A critical analysis on the basic concept of prameha in conventional parlance
Journal name: Ayushdhara
Original article title: A critical analysis on the basic concept of prameha in conventional parlance
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Suman Kundu*
Assistant Professor, Dept. of Kayachikitsa, Raghunath Ayurved Mahavidyalaya & Hospital, Contai, Purba Medinipur, West Bengal
Nisith Kumar Mandal
Assistant Professor, Dept. of Kriya Sharira, Raghunath Ayurved Mahavidyalaya & Hospital, Contai, Purba Medinipur, West Bengal
Dipanjan Jana
Assistant Professor, Dept. of Panchakarma, Raghunath Ayurved Mahavidyalaya & Hospital, Contai, Purba Medinipur, West Bengal
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: A critical analysis on the basic concept of prameha in conventional parlance
Year: 2018
Copyright (license): CC BY-NC-SA 4.0
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Summary of article contents:
Introduction
The article presents a critical analysis of the Ayurvedic disease Prameha, which is characterized by the clinical signs of excessive and contaminated urine. Despite its extensive documentation in classical Ayurvedic texts, the conventional understanding of Prameha remains unclear. The authors, Suman Kundu and colleagues, explore Prameha through the lens of both Ayurvedic and conventional medical literature. The article highlights the lack of established conventional entities for Prameha and emphasizes its significance within the broader context of health and disease management.
Meda Dusti: A Key Pathological Phenomenon
One of the core concepts discussed is Meda Dusti, which is recognized as the central pathological phenomenon underlying Prameha. According to ancient texts, Meda (fat tissue) is significantly impacted in this disease. The authors point out that modern lifestyle factors, including an obesogenic diet and lack of physical activity, contribute to the vitiation of body components, notably affecting the Meda Dhatu. This disturbance is suggested to lead to a metabolic condition known as lipotoxicity, where excess lipids in non-adipose tissues cause cellular dysfunction and injury. The comparison draws parallels between the Ayurvedic concept of Meda and conventional physiological components related to lipid storage and utilization, which is critical for understanding diabetes mellitus and chronic kidney diseases (CKD).
Urinary Manifestations and Pathophysiology
Prameha is primarily defined by its urinary manifestations, characterized by increased urine quantity and contamination. The authors explain that pathologically, this increase in urine can stem from osmotic diuresis and a failure of the kidney’s concentrating mechanisms. They explore how conditions like diabetes mellitus exhibit similar urinary characteristics, with osmotic diuresis as a direct result of elevated blood glucose levels. The discussion emphasizes that these pathological changes highlight the systemic implications of what is traditionally a urological condition, thereby bridging Ayurveda and contemporary medical understanding.
Conclusion
The article concludes that Prameha, as described in Ayurvedic literature, can be attributed to Meda Dusti and is fundamentally linked to abnormal lipid metabolism and its consequences, like lipotoxicity. This condition may lead to excessive urine production and changes in urine quality, akin to the physiological disruptions seen in diabetes and chronic kidney disease. Given these insights, Prameha not only represents a unique Ayurvedic classification of disease but also sheds light on metabolic dysfunctions that align closely with contemporary health issues, thereby promoting a more integrated understanding of health and disease management across different medical paradigms.
FAQ section (important questions/answers):
What is Prameha according to Ayurvedic texts?
Prameha is defined as a systemic disease characterized by excess and contaminated urine, associated with the pathological phenomenon of Meda Dusti, derived from altered lipid homeostasis and dietary factors.
How is Prameha classified in Ayurveda?
Prameha is classified into two types: Sahaja (hereditary) and Apathyanimittaja (acquired), along with further classifications based on the Dosha predominance, leading to three major types: Vataja, Pittaja, and Kaphaja Prameha.
What role does Meda Dusti play in Prameha?
