Charaka Prameha Chikitsa – 6th chapter

6th Chapter of Charaka Samhita Chikitsasthana deals with treatment of Prameha – causes, symptoms, types, treatment and diet for urinary disorders and diabetes.

Treatment of Urinary Disorders Including Diabetes
अथातः प्रमेहचिकित्सितं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
athātaḥ pramehacikitsitaṃ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātreyaḥ||2||

We shall now expound the chapter on the treatment or Prameha ( urinary disorders including diabetes).
Thus, said Lord Atreya [1-2]
निर्मोहमानानुशयो निराशः पुनर्वसुर्ज्ञानतपोविशालः|
कालेऽग्निवेशाय सहेतुलिङ्गानुवाच मेहाञ्शमनं च तेषाम्||३||
nirmohamānānuśayo nirāśaḥ punarvasurjñānatapoviśālaḥ|
kāle’gniveśāya sahetuliṅgānuvāca mehāñśamanaṃ ca teṣām||3||

Punarvasu who is free from delusion, ego, anger and attachment, and who has generosity because of his knowledge and penance, spoke to Agnivesh at the appropriate time about the etiology, signs, symptoms and treatment of Meha [3]

Causes

Causes of Prameha: 
आस्यासुखं स्वप्नसुखं दधीनि ग्राम्यौदकानूपरसाः पयांसि|
नवान्नपानं गुडवैकृतं च प्रमेहहेतुः कफकृच्च सर्वम्||४||
āsyāsukhaṃ svapnasukhaṃ dadhīni grāmyaudakānūparasāḥ payāṃsi|
navānnapānaṃ guḍavaikṛtaṃ ca pramehahetuḥ kaphakṛcca sarvam||4||

Aasyashuka – eating as persons will,
SwapnaSukha- Addiction to the pleasure of sedentary habits and sleep
Dadhi- excess intake of curds
Gramya udaka aanupa rasa – soup of meat of domesticated and aquatic animals and animals from marshy land,
Payas- excess intake of milk and its products preparations,
Navanna – freshly harvested grains
Nava pana- freshly prepared alcoholic drinks,
Guda vaikrtam- preparations of jaggery and
All Kapha- aggravating factors [4]

urinary bladder

Pathogenesis

Prameha Samprapti – Pathogenesis:
मेदश्च मांसं च शरीरजं च क्लेदं कफो बस्तिगतं प्रदूष्य|
करोति मेहान् समुदीर्णमुष्णैस्तानेव पित्तं परिदूष्य चापि||५||
क्षीणेषु दोषेष्ववकृष्य बस्तौ धातून् प्रमेहाननिलः करोति|
दोषो हि बस्तिं समुपेत्य मूत्रं सन्दूष्य मेहाञ्जनयेद्यथास्वम्||६||
medaśca māṃsaṃ ca śarīrajaṃ ca kledaṃ kapho bastigataṃ pradūṣya|
karoti mehān samudīrṇamuṣṇaistāneva pittaṃ paridūṣya cāpi||5||
kṣīṇeṣu doṣeṣvavakṛṣya bastau dhātūn pramehānanilaḥ karoti|
doṣo hi bastiṃ samupetya mūtraṃ sandūṣya mehāñjanayedyathāsvam||6||

Kapha  vitiates Medas (fat tissue), Mamsa (muscle tissue) and Kleda (liquid elements)  of the body located in Basti (urinary tract) and causes different types of meha.
Similarly, Pitta aggravated by hot things, vitiates those elements and causes different types of Pittaja Prameha.
When other 2 Doshas are in a relatively diminished state, the aggravated Vata draws tissue elements, viz, Ojas, Majja and Lasika into the urinary tract and vitiates them to cause the 3rd category of Prameha (Vataja Meha). Different doshas having entered the urinary tract in vitiated conditions give rise to the respective categories of Meha [5-6]

Classification and prognosis

साध्याः कफोत्था दश, पित्तजाः षट् याप्या, न साध्यः पवनाच्चतुष्कः|
समक्रियत्वाद्विषमक्रियत्वान्महात्ययत्वाच्च यथाक्रमं ते||७||
sādhyāḥ kaphotthā daśa, pittajāḥ ṣaṭ yāpyā, na sādhyaḥ pavanāccatuṣkaḥ|
samakriyatvādviṣamakriyatvānmahātyayatvācca yathākramaṃ te||7||

Kaphaja Prameha are of 10 types and they are curable because of the compatibility of the therapies meant for their cure (Samakriyatvat).
Pittaja Prameha are of 6 types and they are only palliable (Yapya) because of the incompatibility of the therapies meant for their treatment. (Vishama Kriyatvaat)
Vatika prameha are of 4 types they are incurable because of their extremely serious nature. [7]

Prameha dosha dushya

Prameha Dosha Dushya: Doshas and tissues that get affected by Prameha: 
कफः सपित्तः पवनश्च दोषा मेदोऽस्रशुक्राम्बुवसालसीकाः|
मज्जा रसौजः पिशितं च दूष्याः प्रमेहिणां, विंशतिरेव मेहाः||८||
kaphaḥ sapittaḥ pavanaśca doṣā medo’sraśukrāmbuvasālasīkāḥ|
majjā rasaujaḥ piśitaṃ ca dūṣyāḥ pramehiṇāṃ, viṃśatireva mehāḥ||8||

Doshas like Kapha, Pitta and Vayu and
Dusyas like Medas, Rakta, Shukra ,Ambu (body fluid), Vasa (fat), Lasika (Lymph) majja (Marrow), Rasa (end product of digestion), Ojas (Immunity factor) and Mamsa (muscle) are responsible for the causation of Prameha which is of 20 types [8]

Signs and symptoms

Prameha Lakshana – Signs and symptoms:
जलोपमं चेक्षुरसोपमं वा घनं घनं चोपरि विप्रसन्नम्|
शुक्लं सशुक्रं शिशिरं शनैर्वा लालेव वा वालुकया युतं वा||९||
विद्यात् प्रमेहान् कफजान् दशैतान् क्षारोपमं कालमथापि नीलम्|
हारिद्र माञ्जिष्ठमथापि रक्तमेतान् प्रमेहान् षडुशन्ति पित्तात्||१०||
मज्जौजसा वा वसयाऽन्वितं वा लसीकया वा सततं विबद्धम्|
चतुर्विधं मूत्रयतीह वाताच्छेषेषु धातुष्वपकर्षितेषु||११||
jalopamaṃ cekṣurasopamaṃ vā ghanaṃ ghanaṃ copari viprasannam|
śuklaṃ saśukraṃ śiśiraṃ śanairvā lāleva vā vālukayā yutaṃ vā||9||
vidyāt pramehān kaphajān daśaitān kṣāropamaṃ kālamathāpi nīlam|
hāridra māñjiṣṭhamathāpi raktametān pramehān ṣaḍuśanti pittāt||10||
majjaujasā vā vasayā’nvitaṃ vā lasīkayā vā satataṃ vibaddham|
caturvidhaṃ mūtrayatīha vātāccheṣeṣu dhātuṣvapakarṣiteṣu||11||

