The word prameha is derived from the ‘miha sechane’ which means watering. Pra means excess of urine in both frequency and volume. Prameha, thus, becomes self-explanatory and holds the twin meanings of “prabhutha mutratha” or excessive urination and “avilmutratha” or turbid urine.
A chronological study of the ayurvedic classics and the samgraha texts shows changing trends of emphasis on its study and practice. It is very interesting to note the prameha has been described eloquently and elaborately in charak samhita chikistha sthana’s sixth chapter. In shusurata samhita it is found in nidana sthana’s sixth chapter and in chikitsha sthana’s 11th, 12th and 13th chapter. While madava nidana describes it in its 33rd chapter, which is prameha nidana.
Genetical view regarding prameha are clearly mentioned by charaka and shusurata samhita. They have given a specific word ‘beej dosha’ i.e., which means a “defect in genes” if transliterated to english. beej means seed and dosha means defect. Charaka has described anatomy of beej as below: beej = semen or shukra beej bhaga = chromosome Sushrutha has said that kshetra, ambu, beeja and ritu are the four factors involving genetic factor of any diseases, and these mean: kshetra > woman’s reproductive organs beej > sperm ambu > watery contents that gives nutrition to fetus ritu > environment around the fertilized ovum or fetus also the physical and mental stages including dietary habits of pregnant lady can cause changes in the body of the offspring.
Ojas and prameha Ojas is essence of life, extract of all the dhatus (body tissue), which manifests in the form of bala (strength). Normally all the physical, psychic, sensory and motor functions are determined by ojas. The appearance of ojas is supposed to be like ghee (in purity and luster), taste is supposed to be like honey, and smell like fried paddy. In diabetes mellitus normal quantity of ojas in the body hampered in two ways: i) by obstruction in vessels (srotorodha) ii) by degeneration of the body contents (dhatukshaya)
a) hetu bedhas (as per etiology)
1. sahaja prameha : juvenile or congenital diabetes 2. kulaja : familial 3. apathyaja : due to improper dietary habits
b) deha prakriti bedhas (as per features of the body)
c) mutra bikara bedhas (as per urinary abnormality)
1. Kaphaja : Kapha causes pramehas by affecting medhas thus altering lipid metabolism), muscles and body fluid situated in urinary bladder. They are of ten types as:
– udakameha (chronic nephritis, diabetes insipidus) > watery urine – iskhumeha (alimentary glycosuria) > like sugar cane – saandrameha (phosphaturia) > viscous urine – saandraprasaadmeha > having solid precipitate – suklameha (chyleuria, albuminuria) > white – sukrameha (spermaturia) > urine with semen – sitameha > cold urine – sainyameha > delayed and very slow impulse of urination – lalmeha (albuminaria) > saliva-like urine – siktameha (lithuria) > urine with gravels
2. Pittaja : Pitta aggravated by hot things causes the same by affecting medas, muscles and body fluid situated in urinary bladder. They are of six types as :
– kcharameha (alkanuria) > urine like alkali – kaalameha (indikanuria) > black urine – nilameha (indikanuria) > blue urine – haridrameha (biluria) > turmeric-like urine – manjisthameha (urobilinuria) > urine is lighter – raktameha (haemeturia) > urine is deep red
3. Vataja : Vayu, on relative diminution of other two doshas, draws on the dhatus in urinary bladder and thus causes prameha. Prameha caused by vata and associated with pain has blackish or reddish urine. They are of four types as:
– majjameha (albuminuria) > urine with majja – ojomeha (diabetes mellitus) > urine with ojas – vasameha (lipuria) > urine with vasa – hastimeha (prostatitis) > urine with lasika