Understanding Mutra Pariksha and its Significance as a Diagnosing Tool in Ayurveda
Examination of the patient and the disease has been explained in classics of Ayurveda with a methodology. In this context, Ashta Sthana Pariksha is explained, among which Mutra Pariksha is one such method. Mutra Pariksha is a tool for the diagnosis and prognosis of a disease. From the period of Brihatrayi till the medieval period, various abnormal colors, smells, tastes, and appearances have been mentioned to diagnose the disease and understand the prognosis. Taila Bindu Pariksha is a unique method of urine analysis told during medieval periods for the understanding of the disease and thus prognosis.
Mutra Pariksha as per Brihatrayi and the medieval period
Brihatrayi (the three texts of Ayurveda – Charaka Samhita, Sushrutha Samhitha, and Ashtanga Hridaya) have given the explanation of general properties of Mutra (urine), normal and abnormal colour, taste, smell, and appearance of urine.
The texts of Ayurveda during the medieval period like Yoga Ratnakara, Vangasena, and Basavarajeeyam have explained Mutra Pariksha (examination method of urine) called Taila Bindu Pariksha which is a unique concept to assess the normal health condition of an individual and analyze the diagnosis and prognosis of the disease.
The variation in colors, smell, and appearance that occur in urine is due to Dosha – Dushya Samurchchana (combined effects of vitiation of Dosha and Dushya). To understand the examination of urine and how it helps in understanding disease and further its prognosis, the properties of urine in terms of color, smell, taste, appearance, Tailu Bindu Pariksha (diagnostic criteria for urine examination) need to be known in various diseases as elaboratively explained in the lexicons of Ayurveda.
Mutra Pariksha as explained in Brihatrayi
General properties of Mutra (urine)
A healthy person’s urine has properties like Kshara (alkaline properties) and Lavana Rasa (salt taste). The appearance is like that of Kupa Jala (well water).
Mutra varna (Colour of urine)
In various clinical conditions, the colour of urine helps in the diagnosis of diseases.
Shukla varna (white colour) is seen in Kaphaja Pandu (a type of Prameha), Udaka Meha and Pishta Meha (types of Prameha); Peeta varna (yellow colour) of urine is an indication of diseases like Piitaja Pandu (anemia due to Pittaja dosha), Haridra Meha (a type of Prameha), Pittaja Mutrakricchra (difficulty in urination due to Pitta dosha), Kamala (jaundice). In Kala Meha (a type of Prameha) and Kumbha Kamala (a type of jaundice), Krishna varna (black colour) of urine is one of the urinary symptoms. Rakta Varna (red colour) of urine is the symptom of Ashmari (calculi), Rakta Meha (a type of Prameha), Mutrasanga (retention of urine).
Rasa and Gandha (taste and smell of urine)
The smell of urine is also a sensory perception and one of the diagnostic methods
to detect the clinical condition. The taste of the urine is assessed by Aaptopadesha and Anumana Pramana (inferential knowledge)as per Ayurveda classics. Amla rasa (sour taste)and Kshara Gandha (alkali smell) of urine are the symptoms of Amla Meha and Kshara Meha (types of Prameha); Nirgandha (odorless) urine is indicative of Udaka Meha; Madhura Rasa and Madhu Gandha (sweet taste and honey-like smell) are the urinary symptoms of Prameha.
Roopa of Mutra (appearance of urine)
Aavilata (turbidity)and Anavilata (no turbidity)of Mutra are the symptoms of Prameha and recovery from Prameha which aid in diagnosis and understanding the prognosis of the Prameha patients respectively. Accham (clear, transparent) urine is seen in Udaka Meha. Sikata Meha and Sandra Meha (crystalline urine and sedimentation of urine) are the indicators of types of Prameha – Sikata and Sandra Meha respectively.
Mutra Pariksha as explained in the texts of the medieval period
Yogaratnakara, Vangasena, and Basavarajeeyam are some of the medieval period authors who have explained the examination methods of urine based on Prakriti, Dosha, specific disease, Sadhya-Asadhyata, Tailu Bindu Pariksha.
