DHAT SYNDROME: A REAPPRAISAL

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Dr. S.K. Jain's Burlington Clinic Pvt Ltd

DHAT SYNDROME: A REAPPRAISAL

               As par discussion with World renowned Sex Specialist Dr. Saransh Jain, according to him. " the term ‘Dhat’ (धातु दोष,) gets its origin from the Sanskrit word ‘Dhatus’, which, according to the Susruta Samhita, means elixir that constitutes the body."

             It was first described in western psychiatric literature by Wig, with vague psychosomatic symptoms of fatigue, weakness, of appetite, guilt and sexual dysfunction, attributed by the patient to loss of semen in nocturnal emission, through urine or masturbation.

Ayurvedic literature describing semen as a vital constituent of the human body dates back to 1500 BC. The disorders of ‘Dhatus’ have been elucidated in the Charak Samhita, which describes a disorder called ‘Shukrameha’ in which there is a passage of semen in the urine. Similar conditions have been described under various names from China (Shen K'uei), Sri Lanka (Prameha) and other parts of South East Asia (Jiryan). Malhotra and Wig called ‘Dhat’ ‘a sexual neurosis of the Orient’.

                  In China, anxiety following semen loss (Shen-K'uie) has been associated with epidemics of Koro, which is another culture-bound syndrome in which the individual holds the belief that his penis is shrinking into his body and disappearing. Tissot's paper in 18th century stating that even an adequate diet could waste away through seminal emission gained popularity amongst the emerging middle class and led Western Europe to an era of masturbating insanity.

                 Some doctors believe dhat syndrome to be either a culture-bound presentation of clinical depression, as a somatized set of symptoms, or a result of Western doctors' misinterpretation of patients' descriptions of their condition. 
It is very common in Nepali culture as well. Most of them come with the complaints of "drops" and become extremely anxious about it and see it as loss of "male power". It is often related with obsessive ruminations and somatoform symptoms. Others see it as a distinct clinical entity which is less culture-bound than these critics assert, and describe it as one form of a syndrome of "semen-loss anxiety" which also occurs in other Eastern cultures as jiryan and shen-k'uei, as well as in Western cultures.
Chlamydia infection might also be related to it because of similar symptoms in case of infection of the urethra (urethritis), which is usually symptomatic, causing a white discharge from the penis with or without pain on urinating (dysuria).

QA
Q1. What are the common symptoms?
Ans: Common symptoms of dhat are:
  1. Weakness, anxiety, sleepness, and guilt which is attribute to semen loss.
  2. Loss of semen through nocturnal emission and masturbation frightens the individual as he believes it to be harmful to the body.
  3. Some patient report a white discharge in their urine which they feel is semen.
  4. Sexual dysfunction may or may not be present.
  5. Pain in wrist, headache and leg pain.
  6. Subsequent loss in memory.

Q2. What is the cause of Dhat syndrome?
Ans: The common causes of Dhat syndrome are
  1. There is no known physical cause for the illness.
  2. It occurs due to wrong beliefs and misconceptions about normal sexual functions.
Q3. What is the treatment available?
Ans: Effective treatments in the form of medication and counseling- psychotherapy are available.
  1. Psychotherapy: Aimed at reassurance and correction of wrong belief.
  2. Medication: To relieve anxiety and sad mood that is often present in such situations.
Q4. What are myth and facts of Dhat Syndrome?
Ans: 
Myth:
  1. Loss of semen is very harmful to the body.
  2. Several drops of blood make one drop of semen.
  3. White discharge in urine contains 'vital substance.
Facts:
  1. Semen loss is a normal sexual process in the body.
  2. There is no such association.
  3. There is no medical basis for this belief.
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