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==Quantity==
The total quantity of mutra is four anjali (personified measurement unit). [Cha. Sa. [[Sharira Sthana]] 7/15] In normal human being, 800 ml to 2 litres of urine is excreted per day.
The total quantity of mutra is four anjali (personified measurement unit). [Cha.Sa.[[Sharira Sthana]] 7/15] In normal human being, 800 ml to 2 litres of urine is excreted per day.
==Functions==
Urine carries following functions:
Urine carries following functions:
1. Separation and excretion of excess moisture from the body
2. Filling the urinary bladder or maintaining fluid volume in bladder [Su. Sa. [[Sutra Sthana]] 15/5], [A.Hr. [[Sutra Sthana]] 11/5]
1.Separation and excretion of excess moisture from the body
The overall function of urinary system is to filter approximately 200 liters of fluid a day from blood. It excretes toxins, metabolic waste products, and excess ions through urine. Essential substances in the blood are reabsorbed. Apart from this, plasma osmolarity and acid-base metabolism is regulated.
2.Filling the urinary bladder or maintaining fluid volume in bladder.[Su. Sa. [[Sutra Sthana]] 15/5], [A.Hr. [[Sutra Sthana]] 11/5]
The channels carrying urine originate from pelvic region including kidneys and the urinary bladder (basti and vankshana). [Cha. Sa. [[ Vimana Sthana ]] 5/8] It involves the urinary system.
The overall function of urinary system is to filter approximately 200 liters of fluid a day from blood. It excretes toxins, metabolic waste products, and excess ions through urine.Essential substances in the blood are reabsorbed.Apart from this, plasma osmolarity and acid-base metabolism is regulated.
==Channels carrying urine (mutravaha srotas)==
The channels carrying urine originate from pelvic region including kidneys and the urinary bladder (basti and vankshana).[Cha.Sa.[[ Vimana Sthana]] 5/8] It involves the urinary system.
=== Diagnostic perspectives ===
=== Diagnostic perspectives ===
=== Causes of vitiation ===
=== Causes of vitiation ===
The channels carrying urine are affected due to following causes:
The channels carrying urine are affected due to following causes:
*Drinking water, eating food or coitus while having the urge of micturition
*Long time and frequent suppression of urge of micturition
Etiology of dysuria (painful/difficult micturition)
*Especially in persons suffering from wasting and trauma.[Cha.Sa.[[Vimana Sthana]]5/20]
*Retention of urine is observed on suppression of urge to ejaculate [Cha.Sa.[[Sutra Sthana]] 7/10]
'''Etiology of dysuria (painful/difficult micturition)'''
*Excessive physical exertion
These are caused of eight type of dysuria (mutrakricchra ).[Cha. Sa. [[Chikitsa Sthana]] 26/32-33]
*Drugs having excessive sharp (tikshna) effect (adverse effects of toxic drugs)
*Un-unctous or excess dry food (that requires more fluid for digestion)
*Habitual intake of alcohol
*Riding on a fast-moving vehicle
*Excessive consumption of the meat of marshy animals and fish
*Intake of food before the previous meal is digested and chronic indigestion
These are causes of eight type of dysuria (mutrakricchra).[Cha.Sa.[[Chikitsa Sthana]]26/32-33]
===Abnormal states==
===Abnormal states==
The increase or decrease in quality and/or quantity of urine can lead to various abnormal conditions. The states can be assessed by following clinical features.
Symptoms of decrease of urine
The increase or decrease in quality and/or quantity of urine can lead to various abnormal conditions.
(mutra kshaya)* Symptoms of increase in urine
The states can be assessed by following clinical features.
{| class="wikitable"
|-
!Symptoms of decrease of urine
(mutra kshaya)* !!Symptoms of increase in urine
(mutra vriddhi)**
(mutra vriddhi)**
Dysuria
|-
|Dysuria ||Increased quantity of urine
Discoloration of urine Increased frequency of micturition
|-
Excessive thirst Pain in lower abdomen (hypogastrium)
|Discoloration of urine||Increased frequency of micturition
Dryness of mouth Abdominal distension
|-
Pain in lower abdomen Not being satisfied on micturition (feeling of incomplete voiding) or urge of frequent micturition
|Excessive thirst ||Pain in lower abdomen (hypogastrium)
Deceased frequency and amount of urine
|-
Hematuria
|Dryness of mouth ||Abdominal distension
*[Cha Sa. [[Sutra Sthana]] 17/70], [Su. Sa. Sutra Sthana 15/11], [A. Hr. Sutra Sthana 11/22]
|-
** [Su. Sa. Sutra Sthana 15/15], [A. Hr. Sutra Sthana 11/13]
|Pain in lower abdomen ||Not being satisfied on micturition (feeling of incomplete voiding) or urge of frequent micturition
Clinical features of affected urinary system:
|-
The symptoms of the affliction of channels carrying urine include excessive excretion, excessive obstruction or suppression of urine, vitiated, diminished or frequent voiding of thick urine with pain. [Cha. Sa. [[Vimana Sthana]] 5/8]
|Deceased frequency and amount of urine ||--
Clinical features of suppression of urge of micturition:
|-
Suppression of the urge of micturition causes pain in the bladder and phallus, dysuria, headache, bending of the body and distension of the lower abdomen. [Cha. Sa. [[Sutra Sthana]] 7/6]
|Hematuria ||--
== Urine Examination (mutra pareeksha) ==
|}
Hippocrates (400 BC), in his text De Urinis Theophilus, mentioned the use of urine to interpret human body functioning, urine was mainly used as a means for prognosis and prediction of outcomes of illness. Theophilus (700 AD) treated uroscopy in a sophisticated objective manner, and contributed to the birth of medieval medical studies.
