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{{#seo:
|title=Prameha Chikitsa
|titlemode=append
|keywords=Sthula Pramehi, Krisha Pramehi, Chikitsa, Diabetes Mellitus, obstinate urinary disorders
|description=Chikitsa Sthana Chapter 6. Management of Prameha (Obstinate Urinary Disorders)
}}
<big>'''[[Chikitsa Sthana]] Chapter 6. Management of Prameha (Obstinate Urinary Disorders)'''</big>
<big>'''[[Chikitsa Sthana]] Chapter 6. Management of Prameha (Obstinate Urinary Disorders)'''</big>
===Sanskrit text, Transliteration and English Translation===
===Sanskrit text, Transliteration and English Translation===
<div class="mw-collapsible mw-collapsed">
अथातः प्रमेहचिकित्सितं व्याख्यास्यामः||१||
अथातः प्रमेहचिकित्सितं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
इति ह स्माह भगवानात्रेयः||२||
<div class="mw-collapsible-content">
athātaḥ pramēhacikitsitaṁ vyākhyāsyāmaḥ||1||
athātaḥ pramēhacikitsitaṁ vyākhyāsyāmaḥ||1||
iti ha smAha bhagavAnAtreyaH||2||
iti ha smAha bhagavAnAtreyaH||2||
</div></div>
We shall now expound the chapter on the treatment of ''Prameha''. Thus, said Lord Atreya. [1-2]
We shall now expound the chapter on the treatment of ''Prameha''. Thus, said Lord Atreya. [1-2]
<div class="mw-collapsible mw-collapsed">
निर्मोहमानानुशयो निराशः पुनर्वसुर्ज्ञानतपोविशालः|
निर्मोहमानानुशयो निराशः पुनर्वसुर्ज्ञानतपोविशालः|
कालेऽग्निवेशाय सहेतुलिङ्गानुवाच मेहाञ्शमनं च तेषाम्||३||
कालेऽग्निवेशाय सहेतुलिङ्गानुवाच मेहाञ्शमनं च तेषाम्||३||
<div class="mw-collapsible-content">
nirmōhamānānuśayō nirāśaḥ punarvasurjñānatapōviśālaḥ|
nirmōhamānānuśayō nirāśaḥ punarvasurjñānatapōviśālaḥ|
kAle~agniveshAya sahetuli~ggAnuvAca Meha~jshamanaM ca teShAm||3||
kAle~agniveshAya sahetuli~ggAnuvAca Meha~jshamanaM ca teShAm||3||
</div></div>
Punarvasu who is free from delusion, ego, hatred and attachment, and who has attained magnanimity because of his knowledge and penance, described the etiology, signs and symptoms, and treatment of ''meha'' (''prameha'') to Agnivesha at proper time (when query was asked).[3]
Punarvasu who is free from delusion, ego, hatred and attachment, and who has attained magnanimity because of his knowledge and penance, described the etiology, signs and symptoms, and treatment of ''meha'' (''prameha'') to Agnivesha at proper time (when query was asked).[3]
==== Etiology of ''prameha'' ====
==== Etiology of ''prameha'' ====
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आस्यासुखं स्वप्नसुखं दधीनि ग्राम्यौदकानूपरसाः पयांसि|
आस्यासुखं स्वप्नसुखं दधीनि ग्राम्यौदकानूपरसाः पयांसि|
नवान्नपानं गुडवैकृतं च प्रमेहहेतुः कफकृच्च सर्वम्||४||
नवान्नपानं गुडवैकृतं च प्रमेहहेतुः कफकृच्च सर्वम्||४||
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āsyāsukhaṁ svapnasukhaṁ dadhīni grāmyaudakānūparasāḥ payāṁsi|
āsyāsukhaṁ svapnasukhaṁ dadhīni grāmyaudakānūparasāḥ payāṁsi|
navAnnapAnaM guDavaikRutaM ca PramehahetuH kaphakRucca sarvam||4||
navAnnapAnaM guDavaikRutaM ca PramehahetuH kaphakRucca sarvam||4||
</div></div>
Over-indulgence in the pleasure of sedentary habits, excess sleep, curds, soup of the meat of domesticated and aquatic animals and animals inhabiting marshy land, milk and its preparations, freshly harvested food articles, freshly prepared drinks, preparations of jaggery and all ''kapha''- aggravating factors are responsible for the causation of ''prameha''. [4]
Over-indulgence in the pleasure of sedentary habits, excess sleep, curds, soup of the meat of domesticated and aquatic animals and animals inhabiting marshy land, milk and its preparations, freshly harvested food articles, freshly prepared drinks, preparations of jaggery and all ''kapha''- aggravating factors are responsible for the causation of ''prameha''. [4]
==== ''Dushya'' (vitiated factors) and pathogeneis ====
==== ''Dushya'' (vitiated factors) and pathogeneis ====
<div class="mw-collapsible mw-collapsed">
मेदश्च मांसं च शरीरजं च क्लेदं कफो बस्तिगतं प्रदूष्य|
मेदश्च मांसं च शरीरजं च क्लेदं कफो बस्तिगतं प्रदूष्य|
दोषो हि बस्तिं समुपेत्य मूत्रं सन्दूष्य मेहाञ्जनयेद्यथास्वम्||६||
दोषो हि बस्तिं समुपेत्य मूत्रं सन्दूष्य मेहाञ्जनयेद्यथास्वम्||६||
<div class="mw-collapsible-content">
mēdaśca māṁsaṁ ca śarīrajaṁ ca klēdaṁ kaphō bastigataṁ pradūṣya|
mēdaśca māṁsaṁ ca śarīrajaṁ ca klēdaṁ kaphō bastigataṁ pradūṣya|
doSho hi bastiM samupetya mUtraM sandUShya Meha~jjanayedyathAsvam||6||
doSho hi bastiM samupetya mUtraM sandUShya Meha~jjanayedyathAsvam||6||
</div></div>
Aggravated ''kapha'' vitiates ''medas, mamsa'' and ''kleda'' of the body located in ''basti'' (bladder and urinary system) and causes different types of ''kapha'' dominant ''meha''.
Aggravated ''kapha'' vitiates ''medas, mamsa'' and ''kleda'' of the body located in ''basti'' (bladder and urinary system) and causes different types of ''kapha'' dominant ''meha''.
