Charak Samhita - Nidana Sthana - Chapter 4 (Prameha Nidana)
Charaka samhita is written by Acharya Charaka. Acharya charaka was a Disciple of Punarvasu Atreya. Charak samhita is a compilation of the ayurvedic Aspects including the Basic concepts, Diagnosis and Treatment. Charaka samhita has 8 sections and 120 chapters and in that 9295 sutras. In charaka samhita, The sutra sthana deals with the Basic principles, Nidana Sthana deals with pathology, Vimana sthana deals with Specific determination, Sharira sthana with Anatomy, Indriya sthana deals with prognosis based on the senses, Chikitsa Sthana deals with therapeutics, Kalpa Sthana deals with Pharmaceutics and Toxicology and Siddhi sthana deals with success in treatment. In this article we will Discuss about the Chapter 4 of nidana sthana named Prameha nidana.
In this chapter it has been explained about the Manifestation of the Prameha Roga. Vitiation of the three doshas (Vata, Pitta, Kapha) causes the twenty types of Prameha and also the other disorders. Below it is explained how the vitiation of the three doshas leads to genesis of Prameha. They are of 10 types due to predominance of Kapha Dosha, 6 Types due to Predominance of Pittaja dosha, 4 types Due to predominance of Vataja Dosha. The causes, symptoms and pathogenesis has been explained according to the Dosha predominance. The Kaphaja prameha are considered as Sadhya, Pittaja prameha considered as palliable and vataja Prameha is termed as Asadhya.
Manifestation Of Prameha
According to the Different causes, Doshas and Dushyas, the response occurs in the form of non manifestation of the Disorders. When these factors do not combine together or are combined in a weakened state or for a long time, Disorder will not be there or will manifest lately in mild form or without other symptoms. The three factors, nidana etc. causes the immediate manifestation of the condition Prameha.
- Prolonged use of the new grains like Hayanaka, Yavaka, Cinaka, Uddalaka, Naisadha, Ikata, Mukundaka, Mahavrihi, Pramodaka and Sugandhaka.
- Use of new Legumes like Harenu and Black gram.
- Meat of the Domesticated, Marshy and Aquatic animals, Vegetables, Sesamum paste.
- Preparation of the rice flour
- Payasa (Rice cooked with milk)
- Krsara (preparation of the rice with Pulses)
- Vilepi (Preparation of Rice- Paste like)
- Sugarcane products
- Fresh wine
- Immature Curd and immature liquids
- Abstinence from physical exercise and cleanliness
- Oversleeping, lying down and sitting etc. produces kapha, Fat, and urine.
Dushyas Of Prameha
- Meda (fat)
- Mamsa (Muscle)
- Kleda (body fluid)
- Shukra (semen)
- Shonita (Blood)
- Vasa (muscle fat)
- Majja (Marrow)
By the combination of these factors, the kapha dosha gets vitiated because of the predominance of the aggravating factors. When it is vitiated, it spreads to all over the body due to laxity. While spreading it gets mixed up with fat because fat is non compact, abundant and similar in properties. while this mixing up the kapha affects its morbidly due to its vitiation. When the vitiated kapha is associated with fat joins with the body fluids and Muscle because the latter is increased excessively, thus affecting the muscles, because of which it produces boils saravika, kacchapica etc. due to sloughing of muscle because of abnormalcy. It affects the body fluid and transforms it in urine and blocks the opening of heavy tubules which are coming out from the urinary bladder and kidney and is also associated with fat and fluid. Thus the kapha produces the kaphaja pramehs and leads to incurability due to abnormality.
The body fluids which mixes up with the Kapha and Fat while it enters into the urinary bladder, is transformed into urine and associated with the 10 properties of the Kapha dosha.
The 10 properties of kapha dosha are:
Kaphaja Prameha Types
In these there is predominance of the kapha dosha and are curable because they are located in the fat which is having the similar properties.
- Udaka-meha: By vitiation of the Kaphaja dosha, the patient excretes urine as transparent, white, abundant, cold, odorless and water-like is known as udakamehi.
- Ikshuvalika-meha: By vitiation of the kapha dosha, one excretes urine as excessively sweet, cold, slightly slimy, Turbid and juice like ikshuvalika.
- Sandramha: One whose urine is kept for whole night precipitates in the pot is known as patient of Sandrameha due to vitiation of kapha.
- Sandraprasadmeha: Due to kapha, The one whose urine is partly precipitates and is partly clear is known as the patient of Sandraprasadmeha.
- Suklameha: The one who excretes the urine frequently as white and flour like is likely suffering from Shuklameha due to vitiation of kapha dosha.
- Sukrameha: The one who passes urine very frequently like Semen or is mixed with semen is said to be a patient of Sukrameha due to vitiation of kapha dosha.