10 types of Kaphaja Meha

1. Udaka meha – Jalopama – The urine resembling water
2. Ikshumeha – urine resembling sugarcane juice
3. Sandra Meha – The urine having high density (ghana), thick
4. Sandra Prasada Meha – The urine having density in lower layers, transparency in the upper layer (Ghanam cha upari viprassannam)
5. Shukla Meha- The urine having white colour
6. Shukra Meha – The urine containing seminal fluid
7. Sheeta meha- The urine with cold touch
8. Shanaih Meha- The urine passing out slowly
9. Lala Meha – The urine containing slimy material like saliva and
10. Sikata Meha- The urine containing sand- like substance, gravels. Read more – Ayurvedic treatment of gravels in urine

6 types of Pittaja Meha

1. Kshara Meha- The urine resembling the solution of alkalies
2. Kala Meha – The urine having black colon
3. Neela Meha – The urine having blue, indigo –colour
4. Haridra meha – The urine having yellow colour like turmeric and
5. Manjistha Meha – The urine having reddish colour like that of Manjishta and
6. Rakta Meha – The urine mixed with blood

4 types of Vataja Meha

1. Majja Meha- The urine mixed with Majja or bone- marrow
2. Ojas Meha or Madhu Meha – The urine mixed with Ojas
3. Vasa Meha – The urine mixed with Vasa or Muscle fat
4. Lasika Meha or Hasti Meha- The urine mixed with Lasika or Lymph

Decrease of other Dhatus or Tissue elements is responsible for the causation of the above mentioned 4 varieties of Vataja Prameha [9-11]

Characteristic Features

वर्णं रसं स्पर्शमथापि गन्धं यथास्वदोषं भजते प्रमेहः|
श्यावारुणो वातकृतः सशूलो मज्जादिसाद्गुण्यमुपैत्यसाध्यः||१२||
varṇaṃ rasaṃ sparśamathāpi gandhaṃ yathāsvadoṣaṃ bhajate pramehaḥ|
śyāvāruṇo vātakṛtaḥ saśūlo majjādisādguṇyamupaityasādhyaḥ||12||

Different categories of Prameha described in verses 9-11 above are characterised by the colour; taste, touch and smell of the respective Dosha.
Vata types of Prameha are characterized by:
Shyava aruna varna mutra- greyish -reddish discoloration of urine,
Shoola – pain and
Majjadi sadgunya – attributes of Majja etc.
These varieties are incurable. [12]

Premonitory signs and symptoms

Prameha Poorvaroopa
स्वेदोऽङ्गगन्धः शिथिलाङ्गता च शय्यासन स्वप्नसुखे रतिश्च|
हृन्नेत्रजिह्वाश्रवणोपदेहो घनाङ्गता केशनखातिवृद्धिः||१३||
शीतप्रियत्वं गलतालुशोषो माधुर्यमास्ये करपाददाहः|
भविष्यतो मेहगदस्य रूपं मूत्रेऽभिधावन्ति पिपीलिकाश्च||१४||
svedo’ṅgagandhaḥ śithilāṅgatā ca śayyāsana svapnasukhe ratiśca|
hṛnnetrajihvāśravaṇopadeho ghanāṅgatā keśanakhātivṛddhiḥ||13||
śītapriyatvaṃ galatāluśoṣo mādhuryamāsye karapādadāhaḥ|
bhaviṣyato mehagadasya rūpaṃ mūtre’bhidhāvanti pipīlikāśca||14||

Premonitory Signs and Symptoms:
Sweda – Sweating
Anga gandha – bad body odour
Shithilangata – flabbiness of body
Shayyasana – liking for constantly lying on the bed, feeling sedentary
Rati – sleeping and leading an easy life
Hrut Upadeha – a feeling as if the heart region is covered with some paste / coating
Netra, Jihva, Shravana Srava – exudation of excreta from eyes, tongue and ears
Ghana angata – bulkiness of the body
Kesha, kha, nakha ati vriddhi- excessive growth of hair and nails
Sheeta priyata – liking for cold things
Gala, talu shosha – dryness of the throat and palate
Madhura aasya – sweet taste in the mouth
Kara pada daha – burning sensation in hands and legs and
Mutre pipilika – swarming of ants on the urine [13-14]

Line of treatment

Prameha Chikitsa Sutra – Line of treatment:
स्थूलः प्रमेही बलवानिहैकः कृशस्तथैकः परिदुर्बलश्च|
सम्बृंहणं तत्र कृशस्य कार्यं संशोधनं दोषबलाधिकस्य||१५||
स्निग्धस्य योगा विविधाः प्रयोज्याः कल्पोपदिष्टा मलशोधनाय |
ऊर्ध्वं तथाऽधश्च मलेऽपनीते मेहेषु सन्तर्पणमेव कार्यम्||१६||
गुल्मः क्षयो मेहनबस्तिशूलं मूत्रग्रहश्चाप्यपतर्पणेन|
प्रमेहिणः स्युः, परितर्पणानि कार्याणि तस्य प्रसमीक्ष्य वह्निम्||१७||
sthūlaḥ pramehī balavānihaikaḥ kṛśastathaikaḥ paridurbalaśca|
sambṛṃhaṇaṃ tatra kṛśasya kāryaṃ saṃśodhanaṃ doṣabalādhikasya||15||
snigdhasya yogā vividhāḥ prayojyāḥ kalpopadiṣṭā malaśodhanāya |
ūrdhvaṃ tathā’dhaśca male’panīte meheṣu santarpaṇameva kāryam||16||
gulmaḥ kṣayo mehanabastiśūlaṃ mūtragrahaścāpyapatarpaṇena|
pramehiṇaḥ syuḥ, paritarpaṇāni kāryāṇi tasya prasamīkṣya vahnim||17||

Prameha Chikitsa Sutra – Line of treatment:
Patients suffering from Prameha can be classified into 2 categories viz,
1) Sthula Pramehi – Those who are obese and strong. They are given Shodhana (cleansing, purification treatment).
2) Krusha Pramehi – Those that is emaciated and weak. They are given nourishing treatment – Brumhana therapy (Read more about Brumhana treatment)  

