URINE ANALYSIS IN ASIAN MEDICINE
Investigation is an important aspect in the process of diagnosis of disease along with clinical examination of patient since ancient era in Asian countries. Several examinations of blood, urine, and stool have proven their importance in disease diagnosis as well as treatment. Among all these tests urine analysis is very important & needy test. Information about this is found from ancient time & is done by almost all streams of Asian medicine.
Urine analysis is done to analyze urine because toxins and excess fluids are removed from the body in urine. Results of urine analysis definitely provide important health clues. It is also used to detect certain diseases, such as diabetes, gout, and other metabolic disorders, as well as kidney disease. It can also be used to uncover evidence of drug abuse.
There is a specific process of collection of urine sample. Accurate urinalysis certainly requires a 'clean catch' of urine. Before a person gives a urine sample, he or she should drink plenty of fluids and wait until 1 or 2 seconds into the flow of urine before catching the urine in the receptacle. For some tests it is important to get the first urine of the day, which contains the highest concentration of toxins and other substances to be analyzed. For other tests, a 24-hour collection of urine may be needed.
Urine analysis is done by various methods in different branches of to Asian Medicine depending upon their fundamentals. Information about urine analysis & its methods are found mostly in Mangolian, Siddha, Tibetan, Chinese & Ayurved. This essay is a compilation of several urine analysis methods according to these branches.
In Mangolian Asian Medicine, the traditional physician reads the pulses, examines the tongue, checks the urine by smell, color and taste and interrogates the patient to diagnose a disease. Feces, urine and sweat are called the three dirts. Amongs them urine is checked by smell, color and taste. This method of urine analysis resembles with panchendriya examination i.e external examination through senses.
Siddha Ashian medicine has explored examination of eight items of the body. This science has nominated these examination as “ennvakaiththervu". According to this branch, physiologically urine has predominance of Appu(water) & it is called as Neer. It examined as follows.
Neer (urine): Neer is collected in the early morning & it is exaxamination is done on the basis of its color. Diagnosis of disease is drawn in following manner. For eg. straw color of urine indicates indigestion, reddish-yellow colour of urine in excessive heat, rose color of urine indicates blood pressure, saffron color of urine is found in jaundice whereas urine looks like meat washed water in renal disease. In this way, physical examination of urine has given importance in ancient mangolian rin examination.
According to Tibetan medicine, diagnosis is divided into three sections such as
Visual observation/ urine analysis
Touch/ pulse palpation &
Questioning/ interrogation
Among all the above three, urine analysis is one of the most unique feature of Tibetan medicine in comparison to other forms of ancient medical science. For the Tibetan physician, the urine is like a mirror. The best time for the Tibetan physician to inspect the urine is first in the morning under natural light, and often in the evening when in winter of course there is no natural light at all.
Tibetan physicians’ make use of urine analysis to get a knowledge of internal imbalance and bodily temperature of the patient. The method of urine analysis in their views is as follows. They check the urine immediately after collecting the sample on the spot by stirring it, They mainly check the consistency, the size of the urine bubbles, color & smell of urine and sediment. This proves that Tibetan doctors have also given importance to physical examination of urine.
Let us see the information about urine analysis given in Chinese Medicine. According to Chinese medicine, Yin-Yang theory is found to be useful in the interpretation of clinical sign & symptoms. This is also applicable in urine examination as a diagnostic tool.
According to them, in the deficiency of Yin urine appears as copious & clear whereas when Yan gets excess, there is scanty & dark urine.
In this way this science has also mentioned about physical examinations of urine.
Now lastly it is unavoidable to have a look on the information given about urine analysis in Ayurved. This science has its own special methods of clinical examination. Both the patient & disease are examined clinically by Ayurvedic method. Among them urine examination is incorporated under patient’s examination. Patient’s examination is done as mentioned below.
Patient’s examination –
8 fold Examination of Certain body parts (for all patients) – Pulse, Urine, Fecal matter, Tongue, Sound, Palpation, Eyes, Built.
Diagnosis of the disease by the examination of urine on the basis of appearance of urine. It is useful to find out aggravated body elements. These observations are mentioned in the following chart.