- Sitameha: The patient who passes the urine frequently as excessively sweet and Cold is known as the patient of Sitameha due to vitiation of kapha dosha.
- Sikatameha: The patient who passes the small particles situated morbidly in urine is known as sikatameha due to vitiation of Kapha.
- Sainemeha: Due to vitiation of Kapha dosha, the one who passes the urine with Difficulty and Slowly without any urge is suffering from sainemeha.
- Alalameha: Due to vitiation of Kapha dosha, the one who excretes urine as bound with threads, salike-like and slimy is known as patient of Alalameha.
The one who uses hot, Sour, Saline, Alkaline and pungent food. Intake of food during indigestion, Is exposed to severe heatof fire and sun, Exertion, irregular diet and anger. The one who is having the similar body, The Pitta gets Vitiated immediately and by the same mechanism it gives rise instantaneously to pittaja prameha.
Types Of Pittaja Prameha
- Ksarameha: The person who is suffering from ksara meha due to the vitiation of the pittaja dosha passes urine like alkali in respect of colour, smell, touch and Taste.
- Kalameha: Due to vitiation of the Pittaja dosha, if someone passes urine constantly as hot and black in colour.
- Nilameha: Due to vitiation of Pittaja dosha, if the patient passes urine as sour and having colour like that of feather of the casa (bird) is considered as Nilameha.
- Lohitameha: The patient passes urine as having the fleshy smell, Is hot, red and Saline Is known as the patient of raktameha.
- Manjistha Meha: One should be diagnosed as manjistha meha in which it excretes urine more frequently like the decoction of the manjistha and has a fleshy smell due to vitiation of Pitta dosha.
- Haridrameha: Due to vitiation of pitta dosha when the patient passes urine like the Decoction of Haridra (Yellow) and pungent is considered as the Haridrameha.
In the person who uses the astringent, pungent, rough, bitter, light, cold, physical exercise, emesis, non unctuous enema, purgation and head evacuation in excess, Due to suppression of the natural Urges, Fasting, Due to the sun, Injury, excitement, Injury, anxiety, Due to excessive blood letting, Vigils and Uneven Body postures or having body similar to vata, The vata dosha gets vitiated easily. When this vitiated vata dosha spreads in the similar body, takes the muscle fat along and enters into the urinary channels, It gives rise to vasameha. When it extracts the majja to mutrabasti, it gives rise to majjameha, When it carries the lymph to mutrasaya and causes continuous excretion of the urine due to the abundance and frequent urination with obstruction due to its dispersing nature. The person passes the urine constantly without any urge like an Excited elephant and hence it is called the patient of the Hastimeha. Ojas is sweet in nature but due to roughness of vayu, it gets associated with astringency and is carried to the urinary bladder, it arises in Madhumeha.
All the types of Vataja Prameha is said to be Asadhya (Incurable) because of its severity and contradictory treatment.
- The patient who passes urine frequently mixed with vasa or the similar, it is said to be suffering from vasameha which is due to vitiation of vata. It is considered as Incurable.
- The one who passes majja (Marrow) along with urine very frequently due to vitiation of vata dosha is known as majja meha.
- The one passes urine in excess and constantly like an Excited elephant Due to vitiation of vata dosha is known as Hastimeha
- Due to vitiation of vata dosha, The one who passes urine as astringent-sweet, pale and rough is considered as Madhumeha. It is considered incurable.
These are the four types of Prameha due to vitiation of vata dosha.
- Matting of hairs
- Sweetness in mouth
- Burning sensation in hands and feet
- Dryness in mouth, palate and throat
- Dirt in the body
- Smearing in body orifices
- Burning sensation
- Numbness in body parts
- Crawling of bees and ants on body and urine
- Morbidities in urine
- Frequent sleep
- Fleshy smell in the body
- Burning sensation
- Boils due to sloughing of muscles, like Alaji, Vidradhi etc.
Among all types of Prameha, the curable one should be managed with Evacuative and Pacificatory measures.
Prameha approaches immediately like a bird who approaches its nest, the person who is greedy and eats anything and has a dislike for bath and Walking.
Death, In the form of Prameha, Takes away immediately the person who is dull in activities, Over Obese, Over uncted and Voracious eater.
The person who takes a balanced diet and maintains the Equilibrium of the Dhatus and Also does the physical exercises enjoys a happy life.
In this chapter, the cause of diseases, aetiology of the Prameha Roga, Combination of the Doshas and Dhatus, its various symptoms, Mechanism of manifestation of 10 types of Kaphaja Prameha Roga, Six Types of Pittaja Prameha, Four types of Vataja Prameha. The prognosis, Prodromal, Complications and Principle of Management has been dealt with in this chapter of Nidana Sthana.