In both the above cases, patient is administered Snehana – oleation treatment. Then, Vamana, Virechana recipes, described in KalpaSthana  are administered.  After Dosha is eliminated, the patient is given Santarpana or nourishing therapy because Apatarpana (fasting) therapy in this condition may produce
Gulma (cystic tumour), Kshaya (chronic respiratory disorder),
Meha – chronic urinary tract disorder
Bastishoola – bladder pain
Mutragraha – urinary retention
Hence, based on the state of Agni (digestion strength), Prameha patient should be given Santarpana (nourishing therapy), after Shodhana. [15-17]

Shamana – alleviation Therapy:
If the patient of Prameha who needs Shodhana or elimination therapy is not eligible for it,  then he is given Shamana treatment (with oral medicines)  [18 1/2]

Pathya for Prameha

संशोधनं नार्हति यः प्रमेही तस्य क्रिया संशमनी प्रयोज्या|
मन्थाः कषाया यवचूर्णलेहाः प्रमेहशान्त्यै लघवश्च भक्ष्याः||१८||
ये विष्किरा ये प्रतुदा विहङ्गास्तेषां रसैर्जाङ्गलजैर्मनोज्ञैः|
यवौदनं रूक्षमथापि वाट्यमद्यात् ससक्तूनपि चाप्यपूपान्||१९||
मुद्गादियूषैरथ तिक्तशाकैः पुराणशाल्योदनमाददीत|
दन्तीङ्गुदीतैलयुतं प्रमेही तथाऽतसीसर्षपतैलयुक्तम्||२०||
सषष्टिकं स्यात्तृणधान्यमन्नं यवप्रधानस्तु भवेत् प्रमेही|
saṃśodhanaṃ nārhati yaḥ pramehī tasya kriyā saṃśamanī prayojyā|
manthāḥ kaṣāyā yavacūrṇalehāḥ pramehaśāntyai laghavaśca bhakṣyāḥ||18||
ye viṣkirā ye pratudā vihaṅgāsteṣāṃ rasairjāṅgalajairmanojñaiḥ|
yavaudanaṃ rūkṣamathāpi vāṭyamadyāt sasaktūnapi cāpyapūpān||19||
mudgādiyūṣairatha tiktaśākaiḥ purāṇaśālyodanamādadīta|
dantīṅgudītailayutaṃ pramehī tathā’tasīsarṣapatailayuktam||20||
saṣaṣṭikaṃ syāttṛṇadhānyamannaṃ yavapradhānastu bhavet pramehī|

The patient suffering from Prameha is given the following food:
Mantha (flour of different types of corn mixed with water), Kashaya (herbal decoctions), barley powder, Avaleha prepared of barely and such other light-to-digest eatables.

Mamsarasa prepared from Vishkira, Pratuda and Vihanga such Jangala animals.

Yavaudana (cooked barley) without adding any dry articles, Vatya (barley porridge) Saktu (roasted corn flour) and Apupa (Pan- cakes) mixed with the meat- soup of gallinaceous (Vishkira) and pecker birds (Pratuda) and animals inhabiting arid land (Jangala);

Purana Shali – old rice cooked and mixed with the soup of green gram etc. and preparations of bitter vegetables
4. Cooked Shashtika rice and Truna Dhanyas mixed with oil of Danti, Ingudi, Atasi and Sarshapa. [18-21]

Importance of Barley

यवस्य भक्ष्यान् विविधांस्तथाऽद्यात् कफप्रमेही मधुसम्प्रयुक्तान्||२१||
निशिस्थितानां त्रिफलाकषाये स्युस्तर्पणाः क्षौद्रयुता यवानाम्|
तान् सीधुयुक्तान् प्रपिबेत् प्रमेही प्रायोगिकान्मेहवधार्थमेव||२२||
ये श्लेष्ममेहे विहिताः कषायास्तैर्भावितानां च पृथग्यवानाम्|
सक्तूनपूपान् सगुडान् सधानान् भक्ष्यांस्तथाऽन्यान् विविधांश्च खादेत्||२३||
खराश्वगोहंसपृषद्भृतानां तथा यवानां विविधाश्च भक्ष्याः|
देयास्तथा वेणुयवा यवानां कल्पेन गोधूममयाश्च भक्ष्याः||२४||
yavasya bhakṣyān vividhāṃstathā’dyāt kaphapramehī madhusamprayuktān||21||
niśisthitānāṃ triphalākaṣāye syustarpaṇāḥ kṣaudrayutā yavānām|
tān sīdhuyuktān prapibet pramehī prāyogikānmehavadhārthameva||22||
ye śleṣmamehe vihitāḥ kaṣāyāstairbhāvitānāṃ ca pṛthagyavānām|
saktūnapūpān saguḍān sadhānān bhakṣyāṃstathā’nyān vividhāṃśca khādet||23||
kharāśvagohaṃsapṛṣadbhṛtānāṃ tathā yavānāṃ vividhāśca bhakṣyāḥ|
deyāstathā veṇuyavā yavānāṃ kalpena godhūmamayāśca bhakṣyāḥ||24||

Barley should constitute the principal ingredient of diet of the patient suffering from Prameha.
The patient suffering from Kaphaja Prameha should take eatables prepared by barley mixed with honey.
Barley soaked in Triphala Kashaya and is kept overnight. It is mixed with honey. It is a nourishing (Tarpana) diet.
It is taken by the patient suffering from Prameha regularly to overcome the disease.
Barley is soaked separately with each of the decoctions prescribed for the treatment of Kaphaja Prameha and taken by the Patient in form of Saktu (Roasted flour), Apupa (pan-cake), Dhana (fried barely) and other types of eatables along with jaggery.

Various eatables prepared from barley or bamboo seed or wheat previously eaten by asses, horse, cows, swans and deer and collected from their Dung – is given to the patient suffering from Prameha. [21-24]

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Specific Therapies

संशोधनोल्लेखनलङ्घनानि काले प्रयुक्तानि कफप्रमेहान्|
जयन्ति पित्तप्रभवान् विरेकः सन्तर्पणः संशमनो विधिश्च||२५||
saṃśodhanollekhanalaṅghanāni kāle prayuktāni kaphapramehān|
jayanti pittaprabhavān virekaḥ santarpaṇaḥ saṃśamano vidhiśca||25||

Purification therapies including Vamana and Langhana – fasting therapies, administered at appropriate time, cure Kaphaja types of Prameha.
Similarly, Pittaja Pramehas are overcome by Virechana, Santarpana (nourishing therapy) and Shamana – alleviation therapies. [25]

General recipes

Recipes for Pramehas in General:
दार्वीं सुराह्वां त्रिफलां समुस्तां कषायमुत्क्वाथ्य पिबेत् प्रमेही|
क्षौद्रेण युक्तामथवा हरिद्रां पिबेद्रसेनामलकीफलानाम्||२६||
dārvīṃ surāhvāṃ triphalāṃ samustāṃ kaṣāyamutkvāthya pibet pramehī|
kṣaudreṇa yuktāmathavā haridrāṃ pibedrasenāmalakīphalānām||26||

