E-ISSN:2456-3110

Review Article

Urine Disorders

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 5 May
Publisherwww.maharshicharaka.in

A comprehensive approach to Urine disorders in Ayurveda

Prakash Nain O.1*, Kumar Gupta R.2, Sainy R.3
DOI: http://dx.doi.org/10.21760/jaims.8.5.19

1* Om Prakash Nain, Post Graduate Scholar, PG Department of Shalya Tantra, Dr. Sarvepalli Radhakrishnan Rajasthan Ayurved University , Jodhpur, Rajasthan, India.

2 Rajesh Kumar Gupta, Post Graduate Scholar, PG Department of Shalya Tantra, Dr. Sarvepalli Radhakrishnan Rajasthan Ayurved University, Jodhpur, Rajasthan, India.

3 Rahul Sainy, Professor and HOD, PG Department of Shalya Tantra, Dr. Sarvepalli Radhakrishnan Rajasthan Ayurved University, Jodhpur, Rajasthan, India.

Mutrakrichha comes under the disorders of Mutravaha Srotas and mainly deals with Shoola (pain) and Kricchrata (dysuria). Acharya Charaka has described eight types of Mutrakrichha. Charaka has also mentioned eight type of Mutragatha. In Mutrakrichha, the vitiated Pitta Dosha along with Vata (mainly Apana Vayu) on reaching Vasti (bladder) afflicts the Mutravaha Srotas due to which the patient feels difficulty in micturition. Materials and Methods: All the textbooks, classical texts and internet sources were explored for Mutrakrichha and urinary tract infection. Data obtained was compiled and presented in an organised manner. Result and Discussion: Mutrakrichha corresponds to the symptoms of urinary tract infection as per texts and the symptoms of UTI can be well managed as per the principles of Ayurveda.

Keywords: UTI, Mutrakrichha, Urinary system in Ayurveda, Mutravaha Srotas

Corresponding Author How to Cite this Article To Browse
Om Prakash Nain, Post Graduate Scholar, PG Department of Shalya Tantra, Dr. Sarvepalli Radhakrishnan Rajasthan Ayurved University , Jodhpur, Rajasthan, India.
Email: 		Om Prakash Nain, Rajesh Kumar Gupta, Rahul Sainy, A comprehensive approach to Urine disorders in Ayurveda. J Ayu Int Med Sci. 2023;8(5):125-128.
Available From
https://jaims.in/jaims/article/view/2486

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-03-28 2023-03-23 2023-03-30 2023-04-06 2023-04-13
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 17%

© 2023by Om Prakash Nain, Rajesh Kumar Gupta, Rahul Sainyand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Nain O et al: A comprehensive approach to Urine disorders in Ayurveda

Introduction

Urinary tract infections (UTIs), the second most common type of infection in the body is one the most serious health problem affecting millions of people each year. The urinary tract infection (UTI) involves infection in the kidneys, ureters, bladder or urethra. These are the organs that urine passes through when eliminated from the body. Women are especially prone to UTIs, even though they generally have anatomically and physiologically normal urinary tract.[1] Reasons for this are not yet well understood. These infections can be very serious when they do occur in men; however, UTIs in men are not as common as in women. A urinary tract infection (UTI) also known as Fearnes syndrome is a microbial infection that affects any part of the urinary tract. Normally, urine is sterile. It is usually free of microbes but does contain fluids, salts and waste products. The main cause agent in at least 90% of uncomplicated infections is Escherichia coli, which live in the bowel (colon) and around the anus. An infection occurs when bacteria get into the bladder or kidney and begin to grow. The infection often starts at the opening of the urethra where the urine leaves the body and moves upward into the urinary tract. Abnormalities of the urinary tract that hinder the flow of urine set the stage for an infection. Although modern antibiotics are being used in UTIs, urinary tract infections can be quickly and easily treated with a herbal treatment with no side effects.

The term Mutrakrichha comes under the disorders of Mutravaha Srotas, and mainly deals with Shool (pain) and Kricchrata (dysuria). Description of this disease in almost all-important classical texts reflects its prevalence in ancient period. Acharya Charaka has described eight types of Mutrakrichha. Charaka has also mentioned eight type of Mutragatha. Mutraghata and Mutrakrichha separately described by Acharya Sushruta in Uttar-tantra. In Mutrakrichha, the vitiated Pitta Dosha along with Vata (mainly Apana Vayu) on reaching Vasti (bladder) afflicts the Mutravaha Srotas due to which the patient feels difficulty in micturition along with symptoms like Peeta Mutrata, Sarakta Mutrata, Sadaha Mutrata, Saruja Mutrata and Muhur-Muhur Mutrata. The above mentioned symptomatology has close resemblance with urinary tract infections, as described in modern texts specifically lower urinary tract infections (urethritis and cystitis).

Therefore in present article attempt has been made to define Mutrakrichha on scientific grounds vis-a-vis urinary tract infection.