==== Classification and Prognosis ====
==== Classification and Prognosis ====
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साध्याः कफोत्था दश, पित्तजाः षट् याप्या, न साध्यः पवनाच्चतुष्कः||
साध्याः कफोत्था दश, पित्तजाः षट् याप्या, न साध्यः पवनाच्चतुष्कः||
समक्रियत्वाद्विषमक्रियत्वान्महात्ययत्वाच्च यथाक्रमं ते||७||
समक्रियत्वाद्विषमक्रियत्वान्महात्ययत्वाच्च यथाक्रमं ते||७||
<div class="mw-collapsible-content">
sādhyāḥ kaphōtthā daśa, pittajāḥ ṣaṭ yāpyā, na sādhyaḥ pavanāccatuṣkaḥ|
sādhyāḥ kaphōtthā daśa, pittajāḥ ṣaṭ yāpyā, na sādhyaḥ pavanāccatuṣkaḥ|
samakriyatvAdviShamakriyatvAnmahAtyayatvAcca yathAkramaM te||7||
samakriyatvAdviShamakriyatvAnmahAtyayatvAcca yathAkramaM te||7||
</div></div>
''Kaphaja pramehas'' are of ten types and they are curable because of their compatibility of the therapies meant for their cure (''samakriyatvata'').
''Kaphaja pramehas'' are of ten types and they are curable because of their compatibility of the therapies meant for their cure (''samakriyatvata'').
==== Vitiating factors involved in pathogenesis ====
==== Vitiating factors involved in pathogenesis ====
<div class="mw-collapsible mw-collapsed">
कफः सपित्तः पवनश्च दोषा मेदोऽस्रशुक्राम्बुवसालसीकाः|
कफः सपित्तः पवनश्च दोषा मेदोऽस्रशुक्राम्बुवसालसीकाः|
मज्जा रसौजः पिशितं च दूष्याः[१] प्रमेहिणां, विंशतिरेव मेहाः||८||
मज्जा रसौजः पिशितं च दूष्याः[१] प्रमेहिणां, विंशतिरेव मेहाः||८||
<div class="mw-collapsible-content">
kaphaḥ sapittaḥ pavanaśca dōṣā mēdō'sraśukrāmbuvasālasīkāḥ|
kaphaḥ sapittaḥ pavanaśca dōṣā mēdō'sraśukrāmbuvasālasīkāḥ|
majjA rasaujaH pishitaM ca dUShyAH pramehiNAM, viMshatireva MehaH||8||
majjA rasaujaH pishitaM ca dUShyAH pramehiNAM, viMshatireva MehaH||8||
</div></div>
''Doshas'' like ''kapha, pitta'' and ''vata,'' and ''dushyas'' like ''medas, rakta, shukra, ambu'' (body fluid), ''vasa'' (muscle fat), ''lasika'' (lymph), ''majja, rasa, ojas'' and ''mamsa'' are responsible for the causation of ''prameha'' which is of twenty types. [8]
''Doshas'' like ''kapha, pitta'' and ''vata,'' and ''dushyas'' like ''medas, rakta, shukra, ambu'' (body fluid), ''vasa'' (muscle fat), ''lasika'' (lymph), ''majja, rasa, ojas'' and ''mamsa'' are responsible for the causation of ''prameha'' which is of twenty types. [8]
==== Twenty types of ''dosha'' dominant ''prameha'' ====
==== Twenty types of ''dosha'' dominant ''prameha'' ====
<div class="mw-collapsible mw-collapsed">
जलोपमं चेक्षुरसोपमं वा घनं घनं चोपरि विप्रसन्नम्|
जलोपमं चेक्षुरसोपमं वा घनं घनं चोपरि विप्रसन्नम्|
चतुर्विधं मूत्रयतीह[१] वाताच्छेषेषु धातुष्वपकर्षितेषु||११||
चतुर्विधं मूत्रयतीह[१] वाताच्छेषेषु धातुष्वपकर्षितेषु||११||
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jalōpamaṁ cēkṣurasōpamaṁ vā ghanaṁ ghanaṁ cōpari viprasannam|
jalōpamaṁ cēkṣurasōpamaṁ vā ghanaṁ ghanaṁ cōpari viprasannam|
caturvidhaM mUtrayatIha vAtAccheSheShu dhAtuShvapakarShiteShu||11||
caturvidhaM mUtrayatIha vAtAccheSheShu dhAtuShvapakarShiteShu||11||
</div></div>
Ten varieties of ''kaphaja meha'' have the following characteristic features:
Ten varieties of ''kaphaja meha'' have the following characteristic features:
==== Criteria for diagnosis ====
==== Criteria for diagnosis ====
<div class="mw-collapsible mw-collapsed">
वर्णं रसं स्पर्शमथापि गन्धं यथास्वदोषं भजते प्रमेहः|
वर्णं रसं स्पर्शमथापि गन्धं यथास्वदोषं भजते प्रमेहः|
श्यावारुणो वातकृतः सशूलो मज्जादिसाद्गुण्यमुपैत्यसाध्यः||१२||
श्यावारुणो वातकृतः सशूलो मज्जादिसाद्गुण्यमुपैत्यसाध्यः||१२||
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varṇaṁ rasaṁ sparśamathāpi gandhaṁ yathāsvadōṣaṁ bhajatē pramēhaḥ|
varṇaṁ rasaṁ sparśamathāpi gandhaṁ yathāsvadōṣaṁ bhajatē pramēhaḥ|
shyAvAruNo vAtakRutaH sashUlo majjAdisAdguNyamupaityasAdhyaH||12||
shyAvAruNo vAtakRutaH sashUlo majjAdisAdguNyamupaityasAdhyaH||12||
</div></div>
Different types of ''prameha'' are characterized by the color, taste, touch and smell of the respective ''dosha''. ''Vatika'' varieties of ''prameha'' are characterized by grayish or reddish coloration of the urine, pain and attributes of ''majja'', etc. These types of ''vatika prameha'' are incurable. [12]
Different types of ''prameha'' are characterized by the color, taste, touch and smell of the respective ''dosha''. ''Vatika'' varieties of ''prameha'' are characterized by grayish or reddish coloration of the urine, pain and attributes of ''majja'', etc. These types of ''vatika prameha'' are incurable. [12]
==== Premonitory signs and symptoms ====
==== Premonitory signs and symptoms ====