Meda Dusti is a key pathological phenomenon in Prameha, indicating lipid imbalance that leads to metabolic dysfunction. This can result in conditions like diabetes mellitus and chronic kidney disease, characterized by excessive and altered urine outputs.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “A critical analysis on the basic concept of prameha in conventional parlance�. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Prameha:
Prameha is an Ayurvedic term that denotes a disease characterized by excessive and contaminated urine passage, known as Avila-Prabhuta-Mutra. This disease involves altered lipid homeostasis, primarily affecting the Meda (fat tissue) and is linked to conditions like diabetes mellitus.
2) Meha:
Meha refers to the part of Prameha dealing with excessive urination. It combines with 'Pra' to form 'Prameha', describing the abundant and frequent passage of urine. This symptom is central to the diagnosis and understanding of Prameha in Ayurvedic medicine.
3) Disease:
Disease, in the context of this text, refers to a pathological condition causing symptoms such as excessive urination. Prameha is a disease categorized in Ayurveda, involving systemic manifestations and characterized by contaminated urine due to Meda Dusti.
4) Medas (Meda, Medash):
Meda, in Ayurveda, represents the fat tissue. Meda Dusti, or dysfunction, is a central pathological phenomenon in Prameha, involving altered lipid metabolism, leading to diseases characterized by excessive urine like diabetes mellitus.
5) Dosha (Dosa):
Dosha are the fundamental bodily humors in Ayurveda: Vata, Pitta, and Kapha. Their imbalance is thought to cause diseases. Prameha is classified based on the predominance of specific Doshas, illustrating its interrelatedness with body types and temperaments.
6) Ayurveda (Ayus-veda):
Ayurveda is an ancient system of medicine from India, emphasizing holistic treatment and prevention. The text discusses Prameha, an Ayurvedic disease marked by excessive urine discharge, showing the importance of integrating Ayurvedic and conventional medical approaches.
7) Prabhuta:
[see source text or glossary: Prabhuta]
8) Pittaja (Pitta-ja):
Pittaja Prameha is a type of Prameha dominated by Pitta Dosha. This classification is based on the characteristics of urine, indicating that different bodily humors (Dosha) play distinct roles in the manifestation of the disease.
9) Vataja (Vata-ja):
Vataja Prameha is another type of Prameha, primarily influenced by Vata Dosha. The presentation and progression of this type differ due to the specific characteristics of Vata Dosha affecting urinary and other systemic symptoms.
10) Kapha:
Kapha Dosha is one of the three primary humors in Ayurveda. Its enhanced Drava Guna (liquid quality) is implicated in Prameha, particularly in Kaphaja Prameha, showing how bodily fluids and systemic health are interconnected.
11) Mutra:
Mutra means urine in Ayurveda. In Prameha, the focus is on Avila-Prabhuta-Mutra, meaning excessive and contaminated urine, which is the primary symptom that relates to systemic disorders like diabetes and chronic kidney disease.
12) Majja:
Majja, or bone marrow, is considered a Dushya (affected tissue) in Prameha. It indicates that this disease affects multiple body systems, leading to complex manifestations related to the degradation of fatty and marrow tissues.
13) Avila:
Avila signifies the turbidity or contamination of urine. In Prameha, Avila-Prabhuta-Mutra denotes the presence of cloudy or impure urine, which is a critical symptom for diagnosis and understanding the pathophysiology of the disease.
14) India:
India is the birthplace of Ayurveda, the ancient medical system that first detailed diseases like Prameha. The text originates from Indian scholars and discussions about integrating Ayurvedic principles with modern medical science.
15) Vasa (Vasha):
Vasa, or muscle fat, is listed as one of the Dushyas (affected tissues) in Prameha. It indicates how the disease extends to various tissues, demonstrating the comprehensive impact of lipid metabolism disorders in the body.
16) Madhavakara:
Acharya Madhavakara is an ancient Ayurvedic scholar whose definitions and explanations of Prameha provide critical insights. His emphasis on urinary symptoms has shaped the understanding and diagnosis of this disease.
