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Dhat syndrome ("semen loss"-related psychological distress) is a culture-bound syndrome seen in the natives of Indian subcontinent, but it is prevalent in other cultures also. Its diagnosis and management issues need to be taught to postgraduates in their teaching program. This syndrome involves vague and multiple somatic and psychological complaints such as fatigue, listlessness, loss of appetite, lack of physical strength, poor concentration, forgetfulness and other vague somatic troubles. These symptoms are usually associated with an anxious and dysphoric mood state. These patients may also present with or without psychosexual dysfunction. The management of Dhat syndrome needs serious attention. The understanding of this condition by Modern Medicine fails to impress most of the patients, and the explanations and reassurances offered prove to be not of much use.

The word "Dhat" derives from the Sanskrit language (the mother of Indo-Aryan languages) word dhatu, meaning "metal," "elixir" or "constituent part of the body" which is considered to be "the most concentrated, perfect and powerful bodily substance, and its preservation guarantees health and longevity." The disorder related to this dhatu, i.e., semen, is mentioned in ancient treatise "Susruta Samhita" as shukrameha ( shukra = sperm; + meha = passage in urine).

Since then, myth prevalent among people of the Indian subcontinent is that "it takes 40 days for 40 drops of food to be converted to one drop of blood, 40 drops of blood to make one drop of bone marrow and 40 drops of bone marrow form one drop of semen." [3]

It is important to learn that this anxiety around seminal loss is not only prevalent in the Indian subcontinent but also in the Western world. From the times of Hippocrates and Aristotle, semen is considered an extremely important part of the body. "Sperms are the excretion of our food; or to put it more clearly, the most perfected component of food" (Aristotle, 384-322 B.C.). Andrew Tissot (1728-97) commented in his treatise on the disease produced by onanism that "losing one ounce of sperm is more debilitating than losing 40 ounces of blood." His statement seems to be closer to the Indian myth.

In many Western European cultures, masturbation was prohibited by religion. Henry Maudsley (1835-1918) even considered that semen loss, especially if it occurs through masturbation, results in serious mental illness. George Beard (1838-1883) considered nocturnal emissions of semen as one of the commonest reasons for neurasthenia. Therefore, the concept of Dhat syndrome or semen-loss syndrome was prevalent among Western cultures with different names at some point of time.

Prakash O. Lessons for postgraduate trainees about Dhat syndrome. Indian J Psychiatry [serial online] 2007 [cited 2011 Mar 29];49:208-10. Available from: http://www.indianjpsychiatry.org/text.asp?2007/49/3/208/37324

Basically the Indian culture in which this syndrome is prevailant, holds high importance to semen. So when boys are going through puberty or adolescence and they are ejaculating more, purposefully or not, semen loss is a big deal. They feel like they are losing vital life juice out of their body. Maybe it is for this reason, that they experience fatigue, loss of strength, loss of appitite, etc. Mind over matter: They THINK they're losing something important out of their body, so they FEEL like they're losing something.