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स्वेदोऽङ्गगन्धः शिथिलाङ्गता च शय्यासनस्वप्नसुखे रतिश्च|
स्वेदोऽङ्गगन्धः शिथिलाङ्गता च शय्यासनस्वप्नसुखे रतिश्च|
भविष्यतो मेहगदस्य रूपं मूत्रेऽभिधावन्ति पिपीलिकाश्च||१४||
भविष्यतो मेहगदस्य रूपं मूत्रेऽभिधावन्ति पिपीलिकाश्च||१४||
<div class="mw-collapsible-content">
svēdō'ṅgagandhaḥ śithilāṅgatā ca śayyāsanasvapnasukhē ratiśca|
svēdō'ṅgagandhaḥ śithilāṅgatā ca śayyāsanasvapnasukhē ratiśca|
shItapriyatvaM galatAlushoSho mAdhuryamAsye karapAdadAhaH| bhaviShyato
shItapriyatvaM galatAlushoSho mAdhuryamAsye karapAdadAhaH| bhaviShyato
Mehagadasya rUpaM mUtre~abhidhAvanti pipIlikAshca||14||
Mehagadasya rUpaM mUtre~abhidhAvanti pipIlikAshca||14||
</div></div>
Sweating, body odor, flabbiness of the body, liking for constantly lying on the bed, sitting, sleeping and leading an easy life, a feeling as if the cardiac region is covered with extraneous material, exudation of excreta from eyes, tongue and ears, corpulence of the body, excessive growth of hair and nails, liking for cold things, dryness of throat and palate, sweet taste in the mouth, burning sensation in hands and legs and swarming of ants on the urine- these are the premonitory signs and symptoms of ''prameha''. [13-14]
Sweating, body odor, flabbiness of the body, liking for constantly lying on the bed, sitting, sleeping and leading an easy life, a feeling as if the cardiac region is covered with extraneous material, exudation of excreta from eyes, tongue and ears, corpulence of the body, excessive growth of hair and nails, liking for cold things, dryness of throat and palate, sweet taste in the mouth, burning sensation in hands and legs and swarming of ants on the urine- these are the premonitory signs and symptoms of ''prameha''. [13-14]
==== Principles of management ====
==== Principles of management ====
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स्थूलः प्रमेही बलवानिहैकः कृशस्तथैकः परिदुर्बलश्च|
स्थूलः प्रमेही बलवानिहैकः कृशस्तथैकः परिदुर्बलश्च|
प्रमेहिणः स्युः, परितर्पणानि[२] कार्याणि तस्य[३] प्रसमीक्ष्य वह्निम्||१७||
प्रमेहिणः स्युः, परितर्पणानि[२] कार्याणि तस्य[३] प्रसमीक्ष्य वह्निम्||१७||
<div class="mw-collapsible-content">
sthūlaḥ pramēhī balavānihaikaḥ kr̥śastathaikaḥ paridurbalaśca|
sthūlaḥ pramēhī balavānihaikaḥ kr̥śastathaikaḥ paridurbalaśca|
pramehiNaH syuH, paritarpaNAni kAryANi tasya prasamIkShya vahnim||17||
pramehiNaH syuH, paritarpaNAni kAryANi tasya prasamIkShya vahnim||17||
</div></div>
Patients suffering from ''prameha'' are classified into two categories, viz. (1) those who are obese and strong, and (2) those who are emaciated and weak.
Patients suffering from ''prameha'' are classified into two categories, viz. (1) those who are obese and strong, and (2) those who are emaciated and weak.
==== ''Samshamana'' ( pacification therapy) ====
==== ''Samshamana'' ( pacification therapy) ====
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संशोधनं नार्हति यः प्रमेही तस्य क्रिया संशमनी प्रयोज्या|
संशोधनं नार्हति यः प्रमेही तस्य क्रिया संशमनी प्रयोज्या|
देयास्तथा वेणुयवा यवानां कल्पेन गोधूममयाश्च भक्ष्याः||२४||
देयास्तथा वेणुयवा यवानां कल्पेन गोधूममयाश्च भक्ष्याः||२४||
<div class="mw-collapsible-content">
saṁśōdhanaṁ nārhati yaḥ pramēhī tasya kriyā saṁśamanī prayōjyā|
saṁśōdhanaṁ nārhati yaḥ pramēhī tasya kriyā saṁśamanī prayōjyā|
kharAshvagohaMsapRuShadbhRutAnAM tathA yavAnAM vividhAshca bhakShyAH| deyAstathA veNuyavA yavAnAM kalpena godhUmamayAshca bhakShyAH||24||
kharAshvagohaMsapRuShadbhRutAnAM tathA yavAnAM vividhAshca bhakShyAH| deyAstathA veNuyavA yavAnAM kalpena godhUmamayAshca bhakShyAH||24||
</div></div>
If the patient of ''prameha'' is not eligible for ''samshodhana'' or elimination therapy, ''samshamana'' or alleviation therapies should be given. [18]
If the patient of ''prameha'' is not eligible for ''samshodhana'' or elimination therapy, ''samshamana'' or alleviation therapies should be given. [18]
==== Specific Therapies ====
==== Specific Therapies ====
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संशोधनोल्लेखनलङ्घनानि काले प्रयुक्तानि कफप्रमेहान्|
संशोधनोल्लेखनलङ्घनानि काले प्रयुक्तानि कफप्रमेहान्|
जयन्ति पित्तप्रभवान् विरेकः सन्तर्पणः संशमनो विधिश्च||२५||
जयन्ति पित्तप्रभवान् विरेकः सन्तर्पणः संशमनो विधिश्च||२५||
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saṁśōdhanōllēkhanalaṅghanāni kālē prayuktāni kaphapramēhān|
saṁśōdhanōllēkhanalaṅghanāni kālē prayuktāni kaphapramēhān|
jayanti pittaprabhavAn virekaH santarpaNaH saMshamano vidhishca||25||