The Patient suffering from Prameha should take the decoction of
Darvi – Berberis aristata
Triphala and
Musta – Cyperus rotundus, mixed with honey
He may also take turmeric, along with the juice of Amalaki [26]

Kaphaja Prameha recipes

Recipes for Kaphaja Prameha – 
हरीतकी कट्फल मुस्त लोध्रं पाठा विडङ्गार्जुन धन्वनाश्च|
उभे हरिद्रे तगरं विडङ्गं कदम्बशालार्जुनदीप्यकाश्च||२७||
दार्वी विडङ्गं खदिरो धवश्च सुराह्वकुष्ठागुरुचन्दनानि|
दार्व्यग्निमन्थौ त्रिफला सपाठा पाठा च मूर्वा च तथा श्वदंष्ट्रा||२८||
यवान्युशीराण्यभयागुडूचीचव्याभयाचित्रकसप्तपर्णाः|
पादैः कषायाः कफमेहिनां ते दशोपदिष्टा मधुसम्प्रयुक्ताः||२९||
harītakī kaṭphala musta lodhraṃ pāṭhā viḍaṅgārjuna dhanvanāśca|
ubhe haridre tagaraṃ viḍaṅgaṃ kadambaśālārjunadīpyakāśca||27||
dārvī viḍaṅgaṃ khadiro dhavaśca surāhvakuṣṭhāgurucandanāni|
dārvyagnimanthau triphalā sapāṭhā pāṭhā ca mūrvā ca tathā śvadaṃṣṭrā||28||
yavānyuśīrāṇyabhayāguḍūcīcavyābhayācitrakasaptaparṇāḥ|
pādaiḥ kaṣāyāḥ kaphamehināṃ te daśopadiṣṭā madhusamprayuktāḥ||29||

The following 10 decoctions, mixed with honey and can be given to the   patients suffering from Kaphaja Prameha
1) Decoction of
Haritaki – Terminalia chebula
Katphala – Myrica nagi
Musta – Cyperus rotundus and
Lodhra – Symplocos racemosa

2) Decoction of
Patha – Cissampelos parieta
Vidanga – Embelia ribes
Arjuna—Terminalia arjuna and
Dhanvana – Grewia tiliaefolia

3) Decoction of
Haridra – Turmeric
Daru haridra – Berberis aristata
Tagara – Valeriana walichii and
Vidanga – Embelia ribes

4) Decoction of
Kadamba – Anthocephalus cadamba
Shala –Shorea robusta
Arjuna- Terminalia arjuna and
Deepyaka – Trachyspermum ammi
5) Decoction of
Darvi – Berberis aristata
Vidanga – Embelia ribes
Khadira – Acacia catechu and
Dhava – Anogeissus latifolia

6) Decoction of
Surahva – Devadaru – Cedrus deodara
Kustha – Saussarea lappa
Aguru – Aqualloria agallocha and
Chandana – Santalum album

7) Decoction of
Darvi – Berberis aristata
Agnimantha – Clerodendrum phlomidis
Triphala and
Patha – Cissampelos pariera

8) Decoction of
Patha – Cissampelos parieta
Murva – Marsedenia tenacissima and
Svadamshtra – Tribulus terrestris

9) Decoction of
Yavani – Hyoscyamus niger
Usheera – Vetiveria zizanoides
Abhaya – Terminalia chebula and
Guduchi – Tinospora cordifolia and

10) Decoction of
Chavya – Piper retrofractum
Abhaya – Terminalia chebula
Citraka – Plumbago zeylanica and
Saptaparna –Alstonia scholaris [ 27-29]

Disease- Treatment Of Charaka Samhita Made Easy

Pittaja Prameha recipes

Recipes for Pittaja Prameha 
उशीर लोध्राञ्जन चन्दनानामुशीर मुस्तामलकाभयानाम्|
पटोल निम्बामलकामृतानां मुस्ताभया पद्मकवृक्षकाणाम्||३०||
लोध्राम्बु कालीयक धातकीनां निम्बार्जुनाम्रातनिशोत्पलानाम्|
शिरीष सर्जार्जुनकेशराणां प्रियङ्गुपद्मोत्पल किंशुकानाम्||३१||
अश्वत्थ पाठासनवेतसानां कटङ्कटेर्युत्पलमुस्तकानाम्|
पैत्तेषु मेहेषु दश प्रदिष्टाः पादैः कषाया मधुसम्प्रयुक्ताः||३२||
uśīra lodhrāñjana candanānāmuśīra mustāmalakābhayānām|
paṭola nimbāmalakāmṛtānāṃ mustābhayā padmakavṛkṣakāṇām||30||
lodhrāmbu kālīyaka dhātakīnāṃ nimbārjunāmrātaniśotpalānām|
śirīṣa sarjārjunakeśarāṇāṃ priyaṅgupadmotpala kiṃśukānām||31||
aśvattha pāṭhāsanavetasānāṃ kaṭaṅkaṭeryutpalamustakānām|
paitteṣu meheṣu daśa pradiṣṭāḥ pādaiḥ kaṣāyā madhusamprayuktāḥ||32||

The following 10 decoctions is mixed with honey and given to patient suffering from Pittaja Prameha.

1. Decoction of
Usheera – Vetiveria zizanioides
Lodhra (Symplocos racemosa),
Anjana – Berberis aristata
Chandana (Sandalwood – Santalum album)

2. Decoction of
Ushira – Vetiver – Vetiveria zizanioides
Musta – Cyperus rotundus
Amalaka – Amla and
Abhaya – Terminalia chebula

3. Decoction of
Patola – Pointed Gourd – Trichosanthes dioica
Nimba – Neem (Azadirachta indica),
Amalaka-Embilica officianalis and
Amruta – Giloy – Tinospora cordifolia

4. Decoction of
Musta – Cyperus rotundus,
Abhaya – Terminalia chebula,
Padmaka – Prunus cerasoides and
Vrukshaka – Kutaja – Holarrhena antidysenterica

5. Decoction of
Lodhra – Symplocos racemosa,
Ambu – pavonia odorata Willd.,
Kaliyaka – Berberis aristata
Dhataki – Woodfordia fruticosa

6. Decoction of
Nimba – Neem (Azadirachta indica),
Arjuna (terminalia arjuna),
Amruta – Tinospora cordifolia
Nisha – Turmeric and
Utpala – Nymphaea alba

7. Decoction of
Sirisa – Albezzia lebbeck
Sarja – Copal tree resin – Vateria indica,
Arjuna (terminalia arjuna) and
Kesara – Mesua ferrea

8. Decoction of
Priyangu (Callicarpa macrophylla),
Padma – Lotus (Nelumbo nucifera),
Utpala (Nymphaea alba) and
Kimshuka – Butea monosperma

9. Decoction of
Ashvattha – Peepal, Buddha tree – Ficus religiosa
Patha – Cyclea peltata
Asana – Indian Kino tree (heart wood) – Pterocarpus marsupium
and
Amlavetasa – Garcinia pedunculata Roxb. / Rheum emodi Wall.

