The urine * of a person suffering from an attack of Udaka-meha becomes white and water-like and is passed without the least pain. In a case of Ikshumeha the urine resembles the expressed juice of sugarcane. It has the colour of wine in a case of Surámeha. The urine in a case of Sikatámaha is passed with pain and is found to leave a sediment of extremely fine and sand-like concretions (Sikatás). In a case of Sanaimeha the urine gushes out at intervals in jets and is charged with a slimy mucous (kaphah). The urine in a case of Lavauameha becomes limpid (non-viscid) and acquires a saline taste. There is horripilation at the time of micturition in a case of Pishtameha (Chyluria), the urine resembling a stream of water, charged with a solution of pasted rice (Pishtam).
In a case of Sándrameha, the urine becomes thick and turbid, while in a case of Sukrameha the urine resembles semen (or the urine is found to be charged with semen: - Mádhaba). In a case of Phenamglia the patient passes frothy urine in broken jets. 10.
* The Sanskiit term Meha literally means to micturate. The verbal noun Mehnnam signifies urination as well as the act of passing any morbid urethral secretion. Hence the urine in most of these cases denotes the fact of its being charged with pus or any other morbid secretion of the urinary organs such as Ojah (albumen), marrow, etc., which imparts their characteristic colours to the fluid, - a fact which determines the nomenclature of the disease and forms the keynote of its diagnosis in the Ayurveda. - Ed.
Now we shall describe the characteristic features of the types of Prameha, which are due to the action of the deranged Pittam. The urine in a case of Nilameha becomes frothy, transparent and bluish. The urine in a case of Haridrámeha becomes deep yellow like turmeric (Haridrá) and is passed with a burning pain. The urine in a case of Amlameha acquires an acid taste and smell. The urine in a case of Kshárameha * resembles an alkaline solution filtered (through a piece of linen). The urine in a case of Manjisthámeha resembles the washing of the Manjisthá, while in a case of Raktameha, the urine is found to be of blood-colour or charged with blood - Madhava). 11.
Now we shall describe the characteristics of the different types of Prameha, which arc due to an exuberance of the deranged Vayu. In a case of Saipimeha, the urine looks like a stream of clarified butter, while in one of Vasáneha it resembles the washings of Vasá. In a case of Kshaudranieha, the urine looks like honey and acquires a sweet taste. In one of Hastimeha, the patient passes a copious quantity of urine, like an excited elephant, at a time, and in one unbroken stream, (the organ becoming steady immediately after the act of micturition). 12.
The fact of the urine being assailed by a swarm of flies, lassitude, growth of flesh (obesity), catarrh, looseness of the limbs, a non-relish for food, indigestion, expectoration of mucous, vomiting, excessive sleep, cough and laboured breathing (Svása) are the supervening traits (Upadrava) of the Kapkaja Prameha. A piercing pain in the testes, a pricking (veda) pain in the bladder, a shooting pain (Tuda) in the penis, a griping pain at the heart, acid eructations, fever, dysentery, a non-relish for food, vomiting, a sensation as if the entire body is emitting fumes, a burning sensation in the skin, thirst, epileptic fits, insomnia, jaundice (Pándu) and a yellow colour of the stool and urine arc the supervening symptoms which mark the Pittaja types of Prameha. An oppressive feeling at the heart (Hridgraha), eager longings for foods of all tastes, insomnia, numbness of the body, fits of shivering, colic pain and constipation of the bowels are the supervening symptoms, which specifically mark the Vátaja types. Thus we have described the nature of the twenty different types of Meha with their supervening evils as well. 13-16.
* The urine acquires a distinct alkaline taste, smell, colour and touch. (Mádhaba Nidánam).
† Charaka has included it within Kshaudra Meha and Madhu Me a.
The ten different types of Pidaká (abscess, carbuncles, pimples, pustules etc.) arc found to crop up on the bodies of patients,suffciing from Prameha, and abounding in fat and Vasá, and whose fundamental principles have been affected by the simultaneous derangement of the Váyu, Pittam and Kapham. They are named as Sarávika, Sarshapiká, Kachchapiká, Jalini, Vinatá, Putrini, Masuriká, Alaji, Vidariká and Vidiadhiká. 17.
An abscess which is raised at the margin and dipped in its centre, so as to resemble an Indian saucer in its shape is called Sáraviká. Pimples or pustules of the shape and size of white mustard seeds are called Sarshápiká. An abscess, resembling (the back of) a tortoise in shape and attended with a burning sensation, is called Kachchapiká by the wise.
An abscess studded with slender vegetations of flesh and attended with an intolerable burning sensation is called Jálini. A large blue-coloured abscess (carbuncle) appearing on the back or the abdomen, and exuding a slimy secretion and attended with a deep-seated pain is called Vinatá A thin and extensive abscess (studded with slender pustules - D.R.) is called Putrini. Pimples to the size of lentil seeds are called Masuriká. A dreadful abscess which is of a red and white colour, studded over with blisters or exuding vesicles is called Alaji. A hard and round abscess as large as a (full-grown) gourd is called Vidáriká. An abscess of the Vidradhi type is called Vidradhiká(carbuncle) by the wise. An incidental abscess in a case of Prameha should be regarded as having its origin in the same morbific principle (Dosha) as that which has produced the disease (Prameha) 18-28.
Prognosis: - A Pidaká,or an abscess,appearing about the region of the heart, anus, head, shoulder, back or at any of the vital joints (Marma) of the body, and attended with other supervening symptoms producing extreme prostration [impaired digestion - D. R.] in the patient should be abandoned as incurable. In a case of Vátaja meha, the deranged Vayu presses all the fundamental principles out of the body through the urethra and rages rampant in the lower part of the body, united with the deranged fat, marrow and Vasá. Hence a case of Vátaja meha, (or its accompanying abscess), is held as incurable. 29-30.
A person in whom the premonitory symptoms (Pur-varupam of Prameha) have appeared and who passes a little larger quantity of urine than usual, should be considered as already afflicted with it. A person afflicted with all or half of the premonitory symptoms of the disease and passing a copious quantity of urine should be considered as one suffering from an attack of Prameha. 31 - 32.
A Prameha patient afflicted with deep-seated abscesses and other distressing symptoms, which are usually found to supervene in the disease, should be pronounced as suffering from Madhumeha and adjudged incurable. A Madhumeha patient seeks a halting place while walking, wants a place to sit on while halting, lies down if he finds a sitting place, and sleeps if he lies down. 33 - 34.
As five mixed colours such as grey, brown, Kapila (bluish yellow), Kapota (blackish grey), Mechaka (light-green) may be produced by combination of the five primary colours in definite proportions (such as white, green, black, yellow and red), so a diversity of causes, through the relative preponderance of the particular kinds of food, and of the deranged Doshas, root principles (Dhátu) and excretions of the body (Mala), may be attributed to the origin of Prameha. 35.
All types of Prameha, not properly treated and attended to at the outset, may ultimately develop into those of Madhumeha types, which are incurable. 36