jayanti pittaprabhavAn virekaH santarpaNaH saMshamano vidhishca||25||
</div></div>
Purificatory therapies including specifically emesis and fasting therapies, administered at the appropriate time, cure ''kaphaja'' types of ''prameha''. Similarly, ''pittaja'' types of ''prameha'' are overcome by purgation, ''santarpana'' (refreshing therapy) and alleviation therapies. [25]
Purificatory therapies including specifically emesis and fasting therapies, administered at the appropriate time, cure ''kaphaja'' types of ''prameha''. Similarly, ''pittaja'' types of ''prameha'' are overcome by purgation, ''santarpana'' (refreshing therapy) and alleviation therapies. [25]
==== Various recipes ====
==== Various recipes ====
<div class="mw-collapsible mw-collapsed">
दार्वीं सुराह्वां त्रिफलां समुस्तां कषायमुत्क्वाथ्य पिबेत् प्रमेही|
दार्वीं सुराह्वां त्रिफलां समुस्तां कषायमुत्क्वाथ्य पिबेत् प्रमेही|
क्षौद्रेण युक्तामथवा हरिद्रां पिबेद्रसेनामलकीफलानाम्||२६||
क्षौद्रेण युक्तामथवा हरिद्रां पिबेद्रसेनामलकीफलानाम्||२६||
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dārvīṁ surāhvāṁ triphalāṁ samustāṁ kaṣāyamutkvāthya pibēt pramēhī|
dārvīṁ surāhvāṁ triphalāṁ samustāṁ kaṣāyamutkvāthya pibēt pramēhī|
kShaudreNa yuktAmathavA haridrAM pibedrasenAmalakIphalAnAm||26||
kShaudreNa yuktAmathavA haridrAM pibedrasenAmalakIphalAnAm||26||
</div></div>
The patient suffering from ''prameha'' should take the decoction of ''darvi, surahva, triphala'' and ''musta'' mixed with honey. He may also take ''haridra'' along with the juice of ''amalaki''. [26]
The patient suffering from ''prameha'' should take the decoction of ''darvi, surahva, triphala'' and ''musta'' mixed with honey. He may also take ''haridra'' along with the juice of ''amalaki''. [26]
===== Decoctions for ''kaphaja prameha'' =====
===== Decoctions for ''kaphaja prameha'' =====
<div class="mw-collapsible mw-collapsed">
हरीतकीकट्फलमुस्तलोध्रं पाठाविडङ्गार्जुनधन्वनाश्च|
हरीतकीकट्फलमुस्तलोध्रं पाठाविडङ्गार्जुनधन्वनाश्च|
पादैः कषायाः कफमेहिनां ते दशोपदिष्टा मधुसम्प्रयुक्ताः||२९||
पादैः कषायाः कफमेहिनां ते दशोपदिष्टा मधुसम्प्रयुक्ताः||२९||
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harītakīkaṭphalamustalōdhraṁ pāṭhāviḍaṅgārjunadhanvanāśca|
harītakīkaṭphalamustalōdhraṁ pāṭhāviḍaṅgārjunadhanvanāśca|
pAdaiH kaShAyAH kaphamehinAM te dashopadiShTA madhusamprayuktAH||29||
pAdaiH kaShAyAH kaphamehinAM te dashopadiShTA madhusamprayuktAH||29||
</div></div>
The following ten decoctions should be mixed with honey and given to patients suffering from ''kaphaja prameha'':
The following ten decoctions should be mixed with honey and given to patients suffering from ''kaphaja prameha'':
===== Decoctions for ''pittaja prameha'' =====
===== Decoctions for ''pittaja prameha'' =====
<div class="mw-collapsible mw-collapsed">
उशीरलोध्राञ्जनचन्दनानामुशीरमुस्ता मलकाभयानाम्|
उशीरलोध्राञ्जनचन्दनानामुशीरमुस्ता मलकाभयानाम्|
पैत्तेषु मेहेषु दश प्रदिष्टाः पादैः कषाया मधुसम्प्रयुक्ताः||३२||
पैत्तेषु मेहेषु दश प्रदिष्टाः पादैः कषाया मधुसम्प्रयुक्ताः||३२||
<div class="mw-collapsible-content">
uśīralōdhrāñjanacandanānāmuśīramustāmalakābhayānām|
uśīralōdhrāñjanacandanānāmuśīramustāmalakābhayānām|
paitteShu meheShu dasha pradiShTAH pAdaiH kaShAyA madhusamprayuktAH||32||
paitteShu meheShu dasha pradiShTAH pAdaiH kaShAyA madhusamprayuktAH||32||
</div></div>
The following ten decoctions should be mixed with honey and given to patients suffering from ''pittaja prameha'':
The following ten decoctions should be mixed with honey and given to patients suffering from ''pittaja prameha'':
===== Decoctions for all types of ''prameha'' =====
===== Decoctions for all types of ''prameha'' =====
<div class="mw-collapsible mw-collapsed">
सर्वेषु मेहेषु मतौ तु पूर्वौ कषाययोगौ विहितास्तु सर्वे|
सर्वेषु मेहेषु मतौ तु पूर्वौ कषाययोगौ विहितास्तु सर्वे|
मेदः कफश्चैव कषाययोगैः स्नेहैश्च वायुः शममेति तेषाम्||३४||
मेदः कफश्चैव कषाययोगैः स्नेहैश्च वायुः शममेति तेषाम्||३४||
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sarvēṣu mēhēṣu matau tu pūrvau kaṣāyayōgau vihitāstu sarvē|
sarvēṣu mēhēṣu matau tu pūrvau kaṣāyayōgau vihitāstu sarvē|
medaH kaphashcaiva kaShAyayogaiH snehaishca vAyuH shamameti teShAm||34||
medaH kaphashcaiva kaShAyayogaiH snehaishca vAyuH shamameti teShAm||34||
</div></div>
Two recipes of decoction are described 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.
Two recipes of decoction are described 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.