As per Vangasena
Mutra Pariksha based on Prakriti
Vata Prakruti people pass urine that is like Neera (water), urine of Pitta Prakruti and Kapha Prakruti is taila tulya (resemble taila) and palvala vari tulya (resemble mud water).
Mutra Pariksha based on the involvement of Dosha
The urine in diseases due to Vata dosha is toyasama (resemble water) and bahutara (large quantity), due to Pitta dosha is Rakta or Peeta Varna (red or yellow colour) and swalpa (less in quantity), due to Kapha dosha it is Shweta varna (white in colour), Ghana (dense) and Snigdha (unctuous), due to Rakta dosha it is Rakta varna (red colour), Snigdha (unctuous) and Ushna (hot).
Mutra Pariksha based on specific disease
Jwara – Shweta dhara, Peeta dhara, (white and yellow urine stream); Deergha Jwara – Rakta dhara (red colored urine stream); Nirama Avastha of Jwara (fever devoid of Ama) – urine resembles Ikshu rasa (sugarcane juice); complicated stage of fever- Krishna dhara (black colored urine); Raktapitta (bleeding disorder)– urine resembles the flower of Kousumba (safflower); Jalodara (ascites) – Ghritakana mutra (urine resembles like the ghee mixed with crystals); Ajeerna (indigestion); Amavata (rheumatoid arthritis) – resembles Takra (buttermilk).
Mutra Pariksha based on Sadhya-asadhyata (prognosis)
If the urine becomes Peeta Varna (yellow colored) and Taila tulya (resembles oil) with bubbles, it is incurable since it is in a complication stage.
In Kshaya roga (tuberculosis), the urine becomes Krishna Varna (black colored), when the urine colour turns Shweta Varna (white colour) it is incurable.
As per Yogaratnakara
Mutra Pariksha based on the involvement of Dosha
In Vataprakopa (aggravation of Vata dosha), the colour of the urine is Neela (blue) and Ruksha (dry); Pittaprakopa (aggravation of Pitta dosha) – Peeta and Aruna Varna (blue and reddish-orange colour), Taila samana (resembling oil); Kaphaprakopa (aggravation of Kapha dosha) – Palvala toya samana (resembling mud water) and Snigdha (sticky); Raktadushana (vitiation of Rakta dosha) – Rakta Varna (red colored), Ushna (hot)and Snigdha (sticky).
Mutra Pariksha based on specific disease
Nava Jwara (fever of recent origin)– urine color is like Dhumra Varna (smoke colored), and Bahumutrata (large quantity of urine); Vatapittaja jwara (fever of Vata-Pitta) – urine color is like Dhumra Varna (smoke colored) and Ushna (hot); Vatakaphaja jwara (fever of Vata-Kapha) – urine is Shweta Varna (white colored) and with Budbuda (bubbles); pittakaphaja jwara (fever of Pitta – Kapha) – the urine is Kalusha (contaminated) and Sarakta (mixed with blood); jeerna jwara (chronic fever) – urine resembles Asruk (blood); Ajeerna (indigestion) – urine resembles Tandulodaka (rice-washed water).
Taila Bindu Pariksha
Taila Bindu Pariksha is a unique method for urine analysis explained by medieval-period authors of Ayurveda, Yogaratnakara, Vangasena, and Basavarajeeyam. This is the method to assess the involvement of dosha and the prognosis of the disease. The assessment is made on the movement of Taila Bindu (oil drop) on the surface of Mutra (urine) in different directions, behavioral patterns of Taila Bindu, and shapes of Taila Bindu that are attained. The specific disease, involvement of dosha, and prognosis are known.
As per Yogaratnakara and Vangasena
- Collection of urine should be done in the last Yama (part) of the night.
- Madhyamadhara (mid-stream of urine) should be collected while Adhyadhara (initial stream of urine) should be discarded.
- The vessel for collection should be Kacha (glass) / Kamsya (bronze) or Mrunmaya Patra (earthen vessel).
