Saturday 30 June 2012

Prameha upadravas {Complications of Prameha}

Doshas which are involved in pathogenesis of the disease. This may further complicate
the problem and must be considered in the management of the original disease, that is called
upadrava. Individual suffering from prameha usually seeks to doctor’s help when the
complications have developed. Fatigue, excessive thirst and excessive urination are some of the
symptoms for which the diseased person approaches physician. Susrutha has described
prameha complications according to dosha pridominance. Briha Thrayees have described
prameha pidaka as a major complication of prameha. Sussrutha has mentioned
“Malabandhata” (constipation) as a commonly observed complication as the body of the
diseased person is loaded with meda hence they do not respond to common purgatives in usual
doses. Modern Physiological theories attribute this complication to the involvement of
autonomous nervous system.
The following symptoms under each category of kaphaja, pithaja and vathaja describes
the dominant element in each diabetic patient. Doshas which are involved in the pathogenesis of
the disease may further complicate the problem and must be critically considered in the
management of the original disease. This element in the treatment is called upadrava. In most 5
cases it is only after the complication have developed, individuals suffering form prameha seek a
physician’s advise.
Sustrutha notes that Dosha predominance is a primary factor in prameha complication.
Susrutha documents that ‘malabandhata’(constipation) is a complication of this disease, because
the individual has a concentration of meda. The average doses of laxatives are not effective in
these cases.
Brihathrayees (Susrutha is one of the Brihathrayee writers) have described prameha as
pidika (diabetic carbuncle) as a major complication of prameha.

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