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क्लेदश्च मेदश्च कफश्च वृद्धः प्रमेहहेतुः प्रसमीक्ष्य तस्मात्। वैद्येन पूर्वं कफपित्तजेषु मेहेषु कार्याण्यपतर्पणानि ॥५१॥
[Indication of apatarpana treatment] Aggravated kleda (liquid element of the body), medas (adipose tissue) and kapha are responsible for the causation of prameha. Keeping this in view, the physician, in the beginning, should administer depletion therapies to patients suffering with kapha and pitta dominant types of prameha.
english translation
या वातमेहान् प्रति पूर्वमुक्ता वातोल्बणानां विहिता क्रिया सा। वायुर्हि मेहेष्वतिकर्शितानां कुप्यत्यसाध्यान् प्रति नास्ति चिन्ता ॥५२॥
[Vata dominant prameha] Formulations described earlier for the vatika prameha are actually meant for vata dominant prameha where vata is secondarily (subsequently) aggravated. If the vata is primarily aggravated in prameha because of excessive depletion of tissue elements, then it is incurable and the physician need not make efforts to treat.
english translation
यैर्हेतुभिर्ये प्रभवन्ति मेहास्तेषु प्रमेहेषु न ते निषेव्याः। हेतोरसेवा विहिता यथैव जातस्य रोगस्य भवेच्चिकित्सा ॥५३॥
[Prevention of prameha] Etiological factors responsible for the causation of different types of prameha should be avoided even after prameha are manifested. The causative factors described shall be avoided during the treatment of those particular diseases (even after its manifestation).
english translation
हारिद्रवर्णं रुधिरं च मूत्रं विना प्रमेहस्य हि पूर्वरूपैः। यो मूत्रयेत्तं न वदेत् प्रमेहं रक्तस्य पित्तस्य हि स प्रकोपः ॥५४॥
[Differentiation between raktapitta and prameha] If the color of the urine is yellow or if blood is excreted through the urine without the prior manifestation of premonitory signs and symptoms of prameha, such a person should not be diagnosed as a patient of prameha. He should be diagnosed as a case of rakta-pitta (a disease characterized by bleeding from different parts of body).
english translation
दृष्ट्वा प्रमेहं मधुरं सपिच्छं मधूपमं स्याद्द्विविधो विचारः। क्षीणेषु दोषेष्वनिलात्मकः स्यात् सन्तर्पणाद्वा कफसम्भवः स्यात् ॥५५॥
[Two types of prameha patient] If the patient suffering from prameha passes urine which is sweet, slimy and honey-like, then there are two possibilities. It is caused either by the diminution of doshas having vata-dominant type or by over- nourishment having kapha dominant type.
english translation