10. Decoction of
Katankateri (Daru Haridra – Berberis aristata
Utpala (Nymphaea alba) and
Musta – Cyperus rotundus . [30-32]

Vataja Prameha recipes

Treatment of Vataja Prameha:
सर्वेषु मेहेषु मतौ तु पूर्वौ कषाययोगौ विहितास्तु सर्वे|
मन्थस्य पाने यवभावनायां स्युर्भोजने पानविधौ पृथक् च||३३||
सिद्धानि तैलानि घृतानि चैव देयानि मेहेष्वनिलात्मकेषु|
मेदः कफश्चैव कषाययोगैः स्नेहैश्च वायुः शममेति तेषाम्||३४||
sarveṣu meheṣu matau tu pūrvau kaṣāyayogau vihitāstu sarve|
manthasya pāne yavabhāvanāyāṃ syurbhojane pānavidhau pṛthak ca||33||
siddhāni tailāni ghṛtāni caiva deyāni meheṣvanilātmakeṣu|
medaḥ kaphaścaiva kaṣāyayogaiḥ snehaiśca vāyuḥ śamameti teṣām||34||

The two recipes of decoction described in verse- 26 are meant for the treatment of all varieties of Prameha.
These decoctions can be used for the preparation of Mantha (a drink prepared of roasted corn flour mixed with water), for the impregnation of barley and for the preparation of different kinds of food and drinks.
Medicated oils and medicated ghee are prepared by cooking with these decoctions is administered to patients sufferings from Vatika Prameha. These Kashayas correct the vitiated Medas.
And Kapha, and the aggravated Vata in these patients gets alleviated by the unctuous ingredients (viz, oil and ghee) included in these recipes. [33-34]

Recipes for Kaphaja and Paittika Prameha
कम्पिल्ल सप्तच्छद शालजानि बैभीत रौहीतक कौटजानि|
कपित्थपुष्पाणि च चूर्णितानि क्षौद्रेण लिह्यात् कफपित्तमेही||३५||
पिबेद्रसेनामलकस्य चापि कल्कीकृतान्यक्षसमानि काले|
जीर्णे च भुञ्जीत पुराणमन्नं मेही रसैर्जाङ्गलजैर्मनोज्ञैः||३६||
kampilla saptacchada śālajāni baibhīta rauhītaka kauṭajāni|
kapitthapuṣpāṇi ca cūrṇitāni kṣaudreṇa lihyāt kaphapittamehī||35||
pibedrasenāmalakasya cāpi kalkīkṛtānyakṣasamāni kāle|
jīrṇe ca bhuñjīta purāṇamannaṃ mehī rasairjāṅgalajairmanojñaiḥ||36||

Powder of
Kampillaka – Mallotus philippinensis,
Barks of Saptacchada (Saptaparna) – Alstonia scholaris – Stem bark, Shala – Shorea robusta,
Bibhitaka – Terminalia bellirica,
Rohitaka – Tecomella undulata and
Kutaja – Connessi bark (Holarrhena antidysenterica Wall.) and
Flower of Kapittha (Feronia limonia) is added with honey, made to linctus (leha) and taken by patients suffering from Kaphaja and Pittaja Prameha.
One Aksha (12 g) of the paste of above mentioned herbs is mixed with the juice of Amalaki (Gooseberry) and given at the appropriate time to patients suffering from Kaphaja and Pittaja types of Prameha.

After the digestion of this medicine, the patient is given to eat old rice cooked and mixed with the delicious soup of the meat of animals living in arid land. [35-36]

Taila and Ghrita for Prameha

Taila and Ghrita medicines for Prameha: 
दृष्ट्वाऽनुबन्धं पवनात् कफस्य पित्तस्य वा स्नेहविधिर्विकल्प्यः|
तैलं कफे स्यात् स्वकषायसिद्धं पित्ते घृतं पित्तहरैः कषायैः||३७||
त्रिकण्टकाश्मन्तकसोमवल्कैर्भल्लातकैः सातिविषैः सलोध्रैः|
वचापटोलार्जुननिम्बमुस्तैर्हरिद्रया पद्मकदीप्यकैश्च||३८||
मञ्जिष्ठया चागुरुचन्दनैश्च सर्वैः समस्तैः कफवातजेषु|
मेहेषु तैलं विपचेद्, घृतं तु पैत्तेषु, मिश्रं त्रिषु लक्षणेषु||३९||
dṛṣṭvā’nubandhaṃ pavanāt kaphasya pittasya vā snehavidhirvikalpyaḥ|
tailaṃ kaphe syāt svakaṣāyasiddhaṃ pitte ghṛtaṃ pittaharaiḥ kaṣāyaiḥ||37||
trikaṇṭakāśmantakasomavalkairbhallātakaiḥ sātiviṣaiḥ salodhraiḥ|
vacāpaṭolārjunanimbamustairharidrayā padmakadīpyakaiśca||38||
mañjiṣṭhayā cāgurucandanaiśca sarvaiḥ samastaiḥ kaphavātajeṣu|
meheṣu tailaṃ vipaced, ghṛtaṃ tu paitteṣu, miśraṃ triṣu lakṣaṇeṣu||39||

If Vata is secondarily aggravated along with Kapha or Pitta, then the patient is administered medicated oil or medicated ghee.
If Vata is associated with Kapha, medicated oil is prepared by boiling oil with the decoction of herbs which alleviate Kapha and
For Vata, associated with Pitta, medicated ghee is prepared by cooking ghee with the decoction of herbs which alleviate Pitta.

Trikantaka– Tribulus terrestris
Ashmantaka – Ficus rumphii
Somavalka – Myrica nagi
Bhallataka (Semecarpus anacardium Linn.),
Ativisha – Aconitum heterophyllum
Lodhra – Symplocos racemosa,
Vacha (Acorus calamus Linn.)
Patola – Pointed Gourd – Trichosanthes dioica
Arjuna (terminalia arjuna),
Nimba – Neem
Musta (Cyperus rotundus),
Haridra (turmeric – Curcuma longa),
Padmaka – Prunus cerasoides,
Deepyaka – Trachyspermum ammi ,
Manjishta – Rubia cordifolia
Agaru – Aquilaria agallocha  and
Chandana (Sandalwood – Santalum album)

All these herbs together is used in the preparation of medicated oil for the treatment of Kaphaja Prameha, associated with Vata. If symptoms of Pitta is also associated, then these herbs are processed with oil and ghee together to prepare Yamaka.

