as per kayachikitsa syllabus

1. Prof Sriram Chandra Mishra
Kayachikitsa Department
VYDS Ayurved Mahavidyalaya,
Khurja
DISORDERS OF THE

2. • मूत्रवहानाां स्त्त्रोतसाां बस्स्त्तमूूलां वांक्षणौ च । (च.वव. 5/8)
• मूत्रवहे द्वे, तयोमूूलां बस्स्त्तमेद्रां च । (सु.शा. 9.12)
आचायू चरक मतेन मूत्रवह स्रोतस का मूल बस्स्त्त (bladder) और वांक्षण
(groin) है तथा आचायू सुश्रुत क
े अनुसार मूत्रवह स्रोतस का मूल बस्स्त्त
(bladder) एवां मेढ्र (urethra) है ।

3. • मूत्रत्रतोदकभक्ष्यस्त्त्रीसेवनान्मूत्रननग्रहात ्।
मूत्रवाहीनन दुष्यस्न्त क्षीणस्त्याभभक्षतस्त्य च ।। (च.वव. 5/20)
 मूत्रवेग की उपस्स्त्थनत में जल का सेवन, भोजन करना, स्त्त्रीसेवन
(sexual intercourse) करना
 मूत्रवेग धारण करना (retention of urge to urinate)
 धातुक्षय (depletion of bodily tissues)
 अभभक्षत (local injury)

4. • प्रदुष्टानाां तु खल्वेषाभमदां ववशेषववज्ञानां भवनत; तद्यथा अनतसृष्टमनतबद्धां प्रक
ु वपतमल्पाल्पमभीक्ष्णां
वा बहलां सशूलां मूत्रयन्तां दृष््वा मूत्रवहान्यस्त्य स्त्त्रोताांभस प्रदुष्टानीनत ववद्यात् । (च.वव. 5/8)
 बहुमूत्रता (Polyurea)
 अल्पमूत्रता / मूत्राघात (Oliguria / Anuria)
 मूत्र प्रवृवि क
े वेग बार बार आना (Increased frequency of urine / Incontinence - unintentional
passing of urine.)
 थोडा थोडा मूत्र त्याग (Interrupted Micturition/ Hesitancy- difficulty in beginning the flow
of urine, Dribbling - बूूँद बूूँद कर टपकना, )
 शुलयुक्त मूत्र त्याग (Dysuria)
 गदला मूत्र त्याग (Turbidity in urine)
 इसक
े अनतररक्त मूत्र क
े वणू, गांध एवां स्त्वरूप में भी पररवतून होता है तथा मूत्रवह स्रोतस में दाह
(Burning Micturition) की प्रतीनत होती है

5. • तत्र ववद्धस्त्यानद्धबस्स्त्तता मूत्रननरोधः स्त्तब्धमेढ्रता च । (सु.शा. 9/12)
 वस्स्त्त आनाह (distension of bladder)
 मूत्रावरोध (anuria)
 मूत्रेस्न्द्रय स्त्तब्धता (stiffness in urethra)

6. • स्त्वेदावगाहनाभ्यङ्गान् सवपूषश्चावपीडकम् । मूत्रे प्रनतहते क
ु याूत्रत्रववधां बस्स्त्तकमू च ॥ (च.सू. 7/7)
 स्त्वेदन - द्रवस्त्वेद
 अवगाहन - उष्ण
 अभ्यङ्ग
 अवपीडन नस्त्य
 अनुवासन, ननरुह तथा उिर इन तीनों वस्स्त्तयों का प्रयोग करना चाहहए ।
• मूत्रवव्स्त्वेदवहानाां चचककत्सा मौत्रकृ स्रिकी। तथाऽनतसाररकी कायाू तथा ज्वरचचककस्त्सकी। (च.वव. 5.28)
 मूत्रवह स्रोतोदुस्ष्ट की चचककत्सा मूत्रकृ रि में वर्णूत चचककत्सा क
े समान करनी चाहहए ।

7. • Nidan Parivarjanam
• Vata-anuloman & Samsodhan – Ex . Basti Chikitsa (Uttar Basti)
• Samsamana –
 Mutra Virechaniya (Diuretics) – Trina Panchamula, Punarnava …
 वृक्षादनी श्वदंष्ट्रा वसुक वशिर पाषाणभेद दभभ क
ु ि काि गुन्द्रेत्कटमूलानीति दिेमातन
मूत्रववरेचनीयातन भवन्न्द्ि (C.Su. 4)
 Mutra Samgrahaniya (Antidiuretics) – Jamun… (Ruksha, Kashay Guna)
 जम्ब्वाम्र प्लक्ष वट कपीिनोदुम्बबराश्वत्थ भल्लािकाश्मन्द्िक सोमवल्का इति दिेमातन
मूत्रसंग्रहणीयातन भवन्न्द्ि (C.Su. 4)
 Mutra Virajaniya (Decolourants) – Padma, Utpala….
 पद्मोत्पल नशलन क
ु मुद सौगन्न्द्िक पुण्डरीक ििपत्र मिुक वियङ्गु िािकीपुष्ट्पाणीति दिेमातन
मूत्रववरजनीयातन भवन्न्द्ि (C.Su. 4)
 Mutra Visodhaniya (Antiseptics) – Khadira…..
 Asmarihara (Antilithics) – Pasanabhedi…
• Sastrakarma (Surgery)