- Examination of the urine should be done after sunrise in the presence of sunlight.
- Drop Taila with the help of Trina (grass) at the center of the vessel.
- Observe the assessment parameters.
Dosha involvement based on the shape of Taila bindu
- Vatavikara – Sarpakara (shape of the snake)
- Pittavikara – Chatrakara (shape of umbrella)
- Kaphavikara – Muktakara (shape of pearl)
Sadhya-asadhyatva (prognosis) based on the direction of the spread of Taila Bindu
- If the Taila Bindu spreads towards Purva (east), Paschima (west), Dakshina (south), and Uttara (north), the disease is easily curable.
- If the Taila Bindu spreads towards Eeshanya (northeast), indicates the death of the patient within a month.
- If the Taila Bindu spreads towards Aagneya (southeast) and Nairutya (southwest), indicate the death of the patient immediately.
- If the Taila Bindu spreads towards Vayavya (northwest), it means the prognosis of the disease is bad.
Sadhya-asadhyatva (prognosis) based on the shape of Taila Bindu
- If the shape of Taila Bindu is Kurma (tortoise), Hala (axe), Sairabha (buffalo), Shastra (sharp instruments), Khadga (sword), etc. the disease becomes Asadhyatva (incurable).
- The shape of Taila Bindu which is Hamsa (swan), Karanda (duck), Kamala (lotus), Chatra (umbrella), etc. indicates Sadhyaroga (curable diseases).
- Chalani (sieve), Mastaka dwaya (human with two heads), etc. indicate Kula dosha, Preta dosha, and Bhoota dosha.
Sadhya-asadhyatva (prognosis) based on the pattern/movement of Taila Bindu
- Taila Bindu when spreads over the surface of the urine, diseases become Sadhya (curable).
- If the Taila Bindu remains stagnant over the surface of the urine, it becomes Asadhya (incurable).
- Taila Bindu when sinks at the bottom of the vessel or rotates, it indicates the death of the patient.
As per Basavarajeeyam
Taila Bindu Pariksha explained by Basavarjeeyam is the shape of Taila Bindu based on which the assessment of dosha involvement and prognosis of the chronic diseases is done.
- Vatavikara – Taila Bindu attains Mandalakara (circular shape) on the surface of the urine.
- Pittajavikara – Taila Bindu attains Bindu Akara (drop) on the surface of the urine.
- Kaphajavikara – Taila Bindu attains Budbudakara (bubble) on the surface of the urine.
- Sannipataja vikara – Taila Bindu sinks at the bottom of the vessel.
Conclusion
Mutra Pariksha is one among the Ashta Sthana Pariksha explained in references to Ayurveda. Different colors, smells, tastes, and appearances of urine indicate the involvement of dosha, the disease-specific, prognosis of the disease. Taila Bindu Pariksha is a method of examination of urine explained by medieval period authors.
The different shapes, patterns, direction of spread, etc. are the parameters of Taila Bindu Pariksha. These ancient and medieval period methods of urine assessment hold a prominent place in diagnosing and treating the disease.
References
- A REVIEW ON MUTRA PAREEKSHA IN AYURVEDA, Journal of Ayurveda and Integrated Medical Sciences, 2017 (Jan-Feb), Volume 2, Issue 1, p. 139-143.
- A CRITICAL REVIEW OF MUTRA PARIKSHA (URINE EXAMINATION) IN THE CONTEXT OF AYURVEDA AND MODERN CONTEXT, World Journal of Pharmaceutical and Medical Research, 2022, Volume 8, Issue 9, p.103-108.
- Sangu PK, Kumar VM, Shekhar MS, Chagam MK, Goli PP, Tirupati PK. A study on Tailabindu pariksha – An ancient Ayurvedic method of urine examination as a diagnostic and prognostic tool. Ayu. 2011 Jan;32(1):76-81. doi: 10.4103/0974-8520.85735. PMID: 22131762; PMCID: PMC3215423.