Puyameha (पूयमेह) - 5 marks answer

1. Definition
   Puyameha is a condition in which pus-like urine or purulent discharge occurs through the urethra, often associated with painful micturition. It is described under Aupasargika vyadhi in Ayurvedic literature.
2. Nidana (causes)
   • Contact with an infected person, especially sexual contact
   • Improper genital hygiene
   • Suppression of urine urge
   • Pitta and Kapha aggravating diet and lifestyle
   • Infection of the urinary tract or genital passages
3. Samprapti
   Vitiated Pitta and Kapha, along with Rakta, affect the Mutravaha srotas and urethral passage. This produces inflammation, burning, pain and formation of puya (pus), which is discharged with urine.
4. Lakshana (clinical features)
   • Pus or pus-like discharge in urine
   • Mutrakrichchhra - painful/difficult micturition
   • Mutradaha - burning during urination
   • Frequent urge to pass urine
   • Pain in penis/urethra and lower abdomen
   • Sometimes fever, redness and swelling around genital region
5. Chikitsa Siddhanta
   • Pitta-Kapha shamana and Mutrala treatment
   • Mild Virechana where indicated
   • Use of cooling, anti-inflammatory and urinary-cleansing measures
   • Pathya: adequate water intake, light food, hygiene, avoidance of spicy food, alcohol and sexual contact until recovery
   • Modern evaluation is necessary: urine examination and testing for urinary/sexually transmitted infection should be done, because pus in urine or urethral discharge may need antimicrobial treatment.