A REVIEW ARTICLE ON ETIO-PATHOGENESIS OF PRAMEHA

Abstract

Prameha is a chronic, multifactorial disease described extensively in Ayurvedic classics, classified under Madhumehadi vyadhi. It is primarily a Kapha-dominant Tridoshaja disease, involving Medas (fat), Mamsa (muscle), Rasa (plasma), and other dhatus, along with the Mutravaha srotas (urinary system). The etiopathogenesis (Nidana-Samprapti) of Prameha reveals a strong correlation with lifestyle-related metabolic disorders, particularly Diabetes Mellitus in modern terms.

The nidana (etiological factors) include excessive intake of Snigdha (unctuous), Guru (heavy), Madhura (sweet), and Shita (cold) foods, sedentary lifestyle, and genetic predisposition. These factors lead to Kapha vriddhi, Agni mandya, and Medodhatvagnimandya, resulting in abnormal metabolism of Medas and other dhatus. The samprapti (pathogenesis) involves Srotodushti of Mutravaha, Medovaha, and Rasavaha srotas, with kleda vriddhi, dhatukshaya, and ojas kshaya in chronic stages.

Progression of disease manifests as 20 types of Prameha, culminating into Madhumeha (Vataja type) with degenerative and immune-related complications. The understanding of Prameha's etiopathology underlines the importance of early diagnosis, lifestyle modification, and dosha-specific interventions in Ayurvedic management.