Materials and Methods

All the relevant text books, Ayurveda classical books and internet sources were explored to get the information about Mutrakrichha and urinary tract infection. All the information obtained was presented in an organised manner.

Results

In our classical text the urinary disorders are described in the form of 8 types of Mutrakrichha, 13 types of Mutraghatas,[2] 4 types of Ashmaris and 20 types of Prameha. Acharya kashyapa had also described the sign and symptoms of Mutrakriccha in Vedna Adhyaya.[3] A healthy urinary tract is generally resistant to infections. However, for anatomical reasons female lower urinary tract is more susceptible. Predisposing factors for recurrent Urinary tract infection include female sex, age below 6 months, obstructive uropathy, severe vesicoureteric reflux, constipation and repeated catheterization poor hygienic conditions and environment, poverty and illiteracy also contribute to the increasing percentage of urinary tract infections. Urinary tract infections occur in 1% of boys and 1-3% of girls.[4] These infections are the common complications during pregnancy, diabetes, polycystic renal disease and in other immune compromised patients. Urinary tract infections are the leading cause of gram-negative sepsis in hospitalized patients. They are important cause of morbidity and might result in renal damage, often in association with vesicoureteric reflux (VUR). Urinary tract infections are second in frequency after upper respiratory tract infections.[5] Incidence and degree of morbidity and mortality from infections are greater with those in the urinary tract than with those of the upper respiratory tract. Bacteria are by far the most common invading organisms but fungi, yeasts and viruses also produce urinary tract infections. Thus, urinary tract infection is potentially a serious condition and failure to realize that this may lead to development of serious chronic pyelonephritis and chronic renal failure. With the introduction of effective antibiotics problem has been solved to some extent but the use of, antibiotics have limitations like side


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effects, chances of reinfection and relapse even after long-term therapy. Simultaneously increasing incidence of resistance and high cost of therapy are common problems.

Mutra is an outcome product digestion of food and metabolism in the body it is passed through urethra.[6] In both Mutraghata and Mutrakrichha, Krichhrata (dysuria) and Mutra-Vibandhta are simultaneously present but in Mutrakrichha there is predominance of Krichhrata (dysuria).

Mutraghata Charaka Samhita Regarding the disease Mutraghata, Acharya Charaka has mentioned eight types in Sutrasthana. Further, in Siddhisthana, thirteen types of Bastirogas have been described under the caption of “Mutradosha”, which are similar to that of Mutraghata as explained by Sushruta. Sushruta Samhita, Sushruta has explained twelve types of Mutraghata in Uttaratantra but he has not mentioned Bastikundala and Vidvighata varieties as described in Charak. Sushrut has described the two types of Mutraukasada i.e., Pittaj & Kaphaj while Charak & Vagbhat only one type i.e., Mutraukasada. Ashtanga Sangraha & Ashtanga Hridaya It includes Mutrakricchra and Ashmari Rogas. More Mutraghata has been elaborately described in “Mutraghata Nidana” interesting thing is that, he has categorized the diseases of Mutravaha Srotas into two i.e., Mutra Atipravrittijanya and Mutra - Apravrittijanya Rogas. Initially, the original text of Atharvaveda in relation to Mutraghata is presented. The translation attempted is gross but definitely conveys entire meaning. The reference of “Gavini” is highly authentic and scientific. Somehow, this reference is not found in Ayurvedic texts. “Basti” is the urinary bladder and the function of “Dharana” (storage) and “Poshana” (release) of urine is performed by it. This is explained with a simile of an ocean and its related rivers. The disease ‘Mutraghata’ are retention of urine is said to occur at both these sites and it may be due to any disease factor. Here in the possibilities of all the causes of obstruction of urine/retention of urine can be thought of. The treatment explained is that of ‘Antahkarmani’ i.e., catheterization by a ‘Loha - Shalaka’. The example of a ‘taut bow’ in relation to ‘Basti’ signifies the functioning of urinary bladder and puts light on modern physiology. Mutra Vegavarodha’ is mentioned as one of the most important causative factor in ‘Mutraghata’. It is but obvious that the Apana Vayu, responsible for normal voiding of urine, is deranged by voluntary suppression

