A CONCEPTUAL REVIEW OF PRAMEHA ACCORDING TO AYURVEDA AND CONTEMPORARY SCIENCE

Prameha is enumerated among the Ashtau Mahagada — the eight gravest and most difficult-to-cure disorders — a placement that itself conveys the seriousness our Acharyas attached to the disease.[1] Etymologically Prameha (Pra + Mih) signifies Prabhuta (excessive) and Avila (turbid) mutrata, the twin cardinal feature of the disease.[2] In essence it is a Kleda-pradhana, Medovaha-srotodushti-janya vyadhi born chiefly of Santarpana (over-nourishment), a sedentary and sleep-indulgent mode of living, and hereditary predisposition. The classics describe twenty varieties of Prameha — ten Kaphaja, six Pittaja and four Vataja — graded in severity, with Madhumeha, a Vataja type, representing the terminal and most intractable stage into which neglected Pramehas ultimately culminate.[3] The Samprapti turns upon vitiation of Kapha and Meda obstructing the channels (Avarana), or upon Dhatukshaya driving Vata, with Vata acting as the Anubandha dosha in both pathways. In contemporary terms the Prameha spectrum corresponds broadly to the continuum of obesity, metabolic syndrome, prediabetes, diabetes mellitus and allied urological disorders. The present review consolidates the Nidana, Purvarupa, Rupa, Samprapti, Bheda, Upadrava, Sadhya-asadhyata and Chikitsa-siddhanta of Prameha from the Brihattrayi, correlated with modern understanding, so as to clarify its pathogenesis and to frame the scope and limitations of its management.