8.  Upper Urinary System (Kidney, Ureters)
 Lower Urinary System (Bladder, Urethra)

9. 1. Renal pyramid
2. Interlobular artery
3. Renal artery
4. Renal vein
5. Renal hilum
6. Renal pelvis
7. Ureter
8. Minor calyx
9. Renal capsule
10.Inferior renal capsule
11.Superior renal
capsule
12.Interlobar vein
13.Nephron
14.Minor calyx
15.Major calyx
16.Renal papilla

10. Blood filtered at Nephron to form urin

11. 1. Glomerulus
2. Efferent arteriole
3. Bowman's capsule
4. Proximal tube
5. Cortical collecting tube
6. Distal tube
7. Loop of Henle
8. Collecting duct
9. Peritubular capillaries
10.Arcuate vein
11.Arcuate artery
12.Afferent arteriole
13.Juxtaglomerular
apparatus

12. Connect to the Ureter
through renal pelvis

13. • This is a network of capillaries containing two types of cells.
1. Endothelial cells – These have large fenestrae (holes).
2. Mesangial cells – These are modified smooth muscle cells
that lie between the capillaries.
• They regulate blood flow by their contractile activity and secrete
extracellular matrix, prostaglandins and cytokines.
• Mesangial cells also have phagocytic activity, removing proteins
and other molecules trapped in the Glomerular Basement
Membrane or filtration barrier.

14. It is composed of a parietal outer layer composed of simple
squamous epithelium and a visceral inner layer formed by
specialized cells called podocytes. The pedicels interdigitate with
pedicels of adjacent podocytes forming filtration slits.
Fluids from blood in the glomerulus are filtered through the
visceral layer of podocytes and the resulting glomerular
filtrate empties into a tubule.

15. A – Renal corpuscle
B – Proximal tubule
C – Distal convoluted tubule
D – Juxtaglomerular apparatus
1. Basement membrane (Basal
lamina)
2. Bowman's capsule – parietal
layer
3. Bowman's capsule – visceral
layer
3a. Pedicels (Foot processes from
podocytes)
3b. Podocyte
4. Bowman's space (urinary
space)
5a. Mesangium – Intraglomerular
cell
5b. Mesangium – Extraglomerular
cell

17.  Detoxify blood
 Increase calcium absorption – Calcitriol (125-
dihydroxycholecalciferol)
 Stimulate RBC production - Erythropoietin
 Regulate BP and electrolyte balance - Renin

18. • BLOOD UREA
• Poor guideline
• Varies with protein intake, liver metabolic capacity and renal
perfusion.
• SERUM CREATININE
• More reliable
• Produced from muscle (breakdown product of creatine
phosphate in muscle) at a uniform rate and almost completely
filtered at the glomerulus.

19. Diseases of the kidney & urinary tract are often clinically silent.
Classification Of Mutraroga – Mutraghata, Mutrakrichhra, Asmari, Prameha
• Anuria / Oliguria (Mutra Apravriti) – Mutrakrichhra, Mutraghata, Asmari
• Polyurea (Mutra Atipravriti) - Prameha
Severe renal diseases may present with non-specific symptoms.
• Tiredness or breathlessness due to renal failure
• Associated anemia or oedema due to fluid retention
Detection often depends on biochemical testing
• Measurement of Serum Creatinine, Blood Urea
• Testing of urine for abnormal constituents

20. LOWER URINARY TRACT
• Dysuria, Frequency, Urgency – Lower UTI
• Impaired Renal Flow, Hesitancy, Dribbling, Incomplete Urine –
Bladder Outflow Obstruction
• Urinary Retention, Incontinence/Enuresis – Sphincter Or Bladder
Wall Dysfunction
UPPER URINARY TRACT
• Loin Pain/Tenderness – Renal Infection, Glomerulonephritis, Renal
Infaction / Obstruction
• Severe Loin Pain Radiating To Iliac Fossa, Groin Or Genitalia –
Acute Obstruction Of Pelvis And Ureter By Calculus Or Blood Clot

21. ABNORMAL URINE VOLUME –
• Anuria Or Oliguria – Acute Renal Failure Or Obstruction To
Flow Of Urine
• Polyuria Or Nocturia – Diabetes Insipidous, CRF
ABNORMAL URINARY CONSTITUENTS –
• Proteinuria – Glomerular Diseases
• Haematuria – Diseases In Urinary Tract
HYPERTENSION
• Acute/Chronic Parenchymal Or Renovascular Disease
URAEMIA
• Advanced Renal Failure
DISEASES OF TESTES & EPIDIDYMIS
• Local Swelling, Pain/Tenderness

22. THANKS