2. PRAMEHA
By
Dr Akhil.H.S
Dept of SHAREERA RACHANA
ALVAS AYURVEDIC COLLEGE.

3. PRAMEHA
•
•
• One of mahagada.
• -

4. DOSHAS AND DHAATUS
• All the three doshas are vitiated.
• – – – – – are vitiated.
• Other are-
- - – .
The doshas chiefly concerned is kapha and
among dhaatus , , are principally
involved. And – are moderately
involved.

5. SROTAS
• involved in prameha are-
- – -

6. • -
• -

7. .
• Moola- basti and vankshana.
closely related to - -
.
is on of the of body. Which depends on
in and s. This
determine the quantity and quality of urine to
be excreted out.

8. •
• -
• Acc to charaka.sarira 7/15-
• is 10 anjali.
• It does sarira dhaarana.It forms part of
pureesha, mutra, sweda, lasika etc. and
dhatus like rasa, rakta, mamsa etc.
• It helps in ahladana, kledana, bandhana ,
vishyandana.

9. • - and
• -

10. •
• Acc to susruta
•
•
• From above reference we can almost consider
it as kidneys.

11. •
• -
• -
• Udaka vaha sroto moola.
• Varuna is considered as creator of kloma.
• Acc to srikantadatta -
• As a koshtanga it should come in thoracic/abdominal
cavity.
• An organ Rt and Below liver is pancreas
• Above kidney- Supra renal glands

12. • Basti
•
•
• Maana is 4 angula
• A bag like structure that collect and store urine
before excretion, it can be Urinary Bladder.

13. LAKSHANA
•
•
•
•
•
•
•
•
•
•
•

15. DIABETES MELLITUS
•
• What is DIABETES MELLITUS?
• Acc to W.H.O –
• It is heterogeneous metabolic disorder
characterized by common feature of chronic
hyperglycemia with disturbance of carbohydrate,
fat, and protein metabolism.
• Depending on the etiology, hyperglycaemia may
result from
• a) reduced insulin secreation.
• b) Decreased glucose use by the body.
• c) increased glucose production.

16. INSULIN
• It’s a peptide hormone (a protien ) secreted by
beta cells of islets of langerhans.
• It helps to transport glucose into the target
cells of the body. And reduces the increased
glucose level of blood.

17. PANCREAS

18. HISTOLOGY

19. ENDOCRINE PART

20. • MAJOR CELLS
Beta cells 70% of islet cells INSULIN
Alpha cells 20% GLUCAGONE
Delta cells 5-10 % SOMATOSTATIN
Pancreatic 1-2 % PANCREATIC
Polypeptide cells POLYPEPTIDE
MINOR CELLS
D1 cells Vaso active Intestinal peptide
Entero chromaffin cells SEROTONIN

21. A- Alpha cell
B- Beta cell
D- Delta cell
F- PP cell

23. SOME MORPHOLOGICAL FEATURES IN
PANCREATIC ISLETS
• Insulitis –
Type 1 – In early stagethere is lymphatic infiltration of t-cells,
macrophages etc
Type2 – Little fibrillous protien deposit.
• Islet cell mass destruction –
Type 1 – As DM become chronic there will be progressive Depletion
of beta cells, eventually result in total loss of pancreatic B-cell
Type 2 –Mildly effected.
• Amyloidosis.
Type 1 –are absent.
Type 2 - Amyloid deposit around capillaries of islet. Causing
compression and atrophy of islet tissue.
Degranulation of B-cells.

24. FEATURES IN DM
• TYPE 1- Absence of insulin due to destruction
of beta cell.
• TYPE 2- Insulin secreation is normal
• a) Insulin resistance.
b) failure of beta cells.

25. MECHANISM OF COMPLICATION
• The process of development of complications
in D.M is explained by 2 mechanisms
1. Non – enzymatic protien glycosylation
2. Polyol pathway mechanism

26. DIABETIC NEPHROPATHY
• Morphologically – 4 types of lesions
1. Diabetic glomerulosclerosis
2. Diabetic vascular lesion
3. Diabetic polynephritis
4. Tubular lesion

28. • Diabetic glomerulosclerosis
DIFFUSE NODULAR
• Thickening of vessels • 1 or More .
• Increase matrix • Ovoid/spear
• Prolyferation of • Surrounded by
matrix capillaries
• Renal ischemia
• Tubular atropy
• Interstitial fibrosis
• Small contracted
kidney

29. DIABETIC NEUROPATHY • Effects all nervous
system.(peripheral
neuropathy is more
clear)
• Basic pathological
changes – . . .
• Glucose deposit in micro
capillaries.
• Demyelination
Schwann cell injury
Axonal damage

31. DIABETIC RETINOPATHY
BACKGROUND RETINOPATHY PROLIFERATIVE RETINOPATHY
• Basement membrane • After long term
thickness increase. • Neovascularisation of retina
• Degeneration of pericytes at optic disc.
and loss of endothelial cells • Friability of newly formed
• Capillary micro-anurism B.V cause easy bleeding-
• Waxy exudate accumilation haemorrhage of vitrous
near micro anurism. • Also proliferation of fibrous
(hyperlipidemia) tissue around B.V
• Dot and Blot – Retina • Contraction of fibro –
• Soft Cotton-wool spot vascular tissue = Retinal
detachment

34. DISCUSSION
• Prameha can not only be compared to D.M, but electrolyte
imbalance etc are also related to prameha.
• The syndrome of D.M is largely covered under prameha.
• Apathyanimitta prameha, sthula prameha in ayurvedic
litrature has similarities with D.M. Madhumeha can almost
be Diabetes Mellitus.
• But to understand remaining 19 types of prameha we need
wide discussion and proper reasoning.
• In general destruction of B-cell mass and obesity are most
important cause of diabetes.
• So approach in treating DM should be to control diet and
good life style.
• Early diagnose and treatment can prevent complications
due to prameha.