Description about the history and concept of Dhat Syndrome is given here.

2. A culture bound syndrome
The term was coined by – Dr.N N Wig in1960
Wig explained Dhat syndrome
The symptoms of Dhat syndrome
Fatiguability
Weakness
Decreased appetite
Sexual dysfunction
Anxiety
Feeling of guilt
The symptoms attribute to “semen loss”
Wig N. Problems of mental health in India. J Clin Soc Psychiatry. 1960;17:48–53.

3. • In Sri Lanka – Prameha
• In China – Shen K’uei
• In Malayesia & Indonesia – Latah
• In Japan - Imu
• Other parts of South East Asia – Jiryan
Mehta V, De A, Balachandran C. Dhat Syndrome: A Reappraisal. Indian J Dermatol.
2009 Jan-Mar; 54(1): 89–90.
Simons RC, Hughes CC. Dordrecht: D Reidel; 1985. The Culture-bound Syndromes:

4. Concept of culture bound
syndrome
Lipsedge M, Littlewood R. Transcultural psychiatry. In: Granville-Grosman, editor. Recent
advances in clinical psychiatry. 3rd ed. Edinburgh: Churchill Livingstone; 1985.
Mehta V, De A, Balachandran C. Dhat Syndrome: A Reappraisal. Indian J Dermatol.
2009 Jan-Mar; 54(1): 89–90.
•1969 – Yap coined the term “Culture
Bound Syndrome”
•Littlewood and Lipsedge defined
Culture Bound Syndrome as “episodic
and dramatic reactions specific to a
particular community”

5. Another debate……..
• Simons and Hughes emphasized that
– Different names has been assigned to the
same entity across different cultures.
– Phenomenologically, they are similar.
Simons RC, Hughes CC. Dordrecht: D Reidel; 1985. The Culture-bound Syndromes:
Folk Illnesses of Psychiatric and Anthropological Interest.

7. • The term “Dhat” is
derived from the
Sanskrit word “Dhatus”
• Susruta Samhita
explains “Dhatus” as
elixir of life.

8. • Ayurveda - Describes
about seven essential
elements of body
(Dhatus)
– Rasa : Fluid extract from
digested food
– Rakta : Blood
– Meda : Fat
– Mamsa : Muscle
– Asthi : Bone
– Majja : Marrow
– Sukra : Semen
Jadhav S. Dhat syndrome: A re-
evaluation. Psychiatry. 2004;3:14–6.

9. • 40 drops of rasa (food extract) = 1 drop of rakta
(blood)
• 40 drops of rakta (blood)= 1 drop of majja (marrow)
• 40 drops of majja (marrow)=1 drop of sukra (Semen)
– Some believe it to be 100 drops
• One drop of semen is
formed from 64000 drops
of food extract
Sumathipala A, Siribaddana SH, Bhugra D. Culture-bound syndromes: The story of
dhat syndrome. Br J Psychiatry. 2004;184:200–9.
Chadda RK, Ahuja N. Dhat syndrome. A sex neurosis of the Indian subcontinent. Br J
Psychiatry. 1990;156:577–9.
El Hamad I, Scarcella C, Pezzoli MC, Bergamaschi V, Castelli F. Forty meals for a
drop of blood. J Travel Med. 2009;16:64–5.
Painuly N, Chakrabarty S. The continuing story of dhat syndrome. Br J
Psychiatry. 2004;185:260.

10. 1500 BC
• Ayurveda
• Charaka Samhita
– Semen loss : Sukrameha –
Passage of semen in urine

11. Charaka Samhita says… Decline in
sexual performance occurs due to
Excessive indulgence in sexual
activities
Obstructing ejaculation of
semen
Sexual intercourse with
impassionate women
Black magic
Overpowering sexual urges

12. Charaka Samhita & Susruta Samhita
describes normal semen as –
Crystal like Oily
Slimy
Thick
Non – corrosive
Sweet
Honey like smell

13. • Shiva Samhita
– Sperm (Virya) is
compared with “seed”
– Loss of semen is
progress towards
death (Falling of seed
leads towards death)
– Hence emphasis was
given in preserving
the semen (seed).
Jadhav S. Dhat syndrome: A re-evaluation. Psychiatry. 2004;3:14–6.
Deb KS, Balhara YPS. Dhat Syndrome: A Review of the World Literature. Indian J Psychol
Med. 2013 Oct-Dec; 35(4): 326–331.

14. Out of the seven essential elements described,
semen is believed to be most precious one,
hence –
• It is the source of strength and stamina
• It needs to be preserved
• Its loss adversely affects the health
Behere PB, Natraj GS. Dhat syndrome: The phenomenology of a culture
bound sex neurosis of the orient. Indian J Psychiatry. 1984;26:76–8.
Singh G. Dhat syndrome revisited. Indian J Psychiatry. 1985;27:119–22.

17. • Tissot's paper in 18th century stating
that even an adequate diet could waste
away through seminal emission gained
popularity amongst the emerging
middle class and led Western Europe to
an era of masturbating insanity.
Mehta V, De A, Balachandran C. Dhat Syndrome: A Reappraisal. Indian J Dermatol.
2009 Jan-Mar; 54(1): 89–90.

18. Islamic concept
Formation of semen
continues after puberty
(Bulugh) and the excess
amount of semen formed
comes out as nocturnal
emission
Prakash O, Kar SK, Sathyanarayana Rao T S. Indian story on semen loss and related
Dhat syndrome. Indian J Psychiatry 2014;56:377-82

19. Islamic concept
• Semen loss due to
masturbation is more
harmful is unlike sexual
intercourse, because there
occurs minimal use of
tactile, visual, olfactory, or
auditory senses for arousal
and it is the psychic
stimulation that produces
excitement
• Psychic excitement results
in emotional disturbancesPrakash O, Kar SK, Sathyanarayana Rao T S. Indian story on semen loss and related
Dhat syndrome. Indian J Psychiatry 2014;56:377-82

20. Buddhist views
• Loss of semen : Sinful
offence
• Nocturnal emission is
considered as an
obstacle in the path of
spiritual progress of
monks
• Semen is the source of
energy and is formed
from purification of food
Faure B. The Red Thread: Buddhist Approaches to Sexuality. Princeton: Princeton
University Press; 1998. p. 86.
Prakash O, Kar SK, Sathyanarayana Rao T S. Indian story on semen loss and related

21. Christianity concepts
• Semen loss through
masturbation is
abnormal and sinful.
• It hampers the normal
procreation by the
process of sexual
intercourse
• Nocturnal emission is
unhygienic & impure
(Holy Bible)Hirsh A. Post-coital sperm retrieval could lead to the wider approval of assisted
conception by some religions. Hum Reprod 1996;11:245-7
Prakash O, Kar SK, Sathyanarayana Rao T S. Indian story on semen loss and related
Dhat syndrome. Indian J Psychiatry 2014;56:377-82.

22. Conclusion
History enables us to understand the
conceptual evolution of a belief.
Dhat syndrome is a classic example, how
an illness behavior was nurtured over
centuries by different cultures
History witnesses that the impact of the

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