of urge of micturition which results in ‘Mutraghata’. Acharya Charaka states the importance of three Marmas, one of which is the Basti by saying – “Marmani Basti Hridayam Shirascha Pradhana Bhutani Vadanti Tajnah Pranashrayat Tani Hi Pidyanto Vatadayo Ashunapi Pidyanti!”[7] i.e., the Basti, Hridaya and Shiras are the three vital points as the Prana sheltered in them. Any affliction of these leads to vitiation of Vata etc., factors and may be fatal to life. In Maharogadhyaya, Acharya Charaka quotes – “Evam Vidhatvat Cha Vayoh Karmanah Svalakshanamidamasya Bhavati Tam Tam Shariraavayavamaavishatah; Tadyathaa – Sramsa, Bhramsha, Vyasa, Sanga Bheda … Tairaanvita Vatavikaaramevaadhyavaset!!”[8] i.e., the natural action of Vata moving from one bodily organ to another are the manifestation of looseness, dislocation, expansion, obstruction, circular movement, piercing pain etc. These are the actions which help the physician to diagnose a disease as predominated by Vata. Acharya Sushruta further substantiated the above concept i.e., “Kruddhascha Kurute Rogan Bastigudaashrayah”[9] i.e. where he says that the vitiated Vata lodged in the Basti and Guda leads to grave diseases. Acharya Dalhana, while commenting on the same verse says - “Medhradvara Samshritatvadapanakritatvat Cha” in context of Basti Rogas, where in the action of vitiated Apana Vayu being located in the Medhra Dvara is emphasized. Thus, from all the above references it becomes clear that it is the “Vata” which is mainly responsible for the manifestation of Basti disorders. This “Vayu” may be provoked either by endogenous or exogenous factors. “Mutravegavarodah” is one such factor, which leads to vitiation of Vata.

Contemporary Science Perspective

Urinary tract infections have plagued mankind long before bacteria were recognized as the causative agents of disease and before urology became an established medical specialty. The Ebers papyrus from ancient Egypt recommended herbal treatment to ameliorate urinary symptoms without providing insight into pathological mechanism. Hippocrates believed that disease was caused by disharmony of the four humours and accordingly diagnosed urinary disorders.[10]

Urinary tract infection refers to both microbial colonization of the urine and tissue invasion of any structure of the urinary tract.



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Bacteria are most commonly responsible, although yeast, fungi and viruses may produce urinary infection. Infants and young children with UTI may present with few specific symptoms Older pediatric patients are more likely to have symptoms and findings attributable to an infection of urinary tract.[11] Differentiating cystitis from pyelonephritis in the paediatric patient is not always possible, although children who appear ill or who present with fever should be presumed to have pyeleronephritis if they have evidence of UTI. Escherichia coli are the most common causative organism of this disease causes approximately 80% of acute infections in patients without catheters. Other gram-negative bacilli, especially Proteus and Klebsiella and occasionally Enterobacter, account for a smaller proportion of uncomplicated infections. Gram-positive cocci play a lesser role in urinary tract infections, nonetheless Staphylococcus saprophyticus, Enterococci, Staphylococcus aureus are associated with acute urinary tract infection in young females and in-patient with renal stone or previous instrumentation.[12]

Discussion and Conclusion

From the study of ancient surgical text Sushruta Samhita, it becomes evident that the urological problems form an important part of medical sciences. It may be the reason that a clear and striking picture regarding their classification, symptomatology, complications and management are available in all the texts. Sushruta the famous Indian surgeon has practised extensive operative surgery on all the systems of the body. Considering and analysis above discussion the study is an attempt to compile the Mutraghat scattered in Brihattrayee and correlate them with modern urinary disorders. Classically divided the Rogas of Mutra in to two categories viz. Mutra Atipravrittija and Mutra Apravrittija Rogas. The symptom complex of both the Mutrakricchra and Mutraghata seems to be overlapping each other. This difference is based on the intensity of “Vibhanda” or “Avarodha” (obstruction) which is more pronounced in Mutraghata. Hence, it may be considered that the Mutraghata is a condition in consequence with some kind of Obstructive Uropathy either mechanical or functional; related either to upper or lower urinary tract resulting in to either partial or complete retention of urine as well as Oliguria or Anuria.


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1. Anjum F, Kadri SM, Ahmad I, Ahmad S. A study of recurrent urinary tract infection among women attending out patient department in S.M.H.S Hospital, Srinagar, Kashmir, India. JK Pract 2004;11:272-3

2. Ch.Su.19/1 Caraka Samhita, with Ayurveda Dipika commentary by Cakrapanidatta, Chowkhamba Krishnadas Academy, 2nd edition, Varanasi

3. Ka.Su.25/21 Bhishgacharya, Shri Satyapala. Kashyapa Samhita “Vidyotini” Hindi commentary, Chaukhambha Sanskrit Sansthan Varanasi, 2004.

4. IAP Textbook of Pediatrics - IVth edition.

5. www.ncbi.nlm.nih.gov

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8. Sharma P.V., Charaka samhita of Agnivesha, English translation, V1 edition, vol. 1, Sutra sthan 24th chapter, Choukambha orientalia, Varanasi, 2001

9. Sharma P.V., Sushruta samhita with English commentary of Dallhana, Vol II, Nidana sthana 1st chapter.

10. www.who.int/en/

11. I.A.P. Textbook of Pediatrics - IVth edition, p. 751, 2009.

12. Harrison‟s principles of internal medicine by Fauci, Braunwald, Kapser, Hauser Longo, Jameson, Loscalzo, 17th edition p. 5665


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