INDEX | Conditions | Urine appearance |
1 | Vata aggravated diseases | Pandu varna (whitish) or slightly ‘Nilam’ (Bluish). |
2 | Pitta aggravated | yellowish or Rakta varna (reddish) |
3 | Kapha dominated | “Phenayukta”, i.e., frothy or Snigdha (cloudy). |
4 | Rakta aggravated | Snigdha, Ushna (hot) and resembles blood. |
5 | combined 2 DoshaS | mixed colours |
6 | Sannipata state (2 Doshas) | Krishna varna (blackish) |
7 | Ajirna’ (indigestion) | Tandulodaka (rice water). |
8 | Navina Jwara (acute fever) | Smoky, affected & passes more urine (Bahu Mutrata) |
9 | Vata Pitta jwara | smoky, watery and hot. |
10 | Shlesma-Pitta jwara - urine is. | polluted and is mixed with blood |
11 | Vata Shlesmajwara - | whitish with air bubbles |
12 | In Jirna (Chronic) jwara - | yellowish and red. |
13 | In Sannipata jwara - | mixed shades depending on the Dosha involvement. |
Tail Bindu Examination- This is a special Ayurvedic urine examination method. Prognosis of disease by the examination of urine by spreading nature of the oil
In this examination, urine is kept in a broad vessel & a drop of oil is placed in the centre of urine. Then the direction of drop is observed & diagnosis is made.
If inserted oil spreads quickly over the surface of urine, that disease is curable.
If the oil does not spread it is considered as difficult to treat.
If the dropped oil directly goes inside and touches the bottom of the vessel, then it is regarded as incurable.
If the oil spreads in the direction of (east) the patient gets relief.
If the oil spreads in the south direction, the individual will suffer from fever and gradually recovers.
If the oil spreads in the northern direction, the patient will definitely be cured and become healthy.
If the oil spreads towards the west, he will attain happiness and health.
If the oil spreads towards the Northeast, the patient is bound to die in a month's time; similarly, if the oil spreads into Southeast or Southwest directions, or when the instilled oil drop splits, the patient is bound to die.
If the oil spreads on to Northwest direction, he is going to die anyway.
It is a good prognosis if the oil creates the images of swan, lotus, chowri composed of the tail of Yak, arch, mountain, elephant, camel, tree, umbrella and house.
If the taila attains the shape of a fish, then the patient is free of dosha and the disease can be treated easily.
If the drop of the taila attains the shape of creeper, a kind of drum, human being, pot, wheel or deer then the disease is considered as the difficultly curable.
If the spreading oil creates the shapes of tortoise, buffalo, honey-bee, bird, headless human body, instrument used in surgery physician should not treat that patient as that disease is incurable.
If the shape of the drop of taila is seen as four-legged, three-legged, two-legged that patient will die soon.
In this way, urine analysis was put into practice by almost all medicinal streams of Asian countries. It can be said that disease diagnosis was done mostly on the basis of physical examinations of urine. Among all Asian countries, Ayurved has explored urine analysis in detail as compared to other medicinal streams.
Methods
Now a day some laboratory tests are available which are as follows.
Urine Routine & Microscopic
Urinary analysis by using urine test strip- It is definitely useful & quantify following things.
Leukocytes – with presence in urine known as leukocyturia
Nitrite – with presence in urine known as nitrituria
Protein – with presence in urine known as proteinuria, albuminuria, or microalbuminuria
Microscopic examination - The numbers and types of cells and/or material such as urinary casts can yield a great detail of information and may suggest a specific diagnosis.
Hematuria – associated with kidney stones, infections, tumors and other conditions
Pyuria – associated with urinary infections
Eosinophiluria – associated with allergic interstitial nephritis, atheroembolic disease
Red blood cell casts – associated with glomerulonephritis, vasculitis, or malignant hypertension
White blood cell casts – associated with acute interstitial nephritis, exudative glomerulonephritis, or severe pyelonephritis
(Heme) granular casts – associated with acute tubular necrosis
Crystalluria – associated with acute urate nephropathy (or acute uric acid nephropathy, AUAN)
Calcium oxalatin – associated with ethylene glycol
Waxy casts – associated with chronic renal disease
Urine culture for urinary tract infection.
Ictotest – to analyze the destruction of old red blood cells in the urine.
Hemoglobin test –to analyz hemorrhage in the urinary system.
