Etiological factor for Prameha: Idle sitting, oversleep, excessive use of curd, meat soup of the domestic, aquatic and marshy animals and milk; new cereal and drinks, products of jiggery and all other kapha-promoting regimens are etiological factors for prameha.
Pathogenesis: Kapha causes pramehas by affecting medas(lipid metabolism), muscles and body fluid situated in urinary bladder. Pitta aggravated by hot things causes the same by affecting the above entities. Vayu, on relative diminution of other two doshas, draws on the dhatus in urinary bladder and thus causes pramehas. Dosha produces respective types of prameha by reaching the urinary bladder and affecting the urine. In (pathogenesis of)pramehas, doshas are kapha, pitta and vata and dushyaas are medas, blood, semen, fluid, muscle-fat, lasika(lymph), majja(marrow), rasa, ojas and muscles.
Types of Prameha- Total 20 types, divided into three main types-Kaphaj-Pittaj-Vataj
A) Kaphaj prameha– 10 types of kaphaj prameha are as follows: where the urine is-
2) like sugarcane juice
4)having solid precipitate
6) with semen
8) with slow impulse
9) saliva like
10) with gravels
B) Pittaj prameha- 6 types of Pittaj prameha are as follows: where the urine is-
1) like alkali
4) yellow like haldi
5) light red like manjishtha
6) deep red
C) Vataj Prameha- 4 types of vataj prameha. Due to vata, when the other dhatus are diminished the patient passes urine of four types
1) with majja
2) with ojas
3) with vasa
4) with lasika
- Kaphaj prameha- curable due to similarity of management
- Pittaj prameha- maintainable due to dissimilarity of management
- Vataj prameha- incurable due to severity of complication
Foul smell in body
Slackness in body, liking for comfort in lying
Sitting and sleeping
Smearing in heart, eyes, tongue and ears
Heaviness in body parts(overweight)
Excessive increase of hairs and nails
Liking for cold, dryness in throat and palate
Sweetness in mouth, burning sensation in hands and feet
One type of patient of Prameha is obese and strong while the other one is lean and weak. Of these, promotive treatment should be given to the lean and evacuation in case of patients having abundance of doshas and strength. After unction, various formulations for evacuation should be administered. After elimination of excreta from upward and downward passages, saturation therapy should be applied in prameha because by de-saturation the patient is affected with gulma, wasting, pain in penis and bladder and obstruction in urine, but the measures for saturation should be applied taking power of digestion into consideration.
The patient of prameha who is not fit for evacuation should be subjected to pacificatory management for alleviation of the disease such as Mantha(churned drink), extracts, linctus made of barley powder and light edibles. He should eat rough food articles such as boiled barley, barley cakes, flour of parched grains and apupa(a dietary preparation) with palatable meat-soup of wild birds particularly gallinaceous and peckers. He should take old Sali rice with soup of mugdha etc. and bitter vegetables addedwith oil of danti and ingudi or linseed and mustard. In cereals, he should use- shashtika, wild rice and mainly barley.
Evacuation, emesis and lightening applied in time overcome the kaphaj pramehas. Likewise, purgation, saturation and pacificatory measures subdue the paitika prameha.
In vatika types of prameha oils and grutas cooked with these decoctions-
1) musta, haritaki, padmaka and kutaja
2) lodhra, hribera, kaliyaka and dhataki
3) nimb, arjuna, amrataka, haridra and utpala etc.
If there is association of vayu with kapha or pitta then unction should be applied. For this oil cooked with its own(anti-kapha)decoction in kapha and ghruta cooked with anti-pitta decoctions in pitta is useful.
Dietary Regimen-(Ch. Chi.6/50)
व्यायमयोगैः विविधैः प्रगाढै उद्वर्तनैः स्नानजलवसेकै
सेव्यत्वक एला अगरु चन्दनादै विलेपनैः आशु सन्ति न मेहा
Prameha disappears quickly by the use of various physical exercises(including yogaasan), profuse anointing, baths, sprinklingsof water and pastes of ushira-twak-ela-agaru-chandan etc.
Commonly used products for Prameha:
1) Aarogya-vardhini tablet
2) Triphala guggul
3) Chandraprabha Vati
4) Kaishor guggul
5) Gokshuradi guggul
8) Nisha-aamalki yog
9) Sanshamani vati
10) Phala-trikaadi kwath
12) Vasant-kusumaakar Ras
13) Prameha-gaja kesari rasa
14) Madhumehadarp rasa