Shodhana in Prameha.

1. Sodhana in Prameha

2. Prameha
• One among Ashta Mahagada(A.H Ni 8/30).
• A Santharpana Janya Vyadhi(Ch.Su23/
• Anushangeenam Sreshta....(Ch Su.25/ )

3. • Prameha = Pra + Meha
• ‘Mih Sechane’
• Mehati Sinchati Mootra Retamsi – To excrete
• Mih – to make water, to wet, to exit semen

4. Definition
• Prakarshena mehati Yasmin Roge sa Prameha (Su.Ni.
• प्रकर्षेण प्रभूतम् प्रचुरं वारं वा मेहतत, मूत्रत्वं करोतत इतत प्रमेह: (मा.ति.३३/१)

5. • Chapters – Ch.Ni-4th , Ch.Chi.6th
• -Su.Ni.6th , Su.Chi.-11th ,12th , 13th
• A.H. Ni-10, A.H.Chi-12

6. Nidana
A.H.NI 10/2,3
• Annapana/kriya _Medo mutra
Kaphavaha
• Swadamla Lavana Snigdha Guru
Picchila Seetala
• Nava Dhanya, Sura
• Anoopa, Ikshu, Guda, Gorasa
• Ekasthana Asana Rati
• Vidhivarjjita Sayanam
CH.NI. 4/5, 6/4
• Intake of Nava Dhanya
• Sarpi, Masha, Soopa
• Gramya Authaka Anoopa
mamsa
• Saaka , Tila, Palala,
Pishtanna,Payasa, Ikshu Vikara,
Ksheera

7. Classification
• Based on Dosha.
• Based on body constitution-(Ch.Chi6/15)
• Based on Nidana- (Su.Chi.11/3)
• Based on Sadhya - Asadhyata

8. Samprapti:
• Nidana Vata, Pitta, Sleshma Dushti.
Medo Dushti
• Mutra Vaha Sroto Dushti localise in Basti (Su.Ni.6/4)

9. Samprapti
Nidana Sevana
Kapha Dushti
cause
vitiation of Kleda, Sweda, Meda, Rasa, Mamsa
StanaSamsraya in Basti Kaphaja
Prameha (A.H.Ni 10/4)

10. Purva Roopa
Sweda, Anga Marda, Anga Sidhilata, Sayya, Asana, Swapna-Sukha,
Hrit netra Jihwa, Sravana Upadeha, Ghanangata, Kesha Nakha Ati
Vridhi, Sheeta priyatwam, Gala Talu Sosham, Asya Madhuryam, Kara
pada Daham, Mutre Abhidhavanti Pipeelika ...(A.H.Ni10/38, 39)
Pipasa, Durgandha, Jadileebhava of Kesa (Su Ni6/5)

11. Lakshana
• Prabhoota Avila Mootratwam (A.H.Ni10/7)
• तत्रातवलप्रभूतमूत्रलक्षणा सवव एव प्रमेहा भवन्ति (सु ति ६/६).
• Even though all Prameha are Tridoshatmaka, there is description of
K, P, V Prameha.
• Kaphaja Prameha=Vata Pitta, Medobhiranvita Sleshma
• Pitta Prameha= Vata Kapha Sonita Medobhiranvita Pitta
• Vata Prameha= Kapha Pitta Vasa Majja Medobhiranvita Vata
(Su.Ni.6/9)

12. Types of Prameha acc.to Dosha
Predominance
• Kaphaja- 10
• Pittaja-6
• Vataja-4

13. Sadhya Asadhyata(Su Ni6/8- 12)
• Kaphaja – Sadhyam-Dosha Dooshyanam Sama Kriyatwat.
• Pittaja- Yapya- Dosha Dooshyanam Vishama Kriyatwat.
• Vataja – Asadhya- Mahatyayikatwat+Vishama kriyatwat.

14. Upadrava of Pameha
अतवपाको अरुतच छतदव तिद्रा कास सपीिस
उपद्रवा प्रजायिे मेहािां कफजन्मिाम् ।
(अ.ह्.ति.१०/२२)
बन्तिमेहियो िोद मुष्कावदरणम् ज्वर:
दाहिृष्णाम्लको मूर्च्ाव तवट्भेद पित्तजन्मिाम्
(अ.ह्.ति.१०/२३)
वापिकािां उदावतव कम्पहृद्ग्रह लोलता
शूलमुतिद्रता शोर्ष कासश्वासश्च जायते
(अ.ह्.ति.१०/२४)

15. Prameha Pitaka
• 10 in numbers.
• Occurs when Prameha left untreated(A.H.ni 10/25).
• Tridoshatmaka (Su.Ni.6/7)
• Site: Sandhi Marma, Mamsala Bhaga
(A.H.NI.10/25-26)
• Adhakaye.. (Su.Ni6/8 )
• Can occur without having Prameha- in condiions of Dushta
Medas.(A.H.ni 10/)

16. Sadhya Asadhyata of Pitaka
• Krichra Sadhya-Saravika, Kacchapika, Jalini, Putrini, Vidarika- due to
Bahu Medas
• Sadhya- Vinata, Masoorika, Sarshapika, Vidrati – due to Alpa Medas
(A.H.NI.10/36)
गुदे ह्रुतत तशरस्यंसे प्रुष्ठे ममवतण च उन्तिता
सोपद्रवा दुबवलाग्ने: तपटका पररवर्ज्वयेत्। (सु.ति६/२०)

