A History of Indian Medical Literature v1.c24.90

v1.c24.90

Chapter ten (pramehanidāna) deals with the following subjects: out of the twenty types of prameha, ten arise from kapha, six from pitta, and four from vāta (10.1a–c);²¹³ prameha is usually caused by foods and drinks which lead to an increase of fatty tissue, urine and kapha (10.1cd–3);²¹⁴ the pathogenesis (10.4–5);²¹⁵ patients with (pra)meha are curable, may be treated palliatively, or should be refused treatment, dependent on the main doṣa involved, the samakriyatā or asamakriyatā (of doṣa and affected dūṣya or dūṣyas), and the mahātyayatā (risks inherent in treatment) (10.6);²¹⁶ the common symptoms of all pramehas (10.7ab);²¹⁷ the combinations of doṣas and dūṣyas, even if these constituents are related to each other, give rise to various colours, etc., of the urine, which makes it possible to describe several types (10.7cd–8ab);²¹⁸ the ten types of prameha (arising from kapha) and the characteristics of the urine in these disorders: udakameha,²¹⁹ ikṣumeha, ²²⁰ sāndrameha, surāmeha, piṣṭameha, śukrameha, sīkatāmeha, śītameha, śanairmeha, and lālāmeha (10.8cd–13);²²¹ the six types (arising from pitta) and their characteristics: kṣārameha, nīlameha, kālameha, hāridrameha, mañjiṣṭhāmeha, and raktameda (10.14–16ab);²²² the four types (arising from vāta) and their characteristics: vasāmeha, majjāmeha, hastimeha, and madhumeha (10.16cd–18c);²²³ the two varieties of madhumeha: with excitement of vāta due to decline of bodily elements (dhātukṣaya) and due to covering of the pathway of vāta by (the other) doṣas (10.18d–19ab);²²⁴ the characteristics of the second variety (10.19cd–20ab);²²⁵ all kinds of prameha develop, if neglected, into madhumeha (10.20cd); all cases of prameha in which the urine is sweet as honey are regarded as madhumeha (10.21);²²⁶ the complications of prameha arising from kapha, pitta or vāta (10.22–24);²²⁷ the ten piṭikās (boils), which may develop in the regions where junctures and marmans are found and in fleshy parts, when prameha is neglected (10.25–26);²²⁸ the characteristics of nine of these ten types: śarāvikā, kacchapikā, jālinī, vinatā, alajī, masūrikā, sarṣapikā, putriṇī, and vidārikā; the tenth, vidradhi, will be described in the next chapter (10.27–34c);²²⁹ the first three, along with putriṇī and vidārī, are hard to resist, because of their abundance of fatty tissue; the other ones, with a predominance of pitta, are resistable, because they arise from a small amount of fatty tissue (10.34cd–35);²³⁰ the doṣa involved is dependent on the type of meha present (10.36ab); ²³¹ these piṭikās also occur without the presence of prameha, when the fatty tissue is corrupted, but their specific characteristics are not easily recognizable in such cases (10.36c–f); ²³² patients passing urine of a turmeric yellow or red colour should not be diagnosed as suffering from prameha, but from raktapitta, if the prodromes of prameha have not appeared (10.37); ²³³ the prodromes of prameha (10.38–39); ²³⁴ cases of prameha in which it is difficult to determine which is the main doṣa involved (10.40); ²³⁵ criteria for the determination of the degree of curability of prameha (10.41). ²³⁶