Medicines for all Pramehas

Medicine for All Types of Prameha
फलत्रिकं दारुनिशां विशालां मुस्तां च निःक्वाथ्य निशां सकल्काम्|
पिबेत् कषायं मधुसम्प्रयुक्तं सर्वप्रमेहेषु समुद्धतेषु||४०||
phalatrikaṃ dāruniśāṃ viśālāṃ mustāṃ ca niḥkvāthya niśāṃ sakalkām|
pibet kaṣāyaṃ madhusamprayuktaṃ sarvaprameheṣu samuddhateṣu||40||

The decoction of-
Triphala,
Daruharidra,
Vishala – Citrullus colocynthis and
Musta – Cyperus rotundus
is mixed with the paste of turmeric and honey.
Intake of this medicine cures all types of Prameha even when these are manifested in acute form. [40]

Madhvasava

लोध्रं शटीं पुष्करमूलमेलां मूर्वां विडङ्गं त्रिफलां यमानीम्|
चव्यं प्रियङ्गुं क्रमुकं विशालां किराततिक्तं कटुरोहिणीं च||४१||
भार्ङ्गीं नतं चित्रकपिप्पलीनां मूलं सकुष्ठातिविषं सपाठम्|
कलिङ्गकन् केशरमिन्द्रसाह्वां नखं सपत्रं मरिचं प्लवं च||४२||
द्रोणेऽम्भसः कर्षसमानि पक्त्वा पूते चतुर्भागजलावशेषे|
रसेऽर्धभागं मधुनः प्रदाय पक्षं निधेयो घृतभाजनस्थः||४३||
मध्वासवोऽयं कफपित्तमेहान् क्षिप्रं निहन्याद्द्विपलप्रयोगात्|
पाण्ड्वामयार्शांस्यरुचिं ग्रहण्या दोषं किलासं विविधं च कुष्ठम्||४४||
इति मध्वासवः|
lodhraṃ śaṭīṃ puṣkaramūlamelāṃ mūrvāṃ viḍaṅgaṃ triphalāṃ yamānīm|
cavyaṃ priyaṅguṃ kramukaṃ viśālāṃ kirātatiktaṃ kaṭurohiṇīṃ ca||41||
bhārṅgīṃ nataṃ citrakapippalīnāṃ mūlaṃ sakuṣṭhātiviṣaṃ sapāṭham|
kaliṅgakan keśaramindrasāhvāṃ nakhaṃ sapatraṃ maricaṃ plavaṃ ca||42||
droṇe’mbhasaḥ karṣasamāni paktvā pūte caturbhāgajalāvaśeṣe|
rase’rdhabhāgaṃ madhunaḥ pradāya pakṣaṃ nidheyo ghṛtabhājanasthaḥ||43||
madhvāsavo’yaṃ kaphapittamehān kṣipraṃ nihanyāddvipalaprayogāt|
pāṇḍvāmayārśāṃsyaruciṃ grahaṇyā doṣaṃ kilāsaṃ vividhaṃ ca kuṣṭham||44||
iti madhvāsavaḥ|

Lodhra – Symplocos racemosa
Shati – Zadoary (root) – Hedychium spicatum / Curcuma zeodaria,
Puskaramoola – Inula racemosa,
Ela – Cardamom,
Murva – Marsdenia tenacissima – Root,
Vidanga – False black pepper – Embelia ribes,
Triphala – Amla, Haritaki, Vibhitaki,
Yavani – Hyoscyamus niger,
Chavya – Piper cubeba,
Priyangu – Callicarpa macrophylla,
Kramuka – Betel nut,
Vishala – Citrullus colocynthis,
Kiratatikta – Swertia chiraita ,
Katurohini – Picrorrhiza kurroa,
Bharangi – Clerodendron serratum (root),
Nata – Indian valerian (root) – Valeriana wallichi,
Chitraka – Leadwort – Plumbago zeylanica,
Pippalimoola – Long pepper root – Piper longum,
Kushta –  Saussurea lappa,
Ativisha – Aconitum heterophyllum,
Patha – Cyclea peltata,
Kalingaka – Connessi Bark – Holarrhena antidysenterica,
Kesara – Mesua ferrea,
Indrasahva
Nakha – Nakha – Capparis zeylanica, capparis sepiaria,
Patra – Cinnamon leaf – Cinnamomum tamala
Maricha – Black pepper
Plava – Nyctanthes arbor-tristis

– one Karsha  (12 g) of each of these herbs is boiled in one Drona (12.288 l) of water till 1/4th remains. This decoction along with half part of honey. It is kept for fermentation in a vessel smeared with ghee for a fort night to prepare Madhvasava.
It instantaneously cures Kaphaja and Pittika types of Meha when administered in a dose of 2 Pala (96 ml)
It also cures-
Pandu – anaemia
Arshas – piles
Aruchi – anorexia,
Grahani Dosha (sprue syndrome),
Kilasa (a type of leucoderma) and
Different types of Kushta ( skin diseases including leprosy). [41-44]

Dantyasava and Bhallatakasava

क्वाथः स एवाष्टपलं च दन्त्या भल्लातकानां च चतुष्पलं स्यात्|
सितोपला त्वष्टपला विशेषः क्षौद्रं च तावत् पृथगासवौ तौ||४५||
kvāthaḥ sa evāṣṭapalaṃ ca dantyā bhallātakānāṃ ca catuṣpalaṃ syāt|
sitopalā tvaṣṭapalā viśeṣaḥ kṣaudraṃ ca tāvat pṛthagāsavau tau||45||

In the above decoction (wide verses 41-44)
8 Palas of Danti – Baliospermum montanum
8 Palas of Sugar and
The same quantity of honey (as described in verses 41-44) is added and processed.
Similarly, in the above mentioned decoction (wide verses 41-44)
4 Palas of Bhallataka – Semecarpus anacardium
8 Palas of sugar and the same quantity of Honey (as described inverses 41-44) is added and processed.
These 2 Asavas namely Dantyasava and Bhallatokusava are useful in the treatment of Prameha [45]