===== Formulations for ''kaphaja'' and ''pittaja prameha'' =====
===== Formulations for ''kaphaja'' and ''pittaja prameha'' =====
<div class="mw-collapsible mw-collapsed">
कम्पिल्लसप्तच्छदशालजानि बैभीतरौहीतककौटजानि|
कम्पिल्लसप्तच्छदशालजानि बैभीतरौहीतककौटजानि|
जीर्णे च भुञ्जीत पुराणमन्नं मेही रसैर्जाङ्गलजैर्मनोज्ञैः||३६||
जीर्णे च भुञ्जीत पुराणमन्नं मेही रसैर्जाङ्गलजैर्मनोज्ञैः||३६||
<div class="mw-collapsible-content">
kampillasaptacchadaśālajāni baibhītarauhītakakauṭajāni|
kampillasaptacchadaśālajāni baibhītarauhītakakauṭajāni|
jIrNe ca bhu~jjIta purANamannaM mehI rasairjA~ggalajairmanoj~jaiH||36||
jIrNe ca bhu~jjIta purANamannaM mehI rasairjA~ggalajairmanoj~jaiH||36||
</div></div>
Powder of ''kampillaka'', barks of ''saptachchada, bibhitaka, rohitaka'' and ''kutaja'' and flower of ''kapittha'' should be added with honey, made to a linctus and taken by patients suffering from ''kaphaja'' and ''pittaja prameha''. One ''aksha'' of the paste of above mentioned drugs should be mixed with the juice of ''amalaki'' and given at the appropriate time to patients suffering from ''kaphaja'' and ''pittaja'' types of ''prameha''. After the digestion of this potion, the patient should be given to eat old rice cooked and mixed with the delicious soup of the meat of animals living in arid land.[35-36]
Powder of ''kampillaka'', barks of ''saptachchada, bibhitaka, rohitaka'' and ''kutaja'' and flower of ''kapittha'' should be added with honey, made to a linctus and taken by patients suffering from ''kaphaja'' and ''pittaja prameha''. One ''aksha'' of the paste of above mentioned drugs should be mixed with the juice of ''amalaki'' and given at the appropriate time to patients suffering from ''kaphaja'' and ''pittaja'' types of ''prameha''. After the digestion of this potion, the patient should be given to eat old rice cooked and mixed with the delicious soup of the meat of animals living in arid land.[35-36]
===== Formulations for ''vata'' association in ''kaphaja'' and ''pittaja prameha'' =====
===== Formulations for ''vata'' association in ''kaphaja'' and ''pittaja prameha'' =====
<div class="mw-collapsible mw-collapsed">
दृष्ट्वाऽनुबन्धं पवनात् कफस्य पित्तस्य वा स्नेहविधिर्विकल्प्यः|
दृष्ट्वाऽनुबन्धं पवनात् कफस्य पित्तस्य वा स्नेहविधिर्विकल्प्यः|
पिबेत् कषायं मधुसम्प्रयुक्तं सर्वप्रमेहेषु समुद्धतेषु||४०||
पिबेत् कषायं मधुसम्प्रयुक्तं सर्वप्रमेहेषु समुद्धतेषु||४०||
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dr̥ṣṭvā'nubandhaṁ pavanāt kaphasya pittasya vā snēhavidhirvikalpyaḥ|
dr̥ṣṭvā'nubandhaṁ pavanāt kaphasya pittasya vā snēhavidhirvikalpyaḥ|
pibet kaShAyaM madhusamprayuktaM sarvaprameheShu samuddhateShu||40||
pibet kaShAyaM madhusamprayuktaM sarvaprameheShu samuddhateShu||40||
</div></div>
If ''vayu'' is secondarily aggravated along with either ''kapha'' or ''pitta'', then the patient should be administered unctuous preparations. For the ''kapha'' aggravation, medicated oil should be processed with the decoction of ''kapha'' alleviating drugs. .For the pitta aggravation, medicated ghee should be processed with the decoction of ''pitta'' alleviating drugs. ''Trikantaka, ashmantaka, somavalka, bhallataka, ativisha, lodhra, vacha, patola, arjuna, nimbi, musta, haridra, padmaka, dipyaka, manjishtha, aguru'' and ''chandana''- all these drugs together should be used in the preparation of medicated oil for the treatment of ''kaphaja prameha'' which is associated with secondarily aggravated ''vayu''. In case of pitta dominance, ghee shall be processed with above mentioned drugs.
If ''vayu'' is secondarily aggravated along with either ''kapha'' or ''pitta'', then the patient should be administered unctuous preparations. For the ''kapha'' aggravation, medicated oil should be processed with the decoction of ''kapha'' alleviating drugs. .For the pitta aggravation, medicated ghee should be processed with the decoction of ''pitta'' alleviating drugs. ''Trikantaka, ashmantaka, somavalka, bhallataka, ativisha, lodhra, vacha, patola, arjuna, nimbi, musta, haridra, padmaka, dipyaka, manjishtha, aguru'' and ''chandana''- all these drugs together should be used in the preparation of medicated oil for the treatment of ''kaphaja prameha'' which is associated with secondarily aggravated ''vayu''. In case of pitta dominance, ghee shall be processed with above mentioned drugs.
==== ''Madhvasava'' ====
==== ''Madhvasava'' ====
<div class="mw-collapsible mw-collapsed">
लोध्रं शटीं पुष्करमूलमेलां मूर्वां विडङ्गं त्रिफलां यमानीम्|
लोध्रं शटीं पुष्करमूलमेलां मूर्वां विडङ्गं त्रिफलां यमानीम्|
इति मध्वासवः|
इति मध्वासवः|
<div class="mw-collapsible-content">
lōdhraṁ śaṭīṁ puṣkaramūlamēlāṁ mūrvāṁ viḍaṅgaṁ triphalāṁ yamānīm|
lōdhraṁ śaṭīṁ puṣkaramūlamēlāṁ mūrvāṁ viḍaṅgaṁ triphalāṁ yamānīm|
iti madhvAsavaH|
iti madhvAsavaH|
</div></div>
''Lodhra, shati, pushkaramula, ela, murva, vidanga, triphala, yamani, chavya, priyangu, kramuka, vishala, kiratatikta, katurohini, bharngi, nata, chitraka, pippalimula, kushtha, ativisha, patha, kalingaka, keshara, indravaruni, nakha, patra, maricha'' and ''plava''- one ''karsha'' of each of these drugs should be boiled in one ''drona'' of water till one fourth remains. This decoction along with half its quantity of honey should be kept inside a ghee smeared jar for a fort night. This is called ''madhvasava''. It instantaneously cures ''kaphaja'' and ''paittika'' types of ''meha'' when administered in a dose of two ''palas''. It also cures ''pandu, arsha, aruchi, grahani dosha, kilasa'' and different types of ''kushtha''.[41-44]
