View source for Mutra (मूत्रम्)

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Mutra or Mootra (मूत्रम्) literally means Urine. Mutra is one of the [[malas (मलाः)]] described in Ayurveda. Malas are the wastes or waste biproducts of the digestion and metabolism. At gross level, malas are known to be 3 viz. Purisha (पुरीषः)/ shakruta (शकृतः), Mutra (मुत्रम्) and sweda (स्वेदः). These are generated as wastes during the digestion and processing of the food that we eat. Mutra among these, is the liquid form of waste equated with Urine. 

== Etymology ==

== Organ entities involved in Mutra formation ==
According to Ayurvedic treatises, the organs involved in the physiology of urine formation are “Mutravaha strotas” which are the channels carrying Mutra. The moola or the root organ is “[[Basti ( बस्तिः)|Basti (बस्तिः)]]” which is the urinary bladder. “Vankshanas” (वंक्षणः। inguinal region) and “Medhra” (मेढ्रम्) which here is the penile region of the urethra.<ref name=":0">Charaka Samhita (Vimanasthanam Adhyaya 5 Sutra 7-8)</ref>

Kidneys are considered as “Vrikka” (वृक्कौ) is the moola or the root organ of “Medavaha [[Strotas (स्रोतसम्)|strotas]]” (मेदोवह स्त्रोतसम्) hence are not a part of the Ayurvedic physiology of urine formation.

== Mutravaha Strotas ==
[[Strotas (स्रोतसम्)|Strotasas]] are precisely channels that are involved in the transportation and transformation of the dhatu and waste substances.<ref name=":0" />

Mutravaha strotas are the channels that transport urine from [[Basti ( बस्तिः)|Basti]] (बस्तिः। urinary bladder) through Medhra (मेढ्रम्) for excretion. Formation of final form of urine from collected liquid waste called as kleda (क्लेदः) in Ayurveda, happens in the mutravaha strotas. When there are disturbances in the these channels of the transportation of urine, signs and symptoms related to vitiation of mutra are observed. These are called as Mutravaha strotasa dushti lakshanas meaning features of vitiation.  

=== Causes of vitiation of Mutravaha strotasa ===
There are certain causes that are responsible for the vitiation of Mutravaha Strotas,<ref>Charaka Samhita (Vimanasthanam Adhyaya 5 Sutra 20)</ref> 

# Drinking water and eating food instead of attending to the urge of urination or holding the urge to pass the urine
# Coitus while neglecting the urge of micturition
# Suppression of the urge of urination specifically by people that are already suffering from emaciation and are wounded.

=== Symptoms of vitiation of Mutravaha strotas ===
When mutravaha strotas is vitiated, it shows following symptoms,<ref name=":0" />
# Excessive urination quantitively 
# Very less expulsion of urine
# Frequent urination
# Diminished urination (in frequency)
# Thick urine consistency
# Painful urination

== Function ==
Inspite of being a mala or waste metabolite in body, it performs certain functions. Therefore disturbances in its levels impact the overall functioning of the body. The functions of Mutra are mentioned as below,<ref>Ashthanga Hrudayam (Sutrasthanam Adhyaya 11 Sutra 5)</ref> <ref>Sushruta Samhita (Sutrasthanam Adhyaya 15 Sutra 5) & Dalhana's commentary on it</ref> 

# Collection, Separation and excretion of unwanted excess watery wastes (known as Kleda) generated from tissue level metabolism in the body
# Filling of the urinary bladder with urine
# Maintenance of volume in the bladder

== Mutra Pareeksha ==
Mutra Pareeksha according to ayurvedic treatises is the diagnostic as well as the prognostic tool of examination. Acharya Yogratnakar has explained “Asthasthana Pareeksha” () one of which is the Mutra pareeksha or the urine examination.