17. Madhumeha
• सवव एव प्रमेहािु कालेि अप्रतत क
ु ववत;
मधुमेहत्वमायतत तदा असाध्या भवन्ति।
(सु.ति.६/२७)
मधुमेतह मधुसमं जायते स तकल तिधा
क्र
ु द्धे धातुक्षयात् वायौ दोर्षावृत पथे अथवा (अ.ह् ति१०/१८)

18. Treatment principle
मेतहिो बतलि: क
ु यावत् आदौ वमि रेचिे
(अ.ह्.तच.१२/२)
(Vamana Virechana for Meda Kleda Prasamanaaya)

19. Snehana
• With Taila –made of Sarshapa Arishta, Nikumba, Aksha,
Karanjaka./Trikandakaadi Taila (A.H.Chi.12/17-18).
• In Vata Kaphaja condition- Taila
• In Pittaja condition- Ghrita
• With Priyangvadi Sidha Taila/Ghrita (Su.Chi.11/7).
• वातोल्बणेर्षु स्नेहांश्च प्रमेहेर्षु प्रकल्पयेत् (अ.ह् तच १२/९)
.Eg.Dhanwantharam Ghritam

20. Swedana
• Contra indicated. (Su.Chi 12/7).
• Anagneya Sweda.

21. Sodhana
• Condition of Sodhana – Dosha Adhikya, Bala Adhikya (CH.CHI 6/15).
• Both Vamana and Virechana .
• Yogas- Vamana-
• रूक्षस्य मेतहिो वमि तिर्षेतधत्वम्, इतर: बलवतस्य वमिम् – कफमेहे
वामयेत्।
(सु.तच.११/७ डल्ह्ण)

22. Vamana
• रूक्षस्य मेतहिो वमि तिर्षेतधत्वम्, इतर: बलवतस्य वमिम् – कफमेहे वामयेत्।
(सु.तच.११/७ डल्ह्ण)

23. Virechana
• Virechana- तपत्तमेहे तवरेचयेत्। प्रगाढम् तवरेचिम् ( डल्. सु तच११/७)-
• Manibhadra gulam.
• Trivrut Lehyam.
• Kalyanaka Gulam
• Snuhi Ksheeram.
• Triphala Kashayam, Katuki,
Abhayadi Modaka.
• After Sodhana, do Santharpana Chikitsa (Ch.Chi 6/15), Tarpana with
Jangala Rasa

24. Niruha Basti
1. Kashaya – Surasadi Kashaya
Kalka- Mahaoushadha, Bhadra, Daru, Musta.(su.chi 11/7)
2.If Daha is there, Kashaya –Nyagrodhati (Su.chi).
 Rasnaamruterandadi Basti (Ch.Si3/61-64)
 Pancha Tiktaka Basti (Ch.Si8/8),
 Somavalka Basti(ch.si 10/43),
 Mustadi Yapana Basti(Ch.Si 12),
 Madhutailika Basti(AH.Kal4/27-28)

25. Anuvasana Basti
• Contra indicated.(Ch Si 2/17)
• दोर्षािुन्तलिश्य उदरम् जियेत् (च तस २/१८)
Saidhavadi Tailam (A.H.Kal.4/62,63)

26. Treatment of Kaphaja Prameha
संशोधिोल्लेखि लंघिाति
काले प्रयुक्ताति कफप्रमेहाि्। (च.तच६/२५)
• रूक्षमुितविं गाढ; व्यायामो तितशजागर
• यच्च अन्यत् स्लेश्ममेदोघ्नम् बतहरिश्च तद् तहतम्। (अ ह्.तच १२/३३)

27. Treatment of Pittaja Prameha
• जयन्ति तपत्त प्रभवाि् तवरेक
• संतपवण संशमिो तवतधश्च (च तच६/२६)

28. Treament of Vatanubandhatwa
• तसद्धाति तैलाति घृताति चैव
• देयाति मेहेर्षु अतिलात्मक
े शु
• (Ch.chi 6/33)

29. Treatment of Santarpanotha Prameha
• संशोधिाररष्ट कर्षायलेहै सिपवणोिाि् शमयेत् प्रमेहाि्।(च.तच ६/४७).
• Treatment of Santarpanotha Vyadhi- Vamana, Virechana, Vyayama,
Upavasa (Ch.Su23)
• Sthoulya Chikitsa-(Ch.Su.21/21-24)

30. Treatment of Krisa pramehi
• स बृंहणं तत्र क
ृ शस्य कायं (च तच ६ )
• बृंहयेत् और्षधाहारै: अमेदो मूत्रलै: क
ृ शम् (अ ह् तच १२/३७)

31. Treatment of Prameha Pitaka
• Apakwam- like Sopha
• Pakwam- like Vrana (A.H.CHI.12/39).
• Vrana Ropana-with Eladi tailam
• Udvartanam – with Aragwadhati
• Parishekam – with Asanadi
• Paanam- Vatsakadi (A.H. Chi 12/.

32. Previous research done
1. Management of Uncontrolled Type-2 Diabetes Mellitus with
Virechana Therapy: A Case Study
2. Role of patol nimbadi basti in prameha – case report
3. A comparative study of Vamana and Virechana Karma in the
management of Sthula Pramehi w.s.r. to Type-2 diabetes.
4. Clinical efficacy of Gokshura-Punarnava Basti in the management
of microalbuminuria in diabetes mellitus

33. Conclusion:
• Prameha generally a Santharana Janya Vikara
• Tridoshaja by nature.
• Sodhana and Samana
• Vamana, Virechana, Niruha Basti are the Sodhana therapy of
Prameha.