''Lodhra, shati, pushkaramula, ela, murva, vidanga, triphala, yamani, chavya, priyangu, kramuka, vishala, kiratatikta, katurohini, bharngi, nata, chitraka, pippalimula, kushtha, ativisha, patha, kalingaka, keshara, indravaruni, nakha, patra, maricha'' and ''plava''- one ''karsha'' of each of these drugs should be boiled in one ''drona'' of water till one fourth remains. This decoction along with half its quantity of honey should be kept inside a ghee smeared jar for a fort night. This is called ''madhvasava''. It instantaneously cures ''kaphaja'' and ''paittika'' types of ''meha'' when administered in a dose of two ''palas''. It also cures ''pandu, arsha, aruchi, grahani dosha, kilasa'' and different types of ''kushtha''.[41-44]
==== ''Dantyasava'' and ''bhallatakasava'' ====
==== ''Dantyasava'' and ''bhallatakasava'' ====
<div class="mw-collapsible mw-collapsed">
क्वाथः स एवाष्टपलं च दन्त्या भल्लातकानां च चतुष्पलं स्यात्|
क्वाथः स एवाष्टपलं च दन्त्या भल्लातकानां च चतुष्पलं स्यात्|
सितोपला त्वष्टपला विशेषः क्षौद्रं च तावत् पृथगासवौ तौ||४५||
सितोपला त्वष्टपला विशेषः क्षौद्रं च तावत् पृथगासवौ तौ||४५||
<div class="mw-collapsible-content">
kvāthaḥ sa ēvāṣṭapalaṁ ca dantyā bhallātakānāṁ ca catuṣpalaṁ syāt|
kvāthaḥ sa ēvāṣṭapalaṁ ca dantyā bhallātakānāṁ ca catuṣpalaṁ syāt|
sitopalA tvaShTapalA visheShaH kShaudraM ca tAvat pRuthagAsavau tau||45||
sitopalA tvaShTapalA visheShaH kShaudraM ca tAvat pRuthagAsavau tau||45||
</div></div>
In the above mentioned decoction, eight ''palas'' of ''danti'', eight ''palas'' of sugar and the same quantity of honey should be added and processed. Similarly, in the above mentioned decoction four ''palas'' of ''bhallataka'', eight ''palas'' of sugar and the same quantity of honey should be added and processed. These two ''asavas'' (namely ''dantyasava'' and ''bhallatokusava'') are useful in the treatment of ''prameha''. [45]
In the above mentioned decoction, eight ''palas'' of ''danti'', eight ''palas'' of sugar and the same quantity of honey should be added and processed. Similarly, in the above mentioned decoction four ''palas'' of ''bhallataka'', eight ''palas'' of sugar and the same quantity of honey should be added and processed. These two ''asavas'' (namely ''dantyasava'' and ''bhallatokusava'') are useful in the treatment of ''prameha''. [45]
==== Beneficial diet and drinks ====
==== Beneficial diet and drinks ====
<div class="mw-collapsible mw-collapsed">
सारोदकं वाऽथ कुशोदकं वा मधूदकं वा त्रिफलारसं वा|
सारोदकं वाऽथ कुशोदकं वा मधूदकं वा त्रिफलारसं वा|
श्वित्रं च कृच्छ्रं कफजं च कुष्ठं तथैव मुद्गामलकप्रयोगान्||४८||
श्वित्रं च कृच्छ्रं कफजं च कुष्ठं तथैव मुद्गामलकप्रयोगान्||४८||
<div class="mw-collapsible-content">
sārōdakaṁ vā'tha kuśōdakaṁ vā madhūdakaṁ vā triphalārasaṁ vā|
sārōdakaṁ vā'tha kuśōdakaṁ vā madhūdakaṁ vā triphalārasaṁ vā|
shvitraM ca kRucchraM kaphajaM ca kuShThaM tathaiva mudgAmalakaprayogAn||48||
shvitraM ca kRucchraM kaphajaM ca kuShThaM tathaiva mudgAmalakaprayogAn||48||
</div></div>
The patient suffering from ''prameha'' should drink ''sarodaka'' (water boiled with the heart- wood of ''khadira'' etc.,), ''kushodaka'' (water boiled with ''kusha''), ''madhudaka'' (water mixed with honey), ''triphala rasa'' (juice or decoction of ''triphala'') or ''sidhu'' (a type of wine) which is properly fermented or ''madhvika'' (another type of wine) which is of superior quality and is prepared after fermenting for a long time.
The patient suffering from ''prameha'' should drink ''sarodaka'' (water boiled with the heart- wood of ''khadira'' etc.,), ''kushodaka'' (water boiled with ''kusha''), ''madhudaka'' (water mixed with honey), ''triphala rasa'' (juice or decoction of ''triphala'') or ''sidhu'' (a type of wine) which is properly fermented or ''madhvika'' (another type of wine) which is of superior quality and is prepared after fermenting for a long time.
==== Indications of above treatment ====
==== Indications of above treatment ====
<div class="mw-collapsible mw-collapsed">
सन्तर्पणोत्थेषु गदेषु योगा मेदस्विनां ये च मयोपदिष्टाः|
सन्तर्पणोत्थेषु गदेषु योगा मेदस्विनां ये च मयोपदिष्टाः|
विरूक्षणार्थं कफपित्तजेषु सिद्धाः प्रमेहेष्वपि ते प्रयोज्याः||४९||
विरूक्षणार्थं कफपित्तजेषु सिद्धाः प्रमेहेष्वपि ते प्रयोज्याः||४९||
<div class="mw-collapsible-content">
santarpaṇōtthēṣu gadēṣu yōgā mēdasvināṁ yē ca mayōpadiṣṭāḥ|
santarpaṇōtthēṣu gadēṣu yōgā mēdasvināṁ yē ca mayōpadiṣṭāḥ|
virUkShaNArthaM kaphapittajeShu siddhAH prameheShvapi te prayojyAH||49||
virUkShaNArthaM kaphapittajeShu siddhAH prameheShvapi te prayojyAH||49||
</div></div>
Effective formulations 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'' dominance. [49]
Effective formulations 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'' dominance. [49]
==== Various external applications ====
==== Various external applications ====
<div class="mw-collapsible mw-collapsed">
व्यायामयोगैर्विविधैः प्रगाढैरुद्वर्तनैः स्नानजलावसेकैः|
व्यायामयोगैर्विविधैः प्रगाढैरुद्वर्तनैः स्नानजलावसेकैः|
सेव्यत्वगेलागुरुचन्दनाद्यैर्विलेपनैश्चाशु[१] न सन्ति मेहाः||५०||
सेव्यत्वगेलागुरुचन्दनाद्यैर्विलेपनैश्चाशु[१] न सन्ति मेहाः||५०||
<div class="mw-collapsible-content">
vyāyāmayōgairvividhaiḥ pragāḍhairudvartanaiḥ snānajalāvasēkaiḥ|
vyāyāmayōgairvividhaiḥ pragāḍhairudvartanaiḥ snānajalāvasēkaiḥ|
sevyatvagelAgurucandanAdyairvilepanaishcAshu na santi MehaH||50||
sevyatvagelAgurucandanAdyairvilepanaishcAshu na santi MehaH||50||
</div></div>
''Pramehas'' get immediately cured by different types of exercises, unction, bath, sprinkling of water over the body and application of ointment made of ''sevya'' (''ushira''), ''tvak, ela, aguru, chandana'' etc. [50]