* *[Cha Sa. [[Sutra Sthana]] 17/70], [Su. Sa. Sutra Sthana 15/11], [A. Hr. Sutra Sthana 11/22]
* **[Su. Sa. Sutra Sthana 15/15], [A. Hr. Sutra Sthana 11/13]
'''Clinical features of affected urinary system:'''
The symptoms of the affliction of channels carrying urine include excessive excretion, excessive obstruction or suppression of urine, vitiated, diminished or frequent voiding of thick urine with pain.[Cha.Sa.[[Vimana Sthana]] 5/8]
'''Clinical features of suppression of urge of micturition:
'''
Suppression of the urge of micturition causes pain in the bladder and phallus, dysuria, headache, bending of the body and distension of the lower abdomen.[Cha.Sa.[[Sutra Sthana]]7/6]
==Urine Examination (mutra pareeksha)==
Hippocrates (400 BC), in his text De Urinis Theophilus, mentioned the use of urine to interpret human body functioning, urine was mainly used as a means for prognosis and prediction of outcomes of illness. Theophilus (700 AD) treated uroscopy in a sophisticated objective manner, and contributed to the birth of medieval medical studies.
The routine urine examination (urinalysis) is a useful tool for determining the health status as well as many diseases especially related to urinary system.
The routine urine examination (urinalysis) is a useful tool for determining the health status as well as many diseases especially related to urinary system.
The examination includes following:
The examination includes following:
a) Physical examination: in terms of volume, colour, appearance, odour, specific gravity.
a) Physical examination: in terms of volume, colour, appearance, odour, specific gravity.
b) Chemical examination: pH, sugar, protein, ketone bodies, bilirubin, urobilinogen, occult blood, nitrates, ascorbic acid
b) Chemical examination: pH, sugar, protein, ketone bodies, bilirubin, urobilinogen, occult blood, nitrates, ascorbic acid
c) Microscopic examination: White blood cells, epithelial cell, red blood cells, casts, crystals, bacteria, yeasts, non-bacterial organisms.
c) Microscopic examination: White blood cells, epithelial cell, red blood cells, casts, crystals, bacteria, yeasts, non-bacterial organisms.
d) Bacterial screening –Gram staining, colony count.
d) Bacterial screening –Gram staining, colony count.
Ayurvedic text describe detailed methodology for collection, examination and interpretation of the results. This was used to diagnose the disease condition based on urine examination. Some of the practices, which are rarely practiced and seem obsolete, are given below. These can be researched further for better understanding of the pathological changes through urine examination.
==Ayurvedic perspective of urine examination==
Method of collection of samples:
The sample of first urine early in the morning shall be collected. While collecting, the first stream of urine should be discarded and collect the subsequent flow in a clean glass vessel. [Y. R. mutra pariksha /2-3]
Ayurvedic text describe detailed methodology for collection, examination and interpretation of the results. This was used to diagnose the disease condition based on urine examination.Some of the practices, which are rarely practiced and seem obsolete, are given below. These can be researched further for better understanding of the pathological changes through urine examination.
Physical characters of urine and predominance of dosha*
Dosha predominance Characteristic features
'''Method of collection of samples:'''
Vata Pale white in color
Kapha frothy
The sample of first urine early in the morning shall be collected. While collecting, the first stream of urine should be discarded and collect the subsequent flow in a clean glass vessel.[Y. R. mutra pariksha /2-3]
Pitta Reddish in color
Sannipata Bluish/blackish in color
'''Physical characters of urine and predominance of dosha'''
*[Y. R. mutra pariksha /4]
{| class="wikitable"
|-
Oil drop method was widely practiced for diagnosis and prognosis of disease conditions. Researches are being conducted to study application of this test in current times. The physician should drop one or two drops of sesame oil (tila taila) into the sample of urine collected.
!Dosha predominance!!Characteristic features*
=== Observations and interpretations ===
|-
Observations Interpretation of dosha predominance
|Vata ||Pale white in color
Changes in the character of urine Shape of oil drop
|-
Bluish discoloration, free from oily appearance Resembling snake (sarpa) Vata
|Kapha ||frothy
Yellowish and slightly reddish, looks like oil Resembling umbrella(chhatra) Pitta
|-
Cloudy, oily, looks like puddle water Resembling a pearl(mukta) Kapha
|Pitta ||Reddish in color
Oily, hot, red color resembling blood Rakta
|-
|Sannipata ||Bluish/blackish in color
|}
* *[Y. R. mutra pariksha /4]
==Method of examination of urine – oil-drop method (taila bindu pariksha)==
Oil drop method was widely practiced for diagnosis and prognosis of disease conditions. Researches are being conducted to study application of this test in current times.The physician should drop one or two drops of sesame oil (tila taila) into the sample of urine collected.
===Observations and interpretations===
{| class="wikitable"
|-
!Observations !! !! Interpretation of dosha predominance
|-
|Changes in the character of urine ||Shape of oil drop ||Interpretation
|-
|Bluish discoloration, free from oily appearance||Resembling snake (sarpa)||Vata
|-
|Yellowish and slightly reddish, looks like oil ||Resembling umbrella(chhatra)||Pitta
|-
|Cloudy, oily, looks like puddle water||Resembling a pearl(mukta)||Kapha
|-
|Oily, hot, red color ||resembling blood|| Rakta
|}
*[Y. R. mutra pariksha /8]
*[Y. R. mutra pariksha /8]
'''Disease wise interpretation'''*
Characteristic feature of urine Disease
Characteristic feature of urine Disease
Resembles rice water Indigestion(ajeerna)
Resembles rice water Indigestion(ajeerna)