Food and drinks

सारोदकं वाऽथ कुशोदकं वा मधूदकं वा त्रिफलारसं वा|
सीधुं पिबेद्वा निगदं प्रमेही माध्वीकमग्र्यं चिरसंस्थितं वा||४६||
मांसानि शूल्यानि मृगद्विजानां खादेद्यवानां विविधांश्च भक्ष्यान्|
संशोधनारिष्टकषायलेहैः सन्तर्पणोत्थाञ् शमयेत् प्रमेहान्||४७||
भृष्टान् यवान् भक्षयतः प्रयोगाच्छुष्कांश्च सक्तून्न भवन्ति मेहाः|
श्वित्रं च कृच्छ्रं कफजं च कुष्ठं तथैव मुद्गामलकप्रयोगान्||४८||
sārodakaṃ vā’tha kuśodakaṃ vā madhūdakaṃ vā triphalārasaṃ vā|
sīdhuṃ pibedvā nigadaṃ pramehī mādhvīkamagryaṃ cirasaṃsthitaṃ vā||46||
māṃsāni śūlyāni mṛgadvijānāṃ khādedyavānāṃ vividhāṃśca bhakṣyān|
saṃśodhanāriṣṭakaṣāyalehaiḥ santarpaṇotthāñ śamayet pramehān||47||
bhṛṣṭān yavān bhakṣayataḥ prayogācchuṣkāṃśca saktūnna bhavanti mehāḥ|
śvitraṃ ca kṛcchraṃ kaphajaṃ ca kuṣṭhaṃ tathaiva mudgāmalakaprayogān||48||

The patient suffering from Prameha should drink-
Sarodaka (water boiled with the heart- wood of Khadira (Acacia catechu etc),
Kushodaka (water boiled with Kusha),
Madhudaka ( water mixed with honey),
Triphala Rasa (Juice or Kashaya of Triphala) or
Seedhu (a type of wine) which is of a superior quality and which is prepared after fermenting for a long time.
Spit –roasted meat of animals and birds and different eatables prepared of barley should be given to the patient to eat.

Different types of Prameha caused by over- nourishment is alleviated by the administration of elimination therapies, Aristas (a type of wine), decoctions and various types of linctus

Persons habitually taking roasted barley, dry corn-flour, Mudga – green gram – Averrhoa carambola and Amalaka do not suffer from Prameha, Svitra ( Leucoderma), Krcchra (drysuria) and Kaphaja Kustha ( skin diseases caused by Kapha). [46-48]

Recipes:
सन्तर्पणोत्थेषु गदेषु योगा मेदस्विनां ये च मयोपदिष्टाः|
विरूक्षणार्थं कफपित्तजेषु सिद्धाः प्रमेहेष्वपि ते प्रयोज्याः||४९||
santarpaṇottheṣu gadeṣu yogā medasvināṃ ye ca mayopadiṣṭāḥ|
virūkṣaṇārthaṃ kaphapittajeṣu siddhāḥ prameheṣvapi te prayojyāḥ||49||

Effective recipes suggested by me for producing drying effect on obese patients while describing the management of diseases caused by over- nourishment are useful in the treatment of Pramehas caused by Kapha and Pitta. [49]

Exercise and other regimens

व्यायामयोगैर्विविधैः प्रगाढैरुद्वर्तनैः स्नानजलावसेकैः|
सेव्यत्वगेलागुरुचन्दनाद्यैर्विलेपनैश्चाशु न सन्ति मेहाः||५०||
Pramehas get immediately cured by different types of strenuous exercise, unction, bath, sprinkling of water over the body and application of ointment made of Sevya (Usheera), Tvak (Cinnamon) , Ela (cardamom), Agaru, Chandana (Sandalwood) etc. [50]

Apatarpana therapy

Apatarpana – Depletion Therapy
क्लेदश्च मेदश्च कफश्च वृद्धः प्रमेहहेतुः प्रसमीक्ष्य तस्मात्|
वैद्येन पूर्वं कफपित्तजेषु मेहेषु कार्याण्यपतर्पणानि||५१||
kledaśca medaśca kaphaśca vṛddhaḥ pramehahetuḥ prasamīkṣya tasmāt|
vaidyena pūrvaṃ kaphapittajeṣu meheṣu kāryāṇyapatarpaṇāni||51||

Aggravated Kleda (Sticky or liquid elements in the body), Medas (fat tissue) and Kapha are responsible for the causation of Prameha.

Keeping this in view, the physician, in the beginning, should administer depletion therapies to patients suffering from Kaphaja and Patittika types of Prameha. [51]

Vatolbana Prameha:
या वातमेहान् प्रति पूर्वमुक्ता वातोल्बणानां विहिता क्रिया सा|
वायुर्हि मेहेष्वतिकर्शितानां कुप्यत्यसाध्यान् प्रति नास्ति चिन्ता||५२||
yā vātamehān prati pūrvamuktā vātolbaṇānāṃ vihitā kriyā sā|
vāyurhi meheṣvatikarśitānāṃ kupyatyasādhyān prati nāsti cintā||52||

Medicines described earlier for the Vatika Prameha are actually meant for Vatolbana Prameha where Vayu is secondarily (subsequently) aggravated.
Vata does get secondarily aggravated in Prameha because of excessive depletion of tissue elements.
The Physician need not make efforts to correct irremediable ailments.
If Vata is primarily aggravated to cause Prameha, then this VAtika Prameha is irremediable [52]

Prohibitions:
यैर्हेतुभिर्ये प्रभवन्ति मेहास्तेषु प्रमेहेषु न ते निषेव्याः|
हेतोरसेवा विहिता यथैव जातस्य रोगस्य भवेच्चिकित्सा||५३||
yairhetubhirye prabhavanti mehāsteṣu prameheṣu na te niṣevyāḥ|
hetorasevā vihitā yathaiva jātasya rogasya bhaveccikitsā||53||

Factors responsible for the causation of different types of Prameha is avoided even after these Pramehas are manifested.
For the prevention of the occurrence of a disease different etiological factors are described to be avoided. These very causative factors are also required to be avoided during the treatment of that particular disease (even after its manifestation). [53]

Differential Diagnosis

हारिद्रवर्णं रुधिरं च मूत्रं विना प्रमेहस्य हि पूर्वरूपैः|
यो मूत्रयेत्तं न वदेत् प्रमेहं रक्तस्य पित्तस्य हि स प्रकोपः||५४||
hāridravarṇaṃ rudhiraṃ ca mūtraṃ vinā pramehasya hi pūrvarūpaiḥ|
yo mūtrayettaṃ na vadet pramehaṃ raktasya pittasya hi sa prakopaḥ||54||

If the colour of the urine is yellow or if blood is excreted through the urine without the prior manifestation of premonitory signs and symptoms of Prameha, such a person should on the other hand be diagnosed as a case of Rakta- Pitta ( a disease characterised by bleeding from different parts of the body.). [54]