''Pramehas'' get immediately cured by different types of exercises, unction, bath, sprinkling of water over the body and application of ointment made of ''sevya'' (''ushira''), ''tvak, ela, aguru, chandana'' etc. [50]
==== Indication of ''apatarpana'' treatment ====
==== Indication of ''apatarpana'' treatment ====
<div class="mw-collapsible mw-collapsed">
क्लेदश्च मेदश्च कफश्च वृद्धः प्रमेहहेतुः प्रसमीक्ष्य तस्मात्|
क्लेदश्च मेदश्च कफश्च वृद्धः प्रमेहहेतुः प्रसमीक्ष्य तस्मात्|
वैद्येन पूर्वं कफपित्तजेषु मेहेषु कार्याण्यपतर्पणानि||५१||
वैद्येन पूर्वं कफपित्तजेषु मेहेषु कार्याण्यपतर्पणानि||५१||
<div class="mw-collapsible-content">
klēdaśca mēdaśca kaphaśca vr̥ddhaḥ pramēhahētuḥ prasamīkṣya tasmāt|
klēdaśca mēdaśca kaphaśca vr̥ddhaḥ pramēhahētuḥ prasamīkṣya tasmāt|
vaidyena pUrvaM kaphapittajeShu meheShu kAryANyapatarpaNAni||51||
vaidyena pUrvaM kaphapittajeShu meheShu kAryANyapatarpaNAni||51||
</div></div>
Aggravated ''kleda'' (liquid element of the body), ''medas'' (adipose 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 with ''kapha'' and ''pitta'' dominant types of prameha. [51]
Aggravated ''kleda'' (liquid element of the body), ''medas'' (adipose 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 with ''kapha'' and ''pitta'' dominant types of prameha. [51]
==== ''Vata'' dominant ''prameha'' ====
==== ''Vata'' dominant ''prameha'' ====
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या वातमेहान् प्रति पूर्वमुक्ता वातोल्बणानां विहिता क्रिया सा|
या वातमेहान् प्रति पूर्वमुक्ता वातोल्बणानां विहिता क्रिया सा|
वायुर्हि मेहेष्वतिकर्शितानां कुप्यत्यसाध्यान् प्रति नास्ति चिन्ता||५२||
वायुर्हि मेहेष्वतिकर्शितानां कुप्यत्यसाध्यान् प्रति नास्ति चिन्ता||५२||
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yā vātamēhān prati pūrvamuktā vātōlbaṇānāṁ vihitā kriyā sā|
yā vātamēhān prati pūrvamuktā vātōlbaṇānāṁ vihitā kriyā sā|
vAyurhi meheShvatikarshitAnAM kupyatyasAdhyAn prati nAsti cintA||52||
vAyurhi meheShvatikarshitAnAM kupyatyasAdhyAn prati nAsti cintA||52||
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Formulations described earlier for the ''vatika prameha'' are actually meant for ''vata'' dominant ''prameha'' where ''vayu'' is secondarily (subsequently) aggravated. If the ''vayu'' is primarily aggravated in ''prameha'' because of excessive depletion of tissue elements, then it is incurable and the physician need not make efforts to treat. [52]
Formulations described earlier for the ''vatika prameha'' are actually meant for ''vata'' dominant ''prameha'' where ''vayu'' is secondarily (subsequently) aggravated. If the ''vayu'' is primarily aggravated in ''prameha'' because of excessive depletion of tissue elements, then it is incurable and the physician need not make efforts to treat. [52]
==== Prevention of ''prameha'' ====
==== Prevention of ''prameha'' ====
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यैर्हेतुभिर्ये प्रभवन्ति मेहास्तेषु प्रमेहेषु न ते निषेव्याः|
यैर्हेतुभिर्ये प्रभवन्ति मेहास्तेषु प्रमेहेषु न ते निषेव्याः|
हेतोरसेवा विहिता यथैव जातस्य रोगस्य भवेच्चिकित्सा||५३||
हेतोरसेवा विहिता यथैव जातस्य रोगस्य भवेच्चिकित्सा||५३||
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yairhētubhiryē prabhavanti mēhāstēṣu pramēhēṣu na tē niṣēvyāḥ|
yairhētubhiryē prabhavanti mēhāstēṣu pramēhēṣu na tē niṣēvyāḥ|
hetorasevA vihitA yathaiva jAtasya rogasya bhaveccikitsA||53||
hetorasevA vihitA yathaiva jAtasya rogasya bhaveccikitsA||53||
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Etiological factors responsible for the causation of different types of ''prameha'' should be avoided even after ''prameha'' are manifested. The causative factors described shall be avoided during the treatment of those particular diseases (even after its manifestation). [53]
Etiological factors responsible for the causation of different types of ''prameha'' should be avoided even after ''prameha'' are manifested. The causative factors described shall be avoided during the treatment of those particular diseases (even after its manifestation). [53]
==== Differentiation between ''raktapitta'' and ''prameha'' ====
==== Differentiation between ''raktapitta'' and ''prameha'' ====
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हारिद्रवर्णं रुधिरं च मूत्रं विना प्रमेहस्य हि पूर्वरूपैः|
हारिद्रवर्णं रुधिरं च मूत्रं विना प्रमेहस्य हि पूर्वरूपैः|
यो मूत्रयेत्तं न वदेत् प्रमेहं रक्तस्य पित्तस्य हि स प्रकोपः||५४||
यो मूत्रयेत्तं न वदेत् प्रमेहं रक्तस्य पित्तस्य हि स प्रकोपः||५४||
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hāridravarṇaṁ rudhiraṁ ca mūtraṁ vinā pramēhasya hi pūrvarūpaiḥ|
hāridravarṇaṁ rudhiraṁ ca mūtraṁ vinā pramēhasya hi pūrvarūpaiḥ|
yo mUtrayettaM na vadet pramehaM raktasya pittasya hi sa prakopaH||54||
yo mUtrayettaM na vadet pramehaM raktasya pittasya hi sa prakopaH||54||
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If the color 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 not be diagnosed as a patient of ''prameha''. He should be diagnosed as a case of ''rakta-pitta'' (a disease characterized by bleeding from different parts of body).[54]
If the color 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 not be diagnosed as a patient of ''prameha''. He should be diagnosed as a case of ''rakta-pitta'' (a disease characterized by bleeding from different parts of body).[54]
==== Two types of ''prameha'' patient ====
==== Two types of ''prameha'' patient ====
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दृष्ट्वा प्रमेहं मधुरं सपिच्छं मधूपमं स्याद्द्विविधो विचारः|
