
Basti to be administered in mutraghata.
(SU. 58/27 28)
Baladi ghrita and Mahabaladi ghrita are some of the
compound drugs used for mutraghata. Most of the
drugs used in mutraghata are diuretic.
Some of the yoga mentioned in Sushruta Samhita :
Ervaruka bhija kalka + Saindhava Kanji
Souvarchala + Sura
Mamsa bhakshana + guda = Madya Madya
Kunkuma + Madhudaka
Dadima + Jiraka + Nagara + Ela + Saindhava = Sura

 Vidarigandhadi & Gokshuramula siddha kshirapaka +

Madhu
Ashvagardabha vasa
Musta + Abhaya + Devadaru + Murva Madhuka Kalka.
Draksha kalka
Nidighika svarasa
Amalaki svarasa + Madhu
Dhatripphala svarasa + Sukshma ela
Tala taruna mula + Shali tandula vari + Sweta karkata
+ Trapusha Swarasa for pana.
Kakolyadi Madhura gandaravya siddha siddha kshira.
Bala+Gokshura + Krounchakasthi + Kokilaksha
+Tandula + Shataparvakamula + Devadaru + Chitraka
+ Akshaaka siddha Kalka.

AHMARI
(wYaur)

ASMARI / UROLITHIASIS

The word Asmari means stone.

In Ayurveda the word Asmari is
mainly used for Urinary calculi and
can
be
considered
as
Mutrasmari(Urolithiasis).
Ashma means Stones
Ari
means
An enemy

Symptoms of Mutrasmari
Excruciating pain over nabhi, vasti, or
at sevani, medra during micturition.
Sudden stoppage of urine flow
Blood stained urine
Twisting and slitting of urine
Aggravation of pain during running
,jolting etc.

MUTRASMARI NIDANA
Teekshna Oushada sevana
Ruksha Madhya sevana
Anupa matsya sevana Sea Food- Fish,
Herring, Fish rhoe, Lobster, Crab, Prawns,
Shrimps, Sardines etc.
Ajeerna bhojana also alter the absorption at
the level of intestines ex:- Hyperuricosuric
calcium, secondary to dietary excess.
Athivyayama
Apathya sevana, diet having more oxalates
(e.g., Cabbage, rhubarb, spinach, coca,
black tea), uric acid and calcium containing

VATAJA ASHMARI
Patients complains
- severe pain in umbilical region or rubs his penis or
fingers his rectum and loudly screams.
- urination, belching and daefecation become
difficult and painful.

Ashmari
Dusky colour
Rough
Uneven in shape
Hard
Facetted and nodular like a Kadambha flower.
(Oxalate calculi/Staghorn calculi)

PITTAJA ASHMARI
Patients complains
Sucking, drawing, and severe burning pain
Symptoms
which
characterise
of
Ushnavatha.
Fever

Ashmari
yellowish, black colour
Like a Ballathaka fruit
Coloured like honey
(Uric acid stones)

KAPHAJA ASHMARI
Patients complains
Heaviness in bladder area
Pain comes when walking or jumping
Pain reduced when rest

Ashmari
White colour
Large size
Like a Hens egg
Colour of the Madhuka flower
(Phosphate stones)

SHUKRASHMARI
Usually formed in adults.
A sudden or abrupt stoppage of a
sexual act or excessive coitus tends to
dislodge the semen from its natural
receptacle.

Treatment of Mutrashmari
wYaur odrefKd jHdrka;l m%;sfuday;#
;refK fNIcx m:Hx m%jDoafO fPo uy;s
- Early stage medicinal treatments
- Later stages - chedana/surgery
Mainly
Shalya
Bhedana
Pathana

Treatments
Bhedana
Polpala,
akkapana,
shilajathu,
kuppameniya
Chandraprabha vati
Decoction

akkapana+polpala+lunuwarana
Pathana
Murunga, lunuwarana, kakiri, ranawara
Decoction murunga, lunuwarana
Mutrakaraka
Sarana, gokatu, truna panchamulaya

PRAMEHA
(m%fy)

PRAMEHA
Prameha is a syndrome which includes all
the
clinical
conditions
which
are
characterized by with more quantity and
increased
frequency
of
abnormal
micturition along with other symptoms.
Prameha can correlate in many ways with
Metabolic Syndrome and Diabetes mellitus.
Inclusion of Prameha among Maha Gada
group in Caraka Nidana Sthana shows the
significance of this disease.

 The word Prameha consist two words.

Pra + Meha
Pra
excessive quantity and
frequency.
Meha
passing of large quantity
of urine. Mehati means to excrete.
The main characteristic features
Prameha said to be
prabhuta mutrata (More urination)
Avila mutrata (Frequent urination)

of

Nidana

Aahara (Dietary) factors:

Sheeta (cold), snigdha (unctuous),Madhura (sweet), medhya(fatty),
drava arma (liquid food), paana (drinks), Excessive intake of Dadhi
(yogurt), meat of aquatic animals, milk, new (not aged) grains,
foodsfdrinkscontaining sugar and jaggery (an un refined form of
cane sugar),foods that are heavy to digest.
Vihara (Lifestyle) factors:
Excessive sleeping, Diva Swapna, (daytime sleeping), Avyayama
(Lack of exercise), Aprasaktum (Idealness, laziness, excessive
sitting), Sedemary lifestyle

Manasika (Psychological) factors:

Disturbance in mental health caused by extreme level of thinking,
Vishaada
(depression), Manasika chinta

Classification of Prameha
Classification can be done based on :
i. Hetu (EtiologY)
ii. Deha Prakruti
iii. Dosha
According to Sushruta:
Hetu Bedhas (Biological Classification) of Prameha
prameha is of 2 types
i. Sahaja Pramehaa
ii. Apathyaja prameha
.

 Sahaja Prameha - due to defect in

beeja.
Means it arises due to genetic defect,
inherited from parents due to some
abnormality in sperm or ovum.
Apathya Nimittaja Prameha
Apathyaja
nimittaja
prameha
is
caused by improper dietetic habits.

Sahaja Prameha
Roopa (Signs & Symptoms)
Prabhuta mutrata (More urination)
Avila mutrata (Frequent turbid
urination - Polyuria)
Krusha (emaciation)
Rooksha (Dryness of mouth & throat)
Alpashi (Loss of appetite)
Pipasa (afflicted with excessive thirst
(Polydipsia)

Types of Prameha
Vataja prameha - 04
Pittaja prameha - 06
Kaphaja prameha- 10
Vataja prameha
1. Vasameha
2. Hasthimeha
3. Sarpimeha
4. Kshaudrameha

 Pittaja meha
1.
2.
3.
4.
5.
6.

Ksharameha
Nilameha
Manjishtameha
Haridrameha
Shonithameha
Amlameha

 Kaphaja meha
1. Udakameha
2. Ikshuwalikameha
3. Sandrameha
4. Surameha
5. Pishtameha
6. Shukrameha
7. Sikathameha
8. Kshanairrmeha
9. Lavanameha
10.Phenameha

Thank you.