(yogratnakar Mutra pareeksha)

A CRITICAL REVIEW OF MUTRA PARIKSHA (URINE EXAMINATION) IN THE CONTEXT OF AYURVEDA & MODERN CONTEXT

=== Taila-Bindu Pareeksha ===
This is a unique method of examination according to Acharya Yogratnakar that includes the usage of Til taila (sesame oil) as the tool for examination.

# Collection of Mutra

Urine is collected for Mutra Pareeksha before four ghatika in the last Yama of the night. Midflow urine is collected in the glass dish, bronze dish, or earthen dish. Then a single drop of tila taila is dropped in the dish filled with urine and the drop is observed.

# Interpretations

{| class="wikitable"
|Shape of oil drop
|Dosha dominant
|-
|Sarpa (snake-like)
|Vata
|-
|Chhatra (umbrella-like)
|Pitta
|-
|Mukta (pearl-like)
|Kapha
|}
{| class="wikitable"
|Movement
|Sadhyasdhyata (prognosis)
|-
|Spreads immediately
|Sadhya (curable)
|-
|Sinks to the bottom
|Asadhya (incurable)
|-
|Does not spread
|Kashtasadhya (difficult to cure)
|}
According to the direction of movement,
{| class="wikitable"
|Spread of oil drop
|Prognosis
|-
|east/west/north/south
|Curable
|-
|Eshanya (North east)
|Death within one month
|-
|Agneya(south east)/nairutya (south west)
|Immediate death
|-
|Vayavya (north west)
|Bad prognosis
|}

== Clinical features of disturbed levels of Mutra ==

=== Mutrakshaya Lakshana ===
(Char.sutr.17.71) (Sush.Sutr.15.11) (Asht.Hrud.Sutr.11.22)

# मूत्रकृच्छ्रं - Painful expulsion of urine.
# मूत्रवैवर्ण्य - discolouration of the urine
# पिपासा - excessive thirst
# मुखं च परिशुष्यति| - dryness of mouth
# Hematuria
# Reduced urine frequency and quantity
# Pain in lower abdomen

=== Mutravriddhi Lakshana ===
(Sush.Sutr.15.15) (Asht.Hrud.Sutr.11.13)

# Increase in the quantity of urine
# Pricking pain in the region of the urinary bladder
# Abdominal distension
# Increased urine frequency 

== Diseases pertaining to Mutra and its channels ==
(Char.sidd.9.25,26)

# Mutrauksada - dense urine
# Mutrajathara - accumulation of urine in the abdominal cavity
# Mutrautsanga - residual urine 
# Mutratita - delayed urination
# Mutrakrichra - dysuria
# Vatashtila - stone-like swelling
# Vatabasti - an affliction of vata dosha in the vasti
# Ushnavata - burning urination
# Raktagranthi - swelling in the bladder 

== General Management ==
Specific medicines

Mutrasangrahaniya, Mutravirajinya, and mutrala are the specific gana or the group of herbs that are responsible for the treatment of various Mutra vikaras. 
{| class="wikitable"
|Gana
|Dravyas
|-
|Mutrasangrahaniya
|(Syzygium cumini)jambu, (Mangifera indica Linn.)amra, (Ficus lacor Buch.)plaksha, (Ficus benghalensis Linn.)vata, (Albizzia lebbeck)kaptana, (Ficus racemosa)udumbara, (Ficus religiosa )ashwattha, (Semecarpus anacardium) bhallataka, (Bauhinia racemosa)ashmantaka, (Acacia catechu Willd )somavalka
|-
|Mutravirajaniya
|Padmak(nelumbo nucefera),Utpala (Nymphea stellata),Saugandhika (white ginger lily),Yashtimadhu (Glycirrhiza glabra), Priyangu (Callicarpa microphila), Dhataki (woodfordia fructicosa)
|-
|Mutrala
|Gokshura (Tribulus terrestris), Vasuka (Indigofera ennaphila), Vashira (Gyanadropis gynandra), Darbha(Desmostachya bipinnata), Kusha, Kasha (Saccharum spontaneum)
|}