17) Medadhatu (Meda-dhatu):
Meda-dhatu refers to the tissue responsible for storing and utilizing fats. Meda Dusti, or dysfunction, is central to Prameha, reflecting abnormalities similar to modern concepts of lipid metabolism and storage disorders.
18) Medicine:
Medicine, as discussed, involves both ancient Ayurvedic practices and modern conventional approaches. The text aims to bridge these methodologies, particularly in understanding and treating diseases like Prameha.
19) Prakopa:
[see source text or glossary: Prakopa]
20) Kaphaja:
Kaphaja Prameha is a type characterized by the predominance of Kapha Dosha. It is identified by specific urinary symptoms and manifestations, illustrating the Ayurvedic approach to diagnosing and managing diseases based on doshic imbalance.
21) Sahaja (Saha-ja):
Sahaja Prameha refers to the hereditary form of the disease. It is caused by 'Beejadosha' or genetic susceptibility, making it incurable according to Acharya Charaka, highlighting the importance of genetic factors in disease manifestation.
22) Shonita (Sonita):
[see source text or glossary: Shonita]
23) Dushya (Dusya):
Dushya refers to the tissues and components affected by a disease. In Prameha, various Dushyas like Meda, Mamsa, and Sonita are impacted, signifying the comprehensive nature of the disease affecting multiple body systems.
24) Lasika:
Lasika, or lymph, is another Dushya involved in Prameha. It indicates that the disease affects not only fat and blood but also lymphatic tissues, contributing to a broader systemic disturbance.
25) Pista (Pishta):
[see source text or glossary: Pishta]
26) Bengal (Bemgal):
Bengal is the region in India where the authors, affiliated with the Raghunath Ayurved Mahavidyalaya & Hospital, are conducting their research, contributing to the academic dialogue on diseases like Prameha in contemporary contexts.
27) Mamsa (Mamsha):
Mamsa, or muscle tissue, is counted among the Dushyas in Prameha. This signifies the disease's systemic impact, leading to muscle degradation along with other tissues, demonstrating its multifaceted pathology.
28) Kleda:
Kleda, meaning moisture or fluid, is a Dushya in Prameha. Its involvement points to the disruption of bodily fluids, contributing to the characteristic symptoms of excessive and contaminated urine in the disease.
29) Varam:
[see source text or glossary: Varam]
30) Dhatu:
Dhatu represents the bodily tissues in Ayurveda. In Prameha, affected Dhatus like Meda and Mamsa point to the systemic nature of the disease, showing a disruption in multiple tissue types due to lipid and fluid imbalance.
31) Shukra (Sukra):
[see source text or glossary: Shukra]
32) Sura (Shura):
[see source text or glossary: Sura]
33) Rasa (Rasha):
Rasa refers to the plasma or primary fluid in Ayurveda. Its disturbance in Prameha indicates the disease's impact on the initial stages of digestion and bodily fluid regulation, emphasizing its comprehensive nature.
34) Diet:
Diet, particularly obesogenic diet, plays a crucial role in the etiology of Prameha. High-fat diets lead to Meda Dusti, contributing to lipid imbalances and systemic issues, underscoring the link between dietary habits and disease.
35) Kaphadosha (Kaphadosa, Kapha-dosha):
[see source text or glossary: Kapha-dosha]
36) Manjishtha (Manjistha, Mamjishtha):
[see source text or glossary: Manjishtha]
37) Discussion:
The discussion section in the text compares Ayurvedic concepts of Prameha with modern pathological understandings. It emphasizes integrating both methodologies to enhance the evidence-based approach to diseases like Prameha.
38) Tridosha (Tridosa, Tri-dosha):
Tri-dosha refers to the three doshas: Vata, Pitta, and Kapha, whose imbalance causes diseases. In Prameha, the predominance of specific doshas aids in categorizing the disease, reflecting the core Ayurvedic principle of health and disease.
