Mūtravaha srotas and its diseases.
Srotas
Prānavaha
Udakavaha
Annavaha
Rasavaha
Raktavaha
Maṃsavaha
Medavaha
Asthivaha
Majjāvaha
Śukravaha
Purīṣavaha
Mūtravaha
Swedavaha
Artava vaha
Mūlasthāna (Caraka)
Hṛdaya, Mahāsrotas
Tālu, Kloma
Āmaśaya, Vāma-pārśwa
Hṛdaya, Daśa dhamanya
Yakṛta, Plīha
Snāyu, Twak
Vṛkka, Vapā vahan
Meda, Jaghana
Asthi, Sandhi
Vṛṣaṇa, Śefa
Pakvaśaya, Guda
Basti, Vañkṣaṇa
Meda, Romakūpa
-
Mūlasthāna (Suśṛta)
Hṛdaya, Rasavahi dhamanyā
Tālu, Kloma
Āmāśaya, Annavāhi dhamanyā
Hṛdaya, Rasavāhi dhamanyā
Yakṛta, Plīha, Rasavāhi dhamanyā
Snāyu, Twak, Raktavāhi dhamanyā
Kaṭi, Vṛkka
Stanau, Vṛśaṇa
Pakvaśaya, Guda
Basti, Medhra
Garbhāśaya, Ārtavavāhi dhamanyā
Duṣṭi of mūtravaha srotas leads to disease.
Srotoduṣṭi Hetu:
 vega dhāraṇa of mūtra vega (with-holding of urge to urinate),
 having food (eating/drinking) when there is the urge to
urinate,
 vyavāya (having sex) when there is the urge to urinate,
 āghāta (being hit) on basti region (lower abdomen) or
medhra (penis) [or vaginal region in the females],
 other reasons like vraṇa (wounds) on the relevant areas…
Lakṣaṇa:
 excessive or scanty micturation
 urinating frequently
 urinating as if urinary passage is blocked
 continuous dripping of urine (urinary incontinence)
 sa-śūla/ sa-dāha (painful/ burning) micturation
 colour, smell, appearance of mūtra being vikṛta (abnormal)
 etc
Cikitsā:
Caraka Sutra. 7:
 Cikitsa should be decided depending on whether the lakṣaṇa
are of mūtra-saṅga (scanty urination) or of mūtra-ati-pravṛtti
(excessive urination).
 If there is scanty urination, treatment similar to the treatment
of mūtra-kṛcchra should be given. For example, use of snehan
and different kinds of swedan in vṛkka and basti regions,
nirūha/ anuvāsan/ uttar basti; use of gokṣura, punarnavā,
dhamāsa, paṣāṇa-bheda etc. to be used.
 If there is excessive urination, treatment similar to treatment
of prameha should be given. For example, use of tikta, kaṣāya
rasa dravya, śilājatu etc.
Mūtra-saṅga (Scanty urination) is of 2 types:
 Mūtra-kṛcchra : urine formation is normal (very little or not
affected) but there is blockage of urine, painful urination.
 Mūtrāghāta : urine formation may be scanty, there may also
be blockage of urine, pain is relatively less.
Mūtra-kṛcchra:
Hetu:
Excessive exercise/ physical activity, excessive consumption of
tīkṣṇa/ rukṣa dravya, excessive alcohol intake, traveling with
speed on horseback (bumpy, fast rides), excessive eating…
Samprāpti:
Vitiated/ aggravated doṣa finding sthāna saṃśraya (occupying
the weak spot) in mūtravaha srotas esp. basti, cause
constriction/ contraction of the srotas/ opening of srotas,
srotorodha (block of srotas) or kṣobha (irritation) etc. causing
pain while urinating. Srotorodha of apāna vāyu causes mūtra
saṅga – retention of urine.
Purvarūpa:
Dark urine, heaviness in basti region, mild pain in basti/ pelvis/
umbilical/ lateral sides of abdomen at urination…
Rūpa:
 General- pain in basti, abdomen, pelvis, sides, even upto
hṛday, gaseous distension of abdomen, hṛllāsa (nausea)…
Rūpa according to types:
 Vataj- severe pain in basti and penis/vagina, very scanty
urination…
 Pittaj- dark yellow or reddish urination, painful and burning
urination…
 Kaphaj- heaviness in basti region and penis/vagina, thick/
dense urination…
 Sannipatik- mix of all above doṣic symptoms…
 Abhighātaj/ Raktaj- is due to abhighāta/ injury to site of basti
or penis… vraṇa (wound) formation, symptoms of vātaj type
with bleeding…
 Puriṣa-vighātaj- Severe constipation (faeces) causes apāna
pratiloman, ādhmāna with distension and symptoms of vātaj
type…
 Śukraj- śukra having been expelled from its own sthāna but
not out of the penis, becoming avaruddha due to any doṣa
esp. vāta, causing blockage of urine and vātaj type…
 Āśmarij- Mūtra being thickened to solidity by drying action of
agni or vāyu, causing formation of aśmari - calculi (stones) or
fine powder (sitakā)… this aśmari causing blockage of the
mūtra marga, sometimes causing wounds and therefore
bleeding etc…
Cikitsā:
Vātānuloman with snehan (internal/external), swedan,
nirūha/anuvāsan/uttar basti, use of mūtral medicines like
gokṣura/ gokṣurādi guggulu, punarnavā/ punarnavādi guggulu,
dhamāsā, pāṣāṇa-bheda, śilājita, chandraprabhā vaṭi, dhānyak
kwātha etc.
According to other doṣa involvement, pravāḷa/ mouktika/
kāmadudhā in burning cases, sukṣma triphāla/ gandhak rasāyan
in case of wounds/ bleeding etc…….
Use of kwātha like arvindāsava, punarnavāsava, varuṇādi kwātha
etc.
Pathyāpathya:
Reducing esp. vātaj hetus, āhāra, vihāra, tomatoes, spinach,
excessive sexual activity…….
Mūtrāghāta: urine formation may be scanty, there may also be
blockage of urine, pain is relatively less.
13 different types of mūtrāghāta are described. After
understanding their descriptions, the spectrum of diagnoses
ranges from spasmodic stricture, urethral stricture, prostatic
enlargement, distended bladder, tumor of the bladder, cystitis,
atonia of bladder etc.
Some of these are treated with surgery eg. tumor of the bladder,
prostatic enlargement (although prostatic enlargement can also
be treated by medicines)…
It would be wise to try and look at situation in which there is less
urine formation. This may be due to problems in the parenchymal
tissue of the kidneys characterized by increase in the Blood urea
levels or Serum creatinine levels
OR
in the pakvāśaya which is the site of formation of urine according
to Caraka.
 Rakta meda prasādat vṛkkau – Suśṛta Sārīra
 Use of vajeri – pakvāśaya of goat. Māṃsa rasa from
pakvāśaya of goat has shown amazing clinical results…