Classification

दृष्ट्वा प्रमेहं मधुरं सपिच्छं मधूपमं स्याद्द्विविधो विचारः|
क्षीणेषु दोषेष्वनिलात्मकः स्यात् सन्तर्पणाद्वा कफसम्भवः स्यात्||५५||
dṛṣṭvā pramehaṃ madhuraṃ sapicchaṃ madhūpamaṃ syāddvividho vicāraḥ|
kṣīṇeṣu doṣeṣvanilātmakaḥ syāt santarpaṇādvā kaphasambhavaḥ syāt||55||

If the patient suffering from Prameha passes urine which is sweet, slimy and honey- like, then there are two possibilities.
It is caused either by the diminution of Doshas and that case it is Vatika type or by over- nourishment when it is of the Kaphaja type. [55]

Prognosis

सपूर्वरूपाः कफपित्तमेहाः क्रमेण ये वातकृताश्च मेहाः|
साध्या न ते, पित्तकृतास्तु याप्याः, साध्यास्तु मेदो यदि न प्रदुष्टम्||५६||
sapūrvarūpāḥ kaphapittamehāḥ krameṇa ye vātakṛtāśca mehāḥ|
sādhyā na te, pittakṛtāstu yāpyāḥ, sādhyāstu medo yadi na praduṣṭam||56||

Kaphaja and Paittika types of prameha, if preceded by their premonitory signs symptoms, are incurable.
Similarly, Vatika Prameha, where Vayu is aggravated right from the beginning, is incurable.
Paittika types of Prameha are generally, palliable. But they are curable if Medas (adipose tissue) is not vitiated [56]

Hereditary Diabetes

जातः प्रमेही मधुमेहिनो वा न साध्य उक्तः स हि बीजदोषात्|
ये चापि केचित् कुलजा विकारा भवन्ति तांश्च प्रवदन्त्यसाध्यान्||५७||
jātaḥ pramehī madhumehino vā na sādhya uktaḥ sa hi bījadoṣāt|
ye cāpi kecit kulajā vikārā bhavanti tāṃśca pravadantyasādhyān||57||

Patients who are diabetic right from the birth(congenital) and those who are born of diabetic parent’s genes.
Similarly, other hereditary (Kulaja= familial) ailments are to be considered as incurable. [57]

Diabetic Carbuncles

प्रमेहिणां याः पिडका मयोक्ता रोगाधिकारे पृथगेव सप्त|
ताः शल्यविद्भिः कुशलैश्चिकित्स्याः शस्त्रेण संशोधनरोपणैश्च||५८||
pramehiṇāṃ yāḥ piḍakā mayoktā rogādhikāre pṛthageva sapta|
tāḥ śalyavidbhiḥ kuśalaiścikitsyāḥ śastreṇa saṃśodhanaropaṇaiśca||58||

7 types of Carbuncles of patients suffering from Prameha described by me in the quadrate on diseases (Rogadhikara) are to be treated by expert surgeons with the help of Sastras (surgical operations.) , samsodhaka (cleansing ) and Ropana (healing) therapies.[ 58]

Read more about diabetic carbuncle
तत्र श्लोकाः-
हेतुर्दोषो दूष्यं मेहानां साध्यतानुरूपश्च|
मेही द्विविधस्त्रिविधं भिषग्जितमतिक्षपणदोषः||५९||
आद्या यवान्नविकृतिर्मन्था मेहापहाः कषायाश्च|
तैलघृतलेहयोगा भक्ष्याः प्रवरासवाः सिद्धाः||६०||
व्यायामविधिर्विविधः स्नानान्युद्वर्तनानि गन्धाश्च|
मेहानां प्रशमार्थं चिकित्सिते दिष्टमेतावत्||६१||
tatra ślokāḥ-
heturdoṣo dūṣyaṃ mehānāṃ sādhyatānurūpaśca|
mehī dvividhastrividhaṃ bhiṣagjitamatikṣapaṇadoṣaḥ||59||
ādyā yavānnavikṛtirmanthā mehāpahāḥ kaṣāyāśca|
tailaghṛtalehayogā bhakṣyāḥ pravarāsavāḥ siddhāḥ||60||
vyāyāmavidhirvividhaḥ snānānyudvartanāni gandhāśca|
mehānāṃ praśamārthaṃ cikitsite diṣṭametāvat||61||

Summary

In the chapter dealing with the treatment for alleviation of Prameha following topics have been discussed
1. Etiology of the Disease
2. Doshas and Dusyas (tissue elements) involved in the pathogenesis of the disease
3. Curability and other wise of the disease
4. Signs and symptoms of the disease
5. 2 types of Prameha
6. 3 categories of therapy. Viz Samsodhana (elimination therapy), Samsamana( alleviation therapy) and Nidana Parivarjana ( avoiding the causative factors)
7. Disadvantages of over depletion
8. Eatables prepared of barley, Mantha, (thin gruel) and decoctions for the cure of Prameha.
9. Medicated oils, medicated ghee, various recipes of linctus, food preparations, good quality Asavas (alcoholic drinks) having known therapeutic utility. And
10. Different methods of exercise, baths, unctions and fragrant applications for the treatment of Prameha.

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते चिकित्सितस्थाने
प्रमेहचिकित्सितं नाम षष्ठोऽध्यायः||६||
ityagniveśakṛte tantre carakapratisaṃskṛte cikitsitasthāne
pramehacikitsitaṃ nāma ṣaṣṭho’dhyāyaḥ||6||

Thus, ends the 6th chapter dealing with the treatment of Prameha (urinary disorders including diabetes) of Chikitsa section of Agnivesha’s work as redacted by Charaka.

7 thoughts on “Charaka Prameha Chikitsa – 6th chapter”

  1. Dear Dr. Hebbar thanks for this chap on Charaka Prameha. Translating Prameha as urinary disorders may not be right I think. Then what would you call mootraghata, mootrakrichra etc.? I think Pramehas are not disorders of Urinary system but appears like various metabolic disorders. As a pediatrician I always view them as inborn errors of metabolism but for others I think they should metabolic sysdromes

    Reply
  2. Hello Doctor,
    Is Yavaudana (cooked barley) cooked barley such that grains still remain separable? How does it need to be cooked?
    Thanks,
    Satyan

    Reply
    • Hi, more details will be published later. Here, whole barley is cooked with water, as you would cook rice.

      Reply
  3. In the sentence for shloka 5-6 under Prameha Samprapti – Pathogenesis:
    “Similarly, Pitta aggravated by hot things, vitiates those elements and cures different types of Pittaja Prameha.” there is a typo. I think the word “cures” should be “causes”?

    Reply
  4. Under Importance of Barley adding Jaggery is recommended for Pathya. But preparations of jaggery is also listed as a cause for Prameha. In Kaphaja Prameha undigested jaggery should already be present in stomach. Would not avoiding jaggery be better for treating Prameha? What is the reason for adding jaggery here?

    Reply

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