39) Vitiation (Vitiated):
Vitiation in Ayurveda denotes the imbalance or disturbance of doshas. In Prameha, Tri-dosha vitiation, particularly involving Kapha, leads to the manifestation of symptoms, highlighting the dynamic nature of bodily humors in health and disease.
40) Ashtanga (Astanga, Ashtan-anga):
[see source text or glossary: Ashtanga]
41) Haridra:
[see source text or glossary: Haridra]
42) Sharira (Sarira):
[see source text or glossary: Sharira]
43) Kshara (Ksara):
[see source text or glossary: Kshara]
44) Sandra (Samdra):
[see source text or glossary: Sandra]
45) Sthula:
Sthula Pramehi refers to Prameha in obese individuals. These patients require different therapeutic strategies than non-obese (Krisha Pramehi) individuals, illustrating the tailored treatment approaches in Ayurveda based on body constitution.
46) Krisha (Krsa):
Krisha Pramehi refers to Prameha in non-obese individuals. Distinct therapeutic approaches are needed for these patients, showing the importance of considering body type and constitution in managing Prameha in Ayurveda.
47) Sikata (Shikata):
[see source text or glossary: Sikata]
48) Lavana:
[see source text or glossary: Lavana]
49) Mandal:
Nisith Kumar Mandal is one of the authors who contributed to this paper's research on Prameha. His work in this field enhances understanding and bridges Ayurvedic concepts with contemporary medical science.
50) Sanai (Shanai):
[see source text or glossary: Shanai]
51) Udaka:
[see source text or glossary: Udaka]
52) Kriya:
Kriya Sharira, or the study of body functions, is the department where co-author Nisith Kumar Mandal works. Understanding bodily functions holistically is crucial for correlating Ayurvedic principles like Prameha with modern physiology.
53) Pitta:
Pitta is one of the three primary doshas in Ayurveda. Its vitiation can lead to Pittaja Prameha, illustrating the role of Pitta in metabolic processes and urine characteristics within the holistic framework of Ayurvedic medicine.
54) Udara:
[see source text or glossary: Udara]
55) Sneha:
[see source text or glossary: Sneha]
56) Asthi (Ashthi):
[see source text or glossary: Asthi]
57) Ikshu (Iksu):
[see source text or glossary: Ikshu]
58) Hastin (Hasti):
[see source text or glossary: Hasti]
59) Rakta:
[see source text or glossary: Rakta]
60) Drava:
[see source text or glossary: Drava]
61) Shukla (Sukla):
[see source text or glossary: Sukla]
62) Phena:
[see source text or glossary: Phena]
63) Kumar:
Nisith Kumar Mandal is a co-author of this paper and an Assistant Professor in the Dept. of Kriya Sharira. His research contributions are significant in the study of Prameha, showing the academic rigor behind analyzing this Ayurvedic disease.
64) Sarpis (Sarpi, Sarpish):
[see source text or glossary: Sarpi]
65) Ayus (Ayush):
[see source text or glossary: Ayush]
66) Lala:
[see source text or glossary: Lala]
67) Jana:
Dipanjan Jana is an Assistant Professor in the Dept. of Panchakarma and a co-author of this paper. His expertise contributes to understanding the Ayurvedic treatment of Prameha, emphasizing comprehensive, therapeutic approaches.
68) Nila:
[see source text or glossary: Nila]
69) Amla:
[see source text or glossary: Amla]
70) Sita (Shita):
[see source text or glossary: Sita]
71) Vata:
Vata, one of the three primary doshas in Ayurveda, is significant in diagnosing Vataja Prameha. Its characteristics influence the disease's presentation, pointing to the Vata dosha's involvement in urinary and systemic symptoms.
72) Guna:
[see source text or glossary: Guna]
73) Kala:
[see source text or glossary: Kala]
74) Food:
Food, particularly obesogenic diets, are crucial etiological factors in Prameha. High-fat foods lead to Meda Dusti, causing systemic lipid imbalances and reflecting the profound connection between dietary habits and disease manifestation in Ayurveda.
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