Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Why ought to we differentiate between the 2 totally different ailments Raktapitta and Prameha?
Mainly, we all know that Raktapitta and Prameha are two totally different ailments which have been defined in Ayurveda treatises. So, we get a doubt in order to why we have to differentially talk about about these two circumstances.
The Cause for that is that Acharya Charaka has made some extent in order to learn how to differentiate these two circumstances in one of many verses within the context of ‘Prameha Chikitsa’ – chapter dealing on the therapy of Prameha, in Chikitsa Sthana, Chapter 6. Properly, which means from medical perspective we should always know the distinction between these two circumstances.
However right here we aren’t differentiating your entire ailments.
Charaka has defined this distinction whereas explaining a variant of Raktapitta – Mutragata Raktapitta i.e. a situation whereby there may be bleeding or seen blood or bloody urine triggered as a result of mutually contaminated blood and urine affecting the urinary passages.
In one of many 20 varieties of Prameha referred to as ‘Rakta Meha’ there may be bloody urine or blood combined urine going out of the physique by way of urinary passages. It’s the differentiating of this situation with Raktapitta that Acharya Charaka is talking about. This differentiation isn’t solely vital from the standpoint of prognosis but additionally to chart out the therapy protocols for each, because the line of therapy differs in each circumstances.
So, on this article I shall be discussing the variations between Raktapitta, primarily adhoga raktapitta i.e. bleeding from the decrease tracts of the physique together with the urinary tract and Rakta Meha, a sort of Prameha, a sub-type of Pittaja Prameha to be exact.
Mutragata Raktapitta v/s Rakta Meha
Raktapitta – Raktapitta is a situation whereby rakta and pitta mutually contaminate one another within the strategy of inflicting the illness and therefore the identify. That is as a result of ashraya ashrayi bhava i.e. resident and residence relationship between these tow bodily entities, rakta or blood being the residence and pitta being the resident. They all the time generally tend to vitiate or contaminate one another.
Raktapitta manifests in a number of instructions and tracts of the physique. Urdhwaga Raktapitta is when bleeding happens from the higher tracts – nostril, eyes, mouth and many others. Adhoga Raktapitta is when bleeding happens from the decrease tracts – urinary passages, anal opening and many others. Tiryakgata Raktapitta is when bleeding happens from the sideward tracts – pores and skin. This isn’t pure blood. It’s the blood which has been contaminated by pitta.
On this dialogue our focus is on adhoga raktapitta with particular reference to ‘mutramarga gata raktapitta’ i.e. bleeding by way of urinary tract.
However, we’ve yet one more situation whereby there may be bleeding from urinary tract.
Rakta Meha – Rakta Meha is a sort of Pittaja Prameha whereby there may be bloody urine passing by way of the urethra. Right here additionally we’re talking about the identical two components which might contaminate one another i.e. pitta and rakta – pitta the causative dosha and rakta the tissue expelled by way of urine, however it’s Prameha and never Raktapitta.
On this situation the particular person voids urine which is foul smelling, sizzling on contact, salty in style and resembles blood in color.
That is precisely why we have to differentiate between these two circumstances.
Differentiation between Raktapitta (Mutragata) and Prameha (Rakta Meha)
हारिद्रवर्णं रुधिरं च मूत्रं विना प्रमेहस्य हि पूर्वरूपैः।
ये मूत्रयेत्तं न वदेत् प्रमेहं रक्तस्य पित्तस्य हि स प्रकोपः॥च.चि.६/५४।
If the color of the urine excreted in prameha is turmeric yellow or purple in color or if blood itself is excreted by way of the urine with out the prior manifestation of the prameha purvarupa i.e. premonitory signs of prameha (and in addition the indicators and signs of prameha) then this situation shouldn’t be identified as prameha. This case needs to be identified as Raktapitta.
Dialogue
From the above stated reference it’s clear that the ‘prameha purvarupa’ i.e. premonitory signs of prameha are the important thing detrimental issue for differentiation or differential prognosis of those two circumstances. The presence or absence of those purvarupas will decide if the bleeding from the urinary tract is prameha or raktapitta.
Allow us to sum up this manner –
Purvarupas are these signs {that a} illness can be manifested in future. Placing it the opposite manner, purvarupas are feeble signs of ‘but to be manifested illness’. Purvarupas are particular for a illness. The purvarupas of a selected illness will trigger that particular illness solely and never every other illness.
Associated Studying – Purvarupa
So, if premonitory signs of Raktapitta are fashioned, the would-be illness is Raktapitta. Equally, the premonitory signs of Prameha will trigger Prameha illness in future.
Premonitory signs of Prameha
स्वेदोऽङ्गगन्धः शिथिलाङ्गता च शय्यासनस्वप्नसुखे रतिश्च।
हृन्नेत्रजिह्वाश्रवणोपदेहो घनाङ्गता केशनखातिवृद्धिः॥
शीतप्रियत्वं गलतालुशोषो माधुर्यमास्ये करपाददाहः।
भविष्यतो मेहगदस्य रूपं मूत्रेऽभिधावन्ति पिपीलिकाश्च॥च.चि.६/१३-१४॥
The premonitory signs of prameha are –
- Sweating,
- Dangerous physique odour,
- Looseness of physique elements,
- Liking for continuously mendacity down on mattress, sitting and sleeping and therefore main a simple and relaxed life,
- Feeling as if there may be coating within the area of coronary heart, eyes, tongue and ears,
- Heaviness of the physique / corpulence
- Extreme development of hair and nails,
- Liking in the direction of chilly issues and luxury,
- Dryness of throat and palate,
- Sweetness within the mouth,
- Burning sensation in arms and legs,
- Ants swarming across the urine
If the above stated premonitory signs are current earlier than manifestation of bloody urine or blood combined urine, it needs to be identified as prameha.
Quite the opposite if there may be bleeding from the urinary tract i.e. bloody urine is seen to be excreted with out the premonitory signs of prameha being manifested, it needs to be identified as adhoga or mutra marga gata raktapitta.
That is additionally the differential prognosis of those two circumstances.
Adhoga Raktapitta will after all be related to causative components, pathogenesis, premonitory signs and signs of raktapitta.
Want of understanding the variations between Rakta Meha and Mutra Marga Gata Raktapitta
Although Rakta Meha and Mutraga Raktapitta are an identical circumstances by way of bleeding from urinary tract they must be differentiated.
The data of the variations between these two circumstances helps in –
- Differential prognosis of those two circumstances which can assist in planning the therapy.
- Planning a correct protocol of therapy as a result of each these circumstances must be handled on totally different traces of therapy together with therapies, medicines and dietetic routine. Mutraga Raktapitta wants Raktapitta line of therapy. Following the pratimargaharana sort of therapy, since it’s a bleeding dysfunction manifesting from decrease route and tracts, the therapy of alternative shall be vamana i.e. emesis. The therapies in Raktapitta needs to be in other way of bleeding. However, Prameha i.e. Rakta Meha shall be handled on the linens of prameha chikitsa, particularly on the traces of treating pittaja prameha.