दृष्ट्वा प्रमेहं मधुरं सपिच्छं मधूपमं स्याद्द्विविधो विचारः|
क्षीणेषु दोषेष्वनिलात्मकः स्यात् सन्तर्पणाद्वा कफसम्भवः स्यात्||५५||
क्षीणेषु दोषेष्वनिलात्मकः स्यात् सन्तर्पणाद्वा कफसम्भवः स्यात्||५५||
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dr̥ṣṭvā pramēhaṁ madhuraṁ sapicchaṁ madhūpamaṁ syāddvividhō vicāraḥ|
dr̥ṣṭvā pramēhaṁ madhuraṁ sapicchaṁ madhūpamaṁ syāddvividhō vicāraḥ|
kShINeShu doSheShvanilAtmakaH syAt santarpaNAdvA kaphasambhavaH syAt||55||
kShINeShu doSheShvanilAtmakaH syAt santarpaNAdvA kaphasambhavaH syAt||55||
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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'' having ''vata''-dominant type or by over- nourishment having ''kapha'' dominant type. [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'' having ''vata''-dominant type or by over- nourishment having ''kapha'' dominant type. [55]
==== Prognosis ====
==== Prognosis ====
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सपूर्वरूपाः कफपित्तमेहाः क्रमेण ये वातकृताश्च मेहाः|
सपूर्वरूपाः कफपित्तमेहाः क्रमेण ये वातकृताश्च मेहाः|
साध्या न ते, पित्तकृतास्तु याप्याः, साध्यास्तु मेदो यदि न प्रदुष्टम्||५६||
साध्या न ते, पित्तकृतास्तु याप्याः, साध्यास्तु मेदो यदि न प्रदुष्टम्||५६||
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sapūrvarūpāḥ kaphapittamēhāḥ kramēṇa yē vātakr̥tāśca mēhāḥ|
sapūrvarūpāḥ kaphapittamēhāḥ kramēṇa yē vātakr̥tāśca mēhāḥ|
sAdhyA na te, pittakRutAstu yApyAH, sAdhyAstu medo yadi na praduShTam||56||
sAdhyA na te, pittakRutAstu yApyAH, sAdhyAstu medo yadi na praduShTam||56||
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''Kapha'' dominant and ''pitta'' dominant types of ''prameha'', if preceded by their premonitory signs and symptoms, are incurable. Similarly, ''vatika prameha'', where ''vayu'' is aggravated right from the beginning is incurable. ''Pitta'' dominant types of ''prameha'' are generally palliable. But they are curable if ''medas'' (adipose tissue) is not vitiated. [56]
''Kapha'' dominant and ''pitta'' dominant types of ''prameha'', if preceded by their premonitory signs and symptoms, are incurable. Similarly, ''vatika prameha'', where ''vayu'' is aggravated right from the beginning is incurable. ''Pitta'' dominant types of ''prameha'' are generally palliable. But they are curable if ''medas'' (adipose tissue) is not vitiated. [56]
==== In-curability of hereditary diseases ====
==== In-curability of hereditary diseases ====
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जातः प्रमेही मधुमेहिनो वा न साध्य उक्तः स हि बीजदोषात्|
जातः प्रमेही मधुमेहिनो वा न साध्य उक्तः स हि बीजदोषात्|
ये चापि केचित् कुलजा विकारा भवन्ति तांश्च प्रवदन्त्यसाध्यान्||५७||
ये चापि केचित् कुलजा विकारा भवन्ति तांश्च प्रवदन्त्यसाध्यान्||५७||
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jātaḥ pramēhī madhumēhinō vā na sādhya uktaḥ sa hi bījadōṣāt|
jātaḥ pramēhī madhumēhinō vā na sādhya uktaḥ sa hi bījadōṣāt|
ye cApi kecit kulajA vikArA bhavanti tAMshca pravadantyasAdhyAn||57||
ye cApi kecit kulajA vikArA bhavanti tAMshca pravadantyasAdhyAn||57||
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Patients who suffer from ''prameha'' since birth (congenital) and those who are borne of ''prameha'' parents (hereditary) are not curable because of the morbidity in their ''bija'' (genes). Similarly, other hereditary (''kulaja''/familial) ailments are considered as incurable. [57]
Patients who suffer from ''prameha'' since birth (congenital) and those who are borne of ''prameha'' parents (hereditary) are not curable because of the morbidity in their ''bija'' (genes). Similarly, other hereditary (''kulaja''/familial) ailments are considered as incurable. [57]
==== Treatment of ''prameha pidaka'' ====
==== Treatment of ''prameha pidaka'' ====
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प्रमेहिणां याः पिडका मयोक्ता रोगाधिकारे पृथगेव सप्त|
प्रमेहिणां याः पिडका मयोक्ता रोगाधिकारे पृथगेव सप्त|
ताः शल्यविद्भिः कुशलैश्चिकित्स्याः शस्त्रेण संशोधनरोपणैश्च||५८||
ताः शल्यविद्भिः कुशलैश्चिकित्स्याः शस्त्रेण संशोधनरोपणैश्च||५८||
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pramēhiṇāṁ yāḥ piḍakā mayōktā rōgādhikārē pr̥thagēva sapta|
pramēhiṇāṁ yāḥ piḍakā mayōktā rōgādhikārē pr̥thagēva sapta|
tAH shalyavidbhiH kushalaishcikitsyAH shastreNa saMshodhanaropaNaishca||58||
tAH shalyavidbhiH kushalaishcikitsyAH shastreNa saMshodhanaropaNaishca||58||
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Seven types of ''prameha pidaka'' of patients suffering from ''prameha'' described in the quadrate on diseases (''rogadhikara'') are to be treated by expert surgeons with the help of ''shastras'' (surgical operations), ''samshodhana'' (cleansing) and ''ropana'' (healing therapies). [58]
Seven types of ''prameha pidaka'' of patients suffering from ''prameha'' described in the quadrate on diseases (''rogadhikara'') are to be treated by expert surgeons with the help of ''shastras'' (surgical operations), ''samshodhana'' (cleansing) and ''ropana'' (healing therapies). [58]
==== Summary ====
==== Summary ====
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तत्र श्लोकाः-
तत्र श्लोकाः-
मेहानां प्रशमार्थं चिकित्सिते दिष्टमेतावत्||६१||
मेहानां प्रशमार्थं चिकित्सिते दिष्टमेतावत्||६१||
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tatra ślōkāḥ-
tatra ślōkāḥ-
MehanAM prashamArthaM cikitsite diShTametAvat||61||
MehanAM prashamArthaM cikitsite diShTametAvat||61||
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Here are the recapulatory verses:
Here are the recapulatory verses: