https://www.carakasamhitaonline.com/api.php?action=feedcontributions&feedformat=atom&user=Agnivesha 2026-04-05T21:11:18Z User contributions MediaWiki 1.43.6 https://www.carakasamhitaonline.com/index.php?title=Ashwagandha&diff=45420 2026-03-17T05:06:00Z

<p>Agnivesha: </p> <hr /> <div>{{#seo:<br /> |title=Charak Samhita<br /> |titlemode=append<br /> |keywords=Ashwagandha, Ashvagandha, Withania Somnifera, Indian ginseng, winter cherry, Charak Samhita, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, ancient Ayurveda text, Indian system of medicine, Ayurveda, Charak, Charaka Samhita, agnivesha, atreya, gopal basisht, yogesh deole, charak samhita wikipedia edition, charak samhita new edition, charaka samhita new edition, carak samhita new edition, caraka samhita new edition, research on charak samhita, text book charak samhita, fundamental principles of ayurveda, basic concepts of ayurveda,<br /> |description='''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> '''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.&lt;ref&gt;{{cite journal |last1=Singh |first1=Narendra |last2=Bhalla |first2=M. |last3=de Jager |first3=P. |last4=Gilca |first4=M. |title=Rational use of Ashwagandha in Ayurveda (Traditional Indian Medicine) – A systematic analysis of the scientific evidence for its pharmacological activities |journal=Journal of Ethnopharmacology |volume=273 |pages=113907 |doi=10.1016/j.jep.2021.113907 |pmc=PMC8274455 |pmid=33831467 |year=2021}}&lt;/ref&gt;&lt;ref&gt;{{cite journal |last1=Mishra |first1=Laxmi C. |last2=Singh |first2=Betilda B. |last3=Dagenais |first3=Simon |title=Scientific basis for the therapeutic use of Withania somnifera (Ashwagandha): a review |journal=Alternative Medicine Review |volume=14 |issue=5 |pages=348–357 |pmid=19803596 |year=2000}}&lt;/ref&gt;<br /> <br /> {{Infobox<br /> |title = Ashwagandha<br /> |label1 = Section/Chapter<br /> |data1 = Herb database/Ashwagandha<br /> |label2 = Botanical name(s)<br /> |data2 = Withania somnifera (Linn.)<br /> |label3 = Family<br /> |data3 = Solanaceae<br /> |label3 = Contributors<br /> |data3 = Dr.Yogesh S. Deole<br /> |label4 = Year of publication <br /> |data4 = 2026<br /> |label5 = Publisher <br /> |data5 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label6 = DOI <br /> |data6 = Awaited<br /> }}<br /> ==English name==<br /> '''Indian ginseng''' or '''winter cherry'''<br /> <br /> ==Synonyms ==<br /> <br /> Ashwagandha, Wajigandha, Varahakarni<br /> <br /> == Ayurvedic pharmacological properties ==<br /> <br /> * '''Rasa''' (taste): Madhura (sweet), tikta (bitter)<br /> * '''Guna''' (properties): Snigdha (unctuous), guru (heavy to digest)<br /> * '''Virya''' (potency): Ushna (hot)<br /> * '''Vipaka''' (post-digestive effect): Madhura<br /> * '''Dosha Effect''': Primarily balances [[Vata dosha|vata]], secondarily kapha; aggravates pitta in excess.<br /> * '''Classical Actions''': Medhya (intellect promoter), balya (strength), vajikarana (aphrodisiac), rasayana (rejuvenative).&lt;ref name=&quot;:0&quot;&gt;{{cite book |last1=Sharma |first1=P.V.|title=Charaka Samhita |publisher=Chaukhamba Orientalia |location=Varanasi |year=2014 |isbn=978-8176371432}}&lt;/ref&gt;<br /> <br /> ==Description==<br /> <br /> A perennial shrub from the [[Solanaceae]] family, native to India, the Middle East, and Africa. It grows 35–75 cm tall with oval leaves, small greenish-yellow flowers, and red-orange berry-like fruits. The name &quot;Ashwagandha&quot; derives from Sanskrit ''ashva'' (horse) and ''gandha'' (smell), referring to the root's horse-like odor and vigor-promoting effects.&lt;ref&gt;{{cite journal |last1=Mirjalili |first1=Mohammad Hossein |last2=Moharramipour |first2=Saman |last3=Hadian |first3=Javad |title=A review on the production of Withania somnifera (Ashwagandha) active principles: Methods and current status |journal=Journal of Medicinal Plants Research |volume=8 |issue=37 |pages=882–900 |doi=10.5897/JMPR2014.5629 |year=2014}}&lt;/ref&gt;<br /> <br /> ==Pharmacognosy==<br /> <br /> Key phytoconstituents include withanolides (e.g., withaferin A, withanolide D), sitoindosides, withanosides, alkaloids (withanine, somniferine), and steroidal lactones. Roots contain highest concentrations (1.5–5% withanolides).&lt;ref&gt;{{cite journal |last1=Kaushik |first1=M.K. |last2=Kaushik |first2=V.K. |last3=Kumar |first3=A. |title=Withania somnifera (L.) Dunal (Ashwagandha): A comprehensive review on ethnopharmacology, pharmacotherapeutics, biomarkers, and pharmacokinetics |journal=Journal of Ethnopharmacology |volume=267 |pages=113451 |doi=10.1016/j.jep.2020.113451 |pmid=33157267 |year=2021}}&lt;/ref&gt;<br /> <br /> ==Clinical Uses==<br /> <br /> ===Reference in Charak Samhita and its actions ===<br /> {| class=&quot;wikitable&quot;<br /> |+<br /> Herbs and their activities<br /> |'''Sr.no.'''<br /> |'''Reference in Charak Samhita'''<br /> |'''Activity'''<br /> |-<br /> |1<br /> |Cha. Sa. Sutra sthana 4/9(2)<br /> |Brumhaniya mahakashaya<br /> |-<br /> |2<br /> |Cha. Sa. Sutra sthana 4/9(7)<br /> |Balya mahakashaya<br /> |-<br /> |3<br /> |Cha. Sa. Vimana Sthana 8/136<br /> |Virechana Dravyani<br /> |-<br /> |4<br /> |Cha. Sa. Vimana Sthana 8/139<br /> |Madhur skandha<br /> |-<br /> |5<br /> |Cha. Sa. Chikitsa Sthana 2/1/34<br /> |Ingredient in Vajikarana Ghrita<br /> |-<br /> |6<br /> |Cha. Sa. Chikitsa Sthana 13/109<br /> |In the treatment of Udara roga (for lepa)<br /> |-<br /> |7<br /> |Cha. Sa. Chikitsa Sthana 14/50<br /> |Dhupan yoga in arsha roga<br /> |-<br /> |8<br /> |Cha. Sa. Chikitsa Sthana 17/117<br /> |Kshara mixed with madhuk ghrit is used in hikka shwasa<br /> |-<br /> |9<br /> |Cha.Sa.Chikitsa Sthana 18/75<br /> |As an ingredient of Dhumapana yoga<br /> |-<br /> |10<br /> |Cha.Sa.Chikitsa Sthana 21/123<br /> |For pradeha prayoga in granthi visarpa<br /> |-<br /> |11<br /> |Cha.Sa.Chikitsa Sthana 23/70<br /> |As an ingredient of Gandha hasti agada<br /> |-<br /> |12<br /> |Cha.Sa.Chikitsa Sthana 23/80<br /> |As an ingredient of Maha -Gandha hasti agada.<br /> |-<br /> |13<br /> |Cha.Sa.Chikitsa Sthana 23/244<br /> |As an ingredient of Amruta ghrita<br /> |-<br /> |14<br /> |Cha.Sa. Chikitsa Sthana 27/43<br /> |As an ingredient of Kushthadi Taila<br /> |-<br /> |15<br /> |Cha.Sa. Chikitsa Sthana 22/50<br /> |As an ingredient of Utsadana Yoga<br /> |-<br /> |16<br /> |Cha.Sa.Chikitsa Sthana 28/166<br /> |As an ingredient of Ashwagandha Taila paka<br /> |-<br /> |17<br /> |Cha.Sa.Chikitsa Sthana 28/170 <br /> |As an ingredient of Vrushamuladi taila<br /> |-<br /> |18<br /> |Cha.Sa.Chikitsa Sthana 28/173<br /> |As an ingredient of Mulaka taila<br /> |-<br /> |19<br /> |Cha.Sa.Chikitsa Sthana 29/73<br /> |As an ingredient of Jeevakadi mahasneha<br /> |-<br /> |20<br /> |Cha.Sa.Chikitsa Sthana 30/260<br /> |As a paniya yoga, in the treatment of Stanya dosha<br /> |}<br /> <br /> === Bhavaprakasha ===<br /> <br /> * Pacifies [[Vata]]-[[Kapha]] dosha<br /> * Alleviates Shwitra (vitiligo)<br /> * Shotha (oedema)<br /> * Kshaya (depletion of tissues)<br /> * Balya (promotes strength)<br /> * Rasayani (rejuvenating)<br /> * Atishukrala (increases semen and sperm count)<br /> <br /> ===Neurological===<br /> Reduces stress and cortisol levels (300–600 mg root extract daily); improves sleep quality and cognitive function in trials.&lt;ref&gt;{{cite journal |last1=Chandrasekhar |first1=K. |last2=Kapoor |first2=J. |last3=Anishetty |first3=S. |title=A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults |journal=Indian Journal of Psychological Medicine |volume=34 |issue=3 |pages=255–262 |doi=10.4103/0253-7176.106022 |pmc=3573577 |pmid=23439798 |year=2012}}&lt;/ref&gt;<br /> <br /> ===Reproductive===<br /> Enhances testosterone, semen quality, and libido in men (675 mg root powder daily).&lt;ref&gt;{{cite journal |last1=Ambiye |first1=V.R. |last2=Langade |first2=D. |last3=Dongre |first3=S. |last4=Apte |first4=S. |last5=Joshi |first5=K. |title=Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: a pilot study |journal=Evidence-Based Complementary and Alternative Medicine |volume=2013 |pages=571420 |doi=10.1155/2013/571420 |pmc=3863556 |pmid=24284701 |year=2013}}&lt;/ref&gt;<br /> <br /> ===Musculoskeletal===<br /> Increases muscle mass and strength (500 mg extract with resistance training).&lt;ref&gt;{{cite journal |last1=Wankhede |first1=S. |last2=Langade |first2=D. |last3=Joshi |first3=K. |last4=Thakurdesai |first4=P.A. |title=Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial |journal=Journal of the International Society of Sports Nutrition |volume=12 |pages=23 |doi=10.1186/s12970-015-0104-9 |pmc=4658772 |pmid=26009251 |year=2015}}&lt;/ref&gt;<br /> <br /> ==Formulations and Dosage==<br /> <br /> Common preparations:<br /> {| class=&quot;wikitable&quot;<br /> !Formulation||Dose||Anupana (vehicle)<br /> |-<br /> |Churna (powder)||3–6 g BID||Warm milk/ghee<br /> |-<br /> |Ghrita||5–10 g/day||As prescribed<br /> |-<br /> |Extract capsules||300–600 mg/day||Water<br /> |}<br /> <br /> ==Safety==<br /> Generally safe (GRAS status); rare GI upset, drowsiness. Contraindicated in hyperthyroidism, pregnancy (uterine stimulant), and nightshade allergy. LD&lt;sub&gt;50&lt;/sub&gt; &gt;2 g/kg in rodents.&lt;ref&gt;{{cite web |title=Withania somnifera (Ashwagandha) Monograph |url=https://www.herbrally.com/monographs/ashwagandha |publisher=HerbRally |access-date=2026-03-16}}&lt;/ref&gt;<br /> <br /> ==Research==<br /> <br /> Over 100 clinical trials support adaptogenic effects; NIH-funded studies are ongoing for anxiety and sleep disorders. Withanolides modulate HPA axis, GABA receptors, and inflammation pathways (NF-κB inhibition).&lt;ref name=&quot;:1&quot;&gt;{{cite journal |last1=Speers |first1=A.B. |last2=Cabey |first2=K.A. |last3=Souza |first3=M.J. |last4=Spencer |first4=E.A. |title=Effects of Withania somnifera (Ashwagandha) on stress and the stress-related neuropsychiatric disorders anxiety, depression, and insomnia |journal=Current Neuropharmacology |volume=20 |issue=7 |pages=1–17 |doi=10.2174/1570159X19666210813150419 |year=2021}}&lt;/ref&gt;<br /> <br /> ==Current availability ==<br /> <br /> Available<br /> <br /> == External links ==<br /> <br /> [https://en.wikipedia.org/wiki/Withania_somnifera Withania Somnifera] <br /> <br /> [https://cb.imsc.res.in/imppat/phytochemical/Withania%20somnifera IMPPAT Database link]<br /> <br /> ==References==<br /> {{reflist}}<br /> <br /> This article is under development...</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Main_Page&diff=45419 2026-03-16T14:48:18Z

<p>Agnivesha: </p> <hr /> <div>__NOTOC__<br /> &lt;no-comment-streams /&gt;<br /> {{#seo:<br /> |title=Charak Samhita<br /> |titlemode=append<br /> |keywords=Charak Samhita, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, ancient Ayurveda text, Indian system of medicine, Ayurveda, Charak, Charaka Samhita, agnivesha, atreya, gopal basisht, yogesh deole, charak samhita wikipedia edition, charak samhita new edition, charaka samhita new edition, carak samhita new edition, caraka samhita new edition, research on charak samhita, text book charak samhita, fundamental principles of ayurveda, basic concepts of ayurveda, diagnostic principles of ayurveda, diagnosis of diseases in ayurveda, specific knowledge of ayurveda, holistic human being, holistic system of medicine, sensorial prognosis, therapeutics, pharmacological, pharmaceutical preparations, therapeutic procedures, detoxication, biopurification, panchakarma procedures, new research in ayurveda, new texts, online ayurveda text, learn ayurveda, what is ayurveda, what is charak samhita?Smriti,Prakriti,Satmya,Aatma,Purusha,Panchamahabhuta,Akasha mahabhuta,Vayu mahabhuta,Agni mahabhuta,Jala mahabhuta,Prithvi mahabhuta,Dhatu,Rasa dhatu,Rakta dhatu,Mamsa dhatu,Meda dhatu,Asthi dhatu,Majja dhatu,Shukra dhatu,Ojas,Ahara vidhi,Tantrayukti,Guna,Panchakarma,Menstrual disorders,Prenatal care (garbhini paricharya),Kha vaigunya,Shatkriyakala,Ayurveda,Snehana (unction therapy),Swedana,Vamana,Virechana,Basti,Nasya,Raktamokshana,Mala,Purisha,Mutra,Garbha‎‎,Contraceptives,‎‎Artava,Dosha,Dinacharya,<br /> Infectious diseases,Prajnaparadha,Langhana,Indriya,Brimhana,Deepana,Rukshana,Pachana,Stambhana,Rasayana,Vajikarana,Aushadha Sevana Kala,<br /> Acid peptic diseases‎‎,Manas (Mind and mental health),Preface- Charak Samhita New Edition,Obesity and Metabolic Syndrome,Nidra, Cardiac diseases,Sutika Paricharya, Buddhi,Hetu, Interactive session on Contemporary Ayurveda,Menopausal Syndrome,Congenital disorders,Neurological diseases,Vyadhi,Neonatal care,Amavata,Agni,Skin diseases in Integrative Medicine,Pramana, Emergency medicine in Ayurveda,Deha Prakriti,Immunization,Kidney diseases,Manas Prakriti, Pratyaksha pramana, Psychiatric diseases,‎‎Cancer,Rheumatic diseases,<br /> Panchakarma in modern lifestyle,Kaarya Kaarana Siddhanta,Aaptopadesha pramana (knowledge by authoritative statement),Jwara (various fevers),Samanya Vishesha Siddhanta (Theory of similarity and dissimilarity),Karma (action),Anumana pramana (knowledge by inference),<br /> Yukti pramana (knowledge by logical application),Disha (directions),Upamana pramana (knowledge by analogy),Linga (symptomatology/features),Adhyayana (Methods of study and learning),Koshtha (gut pattern),Samavaya,Padartha,Abhava,Dravya,Vipaka,<br /> Kala,Sweda,Ayu,Sattva,Dhatvagni, Sharira, Brahmacharya, Bhutagni,Avyakta,Vata dosha,Marma,Madhutailika Basti,Rasa,Vaitarana Basti,Tamas,<br /> Tanmatra,Upavasa,Aushadha,Ritucharya,Pitta dosha,Kapha dosha,Piccha basti, Vikriti,Vyayama,Veerya,Samadhi,Swabhavoparam vada,Rajas,<br /> Prabhava,Shastra, Rogamarga,Dhriti,Dhairya,Srotasa,Janapadodhvansa,Kala Sharira,Varna, Viruddha Ahara,Dhumapana,Ashayapakarsha,Ama,<br /> Shirodhara,Asthapana basti,Yapana basti,Adharma,Samhanana,Aupasargika vyadhi,Pranavaha srotas,Annavaha srotas,Stanya,Nitya sevaniya - asevaniya dravya,Matra basti,Pakshaghata,Udakavaha Srotas,Manovaha Srotas,Pramanatah Pariksha,Udavarta,Adhyapana vidhi, <br /> |description=Charak Samhita is Ayurveda’s definitive treatise and the most referenced text by students, scholars, teachers, physicians and researchers. It has the unique distinction of being the only text available worldwide on restorative science.<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;div style=&quot;border-bottom:1px solid #7cd0ea;background-color:#FFFFFF; text-align:center;border:1px solid #000080; border-radius:8px;padding:0.2em 0.9em 0.2em 0.5em; font-size:160%; font-weight:bold;&quot;&gt;&lt;span style=&quot;color:#00008b&quot;&gt;[[Preface- Charak Samhita New Edition|Charak Samhita New Edition]]&lt;/span&gt;<br /> <br /> &lt;span style=&quot;color:#00008b&quot;&gt;The Definitive Online Edition of [[Ayurveda]]'s Core Treatise on Healthcare with [[Special:Statistics|{{NUMBEROFARTICLES}}]] articles&lt;/span&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding-top:0.50em;margin-bottom: 0.5em; margin-top: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;&quot;&gt;<br /> &lt;h2 id=&quot;mp-dyk-h2_3&quot; style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:160%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;&quot;&gt;&lt;span style=&quot;color:#00008b&quot;&gt;[[Preface- Charak Samhita New Edition|&lt;span style=&quot;color:#000080&quot;&gt;Charak Samhita - Ayurveda's Core Text&lt;/span&gt;]]&lt;/h2&gt;&lt;/div&gt;<br /> <br /> &lt;div style=&quot;width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;&quot;&gt;<br /> &lt;h2 id=&quot;mp-dyk-h2&quot; style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;&quot;&gt;&lt;span style=&quot;color:#00008b&quot;&gt;[[Contents|Contents]]&lt;/span&gt;&lt;/h2&gt;<br /> &lt;div style=&quot;padding:0.1em 0.6em 0.5em;&quot;&gt;<br /> &lt;div style=&quot;-moz-column-width: 20em; -webkit-column-width: 20em; column-width: 20em; width:auto; font-style: normal;&quot;&gt;<br /> &lt;ul&gt;<br /> &lt;li&gt;'''[[Sutra Sthana| I. Section on fundamental principles]] ''' '''([[Sutra Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[Nidana Sthana| II. Section on diagnostic principles]]''' '''([[Nidana Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[Vimana Sthana| III. Section on specific medical principles]]''' '''([[Vimana Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[Sharira Sthana| IV. Section on human being and genesis]]''' '''([[Sharira Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[ Indriya Sthana| V. Section on sensorial prognosis]] ''' '''([[Indriya Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[Chikitsa Sthana| VI. Section on therapeutic principles]] ''' '''([[Chikitsa Sthana]])''' &lt;/li&gt;<br /> &lt;li&gt;'''[[Kalpa Sthana| VII. Section on pharmaceutical preparations]] ''' '''([[Kalpa Sthana]]) ''' <br /> &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[Siddhi Sthana| VIII. Section on therapeutic procedures]]''' ''' ([[Siddhi Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;<br /> &lt;/div&gt; <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding-top:0.50em;margin-bottom: 0.5em; margin-top: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;background-color:#FFFFFF;border:1px solid #000080; border-radius:8px;&quot;&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;<br /> &lt;h2 id=&quot;mp-dyk-h2_3&quot; style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;&quot;&gt;[[Concepts and Contemporary Practices|&lt;span style=&quot;color:#000080&quot;&gt;IX. Monographs, Concepts and Contemporary Practices&lt;/span&gt;]]&lt;/h2&gt;&lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding-top:0.50em;margin-bottom: 0.5em; margin-top: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;background-color:#FFFFFF;border:1px solid #000080; border-radius:8px;&quot;&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;<br /> &lt;h2 id=&quot;mp-dyk-h2_2&quot; style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;&quot;&gt;[https://www.carakasamhitaonline.com/index.php?title=Charak_Samhita_Research,_Training_and_Skill_Development_Centre &lt;span style=&quot;color:#00008b&quot;&gt;Charak Samhita Research, Training and Skill Development Centre&lt;/span&gt;]&lt;/h2&gt;&lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding-top:0.50em;margin-bottom: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;background-color:#FFFFFF;border:1px solid #000080; border-radius:8px;&quot;&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;<br /> &lt;h2 id=&quot;mp-dyk-h2_5&quot; style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;&quot;&gt;&lt;span style=&quot;color:#00008b&quot;&gt;[https://play.google.com/store/apps/details?id=com.csrtsdc.charak Download offline Charak Samhita App]&lt;/span&gt;&lt;/h2&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;&quot;&gt;<br /> <br /> &lt;h2 id=&quot;mp-dyk-h2_6&quot; style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000000; padding:0.2em 0.4em;text-align:center;&quot;&gt;&lt;span style=&quot;color:#00008b&quot;&gt;[[About the Project]]&lt;/span&gt;&lt;/h2&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding-top:0.50em;margin-bottom: 0.5em; margin-top: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;&quot;&gt;<br /> <br /> &lt;h2 style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000000; padding:0.2em 0.4em;text-align:center;&quot;&gt; &lt;span style=&quot;color:#00008b&quot;&gt;'''[[Gopal Basisht|Dr. Gopal Basisht, M.D., &lt;small&gt;Chief Editor and Founder&lt;/small&gt;]] [[Yogesh Deole|Dr. Yogesh Deole, &lt;small&gt;Executive Editor&lt;/small&gt;]]'''&lt;/span&gt;&lt;/h2&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Main_Page&diff=45418 2026-03-16T14:47:46Z

<p>Agnivesha: </p> <hr /> <div>__NOTOC__<br /> {{#nocommentstreams:}}<br /> {{#seo:<br /> |title=Charak Samhita<br /> |titlemode=append<br /> |keywords=Charak Samhita, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, ancient Ayurveda text, Indian system of medicine, Ayurveda, Charak, Charaka Samhita, agnivesha, atreya, gopal basisht, yogesh deole, charak samhita wikipedia edition, charak samhita new edition, charaka samhita new edition, carak samhita new edition, caraka samhita new edition, research on charak samhita, text book charak samhita, fundamental principles of ayurveda, basic concepts of ayurveda, diagnostic principles of ayurveda, diagnosis of diseases in ayurveda, specific knowledge of ayurveda, holistic human being, holistic system of medicine, sensorial prognosis, therapeutics, pharmacological, pharmaceutical preparations, therapeutic procedures, detoxication, biopurification, panchakarma procedures, new research in ayurveda, new texts, online ayurveda text, learn ayurveda, what is ayurveda, what is charak samhita?Smriti,Prakriti,Satmya,Aatma,Purusha,Panchamahabhuta,Akasha mahabhuta,Vayu mahabhuta,Agni mahabhuta,Jala mahabhuta,Prithvi mahabhuta,Dhatu,Rasa dhatu,Rakta dhatu,Mamsa dhatu,Meda dhatu,Asthi dhatu,Majja dhatu,Shukra dhatu,Ojas,Ahara vidhi,Tantrayukti,Guna,Panchakarma,Menstrual disorders,Prenatal care (garbhini paricharya),Kha vaigunya,Shatkriyakala,Ayurveda,Snehana (unction therapy),Swedana,Vamana,Virechana,Basti,Nasya,Raktamokshana,Mala,Purisha,Mutra,Garbha‎‎,Contraceptives,‎‎Artava,Dosha,Dinacharya,<br /> Infectious diseases,Prajnaparadha,Langhana,Indriya,Brimhana,Deepana,Rukshana,Pachana,Stambhana,Rasayana,Vajikarana,Aushadha Sevana Kala,<br /> Acid peptic diseases‎‎,Manas (Mind and mental health),Preface- Charak Samhita New Edition,Obesity and Metabolic Syndrome,Nidra, Cardiac diseases,Sutika Paricharya, Buddhi,Hetu, Interactive session on Contemporary Ayurveda,Menopausal Syndrome,Congenital disorders,Neurological diseases,Vyadhi,Neonatal care,Amavata,Agni,Skin diseases in Integrative Medicine,Pramana, Emergency medicine in Ayurveda,Deha Prakriti,Immunization,Kidney diseases,Manas Prakriti, Pratyaksha pramana, Psychiatric diseases,‎‎Cancer,Rheumatic diseases,<br /> Panchakarma in modern lifestyle,Kaarya Kaarana Siddhanta,Aaptopadesha pramana (knowledge by authoritative statement),Jwara (various fevers),Samanya Vishesha Siddhanta (Theory of similarity and dissimilarity),Karma (action),Anumana pramana (knowledge by inference),<br /> Yukti pramana (knowledge by logical application),Disha (directions),Upamana pramana (knowledge by analogy),Linga (symptomatology/features),Adhyayana (Methods of study and learning),Koshtha (gut pattern),Samavaya,Padartha,Abhava,Dravya,Vipaka,<br /> Kala,Sweda,Ayu,Sattva,Dhatvagni, Sharira, Brahmacharya, Bhutagni,Avyakta,Vata dosha,Marma,Madhutailika Basti,Rasa,Vaitarana Basti,Tamas,<br /> Tanmatra,Upavasa,Aushadha,Ritucharya,Pitta dosha,Kapha dosha,Piccha basti, Vikriti,Vyayama,Veerya,Samadhi,Swabhavoparam vada,Rajas,<br /> Prabhava,Shastra, Rogamarga,Dhriti,Dhairya,Srotasa,Janapadodhvansa,Kala Sharira,Varna, Viruddha Ahara,Dhumapana,Ashayapakarsha,Ama,<br /> Shirodhara,Asthapana basti,Yapana basti,Adharma,Samhanana,Aupasargika vyadhi,Pranavaha srotas,Annavaha srotas,Stanya,Nitya sevaniya - asevaniya dravya,Matra basti,Pakshaghata,Udakavaha Srotas,Manovaha Srotas,Pramanatah Pariksha,Udavarta,Adhyapana vidhi, <br /> |description=Charak Samhita is Ayurveda’s definitive treatise and the most referenced text by students, scholars, teachers, physicians and researchers. It has the unique distinction of being the only text available worldwide on restorative science.<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;div style=&quot;border-bottom:1px solid #7cd0ea;background-color:#FFFFFF; text-align:center;border:1px solid #000080; border-radius:8px;padding:0.2em 0.9em 0.2em 0.5em; font-size:160%; font-weight:bold;&quot;&gt;&lt;span style=&quot;color:#00008b&quot;&gt;[[Preface- Charak Samhita New Edition|Charak Samhita New Edition]]&lt;/span&gt;<br /> <br /> &lt;span style=&quot;color:#00008b&quot;&gt;The Definitive Online Edition of [[Ayurveda]]'s Core Treatise on Healthcare with [[Special:Statistics|{{NUMBEROFARTICLES}}]] articles&lt;/span&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding-top:0.50em;margin-bottom: 0.5em; margin-top: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;&quot;&gt;<br /> &lt;h2 id=&quot;mp-dyk-h2_3&quot; style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:160%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;&quot;&gt;&lt;span style=&quot;color:#00008b&quot;&gt;[[Preface- Charak Samhita New Edition|&lt;span style=&quot;color:#000080&quot;&gt;Charak Samhita - Ayurveda's Core Text&lt;/span&gt;]]&lt;/h2&gt;&lt;/div&gt;<br /> <br /> &lt;div style=&quot;width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;&quot;&gt;<br /> &lt;h2 id=&quot;mp-dyk-h2&quot; style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;&quot;&gt;&lt;span style=&quot;color:#00008b&quot;&gt;[[Contents|Contents]]&lt;/span&gt;&lt;/h2&gt;<br /> &lt;div style=&quot;padding:0.1em 0.6em 0.5em;&quot;&gt;<br /> &lt;div style=&quot;-moz-column-width: 20em; -webkit-column-width: 20em; column-width: 20em; width:auto; font-style: normal;&quot;&gt;<br /> &lt;ul&gt;<br /> &lt;li&gt;'''[[Sutra Sthana| I. Section on fundamental principles]] ''' '''([[Sutra Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[Nidana Sthana| II. Section on diagnostic principles]]''' '''([[Nidana Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[Vimana Sthana| III. Section on specific medical principles]]''' '''([[Vimana Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[Sharira Sthana| IV. Section on human being and genesis]]''' '''([[Sharira Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[ Indriya Sthana| V. Section on sensorial prognosis]] ''' '''([[Indriya Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[Chikitsa Sthana| VI. Section on therapeutic principles]] ''' '''([[Chikitsa Sthana]])''' &lt;/li&gt;<br /> &lt;li&gt;'''[[Kalpa Sthana| VII. Section on pharmaceutical preparations]] ''' '''([[Kalpa Sthana]]) ''' <br /> &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[Siddhi Sthana| VIII. Section on therapeutic procedures]]''' ''' ([[Siddhi Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;<br /> &lt;/div&gt; <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding-top:0.50em;margin-bottom: 0.5em; margin-top: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;background-color:#FFFFFF;border:1px solid #000080; border-radius:8px;&quot;&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;<br /> &lt;h2 id=&quot;mp-dyk-h2_3&quot; style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;&quot;&gt;[[Concepts and Contemporary Practices|&lt;span style=&quot;color:#000080&quot;&gt;IX. Monographs, Concepts and Contemporary Practices&lt;/span&gt;]]&lt;/h2&gt;&lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding-top:0.50em;margin-bottom: 0.5em; margin-top: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;background-color:#FFFFFF;border:1px solid #000080; border-radius:8px;&quot;&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;<br /> &lt;h2 id=&quot;mp-dyk-h2_2&quot; style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;&quot;&gt;[https://www.carakasamhitaonline.com/index.php?title=Charak_Samhita_Research,_Training_and_Skill_Development_Centre &lt;span style=&quot;color:#00008b&quot;&gt;Charak Samhita Research, Training and Skill Development Centre&lt;/span&gt;]&lt;/h2&gt;&lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding-top:0.50em;margin-bottom: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;background-color:#FFFFFF;border:1px solid #000080; border-radius:8px;&quot;&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;<br /> &lt;h2 id=&quot;mp-dyk-h2_5&quot; style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;&quot;&gt;&lt;span style=&quot;color:#00008b&quot;&gt;[https://play.google.com/store/apps/details?id=com.csrtsdc.charak Download offline Charak Samhita App]&lt;/span&gt;&lt;/h2&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;&quot;&gt;<br /> <br /> &lt;h2 id=&quot;mp-dyk-h2_6&quot; style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000000; padding:0.2em 0.4em;text-align:center;&quot;&gt;&lt;span style=&quot;color:#00008b&quot;&gt;[[About the Project]]&lt;/span&gt;&lt;/h2&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding-top:0.50em;margin-bottom: 0.5em; margin-top: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;&quot;&gt;<br /> <br /> &lt;h2 style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000000; padding:0.2em 0.4em;text-align:center;&quot;&gt; &lt;span style=&quot;color:#00008b&quot;&gt;'''[[Gopal Basisht|Dr. Gopal Basisht, M.D., &lt;small&gt;Chief Editor and Founder&lt;/small&gt;]] [[Yogesh Deole|Dr. Yogesh Deole, &lt;small&gt;Executive Editor&lt;/small&gt;]]'''&lt;/span&gt;&lt;/h2&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Ashwagandha&diff=45417 2026-03-16T07:35:42Z

<p>Agnivesha: </p> <hr /> <div>{{#seo:<br /> |title=Charak Samhita<br /> |titlemode=append<br /> |keywords=Ashwagandha, Ashvagandha, Withania Somnifera, Indian ginseng, winter cherry, Charak Samhita, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, ancient Ayurveda text, Indian system of medicine, Ayurveda, Charak, Charaka Samhita, agnivesha, atreya, gopal basisht, yogesh deole, charak samhita wikipedia edition, charak samhita new edition, charaka samhita new edition, carak samhita new edition, caraka samhita new edition, research on charak samhita, text book charak samhita, fundamental principles of ayurveda, basic concepts of ayurveda,<br /> |description='''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> '''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.&lt;ref&gt;{{cite journal |last1=Singh |first1=Narendra |last2=Bhalla |first2=M. |last3=de Jager |first3=P. |last4=Gilca |first4=M. |title=Rational use of Ashwagandha in Ayurveda (Traditional Indian Medicine) – A systematic analysis of the scientific evidence for its pharmacological activities |journal=Journal of Ethnopharmacology |volume=273 |pages=113907 |doi=10.1016/j.jep.2021.113907 |pmc=PMC8274455 |pmid=33831467 |year=2021}}&lt;/ref&gt;&lt;ref&gt;{{cite journal |last1=Mishra |first1=Laxmi C. |last2=Singh |first2=Betilda B. |last3=Dagenais |first3=Simon |title=Scientific basis for the therapeutic use of Withania somnifera (Ashwagandha): a review |journal=Alternative Medicine Review |volume=14 |issue=5 |pages=348–357 |pmid=19803596 |year=2000}}&lt;/ref&gt;<br /> <br /> {{Infobox<br /> |title = Ashwagandha<br /> |label1 = Section/Chapter<br /> |data1 = Herb database/Ashwagandha<br /> |label2 = Botanical name(s)<br /> |data2 = Withania somnifera (Linn.)<br /> |label3 = Family<br /> |data3 = Solanaceae<br /> |label3 = Contributors<br /> |data3 = Dr.Yogesh S. Deole<br /> |label4 = Year of publication <br /> |data4 = 2026<br /> |label5 = Publisher <br /> |data5 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label6 = DOI <br /> |data6 = Awaited<br /> }}<br /> ==English name==<br /> '''Indian ginseng''' or '''winter cherry'''<br /> <br /> ==Synonyms ==<br /> <br /> Ashwagandha, Wajigandha, Varahakarni<br /> <br /> == Ayurvedic pharmacological properties ==<br /> <br /> * '''Rasa''' (taste): Madhura (sweet), tikta (bitter)<br /> * '''Guna''' (properties): Snigdha (unctuous), guru (heavy to digest)<br /> * '''Virya''' (potency): Ushna (hot)<br /> * '''Vipaka''' (post-digestive effect): Madhura<br /> * '''Dosha Effect''': Primarily balances [[Vata dosha|vata]], secondarily kapha; aggravates pitta in excess.<br /> * '''Classical Actions''': Medhya (intellect promoter), balya (strength), vajikarana (aphrodisiac), rasayana (rejuvenative).&lt;ref name=&quot;:0&quot;&gt;{{cite book |last1=Sharma |first1=P.V.|title=Charaka Samhita |publisher=Chaukhamba Orientalia |location=Varanasi |year=2014 |isbn=978-8176371432}}&lt;/ref&gt;<br /> <br /> ==Description==<br /> <br /> A perennial shrub from the [[Solanaceae]] family, native to India, the Middle East, and Africa. It grows 35–75 cm tall with oval leaves, small greenish-yellow flowers, and red-orange berry-like fruits. The name &quot;Ashwagandha&quot; derives from Sanskrit ''ashva'' (horse) and ''gandha'' (smell), referring to the root's horse-like odor and vigor-promoting effects.&lt;ref&gt;{{cite journal |last1=Mirjalili |first1=Mohammad Hossein |last2=Moharramipour |first2=Saman |last3=Hadian |first3=Javad |title=A review on the production of Withania somnifera (Ashwagandha) active principles: Methods and current status |journal=Journal of Medicinal Plants Research |volume=8 |issue=37 |pages=882–900 |doi=10.5897/JMPR2014.5629 |year=2014}}&lt;/ref&gt;<br /> <br /> ==Pharmacognosy==<br /> <br /> Key phytoconstituents include withanolides (e.g., withaferin A, withanolide D), sitoindosides, withanosides, alkaloids (withanine, somniferine), and steroidal lactones. Roots contain highest concentrations (1.5–5% withanolides).&lt;ref&gt;{{cite journal |last1=Kaushik |first1=M.K. |last2=Kaushik |first2=V.K. |last3=Kumar |first3=A. |title=Withania somnifera (L.) Dunal (Ashwagandha): A comprehensive review on ethnopharmacology, pharmacotherapeutics, biomarkers, and pharmacokinetics |journal=Journal of Ethnopharmacology |volume=267 |pages=113451 |doi=10.1016/j.jep.2020.113451 |pmid=33157267 |year=2021}}&lt;/ref&gt;<br /> <br /> ==Clinical Uses==<br /> <br /> ===Reference in Charak Samhita and its actions ===<br /> {| class=&quot;wikitable&quot;<br /> |+<br /> Herbs and their activities<br /> |'''Sr.no.'''<br /> |'''Reference in Charak Samhita'''<br /> |'''Activity'''<br /> |-<br /> |1<br /> |Cha. Sa. Sutra sthana 4/9(2)<br /> |Brumhaniya mahakashaya<br /> |-<br /> |2<br /> |Cha. Sa. Sutra sthana 4/9(7)<br /> |Balya mahakashaya<br /> |-<br /> |3<br /> |Cha. Sa. Vimana Sthana 8/136<br /> |Virechana Dravyani<br /> |-<br /> |4<br /> |Cha. Sa. Vimana Sthana 8/139<br /> |Madhur skandha<br /> |-<br /> |5<br /> |Cha. Sa. Chikitsa Sthana 2/1/34<br /> |Ingredient in Vajikarana Ghrita<br /> |-<br /> |6<br /> |Cha. Sa. Chikitsa Sthana 13/109<br /> |In the treatment of Udara roga (for lepa)<br /> |-<br /> |7<br /> |Cha. Sa. Chikitsa Sthana 14/50<br /> |Dhupan yoga in arsha roga<br /> |-<br /> |8<br /> |Cha. Sa. Chikitsa Sthana 17/117<br /> |Kshara mixed with madhuk ghrit is used in hikka shwasa<br /> |-<br /> |9<br /> |Cha.Sa.Chikitsa Sthana 18/75<br /> |As an ingredient of Dhumapana yoga<br /> |-<br /> |10<br /> |Cha.Sa.Chikitsa Sthana 21/123<br /> |For pradeha prayoga in granthi visarpa<br /> |-<br /> |11<br /> |Cha.Sa.Chikitsa Sthana 23/70<br /> |As an ingredient of Gandha hasti agada<br /> |-<br /> |12<br /> |Cha.Sa.Chikitsa Sthana 23/80<br /> |As an ingredient of Maha -Gandha hasti agada.<br /> |-<br /> |13<br /> |Cha.Sa.Chikitsa Sthana 23/244<br /> |As an ingredient of Amruta ghrita<br /> |-<br /> |14<br /> |Cha.Sa. Chikitsa Sthana 27/43<br /> |As an ingredient of Kushthadi Taila<br /> |-<br /> |15<br /> |Cha.Sa. Chikitsa Sthana 22/50<br /> |As an ingredient of Utsadana Yoga<br /> |-<br /> |16<br /> |Cha.Sa.Chikitsa Sthana 28/166<br /> |As an ingredient of Ashwagandha Taila paka<br /> |-<br /> |17<br /> |Cha.Sa.Chikitsa Sthana 28/170 <br /> |As an ingredient of Vrushamuladi taila<br /> |-<br /> |18<br /> |Cha.Sa.Chikitsa Sthana 28/173<br /> |As an ingredient of Mulaka taila<br /> |-<br /> |19<br /> |Cha.Sa.Chikitsa Sthana 29/73<br /> |As an ingredient of Jeevakadi mahasneha<br /> |-<br /> |20<br /> |Cha.Sa.Chikitsa Sthana 30/260<br /> |As a paniya yoga, in the treatment of Stanya dosha<br /> |}<br /> <br /> === Bhavaprakasha ===<br /> <br /> * Pacifies [[Vata]]-[[Kapha]] dosha<br /> * Alleviates Shwitra (vitiligo)<br /> * Shotha (oedema)<br /> * Kshaya (depletion of tissues)<br /> * Balya (promotes strength)<br /> * Rasayani (rejuvenating)<br /> * Atishukrala (increases semen and sperm count)<br /> <br /> ===Neurological===<br /> Reduces stress and cortisol levels (300–600 mg root extract daily); improves sleep quality and cognitive function in trials.&lt;ref&gt;{{cite journal |last1=Chandrasekhar |first1=K. |last2=Kapoor |first2=J. |last3=Anishetty |first3=S. |title=A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults |journal=Indian Journal of Psychological Medicine |volume=34 |issue=3 |pages=255–262 |doi=10.4103/0253-7176.106022 |pmc=3573577 |pmid=23439798 |year=2012}}&lt;/ref&gt;<br /> <br /> ===Reproductive===<br /> Enhances testosterone, semen quality, and libido in men (675 mg root powder daily).&lt;ref&gt;{{cite journal |last1=Ambiye |first1=V.R. |last2=Langade |first2=D. |last3=Dongre |first3=S. |last4=Apte |first4=S. |last5=Joshi |first5=K. |title=Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: a pilot study |journal=Evidence-Based Complementary and Alternative Medicine |volume=2013 |pages=571420 |doi=10.1155/2013/571420 |pmc=3863556 |pmid=24284701 |year=2013}}&lt;/ref&gt;<br /> <br /> ===Musculoskeletal===<br /> Increases muscle mass and strength (500 mg extract with resistance training).&lt;ref&gt;{{cite journal |last1=Wankhede |first1=S. |last2=Langade |first2=D. |last3=Joshi |first3=K. |last4=Thakurdesai |first4=P.A. |title=Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial |journal=Journal of the International Society of Sports Nutrition |volume=12 |pages=23 |doi=10.1186/s12970-015-0104-9 |pmc=4658772 |pmid=26009251 |year=2015}}&lt;/ref&gt;<br /> <br /> ==Formulations and Dosage==<br /> <br /> Common preparations:<br /> {| class=&quot;wikitable&quot;<br /> !Formulation||Dose||Anupana (vehicle)<br /> |-<br /> |Churna (powder)||3–6 g BID||Warm milk/ghee<br /> |-<br /> |Ghrita||5–10 g/day||As prescribed<br /> |-<br /> |Extract capsules||300–600 mg/day||Water<br /> |}<br /> <br /> ==Safety==<br /> Generally safe (GRAS status); rare GI upset, drowsiness. Contraindicated in hyperthyroidism, pregnancy (uterine stimulant), and nightshade allergy. LD&lt;sub&gt;50&lt;/sub&gt; &gt;2 g/kg in rodents.&lt;ref&gt;{{cite web |title=Withania somnifera (Ashwagandha) Monograph |url=https://www.herbrally.com/monographs/ashwagandha |publisher=HerbRally |access-date=2026-03-16}}&lt;/ref&gt;<br /> <br /> ==Research==<br /> <br /> Over 100 clinical trials support adaptogenic effects; NIH-funded studies are ongoing for anxiety and sleep disorders. Withanolides modulate HPA axis, GABA receptors, and inflammation pathways (NF-κB inhibition).&lt;ref name=&quot;:1&quot;&gt;{{cite journal |last1=Speers |first1=A.B. |last2=Cabey |first2=K.A. |last3=Souza |first3=M.J. |last4=Spencer |first4=E.A. |title=Effects of Withania somnifera (Ashwagandha) on stress and the stress-related neuropsychiatric disorders anxiety, depression, and insomnia |journal=Current Neuropharmacology |volume=20 |issue=7 |pages=1–17 |doi=10.2174/1570159X19666210813150419 |year=2021}}&lt;/ref&gt;<br /> <br /> ==Current availability ==<br /> <br /> Available<br /> <br /> == External links ==<br /> <br /> [https://en.wikipedia.org/wiki/Withania_somnifera Withania Somnifera] <br /> <br /> [https://cb.imsc.res.in/imppat/phytochemical/Withania%20somnifera IMPPAT Database link]<br /> <br /> ==References==<br /> {{reflist}}<br /> <br /> [[Category:Database of herbs and minerals | Herbs]]<br /> <br /> This article is under development...</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Withania_somnifera&diff=45416 2026-03-16T07:33:25Z

<p>Agnivesha: Redirected page to Ashwagandha</p> <hr /> <div>#REDIRECT [[Ashwagandha]]</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Ashwagandha&diff=45415 2026-03-16T07:05:52Z

<p>Agnivesha: </p> <hr /> <div>{{#seo:<br /> |title=Charak Samhita<br /> |titlemode=append<br /> |keywords=Ashwagandha, Ashvagandha, Withania Somnifera, Indian ginseng, winter cherry, Charak Samhita, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, ancient Ayurveda text, Indian system of medicine, Ayurveda, Charak, Charaka Samhita, agnivesha, atreya, gopal basisht, yogesh deole, charak samhita wikipedia edition, charak samhita new edition, charaka samhita new edition, carak samhita new edition, caraka samhita new edition, research on charak samhita, text book charak samhita, fundamental principles of ayurveda, basic concepts of ayurveda,<br /> |description='''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> '''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.&lt;ref&gt;{{cite journal |last1=Singh |first1=Narendra |last2=Bhalla |first2=M. |last3=de Jager |first3=P. |last4=Gilca |first4=M. |title=Rational use of Ashwagandha in Ayurveda (Traditional Indian Medicine) – A systematic analysis of the scientific evidence for its pharmacological activities |journal=Journal of Ethnopharmacology |volume=273 |pages=113907 |doi=10.1016/j.jep.2021.113907 |pmc=PMC8274455 |pmid=33831467 |year=2021}}&lt;/ref&gt;&lt;ref&gt;{{cite journal |last1=Mishra |first1=Laxmi C. |last2=Singh |first2=Betilda B. |last3=Dagenais |first3=Simon |title=Scientific basis for the therapeutic use of Withania somnifera (Ashwagandha): a review |journal=Alternative Medicine Review |volume=14 |issue=5 |pages=348–357 |pmid=19803596 |year=2000}}&lt;/ref&gt;<br /> <br /> {{Infobox<br /> |title = Ashwagandha<br /> |label1 = Section/Chapter<br /> |data1 = Herb database/Ashwagandha<br /> |label2 = Botanical name(s)<br /> |data2 = Withania somnifera (Linn.)<br /> |label3 = Family<br /> |data3 = Solanaceae<br /> |label3 = Contributors<br /> |data3 = Dr.Yogesh S. Deole<br /> |label4 = Year of publication <br /> |data4 = 2026<br /> |label5 = Publisher <br /> |data5 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label6 = DOI <br /> |data6 = Awaited<br /> }}<br /> ==English name==<br /> '''Indian ginseng''' or '''winter cherry'''<br /> <br /> ==Synonyms ==<br /> <br /> Ashwagandha, Wajigandha, Varahakarni<br /> <br /> == Ayurvedic pharmacological properties ==<br /> <br /> * '''Rasa''' (taste): Madhura (sweet), tikta (bitter)<br /> * '''Guna''' (properties): Snigdha (unctuous), guru (heavy to digest)<br /> * '''Virya''' (potency): Ushna (hot)<br /> * '''Vipaka''' (post-digestive effect): Madhura<br /> * '''Dosha Effect''': Primarily balances [[Vata dosha|vata]], secondarily kapha; aggravates pitta in excess.<br /> * '''Classical Actions''': Medhya (intellect promoter), balya (strength), vajikarana (aphrodisiac), rasayana (rejuvenative).&lt;ref name=&quot;:0&quot;&gt;{{cite book |last1=Sharma |first1=P.V.|title=Charaka Samhita |publisher=Chaukhamba Orientalia |location=Varanasi |year=2014 |isbn=978-8176371432}}&lt;/ref&gt;<br /> <br /> ==Description==<br /> <br /> A perennial shrub from the [[Solanaceae]] family, native to India, the Middle East, and Africa. It grows 35–75 cm tall with oval leaves, small greenish-yellow flowers, and red-orange berry-like fruits. The name &quot;Ashwagandha&quot; derives from Sanskrit ''ashva'' (horse) and ''gandha'' (smell), referring to the root's horse-like odor and vigor-promoting effects.&lt;ref&gt;{{cite journal |last1=Mirjalili |first1=Mohammad Hossein |last2=Moharramipour |first2=Saman |last3=Hadian |first3=Javad |title=A review on the production of Withania somnifera (Ashwagandha) active principles: Methods and current status |journal=Journal of Medicinal Plants Research |volume=8 |issue=37 |pages=882–900 |doi=10.5897/JMPR2014.5629 |year=2014}}&lt;/ref&gt;<br /> <br /> ==Pharmacognosy==<br /> <br /> Key phytoconstituents include withanolides (e.g., withaferin A, withanolide D), sitoindosides, withanosides, alkaloids (withanine, somniferine), and steroidal lactones. Roots contain highest concentrations (1.5–5% withanolides).&lt;ref&gt;{{cite journal |last1=Kaushik |first1=M.K. |last2=Kaushik |first2=V.K. |last3=Kumar |first3=A. |title=Withania somnifera (L.) Dunal (Ashwagandha): A comprehensive review on ethnopharmacology, pharmacotherapeutics, biomarkers, and pharmacokinetics |journal=Journal of Ethnopharmacology |volume=267 |pages=113451 |doi=10.1016/j.jep.2020.113451 |pmid=33157267 |year=2021}}&lt;/ref&gt;<br /> <br /> ==Clinical Uses==<br /> <br /> ===Reference in Charak Samhita and its actions ===<br /> {| class=&quot;wikitable&quot;<br /> |+<br /> Herbs and their activities<br /> |'''Sr.no.'''<br /> |'''Reference in Charak Samhita'''<br /> |'''Activity'''<br /> |-<br /> |1<br /> |Cha. Sa. Sutra sthana 4/9(2)<br /> |Brumhaniya mahakashaya<br /> |-<br /> |2<br /> |Cha. Sa. Sutra sthana 4/9(7)<br /> |Balya mahakashaya<br /> |-<br /> |3<br /> |Cha. Sa. Vimana Sthana 8/136<br /> |Virechana Dravyani<br /> |-<br /> |4<br /> |Cha. Sa. Vimana Sthana 8/139<br /> |Madhur skandha<br /> |-<br /> |5<br /> |Cha. Sa. Chikitsa Sthana 2/1/34<br /> |Ingredient in Vajikarana Ghrita<br /> |-<br /> |6<br /> |Cha. Sa. Chikitsa Sthana 13/109<br /> |In the treatment of Udara roga (for lepa)<br /> |-<br /> |7<br /> |Cha. Sa. Chikitsa Sthana 14/50<br /> |Dhupan yoga in arsha roga<br /> |-<br /> |8<br /> |Cha. Sa. Chikitsa Sthana 17/117<br /> |Kshara mixed with madhuk ghrit is used in hikka shwasa<br /> |-<br /> |9<br /> |Cha.Sa.Chikitsa Sthana 18/75<br /> |As an ingredient of Dhumapana yoga<br /> |-<br /> |10<br /> |Cha.Sa.Chikitsa Sthana 21/123<br /> |For pradeha prayoga in granthi visarpa<br /> |-<br /> |11<br /> |Cha.Sa.Chikitsa Sthana 23/70<br /> |As an ingredient of Gandha hasti agada<br /> |-<br /> |12<br /> |Cha.Sa.Chikitsa Sthana 23/80<br /> |As an ingredient of Maha -Gandha hasti agada.<br /> |-<br /> |13<br /> |Cha.Sa.Chikitsa Sthana 23/244<br /> |As an ingredient of Amruta ghrita<br /> |-<br /> |14<br /> |Ca.Sa. Chikitsa Sthana 27/43<br /> |As an ingredient of Kushthadi Taila<br /> |-<br /> |15<br /> |Ca.Sa. Chikitsa Sthana 22/50<br /> |As an ingredient of Utsadana Yoga<br /> |-<br /> |16<br /> |Cha.Sa.Chikitsa Sthana 28/166<br /> |As an ingredient of Ashwagandha Taila paka<br /> |-<br /> |17<br /> |Cha.Sa.Chikitsa Sthana 28/170 <br /> |As an ingredient of Vrushamuladi taila<br /> |-<br /> |18<br /> |Cha.Sa.Chikitsa Sthana 28/173<br /> |As an ingredient of Mulaka taila<br /> |-<br /> |19<br /> |Cha.Sa.Chikitsa Sthana 29/73<br /> |As an ingredient of Jeevakadi mahasneha<br /> |-<br /> |20<br /> |Cha.Sa.Chikitsa Sthana 30/260<br /> |As a paniya yoga, in the treatment of Stanya dosha<br /> |}<br /> <br /> === Bhavaprakasha ===<br /> <br /> * Pacifies [[Vata]]-[[Kapha]] dosha<br /> * Alleviates Shwitra (vitiligo)<br /> * Shotha (oedema)<br /> * Kshaya (depletion of tissues)<br /> * Balya (promotes strength)<br /> * Rasayani (rejuvenating)<br /> * Atishukrala (increases semen and sperm count)<br /> <br /> ===Neurological===<br /> Reduces stress and cortisol levels (300–600 mg root extract daily); improves sleep quality and cognitive function in trials.&lt;ref&gt;{{cite journal |last1=Chandrasekhar |first1=K. |last2=Kapoor |first2=J. |last3=Anishetty |first3=S. |title=A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults |journal=Indian Journal of Psychological Medicine |volume=34 |issue=3 |pages=255–262 |doi=10.4103/0253-7176.106022 |pmc=3573577 |pmid=23439798 |year=2012}}&lt;/ref&gt;<br /> <br /> ===Reproductive===<br /> Enhances testosterone, semen quality, and libido in men (675 mg root powder daily).&lt;ref&gt;{{cite journal |last1=Ambiye |first1=V.R. |last2=Langade |first2=D. |last3=Dongre |first3=S. |last4=Apte |first4=S. |last5=Joshi |first5=K. |title=Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: a pilot study |journal=Evidence-Based Complementary and Alternative Medicine |volume=2013 |pages=571420 |doi=10.1155/2013/571420 |pmc=3863556 |pmid=24284701 |year=2013}}&lt;/ref&gt;<br /> <br /> ===Musculoskeletal===<br /> Increases muscle mass and strength (500 mg extract with resistance training).&lt;ref&gt;{{cite journal |last1=Wankhede |first1=S. |last2=Langade |first2=D. |last3=Joshi |first3=K. |last4=Thakurdesai |first4=P.A. |title=Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial |journal=Journal of the International Society of Sports Nutrition |volume=12 |pages=23 |doi=10.1186/s12970-015-0104-9 |pmc=4658772 |pmid=26009251 |year=2015}}&lt;/ref&gt;<br /> <br /> ==Formulations and Dosage==<br /> <br /> Common preparations:<br /> {| class=&quot;wikitable&quot;<br /> !Formulation||Dose||Anupana (vehicle)<br /> |-<br /> |Churna (powder)||3–6 g BID||Warm milk/ghee<br /> |-<br /> |Ghrita||5–10 g/day||As prescribed<br /> |-<br /> |Extract capsules||300–600 mg/day||Water<br /> |}<br /> <br /> ==Safety==<br /> Generally safe (GRAS status); rare GI upset, drowsiness. Contraindicated in hyperthyroidism, pregnancy (uterine stimulant), and nightshade allergy. LD&lt;sub&gt;50&lt;/sub&gt; &gt;2 g/kg in rodents.&lt;ref&gt;{{cite web |title=Withania somnifera (Ashwagandha) Monograph |url=https://www.herbrally.com/monographs/ashwagandha |publisher=HerbRally |access-date=2026-03-16}}&lt;/ref&gt;<br /> <br /> ==Research==<br /> <br /> Over 100 clinical trials support adaptogenic effects; NIH-funded studies are ongoing for anxiety and sleep disorders. Withanolides modulate HPA axis, GABA receptors, and inflammation pathways (NF-κB inhibition).&lt;ref name=&quot;:1&quot;&gt;{{cite journal |last1=Speers |first1=A.B. |last2=Cabey |first2=K.A. |last3=Souza |first3=M.J. |last4=Spencer |first4=E.A. |title=Effects of Withania somnifera (Ashwagandha) on stress and the stress-related neuropsychiatric disorders anxiety, depression, and insomnia |journal=Current Neuropharmacology |volume=20 |issue=7 |pages=1–17 |doi=10.2174/1570159X19666210813150419 |year=2021}}&lt;/ref&gt;<br /> <br /> ==Current availability ==<br /> <br /> Available<br /> <br /> == External links ==<br /> <br /> [https://en.wikipedia.org/wiki/Withania_somnifera Withania Somnifera] <br /> <br /> [https://cb.imsc.res.in/imppat/phytochemical/Withania%20somnifera IMPPAT Database link]<br /> <br /> ==References==<br /> {{reflist}}<br /> <br /> [[Category: Database of herbs and minerals | Herbs]]<br /> <br /> This article is under development ..</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Ashwagandha&diff=45414 2026-03-16T06:58:33Z

<p>Agnivesha: </p> <hr /> <div>{{#seo:<br /> |title=Charak Samhita<br /> |titlemode=append<br /> |keywords=Ashwagandha, Ashvagandha, Withania Somnifera, Indian ginseng, winter cherry, Charak Samhita, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, ancient Ayurveda text, Indian system of medicine, Ayurveda, Charak, Charaka Samhita, agnivesha, atreya, gopal basisht, yogesh deole, charak samhita wikipedia edition, charak samhita new edition, charaka samhita new edition, carak samhita new edition, caraka samhita new edition, research on charak samhita, text book charak samhita, fundamental principles of ayurveda, basic concepts of ayurveda,<br /> |description='''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> '''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.&lt;ref&gt;{{cite journal |last1=Singh |first1=Narendra |last2=Bhalla |first2=M. |last3=de Jager |first3=P. |last4=Gilca |first4=M. |title=Rational use of Ashwagandha in Ayurveda (Traditional Indian Medicine) – A systematic analysis of the scientific evidence for its pharmacological activities |journal=Journal of Ethnopharmacology |volume=273 |pages=113907 |doi=10.1016/j.jep.2021.113907 |pmc=PMC8274455 |pmid=33831467 |year=2021}}&lt;/ref&gt;&lt;ref&gt;{{cite journal |last1=Mishra |first1=Laxmi C. |last2=Singh |first2=Betilda B. |last3=Dagenais |first3=Simon |title=Scientific basis for the therapeutic use of Withania somnifera (Ashwagandha): a review |journal=Alternative Medicine Review |volume=14 |issue=5 |pages=348–357 |pmid=19803596 |year=2000}}&lt;/ref&gt;<br /> <br /> {{Infobox<br /> |title = Ashwagandha<br /> |label1 = Section/Chapter<br /> |data1 = Herb database/Ashwagandha<br /> |label2 = Botanical name(s)<br /> |data2 = Withania somnifera (Linn.)<br /> |label3 = Family<br /> |data3 = Solanaceae<br /> |label3 = Contributors<br /> |data3 = Dr.Yogesh S. Deole<br /> |label4 = Year of publication <br /> |data4 = 2026<br /> |label5 = Publisher <br /> |data5 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label6 = DOI <br /> |data6 = Awaited<br /> }}<br /> ==English name==<br /> '''Indian ginseng''' or '''winter cherry'''<br /> <br /> ==Synonyms ==<br /> <br /> Ashwagandha, Wajigandha, Varahakarni<br /> <br /> == Ayurvedic pharmacological properties ==<br /> <br /> * '''Rasa''' (taste): Madhura (sweet), tikta (bitter)<br /> * '''Guna''' (properties): Snigdha (unctuous), guru (heavy to digest)<br /> * '''Virya''' (potency): Ushna (hot)<br /> * '''Vipaka''' (post-digestive effect): Madhura<br /> * '''Dosha Effect''': Primarily balances [[Vata dosha|vata]], secondarily kapha; aggravates pitta in excess.<br /> * '''Classical Actions''': Medhya (intellect promoter), balya (strength), vajikarana (aphrodisiac), rasayana (rejuvenative).&lt;ref name=&quot;:0&quot;&gt;{{cite book |last1=Sharma |first1=P.V.|title=Charaka Samhita |publisher=Chaukhamba Orientalia |location=Varanasi |year=2014 |isbn=978-8176371432}}&lt;/ref&gt;<br /> <br /> ==Description==<br /> <br /> A perennial shrub from the [[Solanaceae]] family, native to India, the Middle East, and Africa. It grows 35–75 cm tall with oval leaves, small greenish-yellow flowers, and red-orange berry-like fruits. The name &quot;Ashwagandha&quot; derives from Sanskrit ''ashva'' (horse) and ''gandha'' (smell), referring to the root's horse-like odor and vigor-promoting effects.&lt;ref&gt;{{cite journal |last1=Mirjalili |first1=Mohammad Hossein |last2=Moharramipour |first2=Saman |last3=Hadian |first3=Javad |title=A review on the production of Withania somnifera (Ashwagandha) active principles: Methods and current status |journal=Journal of Medicinal Plants Research |volume=8 |issue=37 |pages=882–900 |doi=10.5897/JMPR2014.5629 |year=2014}}&lt;/ref&gt;<br /> <br /> ==Pharmacognosy==<br /> <br /> Key phytoconstituents include withanolides (e.g., withaferin A, withanolide D), sitoindosides, withanosides, alkaloids (withanine, somniferine), and steroidal lactones. Roots contain highest concentrations (1.5–5% withanolides).&lt;ref&gt;{{cite journal |last1=Kaushik |first1=M.K. |last2=Kaushik |first2=V.K. |last3=Kumar |first3=A. |title=Withania somnifera (L.) Dunal (Ashwagandha): A comprehensive review on ethnopharmacology, pharmacotherapeutics, biomarkers, and pharmacokinetics |journal=Journal of Ethnopharmacology |volume=267 |pages=113451 |doi=10.1016/j.jep.2020.113451 |pmid=33157267 |year=2021}}&lt;/ref&gt;<br /> <br /> ==Clinical Uses==<br /> <br /> ==Reference in Charak Samhita and its actions ==<br /> {| class=&quot;wikitable&quot;<br /> |+<br /> Herbs and their activities<br /> |'''Sr.no.'''<br /> |'''Reference in Charak Samhita'''<br /> |'''Activity'''<br /> |-<br /> |1<br /> |Cha. Sa. Sutra sthana 4/9(2)<br /> |Brumhaniya mahakashaya<br /> |-<br /> |2<br /> |Cha. Sa. Sutra sthana 4/9(7)<br /> |Balya mahakashaya<br /> |-<br /> |3<br /> |Cha. Sa. Vimana Sthana 8/136<br /> |Virechana Dravyani<br /> |-<br /> |4<br /> |Cha. Sa. Vimana Sthana 8/139<br /> |Madhur skandha<br /> |-<br /> |5<br /> |Cha. Sa. Chikitsa Sthana 2/1/34<br /> |Ingredient in Vajikarana Ghrita<br /> |-<br /> |6<br /> |Cha. Sa. Chikitsa Sthana 13/109<br /> |In the treatment of Udara roga (for lepa)<br /> |-<br /> |7<br /> |Cha. Sa. Chikitsa Sthana 14/50<br /> |Dhupan yoga in arsha roga<br /> |-<br /> |8<br /> |Cha. Sa. Chikitsa Sthana 17/117<br /> |Kshara mixed with madhuk ghrit is used in hikka shwasa<br /> |-<br /> |9<br /> |Cha.Sa.Chikitsa Sthana 18/75<br /> |As an ingredient of Dhumapana yoga<br /> |-<br /> |10<br /> |Cha.Sa.Chikitsa Sthana 21/123<br /> |For pradeha prayoga in granthi visarpa<br /> |-<br /> |11<br /> |Cha.Sa.Chikitsa Sthana 23/70<br /> |As an ingredient of Gandha hasti agada<br /> |-<br /> |12<br /> |Cha.Sa.Chikitsa Sthana 23/80<br /> |As an ingredient of Maha -Gandha hasti agada.<br /> |-<br /> |13<br /> |Cha.Sa.Chikitsa Sthana 23/244<br /> |As an ingredient of Amruta ghrita<br /> |-<br /> |14<br /> |Ca.Sa. Chikitsa Sthana 27/43<br /> |As an ingredient of Kushthadi Taila<br /> |-<br /> |15<br /> |Ca.Sa. Chikitsa Sthana 22/50<br /> |As an ingredient of Utsadana Yoga<br /> |-<br /> |16<br /> |Cha.Sa.Chikitsa Sthana 28/166<br /> |As an ingredient of Ashwagandha Taila paka<br /> |-<br /> |17<br /> |Cha.Sa.Chikitsa Sthana 28/170 <br /> |As an ingredient of Vrushamuladi taila<br /> |-<br /> |18<br /> |Cha.Sa.Chikitsa Sthana 28/173<br /> |As an ingredient of Mulaka taila<br /> |-<br /> |19<br /> |Cha.Sa.Chikitsa Sthana 29/73<br /> |As an ingredient of Jeevakadi mahasneha<br /> |-<br /> |20<br /> |Cha.Sa.Chikitsa Sthana 30/260<br /> |As a paniya yoga, in the treatment of Stanya dosha<br /> |}<br /> <br /> === Bhavaprakasha ===<br /> <br /> * Pacifies [[Vata]]-[[Kapha]] dosha<br /> * Alleviates Shwitra (vitiligo)<br /> * Shotha (oedema)<br /> * Kshaya (depletion of tissues)<br /> * Balya (promotes strength)<br /> * Rasayani (rejuvenating)<br /> * Atishukrala (increases semen and sperm count)<br /> <br /> ===Neurological===<br /> Reduces stress and cortisol levels (300–600 mg root extract daily); improves sleep quality and cognitive function in trials.&lt;ref&gt;{{cite journal |last1=Chandrasekhar |first1=K. |last2=Kapoor |first2=J. |last3=Anishetty |first3=S. |title=A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults |journal=Indian Journal of Psychological Medicine |volume=34 |issue=3 |pages=255–262 |doi=10.4103/0253-7176.106022 |pmc=3573577 |pmid=23439798 |year=2012}}&lt;/ref&gt;<br /> <br /> ===Reproductive===<br /> Enhances testosterone, semen quality, and libido in men (675 mg root powder daily).&lt;ref&gt;{{cite journal |last1=Ambiye |first1=V.R. |last2=Langade |first2=D. |last3=Dongre |first3=S. |last4=Apte |first4=S. |last5=Joshi |first5=K. |title=Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: a pilot study |journal=Evidence-Based Complementary and Alternative Medicine |volume=2013 |pages=571420 |doi=10.1155/2013/571420 |pmc=3863556 |pmid=24284701 |year=2013}}&lt;/ref&gt;<br /> <br /> ===Musculoskeletal===<br /> Increases muscle mass and strength (500 mg extract with resistance training).&lt;ref&gt;{{cite journal |last1=Wankhede |first1=S. |last2=Langade |first2=D. |last3=Joshi |first3=K. |last4=Thakurdesai |first4=P.A. |title=Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial |journal=Journal of the International Society of Sports Nutrition |volume=12 |pages=23 |doi=10.1186/s12970-015-0104-9 |pmc=4658772 |pmid=26009251 |year=2015}}&lt;/ref&gt;<br /> <br /> ==Formulations and Dosage==<br /> <br /> Common preparations:<br /> {| class=&quot;wikitable&quot;<br /> !Formulation||Dose||Anupana (vehicle)<br /> |-<br /> |Churna (powder)||3–6 g BID||Warm milk/ghee<br /> |-<br /> |Ghrita||5–10 g/day||As prescribed<br /> |-<br /> |Extract capsules||300–600 mg/day||Water<br /> |}<br /> <br /> ==Safety==<br /> Generally safe (GRAS status); rare GI upset, drowsiness. Contraindicated in hyperthyroidism, pregnancy (uterine stimulant), and nightshade allergy. LD&lt;sub&gt;50&lt;/sub&gt; &gt;2 g/kg in rodents.&lt;ref&gt;{{cite web |title=Withania somnifera (Ashwagandha) Monograph |url=https://www.herbrally.com/monographs/ashwagandha |publisher=HerbRally |access-date=2026-03-16}}&lt;/ref&gt;<br /> <br /> ==Research==<br /> <br /> Over 100 clinical trials support adaptogenic effects; NIH-funded studies are ongoing for anxiety and sleep disorders. Withanolides modulate HPA axis, GABA receptors, and inflammation pathways (NF-κB inhibition).&lt;ref name=&quot;:1&quot;&gt;{{cite journal |last1=Speers |first1=A.B. |last2=Cabey |first2=K.A. |last3=Souza |first3=M.J. |last4=Spencer |first4=E.A. |title=Effects of Withania somnifera (Ashwagandha) on stress and the stress-related neuropsychiatric disorders anxiety, depression, and insomnia |journal=Current Neuropharmacology |volume=20 |issue=7 |pages=1–17 |doi=10.2174/1570159X19666210813150419 |year=2021}}&lt;/ref&gt;<br /> <br /> ==Current availability ==<br /> <br /> Available<br /> <br /> == Exzternal links ==<br /> <br /> [https://en.wikipedia.org/wiki/Withania_somnifera Withania Somnifera] <br /> <br /> [https://cb.imsc.res.in/imppat/phytochemical/Withania%20somnifera IMPPAT Database link]<br /> <br /> ==References==<br /> {{reflist}}<br /> <br /> [[Category: Database of herbs and minerals | Herbs]]<br /> [[Category:Ayurvedic medicines]]<br /> [[Category:Adaptogens]]<br /> [[Category:Withania]]<br /> [[Category:Medicinal plants of Asia]]<br /> <br /> This article is under development ..</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Ashwagandha&diff=45413 2026-03-16T06:47:56Z

<p>Agnivesha: </p> <hr /> <div>'''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.&lt;ref&gt;{{cite journal |last1=Singh |first1=Narendra |last2=Bhalla |first2=M. |last3=de Jager |first3=P. |last4=Gilca |first4=M. |title=Rational use of Ashwagandha in Ayurveda (Traditional Indian Medicine) – A systematic analysis of the scientific evidence for its pharmacological activities |journal=Journal of Ethnopharmacology |volume=273 |pages=113907 |doi=10.1016/j.jep.2021.113907 |pmc=PMC8274455 |pmid=33831467 |year=2021}}&lt;/ref&gt;&lt;ref&gt;{{cite journal |last1=Mishra |first1=Laxmi C. |last2=Singh |first2=Betilda B. |last3=Dagenais |first3=Simon |title=Scientific basis for the therapeutic use of Withania somnifera (Ashwagandha): a review |journal=Alternative Medicine Review |volume=14 |issue=5 |pages=348–357 |pmid=19803596 |year=2000}}&lt;/ref&gt;<br /> <br /> {{Infobox<br /> |title = Ashwagandha<br /> |label1 = Section/Chapter<br /> |data1 = Herb database/Ashwagandha<br /> |label2 = Botanical name(s)<br /> |data2 = Withania somnifera (Linn.)<br /> |label3 = Family<br /> |data3 = Solanaceae<br /> |label3 = Contributors<br /> |data3 = Dr.Yogesh S. Deole<br /> |label4 = Year of publication <br /> |data4 = 2026<br /> |label5 = Publisher <br /> |data5 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label6 = DOI <br /> |data6 = Awaited<br /> }}<br /> ==English name==<br /> '''Indian ginseng''' or '''winter cherry'''<br /> <br /> ==Synonyms ==<br /> <br /> Ashwagandha, Wajigandha, Varahakarni<br /> <br /> == Ayurvedic pharmacological properties ==<br /> <br /> * '''Rasa''' (taste): Madhura (sweet), tikta (bitter)<br /> * '''Guna''' (properties): Snigdha (unctuous), guru (heavy to digest)<br /> * '''Virya''' (potency): Ushna (hot)<br /> * '''Vipaka''' (post-digestive effect): Madhura<br /> * '''Dosha Effect''': Primarily balances [[Vata dosha|vata]], secondarily kapha; aggravates pitta in excess.<br /> * '''Classical Actions''': Medhya (intellect promoter), balya (strength), vajikarana (aphrodisiac), rasayana (rejuvenative).&lt;ref name=&quot;:0&quot;&gt;{{cite book |last1=Sharma |first1=P.V.|title=Charaka Samhita |publisher=Chaukhamba Orientalia |location=Varanasi |year=2014 |isbn=978-8176371432}}&lt;/ref&gt;<br /> <br /> ==Description==<br /> <br /> A perennial shrub from the [[Solanaceae]] family, native to India, the Middle East, and Africa. It grows 35–75 cm tall with oval leaves, small greenish-yellow flowers, and red-orange berry-like fruits. The name &quot;Ashwagandha&quot; derives from Sanskrit ''ashva'' (horse) and ''gandha'' (smell), referring to the root's horse-like odor and vigor-promoting effects.&lt;ref&gt;{{cite journal |last1=Mirjalili |first1=Mohammad Hossein |last2=Moharramipour |first2=Saman |last3=Hadian |first3=Javad |title=A review on the production of Withania somnifera (Ashwagandha) active principles: Methods and current status |journal=Journal of Medicinal Plants Research |volume=8 |issue=37 |pages=882–900 |doi=10.5897/JMPR2014.5629 |year=2014}}&lt;/ref&gt;<br /> <br /> ==Pharmacognosy==<br /> <br /> Key phytoconstituents include withanolides (e.g., withaferin A, withanolide D), sitoindosides, withanosides, alkaloids (withanine, somniferine), and steroidal lactones. Roots contain highest concentrations (1.5–5% withanolides).&lt;ref&gt;{{cite journal |last1=Kaushik |first1=M.K. |last2=Kaushik |first2=V.K. |last3=Kumar |first3=A. |title=Withania somnifera (L.) Dunal (Ashwagandha): A comprehensive review on ethnopharmacology, pharmacotherapeutics, biomarkers, and pharmacokinetics |journal=Journal of Ethnopharmacology |volume=267 |pages=113451 |doi=10.1016/j.jep.2020.113451 |pmid=33157267 |year=2021}}&lt;/ref&gt;<br /> <br /> ==Clinical Uses==<br /> <br /> ==Reference in Charak Samhita and its actions ==<br /> {| class=&quot;wikitable&quot;<br /> |+<br /> Herbs and their activities<br /> |'''Sr.no.'''<br /> |'''Reference in Charak Samhita'''<br /> |'''Activity'''<br /> |-<br /> |1<br /> |Cha. Sa. Sutra sthana 4/9(2)<br /> |Brumhaniya mahakashaya<br /> |-<br /> |2<br /> |Cha. Sa. Sutra sthana 4/9(7)<br /> |Balya mahakashaya<br /> |-<br /> |3<br /> |Cha. Sa. Vimana Sthana 8/136<br /> |Virechana Dravyani<br /> |-<br /> |4<br /> |Cha. Sa. Vimana Sthana 8/139<br /> |Madhur skandha<br /> |-<br /> |5<br /> |Cha. Sa. Chikitsa Sthana 2/1/34<br /> |Ingredient in Vajikarana Ghrita<br /> |-<br /> |6<br /> |Cha. Sa. Chikitsa Sthana 13/109<br /> |In the treatment of Udara roga (for lepa)<br /> |-<br /> |7<br /> |Cha. Sa. Chikitsa Sthana 14/50<br /> |Dhupan yoga in arsha roga<br /> |-<br /> |8<br /> |Cha. Sa. Chikitsa Sthana 17/117<br /> |Kshara mixed with madhuk ghrit is used in hikka shwasa<br /> |-<br /> |9<br /> |Cha.Sa.Chikitsa Sthana 18/75<br /> |As an ingredient of Dhumapana yoga<br /> |-<br /> |10<br /> |Cha.Sa.Chikitsa Sthana 21/123<br /> |For pradeha prayoga in granthi visarpa<br /> |-<br /> |11<br /> |Cha.Sa.Chikitsa Sthana 23/70<br /> |As an ingredient of Gandha hasti agada<br /> |-<br /> |12<br /> |Cha.Sa.Chikitsa Sthana 23/80<br /> |As an ingredient of Maha -Gandha hasti agada.<br /> |-<br /> |13<br /> |Cha.Sa.Chikitsa Sthana 23/244<br /> |As an ingredient of Amruta ghrita<br /> |-<br /> |14<br /> |Ca.Sa. Chikitsa Sthana 27/43<br /> |As an ingredient of Kushthadi Taila<br /> |-<br /> |15<br /> |Ca.Sa. Chikitsa Sthana 22/50<br /> |As an ingredient of Utsadana Yoga<br /> |-<br /> |16<br /> |Cha.Sa.Chikitsa Sthana 28/166<br /> |As an ingredient of Ashwagandha Taila paka<br /> |-<br /> |17<br /> |Cha.Sa.Chikitsa Sthana 28/170 <br /> |As an ingredient of Vrushamuladi taila<br /> |-<br /> |18<br /> |Cha.Sa.Chikitsa Sthana 28/173<br /> |As an ingredient of Mulaka taila<br /> |-<br /> |19<br /> |Cha.Sa.Chikitsa Sthana 29/73<br /> |As an ingredient of Jeevakadi mahasneha<br /> |-<br /> |20<br /> |Cha.Sa.Chikitsa Sthana 30/260<br /> |As a paniya yoga, in the treatment of Stanya dosha<br /> |}<br /> <br /> ===Neurological===<br /> Reduces stress and cortisol levels (300–600 mg root extract daily); improves sleep quality and cognitive function in trials.&lt;ref&gt;{{cite journal |last1=Chandrasekhar |first1=K. |last2=Kapoor |first2=J. |last3=Anishetty |first3=S. |title=A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults |journal=Indian Journal of Psychological Medicine |volume=34 |issue=3 |pages=255–262 |doi=10.4103/0253-7176.106022 |pmc=3573577 |pmid=23439798 |year=2012}}&lt;/ref&gt;<br /> <br /> ===Reproductive===<br /> Enhances testosterone, semen quality, and libido in men (675 mg root powder daily).&lt;ref&gt;{{cite journal |last1=Ambiye |first1=V.R. |last2=Langade |first2=D. |last3=Dongre |first3=S. |last4=Apte |first4=S. |last5=Joshi |first5=K. |title=Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: a pilot study |journal=Evidence-Based Complementary and Alternative Medicine |volume=2013 |pages=571420 |doi=10.1155/2013/571420 |pmc=3863556 |pmid=24284701 |year=2013}}&lt;/ref&gt;<br /> <br /> ===Musculoskeletal===<br /> Increases muscle mass and strength (500 mg extract with resistance training).&lt;ref&gt;{{cite journal |last1=Wankhede |first1=S. |last2=Langade |first2=D. |last3=Joshi |first3=K. |last4=Thakurdesai |first4=P.A. |title=Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial |journal=Journal of the International Society of Sports Nutrition |volume=12 |pages=23 |doi=10.1186/s12970-015-0104-9 |pmc=4658772 |pmid=26009251 |year=2015}}&lt;/ref&gt;<br /> <br /> ==Formulations and Dosage==<br /> <br /> Common preparations:<br /> {| class=&quot;wikitable&quot;<br /> !Formulation||Dose||Anupana (vehicle)<br /> |-<br /> |Churna (powder)||3–6 g BID||Warm milk/ghee<br /> |-<br /> |Ghrita||5–10 g/day||As prescribed<br /> |-<br /> |Extract capsules||300–600 mg/day||Water<br /> |}<br /> <br /> ==Safety==<br /> Generally safe (GRAS status); rare GI upset, drowsiness. Contraindicated in hyperthyroidism, pregnancy (uterine stimulant), and nightshade allergy. LD&lt;sub&gt;50&lt;/sub&gt; &gt;2 g/kg in rodents.&lt;ref&gt;{{cite web |title=Withania somnifera (Ashwagandha) Monograph |url=https://www.herbrally.com/monographs/ashwagandha |publisher=HerbRally |access-date=2026-03-16}}&lt;/ref&gt;<br /> <br /> ==Research==<br /> <br /> Over 100 clinical trials support adaptogenic effects; NIH-funded studies are ongoing for anxiety and sleep disorders. Withanolides modulate HPA axis, GABA receptors, and inflammation pathways (NF-κB inhibition).&lt;ref name=&quot;:1&quot;&gt;{{cite journal |last1=Speers |first1=A.B. |last2=Cabey |first2=K.A. |last3=Souza |first3=M.J. |last4=Spencer |first4=E.A. |title=Effects of Withania somnifera (Ashwagandha) on stress and the stress-related neuropsychiatric disorders anxiety, depression, and insomnia |journal=Current Neuropharmacology |volume=20 |issue=7 |pages=1–17 |doi=10.2174/1570159X19666210813150419 |year=2021}}&lt;/ref&gt;<br /> <br /> ==Current availability ==<br /> <br /> Available<br /> <br /> == Exzternal links ==<br /> <br /> [https://en.wikipedia.org/wiki/Withania_somnifera Withania Somnifera] <br /> <br /> ==References==<br /> {{reflist}}<br /> <br /> [[Category: Database of herbs and minerals | Herbs]]<br /> [[Category:Ayurvedic medicines]]<br /> [[Category:Adaptogens]]<br /> [[Category:Withania]]<br /> [[Category:Medicinal plants of Asia]]<br /> <br /> This article is under development ..</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Ashwagandha&diff=45412 2026-03-16T06:15:03Z

<p>Agnivesha: </p> <hr /> <div>'''Ashwagandha''' ({{lang-sa|अश्वगंधा}} ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.&lt;ref&gt;{{cite journal |last1=Singh |first1=Narendra |last2=Bhalla |first2=M. |last3=de Jager |first3=P. |last4=Gilca |first4=M. |title=Rational use of Ashwagandha in Ayurveda (Traditional Indian Medicine) – A systematic analysis of the scientific evidence for its pharmacological activities |journal=Journal of Ethnopharmacology |volume=273 |pages=113907 |doi=10.1016/j.jep.2021.113907 |pmc=PMC8274455 |pmid=33831467 |year=2021}}&lt;/ref&gt;&lt;ref&gt;{{cite journal |last1=Mishra |first1=Laxmi C. |last2=Singh |first2=Betilda B. |last3=Dagenais |first3=Simon |title=Scientific basis for the therapeutic use of Withania somnifera (Ashwagandha): a review |journal=Alternative Medicine Review |volume=14 |issue=5 |pages=348–357 |pmid=19803596 |year=2000}}&lt;/ref&gt;<br /> <br /> {{Infobox<br /> |title = Ashwagandha<br /> |label1 = Section/Chapter<br /> |data1 = Herb database/Ashwagandha<br /> |label2 = Botanical name(s)<br /> |data2 = Withania somnifera<br /> |label3 = Contributors<br /> |data3 = --<br /> |label4 = Year of publication <br /> |data4 = 2023<br /> |label5 = Publisher <br /> |data5 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label6 = DOI <br /> |data6 = Awaited<br /> }}<br /> ==English name==<br /> --<br /> <br /> ==Synonyms in Charak Samhita==<br /> Ashwagandha<br /> <br /> <br /> == Ayurvedic pharmacological properties ==<br /> <br /> * '''Rasa''' (taste): Madhura (sweet), tikta (bitter)<br /> * '''Guna''' (properties): Snigdha (unctuous), guru (heavy)<br /> * '''Virya''' (potency): Ushna (hot)<br /> * '''Vipaka''' (post-digestive effect): Madhura<br /> * '''Dosha Effect''': Primarily balances [[Vata dosha|vata]], secondarily kapha; aggravates pitta in excess.<br /> * '''Classical Actions''': Medhya (intellect promoter), balya (strength), vajikarana (aphrodisiac), rasayana (rejuvenative).&lt;ref name=&quot;:0&quot;&gt;{{cite book |last1=Sharma |first1=P.V. |title=Charaka Samhita |publisher=Chaukhamba Orientalia |location=Varanasi |year=2014 |isbn=978-8176371432}}&lt;/ref&gt;<br /> <br /> ==Description==<br /> <br /> A perennial shrub from the [[Solanaceae]] family, native to India, the Middle East, and Africa. It grows 35–75 cm tall with oval leaves, small greenish-yellow flowers, and red-orange berry-like fruits. The name &quot;Ashwagandha&quot; derives from Sanskrit ''ashva'' (horse) and ''gandha'' (smell), referring to the root's horse-like odor and vigor-promoting effects.&lt;ref&gt;{{cite journal |last1=Mirjalili |first1=Mohammad Hossein |last2=Moharramipour |first2=Saman |last3=Hadian |first3=Javad |title=A review on the production of Withania somnifera (Ashwagandha) active principles: Methods and current status |journal=Journal of Medicinal Plants Research |volume=8 |issue=37 |pages=882–900 |doi=10.5897/JMPR2014.5629 |year=2014}}&lt;/ref&gt;<br /> <br /> ==Pharmacognosy==<br /> <br /> Key phytoconstituents include withanolides (e.g., withaferin A, withanolide D), sitoindosides, withanosides, alkaloids (withanine, somniferine), and steroidal lactones. Roots contain highest concentrations (1.5–5% withanolides).&lt;ref&gt;{{cite journal |last1=Kaushik |first1=M.K. |last2=Kaushik |first2=V.K. |last3=Kumar |first3=A. |title=Withania somnifera (L.) Dunal (Ashwagandha): A comprehensive review on ethnopharmacology, pharmacotherapeutics, biomarkers, and pharmacokinetics |journal=Journal of Ethnopharmacology |volume=267 |pages=113451 |doi=10.1016/j.jep.2020.113451 |pmid=33157267 |year=2021}}&lt;/ref&gt;<br /> <br /> ==Clinical Uses==<br /> <br /> ==Reference in Charak Samhita and its actions ==<br /> {| class=&quot;wikitable&quot;<br /> |+<br /> Herbs and their activities<br /> |'''Sr.no.'''<br /> |'''Reference in Charak Samhita'''<br /> |'''Activity'''<br /> |-<br /> |1<br /> |Cha. Sa. Sutra sthana 4/9(2)<br /> |Brumhaniya mahakashaya<br /> |-<br /> |2<br /> |Cha. Sa. Sutra sthana 4/9(7)<br /> |Balya mahakashaya<br /> |-<br /> |3<br /> |Cha. Sa. Vimana Sthana 8/136<br /> |Virechana Dravyani<br /> |-<br /> |4<br /> |Cha. Sa. Vimana Sthana 8/139<br /> |Madhur skandha<br /> |-<br /> |5<br /> |Cha. Sa. Chikitsa Sthana 2/1/34<br /> |Ingredient in Vajikarana Ghrita<br /> |-<br /> |6<br /> |Cha. Sa. Chikitsa Sthana 13/109<br /> |In the treatment of Udara roga (for lepa)<br /> |-<br /> |7<br /> |Cha. Sa. Chikitsa Sthana 14/50<br /> |Dhupan yoga in arsha roga<br /> |-<br /> |8<br /> |Cha. Sa. Chikitsa Sthana 17/117<br /> |Kshara mixed with madhuk ghrit is used in hikka shwasa<br /> |-<br /> |9<br /> |Cha.Sa.Chikitsa Sthana 18/75<br /> |As an ingredient of Dhumapana yoga<br /> |-<br /> |10<br /> |Cha.Sa.Chikitsa Sthana 21/123<br /> |For pradeha prayoga in granthi visarpa<br /> |-<br /> |11<br /> |Cha.Sa.Chikitsa Sthana 23/70<br /> |As an ingredient of Gandha hasti agada<br /> |-<br /> |12<br /> |Cha.Sa.Chikitsa Sthana 23/80<br /> |As an ingredient of Maha -Gandha hasti agada.<br /> |-<br /> |13<br /> |Cha.Sa.Chikitsa Sthana 23/244<br /> |As an ingredient of Amruta ghrita<br /> |-<br /> |14<br /> |Ca.Sa. Chikitsa Sthana 27/43<br /> |As an ingredient of Kushthadi Taila<br /> |-<br /> |15<br /> |Ca.Sa. Chikitsa Sthana 22/50<br /> |As an ingredient of Utsadana Yoga<br /> |-<br /> |16<br /> |Cha.Sa.Chikitsa Sthana 28/166<br /> |As an ingredient of Ashwagandha Taila paka<br /> |-<br /> |17<br /> |Cha.Sa.Chikitsa Sthana 28/170 <br /> |As an ingredient of Vrushamuladi taila<br /> |-<br /> |18<br /> |Cha.Sa.Chikitsa Sthana 28/173<br /> |As an ingredient of Mulaka taila<br /> |-<br /> |19<br /> |Cha.Sa.Chikitsa Sthana 29/73<br /> |As an ingredient of Jeevakadi mahasneha<br /> |-<br /> |20<br /> |Cha.Sa.Chikitsa Sthana 30/260<br /> |As a paniya yoga, in the treatment of Stanya dosha<br /> |}<br /> <br /> ===Neurological===<br /> Reduces stress and cortisol levels (300–600 mg root extract daily); improves sleep quality and cognitive function in trials.&lt;ref&gt;{{cite journal |last1=Chandrasekhar |first1=K. |last2=Kapoor |first2=J. |last3=Anishetty |first3=S. |title=A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults |journal=Indian Journal of Psychological Medicine |volume=34 |issue=3 |pages=255–262 |doi=10.4103/0253-7176.106022 |pmc=3573577 |pmid=23439798 |year=2012}}&lt;/ref&gt;<br /> <br /> ===Reproductive===<br /> Enhances testosterone, semen quality, and libido in men (675 mg root powder daily).&lt;ref&gt;{{cite journal |last1=Ambiye |first1=V.R. |last2=Langade |first2=D. |last3=Dongre |first3=S. |last4=Apte |first4=S. |last5=Joshi |first5=K. |title=Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: a pilot study |journal=Evidence-Based Complementary and Alternative Medicine |volume=2013 |pages=571420 |doi=10.1155/2013/571420 |pmc=3863556 |pmid=24284701 |year=2013}}&lt;/ref&gt;<br /> <br /> ===Musculoskeletal===<br /> Increases muscle mass and strength (500 mg extract with resistance training).&lt;ref&gt;{{cite journal |last1=Wankhede |first1=S. |last2=Langade |first2=D. |last3=Joshi |first3=K. |last4=Thakurdesai |first4=P.A. |title=Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial |journal=Journal of the International Society of Sports Nutrition |volume=12 |pages=23 |doi=10.1186/s12970-015-0104-9 |pmc=4658772 |pmid=26009251 |year=2015}}&lt;/ref&gt;<br /> <br /> ==Formulations and Dosage==<br /> <br /> Common preparations:<br /> {| class=&quot;wikitable&quot;<br /> !Formulation||Dose||Anupana (vehicle)<br /> |-<br /> |Churna (powder)||3–6 g BID||Warm milk/ghee<br /> |-<br /> |Ghrita||5–10 g/day||As prescribed<br /> |-<br /> |Extract capsules||300–600 mg/day||Water<br /> |}<br /> <br /> ==Safety==<br /> Generally safe (GRAS status); rare GI upset, drowsiness. Contraindicated in hyperthyroidism, pregnancy (uterine stimulant), nightshade allergy. LD&lt;sub&gt;50&lt;/sub&gt; &gt;2 g/kg in rodents.&lt;ref&gt;{{cite web |title=Withania somnifera (Ashwagandha) Monograph |url=https://www.herbrally.com/monographs/ashwagandha |publisher=HerbRally |access-date=2026-03-16}}&lt;/ref&gt;<br /> <br /> ==Research==<br /> <br /> Over 100 clinical trials support adaptogenic effects; NIH-funded studies ongoing for anxiety and sleep disorders. Withanolides modulate HPA axis, GABA receptors, and inflammation pathways (NF-κB inhibition).&lt;ref name=&quot;:1&quot;&gt;{{cite journal |last1=Speers |first1=A.B. |last2=Cabey |first2=K.A. |last3=Souza |first3=M.J. |last4=Spencer |first4=E.A. |title=Effects of Withania somnifera (Ashwagandha) on stress and the stress-related neuropsychiatric disorders anxiety, depression, and insomnia |journal=Current Neuropharmacology |volume=20 |issue=7 |pages=1–17 |doi=10.2174/1570159X19666210813150419 |year=2021}}&lt;/ref&gt;<br /> <br /> <br /> ==References==<br /> {{reflist}}<br /> <br /> [[Category:Ayurvedic medicines]]<br /> [[Category:Adaptogens]]<br /> [[Category:Withania]]<br /> [[Category:Medicinal plants of Asia]]<br /> <br /> ==Current availability ==<br /> <br /> Available<br /> <br /> ==Current researches ==<br /> [[Category: Database of herbs and minerals | Herbs]]<br /> This article is under development ..</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Vatavyadhi_Chikitsa&diff=45411 2026-02-25T04:20:53Z

<p>Agnivesha: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Vatavyadhi Chikitsa<br /> |titlemode=append<br /> |keywords=Akshepaka, Anyonyavarana, Apana, Ardita, Avabahuka, Avarana, Ayurveda, Convulsive disorders, Dhatukshaya, Facial palsy, Gatavata, General Line of treatment of Vatavyadhi, Gridhrasi, Neurological disorders, Pakshaghata, Prana, Samana, Sciatica, Specific treatments of Vatavyadhi, Stroke, Udana, Vishwachi, Vyana,Ayurveda, Indian system of medicine, charak samhita. <br /> |description=Chikitsa Sthana Chapter 28.Management of disorders caused by vata dosha<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 28.Management of diseases caused by [[vata]] [[dosha]] '''&lt;/big&gt;<br /> {{Infobox<br /> |title = Vatavyadhi Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 28<br /> |label2 = Preceding Chapter<br /> |data2 = [[Urustambha Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Vatarakta Chikitsa ]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Mangalasseri P.<br /> |label7 = Reviewer <br /> |data7 = Ojha S.N.<br /> |label8 = Editors <br /> |data8 = Ojha S.N., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.029 10.47468/CSNE.2020.e01.s06.029]<br /> <br /> }}<br /> &lt;big&gt;'''Abstract &lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;[[Vatavyadhi Chikitsa]] deals with diseases particularly caused by [[vata]] [[dosha]]. It is an important chapter as it encompasses a large spectrum of disorders especially concerned with neurological system, musculoskeletal system, reticulo-endothelial system and further pervades to all other systems in the body. The chapter highlights the five sub classifications of [[vata]], their habitat and functions. The etiological factors of [[vata]]vyadhi are enlisted and two major pathology viz, [[dhatu]]kshaya and ''avarana'' are detailed. In [[dhatu]]kshaya, vitiated [[vata]] assumes the status of gatavata (increased movement of [[vata]]) and occupies various sites leading to [[dhatu]]gata (affecting tissues) [[vata]], ashayagata (affecting various sites) [[vata]] and ''avayava'' (organs) gata[[vata]]. ''Avarana'' (obstruction by covering) is a distinct pathology of [[vata]] in which the free mobility of [[vata]] is hampered. Accordingly, ''avarana'' may happen either due to two other [[dosha]], [[dhatu]] ([[rakta]], etc.) or [[mala]] (waste). ''Avarana'' may also happen in between two subtypes of [[vata]] as the direction of movement of various types of [[vata]] differ. This is called ''anyonyavarana''. The symptomatology, pathology and management strategies of ''avarana'' as well as gata[[vata]] are detailed in the chapter. The most common neurological disorders like ''pakshaghata'' (stroke), ''ardita'' (facial palsy), ''gridhrasi'' (sciatica), ''avabahuka'' (frozen shoulder), ''viswachi'' (cervico brachial neuralgia) etc. are described. Various formulations including medicated oils and ghee etc. are also included in the chapter. The chapter confirms the difficulty in curability of chronic ''vatavyadhi'' affecting debilitated individuals. <br /> &lt;br/&gt;<br /> '''Keywords''': Akshepaka, Anyonyavarana, Apana, Ardita, Avabahuka, Avarana, [[Ayurveda]], Convulsive disorders, [[Dhatu]]kshaya, Facial palsy, Gata[[vata]], General Line of treatment of ''Vatavyadhi, Gridhrasi,'' Neurological disorders, ''Pakshaghata, Prana, Samana,'' Sciatica, Specific treatments of ''Vatavyadhi'', Stroke, ''Udana, Vishwachi, Vyana.''<br /> &lt;/p&gt;<br /> <br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> [[Vatavyadhi Chikitsa]] exclusively deals with certain common disorders where the specific vitiation of [[vata]] takes place. Before entering the chapter, let us consider the etymological derivations of the term [[vata]]. The technical term [[vata]] is derived from Sanskrit root verb ''va'' which means ''gati gandhanayoh'' (movement and continued efforts/enthusiasm.) or by the application of ''kta'' to the root verb ''va'' which again means the same as above, ''vatiti vata'', the term [[vata]] is derived. As all ancient Indian scientific treatise observe strict rules regarding formation of a word, for the brevity and secrecy of expressions, it should be analyzed in detail for better understanding. The meaning of ''gati'' is to acquire; and ''jnana'' is to get aware or to sense. The term ''gandhana'' means to enthuse, to excite or to stimulate. Considering the different meanings of ''gati'', and ''gandhana'' it is understood that the term [[vata]] itself conveys its role as a receptor as well as stimulator. Hence it can be said that [[vata]] is the biological force which recognizes and stimulates all the activities in the body.<br /> <br /> [[Vata]] is the prime [[dosha]]. Owing to its incorporeal nature and instability it is inaccessible in comparison to other two [[dosha]]. The inaccessibility is characterized in regard to its functional and physical attributes but is more relevant regarding the therapeutic aspect. [[Vata]] is also explained as ''achintyaveerya'' (inconceivable prowess) and ''doshaanaam netah'' (propeller of all functional elements in the body).&lt;ref&gt;Dalhana, Sushruta. Nidana Sthana, Cha.1 Vatavyadhi Nidana Adhyaya verse 8. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1. &lt;/ref&gt;<br /> <br /> Before discussing the importance and implications of [[vata]], the references on [[vata]] and neurological elements in vedic literature is to be highlighted. In vedic science two terminologies namely ''prana'' and ''pranaja'' were used to denote nerve impulses. ''Prana'' is ''kriyashakti'' (power for action) and may be compared with motor impulse. ''Pranaja'' is also same as ''prana'' but conveys sensation of taste, smell, vision, sound, coitus, reproduction, pleasure and pain. It can be compared with sensory afferent impulse. Both ''prana'' and ''pranaja'' leave body at death. The entire neural axis is explained as ''sushumna'' (spinal cord) and it extends from the mid-perineum to inside of cranium runing through the middle of the spine to reach the cerebrum, twelve fingers breadth from nose. The shape of ''sushumna'' is compared with flower of ''datura alba'' with two dilatations at thoracic and lumbar areas. The cross section of spinal column is compared with the letter ''Aum'' in which grey matter and white matter is identified as ''chitrini'' (name for grey matter) and ''vajra'' (name for white matter). The neural networks are compared with ''luta tantu'' (spider web).&lt;ref&gt;B C Joshy, Neurology in Ancient India – some evidences, Indian journal of History of science, 19(4):366-396(1984)&lt;/ref&gt; Ten subtypes of ''vata'' are explained and ''dhananjaya'' (the tenth and last subtype) does not leave the body even after death. This is responsible for tissue transplantation after death. The description of ''shadchakra'' (six ''chakras'') is also very striking with latest functional modern neurology. The difference between vedic and ayurvedic neurology is that vedic science used it to attain higher level of consciousness through control of one’s nerve impulses. Ayurvedic science is meant for academic advancement or therapeutics. In [[Ayurveda]] it can be seen that practical utilization of vedic knowledge for therapeutic purpose by modification through experiments and experiences is done. Detailed descriptions of features of [[vata]] are available in various chapters of [[Charak Samhita]] including [[Deerghanjiviteeya Adhyaya]], [[Vatakalakaliya Adhyaya]] and [[Rogabhishagjitiya Vimana]], etc. The pathology and therapeutic aspects of [[vata]] is explained in this chapter. There is no separate chapter for diseases of [[pitta]] and [[kapha dosha]]. [[Vatavyadhi Chikitsa]] is an exclusive chapter dealing with [[vata]] janita vishesha vyadhi (diseases caused by [[vata]] vitiation). It is because of the supremacy of [[vata]]. The chapter is kept just after [[Urustambha Chikitsa]] since in that particular disease ama, [[kapha]], meda, etc. are associated to cause [[vata]]prakopa and ''urustambha''. On application of strenuous [[rukshana]] chikitsa in urustambha, [[vata]]prakopa alone may also happen. Even though in ''nanatmaja'' (single [[dosha]]) [[vata]]vyadhi the presence of other [[dosha]] can be traced, the disease cannot manifest without the vitiation of [[vata]]. <br /> <br /> [[Vata]] as explained earlier is the biological force present in the body which recognizes and stimulates all the activities. Instability of [[vata]] makes it inaccessible. It is characterized by an increase in the ''chala'' (motion) property, which is favored and contributed by other properties also. The ''chala guna'' is directional in nature and termed as ''gati''. ''Gati'' is the distinct quality of [[vata]], very important on physiological and pathological aspects. The ''gati'' of individual components of [[vata]] is to be analyzed according to the intensity, direction and area; depending upon the particular function it is carrying out. When the ''gati'' is aggravated (''gatatva'') or obstructed (''avarana'') the functional normality’s of [[vata]] are impaired. The ''gati'' or ''gatatva'' have two implications, one subjected to activity (to move, carry out or reach-gata) and the second subjected to abode of activity (pathway). ''Gatatva'' is an essential part of any [[vata]]ja samprapti'' (pathogenesis). ''Gatatva'' of [[vata]] is possible in [[dhatu]], upadhatu, asaya'' (sites or hollow cavities of organs), ''avayava'' (part or organ), etc. Consumption of ''ahara'' of relatively higher ''kittansha'' (waste products) leads to diminution of [[dhatu]] and aggravation of [[vata]] [ Cha. Sa. [[Sutra Sthana]] 28/4]. It leads to ''riktata'' (emptiness) and more ''avakasha'' (space) in [[Dhatu|dhatu,]] makes the engorgement and hyper movement of aggravated [[vata]] in the site. [[Dhatu]]gatavata and [[dhatu]]avrita [[vata]] are also distinct pathologies as in ''avarana'' the vitiation of [[vata]] is passive and the ''gati'' is obstructed.<br /> <br /> The chapter begins with praising of powerful [[vata]] followed with five subtypes of [[vata]]. After these descriptions, the etiopathological and therapeutic aspects of [[vata]] are explained. In the present chapter the two distinct pathology of [[vata]] is explained with possible causative factors. In the context of ''gatavata'', the pathology is related to the various [[dhatu]], ashaya or ''avayava'' involved in ''gatatva''. The same way different ''avarana'' of [[vata]] by other two [[dosha]], [[dhatu]], [[mala]], anna, etc. are explained. Since different subtypes of [[vata]] possess different ''gati'' mutual ''avarana'' among subtypes are also possible. The chapter also explains various disorders like ''pakshaghata, ardita, akshepaka, avabahuka'' etc. The general line of treatment of absolute [[vata]] vitiation is detailed in the chapter by giving importance to [[snehana]], [[swedana]], [[samshodhana]], etc. An ample amount of medications including various ''taila yoga, ghr̥ita yoga,'' etc. are also given in the chapter. The specific treatment approaches in exclusive conditions are also explained.<br /> <br /> [[Vata]] vyadhi are group of disorders which are very commonly encountered by ayurvedic physicians. In many diseases like ''pakshaghata, ardita, gridhrasi, kateegraha,'' etc. ayurvedic physicians are claiming better results and it is widely accepted also. Critical understandings of pathology, types, prognostic factors etc. are very important for academic and clinical success. Thus, thorough understanding of [[vata]] roga is essential for every treating physician.<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातो वातव्याधिचिकित्सितं व्याख्यास्यामः ||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः ||२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athAto VātavyādhicikitśītāM vyAkhyAsyAmaH ||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH ||2|| <br /> <br /> athātō vātavyādhicikitśītāṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now we shall expound the chapter [[Vata]] vyadhi chikitsa (Management of diseases caused by [[vata]] [[dosha]]). Thus said Lord Atreya.[1-2]<br /> <br /> === Significance of [[vayu]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वायुरायुर्बलं वायुर्वायुर्धाता शरीरिणाम् | &lt;br /&gt;<br /> वायुर्विश्वमिदं सर्वं प्रभुर्वायुश्च कीर्तितः ||३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> Vāyur AyurbalaM Vāyur VāyurdhAtA sharIriNAm | &lt;br /&gt;<br /> Vāyur vishvamidaM sarvaM prabhurVāyushcakIrtitaH ||3|| &lt;br /&gt;<br /> <br /> Vāyurāyurbalaṁ vāyurvāyurdhātā śarīriṇām| &lt;br /&gt;<br /> vāyurviśvamidaṁ sarvaṁ prabhurvāyuśca kīrtitaḥ||3|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> [[Vayu]] is life, [[vayu]] is strength, [[vayu]] mainstays living organism, the same [[vayu]] is verily the universe, and hence the Lord [[Vayu]] is praised. [3]<br /> <br /> === Important role of [[vayu]] in health ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अव्याहतगतिर्यस्य स्थानस्थः प्रकृतौ स्थितः | &lt;br /&gt;<br /> वायुः स्यात्सोऽधिकं जीवेद्वीतरोगः समाः शतम् ||४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> avyAhatagatiryasya sthānasthaH prakRutau sthitaH | &lt;br /&gt;<br /> VāyuHsyAtso~adhikaM jIvedvItarōgaH samAH shatam ||4||&lt;br /&gt;<br /> <br /> avyāhatagatiryasya sthānasthaḥ prakr̥tau sthitaḥ| &lt;br /&gt;<br /> vāyuḥ syātsō'dhikaṁ jīvēdvītarōgaḥ samāḥ śatam||4|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When normal (non vitiated) [[vayu]] is at its abode with unobstructed (free) movement, is responsible for long lifespan of hundred years devoid of diseases.[4]<br /> <br /> === Types of [[vayu]] and their functions ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्राणोदानसमानाख्यव्यानापानैः स पञ्चधा | &lt;br /&gt;<br /> देहं तन्त्रयते सम्यक् स्थानेष्वव्याहतश्चरन् ||५|| &lt;br /&gt;<br /> <br /> स्थानं प्राणस्य मूर्धोरःकण्ठजिह्वास्यनासिकाः [१] | &lt;br /&gt;<br /> ष्ठीवनक्षवथूद्गारश्वासाहारादि कर्म च ||६|| &lt;br /&gt;<br /> <br /> उदानस्य पुनः स्थानं नाभ्युरः कण्ठ एव च | &lt;br /&gt;<br /> वाक्प्रवृत्तिः प्रयत्नौर्जोबलवर्णादि कर्म च ||७|| &lt;br /&gt;<br /> <br /> स्वेददोषाम्बुवाहीनि स्रोतांसि समधिष्ठितः | &lt;br /&gt;<br /> अन्तरग्नेश्च पार्श्वस्थः समानोऽग्निबलप्रदः ||८|| &lt;br /&gt;<br /> <br /> देहं व्याप्नोति सर्वं तु व्यानः शीघ्रगतिर्नृणाम् | &lt;br /&gt;<br /> गतिप्रसारणाक्षेपनिमेषादिक्रियः सदा ||९|| &lt;br /&gt;<br /> <br /> वृषणौ बस्तिमेढ्रं च नाम्भूरू वङ्क्षणौ गुदम् | &lt;br /&gt;<br /> अपानस्थानमन्त्रस्थः शुक्रमूत्रशकृन्ति [२] च ||१०||&lt;br /&gt;<br /> <br /> सृजत्यार्तवगर्भौ च युक्ताः स्थानस्थिताश्च ते | &lt;br /&gt;<br /> स्वकर्म कुर्वते देहो धार्यते तैरनामयः ||११||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> prānaodAnasamānakhya vyānapānaiH sa pa~jcadhA | &lt;br /&gt;<br /> dehaM tantrayate samyak sthAneShvavyAhatashcaran ||5|| &lt;br /&gt;<br /> <br /> sthānaM prānasya mUrdhoraHkaNThajihvAsyanAsikAH [1] | &lt;br /&gt;<br /> ShThIvanakṣavathūdgArashvAsAhArAdi karma ca ||6|| &lt;br /&gt;<br /> <br /> udānasya punaH sthānaM nAbhyuraH kaNTha eva ca | &lt;br /&gt;<br /> vAkpravRuttiH prayatnaurjobalavarNAdi karma ca ||7|| &lt;br /&gt;<br /> <br /> sveda dōṣambuvAhIni srotAMsi samadhiShThitaH | &lt;br /&gt;<br /> antaragneshca pArshvasthaH Samānao~agnibalapradaH ||8|| &lt;br /&gt;<br /> <br /> dehaM vyApnoti sarvaM tu vyānaH shIghragatirnRuNAm | &lt;br /&gt;<br /> gatiprasAraNAkShepanimeShAdikriyaH sadA ||9|| &lt;br /&gt;<br /> <br /> vRuShaNau bastimeDhraM ca nAmbhUrU va~gkShaNau gudam | &lt;br /&gt;<br /> apāna sthānamantrasthaH śukramūtrashakRunti [2] ca ||10|| &lt;br /&gt;<br /> <br /> sRujatyArtavagarbhau ca yuktAH sthānasthitAshca te | &lt;br /&gt;<br /> svakarma kurvate deho dhAryate tairanAmayaH ||11|| &lt;br /&gt;<br /> <br /> prāṇōdānasamānākhyavyānapāna iḥ sa pañcadhā| &lt;br /&gt;<br /> dēhaṁ tantrayatē samyak sthānēṣvavyāhataścaran||5|| &lt;br /&gt;<br /> <br /> sthānaṁ prāṇasya mūrdhōraḥkaṇṭhajihvāsyanāsikāḥ [1] | &lt;br /&gt;<br /> ṣṭhīvanakṣavathūdgāraśvāsāhārādi karma ca||6|| &lt;br /&gt;<br /> <br /> udānasya punaḥ sthānaṁ nābhyuraḥ kaṇṭha ēva ca| &lt;br /&gt;<br /> vākpravr̥ttiḥ prayatnaurjōbalavarṇādi karma ca||7|| &lt;br /&gt;<br /> <br /> svēdadōṣāmbuvāhīni srōtāṁsi samadhiṣṭhitaḥ| &lt;br /&gt;<br /> antaragnēśca pārśvasthaḥ samānō'gnibalapradaḥ||8|| &lt;br /&gt;<br /> <br /> dēhaṁ vyāpnōti sarvaṁ tu vyānaḥ śīghragatirnr̥ṇām| &lt;br /&gt;<br /> gatiprasāraṇākṣēpanimēṣādikriyaḥ sadā||9|| &lt;br /&gt;<br /> <br /> vr̥ṣaṇau bastimēḍhraṁ ca nābhyūrū vaṅkṣaṇau gudam|&lt;br /&gt; <br /> apānasthānamantrasthaḥ śukramūtraśakr̥nti [2] ca||10|| &lt;br /&gt;<br /> <br /> sr̥jatyārtavagarbhau ca yuktāḥ sthānasthitāśca tē| &lt;br /&gt;<br /> svakarma kurvatē dēhō dhāryatē tairanāmayaḥ||11|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> [[Vayu]] is of five types namely prana, udana, samana, vyana and apana and they mechanize the body optimally occupying their sites without any irregular movement. <br /> <br /> The location of ''prana'' is vertex, thorax, trachea, tongue, mouth and nose and it performs functions of spitting, sneezing, eructation, respiration, deglutition etc. <br /> <br /> The site of ''udana'' is umbilicus, thorax and trachea and is responsible for vocalization, drive, energy, strength, complexion etc. <br /> ''Samana'' is located in channels of sweat, humors and water and lateral to the seat of [[agni]] (digestive enzymes ([[agni]]) and yield strength to the digestive fire. <br /> <br /> ''Vyana'' has swift movement and spreads all over the body and is responsible for gait, flexion, extension, twinkling etc. <br /> ''Apana'' is told to be located in testicles, urinary bladder, penis, umbilicus, thighs, inguinal region and anus and performs ejaculation, micturition, defecation, expulsion of menstrual blood and fetus. <br /> <br /> When these five are located in respective sites optimally, perform their functions, supports life without any morbidity. [5-11]<br /> <br /> === Role of [[vata]]/[[vayu]] in causing diseases ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विमार्गस्था ह्ययुक्ता वा रोगैः स्वस्थानकर्मजैः | &lt;br /&gt;<br /> शरीरं पीडयन्त्येते प्राणानाशु हरन्ति च ||१२|| &lt;br /&gt;<br /> <br /> सङ्ख्यामप्यतिवृत्तानां तज्जानां हि प्रधानतः | &lt;br /&gt;<br /> अशीतिर्नखभेदाद्या रोगाः सूत्रे निदर्शिताः ||१३|| &lt;br /&gt;<br /> <br /> तानुच्यमानान् पर्यायैः सहेतूपक्रमाञ्छृणु | &lt;br /&gt;<br /> केवलं वायुमुद्दिश्य स्थानभेदात्तथाऽऽवृतम् ||१४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vimArgasthA hyayuktA vA rōgaiH svasthānakarmajaiH |&lt;br /&gt; <br /> sharIraM pIDayantyete prānanAshu haranti ca ||12|| &lt;br /&gt;<br /> <br /> sa~gkhyAmapyativRuttAnAM tajjAnAM hi pradhAnataH | &lt;br /&gt;<br /> ashItirnakhabhedAdyA rōgaH sUtre nidarshitAH ||13|| &lt;br /&gt;<br /> <br /> tAnucyamAnAn paryAyaiH sahetUpakramA~jchRuNu | &lt;br /&gt;<br /> kevalaM Vāyu muddishya sthānabhedAttathA~a~avRutam ||14|| &lt;br /&gt;<br /> <br /> vimārgasthā hyayuktā vā rōgaiḥ svasthānakarmajaiḥ| &lt;br /&gt;<br /> śarīraṁ pīḍayantyētē prāṇānāśu haranti ca||12|| &lt;br /&gt;<br /> <br /> saṅkhyāmapyativr̥ttānāṁ tajjānāṁ hi pradhānataḥ| &lt;br /&gt;<br /> aśītirnakhabhēdādyā rōgāḥ sūtrē nidarśitāḥ||13|| &lt;br /&gt;<br /> <br /> tānucyamānān paryāyaiḥ sahētūpakramāñchr̥ṇu| &lt;br /&gt;<br /> kēvalaṁ vāyumuddiśya sthānabhēdāttathā''vr̥tam||14|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When dislodged or impaired, [[dosha]] harm the body by diseases according to their respective site and function, and may even lead to instantaneous death.<br /> <br /> Even though the diseases caused by them are innumerable, starting from ''nakhabheda'' (nail splitting), the major eighty diseases enlisted in [[Sutra Sthana]] are important.<br /> <br /> Now the aforesaid synonymous diseases with etiology and therapeutics are about to explain here, the absolute [[vata]] as per different locations as well as that got obstructed. [12-14]<br /> <br /> === Etiopathology ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रूक्षशीताल्पलघ्वन्नव्यवायातिप्रजागरैः | &lt;br /&gt;<br /> विषमादुपचाराच्च दोषासृक्स्रवणादति ||१५|| &lt;br /&gt;<br /> <br /> लङ्घनप्लवनात्यध्वव्यायामातिविचेष्टितैः | &lt;br /&gt;<br /> धातूनां सङ्क्षयाच्चिन्ताशोकरोगातिकर्षणात् ||१६|| &lt;br /&gt;<br /> <br /> दुःखशय्यासनात् क्रोधाद्दिवास्वप्नाद्भयादपि | &lt;br /&gt;<br /> वेगसन्धारणादामादभिघातादभोजनात् ||१७|| &lt;br /&gt;<br /> <br /> मर्माघाताद्गजोष्ट्राश्वशीघ्रयानापतंसनात् | &lt;br /&gt;<br /> देहे स्रोतांसि रिक्तानि पूरयित्वाऽनिलो बली ||१८|| &lt;br /&gt;<br /> <br /> करोति विविधान् व्याधीन् सर्वाङ्गैकाङ्गसंश्रितान् |१९|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rūkṣashItAlpalaghvannavyavAyAtiprajAgaraiH | &lt;br /&gt;<br /> viShamAdupacArAcca dōṣasRuksravaNAdati ||15|| &lt;br /&gt;<br /> <br /> la~gghanaplavanAtyadhvavyAyAmAtiviceShTitaiH | &lt;br /&gt;<br /> dhātunAM sa~gkṣayaccintAshokarōgatikarShaNAt ||16|| &lt;br /&gt;<br /> <br /> duHkhashayyAsanAt krodhAddivAsvapnAdbhayAdapi | &lt;br /&gt;<br /> vegasandhAraNAdAmAdabhighAtAdabhojanAt ||17|| &lt;br /&gt;<br /> <br /> marmAghAtAdgajoShTrAshvashIghrayAnApataMsanAt | &lt;br /&gt;<br /> dehe srotAMsi riktAni pUrayitvA~anilo balI ||18|| &lt;br /&gt;<br /> <br /> karoti vividhAn vyAdhIn sarvA~ggaikA~ggasaMshritAn |19| &lt;br /&gt;<br /> <br /> rūkṣaśītālpalaghvannavyavāyātiprajāgaraiḥ| &lt;br /&gt;<br /> viṣamādupacārācca dōṣāsr̥ksravaṇādati||15|| &lt;br /&gt;<br /> <br /> laṅghanaplavanātyadhvavyāyāmātivicēṣṭitaiḥ| &lt;br /&gt;<br /> dhātūnāṁ saṅkṣayāccintāśōkarōgātikarṣaṇāt||16|| &lt;br /&gt;<br /> <br /> duḥkhaśayyāsanāt krōdhāddivāsvapnādbhayādapi| &lt;br /&gt;<br /> vēgasandhāraṇādāmādabhighātādabhōjanāt||17|| &lt;br /&gt;<br /> <br /> marmāghātādgajōṣṭrāśvaśīghrayānāpataṁsanāt| &lt;br /&gt;<br /> dēhē srōtāṁsi riktāni pūrayitvā'nilō balī||18|| &lt;br /&gt;<br /> <br /> karōti vividhān vyādhīn sarvāṅgaikāṅgasaṁśritān|19| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Due to intake of dry, cold, deficient and light food; excessive sex and sleeplessness; improper treatments; expelling of [[dosha]] or blood letting; by excessive fasting, swimming, walking, exercising, and physical activity; depletion of tissue elements; worrying, grief, debilitating diseases; usage of uncomfortable beds or seats; anger, day sleep or even with fright; suppression of natural urges, indigestion, trauma, abstaining from food; injury to vital areas, falling from swift moving elephant, camel or horse etc. [[vata]] is aggravated. This gets filled in the vacuous channels in the body and leads to various generalized or localized disorders. [15-19]<br /> <br /> === Premonitory symptoms ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अव्यक्तं लक्षणं तेषां पूर्वरूपमिति स्मृतम् ||१९|| <br /> <br /> आत्मरूपं तु तद्व्यक्तमपायो लघुता पुनः |२०|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> avyaktaM lakShaNaM teShAM pUrvarUpamiti smRutam ||19|| <br /> <br /> AtmarUpaM tu tadvyaktamapAyo laghutA punaH |20| <br /> <br /> avyaktaṁ lakṣaṇaṁ tēṣāṁ pūrvarūpamiti smr̥tam||19|| <br /> <br /> ātmarūpaṁ tu tadvyaktamapāyō laghutā punaḥ|20| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Indistinct manifestation of the diseases are considered as prodromal symptoms.When the cardinal feature is clearly manifested, it is called as symptom, while the lessening of features are indicative of cure. [19-20]<br /> <br /> === General signs and symptoms of [[vata]] vitiation ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सङ्कोचः पर्वणां स्तम्भो भेदोऽस्थ्नां पर्वणामपि ||२०|| <br /> <br /> लोमहर्षः प्रलापश्च पाणिपृष्ठशिरोग्रहः | &lt;br /&gt;<br /> खाञ्ज्यपाङ्गुल्यकुब्जत्वं शोषोऽङ्गानामनिद्रता ||२१|| &lt;br /&gt;<br /> <br /> गर्भशुक्ररजोनाशः स्पन्दनं गात्रसुप्तता | &lt;br /&gt;<br /> शिरोनासाक्षिजत्रूणां ग्रीवायाश्चापि हुण्डनम् ||२२|| &lt;br /&gt;<br /> <br /> भेदस्तोदार्तिराक्षेपो मोहश्चायास एव च | &lt;br /&gt;<br /> एवंविधानि रूपाणि करोति कुपितोऽनिलः ||२३|| &lt;br /&gt;<br /> <br /> हेतुस्थानविशेषाच्च भवेद्रोगविशेषकृत् |२४| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sa~gkocaH parvaNAM stambho bhedo~asthnAM parvaNAmapi ||20|| &lt;br /&gt;<br /> <br /> lomaharShaH pralApashca pANipRuShThashirograhaH | &lt;br /&gt;<br /> khA~jjyapA~ggulyakubjatvaM shoSho~a~ggAnAmanidratA ||21|| &lt;br /&gt;<br /> <br /> garbhaśukrarajonāśaH spandanaM gAtrasuptatA | &lt;br /&gt;<br /> shironAsAkShijatrUNAM grIvAyAshcApi huNDanam ||22|| &lt;br /&gt;<br /> <br /> bhedastodArtirAkShepo mohashcAyAsa eva ca | &lt;br /&gt;<br /> evaMvidhAni rUpANi karoti kupito~anilaH ||23|| &lt;br /&gt;<br /> <br /> hetusthānavisheShAcca bhavedrōgavisheShakRut |24| &lt;br /&gt;<br /> <br /> Saṅkōcaḥ parvaṇāṁ stambhō bhēdō'sthnāṁ parvaṇāmapi||20||&lt;br /&gt;<br /> <br /> lōmaharṣaḥ pralāpaśca pāṇipr̥ṣṭhaśirōgrahaḥ| &lt;br /&gt;<br /> khāñjyapāṅgulyakubjatvaṁ śōṣō'ṅgānāmanidratā||21|| &lt;br /&gt;<br /> <br /> garbhaśukrarajōnāśaḥ spandanaṁ gātrasuptatā| &lt;br /&gt;<br /> śirōnāsākṣijatrūṇāṁ grīvāyāścāpi huṇḍanam||22|| &lt;br /&gt;<br /> <br /> bhēdastōdārtirākṣēpō mōhaścāyāsa ēva ca| &lt;br /&gt;<br /> ēvaṁvidhāni rūpāṇi karōti kupitō'nilaḥ||23|| &lt;br /&gt;<br /> <br /> hētusthānaviśēṣācca bhavēdrōgaviśēṣakr̥t|24| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Vitiated [[vata]] causes various symptoms like contractures, joint stiffness, splitting of bones and joints, horripilation, delirium, spasticity of hands, back and neck; limping, paraplegia, hunch back; organ atrophy, insomnia, intrauterine death of embryo and fetus, diminishing sperms and menstruation fasciculation, generalized numbness, benumbing or paralysis of muscles of head, nose, eyes, supraclavicular part and neck; splitting, pricking or aching type of pains; convulsions, loss of consciousness, fatigue etc. Different specific diseases of [[vata]] are caused by specificity in etiological factors and site of affliction. [20-24]<br /> <br /> === Clinical features of vitiation of [[vata]] at different sites ===<br /> ==== Koshthashrita [[vata]] (vitiation at gastrointestinal tract) ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र कोष्ठाश्रिते दुष्टे निग्रहो मूत्रवर्चसोः ||२४|| <br /> <br /> ब्रध्नहृद्रोगगुल्मार्शःपार्श्वशूलं च मारुते |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra kōṣṭhashrite duShTe nigraho mūtravarcasoH ||24|| <br /> <br /> bradhnahRudrōgagulmArshaHpArshvashUlaM ca mArute | <br /> <br /> tatra kōṣṭhāśritē duṣṭē nigrahō mūtravarcasōḥ||24|| <br /> <br /> bradhnahr̥drōgagulmārśaḥpārśvaśūlaṁ ca mārutē| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When vitiated [[vata]] is located in gastrointestinal tract or in abdomen it leads to urinary retention and constipation, intestinal and epigastric discomforts, gulma, piles and pain in flanks.[24]<br /> <br /> ==== Sarvanga kupita [[vata]] (vitiation all over body) ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सर्वाङ्गुकुपिते वाते गात्रस्फुरणभञ्जने ||२५|| <br /> <br /> वेदनाभिः परीतश्च स्फुटन्तीवास्य सन्धयः | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sarvA~ggukupite vAte gAtrasphuraNabha~jjane ||25|| <br /> <br /> vedanAbhiH parItashca sphuTantIvAsya sandhayaH | <br /> <br /> sarvāṅgakupitē vātē gātrasphuraṇabhañjanē||25|| <br /> <br /> vēdanābhiḥ parītaśca sphuṭantīvāsya sandhayaḥ| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When vitiated [[vata]] is located all over the body, it produces generalized fasciculation and breaking pain; different types of pain and the generalized joint crepitus. [25]<br /> <br /> ==== Guda sthita [[vata]] (vitiation at anus) ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ग्रहो विण्मूत्रवातानां शूलाध्मानाश्मशर्कराः ||२६|| <br /> <br /> जङ्घोरुत्रिकपात्पृष्ठरोगशोषौ गुदस्थिते | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> graho viNmūtravātanAM shUlAdhmAnAshmasharkarAH ||26|| <br /> <br /> ja~gghorutrikapAtpRuShTharōgashoShau [1] gudasthite | <br /> grahō viṇmūtravātānāṁ śūlādhmānāśmaśarkarāḥ||26|| <br /> <br /> jaṅghōrutrikapātpr̥ṣṭharōgaśōṣau [1] gudasthitē| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When vitiated [[vata]] is located in anus, it leads to retention of feces, urine and flatus; colicky pain, flatulence, renal calculi, micro-calculi; diseases with atrophy in calf, thigh, pelvis, and the back.[26]<br /> <br /> ==== Amashaya sthita [[vata]] (vitiation at stomach) ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> हृन्नाभिपार्श्वोदररुक्तृष्णोद्गारविसूचिकाः ||२७|| <br /> <br /> कासः कण्ठास्यशोषश्च श्वासश्चामाशयस्थिते | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> hRunnAbhipArshvodararuktRuShNodgAravisUcikAH ||27|| <br /> <br /> kAsaH kaNThAsyashoShashca shvAsashcĀmashayasthite | <br /> <br /> hr̥nnābhipārśvōdararuktr̥ṣṇōdgāravisūcikāḥ||27|| <br /> <br /> kāsaḥ kaṇṭhāsyaśōṣaśca śvāsaścāmāśayasthitē| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When vitiated [[vata]] is located in stomach, symptoms manifest as pain in epigastrium, umbilicus, flanks and abdomen; morbid thirst, eructation, acute gastroenteritis, cough, dryness of throat and mouth and breathing difficulty.[27]<br /> <br /> === Pakwashaya sthita [[vata]] (vitiation at colon) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पक्वाशयस्थोऽन्त्रकूजं शूलाटोपौ करोति च ||२८|| <br /> <br /> कृच्छ्रमूत्रपुरीषत्वमानाहं त्रिकवेदनाम् | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pakvAshayastho~antrakUjaM shUlATopau karoti ca ||28|| <br /> <br /> kRucchramūtrapurIShatvamAnAhaM trikavedanAm | <br /> <br /> pakvāśayasthō'ntrakūjaṁ śūlāṭōpau karōti ca||28|| <br /> <br /> kr̥cchramūtrapurīṣatvamānāhaṁ trikavēdanām| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When vitiated [[vata]] is located in colon it causes gurgling, colicky pain, tympanites, difficulty in defecation and urination, flatulence and lumbar/ sacroiliac pain. [28]<br /> <br /> === Indriya gata [[vata]] (vitiation in sense organs) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> श्रोत्रादिष्विन्द्रियवधं कुर्याद्दुष्टसमीरणः ||२९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> shrotrAdiShvindriyavadhaM kuryAdduShTasamIraNaH ||29|| <br /> <br /> śrōtrādiṣvindriyavadhaṁ kuryādduṣṭasamīraṇaḥ||29|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When vitiated [[vata]] is located in ear like sense organs leads to sensorial loss in the respective organs. [29]<br /> <br /> === Twaksthita [[vata]] (vitiation at skin) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्वग्रूक्षा स्फुटिता सुप्ता कृशा कृष्णा च तुद्यते | &lt;br /&gt;<br /> आतन्यते सरागा च पर्वरुक् त्वक्स्थितेऽनिले ||३०|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tvagrūkṣa sphuTitA suptA kRushA kRuShNA ca tudyate |&lt;br /&gt; <br /> Atanyate sarAgA ca parvaruk tvaksthite~anile ||30|| &lt;br /&gt;<br /> <br /> tvagrūkṣā sphuṭitā suptā kr̥śā kr̥ṣṇā ca tudyatē| &lt;br /&gt;<br /> ātanyatē sarāgā ca parvaruk tvaksthitē'nilē||30|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When vitiated [[vata]] is located in skin it becomes dry, fissured, numb, thin, blackish. It causes pain along with erythema and strain and leads to pain in distal end of bones.[30]<br /> <br /> === [[Rakta]]gata [[vata]](vitiation at blood) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रुजस्तीव्राः ससन्तापा वैवर्ण्यं कृशताऽरुचिः | &lt;br /&gt;<br /> गात्रे चारूंषि भुक्तस्य स्तम्भश्चासृग्गतेऽनिले ||३१|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rujastIvrAH sasantApA vaivarNyaM kRushatA~aruciH | &lt;br /&gt;<br /> gAtre cArUMShi bhuktasya stambhashcAsRuggate~anile ||31|| &lt;br /&gt;<br /> <br /> rujastīvrāḥ sasantāpā vaivarṇyaṁ kr̥śatā'ruciḥ| &lt;br /&gt;<br /> gātrē cārūṁṣi bhuktasya stambhaścāsr̥ggatē'nilē||31|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When vitiated [[vata]] is located in blood it manifests as severe pain with warmth and discoloration; weight loss, anorexia, specific raised rashes in body and esophageal spasm.[31]<br /> <br /> === Mamsa medogata [[vata]] (vitiation in muscles and fats) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुर्वङ्गं तुद्यतेऽत्यर्थं दण्डमुष्टिहतं तथा | &lt;br /&gt;<br /> सरुक् श्रमितमत्यर्थं [२] मांसमेदोगतेऽनिले ||३२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gurva~ggaM tudyate~atyarthaM daNDamuShTihataM tathA | &lt;br /&gt;<br /> saruk shramitamatyarthaM [2] māṁsamedogate~anile ||32||&lt;br /&gt;<br /> <br /> gurvaṅgaṁ tudyatē'tyarthaṁ daṇḍamuṣṭihataṁ tathā| &lt;br /&gt;<br /> saruk śramitamatyarthaṁ [2] māṁsamēdōgatē'nilē||32|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When vitiated [[vata]] is located in muscles and fat, it manifest as heaviness of body, pricking pain and as if beaten by a strong rod or fist cuff and painful severe fatigue.[32]<br /> <br /> === Majja-asthigata [[vata]] (vitiation in bones and marrow) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भेदोऽस्थिपर्वणां सन्धिशूलं मांसबलक्षयः | &lt;br /&gt;<br /> अस्वप्नः सन्तता रुक् च मज्जास्थिकुपितेऽनिले ||३३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhedo~asthiparvaNAM sandhishUlaM māṁsabalakṣayaH | &lt;br /&gt;<br /> asvapnaH santatA ruk ca majjAsthikupite~anile ||33|| &lt;br /&gt;<br /> <br /> bhēdō'sthiparvaṇāṁ sandhiśūlaṁ māṁsabalakṣayaḥ| &lt;br /&gt;<br /> asvapnaḥ santatā ruk ca majjāsthikupitē'nilē||33|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When vitiated [[vata]] is located in bones and marrow it leads to splitting pain of bones and joints, arthralgia, loss of muscle strength, insomnia and continuous pain.[33]<br /> <br /> === Shukra gata [[vata]] (vitiation in semen) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षिप्रं मुञ्चति बध्नाति शुक्रं गर्भमथापि वा | &lt;br /&gt;<br /> विकृतिं जनयेच्चापि शुक्रस्थः कुपितोऽनिलः ||३४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kShipraM mu~jcati badhnAti śukraM garbhamathApi vA | &lt;br /&gt;<br /> vikRutiM janayeccApi śukrasthaH kupito~anilaH ||34|| &lt;br /&gt;<br /> <br /> kṣipraṁ muñcati badhnāti śukraṁ garbhamathāpi vā| &lt;br /&gt;<br /> vikr̥tiṁ janayēccāpi śukrasthaḥ kupitō'nilaḥ||34|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When vitiated [[vata]] is located in semen, it causes premature ejaculation or anejaculation. It may also lead to preterm or delayed labor. It may also cause deformity in fetus. [34]<br /> <br /> === Snayugata [[vata]] (vitiation in tendons) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बाह्याभ्यन्तरमायामं खल्लिं कुब्जत्वमेव च | &lt;br /&gt;<br /> सर्वाङ्गैकाङ्गरोगांश्च कुर्यात् स्नायुगतोऽनिलः ||३५|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bAhyAbhyantaramAyAmaM khalliM kubjatvameva ca | &lt;br /&gt;<br /> sarvA~ggaikA~ggarōgaMshca kuryAt snAyugato~anilaH ||35|| &lt;br /&gt;<br /> <br /> bāhyābhyantaramāyāmaṁ khalliṁ kubjatvamēva ca| &lt;br /&gt;<br /> sarvāṅgaikāṅgarōgāṁśca kuryāt snāyugatō'nilaḥ||35|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When vitiated [[vata]] is located in neural tissue or tendons, it leads to ophisthotonus or emprosthotonus, radiculopathy, kyphosis, quadriplegia or hemiplegia. [35]<br /> <br /> === Siragata [[vata]] (vitiation in vascular tissue) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शरीरं मन्दरुक्शोफं शुष्यति स्पन्दते तथा | &lt;br /&gt;<br /> सुप्तास्तन्व्यो महत्यो वा सिरा वाते सिरागते ||३६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sharIraM mandarukśōphaM shuShyati spandate tathA |&lt;br /&gt; <br /> suptAstanvyo mahatyo vA sirā vAte sirāgate ||36|| &lt;br /&gt;<br /> <br /> śarīraṁ mandarukśōphaṁ śuṣyati spandatē tathā| &lt;br /&gt;<br /> suptāstanvyō mahatyō vā sirā vātē sirāgatē||36|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When vitiated [[vata]] is located in vascular tissue it leads to mildly painful edema in the body, emaciation, twitching, loss of pulsation along with dilation or coarctation of vessels. [36]<br /> <br /> ===Sandhigata [[vata]] (vitiation in joints) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वातपूर्णदृतिस्पर्शः शोथः सन्धिगतेऽनिले | &lt;br /&gt;<br /> प्रसारणाकुञ्चनयोः प्रवृत्तिश्च [३] सवेदना ||३७|| &lt;br /&gt;<br /> <br /> (इत्युक्तं [४] स्थानभेदेन वायोर्लक्षणमेव च) |३८| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vātapUrNadRutisparshaH śōthaH sandhigate~anile | &lt;br /&gt;<br /> prasAraNAku~jcanayoH pravRuttishca [3] savedanA ||37|| &lt;br /&gt;<br /> <br /> (ityuktaM [4] sthānabhedena vAyorlakShaNameva ca) |38| &lt;br /&gt;<br /> <br /> vātapūrṇadr̥tisparśaḥ śōthaḥ sandhigatē'nilē| &lt;br /&gt;<br /> prasāraṇākuñcanayōḥ pravr̥ttiśca [3] savēdanā||37|| &lt;br /&gt;<br /> <br /> (ityuktaṁ [4] sthānabhēdēna vāyōrlakṣaṇamēva ca)|38| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When vitiated [[vata]] is located in joints, it leads to palpatory feeling of air in joints(crepitus), swelling along with painful flexion and extension.[38]<br /> <br /> Thus the symptomatology of [[vata]] according to various site are explained. [38]<br /> <br /> === ''Ardita'' (facial paralysis) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अतिवृद्धः शरीरार्धमेकं वायुः प्रपद्यते | &lt;br /&gt;<br /> यदा तदोपशोष्यासृग्बाहुं पादं च जानु च ||३८|| &lt;br /&gt;<br /> <br /> तस्मिन् सङ्कोचयत्यर्धे मुखं जिह्मं करोति च | &lt;br /&gt;<br /> वक्रीकरोति नासाभूललाटाक्षिहनूस्तथा ||३९|| &lt;br /&gt;<br /> <br /> ततो वक्रं व्रजत्यास्ये भोजनं वक्रनासिकम् [१] | &lt;br /&gt;<br /> स्तब्धं नेत्रं कथयतः क्षवथुश्च निगृह्यते ||४०|| &lt;br /&gt;<br /> <br /> दीना जिह्मा समुत्क्षिप्ता कला [२] सज्जति चास्य वाक् | &lt;br /&gt;<br /> दन्ताश्चलन्ति बाध्येते श्रवणौ भिद्यते स्वरः ||४१|| &lt;br /&gt;<br /> <br /> पादहस्ताक्षिजङ्घोरुशङ्खश्रवणगण्डरुक् [३] | &lt;br /&gt;<br /> अर्धे तस्मिन्मुखार्धे वा केवले स्यात्तदर्दितम् ||४२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ativRuddhaH sharIrArdhamekaM Vāyu H prapadyate | &lt;br /&gt;<br /> yadA tadopashoShyAsRugbAhuM pAdaM ca jAnu ca ||38|| &lt;br /&gt;<br /> <br /> tasmin sa~gkocayatyardhe mukhaM jihmaM karoti ca | &lt;br /&gt;<br /> vakrIkaroti nAsAbhUlalATAkShihanUstathA ||39|| &lt;br /&gt;<br /> <br /> tato vakraM vrajatyAsye bhojanaM vakranAsikam [1] | &lt;br /&gt;<br /> stabdhaM netraM kathayataH kṣavathūshca nigRuhyate ||40|| &lt;br /&gt;<br /> <br /> dInA jihmA samutkShiptA kalA [2] sajjati cAsya vAk | &lt;br /&gt;<br /> dantAshcalanti bAdhyete shravaNau bhidyate svaraH ||41|| &lt;br /&gt;<br /> <br /> pAdahastAkShija~gghorusha~gkhashravaNagaNDaruk [3] | &lt;br /&gt;<br /> ardhe tasminmukhArdhe vA kevale syAttadarditam ||42||&lt;br /&gt;<br /> <br /> ativr̥ddhaḥ śarīrārdhamēkaṁ vāyuḥ prapadyatē| &lt;br /&gt;<br /> yadā tadōpaśōṣyāsr̥gbāhuṁ pādaṁ ca jānu ca||38|| &lt;br /&gt;<br /> <br /> tasmin saṅkōcayatyardhē mukhaṁ jihmaṁ karōti ca| &lt;br /&gt;<br /> vakrīkarōti nāsābhrūlalāṭākṣihanūstathā||39|| &lt;br /&gt;<br /> <br /> tatō vakraṁ vrajatyāsyē bhōjanaṁ vakranāsikam [1] | &lt;br /&gt;<br /> stabdhaṁ nētraṁ kathayataḥ kṣavathuśca nigr̥hyatē||40|| &lt;br /&gt;<br /> <br /> dīnā jihmā samutkṣiptā kalā [2] sajjati cāsya vāk| &lt;br /&gt;<br /> dantāścalanti bādhyētē śravaṇau bhidyatē svaraḥ||41|| &lt;br /&gt;<br /> <br /> pādahastākṣijaṅghōruśaṅkhaśravaṇagaṇḍaruk [3] | &lt;br /&gt;<br /> ardhē tasminmukhārdhē vā kēvalē syāttadarditam||42|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the excessively increased [[vata]] affects one half of the body, as it diminishes the blood there, leads to contracture of arm, leg and knee of the affected half, and causes distortion of one side of the face and produces asymmetry of the nose, eye brow, fore head, eye and jaw.<br /> <br /> The food goes into one side of the mouth; while speaking the nose gets curved, the eye remains rigid and without blink; the sneeze gets suppressed. His speech is feeble, distorted, strenuous and indistinct. His teeth get rickety, hearing affected and voice is hoarse. There is pain in his feet, hand, eyes, calves, thighs, temples, ears and cheek. This condition, may affect half the body or half of the face only, is called ''ardita'' (facial paralysis). [38-42]<br /> <br /> === ''Antarayama'' (Emprosthotonous) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मन्ये संश्रित्य वातोऽन्तर्यदा नाडीः प्रपद्यते | &lt;br /&gt;<br /> मन्यास्तम्भं तदा कुर्यादन्तरायामसञ्ज्ञितम् ||४३|| &lt;br /&gt;<br /> <br /> अन्तरायम्यते ग्रीवा मन्या च स्तभ्यते भृशम् | &lt;br /&gt;<br /> दन्तानां दंशनं लाला पृष्ठायामः [१] शिरोग्रहः ||४४|| &lt;br /&gt;<br /> <br /> जृम्भा वदनसङ्गश्चाप्यन्तरायामलक्षणम् | &lt;br /&gt;<br /> (इत्युक्तस्त्वन्तरायामो [२] ... |४५|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> manye saMshritya vAto~antaryadA nADIH prapadyate | &lt;br /&gt;<br /> manyAstambhaM tadA kuryAdantarAyAmasa~jj~jitam ||43|| &lt;br /&gt;<br /> <br /> antarAyamyate grIvA manyA ca stabhyate bhRusham | &lt;br /&gt;<br /> dantAnAM daMshanaM lAlA pRuShThAyAmaH [1] shirograhaH ||44|| &lt;br /&gt;<br /> <br /> jRumbhA vadanasa~ggashcApyantarAyAmalakShaNam | &lt;br /&gt;<br /> (ityuktastvantarAyAmo [2] ... |45| &lt;br /&gt;<br /> <br /> manyē saṁśritya vātō'ntaryadā nāḍīḥ prapadyatē| &lt;br /&gt;<br /> manyāstambhaṁ tadā kuryādantarāyāmasañjñitam||43|| &lt;br /&gt;<br /> <br /> antarāyamyatē grīvā manyā ca stabhyatē bhr̥śam| &lt;br /&gt;<br /> dantānāṁ daṁśanaṁ lālā pr̥ṣṭhāyāmaḥ [1] śirōgrahaḥ||44|| &lt;br /&gt;<br /> <br /> jr̥mbhā vadanasaṅgaścāpyantarāyāmalakṣaṇam| &lt;br /&gt;<br /> (ityuktastvantarāyāmō [2] ...|45|&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When [[vata]] get localised in the ''manya'' (neck), lateral aspect of the neck and gets spread into the internal vessels, it causes ''manyastambha'' otherwise named as ''antarayam'' (Emprosthotonus). So the neck becomes convulsed inward and the lateral aspect becomes very stiff, the teeth get clenched with salivation, contraction of the back muscles and the head is stiff; yawning and lock jaw; these are the symptoms of ''antarayam''. Thus ''antarayam'' is explained. [43-45]<br /> <br /> === ''Bahirayama''(ophisthotonous) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ...बहिरायाम उच्यते) ||४५|| &lt;br /&gt;<br /> <br /> पृष्ठमन्याश्रिता बाह्याः शोषयित्वा सिरा बली | &lt;br /&gt;<br /> वायुः कुर्याद्धनुस्तम्भं बहिरायामसञ्ज्ञकम् ||४६|| &lt;br /&gt;<br /> <br /> चापवन्नाम्यमानस्य पृष्ठतो नीयते शिरः | &lt;br /&gt;<br /> उर उत्क्षिप्यते मन्या स्तब्धा ग्रीवाऽवमृद्यते ||४७|| &lt;br /&gt;<br /> <br /> दन्तानां दशनं जृम्भा लालास्रावश्च वाग्ग्रहः | &lt;br /&gt;<br /> जातवेगो निहन्त्येष वैकल्यं वा प्रयच्छति ||४८||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ...bahirAyAma ucyate) ||45|| &lt;br /&gt;<br /> <br /> pRuShThamanyAshritA bAhyAH shoShayitvA sirā balI | &lt;br /&gt;<br /> Vāyu H kuryAddhanustambhaM bahirAyAmasa~jj~jakam ||46|| &lt;br /&gt;<br /> <br /> cApavannAmyamAnasya pRuShThato nIyate shiraH | &lt;br /&gt;<br /> ura utkShipyate manyA stabdhA grIvA~avamRudyate ||47|| &lt;br /&gt;<br /> <br /> dantAnAM dashanaM jRumbhA lAlAsrAvashca vAggrahaH | &lt;br /&gt;<br /> jAtavego nihantyeSha vaikalyaM vA prayacchati ||48||&lt;br /&gt;<br /> <br /> ...bahirāyāma ucyatē)||45||&lt;br /&gt;<br /> <br /> pr̥ṣṭhamanyāśritā bāhyāḥ śōṣayitvā sirā balī| &lt;br /&gt;<br /> vāyuḥ kuryāddhanustambhaṁ bahirāyāmasañjñakam||46|| &lt;br /&gt;<br /> <br /> cāpavannāmyamānasya pr̥ṣṭhatō nīyatē śiraḥ| &lt;br /&gt;<br /> ura utkṣipyatē manyā stabdhā grīvā'vamr̥dyatē||47|| &lt;br /&gt;<br /> <br /> dantānāṁ daśanaṁ jr̥mbhā lālāsrāvaśca vāggrahaḥ| &lt;br /&gt;<br /> jātavēgō nihantyēṣa vaikalyaṁ vā prayacchati||48|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Bahirayama'', will now be described. The potently provoked [[vata]], on getting localized in the posterior and lateral of the neck and constricting external vessels, causes bow leg like rigidity of the body which is called as ''bahirayama'' (ophisthotonous).<br /> <br /> As the body being bent like a bow, the head gets retracted almost touching his back and his chest is thrown forward, the sides of the neck become rigid and the neck in total get compressed along with clenching of teeth, salivation and aphasia. The attack may lead to death of the patient or deformity.[46-48]<br /> <br /> === ''Hanugraha'' (lock jaw) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> हनुमूले स्थितो बन्धात् संस्रयत्यनिलो हनू | &lt;br /&gt;<br /> विवृतास्यत्वमथवा कुर्यात् [१] स्तब्धमवेदनम् ||४९||&lt;br /&gt;<br /> <br /> हनुग्रहं च संस्तभ्य हनुं(नू)संवृतवक्रताम् |५०|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> hanumUle sthito bandhAt saMsrayatyanilo hanU | &lt;br /&gt;<br /> vivRutAsyatvamathavA kuryAt [1] stabdhamavedanam ||49|| &lt;br /&gt;<br /> <br /> hanugrahaM ca saMstabhya hanuM(nU)saMvRutavakratAm |50| &lt;br /&gt;<br /> <br /> hanumūlē sthitō bandhāt saṁsrayatyanilō hanū| &lt;br /&gt;<br /> vivr̥tāsyatvamathavā kuryāt [1] stabdhamavēdanam||49|| &lt;br /&gt;<br /> <br /> hanugrahaṁ ca saṁstabhya hanuṁ(nū)saṁvr̥tavakratām|50| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When the [[vata]] gets localized at the root of the jaws causes dislocation of the jaws and produces either a condition of stiff gaping of mouth without any pain; or by causing spasticity of the jaw, the mouth becomes fixed and cannot be opened. This is called as ''hanugraha'' (lock jaw)<br /> <br /> === ''Aakshepaka'' (episodic contractions) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मुहुराक्षिपति क्रुद्धो गात्राण्याक्षेपकोऽनिलः ||५०|| <br /> <br /> पाणिपादं च संशोष्य सिराः सस्नायुकण्डराः |५१|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> muhurAkShipati kruddho gAtrANyAkShepako~anilaH ||50|| <br /> <br /> pANipAdaM ca saMshoShya sirāH sasnAyukaNDarAH |51| <br /> <br /> muhurākṣipati kruddhō gātrāṇyākṣēpakō'nilaḥ||50|| <br /> <br /> pāṇipādaṁ ca saṁśōṣya sirāḥ sasnāyukaṇḍarāḥ|51| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''akshepaka'' (..), the provoked [[vata]] contracts vessels, tendons and ligaments of the hands and feet cause episodic contraction in different parts of the body. [50-51]<br /> <br /> === ''Dandaka'' (stiffness of body) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाणिपादशिरःपृष्ठश्रोणीः स्तभ्नाति मारुतः ||५१|| <br /> <br /> दण्डवत्स्तब्धगात्रस्य दण्डकः सोऽनुपक्रमः |५२|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pANipAdashiraHpRuShThashroNIH stabhnAti mArutaH ||51|| <br /> <br /> daNDavatstabdhagAtrasya daNDakaH so~anupakramaH |52|<br /> <br /> pāṇipādaśiraḥpr̥ṣṭhaśrōṇīḥ stabhnāti mārutaḥ||51|| <br /> <br /> daṇḍavatstabdhagātrasya daṇḍakaḥ sō'nupakramaḥ|52| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When [[vata]] causes rigidity of muscles of the hands, feet, head, back and hips, so that the body becomes stiff as a stick, is called as ''dandaka'', the condition is irremediable. [51-52]<br /> <br /> === Episodic nature of [[vata]] disorders ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्वस्थः स्यादर्दितादीनां मुहुर्वेगे [१] गतेऽगते ||५२|| <br /> <br /> पीड्यते पीडनैस्तैस्तैर्भिषगेतान् विवर्जयेत् |५३|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> svasthaH syAdarditAdInAM muhurvege [1] gate~agate ||52|| <br /> <br /> pIDyate pIDanaistaistairbhiShagetAn vivarjayet |53| <br /> <br /> svasthaḥ syādarditādīnāṁ muhurvēgē [1] gatē'gatē||52|| <br /> <br /> pīḍyatē pīḍanaistaistairbhiṣagētān vivarjayēt|53| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In diseases like ''ardita'' etc. when the episodic convulsions are gone, the patient returns to normal. Later as the episodes return the patient gets severely afflicted with characteristic features; the physicians should regard this condition as incurable. [52-53]<br /> <br /> === ''Pakshaghata'' (paralysis) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> हत्वैकं मारुतः पक्षं दक्षिणं वाममेव वा ||५३|| &lt;br /&gt;<br /> <br /> कुर्याच्चेष्टानिवृत्तिं हि रुजं वाक्स्तमभमेव [१] च | &lt;br /&gt;<br /> गृहीत्वाऽर्धं शरीरस्य सिराः स्नायूर्विशोष्य च ||५४|| &lt;br /&gt;<br /> <br /> पादं सङ्कोचयत्येकं हस्तं वा तोदशूलकृत् | &lt;br /&gt;<br /> एकाङ्गरोगं तं विद्यात् सर्वाङ्गं [२] सर्वदेहजम् ||५५||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> hatvaikaM mArutaH pakShaM dakShiNaM vAmameva vA ||53|| &lt;br /&gt;<br /> <br /> kuryAcceShTAnivRuttiM hi rujaM vAkstamabhameva [1] ca | &lt;br /&gt;<br /> gRuhItvA~ardhaM sharIrasya sirāH snAyUrvishoShya ca ||54|| &lt;br /&gt;<br /> <br /> pAdaM sa~gkocayatyekaM hastaM vA todashUlakRut | &lt;br /&gt;<br /> ekA~ggarōgaM taM vidyAt sarvA~ggaM [2] sarvadehajam ||55||&lt;br /&gt;<br /> <br /> hatvaikaṁ mārutaḥ pakṣaṁ dakṣiṇaṁ vāmamēva vā||53|| &lt;br /&gt;<br /> <br /> kuryāccēṣṭānivr̥ttiṁ hi rujaṁ vākstambhamēva [1] ca| &lt;br /&gt;<br /> gr̥hītvā'rdhaṁ śarīrasya sirāḥ snāyūrviśōṣya ca||54|| &lt;br /&gt;<br /> <br /> pādaṁ saṅkōcayatyēkaṁ hastaṁ vā tōdaśūlakr̥t| &lt;br /&gt;<br /> ēkāṅgarōgaṁ taṁ vidyāt sarvāṅgaṁ [2] sarvadēhajam||55||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When [[vata]] paralyze one side of the body either right or left, leads to motor deficit, pain and aphasia on the affected side. [This is called as ''pakshaghata'' (hemiplegia)]. By afflicting one side of the body,[[vata]] causes diminution of the vessels and nerves lead to contraction of either one leg or one arm with aching and piercing pain. That condition is to be known ''ekangaroga'' (monoplegia). If it affects whole body it is called ''sarvangaroga'' (quadriplegia).[53-55]<br /> <br /> === ''Gridhrasi'' (sciatica) and ''khalli'' (radiculopathy) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्फिक्पूर्वा कटिपृष्ठोरुजानुजङ्घापदं क्रमात् | &lt;br /&gt;<br /> गृध्रसी स्तम्भरुक्तोदैर्गृह्णाति स्पन्दते मुहुः ||५६|| &lt;br /&gt;<br /> <br /> वाताद्वातकफात्तन्द्रागौरवारोचकान्विता | &lt;br /&gt;<br /> खल्ली तु पादजङ्घोरुकरमूलावमोटनी ||५७||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sphikpUrvA kaTipRuShThorujAnuja~gghApadaM kramAt | &lt;br /&gt;<br /> gRudhrasI stambharuktodairgRuhNAti spandate muhuH ||56|| &lt;br /&gt;<br /> <br /> vātadvātakaphAttandrAgauravArocakAnvitA | &lt;br /&gt;<br /> khallI tu pAdaja~gghorukaramUlAvamoTanI ||57|| &lt;br /&gt;<br /> <br /> sphikpūrvā kaṭi pr̥ṣṭh ōrujānujaṅghāpadaṁ kramāt| &lt;br /&gt;<br /> gr̥dhrasī stambharuktōdairgr̥hṇāti spandatē muhuḥ||56|| &lt;br /&gt;<br /> <br /> vātādvātakaphāttandrāgauravārōcakānvitā| &lt;br /&gt;<br /> khallī tu pādajaṅghōrukaramūlāvamōṭanī||57|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Gridhrasi'' due to [[vata]] is manifested as; stiffness, ache and pricking pain in the course of gluteal region, hip and posterior aspect of thigh, knee, calf and soles and twitching infrequently. If it is due to combined [[vata]] and [[kapha]], there will be additional symptoms of listlessness, heaviness and anorexia. The condition is known as ''khalli'' where there is kneading pain referable to feet, calf, thigh and shoulder. [56-57]<br /> <br /> === Other local disorders ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्थानानामनुरूपैश्च लिङ्गैः शेषान् विनिर्दिशेत् |५८|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sthānanAmanurUpaishca li~ggaiH sheShAn vinirdishet |58| <br /> <br /> sthānānāmanurūpaiśca liṅgaiḥ śēṣān vinirdiśēt|58| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The rest of the disorders should be diagnosed according to the symptoms characteristic of the seat of affection. [58]<br /> <br /> === Pathological factors ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सर्वेष्वेतेषु संसर्गं पित्ताद्यैरुपलक्षयेत् ||५८|| &lt;br /&gt;<br /> <br /> वायोर्धातुक्षयात् कोपो मार्गस्यावरणेन च (वा) | &lt;br /&gt;<br /> वातपित्तकफा देहे सर्वस्रोतोऽनुसारिणः ||५९|| &lt;br /&gt;<br /> <br /> वायुरेव हि सूक्ष्मत्वाद्द्वयोस्तत्राप्युदीरणः [१] | &lt;br /&gt;<br /> कुपितस्तौ समुद्धूय तत्र तत्र क्षिपन् गदान् ||६०|| &lt;br /&gt;<br /> <br /> करोत्यावृतमार्गत्वाद्रसादींश्चोपशोषयेत् |६१| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sarveShveteShu saMsargaM pittAdyairupalakṣayaet ||58|| &lt;br /&gt;<br /> <br /> vAyordhātukṣayat kopo mArgasyĀvaranaena ca (vA) | &lt;br /&gt;<br /> vātapittakaphA dehe sarvasroto~anusAriNaH ||59|| &lt;br /&gt;<br /> <br /> Vāyu reva hi sUkShmatvAddvayostatrApyudIraNaH [1] | &lt;br /&gt;<br /> kupitastau samuddhUya tatra tatra kShipan gadAn ||60|| &lt;br /&gt;<br /> <br /> karotyAvRutamArgatvAdrasAdIMshcopashoShayet |61|&lt;br /&gt;<br /> <br /> sarvēṣvētēṣu saṁsargaṁ pittādyairupalakṣayēt||58|| &lt;br /&gt;<br /> <br /> vāyōrdhātukṣayāt kōpō mārgasyāvaraṇēna ca (vā)| &lt;br /&gt;<br /> vātapittakaphā dēhē sarvasrōtō'nusāriṇaḥ||59|| &lt;br /&gt;<br /> <br /> vāyurēva hi sūkṣmatvāddvayōstatrāpyudīraṇaḥ [1] | &lt;br /&gt;<br /> kupitastau samuddhūya tatra tatra kṣipan gadān||60|| &lt;br /&gt;<br /> <br /> karōtyāvr̥tamārgatvādrasādīṁścōpaśōṣayēt|61| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In all these disorders, the association of other [[dosha]] like [[pitta]] etc. is to be considered. <br /> <br /> The provocation of [[vata]] is either due to [[dhatu]]kshaya, means diminution of tissue elements and/ or due to ''avarana'' means obstruction to its pathway. The [[vata]], [[pitta]] and [[kapha]], always circulate through all the body channels. The [[vata]], owing to its subtle characteristics is really the impeller of the other two. When the [[vata]] is provoked, it propels the other two [[dosha]] and dislodges them about here and there, causing various diseases. Due to ''avarana'' (obstruction in its path), it further causes diminution of the body nutrient fluid and other body elements. [59-61]<br /> <br /> === Avrita [[vata]] (conditions due to obstructed [[vata]]) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> लिङ्गं पित्तावृते दाहस्तृष्णा शूलं भ्रमस्तमः [१] ||६१|| <br /> <br /> कट्वम्ललवणोष्णैश्च विदाहः शीतकामिता | &lt;br /&gt;<br /> <br /> <br /> शैत्यगौरवशूलानि कट्वाद्युपशयोऽधिकम् ||६२||<br /> <br /> लङ्घनायासरूक्षोष्णकामिता च कफावृते | &lt;br /&gt;<br /> <br /> <br /> रक्तावृते सदाहार्तिस्त्वङ्मांसान्तरजो भृशम् ||६३|| <br /> <br /> भवेत् सरागः श्वयथुर्जायन्ते मण्डलानि च | &lt;br /&gt;<br /> <br /> <br /> कठिनाश्च विवर्णाश्च पिडकाः श्वयथुस्तथा ||६४||<br /> हर्षः पिपीलिकानां च सञ्चार इव मांसगे | &lt;br /&gt;<br /> <br /> <br /> चलः स्निग्धो मृदुः शीतः शोफोऽङ्गेष्वरुचिस्तथा ||६५|| <br /> <br /> आढ्यवात इति ज्ञेयः स कृच्छ्रो मेदसाऽऽवृतः | &lt;br /&gt;<br /> <br /> <br /> स्पर्शमस्थ्नाऽऽवृते तूष्णं पीडनं चाभिनन्दति ||६६||<br /> <br /> सम्भज्यते सीदति च सूचीभिरिव तुद्यते | &lt;br /&gt;<br /> <br /> <br /> मज्जावृते विनामः [२] स्याज्जृम्भणं परिवेष्टनम् ||६७||<br /> <br /> शूलं तु पीड्यमाने च पाणिभ्यां लभते सुखम् | &lt;br /&gt;<br /> <br /> <br /> शुक्रावेगोऽतिवेगो वा निष्फलत्वं च शुक्रगे ||६८||&lt;br /&gt;<br /> <br /> <br /> भुक्ते कुक्षौ च रुग्जीर्णे शाम्यत्यन्नावृतेऽनिले | &lt;br /&gt;<br /> <br /> <br /> मूत्राप्रवृत्तिराध्मानं बस्तौ मूत्रावृतेऽनिले ||६९|| &lt;br /&gt;<br /> <br /> <br /> वर्चसोऽतिविबन्धोऽधः स्वे स्थाने परिकृन्तति | <br /> <br /> व्रजत्याशु जरां स्नेहो भुक्ते चानह्यते नरः ||७०||<br /> <br /> चिरात् पीडितमन्नेन दुःखं शुष्कं शकृत् सृजेत् |<br /> <br /> श्रोणीवङ्क्षणपृष्ठेषु रुग्विलोमश्च मारुतः ||७१||<br /> <br /> अस्वस्थं हृदयं चैव वर्चसा त्वावृतेऽनिले |७२|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> li~ggaM pittAvRute dAhastRuShNA shUlaM bhramastamaH [1] ||61|| &lt;br /&gt;<br /> kaTvamlalavaNoShNaishca vidAhaH shItakAmitA | &lt;br /&gt;<br /> <br /> shaityagauravashUlAni kaTvAdyupashayo~adhikam ||62|| &lt;br /&gt;<br /> la~gghanAyAsarUkShoShNakAmitA ca kaphAvRute | &lt;br /&gt;<br /> <br /> raktAvRute sadAhArtistva~gmāṁsantarajo bhRusham ||63|| &lt;br /&gt;<br /> bhavet sarAgaH shvayathurjAyante maNDalAni ca | &lt;br /&gt;<br /> <br /> kaThinAshca vivarNAshca piDakAH shvayathustathA ||64|| &lt;br /&gt;<br /> harShaH pipIlikAnAM ca sa~jcAra iva māṁsage | &lt;br /&gt;<br /> <br /> calaH snigdho mRuduH shItaH shopho~a~ggeShvarucistathA ||65|| &lt;br /&gt;<br /> ADhyavāta iti j~jeyaH sa kRucchro medasA~a~avRutaH | &lt;br /&gt;<br /> <br /> sparshamasthnA~a~avRute tUShNaM pIDanaM cAbhinandati ||66|| &lt;br /&gt;<br /> sambhajyate sIdati ca sUcIbhiriva tudyate | &lt;br /&gt;<br /> <br /> majjAvRute vinAmaH [2] syAjjRumbhaNaM pariveShTanam ||67|| &lt;br /&gt;<br /> shUlaM tu pIDyamAne ca pANibhyAM labhate sukham | &lt;br /&gt;<br /> <br /> śukravego~ativego vA niShphalatvaM ca śukrage ||68|| &lt;br /&gt;<br /> bhukte kukShau ca rugjIrNe shAmyatyannAvRute~anile | &lt;br /&gt;<br /> <br /> mūtrapravRuttirAdhmAnaM bastau mūtravRute~anile ||69|| &lt;br /&gt;<br /> <br /> varcaso~ativibandho~adhaH sve sthAne parikRuntati | &lt;br /&gt;<br /> vrajatyAshu jarAM sneho bhukte cAnahyate naraH ||70|| &lt;br /&gt;<br /> cirAt pIDitamannena duHkhaM shuShkaM shakRut sRujet | &lt;br /&gt;<br /> shroNIva~gkShaNapRuShTheShu rugvilomashca mArutaH ||71|| &lt;br /&gt;<br /> asvasthaM hRudayaM caiva varcasA tvAvRute~anile |72| &lt;br /&gt;<br /> <br /> liṅgaṁ pittāvr̥tē dāhastr̥ṣṇā śūlaṁ bhramastamaḥ [1] ||61|| &lt;br /&gt;<br /> kaṭvamlalavaṇōṣṇaiśca vidāhaḥ śītakāmitā| &lt;br /&gt;<br /> <br /> śaityagauravaśūlāni kaṭvādyupaśayō'dhikam||62|| &lt;br /&gt;<br /> laṅghanāyāsarūkṣōṣṇakāmitā ca kaphāvr̥tē| &lt;br /&gt;<br /> <br /> raktāvr̥tē sadāhārtistvaṅmāṁsāntarajō bhr̥śam||63|| &lt;br /&gt;<br /> bhavēt sarāgaḥ śvayathurjāyantē maṇḍalāni ca| &lt;br /&gt;<br /> <br /> kaṭhināśca vivarṇāśca piḍakāḥ śvayathustathā||64|| &lt;br /&gt;<br /> harṣaḥ pipīlikānāṁ ca sañcāra iva māṁsagē| &lt;br /&gt;<br /> <br /> calaḥ snigdhō mr̥duḥ śītaḥ śōphō'ṅgēṣvarucistathā||65|| &lt;br /&gt;<br /> āḍhyavāta iti jñēyaḥ sa kr̥cchrō mēdasā''vr̥taḥ| &lt;br /&gt;<br /> <br /> sparśamasthnā''vr̥tē tūṣṇaṁ pīḍanaṁ cābhinandati||66|| &lt;br /&gt;<br /> sambhajyatē sīdati ca sūcībhiriva tudyatē| &lt;br /&gt;<br /> <br /> majjāvr̥tē vināmaḥ [2] syājjr̥mbhaṇaṁ parivēṣṭanam||67|| &lt;br /&gt;<br /> śūlaṁ tu pīḍyamānē ca pāṇibhyāṁ labhatē sukham| &lt;br /&gt;<br /> <br /> śukrāvēgō'tivēgō vā niṣphalatvaṁ ca śukragē||68|| &lt;br /&gt;<br /> <br /> bhuktē kukṣau ca rugjīrṇē śāmyatyannāvr̥tē'nilē| &lt;br /&gt;<br /> <br /> mūtrāpravr̥ttirādhmānaṁ bastau mūtrāvr̥tē'nilē||69|| &lt;br /&gt;<br /> varcasō'tivibandhō'dhaḥ svē sthānē parikr̥ntati| &lt;br /&gt;<br /> vrajatyāśu jarāṁ snēhō bhuktē cānahyatē naraḥ||70|| &lt;br /&gt;<br /> cirāt pīḍitamannēna duḥkhaṁ śuṣkaṁ śakr̥t sr̥jēt| &lt;br /&gt;<br /> śrōṇīvaṅkṣaṇapr̥ṣṭhēṣu rugvilōmaśca mārutaḥ||71|| &lt;br /&gt;<br /> asvasthaṁ hr̥dayaṁ caiva varcasā tvāvr̥tē'nilē|72| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ==== [[Vata]] occluded by [[pitta]] ====<br /> <br /> The symptoms of [[vata]] occluded by [[pitta]] are burning sensation, morbid thirst, colic, giddiness, darkness of vision; heart burn on eating pungent, sour, salt and hot things and craving for cold things.[61]<br /> <br /> ==== [[Vata]] occluded by [[kapha]] ==== <br /> <br /> If the [[vata]] is occluded by [[kapha]], there will be excess feeling of cold, heaviness, pain, pacification by pungent and similar other articles, craving for fasting, exertion, dry and hot things.[62]<br /> <br /> ==== [[Vata]] occluded by blood ====<br /> <br /> When it is occluded by the blood, there will be severe burning pain in the area between the skin and the flesh, along with edema and reddish tinge and round patches.[63]<br /> <br /> ==== [[Vata]] occluded by [[mamsa dhatu]] ==== <br /> <br /> In the flesh, it causes hard, discolored boils, and swellings, horripilation and tingling.[64]<br /> <br /> ==== [[Vata]] occluded by [[meda dhatu]] ====<br /> <br /> When the [[vata]] is occluded in the adipose tissue, it causes movable, smooth, soft and cold swellings in the body, as well as anorexia. This condition is known as ''adhyavata'' and is difficult to cure. [65]<br /> <br /> ==== [[Vata]] occluded by [[asthi dhatu]] ====<br /> <br /> When the [[vata]] is occluded in the osseous tissue, the patient likes hot touch (local sudation) and pressing . He has splitting pain and feels as though his body is being pricked with needles.[66]<br /> <br /> ==== [[Vata]] occluded by [[majja dhatu]] ====<br /> <br /> When the [[vata]] is occluded in the marrow, there will be flexure/bending/curving of the body, /pandiculation (stretching and stiffening of the trunk and extremities), excess yawning, twisting and colicky pain. The patient gets relief on pressing with the hand (gentle massage). [67]<br /> <br /> ==== [[Vata]] occluded by [[shukra dhatu]] ====<br /> <br /> If the [[vata]] is occluded in semen, it results in ejaculation or premature ejaculation or sterility.[68]<br /> <br /> ==== [[Vata]] occluded by food ====<br /> <br /> If the [[vata]] is occluded by food, there will be pain in the stomach on ingestion of food and disappearance of pain after digestion.[68]<br /> <br /> ====[[Vata]] occluded by urine ====<br /> <br /> If the [[vata]] is occluded by urine leads to urinary retention and distension of bladder.[69]<br /> <br /> ==== [[Vata]] occluded by feces ==== <br /> <br /> If the [[vata]] is occluded by the fecal matter; it leads to obstinate constipation, scissoring type pain in anal region, all unctuous matter ingested is immediately digested (due to excess dryness in colon), after food intake the person suffers from increased distension of abdomen and owing to the pressure of the food ingested the patient passes dry feces with difficulty and after long delay. He is afflicted with pain in the hips, groins and back; as the [[vata]] moves in a reverse direction causes epigastric discomfort. [70-71]<br /> <br /> === Prognosis ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सन्धिच्युतिर्हनुस्तम्भः [१] कुञ्चनं कुब्जताऽर्दितः ||७२|| &lt;br /&gt;<br /> <br /> पक्षाघातोऽङ्गसंशोषः [२] पङ्गुत्वं खुडवातता | &lt;br /&gt;<br /> स्तम्भनं चाढ्यवातश्च रोगा मज्जास्थिगाश्च ये ||७३|| &lt;br /&gt;<br /> <br /> एते स्थानस्य गाम्भीर्याद्यत्नात् सिध्यन्ति वा न वा | &lt;br /&gt;<br /> नवान् बलवतस्त्वेतान् साधयेन्निरुपद्रवान् ||७४||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sandhicyutirhanustambhaH [1] ku~jcanaM kubjatA~arditaH ||72|| &lt;br /&gt;<br /> <br /> pakShAghAto~a~ggasaMshoShaH [2] pa~ggutvaM khuDavātatA | &lt;br /&gt;<br /> stambhanaM cADhyavātashca rōga majjAsthigAshca ye ||73|| &lt;br /&gt;<br /> <br /> ete sthānasya gAmbhIryAdyatnAt sidhyanti vA na vA | &lt;br /&gt;<br /> navAn balavātastvetAn sAdhayennirupadravAn ||74|| &lt;br /&gt;<br /> <br /> sandhicyutirhanustambhaḥ [1] kuñcanaṁ kubjatā'rditaḥ||72|| &lt;br /&gt;<br /> <br /> pakṣāghātō'ṅgasaṁśōṣaḥ [2] paṅgutvaṁ khuḍavātatā| &lt;br /&gt;<br /> stambhanaṁ cāḍhyavātaśca rōgā majjāsthigāśca yē||73|| &lt;br /&gt;<br /> <br /> ētē sthānasya gāmbhīryādyatnāt sidhyanti vā na vā| &lt;br /&gt;<br /> navān balavātastvētān sādhayēnnirupadravān||74|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Joint dislocation, lock jaw, contracture, hunch back(kyphosis), facial paralysis, hemiplegia, atrophy of a part, paraplegia, arthritis, stiffness, rheumatic conditions and disorders due to affliction of vāta in the marrow; all these on account of their seriousness of the seat affected , may or may not be cured even after deliberate treatment. These can be cured when they are of recent origin in strong patient and without any complications. [72-74]<br /> <br /> === General management of [[vata]] disorders ===<br /> ==== Importance of [[snehana]] (oleation therapy) and [[swedana]](sudation therapy) ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्रियामतः परं सिद्धां वातरोगापहां शृणु | &lt;br /&gt;<br /> केवलं निरुपस्तम्भमादौ स्नेहैरुपाचरेत् ||७५||&lt;br /&gt;<br /> <br /> वायुं सर्पिर्वसातैलमज्जपानैर्नरं ततः | &lt;br /&gt;<br /> स्नेहक्लान्तं समाश्वास्य पयोभिः स्नेहयेत् पुनः ||७६|| &lt;br /&gt;<br /> <br /> यूषैर्ग्राम्याम्बुजानूपरसैर्वा स्नेहसंयुतैः | &lt;br /&gt;<br /> पायसैः कृशरैः साम्ललवणैरनुवासनैः ||७७|| &lt;br /&gt;<br /> <br /> नावनैस्तर्पणैश्चान्नैः [१] सुस्निग्धं स्वेदयेत्ततः | &lt;br /&gt;<br /> स्वभ्यक्तं स्नेहसंयुक्तैर्नाडीप्रस्तरसङ्करैः ||७८|| &lt;br /&gt;<br /> <br /> तथाऽन्यैर्विविधैः स्वेदैर्यथायोगमुपाचरेत् | &lt;br /&gt;<br /> स्नेहाक्तं [२] स्विन्नमङ्गं तु वक्रं स्तब्धमथापि वा ||७९|| &lt;br /&gt;<br /> <br /> शनैर्नामयितुं शक्यं यथेष्टं शुष्कदारुवत् | &lt;br /&gt;<br /> हर्षतोदरुगायामशोथस्तम्भग्रहादयः ||८०|| &lt;br /&gt;<br /> <br /> स्विन्नस्याशु प्रशाम्यन्ति मार्दवं चोपजायते | &lt;br /&gt;<br /> स्नेहश्च धातून्संशुष्कान् पुष्णात्याशु प्रयोजितः ||८१|| &lt;br /&gt;<br /> <br /> बलमग्निबलं पुष्टिं प्राणांश्चाप्यभिवर्धयेत् | &lt;br /&gt;<br /> असकृत्तं पुनः स्नेहैः स्वेदैश्चाप्युपपादयेत् ||८२|| &lt;br /&gt;<br /> <br /> तथा स्नेहमृदौ कोष्ठे न तिष्ठन्त्यनिलामयाः |८३|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kriyAmataH paraM siddhAM vātarōgapahAM shRuNu | &lt;br /&gt;<br /> kevalaM nirupastambhamAdau SnēhairupAcaret ||75|| &lt;br /&gt;<br /> <br /> Vāyu M sarpirvasAtailamajjapāna irnaraM tataH | &lt;br /&gt;<br /> SnēhaklAntaM samAshvAsya payobhiH Snēhayet punaH ||76|| &lt;br /&gt;<br /> <br /> yUShairgrAmyAmbujAnUparasairvA SnēhasaMyutaiH | &lt;br /&gt;<br /> pAyasaiH kRusharaiH sAmlalavaNairanuvAsanaiH ||77|| &lt;br /&gt;<br /> <br /> nAvanaistarpaNaishcAnnaiH [1] susnigdhaM svedayettataH | &lt;br /&gt;<br /> svabhyaktaM SnēhasaMyuktairnADIprastarasa~gkaraiH ||78|| &lt;br /&gt;<br /> <br /> tathA~anyairvividhaiH svedairyathAyogamupAcaret | &lt;br /&gt;<br /> SnēhaktaM [2] svinnama~ggaM tu vakraM stabdhamathApi vA ||79|| &lt;br /&gt;<br /> <br /> shanairnAmayituM shakyaM yatheShTaM shuShkadAruvat | &lt;br /&gt;<br /> harShatodarugAyAmaśōthastambhagrahAdayaH ||80|| &lt;br /&gt;<br /> <br /> svinnasyAshu prashAmyanti mArdavaM copajAyate | &lt;br /&gt;<br /> Snēhashca dhātunsaMshuShkAn puShNAtyAshu prayojitaH ||81|| &lt;br /&gt;<br /> <br /> balamagnibalaM puShTiM prānaMshcApyabhivardhayet | &lt;br /&gt;<br /> asakRuttaM punaH SnēhaiH svedaishcApyupapAdayet ||82|| &lt;br /&gt;<br /> <br /> tathA SnēhamRudau koShThe na tiShThantyanilAmayAH |83| &lt;br /&gt;<br /> <br /> kriyāmataḥ paraṁ siddhāṁ vātarōgāpahāṁ śr̥ṇu| &lt;br /&gt;<br /> kēvalaṁ nirupastambhamādau snēhairupācarēt||75|| &lt;br /&gt;<br /> <br /> vāyuṁ sarpirvasātailamajjapānairnaraṁ tataḥ| &lt;br /&gt;<br /> snēhaklāntaṁ samāśvāsya payōbhiḥ snēhayēt punaḥ||76|| &lt;br /&gt;<br /> <br /> yūṣairgrāmyāmbujānūparasairvā snēhasaṁyutaiḥ| &lt;br /&gt;<br /> pāyasaiḥ kr̥śaraiḥ sāmlalavaṇairanuvāsanaiḥ||77|| &lt;br /&gt;<br /> <br /> nāvanaistarpaṇaiścānnaiḥ [1] susnigdhaṁ svēdayēttataḥ| &lt;br /&gt;<br /> svabhyaktaṁ snēhasaṁyuktairnāḍīprastarasaṅkaraiḥ||78|| &lt;br /&gt;<br /> <br /> tathā'nyairvividhaiḥ svēdairyathāyōgamupācarēt| &lt;br /&gt;<br /> snēhāktaṁ [2] svinnamaṅgaṁ tu vakraṁ stabdhamathāpi vā||79|| &lt;br /&gt;<br /> <br /> śanairnāmayituṁ śakyaṁ yathēṣṭaṁ śuṣkadāruvat| &lt;br /&gt;<br /> harṣatōdarugāyāmaśōthastambhagrahādayaḥ||80|| &lt;br /&gt;<br /> <br /> svinnasyāśu praśāmyanti mārdavaṁ cōpajāyatē| &lt;br /&gt;<br /> snēhaśca dhātūnsaṁśuṣkān puṣṇātyāśu prayōjitaḥ||81|| &lt;br /&gt;<br /> <br /> balamagnibalaṁ puṣṭiṁ prāṇāṁścāpyabhivardhayēt| &lt;br /&gt;<br /> asakr̥ttaṁ punaḥ snēhaiḥ svēdaiścāpyupapādayēt||82|| &lt;br /&gt;<br /> <br /> tathā snēhamr̥dau kōṣṭhē na tiṣṭhantyanilāmayāḥ|83| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now listen to the effective line of treatment for the cure of diseases due to [[vata]]. If there is absolute vitiation of [[vata]] without any kind of association(obstruction), it should be treated at first with oleation therapy, such as internal administration of ghee, fat, oil and marrow. Then as the person, when saturated by the oleation, should be eased by consolation and should again be oleated with unctuous articles added milk; thin gruel of cereals and pulses or meat juice of domestic, wet-land and aquatic animals, milk or meat without bones mixed with sour and salt articles; followed with unctuous enema, nasal medications and nutritive food. [75-77]<br /> <br /> When he is well oleated, he should be subjected to sudation therapy, for which oil is applied externally, and then fomentation is done through tubular, mattress or bolus method or different other types suitable to the situation. [78]<br /> <br /> By application of oleation and sudation, even a deformed stiffened limb can be slowly brought back to normality, just as it possible to bend as desired even a dried piece of wood by such measures. [79]<br /> <br /> Tingling numbness, pricking pain, aches, convulsions, swelling, stiffness and spasticity and similar other conditions can be quickly cured and the softness of the part restored by means of sudation. [80]<br /> <br /> The oleation therapy when applied quickly replenishes the diminished body elements and increases the strength, power of the digestive mechanism, robustness and the vitality. [81]<br /> <br /> The oleation and sudation procedures should be repeatedly administered so that the disorders of [[vata]] may not stay in the viscera softened by oleation procedure. [82]<br /> <br /> ==== ''Mridu samshodhana'' (Mild purgation) ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यद्यनेन सदोषत्वात् कर्मणा न प्रशाम्यति ||८३|| &lt;br /&gt;<br /> <br /> मृदुभिः स्नेहसंयुक्तैरौषधैस्तं विशोधयेत् | &lt;br /&gt;<br /> घृतं तिल्वकसिद्धं वा सातलासिद्धमेव वा ||८४|| &lt;br /&gt;<br /> <br /> पयसैरण्डतैलं वा पिबेद्दोषहरं शिवम् | &lt;br /&gt;<br /> स्निग्धाम्ललवणोष्णाद्यैराहारैर्हि मलश्चितः ||८५|| &lt;br /&gt;<br /> <br /> स्रोतो बद्ध्वाऽनिलं रुन्ध्यात्तस्मात्तमनुलोमयेत् [१] | &lt;br /&gt;<br /> दुर्बलो योऽविरेच्यः स्यात्तं निरूहैरुपाचरेत् ||८६|| &lt;br /&gt;<br /> <br /> पाचनैर्दीपनीयैर्वा भोजनैस्तद्युतैर्नरम् | &lt;br /&gt;<br /> संशुद्धस्योत्थिते चाग्नौ स्नेहस्वेदौ पुनर्हितौ ||८७|| &lt;br /&gt;<br /> <br /> स्वाद्वम्ललवणस्निग्धैराहारैः सततं पुनः | &lt;br /&gt;<br /> नावनैर्धूमपानैश्च सर्वानेवोपपादयेत् ||८८|| &lt;br /&gt;<br /> <br /> इति सामान्यतः प्रोक्तं वातरोगचिकित्सितम् |८९| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yadyanena sa dōṣatvAt karmaNA na prashAmyati ||83|| &lt;br /&gt;<br /> <br /> mRudubhiH SnēhasaMyuktairauShadhaistaM vishodhayet | &lt;br /&gt;<br /> ghRutaM tilvakasiddhaM vA sAtalAsiddhameva vA ||84|| &lt;br /&gt;<br /> <br /> payasairaNDatailaM vA pibed dōṣaharaM shivam | &lt;br /&gt;<br /> snigdhAmlalavaNoShNAdyairAhArairhi malashcitaH ||85|| &lt;br /&gt;<br /> <br /> sroto baddhvA~anilaM rundhyAttasmAttamanulomayet [1] | &lt;br /&gt;<br /> durbalo yo~avirecyaH syAttaM nirUhairupAcaret ||86|| &lt;br /&gt;<br /> <br /> pācanairdIpanIyairvA bhojanaistadyutairnaram | &lt;br /&gt;<br /> saMshuddhasyotthite cAgnau Snēhasvedau punarhitau ||87|| &lt;br /&gt;<br /> <br /> svAdvamlalavaNasnigdhairAhAraiH satataM punaH | &lt;br /&gt;<br /> nAvanairdhUmapāna ishca sarvAnevopapAdayet ||88|| &lt;br /&gt;<br /> <br /> iti SamānayataH proktaM vātarōgacikitśītām |89| &lt;br /&gt;<br /> <br /> yadyanēna sadōṣatvāt karmaṇā na praśāmyati||83|| &lt;br /&gt;<br /> <br /> mr̥dubhiḥ snēhasaṁyuktairauṣadhaistaṁ viśōdhayēt| &lt;br /&gt;<br /> ghr̥taṁ tilvakasiddhaṁ vā sātalāsiddhamēva vā||84|| &lt;br /&gt;<br /> <br /> payasairaṇḍatailaṁ vā pibēddōṣaharaṁ śivam| &lt;br /&gt;<br /> snigdhāmlalavaṇōṣṇādyairāhārairhi malaścitaḥ||85|| &lt;br /&gt;<br /> <br /> srōtō baddhvā'nilaṁ rundhyāttasmāttamanulōmayēt [1] | &lt;br /&gt;<br /> durbalō yō'virēcyaḥ syāttaṁ nirūhairupācarēt||86|| &lt;br /&gt;<br /> <br /> pācanairdīpanīyairvā bhōjanaistadyutairnaram| &lt;br /&gt;<br /> saṁśuddhasyōtthitē cāgnau snēhasvēdau punarhitau||87|| &lt;br /&gt;<br /> <br /> svādvamlalavaṇasnigdhairāhāraiḥ satataṁ punaḥ| &lt;br /&gt;<br /> nāvanairdhūmapānaiśca sarvānēvōpapādayēt||88|| &lt;br /&gt;<br /> <br /> iti sāmānyataḥ prōktaṁ vātarōgacikitśītām|89| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If due to residual morbidity, the symptoms did not subside with the above procedures, then the patient should be cleansed by means of mild drugs mixed with unctuous articles. [83]<br /> <br /> For this purpose the patient may take the medicated ghee prepared with ''tilvaka'' or ''satala'', or castor oil with milk; all of these are auspicious and expel the morbid humors. [84]<br /> <br /> By excessive use of unctuous, sour, salty and hot articles of diet, the excretory matter gets accumulated and occluding the alimentary passage, obstructs the [[vata]], hence ''anulomana'' of [[vata]] should be done. [85]<br /> <br /> Debilitated patients, in whom purgation is contraindicated, should be given evacuative enema followed by a diet consisting of, or mixed with, the drugs of the digestive and appetizer groups. [86]<br /> <br /> Sudation and oleation procedures, repeated again, are beneficial for those whose digestive mechanism has been stimulated as a result of the purificatory procedure. [87]<br /> <br /> All diseases due to [[vata]] vitiation are always to be continually treated with sweet, sour, salty and unctuous articles of diet and nasal medication and inhalations. Thus the treatment of diseases due to [[vata]] provocation has been expounded in general. [88]<br /> <br /> ==== Specific treatment of various conditions ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विशेषतस्तु कोष्ठस्थे वाते क्षारं [१] पिबेन्नरः ||८९|| &lt;br /&gt;<br /> <br /> पाचनैर्दीपनैर्युक्तैरम्लैर्वा [२] पाचयेन्मलान् | &lt;br /&gt;<br /> गुदपक्वाशयस्थे तु कर्मोदावर्तनुद्धितम् ||९०|| &lt;br /&gt;<br /> <br /> आमाशयस्थे शुद्धस्य यथादोषहरीः क्रियाः | &lt;br /&gt;<br /> सर्वाङ्गकुपितेऽभ्यङ्गो बस्तयः सानुवासनाः ||९१|| &lt;br /&gt;<br /> <br /> स्वेदाभ्यङ्गावगाहाश्च हृद्यं चान्नं त्वगाश्रिते | &lt;br /&gt;<br /> शीताः प्रदेहा रक्तस्थे विरेको रक्तमोक्षणम् ||९२|| &lt;br /&gt;<br /> <br /> विरेको मांसमेदःस्थे निरूहाः शमनानि च | &lt;br /&gt;<br /> बाह्याभ्यन्तरतः स्नेहैरस्थिमज्जगतं जयेत् ||९३|| &lt;br /&gt;<br /> <br /> हर्षोऽन्नपानं शुक्रस्थे बलशुक्रकरं हितम् | &lt;br /&gt;<br /> विबद्धमार्गं दृष्ट्वा वा शुक्रं दद्याद्विरेचनम् ||९४|| &lt;br /&gt;<br /> <br /> विरिक्तप्रतिभुक्तस्य पूर्वोक्तां कारयेत् क्रियाम् | &lt;br /&gt;<br /> गर्भे शुष्के तु वातेन बालानां चापि शुष्यताम् ||९५|| &lt;br /&gt;<br /> <br /> सिताकाश्मर्यमधुकैर्हितमुत्थापने पयः | &lt;br /&gt;<br /> हृदि प्रकुपिते सिद्धमंशुमत्या पयो हितम् ||९६|| &lt;br /&gt;<br /> <br /> मत्स्यान्नाभिप्रदेशस्थे सिद्धान् बिल्वशलाटुभिः | &lt;br /&gt;<br /> वायुना वेष्ट्यमाने तु गात्रे स्यादुपनाहनम् ||९७|| &lt;br /&gt;<br /> <br /> तैलं सङ्कुचितेऽभ्यङ्गो माषसैन्धवसाधितम् | &lt;br /&gt;<br /> बाहुशीर्षगते नस्यं पानं चौत्तरभक्तिकम् ||९८|| &lt;br /&gt;<br /> <br /> बस्तिकर्म त्वधो नाभेः शस्यते चावपीडकः |९९| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> visheShatastu kōṣṭhasthe vAte kShAraM [1] pibennaraH ||89|| &lt;br /&gt;<br /> <br /> pācanairdIpanairyuktairamlairvA [2] pAcayenmalAn | &lt;br /&gt;<br /> gudapakvAshayasthe tu karmodAvartanuddhitam ||90|| &lt;br /&gt;<br /> <br /> Āmashayasthe shuddhasya yathA dōṣaharIH kriyAH | &lt;br /&gt;<br /> sarvA~ggakupite~abhya~ggo bastayaH sAnuvAsanAH ||91|| &lt;br /&gt;<br /> <br /> svedAbhya~ggAvagAhAshca hRudyaM cAnnaM tvagAshrite | &lt;br /&gt;<br /> shItAH pradehA raktasthe vireko raktamokShaNam ||92|| &lt;br /&gt;<br /> <br /> vireko māṁsamedaHsthe nirUhAH shamanAni ca | &lt;br /&gt;<br /> bAhyAbhyantarataH SnēhairasthimajjagataM jayet ||93|| &lt;br /&gt;<br /> <br /> harSho~annapāna M śukrasthe balaśukrakaraM hitam | &lt;br /&gt;<br /> vibaddhamArgaM dRuShTvA vA śukraM dadyAdvirēcanam ||94|| &lt;br /&gt;<br /> <br /> viriktapratibhuktasya pUrvoktAM kArayet kriyAm | &lt;br /&gt;<br /> garbhe shuShke tu vAtena bAlAnAM cApi shuShyatAm ||95|| &lt;br /&gt;<br /> <br /> śītākAshmaryamadhukairhitamutthApānae payaH | &lt;br /&gt;<br /> hRudi prakupite siddhamaMshumatyA payo hitam ||96||&lt;br /&gt;<br /> <br /> matsyAnnAbhipradeshasthe siddhAn bilvashalATubhiH | &lt;br /&gt;<br /> Vāyu nA veShTyamAne tu gAtre syAdupanAhanam ||97|| &lt;br /&gt;<br /> <br /> tailaM sa~gkucite~abhya~ggo mAShasaindhavasAdhitam | &lt;br /&gt;<br /> bAhushIrShagate nasyaM pAnaM cauttarabhaktikam ||98|| &lt;br /&gt;<br /> <br /> bastikarma tvadho nAbheH shasyate cAvapIDakaH |99| &lt;br /&gt;<br /> <br /> viśēṣatastu kōṣṭhasthē vātē kṣāraṁ [1] pibēnnaraḥ||89|| &lt;br /&gt;<br /> <br /> pācanairdīpanairyuktairamlairvā [2] pācayēnmalān| &lt;br /&gt;<br /> gudapakvāśayasthē tu karmōdāvartanuddhitam||90|| &lt;br /&gt;<br /> <br /> āmāśayasthē śuddhasya yathādōṣaharīḥ kriyāḥ| &lt;br /&gt;<br /> sarvāṅgakupitē'bhyaṅgō bastayaḥ sānuvāsanāḥ||91|| &lt;br /&gt;<br /> <br /> svēdābhyaṅgāvagāhāśca hr̥dyaṁ cānnaṁ tvagāśritē| &lt;br /&gt;<br /> śītāḥ pradēhā raktasthē virēkō raktamōkṣaṇam||92|| &lt;br /&gt;<br /> <br /> virēkō māṁsamēdaḥsthē nirūhāḥ śamanāni ca| &lt;br /&gt;<br /> bāhyābhyantarataḥ snēhairasthimajjagataṁ jayēt||93|| &lt;br /&gt;<br /> <br /> harṣō'nnapānaṁ śukrasthē balaśukrakaraṁ hitam| &lt;br /&gt;<br /> vibaddhamārgaṁ dr̥ṣṭvā vā śukraṁ dadyādvirēcanam||94|| &lt;br /&gt;<br /> <br /> viriktapratibhuktasya pūrvōktāṁ kārayēt kriyām| &lt;br /&gt;<br /> garbhē śuṣkē tu vātēna bālānāṁ cāpi śuṣyatām||95|| &lt;br /&gt;<br /> <br /> sitākāśmaryamadhukairhitamutthāpanē payaḥ| &lt;br /&gt;<br /> hr̥di prakupitē siddhamaṁśumatyā payō hitam||96|| &lt;br /&gt;<br /> <br /> matsyānnābhipradēśasthē siddhān bilvaśalāṭubhiḥ| &lt;br /&gt;<br /> vāyunā vēṣṭyamānē tu gātrē syādupanāhanam||97|| &lt;br /&gt;<br /> <br /> tailaṁ saṅkucitē'bhyaṅgō māṣasaindhavasādhitam| &lt;br /&gt;<br /> bāhuśīrṣagatē nasyaṁ pānaṁ cauttarabhaktikam||98|| &lt;br /&gt;<br /> <br /> bastikarma tvadhō nābhēḥ śasyatē cāvapīḍakaḥ|99| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ==== Treatment of [[vata]] located in alimentary tract ====<br /> <br /> Now to be specific; in the condition of morbid [[vata]] lodged in the alimentary tract, the patient should drink alkaline drugs or digestion of humors is to be done with digestive and appetizer groups of drugs.[89]<br /> <br /> ==== Treatment of [[vata]] located in colon ==== <br /> <br /> In condition of morbid [[vata]] lodged in the rectum or the colon, the treatment of ''udavarta'' should be given. [90]<br /> <br /> ==== Treatment of [[vata]] located in stomach ====<br /> <br /> If it is lodged in the stomach, after the purificatory process, specific treatment as per the [[dosha]] should be given.<br /> <br /> ==== Treatment of [[vata]] located in entire body ====<br /> <br /> When the [[vata]] is provoked in the entire body, oil massage, evacuative enema and unctuous enema should be given. [91]<br /> <br /> ==== Treatment of [[vata]] located in skin ====<br /> <br /> When the skin is affected, sudation, oil application, hot immersion bath and cordial food should be given.<br /> <br /> ==== Treatment of [[vata]] located in blood ====<br /> <br /> When the blood is affected, thick and cold external applications, purgation and blood letting are to be done. [92]<br /> <br /> ==== Treatment of [[vata]] located in muscle flesh and fat ====<br /> <br /> As the flesh and fat is affected purgation, evacuative enema and palliative measures should be administered.<br /> <br /> ==== Treatment of [[vata]] located in osseous tissue and bone marrow ====<br /> <br /> The osseous tissues and bone-marrow affliction should be corrected with internal and external oleation therapy.[93]<br /> <br /> ==== Treatment of [[vata]] located in semen and intrauterine growth retardation ==== <br /> <br /> If the semen is affected, virility enhancing food and drinks which promote strength and semen are beneficial. If the passage of semen is found to be occluded, purgation should be administered. Only after purgation and consumption of diet, the previously mentioned line of treatment should be carried out.[94]<br /> <br /> When [[vata]] causes intrauterine growth retardation or new born is emaciated, then milk prepared with sugar, ''kashmarya'' and ''madhuka'' is beneficial for restoration.[95]<br /> <br /> ==== Treatment of [[vata]] located in cardiac region ==== <br /> <br /> If the provoked [[vata]] is located in the cardiac region, the milk prepared of aṁśumati is beneficial. <br /> <br /> ==== Treatment of [[vata]] located in umbilicus ====<br /> <br /> If it is located in the umbilicus, fish processed with unripe ''bilva'' fruits should be given.[97]<br /> <br /> ==== Treatment of [[vata]] located in parts of body ==== <br /> <br /> If there are cramps in any part of the body, poultice should be applied.<br /> <br /> In contractures of body parts, external massage with the medicated oil prepared with black gram and rock salt should be prescribed.<br /> <br /> If there is [[vata]] provocation in the shoulders nasal medication and ghee should be administered after food. <br /> <br /> When the morbid [[vata]] is localized below the umbilical region, enema and ''avapidhaka sneha'' are recommended.[98]<br /> <br /> === Treatment of [[vata]] disorders affecting tendon, ligaments and vessels ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अर्दिते नावनं मूर्ध्नि तैलं तर्पणमेव च ||९९|| &lt;br /&gt;<br /> <br /> नाडीस्वेदोपनाहाश्चाप्यानूपपिशितैर्हिताः | &lt;br /&gt;<br /> स्वेदनं स्नेहसंयुक्तं पक्षाघाते विरेचनम् ||१००|| &lt;br /&gt;<br /> <br /> अन्तराकण्डरागुल्फं सिरा बस्त्यग्निकर्म च | &lt;br /&gt;<br /> गृध्रसीषु प्रयुञ्जीत खल्ल्यां तूष्णोपनाहनम् ||१०१|| &lt;br /&gt;<br /> <br /> पायसैः कृशरैर्मांसैः शस्तं तैलघृतान्वितैः | &lt;br /&gt;<br /> व्यात्तानने हनुं स्विन्नामङ्गुष्ठाभ्यां प्रपीड्य च ||१०२|| &lt;br /&gt;<br /> <br /> प्रदेशिनीभ्यां चोन्नाभ्य चिबुकोन्नामनं हितम् | &lt;br /&gt;<br /> स्रस्तं स्वं गमयेत्स्थानं स्तब्धं स्विन्नं विनामयेत् ||१०३||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ardite nAvanaM mUrdhni tailaM tarpaNameva ca ||99|| &lt;br /&gt;<br /> <br /> nADIsvedopanAhAshcApyAnUpapishitairhitAH | &lt;br /&gt;<br /> svedanaM SnēhasaMyuktaM pakShAghAte virēcanam ||100|| &lt;br /&gt;<br /> <br /> antarAkaNDarAgulphaM [1] sirā bastyagnikarma ca | &lt;br /&gt;<br /> gRudhrasIShu prayu~jjIta khallyAM tUShNopanAhanam ||101|| &lt;br /&gt;<br /> <br /> pAyasaiH kRusharairmāṁsaiH shastaM tailaghRutAnvitaiH | &lt;br /&gt;<br /> vyAttAnane [2] hanuM svinnAma~gguShThAbhyAM prapIDya ca ||102|| &lt;br /&gt;<br /> <br /> pradeshinIbhyAM connAbhya cibukonnAmanaM hitam | &lt;br /&gt;<br /> srastaM svaM gamayetsthānaM stabdhaM svinnaM vinAmayet ||103|| &lt;br /&gt;<br /> <br /> arditē nāvanaṁ mūrdhni tailaṁ tarpaṇamēva ca||99|| &lt;br /&gt;<br /> <br /> nāḍīsvēdōpanāhāścāpyānūpapiśitairhitāḥ| &lt;br /&gt;<br /> svēdanaṁ snēhasaṁyuktaṁ pakṣāghātē virēcanam||100|| &lt;br /&gt;<br /> <br /> antarākaṇḍarāgulphaṁ [1] sirā bastyagnikarma ca| &lt;br /&gt;<br /> gr̥dhrasīṣu prayuñjīta khallyāṁ tūṣṇōpanāhanam||101|| &lt;br /&gt;<br /> <br /> pāyasaiḥ kr̥śarairmāṁsaiḥ śastaṁ tailaghr̥tānvitaiḥ| &lt;br /&gt;<br /> vyāttānanē [2] hanuṁ svinnāmaṅguṣṭhābhyāṁ prapīḍya ca||102|| &lt;br /&gt;<br /> <br /> pradēśinībhyāṁ cōnnābhya cibukōnnāmanaṁ hitam| &lt;br /&gt;<br /> srastaṁ svaṁ gamayētsthānaṁ stabdhaṁ svinnaṁ vināmayēt||103|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In facial paralysis, nasal medication, overhead application of oil, ''tarpaṇa'', tubular fomentation and poultices prepared of the flesh of aquatic animals are beneficial.[99]<br /> <br /> In hemiplegia, sudation with unctuous preparations and purgation are beneficial. <br /> <br /> In sciatica, venesection of the vein situated between medially situated tendon (''kandhara'') and ''gulpha'', enema and cauterization should be resorted.[100]<br /> <br /> In ''khalli'', hot poultices prepared with milk pudding or ''krishara'' or flesh mixed with oil and ghee are beneficial.[101]<br /> <br /> In lock jaw; in case of opened fixed mouth, the jaw should be subjected to sudation procedure first and then it should be pressed downwards by the thumbs (inserting in the mouth and pressing on the molar teeth) and pushed upwards by fingers (which are placed externally below the chin) is beneficial. So the subluxated part will reach its proper position. In stiffness it should be subjected to sudation procedure and flexed. [102-103]<br /> <br /> === Specific treatment as per site and ''dushya'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्रत्येकं स्थानदूष्यादिक्रियावैशेष्यमाचरेत् [१] |१०४|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pratyekaM sthānadUShyAdikriyAvaisheShyamAcaret [1] |104| <br /> <br /> pratyēkaṁ sthānadūṣyādikriyāvaiśēṣyamācarēt [1] |104| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Specific line of treatment should be adopted in specific condition depending on site of affliction and the vitiated tissue involved.[104]<br /> <br /> ==== [[Brimhana]] (nourishment) treatment ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सर्पिस्तैलवसामज्जसेकाभ्यञ्जनबस्तयः [१] ||१०४|| &lt;br /&gt;<br /> <br /> स्निग्धाः स्वेदा निवातं च स्थानं प्रावरणानि च | &lt;br /&gt;<br /> रसाः पयांसि भोज्यानि स्वाद्वम्ललवणानि च ||१०५|| &lt;br /&gt;<br /> <br /> बृंहणं यच्च तत् सर्वं प्रशस्तं वातरोगिणाम् |१०६|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sarpistailavasAmajjasekAbhya~jjanabastayaH [1] ||104|| &lt;br /&gt;<br /> <br /> snigdhAH svedA nivātaM ca sthānaM prĀvaranani ca | &lt;br /&gt;<br /> rasAH payAMsi bhojyAni svAdvamlalavaNAni ca ||105|| &lt;br /&gt;<br /> <br /> bRuMhaNaM yacca tat sarvaM prashastaM vātarogiNAm |106| &lt;br /&gt;<br /> <br /> sarpistailavasāmajjasēkābhyañjanabastayaḥ [1] ||104||&lt;br /&gt;<br /> <br /> snigdhāḥ svēdā nivātaṁ ca sthānaṁ prāvaraṇāni ca| &lt;br /&gt;<br /> rasāḥ payāṁsi bhōjyāni svādvamlalavaṇāni ca||105|| &lt;br /&gt;<br /> <br /> br̥ṁhaṇaṁ yacca tat sarvaṁ praśastaṁ vātarōgiṇām|106| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Ghee, oil, fat, marrow, affusion, massage, enema, unctuous sudation, staying at calm places (without strong wind), covering with blankets, meat soups, various milks, articles of diet of sweet, sour and salt tastes and whatever is nourishing are beneficial for disorders due to [[vata]].[104-106]<br /> <br /> === Various formulations ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बलायाः पञ्चमूलस्य दशमूलस्य वा रसे ||१०६|| &lt;br /&gt;<br /> <br /> अजशीर्षाम्बुजानूपमांसादपिशितैः पृथक् | &lt;br /&gt;<br /> साधयित्वा रसान् स्निग्धान्दध्यम्लव्योषसंस्कृतान् ||१०७|| &lt;br /&gt;<br /> <br /> भोजयेद्वातरोगार्तं तैर्व्यक्तलवणैर्नरम् | &lt;br /&gt;<br /> एतैरेवोपनाहांश्च पिशितैः सम्प्रकल्पयेत् ||१०८|| &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> balAyAH pa~jcamUlasya dashamUlasya vA rase ||106|| &lt;br /&gt;<br /> <br /> ajashIrShAmbujAnUpamāṁsadapishitaiH pRuthak | &lt;br /&gt;<br /> sAdhayitvA rasAn snigdhAndadhyamlavyoShasaMskRutAn ||107|| &lt;br /&gt;<br /> <br /> bhojayedvātarōgartaM tairvyaktalavaNairnaram | &lt;br /&gt;<br /> etairevopanAhAMshca pishitaiH samprakalpayet ||108|| &lt;br /&gt;<br /> <br /> balāyāḥ pañcamūlasya daśamūlasya vā rasē||106|| &lt;br /&gt;<br /> <br /> ajaśīrṣāmbujānūpamāṁsādapiśitaiḥ pr̥thak| &lt;br /&gt;<br /> sādhayitvā rasān snigdhāndadhyamlavyōṣasaṁskr̥tān||107|| &lt;br /&gt;<br /> <br /> bhōjayēdvātarōgārtaṁ tairvyaktalavaṇairnaram| &lt;br /&gt;<br /> ētairēvōpanāhāṁśca piśitaiḥ samprakalpayēt||108|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient afflicted with [[vata]] disorders should be given meat soup of the flesh of the head of the goat, or of the aquatic, wet land or carnivorous animals prepared separately in the decoction of ''sida'' species, ''panchamoola'' and ''dashamoola'' seasoned with unctuous articles, sour curds and ''trikatu'' which is salted liberally.[106-107]<br /> <br /> Poultices should be prepared from the same flesh as mixed with ghee, oil and sour articles, with the boneless flesh well crushed and steamed. [108]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> घृततैलयुतैः साम्लैः क्षुण्णस्विन्नैरनस्थिभिः | &lt;br /&gt;<br /> पत्रोत्क्वाथपयस्तैलद्रोण्यः स्युरवगाहने ||१०९|| &lt;br /&gt;<br /> <br /> स्वभ्यक्तानां प्रशस्यन्ते सेकाश्चानिलरोगिणाम् | &lt;br /&gt;<br /> आनूपौदकमांसानि दशमूलं शतावरीम् ||११०|| &lt;br /&gt;<br /> <br /> कुलत्थान् बदरान्माषांस्तिलान्रास्नां यवान् बलाम् | &lt;br /&gt;<br /> वसादध्यारनालाम्लैः सह कुम्भ्यां विपाचयेत् ||१११|| &lt;br /&gt;<br /> <br /> नाडीस्वेदं प्रयुञ्जीत पिष्टैश्चाप्युपनाहनम् | &lt;br /&gt;<br /> तैश्च सिद्धं घृतं तैलमभ्यङ्गं पानमेव च ||११२|| &lt;br /&gt;<br /> <br /> मुस्तं किण्वं तिलाः कुष्ठं सुराह्वं लवणं नतम् | &lt;br /&gt;<br /> दधिक्षीरचतुःस्नेहैः सिद्धं स्यादुपनाहनम् ||११३|| &lt;br /&gt;<br /> <br /> उत्कारिकावेसवारक्षीरमाषतिलौदनैः | &lt;br /&gt;<br /> एरण्डबीजगोधूमयवकोलस्थिरादिभिः ||११४|| &lt;br /&gt;<br /> <br /> सस्नेहैः सरुजं गात्रमालिप्य बहलं भिषक् | &lt;br /&gt;<br /> एरण्डपत्रैर्बध्नीयाद्रात्रौ कल्यं विमोक्षयेत् ||११५|| &lt;br /&gt;<br /> <br /> क्षीराम्बुना ततः सिक्तं पुनश्चैवोपनाहितम् | &lt;br /&gt;<br /> मुञ्चेद्रात्रौ दिवाबद्धं चर्मभिश्च सलोमभिः ||११६|| &lt;br /&gt;<br /> <br /> फलानां तैलयोनीनामम्लपिष्टान् सुशीतलान् | &lt;br /&gt;<br /> प्रदेहानुपनाहांश्च गन्धैर्वातहरैरपि ||११७|| &lt;br /&gt;<br /> <br /> पायसैः कृशरैश्चैव कारयेत् स्नेहसंयुतैः |११८|&lt;br /&gt;<br /> <br /> रूक्षशुद्धानिलार्तानामतः स्नेहान् प्रचक्ष्महे||११८|| &lt;br /&gt;<br /> विविधान् विविधव्याधिप्रशमायामृतोपमान्| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ghRutatailayutaiH sAmlaiH kShuNNasvinnairanasthibhiH | &lt;br /&gt;<br /> patrotkvAthapayastailadroNyaH syuravagAhane ||109|| &lt;br /&gt;<br /> <br /> svabhyaktAnAM prashasyante sekAshcAnilarogiNAm | &lt;br /&gt;<br /> AnUpaudakamāṁsani dashamUlaM shatAvarIm ||110|| &lt;br /&gt;<br /> <br /> kulatthAn badarAnmAShAMstilAnrāsnāM yavAn balAm | &lt;br /&gt;<br /> vasAdadhyAranAlAmlaiH saha kumbhyAM vipAcayet ||111|| &lt;br /&gt;<br /> <br /> nADIsvedaM prayu~jjIta piShTaishcApyupanAhanam | &lt;br /&gt;<br /> taishca siddhaM ghRutaM tailamabhya~ggaM pAnameva ca ||112|| &lt;br /&gt;<br /> <br /> mustaM kiNvaM tilAH kuṣṭhaM surAhvaM lavaNaM natam | &lt;br /&gt;<br /> dadhikShIracatuHSnēhaiH siddhaM syAdupanAhanam ||113|| &lt;br /&gt;<br /> <br /> utkArikAvesavArakShIramAŚaṭīlaudānaiH | &lt;br /&gt;<br /> eraṇḍabIjagodhUmayavakōlasthirAdibhiH ||114|| &lt;br /&gt;<br /> <br /> saSnēhaiH sarujaM gAtramAlipya bahalaM bhiShak | &lt;br /&gt;<br /> eraṇḍapatrairbadhnIyAdrAtrau kalyaM vimokṣayaet ||115|| &lt;br /&gt;<br /> <br /> kShIrAmbunA tataH siktaM punashcaivopanAhitam | &lt;br /&gt;<br /> mu~jcedrAtrau divAbaddhaM carmabhishca salomabhiH ||116|| &lt;br /&gt;<br /> <br /> phalAnAM tailayonInAmamlapiShTAn sushItalAn | &lt;br /&gt;<br /> pradehAnupanAhAMshca gandhairvātaharairapi ||117|| &lt;br /&gt;<br /> <br /> pAyasaiH kRusharaishcaiva kArayet SnēhasaMyutaiH |118| &lt;br /&gt;<br /> <br /> rūkṣashuddhAnilArtAnAmataH Snēhan pracakShmahe ||118|| &lt;br /&gt;<br /> vividhAn vividhavyAdhiprashamAyAmRutopamAn | &lt;br /&gt;<br /> <br /> ghr̥tatailayutaiḥ sāmlaiḥ kṣuṇṇasvinnairanasthibhiḥ|&lt;br /&gt; <br /> patrōtkvāthapayastailadrōṇyaḥ syuravagāhanē||109|| &lt;br /&gt;<br /> <br /> svabhyaktānāṁ praśasyantē sēkāścānilarōgiṇām| &lt;br /&gt;<br /> ānūpaudakamāṁsāni daśamūlaṁ śatāvarīm||110|| &lt;br /&gt;<br /> <br /> kulatthān badarānmāṣāṁstilānrāsnāṁ yavān balām| &lt;br /&gt;<br /> vasādadhyāranālāmlaiḥ saha kumbhyāṁ vipācayēt||111|| &lt;br /&gt;<br /> <br /> nāḍīsvēdaṁ prayuñjīta piṣṭaiścāpyupanāhanam| &lt;br /&gt;<br /> taiśca siddhaṁ ghr̥taṁ tailamabhyaṅgaṁ pānamēva ca||112|| &lt;br /&gt;<br /> <br /> mustaṁ kiṇvaṁ tilāḥ kuṣṭhaṁ surāhvaṁ lavaṇaṁ natam| &lt;br /&gt;<br /> dadhikṣīracatuḥsnēhaiḥ siddhaṁ syādupanāhanam||113|| &lt;br /&gt;<br /> <br /> utkārikāvēsavārakṣīramāṣatilaudānaiḥ| &lt;br /&gt;<br /> ēraṇḍabījagōdhūmayavakōlasthirādibhiḥ||114|| &lt;br /&gt;<br /> <br /> sasnēhaiḥ sarujaṁ gātramālipya bahalaṁ bhiṣak| &lt;br /&gt;<br /> ēraṇḍapatrairbadhnīyādrātrau kalyaṁ vimōkṣayēt||115|| &lt;br /&gt;<br /> <br /> kṣīrāmbunā tataḥ siktaṁ punaścaivōpanāhitam| &lt;br /&gt;<br /> muñcēdrātrau divābaddhaṁ carmabhiśca salōmabhiḥ||116|| &lt;br /&gt;<br /> <br /> phalānāṁ tailayōnīnāmamlapiṣṭān suśītalān| &lt;br /&gt;<br /> pradēhānupanāhāṁśca gandhairvātaharairapi||117|| &lt;br /&gt;<br /> <br /> pāyasaiḥ kr̥śaraiścaiva kārayēt snēhasaṁyutaiḥ|118| &lt;br /&gt;<br /> <br /> rūkṣaśuddhānilārtānāmataḥ snēhān pracakṣmahē||118|| &lt;br /&gt;<br /> vividhān vividhavyādhipraśamāyāmr̥tōpamān| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> For immersion bath, vessel should be filled with the decoction of the leaves curative of [[vata]] or with medicated milk or oil. <br /> <br /> Affusion is recommended after a good oil massage to the patient suffering from [[vata]] disorder. [109]<br /> <br /> Cook in a pot the flesh of wetland and aquatic creatures, ''dashamoola'', asparagus, horse-gram, jujube, black gram, sesame, ''rasna'', barley and ''sida'' along with fat, curds, acetic acid and sour articles and administer this in the form of kettle sudation. This in the form of paste may also be used as poultice. And medicated ghee and oil prepared with this may be used for external massage as well as internal administration. [110-112]<br /> <br /> The preparations made of ''musta'', yeast, sesame, ''kushtha, devadaru,'' rock salt and ''nata'', along with curds milk and the four varieties of unctuous articles should be used as poultice. [113]<br /> <br /> The physician should give on the painful part, a thick application prepared of pancakes, ''vesavara'' preparation, milk, black gram, sesame, boiled rice, castor seeds, wheat, barley, ''badara,'' and ''sthira'' etc mixed with unctuous articles. This application should be at night and bandaged with caster leaves, and the bandage should be removed the next morning. Then the part should be poured with milk added with water and again poultice. The bandage which is applied during the day must be of leather with fur, and it should be removed at night. [114-116]<br /> <br /> Thick applications can be made of oleiferous fruits well pasted with sour articles and be applied after it gets cool. And poultices can be made of the fragrant group of drugs curative of [[vata]], milk pudding or ''krishara'' mixed with unctuous articles be used. [117]<br /> <br /> We shall describe the various unctuous preparations which are comparable to nectar and are curative of disorders in those who are afflicted with dryness after purification and [[vata]] provocation. [118]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्रोणेऽम्भसः पचेद्भागान् दशमूलाच्चतुष्पलान्||११९|| &lt;br /&gt;<br /> <br /> यवकोलकुलत्थानां भागैः प्रस्थोन्मितैः सह| &lt;br /&gt;<br /> पादशेषे रसे पिष्टैर्जीवनीयैः सशर्करैः||१२०|| &lt;br /&gt;<br /> <br /> तथा खर्जूरकाश्मर्यद्राक्षाबदरफल्गुभिः| &lt;br /&gt;<br /> सक्षीरैः सर्पिषः प्रस्थः सिद्धः केवलवातनुत्||१२१||&lt;br /&gt;<br /> <br /> निरत्ययः प्रयोक्तव्यः पानाभ्यञ्जनबस्तिषु| &lt;br /&gt;<br /> चित्रकं नागरं रास्नां पौष्करं पिप्पलीं शटीम्||१२२|| &lt;br /&gt;<br /> <br /> पिष्ट्वा विपाचयेत् सर्पिर्वातरोगहरं परम्| &lt;br /&gt;<br /> बलाबिल्वशृते क्षीरे घृतमण्डं विपाचयेत्||१२३|| &lt;br /&gt;<br /> <br /> तस्य शुक्तिः प्रकुञ्चो वा नस्यं मूर्धगतेऽनिले| &lt;br /&gt;<br /> ग्राम्यानूपौदकानां तु भित्वाऽस्थीनि पचेज्जले||१२४|| &lt;br /&gt;<br /> <br /> तं स्नेहं दशमूलस्य कषायेण पुनः पचेत्| &lt;br /&gt;<br /> जीवकर्षभकास्फोताविदारीकपिकच्छुभिः||१२५|| &lt;br /&gt;<br /> <br /> वातघ्नैर्जीवनीयैश्च कल्कैर्द्विक्षीरभागिकम्| &lt;br /&gt;<br /> तत्सिद्धं नावनाभ्यङ्गात्तथा पानानुवासनात्||१२६|| &lt;br /&gt;<br /> <br /> सिरापर्वास्थिकोष्ठस्थं प्रणुदत्याशु मारुतम्| &lt;br /&gt;<br /> ये स्युः प्रक्षीणमज्जानः क्षीणशुक्रौजसश्च ये||१२७|| &lt;br /&gt;<br /> <br /> बलपुष्टिकरं तेषामेतत् स्यादमृतोपमम्| &lt;br /&gt;<br /> तद्वत्सिद्धा वसा नक्रमत्स्यकूर्मचुलूकजा||१२८|| &lt;br /&gt;<br /> <br /> प्रत्यग्रा विधिनाऽनेन नस्यपानेषु शस्यते| &lt;br /&gt;<br /> प्रस्थः स्यात्त्रिफलायास्तु कुलत्थकुडवद्वयम्||१२९|| &lt;br /&gt;<br /> <br /> कृष्णगन्धात्वगाढक्योः पृथक् पञ्चपलं भवेत्| &lt;br /&gt;<br /> रास्नाचित्रकयोर्द्वे द्वे दशमूलं पलोन्मितम्||१३०|| &lt;br /&gt;<br /> <br /> जलद्रोणे पचेत् पादशेषे प्रस्थोन्मितं पृथक्| &lt;br /&gt;<br /> सुरारनालदध्यम्लसौवीरकतुषोदकम्||१३१|| &lt;br /&gt;<br /> <br /> कोलदाडिमवृक्षाम्लरसं तैलं वसां घृतम्| &lt;br /&gt;<br /> मज्जानं च पयश्चैव जीवनीयपलानि षट्||१३२|| &lt;br /&gt;<br /> <br /> कल्कं दत्त्वा महास्नेहं सम्यगेनं विपाचयेत्| &lt;br /&gt;<br /> सिरामज्जास्थिगे वाते सर्वाङ्गैकाङ्गरोगिषु||१३३|| &lt;br /&gt;<br /> <br /> वेपनाक्षेपशूलेषु तदभ्यङ्गे प्रयोजयेत्| &lt;br /&gt;<br /> निर्गुण्ड्या मूलपत्राभ्यां गृहीत्वा स्वरसं ततः||१३४|| &lt;br /&gt;<br /> <br /> तेन सिद्धं समं तैलं नाडीकुष्ठानिलार्तिषु| &lt;br /&gt;<br /> हितं पामापचीनां च पानाभ्यञ्जनपूरणम्||१३५|| &lt;br /&gt;<br /> <br /> कार्पासास्थिकुलत्थानां रसे सिद्धं च वातनुत्|१३६| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> droNe~ambhasaH pacedbhAgAn dashamUlAccatuShpalAn ||119|| &lt;br /&gt;<br /> <br /> yavakōlakulatthAnAM bhAgaiH prasthonmitaiH saha | &lt;br /&gt;<br /> pAdasheShe rase piShTairjIvanIyaiH sasharkaraiH ||120|| &lt;br /&gt;<br /> <br /> tathA kharjUrakAshmaryadrAkShAbadaraphalgubhiH | &lt;br /&gt;<br /> sakShIraiH sarpiShaH prasthaH siddhaH kevalavātanut ||121|| &lt;br /&gt;<br /> <br /> niratyayaH prayoktavyaH pAnAbhya~jjanabastiShu | &lt;br /&gt;<br /> citrakaM nAgaraM rāsnāM pauShkaraM pippalIM śaṭīm ||122|| &lt;br /&gt;<br /> <br /> piShTvA vipAcayet sarpirvātarōgaharaM param | &lt;br /&gt;<br /> balAbilvashRute kShIre ghRutamaNDaM vipAcayet ||123|| &lt;br /&gt;<br /> <br /> tasya shuktiH praku~jco vA nasyaM mUrdhagate~anile | &lt;br /&gt;<br /> grAmyAnUpaudakAnAM tu bhitvA~asthIni pacejjale ||124|| &lt;br /&gt;<br /> <br /> taM SnēhaM dashamUlasya kaShAyeNa punaH pacet | &lt;br /&gt;<br /> jIvakarShabhakAsphotAvidArIkapikacchubhiH ||125|| &lt;br /&gt;<br /> <br /> vātaghnairjIvanIyaishca kalkairdvikShIrabhAgikam | &lt;br /&gt;<br /> tatsiddhaM nAvanAbhya~ggAttathA pAnAnuvAsanAt ||126|| &lt;br /&gt;<br /> <br /> sirāparvAsthikōṣṭhasthaM prānaudatyAshu mArutam | &lt;br /&gt;<br /> ye syuH prakShINamajjAnaH kShINaśukraujasashca ye ||127|| &lt;br /&gt;<br /> <br /> balapuShTikaraM teShAmetat syAdamRutopamam | &lt;br /&gt;<br /> tadvatsiddhA vasA nakramatsyakUrmaculUkajA ||128|| &lt;br /&gt;<br /> <br /> pratyagrA vidhinA~anena nasYāpanaeShu shasyate | &lt;br /&gt;<br /> prasthaH syAttriphalAyAstu kulatthakuDavadvayam ||129|| &lt;br /&gt;<br /> <br /> kRuShNagandhAtvagADhakyoH pRuthak pa~jcapalaM bhavet | &lt;br /&gt;<br /> rāsnācitrakayordve dve dashamUlaM palonmitam ||130|| &lt;br /&gt;<br /> <br /> jaladroNe pacet pAdasheShe prasthonmitaM pRuthak | &lt;br /&gt;<br /> surAranAladadhyamlasauvIrakatuShodakam ||131|| &lt;br /&gt;<br /> <br /> kōladADimavRūkṣamlarasaM tailaM vasAM ghRutam | &lt;br /&gt;<br /> majjAnaM ca payashcaiva jIvanIyapalAni ShaT ||132|| &lt;br /&gt;<br /> <br /> kalkaM dattvA mahASnēhaM samyagenaM vipAcayet | &lt;br /&gt;<br /> sirāmajjAsthige vAte sarvA~ggaikA~ggarogiShu ||133|| &lt;br /&gt;<br /> <br /> vepanAkShepashUleShu tadabhya~gge prayojayet | &lt;br /&gt;<br /> nirguNDyA mUlapatrAbhyAM gRuhItvA svarasaM tataH ||134|| &lt;br /&gt;<br /> <br /> tena siddhaM samaM tailaM nADIkuṣṭhanilArtiShu | &lt;br /&gt;<br /> hitaM pAmApacInAM ca pAnAbhya~jjanapUraNam ||135|| &lt;br /&gt;<br /> <br /> kArpAsAsthikulatthAnAM rase siddhaM ca vātanut |136| &lt;br /&gt;<br /> <br /> drōṇē'mbhasaḥ pacēdbhāgān daśamūlāccatuṣpalān||119|| &lt;br /&gt;<br /> <br /> yavakōlakulatthānāṁ bhāgaiḥ prasthōnmitaiḥ saha| &lt;br /&gt;<br /> pādaśēṣē rasē piṣṭairjīvanīyaiḥ saśarkaraiḥ||120|| &lt;br /&gt;<br /> <br /> tathā kharjūrakāśmaryadrākṣābadaraphalgubhiḥ| &lt;br /&gt;<br /> sakṣīraiḥ sarpiṣaḥ prasthaḥ siddhaḥ kēvalavātanut||121|| &lt;br /&gt;<br /> <br /> niratyayaḥ prayōktavyaḥ pānābhyañjanabastiṣu| &lt;br /&gt;<br /> citrakaṁ nāgaraṁ rāsnāṁ pauṣkaraṁ pippalīṁ śaṭīm||122|| &lt;br /&gt;<br /> <br /> piṣṭvā vipācayēt sarpirvātarōgaharaṁ param| &lt;br /&gt;<br /> balābilvaśr̥tē kṣīrē ghr̥tamaṇḍaṁ vipācayēt||123|| &lt;br /&gt;<br /> <br /> tasya śuktiḥ prakuñcō vā nasyaṁ mūrdhagatē'nilē| &lt;br /&gt;<br /> grāmyānūpaudakānāṁ tu bhitvā'sthīni pacējjalē||124|| &lt;br /&gt;<br /> <br /> taṁ snēhaṁ daśamūlasya kaṣāyēṇa punaḥ pacēt| &lt;br /&gt;<br /> jīvakarṣabhakāsphōtāvidārīkapikacchubhiḥ||125|| &lt;br /&gt;<br /> <br /> vātaghnairjīvanīyaiśca kalkairdvikṣīrabhāgikam| &lt;br /&gt;<br /> tatsiddhaṁ nāvanābhyaṅgāttathā pānānuvāsanāt||126|| &lt;br /&gt;<br /> <br /> sirāparvāsthikōṣṭhasthaṁ praṇudatyāśu mārutam| &lt;br /&gt;<br /> yē syuḥ prakṣīṇamajjānaḥ kṣīṇaśukraujasaśca yē||127|| &lt;br /&gt;<br /> <br /> balapuṣṭikaraṁ tēṣāmētat syādamr̥tōpamam| &lt;br /&gt;<br /> tadvatsiddhā vasā nakramatsyakūrmaculūkajā||128|| &lt;br /&gt;<br /> <br /> pratyagrā vidhinā'nēna nasyapānēṣu śasyatē| &lt;br /&gt;<br /> prasthaḥ syāttriphalāyāstu kulatthakuḍavadvayam||129|| &lt;br /&gt;<br /> <br /> kr̥ṣṇagandhātvagāḍhakyōḥ pr̥thak pañcapalaṁ bhavēt| &lt;br /&gt;<br /> rāsnācitrakayōrdvē dvē daśamūlaṁ palōnmitam||130|| &lt;br /&gt;<br /> <br /> jaladrōṇē pacēt pādaśēṣē prasthōnmitaṁ pr̥thak| &lt;br /&gt;<br /> surāranāladadhyamlasauvīrakatuṣōdakam||131|| &lt;br /&gt;<br /> <br /> kōladāḍimavr̥kṣāmlarasaṁ tailaṁ vasāṁ ghr̥tam| &lt;br /&gt;<br /> majjānaṁ ca payaścaiva jīvanīyapalāni ṣaṭ||132|| &lt;br /&gt;<br /> <br /> kalkaṁ dattvā mahāsnēhaṁ samyagēnaṁ vipācayēt| &lt;br /&gt;<br /> sirāmajjāsthigē vātē sarvāṅgaikāṅgarōgiṣu||133|| &lt;br /&gt;<br /> <br /> vēpanākṣēpaśūlēṣu tadabhyaṅgē prayōjayēt| &lt;br /&gt;<br /> nirguṇḍyā mūlapatrābhyāṁ gr̥hītvā svarasaṁ tataḥ||134|| &lt;br /&gt;<br /> <br /> tēna siddhaṁ samaṁ tailaṁ nāḍīkuṣṭhānilārtiṣu| &lt;br /&gt;<br /> hitaṁ pāmāpacīnāṁ ca pānābhyañjanapūraṇam||135|| &lt;br /&gt;<br /> <br /> kārpāsāsthikulatthānāṁ rasē siddhaṁ ca vātanut|136| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Four ''pala'' (192 gm) of ''dashamoola'' should be decocted in one ''drone'' of water adding 64 ''tolas'' (768 gm) of barley, ''badara'' and horse gram. When it is reduced to one fourth quantity, prepare a medicated ghee in this decoction by taking 16 ''pala'' (768 gm) of ghee and adding milk, the paste of the ''jeevaniya'' drugs, sugar, dates, white teak, grape, ''badara'' and fig. This ghee is curative of disorders due to absolute ''vata''. This preparation is harmless and should be used for internal administration, external massage and enema. [119-121] <br /> <br /> Medicated ghee, prepared with the paste of ''chitraka'', dry-ginger, ''rasna, pushkara,'' long pepper and ''shathi'' is excellent to cure [[vata]]-disorders. [122]<br /> <br /> The supernatant part of ghee should be prepared with the milk boiled with ''sida'' and ''bilva''. Two or four ''tolas'' (48 gm) of this should be used as nasal medication in condition of morbid [[vata]] affecting the head. [123]<br /> <br /> The bones of the domestic, wet-land and aquatic animals should be broken into bits and cooked in water. The unctuous fluid obtained should again be cooked in the decoction of the ''dashamoola'', adding the paste of ''rishabhaka, sphota, vidari'' and ''kapikachchu'' and of [[vata]]-curative drugs or ''jeevaniya'' group of drugs and double the quantity of milk. By the use of this preparation as nasal medication, massage, internal administration and unctuous enema, the morbid [[vata]] affecting the vessels, joints, bones and in ''kushtha'' gets quickly cured. For those suffering from loss of marrow as well as those who suffer from loss of semen and vital essence, this imparts strength and robustness and acts like nectar. [124-127]<br /> <br /> The fresh fat of the alligator, fish, tortoise or the porpoise prepared similarly as described above is recommended as nasal medication and for internal administration. [128]<br /> <br /> Take 64 ''tolas'' (768 gm) of the ''triphala'', 32 ''tolas'' (384 gm) of horse gram, 20 ''tolas'' (240 gm) each of the bark of the ''krishnagandha'' and ''adhaki'', 8 ''tolas'' (96 gm) each of ''rasna, chitraka'' and four ''tolas'' (48 gm) of each of the ''dashamoola'' and decoct them in 1 ''drone'' (12.288 l) of water, reduced to one fourth of its quantity. Than add 64 ''tolas'' (768 gm) each of ''sura, aranala,'' sour curds, ''sauveeraka, tushodakam,'' the decoction of small ''badara,'' pomegranate, tamarind, butter, oil, fat, ghee, marrow, milk and 24 ''tolas'' (288gm) of the paste of the ''jeevaniya'' group of drugs, and prepare the ''mahasneha'' preparation in the due manner. [129-132]<br /> <br /> This should be used as inunction in morbid [[vata]] affecting the vessels. Marrow and bones as well as is conditions of tremors contractions and colic, and [[vata]] disorder affecting the entire body or only a part of the body. [133]<br /> <br /> The expressed juice of the root and leaves of ''nirgundi'' should be cooked with an equal quantity of oil. This oil can be used for internal administration, external massage and ear-fill; it is beneficial in sinuses or fistula -in -ano, dermatosis and other [[vata]] disorders as well as in scabies and scrofula. The oil prepared with the decoction of cotton seeds and horse gram is also curative of [[vata]]. [134-135]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मूलकस्वरसे क्षीरसमे स्थाप्यं त्र्यहं दधि||१३६||&lt;br /&gt;<br /> <br /> तस्याम्लस्य त्रिभिः प्रस्थैस्तैलप्रस्थं विपाचयेत् | &lt;br /&gt;<br /> यष्ट्याह्वशर्करारास्नालवणार्द्रकनागरैः ||१३७|| &lt;br /&gt;<br /> <br /> सुपिष्टैः पलिकैः पानात्तदभ्यङ्गाच्च वातनुत् |१३८|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mUlakasvarase kShIrasame sthApyaM tryahaM dadhi ||136|| &lt;br /&gt;<br /> <br /> tasyAmlasya tribhiH prasthaistailaprasthaM vipAcayet | &lt;br /&gt;<br /> yaShTyAhvasharkarArāsnālavaNArdrakanAgaraiH ||137|| &lt;br /&gt;<br /> <br /> supiShTaiH palikaiH pAnAttadabhya~ggAcca vātanut |138| &lt;br /&gt;<br /> <br /> mūlakasvarasē kṣīrasamē sthāpyaṁ tryahaṁ dadhi||136|| &lt;br /&gt;<br /> <br /> tasyāmlasya tribhiḥ prasthaistailaprasthaṁ vipācayēt| &lt;br /&gt;<br /> yaṣṭyāhvaśarkarārāsnālavaṇārdrakanāgaraiḥ||137|| &lt;br /&gt;<br /> <br /> supiṣṭaiḥ palikaiḥ pānāttadabhyaṅgācca vātanut|138| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Curds should be kept for three days in a mixture of equal measures of the expressed juice of radish and milk. Prepare medicated oil by taking 64 ''tolas'' (768 gm) of oil and triple the quantity of this sour preparation adding the paste of 4 ''tolas'' (48 gm) each of liquorice, sugar, ''rasna,'' rock salt and green ginger. This oil can be used for internal administration and external application as curative of [[vata]]. [136-137]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पञ्चमूलकषायेण पिण्याकं बहुवार्षिकम् ||१३८||&lt;br /&gt;<br /> <br /> पक्त्वा तस्य रसं पूत्वा तैलप्रस्थं विपाचयेत् | &lt;br /&gt;<br /> पयसाऽष्टगुणेनैतत् सर्ववातविकारनुत् ||१३९|| &lt;br /&gt;<br /> <br /> संसृष्टे श्लेष्मणा चैतद्वाते शस्तं विशेषतः | &lt;br /&gt;<br /> यवकोलकुलत्थानां श्रेयस्याः शुष्कमूलकात् ||१४०|| &lt;br /&gt;<br /> <br /> बिल्वाच्चाञ्जलिमेकैकं द्रवैरम्लैर्विपाचयेत् | &lt;br /&gt;<br /> तेन तैलं कषायेण फलाम्लैः कटुभिस्तथा ||१४१|| &lt;br /&gt;<br /> <br /> पिष्टैः सिद्धं महावातैरार्तः शीते प्रयोजयेत् |१४२|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pa~jcamUlakaShAyeNa piNyAkaM bahuvArShikam ||138|| &lt;br /&gt;<br /> <br /> paktvA tasya rasaM pUtvA [1] tailaprasthaM vipAcayet | &lt;br /&gt;<br /> payasA~aShTaguNenaitat sarvavātavikAranut ||139|| &lt;br /&gt;<br /> <br /> saMsRuShTe shleShmaNA caitadvAte shastaM visheShataH | &lt;br /&gt;<br /> yavakōlakulatthAnAM shreyasyAH shuShkamUlakAt ||140|| &lt;br /&gt;<br /> <br /> bilvAccA~jjalimekaikaM dravairamlairvipAcayet | &lt;br /&gt;<br /> tena tailaM kaShAyeNa phalAmlaiH kaTubhistathA ||141|| &lt;br /&gt;<br /> <br /> piShTaiH siddhaM mahAvātairArtaH shIte prayojayet |142| &lt;br /&gt;<br /> <br /> pañcamūlakaṣāyēṇa piṇyākaṁ bahuvārṣikam||138|| &lt;br /&gt;<br /> <br /> paktvā tasya rasaṁ pūtvā [1] tailaprasthaṁ vipācayēt| &lt;br /&gt;<br /> payasā'ṣṭaguṇēnaitat sarvavātavikāranut||139|| &lt;br /&gt;<br /> <br /> saṁsr̥ṣṭē ślēṣmaṇā caitadvātē śastaṁ viśēṣataḥ| &lt;br /&gt;<br /> yavakōlakulatthānāṁ śrēyasyāḥ śuṣkamūlakāt||140|| &lt;br /&gt;<br /> <br /> bilvāccāñjalimēkaikaṁ dravairamlairvipācayēt| &lt;br /&gt;<br /> tēna tailaṁ kaṣāyēṇa phalāmlaiḥ kaṭubhistathā||141|| &lt;br /&gt;<br /> <br /> piṣṭaiḥ siddhaṁ mahāvātairārtaḥ śītē prayōjayēt|142| &lt;br /&gt;<br /> <br /> pañcamūlakaṣāyēṇa piṇyākaṁ bahuvārṣikam||138|| &lt;br /&gt;<br /> <br /> paktvā tasya rasaṁ pūtvā [1] tailaprasthaṁ vipācayēt| &lt;br /&gt;<br /> payasā'ṣṭaguṇēnaitat sarvavātavikāranut||139|| &lt;br /&gt;<br /> <br /> saṁsr̥ṣṭē ślēṣmaṇā caitadvātē śastaṁ viśēṣataḥ| &lt;br /&gt;<br /> yavakōlakulatthānāṁ śrēyasyāḥ śuṣkamūlakāt||140|| &lt;br /&gt;<br /> <br /> bilvāccāñjalimēkaikaṁ dravairamlairvipācayēt| &lt;br /&gt;<br /> tēna tailaṁ kaṣāyēṇa phalāmlaiḥ kaṭubhistathā||141|| &lt;br /&gt;<br /> <br /> piṣṭaiḥ siddhaṁ mahāvātairārtaḥ śītē prayōjayēt|142| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Cook very old oil-cake in the decoction of dashamūla; strain the solution and prepare a medicated oil in this solution by taking 64 ''tolas'' (768 gm) of oil and eight times the quantity of milk. This oil is curative of all disorders of [[vata]]. This is specially recommended in conditions of [[vata]] associated with [[kapha]].[138-139]<br /> <br /> Take 16 ''tolas'' (192 gm) each of barley, ''kola'', horse gram, ''shreyasi,'' dry radish and ''bilva'' and cook them in a sour solution. The medicated oil prepared with this decoction along with sour fruit and the paste of pungent spices, should be used by the patient suffering from severe disorders of [[vata]], in the cold season. [140-141]<br /> <br /> ==== ''Sahachara taila'' and ''baladi taila'' ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सर्ववातविकाराणां तैलान्यन्यान्यतः शृणु ||१४२|| &lt;br /&gt;<br /> <br /> चतुष्प्रयोगाण्यायुष्यबलवर्णकराणि च | &lt;br /&gt;<br /> रजःशुक्रप्रदोषघ्नान्यपत्यजननानि च ||१४३|| &lt;br /&gt;<br /> <br /> निरत्ययानि सिद्धानि सर्वदोषहराणि च | &lt;br /&gt;<br /> सहाचरतुलायाश्च रसे तैलाढकं पचेत् ||१४४|| &lt;br /&gt;<br /> <br /> मूलकल्काद्दशपलं पयो दत्त्वा चतुर्गुणम् | &lt;br /&gt;<br /> सिद्धेऽस्मिञ्छर्कराचूर्णादष्टादशपलं भिषक् ||१४५|| &lt;br /&gt;<br /> <br /> विनीय दारुणेष्वेतद्वातव्याधिषु योजयेत् | &lt;br /&gt;<br /> श्वदंष्ट्रास्वरसप्रस्थौ द्वौ समौ पयसा सह ||१४६|| &lt;br /&gt;<br /> <br /> षट्पलं शृङ्गवेरस्य गुडस्याष्टपलं तथा | &lt;br /&gt;<br /> तैलप्रस्थं विपक्वं तैर्दद्यात् सर्वानिलार्तिषु ||१४७|| &lt;br /&gt;<br /> <br /> जीर्णे तैले च दुग्धेन पेयाकल्पः प्रशस्यते | &lt;br /&gt;<br /> बलाशतं गुडूच्याश्च पादं रास्नाष्टभागिकम् ||१४८|| &lt;br /&gt;<br /> <br /> जलाढकशते पक्त्वा दशभागस्थिते रसे | &lt;br /&gt;<br /> दधिमस्त्विक्षुनिर्यासशुक्तैस्तैलाढकं समैः ||१४९|| &lt;br /&gt;<br /> <br /> पचेत् साजपयोऽर्धांशैः कल्कैरेभिः पलोन्मितैः | &lt;br /&gt;<br /> शटीसरलदार्वेलामञ्जिष्ठागुरुचन्दनैः ||१५०|| &lt;br /&gt;<br /> <br /> पद्मकातिविषामुस्तसूर्पपर्णीहरेणुभिः | &lt;br /&gt;<br /> यष्ट्याह्वसुरसव्याघ्रनखर्षभकजीवकैः ||१५१|| &lt;br /&gt;<br /> <br /> पलाशरसकस्तूरीनलिकाजातिकोषकैः | &lt;br /&gt;<br /> स्पृक्काकुङ्कुमशैलेयजातीकटुफलाम्बुभिः ||१५२|| &lt;br /&gt;<br /> <br /> त्वचाकुन्दुरुकर्पूरतुरुष्कश्रीनिवासकैः [१] | &lt;br /&gt;<br /> लवङ्गनखकक्कोलकुष्ठमांसीप्रियङ्गुभिः ||१५३|| &lt;br /&gt;<br /> <br /> स्थौणेयतगरध्यामवचामदनपल्लवैः | &lt;br /&gt;<br /> सनागकेशरैः सिद्धे क्षिपेच्चात्रावतारिते ||१५४|| &lt;br /&gt;<br /> <br /> पत्रकल्कं ततः पूतं विधिना तत् प्रयोजयेत् | &lt;br /&gt;<br /> श्वासं कासं ज्वरं हिक्कां [२] छर्दिं गुल्मान् क्षतं क्षयम् ||१५५|| &lt;br /&gt;<br /> <br /> प्लीहशोषावपस्मारमलक्ष्मीं च प्रणाशयेत् | &lt;br /&gt;<br /> बलातैलमिदं श्रेष्ठं वातव्याधिविनाशनम् ||१५६|| &lt;br /&gt;<br /> <br /> (अग्निवेशाय गुरुणा कृष्णात्रेयेण भाषितम्) | &lt;br /&gt;<br /> इति बलातैलम् |&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sarvavātavikArANAM tailAnyanyAnyataH shRuNu ||142|| &lt;br /&gt;<br /> <br /> catuShprayogANyAyuShyabalavarNakarANi ca | &lt;br /&gt;<br /> rajaHśukrapra dōṣaghnAnyapatyajananAni ca ||143|| &lt;br /&gt;<br /> <br /> niratyayAni siddhAni sarva dōṣaharANi ca | &lt;br /&gt;<br /> sahAcaratulAyAshca rase tailADhakaM pacet ||144|| &lt;br /&gt;<br /> <br /> mUlakalkAddashapalaM payo dattvA caturguNam | &lt;br /&gt;<br /> siddhe~asmi~jcharkarAcUrNAdaShTAdashapalaM bhiShak ||145|| &lt;br /&gt;<br /> <br /> vinIya dAruNeShvetadVātavyādhiShu yojayet | &lt;br /&gt;<br /> shvadaMShTrAsvarasaprasthau dvau samau payasA saha ||146|| &lt;br /&gt;<br /> <br /> ShaTpalaM shRu~ggaverasya guDasyAShTapalaM tathA | &lt;br /&gt;<br /> tailaprasthaM vipakvaM tairdadyAt sarvAnilArtiShu ||147|| &lt;br /&gt;<br /> <br /> jIrNe taile ca dugdhena peyAkalpaH prashasyate | &lt;br /&gt;<br /> balAshataM guDUcyAshca pAdaM rāsnāShTabhAgikam ||148|| &lt;br /&gt;<br /> <br /> jalADhakashate paktvA dashabhAgasthite rase | &lt;br /&gt;<br /> dadhimastvikShuniryAsashuktaistailADhakaM samaiH ||149|| &lt;br /&gt;<br /> <br /> pacet sAjapayo~ardhAMshaiH kalkairebhiH palonmitaiH | &lt;br /&gt;<br /> śaṭīsaraladArvelAma~jjiShThAgurucandanaiH ||150|| &lt;br /&gt;<br /> <br /> padmakAtiviṣāmustasUrpaparNIhareNubhiH | &lt;br /&gt;<br /> yaShTyAhvasurasavyAghranakharShabhakajIvakaiH ||151|| &lt;br /&gt;<br /> <br /> palAsharasakastUrInalikAjAtikoShakaiH | &lt;br /&gt;<br /> spRukkAku~gkumashaileyajAtIkaTuphalAmbubhiH ||152|| &lt;br /&gt;<br /> <br /> tvacAkundurukarpUraturuShkashrInivAsakaiH [1] | &lt;br /&gt;<br /> lava~gganakhakakkōlakuṣṭhamAMsIpriya~ggubhiH ||153|| &lt;br /&gt;<br /> <br /> sthauNeyatagaradhyAmavacAmadanapallavaiH | &lt;br /&gt;<br /> sanAgakesharaiH siddhe kShipeccAtrAvātarite ||154|| &lt;br /&gt;<br /> <br /> patrakalkaM tataH pUtaM vidhinA tat prayojayet | &lt;br /&gt;<br /> shvAsaM kAsaM jvaraM hikkAM [2] chardiM gulmAn kShataM kṣayam ||155|| &lt;br /&gt;<br /> <br /> plIhashoShAvapasmAramalakShmIM ca prānāśayet | &lt;br /&gt;<br /> balAtailamidaM shreShThaM Vātavyādhivināśanam ||156|| &lt;br /&gt;<br /> <br /> (agniveshAya guruNA kRuShNAtreyeNa bhAShitam) | &lt;br /&gt;<br /> iti balAtailam |&lt;br /&gt;<br /> <br /> sarvavātavikārāṇāṁ tailānyanyānyataḥ śr̥ṇu||142|| &lt;br /&gt;<br /> <br /> catuṣprayōgāṇyāyuṣyabalavarṇakarāṇi ca| &lt;br /&gt;<br /> rajaḥśukrapradōṣaghnānyapatyajananāni ca||143|| &lt;br /&gt;<br /> <br /> niratyayāni siddhāni sarvadōṣaharāṇi ca| &lt;br /&gt;<br /> sahācaratulāyāśca rasē tailāḍhakaṁ pacēt||144|| &lt;br /&gt;<br /> <br /> mūlakalkāddaśapalaṁ payō dattvā caturguṇam| &lt;br /&gt;<br /> siddhē'smiñcharkarācūrṇādaṣṭādaśapalaṁ bhiṣak||145|| &lt;br /&gt;<br /> <br /> vinīya dāruṇēṣvētadvātavyādhiṣu yōjayēt| &lt;br /&gt;<br /> śvadaṁṣṭrāsvarasaprasthau dvau samau payasā saha||146|| &lt;br /&gt;<br /> <br /> ṣaṭpalaṁ śr̥ṅgavērasya guḍasyāṣṭapalaṁ tathā| &lt;br /&gt;<br /> tailaprasthaṁ vipakvaṁ tairdadyāt sarvānilārtiṣu||147|| &lt;br /&gt;<br /> <br /> jīrṇē tailē ca dugdhēna pēyākalpaḥ praśasyatē| &lt;br /&gt;<br /> balāśataṁ guḍūcyāśca pādaṁ rāsnāṣṭabhāgikam||148|| &lt;br /&gt;<br /> <br /> jalāḍhakaśatē paktvā daśabhāgasthitē rasē| &lt;br /&gt;<br /> dadhimastvikṣuniryāsaśuktaistailāḍhakaṁ samaiḥ||149|| &lt;br /&gt;<br /> <br /> pacēt sājapayō'rdhāṁśaiḥ kalkairēbhiḥ palōnmitaiḥ| &lt;br /&gt;<br /> śaṭīsaraladārvēlāmañjiṣṭhāgurucandanaiḥ||150|| &lt;br /&gt;<br /> <br /> padmakātiviṣāmustasūrpaparṇīharēṇubhiḥ| &lt;br /&gt;<br /> yaṣṭyāhvasurasavyāghranakharṣabhakajīvakaiḥ||151|| &lt;br /&gt;<br /> <br /> palāśarasakastūrīnalikājātikōṣakaiḥ| &lt;br /&gt;<br /> spr̥kkākuṅkumaśailēyajātīkaṭuphalāmbubhiḥ||152|| &lt;br /&gt;<br /> <br /> tvacākundurukarpūraturuṣkaśrīnivāsakaiḥ [1] | &lt;br /&gt;<br /> lavaṅganakhakakkōlakuṣṭhamāṁsīpriyaṅgubhiḥ||153|| &lt;br /&gt;<br /> <br /> sthauṇēyatagaradhyāmavacāmadanapallavaiḥ| &lt;br /&gt;<br /> sanāgakēśaraiḥ siddhē kṣipēccātrāvatāritē||154|| &lt;br /&gt;<br /> <br /> patrakalkaṁ tataḥ pūtaṁ vidhinā tat prayōjayēt| &lt;br /&gt;<br /> śvāsaṁ kāsaṁ jvaraṁ hikkāṁ [2] chardiṁ gulmān kṣataṁ kṣayam||155|| &lt;br /&gt;<br /> <br /> plīhaśōṣāvapasmāramalakṣmīṁ ca praṇāśayēt| &lt;br /&gt;<br /> balātailamidaṁ śrēṣṭhaṁ vātavyādhivināśanam||156|| &lt;br /&gt;<br /> <br /> (agnivēśāya guruṇā kr̥ṣṇātrēyēṇa bhāṣitam)| &lt;br /&gt;<br /> iti balātailam| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Listen now to the description of other preparations of oils for all types of diseases of [[vata]] that can be used in all the four therapeutic modes; that are promotive of longevity, strength and complexion; that are curative of menstrual and seminal disorders; which are inductive of progeny; and which are free from harmful effects and are generally curative of all kinds of morbidity. [142-143]<br /> <br /> Prepare medicated oil in 400 ''tolas'' (4.8 l) of the decoction of ''sahachara'', by using 256 ''tolas'' (3.072 liters) of oil and adding 40 ''tolas'' (480 gm) of the paste of radish and four times the quantity milk is added.The physician should use this oil mixed with 72 ''tolas'' (864 gm) of powdered sugar, in severe types of [[vata]] disorder. [144-145]<br /> <br /> Prepare medicated oil by taking 64 ''tolas'' (768 ml) of oil along with 128 ''tolas'' (1.536 liters) of the expressed juice of ''shvadamshthra'', equal quantity of milk, 24 ''tolas'' (288 gm) of dry ginger and 32 ''tolas'' (384 gm) of jaggery. This should be administered in all kinds of disorders of ''vata''. After the dose of oil has been digested the regimen of thin gruel along with milk is recommended. [146-147]<br /> <br /> Take 400 ''tolas'' (4.8 kg) of ''bala'', fourth part of ''guduchi'' and one eighth quantity of ''rasna'' and cook in 1 ''adhaka'' (307.2 l) of water till it is reduced to one tenth of the quantity. Prepare 256 ''tolas'' (3.072 l) of oil with this decoction adding equal quantities of whey, sugarcane juice and vinegar along with half the quantity of goat’s milk and the paste of four ''tolas'' (48 gm) of the leaves of each of the following drugs:- ''shathi, sarala, darvi, ela, manjishtha, agaru, chandana, padmaka, ativisha, musta, surpaparni, harenu, yashthimadhu, surasa, vyaghranakha, rshabhaka, jeevakaih,'' juice of ''palasha, kastūrī, nalika,'' buds of jasmine, ''sprrikka, kunkuma, shaileya, jati phala, kathuphala, ambu, tvak, kunduru, karpura, aturushka, shrinivasa, lavanga, nakha, kakkoli, kushtha, mamsi, priyangu, sthauneya, tagara, dhyama, vacha,'' leaves of ''madana'' and ''nagakesar''. This should then be strained and the paste of fragrant drugs are added to it and administered duly. This excellent ''bala'' oil is curative of [[vata]] disorders in general. It can be used in dyspnea, cough, fever, hiccup, vomiting, ''gulma'', pectoral lesions, cachexia, splenic disorders, emaciation, epilepsy and lack of lustre. [148-154]<br /> <br /> ==== ''Amritadi tailam'' ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अमृतायास्तुलाः पञ्च द्रोणेष्वष्टस्वपां पचेत् ||१५७|| &lt;br /&gt;<br /> <br /> पादशेषे समक्षीरं तैलस्य द्व्याढकं पचेत् | &lt;br /&gt;<br /> एलामांसीनतोशीरसारिवाकुष्ठचन्दनैः ||१५८|| &lt;br /&gt;<br /> <br /> बलातामलकीमेदाशतपुष्पर्धिजीवकैः [१] | &lt;br /&gt;<br /> काकोलीक्षीरकाकोलीश्रावण्यतिबलानखैः ||१५९|| &lt;br /&gt;<br /> <br /> महाश्रावणिजीवन्तीविदारीकपिकच्छुभिः | &lt;br /&gt;<br /> शतावरीमहामेदाकर्कटाख्याहरेणुभिः ||१६०|| &lt;br /&gt;<br /> <br /> वचागोक्षुरकैरण्डरास्नाकालासहाचरैः | &lt;br /&gt;<br /> वीराशल्लकिमुस्तत्वक्पत्रर्षभकबालकैः ||१६१|| &lt;br /&gt;<br /> <br /> सहैलाकुङ्कुमस्पृक्कात्रिदशाह्वैश्च कार्षिकैः | &lt;br /&gt;<br /> मञ्जिष्ठायास्त्रिकर्षेण मधुकाष्टपलेन च ||१६२|| &lt;br /&gt;<br /> <br /> कल्कैस्तत् क्षीणवीर्याग्निबलसम्मूढचेतसः | &lt;br /&gt;<br /> उन्मादारत्यपस्मारैरार्तांश्च प्रकृतिं नयेत् ||१६३|| &lt;br /&gt;<br /> <br /> वातव्याधिहरं श्रेष्ठं तैलाग्र्यममृताह्वयम् | &lt;br /&gt;<br /> (कृष्णात्रेयेण [२] गुरुणा भाषितं वैद्यपूजितम्) ||१६४|| &lt;br /&gt;<br /> <br /> इत्यमृताद्यं तैलम् |&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> amRutAyAstulAH pa~jca droNeShvaShTasvapAM pacet ||157|| &lt;br /&gt;<br /> <br /> pAdasheShe samakShIraM tailasya dvyADhakaM pacet | &lt;br /&gt;<br /> elAmAMsInatoshIrasArivAkuṣṭhacandanaiH ||158|| &lt;br /&gt;<br /> <br /> balAtAmalakImedAshatapuShpardhijIvakaiH [1] | &lt;br /&gt;<br /> kAkolIkShIrakAkolIshrAvaNyatibalAnakhaiH ||159|| &lt;br /&gt;<br /> <br /> mahAshrAvaNijIvantIvidArIkapikacchubhiH | &lt;br /&gt;<br /> shatAvarImahAmedAkarkaTAkhyAhareNubhiH ||160|| &lt;br /&gt;<br /> <br /> vacAgokShurakairaNDarāsnākAlAsahAcaraiH | &lt;br /&gt;<br /> vIrAshallakimustatvakpatrarShabhakabAlakaiH ||161|| &lt;br /&gt;<br /> <br /> sahailAku~gkumaspRukkAtridashAhvaishca kArShikaiH | &lt;br /&gt;<br /> ma~jjiShThAyAstrikarSheNa madhukAShTapalena ca ||162|| &lt;br /&gt;<br /> <br /> kalkaistat kShINavIryAgnibalasammUDhacetasaH | &lt;br /&gt;<br /> unmAdAratyapasmArairArtAMshca prakRutiM nayet ||163|| &lt;br /&gt;<br /> <br /> VātavyādhiharaM shreShThaM tailAgryamamRutAhvayam | &lt;br /&gt;<br /> (kRuShNAtreyeNa [2] guruNA bhAShitaM vaidyapUjitam) ||164|| &lt;br /&gt;<br /> <br /> ityamRutAdyaM tailam | &lt;br /&gt;<br /> <br /> amr̥tāyāstulāḥ pañca drōṇēṣvaṣṭasvapāṁ pacēt||157|| &lt;br /&gt;<br /> <br /> pādaśēṣē samakṣīraṁ tailasya dvyāḍhakaṁ pacēt| &lt;br /&gt;<br /> ēlāmāṁsīnatōśīrasārivākuṣṭhacandanaiḥ||158|| &lt;br /&gt;<br /> <br /> balātāmalakīmēdāśatapuṣpardhijīvakaiḥ [1] | &lt;br /&gt;<br /> kākōlīkṣīrakākōlīśrāvaṇyatibalānakhaiḥ||159|| &lt;br /&gt;<br /> <br /> mahāśrāvaṇijīvantīvidārīkapikacchubhiḥ| &lt;br /&gt;<br /> śatāvarīmahāmēdākarkaṭākhyāharēṇubhiḥ||160|| &lt;br /&gt;<br /> <br /> vacāgōkṣurakairaṇḍarāsnākālāsahācaraiḥ| &lt;br /&gt;<br /> vīrāśallakimustatvakpatrarṣabhakabālakaiḥ||161|| &lt;br /&gt;<br /> <br /> sahailākuṅkumaspr̥kkātridaśāhvaiśca kārṣikaiḥ| &lt;br /&gt;<br /> mañjiṣṭhāyāstrikarṣēṇa madhukāṣṭapalēna ca||162|| &lt;br /&gt;<br /> <br /> kalkaistat kṣīṇavīryāgnibalasammūḍhacētasaḥ| &lt;br /&gt;<br /> unmādāratyapasmārairārtāṁśca prakr̥tiṁ nayēt||163|| &lt;br /&gt;<br /> <br /> vātavyādhiharaṁ śrēṣṭhaṁ tailāgryamamr̥tāhvayam| &lt;br /&gt;<br /> (kr̥ṣṇātrēyēṇa [2] guruṇā bhāṣitaṁ vaidyapūjitam)||164|| &lt;br /&gt;<br /> <br /> ityamr̥tādyaṁ tailam &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Prepare decoction of 2000 ''tolas'' (24 kg) of ''guduchi'' in 5 ''drone'' (98.304 l) of water by reducing to ¼th its quantity. Later add 512 ''tolas'' (60144 l) of sesame oil and equal quantity of milk in this decoction, along with paste of 1 ''tola'' (12 gm) each of cardamom, ''ela, mamsi, nata, ushira, sariva, kushtha, chandana, bala, tamalaki, meda, shatapushpa, riddhi, jeevaka, kakoli, ksheerakakoli, shravani, atibala, nakha, mahashravani, jeevanti,vidari, kapikacchu, shatavari, mahameda, karkata, harenu, vacha, gokshura, eranda, rasna, kala, sahachara, bala, veera, shallaki, musta, tvak, patra, rishabhaka, balaka, ela, kunkuma, sprikka'' and three ''tolas'' (36 gm) of manjishtha and 32 ''tolas'' (384 gm) of ''yashtimadhu''. It restores the health of those affected with reduced semen, digestive power and vitality. Normalizes individuals with insanity and epilepsy and is excellent to cure [[vata]] disorder. This is the ''amritadya taila'' propounded by preceptor ''krishnatreya'' who was respected by reverent physicians. [157- 164]<br /> <br /> ==== ''Rasna taila'' ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रास्नासहस्रनिर्यूहे तैलद्रोणं विपाचयेत् | &lt;br /&gt;<br /> गन्धैर्हैमवतैः पिष्टैरेलाद्यैश्चानिलार्तिनुत् ||१६५|| &lt;br /&gt;<br /> <br /> कल्पोऽयमश्वगन्धायां प्रसारण्यां बलाद्वये | &lt;br /&gt;<br /> क्वाथकल्कपयोभिर्वा बलादीनां पचेत् पृथक् ||१६६|| &lt;br /&gt;<br /> <br /> इति रास्नातैलम् | &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rāsnāsahasraniryUhe tailadroNaM vipAcayet | &lt;br /&gt;<br /> gandhairhaimavātaiH piShTairelAdyaishcAnilArtinut ||165|| &lt;br /&gt;<br /> <br /> kalpo~ayamashvagandhAyAM prasAraNyAM balAdvaye | &lt;br /&gt;<br /> kvAthakalkapayobhirvA balAdInAM pacet pRuthak ||166|| &lt;br /&gt;<br /> <br /> iti rāsnātailam | &lt;br /&gt;<br /> <br /> rāsnāsahasraniryūhē tailadrōṇaṁ vipācayēt| &lt;br /&gt;<br /> gandhairhaimavātaiḥ piṣṭairēlādyaiścānilārtinut||165|| &lt;br /&gt;<br /> <br /> kalpō'yamaśvagandhāyāṁ prasāraṇyāṁ balādvayē| &lt;br /&gt;<br /> kvāthakalkapayōbhirvā balādīnāṁ pacēt pr̥thak||166|| &lt;br /&gt;<br /> <br /> iti rāsnātailam &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The medicated oil is prepared by taking 1024 ''tolas'' (12.288 l) of oil and cooking it in 4000 ''tolas'' (48 l) of the decoction of ''rasna'' along with the paste of the fragrant groups of drugs grown in the Himalayas, as well as the cardamom group of drugs. This oil is curative of [[vata]]. A similar preparation of ''ashvagandha'' and ''prasarani'' and the two varieties of ''sida'' or the medicated oil of ''sida'' and other drugs may be prepared using these drugs individually in the form of decoction, paste or milk.<br /> <br /> Thus, ''rasna taila'' has been explained. [165–166]<br /> <br /> ==== ''Mulakadya taila'' and ''vrishmuladi taila'' ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मूलकस्वरसं क्षीरं तैलं दध्यम्लकाञ्जिकम् | &lt;br /&gt;<br /> तुल्यं विपाचयेत् कल्कैर्बलाचित्रकसैन्धवैः ||१६७|| &lt;br /&gt;<br /> <br /> पिप्पल्यतिविषारास्नाचविकागुरुशिग्रुकैः | &lt;br /&gt;<br /> भल्लातकवचाकुष्ठश्वदंष्ट्राविश्वभेषजैः ||१६८|| &lt;br /&gt;<br /> <br /> पुष्कराह्वशटीबिल्वशताह्वानतदारुभिः | &lt;br /&gt;<br /> तत्सिद्धं पीतमत्युग्रान् हन्ति वातात्मकान् गदान् ||१६९|| &lt;br /&gt;<br /> <br /> इति मूलकाद्यं तैलम् | &lt;br /&gt;<br /> <br /> वृषमूलगुडूच्योश्च द्विशतस्य शतस्य च | &lt;br /&gt;<br /> चित्रकात् साश्वगन्धाच्च क्वाथे तैलाढकं पचेत् ||१७०|| &lt;br /&gt;<br /> <br /> सक्षीरं वायुना भग्ने दद्याज्जर्जरिते तथा | &lt;br /&gt;<br /> प्राक्तैलावापसिद्धं च भवेदेतद्गुणोत्तरम् ||१७१|| &lt;br /&gt;<br /> <br /> इति वृषमूलादितैलम् |&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mUlakasvarasaM kShIraM tailaM dadhyamlakA~jjikam | &lt;br /&gt;<br /> tulyaM vipAcayet kalkairbalAcitrakasaindhavaiH ||167|| &lt;br /&gt;<br /> <br /> pippalyativiṣārāsnācavikAgurushigrukaiH | &lt;br /&gt;<br /> bhallAtakavacAkuṣṭhashvadaMShTrAvishvabheShajaiH ||168|| &lt;br /&gt;<br /> <br /> puShkarAhvaśaṭībilvashatAhvAnatadArubhiH | &lt;br /&gt;<br /> tatsiddhaM pItamatyugrAn hanti vātatmakAn gadAn ||169|| &lt;br /&gt;<br /> <br /> iti mUlakAdyaM tailam | &lt;br /&gt;<br /> <br /> vRuShamUlaguDUcyoshca dvishatasya shatasya ca | &lt;br /&gt;<br /> citrakAt sAshvagandhAcca kvAthe tailADhakaM pacet ||170|| &lt;br /&gt;<br /> <br /> sakShIraM Vāyu nA bhagne dadyAjjarjarite tathA | &lt;br /&gt;<br /> prAktailAvApasiddhaM ca bhavedetadguNottaram ||171|| &lt;br /&gt;<br /> <br /> iti vRuShamUlAditailam | &lt;br /&gt;<br /> <br /> mūlakasvarasaṁ kṣīraṁ tailaṁ dadhyamlakāñjikam| &lt;br /&gt;<br /> tulyaṁ vipācayēt kalkairbalācitrakasaindhavaiḥ||167|| &lt;br /&gt;<br /> <br /> pippalyativiṣārāsnācavikāguruśigrukaiḥ| &lt;br /&gt;<br /> bhallātakavacākuṣṭhaśvadaṁṣṭrāviśvabhēṣajaiḥ||168|| &lt;br /&gt;<br /> <br /> puṣkarāhvaśaṭībilvaśatāhvānatadārubhiḥ| &lt;br /&gt;<br /> tatsiddhaṁ pītamatyugrān hanti vātātmakān gadān||169|| &lt;br /&gt;<br /> <br /> iti mūlakādyaṁ tailam| &lt;br /&gt;<br /> <br /> vr̥ṣamūlaguḍūcyōśca dviśatasya śatasya ca| &lt;br /&gt;<br /> citrakāt sāśvagandhācca kvāthē tailāḍhakaṁ pacēt||170|| &lt;br /&gt;<br /> <br /> sakṣīraṁ vāyunā bhagnē dadyājjarjaritē tathā| &lt;br /&gt;<br /> prāktailāvāpasiddhaṁ ca bhavēdētadguṇōttaram||171|| &lt;br /&gt;<br /> <br /> iti vr̥ṣamūlāditailam| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Medicated oil is prepared by taking 64 ''tolas'' (768 gm) of oil and cooking it in equal quantities of radish juice, milk, sour curds, and sour ''kanji'', the paste of ''sida, chitraka,'' rock salt, ''pippali, ativisha, rasna, chavika, agaru, shigru, bhallataka, vacha, kushtha, shvadamishtra, vishvabheshaja, pushkara, shati, bilwa, shatahva, nata,'' and ''devadaru''. This ''mulakadya taila'', when taken internally, cures even very severe types of ''vata'' disorders. [167-169]<br /> <br /> 256 ''tolas'' (3.072 l) of sesame oil are cooked in 800 ''tolas'' (9.6 l) of the decoction of ''vrisha'' roots and guduchi, and 400 ''tolas'' (4.8 l) of the decoction of ''chitraka, ashvagandha'' and milk. This medicated oil should be prescribed in fractured or serious conditions of bone due to ''vata''. It becomes exceedingly effective if prepared with the paste mentioned in earlier oils. [170-171]<br /> <br /> ==== ''Mulaka taila'' ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रास्नाशिरीषयष्ट्याह्वशुण्ठीसहचरामृताः ||१७२|| &lt;br /&gt;<br /> <br /> स्योनाकदारुशम्पाकहयगन्धात्रिकण्टकाः | &lt;br /&gt;<br /> एषां दशपलान् भागान् कषायमुपकल्पयेत् ||१७३||&lt;br /&gt;<br /> <br /> ततस्तेन कषायेण सर्वगन्धैश्च कार्षिकैः | &lt;br /&gt;<br /> दध्यारनालमाषाम्बुमूलकेक्षुरसैः [१] शुभैः ||१७४||&lt;br /&gt;<br /> <br /> पृथक् प्रस्थोन्मितैः सार्धं तैलप्रस्थं विपाचयेत् | &lt;br /&gt;<br /> प्लीहमूत्रग्रहश्वासकासमारुतरोगनुत् [२] ||१७५|| &lt;br /&gt;<br /> <br /> एतन्मूलकतैलाख्यं [३] वर्णायुर्बलवर्धनम् | &lt;br /&gt;<br /> इति मूलकतैलम् | &lt;br /&gt;<br /> <br /> यवकोलकुलत्थानां मत्स्यानां शिग्रुबिल्वयोः | &lt;br /&gt;<br /> रसेन मूलकानां च तैलं दधिपयोन्वितम् ||१७६|| &lt;br /&gt;<br /> <br /> साधयित्वा भिषग्दद्यात् सर्ववातामयापहम् | &lt;br /&gt;<br /> लशुनस्वरसे सिद्धं तैलमेभिश्च वातनुत् ||१७७|| &lt;br /&gt;<br /> <br /> तैलान्येतान्यृतुस्नातामङ्गनां पाययेत च | &lt;br /&gt;<br /> पीत्वाऽन्यतममेषां हि वन्ध्याऽपि जनयेत् सुतम् ||१७८|| &lt;br /&gt;<br /> <br /> यच्च शीतज्वरे तैलमगुर्वाद्यमुदाहृतम् | &lt;br /&gt;<br /> अनेकशतशस्तच्च सिद्धं स्याद्वातरोगनुत् ||१७९|| &lt;br /&gt;<br /> <br /> वक्ष्यन्ते यानि तैलानि वातशोणितकेऽपि च | &lt;br /&gt;<br /> तानि चानिलशान्त्यर्थं सिद्धिकामः प्रयोजयेत् ||१८०|| &lt;br /&gt;<br /> <br /> नास्ति तैलात् परं किञ्चिदौषधं मारुतापहम् | &lt;br /&gt;<br /> व्यवाय्युष्णगुरुस्नेहात् संस्काराद्वलवत्तरम् ||१८१||&lt;br /&gt;<br /> <br /> गणैर्वातहरैस्तस्माच्छतशोऽथं सहस्रशः | &lt;br /&gt;<br /> सिद्धं क्षिप्रतरं हन्ति सूक्ष्ममार्गस्थितान् गदान् ||१८२||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rāsnāshirIShayaShTyAhvashuNThIsahacarAmRutAH ||172|| &lt;br /&gt;<br /> <br /> syonAkadArushampAkahayagandhAtrikaNTakAH | &lt;br /&gt;<br /> eShAM dashapalAn bhAgAn kaShAyamupakalpayet ||173|| &lt;br /&gt;<br /> <br /> tatastena kaShAyeNa sarvagandhaishca kArShikaiH | &lt;br /&gt;<br /> dadhyAranAlamAShAmbumUlakekShurasaiH [1] shubhaiH ||174|| &lt;br /&gt;<br /> <br /> pRuthak prasthonmitaiH sArdhaM tailaprasthaM vipAcayet | &lt;br /&gt;<br /> plIhamūtragrahashvAsakAsamArutarōganut [2] ||175|| &lt;br /&gt;<br /> <br /> etanmUlakatailAkhyaM [3] varNAyurbalavardhanam | &lt;br /&gt;<br /> iti mUlakatailam | &lt;br /&gt;<br /> <br /> yavakōlakulatthAnAM matsyAnAM shigrubilvayoH | &lt;br /&gt;<br /> rasena mUlakAnAM ca tailaM dadhipayonvitam ||176|| &lt;br /&gt;<br /> <br /> sAdhayitvA bhiShagdadyAt sarvavātamayApaham | &lt;br /&gt;<br /> lashunasvarase siddhaM tailamebhishca vātanut ||177|| &lt;br /&gt;<br /> <br /> tailAnyetAnyRutuṣṇā tAma~gganAM pAyayeta ca | &lt;br /&gt;<br /> pItvA~anyatamameShAM hi vandhyA~api janayet sutam ||178|| &lt;br /&gt;<br /> <br /> yacca shItajvare tailamagurvAdyamudAhRutam | &lt;br /&gt;<br /> anekashatashastacca siddhaM syAdvātarōganut ||179|| &lt;br /&gt;<br /> <br /> vakShyante yAni tailAni vātashoNitake~api ca | &lt;br /&gt;<br /> tAni cAnilashAntyarthaM siddhikAmaH prayojayet ||180|| &lt;br /&gt;<br /> <br /> nAsti tailAt paraM ki~jcidauShadhaM mArutApaham | &lt;br /&gt;<br /> vyavAyyuShNaguruSnēhat saMskArAdvalavattaram ||181|| &lt;br /&gt;<br /> <br /> gaNairvātaharaistasmAcchatasho~athaM sahasrashaH | &lt;br /&gt;<br /> siddhaM kShiprataraM hanti sUkShmamArgasthitAn gadAn ||182|| &lt;br /&gt;<br /> <br /> rāsnāśirīṣayaṣṭyāhvaśuṇṭhīsahacarāmr̥tāḥ||172|| &lt;br /&gt;<br /> <br /> syōnākadāruśampākahayagandhātrikaṇṭakāḥ| &lt;br /&gt;<br /> ēṣāṁ daśapalān bhāgān kaṣāyamupakalpayēt||173|| &lt;br /&gt;<br /> <br /> tatastēna kaṣāyēṇa sarvagandhaiśca kārṣikaiḥ| &lt;br /&gt;<br /> dadhyāranālamāṣāmbumūlakēkṣurasaiḥ [1] śubhaiḥ||174|| &lt;br /&gt;<br /> <br /> pr̥thak prasthōnmitaiḥ sārdhaṁ tailaprasthaṁ vipācayēt| &lt;br /&gt;<br /> plīhamūtragrahaśvāsakāsamārutarōganut [2] ||175|| &lt;br /&gt;<br /> <br /> ētanmūlakatailākhyaṁ [3] varṇāyurbalavardhanamiti <br /> mūlakatailamyavakōlakulatthānāṁ matsyānāṁśigrubilvayōḥ| &lt;br /&gt;<br /> rasēna mūlakānāṁ ca tailaṁ dadhipayōnvitam||176|| &lt;br /&gt;<br /> <br /> sādhayitvā bhiṣagdadyāt sarvavātāmayāpaham| &lt;br /&gt;<br /> laśunasvarasē siddhaṁ tailamēbhiśca vātanut||177|| &lt;br /&gt;<br /> <br /> tailānyētānyr̥tusnātāmaṅganāṁ pāyayēta ca| &lt;br /&gt;<br /> pītvā'nyatamamēṣāṁ hi vandhyā'pi janayēt sutam||178|| &lt;br /&gt;<br /> <br /> yacca śītajvarē tailamagurvādyamudāhr̥tam| &lt;br /&gt;<br /> anēkaśataśastacca siddhaṁ syādvātarōganut||179|| &lt;br /&gt;<br /> <br /> vakṣyantē yāni tailāni vātaśōṇitakē'pi ca| &lt;br /&gt;<br /> tāni cānilaśāntyarthaṁ siddhikāmaḥ prayōjayēt||180|| &lt;br /&gt;<br /> <br /> nāsti tailāt paraṁ kiñcidauṣadhaṁ mārutāpaham| &lt;br /&gt;<br /> vyavāyyuṣṇagurusnēhāt saṁskārādvalavattaram||181|| &lt;br /&gt;<br /> <br /> gaṇairvātaharaistasmācchataśō'tha sahasraśaḥ| &lt;br /&gt;<br /> siddhaṁ kṣiprataraṁ hanti sūkṣmamārgasthitān gadān||182|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Prepare a decoction by taking 40 ''tolas'' (48 gm) of each of ''rasna, shirisha,'' liquorice, dry ginger, ''sahachara, guduchi, syonaka, devadaru, shampaka, ashvagandha'' and ''gokshura''. Then oil is prepared by taking 64 ''tolas'' (768 ml) of sesame oil and cooking it in the above said decoction along with 64 ''tolas'' (768 ml) each of curds, ''aranala'', decoction of black gram, juices of good quality of radish, and sugar cane, adding one ''tola'' (12 gm) of the paste of each of the ''gandhavarga'' drugs. <br /> This ''mūlaka'' oil is curative of splenic disorders, retention of urine, dyspnoea, cough and other [[vata]] disorders. It is also promotive of complexion, life and vitality. Thus ''mūlaka taila'' is explained. [172-173]<br /> <br /> Medicated oil is prepared by taking sesame oil and cooking it in the decoction of barley, ''kola'', horse gram, fish, drumstick, ''bael'', radish, curds and milk. This is curative of all [[vata]] disorders. The medicated oil prepared in the expressed juice of garlic and the drugs mentioned above, is curative of [[vata roga]]. These different oils may be given as potion to a woman who has just taken her purificatory bath on the cessation of menses. By taking any of this medicated oil as ''pana'', even a sterile woman will become fertile. <br /> <br /> The ''agurvadya'' oil, which has been described in the treatment of ''shita jwara'', if processed again many hundred times, becomes curative of [[vata]] disorders. And the medicated oils, which will be described in the therapeutics of rheumatic conditions, may be prescribed for the alleviation of vāta disorders, by the physician desirous of success in treatment. [176-180]<br /> <br /> There exists no medication superior to oil as a remedy for [[vata]], due to its quality of extreme spreadability, hot in potency, heaviness, unctuousness and by virtue of becoming more powerful on being medicated with the [[vata]] curative group of drugs. <br /> <br /> Being also capable of further intensification of potency, by being processed again for hundreds or thousands of times, ''taila'' very quickly cures the diseases which are located into even the minutest part of the body. [181-182]<br /> <br /> === Management of avrita [[vata]] conditions ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्रिया साधारणी सर्वा संसृष्टे चापि शस्यते | &lt;br /&gt;<br /> वाते पित्तादिभिः स्रोतःस्वावृतेषु विशेषतः ||१८३|| &lt;br /&gt;<br /> <br /> पित्तावृते विशेषेण शीतामुष्णां तथा क्रियाम् | &lt;br /&gt;<br /> व्यत्यासात् कारयेत् सर्पिर्जीवनीयं च शस्यते ||१८४|| &lt;br /&gt;<br /> <br /> धन्वमांसं यवाः शालिर्यापनाः क्षीरबस्तयः | &lt;br /&gt;<br /> विरेकः क्षीरपानं च पञ्चमूलीबलाशृतम् ||१८५|| &lt;br /&gt;<br /> <br /> मधुयष्टिबलातैलघृतक्षीरैश्च सेचनम् | &lt;br /&gt;<br /> पञ्चमूलकषायेण कुर्याद्वा शीतवारिणा ||१८६|| &lt;br /&gt;<br /> <br /> कफावृते यवान्नानि जाङ्गला मृगपक्षिणः | &lt;br /&gt;<br /> स्वेदास्तीक्ष्णा निरूहाश्च वमनं सविरेचनम् ||१८७|| &lt;br /&gt;<br /> <br /> जीर्णं सर्पिस्तथा तैलं तिलसर्षपजं हितम् | &lt;br /&gt;<br /> संसृष्टे कफपित्ताभ्यां पित्तमादौ विनिर्जयेत् ||१८८||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kriyA sAdhAraNI sarvA saMsRuShTe cApi shasyate | &lt;br /&gt;<br /> vAte pittAdibhiH srotaHsvAvRuteShu visheShataH ||183|| &lt;br /&gt;<br /> <br /> pittAvRute visheSheNa shItAmuShNAM tathA kriyAm | &lt;br /&gt;<br /> vyatyAsAt kArayet sarpirjIvanIyaM ca shasyate ||184|| &lt;br /&gt;<br /> <br /> dhanvamāṁsaM yavAH shAlirYāpana H kShIrabastayaH | &lt;br /&gt;<br /> virekaH kShIrapāna M ca pa~jcamUlIbalAshRutam ||185|| &lt;br /&gt;<br /> <br /> madhuyaShTibalAtailaghRutakShIraishca secanam | &lt;br /&gt;<br /> pa~jcamUlakaShAyeNa kuryAdvA shItavAriNA ||186|| &lt;br /&gt;<br /> <br /> kaphAvRute yavAnnAni jA~ggalA mRugapakShiNaH | &lt;br /&gt;<br /> svedAstIkShNA nirUhAshca vamanaM savirēcanam ||187|| &lt;br /&gt;<br /> <br /> jIrNaM sarpistathA tailaM tilasarShapajaM hitam | &lt;br /&gt;<br /> saMsRuShTe kaphapittAbhyAM pittamAdau vinirjayet ||188|| &lt;br /&gt;<br /> <br /> kriyā sādhāraṇī sarvā saṁsr̥ṣṭē cāpi śasyatē|&lt;br /&gt;<br /> vātē pittādibhiḥ srōtaḥsvāvr̥tēṣu viśēṣataḥ||183|| &lt;br /&gt;<br /> <br /> pittāvr̥tē viśēṣēṇa śītāmuṣṇāṁ tathā kriyām| &lt;br /&gt;<br /> vyatyāsāt kārayēt sarpirjīvanīyaṁ ca śasyatē||184|| &lt;br /&gt;<br /> <br /> dhanvamāṁsaṁ yavāḥ śāliryāpanāḥ kṣīrabastayaḥ| &lt;br /&gt;<br /> virēkaḥ kṣīrapānaṁ ca pañcamūlībalāśr̥tam||185|| &lt;br /&gt;<br /> <br /> madhuyaṣṭibalātailaghr̥takṣīraiśca sēcanam| &lt;br /&gt;<br /> pañcamūlakaṣāyēṇa kuryādvā śītavāriṇā||186|| &lt;br /&gt;<br /> <br /> kaphāvr̥tē yavānnāni jāṅgalā mr̥gapakṣiṇaḥ| &lt;br /&gt;<br /> svēdāstīkṣṇā nirūhāśca vamanaṁ savirēcanam||187|| &lt;br /&gt;<br /> <br /> jīrṇaṁ sarpistathā tailaṁ tilasarṣapajaṁ hitam| &lt;br /&gt;<br /> saṁsr̥ṣṭē kaphapittābhyāṁ pittamādau vinirjayēt||188|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> This general line of treatment is also recommended in conditions of association with morbidity of other humors, but especially when the body channels have been occluded by [[pitta]] and [[kapha]] in [[vata]] disorders. [183]<br /> <br /> ==== Management of [[pitta]]vrita [[vata]] ====<br /> <br /> In condition of occlusion of [[pitta]], the physician should administer cold and hot lins of treatment in alternation. Here, ghee prepared of ''jeevaniya gana'' is recommended.<br /> <br /> Diet which contains flesh of ''jaṇgala'' animals, barley and ''shali'' rice, ''yapana'' enema, milk enema, purgation, drinking of milk, decoction of ''panchamula'' and ''sida'' is also beneficial.[184-185]<br /> <br /> The patient should be given ''dharā'' with medicated oil or ghee or milk prepared with liquorice and ''sida'', or with the decoction of ''panchamūla'' or with cold water. [186]<br /> <br /> In conditions of occlusion by [[kapha]] articles made of barley, the flesh of animals and birds of ''jangala'' area as diet is effective along with strong sudation, evacuative enema and emesis and purgation. Old ghee, sesame oil and mustard oil are also beneficial. [187-187 ½]<br /> <br /> In the condition of occlusion by both [[kapha]] and [[pitta]], [[pitta]] must be subdued first. [188]<br /> <br /> === Management of various condition of [[vata]] located in other sites ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आमाशयगतं मत्वा कफं वमनमाचरेत् ||१८९|| &lt;br /&gt;<br /> <br /> पक्वाशये विरेकं तु पित्ते सर्वत्रगे तथा | &lt;br /&gt;<br /> स्वेदैर्विष्यन्दितः श्लेष्मा यदा पक्वाशये स्थितः ||१९०|| &lt;br /&gt;<br /> <br /> पित्तं वा दर्शयेल्लिङ्गं बस्तिभिस्तौ विनिर्हरेत् | &lt;br /&gt;<br /> श्लेष्मणाऽनुगतं वातमुष्णैर्गोमूत्रसंयुतैः ||१९१|| &lt;br /&gt;<br /> <br /> निरूहैः पित्तसंसृष्टं निर्हरेत् क्षीरसंयुतैः | &lt;br /&gt;<br /> मधुरौषधसिद्धैश्च तैलैस्तमनुवासयेत् ||१९२|| &lt;br /&gt;<br /> <br /> शिरोगते तु सकफे धूमनस्यादि कारयेत् | &lt;br /&gt;<br /> हृते पित्ते कफे यः स्यादुरःस्रोतोऽनुगोऽनिलः ||१९३|| &lt;br /&gt;<br /> <br /> सशेषः स्यात् क्रिया तत्र कार्या केवलवातिकी | &lt;br /&gt;<br /> शोणितेनावृते कुर्याद्वातशोणितकीं क्रियाम् ||१९४|| &lt;br /&gt;<br /> <br /> प्रमेहवातमेदोघ्नीमामवाते [३] प्रयोजयेत् | &lt;br /&gt;<br /> स्वेदाभ्यङ्गरसक्षीरस्नेहा मांसावृते हिताः ||१९५|| &lt;br /&gt;<br /> <br /> महास्नेहोऽस्थिमज्जस्थे पूर्ववद्रेतसाऽऽवृते | &lt;br /&gt;<br /> अन्नावृते तदुल्लेखः [४] पाचनं दीपनं लघु ||१९६|| &lt;br /&gt;<br /> <br /> मूत्रलानि तु मूत्रेण स्वेदाः सोत्तरबस्तयः | &lt;br /&gt;<br /> शकृता तैलमैरण्डं स्निग्धोदावर्तवत्क्रिया [५] ||१९७|| &lt;br /&gt;<br /> <br /> स्वस्थानस्थो बली दोषः प्राक् तं स्वैरौषधैर्जयेत् | &lt;br /&gt;<br /> वमनैर्वा विरेकैर्वा बस्तिभिः शमनेन वा ||१९८|| &lt;br /&gt;<br /> <br /> (इत्युक्तमावृते वाते पित्तादिभिर्यथायथम् [६] ) |१९९|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ĀmashayagataM matvA [1] kaphaM vamanamAcaret ||189|| &lt;br /&gt;<br /> <br /> pakvAshaye virekaM tu pitte sarvatrage tathA | &lt;br /&gt;<br /> svedairviShyanditaH shleShmA yadA pakvAshaye sthitaH ||190|| &lt;br /&gt;<br /> <br /> pittaM vA darshayelli~ggaM bastibhistau vinirharet | &lt;br /&gt;<br /> shleShmaNA~anugataM vātamuShNairgomūtrasaMyutaiH ||191|| &lt;br /&gt;<br /> <br /> nirUhaiH pittasaMsRuShTaM nirharet kShIrasaMyutaiH | &lt;br /&gt;<br /> madhurauShadhasiddhaishca tailaistamanuvAsayet ||192|| &lt;br /&gt;<br /> <br /> shirōgate tu sakaphe dhUmanasyAdi kArayet | &lt;br /&gt;<br /> hRute pitte kaphe yaH syAduraHsroto~anugo~anilaH ||193|| &lt;br /&gt;<br /> <br /> sasheShaH [2] syAt kriyA tatra kAryA kevalavAtikI | &lt;br /&gt;<br /> shoNitenAvRute kuryAdvātashoNitakIM kriyAm ||194|| &lt;br /&gt;<br /> <br /> pramehavātamedoghnImAmavAte [3] prayojayet | &lt;br /&gt;<br /> svedAbhya~ggarasakShIraSnēha māṁsavRute hitAH ||195|| &lt;br /&gt;<br /> <br /> mahAsneho~asthimajjasthe pUrvavadretasA~a~avRute | &lt;br /&gt;<br /> annAvRute tadullekhaH [4] pācanaM dIpanaM laghu ||196|| &lt;br /&gt;<br /> <br /> mūtralAni tu mUtreNa svedAH sottarabastayaH | &lt;br /&gt;<br /> shakRutA tailamairaNDaM snigdhodAvartavatkriyA [5] ||197|| &lt;br /&gt;<br /> <br /> svasthānastho balI dōṣaH prAk taM svairauShadhairjayet | &lt;br /&gt;<br /> vamanairvA virekairvA bastibhiH shamanena vA ||198|| &lt;br /&gt;<br /> <br /> (ityuktamAvRute vAte pittAdibhiryathAyatham [6] ) |199| &lt;br /&gt;<br /> <br /> āmāśayagataṁ matvā [1] kaphaṁ vamanamācarēt||189|| &lt;br /&gt;<br /> <br /> pakvāśayē virēkaṁ tu pittē sarvatragē tathā| &lt;br /&gt;<br /> svēdairviṣyanditaḥ ślēṣmā yadā pakvāśayē sthitaḥ||190|| &lt;br /&gt;<br /> <br /> pittaṁ vā darśayēlliṅgaṁ bastibhistau vinirharēt| &lt;br /&gt;<br /> ślēṣmaṇā'nugataṁ vātamuṣṇairgōmūtrasaṁyutaiḥ||191|| &lt;br /&gt;<br /> <br /> nirūhaiḥ pittasaṁsr̥ṣṭaṁ nirharēt kṣīrasaṁyutaiḥ| &lt;br /&gt;<br /> madhurauṣadhasiddhaiśca tailaistamanuvāsayēt||192|| &lt;br /&gt;<br /> <br /> śirōgatē tu sakaphē dhūmanasyādi kārayēt| &lt;br /&gt;<br /> hr̥tē pittē kaphē yaḥ syāduraḥsrōtō'nugō'nilaḥ||193|| &lt;br /&gt;<br /> <br /> saśēṣaḥ [2] syāt kriyā tatra kāryā kēvalavātikī| &lt;br /&gt;<br /> śōṇitēnāvr̥tē kuryādvātaśōṇitakīṁ kriyām||194|| &lt;br /&gt;<br /> <br /> pramēhavātamēdōghnīmāmavātē [3] prayōjayēt| &lt;br /&gt;<br /> svēdābhyaṅgarasakṣīrasnēhā māṁsāvr̥tē hitāḥ||195|| &lt;br /&gt;<br /> <br /> mahāsnēhō'sthimajjasthē pūrvavadrētasā''vr̥tē| &lt;br /&gt;<br /> annāvr̥tē tadullēkhaḥ [4] pācanaṁ dīpanaṁ laghu||196|| &lt;br /&gt;<br /> <br /> mūtralāni tu mūtrēṇa svēdāḥ sōttarabastayaḥ| &lt;br /&gt;<br /> śakr̥tā tailamairaṇḍaṁ snigdhōdāvartavatkriyā [5] ||197|| &lt;br /&gt;<br /> <br /> svasthānasthō balī dōṣaḥ prāk taṁ svairauṣadhairjayēt| &lt;br /&gt;<br /> vamanairvā virēkairvā bastibhiḥ śamanēna vā||198|| &lt;br /&gt;<br /> <br /> (ityuktamāvr̥tē vātē pittādibhiryathāyatham [6] )|199| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> On finding that [[kapha]] is located in the stomach (''amashaya''), emesis should be given and if it is located in the colon (''pakvashaya''), the treatment of choice is purgation. If [[pitta]] has pervaded all over the body, again the same (purgation) should be given. [189-189 ½]<br /> <br /> As [[kapha]] or [[pitta]] gets liquefied by sudation, and gets accumulated in the colon and the symptoms of ''pitta'' manifest, both of these should be eliminated by the use of enema. [190-190 ½]<br /> <br /> If [[vata]] is associated with [[kapha]], it should be eliminated by warm evacuative enema mixed with cow’s urine. If [[vata]] is associated with [[pitta]], it should be eliminated by evacuative enema mixed with milk. Then the patient should be given unctuous enema prepared with the ''madhura rasa'' group of drugs. [191-192]<br /> <br /> In condition of [[vata]] located in the head and associated with [[kapha]], inhalation and nasal medication should be given. [192 ½]<br /> <br /> If after the elimination of [[pitta]] and [[kapha]], there remains a residual morbidity of [[vata]] in the channels of the chest region, the treatment indicated in absolute [[vata]] should be given. [193- 193 ½]<br /> <br /> If [[vata]] is occluded by blood, the line of treatment should be the same as indicated in ''vatashonita''.[194]<br /> <br /> In ama [[vata]], treatment curative of ''prameha, [[vata]] and ''meda'', should be given. [194 ½]<br /> <br /> If [[vata]] is occluded by the flesh, than sudation, massage, meat juices, milk and unctuous medications are recommended. [195]<br /> <br /> If [[vata]] is occluded by the osseous tissue or the marrow, ''mahasneha'' should be given. If occluded in the semen, the treatment has already been described. [195 ½]<br /> <br /> If [[vata]] is occluded by food, then emesis, digestives, carminatives and light diet are recommended. [196]<br /> <br /> If occluded by urine, diuretics, sudation and trans-urethral enema are recommended. If [[vata]] is occluded by fecal matter, the remedies are castor oil and unctuous therapy as indicated in ''udavarta''. [197]<br /> <br /> A morbid humor, while in its natural habitat, and when more powerful; it should be first subdued by its own suitable medications such as emesis, purgation, enema or sudation. [198]<br /> <br /> Thus has been described the treatment of conditions of occlusion of [[vata]] by [[pitta]], etc. [198 ½]<br /> <br /> === Mutual occlusions by types of [[vata]] and their management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मारुतानां हि पञ्चानामन्योन्यावरणे शृणु ||१९९|| &lt;br /&gt;<br /> <br /> लिङ्गं व्याससमासाभ्यामुच्यमानं मयाऽनघ! | &lt;br /&gt;<br /> प्राणो वृणोत्युदानादीन् प्राणं वृण्वन्ति तेऽपि च ||२००|| &lt;br /&gt;<br /> <br /> उदानाद्यास्तथाऽन्योन्यं सर्व एव यथाक्रमम् | &lt;br /&gt;<br /> विंशतिर्वरणान्येतान्युल्बणानां [१] परस्परम् ||२०१|| &lt;br /&gt;<br /> <br /> मारुतानां हि पञ्चानां तानि सम्यक् प्रतर्कयेत् | &lt;br /&gt;<br /> सर्वेन्द्रियाणां शून्यत्वं ज्ञात्वा स्मृतिबलक्षयम् ||२०२|| &lt;br /&gt;<br /> <br /> व्याने प्राणावृते लिङ्गं कर्म तत्रोर्ध्वजत्रुकम् | &lt;br /&gt;<br /> स्वेदोऽत्यर्थं लोमहर्षस्त्वग्दोषः सुप्तगात्रता ||२०३|| &lt;br /&gt;<br /> <br /> प्राणे व्यानावृते तत्र स्नेहयुक्तं विरेचनम् | &lt;br /&gt;<br /> प्राणावृते समाने स्युर्जडगद्गदमूकताः ||२०४|| &lt;br /&gt;<br /> <br /> चतुष्प्रयोगाः शस्यन्ते स्नेहास्तत्र सयापनाः | &lt;br /&gt;<br /> समानेनावृतेऽपाने [२] ग्रहणीपार्श्वहृद्गदाः ||२०५||&lt;br /&gt;<br /> <br /> शूलं चामाशये तत्र दीपनं सर्पिरिष्यते |२०६|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mArutAnAM hi pa~jcAnAmanyonyĀvaranae shRuNu ||199|| &lt;br /&gt;<br /> <br /> li~ggaM vyAsasamAsAbhyAmucyamAnaM mayA~anagha! | &lt;br /&gt;<br /> prānao vRuNotyudānadIn prānaM vRuNvanti te~api ca ||200|| &lt;br /&gt;<br /> <br /> udānadyAstathA~anyonyaM sarva eva yathAkramam | &lt;br /&gt;<br /> viMśaṭīrvaraNAnyetAnyulbaNAnAM [1] parasparam ||201|| &lt;br /&gt;<br /> <br /> mArutAnAM hi pa~jcAnAM tAni samyak pratarkayet | &lt;br /&gt;<br /> sarvendriyANAM shUnyatvaM j~jAtvA smRutibalakṣayam ||202|| &lt;br /&gt;<br /> <br /> vyānae prānavRute li~ggaM karma tatrordhvajatrukam | &lt;br /&gt;<br /> svedo~atyarthaM lomaharShastvag dōṣaH suptagAtratA ||203|| &lt;br /&gt;<br /> <br /> prānae vyānavRute tatra SnēhayuktaM virēcanam | &lt;br /&gt;<br /> prānavRute Samānae syurjaDagadgadamUkatAH ||204|| &lt;br /&gt;<br /> <br /> catuShprayogAH shasyante Snēhastatra saYāpana H | &lt;br /&gt;<br /> SamānaenAvRute~apānae [2] grahaNIpArshvahRudgadAH ||205|| &lt;br /&gt;<br /> <br /> shUlaM cAmAshaye tatra dIpanaM sarpiriShyate |206| &lt;br /&gt;<br /> <br /> mārutānāṁ hi pañcānāmanyōnyāvaraṇē śr̥ṇu||199|| &lt;br /&gt;<br /> <br /> liṅgaṁ vyāsasamāsābhyāmucyamānaṁ mayā'nagha!| &lt;br /&gt;<br /> prāṇō vr̥ṇōtyudānādīn prāṇaṁ vr̥ṇvanti tē'pi ca||200|| &lt;br /&gt;<br /> <br /> udānādyāstathā'nyōnyaṁ sarva ēva yathākramam| &lt;br /&gt;<br /> viṁśatirvaraṇānyētānyulbaṇānāṁ [7] parasparam||201|| &lt;br /&gt;<br /> <br /> mārutānāṁ hi pañcānāṁ tāni samyak pratarkayēt| &lt;br /&gt;<br /> sarvēndriyāṇāṁ śūnyatvaṁ jñātvā smr̥tibalakṣayam||202|| &lt;br /&gt;<br /> <br /> vyānē prāṇāvr̥tē liṅgaṁ karma tatrōrdhvajatrukam| &lt;br /&gt;<br /> svēdō'tyarthaṁ lōmaharṣastvagdōṣaḥ suptagātratā||203|| &lt;br /&gt;<br /> <br /> prāṇē vyānāvr̥tē tatra snēhayuktaṁ virēcanam| &lt;br /&gt;<br /> prāṇāvr̥tē samānē syurjaḍagadgadamūkatāḥ||204|| &lt;br /&gt;<br /> <br /> catuṣprayōgāḥ śasyantē snēhāstatra sayāpanāḥ| &lt;br /&gt;<br /> samānēnāvr̥tē'pānē [8] grahaṇīpārśvahr̥dgadāḥ||205|| &lt;br /&gt;<br /> <br /> śūlaṁ cāmāśayē tatra dīpanaṁ sarpiriṣyatē|206|&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Oh Sinless Dear! I shall next describe the mutual obstruction between the five types of [[vata]] in detailed and concised manner. [199-199 ½]<br /> <br /> The prana [[vata]] occludes the ''udana'' and other types of [[vata]] while they too may occlude the ''prana.'' [200]<br /> <br /> ''Udana'' and all other types of vāta may occlude one another in the same manner. There occur twenty conditions of occlusion caused by mutual obstruction of these five types of provoked [[vata]]. These should be properly debated. [201-201½]<br /> <br /> On observing the loss of function of all the sense organs, and loss of memory and strength, it should be diagnosed as the condition of the occlusion of ''vyana'' by ''prana''.<br /> <br /> Here the therapeutic approaches above the supra-clavicular region of the body are to be done. [202-202½]<br /> <br /> When ''prana'' gets occluded by ''vyana'' excessive perspiration, horripilation, skin diseases, and numbness of limbs is manifested. The treatment is purgation combined with unctuous articles. [203-203½]<br /> <br /> In condition of occlusion of ''samana'' by ''prana'', the speech will be scanty, slurred or even muteness can occur. All the four modes of unctuous therapy along with ''yapana'' enema are recommended as treatment. [204-204½]<br /> <br /> In condition of occlusion of ''apana'' by ''samana, grahani,'' pain in ''parshva'', heart diseases and colicky pain of the stomach manifest where treatment indicated is the ghee medicated with digestive stimulants. [205-205½]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शिरोग्रहः प्रतिश्यायो निःश्वासोच्छ्वाससङ्ग्रहः ||२०६|| &lt;br /&gt;<br /> <br /> हृद्रोगो मुखशोषश्चाप्युदाने प्राणसंवृते | &lt;br /&gt;<br /> तत्रोर्ध्वभागिकं कर्म कार्यमाश्वासनं तथा ||२०७|| &lt;br /&gt;<br /> <br /> कर्मौजोबलवर्णानां नाशो मृत्युरथापि वा | &lt;br /&gt;<br /> उदानेनावृते प्राणे तं शनैः शीतवारिणा ||२०८|| &lt;br /&gt;<br /> <br /> सिञ्चेदाश्वासयेच्चैनं सुखं चैवोपपादयेत् | &lt;br /&gt;<br /> उर्ध्वगेनावृतेऽपाने छर्दिश्वासादयो गदाः ||२०९|| &lt;br /&gt;<br /> <br /> स्युर्वाते तत्र बस्त्यादि भोज्यं चैवानुलोमनम् | &lt;br /&gt;<br /> मोहोऽल्पोऽग्निरतीसार ऊर्ध्वगेऽपानसंवृते ||२१०|| &lt;br /&gt;<br /> <br /> वाते स्याद्वमनं तत्र दीपनं ग्राहि चाशनम् | &lt;br /&gt;<br /> वम्याध्मानमुदावर्तगुल्मार्तिपरिकर्तिकाः ||२११|| &lt;br /&gt;<br /> <br /> लिङ्गं व्यानावृतेऽपाने तं स्निग्धैरनुलोमयेत् | &lt;br /&gt;<br /> अपानेनावृते व्याने भवेद्विण्मूत्ररेतसाम् ||२१२|| &lt;br /&gt;<br /> <br /> अतिप्रवृत्तिस्तत्रापि सर्वं सङ्ग्रहणं मतम् | &lt;br /&gt;<br /> मूर्च्छा तन्द्रा प्रलापोऽङ्गसादोऽग्न्योजोबलक्षयः ||२१३|| &lt;br /&gt;<br /> <br /> समानेनावृते व्याने व्यायामो लघुभोजनम् | &lt;br /&gt;<br /> स्तब्धताऽल्पाग्निताऽस्वेदश्चेष्टाहानिर्निमीलनम् ||२१४|| &lt;br /&gt;<br /> <br /> उदानेनावृते व्याने तत्र पथ्यं मितं लघु | &lt;br /&gt;<br /> पञ्चान्योन्यावृतानेवं वातान् बुध्येत लक्षणैः ||२१५|| &lt;br /&gt;<br /> <br /> एषां स्वकर्मणां हानिर्वृद्धिर्वाऽऽवरणे मता | &lt;br /&gt;<br /> यथास्थूलं समुद्दिष्टमेतदावरणेऽष्टकम् ||२१६|| &lt;br /&gt;<br /> <br /> सलिङ्गभेषजं सम्यग्बुधानां बुद्धिवृद्धये |२१७|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> shirograhaH pratishyAyo niHshvAsocchvAsasa~ggrahaH ||206|| &lt;br /&gt;<br /> <br /> hRudrogo mukhashoShashcApyudānae prānasaMvRute | &lt;br /&gt;<br /> tatrordhvabhAgikaM karma kAryamAshvAsanaM tathA ||207|| &lt;br /&gt;<br /> <br /> karmaujobalavarNAnAM nAsho mRutyurathApi vA | &lt;br /&gt;<br /> udānaenAvRute prānae taM shanaiH shItavAriNA ||208|| &lt;br /&gt;<br /> <br /> si~jcedAshvAsayeccainaM sukhaM caivopapAdayet | &lt;br /&gt;<br /> urdhvagenAvRute~apānae chardishvAsAdayo gadAH ||209|| &lt;br /&gt;<br /> <br /> syurvAte tatra bastyAdi bhojyaM caivAnulomanam | &lt;br /&gt;<br /> moho~alpo~agnira’tīsāra Urdhvage~apāna saMvRute ||210|| &lt;br /&gt;<br /> <br /> vAte syAdvamanaM tatra dIpanaM grAhi cAshanam | &lt;br /&gt;<br /> vamyAdhmAnamudAvartagulmArtiparikartikAH ||211|| &lt;br /&gt;<br /> <br /> li~ggaM vyānavRute~apānae taM snigdhairanulomayet | &lt;br /&gt;<br /> apānaenAvRute vyānae bhavedviNmūtraretasAm ||212|| &lt;br /&gt;<br /> <br /> atipravRuttistatrApi sarvaM sa~ggrahaNaM matam | &lt;br /&gt;<br /> mUrcchA tandrA pralApo~a~ggasAdo~agnyojobalakṣayaH ||213|| &lt;br /&gt;<br /> <br /> SamānaenAvRute vyānae vyAyAmo laghubhojanam | &lt;br /&gt;<br /> stabdhatA~alpAgnitA~asvedashceShTAhAnirnimIlanam ||214|| &lt;br /&gt;<br /> <br /> udānaenAvRute vyānae tatra pathyaM mitaM laghu | &lt;br /&gt;<br /> pa~jcAnyonyAvRutAnevaM vātan budhyeta lakShaNaiH ||215|| &lt;br /&gt;<br /> <br /> eShAM svakarmaNAM hAnirvRuddhirvA~a~āvaranae matA | &lt;br /&gt;<br /> yathAsthUlaM samuddiShTametadĀvaranae~aShTakam ||216|| &lt;br /&gt;<br /> <br /> sali~ggabheShajaM samyagbudhAnAM buddhivRuddhaye |217| &lt;br /&gt;<br /> <br /> śirōgrahaḥ pratiśyāyō niḥśvāsōcchvāsasaṅgrahaḥ||206|| &lt;br /&gt;<br /> <br /> hr̥drōgō mukhaśōṣaścāpyudānē prāṇasaṁvr̥tē| &lt;br /&gt;<br /> tatrōrdhvabhāgikaṁ karma kāryamāśvāsanaṁ tathā||207|| &lt;br /&gt;<br /> <br /> karmaujōbalavarṇānāṁ nāśō mr̥tyurathāpi vā| &lt;br /&gt;<br /> udānēnāvr̥tē prāṇē taṁ śanaiḥ śītavāriṇā||208|| &lt;br /&gt;<br /> <br /> siñcēdāśvāsayēccainaṁ sukhaṁ caivōpapādayēt| &lt;br /&gt;<br /> urdhvagēnāvr̥tē'pānē chardiśvāsādayō gadāḥ||209|| &lt;br /&gt;<br /> <br /> syurvātē tatra bastyādi bhōjyaṁ caivānulōmanam| &lt;br /&gt;<br /> mōhō'lpō'gniratīsāra ūrdhvagē'pānasaṁvr̥tē||210|| &lt;br /&gt;<br /> <br /> vātē syādvamanaṁ tatra dīpanaṁ grāhi cāśanam| &lt;br /&gt;<br /> vamyādhmānamudāvartagulmārtiparikartikāḥ||211|| &lt;br /&gt;<br /> <br /> liṅgaṁ vyānāvr̥tē'pānē taṁ snigdhairanulōmayēt| &lt;br /&gt;<br /> apānēnāvr̥tē vyānē bhavēdviṇmūtrarētasām||212|| &lt;br /&gt;<br /> <br /> atipravr̥ttistatrāpi sarvaṁ saṅgrahaṇaṁ matam| &lt;br /&gt;<br /> mūrcchā tandrā pralāpō'ṅgasādō'gnyōjōbalakṣayaḥ||213|| &lt;br /&gt;<br /> <br /> samānēnāvr̥tē vyānē vyāyāmō laghubhōjanam| &lt;br /&gt;<br /> stabdhatā'lpāgnitā'svēdaścēṣṭāhānirnimīlanam||214|| &lt;br /&gt;<br /> <br /> udānēnāvr̥tē vyānē tatra pathyaṁ mitaṁ laghu| &lt;br /&gt;<br /> pañcānyōnyāvr̥tānēvaṁ vātān budhyēta lakṣaṇaiḥ||215|| &lt;br /&gt;<br /> <br /> ēṣāṁ svakarmaṇāṁ hānirvr̥ddhirvā''varaṇē matā| &lt;br /&gt;<br /> yathāsthūlaṁ samuddiṣṭamētadāvaraṇē'ṣṭakam||216|| &lt;br /&gt;<br /> <br /> saliṅgabhēṣajaṁ samyagbudhānāṁ buddhivr̥ddhayē|217| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In conditions of occlusion of ''udana'' by ''prana'', there is neck rigidity, coryza, impediment to inspiration and expiration, cardiac disorders and dryness of the mouth.<br /> <br /> Here the treatment is as indicated in diseases of the parts above the supra-clavicular region and consolation. [206-207]<br /> <br /> In condition of occlusion of ''prana'' by ''udana'', there will be loss of function, vital essence, strength and complexion or it may even lead to death.<br /> <br /> This condition should be treated by gradual pouring with cold water and comforting measures in such a way that the patient may be restored to health. [208-208½]<br /> <br /> In condition of the occlusion of ''apana'' by ''udana'', there will be vomiting, dyspnea, and similar other disorders. The treatment is enema and similar measures, and diet inducing ''vata anulomana''. [209-209½]<br /> <br /> In condition of the occlusion of ''udana'' by ''apana'', there occur stupor, reduced digestive mechanism and diarrhea. The treatment measures are emesis and diet that is digestive, stimulant and ''grahi''. [210-210½]<br /> <br /> In condition of occlusion of ''apana'' by ''vyana'', there occur the symptoms of vomiting, distension of abdomen, ''udavarta, gulma,'' colic and griping pain. This condition should be treated by ''anulomana'' by means of unctuous medications. [211-211½]<br /> <br /> In condition of occlusion of ''vyana'' by ''apana'', there occurs excessive discharge of feces, urine and semen. Here the treatment indicated is ''sangrahana'' therapy. [212-212½]<br /> <br /> In condition of occlusion of ''vyana'' by ''samana'', there occurs fainting, stupor, garrulousness, asthenia of the limbs, reduced digestive mechanism, vital essence and strength. Exercise and light diet are indicated as treatment for this condition. [213-213½]<br /> <br /> In condition of occlusion of ''vyana'' by ''udana'', there occurs rigidity, decreased gastro-intestinal enzymes activity, anhidrosis, and loss of movement and absence of winking. The treatment is wholesome, measured and light diet. [214-214½]<br /> <br /> By the symptoms one should diagnose the condition of mutual occlusion of these five types of [[vata]], and it has been laid down that there will occurs either the increase or decrease of its functions as the particular type of [[vata]] is affected. [215-215½]<br /> <br /> Thus have been described in general this eight conditions of mutual occlusion along with their symptoms and treatment, in order to aid the understanding of intelligent physicians. [216-216½]<br /> <br /> === General guidelines for management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्थानान्यवेक्ष्य वातानां वृद्धिं हानिं च कर्मणाम् ||२१७|| &lt;br /&gt;<br /> <br /> द्वादशावरणान्यन्यान्यभिलक्ष्य भिषग्जितम् | &lt;br /&gt;<br /> कुर्यादभ्यञ्जनस्नेहपानबस्त्यादि [१] सर्वशः ||२१८|| &lt;br /&gt;<br /> <br /> क्रममुष्णमनुष्णं वा व्यत्यासादवचारयेत् |२१९|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sthānanyavekShya vātanAM vRuddhiM hAniM ca karmaNAm ||217|| &lt;br /&gt;<br /> <br /> dvAdashĀvarananyanyAnyabhilakShya bhiShagjitam | &lt;br /&gt;<br /> kuryAdabhya~jjanaSnēhapāna bastyAdi [1] sarvashaH ||218|| &lt;br /&gt;<br /> <br /> kramamuShNamanuShNaM vA vyatyAsAdavacArayet |219| &lt;br /&gt;<br /> <br /> sthānānyavēkṣya vātānāṁ vr̥ddhiṁ hāniṁ ca karmaṇām||217||&lt;br /&gt;<br /> <br /> dvādaśāvaraṇānyanyānyabhilakṣya bhiṣagjitam| &lt;br /&gt;<br /> kuryādabhyañjanasnēhapānabastyādi [1] sarvaśaḥ||218|| &lt;br /&gt;<br /> <br /> kramamuṣṇamanuṣṇaṁ vā vyatyāsādavacārayēt|219| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> On investigating the habitat of each type of [[vata]], as well as the signs of increase or decrease of its functions, the physician should diagnose the remaining twelve conditions of mutual occlusions and should treat them by means of external application, unctuous internal administration, enema and all other procedures, or he may be alternatively given cold and hot measures. [217-218½]<br /> <br /> === Specific principles of management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> उदानं योजयेदूर्ध्वमपानं चानुलोमयेत् ||२१९|| &lt;br /&gt;<br /> <br /> समानं शमयेच्चैव त्रिधा व्यानं तु योजयेत् | &lt;br /&gt;<br /> प्राणो रक्ष्यश्चतुर्भ्योऽपि स्थाने ह्यस्य स्थितिर्ध्रुवा ||२२०||&lt;br /&gt; <br /> <br /> स्वं स्थानं गमयेदेवं वृतानेतान् विमार्गगान् |२२१|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> udānaM yojayedUrdhvamapāna M cAnulomayet ||219|| &lt;br /&gt;<br /> <br /> samānaM shamayeccaiva tridhA vyānaM tu yojayet | &lt;br /&gt;<br /> prānao rakShyashcaturbhyo~api sthAne hyasya sthitirdhruvA ||220|| &lt;br /&gt;<br /> <br /> svaM sthānaM gamayedevaM vRutAnetAn vimArgagAn |221| &lt;br /&gt;<br /> <br /> udānaṁ yōjayēdūrdhvamapānaṁ cānulōmayēt||219|| &lt;br /&gt;<br /> <br /> samānaṁ śamayēccaiva tridhā vyānaṁ tu yōjayēt| &lt;br /&gt;<br /> prāṇō rakṣyaścaturbhyō'pi sthānē hyasya sthitirdhruvā||220|| &lt;br /&gt;<br /> <br /> svaṁ sthānaṁ gamayēdēvaṁ vr̥tānētān vimārgagān|221| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''udana'' should be regulated upwards and the ''apana'' downwards. The ''samana'' should be alleviated and the ''vyana'' should be treated by all the three methods. Even more carefully than the other four types of [[vata]], the ''prana'' should be maintained, because life depends on the proper maintenance of it in its habitat.<br /> <br /> Thus the physician should regulate and establish types of [[vata]] in their normal habitats, which have been occluded and misdirected. [219-220½]<br /> <br /> === Types of [[vata]] occluded by [[dosha]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मूर्च्छा दाहो भ्रमः शूलं विदाहः शीतकामिता ||२२१|| &lt;br /&gt;<br /> <br /> छर्दनं च विदग्धस्य प्राणे पित्तसमावृते | &lt;br /&gt;<br /> ष्ठीवनं क्षवथूद्गारनिःश्वासोच्छ्वाससङ्ग्रहः ||२२२|| &lt;br /&gt;<br /> <br /> प्राणे कफावृते रूपाण्यरुचिश्छर्दिरेव च | &lt;br /&gt;<br /> मूर्च्छाद्यानि च रूपाणि दाहो नाभ्युरसः क्लमः ||२२३|| &lt;br /&gt;<br /> <br /> ओजोभ्रंशश्च सादश्चाप्युदाने पित्तसंवृते | &lt;br /&gt;<br /> आवृते श्लेष्मणोदाने वैवर्ण्यं वाक्स्वरग्रहः ||२२४|| &lt;br /&gt;<br /> <br /> दौर्बल्यं गुरुगात्रत्वमरुचिश्चोपजायते | &lt;br /&gt;<br /> अतिस्वेदस्तृषा दाहो मूर्च्छा चारुचिरेव [१] च ||२२५|| &lt;br /&gt;<br /> <br /> पित्तावृते समाने स्यादुपघातस्तथोष्मणः | &lt;br /&gt;<br /> अस्वेदो वह्निमान्द्यं च लोमहर्षस्तथैव च ||२२६|| &lt;br /&gt;<br /> <br /> कफावृते समाने स्याद्गात्राणां चातिशीतता | &lt;br /&gt;<br /> व्याने पित्तावृते तु स्याद्दाहः सर्वाङ्गगः क्लमः ||२२७|| &lt;br /&gt;<br /> <br /> गात्रविक्षेपसङ्गश्च ससन्तापः सवेदनः | &lt;br /&gt;<br /> गुरुता सर्वगात्राणां सर्वसन्ध्यस्थिजा रुजः ||२२८|| &lt;br /&gt;<br /> <br /> व्याने कफावृते लिङ्गं गतिसङ्गस्तथाऽधिकः [२] | &lt;br /&gt;<br /> हारिद्रमूत्रवर्चस्त्वं तापश्च गुदमेढ्रयोः ||२२९|| &lt;br /&gt;<br /> <br /> लिङ्गं पित्तावृतेऽपाने रजसश्चातिवर्तनम् | &lt;br /&gt;<br /> भिन्नामश्लेष्मसंसृष्टगुरुवर्चःप्रवर्तनम् ||२३०|| &lt;br /&gt;<br /> <br /> श्लेष्मणा संवृतेऽपाने कफमेहस्य चागमः |२३१|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mUrcchA dAho bhramaH shUlaM vidAhaH shItakAmitA ||221|| &lt;br /&gt;<br /> <br /> chardanaM ca vidagdhasya prānae pittasamAvRute | &lt;br /&gt;<br /> ShThIvanaM kṣavathūdgAraniHshvAsocchvAsasa~ggrahaH ||222|| &lt;br /&gt;<br /> <br /> prānae kaphAvRute rUpANyarucishchardireva ca | &lt;br /&gt;<br /> mUrcchAdyAni ca rUpANi dAho nAbhyurasaH klamaH ||223|| &lt;br /&gt;<br /> <br /> ojobhraMshashca sAdashcApyudānae pittasaMvRute | &lt;br /&gt;<br /> AvRute shleShmaNodAne vaivarNyaM vAksvaragrahaH ||224|| &lt;br /&gt;<br /> <br /> daurbalyaM gurugAtratvamarucishcopajAyate | &lt;br /&gt;<br /> atisvedastRuShA dAho mUrcchA cArucireva [1] ca ||225|| &lt;br /&gt;<br /> <br /> pittAvRute Samānae syAdupaghAtastathoShmaNaH | &lt;br /&gt;<br /> asvedo vahnimAndyaM ca lomaharShastathaiva ca ||226|| &lt;br /&gt;<br /> <br /> kaphAvRute Samānae syAdgAtrANAM cAtishItatA | &lt;br /&gt;<br /> vyānae pittAvRute tu syAddAhaH sarvA~ggagaH klamaH ||227|| &lt;br /&gt;<br /> <br /> gAtravikShepasa~ggashca sasantApaH savedanaH | &lt;br /&gt;<br /> gurutA sarvagAtrANAM sarvasandhyasthijA rujaH ||228|| &lt;br /&gt;<br /> <br /> vyānae kaphAvRute li~ggaM gatisa~ggastathA~adhikaH [2] | &lt;br /&gt;<br /> hAridramūtravarcastvaM tApashca gudameDhrayoH ||229|| &lt;br /&gt;<br /> <br /> li~ggaM pittAvRute~apānae rajasashcAtivartanam | &lt;br /&gt;<br /> bhinnAmashleShmasaMsRuShTaguruvarcaHpravartanam ||230|| &lt;br /&gt;<br /> <br /> shleShmaNA saMvRute~apānae kaphamehasya cAgamaH |231| &lt;br /&gt;<br /> <br /> mūrcchā dāhō bhramaḥ śūlaṁ vidāhaḥ śītakāmitā||221|| &lt;br /&gt;<br /> <br /> chardanaṁ ca vidagdhasya prāṇē pittasamāvr̥tē| &lt;br /&gt;<br /> ṣṭhīvanaṁ kṣavathūdgāraniḥśvāsōcchvāsasaṅgrahaḥ||222|| &lt;br /&gt;<br /> <br /> prāṇē kaphāvr̥tē rūpāṇyaruciśchardirēva ca| &lt;br /&gt;<br /> mūrcchādyāni ca rūpāṇi dāhō nābhyurasaḥ klamaḥ||223|| &lt;br /&gt;<br /> <br /> ōjōbhraṁśaśca sādaścāpyudānē pittasaṁvr̥tē| &lt;br /&gt;<br /> āvr̥tē ślēṣmaṇōdānē vaivarṇyaṁ vāksvaragrahaḥ||224|| &lt;br /&gt;<br /> <br /> daurbalyaṁ gurugātratvamaruciścōpajāyatē| &lt;br /&gt;<br /> atisvēdastr̥ṣā dāhō mūrcchā cārucirēva [11] ca||225|| &lt;br /&gt;<br /> <br /> pittāvr̥tē samānē syādupaghātastathōṣmaṇaḥ| &lt;br /&gt;<br /> asvēdō vahnimāndyaṁ ca lōmaharṣastathaiva ca||226|| &lt;br /&gt;<br /> <br /> kaphāvr̥tē samānē syādgātrāṇāṁ cātiśītatā| &lt;br /&gt;<br /> vyānē pittāvr̥tē tu syāddāhaḥ sarvāṅgagaḥ klamaḥ||227|| &lt;br /&gt;<br /> <br /> gātravikṣēpasaṅgaśca sasantāpaḥ savēdanaḥ| &lt;br /&gt;<br /> gurutā sarvagātrāṇāṁ sarvasandhyasthijā rujaḥ||228|| &lt;br /&gt;<br /> <br /> vyānē kaphāvr̥tē liṅgaṁ gatisaṅgastathā'dhikaḥ [12] | &lt;br /&gt;<br /> hāridramūtravarcastvaṁ tāpaśca gudamēḍhrayōḥ||229|| &lt;br /&gt;<br /> <br /> liṅgaṁ pittāvr̥tē'pānē rajasaścātivartanam| &lt;br /&gt;<br /> bhinnāmaślēṣmasaṁsr̥ṣṭaguruvarcaḥpravartanam||230|| &lt;br /&gt;<br /> <br /> ślēṣmaṇā saṁvr̥tē'pānē kaphamēhasya cāgamaḥ|231| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In occlusion of ''prana'' by [[pitta]] fainting, giddiness, colic, burning sensation, craving for cold things and vomiting of acidic gastric material are seen as symptoms. [221-221½]<br /> <br /> In occlusion of ''prana'' by [[kapha]], there occur symptoms such as frequent spitting, sneezing, eructation, impediment to the inspiration and expiration, anorexia and vomiting. [222-222½]<br /> <br /> In condition of occlusion of ''udana'' by [[pitta]], there occur symptoms such as fainting etc and burning in the umbilical region and chest, exhaustion, loss of vital essence and asthenia. [223-223½]<br /> <br /> In occlusion of ''udana'' by [[kapha]], there occur discolorations, aphasia and dysarthria, debility, heaviness of the body and anorexia. [224-224½]<br /> <br /> In condition of occlusion of ''samana'' by [[pitta]], there occur hyperhidrosis, thirst, burning, fainting, anorexia, derangement of appetite and decreased gastro-intestinal enzyme activity. [225-225½]<br /> <br /> In condition of occlusion of the ''samana'' by [[kapha]], there occur anhidrosis, reduced gastro-intestinal enzyme activity, horripilation and excessive coldness of the limbs. [226-226½]<br /> <br /> In condition of occlusion of ''vyana'' by [[pitta]], there occur burning all over the body, exhaustion, chorea or poverty of movements accompanied with temperature and pain. [227-227½]<br /> <br /> In condition of occlusion of ''vyana'' by [[kapha]], there occur symptoms such as heaviness of the limbs, pain in all the bones and joints, and impaired gait. [228-228½]<br /> <br /> In condition of occlusion of ''apana'' by [[pitta]], there occur symptoms such as yellowish discoloration of urine and feces, sensation of heat in the rectum and penis and excessive flow of the menses. [229-229½]<br /> <br /> In condition of occlusion of ''apana'' by [[kapha]], there occur stools that are loose, heavy and mixed with undigested matter and mucus and [[kapha]] dominated ''prameha''. [230-230½]<br /> <br /> === Guidelines for diagnosis of conditions ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> लक्षणानां तु मिश्रत्वं पित्तस्य च कफस्य च ||२३१|| &lt;br /&gt;<br /> <br /> उपलक्ष्य भिषग्विद्वान् मिश्रमावरणं वदेत् | &lt;br /&gt;<br /> यद्यस्य वायोर्निर्दिष्टं स्थानं तत्रेतरौ स्थितौ ||२३२|| &lt;br /&gt;<br /> <br /> दोषौ बहुविधान् व्याधीन् दर्शयेतां यथानिजान् | &lt;br /&gt;<br /> आवृतं श्लेष्मपित्ताभ्यां प्राणं चोदानमेव च ||२३३|| &lt;br /&gt;<br /> <br /> गरीयस्त्वेन पश्यन्ति भिषजः शास्त्रचक्षुषः | &lt;br /&gt;<br /> विशेषाज्जीवितं प्राणे उदाने संश्रितं बलम् ||२३४|| &lt;br /&gt;<br /> <br /> स्यात्तयोः पीडनाद्धानिरायुषश्च बलस्य च | &lt;br /&gt;<br /> सर्वेऽप्येतेऽपरिज्ञाताः परिसंवत्सरास्तथा ||२३५|| &lt;br /&gt;<br /> <br /> उपेक्षणादसाध्याः स्युरथवा दुरुपक्रमाः [१] |२३६|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> lakShaNAnAM tu mishratvaM pittasya ca kaphasya ca ||231|| &lt;br /&gt;<br /> <br /> upalakShya bhiShagvidvAn mishramĀvaranaM vadet | &lt;br /&gt;<br /> yadyasya vAyornirdiShTaM sthānaM tatretarau sthitau ||232|| &lt;br /&gt;<br /> <br /> dōṣau bahuvidhAn vyAdhIn darshayetAM yathAnijAn | &lt;br /&gt;<br /> AvRutaM shleShmapittAbhyAM prānaM codAnameva ca ||233|| &lt;br /&gt;<br /> <br /> garIyastvena pashyanti bhiShajaH shAstracakShuShaH | &lt;br /&gt;<br /> visheShAjjIvitaM prānae udānae saMshritaM balam ||234|| &lt;br /&gt;<br /> <br /> syAttayoH pIDanAddhAnirAyuShashca balasya ca | &lt;br /&gt;<br /> sarve~apyete~aparij~jAtAH parisaMvatsarAstathA ||235|| &lt;br /&gt;<br /> <br /> upekShaNAdasAdhyAH syurathavA durupakramAH [1] |236| &lt;br /&gt;<br /> <br /> lakṣaṇānāṁ tu miśratvaṁ pittasya ca kaphasya ca||231|| &lt;br /&gt;<br /> <br /> upalakṣya bhiṣagvidvān miśramāvaraṇaṁ vadēt| &lt;br /&gt;<br /> yadyasya vāyōrnirdiṣṭaṁ sthānaṁ tatrētarau sthitau||232|| &lt;br /&gt;<br /> <br /> dōṣau bahuvidhān vyādhīn darśayētāṁ yathānijān| &lt;br /&gt;<br /> āvr̥taṁ ślēṣmapittābhyāṁ prāṇaṁ cōdānamēva ca||233|| &lt;br /&gt;<br /> <br /> garīyastvēna paśyanti bhiṣajaḥ śāstracakṣuṣaḥ| &lt;br /&gt;<br /> viśēṣājjīvitaṁ prāṇē udānē saṁśritaṁ balam||234|| &lt;br /&gt;<br /> <br /> syāttayōḥ pīḍanāddhānirāyuṣaśca balasya ca| &lt;br /&gt;<br /> sarvē'pyētē'parijñātāḥ parisaṁvatsarāstathā||235|| &lt;br /&gt;<br /> <br /> upēkṣaṇādasādhyāḥ syurathavā durupakramāḥ [13] |236| &lt;br /&gt;<br /> <br /> lakṣaṇānāṁ tu miśratvaṁ pittasya ca kaphasya ca||231|| &lt;br /&gt;<br /> <br /> upalakṣya bhiṣagvidvān miśramāvaraṇaṁ vadēt| &lt;br /&gt;<br /> yadyasya vāyōrnirdiṣṭaṁ sthānaṁ tatrētarau sthitau||232|| &lt;br /&gt;<br /> <br /> dōṣau bahuvidhān vyādhīn darśayētāṁ yathānijān| &lt;br /&gt;<br /> āvr̥taṁ ślēṣmapittābhyāṁ prāṇaṁ cōdānamēva ca||233|| &lt;br /&gt;<br /> <br /> garīyastvēna paśyanti bhiṣajaḥ śāstracakṣuṣaḥ| &lt;br /&gt;<br /> viśēṣājjīvitaṁ prāṇē udānē saṁśritaṁ balam||234|| &lt;br /&gt;<br /> <br /> syāttayōḥ pīḍanāddhānirāyuṣaśca balasya ca| &lt;br /&gt;<br /> sarvē'pyētē'parijñātāḥ parisaṁvatsarāstathā||235|| &lt;br /&gt;<br /> <br /> upēkṣaṇādasādhyāḥ syurathavā durupakramāḥ [1] |236| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> On observing the mixed symptoms of [[pitta]] and [[kapha]], the learned physician should diagnose it as a condition of combined occlusion. [231-231½]<br /> <br /> If the two other [[dosha]] get located in the places described as the habitat of [[vata]], they manifest various symptoms of disorders characteristic to each of them. [232-232½]<br /> <br /> Medical authorities regard, as most serious, the condition of occlusion of ''prana'' or ''udana'' by [[kapha]] and [[pitta]] combined, because life is particularly dependent on ''prana'', and strength on ''udana;'' and occlusion of them, will result in loss of life and vitality. [233-234½]<br /> <br /> If all these conditions are either undiagnosed or neglected for longer than a year, they become either incurable or extreme difficult to cure. [235-235½]<br /> <br /> === Complications and management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> हृद्रोगो विद्रधिः प्लीहा गुल्मोऽतीसार एव च ||२३६|| &lt;br /&gt;<br /> <br /> भवन्त्युपद्रवास्तेषामावृतानामुपेक्षणात् | &lt;br /&gt;<br /> तस्मादावरणं वैद्यः पवनस्योपलक्षयेत् ||२३७|| &lt;br /&gt;<br /> <br /> पञ्चात्मकस्य वातेन पित्तेन श्लेष्मणाऽपि वा | &lt;br /&gt;<br /> भिषग्जितमतः सम्यगुपलक्ष्य समाचरेत् ||२३८|| &lt;br /&gt;<br /> <br /> अनभिष्यन्दिभिः स्निग्धैः स्रोतसां शुद्धिकारकैः | &lt;br /&gt;<br /> कफपित्ताविरुद्धं यद्यच्च वातानुलोमनम् ||२३९|| &lt;br /&gt;<br /> <br /> सर्वस्थानावृतेऽप्याशु तत् कार्यं मारुते हितम् | &lt;br /&gt;<br /> यापना बस्तयः प्रायो मधुराः सानुवासनाः ||२४०|| &lt;br /&gt;<br /> <br /> प्रसमीक्ष्य बलाधिक्यं मृदु वा स्रंसनं हितम् | &lt;br /&gt;<br /> रसायनानां सर्वेषामुपयोगः प्रशस्यते ||२४१|| &lt;br /&gt;<br /> <br /> शैलस्य जतुनोऽत्यर्थं पयसा गुग्गुलोस्तथा | &lt;br /&gt;<br /> लेहं वा भार्गवप्रोक्तमभ्यसेत् क्षीरभुङ्नरः ||२४२|| &lt;br /&gt;<br /> <br /> अभयामलकीयोक्तमेकादशसिताशतम् [१] | &lt;br /&gt;<br /> अपानेनावृते सर्वं दीपनं ग्राहि भेषजम् ||२४३|| &lt;br /&gt;<br /> <br /> वातानुलोमनं यच्च पक्वाशयविशोधनम् | &lt;br /&gt;<br /> इति सङ्क्षेपतः प्रोक्तमावृतानां चिकित्सितम् ||२४४|| &lt;br /&gt;<br /> <br /> प्राणादीनां भिषक् कुर्याद्वितर्क्य स्वयमेव तत् | &lt;br /&gt;<br /> <br /> पित्तावृते तु पित्तघ्नैर्मारुतस्याविरोधिभिः | &lt;br /&gt;<br /> कफावृते कफघ्नैस्तु मारुतस्यानुलोमनैः ||२४५||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> hRudrogo vidradhiH plIhA gulmo~a’tīsāra eva ca ||236|| &lt;br /&gt;<br /> <br /> bhavantyupadravAsteShAmAvRutAnAmupekShaNAt | &lt;br /&gt;<br /> tasmAdĀvaranaM vaidyaH pavanasyopalakṣayaet ||237|| &lt;br /&gt;<br /> <br /> pa~jcAtmakasya vAtena pittena shleShmaNA~api vA | &lt;br /&gt;<br /> bhiShagjitamataH samyagupalakShya samAcaret ||238|| &lt;br /&gt;<br /> <br /> anabhiShyandibhiH snigdhaiH srotasAM shuddhikArakaiH | &lt;br /&gt;<br /> kaphapittAviruddhaM yadyacca vātanulomanam ||239|| &lt;br /&gt;<br /> <br /> sarvasthānavRute~apyAshu tat kAryaM mArute hitam | &lt;br /&gt;<br /> Yāpana bastayaH prAyo madhurAH sAnuvAsanAH ||240|| &lt;br /&gt;<br /> <br /> prasamIkShya balAdhikyaM mRudu vA sraMsanaM hitam | &lt;br /&gt;<br /> rasāyananAM sarveShAmupayogaH prashasyate ||241|| &lt;br /&gt;<br /> <br /> shailasya jatuno~atyarthaM payasA guggulostathA | &lt;br /&gt;<br /> lehaM vA bhArgavaproktamabhyaset kShIrabhu~gnaraH ||242|| &lt;br /&gt;<br /> <br /> abhayAmalakIyoktamekAdashaśītāshatam [1] | &lt;br /&gt;<br /> apānaenAvRute sarvaM dIpanaM grAhi bheShajam ||243|| &lt;br /&gt;<br /> <br /> vātanulomanaM yacca pakvAshayavishodhanam | &lt;br /&gt;<br /> iti sa~gkShepataH proktamAvRutAnAM cikitśītām ||244|| &lt;br /&gt;<br /> <br /> prānadInAM bhiShak kuryAdvitarkya svayameva tat | &lt;br /&gt;<br /> <br /> pittAvRute tu pittaghnairmArutasyAvirodhibhiH | &lt;br /&gt;<br /> kaphAvRute kaphaghnaistu mArutasyAnulomanaiH ||245|| &lt;br /&gt;<br /> <br /> hr̥drōgō vidradhiḥ plīhā gulmō'tīsāra ēva ca||236|| &lt;br /&gt;<br /> <br /> bhavantyupadravāstēṣāmāvr̥tānāmupēkṣaṇāt| &lt;br /&gt;<br /> tasmādāvaraṇaṁ vaidyaḥ pavanasyōpalakṣayēt||237|| &lt;br /&gt;<br /> <br /> pañcātmakasya vātēna pittēna ślēṣmaṇā'pi vā| &lt;br /&gt;<br /> bhiṣagjitamataḥ samyagupalakṣya samācarēt||238|| &lt;br /&gt;<br /> <br /> anabhiṣyandibhiḥ snigdhaiḥ srōtasāṁ śuddhikārakaiḥ| &lt;br /&gt;<br /> kaphapittāviruddhaṁ yadyacca vātānulōmanam||239|| &lt;br /&gt;<br /> <br /> sarvasthānāvr̥tē'pyāśu tat kāryaṁ mārutē hitam| &lt;br /&gt;<br /> yāpanā bastayaḥ prāyō madhurāḥ sānuvāsanāḥ||240|| &lt;br /&gt;<br /> <br /> prasamīkṣya balādhikyaṁ mr̥du vā sraṁsanaṁ hitam| &lt;br /&gt;<br /> rasāyanānāṁ sarvēṣāmupayōgaḥ praśasyatē||241|| &lt;br /&gt;<br /> <br /> śailasya jatunō'tyarthaṁ payasā guggulōstathā| &lt;br /&gt;<br /> lēhaṁ vā bhārgavaprōktamabhyasēt kṣīrabhuṅnaraḥ||242|| &lt;br /&gt;<br /> <br /> abhayāmalakīyōktamēkādaśasitāśatam [14] | &lt;br /&gt;<br /> apānēnāvr̥tē sarvaṁ dīpanaṁ grāhi bhēṣajam||243|| &lt;br /&gt;<br /> <br /> vātānulōmanaṁ yacca pakvāśayaviśōdhanam| &lt;br /&gt;<br /> iti saṅkṣēpataḥ prōktamāvr̥tānāṁ cikitśītām||244|| &lt;br /&gt;<br /> <br /> prāṇādīnāṁ bhiṣak kuryādvitarkya svayamēva tat| &lt;br /&gt;<br /> <br /> pittāvr̥tē tu pittaghnairmārutasyāvirōdhibhiḥ| &lt;br /&gt;<br /> kaphāvr̥tē kaphaghnaistu mārutasyānulōmanaiḥ||245|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As a result of neglecting these conditions of occlusions, there occur complications such as cardiac disorders, abscesses, splenic disorders, ''gulma'' and diarrhea. [236-236½]<br /> <br /> Therefore, the physician should diagnose the condition of occlusion of the five types of [[vata]], by [[vata]], [[pitta]], or [[kapha]]. [237-237½]<br /> <br /> After having well thought about the proper medications, the physician should treat the patient by measures which are non-''abhishyandi'', unctuous and depurative of body channels. [238-238½]<br /> <br /> In condition of occlusion of [[vata]] in all its habitats, taking prompt measures which are [[vata]] anulomana and at the same time not antagonistic to [[kapha]] and [[pitta]] is beneficial. [239-239½]<br /> <br /> The ''yapana'' enema as well as the sweet unctuous enema is generally beneficial, and if the patient found to be sufficiently strong mild laxatives may be used. [240-240½]<br /> <br /> The use of all kinds of [[rasayana]] is highly recommended. A course of ''shilajatu'' and a course of ''guggulu'' with milk are especially beneficial. [241-241½]<br /> <br /> The patient living on milk diet, may take a course of [[rasayana]] (told by Bhargava explained in ''Abhayamalaki Pada'') containing 4400 ''tolas'' (52.8 kg) of sugar. (242-242½)<br /> <br /> In condition of occlusion by ''apana'', all measures that are [[deepana]], grahi, [[vata]] anulomana and which cleanse ''pakvashaya'' constitute the treatment. [243-243½]<br /> <br /> Thus has been described in brief the line of treatment in conditions of occlusion of ''prana'' and other types of [[vata]]; the physician should use his own discretion and give the proper treatment. [244-244½]<br /> <br /> In a condition of occlusion of [[vata]] by [[pitta]], the physician should administer medications curative of [[pitta]] and not antagonistic to [[vata]]. <br /> <br /> In a condition of occlusion of [[vata]] by [[kapha]], medications curative of [[kapha]] and [[vata]] anulomana should be given. [245]<br /> <br /> === Similarity in macrocosm and microcosm ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> लोके वाय्वर्कसोमानां दुर्विज्ञेया यथा गतिः | &lt;br /&gt;<br /> तथा शरीरे वातस्य पित्तस्य च कफस्य च ||२४६||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> loke vAyvarkasomAnAM durvij~jeyA yathA gatiH | &lt;br /&gt;<br /> tathA sharIre vātasya pittasya ca kaphasya ca ||246||&lt;br /&gt;<br /> <br /> lōkē vāyvarkasōmānāṁ durvijñēyā yathā gatiḥ| &lt;br /&gt;<br /> tathā śarīrē vātasya pittasya ca kaphasya ca||246|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Just as in the universe the courses of the air, the sun and the moon are difficult to comprehend, even so are the forces of [[vata]], [[pitta]] and [[kapha]] in the body.[246]<br /> <br /> === Four states of [[dosha]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षयं वृद्धिं समत्वं च तथैवावरणं भिषक् | &lt;br /&gt;<br /> विज्ञाय पवनादीनां न प्रमुह्यति कर्मसु ||२४७||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣayaM vRuddhiM samatvaM ca tathaivĀvaranaM bhiShak | &lt;br /&gt;<br /> vij~jAya pavanAdInAM na pramuhyati karmasu ||247|| &lt;br /&gt;<br /> <br /> kṣayaṁ vr̥ddhiṁ samatvaṁ ca tathaivāvaraṇaṁ bhiṣak| &lt;br /&gt;<br /> vijñāya pavanādīnāṁ na pramuhyati karmasu||247|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The physician who understand the condition of decrease, increase, normality and occlusion of [[vata]] and other [[dosha]], is not deluded with regard to treatment.[247]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकौ- <br /> <br /> पञ्चात्मनः स्थानवशाच्छरीरे स्थानानि कर्माणि च देहधातोः | &lt;br /&gt;<br /> प्रकोपहेतुः कुपितश्च रोगान् स्थानेषु चान्येषु वृतोऽवृतश्च ||२४८||&lt;br /&gt;<br /> <br /> प्राणेश्वरः प्राणभृतां करोति क्रिया च तेषामखिला निरुक्ता | &lt;br /&gt;<br /> तां देशसात्म्यर्तुबलान्यवेक्ष्य प्रयोजयेच्छास्त्रमतानुसारी ||२४९||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra shlokau- <br /> <br /> pa~jcAtmanaH sthānavashAccharIre sthānani karmANi ca dehadhAtoH | &lt;br /&gt;<br /> prakopahetuH kupitashca rōgan sthAneShu cAnyeShu vRuto~avRutashca ||248||&lt;br /&gt;<br /> <br /> prānaeshvaraH prānabhRutAM karoti kriyA ca teShAmakhilA niruktA | &lt;br /&gt;<br /> tAM deshasAtmyartubalAnyavekShya prayojayecchAstramatAnusArI ||249||&lt;br /&gt;<br /> <br /> tatra ślōkau- <br /> <br /> pañcātmanaḥ sthānavaśāccharīrē sthānāni karmāṇi ca dēhadhātōḥ| &lt;br /&gt;<br /> prakōpahētuḥ kupitaśca rōgān sthānēṣu cānyēṣu vr̥tō'vr̥taśca||248|| &lt;br /&gt;<br /> <br /> prāṇēśvaraḥ prāṇabhr̥tāṁ karōti kriyā ca tēṣāmakhilā niruktā| &lt;br /&gt;<br /> tāṁ dēśasātmyartubalānyavēkṣya prayōjayēcchāstramatānusārī||249|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The [[vata]] being the subject of this chapter, the habitats and functions of the five-fold body sustaining element [[vata]], have been dealt with here. The causes of provocation, the diseases which this life controlling principle of [[vata]] gives rise to in the persons, when provoked, both in its own habitat and in other places, both in conditions of occlusion and in no occlusion, and the treatment of all those disease have been fully expounded here. The physician guided by the directions of the science, should administer the treatment, giving full consideration to factors of place, similarity, season and strength. [248-249]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने वातव्याधिचिकित्सितं नामाष्टाविंशोऽध्यायः ||२८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> Ity agniveshakRute tantre carakapratisaMskRute~aprApte dRuDhabalasampUrite cikitsāsthAne VātavyādhicikitśītāM nAmAShTAviMsho~adhyAyaH ||28||<br /> <br /> ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē vātavyādhicikitśītāṁnāmāṣṭāviṁśō'dhyāyaḥ||28|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus, in the section on ‘Therapeutics’, in the treatise compiled by Agnivesha and revised by Charak, the twenty-eighth chapter entitled [[Vatavyadhi Chikitsa]] not being available, the same as restored by Dridhabala, is completed.[28]<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> #[[Vayu]]/[[vata]] is responsible for life, strength and functioning of living organisms. <br /> #Normal (non vitiated) [[vayu]]/[[vata]] with unobstructed (free) movement and location at its natural site, is responsible for long healthy lifespan. <br /> #[[Vayu]]/[[vata]] is of five types namely ''prana, udāna, samana, vyana'' and ''apana'' and they mechanize the body optimally occupying their sites without any irregular movement. <br /> #The location of ''prana'' is vertex, thorax, trachea, tongue, mouth and nose and it performs functions of spitting, sneezing, eructation, respiration, deglutition etc. <br /> #The site of ''udana'' is umbilicus, thorax and trachea and is responsible for vocalization, drive, energy, strength, complexion etc. <br /> #''Samana'' is located in channels of sweat, humors and water and lateral to the seat of [[agni]] (digestive enzymes ([[agni]]) and yield strength to the digestive fire. <br /> #''Vyana'' has swift movement and spreads all over the body and is responsible for gait, flexion, extension, twinkling etc. <br /> #''Apana'' is located in testicles, urinary bladder, penis, umbilicus, thighs, inguinal region and anus and performs ejaculation, micturition, defecation, expulsion of menstrual blood and fetus. <br /> #When these five are located in respective sites optimally, they perform their functions and support life without any morbidity. <br /> #Due to various [[vata]] provoking factors, [[vata]] is vitiated and it fills the empty channels and leads to various disorders at that particular site. <br /> #The onset of [[vata]] disorders is generally sudden without any premonitory signs. <br /> #The diagnosis of [[vata]] disorders is based upon the symptoms characteristic of the seat of affliction.<br /> #In all [[vata]] disorders, the association of other [[dosha]] like [[pitta]] etc. is to be considered. <br /> #The provocation of [[vata]] is either due to [[dhatu]]kshaya, means diminution of tissue elements and/ or due to ''avarana'' means obstruction to its pathway. The [[vata]], [[pitta]] and [[kapha]] always circulate through all the body channels. <br /> #The [[vata]], owing to its quality of subtleness is really the impeller of the other two [[dosha]]. <br /> #When the [[vata]] is provoked, it propels the other two [[dosha]] and dislodges them about here and there, causing various diseases. Due to ''avarana'' (obstruction in its path), it further causes diminution of the body nutrient fluid and other body elements.<br /> #In case of ''avarana'' (occlusion of [[vata]]), the clinical presentation includes the increased signs of [[dosha]] which is occluding [[vata]]. <br /> #In pure vitiation of [[vata]], without any association or obstruction by other [[dosha]], [[snehana]] and [[swedana]] therapy are first principles of treatment. <br /> #Mild cleansing with unctuous drugs shall be given to remove the residual morbidity. <br /> #By excessive use of unctuous, sour, salty and hot articles of diet, the excretory matter gets accumulated, occluding the alimentary passage, obstructs the [[vata]], hence ''anulomana'' of [[vata]] should be done.<br /> #Specific line of treatment should be adopted in specific condition depending on site of affliction and the vitiated tissue involved.<br /> #Ghee, oil, fat, marrow, affusion, massage, enema, unctuous sudation, staying at calm places (without strong wind), covering with blankets, meat soups, various milks, articles of diet of sweet, sour and salty taste and whatever is nourishing are beneficial for disorders due to [[vata]].<br /> #[[Pitta]] and [[kapha]] [[dosha]] occlude [[vata]] [[dosha]] at their sites and result in disorders. The clinical features are dominated by the vitiated [[dosha]]. The functions of obstructed [[dosha]] are decreased in these conditions. <br /> #The various types of [[vata]] [[dosha]] can mutually occlude each other’s pathways and result in disorders. There are increased signs of obstructing types of [[vata]] and decreased functions of obstructed type of [[vata]] [[dosha]]. <br /> #The ''udana'' should be regulated with therapies leading to its upward movement. The ''apana'' should be regulated with therapies leading to its downwards movement. The ''samana'' should be alleviated and the ''vyana'' should be treated by all the three methods. ''Prana'' should be maintained even more carefully than the other four types of [[vata]], because life depends on the proper maintenance of it in its habitat. Thus, the treatment is intended to regulate and establish types of vāta in their normal habitats, which have been occluded and misdirected.<br /> #Life and vitality is particularly dependent on ''prana'', and strength on ''udana;'' and occlusion of them, will result in loss of life and vitality.<br /> #In a condition of occlusion of [[vata]] by [[pitta]], the treatment is done with medications curative of [[pitta]] and not antagonistic to [[vata]]. <br /> #In a condition of occlusion of [[vata]] by [[kapha]], medications curative of [[kapha]] and [[vata]] anulomana should be given.<br /> #Just as in the universe the courses of the air, the sun and the moon are difficult to comprehend, even so are the forces of [[vata]], [[pitta]] and [[kapha]] in the body. The first three are responsible for all functions in macrocosm, whereas the latter three are for functions in microcosm. <br /> #There are four conditions viz. decrease, increase, normality and occlusion of [[vata]] and other [[dosha]].<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> <br /> === Importance of [[vata]] [[dosha]] in overall health and disease ===<br /> <br /> This text highlights the grandness of [[vata dosha]]. [[Vata]] is equated to [[ayu]]. Life is sustained by [[vayu]] only. Even though [[ayu]] is previously defined as conglomeration of [[sharira]] (physical body), [[indriya]] (sensorium), [[sattva]] (mind) and [[atma]] (soul). [Cha. Sa. [[Sutra Sthana]] 1/42] Here it is mentioned equivalent to [[vayu]]. The sense organs, mind and soul in physical body are manifested through the functions of [[vayu]] only. The strength of the individual is also provided by [[vayu]]. These two usages of [[ayu]] and bala are later explained as, ''prana'' is life and ''udana'' is strength. [verse 3]<br /> <br /> [[Vata]] performs all its activity for a healthy long life subject to status of its three functions. They are ''akupita''(not increased, decreased or vitiated), ''sthanastha'' (located in its own place) and ''avyahatagati''(nothing is interfering with its movement or ''gati'').<br /> <br /> === Nature of [[vata]] ===<br /> <br /> [[Pitta]] and [[kapha]] are relatively compact and in corporeal form. On the contrary [[vata]] is incorporeal (''avayavasamghatarahita''). It can be termed as rarified in nature. The [[vata]] is ''anavasthita'' (unstable) too. These two properties are due to its composition formed by [[akasha]] and [[vayu]] predominantly&lt;ref&gt; Indu, Vagbhata, Sutra sthana Chap 20 Doshabhediya Verse 2, In: Sreekumari Amma (eds.) 1st ed. Trivandrum: Publication Division; Ayurveda College, 2000.&lt;/ref&gt; which are incorporeal (''amurta''). ''Chalatva'' (mobility) and ''apratighata'' (unobstructability) are characteristics of [[vayu]] and [[akasha]] perceptible by the tactile sense organ. [Cha. Sa. [[Sharira Sthana]] 1/29-30] The biological [[vata]] (which is present in the living being) is self originated (''svayambhu''), subtle (''sukshma'') and all pervasive (''sarvagata''). It is invisible (''[[avyakta]]'') but its activities are patent or manifest (''vyaktakarma'').&lt;ref&gt;Dalhana, Sushruta. Nidana Sthana, Cha.1 Vatavyadhi Nidana Adhyaya verse 5. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.&lt;/ref&gt;<br /> <br /> Anavasthita (unstable) is due to chala property of [[vata]]. This continuous moving nature of [[vata]] is explained with other terminologies also like ''sheeghravata''(swift movement)[Cha. Sa. [[Vimana Sthana]] 8/98], ''ashukari'' (instantaneous action), ''muhushchari'' (rhythmic movement).&lt;ref&gt;Dalhana, Sushruta. Nidana Sthana, Cha.1 Vatavyadhi Nidana Adhyaya verse 9. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.&lt;/ref&gt;. It abounds in the fundamental quality of ''raja'' (the principle of cohesion and action). The predominance of ''raja'' is responsible for the instability of [[vata]]. The quality of ''chalatva'' is directional in nature, which is explained by the term ''gati''. [[Vata]] convenes all bodily activities by this important feature.<br /> <br /> Owing to its incorporeal nature and instability [[vata]] is ''anasadhya'' (inaccessible) also. The inaccessibility is characterized in regard to its functional and physical attributes but more relevant regarding the therapeutic aspect. Above explained cardinal features make [[vata]] achintya veerya (inconceivable prowess) and [[dosha]]nam neta (propeller of all functional elements in the body).[Cha. Sa. [[Sutra Sthana]] 1/8]<br /> <br /> === Properties of [[vata]] ===<br /> <br /> In [[Vatakalakaliya Adhyaya]], questions have been raised about exciting and alleviating factors regarding qualities of [[vata]]. ''Ruksha''(dry), ''laghu''(light), ''sheeta''(cool), ''daruna'' (dreadful), ''khara'' (rough) and ''vishada'' (clean) have been explained as qualities of [[vata]]. Repeated use of substances with these qualities and actions of such similar qualities causes aggravation and excitation of [[vata]] and is alleviated by use of substances possessing contrary qualities. This brings out the phenomenon of two mutually interrelated and inseparable of sharira [[vayu]] viz. <br /> #that, the sharira [[vayu]] is a biophysical force and <br /> #that it is closely associated with material substances which form part of the structure of the body for example, functions of nervous system. It is a chemical reaction sequence which occurs during the course of life. This chemical reaction –sequence, can be accelerated (excited) or inhibited by substances with similar properties (''dravya samanya''), qualities (''guna samanya'') and actions (''karma samanya'') and inhibited by substances with opposite properties. In other words, it may be concluded that the bio – physical force – the ''sharira vayu'' – is closely linked with some material structural factors. These can be influenced by diet and medicine on the basis of similar increase and opposite decrease.<br /> <br /> Sodium, potassium, calcium, and chloride ions are continuously moving around (brownian movement) which is the result of their ionic state (''swabhava / swayambhu guna''). The ionic inflow and outflow within the cell causes depolarization and repolarization or in other words impulse is generated. Hyper or hypo state of these ions is the cause for disease condition which may present in the form of seizures, palpitations, muscle cramps, lethargy, altered sensorium, coma and death.<br /> <br /> Therefore, the biological energy produced by this ionic movement is the cause for ''sharira vayu'' and as per modern science too their concentration depends on ''ahara'' and ''vihara''.<br /> <br /> The continuous, controlled movement of the ions is responsible for cell activity which together at the level of cells contributes to tissue activity which together contributes to the organ, system and in turn whole body. [verse 4]<br /> <br /> ==== Types of [[vata]] [[dosha]] ====<br /> <br /> In Vedic literature, as a medical system, the important five types of [[vata]] are explained with their locations and functions. The word ''tantrayate'' is used to explain the functional quality of [[vata]] and ''sharira'' (physical body) is ''yantra'' for functioning of ''tantra''. The [[vata]] [[dosha]] on basis of its functions is classified into five types. They reside in the ''sharira'' at the level of ''sharira paramanu'' (cell) and also at gross level. Five types of [[vata]] work together in a synchronized manner for the normal functioning of the sharira ([[vayu]] tantrayantra dhara). [verse 5-11]<br /> <br /> === General etiological factors and basic pathogenesis of ''vata'' disorders ===<br /> <br /> The etiological factors can be divided into two:<br /> <br /> #which cause direct [[vata]] vitiation and <br /> #which cause indirect [[vata]] vitiation. <br /> <br /> Day sleep (''divaswapna'') do not directly lead to vitiation of [[vata]]. However, it leads to formation of ''ama'' and cause [[vata]] vitiation indirectly by obstructing [[vata]]. ''Vegasandharana'' (suppression of natural urges) and ''marmabhighata'' (trauma to vital organs) etc. are examples of direct vitiation. The pathogenesis is also bi-fold. The initial pathology is aggravation of [[vata]] and diminution of [[dhatu]] and vice versa. One augments the other. This ultimately causes emptiness in channels and rarity in tissues which gives more space for movements of [[vata]]. The second pathology is by increase in [[dhatu]] leading to excessive filling in channels to cause their clogging and blocking [[vata]]. [verse 15-19]<br /> <br /> ==== Premonitory signs and symptoms ====<br /> <br /> Clinical manifestations may not be apparent because of vague manifestation of symptoms (''Avyaktam lakshanam''). This occurs in two situations, either the pathogenesis is extremely slow or it is abrupt. In the initial case, it is unable to appreciate the prodromal symptoms and presenting complaints separately. If it is an abrupt pathology the clinical presentation immediately follows the prodromal symptoms without appreciable gap. [verse 19-20]<br /> <br /> ==== Clinical features ====<br /> <br /> The clinical presentations vary according to the specificity of [[hetu]] (cause) and ''sthana'' (location). The treatment options also vary accordingly. For example if [[vata]] prakopa takes place due to ''ruksha vriddhi'' in ''pakvashaya'' it may lead to habitual constipation in which ''snigdha, ushna'' and ''tikshna aushadha'' like ''mishraka sneha'' may be a good treatment option. <br /> <br /> If the same [[vata]] gets vitiated in ''amashaya'' due to ''snigdha vriddhi'', it leads to gastro-esophageal reflux disease (GERD), ''ruksha ushna'' and ''tikshna'' like ''gomutra bhavita shaddharana'' is the ideal treatment option. ''Anuvasana'' is the ideal therapy in [[vata]] vitiated in ''pakwashaya'', whereas [[vamana]] is the best therapy in [[vata]] vitiated in ''amashaya''. [verse 20-24]<br /> <br /> ==== Three modes of pathogenesis of [[vata]] diseases ====<br /> <br /> The three characteristics of [[vata]] vitiation viz. ''svatantra dushti'' (vitiation due to independent specific causes), gata [[vata]] (increased movement of [[vata]]) and ''avarana'' (obstruction to movement of [[vata]]). imply three possible modes of pathogenesis in [[vata]] diseases. These can be further analyzed as follows; due to the following three important properties of [[vata]], it is regarded entirely different from other [[dosha]][Cha. Sa. [[Sutra Sthana]] 12/3]<br /> <br /> #''Asamghata'' (Incorporeal)<br /> #''Anavasthita'' (Unstable)<br /> #''Anasadhya'' (Inaccessible)<br /> <br /> === Pathogenesis of various conditions ===<br /> <br /> All the verses explain a specific type of ''samprapti'' (pathogenesis) like koshthagata [[vata]] ([[vata]] affecting alimentary tract), amashayagata [[vata]] ([[vata]] affecting stomach.) etc. They are not to be considered as a single disease. These specific diseases may lead to many disease presentations in which the treatment strategies can be generalized. Any [[dosha]] may occupy any particular site or area and lead to diseases. This type of pathology of vitiated [[vata]] is called as gata[[vata]]. Normally in all gata[[vata]], the affected dushya(vitiated body components) will be ''kshina'' (depleted) and affected ''srotas'' will be ''rikta'' (empty). The concept of gata[[vata]] can be further explored physiologically.[[Dhatu]] are classified into two types’ ''asthayi'' (temporary) [[dhatu]] and sthayi(permanent) [[dhatu]]. Asthayi [[dhatu]] are the ones which are ''dravaswarupa'' (liquid state) and undergoing conversion (''parinam apadyamananam'') and they are being ''vikshepita'' (circulated) from their ''mulasthana'' (origin) throughout the ''sharira'' (''abhivahana'') for the purpose of ''poshana'' (nourishment) of the sthayi [[dhatu]]. This ''parinamana'' (conversion) and ''abhivahana prakriya''(transportation) takes place in ''marga'' (channel) which are known as ''srotas''; hence ''marga'' is one of the synonym used for ''srotas'' along with ''sira'' (vein), ''dhamani'' (artery), ''rasayani'' (capillary), ''rasavahini'' (channels carrying nutrient fluid), ''nadi'' (nerve), ''panthana'' (pathway), ''sharira chhidra'' (perforated channel), ''samvrita-asamvritani'' (covered or uncovered), ''sthana'' (site), ''ashaya'' (organ), ''niketa'' (habitat), ''shariradhatu avakasha'' (hollow space in body tissues).<br /> <br /> ''Prakupita''(vitiated) [[dosha]] have the capacity to further vitiate both ''sthanastha dhatu'' (fixed tissue element) as well as ''margagata'' (circulating tissue elements) sharira [[dhatu]]. When prakupita [[vata]] vitiates the [[dhatu]], it is called as gata[[vata]]. In this condition, vitiated [[vata]] affects the specific site due to specific etiological factors. While designing treatment protocol, in this context specific etiological factors for each and every gata[[vata]] related diseases must be observed to clarify why vitiated [[vata]] goes to specific part of the body or to specific [[dhatu]] to develop kosthagata [[vata]], raktagata [[vata]] etc. In this condition, [[dhatu]] is ''dushya'' (getting vitiated).<br /> <br /> '''Koshthagata [[vata]]:''' <br /> <br /> [[Vata]] getting vitiated in the koshtha(alimentary tract) is explained as koshthagata [[vata]]. <br /> <br /> '''Gudagata [[vata]]:''' <br /> <br /> It can also be explained that gudagata [[vata]] and pakvashayagata [[vata]] are different clinical entities. In gudagata [[vata]], obstruction of stool, urine and flatus is observed, whereas in pakvashayagata [[vata]] there is painful defecation, micturition with ''antrakujana'' (gurgling sound), ''atopa'' (distension) and ''anaha'' (constipation). ''Ashma sarkara'' (urolith) is exclusively present in gudagata [[vata]] with pain and atrophy in calf muscles, thighs, sacram, feet and back. This can be compared with lumbo-sacral plexopathy. It may be understood as in case of ''pakvashaya gatavata'', proximal part of large intestine along with ascending, transverse and descending colon is involved; whereas in gudagata [[vata]], involvement of sigmoid colon, rectum, anus and their nerve supply.<br /> <br /> '''Amashayagata [[vata]]''': <br /> <br /> This is a typical presentation of [[vata]] leaving its own site and vitiating other site. Here the local [[dosha]] is considered important because it is more virulent than the external [[dosha]] coming from other sites. The clinical entities originating from ''amashaya'' (stomach) are caused due to vitiated [[vata]] entering into ''amashaya''. It increases emptiness of stomach leading to indigestion or ''ama pradoshaja vikara'' like ''visuchika'' (diarrhea) etc.<br /> <br /> '''Indriyagata [[vata]]''': <br /> <br /> Indriyagata [[vata]] is applicable to any sense organ. ''Indriya vadha'' may be interpreted as complete, partial or minimal loss of sensation. ''Shrotra''(ears) has specific importance among other ''indriya'', in which inherent [[dosha]] of ''shrotra'' is [[vata]] itself. So [[vata]] prakopa in ''shrotra'' is more impacting. It is worthy to remember the notion in vatakalakaleeya that [[vata]] is ''sarvendriyanam udyojaka'' (motivating factors for all sense organs).<br /> <br /> '''Twakgata [[vata]]''': <br /> <br /> ''Tvak'' (skin) is referred as somatic organ even though it is a sensory organ. ''Supti'' (numbness) and ''toda'' (pricking sensation) are not symptoms specific to ''tvakindriya.'' Here ''tvak'' represents [[rasa dhatu]]. Rasa does not have cellular pattern and hence not included in ''shakha''. The ''tvak'' is derivative of ''rasa'' and is included in ''shakha''. ''Tvakindriya gatavata'' should be understood under indriyagata[[vata]].<br /> <br /> '''Siragata [[vata]]''': <br /> <br /> When [[vata]] afflicts ''sira'' (blood vessel) it may broaden or narrow the sirā. Widening may lead to ''shopha'' and narrowing may lead to ''shosha'' or vice versa as per the site of affliction. Two different conditions of vascular diseases i.e. aneurysym (''mahat'') and atherosclerosis / venous thrombosis (''tanu'') are examples.<br /> <br /> '''Sandhigata [[vata]] (osteoarthritis)''': <br /> <br /> There is depletion of periarticular and articular tissue by vitiated [[vata]] in sandhigata [[vata]]/osteoarthritis, empty spaces are occupied by [[vata]] which is felt as crepitus on palpation. [[Vata]] also causes hypertrophic tissue in the form of osteophytes and causes painful flexion and extension movements. This is the characteristic feature of swelling in sandhigata [[vata]]. <br /> <br /> '''Ardita''': <br /> <br /> ''Ardita'' is a disease of episodic origin. It may lead to facial paralysis or hemiplegia or both. In other classics ''ardita'' is explained as facial paralysis only. [verse 38-42]<br /> <br /> '''Antarayama (emprosthotonous) and bahirayama(ophisthotonous):''' <br /> <br /> These diseases are tetany like conditions in which the body is sharply bent forward and backward respectively. [verse 43-48]<br /> <br /> '''Hanugraha''': <br /> <br /> It is a lockjaw like condition that may be persistent or intermittent or recurrent due to vitiation of [[vata]] affecting the mandibular joint. [verse 49]<br /> <br /> '''Dandaka''':<br /> <br /> ''Dandaka'' is a condition in which the muscles are hypertonic but without convulsions. When it further manifests as tonic clonic convulsions it is referred as ''danda akshepaka''. This condition is caused due to vitiation of [[vata]] simultaneously in muscle groups. [verse 51]<br /> <br /> '''Episodic nature of various [[vata]] disorders''' <br /> <br /> The disorders mentioned from ''ardita'' onwards are ''vegavana'' (episodic). All ''vegavana'' disorders have two phases, ''vega'' and ''vegantara''. ''Vegantara'' is the symptom free period and is considered as right time for medication. [verse 52]<br /> <br /> '''Pakshaghata''': <br /> <br /> Three diseases namely ''pakshaghata''(hemiplegia), ''ekangaroga'' (monoplegia) and ''sarvangaroga'' (quadriplegia) are explained. In ''pakshaghata'' no painful symptoms are explained. ''Sira'' and ''snayu'' are considered as ''dushya'' in ''ekangaroga'' and ''sarvangaroga''. ''Sira'' is the ''upadhatu'' of [[rakta]] and ''snayu'' is the ''upadhatu'' of meda, therefore ''meda'' and ''rakta'' have vital role in pathogenesis of these diseases. [verse 53-55]<br /> <br /> '''Gridhrasi''': <br /> <br /> ''Gridhrasi'' is a ''snayugata'' (affecting tendon) ''roga''. The word ''gridhrasi'' is derived from ''ghridhra'', which means vulture, the typical gait of the disease is highlighted by the name. The patient’s gait is changed like a vulture due to affected tendons by vitiated [[vata]]. <br /> <br /> ''Khalli'' is the term given to severe painful twisting conditions of tendons. [verse 56-57]<br /> <br /> '''Nomenclature of diseases:''' <br /> <br /> All the [[vata]] disorders cannot be named or explained. They should be understood on the basis of site of affliction as well as nomenclature. [verse 58]<br /> <br /> '''Diagnosis of [[dhatu]]kshaya (degenerative pathology) and avarana (obstructive pathology) induced vitiation of [[vata]]:''' <br /> <br /> [[Vata]] can be vitiated due to [[dhatu]]kshaya and ''margavarana'' types of pathogenesis. [[Dhatu]]kshaya leads to depletion of tissues and more space for [[vata]] to move. This leads to gata[[vata]] phenomenon. ''Avarana'' of [[vata]] can be caused by other [[dosha]] or [[dhatu]]. So the differences between ''avarana'' and gata[[vata]] should be understood.<br /> <br /> The word, ''avarana'' means obstruction or resistance or friction to the normal ''gati'' of [[vata]]. Hence when its normal movement is hampered or vitiated, it becomes ''avrita'' and leads to different disorders. The gatatva and avritatva are entirely different phenomenon. Here an attempt is being made to differentiate the both physio-pathologies. [16]<br /> <br /> #In ''avarana'', generally the vitiation of [[vata]] is passive. When vitiated [[dosha]] or any other thing obstructs the pathway of [[vata]], avarana happens. Normal state of [[vata]] gets vitiated as ''avarana'' progresses. The substance which obstructs the pathway of [[vata]] is called as ''avaraka'' and the [[dosha]] ([[vata]] in general or its components) affected by ''avarana'' is called as ''avariya'' or ''avrita''. Normally the ''avarana'' is caused by the etiological factors for the vitiation of ''avaraka''. Etiological factors for the vitiation of [[vata]] (''sva nidana'') will be absent. In case of gata[[vata]] the vitiation of [[vata]] will be active. Here its own etiological factors are operating in the vitiation of [[vata]] in the pathogenesis and the vitiated [[vata]] adopts specific pathway and abnormally localizes at particular sites.<br /> #In the process of ''avarana chala'' property of [[vata]] is diminished due to obstruction. Other properties are not involved in the process of obstruction. But in case of ''gatatva'' the vitiation of [[vata]] takes place by involvement of other properties like ''ruksha, laghu, khara, vishada'' etc along with ''chala''.<br /> #In ''avarana'' the ''gati'' of [[vata]] is obstructed partially or fully. Once gets obstructed the [[vata]] may simply get lodged there (''baddha marga, margarodha''), try to nullify the obstruction, may get covered by the obstructing substance (''avrita''), adopt an opposite direction (''pratiloma'') or alter the direction (''viloma''). The different terminologies have been used to denote ''avarana'' in different contexts according to the nature of ''avarana'' and the state of [[vata]] and ''marga'' (passage). In case of ''gatatva'' the ''gati'' of vitiated [[vata]] aggravated and starts moving abnormally leading to localization at particular sites.''Avarana'' is caused by ''purnata'' (filling) of other [[dosha]] in the ''srotas/marga'' (passage) of [[vata]]. In ''gatatva'' the ''srotas'' or sites of occupation of [[vata]] are ''rikta'' (unfilled or spacious) and the aggravated [[vata]] fills the ''srotas''/site.<br /> #In ''avarana'' of [[vata]], swakarma vriddhi (exaggerated activities) of ''avaraka'' (covering [[dosha]]) is manifested. The ''avrita'' (i.e. [[vata]]) will show ''swakarma hani'' (diminished activity). This is the general feature of ''avarana''. Here the excessively increased strong ''avaraka'' suppresses the normal action of ''avrita'' (i.e.[[vata]]). Therefore, when the obstruction is complete it may lead to the ''prakopa'' of [[vata]] resulting in the presentation of [[vata]] vitiated symptoms as well as its disorders[ Cha. Sa. [[Chikitsa Sthana]] 28/215, Chakrapani]. In case of ''gatatva'' the symptomatology will be predominantly of [[vata]] vitiation and pain is a common and chief complaint in all the conditions of ''gatatva''.<br /> #Obstruction or covering of [[vata]] is possible by body components like [[dosha]] ([[pitta]] and [[kapha]]),tissues,food, excretory products or mutual affliction of [[vata]] types. Gatatva of [[vata]] (affection) is happening in empty spaces or hollow cavities of tissues, their elements, organs and other body parts. In ''avarana'', the body component is in increased state causing fullness in respected channels, while in ''gatatva'' pathology, the body components are in depleted state casusing emptiness in the respected channels. Dhatugata [[vata]] will be presented with decreased quality of tissues associated with signs of vitiated [[vata]]. Obviously, exceptions are possible according to the complexities of process of ''avarana'' or ''gatatva''.<br /> #In case of ''avarana'' of [[vata]], the ''avaraka'' is important for treatment since vitiation of [[vata]] is passive. When ''avarana'' is removed vitiated [[vata]] gets pacified. But in cases of ''gatatva'', the vitiated [[vata]] has to be treated first along with correction of ''adhisthana''.<br /> #Diagnosis of ''avarana'' is made with the help of ''upashaya–anupashaya'' (pacifying and aggravating factors) method. Diagnosis of ''gatatva'' is made according to the ''rupa'' (symptomatology). <br /> #Complications of ''avarana'' are explained in case of improper diagnosis and delayed treatment like ''hridroga, vidradhi, kamala'' etc. No known complication occur in ''gatatva''.<br /> #''Avarana'' of [[vata]] may cause depletion of nutrition to [[dhatu]] ([[dhatu]]gata sama) leading to successive diminition of rasadi [[dhatu]](''rasadimscha upasosayet'').[Cha. sa. [[Sutra Sthana]] 28/61] No such reference is available in case of ''gatatva''. <br /> <br /> The discussed points are briefly enlisted in the table below:<br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| ''Avrita''(obstructed) [[vata]]<br /> ! scope=&quot;col&quot;| ''Gata'' (excess movement) [[vata]]<br /> |-<br /> | Vitiation of [[vata]] is passive<br /> | Vitiation of [[vata]] is active<br /> |-<br /> | Normally ''svanidana''(specific causes for vitiation) of [[vata]] are not responsible<br /> | Vitiation of [[vata]] by ''svanidana''<br /> |-<br /> | Only ''chala'' property of [[vata]] is involved and it is diminished in the phenomenon<br /> | Other properties of [[vata]] are also involved and the ''chala'' property aggravated in the phenomenon<br /> |-<br /> | ''Gati'' of [[vata]] is obstructed<br /> | ''Gati'' of [[vata]] is aggravated<br /> |-<br /> | ''Purnata''(fullness) in ''srotas/marga''<br /> | ''Riktaka''(emptiness) in ''srotas''<br /> |-<br /> | [[Vata]] shows ''svakarma hani'' (decreased function)<br /> | [[Vata]] shows ''svakarma vriddhi'' (increased function)<br /> |-<br /> | [[Dhatu]] are in ''vriddhi'' (increase) or ''saama''<br /> | [[Dhatu]] daurbalya (decrease) present<br /> |-<br /> | ''Avarana'' possible with other [[dosha]]/anna/[[mala]]/individual components of [[vata]]<br /> | Not possible<br /> |-<br /> | ''Avarana'' by ''avayava''(body part) or ''ashaya''(organ) not possible<br /> | ''Gatatva'' in ''ashaya'' and ''avayava'' explained<br /> |-<br /> | ''Avaraka'' gets importance in treatment<br /> | [[Vata]] gets importance in treatment<br /> |-<br /> | Diagnosis made with ''upashaya anupashaya'' (hit and trial)<br /> | Diagnosis with ''rupa''<br /> |-<br /> | Complications of ''avarana'' possible<br /> | None<br /> |-<br /> | Successive diminution of rasadi [[dhatu]] possible<br /> | None<br /> |}<br /> <br /> As ''avarana'' proceeds it may end up in [[dhatu]]kshaya as the ''avrita'' will block [[rasa dhatu]] which give nourishment. This is commonly observed. This is possible in many other disorders also. The best example is rajayakshma. <br /> <br /> '''Prognosis''': <br /> <br /> Exclusive [[vata]] disorders are serious and have poor prognosis. The symptoms / diseases explained manifest when vitiated [[vata]] affects vital parts. The therapeutic approaches should be cautious and extra efforts are essential for a better recovery. As the disease becomes chronic the curability rate drastically declines. The physical strength of the patient is also very important in determining prognosis. [verse 72-74]<br /> <br /> '''General principles of management''': <br /> <br /> The general line of management of ''vatavyadhi'' applies to absolute [[vata]] vitiation only. If there is any association or obstruction of other dosha in ''vatavyadhi'', the treatment will be different. ''Kevalam'' term indicates pathology of vitiation of exclusive [[vata]]. ''Nirupastambha'' is condition without any association of other [[dosha]]. This pathology shall be primarily treated with oleation therapy.<br /> <br /> As in exclusive [[vata]]ja disease the major ''gunavriddhi'' is ''ruksha'' which leads to ''riktata'' in ''srotas'' and [[dhatu]] and more ''avakasha'' (space) for [[vata]]; [[snehana]] is essential and ideal. Various methods for [[snehana]] are employed depending on ''avastha'' (stage), ''sthana'' (site) and ''bala'' (strength) of the diseases and as well as patient.<br /> <br /> Following [[snehana]], [[swedana]] is also mandatory. Here the ''ushna guna'' (hot property) operates to control ''sheeta'' (cold). Repeated [[snehana]] and [[swedana]] imparts high grade of flexibility. <br /> <br /> ''Sneha'' is a good medium to control [[vata]] as well as [[vata]]-[[pitta]]. Generally, this line of treatment can be counted as a part of [[brimhana]]. [verse 75-83]<br /> <br /> Repeated [[snehana]] and [[swedana]] therapies can control [[vata]] well. However, ''samshodhana'' (purification) therapies are executed to remove the residual [[dosha]]. As ''shodhana'' has a definite chance for causation of [[vata]] prakopa, the approach should be cautious, so ''mridu samshodana'' (mild purification) is done. Sneha [[virechana]] is done by ''tilwaka ghrita'' or ''eranda taila'', etc. ''Eranda taila'' is very effective in treating [[vata]] prakopa due to ''udavarta''. If [[virechana]] is not possible, ''anulomana'' diet should be adviced. If the patient is extremely weak niruha is better option. Even after ''shodhana''; recurrent application of [[snehana]] and [[swedana]] are essential.[verse 83-88] <br /> <br /> ==== Management of [[vata]] at different sites ====<br /> <br /> Treatment of disorders of [[vata]], when located in different sites, habitat (''sthana'') is more important in comparison to the invaded (''agantu'') [[dosha]] e.g in koshthagata [[vata]], koshtha is given preference in treatment, and so ''kshara'' is used which helps in digestion ([[pachana]]). But when [[vata]] is located in ''pakvashaya'' or ''guda'' which is [[vata]]sthana, udavartahara treatment is selected, which includes [[vata]] anulomana, [[basti]], varti'' etc. In amashayagata [[vata]], shodhana in the form of [[vamana]] is done. ''<br /> <br /> ''Hridaya anna'' (favourite food) is typically indicated in tvakgata [[vata]] because, rūkṣatā in tvak is a result of rasakṣaya caused by overworrying.[Cha. Sa. [[Vimana Sthana]] 5/13]<br /> <br /> Bahya [[snehana]] in the form of ''abhyanga'' or ''dhara'', etc are very effective in [[asthi dhatu]]gata and [[majja dhatu]]gata [[vata]]. Abhyantara [[snehana]] replenishes [[meda dhatu]] and subsequently [[asthi dhatu]] and [[majja dhatu]]. It is worthy to note the utility of ''tikta ghrita'' in [[asthi dhatu]] kshaya. <br /> <br /> In ''shukrakshaya'' (depletion of ''shukra''), ''harshana'' (pleasure) and ''vrishya annapana'' (aphorodisiac diet) is very useful. &lt;ref&gt;Vagbhata, Sharira Sthana Chap 5 , Angavibhaga Adhyaya, Verse 67. In: Bhishagacharya Harisastri Paradikara Vaidya (eds.) 9th ed. Varanasi: Chaukhambha Orientalia; 2005. P798&lt;/ref&gt;<br /> <br /> === Management of ''ardita'' (facial palsy) ===<br /> <br /> The line of treatment of ''ardita'' aims at ''mastishkya'' (brain), therefore, [[nasya]] is indicated. [[Nasya]] is explained to be the direct entrance to the cranial vault. [[Nasya]] may be ''shodhana, shamana'' or [[brimhana]] as the case may be. But there is an opinion that since the word ''navana'' is used, it means snaihika [[nasya]]. ''Murdhni taila'' is absolutely meant for treatment in head region and is of four types viz. ''abhyanga'' ( head massage), ''seka'' (pouring liquid on head), ''pichu'' ( therapeutic unctuous swab on head) and ''shirobasti''. ''Tarpana'' (nourishment therapy) is ''akshitarpana'' (nourishing eyes) and ''shrotratarpana'' (nourishing ears). ''Nadisweda'' is very specific in ''ardita'' and ''ksheeradhooma'' (medicated fumes of milk).<br /> <br /> Poultice prepared from flesh of marshy animals is used for [[brimhana]] in atrophy of muscles. [[Vamana]] is indicated in ''ardita'', when it is associated with ''shopha'' and ''raktamokshana'' is indicated when associated with ''daha'' (burning) and ''raga'' (redness).<br /> <br /> In ''pakshaghata, [[swedana]], fomentation mixed with unctuous material and [[virechana]] or purgation therapy with unctuous substance is indicated. [[Virechana]] is the line of treatment in ''pakshaghata'' and outweighs [[basti]] which is said to be ideal for [[vata]]kopa. ''Pakshaghata'' may be understood as a concealed ''urdhwaga raktapitta'' (bleeding from upper orifices of body) in which the only and effective choice is ''adho-shodhana'' (purgation). ''Gridhrasi'' is a tendon and ligament disorder and ''shastra, kshara,'' and ''agnikarma'' are the main line of treatment. Therefore ''siravyadha'' (blood letting) and ''dahakarma'' (cauterization) is advised. [[Basti]] is also a good choice since pakvashayagata [[vata]] leads to ''kateegraha'' and ''gridhrasi''. <br /> <br /> ''Agnikarma'' and ''siravyadha'' are the two line of treatment which are useful in acute phase to relieve the pain in ''gridhrasi'' and also in ''khalli''. ''Agnikarma'' relieves muscle spasm thereby reducing pain whereas ''siravyadha'' may be helpful by reducing the blood stasis. Improved circulation removes cytokines and other inflammatory factors thereby reducing pain. (99-103)<br /> <br /> ''Agnikarma'' is a para surgical procedure in which a metallic thin pointed rod called ''shalaka'' is heated and applied to specific points of pain for relief. It is commonly used as efficient pain reducing therapy in musculoskeletal disorders.<br /> <br /> === Importance of site of affliction in treatment ===<br /> <br /> The specificity of treatment depends on the site of affliction and the associated morbid tissues. For example masthishkya is very specific for ardita, pakshaghata, indriyagatavata etc. Even though [[vamana]] is [[kapha]]hara, it is exclusively indicated in āmashayagata vāta taking into account of site of affliction. [verse 104]<br /> <br /> [[Brimhana]] treatment of [[vata]] vitiation: The treatment of exclusive [[vata]] vitiation (without involvement of other [[dosha]]) is [[brimhana]]. If associated [[dosha]] is present, they shall be treated first. [verse 105]<br /> <br /> Bala is excellent for lone vitiated [[vata]]. The head of goat is indicated on the basis of the principle ‘samanyam vridhikaranam’(like increases like). These also explain the awareness of utilization of brain of goat in degenerative brain lesions. Lavana relieves stambha (stiffness) and samghata (conglomeration). Upanaha is also prepared with such well fomented flesh and added with different oils, salts etc. Such upanāha are brimhana. [verse 106-108]<br /> <br /> === Avagaha (immersion) sweda ===<br /> <br /> Avagaha is typically indicated in apana vaigunya (defects due to apana [[vata]] vitiation), it is a type of drava sweda (liquid fomentation). Nadisweda is also an excellent option for all types of vataroga. Poultices (upanaha) of different types provide self generated heat to cause swedana. It is by virtue of various dhanya (cereals) and kinwa (yeast) available in it. [verse 109-118]<br /> <br /> === Different formulations===<br /> <br /> Different medicated ghrita, taila, vasa, majja and maha sneha (combination of all four sneha) are indicated for various conditions in the form of oral ingestion, inhalation, enema and external application etc. Maha sneha is guru (heavy to digest) and ultimately indicated in disorders like convulsions, tremor etc. [verse 119-136]<br /> <br /> Pinyaka taila is a preparation in which ruksha [[guna]] is imparted to taila and is highly useful in [[kapha]] associated [[Vata]] vyadhi. [verse 136-137]<br /> <br /> === Importance of oil in treatment of [[vata]]=== <br /> <br /> By virtue of vyavayi [[guna]] (pervading/diffusive), it reaches the different interior parts of the body without any metabolic changes. By processing taila can adopt any type of qualitative changes. The drugs are potentiated by repeated processing in its own media. Drugs like ksheerbala (101 avartita), dhanwatharam (21 avartita) etc. are worth mentioning here. This approach of samskara makes sneha as sukshma sneha (with better bio-availability and penetration). [verse 181-182]<br /> <br /> <br /> === Management of avrita [[vata]] ===<br /> <br /> In [[pitta]]vritta [[vata]], hot and cold should be applied alternately. Jivaniya sarpi is also very [[brimhana]]. [[Brimhana]] is the ideal pacifying line of treatment for [[vata]] and [[vata]]-[[pitta]]. <br /> <br /> In [[kapha]]vritta [[vata]], ruksha is given importance. In association of [[kapha]] along with [[pitta]] in [[vata]]roga, [[pitta]] should be given importance in management. It is because of the fact that [[pitta]] makes the disease process as ‘ashukari’(instantaneous). <br /> <br /> In [[Kapha]]vritta [[vata]]; tikshna sweda, niruha and [[vamana]] which reduces [[kapha]] is indicated followed by [[virechana]] intended for [[vata]] anulomana and also useful for [[kapha]].<br /> <br /> Jirna/purana sarpi (old ghee) which has [[kapha]]ghna quality has to be used; tila and sarshapa which are [[kapha]] [[vata]]ghna are to be used. Warm drinks of yava, jangala mamsa rasa which gives strength to the patient without increasing kapha are to be administered. [verse 183-188]<br /> <br /> Kshara [[basti]] (gomutrayukta [[basti]]) in case of [[kapha]]-[[vata]] and ksheera [[basti]] in [[pitta]]-[[vata]] is recommended. [[Rakta]]vruta [[vata]] is similar to uttana-vatarakta and treatment is accordingly same. [[Rakta]] avruta [[vata]] is one of the phases of vatarakta. Thus [[raktamokshana]] and [[basti]] chikitsa which is useful in vatarakta is also helpful in rakta avruta [[vata]]. <br /> <br /> Prameha samprapti mentioned in Sutra sthana 17th chapter explains [[kapha]], [[pitta]], [[meda dhatu]] and [[mamsa dhatu]] which when increased causes avarana of [[vata]]. Therefore, pramehagna cikitsa is helpful in meda avruta [[vata]] and also in mamsavrutta [[vata]]. Hence in mamsavrutta [[vata]] the pipilika iva sanchara (tingling sensation) reduces, if prameha is treated. Similarly, in obesity, medasavruta [[vata]] ([[vata]] obstructed by excess meda) [Cha.Sa.[[Sutra Sthana]] 21/5] and meda and mamsa ativridhi [Cha.Sa.[[Sutra Sthana]] 21/9] is observed. These conditions are best treated on the principles of management of prameha, sthaulya associated with vitiated [[vata]]. Therapeutic emesis to expel out the intoxicated food in stomach is advised in condition of annavrita [[vata]] ( [[vata]] obstructed by food). [[Pachana]] and [[deepana]] helps in digestion and also pacifies [[vata]].<br /> <br /> Hot fomentation reduces urethral pressure. A study done by Shafik A. showed that sitting in warm water helps in micturition which seems to be initiated by reflex internal urethral sphincter relaxation. A thermo sphincter reflex is likely to be involved.<br /> <br /> Uttara basti effect is similar to catheterization. Further depending on the medicines used for uttara basti, tri[[dosha]] shamana can be done.<br /> <br /> The lines of treatment of [[rakta]]gata [[vata]] and raktvrita [[vata]] as well as [[shukra]]gata [[vata]] and shukrāavruta [[vata]] are one and the same irrespective difference in samprapti as gata [[vata]] or avruta [[vata]]. It is because of the fact that [[rakta]] and [[shukra]] are mobile and comparatively pervaded all over the body like [[vata]] so gata[[vata]] and avruta [[vata]] are mutually complimentary here. <br /> Finally, the treatment strategies of anyasthanagata(in other sites) [[vata]] are explained. The importance is given to sthanastha [[dosha]] (in own sites).[Verse 189-199]<br /> <br /> Movements of [[vata]] and concept of anyonyavarana:As discussed earlier avyahatagati (free movement) is a cardinal feature of [[vata]] to perform normally. In [[avarana]] certain obstacles like [[dosha]], [[dhatu]] or anna etc which are immobile, occupy the pathway of mobile [[vata]. It is not mandatory that such immobile articles only cause obstruction to [[vata]]. If the individual sub types of [[vata]] are considered prana, udana, vyana, samana and apana are mobile and has some specific direction for their gati. For example, prana has movement from murdha (head) to downwards. Udana has movement from uras(chest) to upwards. Vyana moves upward downward and sidewards like rasa. Samana moves around jatharagni. Apana move downwards from pakvashaya. This can be further analysed as follows. Udana possess upward movement. Likewise ‘apana’ has downward direction. Vyana [[vayu]] moves in horizontal direction (vyāpanat vyāna uccyate) along with upward and downward directions as rasa samvahana (circulation) is concerned.[19]Samana is also having such qualities to equally distribute the nutrients through out the body. Prana has multi directional gati. So, the movements of individual subtypes of vāta are directional in nature. When these meet in opposite direction it makes anyonyavarana. For example prāna and udāna meet opposite and interfere with mutual normal movements leads to difficulty in inspiration as well as expiration which is comparatively irreversible. This concept is called anyonyāvarana. It is of 20 types taking into account of 5 different types making 4 particular combinations. Anyonyāvarana are comparatively difficult situations. [verses 199-206]<br /> <br /> Anyonya avarana is characterized by Svakarma hani or vriddhi (either increase or decrease in functions) which depends on the nature and site of anyonyāvarana (mutual covering). For example prana avruta udana may lead to difficulty in respiration, followed with cardiac symptoms, aphasia or dysarthria and some times upper respiratory symptoms. This presentation is comparatively acute in onset and. Here the functions of udāna are masked by prana. But in udana avruta prana the symptoms are loss of motor power, immunity and complexion leading to death. Here the functions of prana are seriously hampered. This symptom may be acute or chronic in nature. When apana got avarana by udana the normal peristalsis is hampared and anulomana is the line of treatment. In apana avarana to udana increased bowel motility can be seen grāhi is the line of treatment which should be adopted here.<br /> <br /> === Rehabilitation of [[vata]]=== <br /> <br /> Prakrutisthapanam means re-establishment in its own pathway (sva margaga)/ or in its own place (sva sthana gamayed enam). Therefore for udana [[vayu]], [[vamana]] etc. treatment should be administered to regulate the normal functional status of udana [[vayu]]. Apana has adhogati, therefore anulomana chikitsā should be done, thereby regularizing the urdhva apana bhava of Apana [[vayu]]. Shamana should be line of treatment for samana [[vayu]]. Empowering digestive power should be done. Samana being sited near [[agni]], proper digestion and absorption of essential elements will be observed. Proper electrolyte balance will be maintained, thereby maintaining the pH of body fluids. As discussed previously vyāna has all the three gati i.e. urdhva, adho and madhya gati. Here the general line of treatment of anyonyavarana is discussed. [verse 219-221]<br /> <br /> ===Importance of udana and prana vata===<br /> <br /> Among various avarana, the involvement of udana and prana are very important. As explained in the introductory comments, prana is life and udana is strength. These are very vital issues as far as avarana is concerned. Improper management or avoidance of treatments may lead to permanant disabilities in avarana. [verse 231-236]<br /> <br /> === Complications of Avarana===<br /> <br /> This includes hrudroga, vidradhi, plīhā, gulma, atisara. Hrudroga is a common complication of ill treated avarana of prana and udana. Vidradhi and pliha are caused by wrongly managed avarana of vyana. Gulma and atisara are common complications of avarana of samana and apana. <br /> <br /> Srotoshodhana is an important line of management in Avarana. It ensures unobstructed movement of [[vata]]. All abhishyandi(increasing discharges in body) food causes srotorodha (obstruction of channels). Yapana [[Basti]] is ideal for all age group and safe to severe clinical presentations. It protects all marma points. As it is neither lekhana (reducing body components), nor [[brimhana]], it is useful for managing [[vata]] as well as avaraka [[kapha]] or [[pitta]]. Guggulu rasāyana and shilajatu rasāyana is ideal for many clinical conditions of avarana.<br /> <br /> === Related chapters ===<br /> <br /> [[Vatakalakaliya Adhyaya]], [[Basti]], [[Snehana]], [[Panchakarma]]<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References ==<br /> <br /> &lt;/div&gt;<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[Vatavyadhi Chikitsa#top| Back to the Top]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Trimarmiya_Siddhi&diff=45410 2026-02-16T08:48:49Z

<p>Agnivesha: /* Time of administration of uttara basti */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Trimarmiya Siddhi<br /> |titlemode=append<br /> |keywords=Marma (vital points), Diseases of head and nervous system, Heart and cardiovascular system, bladder, kidney and urinary system, Apatantraka, Ardhavabhedaka, Basti, Hridaya, Mutradosha, Nasya, Shiromarma, Suravarta, Tandra, Trimarma, Udavarta,Uttara basti, per vaginal drug delivery, per urethral drug delivery,Ayurveda, Indian system of medicine, charak samhita. <br /> |description=Siddhi Sthana Chapter 9. Management of diseases of three vital organs<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Siddhi Sthana]] Chapter 9. Management of diseases of three vital organs'''&lt;/big&gt;<br /> {{Infobox<br /> |title = Trimarmiya Siddhi<br /> |label1 = Section/Chapter<br /> |data1 = [[Siddhi Sthana]] Chapter 9<br /> |label2 = Preceding Chapter<br /> |data2 = [[Prasrita Yogiyam Siddhi]]<br /> |label4 = Succeeding Chapter<br /> |data4 = [[Basti Siddhi]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Shenoy R.<br /> |label7 = Reviewer <br /> |data7 = Panse A.<br /> |label8 = Editors<br /> |data8 = Thakar A. B., Mangalasseri P., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s08.010 10.47468/CSNE.2020.e01.s08.010]<br /> }}<br /> &lt;big&gt;''' Abstract &lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;This chapter describes importance of three vital organs viz. ''hridaya'' (heart), ''shiras'' (head) and ''basti'' (urinary bladder) during purification procedures. The etio-pathogenesis of ''marma'' disorders are elaborated in detail with their management. The diseases include ''apatantraka'' (Opisthotomus), ''tandra'' (drowsiness) related to ''hridaya'' involvement, thirteen types of ''mutra dosha'' (diseases caused due to vitiation of urine), and diseases related to head viz. ''shankhaka'' (acute temporal headache ), ''ardhavabhedaka'' (one sided headache or migraine), ''suryavarta'' (headache that increases with sun rise) and ''anantavata'' (headache that starts from an area and then gradually involves the entire head and face). ''Uttara basti'' (per urethral and per vaginal drug delivery) as a treatment modality, its procedure of administration and dimensions of ''netra'' (nozzle) are discussed in detail for the management of urinary and reproductive systemic disorders. ''[[Nasya]]'' therapy (nasal errhines) is described for the management of disorders of head. The chapter emphasizes on importance of sustaining health of ''marma'' by following preventive measures and timely treatment. <br /> &lt;br/&gt;<br /> '''Keywords''': ''Marma'' (vital points), Diseases of head and nervous system, Heart and cardiovascular system, bladder, kidney and urinary system, ''Apatantraka, Ardhavabhedaka, Basti, Hridaya, Mutradosha, [[Nasya]], Shiromarma, Suravarta, Tandra, Trimarma, Udavarta,Uttara basti,'' per vaginal drug delivery, per urethral drug delivery.<br /> &lt;/p&gt;<br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> [[Panchakarma]] and ''[[basti]]'' in particular can cause complications pertaining to ''marmas'' especially to the three vital points (''trimarma-hridaya, shiras'' and ''basti'') and successful treatment entails the proper administration of ''[[basti]]''. All marmas fall under the ''madhyama rogamarga'' (disease pathways including internal systems) [ Cha.Sa.[[Sutra Sthana]] 11/48], and their diseases are difficult to manage. ''[[Vata dosha]]'' is important in etio-pathology of any disease, because the it is responsible for movement of vitiated ''[[dosha]]s'' to other sites of disease (''roga marga''). ''[[Basti]]'' is the best treatment to alleviate ''[[vata]]'' and manage these diseases [Cha.Sa [[Siddhi Sthana]] 1/38-39]. Some diseases described in this chapter are not mentioned in the [[Trimarmiya Chikitsa]] chapter [Cha. Sa.[[Chikitsa Sthana]] 26] described earlier.<br /> <br /> ''Uttara basti'' (per urethral and per vaginal drug delivery) is the third type of ''[[basti]]'' in the management of ''shukravaha srotas'' (reproductive system) and ''mutravaha srotas'' (urinary systems). This treatment modality to deliver drug in bladder in case of urinary system disorders and in uterus in case of uterine and reproductive system disorders is explained in detail. ''[[Nasya]]'' therapy (nasal errhines), its types and its importance in management of disorders of head is described further. Thus, the present chapter encompasses etio-pathology and medical management of all disorders related to heart, head and urinary system.<br /> <br /> == Sanskrit text, Transliteration and English Translation == <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातस्त्रिमर्मीयां सिद्धिं व्याख्यास्यामः||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः||२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātastrimarmīyāṁ siddhiṁ vyākhyāsyāmaḥ||1||<br /> <br /> iti ha smāha bhagavānātrēyaḥ||2||<br /> <br /> athAtastrimarmIyAM siddhiM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now we shall expound the chapter &quot;Trimarmiya Siddhi&quot; (Management of diseases of three vital organs). Thus said Lord Atreya [1-2]<br /> &lt;/div&gt;<br /> === Description of ''marma'' (vital points and organs) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सप्तोत्तरं मर्मशतमस्मिञ्छरीरे स्कन्धशाखासमाश्रितमग्निवेश!| <br /> <br /> तेषामन्यतमपीडायां समधिका पीडा भवति, चेतनानिबन्धवैशेष्यात्| <br /> <br /> तत्र शाखाश्रितेभ्यो मर्मभ्यः स्कन्धाश्रितानि गरीयांसि, शाखानां तदाश्रितत्वात्; स्कन्धाश्रितेभ्योऽपि हृद्वस्तिशिरांसि, तन्मूलत्वाच्छरीरस्य||३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> saptōttaraṁ marmaśatamasmiñcharīrē skandhaśākhāsamāśritamagnivēśa!| <br /> <br /> tēṣāmanyatamapīḍāyāṁ samadhikā pīḍā bhavati, cētanānibandhavaiśēṣyāt| <br /> <br /> tatra śākhāśritēbhyō marmabhyaḥ skandhāśritāni garīyāṁsi, śākhānāṁ tadāśritatvāt; skandhāśritēbhyō'pi hr̥dvastiśirāṁsi, tanmūlatvāccharīrasya||3||<br /> <br /> saptottaraM marmashatamasmi~jcharIre skandhashAkhAsamAshritamagnivesha!| <br /> <br /> teShAmanyatamapIDAyAM samadhikA pIDA bhavati, cetanAnibandhavaisheShyAt| <br /> <br /> tatra shAkhAshritebhyo marmabhyaH skandhAshritAni garIyAMsi, shAkhAnAM tadAshritatvAt; skandhAshritebhyo~api hRudvastishirAMsi, tanmUlatvAccharIrasya||3||<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> Hey Agnivesha! There are 107 ''marmas'' in this ''sharira'' situated in the ''skandha'' (trunk) and ''shakha'' (extremities or limbs). Trauma or pain occurring in these areas is much more intense as compared to other parts because of ''chetana'' (life) is bound to these sites.<br /> <br /> The ''marmas'' related to ''skandha'' are more important than those situated in the ''shakha'' because the ''shakha'' is attached to the ''skandha'' and more so among the ''skandha'' situated ''marmas, hrid, basti'' and ''shiras'' are important owing to the fact that they are the root cause of body (on them depends the existence or otherwise of the body).[3]<br /> &lt;/div&gt;<br /> === Description of three vital organs ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र हृदये दश धमन्यः प्राणापानौ मनो बुद्धिश्चेतना महाभूतानि च नाभ्यामरा इव प्रतिष्ठितानि, शिरसि इन्द्रियाणि इन्द्रियप्राणवहानि च स्रोतांसि सूर्यमिव गभस्तयः संश्रितानि, बस्तिस्तु स्थूलगुदमुष्कसेवनीशुक्रमूत्रवाहिनीनां नाडी(ली)नां मध्ये मूत्रधारोऽम्बुवहानां सर्वस्रोतसामुदधिरिवापगानां प्रतिष्ठा, बहुभिश्च तन्मूलैर्मर्मसञ्ज्ञकैः स्रोतोभिर्गगनमिव दिनकरकरैर्व्याप्तमिदं शरीरम्||४||<br /> <br /> तेषां त्रयाणामन्यतमस्यापि भेदादाश्वेव शरीरभेदः स्यात्, आश्रयनाशादाश्रितस्यापि विनाशः; तदुपघातात्तु घोरतरव्याधिप्रादुर्भावः; तस्मादेतानि विशेषेण रक्ष्याणि बाह्याभिघाद्वातादिभ्यश्च||५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra hr̥dayē daśa dhamanyaḥ prāṇāpānau manō buddhiścētanā mahābhūtāni ca nābhyāmarā iva pratiṣṭhitāni, śirasi indriyāṇi indriyaprāṇavahāni ca srōtāṁsi sūryamiva gabhastayaḥ saṁśritāni, bastistu sthūlagudamuṣkasēvanīśukramūtravāhinīnāṁ nāḍī(lī)nāṁ m adhyē mūtradhārō'mbuvahānāṁ sarvasrōtasāmudadhirivāpagānāṁ pratiṣṭhā, bahubhiśca tanmūlairmarmasañjñakaiḥ srōtōbhirgaganamiva dinakarakarairvyāptamidaṁ śarīram||4|| <br /> <br /> tēṣāṁ trayāṇāmanyatamasyāpi bhēdādāśvēva śarīrabhēdaḥ syāt, āśrayanāśādāśritasyāpi vināśaḥ; tadupaghātāttu ghōrataravyādhiprādurbhāvaḥ; tasmādētāni viśēṣēṇa rakṣyāṇi bāhyābhighādvātādibhyaśca||5||<br /> <br /> tatra hRudaye dasha dhamanyaH prANApAnau mano buddhishcetanA mahAbhUtAni ca nAbhyAmarA iva pratiShThitAni, shirasi indriyANi indriyaprANavahAni casrotAMsi sUryamiva gabhastayaH saMshritAni, bastistu sthUlagudamuShkasevanIshukramUtravAhinInAM nADI(lI)nAM madhye mUtradhAro~ambuvahAnAMsarvasrotasAmudadhirivApagAnAM pratiShThA , bahubhishca tanmUlairmarmasa~jj~jakaiH srotobhirgaganamiva dinakarakarairvyAptamidaM sharIram||4|| <br /> <br /> teShAM trayANAmanyatamasyApi bhedAdAshveva sharIrabhedaH syAt, AshrayanAshAdAshritasyApi vinAshaH; tadupaghAtAttu ghorataravyAdhiprAdurbhAvaH;tasmAdetAni visheSheNa rakShyANi bAhyAbhighAdvAtAdibhyashca||5|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> In the ''hridaya'' (heart), are situated the ten ''dhamani'' (ten great vessels arising from the heart), ''prana, apana, manas'' (mind), ''buddhi'' (intellect), ''chetana'' (life), ''[[mahabhuta]]s'' (5 fundamental elements) just like spokes to the axle in the center of a wheel. <br /> <br /> In the ''shiras'' (head) are situated the ''[[indriya]]s'' (the seat of special senses), the ''srotas'' (channels) pertaining to the conduction of ''[[indriya]]'' and ''prana'' like the radiating spicules of the rays of sunlight. <br /> <br /> The ''basti'' (bladder) situated in the midst of ''sthula guda'' (rectum), ''mushka'' (scrotum), ''sevani'' (perineal raphe), ''nadis'' carrying ''[[mutra]]'' (urine) and ''[[shukra]]'' (semen) is the ''mutradhara'' (reservoir of urine) in to which drain all the ''ambuvaha srotas'', similar to the ''udadhi'' (sea/ ocean) into which drain all the rivers. Hence, the body may be described to be pervaded by innumerable ''srotas'' nourishing ''marmas'' similar to the sky which is pervaded by the rays of sunlight. <br /> <br /> Among all the ''marmas, bheda'' (injury) to these 3 ''marmas'' (''hridaya, shiras'' and ''basti'') leads to sudden loss to the body. The destruction of substance (''ashraya'') leads to the destruction of the substrate. Its injury leads to severe disease manifestation. Hence, these should be especially protected against external injury and ''vatadi [[dosha]]s''.[5]<br /> &lt;/div&gt;<br /> === Clinical signs of injury to three ''marmas'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र हृद्यभिहते कासश्वासबलक्षयकण्ठशोषक्लोमाकर्षणजिह्वानिर्गममुखतालुशोषापस्मारोन्मादप्रलापचित्तनाशादयः स्युः; शिरस्यभिहते मन्यास्तम्भार्दितचक्षुर्विभ्रममोहोद्वेष्टनचेष्टानाशकासश्वासहनुग्रहमूकगद्गदत्वाक्षिनिमीलन- गण्डस्पन्दनजृम्भणलालास्रावस्वरहानिवदनजिह्मत्वादीनि, बस्तौ तु वातमूत्रवर्चोनिग्रहवङ्क्षणमेहनबस्तिशूलकुण्डलोदावर्तगुल्मानिलाष्ठीलोपस्तम्भनाभिकुक्षिगुदश्रोणिग्रहादयः; वाताद्युपसृष्टानां त्वेषां लिङ्गानि चिकित्सिते सक्रियाविधीन्युक्तानि||६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra hr̥dyabhihatē kāsaśvāsabalakṣayakaṇṭhaśōṣaklōmākarṣaṇajihvānirgamamukhatāluśōṣāpasmārōnmādapralāpacittanāśādayaḥ syuḥ; śirasyabhihatē manyāstambhārditacakṣurvibhramamōhōdvēṣṭanacēṣṭānāśakāsaśvāsahanugrahamūkagadgadatvākṣinimīlana- gaṇḍaspandanajr̥mbhaṇalālāsrāvasvarahānivadanajihmatvādīni, bastau tu vātamūtravarcōnigrahavaṅkṣaṇamēhanabastiśūlakuṇḍalōdāvartagulmānilāṣṭhīlōpastambhanābhikukṣigudaśrōṇigrahādayaḥ ; vātādyupasr̥ṣṭānāṁ tvēṣāṁ liṅgāni cikitsitē sakriyāvidhīnyuktāni||6||<br /> <br /> tatra hRudyabhihate kAsashvAsabalakShayakaNThashoShaklomAkarShaNajihvAnirgamamukhatAlushoShApasmAronmAdapralApacittanAshAdayaH syuH; shirasyabhihate manyAstambhArditacakShurvibhramamohodveShTanaceShTAnAshakAsashvAsahanugrahamUkagadgadatvAkShinimIlana- gaNDaspandanajRumbhaNalAlAsrAvasvarahAnivadanajihmatvAdIni, bastau tu vAtamUtravarconigrahava~gkShaNamehanabastishUlakuNDalodAvartagulmAnilAShThIlopastambhanAbhikukShigudashroNigrahAdayaH; vAtAdyupasRuShTAnAM tveShAM li~ggAni cikitsite sakriyAvidhInyuktAni||6||<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> Injury to the ''hridaya'' leads to ''kasa'' (cough), ''shwasa'' (breathlessness), ''balakshaya'' (weakness), ''kantashosha'' (dryness of throat), ''klomakarshana'' (a form of severe chest pain), ''jihvanirgama'' (prolapse of tongue), ''mukhashosha'' (dryness of mouth), ''talushosha'' (dryness of palate), ''apasmara'' (epilepsy), ''unmada'' (psychosis), ''pralapa'' (irrelevant speech), ''chittanahsa'' (loss of mental integrity) etc.<br /> <br /> Injury to the ''shiras'' leads to ''manyastambha'' (stiffness of neck), ''ardita'' (hemiplegia with facial palsy), ''chakshuvibhrama'' (improper movements of eyeball/lesions in sight), ''moha'' (a state of confusion), ''udveshtana'' (twisting pain in the head), ''cheshtanasha'' (loss of body functions), ''kasa'' (cough), ''shwasa'' (breathlessness), ''hanugraha'' (stiffness of jaw), ''muka'' (dumbness), ''gadgada'' (hoarseness of voice), ''akshinimilana'' (ptosis), ''gandaspandana'' (twitching in cheek), ''jrambhana'' (excessive yawning), ''lalasrava'' (dribbling of saliva), ''svarahani'' (aphonia), ''vadana jihmatva'' (deviation of face) etc.<br /> <br /> Affliction of ''basti'' causes ''[[vata]]- [[mutra]]- varcha nigraha'' (retention of flatus, urine and stools), ''vankshana- mehana- basti shula'' (pain in groin, genitals and bladder region), ''kundala'' (retrogressive movement of ''[[vata]]'' or ''[[mutra]]''), ''udavarta'' (reflux of ''[[vata]]'' or ''[[mutra]]''), ''gulma'' (abdominal lumps ), ''anila asthila'' (a solid mass due to aggravated ''[[vata]]''), ''upastambha'' (obstruction or retention of urine), ''nabhi- kukshi- guda- shroni graha'' (stiffness in umbilicus, epigastrium, rectum and pelvis) etc. <br /> <br /> These mentioned symptoms due to affliction by ''vatadi [[dosha]]s'' have been explained in [[Chikitsa Sthana]] with their management. [6]<br /> &lt;/div&gt;<br /> === Importance of ''[[vata dosha]]'' and ''[[basti]]'' therapy ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> किन्त्वेतानि विशेषतोऽनिलाद्रक्ष्याणि, अनिलो हि पित्तकफसमुदीरणे हेतुः प्राणमूलं च, स बस्तिकर्मसाध्यतमः, तस्मान्न बस्तिसमं किञ्चित् कर्म मर्मपरिपालनमस्ति| <br /> तत्र षडास्थापनस्कन्धान् विमाने द्वौ चानुवासनस्कन्धाविह च विहितान् बस्तीन् बुद्ध्या विचार्य महामर्मपरिपालनार्थं प्रयोजयेद्वातव्याधिचिकित्सां च||७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kintvētāni viśēṣatō'nilādrakṣyāṇi, anilō hi pittakaphasamudīraṇē hētuḥ prāṇamūlaṁ ca, sa bastikarmasādhyatamaḥ, tasmānna bastisamaṁ kiñcit karma marmaparipālanamasti| <br /> tatra ṣaḍāsthāpanaskandhān vimānē dvau cānuvāsanaskandhāviha ca vihitān bastīn buddhyā vicārya mahāmarmaparipālanārthaṁ prayōjayēdvātavyādhicikitsāṁ ca||7||<br /> <br /> kintvetAni visheShato~anilAdrakShyANi, anilo hi pittakaphasamudIraNe hetuH prANamUlaM ca, sa bastikarmasAdhyatamaH, tasmAnna bastisamaM ki~jcit karma marmaparipAlanamasti| <br /> tatra ShaDAsthApanaskandhAn vimAne dvau cAnuvAsanaskandhAviha ca vihitAn bastIn buddhyA vicArya mahAmarmaparipAlanArthaM prayojayedvAtavyAdhicikitsAM ca||7||<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> However, these ''marmas'' have to be protected especially from ''anila'' (''[[vata]]''), as ''[[vata]]'' is the prime factor or cause for the aggravation of ''[[pitta]]'' and ''[[kapha]]'' and also it is the cause of ''prana'' (life) and is best palliable by ''[[basti]]''. Hence, there is no treatment better than ''[[basti]]'' to maintain the ''marma''. Hereby, the six ''asthapana skandhas'' (decoction enemas) and also the two ''anuvasana skandhas'' described in [[Vimana Sthana]], as well as the ''[[basti]]s'' described in [[Siddhi Sthana]] with the treatment of ''vatavyadhi chikitsa'' may be rationally employed in the protection and restoration of the ''maha marmas'' (three great ''marmas'').[7]<br /> &lt;/div&gt;<br /> === Management of ''marma'' disorders ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भूयश्च हृद्युपसृष्टे हिङ्गुचूर्णं लवणानामन्यतमचूर्णसंयुक्तं मातुलुङ्गस्य रसेनान्येन वाऽम्लेन हृद्येन वा पाययेत्, स्थिरादिपञ्चमूलीरसः सशर्करः पानार्थं, बिल्वादिपञ्चमूलरससिद्धा च यवागूः, हृद्रोगविहितं च कर्म; मूर्ध्नि तु वातोपसृष्टेऽभ्यङ्गस्वेदनोपनाहस्नेहपाननस्तःकर्मावपीडनधूमादीनि; बस्तौ तु कुम्भीस्वेदः, वर्तयः, श्यामादिभिर्गोमूत्रसिद्धो निरूहः, बिल्वादिभिश्च सुरासिद्धः, शरकाशेक्षुदर्भगोक्षुरकमूलशृतक्षीरैश्च त्रपुसैर्वारुखराश्वाबीजयवर्षभकवृद्धिकल्कितो निरूहः, पीतदारुसिद्धतैलेनानुवासनं, तैल्वकं च सर्पिर्विरेकार्थं, शतावरीगोक्षुरकबृहतीकण्टकारिकागुडूचीपुनर्नवोशीरमधुकद्विसारिवालोध्रश्रेयसीकुशकाशमूलकषायक्षीरचतुर्गुणं बलावृषर्षभकखराश्वोपकुञ्चिकावत्सकत्रपुसैर्वारुबीजशितिवारकमधुकवचाशतपुष्पाश्मभेदकवर्षाभूमदनफलकल्कसिद्धं तैलमुत्तरबस्तिर्निरूहो वा शुद्धस्निग्धस्विन्नस्य बस्तिशूलमूत्रविकारहर इति||८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhūyaśca hr̥dyupasr̥ṣṭē hiṅgucūrṇaṁ lavaṇānāmanyatamacūrṇasaṁyuktaṁ mātuluṅgasya rasēnānyēna vā'mlēna hr̥dyēna vā pāyayēt, sthirādipañcamūlīrasaḥ saśarkaraḥ pānārthaṁ, bilvādipañcamūlarasasiddhā ca yavāgūḥ, hr̥drōgavihitaṁ ca karma; mūrdhni tu vātōpasr̥ṣṭē'bhyaṅgasvēdanōpanāhasnēhapānanastaḥkarmāvapīḍanadhūmādīni; bastau tu kumbhīsvēdaḥ, vartayaḥ, śyāmādibhirgōmūtrasiddhō nirūhaḥ, bilvādibhiśca surāsiddhaḥ, śarakāśēkṣudarbhagōkṣurakamūlaśr̥takṣīraiśca trapusairvārukharāśvābījayavarṣabhakavr̥ddhikalkitō nirūhaḥ, pītadārusiddhatailēnānuvāsanaṁ, tailvakaṁ ca sarpirvirēkārthaṁ, śatāvarīgōkṣurakabr̥hatīkaṇṭakārikāguḍūcīpunarnavōśīramadhukadvisārivālōdhraśrēyasīkuśakāśamūlakaṣāyakṣīracaturguṇaṁ balāvr̥ṣarṣabhakakharāśvōpakuñcikāvatsakatrapusairvārubījaśitivārakamadhukavacāśatapuṣpāśmabhēdakavarṣābhūmadanaphalakalkasiddhaṁ tailamuttarabastirnirūhō vā śuddhasnigdhasvinnasya bastiśūlamūtravikārahara iti||8|| <br /> <br /> bhUyashca hRudyupasRuShTe hi~ggucUrNaM lavaNAnAmanyatamacUrNasaMyuktaM mAtulu~ggasya rasenAnyena vA~amlena hRudyena vA pAyayet, sthirAdipa~jcamUlIrasaH sasharkaraH pAnArthaM, bilvAdipa~jcamUlarasasiddhA ca yavAgUH, hRudrogavihitaM ca karma; mUrdhni tu vAtopasRuShTe~abhya~ggasvedanopanAhasnehapAnanastaHkarmAvapIDanadhUmAdIni; bastau tu kumbhIsvedaH, vartayaH, shyAmAdibhirgomUtrasiddho nirUhaH, bilvAdibhishca surAsiddhaH, sharakAshekShudarbhagokShurakamUlashRutakShIraishca trapusairvArukharAshvAbIjayavarShabhakavRuddhikalkito nirUhaH, pItadArusiddhatailenAnuvAsanaM, tailvakaM ca sarpirvirekArthaM, shatAvarIgokShurakabRuhatIkaNTakArikAguDUcIpunarnavoshIramadhukadvisArivAlodhrashreyasIkushakAshamUlakaShAyakShIracaturguNaM balAvRuSharShabhakakharAshvopaku~jcikAvatsakatrapusairvArubIjashitivArakamadhukavacAshatapuShpAshmabhedakavarShAbhUmadanaphalakalkasiddhaM tailamuttarabastirnirUho vA shuddhasnigdhasvinnasya bastishUlamUtravikArahara iti||8||<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> When the ''hridaya'' is predominantly affected, one should consume powdered ''hingu'' (asafetida) with ''lavana'' (rock salt) (primary base, in a powdered form) admixed with juice of ''matulunga'' (Citrus indica) or any other juice which is predominantly sour in taste and liked by the individual. ''Sthiradi panchamula'' (Five roots comprising ''sthira/ salaparni''- Desmodium gangeticum, ''Prishniparni''- Uraria picta, ''brihati''- Solanum indicum, ''kantakari''- Solanum surattense/ xanthocarpum, ''gokshura''- Tribulus terrestris) ''rasa'' with sugar for drinking, ''yavagu'' (porridge) prepared out of ''bilvadi panchamula'' (five great roots comprising ''bilva''- Aegle marmelos, ''agnimantha''- Clerodendrum phlomides, ''syonaka''- Oroxylum indicum , ''patala''- Stereospermum tetragonum , ''Gambhari''- Gmelina arborea) ''rasa'', treatment modalities described under ''hridroga''.<br /> <br /> When ''murdhni'' (shiras ) is afflicted by ''[[vata]], abhyanga'' (oil massage), ''sweda'' (fomentation), ''upanaha'' (poultice), ''snehapana'' (internal oleation), ''nastah'' ( nasal drug aministration errhines) such as ''avapidana'' (with ''churnas''), ''dhuma'' (smoke) should be employed.<br /> <br /> In disorders of ''basti, kumbhisweda'' ( a type of ''mahasweda'' described in [Cha.Sa.[[Sutra Sthana]] 14/56-58], ''varti prayoga'' (urethral suppository), ''niruha [[basti]]'' (decoction enema) prepared of ''shyamadi'' (Operculina turpethum etc) drugs with ''gomutra'' (Cows Urine) or ''bilvadi'' (Aegle marmelos etc) drugs with ''sura'' (fermented liquid), or with ''sara'' (Saccharum munja), ''kasa'' (Saccharum spontaneum), ''ikshu'' (Saccharum officinarum), ''darbha'' (Eragrostis cynosuroides/ Desmostachya bipinnata), ''gokshura'' (Tribulus terrestris), ''mulaka'' (Raphanus sativus) ''kvatha'' mixed with milk and paste of ''trapusa'' ( Cucumis sativus), ''ervaruka'' (Cucumis sativus- bitter), ''kharasvabija'' (Ajamoda- Apium graveolens), ''yava'' (Hordeum vulgare), ''rishabhaka'' (Microstylis muscifera Ridley ), ''vriddhi'' ((Habenaria intermedia D.Don syn. Habenaria arietina H.f.) ); ''anuvasana'' (Oil enema) with ''taila'' prepared from ''pitadaru'' (Berberis aristata), ghee prepared out of ''tilvaka'' (Symplocos racemosa or Viburnum sp.) for ''virechana'' (purgation); oil prepared out of ''kashaya'' (decoction) of ''shatavari'' (Asparagus racemosus), ''gokshura'' (Tribulus terrestris), ''brahati'' (Solanum indicum), ''kantakari'' (Solanum xanthocarpum), ''guduchi'' (Tinospora cordifolia), ''punarnava'' (Boerhavia diffusa), ''usira'' (Vetiveria zizanoides), ''madhuka'' (Glycyrrhiza glabra), 2 ''sariva''(''sveta sariva''- Hemidesmus indicus and ''krishna sariva''- Cryptolepis buchanana), ''lodhra'' (Symplocos racemosa), ''shreyasi'' (Cavya-Piper chaba), ''kusha'' (Desmostachys bipinnata), ''kasha'' (Saccharum spontaneum) roots, with 4 times ''kshira'' (milk), ''kalka''(paste) made of ''bala'' (Sida cordifolia), ''vrisha'' (Adhatoda vasica), ''rishabhaka'' (Microstylis muscifera Ridley ), ''kharashva'' (Ajamoda- Apium graveolens), ''upakunchika'' (Elatteria cardomum), ''vatsaka'' (Holarrhena antidysenterica), ''trapusha'' (Cucumis sativus), ''ervarubija'' (Cucumis sativus seeds), ''shitivaraka'' (Sunishannaka- Marsilea quadrifida), ''madhuka'' (Glycyrrhiza glabra), ''vacha'' (Acorus calamus), ''shatapushpa'' (Peucedanum graveolens/ Anethum graveolens), ''asmabhedaka'' (Bergenia ligulata), ''varshabhu'' (Trianthema monogyna/ crystallina), ''madanaphala'' (Randia spinosa) should be used for ''uttara basti'' (enema into urethral route), and ''niruha'' (decoction enema) after ''[[shodhana]]'' (purification) , in an individual who is ''snigdha svinna'' (who is properly oleated and fomented) alleviates ''basti shula'' (pain in ''basti'') and ''mutra vikara'' (urinary disorders). [8] <br /> &lt;/div&gt;<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भवन्ति चात्र श्लोकाः- &lt;br /&gt;<br /> <br /> हृदये मूर्ध्नि बस्तौ च नृणां प्राणाः प्रतिष्ठिताः| &lt;br /&gt;<br /> तस्मात्तेषां सदा यत्नं कुर्वीत परिपालने||९|| &lt;br /&gt;<br /> <br /> आबाधवर्जनं नित्यं स्वस्थवृत्तानुवर्तनम्| &lt;br /&gt;<br /> उत्पन्नार्तिविघातश्च मर्मणां परिपालनम्||१०||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhavanti cātra ślōkāḥ- &lt;br /&gt;<br /> <br /> hr̥dayē mūrdhni bastau ca nr̥ṇāṁ prāṇāḥ pratiṣṭhitāḥ| &lt;br /&gt;<br /> tasmāttēṣāṁ sadā yatnaṁ kurvīta paripālanē||9|| &lt;br /&gt;<br /> <br /> ābādhavarjanaṁ nityaṁ svasthavr̥ttānuvartanam| &lt;br /&gt;<br /> utpannārtivighātaśca marmaṇāṁ paripālanam||10||&lt;br /&gt;<br /> <br /> bhavanti cAtra shlokAH- &lt;br /&gt;<br /> <br /> hRudaye mUrdhni bastau ca nRuNAM prANAH pratiShThitAH| &lt;br /&gt;<br /> tasmAtteShAM sadA yatnaM kurvIta paripAlane||9|| &lt;br /&gt;<br /> <br /> AbAdhavarjanaM nityaM svasthavRuttAnuvartanam| &lt;br /&gt;<br /> utpannArtivighAtashca marmaNAM paripAlanam||10||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> Thereby concluding the ''Slokha''-<br /> <br /> In the ''hridaya, murdhna'' (head) and ''basti'' of individuals is situated the ''prana'' (life element) and hence attempts should be made to maintain ''paripalana'' (maintain normalcy) them. ''Abadhavarjana'' (avoidance of factors that cause affliction to ''marmas''), ''svasthavrittanuvartana'' (following the healthy regimen), ''utpannarti vighata'' (management of the existing conditions) ensures maintenance of ''marmas'' (''marma paripalana'').[9-10]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अत उर्ध्वं विकारा ये त्रिमर्मीये चिकित्सिते| &lt;br /&gt;<br /> न प्रोक्ता मर्मजास्तेषां कांश्चिद्वक्ष्यामि सौषधान्||११||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ata urdhvaṁ vikārā yē trimarmīyē cikitsitē|&lt;br /&gt; <br /> na prōktā marmajāstēṣāṁ kāṁścidvakṣyāmi sauṣadhān||11||&lt;br /&gt;<br /> <br /> ata urdhvaM vikArA ye trimarmIye cikitsite| &lt;br /&gt;<br /> na proktA marmajAsteShAM kAMshcidvakShyAmi sauShadhAn||11||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Hence forward, will be described some of the diseases related to ''marma'' that have not been described in the chapter [[Trimarmiya Chikitsa]], alongwith their treatment.[11]<br /> <br /> === Etiopathology of ''apatantraka'' (Opisthtomus) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्रुद्धः स्वैः कोपनैर्वायुः स्थानादूर्ध्वं प्रपद्यते| &lt;br /&gt;<br /> पीडयन् हृदयं गत्वा शिरः शङ्खौ च पीडयन्||१२|| &lt;br /&gt;<br /> <br /> धनुर्वन्नमयेद्गात्राण्याक्षिपेन्मोहयेत्तथा| &lt;br /&gt;<br /> (नमयेच्चाक्षिपेच्चाङ्गान्युच्छ्वासं निरुणद्धि च)| &lt;br /&gt;<br /> कृच्छ्रेण चाप्युच्छ्वसिति स्तब्धाक्षोऽथ निमीलकः ||१३|| &lt;br /&gt;<br /> <br /> कपोत इव कूजेच्च निःसञ्ज्ञः सोऽपतन्त्रकः| &lt;br /&gt;<br /> दृष्टिं संस्तम्भ्य सञ्ज्ञां च हत्वा कण्ठेन कूजति||१४|| &lt;br /&gt;<br /> <br /> हृदि मुक्ते नरः स्वास्थ्यं याति मोहं वृते पुनः| &lt;br /&gt;<br /> वायुना दारुणं प्राहुरेके तमपतानकम्||१५||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kruddhaḥ svaiḥ kōpanairvāyuḥ sthānādūrdhvaṁ prapadyatē| &lt;br /&gt;<br /> pīḍayan hr̥dayaṁ gatvā śiraḥ śaṅkhau ca pīḍayan||12|| &lt;br /&gt;<br /> <br /> dhanurvannamayēdgātrāṇyākṣipēnmōhayēttathā| &lt;br /&gt;<br /> (namayēccākṣipēccāṅgānyucchvāsaṁ niruṇaddhi ca)| &lt;br /&gt;<br /> kr̥cchrēṇa cāpyucchvasiti stabdhākṣō'tha nimīlakaḥ ||13|| &lt;br /&gt;<br /> <br /> kapōta iva kūjēcca niḥsañjñaḥ sō'patantrakaḥ| &lt;br /&gt;<br /> dr̥ṣṭiṁ saṁstambhya sañjñāṁ ca hatvā kaṇṭhēna kūjati||14|| &lt;br /&gt;<br /> <br /> hr̥di muktē naraḥ svāsthyaṁ yāti mōhaṁ vr̥tē punaḥ| &lt;br /&gt;<br /> vāyunā dāruṇaṁ prāhurēkē tamapatānakam||15||&lt;br /&gt;<br /> <br /> kruddhaH svaiH kopanairvAyuH sthAnAdUrdhvaM prapadyate| &lt;br /&gt;<br /> pIDayan hRudayaM gatvA shiraH sha~gkhau ca pIDayan||12|| &lt;br /&gt;<br /> <br /> dhanurvannamayedgAtrANyAkShipenmohayettathA| &lt;br /&gt;<br /> (namayeccAkShipeccA~ggAnyucchvAsaM niruNaddhi ca)| &lt;br /&gt;<br /> kRucchreNa cApyucchvasiti stabdhAkSho~atha nimIlakaH ||13|| &lt;br /&gt;<br /> <br /> kapota iva kUjecca niHsa~jj~jaH so~apatantrakaH| &lt;br /&gt;<br /> dRuShTiM saMstambhya sa~jj~jAM ca hatvA kaNThena kUjati||14|| &lt;br /&gt;<br /> <br /> hRudi mukte naraH svAsthyaM yAti mohaM vRute punaH| &lt;br /&gt;<br /> vAyunA dAruNaM prAhureke tamapatAnakam||15||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Vata]]'' aggaravated by its own causative factors moves upwards from its ''sthana'' (site), reaching the ''hridaya'' produces pain or discomfort in ''hridaya'' (heart) and also in ''shira'' (head) and ''shankha'' (temporal area). It causes a bow-like bending of the body, ''akshipet'' (involuntary jerks) and ''mohayet'' (altered consciousness). (It causes involuntary bending or contractures and jerky movements and also obstruction to breathing). The person breathes out with difficulty, has spasm of eye movements or drooping, makes cooing sounds like a dove, becomes unconscious. The condition is called ''apatantraka''. Some authors call a variant of this condition as ''apatanaka'', in which there is fixity of eyes (gaze fixed) and grunting sounds from throat. When ''hridaya'' is free of ''[[dosha]]s'' the person becomes healthy and becomes unconscious again when gets afflicted with ''[[dosha]]s'' and is due to severe aggravation of ''[[vata]]''. [12-15]<br /> <br /> === Management of ''apatantraka'' (opisthotomus) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> श्वसनं कफवाताभ्यां रुद्धं तस्य विमोक्षयेत्| &lt;br /&gt;<br /> तीक्ष्णैः प्रधमनैः सञ्ज्ञां तासु मुक्तासु विन्दति||१६|| &lt;br /&gt;<br /> <br /> मरिचं शिग्रुबीजानि विडङ्गं च फणिज्झकम्| &lt;br /&gt;<br /> एतानि सूक्ष्मचूर्णानि दद्याच्छीर्षविरेचनम्||१७|| &lt;br /&gt;<br /> <br /> तुम्बुरूण्यभया हिङ्गु पौष्करं लवणत्रयम्| &lt;br /&gt;<br /> यवक्वाथाम्बुना पेयं हृद्ग्रहे चापतन्त्रके ||१८|| &lt;br /&gt;<br /> <br /> हिङ्ग्वम्लवेतसं शुण्ठीं ससौवर्चलदाडिमम्| &lt;br /&gt;<br /> पिबेद्वातकफघ्नं च कर्म हृद्रोगनुद्धितम्||१९|| &lt;br /&gt;<br /> <br /> शोधना बस्तयस्तीक्ष्णा न हितास्तस्य कृत्स्नशः| &lt;br /&gt;<br /> सौवर्चलाभयाव्योषैः सिद्धं तस्मै घृतं हितम्||२०||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śvasanaṁ kaphavātābhyāṁ ruddhaṁ tasya vimōkṣayēt| &lt;br /&gt;<br /> tīkṣṇaiḥ pradhamanaiḥ sañjñāṁ tāsu muktāsu vindati||16|| &lt;br /&gt;<br /> <br /> maricaṁ śigrubījāni viḍaṅgaṁ ca phaṇijjhakam| &lt;br /&gt;<br /> ētāni sūkṣmacūrṇāni dadyācchīrṣavirēcanam||17|| &lt;br /&gt;<br /> <br /> tumburūṇyabhayā hiṅgu pauṣkaraṁ lavaṇatrayam| &lt;br /&gt;<br /> yavakvāthāmbunā pēyaṁ hr̥dgrahē cāpatantrakē ||18||&lt;br /&gt;<br /> <br /> hiṅgvamlavētasaṁ śuṇṭhīṁ sasauvarcaladāḍimam| &lt;br /&gt;<br /> pibēdvātakaphaghnaṁ ca karma hr̥drōganuddhitam||19|| &lt;br /&gt;<br /> <br /> śōdhanā bastayastīkṣṇā na hitāstasya kr̥tsnaśaḥ| &lt;br /&gt;<br /> sauvarcalābhayāvyōṣaiḥ siddhaṁ tasmai ghr̥taṁ hitam||20||&lt;br /&gt;<br /> <br /> shvasanaM kaphavAtAbhyAM ruddhaM tasya vimokShayet| &lt;br /&gt;<br /> tIkShNaiH pradhamanaiH sa~jj~jAM tAsu muktAsu vindati||16|| &lt;br /&gt;<br /> <br /> maricaM shigrubIjAni viDa~ggaM ca phaNijjhakam| &lt;br /&gt;<br /> etAni sUkShmacUrNAni dadyAcchIrShavirecanam||17|| &lt;br /&gt;<br /> <br /> tumburUNyabhayA hi~ggu pauShkaraM lavaNatrayam| &lt;br /&gt;<br /> yavakvAthAmbunA peyaM hRudgrahe cApatantrake ||18|| &lt;br /&gt;<br /> <br /> hi~ggvamlavetasaM shuNThIM sasauvarcaladADimam| &lt;br /&gt;<br /> pibedvAtakaphaghnaM ca karma hRudroganuddhitam||19|| &lt;br /&gt;<br /> <br /> shodhanA bastayastIkShNA na hitAstasya kRutsnashaH| &lt;br /&gt;<br /> sauvarcalAbhayAvyoShaiH siddhaM tasmai ghRutaM hitam||20||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The aggravated ''[[kapha]] [[vata]] [[dosha]]s'' cause obstruction to ''shvasana'' (breathing) which should be cleared by ''tikshna pradhamana [[nasya]]'' (powder blowing into nostrils). This restores the ''sanjna'' (consciousness). ''Sirsha virechana'' (purification of head) should be given using very fine powder of ''maricha'' (black peper/Piper indicum), ''shigrubija'' (seeds of Moringa olifera), ''vidanga'' (Embelia ribes) and ''phaninjjaka'' (Marubaka- Origanum majorana). In ''hridgraha'' (stiffness or tightness in Heart) and ''apatantraka'' one should consume ''tumburu'' (Zanthoxylum alatum), ''abhaya'' (Terminalia chebula fruit), ''hingu'' (Asafoetida), ''pushkara'' (Inula racemosa), three types of ''lavana'' (''saindhava, sauvarcala'' and ''bida lavana'') with decoction of ''yava'' (Hordeum vulgare). Consume ''hingu'' (Asafoetida), a''mlavetasa'' (Garcinia pedunculata), ''sunthi'' (Zingiber officinale), with ''sauvarchala'' (sorchal salt) and ''dadima'' (juice of pomergranate/ Punica granatum) and employ treatment that alleviates ''[[vata]] [[kapha]] [[dosha]]s'' and which cures ''hridroga'' (cardiac disorders). ''Tikshna shodhana [[basti]]'' (strong purificatory enemas) is totally unsuitable. ''Ghrita'' prepared by ''sauvarchala'' salt, ''abhaya'' (Terminalia chebula), ''vyosha'' (''pippali, maricha, sunthi'' i.e., Piper longum, Piper indicum and Zingiber officinale) is suitable. [16-20]<br /> <br /> === Etiopathology and treatment of ''tandra'' (drowsiness) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मधुरस्निग्धगुर्वन्नसेवनाच्चिन्तनाच्छ्रमात् | &lt;br /&gt;<br /> शोकाद्व्याध्यनुषङ्गाच्च वायुनोदीरितः कफः||२१|| &lt;br /&gt;<br /> <br /> यदाऽसौ समवस्कन्द्य हृदयं हृदयाश्रयान्| &lt;br /&gt;<br /> समावृणोति ज्ञानादींस्तदा तन्द्रोपजायते||२२|| &lt;br /&gt;<br /> <br /> हृदये व्याकुलीभावो वाक्चेष्टेन्द्रियगौरवम्| &lt;br /&gt;<br /> मनोबुद्ध्यप्रसादश्च तन्द्राया लक्षणं मतम्||२३|| &lt;br /&gt;<br /> <br /> कफघ्नं तत्र कर्तव्यं शोधनं शमनानि च| &lt;br /&gt;<br /> व्यायामो रक्तमोक्षश्च भोज्यं च कटुतिक्तकम्||२४||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> madhurasnigdhagurvannasēvanāccintanācchramāt | &lt;br /&gt;<br /> śōkādvyādhyanuṣaṅgācca vāyunōdīritaḥ kaphaḥ||21|| &lt;br /&gt;<br /> <br /> yadā'sau samavaskandya hr̥dayaṁ hr̥dayāśrayān| &lt;br /&gt;<br /> samāvr̥ṇōti jñānādīṁstadā tandrōpajāyatē||22|| &lt;br /&gt;<br /> <br /> hr̥dayē vyākulībhāvō vākcēṣṭēndriyagauravam| &lt;br /&gt;<br /> manōbuddhyaprasādaśca tandrāyā lakṣaṇaṁ matam||23|| &lt;br /&gt;<br /> <br /> kaphaghnaṁ tatra kartavyaṁ śōdhanaṁ śamanāni ca| &lt;br /&gt;<br /> vyāyāmō raktamōkṣaśca bhōjyaṁ ca kaṭutiktakam||24||&lt;br /&gt;<br /> <br /> madhurasnigdhagurvannasevanAccintanAcchramAt | &lt;br /&gt;<br /> shokAdvyAdhyanuSha~ggAcca vAyunodIritaH kaphaH||21|| &lt;br /&gt;<br /> <br /> yadA~asau samavaskandya hRudayaM hRudayAshrayAn| &lt;br /&gt;<br /> samAvRuNoti j~jAnAdIMstadA tandropajAyate||22|| &lt;br /&gt;<br /> <br /> hRudaye vyAkulIbhAvo vAkceShTendriyagauravam| &lt;br /&gt;<br /> manobuddhyaprasAdashca tandrAyA lakShaNaM matam||23|| &lt;br /&gt;<br /> <br /> kaphaghnaM tatra kartavyaM shodhanaM shamanAni ca| &lt;br /&gt;<br /> vyAyAmo raktamokShashca bhojyaM ca kaTutiktakam||24||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Due to consumption of ''anna'' (foods) that are ''madhura'' (sweet), ''snigdha'' (unctuous), ''guru'' (heavy to digest), ''chintana'' (excessive thinking), ''shrama'' (exertion), ''shoka'' (grief), ''vyadhyanushanga'' (chronicity of diseases), ''[[kapha]]'' aggravated by ''[[vata]]'' in association when gets lodged in ''hridaya'', obscures the process of ''jnana, tandra'' (drowsiness) occurs. The symptoms of ''tandra'' are ''hridaye vyakulibhava'' (uneasiness or discomfort in the region of heart), sluggishness of speech and physical activity, decreased acuity of the sense organs, clouding of mind and intellect. This condition should be managed by ''[[shodhana]]'' and ''shamana'' measures that are ''kaphahara, vyayama'' (exercise), ''[[raktamokshana]]'' (blood letting) and intake of foods that are predominantly ''katu'' (pungent) and ''tikta'' (bitter).[21-24]<br /> <br /> === Thirteen types of urinary disorders ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मूत्रौकसादो जठरं कृच्छ्रमुत्सङ्गसङ्क्षयौ| &lt;br /&gt;<br /> मूत्रातीतोऽनिलाष्ठीला वातबस्त्युष्णमारुतौ||२५|| &lt;br /&gt;<br /> <br /> वातकुण्डलिका ग्रन्थिर्विड्घातो बस्तिकुण्डलम्| &lt;br /&gt;<br /> त्रयोदशैते मूत्रस्य दोषास्ताँल्लिङ्गतः शृणु||२६||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mūtraukasādō jaṭharaṁ kr̥cchramutsaṅgasaṅkṣayau| &lt;br /&gt;<br /> mūtrātītō'nilāṣṭhīlā vātabastyuṣṇamārutau||25|| &lt;br /&gt;<br /> <br /> vātakuṇḍalikā granthirviḍghātō bastikuṇḍalam| &lt;br /&gt;<br /> trayōdaśaitē mūtrasya dōṣāstāmँlliṅgataḥ śr̥ṇu||26||&lt;br /&gt;<br /> <br /> mUtraukasAdo jaTharaM kRucchramutsa~ggasa~gkShayau| &lt;br /&gt;<br /> mUtrAtIto~anilAShThIlA vAtabastyuShNamArutau||25|| &lt;br /&gt;<br /> <br /> vAtakuNDalikA granthirviDghAto bastikuNDalam| &lt;br /&gt;<br /> trayodashaite mUtrasya doShAstA@mlli~ggataH shRuNu||26||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Mutraukasada''(dense urine), ''mutrajathara'' (accumulation of urine in abdominal cavity), ''mutrakrichchra'' (dysuria), ''mutrotsanga'' (residual urination), ''mutrasamkshaya'' (suppression of urine formation), ''mutratita'' (delayed micturition), ''vatashthila'' (hard globular swelling like tumor), ''vatabasti'' (vata affection of bladder), ''ushnavata'' (vata-pitta vitiation of urine/burning micturition), ''vatakundalika'' (scanty and painful flow of urine), ''granthi'' (cyst at the neck of bladder), ''vidghata'' (feces coming through urine) and ''bastikundala'' (circular distension of bladder) are the thirteen varieties of ''mutra dosha'' (urinary disorders) and listen to them with their symptoms.[25-26]<br /> <br /> === ''Mutraukasada'' (dense urine) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तं कफो द्वावपि वा बस्तौ संहन्यते यदा| &lt;br /&gt;<br /> मारुतेन तदा मूत्रं रक्तं पीतं घनं सृजेत्||२७|| &lt;br /&gt;<br /> <br /> सदाहं श्वेतसान्द्रं वा सर्वैर्वा लक्षणैर्युतम्| &lt;br /&gt;<br /> मूत्रौकसादं तं विद्यात् पित्तश्लेष्महरैर्जयेत्||२८||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pittaṁ kaphō dvāvapi vā bastau saṁhanyatē yadā| &lt;br /&gt;<br /> mārutēna tadā mūtraṁ raktaṁ pītaṁ ghanaṁ sr̥jēt||27|| &lt;br /&gt;<br /> <br /> sadāhaṁ śvētasāndraṁ vā sarvairvā lakṣaṇairyutam| &lt;br /&gt;<br /> mūtraukasādaṁ taṁ vidyāt pittaślēṣmaharairjayēt||28||&lt;br /&gt;<br /> <br /> pittaM kapho dvAvapi vA bastau saMhanyate yadA| &lt;br /&gt;<br /> mArutena tadA mUtraM raktaM pItaM ghanaM sRujet||27|| &lt;br /&gt;<br /> <br /> sadAhaM shvetasAndraM vA sarvairvA lakShaNairyutam| &lt;br /&gt;<br /> mUtraukasAdaM taM vidyAt pittashleShmaharairjayet||28||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Pitta]], [[kapha]]'' both or singly getting aggravated with ''[[vata]]'', when reach into the ''basti'' cause reddish, yellowish, thick urine to flow, with burning, or whitish, thick or with all the symptoms. The condition is called ''mutraukasada'' and should be treated with ''[[pitta]] [[kapha]]hara'' measures.[27-28]<br /> <br /> === ''Mutra jathara'' (accumulation of urine in abdominal cavity) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विधारणात् प्रतिहतं वातोदावर्तितं यदा| &lt;br /&gt;<br /> पूरयत्युदरं मूत्रं तदा तदनिमित्तरुक्||२९||&lt;br /&gt;<br /> <br /> अपक्तिमूत्रविट्सङ्गैस्तन्मूत्रजठरं वदेत्| &lt;br /&gt;<br /> मूत्रवैरेचनीं तत्र चिकित्सां सम्प्रयोजयेत्||३०|| &lt;br /&gt;<br /> <br /> हिङ्गुद्विरुत्तरं चूर्णं त्रिमर्मीये प्रकीर्तितम्| &lt;br /&gt;<br /> हन्यान्मूत्रोदरानाहमाध्मानं गुदमेढ्रयोः||३१||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vidhāraṇāt pratihataṁ vātōdāvartitaṁ yadā| &lt;br /&gt;<br /> pūrayatyudaraṁ mūtraṁ tadā tadanimittaruk||29|| &lt;br /&gt;<br /> <br /> apaktimūtraviṭsaṅgaistanmūtrajaṭharaṁ vadēt| &lt;br /&gt;<br /> mūtravairēcanīṁ tatra cikitsāṁ samprayōjayēt||30||&lt;br /&gt;<br /> <br /> hiṅgudviruttaraṁ cūrṇaṁ trimarmīyē prakīrtitam| &lt;br /&gt;<br /> hanyānmūtrōdarānāhamādhmānaṁ gudamēḍhrayōḥ||31||&lt;br /&gt;<br /> <br /> vidhAraNAt pratihataM vAtodAvartitaM yadA| &lt;br /&gt;<br /> pUrayatyudaraM mUtraM tadA tadanimittaruk||29|| &lt;br /&gt;<br /> <br /> apaktimUtraviTsa~ggaistanmUtrajaTharaM vadet| &lt;br /&gt;<br /> mUtravairecanIM tatra cikitsAM samprayojayet||30|| &lt;br /&gt;<br /> <br /> hi~ggudviruttaraM cUrNaM trimarmIye prakIrtitam| &lt;br /&gt;<br /> hanyAnmUtrodarAnAhamAdhmAnaM gudameDhrayoH||31||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Withholding the urge to urinate, causes ''[[vata]]'' to get obstructed in its normal pathway which causes ''udavarta'' (reversal of movements) and thereby the ''mutra'' fills up in the ''udara'' producing inconsistent pain, sense of indigestion, obstruction to the flow of ''[[mutra]]'' and ''vid''. This is called ''mutra jathara''. ''Mutra virechana chikitsa'' (diuresis) should be employed in this condition. ''Hingu dvirittara churna'' clears ''mutrodara'' (distension of abdomen due to urinary retention), ''anaha'' (simple distension due to indigestion or constipation), ''adhmana'' (distension with pain) of ''guda'' (anus) and ''medhra'' (phallum). [29-31]<br /> <br /> === ''Mutra krichchra'' (dysuria) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मूत्रितस्य व्यवायात्तु रेतो वातोद्धतं च्युतम्| &lt;br /&gt;<br /> पूर्वं मूत्रस्य पश्चाद्वा स्रवेत् कृच्छ्रं तदुच्यते||३२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mūtritasya vyavāyāttu rētō vātōddhataṁ cyutam| &lt;br /&gt;<br /> pūrvaṁ mūtrasya paścādvā sravēt kr̥cchraṁ taducyatē||32|| &lt;br /&gt;<br /> <br /> mUtritasya vyavAyAttu reto vAtoddhataM cyutam| &lt;br /&gt;<br /> pUrvaM mUtrasya pashcAdvA sravet kRucchraM taducyate||32||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Indulgence in sexual intercourse by a person with active urge to micturate causes affliction of the dislodged ''[[shukra]]'' (seminal secretions) which flows either before or after the urine stream and this is called ''mutra krichchra''.[32]<br /> <br /> === ''Mutrotsanga'' (residual urination) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> खवैगुण्यानिलाक्षेपैः किञ्चिन्मूत्रं च तिष्ठति| &lt;br /&gt;<br /> मणिसन्धौ स्रवेत् पश्चात्तदरुग्वाऽथ चातिरुक्||३३|| &lt;br /&gt;<br /> <br /> मूत्रोत्सङ्गः स विच्छिन्नमुच्छेषगुरुशेफसः | &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> khavaiguṇyānilākṣēpaiḥ kiñcinmūtraṁ ca tiṣṭhati| &lt;br /&gt;<br /> maṇisandhau sravēt paścāttadarugvā'tha cātiruk||33|| &lt;br /&gt;<br /> <br /> mūtrōtsaṅgaḥ sa vicchinnamucchēṣaguruśēphasaḥ| &lt;br /&gt;<br /> <br /> khavaiguNyAnilAkShepaiH ki~jcinmUtraM ca tiShThati| &lt;br /&gt;<br /> maNisandhau sravet pashcAttadarugvA~atha cAtiruk||33|| &lt;br /&gt;<br /> <br /> mUtrotsa~ggaH sa vicchinnamuccheShagurushephasaH | &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Due to ''khavaigunya'' (structural deformity) in the ''mutravaha srotas'', severe ''[[vata]]'' aggravation, some urine remains in the ''manisandhi'' (base of penis) and discharges sometime later either without pain or with severe pain. ''[[Mutra]]'' passes in ''vichchinna'' (split form) and ''uchchesha'' (with some residual urine in the enlarged or engorged penis) from the ''guru shepha'' (enlarged penis due to accumulation of excess urine in the penis). This is ''mutrotsanga''. [33-33½]<br /> <br /> === ''Mutra samkshaya'' (suppression of urine formation) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वाताकृतिर्भवेद्वातान्मूत्रे शुष्यति सङ्क्षयः||३४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vātākr̥tirbhavēdvātānmūtrē śuṣyati saṅkṣayaḥ||34||<br /> <br /> vAtAkRutirbhavedvAtAnmUtre shuShyati sa~gkShayaH||34|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Due to aggravation of ''[[vata]]'', the urine gets decreased with manifestation of ''vatakriti'' (symptoms of aggravated ''[[vata]]''). The condition is ''mutra kshaya''. [34]<br /> <br /> === ''Mutratita'' (delayed micturition) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चिरं धारयतो मूत्रं त्वरया न प्रवर्तते| &lt;br /&gt;<br /> मेहमानस्य मन्दं वा मूत्रातीतः स उच्यते||३५|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ciraṁ dhārayatō mūtraṁ tvarayā na pravartatē| &lt;br /&gt;<br /> mēhamānasya mandaṁ vā mūtrātītaḥ sa ucyatē||35||&lt;br /&gt;<br /> <br /> ciraM dhArayato mUtraM tvarayA na pravartate| &lt;br /&gt;<br /> mehamAnasya mandaM vA mUtrAtItaH sa ucyate||35|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In a person withholding for long, the urge to urinate, the urine does not flow instantly or flows with mild stream. This is called ''mutratita''.[35]<br /> <br /> === ''Ashthila'' (hard globular swelling like tumor) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आध्मापयन् बस्तिगुदं रुद्ध्वा वायुश्चलोन्नताम्| &lt;br /&gt;<br /> कुर्यात्तीव्रार्तिमष्ठीलां मूत्रविण्मार्गरोधिनीम्||३६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ādhmāpayan bastigudaṁ ruddhvā vāyuścalōnnatām| &lt;br /&gt;<br /> kuryāttīvrārtimaṣṭhīlāṁ mūtraviṇmārgarōdhinīm||36|| &lt;br /&gt;<br /> <br /> AdhmApayan bastigudaM ruddhvA vAyushcalonnatAm| &lt;br /&gt;<br /> kuryAttIvrArtimaShThIlAM mUtraviNmArgarodhinIm||36|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When ''[[vata]]'' obstructs the path of ''[[mutra]]'', it causes ''adhmana'' (distension) of ''basti'' (bladder area) and ''guda'' (rectal area) producing ''ashthila'' (stone like hard mass or swelling) which is ''chala'' (freely mobile), ''unnata'' (elevated) which causes ''tivra arti'' (severe pain) and ''vinmutrarodhini'' (obstruction to stools and urine). [36]<br /> <br /> === ''Vatabasti'' (''[[vata]]'' affliction of bladder) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मूत्रं धारयतो बस्तौ वायुः क्रुद्धो विधारणात्| &lt;br /&gt;<br /> मूत्ररोधार्तिकण्डूभिर्वातबस्तिः स उच्यते||३७|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mūtraṁ dhārayatō bastau vāyuḥ kruddhō vidhāraṇāt| &lt;br /&gt;<br /> mūtrarōdhārtikaṇḍūbhirvātabastiḥ sa ucyatē||37||&lt;br /&gt;<br /> <br /> mUtraM dhArayato bastau vAyuH kruddho vidhAraNAt| &lt;br /&gt;<br /> mUtrarodhArtikaNDUbhirvAtabastiH sa ucyate||37|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Withholding the urine in the ''basti'' causes ''[[vata]]'' to aggravate which causes ''mutrarodha'' (urinary obstruction), ''arti'' (pain), ''kandu'' (itching) and this is called ''vatabasti''. [37]<br /> <br /> === ''Ushnavata'' ((''vata-pitta'' affliction of urine/burning micturition) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> उष्मणा सोष्मकं मूत्रं शोषयन् रक्तपीतकम्| &lt;br /&gt;<br /> उष्णवातः सृजेत् कृच्छ्राद्बस्त्युपस्थार्तिदाहवान्||३८|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> uṣmaṇā sōṣmakaṁ mūtraṁ śōṣayan raktapītakam| &lt;br /&gt;<br /> uṣṇavātaḥ sr̥jēt kr̥cchrādbastyupasthārtidāhavān||38|| &lt;br /&gt;<br /> <br /> uShmaNA soShmakaM mUtraM shoShayan raktapItakam| &lt;br /&gt;<br /> uShNavAtaH sRujet kRucchrAdbastyupasthArtidAhavAn||38|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Due to indulgence in ''ushma'' (factors that increase the heat in the body), there will be ''mutra shosha'' (decrease in ''[[mutra]]''), ''raktapita mutra'' (reddish or yellowish urine), passed with difficulty (''krichchrat''), causing ''arti'' (pain) and ''daha'' (burning) in ''basti'' (urinary bladder) and ''upastha'' (genitalia). This is ''ushnavata''. [38]<br /> <br /> === ''Vatakundalika'' (scanty and painful flow of urine) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गतिसङ्गादुदावृत्तः स मूत्रस्थानमार्गयोः| &lt;br /&gt;<br /> मूत्रस्य विगुणो वायुर्भग्नव्याविद्धकुण्डली||३९|| &lt;br /&gt;<br /> <br /> मूत्रं विहन्ति संस्तम्भभङ्गगौरववेष्टनैः| &lt;br /&gt;<br /> तीव्ररुङ्मूत्रविट्सङ्गैर्वातकुण्डलिकेति सा||४०|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gatisaṅgādudāvr̥ttaḥ sa mūtrasthānamārgayōḥ| &lt;br /&gt;<br /> mūtrasya viguṇō vāyurbhagnavyāviddhakuṇḍalī||39|| &lt;br /&gt;<br /> <br /> mūtraṁ vihanti saṁstambhabhaṅgagauravavēṣṭanaiḥ| &lt;br /&gt;<br /> tīvraruṅmūtraviṭsaṅgairvātakuṇḍalikēti sā||40||&lt;br /&gt;<br /> <br /> gatisa~ggAdudAvRuttaH sa mUtrasthAnamArgayoH| &lt;br /&gt;<br /> mUtrasya viguNo vAyurbhagnavyAviddhakuNDalI||39|| &lt;br /&gt;<br /> <br /> mUtraM vihanti saMstambhabha~ggagauravaveShTanaiH| &lt;br /&gt;<br /> tIvraru~gmUtraviTsa~ggairvAtakuNDaliketi sA||40|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Due to ''gatisanga'' (obstruction in the pathway) of ''[[mutra]]'' in the ''mutrasthana'' (''mutrasaya'') and ''mutramarga'' (''mutravaha srotas''), the ''viguna vayu'' (aggravated ''[[vata]]'') becomes ''udavratta'' (reflux or moves in opposite direction) and thereby ''bhagna'' (broken), ''vyaviddha'' (zigzag) or ''kundali'' (rotatory) in its pathway. It then affects the ''[[mutra]]'' with ''samstambha'' (stiffness or rigidity), ''bhanga'' (breaking pain), ''gaurava'' (heaviness), ''veshtana'' (twisting pain), ''tivraruk'' (severe pain) and ''mutravitsanga'' (retention of urine and feces). The condition is called ''vata kundalika''. [39-40]<br /> <br /> === ''Raktagranthi'' (nodular swelling in bladder) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रक्तं वातकफाद्दुष्टं बस्तिद्वारे सुदारुणम्| &lt;br /&gt;<br /> ग्रन्थिं कुर्यात् स कृच्छ्रेण सृजेन्मूत्रं तदावृतम्||४१|| &lt;br /&gt;<br /> <br /> अश्मरीसमशूलं तं रक्तग्रन्थिं प्रचक्षते| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> raktaṁ vātakaphādduṣṭaṁ bastidvārē sudāruṇam| &lt;br /&gt;<br /> granthiṁ kuryāt sa kr̥cchrēṇa sr̥jēnmūtraṁ tadāvr̥tam||41|| &lt;br /&gt;<br /> <br /> aśmarīsamaśūlaṁ taṁ raktagranthiṁ pracakṣatē|&lt;br /&gt;<br /> <br /> raktaM vAtakaphAdduShTaM bastidvAre sudAruNam| &lt;br /&gt;<br /> granthiM kuryAt sa kRucchreNa sRujenmUtraM tadAvRutam||41|| &lt;br /&gt;<br /> <br /> ashmarIsamashUlaM taM raktagranthiM pracakShate| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Rakta]]'' getting vitiated by ''[[vata]]'' and ''[[kapha]]'', produces a grievous nodular swelling (''granthi'') which obstructs the ''[[mutra]]'' and as a result the ''[[mutra]]'' is eliminated with difficulty and pain similar to urinary calculus. The condition is called ''raktagranthi''. [41-41½]<br /> <br /> === ''Vid vighata'' (feces coming through urine) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रूक्षदुर्बलयोर्वातेनोदावृत्तं शकृद्यदा||४२|| &lt;br /&gt;<br /> <br /> मूत्रस्रोतः प्रपद्येत विट्संसृष्टं तदा नरः| &lt;br /&gt;<br /> विड्गन्धं मूत्रयेत् कृच्छ्राद्विड्विघातं विनिर्दिशेत्||४३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rūkṣadurbalayōrvātēnōdāvr̥ttaṁ śakr̥dyadā||42|| &lt;br /&gt;<br /> <br /> mūtrasrōtaḥ prapadyēta viṭsaṁsr̥ṣṭaṁ tadā naraḥ| &lt;br /&gt;<br /> viḍgandhaṁ mūtrayēt kr̥cchrādviḍvighātaṁ vinirdiśēt||43|| &lt;br /&gt;<br /> <br /> rUkShadurbalayorvAtenodAvRuttaM shakRudyadA||42|| &lt;br /&gt;<br /> <br /> mUtrasrotaH prapadyeta viTsaMsRuShTaM tadA naraH| &lt;br /&gt;<br /> viDgandhaM mUtrayet kRucchrAdviDvighAtaM vinirdishet||43||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In a ''ruksha'' (emaciated) and ''durbala'' (weak) person, due to aggravated ''[[vata]]'' when ''shakrita'' (stool matter) becomes ''udavarta'' (moves into other pathway) and enters the channels of ''[[mutra]]'', the person passes ''[[mutra]]'' admixed with stool matter bearing a fecal odor with difficulty. The condition is called ''vidvighata''.[42-43]<br /> <br /> === ''Basti kundala'' (circular distension of bladder) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्रुताध्वलङ्घनायासादभिघातात् प्रपीडनात्| &lt;br /&gt;<br /> स्वस्थानाद्वस्तिरुद्वृत्तः स्थूलस्तिष्ठति गर्भवत्||४४|| &lt;br /&gt;<br /> <br /> शूलस्पन्दनदाहार्तो बिन्दुं बिन्दुं स्रवत्यपि| &lt;br /&gt;<br /> पीडितस्तु सृजेद्धारां संस्तम्भोद्वेष्टनार्तिमान्||४५|| &lt;br /&gt;<br /> <br /> बस्तिकुण्डलमाहुस्तं घोरं शस्त्रविषोपमम्| &lt;br /&gt;<br /> पवनप्रबलं प्रायो दुर्निवारमबुद्धिभिः||४६|| &lt;br /&gt;<br /> <br /> तस्मिन् पित्तान्विते दाहः शूलं मूत्रविवर्णता| &lt;br /&gt;<br /> श्लेष्मणा गौरवं शोफः स्निग्धं मूत्रं घनं सितम्||४७|| &lt;br /&gt;<br /> <br /> श्लेष्मरुद्धबिलो बस्तिः पित्तोदीर्णो न सिध्यति| &lt;br /&gt;<br /> अविभ्रान्तबिलः साध्यो न तु यः कुण्डलीकृतः||४८|| &lt;br /&gt;<br /> <br /> स्याद्वस्तौ कुण्डलीभूते हृन्मोहः श्वास एव च|४९|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> drutādhvalaṅghanāyāsādabhighātāt prapīḍanāt| &lt;br /&gt;<br /> svasthānādvastirudvr̥ttaḥ sthūlastiṣṭhati garbhavat||44|| &lt;br /&gt;<br /> <br /> śūlaspandanadāhārtō binduṁ binduṁ sravatyapi| &lt;br /&gt;<br /> pīḍitastu sr̥jēddhārāṁ saṁstambhōdvēṣṭanārtimān||45||&lt;br /&gt; <br /> <br /> bastikuṇḍalamāhustaṁ ghōraṁ śastraviṣōpamam| &lt;br /&gt;<br /> pavanaprabalaṁ prāyō durnivāramabuddhibhiḥ||46|| <br /> <br /> tasmin pittānvitē dāhaḥ śūlaṁ mūtravivarṇatā| &lt;br /&gt;<br /> ślēṣmaṇā gauravaṁ śōphaḥ snigdhaṁ mūtraṁ ghanaṁ sitam||47|| &lt;br /&gt;<br /> <br /> ślēṣmaruddhabilō bastiḥ pittōdīrṇō na sidhyati| &lt;br /&gt;<br /> avibhrāntabilaḥ sādhyō na tu yaḥ kuṇḍalīkr̥taḥ||48|| &lt;br /&gt;<br /> <br /> syādvastau kuṇḍalībhūtē hr̥nmōhaḥ śvāsa ēva ca|49|| &lt;br /&gt;<br /> <br /> drutAdhvala~gghanAyAsAdabhighAtAt prapIDanAt| &lt;br /&gt;<br /> svasthAnAdvastirudvRuttaH sthUlastiShThati garbhavat||44|| &lt;br /&gt;<br /> <br /> shUlaspandanadAhArto binduM binduM sravatyapi| &lt;br /&gt;<br /> pIDitastu sRujeddhArAM saMstambhodveShTanArtimAn||45|| &lt;br /&gt;<br /> <br /> bastikuNDalamAhustaM ghoraM shastraviShopamam| &lt;br /&gt;<br /> pavanaprabalaM prAyo durnivAramabuddhibhiH||46|| &lt;br /&gt;<br /> <br /> tasmin pittAnvite dAhaH shUlaM mUtravivarNatA| &lt;br /&gt;<br /> shleShmaNA gauravaM shophaH snigdhaM mUtraM ghanaM sitam||47|| &lt;br /&gt;<br /> <br /> shleShmaruddhabilo bastiH pittodIrNo na sidhyati| &lt;br /&gt;<br /> avibhrAntabilaH sAdhyo na tu yaH kuNDalIkRutaH||48|| &lt;br /&gt;<br /> <br /> syAdvastau kuNDalIbhUte hRunmohaH shvAsa eva ca|49|&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Due to factors such as fast walking, fasting, exhaustion, injury and compression, the ''basti'' is displaced upwards giving the appearance of distended gravid uterus. The patient manifests with ''shula'' (severe pain), ''spandana'' (involuntary contractions or spasms) and ''daha'' (burning) and passes urine drop by drop. On straining there is streamed urine with ''samstambha'' (griping pain), ''udvestana'' (twisting pain) or ''arti'' (simple pain). The condition is called ''basti kundala'' and is similar to ''shastra'' (sharp weapon), ''visha'' (poison) in its action. The condition is dominant of ''[[vata]]'' and is incurable by the unintelligent.<br /> <br /> When ''[[vata]]'' is associated with ''[[pitta]]'', there occurs ''daha'' (burning), ''shula'' (colicky pain) and discoloration of urine.<br /> <br /> Association with ''[[kapha]]'' causes ''gaurava'' (heaviness), ''shopha'' (swelling), and the ''[[mutra]]'' is ''snigdha'' (unctuous), ''ghana'' (thick) and ''sita'' (whitish).<br /> <br /> When ''[[kapha]]'' obstructs the bladder neck or when ''[[pitta]]'' is severely aggravated it is incurable. If bladder neck is unobstructed, it is curable but not when there is circumgyration. When there is circumgyration in bladder it causes ''hrid moha'' (altered consciousness) and breathlessness. [44-48½]<br /> <br /> === Management of urinary disorders ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दोषाधिक्यमवेक्ष्यैतान् मूत्रकृच्छ्रहरैर्जयेत्॥४९॥<br /> <br /> बस्तिमुत्तरबस्तिं च सर्वेषामेव दापयेत् |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dōṣādhikyamavēkṣyaitān mūtrakr̥cchraharairjayēt||49|| <br /> <br /> bastimuttarabastiṁ ca sarvēṣāmēva dāpayēt|50|<br /> <br /> doShAdhikyamavekShyaitAn mUtrakRucchraharairjayet||49|| <br /> <br /> bastimuttarabastiM ca sarveShAmeva dApayet|50|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> These conditions should be examined in terms of dominance of ''[[dosha]]'' and treated by measures that relieve ''mutrakrichchra'' (dysuria). ''[[Basti]]'' (rectal enemas) and ''uttara basti'' (Bladder enemas) should be administered in all these conditions. [49-49½]<br /> <br /> === Description of ''uttara basti'' (urethral/per vaginal drug administration) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुष्पनेत्रं तु हैमं स्याच्छ्लक्ष्णमौत्तरबस्तिकम्||५०|| &lt;br /&gt;<br /> <br /> जात्यश्वहनवृन्तेन समं गोपुच्छसंस्थितम्| &lt;br /&gt;<br /> रौप्यं वा सर्षपच्छिद्रं द्विकर्णं द्वादशाङ्गुलम्||५१|| &lt;br /&gt;<br /> <br /> तेनाजबस्तियुक्तेन स्नेहस्यार्धपलं नयेत्| &lt;br /&gt;<br /> यथावयोविशेषेण स्नेहमात्रां विकल्प्य वा||५२|| &lt;br /&gt;<br /> <br /> स्नातस्य भुक्तभक्तस्य रसेन पयसाऽपि वा| &lt;br /&gt;<br /> सृष्टविण्मूत्रवेगस्य पीठे जानुसमे मृदौ||५३|| &lt;br /&gt;<br /> <br /> ऋजोः सुखोपविष्टस्य हृष्टे मेढ्रे घृताक्तया| &lt;br /&gt;<br /> शलाकयाऽन्विष्य गतिं यद्यप्रतिहता व्रजेत्||५४|| &lt;br /&gt;<br /> <br /> ततः शेफःप्रमाणेन पुष्पनेत्रं प्रवेशयेत्| &lt;br /&gt;<br /> गुदवन्मूत्रमार्गेण प्रणयेदनु सेवनीम्||५५|| &lt;br /&gt;<br /> <br /> हिंस्यादतिगतं बस्तिमूने स्नेहो न गच्छति| &lt;br /&gt;<br /> सुखं प्रपीड्य निष्कम्पं निष्कर्षेन्नेत्रमेव च||५६|| &lt;br /&gt;<br /> <br /> प्रत्यागते द्वितीयं च तृतीयं च प्रदापयेत्| &lt;br /&gt;<br /> अनागच्छन्नुपेक्ष्यस्तु रजनीव्युषितस्य च||५७||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> puṣpanētraṁ tu haimaṁ syācchlakṣṇamauttarabastikam||50|| &lt;br /&gt;<br /> <br /> jātyaśvahanavr̥ntēna samaṁ gōpucchasaṁsthitam| &lt;br /&gt;<br /> raupyaṁ vā sarṣapacchidraṁ dvikarṇaṁ dvādaśāṅgulam||51|| &lt;br /&gt;<br /> <br /> tēnājabastiyuktēna snēhasyārdhapalaṁ nayēt| &lt;br /&gt;<br /> yathāvayōviśēṣēṇa snēhamātrāṁ vikalpya vā||52|| &lt;br /&gt;<br /> <br /> snātasya bhuktabhaktasya rasēna payasā'pi vā| &lt;br /&gt;<br /> sr̥ṣṭaviṇmūtravēgasya pīṭhē jānusamē mr̥dau||53|| &lt;br /&gt;<br /> <br /> r̥jōḥ sukhōpaviṣṭasya hr̥ṣṭē mēḍhrē ghr̥tāktayā| &lt;br /&gt;<br /> śalākayā'nviṣya gatiṁ yadyapratihatā vrajēt||54|| &lt;br /&gt;<br /> <br /> tataḥ śēphaḥpramāṇēna puṣpanētraṁ pravēśayēt| &lt;br /&gt;<br /> gudavanmūtramārgēṇa praṇayēdanu sēvanīm||55|| &lt;br /&gt;<br /> <br /> hiṁsyādatigataṁ bastimūnē snēhō na gacchati| &lt;br /&gt;<br /> sukhaṁ prapīḍya niṣkampaṁ niṣkarṣēnnētramēva ca||56|| &lt;br /&gt;<br /> <br /> pratyāgatē dvitīyaṁ ca tr̥tīyaṁ ca pradāpayēt| &lt;br /&gt;<br /> anāgacchannupēkṣyastu rajanīvyuṣitasya ca||57||&lt;br /&gt;<br /> <br /> puShpanetraM tu haimaM syAcchlakShNamauttarabastikam||50|| &lt;br /&gt;<br /> <br /> jAtyashvahanavRuntena samaM gopucchasaMsthitam| &lt;br /&gt;<br /> raupyaM vA sarShapacchidraM dvikarNaM dvAdashA~ggulam||51|| &lt;br /&gt;<br /> <br /> tenAjabastiyuktena snehasyArdhapalaM nayet| &lt;br /&gt;<br /> yathAvayovisheSheNa snehamAtrAM vikalpya vA||52|| &lt;br /&gt;<br /> <br /> snAtasya bhuktabhaktasya rasena payasA~api vA| &lt;br /&gt;<br /> sRuShTaviNmUtravegasya pIThe jAnusame mRudau||53|| &lt;br /&gt;<br /> <br /> RujoH sukhopaviShTasya hRuShTe meDhre ghRutAktayA| &lt;br /&gt;<br /> shalAkayA~anviShya gatiM yadyapratihatA vrajet||54|| &lt;br /&gt;<br /> <br /> tataH shephaHpramANena puShpanetraM praveshayet| &lt;br /&gt;<br /> gudavanmUtramArgeNa praNayedanu sevanIm||55|| &lt;br /&gt;<br /> <br /> hiMsyAdatigataM bastimUne sneho na gacchati| &lt;br /&gt;<br /> sukhaM prapIDya niShkampaM niShkarShennetrameva ca||56|| &lt;br /&gt;<br /> <br /> pratyAgate dvitIyaM ca tRutIyaM ca pradApayet| &lt;br /&gt;<br /> rajanIvyuShitasya ca||57||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Pushpanetra'' (''uttara basti'' nozzle) used for ''uttara basti'' should be made of gold or silver, smooth, be similar to stalk of ''jati'' (Jasminum officinale), or ''asvahana'' (''Karavira''- Nerium odorum/ indicum) and like cow’s tail (tapering). It should be 12 ''angulas'' long, have two ridges (''dvikarna'') and ''sarshapachidra'' (permitting the passage of mustard seed). It fitted on to goats bladder, half ''pala'' (25ml) of ''sneha'' should be taken or the quantity of ''sneha'' should be judiciously calculated in consideration of the patient’s age. <br /> <br /> The patient having bathed, taken food with ''mamsarasa'' or milk, after clearing the urges of urine and feces, seated erect comfortably on a soft seat of knee height, the erect penis probed with a ''shalaka'' (metallic probe) duly lubricated with ghee and if found to be unobstructed, then in accordance with the size of penis the enema nozzle should be introduced as per the procedure of ''guda[[basti]]'' i.e., along the direction of perineal raphe. If it is excessively introduced it causes pain and if insufficiently introduced the ''[[snehana]]'' does not occur. After compressing the ''basti yantra'' (douche bag) without shaking and comfortably (without causing discomfort to the patient) the ''basti netra'' should be removed. In case, the ''[[basti]]'' medicine comes out, a second and even a third enema may be given. If it does not come out then it can be ignored for a night. [50-57]<br /> <br /> === ''Pippalyadi varti'' (medicated wick/suppository)===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पिप्पलीलवणागारधूमापामार्गसर्षपैः| &lt;br /&gt;<br /> वार्ताकुरसनिर्गुण्डीशम्पाकैः ससहाचरैः||५८||&lt;br /&gt;<br /> <br /> मूत्राम्लपिष्टैः सगुडैर्वर्तिं कृत्वा प्रवेशयेत्| &lt;br /&gt;<br /> अग्रे तु सर्षपाकारां पश्चार्धे माषसम्मिताम्||५९|| &lt;br /&gt;<br /> <br /> नेत्रदीर्घां घृताभ्यक्तां सुकुमारामभङ्गुराम्| &lt;br /&gt;<br /> नेत्रवन्मूत्रनाड्यां तु पायौ चाङ्गुष्ठसम्मिताम्||६०||&lt;br /&gt;<br /> <br /> स्नेहे प्रत्यागते ताभ्यामानुवासनिको विधिः| &lt;br /&gt;<br /> परिहारश्च सव्यापत् ससम्यग्दत्तलक्षणः||६१||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pippalīlavaṇāgāradhūmāpāmārgasarṣapaiḥ| &lt;br /&gt;<br /> vārtākurasanirguṇḍīśampākaiḥ sasahācaraiḥ||58|| &lt;br /&gt;<br /> <br /> mūtrāmlapiṣṭaiḥ saguḍairvartiṁ kr̥tvā pravēśayēt| &lt;br /&gt;<br /> agrē tu sarṣapākārāṁ paścārdhē māṣasammitām||59|| &lt;br /&gt;<br /> <br /> nētradīrghāṁ ghr̥tābhyaktāṁ sukumārāmabhaṅgurām| &lt;br /&gt;<br /> nētravanmūtranāḍyāṁ tu pāyau cāṅguṣṭhasammitām||60||&lt;br /&gt;<br /> <br /> snēhē pratyāgatē tābhyāmānuvāsanikō vidhiḥ| &lt;br /&gt;<br /> parihāraśca savyāpat sasamyagdattalakṣaṇaḥ||61||&lt;br /&gt;<br /> <br /> pippalIlavaNAgAradhUmApAmArgasarShapaiH| &lt;br /&gt;<br /> vArtAkurasanirguNDIshampAkaiH sasahAcaraiH||58|| &lt;br /&gt;<br /> <br /> mUtrAmlapiShTaiH saguDairvartiM kRutvA praveshayet| &lt;br /&gt;<br /> agre tu sarShapAkArAM pashcArdhe mAShasammitAm||59|| &lt;br /&gt;<br /> <br /> netradIrghAM ghRutAbhyaktAM sukumArAmabha~ggurAm| &lt;br /&gt;<br /> netravanmUtranADyAM tu pAyau cA~gguShThasammitAm||60|| &lt;br /&gt;<br /> <br /> snehe pratyAgate tAbhyAmAnuvAsaniko vidhiH| &lt;br /&gt;<br /> parihArashca savyApat sasamyagdattalakShaNaH||61|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Varti'' (suppository) prepared out of ''pippali'' (Piper longum), ''lavana'' (rock salt), ''agaradhuma'' (house soot), ''apamarga'' (Achyranthus aspera), ''sarshapa'' (Brassica campestris), ''vartaku'' (Solanum melongena), ''nirgundi'' juice (juice of Vitex negundo), ''shampaka'' (Cassia fistula), ''sahachara'' (Barleria prionitis), ''mutra'' (Urine of cattle etc. 8 animals), ''amla'' (''amlavarga dravyas'' like ''nimbuka'' etc) with ''gud'' (jaggery) all pounded together and ''varti'' prepared which is introduced into the urinary passage. The tip of ''varti'' should be of the size of ''sarshapa'' (seed of Brassica campestris) and the other end resembling ''masha'' (Phaseolus radiatus). In the ''mutranadi'' (urinary passage), it should be introduced like the ''bastinetra'' and in the ''payu'' (anal orifice) it should be of thickness upto 1 ''angushta''. When the ''sneha'' comes out, it should be followed by ''anuvasana basti vidhi'' (procedures mentioned in the after care of ''anuvasana basti''). The ''vyapat'' (complications), their management and symptoms of proper administration are also similar to ''anuvasana basti'' procedure.[58-61]<br /> <br /> === Time of administration of ''uttara basti'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्त्रीणामार्तवकाले तु प्रतिकर्म तदाचरेत्| &lt;br /&gt;<br /> गर्भासना सुखं स्नेहं तदाऽऽदत्ते ह्यपावृता||६२|| &lt;br /&gt;<br /> <br /> गर्भं योनिस्तदा शीघ्रं जिते गृह्णाति मारुते| &lt;br /&gt;<br /> बस्तिजेषु विकारेषु योनिविभ्रंशजेषु च||६३|| &lt;br /&gt;<br /> <br /> योनिशूलेषु तीव्रेषु योनिव्यापत्स्वसृग्दरे| &lt;br /&gt;<br /> अप्रस्रवति मूत्रे च बिन्दुं बिन्दुं स्रवत्यपि||६४||&lt;br /&gt;<br /> <br /> विदध्यादुत्तरं बस्तिं यथास्वौषधसंस्कृतम् |६५|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> strīṇāmārtavakālē tu pratikarma tadācarēt| &lt;br /&gt;<br /> garbhāsanā sukhaṁ snēhaṁ tadā''dattē hyapāvr̥tā||62|| &lt;br /&gt;<br /> <br /> garbhaṁ [1] yōnistadā śīghraṁ jitē gr̥hṇāti mārutē| &lt;br /&gt;<br /> bastijēṣu vikārēṣu yōnivibhraṁśajēṣu ca||63|| &lt;br /&gt;<br /> <br /> yōniśūlēṣu tīvrēṣu yōnivyāpatsvasr̥gdarē| &lt;br /&gt;<br /> aprasravati mūtrē ca binduṁ binduṁ sravatyapi||64|| &lt;br /&gt;<br /> <br /> vidadhyāduttaraṁ bastiṁ yathāsvauṣadhasaṁskr̥tam [2] |65| &lt;br /&gt;<br /> <br /> strINAmArtavakAle tu pratikarma tadAcaret| &lt;br /&gt;<br /> garbhAsanA sukhaM snehaM tadA~a~adatte hyapAvRutA||62|| &lt;br /&gt;<br /> <br /> garbhaM [1] yonistadA shIghraM jite gRuhNAti mArute| &lt;br /&gt;<br /> bastijeShu vikAreShu yonivibhraMshajeShu ca||63|| &lt;br /&gt;<br /> <br /> yonishUleShu tIvreShu yonivyApatsvasRugdare| &lt;br /&gt;<br /> aprasravati mUtre ca binduM binduM sravatyapi||64|| &lt;br /&gt;<br /> <br /> vidadhyAduttaraM bastiM yathAsvauShadhasaMskRutam [2] |65|&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In women, ''uttara basti'' should be administered immediately after the menses as the vagina is then open and easily receives the ''sneha'' administered, thereby the ''[[vata]]'' being subdued, it easily becomes impregnable. ''Uttara basti'' with appropriate medicines should be administered in disorders of ''basti'' (Urinary bladder), prolapse of uterus, severe pain related to uterus, 20 diseases of uterus and vagina (described in [Cha.Sa.[[Chikitsa Sthana]] 30th chapter], menorrhagia-metrorrhagia conditions, retention of urine and dribbling incontinence.[62-64½]<br /> <br /> === Dimensions of nozzle for ''uttara basti'' and its procedure ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुष्पनेत्रप्रमाणं तु प्रमदानां दशाङ्गुलम्||६५|| &lt;br /&gt;<br /> <br /> मूत्रस्रोतःपरीणाहं मुद्गस्रोतोऽनुवाहि च| &lt;br /&gt;<br /> अपत्यमार्गे नारीणां विधेयं चतुरङ्गुलम्||६६|| &lt;br /&gt;<br /> <br /> द्व्यङ्गुलं मूत्रमार्गे तु बालायास्त्वेकमङ्गुलम्| &lt;br /&gt;<br /> उत्तानायाः शयानायाः सम्यक् सङ्कोच्य सक्थिनी||६७|| &lt;br /&gt;<br /> <br /> अथास्याः प्रणयेन्नेत्रमनुवंशगतं सुखम्| &lt;br /&gt;<br /> द्विस्त्रिश्चतुरिति स्नेहानहोरात्रेण योजयेत्||६८|| &lt;br /&gt;<br /> <br /> बस्तौ, बस्तौ प्रणीते च वर्तिः पीनतरा भवेत्| &lt;br /&gt;<br /> त्रिरात्रं कर्म कुर्वीत स्नेहमात्रां विवर्धयेत्||६९|| &lt;br /&gt;<br /> <br /> अनेनैव विधानेन कर्म कुर्यात् पुनस्त्र्यहात्|७०|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> puṣpanētrapramāṇaṁ tu pramadānāṁ daśāṅgulam||65|| &lt;br /&gt;<br /> <br /> mūtrasrōtaḥparīṇāhaṁ mudgasrōtō'nuvāhi ca| &lt;br /&gt;<br /> apatyamārgē nārīṇāṁ vidhēyaṁ caturaṅgulam||66||&lt;br /&gt;<br /> <br /> dvyaṅgulaṁ mūtramārgē tu bālāyāstvēkamaṅgulam| &lt;br /&gt;<br /> uttānāyāḥ śayānāyāḥ samyak saṅkōcya sakthinī||67|| &lt;br /&gt;<br /> <br /> athāsyāḥ praṇayēnnētramanuvaṁśagataṁ sukham| &lt;br /&gt;<br /> dvistriścaturiti snēhānahōrātrēṇa yōjayēt||68|| &lt;br /&gt;<br /> <br /> bastau, bastau praṇītē ca vartiḥ pīnatarā bhavēt| &lt;br /&gt;<br /> trirātraṁ karma kurvīta snēhamātrāṁ vivardhayēt||69|| &lt;br /&gt;<br /> <br /> anēnaiva vidhānēna karma kuryāt punastryahāt|70|&lt;br /&gt;<br /> <br /> puShpanetrapramANaM tu pramadAnAM dashA~ggulam||65|| &lt;br /&gt;<br /> <br /> mUtrasrotaHparINAhaM mudgasroto~anuvAhi ca| &lt;br /&gt;<br /> apatyamArge nArINAM vidheyaM catura~ggulam||66|| &lt;br /&gt;<br /> <br /> dvya~ggulaM mUtramArge tu bAlAyAstvekama~ggulam| &lt;br /&gt;<br /> uttAnAyAH shayAnAyAH samyak sa~gkocya sakthinI||67|| &lt;br /&gt;<br /> <br /> athAsyAH praNayennetramanuvaMshagataM sukham| &lt;br /&gt;<br /> dvistrishcaturiti snehAnahorAtreNa yojayet||68|| &lt;br /&gt;<br /> <br /> bastau, bastau praNIte ca vartiH pInatarA bhavet| &lt;br /&gt;<br /> trirAtraM karma kurvIta snehamAtrAM vivardhayet||69||&lt;br /&gt;<br /> <br /> anenaiva vidhAnena karma kuryAt punastryahAt|70|&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''uttarabasti'' nozzle for females should be 10 ''angulas'' in length, circumference as equal to that of urethra and its inner lumen permitting a seed of ''mudga'' (whole green gram/ phaseolus mungo). It should be introduced to a length of 4 ''angulas'' in the genital tract and 2 ''angulas'' into urinary tract for adult females and 1 ''angula'' for ''bala'' (unmarried below 16 years of age). The lady lying down supine with thighs folded upon itself, should be introduced the nozzle comfortably in the direction parallel to the spine. Two, three or four unctuous enemas may be administered in a span of 24 hours. The ''varti'' (suppository) to be administered for elimination of ''[[basti]]'' medicament should be thicker than the enema nozzle. This ''uttarabasti'' should be done for three consecutive nights with gradual increase in the dose of unctuous medicament. The procedure should be likewise repeated after 3 days.[65-69½]<br /> <br /> === Etiopathology and management of diseases of Head ===<br /> <br /> ==== ''Shankhaka'' (temporal headache) ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अतः शिरोविकाराणां कश्चिद्भेदः प्रवक्ष्यते||७०|| &lt;br /&gt;<br /> <br /> रक्तपित्तानिला दुष्टाः शङ्खदेशे विमूर्च्छिताः| &lt;br /&gt;<br /> तीव्ररुग्दाहरागं हि शोफं कुर्वन्ति दारुणम्||७१|| &lt;br /&gt;<br /> <br /> स शिरो विषवद्वेगी निरुध्याशु गलं तथा| &lt;br /&gt;<br /> त्रिरात्राज्जीवितं हन्ति शङ्खको नाम नामतः||७२|| &lt;br /&gt;<br /> <br /> परं त्र्यहाज्जीवति चेत् प्रत्याख्यायाचरेत् क्रियाम्| &lt;br /&gt;<br /> शिरोविरेकसेकादि सर्वं वीसर्पनुच्च यत्||७३||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ataḥ śirōvikārāṇāṁ kaścidbhēdaḥ pravakṣyatē||70|| &lt;br /&gt;<br /> <br /> raktapittānilā duṣṭāḥ śaṅkhadēśē vimūrcchitāḥ| &lt;br /&gt;<br /> tīvrarugdāharāgaṁ hi śōphaṁ kurvanti dāruṇam||71|| &lt;br /&gt;<br /> <br /> sa śirō viṣavadvēgī nirudhyāśu galaṁ tathā| &lt;br /&gt;<br /> trirātrājjīvitaṁ hanti śaṅkhakō nāma nāmataḥ||72|| &lt;br /&gt;<br /> <br /> paraṁ tryahājjīvati cēt pratyākhyāyācarēt kriyām| &lt;br /&gt;<br /> śirōvirēkasēkādi sarvaṁ vīsarpanucca yat||73||&lt;br /&gt;<br /> <br /> ataH shirovikArANAM kashcidbhedaH pravakShyate||70|| &lt;br /&gt;<br /> <br /> raktapittAnilA duShTAH sha~gkhadeshe vimUrcchitAH| &lt;br /&gt;<br /> tIvrarugdAharAgaM hi shophaM kurvanti dAruNam||71|| &lt;br /&gt;<br /> <br /> sa shiro viShavadvegI nirudhyAshu galaM tathA| &lt;br /&gt;<br /> trirAtrAjjIvitaM hanti sha~gkhako nAma nAmataH||72|| &lt;br /&gt;<br /> <br /> paraM tryahAjjIvati cet pratyAkhyAyAcaret kriyAm| &lt;br /&gt;<br /> shirovirekasekAdi sarvaM vIsarpanucca yat||73||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Here after shall be elaborated certain diseases of the head. The aggravated ''[[rakta]], [[pitta]]'' and ''[[vata]]'' getting lodged in the ''shankhadesha'' (temporal area) produce a severe painful swelling with redness. It is acute in manifestation like poison and obstructs the channels of the head and neck, killing the patient in 3 nights. If the patient survives beyond these 3 days, then considering the condition as ''pratyakhyeya'' (incurable but manageable) one should administer treatment modalities such as ''shirovirecha'' (errhines), ''seka'' (affusions) etc., which are curative of ''visarpa'' (erysipelas like lesions).[70-73]<br /> <br /> ==== ''Ardhavabhedaka'' (migraine affecting one side of head) ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रूक्षात्यध्यशनात् पूर्ववातावश्यायमैथुनैः| &lt;br /&gt;<br /> वेगसन्धारणायासव्यायामैः कुपितोऽनिलः||७४|| &lt;br /&gt;<br /> <br /> केवलः सकफो वाऽर्धं गृहीत्वा शिरसस्ततः| &lt;br /&gt;<br /> मन्याभ्रूशङ्खकर्णाक्षिललाटार्धेऽतिवेदनाम्||७५|| &lt;br /&gt;<br /> <br /> शस्त्रारणिनिभां कुर्यात्तीव्रां सोऽर्धावभेदकः| &lt;br /&gt;<br /> नयनं वाऽथवा श्रोत्रमतिवृद्धो विनाशयेत्||७६|| &lt;br /&gt;<br /> <br /> चतुःस्नेहोत्तमा मात्रा शिरःकायविरेचनम्| &lt;br /&gt;<br /> नाडीस्वेदो घृतं जीर्णं बस्तिकर्मानुवासनम्||७७||&lt;br /&gt; <br /> <br /> उपनाहः शिरोबस्तिर्दहनं चात्र शस्यते| &lt;br /&gt;<br /> प्रतिश्याये शिरोरोगे यच्चोद्दिष्टं चिकित्सितम्||७८||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rūkṣātyadhyaśanāt pūrvavātāvaśyāyamaithunaiḥ| &lt;br /&gt;<br /> vēgasandhāraṇāyāsavyāyāmaiḥ kupitō'nilaḥ||74|| &lt;br /&gt;<br /> <br /> kēvalaḥ sakaphō vā'rdhaṁ gr̥hītvā śirasastataḥ| &lt;br /&gt;<br /> manyābhrūśaṅkhakarṇākṣilalāṭārdhē'tivēdanām||75|| &lt;br /&gt;<br /> <br /> śastrāraṇinibhāṁ kuryāttīvrāṁ sō'rdhāvabhēdakaḥ| &lt;br /&gt;<br /> nayanaṁ vā'thavā śrōtramativr̥ddhō vināśayēt||76|| &lt;br /&gt;<br /> <br /> catuḥsnēhōttamā mātrā śiraḥkāyavirēcanam| &lt;br /&gt;<br /> nāḍīsvēdō ghr̥taṁ jīrṇaṁ bastikarmānuvāsanam||77|| &lt;br /&gt;<br /> <br /> upanāhaḥ śirōbastirdahanaṁ cātra śasyatē| &lt;br /&gt;<br /> pratiśyāyē śirōrōgē yaccōddiṣṭaṁ cikitsitam||78||&lt;br /&gt;<br /> <br /> rUkShAtyadhyashanAt pUrvavAtAvashyAyamaithunaiH| &lt;br /&gt;<br /> vegasandhAraNAyAsavyAyAmaiH kupito~anilaH||74|| &lt;br /&gt;<br /> <br /> kevalaH sakapho vA~ardhaM gRuhItvA shirasastataH| &lt;br /&gt;<br /> manyAbhrUsha~gkhakarNAkShilalATArdhe~ativedanAm||75|| &lt;br /&gt;<br /> <br /> shastrAraNinibhAM kuryAttIvrAM so~ardhAvabhedakaH| &lt;br /&gt;<br /> nayanaM vA~athavA shrotramativRuddho vinAshayet||76|| &lt;br /&gt;<br /> <br /> catuHsnehottamA mAtrA shiraHkAyavirecanam| &lt;br /&gt;<br /> nADIsvedo ghRutaM jIrNaM bastikarmAnuvAsanam||77|| &lt;br /&gt;<br /> <br /> upanAhaH shirobastirdahanaM cAtra shasyate| &lt;br /&gt;<br /> pratishyAye shiroroge yaccoddiShTaM cikitsitam||78||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Vata]]'' aggravated due to consumption of ''ruksha'' (dry/ ununctuous) substances, excessive quantity or frequent intake (''adhyashana''), easterly breeze, dew/snow, sexual intercourse, withholding of urges, exhaustion and exercise, either singly or along with ''[[kapha]]'', affecting either half of the head produces severe pain in neck, eyebrow, temples, ear, eye, forehead of one side. The condition is acutely severe like a sharp weapon or fire-log and is called ''ardhavabhedaka''. The condition when severe may impair the functions of an eye or an ear. The 4 ''snehas'' (''taila, ghrita, vasa'' and ''majja'') in the maximum dose, ''kayavirechana'' (purgation), ''sirovirechana'' (purificatory errhines), ''nadisweda'', 10 year old ghee, oil enemas, poultices, ''shirobasti'', cautery are advocated here. The management told for ''pratishyaya'' (rhinitis) and headaches as mentioned should also be employed appropriately. [74-78]<br /> <br /> ==== ''Suryavarta'' (headache increasing after sun-rise and in noon) ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सन्धारणादजीर्णाद्यैर्मस्तिष्कं रक्तमारुतौ| &lt;br /&gt;<br /> दुष्टौ दूषयतस्तच्च दुष्टं ताभ्यां विमूर्च्छितम्||७९||&lt;br /&gt;<br /> <br /> सूर्योदयेंऽशुसन्तापाद्द्रवं विष्यन्दते शनैः| &lt;br /&gt;<br /> ततो दिने शिरःशूलं दिनवृद्ध्या विवर्धते||८०|| &lt;br /&gt;<br /> <br /> दिनक्षये ततः स्त्याने मस्तिष्के सम्प्रशाम्यति| &lt;br /&gt;<br /> सूर्यावर्तः स तत्र स्यात् सर्पिरौत्तरभक्तिकम्||८१|| &lt;br /&gt;<br /> <br /> शिरःकायविरेकौ च मूर्ध्ना त्रिस्नेहधारणम् | &lt;br /&gt;<br /> जाङ्गलैरुपनाहश्च घृतक्षीरैश्च सेचनम् ||८२|| &lt;br /&gt;<br /> <br /> बर्हितित्तिरिलावादिशृतक्षीरोत्थितं घृतम्| &lt;br /&gt;<br /> स्यान्नावनं जीवनीयक्षीराष्टगुणसाधितम्||८३||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sandhāraṇādajīrṇādyairmastiṣkaṁ raktamārutau| &lt;br /&gt;<br /> duṣṭau dūṣayatastacca duṣṭaṁ tābhyāṁ vimūrcchitam||79|| &lt;br /&gt;<br /> <br /> sūryōdayēṁ'śusantāpāddravaṁ viṣyandatē śanaiḥ| &lt;br /&gt;<br /> tatō dinē śiraḥśūlaṁ dinavr̥ddhyā vivardhatē||80|| &lt;br /&gt;<br /> <br /> dinakṣayē tataḥ styānē mastiṣkē sampraśāmyati| &lt;br /&gt;<br /> sūryāvartaḥ sa tatra syāt sarpirauttarabhaktikam||81|| &lt;br /&gt;<br /> <br /> śiraḥkāyavirēkau ca mūrdhnā trisnēhadhāraṇam | &lt;br /&gt;<br /> jāṅgalairupanāhaśca ghr̥takṣīraiśca sēcanam ||82|| &lt;br /&gt;<br /> <br /> barhitittirilāvādiśr̥takṣīrōtthitaṁ ghr̥tam| &lt;br /&gt;<br /> syānnāvanaṁ jīvanīyakṣīrāṣṭaguṇasādhitam||83||&lt;br /&gt;<br /> <br /> sandhAraNAdajIrNAdyairmastiShkaM raktamArutau| &lt;br /&gt;<br /> duShTau dUShayatastacca duShTaM tAbhyAM vimUrcchitam||79|| &lt;br /&gt;<br /> <br /> sUryodayeM~ashusantApAddravaM viShyandate shanaiH| &lt;br /&gt;<br /> tato dine shiraHshUlaM dinavRuddhyA vivardhate||80|| &lt;br /&gt;<br /> <br /> dinakShaye tataH styAne mastiShke samprashAmyati| &lt;br /&gt;<br /> sUryAvartaH sa tatra syAt sarpirauttarabhaktikam||81|| &lt;br /&gt;<br /> <br /> shiraHkAyavirekau ca mUrdhnA trisnehadhAraNam | &lt;br /&gt;<br /> jA~ggalairupanAhashca ghRutakShIraishca secanam ||82|| &lt;br /&gt;<br /> <br /> barhitittirilAvAdishRutakShIrotthitaM ghRutam| &lt;br /&gt;<br /> syAnnAvanaM jIvanIyakShIrAShTaguNasAdhitam||83|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Witholding the urges, indigestion etc. leads to the vitiation of ''[[rakta]]'' and ''[[vata]]'' which in turn vitiate the ''mastishka'' (brain). Thus, affected by the vitiated ''[[rakta]]'' and ''[[vata]]'', at sunrise due to the heat of sunrays these slowly liquefy and thereby during the day there is headache which increases with the day. At the end of the day as they solidify, the headache subsides. The condition is called ''suryavarta'' and is managed by post-prandial ghee consumption, ''shirovireka'' (purificatory errhines), ''kayavireka'' (purgation), ''shiropichu'' (holding a gauze or piece of cotton soaked in medicated oil over the vertex) or ''shirobasti'' (holding medicated oil in a circular tank like formation over the head) with ''trisnehas'', poultices prepared with ''jangala mamsa'' (meat of animals living in dry lands), affusions with ghee and milk, ghee (''[[nasya]]'') errhines prepared out of ''ksheerapaka'' of ''barhi, tittiri, lava'' (birds that live on land) etc. and ''navana'' (unctuous errhines) with ghee processed with 8 parts milk and ''jeevaniya'' drugs (''jeevaka, jeevanti''- Leptadenia reticulata, ''rishabhaka, kakoli, kshirakakoli'' etc.).[79-83]<br /> <br /> === ''Anantavata'' (pulsating headache involving all areas of head) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> (उपवासातिशोकातिरूक्षशीताल्पभोजनैः)| &lt;br /&gt;<br /> दुष्टा दोषास्त्रयो मन्यापश्चाद्घाटासु वेदनाम्||८४|| &lt;br /&gt;<br /> <br /> तीव्रां कुर्वन्ति सा चाक्षिभ्रूशङ्खेष्ववतिष्ठते| &lt;br /&gt;<br /> स्पन्दनं गण्डपार्श्वस्य नेत्ररोगं हनुग्रहम्||८५|| &lt;br /&gt;<br /> <br /> सोऽनन्तवातस्तं हन्यात् सिरार्कावर्तनाशनैः| &lt;br /&gt;<br /> वातो रूक्षादिभिः क्रुद्धः शिरःकम्पमुदीरयेत्||८६|| &lt;br /&gt;<br /> <br /> तत्रामृताबलारास्नामहाश्वेताश्वगन्धकैः| &lt;br /&gt;<br /> स्नेहस्वेदादि वातघ्नं शस्तं नस्यं च तर्पणम्||८७||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> (upavāsātiśōkātirūkṣaśītālpabhōjanaiḥ)| &lt;br /&gt;<br /> duṣṭā dōṣāstrayō manyāpaścādghāṭāsu vēdanām||84|| &lt;br /&gt;<br /> <br /> tīvrāṁ kurvanti sā cākṣibhrūśaṅkhēṣvavatiṣṭhatē| &lt;br /&gt;<br /> spandanaṁ gaṇḍapārśvasya nētrarōgaṁ hanugraham||85|| &lt;br /&gt;<br /> <br /> sō'nantavātastaṁ hanyāt sirārkāvartanāśanaiḥ| &lt;br /&gt;<br /> vātō rūkṣādibhiḥ kruddhaḥ śiraḥkampamudīrayēt||86|| &lt;br /&gt;<br /> <br /> tatrāmr̥tābalārāsnāmahāśvētāśvagandhakaiḥ| &lt;br /&gt;<br /> snēhasvēdādi vātaghnaṁ śastaṁ nasyaṁ ca tarpaṇam||87||&lt;br /&gt;<br /> <br /> (upavAsAtishokAtirUkShashItAlpabhojanaiH)| &lt;br /&gt;<br /> duShTA doShAstrayo manyApashcAdghATAsu vedanAm||84|| &lt;br /&gt;<br /> <br /> tIvrAM kurvanti sA cAkShibhrUsha~gkheShvavatiShThate| &lt;br /&gt;<br /> spandanaM gaNDapArshvasya netrarogaM hanugraham||85|| &lt;br /&gt;<br /> <br /> so~anantavAtastaM hanyAt sirArkAvartanAshanaiH| &lt;br /&gt;<br /> vAto rUkShAdibhiH kruddhaH shiraHkampamudIrayet||86|| &lt;br /&gt;<br /> <br /> tatrAmRutAbalArAsnAmahAshvetAshvagandhakaiH| &lt;br /&gt;<br /> snehasvedAdi vAtaghnaM shastaM nasyaM ca tarpaNam||87||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The three ''[[dosha]]s'' aggravated due to fasting, severe grief, consumption of food which is ununctuous, cold and less in quantity, producing severe pain in ''manya'' (antero lateral part of neck) and then ''ghata'' (posterior part of neck). Later the pain localizes to the eye, eyebrow and temples, causes twitching in the cheek, diseases of the eye and stiffness of the jaw. The condition is called ''anantavata''. <br /> It is treated by ''siravyadha'' (venesection) and medicines that cure ''suryavarta''. The ''[[vata]]'' aggravated by ''ruksha'' etc factors produces tremors of the head. In this condition ''amrita'' (Tinospora cordifolia), ''bala'' (Sida cordifolia), ''rasna'' (Pluchea lanceolata), ''mahashveta'' (Clitoria ternatea Linn.), ''ashvagandha'' (Withania sommifera) which are alleviators of ''[[vata]]'' should be used for oleation, fomentation and ''tarpana [[nasya]]'' (nourishing errhines) should be employed.[84-87]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नस्तःकर्म च कुर्वीत शिरोरोगेषु शास्त्रविद्| &lt;br /&gt;<br /> द्वारं हि शिरसो नासा तेन तद् व्याप्य हन्ति तान्||८८|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nastaḥkarma ca kurvīta śirōrōgēṣu śāstravid| &lt;br /&gt;<br /> dvāraṁ hi śirasō nāsā tēna tad vyāpya hanti tān||88|| &lt;br /&gt;<br /> <br /> nastaHkarma ca kurvIta shirorogeShu shAstravid| &lt;br /&gt;<br /> dvAraM hi shiraso nAsA tena tad vyApya hanti tAn||88||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A physician proficient in the [[Ayurveda]] scriptures should employ ''[[nasya]] karma'' (errhines) in diseases of the head as the nose being the gateway of head, the medicines administered thereby pervades into the head and cures diseases pertaining to the head.[88]<br /> <br /> === Types of ''[[nasya]]'' (nasal drug delivery therapy) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नावनं चावपीडश्च ध्मापनं धूम एव च| &lt;br /&gt;<br /> प्रतिमर्शश्च विज्ञेयं नस्तःकर्म तु पञ्चधा||८९|| &lt;br /&gt;<br /> <br /> स्नेहनं शोधनं चैव द्विविधं नावनं स्मृतम्| &lt;br /&gt;<br /> शोधनः स्तम्भनश्च स्यादवपीडो द्विधा मतः ||९०|| &lt;br /&gt;<br /> <br /> चूर्णस्याध्मापनं तद्धि देहस्रोतोविशोधनम् | &lt;br /&gt;<br /> विज्ञेयस्त्रिविधो धूमः प्रागुक्तः शमनादिकः||९१||&lt;br /&gt;<br /> <br /> प्रतिमर्शो भवेत् स्नेहो निर्दोष उभयार्थकृत्| &lt;br /&gt;<br /> एवं तद्रेचनं कर्म तर्पणं शमनं त्रिधा||९२||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nāvanaṁ cāvapīḍaśca dhmāpanaṁ dhūma ēva ca| &lt;br /&gt;<br /> pratimarśaśca vijñēyaṁ nastaḥkarma tu pañcadhā||89|| &lt;br /&gt;<br /> <br /> snēhanaṁ śōdhanaṁ caiva dvividhaṁ nāvanaṁ smr̥tam| &lt;br /&gt;<br /> śōdhanaḥ stambhanaśca syādavapīḍō dvidhā mataḥ ||90|| &lt;br /&gt;<br /> <br /> cūrṇasyādhmāpanaṁ taddhi dēhasrōtōviśōdhanam | &lt;br /&gt;<br /> vijñēyastrividhō dhūmaḥ prāguktaḥ śamanādikaḥ||91|| &lt;br /&gt;<br /> <br /> pratimarśō bhavēt snēhō nirdōṣa ubhayārthakr̥t| &lt;br /&gt;<br /> ēvaṁ tadrēcanaṁ karma tarpaṇaṁ śamanaṁ tridhā||92||&lt;br /&gt;<br /> <br /> nAvanaM cAvapIDashca dhmApanaM dhUma eva ca| &lt;br /&gt;<br /> pratimarshashca vij~jeyaM nastaHkarma tu pa~jcadhA||89|| &lt;br /&gt;<br /> <br /> snehanaM shodhanaM caiva dvividhaM nAvanaM smRutam| &lt;br /&gt;<br /> shodhanaH stambhanashca syAdavapIDo dvidhA mataH ||90|| &lt;br /&gt;<br /> <br /> cUrNasyAdhmApanaM taddhi dehasrotovishodhanam | &lt;br /&gt;<br /> vij~jeyastrividho dhUmaH prAguktaH shamanAdikaH||91|| &lt;br /&gt;<br /> <br /> pratimarsho bhavet sneho nirdoSha ubhayArthakRut| &lt;br /&gt;<br /> evaM tadrecanaM karma tarpaNaM shamanaM tridhA||92||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Nasya]] karma'' is said to be of 5 types- ''navana'' (unctuous errhines), ''avapida'' (expressed errhines), ''dhmapana'' (powder errhines), ''dhuma'' (smoke inhalation) and ''pratimarsha'' (low dose unctuous errhines). ''Navana'' (unctuous errhines) is of two types viz, ''snehana'' (oleating) and ''shodhana'' (purificatory). ''Avapida'' (Expressed errhine) is of two types-''shodhana'' (purificatory) and ''stambhana'' (astringent). Blowing of ''churna'' (powder errhine) is said to cleanse the body passages. ''Dhuma'' (smoke inhalation) is said to be of three types ie, ''shamana'' etc (palliative, oleating and purificatory) as mentioned before. ''Pratimarsha'' is an oleative type of errhine without any adverse effects whatsoever and serves both (oleation and purification). Hence, the above mentioned 5 types of errhines fall into 3 categories – ''rechana'' (purificatory), ''tarpana'' (nourishing) and ''samana'' (palliative). [89-92]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्तम्भसुप्तिगुरुत्वाद्याः श्लैष्मिका ये शिरोगदाः| &lt;br /&gt;<br /> शिरोविरेचनं तेषु नस्तःकर्म प्रशस्यते||९३|| &lt;br /&gt;<br /> <br /> ये च वातात्मका रोगाः शिरःकम्पार्दितादयः| &lt;br /&gt;<br /> शिरसस्तर्पणं तेषु नस्तःकर्म प्रशस्यते ||९४|| &lt;br /&gt;<br /> <br /> रक्तपित्तादिरोगेषु शमनं नस्यमिष्यते| &lt;br /&gt;<br /> ध्मापनं धूमपानं च तथा योग्येषु शस्यते ||९५|| &lt;br /&gt;<br /> <br /> (दोषादिकं समीक्ष्यैव भिषक् सम्यक् च कारयेत्)|९६|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> stambhasuptigurutvādyāḥ ślaiṣmikā yē śirōgadāḥ| &lt;br /&gt;<br /> śirōvirēcanaṁ tēṣu nastaḥkarma praśasyatē||93|| &lt;br /&gt;<br /> <br /> yē ca vātātmakā rōgāḥ śiraḥkampārditādayaḥ| &lt;br /&gt;<br /> śirasastarpaṇaṁ tēṣu nastaḥkarma praśasyatē ||94|| &lt;br /&gt;<br /> <br /> raktapittādirōgēṣu śamanaṁ nasyamiṣyatē| &lt;br /&gt;<br /> dhmāpanaṁ dhūmapānaṁ ca tathā yōgyēṣu śasyatē ||95||&lt;br /&gt;<br /> <br /> (dōṣādikaṁ samīkṣyaiva bhiṣak samyak ca kārayēt)|96|&lt;br /&gt;<br /> <br /> stambhasuptigurutvAdyAH shlaiShmikA ye shirogadAH| &lt;br /&gt;<br /> shirovirecanaM teShu nastaHkarma prashasyate||93|| &lt;br /&gt;<br /> <br /> ye ca vAtAtmakA rogAH shiraHkampArditAdayaH| &lt;br /&gt;<br /> shirasastarpaNaM teShu nastaHkarma prashasyate ||94|| &lt;br /&gt;<br /> <br /> raktapittAdirogeShu shamanaM nasyamiShyate| &lt;br /&gt;<br /> dhmApanaM dhUmapAnaM ca tathA yogyeShu shasyate ||95|| &lt;br /&gt;<br /> <br /> (doShAdikaM samIkShyaiva bhiShak samyak ca kArayet)|96|&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''kaphaja shirorogas'' characterized by stiffness, numbness, heaviness etc. ''Nasta karma''(nasal errhines) especially purificatory type is beneficial. Those diseases of head which are due to [[vata]] such as tremors of the head, facial palsy etc in them ''nastakarma'' in the form of ''tarpana'' is most suited. In diseases like ''raktapitta'' (bleeding dyscrasias) palliative errhines are indicated. Powder errhines and smoke inhalation are indicated for appropriate ones (treatment should be carried out by the physician after duly considering the ''[[dosha]]'' etc factors).[93-95½]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> फलादिभेषजं प्रोक्तं शिरसो यद्विरेचनम्||९६|| &lt;br /&gt;<br /> <br /> तच्चूर्णं कल्पयेत्तेन पचेत् स्नेहं विरेचनम्| &lt;br /&gt;<br /> यदुक्तं मधुरस्कन्धे भेषजं तेन तर्पणम्||९७|| &lt;br /&gt;<br /> <br /> साधयित्वा भिषक् स्नेहं नस्तः कुर्याद्विधानवित्|९८|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> phalādibhēṣajaṁ prōktaṁ śirasō yadvirēcanam||96|| &lt;br /&gt;<br /> <br /> taccūrṇaṁ kalpayēttēna pacēt snēhaṁ virēcanam| &lt;br /&gt;<br /> yaduktaṁ madhuraskandhē bhēṣajaṁ tēna tarpaṇam||97|| &lt;br /&gt;<br /> <br /> sādhayitvā bhiṣak snēhaṁ nastaḥ kuryādvidhānavit|98| &lt;br /&gt;<br /> <br /> phalAdibheShajaM proktaM shiraso yadvirecanam||96|| &lt;br /&gt;<br /> <br /> taccUrNaM kalpayettena pacet snehaM virecanam| &lt;br /&gt;<br /> yaduktaM madhuraskandhe bheShajaM tena tarpaNam||97|| &lt;br /&gt;<br /> <br /> sAdhayitvA bhiShak snehaM nastaH kuryAdvidhAnavit|98|&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The fruit etc. seven categories of medications suitable as errhines for purification of head mentioned in [[Rogabhishagjitiya Vimana]] may be used as powder and in oil base for purification. The drugs of sweet category mentioned in the that chapter may be used for ''tarpana'' (nourishing). With these mentioned drugs the ''sneha'' should be prepared and used by the physician who is skillful in the errhine therapy.[96-97½]<br /> <br /> === Procedure of [[nasya]] therapy ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्राक्सूर्ये मध्यसूर्ये वा प्राक्कृतावश्यकस्य च||९८|| &lt;br /&gt;<br /> <br /> उत्तानस्य शयानस्य शयने स्वास्तृते सुखम्| &lt;br /&gt;<br /> प्रलम्बशिरसः किञ्चित् किञ्चित् पादोन्नतस्य च||९९|| &lt;br /&gt;<br /> <br /> दद्यान्नासापुटे स्नेहं तर्पणं बुद्धिमान् भिषक्| &lt;br /&gt;<br /> अनवाक्शिरसो नस्यं न शिरः प्रतिपद्यते||१००|| &lt;br /&gt;<br /> <br /> अत्यवाक्शिरसो नस्यं मस्तुलुङ्गेऽवतिष्ठति| &lt;br /&gt;<br /> अत एवंशयानस्य शुद्ध्यर्थं स्वेदयेच्छिरः||१०१|| &lt;br /&gt;<br /> <br /> संस्वेद्य नासामुन्नम्य वामेनाङ्गुष्ठपर्वणा| &lt;br /&gt;<br /> हस्तेन दक्षिणेनाथ कुर्यादुभयतः समम्||१०२|| &lt;br /&gt;<br /> <br /> प्रणाड्या पिचुना वाऽपि नस्तःस्नेहं यथाविधि| &lt;br /&gt;<br /> कृते च स्वेदयेद्भूय आकर्षेच्च पुनः पुनः||१०३||&lt;br /&gt;<br /> <br /> तं स्नेहं श्लेष्मणा साकं तथा स्नेहो न तिष्ठति| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> prāksūryē madhyasūryē vā prākkr̥tāvaśyakasya ca||98|| &lt;br /&gt;<br /> <br /> uttānasya śayānasya śayanē svāstr̥tē sukham| &lt;br /&gt;<br /> pralambaśirasaḥ kiñcit kiñcit pādōnnatasya ca||99|| &lt;br /&gt;<br /> <br /> dadyānnāsāpuṭē snēhaṁ tarpaṇaṁ buddhimān bhiṣak| &lt;br /&gt;<br /> anavākśirasō nasyaṁ na śiraḥ pratipadyatē||100|| &lt;br /&gt;<br /> <br /> atyavākśirasō nasyaṁ mastuluṅgē'vatiṣṭhati| &lt;br /&gt;<br /> ata ēvaṁśayānasya śuddhyarthaṁ svēdayēcchiraḥ||101|| &lt;br /&gt;<br /> <br /> saṁsvēdya nāsāmunnamya vāmēnāṅguṣṭhaparvaṇā| &lt;br /&gt;<br /> hastēna dakṣiṇēnātha kuryādubhayataḥ samam||102|| &lt;br /&gt;<br /> <br /> praṇāḍyā picunā vā'pi nastaḥsnēhaṁ yathāvidhi| &lt;br /&gt;<br /> kr̥tē ca svēdayēdbhūya ākarṣēcca punaḥ punaḥ||103|| &lt;br /&gt;<br /> <br /> taṁ snēhaṁ ślēṣmaṇā sākaṁ tathā snēhō na tiṣṭhati|&lt;br /&gt;<br /> prAksUrye madhyasUrye vA prAkkRutAvashyakasya ca||98|| &lt;br /&gt;<br /> <br /> uttAnasya shayAnasya shayane svAstRute sukham| &lt;br /&gt;<br /> pralambashirasaH ki~jcit ki~jcit pAdonnatasya ca||99|| &lt;br /&gt;<br /> <br /> dadyAnnAsApuTe snehaM tarpaNaM buddhimAn bhiShak| &lt;br /&gt;<br /> anavAkshiraso nasyaM na shiraH pratipadyate||100|| &lt;br /&gt;<br /> <br /> atyavAkshiraso nasyaM mastulu~gge~avatiShThati| &lt;br /&gt;<br /> ata evaMshayAnasya shuddhyarthaM svedayecchiraH||101|| &lt;br /&gt;<br /> <br /> saMsvedya nAsAmunnamya vAmenA~gguShThaparvaNA| &lt;br /&gt;<br /> hastena dakShiNenAtha kuryAdubhayataH samam||102|| &lt;br /&gt;<br /> <br /> praNADyA picunA vA~api nastaHsnehaM yathAvidhi| &lt;br /&gt;<br /> kRute ca svedayedbhUya AkarShecca punaH punaH||103|| &lt;br /&gt;<br /> <br /> taM snehaM shleShmaNA sAkaM [1] tathA sneho na tiShThati|&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Tarpana sneha [[nasya]]'' should be administered into the nostrils of a patient in the early morning or mid noon, who has attended to his ablutions lying down supine comfortably on a well spread couch, with head extended and the foot slightly raised. If the head is not lowered at all, the medication does not reach the head. If the head is excessively lowered the [[nasya]] medication may reach into the brain. Hence, a reclining patient for proper purification should be administered fomentation to the head. After proper fomentation, the tip of nose elevated with the thumb of left hand and with the right hand the unctuous errhine should be dropped into the nostril through a tube or gauze, equally into both the nostrils. After having done this, the head should be duly fomented and the instilled medicine should be repeatedly extracted along with the phlegmmatous discharge so that no medicine remains. (98-103½)<br /> <br /> === ''Dhumapana'' (medicated smoking) and post ''[[nasya]]'' therapy ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्वेदेनोत्क्लेशितः श्लेष्मा नस्तःकर्मण्युपस्थितः ||१०४||&lt;br /&gt;<br /> <br /> भूयः स्नेहस्य शैत्येन शिरसि स्त्यायते ततः| &lt;br /&gt;<br /> श्रोत्रमन्यागलाद्येषु विकाराय स कल्पते||१०५|| &lt;br /&gt;<br /> <br /> ततो नस्तःकृते धूमं पिबेत् कफविनाशनम् | &lt;br /&gt;<br /> हितान्नभुङ्निवातोष्णसेवी स्यान्नियतेन्द्रियः||१०६|| &lt;br /&gt;<br /> <br /> विधिरेषोऽवपीडस्य कार्यः प्रध्मापनस्य तु| &lt;br /&gt;<br /> तत् षडङ्गुलया नाड्या धमेच्चूर्णं मुखेन तु||१०७|| &lt;br /&gt;<br /> <br /> विरिक्तशिरसं तूष्णं पाययित्वाऽम्बु भोजयेत्| &lt;br /&gt;<br /> लघु त्रिष्वविरुद्धं च निवातस्थमतन्द्रितः||१०८|| &lt;br /&gt;<br /> <br /> विरेकशुद्धो दोषस्य कोपनं यस्य सेवते| &lt;br /&gt;<br /> स दोषो विचरंस्तत्र करोति स्वान् गदान् बहून्||१०९||&lt;br /&gt;<br /> <br /> यथास्वं विहितां तेषु क्रियां कुर्याद्विचक्षणः| &lt;br /&gt;<br /> अकालकृतजातानां रोगाणामनुरूपतः||११०||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> svēdēnōtklēśitaḥ ślēṣmā nastaḥkarmaṇyupasthitaḥ ||104|| &lt;br /&gt;<br /> <br /> bhūyaḥ snēhasya śaityēna śirasi styāyatē tataḥ| &lt;br /&gt;<br /> śrōtramanyāgalādyēṣu vikārāya sa kalpatē||105|| &lt;br /&gt;<br /> <br /> tatō nastaḥkr̥tē dhūmaṁ pibēt kaphavināśanam | &lt;br /&gt;<br /> hitānnabhuṅnivātōṣṇasēvī syānniyatēndriyaḥ||106|| &lt;br /&gt;<br /> <br /> vidhirēṣō'vapīḍasya kāryaḥ pradhmāpanasya tu| &lt;br /&gt;<br /> tat ṣaḍaṅgulayā nāḍyā dhamēccūrṇaṁ mukhēna tu||107|| &lt;br /&gt;<br /> <br /> viriktaśirasaṁ tūṣṇaṁ pāyayitvā'mbu bhōjayēt| &lt;br /&gt;<br /> laghu triṣvaviruddhaṁ ca nivātasthamatandritaḥ||108|| &lt;br /&gt;<br /> <br /> virēkaśuddhō dōṣasya kōpanaṁ yasya sēvatē| &lt;br /&gt;<br /> sa dōṣō vicaraṁstatra karōti svān gadān bahūn||109|| &lt;br /&gt;<br /> <br /> yathāsvaṁ vihitāṁ tēṣu kriyāṁ kuryādvicakṣaṇaḥ| &lt;br /&gt;<br /> akālakr̥tajātānāṁ rōgāṇāmanurūpataḥ||110|| &lt;br /&gt;<br /> <br /> svedenotkleshitaH shleShmA nastaHkarmaNyupasthitaH ||104|| &lt;br /&gt;<br /> <br /> bhUyaH snehasya shaityena shirasi styAyate tataH| &lt;br /&gt;<br /> shrotramanyAgalAdyeShu vikArAya sa kalpate||105|| &lt;br /&gt;<br /> <br /> tato nastaHkRute dhUmaM pibet kaphavinAshanam | &lt;br /&gt;<br /> hitAnnabhu~gnivAtoShNasevI syAnniyatendriyaH||106|| &lt;br /&gt;<br /> <br /> vidhireSho~avapIDasya kAryaH pradhmApanasya tu| &lt;br /&gt;<br /> tat ShaDa~ggulayA nADyA dhameccUrNaM mukhena tu||107|| &lt;br /&gt;<br /> <br /> viriktashirasaM tUShNaM pAyayitvA~ambu bhojayet| &lt;br /&gt;<br /> laghu triShvaviruddhaM ca nivAtasthamatandritaH||108|| &lt;br /&gt;<br /> <br /> virekashuddho doShasya kopanaM yasya sevate| &lt;br /&gt;<br /> sa doSho vicaraMstatra karoti svAn gadAn bahUn||109|| &lt;br /&gt;<br /> <br /> yathAsvaM vihitAM teShu kriyAM kuryAdvicakShaNaH| &lt;br /&gt;<br /> akAlakRutajAtAnAM rogANAmanurUpataH||110|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The mucus liquefied by the sudation, accumulated by the administration of errhine will get condensed back in the head due to the inherent coldness of the unctuous errhine which leads to diseases of ears, neck and throat. Hence, after the errhine therapy, one should take smoking which eliminates ''[[kapha]]'', consume wholesome diet, resort to breezeless, warm residence and observe self restraint. <br /> <br /> The same procedure should be employed for administration of ''avapida [[nasya]]'' (expressed errhine). As regards ''pradhmapana'' (powder inhalation), the medicinal powder should be blown by mouth through a 6 ''Angula'' long tube. After purification of the head he should be made to drink hot water followed by predominant fluid diet which is light and not against the three ''[[dosha]]s'', and then made to reside in a breezeless place by vigilant physician. One who is purified off the ''[[dosha]]s'' if indulges in factors which cause ''[[dosha]]'' aggravation, the ''[[dosha]]s'' getting provoked move about in the body producing many diseases due to them. In these the wise physician should carry out treatments as mentioned and as appropriate for diseases arising due to untimely administration of errhine therapy. [104-110]<br /> <br /> === The treatment of vitiated ''[[dosha]]s'' after ''[[nasya]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अजीर्णे भोजने भुक्ते तोये पीतेऽथ दुर्दिने| &lt;br /&gt;<br /> प्रतिश्याये नवे स्नाते स्नेहपानेऽनुवासने||१११|| &lt;br /&gt;<br /> <br /> नावनं स्नेहनं रोगान् करोति श्लैष्मिकान् बहून्| &lt;br /&gt;<br /> तत्र श्लेष्महरः सर्वस्तीक्ष्णोष्णादिर्विधिर्हितः||११२|| &lt;br /&gt;<br /> <br /> क्षामे विरेचिते गर्भे व्यायामाभिहते तृषि| &lt;br /&gt;<br /> वातो रूक्षेण नस्येन क्रुद्धः स्वाञ्जनयेद्गदान्||११३|| &lt;br /&gt;<br /> <br /> तत्र वातहरः सर्वो विधिः स्नेहनबृंहणः| &lt;br /&gt;<br /> स्वेदादिः, स्याद्घृतं क्षीरं गर्भिण्यास्तु विशेषतः||११४|| &lt;br /&gt;<br /> <br /> ज्वरशोकातितप्तानां तिमिरं मद्यपस्य तु| &lt;br /&gt;<br /> रूक्षैः शीताञ्जनैर्लेपैः पुटपाकैश्च साधयेत् ||११५||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ajīrṇē bhōjanē bhuktē tōyē pītē'tha durdinē| &lt;br /&gt;<br /> pratiśyāyē navē snātē snēhapānē'nuvāsanē||111|| &lt;br /&gt;<br /> <br /> nāvanaṁ snēhanaṁ rōgān karōti ślaiṣmikān bahūn| &lt;br /&gt;<br /> tatra ślēṣmaharaḥ sarvastīkṣṇōṣṇādirvidhirhitaḥ||112|| &lt;br /&gt;<br /> <br /> kṣāmē virēcitē garbhē vyāyāmābhihatē tr̥ṣi| &lt;br /&gt;<br /> vātō rūkṣēṇa nasyēna kruddhaḥ svāñjanayēdgadān||113|| &lt;br /&gt;<br /> <br /> tatra vātaharaḥ sarvō vidhiḥ snēhanabr̥ṁhaṇaḥ| &lt;br /&gt;<br /> svēdādiḥ, syādghr̥taṁ kṣīraṁ garbhiṇyāstu viśēṣataḥ||114|| &lt;br /&gt;<br /> <br /> jvaraśōkātitaptānāṁ timiraṁ madyapasya tu| &lt;br /&gt;<br /> rūkṣaiḥ śītāñjanairlēpaiḥ puṭapākaiśca sādhayēt ||115||&lt;br /&gt;<br /> <br /> ajIrNe bhojane bhukte toye pIte~atha durdine| &lt;br /&gt;<br /> pratishyAye nave snAte snehapAne~anuvAsane||111|| &lt;br /&gt;<br /> <br /> nAvanaM snehanaM rogAn karoti shlaiShmikAn bahUn| &lt;br /&gt;<br /> tatra shleShmaharaH sarvastIkShNoShNAdirvidhirhitaH||112|| &lt;br /&gt;<br /> <br /> kShAme virecite garbhe vyAyAmAbhihate tRuShi| &lt;br /&gt;<br /> vAto rUkSheNa nasyena kruddhaH svA~jjanayedgadAn||113|| &lt;br /&gt;<br /> <br /> tatra vAtaharaH sarvo vidhiH snehanabRuMhaNaH| &lt;br /&gt;<br /> svedAdiH, syAdghRutaM kShIraM garbhiNyAstu visheShataH||114|| &lt;br /&gt;<br /> <br /> jvarashokAtitaptAnAM timiraM madyapasya tu| &lt;br /&gt;<br /> rUkShaiH shItA~jjanairlepaiH puTapAkaishca sAdhayet ||115||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Unctuous errhine administered in patients of indigestion, soon after major food, water consumption, on an unsuitable (cloudy) day, in case of acute rhinitis, after bath, internal oleation, oil enema gives rise to many diseases of ''[[kapha]]''. In these conditions all measures that alleviate ''[[kapha]]'' such as penetrating, hot etc are beneficial. <br /> <br /> Ununctuous or dry errhines in persons who are emaciated, after purgation, pregnant, exhausted due to severe exercise, thirsty, leads to aggravation of ''[[vata]]'' and produce diseases due to it. In such conditions all ''[[vata]]'' alleviating measures such as oleation, nourishing therapy, sudation etc should be done. In case of pregnant especially, ghee and milk should be administered. <br /> Unctuous errhine administered in those afflicted by severe fever, grief and alcoholics causes dimness of vision. It should be managed by collyrium and applications to the eye and instillation of medicine prepared by ''putapaka'' method which are un-unctuous and cold. [111-115]<br /> <br /> === Types of ''navana'' (unctuous errhines) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्नेहनं शोधनं चैव द्विविधं नावनं मतम्| &lt;br /&gt;<br /> प्रतिमर्शस्तु नस्यार्थं करोति न च दोषावान्||११६|| &lt;br /&gt;<br /> <br /> नस्तः स्नेहाङ्गुलिं दद्यात् प्रातर्निशि च सर्वदा| &lt;br /&gt;<br /> न चोच्छिङ्घेदरोगाणां प्रतिमर्शः स दार्ढ्यकृत्||११७||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snēhanaṁ śōdhanaṁ caiva dvividhaṁ nāvanaṁ matam| &lt;br /&gt;<br /> pratimarśastu nasyārthaṁ karōti na ca dōṣāvān||116||&lt;br /&gt;<br /> <br /> nastaḥ snēhāṅguliṁ dadyāt prātarniśi ca sarvadā| &lt;br /&gt;<br /> na cōcchiṅghēdarōgāṇāṁ pratimarśaḥ sa dārḍhyakr̥t||117||&lt;br /&gt;<br /> <br /> snehanaM shodhanaM caiva dvividhaM nAvanaM matam| &lt;br /&gt;<br /> pratimarshastu nasyArthaM karoti na ca doShAvAn||116|| &lt;br /&gt;<br /> <br /> nastaH snehA~gguliM dadyAt prAtarnishi ca sarvadA| &lt;br /&gt;<br /> na cocchi~gghedarogANAM pratimarshaH sa dArDhyakRut||117||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Unctuous errhine (all errhines for that matter) is of two types- oleating and purificatory. ''Pratimarsha'' (low dose unctuous errhine) serves both the purpose and does not produce any ill effects. In the morning, night and at all times, one should use an oleated finger for ''pratimarsha''. It should not be inhaled deeply. It is suitable for healthy and serves to strengthen the head.[116-117]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकौ &lt;br /&gt;<br /> <br /> त्रीणि यस्मात् प्रधानानि मर्माण्यभिहतेषु च| &lt;br /&gt;<br /> तेषु लिङ्गं चिकित्सां च रोगभेदाश्च सौषधाः||११८|| &lt;br /&gt;<br /> <br /> विधिरुत्तरबस्तेश्च नस्तःकर्मविधिस्तथा| &lt;br /&gt;<br /> सव्यापद्भेषजं सिद्धौ मर्माख्यायां प्रकीर्तितम्||११९||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkau &lt;br /&gt;<br /> <br /> trīṇi yasmāt pradhānāni marmāṇyabhihatēṣu ca| &lt;br /&gt;<br /> tēṣu liṅgaṁ cikitsāṁ ca rōgabhēdāśca sauṣadhāḥ||118|| &lt;br /&gt;<br /> <br /> vidhiruttarabastēśca nastaḥkarmavidhistathā| &lt;br /&gt;<br /> savyāpadbhēṣajaṁ siddhau marmākhyāyāṁ prakīrtitam||119||&lt;br /&gt;<br /> <br /> tatra shlokau &lt;br /&gt;<br /> <br /> trINi yasmAt pradhAnAni marmANyabhihateShu ca| &lt;br /&gt;<br /> teShu li~ggaM cikitsAM ca rogabhedAshca sauShadhAH||118|| &lt;br /&gt;<br /> <br /> vidhiruttarabasteshca nastaHkarmavidhistathA| &lt;br /&gt;<br /> savyApadbheShajaM siddhau marmAkhyAyAM prakIrtitam||119||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> To conclude the verses- <br /> <br /> The 3 most important among the ''marmas'', signs and symptoms due to their injury, their treatment, diseases affecting these ''marmas'' with their management, ''uttarabasti'' procedure, procedure of ''[[nasya]]karma'', their complications with management have all been described in the chapter on ''siddhi'' related to three ''marmas''.[118-119]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते <br /> सिद्धिस्थाने त्रिमर्मीयसिद्धिर्नाम नवमोऽध्यायः||९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē'prāptē dr̥ḍhabalasampūritē <br /> siddhisthānē trimarmīyasiddhirnāma navamō'dhyāyaḥ||9|| <br /> <br /> ityagniveshakRute tantre carakapratisaMskRute~aprApte dRuDhabalasampUrite <br /> siddhisthAne trimarmIyasiddhirnAma navamo~adhyAyaH||9||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Hence, the 9th chapter of [[Siddhi Sthana]] named [[Trimarmiya Siddhi]], which was unavailable and hence, completed by Dridhabala in Agnivesha’s compendium redacted by Charaka.<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *''Marmas'' are the vital junctions and organs in the body. <br /> *''Marmas'' are the site of ''chetana'' (vital power of life). Therefore, their diseases/injuries are more severe and need immediate attention in treatment. <br /> *The vital organs in trunk and abdomen are more important that those in extremities or at superficial level.<br /> *''Hridaya'' (heart including cardio-vascular system), ''basti'' (Urinary bladder including urinary system and kidneys) and ''shiras'' (head including sensory-motor nervous system) are important owing to the fact that they are the roots of body and the existence of life depends on them. <br /> *''Hridaya'' (heart) is the center for receiving the ten ''dhamani'' (ten great vessels arising from the heart), ''prana, apana, [[manas]]'' (mind), ''[[buddhi]]'' (intellect), ''chetana'' (life), ''[[mahabhuta]]s'' (5 fundamental elements) just like spokes to the axle in the center of a wheel.<br /> *''Shiras'' (head) is the centre for the ''[[indriya]]s'' (the seat of special senses), the ''srotas'' (channels) pertaining to the conduction of ''[[indriya]]'' and ''prana'' like the radiating spicules of the rays of sunlight.<br /> *The ''basti'' (bladder) is center that is related with the functions of ''sthula guda'' (rectum), ''mushka'' (scrotum), ''sevani'' (perineal raphe), urinary channels and ''[[shukra]]'' (semen). It is also the ''mutradhara'' (reservoir of urine) in to all the water carrying channels in the body drain, similar to all the rivers drain into the ''udadhi'' (sea/ ocean). <br /> *Injury to these three ''marmas'' (''hridaya, shiras'' and basti) leads to sudden loss to the life. Therefore these should be especially protected against external injury and ''vatadi [[dosha]]s''.<br /> *''[[Vata]]'' is the prime factor or cause for the aggravation of ''[[pitta]]'' and ''[[kapha]]'' and also it is the cause of ''prana'' (life) and is best managed by ''[[basti]]''.<br /> *''Prana'' (life) is situated at ''hridaya'' (heart), ''murdhna'' (head) and ''[[basti]]'' (bladder and urinary system). Hence attempts should be made to maintain ''paripalana'' (maintain normalcy) them. ''Abadhavarjana'' (avoidance of factors that cause affliction to ''marmas''), ''svasthavrittanuvartana'' (following the healthy regimen), ''utpannarti vighata'' (management of the existing conditions) ensures maintenance of ''marmas'' (''marma paripalana'').<br /> *''Apatantraka'' (opisthotomus) disease is caused by ''[[kapha]]-[[vata]]'' dominance and it shall be managed by ''[[kapha]]-[[vata]]'' pacifying measures including ''tikshna pradhamana [[nasya]]'' (powder blowing into nostrils). Strong purification enemas are contraindicated in the treatment of ''apatantraka''. <br /> *''Tandra'' (drowsiness) is caused due to vitiation of ''[[vata]]'' and ''[[kapha dosha]]''. This condition should be managed by ''[[shodhana]]'' and ''shamana'' measures that are ''kaphahara, [[vyayama]]'' (exercise), ''[[raktamokshana]]'' (bloodletting) and intake of foods that are predominantly ''katu'' (pungent) and ''tikta'' (bitter).<br /> *The urinary disorder occur mainly due to suppression of urine urge, vitiation of ''[[dosha]]s'' in urine. These conditions should be treated based on dominance of ''[[dosha]]'' and by measures that relieve ''mutrakrichchra'' (dysuria), ''[[basti]]'' ( per rectal enemas) and ''uttara basti'' (per urethral enemas).<br /> *Improper diet and lifestyle habits are causative factors for various types of headaches. The ''[[dosha]]s'' with ''[[rakta]]'' are involved in the etio-pathology of head diseases.<br /> *Administration of four ''snehas'' (''taila, ghrita, vasa'' and ''majja'') in the maximum dose, ''Kaya[[virechana]]'' (purgation), ''shirovirechana'' (purificatory errhines), ''nadisweda'' ( fomentation), 10 year old ghee, oil enemas, poultices, ''shirobasti'', cautery are advocated in the management of head diseases. <br /> *The disorders of head and organs in the supra-clavicular region can be managed by ''[[nasya]] karma'' (errhines). Nasal drug administration is the gateway of head, the medicines administered thereby pervade into the head and cures diseases pertaining to the head.<br /> *In ''[[kapha]]'' dominant diseases of head with obstructive pathology, ''[[nasya]]'' (nasal errhines) of purificatory type are advised. <br /> *In ''[[vata]]'' dominant diseases of head with degenerative pathology, ''[[nasya]]'' (nasal errhines) of nourishing type are advised. <br /> *In ''[[pitta]]'' dominant diseases of head with hemorrhagic pathology, ''[[nasya]]'' (nasal errhines) of palliative type are advised.<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> <br /> The concept of ''marma'' described in [[Ayurveda]] texts differs with those described in ''Keraliya Marma Chikitsa'' (''Kalari Marma'') and the Tamilian ''marma'' concept. The numbers and positions also vary greatly. The Keraliyan ''marma'' concept seems to be more related to warfare medicine and the management of trauma while the tamilian ''marma'' concept is more so as described in [[Ayurveda]] related to ''kshata'' as well well as ''doshaja aghata''. [[Ayurveda]] believes that suppression of urges, over enthusiastic activities, strainful activities, faulty treatment practices can actually cause ''doshaja marmaghata''.<br /> <br /> Clinical conditions like paralysis, paresis, paraplegia, quadriplegia, haemorrhage can be understood on Ayurvedic lines by taking clue from here. When it takes place at ''shirasthana'' above mentioned conditions can manifest. They need to be treated on the lines of treatment of ''marmaghata'' rather than only treating them as ''vatavyadhi''. <br /> <br /> The clinical presentations described to occur under the affection of three ''marmas'' are almost practically found in relation to ''[[dosha]]'' aggravations affecting the ''marmas'' and also in case of their injury. Some symptoms are due to direct organ damage and others due to reflex neurological or hormonal disturbances.<br /> <br /> ''[[Vata]]'' is considered to be cause of provocation of ''[[pitta]]'' and ''[[kapha]]''. In the process of disease formation direct reference of involvement of ''[[vata]]'' as early as in the stage of ''prasara'' (third out of six stages of disease formation) ''[[vata]]'' is also said to be cause of life to underline its importance as well as the need to address it urgently. Amongst all the treatments of ''[[vata]], [[basti]]'' is the best purely on its merits to take care of ''[[vata]]'' disorders of all the systems throughout the body. <br /> <br /> ''Hridaya'' when gets affected, is managed by juices which are ''amla'' (sour) in taste ,as it is best among ''hridya dravyas''.<br /> The drug ''hingu'' (asafoetida) has been found to be effective as a ''vatanulomaka, [[pachana]], amahara,'' and ''sulaghna''. It is also widely used in ''udavarta'' conditions, to relieve functional spasms of smooth muscles as in intestinal colic. ''Hingu vachadi churna'' is specifically used for such conditions. Clinical conditions related to ''Trimarma'' are alarmingly high today. By effecting subtle changes in life style in accordance with classical guidelines will help to reduce life risk to great extent. Preventing the injury to vital organs and timely appropriate management in case of diseases is the key to prevention of diseases and promotion of health. <br /> <br /> ''Apatantraka''(opisthotomus) is due to obstruction of ''[[kapha]]'' to ''[[vata]]'', ''apatanaka''(status epilepticus) is only due to ''[[vata]]''.<br /> <br /> Based on the descriptions of the condition involving the heart which is the ''[[manas]]a sthana'' and the involvement of head as well, with clinical manifestations like unconsciousness with flexion spasms or bending of the body, which is temporary, this condition may be considered as a form of syncope.<br /> <br /> Treatment schedule for ''apatantraka'' starts with ''tikshna pradhamana'' as ''prana vilomatva'' has to be corrected to maintain the life of the patient. Second in line is ''shirovirechana'', as vitiated ''[[vata]]'' creates pain in ''sirah'' and ''shankha'' by taking upward course. Then treatment for pacification of ''[[vata]] [[kapha]]'' in ''hridroga'' is applied to take care of ''hridaya'', as ''[[vata]]'' also occupies ''hridaya'' when does upward direction. Further ''[[basti]]'' would have been an ideal option to take ''[[vata]]'' into its own site and pacify it, but it should not be strong, it is to be given in lesser quantity. Involvement of ''hridaya'' in pathogenesis might have prompted this thought, as strong ''basti'' might cause dehydration due to excess elimination leading to fatal condition of ''hridaya''.<br /> <br /> Fine powders of ''shirovirechana'' medicines can clear obstructive pathology faster and hence are preferred. ''Maricha'' which is ''pramathi'' i.e., with its potency drags the ''[[dosha]]s'' out of ''srotasas'' (channels) and removes them from the system. Other medicines ''shigrubija, vidanga'' are known for their ''shirovirechana'' activity.<br /> <br /> ''[[Vata]]'' and ''[[kapha]]'' are both considered as causative factors for the onset of ''tandra''. ''[[Vata]]'' agitates ''[[kapha]]'', which in turn occupies ''hridaya''. The knowledge process gets blocked leading to ''tandra''. Treatment aims at eliminating and pacifying ''[[kapha]]''. ''[[Vyayama]]'' and diet of pungent and bitter tastes which acts against ''[[kapha]]'' are suitable. The unusual reference of blood letting can be attributed to involvement of ''hridaya'', which is an organ made up of purest form of ''[[rakta]]''.<br /> <br /> The factors that bring about physical and mental exertion with foods that prolong the digestion or are heavy for digestion bring about an aggravation of ''[[kapha]]'' with ''[[vata]]'' and ''tamo [[guna]]'' thereby producing ''tandra'' (drowsiness). Hence, all medicines that help to clear the ''avarana'' of ''[[manas]]'' by these ''[[doshas]]]'' may be employed, especially so ''teekshna pradhamana nasya''.<br /> <br /> The ''mutravaha srotovikaras'' have been broadly classified into ''mutra atipravrittija'' (excess urination) and ''mutra apravrittija'' (less urination) ''vikaras'' by Vagbhata (A.H.Ni.9/40). The former includes twenty varieties of ''prameha'' and the latter includes two categories of disorders – 8 types of ''mutrakrichchra'' (dysuria) and 12 types ''mutraghata'' (urinary disorders), though both the set of disorders are described under the title ''mutraghata''. Under ''mutraghata, bastikundala'' (circular distension of bladder) is not described. <br /> <br /> In general terms though we find that ''mutraghata'' is described as condition with suppression or less production of urine and ''mutrakrichchra'' as dysuria, not all conditions described under ''mutraghata'' are characterized by oliguria or reduced output.<br /> <br /> Most of the conditions seem to occur predominantly by retention of urine or bladder distension. ''Mutrasaada, mutraukasaada'' and ''ushnavata'' may be considered as scanty urination or oliguria; ''Mutrakshaya'' may be equated to oliguria or anuria.<br /> <br /> ''Mutrakrichchra'' is a condition of dysuria due to spermorrhoea. Others like ''vatabasti, mutratita, mutrajathara'' seem to occur due to voluntary withholding of the urge of micturition resulting in physiological bladder atony as in mutratita or retention with pain as in ''vatabasti'' and atonied distended bladder in ''mutrajathara'' all progressive conditions of the same pathological process. <br /> <br /> ''Bastikundala'' also seems to be a condition of bladder atony but with superadded cystitis due to severe physical stress and states of dehydration. In ''vatashthila'' and ''mutragranthi'' there seems to be an obvious anatomical growth which causes obstruction to the urine pathway which may be considered as prostatomegaly and vesicle tumors respectively. The condition of ''vatakundalika'', though from the ''Nidana'' seems to be similar to the conditions of withholding the urge of urination, due to the symptoms seems more or less like urethral stricture. ''Mutrotsanga'' seems to be a condition of acute urethritis or cystitis where there is stranguary, dysuria, hesitancy and sometimes blood in urine. ''Mutrakshaya'' more or less seems like anuria or oliguria due to dehydration. ''Vidvighata'' clearly seems a case of recto vesicle or rectourethral fistula. <br /> <br /> Susruta describes ''pittaja'' and ''kaphaja'' types of ''mutraukasada'' (dense urine) as two different conditions. In ''pittaja mutraukasada'' he describes that on drying, the urine resembles ''gorochana churna'' (powder of a stone or 'bezoar' found in cattle) and in case of ''kaphaja'' variety, on drying the urine becomes like ''shankha churna'' (powder of conch shell). <br /> <br /> Due to holding of natural urges, obstruction to the downward movement of ''[[vata]]'' makes ''vata gati'' in to upward and circular, manifesting in to severe condition called ''mutrajathara'' (accumulation of urine in abdominal cavity). Along with symptoms like retention of urine and stool, indigestion is also one of the symptoms.<br /> <br /> Based on the descriptions, the condition seems to be a neurological disturbance of bladder function due to repeated withholding the urge of micturition.<br /> <br /> All the above mentioned ''[[mutra]]doshas'' are in accordance with the ''nidanas'' described under Ca.Vi.5/20 ie, drinking water, consuming food, indulging in sexual intercourse when one feels the urge to micturate and withholding the urge of micturition especially in an emaciated or traumatized individual. <br /> <br /> The condition ''mutratita'' seems to be a physiological atony of bladder owing to prolonged withholding the urge to micturate, thereby the bladder contractions wean away and paves the way for atony. Recurrent withholding the urge may result in pathological atony as well as neurological disturbances in bladder function due to disturbances in the balance between sympathetic and parasympathetic functions. This concept may be practically found in patients of diabetes mellitus with recurrent urinary tract infections (cystitis), wherein USG reveals significant residual urine in bladder due to bladder atony. Such patients are immensely benefited by toilet training ie, developing a habit of regular micturition at timely intervals which in due course reduces the incidence of recurrent urinary tract infections and in due course significantly reduces the residual urine, possibly improving the bladder tone and nervous integrity.<br /> <br /> The role of ''[[basti]] chikitsa'' and specifically ''uttarabasti'' in the management of ''apana vata vikriti'' and also ''sthana dushti'' (local vitiation) has been highlighted in the classical texts.<br /> <br /> The drugs having ''mutrala'' (mutravirecaneeya and mutravirajaneeya) actions are all useful in the above mentioned ''mutradoshas''. The ''mutravirajaneeya, mutravirechaneeya gana dravyas''[Cha.Sa.[[Sutra Sthana]] 4/15] are very helpful. <br /> <br /> The descriptions of the procedure with materials or equipment used thereby are clearly stated in the texts. Gold and silver are metals considered to be soft and malleable. The ''uttarabasti'' nozzle prepared out of these are specially suited for introducing into urethra as it is extremely vulnerable to trauma during the procedure which can be minimized by these metals. Primarily the chance of injury is due to the fact that male urethra is curved (‘S’ shaped) and straightened slightly when the penis is erect. Nevertheless, when fully straight there is a increased chance of trauma. Further these metals have a protective effect on the body.<br /> <br /> In clinical practice, simple rubber catheters no. 6 or 7 may be used for the procedure after sterilization by autoclaving and so should be the medicine used for ''uttarabasti''. With due aseptic precautions, the procedure should be carried out in a fumigated room preferably like an O.T. procedure which reduces the likely chances of U.T.I. Nevertheless, in the outcome the chances of asymptomatic pyuria or abacteriuric pyuria are always there. These possibly can be minimized with the use of filtered medicament (so as to ensure no particles), pre-autoclaved and administered with nozzle of gold or silver. Though the classical position of the patient is seating, lying down position is equally easy and the patient may be made to feel more comfortable. An hour after the procedure, the patient should be instructed to consume plenty of oral fluids to maintain a high urine output. The patients comfortably retain the medicament for 2-4 hours. The procedure may be done daily for 8 days after an initial ''gudagata asthapana basti''. The procedure is done after asking the patient to evacuate the bladder and bowel. <br /> <br /> The drugs described are mostly ''ushna veerya, vatanulomana'' and hence are highly beneficial in clearing the ''avarodha''(obstruction) of ''aushadha''.<br /> <br /> The indication of administration of ''varti'' into ''gudamarga'' as well, probably indicates that some reflex mechanisms are involved in the evacuation of bladder in case of retained medicament. This in the classical description may be explained as causing ''apanavatanulomana''.<br /> <br /> The modern gynecological texts describe per vaginal investigative procedures to be carried out soon after the menses after the stoppage of bleeding. In practice, it’s the ideal time for the ''uttarabasti'' as it’s the time wherein this is naturally open to shed the endometrium which almost closes by the period of ovulation. Further, not only do the medicament enter the uterus with ease but also it acts at a time ideal for it to receive the sperms as well as provides a conducive environment for implantation of fertilized ovum maximizing the chances to conceive.<br /> <br /> Vitiated ''[[rakta]], [[pitta]]'' and ''[[vata]]'' takes course of ''shirah''(head), especially ''shankha'' (temporal region), a ''marma'' of the type ''sadyahpranahara'' (acute life threatening), making the condition incurable. Involvement of ''[[rakta dhatu]]'' in diseases of ''shirah'' is appreciated by Charaka in [Cha.Sa.[[Sutra Sthana]] 17/11] ''[[Pitta]]'' dominating symptoms like ''daha'' (burning sensation), ''raga'' (redness) and vitiation of ''[[rakta dhatu]]'' brings in treatment of ''visarpa'' in to picture, as it also has both these entities vitiated.<br /> <br /> The consideration of ''shankhaka'' as ''pratyakhyeya vyadhi'' and the initiation of treatment in case of survival probably indicates the fact that there could be residual symptoms needing effective management and also that there is a likely chance of recurrence.<br /> <br /> Pathogenesis of the disease indicates two different ways of vitiation of ''[[dosha]], [[vata]]'' and ''[[vata]][[kapha]]''. Further treatment can also be understood on this basis. Use of ''Chatusneha'' (all four ''snehas ghrita, taila, vasa, majja''), procedures like ''shirobasti, anuvasanabasti,'' aimed at pacifying ''[[vata]]'' while more aggresive treatments like ''shirovirechana, [[virechana]],'' use of 10 year old ghee, ''upanaha'' (poultice), ''dahana'' (cautery) are useful in ''[[vata]][[kapha]]'' dominating condition.<br /> <br /> From the descriptions, it appears that this condition could possibly be migraine. The possible triggering factors such as sleep deprivation, physical exhaustion, mental factors such as anxiety, stress etc, may all be understood under the ''nidanas'' described in the classics. The location of pain is also similar. The severity of pain and the disturbances of vision and audition are all classical being found in the stage of aura and may even associate with the proper stage. <br /> <br /> Treatment is aimed at elimination of ''[[dosha]]'' initially followed by pacification of them by various means. Three ''sneha'' viz, ''taila, ghrita, vasa'' to be used in ''murdha taila'' form (holding these materials on head). Here ''majja'' is excluded as it is ''gurutara'' (most heavy amongst ''snehas''). ''Seka''(effusion) in the form of ''ghrita'', milk will help in pacifying ''[[vata]]'' by acting as ''[[brimhana]]'' (nourishment), at the same time ''[[rakta]]prasadana'' (pacifying the impurities in blood) is achieved. ''[[Nasya]]'' with ''jeevaniya ghrita'' is also to pacify ''[[vata]]'' and to account for ''[[rakta]]prasadana''. <br /> <br /> In Bhavaprakasa Nighantu, due to non availability, ''pratinidhi'' (substitutes) have been described for ''ashtha varga'' (group of eight vitalizer herbs) drugs like ''vidarikanda'' (Pueraria tuberosa) for ''jeevaka'' and ''rshabhaka, ashvagandha'' (Withania somnifera) for ''kakoli'' and ''kshirakakoli, varahikanda'' (Dioscorea bulbifera) for ''riddhi'' and ''vriddhi, shatavari'' (Asparagus racemosus) for ''meda'' and ''mahameda''.<br /> <br /> The description of the incidence and timing of the symptoms point to the condition of frontal sinusitis which usually starts as a dull headache in the morning that increases in severity as the day progresses. Occasionally it may be relieved by sleep or sometimes not which depends on the relative dominance of ''[[rakta]]'' and ''[[vata]]''. <br /> <br /> As the condition is purely ''[[vata]]'' dominant, all the treatments described for ''suryavarta'' such as ''ghritapana, ghrita [[nasya]], siropichu, sirobasti'' are all beneficial. If the condition is associated with ''[[rakta]]vrita [[vata]], siravyadha'' is utmost beneficial. This condition may be possibly correlated with Trigeminal neuralgia, based on the location of pain. ''Siravyadha'' at the temporal area is of utmost benefit in neuralgic headaches. <br /> <br /> It is uncontroversial that nose is the gateway of head as all the authors of ''brihattrayis'' and ''laghutrayis'' have shared the importance of ''[[nasya]]karma'' in ''shirorogas''.<br /> <br /> Though the exact mode of action of ''[[nasya]]'' is not studied some hypotheses have been put forward by the scholars of [[Ayurveda]]. One of them is that the medicament directly penetrates into the brain, as fat soluble substances can easily diffuse through the cribriform plate of ethmoid bone (which forms the roof of the nasal cavity) which is porous and owing to the location of olfactory bulbs the medicament can percolate along the fibers of olfactory nerve. The second most agreeable hypothesis is the receptor theory, which believes stimulation of certain brain centers through specific receptors situated in the nasal cavity. The administration of posterior pituitary extract into nostrils by means of sprays, practically and successfully followed in diabetes insipidus is a proof sufficient that through suitable formulation, medicament may be made to act on the brain.<br /> <br /> It is clearly described that ''sneha [[nasya]]'' should be done in ''[[vata]]'' aggravation and ''ruksha [[nasya]]'' should be done in ''kaphaja'' diseases. If this indication is ignored the complications that may follow and the measures to tackle them is described in the above verses.<br /> <br /> In Ashtanga Hridaya, ten specific timings suitable for administration of ''pratimarsha'' have been described.<br /> <br /> In practice, especially in conditions of migraine, allergic rhinitis and atopic rhinitis we advise patients to smear medicated oil or ghee into the nostrils using an oleated finger. This may be considered a form of ''pratimarsha'' itself.<br /> <br /> === Related Chapters ===<br /> * [[Kiyanta Shiraseeya Adhyaya]] <br /> * [[Trimarmiya Chikitsa]]<br /> <br /> &lt;/div&gt;<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Prasrita_Yogiyam_Siddhi&diff=45409 2026-02-11T09:17:41Z

<p>Agnivesha: /* Treatment of atisara (diarrhea) mixed with kapa-rakta-pitta-shakrita */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Prasrita Yogiyam Siddhi<br /> |titlemode=append<br /> |keywords=atisara, basti, doshanulomana, grahi, karsha, karmanaviplutanam, niruha, pachana, Panchakarma, prasrita, prastha, snehabasti, vyapat, enema in delicate persons, complication of Panchakarma,Ayurveda, Indian system of medicine, charak samhita. <br /> |description=Siddhi Sthana Chapter 8. Standardized therapeutic enema formulations in a dose of ''Prasrita'' Unit<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Siddhi Sthana]] Chapter 8. Standardized therapeutic enema formulations in a dose of ''Prasrita'' Unit'''&lt;/big&gt;<br /> {{Infobox<br /> |title = Prasrita Yogiyam Siddhi<br /> |label1 = Section/Chapter<br /> |data1 = [[Siddhi Sthana]] Chapter 8<br /> |label2 = Preceding Chapter<br /> |data2 = [[Bastivyapat Siddhi]]<br /> |label4 = Succeeding Chapter<br /> |data4 = [[Trimarmiya Siddhi]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Gupta S.N.<br /> |label7 = Reviewer <br /> |data7 = Panse A.<br /> |label8 = Editors<br /> |data8 = Thakar A. B., Mangalasseri P., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s08.009 10.47468/CSNE.2020.e01.s08.009]<br /> }}<br /> &lt;big&gt;''' Abstract &lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;This chapter describes recipes of ''prasritayogiya bastis'' (enema formulation in which ingredients are measured in unit of ''prasrita''). ''Prasrita'' is a measurement, which is approximately equal to 100 millilitre. Nine types of ''[[basti]]'' therapies for various clinical conditions including ''prameha'' (urinary disorders including diabetes), ''abhishyanda'' (oozing), ''kushtha'' (skin diseases), ''krimi'' (worm infestation), ''mutrakrichchra'' (dysuria) and alike are described. ''Atisara'', a clinical condition characterized by frequent defecation with altered composition and consistency of stool is described in detail. ''Atisara'' has various forms depending upon involvement of six morbid components in the pathogenesis viz. ''ama'' (stool with undigested material), ''shakrita'' (stool only), ''[[vata]]'' (with dominant flatulence), ''asrik'' (stool with blood), ''[[pitta]]'' and ''[[kapha]]''. Different recipes of ''[[basti]]'', oral medicaments and food preparations are described to treat these ''atisara'' conditions. These remedies are practically quite useful in several modern diseases like ulcerative colitis and irritable bowel syndrome.<br /> &lt;br/&gt;<br /> '''Keywords''': ''atisara, [[basti]], doshanulomana, grahi, karsha, karmanaviplutanam, niruha, [[pachana]],'' [[Panchakarma]], ''prasrita, prastha, snehabasti, vyapat,'' enema in delicate persons, complication of [[Panchakarma]].<br /> &lt;/p&gt;<br /> <br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> There are two main types of ''[[basti]]'' according to the composition and the action. ''Anuvasana basti'' is composed of unctuous substance and it is to be retained for minimum nine hours. ''Asthapana basti'' contains mainly decoction with least oil and is evacuated after few minutes. ''[[Basti]]'' is administered through ano-rectal route and acting through the ''pakvashaya'' (colon). It is useful in several diseases particularly [[vata]] disorders having roots in ''pakvashaya''. It is claimed to be half a treatment or even a complete treatment by ancient practitioners&lt;ref&gt;Charak. Siddhi Sthana, Cha.1 Kalpana Siddhi Adhyaya verse 38-40. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi:Munshiram Manoharlal publishers pvt. Ltd; 1981; P 683-684.&lt;/ref&gt;. It is not only a procedure of ''[[shodhana]]'' but also providing a recto-colonic route of drug administration. <br /> <br /> Previous chapter ([[Bastivyapat Siddhi]]) deals with the ''vyapat'' (complications) arising due to faulty application of ''[[basti]]s''. Present chapter begins with the treatment of those patients who developed complications as a result of faulty application of therapies (''karmana viplutanam'') and for the tender persons who are not able to tolerate strong measures. For this purpose, chapter describes mild form of ''niruha bastis''. The ingredients of these ''[[basti]]s'' are measured in the unit of ''prasrita''. Therefore the name of the chapter is [[Prasrita Yogiyam Siddhi]]. The unit ''prasrita'' is equal to two ''palas'', which is approximately equal to 100 milliliter (1 ''pala''= approx. 50 ml).&lt;ref&gt;Chakrapani, Charak. Siddhi Sthana, Cha.8 Bastivyapad Siddhi ver.04. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed.New Delhi:Munshiram Manoharlal publishers pvt. Ltd; 1981; P 713&lt;/ref&gt;&lt;ref&gt;Agnihotri Avadhabihari; Bhaiṣajyakalpanā Vijñāna; Chaukhamba orientalia publication, 6th edition, 2006, P 7-20&lt;/ref&gt;<br /> <br /> == Sanskrit text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातः प्रासृतयोगीयां सिद्धिं व्याख्यास्यामः||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः||२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> Athātaḥ prāsṛtayōgīyāṁ siddhiṁ vyākhyāsyāmaḥ ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ ||2||<br /> <br /> athAtaH prAsRutayogIyAM siddhiM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now we shall expound the chapter &quot;Prasrita Yogiyam Siddhi&quot; (Standardized therapeutic enema formulations in a dose of ''Prasrita'' Unit). Thus said Lord Atreya. [1-2]<br /> <br /> Note: The chapter describes the formulations having ingredients measured in the unit ''prasrita''(approximately equal to 100 millilitre).<br /> <br /> === Objective of ''prasrita basti'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथेमान् सुकुमाराणां निरूहान् स्नेहनान् मृदून्| <br /> <br /> कर्मणा विप्लुतानां च वक्ष्यामि प्रसृतैः पृथक्||३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athēmān sukumārāṇāṁ nirūhān snēhanān mṛdūn| <br /> <br /> karmaṇā viplutānāṁ ca vakṣyāmi prasṛtaiḥ pṛthak||3||<br /> <br /> athemAn sukumArANAM nirUhAn snehanAn mRudUn| <br /> <br /> karmaNA viplutAnAM ca vakShyAmi prasRutaiH pRuthak||3||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now, I (Atreya) shall explain oleaginous and mild form of ''niruha [[basti]]s'', for the tender persons and the patients suffered from complications as a result of therapies. Composition of those will be in the unit of ''prasrita''. [3]<br /> <br /> === ''Pancha prasritiki Basti''-I ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षीराद्द्वौ प्रसृतौ कार्यौ मधुतैलघृतात्त्रयः| <br /> <br /> खजेन मथितो बस्तिर्वातघ्नो बलवर्णकृत्||४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣīrāddvau prasṛtau kāryau madhutailaghṛtāttrayaḥ| <br /> <br /> khajēna mathitō bastirvātaghno balavarṇakṛt||4|| <br /> <br /> kShIrAddvau prasRutau kAryau madhutailaghRutAttrayaH| <br /> <br /> khajena mathito bastirvAtaghno balavarNakRut||4|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Two ''prasritas'' of milk and three ''prasritas'' of ''madhu'' (honey), ''taila'' (sesame oil) and ''ghrita'' (clarified butter) are taken together and churned with a churning stick. This ''[[basti]]'' eliminates ''[[vata]]'', and promotes strength as well as complexion. [4]<br /> <br /> === ''Ashta-prasritiki basti'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> एकैकः प्रसृतस्तैलप्रसन्नाक्षौद्रसर्पिषाम्| <br /> <br /> बिल्वादिमूलक्वाथाद्द्वौ कौलत्थाद्द्वौ स वातनुत्||५|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ēkaikaḥ prasṛtastailaprasannākṣaudrasarpiṣām| <br /> <br /> bilvādimūlakvāthāddvau kaulatthāddvau sa vātanut||5|| <br /> <br /> ekaikaH prasRutastailaprasannAkShaudrasarpiShAm| <br /> <br /> bilvAdimUlakvAthAddvau kaulatthAddvau sa vAtanut||5|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Basti]]'', composed of one ''prasrita'' each of ''taila'' (sesame oil), ''prasanna''(supernatant part of ''sura''- a type of alcoholic preparation), ''kshaudra'' (honey) and ''ghrita'' (clarified butter) and two ''prasritas'' each of the decoctions of roots of ''bilvadi'' (a group of plants that begins with ''bilva''-Aegle marmelos Carr.) as well as two ''prasritas'' of ''kulattha'' (Phaseolus biflorus Linn.), antagonizes ''[[vata]]''. [5]<br /> <br /> === ''Nava--prasritiki basti'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पञ्चमूलरसात् पञ्च द्वौ तैलात् क्षौद्रसर्पिषोः| <br /> <br /> एकैकः प्रसृतो बस्तिः स्नेहनीयोऽनिलापहः||६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pañcamūlarasāt pañca dvau tailāt kṣaudrasarpiṣoḥ|<br /> <br /> ēkaikaḥ prasṛto bastiḥ snēhanīyō'nilāpahaḥ||6||<br /> <br /> pa~jcamUlarasAt pa~jca dvau tailAt kShaudrasarpiShoH| <br /> <br /> ekaikaH prasRuto bastiH snehanIyo~anilApahaH||6||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Basti]]'' prepared with five ''prasritas'' of the decoction of ''panchamula'' (''bilva, shyonaka, gambhari, patala'' and ''agnimantha''), two ''prasritas'' of ''taila'' (sesame oil) and one ''prasrita'' each of ''kshaudra'' (honey) as well as ''sarpi'' (''ghrita''), oleates (the body) and expels ''[[vata]]''. [6]<br /> <br /> === ''Chatu-prasritiki basti''-I ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सैन्धवार्धाक्ष एकैकः क्षौद्रतैलपयोघृतात्| <br /> <br /> प्रसृतो हपुषाकर्षो निरूहः शुक्रकृत् परम्||७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> saindhavārdhākṣa ēkaikaḥ kṣaudratailapayōghṛtāt| <br /> <br /> prasṛtō hapuṣākarṣō nirūhaḥ śukrakṛt param||7||<br /> <br /> saindhavArdhAkSha ekaikaH kShaudratailapayoghRutAt| <br /> <br /> prasRuto hapuShAkarSho nirUhaH shukrakRut param||7||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Niruha basti'', prepared with half ''aksha'' (about 6 grams) of ''saindhava'' (rock salt) one ''prasrita'' each of honey, sesame oil, milk, and ''ghrita'', and one ''karsha'' (about 12 grams) of ''hapusha'' (Juniperus communis Linn.), is an excellent promoter of ''shukra''. [7]<br /> <br /> === ''Panchatikta niruha basti'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पटोलनिम्बभूनिम्बरास्नासप्तच्छदाम्भसः| <br /> <br /> चत्वारः प्रसृता एको घृतात् सर्षपकल्कितः||८|| <br /> <br /> निरूहः पञ्चतिक्तोऽयं मेहाभिष्यन्दकुष्ठनुत् |९|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> paṭōlanimbabhūnimbarāsnāsaptacchadāmbhasaḥ| <br /> <br /> catvāraḥ prasṛtā ēkō ghṛtāt sarṣapakalkitaḥ||8|| <br /> <br /> nirūhaḥ pañcatiktō'yaṁ mēhābhiṣyandakuṣṭhanut |9|<br /> <br /> paTolanimbabhUnimbarAsnAsaptacchadAmbhasaH| <br /> <br /> catvAraH prasRutA eko ghRutAt sarShapakalkitaH||8|| <br /> <br /> nirUhaH pa~jcatikto~ayaM mehAbhiShyandakuShThanut |9|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A ''[[basti]]'' prepared by mixing four ''prasritas'' of decoction of ''patola'' (Trichosanthes dioica Roxb.), ''nimba'' (Azadirachta indica A.Juss.), ''bhunimba'' (Andrographis paniculata Nees.), ''rasna'' (Pluchea lanceolata Oliver &amp;Hiern.), ''saptacchada'' (Alstonia scholaris R.Br.); one ''prasrita'' of ''ghrita'', mixed with a ''kalka'' (paste) of ''sarshapa'' (Brassica campestris Linn.) is known as ''panchatikta niruha'' and is acting against ''prameha, abhishyanda'' and ''kushtha''. [8-8½]<br /> <br /> '''Note''': The quantity of ''kalka'' of ''sarshapa'' is not mentioned in the above recipe. According to commentary of Chakrapani on this verse, it may be decided.&lt;ref&gt;Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.8-9. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.&lt;/ref&gt;<br /> In the ''niruha basti'' with an amount of twelve ''prasritas'', the amount of ''kalka'' is usually two ''palas'' (about 100 gms). In present recipe, the amount is five ''prasritas'' and therefore the amount of ''kalka'' of ''sarshapa'' would be about 40 gms. This principle is applicable in latter recipes also where the amount of ''kalka'' is not mentioned.<br /> <br /> === ''Shat-prasritika basti'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विडङ्गत्रिफलाशिग्रुफलमुस्ताखुपर्णिजात्||९|| <br /> <br /> कषायात् प्रसृताः पञ्च तैलादेको विमथ्य तान्| <br /> <br /> विडङ्गपिप्पलीकल्को निरूहः क्रिमिनाशनः||१०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> viḍaṅgatriphalāśigruphalamustākhuparṇijāt||9||<br /> <br /> kaṣāyāt prasṛtāḥ pañca tailādēkō vimathya tān| <br /> <br /> viḍaṅgapippalīkalkō nirūhaḥ krimināśanaḥ||10||<br /> <br /> viDa~ggatriphalAshigruphalamustAkhuparNijAt||9|| <br /> <br /> kaShAyAt prasRutAH pa~jca tailAdeko vimathya tAn|<br /> <br /> viDa~ggapippalIkalko nirUhaH kriminAshanaH||10||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Five ''prasritas'' of decoction of ''vidanga'' (Embelia ribes Burm.), ''triphala'' (a combination of three fruits viz. Emblica officinalis Gaertn, terminalia chebula Retz. and terminalia belerica Roxb.), ''shigru'' (Moringa oleifera Linn.), ''madanaphala'' (Randia dumetorum Lam.), ''musta'' (Cyperus rotundus Linn.) and ''akhuparni'' (Merremia emarginata Burm.) and one ''prasrita'' of ''tila taila'' (sesame oil) churned together with a paste of ''vidanga'' (Embelia ribes Burm.) and ''pippali'' (Piper longum Linn.) is ''kriminashana niruha'' (''niruha'' acting against parasites) [9-10]<br /> <br /> === ''Sapta-prasritika basti'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पयस्येक्षुस्थिरारास्नाविदारीक्षौद्रसर्पिषाम्| <br /> <br /> एकैकः प्रसृतो बस्तिः कृष्णाकल्को वृषत्वकृत्||११|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> payasyēkṣusthirārāsnāvidārīkṣaudrasarpiṣām| <br /> <br /> ēkaikaḥ prasṛtō bastiḥ kṛṣṇākalkō vṛṣatvakṛt||11|| <br /> <br /> payasyekShusthirArAsnAvidArIkShaudrasarpiShAm| <br /> <br /> ekaikaH prasRuto bastiH kRuShNAkalko vRuShatvakRut||11|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Basti]]'' prepared with decoction of one ''prasrita'' of each of ''payasya'' (Fritillaria roylei Hook.), ''ikshu'' (Saccharum officinarum Linn.), ''sthira'' (Desmodium gangeticum DC.), ''rasna'' (Pluchea lanceolata Oliver &amp; Hiern.) and ''vidari'' (Pueraria tuberosa DC.); one ''prasrita'' each of honey and ''ghrita'', and paste of ''pippali'' (Piper longum Linn.) is ''vrishya'' (enhancing libido and sexual vigour). [11]<br /> <br /> === ''Chatu-prasritika basti''-II ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चत्वारस्तैलगोमूत्रदधिमण्डाम्लकाञ्जिकात्| <br /> <br /> प्रसृताः सर्षपैः कल्कैर्विट्सङ्गानाहभेदनः ||१२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> catvārastailagōmūtradadhimaṇḍāmlakāñjikāt <br /> <br /> prasṛtāḥ sarṣapaiḥ kalkairviṭsaṅgānāhabhēdanaḥ ||12||<br /> <br /> catvArastailagomUtradadhimaNDAmlakA~jjikAt| <br /> <br /> prasRutAH sarShapaiH kalkairviTsa~ggAnAhabhedanaH ||12||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Basti]]'' prepared with a total of four ''prasritas'' of ''tila taila'' (sesame oil), cow’s urine, ''dadhimanda'' (whey) and ''amlakanji'' (fermented sour gruel) mixed with a paste of ''sarshapa'' (Brassica campestris Linn.) relieves the stagnation of stool and constipation. [12]<br /> <br /> === ''Pancha-prasritika basti''-II ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> श्वदंष्ट्राश्मभिदेरण्डरसात्तैलात् सुरासवात्| <br /> <br /> प्रसृताः पञ्च यष्ट्याह्वकौन्तीमागधिकासिताः||१३|| <br /> <br /> कल्कः स्यान्मूत्रकृच्छ्रे तु सानाहे बस्तिरुत्तमः| <br /> <br /> एते सलवणाः कोष्णा निरूहाः प्रसृतैर्नव||१४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śvadaṁṣṭrāśmabhidēraṇḍarasāttailāt surāsavāt| <br /> <br /> prasṛtāḥ pañca yaṣṭyāhvakauntīmāgadhikāsitāḥ||13||<br /> <br /> kalkaḥ syānmūtrakṛcchrē tu sānāhē bastiruttamaḥ| <br /> <br /> ētē salavaṇāḥ kōṣṇā nirūhāḥ prasṛtairnava||14||<br /> <br /> shvadaMShTrAshmabhideraNDarasAttailAt surAsavAt| <br /> <br /> prasRutAH pa~jca yaShTyAhvakauntImAgadhikAsitAH||13|| <br /> <br /> kalkaH syAnmUtrakRucchre tu sAnAhe bastiruttamaH| <br /> <br /> ete salavaNAH koShNA nirUhAH prasRutairnava||14||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Basti]]'' prepared with five ''prasritas'' decoction of ''shvadamshtra'' (Tribulus terrestris Linn.), ''ashmabhida'' (Bergenia ligulata Wall.), ''eranda'' (Ricinus communis Linn.) together, ''taila'' and ''surasava'' (an alcoholic preparation) added with paste of ''yashti'' (Glycyrrhiza glabra Linn.), ''kaunti'' (Piper aurantiacum Wall.), ''magadhika'' (Piper longum Linn.) and ''sitah'' (sugar candy) is useful in ''mutrakricchra'' (a condition characterized by difficult and painful micturition) and ''anaha'' (constipation). These nine ''prasrita bastis'' are given with salt and moderately warm. [13-14]<br /> <br /> === Treatment of stagnated ''[[basti]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मृदुबस्तिजडीभूते तीक्ष्णोऽन्यो बस्तिरिष्यते| <br /> <br /> तीक्ष्णैर्विकर्षिते स्वादु प्रत्यास्थापनमिष्यते ||१५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mṛdubastijaḍībhūtē tīkṣṇō'nyō bastiriṣyatē| <br /> <br /> tīkṣṇairvikarṣitē svādu pratyāsthāpanamiṣyatē [1] ||15||<br /> <br /> mRudubastijaDIbhUte tIkShNo~anyo bastiriShyate| <br /> <br /> tIkShNairvikarShite svAdu pratyAsthApanamiShyate ||15||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If a ''mridubasti'' (mild acting ''[[basti]]'') gets stagnated, that needs another ''teekshna basti'' (strong and sharp acting ''[[basti]]''). One, who is emaciated because of strong ''[[basti]]s'', requires ''asthapana [[basti]]'' prepared with ''madhura'' (sweet) substances. [15]<br /> <br /> === Treatment of ''guda-daha'' (burning sensation in anus) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वातोपसृष्टस्योष्णैः स्युर्गुददाहादयो यदि| <br /> <br /> द्राक्षाम्बुना त्रिवृत्कल्कं दद्याद्दोषानुलोमनम्||१६|| <br /> <br /> तद्धि पित्तशकृद्वातान् हृत्वा दाहादिकाञ्जयेत्| <br /> <br /> शुद्धश्चापि पिबेच्छीतां यवागूं शर्करायुताम्||१७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vātōpasṛṣṭasyōṣṇaiḥ syurgudadāhādayō yadi| <br /> <br /> drākṣāmbunā trivṛtkalkaṁ dadyāddōṣānulōmanam||16|| <br /> <br /> taddhi pittaśakṛdvātān hṛtvā dāhādikāñjayēt| <br /> <br /> śuddhaścāpi pibēcchītāṁ yavāgūṁ śarkarāyutām||17||<br /> <br /> vAtopasRuShTasyoShNaiH syurgudadAhAdayoyadi| <br /> <br /> drAkShAmbunA trivRutkalkaM dadyAddoShAnulomanam||16|| <br /> <br /> taddhi pittashakRudvAtAn hRutvA dAhAdikA~jjayet| <br /> <br /> shuddhashcApi pibecchItAM yavAgUM sharkarAyutAm||17||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If a patient with ''[[vata]]'' disorder suffers from anorectal burning (and other similar ''[[pitta]]''-related symptoms) due to (administration of) hot ''[[basti]]s'', a mixture of ''drakshambu'' (grape juice or decoction of raisins) and ''trivritkalka'' (paste of Operculina turpethum Linn.), which is ''doshanulshmana'' (bringing the movement of ''[[dosha]]'' in right direction) is given. This relieves burning sensation and similar conditions by expelling the ''[[pitta]]'', stool and ''[[vata]]''. After the body is cleansed, the patient has to take cold ''yavagu'' added with sugar. [16-17]<br /> <br /> === Treatment of ''mala kshaya'' (depletion of stool) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथवाऽतिविरिक्तः स्यात् क्षीणविट्कः स भक्षयेत्|<br /> <br /> माषयूषेण कुल्माषान् पिबेन्मध्वथवा सुराम्||१८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athavā'tiviriktaḥ syāt kṣīṇaviṭkaḥ sa bhakṣayēt <br /> <br /> māṣayūṣēṇa kulmāṣān pibēnmadhvathavā surām||18||<br /> <br /> athavA~ativiriktaH syAt kShINaviTkaH sa bhakShayet| <br /> <br /> mAShayUSheNa kulmAShAn pibenmadhvathavA surAm||18||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> On the other hand, if a patient has excessive purgation and suffers from depletion of stool (and other essential body components e.g. fluids), he or she has to take ''kulmasha'' (half cooked grains) with ''mashayoosha'' (soup of Phaseolus mungo Linn.), or ''sura'' (an alcoholic preparation) or honey. [18]<br /> <br /> === Treatment of ''amaja shula'' (abdominal pain due to improper digestion) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सामं चेत् कुणपं शूलैरुपविशेदरोचकी| <br /> <br /> स घनातिविषाकुष्ठनतदारुवचाः पिबेत्||१९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sāmaṁ cēt kuṇapaṁ śūlairupaviśēdarōcakī| <br /> <br /> sa ghanātiviṣākuṣṭhanatadāruvacāḥ pibēt||19||<br /> <br /> sAmaM cet kuNapaM shUlairupavishedarocakI| <br /> <br /> sa ghanAtiviShAkuShThanatadAruvacAH pibet||19|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> (A decoction of) ''musta'' (Cyperus rotundus Linn.), ''ativisha'' (Aconitum heterophyllum wall.), ''kushtha'' (Saussurea lappa C.B.Clarke.), ''nata'' (Valeriana wallichii DC.), ''daru'' (Cedrus deodara Roxb.) and ''vacha'' (Acorus calamus Linn.) is recommended to a patient with loss of appetite, passing ''sama'' stool (i.e., stool containing ''ama'') smelling like a dead (decomposing) body and with abdominal pain. [19]<br /> <br /> === Treatment of ''atisara'' (diarrhea) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शकृद्वातमसृक् पित्तं कफं वा योऽतिसार्यते| <br /> <br /> पक्वं , तत्र स्ववर्गीयैर्बस्तिः श्रेष्ठं भिषग्जितम्||२०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śakṛdvātamasṛk pittaṁ kaphaṁ vā yō'tisāryatē| <br /> <br /> pakvaṁ , tatra svavargīyairbastiḥ śrēṣṭhaṁ bhiṣagjitam||20||<br /> <br /> shakRudvAtamasRuk pittaM kaphaM vA yo~atisAryate| <br /> <br /> pakvaM , tatra svavargIyairbastiH shreShThaM bhiShagjitam||20||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When a patient has ''pakva atisara'' (without undigested material) passing ''shakrita'' (stool), ''[[vata]], asrika'' (blood), ''[[pitta]]'' or ''[[kapha]]'', then ''[[basti]]'' prepared with a specific group of medicines acting against each of these pathologies is best measure. [20]<br /> <br /> === Six types of ''atisara'' and its common complications ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> षण्णामेषां द्विसंसर्गात् त्रिंशद्भेदा भवन्ति तु| <br /> <br /> केवलैः सह षट्त्रिंशद्विद्यात् सोपद्रवानपि||२१||<br /> <br /> शूलप्रवाहिकाध्मानपरिकर्त्यरुचिज्वरान्| <br /> <br /> तृष्णोष्णदाहमूर्च्छादींश्चैषां विद्यादुपद्रवान्||२२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ṣaṇṇāmēṣāṁ dvisaṁsargāt triṁśadbhēdā bhavanti tu| <br /> <br /> kēvalaiḥ saha ṣaṭtriṁśadvidyāt sōpadravānapi||21||<br /> <br /> śūlapravāhikādhmānaparikartyarucijvarān| <br /> <br /> tṛṣṇōṣṇadāhamūrcchādīṁścaiṣāṁ vidyādupadravān||22||<br /> <br /> ShaNNAmeShAM dvisaMsargAt triMshadbhedA bhavanti tu| <br /> <br /> kevalaiH saha ShaTtriMshadvidyAt sopadravAnapi||21||<br /> <br /> shUlapravAhikAdhmAnaparikartyarucijvarAn| <br /> <br /> tRuShNoShNadAhamUrcchAdIMshcaiShAM vidyAdupadravAn||22||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> These six types of ''atisara'' may have thirty variants as a result of mutual combination of two morbid factors. Together with basic six, they constitute thirty six types, which manifest along with their complications. ''Shoola'' (abdominal pain), ''pravahika'' (dysentery), ''adhmana'' (abdominal distension) ''parikarti'' (anal pain), ''aruchi'' (distaste for food), ''[[jwara]]'' (fever), ''tṛishna'' (thirst), ''ushnatva'' (feeling of heat), ''daha'' (burning sensation) and ''murccha''(syncope) are its complications (''upadrava''). [21-22]<br /> <br /> === Treatment of ''ama-atisara'' ( diarrhea with improper digestion) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्रामेऽन्तरपानं स्यात् व्योषाम्ललवणैर्युतम्| <br /> <br /> पाचनं शस्यते बस्तिरामे हि प्रतिषिध्यते||२३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatrāmē'ntarapānaṁ syāt vyōṣāmlalavaṇairyutam| <br /> <br /> ṁ śasyatē bastirāmē hi pratiṣidhyatē||23||<br /> <br /> tatrAme~antarapAnaM syAt vyoShAmlalavaNairyutam| <br /> <br /> pAcanaM shasyate bastirAme hi pratiShidhyate||23||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In case of ''amatisara'', a drink having ''[[pachana]]'' action added with ''trikatu'' (a group of three pungent drugs viz. rhizome of Zingiber officinalis Roxb.; fruits of Piper nigrum Linn. and Piper longum Linn.), ''amla'' (sour) and ''lavana'' (salty) substances is recommended. ''[[Basti]]s'' are contraindicated in ''ama'' condition. [23]<br /> <br /> === Treatment of ''shakrita-atisara'' and ''[[vata]] atisara''( diarrhea with excess stools and ''[[vata]]'') ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वातघ्नैर्ग्राहिवर्गीयैर्बस्तिः शकृति शस्यते |<br /> <br /> स्वाद्वम्ललवणैः शस्तः स्नेहबस्तिः समीरणे||२४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vātaghnairgrāhivargīyairbastiḥ śakṛti śasyatē<br /> <br /> svādvamlalavaṇaiḥ śastaḥ snēhabastiḥ samīraṇē||24||<br /> <br /> vAtaghnairgrAhivargIyairbastiH shakRuti shasyate<br /> <br /> svAdvamlalavaNaiH shastaH snehabastiH samIraNe||24|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''shakritatisara'' (''atisara'' in which only stool is passed), ''[[basti]]'' with ''vataghna'' and ''grahi'' category of medicines is recommended. In ''[[vata]]'' related ''atisara, sneha [[basti]]'' with ''svadu'' (sweet), ''amla'' (sour) and ''lavana'' (salty) substances is acclaimed. [24]<br /> <br /> === Treatment of ''[[rakta]] atisara, [[pitta]] atisara'' and ''[[kapha]] atisara'' (diarrhea with blood, ''[[pitta]]'' and ''[[kapha]]'') ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रक्ते रक्तेन, पित्ते तु कषायस्वादुतिक्तकैः| <br /> <br /> सार्यमाणे कफे बस्तिः कषायकटुतिक्तकैः||२५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> raktē raktēna, pittē tu kaṣāyasvādutiktakaiḥ| <br /> <br /> sāryamāṇē kaphē bastiḥ kaṣāyakaṭutiktakaiḥ||25||<br /> <br /> rakte raktena, pitte tu kaShAyasvAdutiktakaiH| <br /> <br /> sAryamANe kaphe bastiH kaShAyakaTutiktakaiH||25||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''[[rakta]] atisara'' (diarrhea with blood) ''[[basti]]'' with blood, in ''[[pitta]] atisara [[basti]]'' with ''kashaya'' (astringent), ''madhura'' (sweet) and ''tikta'' (bitter) substances and in ''[[kapha]] atisara'' with ''kashaya'' (astringent), ''katu'' (pungent) and ''tikta'' (bitter) substances is to be administered. [25]<br /> <br /> === Treatment of ''atisara'' (diarrhea) mixed with ''shakrita-ama'' and ''[[vata]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शकृता वायुना वाऽऽमे तेन वर्चस्यथानिले| <br /> <br /> संसृष्टेऽन्तरपानं स्याद् व्योषाम्ललवणैर्युतम्||२६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śakṛtā vāyunā vā”me tena varcasyathānilē| <br /> <br /> saṁsṛṣṭē'ntarapānaṁ syād vyōṣāmlalavaṇairyutam||26|| <br /> <br /> shakRutA vAyunA vA~a~ame tena varcasyathAnile| <br /> <br /> saMsRuShTe~antarapAnaM syAd vyoShAmlalavaNairyutam||26|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In the conditions where ''ama'' is associated with ''shakrita'' (stool) or ''[[vata]]'', or ''shakrita'' (stool) or ''[[vata]]'' is associated with ''ama'' a drink, prepared with ''vyosha'' (a group of three pungent drugs, commonly known as ''trikatu'', viz. rhizome of Zingiber officinalis Roxb.; fruits of Piper nigrum Linn. and Piper longum Linn.), sour and salty substances, is recommended. [26]<br /> <br /> === Treatment of ''atisara'' (diarrhea) mixed with ''[[pitta]]-[[rakta]]'' and ''ama'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तेनामेऽसृजा वाऽपि तयोरामेन वा पुनः| <br /> <br /> संसृष्टयोर्भवेत् पानं सव्योषस्वादुतिक्तकम्||२७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pittēnāmē'sṛjā vā'pi tayōrāmēna vā punaḥ| <br /> <br /> saṁsṛṣṭayōrbhavēt pānaṁ savyōṣasvādutiktakam||27||<br /> <br /> pittenAme~asRujA vA~api tayorAmena vA punaH| <br /> <br /> saMsRuShTayorbhavet pAnaM savyoShasvAdutiktakam||27||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If there is association of ''ama'' with ''[[pitta]]'' or ''[[rakta]]'' or of both separately with ''ama'' then a drink with ''trikaṭu'', sweet and bitter substances is indicated. [27]<br /> <br /> === Treatment of ''atisara'' (diarrhea)mixed with ''[[kapha]]-ama'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तथाऽऽमे कफसंसृष्टे कषायव्योषतिक्तकम्| <br /> <br /> आमेन तु कफे व्योषकषायलवणैर्युतम्||२८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tathā''mē kaphasaṁsṛṣṭē kaṣāyavyōṣatiktakam| <br /> <br /> āmēna tu kaphē vyōṣakaṣāyalavaṇairyutam||28|| <br /> <br /> tathA~a~ame kaphasaMsRuShTe kaShAyavyoShatiktakam|<br /> <br /> Amena tu kaphe vyoShakaShAyalavaNairyutam||28|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If ''ama'' is associated with ''[[kapha]]'', a ''[[basti]]'' containing ''kashaya'' (astringent), ''trikatu'' and bitter substances and when ''[[kapha]]'' is associated with ''ama'', a ''[[basti]]'' containing ''trikatu, kashaya'' (astringent) and salty substances is recommended. [28]<br /> <br /> === Treatment of ''atisara'' (diarrhea) mixed with ''[[pitta]]-[[vata]]-shakrita'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वातेन विशि पित्ते वा विट्पित्ताभ्यां तथाऽनिले| <br /> <br /> मधुराम्लकषायः स्यात् संसृष्टे बस्तिरुत्तमः||२९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vātēna viśi pittē vā viṭpittābhyāṁ tathā'nilē| <br /> <br /> madhurāmlakaṣāyaḥ syāt saṁsṛṣṭē bastiruttamaḥ||29||<br /> <br /> vAtena vishi pitte vA viTpittAbhyAM tathA~anile| <br /> <br /> madhurAmlakaShAyaH syAt saMsRuShTe bastiruttamaH||29||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When stool or ''[[pitta]]'' is associated with ''[[vata]]'' or ''[[vata]]'' is associated with stool and ''[[pitta]]'', a ''[[basti]]'' with sweet, sour and astringent substances, is excellent. [29]<br /> <br /> === Treatment of ''atisara'' (diarrhea) mixed with ''[[pitta]]-[[rakta]]-shakrita'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शकृच्छोणितयोः पित्तशकृतो रक्तपित्तयोः| <br /> <br /> बस्तिरन्योन्यसंसर्गे कषायस्वादुतिक्तकः||३०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śakṛcchōṇitayōḥ pittaśakṛtō raktapittayōḥ| <br /> <br /> bastiranyōnyasaṁsargē kaṣāyasvādutiktakaḥ||30||<br /> <br /> shakRucchoNitayoH pittashakRuto raktapittayoH| <br /> <br /> bastiranyonyasaMsarge kaShAyasvAdutiktakaH||30|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In case of morbid mutual associations of ''[[pitta]]'' with stool and ''[[rakta]]'', as well as stool with ''[[rakta]]'' and ''[[pitta]], [[basti]]'' with astringent, sweet and bitter ingredients. [30]<br /> <br /> === Treatment of ''atisara'' (diarrhea) mixed with ''[[kapha]]-[[rakta]]-[[pitta]]-shakrita'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कफेन विशि पित्ते वा कफे विट्पित्तशोणितैः| <br /> <br /> व्योषतिक्तकषायः स्यात् संसृष्टे बस्तिरुत्तमः||३१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaphēna viśi pittē vā kaphē viṭpittaśōṇitaiḥ| <br /> <br /> vyōṣatiktakaṣāyaḥ syāt saṁsṛṣṭē bastiruttamaḥ||31||<br /> <br /> kaphena vishi pitte vA kaphe viTpittashoNitaiH| <br /> <br /> vyoShatiktakaShAyaH syAt saMsRuShTe bastiruttamaH||31||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In case of similar associations of ''[[kapha]]'' with stool or ''[[pitta]]''; or of stool or ''[[pitta]]'' or ''[[rakta]]'' with ''[[kapha]]'', a ''[[basti]]'' with ''trikatu'', bitter and ''kashaya'' ingredients is to be recommended. [31]<br /> <br /> === Treatment of ''atisara'' (diarrhea) mixed with ''[[vata]]-[[kapha]]-shakrita'' and ''[[rakta]]-[[kapha]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्याद्बस्तिर्व्योषतिक्ताम्लः संसृष्टे वायुना कफे| <br /> <br /> मधुरव्योषतिक्तस्तु रक्ते कफविमूर्च्छिते||३२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> syādbastirvyōṣatiktāmlaḥ saṁsṛṣṭē vāyunā kaphē| <br /> <br /> madhuravyōṣatiktastu raktē kaphavimūrcchitē||32|| <br /> <br /> syAdbastirvyoShatiktAmlaH saMsRuShTe vAyunA kaphe| <br /> <br /> madhuravyoShatiktastu rakte kaphavimUrcchite||32||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''atisara'' where ''[[kapha]]'' is associated with ''[[vata]], [[basti]]'' with ''trikatu'', bitter and sour ingredients, and if ''[[rakta]]'' is associated with ''[[kapha]]'' then with sweet, ''trikatu'' and bitter is recommended. [32]<br /> <br /> === Treatment of ''atisara'' (diarrhea) mixed with ''[[kapha]]- [[vata]] -shakrita'' and ''[[vata]]-[[pitta]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मारुते कफसंसृष्टे व्योषाम्ललवणो भवेत्| <br /> <br /> बस्तिर्वातेन पित्ते तु कार्यः स्वाद्वम्लतिक्तकः||३३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mārutē kaphasaṁsṛṣṭē vyōṣāmlalavaṇō bhavēt| <br /> <br /> bastirvātēna pittē tu kāryaḥ svādvamlatiktakaḥ||33||<br /> <br /> mArute kaphasaMsRuShTe vyoShAmlalavaNo bhavet| <br /> <br /> bastirvAtena pitte [2] tu kAryaH svAdvamlatiktakaH||33||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If ''[[vata]]'' is accompanied by ''[[kapha]]'', a ''[[basti]]'' with ''trikatu'', sour and salty ingredients; and when ''[[pitta]]'' is associated with ''[[vata]], [[basti]]'' with sweet, sour and bitter substances is to be administered. [33]<br /> <br /> === Treatment for conditions due to ''samsarga'' (combination of ''[[dosha]]'') ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिचतुःपञ्चसंसर्गानेवमेव विकल्पयेत्| <br /> <br /> युक्तिश्चैषातिसारोक्ता सर्वरोगेष्वपि स्मृता||३४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tricatuḥpañcasaṁsargānēvamēva vikalpayēt| <br /> <br /> yuktiścaiṣātisārōktā sarvarōgēṣvapi smṛtā||34||<br /> <br /> tricatuHpa~jcasaMsargAnevameva vikalpayet| <br /> <br /> yuktishcaiShAtisAroktA sarvarogeShvapi smRutA||34||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Similarly a plan may be designed in cases of morbid combinations of three, four or five components. This planning for ''atisara'' is applicable in all disease conditions. [34]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> युगपत् षड्रसं षण्णां संसर्गे पाचनं भवेत् | <br /> <br /> निरामाणां तु पञ्चानां बस्तिः षाड्रसिको मतः||३५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yugapat ṣaḍrasaṁ ṣaṇṇāṁ saṁsargē pācanaṁ bhavēt [1] | <br /> <br /> nirāmāṇāṁ tu pañcānāṁ bastiḥ ṣāḍrasikō mataḥ||35|| <br /> <br /> yugapat ShaDrasaM ShaNNAM saMsarge pAcanaM bhavet [1] | <br /> <br /> nirAmANAM tu pa~jcAnAM bastiH ShADrasiko mataH||35||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''atisara'', if all six pathological components are simultaneously involved, a ''[[pachana]]'' (causing or promoting digestion or transformation) medicine containing the drugs of all six tastes is useful, while in ''nirama'' (without ''ama'') condition, where other five are involved a ''[[basti]]'' consisting of all six ''rasas'' (tastes) is indicated. [35]<br /> <br /> === ''Sarvatisara nashaka ghrita'' (medicated ghee for treatment of all types of diarrhea) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> उदुम्बरशलाटूनि जम्ब्वाम्रोदुम्बरत्वचः| <br /> <br /> शङ्खं सर्जरसं लाक्षां कर्दमं च पलांशिकम्||३६|| <br /> <br /> पिष्ट्वा तैः सर्पिषः प्रस्थं क्षीरद्विगुणितं पचेत्| <br /> <br /> अतीसारेषु सर्वेषु पेयमेतद्यथाबलम्||३७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> udumbarani jambvāmrōdumbaratvacaḥ| <br /> <br /> śaṅkhaṁ sarjarasaṁ lākṣāṁ kardamaṁ ca palāṁśikam||36|| <br /> <br /> piṣṭvā taiḥ sarpiṣaḥ prasthaṁ kṣīradviguṇitaṁ pacēt|<br /> <br /> atīsārēṣu sarvēṣu pēyamētadyathābalam||37||<br /> <br /> udumbarashalATUni jambvAmrodumbaratvacaH| <br /> <br /> sha~gkhaM sarjarasaM lAkShAM kardamaM ca palAMshikam||36|| <br /> <br /> piShTvA taiH sarpiShaH prasthaM kShIradviguNitaM pacet| <br /> <br /> atIsAreShu sarveShu peyametadyathAbalam||37||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A freshly prepared paste of ''udumbarashalaatu'' (unripe fruits of Ficus glomerata Roxb.), bark of ''jaambu'' (Syzygium cumini Skeels.), ''amra'' (Mangifera indica Linn.) and ''udumbara'' (Ficus glomerata Roxb.); ''sankha'' (conch shell), ''sarjarasa'' (resin of Vateria indica Linn.), ''laaksha'' (resinous secretion of Laccifera lacca Kerr.) and ''kardama'' (a type of rice), each one ''pala'' (about 50 grams) is to be cooked with one ''prastha'' (about 800 ml.) of ''ghrita'', and two ''prastha'' of milk. This (thus prepared ''ghrita'') is to be taken in all types of ''atisara'' according to ''bala'' (strength of the patient as well as disease). [36-37]<br /> <br /> === ''Sarvatisara nashaka yavagu'' (medicated gruel for treatment of all types of diarrhea) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कच्छुराधातकीबिल्वसमङ्गारक्तशालिभिः| <br /> <br /> मसूराश्वत्थशुङ्गैश्च यवागूः स्याज्जले शृतैः||३८|| <br /> <br /> बालोदुम्बरकट्वङ्गसमङ्गाप्लक्षपल्लवैः | <br /> <br /> मसूरधातकीपुष्पबलाभिश्च तथा भवेत्||३९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kacchurādhātakībilvasamaṅgāraktaśālibhiḥ| <br /> <br /> masūrāśvatthaśuṅgaiśca yavāgūḥ syājjalē śṛtaiḥ||38||<br /> <br /> bālōdumbarakaṭvaṅgasamaṅgāplakṣapallavaiḥ | <br /> <br /> masūradhātakīpuṣpabalābhiśca tathā bhavēt||39||<br /> <br /> kacchurAdhAtakIbilvasama~ggAraktashAlibhiH| <br /> <br /> masUrAshvatthashu~ggaishca yavAgUH syAjjale shRutaiH||38|| <br /> <br /> bAlodumbarakaTva~ggasama~ggAplakShapallavaiH | <br /> <br /> masUradhAtakIpuShpabalAbhishca tathA bhavet||39||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A ''yavagu'' (gruel) prepared by cooking ''raktashali'' (a variety of rice brownish in color) and ''masura'' (Lens culinaris Medic.)) in a decoction of ''kacchura'' (Mucuna pruriens Baker. ), ''dhataki'' (Woodfordia fruticosa Kurz.), ''bilva'' (Aegle marmelos Carr.), ''samanga'' (Mimosa pudica Linn.) and ''ashvatthashunga'' (leaf bud of Ficus religiosa Linn.) is beneficial in ''atisara''.<br /> <br /> Similar preparation can be made with unripe fruit of ''udumbara'', leaves of ''kathvanga'' (Ailanthus excelsa Roxb.) and ''samanga'' as well as ''plaksha'' (Ficus lacor Buch.), ''masura'' (Lens culinaris Medic.) and ''dhataki'' flowers. [38-39]<br /> <br /> === Treatment of all types of diarrhea ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्थिरादीनां बलादीनामिक्ष्वादीनामथापि वा| <br /> <br /> क्वाथेषु समसूराणां यवाग्वः स्युः पृथक् पृथक्||४०|| <br /> <br /> कच्छुरामूलशाल्यादितण्डुलैरुपसाधिताः| <br /> <br /> दधितक्रारनालाम्लक्षीरेष्विक्षुरसेऽपि वा||४१|| <br /> <br /> शीताः सशर्कराक्षौद्राः सर्वातिसारनाशनाः| <br /> <br /> ससर्पिर्मरिचाजाज्यो मधुरा लवणाः शिवाः||४२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sthirādīnāṁ balādīnāmikṣvādīnāmathāpi vā| <br /> <br /> kvāthēṣu samasūrāṇāṁ yavāgvaḥ syuḥ pṛthak pṛthak||40|| <br /> <br /> kacchurāmūlaśālyāditaṇḍulairupasādhitāḥ| <br /> <br /> dadhitakrāranālāmlakṣīrēṣvikṣurasē'pi vā||41|| <br /> <br /> śītāḥ saśarkarākṣaudrāḥ sarvātisāranāśanāḥ| <br /> <br /> sasarpirmaricājājyō madhurā lavaṇāḥ śivāḥ||42|| <br /> <br /> sthirAdInAM balAdInAmikShvAdInAmathApi vA| <br /> <br /> kvAtheShu samasUrANAM yavAgvaH syuH pRuthak pRuthak||40|| <br /> <br /> kacchurAmUlashAlyAditaNDulairupasAdhitAH| <br /> <br /> dadhitakrAranAlAmlakShIreShvikShurase~api vA||41|| <br /> <br /> shItAH sasharkarAkShaudrAH sarvAtisAranAshanAH| <br /> <br /> sasarpirmaricAjAjyo madhurA lavaNAH shivAH||42||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Different ''yavagus'' can be prepared by combining ''masura'' (Lens culinaris Medic.) with the decoctions of ''sthiradi, baladi'' and ''ikshvadi'' (groups of plants). [40]<br /> <br /> Roots of ''kacchura'' (Mucuna pruriens Baker.) and rice of ''shali'' and other varieties cooked with ''dadhi'' (yogurt), ''takra'' (churned yogurt), ''aranala'' (sour fermented supernatant of cooked rice), ''ksheera'' (milk) or ''ikshurasa'' (sugarcane juice), and after being cooled added with sugar and honey, is able to treat all types of ''atisara''. The above-mentioned gruels are promising (anti-diarreal) when added with ''ghrita'', pepper and cumin (Cuminum cyminum Linn.), sweet substances and rock salt. [41-42]<br /> <br /> === Treatment principles ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भवन्ति चात्र श्लोकाः-<br /> <br /> स्निग्धाम्ललवणमधुरं पानं बस्तिश्च मारुते कोष्णः| <br /> <br /> शीतं तिक्तकषायं मधुरं पित्ते च रक्ते च||४३|| <br /> <br /> तिक्तोष्णकषायकटुश्लेष्मणि सङ्ग्राहि वातनुच्छकृति| <br /> <br /> पाचनमामे पानं पिच्छासृग्बस्तयो रक्ते||४४|| <br /> <br /> अतिसारं प्रत्युक्तं मिश्रं द्वन्द्वादियोगजेष्वपि च| <br /> <br /> तत्रोद्रेकविशेषाद्दोषेषूपक्रमः कार्यः||४५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhavanti cātra ślōkāḥ- <br /> <br /> snigdhāmlalavaṇamadhuraṁ pānaṁ bastiśca mārutē kōṣṇaḥ| <br /> <br /> śītaṁ tiktakaṣāyaṁ madhuraṁ pittē ca raktē ca||43|| <br /> <br /> tiktōṣṇakaṣāyakaṭuślēṣmaṇi saṅgrāhi vātanucchakṛti| <br /> <br /> pācanamāmē pānaṁ picchāsṛgbastayō raktē||44|| <br /> <br /> atisāraṁ pratyuktaṁ miśraṁ dvandvādiyōgajēṣvapi [1] ca| <br /> <br /> tatrōdrēkaviśēṣāddōṣēṣūpakramaḥ kāryaḥ||45|| <br /> <br /> bhavanti cAtra shlokAH- <br /> <br /> snigdhAmlalavaNamadhuraM pAnaM bastishca mArute koShNaH| <br /> <br /> shItaM tiktakaShAyaM madhuraM pitte ca rakte ca||43|| <br /> <br /> tiktoShNakaShAyakaTushleShmaNi sa~ggrAhi vAtanucchakRuti| <br /> <br /> pAcanamAme pAnaM picchAsRugbastayo rakte||44|| <br /> <br /> atisAraM pratyuktaM mishraM dvandvAdiyogajeShvapi ca| <br /> <br /> tatrodrekavisheShAddoSheShUpakramaH kAryaH||45||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Here the ''shlokas'' (verses) remain-<br /> <br /> (Besides the above some more treatment-principles useful in ''atisaras'' are given below as per the factors involved)<br /> <br /> #''[[Vata]]: snigdha'' (unctuous) ''amla'' (sour) ''lavana'' (salty) and ''madhura'' (sweet) liquids orally and warm ''[[basti]]s'' with same substances. <br /> #''[[Pitta]]'' and ''[[rakta]]'': cold bitter astringent and sweet substances.<br /> #''[[Kapha]]'': bitter, hot, astringent and pungent substances.<br /> #''Shakrita'' (stool): ''sangrahi'' (checks ''atisara'' through improving the digestion) and ''vataghna'' (measures)<br /> #''Ama: [[pachana]]'' (measures digesting ''ama'')<br /> #''[[Rakta]]: picchabasti'' and ''raktabasti'' <br /> #''Atisara'' may also be in combination of two or more factors. In those conditions treatment is to be planned according to dominance of the ''[[dosha]]s'' (and the factors involved). [43-45]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकः- <br /> <br /> प्रासृतिकाः सव्यापत्क्रिया निरूहास्तथाऽतिसारहिताः| <br /> <br /> रसकल्पघृतयवाग्वश्चोक्ता गुरुणा प्रसृतसिद्धौ||४६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkaḥ- <br /> <br /> prāsṛtikāḥ savyāpatkriyā nirūhāstathā'tisārahitāḥ| <br /> <br /> rasakalpaghṛtayavāgvaścōktā [1] guruṇā prasṛtasiddhau||46|| <br /> <br /> tatra shlokaH- <br /> <br /> prAsRutikAH savyApatkriyA nirUhAstathA~atisArahitAH| <br /> <br /> rasakalpaghRutayavAgvashcoktA [1] guruNA prasRutasiddhau||46||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In this chapter of [[Prasrita Yogiyam Siddhi]] management of the complications, ''prasritika niruhas'', and the ''[[basti]]s,'' decoctions, ''ghrita'', gruels useful in the management of ''atisaras'' are presented by the teacher. [46]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते <br /> <br /> दृढबलसम्पूरिते सिद्धिस्थाने प्रासृतयोगीयसिद्धिर्नामाष्टमोऽध्यायः ||८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagnivēśakṛtē tantrē carakapratisaṁskṛtē'prāptē <br /> <br /> dṛḍhabalasampūritē siddhisthānē prāsṛtayōgīyasiddhirnāmāṣṭamō'dhyāyaḥ [1] ||8|| <br /> <br /> ityagniveshakRute tantre carakapratisaMskRute~aprApte <br /> <br /> dRuDhabalasampUrite siddhisthAne prAsRutayogIyasiddhirnAmAShTamo~adhyAyaH [1] ||8||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus in the treatise (originally) prepared by Agnivesha, edited by Charak and supplemented the lost parts by Dridhabala, in [[Siddhi Sthana]], the eighth chapter entitled [[Prasrita Yogiyam Siddhi]] is concluded.<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *A milder form of ''[[basti]]'' can get stagnated inside leading to complications of not eliminating ''[[dosha]]s''. This may result into ''ayoga'' or ''heenayoga'' (insufficient action). On the contrary if a ''[[basti]]'' is stronger it may cause an ''atiyoga'' (action in excess) causing excessive evacuation of ''[[dosha]]'' along with body constituents.<br /> *Faulty application of ''[[basti]]s'' may cause a complication in the form of ''atisara'' (diarrhea).<br /> *''Atisara'' (diarrhea) may be either acute with undigested material associated with ''ama'' or chronic without much undigested material/ ''pakwa''.<br /> *''Pakwa'' type of ''atisara'' is again of five types as with ''shakrita'' (fecal matter), with ''[[vata]]'' (flatus), with ''asrika'' (blood), with ''[[pitta]]'' and with ''[[kapha]]''. <br /> *Basic principle of treatment of every condition associated with ''ama'' is ''amapachana''. Decoction / powder of ''musta, ativisha, kushtha, nata, daru'' and ''vacha'' are ideal for ''amapachana''. This recipe is useful in ''amatisara''. <br /> *To manage ''pakvatisara'', medicines of two categories viz. ''vataghna'' (anti-''vata'') and ''grahi'' (anti-diarrheal by promoting digestion and absorption) are used. <br /> *''Picchabasti'' and ''raktabasti'' are treatments for diarrhea with blood.These can be considered as ''[[stambhana]]'' (stop bleeding) and ''vishesha [[brimhana]]'' (enhance internal strength). <br /> *The treatment principles of various types of ''atisara'' due to complications of ''[[basti]]'' therapy:<br /> **''[[Vata]]'': ''snigdha'' (unctuous), ''amla'' (sour), ''lavana'' (salty) and ''madhura'' (sweet) liquids orally and warm ''[[basti]]s'' with same substances. <br /> **''[[Pitta]]'' and ''[[rakta]]'': cold bitter astringent and sweet substances.<br /> **''[[Kapha]]'': bitter, hot, astringent and pungent substances.<br /> **''Shakrita'' (stool): ''sangrahi'' (checks ''atisara'' through improving the digestion) and ''vataghna'' (measures)<br /> **''Ama: [[pachana]]'' (measures digesting ''ama'')<br /> **''[[Rakta]]: picchabasti'' and ''raktabasti''.<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> <br /> The unit ''prasrita'', according to [[Charak Samhita]] is an amount of two ''palas'' which is approximately equal to 100 milliliter (1''pala''=50ml).&lt;ref&gt;Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.4. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.&lt;/ref&gt;,&lt;ref&gt;Agnihotri Avadhabihari; Bhaiṣajyakalpanā Vijñāna; Chaukhamba orientalia publication, 6th edition, 2006, P 7-20.&lt;/ref&gt; (verse 1-2)[[Charak Samhita]] is written in the form of dialogue between the teacher (Atreya) and his disciples (mainly Agnivesha). Mild form of ''[[shodhana]]'' measures are for those subjects who are not suitable for strong measures and for the patients who suffered with the complications of the measures described in previous chapters. ''[[Vamana]]'' and ''[[virechana]]'' are major procedures for ''[[shodhana]]''. However, these are contraindicated for the tender persons. Tender persons may not tolerate even ''[[basti]]''. Therefore, mild forms of ''[[basti]]s'' are described for them. Similarly, the measures to treat the complications developed due to the faulty application of the procedures especially the ''[[basti]]''. <br /> <br /> Some translators interpreted the phrase ''karmana viplutanama'' as ‘exhausted of hard work’.&lt;ref&gt; Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.3. In: Dash Bhagavan &amp; Sharma R K, Editor. Charak Samhita.2nd ed. Varanasi: Chowkhamba Sanskrit Series, 2005; P 310&lt;/ref&gt;<br /> However, the meaning of this phrase can be taken as ‘complicated by the consequences of the therapies’, which seems to be more appropriate in this context. The complications may be natural consequences of the therapies or may be due to faulty application. (verse 3)<br /> <br /> The recipe in verse 4 is composed of total five ''prasritas'' (2 ''prasritas'' of milk, 1 ''prasrita'' each of honey, sesame oil and ''ghrita''), therefore this ''[[basti]]'' is named by Gangadhara as ''panchaprasrtika basti''.&lt;ref&gt;Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya . In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3735.&lt;/ref&gt; This ''[[basti]]'' is useful for eliminating ''[[vata]]'' as well as promoting the strength and the complexion. <br /> <br /> ''[[Vata]]'' eliminating measures usually promotes quality of ''[[dhatu]]s'' and ''upadhatus'' (structural components of the body). This eventually results in promotion of the body strength and the complexion. Word ''bala'' also denotes the immune function; hence this may also be interpreted as promoting immune activity. In ancient time to mix a ''[[basti]]'' material, churning stick was used. In modern time an electric blender is an ideal alternative. With a blender the mixture is better homogenized than a manual churning stick.<br /> <br /> Chakrapani considered ''bilvadi'' group in his [[Ayurveda]] ''deepika'' commentary as ''dashamula''.&lt;ref&gt;Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.5. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.&lt;/ref&gt; This group consists of roots of ten plants viz. ''bilva'' (Aegle marmelos Carr.), ''shyonaka'' (Oroxylum indicumVent.),''gambhari'' (Gmelina arborea Roxb.), ''patala'' (Stereospermum suaveolensDC.),''agnimantha'' (Premna integrifolia Roxb.), ''shalaparni'' (Desmodium gangeticumDC.), ''prishniparni'' (Uraria picta Desr.) ''brihati'' (Solanum indicum Linn.), ''kantakari'' (Solanum suranttense Burm.) and ''gokshura'' (Tribulus terrestris Linn.). <br /> <br /> While Gangadhara in his ''Jalpakalpataru'' commentary mentions this as ''panchamula'' –the roots of a group of five plants viz. ''bilva,shyonaka, gambhari, patala'' and ''agnimantha.''&lt;ref&gt;Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya.Verse 5 In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3735.&lt;/ref&gt;Since next verse (5th) describes a recipe with ''panchamula'', in this verse considering ''bilvadi'' as ''dashamula'' is more logical and practical. This ''[[basti]]'' consists a total of eight ''prasritas'' (one ''prasrita'' each of ''taila, prasanna, madhu'' and ''ghrita'' and two ''prasritas'' each of ''bilvadi'' decoction and ''kulattha'' decoction). Therefore, Gangadhara names this as ''ashtaprasritika [[basti]]''.&lt;ref&gt;Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya . In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3735.&lt;/ref&gt;<br /> <br /> The ''[[basti]]'' in verse six, consists of total nine ''prasritas'' i.e. ''panchamula'' decoction- five ''prasritas'', sesame oil - two ''prasritas'', honey- one ''prasrita, ghrita''- one ''prasrita''. Therefore, Gangadhara names this as ''navaprasritika [[basti]]''.&lt;ref&gt;Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya . In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3736.&lt;/ref&gt; (verses 4-6)<br /> <br /> ''Aksha'' and ''karsha'' are the units of same amount, which is equal to about twelve grams. Hence the amount of rock salt in this [[basti]] would be about 6 grams. ''[[Shukra]]'' is one of the seven ''[[dhatu]]s'' (structural components). ''[[Shukra]]'' is not a single entity. It comprises male reproductive cells and substances including the androgenic hormones responsible for manhood in a man. This ''[[basti]]'' promotes quality and quantity of all these entities in the body.<br /> <br /> The usual contents of a ''niruha [[basti]]'' are salt, honey, oil'', kalka'' and decoction (or a liquid). These are to be mixed by churning in the sequence as mentioned above. Here the mixing may be in this sequence- ''saindhava'', honey, oil, ''ghrita, hapusha'' (fruits of Juniperus communis Linn.)and milk.(verse 7)<br /> <br /> ''[[Basti]]'' is usually contraindicated in ''kushtha''&lt;ref&gt;Charak. Sidhi Sthana, Cha.2 Panchakamiya Siddhi ver.14. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 688.&lt;/ref&gt;. However, Sushruta Samhita recommends ''niruhabastis'' in this condition.&lt;ref&gt;Sushruta. Chikitsa Sthana, Cha.35 Netrabastipramana pravibhaga Chikitsitam Adhyaya verse 22. In: Jadavaji Trikamji Aacharya and Narayana Ram Acharya, Editors. Sushruta Samhita. 4th ed. Varanasi: Chaukhambha Orientalia;1980, P 527.&lt;/ref&gt; Practically ''niruha [[basti]]'', with bitter substances e.g. ''panchatikta niruha'', is useful in ''kushtha''.<br /> <br /> The quantity of ''kalka'' of ''sarshapa'' is not mentioned in the above recipe. According to commentary of Chakrapani on this verse, it may be decided. &lt;ref&gt;Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.8-9. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.&lt;/ref&gt; In the ''niruha bastis'' with an amount of twelve ''prasritas'', the amount of ''kalka'' is usually two ''palas'' (about 100gms). In present recipe, the amount is five ''prasritas'' and therefore the amount of ''kalka'' of ''sarshapa'' would be about 40 gms. This principle is applicable in latter recipes also where the amount of ''kalka'' is not mentioned. <br /> <br /> This ''[[basti]]'' contains ''vidanga'' (Embelia ribes Burm.) which is the best among ''krimighna''(anti-parasitic) [Cha. Sa. [[Sutra Sthana]] 25/40] substances. Therefore, it has a ''kriminashana'' effect. (verse 9-10)<br /> <br /> Gangadhara in his ''Jalpakalpataru'' commentary considers ''payasyas ksheerakakoli'', which is Fritillaria roylei Hook. Some scholars consider ''payasyaas vidari'', but at present, ''vidari'' recipies already include one ingredient therefore to consider it ''ksheerakakoli'' is appropriate.<br /> <br /> In the recipes of verse 11-12, the amount of paste is not mentioned. This may be calculated as stated in earlier verse 8th -9th. (verse 11-12)<br /> <br /> In above verses from 4 to 14, nine recipes of ''prasrita bastis'' are described. Here a special and practical instruction is given that even if salt is not mentioned in any of the recipes, rock salt is to be added and these ''[[basti]]s'' are always given with a moderate warm temperature.<br /> <br /> While preparing the ''[[basti]]s'', rock salt is to be added. The amount is to be calculated according to the principle described in the 7th verse i.e. about 6 gms. After preparing the ''[[basti]]'', to keep it warm until it is administered, a hot water bath may be used. (verse 13-14)<br /> <br /> In the verse 15-16, two opposite possibilities are described. It may be milder than normal or it may be stronger than a normal. A mild ''[[basti]]'' is unable not only to eliminate ''[[dosha]]s'', but it itself is not ableto come out. This is ''ayoga'' or ''heenayoga'' (insufficient action). In such a case a ''[[basti]]'' is to be repeated with a stronger recipe. Contrary to this, if a ''[[basti]]'' is stronger it may cause an ''atiyoga'' (action in excess) causing evacuation of colonic contents more than required and eventually loss of essential substances.<br /> <br /> A soft acting ''[[basti]]'' is not able to eliminate the ''[[dosha]]s'' and may get stagnated and cause disturbance. To eliminate it, a strong and sharp acting ''[[basti]]'' is recommended. If strong ''[[basti]]s'' have caused emaciation, dehydration or weakness, the ''[[basti]]s'' with ''madhura'' (sweet) substances are useful because ''madhura'' substances are nourishing in action. (verses 15-16)<br /> <br /> In ''[[vata]]''-related disorders, ''[[basti]]'' material with physically and pharmacologically hot property is preferred. It may cause ''[[pitta]]'' aggravation resulting in burning sensation and other such ''[[pitta]]''-related symptoms. In such a condition, grape juice or decoction of raisins added with a ''kalka'' (paste) of ''trivrita'' (Operculina turpethum Linn.) is given. In case of unavailability of ''kalka'', its powder can be used. This cures the burning sensation and other ''[[pitta]]''-related symptoms with its anti-''[[pitta]]'' action and expulsion of stool, ''[[pitta]]'' and ''[[vata]]''. ''Yavagu'' with sugar is given for nourishing purpose after this laxation. (verses 16-17)<br /> <br /> If the purgation is in excess, it may cause significant loss of stool along with essential substances (e.g.water and electrolytes). This requires immediate attention to prevent the harm due to depletion of essential body components.<br /> <br /> In such a condition it is to be corrected by eating ''mashayusha'' (soup of black beans) and ''kulmasha'' (half cooked grains); and by taking honey or ''sura''. ''Kulmasha'' is also interpreted as a sour gruel (prepared by the spontaneous fermentation of fruit-juices or boiled rice). However, according to Chakrapani this is half cooked grain (barley etc.), which is popularly known as ''ghughuni''.&lt;ref&gt;Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.18. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.&lt;/ref&gt;,&lt;ref&gt;Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya. Verse 13-14.In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3738.&lt;/ref&gt;. This is known as ''ghughari'' in Gujarat and western Madhya Pradesh. This is more suitable interpretation. This is considered to be well nourishing food article. (verse 18)<br /> <br /> Faulty application of ''[[basti]]s'' may cause a complication in the form of atisāra. ''Atisāra'' is a clinical condition of colon characterized by excessive and frequent defecation with altered consistency of stool. In short it may be interpreted as diarrhea. In next verse different forms of atisāra and their management are described. In this verse the condition is characterized by sāma stool (stool containing āma- undigested material), which smells like a decomposing body (putrid smell) and is associated with abdominal pain. Āma is a substance produced due to weak agni resulting in incomplete transformation of substance. In the present context, due to weak jatharāgni the transformation of food in to digested absorbable substances is incomplete resulting in to production of some intermediate substances.&lt;ref&gt;Vagbhata. Sutra Sthana, Cha.13 Doshopakramaniya Adhyaya verse 25. In: Bhiṣagācārya Hariśāstrī Parādakara Vaidya, Editors. Ashtanga Hridayam. 1oth ed. Varanasi: Chaukhambha Orientalia;2000.p.4.2014; P 216.&lt;/ref&gt; ,&lt;ref&gt;Vijayarakshita and Srikanthadata, Madavakara chapter 25,Amavata nidana Verse 5, In: Brakmanand Tripathi Editor, Madhava Nidana ? ed. Varanasi: Chaukhamba Surabharati Prakashan,2012; P 573-574.&lt;/ref&gt;These substances are known as āma. Because of its adherent quality it is supposed to be a pathogenic substance.In this condition a decoction of ''mustā, ativiṣā, kuṣṭha, nata, dāru'' and ''vacā'' is recommended. These medicines help in ''[[pachana]]'' (termination) of āma.<br /> <br /> This chapter describes six types of ''atisāra'' based on the pathogens being excreted in excess. This verse explains the remedy for one of them in which patient passes stool with significant undigested material. This undigested material causes putrid smell after decomposition. Decomposition also produces some toxic substances, which cause abdominal pain and loss of appetite. The recipe described here is not useful in atisāra produced as complication of [[basti]] but also in āmātisāra of any origin. (verse 19)<br /> <br /> This verse number 20 describes other five types of atisāra. In this way, six types of atisāras those are depicted in above verses are as follow.<br /> <br /> #''Atisara'' (diarrhea) in which stool contains ''ama'' (undigested material) <br /> #Atisāra (diarrhea) in which stool is pakva i.e.free from āma (undigested material) <br /> #Atisāra (diarrhea) in which stool is pakva and containing [[vata]] i.e. significant flatulence.<br /> #Atisāra (diarrhea) in which stool is pakva and containing asṛk (blood).<br /> #Atisāra (diarrhea) in which stool is pakva and containing [[pitta]].<br /> #Atisāra (diarrhea) in which stool is pakva and containing [[kapha]].<br /> <br /> For the management of these conditions [[basti]]s prepared with the svavargīya medicines (group of medicines acting against particular pathologies) are given.&lt;ref&gt;Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.20. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714.&lt;/ref&gt; For example the vargas (classified groups) described in Ṣaḍvirecanaśatāśrīya chapter (chapter 4th) of sūtrasthāna of Carakasaṁhitā. So, the recommended group of medicines for last five conditions of pathology is purīṣasaṁgrahaṇīya [Cha.Sa.[[Sutra Sthana]] 4/8/31], vātaghna, śoṇitasthāpana [Cha.Sa.[[Sutra Sthana]] 4/8/46], pittaghna and kaphaghna vargas respectively.&lt;ref&gt;Chakrapani, Charak. Sidhi Sthana, Cha.4 Snehavyapat Siddhi ver.8. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714. P 33 &amp; 34.&lt;/ref&gt;.Purīṣasaṁgrahaṇīya group consists of priyaṅgu (Callicarpa macrophylla R.Br.), ananta (Hemidesmus indicusR.Br.), Seed of mango, kaṭvaṅga (Ailanthus excelsa Roxb.), lodhra (Symplocos racemosa Roxb.), mocharasa (secretion of Salmalia malabarica Scott&amp;Endl.), samṅgā (Mimosa pudica Linn.), dhātakī (Woodfordia fruticosa Kurz.), padmā (Clerodendrum serratum Linn.) and padmakesara (Stamen of Nelumbo nucifera Gaertn.). shoṇitasthāpana group consists of honey, madhuka (Glycyrrhiza glabra Linn.), saffron, mocarasa (secretion of Salmalia malabarica Scott &amp;Endl.), broken earthen vessel, lodhra (Symplocos racemosa Roxb.), gairika (red ochre), priyaṅgu (Callicarpa macrophylla R.Br.), sharkarā(sugar) and lājā (puffed rice).&lt;ref&gt;Chakrapani, Charak. Sidhi Sthana, Cha.4 Snehavyapat Siddhi ver.8. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714. P 33 &amp; 34.&lt;/ref&gt;The form of [[basti]] is not described here. However, this may be decided according to disease condition and patient’s tolerance. (verse 20)<br /> <br /> In this version of [[Charak Samhita]] thirty six variants are cited, but another version ‘kēvalaiḥ saha ceṭ triṁśadvidyāt sōpadravānapi’ mentions only thirty.&lt;ref&gt;Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya . In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3739.&lt;/ref&gt; Gaṅgādhara also explains thirty forms in the following manner.&lt;ref&gt;Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya.Verse 17 In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3739.&lt;/ref&gt;<br /> <br /> The six basic forms of atisāra are: <br /> #āmātisāra (diarrhea with undigested material) <br /> #śakṛdatisāra (frequent stool only) <br /> #vātātisāra (that with significant flatulence) <br /> #asṛkātisāra (that with blood)<br /> #pittātisāra (that with [[pitta]]) and <br /> #kaphātisāra (that with [[kapha]]).<br /> <br /> Due to saṁsarga (mutual combinations of two) a total of fifteen variants occur, viz.<br /> #āma-śakṛd, āma-[[vata]], āma-asṛk, āma-[[pitta]], āma-[[kapha]],<br /> #śakṛd-[[vata]], śakṛd-asṛk, śakṛd-[[pitta]], śakṛd-[[kapha]],<br /> #vāta-asṛk, [[vata]]-[[pitta]], [[vata]]-[[kapha]],<br /> #asṛk-[[pitta]], asṛk-[[kapha]], and<br /> #[[pitta]]-[[kapha]].<br /> <br /> Nine ''upadrava'' as cited above.<br /> <br /> The upadravas in present version of chapter are ten. Gaṅgādhara has taken description of nine upadravas from another version.&lt;ref&gt;Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya. In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3739.&lt;/ref&gt; But upadravas cannot be counted among types of a disease. Hence the thirtysix variants would be in following manner.<br /> <br /> The six basic forms of atisāra are as mentioned above.<br /> <br /> Due to saṁsarga (mutual combinations of two) a total of thirty variants occur, viz. fifteen samsargas as mentioned above and other fifteen are as below:<br /> #śakṛd- āma, [[vata]]-āma, asṛk-āma, [[pitta]]-āma, [[kapha]]-āma,<br /> #[[vata]]-śakṛd, asṛk-śakṛd, [[pitta]]-śakṛd, [[kapha]]-śakṛd,<br /> #asṛk-[[vata]], [[pitta]]-[[vata]], [[kapha]]-[[vata]],<br /> #[[pitta]]-asṛk, [[kapha]]-asṛk, and<br /> #[[kapha]]-[[pitta]].<br /> <br /> Moreover [[Charak Samhita]] describes types of atisāra in its chapter 19th of [[Sutra Sthana]] and 19th chapter of [[Chikitsa Sthana]] differently. &lt;ref&gt; Charak. Sutra Sthana, Cha.19 Ashtodariya Adhyaya ver.4/3. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 110.&lt;/ref&gt;,&lt;ref&gt; Charak. Chiktsa Sthana, Cha.19 Atisara Chikitsitam Adhyaya. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 547-549.&lt;/ref&gt; The context of the topic atisāra in present chapter is absolutely different. Here it is described first as a complication of [[basti]], which eloborted further in the chapter. In earlier sections atisāra was described as a primary disease manifested because of its own physical and mental etiological factors. (verse 21-22)<br /> <br /> Basic principle of treatment of every condition associated with āma is āmapāchana (termination of āma by promoting function of agni). For this purpose mustā, ativiṣā, kuṣṭha, nata, dāru and vacā (which are mentioned in 19th verse) are to be given. This combination may be given in form of powder or as decoction. This recipe is useful in āmātisāra every origin. (verse 23)<br /> <br /> For vātaghna medicines to be used in [[vata]] associated atisara, Cakrapāṇi recommends daśhamula, while Gaṅgādhara considers bṛhat pañchamūla (see the commentary on 5th verse). For grāhī purpose the medicines of purīṣasaṁgrahaṇīya varga [Cha.Sa.[[Sutra Sthana]].4/8/31] are to be used.&lt;ref&gt;Charak. Chiktsa Sthana, Cha.19 Atisara Chikitsitam Adhyaya. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 33 &amp; 34.&lt;/ref&gt;<br /> <br /> Next condition in which atisāra is associated with dominance of [[vata]], snēha [[basti]] supplemented with sweet, sour and salty substances is recommended. Being opposite to the properties of [[vata]], the substances in this [[basti]] antagonizes the [[vata]] principle. (verse 24)<br /> <br /> Now the management of other conditions - raktātisāra, pittātisāra and kaphātisāra is explained. In raktātisāra, a [[basti]] with blood of animals e.g. goat, is given. This not only stops the bleeding but also supplements the substances to produce blood, which is lost due to colonic bleeding. [[Pitta]] pacifying remedies also helpful in this condition and therefore the remedies useful in pittātisāra can also be given in raktātisāra. Substances with astringent, sweet and bitter tastes have [[pitta]]-antagonizing action and hence the [[basti]] consists of such substances are helpful in management of pittātisāra. Substances with astringent, pungent and bitter tastes have [[kapha]]-antagonizing action; therefore, a [[basti]] with such medicines is beneficial in kaphātisāra.<br /> <br /> The [[basti]] used in pittātisāra is useful in raktātisāra also. Applying this principle, this type of [[basti]] may be used in a disease entity known as ulcerative colitis. (verse 25)<br /> <br /> These verses number 26-27 describe management plan for the saṁsargaja atisāras (in which two morbid components are associated and have mutual vitiation). Cakrapāṇi in his commentary decides the main and secondary role of the involved components on the basis of vibhakti (noun case) of the words. 7th vibhakti signifies the main role while 3rd expresses secondary role of the factors.&lt;ref&gt;Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.26-31. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714.&lt;/ref&gt;<br /> <br /> In the 26th verse the possible combination are-<br /> #āma is associated with śakṛt i.e.stool (āma is primary and stool is secondary)<br /> #āma is associated with [[vata]] (āma is primary and [[vata]] is secondary)<br /> #śakṛt (stool) is associated with āma (stool is primary āma is secondary)<br /> #[[vata]] is associated with āma ([[vata]] is primary and āma is secondary)<br /> <br /> In the 27th verse the possible combination are-<br /> #āma is associated with [[pitta]] (āma is primary and [[pitta]] is secondary)<br /> #āma is associated with [[rakta]] (āma is primary and [[rakta]] is secondary)<br /> #[[pitta]] is associated with āma ([[pitta]] is primary and āma is secondary)<br /> #[[rakta]] is associated with āma ([[rakta]] is primary and āma is secondary)<br /> <br /> In these conditions in mentioned in 26th verse, a drink prepared with trikaṭu, sour and salty substances is recommended. While the conditions mentioned in 27th verse, are manageable with adrink, prepared with trikaṭu, sweet and bitter substances are useful. (verse 26-27)<br /> <br /> The description of saṁsargaja atisāras continues in these verses 28-29. In the 28th verse, the possible combination are-<br /> <br /> #āma is associated with [[kapha]] (āma is primary and [[kapha]] is secondary)<br /> #[[kapha]] is associated with āma ([[kapha]] is primary and āma is secondary)<br /> <br /> In 1st condition the recommended [[basti]] is with trikaṭu, astringent and bitter substances while in 2nd condition with trikaṭu, astringent and salty medicines.<br /> <br /> In a pāthabheda (another version) of 29th verse&lt;ref&gt;Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya.Verse 23 In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3741.&lt;/ref&gt;, [[rakta]]is also included. With this inclusion the possible combination are-<br /> <br /> #śakṛt (stool) is associated with [[vāta]] (stool is primary and [[vata]] is secondary)<br /> #[[pitta]] is associated with [[vāta]] ([[pitta]] is primary and [[vata]] is secondary)<br /> #[[rakta]] is associated with [[vāta]] ([[pitta]] is primary and āma is secondary) <br /> #[[vata]] is associated withstool([[vata]] is primary and stool is secondary)<br /> #[[vata]] is associated with [[pitta]] ([[vata]] is primary and [[pitta]] is secondary)<br /> #[[vata]] is associated with [[rakta]] ([[vata]] is primary and [[rakta]] is secondary)<br /> <br /> In these pathological conditions a [[basti]] with sweet, sour and astringent materials is acclaimed. (verse 28-29)<br /> <br /> The management of saṁsargaja atisāras further continues in these verses. In the 30th verse the possible combination are-<br /> #[[rakta]] is associated with śakṛt i.e. stool([[rakta]] is primary and stool is secondary)<br /> #[[rakta]] is associated with [[pitta]] ([[rakta]] is primary and [[pitta]] is secondary)<br /> #śakṛt (stool) is associated with [[pitta]] (stool is primary and [[pitta]] is secondary) <br /> #śakṛt stool is associated with [[rakta]] (stool is primary and [[rakta]] is secondary)<br /> #[[pitta]] is associated with [[rakta]] ([[pitta]] is primary and [[rakta]] is secondary)<br /> #[[pitta]] is associated with śakṛt stool ([[pitta]] is primary and stool is secondary)<br /> <br /> In the 31st verse the possible combination are-<br /> #stool is associated with [[kapha]] (stool is primary and [[kapha]] is secondary)<br /> #[[pitta]] is associated with [[kapha]] ([[pitta]] is primary and [[kapha]] is secondary)<br /> #[[kapha]] is associated with stool ([[kapha]] is primary andstool is secondary) <br /> #[[kapha]] is associated with [[pitta]] ([[kapha]] is primary and [[pitta]] is secondary)<br /> #[[kapha]] is associated with [[rakta]] ([[kapha]] is primary and [[rakta]] issecondary)<br /> <br /> The conditions mentioned in 30th verse are managed by administration of [[basti]] prepared with astringent, sweet and bitter ingredients. While the pathologies in 31stverse, are manageable by a [[basti]] with trikaṭu, bitter and astringent ingredients. (verse 30-31)<br /> <br /> In these verses 32-33, four more combinations of pathology are described with their management. In 32nd verse the [[kapha]] is main factor with [[vata]] as secondary and [[rakta]] as main with [[kapha]] as secondary while in 33rd verse [[vata]] is main factor with [[kapha]] as secondary and [[pitta]] as main with [[vata]] as secondary.<br /> <br /> Type of atisāra according to involvement of factors. Reccommended material for [[basti]]<br /> [[Kapha]] is main factor with [[vata]] as secondary trikaṭu, bitter and sour ingredients<br /> [[Rakta]] as main with [[kapha]] as secondary sweet,trikaṭu and bitter <br /> [[Vata]] is main factor with [[kapha]] as secondary trikaṭu,sour and salty<br /> [[Pitta]] is main with [[vata]] as secondary. sweet, sour and bitter(verse 32-33)<br /> <br /> There are six components involved in the pathogenesis of atisāra. In earlier verses the combinations of two components are described. The combinations of three, four or five are also possible. Gaṅgādhara in his Jalpakalpataru commentary mentions the possibility of combination of all six also.&lt;ref&gt;Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya. In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3742-43.&lt;/ref&gt; This appears logical, as when five may combine six together may also be possible. <br /> <br /> According to Gaṅgādhara, the following combinations may happen viz. ten clinical forms due to combinations of three, six forms due to combinations of four, three forms due to combinations of five and one form with all six. In this way twenty forms are possible. These combinations are as below.<br /> <br /> Combinations of three Combinations of four Combinations of five Combination of six<br /> āmaviḍvātaja<br /> āmaviḍasṛja<br /> āmaviḍpittaja<br /> āmaviḍkaphaja<br /> viḍvātāsṛja<br /> viḍvātapittaja<br /> viḍvātakaphaja<br /> vātāsṛkpittaja<br /> vātāsṛkkaphaja<br /> asṛkpittakaphaja <br /> āmaviḍvātāsṛja<br /> āmaviḍvātapittaja<br /> āmaviḍvātakaphaja<br /> viḍvātāsṛkpittaja<br /> viḍvātāsṛkkaphaja<br /> vātāsṛkpittakaphaja <br /> āmaviḍvātāsṛkpittaja<br /> āmaviḍvātāsṛkkaphaja<br /> viḍvātāsṛkpitta kaphaja<br /> āmaviḍvātāsṛkpittakaphaja(verse 34) <br /> <br /> If case of association of āma, [[basti]]s are contraindicated. This is a general rule. In such condition the āmapācana (preparation to terminate āma)is given. However, in nirāma condition (without association of āma), [[basti]]s are recommended. (verse 35)<br /> <br /> In these verses 36-37, two new units of measurement are described i.e. pala and prastha. After calculating these amounts in modern units of metric system, pala is around 50 gms or 50 ml while prastha around 800 ml. Though, in previous verses the management of different types of atisāras, has been described. In coherence of the topic, more remedies for atisāra are described in present verses.<br /> <br /> This medicated ghṛta is processed with plants having [[stambhana]] action. Therefore, it is useful in all types of atisāra. Being a nourishing preparation, it is useful in compensating the loss of the essential body substances. A [[basti]] may also be given with this preparation and should be retained as much as possible. This type of [[basti]] may be useful in inflammatory bowel diseases. (verse 36-37)<br /> <br /> The remedies for atisāra continue in these verses 38-39. These verses describe recipe of medicated gruels useful in management of this disease. First the decoction is prepared according to the recipe of ṣaḍaṅgapānīya.&lt;ref&gt;Chakrapani, Charak. Chikitsa Sthana, Cha.3 Jwara Chikitsitam ver.145 In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714.P 410.&lt;/ref&gt;,&lt;ref&gt;Agnihotri Avadhabihari; Bhaiṣajyakalpanā Vijñāna; Chaukhamba orientalia publication, 6th edition, 2006, P 146-147.&lt;/ref&gt;<br /> <br /> For this purpose one part of the course powder of all plants is boiled with 64 parts of water. When water is reduced to half, this is to be taken to cook yavāgū. There are three varieties of yavāgū-maṇḍa, peyā and vilepī. These three are gradually thicker in consistency and may be chosen according to strength of a patient and his agni. (verse 38-39)<br /> <br /> Gaṅgādhara considers Sthirādi group of plants as Svalpapañcamūla consists of śālaparṇī (Desmodium gangeticum DC.), pṛśniparṇī (Uraria picta Desr.) bṛhatī (Solanum indicum Linn.) kaṇṭakārī (Solanum suranttense Burm.) and gokṣura (Tribulus terrestris Linn.). About balādi group there is no clarification by any commentator however the plants Sida cordifolia Linn., abutilon indicum Linn., Sida rhombifolia Linn. and Grewia hirsute Vahl. may be taken for this purpose. Ikṣvādi is considered by Cakrapāṇi as roots of Saccharum officinarum Linn., Desmostachya bipinnata Stapf., Saccharum spontaneum Linn. and roots of rice.<br /> There is another version of verse 42, which mentions last line as ‘sasarpirlavaṇā yojyā madhurā lavaṇāpi vā’ which means that this preparation can be used with ghṛta and rock salt in sweet or salty form.<br /> <br /> Above verses give some more recipes for medicated yavāgūs those are helpful in management of atisāra. (verse 40-42)<br /> In these verses some additional and useful remedies for management of various types of atisāra are given. It is to be recalled that in this chapter, authors have considered six factors responsible in pathogenesis and manifestation of atisāra viz. āma [[vata]], [[pitta]], [[kapha]], [[rakta]] and sakṛt (stool). The treatments are to be considered as per the factors involved. (verse 43-45)<br /> The chapter describes various clinical forms of atisara according to the components involved in the pathogenesis. The therapeutics for these various forms of atisāra is described in a planned manner. Ayurvedic management is not merely medicaments but it recommends the food preparations those are helpful in restoring the normalcy of the body components of the patient. Thus the chapter is significantly useful for clinical practice of [[basti]] therapies and the treatment of disease atisāra, which includes several modern diseases such as ulcerative colitis, Crohn’s dieases and irritable bowel syndrome. (verse 46)<br /> The [[basti]] formulations mentioned in this chapter are used widely in today’s clinical practice. However, though atisara (diarrhea) is explained in detail as complication of improperly administered [[basti]], in todays clinical practice, this complication is observed rarely.<br /> &lt;/div&gt;<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Kasa_Chikitsa&diff=45408 2026-01-30T08:37:20Z

<p>Agnivesha: /* Management of kshataja kasa (due to injury) */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Kasa Chikitsa<br /> |titlemode=append<br /> |keywords=kasa, cough, treatment of cough, respiratory diseases, kshataja, kshayaja, Snehapana, vamana, virehna, vairechanika nasya (nasal catarrhal), dhumapana (medicated cigarettes),Ayurveda, Indian system of medicine, charak samhita. <br /> |description=Chikitsa Sthana Chapter 18. Management of Kasa (Cough of various origins)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 18. Management of Kasa (Cough of various origins) &lt;/big&gt;''' <br /> {{Infobox<br /> |title = Kasa Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 18<br /> |label2 = Preceding Chapter<br /> |data2 = [[Hikka Shwasa Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Atisara Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Nesari T., Mallya S., [[Yogesh Deole|Deole Y. S.]]<br /> |label7 = Reviewer <br /> |data7 = Prasad B.S., Mali P.<br /> |label8 = Editors<br /> |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.019 10.47468/CSNE.2020.e01.s06.019]<br /> }}<br /> &lt;big&gt;'''Abstract &lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;''Hikka, shwasa'' and ''kasa'' (hiccups, dyspnea and cough) are the three main diseases of ''pranavaha srotas'' (respiratory system). There are similarities in clinical presentation and management of these three. Therefore, these are described in sequence. ''Kasa'' is categorized in to five types based on its dominance of dosha and etiology. The vata dominant, pitta dominant and kapha dominant kasa are curable with proper medication. The other two types originating due to kshata (injury) and depletion of body constituents (kshaya) are palliable (yapya). Avoiding etiological factors (Nidana parivarjana), purification therapy ([[shodhana]]), pacification therapy ([[shamana]]), disease specific treatment (vyadhiahara [[rasayana]]) are principles of management for all types of ''kasa''. Administration of [[shodhana]] therapy is important. The reduction in persistent nature of illness with episodic exacerbation and the severity is possible if all modalities are followed in sequence. <br /> &lt;br/&gt;&lt;br/&gt;<br /> '''Keywords''': ''kasa'', cough, treatment of cough, respiratory diseases, kshataja, kshayaja, snehapana, [[vamana]], [[virechana]], vairechanika [[nasya]] (nasal catarrhal), [[dhumapana]] (medicated cigarettes).<br /> &lt;/p&gt;<br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> ''Pranavaha srotas'' is a vital system of the body and although this ''srotas'' is more susceptible to abuse from little amount of smoke, allergens, adulterants, petrochemicals and many pollutants in atmosphere, there are a variety of disorders and diseases that are temporary and harmless, while others can be life threatening. In literature, ''pranavaha srotas'' disorders are elaborated under the heading of ''shwasa, kasa, hikka, rajayakshma'' and ''urakshata'' (''kshata-kshina''). Cough, expectoration, breathlessness, sore throat, chest pain are common clinical features of respiratory diseases. ''Kasa'' is one such disease, which is identified by the hoarse phonetic sound, produced due to the pathological process of [[dosha]] dushti'' (vitiation of [[dosha]]), ''vimarga gamana'' (diverted movement) of ''pranavata'' and ''avarana'' (occlusions) of [[vayu]] by the [[kapha]]. The main pathology is in chest region with reduced functioning of the respiratory system. <br /> <br /> Smoke, dust, and over exertion (''dhumopaghata, raja, vyayama'') are largely considered as causative factors (''samanya nidana''). These may cause direct damage to the harmony of the ''pranavaha srotas'' which occurs in all respiratory disorders. Apart from above said causative factors some in particular like ''guru'' (heavy), ''snigdha'' (unctuous), ''madhura'' (sweet), ''asatmya'' (unhabituated), ''paryushita ahara'' (rotten food) will cause vitiation of [[dosha]], more specifically [[vata]] and [[kapha]] which will in turn have its impact on ''pranavaha srotas'' to cause structural and functional impairments (''kha vaigunya''). Improper diet will result in the improper digestion and absorption of ''ahara rasa'' which will in turn produce ''kasa''. These can be considered as intrinsic factors for the pathogenesis. <br /> <br /> Prodromal symptoms (''purvarupa'') are irritation of throat with pricking sensation, itching (''kantha kandu'')and inability to swallow (''bhojyanam avarodha''). These are very much similar with upper respiratory tract infection leading to condition of pharyngitis or pharyngotonsillitis and persistence of such upper respiratory tract infection will further spread to lower respiratory tract.<br /> <br /> There are five types of ''kasa'' namely,[[vata]]ja, [[pitta]]ja, [[kapha]]ja, kshataja and kshayaja. ''Vatika kasa'' is more related to upper respiratory tract with ''swarabheda'' (hoarseness of voice) as its diagnostic feature and is unproductive. It resembles more to allergic rhinobronchitis, which may be self-limiting and curable. ''Paittika'' and [[kapha]]ja kasa'' involve lower respiratory tract and are productive in nature. While ''paittika kasa'' seems to be the result of inflammation, [[kapha]]ja kasa is due to mucosal hypertrophy of bronchial lining or chronic bronchitis. ''Kshyaja kasa'' is a state of chronic cough associated with emaciation. Charak has mentioned that the disturbance in the action of ''jatharagni'' all the three [[dosha]] get vitiated, which causes emaciation of [[dhatu]] of the body either due to ''anulomana kshaya'' or ''pratiloma kshaya'' [Cha.Sa. [[Chikitsa Sthana]] 18/24]. That makes it different from ''shosha'', which is a tri[[dosha]]ja disease manifests as a group of several diseases. ''Kshataja kasa'' is associated with break in integrity of lung parenchyma with ''shonita darshana'' (blood tinged mucous) as a symptom. There may or may not be ''shosha'' (emaciation).<br /> <br /> Snehapana, [[vamana]], [[virechana]], vairechanika [[nasya]] (nasal catarrhal), [[dhumapana]] (medicated cigaretes) are indicated as treatment modalities in different types of ''kasa''.<br /> &lt;/div&gt;<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातः कासचिकित्सितं व्याख्यास्यामः ||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः ||२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātaḥ kāsacikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2|<br /> <br /> athAtaH kAsacikitsitaM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> Now we shall expound the chapter &quot;Kasa chikitsa&quot;(Management of cough of various origins). Thus said Lord Atreya.[1-2]<br /> <br /> === Types ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तपसा यशसा धृत्या धिया च परयाऽन्वितः | <br /> आत्रेयः कासशान्त्यर्थं प्राह सिद्धं चिकित्सितम् ||३||<br /> <br /> वातादिजास्त्रयो ये च क्षतजः क्षयजस्तथा | <br /> पञ्चैते स्युर्नृणां कासा वर्धमानाः क्षयप्रदाः ||४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tapasā yaśasā dhr̥tyā dhiyā ca parayā'nvitaḥ| <br /> ātrēyaḥ kāsaśāntyarthaṁ prāha siddhaṁ cikitsitam||3|| <br /> <br /> vātādijāstrayō yē ca kṣatajaḥ kṣayajastathā| <br /> pañcaitē syurnr̥ṇāṁ kāsā vardhamānāḥ kṣayapradāḥ||4|| <br /> <br /> tapasA yashasA dhRutyA dhiyA ca parayA~anvitaH| <br /> AtreyaH kAsashAntyarthaM prAha siddhaM cikitsitam||3|| <br /> <br /> vAtAdijAstrayo ye ca kShatajaH kShayajastathA| <br /> pa~jcaite syurnRuNAM kAsA vardhamAnAH kShayapradAH||4|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Atreya, endowed with power of penance, fame and perseverance and super-intellect expounded the infallible therapies for the treatment of ''kasa''. There are five types of ''kasa''. If exacerbated they may cause kshaya. These five types are [[vata]]ja, [[pitta]]ja, [[kapha]]ja, kshataja and kshayaja. [3-4]<br /> <br /> === Premonitory signs ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पूर्वरूपं भवेत्तेषां शूकपूर्णगलास्यता | <br /> कण्ठे कण्डूश्च भोज्यानामवरोधश्च जायते ||५|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pūrvarūpaṁ bhavēttēṣāṁ śūkapūrṇagalāsyatā| <br /> kaṇṭhē kaṇḍūśca bhōjyānāmavarōdhaśca jāyatē||5|| <br /> <br /> pUrvarUpaM bhavetteShAM shUkapUrNagalAsyatA| <br /> kaNThe kaNDUshca bhojyAnAmavarodhashca jAyate||5|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Following are the premonitory signs and symptoms of ''kasa'': <br /> <br /> #Sensation as if throat and mouth are filled with ''shooka'' (thorns).<br /> #Itching sensation in the throat.<br /> #Inability to swallow food.[3-4]<br /> <br /> === Pathophysiology ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अधःप्रतिहतो वायुरूर्ध्वस्रोतःसमाश्रितः | <br /> उदानभावमापन्नः कण्ठे सक्तस्तथोरसि ||६|| <br /> <br /> आविश्य शिरसः खानि सर्वाणि प्रतिपूरयन् | <br /> आभञ्जन्नाक्षिपन् देहं हनुमन्ये तथाऽक्षिणी ||७|| <br /> <br /> नेत्रे पृष्ठमुरःपार्श्वे निर्भुज्य स्तम्भयंस्ततः | <br /> शुष्को वा सकफो वाऽपि कसनात्कास उच्यते ||८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> adhaḥpratihatō vāyurūrdhvasrōtaḥsamāśritaḥ| <br /> udānabhāvamāpannaḥ kaṇṭhē saktastathōrasi||6|| <br /> <br /> āviśya śirasaḥ khāni sarvāṇi pratipūrayan| <br /> ābhañjannākṣipan dēhaṁ hanumanyē tathā'kṣiṇī||7|| <br /> <br /> nētrē pr̥ṣṭhamuraḥpārśvē nirbhujya stambhayaṁstataḥ| <br /> śuṣkō vā sakaphō vā'pi kasanātkāsa ucyatē||8|| <br /> <br /> adhaHpratihato vAyurUrdhvasrotaHsamAshritaH| <br /> udAnabhAvamApannaH kaNThe saktastathorasi||6|| <br /> <br /> Avishya shirasaH khAni sarvANi pratipUrayan| <br /> Abha~jjannAkShipan dehaM hanumanye tathA~akShiNI||7|| <br /> <br /> netre pRuShThamuraHpArshve nirbhujya stambhayaMstataH| <br /> shuShko vA sakapho vA~api kasanAtkAsa ucyate||8|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> [[Vata]] being obstructed in the lower region of the body, moves upwards, afflicts the channels of circulation in the upper part of the body, takes over the function of udana vayu and gets localized in the throat and chest. Then entering all the cavities in the head, fills them up and causes hunching and convulsive movements of the body, jaws, sides of the neck and eyes. Thereafter this obstructed [[vata]] causes contraction and stiffness of the eyes, back, chest and sides of the chest, gives rise to ''kasa'' which may be dry or with phlegm because of which it is known as ''kasa''.[6-8]<br /> <br /> === Specific features of ''kasa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्रतिघातविशेषेण तस्य वायोः सरंहसः | <br /> वेदनाशब्दवैशिष्ट्यं कासानामुपजायते ||९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pratighātaviśēṣēṇa tasya vāyōḥ saraṁhasaḥ| <br /> vēdanāśabdavaiśiṣṭyaṁ kāsānāmupajāyatē||9|| <br /> <br /> pratighAtavisheSheNa tasya vAyoH saraMhasaH| <br /> vedanAshabdavaishiShTyaM kAsAnAmupajAyate||9|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Specific variations in the pain and sound associated with different types of ''kasa'' are caused by the specific nature of the obstruction (by [[kapha]], etc.) to the force fully moving [[vayu]].[9]<br /> <br /> ==== Etiological factors, clinical features of [[Vata]]ja kasa ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रूक्षशीतकषायाल्पप्रमितानशनं स्त्रियः | <br /> वेगधारणमायासो वातकासप्रवर्तकाः ||१०|| <br /> <br /> हृत्पार्श्वोरःशिरःशूलस्वरभेदकरो भृशम् | <br /> शुष्कोरःकण्ठवक्रस्य हृष्टलोम्नः प्रताम्यतः ||११|| <br /> <br /> निर्घोषदैन्यस्तननदौर्बल्यक्षोभमोहकृत् | <br /> शुष्ककासः कफं शुष्कं कृच्छ्रान्मुक्त्वाऽल्पतां व्रजेत् ||१२|| <br /> <br /> स्निग्धाम्ललवणोष्णैश्च भुक्तपीतैः प्रशाम्यति | <br /> ऊर्ध्ववातस्य जीर्णेऽन्ने वेगवान्मारुतो भवेत् ||१३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rūkṣaśītakaṣāyālpapramitānaśanaṁ striyaḥ| <br /> vēgadhāraṇamāyāsō vātakāsapravartakāḥ||10|| <br /> <br /> hr̥tpārśvōraḥśiraḥśūlasvarabhēdakarō bhr̥śam| <br /> śuṣkōraḥkaṇṭhavakrasya hr̥ṣṭalōmnaḥ pratāmyataḥ||11|| <br /> <br /> nirghōṣadainyastananadaurbalyakṣōbhamōhakr̥t| <br /> śuṣkakāsaḥ kaphaṁ śuṣkaṁ kr̥cchrānmuktvā'lpatāṁ vrajēt||12|| <br /> <br /> snigdhāmlalavaṇōṣṇaiśca bhuktapītaiḥ praśāmyati| <br /> ūrdhvavātasya jīrṇē'nnē vēgavānmārutō bhavēt||13|| <br /> <br /> rUkShashItakaShAyAlpapramitAnashanaM striyaH| <br /> vegadhAraNamAyAso vAtakAsapravartakAH||10|| <br /> <br /> hRutpArshvoraHshiraHshUlasvarabhedakaro bhRusham| <br /> shuShkoraHkaNThavakrasya hRuShTalomnaH pratAmyataH||11|| <br /> <br /> nirghoShadainyastananadaurbalyakShobhamohakRut| <br /> shuShkakAsaH kaphaM shuShkaM kRucchrAnmuktvA~alpatAM vrajet||12|| <br /> <br /> snigdhAmlalavaNoShNaishca bhuktapItaiH prashAmyati| <br /> UrdhvavAtasya jIrNe~anne vegavAnmAruto bhavet||13|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Following are the causative factors of ''vatika'' type of ''kasa'':<br /> <br /> #Intake of ''ruksha'' (dry), ''sheeta''(cold), ''kashaya'' (astringent) type of food.<br /> #Intake of food in less quantity or much less quantity or not taking food at all.<br /> #Excess indulgence in ''vyavaya''.<br /> #Suppression of ''vega''.<br /> #Excessive physical strain.<br /> <br /> Its signs and symptoms are as follows:<br /> <br /> #Excruciating pain in the epigastric region, flanks, chest, and head.<br /> #Excessive hoarseness of the voice.<br /> #Dryness in the chest, throat and mouth.<br /> #Horripilation and fainting.<br /> #Resonant sound during coughing, looks hopeless, hollow sound during coughing.<br /> #weakness, agitated, illusive perceptions.<br /> #Dry cough<br /> #Expectorate scanty phlegm with pain.<br /> #The ''kasa'' gets alleviated by the food and drinks that are ''snigdha, amla, lavana'' and ''ushna''.<br /> #The upward movements increases [[vata]] after digestion of food.[10-13]<br /> <br /> ==== Etiological factors, clinical features of [[Pitta]]ja kasa ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कटुकोष्णविदाह्यम्लक्षाराणामतिसेवनम् | <br /> पित्तकासकरं क्रोधः सन्तापश्चाग्निसूर्यजः ||१४|| <br /> <br /> पीतनिष्ठीवनाक्षित्वं तिक्तास्यत्वं स्वरामयः | <br /> उरोधूमायनं तृष्णा दाहो मोहोऽरुचिर्भ्रमः ||१५|| <br /> <br /> प्रततं कासमानश्च ज्योतींषीव च पश्यति | <br /> श्लेष्माणं पित्तसंसृष्टं निष्ठीवति च पैत्तिके ||१६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭukōṣṇavidāhyamlakṣārāṇāmatisēvanam| <br /> pittakāsakaraṁ krōdhaḥ santāpaścāgnisūryajaḥ||14|| <br /> <br /> pītaniṣṭhīvanākṣitvaṁ tiktāsyatvaṁ svarāmayaḥ| <br /> urōdhūmāyanaṁ tr̥ṣṇā dāhō mōhō'rucirbhramaḥ||15|| <br /> <br /> pratataṁ kāsamānaśca jyōtīṁṣīva ca paśyati| <br /> ślēṣmāṇaṁ pittasaṁsr̥ṣṭaṁ niṣṭhīvati ca paittikē||16|| <br /> <br /> kaTukoShNavidAhyamlakShArANAmatisevanam| <br /> pittakAsakaraM krodhaH santApashcAgnisUryajaH||14|| <br /> <br /> pItaniShThIvanAkShitvaM tiktAsyatvaM svarAmayaH| <br /> urodhUmAyanaM tRuShNA dAho moho~arucirbhramaH||15||<br /> <br /> pratataM kAsamAnashca jyotIMShIva ca pashyati| <br /> shleShmANaM pittasaMsRuShTaM niShThIvati ca paittike||16||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Excessive intake of ''ushna, katu, vidahi, amla'' and ''kshara'' type of ''ahara; krodha, santapa'' , exposure to the heat of the fire and sun are the causative factors of [[pitta]]ja kasa''.<br /> <br /> Signs and symptoms of [[pitta]]ja kasa'' are as follows:<br /> #Yellowish sputum and eyes<br /> #Bitter taste in mouth<br /> #Voice disorders <br /> #Feeling of smoke is being vomited out of the chest<br /> #Morbid thirst, burning, illusive, anorexia and giddiness<br /> #Appearance of twinkling stars in front of the eyes while coughing continuously<br /> #Expectoration of sputum mixed with [[pitta]]. [14-16]<br /> <br /> ==== Etiological factors, clinical features of [[Kapha]]ja kasa ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुर्वभिष्यन्दिमधुरस्निग्धस्वप्नाविचेष्टनैः | <br /> वृद्धः श्लेष्माऽनिलं रुद्ध्वा कफकासं करोति हि ||१७|| <br /> <br /> मन्दाग्नित्वारुचिच्छर्दिपीनसोत्क्लेशगौरवैः | <br /> लोमहर्षास्यमाधुर्यक्लेदसंसदनैर्युतम् ||१८|| <br /> <br /> बहुलं मधुरं स्निग्धं निष्ठीवति घनं कफम् | <br /> कासमानो ह्यरुग् वक्षः सम्पूर्णमिव मन्यते ||१९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gurvabhiṣyandimadhurasnigdhasvapnāvicēṣṭanaiḥ| <br /> vr̥ddhaḥ ślēṣmā'nilaṁ ruddhvā kaphakāsaṁ [1] karōti hi||17|| <br /> <br /> mandāgnitvārucicchardipīnasōtklēśagauravaiḥ| <br /> lōmaharṣāsyamādhuryaklēdasaṁsadanairyutam||18|| <br /> <br /> bahulaṁ madhuraṁ snigdhaṁ niṣṭhīvati ghanaṁ kapham| <br /> kāsamānō hyarug vakṣaḥ sampūrṇamiva manyatē||19|| <br /> <br /> gurvabhiShyandimadhurasnigdhasvapnAviceShTanaiH| <br /> vRuddhaH shleShmA~anilaM ruddhvA kaphakAsaM [1] karoti hi||17|| <br /> <br /> mandAgnitvArucicchardipInasotkleshagauravaiH| <br /> lomaharShAsyamAdhuryakledasaMsadanairyutam||18|| <br /> <br /> bahulaM madhuraM snigdhaM niShThIvati ghanaM kapham| <br /> kAsamAno hyarug vakShaH sampUrNamiva manyate||19|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Intake of heavy to digest, slimy, excessive sweets and oily foods ; excessive sleep and habitual inertia leads to aggravation of [[kapha]] and thereby obstructs the movement of [[vata]] which gives rise to [[kapha]]ja type of ''kasa''.<br /> <br /> The signs and symptoms of [[kapha]]ja type of ''kasa'' are as follows:<br /> #Lowered digestion process, anorexia, vomitng, nasal discharge, nausea and heaviness<br /> #Horripilation, stickiness and sweetness of the mouth<br /> #Expectoration of thick, sweet, slimy, phlegm in large quantity<br /> #Not feeling of pain in the chest while coughing<br /> #Feeling of fullness in the chest [17-19]<br /> <br /> ==== Etiological factors, clinical features of ''Kshataja kasa'' ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अतिव्यवायभाराध्वयुद्धाश्वगजविग्रहैः | <br /> रूक्षस्योरः क्षतं वायुर्गृहीत्वा कासमावहेत् ||२०|| <br /> <br /> स पूर्वं कासते शुष्कं ततः ष्ठीवेत् सशोणितम् | <br /> कण्ठेन रुजताऽत्यर्थं विरुग्णेनेव चोरसा ||२१|| <br /> <br /> सूचीभिरिव तीक्ष्णाभिस्तुद्यमानेन शूलिना | <br /> दुःखस्पर्शेन शूलेन भेदपीडाभितापिना ||२२|| <br /> <br /> पर्वभेदज्वरश्वासतृष्णावैस्वर्यपीडितः | <br /> पारावत इवाकूजन् कासवेगात्क्षतोद्भवात् ||२३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ativyavāyabhārādhvayuddhāśvagajavigrahaiḥ| <br /> rūkṣasyōraḥ kṣataṁ vāyurgr̥hītvā kāsamāvahēt||20|| <br /> <br /> sa pūrvaṁ kāsatē śuṣkaṁ tataḥ ṣṭhīvēt saśōṇitam| <br /> kaṇṭhēna rujatā'tyarthaṁ virugṇēnēva cōrasā||21|| <br /> <br /> sūcībhiriva tīkṣṇābhistudyamānēna śūlinā| <br /> duḥkhasparśēna śūlēna bhēdapīḍābhitāpinā||22|| <br /> <br /> parvabhēdajvaraśvāsatr̥ṣṇāvaisvaryapīḍitaḥ| <br /> pārāvata ivākūjan kāsavēgātkṣatōdbhavāt||23|| <br /> <br /> ativyavAyabhArAdhvayuddhAshvagajavigrahaiH| <br /> rUkShasyoraH kShataM vAyurgRuhItvA kAsamAvahet||20|| <br /> <br /> sa pUrvaM kAsate shuShkaM tataH ShThIvet sashoNitam| <br /> kaNThena rujatA~atyarthaM virugNeneva corasA||21|| <br /> <br /> sUcIbhiriva tIkShNAbhistudyamAnena shUlinA| <br /> duHkhasparshena shUlena bhedapIDAbhitApinA||22|| <br /> <br /> parvabhedajvarashvAsatRuShNAvaisvaryapIDitaH| <br /> pArAvata ivAkUjan kAsavegAtkShatodbhavAt||23|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Excessive indulgence in ''vyavaya'', carrying excessive heavy load, walking excessively long distance, indulgence in fighting, excessive indulgence in restraining the movement of horses and elephants etc. factors cause injury to the chest and bring about ''rukshata'' in the body and in turn causes aggravation of [[vata]] there by results in the manifestation of ''kshataja kasa''.<br /> <br /> Signs and symptoms of ''kshataja kasa'' are as follows:<br /> <br /> #The cough will be dry in the beginning followed by blood tinged sputum<br /> #Excessive pain in the throat and feeling of cracking pain in the chest<br /> #Pricking type of pain as if pricked by sharp needles<br /> #Excruciating pain and discomfort by touch on chest, miserable appearance.<br /> #Pain in joints and fingers, fever, labored breath, thirst and altered voice<br /> #While coughing, sounds humming like pigeon. [20-23]<br /> <br /> ==== Etiological factors, clinical features of ''Kshayaja kasa'' ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विषमासात्म्यभोज्यातिव्यवायाद्वेगनिग्रहात् | <br /> घृणिनां शोचतां नॄणां व्यापन्नेऽग्नौ त्रयो मलाः ||२४|| <br /> <br /> कुपिताः क्षयजं कासं कुर्युर्देहक्षयप्रदम् | <br /> दुर्गन्धं हरितं रक्तं ष्ठीवेत् पूयोपमं कफम् ||२५|| <br /> <br /> स्थानादुत्कासमानश्च हृदयं मन्यते च्युतम् | <br /> अकस्मादुष्णशीतार्तो बह्वाशी दुर्बलः कृशः ||२६|| <br /> <br /> स्निग्धाच्छमुखवर्णत्वक् श्रीमद्दर्शनलोचनः | <br /> पाणिपादतलैः श्लक्ष्णैः सततासूयको घृणी ||२७|| <br /> <br /> ज्वरो मिश्राकृतिस्तस्य पार्श्वरुक् पीनसोऽरुचिः | <br /> भिन्नसंहतवर्चस्त्वं स्वरभेदोऽनिमित्ततः ||२८|| <br /> <br /> इत्येष क्षयजः कासः क्षीणानां देहनाशनः | <br /> साध्यो बलवतां वा स्याद्याप्यस्त्वेवं क्षतोत्थितः ||२९|| <br /> <br /> नवौ कदाचित् सिध्येतामेतौ पादगुणान्वितौ | <br /> स्थविराणां जराकासः सर्वो याप्यः प्रकीर्तितः ||३०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> viṣamāsātmyabhōjyātivyavāyādvēganigrahāt| <br /> ghr̥ṇināṁ śōcatāṁ nr̥̄ṇāṁ vyāpannē'gnau trayō malāḥ||24|| <br /> <br /> kupitāḥ kṣayajaṁ kāsaṁ kuryurdēhakṣayapradam| <br /> durgandhaṁ haritaṁ raktaṁ ṣṭhīvēt pūyōpamaṁ kapham||25|| <br /> <br /> sthānādutkāsamānaśca hr̥dayaṁ manyatē cyutam [1] | <br /> akasmāduṣṇaśītārtō bahvāśī durbalaḥ kr̥śaḥ||26|| <br /> <br /> snigdhācchamukhavarṇatvak śrīmaddarśanalōcanaḥ [2] | <br /> pāṇipādatalaiḥ ślakṣṇaiḥ satatāsūyakō [3] ghr̥ṇī||27|| <br /> <br /> jvarō miśrākr̥tistasya pārśvaruk pīnasō'ruciḥ| <br /> bhinnasaṁhatavarcastvaṁ [4] svarabhēdō'nimittataḥ||28|| <br /> <br /> ityēṣa kṣayajaḥ kāsaḥ kṣīṇānāṁ dēhanāśanaḥ| <br /> sādhyō balavatāṁ vā syādyāpyastvēvaṁ kṣatōtthitaḥ||29|| <br /> <br /> navau kadācit sidhyētāmētau pādaguṇānvitau| <br /> sthavirāṇāṁ jarākāsaḥ sarvō yāpyaḥ prakīrtitaḥ||30|| <br /> <br /> viShamAsAtmyabhojyAtivyavAyAdveganigrahAt| <br /> ghRuNinAM shocatAM nRUNAM vyApanne~agnau trayo malAH||24|| <br /> <br /> kupitAH kShayajaM kAsaM kuryurdehakShayapradam| <br /> durgandhaM haritaM raktaM ShThIvet pUyopamaM kapham||25|| <br /> <br /> sthAnAdutkAsamAnashca hRudayaM manyate cyutam [1] | <br /> akasmAduShNashItArto bahvAshI durbalaH kRushaH||26|| <br /> <br /> snigdhAcchamukhavarNatvak shrImaddarshanalocanaH [2] | <br /> pANipAdatalaiH shlakShNaiH satatAsUyako [3] ghRuNI||27|| <br /> <br /> jvaro mishrAkRutistasya pArshvaruk pInaso~aruciH| <br /> bhinnasaMhatavarcastvaM [4] svarabhedo~animittataH||28||<br /> <br /> ityeSha kShayajaH kAsaH kShINAnAM dehanAshanaH| <br /> sAdhyo balavatAM vA syAdyApyastvevaM kShatotthitaH||29|| <br /> <br /> navau kadAcit sidhyetAmetau pAdaguNAnvitau| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Intake of ''vishamashana'' and ''asatmya ahara'', indulgence in ''vyavaya'', suppression of ''vega, ghrina'' and ''shoka'' etc factors leads to vitiation of [[agni]] thereby aggravation of tri[[dosha]] giving rise to ''kshayaja kasa''.<br /> <br /> Signs and symptoms of ''kshayaja kasa'' are as follows:<br /> #Expectoration of the [[kapha]], which is greenish, red in colour, associated with pus and bad odor.<br /> #While coughing person feels as if the heart is displaced.<br /> #Feels suddenly afflicted with both hot and cold sensations.<br /> #Consumption of food in excessive quantity<br /> #Feeling of very weak, and emaciation<br /> #Clean and unctuous complexion of face, associated with gracious appearance of face and eyes.<br /> #Soft silky touch of hands and foot.<br /> #Person always finds fault with others and develops immensely hateful disposition.<br /> #Person suffers from diseases like ''jwara'' (having signs and symptoms of all [[dosha]]), nasal congestion, anorexia, painful flanks, altered voice.<br /> #Feces hard or loose frequently without apparent cause stool.<br /> <br /> This is called ''kshayaja kasa'' which leads to the death of the patient if he is already very weak. If the patient is strong, then the disease can be cured.<br /> <br /> ''Kshataja kasa'' is palliable if the patient is strong. If these two diseases(''kshataja'' and ''kshayaja'') are in their initial stage and if all four ''chikitsa chatushpada'' are endowed with efficiency, then both of these are curable. All types of ''kasa'' are however palliable if the patient is old. [24-30]<br /> <br /> === Prognosis ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रीन्साध्यान्साधयेत्पूर्वान् पथ्यैर्याप्यांश्च यापयेत् | <br /> चिकित्सामत ऊर्ध्वं तु शृणु कासनिबर्हिणीम् ||३१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> trīnsādhyānsādhayētpūrvān pathyairyāpyāṁśca yāpayēt| <br /> cikitsāmata ūrdhvaṁ tu śr̥ṇu kāsanibarhiṇīm||31|| <br /> <br /> trInsAdhyAnsAdhayetpUrvAn pathyairyApyAMshca yApayet| <br /> cikitsAmata UrdhvaM tu shRuNu kAsanibarhiNIm||31|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The first three types of ''kasa'' ([[vata]]ja, [[pitta]]ja, [[kapha]]ja) should be treated as these are ''sadhya vyadhi''. Whereas other two types (''khataja'' and ''kshayaja'') should be palliated with appropriate drugs and diet.<br /> <br /> Treatment of different types of ''kasa'' has been described here after.[31]<br /> <br /> === Management ===<br /> === Management of [[vata]] [[dosha]] dominant kasa ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रूक्षस्यानिलजं कासमादौ स्नेहैरुपाचरेत् | <br /> सर्पिर्भिर्बस्तिभिः पेयायूषक्षीररसादिभिः ||३२|| <br /> <br /> वातघ्नसिद्धैः स्नेहाद्यैर्धूमैर्लेहैश्च युक्तितः | <br /> अभ्यङ्गैः परिषेकैश्च स्निग्धैः स्वेदैश्च बुद्धिमान् ||३३|| <br /> <br /> बस्तिभिर्बद्धविड्वातं शुष्कोर्ध्वं चोर्ध्वभक्तिकैः | <br /> घृतैः सपित्तं सकफं जयेत् स्नेहविरेचनैः ||३४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rūkṣasyānilajaṁ kāsamādau snēhairupācarēt| <br /> sarpirbhirbastibhiḥ pēyāyūṣakṣīrarasādibhiḥ||32|| <br /> <br /> vātaghnasiddhaiḥ snēhādyairdhūmairlēhaiśca yuktitaḥ| <br /> abhyaṅgaiḥ pariṣēkaiśca snigdhaiḥ svēdaiśca buddhimān||33|| <br /> <br /> bastibhirbaddhaviḍvātaṁ śuṣkōrdhvaṁ cōrdhvabhaktikaiḥ| <br /> ghr̥taiḥ sapittaṁ sakaphaṁ jayēt snēhavirēcanaiḥ||34|| <br /> <br /> rUkShasyAnilajaM kAsamAdau snehairupAcaret| <br /> sarpirbhirbastibhiH peyAyUShakShIrarasAdibhiH||32|| <br /> <br /> vAtaghnasiddhaiH snehAdyairdhUmairlehaishca yuktitaH| <br /> abhya~ggaiH pariShekaishca snigdhaiH svedaishca buddhimAn||33|| <br /> <br /> bastibhirbaddhaviDvAtaM shuShkordhvaM cordhvabhaktikaiH| <br /> ghRutaiH sapittaM sakaphaM jayet snehavirecanaiH||34|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As dryness (rukshata) will be more prominent in [[vata]]ja type of ''kasa'', it should be treated with unctuous therapies (snehika upacharas). Ghrita pana,[[basti]], peya, yusha, ksheera, mamsa rasa etc. should be prepared with [[vata]]ghna dravya and is to be administered properly. <br /> <br /> [[Abhyanga]], [[parisheka]] (sprinkling or pouring), snigdha sweda etc. should be followed appropriately. <br /> <br /> If it is associated with constipation and flatulence should be treated with [[basti]]. If the person has dryness in the upper part of the body, and is associated with aggravated [[pitta]], then he should be given medicated [[ghrita]] after intake of food. <br /> <br /> If the person has dryness of the upper part of the body associated with [[kapha]] aggravation, then he should be treated with snigdha [[virechana]].[32-34]<br /> <br /> ==== Kantakari ghrita ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कण्टकारीगुडूचीभ्यां पृथक् त्रिंशत्पलाद्रसे | <br /> प्रस्थः सिद्धो घृताद्वातकासनुद्वह्निदीपनः ||३५|| <br /> <br /> इति कण्टकारीघृतम् | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṇṭakārīguḍūcībhyāṁ pr̥thak triṁśatpalādrasē| <br /> prasthaḥ siddhō ghr̥tādvātakāsanudvahnidīpanaḥ||35|| <br /> <br /> iti kaṇṭakārīghr̥tam| kaNTakArIguDUcIbhyAM pRuthak triMshatpalAdrase| <br /> prasthaH siddho ghRutAdvAtakAsanudvahnidIpanaH||35|| <br /> <br /> iti kaNTakArIghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thirty ''pala'' of ''kantakari'' and ''guduchi kashaya'' each is to be boiled with ''ghrita'' to prepare 1 ''Prastha'' of ''ghrita''. This particular ''ghrita'' is beneficial in ''vatika kasa''. It promotes the power of digestion. Thus ends the description of ''kantakari ghrita''.[35]<br /> <br /> ==== Pippalyadi ghrita ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पिप्पलीपिप्पलीमूलचव्यचित्रकनागरैः | <br /> धान्यपाठावचारास्नायष्ट्याह्वक्षारहिङ्गुभिः ||३६|| <br /> <br /> कोलमात्रैर्घृतप्रस्थाद्दशमूलीरसाढके | <br /> सिद्धाच्चतुर्थिकां पीत्वा पेयामण्डं पिबेदनु ||३७|| <br /> <br /> तच्छ्वासकासहृत्पार्श्वग्रहणीदोषगुल्मनुत् | <br /> पिप्पल्याद्यं घृतं चैतदात्रेयेण प्रकीर्तितम् ||३८|| <br /> <br /> इति पिप्पल्यादिघृतम् | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pippalīpippalīmūlacavyacitrakanāgaraiḥ| <br /> dhānyapāṭhāvacārāsnāyaṣṭyāhvakṣārahiṅgubhiḥ||36|| <br /> <br /> kōlamātrairghr̥taprasthāddaśamūlīrasāḍhakē| <br /> siddhāccaturthikāṁ pītvā pēyāmaṇḍaṁ pibēdanu||37|| <br /> <br /> tacchvāsakāsahr̥tpārśvagrahaṇīdōṣagulmanut| <br /> pippalyādyaṁ ghr̥taṁ caitadātrēyēṇa prakīrtitam||38|| <br /> <br /> iti pippalyādighr̥tam| pippalIpippalImUlacavyacitrakanAgaraiH| <br /> dhAnyapAThAvacArAsnAyaShTyAhvakShArahi~ggubhiH||36|| <br /> <br /> kolamAtrairghRutaprasthAddashamUlIrasADhake| <br /> siddhAccaturthikAM pItvA peyAmaNDaM pibedanu||37|| <br /> <br /> tacchvAsakAsahRutpArshvagrahaNIdoShagulmanut| <br /> pippalyAdyaM ghRutaM caitadAtreyeNa prakIrtitam||38|| <br /> <br /> iti pippalyAdighRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of ''ghrita'' is to be cooked by adding one ''adhaka'' of the decoction of ''dashamoola'' and the paste of one ''kola'' of each ''pippali, pippali-moola, chavya, chitraka, nagara, dhanyaka, patha, vacha, rasna, yashtimadhu, kshara'', and ''hingu''. Intake of one ''chaturthika'' (''pala'') of this ''ghrita'' along with ''peya, manda'' is beneficial in ''shwasa, kasa, hridroga, parshwashoola, grahani'' and ''gulma''. This particular formulation is known as ''pipplyaadi ghrita'' and is propounded by Atreya. <br /> <br /> Thus ends the description of ''pipplyadi-ghrita''.[36-38]<br /> <br /> ==== Tryushanadi ghrita ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्र्यूषणं त्रिफलां द्राक्षां काश्मर्याणि परूषकम् | <br /> द्वे पाठे देवदार्वृद्धिं स्वगुप्तां चित्रकं शटीम् ||३९|| <br /> <br /> ब्राह्मीं तामलकीं मेदां काकनासां शतावरीम् | <br /> त्रिकण्टकं विदारीं च पिष्ट्वा कर्षसमं घृतात् ||४०|| <br /> <br /> प्रस्थं चतुर्गुणे क्षीरे सिद्धं कासहरं पिबेत् | <br /> ज्वरगुल्मारुचिप्लीहशिरोहृत्पार्श्वशूलनुत् ||४१|| <br /> <br /> कामलार्शोऽनिलाष्ठीलाक्षतशोषक्षयापहम् | <br /> त्र्यूषणं नाम विख्यातमेतद्धृतमनुत्तमम् ||४२|| <br /> <br /> इति त्र्यूषणाद्यं घृतम् |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tryūṣaṇaṁ triphalāṁ drākṣāṁ kāśmaryāṇi parūṣakam| <br /> dvē pāṭhē dēvadārvr̥ddhiṁ svaguptāṁ citrakaṁ śaṭīm||39|| <br /> <br /> brāhmīṁ [1] tāmalakīṁ mēdāṁ kākanāsāṁ śatāvarīm| <br /> trikaṇṭakaṁ vidārīṁ ca piṣṭvā karṣasamaṁ ghr̥tāt||40|| <br /> <br /> prasthaṁ caturguṇē kṣīrē siddhaṁ kāsaharaṁ pibēt| <br /> jvaragulmāruciplīhaśirōhr̥tpārśvaśūlanut||41|| <br /> <br /> kāmalārśō'nilāṣṭhīlākṣataśōṣakṣayāpaham| <br /> tryūṣaṇaṁ nāma vikhyātamētaddhr̥tamanuttamam||42|| <br /> <br /> iti tryūṣaṇādyaṁ ghr̥tam| tryUShaNaM triphalAM drAkShAM kAshmaryANi parUShakam| <br /> dve pAThe devadArvRuddhiM svaguptAM citrakaM shaTIm||39|| <br /> <br /> brAhmIM [1] tAmalakIM medAM kAkanAsAM shatAvarIm| <br /> trikaNTakaM vidArIM ca piShTvA karShasamaM ghRutAt||40|| <br /> <br /> prasthaM caturguNe kShIre siddhaM kAsaharaM pibet| <br /> jvaragulmAruciplIhashirohRutpArshvashUlanut||41|| <br /> <br /> kAmalArsho~anilAShThIlAkShatashoShakShayApaham| <br /> tryUShaNaM nAma vikhyAtametaddhRutamanuttamam||42|| <br /> <br /> iti tryUShaNAdyaM ghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of ''ghrita'' should be cooked by adding four ''prasthas'' of milk and the paste of one ''karsha'' each of ''tryushana, triphala, draksha, kashmari, parushaka, dve patha'' (''patha, raja patha''), ''devadaru, rddhi, swagupta, chitraka, shati, brahmi, tamalaki, meda, kakanasa, shatavari, trikantaka, vidari''. This is an effective ''kasahara'' formulation. It also cures ''jwara, gulma, aruchi, pleeha, shirah shoola, hrit shoola, parshwa shoola, kamala, arshas, ashtheela, kshata, shosha, kshaya''. This well known formulation is named as ''tryushanadi ghrita''.<br /> <br /> Thus ends the description of ''tryushanadi ghrita''. [39-42]<br /> <br /> ==== Rasna ghritam ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्रोणेऽपां साधयेद्रास्नां दशमूलीं शतावरीम् | <br /> पलिकां माणिकांशांस्तु कुलत्थान्बदरान्यवान् ||४३|| <br /> <br /> तुलार्धं चाजमांसस्य पादशेषेण तेन च | <br /> घृताढकं समक्षीरं जीवनीयैः पलोन्मितैः ||४४|| <br /> <br /> सिद्धं तद्दशभिः कल्कैर्नस्यपानानुवासनैः | <br /> समीक्ष्य वातरोगेषु यथावस्थं प्रयोजयेत् ||४५|| <br /> <br /> पञ्चकासान् शिरःकम्पं शूलं वङ्क्षणयोनिजम् | <br /> सर्वाङ्गैकाङ्गरोगांश्च सप्लीहोर्ध्वानिलाञ्जयेत् ||४६|| <br /> <br /> इति रास्नाघृतम् | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> drōṇē'pāṁ sādhayēdrāsnāṁ daśamūlīṁ śatāvarīm| <br /> palikāṁ māṇikāṁśāṁstu kulatthānbadarānyavān||43|| <br /> <br /> tulārdhaṁ cājamāṁsasya pādaśēṣēṇa tēna ca| <br /> ghr̥tāḍhakaṁ samakṣīraṁ jīvanīyaiḥ palōnmitaiḥ||44|| <br /> <br /> siddhaṁ taddaśabhiḥ kalkairnasyapānānuvāsanaiḥ| <br /> samīkṣya vātarōgēṣu yathāvasthaṁ prayōjayēt||45|| <br /> <br /> pañcakāsān śiraḥkampaṁ śūlaṁ vaṅkṣaṇayōnijam| <br /> sarvāṅgaikāṅgarōgāṁśca saplīhōrdhvānilāñjayēt||46|| <br /> <br /> iti rāsnāghr̥tam| droNe~apAM sAdhayedrAsnAM dashamUlIM shatAvarIm| <br /> palikAM mANikAMshAMstu kulatthAnbadarAnyavAn||43|| <br /> <br /> tulArdhaM cAjamAMsasya pAdasheSheNa tena ca| <br /> ghRutADhakaM samakShIraM jIvanIyaiH palonmitaiH||44|| <br /> <br /> siddhaM taddashabhiH kalkairnasyapAnAnuvAsanaiH| <br /> samIkShya vAtarogeShu yathAvasthaM prayojayet||45|| <br /> <br /> pa~jcakAsAn shiraHkampaM shUlaM va~gkShaNayonijam| <br /> sarvA~ggaikA~ggarogAMshca saplIhordhvAnilA~jjayet||46|| <br /> <br /> iti rAsnAghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In one ''drona'' of water, one ''pala'' of each of ''rasna, dashamoolas,'' one ''manika'' of each of ''kulattha, badara, yava'' and half ''tula'' of ''ajamamsa'' should be added and boiled till one fourth of water remains. To this decoction, one ''adhaka'' of each of ''ghrita, ksheera'' and one ''pala'' of each of ten drugs belonging to ''jivaneeya'' (''dashemani'') should be added and cooked. This prepared ''ghrita'' should be used in the form of [[nasya]], pana and ''anuvasana'', after proper assessment of the stages of [[vata]]roga. This cures five types of ''kasa, shirahshoola, kamparoga, vankshna'' and ''yoni roga'', diseases afflicting whole body or only one limb of the body, pleeha roga, urdhwa [[vata]].<br /> <br /> Thus ends the description of ''rasna- ghrita''.[43-46]<br /> ==== Various formulations ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विडङ्गं नागरं रास्ना पिप्पली हिङ्गु सैन्धवम् | <br /> भार्गी क्षारश्च तच्चूर्णं पिबेद्वा घृतमात्रया ||४७|| <br /> <br /> सकफेऽनिलजे कासे श्वासहिक्काहताग्निषु | <br /> द्वौ क्षारौ पञ्चकोलानि पञ्चैव लवणानि च ||४८|| <br /> <br /> शटीनागरकोदीच्यकल्कं वा वस्त्रगालितम् | <br /> पाययेत घृतोन्मिश्रं वातकासनिबर्हणम् ||४९|| <br /> <br /> दुरालभां शटीं द्राक्षां शृङ्गवेरं सितोपलाम् | <br /> लिह्यात् कर्कटशृङ्गीं च कासे तैलेन वातजे ||५०|| <br /> <br /> दुःस्पर्शां पिप्पलीं मुस्तं भार्गीं कर्कटकीं शटीम् | <br /> पुराणगुडतैलाभ्यां चूर्णितं वाऽपि लेहयेत् ||५१|| <br /> <br /> विडङ्गं सैन्धवं कुष्ठं व्योषं हिङ्गु मनःशिलाम् | <br /> मधुसर्पिर्युतं कासहिक्काश्वासं जयेल्लिहन् ||५२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> viḍaṅgaṁ nāgaraṁ rāsnā pippalī hiṅgu saindhavam| <br /> bhārgī kṣāraśca taccūrṇaṁ pibēdvā ghr̥tamātrayā||47|| <br /> <br /> sakaphē'nilajē kāsē śvāsahikkāhatāgniṣu| <br /> dvau kṣārau pañcakōlāni pañcaiva lavaṇāni ca||48|| <br /> <br /> śaṭīnāgarakōdīcyakalkaṁ vā vastragālitam| <br /> pāyayēta ghr̥tōnmiśraṁ vātakāsanibarhaṇam||49|| <br /> <br /> durālabhāṁ śaṭīṁ drākṣāṁ śr̥ṅgavēraṁ sitōpalām| <br /> lihyāt karkaṭaśr̥ṅgīṁ ca kāsē tailēna vātajē||50|| <br /> <br /> duḥsparśāṁ pippalīṁ mustaṁ bhārgīṁ karkaṭakīṁ śaṭīm| <br /> purāṇaguḍatailābhyāṁ cūrṇitaṁ vā'pi lēhayēt||51|| <br /> <br /> viḍaṅgaṁ saindhavaṁ kuṣṭhaṁ vyōṣaṁ hiṅgu manaḥśilām| <br /> madhusarpiryutaṁ [1] kāsahikkāśvāsaṁ jayēllihan||52|| <br /> <br /> viDa~ggaM nAgaraM rAsnA pippalI hi~ggu saindhavam| <br /> bhArgI kShArashca taccUrNaM pibedvA ghRutamAtrayA||47|| <br /> <br /> sakaphe~anilaje kAse shvAsahikkAhatAgniShu| <br /> dvau kShArau pa~jcakolAni pa~jcaiva lavaNAni ca||48|| <br /> <br /> shaTInAgarakodIcyakalkaM vA vastragAlitam| <br /> pAyayeta ghRutonmishraM vAtakAsanibarhaNam||49|| <br /> <br /> durAlabhAM shaTIM drAkShAM shRu~ggaveraM sitopalAm| <br /> lihyAt karkaTashRu~ggIM ca kAse tailena vAtaje||50|| <br /> <br /> duHsparshAM pippalIM mustaM bhArgIM karkaTakIM shaTIm| <br /> purANaguDatailAbhyAM cUrNitaM vA~api lehayet||51|| <br /> <br /> viDa~ggaM saindhavaM kuShThaM vyoShaM hi~ggu manaHshilAm| <br /> madhusarpiryutaM [1] kAsahikkAshvAsaM jayellihan||52||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Intake of the powder prepared out of ''vidanga, nagara, rasna, pippali, hingu, saindhava lavana, bharangi'' and ''kshara'' along with appropriate quantity of ''ghrita'' is beneficial in [[vata]]ja kasa, [[kapha]]ja kasa, shwasa, hikka and suppression of digestion power.<br /> <br /> Fine ''vastragalita'' powder prepared out of ''dwou kshara''(''yava kshara'' &amp; ''sarja kshara''), ''pancha kola, pancha lavana, shati, nagara'' and ''udichya'' , taken along with appropriate quantity of ''ghrita'' cures ''vatika'' type of ''kasa''.<br /> <br /> Intake of the powder prepared out of ''duralabha, shati, draksha, shringavera, sitopala, karkata shringi'' along with mixed with ''taila'' and its licking will cure [[vata]]ja kasa.<br /> <br /> The powder of ''dusparsha, pippali, musta, bharangi, karkataki,'' and ''shati'' should be mixed with ''purana guda'' and ''taila''.<br /> <br /> Taken this powder in the form of ''leha'' is beneficial in ''vatika'' type of ''kasa''.<br /> <br /> Powder prepared out of ''vidanga, saindhava lavana, kushtha, vyosha, hingu, manahshila'' taken along with ''madhua'' and ''sarpi'' in the form of ''leha'' eradicates ''kasa, hikka'' and ''shwasa''.[47-52]<br /> <br /> ==== ''Chitrakadi leha'' ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चित्रकं पिप्पलीमूलं व्योषं हिङ्गु दुरालभाम् | <br /> शटीं पुष्करमूलं च श्रेयसीं सुरसां वचाम् ||५३|| <br /> <br /> भार्गीं छिन्नरुहां रास्नां शृङ्गीं द्राक्षां च कार्षिकान् | <br /> कल्कानर्धतुलाक्वाथे निदिग्ध्याः पलविंशतिम् ||५४|| <br /> <br /> दत्त्वा मत्स्यण्डिकायाश्च घृताच्च कुडवं पचेत् | <br /> सिद्धं शीतं पृथक् क्षौद्रपिप्पलीकुडवान्वितम् ||५५|| <br /> <br /> चतुष्पलं तुगाक्षीर्याश्चूर्णितं तत्र दापयेत् | <br /> लेहयेत् कासहृद्रोगश्वासगुल्मनिवारणम् ||५६|| <br /> <br /> इति चित्रकादिलेहः |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> citrakaṁ pippalīmūlaṁ vyōṣaṁ hiṅgu durālabhām| <br /> śaṭīṁ puṣkaramūlaṁ ca śrēyasīṁ surasāṁ vacām||53|| <br /> <br /> bhārgīṁ chinnaruhāṁ rāsnāṁ śr̥ṅgīṁ drākṣāṁ ca kārṣikān| <br /> kalkānardhatulākvāthē nidigdhyāḥ palaviṁśatim [1] ||54|| <br /> <br /> dattvā matsyaṇḍikāyāśca ghr̥tācca kuḍavaṁ pacēt| <br /> siddhaṁ śītaṁ pr̥thak kṣaudrapippalīkuḍavānvitam||55|| <br /> <br /> catuṣpalaṁ tugākṣīryāścūrṇitaṁ tatra dāpayēt| <br /> lēhayēt kāsahr̥drōgaśvāsagulmanivāraṇam||56|| <br /> <br /> iti citrakādilēhaḥ|<br /> <br /> citrakaM pippalImUlaM vyoShaM hi~ggu durAlabhAm| <br /> shaTIM puShkaramUlaM ca shreyasIM surasAM vacAm||53|| <br /> <br /> bhArgIM chinnaruhAM rAsnAM shRu~ggIM drAkShAM ca kArShikAn| <br /> kalkAnardhatulAkvAthe nidigdhyAH palaviMshatim [1] ||54|| <br /> <br /> dattvA matsyaNDikAyAshca ghRutAcca kuDavaM pacet| <br /> siddhaM shItaM pRuthak kShaudrapippalIkuDavAnvitam||55|| <br /> <br /> catuShpalaM tugAkShIryAshcUrNitaM tatra dApayet| <br /> lehayet kAsahRudrogashvAsagulmanivAraNam||56|| <br /> <br /> iti citrakAdilehaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In half ''tula'' of the decoction of ''nidigdhika''(Solanum xanthocarpum), the powder or paste of one ''karsha'' of each of ''chitraka, pippalimula, vyosha, hingu, duralabha, shati, pushkaramoola, shreyasi, surasa, vacha, bharangi, chinnaruha, rasna, shringi, draksha'' should be added. To this twenty ''palas'' of ''matsyandika'' and one ''kudava'' of ''ghrita'' should be added and cooked, There after when it becomes cool, one ''kudava'' of each of ''madhu, pippali'' powder, four ''palas'' of the powder of ''tugakshiri'' should be added. This ''leha'' will cure ''kasa, hridroga, shwasa, gulma''.<br /> <br /> Thus ends the description of ''chitrakadi leha''.[53-56]<br /> <br /> ==== Agastya haritaki ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दशमूलीं स्वयङ्गुप्तां शङ्खपुष्पीं शटीं बलाम् | <br /> हस्तिपिप्पल्यपामार्गपिप्पलीमूलचित्रकान् ||५७|| <br /> <br /> भार्गीं पुष्करमूलं च द्विपलांशं यवाढकम् | <br /> हरीतकीशतं चैकं जले पञ्चाढके पचेत् ||५८|| <br /> <br /> यवैः स्विन्नैः कषायं तं पूतं तच्चाभयाशतम् | <br /> पचेद्गुडतुलां दत्त्वा कुडवं च पृथग्घृतात् ||५९|| <br /> <br /> तैलात् सपिप्पलीचूर्णात् सिद्धशीते च माक्षिकात् | <br /> लिह्याद्द्वे चाभये नित्यमतः खादेद्रसायनात् ||६०|| <br /> <br /> तद्वलीपलितं हन्ति वर्णायुर्बलवर्धनम् | <br /> पञ्चकासान् क्षयं श्वासं हिक्कां च विषमज्वरम् ||६१||<br /> <br /> हन्यात्तथाऽर्शोग्रहणीहृद्रोगारुचिपीनसान् | <br /> अगस्त्यविहितं श्रेष्ठं रसायनमिदं शुभम् ||६२|| <br /> <br /> इत्यगस्त्यहरीतकी | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> daśamūlīṁ svayaṅguptāṁ śaṅkhapuṣpīṁ śaṭīṁ balām| <br /> hastipippalyapāmārgapippalīmūlacitrakān||57|| <br /> <br /> bhārgīṁ puṣkaramūlaṁ ca dvipalāṁśaṁ yavāḍhakam| <br /> harītakīśataṁ caikaṁ jalē pañcāḍhakē pacēt||58||<br /> <br /> yavaiḥ svinnaiḥ kaṣāyaṁ taṁ pūtaṁ taccābhayāśatam| <br /> pacēdguḍatulāṁ dattvā kuḍavaṁ ca pr̥thagghr̥tāt||59|| <br /> <br /> tailāt sapippalīcūrṇāt siddhaśītē ca mākṣikāt| <br /> lihyāddvē cābhayē nityamataḥ khādēdrasāyanāt||60|| <br /> <br /> tadvalīpalitaṁ hanti varṇāyurbalavardhanam| <br /> pañcakāsān kṣayaṁ śvāsaṁ hikkāṁ ca viṣamajvaram||61|| <br /> <br /> hanyāttathā'rśōgrahaṇīhr̥drōgārucipīnasān| <br /> agastyavihitaṁ śrēṣṭhaṁ rasāyanamidaṁ śubham||62|| <br /> <br /> ityagastyaharītakī| <br /> dashamUlIM svaya~gguptAM sha~gkhapuShpIM shaTIM balAm| <br /> hastipippalyapAmArgapippalImUlacitrakAn||57|| <br /> <br /> bhArgIM puShkaramUlaM ca dvipalAMshaM yavADhakam| <br /> harItakIshataM caikaM jale pa~jcADhake pacet||58|| <br /> <br /> yavaiH svinnaiH kaShAyaM taM pUtaM taccAbhayAshatam| <br /> pacedguDatulAM dattvA kuDavaM ca pRuthagghRutAt||59|| <br /> <br /> tailAt sapippalIcUrNAt siddhashIte ca mAkShikAt| <br /> lihyAddve cAbhaye nityamataH khAdedrasAyanAt||60|| <br /> <br /> tadvalIpalitaM hanti varNAyurbalavardhanam| <br /> pa~jcakAsAn kShayaM shvAsaM hikkAM ca viShamajvaram||61|| <br /> <br /> hanyAttathA~arshograhaNIhRudrogArucipInasAn| <br /> agastyavihitaM shreShThaM rasAyanamidaM shubham||62|| <br /> ityagastyaharItakI| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Two palas of each among ''dashamoola, swayamgupta, shankahpushpi, shati, bala, hasti pippali, apamarga, pippalimoola, chitraka, bharangi, pushkaramoola'' should be added with one ''adhaka'' of water, these drugs should be cooked till the grains of ''yava'' becomes soft. And then decoction should be strained out. These hundred fruits of ''abhaya'' should be added with above mentioned decoction, one ''tula'' of ''guda'', one ''kudava'' of ''ghrita, taila'' and powder of ''pippali''. This is to be cooked and after attaining coldness one ''kudava'' of ''makshika'' is to be added. <br /> <br /> Intake of two fruits of ''haritaki'' along with ''leha'' daily is considered as [[rasayana]]. It removes ''vali, palita''; increases [[varna]], [[ayu]] and [[bala]]. Beneficial in ''panchakasa, kshaya, shwaasa, hikka, vishamajwara, arshas, grahani, hridroga, aruchi, pinasa''. This excellent formulation is propounded by Agastya and is auspicious.<br /> <br /> Thus, ends the description of ''Agastya-haritaki''.[57-62]<br /> <br /> ==== Other formulations ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सैन्धवं पिप्पलीं भार्गीं शृङ्गवेरं दुरालभाम् | <br /> दाडिमाम्लेन कोष्णेन भार्गीनागरमम्बुना ||६३|| <br /> <br /> पिबेत् खदिरसारं वा मदिरादधिमस्तुभिः | <br /> अथवा पिप्पलीकल्कं घृतभृष्टं ससैन्धवम् ||६४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> saindhavaṁ pippalīṁ bhārgīṁ śr̥ṅgavēraṁ durālabhām| <br /> dāḍimāmlēna kōṣṇēna bhārgīnāgaramambunā||63||<br /> <br /> pibēt khadirasāraṁ [1] vā madirādadhimastubhiḥ| <br /> athavā pippalīkalkaṁ ghr̥tabhr̥ṣṭaṁ sasaindhavam||64||<br /> <br /> saindhavaM pippalIM bhArgIM shRu~ggaveraM durAlabhAm| <br /> dADimAmlena koShNena bhArgInAgaramambunA||63||<br /> <br /> pibet khadirasAraM [1] vA madirAdadhimastubhiH| <br /> athavA pippalIkalkaM ghRutabhRuShTaM sasaindhavam||64|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Intake of the powder of ''saindhava, pippali, bharangi, shringavera'' and ''duralabha'' along with lukewarm juice of sour ''dadima'' or the decoction of ''nagara'' cures [[vata]]ja kasa. <br /> <br /> Intake of ''khadira saara'' along with ''madira'' or ''takra''; intake of ''pippali'' fried with ''ghrita'' mixed with ''saindhava'' is beneficial in [[vata]]ja kasa. [63-64]<br /> <br /> ==== [[Dhumapana]] (medicated smoke inhalation) formulations ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शिरसः पीडने स्रावे नासाया हृदि ताम्यति | <br /> कासप्रतिश्यायवतां धूमं वैद्यः प्रयोजयेत् ||६५|| <br /> <br /> दशाङ्गुलोन्मितां नाडीमथवाऽष्टाङ्गुलोन्मिताम् | <br /> शरावसम्पुटच्छिद्रे कृत्वा जिह्मां विचक्षणः ||६६|| <br /> <br /> वैरेचनं मुखेनैव कासवान् धूममापिबेत् | <br /> तमुरः केवलं प्राप्तं मुखेनैवोद्वमेत् पुनः ||६७|| <br /> <br /> स ह्यस्य तैक्ष्ण्याद्विच्छिद्य श्लेष्माणमुरसि स्थितम् | <br /> निष्कृष्य शमयेत् कासं वातश्लेष्मसमुद्भवम् ||६८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śirasaḥ pīḍanē srāvē nāsāyā hr̥di tāmyati| <br /> kāsapratiśyāyavatāṁ dhūmaṁ vaidyaḥ prayōjayēt||65|| <br /> <br /> daśāṅgulōnmitāṁ nāḍīmathavā'ṣṭāṅgulōnmitām| <br /> śarāvasampuṭacchidrē kr̥tvā jihmāṁ vicakṣaṇaḥ||66|| <br /> <br /> vairēcanaṁ mukhēnaiva kāsavān dhūmamāpibēt| <br /> tamuraḥ kēvalaṁ prāptaṁ mukhēnaivōdvamēt punaḥ||67|| <br /> <br /> sa hyasya taikṣṇyādvicchidya ślēṣmāṇamurasi sthitam| <br /> niṣkr̥ṣya śamayēt kāsaṁ vātaślēṣmasamudbhavam||68||<br /> <br /> shirasaH pIDane srAve nAsAyA hRudi tAmyati| <br /> kAsapratishyAyavatAM dhUmaM vaidyaH prayojayet||65|| <br /> <br /> dashA~ggulonmitAM nADImathavA~aShTA~ggulonmitAm| <br /> sharAvasampuTacchidre kRutvA jihmAM vicakShaNaH||66|| <br /> <br /> vairecanaM mukhenaiva kAsavAn dhUmamApibet| <br /> tamuraH kevalaM prAptaM mukhenaivodvamet punaH||67|| <br /> <br /> sa hyasya taikShNyAdvicchidya shleShmANamurasi sthitam| <br /> niShkRuShya shamayet kAsaM vAtashleShmasamudbhavam||68|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If there is pain in the ''shiras, nasa srava, arrhythmia'' of ''hridaya'' and ''pratishyaya'' in ''kasa'' then the physician should administer ''dhuma''. A wise physician should keep the ingredients of the recipe which cause elimination of [[dosha]] from the head inside two earthen plates with their brims sealed with mud-smeared cloth. In the upper plate there should be a hole to which a tube, ten or eight ''angulas'' in length, should be inserted in slightly curved form. The patient suffering from ''kasa'' should smoke the fume emanating from this tube through his mouth. After the smoke pervades the entire chest, it should be smoked out through the mouth. Because of the sharpness of the ingredients used in this recipe, the phlegm located in the chest gets detached and forcibly thrown out as a result of which ''kasa'' caused by [[vayu]] and [[kapha]] gets alleviated. [65-68]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मनःशिलालमधुकमांसीमुस्तेङ्गुदैः पिबेत् | <br /> धूमं तस्यानु च क्षीरं सुखोष्णं सगुडं पिबेत् ||६९|| <br /> <br /> एष कासान् पृथग्दोषसन्निपातसमुद्भवान् | <br /> धूमो हन्यादसंसिद्धानन्यैर्योगशतैरपि ||७०|| <br /> <br /> प्रपौण्डरीकं मधुकं शार्ङ्गेष्टां समनःशिलाम् | <br /> मरिचं पिप्पलीं द्राक्षामेलां सुरसमञ्जरीम् ||७१|| <br /> <br /> कृत्वा वर्तिं पिबेद्धूमं क्षौमचेलानुवर्तिताम् | <br /> घृताक्तामनु च क्षीरं गुडोदकमथापि वा ||७२|| <br /> <br /> मनःशिलैलामरिचक्षाराञ्जनकुटन्नटैः | <br /> वंशलेखनसेव्यालक्षौमलक्तकरोहिषैः ||७३|| <br /> <br /> पूर्वकल्पेन धूमोऽयं सानुपानो विधीयते | <br /> मनःशिलाले तद्वच्च पिप्पलीनागरैः सह ||७४|| <br /> <br /> त्वगैङ्गुदी बृहत्यौ द्वे तालमूली मनःशिला | <br /> कार्पासास्थ्यश्वगन्धा च धूमः कासविनाशनः ||७५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> manaḥśilālamadhukamāṁsīmustēṅgudaiḥ pibēt| <br /> dhūmaṁ tasyānu ca kṣīraṁ sukhōṣṇaṁ saguḍaṁ pibēt||69|| <br /> <br /> ēṣa kāsān pr̥thagdōṣasannipātasamudbhavān| <br /> dhūmō hanyādasaṁsiddhānanyairyōgaśatairapi||70|| <br /> <br /> prapauṇḍarīkaṁ madhukaṁ śārṅgēṣṭāṁ samanaḥśilām| <br /> maricaṁ pippalīṁ drākṣāmēlāṁ surasamañjarīm||71|| <br /> <br /> kr̥tvā vartiṁ pibēddhūmaṁ kṣaumacēlānuvartitām| <br /> ghr̥tāktāmanu ca kṣīraṁ guḍōdakamathāpi vā||72|| <br /> <br /> manaḥśilailāmaricakṣārāñjanakuṭannaṭaiḥ| <br /> vaṁśalēkhanasēvyālakṣaumalaktakarōhiṣaiḥ [1] ||73|| <br /> <br /> pūrvakalpēna dhūmō'yaṁ sānupānō vidhīyatē| <br /> manaḥśilālē tadvacca pippalīnāgaraiḥ saha||74|| <br /> <br /> tvagaiṅgudī br̥hatyau dvē tālamūlī manaḥśilā| <br /> kārpāsāsthyaśvagandhā ca dhūmaḥ kāsavināśanaḥ||75||<br /> <br /> manaHshilAlamadhukamAMsImuste~ggudaiH pibet| <br /> dhUmaM tasyAnu ca kShIraM sukhoShNaM saguDaM pibet||69||<br /> <br /> eSha kAsAn pRuthagdoShasannipAtasamudbhavAn| <br /> dhUmo hanyAdasaMsiddhAnanyairyogashatairapi||70|| <br /> <br /> prapauNDarIkaM madhukaM shAr~ggeShTAM samanaHshilAm| <br /> maricaM pippalIM drAkShAmelAM surasama~jjarIm||71|| <br /> <br /> kRutvA vartiM pibeddhUmaM kShaumacelAnuvartitAm| <br /> ghRutAktAmanu ca kShIraM guDodakamathApi vA||72|| <br /> <br /> manaHshilailAmaricakShArA~jjanakuTannaTaiH| <br /> vaMshalekhanasevyAlakShaumalaktakarohiShaiH [1] ||73|| <br /> <br /> pUrvakalpena dhUmo~ayaM sAnupAno vidhIyate| <br /> manaHshilAle tadvacca pippalInAgaraiH saha||74|| <br /> <br /> tvagai~ggudI bRuhatyau dve tAlamUlI manaHshilA| <br /> kArpAsAsthyashvagandhA ca dhUmaH kAsavinAshanaH||75|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Intake of lukewarm milk along with guda after the ''dhumapana'' using ''manahshila, ala''(''haritala''), ''madhuka, jatamansi, ingudi'' cures ''kasa'' of ''prthakdosha'' (three [[dosha]] individually) or ''sannipatika''. This can cure such ailments which were not cured even after the treatment with hundred other recipes.<br /> <br /> The paste prepared out of ''prapoundarika, madhuka, sharangeshta, manhashila, maricha, pippali, draksha, ela'' and ''surasa manjari''(inflorescence of Ocimum sanctum), should be smeared on silk cloth and a ''varti'' should be prepared. This ''varti'' smeared with ''ghrita'' should be used for ''dhumapana'', followed by intake of milk or jaggery mixed with water cures both ''ekadoshaja'' and ''sannipatika kasa''.<br /> <br /> ''Dhuma varti'' prepared out of ''manahshila, ela, maricha, kshara, anjana, kutannata, vamshalekhana, sevya, ala, kshouma, alakthaka, rohisha'' as per earlier mentioned procedure and should be administered along with prior said ''anupana'', in ''kasa''. <br /> <br /> Similarly ''dhumavarti'' can be prepared out of ''manahshila, ala, pippali'' and ''nagara''.<br /> <br /> ''Dhuma'' therapy using bark of ''ingudi, brihati, kantakari, talamuli, manahshila, karpasasthi'' (Seeds of ''karpasa''), ''ashwagandha'' cures ''kasa''. [69-75]<br /> <br /> === Diet recipes ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ग्राम्यानूपौदकैः शालियवगोधूमषष्टिकान् | <br /> रसैर्माषात्मगुप्तानां यूषैर्वा भोजयेद्धितान् ||७६|| <br /> <br /> यवानीपिप्पलीबिल्वमध्यनागरचित्रकैः | <br /> रास्नाजाजीपृथक्पर्णीपलाशशटिपौष्करैः ||७७|| <br /> <br /> स्निग्धाम्ललवणां सिद्धां पेयामनिलजे पिबेत् | <br /> कटीहृत्पार्श्वकोष्ठार्तिश्वासहिक्काप्रणाशिनीम् ||७८|| <br /> <br /> दशमूलरसे तद्वत्पञ्चकोलगुडान्विताम् | <br /> सिद्धां समतिलां दद्यात्क्षीरे वाऽपि ससैन्धवाम् ||७९||<br /> <br /> मात्स्यकौक्कुटवाराहैरामिषैर्वा घृतान्विताम् | <br /> सिद्धां ससैन्धवां पेयां वातकासी पिबेन्नरः ||८०|| <br /> <br /> वास्तुको वायसीशाकं मूलकं सुनिषण्णकम् | <br /> स्नेहास्तैलादयो भक्ष्याः क्षीरेक्षुरसगौडिकाः ||८१|| <br /> <br /> दध्यारनालाम्लफलप्रसन्नापानमेव च | <br /> शस्यते वातकासे तु स्वाद्वम्ललवणानि च ||८२|| <br /> <br /> इति वातकासचिकित्सा | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> grāmyānūpaudakaiḥ śāliyavagōdhūmaṣaṣṭikān| <br /> rasairmāṣātmaguptānāṁ yūṣairvā bhōjayēddhitān||76|| <br /> <br /> yavānīpippalībilvamadhyanāgaracitrakaiḥ| <br /> rāsnājājīpr̥thakparṇīpalāśaśaṭipauṣkaraiḥ||77|| <br /> <br /> snigdhāmlalavaṇāṁ siddhāṁ pēyāmanilajē pibēt| <br /> kaṭīhr̥tpārśvakōṣṭhārtiśvāsahikkāpraṇāśinīm||78|| <br /> <br /> daśamūlarasē tadvatpañcakōlaguḍānvitām| <br /> siddhāṁ samatilāṁ dadyātkṣīrē vā'pi sasaindhavām||79|| <br /> <br /> mātsyakaukkuṭavārāhairāmiṣairvā ghr̥tānvitām| <br /> siddhāṁ [1] sasaindhavāṁ pēyāṁ vātakāsī pibēnnaraḥ||80|| <br /> <br /> vāstukō vāyasīśākaṁ mūlakaṁ suniṣaṇṇakam| <br /> snēhāstailādayō bhakṣyāḥ kṣīrēkṣurasagauḍikāḥ||81|| <br /> <br /> dadhyāranālāmlaphalaprasannāpānamēva ca| <br /> śasyatē vātakāsē tu svādvamlalavaṇāni ca||82|| <br /> <br /> iti vātakāsacikitsā| <br /> <br /> grAmyAnUpaudakaiH shAliyavagodhUmaShaShTikAn| <br /> rasairmAShAtmaguptAnAM yUShairvA bhojayeddhitAn||76|| <br /> <br /> yavAnIpippalIbilvamadhyanAgaracitrakaiH| <br /> rAsnAjAjIpRuthakparNIpalAshashaTipauShkaraiH||77|| <br /> <br /> snigdhAmlalavaNAM siddhAM peyAmanilaje pibet| <br /> kaTIhRutpArshvakoShThArtishvAsahikkApraNAshinIm||78|| <br /> <br /> dashamUlarase tadvatpa~jcakolaguDAnvitAm| <br /> siddhAM samatilAM dadyAtkShIre vA~api sasaindhavAm||79|| <br /> <br /> mAtsyakaukkuTavArAhairAmiShairvA ghRutAnvitAm| <br /> siddhAM [1] sasaindhavAM peyAM vAtakAsI pibennaraH||80|| <br /> <br /> vAstuko vAyasIshAkaM mUlakaM suniShaNNakam| <br /> snehAstailAdayo bhakShyAH kShIrekShurasagauDikAH||81|| <br /> <br /> dadhyAranAlAmlaphalaprasannApAnameva ca| <br /> shasyate vAtakAse tu svAdvamlalavaNAni ca||82|| <br /> <br /> iti vAtakAsacikitsA| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Intake of ''shashtikashali, shali, yava, godhuma'' along with the ''mamsa rasa'' or ''yusha'' prepared out of ''masha'' or ''Atmagupta'' is beneficial in ''vataja kasa. Peya'' prepared out of ''yavani, pippali, bilwa, nagara, chitraka, rasna, ajaji, prithakparni, palasha, shati'' and ''pushkaramoola'' by adding ''snigdha, amla'' and ''lavana dravyas'' is beneficial in ''vataja kasa''. This particular ''peya'' is helpful in curing ''vataja kasa'' associated with ''shoola'' in ''kati, parshwa, koshta, hikka'' and ''shwasa''.<br /> <br /> Intake of ''peya'' prepared with ''dashamoola kashaya'' by adding the powder of ''panchakola'' and ''gud'' is specifically useful in [[vata]]ja kasa. Similarly the ''peya'' prepared by adding equal quantity of ''tila'' and boiled by adding ''ksheera'' is also useful in this ''kasa''. <br /> <br /> ''Peya'' prepared out of ''matsya, kukkuta, varaha mamsa'' by adding ''ghrita'' and ''saindhava lavana'' should be taken by a person suffering from ''vataja kasa''. Vegetables like ''vastuka, vayasi, mulaka, sunishannaka'' should be used in ''vataja kasa'' along with adequate quantity of ''sneha, kshera, ikshurasa'' and ''gud''. ''Aranala, amla phala, prasanna'' etc foods and drinks which are ''madhura, amla, lavana'' in nature are useful in ''vataja kasa''.[76-82]<br /> <br /> === Management of [[pitta]] [[dosha]] dominant kasa ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पैत्तिके सकफे कासे वमनं सर्पिषा हितम् | <br /> तथा मदनकाश्मर्यमधुकक्वथितैर्जलैः ||८३|| <br /> <br /> यष्ट्याह्वफलकल्कैर्वा विदारीक्षुरसायुतैः | <br /> हृतदोषस्ततः शीतं मधुरं च क्रमं भजेत् ||८४|| <br /> <br /> पैत्ते तनुकफे कासे त्रिवृतां मधुरैर्युताम् | <br /> दद्याद्घनकफे तिक्तैर्विरेकार्थे युतां भिषक् ||८५|| <br /> <br /> स्निग्धशीतस्तनुकफे रूक्षशीतः कफे घने | <br /> क्रमः कार्यः परं भोज्यैः स्नेहैर्लेहैश्च शस्यते ||८६|| <br /> <br /> शृङ्गाटकं पद्मबीजं नीलीसाराणि पिप्पली | <br /> पिप्पलीमुस्तयष्ट्याह्वद्राक्षामूर्वामहौषधम् ||८७||<br /> <br /> लाजाऽमृतफला द्राक्षा त्वक्क्षीरी पिप्पली सिता | <br /> पिप्पलीपद्मकद्राक्षा बृहत्याश्च फलाद्रसः ||८८|| <br /> <br /> खर्जूरं पिप्पली वांशी श्वदंष्ट्रा चेति पञ्च ते | <br /> घृतक्षौद्रयुता लेहाः श्लोकार्धैः पित्तकासिनाम् ||८९|| <br /> <br /> शर्कराचन्दनद्राक्षामधुधात्रीफलोत्पलैः | <br /> पैत्ते, समुस्तमरिचः सकफे, सघृतोऽनिले ||९०|| <br /> <br /> मृद्वीकार्धशतं त्रिंशत्पिप्पलीः शर्करापलम् | <br /> लेहयेन्मधुना गोर्वा क्षीरपं च शकृद्रसम् ||९१|| <br /> <br /> त्वगेलाव्योषमृद्वीकापिप्पलीमूलपौष्करैः | <br /> लाजामुस्तशटीरास्नाधात्रीफलबिभीतकैः ||९२|| <br /> <br /> शर्कराक्षौद्रसर्पिर्भिर्लेहः कासविनाशनः | <br /> श्वासं हिक्कां क्षयं चैव हृद्रोगं च प्रणाशयेत् ||९३|| <br /> <br /> पिप्पल्यामलकं द्राक्षां लाक्षां लाजां सितोपलाम् | <br /> क्षीरे पक्त्वा घनं शीतं लिह्यात् क्षौद्राष्टभागिकम् ||९४|| <br /> <br /> विदारीक्षुमृणालानां रसान् क्षीरं सितोपलाम् | <br /> पिबेद्वा मधुसंयुक्तं पित्तकासहरं परम् ||९५|| <br /> <br /> मधुरैर्जाङ्गलरसैः श्यामाकयवकोद्रवाः | <br /> मुद्गादियूषैः शाकैश्च तिक्तकैर्मात्रया हिताः ||९६|| <br /> <br /> घनश्लेष्मणि लेहास्तु तिक्तका मधुसंयुताः | <br /> शालयः स्युस्तनुकफे षष्टिकाश्च रसादिभिः ||९७|| <br /> <br /> शर्कराम्भोऽनुपानार्थं द्राक्षेक्षूणां रसाः पयः | <br /> सर्वं च मधुरं शीतमविदाहि प्रशस्यते ||९८|| <br /> <br /> काकोलीबृहतीमेदायुग्मैः सवृषनागरैः | <br /> पित्तकासे रसान् क्षीरं यूषांश्चाप्युपकल्पयेत् ||९९|| <br /> <br /> शरादिपञ्चमूलस्य पिप्पलीद्राक्षयोस्तथा | <br /> कषायेण शृतं क्षीरं पिबेत् समधुशर्करम् ||१००|| <br /> <br /> स्थिरासितापृश्निपर्णीश्रावणीबृहतीयुगैः | <br /> जीवकर्षभकाकोलीतामलक्यृद्धिजीवकैः ||१०१|| <br /> <br /> शृतं पयः पिबेत् कासी ज्वरी दाही क्षतक्षयी | <br /> तज्जं वा साधयेत् सर्पिः सक्षीरेक्षुरसं भिषक् ||१०२|| <br /> <br /> जीवकाद्यैर्मधुरकैः फलैश्चाभिषुकादिभिः | <br /> कल्कैस्त्रिकार्षिकैः सिद्धे पूतशीते प्रदापयेत् ||१०३|| <br /> <br /> शर्करापिप्पलीचूर्णं त्वक्क्षीर्या मरिचस्य च | <br /> शृङ्गाटकस्य चावाप्य क्षौद्रगर्भान्पलोन्मितान् ||१०४|| <br /> <br /> गुडान् गोधूमचूर्णेन कृत्वा खादेद्धिताशनः | <br /> शुक्रासृग्दोषशोषेषु कासे क्षीणक्षतेषु च ||१०५|| <br /> <br /> शर्करानागरोदीच्यं कण्टकारीं शटीं समम् | <br /> पिष्ट्वा रसं पिबेत्पूतं वस्त्रेण घृतमूर्च्छितम् ||१०६|| <br /> <br /> महिष्यजाविगोक्षीरधात्रीफलरसैः समैः | <br /> सर्पिः सिद्धं पिबेद्युक्त्या पित्तकासनिबर्हणम् ||१०७|| <br /> <br /> इति पित्तकासचिकित्सा | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> paittikē sakaphē kāsē vamanaṁ sarpiṣā hitam| <br /> tathā madanakāśmaryamadhukakvathitairjalaiḥ||83|| <br /> <br /> yaṣṭyāhvaphalakalkairvā vidārīkṣurasāyutaiḥ| <br /> hr̥tadōṣastataḥ śītaṁ madhuraṁ ca kramaṁ bhajēt||84|| <br /> <br /> paittē tanukaphē kāsē trivr̥tāṁ madhurairyutām| <br /> dadyādghanakaphē tiktairvirēkārthē yutāṁ bhiṣak||85|| <br /> <br /> snigdhaśītastanukaphē rūkṣaśītaḥ kaphē ghanē| <br /> kramaḥ kāryaḥ paraṁ bhōjyaiḥ snēhairlēhaiśca śasyatē||86|| <br /> <br /> śr̥ṅgāṭakaṁ padmabījaṁ nīlīsārāṇi pippalī| <br /> pippalīmustayaṣṭyāhvadrākṣāmūrvāmahauṣadham||87|| <br /> <br /> lājā'mr̥taphalā drākṣā tvakkṣīrī pippalī sitā| <br /> pippalīpadmakadrākṣā br̥hatyāśca phalādrasaḥ||88|| <br /> <br /> kharjūraṁ pippalī vāṁśī śvadaṁṣṭrā cēti pañca tē| <br /> ghr̥takṣaudrayutā lēhāḥ ślōkārdhaiḥ pittakāsinām||89|| <br /> <br /> śarkarācandanadrākṣāmadhudhātrīphalōtpalaiḥ| <br /> paittē, samustamaricaḥ sakaphē, saghr̥tō'nilē||90|| <br /> <br /> mr̥dvīkārdhaśataṁ triṁśatpippalīḥ śarkarāpalam| <br /> lēhayēnmadhunā gōrvā kṣīrapaṁ [1] ca śakr̥drasam||91|| <br /> <br /> tvagēlāvyōṣamr̥dvīkāpippalīmūlapauṣkaraiḥ| <br /> lājāmustaśaṭīrāsnādhātrīphalabibhītakaiḥ||92|| <br /> <br /> śarkarākṣaudrasarpirbhirlēhaḥ kāsavināśanaḥ| <br /> śvāsaṁ hikkāṁ kṣayaṁ caiva hr̥drōgaṁ ca praṇāśayēt||93|| <br /> <br /> pippalyāmalakaṁ drākṣāṁ lākṣāṁ lājāṁ sitōpalām| <br /> kṣīrē paktvā ghanaṁ śītaṁ lihyāt kṣaudrāṣṭabhāgikam||94|| <br /> <br /> vidārīkṣumr̥ṇālānāṁ rasān kṣīraṁ sitōpalām| <br /> pibēdvā madhusaṁyuktaṁ pittakāsaharaṁ param||95|| <br /> <br /> madhurairjāṅgalarasaiḥ śyāmākayavakōdravāḥ| <br /> mudgādiyūṣaiḥ śākaiśca tiktakairmātrayā hitāḥ||96|| <br /> <br /> ghanaślēṣmaṇi lēhāstu tiktakā madhusaṁyutāḥ| <br /> śālayaḥ syustanukaphē ṣaṣṭikāśca rasādibhiḥ||97|| <br /> <br /> śarkarāmbhō'nupānārthaṁ drākṣēkṣūṇāṁ rasāḥ payaḥ| <br /> sarvaṁ ca madhuraṁ śītamavidāhi praśasyatē||98|| <br /> <br /> kākōlībr̥hatīmēdāyugmaiḥ savr̥ṣanāgaraiḥ| <br /> pittakāsē rasān kṣīraṁ yūṣāṁścāpyupakalpayēt||99|| <br /> <br /> śarādipañcamūlasya pippalīdrākṣayōstathā| <br /> kaṣāyēṇa śr̥taṁ kṣīraṁ pibēt samadhuśarkaram||100|| <br /> <br /> sthirāsitāpr̥śniparṇīśrāvaṇībr̥hatīyugaiḥ| <br /> jīvakarṣabhakākōlītāmalakyr̥ddhijīvakaiḥ||101|| <br /> <br /> śr̥taṁ payaḥ pibēt kāsī jvarī dāhī kṣatakṣayī| <br /> tajjaṁ vā sādhayēt sarpiḥ sakṣīrēkṣurasaṁ bhiṣak||102|| <br /> <br /> jīvakādyairmadhurakaiḥ phalaiścābhiṣukādibhiḥ| <br /> kalkaistrikārṣikaiḥ siddhē pūtaśītē pradāpayēt||103|| <br /> <br /> śarkarāpippalīcūrṇaṁ tvakkṣīryā maricasya ca| <br /> śr̥ṅgāṭakasya cāvāpya kṣaudragarbhānpalōnmitān||104|| <br /> <br /> guḍān gōdhūmacūrṇēna kr̥tvā khādēddhitāśanaḥ| <br /> śukrāsr̥gdōṣaśōṣēṣu kāsē kṣīṇakṣatēṣu ca||105|| <br /> <br /> śarkarānāgarōdīcyaṁ kaṇṭakārīṁ śaṭīṁ samam| <br /> piṣṭvā rasaṁ pibētpūtaṁ vastrēṇa ghr̥tamūrcchitam||106|| <br /> <br /> mahiṣyajāvigōkṣīradhātrīphalarasaiḥ samaiḥ| <br /> sarpiḥ siddhaṁ pibēdyuktyā pittakāsanibarhaṇam||107|| <br /> <br /> iti pittakāsacikitsā| <br /> <br /> paittike sakaphe kAse vamanaM sarpiShA hitam| <br /> tathA madanakAshmaryamadhukakvathitairjalaiH||83|| <br /> <br /> yaShTyAhvaphalakalkairvA vidArIkShurasAyutaiH| <br /> hRutadoShastataH shItaM madhuraM ca kramaM bhajet||84|| <br /> <br /> paitte tanukaphe kAse trivRutAM madhurairyutAm| <br /> dadyAdghanakaphe tiktairvirekArthe yutAM bhiShak||85|| <br /> <br /> snigdhashItastanukaphe rUkShashItaH kaphe ghane| <br /> kramaH kAryaH paraM bhojyaiH snehairlehaishca shasyate||86|| <br /> <br /> shRu~ggATakaM padmabIjaM nIlIsArANi pippalI| <br /> pippalImustayaShTyAhvadrAkShAmUrvAmahauShadham||87|| <br /> <br /> lAjA~amRutaphalA drAkShA tvakkShIrI pippalI sitA| <br /> pippalIpadmakadrAkShA bRuhatyAshca phalAdrasaH||88|| <br /> <br /> kharjUraM pippalI vAMshI shvadaMShTrA ceti pa~jca te| <br /> ghRutakShaudrayutA lehAH shlokArdhaiH pittakAsinAm||89|| <br /> <br /> sharkarAcandanadrAkShAmadhudhAtrIphalotpalaiH| <br /> paitte, samustamaricaH sakaphe, saghRuto~anile||90|| <br /> <br /> mRudvIkArdhashataM triMshatpippalIH sharkarApalam| <br /> lehayenmadhunA gorvA kShIrapaM [1] ca shakRudrasam||91|| <br /> <br /> tvagelAvyoShamRudvIkApippalImUlapauShkaraiH| <br /> lAjAmustashaTIrAsnAdhAtrIphalabibhItakaiH||92|| <br /> <br /> sharkarAkShaudrasarpirbhirlehaH kAsavinAshanaH| <br /> shvAsaM hikkAM kShayaM caiva hRudrogaM ca praNAshayet||93|| <br /> <br /> pippalyAmalakaM drAkShAM lAkShAM lAjAM sitopalAm| <br /> kShIre paktvA ghanaM shItaM lihyAt kShaudrAShTabhAgikam||94|| <br /> <br /> vidArIkShumRuNAlAnAM rasAn kShIraM sitopalAm| <br /> pibedvA madhusaMyuktaM pittakAsaharaM param||95|| <br /> <br /> madhurairjA~ggalarasaiH shyAmAkayavakodravAH| <br /> mudgAdiyUShaiH shAkaishca tiktakairmAtrayA hitAH||96|| <br /> <br /> ghanashleShmaNi lehAstu tiktakA madhusaMyutAH| <br /> shAlayaH syustanukaphe ShaShTikAshca rasAdibhiH||97|| <br /> <br /> sharkarAmbho~anupAnArthaM drAkShekShUNAM rasAH payaH| <br /> sarvaM ca madhuraM shItamavidAhi prashasyate||98|| <br /> <br /> kAkolIbRuhatImedAyugmaiH savRuShanAgaraiH| <br /> pittakAse rasAn kShIraM yUShAMshcApyupakalpayet||99|| <br /> <br /> sharAdipa~jcamUlasya pippalIdrAkShayostathA| <br /> kaShAyeNa shRutaM kShIraM pibet samadhusharkaram||100|| <br /> <br /> sthirAsitApRushniparNIshrAvaNIbRuhatIyugaiH| <br /> jIvakarShabhakAkolItAmalakyRuddhijIvakaiH||101|| <br /> <br /> shRutaM payaH pibet kAsI jvarI dAhI kShatakShayI| <br /> tajjaM vA sAdhayet sarpiH sakShIrekShurasaM bhiShak||102|| <br /> <br /> jIvakAdyairmadhurakaiH phalaishcAbhiShukAdibhiH| <br /> kalkaistrikArShikaiH siddhe pUtashIte pradApayet||103|| <br /> <br /> sharkarApippalIcUrNaM tvakkShIryA maricasya ca| <br /> shRu~ggATakasya cAvApya kShaudragarbhAnpalonmitAn||104|| <br /> <br /> guDAn godhUmacUrNena kRutvA khAdeddhitAshanaH| <br /> shukrAsRugdoShashoSheShu kAse kShINakShateShu ca||105|| <br /> <br /> sharkarAnAgarodIcyaM kaNTakArIM shaTIM samam| <br /> piShTvA rasaM pibetpUtaM vastreNa ghRutamUrcchitam||106|| <br /> <br /> mahiShyajAvigokShIradhAtrIphalarasaiH samaiH| <br /> sarpiH siddhaM pibedyuktyA pittakAsanibarhaNam||107|| <br /> iti pittakAsacikitsA| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If [[pitta]]ja kasa is associated with the aggravation of [[kapha]], then [[vamana]] karma is to be advised with ''ghrita'' or using the ''kashaya'' prepared out of ''madana, kashmari, madhuka''. [[Vamana]] can also be induced by using the ''klaka'' of ''madanaphal'' and ''madhuyashti'' along with ''vidari'' and ''ikshurasa''. Once after the elimination of aggravated ''doshas'' he should be treated with ''sheeta'' and ''madhura aharas''.<br /> <br /> If in [[pitta]]ja kasa the phlegm is thin then [[virechana]] is to be advised using ''trivrita'' mixed with ''madhura dravyas'', followed by ''snigdha'' and ''sheeta ahara''. Whereas if the phlegm is thick then ''trivrita'' is to be mixed with ''tiktha dravyas'', followed by ''ruksha'' and ''sheeta dravyas''.<br /> <br /> After proper ''shodhana'' therapy person should be treated with ''snigdha leha kalpanas''.<br /> <br /> Following five formulations have been advised for [[pitta]]ja kasa along with ''ghrita'' and ''kshoudra'' and made into the form of ''leha'':<br /> #''Shringataka, padma beeja, sara'' of ''nili,'' and ''pippali''<br /> #''Pippali, musta, yashtimadhu, draksha, murva, mahoushadha''<br /> #''Laja, amritapahala, draksha, tavaksheeri, pippali, sita''<br /> #''Pippali, padmaka, draksha, brihati phalarasa''<br /> #''Kharjuara, pippali, vamshalochana, shwadamshtra''<br /> <br /> If ''kasa'' is exclusively of ''pitta'', then the patient should be given the combination of ''sharkara, chanadana, draksha, madhu, dhatriphala'' and ''utpala''. If there is association of [[kapha]], then he should administer this along with ''musta'' and ''maricha.'' If however, it is associated with [[vata]], then it should be used with ''ghrita''.<br /> <br /> Fifty fruits of ''mridvika,'' thirty fruits of ''pippali'' and one ''pala'' of sugar should be added with ''madhu'', and given to the patient suffering from ''pittaja kasa''.<br /> <br /> Administration of ''madhu'' either with cows milk or urine is beneficial in [[pitta]]ja kasa. But during this therapy patient should drink only milk. The ''leha'' prepared out of ''twak, ela, shunthi, pippali, maricha, mridvika, pippalimula, pushkaramula, laja, musta, shati, rasna, dhatriphala'' and ''bibhitaka'' along with ''sharkara, madhu'' and ''ghrita'' cures ''kasa, shwasa, hikka, kshaya, hridroga. Pippali, amalaki, draksha, lakshai, laja'' and ''sitopala'' should be cooked by adding milk. When it becomes cool , one eighth part of ''madhu'' should be added. This is indicated in ''kasa''. Intake of the liquid prepared out ''vidari, ikshu, mrinala, ksheera'' and ''sitopala'' mixed with ''madhu'' cures [[pitta]]ja kasa effectively. Intake of ''yusha'' prepared out of ''shyamaka, yavaka, kodrava, mudga'' along with sweet ''jangal mamsa rasa'' along with ''tiktha shaka'' is beneficial in ''pittaja kasa''. If the phlegm is thick then the patient should be administered with ''lehas'' prepared out of ''tiktha rasa dravyas'' along with ''madhu''. If the phlegm is thin, then the patient should be given with ''shali'' and ''shashtika shali'' along with ''mamsa rasa''.<br /> <br /> In this [[pitta]]ja kasa drink prepared out of ''sharkara, draksha, ikshurasa'' and milk are beneficial. All things which are ''madhura, sheeta'' and ''avidahi'' should be used.<br /> <br /> Dishes like ''mamsa rasa, ksheera, yusha'' etc prepared out of ''kakoli, brihati, meda, mahameda, vasa'' and ''nagara'' are to be used in [[pitta]]ja kasa. Similarly milk boiled with ''sharadi panchamoola''(Trinapanchamoola), ''pippali, draksha'' along with ''madhu'' and ''sharkara'' should be taken in [[pitta]]ja kasa. <br /> <br /> Milk boiled with ''sthira, sita, prashniparni, sharavani, brihati, kantakari, jivaka, rshabhaka, kakoli, tamalaki, rddhi'' and ''jivaka'' is useful in the treatment of ''kasa, jwara, daha, kshata'' and ''kshaya''. <br /> <br /> The ''ghrita'' collected from the above mentioned should be added with milk, ''ikshu rasa'' and the paste of three ''karsas'' of each of the ''madhura dravya'' belonging to ''jivaneeya'' group, fruits of ''abhishuka'' etc and cooked. The ''ghrita'' should then be filtered out and made to cool. To this the powder of ''sharkara, pippali, tvak-kshiri, maricha , shringatak'' and ''madhu'' should be added. This paste should be added with wheat-flour and ''gud'' (''sarpi gud'') should be prepared out of it. Intake of this cures ''shukra'' and ''asrig dosha, shosha, kasa , kshataksheena'' etc. <br /> <br /> Fine paste of ''sharkara, nagara, udeechya, kantakari, shati'' should be prepared and is to be filtered through a cloth. This liquid is to be used for the ''ghrita murchana''. This ''murchita ghrita'' cures [[pitta]]ja kasa.<br /> <br /> ''Ghrita'' should be cooked with ''mahisha, aja'' and cows milk, along with ''dhatri phala rasa'', all taken in equal quantity. Intake of this ''ghrita'' in appropriate quantity cures [[pitta]]ja kasa.<br /> <br /> Thus ends the description of [[pitta]]ja kasa. [83-107]<br /> <br /> === Management of [[kapha]] [[dosha]] dominant kasa ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बलिनं वमनैरादौ शोधितं कफकासिनम् | <br /> यवान्नैः कटूरूक्षोष्णैः कफघ्नैश्चाप्युपाचरेत् ||१०८|| <br /> <br /> पिप्पलीक्षारिकैर्युषैः कौलत्थैर्मूलकस्य च | <br /> लघून्यन्नानि भुञ्जीत रसैर्वा कटुकान्वितैः ||१०९|| <br /> <br /> धान्वबैलरसैः स्नेहैस्तिलसर्षपबिल्वजैः | <br /> मध्वम्लोष्णाम्बुतक्रं वा मद्यं वा निगदं पिबेत् ||११०|| <br /> <br /> पौष्करारग्वधं मूलं पटोलं तैर्निशास्थितम् | <br /> जलं मधुयुतं पेयं कालेष्वन्नस्य वा त्रिषु ||१११||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> balinaṁ vamanairādau śōdhitaṁ kaphakāsinam| <br /> yavānnaiḥ kaṭurūkṣōṣṇaiḥ kaphaghnaiścāpyupācarēt||108|| <br /> <br /> pippalīkṣārikairyūṣaiḥ kaulatthairmūlakasya ca| <br /> laghūnyannāni bhuñjīta rasairvā kaṭukānvitaiḥ||109|| <br /> <br /> dhānvabailarasaiḥ snēhaistilasarṣapabilvajaiḥ| <br /> madhvamlōṣṇāmbutakraṁ vā madyaṁ vā nigadaṁ pibēt||110|| <br /> <br /> pauṣkarāragvadhaṁ mūlaṁ paṭōlaṁ tairniśāsthitam| <br /> jalaṁ madhuyutaṁ pēyaṁ kālēṣvannasya vā triṣu||111|| <br /> <br /> balinaM vamanairAdau shodhitaM kaphakAsinam| <br /> yavAnnaiH kaTurUkShoShNaiH kaphaghnaishcApyupAcaret||108|| <br /> <br /> pippalIkShArikairyUShaiH kaulatthairmUlakasya ca| <br /> laghUnyannAni bhu~jjIta rasairvA kaTukAnvitaiH||109|| <br /> <br /> dhAnvabailarasaiH snehaistilasarShapabilvajaiH| <br /> madhvamloShNAmbutakraM vA madyaM vA nigadaM pibet||110|| <br /> <br /> pauShkarAragvadhaM mUlaM paTolaM tairnishAsthitam| <br /> jalaM madhuyutaM peyaM kAleShvannasya vA triShu||111|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the person suffering from [[kapha]]ja kasa is strong, then he should follow ''shodhana'' procedure by means of [[vamana]]. There after he should be given with ''yava'' and such other [[kapha]]ghna food which are ''katu, ruksha'' and ''ushna'' in nature.<br /> <br /> The person should take ''laghu ahara'' with the ''yusha'' prepared out of ''kulattha, pippali, kshara, mulaka'' or with the ''mamsa rasa'' of animals of arid zone/ ''bilehsya'' etc. mixed with ''katu rasadravya, srashapataila'' and ''bilva''.<br /> <br /> Drinks such as ''madhu, amala rasa,'' warm water, butter milk or harmless ''madya'' are preferred in [[kapha]]ja kasa. Roots of ''pushkaramoola, argwadha, patola, tinisha'' should be kept in water for whole night. Next morning water should be strained out and added with ''madhu''. This should be taken before, during and after food. [108-111]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कट्फलं कत्तृणं भार्गीं मुस्तं धान्यं वचाभये | <br /> शुण्ठीं पर्पटकं शृङ्गीं सुराह्वं च शृतं जले ||११२|| <br /> <br /> मधुहिङ्गुयुतं पेयं कासे वातकफात्मके | <br /> कण्ठरोगे मुखे शूने श्वासहिक्काज्वरेषु च ||११३|| <br /> <br /> पाठां शुण्ठीं शटीं मूर्वां गवाक्षीं मुस्तपिप्पलीम् | <br /> पिष्ट्वा घर्माम्बुना हिङ्गुसैन्धवाभ्यां युतां पिबेत् ||११४|| <br /> <br /> नागरातिविषे मुस्तं शृङ्गीं कर्कटकस्य च | <br /> हरीतकीं शटीं चैव तेनैव विधिना पिबेत् ||११५|| <br /> <br /> तैलभृष्टं च पिप्पल्याः कल्काक्षं ससितोपलम् | <br /> पिबेद्वा श्लेष्मकासघ्नं कुलत्थरससंयुतम् ||११६|| <br /> <br /> कासमर्दाश्वविट्भृङ्गराजवार्ताकजो रसः | <br /> सक्षौद्रः कफकासघ्नः सुरसस्यासितस्य च ||११७|| <br /> <br /> देवदारु शटी रास्ना कर्कटाख्या दुरालभा | <br /> पिप्पली नागरं मुस्तं पथ्याधात्रीसितोपलाः ||११८|| <br /> <br /> मधुतैलयुतावेतौ लेहौ वातानुगे कफे | <br /> पिप्पली पिप्पलीमूलं चित्रको हस्तिपिप्पली ||११९|| <br /> <br /> पथ्या तामलकी धात्री भद्रमुस्ता च पिप्पली | <br /> देवदार्वभया मुस्तं पिप्पली विश्वभेषजम् ||१२०|| <br /> <br /> विशाला पिप्पली मुस्तं त्रिवृता चेति लेहयेत् | <br /> चतुरो मधुना लेहान् कफकासहरान् भिषक् ||१२१|| <br /> <br /> सौवर्चलाभयाधात्रीपिप्पलीक्षारनागरम् | <br /> चूर्णितं सर्पिषा वातकफकासहरं पिबेत् ||१२२||<br /> <br /> दशमूलाढके प्रस्थं घृतस्याक्षसमैः पचेत् | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭphalaṁ kattr̥ṇaṁ bhārgīṁ mustaṁ dhānyaṁ vacābhayē| <br /> śuṇṭhīṁ parpaṭakaṁ śr̥ṅgīṁ surāhvaṁ ca śr̥taṁ jalē||112||<br /> <br /> madhuhiṅguyutaṁ pēyaṁ kāsē vātakaphātmakē| <br /> kaṇṭharōgē mukhē śūnē śvāsahikkājvarēṣu ca||113||<br /> <br /> pāṭhāṁ śuṇṭhīṁ śaṭīṁ mūrvāṁ gavākṣīṁ mustapippalīm| <br /> piṣṭvā gharmāmbunā hiṅgusaindhavābhyāṁ yutāṁ pibēt||114|| <br /> <br /> nāgarātiviṣē mustaṁ śr̥ṅgīṁ karkaṭakasya ca| <br /> harītakīṁ śaṭīṁ caiva tēnaiva vidhinā pibēt||115|| <br /> <br /> tailabhr̥ṣṭaṁ ca pippalyāḥ kalkākṣaṁ sasitōpalam| <br /> pibēdvā ślēṣmakāsaghnaṁ kulattharasasaṁyutam||116|| <br /> <br /> kāsamardāśvaviṭbhr̥ṅgarājavārtākajō rasaḥ| <br /> sakṣaudraḥ kaphakāsaghnaḥ surasasyāsitasya ca||117|| <br /> <br /> dēvadāru śaṭī rāsnā karkaṭākhyā durālabhā| <br /> pippalī nāgaraṁ mustaṁ pathyādhātrīsitōpalāḥ||118|| <br /> <br /> madhutailayutāvētau lēhau vātānugē kaphē| <br /> pippalī pippalīmūlaṁ citrakō hastipippalī||119|| <br /> <br /> pathyā tāmalakī dhātrī bhadramustā ca pippalī| <br /> dēvadārvabhayā mustaṁ pippalī viśvabhēṣajam||120|| <br /> <br /> viśālā pippalī mustaṁ trivr̥tā cēti lēhayēt| <br /> caturō madhunā lēhān kaphakāsaharān bhiṣak||121|| <br /> <br /> sauvarcalābhayādhātrīpippalīkṣāranāgaram| <br /> cūrṇitaṁ sarpiṣā vātakaphakāsaharaṁ pibēt||122|| <br /> <br /> kaTphalaM kattRuNaM bhArgIM mustaM dhAnyaM vacAbhaye| <br /> shuNThIM parpaTakaM shRu~ggIM surAhvaM ca shRutaM jale||112|| <br /> <br /> madhuhi~gguyutaM peyaM kAse vAtakaphAtmake| <br /> kaNTharoge mukhe shUne shvAsahikkAjvareShu ca||113|| <br /> <br /> pAThAM shuNThIM shaTIM mUrvAM gavAkShIM mustapippalIm| <br /> piShTvA gharmAmbunA hi~ggusaindhavAbhyAM yutAM pibet||114|| <br /> <br /> nAgarAtiviShe mustaM shRu~ggIM karkaTakasya ca| <br /> harItakIM shaTIM caiva tenaiva vidhinA pibet||115|| <br /> <br /> tailabhRuShTaM ca pippalyAH kalkAkShaM sasitopalam| <br /> pibedvA shleShmakAsaghnaM kulattharasasaMyutam||116|| <br /> <br /> kAsamardAshvaviTbhRu~ggarAjavArtAkajo rasaH| <br /> sakShaudraH kaphakAsaghnaH surasasyAsitasya ca||117|| <br /> <br /> devadAru shaTI rAsnA karkaTAkhyA durAlabhA| <br /> pippalI nAgaraM mustaM pathyAdhAtrIsitopalAH||118|| <br /> <br /> madhutailayutAvetau lehau vAtAnuge kaphe| <br /> pippalI pippalImUlaM citrako hastipippalI||119|| <br /> <br /> pathyA tAmalakI dhAtrI bhadramustA ca pippalI| <br /> devadArvabhayA mustaM pippalI vishvabheShajam||120|| <br /> <br /> vishAlA pippalI mustaM trivRutA ceti lehayet| <br /> caturo madhunA lehAn kaphakAsaharAn bhiShak||121|| <br /> <br /> sauvarcalAbhayAdhAtrIpippalIkShAranAgaram| <br /> cUrNitaM sarpiShA vAtakaphakAsaharaM pibet||122|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Decoction prepared by boiling drugs such as ''katphala, kuttrana, bharangi, musta, dhanyaka, vacha, abhaya, shunthi, parpata, shrungi'' and ''surahva'' is to be used in ''kasa'' associated with [[vata]] and [[kapha]] along with ''madhu'' and ''hingu''. This is also beneficial in ''kantharoga, mukha roga, shoola, shwasa, hikka'' and ''jwara''.<br /> <br /> ''Patha, shunthi, shati, murva, gavakshi, musta'' and ''pippali'' paste taken along with hot water by adding ''hingu'' and ''saindhava'' cures ''kasa''. Similarly administration of ''nagara, ativisha, musta, karkatashringi, haritaki'' and ''shati'' is also beneficial.<br /> <br /> One ''aksha'' of the paste of ''pippali'', fried with oil should be added with ''sitopala''. Intake of this recipe along with ''kulattha yusha'' cures [[kapha]]ja kasa. The ''swarasa'' extracted out of ''kasamarda'', stool of horse, ''bhringaraja, vartaka'' and black variety of ''surasa'' along with honey cures [[kapha]]ja kasa.<br /> <br /> Powder prepared out of ''devadaru, shati, rasna, karkatashringi, duralabha'' taken along with ''madhu'' and ''taila'' is effective in [[vata]]nuga [[kapha]]ja kasa.<br /> <br /> ''Pippali, nagara, musta, haritaki, amalaki'' and ''sitopala'' is to be taken along with ''madhu'' and ''taila'' is effective in [[vata]]nuga [[kapha]]ja kasa.<br /> <br /> ''Pippali, pippalimula, chitraka'' and ''gaja pippali'' should be made into ''leha'' form by adding ''madhu''. Intake of this cures [[kapha]]ja kasa.<br /> <br /> Similarly ''pathya, tamalaki, dhatri, bhadra-musta'' and ''pippali'' combination taken along with ''madhu'' cures ''kaphajakasa''.<br /> ''Vishala, pippali, musta, trivrit'' should be taken along with honey in [[kapha]]ja kasa.<br /> <br /> Intake of the powder prepared out of ''souvarchala, abhaya, dhatri, pipplai, kshara'' and ''nagara'' taken along with ''ghrita'' cures ''kasa'' caused by [[vata]] and [[kapha]]. [112-122]<br /> <br /> ==== Dashamuladi ghritam ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुष्कराह्वशटीबिल्वसुरसव्योषहिङ्गुभिः ||१२३|| <br /> <br /> पेयानुपानं तत् पेयं कासे वातकफात्मके | <br /> श्वासरोगेषु सर्वेषु कफवातात्मकेषु च ||१२४|| <br /> <br /> इति दशमूलादिघृतम् | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> daśamūlāḍhakē prasthaṁ ghr̥tasyākṣasamaiḥ pacēt| <br /> puṣkarāhvaśaṭībilvasurasavyōṣahiṅgubhiḥ||123|| <br /> <br /> pēyānupānaṁ tat pēyaṁ kāsē vātakaphātmakē| <br /> śvāsarōgēṣu sarvēṣu kaphavātātmakēṣu ca||124|| <br /> <br /> iti daśamūlādighr̥tam|<br /> <br /> dashamUlADhake prasthaM ghRutasyAkShasamaiH pacet| <br /> puShkarAhvashaTIbilvasurasavyoShahi~ggubhiH||123|| <br /> <br /> peyAnupAnaM tat peyaM kAse vAtakaphAtmake| <br /> shvAsarogeShu sarveShu kaphavAtAtmakeShu ca||124|| <br /> <br /> iti dashamUlAdighRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of ''dashamoola'' should be cooked by adding one ''adhaka'' of the decoction of ''dashamoola'' and the paste of one ''aksha'' each of ''pushkar-moola, shati, bilva, surasa, shunthi, pippali, maricha'' and ''hingu''. Administration of this ghee followed by ''peya'' as ''anupana'' cure [[vata]] [[kapha]]ja kasa, shwasa roga.<br /> <br /> Thus ends the description of ''dashamooladi ghrita''. [123-124]<br /> <br /> ==== Kantakari ghritam ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> समूलफलपत्रायाः कण्टकार्या रसाढके | <br /> घृतप्रस्थं बलाव्योषविडङ्गशटिचित्रकैः ||१२५|| <br /> <br /> सौवर्चलयवक्षारपिप्पलीमूलपौष्करैः | <br /> वृश्चीरबृहतीपथ्यायवानीदाडिमर्धिभिः ||१२६|| <br /> <br /> द्राक्षापुनर्नवाचव्यदुरालम्भाम्लवेतसैः | <br /> शृङ्गीतामलकीभार्गीरास्नागोक्षुरकैः पचेत् ||१२७|| <br /> <br /> कल्कैस्तत् सर्वकासेषु हिक्काश्वासेषु शस्यते | <br /> कण्टकारीघृतं ह्येतत् कफव्याधिनिसूदनम् ||१२८|| <br /> <br /> इति कण्टकारीघृतम् |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> samūlaphalapatrāyāḥ kaṇṭakāryā rasāḍhakē| <br /> ghr̥taprasthaṁ balāvyōṣaviḍaṅgaśaṭicitrakaiḥ||125|| <br /> <br /> sauvarcalayavakṣārapippalīmūlapauṣkaraiḥ| <br /> vr̥ścīrabr̥hatīpathyāyavānīdāḍimardhibhiḥ||126|| <br /> <br /> drākṣāpunarnavācavyadurālambhāmlavētasaiḥ| <br /> śr̥ṅgītāmalakībhārgīrāsnāgōkṣurakaiḥ pacēt||127|| <br /> <br /> kalkaistat sarvakāsēṣu hikkāśvāsēṣu śasyatē| <br /> kaṇṭakārīghr̥taṁ hyētat kaphavyādhinisūdanam||128|| <br /> <br /> iti kaṇṭakārīghr̥tam| <br /> <br /> samUlaphalapatrAyAH kaNTakAryA rasADhake| <br /> ghRutaprasthaM balAvyoShaviDa~ggashaTicitrakaiH||125|| <br /> <br /> sauvarcalayavakShArapippalImUlapauShkaraiH| <br /> vRushcIrabRuhatIpathyAyavAnIdADimardhibhiH||126|| <br /> <br /> drAkShApunarnavAcavyadurAlambhAmlavetasaiH| <br /> shRu~ggItAmalakIbhArgIrAsnAgokShurakaiH pacet||127|| <br /> <br /> kalkaistat sarvakAseShu hikkAshvAseShu shasyate| <br /> kaNTakArIghRutaM hyetat kaphavyAdhinisUdanam||128|| <br /> <br /> iti kaNTakArIghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''adhaka'' of ''kantakari kashaya'' should be prepared using its root, fruit and leaves. This is to be processed with one ''prastha'' of ''ghrita'' by adding the paste of ''bala, shunthi, pippali, maricha, vidanga, shati, chitraka, sauvarchala, yavakshara, pippalimula, pushkarmoola, vrischira, brihati, pathya, yavani, dadima, riddhi, draksha, punaranava, chavya, duralabha, amlavetasa, shringi, tamalaki, bharangi, rasna'' and ''gokshuara''. This is beneficial in all types of ''kasa, hikka'' and ''shwasa''. This is known as ''kantakari ghrita'' and it cures all types of [[kapha]]ja diseases.<br /> <br /> Thus ends the description of ''kantakari-ghrita''.<br /> <br /> ==== Kulatthadi ghritam ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कुलत्थरसयुक्तं वा पञ्चकोलशृतं घृतम् | <br /> पाययेत् कफजे कासे हिक्काश्वासे च शस्यते ||१२९|| <br /> <br /> इति कुलत्थादिघृतम् | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kulattharasayuktaṁ vā pañcakōlaśr̥taṁ ghr̥tam| <br /> pāyayēt kaphajē kāsē hikkāśvāsē ca śasyatē||129|| <br /> <br /> iti kulatthādighr̥tam|<br /> <br /> kulattharasayuktaM vA pa~jcakolashRutaM ghRutam| <br /> pAyayet kaphaje kAse hikkAshvAse ca shasyate||129|| <br /> <br /> iti kulatthAdighRutam|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Ghrita'' cooked with the decoction of ''kulattha'' or with that of ''panchakola'' is useful in [[kapha]]ja kasa, hikka and ''shwasa''. <br /> <br /> Thus ends the description of ''kulatthadi- ghrita''. [125-129]<br /> <br /> ==== [[Dhuma]] (medicated smmoke) formulations ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> धूमांस्तानेव दद्याच्च ये प्रोक्ता वातकासिनाम् | <br /> कोशातकीफलान्मध्यं पिबेद्वा समनःशिलम् ||१३०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dhūmāṁstānēva dadyācca yē prōktā vātakāsinām| <br /> kōśātakīphalānmadhyaṁ pibēdvā samanaḥśilam||130|| <br /> <br /> dhUmAMstAneva dadyAcca ye proktA vAtakAsinAm| <br /> koshAtakIphalAnmadhyaM pibedvA samanaHshilam||130|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Dhuma yogas'' which have been mentioned at the context of [[vata]]ja kasa can also be administered in [[pitta]]ja kasa. Specifically ''manshilla'' kept inside the ''koshataki phala majja'' is useful in the form of ''dhupana'' in [[kapha]]ja-kasa. [130]<br /> <br /> === Principles of treatment in various states of [[dosha]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तमकः कफकासे तु स्याच्चेत् पित्तानुबन्धजः | <br /> पित्तकासक्रियां तत्र यथावस्थं प्रयोजयेत् ||१३१|| <br /> <br /> वाते कफानुबन्धे तु कुर्यात् कफहरीं क्रियाम् | <br /> पित्तानुबन्धयोर्वातकफयोः पित्तनाशिनीम् ||१३२|| <br /> <br /> आर्द्रे विरूक्षणं, शुष्के स्निग्धं, वातकफात्मके | <br /> कासेऽन्नपानं कफजे सपित्ते तिक्तसंयुतम् ||१३३|| <br /> <br /> इति कफजकासचिकित्सा | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tamakaḥ kaphakāsē tu syāccēt pittānubandhajaḥ| <br /> pittakāsakriyāṁ tatra yathāvasthaṁ prayōjayēt||131|| <br /> <br /> vātē kaphānubandhē tu kuryāt kaphaharīṁ kriyām| <br /> pittānubandhayōrvātakaphayōḥ pittanāśinīm||132|| <br /> <br /> ārdrē virūkṣaṇaṁ, śuṣkē snigdhaṁ, vātakaphātmakē| <br /> kāsē'nnapānaṁ kaphajē sapittē tiktasaṁyutam||133|| <br /> <br /> iti kaphajakāsacikitsā| <br /> <br /> tamakaH kaphakAse tu syAccet pittAnubandhajaH| <br /> pittakAsakriyAM tatra yathAvasthaM prayojayet||131|| <br /> <br /> vAte kaphAnubandhe tu kuryAt kaphaharIM kriyAm| <br /> pittAnubandhayorvAtakaphayoH pittanAshinIm||132|| <br /> <br /> Ardre virUkShaNaM, shuShke snigdhaM, vAtakaphAtmake| <br /> kAse~annapAnaM kaphaje sapitte tiktasaMyutam||133|| <br /> <br /> iti kaphajakAsacikitsA| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If [[kapha]]ja kasa is associated with ''tamaka''(a type of ''shwasa'') then at this stage of ''kasa'', therapies prescribed for [[pitta]]ja kasa should be administered. <br /> <br /> If there is association [[kapha]] in [[vata]]ja kasa the [[kapha]]hara measures should be administered.<br /> <br /> If [[pitta]] is associated with [[vata]]ja and [[kapha]]ja kasa then [[pitta]]hara measures should be followed.<br /> <br /> If [[vata]]ja and [[kapha]]ja kasa are associated with expectoration of phlegm, then ''rukshana'' therapy should be followed, whereas if not associated with phlegm then ''snigdha'' therapy should be administered.<br /> <br /> If [[kapha]]ja kasa is associated with [[pitta]], then the patient should be given food and drinks mixed with ''tikta dravyas''.<br /> <br /> Thus ends the description of [[kapha]]ja kasa.[131-134]<br /> <br /> === Management of kshataja kasa (due to injury) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कासमात्ययिकं मत्वा क्षतजं त्वरया जयेत् | <br /> मधुरैर्जीवनीयैश्च बलमांसविवर्धनैः ||१३४|| <br /> <br /> पिप्पली मधुकं पिष्टं कार्षिकं ससितोपलम् | <br /> प्रास्थिकं गव्यमाजं च क्षीरमिक्षुरसस्तथा ||१३५|| <br /> <br /> यवगोधूममृद्वीकाचूर्णमामलकाद्रसः | <br /> तैलं च प्रसृतांशानि तत् सर्वं मृदुनाऽग्निना ||१३६|| <br /> <br /> पचेल्लेहं घृतक्षौद्रयुक्तः स क्षतकासहा | <br /> श्वासहृद्रोगकार्श्येषु हितो वृद्धेऽल्परेतसि ||१३७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kāsamātyayikaṁ matvā kṣatajaṁ tvarayā jayēt| <br /> madhurairjīvanīyaiśca balamāṁsavivardhanaiḥ||134|| <br /> <br /> pippalī madhukaṁ piṣṭaṁ kārṣikaṁ sasitōpalam| <br /> prāsthikaṁ gavyamājaṁ ca kṣīramikṣurasastathā||135|| <br /> <br /> yavagōdhūmamr̥dvīkācūrṇamāmalakādrasaḥ| <br /> tailaṁ ca prasr̥tāṁśāni tat sarvaṁ mr̥dunā'gninā||136|| <br /> <br /> pacēllēhaṁ ghr̥takṣaudrayuktaḥ sa kṣatakāsahā| <br /> śvāsahr̥drōgakārśyēṣu hitō vr̥ddhē'lparētasi||137|| <br /> <br /> kAsamAtyayikaM matvA kShatajaM tvarayA jayet| <br /> madhurairjIvanIyaishca balamAMsavivardhanaiH||134|| <br /> <br /> pippalI madhukaM piShTaM kArShikaM sasitopalam| <br /> prAsthikaM gavyamAjaM ca kShIramikShurasastathA||135|| <br /> <br /> yavagodhUmamRudvIkAcUrNamAmalakAdrasaH| <br /> tailaM ca prasRutAMshAni tat sarvaM mRudunA~agninA||136|| <br /> <br /> pacellehaM ghRutakShaudrayuktaH sa kShatakAsahA| <br /> shvAsahRudrogakArshyeShu hito vRuddhe~alparetasi||137|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Kshataja kasa'' is a serious ailment. Keeping this in view the treatment of the patient should be initiated instantaneously with ''madhura'' and ''jivaniya dravyas'', which are promoters of ''bala'' and ''mamsa''. <br /> <br /> The paste of one ''karsha'' of each of ''pippali, madhuka,'' one ''karsha'' of ''sitopala'', one ''prastha'' of each of cows milk, goats milk and ''ikshurasa'', one ''prastha'' of the powder of ''yava, godhuma, draksha'' and one ''prastha'' of each of the juice of ''amalaka'' and ''tilataila'' should be cooked over mridu [[agni]]. Intake of this ''leha'' along with ''ghrita'' and ''madhu'' cures ''kshataja kasa, shwasa, hridroga'' and ''kshata''. It is also useful for old persons and those who have less semen.[134-137]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षतकासाभिभूतानां वृत्तिः स्यात् पित्तकासिकी | <br /> क्षीरसर्पिर्मधुप्राया संसर्गे तु विशेषणम् ||१३८|| <br /> <br /> वातपित्तार्दितेऽभ्यङ्गो गात्रभेदे घृतैर्हितः | <br /> तैलैर्मारुतरोगघ्नैः पीड्यमाने च वायुना ||१३९|| <br /> <br /> हृत्पार्श्वार्तिषु पानं स्याज्जीवनीयस्य सर्पिषः | <br /> सदाहं कासिनो रक्तं ष्ठीवतः सबलेऽनले ||१४०|| <br /> <br /> मांसोचितेभ्यः क्षामेभ्यो लावादीनां रसा हिताः | <br /> तृष्णार्तानां पयश्छागं शरमूलादिभिः शृतम् ||१४१|| <br /> <br /> रक्ते स्रोतोभ्य आस्याद्वाऽप्यागते क्षीरजं घृतम् | <br /> नस्यं पानं यवागूर्वा श्रान्ते क्षामे हतानले ||१४२|| <br /> <br /> स्तम्भायामेषु महतीं मात्रां वा सर्पिषः पिबेत् | <br /> कुर्याद्वा वातरोगघ्नं पित्तरक्ताविरोधि यत् ||१४३|| <br /> <br /> निवृत्ते क्षतदोषे तु कफे वृद्ध उरः क्षते | <br /> दाल्यते कासिनो यस्य स धूमान्ना पिबेदिमान् ||१४४|| <br /> <br /> द्वे मेदे मधुकं द्वे च बले तैः क्षौमलक्तकैः | <br /> वर्तितैर्धूममापीय जीवनीयघृतं पिबेत् ||१४५|| <br /> <br /> मनःशिलापलाशाजगन्धात्वक्क्षीरिनागरैः | <br /> भावयित्वा पिबेत् क्षौममनु चेक्षुगुडोदकम् ||१४६|| <br /> <br /> पिष्ट्वा मनःशिलां तुल्यामार्द्रया वटशुङ्गया | <br /> ससर्पिष्कं पिबेद्धूमं तित्तिरिप्रतिभोजनम् ||१४७|| <br /> <br /> भावितं जीवनीयैर्वा कुलिङ्गाण्डरसायुतैः | <br /> क्षौमं धूमं पिबेत् क्षीरं शृतं चायोगुडैरनु ||१४८|| <br /> <br /> इति क्षतजकासचिकित्सा |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣatakāsābhibhūtānāṁ vr̥ttiḥ syāt pittakāsikī| <br /> kṣīrasarpirmadhuprāyā saṁsargē tu viśēṣaṇam||138|| <br /> <br /> vātapittārditē'bhyaṅgō gātrabhēdē ghr̥tairhitaḥ| <br /> tailairmārutarōgaghnaiḥ pīḍyamānē ca vāyunā||139|| <br /> <br /> hr̥tpārśvārtiṣu pānaṁ syājjīvanīyasya sarpiṣaḥ| <br /> sadāhaṁ kāsinō raktaṁ ṣṭhīvataḥ sabalē'nalē||140|| <br /> <br /> māṁsōcitēbhyaḥ kṣāmēbhyō lāvādīnāṁ rasā hitāḥ| <br /> tr̥ṣṇārtānāṁ payaśchāgaṁ śaramūlādibhiḥ śr̥tam||141|| <br /> <br /> raktē srōtōbhya āsyādvā'pyāgatē kṣīrajaṁ ghr̥tam| <br /> nasyaṁ pānaṁ yavāgūrvā śrāntē kṣāmē hatānalē||142|| <br /> <br /> stambhāyāmēṣu mahatīṁ mātrāṁ vā sarpiṣaḥ pibēt| <br /> kuryādvā vātarōgaghnaṁ pittaraktāvirōdhi yat||143|| <br /> <br /> nivr̥ttē kṣatadōṣē tu kaphē vr̥ddha uraḥ [1] kṣatē| <br /> dālyatē kāsinō yasya sa dhūmānnā pibēdimān||144|| <br /> <br /> dvē mēdē madhukaṁ dvē ca balē taiḥ kṣaumalaktakaiḥ| <br /> vartitairdhūmamāpīya jīvanīyaghr̥taṁ pibēt||145|| <br /> <br /> manaḥśilāpalāśājagandhātvakkṣīrināgaraiḥ| <br /> bhāvayitvā pibēt kṣaumamanu cēkṣuguḍōdakam||146|| <br /> <br /> piṣṭvā manaḥśilāṁ tulyāmārdrayā vaṭaśuṅgayā| <br /> sasarpiṣkaṁ pibēddhūmaṁ tittiripratibhōjanam||147|| <br /> <br /> bhāvitaṁ jīvanīyairvā kuliṅgāṇḍarasāyutaiḥ| <br /> kṣaumaṁ dhūmaṁ pibēt kṣīraṁ śr̥taṁ cāyōguḍairanu||148|| <br /> <br /> iti kṣatajakāsacikitsā| <br /> kShatakAsAbhibhUtAnAM vRuttiH syAt pittakAsikI| <br /> kShIrasarpirmadhuprAyA saMsarge tu visheShaNam||138|| <br /> <br /> vAtapittArdite~abhya~ggo gAtrabhede ghRutairhitaH| <br /> tailairmArutarogaghnaiH pIDyamAne ca vAyunA||139|| <br /> <br /> hRutpArshvArtiShu pAnaM syAjjIvanIyasya sarpiShaH| <br /> sadAhaM kAsino raktaM ShThIvataH sabale~anale||140|| <br /> <br /> mAMsocitebhyaH kShAmebhyo lAvAdInAM rasA hitAH| <br /> tRuShNArtAnAM payashchAgaM sharamUlAdibhiH shRutam||141|| <br /> <br /> rakte srotobhya AsyAdvA~apyAgate kShIrajaM ghRutam| <br /> nasyaM pAnaM yavAgUrvA shrAnte kShAme hatAnale||142|| <br /> <br /> stambhAyAmeShu mahatIM mAtrAM vA sarpiShaH pibet| <br /> kuryAdvA vAtarogaghnaM pittaraktAvirodhi yat||143|| <br /> <br /> nivRutte kShatadoShe tu kaphe vRuddha uraH [1] kShate| <br /> dAlyate kAsino yasya sa dhUmAnnA pibedimAn||144|| <br /> <br /> dve mede madhukaM dve ca bale taiH kShaumalaktakaiH| <br /> vartitairdhUmamApIya jIvanIyaghRutaM pibet||145|| <br /> <br /> manaHshilApalAshAjagandhAtvakkShIrinAgaraiH| <br /> bhAvayitvA pibet kShaumamanu cekShuguDodakam||146|| <br /> <br /> piShTvA manaHshilAM tulyAmArdrayA vaTashu~ggayA| <br /> sasarpiShkaM pibeddhUmaM tittiripratibhojanam||147|| <br /> <br /> bhAvitaM jIvanIyairvA kuli~ggANDarasAyutaiH| <br /> kShaumaM dhUmaM pibet kShIraM shRutaM cAyoguDairanu||148|| <br /> <br /> iti kShatajakAsacikitsA| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The medicaments prescribed for the [[pitta]]ja kasa are also useful for ''kshataja kasa''. Generally milk, ghee and honey should be given to such patients. If two [[dosha]] are involved in the pathogenesis of this ailment then special therapies are required.<br /> <br /> If this ailment is associated with [[vata]] and [[pitta]] and the person has pain all over the body then ''abhyanga'' should be given with ghee. If there is excessive [[vata]] aggravation, causing pain, then ''abhyanga'' should be given with ''taila'' prepared out of [[vata]]hara dravya. <br /> <br /> The person suffering from ''kasa'' along with pain in ''hridaya'' and ''parshwa'' associated with burning sensation, hemoptysis, and aggravation of [[agni]] should take jivaniya siddha ghrita.<br /> <br /> If the person weak and habituated to take mamsa then the ''mamsarasa'' prepared out of lava is beneficial for him. <br /> <br /> If he is suffering from ''trishna'' then he can take goats milk processed with ''trinapanchamoola''.<br /> <br /> If there is bleeding then he should take the ghee extracted out of this milk. Or this ghee can be administered in the form of [[nasya]] or as a drink.<br /> <br /> If the patient of ''kshata'' is fatigued and weak, and if he has low power of digestion, then he should be given ''yavagu'' to eat.<br /> <br /> If there is ''stambha'' and ''ayama'' then the patient should be given ghee in large quantities.<br /> <br /> Thus all therapies which alleviate the [[vata]], simultaneously which do not aggravate [[pitta]] and [[rakta]] should be followed in such persons.<br /> <br /> After ''khsataja kasa'' treatment, after complete relief, still person is complaining of pain at the place of injury due to aggravation of [[kapha]], should be given ''dhumapana chikitsa'' with following combination.<br /> <br /> ''Meda, mahameda, madhuka, bala'' and ''mahabala'' should be made into paste and smeared over silk-cloth and ''varti'' is to be prepared. After the ''pana'' of this ''dhumavarti'' should be prepared by smearing a piece of silk cloth with the paste of ''manahshila'', ''palasha, ajagandha, tavksheeri,'' and ''nagara''. After ''dhumapana'' the person should drink ''ikshurasa'' and water mixed with jaggery.<br /> <br /> ''Manhashila'' should be made into a paste by tritrating it with the vatashrunga. To this ghee should be added. After ''dhuma'' the person should be given ''tittiri pakshi mamsa rasa''.<br /> <br /> The silk cloth should be soaked with ''jivaniya gana dravyas'' or with egg yolk of ''kulinga''. With this ''varti'' should be prepared and after ''dhumapana'', the person should take the milk soaked with hot iron balls. This is beneficial in ''kshataja kasa''.[138-148]<br /> <br /> === Management of kshayaja kasa (due to depletion)=== <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सम्पूर्णरूपं क्षयजं दुर्बलस्य विवर्जयेत् | <br /> नवोत्थितं बलवतः प्रत्याख्यायाचरेत् क्रियाम् ||१४९|| <br /> <br /> तस्मै बृंहणमेवादौ कुर्यादग्नेश्च दीपनम् | <br /> बहुदोषाय सस्नेहं मृदु दद्याद्विरेचनम् ||१५०|| <br /> <br /> शम्पाकेन त्रिवृतया मृद्वीकारसयुक्तया | <br /> तिल्वकस्य कषायेण विदारीस्वरसेन च ||१५१|| <br /> <br /> सर्पिः सिद्धं पिबेद्युक्त्या क्षीणदेहो विशोधनम् | <br /> (हितं तद्देहबलयोरस्य संरक्षणं मतम् ) ||१५२|| <br /> <br /> पित्ते कफे च सङ्क्षीणे परिक्षीणेषु धातुषु | <br /> घृतं कर्कटकीक्षीरद्विबलासाधितं पिबेत् ||१५३|| <br /> <br /> विदारीभिः कदम्बैर्वा तालसस्यैस्तथा शृतम् | <br /> घृतं पयश्च मूत्रस्य वैवर्ण्ये कृच्छ्रनिर्गमे ||१५४|| <br /> <br /> शूने सवेदने मेढ्रे पायौ सश्रोणिवङ्क्षणे | <br /> घृतमण्डेन मधुनाऽनुवास्यो मिश्रकेण वा ||१५५|| <br /> <br /> जाङ्गलैः प्रतिभुक्तस्य वर्तकाद्या बिलेशयाः | <br /> क्रमशः प्रसहाश्चैव प्रयोज्याः पिशिताशिनः ||१५६|| <br /> <br /> औष्ण्यात् प्रमाथिभावाच्च स्रोतोभ्यश्च्यावयन्ति ते | <br /> कफं, शुद्धैश्च तैः पुष्टिं कुर्यात्सम्यग्वहन्रसः ||१५७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sampūrṇarūpaṁ kṣayajaṁ durbalasya vivarjayēt| <br /> navōtthitaṁ balavataḥ pratyākhyāyācarēt kriyām||149|| <br /> <br /> tasmai br̥ṁhaṇamēvādau kuryādagnēśca dīpanam| <br /> bahudōṣāya sasnēhaṁ mr̥du dadyādvirēcanam||150|| <br /> <br /> śampākēna trivr̥tayā mr̥dvīkārasayuktayā| <br /> tilvakasya kaṣāyēṇa vidārīsvarasēna ca||151|| <br /> <br /> sarpiḥ siddhaṁ pibēdyuktyā kṣīṇadēhō viśōdhanam| <br /> (hitaṁ taddēhabalayōrasya saṁrakṣaṇaṁ matam [1] )||152|| <br /> <br /> pittē kaphē ca saṅkṣīṇē parikṣīṇēṣu dhātuṣu| <br /> ghr̥taṁ karkaṭakīkṣīradvibalāsādhitaṁ pibēt||153|| <br /> <br /> vidārībhiḥ kadambairvā tālasasyaistathā śr̥tam| <br /> ghr̥taṁ payaśca mūtrasya vaivarṇyē kr̥cchranirgamē||154|| <br /> <br /> śūnē savēdanē mēḍhrē pāyau saśrōṇivaṅkṣaṇē| <br /> ghr̥tamaṇḍēna madhunā'nuvāsyō [2] miśrakēṇa vā||155|| <br /> <br /> jāṅgalaiḥ pratibhuktasya vartakādyā bilēśayāḥ| <br /> kramaśaḥ prasahāścaiva prayōjyāḥ piśitāśinaḥ||156|| <br /> <br /> auṣṇyāt pramāthibhāvācca srōtōbhyaścyāvayanti tē| <br /> kaphaṁ, śuddhaiśca taiḥ puṣṭiṁ kuryātsamyagvahanrasaḥ||1<br /> 57|| <br /> <br /> sampUrNarUpaM kShayajaM durbalasya vivarjayet| <br /> navotthitaM balavataH pratyAkhyAyAcaret kriyAm||149|| <br /> <br /> tasmai bRuMhaNamevAdau kuryAdagneshca dIpanam| <br /> bahudoShAya sasnehaM mRudu dadyAdvirecanam||150|| <br /> <br /> shampAkena trivRutayA mRudvIkArasayuktayA| <br /> tilvakasya kaShAyeNa vidArIsvarasena ca||151|| <br /> <br /> sarpiH siddhaM pibedyuktyA kShINadeho vishodhanam| <br /> (hitaM taddehabalayorasya saMrakShaNaM matam [1] )||152|| <br /> <br /> pitte kaphe ca sa~gkShINe parikShINeShu dhAtuShu| <br /> ghRutaM karkaTakIkShIradvibalAsAdhitaM pibet||153|| <br /> <br /> vidArIbhiH kadambairvA tAlasasyaistathA shRutam| <br /> ghRutaM payashca mUtrasya vaivarNye kRucchranirgame||154|| <br /> <br /> shUne savedane meDhre pAyau sashroNiva~gkShaNe| <br /> ghRutamaNDena madhunA~anuvAsyo [2] mishrakeNa vA||155|| <br /> <br /> jA~ggalaiH pratibhuktasya vartakAdyA bileshayAH| <br /> kramashaH prasahAshcaiva prayojyAH pishitAshinaH||156|| <br /> <br /> auShNyAt pramAthibhAvAcca srotobhyashcyAvayanti te| <br /> kaphaM, shuddhaishca taiH puShTiM kuryAtsamyagvahanrasaH||157|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If ''kshayaja kasa'' is manifested with all the signs and symptoms, and if the patient is weak, then he should not be treated. However if the disease has recently occurred and if the patient is strong enough, then he may be treated even though the disease is incurable. In the beginning the person should be given [[brihmana]] therapy along with [[agni]] [[deepana]]. If [[dosha]] aggravation is more, then he can be given mild purgation therapy along with ''snigdha dravyas''.<br /> <br /> Ghee cooked with the decoction of ''shamapaka''(fruit pulp of ''aragwadha''), ''trivrit, mridvika rasa, tilvaka kashaya'' and ''vidari swarasa'' should be given in appropriate dosage for the ''shodhana'' of ''ksheena'' person. It protects the body as well as gives strength for the ''uras''. <br /> <br /> When [[pitta]] and [[kapha]] are reduced in quantity, along emaciation of [[dhatu]], then the person should take the ''ghrita'' prepared out of ''karkatashringi'', milk, ''bala'' and ''atibala''.<br /> <br /> If there is association of ''mutra vaivarnyata'' or ''krichchchrata'', then he should be given the milk boiled with ''vidari, kadamba'' or with tender fruits of ''tala''.<br /> <br /> If there is swelling and pain in the ''medhra, payu, shroni'' and ''vankshana'', then the person should be given the ''anuvasana'' prepared out of ''ghritamanda, madhu'' or with ''mishraka sneha''.<br /> <br /> After ''anuvasana'' the person should be fed with ''mamsa rasa'' prepared out of ''jangala, prasaha, bileshaya,'' and ''vartakas''. Because of their ''ushnata, pramathi bhava'' these move properly in all ''srotas'' and cause dryness of [[kapha]] and simultaneously they nourish the ''srotas''.[149-157]<br /> <br /> ==== Dvi-panchamuladi ghritam ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्विपञ्चमूलीत्रिफलाचविकाभार्गिचित्रकैः | <br /> कुलत्थपिप्पलीमूलपाठाकोलयवैर्जले ||१५८|| <br /> <br /> शृतैर्नागरदुःस्पर्शापिप्पलीशटिपौष्करैः | <br /> कल्कैः कर्कटशृङ्ग्या च समैः सर्पिर्विपाचयेत् ||१५९||<br /> <br /> सिद्धैऽस्मिंश्चूर्णितौ क्षारौ द्वौ पञ्च लवणानि च | <br /> दत्त्वा युक्त्या पिबेन्मात्रां क्षयकासनिपीडितः ||१६०|| <br /> <br /> इति द्विपञ्चमूलादिघृतम् | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dvipañcamūlītriphalācavikābhārgicitrakaiḥ| <br /> kulatthapippalīmūlapāṭhākōlayavairjalē||158|| <br /> <br /> śr̥tairnāgaraduḥsparśāpippalīśaṭipauṣkaraiḥ| <br /> kalkaiḥ karkaṭaśr̥ṅgyā ca samaiḥ sarpirvipācayēt||159|| <br /> <br /> siddhē'smiṁścūrṇitau kṣārau dvau pañca lavaṇāni ca| <br /> dattvā yuktyā pibēnmātrāṁ kṣayakāsanipīḍitaḥ||160|| <br /> <br /> iti dvipañcamūlādighr̥tam| <br /> <br /> dvipa~jcamUlItriphalAcavikAbhArgicitrakaiH| <br /> kulatthapippalImUlapAThAkolayavairjale||158|| <br /> <br /> shRutairnAgaraduHsparshApippalIshaTipauShkaraiH| <br /> kalkaiH karkaTashRu~ggyA ca samaiH sarpirvipAcayet||159|| <br /> <br /> siddhe~asmiMshcUrNitau kShArau dvau pa~jca lavaNAni ca| <br /> dattvA yuktyA pibenmAtrAM kShayakAsanipIDitaH||160|| <br /> <br /> iti dvipa~jcamUlAdighRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Decoction should be prepared out of ''bilva, shyonaka, gambhari, patala, ganikarika, shalaparni, prashanaparni, brihati, kantakari, gokshuara, haritaki, bibhitaka, amalaki, chavika, bharangi, chitraka, kulattha, pippali moola, patha, kola'' and ''yava''. To this decoction ghee and the paste prepared out of ''nagara, dusparsha, pippali, shati, karkatashringi'' and ''pushkara'' should be added and ''ghritapachana'' should be done. After proper ''paka'' powder prepared out of ''yavakshara, sarjakshara, saindhava-lavana, samudra-lavana, sauvarchala-lavana, vida-lavana'' and ''audbhida-lavana'' is to be added. Intake of this cures ''kshayajakasa''.<br /> <br /> Thus ends the description of ''dwi-pancha-mooladi-ghrita''.[158-160]<br /> <br /> ==== Guduchyadi ghritam ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुडूचीं पिप्पलीं मूर्वां हरिद्रां श्रेयसीं वचाम् | <br /> निदिग्धिकां कासमर्दं पाठां चित्रकनागरम् ||१६१|| <br /> <br /> जले चतुर्गुणे पक्त्वा पादशेषेण तत्समम् | <br /> सिद्धं सर्पिः पिबेद्गुल्मश्वासार्तिक्षयकासनुत् ||१६२|| <br /> <br /> इति गुडूच्यादिघृतम् | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> guḍūcīṁ pippalīṁ mūrvāṁ haridrāṁ śrēyasīṁ vacām| <br /> nidigdhikāṁ kāsamardaṁ pāṭhāṁ citrakanāgaram||161|| <br /> <br /> jalē caturguṇē paktvā pādaśēṣēṇa tatsamam| <br /> siddhaṁ sarpiḥ pibēdgulmaśvāsārtikṣayakāsanut||162|| <br /> <br /> iti guḍūcyādighr̥tam|<br /> <br /> guDUcIM pippalIM mUrvAM haridrAM shreyasIM vacAm| <br /> nidigdhikAM kAsamardaM pAThAM citrakanAgaram||161|| <br /> <br /> jale caturguNe paktvA pAdasheSheNa tatsamam| <br /> siddhaM sarpiH pibedgulmashvAsArtikShayakAsanut||162|| <br /> <br /> iti guDUcyAdighRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Guduchi, pippali, murva, haridra, shreyasi, vacha, nidigdhika, kasmarda, patha, chitraka'' and ''nagara'' are to be boiled with four times of water, till the quantity of water reduces to one-fourth. To this decoction equal quantity of ''ghrita'' should be added and cooked. Intake of this cures ''gulma, shwasa'' and ''kshayajakasa''.<br /> <br /> Thus ends the description of ''guduchyaadi-ghrita''.[161-162]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कासमर्दाभयामुस्तपाठाकट्फलनागरैः | <br /> पिप्पलीकटुकाद्राक्षाकाश्मर्यसुरसैस्तथा ||१६३|| <br /> <br /> अक्षमात्रैर्घृतप्रस्थं क्षीरद्राक्षारसाढके | <br /> पचेच्छोषज्वरप्लीहसर्वकासहरं शिवम् ||१६४|| <br /> <br /> धात्रीफलैः क्षीरसिद्धैः सर्पिर्वाऽप्यवचूर्णितम् | <br /> द्विगुणे दाडिमरसे विपक्वं व्योषसंयुतम् ||१६५|| <br /> <br /> पिबेदुपरि भक्तस्य यवक्षारघृतं नरः | <br /> पिप्पलीगुडसिद्धं वा च्छागक्षीरयुतं घृतम् ||१६६|| <br /> <br /> एतान्यग्निविवृद्ध्यर्थं सर्पींषि क्षयकासिनाम् | <br /> स्युर्दोषबद्धकोष्ठोरःस्रोतसां च विशुद्धये ||१६७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kāsamardābhayāmustapāṭhākaṭphalanāgaraiḥ| <br /> pippalīkaṭukādrākṣākāśmaryasurasaistathā||163|| <br /> <br /> akṣamātrairghr̥taprasthaṁ kṣīradrākṣārasāḍhakē| <br /> pacēcchōṣajvaraplīhasarvakāsaharaṁ śivam||164|| <br /> <br /> dhātrīphalaiḥ kṣīrasiddhaiḥ sarpirvā'pyavacūrṇitam| <br /> dviguṇē dāḍimarasē vipakvaṁ vyōṣasaṁyutam||165|| <br /> <br /> pibēdupari bhaktasya yavakṣāraghr̥taṁ naraḥ| <br /> pippalīguḍasiddhaṁ vā cchāgakṣīrayutaṁ ghr̥tam||166|| <br /> <br /> ētānyagnivivr̥ddhyarthaṁ sarpīṁṣi kṣayakāsinām| <br /> syurdōṣabaddhakōṣṭhōraḥsrōtasāṁ ca viśuddhayē||167|| <br /> <br /> kAsamardAbhayAmustapAThAkaTphalanAgaraiH| <br /> pippalIkaTukAdrAkShAkAshmaryasurasaistathA||163|| <br /> <br /> akShamAtrairghRutaprasthaM kShIradrAkShArasADhake| <br /> pacecchoShajvaraplIhasarvakAsaharaM shivam||164|| <br /> <br /> dhAtrIphalaiH kShIrasiddhaiH sarpirvA~apyavacUrNitam| <br /> dviguNe dADimarase vipakvaM vyoShasaMyutam||165|| <br /> <br /> pibedupari bhaktasya yavakShAraghRutaM naraH| <br /> pippalIguDasiddhaM vA cchAgakShIrayutaM ghRutam||166|| <br /> <br /> etAnyagnivivRuddhyarthaM sarpIMShi kShayakAsinAm| <br /> syurdoShabaddhakoShThoraHsrotasAM ca vishuddhaye||167|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of ''ghrita'' should be cooked by adding the paste of one ''aksha'' of each of ''kasamarda, abhaya, musta, patha, katphala, nagara, pippali, katuka, draksha, kashmarya'' and ''surasa''; one ''adhaka'' of milk and one ''adhaka'' of grape juice. Thus prepared ''ghrita'' is considered as auspicious, and cures ''shosha, jwara, pleeha'' and ''kasa''. <br /> <br /> ''Dhatri phala'' or ''dhatriphala'' powder should be cooked with ''ksheera'' and ''ghrita'' for ''ghritapaka, yava-kshara-ghrita'' prepared by adding double the quantity of ''dadima-rasa'' and the powder of ''vyosha'', and which should be taken at the end of a meal; ''ghrita'' cooked with the paste of ''pippali, gud'' and ''chaga dugdha'';<br /> <br /> All the above mentioned ''ghrita'' will promote agni of the patient suffering from ''kshayajakasa''. These also cleanse the adhered ''doshas'' from the ''srotas'' of ''koshtha'' and ''uras''.[163-167]<br /> <br /> ==== Haritaki leha ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> हरीतकीर्यवक्वाथद्व्याढके विंशतिं पचेत् | <br /> स्विन्ना मृदित्वा तास्तस्मिन् पुराणं गुडषट्पलम् ||१६८|| <br /> <br /> दद्यान्मनःशिलाकर्षं कर्षार्धं च रसाञ्जनात् | <br /> कुडवार्धं च पिप्पल्याः स लेहः श्वासकासनुत् ||१६९|| <br /> <br /> इति हरीतकीलेहः |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> harītakīryavakvāthadvyāḍhakē viṁśatiṁ pacēt| <br /> svinnā mr̥ditvā tāstasmin purāṇaṁ guḍaṣaṭpalam||168|| <br /> <br /> dadyānmanaḥśilākarṣaṁ karṣārdhaṁ ca rasāñjanāt| <br /> kuḍavārdhaṁ ca pippalyāḥ sa lēhaḥ śvāsakāsanut||169|| <br /> <br /> iti harītakīlēhaḥ| <br /> <br /> harItakIryavakvAthadvyADhake viMshatiM pacet| <br /> svinnA mRuditvA tAstasmin purANaM guDaShaTpalam||168|| <br /> <br /> dadyAnmanaHshilAkarShaM karShArdhaM ca rasA~jjanAt| <br /> kuDavArdhaM ca pippalyAH sa lehaH shvAsakAsanut||169|| <br /> <br /> iti harItakIlehaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Twenty fruits of ''haritaki'' should be boiled with one ''adhaka'' of ''yava kashaya''. These boiled and soft fruits of ''haritaki'' are to be smashed. To this paste, six ''palas'' of ''purana gud'', one ''karsha'' of ''rasanjana'', half ''kudava'' of ''pippali'' should be added and cooked. This particular ''leha'' cures ''shwasa'' and ''kasa''.<br /> <br /> Thus ends the description of ''haritaki-leha''. [168-169]<br /> <br /> ==== Padmakadi leha ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> श्वाविधः सूचयो दग्धाः सघृतक्षौद्रशर्कराः | <br /> श्वासकासहरा बर्हिपादौ वा क्षौद्रसर्पिषा ||१७०|| <br /> <br /> एरण्डपत्रक्षारं वा व्योषतैलगुडान्वितम् | <br /> लिह्यादेतेन विधिना सुरसैरण्डपत्रजम् ||१७१|| <br /> <br /> द्राक्षापद्मकवार्ताकपिप्पलीः क्षौद्रसर्पिषा | <br /> लिह्यात्त्र्यूषणचूर्णं वा पुराणगुडसर्पिषा ||१७२|| <br /> <br /> चित्रकं त्रिफलाजाजी कर्कटाख्या कटुत्रिकम् | <br /> द्राक्षां च क्षौद्रसर्पिर्भ्यां लिह्यादद्याद्गुडेन वा ||१७३|| <br /> <br /> पद्मकं त्रिफलां व्योषं विडङ्गं सुरदारु च | <br /> बलां रास्नां च तुल्यानि सूक्ष्मचूर्णानि कारयेत् ||१७४|| <br /> <br /> सर्वैरेभिः समं चूर्णैः पृथक् क्षौद्रं घृतं सिताम् | <br /> विमथ्य लेहयेल्लेहं सर्वकासहरं शिवम् ||१७५|| <br /> <br /> जीवन्तीं मधुकं पाठां त्वक्क्षीरीं त्रिफलां शटीम् | <br /> मुस्तैले पद्मकं द्राक्षां द्वे बृहत्यौ वितुन्नकम् ||१७६||<br /> <br /> सारिवां पौष्करं मूलं कर्कटाख्यां रसाञ्जनम् | <br /> पुनर्नवां लोहरजस्त्रायमाणां यवानिकाम् ||१७७|| <br /> <br /> भार्गीं तामलकीमृद्धिं विडङ्गं धन्वयासकम् | <br /> क्षारचित्रकचव्याम्लवेतसव्योषदारु च ||१७८|| <br /> <br /> चूर्णीकृत्य समांशानि लेहयेत् क्षौद्रसर्पिषा | <br /> चूर्णात्पाणितलं पञ्च कासानेतद् व्यपोहति ||१७९|| <br /> <br /> इति पद्मकादिलेहः |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śvāvidhaḥ sūcayō dagdhāḥ saghr̥takṣaudraśarkarāḥ| <br /> śvāsakāsaharā barhipādau vā kṣaudrasarpiṣā||170|| <br /> <br /> ēraṇḍapatrakṣāraṁ vā vyōṣatailaguḍānvitam| <br /> lihyādētēna vidhinā surasairaṇḍapatrajam||171|| <br /> <br /> drākṣāpadmakavārtākapippalīḥ kṣaudrasarpiṣā| <br /> lihyāttryūṣaṇacūrṇaṁ vā purāṇaguḍasarpiṣā||172|| <br /> <br /> citrakaṁ triphalājājī karkaṭākhyā kaṭutrikam| <br /> drākṣāṁ ca kṣaudrasarpirbhyāṁ lihyādadyādguḍēna vā||173|| <br /> <br /> padmakaṁ triphalāṁ vyōṣaṁ viḍaṅgaṁ suradāru ca| <br /> balāṁ rāsnāṁ ca tulyāni sūkṣmacūrṇāni kārayēt||174|| <br /> <br /> sarvairēbhiḥ samaṁ cūrṇaiḥ pr̥thak kṣaudraṁ ghr̥taṁ sitām| <br /> vimathya lēhayēllēhaṁ sarvakāsaharaṁ śivam||175|| <br /> <br /> jīvantīṁ madhukaṁ pāṭhāṁ tvakkṣīrīṁ triphalāṁ śaṭīm| <br /> mustailē padmakaṁ drākṣāṁ dvē br̥hatyau vitunnakam||176|| <br /> <br /> sārivāṁ pauṣkaraṁ mūlaṁ karkaṭākhyāṁ rasāñjanam| <br /> punarnavāṁ lōharajastrāyamāṇāṁ yavānikām||177|| <br /> <br /> bhārgīṁ tāmalakīmr̥ddhiṁ viḍaṅgaṁ dhanvayāsakam| <br /> kṣāracitrakacavyāmlavētasavyōṣadāru ca||178|| <br /> <br /> cūrṇīkr̥tya samāṁśāni lēhayēt kṣaudrasarpiṣā| <br /> cūrṇātpāṇitalaṁ pañca kāsānētad vyapōhati||179|| <br /> <br /> iti padmakādilēhaḥ| <br /> <br /> shvAvidhaH sUcayo dagdhAH saghRutakShaudrasharkarAH| <br /> shvAsakAsaharA barhipAdau vA kShaudrasarpiShA||170|| <br /> <br /> eraNDapatrakShAraM vA vyoShatailaguDAnvitam| <br /> lihyAdetena vidhinA surasairaNDapatrajam||171|| <br /> <br /> drAkShApadmakavArtAkapippalIH kShaudrasarpiShA| <br /> lihyAttryUShaNacUrNaM vA purANaguDasarpiShA||172|| <br /> <br /> citrakaM triphalAjAjI karkaTAkhyA kaTutrikam| <br /> drAkShAM ca kShaudrasarpirbhyAM lihyAdadyAdguDena vA||173|| <br /> <br /> padmakaM triphalAM vyoShaM viDa~ggaM suradAru ca| <br /> balAM rAsnAM ca tulyAni sUkShmacUrNAni kArayet||174|| <br /> <br /> sarvairebhiH samaM cUrNaiH pRuthak kShaudraM ghRutaM sitAm| <br /> vimathya lehayellehaM sarvakAsaharaM shivam||175|| <br /> <br /> jIvantIM madhukaM pAThAM tvakkShIrIM triphalAM shaTIm| <br /> mustaile padmakaM drAkShAM dve bRuhatyau vitunnakam||176|| <br /> <br /> sArivAM pauShkaraM mUlaM karkaTAkhyAM rasA~jjanam| <br /> punarnavAM loharajastrAyamANAM yavAnikAm||177|| <br /> <br /> bhArgIM tAmalakImRuddhiM viDa~ggaM dhanvayAsakam| <br /> kShAracitrakacavyAmlavetasavyoShadAru ca||178|| <br /> <br /> cUrNIkRutya samAMshAni lehayet kShaudrasarpiShA| <br /> cUrNAtpANitalaM pa~jca kAsAnetad vyapohati||179|| <br /> <br /> iti padmakAdilehaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Quills of ''svavit'' should be burnt. Intake of these ashes along with ghee, honey and ''ikshurasa'' cure ''kasa'' and ''shwasa''.<br /> Intake of the ash prepared by burning the peacock leg, along with ''madhu'' and ''ghrita'' cures ''kasa'' and ''shwasa''.<br /> <br /> The ''kshara'' should be prepared out of ''eranda'' leaves. Intake of this along with ''shunthi, maricha, taila'' and ''gud'' cures ''kasa'' and ''shwasa''.<br /> <br /> Similarly ''kshara'' prepared out of ''eranda'' leaves and ''surasa'' can be used in above said manner.<br /> <br /> The powder of ''draksha, padmaka, vartaka'' and ''pippali'' should be added with ''madhu'' and ''ghrita''. Intake of this cures ''shwasa'' and ''kasa''.<br /> <br /> Intake of ''tryushana'' powder along with ''purana gud'' and ''srapi'' is also effective in ''kasa'' and ''shwasa''.<br /> <br /> The powder of ''chitraka, haritaki, bibhitaka, amalaka, ajaji, karkatashringi, shunthi, pippali, maricha'' and ''draksha'' should be mixed with ''madhu, ghrita'' and ''purana gud''. Intake of these two cures ''kasa'' and ''shwasa''.<br /> <br /> ''Padmaka, triphala, vyosha, vidanga, suradaru, bala'' and ''rasna'' taken in equal quantity should be made into fine powder. To this powder equal quantity of ''madhu, ghrita'' and sugar should be added and mixed well. This cures all types of ''kasa''.<br /> <br /> ''Jivanti, madhuka, patha, tavaksheeri, triphala, shati, musta, ela, padmaka, draksha, brihati, kantakari, vitunnaka, sariva, pushkara, karkatashringi, rasanjana, punaranava, loha, rajatha, trayamana, yavanika, bharangi, tamalaki, riddhi, vidanga, dhanvayaasa, kshara, chitraka, chavya, amlavetasa, vyosha'', and ''devadaru'' should be taken in equal quantity and a fine powder should be prepared. Intake of this powder in one ''panitala matra'' along with ''madhu'' and ''ghrita'' cures all five types of ''kasa''.[170-179]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> लिह्यान्मरिचचूर्णं वा सघृतक्षौद्रशर्करम् | <br /> बदरीपत्रकल्कं वा घृतभृष्टं ससैन्धवम् ||१८०|| <br /> <br /> स्वरभेदे च कासे च लेहमेतं प्रयोजयेत् | <br /> पत्रकल्कं घृतैर्भृष्टं तिल्वकस्य सशर्करम् ||१८१|| <br /> <br /> पेया चोत्कारिका च्छर्दितृट्कासामातिसारनुत् | <br /> गौरसर्षपगण्डीरविडङ्गव्योषचित्रकान् | <br /> साभयान् साधयेत्तोये यवागूं तेन चाम्भसा ||१८२|| <br /> <br /> ससर्पिर्लवणां कासे हिक्काश्वासे सपीनसे | <br /> पाण्ड्वामये क्षये शोथे कर्णशूले च दापयेत् ||१८३|| <br /> <br /> कण्टकारीरसे सिद्धो मुद्गयूषः सुसंस्कृतः | <br /> सगौरामलकः साम्लः सर्वकासभिषग्जितम् ||१८४|| <br /> <br /> वातघ्नौषधनिष्क्वाथं क्षीरं यूषान् रसानपि | <br /> वैष्किरप्रतुदान् बैलान् दापयेत् क्षयकासिने ||१८५|| <br /> <br /> क्षतकासे च ये धूमाः सानुपाना निदर्शिताः | <br /> क्षयकासेऽपि तानेव यथावस्थं प्रयोजयेत् ||१८६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> lihyānmaricacūrṇaṁ vā saghr̥takṣaudraśarkaram| <br /> badarīpatrakalkaṁ vā ghr̥tabhr̥ṣṭaṁ sasaindhavam||180|| <br /> <br /> svarabhēdē ca [1] kāsē ca lēhamētaṁ prayōjayēt| <br /> patrakalkaṁ ghr̥tairbhr̥ṣṭaṁ tilvakasya saśarkaram||181|| <br /> <br /> pēyā cōtkārikā ccharditr̥ṭkāsāmātisāranut| <br /> gaurasarṣapagaṇḍīraviḍaṅgavyōṣacitrakān| <br /> sābhayān sādhayēttōyē yavāgūṁ tēna cāmbhasā||182|| <br /> <br /> sasarpirlavaṇāṁ kāsē hikkāśvāsē sapīnasē| <br /> pāṇḍvāmayē kṣayē śōthē [2] karṇaśūlē ca dāpayēt||183|| <br /> <br /> kaṇṭakārīrasē siddhō mudgayūṣaḥ susaṁskr̥taḥ| <br /> sagaurāmalakaḥ sāmlaḥ sarvakāsabhiṣagjitam||184|| <br /> <br /> vātaghnauṣadhaniṣkvāthaṁ kṣīraṁ yūṣān rasānapi| <br /> vaiṣkirapratudān bailān dāpayēt kṣayakāsinē||185|| <br /> <br /> kṣatakāsē ca yē dhūmāḥ sānupānā nidarśitāḥ| <br /> kṣayakāsē'pi tānēva yathāvasthaṁ prayōjayēt||186|| <br /> <br /> lihyAnmaricacUrNaM vA saghRutakShaudrasharkaram| <br /> badarIpatrakalkaM vA ghRutabhRuShTaM sasaindhavam||180|| <br /> <br /> svarabhede ca [1] kAse ca lehametaM prayojayet| <br /> patrakalkaM ghRutairbhRuShTaM tilvakasya sasharkaram||181|| <br /> <br /> peyA cotkArikA ccharditRuTkAsAmAtisAranut| <br /> gaurasarShapagaNDIraviDa~ggavyoShacitrakAn| <br /> sAbhayAn sAdhayettoye yavAgUM tena cAmbhasA||182|| <br /> <br /> sasarpirlavaNAM kAse hikkAshvAse sapInase| <br /> pANDvAmaye kShaye shothe [2] karNashUle ca dApayet||183|| <br /> <br /> kaNTakArIrase siddho mudgayUShaH susaMskRutaH| <br /> sagaurAmalakaH sAmlaH sarvakAsabhiShagjitam||184|| <br /> <br /> vAtaghnauShadhaniShkvAthaM kShIraM yUShAn rasAnapi| <br /> vaiShkirapratudAn bailAn dApayet kShayakAsine||185|| <br /> <br /> kShatakAse ca ye dhUmAH sAnupAnA nidarshitAH| <br /> kShayakAse~api tAneva yathAvasthaM prayojayet||186|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The powder of ''maricha'' should be given with ''ghrita, madhu'' and ''sharkara''. ''Badara'' leaves should be fried with ghee and this given with ''saindhava lavana''. Both these formulations are beneficial in ''kasa'' and ''swarabheda''.<br /> <br /> The paste of the leaves of ''tilvaka'' should be sizzled with ''ghrita'' and made in to ''utkarika'' by adding sugar. Intake of this cures ''chhardi, trishna, kasa,''and ''amatisaara''.<br /> <br /> White variety of ''sarshapa, gandira, vidanga, vyosha, chitraka'' and ''abhaya'' should be boiled with water and the decoction is to be prepared. With this decoction ''yavagu'' should be prepared. This ''yavagu'' administered along with ''ghrita'' and ''lavana'' is beneficial in ''kasa, hikka, shwasa, pinasa, pandu, kshaya, shotha'' and ''karnashoola''.<br /> <br /> ''Mudga yusha'' should be prepared by using ''kantakari'' decoction. Intake of this ''yusha'' along with ''goura amalaka'' and other ''amla dravyas'' cure all types of ''kasa''.<br /> <br /> ''Ksheera, yusha, mamsa rasa'' are preferred in ''kshayajakasa'' persons. For the preparation of ''mamasarasa vishkira, pratuda'' and ''bileshaya mamsa'' should be added. Always these food preparations should be prepared by [[vata]]ghna drugs.<br /> <br /> ''Dhumapana'' formulations mentioned in reference to ''kshatajakasa'' can also be administered to the patients suffering from ''kshayajakasa''.[180-186]<br /> <br /> ==== Principles of management ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दीपनं बृंहणं चैव स्रोतसां च विशोधनम् | <br /> व्यत्यासात्क्षयकासिभ्यो बल्यं सर्वं हितं भवेत् ||१८७|| <br /> <br /> सन्निपातभवोऽप्येष क्षयकासः सुदारुणः | <br /> सन्निपातहितं तस्मात् सदा कार्यं भिषग्जितम् ||१८८|| <br /> <br /> दोषानुबलयोगाच्च हरेद्रोगबलाबलम् | <br /> कासेष्वेषु गरीयांसं जानीयादुत्तरोत्तरम् ||१८९||<br /> <br /> भोज्यं पानानि सर्पींषि लेहाश्च सह पानकैः | <br /> क्षीरं सर्पिर्गुडा धूमाः कासभैषज्यसङ्ग्रहः ||१९०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dīpanaṁ br̥ṁhaṇaṁ caiva srōtasāṁ ca viśōdhanam| <br /> vyatyāsātkṣayakāsibhyō balyaṁ sarvaṁ hitaṁ bhavēt||187|| <br /> <br /> sannipātabhavō'pyēṣa kṣayakāsaḥ sudāruṇaḥ| <br /> sannipātahitaṁ tasmāt sadā kāryaṁ bhiṣagjitam||188|| <br /> <br /> dōṣānubalayōgācca harēdrōgabalābalam| <br /> kāsēṣvēṣu garīyāṁsaṁ jānīyāduttarōttaram||189|| <br /> <br /> bhōjyaṁ pānāni sarpīṁṣi lēhāśca [1] saha pānakaiḥ| <br /> kṣīraṁ sarpirguḍā dhūmāḥ kāsabhaiṣajyasaṅgrahaḥ||190|| <br /> <br /> dIpanaM bRuMhaNaM caiva srotasAM ca vishodhanam| <br /> vyatyAsAtkShayakAsibhyo balyaM sarvaM hitaM bhavet||187|| <br /> <br /> sannipAtabhavo~apyeSha kShayakAsaH sudAruNaH| <br /> sannipAtahitaM tasmAt sadA kAryaM bhiShagjitam||188|| <br /> <br /> doShAnubalayogAcca haredrogabalAbalam| <br /> kAseShveShu garIyAMsaM jAnIyAduttarottaram||189|| <br /> <br /> bhojyaM pAnAni sarpIMShi lehAshca [1] saha pAnakaiH| <br /> kShIraM sarpirguDA dhUmAH kAsabhaiShajyasa~ggrahaH||190|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> [[Dipana]], [[brihmana]] and ''srotoshodhana'' therapies should be followed alternatively in the patient suffering from ''kshyajakaasa''. All such therapies which are ''balya'' are preferred in this condition. <br /> <br /> ''Kshayajakasa'' is caused by ''sannipata''. Therefore therapies which alleviate tri[[dosha]] are to be administered for the treatment.<br /> <br /> But still ''bala'' (strength) and ''abalata'' (weakness) of the disease is determined by the nature of aggravation of associated [[dosha]]. Keeping this in view, treatment should be administered.<br /> <br /> The physician should know that among these five kasa, the succeeding ones are more serious than the preceding. <br /> Different formulations mentioned under [[Kasa Chikitsa]] ''adhyaya'' are as follows:<br /> <br /> ''Bhojya, pana, sarpi, leha, panaka, ksheera, sarpiguda'' and ''dhuma''.[187-190]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकः- <br /> <br /> सङ्ख्या निमित्तं रूपाणि साध्यासाध्यत्वमेव च | <br /> कासानां भेषजं प्रोक्तं गरीयस्त्वं च कासिनः ||१९१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkaḥ- <br /> <br /> saṅkhyā nimittaṁ rūpāṇi sādhyāsādhyatvamēva ca| <br /> kāsānāṁ bhēṣajaṁ prōktaṁ garīyastvaṁ ca kāsinaḥ||191|| <br /> <br /> tatra shlokaH- <br /> <br /> sa~gkhyA nimittaM rUpANi sAdhyAsAdhyatvameva ca| <br /> kAsAnAM bheShajaM proktaM garIyastvaM ca kAsinaH||191|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Sankhya'' (types of ''kasa''), ''nimitta'' (etiological factors), ''rupa'' (signs and symptoms), ''sadhya-asadhyata'' (curability and incurability), ''kasa bheshaja'' (medicinal formulations), ''gariyastva'' (comparative seriousness of the disease) – have been discussed under this chapter. [191]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते <br /> चिकित्सास्थाने कासचिकित्सितं नामाष्टादशोऽध्यायः ||१८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē'prāptē dr̥ḍhabalasampūritē <br /> cikitsāsthānē kāsacikitsitaṁ nāmāṣṭādaśō'dhyāyaḥ||18|| <br /> <br /> cikitsAsthAne kAsacikitsitaM nAmAShTAdasho~adhyAyaH||18|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus ends the eighteenth chapter in [[Chikitsa Sthana]] dealing with treatment of ''kasa'' in the work of Agnivesha which was redacted by Charak and because of non-availability supplemented by Dridhabala.<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *[[Vata]] being obstructed in the lower region of the body, moves upwards, afflicts the channels of circulation in the upper part of the body, takes over the function of udana [[vayu]] and gets localized in the throat and chest, then enters and fills up all the cavities in the head. <br /> *Udana[[vata]] plays key role in ''kasa''. It is located in sinuses, throat and upper respiratory tract. Its main function is to exude out secretions from head and upper respiratory tract, effortlessly. <br /> *Due to one group of etiological factors, sinuses and bronchial tree gets filled with secretions. Another group of factors like over exertion, weaken the functions of udana[[vata]] by over consuming it.<br /> *Since udana[[vata]] is not available, the physiological mechanism of ''kasa'' (cough reflex) starts to work causing forceful, frictionful expectoration with sound.<br /> *In order to prevent damage to delicate mucosa and avoid friction, treatment with good amount of ghee after meal is best.<br /> *In contrast to ''hikka'' and shwasa, [[pitta]] is not involved ''kasa'' except ''paittic kasa''. &lt;/div&gt;<br /> <br /> == Vidhi Vimarsha (Applied Inferences) ==<br /> <br /> === Diagnostic codes===<br /> <br /> National Ayurveda Morbidity Code: EA-3&lt;ref&gt;Avaialable from http://namstp.ayush.gov.in/#/Ayurveda accessed on 10/06/2021&lt;/ref&gt;<br /> <br /> ICD code: R05<br /> <br /> === Causes of kasa ===<br /> <br /> '''Dietary:'''<br /> <br /> *Excessive intake of dry, cold and astringent food <br /> *Excess fasting <br /> *Taking food in less quantity [Cha.Sa.[[Chikitsa Sthana]] 18/10]<br /> *Excessive intake of hot, spicy, sour foods [Cha.Sa.[[Chikitsa Sthana]] 18/14]<br /> *Intake of heavy to digest, slimy, sweet and oily foods [Cha.Sa.[[Chikitsa Sthana]] 18/17]<br /> <br /> '''Lifestyle:'''<br /> <br /> *Excessive indulgence in sex <br /> *Excessive physical strain <br /> *Suppression of natural urges [Cha.Sa.[[Chikitsa Sthana]] 18/10]<br /> *Excessive exposure to heat [Cha.Sa.[[Chikitsa Sthana]] 18/14]<br /> *Excessive sleep and inactivity [Cha.Sa.[[Chikitsa Sthana]] 18/17]<br /> *Carrying a hefty load<br /> *Walking excessively long distance<br /> *Chest injury <br /> *Indirect trauma due to excessive heavy exertional work like in bullfight, controlling mighty animals like horses and elephants as in occupational fieldworks [Cha.Sa.[[Chikitsa Sthana]] 18/20]<br /> <br /> '''Psychological:'''<br /> <br /> *Anger and grief [Cha.Sa.[[Chikitsa Sthana]] 18/14]<br /> <br /> '''Acute exacerbating causes:'''<br /> <br /> *Exposure to smoke and dust <br /> *Entry of food into respiratory tract [Su.Sa.Uttara Sthana 52/4]&lt;ref name= Susruta&gt; Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.&lt;/ref&gt;<br /> <br /> ===Classification===<br /> <br /> #[[Vata]] [[dosha]] predominance<br /> #[[Pitta]] [[dosha]] predominance<br /> #[[Kapha]] [[dosha]] predominance<br /> #Traumatic injury (kshataja)<br /> #Depletion of body tissues (kshayaja) [Cha.Sa.[[Chikitsa Sthana]] 18/3-4]<br /> <br /> ===Premonitory features===<br /> <br /> *Thorny feeling in mouth and throat <br /> *Itching in throat <br /> *Obstruction in deglutition [Cha.Sa.[[Chikitsa Sthana]] 18/4]<br /> *Coating of mucous or sticky secretions in throat and palate<br /> *Low raspy voice<br /> *Anorexia <br /> *Low digestive capacity [Su.Sa.Uttara Sthana 52/7]&lt;ref name=Susruta/&gt;<br /> <br /> ===Clinical features===<br /> <br /> ====General clinical features====<br /> <br /> The voice of patient resembles the sound that comes out of a broken bronze vessel. [Su.Sa.Uttara Sthana 52/5]&lt;ref name=Susruta/&gt;<br /> <br /> ====[[Dosha]] specific clinical features====<br /> <br /> ======[[Vata]] dominant kasa======<br /> <br /> *Excruciating pain in the epigastric region, flanks, chest, and head<br /> *Excessive hoarseness of the voice<br /> *Dryness in the chest, throat and mouth<br /> *Horripilation and fainting<br /> *Resonant sound during coughing, looks hopeless, hollow sound during coughing<br /> *Weakness, agitated, illusive perceptions<br /> *Dry cough<br /> *Painful coughing with scanty expectoration <br /> *Cough gets alleviated by the food and drinks that are unctuous, hot, salty and sour<br /> *Increases after digestion of food [Cha.Sa.[[Chikitsa Sthana]] 18/10-13]<br /> <br /> ======[[Pitta]] dominant kasa======<br /> <br /> *Yellowish sputum and eyes<br /> *Bitter taste in mouth<br /> *Abnormal voice or inflammation of vocal apparatus as in pharyngitis, laryngitis <br /> *A feeling of smoke is being vomited out of the chest<br /> *Morbid thirst, burning, illusive, anorexia and giddiness<br /> *Appearance of twinkling stars in front of the eyes while coughing continuously<br /> *Expectoration of sputum mixed with [[pitta]] [Cha.Sa.[[Chikitsa Sthana]] 15-16]<br /> <br /> ======[[Kapha]] dominant kasa======<br /> <br /> *Poor digestion<br /> *Anorexia, vomiting, nausea <br /> *Nasal discharge<br /> *Heaviness<br /> *Horripilation, stickiness, and sweetness of the mouth<br /> *Expectoration of thick, sweet, slimy phlegm in large quantity<br /> *Painless coughing and smooth release of sputum is differentiating feature of [[kapha]] dominance <br /> *Feeling of fullness in the chest [Cha.Sa.[[Chikitsa Sthana]] 18/18-19]<br /> <br /> In a study, [[kapha]]kasa is compared with chronic bronchitis.&lt;ref name=shilpals&gt;Shilpa L.S., Prashanth A.S. A Critical Review on the Etiopathogenesis and Treatment of Kaphaja Kasa (Chronic Bronchitis). J Ayurveda Integr Med Sci 2016;4:118-122. http://dx.doi.org/10.21760/jaims.v1i4.6928&lt;/ref&gt;<br /> <br /> ====== Kasa as a result of trauma (kshataja)======<br /> <br /> *Initial dry cough followed by blood-tinged sputum<br /> *Excessive pain in the throat <br /> *Cracking pain in the chest<br /> *Sharp pricking pain <br /> *Excruciating pain and discomfort on touching the chest <br /> *Miserable appearance.<br /> *Pain in joints and fingers, fever, labored breath, thirst, and altered voice<br /> *While coughing, sounds humming like a pigeon. [Cha.Sa.[[Chikitsa Sthana]] 18/20-23]<br /> <br /> ======Kasa due to depletion of body tissues (kshayaja)======<br /> <br /> *Expectoration of greenish, reddish sputum, associated with pus and bad odor.<br /> *While coughing, the person feels as if the heart is displaced.<br /> *Feels suddenly afflicted with both hot and cold sensations<br /> *Weakness and emaciation even after taking food in excessive quantity<br /> *The clean and unctuous complexion of the face, associated with the gracious appearance of face and eyes.<br /> *The soft silky touch of hands and foot<br /> *The person always finds fault with others and develops an immensely hateful disposition<br /> *The person suffers from diseases like [[jwara]] (having signs and symptoms of all [[dosha]]), nasal congestion, anorexia, painful flanks, and altered voice<br /> *Frequent hard or loose stools without apparent cause [Cha.Sa.[[Chikitsa Sthana]] 18/25-28]<br /> <br /> ===Pathogenesis===<br /> <br /> [[File:Kasa_Samprapti.JPG|500px|'''Image 1: Samprapti of Kasa'''|thumb]]<br /> <br /> *[[Dosha]]: [[Vata]], [[Kapha]]<br /> *[[Dushya]]: [[Rasa]]<br /> *Srotasa: pranavaha, rasavaha<br /> *Site of origin: amashaya (stomach) <br /> *Site of manifestation/clinical presentation: Throat (kantha) and chest (uras)<br /> *Type of pathogenesis: Obstruction (sanga), Movement of [[dosha]] in the wrong direction (vimargagamana)[Cha.Sa.[[Chikitsa Sthana]] 18/6-8]<br /> <br /> ===Clinical examination===<br /> <br /> *Respiratory rate <br /> *Pulse examination <br /> *Chest examination by auscultation, palpation and percussion<br /> <br /> ===Investigations===<br /> <br /> '''Radiological examinations:'''<br /> <br /> *Chest X-Ray<br /> *C.T.Scan of chest and thoracic region<br /> <br /> '''Laboratory investigations:'''<br /> <br /> *Sputum examination <br /> *Absolute Eosinophil count <br /> <br /> ===Prognosis===<br /> <br /> *[[Vata]], [[pitta]] and [[kapha]] dominant kasa are curable. <br /> *Cough due to trauma (kshataja) and cough due to depletion of body tissues (kshayaja) are curable initially and in strong individuals. In the chronic stage, they can be controlled and palliated with appropriate drugs and diet. [Cha.Sa.[[Chikitsa Sthana]] 18/29-31]<br /> <br /> '''Poor prognostic features:''' <br /> <br /> If the patient is weak, cough due to depletion of body tissues (kshayaja kasa) may cause death. All types are palliable in old patients.[Cha.Sa.[[Chikitsa Sthana]] 18/29-30]<br /> <br /> ===Management===<br /> <br /> ====Principles of management====<br /> <br /> *Avoidance of etiological factors <br /> *Purification therapy (shodhana) as per dominance of [[dosha]]<br /> *Pacification therapy (shamana) as per dominance of [[dosha]]<br /> *Disease-specific rejuvenation treatment (vyadhiahara [[rasayana]])<br /> <br /> ====[[Dosha]] specific treatment principles====<br /> <br /> ======[[Vata]] predominance======<br /> <br /> *Unctuous therapies ([[snehana]]) <br /> *Dietary supplements like gruels, milk, meat etc. processed with [[vata]] alleviating medicines can be used. [Cha.Sa.[[Chikitsa Sthana]] 18/32-33] <br /> *Therapeutic enema ([[basti]]) [Cha.Sa.[[Chikitsa Sthana]] 18/32]<br /> *In association [[kapha]] or [[pitta]], [[dosha]]-specific measures shall be used. [Cha.Sa.[[Chikitsa Sthana]] 18/132] When [[vata]] dominant kasa is associated with [[pitta]], medicated ghee and milk after food is indicated. [A.Hr.Chikitsa Sthana 3/2]&lt;ref name= Hridaya &gt; Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.&lt;/ref&gt;<br /> <br /> ======[[Pitta]] predominance======<br /> <br /> *Therapeutic purgation ([[virechana]]) [Cha.Sa.[[Chikitsa Sthana]] 18/85]<br /> *Other purification therapies as per quantity of [[dosha]]<br /> *Unctuous electuaries [Cha.Sa.[[Chikitsa Sthana]] 18/86]<br /> <br /> ======[[Kapha]] predominance======<br /> <br /> *Therapeutic emesis ([[vamana]]) [Cha.Sa.[[Chikitsa Sthana]] 18/108] <br /> *Dry and light to digest foods <br /> *The oil exuding out from burning log of Cedrus deodara (devadaru) is used in treatment. It is mixed with powders of Piper longum, Piper nigrum and Zingiber officinale (trikatu), and ash of Hordeum vulgare (yavakshara) as a first line of treatment. [A.Hr.Chikitsa Sthana 3/41]&lt;ref name=Hridaya/&gt;<br /> <br /> ====Disease-specific treatment principles====<br /> <br /> =====Cough due to traumatic injury =====<br /> <br /> *This acute condition should be treated immediately with drugs promoting strength and improving muscle tissues ([[mamsa dhatu]]). Sweet and life-promoting (jivaniya) drugs shall be used. [Cha.Sa.[[Chikitsa Sthana]] 18/134] <br /> *Kerria lacca (laksha) mixed with honey with milk is advised. [A.Hr.Chikitsa Sthana 3/73]&lt;ref name=Hridaya/&gt; <br /> *Medicines used for [[pitta]] dominant kasa are indicated.<br /> *Milk, ghee, and honey are given in such patients. [Cha.Sa.[[Chikitsa Sthana]] 18/138] <br /> *All therapies which alleviate [[vata]][[dosha]], and do not aggravate [[pitta]] and [[rakta]] should be followed in such persons.<br /> *Ghee prepared with life-promoting (jivaniya) medicines. <br /> *Meat, meat soup prepared out of common quail (lava)<br /> *Goat’s milk processed with trinapanchamoola (combination of Desmostachyabipinnata, Saccharum spontaneum, Phragmites karka, Imperata cylindrical, Saccharum officinarum etc.) in case of morbid thirst (trushna)<br /> *Ghee in the form of nasal administration ([[nasya]]) or as a drink in case of bleeding.<br /> *In case of stiffness of body, ghee in larger quantity should be given.[Cha.Sa.[[Chikitsa Sthana]] 18/139-143]<br /> <br /> ===== Cough due to depletion of body tissues or degenerative conditions ===== <br /> <br /> In the initial stage, nourishing therapy ([[brimhana]]) with [[deepana]] (therapies that increase digestive capacity) should be given. [Cha.Sa.[[Chikitsa Sthana]] 18/150] These therapies and purification therapies (srotoshodana) shall be done alternatively. As all three [[dosha]]s are vitiated in this type of kasa, the therapies aim to pacify and balance all three [[dosha]]s. [Cha.Sa.[[Chikitsa Sthana]] 18/187-88]<br /> <br /> If the amount of [[pitta]] and [[kapha]] are less, and associated with emaciation, then ghee processed with Pistacia chinensis (karkatakasringi), Sida cordifolia (bala), Sidarhombifolia (atibala) and milk should be given.<br /> <br /> If kasa is associated with discoloration or difficulty in urination, then milk processed with Pueraria tuberose (vidari), Neolamarckia cadamba (kadamba) or with tender fruits of Flacourita jangomas (tall) should be given. [Cha.Sa.[[Chikitsa Sthana]] 18/153-54] <br /> <br /> ==== [[Panchakarma]] procedures with safety precautions ====<br /> <br /> *Internal administration of unctuous substances (snehapana): In [[vata]]kasa [Cha.Sa.[[Chikitsa Sthana]] 18/32-33] <br /> *Oil massage (abhyanga): It is indicated in [[vata]] dominant kasa [Cha.Sa.[[Chikitsa Sthana]] 18/32-33] and cough due to chest injury associated with [[vata]] and [[pitta]]. [Cha.Sa.[[Chikitsa Sthana]] 18/139] <br /> *Fomentation: Unctuous fomentation is indicated in [[vata]] dominant kasa [Cha.Sa.[[Chikitsa Sthana]] 18/32-33] <br /> *Therapeutic enema ([[basti]]): It is indicated in [[vata]] dominant kasa associated with constipation and flatulence [Cha.Sa.[[Chikitsa Sthana]] 18/32-33] <br /> *Therapeutic purgation ([[virechana]]): Purgation with unctuous substance (like castor oil) shall be given in case of dryness and aggravation of [[kapha]]. [ [Cha.Sa.[[Chikitsa Sthana]] 18/34] In case of thin phlegm, then Operculina turpethum (trivrit) mixed with sweet substances is advised for purgation. In case of thick phlegm, Operculina turpethum (trivrit) mixed with bitter substances is advised for purgation. [Cha.Sa.[[Chikitsa Sthana]] 18/85] Mild purgation is advised to reduce aggravated [[dosha]] in kasa due to depletion of body tissues. [Cha.Sa.[[Chikitsa Sthana]] 18/150] <br /> *Medicated smoke/fumigation (dhuma): It is indicated in case of headache and coryza associated with [[vata]] and [[kapha]][[dosha]]. [Cha.Sa.[[Chikitsa Sthana]] 18/65-68] <br /> *Therapeutic emesis ([[vamana]]): In [[pitta]] dominant kasa associated with [[kapha]][[dosha]], therapeutic emesis ([[vamana]]) is advised with decoction (kashaya) prepared out of Catunaregam spinosa (madana), Gmelina arborea (kashmari), Glycyrrhiza glabra (madhuka) etc. [Cha.Sa.[[Chikitsa Sthana]] 18/83] In [[kapha]] dominant kasa and strong person, therapeutic emesis shall be done first. [Cha.Sa.[[Chikitsa Sthana]] 18/108] <br /> *Intra nasal drug administration ([[nasya]]): If bleeding is present in kasa (as a result of trauma), trinapanchamula ghee is used for [[nasya]]. It is prepared from milk processed with herbs of trinapanchamoola (combination of Desmostachyabi pinnata, Saccharum spontaneum, Phragmites karka, Imperata cylindrical, Saccharum officinarum etc.). [Cha.Sa.[[Chikitsa Sthana]] 18/142] In [[kapha]] dominant kasa, nasal instillation with medicines having purificatory properties (shirovirechana nasya) is advised. [Su.Sa.Uttara Sthana 52/28]&lt;ref name=Susruta/&gt;<br /> *Decoction enema (niruha [[basti]]): Therapeutic enema with decoction is indicated [Su.Sa.Uttara Sthana 52/27]&lt;ref name=Susruta/&gt; in [[vata]] dominant kasa with constipation and flatulence. [A.Hr. Chikitsa Sthana 3/2]&lt;ref name=Hridaya/&gt;<br /> *Medicated unctuous enema (anuvasana [[basti]]): Medicated unctuous enema (anuvasana) is advised if pain and swelling in loin, groin, anus or penile region are present in kasa (due to depletion of body tissue) patient. [Cha.Sa.[[Chikitsa Sthana]] 18/155]. It is indicated in [[vata]] dominant kasa. [Su.Sa.Uttara Sthana 52/27]&lt;ref name=Susruta/&gt;<br /> <br /> ====Medicines used in current practice====<br /> <br /> =====Herbs=====<br /> <br /> Piper longam (pippali), Piper nigrum (maricha), Flacourtia jangomas (talisapatra), Solanum virginianum (kantakari), Inula racemosa (pushkaramula).&lt;ref name=Ranades&gt;Ranade S. Pranavaha srotas (Respiratory sysytem). In: Kayachikitsa Vol 2. Delhi: Chaukhamba Sanskrit pratishthan; 2014: 212-24&lt;/ref&gt;<br /> <br /> =====Herbal formulations=====<br /> <br /> Agastya Haritaki [Cha.Sa.[[Chikitsa Sthana]] 18/ 57-62], Kushmandarasayana [A.Hr.Chikitsa Sthana 3/114-117]&lt;ref name=Hridaya/&gt;, Vyaghriharitaki [B.R.15/169-172]&lt;ref name=Ratnavali&gt; Govindadas. Bhaishajyaratnavali. Translated from Sanskrit by Kanjiv Lochan. Reprint. Varanasi: Chaukhambha Sanskrit sansthan;2008.&lt;/ref&gt;, Talisadichurna [B.R 15/36-40]&lt;ref name=Ratnavali/&gt;, Vasa arishta&lt;ref name=shilpals/&gt;, Vasa avaleha [B.R.15/179-181]&lt;ref name=Ratnavali/&gt;, Sitopaladi churna&lt;ref name=shilpals/&gt;, Lavangadivati [B.R.15/35]&lt;ref name=Ratnavali/&gt;, Khadiradi vati&lt;ref name=Ranades/&gt;, Kanakasava.&lt;ref name=Ranades/&gt;<br /> <br /> =====Herbo-mineral formulations=====<br /> <br /> Laxmivilasa rasa [B.R 15/130-37]&lt;ref name=Ratnavali/&gt;, Kasakuthara rasa, Svachandabhairava rasa&lt;ref name=shilpals/&gt;, Hema garbha potalirasa&lt;ref name=shilpals/&gt;, Rudraparpati, Bhutankusha rasa&lt;ref name=Ranades/&gt;, Amritarnava rasa[B.R 15/60-61]&lt;ref name=Ratnavali/&gt;<br /> <br /> ====Wholesome diet====<br /> <br /> Meat soup along with wheat, barley, rice etc. and sweet, sour and salty foods are wholesome in kasa with [[vata]] predominance.[Cha.Sa.[[Chikitsa Sthana]] 18/76-82]<br /> <br /> Dysphania ambrosioides (vastuka), Solanum americanum (vayasi), Senna occidentalis (kasaghna), fruits and leaves of Solanum virginianum (kantakari), dried tender Raphanus raphanistrum (mulaka), Sesamum indicum (tila) oil, edibles prepared from milk, sugarcane juice and jaggery, whey of curds, juice prepared from sour fruits and fermented beverages are wholesome in [[vata]]kasa. [A.Hr.Chikitsa Sthana 3/23-24]&lt;ref name=Hridaya/&gt;<br /> <br /> In kasa with [[pitta]] predominance, sweet and cold things are advised. Shyamaka, Hordeum vulgare (yava), Paspalum scrobiculatum (kodrava), bitter vegetables etc. are wholesome. [B.R 15/8]&lt;ref name=Ratnavali/&gt; [Cha.Sa.[[Chikitsa Sthana]] 18/98]<br /> <br /> Hot and spicy food materials are wholesome in kasa with [[kapha]] predominance. [Cha.Sa.[[Chikitsa Sthana]] 18/108] <br /> <br /> Drinks such as honey (madhu), warm water, buttermilk etc. are preferred in kasa with [[kapha]] predominance. [Cha.Sa.[[Chikitsa Sthana]] 18/110] <br /> <br /> Piper longum, Piper nigrum and Zingiber officinale (trikatu)[Su.Sa.Uttara Sthana 52/29]&lt;ref name=Susruta/&gt;, barley, green gram, horse gram etc. are wholesome in [[kapha]]kasa.[A.Hr.Chikitsa Sthana 3/43]&lt;ref name=Hridaya/&gt;<br /> <br /> Goat’s milk is good in all types of kasa.&lt;ref name=shilpals/&gt;<br /> <br /> ===Complications===<br /> <br /> If kasa is not appropriately treated, it leads to consumption (rajayakshma) due to aggravation of all three [[dosha]] and depletion of body tissues.[Su.Sa.Uttara Sthana 52/6]&lt;ref name=Susruta/&gt;<br /> <br /> ===Contemporary views===<br /> <br /> ====Case reports====<br /> <br /> =====Solanum xanthocarpum=====<br /> <br /> The whole plant (panchanga) of Solanum xanthocarpum showed significant anti-tussive activity when compared to its roots. Administration of 10 gms of powder of drug for 10 days in 30 patients reported better action over [[kapha]] dominant kasa. The drug might be suppressing the central cough center by stimulating opioid receptors in the brain. It may be acting through protective ciliary activity in the respiratory tract. The action as demulcent can relieve cough.&lt;ref name=mansukh&gt;Mansukh S Parmar (2012): A comparative pharmacognostical, physicochemical and pharmacological study of moola and panchanga of Kantakari (Solanum xanthocarpum Schrad. &amp; Wendl.) w.s.r. to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&amp;RA, Jamnagar&lt;/ref&gt;<br /> <br /> =====Tribulus terrestris=====<br /> <br /> An experimental study reported anti-tussive activity of root powder of Tribulus terrestris (laghu gokshura) in sulphur dioxide induced cough models. The number of cough episodes was significantly less in Tribulus terrestris (laghu gokshura) root administered group. While root of Pedalium murex (brihat gokshura) showed insignificant decrease in number of cough episodes. In a clinical study, administration of powder of Tribulus terrestris (laghu gokshura) root and root of Pedalium murex (brihat gokshura), 3gm twice a day in 28 patients of kasa is observed. It reported better effect in group administered with Tribulus terrestris. The effect was better in reducing [[vata]]kasa. This study also suggested effect of drug on central nervous system and its anti-inflammatory activity.&lt;ref name=chandrika&gt;Chandrika N Methekar (2012): A comparative pharmacognostical and phyto pharmacological assessment of moola, panchanga of laghu gokshura (Tribulus terrestris Linn.) and Brihat gokshura (Pedalium murex Linn.) w.s.r to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&amp;RA, Jamanagar&lt;/ref&gt; <br /> <br /> =====Combination of terminalia chebula and rock salt===== <br /> <br /> In a study conducted on 19 patients, Terminalia chebula (haritaki) with Rock salt (saindava lavana) was found effective in reducing the symptoms of [[kapha]]kasa. There was 92.3% relief in cough with sputum and itching in throat. The action of haritaki on [[vata]] and [[kapha]][[dosha]] due to its hot potency is observed as reason behind efficacy.&lt;ref name=rout&gt;Rout AK, Dwivedi RR. A clinical study of Haritaki and Saindhava Lavana in Kaphaja Kasa with special reference to Samyoga Guna. Ayu. 2011 Jul;32(3):357-60. doi: 10.4103/0974-8520.93914. PMID: 22736910; PMCID: PMC3326882.&lt;/ref&gt; <br /> <br /> =====Kantakari-maricha leha=====<br /> <br /> In a study, kantakari-marichaleha (ayurvedic formulation) was administered for 7 days in 30 children with symptoms of [[kapha]]kasa. It was found effective in reducing the signs and symptoms.&lt;ref name=sawant&gt;Sawant S, Nandgaonkar J A, Gujarathi R H. Efficacy of kantakari maricha leha on kaphaja kasa in children of age group 1 to 5 years. WJPR. 2018 Mar;7(7):1250-55. doi: 10.20959/wjpr20187-11693&lt;/ref&gt; <br /> <br /> =====Samasharkara powder formulation=====<br /> <br /> In another study on 60 patients with [[kapha]]kasa, 10gms of Samasarkarachurna for 15 days is found effective in reducing the signs and symptoms.&lt;ref name=dighe&gt;Dighe P M. Efficacy of Samsharkara Churna in Kaphaj Kasa. Ijam. 2013, 4(1), 36-42&lt;/ref&gt; <br /> <br /> =====Bhrigarajasava as adjunct to anti tubercular treatment=====<br /> <br /> In another study conducted on 60 patients with pulmonary tuberculosis (TB), administration of Bhrigarajasava along with the standard treatment was found effective in reducing the cough. The cough progressively diminished and became occasional and non-productive within 15 days of treatment.&lt;ref&gt;Dornala SN, Dornala SS. Clinical efficacy of Bhringarajasava as Naimittika Rasayana in Rajayakshma with special reference to pulmonary tuberculosis. Ayu. 2012 Oct;33(4):523-9. doi: 10.4103/0974-8520.110536. PMID: 23723670; PMCID: PMC3665204.&lt;/ref&gt;<br /> <br /> =====Vyaghri-haritaki avaleha in chronic bronchitis=====<br /> <br /> A study on 66 patients with chronic bronchitis reported that Vyaghri-haritaki avaleha effectively reduced the productive cough, which is the cardinal feature of chronic bronchitis.&lt;ref&gt;Ram J, Baghel MS. Clinical efficacy of Vyaghriharitaki Avaleha in the management of chronic bronchitis. Ayu. 2015 Jan-Mar;36(1):50-5. doi: 10.4103/0974-8520.169009. PMID: 26730139; PMCID: PMC4687240.&lt;/ref&gt;<br /> <br /> In another study conducted on 25 patients of kasa, administration of vyaghri-haritaki avaleha for four weeks showed highly significant results signs and symptoms.&lt;ref&gt;Suhas A. Chaudhary, Patel KS, Kori VK , Rajagopala S. Management of doshika kasa in subacute and chronic stage with Vyaghri haritaki avaleha in children. Ayurpharm Int J Ayur Alli Sci. 2014;3(4):97-111.&lt;/ref&gt; <br /> <br /> =====Unctuous enema in pertussis=====<br /> <br /> Administration of unctuous enema (sneha[[basti]]) in pertussis patients of pediatric age group ( n=2) was studied. It was found very effective in reducing dry cough. Sesame oil in a dose of 10 - 20ml is used in [[basti]] for 14 days along with antimicrobial therapy. Initially, the intensity of cough was reduced, followed by a reduction in the frequency of cough episodes. Unctuous enema acts directly over the colon to restore normal functions of [[vata]][[dosha]].&lt;ref&gt;Gujarathi RH, Gokhale VM, Tongaonkar JN. Effect of Basti (oil enema) therapy for the management of cough in pertussis. Ayu. 2013 Oct;34(4):397-400. doi: 10.4103/0974-8520.127722. PMID: 24696577; PMCID: PMC3968703.&lt;/ref&gt;<br /> <br /> =====Kasahara dashemani tablets=====<br /> <br /> In 40 children with kasa, administration of Kasahara Dashemani vati for 60 days showed relief in all symptoms of kasa. Reduction in acute eosinophil count (AEC) and erythrocyte sedimentation rate (ESR) levels are noted. The decrease in IgE levels indicates the drug’s action against allergy. It is found effective in [[vata]] and [[pitta]] predominant kasa.&lt;ref&gt;Subrahmanya NK, Patel KS, Kori VK, Shrikrishna R. Role of Kasahara Dashemani Vati in Kasa and Vyadhikshamatva in children with special reference to recurrent respiratory tract infections. Ayu. 2013 Jul;34(3):281-7. doi: 10.4103/0974-8520.123124. PMID: 24501524; PMCID: PMC3902595.&lt;/ref&gt;<br /> <br /> === List of research works done ===<br /> <br /> #Mansukh S Parmar (2012): A comparative pharmacognostical, physicochemical and pharmacological study of moola and panchanga of Kantakari (Solanum xanthocarpum Schrad. &amp; Wendl.) w.s.r. to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&amp;RA, Jamnagar<br /> #Chandrika N Methekar (2012): A comparative pharmacognostical and phyto pharmacological assessment of moola, panchanga of laghugokshura (Tribulus terrestris Linn.) and Brihatgokshura (Pedalium murex Linn.) w.s.r to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&amp;RA, Jamanagar<br /> <br /> === Abbreviations ===<br /> <br /> Cha. = Charak, Su. = Sushruta, A. = Ashtanga, Hr. = Hridayam, Sa. = Samhita, B.R = Bhaishajya ratnavali<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References ==<br /> <br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

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<p>Agnivesha: </p> <hr /> <div>{{#seo:<br /> |title=Adhyaya (Chapters) - Charak Samhita<br /> |titlemode=append<br /> |keywords=Charak Samhita Adhyaya, Charak Samhita chapters, Charak Samhita Index, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, contents of charak samhita, Indian system of medicine, ayurveda, diagnosis, therapeutics, management, preventive medicine, prognosis of disease, rejuvenation, aphrodisiac therapy, fever, skin diseases, principles of ayurveda, pharmaceutical preparations.<br /> |description=Complete list and links to all one hundred twenty chapters of Charak Samhita organized by sections (Sthana)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=Charak Samhita - Ancient Ayurvedic Text<br /> |type=article<br /> }}<br /> __NOTOC__<br /> &lt;div style=&quot;max-width: 1200px; margin: 0 auto; padding: 20px; font-family: 'Segoe UI', Tahoma, Geneva, Verdana, sans-serif;&quot;&gt;<br /> <br /> &lt;div style=&quot;text-align: center; margin-bottom: 40px; padding-bottom: 20px; border-bottom: 3px solid #2c5aa0;&quot;&gt;<br /> &lt;h1 style=&quot;color: #2c5aa0; margin-bottom: 10px; font-size: 2.5em;&quot;&gt;Charak Samhita - 120 Chapters (Adhyaya)&lt;/h1&gt;<br /> &lt;p style=&quot;color: #666; font-size: 1.1em; font-style: italic;&quot;&gt;Complete Index of Chapters Organized by Eight Sections (Sthana)&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;margin-bottom: 30px;&quot;&gt;<br /> &lt;div style=&quot;background: #f0f7ff; border: 2px solid #2c5aa0; border-radius: 10px; padding: 15px; text-align: center;&quot;&gt;<br /> &lt;h3 style=&quot;margin-top: 0; color: #2c5aa0;&quot;&gt;Quick Navigation&lt;/h3&gt;<br /> &lt;div style=&quot;font-size: 1.1em; line-height: 1.6;&quot;&gt;<br /> [[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]&lt;br&gt;<br /> [[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Sutra Sthana --&gt;<br /> &lt;div id=&quot;Sutra&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;I&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Sutra Sthana|Section on Fundamental Principles (Sutra Sthana)]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Basic principles of Ayurveda, daily regimen, seasonal regimen, and fundamental therapies&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Deerghanjiviteeya Adhyaya|Longevity (Deerghanjiviteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Apamarga Tanduliya Adhyaya|Dehusked Seeds of Apamarga (Apamarga Tanduliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Aragvadhiya Adhyaya|Aragvadha (Cassia) and Other Medicines (Aragvadhiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Shadvirechanashatashritiya Adhyaya|Resources of Six Hundred Evacuatives (Shadvirechanashatashritiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Matrashiteeya Adhyaya|Proper Quantity of Food (Matrashiteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Tasyashiteeya Adhyaya|Seasonal Regimen (Tasyashiteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Naveganadharaniya Adhyaya|Natural Urges (Naveganadharaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Indriyopakramaniya Adhyaya|Disciplinary Protocol for Sense Organs (Indriyopakramaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Khuddakachatushpada Adhyaya|Four Fundamental Components of Healthcare (Khuddakachatushpada Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Mahachatushpada Adhyaya|Four Important Components of Therapeutics (Mahachatushpada Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Tistraishaniya Adhyaya|Three Desires of Life (Tistraishaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vatakalakaliya Adhyaya|Merits and Demerits of Vata (Vatakalakaliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sneha Adhyaya|Oleation Therapies (Sneha Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sweda Adhyaya|Sudation Therapies (Sweda Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Upakalpaniya Adhyaya|Hospital Management Guidelines (Upakalpaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Chikitsaprabhritiya Adhyaya|Assessment in Panchakarma (Chikitsaprabhritiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kiyanta Shiraseeya Adhyaya|Diseases of Vital Organs (Kiyanta Shiraseeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trishothiya Adhyaya|Three Types of Swellings (Trishothiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Ashtodariya Adhyaya|Numerical Classification of Diseases (Ashtodariya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Maharoga Adhyaya|Dosha Specific Classification (Maharoga Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Ashtauninditiya Adhyaya|Eight Undesirable Constitutions (Ashtauninditiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Langhanabrimhaniya Adhyaya|Reduction and Nourishing Therapies (Langhanabrimhaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Santarpaniya Adhyaya|Over-nutrition and Under-nutrition (Santarpaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vidhishonitiya Adhyaya|Characteristics of Shonita (Blood) (Vidhishonitiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Yajjah Purushiya Adhyaya|Origin of Human Beings (Yajjah Purushiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Atreyabhadrakapyiya Adhyaya|Pharmacological Principles (Atreyabhadrakapyiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Annapanavidhi Adhyaya|Classification of Food and Beverages (Annapanavidhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vividhashitapitiya Adhyaya|Sequential Effects of Food (Vividhashitapitiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Dashapranayataneeya Adhyaya|Ten Seats of Life Forces (Dashapranayataneeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Arthedashmahamooliya Adhyaya|Ten Great Vessels from Heart (Arthedashmahamooliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Nidana Sthana --&gt;<br /> &lt;div id=&quot;Nidana&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;II&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Nidana Sthana|Section on Diagnostic Principles (Nidana Sthana)]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Etiology, pathogenesis, and diagnosis of major diseases&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Jwara Nidana Adhyaya|Diagnosis of Jwara (Fever) (Jwara Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Raktapitta Nidana Adhyaya|Diagnosis of Bleeding Disorders (Raktapitta Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Gulma Nidana Adhyaya|Diagnosis of Abdominal Lumps (Gulma Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Prameha Nidana Adhyaya|Diagnosis of Urinary Disorders (Prameha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kushtha Nidana Adhyaya|Diagnosis of Skin Diseases (Kushtha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Shosha Nidana Adhyaya|Diagnosis of Wasting Disease (Shosha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Unmada Nidana Adhyaya|Diagnosis of Psychosis (Unmada Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Apasmara Nidana Adhyaya|Diagnosis of Seizure Disorders (Apasmara Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Vimana Sthana --&gt;<br /> &lt;div id=&quot;Vimana&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;III&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Vimana Sthana|Section on Specific Medical Principles (Vimana Sthana)]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Detailed knowledge of diseases, channels, and examination methods&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Rasa Vimana Adhyaya|Taste-based Factors (Rasa Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trividhakukshiya Vimana Adhyaya|Three Parts of Abdomen (Trividhakukshiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Janapadodhvansaniya Vimana Adhyaya|Destruction of Communities (Janapadodhvansaniya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trividha Roga Vishesha Vijnaniya Vimana Adhyaya|Three Methods of Disease Knowledge (Trividha Roga Vishesha Vijnaniya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sroto Vimana Adhyaya|Channels of Transport (Sroto Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Roganika Vimana Adhyaya|Classification of Diseases (Roganika Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vyadhita Rupiya Vimana Adhyaya|Types of Patients (Vyadhita Rupiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Rogabhishagjitiya Vimana Adhyaya|Conquering Debate and Disease (Rogabhishagjitiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Sharira Sthana --&gt;<br /> &lt;div id=&quot;Sharira&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;IV&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Sharira Sthana|Section on Human Being and Genesis (Sharira Sthana)]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Embryology, anatomy, and physiology of human beings&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Katidhapurusha Sharira Adhyaya|Holistic Human Being (Katidhapurusha Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Atulyagotriya Sharira Adhyaya|Different Clans (Atulyagotriya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Khuddika Garbhavakranti Sharira Adhyaya|Factors for Embryogenesis (Khuddika Garbhavakranti Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Mahatigarbhavakranti Sharira Adhyaya|Embryonic Development (Mahatigarbhavakranti Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Purusha Vichaya Sharira Adhyaya|Detailed Study of Human Being (Purusha Vichaya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sharira Vichaya Sharira Adhyaya|Analytical Study of Body (Sharira Vichaya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sharira Sankhya Sharira Adhyaya|Numerological Account (Sharira Sankhya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Jatisutriya Sharira Adhyaya|Obstetrics and Neonatal Care (Jatisutriya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Indriya Sthana --&gt;<br /> &lt;div id=&quot;Indriya&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;V&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Indriya Sthana|Section on Sensorial Prognosis (Indriya Sthana)]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Prognosis based on signs and symptoms from sense organs&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Varnasvariyam Indriyam Adhyaya|Fatal Signs in Complexion and Voice (Varnasvariyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Pushpitakam Indriyam Adhyaya|Fatal Signs of Tactile and Olfactory Perception (Pushpitakam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Parimarshaneeyam Indriyam Adhyaya|Palpable Signs of Death (Parimarshaneeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Indriyaneekam Indriyam Adhyaya|Fatal Signs in Sense Organs (Indriyaneekam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Purvarupeeyam Indriyam Adhyaya|Prognosis by Prodromal Symptoms (Purvarupeeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Katamanisharireeyam Indriyam Adhyaya|Specific Fatal Clinical Features (Katamanisharireeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Pannarupiyam Indriyam Adhyaya|Changes in Shadows and Complexion (Pannarupiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Avakshiraseeyam Indriyam Adhyaya|Inverted Shadow of Dying Person (Avakshiraseeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Yasyashyavanimittiyam Indriyam Adhyaya|Palliative Care Signs (Yasyashyavanimittiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sadyomaraneeyam Indriyam Adhyaya|Signs of Instant Death (Sadyomaraneeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Anujyotiyam Indriyam Adhyaya|Diminution of Agni (Anujyotiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Gomayachurniyam Indriyam Adhyaya|Characteristics of Messenger (Gomayachurniyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Chikitsa Sthana --&gt;<br /> &lt;div id=&quot;Chikitsa&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;VI&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Chikitsa Sthana|Section on Therapeutic Principles (Chikitsa Sthana)]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Management and treatment of various diseases&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Rasayana Adhyaya|Rejuvenation Therapy (Rasayana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vajikarana Adhyaya|Aphrodisiac Therapy (Vajikarana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Jwara Chikitsa Adhyaya|Management of Jwara (Fever) (Jwara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Raktapitta Chikitsa Adhyaya|Management of Bleeding Disorders (Raktapitta Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Gulma Chikitsa Adhyaya|Management of Gulma (Gulma Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Prameha Chikitsa Adhyaya|Management of Urinary Disorders (Prameha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kushtha Chikitsa Adhyaya|Management of Skin Diseases (Kushtha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Rajayakshma Chikitsa Adhyaya|Management of Wasting Diseases (Rajayakshma Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Unmada Chikitsa Adhyaya|Management of Psychosis (Unmada Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Apasmara Chikitsa Adhyaya|Management of Seizure Disorders (Apasmara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kshatakshina Chikitsa Adhyaya|Management of Emaciation due to Trauma (Kshatakshina Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Shvayathu Chikitsa Adhyaya|Management of Swellings (Shvayathu Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Udara Chikitsa Adhyaya|Management of Abdominal Enlargement (Udara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Arsha Chikitsa Adhyaya|Management of Hemorrhoids (Arsha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Grahani Chikitsa Adhyaya|Management of Digestive Diseases (Grahani Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Pandu Chikitsa Adhyaya|Management of Anemia (Pandu Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Hikka Shwasa Chikitsa Adhyaya|Management of Hiccups and Dyspnea (Hikka Shwasa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kasa Chikitsa Adhyaya|Management of Cough (Kasa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Atisara Chikitsa Adhyaya|Management of Diarrhea (Atisara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Chhardi Chikitsa Adhyaya|Management of Vomiting (Chhardi Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Visarpa Chikitsa Adhyaya|Management of Acute Spreading Erysipelas (Visarpa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trishna Chikitsa Adhyaya|Management of Morbid Thirst (Trishna Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Visha Chikitsa Adhyaya|Management of Poisoning (Visha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Madatyaya Chikitsa Adhyaya|Management of Intoxication (Madatyaya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Dwivraniya Chikitsa Adhyaya|Management of Ulcers (Dwivraniya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trimarmiya Chikitsa Adhyaya|Management of Three Vital Organs (Trimarmiya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Urustambha Chikitsa Adhyaya|Management of Thigh and Hip Diseases (Urustambha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vatavyadhi Chikitsa Adhyaya|Management of Vata Diseases (Vatavyadhi Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vatarakta Chikitsa Adhyaya|Management of Vata and Rakta Diseases (Vatarakta Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Yonivyapat Chikitsa Adhyaya|Management of Genital Tract Disorders (Yonivyapat Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Kalpa Sthana --&gt;<br /> &lt;div id=&quot;Kalpa&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;VII&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Kalpa Sthana|Section on Pharmaceutical Preparations (Kalpa Sthana)]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Formulation and preparation of medicinal compounds&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Madana Kalpa Adhyaya|Preparations of Madanaphala (Madana Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Jimutaka Kalpa Adhyaya|Preparations of Jimutaka (Jimutaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Ikshvaku Kalpa Adhyaya|Preparations of Ikshvaku (Ikshvaku Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Dhamargava Kalpa Adhyaya|Preparations of Dhamargava (Dhamargava Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vatsaka Kalpa Adhyaya|Preparations of Vatsaka (Vatsaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kritavedhana Kalpa Adhyaya|Preparations of Kritavedhana (Kritavedhana Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Shyamatrivrita Kalpa Adhyaya|Preparations of Shyama Trivrita (Shyamatrivrita Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Chaturangula Kalpa Adhyaya|Preparations of Chaturangula (Chaturangula Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Tilvaka Kalpa Adhyaya|Preparations of Tilvaka (Tilvaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sudha Kalpa Adhyaya|Preparations of Sudha (Sudha Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Saptalashankhini Kalpa Adhyaya|Preparations of Saptala and Shankhini (Saptalashankhini Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Dantidravanti Kalpa Adhyaya|Preparations of Danti and Dravanti (Dantidravanti Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Siddhi Sthana --&gt;<br /> &lt;div id=&quot;Siddhi&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;VIII&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Siddhi Sthana|Section on Therapeutic Procedures (Siddhi Sthana)]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Administration of purification therapies and Panchakarma&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle (Netrabastivyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation (Vamana Virechana Vyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema (Bastivyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations (Prasrita Yogiyam Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs (Trimarmiya Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Basti Siddhi Adhyaya|Successful Enema Administration (Basti Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits (Phalamatra Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema (Uttar Basti Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;margin-top: 50px; padding: 25px; background: #f0f7ff; border-radius: 10px; text-align: center; border: 1px solid #cce0ff;&quot;&gt;<br /> &lt;div style=&quot;font-size: 1.2em; margin-bottom: 15px; color: #2c5aa0;&quot;&gt;<br /> &lt;strong&gt;Total Chapters: 120&lt;/strong&gt; | &lt;strong&gt;Sections: 8&lt;/strong&gt;<br /> &lt;/div&gt;<br /> &lt;p style=&quot;color: #666; font-size: 0.95em; max-width: 800px; margin: 0 auto; line-height: 1.6;&quot;&gt;This index provides links to all chapters of Charak Samhita, the foundational text of Ayurveda. Each section (Sthana) covers specific aspects of Ayurvedic knowledge and practice.&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;/div&gt;<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;position:fixed; bottom:40px; left:40px; z-index:9999; background: #2c5aa0; border-radius: 50px; padding: 12px 20px; box-shadow: 0 4px 12px rgba(0,0,0,0.15);&quot;&gt;<br /> &lt;span style=&quot;color:white; font-size:0.9em; font-family:verdana,sans-serif; font-weight:bold;&quot;&gt;<br /> [[#top|↑ Back to Top]]<br /> &lt;/span&gt;<br /> &lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Sandip_Bhagyoday&diff=45405 2026-01-20T14:07:14Z

<p>Agnivesha: </p> <hr /> <div>{{#seo:<br /> |title=Adhyaya (Chapters) - Charak Samhita<br /> |titlemode=append<br /> |keywords=Charak Samhita Adhyaya, Charak Samhita chapters, Charak Samhita Index, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, contents of charak samhita, Indian system of medicine, ayurveda, diagnosis, therapeutics, management, preventive medicine, prognosis of disease, rejuvenation, aphrodisiac therapy, fever, skin diseases, principles of ayurveda, pharmaceutical preparations.<br /> |description=Complete list and links to all one hundred twenty chapters of Charak Samhita organized by sections (Sthana)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=Charak Samhita - Ancient Ayurvedic Text<br /> |type=article<br /> }}<br /> __NOTOC__<br /> &lt;div style=&quot;max-width: 1200px; margin: 0 auto; padding: 20px; font-family: 'Segoe UI', Tahoma, Geneva, Verdana, sans-serif;&quot;&gt;<br /> <br /> &lt;div style=&quot;text-align: center; margin-bottom: 40px; padding-bottom: 20px; border-bottom: 3px solid #2c5aa0;&quot;&gt;<br /> &lt;h1 style=&quot;color: #2c5aa0; margin-bottom: 10px; font-size: 2.5em;&quot;&gt;Charak Samhita - 120 Chapters (Adhyaya)&lt;/h1&gt;<br /> &lt;p style=&quot;color: #666; font-size: 1.1em; font-style: italic;&quot;&gt;Complete Index of Chapters Organized by Eight Sections (Sthana)&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;margin-bottom: 30px;&quot;&gt;<br /> &lt;div style=&quot;background: #f0f7ff; border: 2px solid #2c5aa0; border-radius: 10px; padding: 15px; text-align: center;&quot;&gt;<br /> &lt;h3 style=&quot;margin-top: 0; color: #2c5aa0;&quot;&gt;Quick Navigation&lt;/h3&gt;<br /> &lt;div style=&quot;font-size: 1.1em; line-height: 1.6;&quot;&gt;<br /> [[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]&lt;br&gt;<br /> [[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Sutra Sthana --&gt;<br /> &lt;div id=&quot;Sutra&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;I&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Sutra Sthana|Section on Fundamental Principles]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Basic principles of Ayurveda, daily regimen, seasonal regimen, and fundamental therapies&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Deerghanjiviteeya Adhyaya|Longevity (Deerghanjiviteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Apamarga Tanduliya Adhyaya|Dehusked Seeds of Apamarga (Apamarga Tanduliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Aragvadhiya Adhyaya|Aragvadha (Cassia) and Other Medicines (Aragvadhiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Shadvirechanashatashritiya Adhyaya|Resources of Six Hundred Evacuatives (Shadvirechanashatashritiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Matrashiteeya Adhyaya|Proper Quantity of Food (Matrashiteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Tasyashiteeya Adhyaya|Seasonal Regimen (Tasyashiteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Naveganadharaniya Adhyaya|Natural Urges (Naveganadharaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Indriyopakramaniya Adhyaya|Disciplinary Protocol for Sense Organs (Indriyopakramaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Khuddakachatushpada Adhyaya|Four Fundamental Components of Healthcare (Khuddakachatushpada Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Mahachatushpada Adhyaya|Four Important Components of Therapeutics (Mahachatushpada Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Tistraishaniya Adhyaya|Three Desires of Life (Tistraishaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vatakalakaliya Adhyaya|Merits and Demerits of Vata (Vatakalakaliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sneha Adhyaya|Oleation Therapies (Sneha Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sweda Adhyaya|Sudation Therapies (Sweda Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Upakalpaniya Adhyaya|Hospital Management Guidelines (Upakalpaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Chikitsaprabhritiya Adhyaya|Assessment in Panchakarma (Chikitsaprabhritiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kiyanta Shiraseeya Adhyaya|Diseases of Vital Organs (Kiyanta Shiraseeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trishothiya Adhyaya|Three Types of Swellings (Trishothiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Ashtodariya Adhyaya|Numerical Classification of Diseases (Ashtodariya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Maharoga Adhyaya|Dosha Specific Classification (Maharoga Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Ashtauninditiya Adhyaya|Eight Undesirable Constitutions (Ashtauninditiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Langhanabrimhaniya Adhyaya|Reduction and Nourishing Therapies (Langhanabrimhaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Santarpaniya Adhyaya|Over-nutrition and Under-nutrition (Santarpaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vidhishonitiya Adhyaya|Characteristics of Shonita (Blood) (Vidhishonitiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Yajjah Purushiya Adhyaya|Origin of Human Beings (Yajjah Purushiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Atreyabhadrakapyiya Adhyaya|Pharmacological Principles (Atreyabhadrakapyiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Annapanavidhi Adhyaya|Classification of Food and Beverages (Annapanavidhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vividhashitapitiya Adhyaya|Sequential Effects of Food (Vividhashitapitiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Dashapranayataneeya Adhyaya|Ten Seats of Life Forces (Dashapranayataneeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Arthedashmahamooliya Adhyaya|Ten Great Vessels from Heart (Arthedashmahamooliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Nidana Sthana --&gt;<br /> &lt;div id=&quot;Nidana&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;II&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Nidana Sthana|Section on Diagnostic Principles]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Etiology, pathogenesis, and diagnosis of major diseases&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Jwara Nidana Adhyaya|Diagnosis of Jwara (Fever) (Jwara Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Raktapitta Nidana Adhyaya|Diagnosis of Bleeding Disorders (Raktapitta Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Gulma Nidana Adhyaya|Diagnosis of Abdominal Lumps (Gulma Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Prameha Nidana Adhyaya|Diagnosis of Urinary Disorders (Prameha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kushtha Nidana Adhyaya|Diagnosis of Skin Diseases (Kushtha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Shosha Nidana Adhyaya|Diagnosis of Wasting Disease (Shosha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Unmada Nidana Adhyaya|Diagnosis of Psychosis (Unmada Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Apasmara Nidana Adhyaya|Diagnosis of Seizure Disorders (Apasmara Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Vimana Sthana --&gt;<br /> &lt;div id=&quot;Vimana&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;III&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Vimana Sthana|Section on Specific Medical Principles]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Detailed knowledge of diseases, channels, and examination methods&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Rasa Vimana Adhyaya|Taste-based Factors (Rasa Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trividhakukshiya Vimana Adhyaya|Three Parts of Abdomen (Trividhakukshiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Janapadodhvansaniya Vimana Adhyaya|Destruction of Communities (Janapadodhvansaniya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trividha Roga Vishesha Vijnaniya Vimana Adhyaya|Three Methods of Disease Knowledge (Trividha Roga Vishesha Vijnaniya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sroto Vimana Adhyaya|Channels of Transport (Sroto Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Roganika Vimana Adhyaya|Classification of Diseases (Roganika Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vyadhita Rupiya Vimana Adhyaya|Types of Patients (Vyadhita Rupiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Rogabhishagjitiya Vimana Adhyaya|Conquering Debate and Disease (Rogabhishagjitiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Sharira Sthana --&gt;<br /> &lt;div id=&quot;Sharira&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;IV&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Sharira Sthana|Section on Human Being and Genesis]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Embryology, anatomy, and physiology of human beings&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Katidhapurusha Sharira Adhyaya|Holistic Human Being (Katidhapurusha Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Atulyagotriya Sharira Adhyaya|Different Clans (Atulyagotriya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Khuddika Garbhavakranti Sharira Adhyaya|Factors for Embryogenesis (Khuddika Garbhavakranti Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Mahatigarbhavakranti Sharira Adhyaya|Embryonic Development (Mahatigarbhavakranti Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Purusha Vichaya Sharira Adhyaya|Detailed Study of Human Being (Purusha Vichaya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sharira Vichaya Sharira Adhyaya|Analytical Study of Body (Sharira Vichaya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sharira Sankhya Sharira Adhyaya|Numerological Account (Sharira Sankhya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Jatisutriya Sharira Adhyaya|Obstetrics and Neonatal Care (Jatisutriya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Indriya Sthana --&gt;<br /> &lt;div id=&quot;Indriya&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;V&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Indriya Sthana|Section on Sensorial Prognosis]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Prognosis based on signs and symptoms from sense organs&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Varnasvariyam Indriyam Adhyaya|Fatal Signs in Complexion and Voice (Varnasvariyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Pushpitakam Indriyam Adhyaya|Fatal Signs of Tactile and Olfactory Perception (Pushpitakam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Parimarshaneeyam Indriyam Adhyaya|Palpable Signs of Death (Parimarshaneeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Indriyaneekam Indriyam Adhyaya|Fatal Signs in Sense Organs (Indriyaneekam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Purvarupeeyam Indriyam Adhyaya|Prognosis by Prodromal Symptoms (Purvarupeeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Katamanisharireeyam Indriyam Adhyaya|Specific Fatal Clinical Features (Katamanisharireeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Pannarupiyam Indriyam Adhyaya|Changes in Shadows and Complexion (Pannarupiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Avakshiraseeyam Indriyam Adhyaya|Inverted Shadow of Dying Person (Avakshiraseeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Yasyashyavanimittiyam Indriyam Adhyaya|Palliative Care Signs (Yasyashyavanimittiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sadyomaraneeyam Indriyam Adhyaya|Signs of Instant Death (Sadyomaraneeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Anujyotiyam Indriyam Adhyaya|Diminution of Agni (Anujyotiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Gomayachurniyam Indriyam Adhyaya|Characteristics of Messenger (Gomayachurniyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Chikitsa Sthana --&gt;<br /> &lt;div id=&quot;Chikitsa&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;VI&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Chikitsa Sthana|Section on Therapeutic Principles]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Management and treatment of various diseases&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Rasayana Adhyaya|Rejuvenation Therapy (Rasayana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vajikarana Adhyaya|Aphrodisiac Therapy (Vajikarana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Jwara Chikitsa Adhyaya|Management of Jwara (Fever) (Jwara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Raktapitta Chikitsa Adhyaya|Management of Bleeding Disorders (Raktapitta Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Gulma Chikitsa Adhyaya|Management of Gulma (Gulma Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Prameha Chikitsa Adhyaya|Management of Urinary Disorders (Prameha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kushtha Chikitsa Adhyaya|Management of Skin Diseases (Kushtha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Rajayakshma Chikitsa Adhyaya|Management of Wasting Diseases (Rajayakshma Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Unmada Chikitsa Adhyaya|Management of Psychosis (Unmada Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Apasmara Chikitsa Adhyaya|Management of Seizure Disorders (Apasmara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kshatakshina Chikitsa Adhyaya|Management of Emaciation due to Trauma (Kshatakshina Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Shvayathu Chikitsa Adhyaya|Management of Swellings (Shvayathu Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Udara Chikitsa Adhyaya|Management of Abdominal Enlargement (Udara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Arsha Chikitsa Adhyaya|Management of Hemorrhoids (Arsha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Grahani Chikitsa Adhyaya|Management of Digestive Diseases (Grahani Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Pandu Chikitsa Adhyaya|Management of Anemia (Pandu Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Hikka Shwasa Chikitsa Adhyaya|Management of Hiccups and Dyspnea (Hikka Shwasa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kasa Chikitsa Adhyaya|Management of Cough (Kasa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Atisara Chikitsa Adhyaya|Management of Diarrhea (Atisara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Chhardi Chikitsa Adhyaya|Management of Vomiting (Chhardi Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Visarpa Chikitsa Adhyaya|Management of Acute Spreading Erysipelas (Visarpa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trishna Chikitsa Adhyaya|Management of Morbid Thirst (Trishna Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Visha Chikitsa Adhyaya|Management of Poisoning (Visha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Madatyaya Chikitsa Adhyaya|Management of Intoxication (Madatyaya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Dwivraniya Chikitsa Adhyaya|Management of Ulcers (Dwivraniya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trimarmiya Chikitsa Adhyaya|Management of Three Vital Organs (Trimarmiya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Urustambha Chikitsa Adhyaya|Management of Thigh and Hip Diseases (Urustambha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vatavyadhi Chikitsa Adhyaya|Management of Vata Diseases (Vatavyadhi Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vatarakta Chikitsa Adhyaya|Management of Vata and Rakta Diseases (Vatarakta Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Yonivyapat Chikitsa Adhyaya|Management of Genital Tract Disorders (Yonivyapat Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Kalpa Sthana --&gt;<br /> &lt;div id=&quot;Kalpa&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;VII&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Kalpa Sthana|Section on Pharmaceutical Preparations]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Formulation and preparation of medicinal compounds&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Madana Kalpa Adhyaya|Preparations of Madanaphala (Madana Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Jimutaka Kalpa Adhyaya|Preparations of Jimutaka (Jimutaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Ikshvaku Kalpa Adhyaya|Preparations of Ikshvaku (Ikshvaku Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Dhamargava Kalpa Adhyaya|Preparations of Dhamargava (Dhamargava Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vatsaka Kalpa Adhyaya|Preparations of Vatsaka (Vatsaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kritavedhana Kalpa Adhyaya|Preparations of Kritavedhana (Kritavedhana Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Shyamatrivrita Kalpa Adhyaya|Preparations of Shyama Trivrita (Shyamatrivrita Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Chaturangula Kalpa Adhyaya|Preparations of Chaturangula (Chaturangula Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Tilvaka Kalpa Adhyaya|Preparations of Tilvaka (Tilvaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sudha Kalpa Adhyaya|Preparations of Sudha (Sudha Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Saptalashankhini Kalpa Adhyaya|Preparations of Saptala and Shankhini (Saptalashankhini Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Dantidravanti Kalpa Adhyaya|Preparations of Danti and Dravanti (Dantidravanti Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Siddhi Sthana --&gt;<br /> &lt;div id=&quot;Siddhi&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;VIII&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Siddhi Sthana|Section on Therapeutic Procedures]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Administration of purification therapies and Panchakarma&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle (Netrabastivyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation (Vamana Virechana Vyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema (Bastivyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations (Prasrita Yogiyam Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs (Trimarmiya Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Basti Siddhi Adhyaya|Successful Enema Administration (Basti Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits (Phalamatra Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema (Uttar Basti Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;margin-top: 50px; padding: 25px; background: #f0f7ff; border-radius: 10px; text-align: center; border: 1px solid #cce0ff;&quot;&gt;<br /> &lt;div style=&quot;font-size: 1.2em; margin-bottom: 15px; color: #2c5aa0;&quot;&gt;<br /> &lt;strong&gt;Total Chapters: 120&lt;/strong&gt; | &lt;strong&gt;Sections: 8&lt;/strong&gt;<br /> &lt;/div&gt;<br /> &lt;p style=&quot;color: #666; font-size: 0.95em; max-width: 800px; margin: 0 auto; line-height: 1.6;&quot;&gt;This index provides links to all chapters of Charak Samhita, the foundational text of Ayurveda. Each section (Sthana) covers specific aspects of Ayurvedic knowledge and practice.&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;/div&gt;<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;position:fixed; bottom:40px; left:40px; z-index:9999; background: #2c5aa0; border-radius: 50px; padding: 12px 20px; box-shadow: 0 4px 12px rgba(0,0,0,0.15);&quot;&gt;<br /> &lt;span style=&quot;color:white; font-size:0.9em; font-family:verdana,sans-serif; font-weight:bold;&quot;&gt;<br /> [[#top|↑ Back to Top]]<br /> &lt;/span&gt;<br /> &lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Sandip_Bhagyoday&diff=45404 2026-01-20T14:04:33Z

<p>Agnivesha: </p> <hr /> <div>{{#seo:<br /> |title=Adhyaya (Chapters) - Charak Samhita<br /> |titlemode=append<br /> |keywords=Charak Samhita Adhyaya, Charak Samhita chapters, Charak Samhita Index, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, contents of charak samhita, Indian system of medicine, ayurveda, diagnosis, therapeutics, management, preventive medicine, prognosis of disease, rejuvenation, aphrodisiac therapy, fever, skin diseases, principles of ayurveda, pharmaceutical preparations.<br /> |description=Complete list and links to all one hundred twenty chapters of Charak Samhita organized by sections (Sthana)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=Charak Samhita - Ancient Ayurvedic Text<br /> |type=article<br /> }}<br /> <br /> &lt;div style=&quot;max-width: 1200px; margin: 0 auto; padding: 20px; font-family: 'Segoe UI', Tahoma, Geneva, Verdana, sans-serif;&quot;&gt;<br /> <br /> &lt;div style=&quot;text-align: center; margin-bottom: 40px; padding-bottom: 20px; border-bottom: 3px solid #2c5aa0;&quot;&gt;<br /> &lt;h1 style=&quot;color: #2c5aa0; margin-bottom: 10px; font-size: 2.5em;&quot;&gt;Charak Samhita - 120 Chapters (Adhyaya)&lt;/h1&gt;<br /> &lt;p style=&quot;color: #666; font-size: 1.1em; font-style: italic;&quot;&gt;Complete Index of Chapters Organized by Eight Sections (Sthana)&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;margin-bottom: 30px;&quot;&gt;<br /> &lt;div style=&quot;background: #f0f7ff; border: 2px solid #2c5aa0; border-radius: 10px; padding: 15px; text-align: center;&quot;&gt;<br /> &lt;h3 style=&quot;margin-top: 0; color: #2c5aa0;&quot;&gt;Quick Navigation&lt;/h3&gt;<br /> &lt;div style=&quot;font-size: 1.1em; line-height: 1.6;&quot;&gt;<br /> [[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]&lt;br&gt;<br /> [[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Sutra Sthana --&gt;<br /> &lt;div id=&quot;Sutra&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;I&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Sutra Sthana|Section on Fundamental Principles]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Basic principles of Ayurveda, daily regimen, seasonal regimen, and fundamental therapies&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Deerghanjiviteeya Adhyaya|Longevity (Deerghanjiviteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Apamarga Tanduliya Adhyaya|Dehusked Seeds of Apamarga (Apamarga Tanduliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Aragvadhiya Adhyaya|Aragvadha (Cassia) and Other Medicines (Aragvadhiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Shadvirechanashatashritiya Adhyaya|Resources of Six Hundred Evacuatives (Shadvirechanashatashritiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Matrashiteeya Adhyaya|Proper Quantity of Food (Matrashiteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Tasyashiteeya Adhyaya|Seasonal Regimen (Tasyashiteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Naveganadharaniya Adhyaya|Natural Urges (Naveganadharaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Indriyopakramaniya Adhyaya|Disciplinary Protocol for Sense Organs (Indriyopakramaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Khuddakachatushpada Adhyaya|Four Fundamental Components of Healthcare (Khuddakachatushpada Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Mahachatushpada Adhyaya|Four Important Components of Therapeutics (Mahachatushpada Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Tistraishaniya Adhyaya|Three Desires of Life (Tistraishaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vatakalakaliya Adhyaya|Merits and Demerits of Vata (Vatakalakaliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sneha Adhyaya|Oleation Therapies (Sneha Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sweda Adhyaya|Sudation Therapies (Sweda Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Upakalpaniya Adhyaya|Hospital Management Guidelines (Upakalpaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Chikitsaprabhritiya Adhyaya|Assessment in Panchakarma (Chikitsaprabhritiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kiyanta Shiraseeya Adhyaya|Diseases of Vital Organs (Kiyanta Shiraseeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trishothiya Adhyaya|Three Types of Swellings (Trishothiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Ashtodariya Adhyaya|Numerical Classification of Diseases (Ashtodariya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Maharoga Adhyaya|Dosha Specific Classification (Maharoga Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Ashtauninditiya Adhyaya|Eight Undesirable Constitutions (Ashtauninditiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Langhanabrimhaniya Adhyaya|Reduction and Nourishing Therapies (Langhanabrimhaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Santarpaniya Adhyaya|Over-nutrition and Under-nutrition (Santarpaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vidhishonitiya Adhyaya|Characteristics of Shonita (Blood) (Vidhishonitiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Yajjah Purushiya Adhyaya|Origin of Human Beings (Yajjah Purushiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Atreyabhadrakapyiya Adhyaya|Pharmacological Principles (Atreyabhadrakapyiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Annapanavidhi Adhyaya|Classification of Food and Beverages (Annapanavidhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vividhashitapitiya Adhyaya|Sequential Effects of Food (Vividhashitapitiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Dashapranayataneeya Adhyaya|Ten Seats of Life Forces (Dashapranayataneeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Arthedashmahamooliya Adhyaya|Ten Great Vessels from Heart (Arthedashmahamooliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Nidana Sthana --&gt;<br /> &lt;div id=&quot;Nidana&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;II&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Nidana Sthana|Section on Diagnostic Principles]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Etiology, pathogenesis, and diagnosis of major diseases&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Jwara Nidana Adhyaya|Diagnosis of Jwara (Fever) (Jwara Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Raktapitta Nidana Adhyaya|Diagnosis of Bleeding Disorders (Raktapitta Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Gulma Nidana Adhyaya|Diagnosis of Abdominal Lumps (Gulma Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Prameha Nidana Adhyaya|Diagnosis of Urinary Disorders (Prameha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kushtha Nidana Adhyaya|Diagnosis of Skin Diseases (Kushtha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Shosha Nidana Adhyaya|Diagnosis of Wasting Disease (Shosha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Unmada Nidana Adhyaya|Diagnosis of Psychosis (Unmada Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Apasmara Nidana Adhyaya|Diagnosis of Seizure Disorders (Apasmara Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Vimana Sthana --&gt;<br /> &lt;div id=&quot;Vimana&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;III&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Vimana Sthana|Section on Specific Medical Principles]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Detailed knowledge of diseases, channels, and examination methods&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Rasa Vimana Adhyaya|Taste-based Factors (Rasa Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trividhakukshiya Vimana Adhyaya|Three Parts of Abdomen (Trividhakukshiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Janapadodhvansaniya Vimana Adhyaya|Destruction of Communities (Janapadodhvansaniya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trividha Roga Vishesha Vijnaniya Vimana Adhyaya|Three Methods of Disease Knowledge (Trividha Roga Vishesha Vijnaniya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sroto Vimana Adhyaya|Channels of Transport (Sroto Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Roganika Vimana Adhyaya|Classification of Diseases (Roganika Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vyadhita Rupiya Vimana Adhyaya|Types of Patients (Vyadhita Rupiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Rogabhishagjitiya Vimana Adhyaya|Conquering Debate and Disease (Rogabhishagjitiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Sharira Sthana --&gt;<br /> &lt;div id=&quot;Sharira&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;IV&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Sharira Sthana|Section on Human Being and Genesis]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Embryology, anatomy, and physiology of human beings&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Katidhapurusha Sharira Adhyaya|Holistic Human Being (Katidhapurusha Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Atulyagotriya Sharira Adhyaya|Different Clans (Atulyagotriya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Khuddika Garbhavakranti Sharira Adhyaya|Factors for Embryogenesis (Khuddika Garbhavakranti Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Mahatigarbhavakranti Sharira Adhyaya|Embryonic Development (Mahatigarbhavakranti Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Purusha Vichaya Sharira Adhyaya|Detailed Study of Human Being (Purusha Vichaya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sharira Vichaya Sharira Adhyaya|Analytical Study of Body (Sharira Vichaya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sharira Sankhya Sharira Adhyaya|Numerological Account (Sharira Sankhya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Jatisutriya Sharira Adhyaya|Obstetrics and Neonatal Care (Jatisutriya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Indriya Sthana --&gt;<br /> &lt;div id=&quot;Indriya&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;V&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Indriya Sthana|Section on Sensorial Prognosis]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Prognosis based on signs and symptoms from sense organs&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Varnasvariyam Indriyam Adhyaya|Fatal Signs in Complexion and Voice (Varnasvariyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Pushpitakam Indriyam Adhyaya|Fatal Signs of Tactile and Olfactory Perception (Pushpitakam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Parimarshaneeyam Indriyam Adhyaya|Palpable Signs of Death (Parimarshaneeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Indriyaneekam Indriyam Adhyaya|Fatal Signs in Sense Organs (Indriyaneekam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Purvarupeeyam Indriyam Adhyaya|Prognosis by Prodromal Symptoms (Purvarupeeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Katamanisharireeyam Indriyam Adhyaya|Specific Fatal Clinical Features (Katamanisharireeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Pannarupiyam Indriyam Adhyaya|Changes in Shadows and Complexion (Pannarupiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Avakshiraseeyam Indriyam Adhyaya|Inverted Shadow of Dying Person (Avakshiraseeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Yasyashyavanimittiyam Indriyam Adhyaya|Palliative Care Signs (Yasyashyavanimittiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sadyomaraneeyam Indriyam Adhyaya|Signs of Instant Death (Sadyomaraneeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Anujyotiyam Indriyam Adhyaya|Diminution of Agni (Anujyotiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Gomayachurniyam Indriyam Adhyaya|Characteristics of Messenger (Gomayachurniyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Chikitsa Sthana --&gt;<br /> &lt;div id=&quot;Chikitsa&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;VI&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Chikitsa Sthana|Section on Therapeutic Principles]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Management and treatment of various diseases&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Rasayana Adhyaya|Rejuvenation Therapy (Rasayana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vajikarana Adhyaya|Aphrodisiac Therapy (Vajikarana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Jwara Chikitsa Adhyaya|Management of Jwara (Fever) (Jwara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Raktapitta Chikitsa Adhyaya|Management of Bleeding Disorders (Raktapitta Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Gulma Chikitsa Adhyaya|Management of Gulma (Gulma Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Prameha Chikitsa Adhyaya|Management of Urinary Disorders (Prameha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kushtha Chikitsa Adhyaya|Management of Skin Diseases (Kushtha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Rajayakshma Chikitsa Adhyaya|Management of Wasting Diseases (Rajayakshma Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Unmada Chikitsa Adhyaya|Management of Psychosis (Unmada Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Apasmara Chikitsa Adhyaya|Management of Seizure Disorders (Apasmara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kshatakshina Chikitsa Adhyaya|Management of Emaciation due to Trauma (Kshatakshina Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Shvayathu Chikitsa Adhyaya|Management of Swellings (Shvayathu Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Udara Chikitsa Adhyaya|Management of Abdominal Enlargement (Udara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Arsha Chikitsa Adhyaya|Management of Hemorrhoids (Arsha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Grahani Chikitsa Adhyaya|Management of Digestive Diseases (Grahani Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Pandu Chikitsa Adhyaya|Management of Anemia (Pandu Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Hikka Shwasa Chikitsa Adhyaya|Management of Hiccups and Dyspnea (Hikka Shwasa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kasa Chikitsa Adhyaya|Management of Cough (Kasa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Atisara Chikitsa Adhyaya|Management of Diarrhea (Atisara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Chhardi Chikitsa Adhyaya|Management of Vomiting (Chhardi Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Visarpa Chikitsa Adhyaya|Management of Acute Spreading Erysipelas (Visarpa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trishna Chikitsa Adhyaya|Management of Morbid Thirst (Trishna Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Visha Chikitsa Adhyaya|Management of Poisoning (Visha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Madatyaya Chikitsa Adhyaya|Management of Intoxication (Madatyaya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Dwivraniya Chikitsa Adhyaya|Management of Ulcers (Dwivraniya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trimarmiya Chikitsa Adhyaya|Management of Three Vital Organs (Trimarmiya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Urustambha Chikitsa Adhyaya|Management of Thigh and Hip Diseases (Urustambha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vatavyadhi Chikitsa Adhyaya|Management of Vata Diseases (Vatavyadhi Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vatarakta Chikitsa Adhyaya|Management of Vata and Rakta Diseases (Vatarakta Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Yonivyapat Chikitsa Adhyaya|Management of Genital Tract Disorders (Yonivyapat Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Kalpa Sthana --&gt;<br /> &lt;div id=&quot;Kalpa&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;VII&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Kalpa Sthana|Section on Pharmaceutical Preparations]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Formulation and preparation of medicinal compounds&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Madana Kalpa Adhyaya|Preparations of Madanaphala (Madana Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Jimutaka Kalpa Adhyaya|Preparations of Jimutaka (Jimutaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Ikshvaku Kalpa Adhyaya|Preparations of Ikshvaku (Ikshvaku Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Dhamargava Kalpa Adhyaya|Preparations of Dhamargava (Dhamargava Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vatsaka Kalpa Adhyaya|Preparations of Vatsaka (Vatsaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Kritavedhana Kalpa Adhyaya|Preparations of Kritavedhana (Kritavedhana Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Shyamatrivrita Kalpa Adhyaya|Preparations of Shyama Trivrita (Shyamatrivrita Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Chaturangula Kalpa Adhyaya|Preparations of Chaturangula (Chaturangula Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Tilvaka Kalpa Adhyaya|Preparations of Tilvaka (Tilvaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Sudha Kalpa Adhyaya|Preparations of Sudha (Sudha Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Saptalashankhini Kalpa Adhyaya|Preparations of Saptala and Shankhini (Saptalashankhini Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Dantidravanti Kalpa Adhyaya|Preparations of Danti and Dravanti (Dantidravanti Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Siddhi Sthana --&gt;<br /> &lt;div id=&quot;Siddhi&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;VIII&lt;/div&gt;<br /> &lt;div&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Siddhi Sthana|Section on Therapeutic Procedures]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Administration of purification therapies and Panchakarma&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle (Netrabastivyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation (Vamana Virechana Vyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema (Bastivyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations (Prasrita Yogiyam Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs (Trimarmiya Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Basti Siddhi Adhyaya|Successful Enema Administration (Basti Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits (Phalamatra Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema (Uttar Basti Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;margin-top: 50px; padding: 25px; background: #f0f7ff; border-radius: 10px; text-align: center; border: 1px solid #cce0ff;&quot;&gt;<br /> &lt;div style=&quot;font-size: 1.2em; margin-bottom: 15px; color: #2c5aa0;&quot;&gt;<br /> &lt;strong&gt;Total Chapters: 120&lt;/strong&gt; | &lt;strong&gt;Sections: 8&lt;/strong&gt;<br /> &lt;/div&gt;<br /> &lt;p style=&quot;color: #666; font-size: 0.95em; max-width: 800px; margin: 0 auto; line-height: 1.6;&quot;&gt;This index provides links to all chapters of Charak Samhita, the foundational text of Ayurveda. Each section (Sthana) covers specific aspects of Ayurvedic knowledge and practice.&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;/div&gt;<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;position:fixed; bottom:40px; left:40px; z-index:9999; background: #2c5aa0; border-radius: 50px; padding: 12px 20px; box-shadow: 0 4px 12px rgba(0,0,0,0.15);&quot;&gt;<br /> &lt;span style=&quot;color:white; font-size:0.9em; font-family:verdana,sans-serif; font-weight:bold;&quot;&gt;<br /> [[#top|↑ Back to Top]]<br /> &lt;/span&gt;<br /> &lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Sandip_Bhagyoday&diff=45403 2026-01-20T13:57:30Z

<p>Agnivesha: </p> <hr /> <div>&lt;div class=&quot;charak-index-container&quot; style=&quot;max-width: 1200px; margin: 0 auto; padding: 20px; font-family: 'Segoe UI', Tahoma, Geneva, Verdana, sans-serif;&quot;&gt;<br /> <br /> &lt;div class=&quot;charak-header&quot; style=&quot;text-align: center; margin-bottom: 40px; padding-bottom: 20px; border-bottom: 3px solid #2c5aa0;&quot;&gt;<br /> &lt;h1 style=&quot;color: #2c5aa0; margin-bottom: 10px; font-size: 2.5em;&quot;&gt;Charak Samhita - 120 Chapters (Adhyaya)&lt;/h1&gt;<br /> &lt;p class=&quot;subtitle&quot; style=&quot;color: #666; font-size: 1.1em; font-style: italic;&quot;&gt;Complete Index of Chapters Organized by Eight Sections (Sthana)&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;charak-navigation&quot; style=&quot;margin-bottom: 30px;&quot;&gt;<br /> &lt;div class=&quot;nav-box&quot; style=&quot;background: #f0f7ff; border: 2px solid #2c5aa0; border-radius: 10px; padding: 15px; text-align: center;&quot;&gt;<br /> &lt;h3 style=&quot;margin-top: 0; color: #2c5aa0;&quot;&gt;Quick Navigation&lt;/h3&gt;<br /> &lt;div class=&quot;nav-links&quot; style=&quot;font-size: 1.1em; line-height: 1.6;&quot;&gt;<br /> [[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]&lt;br&gt;<br /> [[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Repeat this pattern for all sections --&gt;<br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Siddhi&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot; style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot; style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;VIII&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Siddhi Sthana|Section on Therapeutic Procedures]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot; style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Administration of purification therapies and Panchakarma&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid&quot; style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle (Netrabastivyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation (Vamana Virechana Vyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema (Bastivyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations (Prasrita Yogiyam Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs (Trimarmiya Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Basti Siddhi Adhyaya|Successful Enema Administration (Basti Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits (Phalamatra Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema (Uttar Basti Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;charak-footer&quot; style=&quot;margin-top: 50px; padding: 25px; background: #f0f7ff; border-radius: 10px; text-align: center; border: 1px solid #cce0ff;&quot;&gt;<br /> &lt;div class=&quot;total-chapters&quot; style=&quot;font-size: 1.2em; margin-bottom: 15px; color: #2c5aa0;&quot;&gt;<br /> &lt;strong&gt;Total Chapters: 120&lt;/strong&gt; | &lt;strong&gt;Sections: 8&lt;/strong&gt;<br /> &lt;/div&gt;<br /> &lt;p class=&quot;footer-note&quot; style=&quot;color: #666; font-size: 0.95em; max-width: 800px; margin: 0 auto; line-height: 1.6;&quot;&gt;This index provides links to all chapters of Charak Samhita, the foundational text of Ayurveda. Each section (Sthana) covers specific aspects of Ayurvedic knowledge and practice.&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;/div&gt;<br /> <br /> &lt;!-- Back to top button --&gt;<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;position:fixed; bottom:40px; left:40px; z-index:9999; background: #2c5aa0; border-radius: 50px; padding: 12px 20px; box-shadow: 0 4px 12px rgba(0,0,0,0.15);&quot;&gt;<br /> &lt;span style=&quot;color:white; font-size:0.9em; font-family:verdana,sans-serif; font-weight:bold;&quot;&gt;<br /> [[#top|↑ Back to Top]]<br /> &lt;/span&gt;<br /> &lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Sandip_Bhagyoday&diff=45402 2026-01-20T13:57:07Z

<p>Agnivesha: </p> <hr /> <div>&lt;div style=&quot;max-width: 1200px; margin: 0 auto; padding: 20px; font-family: Arial, sans-serif;&quot;&gt;<br /> <br /> &lt;div style=&quot;text-align: center; margin-bottom: 40px; padding-bottom: 20px; border-bottom: 3px solid #2c5aa0;&quot;&gt;<br /> &lt;h1 style=&quot;color: #2c5aa0; margin-bottom: 10px;&quot;&gt;Charak Samhita - 120 Chapters&lt;/h1&gt;<br /> &lt;p style=&quot;color: #666;&quot;&gt;Complete Index of Chapters&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;background: #f0f7ff; border: 2px solid #2c5aa0; border-radius: 10px; padding: 15px; text-align: center; margin-bottom: 30px;&quot;&gt;<br /> &lt;h3 style=&quot;color: #2c5aa0; margin-top: 0;&quot;&gt;Quick Navigation&lt;/h3&gt;<br /> &lt;div&gt;<br /> [[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]&lt;br&gt;<br /> [[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Sections with minimal styling --&gt;<br /> &lt;div style=&quot;margin-bottom: 30px; background: white; border: 1px solid #ddd; border-radius: 5px;&quot;&gt;<br /> &lt;div style=&quot;background: #2c5aa0; color: white; padding: 15px;&quot;&gt;<br /> &lt;h2 style=&quot;margin: 0;&quot;&gt;[[Siddhi Sthana|Section on Therapeutic Procedures]]&lt;/h2&gt;<br /> &lt;p style=&quot;margin: 5px 0 0 0; opacity: 0.9;&quot;&gt;Administration of purification therapies&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;div style=&quot;padding: 20px;&quot;&gt;<br /> &lt;ol&gt;<br /> &lt;li&gt;'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Basti Siddhi Adhyaya|Successful Enema Administration]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Sandip_Bhagyoday&diff=45401 2026-01-20T13:55:32Z

<p>Agnivesha: </p> <hr /> <div>&lt;div class=&quot;charak-index-container&quot; style=&quot;max-width: 1200px; margin: 0 auto; padding: 20px; font-family: 'Segoe UI', Tahoma, Geneva, Verdana, sans-serif;&quot;&gt;<br /> <br /> &lt;div class=&quot;charak-header&quot; style=&quot;text-align: center; margin-bottom: 40px; padding-bottom: 20px; border-bottom: 3px solid #2c5aa0;&quot;&gt;<br /> &lt;h1 style=&quot;color: #2c5aa0; margin-bottom: 10px; font-size: 2.5em;&quot;&gt;Charak Samhita - 120 Chapters (Adhyaya)&lt;/h1&gt;<br /> &lt;p class=&quot;subtitle&quot; style=&quot;color: #666; font-size: 1.1em; font-style: italic;&quot;&gt;Complete Index of Chapters Organized by Eight Sections (Sthana)&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;charak-navigation&quot; style=&quot;margin-bottom: 30px;&quot;&gt;<br /> &lt;div class=&quot;nav-box&quot; style=&quot;background: #f0f7ff; border: 2px solid #2c5aa0; border-radius: 10px; padding: 15px; text-align: center;&quot;&gt;<br /> &lt;h3 style=&quot;margin-top: 0; color: #2c5aa0;&quot;&gt;Quick Navigation&lt;/h3&gt;<br /> &lt;div class=&quot;nav-links&quot; style=&quot;font-size: 1.1em; line-height: 1.6;&quot;&gt;<br /> [[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]&lt;br&gt;<br /> [[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;!-- Repeat this pattern for all sections --&gt;<br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Siddhi&quot; style=&quot;margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot; style=&quot;background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot; style=&quot;font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;&quot;&gt;VIII&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2 style=&quot;margin: 0 0 10px 0; font-size: 1.8em;&quot;&gt;[[Siddhi Sthana|Section on Therapeutic Procedures]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot; style=&quot;margin: 0; opacity: 0.9; font-size: 1em;&quot;&gt;Administration of purification therapies and Panchakarma&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid&quot; style=&quot;padding: 30px;&quot;&gt;<br /> &lt;ol start=&quot;1&quot; style=&quot;margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;&quot;&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle (Netrabastivyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation (Vamana Virechana Vyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema (Bastivyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations (Prasrita Yogiyam Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs (Trimarmiya Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Basti Siddhi Adhyaya|Successful Enema Administration (Basti Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits (Phalamatra Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li style=&quot;margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;&quot;&gt;'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema (Uttar Basti Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;charak-footer&quot; style=&quot;margin-top: 50px; padding: 25px; background: #f0f7ff; border-radius: 10px; text-align: center; border: 1px solid #cce0ff;&quot;&gt;<br /> &lt;div class=&quot;total-chapters&quot; style=&quot;font-size: 1.2em; margin-bottom: 15px; color: #2c5aa0;&quot;&gt;<br /> &lt;strong&gt;Total Chapters: 120&lt;/strong&gt; | &lt;strong&gt;Sections: 8&lt;/strong&gt;<br /> &lt;/div&gt;<br /> &lt;p class=&quot;footer-note&quot; style=&quot;color: #666; font-size: 0.95em; max-width: 800px; margin: 0 auto; line-height: 1.6;&quot;&gt;This index provides links to all chapters of Charak Samhita, the foundational text of Ayurveda. Each section (Sthana) covers specific aspects of Ayurvedic knowledge and practice.&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;/div&gt;<br /> <br /> &lt;!-- Back to top button --&gt;<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;position:fixed; bottom:40px; left:40px; z-index:9999; background: #2c5aa0; border-radius: 50px; padding: 12px 20px; box-shadow: 0 4px 12px rgba(0,0,0,0.15);&quot;&gt;<br /> &lt;span style=&quot;color:white; font-size:0.9em; font-family:verdana,sans-serif; font-weight:bold;&quot;&gt;<br /> [[#top|↑ Back to Top]]<br /> &lt;/span&gt;<br /> &lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Sandip_Bhagyoday&diff=45400 2026-01-20T13:50:54Z

<p>Agnivesha: </p> <hr /> <div>{{#seo:<br /> |title=Adhyaya (Chapters) - Charak Samhita<br /> |titlemode=append<br /> |keywords=Charak Samhita Adhyaya, Charak Samhita chapters, Charak Samhita Index, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, contents of charak samhita, Indian system of medicine, ayurveda, diagnosis, therapeutics, management, preventive medicine, prognosis of disease, rejuvenation, aphrodisiac therapy, fever, skin diseases, principles of ayurveda, pharmaceutical preparations.<br /> |description=Complete list and links to all one hundred twenty chapters of Charak Samhita organized by sections (Sthana)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=Charak Samhita - Ancient Ayurvedic Text<br /> |type=article<br /> }}<br /> <br /> &lt;div class=&quot;charak-index-container&quot;&gt;<br /> <br /> &lt;div class=&quot;charak-header&quot;&gt;<br /> &lt;h1&gt;Charak Samhita - 120 Chapters (Adhyaya)&lt;/h1&gt;<br /> &lt;p class=&quot;subtitle&quot;&gt;Complete Index of Chapters Organized by Eight Sections (Sthana)&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;charak-navigation&quot;&gt;<br /> &lt;div class=&quot;nav-box&quot;&gt;<br /> &lt;h3&gt;Quick Navigation&lt;/h3&gt;<br /> &lt;div class=&quot;nav-links&quot;&gt;<br /> [[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]&lt;br&gt;<br /> [[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Sutra&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;I&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Sutra Sthana|Section on Fundamental Principles]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Basic principles of Ayurveda, daily regimen, seasonal regimen, and fundamental therapies&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Deerghanjiviteeya Adhyaya|Longevity (Deerghanjiviteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Apamarga Tanduliya Adhyaya|Dehusked Seeds of Apamarga (Apamarga Tanduliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Aragvadhiya Adhyaya|Aragvadha (Cassia) and Other Medicines (Aragvadhiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Shadvirechanashatashritiya Adhyaya|Resources of Six Hundred Evacuatives (Shadvirechanashatashritiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Matrashiteeya Adhyaya|Proper Quantity of Food (Matrashiteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Tasyashiteeya Adhyaya|Seasonal Regimen (Tasyashiteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Naveganadharaniya Adhyaya|Natural Urges (Naveganadharaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Indriyopakramaniya Adhyaya|Disciplinary Protocol for Sense Organs (Indriyopakramaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Khuddakachatushpada Adhyaya|Four Fundamental Components of Healthcare (Khuddakachatushpada Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Mahachatushpada Adhyaya|Four Important Components of Therapeutics (Mahachatushpada Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Tistraishaniya Adhyaya|Three Desires of Life (Tistraishaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vatakalakaliya Adhyaya|Merits and Demerits of Vata (Vatakalakaliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Sneha Adhyaya|Oleation Therapies (Sneha Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Sweda Adhyaya|Sudation Therapies (Sweda Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Upakalpaniya Adhyaya|Hospital Management Guidelines (Upakalpaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Chikitsaprabhritiya Adhyaya|Assessment in Panchakarma (Chikitsaprabhritiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Kiyanta Shiraseeya Adhyaya|Diseases of Vital Organs (Kiyanta Shiraseeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Trishothiya Adhyaya|Three Types of Swellings (Trishothiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Ashtodariya Adhyaya|Numerical Classification of Diseases (Ashtodariya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Maharoga Adhyaya|Dosha Specific Classification (Maharoga Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Ashtauninditiya Adhyaya|Eight Undesirable Constitutions (Ashtauninditiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Langhanabrimhaniya Adhyaya|Reduction and Nourishing Therapies (Langhanabrimhaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Santarpaniya Adhyaya|Over-nutrition and Under-nutrition (Santarpaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vidhishonitiya Adhyaya|Characteristics of Shonita (Blood) (Vidhishonitiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Yajjah Purushiya Adhyaya|Origin of Human Beings (Yajjah Purushiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Atreyabhadrakapyiya Adhyaya|Pharmacological Principles (Atreyabhadrakapyiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Annapanavidhi Adhyaya|Classification of Food and Beverages (Annapanavidhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vividhashitapitiya Adhyaya|Sequential Effects of Food (Vividhashitapitiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Dashapranayataneeya Adhyaya|Ten Seats of Life Forces (Dashapranayataneeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Arthedashmahamooliya Adhyaya|Ten Great Vessels from Heart (Arthedashmahamooliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Nidana&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;II&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Nidana Sthana|Section on Diagnostic Principles]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Etiology, pathogenesis, and diagnosis of major diseases&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid columns-2&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Jwara Nidana Adhyaya|Diagnosis of Jwara (Fever) (Jwara Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Raktapitta Nidana Adhyaya|Diagnosis of Bleeding Disorders (Raktapitta Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Gulma Nidana Adhyaya|Diagnosis of Abdominal Lumps (Gulma Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Prameha Nidana Adhyaya|Diagnosis of Urinary Disorders (Prameha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Kushtha Nidana Adhyaya|Diagnosis of Skin Diseases (Kushtha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Shosha Nidana Adhyaya|Diagnosis of Wasting Disease (Shosha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Unmada Nidana Adhyaya|Diagnosis of Psychosis (Unmada Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Apasmara Nidana Adhyaya|Diagnosis of Seizure Disorders (Apasmara Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Vimana&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;III&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Vimana Sthana|Section on Specific Medical Principles]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Detailed knowledge of diseases, channels, and examination methods&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid columns-2&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Rasa Vimana Adhyaya|Taste-based Factors (Rasa Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Trividhakukshiya Vimana Adhyaya|Three Parts of Abdomen (Trividhakukshiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Janapadodhvansaniya Vimana Adhyaya|Destruction of Communities (Janapadodhvansaniya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Trividha Roga Vishesha Vijnaniya Vimana Adhyaya|Three Methods of Disease Knowledge (Trividha Roga Vishesha Vijnaniya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Sroto Vimana Adhyaya|Channels of Transport (Sroto Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Roganika Vimana Adhyaya|Classification of Diseases (Roganika Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vyadhita Rupiya Vimana Adhyaya|Types of Patients (Vyadhita Rupiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Rogabhishagjitiya Vimana Adhyaya|Conquering Debate and Disease (Rogabhishagjitiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Sharira&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;IV&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Sharira Sthana|Section on Human Being and Genesis]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Embryology, anatomy, and physiology of human beings&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid columns-2&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Katidhapurusha Sharira Adhyaya|Holistic Human Being (Katidhapurusha Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Atulyagotriya Sharira Adhyaya|Different Clans (Atulyagotriya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Khuddika Garbhavakranti Sharira Adhyaya|Factors for Embryogenesis (Khuddika Garbhavakranti Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Mahatigarbhavakranti Sharira Adhyaya|Embryonic Development (Mahatigarbhavakranti Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Purusha Vichaya Sharira Adhyaya|Detailed Study of Human Being (Purusha Vichaya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Sharira Vichaya Sharira Adhyaya|Analytical Study of Body (Sharira Vichaya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Sharira Sankhya Sharira Adhyaya|Numerological Account (Sharira Sankhya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Jatisutriya Sharira Adhyaya|Obstetrics and Neonatal Care (Jatisutriya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Indriya&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;V&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Indriya Sthana|Section on Sensorial Prognosis]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Prognosis based on signs and symptoms from sense organs&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid columns-3&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Varnasvariyam Indriyam Adhyaya|Fatal Signs in Complexion and Voice (Varnasvariyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Pushpitakam Indriyam Adhyaya|Fatal Signs of Tactile and Olfactory Perception (Pushpitakam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Parimarshaneeyam Indriyam Adhyaya|Palpable Signs of Death (Parimarshaneeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Indriyaneekam Indriyam Adhyaya|Fatal Signs in Sense Organs (Indriyaneekam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Purvarupeeyam Indriyam Adhyaya|Prognosis by Prodromal Symptoms (Purvarupeeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Katamanisharireeyam Indriyam Adhyaya|Specific Fatal Clinical Features (Katamanisharireeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Pannarupiyam Indriyam Adhyaya|Changes in Shadows and Complexion (Pannarupiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Avakshiraseeyam Indriyam Adhyaya|Inverted Shadow of Dying Person (Avakshiraseeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Yasyashyavanimittiyam Indriyam Adhyaya|Palliative Care Signs (Yasyashyavanimittiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Sadyomaraneeyam Indriyam Adhyaya|Signs of Instant Death (Sadyomaraneeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Anujyotiyam Indriyam Adhyaya|Diminution of Agni (Anujyotiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Gomayachurniyam Indriyam Adhyaya|Characteristics of Messenger (Gomayachurniyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Chikitsa&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;VI&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Chikitsa Sthana|Section on Therapeutic Principles]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Management and treatment of various diseases&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid columns-2&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Rasayana Adhyaya|Rejuvenation Therapy (Rasayana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vajikarana Adhyaya|Aphrodisiac Therapy (Vajikarana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Jwara Chikitsa Adhyaya|Management of Jwara (Fever) (Jwara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Raktapitta Chikitsa Adhyaya|Management of Bleeding Disorders (Raktapitta Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Gulma Chikitsa Adhyaya|Management of Gulma (Gulma Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Prameha Chikitsa Adhyaya|Management of Urinary Disorders (Prameha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Kushtha Chikitsa Adhyaya|Management of Skin Diseases (Kushtha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Rajayakshma Chikitsa Adhyaya|Management of Wasting Diseases (Rajayakshma Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Unmada Chikitsa Adhyaya|Management of Psychosis (Unmada Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Apasmara Chikitsa Adhyaya|Management of Seizure Disorders (Apasmara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Kshatakshina Chikitsa Adhyaya|Management of Emaciation due to Trauma (Kshatakshina Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Shvayathu Chikitsa Adhyaya|Management of Swellings (Shvayathu Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Udara Chikitsa Adhyaya|Management of Abdominal Enlargement (Udara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Arsha Chikitsa Adhyaya|Management of Hemorrhoids (Arsha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Grahani Chikitsa Adhyaya|Management of Digestive Diseases (Grahani Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Pandu Chikitsa Adhyaya|Management of Anemia (Pandu Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Hikka Shwasa Chikitsa Adhyaya|Management of Hiccups and Dyspnea (Hikka Shwasa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Kasa Chikitsa Adhyaya|Management of Cough (Kasa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Atisara Chikitsa Adhyaya|Management of Diarrhea (Atisara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Chhardi Chikitsa Adhyaya|Management of Vomiting (Chhardi Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Visarpa Chikitsa Adhyaya|Management of Acute Spreading Erysipelas (Visarpa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Trishna Chikitsa Adhyaya|Management of Morbid Thirst (Trishna Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Visha Chikitsa Adhyaya|Management of Poisoning (Visha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Madatyaya Chikitsa Adhyaya|Management of Intoxication (Madatyaya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Dwivraniya Chikitsa Adhyaya|Management of Ulcers (Dwivraniya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Trimarmiya Chikitsa Adhyaya|Management of Three Vital Organs (Trimarmiya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Urustambha Chikitsa Adhyaya|Management of Thigh and Hip Diseases (Urustambha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vatavyadhi Chikitsa Adhyaya|Management of Vata Diseases (Vatavyadhi Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vatarakta Chikitsa Adhyaya|Management of Vata and Rakta Diseases (Vatarakta Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Yonivyapat Chikitsa Adhyaya|Management of Genital Tract Disorders (Yonivyapat Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Kalpa&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;VII&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Kalpa Sthana|Section on Pharmaceutical Preparations]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Formulation and preparation of medicinal compounds&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid columns-3&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Madana Kalpa Adhyaya|Preparations of Madanaphala (Madana Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Jimutaka Kalpa Adhyaya|Preparations of Jimutaka (Jimutaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Ikshvaku Kalpa Adhyaya|Preparations of Ikshvaku (Ikshvaku Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Dhamargava Kalpa Adhyaya|Preparations of Dhamargava (Dhamargava Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vatsaka Kalpa Adhyaya|Preparations of Vatsaka (Vatsaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Kritavedhana Kalpa Adhyaya|Preparations of Kritavedhana (Kritavedhana Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Shyamatrivrita Kalpa Adhyaya|Preparations of Shyama Trivrita (Shyamatrivrita Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Chaturangula Kalpa Adhyaya|Preparations of Chaturangula (Chaturangula Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Tilvaka Kalpa Adhyaya|Preparations of Tilvaka (Tilvaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Sudha Kalpa Adhyaya|Preparations of Sudha (Sudha Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Saptalashankhini Kalpa Adhyaya|Preparations of Saptala and Shankhini (Saptalashankhini Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Dantidravanti Kalpa Adhyaya|Preparations of Danti and Dravanti (Dantidravanti Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Siddhi&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;VIII&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Siddhi Sthana|Section on Therapeutic Procedures]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Administration of purification therapies and Panchakarma&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid columns-3&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Kalpana Siddhi Adhyaya|Standard Administration of Purification (Kalpana Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Panchakarmiya Siddhi Adhyaya|Successful Panchakarma Administration (Panchakarmiya Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Bastisutriyam Siddhi Adhyaya|Standard Practices of Basti (Bastisutriyam Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Snehavyapat Siddhi Adhyaya|Complications of Unctuous Enema (Snehavyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle (Netrabastivyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation (Vamana Virechana Vyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema (Bastivyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations (Prasrita Yogiyam Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs (Trimarmiya Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Basti Siddhi Adhyaya|Successful Enema Administration (Basti Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits (Phalamatra Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema (Uttar Basti Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> &lt;div class=&quot;charak-footer&quot;&gt;<br /> &lt;div class=&quot;total-chapters&quot;&gt;<br /> &lt;strong&gt;Total Chapters: 120&lt;/strong&gt; | &lt;strong&gt;Sections: 8&lt;/strong&gt;<br /> &lt;/div&gt;<br /> &lt;p class=&quot;footer-note&quot;&gt;This index provides links to all chapters of Charak Samhita, the foundational text of Ayurveda. Each section (Sthana) covers specific aspects of Ayurvedic knowledge and practice.&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;/div&gt;<br /> <br /> &lt;style&gt;<br /> .charak-index-container {<br /> max-width: 1200px;<br /> margin: 0 auto;<br /> padding: 20px;<br /> font-family: 'Segoe UI', Tahoma, Geneva, Verdana, sans-serif;<br /> }<br /> <br /> .charak-header {<br /> text-align: center;<br /> margin-bottom: 40px;<br /> padding-bottom: 20px;<br /> border-bottom: 3px solid #2c5aa0;<br /> }<br /> <br /> .charak-header h1 {<br /> color: #2c5aa0;<br /> margin-bottom: 10px;<br /> font-size: 2.5em;<br /> }<br /> <br /> .charak-header .subtitle {<br /> color: #666;<br /> font-size: 1.1em;<br /> font-style: italic;<br /> }<br /> <br /> .charak-navigation {<br /> margin-bottom: 30px;<br /> }<br /> <br /> .nav-box {<br /> background: #f0f7ff;<br /> border: 2px solid #2c5aa0;<br /> border-radius: 10px;<br /> padding: 15px;<br /> text-align: center;<br /> }<br /> <br /> .nav-box h3 {<br /> margin-top: 0;<br /> color: #2c5aa0;<br /> }<br /> <br /> .nav-links {<br /> font-size: 1.1em;<br /> line-height: 1.6;<br /> }<br /> <br /> .sthna-section {<br /> margin-bottom: 50px;<br /> background: white;<br /> border-radius: 12px;<br /> box-shadow: 0 4px 15px rgba(0,0,0,0.08);<br /> overflow: hidden;<br /> border: 1px solid #e0e0e0;<br /> }<br /> <br /> .sthna-header {<br /> background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%);<br /> color: white;<br /> padding: 25px;<br /> display: flex;<br /> align-items: center;<br /> gap: 25px;<br /> }<br /> <br /> .sthna-number {<br /> font-size: 3em;<br /> font-weight: bold;<br /> opacity: 0.9;<br /> min-width: 60px;<br /> }<br /> <br /> .sthna-title h2 {<br /> margin: 0 0 10px 0;<br /> font-size: 1.8em;<br /> }<br /> <br /> .sthna-title h2 a {<br /> color: white !important;<br /> text-decoration: none;<br /> }<br /> <br /> .sthna-title h2 a:hover {<br /> text-decoration: underline;<br /> }<br /> <br /> .sthna-desc {<br /> margin: 0;<br /> opacity: 0.9;<br /> font-size: 1em;<br /> }<br /> <br /> .chapters-grid {<br /> padding: 30px;<br /> }<br /> <br /> .chapters-grid ol {<br /> margin: 0;<br /> padding-left: 20px;<br /> }<br /> <br /> .chapters-grid li {<br /> margin-bottom: 12px;<br /> line-height: 1.5;<br /> padding: 8px 0;<br /> border-bottom: 1px dashed #eee;<br /> transition: all 0.2s ease;<br /> }<br /> <br /> .chapters-grid li:hover {<br /> background: #f9f9f9;<br /> padding-left: 10px;<br /> border-bottom-color: #2c5aa0;<br /> }<br /> <br /> .chapters-grid li a {<br /> color: #2c5aa0;<br /> text-decoration: none;<br /> font-weight: 500;<br /> }<br /> <br /> .chapters-grid li a:hover {<br /> text-decoration: underline;<br /> color: #1a3d7a;<br /> }<br /> <br /> /* Responsive columns */<br /> .columns-2 {<br /> column-count: 2;<br /> column-gap: 40px;<br /> }<br /> <br /> .columns-3 {<br /> column-count: 3;<br /> column-gap: 40px;<br /> }<br /> <br /> .charak-footer {<br /> margin-top: 50px;<br /> padding: 25px;<br /> background: #f0f7ff;<br /> border-radius: 10px;<br /> text-align: center;<br /> border: 1px solid #cce0ff;<br /> }<br /> <br /> .total-chapters {<br /> font-size: 1.2em;<br /> margin-bottom: 15px;<br /> color: #2c5aa0;<br /> }<br /> <br /> .footer-note {<br /> color: #666;<br /> font-size: 0.95em;<br /> max-width: 800px;<br /> margin: 0 auto;<br /> line-height: 1.6;<br /> }<br /> <br /> /* Back to top button */<br /> #BackToTop {<br /> background: #2c5aa0;<br /> border-radius: 50px;<br /> padding: 12px 20px;<br /> bottom: 40px;<br /> left: 40px;<br /> box-shadow: 0 4px 12px rgba(0,0,0,0.15);<br /> }<br /> <br /> #BackToTop span {<br /> color: white !important;<br /> font-size: 0.9em;<br /> border: none;<br /> }<br /> <br /> /* Responsive design */<br /> @media (max-width: 768px) {<br /> .columns-2,<br /> .columns-3 {<br /> column-count: 1;<br /> }<br /> <br /> .sthna-header {<br /> flex-direction: column;<br /> text-align: center;<br /> gap: 15px;<br /> }<br /> <br /> .sthna-number {<br /> font-size: 2.5em;<br /> }<br /> <br /> .chapters-grid {<br /> padding: 20px;<br /> }<br /> <br /> .charak-header h1 {<br /> font-size: 2em;<br /> }<br /> }<br /> <br /> @media (max-width: 480px) {<br /> .charak-index-container {<br /> padding: 10px;<br /> }<br /> <br /> .sthna-header {<br /> padding: 20px 15px;<br /> }<br /> <br /> .chapters-grid {<br /> padding: 15px;<br /> }<br /> <br /> #BackToTop {<br /> bottom: 20px;<br /> left: 20px;<br /> padding: 10px 15px;<br /> }<br /> }<br /> &lt;/style&gt;<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;position:fixed; z-index:9999;&quot;&gt;<br /> &lt;span style=&quot;font-family:verdana,sans-serif; font-weight:bold; display:block;&quot;&gt;<br /> [[#top|↑ Back to Top]]<br /> &lt;/span&gt;<br /> &lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Sandip_Bhagyoday&diff=45399 2026-01-20T13:47:54Z

<p>Agnivesha: </p> <hr /> <div>{{#seo:<br /> |title=Adhyaya (Chapters) - Charak Samhita<br /> |titlemode=append<br /> |keywords=Charak Samhita Adhyaya, Charak Samhita chapters, Charak Samhita Index, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, contents of charak samhita, Indian system of medicine, ayurveda, diagnosis, therapeutics, management, preventive medicine, prognosis of disease, rejuvenation, aphrodisiac therapy, fever, skin diseases, principles of ayurveda, pharmaceutical preparations.<br /> |description=Complete list and links to all one hundred twenty chapters of Charak Samhita organized by sections (Sthana)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=Charak Samhita - Ancient Ayurvedic Text<br /> |type=article<br /> }}<br /> <br /> &lt;div class=&quot;charak-index-container&quot;&gt;<br /> <br /> &lt;div class=&quot;charak-header&quot;&gt;<br /> &lt;h1&gt;Charak Samhita - 120 Chapters (Adhyaya)&lt;/h1&gt;<br /> &lt;p class=&quot;subtitle&quot;&gt;Complete Index of Chapters Organized by Eight Sections (Sthana)&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;charak-navigation&quot;&gt;<br /> &lt;div class=&quot;nav-box&quot;&gt;<br /> &lt;h3&gt;Quick Navigation&lt;/h3&gt;<br /> &lt;div class=&quot;nav-links&quot;&gt;<br /> [[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]&lt;br&gt;<br /> [[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Sutra&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;I&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Sutra Sthana|Section on Fundamental Principles]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Basic principles of Ayurveda, daily regimen, seasonal regimen, and fundamental therapies&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Deerghanjiviteeya Adhyaya|Longevity (Deerghanjiviteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Apamarga Tanduliya Adhyaya|Dehusked Seeds of Apamarga (Apamarga Tanduliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Aragvadhiya Adhyaya|Aragvadha (Cassia) and Other Medicines (Aragvadhiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Shadvirechanashatashritiya Adhyaya|Resources of Six Hundred Evacuatives (Shadvirechanashatashritiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Matrashiteeya Adhyaya|Proper Quantity of Food (Matrashiteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Tasyashiteeya Adhyaya|Seasonal Regimen (Tasyashiteeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Naveganadharaniya Adhyaya|Natural Urges (Naveganadharaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Indriyopakramaniya Adhyaya|Disciplinary Protocol for Sense Organs (Indriyopakramaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Khuddakachatushpada Adhyaya|Four Fundamental Components of Healthcare (Khuddakachatushpada Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Mahachatushpada Adhyaya|Four Important Components of Therapeutics (Mahachatushpada Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Tistraishaniya Adhyaya|Three Desires of Life (Tistraishaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vatakalakaliya Adhyaya|Merits and Demerits of Vata (Vatakalakaliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Sneha Adhyaya|Oleation Therapies (Sneha Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Sweda Adhyaya|Sudation Therapies (Sweda Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Upakalpaniya Adhyaya|Hospital Management Guidelines (Upakalpaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Chikitsaprabhritiya Adhyaya|Assessment in Panchakarma (Chikitsaprabhritiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Kiyanta Shiraseeya Adhyaya|Diseases of Vital Organs (Kiyanta Shiraseeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Trishothiya Adhyaya|Three Types of Swellings (Trishothiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Ashtodariya Adhyaya|Numerical Classification of Diseases (Ashtodariya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Maharoga Adhyaya|Dosha Specific Classification (Maharoga Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Ashtauninditiya Adhyaya|Eight Undesirable Constitutions (Ashtauninditiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Langhanabrimhaniya Adhyaya|Reduction and Nourishing Therapies (Langhanabrimhaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Santarpaniya Adhyaya|Over-nutrition and Under-nutrition (Santarpaniya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vidhishonitiya Adhyaya|Characteristics of Shonita (Blood) (Vidhishonitiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Yajjah Purushiya Adhyaya|Origin of Human Beings (Yajjah Purushiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Atreyabhadrakapyiya Adhyaya|Pharmacological Principles (Atreyabhadrakapyiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Annapanavidhi Adhyaya|Classification of Food and Beverages (Annapanavidhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vividhashitapitiya Adhyaya|Sequential Effects of Food (Vividhashitapitiya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Dashapranayataneeya Adhyaya|Ten Seats of Life Forces (Dashapranayataneeya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Arthedashmahamooliya Adhyaya|Ten Great Vessels from Heart (Arthedashmahamooliya Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Nidana&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;II&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Nidana Sthana|Section on Diagnostic Principles]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Etiology, pathogenesis, and diagnosis of major diseases&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid columns-2&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Jwara Nidana Adhyaya|Diagnosis of Jwara (Fever) (Jwara Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Raktapitta Nidana Adhyaya|Diagnosis of Bleeding Disorders (Raktapitta Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Gulma Nidana Adhyaya|Diagnosis of Abdominal Lumps (Gulma Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Prameha Nidana Adhyaya|Diagnosis of Urinary Disorders (Prameha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Kushtha Nidana Adhyaya|Diagnosis of Skin Diseases (Kushtha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Shosha Nidana Adhyaya|Diagnosis of Wasting Disease (Shosha Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Unmada Nidana Adhyaya|Diagnosis of Psychosis (Unmada Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Apasmara Nidana Adhyaya|Diagnosis of Seizure Disorders (Apasmara Nidana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Vimana&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;III&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Vimana Sthana|Section on Specific Medical Principles]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Detailed knowledge of diseases, channels, and examination methods&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid columns-2&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Rasa Vimana Adhyaya|Taste-based Factors (Rasa Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Trividhakukshiya Vimana Adhyaya|Three Parts of Abdomen (Trividhakukshiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Janapadodhvansaniya Vimana Adhyaya|Destruction of Communities (Janapadodhvansaniya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Trividha Roga Vishesha Vijnaniya Vimana Adhyaya|Three Methods of Disease Knowledge (Trividha Roga Vishesha Vijnaniya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Sroto Vimana Adhyaya|Channels of Transport (Sroto Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Roganika Vimana Adhyaya|Classification of Diseases (Roganika Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vyadhita Rupiya Vimana Adhyaya|Types of Patients (Vyadhita Rupiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Rogabhishagjitiya Vimana Adhyaya|Conquering Debate and Disease (Rogabhishagjitiya Vimana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Sharira&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;IV&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Sharira Sthana|Section on Human Being and Genesis]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Embryology, anatomy, and physiology of human beings&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid columns-2&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Katidhapurusha Sharira Adhyaya|Holistic Human Being (Katidhapurusha Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Atulyagotriya Sharira Adhyaya|Different Clans (Atulyagotriya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Khuddika Garbhavakranti Sharira Adhyaya|Factors for Embryogenesis (Khuddika Garbhavakranti Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Mahatigarbhavakranti Sharira Adhyaya|Embryonic Development (Mahatigarbhavakranti Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Purusha Vichaya Sharira Adhyaya|Detailed Study of Human Being (Purusha Vichaya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Sharira Vichaya Sharira Adhyaya|Analytical Study of Body (Sharira Vichaya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Sharira Sankhya Sharira Adhyaya|Numerological Account (Sharira Sankhya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Jatisutriya Sharira Adhyaya|Obstetrics and Neonatal Care (Jatisutriya Sharira Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Indriya&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;V&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Indriya Sthana|Section on Sensorial Prognosis]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Prognosis based on signs and symptoms from sense organs&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid columns-3&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Varnasvariyam Indriyam Adhyaya|Fatal Signs in Complexion and Voice (Varnasvariyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Pushpitakam Indriyam Adhyaya|Fatal Signs of Tactile and Olfactory Perception (Pushpitakam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Parimarshaneeyam Indriyam Adhyaya|Palpable Signs of Death (Parimarshaneeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Indriyaneekam Indriyam Adhyaya|Fatal Signs in Sense Organs (Indriyaneekam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Purvarupeeyam Indriyam Adhyaya|Prognosis by Prodromal Symptoms (Purvarupeeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Katamanisharireeyam Indriyam Adhyaya|Specific Fatal Clinical Features (Katamanisharireeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Pannarupiyam Indriyam Adhyaya|Changes in Shadows and Complexion (Pannarupiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Avakshiraseeyam Indriyam Adhyaya|Inverted Shadow of Dying Person (Avakshiraseeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Yasyashyavanimittiyam Indriyam Adhyaya|Palliative Care Signs (Yasyashyavanimittiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Sadyomaraneeyam Indriyam Adhyaya|Signs of Instant Death (Sadyomaraneeyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Anujyotiyam Indriyam Adhyaya|Diminution of Agni (Anujyotiyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Gomayachurniyam Indriyam Adhyaya|Characteristics of Messenger (Gomayachurniyam Indriyam Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Chikitsa&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;VI&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Chikitsa Sthana|Section on Therapeutic Principles]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Management and treatment of various diseases&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid columns-2&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Rasayana Adhyaya|Rejuvenation Therapy (Rasayana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vajikarana Adhyaya|Aphrodisiac Therapy (Vajikarana Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Jwara Chikitsa Adhyaya|Management of Jwara (Fever) (Jwara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Raktapitta Chikitsa Adhyaya|Management of Bleeding Disorders (Raktapitta Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Gulma Chikitsa Adhyaya|Management of Gulma (Gulma Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Prameha Chikitsa Adhyaya|Management of Urinary Disorders (Prameha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Kushtha Chikitsa Adhyaya|Management of Skin Diseases (Kushtha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Rajayakshma Chikitsa Adhyaya|Management of Wasting Diseases (Rajayakshma Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Unmada Chikitsa Adhyaya|Management of Psychosis (Unmada Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Apasmara Chikitsa Adhyaya|Management of Seizure Disorders (Apasmara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Kshatakshina Chikitsa Adhyaya|Management of Emaciation due to Trauma (Kshatakshina Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Shvayathu Chikitsa Adhyaya|Management of Swellings (Shvayathu Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Udara Chikitsa Adhyaya|Management of Abdominal Enlargement (Udara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Arsha Chikitsa Adhyaya|Management of Hemorrhoids (Arsha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Grahani Chikitsa Adhyaya|Management of Digestive Diseases (Grahani Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Pandu Chikitsa Adhyaya|Management of Anemia (Pandu Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Hikka Shwasa Chikitsa Adhyaya|Management of Hiccups and Dyspnea (Hikka Shwasa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Kasa Chikitsa Adhyaya|Management of Cough (Kasa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Atisara Chikitsa Adhyaya|Management of Diarrhea (Atisara Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Chhardi Chikitsa Adhyaya|Management of Vomiting (Chhardi Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Visarpa Chikitsa Adhyaya|Management of Acute Spreading Erysipelas (Visarpa Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Trishna Chikitsa Adhyaya|Management of Morbid Thirst (Trishna Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Visha Chikitsa Adhyaya|Management of Poisoning (Visha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Madatyaya Chikitsa Adhyaya|Management of Intoxication (Madatyaya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Dwivraniya Chikitsa Adhyaya|Management of Ulcers (Dwivraniya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Trimarmiya Chikitsa Adhyaya|Management of Three Vital Organs (Trimarmiya Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Urustambha Chikitsa Adhyaya|Management of Thigh and Hip Diseases (Urustambha Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vatavyadhi Chikitsa Adhyaya|Management of Vata Diseases (Vatavyadhi Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vatarakta Chikitsa Adhyaya|Management of Vata and Rakta Diseases (Vatarakta Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Yonivyapat Chikitsa Adhyaya|Management of Genital Tract Disorders (Yonivyapat Chikitsa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Kalpa&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;VII&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Kalpa Sthana|Section on Pharmaceutical Preparations]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Formulation and preparation of medicinal compounds&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid columns-3&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Madana Kalpa Adhyaya|Preparations of Madanaphala (Madana Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Jimutaka Kalpa Adhyaya|Preparations of Jimutaka (Jimutaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Ikshvaku Kalpa Adhyaya|Preparations of Ikshvaku (Ikshvaku Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Dhamargava Kalpa Adhyaya|Preparations of Dhamargava (Dhamargava Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vatsaka Kalpa Adhyaya|Preparations of Vatsaka (Vatsaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Kritavedhana Kalpa Adhyaya|Preparations of Kritavedhana (Kritavedhana Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Shyamatrivrita Kalpa Adhyaya|Preparations of Shyama Trivrita (Shyamatrivrita Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Chaturangula Kalpa Adhyaya|Preparations of Chaturangula (Chaturangula Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Tilvaka Kalpa Adhyaya|Preparations of Tilvaka (Tilvaka Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Sudha Kalpa Adhyaya|Preparations of Sudha (Sudha Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Saptalashankhini Kalpa Adhyaya|Preparations of Saptala and Shankhini (Saptalashankhini Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Dantidravanti Kalpa Adhyaya|Preparations of Danti and Dravanti (Dantidravanti Kalpa Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;sthna-section&quot; id=&quot;Siddhi&quot;&gt;<br /> &lt;div class=&quot;sthna-header&quot;&gt;<br /> &lt;div class=&quot;sthna-number&quot;&gt;VIII&lt;/div&gt;<br /> &lt;div class=&quot;sthna-title&quot;&gt;<br /> &lt;h2&gt;[[Siddhi Sthana|Section on Therapeutic Procedures]]&lt;/h2&gt;<br /> &lt;p class=&quot;sthna-desc&quot;&gt;Administration of purification therapies and Panchakarma&lt;/p&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;chapters-grid columns-3&quot;&gt;<br /> &lt;ol start=&quot;1&quot;&gt;<br /> &lt;li&gt;'''[[Kalpana Siddhi Adhyaya|Standard Administration of Purification (Kalpana Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Panchakarmiya Siddhi Adhyaya|Successful Panchakarma Administration (Panchakarmiya Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Bastisutriyam Siddhi Adhyaya|Standard Practices of Basti (Bastisutriyam Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Snehavyapat Siddhi Adhyaya|Complications of Unctuous Enema (Snehavyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle (Netrabastivyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation (Vamana Virechana Vyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema (Bastivyapat Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations (Prasrita Yogiyam Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs (Trimarmiya Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Basti Siddhi Adhyaya|Successful Enema Administration (Basti Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits (Phalamatra Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;li&gt;'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema (Uttar Basti Siddhi Adhyaya)]]'''&lt;/li&gt;<br /> &lt;/ol&gt;<br /> &lt;/div&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div class=&quot;charak-footer&quot;&gt;<br /> &lt;div class=&quot;total-chapters&quot;&gt;<br /> &lt;strong&gt;Total Chapters: 120&lt;/strong&gt; | &lt;strong&gt;Sections: 8&lt;/strong&gt;<br /> &lt;/div&gt;<br /> &lt;p class=&quot;footer-note&quot;&gt;This index provides links to all chapters of Charak Samhita, the foundational text of Ayurveda. Each section (Sthana) covers specific aspects of Ayurvedic knowledge and practice.&lt;/p&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;/div&gt;<br /> <br /> &lt;style&gt;<br /> .charak-index-container {<br /> max-width: 1200px;<br /> margin: 0 auto;<br /> padding: 20px;<br /> font-family: 'Segoe UI', Tahoma, Geneva, Verdana, sans-serif;<br /> }<br /> <br /> .charak-header {<br /> text-align: center;<br /> margin-bottom: 40px;<br /> padding-bottom: 20px;<br /> border-bottom: 3px solid #2c5aa0;<br /> }<br /> <br /> .charak-header h1 {<br /> color: #2c5aa0;<br /> margin-bottom: 10px;<br /> font-size: 2.5em;<br /> }<br /> <br /> .charak-header .subtitle {<br /> color: #666;<br /> font-size: 1.1em;<br /> font-style: italic;<br /> }<br /> <br /> .charak-navigation {<br /> margin-bottom: 30px;<br /> }<br /> <br /> .nav-box {<br /> background: #f0f7ff;<br /> border: 2px solid #2c5aa0;<br /> border-radius: 10px;<br /> padding: 15px;<br /> text-align: center;<br /> }<br /> <br /> .nav-box h3 {<br /> margin-top: 0;<br /> color: #2c5aa0;<br /> }<br /> <br /> .nav-links {<br /> font-size: 1.1em;<br /> line-height: 1.6;<br /> }<br /> <br /> .sthna-section {<br /> margin-bottom: 50px;<br /> background: white;<br /> border-radius: 12px;<br /> box-shadow: 0 4px 15px rgba(0,0,0,0.08);<br /> overflow: hidden;<br /> border: 1px solid #e0e0e0;<br /> }<br /> <br /> .sthna-header {<br /> background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%);<br /> color: white;<br /> padding: 25px;<br /> display: flex;<br /> align-items: center;<br /> gap: 25px;<br /> }<br /> <br /> .sthna-number {<br /> font-size: 3em;<br /> font-weight: bold;<br /> opacity: 0.9;<br /> min-width: 60px;<br /> }<br /> <br /> .sthna-title h2 {<br /> margin: 0 0 10px 0;<br /> font-size: 1.8em;<br /> }<br /> <br /> .sthna-title h2 a {<br /> color: white !important;<br /> text-decoration: none;<br /> }<br /> <br /> .sthna-title h2 a:hover {<br /> text-decoration: underline;<br /> }<br /> <br /> .sthna-desc {<br /> margin: 0;<br /> opacity: 0.9;<br /> font-size: 1em;<br /> }<br /> <br /> .chapters-grid {<br /> padding: 30px;<br /> }<br /> <br /> .chapters-grid ol {<br /> margin: 0;<br /> padding-left: 20px;<br /> }<br /> <br /> .chapters-grid li {<br /> margin-bottom: 12px;<br /> line-height: 1.5;<br /> padding: 8px 0;<br /> border-bottom: 1px dashed #eee;<br /> transition: all 0.2s ease;<br /> }<br /> <br /> .chapters-grid li:hover {<br /> background: #f9f9f9;<br /> padding-left: 10px;<br /> border-bottom-color: #2c5aa0;<br /> }<br /> <br /> .chapters-grid li a {<br /> color: #2c5aa0;<br /> text-decoration: none;<br /> font-weight: 500;<br /> }<br /> <br /> .chapters-grid li a:hover {<br /> text-decoration: underline;<br /> color: #1a3d7a;<br /> }<br /> <br /> /* Responsive columns */<br /> .columns-2 {<br /> column-count: 2;<br /> column-gap: 40px;<br /> }<br /> <br /> .columns-3 {<br /> column-count: 3;<br /> column-gap: 40px;<br /> }<br /> <br /> .charak-footer {<br /> margin-top: 50px;<br /> padding: 25px;<br /> background: #f0f7ff;<br /> border-radius: 10px;<br /> text-align: center;<br /> border: 1px solid #cce0ff;<br /> }<br /> <br /> .total-chapters {<br /> font-size: 1.2em;<br /> margin-bottom: 15px;<br /> color: #2c5aa0;<br /> }<br /> <br /> .footer-note {<br /> color: #666;<br /> font-size: 0.95em;<br /> max-width: 800px;<br /> margin: 0 auto;<br /> line-height: 1.6;<br /> }<br /> <br /> /* Back to top button */<br /> #BackToTop {<br /> background: #2c5aa0;<br /> border-radius: 50px;<br /> padding: 12px 20px;<br /> bottom: 40px;<br /> left: 40px;<br /> }<br /> <br /> #BackToTop span {<br /> color: white !important;<br /> font-size: 0.9em;<br /> border: none;<br /> }<br /> <br /> /* Responsive design */<br /> @media (max-width: 768px) {<br /> .columns-2,<br /> .columns-3 {<br /> column-count: 1;<br /> }<br /> <br /> .sthna-header {<br /> flex-direction: column;<br /> text-align: center;<br /> gap: 15px;<br /> }<br /> <br /> .sthna-number {<br /> font-size: 2.5em;<br /> }<br /> <br /> .chapters-grid {<br /> padding: 20px;<br /> }<br /> <br /> .charak-header h1 {<br /> font-size: 2em;<br /> }<br /> }<br /> <br /> @media (max-width: 480px) {<br /> .charak-index-container {<br /> padding: 10px;<br /> }<br /> <br /> .sthna-header {<br /> padding: 20px 15px;<br /> }<br /> <br /> .chapters-grid {<br /> padding: 15px;<br /> }<br /> }<br /> &lt;/style&gt;<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#2c5aa0; position:fixed; bottom:40px; left:40px; z-index:9999; padding:0; margin:0; border-radius:50px; box-shadow:0 4px 12px rgba(0,0,0,0.15);&quot;&gt;<br /> &lt;span style=&quot;color:white; font-size:0.9em; font-family:verdana,sans-serif; padding:12px 20px; font-weight:bold; display:block;&quot;&gt;<br /> [[#top|↑ Back to Top]]<br /> &lt;/span&gt;<br /> &lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Main_Page&diff=45398 2026-01-20T13:41:16Z

<p>Agnivesha: </p> <hr /> <div>__NOTOC__<br /> ‎&lt;no-comment-streams /&gt;<br /> {{#seo:<br /> |title=Charak Samhita<br /> |titlemode=append<br /> |keywords=Charak Samhita, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, ancient Ayurveda text, Indian system of medicine, Ayurveda, Charak, Charaka Samhita, agnivesha, atreya, gopal basisht, yogesh deole, charak samhita wikipedia edition, charak samhita new edition, charaka samhita new edition, carak samhita new edition, caraka samhita new edition, research on charak samhita, text book charak samhita, fundamental principles of ayurveda, basic concepts of ayurveda, diagnostic principles of ayurveda, diagnosis of diseases in ayurveda, specific knowledge of ayurveda, holistic human being, holistic system of medicine, sensorial prognosis, therapeutics, pharmacological, pharmaceutical preparations, therapeutic procedures, detoxication, biopurification, panchakarma procedures, new research in ayurveda, new texts, online ayurveda text, learn ayurveda, what is ayurveda, what is charak samhita?Smriti,Prakriti,Satmya,Aatma,Purusha,Panchamahabhuta,Akasha mahabhuta,Vayu mahabhuta,Agni mahabhuta,Jala mahabhuta,Prithvi mahabhuta,Dhatu,Rasa dhatu,Rakta dhatu,Mamsa dhatu,Meda dhatu,Asthi dhatu,Majja dhatu,Shukra dhatu,Ojas,Ahara vidhi,Tantrayukti,Guna,Panchakarma,Menstrual disorders,Prenatal care (garbhini paricharya),Kha vaigunya,Shatkriyakala,Ayurveda,Snehana (unction therapy),Swedana,Vamana,Virechana,Basti,Nasya,Raktamokshana,Mala,Purisha,Mutra,Garbha‎‎,Contraceptives,‎‎Artava,Dosha,Dinacharya,<br /> Infectious diseases,Prajnaparadha,Langhana,Indriya,Brimhana,Deepana,Rukshana,Pachana,Stambhana,Rasayana,Vajikarana,Aushadha Sevana Kala,<br /> Acid peptic diseases‎‎,Manas (Mind and mental health),Preface- Charak Samhita New Edition,Obesity and Metabolic Syndrome,Nidra, Cardiac diseases,Sutika Paricharya, Buddhi,Hetu, Interactive session on Contemporary Ayurveda,Menopausal Syndrome,Congenital disorders,Neurological diseases,Vyadhi,Neonatal care,Amavata,Agni,Skin diseases in Integrative Medicine,Pramana, Emergency medicine in Ayurveda,Deha Prakriti,Immunization,Kidney diseases,Manas Prakriti, Pratyaksha pramana, Psychiatric diseases,‎‎Cancer,Rheumatic diseases,<br /> Panchakarma in modern lifestyle,Kaarya Kaarana Siddhanta,Aaptopadesha pramana (knowledge by authoritative statement),Jwara (various fevers),Samanya Vishesha Siddhanta (Theory of similarity and dissimilarity),Karma (action),Anumana pramana (knowledge by inference),<br /> Yukti pramana (knowledge by logical application),Disha (directions),Upamana pramana (knowledge by analogy),Linga (symptomatology/features),Adhyayana (Methods of study and learning),Koshtha (gut pattern),Samavaya,Padartha,Abhava,Dravya,Vipaka,<br /> Kala,Sweda,Ayu,Sattva,Dhatvagni, Sharira, Brahmacharya, Bhutagni,Avyakta,Vata dosha,Marma,Madhutailika Basti,Rasa,Vaitarana Basti,Tamas,<br /> Tanmatra,Upavasa,Aushadha,Ritucharya,Pitta dosha,Kapha dosha,Piccha basti, Vikriti,Vyayama,Veerya,Samadhi,Swabhavoparam vada,Rajas,<br /> Prabhava,Shastra, Rogamarga,Dhriti,Dhairya,Srotasa,Janapadodhvansa,Kala Sharira,Varna, Viruddha Ahara,Dhumapana,Ashayapakarsha,Ama,<br /> Shirodhara,Asthapana basti,Yapana basti,Adharma,Samhanana,Aupasargika vyadhi,Pranavaha srotas,Annavaha srotas,Stanya,Nitya sevaniya - asevaniya dravya,Matra basti,Pakshaghata,Udakavaha Srotas,Manovaha Srotas,Pramanatah Pariksha,Udavarta,Adhyapana vidhi, <br /> |description=Charak Samhita is Ayurveda’s definitive treatise and the most referenced text by students, scholars, teachers, physicians and researchers. It has the unique distinction of being the only text available worldwide on restorative science.<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;div style=&quot;border-bottom:1px solid #7cd0ea;background-color:#FFFFFF; text-align:center;border:1px solid #000080; border-radius:8px;padding:0.2em 0.9em 0.2em 0.5em; font-size:160%; font-weight:bold;&quot;&gt;&lt;span style=&quot;color:#00008b&quot;&gt;[[Preface- Charak Samhita New Edition|Charak Samhita New Edition]]&lt;/span&gt;<br /> <br /> &lt;span style=&quot;color:#00008b&quot;&gt;The Definitive Online Edition of [[Ayurveda]]'s Core Treatise on Healthcare with [[Special:Statistics|{{NUMBEROFARTICLES}}]] articles&lt;/span&gt;<br /> &lt;/div&gt;<br /> <br /> &lt;div style=&quot;padding-top:0.50em;margin-bottom: 0.5em; margin-top: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;&quot;&gt;<br /> &lt;h2 id=&quot;mp-dyk-h2_3&quot; style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:160%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;&quot;&gt;&lt;span style=&quot;color:#00008b&quot;&gt;[[Preface- Charak Samhita New Edition|&lt;span style=&quot;color:#000080&quot;&gt;Charak Samhita - Ayurveda's Core Text&lt;/span&gt;]]&lt;/h2&gt;&lt;/div&gt;<br /> <br /> &lt;div style=&quot;width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;&quot;&gt;<br /> &lt;h2 id=&quot;mp-dyk-h2&quot; style=&quot;clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;&quot;&gt;&lt;span style=&quot;color:#00008b&quot;&gt;[[Contents|Contents]]&lt;/span&gt;&lt;/h2&gt;<br /> &lt;div style=&quot;padding:0.1em 0.6em 0.5em;&quot;&gt;<br /> &lt;div style=&quot;-moz-column-width: 20em; -webkit-column-width: 20em; column-width: 20em; width:auto; font-style: normal;&quot;&gt;<br /> &lt;ul&gt;<br /> &lt;li&gt;'''[[Sutra Sthana| I. Section on fundamental principles]] ''' '''([[Sutra Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[Nidana Sthana| II. Section on diagnostic principles]]''' '''([[Nidana Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[Vimana Sthana| III. Section on specific medical principles]]''' '''([[Vimana Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[Sharira Sthana| IV. Section on human being and genesis]]''' '''([[Sharira Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[ Indriya Sthana| V. Section on sensorial prognosis]] ''' '''([[Indriya Sthana]])''' &lt;/li&gt;<br /> &lt;/ul&gt;&lt;ul&gt;<br /> &lt;li&gt;'''[[Chikitsa Sthana| VI. Section on therapeutic principles]] ''' '''([[Chikitsa Sthana]])''' &lt;/li&gt;<br /> &lt;li&gt;'''[[Kalpa Sthana| VII. 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Agnivesha https://www.carakasamhitaonline.com/index.php?title=Shyamatrivrita_Kalpa_Adhyaya&diff=45397 2026-01-13T05:03:10Z

<p>Agnivesha: /* Preparations of Trivrita along with Jivaka, etc. */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Shyamatrivrita Kalpa Adhyaya<br /> |titlemode=append<br /> |keywords=Shyama, Trivrita, Virechana, Operculana turpenthum Linn., purgation, Ayurveda, Indian system of medicine, charak samhita.<br /> |description=Kalpa Sthana Chapter 7. Pharmaceutical preparations of Shyama Trivrita<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Kalpa Sthana]] Chapter 7. Pharmaceutical preparations of Shyama Trivrita '''&lt;/big&gt;<br /> {{Infobox<br /> |title = Shyamatrivrita Kalpa Adhyaya<br /> |label1 = Section/Chapter<br /> |data1 = [[Kalpa Sthana]] Chapter 7<br /> |label2 = Preceding Chapter<br /> |data2 = [[Kritavedhana Kalpa Adhyaya]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Chaturangula Kalpa Adhyaya]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Sitaram B., Sawant B.<br /> |label7 = Reviewer <br /> |data7 = Sawant B., Nishteswar K.<br /> |label8 = Editors<br /> |data8 = Nishteswar K., Sawant B., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s07.008 10.47468/CSNE.2020.e01.s07.008]<br /> }}<br /> &lt;big&gt;'''Abstract'''&lt;/big&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The seventh Chapter of [[Kalpa Sthana]] deals with the pharmaceutical preparations for ''virechana karma'' (purgative therapy) using ''Shyama'' and ''Trivrita''. ''Trivrita'', is considered best purgative because of its effectiveness and minimal side effects. The chapter describes synonyms of the plant, its morphology, pharmacological properties, the varieties of plant with their different indications and untoward effects, the method of collection of the plant part used i.e. the root and its storage are also described. Then, one hundred and ten preparations using ''Trivrita'' or ''Shyama'' or combination of these two drugs are enlisted. Proportions of different drugs that are to be used along with the main drug are discussed and the dosage to different individuals is also presented. Recipes made of ''Trivrita'' or ''Shyama'' are formulated in such a way to suit any individual depending upon the seasons and climatic conditions.&lt;br/&gt;<br /> <br /> '''Keywords''': Shyama, Trivrita, [[Virechana]], Operculana turpenthum Linn., purgation.<br /> &lt;/p&gt;<br /> <br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> The first six chapters of this section dealt with preparations used for [[Vamana]] Karma (therapeutic emesis). The preparations aimed at [[Virechana]] Karma (therapeutic purgation) begin with this chapter and are extended in five more chapters. ''Trivrita'' is considered the best as it causes very little side effects and less spasmodic pain during the process of purgation, that is the reason many recipes of this drug are being described.<br /> <br /> The action of [[Virechana]] drugs known as laxatives or purgatives or cathartics varies depending upon the drug used. The different varieties of drugs used in modern medicine act according to their structure and chemical composition. The latency and effect of all laxatives vary with dosage. In sufficiently high dosage, many laxatives promote catharsis, which implies purgation with more fluid evacuation. Generally many of the drugs used in [[Ayurveda]] for catharsis or laxative action are stimulant laxatives. These drugs stimulate accumulation of water and electrolytes in the colonic lumen and they also enhance intestinal motility. Anthraquinones that are present in many of the Ayurvedic drugs like ''Haritaki, Aragvadha'' or ''Trivrita'' exert their action similarly. They reduce net absorption of electrolytes and water and also increase the permeability of the mucosa, possibly by making tight junctions leaky. This persistent action allows fats to secrete through the intestinal mucosa there by reducing the overall levels of triglycerides in the body. Many of the laxatives of this type increase the synthesis of prostaglandins and this action may contribute to increased secretion of water and electrolytes and is a factor for the spasmodic pain during the process of catharsis. In the present chapter, purgative preparations of ''Trivrita'' are described.<br /> <br /> == Sanskrit Text, Transliteration with English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातः श्यामात्रिवृत्कल्पं व्याख्यास्यामः ||१||<br /> <br /> इति ह स्माह भगवानात्रेयः ||२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athatah shyamatrivrutkalpam vyakhyasyamah ||1|| <br /> <br /> iti ha smaha bhagavanatreyah ||2|| <br /> <br /> athatah shyamatrivrutkalpam vyakhyasyamah||1|| <br /> <br /> iti ha smaha bhagavanatreyah||2|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now we shall expound the chapter &quot;Shyamatrivrita Kalpa&quot; (Pharmaceutical preparations of Shyama Trivrita). Thus said Lord Atreya.[1-2]<br /> <br /> === Importance of ''Trivrita'' as a Purgative ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विरेचने त्रिवृन्मूलं श्रेष्ठमाहुर्मनीषिणः |<br /> <br /> तस्याः सञ्ज्ञा गुणाः कर्म भेदः कल्पश्च वक्ष्यते ||३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> virechane trivrunmulam shreshthamahurmanishinah | <br /> <br /> tasyah saungya gunah karma bhedah kalpashcha vakshyate ||3|| <br /> <br /> virechane trivrunmulam shreshthamahurmanishinah | <br /> <br /> tasyah saungya gunah karma bhedah kalpashcha vakshyate||3|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> According to physicians who are knowledgeable and wise, the root of ''Trivrita'' is considered the best among the purgative drugs. Now, its identity in the form of Synonyms, Pharmacological properties, Therapeutic actions, varieties or types and recipes will be described (in the following verses). [3]<br /> <br /> === Identity and Synonyms ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिभण्डी त्रिवृता चैव श्यामा कूटरणा तथा | <br /> <br /> सर्वानुभूतिः सुवहा शब्दैः पर्यायवाचकैः ||४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tribhandi trivruta chaiva shyama kutarana tatha | <br /> <br /> sarvanubhutih suvaha shabdaih paryayavachakaihi ||4|| <br /> <br /> tribhandi trivruta chaiva shyama kutarana tatha| <br /> <br /> sarvanubhutih suvaha shabdaih paryayavachakaihi ||4|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Tribhandi, Trivrita, Shyama, Kutarana, Sarvanubhuti'' and ''Suvaha'' are the synonyms of the drug ''Trivrita''. [4]<br /> <br /> === Properties ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कषाया मधुरा रूक्षा विपाके कटुका च सा | &lt;br /&gt;<br /> कफपित्तप्रशमनी रौक्ष्याच्चानिलकोपनी ||५|| &lt;br /&gt;<br /> <br /> सेदानीमौषधैर्युक्ता वातपित्तकफापहैः | &lt;br /&gt;<br /> कल्पवैशेष्यमासाद्य सर्वरोगहरा भवेत् ||६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kashaya madhura ruksha vipake katuka cha sa | &lt;br /&gt;<br /> kaphapittaprashamani raukshyacchaanilakopani ||5|| &lt;br /&gt;<br /> <br /> sedanimaushadhairyukta vatapittakaphapahaih | &lt;br /&gt;<br /> kalpavaisheshyamasadya sarvarogahara bhavet ||6|| &lt;br /&gt;<br /> <br /> kashaya madhura ruksha vipake katuka cha sa| &lt;br /&gt;<br /> kaphapittaprashamani raukshyacchaanilakopani||5|| &lt;br /&gt;<br /> <br /> sedanimaushadhairyukta vatapittakaphapahaih| &lt;br /&gt;<br /> kalpavaisheshyamasadya [1] sarvarogahara bhavet||6|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Trivrita'' is astringent and sweet in taste, dry (not oily or creamy) and pungent in ''vipaka'' (post digestive effect). Due to its dry property it pacifies [[kapha]] and [[pitta]] and aggravates [[vata]]. Even then, when utilized along with drugs which pacify [[vata]], [[pitta]] and [[kapha]] and also depending upon the combinations used in various pharmaceutical preparations, this drug attains the capacity of curing all types of diseases. [5-6]<br /> <br /> === Types of ''Trivrita'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मूलं तु द्विविधं तस्याः श्यामं चारुणमेव च |<br /> <br /> तयोर्मुख्यतरं विद्धि मूलं यदरुणप्रभम् ||७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mulam tu dvividham tasyah shyamam charunameva cha | <br /> <br /> tayormukhyataram viddhi mulam yadarunaprabham ||7|| <br /> <br /> mulam tu dvividham tasyah shyamam charunameva cha| <br /> <br /> tayormukhyataram viddhi mulam yadarunaprabham||7|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Roots of the plant ''Trivrita'' are of two types. The one that is black (''shyama'') is more beneficial than the other blackish red one. [7]<br /> <br /> === Utility of Pink Variety ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सुकुमारे शिशौ वृद्धे मृदुकोष्ठे च तच्छुभम् | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sukumare shishau vruddhe mrudukoshthe cha tacchubham ||7½ |||<br /> <br /> sukumare shishau vruddhe mrudukoshthe cha tacchubham | <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The root of the Trivruta having blackish red color can be used as a purgative drug, for persons having delicate health, for children, for aged and for persons having laxed bowel (''Mridu koshtha'') [7½]<br /> <br /> === Utility of Black variety ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मोहयेदाशुकारित्वाच्छ्यामा क्षिण्वीत मूर्च्छयेत् ||८||<br /> <br /> तैक्ष्ण्यात् कर्षति हृत्कण्ठमाशु दोषं हरत्यपि | <br /> <br /> शस्यते बहुदोषाणां क्रूरकोष्ठाश्च ये नराः ||९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mohayedashukaritvacchyama kshinvita murcchayet ||8|| <br /> <br /> taikshnyat karshati hrutkanthamashu dosham haratyapi | <br /> <br /> shasyate bahudoshanam krurakoshthashcha ye narah ||9|| <br /> <br /> mohayedashukaritvacchyama kshinvita murcchayet ||8|| <br /> <br /> taikshnyat karshati hrutkanthamashu dosham haratyapi| <br /> <br /> shasyate bahudoshanam krurakoshthashcha ye narah||9||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The root of the ''Trivrita'' having black colour, when used for purgative action, due to its instantaneous action, leads to unconsciousness, loss (of tissue elements or in another sense, electrolytes) and fainting. Due to its rapid action, it causes spasmodic pain (torment) in the cardiac region and throat. It eliminates the morbid (accumulated) material instantaneously. Hence, this variety is highly useful in persons having excessively aggravated [[dosha]] and highly constipated bowel (''Krura koshtha'') [7 ½ -9]<br /> <br /> === Method of collection ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुणवत्यां तयोर्भूमौ जातं मूलं समुद्धरेत् |<br /> <br /> उपोष्य प्रयतः शुक्ले शुक्लवासाः समाहितः ||१०|| <br /> <br /> गम्भीरानुगतं श्लक्ष्णमतिर्यग्विसृतं च यत् | <br /> <br /> तद्विपाट्योद्धरेद्गर्भं त्वचं शुष्कां निधापयेत् ||११|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gunavatyam tayorbhumau jatam mulam samuddharet | <br /> <br /> uposhya prayatah shukle shuklavasah samahitah ||10|| <br /> <br /> gambhiranugatam shlakshnamatiryagvisrutam cha yat | <br /> <br /> tadvipatyoddharedgarbham tvacham shushkam nidhapayet ||11|| <br /> <br /> gunavatyam tayorbhumau jatam mulam samuddharet| <br /> <br /> uposhya prayatah shukle shuklavasah samahitah||10|| <br /> <br /> gambhiranugatam shlakshnamatiryagvisrutam cha yat| <br /> <br /> tadvipatyoddharedgarbham [1] tvacham shushkam nidhapayet||11||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Both the varieties of the ''Trivrita'' root, growing in good soil, should be uprooted from the ground by a person who has observed fast, in ''Shukla Paksha'', who is wearing white colored formal clothing and who has got concentration of mind. The roots should have deeply penetrated, smooth (without nodes or side roots), and not spreading sideways. Then, these roots are to be split and the pith is to be removed. Then, the root bark is to be separated. When the bark of the root is completely dried, it is to be appropriately preserved. [10-11]<br /> <br /> === Preparatory measures ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्निग्धस्विन्नो विरेच्यस्तु पेयामात्रोषितः सुखम् |१२|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snigdhasvinno virechyastu peyamatroshitah sukham |12| <br /> <br /> snigdhasvinno virechyastu peyamatroshitah sukham|12| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The person who has undergone oleation and fomentation therapies (who is ready to be given purgative drug the next day, is to be given ''peya'' (gruel made of cereals, which is thin) as food in the previous night so that, he purges with ease (in the next morning, after administration of the purgative drug). [11 ½]<br /> <br /> === Preparations of ''Trivrita'' along with sour liquid etc. ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अक्षमात्रं तयोः पिण्डं विनीयाम्लेन ना पिबेत् ||१२|| <br /> <br /> गोऽव्यजामहिषीमूत्रसौवीरकतुषोदकैः | <br /> <br /> प्रसन्नया त्रिफलया शृतया च पृथक् पिबेत् ||१३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> akshamatram tayoh pindam viniyamlena na pibet ||12|| <br /> <br /> goavyajamahishimutrasauvirakatushodakaih | <br /> <br /> prasannaya triphalaya shrutaya cha pruthak pibet ||13|| <br /> <br /> akshamatram tayoh pindam viniyamlena na pibet||12|| <br /> <br /> goavyajamahishimutrasauvirakatushodakaih| <br /> <br /> prasannaya triphalaya shrutaya cha pruthak pibet||13|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Grinded paste of, either of the roots of ''Trivrita'' or in combination, in a round bolus form (''pinda''), in a dose of around 12 Gms. (one ''aksha'') should be mixed with sour drinks (''kanjika''), and can be taken in by a person (who is to be purgated).<br /> <br /> Similarly, urine of cow, sheep, goat or she-buffalo, vinegar (''sauviraka''), a sour drink prepared of raw barley (''tushodaka''), a type of diluted wine (''Prasanna'') or the decoction of ''Triphala'' should be used separately to take this paste of ''Trivrita''. [11 ½ - 13]<br /> <br /> === Preparations of ''Trivrita'' in powder form ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> एकैकं सैन्धवादीनां द्वादशानां सनागरम् | &lt;br /&gt;<br /> त्रिवृद्द्विगुणसंयुक्तं चूर्णमुष्णाम्बुना पिबेत् ||१४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ekaikam saindhavadinam dvadashanam sanagaram | &lt;br /&gt;<br /> trivrddvigunasamyuktam churnamushnambuna pibet ||14|| &lt;br /&gt;<br /> <br /> ekaikam saindhavadinam dvadashanam sanagaram| &lt;br /&gt;<br /> trivruddvigunasamyuktam churnamushnambuna pibet||14|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Two parts of ''Trivrita'' root powder may be mixed with one part of salt out of its twelve types (''Saindhava, Sauvarchala, Kala, Bida, Pakya, Anupa, Kupya, Valukaja, Maulaka, Samudra, Romaka,'' and ''Audbhida''). These preparations should be taken in along with ''Nagara'' (dry ginger powder) and hot water. [14]<br /> <br /> === Preparations of ''Trivrita'' to be taken along with Cow Urine ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पिप्पली पिप्पलीमूलं मरिचं गजपिप्पली | &lt;br /&gt;<br /> सरलः किलिमं हिङ्गु भार्गी तेजोवती तथा ||१५|| &lt;br /&gt;<br /> <br /> मुस्तं हैमवती पथ्या चित्रको रजनी वचा | &lt;br /&gt;<br /> स्वर्णक्षीर्यजमोदा च शृङ्गवेरं च तैः पृथक् ||१६|| &lt;br /&gt;<br /> <br /> एकैकार्धांशसंयुक्तं पिबेद्गोमूत्रसंयुतम् |१७| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pippali pippalimulam maricham gajapippali | &lt;br /&gt;<br /> saralah kilimam hingu bhargi tejovati tatha ||15|| &lt;br /&gt;<br /> <br /> mustam haimavati pathya chitrako rajani vacha | &lt;br /&gt;<br /> svarnakshiryajamoda cha shrungaveram cha taih pruthak ||16|| &lt;br /&gt;<br /> <br /> ekaikardhamshasamyuktam pibedgomutrasamyutam |17| &lt;br /&gt;<br /> <br /> pippali pippalimulam maricham gajapippali| &lt;br /&gt;<br /> saralah kilimam hingu bhargi tejovati tatha||15|| &lt;br /&gt;<br /> <br /> mustam haimavati pathya chitrako rajani vacha| &lt;br /&gt;<br /> svarnakshiryajamoda cha shrungaveram cha taih pruthak||16|| &lt;br /&gt;<br /> <br /> ekaikardhamshasamyuktam pibedgomutrasamyutam|17|&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One part of ''Trivrita'' root powdered should be added with half part of the powder of either ''Pippali, Pippalimula, Maricha, Gajapippali, Sarala, Kilima, Hingu, Bharngi, Tejovati, Musta, Haimavati, Pathya, Chitraka, Rajani (Haridra), Vacha, Svarna Kshiri, Ajamoda,'' or ''Shringavera''. Any one of these may be taken in, along with cow urine for purgation. [15-16- 16 ½]<br /> <br /> === Preparation of ''Trivrita'' along with ''Madhuka'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मधुकार्धांशसंयुक्तं शर्कराम्बुयुतं पिबेत् ||१७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> madhukardhamshasamyuktam sharkarambuyutam pibet ||17|| <br /> <br /> madhukardhamshasamyuktam sharkarambuyutam pibet||17|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Half part of ''Madhuka'' (''Yashtimadhu'') powder may be added with one part of ''Trivrita'' powder this mixture can be taken in along with sugar water for purgation. [17]<br /> <br /> === Preparations of ''Trivrita'' along with ''Jivaka'', etc. ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> जीवकर्षभकौ मेदां श्रावणीं कर्काटाह्वयाम् | &lt;br /&gt;<br /> मुद्गमाषाख्यपर्ण्यौ च महतीं श्रावणीं तथा ||१८|| &lt;br /&gt;<br /> <br /> काकोलीं क्षीरकाकोलीमिन्द्रां छिन्नरुहां तथा | &lt;br /&gt;<br /> क्षीरशुक्लां पयस्यां च यष्ट्याह्वं विधिना पिबेत् ||१९|| &lt;br /&gt;<br /> <br /> वातपित्तहितान्येतान्यन्यानि तु कफानिले |२०| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> jivakarhushabhakau medam shravanim karkatahvayam | &lt;br /&gt;<br /> mudgamashakhyaparnyau cha mahatim shravanim tatha ||18|| &lt;br /&gt;<br /> <br /> kakolim kshirakakolimindram chinnaruham tatha | &lt;br /&gt;<br /> kshirashuklam payasyam cha yashtyahvam vidhina pibet ||19|| &lt;br /&gt;<br /> <br /> vatapittahitanyetanyanyani tu kaphanile |20| &lt;br /&gt;<br /> <br /> jivakarhushabhakau medam shravanim karkatahvayam| &lt;br /&gt;<br /> mudgamashakhyaparnyau cha mahatim shravanim tatha||18|| &lt;br /&gt;<br /> <br /> kakolim kshirakakolimindram [1] chinnaruham tatha| &lt;br /&gt;<br /> kshirashuklam payasyam cha yashtyahvam vidhina pibet||19|| &lt;br /&gt;<br /> <br /> vatapittahitanyetanyanyani tu kaphanile|20| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The powder of ''Trivrita'' can be taken along with the powder of either, ''Jivaka, Rhushbhaka, Meda, Shravani (Mundi), Karkatashringi, Mudgaparni, Mashaparni, Maha-shravani, Kakoli, Kshirakakoli, Indra (Indravaruni), Chinna riha (Guduchi), Kshirashukla (Kshiravidari)'' or ''Payasya (Arka-puspha)'' for purgation. Similarly, the powder of ''Trivrita'' root can be taken along with ''Yashtimadhu (Madhuka)'' for purgation. The above-mentioned preparations are useful for diseases caused by[[vata]] and [[pitta]]. The preparations that will be useful for the diseases caused by [[kapha]] and [[vata]] will be described later. [18 –19½]<br /> <br /> === Preparations of Trivrita, to be taken along with liquids ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षीरमांसेक्षुकाश्मर्यद्राक्षापीलुरसैः पृथक् ||२०|| <br /> <br /> सर्पिषा वा तयोश्चूर्णमभयार्धांशिकं पिबेत् |२१| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kshiramamsekshukashmaryadrakshapilurasaih pruthak ||20|| <br /> <br /> sarpisha va tayoshchurnamabhayardhamshikam pibet |21| <br /> <br /> kshiramamsekshukashmaryadrakshapilurasaih pruthak||20|| <br /> <br /> sarpisha va tayoshchurnamabhayardhamshikam pibet|21|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One part of the ''Trivrita'' root powdered mixed with half part of powdered ''haritaki'' may be taken in along with either, Milk, Meat-soup, Sugar cane juice, Fruit juice of ''Kashmarya (Gambhari)'', Fruit juice of ''Draksha'' (grapes), Fruit Juice of ''Pilu'', or Ghee, for purgation. [19 ½ - 20½]<br /> <br /> === Preparation of ''Trivrita'' in the form of Linctus (No. 1) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> लिह्याद्वा मधुसर्पिर्भ्यां संयुक्तं ससितोपलम् ||२१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> lihyadva madhusarpirbhyam samyuktam sasitopalam ||21|| <br /> <br /> lihyadva madhusarpirbhyam samyuktam sasitopalam||21|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> (Powered root of ''Trivrita'' may be) added with honey and ghee (to form a linctus). Then, crudely powdered sugar candy is added to it (and taken in for purgation) [21]<br /> <br /> === Preparation of ''Trivrita'' in the form of linctus (No. 2) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अजगन्धा तुगाक्षीरी विदारी शर्करा त्रिवृत् | &lt;br /&gt;<br /> चूर्णितं क्षौद्रसर्पिर्भ्यां लीढ्वा साधु विरिच्यते ||२२|| &lt;br /&gt;<br /> <br /> सन्निपातज्वरस्तम्भदाहतृष्णार्दितो नरः | &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ajagandha tugakshiri vidari sharkara trivrut | &lt;br /&gt;<br /> churnitam kshaudrasarpirbhyam lidhva sadhu virichyate ||22|| &lt;br /&gt;<br /> <br /> sannipatajvarastambhadahatrushnardito narah |&lt;br /&gt;<br /> <br /> ajagandha tugakshiri vidari sharkara trivrut| &lt;br /&gt;<br /> churnitam kshaudrasarpirbhyam lidhva sadhu virichyate||22|| &lt;br /&gt;<br /> <br /> sannipatajvarastambhadahatrushnardito narah| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The powders of ''Ajagandha, Tugakshiri, Vidari, Sarkara'' (sugar) and ''Trivrita'' may be mixed with honey and ghee. This linctus taken in, is useful as a mild purgative, for the patient suffering from ''Sannipata Jwara'' (fevers caused by aggravation of all the three ''doshas''), ''Stambha'' (either retention of urine and faeces or generalized stiffness of the body), ''Daha'' (burning sensation in some parts or throughout the body) and ''Trishna'' (Thirst due to some underlying pathology). [22- 22 ½]<br /> <br /> === Preparation of ''Trivrita'' in the form of linctus (No. 3) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> श्यामात्रिवृत्कषायेण कल्केन च सशर्करम् ||२३|| <br /> <br /> साधयेद्विधिवल्लेहं लिह्यात् पाणितलं ततः | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> shyamatrivrutkashayena kalkena cha sasharkaram ||23|| <br /> <br /> sadhayedvidhivalleham lihyat panitalam tatah | <br /> <br /> shyamatrivrutkashayena kalkena cha sasharkaram||23|| <br /> <br /> sadhayedvidhivalleham lihyat panitalam tatah| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> With the decoction and paste (either dried powder or wet paste) of the black variety of Trivruta root, a linctus is to be prepared following the prescribed procedure) using sugar (as a solvent). In a dose of one ''panitala'' this linctus can be taken in (for purgation). [22 ½ - 23½]<br /> <br /> === Preparation of ''Trivrita'' in the form of linctus (No. 4) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सक्षौद्रां शर्करां पक्त्वा कुर्यान्मृद्भाजने नवे ||२४|| <br /> <br /> क्षिपेच्छीते त्रिवृच्चूर्णं त्वक्पत्रमरिचैः सह | <br /> <br /> मात्रया लेहयेदेतदीश्वराणां विरेचनम् ||२५|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sakshaudram sharkaram paktva kuryanmrudbhajane nave ||24|| <br /> <br /> kshipecchite trivrucchurnam tvakpatramarichaih saha | <br /> <br /> matraya lehayedetadishvaranam virechanam ||25|| <br /> <br /> sakshaudram sharkaram paktva kuryanmrudbhajane nave||24|| <br /> <br /> kshipecchite [1] trivruccurnam tvakpatramarichaih saha| <br /> <br /> matraya [2] lehayedetadishvaranam virechanam||25|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Sugar and honey are mixed well and boiled (till the sugar is completely dissolved) in a new earthen vessel. When it is properly cooked and cooled, powdered ''Trivrita'' may be added to it, along with powders of ''Tvak'' (Cinnamon bark), ''Patra'' (Cinnamon leaves) and ''Maricha'' (black pepper) are added to it. This linctus can be taken in, in the prescribed and suitable dose. This is a useful purgative for persons belonging to the upper class. [2 ½ - 25]<br /> <br /> === Preparation of ''Trivrita'' in the form of Linctus (No. 5) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कुडवांशान् रसानिक्षुद्राक्षापीलुपरुषकात् | &lt;br /&gt;<br /> सितोपलापलं क्षौद्रात् कुडवार्धं च साधयेत् ||२६|| &lt;br /&gt;<br /> <br /> तं लेहं योजयेच्छीतं त्रिवृच्चूर्णेन शास्त्रवित् | &lt;br /&gt;<br /> एतदुत्सन्नपित्तानामीश्वराणां विरेचनम् ||२७|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kudavamshan rasanikshudrakshapiluparushakat | &lt;br /&gt;<br /> sitopalapalam kshaudrat kudavardham cha sadhayet ||26|| &lt;br /&gt;<br /> <br /> tam leham yojayecchitam trivrucchurnena shastravit | &lt;br /&gt;<br /> etadutsannapittanamishvaranam virechanam ||27|| &lt;br /&gt;<br /> <br /> kudavamshan [3] rasanikshudrakshapiluparushakat| &lt;br /&gt;<br /> sitopalapalam kshaudrat kudavardham cha sadhayet||26|| &lt;br /&gt;<br /> <br /> tam leham yojayecchitam trivrucchurnena shastravit| &lt;br /&gt;<br /> etadutsannapittanamishvaranam [4] virechanam||27|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Each one ''kudava'' (approx 200 ml) of the juices of ''Ikshu, Draksha, Pilu'' and ''Parushaka,'' one ''pala'' (approx.48g) of ''Sitopala'' (sugar candy) and half a ''kudava'' (approx 100 ml) of honey are to be boiled together. When it is cooled, powdered ''Trivrita'' is to be added to it by experts (in the field of such preparations) and made into linctus. This preparation is highly useful as a purgative for those persons, who are having excessively aggravated ''pitta dosha'' and who are from the upper classes of the society. [26-27]<br /> <br /> === Preparations of ''Trivrita'' with Sugar ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शर्करामोदकान् वर्तीर्गुलिकामांसपूपकान् | &lt;br /&gt;<br /> अनेन विधिना कुर्यात् पैत्तिकानां विरेचनम् ||२८|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sharkaramodakan vartirgulikamamsapupakan | &lt;br /&gt;<br /> anena vidhina kuryat paittikanam virechanam ||28|| &lt;br /&gt;<br /> <br /> sharkaramodakan vartirgulikamamsapupakan| &lt;br /&gt;<br /> anena vidhina kuryat paittikanam virechanam||28|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Following the same method (as mentioned in the above verses) preparations may be done in the form of ''Sharkara modaka'' (round, ball like sweets made of sugar), ''Sharkara varti'' (rolls made of sugar), ''Sharkaragulika'' (Pills made with sugar) and ''Sharkara mamsapupaka'' (Cake prepared with sugar and meat). These preparations are useful as purgatives for those persons, suffering from diseases caused by [[pitta]] [[dosha]] [28]<br /> <br /> === Preparations of ''Trivrita'' in the form of linctus (No. 6) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पिप्पलीं नागरं क्षारं श्यामां त्रिवृतया सह | &lt;br /&gt;<br /> लेहयेन्मधुना सार्धं श्लेष्मलानां विरेचनम् ||२९||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pippalim nagaram ksharam shyamam trivrutaya saha | &lt;br /&gt;<br /> lehayenmadhuna sardham shleshmalanam virechanam ||29|| &lt;br /&gt;<br /> <br /> pippalim nagaram ksharam shyamam trivrutaya saha| &lt;br /&gt;<br /> lehayenmadhuna sardham shleshmalanam virechanam||29|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The powder of ''Trivrita'' (having pink roots) may be added with powders of ''Pippali, Nagara, Kshara'' (an alkali preparation) and ''Shyama'' (the variety having black roots).<br /> <br /> To this mixed powder, honey may be added and can be taken in, in the form of linctus for purgation for those having [[kapha]] type of constitution or for those persons suffering from disease due to the aggravation of [[kapha]].<br /> <br /> === Preparation of ''Trivrita'' in the form of linctus (No. 7) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मातुलुङ्गाभयाधात्रीश्रीपर्णीकोलदाडिमात् |&lt;br /&gt;<br /> सुभृष्टान् स्वरसांस्तैले साधयेत्तत्र चावपेत् ||३०|| &lt;br /&gt;<br /> <br /> सहकारात् कपित्थाच्च मध्यमम्लं च यत् फलम् |&lt;br /&gt;<br /> पूर्ववद्बहलीभूते त्रिवृच्चूर्णं समावपेत् ||३१|| &lt;br /&gt;<br /> <br /> त्वक्पत्रकेशरैलानां चूर्णं मधु च मात्रया |&lt;br /&gt;<br /> लेहोऽयं कफपूर्णानामीश्वराणां विरेचनम् ||३२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> matulungabhayadhatrishriparnikoladadimat | &lt;br /&gt;<br /> subhrushtan svarasamstaile sadhayettatra chavapet ||30||&lt;br /&gt;<br /> <br /> sahakarat kapitthaccha madhyamamlam cha yat phalam | &lt;br /&gt;<br /> purvavadbahalibhute trivrucchurnam samavapet ||31|| &lt;br /&gt;<br /> <br /> tvakpatrakesharailanam curnam madhu cha matraya | &lt;br /&gt;<br /> lehoayam kaphapurnanamishvaranam virechanam ||32|| &lt;br /&gt;<br /> <br /> matulungabhayadhatrishriparnikoladadimat| &lt;br /&gt;<br /> subhrushtan svarasamstaile sadhayettatra chavapet||30|| &lt;br /&gt;<br /> <br /> sahakarat kapitthaccha madhyamamlam cha yat phalam| &lt;br /&gt;<br /> purvavadbahalibhute trivruccurnam samavapet||31|| &lt;br /&gt;<br /> <br /> tvakpatrakesharailanam curnam madhu cha matraya| &lt;br /&gt;<br /> lehoayam kaphapurnanamishvaranam virechanam||32|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The juice of ''Matulunga, Abhaya, Dhatri, Shriparni, Kola'' and ''Dadima'' are to be properly sizzled (fried till a hissing sound comes out) and cooked in oil by adding the pulp of ''Sahakara'' (mango), ''Kapittha'' (wood apple) and ''Matulunga'' (Sour fruit). When the preparation starts concentrating, the powder of ''Trivrita'', root along with the powders of ''Tvak, Patra, Keshara'' and ''Ela'' are to be added. Finally honey is to be added to make linctus. Intake of this linctus in appropriate dose is useful as a purgative for those persons from upper classes.[30-32]<br /> <br /> === Preparations of ''Trivrita'' in the form of Syrup etc. ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पानकानि रसान् यूषान्मोदकान् रागषाडवान् |&lt;br /&gt;<br /> अनेन विधिना कुर्याद्विरेकार्थं कफाधिके ||३३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> panakani rasan yushanmodakan ragashadavan | &lt;br /&gt;<br /> anena vidhina kuryadvirekartham kaphadhike ||33|| &lt;br /&gt;<br /> <br /> panakani rasan yushanmodakan ragashadavan| &lt;br /&gt;<br /> anena vidhina kuryadvirekartham kaphadhike||33|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Similar to the above mentioned procedure, the preparations (of ''Trivrita'') are to be made in the forms of ''Panak'' (syrup), ''Rasa'' (meat soup), ''Yusha'' (pulse-soup), ''Modaka'' (sweet-meat), and ''Raga'' – ''shadava'' (sour drinks with and pungent taste). These preparations can be administered for purgation to persons having aggravated [[kapha]]. [33]<br /> <br /> === Preparations of ''Trivrita'' in the form of ''Tarpana'' (soothing drink) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भृङ्गैलाभ्यां समा नीली तैस्त्रिवृत्तैश्च शर्करा |&lt;br /&gt;<br /> चूर्णं फलरसक्षौद्रशक्तुभिस्तर्पणं पिबेत् ||३४|| &lt;br /&gt;<br /> <br /> वातपित्तकफोत्थेषु रोगेष्वल्पानलेषु च | &lt;br /&gt;<br /> नरेषु सुकुमारेषु निरपायं विरेचनम् ||३५|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhrngailabhyam sama nili taistrivruttaishcha sharkara | &lt;br /&gt;<br /> churnam phalarasakshaudrashaktubhistarpanam pibet ||34|| &lt;br /&gt;<br /> <br /> vatapittakaphottheshu rogeshvalpanaleshu cha | &lt;br /&gt;<br /> nareshu sukumareshu nirapayam virechanam ||35|| &lt;br /&gt;<br /> <br /> bhrungailabhyam sama nili taistrivruttaishcha sharkara| &lt;br /&gt;<br /> churnam phalarasakshaudrashaktubhistarpanam pibet||34|| &lt;br /&gt;<br /> <br /> vatapittakaphottheshu rogeshvalpanaleshu cha| &lt;br /&gt;<br /> nareshu sukumareshu nirapayam virechanam||35|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A ''Tarpana'' or soothing drink should be prepared by adding the powder of one part of ''Bhringa'', one part of ''Ela'' (Cinnamon bark), two parts of ''Nili'', three parts of ''Trivrita'' and seven parts of sugar to the juice of ''Dadima'', honey and powder of pop-rice or barley. This is a very safe purgative preparation for the patients suffering from diseases due to [[vata]], [[pitta]] and [[kapha]], for persons having low digestive fire and for persons who are very much tender or delicate. [34-35]<br /> <br /> === Preparation of ''Trivrita'' in the form of ''Modaka'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शर्करात्रिफलाश्यामात्रिवृत्पिप्पलिमाक्षिकैः |&lt;br /&gt;<br /> मोदकः सन्निपातोर्ध्वरक्तपित्तज्वरापहः ||३६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sharkaratriphalashyamatrivrutpippalimakshikaihi | &lt;br /&gt;<br /> modakah sannipatordhvaraktapittajvarapahah ||36|| &lt;br /&gt;<br /> <br /> sharkaratriphalashyamatrivrutpippalimakshikaihi | &lt;br /&gt;<br /> modakah sannipatordhvaraktapittajvarapahah||36|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A ''Modaka'' (large sized round sweet-meat) may be prepared using sugar, ''Haritaki, Vibhitaki, and Amalaki'', black variety of ''Trivrita'' roots, ''Pippali'' and honey. Intake of this preparation cures ''Sannipata'' (simultaneous aggravation of all the three [[dosha]] and diseases caused there upon), ''Urdhva Raktapitta'' (bleeding from the opening of the upper parts of the body like mouth or nose) and fever. [36]<br /> <br /> === Preparation of ''Trivrita'' in the form of linctus (No. 8) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिवृच्छाणा मतास्तिस्रस्तिस्रश्च त्रिफलात्वचः |&lt;br /&gt;<br /> विडङ्गपिप्पलीक्षारशाणास्तिस्रश्च चूर्णिताः ||३७|| &lt;br /&gt;<br /> <br /> लिह्यात् सर्पिर्मधुभ्यां च मोदकं वा गुडेन तु | &lt;br /&gt;<br /> भक्षयेन्निष्परीहारमेतच्छोधनमुत्तमम् ||३८|| &lt;br /&gt;<br /> <br /> गुल्मं प्लीहोदरं श्वासं हलीमकमरोचकम् | &lt;br /&gt;<br /> कफवातकृतांश्चान्यान् व्याधीनेतह्यपोहति ||३९|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> trivrcchana matastisrastisrashcha triphalatvachah | &lt;br /&gt;<br /> vidangapippaliksharashanastisrashcha churnitah ||37|| &lt;br /&gt;<br /> <br /> lihyat sarpirmadhubhyam cha modakam va gudena tu | &lt;br /&gt;<br /> bhakshayennishpariharametacchodhanamuttamam ||38|| &lt;br /&gt;<br /> <br /> gulmam plihodaram shvasam halimakamarochakam | &lt;br /&gt;<br /> kaphavatakrutamshchanyan vyadhinetahyapohati ||39|| &lt;br /&gt;<br /> <br /> trivrucchana matastisrastisrashcha triphalatvachah| &lt;br /&gt;<br /> vidangapippaliksharashanastisrashcha churnitah||37||&lt;br /&gt;<br /> <br /> lihyAt sarpirmadhubhyam cha modakam va gudena tu| &lt;br /&gt;<br /> bhakshayennishpariharametacchodhanamuttamam ||38|| &lt;br /&gt;<br /> <br /> gulmam plihodaram shvasam halimakamarochakam| &lt;br /&gt;<br /> kaphavatakrutamshchanyan vyadhinetahyapohati||39||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Three ''shanas'' of ''Trivrita'' powder is to be added with one ''shana'' rind powders of ''Haritaki, Vibhitaki, Amalaki,'' ''Vidanga'', ''Pippali'' and ''Kshara'' (an alkali preparation). This compounded powder may be mixed with ghee and honey and made to linctus or to an ''Modaka'' (round large sized sweet meat) using jaggery. This is considered as a good purgative and a person using it need not follow any dietary or any other restrictions. If this preparation is taken in, it can cure ''gulma'' (benign tumors of intestines), ''Plihodara'' (splenomegaly), ''Shvasa'' (broncho-spasm), ''Halimaka'' (chronic hepatitis), ''Arochaka'' (anorexia) and other such diseases caused by the aggravation of [[kapha]] and [[vata]] [37-39]<br /> <br /> === Preparation of ''Trivrita'' in the form of ''Modaka'' (No. 2) ===<br /> ==== ''Kalyanaka guda'' ====<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विडङ्गपिप्पलीमूलत्रिफलाधान्यचित्रकान् |&lt;br /&gt;<br /> मरिचेन्द्रयवाजाजीपिप्पलीहस्तिपिप्पलीः ||४०||&lt;br /&gt;<br /> <br /> लवणान्यजमोदां च चूर्णितं कार्षिकं पृथक् | &lt;br /&gt;<br /> तिलतैलत्रिवृच्चूर्णभागौ चाष्टपलोन्मितौ ||४१|| &lt;br /&gt;<br /> <br /> धात्रीफलरसप्रस्थांस्त्रीन् गुडार्धतुलां तथा | &lt;br /&gt;<br /> पक्त्वा मृद्वग्निना खादेद्बदरोदुम्बरोपमान् ||४२||&lt;br /&gt;<br /> <br /> गुडान् कृत्वा न चात्र स्याद्विहाराहारयन्त्रणा | &lt;br /&gt;<br /> मन्दाग्नित्वं ज्वरं मूर्च्छां मूत्रकृच्छ्रमरोचकम् ||४३|| &lt;br /&gt;<br /> <br /> अस्वप्नं गात्रशूलं च कासं श्वासं भ्रमं क्षयम् | &lt;br /&gt;<br /> कुष्ठार्शःकामलामेहगुल्मोदरभगन्दरान् ||४४|| &lt;br /&gt;<br /> <br /> ग्रहणीपाण्डुरोगांश्च हन्युः पुंसवनाश्च ते | &lt;br /&gt;<br /> कल्याणका इति ख्याताः सर्वेष्वृतुषु यौगिकाः ||४५|| &lt;br /&gt;<br /> <br /> इति कल्याणकगुडः |४६| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vidangapippalimulatriphaladhanyacitrakan | &lt;br /&gt;<br /> marichendrayavajajipippalihastipippalih ||40|| &lt;br /&gt;<br /> <br /> lavananyajamodam cha churnitam karshikam pruthak | &lt;br /&gt;<br /> tilatailatrivrcchurnabhagau chashtapalonmitau ||41|| &lt;br /&gt;<br /> <br /> dhatriphalarasaprasthamstrin gudardhatulam tatha | &lt;br /&gt;<br /> paktva mrudvagnina khadedbadarodumbaropaman ||42|| &lt;br /&gt;<br /> <br /> gudan krutva na chatra syadviharaharayantrana | &lt;br /&gt;<br /> mandagnitvam jvaram murccham mutrakrucchramarochakam ||43|| &lt;br /&gt;<br /> <br /> asvapnam gatrashulam cha kasam shvasam bhramam kshayam | &lt;br /&gt;<br /> kushtharshahkamalamehagulmodarabhagandaran ||44|| &lt;br /&gt;<br /> <br /> grahanipandurogamshcha hanyuh pumsavanashcha te | &lt;br /&gt;<br /> kalyanaka iti khyatah sarveshvrtushu yaugikah ||45|| &lt;br /&gt;<br /> <br /> iti kalyanakagudah |46| &lt;br /&gt;<br /> <br /> vidangapippalimulatriphaladhanyacitrakan| &lt;br /&gt;<br /> marichendrayavajajipippalihastipippalih||40|| &lt;br /&gt;<br /> <br /> lavananyajamodam cha churnitam karshikam pruthak| &lt;br /&gt;<br /> tilatailatrivrucchurnabhagau chashtapalonmitau||41|| &lt;br /&gt;<br /> <br /> dhatriphalarasaprasthamstrin gudardhatulam tatha| &lt;br /&gt;<br /> paktva mrudvagnina khadedbadarodumbaropaman||42|| &lt;br /&gt;<br /> <br /> gudan krutva na chatra syadviharaharayantrana| &lt;br /&gt;<br /> mandagnitvam jvaram murccham mutrakrucchramarochakam||43|| &lt;br /&gt;<br /> <br /> asvapnam gatrashulam cha kasam shvasam bhramam kshayam| &lt;br /&gt;<br /> kushtharshahkamalamehagulmodarabhagandaran||44|| &lt;br /&gt;<br /> <br /> grahanipandurogamshcha hanyuh pumsavanashcha te| &lt;br /&gt;<br /> kalyanaka iti khyatah sarveshvrutushu yaugikah||45|| &lt;br /&gt;<br /> <br /> iti kalyanakagudah|46| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Each one ''karsha'' (around 12 grams) of ''Vidanga, Pippalimula, Triphala, Dhanyaka, Chitraka, Maricha, Indrayava, Ajaji Hasti pippali, Saindhava lavana, Samudra lavana, Vida lavana, Sauvarchala lavana, Audbhida lavana'' and ''Ajamoda'' are to be powdered separately and mixed together. Then, each eight ''pala'' (around 320 grams) of sesame oil and powdered root of ''Trivrita'' are added. Then, three ''prasthas'' (around 2.20 litres) juice of ''Amalaki'' and half a ''tula'' of jaggery are added to the entire material and cooked over mild fire. (When, it is completely cooked), round pills (''Guda'') of the size of ''Badara'' or ''Udumbara'' are made from the compound. While taking in these pills, there is no need of restrictions of food or any other regimen. Utilization of this purgative drug relieves loss of digestive power (''Mandagni''), fever (''Jwara''), fainting (''Murchcha''), dysuria (''Mutrakrichchra''), anorexia (''Arochaka''), insomnia (''Asvapna''), body pains (''Gatrashula''), cough (''Kasa''), bronchitis (''Shvasa''), vertigo (''Bhrama''), loss of tissues (''Kshaya''), skin diseases (''Kushtha''), haemorrhoids (''Arshas''), jaundice (''Kamala''), urinary tract diseases including diabetes (''Meha''), benign tumors of the intestines (''Gulma''), diseases of the visceral organs (''Udara''), fistula-in-ano (''Bhagandara''), dysentery (''Grahani''), and anaemia (''Panduroga''). This medicinal preparation also helps in conceiving a male progeny (''pumsavana''). The preparation, thus made and used is known as ''Kalyanaka guda'' and can be used in all seasons [40-45 ½]<br /> <br /> === Preparation of ''Trivrita'' in the form of ''Modaka'' ( bolus)(No. 3) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> व्योषत्वक्पत्रमुस्तैलाविडङ्गामलकाभयाः |&lt;br /&gt;<br /> समभागा भिषग्दद्याद्द्विगुणं च मुकूलकम् ||४६|| &lt;br /&gt;<br /> <br /> त्रिवृतोऽष्टगुणं भागं शर्करायाश्च षड्गुणम् | &lt;br /&gt;<br /> चूर्णितं गुडिकाः कृत्वा क्षौद्रेण पलसम्मिताः ||४७|| &lt;br /&gt;<br /> <br /> भक्षयेत् कल्यमुत्थाय शीतं चानु पिबेज्जलम् | &lt;br /&gt;<br /> मूत्रकृच्छ्रे ज्वरे वम्यां कासे श्वासे भ्रमे क्षये ||४८|| &lt;br /&gt;<br /> <br /> तापे पाण्ड्वामयेऽल्पेऽग्नौ शस्ता निर्यन्त्रणाशिनः | &lt;br /&gt;<br /> योगः सर्वविषाणां च मतः श्रेष्ठो विरेचने ||४९|| &lt;br /&gt;<br /> <br /> मूत्रजानां च रोगाणां विधिज्ञेनावचारितः |५०| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vyoshatvakpatramustailavidangamalakabhayah | &lt;br /&gt;<br /> samabhaga bhishagdadyaddvigunam cha mukulakam ||46|| &lt;br /&gt;<br /> <br /> trivrutoashtagunam bhagam sharkarayashcha shadgunam | &lt;br /&gt;<br /> churnitam gudikah krutva kshaudrena palasammitah ||47|| &lt;br /&gt;<br /> <br /> bhakshayet kalyamutthaya shitam chanu pibejjalam | &lt;br /&gt;<br /> mutrakrucchre jvare vamyam kase shvase bhrame kshaye ||48|| &lt;br /&gt;<br /> <br /> tape pandvamayealpeagnau shasta niryantranashinah | &lt;br /&gt;<br /> yogah sarvavishanam cha matah shreshtho virechane ||49|| &lt;br /&gt;<br /> <br /> mutrajanam cha roganam vidhinyenavacharitah |50| &lt;br /&gt;<br /> <br /> vyoshatvakpatramustailavidangamalakabhayah | &lt;br /&gt;<br /> samabhaga bhishagdadyaddvigunam cha mukulakam||46|| &lt;br /&gt;<br /> <br /> trivrutoashtagunam bhagam sharkarayashcha shadgunam| &lt;br /&gt;<br /> churnitam gudikah krutva kshaudrena palasammitah||47|| &lt;br /&gt;<br /> <br /> bhakshayet kalyamutthaya shitam chanu pibejjalam| &lt;br /&gt;<br /> mutrakrucchre jvare vamyam kase shvase bhrame kshaye||48|| &lt;br /&gt;<br /> <br /> tape pandvamayealpeagnau shasta niryantranashinah| &lt;br /&gt;<br /> yogah sarvavishanam cha matah shreshtho virechane||49|| &lt;br /&gt;<br /> <br /> mutrajanam cha roganam vidhinyenavacharitah|50| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Each one part of ''Shunthi, Pippali, Maricha, Tvak, Patra, Musta, Ela, Vidanga, Amalaki'' and ''Haritaki,'' two parts of ''Mukulaka'' (''Danti''), eight parts of ''Trivrita'' and six parts of sugar are to be made into powder. To this compound, honey is added and ''Gudika'' (round large pills), each weighing one ''pala'' (around 40 grams) are to be made. One such pill is to be consumed early in the morning after rising from the bed. Cool water can be taken in along with the pill. This is very much useful in dysuria (''Mutrakrchchra''), fever (''Jwara''), vomiting (''Vami''), cough (''Kasa''), bronchial spasm (''Shwasa''), vertigo (''Bhrama''), tissue loss (''Kshaya'') burning sensation (''Tapa''), anemia (''Pandu'') and loss of digestive fire (''Alpagni''). It can be used without following any restrictions regarding food or regimen. It can be used as an excellent purgative drug in all cases of poisoning and also in cases of diseases of urinary tract. [45 ½ - 49½]<br /> <br /> === Preparation of ''Trivrita'' in the form of ''Modaka'' (bolus) (No. 4) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पथ्याधात्र्युरुबूकाणां प्रसृतौ द्वौ त्रिवृत्पलम् ||५०||<br /> <br /> दश तान्मोदकान् कुर्यादीश्वराणां विरेचनम् |५१| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pathyadhatryurubukanam prasrutau dvau trivrutpalam ||50|| <br /> <br /> dasha tanmodakan kuryadishvaranam virechanam |51| <br /> <br /> pathyadhatryurubukanam prasrutau dvau trivrutpalam||50|| <br /> <br /> dasha tanmodakan kuryadishvaranam virechanam|51|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''pala'' (around 50 grams) of ''Trivrita'' powder may be added with two ''prasrita'' (around 180 grams) powder of ''Pathya, Dhatri'' and ''Urubuka'' (root bark powder of Castor plant). (After adding sufficient quantity of honey), ten large sized bolus like pills may be prepared. This is ideal for upper class persons and delicate persons for purgation. [49½ - 50½]<br /> <br /> === Preparation of ''Trivrita'' in the form of ''Modaka'' (bolus) (no.5) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिवृद्धैमवती श्यामा नीलिनी हस्तिपिप्पली ||५१||&lt;br /&gt;<br /> <br /> समूला पिप्पली मुस्तमजमोदा दुरालभा | &lt;br /&gt;<br /> कार्षिकं नागरपलं गुडस्य पलविंशतिम् ||५२|| &lt;br /&gt;<br /> <br /> चूर्णितं मोदकान् कुर्यादुदुम्बरफलोपमान् | &lt;br /&gt;<br /> हिङ्गुसौवर्चलव्योषयवानीबिडजीरकैः ||५३|| &lt;br /&gt;<br /> <br /> वचाजगन्धात्रिफलाचव्यचित्रकधान्यकैः | &lt;br /&gt;<br /> मोदकान् वेष्टयेच्चूर्णैस्तान् सतुम्बुरुदाडिमैः ||५४|| &lt;br /&gt;<br /> <br /> त्रिकवङ्क्षणहृद्बस्तिकोष्ठार्शःप्लीहशूलिनाम् | &lt;br /&gt;<br /> हिक्काकासारुचिश्वासकफोदावर्तिनां शुभाः ||५५|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> trivruddhaimavati shyama nilini hastipippali ||51|| &lt;br /&gt;<br /> <br /> samula pippali mustamajamoda duralabha | &lt;br /&gt;<br /> karshikam nagarapalam gudasya palavimshatim ||52|| &lt;br /&gt;<br /> <br /> churnitam modakan kuryadudumbaraphalopaman | &lt;br /&gt;<br /> hingusauvarchalavyoshayavanibidajirakaih ||53|| &lt;br /&gt;<br /> <br /> vachajagandhatriphalachavyacitrakadhanyakaih | &lt;br /&gt;<br /> modakan veshtayecchurnaistan satumburudadimaihi ||54|| &lt;br /&gt;<br /> <br /> trikavankshanahrudbastikoshtharshahplihashulinam | &lt;br /&gt;<br /> hikkakasarucishvasakaphodavartinam shubhah ||55|| &lt;br /&gt;<br /> <br /> trivruddhaimavati shyama nilini hastipippali||51|| &lt;br /&gt;<br /> <br /> samula pippali mustamajamoda duralabha| &lt;br /&gt;<br /> karshikam nagarapalam gudasya palavimshatim||52|| &lt;br /&gt;<br /> <br /> churnitam modakan kuryadudumbaraphalopaman| &lt;br /&gt;<br /> hingusauvarchalavyoshayavanibidajirakaih||53|| &lt;br /&gt;<br /> <br /> vachajagandhatriphalachavyacitrakadhanyakaih| &lt;br /&gt;<br /> modakan veshtayecchurnaistan satumburudadimaihi ||54|| &lt;br /&gt;<br /> <br /> trikavakshanahrudbastikoshtharshahplihashulinam| &lt;br /&gt;<br /> hikkakasarucishvasakaphodavartinam shubhah ||55|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Each one ''karsha'' (around 12 grams) of the ''Trivrita'' powder (the variety having pink roots), ''Haimavati'' (rind of ''Haritaki''). ''Shyama'' (the variety having black roots) ''Nilini, Hastipippali, Pippalimula, Musta, Ajamoda'' and ''Duralabha'', one ''pala'' of ''Nagara'' and twenty ''pala'' of jaggery are mixed together. ''Modakas'' (large pills of the size of ''Udumbara'' fruit may be preferred using the above said paste like mixture. These ''modakas'' are to be rolled well in a compounded powder of ''Hingu, Sauvarchala lavana, Vyosha (Trikatu), Yavani, Bidalavana, Jiraka, Vacha, Ajagandha, Triphala, Chavya, Chitraka, Dhanyaka, Tumburu'' and ''Dadima'' (bark powder), till the ''modakas'' (bolus) are covered completely. These ''modakas'' are positively indicated in pain in the Lumbo-Sacral area (''Trika''), inguinal area (''Vamkshana''), Cardiac or epigastric region (''Hridaya''), pelvic area (''Vasti'') and umbilical area (''Koshtha''), hemorrhoids (''Arshas''), Splenic disorders (''Plihashula''), hiccup (''Hikka''), Cough (''Kasa''), anorexia (''Aruchi''), bronchial spasm (''Shwasa'') and reversed peristalsis due to the obstruction in the stomach due to aggravated ''kapha'' (''kaphaja udavarta''). [50½ -55]<br /> <br /> === Purgative preparation of ''Trivrita'' useful in Rainy season ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिवृतां कौटजं बीजं पिप्पलीं विश्वभेषजम् |&lt;br /&gt;<br /> क्षौद्रद्राक्षारसोपेतं वर्षास्वेतद्विरेचनम् ||५६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> trivrutam kautajam bijam pippalim vishvabheshajam | &lt;br /&gt;<br /> kshaudradraksharasopetam varshasvetadvirechanam ||56|| &lt;br /&gt;<br /> <br /> trivrutam kautajam bijam pippalim vishvabheshajam| &lt;br /&gt;<br /> kshaudradraksharasopetam varshasvetadvirechanam||56|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The powder of ''Trivrita, Kutajabija, Pippali'' and ''Vishvabheshaja'' (''Shunthi'') are to be mixed with honey and grape juice. This preparation is useful as a purgative in rainy reason. [56]<br /> <br /> === Preparation of ''Trivrita'' useful in post-rainy season ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिवृद्दुरालभामुस्तशर्करोदीच्यचन्दनम् |&lt;br /&gt;<br /> द्राक्षाम्बुना सयष्ट्याह्वसातलं जलदात्यये ||५७|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> trivrdduralabhamustasharkarodicyachandanam | &lt;br /&gt;<br /> drakshambuna sayashtyahvasatalam jaladatyaye ||57|| &lt;br /&gt;<br /> <br /> trivrudduralabhamustasharkarodicyachandanam| &lt;br /&gt;<br /> drakshambuna sayashtyahvasatalam jaladatyaye||57|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The powder of ''Trivrita, Duralabha, Musta, Sugar, Udichya'' (''Balaka''), ''Chandana, Yashti'' and ''Satala'' (''charmakasa'') may be token in along with ''Drakshambu'' (grape water) for purgation. This preparation is useful in post-rainy season.[57]<br /> <br /> === Preparation of ''Trivrita'' useful in winter ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिवृतां चित्रकं पाठामजाजीं सरलं वचाम् |&lt;br /&gt;<br /> स्वर्णक्षीरीं च हेमन्ते पिष्ट्वा तूष्णाम्बुना पिबेत् ||५८|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> trivrutam citrakam pathamajajim saralam vacham | &lt;br /&gt;<br /> svarnakshirim cha hemante pishtva tushnambuna pibet ||58|| &lt;br /&gt;<br /> <br /> trivrutam citrakam pathamajajim saralam vacham| &lt;br /&gt;<br /> svarnakshirim cha hemante pishtva tushnambuna pibet||58|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The powder or paste of ''Trivrita, Chitraka, Patha, Ajaji, Sarala, Vacha'' and ''Svarnakshiri'' may be taken in, along with hot water. This preparation causes purgation in ''Hemanta'' i.e. winter season.[58]<br /> <br /> === Preparation of ''Trivrita'' useful in summer ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शर्करा त्रिवृता तुल्या ग्रीष्मकाले विरेचनम् |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sharkara trivruta tulya grishmakale virechanam | 58 ½ |<br /> <br /> sharkara trivruta tulya grishmakale virechanam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The powder of ''Trivrita'', mixed with equal quantity of sugar, can be taken in during summer, for purgation.[58½]<br /> <br /> === Preparation of ''Trivrita'' suitable during any season ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिवृत्त्रायन्तिहपुषाः सातलां कटुरोहिणीम् ||५९|| &lt;br /&gt;<br /> <br /> स्वर्णक्षीरीं च सञ्चूर्ण्य गोमूत्रे भावयेत्त्र्यहम् | &lt;br /&gt;<br /> एष सर्वर्तुको योगः स्निग्धानां मलदोषहृत् ||६०|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> trivruttrayantihapushah satalam katurohinim ||59|| &lt;br /&gt;<br /> <br /> svarnakshirim cha sancurnya gomutre bhavayettryaham | &lt;br /&gt;<br /> esha sarvartuko yogah snigdhanam maladoshahrt ||60|| &lt;br /&gt;<br /> <br /> trivruttrayantihapushah satalam katurohinim ||59|| &lt;br /&gt;<br /> <br /> svarnakshirim cha sanchurnya gomutre bhavayettryaham| &lt;br /&gt;<br /> esha sarvartuko yogah snigdhanam maladoshahrut||60|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Trivrita, Trayanti, Hapusha, Satala, Katurohini'' and ''Svaranakshiri'' are to be powdered well and soaked in cows urine continuously for a period of three days. This preparation is ideal for purgation during all seasons. It can easily expel out the stagnated morbid material from the bodies of persons, who are ''Snigdha'' (persons who underwent oleation therapy or persons who are naturally having sufficient quantity of fatty tissues in their body stores).[58½ - 60]<br /> <br /> === Preparation of ''Trivrita'' suitable during any season ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिवृच्छ्यामा दुरालम्भा वत्सकं हस्तिपिप्पली |&lt;br /&gt;<br /> नीलिनी त्रिफला मुस्तं कटुका च सुचूर्णितम् ||६१|| &lt;br /&gt;<br /> <br /> सर्पिर्मांसरसोष्णाम्बुयुक्तं पाणितलं ततः | &lt;br /&gt;<br /> पिबेत् सुखतमं ह्येतद्रूक्षाणामपि शस्यते ||६२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> trivrcchyama duralambha vatsakam hastipippali | &lt;br /&gt;<br /> nilini triphala mustam katuka cha suchurnitam ||61|| &lt;br /&gt;<br /> <br /> sarpirmamsarasoshnambuyuktam panitalam tatah | &lt;br /&gt;<br /> pibet sukhatamam hyetadrukshanamapi shasyate ||62|| &lt;br /&gt;<br /> <br /> trivrucchyama duralambha vatsakam hastipippali| &lt;br /&gt;<br /> nilini triphala mustam katuka cha suchurnitam||61|| &lt;br /&gt;<br /> <br /> sarpirmamsarasoshnambuyuktam panitalam tatah| &lt;br /&gt;<br /> pibet sukhatamam hyetadrukshanamapi shasyate||62|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Trivrita'' (root having pink color), ''Shyama'' (root having black color), ''Duralambha, Vatsaka, Hastipippali, Nilini, Triphala, Musta'' and ''Katuka'' are to be finely powdered. This powder is to be taken in, along with ghee, meat-sour and hot water, in a dose of one ''Panitala'' (around 12 grams). This preparation causes purgation with ease and is indicated even to persons who are ''Ruksha'' (who didn’t undergo oleation therapy or who are ''Ruksha'' (who didn’t undergo oleation therapy or who do not possess sufficient quantity of fat stores in their body). [61-62]<br /> <br /> === Preparation of ''Trivrita'' in the form of powder ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्र्यूषणं त्रिफला हिङ्गु कार्षिकं त्रिवृतापलम् |&lt;br /&gt;<br /> सौवर्चलार्धकर्षं च पलार्धं चाम्लवेतसात् ||६३|| &lt;br /&gt;<br /> <br /> तच्चूर्णं शर्करातुल्यं मद्येनाम्लेन वा पिबेत् | &lt;br /&gt;<br /> गुल्मपार्श्वार्तिनुत्सिद्धं जीर्णे चाद्याद्रसौदनम् ||६४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tryushanam triphala hingu karshikam trivrutapalam | &lt;br /&gt;<br /> sauvarchalardhakarsham cha palardham chamlavetasat ||63|| &lt;br /&gt;<br /> <br /> tacchurnam sharkaratulyam madyenamlena va pibet | &lt;br /&gt;<br /> gulmaparshvartinutsiddham jirne chadyadrasaudanam ||64|| &lt;br /&gt;<br /> <br /> tryushanam triphala hingu karshikam trivrutapalam| &lt;br /&gt;<br /> sauvarchalardhakarsham cha palardham chamlavetasat||63|| &lt;br /&gt;<br /> <br /> tacchurnam sharkaratulyam madyenamlena va pibet| &lt;br /&gt;<br /> gulmaparshvartinutsiddham jirne chadyadrasaudanam||64||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Each one ''karsha'' (around 12 grams) of ''Tryushana, Triphala'' and ''Hingu,'' one ''pala'' (around 48 grams) of ''Trivrita,'' half a ''karsha'' (around 6 grams) of ''sauvarchala'' salt and half a ''pala'' (around 24 grams) of ''Amlavetasa'' are to be powdered well and mixed with equal quantity of powdered sugar. This preparation, in the form of powder can be taken in along with alcohol or sour juices (of fruits). This preparation surely relieves pain originating from ''Gulma'' (a benign intestinal tumor) and ''Parshva'' (both the sides of the chest cavity). When the medicinal preparation is completely digested, the patient can be given a diet comprising of meat soup. [63-64]<br /> <br /> === Preparation of ''Trivrita'' in the form of ''Tarpana'' (With nourishing drink) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिवृतां त्रिफलां दन्तीं सप्तलां व्योषसैन्धवम् |&lt;br /&gt;<br /> कृत्वा चूर्णं तु सप्ताहं भाव्यमामलकीरसे ||६५|| &lt;br /&gt;<br /> <br /> तद्योज्यं तर्पणे यूषे पिशिते रागयुक्तिषु |६६| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> trivrutam triphalam dantim saptalam vyoshasaindhavam | &lt;br /&gt;<br /> krutva churnam tu saptaham bhavyamamalakirase ||65|| &lt;br /&gt;<br /> <br /> tadyojyam tarpane yushe pishite ragayuktishu |66| &lt;br /&gt;<br /> <br /> trivrutam triphalam dantim saptalam vyoshasaindhavam| &lt;br /&gt;<br /> krutva churnam tu saptaham bhavyamamalakirase||65|| &lt;br /&gt;<br /> <br /> tadyojyam tarpane yushe pishite ragayuktishu|66| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Trivrita, Haritaki, Vibhitaki, Amalaki, Danti, Saptala, Shunthi, Pippali, Maricha'' and ''Saindhava'' are powdered well. This powder is to be soaked in the juice of ''Amalaki'' for seven days. This preparation can be used along with either ''Tarpana'' (nourishing) soothing drink or ''Yusha'' (pulse-soup) or ''pishita'' (meat or meat-soup) or any other drinks like ''raga'' (a drink mixed with sweet, sour and pungent tastes).[65- 65½]<br /> <br /> === Preparations of ''Trivrita'' in the form of medicated ghee and milk ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तुल्याम्लं त्रिवृताकल्कसिद्धं गुल्महरं घृतम् ||६६||&lt;br /&gt;<br /> <br /> श्यामात्रिवृतयोर्मूलं पचेदामलकैः सह | &lt;br /&gt;<br /> जले तेन कषायेण पक्त्वा सर्पिः पिबेन्नरः ||६७|| &lt;br /&gt;<br /> <br /> श्यामात्रिवृत्कषायेण सिद्धं सर्पिः पिबेत्तथा | &lt;br /&gt;<br /> साधितं वा पयस्ताभ्यां सुखं तेन विरिच्यते ||६८|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tulyamlam trivrutakalkasiddham gulmaharam ghrutam ||66|| &lt;br /&gt;<br /> <br /> shyamatrivrutayormulam pachedamalakaih saha | &lt;br /&gt;<br /> jale tena kashayena paktva sarpih pibennarah ||67|| &lt;br /&gt;<br /> <br /> shyamatrivrutkashayena siddham sarpih pibettatha | &lt;br /&gt;<br /> sadhitam va payastabhyam sukham tena virichyate ||68|| &lt;br /&gt;<br /> <br /> tulyamlam trivrutakalkasiddham gulmaharam ghrutam||66||&lt;br /&gt;<br /> <br /> shyamatrivrutayormulam pachedamalakaih saha| &lt;br /&gt;<br /> jale tena kashayena paktva sarpih pibennarah||67|| &lt;br /&gt;<br /> <br /> shyamatrivrutkashayena siddham sarpih pibettatha| &lt;br /&gt;<br /> sadhitam va payastabhyam sukham tena virichyate||68|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Equal quantity of sour juice and ghee are to be boiled along with the paste of ''Trivrita''. This medicated ghee relieves ''Gulma'' (abdominal lumps).<br /> <br /> The root of ''Shyama'' (the variety of ''Trivrita'' having black root) and ''Trivrita'' (the variety having pinkish root) are to be boiled in water along with the paste of ''Amalaki''. Using this decoction, medicated ghee is prepared and taken in (for purgation).<br /> <br /> Using the decoctions of ''Shyama'' (the variety of ''Trivrita'' having black root) and ''Trivrita'' (the variety having pinkish root), medicated ghee can be prepared and taken in (for purgation).<br /> <br /> Using both of the varieties of ''Trivrita'' milk is boiled, filtered and used for purgation with ease. [65½ - 68]<br /> <br /> === Preparations of ''Trivrita'' in the form of alcoholic beverages ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिवृन्मुष्टींस्तु सनखानष्टौ द्रोणेऽम्भसः पचेत् |&lt;br /&gt;<br /> पादशेषं कषायं तं पूतं गुडतुलायुतम् ||६९||&lt;br /&gt;<br /> <br /> स्निग्धे स्थाप्यं घटे क्षौद्रपिप्पलीफलचित्रकैः | &lt;br /&gt;<br /> प्रलिप्ते मधुना मासं जातं तन्मात्रया पिबेत् ||७०|| &lt;br /&gt;<br /> <br /> ग्रहणीपाण्डुरोगघ्नं गुल्मश्वयथुनाशनम् | &lt;br /&gt;<br /> सुरां वा त्रिवृतायोगकिण्वां तत्क्वाथसंयुताम् ||७१|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> trivrnmushtimstu sanakhanashtau droneambhasah pachet | &lt;br /&gt;<br /> padashesham kashayam tam putam gudatulayutam ||69|| &lt;br /&gt;<br /> <br /> snigdhe sthapyam ghate kshaudrapippaliphalacitrakaihi | &lt;br /&gt;<br /> pralipte madhuna masam jatam tanmatraya pibet ||70|| &lt;br /&gt;<br /> <br /> grahanipandurogaghnam gulmashvayathunashanam | &lt;br /&gt;<br /> suram va trivrutayogakinvam tatkvathasamyutam ||71|| &lt;br /&gt;<br /> <br /> trivrunmushtimstu sanakhanashtau droneambhasah pachet | &lt;br /&gt;<br /> padashesham kashayam tam putam gudatulayutam ||69|| &lt;br /&gt;<br /> <br /> snigdhe sthapyam ghate kshaudrapippaliphalacitrakaihi | &lt;br /&gt;<br /> pralipte madhuna masam jatam tanmatraya pibet ||70|| &lt;br /&gt;<br /> <br /> grahanipandurogaghnam gulmashvayathunashanam | &lt;br /&gt;<br /> suram va trivrutayogakinvam tatkvathasamyutam ||71|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Eight fist-full of ''Trivrita'' root is to be boiled in one ''drona'' of water till one fourth of the water remains. Then the decoction is filtered out and mixed with one ''tula'' of jaggery, honey and powders of ''Pippali'' seeds of / ''Madana phala'' and ''Chitraka''. Then the entire liquid is poured into an earthen vessel, whose inner side is thoroughly coated with ghee initially followed by a second coat with the powders of ''Pippali, Madana bija'' and ''Chitraka'', grinded with honey. The vessel is to be covered and left over for one month. When fermented well, this can be taken in, in appropriate dosage, which cures dysentery (''Grahani''), anaemia (''Pandu''), abdominal lumps (''Gulma''), and edema (''Shvayathu'').<br /> <br /> Similarly, the fermented liquid prepared using the decoction of ''Trivrita'' and ''Kinva'' (sediment left behind after the fermentation process is over) of the above preparation may also be used (for purgation).[69-71]<br /> <br /> === Preparations of ''Trivrita'' in the form of ''Kanjika'' (fermented gruels) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यवैः श्यामात्रिवृत्क्वाथस्विन्नैः कुल्माषमम्भसा |&lt;br /&gt;<br /> आसुतं षडहं पल्ले जातं सौवीरकं पिबेत् ||७२|| &lt;br /&gt;<br /> <br /> भृष्टान् वा सतुषाञ्छुद्धान् यवांस्तच्चूर्णसंयुतान् | &lt;br /&gt;<br /> आसुतानम्भसा तद्वत् पिबेज्जातं तुषोदकम् ||७३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yavaihi shyamatrivrutkvathasvinnaihi kulmashamambhasa | &lt;br /&gt;<br /> asutam shadaham palle jatam sauvirakam pibet ||72|| &lt;br /&gt;<br /> <br /> bhrushtan va satushanchuddhan yavamstacchurnasamyutan | &lt;br /&gt;<br /> asutanambhasa tadvat pibejjatam tushodakam ||73|| &lt;br /&gt;<br /> <br /> yavaihi shyamatrivrutkvathasvinnaihi kulmashamambhasa| &lt;br /&gt;<br /> Asutam shadaham palle jatam sauvirakam pibet||72|| &lt;br /&gt;<br /> <br /> bhrushtan va satushaachuddhan yavamstacchurnasamyutan| &lt;br /&gt;<br /> asutanambhasa tadvat pibejjatam tushodakam||73|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Dehusked barley is to be steam boiled with the decoction of ''Shyama'' (the variety of ''Trivrita'' having black roots) and ''Trivrita'' (the variety of ''Trivrita'' having pink roots). This steam boiled barley (''Kulmasha'') is to be mixed with water, (kept in a pot) and allowed to ferment for six days covered by a heap of grains (''Palla''). The ''Sauviraka'' (fermented liquid) prepared can be taken in (for the purpose of purgation).<br /> <br /> Alternatively, unhusked barley is to be fried well and powdered. This powder, along with the powdered root of ''Trivrita'' can be mixed with water and stored for six days till fermentation, following the procedure of the previous preparation. This ''Tushodaka'' (Fermented liquid) can be utilized for the purpose of purgation. [72-73]<br /> <br /> === Preparations of ''Trivrita'' in the form of ''Badara'' etc. ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तथा मदनकल्पोक्तान् षाडवादीन् पृथग्दश |&lt;br /&gt;<br /> त्रिवृच्चूर्णेन संयोज्य विरेकार्थं प्रयोजयेत् ||७४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatha madanakalpoktan shadavadin prthagdasha | &lt;br /&gt;<br /> trivrcchurnena samyojya virekartham prayojayet ||74|| &lt;br /&gt;<br /> <br /> tatha madanakalpoktan shadavadin pruthagdasha| &lt;br /&gt;<br /> trivrucchurnena samyojya virekartham prayojayet||74|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As described in [[Madanakalpa Adhyaya]] verse 26, ten such preparations in different forms like ''Shadava'' etc. using the powder of ''Trivrita'' can be made and used for purgation.[74]<br /> <br /> === Methods of making the drug more palatable ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भवतश्चात्र-&lt;br /&gt;<br /> <br /> त्वक्केशराम्रातकदाडिमैलासितोपलामाक्षिकमातुलुङ्गैः | &lt;br /&gt;<br /> मद्यैस्तथाऽम्लैश्च मनोनुकूलैर्युक्तानि देयानि विरेचनानि ||७५||&lt;br /&gt; <br /> <br /> शीताम्बुना पीतवतश्च तस्य सिञ्चेन्मुखं छर्दिविघातहेतोः | &lt;br /&gt;<br /> हृद्यांश्च मृत्पुष्पफलप्रवालानम्लं च दद्यादुपजिघ्रणार्थम् ||७६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhavatashchatra- &lt;br /&gt;<br /> <br /> tvakkesharamratakadadimailasitopalamakshikamatulungaihi | &lt;br /&gt;<br /> madyaistathaamlaishcha manonukulairyuktani deyani virechanani ||75|| &lt;br /&gt;<br /> <br /> shitambuna pitavatashcha tasya sinchenmukham chardivighatahetoh | &lt;br /&gt;<br /> hrudyamshcha mrutpushpaphalapravalanamlam cha dadyadupajighranartham ||76|| &lt;br /&gt;<br /> <br /> bhavatashchatra- &lt;br /&gt;<br /> <br /> tvakkesharamratakadadimailasitopalamakshikamatulungaihi | &lt;br /&gt;<br /> madyaistathaamlaishcha manonukulairyuktani deyani virechanani ||75|| &lt;br /&gt;<br /> <br /> shitambuna pitavatashcha tasya sinchenmukham chardivighatahetoh | &lt;br /&gt;<br /> hrudyamshcha mrutpushpaphalapravalanamlam cha dadyadupajighranartham ||76|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus, it is said,<br /> <br /> A purgative drug may be administered along with, ''Twak'' (cinnamon bark), ''Kesara'' (saffron), ''Amrataka, Dadima, Ela, Sitopala'' (sugar candy), honey, ''Matulunga'', alcohol or fermented liquid and sour drinks, to make them more palatable or cordial.<br /> <br /> If a person develops vomiting sensation after consuming a purgative drug, cool water may be sprinkled over his face. He can be advised to inhale pleasing aromas or fragrances originating from earth, flowers, fruits, tender leaves and sour substances, which control the same.[75-76]<br /> <br /> === Summary of the chapter ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकाः- &lt;br /&gt;<br /> <br /> एकोऽम्लादिभिरष्टौ च दश द्वौ सैन्धवादिभिः | &lt;br /&gt;<br /> मूत्रेऽष्टादश यष्ट्यां द्वौ जीवकादौ चतुर्दश ||७७|| &lt;br /&gt;<br /> <br /> क्षीरादौ सप्त लेहेऽष्टौ चत्वारः सितयाऽपि च | &lt;br /&gt;<br /> पानकादिषु पञ्चैव षडृतौ पञ्च मोदकाः ||७८|| &lt;br /&gt;<br /> <br /> चत्वारश्च घृते क्षीरे द्वौ चूर्णे तर्पणे तथा |&lt;br /&gt;<br /> द्वौ मद्ये काञ्जिके द्वौ च दशान्ये षाडवादिषु ||७९|| &lt;br /&gt;<br /> <br /> श्यामायास्त्रिवृतायाश्च कल्पेऽस्मिन् समुदाहृतम् | &lt;br /&gt;<br /> शतं दशोत्तरं सिद्धं योगानां परमर्षिणा ||८०|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra shlokah- &lt;br /&gt;<br /> <br /> ekoamladibhirashtau cha dasha dvau saindhavadibhih | &lt;br /&gt;<br /> mutreashtadasha yashtyam dvau jivakadau chaturdasha ||77|| &lt;br /&gt;<br /> <br /> kshiradau sapta leheashtau chatvarah sitayaapi cha | &lt;br /&gt;<br /> panakadishu panchaiva shadrutau pancha modakah ||78|| &lt;br /&gt;<br /> <br /> chatvarashcha ghrte kshire dvau curne tarpane tatha | &lt;br /&gt;<br /> dvau madye kanjike dvau cha dashanye shadavadishu ||79|| &lt;br /&gt;<br /> <br /> shyamayastrivrutayashcha kalpeasmin samudahrutam | &lt;br /&gt;<br /> shatam dashottaram siddham yoganam paramarshina ||80|| &lt;br /&gt;<br /> <br /> tatra shlokah- &lt;br /&gt;<br /> <br /> ekoamladibhirashtau cha dasha dvau saindhavadibhih| &lt;br /&gt;<br /> mutreashtadasha yashtyam dvau jivakadau chaturdasha||77|| &lt;br /&gt;<br /> <br /> kshiradau sapta leheashtau chatvarah sitayaapi cha| &lt;br /&gt;<br /> panakadishu panchaiva shadrutau panjcha modakah||78|| &lt;br /&gt;<br /> <br /> chatvarashcha ghrute kshire dvau curne tarpane tatha| &lt;br /&gt;<br /> dvau madye kanjike dvau cha dashanye shadavadishu||79||&lt;br /&gt;<br /> <br /> shyamayastrivrutayashcha kalpeasmin samudahrutam| &lt;br /&gt;<br /> shatam dashottaram siddham yoganam paramarshina||80|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> To sum up,<br /> <br /> The chapter on the pharmaceutical preparations of ''Shyama Trivrita'', the great seer (Charaka) has prescribed one hundred and ten formulations to be used as purgatives. They are summarized here, as follows:<br /> #Nine preparations with sour juice etc.;<br /> #Twelve preparations with rock salt etc.;<br /> #Eighteen preparations with cow’s urine<br /> #Two preparations with ''Yashtimadhu''<br /> #Fourteen preparations with ''Jivaka'', etc;<br /> #Seven preparations with milk etc.<br /> #Eight preparations in the form of linctus. <br /> #Four preparations with sugar<br /> #Five preparations in the form of syrup etc.<br /> #Six preparations for different seasons.<br /> #Five preparations in the form of ''Modaka'' (large pills).<br /> #Four preparations in the form of medicated ghee or medicated milk.<br /> #Two preparations, one, in the form of powder and another in the form of soothing drink.<br /> #Two preparations in the form of medicated alcohol<br /> #Two preparations in the form of ''Kanji'' (fermented beverage)<br /> #Ten preparations in the form of ''Shadava, Badara'', etc.; [77-80]<br /> <br /> Colophon:<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते <br /> दृढबलसम्पूरिते कल्पस्थाने श्यामात्रिवृत्कल्पो नाम सप्तमोऽध्यायः ||७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagniveshakrte tantre charakapratisamskruteaprapte <br /> drudhabalasampurite kalpasthane shyamatrivrutkalpo nama saptamoadhyayah ||7||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus ends the seventh chapter titled “The pharmaceutical preparations of ''Shyama Trivrita''” in the section named [[Kalpa Sthana]] of the work of Agnivesha, as redacted by Charaka and supplemented by Dridhabala.<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *''Trivrita'' is ''kashaya''(astringent), ''madhura''(sweet) ''rasa, katu''(pungent), ''vipaka''(product after digestion), and ''ruksha''(dry) properties. These properties do not support the purgative action, in spite of this ''Trivrita'' is best among purgative drug. <br /> *It pacifies [[kapha]] and [[pitta]] and aggravates [[vata]] due to its ''ruksha''(dry) property. <br /> *Roots of ''Trivrita'' are used in pharmaceutical processing. These are of two types: black (''Shyama'') and the other having Blackish red. The latter are more useful between them.<br /> *The blackish red root of ''Trivrita'' can be safely used as mild purgative in tender persons, children, old aged people and those with laxed bowel. The blackish variety is strong purgative and can cause untoward effects. It is used in more aggravation of [[dosha]] and hard bowel persons. <br /> *After combining with respective [[dosha]] pacifying drugs, ''Trivrita'' can be used in treatment of all diseases due to any [[dosha]] vitiation. It can also be used in all seasons in combination with various drugs.<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> <br /> === Synonyms ===<br /> <br /> The first two synonyms ''Tribhandi'' and Trivrita are indicative of the nature of its stem. It is a stout, twining and three winged stem. ''Tribhandi'' specifically denotes its wavy looking stem in three angles. Trivrita points at its nature of growth of the stem in three directions.<br /> <br /> ''Shyama'' is indicative of the color of its root. The fourth word ''Kutarana'' is probably a misspelt synonym. It will be very much ideal, if we read it as ''Kotarana'' which directs us towards its flower. Flowers are generally white in colour, funnel shaped and arranged in few flowered cymes. The meaning of ''Kotara'' is hollow and the petals of the flower form a hollow and funnel like tubular structure and are an identification point to many of the flowers of the Ipomoea genera. When a ''Pratyaya'' (suffix) is added to the word ''Kotara'', the final word ''Kotarana'' is formed. The last two synonyms, ''Sarvanubhuti'' and ''Suvaha'' open us a clue regarding its wide acceptability and suitability to all individuals, causing no spasmodic pain and any other such type of undesired actions. ''Sarvanubhuti'' means suitability to all and ''Suvaha'' means tolerated by all. (Verse 4)<br /> <br /> === Properties ===<br /> <br /> Some drugs have got inborn tendency to act in some pathological conditions. Similarly, ''Trivrita'' has the natural property to aggravate [[vata]] and pacify [[pitta]] and [[kapha]]. But when prepared with [[vata]] pacifying drugs, it cures diseases caused by [[vata]]. Similarly, when prepared with [[pitta]] and [[kapha]] pacifying drugs, it can be capable of curing diseases caused by [[pitta]], and [[kapha]] respectively. This property of modulating the pharmacological action depending upon the preparation is known as ''Samskarabhivartana; Ghuta'' or clarified butter is also said to possess the similar property.<br /> <br /> Pharmacological Properties of a drug are described in any context to gain full length knowledge about its therapeutic actions. But at times, there may not be exact concordance between these two. The Ayurvedic parameters like ''rasa, guna'', etc.; generally show or exhibit the same therapeutic actions, attributed to them. But some drugs that are strong emetics, purgatives and antitoxic, do not imbibe themselves to the theoretical parameters and exert their individualized action. So, ''Trivrita'' also can be considered as a drug with individualized action. (Verse 5-6)<br /> <br /> === Types ===<br /> <br /> The commentators like Chakrapani opined that Charaka preferred the blackish red variety because of its good or sustained purgative action along with less or little undesired actions, causing no ''vyapatti'' (complications). <br /> <br /> Actually, there is no confusion regarding the source of ''Trivrita'', which is the root of Operculum turpethum (Linn) Silva Manso, Syn. Ipomoea turpethum R. Br. (Fam. Convolvulaceae). Then, how it happens to procure two types of roots having different colors and different pharmacological actions with difference in the intensity of the action of purgation. Either they should be from different genera or different species or should be from an entirely different plant. The confusion originated at this juncture, complicated by commentators, traders and less knowledgeable physicians. Adding to the existing confusion, we can find two more words in Sushruta Samhita and they are ''Maha Trivrita'' (or major ''trivrita'') and ''Maha Shyama'' (major''shyama''). They probably are the roots of a fully grown/mature plant, where the roots tend to grow large because of the perennial nature of the twining plant. At the same time, traders, who market the drug started selling some different roots or stem pieces with the name of ''trivrita'' or ''shyama'', knowingly or unknowingly for hundreds of years. But in the market, stem pieces or rarely root pieces of Marsdenia tenacissima W. &amp; A are sold under the name of ''trivrita'' or ''shyama'' which are neither black nor white, but when sold as they are, they look black and when decorticated, they appear white or pinkish white. In the markets of Kanpur in India, the roots of Operculina turpethnum are sold with the name of ''vidhara'' or ''vriddhadaru'', which is not mentioned by either Charaka or Sushruta. Recently, as reported by Dr K. Nishteswar, roots of ''Ipomoea triloba'' are also sold with the name of ''trivrita'' in the markets of Gujarat.<br /> <br /> It is well reported and also observed by the author personally that, the root bark of ''Operculina turpethum (Linn)'' Silva Manso, when dried under the sun becomes white and when shade dried, turns black. This point is to be observed very carefully because, in the original text, Charaka nowhere mentioned two plant species but mentioned two varieties of roots, which is supported by the word ''Tasyah Mulam Dvividham'' i.e., its root is of two types using singular form for the plant. Hence, the concept of sun-dried and shade-dried roots, stands good and it is a known fact that factors like storage, preservation, exposure to heat or sunlight bring many changes in the chemical constituents of plant parts but, till date no research work has been conducted in differentiating the constituents of differently dried root parts, which may bring some light into the subject.<br /> <br /> But, with lapse of time, by the time of lexicographers like Sodhala, Dhanvantari and Bhavamishra, the other variety of ''Shyama'' intruded the market or trade and new plant species having better or equivalent laxative or purgative action attracted the authors. Some new synonyms like ''Palindi, Kali, Masuravidala'' and ''Kalameshika'' are attributed to the black variety of ''Trivrita'' i.e. ''Shyama'' and this variety is distinctly separated as a new variety, while disregarding the opinion of Charaka or Sushruta who never considered two plant species but explored only two varieties of roots. Then, some species of Ipomoea which resembles the morphological synonyms is to be searched for. In this prolonged process, many modern authors suggested different species, depending upon the traditional utility and morphological similarities. One of such plants Ipomoea petaloidea can be equated with ''Shyama'', basing on the synonyms. The word ''Palindi'' indicates the flowers; The upper part of the sepals is divided and resembles ''pali'', i.e., ear lobe. ''Kali'' and ''Kalameshika'' denote the color of the flowers as bluish black where as that of ''Shveta Trivrita'' (Operculina sp) appear pure white. ''Masuravidala'' means the two separated parts of the lens shaped lentil seed and the leaves of Ipomoea pes-caprae (Linn.) Sweet, exactly resemble them. Hence, some authors considered this species also as ''Shyama''.<br /> <br /> Then, coming to the opinions of different modern day authors, Bapalal has suggested using ''jalapa'' i.e. Exogoneum purge, Benth. As the white variety of ''Trivrita'', well developed ''Trivrita'' as ''Maha Shyama'' and O. turpethum as ''Shyama''. Sharma, P.V accepted O. Turpethum as ''Trivrita'' and Ipomoea petaloidea Chois as Shyama. Regarding Maha Shyama, he has suggested two possibilities. It is either some Ipomoea or Euphorbia species.<br /> <br /> But according to the opinion of the author, if, we wish to follow the instructions of Charaka as they are, ''Trivrita'' is only one plant i.e. Operculina turpethum (Linn.) Silva Manso and we have to use the roots of the same plant. If we need to procure pinkish roots, we have to dry them in sunlight and for black roots they may be dried in shade. This practice can be continued till a final conclusion, basing on the phyto-chemical, pharmacological and therapeutic works and till that time, it is better not to confuse with the names and traditional practice of using different plant species for purgation can be continued. (Verse 7)<br /> <br /> === Indications ===<br /> <br /> According to the indications, persons having delicate health and children are not advised purgative therapy. Even then, it may be necessary sometimes to utilize purgatives for such persons also. Then, ''Trivrita'', having blackish red root can be administered safely.<br /> Generally, there will be exceptions for any prescribed rule and the same thing is applicable in case of purgatives also. Though, they are not indicated for all, in case of emergency situations, because of the high safety margin, ''Trivrita'' roots of blackish red variety may be used.<br /> <br /> The first blackish red variety acts as a mild purgative but black variety acts as a cathartic. It can cause many undesired actions also due to its potent activity. It mainly creates spasm in the alimentary tract. So, the person experiences pain in the throat and cardiac regions immediately after consuming the drug. When, excessive purgation occurs naturally, there is tissue loss, electrolyte imbalance and dehydration and as a result, the patient may undergo stupor and unconsciousness. Even then, it is highly praised for its prompt action and potent evacuative capacity of bowels.<br /> <br /> === Method of collection ===<br /> <br /> The method of collecting emetic and purgative drugs is well described in [[Madanakalpa Adhyaya]]. The same method may be followed in case of ''trivrita'' also. Additionally, some specific measures that are to be followed while collecting ''trivrita'' roots are mentioned here. The root of ''trivrita'' that is penetrated deep into the earth is to be collected. A Synonym, ''Sarala'' which denotes the deeply and straightly penetrating nature of the root is mentioned in Dhanvantari Nighantu and Bhavaprakasha. The roots that spread sideways are not stout and are not supplied with sufficient nutrition. Hence, they may not contain the needed chemical constituents and are to be avoided. Usually, the pith inside a root acts for stability and never contains any type of active principles. Without removing the pith, the bark cannot be dried quickly. Anyhow, the methods of storage, as suggested in the first chapter can be followed.<br /> <br /> === Various preparations ===<br /> <br /> Administration of thin gruel, in the previous night is an exception to the general rule to the purgation process, as stated in Sutra 13:18. There, it is said that the person who is to be purgated is to be given a liquid diet along with meat-soup which is unctuous (''Snehavat'') and hot, continuously for three days. But when, purgation with ''trivrita'' is being done, this rule need not be followed and a single semi liquid diet in the previous night is sufficient. Anyhow, it is to be given when hot and is prepared with meat soup, adding ghee. The reason for this exception is that, ''trivrita'' is such a drug which can cause purgation with ease, causing less or little complications.<br /> <br /> In total, 110 preparations of ''trivrita'' are described in this chapter, utilizing different vehicles and different forms that are suitable for each individual. Out of them nine preparations are counted here. Fermented liquids or urine of different animals are used. Though, the secondary purpose of liquid is to swallow the drug easily, the main purpose is to facilitate the action of the drug.i.e ''trivrita''. In general, the fermented liquids can expel out the hard ''feces'' (''bhedi''), palatable and control reversed peristalsis there by reducing the spasm generated during the administration of purgatives. The person suffers from less colicky pain by using them. The use of urine of different animals helps to pacify [[kapha]] and alleviate colicky pain. Thus, the use of vehicles, enhance the desired action of the main drug and reduce the undesired actions.<br /> <br /> === Twelve preparations ===<br /> <br /> Another twelve preparations of ''trivrita'', along with twelve different types of salts are described. Anyone of them should be mixed with the powdered root of ''trivrita'' and powdered ginger and taken in with hot water. The list of the salts is not mentioned here but as per the suggestion of Chakrapani, the commentator, they are enlisted here from the eighth chapter of [[Vimana Sthana]] of [[Charaka Samhita]]. There, total number of fifteen salts is mentioned and Charaka advised here, to consider the first twelve salts. The other three types of salts that are left over are ''ushara, pateyaka'' and ''pamshya''. The main purpose of mixing any of the salts in the process of purgation is to prevent dehydration and electrolyte loss. Addition of dry ginger (''shunthi'') also serves the purpose of breaking the hard feces and reducing spasmodic pain.<br /> <br /> === Eighteen formulations ===<br /> <br /> Eighteen formulations, using eighteen drugs along with the powdered root of ''trivrita'' which can be used along with cow’s urine as a liquid vehicle are mentioned. All the plant drugs that are used here are appetizers, stimulants and they relieve spasm as well. The role of cow’s urine in this context is quite reasonable in the sense that, it acts as a stimulant and is capable of modulating the action of any drug taken along with it positively. That itself is capable of doing mild laxation and acts as an anti-toxic drug.<br /> <br /> === Yashtimadhu combination ===<br /> <br /> One preparation, along with ''yashtimadhu'' is described. In the index at the end of this chapter, two preparations, using the same drug are enlisted. The other one is narrated in the verse no. 19. This preparation is very much palatable and is specifically useful for those persons having [[pitta]] type of constitution who are suffering from symptoms like throat burn.<br /> <br /> === Fourteen preparations ===<br /> <br /> Fourteen preparations using ''trivrita'' along with fourteen different drugs like ''jivaka'' are narrated. Additionally, one more preparation, using ''yashtimadhu'' is also described. These preparations are very much palatable as most of the drugs are sweet in taste. Though, some of them are bitter, their ''vipaka'' or post digestive effect is sweet. So, apart from causing purgation, they relieve many diseases caused by [[vata]] and [[pitta]] and act as rejuvenatives ([[rasayana]]) as well.<br /> <br /> === Seven preparations ===<br /> <br /> Total number of seven preparations, of ''trivrita'' are prescribed, using seven different ingredients. Many of them are having sweet taste and are able to control [[vata]] potentially. Milk and meat soup are highly palatable and can be given to individuals with their choice. The third one is sugar cane juice, accepted by all and is an addition to the laxative action. The next three recipes are fruit juices and have got pure sweet taste with mild laxative action. The seventh one is ghee which alleviates [[vata]] and reduces the drastic action of any purgative drug. ''Haritaki'' is added half the quantity to the main drug to enhance the purgative action of ''trivrita'' very safely and in a sustained manner.<br /> <br /> === Avaleha (linctus) ===<br /> <br /> This is the first one of the eight preparations in the form of linctus. ''Avaleha'' or linctus is such a preparation which provides additional palatability to any of the drug mixed with it. Persons, who feel aversion to medicinal preparations that too emetics or purgatives due to their bitter taste or disagreeable aroma, can easily consume such preparations.<br /> <br /> === Powder combinations ===<br /> <br /> The powders of three more drugs along with powdered sugar are advised to be taken along with ''trivrita'' in the powder form. They are thoroughly mixed with honey and ghee to make it linctus. But, nowhere, the proportion of the drugs used is mentioned either by Charaka or the commentators. Ashtanga Hridaya also followed the same verse but didn’t mention either the proportion or the dosage. Because, this preparation is used in conditions like fever and thirst, it will be better to use the ingredients in equal proportions and limit the dose for laxation but not for purgation.<br /> <br /> === Proportion of trivrita ===<br /> <br /> In this preparation, the proportions of individual ingredients are mentioned by Chakrapani. One part of the powder or paste of ''trivrita'', One part of sugar and one-fourth part of the decoction of ''trivrita'' may be used to make an agreeable form of preparation. This is highly palatable as this contains only the black variety of ''trivrita'' as its ingredient, it can be used with caution but more precisely.<br /> <br /> <br /> As a principle, honey is not heated or boiled, which makes it poisonous, according to the Ayurvedic texts. But in this preparation, exceptionally, it is advised by Charaka himself to boil honey and melt sugar. It is true that, honey bees collect honey from many poisonous flowers also. This toxicity may enhance, when the honey is heated or boiled. But, when given along with as a purgative drug, there is less chance of honey being absorbed into the system. Apart from this, it enhances the palatability of the preparation and intestinal motility is increased due to the ''ushna viryata''. The proportions of ingredients in this preparation are, powdered ''trivrita'' in one-fourth quantity to the syrup and the other drugs like cinnamon bark in the required quantity. Their purpose is to enhance the flavor of the preparation, to make it acceptable.<br /> <br /> This preparation (Verse 23 ½ - 25) is intended for rich people and whose physique is tender. As they usually consume high fat diet regularly, they need not undergo oleation therapy as a prerequisite to purgation. This linctus can cause purgation even in them, with ease. <br /> <br /> Though, the quantity of ''trivrita'' to be added is not mentioned here, as a common rule, one-fourth quantity to the liquids may be added. The fruit juices in general and juices of grapes and ''pilu'' specifically cause mild laxation and expel out the stagnated [[pitta]] [[dosha]] from the body effectively. The honey that is heated also can act as a [[pitta]] aggravating factor to mobilize it from the existing place and move it out. Similar preparation is found also in Sushruta Samhita and Ashtanga Hridaya. (Verse 26-27)<br /> <br /> These preparations (Verse 28) are made in the similar process as that of linctus. For making these preparations, sugarcane juice etc; as described in the verses 26-27 are to be utilized accordingly.<br /> <br /> In this preparation (Verse 29), both the varieties of ''trivrita'' roots are used for their synergistic action. Though, the propositions are not mentioned, they can be taken in equal quantity. The other drugs are also able to check the status of [[kapha]] and help to expel out the stagnated [[kapha]] from the body. ''Kshara'' mentioned here is an alkali preparation that is prepared synthetically, using grasses and herbs.<br /> <br /> This preparation (Verse 30-32) can be made as per the method mentioned in verses 26-27. Quantity of the ingredients individually is not mentioned here. But for all practical purposes, the juice of ''Matulunga'', etc; are to be taken in the quantity of one ''kudava'' each. This is as per the suggestions made by Chakrapani.<br /> <br /> In Verse 33, five types of preparations are mentioned for better palatability. These preparations also help in averting any type of undesired action. Moreover, these due to their liquid nature, pass on to the large intestines very easily so that the drug action starts early.<br /> <br /> <br /> This type of smoothening drink (Verse 34-35) is one of the two, prescribed in the same chapter. This is very much pleasing, tasty, aromatic and strength giving while causing purgation. The recipient never feels tired even after purgation as the complications are little.<br /> <br /> This (Verse 36) is one of the five preparations of ''trivrita'' in the form of ''modaka''. The taste of this is good and causes less hazardous effects on the body while curing the disease proper.<br /> <br /> This (Verse 37-39) is the eighth and the last one of the preparations in the form of linctus. Measurement of ''modaka'' used here is one ''shana'' which measures approximately 3.0 grams. Because this contains many drugs which pacify [[kapha]], the preparation is indicated in upper abdominal diseases including bronchitis. Though it is said that no restrictions of any type are required here, they are to be followed cautiously and judiciously so that unexpected complications do not arise.<br /> <br /> === Kalyanaka guda ===<br /> <br /> This preparation, known as ''kalyanaka guda'' is the second one in the form of ''modaka''. The quantity of ''trivrita'' in this multi drug preparation is proportionately low; so, even though, this is consumed in different seasons without following any restrictions, there may not be any undesired effects. Moreover, an additional advantage of this preparation, which usual purgative does not possess is that it can help in promoting male progeny.<br /> <br /> <br /> This is the third preparation (Verse 45 ½ - 49½) in the form of ''modaka''. This is also known as ''abhayadi modaka'', according to Chakrapani. The quantity of honey is not prescribed here and can be used as per the need to prepare the ''modaka''. He further says that ''danti'' and ''trivrita'' are to be used two times and eight times to the total ingredients of ''shunthi'' etc; or can be used two parts and eight parts respectively. He did not clarify the proportions but put forth the opinions of others. This is a special preparation in the sense that, he added one more purgative drug i.e. ''danti''. There seems to be similar preparation mentioned in the Ashtanga Hridaya, known by the name of ''Avipattiyoga''. In that formulation, ''danti'' is not added and the proportion of ''trivrita'' is suggested as nine parts, as the other ingredients are nine in number and each one part of them are taken for the preparation. This opinion is further supported by both of the commentators Hemadri and Arunadatta and we can follow the same opinion for all practical purposes.<br /> <br /> This (Verse 49½ - 50½) is the fourth formulation of ''trivrita'' in the form of ''modaka''. Here, Charaka has used the word ''urubuka'' (castor plant) but did not mention the part of the plant to be used. Ancient commentators on any of the verse too did not give their opinion. Some modern commentators advised to take powdered seed which does not appear to be correct since the powder is highly toxic and can kill a person in that dose. Hence, it is ideal to use the root bark of castor plant which is not toxic but causes purgation without causing intestinal spasm.<br /> <br /> The fifth type of trivrita formulation (Verse 50½ -55) in the form of modaka is prepared by dividing it into two parts - while the first one is preparation of large sized pills, the second part consists of application of medicated powders over it to make it more effective and palatable. There is a debate regarding the part of ''dadima'' to be used for preparations. In the similar compound, as mentioned in Ashtanga Hridaya, the preparation of ''modaka'' and its ingredients are to certain extent similar but the rolling (''veshtana'') process is not present. The seed powder of ''dadima'' is not effective therapeutically when dried and hence, the powder of the stem bark, which has got many potent actions against the diseases of colon that, can be used. Due to the addition of drugs like ''vacha, chitraka'' and ''tumburu'', diseases due to [[kapha]] are definitely alleviated.<br /> <br /> === Importance of Trivrita ===<br /> <br /> ''Trivrita'' is undoubtedly considered the best of all the drugs used for purgation due to its potent activity with very little undesired actions. Even then, the climatic conditions and impact of different seasons on our bodily functions cannot be neglected.<br /> <br /> To make this drug more safe and more effective surpassing these climatic changes, Charaka has given four different preparations, useful for four seasons - summer, rainy/monsoon, autumn and winter. Apart from these four, he has also formulated two preparations that are useful for all seasons. Though it is stated that, for a healthy person, purgation therapy is to be employed in post rainy season, it has to be administered as and when an emergency state occurs in any season. There, this preparation helps a physician and the patient to cope up with the situation safely. In rainy season, there is a dominance of ''vata'' and the addition of ''shunthi'', honey and grape juice help to overcome this problem.<br /> <br /> In this purgative preparation (Verse 57) that is useful in post rainy season, two drugs of plant origin appear to be confusing. They are ''duralabha'' and ''udichya''. ''Duralabha'' can be better equated with Fagonia cretica Linn. As some sweet resionous substance is prepared from this plant and marketed which pacifies [[Pitta]]. So the other plant ''udichya'' can be equated with some Valeriana sp. which acts against [[pitta]].<br /> <br /> The word ''drakshambu'' is different from the juice of grapes. Grape juice is a direct extraction of the fruits through compression. But for grape water, dry grapes are to be soaked in water over night, thoroughly squeezed and filtered. The difference between them is that the first one is more concentrated and the latter is more diluted.<br /> <br /> === Contraindication of purgation therapy and seasons affecting its efficacy ===<br /> <br /> Purgation therapy is not indicated during winter season due to the likely development of intestinal spasm because of the cold wave. Even then, in case of emergency or in a particular disease where [[kapha]] is causing problem or obstructing the lower parts of the colon, this purgation therapy is indicated. The powders mixed together can be ground well with hot water, so that the actual compound acts upon the system with ease.<br /> <br /> During hot summer, purgation therapy is not at all advised due to the fear of developing dehydration or electrolyte imbalance. Even during that season, if need arises, ''trivrita'' can be utilized without any complication. To avoid any unexpected problem Charaka suggested using it with sugar which can prevent gastritis due to [[pitta]].<br /> <br /> <br /> This formula (Verse 58½ - 60 )contains good number of purgative drugs apart from ''trivrita'', such as ''satala'' and ''svaranakshiri''. ''Katurohini'' is famous for its action of breaking and expelling out hard fecal matter. Moreover, all the drugs are allowed to soak in cow’s urine for three days. This entire process makes the compound more sharp and potent. So, this drug is said to cause proper purgation in patients who are overweight or who have undergone comprehensive oleation therapy. This can be used in all seasons irrespective of the climatic conditions because all the ingredients used are safe and never cause drastic purgation. This also means that, it should never be used in patients who have not undergone oleation.<br /> <br /> This preparation (Verse 61-62) contains both of the Trivruta roots (Pink and black) along with Nilini, a purgative drug. Even then, as it is advised to consume this preparation along with ghee and meat soup, it can be given even to persons who have less storage of fats in their body and who didn’t undergo oleation therapy. Thus, a total number of six preparations are prescribed in concordance with the seasons of varying climatic conditions.<br /> <br /> Verse 63-64: Though Chakrapani confused a little bit in numbering this preparation as the first one in the powder form, the preparation vide verse Nos. 34-35, in the form of Tarpana can be taken as the first one and the preparations of verse nos. 63-64 and 65 – ½ 66 can be considered as the second preparation. Then, the total number of one hundred and ten comes to a factual conclusion.<br /> <br /> In Verse 65- 65½, is the second one of the two preparations with ''trivrita'' used in the form of nourishing drink. This is highly palatable, nutritious and purgative and never causes any type of complications.<br /> <br /> Total four preparations (Verse 65½-68 )are described using ghee or milk as base. Both of the varieties of ''trivrita'' are utilized here as the main drugs of the compound. As milk or ghee are used along with, the harmful side effects of ''shyama'' never crop up.<br /> <br /> Two preparations (Verse 69-71) in the form of fermented beverages are mentioned. The main purpose is to store the preparation for a longer period of time. Additionally, the palatability becomes an advantage. This can also be used in persons habituated to alcohol for a longer period.<br /> <br /> These two preparations (Verse 72-73) are also fermented liquids like the preparations mentioned in verses 69-71. They are easily absorbable, palatable, fast acting and can be stored for a longer period of time. The first one is ''sauviraka'' which is prepared with dehusked barley and boiled. The second one is prepared with unhusked barley in the powder form and not boiled. These two preparations are equally effective and are suggested for those patients who are habituated to alcoholic beverages.<br /> <br /> === Enhancing palatability of formulation ===<br /> <br /> Here, ten preparations, utilizing the powdered root of ''trivrita'' are suggested. Their names and method of preparations are described in Charak Samhita [ Cha. Sa.[[Kalpa Sthana]] 1/26 ].<br /> #Badara – badava – Sour liquid made of jujube fruit<br /> #Raga – A liquid with, sour and pungent tastes.<br /> #Leha – A linctus<br /> #Modaka – A type of Indian sweet<br /> #Utkarika – A cake like preparation<br /> #Tarpana – Soothening drink<br /> #Panaka – Syrup<br /> #Mamsarasa – meat soup<br /> #Yusha – Pulse Soup and (or)<br /> #Madya – Alcoholic beverages.<br /> <br /> These preparations using ''Trivrita'' as the base drug enhance the pharmacological activity, palatability and acceptability.<br /> <br /> A common phenomenon that occurs after administration of purgative drugs is that, quite often, the patient develops nausea or vomiting sensation. If he vomits, the drug consumed becomes useless and can’t be given once again the same day. The reason is that many of such drugs are either bitter or aversive. So, the palatability of the preparation is to be maintained inspite of all the precautions, if he develops nausea, it is to be averted following certain methods which are pleasing to the mind.<br /> <br /> === Further reading ===<br /> <br /> #Kohli KR, Nipanukar SU, Kadbahane KP. A comprehensive review on Trivruta (Operculina turpethum) International journal of Pharma and biosciences, 2010: 1(4) 443-52<br /> #Bhande RM, Lakshmayya, Kumar P. Pharmacological Screening of root of Operculina turpethum and its formulations. Acta Pharmaceutica Sciencia, 2006: 48 11-7.<br /> #Sharma V. Singh M Operculina turpethum as a panoramic herbal medicine: a review, International journal of Pharmaceutical sciences and research 2012. 3(1) : 21-5<br /> #Kumar SV, sujatha C. Syamala J, Nayasudha B, Misra SH, Protective effect of root extract of Operculima turpethum Linn. Against paracetamol induced hepatotoxicity in rats. Indian J. of pharm Sci – 2006: 28 (1) 32-5.<br /> #Nitin Mahurkar A, Arati Malpani, S.Girish Kumar, RGUHS J. Pharm Sci. Vol 2, 4, 2012. 73-79.<br /> #Md. Harumal Rashid, MA Gafur, Antibacterial and Cytotoxic activities of extracts and isolated compounds of ipomolaturpethum, Pakistan Journal of Biological sciences 5(5) 597-599, (2002).<br /> #C. Anbuselvam, K. Vijayavel, Operculina turpethum against 7, 12 dimethylbenzanthracine induced oxidative stress with ref. to breast cancer in rats. Chemico Biological interactions, 168: 229-236 (2007).<br /> #Chunnekar, KC, Hota SP. Plants of Bhavaprakasha, Pub. 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Agnivesha https://www.carakasamhitaonline.com/index.php?title=Emergency_medicine_in_Ayurveda&diff=45396 2026-01-03T08:59:34Z

<p>Agnivesha: /* References of emergency conditions in Ayurveda texts */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:Emergency medicine in Ayurveda<br /> |title=<br /> |titlemode=append<br /> |keywords= Principles, diagnosis, management, medical emergencies, life-threatening condition, medical system healthcare, symbiohealth, charak samhita, caraka samhita, Indian system of medicine, alternative medicine, complementary medicine, Upendra Dixit, atyayika chikitsa, <br /> |description= Principles of diagnosis and management of medical emergencies in Ayurveda are described. <br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> '''Principles of Diagnosis and Management of medical emergencies in Ayurveda'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;<br /> (This article is based on a lecture delivered by Dr. Upendra Dixit, Chief consultant, Dixit Ayurveda, Goa, India., in Prof.M.S.Baghel Memorial Lecture Series on October 09, 2021.) &lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> <br /> |label1 = Section/Chapter/topic<br /> |data1 = [[Concepts and Contemporary Practices]] -[[Nidana]] [[Chikitsa]] /Emergency medicine <br /> <br /> |label2 = Author<br /> |data2 = Dixit U.&lt;sup&gt;1&lt;/sup&gt;<br /> <br /> |label3 = Reviewers <br /> |data3 = [[Gopal Basisht|Basisht G.]]&lt;sup&gt;2&lt;/sup&gt; <br /> <br /> |label4 = Editors<br /> |data4 = [[Yogesh Deole|Deole Y.S.]]&lt;sup&gt;2&lt;/sup&gt;, [[Gopal Basisht|Basisht G.]]&lt;sup&gt;2&lt;/sup&gt; <br /> <br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;Chief consultant, Dixit Ayurveda, Goa, India.<br /> <br /> &lt;sup&gt;2&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.&amp; R.A., Jamnagar, Gujarat, India <br /> <br /> <br /> |label6 = Correspondence email:<br /> |data6 = carakasamhita@gmail.com<br /> <br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> <br /> |label8 = Date of first publication:<br /> |data8 = December 10, 2021<br /> <br /> |label9 = DOI<br /> |data9 = 10.47468/CSNE.2021.e01.s09.076<br /> }}<br /> <br /> &lt;div style='text-align:justify;'&gt;<br /> The Atharvaveda quotes assurance statements by the sages to the person on the death bed. <br /> <br /> “Do not fear. You won’t die. We will save your life. “[Atharva veda 5.30.8] <br /> <br /> Ashtanga Hridaya quotes, [[Ayurveda]] can save the life of a person from the noose of death by using various measures. [A.Hr.Uttara tantra 44/74]&lt;ref name=AH&gt;Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.&lt;/ref&gt; <br /> <br /> It shows that medical emergency measures were handled successfully in ancient times to save human lives. Though no science can completely assure to prevent death, the physician has to try to save a life until the last breath. The physician is required to study the management of medical emergencies to find better, safe, and cost-effective healthcare solutions to save lives. <br /> &lt;/div&gt;<br /> ==References of emergency conditions in Ayurveda texts==<br /> &lt;div style='text-align:justify;'&gt;<br /> The word ‘atyaya’ denotes destruction or death. [Chakrapani, Cha.Sa. [[Sharira Sthana]] 1/50] [Dalhana, Su.Sa. Sharira Sthana 10/19-20].&lt;ref name=SU&gt;Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.&lt;/ref&gt; The word ‘atyayika’ denotes the quickest possible treatment done to protect life without any delay. [Dallhana, Su.Sa. Sharira Sthana. 8/5]&lt;ref name=SU /&gt; [Hemadri A.Hr.Sutra Sthana 2/33]&lt;ref name=AH /&gt; Therefore, the medicines to be used in medical emergencies shall be ready with the physician for first aid emergency treatment, even if the patient is to be referred to higher critical care centers. <br /> <br /> The word niratyaya explains how diet, various activities, and treatments can be performed in such a safe way that complications leading to severe consequences and emergencies can be prevented. <br /> &lt;/div&gt;<br /> <br /> ==Medical emergencies== <br /> &lt;div style='text-align:justify;'&gt;<br /> American college of emergency physicians has listed 1733 emergency conditions.&lt;ref&gt;Available from http://emedicine.medscape.com/emergency_medicine accessed on 03/12/2021 &lt;/ref&gt; It shows the scope of emergencies occurring in various medical fields. From this, we can understand that emergency medicine is a vast field. [[Ayurveda]] has a lot of potential to contribute to medical emergencies. However, it is not much explored in the current practices of [[Ayurveda]]. Although a few [[Ayurveda]] consultants are working in this field. Recently AVP research foundation, Coimbatore has undertaken a project on Ayurvedic emergency medicine. Not much literature is available to study the subject of management of emergency conditions through [[Ayurveda]]. A series of articles entitled ‘Basic principles of emergency treatment of [[Ayurveda]]’, published in AYU Journal written by Vaidya Mhaiskar V.B.&lt;ref&gt;Mhaiskar V.B. Basic principles of emergency medicine in Ayurveda (Gujarathi). Gujarat Ayurved University. Jamanagar&lt;/ref&gt; is one of the best sources to learn this topic. <br /> [[Ayurveda]] especially Brihat Trayi (texts termed as a great triad) provides lot of references regarding emergency conditions and their treatment. Here are a few examples:<br /> <br /> The condition of [[Vata]] dominant prameha (obstinate urinary disorders including diabetes) is incurable and has potential of causing emergency conditions. [Cha.Sa. [[Nidana Sthana]] 4/38]<br /> <br /> The [[pitta]] dominant gulma should be treated as an emergency condition. [Cha.Sa.[[Chikitsa Sthana]] 5/114]<br /> <br /> The cough (kasa) due to chest injury shall be treated as an emergency condition. [Cha.Sa. [[Chikitsa Sthana]] 8/134]<br /> <br /> The erysipelas (visarpa) due to vitiation of all [[dosha]] is considered as an emergency condition. [Cha.Sa.[[Chikitsa Sthana]] 21/41]<br /> <br /> The physician shall treat weak patients with utmost care to prevent complications. [Cha.Sa. [[Vimana Sthana]] 8/94]<br /> <br /> In an emergency condition, one should administer the purification therapies (shodhana) with great care. [Cha.Sa.[[Vimana Sthana]] 8/127]<br /> <br /> For understanding emergency treatment , all such references need to be compiled and thoroughly studied. The author has made efforts in this regard. <br /> &lt;/div&gt;<br /> <br /> ==Causative factors of emergency or life-threatening condition==<br /> &lt;div style='text-align:justify;'&gt;<br /> From all textual references, it can be understood that certain factors cause most emergencies. They are as below:<br /> <br /> *[[Marma|Marma (vital organs)]]<br /> <br /> *[[Rakta]] (blood)<br /> <br /> *[[Oja]] (immunity and essence of body tissues)<br /> <br /> *Udaka (fluid) <br /> <br /> *Prana vayu (a type of [[vata dosha]])<br /> <br /> *Pranavaha Srotasa (respiratory system transporting vital air) <br /> <br /> *[[Agni]] (digestion and metabolism)<br /> <br /> *Udana vayu (a type of [[vata dosha]])<br /> <br /> *[[Dhatu]] gata avastha (state of the affliction of tissues)<br /> <br /> *Shulopahatava ( Pain threshold or severity)<br /> <br /> *Upadrava jushtata (comorbid conditions or complications of various diseases)<br /> <br /> *Janapadodhwasa (epidemics and pandemic conditions)<br /> &lt;/div&gt;<br /> <br /> ==Concept of prana in [[Ayurveda]]==<br /> &lt;div style='text-align:justify;'&gt;<br /> The term prana is used for the vitality of life or life force. It is essential to understand the concept of prana and its importance in life-threatening emergency conditions.There are twelve sites of vitality (prana). Ayurvedic texts use the word ‘Prana’ as a synonym for certain body constituents. Prana is also used as a prefix to the names of certain body constituents.This indicates these body constituents are most vital, for saving a life. [[Agni]], Soma, Vayu, Sattva, Rajas, Tamas, [[Atma]] and [[Pancha mahabhuta]].[Su.Sa.Sharira Sthana 4/3]&lt;ref name=SU /&gt; <br /> <br /> The two temples, the three vital organs, the throat, rakta dhatu (blood), shukra dhatu (reproductive tissue), oja (the vital essence), and the anus are ten sites of life forces (prana).[Cha.Sa.[[Sutra Sthana]] 29/3]<br /> <br /> Prana vayu is one of the five types of [[Vata dosha]][Cha.Sa. [[Chikitsa Sthana]] 28/234].Food (anna)[Cha.Sa.[[Chikitsa Sthana]]24/60], water (udaka)[A.S.Sutra Sthana.6.11]&lt;ref name=AS&gt;Vridha Vagbhata, Ashtanga Sangraha. Edited by Shivaprasad Sharma. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012.&lt;/REF&gt; and strength or immunity (balam) are factors influencing vitality[Dalhana, on Su.Sa.Sutra Sthana 17/13].&lt;ref name=SU /&gt; <br /> <br /> The vitality from external sources or nature (bahya prana) and internal vitality (abhyantara prana) sustain human life. The vitality from external sources or nature is converted into internal vitality through channels of transportation and transformation of vitality (pranavaha srotasa) [Su.Sa.Sutra Sthana 17/13].&lt;ref name=SU/&gt; The vitality especially depends on blood tissue (rakta)[Cha.Sa.[[Sutra Sthana]] 24/4], essence ([[oja]]) (Chakrapani on Cha.Sa.[[Sutra Sthana]]28/4], digestion, and metabolism ([[agni]])[Cha.Sa.[[Chikitsa Sthana]]15/3,4]. It is presented through sensory and motor organs (indriya)[Cha.Sa.[[Sutra Sthana]]1/48]. <br /> <br /> Injury to the umbilicus (nabhi)[Su. Sa.Sharira Sthana 7/5]&lt;ref name=SU /&gt; , channels carrying nutrient fluid (rasavaha srotasa)[Su. Sa.Sharira Sthana 9/12]&lt;ref name=SU/&gt;, blood vessels (sira) can lead to sudden death(Dalhana on Su.Sa.Sharira Sthana 7/5].&lt;ref name=SU/&gt; <br /> <br /> Commonly observed clinical features in an emergency: <br /> <br /> * Acute and severe pain in vital organs like cardiac pain or abdominal pain etc. as observed in trimarmiya chikitsa chapter of charak Samhita. It is mentioned as sahasa daruna marmaruja. <br /> <br /> * Acute hemorrhage or excessive bleeding (sahasa atyartha raktasrava)<br /> <br /> * Dyspnoea (shvasakashta) <br /> <br /> * Sudden loss of sensation (sahasa indriyanasha)<br /> <br /> * Unconsciousness (sanjna nasha) <br /> <br /> * Syncope (moorchha)<br /> <br /> * Acute organ failure <br /> <br /> * Clinical features of the affliction of vital organs can cause death within seven days (sadya pranahara marma) like loss of perception, sudden vomiting, excess perspiration, a sudden feeling of heaviness [A.Sa.Sharira Sthana 7/47]&lt;ref name=AS/&gt;<br /> <br /> The clinical features of near-death patients are described in chapters of [[Indriya Sthana]].<br /> <br /> ==Diagnostic tools ==<br /> <br /> * In addition to the above clinical features, arishta or fatal signs observed in the patients are tools to diagnose emergency conditions. These appear suddenly, without any known cause, with the constantly deteriorating condition of the patient. <br /> <br /> * Changes in breathing patterns or respiration can indicate emergency conditions. Guidelines about this can be referred from the clinical features of affection of channels of transportation and transformation of prana (pranavaha srotasa). [Cha.Sa. [[Vimana Sthana]] 5/8]The patterns of respiration are described under types of shwasa like maha (a type of shwasa disease), urdhva (a type of shwasa disease) and chhinna (a type of shwasa disease) shwasa [Cha.Sa.[[Chikitsa Sthana]] 17] can be studied to understand emergency conditions resulting into death.<br /> <br /> * Dehydration status – can be understood from the clinical features of affection of channels of transportation and transformation of udaka (udakavaha srotasa). [Cha.Sa.[[Vimana Sthana]] 5/8]<br /> <br /> * Consequences of excessive emesis and purgation (atiyoga of vamana and virechana) are described showing emergency conditions. Effects ranging from mild degrees like dryness in the throat to severe effects like dilatation of pupil as precursor to death are described. [A.Sa.Sutra Sthana 27/20]&lt;ref name=AS /&gt;<br /> <br /> * Status of consciousness and orientation<br /> <br /> ==Consequences of the affliction of [[Marma|marma]] == <br /> Injury to different vital structures ([[Marma|marma]]) can have various consequences. Certain [[Marma|marma]] called 'sadyopranahara marma’ can lead to death instantaneously or within a week. General signs and symptoms can guide about injury to [[Marma|marma]], and accordingly the patient can be cared for. The clinical features are numbness of the body (deha supti), heaviness, confusional state, desire of cold things, excess perspiration, syncope, vomiting, dyspnoea, [A. Sa. Sharira sthana 7/47]&lt;ref name=AS/&gt;<br /> <br /> Injury to [[Marma|marma]] causes vasodilatation and profuse bleeding. This may lead to death. [A.Hr.Sharira Sthana 4/65]&lt;ref name= AH/&gt;<br /> <br /> ==Clinical assessment - Nadi (pulse examination)==<br /> Texts like Yogaratnakar etc. describe pulse examination. Here certain readings about pulse can indicate emergency conditions and imminent death of the patient. E.g. the pulse is irregular and unstable in case of emergency conditions. [Yoga Ratnakar] The other clinical parameters can be implied to assess critical conditions.<br /> <br /> ==Life-threatening conditions ==<br /> Certain diseases are specifically mentioned as resulting in death. In this regard, the following chapters shall be studied in depth to understand critical conditions in [[Ayurveda]]. <br /> <br /> *Jwara specifically sannipatika jwara (due to combination of all dosha) [Cha.Sa.[[Chikitsa Sthana]] 3] <br /> <br /> * Shwasa and Hikka (respiratory failure) [Cha.Sa.[[Chikitsa Sthana]] 17]<br /> <br /> * Sanyasa (coma) [Cha.Sa.[[Sutra Sthana]] 24]<br /> <br /> * Visarpa (eryspelas) [Cha.Sa.[[Chikitsa Sthana]] 21]<br /> <br /> ==Medical ethics in critical conditions==<br /> <br /> The patient on the death bed may not survive due to his predestined life span. However, the physician shall treat the patient till the last breath with a hope of life. Proper consent shall be taken from the close relatives of the patient after informing them of details about the critical condition. [A.Sa.Sharira Sthana 7/75] &lt;ref name=AS /&gt;<br /> <br /> ==Management of emergency conditions==<br /> <br /> The principles of management of emergency conditions include: <br /> <br /> * Protecting prana and [[Marma|marma]] (vital organs and structures) especially heart, brain, and urinary system <br /> <br /> * Use of antidotes or medicines used in poisoning (agada)<br /> <br /> * Protection and enhancement of oja (essence) and strength or immunity (bala)<br /> <br /> * Protection and maintenance of digestion and metabolism (agni)<br /> <br /> * Protection of sensory and motor organs (indriya) that are sites of consciousness (chetana)<br /> <br /> == Emergency medicine kit ==<br /> <br /> A kit of potent Ayurveda medicines shall always be ready with the physicians. It consists of the following:<br /> <br /> * Honey <br /> <br /> * Ardraka sattva or ginger juice <br /> <br /> * Levigating stone<br /> <br /> * Suvarna sutashekhara pottali <br /> <br /> * Hemagarbha pottali <br /> <br /> * Trailokya Chintamani rasa pottali<br /> <br /> * Other life-saving medicines and instruments<br /> <br /> To make proper use of these medicines to save the life of the patients, it is necessary to understand the exact mode of action of these medicines. With such knowledge, the physician can select appropriate medicine in the appropriate conditions. Here is a summary of the mode of action of these three most important medicines-<br /> <br /> ===1. Hemagarbha===<br /> <br /> * The veiling of tamas (inertia) on intellect ([[buddhi]]) and mind ([[mana]]) is removed and consciousness is regained and maintained.<br /> <br /> * [[Indriya]] (sense organs) are activated.<br /> <br /> * Chhedana (pertusion) of [[kapha dosha]] removes obstruction in the movement of [[vata dosha]]<br /> <br /> * Restore normal movement of [[vata]], by correcting avasada (slackening) – especially of prana, udana, and samana.<br /> <br /> * Maintains and increases heart rate, pulse rate, and heart rate in case of avasada (slackening)<br /> <br /> * Activates and promotes [[agni]] (deepana)<br /> <br /> * Specially used in Shlaishmika ([[kapha]] dominant), Antrika (intestinal affliction), and shvasanaka sannipata (respiratory affliction), tamaka-maha and urdhva shvasa, sanyasa etc.<br /> <br /> ===2. Trailokyachintamani rasa===<br /> <br /> * Removes the veiling of abnormal [[kapha dosha]]<br /> <br /> * Restores normal movements of [[vata dosha]], by correcting avasada(slackening)<br /> <br /> * [[Agni]]- dhatvagni deepana ( activates- ignites [[agni]])<br /> <br /> * Instantaneously increases [[oja]]<br /> <br /> * Destroys visha(~ poisons/toxins)<br /> <br /> * Protects heart and senses<br /> <br /> * Specially used in shlaishmika and shvasanaka sannipata.<br /> <br /> * Hridroga caused by obstruction of channels (srotas) by [[kapha]], ama, etc., Also in Hridroga caused by sudden depletion of [[oja]] or psychological factors like grief etc.<br /> <br /> * By controlling actions of prana, activities of senses([[indriya]]) are maintained, Avasada(slackening) is removed, which controls and maintains normal functions of the heart and lungs.<br /> <br /> * Provides immediate relief in hritshoola(angina)<br /> <br /> * Controls actions of vyana, thereby the actions of muscles<br /> <br /> * Vishanashaka (destroys toxins)<br /> <br /> * Specially used in critical conditions of hemiplegia (pakhaghata) and other [[vata]] dominant [[vyadhi]], in patients with severe debility<br /> <br /> ===3. Suvarna Sootashekhara===<br /> <br /> * Best medicine for restoring the normalcy of all three [[dosha]].<br /> <br /> * Maintains and regulates normal functions of all five types of [[vata dosha]].<br /> <br /> * By regulating actions of prana, regulates functions of senses([[indriya]]), mind([[mana]]), and intelligence([[buddhi]])<br /> <br /> * By regulating the actions of prana, regulates heart and respiration rate.<br /> <br /> * By regulating actions of samana, causes [[agni]] deepti(activates- ignites [[agni]]), regulates secretions of [[pitta dosha]], regulates gastrointestinal motility, regulates assimilation, separation, and absorption process (sarakitta vibhajana)<br /> <br /> * Samana, regulates sweating and maintenance of body temperature and energy levels.<br /> <br /> * Vyana, regulates circulation, sweating and bleeding process, movements of muscles, and other physical activities.<br /> <br /> * Apana, regulates defecation, micturition, etc. processes.<br /> <br /> * Performs pachana of sama [[pitta]], especially with amla, drava, and visra [[guna]]. <br /> <br /> * Controls [[kapha]]<br /> <br /> * Destroys visha(~ poisons/toxins)<br /> <br /> These pharmacological activities are observed in clinical experiences. More research on experimental models can be done on these medicines. <br /> Usually, these medicines are levigated on a specific levigating stone and applied on the gums of unconscious patients. For levigation, a small drop of honey and in specific conditions, 2-3 drops of ginger juice are used. The medicine is in minute quantity, so chances of entering into the respiratory tract are minimum. The medicine starts showing its actions within a few seconds. Many of such patients are in the intensive care unit (I.C.U.), on monitors. In such patients, the changes in heart rate, blood pressure, respiratory rate, etc. are observed instantaneously. Eg. The hemagarbha pottali was observed to instantaneously increase heart rate and improve the rate of respiration after application on gums in intensive care patients. Further research is needed to study the exact mode of action of these medicines. <br /> <br /> [[Ayurveda]] has described the criteria for prognosis of patients. Charaka Samhita presents a separate section on the prognosis of the patients and specific signs and symptoms observed in the critical patients (arishta), indicating certain death in the near future. In such patients, a complete cure is not possible. But even in these patients, it is observed that the life span can be extended for some time with Ayurvedic emergency medicines. If such signs and symptoms(Arishta), are not observed, the patient can survive for a longer period.<br /> <br /> ==Importance of food== <br /> Food plays an essential role in maintaining vitality in critical conditions. If the food is not given as per the digestive capacity ([[agni]]) of the patient, then it leads to the formation of toxic metabolites ([[ama]]). This further blocks the channels of transportation of nutrients ([[srotas]]) and worsens the condition. Therefore, easy-to-digest food like green gram soup (mudga yusha) is advisable to be given in critical cases. The wholesome food that is suitable to the patient and helpful in treating underlying disease conditions is advised.<br /> <br /> ==Experience-based evidence == <br /> It is difficult to maintain documentation of all cases while managing emergency medical conditions because the priority of the physician at that time is to save the life of the patient. There are further limitations to access case records of the patients from hospitals. The author has tried to maintain the records, as far as possible. The author has treated more than 170 critical patients in intensive care units of various hospitals in Goa and outside. In many of these patients, when the ongoing modern medical treatment was not showing the desired effects, Ayurvedic treatment was given as an adjuvant. Some patients were treated with Ayurvedic treatment only. Even during the pandemic of SARS COVID 19, around 40 patients showed better improvement when Ayurvedic treatment was given as an adjuvant to the modern medicines <br /> <br /> ==Acute conditions==<br /> [[Ayurveda]] has the potential to treat various acute conditions. For this, various methods of management and quick-acting medicines are available. The author has experienced various such conditions like high fevers, acute asthmatic exacerbation, hiccups, hypertension and hypotension, diarrhea including cholera, and gastroenteritis. In such acute conditions, it is experienced that [[Ayurveda]] has quick-acting medicines by which improvements can be observed right from the first dose, and within a few minutes changes are noted.<br /> <br /> ==Case reports of critical cases==<br /> Following case reports are available with necessary investigation reports, discharge summaries and videos wherever necessary.<br /> <br /> ===Case 1===<br /> <br /> A 68-year-old male patient with a history of hypertension for 10 years, alcoholic liver disease, cirrhosis, and adenocarcinoma of stomach was treated with ayurvedic treatments. He was in a comatosed state after suffering from seizures, cerebrovascular stroke due to intracranial hemorrhage, and hemiplegia. He was not responding to modern treatment in the hospital ICU, therefore was taken for home care treatment. Then onwards he was only on Ayurvedic treatment. The patient was treated with medicines like sutendra rasayana with honey, Arpisa rasayana, a combination of dhatri, raktapachaka and dhamasa . tapyadi loha, swarna raja vangeshwara rasa, haridra ghana, kukkuta nakhi, rasa sindura with honey. The patient regained consciousness in three to four days and was relieved of major symptoms. He survived for more than one and a half years. <br /> <br /> ===Case 2===<br /> <br /> A thirty-year old male patient suffered from a road traffic accident. He was in a coma due to traumatic brain injury. The injury included 10x,2x deep lacerated wound on right side forehead, brain contusion at the frontal lobe, and intraventricular bleeding on the right side. Since he was not responding to ongoing treatment in the ICU, in addition to the conventional treatment, the patient was treated with Ayurvedic medicines like swarna sindoora (30 mg) mixed with haridra ghana and honey applied on the gums of the patient. The patient became semiconscious in two days and improved in orientation, too. The patient was further treated with Yogendra rasa (60 mg). He regained consciousness and recovered completely. <br /> <br /> ===Case 3===<br /> <br /> A 43-year-old male patient suffered from skull and facial bones fractures due to a road traffic accident 10 years ago. He suffered from epilepsy and was taking treatment. The patient-reported history of excess mental stress, excess fasting (paryushana upavasa in the Jain tradition), anorexia, and anger. He suffered from convulsions and became unconscious due to intracerebral hemorrhage of 7.9 x 5.6 cm size in right temporoparietal region. Fever and sepsis-like conditions were observed. Since he was not responding to the ongoing ICU treatment, he was treated with Ayurvedic medicines like sindura bhushana mixed with haridra ghana every four hours applied on gums. Medicated water processed with gold (Suvarna siddha jala) and green gram soup was given to the patient through Ryle’s tube. Jaymangal rasa and guduchi ghana was added to treat fever. The fever subsided in one day and subsequently, the patient started maintaining oxygen levels. The life support system was taken off. The orientation and consciousness improved significantly in a week of treatment. Arpisa rasayana, Jaymangal rasa, vara, and raktapachaka medicines were continued for the next two weeks, till the complete recovery of the patient. Significant clinical improvement in neurological functions was observed in this patient. The patient recovered completely and he is well to date.<br /> <br /> ===Case 4 ===<br /> <br /> During May and June 2021, the author treated more than 30 ICU patients of COVID 19. Here, Ayurvedic treatment was given as adjuvant treatment, along with the ongoing ICU treatment. It was observed that with adjuvant Ayurvedic treatment, the patients had better and quicker improvement and better survival chances.<br /> <br /> A 72 years male patient with h/o DM, HTN, IHD, PTCA was COVID +_ve, admitted in the hospital with HRCT score 17/25, CORAD scores 6, and SPO2 84. He was suffering from high fever, breathing difficulty, and severe debility. Since expected improvement was not observed even after 9 days of conventional treatment, Ayurvedic treatment was started as an adjuvant. Sootashekhara with Vasa, Haridra, Kantakari, Saptaparnadi thrice a day was prescribed. Triphala with Arogyavardhini and Rasapachaka were given in between meals. Jayamangal Rasa with Rasaka was given two times in the morning and evening. Fever subsided within 2 days. After which, mahalakshmivilasa was added. He started maintaining O2 levels and the mask was removed within 6 days. He recovered completely.<br /> <br /> There is a wide scope of research on the role of Ayurveda medicines in the treatment of critical and medical emergency conditions. It can be helpful to provide a safe, cost-effective, and better solution to extend life with a higher survival chance.<br /> <br /> == Related chapters == <br /> <br /> [[Trimarmiya Chikitsa Adhyaya]], [[Vatavyadhi Chikitsa Adhyaya]], [[Trimarmiya Siddhi Adhyaya]]<br /> <br /> &lt;big&gt;'''Link to video lecture: https://fb.watch/8l9mKsmLtT/'''&lt;/big&gt; <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=MediaWiki:Common.css&diff=45395 2025-12-30T16:12:33Z

<p>Agnivesha: </p> <hr /> <div>/* CSS placed here will be applied to all skins */<br /> /* Reset italic styling set by user agent */<br /> cite, dfn {<br /> font-style: inherit;<br /> }<br /> <br /> /* Straight quote marks for &lt;q&gt; */<br /> q {<br /> quotes: '&quot;' '&quot;' &quot;'&quot; &quot;'&quot;;<br /> }<br /> <br /> /* Avoid collision of blockquote with floating elements by swapping margin and padding */<br /> blockquote {<br /> overflow: hidden;<br /> margin: 1em 0;<br /> padding: 0 40px;<br /> }<br /> <br /> /* Prevent the 'double bold' bug in Firefox when using DirectWrite */<br /> strong.selflink {<br /> font-weight: 700;<br /> }<br /> <br /> /* Consistent size for &lt;small&gt;, &lt;sub&gt; and &lt;sup&gt; */<br /> small {<br /> font-size: 85%;<br /> }<br /> .mw-body-content sub,<br /> .mw-body-content sup,<br /> span.reference /* for Parsoid */ {<br /> font-size: 80%;<br /> }<br /> <br /> /* Same spacing for indented and unidented paragraphs on talk pages */<br /> .ns-talk .mw-body-content dd {margin-top:0.4em; margin-bottom:0.4em;}<br /> <br /> /* Main page fixes */<br /> #interwiki-completelist {<br /> font-weight: bold;<br /> }<br /> body.page-Main_Page #ca-delete,<br /> body.page-Main_Page #ca-move {<br /> display: none !important;<br /> }<br /> body.page-Main_Page #mp-topbanner {<br /> clear: both;<br /> }<br /> <br /> /* Reduce page jumps by hiding collapsed/dismissed content */<br /> .client-js .mw-special-Watchlist #watchlist-message,<br /> .client-js .collapsible.collapsed &gt; tbody &gt; tr:not(:first-child) {<br /> display: none;<br /> }<br /> <br /> /* Tone down 'Changed since last visit' colors */<br /> span.updatedmarker {<br /> background-color: transparent;<br /> color: #006400;<br /> }<br /> <br /> /* Edit window toolbar */<br /> #toolbar {<br /> height: 22px;<br /> margin-bottom: 6px;<br /> }<br /> <br /> /* Hide charinsert base for those not using the gadget */<br /> #editpage-specialchars {<br /> display: none;<br /> }<br /> <br /> /* Highlight linked elements (such as clicked references) in blue */<br /> body.action-info .mw-body-content :target,<br /> .citation:target {<br /> background-color: #DEF; /* Fallback */<br /> background-color: rgba(0, 127, 255, 0.133);<br /> }<br /> <br /> /* Styling for citations. Breaks long urls, etc., rather than overflowing box */<br /> .citation {<br /> word-wrap: break-word;<br /> }<br /> <br /> /* For linked citation numbers and document IDs, where the number need not be shown<br /> on a screen or a handheld, but should be included in the printed version */<br /> @media screen, handheld {<br /> .citation .printonly {<br /> display: none;<br /> }<br /> }<br /> <br /> /* Make the list of references smaller */<br /> ol.references,<br /> div.reflist,<br /> div.refbegin {<br /> font-size: 90%; /* Default font-size */<br /> margin-bottom: 0.5em;<br /> }<br /> div.refbegin-100 {<br /> font-size: 100%; /* Option for normal fontsize in {{refbegin}} */<br /> }<br /> div.reflist ol.references {<br /> font-size: 100%; /* Reset font-size when nested in div.reflist */<br /> margin-bottom: 0; /* Avoid double margin when nested in dev.reflist */<br /> list-style-type: inherit; /* Enable custom list style types */<br /> }<br /> <br /> /* Ensure refs in table headers and the like aren't bold or italic */<br /> sup.reference {<br /> font-weight: normal;<br /> font-style: normal;<br /> }<br /> <br /> /* Allow hidden ref errors to be shown by user CSS */<br /> span.brokenref {<br /> display: none;<br /> }<br /> <br /> /* Hanging indentation for Template:Refbegin */<br /> .refbegin-hanging-indents &gt; ul {<br /> list-style-type: none;<br /> margin-left: 0;<br /> }<br /> .refbegin-hanging-indents &gt; ul &gt; li,<br /> .refbegin-hanging-indents &gt; dl &gt; dd {<br /> margin-left: 0;<br /> padding-left: 3.2em;<br /> text-indent: -3.2em;<br /> list-style: none;<br /> }<br /> <br /> /* Reset top margin for lists embedded in columns */<br /> div.columns {<br /> margin-top: 0.3em;<br /> }<br /> div.columns dl,<br /> div.columns ol,<br /> div.columns ul {<br /> margin-top: 0;<br /> }<br /> <br /> /* Avoid elements from breaking between columns */<br /> .nocolbreak,<br /> div.columns li,<br /> div.columns dd dd {<br /> -webkit-column-break-inside: avoid;<br /> page-break-inside: avoid;<br /> break-inside: avoid-column;<br /> }<br /> <br /> /* Style for [[Template:Flowlist]] that Lets lists flow around floating objecs */<br /> .flowlist ul {<br /> overflow-x: hidden;<br /> margin-left: 0;<br /> padding-left: 1.6em;<br /> }<br /> .flowlist ol {<br /> overflow-x: hidden;<br /> margin-left: 0;<br /> padding-left: 3.2em;<br /> }<br /> .flowlist dl {<br /> overflow-x: hidden;<br /> }<br /> <br /> /* Style for horizontal lists (separator following item).<br /> @source mediawiki.org/wiki/Snippets/Horizontal_lists<br /> @revision 8 (2016-05-21)<br /> @author [[User:Edokter]]<br /> */<br /> .hlist dl,<br /> .hlist ol,<br /> .hlist ul {<br /> margin: 0;<br /> padding: 0;<br /> }<br /> /* Display list items inline */<br /> .hlist dd,<br /> .hlist dt,<br /> .hlist li {<br /> margin: 0;<br /> display: inline;<br /> }<br /> /* Display nested lists inline */<br /> .hlist.inline,<br /> .hlist.inline dl,<br /> .hlist.inline ol,<br /> .hlist.inline ul,<br /> .hlist dl dl, .hlist dl ol, .hlist dl ul,<br /> .hlist ol dl, .hlist ol ol, .hlist ol ul,<br /> .hlist ul dl, .hlist ul ol, .hlist ul ul {<br /> display: inline;<br /> }<br /> /* Hide empty list items */<br /> .hlist .mw-empty-li {<br /> display: none;<br /> }<br /> /* Generate interpuncts */<br /> .hlist dt:after {<br /> content: &quot;: &quot;;<br /> }<br /> .hlist dd:after,<br /> .hlist li:after {<br /> content: &quot; · &quot;;<br /> font-weight: bold;<br /> }<br /> .hlist dd:last-child:after,<br /> .hlist dt:last-child:after,<br /> .hlist li:last-child:after {<br /> content: none;<br /> }<br /> /* Add parentheses around nested lists */<br /> .hlist dd dd:first-child:before, .hlist dd dt:first-child:before, .hlist dd li:first-child:before,<br /> .hlist dt dd:first-child:before, .hlist dt dt:first-child:before, .hlist dt li:first-child:before,<br /> .hlist li dd:first-child:before, .hlist li dt:first-child:before, .hlist li li:first-child:before {<br /> content: &quot; (&quot;;<br /> font-weight: normal;<br /> }<br /> .hlist dd dd:last-child:after, .hlist dd dt:last-child:after, .hlist dd li:last-child:after,<br /> .hlist dt dd:last-child:after, .hlist dt dt:last-child:after, .hlist dt li:last-child:after,<br /> .hlist li dd:last-child:after, .hlist li dt:last-child:after, .hlist li li:last-child:after {<br /> content: &quot;)&quot;;<br /> font-weight: normal;<br /> }<br /> /* Put ordinals in front of ordered list items */<br /> .hlist ol {<br /> counter-reset: listitem;<br /> }<br /> .hlist ol &gt; li {<br /> counter-increment: listitem;<br /> }<br /> .hlist ol &gt; li:before {<br /> content: &quot; &quot; counter(listitem) &quot;\a0&quot;;<br /> }<br /> .hlist dd ol &gt; li:first-child:before,<br /> .hlist dt ol &gt; li:first-child:before,<br /> .hlist li ol &gt; li:first-child:before {<br /> content: &quot; (&quot; counter(listitem) &quot;\a0&quot;;<br /> }<br /> <br /> /* Unbulleted lists */<br /> .plainlist ol,<br /> .plainlist ul {<br /> line-height: inherit;<br /> list-style: none none;<br /> margin: 0;<br /> }<br /> .plainlist ol li,<br /> .plainlist ul li {<br /> margin-bottom: 0;<br /> }<br /> <br /> /* Default style for navigation boxes */<br /> .navbox { /* Navbox container style */<br /> box-sizing: border-box;<br /> border: 1px solid #a2a9b1;<br /> width: 100%;<br /> clear: both;<br /> font-size: 88%;<br /> text-align: center;<br /> padding: 1px;<br /> margin: 1em auto 0; /* Prevent preceding content from clinging to navboxes */<br /> }<br /> .navbox .navbox {<br /> margin-top: 0; /* No top margin for nested navboxes */<br /> }<br /> .navbox + .navbox {<br /> margin-top: -1px; /* Single pixel border between adjacent navboxes */<br /> }<br /> .navbox-inner,<br /> .navbox-subgroup {<br /> width: 100%;<br /> }<br /> .navbox-group,<br /> .navbox-title,<br /> .navbox-abovebelow {<br /> padding: 0.25em 1em; /* Title, group and above/below styles */<br /> line-height: 1.5em;<br /> text-align: center;<br /> }<br /> th.navbox-group { /* Group style */<br /> white-space: nowrap;<br /> /* @noflip */<br /> text-align: right;<br /> }<br /> .navbox,<br /> .navbox-subgroup {<br /> background: #fdfdfd; /* Background color */<br /> }<br /> .navbox-list {<br /> line-height: 1.5em;<br /> border-color: #fdfdfd; /* Must match background color */<br /> }<br /> .navbox th,<br /> .navbox-title {<br /> background: #ccccff; /* Level 1 color */<br /> }<br /> .navbox-abovebelow,<br /> th.navbox-group,<br /> .navbox-subgroup .navbox-title {<br /> background: #ddddff; /* Level 2 color */<br /> }<br /> .navbox-subgroup .navbox-group,<br /> .navbox-subgroup .navbox-abovebelow {<br /> background: #e6e6ff; /* Level 3 color */<br /> }<br /> .navbox-even {<br /> background: #f7f7f7; /* Even row striping */<br /> }<br /> .navbox-odd {<br /> background: transparent; /* Odd row striping */<br /> }<br /> .navbox .hlist td dl,<br /> .navbox .hlist td ol,<br /> .navbox .hlist td ul,<br /> .navbox td.hlist dl,<br /> .navbox td.hlist ol,<br /> .navbox td.hlist ul {<br /> padding: 0.125em 0; /* Adjust hlist padding in navboxes */<br /> }<br /> <br /> /* Default styling for Navbar template */<br /> .navbar {<br /> display: inline;<br /> font-size: 88%;<br /> font-weight: normal;<br /> }<br /> .navbar ul {<br /> display: inline;<br /> white-space: nowrap;<br /> }<br /> .mw-body-content .navbar ul {<br /> line-height: inherit;<br /> }<br /> .navbar li {<br /> word-spacing: -0.125em;<br /> }<br /> .navbar.mini li abbr[title] {<br /> font-variant: small-caps;<br /> border-bottom: none;<br /> text-decoration: none;<br /> cursor: inherit;<br /> }<br /> /* Navbar styling when nested in infobox and navbox */<br /> .infobox .navbar {<br /> font-size: 100%;<br /> }<br /> .navbox .navbar {<br /> display: block;<br /> font-size: 100%;<br /> }<br /> .navbox-title .navbar {<br /> /* @noflip */<br /> float: left;<br /> /* @noflip */<br /> text-align: left;<br /> /* @noflip */<br /> margin-right: 0.5em;<br /> }<br /> <br /> /* 'show'/'hide' buttons created dynamically by the CollapsibleTables javascript<br /> in [[MediaWiki:Common.js]] are styled here so they can be customised. */<br /> .collapseButton {<br /> /* @noflip */<br /> float: right;<br /> font-weight: normal;<br /> /* @noflip */<br /> margin-left: 0.5em;<br /> /* @noflip */<br /> text-align: right;<br /> width: auto;<br /> }<br /> <br /> /* Styling for JQuery makeCollapsible, matching that of collapseButton */<br /> .mw-collapsible-toggle {<br /> font-weight: normal;<br /> /* @noflip */<br /> text-align: right;<br /> }<br /> <br /> /* Infobox template style */<br /> .infobox {<br /> border: 1px solid #a2a9b1;<br /> border-spacing: 3px;<br /> background-color: #f8f9fa;<br /> color: black;<br /> /* @noflip */<br /> margin: 0.5em 0 0.5em 1em;<br /> padding: 0.2em;<br /> /* @noflip */<br /> float: right;<br /> /* @noflip */<br /> clear: right;<br /> font-size: 88%;<br /> line-height: 1.5em;<br /> }<br /> .infobox caption {<br /> font-size: 125%;<br /> font-weight: bold;<br /> padding: 0.2em;<br /> }<br /> .infobox td,<br /> .infobox th {<br /> vertical-align: top;<br /> /* @noflip */<br /> text-align: left;<br /> }<br /> .infobox.bordered {<br /> border-collapse: collapse;<br /> }<br /> .infobox.bordered td,<br /> .infobox.bordered th {<br /> border: 1px solid #a2a9b1;<br /> }<br /> .infobox.bordered .borderless td,<br /> .infobox.bordered .borderless th {<br /> border: 0;<br /> }<br /> <br /> .infobox.sisterproject {<br /> width: 20em;<br /> font-size: 90%;<br /> }<br /> <br /> .infobox.standard-talk {<br /> border: 1px solid #c0c090;<br /> background-color: #f8eaba;<br /> }<br /> .infobox.standard-talk.bordered td,<br /> .infobox.standard-talk.bordered th {<br /> border: 1px solid #c0c090;<br /> }<br /> <br /> /* styles for bordered infobox with merged rows */<br /> .infobox.bordered .mergedtoprow td,<br /> .infobox.bordered .mergedtoprow th {<br /> border: 0;<br /> border-top: 1px solid #a2a9b1;<br /> /* @noflip */<br /> border-right: 1px solid #a2a9b1;<br /> }<br /> <br /> .infobox.bordered .mergedrow td,<br /> .infobox.bordered .mergedrow th {<br /> border: 0;<br /> /* @noflip */<br /> border-right: 1px solid #a2a9b1;<br /> }<br /> <br /> /* Styles for geography infoboxes, eg countries,<br /> country subdivisions, cities, etc. */<br /> .infobox.geography {<br /> border-collapse: collapse;<br /> line-height: 1.2em;<br /> font-size: 90%;<br /> }<br /> <br /> .infobox.geography td,<br /> .infobox.geography th {<br /> border-top: 1px solid #a2a9b1;<br /> padding: 0.4em 0.6em 0.4em 0.6em;<br /> }<br /> .infobox.geography .mergedtoprow td,<br /> .infobox.geography .mergedtoprow th {<br /> border-top: 1px solid #a2a9b1;<br /> padding: 0.4em 0.6em 0.2em 0.6em;<br /> }<br /> <br /> .infobox.geography .mergedrow td,<br /> .infobox.geography .mergedrow th {<br /> border: 0;<br /> padding: 0 0.6em 0.2em 0.6em;<br /> }<br /> <br /> .infobox.geography .mergedbottomrow td,<br /> .infobox.geography .mergedbottomrow th {<br /> border-top: 0;<br /> border-bottom: 1px solid #a2a9b1;<br /> padding: 0 0.6em 0.4em 0.6em;<br /> }<br /> <br /> .infobox.geography .maptable td,<br /> .infobox.geography .maptable th {<br /> border: 0;<br /> padding: 0;<br /> }<br /> <br /> /* Normal font styling for table row headers with scope=&quot;row&quot; tag */<br /> .wikitable.plainrowheaders th[scope=row] {<br /> font-weight: normal;<br /> /* @noflip */<br /> text-align: left;<br /> }<br /> <br /> /* Lists in data cells are always left-aligned */<br /> .wikitable td ul,<br /> .wikitable td ol,<br /> .wikitable td dl {<br /> /* @noflip */<br /> text-align: left;<br /> }<br /> /* ...unless they also use the hlist class */<br /> .toc.hlist ul,<br /> #toc.hlist ul,<br /> .wikitable.hlist td ul,<br /> .wikitable.hlist td ol,<br /> .wikitable.hlist td dl {<br /> text-align: inherit;<br /> }<br /> <br /> /* Icons for medialist templates [[Template:Listen]],<br /> [[Template:Multi-listen_start]], [[Template:Video]],<br /> [[Template:Multi-video_start]] */<br /> div.listenlist {<br /> background: url(&quot;//upload.wikimedia.org/wikipedia/commons/4/47/Sound-icon.svg&quot;) no-repeat scroll 0 0 transparent;<br /> background-size: 30px;<br /> padding-left: 40px;<br /> }<br /> <br /> /* Fix for hieroglyphs specificality issue in infoboxes ([[Phabricator:43869]]) */<br /> table.mw-hiero-table td {<br /> vertical-align: middle;<br /> }<br /> <br /> /* Style rules for media list templates */<br /> div.medialist {<br /> min-height: 50px;<br /> margin: 1em;<br /> /* @noflip */<br /> background-position: top left;<br /> background-repeat: no-repeat;<br /> }<br /> div.medialist ul {<br /> list-style-type: none;<br /> list-style-image: none;<br /> margin: 0;<br /> }<br /> div.medialist ul li {<br /> padding-bottom: 0.5em;<br /> }<br /> div.medialist ul li li {<br /> font-size: 91%;<br /> padding-bottom: 0;<br /> }<br /> <br /> /* Change the external link icon to an Adobe icon for all PDF files<br /> in browsers that support these CSS selectors, like Mozilla and Opera */<br /> div#content a[href$=&quot;.pdf&quot;].external,<br /> div#content a[href*=&quot;.pdf?&quot;].external,<br /> div#content a[href*=&quot;.pdf#&quot;].external,<br /> div#content a[href$=&quot;.PDF&quot;].external,<br /> div#content a[href*=&quot;.PDF?&quot;].external,<br /> div#content a[href*=&quot;.PDF#&quot;].external,<br /> div#mw_content a[href$=&quot;.pdf&quot;].external,<br /> div#mw_content a[href*=&quot;.pdf?&quot;].external,<br /> div#mw_content a[href*=&quot;.pdf#&quot;].external,<br /> div#mw_content a[href$=&quot;.PDF&quot;].external,<br /> div#mw_content a[href*=&quot;.PDF?&quot;].external,<br /> div#mw_content a[href*=&quot;.PDF#&quot;].external {<br /> background: url(&quot;//upload.wikimedia.org/wikipedia/commons/2/23/Icons-mini-file_acrobat.gif&quot;) no-repeat right;<br /> /* @noflip */<br /> padding-right: 18px;<br /> }<br /> <br /> /* Content in columns with CSS instead of tables ([[Template:Columns]]) */<br /> div.columns-2 div.column {<br /> /* @noflip */<br /> float: left;<br /> width: 50%;<br /> min-width: 300px;<br /> }<br /> div.columns-3 div.column {<br /> /* @noflip */<br /> float: left;<br /> width: 33.3%;<br /> min-width: 200px;<br /> }<br /> div.columns-4 div.column {<br /> /* @noflip */<br /> float: left;<br /> width: 25%;<br /> min-width: 150px;<br /> }<br /> div.columns-5 div.column {<br /> /* @noflip */<br /> float: left;<br /> width: 20%;<br /> min-width: 120px;<br /> }<br /> <br /> /* Messagebox templates */<br /> .messagebox {<br /> border: 1px solid #a2a9b1;<br /> background-color: #f8f9fa;<br /> width: 80%;<br /> margin: 0 auto 1em auto;<br /> padding: .2em;<br /> }<br /> .messagebox.merge {<br /> border: 1px solid #c0b8cc;<br /> background-color: #f0e5ff;<br /> text-align: center;<br /> }<br /> .messagebox.cleanup {<br /> border: 1px solid #9f9fff;<br /> background-color: #efefff;<br /> text-align: center;<br /> }<br /> .messagebox.standard-talk {<br /> border: 1px solid #c0c090;<br /> background-color: #f8eaba;<br /> margin: 4px auto;<br /> }<br /> /* For old WikiProject banners inside banner shells. */<br /> .mbox-inside .standard-talk,<br /> .messagebox.nested-talk {<br /> border: 1px solid #c0c090;<br /> background-color: #f8eaba;<br /> width: 100%;<br /> margin: 2px 0;<br /> padding: 2px;<br /> }<br /> .messagebox.small {<br /> width: 238px;<br /> font-size: 85%;<br /> /* @noflip */<br /> float: right;<br /> clear: both;<br /> /* @noflip */<br /> margin: 0 0 1em 1em;<br /> line-height: 1.25em;<br /> }<br /> .messagebox.small-talk {<br /> width: 238px;<br /> font-size: 85%;<br /> /* @noflip */<br /> float: right;<br /> clear: both;<br /> /* @noflip */<br /> margin: 0 0 1em 1em;<br /> line-height: 1.25em;<br /> background: #F8EABA;<br /> }<br /> <br /> /* Cell sizes for ambox/tmbox/imbox/cmbox/ombox/fmbox/dmbox message boxes */<br /> th.mbox-text, td.mbox-text { /* The message body cell(s) */<br /> border: none;<br /> /* @noflip */<br /> padding: 0.25em 0.9em; /* 0.9em left/right */<br /> width: 100%; /* Make all mboxes the same width regardless of text length */<br /> }<br /> td.mbox-image { /* The left image cell */<br /> border: none;<br /> /* @noflip */<br /> padding: 2px 0 2px 0.9em; /* 0.9em left, 0px right */<br /> text-align: center;<br /> }<br /> td.mbox-imageright { /* The right image cell */<br /> border: none;<br /> /* @noflip */<br /> padding: 2px 0.9em 2px 0; /* 0px left, 0.9em right */<br /> text-align: center;<br /> }<br /> td.mbox-empty-cell { /* An empty narrow cell */<br /> border: none;<br /> padding: 0;<br /> width: 1px;<br /> }<br /> <br /> /* Article message box styles */<br /> table.ambox {<br /> margin: 0 10%; /* 10% = Will not overlap with other elements */<br /> border: 1px solid #a2a9b1;<br /> /* @noflip */<br /> border-left: 10px solid #36c; /* Default &quot;notice&quot; blue */<br /> background: #fbfbfb;<br /> }<br /> table.ambox + table.ambox { /* Single border between stacked boxes. */<br /> margin-top: -1px;<br /> }<br /> .ambox th.mbox-text,<br /> .ambox td.mbox-text { /* The message body cell(s) */<br /> padding: 0.25em 0.5em; /* 0.5em left/right */<br /> }<br /> .ambox td.mbox-image { /* The left image cell */<br /> /* @noflip */<br /> padding: 2px 0 2px 0.5em; /* 0.5em left, 0px right */<br /> }<br /> .ambox td.mbox-imageright { /* The right image cell */<br /> /* @noflip */<br /> padding: 2px 0.5em 2px 0; /* 0px left, 0.5em right */<br /> }<br /> <br /> table.ambox-notice {<br /> /* @noflip */<br /> border-left: 10px solid #36c; /* Blue */<br /> }<br /> table.ambox-speedy {<br /> /* @noflip */<br /> border-left: 10px solid #b32424; /* Red */<br /> background: #fee7e6; /* Pink */<br /> }<br /> table.ambox-delete {<br /> /* @noflip */<br /> border-left: 10px solid #b32424; /* Red */<br /> }<br /> table.ambox-content {<br /> /* @noflip */<br /> border-left: 10px solid #f28500; /* Orange */<br /> }<br /> table.ambox-style {<br /> /* @noflip */<br /> border-left: 10px solid #fc3; /* Yellow */<br /> }<br /> table.ambox-move {<br /> /* @noflip */<br /> border-left: 10px solid #9932cc; /* Purple */<br /> }<br /> table.ambox-protection {<br /> /* @noflip */<br /> border-left: 10px solid #a2a9b1; /* Gray-gold */<br /> }<br /> <br /> /* Image message box styles */<br /> table.imbox {<br /> margin: 4px 10%;<br /> border-collapse: collapse;<br /> border: 3px solid #36c; /* Default &quot;notice&quot; blue */<br /> background: #fbfbfb;<br /> }<br /> .imbox .mbox-text .imbox { /* For imboxes inside imbox-text cells. */<br /> margin: 0 -0.5em; /* 0.9 - 0.5 = 0.4em left/right. */<br /> display: block; /* Fix for webkit to force 100% width. */<br /> }<br /> .mbox-inside .imbox { /* For imboxes inside other templates. */<br /> margin: 4px;<br /> }<br /> <br /> table.imbox-notice {<br /> border: 3px solid #36c; /* Blue */<br /> }<br /> table.imbox-speedy {<br /> border: 3px solid #b32424; /* Red */<br /> background: #fee7e6; /* Pink */<br /> }<br /> table.imbox-delete {<br /> border: 3px solid #b32424; /* Red */<br /> }<br /> table.imbox-content {<br /> border: 3px solid #f28500; /* Orange */<br /> }<br /> table.imbox-style {<br /> border: 3px solid #fc3; /* Yellow */<br /> }<br /> table.imbox-move {<br /> border: 3px solid #9932cc; /* Purple */<br /> }<br /> table.imbox-protection {<br /> border: 3px solid #a2a9b1; /* Gray-gold */<br /> }<br /> table.imbox-license {<br /> border: 3px solid #88a; /* Dark gray */<br /> background: #f7f8ff; /* Light gray */<br /> }<br /> table.imbox-featured {<br /> border: 3px solid #cba135; /* Brown-gold */<br /> }<br /> <br /> /* Category message box styles */<br /> table.cmbox {<br /> margin: 3px 10%;<br /> border-collapse: collapse;<br /> border: 1px solid #a2a9b1;<br /> background: #DFE8FF; /* Default &quot;notice&quot; blue */<br /> }<br /> <br /> table.cmbox-notice {<br /> background: #D8E8FF; /* Blue */<br /> }<br /> table.cmbox-speedy {<br /> margin-top: 4px;<br /> margin-bottom: 4px;<br /> border: 4px solid #b32424; /* Red */<br /> background: #FFDBDB; /* Pink */<br /> }<br /> table.cmbox-delete {<br /> background: #FFDBDB; /* Red */<br /> }<br /> table.cmbox-content {<br /> background: #FFE7CE; /* Orange */<br /> }<br /> table.cmbox-style {<br /> background: #FFF9DB; /* Yellow */<br /> }<br /> table.cmbox-move {<br /> background: #E4D8FF; /* Purple */<br /> }<br /> table.cmbox-protection {<br /> background: #EFEFE1; /* Gray-gold */<br /> }<br /> <br /> /* Other pages message box styles */<br /> table.ombox {<br /> margin: 4px 10%;<br /> border-collapse: collapse;<br /> border: 1px solid #a2a9b1; /* Default &quot;notice&quot; gray */<br /> background: #f8f9fa;<br /> }<br /> <br /> table.ombox-notice {<br /> border: 1px solid #a2a9b1; /* Gray */<br /> }<br /> table.ombox-speedy {<br /> border: 2px solid #b32424; /* Red */<br /> background: #fee7e6; /* Pink */<br /> }<br /> table.ombox-delete {<br /> border: 2px solid #b32424; /* Red */<br /> }<br /> table.ombox-content {<br /> border: 1px solid #f28500; /* Orange */<br /> }<br /> table.ombox-style {<br /> border: 1px solid #fc3; /* Yellow */<br /> }<br /> table.ombox-move {<br /> border: 1px solid #9932cc; /* Purple */<br /> }<br /> table.ombox-protection {<br /> border: 2px solid #a2a9b1; /* Gray-gold */<br /> }<br /> <br /> /* Talk page message box styles */<br /> table.tmbox {<br /> margin: 4px 10%;<br /> border-collapse: collapse;<br /> border: 1px solid #c0c090; /* Default &quot;notice&quot; gray-brown */<br /> background: #f8eaba;<br /> }<br /> .mediawiki .mbox-inside .tmbox { /* For tmboxes inside other templates. The &quot;mediawiki&quot; class ensures that */<br /> margin: 2px 0; /* this declaration overrides other styles (including mbox-small above) */<br /> width: 100%; /* For Safari and Opera */<br /> }<br /> .mbox-inside .tmbox.mbox-small { /* &quot;small&quot; tmboxes should not be small when */<br /> line-height: 1.5em; /* also &quot;nested&quot;, so reset styles that are */<br /> font-size: 100%; /* set in &quot;mbox-small&quot; above. */<br /> }<br /> <br /> table.tmbox-speedy {<br /> border: 2px solid #b32424; /* Red */<br /> background: #fee7e6; /* Pink */<br /> }<br /> table.tmbox-delete {<br /> border: 2px solid #b32424; /* Red */<br /> }<br /> table.tmbox-content {<br /> border: 2px solid #f28500; /* Orange */<br /> }<br /> table.tmbox-style {<br /> border: 2px solid #fc3; /* Yellow */<br /> }<br /> table.tmbox-move {<br /> border: 2px solid #9932cc; /* Purple */<br /> }<br /> table.tmbox-protection,<br /> table.tmbox-notice {<br /> border: 1px solid #c0c090; /* Gray-brown */<br /> }<br /> <br /> /* Disambig and set index box styles */<br /> table.dmbox {<br /> clear: both;<br /> margin: 0.9em 1em;<br /> border-top: 1px solid #ccc;<br /> border-bottom: 1px solid #ccc;<br /> background: transparent;<br /> }<br /> <br /> /* Footer and header message box styles */<br /> table.fmbox {<br /> clear: both;<br /> margin: 0.2em 0;<br /> width: 100%;<br /> border: 1px solid #a2a9b1;<br /> background: #f8f9fa; /* Default &quot;system&quot; gray */<br /> }<br /> table.fmbox-system {<br /> background: #f8f9fa;<br /> }<br /> table.fmbox-warning {<br /> border: 1px solid #bb7070; /* Dark pink */<br /> background: #ffdbdb; /* Pink */<br /> }<br /> table.fmbox-editnotice {<br /> background: transparent;<br /> }<br /> /* Div based &quot;warning&quot; style fmbox messages. */<br /> div.mw-warning-with-logexcerpt,<br /> div.mw-lag-warn-high,<br /> div.mw-cascadeprotectedwarning,<br /> div#mw-protect-cascadeon,<br /> div.titleblacklist-warning,<br /> div.locked-warning {<br /> clear: both;<br /> margin: 0.2em 0;<br /> border: 1px solid #bb7070;<br /> background: #ffdbdb;<br /> padding: 0.25em 0.9em;<br /> }<br /> /* Div based &quot;system&quot; style fmbox messages.<br /> Used in [[MediaWiki:Readonly lag]]. */<br /> div.mw-lag-warn-normal,<br /> div.fmbox-system {<br /> clear: both;<br /> margin: 0.2em 0;<br /> border: 1px solid #a2a9b1;<br /> background: #f8f9fa;<br /> padding: 0.25em 0.9em;<br /> }<br /> <br /> /* These mbox-small classes must be placed after all other<br /> ambox/tmbox/ombox etc classes. &quot;html body.mediawiki&quot; is so<br /> they override &quot;table.ambox + table.ambox&quot; above. */<br /> html body.mediawiki .mbox-small { /* For the &quot;small=yes&quot; option. */<br /> /* @noflip */<br /> clear: right;<br /> /* @noflip */<br /> float: right;<br /> /* @noflip */<br /> margin: 4px 0 4px 1em;<br /> box-sizing: border-box;<br /> width: 238px;<br /> font-size: 88%;<br /> line-height: 1.25em;<br /> }<br /> html body.mediawiki .mbox-small-left { /* For the &quot;small=left&quot; option. */<br /> /* @noflip */<br /> margin: 4px 1em 4px 0;<br /> box-sizing: border-box;<br /> overflow: hidden;<br /> width: 238px;<br /> border-collapse: collapse;<br /> font-size: 88%;<br /> line-height: 1.25em;<br /> }<br /> <br /> /* Style for compact ambox */<br /> /* Hide the images */<br /> .compact-ambox table .mbox-image,<br /> .compact-ambox table .mbox-imageright,<br /> .compact-ambox table .mbox-empty-cell {<br /> display: none;<br /> }<br /> /* Remove borders, backgrounds, padding, etc. */<br /> .compact-ambox table.ambox {<br /> border: none;<br /> border-collapse: collapse;<br /> background: transparent;<br /> margin: 0 0 0 1.6em !important;<br /> padding: 0 !important;<br /> width: auto;<br /> display: block;<br /> }<br /> body.mediawiki .compact-ambox table.mbox-small-left {<br /> font-size: 100%;<br /> width: auto;<br /> margin: 0;<br /> }<br /> /* Style the text cell as a list item and remove its padding */<br /> .compact-ambox table .mbox-text {<br /> padding: 0 !important;<br /> margin: 0 !important;<br /> }<br /> .compact-ambox table .mbox-text-span {<br /> display: list-item;<br /> line-height: 1.5em;<br /> list-style-type: square;<br /> list-style-image: url(/w/skins/MonoBook/bullet.gif);<br /> }<br /> .skin-vector .compact-ambox table .mbox-text-span {<br /> list-style-type: disc;<br /> list-style-image: url(/w/skins/Vector/images/bullet-icon.svg);<br /> list-style-image: url(/w/skins/Vector/images/bullet-icon.png)\9;<br /> }<br /> /* Allow for hiding text in compact form */<br /> .compact-ambox .hide-when-compact {<br /> display: none;<br /> }<br /> <br /> /* Remove default styles for [[MediaWiki:Noarticletext]]. */<br /> div.noarticletext {<br /> border: none;<br /> background: transparent;<br /> padding: 0;<br /> }<br /> <br /> /* Hide (formatting) elements from screen, but not from screenreaders */<br /> .visualhide {<br /> position: absolute;<br /> left: -10000px;<br /> top: auto;<br /> width: 1px;<br /> height: 1px;<br /> overflow: hidden;<br /> }<br /> <br /> /* Bold save button */<br /> #wpSave {<br /> font-weight: bold;<br /> }<br /> <br /> /* class hiddenStructure is defunct. See [[Wikipedia:hiddenStructure]] */<br /> .hiddenStructure {<br /> display: inline !important;<br /> color: #f00;<br /> background-color: #0f0;<br /> }<br /> <br /> /* suppress missing interwiki image links where #ifexist cannot<br /> be used due to high number of requests see .hidden-redlink on<br /> [[m:MediaWiki:Common.css]] */<br /> .check-icon a.new {<br /> display: none;<br /> speak: none;<br /> }<br /> <br /> /* Removes underlines from certain links */<br /> .nounderlines a,<br /> .IPA a:link, .IPA a:visited {<br /> text-decoration: none !important;<br /> }<br /> <br /> /* Standard Navigationsleisten, aka box hiding thingy<br /> from .de. Documentation at [[Wikipedia:NavFrame]]. */<br /> div.NavFrame {<br /> margin: 0;<br /> padding: 4px;<br /> border: 1px solid #a2a9b1;<br /> text-align: center;<br /> border-collapse: collapse;<br /> font-size: 95%;<br /> }<br /> div.NavFrame + div.NavFrame {<br /> border-top-style: none;<br /> border-top-style: hidden;<br /> }<br /> div.NavPic {<br /> background-color: #fff;<br /> margin: 0;<br /> padding: 2px;<br /> /* @noflip */<br /> float: left;<br /> }<br /> div.NavFrame div.NavHead {<br /> line-height: 1.6em;<br /> font-weight: bold;<br /> background-color: #ccf;<br /> position: relative;<br /> }<br /> div.NavFrame p,<br /> div.NavFrame div.NavContent,<br /> div.NavFrame div.NavContent p {<br /> font-size: 100%;<br /> }<br /> div.NavEnd {<br /> margin: 0;<br /> padding: 0;<br /> line-height: 1px;<br /> clear: both;<br /> }<br /> a.NavToggle {<br /> position: absolute;<br /> top: 0;<br /> /* @noflip */<br /> right: 3px;<br /> font-weight: normal;<br /> font-size: 90%;<br /> }<br /> <br /> /* Hatnotes and disambiguation notices */<br /> .hatnote {<br /> font-style: italic;<br /> }<br /> .hatnote i {<br /> font-style: normal;<br /> }<br /> div.hatnote {<br /> /* @noflip */<br /> padding-left: 1.6em;<br /> margin-bottom: 0.5em;<br /> }<br /> div.hatnote + div.hatnote {<br /> margin-top: -0.5em;<br /> }<br /> <br /> /* Allow transcluded pages to display in lists rather than a table. */<br /> .listify td { display: list-item; }<br /> .listify tr { display: block; }<br /> .listify table { display: block; }<br /> <br /> /* Geographical coordinates defaults. See [[Template:Coord/link]]<br /> for how these are used. The classes &quot;geo&quot;, &quot;longitude&quot;, and<br /> &quot;latitude&quot; are used by the [[Geo microformat]]. */<br /> .geo-default, .geo-dms, .geo-dec { display: inline; }<br /> .geo-nondefault, .geo-multi-punct { display: none; }<br /> .longitude, .latitude { white-space: nowrap; }<br /> <br /> /* Temporary(!) fix for horizontal TOC in Blink (Chrone/Opera) */<br /> .hlist .tocnumber,<br /> .hlist .toctext {<br /> display: inline;<br /> }<br /> /* When &lt;div class=&quot;nonumtoc&quot;&gt; is used on the table of contents,<br /> the ToC will display without numbers */<br /> .nonumtoc .tocnumber {<br /> display: none;<br /> }<br /> .nonumtoc #toc ul,<br /> .nonumtoc .toc ul {<br /> line-height: 1.5em;<br /> list-style: none none;<br /> margin: .3em 0 0;<br /> padding: 0;<br /> }<br /> .hlist.nonumtoc #toc ul ul,<br /> .hlist.nonumtoc .toc ul ul {<br /> /* @noflip */<br /> margin: 0;<br /> }<br /> <br /> /* Allow limiting of which header levels are shown in a TOC;<br /> &lt;div class=&quot;toclimit-3&quot;&gt;, for instance, will limit to<br /> showing ==headings== and ===headings=== but no further<br /> (as long as there are no =headings= on the page, which<br /> there shouldn't be according to the MoS). */<br /> .toclimit-2 .toclevel-1 ul,<br /> .toclimit-3 .toclevel-2 ul,<br /> .toclimit-4 .toclevel-3 ul,<br /> .toclimit-5 .toclevel-4 ul,<br /> .toclimit-6 .toclevel-5 ul,<br /> .toclimit-7 .toclevel-6 ul {<br /> display: none;<br /> }<br /> <br /> /* Styling for Template:Quote */<br /> blockquote.templatequote div.templatequotecite {<br /> line-height: 1.5em;<br /> /* @noflip */<br /> text-align: left;<br /> /* @noflip */<br /> padding-left: 1.6em;<br /> margin-top: 0;<br /> }<br /> <br /> /* User block messages */<br /> div.user-block {<br /> padding: 5px;<br /> margin-bottom: 0.5em;<br /> border: 1px solid #A9A9A9;<br /> background-color: #FFEFD5;<br /> }<br /> <br /> /* Prevent line breaks in silly places:<br /> 1) Where desired<br /> 2) Links when we don't want them to<br /> 3) Bold &quot;links&quot; to the page itself<br /> 4) Ref tags with group names &lt;ref group=&quot;Note&quot;&gt; --&gt; &quot;[Note 1]&quot; */<br /> .nowrap,<br /> .nowraplinks a,<br /> .nowraplinks .selflink,<br /> sup.reference a {<br /> white-space: nowrap;<br /> }<br /> .nowrap pre {<br /> white-space: pre;<br /> }<br /> /* But allow wrapping where desired: */<br /> .wrap,<br /> .wraplinks a {<br /> white-space: normal;<br /> }<br /> <br /> /* For template documentation */<br /> .template-documentation {<br /> clear: both;<br /> margin: 1em 0 0 0;<br /> border: 1px solid #a2a9b1;<br /> background-color: #ecfcf4;<br /> padding: 1em;<br /> }<br /> <br /> /* Increase the height of the image upload box */<br /> #wpUploadDescription {<br /> height: 13em;<br /> }<br /> <br /> /* Minimum thumb width */<br /> .thumbinner {<br /> min-width: 100px;<br /> }<br /> <br /> /* The backgrounds for galleries. */<br /> div#content .gallerybox div.thumb {<br /> /* Light gray padding */<br /> background-color: #f8f9fa;<br /> }<br /> /* Put a chequered background behind images, only visible if they have transparency.<br /> '.filehistory a img' and '#file img:hover' are handled by MediaWiki core (as of 1.19) */<br /> .gallerybox .thumb img {<br /> background: #fff url(//upload.wikimedia.org/wikipedia/commons/5/5d/Checker-16x16.png) repeat;<br /> }<br /> /* But not on articles, user pages, portals or with opt-out. */<br /> .ns-0 .gallerybox .thumb img,<br /> .ns-2 .gallerybox .thumb img,<br /> .ns-100 .gallerybox .thumb img,<br /> .nochecker .gallerybox .thumb img {<br /> background: #fff;<br /> }<br /> <br /> /* Prevent floating boxes from overlapping any category listings,<br /> file histories, edit previews, and edit [Show changes] views. */<br /> #mw-subcategories, #mw-pages, #mw-category-media,<br /> #filehistory, #wikiPreview, #wikiDiff {<br /> clear: both;<br /> }<br /> <br /> body.rtl #mw-articlefeedbackv5, body.rtl #mw-articlefeedback {<br /> display: block; /* Override inline block mode */<br /> margin-bottom: 1em;<br /> /* @noflip */<br /> clear: right; /* Clear any info boxes that stick out */<br /> /* @noflip */<br /> float: right; /* Prevents margin collapsing */<br /> }<br /> <br /> /* Selectively hide headers in WikiProject banners */<br /> .wpb .wpb-header { display: none; }<br /> .wpbs-inner .wpb .wpb-header { display: block; } /* for IE */<br /> .wpbs-inner .wpb .wpb-header { display: table-row; } /* for real browsers */<br /> .wpbs-inner .wpb-outside { display: none; } /* hide things that should only display outside shells */<br /> <br /> /* Styling for Abuse Filter tags */<br /> .mw-tag-markers {<br /> font-style:italic;<br /> font-size:90%;<br /> }<br /> <br /> /* Hide stuff meant for accounts with special permissions. Made visible again in<br /> [[MediaWiki:Group-sysop.css]], [[MediaWiki:Group-accountcreator.css]],<br /> [[MediaWiki:Group-templateeditor.css]], [[MediaWiki:Group-extendedmover.css]] and [[Mediawiki:Group-autoconfirmed.css]]. */<br /> .sysop-show,<br /> .accountcreator-show,<br /> .templateeditor-show,<br /> .extendedmover-show,<br /> .autoconfirmed-show,<br /> .user-show {<br /> display: none;<br /> }<br /> <br /> /**<br /> * Hide the redlink generated by {{Editnotice}},<br /> * this overrides the &quot;.sysop-show { display: none; }&quot; above that applies<br /> * to the same link as well. See [[phab:T45013]]<br /> *<br /> * Hide the images in editnotices to keep them readable in VE view.<br /> * Long term, editnotices should become a core feature so that they can be designed responsive.<br /> */<br /> .ve-ui-mwNoticesPopupTool-item .editnotice-redlink,<br /> .ve-ui-mwNoticesPopupTool-item .mbox-image,<br /> .ve-ui-mwNoticesPopupTool-item .mbox-imageright {<br /> display: none !important;<br /> }<br /> <br /> /* Remove bullets when there are multiple edit page warnings */<br /> ul.permissions-errors &gt; li {<br /> list-style: none none;<br /> }<br /> ul.permissions-errors {<br /> margin: 0;<br /> }<br /> <br /> /* No linewrap on the labels of the login/signup page */<br /> body.page-Special_UserLogin .mw-label label,<br /> body.page-Special_UserLogin_signup .mw-label label {<br /> white-space: nowrap;<br /> }<br /> <br /> /* Pie chart: transparent borders */<br /> .transborder {<br /> border: solid transparent;<br /> }<br /> <br /> /* Generic class for Times-based serif, texhtml class for inline math */<br /> .times-serif,<br /> span.texhtml {<br /> font-family: &quot;Nimbus Roman No9 L&quot;, &quot;Times New Roman&quot;, Times, serif;<br /> font-size: 118%;<br /> line-height: 1;<br /> }<br /> span.texhtml {<br /> white-space: nowrap;<br /> }<br /> span.texhtml span.texhtml {<br /> font-size: 100%;<br /> }<br /> span.mwe-math-mathml-inline {<br /> font-size: 118%;<br /> }<br /> <br /> /* Force tabular and lining display for digits and texhtml */<br /> .digits,<br /> .texhtml {<br /> -moz-font-feature-settings: &quot;lnum&quot;, &quot;tnum&quot;, &quot;kern&quot; 0;<br /> -webkit-font-feature-settings: &quot;lnum&quot;, &quot;tnum&quot;, &quot;kern&quot; 0;<br /> font-feature-settings: &quot;lnum&quot;, &quot;tnum&quot;, &quot;kern&quot; 0;<br /> font-variant-numeric: lining-nums tabular-nums;<br /> font-kerning: none;<br /> }<br /> <br /> /* Make &lt;math display=&quot;block&quot;&gt; be left aligned with one space indent for compatibility with style conventions */<br /> .mwe-math-fallback-image-display,<br /> .mwe-math-mathml-display {<br /> margin-left: 1.6em !important;<br /> margin-top: 0.6em;<br /> margin-bottom: 0.6em;<br /> }<br /> .mwe-math-mathml-display math {<br /> display: inline;<br /> }<br /> <br /> /* Fix styling of transcluded prefindex tables */<br /> table#mw-prefixindex-list-table,<br /> table#mw-prefixindex-nav-table {<br /> width: 98%;<br /> }<br /> <br /> /* For portals, added 2011-12-07 -bv<br /> On wide screens, show these as two columns<br /> On narrow and mobile screens, let them collapse into a single column */<br /> .portal-column-left {<br /> float: left;<br /> width: 50%;<br /> }<br /> .portal-column-right {<br /> float: right;<br /> width: 49%;<br /> }<br /> .portal-column-left-wide {<br /> float: left;<br /> width: 60%;<br /> }<br /> .portal-column-right-narrow {<br /> float: right;<br /> width: 39%;<br /> }<br /> .portal-column-left-extra-wide {<br /> float: left;<br /> width: 70%;<br /> }<br /> .portal-column-right-extra-narrow {<br /> float: right;<br /> width: 29%;<br /> }<br /> @media only screen and (max-width: 800px) {<br /> /* Decouple the columns on narrow screens */<br /> .portal-column-left,<br /> .portal-column-right,<br /> .portal-column-left-wide,<br /> .portal-column-right-narrow,<br /> .portal-column-left-extra-wide,<br /> .portal-column-right-extra-narrow {<br /> float: inherit;<br /> width: inherit;<br /> }<br /> }<br /> <br /> /* Formerly for announcements, now used intermittently */<br /> #bodyContent .letterhead {<br /> background-image:url('//upload.wikimedia.org/wikipedia/commons/e/e0/Tan-page-corner.png');<br /> background-repeat:no-repeat;<br /> padding: 2em;<br /> background-color: #faf9f2;<br /> }<br /> <br /> /* Tree style lists */<br /> .treeview ul {<br /> padding: 0;<br /> margin: 0;<br /> }<br /> .treeview li {<br /> padding: 0;<br /> margin: 0;<br /> list-style-type: none;<br /> list-style-image: none;<br /> }<br /> .treeview li li {<br /> background: url(&quot;//upload.wikimedia.org/wikipedia/commons/f/f2/Treeview-grey-line.png&quot;) no-repeat 0 -2981px;<br /> /* @noflip */<br /> padding-left: 20px;<br /> text-indent: 0.3em;<br /> }<br /> .treeview li li.lastline {<br /> background-position: 0 -5971px<br /> }<br /> .treeview li.emptyline &gt; ul {<br /> /* @noflip */<br /> margin-left: -1px;<br /> }<br /> .treeview li.emptyline &gt; ul &gt; li:first-child {<br /> background-position: 0 9px<br /> }<br /> <br /> /* hidden sortkey for tablesorter */<br /> td .sortkey,<br /> th .sortkey {<br /> display: none;<br /> speak: none;<br /> }<br /> <br /> /* Make it possible to hide checkboxes in &lt;inputbox&gt; */<br /> .inputbox-hidecheckboxes form .inputbox-element,<br /> .inputbox-hidecheckboxes .mw-ui-checkbox {<br /> display: none !important;<br /> }<br /> <br /> /* Work-around for [[Phabricator:25965]] (Kaltura advertisement) */<br /> .k-player .k-attribution {<br /> visibility: hidden;<br /> }<br /> <br /> /* Move 'play' button of video player to bottom left corner */<br /> .PopUpMediaTransform a .play-btn-large {<br /> margin: 0;<br /> top: auto;<br /> right: auto;<br /> bottom: 0;<br /> left: 0;<br /> }<br /> <br /> /* Hide FlaggedRevs notice UI when there are no pending changes */<br /> .flaggedrevs_draft_synced,<br /> .flaggedrevs_stable_synced {<br /> display: none;<br /> }<br /> /* Social Links styling */<br /> .social-links-portlet {<br /> margin-top: 20px;<br /> border-top: 1px solid #eee;<br /> padding-top: 10px;<br /> }<br /> <br /> .social-links-portlet h3 {<br /> font-size: 14px;<br /> color: #333;<br /> margin-bottom: 10px;<br /> text-align: center;<br /> }<br /> <br /> .social-links-portlet .body {<br /> padding: 5px;<br /> text-align: center;<br /> }<br /> <br /> .social-links-portlet .fb-like,<br /> .social-links-portlet .g-ytsubscribe,<br /> .social-links-portlet .twitter-follow-button {<br /> margin: 10px auto;<br /> display: inline-block;<br /> }</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=MediaWiki:Citethispage-content&diff=45394 2025-11-27T14:00:52Z

<p>Agnivesha: </p> <hr /> <div>__NOTOC__<br /> &lt;div class=&quot;mw-specialCiteThisPage-bibliographic&quot;&gt;<br /> <br /> == Bibliographic details for {{FULLPAGENAME}} ==<br /> *{{#switch: {{FULLPAGENAME}}<br /> | Charak Samhita New Edition = Names of the authors of the chapter<br /> | Sutra Sthana = Names of the authors of the chapter<br /> | Nidana Sthana = Names of the authors of the chapter<br /> | Vimana Sthana = Names of the authors of the chapter<br /> | Sharira Sthana = Names of the authors of the chapter<br /> | Indriya Sthana = Names of the authors of the chapter<br /> | Chikitsa Sthana = Names of the authors of the chapter<br /> | Kalpa Sthana = Names of the authors of the chapter<br /> | Siddhi Sthana = Names of the authors of the chapter<br /> | Names of the authors of the chapter (Translator and commentator)<br /> }} : {{TranslatorSurnameFirst}}<br /> <br /> * Name of Adhyaya (Chapter) : {{AdhyayaName}}<br /> * Name of Samhita (Treatise) : Charak Samhita New Edition<br /> * Name of the Editor : {{EditorSurnameFirst}}<br /> * Sthana (Section) : {{SthanaName}}<br /> <br /> * Link to the chapter: {{canonicalurl:{{FULLPAGENAME}}}}<br /> * Publisher name : Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)<br /> * City of publication : Jamnagar, India<br /> * Year of publication : 2020<br /> * Edition no. : 01<br /> * Date of last revision: {{CURRENTDAY}} {{CURRENTMONTHNAME}} {{CURRENTYEAR}} {{CURRENTTIME}} UTC<br /> * Date retrieved: &lt;citation&gt;{{CURRENTDAY}} {{CURRENTMONTHNAME}} {{CURRENTYEAR}} {{CURRENTTIME}} UTC&lt;/citation&gt;<br /> * Page Version ID: {{PAGEID}}<br /> * DOI : {{DoiWithLink}}<br /> <br /> &lt;/div&gt;<br /> &lt;div class=&quot;plainlinks mw-specialCiteThisPage-styles&quot;&gt;<br /> <br /> == Citation styles for {{FULLPAGENAME}} ==<br /> <br /> === [[AMA|AMA style]] ===<br /> {{TranslatorSurnameFirst}}. {{AdhyayaName}}. In: {{EditorSurnameFirst}}, eds. Charak Samhita New Edition. 1&lt;sup&gt;st&lt;/sup&gt; ed. Jamnagar, Ind: CSRTSDC; 2020. {{canonicalurl:{{FULLPAGENAME}}}}. Accessed &lt;citation&gt;{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}&lt;/citation&gt;.<br /> <br /> === [[APA style]] ===<br /> {{TranslatorSurnameFirst}}. ({{DateOfPublication}}). {{AdhyayaName}}. In: {{EditorSurnameFirst}}, (Eds.), Charak Samhita New Edition (1&lt;sup&gt;st&lt;/sup&gt; ed. pp.{{PageNo}}). CSRTSDC. {{DoiLink}}<br /> <br /> === [[The MLA style manual|MLA style]] ===<br /> {{TranslatorSurnameFirst}}. &quot;{{AdhyayaName}}&quot;. Charak Samhita New Edition, edited by {{EditorSurnameFirst}}, eds., 1&lt;sup&gt;st&lt;/sup&gt; edition, CSRTSDC, {{DateOfPublication}}, pp. {{PageNo}}, Doi:{{DoiWithLink}}<br /> <br /> === [[MHRA Style Guide|MHRA style]] ===<br /> {{TranslatorSurnameFirst}}, {{AdhyayaName}}, In Charak Samhita New Edition, ed.by {{EditorSurnameFirst}}, 1&lt;sup&gt;st&lt;/sup&gt; edition (Ind:Jamnagar,2020), pp.{{PageNo}}. CSRTSDC ebook Doi:{{DoiWithLink}}<br /> <br /> === [[The Chicago Manual of Style|Chicago style]] ===<br /> {{TranslatorNameFirst}}, &quot;{{AdhyayaName}}&quot; in Charak Samhita New Edition, ed.by {{EditorNameFirst}}, page {{PageNo}}, (Jamnagar:CSRTSDC,2020), {{canonicalurl:{{FULLPAGENAME}}}} (accessed &lt;citation&gt;{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}&lt;/citation&gt;).<br /> <br /> === [[Council of Science Editors|CBE/CSE style]] ===<br /> {{TranslatorSurnameFirst}}. ({{DateOfPublication}}) {{AdhyayaName}}. In: {{EditorSurnameFirst}}, editor(s). Charak Samhita New Edition.Jamnagar:CSRTSDC; [accessed &lt;citation&gt;{{CURRENTYEAR}} {{CURRENTMONTHNAME}} {{CURRENTDAY}}&lt;/citation&gt;]. Doi:{{DoiWithLink}}<br /> <br /> === [[Bluebook|Bluebook style]] ===<br /> {{AdhyayaName}}, in Charak Samhita New Edition ({{TranslatorSurnameFirst}}, 2020), {{canonicalurl:{{FULLPAGENAME}}}} (last visited &lt;citation&gt;{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}&lt;/citation&gt;).<br /> <br /> === [[BibTeX]] entry ===<br /> <br /> @book{{{#explode:{{TranslatorSurnameFirst}}| |0}}{{PAGEID}},<br /> title = &lt;nowiki&gt;{&lt;/nowiki&gt;{{FULLPAGENAME}}&lt;nowiki&gt;}&lt;/nowiki&gt; --- {Charak Samhita New Edition},<br /> author = &lt;nowiki&gt;{&lt;/nowiki&gt;{{TranslatorSurnameFirst}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> editor = &lt;nowiki&gt;{&lt;/nowiki&gt;{{EditorSurnameFirst}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> year = &lt;nowiki&gt;{&lt;/nowiki&gt;{{DateOfPublication}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> pages = &lt;nowiki&gt;{&lt;/nowiki&gt;{{PageNo}}-{{PageNo}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> publisher = {Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)},<br /> url = &quot;{{canonicalurl:{{FULLPAGENAME}}}}&quot;,<br /> doi = &lt;nowiki&gt;{&lt;/nowiki&gt;{{DoiWithLink}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> note = &quot;[Online; accessed &lt;citation&gt;{{CURRENTDAY}}-{{CURRENTMONTHNAME}}-{{CURRENTYEAR}}&lt;/citation&gt;]&quot;<br /> }<br /> <br /> When using the [[LaTeX]] package url (&lt;code&gt;\usepackage{url}&lt;/code&gt; somewhere in the preamble) which tends to give much more nicely formatted web addresses, the following may be preferred:<br /> <br /> @book{{{#explode:{{TranslatorSurnameFirst}}| |0}}{{PAGEID}},<br /> title = &lt;nowiki&gt;{&lt;/nowiki&gt;{{FULLPAGENAME}}&lt;nowiki&gt;}&lt;/nowiki&gt; --- {Charak Samhita New Edition},<br /> author = &lt;nowiki&gt;{&lt;/nowiki&gt;{{TranslatorSurnameFirst}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> editor = &lt;nowiki&gt;{&lt;/nowiki&gt;{{EditorSurnameFirst}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> year = &lt;nowiki&gt;{&lt;/nowiki&gt;{{DateOfPublication}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> pages = &lt;nowiki&gt;{&lt;/nowiki&gt;{{PageNo}}-{{PageNo}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> publisher = {Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)},<br /> url = &quot;{{canonicalurl:{{FULLPAGENAME}}}}&quot;,<br /> doi = &lt;nowiki&gt;{&lt;/nowiki&gt;{{DoiWithLink}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> note = &quot;[Online; accessed &lt;citation&gt;{{CURRENTDAY}}-{{CURRENTMONTHNAME}}-{{CURRENTYEAR}}&lt;/citation&gt;]&quot;<br /> }<br /> <br /> <br /> &lt;/div&gt; &lt;!--closing div for &quot;plainlinks&quot;--&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=MediaWiki:Citethispage-content&diff=45393 2025-11-27T13:43:04Z

<p>Agnivesha: </p> <hr /> <div>__NOTOC__<br /> &lt;div class=&quot;mw-specialCiteThisPage-bibliographic&quot;&gt;<br /> <br /> == Bibliographic details for {{FULLPAGENAME}} ==<br /> *{{#switch: {{FULLPAGENAME}}<br /> | Charak Samhita New Edition = Names of the authors of the chapter<br /> | Sutra Sthana = Names of the authors of the chapter<br /> | Nidana Sthana = Names of the authors of the chapter<br /> | Vimana Sthana = Names of the authors of the chapter<br /> | Sharira Sthana = Names of the authors of the chapter<br /> | Indriya Sthana = Names of the authors of the chapter<br /> | Chikitsa Sthana = Names of the authors of the chapter<br /> | Kalpa Sthana = Names of the authors of the chapter<br /> | Siddhi Sthana = Names of the authors of the chapter<br /> | Names of the authors of the chapter (Translator and commentator)<br /> }} : {{TranslatorSurnameFirst}}<br /> <br /> * Name of Adhyaya (Chapter) : {{AdhyayaName}}<br /> * Name of Samhita (Treatise) : Charak Samhita New Edition<br /> * Name of the Editor : {{EditorSurnameFirst}}<br /> * Sthana (Section) : {{SthanaName}}<br /> <br /> * Link to the chapter: {{canonicalurl:{{FULLPAGENAME}}}}<br /> * Publisher name : Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)<br /> * City of publication : Jamnagar, India<br /> * Year of publication : 2020<br /> * Edition no. : 01<br /> * Date of last revision: {{CURRENTDAY}} {{CURRENTMONTHNAME}} {{CURRENTYEAR}} {{CURRENTTIME}} UTC<br /> * Date retrieved: &lt;citation&gt;{{CURRENTDAY}} {{CURRENTMONTHNAME}} {{CURRENTYEAR}} {{CURRENTTIME}} UTC&lt;/citation&gt;<br /> * Page Version ID: {{PAGEID}}<br /> * DOI : {{DoiWithLink}}<br /> <br /> &lt;/div&gt;<br /> &lt;div class=&quot;plainlinks mw-specialCiteThisPage-styles&quot;&gt;<br /> <br /> == Citation styles for {{FULLPAGENAME}} ==<br /> <br /> === [[AMA|AMA style]] ===<br /> {{TranslatorSurnameFirst}}. {{AdhyayaName}}. In: {{EditorSurnameFirst}}, eds. Charak Samhita New Edition. 1&lt;sup&gt;st&lt;/sup&gt; ed. Jamnagar, Ind: CSRTSDC; 2020. {{canonicalurl:{{FULLPAGENAME}}}}. Accessed &lt;citation&gt;{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}&lt;/citation&gt;.<br /> <br /> === [[APA style]] ===<br /> {{TranslatorSurnameFirst}}. ({{DateOfPublication}}). {{AdhyayaName}}. In: {{EditorSurnameFirst}}, (Eds.), Charak Samhita New Edition (1&lt;sup&gt;st&lt;/sup&gt; ed. pp.{{PageNo}}). CSRTSDC. {{DoiLink}}<br /> <br /> === [[The MLA style manual|MLA style]] ===<br /> {{TranslatorSurnameFirst}}. &quot;{{AdhyayaName}}&quot;. Charak Samhita New Edition, edited by {{EditorSurnameFirst}}, eds., 1&lt;sup&gt;st&lt;/sup&gt; edition, CSRTSDC, {{DateOfPublication}}, pp. {{PageNo}}, Doi:{{DoiWithLink}}<br /> <br /> === [[MHRA Style Guide|MHRA style]] ===<br /> {{TranslatorSurnameFirst}}, {{AdhyayaName}}, In Charak Samhita New Edition, ed.by {{EditorSurnameFirst}}, 1&lt;sup&gt;st&lt;/sup&gt; edition (Ind:Jamnagar,2020), pp.{{PageNo}}. CSRTSDC ebook Doi:{{DoiWithLink}}<br /> <br /> === [[The Chicago Manual of Style|Chicago style]] ===<br /> {{TranslatorNameFirst}}, &quot;{{AdhyayaName}}&quot; in Charak Samhita New Edition, ed.by {{EditorNameFirst}}, page {{PageNo}}, (Jamnagar:CSRTSDC,2020), {{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}} (accessed &lt;citation&gt;{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}&lt;/citation&gt;).<br /> <br /> === [[Council of Science Editors|CBE/CSE style]] ===<br /> {{TranslatorSurnameFirst}}. ({{DateOfPublication}}) {{AdhyayaName}}. In: {{EditorSurnameFirst}}, editor(s). Charak Samhita New Edition.Jamnagar:CSRTSDC; [accessed &lt;citation&gt;{{CURRENTYEAR}} {{CURRENTMONTHNAME}} {{CURRENTDAY}}&lt;/citation&gt;]. Doi:{{DoiWithLink}}<br /> <br /> === [[Bluebook|Bluebook style]] ===<br /> {{AdhyayaName}}, in Charak Samhita New Edition ({{TranslatorSurnameFirst}}, 2020), {{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}} (last visited &lt;citation&gt;{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}&lt;/citation&gt;).<br /> <br /> === [[BibTeX]] entry ===<br /> <br /> @book{{{#explode:{{TranslatorSurnameFirst}}| |0}}{{PAGEID}},<br /> title = &lt;nowiki&gt;{&lt;/nowiki&gt;{{FULLPAGENAME}}&lt;nowiki&gt;}&lt;/nowiki&gt; --- {Charak Samhita New Edition},<br /> author = &lt;nowiki&gt;{&lt;/nowiki&gt;{{TranslatorSurnameFirst}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> editor = &lt;nowiki&gt;{&lt;/nowiki&gt;{{EditorSurnameFirst}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> year = &lt;nowiki&gt;{&lt;/nowiki&gt;{{DateOfPublication}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> pages = &lt;nowiki&gt;{&lt;/nowiki&gt;{{PageNo}}-{{PageNo}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> publisher = {Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)},<br /> url = &quot;{{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}}&quot;,<br /> doi = &lt;nowiki&gt;{&lt;/nowiki&gt;{{DoiWithLink}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> note = &quot;[Online; accessed &lt;citation&gt;{{CURRENTDAY}}-{{CURRENTMONTHNAME}}-{{CURRENTYEAR}}&lt;/citation&gt;]&quot;<br /> }<br /> <br /> When using the [[LaTeX]] package url (&lt;code&gt;\usepackage{url}&lt;/code&gt; somewhere in the preamble) which tends to give much more nicely formatted web addresses, the following may be preferred:<br /> <br /> @book{{{#explode:{{TranslatorSurnameFirst}}| |0}}{{PAGEID}},<br /> title = &lt;nowiki&gt;{&lt;/nowiki&gt;{{FULLPAGENAME}}&lt;nowiki&gt;}&lt;/nowiki&gt; --- {Charak Samhita New Edition},<br /> author = &lt;nowiki&gt;{&lt;/nowiki&gt;{{TranslatorSurnameFirst}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> editor = &lt;nowiki&gt;{&lt;/nowiki&gt;{{EditorSurnameFirst}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> year = &lt;nowiki&gt;{&lt;/nowiki&gt;{{DateOfPublication}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> pages = &lt;nowiki&gt;{&lt;/nowiki&gt;{{PageNo}}-{{PageNo}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> publisher = {Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)},<br /> url = &quot;{{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}}&quot;,<br /> doi = &lt;nowiki&gt;{&lt;/nowiki&gt;{{DoiWithLink}}&lt;nowiki&gt;}&lt;/nowiki&gt;,<br /> note = &quot;[Online; accessed &lt;citation&gt;{{CURRENTDAY}}-{{CURRENTMONTHNAME}}-{{CURRENTYEAR}}&lt;/citation&gt;]&quot;<br /> }<br /> <br /> <br /> &lt;/div&gt; &lt;!--closing div for &quot;plainlinks&quot;--&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=MediaWiki:Citethispage-content&diff=45392 2025-11-27T13:41:17Z

<p>Agnivesha: </p> <hr /> <div>__NOTOC__<br /> &lt;div class=&quot;mw-specialCiteThisPage-bibliographic&quot;&gt;<br /> <br /> == Bibliographic details for {{FULLPAGENAME}} ==<br /> *{{#switch: {{FULLPAGENAME}}<br /> | Charak Samhita New Edition = Names of the authors of the chapter<br /> | Sutra Sthana = Names of the authors of the chapter<br /> | Nidana Sthana = Names of the authors of the chapter<br /> | Vimana Sthana = Names of the authors of the chapter<br /> | Sharira Sthana = Names of the authors of the chapter<br /> | Indriya Sthana = Names of the authors of the chapter<br /> | Chikitsa Sthana = Names of the authors of the chapter<br /> | Kalpa Sthana = Names of the authors of the chapter<br /> | Siddhi Sthana = Names of the authors of the chapter<br /> | Names of the authors of the chapter (Translator and commentator)<br /> }} : {{TranslatorSurnameFirst}}<br /> <br /> * Name of Adhyaya (Chapter) : {{AdhyayaName}}<br /> * Name of Samhita (Treatise) : Charak Samhita New Edition<br /> * Name of the Editor : {{EditorSurnameFirst}}<br /> * Sthana (Section) : {{SthanaName}}<br /> <br /> * Link to the chapter: {{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}}<br /> * Publisher name : Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)<br /> * City of publication : Jamnagar, India<br /> * Year of publication : 2020<br /> * Edition no. : 01<br /> * Date of last revision: {{CURRENTDAY}} {{CURRENTMONTHNAME}} {{CURRENTYEAR}} {{CURRENTTIME}} UTC<br /> * Date retrieved: &lt;citation&gt;{{CURRENTDAY}} {{CURRENTMONTHNAME}} {{CURRENTYEAR}} {{CURRENTTIME}} UTC&lt;/citation&gt;<br /> * Page Version ID: {{PAGEID}}<br /> * DOI : {{DoiWithLink}}<br /> <br /> &lt;/div&gt;<br /> &lt;div class=&quot;plainlinks mw-specialCiteThisPage-styles&quot;&gt;<br /> <br /> == Citation styles for {{FULLPAGENAME}} ==<br /> <br /> === [[AMA|AMA style]] ===<br /> {{TranslatorSurnameFirst}}. {{AdhyayaName}}. In: {{EditorSurnameFirst}}, eds. Charak Samhita New Edition. 1&lt;sup&gt;st&lt;/sup&gt; ed. Jamnagar, Ind: CSRTSDC; 2020. {{canonicalurl:{{FULLPAGENAME}}}}. Accessed &lt;citation&gt;{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}&lt;/citation&gt;.<br /> <br /> === [[APA style]] ===<br /> {{TranslatorSurnameFirst}}. ({{DateOfPublication}}). {{AdhyayaName}}. In: {{EditorSurnameFirst}}, (Eds.), Charak Samhita New Edition (1&lt;sup&gt;st&lt;/sup&gt; ed. pp.{{PageNo}}). CSRTSDC. {{DoiLink}}<br /> <br /> === [[The MLA style manual|MLA style]] ===<br /> {{TranslatorSurnameFirst}}. &quot;{{AdhyayaName}}&quot;. Charak Samhita New Edition, edited by {{EditorSurnameFirst}}, eds., 1&lt;sup&gt;st&lt;/sup&gt; edition, CSRTSDC, {{DateOfPublication}}, pp. {{PageNo}}, Doi:{{DoiWithLink}}<br /> <br /> === [[MHRA Style Guide|MHRA style]] ===<br /> {{TranslatorSurnameFirst}}, {{AdhyayaName}}, In Charak Samhita New Edition, ed.by {{EditorSurnameFirst}}, 1&lt;sup&gt;st&lt;/sup&gt; edition (Ind:Jamnagar,2020), pp.{{PageNo}}. CSRTSDC ebook Doi:{{DoiWithLink}}<br /> <br /> === [[The Chicago Manual of Style|Chicago style]] ===<br /> {{TranslatorNameFirst}}, &quot;{{AdhyayaName}}&quot; in Charak Samhita New Edition, ed.by {{EditorNameFirst}}, page {{PageNo}}, (Jamnagar:CSRTSDC,2020), {{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}} (accessed &lt;citation&gt;{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}&lt;/citation&gt;).<br /> <br /> === [[Council of Science Editors|CBE/CSE style]] ===<br /> {{TranslatorSurnameFirst}}. ({{DateOfPublication}}) {{AdhyayaName}}. In: {{EditorSurnameFirst}}, editor(s). Charak Samhita New Edition.Jamnagar:CSRTSDC; [accessed &lt;citation&gt;{{CURRENTYEAR}} {{CURRENTMONTHNAME}} {{CURRENTDAY}}&lt;/citation&gt;]. 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Agnivesha https://www.carakasamhitaonline.com/index.php?title=Trishna_Chikitsa&diff=45391 2025-11-24T05:24:07Z

<p>Agnivesha: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Trishna Chikitsa<br /> |titlemode=append<br /> |keywords=trishna, vata, pitta, mukha shosha, jala, thirst, polydipsia, water and fluid balance, osmosis, ion balance,Ayurveda, Indian system of medicine, charak samhita online, caraka samhita, why a person feel thirsty?<br /> |description=Chikitsa Sthana Chapter 22. Management of Trishna (Morbid thirst)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;''' [[Chikitsa Sthana]] Chapter 22. Management of Trishna (Morbid thirst) &lt;/big&gt;''' <br /> {{Infobox<br /> |title = Trishna Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 22<br /> |label2 = Preceding Chapter<br /> |data2 = [[Visarpa Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Visha Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Sharma R.<br /> |label7 = Reviewer <br /> |data7 = Pande A.<br /> |label8 = Editors <br /> |data8 = Ojha S.N., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.023 10.47468/CSNE.2020.e01.s06.023]<br /> <br /> |header3 = <br /> <br /> }}<br /> <br /> &lt;big&gt;''' Abstract &lt;/big&gt;''' <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;''Trishna'' and ''pipasa'' are two commonly used words denoting desire for water, the difference between the two is, ''trishna'' is pathological and ''pipasa'' is physiological. Generally, desire for water is physiological process to maintain fluid balance but if ''dosha'' are vitiated then they can lead to excessive thirst and can produce ''trishna'', a disease in which person constantly craves for the water. Beside independent disease, ''trishna'' or thirst is also seen as prodromal symptom, clinical feature, complication, poor prognostic sign etc. in various clinical conditions. In this chapter, etiological factors, premonitory symptoms, pathogenesis, clinical features and complications of trishna as a disease are discussed.<br /> &lt;/br&gt;<br /> '''Keywords''': trishna, [[vata]], [[pitta]], mukha shosha, jala, thirst, polydipsia, water and fluid balance, osmosis, ion balance.<br /> &lt;/p&gt;<br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> ‘Water is not necessary to life but rather life itself’ – This quotation describes importance of water in our life. Water is the most abundant constituent in the body, comprising approximately 50% of body weight in women and 60% in men.&lt;ref&gt; Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., editors. Harrison’s principles of internal medicine., Chapter 46, Fluid and Electrolyte Disturbances, Sodium and Water, 16th ed. New York: McGraw Hill; 2005.&lt;/ref&gt; It is crucial for survival as it performs various functions. It transports nutrients to the tissues, removes metabolic waste products, detoxifies body elements, regulates body temperature, maintains pH, electrolyte balance etc. and homeostasis of body. In normal physiological process, certain amount of fluid is lost continuously. If this fluid balance is not maintained then, both acute and chronic fluid deficits may lead to number of adverse health outcomes. Even modest fluid deficits may precipitate adverse events, especially in young children, in the frail elderly and in those with poor health.&lt;ref&gt;Maughan RJ., Hydration, morbidity, and mortality in vulnerable populations, Nutr Rev. 2012 Nov;70 Suppl 2:S152-5.&lt;/ref&gt; Fluid balance in body is maintained via thirst, a feedback-controlled variable, regulated acutely by central and peripheral mechanisms.&lt;ref&gt;Millard-Stafford M, Wendland DM, O'Dea NK, Norman TL, Thirst and hydration status in everyday life. Nutr Rev. 2012 Nov;70 Suppl 2:S147-51&lt;/ref&gt; Thirst is physiological but when it exceeds its threshold it becomes pathological and is common in many diseases. Modern science accepts it as symptom only and have not given it as an entity of ‘disease’. [[Ayurveda]] is more comprehensive and broader in its approach. Fluid imbalance is a major cause of morbidity and mortality and considering this fact ‘thirst’ which is an indicator of fluid imbalance has been described as separate disease and not merely a symptom.<br /> <br /> The other meaning of ''trishna'' is greed or insatiable desire for something. It can be referred that word ''trishna'' not only denotes physical craving but includes psychological desires also. In morbid thirst both body and mind crave and there are conditions like psychogenic polydypsia in which thirst is only due to mental involvement. As mind plays an important role in thirst as a disease this chapter has been named as ''trishna chikitsitam'' (or [[Trishna Chikitsa]]) not ''pipasa chikitsitam''. <br /> <br /> ''Trishna'' word in [[Ayurveda]] is interchangeably used for physiological as well as pathological thirst. Normally, [[vata]] and [[pitta]] are the two [[dosha]] inseparably involved in causing ''trishna'' as they have ''shoshana guna'' (property to absorb the water element) but the difference is [[vata]] absorbs the moisture by its dry property, whereas [[pitta]] does it by its hot property. Thirst is function of unvitiated [[pitta]] and clinically presents as ''mukha shosha'' (dry mouth) which occurs due to [[vata]]. So, it can be said that both [[dosha]] are inseparably involved in thirst production. When they are ‘unvitiated’, physiological thirst is produced and when ‘vitiated’ they can cause ''trishna''. Based on etiological factor and pathogenesis involved, ''trishna'' is classified into five types – [[vata]]ja, [[pitta]]ja, amaja, kshayaja and ''upasargaja''. These [[dosha]] absorb water from the saumya [[dhatu]] like [[rasa dhatu]], udaka and [[kapha]] (tissues in which water content is more). Three more types – [[kapha]]ja, bhaktodhabhavaja'' (after excess eating) and ''kshataja'' (thirst produced due to external injury). <br /> <br /> Presently we rely only on fluid and electrolyte supplementation to treat thirst. Treatment of ''trishna'' by ayurvedic principles may open newer vistas in the cases where thirst is difficult to treat. Increased mortality due to dehydration, especially in vulnerable populations, it is commonly observed during periods of abnormally warm weather.&lt;ref&gt; Maughan RJ.,Nutr Rev. 2012 Nov;70 Suppl 2:S152-5, Hydration, morbidity, and mortality in vulnerable populations.&lt;/ref&gt; Mortality rate is high in remote areas where health care facilities are not good enough. Ayurvedic preparations mentioned in this chapter are easy to make, can be life saving where sophisticated medical care is not available. Based on Ayurvedic principles, rules regarding use of water in various diseases have been also given in this chapter.<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातस्तृष्णाचिकित्सितं व्याख्यास्यामः ||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः ||२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātastrishnacikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2||<br /> <br /> athAtastRuṣṇacikitsitaM vyAkhyAsyAmaH ||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH ||2||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now we shall expound the chapter &quot;Trishna Chikitsa&quot; (Management of morbid thirst).Thus said the Lord atreya. [1-2]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ज्ञानप्रशमतपोभिः ख्यातोऽत्रिसुतो जगद्धितेऽभिरतः | <br /> <br /> तृष्णानां प्रशमार्थं चिकित्सितं प्राह पञ्चानाम् ||३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> jñānapraśamatapōbhiḥ khyātō'trisutō jagaddhitē'bhirataḥ| <br /> <br /> trishnanāṁ praśamārthaṁ cikitsitaṁ prāha pañcānām||3||<br /> <br /> j~jAnaprashamatapobhiH khyAto~atrisuto jagaddhite~abhirataH | <br /> <br /> tRuṣṇanAM prashamArthaM cikitsitaM prAha pa~jcAnAm ||3||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The son of Atri, famed for his sagaciousness, tranquility, austerity and devoted to the wellness of the world, expounded the chapter therapeutics of morbid thirst. [3]<br /> <br /> === Etio-pathogenesis ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षोभाद्भयाच्छ्रमादपि शोकात्क्रोधाद्विलङ्घनान्मद्यात् | <br /> <br /> क्षाराम्ललवणकटुकोष्णरूक्षशुष्कान्नसेवाभिः ||४|| <br /> <br /> धातुक्षयगदकर्षणवमनाद्यतियोगसूर्यसन्तापैः | <br /> <br /> पित्तानिलौ प्रवृद्धौ सौम्यान्धातूंश्च शोषयतः ||५|| <br /> <br /> रसवाहिनीश्च नालीर्जिह्वामूलगलतालुकक्लोम्नः | <br /> <br /> संशोष्य नृणां देहे कुरुतस्तृष्णां महाबलावेतौ ||६|| <br /> <br /> पीतं पीतं हि जलं शोषयतस्तावतो न याति शमम् | <br /> <br /> घोरव्याधिकृशानां प्रभवत्युपसर्गभूता सा ||७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣōbhādbhayācchramādapi śōkātkrōdhādvilaṅghanānmadyāt| <br /> <br /> kṣārāmlalavaṇakaṭukōṣṇarūkṣaśuṣkānnasēvābhiḥ||4|| <br /> <br /> dhātukṣayagadakarṣaṇavamanādyatiyōgasūryasantāpaiḥ| <br /> <br /> pittānilau pravr̥ddhau saumyāndhātūṁśca śōṣayataḥ||5|| <br /> <br /> rasavāhinīśca nālīrjihvāmūlagalatālukaklōmnaḥ [1] | <br /> <br /> saṁśōṣya nr̥ṇāṁ dēhē kurutastrishnaṁ mahābalāvētau||6|| <br /> <br /> pītaṁ pītaṁ hi jalaṁ śōṣayatastāvatō na yāti śamam| <br /> <br /> ghōravyādhikr̥śānāṁ prabhavatyupasargabhūtā [2] sā||7||<br /> <br /> kShobhAdbhayAcchramAdapi shokAtkrodhAdvila~gghanAnmadyAt | <br /> <br /> kShArAmlalavaNakaTukoShNarūkṣashuShkAnnasevAbhiH ||4|| <br /> <br /> dhātukShayagadakarShaNavamanAdyatiyogasUryasantApaiH | <br /> <br /> pittAnilau pravRuddhau saumyAndhātuMshca śōṣayataH ||5|| <br /> <br /> rasavAhinIshca nAlIrjihvAmUlagalatAlukaklomnaH | <br /> <br /> saMshoShya nRuNAM dehe kurutastRuṣṇaM mahAbalAvetau ||6|| <br /> <br /> pItaM pItaM hi jalaM śōṣayatastAvato na yAti shamam | <br /> <br /> ghoravyAdhikRushAnAM prabhavatyupasargabhUtA sA ||7||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As a result of shock/excess distress, fear, fatigue, grief, anger, extreme starvation, alcoholism, regular use of alkaline and sour substances, use of excessive salt, pungent, salty, dry and dehydrated food, emaciation due to excessive loss of basic body forming elements and emaciation due to disease, excessive use of purifactory procedures, excessive exposure to sunlight, [[pitta]] and [[vata]] get severely vitiated and dry up the watery contents of the body. These two [[dosha]] vigorously dehydrate the fluid carrying ducts and channels situated at the base of the tongue, throat, palate and ''kloma'' which causes morbid thirst in a man. Though the patient perpetually drinks water yet his thirst is not quenched. Such morbid thirst arises as a complication in the persons suffering from emaciation due to grave diseases. [4-8]<br /> <br /> === Premonitory and cardinal symptoms and signs ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्राग्रूपं मुखशोषः, स्वलक्षणं सर्वदाऽम्बुकामित्वम् | <br /> <br /> तृष्णानां सर्वासां लिङ्गानां लाघवमपायः ||८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> prāgrūpaṁ mukhaśōṣaḥ, svalakṣaṇaṁ sarvadā'mbukāmitvam| <br /> <br /> trishnanāṁ sarvāsāṁ liṅgānāṁ lāghavamapāyaḥ||8|| <br /> <br /> prAgrUpaM mukhaśōṣaH, svalakShaNaM sarvadA~ambukAmitvam | <br /> <br /> tRuṣṇanAM sarvAsAM li~ggAnAM lAghavamapAyaH ||8||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The premonitory symptoms of morbid thirst are dryness of mouth along with constant craving for water as a cardinal symptom. All the clinical features of morbid thirst may occur in mild form or some of the features may be seen in premonitory stage of morbid thirst. [8]<br /> <br /> === General clinical signs and symptoms ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मुखशोषस्वरभेदभ्रमसन्तापप्रलापसंस्तम्भान् | <br /> <br /> ताल्वोष्ठकण्ठजिह्वाकर्कशतां चित्तनाशं च ||९|| <br /> <br /> जिह्वानिर्गममरुचिं बाधिर्यं मर्मदूयनं सादम् | <br /> <br /> तृष्णोद्भूता कुरुते, पञ्चविधां लिङ्गतः शृणु ताम् ||१०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mukhaśōṣasvarabhēdabhramasantāpapralāpasaṁstambhān| <br /> <br /> tālvōṣṭhakaṇṭhajihvākarkaśatāṁ cittanāśaṁ ca||9|| <br /> <br /> jihvānirgamamaruciṁ bādhiryaṁ marmadūyanaṁ sādam| <br /> <br /> tr̥ṣṇōdbhūtā kurutē, pañcavidhāṁ liṅgataḥ śr̥ṇu tām||10|| <br /> <br /> mukhaśōṣasvarabhedabhramasantApapralApasaMstambhAn | <br /> <br /> tAlvoShThakaNThajihvAkarkashatAM cittanAshaM ca ||9|| <br /> <br /> jihvAnirgamamaruciM bAdhiryaM marmadUyanaM sAdam | <br /> <br /> tRuShNodbhUtA kurute, pa~jcavidhAM li~ggataH shRuNu tAm ||10||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Dryness of mouth, hoarseness of voice, giddiness, burning sensation all over body, delirium, rigidity, dryness and roughness of palate, lip, throat and tongue, stupefaction, loss of concentration, protrusion of the tongue, anorexia, auditory impairment, burning sensation in vital organs and exhaustion are the symptoms of morbid thirst. Now listen carefully the symptoms of each of the five varieties of morbid thirst separately.[9-10]<br /> <br /> === [[Vata]] dominant ''trishna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अब्धातुं देहस्थं कुपितः पवनो यदा विशोषयति | <br /> <br /> तस्मिञ्शुष्के शुष्यत्यबलस्तृष्यत्यथ विशुष्यन् ||११||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> abdhātuṁ dēhasthaṁ kupitaḥ pavanō yadā viśōṣayati| <br /> <br /> tasmiñśuṣkē śuṣyatyabalastr̥ṣyatyatha viśuṣyan||11|| <br /> <br /> abdhātuM dehasthaM kupitaH pavano yadA viśōṣayati | <br /> <br /> tasmi~jshuShke shuShyatyabalastRuShyatyatha vishuShyan ||11||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Vitiated [[vata]] absorbs the watery elements in the body. As a result of absorption of these fluids, the weak person gets dehydrated and consequently suffers from morbid thirst. [11]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> निद्रानाशः शिरसो भ्रमस्तथा शुष्कविरसमुखता च स्रोतोऽवरोध इति च स्याल्लिङ्गं वाततृष्णायाः ||१२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nidrānāśaḥ śirasō bhramastathā śuṣkavirasamukhatā ca <br /> <br /> srōtō'varōdha iti ca syālliṅgaṁ vātatrishnayāḥ||12||<br /> <br /> nidrAnAshaH shiraso bhramastathA shuShkavirasamukhatA ca sroto~avarodha iti ca syAlli~ggaM VātatRuṣṇayAH ||12||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Lack of sleep, giddiness, dry mouth, distaste, and occlusion of the channels are the symptoms of the [[vata]]ja morbid thirst. [12]<br /> <br /> === [[Pitta]] dominant ''trishna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तं मतमाग्नेयं कुपितं चेत्तापयत्यपां धातुम् | <br /> <br /> सन्तप्तः स हि जनयेत्तृष्णां दाहोल्बणां नॄणाम् ||१३|| <br /> <br /> तिक्तास्यत्वं शिरसो दाहः शीताभिनन्दता मूर्च्छा | <br /> <br /> पीताक्षिमूत्रवर्चस्त्वमाकृतिः पित्ततृष्णायाः ||१४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pittaṁ matamāgnēyaṁ kupitaṁ cēttāpayatyapāṁ dhātum| <br /> <br /> santaptaḥ sa hi janayēttrishnaṁ dāhōlbaṇāṁ nr̥̄ṇām||13|| <br /> <br /> tiktāsyatvaṁ śirasō dāhaḥ śītābhinandatā mūrcchā| <br /> <br /> pītākṣimūtravarcastvamākr̥tiḥ pittatrishnayāḥ||14|| <br /> <br /> pittaM matamAgneyaM kupitaM cettApayatyapAM dhātum | <br /> <br /> santaptaH sa hi janayettRuṣṇaM dAholbaNAM nRUNAm ||13|| <br /> <br /> tiktAsyatvaM shiraso dAhaH shItAbhinandatA mUrcchA |<br /> <br /> pItAkShimUtravarcastvamAkRutiH pittatRuṣṇayAH ||14||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The [[pitta]] is regarded as the thermal elements in the body which on vitiation, heats the watery elements to cause morbid thirst and person suffers from excessive burning sensation.<br /> <br /> Bitter taste in the mouth, burning sensation in the head, cravings for cold things, fainting and yellowish discoloration of eyes, urine and feces, are the clinical features of [[pitta]]ja morbid thirst.[13-14]<br /> <br /> === ''Trishna'' due to ''ama'' vitiation ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तृष्णा याऽऽमप्रभवा साऽप्याग्नेयाऽऽमपित्तजनितत्वात् | <br /> <br /> लिङ्गं तस्याश्चारुचिराध्मानकफप्रसेकौ च ||१५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> trishna yā''maprabhavā sā'pyāgnēyā''mapittajanitatvāt [1] | <br /> <br /> liṅgaṁ tasyāścārucirādhmānakaphaprasēkau ca||15|| <br /> <br /> tRuṣṇa yA~a~amaprabhavA sA~apyAgneyA~a~amapittajanitatvAt | <br /> <br /> li~ggaM tasyAshcArucirAdhmAnakaphaprasekau ca ||15||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Morbid thirst, which originates from incomplete transformation or metabolism of food, is also a [[pitta]]ja type as it originates from ''ama'' and [[pitta]] ([[pitta]] obstructed due to vitiated ''ama''). Its clinical features are anorexia, flatulence and excessive salivation. [15]<br /> <br /> === ''Trishna'' due to depletion of body elements ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> देहो रसजोऽम्बुभवो रसश्च तस्य क्षयाच्च तृष्येद्धि | <br /> <br /> दीनस्वरः प्रताम्यन् संशुष्कहृदयगलतालुः ||१६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dēhō rasajō'mbubhavō rasaśca tasya kṣayācca tr̥ṣyēddhi| <br /> <br /> dīnasvaraḥ pratāmyan saṁśuṣkahr̥dayagalatāluḥ [1] ||16|| <br /> <br /> deho rasajo~ambubhavo rasashca tasya kShayAcca tRuShyeddhi | <br /> <br /> dInasvaraH pratAmyan saMshuShkahRudayagalatAluH ||16||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The body is composed of watery elements and the colloidal fluids of the body are in turn composed of the aqueous elements. The loss of these watery elements induces thirst, low voice (altered voice), fainting, dryness of throat and palate. [16]<br /> <br /> === ''Trishna'' due to complications of other diseases ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भवति खलु योपसर्गात्तृष्णा सा शोषिणी कष्टा | <br /> <br /> ज्वरमेहक्षयशोषश्वासाद्युपसृष्टदेहानाम् ||१७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhavati khalu yōpasargāttrishna sā śōṣiṇī kaṣṭā| <br /> <br /> jvaramēhakṣayaśōṣaśvāsādyupasr̥ṣṭadēhānām [1] ||17||<br /> <br /> bhavati khalu yopasargAttRuṣṇa sA shoShiNI kaShTA | <br /> <br /> jvaramehakShayaśōṣashvAsAdyupasRuShTadehAnAm ||17||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Morbid thirst which occurs in a person as a complication of fever, urinary disorders in which abnormal and increased quantity of urine is passed, emaciation, consumption, dyspnea and similar other disorders, cause severe dehydration and such type of ''trishna'' is very difficult to treat.[17]<br /> <br /> === Serious consequence of ''trishna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सर्वास्त्वतिप्रसक्ता रोगकृशानां वमिप्रसक्तानाम् | <br /> <br /> घोरोपद्रवयुक्तास्तृणा मरणाय विज्ञेयाः ||१८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sarvāstvatiprasaktā rōgakr̥śānāṁ vamiprasaktānām| <br /> <br /> ghōrōpadravayuktāstr̥ṇā maraṇāya vijñēyāḥ||18|| <br /> <br /> sarvAstvatiprasaktA rogakRushAnAM vamiprasaktAnAm | <br /> <br /> ghoropadravayuktAstRuNA maraNAya vij~jeyAH ||18||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> All varieties of diseases which are chronic in nature, which occur in the patients emaciated by diseases and afflicted with perpetual vomiting which occurs along with grave complications to be known as being indicative of approaching death. [18]<br /> <br /> === Role of [[vata]] and [[pitta]] in ''trishna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नाग्निं विना हि तर्षः पवनाद्वा तौ हि शोषणे हेतू | <br /> <br /> अब्धातोरतिवृद्धावपां क्षये तृष्यते नरो हि ||१९|| <br /> <br /> गुर्वन्नपयःस्नेहैः सम्मूर्च्छद्भिर्विदाहकाले च | <br /> <br /> यस्तृष्येद्वृतमार्गे तत्राप्यनिलानलौ हेतू ||२०|| <br /> <br /> तीक्ष्णोष्णरूक्षभावान्मद्यं पित्तानिलौ प्रकोपयति | <br /> <br /> शोषयतोऽपां धातुं तावेव हि मद्यशीलानाम् ||२१|| <br /> <br /> तप्तास्विव सिकतासु हि तोयमाशु शुष्यति क्षिप्तम् | <br /> <br /> तेषां सन्तप्तानां हिमजलपानाद्भवति शर्म ||२२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nāgniṁ vinā hi tarṣaḥ pavanādvā tau hi śōṣaṇē hētū| <br /> <br /> abdhātōrativr̥ddhāvapāṁ kṣayē tr̥ṣyatē narō hi||19|| <br /> <br /> gurvannapayaḥsnēhaiḥ sammūrcchadbhirvidāhakālē ca| <br /> <br /> yastr̥ṣyēdvr̥tamārgē tatrāpyanilānalau hētū||20|| <br /> <br /> tīkṣṇōṣṇarūkṣabhāvānmadyaṁ pittānilau prakōpayati| <br /> <br /> śōṣayatō'pāṁ dhātuṁ tāvēva hi madyaśīlānām||21|| <br /> <br /> taptāsviva sikatāsu hi tōyamāśu śuṣyati kṣiptam| <br /> <br /> tēṣāṁ santaptānāṁ himajalapānādbhavati śarma||22|| <br /> <br /> nAgniM vinA hi tarShaH pavanAdvA tau hi śōṣane hetU | <br /> <br /> abdhAtorativRuddhAvapAM kShaye tRuShyate naro hi ||19|| <br /> <br /> gurvannapayaHsnehaiH sammUrcchadbhirvidAhakAle ca | <br /> <br /> yastRuShyedvRutamArge tatrApyanilAnalau hetU ||20|| <br /> <br /> tIkShNoShNarūkṣabhAvAnmadyaM pittAnilau prakopayati | <br /> <br /> śōṣayato~apAM dhātuM tAveva hi madyashIlAnAm ||21|| <br /> <br /> taptAsviva sikatAsu hi toyamAshu shuShyati kShiptam | <br /> <br /> teShAM santaptAnAM himajalapAnAdbhavati sharma ||22||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thirst can‘t occur without [[pitta]] (heat) and [[vata]]; the excessive increase in these two elements results in absorption of the watery element, and loss of water in body leads to thirst.<br /> <br /> In a condition where person after indulging in heavy food, milk and unctuous articles, which during the digestive process cause thirst by obstructing the channels, in such condition [[vata]] and the thermal elements act as the causative factors.<br /> <br /> Alcohol by its quality being ''tikshna'' (the property which causes sharp action and quick penetration), salty, sultry and dry, provokes [[pitta]] and [[vata]]. These two factors ([[pitta]] and [[vata]]) dry up the watery elements of the body in alcohol addicts. Just as hot sand absorbs and dries up the water poured on it, similarly relief is obtained by pouring of the cold water.[19-22]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शिशिरस्नातस्योष्मा रुद्धः कोष्ठं प्रपद्य तर्षयति | <br /> <br /> तस्मान्नोष्णक्लान्तो भजेत सहसा जलं शीतम् ||२३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śiśirasnātasyōṣmā ruddhaḥ kōṣṭhaṁ prapadya tarṣayati| <br /> <br /> tasmānnōṣṇaklāntō bhajēta sahasā jalaṁ śītam [1] ||23|| <br /> <br /> shishirasnAtasyoShmA ruddhaH koShThaM prapadya tarShayati | <br /> <br /> tasmAnnoShNaklAnto bhajeta sahasA jalaM shItam ||23||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The body heat of the person is obstructed in the peripheral region by a cold bath and it passes to the internal organs and produces thirst. Therefore, the person who is fatigued by excessive heat should not take cold water immediately. [23]<br /> <br /> === Management of ''trishna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> लिङ्गं सर्वास्वेतास्वनिलक्षयपित्तजं भवत्यथ तु | <br /> <br /> पृथगागमाच्चिकित्सितमतः प्रवक्ष्यामि तृष्णानाम् ||२४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> liṅgaṁ sarvāsvētāsvanilakṣayapittajaṁ bhavatyatha tu| <br /> <br /> pr̥thagāgamāccikitsitamataḥ pravakṣyāmi trishnanām||24|| <br /> <br /> li~ggaM sarvAsvetAsvanilakShayapittajaM bhavatyatha tu | <br /> <br /> pRuthagAgamAccikitsitamataH pravakShyAmi tRuṣṇanAm ||24||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In all these types of the morbid thirst, symptoms arising from the vitiation of [[vata]], [[pitta]] and loss of watery elements of the body are manifested. Now, I shall describe the treatment of morbid thirst of various types one by one according to the authoritative tradition. [24]<br /> <br /> === Properties of pure rain water and its benefits ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अपां क्षयाद्धि तृष्णा संशोष्य नरं प्रणाशयेदाशु | <br /> <br /> तस्मादैन्द्रं तोयं समधु पिबेत्तद्गुणं वाऽन्यत् ||२५|| <br /> <br /> किञ्चित्तुवरानुरसं तनु लघु शीतलं सुगन्धि सुरसं च | <br /> <br /> अनभिष्यन्दि च यत्तत्क्षितिगतमप्यैन्द्रवज्ज्ञेयम् ||२६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> apāṁ kṣayāddhi trishna saṁśōṣya naraṁ praṇāśayēdāśu| <br /> <br /> tasmādaindraṁ tōyaṁ samadhu pibēttadguṇaṁ vā'nyat||25|| <br /> <br /> kiñcittuvarānurasaṁ tanu laghu śītalaṁ sugandhi surasaṁ ca| <br /> <br /> anabhiṣyandi ca yattatkṣitigatamapyaindravajjñēyam||26||<br /> <br /> apAM kShayAddhi tRuṣṇa saMshoShya naraM praNAshayedAshu | <br /> <br /> tasmAdaindraM toyaM samadhu pibettadguNaM vA~anyat ||25|| <br /> <br /> ki~jcittuvarAnurasaM tanu laghu shItalaM sugandhi surasaM ca | <br /> <br /> anabhiShyandi ca yattatkShitigatamapyaindravajj~jeyam ||26||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Due to the loss of watery elements, man becomes dehydrated and dies soon due to thirst; the patients should therefore drink pure rain water mixed with honey, or any other water having similar properties that of rain water.<br /> <br /> The water, that has slight astringent, secondary taste, which is light to digest, cool, possess good smell and taste and devoid of channel blocking quality, should be considered equal to rain water in effect though it may be terrestrial.[25-26]<br /> <br /> === Various diet recipes in management of ''trishna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शृतशीतं ससितोपलमथवा शरपूर्वपञ्चमूलेन | <br /> <br /> लाजासक्तुसिताह्वामधुयुतमैन्द्रेण वा मन्थम् ||२७|| <br /> <br /> वाट्यं वाऽऽमयवानां शीतं मधुशर्करायुतं दद्यात् | <br /> <br /> पेयां वा शालीनां दद्याद्वा कोरदूषाणाम् ||२८|| <br /> <br /> पयसा शृतेन भोजनमथवा मधुशर्करायुतं योज्यम् | <br /> <br /> पारावतादिकरसैर्घृतभृष्टैर्वाऽप्यलवणाम्लैः ||२९|| <br /> <br /> तृणपञ्चमूलमुञ्जातकैः प्रियालैश्च जाङ्गलाः सुकृताः | <br /> <br /> शस्ता रसाः पयो वा तैः सिद्धं शर्करामधुमत् ||३०||<br /> <br /> शतधौतघृतेनाक्तः पयः पिबेच्छीततोयमवगाह्य | <br /> <br /> मुद्गमसूरचणकजा रसास्तु भृष्टा घृते देयाः ||३१|| <br /> <br /> मधुरैः सजीवनीयैः शीतैश्च सतिक्तकैः शृतं क्षीरम् | <br /> <br /> पानाभ्यञ्जनसेकेष्विष्टं मधुशर्करायुक्तम् ||३२|| <br /> <br /> तज्जं वा घृतमिष्टं पानाभ्यङ्गेषु नस्यमपि च स्यात् | <br /> <br /> नारीपयः सशर्करमुष्ट्र्या अपि नस्यमिक्षुरसः ||३३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śr̥taśītaṁ sasitōpalamathavā śarapūrvapañcamūlēna| <br /> <br /> lājāsaktusitāhvāmadhuyutamaindrēṇa [4] vā mantham||27|| <br /> <br /> vāṭyaṁ vā''mayavānāṁ śītaṁ madhuśarkarāyutaṁ dadyāt| <br /> <br /> pēyāṁ vā śālīnāṁ dadyādvā kōradūṣāṇām||28|| <br /> <br /> payasā śr̥tēna bhōjanamathavā madhuśarkarāyutaṁ yōjyam| <br /> <br /> pārāvatādikarasairghr̥tabhr̥ṣṭairvā'pyalavaṇāmlaiḥ||29|| <br /> <br /> tr̥ṇapañcamūlamuñjātakaiḥ priyālaiśca jāṅgalāḥ sukr̥tāḥ| <br /> <br /> śastā rasāḥ payō vā taiḥ siddhaṁ śarkarāmadhumat||30|| <br /> <br /> śatadhautaghr̥tēnāktaḥ payaḥ pibēcchītatōyamavagāhya| <br /> <br /> mudgamasūracaṇakajā rasāstu bhr̥ṣṭā ghr̥tē [5] dēyāḥ||31|| <br /> <br /> madhuraiḥ sajīvanīyaiḥ śītaiśca satiktakaiḥ śr̥taṁ kṣīram| <br /> <br /> pānābhyañjanasēkēṣviṣṭaṁ madhuśarkarāyuktam||32|| <br /> <br /> tajjaṁ vā ghr̥tamiṣṭaṁ pānābhyaṅgēṣu nasyamapi ca syāt| <br /> <br /> nārīpayaḥ saśarkaramuṣṭryā api nasyamikṣurasaḥ||33|| <br /> <br /> shRutashItaM sasitopalamathavA sharapUrvapa~jcamUlena | <br /> <br /> lAjAsaktusitAhvAmadhuyutamaindreNa vA mantham ||27|| <br /> <br /> vATyaM vA~a~amayavAnAM shItaM madhusharkarAyutaM dadyAt | <br /> <br /> pēyāM vA shAlInAM dadyAdvA koradUShANAm ||28|| <br /> <br /> payasA shRutena bhojanamathavA madhusharkarAyutaM yojyam | <br /> <br /> pArAVātadikarasairghRutabhRuShTairvA~apyalavaNAmlaiH ||29|| <br /> <br /> tRuNapa~jcamUlamu~jjAtakaiH priyAlaishca jA~ggalAH sukRutAH | <br /> <br /> shastA rasAH payo vA taiH siddhaM sharkarAmadhumat ||30|| <br /> <br /> shatadhautaghRutenAktaH payaH pibecchItatoyamavagAhya | <br /> <br /> mudgamasUracaNakajA rasAstu bhRuShTA ghRute deyAH ||31|| <br /> <br /> madhuraiH sajIvanIyaiH shItaishca satiktakaiH shRutaM kShIram | <br /> <br /> pAnAbhya~jjanasekeShviShTaM madhusharkarAyuktam ||32|| <br /> <br /> tajjaM vA ghRutamiShTaM pAnAbhya~ggeShu nasyamapi ca syAt | <br /> <br /> nArIpayaH sasharkaramuShTryA api nasyamikShurasaH ||33||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The physician may give the decoction of roots of the ''shara panchamula'' after cooling and mixing with sugar or the demulcent drink prepared of roasted paddy powder, sugar, honey and rain water; or he may give the top part of half cooked barley gruels cooled and mixed with sugar or he may give the thin gruel of ''shali'' rice or of common millets.<br /> <br /> Food mixed with boiled milk or with honey and sugar, or with meat juice of the pigeon and other similar birds of its group may be given after seasoning it with ghee. Sour or salty substances should not be added as mentioned in classical procedure.<br /> <br /> The meat of ''jangala'' animals well prepared with the roots of the ''trina panchamula, munjataka'' and ''priyala'' must be recommended; or the milk prepared with the above drugs mixed with sugar and honey should be given.<br /> <br /> The patients anointing himself with the ''shatadhauta'' ghee (ghee processed for hundred times) and taking cold bath, should drink milk or soups of green gram, lentils and chicken peas, seasoned with ghee.<br /> <br /> The milk boiled with drugs of sweet groups of medicine, or life promoter group of medicine, cool and bitter group of medicine mixed with honey and sugar may be utilized as potion for inunction and affusion.<br /> <br /> Or, the ghee prepared out of this medicated milk is propitious as potion and inunction as well as nasal medication. Breast milk or camel’s milk with sugar or sugarcane juice is good as nasal medication. [27-33]<br /> <br /> === Various therapeutics modalities ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षीरेक्षुरसगुडोदकसितोपलाक्षौद्रसीधुमार्द्वीकैः | <br /> <br /> वृक्षाम्लमातुलुङ्गैर्गण्डूषास्तालुशोषघ्नाः ||३४|| <br /> <br /> जम्ब्वाम्रातकबदरीवेतसपञ्चवल्कपञ्चाम्लैः | <br /> <br /> हृन्मुखशिरःप्रदेहाःसघृता मूर्च्छाभ्रमतृष्णाघ्नाः स्युः ||३५|| <br /> <br /> दाडिमदधित्थलोध्रैः सविदारीबीजपूरकैः शिरसः | <br /> <br /> लेपो गौरामलकैर्घृतारनालायुतैश्च हितः ||३६|| <br /> <br /> शैवलपङ्काम्बुरुहैः साम्लैः सघृतैश्च शक्तुभिर्लेपः | <br /> <br /> मस्त्वारनालार्द्रवसनकमलमणिहारसंस्पर्शाः ||३७|| <br /> <br /> शिशिराम्बुचन्दनार्द्रस्तनतटपाणितलगात्रसंस्पर्शाः | <br /> <br /> क्षौमार्द्रनिवसनानां वराङ्गनानां प्रियाणां च ||३८|| <br /> <br /> हिमवद्दरीवनसरित्सरोऽम्बुजपवनेन्दुपादशिशिराणाम् | <br /> <br /> रम्यशिशिरोदकानां स्मरणं कथाश्च तृष्णाघ्नाः ||३९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kShIrekShurasaguDodakasitopalAkShaudrasIdhumArdvIkaiH |<br /> <br /> vRūkṣamlamAtulu~ggairgaNDUShAstAlushoShaghnAH ||34|| <br /> <br /> jambvAmrAtakabadarIvetasapa~jcavalkapa~jcAmlaiH | <br /> <br /> hRunmukhashiraHpradehAHsaghRutA mUrcchAbhramatRuṣṇaghnAH syuH ||35|| <br /> <br /> dADimadadhitthalodhraiH savidArIbIjapUrakaiH shirasaH | <br /> <br /> lepo gaurAmalakairghRutAranAlAyutaishca hitaH ||36|| <br /> <br /> shaivalapa~gkAmburuhaiH sAmlaiH saghRutaishca shaktubhirlepaH | <br /> <br /> mastvAranAlArdravasanakamalamaNihArasaMsparshAH ||37|| <br /> <br /> shishirAmbucandanArdrastanataTapANitalagAtrasaMsparshAH | <br /> <br /> kShaumArdranivasanAnAM varA~gganAnAM priyANAM ca ||38|| <br /> <br /> himavaddarIvanasaritsaro~ambujapavanendupAdashishirANAm | <br /> <br /> ramyashishirodakAnAM smaraNaM kathAshca tRuṣṇaghnAH ||39||<br /> <br /> kShIrekShurasaguDodakasitopalAkShaudrasIdhumArdvIkaiH | <br /> <br /> vRūkṣamlamAtulu~ggairgaNDUShAstAluśōṣaghnAH ||34|| <br /> <br /> jambvAmrAtakabadarIvetasapa~jcavalkapa~jcAmlaiH | <br /> <br /> hRunmukhashiraHpradehAHsaghRutA mUrcchAbhramatRuṣṇaghnAH syuH ||35|| <br /> <br /> dADimadadhitthalodhraiH savidArIbIjapUrakaiH shirasaH | <br /> <br /> lepo gaurAmalakairghRutAranAlAyutaishca hitaH ||36|| <br /> <br /> shaivalapa~gkAmburuhaiH sAmlaiH saghRutaishca ŚaktubhirlepaH | <br /> <br /> mastvAranAlArdravasanakamalamaNihArasaMsparshAH ||37|| <br /> <br /> shishirAmbucandanArdrastanataTapANitalagAtrasaMsparshAH | <br /> <br /> kShaumArdranivasanAnAM varA~gganAnAM priyANAM ca ||38|| <br /> <br /> himavaddarIvanasaritsaro~ambujapavanendupAdashishirANAm | <br /> <br /> ramyashishirodakAnAM smaraNaM kathAshca tRuṣṇaghnAH ||39||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The gargles of milk, sugarcane juice, jaggery water, sugar, honey, and wine prepared from sugarcane, grape wine, ''kokam'' (Garcinia cambogia) and citron fruit are beneficial in curing dryness of the palate.<br /> <br /> The application of ''jambu'' (Syzgium cumini), Indian hog plum jujube, country willow, barks of five herbs (''panchavalkal'') and the herbs of ''panchamla'' group mixed with ghee over pericardial region, face are curative of fainting, giddiness and thirst.<br /> <br /> When external application of paste prepared from pomegranate, wood apple, ''lodhra'' (Symplocos racemosa), white yam and citron or of whitish emblica myrobalans mixed with ghee and sour wheat porridge is done over head area it proves useful.<br /> <br /> Paste prepared from moss, mud, and lotuses or with roasted paddy powder mixed with sour articles and ghee or application of wet cloth soaked in whey or sour wheat ''conjee'' or application of lotuses or of garlands of precious stones should be done. The contact of the breast and hands of resplendent and beloved women clad in wet silken garments and besmeared with cool and fragrant waters or sandal paste, proves beneficial.<br /> <br /> The thinking of or listening to the description of Himalayan caves, woods, streams, lakes, lotuses, breezes, moonlight, and other cool things as well as of lovely cool waters- these have an allaying effect on morbid thirst.[34-39]<br /> <br /> === Guidelines for management of [[vata]] dominant ''trishna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वातघ्नमन्नपानं मृदु लघु शीतं च वाततृष्णायाम् | <br /> <br /> क्षयकासनुच्छृतं क्षीरघृतमूर्ध्ववाततृष्णाघ्नम् ||४०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vātaghnamannapānaṁ mr̥du laghu śītaṁ ca vātatrishnayām| <br /> <br /> kṣayakāsanucchr̥taṁ kṣīraghr̥tamūrdhvavātatrishnaghnam ||40|| <br /> <br /> VātaghnamannapAnaM mRudu laghu shItaM ca VātatRuṣṇayAm | <br /> <br /> kShayakAsanucchRutaM kShIraghRutamUrdhvaVātatRuṣṇaghnam ||40||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the morbid thirst is due to[[vata]] dominance, then soft, light to digest food and drink with cooling property, curative of [[vata]] are recommended. Also ghee which is churned directly from milk is indicated which has been mentioned for the treatment of ''kshayaja kasa'' (cough due to wasting) and is curative of thirst and dyspnea. [40]<br /> <br /> === Guidelines for management of [[pitta]] dominant ''trishna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्याज्जीवनीयसिद्धं क्षीरघृतं वातपित्तजे तर्ष |४१|<br /> <br /> पैत्ते द्राक्षाचन्दनखर्जूरोशीरमधुयुतं तोयम् ||४१|| <br /> <br /> लोहितशालितण्डुलखर्जूरपरूषकोत्पलद्राक्षाः | <br /> <br /> मधु पक्वलोष्टमेव च जले स्थितं शीतलं पेयम् ||४२|| <br /> <br /> लोहितशालिप्रस्थः सलोध्रमधुकाञ्जनोत्पलः क्षुण्णः | <br /> <br /> पक्वामलोष्टजलमधुसमायुतो मृन्मये पेयः ||४३|| <br /> <br /> वटमातुलुङ्गवेतसपल्लवकुशकाशमूलयष्ट्याह्वैः | <br /> <br /> सिद्धेऽम्भस्यग्निनिभां कृष्णमृदं कृष्णसिकतां वा ||४४|| <br /> <br /> तत्पानि नवकपालान्यथवा निर्वाप्य पाययेताच्छम् | <br /> <br /> आपाकशर्करं वाऽमृतवल्ल्युदकं तृषां हन्ति ||४५|| <br /> <br /> क्षीरवतां मधुराणां शीतानां शर्करामधुविमिश्राः | <br /> <br /> शीतकषाया मृद्भृष्टसंयुताः पित्ततृष्णाघ्नाः ||४६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> syājjīvanīyasiddhaṁ kṣīraghr̥taṁ vātapittajē tarṣa|41| <br /> <br /> paittē drākṣācandanakharjūrōśīramadhuyutaṁ tōyam||41|| <br /> <br /> lōhitaśālitaṇḍulakharjūraparūṣakōtpaladrākṣāḥ| <br /> <br /> madhu pakvalōṣṭamēva ca jalē sthitaṁ śītalaṁ pēyam||42|| <br /> <br /> lōhitaśāliprasthaḥ salōdhramadhukāñjanōtpalaḥ kṣuṇṇaḥ| <br /> <br /> pakvāmalōṣṭajalamadhusamāyutō [9] mr̥nmayē pēyaḥ||43|| <br /> <br /> vaṭamātuluṅgavētasapallavakuśakāśamūlayaṣṭyāhvaiḥ| <br /> <br /> siddhē'mbhasyagninibhāṁ kr̥ṣṇamr̥daṁ kr̥ṣṇasikatāṁ vā||44|| <br /> <br /> taptāni navakapālānyathavā nirvāpya pāyayētāccham| <br /> <br /> āpākaśarkaraṁ vā'mr̥tavallyudakaṁ tr̥ṣāṁ hanti||45|| <br /> <br /> kṣīravatāṁ madhurāṇāṁ śītānāṁ śarkarāmadhuvimiśrāḥ| <br /> <br /> śītakaṣāyā mr̥dbhr̥ṣṭasaṁyutāḥ pittatrishnaghnāḥ||46|| <br /> <br /> syAjjIvanIyasiddhaM kShIraghRutaM Vātapittaje tarSha |41|<br /> <br /> paitte drAkShAcandanakharjUroshIramadhuyutaM toyam ||41|| <br /> <br /> lohitashAlitaNDulakharjUraparUShakotpaladrAkShAH | <br /> <br /> madhu pakvaloShTameva ca jale sthitaM shItalaM pēyām ||42|| <br /> <br /> lohitashAliprasthaH salodhramadhukA~jjanotpalaH kShuNNaH | <br /> <br /> pakvAmaloShTajalamadhusamAyuto mRunmaye pēyāH ||43|| <br /> <br /> VātamAtulu~ggavetasapallavakushakAshamUlayaShTyAhvaiH | <br /> <br /> siddhe~ambhasyagninibhAM kRuṣṇamRudaM kRuṣṇasikatAM vA ||44|| <br /> <br /> tatpAni navakapAlAnyathavA nirvApya pAyayetAccham | <br /> <br /> ApAkasharkaraM vA~amRutavallyudakaM tRuShAM hanti ||45|| <br /> <br /> kShIraVātaM madhurANAM shItAnAM sharkarAmadhuvimishrAH | <br /> <br /> shItakaShAyA mRudbhRuShTasaMyutAH pittatRuṣṇaghnAH ||46||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In morbid thirst due to [[vata]] and [[pitta]], the ghee taken out of milk prepared with drugs of life promoter group, is recommended.<br /> <br /> In [[pitta]]ja morbid thirst, water mixed with grapes, sandalwood, dates, vetiveria zizanioidis, honey and cold water in which red ''shali'' rice, dates, ''parushaka'', blue water lily, grapes, honey and a baked lump of earth have been kept, may be given or water kept in earthen pot in which 64 tola of red ''shali'' rice, pounded with ''lodhra'', liquorice, antimony and blue water lily are put and in which a baked clod of clay, water and honey have been integrated. This is a curative drink in morbid thirst.<br /> <br /> In the water prepared with sprouts of banyan, citrus medica, country willow, roots of sacrificial and thatch grass and liquorice and quench black earthen or black sand or pieces of new earthen vessel which have been heated up to red hot. Use supernatant part of this mixture and give it to the patient.<br /> <br /> Quench red hot stones in decoction of ''guduchi'' and use it after cooling it.<br /> <br /> The cold infusions prepared from ''kshiri'' and ''madhur, shita'' group of plants should be given after adding sugar and honey quenching of baked clay should be done as described earlier. It is useful in [[pitta]]ja trishna. [41-46]<br /> <br /> === Guidelines for management of ''amaja trishna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> व्योषवचाभल्लातकतिक्तकषायास्तथाऽऽमतृष्णाघ्नाः | <br /> <br /> यच्चोक्तं कफजायां वम्यां तच्चैव कार्यं स्यात् ||४७|| <br /> <br /> स्तम्भारुच्यविपाकालस्यच्छर्दिषु कफानुगां तृष्णाम् | <br /> <br /> ज्ञात्वा दधिमधुतर्पणलवणोष्णजलैर्वमनमिष्टम् ||४८|| <br /> <br /> दाडिममम्लफलं वाऽप्यन्यत् सकषायमथ लेहम् | <br /> <br /> पेयमथवा प्रदद्याद्रजनीशर्करायुक्तम् ||४९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vyōṣavacābhallātakatiktakaṣāyāstathā''matrishnaghnāḥ| <br /> <br /> yaccōktaṁ kaphajāyāṁ vamyāṁ taccaiva kāryaṁ syāt||47|| <br /> <br /> stambhārucyavipākālasyacchardiṣu kaphānugāṁ trishnam| <br /> <br /> jñātvā dadhimadhutarpaṇalavaṇōṣṇajalairvamanamiṣṭam||48|| <br /> <br /> dāḍimamamlaphalaṁ vā'pyanyat sakaṣāyamatha lēham| <br /> <br /> pēyamathavā pradadyādrajanīśarkarāyuktam [12] ||49|| <br /> <br /> vyoShavacAbhallAtakatiktakaShAyAstathA~a~amatRuṣṇaghnAH | <br /> <br /> yaccoktaM kaphajAyAM vamyAM taccaiva kAryaM syAt ||47|| <br /> <br /> stambhArucyavipAkAlasyacchardiShu kaphAnugAM tRuṣṇam | <br /> <br /> j~jAtvA dadhimadhutarpaNalavaNoShNajalairvamanamiShTam ||48|| <br /> <br /> dADimamamlaphalaM vA~apyanyat sakaShAyamatha leham | <br /> <br /> pēyāmathavA pradadyAdrajanIsharkarAyuktam ||49|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''amaja trishna'', decoctions prepared form ''trikatu'', sweet flag, marking nut and drugs of bitter groups are useful; or treatment principles of [[kapha]]ja chhardi can be used.<br /> <br /> Rigidity, anorexia, indigestion, lethargy and regurgitation are suggestive of [[kapha]]ja type of thirst. In such condition, a dose of prepared curds, honey demulcent drink, salt and warm water should be used to induce vomiting.<br /> <br /> The physician may also give pomegranate or other sour fruits or the linctus mixed with astringent substances or he may give a potion containing turmeric and sugar.[47-49]<br /> <br /> === Guidelines for management of ''kshayaja trishna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षयकासेन तु तुल्या क्षयतृष्णा सा गरीयसी नॄणाम् | <br /> <br /> क्षीणक्षतशोषहितैस्तस्मात्तां भेषजैः शमयेत् ||५०|| <br /> <br /> पानतृषार्तः पानं त्वर्धोदकमम्ललवणगन्धाढ्यम् | <br /> <br /> शिशिरस्नातः पानं मद्याम्बु गुडाम्बु वा तृषितः ||५१|| <br /> <br /> भक्तोपरोधतृषितः स्नेहतृषार्तोऽथवा तनुयवागूम् | <br /> <br /> प्रपिबेद्गुरुणा तृषितो भुक्तेन तदुद्धरेद्भुक्तम् ||५२|| <br /> <br /> मद्याम्बु वाऽम्बु कोष्णं बलवांस्तृषितः समुल्लिखेत् पीत्वा | <br /> <br /> मागधिकाविशदमुखः सशर्करं वा पिबेन्मन्थम् ||५३|| <br /> <br /> बलवांस्तु तालुशोषे पिबेद्धृतं तृष्यमद्याच्च | <br /> <br /> सर्पिर्भृष्टं क्षीरं मांसरसांश्चाबलः स्निग्धान् ||५४|| <br /> <br /> अतिरूक्षदुर्बलानां तर्षं शमयेन्नृणामिहाशु पयः | <br /> <br /> छागो वा घृतभृष्टः शीतो मधुरो रसो हृद्यः ||५५|| <br /> <br /> स्निग्धेऽन्ने भुक्ते या तृष्णा स्यात्तां गुडाम्बुना शमयेत् | <br /> <br /> तर्षं मूर्च्छाभिहतस्य रक्तपित्तापहैर्हन्यात् ||५६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣayakāsēna tu tulyā kṣayatrishna sā garīyasī nr̥̄ṇām| <br /> <br /> kṣīṇakṣataśōṣahitaistasmāttāṁ bhēṣajaiḥ śamayēt||50|| <br /> <br /> pānatr̥ṣārtaḥ pānaṁ tvardhōdakamamlalavaṇagandhāḍhyam| <br /> <br /> śiśirasnātaḥ pānaṁ madyāmbu guḍāmbu vā tr̥ṣitaḥ||51|| <br /> <br /> bhaktōparōdhatr̥ṣitaḥ snēhatr̥ṣārtō'thavā tanuyavāgūm| <br /> <br /> prapibēdguruṇā tr̥ṣitō bhuktēna taduddharēdbhuktam||52|| <br /> <br /> madyāmbu vā'mbu kōṣṇaṁ balavāṁstr̥ṣitaḥ samullikhēt pītvā| <br /> <br /> māgadhikāviśadamukhaḥ saśarkaraṁ vā pibēnmantham||53|| <br /> <br /> balavāṁstu tāluśōṣē pibēddhr̥taṁ tr̥ṣyamadyācca| <br /> <br /> sarpirbhr̥ṣṭaṁ kṣīraṁ māṁsarasāṁścābalaḥ snigdhān||54|| <br /> <br /> atirūkṣadurbalānāṁ tarṣaṁ śamayēnnr̥ṇāmihāśu payaḥ| <br /> <br /> chāgō vā ghr̥tabhr̥ṣṭaḥ śītō madhurō rasō hr̥dyaḥ||55|| <br /> <br /> snigdhē'nnē bhuktē yā trishna syāttāṁ guḍāmbunā śamayēt| <br /> <br /> tarṣaṁ mūrcchābhihatasya raktapittāpahairhanyāt||56|| <br /> <br /> kShayakAsena tu tulyA kShayatRuṣṇa sA garIyasI nRUNAm | <br /> <br /> kShINakShataśōṣahitaistasmAttAM bheShajaiH shamayet ||50|| <br /> <br /> pAnatRuShArtaH pAnaM tvardhodakamamlalavaNagandhADhyam | <br /> <br /> shishirasnAtaH pAnaM madyAmbu guDAmbu vA tRuShitaH ||51|| <br /> <br /> bhaktoparodhatRuShitaH snehatRuShArto~athavA tanuyavAgUm |<br /> <br /> prapibedguruNA tRuShito bhuktena taduddharedbhuktam ||52|| <br /> <br /> madyAmbu vA~ambu koShNaM balavAMstRuShitaH samullikhet pItvA | <br /> <br /> mAgadhikAvishadamukhaH sasharkaraM vA pibenmantham ||53|| <br /> <br /> balavAMstu tAlushoShe pibeddhRutaM tRuShyamadyAcca | <br /> <br /> sarpirbhRuShTaM kShIraM māṁsarasAMshcAbalaH snigdhAn ||54|| <br /> <br /> atirūkṣadurbalAnAM tarShaM shamayennRuNAmihAshu payaH | <br /> <br /> chAgo vA ghRutabhRuShTaH shIto madhuro raso hRudyaH ||55|| <br /> <br /> snigdhe~anne bhukte yA tRuṣṇa syAttAM guDAmbunA shamayet | <br /> <br /> tarShaM mUrcchAbhihatasya raktapittApahairhanyAt ||56||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Kshayaja trishna'' is serious in nature as like ''kshayaja kasa'' (cough due to wasting), therefore this type of thirst should be treated with medications mentioned in cough due to wasting. Medications mentioned in ''kshatakshina'' and ''shosha'' are helpful.<br /> <br /> In polydipsia due to alcoholism, a potion of wine diluted with equal amount of water mixed with sour, salt and liberal quantity of fragrant substances are advised. In thirst immediately after a cold bath, a drink of diluted wine or jaggery water is recommended. If thirst is due to abstinence from food or due to indigestion of unctuous diet, the patient may take thin medicated gruel; if the thirst is due to ingestion of heavy meal, the patient should vomit out the food.<br /> <br /> If patient is strong enough, he may drink a dose of wine and water or warm water before vomiting and after cleaning mouth with long pepper, he may take a demulcent drink with sugar.<br /> <br /> If the thirsty patient has good strength and he suffers from dry palate, he may drink ghee or use it in his food; if the patient is weak, he may take milk seasoned with ghee or unctuous meat juice.<br /> <br /> The people who are extremely dehydrated and are weak can pacify their thirst immediately by milk or the cool and sweet meat juice of goat seasoned with ghee.<br /> <br /> The thirst resulting from eating unctuous food should be quenched with jaggery water; and the thirst in a person who has fainted should be remedied by medication mentioned in ''murchha'' (fainting).[50-56]<br /> <br /> === Indications of cold and hot water ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तृट्दाहमूर्च्छाभ्रमक्लममदात्ययास्रविषपित्ते |<br /> <br /> शस्तं स्वभावशीतं, शृतशीतं सन्निपातेऽम्भः ||५७|| <br /> <br /> हिक्काश्वासनवज्वरपीनसघृतपीतपार्श्वगलरोगे | <br /> <br /> कफवातकृते स्त्याने सद्यःशुद्धे च हितमुष्णम् ||५८|| <br /> <br /> पाण्डूदरपीनसमेहगुल्ममन्दानलातिसारेषु | <br /> <br /> प्लीह्नि च तोयं न हितं काममसह्ये पिबेदल्पम् ||५९|| <br /> <br /> पूर्वामयातुरः सन् दीनस्तृष्णार्दितो जलं काङ्क्षन् | <br /> <br /> न लभेत स चेन्मरणमाश्वेवाप्नुयाद्दीर्घरोगं वा ||६०|| <br /> <br /> तस्माद्धान्याम्बु पिबेत्तृष्यन् रोगी सशर्कराक्षौद्रम् | <br /> <br /> यद्वा तस्यान्यत्स्यात् सात्म्यं रोगस्य तच्चेष्टम् ||६१|| <br /> <br /> तस्यां विनिवृत्तायां तज्जन्य उपद्रवः सुखं जेतुम् | <br /> <br /> तस्मात्तृष्णां पूर्वं जयेद्बहुभ्योऽपि रोगेभ्यः ||६२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tr̥ṭdāhamūrcchābhramaklamamadātyayāsraviṣapittē | <br /> <br /> śastaṁ svabhāvaśītaṁ, śr̥taśītaṁ sannipātē'mbhaḥ||57|| <br /> <br /> hikkāśvāsanavajvarapīnasaghr̥tapītapārśvagalarōgē| <br /> <br /> kaphavātakr̥tē styānē sadyaḥśuddhē ca hitamuṣṇam||58|| <br /> <br /> pāṇḍūdarapīnasamēhagulmamandānalātisārēṣu| <br /> <br /> plīhni ca tōyaṁ na hitaṁ kāmamasahyē pibēdalpam||59|| <br /> <br /> pūrvāmayāturaḥ san dīnastrishnarditō jalaṁ kāṅkṣan| <br /> <br /> na labhēta sa cēnmaraṇamāśvēvāpnuyāddīrgharōgaṁ vā||60|| <br /> <br /> tasmāddhānyāmbu pibēttr̥ṣyan rōgī saśarkarākṣaudram| <br /> <br /> yadvā tasyānyatsyāt sātmyaṁ rōgasya taccēṣṭam||61|| <br /> <br /> tasyāṁ vinivr̥ttāyāṁ tajjanya upadravaḥ sukhaṁ jētum| <br /> <br /> tasmāttrishnaṁ pūrvaṁ jayēdbahubhyō'pi rōgēbhyaḥ||62|| <br /> <br /> tRuTdAhamUrcchAbhramaklamamadAtyayAsraviShapitte | <br /> <br /> shastaM svabhAvashItaM, shRutashItaM sannipAte~ambhaH ||57|| <br /> <br /> hikkAshvAsanavajvarapInasaghRutapItapArshvagalaroge | <br /> <br /> kaphaVātakRute styAne sadyaHshuddhe ca hitamuṣṇam ||58|| <br /> <br /> pANDUdarapInasamehagulmamandAnalAtisAreShu | <br /> <br /> plIhni ca toyaM na hitaM kAmamasahye pibedalpam ||59|| <br /> <br /> pUrvAmayAturaH san dInastRuṣṇardito jalaM kA~gkShan | <br /> <br /> na labheta sa cenmaraNamAshvevApnuyAddIrgharogaM vA ||60|| <br /> <br /> tasmAddhAnyAmbu pibettRuShyan rogI sasharkarAkShaudram | <br /> <br /> yadvA tasyAnyatsyAt sAtmyaM rogasya tacceShTam ||61|| <br /> <br /> tasyAM vinivRuttAyAM tajjanya upadravaH sukhaM jetum | <br /> <br /> tasmAttRuṣṇaM pUrvaM jayedbahubhyo~api rogebhyaH ||62||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Fresh cold water is beneficial in thirst associated with fainting, giddiness, exhaustion, alcoholism, poisoning and disorder of [[rakta]] and [[pitta]]. <br /> <br /> In thirst caused by ''sannipata'' (vitiation of all [[dosha]]) ''tridoshaja'', water cooled after boiling is beneficial.<br /> <br /> Warm water is useful in condition like hiccough, dyspnea, acute fever, coryza, after consumption of ghee, disorders of flanks and throat, diseases caused by [[kapha]] and [[vata]], or when the [[dosha]] are still not moving properly in the body and just after the purificatory treatment.<br /> <br /> In anemia, abdominal disease, ''gulma, meha,'' depleted digestive power, diarrhea and splenic disorders water intake is not beneficial; but if the thirst is unbearable, the patient may drink water in less quantity.<br /> <br /> If the patient is suffering from the above mentioned diseases and has become miserably afflicted with thirst and craving for water and if he does not get water, he may soon die or be afflicted with chronic illness then such thirsty patient may drink coriander water mixed with honey and sugar, or other medicated water which is wholesome in this condition.<br /> <br /> If the thirst is remedied, it is facile to subdue the complication arising from it; therefore thirst should be treated first in all diseases. [57-62]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकः- <br /> <br /> हेतू यथाऽग्निपवनौ कुरुतः सोपद्रवां च पञ्चानाम् | <br /> <br /> तृष्णानां पृथगाकृतिरसाध्यता साधनं चोक्तम् ||६३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkaḥ- <br /> <br /> hētū yathā'gnipavanau kurutaḥ sōpadravāṁ ca pañcānām| <br /> <br /> trishnanāṁ pr̥thagākr̥tirasādhyatā sādhanaṁ cōktam||63|| <br /> <br /> tatra shlokaH- <br /> <br /> hetU yathA~agnipavanau kurutaH sopadravAM ca pa~jcAnAm | <br /> <br /> tRuṣṇanAM pRuthagAkRutirasAdhyatA sAdhanaM coktam ||63||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Here is the recapitulatory verse-<br /> <br /> How the thermal factors and [[vata]] are the two causative factors for five kinds of ''trishna'', their separate characteristics, the incurable condition and the method of remedy have all been described.[63]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने तृष्णारोगचिकित्सितं नाम द्वाविंशोऽध्यायः ||२२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē trishnarōgacikitsitaṁnāma dvāviṁśō'dhyāyaḥ||22|| <br /> <br /> ityagniveshakRute tantre carakapratisaMskRute~aprApte dRuDhabalasampUrite cikitsāsthAne tRuṣṇarogacikitsitaM nAma dvAviMsho~adhyAyaH ||22||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus, in the section of therapeutics in the treatise complied by Agnivesha and revised by Charak, the twenty second chapter entitled [[Trishna Chikitsa]] not being available, annotated by Charak and redacted by Dridhabala, is completed.[22]<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *Morbid thirst is caused by severe vitiation of [[pitta]] and [[vata]] [[dosha]]. <br /> *Etiological factors for ''trishna'' are vitiated [[vata]] and [[pitta]] as both [[dosha]] have absorbent (''shoshaka'') property which damage the ''rasavaha'' and ''udakavaha srotas'' and manifest the symptom of constant craving for water.<br /> *Severely vitiated [[dosha]] vigorously dehydrate the fluid carrying ducts and channels situated at the base of the tongue, throat, palate and ''kloma'' leading to morbid thirst in a person.<br /> *Constant craving for water is the cardinal symptom of pathological thirst. <br /> *The morbid thirst is classified into [[vata]] dominant, [[pitta]] dominant, that due to vitiation of ''ama'', due to excess depletion of body elements and as a complication of other diseases. <br /> *Rain water is the best remedy to pacify thirst. The water, that has slight astringent taste, light to digest, cool properties, possess good smell and taste and is devoid of channel blocking quality, should be considered equal to rain water in effect though it may be terrestrial. Various recipes having same properties are used in management of thirst.<br /> *The management principle of ''trishna'' includes rehydration with pure rain water, medicated water, external application of medicinal pastes.<br /> *The temperature of water plays key role in the management of ''trishna''. Hot water, normal water and cold water shall be used after proper assessment of [[dosha]] dominant condition. <br /> *Nourishment of all body elements ([[dhatu]]) depends on ''ahara rasa''. ''Rasa'' is predominantly ''apya'' (dominated by water element) in nature. So, diminution of [[rasa dhatu]] ultimately leads to loss of water content in body and production of ''trishna''.<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> <br /> === Differentiation between ''trishna'' and ''pipasa'' ===<br /> <br /> ''Trishna'' and ''pipasa'' are two commonly used terms. ''Trishna'' is pathological thirst while ''pipasa'' is physiological. Physiological thirst is relieved after adequate water intake, whereas, pathological thirst is not relieved even after repeated water intake. Both of them are due to [[vata]] and [[pitta]] [[dosha]]. In ''pipasa'' they are in balanced state while in ''trishna'' they are vitiated. ''Trishna'' is manifestation of decrease in saumya [[dhatu]] (body elements composed of predominantly water) in body [[rasa dhatu]], [[rakta dhatu]], lasika, kleda, [[meda dhatu]], and urine. One common channel, ''udakavaha srotas'' regulates all the water content of the body. It is situated between palate, tongue and throat.<br /> <br /> ==== ''Udakavaha srotasa'' ====<br /> <br /> The root of transport channels of water are ''talu'' and ''kloma'' which have more than anatomical importance. They include the area of brain where thirst center is located and also throughout the body where the osmo-regulators are situated. They signal to higher integrative centers, where ultimately the conscious craving arises. As described in context of ''udara chikitsa, kloma'' should be understood as a physiological entity and may be compared with interstitial fluid which has definite role in pathogenesis of thirst as described in the chapter.<br /> <br /> === Fluid balance, normal quantity of water and other elements ===<br /> <br /> The regulation of the volume and composition of body fluids (''udaka''), their distribution throughout the body, and balancing the pH of body fluids is crucial to maintaining overall homeostasis and health. The water and dissolved solutes throughout the body constitute the body fluids. Regulatory mechanisms involving the kidneys and other organs normally maintain homeostasis of the body fluids. Malfunction in any or all of them may seriously endanger the functioning of organs throughout the body. <br /> <br /> Body fluids are present in two main “compartments”—inside cells and outside cells. About two-thirds of body fluid is intracellular fluid (ICF) or cytosol, the fluid within cells. The other third, called extracellular fluid (ECF) includes all other body fluids.<br /> <br /> About 80% of the ECF is interstitial fluid, which occupies the microscopic spaces between tissue cells, and 20% of the ECF is plasma, the liquid portion of the blood. Other extracellular fluids that are grouped with interstitial fluid include lymph in lymphatic vessels; cerebrospinal fluid in the nervous system; synovial fluid in joints; aqueous humor and vitreous body in the eyes; endolymph and perilymph in the ears; and pleural, pericardial, and peritoneal fluids between serous membranes. The body is in fluid balance when the required amounts of water and solutes are present and are correctly proportioned among the various compartments. Water is by far the largest single component of the body, making up 45–75% of total body mass, depending on age and gender.<br /> <br /> It may be noted that ''udaka'' has been mentioned to be present in quantity of ten ''anjali'' and this quantity is irrespective of ''rasa'' which is nine ''anjali'' in quantity and ''rakta'' is eight ''anjali'' in quantity. But this ''udaka'' acts as a replacement for [[rakta]] and [[rasa dhatu]] as and when necessary. ''Sweda, lasika, [[kapha]], etc. are also ''jaliya'' (watery) entity which are closely related with ''udaka''.<br /> <br /> === Mechanisms of fluid balance ===<br /> <br /> *Osmosis is the primary means of water movement between intracellular fluid and interstitial fluid, the concentration of solutes in these fluids determines the direction of water movement. Because most solutes in body fluids are electrolytes, inorganic compounds that dissociate into ions, fluid balance is closely related to electrolyte balance. Because intake of water and electrolytes rarely occurs in exactly the same proportions as their presence in body fluids, the ability of the kidneys to excrete excess water by producing dilute urine, or to excrete excess electrolytes by producing concentrated urine, is of utmost importance in the maintenance of homeostasis. ''Sama anayati iti samanam'' is the definition of samana [[vayu]]. ''Samana'' has a seat in ''sweda, [[dosha]] and ''ambhuvaha srotas''. As discussed above maintaining the pH (''sami karoti'') is brought about by specific ionic movement and this particular force is provided by samana [[vayu]]. It maintains the pH by maintaining a specific ratio of solutes and solvents and if this specific ratio is disturbed it leads to various diseases for e.g. a decrease in blood volume causes blood pressure to fall. This change stimulates the kidneys to release renin, which promotes the formation of angiotensin II. Increased nerve impulses from osmo-receptors in the hypothalamus, triggered by increased blood osmolarity, and increased angiotensin II in the blood both stimulate the thirst center in the hypothalamus. Other signals that stimulate thirst come from (1) neurons in the mouth that detect dryness due to a decreased flow of saliva and (2) baroreceptors that detect lowered blood pressure in the heart and blood vessels. As a result, the sensation of thirst increases, which usually leads to increased fluid intake (if fluids are available) and restoration of normal fluid volume. Overall, fluid gain balances fluid loss. Sometimes, however, the sensation of thirst does not occur quickly enough or access to fluids is restricted, and significant dehydration ensues. This happens most often in elderly people, in infants, and in those who are in a confused mental state. Even though the loss of water and solutes through sweating and exhalation increases during exercise, elimination of excess body water or solutes occurs mainly by control of their loss in urine.<br /> *The extent of urinary salt (NaCl) loss is the main factor that determines body fluid volume. The reason for this is that “water follows solutes” in osmosis, and the two main solutes in extracellular fluid (and in urine) are sodium ions (Na) and chloride ions (Cl). In a similar way, the main factor that determines body fluid osmolarity is the extent of urinary water loss. Because our daily diet contains a highly variable amount of NaCl, urinary excretion of Na and Cl must also vary to maintain homeostasis. Hormonal changes regulate the urinary loss of these ions, which in turn affects blood volume. The increased intake of NaCl produces an increase in plasma levels of Na and Cl (the major contributors to osmolarity of extracellular fluid). As a result, the osmolarity of interstitial fluid increases, which causes movement of water from intracellular fluid into interstitial fluid and then into plasma. Such water movement increases blood volume. <br /> *Water balance and electrolyte balance are closely linked. The body works to keep the total amount of water and the levels of electrolytes in the blood constant. For example, when the sodium level becomes too high, thirst develops, leading to an increased intake of fluids. In addition, vasopressin (also called antidiuretic hormone), a hormone secreted by the brain in response to dehydration, causes the kidneys to excrete less water. The combined effect is an increased amount of water in the blood. As a result, sodium is diluted and the balance of sodium and water is restored. When the sodium level becomes too low, the kidneys excrete more water, which decreases the amount of water in the blood, again restoring the balance. Water flows passively (by osmosis) from one area or compartment of the body to another. This passive flow allows the larger volumes of fluid in the cells and the area around the cells to act as reservoirs to protect the more critical but smaller volume of fluid in the blood vessels from dehydration.<br /> *Function of samana [[vayu]] needs to be understood. Sweda [[dosha]] ambuvaha srotas is the seat for ''samana vayu''. Maintaining the balance is the function of samana [[vayu]] and it is brought about by ''grahanati'' (to retain food until digested), ''pachati'' (to digest) , ''vivechayati'' (differentiating between waste and useful product) and ''munchati'' (to release waste to ''apana'') action. Samana [[vayu]] is vital for organisms to be able to maintain their fluid levels in very narrow ranges. One set of receptors responsible for thirst detects the concentration of interstitial fluid. The other set of receptors detects blood volume. Arterial baroreceptors sense a decreased arterial pressure, and signal to the central nervous system in the area postrema and nucleus tractus solitarii. Cardiopulmonary receptors sense a decreased blood volume, and signal to area postrema and nucleus tractus solitarii as well. This explains the function of ''srotas sthita maruta'' (vyana [[vayu]]) and [[manas]] due to its ''satva guna'' helps in getting knowledge about the surrounding.<br /> *Osmometric thirst occurs when the solute concentration of the interstitial fluid increases. This increase draws water out of the cells, and they shrink in volume. The solute concentration of the interstitial fluid increases by high intake of sodium in diet or by the drop in volume of extracellular fluids (such as blood plasma and cerebrospinal fluid) due to loss of water through perspiration, respiration, urination and defecation. The increase in interstitial fluid solute concentration causes water to migrate from the cells of the body, through their membranes, to the extracellular compartment, by osmosis, thus causing cellular dehydration.<br /> <br /> The above mechanisms are disturbed in ''trishna''.<br /> <br /> === Etiopathogenesis of ''trishna'' ===<br /> <br /> In morbid thirst, [[vata]] and [[pitta]] [[dosha]] are predominately involved. Etiological factors aggravate either [[vata]], [[pitta]] or both and manifest ''trishna''. Both [[dosha]] have absorbent (''soshaka'') property, [[vata]] [[dosha]] by its drying property and [[pitta]] by its heating property. Therefore excess exposure to various factors in diet and lifestyles leading to dryness and heat inside the body are considered as causative factors for ''trishna''. Some of the commonly observed factors are enlisted below: <br /> *'''Dietary causes''': Regular use of alkaline &amp; sour substances, use of excessive salt, pungent, salty, dry and dehydrated food, extreme starvation, alcoholism<br /> *'''Lifestyle causes''': Excess exercise [Cha.Sa. [[Sutra Sthana]] 7/33], excess distress, excessive exposure to sunlight, fatigue.<br /> *'''Psychological causes''': Fear, grief, anger<br /> *'''Iatrogenic causes''': Excessive use of purification procedures, improper ''snehapana'' (administration of therapeutic medicated ghee or similar unctuous substance) [Cha. Sa.[[Sutra Sthana]] 13/71]<br /> *Due to chronic diseases leading to emaciation and excessive loss of basic body forming elements <br /> *Associated symptom of diseases like ''shotha'' [Cha. Sa. [[Sutra Sthana]] 18/18], [[pitta]] dominant ''gulma'' [Cha.Sa. [[Chikitsa Sthana]] 5/36], ''vrana'' [Cha. Sa. [[Chikitsa Sthana]] 25/30], ''udavarta'' [Cha.Sa. [[Chikitsa Sthana]] 26/9], ''prameha'' [Cha.Sa. [[Nidana Sthana]] 4/48], ''kushtha'' [Cha. Sa.[[Nidana Sthana]] 5/11], ''antarvega jwara'' [Cha.Sa.[[Chikitsa Sthana]] 3/39], ''bahirvegi jwara'' [Cha. Sa. [[Chikitsa Sthana]] 3/41],[[rakta dhatu]]gata jwara[Cha. Sa. [[Chikitsa Sthana]] 3/77] , [[vata]] [[pitta]] jwara[ Cha.Sa.[[Chikitsa Sthana]] 3/85], ''shleshma-paittika jwara'' [Cha.Sa. [[Chikitsa Sthana]] 3/88], [[pitta]] kapholvana hina [[vata]] sannipata jwara''[Cha.Sa.[[Chikitsa Sthana]] 3/93] , ''vatolvana [[kapha]] [[pitta]] hina sannipata jwara'' [Cha.Sa.[[Chikitsa Sthana]] 3/94], ''pittolvana madhya [[kapha]] hina [[vata]] jwara'' [Cha.Sa. [[Chikitsa Sthana]] 3/98], ''sama sannipata jwara''[Cha.Sa.[[Chikitsa Sthana]] 3/102], ''pittolvana [[vata]] madhya [[kapha]] hina jwara''[Cha.Sa. [[Chikitsa Sthana]] 3/106], ''pachyamana jwara'' [Cha.Sa.[[Chikitsa Sthana]] 3/136], ''romantika'' [Cha.Sa.[[Chikitsa Sthana]] 12/92], ''pittodara'' [Cha.Sa.[[Chikitsa Sthana]] 13/28], ''badhagudodara'' [Cha.Sa.[[Chikitsa Sthana]] 13/41],''chhidrodara'' [Cha. Sa. [[Chikitsa Sthana]] 13/44], ''sahaja arsha''[Cha. Sa. [[Chikitsa Sthana]] 14/8 ], ''paittika ajirna'' [Cha. Sa.[[Chikitsa Sthana]] 15/46], ''grahani'' [Cha. Sa. [[Chikitsa Sthana]] 15/53] ,[[vata]]ja grahani [Cha.Sa.[[Chikitsa Sthana]] 15/61],''paittika pandu'' [Cha. Sa. [[Chikitsa Sthana ]] 16 /20], ''halimaka'' [Cha.Sa. [[Chikitsa Sthana]] 16/133],''vyapeta hikka'' [Cha.Sa. [[Chikitsa Sthana]] 17/32], ''paittika kasa'' [Cha.Sa.[[Chikitsa Sthana]] 18/15], ''kshataja kasa'' [Cha.Sa.[[Chikitsa Sthana]] 18/23], ''paittika atisara'' [Cha. Sa.[[Chikitsa Sthana]] 19/6],''raktatisara'' [Cha.Sa. [[Chikitsa Sthana]] 19/70], ''sannitpatika chhardi'' [Cha. Sa. [[Chikitsa Sthana]] 20/15], ''abhyantara visarpa'' [Cha. Sa. [[Chikitsa Sthana]] 21/16], ''paittika visarpa'' [Cha.Sa. [[Chikitsa Sthana]] 21/32],''vata-paittika visarpa'' [Cha.Sa.[[Chikitsa Sthana]] 21/36],''paittika madatyaya'' [Cha.Sa.[[Chikitsa Sthana]] 24/94], ''madatyaya'' general symptom [Cha.Sa.[[Chikitsa Sthana]] 24/101], ''tikshna madatyaya'' [Cha.Sa.[[Chikitsa Sthana]] 24/113],''vikshaya'' [Cha.Sa. [[Chikitsa Sthana]] 24/ 102],''paittika vrana'' [Cha.Sa.[[Chikitsa Sthana]] 25/13], ''paittika mukharoga'' [Cha.Sa.[[Chikitsa Sthana]] 26/120],''pittavrita vayu'' [Cha.Sa.[[Chikitsa Sthana]] 28 /61], ''paittika vatarakta'' [Cha.Sa. [[Chikitsa Sthana]] 29/ 28], ''dhvaja bhanga'' [Cha. Sa.[[Chikitsa Sthana]] 30/171], ''paittika shiroroga'' [Cha.Sa.[[Sutra Sthana]] 17/23], ''paittika hridroga'' [Cha.Sa.[[Sutra Sthana]] 17 /33], [[vata]]-[[kapha]] kshaya [[pitta]] vriddhi[Cha.Sa.[[Sutra Sthana]] 17 /60], ''alaji'' [Cha.Sa.[[Sutra Sthana]].17/88],[[vata]]-[[pitta]]janya vidradhi [Cha.Sa.[[Sutra Sthana]] 17/ 96], [[pitta]] nanatmaja vikara'' [Cha.Sa.[[Sutra Sthana]] 20 /14 ], ''ambuvaha sroto dushti'' [Cha.Sa.[[ Vimana Sthana]] 5 /11],''paittika jwara'' [Cha.Sa. [[Nidana Sthana]] 1/24]. <br /> *Complication (''upasarga'') of diseases like ''jwara, meha, kshaya, shosha, shwasa'' [Cha.Sa. [[Chikitsa Sthana]] 22/17]<br /> <br /> === General pathogenesis ===<br /> <br /> Due to above mentioned factors, [[vata]] and [[pitta]] [[dosha]] are vitiated and further affect channels carrying fluids like ''rasavaha'' and ''udakavaha srotasa''.<br /> <br /> === Etio-pathological factors in thirst ===<br /> <br /> Acute fall in blood pressure and/or blood volume will also stimulate thirst. 15% or more reduction in circulating blood volume is required for this effect. However, the effects are short-lived and the effect of osmolality changes on thirst is more significant. <br /> <br /> Thus classification may be done as follows:<br /> ==== A. Causes of excessive thirst without excessive urination ====<br /> ==== 1. Dehydration due to: ====<br /> *Excessive sweating (diaphoresis)<br /> *Diarrhea<br /> *Large loose stools after eating foods high in fiber<br /> *Hyperventilation due to anxiousness, certain diseases, such as pneumonia, or at high altitudes.<br /> <br /> ==== 2. Other causes of dry mouth ====<br /> <br /> '''Acute (sudden) causes of dry mouth''':<br /> *Eating dry or spicy or salty foods<br /> *Breathing dry air, breathing through the mouth, snoring, smoking, chewing tobacco<br /> *Anxiety, depression, stress <br /> *Hangover<br /> *Disorder of salivary glands (mumps, side effect of irradiation) <br /> *Stroke <br /> *Shock (hypovolemic, septic, anaphylactic)<br /> <br /> '''Chronic causes of dry mouth (xerostomia)''':<br /> *Anemia<br /> *Hypertension<br /> *Oral thrush caused by fungal [candida] infection<br /> *Disorders of salivary glands (sialadenitis, stones)<br /> *Autoimmune diseases: Sjögren’s syndrome, systemic lupus erythematosus (SLE), systemic sclerosis, sarcoidosis (neurosarcoidosis), rheumatoid arthritis <br /> *Parkinson’s disease<br /> *HIV/AIDS<br /> *Alzheimer’s disease<br /> *Mouth or throat cancer<br /> *Cystic fibrosis<br /> <br /> '''Dry mouth as a side effect of medications or supplements''':<br /> *Anti-acne drugs: tretinoin <br /> *Anticholinergics (spasmolytics): atropine <br /> *Antidepressants: fluoxetine <br /> *Antidiarrheals: bismuth subsalicylate, loperamide<br /> *Antiemetics (drugs to treat nausea/vomiting): chlorpromazine, metoclopramide, ondansetron, promethazine, scopolamine <br /> *Antihistamines <br /> *Antiepileptics: valproate, topiramate<br /> *Antiparkinsonians <br /> *Antipsoriatics: acitretin<br /> *Antipsychotics: modafinil, phenothiazines, risperidone, indapamide<br /> *Antivirals: ritonavir, indinavir; antiretrovirals (to treat AIDS) <br /> *Aspirin overdose <br /> *Beta-blockers (for heart disease, hypertension): atenolol, propranolol<br /> *Bronchodilators (to treat asthma): theophylline, salbutamol <br /> *Chemotherapeutics: bortezomib, cisplatin <br /> *Muscle relaxants <br /> *Nasal decongestants (sprays)<br /> *Non-steroidal anti-inflammatory drugs (NSAIDs): aspirin, diclofenac, ibuprofen, naproxen<br /> *Opiates: morphine <br /> *Sedatives (sleeping pills: diazepam)<br /> *Steroids <br /> *Stimulants: armodafinil <br /> <br /> '''Illegal Drugs''':<br /> *Marijuana (cannabis) <br /> *Ecstasy (MDMA) <br /> *Cocaine <br /> *Heroin <br /> *Amphetamine<br /> <br /> ==== B. Causes of excessive thirst with excessive urination ====<br /> <br /> ==== Psychogenic Polydipsia ====<br /> <br /> In most cases of polydipsia, people drink water to replace water they have lost due to excessive urination caused by certain organic disorders. Individuals with primary or psychogenic polydipsia (often associated with schizophrenia) have no organic disorder, but they believe or feel they should drink a lot of fluid. This can lead to water intoxication (hyponatremia), which can be life threatening.<br /> <br /> ==== Brain Disorders Resulting in Central Diabetes Insipidus ====<br /> <br /> *Head injury, tumor, stroke <br /> <br /> ==== Impaired Kidney Function Resulting in Nephrogenic Diabetes Insipidus ====<br /> <br /> *Salt-wasting nephropathy (in a polycystic kidney disease) , post-obstructive diuresis (after resolution of urinary tract blockage), medullary kidney cystic disease, proximal renal tubular acidosis<br /> <br /> ==== Heart Disorders ====<br /> *Supraventricular tachycardia (a type of heart arrhythmia), postural hypotension, systemic capillary leak syndrome<br /> <br /> ==== Hormonal Disorders ====<br /> *Gestational diabetes insipidus; in the 3rd trimester of pregnancy<br /> *Adrenal hyperactivity<br /> *Epinephrine (adrenaline)-secreting tumor (pheochromocytoma) in the adrenal medulla <br /> *Pituitary disorders: <br /> **Cushing’s syndrome <br /> **Sheehan’s syndrome (pituitary infarct)<br /> **Hyperthyroidism, especially acute severe thyrotoxicosis (thyroid storm) (hyperglycemia, excessive sweating and diarrhea lead to polydipsia)<br /> **Hyperparathyroidism <br /> <br /> ==== Metabolic Disorders ====<br /> *Hypokalemia <br /> *Hypercalcemia<br /> *Hypernatremia<br /> <br /> ==== Genetic and Congenital Disorders ====<br /> *Aceruloplasminemia<br /> *Alsing syndrome<br /> *Bartter’s syndrome <br /> *Boichis syndrome <br /> *Cystinosis <br /> *DEND syndrome <br /> *EAST syndrome <br /> *Fanconi syndrome<br /> *Froelich’s syndrome<br /> *Gitelman syndrome <br /> *Liddle’s syndrome <br /> *Nephronophthisis <br /> *Schroeder syndrome<br /> *Sickle cell anemia <br /> *Wolfram (DIDMOAD) syndrome<br /> *Apparent Mineralocorticoid Excess Syndrome<br /> <br /> ==== Other Disorders ====<br /> *Adiposogenital dystrophy <br /> *Langerhans cell histiocytosis<br /> *Omega-3 FFA deficiency syndrome<br /> *Sarcoidosis (neurosarcoidosis) <br /> *Tumors/cancers: <br /> **Adrenal adenoma <br /> **Ganglioblastoma <br /> **Glucagonoma — glucagon secreting tumor (gluconeogenesis &gt; hyperglycemia &gt; polydipsia) <br /> **Multiple myeloma <br /> **Pheochromocytoma<br /> <br /> ==== Drugs ====<br /> *Amphotericin B <br /> *Antiobesity drugs: lorcaserin, orlistat, phentermine, sibutramine<br /> *Caffeine intoxication (excessive coffee or tea drinking) <br /> *Demeclocycline <br /> *Diuretics<br /> *Lithium <br /> *Vitamin D overdose (hypervitaminosis D)<br /> <br /> ==== Poisons ====<br /> *Acid ingestion <br /> *Amanita muscaria (fly agaric) and other toxic mushrooms <br /> *Arsine gas <br /> *Belladonna-like plant<br /> *Bloodroot <br /> *Death camas <br /> *Horse nettle intake<br /> *Jimsonweed/Jamestown weed ingestion<br /> *Meadow Saffron plant<br /> *Mercury poisoning in children (acrodynia, pink disease)<br /> *Yellow jessamine (jasmine poisoning) <br /> *Snake bites <br /> <br /> ==== Table 1: Condition with morbid thirst and diagnostic tests ====<br /> <br /> {|class=&quot;wikitable&quot;<br /> |-<br /> !scope = &quot;col&quot;| CONDITION<br /> !scope = &quot;col&quot;| SYMPTOMS AND SIGNS (besides excessive urination and thirst)<br /> !scope = &quot;col&quot;| LAB TESTS<br /> |-<br /> !scope = &quot;row&quot;| Dehydration<br /> |Sudden weight loss, dark urine (decreased, not increased urination)<br /> |Decreased 24-hour urine; in mild and moderate dehydration: normal blood sodium; in severe dehydration: increased blood sodium<br /> |-<br /> !scope = &quot;row&quot;| Heat exhaustion or heat stroke<br /> |Exhaustion, cool, clammy skin, increased body temperature (in heat stroke: warm skin, body T &gt; 105.8 °F or 41 °C)<br /> |Decreased 24-hour urine<br /> |-<br /> !scope = &quot;row&quot;| Diabetes mellitus<br /> |Hunger or poor appetite, weight loss, extreme fatigue, blurred vision, jock itch, diabetes in family<br /> |Increased glucose levels in the blood and urine<br /> |-<br /> !scope = &quot;row&quot;| Diabetes insipidus (central and nephrogenic)<br /> |History of brain trauma, surgery or tumor, or a kidney disease<br /> |Decreased urine specific gravity and osmolality, increased blood sodium<br /> |-<br /> !scope = &quot;row&quot;| Diuretics<br /> |Dry mouth<br /> |Decreased urine specific gravity<br /> |-<br /> !scope = &quot;row&quot;| Psychogenic polydipsia<br /> |Usually in individuals with schizophrenia treated with antipsychotics<br /> |Increased 24-hour urine, decreased urine specific gravity and osmolality, sometimes: decreased blood sodium<br /> |-<br /> !scope = &quot;row&quot;| Adrenal hyperactivity (hyperaldosteronism)<br /> |Increased blood pressure<br /> |Decreased blood potassium, increased urine potassium, increased blood aldosterone after sodium challenge<br /> |-<br /> !scope = &quot;row&quot;| Anorexia nervosa<br /> |Severely decreased body weight<br /> |Mineral and vitamin deficiencies (hypokalemia, low iron, etc.)<br /> |-<br /> !scope = &quot;row&quot;| Postural (orthostatic) hypotension <br /> |Dizziness after raising up, Drop of blood pressure &gt; 30 mm Hg upon standing<br /> |Nothing typical<br /> |-<br /> !scope = &quot;row&quot;| Hypertension<br /> |Increased blood pressure<br /> |Possible increase of blood aldosterone, renin<br /> |-<br /> !scope = &quot;row&quot;| Anemia<br /> |Paleness, fatigue, hyperventilation<br /> |Decreased RBC or abnormal erythrocytes<br /> |-<br /> !scope = &quot;row&quot;| Congestive heart failure <br /> |Chest pain, swollen legs<br /> |ECG abnormalities<br /> |-<br /> !scope = &quot;row&quot;| Liver cirrhosis <br /> |History of alcoholism, poor appetite, loss of weight, spider nevuses<br /> |Decreased serum proteins (albumin), increased liver enzymes and bilirubin<br /> |-<br /> !scope = &quot;row&quot;| Chronic dry mouth (xerostomia) in Sjögren’s syndrome and SLE<br /> |Rash, joint pain<br /> |Specific antibodies in the blood<br /> |-<br /> !scope = &quot;row&quot;| Shock (hypovolemic, septic, anaphylactic)<br /> |Cool, clammy skin, increased heart rate; in late shock: lethargy, low blood pressure<br /> |Septic shock: increased or decreased white blood cells (WBC), increased blood glucose<br /> |-<br /> !scope = &quot;row&quot;| Ecstasy (MDMA), cocaine, marijuana <br /> |Euphoria<br /> |Positive urine drug test<br /> |-<br /> !scope = &quot;row&quot;| Opiates (morphine, heroin)<br /> |Sleepiness<br /> |Positive urine drug test<br /> |}<br /> <br /> === Laboratory Tests ===<br /> ==== Blood Tests ====<br /> ==== Glucose Elevated ====<br /> <br /> *Diabetes mellitus<br /> *Cushing’s syndrome<br /> *Early phase of hypovolemic shock (bleeding)<br /> *Pheochromocytoma <br /> <br /> ==== Sodium ====<br /> <br /> *Normal levels (135-145 meq/L):<br /> **In most cases of dehydration (diarrhea, vomiting, excessive sweating)<br /> **Within 8 hours of onset of acute bleeding<br /> *Hyponatremia (&lt;135 meq/L): <br /> **&gt;8 hours after onset of bleeding, when interstitial fluid moves into the intravascular space<br /> **Sometimes after repeated vomiting or severe diarrhea<br /> **Water intoxication<br /> **Diabetic ketoacidosis (usually) <br /> **Cerebral salt wasting (head injury, tumor) <br /> **Hypernatremia (&gt;145 meq/L) <br /> **Dehydration (sometimes) <br /> **Diabetes insipidus <br /> <br /> ==== Potassium ==== <br /> *Hypokalemia: <br /> **Hyperaldosteronism<br /> **Anorexia nervosa<br /> **Hyperthyroidism<br /> *Hyperkalemia: <br /> **Diabetic ketoacidosis (usually) <br /> <br /> ==== Calcium ====<br /> *Hypercalcemia: <br /> **Hyperparathyroidism<br /> **Hypervitaminosis D <br /> *Hypocalcemia: <br /> **Diabetic ketoacidosis (usually) <br /> <br /> ==== CBC ====<br /> *White blood cells increased or decreased in sepsis<br /> <br /> ==== Hematocrit (HCT) ====<br /> *Decreased in water intoxication<br /> <br /> ==== Blood Urea Nitrogen (BUN) ====<br /> *Increased in kidney failure<br /> *Decreased in water intoxication<br /> <br /> ==== pH ====<br /> *&lt;7.3 (diabetic ketoacidosis) <br /> <br /> ==== Proteins ====<br /> *Hypoalbuminemia in liver cirrhosis, nephrotic syndrome, severe malnutrition<br /> <br /> ==== Hormone levels ====<br /> *ADH <br /> *Decreased in central diabetes insipidus<br /> *Increased in nephrogenic diabetes insipidus <br /> *ACTH may be increased in pituitary adenoma or adrenal hyperplasia<br /> *Cortisol may be increased in adrenal adenoma<br /> *Aldosterone may be increased in adrenal adenoma or primary hyperaldosteronism<br /> <br /> ==== Urine Tests ====<br /> *Osmolality <br /> *&lt;200 mOsm/kg in psychogenic polydipsia, diabetes insipidus <br /> *Specific gravity <br /> *&lt;1.005 in diabetes insipidus<br /> *Glucose <br /> *Untreated diabetes mellitus 1 or 2 <br /> *Pheochromocytoma; rare <br /> *Proteins <br /> *In nephrotic syndrome<br /> *Sodium &gt;20 meq/L: cerebral salt wasting<br /> <br /> ==== Principles of management ====<br /> <br /> The treatment modalities intended to pacify [[vata]] and [[pitta]] [[dosha]] are applied for management of ''trishna''. Specifically rain water, water processed with drugs having ''manda'' (mild) and ''sheeta'' (cool) properties, various medicated ghee mentioned in the text are used to manage ''trishna''.<br /> <br /> ==== Various preparations used in management ====<br /> ==== Food and beverages ====<br /> *''Trina panchamula'' medicated water<br /> ''Trina Panchamula'' contains five drugs namely ''kusha, kasha, nala, darbha'' and ''kandekshu''. It pacifies [[pitta]] and it is indicated in ''trishna''&lt;ref&gt; Sushruta. Sutra Sthana, Cha.38 Dravyasangrahaneeya Adhyaya verse 77. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.&lt;/ref&gt;. In ''Bhaisajya Ratnavali, Shara'' is given in place of ''Nala''. (''Bhaisajya Ratnavali, Mutrakricharogadhikar'' 10)<br /> <br /> ''Kusha – Desmostachya bipinnata''<br /> <br /> ''Kasha – Saccharum spontaneum''<br /> <br /> ''Shara – Saccharum munja''<br /> <br /> ''Darbha'' –Imperata cylindrical<br /> <br /> ''Ikshu'' – Sugarcane – Saccharum officinarum<br /> <br /> The above drugs should be taken along with water in ratio of 1:64 and then it should be reduced to half by boiling and later on filtered and used after cooling similar to Shadangapaniya vidhi as explained in [[Jwara Chikitsa]].<br /> *''Laja sattu'': ''Laja sattu'' is a thin gruel prepared from ''laja'' (parched rice) or roasted rice. It should be prepared with rain water and should be given to patient after mixing honey and sugar to it [Cha. Sa. [[Sutra Sthana]] 27/256].<br /> *''Yava'' medicated gruel: ''Yava'' (barley) is used in ''yava vatya'' (a gruel prepared out of one part of coarse powder of roasted ''yava'' (barley) and 14 parts of water).<br /> *''Peya'' is thin gruel of rice along with its solid portion (''sikta''). To prepare ''peya'', 14 parts of water and one part of broken rice are taken and boiled well till all the rice particles become soft. ''Peya'' prepared with ''shali'' and ''koradusha'' (type of cereal) pacifies thirst.<br /> *Food boiled with milk and ''mamsa rasa'' mixed with honey and ''sita'' (kind of sugar) should be given. ''Sita'' pacifies [[vata]] and [[pitta]] [[dosha]] so it is useful in patient of thirst &lt;ref&gt;Bhavamishra. Bhavaprakasha -Volume II. Chapter 23, Verse 31, Translated from Sanskrit by K.R. Srikantha Murthy. Reprint ed. Varanasi: Krishnadas academy;2004.pp.-&lt;/ref&gt;.<br /> *''Trina panchamula, munjataka, priyala'' drugs should be mixed with ''mamsa rasa'' or ''kshira paka'' prepared from these should be given after mixing honey and sugar to it. All above drugs pacify [[pitta]] hence quench the thirst.<br /> <br /> ==== External applications ====<br /> <br /> External application of ''shatadhauta ghrita'' is [[pitta]] shamaka so it should be used. ''Yusha'' is a soup prepared from pulses. Drugs which are ''madhura, tikta, sheeta'' and having ''jeevaniya'' properties, pacify [[pitta]]. They should be given to the patient for drinking as well as for external application.<br /> <br /> ==== Medicated ghee ====<br /> <br /> ''Ghrita'' processed with drugs of ''madhuradi gana'' mentioned in [[Vimana Sthana]] 8th chapter should be used for drinking, massage and sprinkling purpose. ''Ghrita'' is best for pacifying [[pitta]] and [[vata]].[Cha.Sa. [[Sutra Sthana]] 25/40] When processed with ''madhura gana'' drugs its property increases as it is ''yogavahi'' in nature (the one that accelerates the properties of others).<br /> <br /> ==== Nasal administration ====<br /> <br /> Various milk or juice of sugarcane when administered through nasal route decreases thirst. [Cha.Sa.[[ Sutra Sthana ]] 27/224]<br /> Following table enlists various diet recipes and medicinal formulations used in the management of ''trishna'' referred at various places.<br /> <br /> ==== Table 2: Diet and formulations for management of ''trishna'' ====<br /> <br /> {| class = &quot;wikitable&quot;<br /> |-<br /> !scope = &quot;col&quot;| Name of Formulations<br /> !scope = &quot;col&quot;| References<br /> |-<br /> | ''Peya''<br /> | [Cha. Sa. [[Chikitsa Sthana]] 3/187]<br /> |-<br /> | General property of milk pacifying ''trishna''<br /> | [Cha. Sa. [[Sutra Sthana]] 1/109]<br /> |-<br /> | Use of ''panchatikta kwatha''<br /> | [Cha. Sa. [[Chikitsa Sthana]] 3/200 ]<br /> |-<br /> | Use of ''Vidarigandhadi, Bilva, Utpala'' etc.<br /> | [Cha. Sa. [[Chikitsa Sthana]] 4/51]<br /> |-<br /> | ''Rohityada Ghrita''<br /> | [Cha. Sa. [[Chikitsa Sthana]] 5/117]<br /> |-<br /> | ''Duralabhadya Ghrita''<br /> | [Cha. Sa. [[Chikitsa Sthana]] 8/110]<br /> |-<br /> | ''Eladi Gutika''<br /> | [Cha. Sa. [[Chikitsa Sthana]] 11/23 ]<br /> |-<br /> | ''Amritaprasha Ghrita''<br /> | [Cha.Sa. [[Chikitsa Sthana]] 11 /43]<br /> |-<br /> | ''Tritiya Sarpi Guda''<br /> | [Cha. Sa. [[Chikitsa Sthana]] 11/65 ]<br /> |-<br /> | ''Patolamuladi Kwatha''<br /> | [Cha. Sa. [[Chikitsa Sthana]] 12/54]<br /> |-<br /> | ''Water Siddha'' with ''Trina panchamula Kwatha''<br /> | [Cha. Sa. [[Chikitsa Sthana]] 18/141]<br /> |-<br /> | ''Chandana'',sugar, honey with ''Tandulodaka''<br /> | [Cha. Sa. [[Chikitsa Sthana]] 19/86]<br /> |-<br /> | Use of ''Gairika, Sugandhabala'' with ''Tandulodaka''<br /> | [Cha. Sa. [[Chikitsa Sthana]] 20/32]<br /> |-<br /> | ''Drakshadi sita Kwatha/ Prapoundarika Kwatha''<br /> | [Cha. Sa. [[Chikitsa Sthana]] 21/58 ]<br /> |-<br /> |''Water processed with ''Parushaka'' and ''Pilu; Chatuparni; Musta, Dadima, Laja''<br /> | [Cha. Sa. [[Chikitsa Sthana]] 24/149] <br /> |-<br /> |Cold water<br /> |[Cha. Sa. [[Chikitsa Sthana]] 24/163]<br /> |-<br /> |''Madhura rasa''<br /> |[Cha. Sa. [[Chikitsa Sthana]] 26/43]<br /> |-<br /> |''Tikta rasa''<br /> |[Cha. Sa. [[Chikitsa Sthana]] 26/43 ]<br /> |-<br /> |''Rakta Shali''<br /> |[Cha. Sa. [[Chikitsa Sthana]] 27/11]<br /> |-<br /> |''Ervaruka''<br /> |[Cha. Sa. [[Chikitsa Sthana]] 27/111]<br /> |-<br /> |''Mridvika''<br /> |[Cha. Sa. [[Chikitsa Sthana]] 27/125 ]<br /> |-<br /> |''Sarkara''<br /> |[Cha. Sa. [[Chikitsa Sthana]] 27/242 ]<br /> |-<br /> |''Laja peya''<br /> |[Cha. Sa. [[Chikitsa Sthana]] 27/250 ]<br /> |-<br /> |''Saktu''<br /> |[Cha. Sa. [[Chikitsa Sthana]] 27/264 ]<br /> |}<br /> <br /> *''Gandusha'':<br /> ''Gandusha'' (filling the mouth to its full capacity with liquid without allowing its movement in oral cavity) with various sweet and sour drugs is useful in thirst. ''Madhura rasa'' pacify ''pitta'' whereas ''amla rasa'' is cold on external application and increases salivation so both have soothing effect in dry mouth.&lt;ref&gt;Sushruta. Sutra Sthana, Cha.42 Rasavishesha Vijnaniya Adhyaya verse 10. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.&lt;/ref&gt; Use of ''amla'' drugs in the form of external application has also been advocated as they have cooling effect on touch. Thinking about cold things and environment is a part of psychotherapy which helps patient to combat desire of water.<br /> <br /> ==== Management of [[vata]] dominant ''trishna'' ====<br /> All dietary formulations and drugs used in [[vata]]ja trishna must have property to pacify [[vata]]. Milk and ''ghrita'' mentioned in ''kshayaja kasa'' (like ''dwipanchamuladi ghrita, guduchyadi ghrita, kasmardadi ghrita'' etc.) pacify [[vata]] [[dosha]] effectively and thus these preparations can also be used in [[vata]]ja trishna.<br /> <br /> ==== Management of [[pitta]] dominant ''trishna'' ====<br /> <br /> Various [[pitta]] pacifying drugs mixed with water are mentioned in treatment of [[pitta]]ja trishna''. These drugs pacify [[pitta]] as well as they are useful in maintaining water homeostasis.<br /> <br /> Water obtained after quenching of baked earth is said to be best for pacifying excessive thirst in ''agrya prakarana''. This simple method can be clinically evaluated in patients of morbid thirst. [Cha. Sa. [[Sutra Sthana]] 25/40].<br /> <br /> ==== Management of ''amaja trishna'' ====<br /> <br /> To treat ''amaja trishna'', it is necessary that first ''ama'' is removed. For ''ama pachana'' drugs which increase [[agni]] can be used as well. Treatment of [[kapha]]ja chhardi can be followed as [[kapha]] nasaka'' treatment helps to remove ''ama''. If symptoms pertaining to ''ama'' are seen than ''ama'' should be removed by inducing emesis and warm water should be used to increase [[agni]] to remove ''ama''. As discussed earlier ''kshaya'' refers to emaciation of tissues. So, treatment which helps in revitalizing the tissue can be used as mentioned in ''kshatakshina, shosha'' can also be used.<br /> <br /> ==== Management of ''trishna'' due to ''madatyaya'' ====<br /> <br /> Use of alcohol for treating thirst induced due to alcohol is example of ''Hetu Vipritarthakari'' (treatment with a substance similar to the cause).<br /> <br /> ==== Effect of cold water and hot water on body fluid balance ====<br /> <br /> In conditions of dehydration and where [[pitta]] is dominant (''Dhaha, bhrama, madatyaya'' etc) cold water should be given as it restores water content in body as well as pacify [[pitta]] by its sheeta [[guna]]. After boiling, water becomes free from various micro-organisms. Boiled water should be used in ''sannipatika'' diseases after cooling, such diseases are difficult to treat. In a study it was found that temperature range from 55 to 65 degree C is critical for effective elimination of enteric/pathogenic bacterial components.&lt;ref&gt; Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., editors. Harrison’s principles of internal medicine, Chapter 11. Palliative and End-of-Life Care,16th ed. New York: McGraw Hill; 2005&lt;/ref&gt; As all three [[dosha]] are involved we can’t use hot or cold water as they will aggravate at least one of the [[dosha]] (hot will increase [[pitta]], cold water will increase [[vata]]/[[kapha]]) so normal water should be used.<br /> <br /> In conditions with [[vata]]/[[kapha]]/[[vata]]-[[kapha]] dominance like ''hikka-shwasa'' ([[kapha]] [[vata]] tamako''), fever of recent origin (''nutana jwara'' in ''samavastha'') etc. Warm water should be given. After ''ghrita'' consumption, warm water should be used as it increases absorption of ''ghrita''. Warm water increases [[agni]] in ''nutan jwara''.[ Cha. Sa. [[Chikitsa Sthana]] 3/144], [ Cha. Sa. [[Vimana Sthana]] 3/40]<br /> <br /> In a study it was concluded that drinking hot fluids transiently increases nasal mucus velocity and so hot liquid is superior to cold liquids in the management of fluids in upper respiratory tract infections.&lt;ref&gt;Saketkhoo K, Januszkiewicz A, Sackner MA., Effects of drinking hot water, cold water, and chicken soup on nasal mucus velocity and nasal airflow resistance, Chest. 1978 Oct;74 (4):408-10.&lt;/ref&gt;<br /> <br /> Water is major constituent and is needed for normal physiological process of the body. Any disturbance in its homeostasis will lead to production of many diseases. Some diseases occur due to water deficit whereas in many diseases water retention in the body is their main cause. According to Ayurvedic principles in such conditions water use should be minimal. Due to same reason it is contraindicated in ''udara''. In ''jalodara'' (ascites) excessive intake of water is one of the causes.[ Cha. Sa. [[Chikitsa Sthana]] 13/45]<br /> <br /> In ''pandu'' there is presence of hemodilution and edema so water intake should be restricted to minimal. In ''gulma, mandagni'' is main causative factor. [Cha. Sa.[[Chikitsa Sthana]] 5/112]<br /> <br /> Excessive intake of water causes ''mandagni'' and if, water is taken in ''mandagni'' stage excessively, strength of [[agni]] decreases further &lt;ref&gt;Madhavakara. Madhava Nidanam (Roga vinischaya) Chap 6 Verse 7. Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--&lt;/ref&gt;. So, water is contraindicated in ''mandagni'' stage. If needed, water can be given in less quantity.<br /> Nowadays we are using bottled water frequently. So, it is necessary that we analyze properties of bottled water also. Studies have shown that chemicals called phthalates, which are known to disrupt testosterone and other hormones, can leach into bottled water over time. One study found that water that had been stored for 10 weeks in plastic and in glass bottles contained phthalates, suggesting that the chemicals could be coming from the plastic cap or liner.&lt;ref&gt;Available from: http://www.nrdc.org/about &lt;/ref&gt; The bacterial count in bottled water increased dramatically, from less than 1 colony per milliliter (col/mL) to 38,000 col/mL over 48 hours of storage at 37 degrees C. Bacterial growth was markedly reduced at cold temperatures (refrigeration) compared with room temperature, with 50% fewer bacterial colonies in 24 hours and 84% fewer colonies in 48 hours. Interestingly, tap water resulted in only minimal growth, especially at cold temperatures (&lt; 100 col/mL at 48 hours). These findings may be useful to increase public awareness and development of guidelines on storage temperature and expiration time for bottled water once it is opened and used.&lt;ref&gt;Raj SD., Bottled water: how safe is it? Water Environ Res. 2005 Nov-Dec;77(7):3013-8.&lt;/ref&gt; In a study it was suggested that various types of unfinished beverages have microorganism growth and can include food borne pathogens and bacterial toxins.&lt;ref&gt;Watanabe M, Ohnishi T, Araki E, Kanda T, Tomita A, Ozawa K, Goto K, Sugiyama K, Konuma H, Hara-Kudo Y., Characteristics of bacterial and fungal growth in plastic bottled beverages under a consuming condition model, J Environ Sci Health A Tox Hazard Subst Environ Eng. 2014;49(7):819-26.&lt;/ref&gt; This suggests that proper and judicious use of water should be done in healthy as well as diseases condition.<br /> &lt;/div&gt;<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References ==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Visarpa_Chikitsa&diff=45390 2025-11-18T04:32:24Z

<p>Agnivesha: /* Introduction */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Visarpa Chikitsa<br /> |titlemode=append<br /> |keywords=Visarpa, Parisarpa, Erysepalas, Gangrene, Septicaemia, Sepsis, Fulminant spreading skin infections,Ayurveda, Indian system of medicine, charak samhita. <br /> |description=Chikitsa Sthana Chapter 21. Management of Visarpa (acute spreading erysepalas)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 21. Management of Visarpa (acute spreading erysepalas)&lt;/big&gt;'''<br /> {{Infobox<br /> |title = Visarpa Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 21<br /> |label2 = Preceding Chapter<br /> |data2 = [[Chhardi Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Trishna Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Kendre M.<br /> |label7 = Reviewer <br /> |data7 = Ojha S.N.<br /> |label8 = Editors <br /> |data8 = Ojha S.N., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.022 10.47468/CSNE.2020.e01.s06.022]<br /> }}<br /> &lt;big&gt;'''Abstract &lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;This chapter deals with detailed description of etiopathogenesis, classification and management principles of ''visarpa''. This is acute disease with a quick spread involving mainly skin, blood, lymph and muscle tissue due to vitiation of all three [[dosha]]. Disease is clinically presented in three pathways viz. external, internal and both. Based on the involvement of dominant [[dosha]], it is classified into seven types. Prognosis and treatment duration of disease is proportionate to degree of involvement of [[dosha]] and affected internal organs. As the basic nature of disease is [[rakta]] and [[pitta]] dominant, management is focused on body purification treatments especially therapeutic purgation, blood letting, fasting therapy, medicated ghee, use of bitter drugs and various external applications having soothing and cooling effect. Guidelines for external application in the form of ''pralepa, pradeha'' and ''alepa'' are enlisted in the chapter. Blood letting is emphasized as most important treatment in ''visarpa''. <br /> &lt;br/&gt;<br /> '''Keywords''': ''Visarpa, Parisarpa,'' Erysepalas, Gangrene, Septicaemia, Sepsis, Fulminant spreading skin infections.<br /> &lt;/p&gt;<br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> The twenty first chapter is named [[Visarpa Chikitsa]]. The term ''visarpa'' has two parts viz., ''vi'' and ''sarpa''- ''vi'' stands for ''vividha'' meaning ‘various’ (ways) and ''sarpa'' stands for ''sarpan'' means ‘spreading’. Erythematous, pustular, glandular etc. lesions which spread rapidly in localized or generalized pattern are known as ''visarpa'' [ Cha.Sa. [[Chikitsa Sthana]] 21/11, Chakrapani]. This aliment is also called ''parisarpa''. The prefix ''pari'' stands for ''paritah'' or ''sarvatah'' meaning all over. The disease which spreads all over the body is called ''visarpa''. [Cha. Sa.[[ Chikitsa Sthana]] 21/11, Chakrapani]. This indicates that ''visarpa'' is an umbrella term used for acute spreading disorders caused due to vitiation of [[rakta]]. <br /> <br /> In this chapter Atreya answers the queries about ''visarpa'' derivation, synonyms, classification, [[dosha]], dushya,etiology, habitat, gradation, symptoms, complications, prognosis and treatment of curable ones. The chapter follows that of [Cha. Sa. [[Chhardi Chikitsa|Chhardi]] Chikitsa ] because suppression of chhardi (vomiting) causes [[Rakta dhatu|rakta]] dushti(vitiation of blood) leading to visarpa indicating that [[Rakta dhatu|rakta]] (blood) vitiating factors and vitiation of rakta is an important basic underlying phenomenon prior to the visarpa.<br /> <br /> ''Visarpa'' is acute, spreading and fatal in nature leading to death if not treated promptly. On location basis this is classified into ''bahih-shrita'' (externally situated), ''antah-shrita'' (internally situated) and ''ubhayasam shrita'' (all over situated). ''Bahih-shrita visarpa'' is fulminant, spreading skin and flesh infection with symptoms and signs of inflammatory edema, blisters, ulcers, fever, pain etc. and is curable. ''Antah-shrita visarpa'' involves internal vital organs with mild septicaemia and is curable before complications. ''Ubhayasamshrita visarpa'' has advanced manifestations of both types spreading all over body with severe septicaemia and is fatal.<br /> <br /> ''Visarpa'' never occurs without association of [[rakta]] and [[pitta]], hence general treatment of ''visarpa'' is described by considering [[rakta]] and [[pitta]] vitiation. Specific treatments are described by considering particular [[dosha]] involvement. <br /> Various etiological factors of ''visarpa'' are diet, life style, injury, poison, toxin, burn etc. vitiates [[rakta]] as well as [[dosha]] ([[vata]], [[pitta]] and [[kapha]]) and other [[dhatu]] (body elements) leading to fulminant disease requiring urgent medical care.<br /> <br /> Seven components are involved in the pathogenesis of ''visarpa'' viz., [[rakta]] (blood), ''lasika'' (lymph), ''tvak'' (skin), [[mamsa dhatu]] (flesh), [[vata]], [[pitta]]&lt;nowiki/&gt;and [[Kapha dosha|kapha]]. Same components are associated with [[Kushtha Chikitsa|kushtha]] (various skin disorders) but clinical presentation of both the diseases is different because etiological factors act different. As kushtha is chronic in nature and visarpa is acute in nature[Cha. Sa. Chikitsa Sthana 21/15,Chakrapani] therefore spreading kushtha should not be interpreted as visarpa. <br /> <br /> It is also classified into ''vatika, paittika, slaishmika, agni visarpa, kardam visarpa, granthi visarpa'' and ''sannipatik'' on [[dosha]] basis. ''Bahih-shrita visarpa'' involves exterior part i.e. Skin, flesh, etc. of the body having symptoms like inflammatory oedema, blisters, ulcers, fever, pain etc. and is curable. ''Agni visarpa'' and ''kardam visarpa'' may be cured with appropriate timely management otherwise negligence leads to death of the patient. ''Granthi visarpa'' should be treated before complications otherwise it becomes incurable. ''Sannipatika visarpa'' is a severe manifestation of the disease leading to death.[Cha. Sa. [[Chikitsa Sthana]] 21/42] <br /> <br /> In ''visarpa, shodhana'' therapy has given prime importance because ''rakta kleda'' (putrificatory ingredient) and [[dosha]] vitiation is at higher level hence ''samana'' (pacification) therapy is not very effective. ''Visarpa'' never occurs without association of [[rakta]] and [[pitta]]. Hence general treatment of ''visarpa'' is described by considering [[rakta]] and [[pitta]] vitiation. Specific treatments are described as per the involvement of [[dosha]]. Single ''raktamokshana'' (blood letting) treatment is equal to all of other treatments described for ''visarpa''. [Cha. Sa. [[Chikitsa Sthana]] 21/141-143]. <br /> <br /> ''Kshataja visarpa'' is another variety mentioned additionally in Sushruta Samhita. The later texts followed the same description with addition of some medications.<br /> &lt;/div&gt;<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातो विसर्पचिकित्सितं व्याख्यास्यामः ||१||<br /> <br /> इति ह स्माह भगवानात्रेयः ||२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātō visarpacikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2|| <br /> <br /> athAto visarpacikitsitaM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> Now we shall expound the chapter &quot;Visarpa Chikitsa&quot; (Management of acute spreading erysepalas). Thus said Lord Atreya. [1-2] <br /> <br /> === Agnivesha’s queries on ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कैलासे किन्नराकीर्णे बहुप्रस्रवणौषधे | <br /> <br /> पादपैर्विविधैः स्निग्धैर्नित्यं कुसुमसम्पदा ||३|| <br /> <br /> वमद्भिर्मधुरान् गन्धान् सर्वतः स्वभ्यलङ्कृते | <br /> <br /> विहरन्तं जितात्मानमात्रेयमृषिवन्दितम् ||४|| <br /> <br /> महर्षिभिः परिवृतं सर्वभूतहिते रतम् | <br /> <br /> अग्निवेशो गुरुं काले विनयादिदमुक्तवान् ||५|| <br /> <br /> भगवन्! दारुणं रोगमाशीविषविषोपमम् | <br /> <br /> विसर्पन्तं शरीरेषु देहिनामुपलक्षये ||६|| <br /> <br /> सहसैव नरास्तेन परीताः शीघ्रकारिणा | <br /> <br /> विनश्यन्त्यनुपक्रान्तास्तत्र नः संशयो महान् ||७|| <br /> <br /> स नाम्ना केन विज्ञेयः सञ्ज्ञितः केन हेतुना | <br /> <br /> कतिभेदः कियद्धातुः किन्निदानः किमाश्रयः ||८|| <br /> <br /> सुखसाध्यः कृच्छ्रसाध्यो ज्ञेयो यश्चानुपक्रमः | <br /> <br /> कथं कैर्लक्षणैः किं च भगवन्! तस्य भेषजम् ||९|| <br /> <br /> तदग्निवेशस्य वचः श्रुत्वाऽऽत्रेयः पुनर्वसुः | <br /> <br /> यथावदखिलं सर्वं प्रोवाच मुनिसत्तमः ||१०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kailāsē kinnarākīrṇē bahuprasravaṇauṣadhē| <br /> <br /> pādapairvividhaiḥ snigdhairnityaṁ kusumasampadā||3|| <br /> <br /> vamadbhirmadhurān gandhān sarvātaḥ svabhyalaṅkr̥tē| <br /> <br /> viharantaṁ jitātmānamātrēyamr̥ṣivanditam||4|| <br /> <br /> maharṣibhiḥ parivr̥taṁ sarvabhūtahitē ratam| <br /> <br /> agnivēśō guruṁ kālē vinayādidamuktavān||5|| <br /> <br /> bhagavan! dāruṇaṁ rōgamāśīviṣaviṣōpamam| <br /> <br /> visarpantaṁ śarīrēṣu dēhināmupalakṣayē||6|| <br /> <br /> sahasaiva narāstēna parītāḥ śīghrakāriṇā| <br /> <br /> vinaśyantyanupakrāntāstatra naḥ saṁśayō mahān||7|| <br /> <br /> sa nāmnā kēna vijñēyaḥ sañjñitaḥ kēna hētunā| <br /> <br /> katibhēdaḥ kiyaddhātuḥ kinnidānaḥ kimāśrayaḥ||8|| <br /> <br /> sukhasādhyaḥ kr̥cchrasādhyō jñēyō yaścānupakramaḥ| <br /> <br /> kathaṁ kairlakṣaṇaiḥ kiṁ ca bhagavan! tasya bhēṣajam||9|| <br /> <br /> tadagnivēśasya vacaḥ śrutvā''trēyaḥ punarvasuḥ| <br /> <br /> yathāvadakhilaṁ sarvaṁ prōvāca munisattamaḥ||10||<br /> <br /> kailAse kinnarAkIrNe bahuprasravaNauShadhe| <br /> <br /> pAdapairvividhaiH snigdhairnityaM kusumasampadA||3||<br /> <br /> vamadbhirmadhurAn gandhAn sarvātaH svabhyala~gkRute| <br /> <br /> viharantaM jitAtmAnamAtreyamRuShivanditam||4|| <br /> <br /> maharShibhiH parivRutaM sarvabhUtahite ratam| <br /> <br /> agnivesho guruM kAle vinayAdidamuktavAn||5|| <br /> <br /> bhagavan! dAruNaM rōgamAshIviShaviShopamam| <br /> <br /> visarpantaM sharIreShu dehinAmupalakShaye||6|| <br /> <br /> sahasaiva narAstena parItAH shIghrakAriNA| <br /> <br /> vinashyantyanupakrAntAstatra naH saMshayo mahAn||7|| <br /> <br /> sa nAmnA kena vij~jeyaH sa~jj~jitaH kena hetunA| <br /> <br /> katibhedaH kiyaddhātuH kinnidAnaH kimAshrayaH||8|| <br /> <br /> sukhasAdhyaH kRucchrasAdhyo j~jeyo yashcAnupakramaH| <br /> <br /> kathaM kairlakShaNaiH kiM ca bhagavan! tasya bheShajam||9|| <br /> <br /> tadagniveshasya vacaH shrutvA~a~atreyaH punarvasuH| <br /> <br /> yathAvadakhilaM sarvaM provAca munisattamaH||10|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In the Kailas region inhabited by ''kinnaras'', having numerous water streams and medicinal plants with ever emitting sweet pleasant (''ishat gandha'') aroma by their wealth of flowers, Atreya who had great self-control, was surrounded by great sages and engaged in welfare of all creatures. Then Agnivesha choosing the appropriate time asked politely to his enlightened teacher, <br /> “Oh Lord, I observe the acute emergency disease in the body of human being which spreads with the virulence of snake-venom. Those human who are afflicted by this acute fulminating disease succumb to death quickly, unless treated promptly. We are in great need of enlightenment concerning this disease. <br /> <br /> By which name should it be known? Why does it derive its name? What are its varieties? Which body elements are involved in its pathogenesis? What is its etiology? Where is its location? How to understand its prognosis i.e. easy curable, difficult to cure and incurable? What are the signs and symptoms of this disease? And O worshipful one! What is the method of its treatment?”<br /> Having heard the queries of Agnivesha, Atreya Punarvasu, the foremost among the sages, explained all the relevant details of the disease ''visarpa''. [3-10]<br /> <br /> === Definition of ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विविधं सर्पति यतो विसर्पस्तेन स स्मृतः | <br /> <br /> परिसर्पोऽथवा नाम्ना सर्वतः परिसर्पणात् ||११||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vividhaṁ sarpati yatō visarpastēna sa smr̥taḥ| <br /> <br /> parisarpō'thavā nāmnā sarvātaḥ parisarpaṇāt||11|| <br /> <br /> vividhaM sarpati yato visarpastena sa smRutaH| <br /> <br /> parisarpo~athavA nAmnA sarvātaH parisarpaNAt||11|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> It spreads in various ways hence known as ''visarpa''. It is also called ''parisarpa'' due to its extensive spreading.[11]<br /> <br /> === Classification ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स च सप्तविधो दोषैर्विज्ञेयः सप्तधातुकः | <br /> <br /> पृथक् त्रयस्त्रिभिश्चैको विसर्पो द्वन्द्वजास्त्रयः ||१२|| <br /> <br /> वातिकः पैत्तिकश्चैव कफजः सान्निपातिकः | <br /> <br /> चत्वार एते विसर्पा वक्ष्यन्ते द्वन्द्वजास्त्रयः ||१३|| <br /> <br /> आग्नेयो वातपित्ताभ्यां ग्रन्थ्याख्यः कफवातजः | <br /> <br /> यस्तु कर्दमको घोरः स पित्तकफसम्भवः ||१४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sa ca saptavidhō dōṣairvijñēyaḥ saptadhātukaḥ| <br /> <br /> pr̥thak trayastribhiścaikō visarpō dvandvajāstrayaḥ||12|| <br /> <br /> vātikaḥ paittikaścaiva kaphajaḥ sānnipātikaḥ| <br /> <br /> catvāra ētē visarpā vakṣyantē dvandvajāstrayaḥ||13|| <br /> <br /> āgnēyō vātapittābhyāṁ granthyākhyaḥ kaphavātajaḥ| <br /> <br /> yastu kardamakō ghōraḥ sa pittakaphasambhavaḥ||14|| <br /> <br /> sa ca saptavidho dōṣairvij~jeyaH saptadhātukaH| <br /> <br /> pRuthak trayastribhishcaiko visarpo dvandvajAstrayaH||12|| <br /> <br /> vAtikaH paittikashcaiva kaphajaH sAnnipAtikaH| <br /> <br /> catvAra ete visarpA vakShyante dvandvajAstrayaH||13|| <br /> <br /> Agneyo vātapittAbhyAM granthyAkhyaH kaphavātajaH| <br /> <br /> yastu kardamako ghoraH sa pittakaphasambhavaH||14|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Visarpa'' is of seven types as per [[dosha]] basis and it involves seven body elements.<br /> <br /> Three types of ''visarpa'' are due to the morbidity of individual [[dosha]]; one variety is due to the morbidity of all the three [[dosha]] and three varieties are due to the morbidity of any of the two [[dosha]]. <br /> <br /> ''Vatika, paittika, kaphaja'' and ''sannipatik'' these are the four varieties of ''visarpa'' and the remaining three varieties viz., [[vata]]-[[pitta]]ja, [[kapha]]-[[vata]]ja and [[pitta]]-[[kapha]]ja type will now be described.<br /> <br /> The variety due to morbid [[vata]]-[[pitta]] is agnivisarpa, [[kapha]]-[[vata]] cause ''granthi visarpa'' and [[pitta]]-[[kapha]] leads to serious condition known as ''kardamaka visarpa''. [12-14]<br /> <br /> === Vitiated factors ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रक्तं लसीकात्वङ्मांसं दूष्यं दोषास्त्रयो मलाः | <br /> <br /> विसर्पाणां समुत्पत्तौ विज्ञेयाः सप्त धातवः ||१५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> raktaṁ lasīkā tvaṅmāṁsaṁ dūṣyaṁ dōṣāstrayō malāḥ| <br /> <br /> visarpāṇāṁ samutpattau vijñēyāḥ sapta dhātavaḥ||15||<br /> <br /> raktaM lasIkA tva~gmAMsaM dUShyaM dōṣastrayo malAH| <br /> <br /> visarpANAM samutpattau vij~jeyAH sapta dhAtavaH||15|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Blood, lymph, skin, flesh and three [[dosha]], these seven elements are involved in the pathogenesis of ''visarpa'' of all kinds. [15]<br /> <br /> === Etiology ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> लवणाम्लकटष्णानां रसानामतिसेवनात् | <br /> <br /> दध्यम्लमस्तुशुक्तानां सुरासौवीरकस्य च ||१६|| <br /> <br /> व्यापन्नबहुमद्योष्णरागषाडवसेवनात् | <br /> <br /> शाकानां हरितानां च सेवनाच्च विदाहिनाम् ||१७|| <br /> <br /> कूर्चिकानां किलाटानां सेवनान्मन्दकस्य च | <br /> <br /> दध्नः शाण्डाकिपूर्वाणामासुतानां च सेवनात् ||१८||<br /> <br /> तिलमाषकुलत्थानां तैलानां पैष्टिकस्य च | <br /> <br /> ग्राम्यानूपौदकानां च मांसानां लशुनस्य च ||१९|| <br /> <br /> प्रक्लिन्नानामसात्म्यानां विरुद्धानां च सेवनात् |<br /> <br /> अत्यादानाद्दिवास्वप्नादजीर्णाध्यशनात् क्षतात् ||२०||<br /> <br /> क्षतबन्धप्रपतनाद्धर्मकर्मातिसेवनात् [१] | <br /> <br /> विषवाताग्निदोषाच्च विसर्पाणां समुद्भवः ||२१|| <br /> <br /> एतैर्निदानैर्व्यामिश्रैः कुपिता मारुतादयः | <br /> <br /> दूष्यान् सन्दूष्य रक्तादीन् विसर्पन्त्यहिताशिनाम् ||२२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> lavaṇāmlakaṭūṣṇānāṁ rasānāmatisēvanāt| <br /> <br /> dadhyamlamastuśuktānāṁ surāsauvīrakasya ca||16|| <br /> <br /> vyāpannabahumadyōṣṇarāgaṣāḍavasēvanāt| <br /> <br /> śākānāṁ haritānāṁ ca sēvanācca vidāhinām||17|| <br /> <br /> kūrcikānāṁ kilāṭānāṁ sēvanānmandakasya ca| <br /> <br /> dadhnaḥ śāṇḍākipūrvāṇāmāsutānāṁ ca sēvanāt||18|| <br /> <br /> tilamāṣakulatthānāṁ tailānāṁ paiṣṭikasya ca| <br /> <br /> grāmyānūpaudakānāṁ ca māṁsānāṁ laśunasya ca||19|| <br /> <br /> praklinnānāmasātmyānāṁ viruddhānāṁ ca sēvanāt| <br /> <br /> atyādānāddivāsvapnādajīrṇādhyaśanāt kṣatāt||20|| <br /> <br /> kṣatabandhaprapatanāddharmakarmātisēvanāt [1] | <br /> <br /> viṣavātāgnidōṣācca visarpāṇāṁ samudbhavaḥ||21|| <br /> <br /> ētairnidānairvyāmiśraiḥ kupitā mārutādayaḥ| <br /> <br /> dūṣyān sandūṣya raktādīn visarpantyahitāśinām||22|| <br /> <br /> lavaNAmlakaTUShNAnAM rasAnAmatisevanAt| <br /> <br /> dadhyamlamastushuktAnAM surAsauvIrakasya ca||16|| <br /> <br /> vyApannabahumadyoShNarAgaShADavasevanAt| <br /> <br /> shAkAnAM haritAnAM ca sevanAcca vidAhinAm||17|| <br /> <br /> kUrcikAnAM kilATAnAM sevanAnmandakasya ca| <br /> <br /> dadhnaH shANDAkipUrvANAmAsutAnAM ca sevanAt||18|| <br /> <br /> tilamAShakulatthAnAM tailAnAM paiShTikasya ca| <br /> <br /> grAmyAnUpaudakAnAM ca mAMsAnAM lashunasya ca||19|| <br /> <br /> praklinnAnAmasAtmyAnAM viruddhAnAM ca sevanAt| <br /> <br /> atyAdAnAddivAsvapnAdajIrNAdhyashanAt kShatAt||20||<br /> <br /> kShatabandhaprapatanAddharmakarmAtisevanAt [1] | <br /> <br /> viShavātagnidōṣacca visarpANAM samudbhavaH||21|| <br /> <br /> etairnidAnairvyAmishraiH kupitA mArutAdayaH| <br /> <br /> dUShyAn sandUShya raktAdIn visarpantyahitAshinAm||22|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The following are the causative factors of the ''visarpa'':<br /> <br /> Excessive indulgence in ''lavana'' (salt), ''amla'' (sour), ''katu'' (pungent) and ''ushna'' (hot ingredients); as also in ''amla dadhi'' (sour curd), ''dadhi mastu'' (whey), ''shukta'' (vinegars), ''sura'' (type of liquor) and ''sauviraka'' (type of wine); the use of ''vyapanna madya'' (contaminated wine) or excessive liquor or heat inducing ''raga'' (condiments) and ''sadava'' (confectionery), the use of ''vidahi'' (causes burning), ''shaka'' (vegetables) and ''harita'' (''lashunadi harita'' group ''dravya''), ''kilata'' (cheese), ''kurchika'' (inspissated milk) and ''mandaka'' (immature curd), the use of ''sandaki'' (fermented wine), as also of ''paistika'' (one made up of ''pistamai padarth'' or pastries) and oils made of sesame, black gram and horse gram, the use of flesh of domesticated, wet land and aquatic animals and garlic, the use of the ''praklinna'' (putrified food), ''asatmya'' (unwholesome) and ''viruddha'' (mutually contradictory ingredients), over eating, sleeping during day time, ''ajirnashana'' (eating during indigestion), ''adhyashana'' (eating food immediately after the meal); ''kshatat'' (traumatic injury), ''kshata'' (wounds), ''bandha'' (ligatures), ''prapatana'' (trauma due to falls) over exposure to sun, strainful work, poisons, poisonous air,burns etc.<br /> <br /> By combination of above mentioned etiological factors, the provoked [[vata]]di [[dosha]] affect the susceptible body elements such as [[rakta]], lasika etc. and spread in the body in those indulged in unwholesome diet. [16-22]<br /> <br /> === Pathways of spreading the disease ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बहिःश्रितः श्रितश्चान्तस्तथा चोभयसंश्रितः | <br /> <br /> विसर्पो बलमेतेषां ज्ञेयं गुरु यथोत्तरम् ||२३|| <br /> <br /> बहिर्मार्गाश्रितं साध्यमसाध्यमुभयाश्रितम् | <br /> <br /> विसर्पं दारुणं विद्यात् सुकृच्छ्रं त्वन्तराश्रयम् ||२४|| <br /> <br /> अन्तःप्रकुपिता दोषा विसर्पन्त्यन्तराश्रये | <br /> <br /> बहिर्बहिःप्रकुपिताः सर्वत्रोभयसंश्रिताः ||२५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bahiḥśritaḥ śritaścāntastathā cōbhayasaṁśritaḥ| <br /> <br /> visarpō balamētēṣāṁ jñēyaṁ guru yathōttaram||23|| <br /> <br /> bahirmārgāśritaṁ sādhyamasādhyamubhayāśritam| <br /> <br /> visarpaṁ dāruṇaṁ vidyāt sukr̥cchraṁ tvantarāśrayam||24|| <br /> <br /> antaḥprakupitā dōṣā visarpantyantarāśrayē| <br /> <br /> bahirbahiḥprakupitāḥ sarvatrōbhayasaṁśritāḥ||25||<br /> <br /> bahiHshritaH shritashcAntastathA cobhayasaMshritaH| <br /> <br /> visarpo balameteShAM j~jeyaM guru yathottaram||23|| <br /> <br /> bahirmArgAshritaM sAdhyamasAdhyamubhayAshritam| <br /> <br /> visarpaM dAruNaM vidyAt sukRucchraM tvantarAshrayam||24|| <br /> <br /> antaHprakupitA dōṣa visarpantyantarAshraye| <br /> <br /> bahirbahiHprakupitAH sarvatrobhayasaMshritAH||25||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Externally situated (pathogenesis in shakha, [[rasa dhatu]]and [[rakta dhatu]]), internally situated (pathogenesis in internal organs and other [[dhatu]]) and situated in both (externally as well as internally) pathways ''visarpa'' is to be known more and more serious consecutively. <br /> <br /> Externally situated ''visarpa'' is curable, internally situated ''visarpa'' is very serious and difficult to cure whereas externally as well as internally situated type is incurable.<br /> <br /> The humors provoked in internal regions spreads internally, if provoked in external regions spreads externally and if provoked in both regions spreads all over the body.[23-25]<br /> <br /> === Causes and features of internal and external ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मर्मोपघातात् सम्मोहादयनानां विघट्टनात् | <br /> <br /> तृष्णातियोगाद्वेगानां विषमाणां प्रवर्तनात् ||२६|| <br /> <br /> विद्याद्विसर्पमन्तर्जमाशु चाग्निबलक्षयात् | <br /> <br /> अतो विपर्ययाद्बाह्यमन्यैर्विद्यात् स्वलक्षणैः ||२७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> marmōpaghātāt sammōhādayanānāṁ vighaṭṭanāt| <br /> <br /> tr̥ṣṇātiyōgādvēgānāṁ viṣamāṇāṁ pravartanāt||26|| <br /> <br /> vidyādvisarpamantarjamāśu cāgnibalakṣayāt| <br /> <br /> atō viparyayādbāhyamanyairvidyāt svalakṣaṇaiḥ||27||<br /> <br /> marmopaghAtAt sammohAdayanAnAM vighaTTanAt| <br /> <br /> tRuShNAtiyōgadvegAnAM viShamANAM pravartanAt||26|| <br /> <br /> vidyAdvisarpamantarjamAshu cAgnibalakShayAt| <br /> <br /> ato viparyayAdbAhyamanyairvidyAt svalakShaNaiH||27||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Affliction of vital organs, impaired consciousness, impaired circulation, morbid thirst and impaired natural urges and sudden reduction in digestive as well as immune power of body is known as ''antah-visarpa''. ''Bahih-visarpa'' should be understood by the external manifestations appearing on skin flesh etc. and by their own specific symptoms. [26-27]<br /> <br /> === Bad prognostic features ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यस्य सर्वाणि लिङ्गानि बलवद्यस्यकारणम् | <br /> <br /> यस्य चोपद्रवाः कष्टा मर्मगो यश्च हन्ति सः ||२८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yasya sarvāṇi liṅgāni balavadyasya kāraṇam| <br /> <br /> yasya cōpadravāḥ kaṣṭā marmagō yaśca hanti saḥ||28|| <br /> <br /> yasya sarvANi li~ggAni balavadyasya kAraNam| <br /> <br /> yasya copadravAH kaShTA marmago yashca hanti saH||28|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Visarpa'' manifesting with all signs and symptoms, having strong etiological factors, which is associated with formidable complications and that situates as well as affects vital parts, proves fatal.[28]<br /> &lt;/div&gt;<br /> === Etio-pathogeneis and clinical features of [[vata]] dominant ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रूक्षोष्णैः केवलो वायुः पूरणैर्वा समावृतः |<br /> <br /> प्रदुष्टो दूषयन् दूष्यान् विसर्पति यथाबलम् ||२९||<br /> <br /> तस्य रूपाणि- भ्रमदवथुपिपासानिस्तोदशूलाङ्गमर्दोद्वेष्टनकम्पज्वरतमककासास्थिसन्धिभेदविश्लेषणवेपनारोचकाविपाकाश्चक्षुषोराकुलत्वमस्रागमनं पिपीलिकासञ्चार इव चाङ्गेषु, यस्मिंश्चावकाशे विसर्पो विसर्पति [१] सोऽवकाशः श्यावारुणाभासः श्वयथुमान् निस्तोदभेदशूलायामसङ्कोचहर्षस्फुरणैरतिमात्रं प्रपीड्यते, अनुपक्रान्तश्चोपचीयते शीघ्रभेदैः स्फोटकैस्तनुभिररुणाभैः श्यावैर्वा तनुविशदारुणाल्पास्रावैः, विबद्धवातमूत्रपुरीषश्च भवति, निदानोक्तानि चास्य नोपशेरते विपरीतानि चोपशेरत इति वातविसर्पः ||३०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rūkṣōṣṇaiḥ kēvalō vāyuḥ pūraṇairvā samāvr̥taḥ| <br /> <br /> praduṣṭō dūṣayan dūṣyān visarpati yathābalam||29|| <br /> <br /> tasya rūpāṇi- bhramadavathupipāsānistōdaśūlāṅgamardōdvēṣṭanakampajvaratamaka-kāsāsthisandhibhēdaviślēṣaṇavēpanārōcakāvipākāścakṣuṣōrākulatvamasrāgamanaṁ pipīlikāsañcāra ivacāṅgēṣu, yasmiṁścāvakāśē visarpō visarpati [1] sō'vakāśaḥ śyāvāruṇābhāsaḥ śvayathumānnistōdabhēdaśūlāyāmasaṅkōcaharṣasphuraṇairatimātraṁ prapīḍyatē, anupakrāntaścōpacīyatēśīghrabhēdaiḥ sphōṭakaistanubhiraruṇābhaiḥ śyāvairvā tanuviśadāruṇālpāsrāvaiḥ,vibaddhavātamūtrapurīṣaśca bhavati, nidānōktāni cāsya nōpaśēratē viparītāni cōpaśērata itivātavisarpaḥ||30||<br /> <br /> rUkShoShNaiH kevalo vAyuH pUraNairvA samAvRutaH| <br /> <br /> praduShTo dUShayan dUShyAn visarpati yathAbalam||29|| <br /> <br /> tasya rUpANi- bhramadavathupipAsAnistodashUlA~ggamardodveShTanakampajvaratamaka-kAsAsthisandhibhedavishleShaNavepanArocakAvipAkAshcakShuShorAkulatvamasrAgamanaMpipIlikAsa~jcAra iva cA~ggeShu, yasmiMshcAvakAshe visarpo visarpati [1] so~avakAshaHshyAvAruNAbhAsaH shvayathumAn nistodabhedashUlAyAmasa~gkocaharShasphuraNairatimAtraMprapIDyate, anupakrAntashcopacIyate shIghrabhedaiH sphoTakaistanubhiraruNAbhaiH shyAvairvātanuvishadAruNAlpAsrAvaiH, vibaddhavātamUtrapurIShashca bhavati, nidAnoktAni cAsya nopasherateviparItAni copasherata iti vātavisarpaH||30||<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> [[Vayu]] aggravated by ununctuous and hot ingredients or by the obstruction due to vitiated [[dosha]], impairs the body elements and spreads in proportion to its strength. <br /> <br /> Its signs and symptoms are giddiness, burning sensation, excessive thirst, pricking sensation, severe pain, body ache, cramps, shivering, fever, feeling of entering in darkness, cough, breaking and splitting pains in the bones and joints, looseness in joints, trembling, anorexia, indigestion, congestion of the eyes, lacrimation and paresthesia; the region where the inflammation is spreading becomes blackish and reddish in color and edematous. The patient suffers from severe pricking, splitting or aching pain in the part affected as also extension and contractions of the parts, horripilation and quivering. If not treated it gives rise to quick bursting small blackish or reddish blisters with thin clear reddish and scanty discharge. The patient also suffers from the retention of flatus, urine and feces. Etiological factors do not suit and the contrary ones suit the patient, this is [[vata]] dominant ''visarpa''. [29-30]<br /> &lt;/div&gt;<br /> === Etio-pathogeneis and clinical features of [[pitta]] dominant ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तमुष्णोपचारेण विदाह्यम्लाशनैश्चितम् | <br /> <br /> दूष्यान् सन्दूष्य धमनीः [१] पूरयन् वै विसर्पति ||३१||<br /> <br /> तस्य रूपाणि- ज्वरस्तृष्णा मूर्च्छा मोहश्छर्दिररोचकोऽङ्गभेदः स्वेदोऽतिमात्रमन्तर्दाहः प्रलापः शिरोरुक् चक्षुषोराकुलत्वमस्वप्नमरतिर्भ्रमः शीतवातवारितर्षोऽतिमात्रं हरितहारिद्रनेत्रमूत्रवर्चस्त्वं हरितहारिद्ररूपदर्शनं च, यस्मिंश्चावकाशे विसर्पोऽनुसर्पति सोऽवकाशस्ताम्रहरितहारिद्रनीलकृष्णरक्तानां वर्णानामन्यतमं पुष्यति, सोत्सेधैश्चातिमात्रं दाहसम्भेदनपरीतैः स्फोटकैरुपचीयते तुल्यवर्णास्रावैश्चिरपाकैश्च, निदानोक्तानि चास्य नोपशेरते विपरीतानि चोपशेरत इति पित्तविसर्पः ||३२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pittamuṣṇōpacārēṇa vidāhyamlāśanaiścitam| <br /> <br /> dūṣyān sandūṣya dhamanīḥ [1] pūrayan vai visarpati||31|| <br /> <br /> tasya rūpāṇi- jvarastr̥ṣṇā mūrcchā mōhaśchardirarōcakō'ṅgabhēdaḥ svēdō'timātramantardāhaḥ pralāpaḥśirōruk cakṣuṣōrākulatvamasvapnamaratirbhramaḥ śītavātavāritarṣō'timātraṁharitahāridranētramūtravarcastvaṁ haritahāridrarūpadarśanaṁ ca, yasmiṁścāvakāśē visarpō'nusarpatisō'vakāśastāmraharitahāridranīlakr̥ṣṇaraktānāṁ varṇānāmanyatamaṁ puṣyati, sōtsēdhaiścātimātraṁdāhasambhēdanaparītaiḥ sphōṭakairupacīyatē tulyavarṇāsrāvaiścirapākaiśca, nidānōktāni cāsyanōpaśēratē viparītāni cōpaśērata iti pittavisarpaḥ||32|| <br /> <br /> pittamuShNopacAreNa vidAhyamlAshanaishcitam| <br /> <br /> dUShyAn sandUShya dhamanIH [1] pUrayan vai visarpati||31|| <br /> <br /> tasya rUpANi- jvarastRuShNA mUrcchA mohashchardirarocako~a~ggabhedaHsvedo~atimAtramantardAhaH pralApaH shiroruk cakShuShorAkulatvamasvapnamaratirbhramaHshItavātavAritarSho~atimAtraM haritahAridranetramUtravarcastvaM haritahAridrarUpadarshanaM ca,yasmiMshcAvakAshe visarpo~anusarpati so~avakAshastAmraharitahAridranIlakRuShNaraktAnAMvarNAnAmanyatamaM puShyati, sotsedhaishcAtimAtraM dAhasambhedanaparItaiH sphoTakairupacIyatetulyavarNAsrAvaishcirapAkaishca, nidAnoktAni cAsya nopasherate viparItAni copasherata itipittavisarpaH||32|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> The [[pitta]] aggravated by the use of hot regimen, by eating irritant and sour foods vitiates the susceptible body elements and by feeling the vessels, begins to spread.<br /> <br /> Its signs and symptoms are fever, morbid thirst, fainting, disturbed consciousness, vomiting, anorexia, breaking body ache, excessive perspiration, burning, delirium, headache, congestion of the eyes, insomnia, restlessness, giddiness, excessive desire for cold air and water. Greenish or yellowish coloration of eyes, urine and feces, objects visualizes green and yellow. In the region where the ''visarpa'' spreads, becomes coppery, greenish, yellowish, bluish, blackish, reddish color. Affected part becomes excessively edematous and full of pustules, having intense burning and tearing pain, suppurating quickly and discharging fluid of similar color.<br /> <br /> The etiological factors do no suit and the contrary ones suit the patient. This is [[pitta]] dominant ''visarpa''. [31-32]<br /> &lt;/div&gt;<br /> === Etio-pathogeneis and clinical features of [[kapha]] dominant ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्वाद्वम्ललवणस्निग्धगुर्वन्नस्वप्नसञ्चितः | <br /> <br /> कफः सन्दूषयन् दूष्यान् कृच्छ्रमङ्गे विसर्पति ||३३|| <br /> <br /> तस्य रूपाणि- शीतकः शीतज्वरो गौरवं निद्रा तन्द्राऽरोचको मधुरास्यत्वमास्योपलेपो निष्ठीविका छर्दिरालस्यं स्तैमित्यमग्निनाशो दौर्बल्यं च, यस्मिंश्चावकाशे विसर्पोऽनुसर्पति सोऽवकाशः श्वयथुमान् पाण्डुर्नातिरक्तः स्नेहसुप्तिस्तम्भगौरवैरन्वितोऽल्पवेदनः कृच्छ्रपाकैश्चिरकारिभिर्बहुलत्वगुपलेपैः स्फोटः श्वेतपाण्डुभिरनुबध्यते, प्रभिन्नस्तु श्वेतं पिच्छिलं तन्तुमद्धनमनुबद्धं स्निग्धमास्रावं स्रवति, ऊर्ध्वं च गुरुभिः स्थिरैर्जालावततैः स्निग्धैर्बहुलत्वगुपलेपैर्व्रणैरनुबध्यतेऽनुषङ्गी च भवति, श्वेतनखनयनवदनत्वङ्मूत्रवर्चस्त्वं, निदानोक्तानि चास्य नोपशेरते विपरीतानि चोपशेरत इति श्लेष्मविसर्पः ||३४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> svādvamlalavaṇasnigdhagurvannasvapnasañcitaḥ| <br /> <br /> kaphaḥ sandūṣayan dūṣyān kr̥cchramaṅgē visarpati||33|| <br /> <br /> tasya rūpāṇi- śītakaḥ śītajvarō gauravaṁ nidrā tandrā'rōcakō madhurāsyatvamāsyōpalēpō niṣṭhīvikāchardirālasyaṁ staimityamagnināśō daurbalyaṁ ca, yasmiṁścāvakāśē visarpō'nusarpati sō'vakāśaḥśvayathumān pāṇḍurnātiraktaḥ snēhasuptistambhagauravairanvitō'lpavēdanaḥkr̥cchrapākaiścirakāribhirbahulatvagupalēpaiḥ sphōṭaḥ śvētapāṇḍubhiranubadhyatē, prabhinnastu śvētaṁpicchilaṁ tantumaddhanamanubaddhaṁ snigdhamāsrāvaṁ sravati, ūrdhvaṁ ca gurubhiḥsthirairjālāvātataiḥ snigdhairbahulatvagupalēpairvraṇairanubadhyatē'nuṣaṅgī ca bhavati,śvētanakhanayanavadanatvaṅmūtravarcastvaṁ, nidānōktāni cāsya nōpaśēratē viparītāni cōpaśērata itiślēṣmavisarpaḥ||34|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> [[Kapha]] excessively accumulated due to intake of sweet, sour, salt, unctuous and heavy foods, and also by excessive sleep, vitiates the susceptible body elements and spreads with slow speed in the body. <br /> <br /> Its signs and symptoms are chills, fever with chills, heaviness, excess sleep, drowsiness, adherence of sticky material in the mouth, excess spitting, vomiting, lassitude, timidity, loss of appetite and prostration. The region where the disease spreads becomes edematous, pallor or slight red, unctuous, numbness, rigidness, heaviness and slight pain. It suppurates hardly and chronic in nature. It is studded with eruptions which are covered with a thick skin and having white pale color. When burst, they discharge white, slimy, fibrinous, dense, sticky and viscid discharge from it. Thereafter it is followed by the ulcers which are heavy, deep seated, surrounded by capillary network, unctuous and covered with many skin scabs. These ulcers are chronic in nature. The nails, eyes, face, skin, urine and faces of the patient appear pale. The etiological factors do no suit and the contrary ones suit the patient. This is [[kapha]]ja visarpa''. [33-34]<br /> &lt;/div&gt;<br /> === Etio-pathogenesis and clinical features of [[vata]]-[[pitta]] dominant ''agni visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वातपित्तं प्रकुपितमतिमात्रं स्वहेतुभिः | <br /> <br /> परस्परं लब्धबलं दहद्गात्रं विसर्पति ||३५|| <br /> <br /> तदुपतापादातुरः सर्वशरीरमङ्गारैरिवाकीर्यमाणं मन्यते, छर्द्यतीसारमूर्च्छादाहमोहज्वरतमकारोचकास्थिसन्धिभेदतृष्णाविपाकाङ्गभेदादिभिश्चाभिभूयते, यं यं चावकाशं विसर्पोऽनुसर्पति सोऽवकाशः शान्ताङ्गारप्रकाशोऽतिरक्तो वा भवति, अग्निदग्धप्रकारैश्च स्फोटैरुपचीयते, स शीघ्रगत्वादाश्वेव मर्मानुसारी भवति, मर्मणि चोपतप्ते पवनोऽतिबलो भिनत्त्यङ्गान्यतिमात्रं प्रमोहयति सञ्ज्ञां, हिक्काश्वासौ जनयति, नाशयति निद्रां, स नष्टनिद्रः प्रमूढसञ्ज्ञो व्यथितचेता न क्वचन सुखमुपलभते, अरतिपरीतः स्थानादासनाच्छय्यां क्रान्तुमिच्छति, क्लिष्टभूयिष्ठश्चाशु निद्रां भजति, दुर्बलो दुःखप्रबोधश्च भवति; तमेवंविधमग्निविसर्पपरीतमचिकित्स्यं विद्यात् ||३६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vātapittaṁ prakupitamatimātraṁ svahētubhiḥ| <br /> <br /> parasparaṁ labdhabalaṁ dahadgātraṁ visarpati||35||<br /> <br /> tadupatāpādāturaḥ sarvaśarīramaṅgārairivākīryamāṇaṁ manyatē,chardyatīsāramūrcchādāhamōhajvaratamakārōcakāsthisandhibhēdatr̥ṣṇāvipākāṅgabhēdādibhiścābhibhūyatē,yaṁ yaṁ cāvakāśaṁ visarpō'nusarpati sō'vakāśaḥ śāntāṅgāraprakāśō'tiraktō vā bhavati,agnidagdhaprakāraiśca sphōṭairupacīyatē, sa śīghragatvādāśvēva marmānusārī bhavati, marmaṇi cōpataptēpavanō'tibalō bhinattyaṅgānyatimātraṁ pramōhayati sañjñāṁ, hikkāśvāsau janayati, nāśayati nidrāṁ, sanaṣṭanidraḥ pramūḍhasañjñō vyathitacētā na kvacana sukhamupalabhatē, aratiparītaḥsthānādāsanācchayyāṁ krāntumicchati, kliṣṭabhūyiṣṭhaścāśu nidrāṁ bhajati, durbalō duḥkhaprabōdhaścabhavati; tamēvaṁvidhamagnivisarpaparītamacikitsyaṁ vidyāt||36||<br /> <br /> vātapittaM prakupitamatimAtraM svahetubhiH| <br /> <br /> parasparaM labdhabalaM dahadgAtraM visarpati||35|| <br /> <br /> tadupatApAdAturaH sarvasharIrama~ggArairivAkIryamANaM manyate,chardyatIsAramUrcchAdAhamohajvaratamakArocakAsthisandhibhedatRuShNAvipAkA~ggabhedAdibhishcAbhibhUyate,yaM yaM cAvakAshaM visarpo~anusarpati so~avakAshaH shAntA~ggAraprakAsho~atirakto vA bhavati,agnidagdhaprakAraishca sphoTairupacIyate, sa shIghragatvAdAshveva marmAnusArI bhavati, marmaNi copataptepavano~atibalo bhinattya~ggAnyatimAtraM pramohayati sa~jj~jAM, hikkAshvAsau janayati, nAshayati nidrAM, sanaShTanidraH pramUDhasa~jj~jo vyathitacetA na kvacana sukhamupalabhate, aratiparItaH sthAnAdAsanAcchayyAMkrAntumicchati, kliShTabhUyiShThashcAshu nidrAM bhajati, durbalo duHkhaprabodhashca bhavati;tamevaMvidhamagnivisarpaparItamacikitsyaM vidyAt||36|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> When ''vata-pitta'' vitiated severely due to their respective etiological factors and strengthened mutually, spreads producing severe burning pain in the body. <br /> <br /> The patient affected with this type of ''visarpa'' feels as if his body is sprinkled with flaming coals. He suffers from vomiting, diarrhea, fainting, burning sensation, disturbed consciousness, fever, feeling of darkness, anorexia, breaking pain in bones and joints, morbid thirst, indigestion, breaking body pain etc. The part where the disease spreads looks like extinguished charcoal or blood like red, affected region gets covered with blisters like those caused by burns. Due to its rapid progress, it soon spreads to vital regions. When the vital parts gets affected, the [[vata]] which is excessively aggravated causes extensive disintegration of the tissues and leads to disturbed consciousness, produces hiccup, dyspnea and insomnia. That sleepless patient with disturbed consciousness and miserable mind does not get relief anywhere. He becomes restless in standing, seating and desires to lie on bed, thus exceedingly exhausted due to pain soon falls into deep sleep. Being debilitated, he is aroused from this state with difficulty. One suffering from ''agni-visarpa'' is to be regarded as incurable.[35-36]<br /> &lt;/div&gt;<br /> === Etio-pathogenesis and clinical features of [[kapha]]-[[pitta]] dominant ''kardam visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कफपित्तं प्रकुपित्तं बलवत् स्वेन हेतुना | <br /> <br /> विसर्पत्येकदेशे तु प्रक्लेदयति देहिनम् ||३७||<br /> <br /> तद्विकाराः- शीतज्वरः शिरोगुरुत्वं दाहः स्तैमित्यमङ्गावसदनं निद्रा तन्द्रा मोहोऽन्नद्वेषः प्रलापोऽग्निनाशो दौर्बल्यमस्थिभेदो मूर्च्छा पिपासा स्रोतसां प्रलेपो जाड्यमिन्द्रियाणां प्रायोपवेशनमङ्गविक्षेपोऽङ्गमर्दोऽरतिरौत्सुक्यं चोपजायते, प्रायश्चामाशये विसर्पत्यलसक एकदेशग्राही च, यस्मिंश्चावकाशे विसर्पो विसर्पति सोऽवकाशो रक्तपीतपाण्डुपिडकावकीर्ण इव मेचकाभः कालो मलिनः स्निग्धो बहूष्मा गुरुः स्तिमितवेदनः श्वयथुमान् गम्भीरपाको निरास्रावः शीघ्रक्लेदः स्विन्नक्लिन्नपूतिमांसत्वक् क्रमेणाल्परुक् परामृष्टोऽवदीर्यते कर्दम इवावपीडितोऽन्तरं प्रयच्छत्युपक्लिन्नपूतिमांसत्यागी सिरास्नायुसन्दर्शी कुणपगन्धी च भवति सञ्ज्ञास्मृतिहन्ता च; तं कर्दमविसर्पपरीतमचिकित्स्यं विद्यात् ||३८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaphapittaṁ prakupittaṁ balavat svēna hētunā| <br /> <br /> visarpatyēkadēśē tu praklēdayati dēhinam||37|| <br /> <br /> tadvikārāḥ- śītajvaraḥ śirōgurutvaṁ dāhaḥ staimityamaṅgāvasadanaṁ nidrā tandrā mōhō'nnadvēṣaḥpralāpō'gnināśō daurbalyamasthibhēdō mūrcchā pipāsā srōtasāṁ pralēpō jāḍyamindriyāṇāṁprāyōpavēśanamaṅgavikṣēpō'ṅgamardō'ratirautsukyaṁ cōpajāyatē, prāyaścāmāśayē visarpatyalasakaēkadēśagrāhī ca, yasmiṁścāvakāśē visarpō visarpati sō'vakāśō raktapītapāṇḍupiḍakāvakīrṇa ivamēcakābhaḥ kālō malinaḥ snigdhō bahūṣmā guruḥ stimitavēdanaḥ śvayathumān gambhīrapākō nirāsrāvaḥśīghraklēdaḥ svinnaklinnapūtimāṁsatvak kramēṇālparuk parāmr̥ṣṭō'vadīryatē kardama ivāvapīḍitō'ntaraṁprayacchatyupaklinnapūtimāṁsatyāgī sirāsnāyusandarśī kuṇapagandhī ca bhavati sañjñāsmr̥tihantā ca;taṁ kardamavisarpaparītamacikitsyaṁ vidyāt||38||<br /> <br /> kaphapittaM prakupittaM balavat svena hetunA| <br /> <br /> visarpatyekadeshe tu prakledayati dehinam||37|| <br /> <br /> tadvikArAH- shItajvaraH shirogurutvaM dAhaH staimityama~ggAvasadanaM nidrA tandrAmoho~annadveShaH pralApo~agninAsho daurbalyamasthibhedo mUrcchA pipAsA srotasAM pralepojADyamindriyANAM prAyopaveshanama~ggavikShepo~a~ggamardo~aratirautsukyaM copajAyate,prAyashcAmAshaye visarpatyalasaka ekadeshagrAhI ca, yasmiMshcAvakAshe visarpo visarpatiso~avakAsho raktapItapANDupiDakAvakIrNa iva mecakAbhaH kAlo malinaH snigdho bahUShmA guruHstimitavedanaH shvayathumAn gambhIrapAko nirAsrAvaH shIghrakledaH svinnaklinnapUtimAMsatvakkrameNAlparuk parAmRuShTo~avadIryate kardama ivAvapIDito~antaraMprayacchatyupaklinnapUtimAMsatyAgI sirAsnAyusandarshI kuNapagandhI ca bhavati sa~jj~jAsmRutihantAca; taM kardamavisarpaparItamacikitsyaM vidyAt||38|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> Excessively aggravated [[kapha]] [[pitta]] due to their respective etiological factors, spreads in the body causing suppuration of the tissues in particular part. <br /> <br /> Its signs and symptoms are fever with chills, heaviness of the head, burning sensation, timidity, prostration, excessive sleep, drowsiness, disturbed consciousness, food dislike, delirium, loss of appetite, weakness, breaking pain in bones, fainting, morbid thirst, adhesions of sticky material in channels, dullness of the senses, mostly seating, abnormal movements of limbs, body pain, restlessness, anxiety, often it spreads to ''amashaya''. It is localized and spreads with slow speed.<br /> <br /> The part where the disease spreads looks as if filled with reddish, yellowish, pale eruptions. The affected part becomes muddy, black, dirty, unctuous, excess hot, heavy, dull aching, edematous, with deep seated suppuration, having no discharge, rapidly become sloughy, sweated suppurated, having putrid flesh and skin, gradual little pain, when touched bursts and gives space on pressing, throws out decomposed and putrefied flesh, shows blood vessels, ligaments and has cadaverous smell and causes disturbed consciousness as well as memory. This is called ''kardam visarpa'' and is incurable. [37-38]<br /> &lt;/div&gt;<br /> === Etio-pathogenesis and clinical features of [[kapha]] [[vata]] dominant ''granthi visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्थिरगुरुकठिनमधुरशीतस्निग्धान्नपानाभिष्यन्दिसेविनामव्यायामादिसेविनामप्रतिक <br /> र्मशीलानां श्लेष्मा वायुश्च प्रकोपमापद्यते, तावुभौ दुष्टप्रवृद्धावतिबलौ प्रदूष्य दूष्यान् विसर्पाय कल्पेते; तत्र वायुः श्लेष्मणा विबद्धमार्गस्तमेव श्लेष्माणमनेकधा भिन्दन् क्रमेण ग्रन्थिमालां कृच्छ्रपाकसाध्यां कफाशये सञ्जनयति, उत्सन्नरक्तस्य वा प्रदूष्य रक्तं सिरास्नायुमांसत्वगाश्रितं ग्रन्थीनां मालां कुरुते तीव्ररुजानां स्थूलानामणूनां वा दीर्घवृत्तरक्तानां, तदुपतापाज्ज्वरातिसारकासहिक्काश्वासशोषप्रमोहवैवर्ण्यारोचकाविपाकप्रसेकच्छ <br /> र्दिर्मूर्च्छाङ्गभङ्गनिद्रारतिसदनाद्याः प्रादुर्भवन्त्युपद्रवाः; स एतैरुपद्रुतः सर्वकर्मणां विषयमतिपतितो विवर्जनीयो भवतीति ग्रन्थिविसर्पः ||३९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sthiragurukaṭhinamadhuraśītasnigdhānnapānābhiṣyandisēvināmavyāyāmādisēvināmapratikarmaśīlānāṁślēṣmā vāyuśca prakōpamāpadyatē, tāvubhau duṣṭapravr̥ddhāvatibalau pradūṣya dūṣyān visarpāyakalpētē; tatra vāyuḥ ślēṣmaṇā vibaddhamārgastamēva ślēṣmāṇamanēkadhā bhindan kramēṇagranthimālāṁ kr̥cchrapākasādhyāṁ kaphāśayē sañjanayati, utsannaraktasya vā pradūṣya raktaṁsirāsnāyumāṁsatvagāśritaṁ granthīnāṁ mālāṁ kurutē tīvrarujānāṁ sthūlānāmaṇūnāṁ vādīrghavr̥ttaraktānāṁ, tadupatāpājjvarātisārakāsahikkāśvāsaśōṣapramōhavaivarṇyārōcakāvipākaprasēkacchardirmūrcchāṅgabhaṅganidrāratisadanādyāḥprādurbhavantyupadravāḥ; sa ētairupadrutaḥ sarvakarmaṇāṁ viṣayamatipatitō vivarjanīyō bhavatītigranthivisarpaḥ||39|| <br /> <br /> sthiragurukaThinamadhurashItasnigdhAnnapAnAbhiShyandisevinAmavyAyAmAdisevinAmapratikarmashIlAnAMshleShmA vAyushca prakopamApadyate, tAvubhau duShTapravRuddhAvatibalau pradUShya dUShyAnvisarpAya kalpete; tatra vAyuH shleShmaNA vibaddhamArgastameva shleShmANamanekadhA bhindankrameNa granthimAlAM kRucchrapAkasAdhyAMkaphAshaye sa~jjanayati, utsannaraktasya vA pradUShyaraktaM sirAsnAyumAMsatvagAshritaM granthInAM mAlAM kurute tIvrarujAnAM sthUlAnAmaNUnAM vAdIrghavRuttaraktAnAM, tadupatApAjjvarAtisArakAsahikkAshvAsashoSha-pramohavaivarNyArocakAvipAkaprasekacchardirmUrcchA~ggabha~gganidrAratisadanAdyAHprAdurbhavantyupadravAH; sa etairupadrutaH sarvakarmaNAM viShayamatipatito vivarjanIyo bhavatItigranthivisarpaH||39|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> [[Kapha]] and [[vata]] gets vitiated due to the use of firm, heavy, hard, sweet, cold, unctuous, and ''abhishyandi'' (which increase discharges and cause obstruction) ingredients of diet, lack of physical exercise etc. not following preventive seasonal [[Panchakarma]] purification. Deranged excessively, aggravated, powerful both [[kapha]] and [[vata]] vitiates the susceptible body elements giving rise to ''granthi visarpa''. Thereafter the [[vata]] being occluded by [[kapha]] in its progress and disintegrates [[kapha]] in many ways and gradually giving rise to chain of glands, hardly suppurating and difficult to cure, in the habitats of [[kapha]].<br /> <br /> In a person having aggravated blood, vitiated [[kapha]]-[[pitta]] provoke blood giving rise to a series of glandular enlargements which are exceedingly painful, large or small or elongated or round and of red color, located in blood vessels, ligaments, flesh and skin. Being afflicted, complications arise like fever, diarrhea, cough, hiccup, dyspnea, emaciation disturbed consciousness, abnormal complexion, anorexia, indigestion, excess salivation, vomiting, fainting, breaking pain in body , excessive sleep, restlessness, malaise, the patient associated with these complications goes beyond the reach of all remedial measures and as such is rejectable. This is ''granthi visarpa''.[39]<br /> <br /> === ''Upadrava'' (complications) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> उपद्रवस्तु खलु रोगोत्तरकालजो रोगाश्रयो रोग एव स्थूलोऽणुर्वा, रोगात् पश्चाज्जायत इत्युपद्रवसञ्ज्ञः| <br /> तत्र प्रधानो व्याधिः, व्याधेर्गुणभूत [१] उपद्रवः, तस्य प्रायः प्रधानप्रशमे प्रशमो भवति | <br /> स तु पीडाकरतरो भवति पश्चादुत्पद्यमानो व्याधिपरिक्लिष्टशरीरत्वात्; तस्मादुपद्रवं त्वरमाणोऽभिबाधेत ||४०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> upadravastu khalu rōgōttarakālajō rōgāśrayō rōga ēva sthūlō'ṇurvā, rōgāt paścājjāyataityupadravasañjñaḥ| <br /> tatra pradhānō vyādhiḥ, vyādhērguṇabhūta [1] upadravaḥ, tasya prāyaḥ pradhānapraśamē praśamōbhavati| <br /> sa tu pīḍākaratarō bhavati paścādutpadyamānō vyādhiparikliṣṭaśarīratvāt; tasmādupadravaṁtvaramāṇō'bhibādhēta||40|| <br /> <br /> upadravastu khalu rogottarakAlajo rōgashrayo rōga eva sthUlo~aNurvA, rōgat pashcAjjAyataityupadravasa~jj~jaH| <br /> tatra pradhAno vyAdhiH, vyAdherguNabhUta [1] upadravaH, tasya prAyaH pradhAnaprashame prashamobhavati| <br /> sa tu pIDAkarataro bhavati pashcAdutpadyamAno vyAdhiparikliShTasharIratvAt; tasmAdupadravaMtvaramANo~abhibAdheta||40|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Upadrava'' (complication) is disorder itself, outsized or undersized manifesting in the later period of a disease and rooted in the same (disease). ''Upadrava'' is so named because it manifests after the disease. Hence the main disease is primary and complication is secondary, it is generally pacified when the main disease gets pacified. It is more troublesome than the main disease itself, because it appears in the later stages of disease when the body is already weakened. Hence, one should treat the complications very promptly.[40]<br /> <br /> === Severity of ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सर्वायतनसमुत्थं सर्वलिङ्गव्यापिनं सर्वधात्वनुसारिणमाशुकारिणं महात्ययिकमिति सन्निपातविसर्पमचिकित्स्यं विद्यात् ||४१||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sarvāyatanasamutthaṁ sarvaliṅgavyāpinaṁ sarvadhātvanusāriṇamāśukāriṇaṁ mahātyayikamitisannipātavisarpamacikitsyaṁ vidyāt||41|| <br /> <br /> sarvAyatanasamutthaM sarvali~ggavyApinaM sarvadhAtvanusAriNamAshukAriNaM mahAtyayikamitisannipAtavisarpamacikitsyaM vidyAt||41||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''visarpa'' which is caused by all etiological factors, manifesting with all signs and symptoms, spreads in all body elements very rapidly and great disastrous is known as ''sannipataja visarpa'' and is not treatable. [41]<br /> &lt;/div&gt;<br /> === Prognosis of ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र वातपित्तश्लेष्मनिमित्ता विसर्पास्त्रयः साध्या भवन्ति; अग्निकर्दमाख्यौ पुनरनुपसृष्टे मर्मणि अनुपगते वा सिरास्नायुमांसक्लेदे साधारणक्रियाभिरुभावेवाभ्यस्यमानौ प्रशान्तिमापद्येयाताम्, अनादरोपक्रान्तः पुनस्तयोरन्यतरो हन्याद्देहमाश्वेवाशीविषवत्; तथा ग्रन्थिविसर्पमजातोपद्रवमारभेत चिकित्सितुम्, उपद्रवोपद्रुतं त्वेनं परिहरेत्; सन्निपातजं तु सर्वधात्वनुसारित्वादाशुकारित्वाद्विरुद्धोपक्रमत्वाच्चासाध्यं विद्यात् ||४२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra vātapittaślēṣmanimittā visarpāstrayaḥ sādhyā bhavanti; agnikardamākhyau punaranupasr̥ṣṭēmarmaṇi anupagatē vā sirāsnāyumāṁsaklēdē sādhāraṇakriyābhirubhāvēvābhyasyamānaupraśāntimāpadyēyātām, anādarōpakrāntaḥ punastayōranyatarō hanyāddēhamāśvēvāśīviṣavat; tathāgranthivisarpamajātōpadravamārabhēta cikitsitum, upadravōpadrutaṁ tvēnaṁ pariharēt; sannipātajaṁ tusarvadhātvanusāritvādāśukāritvādviruddhōpakramatvāccāsādhyaṁ vidyāt||42|| <br /> <br /> tatra vātapittashleShmanimittA visarpAstrayaH sAdhyA bhavanti; agnikardamAkhyau punaranupasRuShTemarmaNi anupagate vA sirAsnAyumAMsaklede sAdhAraNakriyAbhirubhAvevAbhyasyamAnauprashAntimApadyeyAtAm, anAdaropakrAntaH punastayoranyataro hanyAddehamAshvevAshIviShavat;tathA granthivisarpamajAtopadravamArabheta cikitsitum, upadravopadrutaM tvenaM pariharet;sannipAtajaM tu sarvadhAtvanusAritvAdAshukAritvAdviruddhopakramatvAccAsAdhyaM vidyAt||42|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> Among all types of ''visarpa vatik'', ''paittik'' and [[kapha]]ja these three are curable. ''Agni'' and ''kardam visarpa'' not spreading to vital organs and causing no suppuration of the vessels, ligaments and muscles can be pacified by the general treatment of ''visarpa''. When managed with negligence both may cause death of patients like snake venom. ''Granthi visarpa'' should be treated before complications has arisen, otherwise should be rejected. ''Sannipataja visarpa'' should be taken as incurable because of it is spreading to all [[dhatu]], very fulminant and refractory to treatment.[42]<br /> <br /> === Principles of treatment ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र साध्यानां साधनमनुव्याख्यास्यामः ||४३|| <br /> <br /> लङ्घनोल्लेखने शस्ते तिक्तकानां च सेवनम् | <br /> <br /> कफस्थानगते सामे रूक्षशीतैः प्रलेपयेत् ||४४||<br /> <br /> पित्तस्थानगतेऽप्येतत् सामे कुर्याच्चिकित्सितम् | <br /> <br /> शोणितस्यावसेकं च विरेकं च विशेषतः ||४५|| <br /> <br /> मारुताशयसम्भूतेऽप्यादितः स्याद्विरूक्षणम् | <br /> <br /> रक्तपित्तान्वयेऽप्यादौ स्नेहनं न हितं मतम् ||४६|| <br /> <br /> वातोल्बणे तिक्तघृतं पैत्तिके च प्रशस्यते | <br /> <br /> लघुदोषे, महादोषे पैत्तिके स्याद्विरेचनम् ||४७|| <br /> <br /> न घृतं बहुदोषाय देयं यन्न [१] विरेचयेत् | <br /> <br /> तेन दोषो ह्युपष्टब्धस्त्वङ्मांसरुधिरं पचेत् ||४८|| <br /> <br /> तस्माद्विरेकमेवादौ शस्तं विद्याद्विसर्पिणः | <br /> <br /> रुधिरस्यावसेकं च तद्ध्यस्याश्रयसञ्ज्ञितम् ||४९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra sādhyānāṁ sādhanamanuvyākhyāsyāmaḥ||43|| <br /> <br /> laṅghanōllēkhanē śastē tiktakānāṁ ca sēvanam| <br /> <br /> kaphasthānagatē sāmē rūkṣaśītaiḥ pralēpayēt||44|| <br /> <br /> pittasthānagatē'pyētat sāmē kuryāccikitsitam| <br /> <br /> śōṇitasyāvasēkaṁ ca virēkaṁ ca viśēṣataḥ||45||<br /> <br /> mārutāśayasambhūtē'pyāditaḥ syādvirūkṣaṇam| <br /> <br /> raktapittānvayē'pyādau snēhanaṁ na hitaṁ matam||46|| <br /> <br /> vātōlbaṇē tiktaghr̥taṁ paittikē ca praśasyatē| <br /> <br /> laghudōṣē, mahādōṣē paittikē syādvirēcanam||47|| <br /> <br /> na ghr̥taṁ bahudōṣāya dēyaṁ yanna [1] virēcayēt| <br /> <br /> tēna dōṣō hyupaṣṭabdhastvaṅmāṁsarudhiraṁ pacēt||48|| <br /> <br /> tasmādvirēkamēvādau śastaṁ vidyādvisarpiṇaḥ| <br /> <br /> rudhirasyāvasēkaṁ ca taddhyasyāśrayasañjñitam||49|| <br /> <br /> tatra sAdhyAnAM sAdhanamanuvyAkhyAsyAmaH||43|| <br /> <br /> la~gghanollekhane shaste tiktakAnAM ca sevanam| <br /> <br /> kaphasthAnagate sAme rūkṣashItaiH pralepayet||44|| <br /> <br /> pittasthAnagate~apyetat sAme kuryAccikitsitam| <br /> <br /> shoNitasyAvasekaM ca virekaM ca visheShataH||45|| <br /> <br /> mArutAshayasambhUte~apyAditaH syAdvirūkṣaNam| <br /> <br /> raktapittAnvaye~apyAdau snehanaM na hitaM matam||46||<br /> <br /> vAtolbaNe tiktaghRutaM paittike ca prashasyate| <br /> <br /> laghudoShe, mahAdoShe paittike syAdvirecanam||47||<br /> <br /> na ghRutaM bahudōṣaya deyaM yanna [1] virecayet| <br /> <br /> tena doSho hyupaShTabdhastva~gmAMsarudhiraM pacet||48|| <br /> <br /> tasmAdvirekamevAdau shastaM vidyAdvisarpiNaH| <br /> <br /> rudhirasyAvasekaM ca taddhyasyAshrayasa~jj~jitam||49|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now the treatment of the curable varieties of ''visarpa'' will be described. <br /> <br /> If the ''visarpa'' is caused with ama [[dosha]]([[dosha]] in the state of incomplete transformation) and is located in [[kapha]]sthana (in thorax and upper body parts), then [[langhana]] (fasting therapy), [[vamana]] (emesis) therapy, ''tikta'' (bitter) drugs internally and application of paste of drugs with dry and cold properties externally is beneficial. <br /> <br /> The same treatment should be adopted in case of association of ''ama'' and location in [[pitta]] sthana (abdomen and middle parts of body). <br /> <br /> In addition, [[rakta]]mokshana (blood letting) and [[virechana]] (purgation therapy) are specially indicated. <br /> <br /> If ''sama'' (with ama [[dosha]]) ''visarpa'' is arouse from ''vatashaya'' (pelvis and lower part of body) ununctuous measures are indicated in the beginning. Even in association with [[rakta]]-[[pitta]] uncting measure is not regarded as beneficial in the beginning. <br /> <br /> In [[vata]]ja visarpa and paittika visarpa of mild aggravated [[dosha]] tiktaka ghritam is beneficial. But if the [[pitta]] [[dosha]] is excessively aggravated then [[virechana]] should be given. <br /> <br /> In the condition of excessively aggravated [[dosha]], ghee should not be given at first which does not cause [[virechana]]. Because non purgating ghee occlude the [[dosha]] resulting in decomposed skin, flesh and blood. Hence in visarpa, [[virechana]] followed by [[rakta]]mokshana is recommended because the disorder is located in blood.[43-49]<br /> <br /> === Formulations used in ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इति वीसर्पनुत् प्रोक्तं समासेन चिकित्सितम् | <br /> <br /> एतदेव पुनः सर्वं व्यासतः सम्प्रवक्ष्यते ||५०|| <br /> <br /> मदनं मधुकं निम्बं वत्सकस्य फलानि च | <br /> <br /> वमनं सम्प्रदातव्यं विसर्पे कफपित्तजे ||५१|| <br /> <br /> पटोलपिचुमर्दाभ्यां पिप्पल्या मदनेन च | <br /> <br /> विसर्पे वमनं शस्तं तथा चेन्द्रयवैः सह ||५२|| <br /> <br /> यांश्च योगान् प्रवक्ष्याभि कल्पेषु कफपित्तिनाम् | <br /> <br /> विसर्पिणां प्रयोज्यास्ते दोषनिर्हरणाः शिवाः ||५३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> iti vīsarpanut prōktaṁ samāsēna cikitsitam| <br /> <br /> ētadēva punaḥ sarvaṁ vyāsataḥ sampravakṣyatē||50|| <br /> <br /> madanaṁ madhukaṁ nimbaṁ vatsakasya phalāni ca| <br /> <br /> vamanaṁ sampradātavyaṁ visarpē kaphapittajē||51|| <br /> <br /> paṭōlapicumardābhyāṁ pippalyā madanēna ca| <br /> <br /> visarpē vamanaṁ śastaṁ tathā cēndrayavaiḥ saha||52|| <br /> <br /> yāṁśca yōgān pravakṣyābhi kalpēṣu kaphapittinām| <br /> <br /> visarpiṇāṁ prayōjyāstē dōṣanirharaṇāḥ śivāḥ||53|| <br /> <br /> iti vIsarpanut proktaM samAsena cikitsitam| <br /> <br /> etadeva punaH sarvaM vyAsataH sampravakShyate||50|| <br /> <br /> madanaM madhukaM nimbaM vatsakasya phalAni ca| <br /> <br /> vamanaM sampradAtavyaM visarpe kaphapittaje||51|| <br /> <br /> patōlapicumardAbhyAM pippalyA madanena ca| <br /> <br /> visarpe vamanaM shastaM tathA cendrayavaiH saha||52|| <br /> <br /> yAMshca yōgan pravakShyAbhi kalpeShu kaphapittinAm| <br /> <br /> visarpiNAM prayojyAste dōṣanirharaNAH shivAH||53||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus the treatment principles of ''visarpa'' have been described in brief. The same is being detailed further. <br /> <br /> In [[kapha]] [[pitta]]ja visarpa, [[vamana]] should be given with the ''madana'' (Randia spinosa), ''madhuka'' (Glycyrrhiza glabra Linn), ''nimba'' (Azadirachta indica), and fruits of ''vatsaka'' (Holarrhena antidysenterica Linn). <br /> <br /> In visarpa [[vamana]] is beneficial with ''patola'' (Trichosanthes dioica Roxb), ''pichumarda'' (Azadirachta indica), ''pippali'' (Piper longum linn), ''madana'' (Randia spinosa) and ''indrayava'' (Holarrhena antidysenterica Linn). <br /> <br /> Further, all those formulations which will be described in ''kalpasthana'' in connection with the disorders of [[kapha]] [[pitta]] should be used for the patients of ''visarpa'' as well because they are eliminative of morbid [[dosha]] and are beneficial.[50-53]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मुस्तनिम्बपटोलानां चन्दनोत्पलयोरपि | <br /> <br /> सारिवामलकोशीरमुस्तानां वा विचक्षणः ||५४|| <br /> <br /> कषायान् पाययेद्वैद्यः सिद्धान् वीसर्पनाशनान् | <br /> <br /> किराततिक्तकं लोध्रं चन्दनं सदुरालभम् ||५५|| <br /> <br /> नागरं पद्मकिञ्जल्कमुत्पलं सबिभीतकम् | <br /> <br /> मधुकं नागपुष्पं च दद्याद्वीसर्पशान्तये ||५६|| <br /> <br /> प्रपौण्डरीकं मधुकं पद्मकिञ्जल्कमुत्पलम् | <br /> <br /> नागपुष्पं च लोध्रं च तेनैव विधिना पिबेत् ||५७|| <br /> <br /> द्राक्षां पर्पटकं शुण्ठीं गुडूचीं धन्वयासकम् | <br /> <br /> निशापर्युषितं दद्यात्तृष्णावीसर्पशान्तये ||५८|| <br /> <br /> पटोलं पिचुमर्दं च दार्वीं कटुकरोहिणीम् | <br /> <br /> यष्ट्याह्वां त्रायमाणां च दद्याद्वीसर्पशान्तये ||५९|| <br /> <br /> पटोलादिकषायं वा पिबेत्त्रिफलया सह | <br /> <br /> मसूरविदलैर्युक्तं घृतमिश्रं प्रदापयेत् ||६०|| <br /> <br /> पटोलपत्रमुद्गानां रसमामलकस्य च | <br /> <br /> पाययेत घृतोन्मिश्रं नरं वीसर्पपीडितम् ||६१||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mustānimbapaṭōlānāṁ candanōtpalayōrapi| <br /> <br /> sārivāmalakōśīramustānāṁ vā vicakṣaṇaḥ||54|| <br /> <br /> kaṣāyān pāyayēdvaidyaḥ siddhān vīsarpanāśanān| <br /> <br /> kirātatiktakaṁ lōdhraṁ candanaṁ sadurālabham||55|| <br /> <br /> nāgaraṁ padmakiñjalkamutpalaṁ sabibhītakam| <br /> <br /> madhukaṁ nāgapuṣpaṁ ca dadyādvīsarpaśāntayē||56|| <br /> <br /> prapauṇḍarīkaṁ madhukaṁ padmakiñjalkamutpalam| <br /> <br /> nāgapuṣpaṁ ca lōdhraṁ ca tēnaiva vidhinā pibēt||57|| <br /> <br /> drākṣāṁ parpaṭakaṁ śuṇṭhīṁ guḍūcīṁ dhanvayāsakam| <br /> <br /> niśāparyuṣitaṁ dadyāttr̥ṣṇāvīsarpaśāntayē||58|| <br /> <br /> paṭōlaṁ picumardaṁ ca dārvīṁ kaṭukarōhiṇīm| <br /> <br /> yaṣṭyāhvāṁ trāyamāṇāṁ ca dadyādvīsarpaśāntayē||59|| <br /> <br /> paṭōlādikaṣāyaṁ vā pibēttriphalayā saha| <br /> <br /> masūravidalairyuktaṁ ghr̥tamiśraṁ pradāpayēt||60|| <br /> <br /> paṭōlapatramudgānāṁ rasamāmalakasya ca| <br /> <br /> pāyayēta ghr̥tōnmiśraṁ naraṁ vīsarpapīḍitam||61|| <br /> <br /> mustānimbapatōlanAM candanotpalayorapi| <br /> <br /> sArivAmalakoshIramustānAM vA vicakShaNaH||54|| <br /> <br /> kaShAyAn pAyayedvaidyaH siddhAn vIsarpanAshanAn| <br /> <br /> kirAtatiktakaM lōdhraM candanaM sadurAlabham||55|| <br /> <br /> nAgaraM padmaki~jjalkamutpalaM sabibhItakam| <br /> <br /> madhukaM nAgapuShpaM ca dadyAdvIsarpashAntaye||56|| <br /> <br /> prapauNDarIkaM madhukaM padmaki~jjalkamutpalam| <br /> <br /> nAgapuShpaM ca lōdhraM ca tenaiva vidhinA pibet||57|| <br /> <br /> drAkShAM parpaTakaM shuNThIM guDUcIM dhanvayAsakam| <br /> <br /> nishAparyuShitaM dadyAttRuShNAvIsarpashAntaye||58|| <br /> <br /> patōlaM picumardaM ca dArvIM kaTukarōhinim| <br /> <br /> yaShTyAhvAM trAyamANAM ca dadyAdvIsarpashAntaye||59|| <br /> <br /> patōladikaShAyaM vA pibettriphalayA saha|<br /> <br /> masUravidalairyuktaM ghRutamishraM pradApayet||60|| <br /> <br /> patōlapatramudgAnAM rasamAmalakasya ca| <br /> <br /> pAyayeta ghRutonmishraM naraM vIsarpapIDitam||61||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The skillful physician should administer the decoctions of tested efficacy for the cure of ''visarpa'' made up of ''musta'' (Cyperus rotundus linn), ''nimba'' (Azadirachta indica) and ''patola'' (Trichosanthes dioica Roxb) or ''chandana'' (Santalum album linn) and utpal (Nymphaea nouchali) or ''sariva'' (Hemidesmus indicus), ''amalaki'' (Emblica officinalis), ''ushira'' (Vetiveria zizanioidis Linn) and ''musta'' (Cyperus rotundus linn). <br /> <br /> ''Kiratatikta'' (Swertia chirayita), ''lodhra'' (Symplocos racemosa), ''chandana'' (Santalum album linn), ''duralabha'' (Fagonia cretica), ''shunthi'' (Zingiber officinale), ''padmakinjalka'' (Prunus cerasoides), ''utpala'' (Nymphaea nouchali), ''bibhitaka'' (Terminalia bellirica), ''madhuka'' (Glycyrrhiza glabra Linn) and ''nagapushpa'' (Mesua ferrea Linn), this formulation physician may administer for the alleviation of ''visarpa''. <br /> <br /> ''Prapaundrika'' (Nelumbo nucifera), ''madhuka'' (Glycyrrhiza glabra Linn), ''padmakinjalka'' (Prunus cerasoides), ''utpala'' (Nymphaea nouchali), ''nagapuspa'' (Mesua ferrea Linn), and ''lodhra'' (Symplocos racemosa), should be taken by the above method. <br /> <br /> ''Draksha'' (Vitis vinifera Linn), ''parpataka'' (Carthmus tinctorius), ''shunthi'' (Zingiber officinale), ''guduchi'' (Tinospora cordifolia) and ''dhanvayasa'' (fagonia cretica) kept for the whole night in the water (''shitakashaya''), should be administered to alleviate morbid thirst and ''visarpa''. <br /> <br /> ''Patola'' (Trichosanthes dioica Roxb.), ''pichumarda'' (Azadirachta indica), ''darvi'' (Berberis aristata), ''katuki'' (Picrorhiza kurroa), ''rohini'' (Terminalia chebula), ''yasti'' (Glycyrrhiza glabra Linn.), and ''trayamana'' (Gentiana kurroo) should be administered to alleviate ''visarpa''. <br /> <br /> Physician should administer ''patoladi kashaya'' with ''triphala'' (''Haritaki'' -Terminalia chebula, ''Bibhitaki''-Terminalia bellirica, and ''amalaki''- Emblica officinalis) and ''masur'' (lentil pulse) mixed with ghee. <br /> <br /> Physician should administer ''patola patra'' (Trichosanthes dioica Roxb.), ''mudga'' (green gram) and ''amalaki'' juice (Emblica officinalis) mixed with ghee. [54-61]<br /> <br /> === Formulations for [[dosha]] situated in koshtha, [[pitta]] dominant ''visarpa'' and [[virechana]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यच्च सर्पिर्महातिक्तं पित्तकुष्ठनिबर्हणम् | <br /> <br /> निर्दिष्टं तदपि प्राज्ञो दद्याद्वीसर्पशान्तये ||६२|| <br /> <br /> त्रायमाणाघृतं सिद्धं गौल्मिके यदुदाहृतम् | <br /> <br /> विसर्पाणां प्रशान्त्यर्थं दद्यात्तदपि बुद्धिमान् ||६३|| <br /> <br /> त्रिवृच्चूर्णं समालोड्य सर्पिषा पयसाऽपि वा |<br /> <br /> घर्माम्बुना वा संयोज्य मृद्वीकानां रसेन वा ||६४|| <br /> <br /> विरेकार्थं प्रयोक्तव्यं सिद्धं वीसर्पनाशनम् | <br /> <br /> त्रायमाणाशृतं वाऽपि पयो दद्याद्विरेचनम् ||६५|| <br /> <br /> त्रिफलारससंयुक्तं सर्पिस्त्रिवृतया सह | <br /> <br /> प्रयोक्तव्यं विरेकार्थं विसर्पज्वरनाशनम् ||६६|| <br /> <br /> रसमामलकानां वा घृतमिश्रं प्रदापयेत् | <br /> <br /> स एव गुरुकोष्ठाय त्रिवृच्चूर्णयुतो हितः ||६७||<br /> <br /> दोषे कोष्ठगते भूय एतत् कुर्याच्चिकित्सितम् |68|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yacca sarpirmahātiktaṁ pittakuṣṭhanibarhaṇam| <br /> <br /> nirdiṣṭaṁ tadapi prājñō dadyādvīsarpaśāntayē||62|| <br /> <br /> trāyamāṇāghr̥taṁ siddhaṁ gaulmikē yadudāhr̥tam| <br /> <br /> visarpāṇāṁ praśāntyarthaṁ dadyāttadapi buddhimān||63|| <br /> <br /> trivr̥ccūrṇaṁ samālōḍya sarpiṣā payasā'pi vā| <br /> <br /> gharmāmbunā vā saṁyōjya mr̥dvīkānāṁ rasēna vā||64|| <br /> <br /> virēkārthaṁ prayōktavyaṁ siddhaṁ vīsarpanāśanam| <br /> <br /> trāyamāṇāśr̥taṁ vā'pi payō dadyādvirēcanam||65|| <br /> <br /> triphalārasasaṁyuktaṁ sarpistrivr̥tayā saha| <br /> <br /> prayōktavyaṁ virēkārthaṁ visarpajvaranāśanam||66|| <br /> <br /> rasamāmalakānāṁ vā ghr̥tamiśraṁ pradāpayēt| <br /> <br /> sa ēva gurukōṣṭhāya trivr̥ccūrṇayutō hitaḥ||67|| <br /> <br /> dōṣē kōṣṭhagatē bhūya ētat kuryāccikitsitam|68| <br /> <br /> yacca sarpirmahAtiktaM pittakuShThanibarhaNam| <br /> <br /> nirdiShTaM tadapi prAj~jo dadyAdvIsarpashAntaye||62|| <br /> <br /> trAyamANAghRutaM siddhaM gaulmike yadudAhRutam| <br /> <br /> visarpANAM prashAntyarthaM dadyAttadapi buddhimAn||63|| <br /> <br /> trivRuccUrNaM samAloDya sarpiShA payasA~api vA| <br /> <br /> gharmAmbunA vA saMyojya mRudvIkAnAM rasena vA||64|| <br /> <br /> virekArthaM prayoktavyaM siddhaM vIsarpanAshanam| <br /> <br /> trAyamANAshRutaM vA~api payo dadyAdvirecanam||65|| <br /> <br /> triphalArasasaMyuktaM sarpistrivRutayA saha| <br /> <br /> prayoktavyaM virekArthaM visarpajvaranAshanam||66|| <br /> <br /> rasamAmalakAnAM vA ghRutamishraM pradApayet| <br /> <br /> sa eva gurukoShThAya trivRuccUrNayuto hitaH||67|| <br /> <br /> doShe koShThagate bhUya etat kuryAccikitsitam|68| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''mahatikta ghritam'' indicated in ''paittika kustha'' should also be given by the intelligent physician for the alleviation of ''visarpa''. <br /> <br /> ''Trayamana ghritam'' of tested efficacy mentioned in the treatment of ''gulma'' should be administered by the brilliant physician to alleviate ''visarpa''. <br /> <br /> The powder of ''trivritta'' (Operculina turpethum Linn) mixed with ghee or milk or hot water or ''mridvika'' (Vitis vinifera Linn) juice should be administered for [[virechana]] and is tested to alleviate ''visarpa'' or ''trayamana'' (Gentiana kurroo) decocted with milk should be given for [[virechana]]. <br /> <br /> The decoction of ''triphala'' (''Haritaki, Bibhitaki'' and ''Amalaki'') mixed with ghee and ''trivritta'' (Operculina turpethum Linn) and used for [[virechana]] to alleviate ''visarpa'' and ''jwara''.<br /> <br /> The juice of ''amalaki'' (Emblica officinalis) mixed with ghee should be administered in ''visarpa'' patient of heavy bowel the same preparation mixed with ''trivritta'' (Operculina turpethum Linn) powder is beneficial. <br /> <br /> When the morbid [[dosha]] are situated in ''kostha'' (internally), these measures should be administered.[62-67]<br /> <br /> === Formulations for [[dosha]] situated in ''shakha'' and modes of blood letting ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शाखादुष्टे तु रुधिरे रक्तमेवादितो हरेत् ||६८|| <br /> <br /> भिषग्वातान्वितं रक्तं विषाणेन विनिर्हरेत् | <br /> <br /> पित्तान्वितं जलौकोभिः, कफान्वितमलाबुभिः ||६९|| <br /> <br /> यथासन्नं विकारस्य व्यधयेदाशु वा सिराम् | <br /> <br /> त्वङ्मांसस्नायुसङ्क्लेदो रक्तक्लेदाद्धि जायते ||७०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śākhāduṣṭē tu rudhirē raktamēvāditō harēt||68|| <br /> <br /> bhiṣagvātānvitaṁ raktaṁ viṣāṇēna vinirharēt| <br /> <br /> pittānvitaṁ jalaukōbhiḥ, kaphānvitamalābubhiḥ||69|| <br /> <br /> yathāsannaṁ vikārasya vyadhayēdāśu vā sirām| <br /> <br /> tvaṅmāṁsasnāyusaṅklēdō raktaklēdāddhi jāyatē||70|| <br /> <br /> shAkhAduShTe tu rudhire raktamevAdito haret||68|| <br /> <br /> bhiShagvātanvitaM raktaM viShANena vinirharet| <br /> <br /> pittAnvitaM jalaukobhiH, kaphAnvitamalAbubhiH||69|| <br /> <br /> yathAsannaM vikArasya vyadhayedAshu vA sirAm| <br /> <br /> tva~gmAMsasnAyusa~gkledo raktakledAddhi jAyate||70||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If [[dosha]] in ''shakha'' (body elements) vitiate the blood then ''raktamokshana'' should be administered at first. The physician should use ''vishana'' (deer horn) in [[vata]] dominance, ''jalauka'' (Hirudinea medicinalis) in [[pitta]] dominance and ''alabu'' (lagenaria siceraria) in [[kapha]] dominance for blood letting or physician should perform ''siravyadha'' (blood letting through vein) promptly from the adjacent vein to the affected part, without which ''rakta kleda'' (putrifying blood content) gives rise to decomposed skin, flesh and ligaments. [68-70]<br /> <br /> === External applications ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अन्तःशरीरे [१] संशुद्धे दोषे त्वङ्मांससंश्रिते | <br /> <br /> आदितो वाऽल्पदोषाणां क्रिया बाह्या प्रवक्ष्यते ||७१||<br /> <br /> उदुम्बरत्वङ्मधुकं पद्मकिञ्जल्कमुत्पलम् | <br /> <br /> नागपुष्पं प्रियङ्गुश्च प्रदेहः सघृतो हितः ||७२||<br /> <br /> न्यग्रोधपादास्तरुणाः कदलीगर्भसंयुताः | <br /> <br /> बिसग्रन्थिश्च लेपः स्याच्छतधौतघृताप्लुतः ||७३||<br /> <br /> कालीयं मधुकं हेम वन्यं चन्दनपद्मकौ | <br /> <br /> एला मृणालं फलिनी प्रलेपः स्याद्धृताप्लुतः ||७४|| <br /> <br /> शाद्वलं च मृणालं च शङ्खं चन्दनमुत्पलम् |<br /> <br /> वेतसस्य च मूलानि प्रदेहः स्यात् सतण्डुलः ||७५||<br /> <br /> सारिवा पद्मकिञ्जल्कमुशीरं नीलमुत्पलम् | <br /> <br /> मञ्जिष्ठा चन्दनं लोध्रमभया च प्रलेपनम् ||७६|| <br /> <br /> नलदं च हरेणुश्च लोध्रं मधुकपद्मकौ [२] |<br /> <br /> दूर्वा सर्जरसश्चैव सघृतं स्यात् प्रलेपनम् ||७७||<br /> <br /> यावकाः सक्तवश्चैव सर्पिषा सह योजिताः | <br /> <br /> प्रदेहो मधुकं वीरा सघृता यवसक्तवः ||७८|| <br /> <br /> बलामुत्पलशालूकं वीरामगुरुचन्दनम् | <br /> <br /> कुर्यादालेपनं वैद्यो मृणालं च बिसान्वितम् ||७९||<br /> <br /> यवचूर्णं समधुकं सघृतं च प्रलेपनम् | <br /> <br /> हरेणवो मसुराश्च समुद्गाः श्वेतशालयः ||८०|| <br /> <br /> पृथक् पृथक् प्रदेहाः स्युः सर्वे वा सर्पिषा सह | <br /> <br /> पद्मिनीकर्दमः शीतो मौक्तिकं पिष्टमेव वा ||८१|| <br /> <br /> शङ्खः प्रवालः शुक्तिर्वा गैरिकं वा घृताप्लुतम् | <br /> <br /> (पृथगेते प्रदेहाश्च हिता ज्ञेया विसर्पिणाम् [३] ) | <br /> <br /> प्रपौण्डरीकं मधुकं बला शालूकमुत्पलम् ||८२|| <br /> <br /> न्यग्रोधपत्रदुग्धीके सघृतं स्यात् प्रलेपनम् | <br /> <br /> बिसानि च मृणालं च सघृताश्च कशेरुकाः ||८३|| <br /> <br /> शतावरीविदार्योश्च कन्दौ धौतघृताप्लुतौ | <br /> <br /> शैवालं नलमूलानि गोजिह्वा वृषकर्णिका ||८४|| <br /> <br /> इन्द्राणिशाकं सघृतं शिरीषत्वग्बलाघृतम् [४] | <br /> <br /> न्यग्रोधोदुम्बरप्लक्षवेतसाश्वत्थपल्लवैः ||८५|| <br /> <br /> त्वक्कल्कैर्बहुसर्पिर्भिः शीतैरालेपनं हितम् | <br /> <br /> प्रदेहाः सर्व एवैते वातपित्तोल्बणे [५] शुभाः ||८६||<br /> <br /> सकफे [६] तु प्रवक्ष्यामि प्रदेहानपरान् हितान् | <br /> <br /> त्रिफलां पद्मकोशीरं समङ्गां करवीरकम् ||८७|| <br /> <br /> नलमूलान्यनन्तां च प्रदेहमुपकल्पयेत् | <br /> <br /> खदिरं सप्तपर्णं च मुस्तमारग्वधं धवम् ||८८|| <br /> <br /> कुरण्टकं देवदारु दद्यादालेपनं भिषक् | <br /> <br /> आरग्वधस्य पत्राणि त्वचं श्लेष्मातकस्य च ||८९|| <br /> <br /> इन्द्राणिशाकं काकाह्वां शिरीषकुसुमानि च | <br /> <br /> शैवालं नलमूलानि वीरां गन्धप्रियङ्गुकाम् ||९०|| <br /> <br /> त्रिफलां मधुकं वीरां शिरीषकुसुमानि च | <br /> <br /> प्रपौण्डरीकं ह्रीबेरं दार्वीत्वङ्मधुकं बलाम् ||९१|| <br /> <br /> पृथगालेपनं कुर्याद्द्वन्द्वशः सर्वशोऽपि वा | <br /> <br /> प्रदेहाः सर्व एवैते देयाः स्वल्पघृताप्लुताः ||९२|| <br /> <br /> वातपित्तोल्बणे ये तु प्रदेहास्ते घृताधिकाः | <br /> <br /> घृतेन शतधौतेन प्रदिह्यात् केवलेन वा ||९३|| <br /> <br /> घृतमण्डेन शीतेन पयसा मधुकाम्बुना | <br /> <br /> पञ्चवल्ककषायेण सेचयेच्छीतलेन वा ||९४|| <br /> <br /> वातासृक्पित्तबहुलं विसर्पं बहुशो भिषक् | <br /> <br /> सेचनास्ते प्रदेहा ये त एव घृतसाधनाः ||९५|| <br /> <br /> ते चूर्णयोगा वीसर्पव्रणानामवचूर्णनाः | <br /> <br /> दूर्वास्वरससिद्धं च घृतं स्याद्व्रणरोपणम् ||९६|| <br /> <br /> दार्वीत्वङूमधुकं लोध्रं केशरं चावचूर्णनम् | <br /> <br /> पटोलः पिचुमर्दश्च त्रिफला मधुकोत्पले ||९७|| <br /> <br /> एतत् प्रक्षालनं सर्पिर्व्रणचूर्णं प्रलेपनम् |<br /> <br /> प्रदेहाः सर्व एवैते कर्तव्याः सम्प्रसादनाः [१] ||९८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> antaḥśarīrē [1] saṁśuddhē dōṣē tvaṅmāṁsasaṁśritē| <br /> <br /> āditō vā'lpadōṣāṇāṁ kriyā bāhyā pravakṣyatē||71||<br /> <br /> udumbaratvaṅmadhukaṁ padmakiñjalkamutpalam| <br /> <br /> nāgapuṣpaṁ priyaṅguśca pradēhaḥ saghr̥tō hitaḥ||72|| <br /> <br /> nyagrōdhapādāstaruṇāḥ kadalīgarbhasaṁyutāḥ| <br /> <br /> bisagranthiśca lēpaḥ syācchatadhautaghr̥tāplutaḥ||73|| <br /> <br /> kālīyaṁ madhukaṁ hēma vanyaṁ candanapadmakau| <br /> <br /> ēlā mr̥ṇālaṁ phalinī pralēpaḥ syāddhr̥tāplutaḥ||74|| <br /> <br /> śādvalaṁ ca mr̥ṇālaṁ ca śaṅkhaṁ candanamutpalam| <br /> <br /> vētasasya ca mūlāni pradēhaḥ syāt sataṇḍulaḥ||75|| <br /> <br /> sārivā padmakiñjalkamuśīraṁ nīlamutpalam| <br /> <br /> mañjiṣṭhā candanaṁ lōdhramabhayā ca pralēpanam||76|| <br /> <br /> naladaṁ ca harēṇuśca lōdhraṁ madhukapadmakau [2] |<br /> <br /> dūrvā sarjarasaścaiva saghr̥taṁ syāt pralēpanam||77|| <br /> <br /> yāvakāḥ saktavaścaiva sarpiṣā saha yōjitāḥ| <br /> <br /> pradēhō madhukaṁ vīrā saghr̥tā yavasaktavaḥ||78|| <br /> <br /> balāmutpalaśālūkaṁ vīrāmagurucandanam| <br /> <br /> kuryādālēpanaṁ vaidyō mr̥ṇālaṁ ca bisānvitam||79|| <br /> <br /> yavacūrṇaṁ samadhukaṁ saghr̥taṁ ca pralēpanam| <br /> <br /> harēṇavō masurāśca samudgāḥ śvētaśālayaḥ||80|| <br /> <br /> pr̥thak pr̥thak pradēhāḥ syuḥ sarvē vā sarpiṣā saha| <br /> <br /> padminīkardamaḥ śītō mauktikaṁ piṣṭamēva vā||81|| <br /> <br /> śaṅkhaḥ pravālaḥ śuktirvā gairikaṁ vā ghr̥tāplutam| <br /> <br /> (pr̥thagētē pradēhāśca hitā jñēyā visarpiṇām [3] )| <br /> <br /> prapauṇḍarīkaṁ madhukaṁ balā śālūkamutpalam||82|| <br /> <br /> nyagrōdhapatradugdhīkē saghr̥taṁ syāt pralēpanam| <br /> <br /> bisāni ca mr̥ṇālaṁ ca saghr̥tāśca kaśērukāḥ||83|| <br /> <br /> śatāvarīvidāryōśca kandau dhautaghr̥tāplutau| <br /> <br /> śaivālaṁ nalamūlāni gōjihvā vr̥ṣakarṇikā||84|| <br /> <br /> indrāṇiśākaṁ saghr̥taṁ śirīṣatvagbalāghr̥tam [4] | <br /> <br /> nyagrōdhōdumbaraplakṣavētasāśvatthapallavaiḥ||85|| <br /> <br /> tvakkalkairbahusarpirbhiḥ śītairālēpanaṁ hitam| <br /> <br /> pradēhāḥ sarva ēvaitē vātapittōlbaṇē [5] śubhāḥ||86|| <br /> <br /> sakaphē [6] tu pravakṣyāmi pradēhānaparān hitān| <br /> <br /> triphalāṁ padmakōśīraṁ samaṅgāṁ karavīrakam||87|| <br /> <br /> nalamūlānyanantāṁ ca pradēhamupakalpayēt| <br /> <br /> khadiraṁ saptaparṇaṁ ca mustāmāragvadhaṁ dhavam||88|| <br /> <br /> kuraṇṭakaṁ dēvadāru dadyādālēpanaṁ bhiṣak| <br /> <br /> āragvadhasya patrāṇi tvacaṁ ślēṣmātakasya ca||89|| <br /> <br /> indrāṇiśākaṁ kākāhvāṁ śirīṣakusumāni ca| <br /> <br /> śaivālaṁ nalamūlāni vīrāṁ gandhapriyaṅgukām||90|| <br /> <br /> triphalāṁ madhukaṁ vīrāṁ śirīṣakusumāni ca| <br /> <br /> prapauṇḍarīkaṁ hrībēraṁ dārvītvaṅmadhukaṁ balām||91|| <br /> <br /> pr̥thagālēpanaṁ kuryāddvandvaśaḥ sarvaśō'pi vā| <br /> <br /> pradēhāḥ sarva ēvaitē dēyāḥ svalpaghr̥tāplutāḥ||92|| <br /> <br /> vātapittōlbaṇē yē tu pradēhāstē ghr̥tādhikāḥ| <br /> <br /> ghr̥tēna śatadhautēna pradihyāt kēvalēna vā||93|| <br /> <br /> ghr̥tamaṇḍēna śītēna payasā madhukāmbunā| <br /> <br /> pañcavalkakaṣāyēṇa sēcayēcchītalēna vā||94|| <br /> <br /> vātāsr̥kpittabahulaṁ visarpaṁ bahuśō bhiṣak| <br /> <br /> sēcanāstē pradēhā yē ta ēva ghr̥tasādhanāḥ||95|| <br /> <br /> tē cūrṇayōgā vīsarpavraṇānāmavacūrṇanāḥ| <br /> <br /> dūrvāsvarasasiddhaṁ ca ghr̥taṁ syādvraṇarōpaṇam||96|| <br /> <br /> dārvītvaṅmadhukaṁ lōdhraṁ kēśaraṁ cāvacūrṇanam| <br /> <br /> paṭōlaḥ picumardaśca triphalā madhukōtpalē||97|| <br /> <br /> ētat prakṣālanaṁ sarpirvraṇacūrṇaṁ pralēpanam|98|<br /> <br /> antaHsharIre [1] saMshuddhe doShe tva~gmAMsasaMshrite| <br /> <br /> Adito vA~alpadōṣaNAM kriyA bAhyA pravakShyate||71|| <br /> <br /> udumbaratva~gmadhukaM padmaki~jjalkamutpalam| <br /> <br /> nAgapuShpaM priya~ggushca pradehaH saghRuto hitaH||72|| <br /> <br /> nyagrodhapAdAstaruNAH kadalIgarbhasaMyutAH| <br /> <br /> bisagranthishca lepaH syAcchatadhautaghRutAplutaH||73|| <br /> <br /> kAlIyaM madhukaM hema vanyaM candanapadmakau| <br /> <br /> elA mRuNAlaM phalinI pralepaH syAddhRutAplutaH||74|| <br /> <br /> shAdvalaM ca mRuNAlaM ca sha~gkhaM candanamutpalam| <br /> <br /> vetasasya ca mUlAni pradehaH syAt sataNDulaH||75|| <br /> <br /> sArivA padmaki~jjalkamushIraM nIlamutpalam| <br /> <br /> ma~jjiShThA candanaM lōdhramabhayA ca pralepanam||76|| <br /> <br /> naladaM ca hareNushca lōdhraM madhukapadmakau [2] | <br /> <br /> dUrvA sarjarasashcaiva saghRutaM syAt pralepanam||77|| <br /> <br /> yAvakAH saktavashcaiva sarpiShA saha yojitAH| <br /> <br /> pradeho madhukaM vIrA saghRutA yavasaktavaH||78|| <br /> <br /> balAmutpalashAlUkaM vIrAmagurucandanam| <br /> <br /> kuryAdAlepanaM vaidyo mRuNAlaM ca bisAnvitam||79|| <br /> <br /> yavacUrNaM samadhukaM saghRutaM ca pralepanam| <br /> <br /> hareNavo masurAshca samudgAH shvetashAlayaH||80|| <br /> <br /> pRuthak pRuthak pradehAH syuH sarve vA sarpiShA saha| <br /> <br /> padminIkardamaH shIto mauktikaM piShTameva vA||81|| <br /> <br /> sha~gkhaH pravAlaH shuktirvA gairikaM vA ghRutAplutam| <br /> <br /> (pRuthagete pradehAshca hitA j~jeyA visarpiNAm [3] )| <br /> <br /> prapauNDarIkaM madhukaM balA shAlUkamutpalam||82|| <br /> <br /> nyagrodhapatradugdhIke saghRutaM syAt pralepanam| <br /> <br /> bisAni ca mRuNAlaM ca saghRutAshca kasherukAH||83|| <br /> <br /> shatAvarIvidAryoshca kandau dhautaghRutAplutau| <br /> <br /> shaivAlaM nalamUlAni gojihvA vRuShakarNikA||84|| <br /> <br /> indrANishAkaM saghRutaM shirIShatvagbalAghRutam [4] | <br /> <br /> nyagrodhodumbaraplakShavetasAshvatthapallavaiH||85|| <br /> <br /> tvakkalkairbahusarpirbhiH shItairAlepanaM hitam| <br /> <br /> pradehAH sarva evaite vātapittolbaNe [5] shubhAH||86|| <br /> <br /> sakaphe [6] tu pravakShyAmi pradehAnaparAn hitAn| <br /> <br /> triphalAM padmakoshIraM sama~ggAM karavIrakam||87|| <br /> <br /> nalamUlAnyanantAM ca pradehamupakalpayet| <br /> <br /> khadiraM saptaparNaM ca mustāmAragvadhaM dhavam||88|| <br /> <br /> kuraNTakaM devadAru dadyAdAlepanaM bhiShak| <br /> <br /> Aragvadhasya patrANi tvacaM shleShmAtakasya ca||89|| <br /> <br /> indrANishAkaM kAkAhvAM shirIShakusumAni ca| <br /> <br /> shaivAlaM nalamUlAni vIrAM gandhapriya~ggukAm||90|| <br /> <br /> triphalAM madhukaM vIrAM shirIShakusumAni ca| <br /> <br /> prapauNDarIkaM hrIberaM dArvItva~gmadhukaM balAm||91|| <br /> <br /> pRuthagAlepanaM kuryAddvandvashaH sarvasho~api vA| <br /> <br /> pradehAH sarva evaite deyAH svalpaghRutAplutAH||92|| <br /> <br /> vātapittolbaNe ye tu pradehAste ghRutAdhikAH| <br /> <br /> ghRutena shatadhautena pradihyAt kevalena vA||93|| <br /> <br /> ghRutamaNDena shItena payasA madhukAmbunA| <br /> <br /> pa~jcavalkakaShAyeNa secayecchItalena vA||94|| <br /> <br /> vātasRukpittabahulaM visarpaM bahusho bhiShak| <br /> <br /> secanAste pradehA ye ta eva ghRutasAdhanAH||95|| <br /> <br /> te cUrNayōga vIsarpavraNAnAmavacUrNanAH| <br /> <br /> dUrvAsvarasasiddhaM ca ghRutaM syAdvraNaropaNam||96|| <br /> <br /> dArvItva~gmadhukaM lōdhraM kesharaM cAvacUrNanam| <br /> <br /> patōlaH picumardashca triphalA madhukotpale||97|| <br /> <br /> etat prakShAlanaM sarpirvraNacUrNaM pralepanam|98| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After the body is cleansed internally (systemic) and morbid [[dosha]] remains in the skin and flesh (external tissues), or [[dosha]] morbidity is little, the external treatment to be carried out will now be described. <br /> <br /> The bark of ''udumbara'' (Ficus glomerata), ''madhuka'' (Glycyrrhiza glabra Linn), ''padmakinjalka'' (Prunas cerasoides), ''utpala'' (Nymphaea nouchali), ''nagapuspa'' (Mesua ferrea Linn) and ''priyangu'' (Callicarpa macrophylla) mixed with ghee and applied externally as ''pradeha'' and is beneficial. <br /> <br /> The tender adventitious roots of ''nyagrodha'' (Ficus bengalensis Linn), pith of ''kadali'' (Musa paradisiaca Linn.) and rhizome of lotus should be mixed with ghee washed hundred times and is applied externally as a ''lepa''.<br /> <br /> The ''kaliyaka'' (Santalum album Linn), ''madhuka'' (Glycyrrhiza glabra Linn), ''hema'' (calophyllum inophyllum), ''vanya'' (cyperus esculentus), ''chandana'' (Santalum album Linn), ''padmaka'' (Prunas cerasoides), ''ela'' (Elettaria cardamomum), ''mrnala'' (Nelumbo nucifera) and ''phalini'' (Callicarpa macrophylla) should be mixed with ghee and is applied externally as a ''pralepa''. <br /> <br /> The roots ''shadvala'' (Elymus repens), ''mrnala'' (Nelumbo nucifera), ''shankha'' (conch shells), ''chandana'' (Santalum album Linn), ''utpala'' (Nymphaea nouchali), ''vetas'' (Salix caprea Linn) and ''tandula'' (rice) should be applied externally as a ''pradeha''. <br /> ''Sariva'' (Hemidesmus indicus), ''padmakinjalka'' (Prunas cerasoides), ''ushira'' (Vetiveria zizanioidis), ''nila utpala'' (Nymphaea caerulea), ''manjistha'' (Rubia cordifolia), ''chandana'' (Santalum album Linn), ''lodhra'' (symplocos racemosa) and ''abhaya'' (Terminalia chebula) should be applied externally as ''pralepa''. <br /> <br /> ''Nalada'' (Vetiveria zizanioidis), ''harenu'' (Vitex negundo Linn), ''lodhra'' (Symplocos racemosa), ''madhuka'' (Glycyrrhiza glabra Linn), ''padmaka'' (Prunas cerasoides), ''durva'' (Cynodon dactylon) and ''sarjarasa'' (Shorea robusta) should be mixed with ghee and used externally as a ''pralepa''.<br /> <br /> The gruel prepared of barley or roasted flour of cereals should be mixed with ghee and also ''madhuka'' (Glycyrrhiza glabra Linn), ''vira'' (Pueraria tuberose) and ''yavasaktu'' mixed with ghee should be used externally as a ''pradeha''. <br /> <br /> The physician should use mixture of ''bala'' (Sida cordifolia Linn), ''utpala'' (Nymphaea nouchali), ''shaluka'' (Asparagus racemosus), ''vira'' (Pueraria tuberose), ''aguru'' (Aquilaria agallocha), ''chandana'' (Santalum album Linn), ''mrnala'' (stalk) and ''bisa'' (tubers of Nelumbo nucifera) externally as ''alepan'' (local application as a smear or thick paste or coating). <br /> <br /> The powder of barley mixed with honey and ghee should be used externally as a ''pralepa'' (application as thin paste). <br /> <br /> ''Harenu'' (Pisum sativum), ''masura'' (Lens culinaris), ''mudga'' (Vigna radiata) and white ''shali'' rice should be mixed with ghee individually or in combination and used externally as a ''pradeha'' (application as a poultice).<br /> <br /> The cooling mud at the root of lotus, pearls or rice flour or conch shells, coral, oyster shell and ochre should be mixed with ghee separately and beneficial externally as a ''pradeha'' in ''visarpa''.<br /> <br /> ''Prapaundarika'' (Nelumbo nucifera), ''madhuka'' (Glycyrrhiza glabra Linn), ''bala'' (Sida cordifolia), ''shaluka'' (Asparagus racemosus), ''utpala'' (Nymphaea nouchali), ''nyagrodha'' (Ficus bengalensis Linn) and ''dugdhika'' (Euphorbia hirta Linn.) mixed with ghee should be used externally as a ''pralepan''. <br /> <br /> The ''bisa'' (lotus fibres), ''mrnala'' (lotus stalks) and ''kasheruka'' (Cyperus esculentus) mixed with ghee. The ''shatavari'' (Asparagus racemosus) and ''vidarikand'' (Pueraria tuberose) mixed with washed ghee.<br /> <br /> The ''shaival'' (moss), root of ''nala'' (phragmites australis), ''gojihva'' (Amorphophallus paeoniifolius), ''vrsa karnika'' (Calystegia soldanella) and ''indranishaka'' (Vitex agnus-castus) mixed with ghee.<br /> <br /> The bark of ''sirisa'' (Albizzia lebbeck) and ''bala'' (Sida cordifolia Linn) mixed with ghee. ''Nyagrodha'' (Ficus bengalensis Linn), ''udumbar'' (Ficus glomerata), ''plaksha'' (Ficus sycomorus), ''vetas'' (Salix caprea Linn), ''asvattha'' (Ficus religiosa) leaves and bark mixed with ample ghee used as a cold ''alepan'' is beneficial. <br /> <br /> All these external applications are beneficial in [[vata]] [[pitta]] predominant ''visarpa''. <br /> <br /> Other external applications useful in [[kapha]] predominant ''visarpa'' will be described here after. ''Triphala'' (''haritaki, bibhitaki'' and ''amalaki''), ''padmaka'' (Prunas cerasoides), ''usir'' (Vetiveria zizanioidis Linn), ''samanga'' (Mimosa pudica), ''karviraka'' (Nerium indicum), root of ''nala'' (Phragmites australis) and ''ananta'' (hemidesmus indicus) should be used externally as a ''pradeha''. <br /> <br /> ''Khadira'' (Acacia catechu), ''saptaparna'' (Alstonia scholaris), ''musta'' (Cyperus rotundus linn), ''aragvadha'' (Cassia fistula Linn), ''dhava'' (Anogeissus latifolia, Wall). ''Kurantaka'' (Lawsonia inermis) and ''devdaru'' (Cedrus deodar) should be applied externally as a ''pradeha''.<br /> <br /> ''Aragvadha'' leaves (Cassia fistula Linn.) and ''sleshmantak'' bark (Cordia dichotoma), ''indrani shak'' (Vitex negundo Linn), ''kakahva'' (Canvalia gladiata) and ''sirisa'' flowers (Albizia lebbeck Linn.), ''saivala'' (Spirogyra maxima) root of ''nala'' (Phragmites australis), ''veera'' (Pueraria tuberose) and ''gandpriyangu'' (Callicarpa macrophylla), ''triphala'' (''Haritaki, Bibhitaki'' and ''Amalaki''), ''madhuka'' (Glycyrrhiza glabra Linn), ''prapaundrika'' (nelumbo nucifera), ''hribera'' (Pavonia odorata), bark of ''darvi'' (Berberis aristata), and ''bala'' (Sida cordifolia Linn.) - these should be applied singly, dually or collectively as a ''pradeha''. All these external applications should be mixed with small quantity of ghee. In [[vata]] [[pitta]] predominant condition these preparations should be mixed with profuse quantity of ghee.<br /> <br /> The applications of ''shatdhaut ghrita'' as ''pradeha'' or effuse with cold ghee scum, or cold milk or cold decoction of ''madhuka'' (Glycyrrhiza glabra Linn), or ''panchavalka'' (bark of ''nygrodha, udumbara, asvattha, plaksa'' and ''vetasa''), the physician should use frequently in [[vata]], [[rakta]] and [[pitta]] predominant ''visarpa''.<br /> <br /> The external application mentioned as ''pradeha'' may also be used for sprinkling or for preparation ''ghrita yoga'' or ''churna yoga'' used for dusting in wounds of ''visarpa'', ghee cooked with ''durva'' juice promotes wound healing.<br /> <br /> Bark of ''daruharidra'' (Berberis aristata), ''madhuka'' (Glycyrrhiza glabra Linn), ''lodhra'' (Symplocos racemosa) and ''keshara'' (Crocus sativus Linn), powder may be used for dusting the ulcers. ''Patola'' (Trichosanthes dioica Roxb), ''pichumarda'' (Azadirachta indica), ''triphala'' (''haritaki, bibhitaki'' and ''amalaki''), ''madhuka'' (Glycyrrhiza glabra Linn) and ''utpala'' (Nymphaea nouchali), these ingredients may be used to prepare decoction for cleansing the ulcers or to prepare ''ghrita'' or to prepare powder for dusting the ulcers or to prepare ''pralepa''.<br /> <br /> All these external applications as ''pradeha'' should be used for ''samprasadana'' (cleansing and pacifying the blood). [71-98]<br /> <br /> === Guidelines for local application and its types ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षणे क्षणे प्रयोक्तव्याः पूर्वमुद्धृत्य लेपनम् | <br /> <br /> अधावनोद्धृते पूर्वे प्रदेहा बहुशोऽघनाः ||९९|| <br /> <br /> देयाः प्रदेहाः कफजे पर्याधानोद्धृते घनाः | <br /> <br /> त्रिभागाङ्गुष्ठमात्रः स्यात् प्रलेपः कल्कपेषितः ||१००|| <br /> <br /> नातिस्निग्धो न रूक्षश्च न पिण्डो न द्रवः समः |<br /> <br /> न च पर्युषितं लेपं कदाचिदवचारयेत् ||१०१|| <br /> <br /> न च तेनैव लेपेन पुनर्जातु प्रलेपयेत् | <br /> <br /> क्लेदवीसर्पशूलानि सोष्णाभावात् प्रवर्तयेत् ||१०२|| <br /> <br /> लेपो ह्युपरि पट्टस्य कृतः स्वेदयति व्रणम् | <br /> <br /> स्वेदजाः पिडकास्तस्य कण्डूश्चैवोपजायते ||१०३|| <br /> <br /> उपर्युपरि लेपस्य लेपो यद्यवचार्यते | <br /> <br /> तानेव दोषाञ्जनयेत् पट्टस्योपरि यान् कृतः ||१०४|| <br /> <br /> अतिस्निग्धोऽतिद्रवश्च लेपो यद्यवचार्यते | <br /> <br /> त्वचि न श्लिष्यते सम्यङ्न दोषं शमयत्यपि ||१०५|| <br /> <br /> तन्वालिप्तं न कुर्वीत संशुष्को ह्यापुटायते | <br /> <br /> न चौषधिरसो व्याधिं प्राप्नोत्यपि च शुष्यति ||१०६|| <br /> <br /> तन्वालिप्तेन ये दोषास्तानेव जनयेद्भृशम् | <br /> <br /> संशुष्कः पीडयेद्व्याधिं निःस्नेहो ह्यवचारितः ||१०७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pradēhāḥ sarva ēvaitē kartavyāḥ samprasādanāḥ [1] ||98|| <br /> <br /> kṣaṇē kṣaṇē prayōktavyāḥ pūrvamuddhr̥tya lēpanam| <br /> <br /> adhāvanōddhr̥tē pūrvē pradēhā bahuśō'ghanāḥ||99|| <br /> <br /> dēyāḥ pradēhāḥ kaphajē paryādhānōddhr̥tē ghanāḥ| <br /> <br /> tribhāgāṅguṣṭhamātraḥ syāt pralēpaḥ kalkapēṣitaḥ||100|| <br /> <br /> nātisnigdhō na rūkṣaśca na piṇḍō na dravaḥ samaḥ| <br /> <br /> na ca paryuṣitaṁ lēpaṁ kadācidavacārayēt||101|| <br /> <br /> na ca tēnaiva lēpēna punarjātu pralēpayēt| <br /> <br /> klēdavīsarpaśūlāni sōṣṇābhāvāt pravartayēt||102|| <br /> <br /> lēpō hyupari paṭṭasya kr̥taḥ svēdayati vraṇam| <br /> <br /> svēdajāḥ piḍakāstasya kaṇḍūścaivōpajāyatē||103|| <br /> <br /> uparyupari lēpasya lēpō yadyavacāryatē| <br /> <br /> tānēva dōṣāñjanayēt paṭṭasyōpari yān kr̥taḥ||104|| <br /> <br /> atisnigdhō'tidravaśca lēpō yadyavacāryatē| <br /> <br /> tvaci na śliṣyatē samyaṅna dōṣaṁ śamayatyapi||105|| <br /> <br /> tanvāliptaṁ na kurvīta saṁśuṣkō hyāpuṭāyatē| <br /> <br /> na cauṣadhirasō vyādhiṁ prāpnōtyapi ca śuṣyati||106|| <br /> <br /> tanvāliptēna yē dōṣāstānēva janayēdbhr̥śam| <br /> <br /> saṁśuṣkaḥ pīḍayēdvyādhiṁ niḥsnēhō hyavacāritaḥ||107|| <br /> <br /> pradehAH sarva evaite kartavyAH samprasAdanAH [1] ||98|| <br /> <br /> kShaNe kShaNe prayoktavyAH pUrvamuddhRutya lepanam| <br /> <br /> adhAvanoddhRute pUrve pradehA bahusho~aghanAH||99|| <br /> <br /> deyAH pradehAH kaphaje paryAdhAnoddhRute ghanAH| <br /> <br /> tribhAgA~gguShThamAtraH syAt pralepaH kalkapeShitaH||100|| <br /> <br /> nAtisnigdho na rūkṣashca na piNDo na dravaH samaH| <br /> <br /> na ca paryuShitaM lepaM kadAcidavacArayet||101|| <br /> <br /> na ca tenaiva lepena punarjAtu pralepayet| <br /> <br /> kledavIsarpashUlAni soShNAbhAvAt pravartayet||102|| <br /> <br /> lepo hyupari paTTasya kRutaH svedayati vraNam| <br /> <br /> svedajAH piDakAstasya kaNDUshcaivopajAyate||103|| <br /> <br /> uparyupari lepasya lepo yadyavacAryate| <br /> <br /> tAneva dōṣa~jjanayet paTTasyopari yAn kRutaH||104|| <br /> <br /> atisnigdho~atidravashca lepo yadyavacAryate| <br /> <br /> tvaci na shliShyate samya~gna dōṣaM shamayatyapi||105|| <br /> <br /> tanvAliptaM na kurvIta saMshuShko hyApuTAyate| <br /> <br /> na cauShadhiraso vyAdhiM prApnotyapi ca shuShyati||106|| <br /> <br /> tanvAliptena ye dōṣastAneva janayedbhRusham| <br /> <br /> saMshuShkaH pIDayedvyAdhiM niHsneho hyavacAritaH||107|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> These ''lepa'' (local applications of pastes) are to be used repeatedly after removing the previous applied ''lepa''.<br /> <br /> Thin ''predeha'' should be applied as thick paste repeatedly after removing the previous one, but without washing it. <br /> <br /> In [[kapha]]ja visarpa, pradeha should be repeatedly applied as thick paste after removing the previous dried paste.<br /> <br /> The ''pralepa'' should be prepared as ''kalka'' (micronized paste) and applied of thickness equal to one third of the thumb. <br /> <br /> A ''pralepa'' should be neither too unctuous nor too dry, neither too solid nor too liquid, but of the right consistency. <br /> <br /> The stale ''lepa'' should never be used for application; the previously used ''lepa'' should not be used again for application, because it causes accumulation of heat leading to ''kleda'' (putrification), ''visarpa'' (spread of disease) and pain.<br /> <br /> The ''pralepa'' smeared over a piece of cloth, and that cloth is used for application on wound, it sudates the wound and consequently ''swedaja pidaka'' (boils) and itching are induced. <br /> <br /> If the ''pralepa'' is applied without removing the previous ''pralepa'', it produces same adverse effects as those mentioned above in the case of applications over the bandage. <br /> <br /> The ''pralepa'' applied externally that is either too unctuous or too fluid does not adhere properly and therefore cannot alleviate the diseased condition. <br /> <br /> Thin ''lepa'' should not be applied because while drying develops cracks and medicinal property of ''lepa'' does not penetrates properly in the affected part as it dries up quickly.<br /> <br /> If the ''pralepa'' is applied without mixing ghee, it produces same but in excess adverse effects as described for thin ''pralepa''. While getting dried up this ''pralepa'' leads to aggravation of disease manifestation. [99-107]<br /> <br /> === Diet recipes for treatment of ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अन्नपानानि वक्ष्यामि विसर्पाणां निवृत्तये | <br /> <br /> लङ्घितेभ्यो हितो मन्थो रूक्षः सक्षौद्रशर्करः ||१०८|| <br /> <br /> मधुरः किञ्चिदम्लो वा दाडिमामलकान्वितः | <br /> <br /> सपरूषकमृद्वीकः सखर्जूरः शृताम्बुना ||१०९|| <br /> <br /> तर्पणैर्यवशालीनां सस्नेहा चावलेहिका | <br /> <br /> जीर्णे पुराणशालीनां यूषैर्भुञ्जीत भोजनम् ||११०|| <br /> <br /> मुद्गान्मसूरांश्चणकान् यूषार्थमुपकल्पयेत् | <br /> <br /> अनम्लान् दाडिमाम्लान् वा पटोलामलकैः सह ||१११|| <br /> <br /> जाङ्गलानां च मांसानां रसांस्तस्योपकल्पयेत् | <br /> <br /> रूक्षान् परूषकद्राक्षादाडिमामलकान्वितान् ||११२|| <br /> <br /> रक्ताः श्वेता महाह्वाश्च शालयः षष्टिकैः सह | <br /> <br /> भोजनार्थे प्रशस्यन्ते पुराणाः सुपरिस्रुताः ||११३|| <br /> <br /> यवगोधूमशालीनां सात्म्यान्येव प्रदापयेत् | <br /> <br /> येषां नात्युचितः शालिर्नरा ये च कफाधिकाः ||११४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> annapānāni vakṣyāmi visarpāṇāṁ nivr̥ttayē| <br /> <br /> laṅghitēbhyō hitō manthō rūkṣaḥ sakṣaudraśarkaraḥ||108|| <br /> <br /> madhuraḥ kiñcidamlō vā dāḍimāmalakānvitaḥ| <br /> <br /> saparūṣakamr̥dvīkaḥ sakharjūraḥ śr̥tāmbunā||109|| <br /> <br /> tarpaṇairyavaśālīnāṁ sasnēhā cāvalēhikā| <br /> <br /> jīrṇē purāṇaśālīnāṁ yūṣairbhuñjīta bhōjanam||110|| <br /> <br /> mudgānmasūrāṁścaṇakān yūṣārthamupakalpayēt| <br /> <br /> anamlān dāḍimāmlān vā paṭōlāmalakaiḥ saha||111|| <br /> <br /> jāṅgalānāṁ ca māṁsānāṁ rasāṁstasyōpakalpayēt| <br /> <br /> rūkṣān parūṣakadrākṣādāḍimāmalakānvitān||112|| <br /> <br /> raktāḥ śvētā mahāhvāśca śālayaḥ ṣaṣṭikaiḥ saha| <br /> <br /> bhōjanārthē praśasyantē purāṇāḥ suparisrutāḥ||113|| <br /> <br /> yavagōdhūmaśālīnāṁ sātmyānyēva pradāpayēt| <br /> <br /> yēṣāṁ nātyucitaḥ śālirnarā yē ca kaphādhikāḥ||114|| <br /> <br /> annapAnAni vakShyAmi visarpANAM nivRuttaye| <br /> <br /> la~gghitebhyo hito mantho rūkṣaH sakShaudrasharkaraH||108|| <br /> <br /> madhuraH ki~jcidamlo vA dADimAmalakAnvitaH| <br /> <br /> saparUShakamRudvIkaH sakharjUraH shRutAmbunA||109|| <br /> <br /> tarpaNairyavashAlInAM sasnehA cAvalehikA| <br /> <br /> jIrNe purANashAlInAM yUShairbhu~jjIta bhojanam||110|| <br /> <br /> mudgAnmasUrAMshcaNakAn yUShArthamupakalpayet| <br /> <br /> anamlAn dADimAmlAn vA patōlamalakaiH saha||111|| <br /> <br /> jA~ggalAnAM ca mAMsAnAM rasAMstasyopakalpayet| <br /> <br /> rūkṣan parUShakadrAkShAdADimAmalakAnvitAn||112|| <br /> <br /> raktAH shvetA mahAhvAshca shAlayaH ShaShTikaiH saha| <br /> <br /> bhojanArthe prashasyante purANAH suparisrutAH||113|| <br /> <br /> yavagodhUmashAlInAM sAtmyAnyeva pradApayet| <br /> <br /> yeShAM nAtyucitaH shAlirnarA ye ca kaphAdhikAH||114|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The diet regimen helps to alleviate ''visarpa'' is described here after.<br /> <br /> In the beginning [[langhana]] (fasting therapy) should be given. There after use of ''mantha'' (roasted flour mixed with water in specific proportion and kept for specific time) is beneficial. The ''mantha'' should be without unctus ingredients and added with honey and sugar. It becomes sweet sour in taste due to mixing of ''dadima'' (Punica granatum Linn.) or ''amalaki'' (Emblica officinalis) and ''parushaka'' or ''mrdvika'' (Vitis vinifera Linn) or ''kharjura'' (Phoenix sylvestris) and boiled water should be used to prepare ''mantha''. <br /> <br /> Thereafter linctus made of the flour of roasted barley and ''shali'' rice and mixed with ghee should be given in the form of ''avalehika''. After digestion of ''avalehika'', one should take old ''shali'' rice with soup of green gram or lentils or Bengal gram, soured or not soured with pomegranates and added with ''patola'' (Trichosanthes dioica Roxb) and ''amalaki''. He may also take meat soup of wild animals without ghee and added with ''parushaka'' or ''draksha'' or ''dadima'' or ''amalaki''. Red or white or extra long variety of ''shastika'' rice, which are old, well boiled and residual water should be completely drained, it is beneficial food. <br /> <br /> The persons who have predominance of [[kapha]] and not suited to rice should be given the preparation of barley or wheat or ''purana shali'' which is suitable.[108-114]<br /> <br /> === Contra-indications in ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विदाहीन्यन्नपानानि विरुद्धं स्वपनं दिवा | <br /> <br /> क्रोधव्यायामसूर्याग्निप्रवातांश्च विवर्जयेत् ||११५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vidāhīnyannapānāni viruddhaṁ svapanaṁ divā| <br /> <br /> krōdhavyāyāmasūryāgnipravātāṁśca vivarjayēt||115|| <br /> <br /> vidAhInyannapAnAni viruddhaM svapanaM divA| <br /> <br /> krodhavyAyAmasUryAgnipravātaMshca vivarjayet||115|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient should avoid the ''vidahi'' (that causes burning) and ''viruddha'' (mutually contradictory or incompatible) diet, day sleep, anger, exercise, exposure to sun heat, fire and fast winds.[115]<br /> <br /> === General guidelines of treatment ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कुर्याच्चिकित्सितादस्माच्छीतप्रायाणि पैत्तिके | <br /> <br /> रूक्षप्रायाणि कफजे स्नैहिकान्यनिलात्मके ||११६||<br /> <br /> वातपित्तप्रशमनमग्निवीसर्पणे हितम् | <br /> <br /> कफपित्तप्रशमनं प्रायः कर्दमसञ्ज्ञिते ||११७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kuryāccikitsitādasmācchītaprāyāṇi paittikē| <br /> <br /> rūkṣaprāyāṇi kaphajē snaihikānyanilātmakē||116|| <br /> <br /> vātapittapraśamanamagnivīsarpaṇē hitam| <br /> <br /> kaphapittapraśamanaṁ prāyaḥ kardamasañjñitē||117||<br /> <br /> kuryAccikitsitAdasmAcchItaprAyANi paittike| <br /> <br /> rūkṣaprAyANi kaphaje snaihikAnyanilAtmake||116|| <br /> <br /> vātapittaprashamanamagnivIsarpaNe hitam| <br /> <br /> kaphapittaprashamanaM prAyaH kardamasa~jj~jite||117||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Of these measures, predominantly ''sheeta'' (cool) measures are prescribed in [[pitta]] dominant condition, ''ruksha'' in [[kapha]] dominant condition and ''snigdha'' in [[vata]] dominant condition of ''visarpa''.<br /> <br /> In agni visarpa, [[vata]]-[[pitta]] pacifying measures are beneficial and in ''kardama visarpa'' mostly [[kapha]] [[pitta]] alleviating measures should be administered.[116-117]<br /> <br /> === Treatment of ''granthi visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रक्तपित्तोत्तरं दृष्ट्वा ग्रन्थिवीसर्पमादितः | <br /> <br /> रूक्षणैर्लङ्घनैः सेकैः प्रदेहैः पाञ्चवल्कलैः ||११८|| <br /> <br /> सिरामोक्षैर्जलौकोभिर्वमनैः सविरेचनैः | <br /> <br /> घृतैः कषायतिक्तैश्च कालज्ञः समुपाचरेत् ||११९||<br /> <br /> ऊर्ध्वं चाधश्च शुद्धाय रक्ते चाप्यवसेचिते | <br /> <br /> वातश्लेष्महरं कर्म ग्रन्थिवीसर्पिणे हितम् ||१२०||<br /> <br /> उत्कारिकाभिरुष्णाभिरुपनाहःप्रशस्यते| <br /> <br /> स्निग्धाभिर्वेशवारैर्वा ग्रन्थिवीसर्पशूलिनाम् ||१२१|| <br /> <br /> दशमूलोपसिद्धेन तैलेनोष्णेन सेचयेत् |<br /> <br /> कुष्ठतैलेन चोष्णेन पाक्यक्षारयुतेन च ||१२२||<br /> <br /> गोमूत्रैः पत्रनिर्यूहैरुष्णैर्वा परिषेचयेत् | <br /> <br /> सुखोष्णया प्रदिह्याद्वा पिष्टया चाश्वगन्धया ||१२३|| <br /> <br /> शुष्कमूलककल्केन नक्तमालत्वचाऽपि वा | <br /> <br /> बिभीतकत्वचां वाऽपि कल्केनोष्णेन लेपयेत् ||१२४|| <br /> <br /> बलां नागबलां पथ्यां भूर्जग्रन्थिं बिभीतकम् | <br /> <br /> वंशपत्राण्यग्निमन्थं कुर्याद्ग्रन्थिप्रलेपनम् ||१२५|| <br /> <br /> दन्ती चित्रकमूलत्वक् सुधार्कपयसी गुडः | <br /> <br /> भल्लातकास्थि कासीसं लेपो भिन्द्याच्छिलामपि ||१२६|| <br /> <br /> बहिर्मार्गास्थितं ग्रन्थिं किं पुनः कफसम्भवम् | <br /> <br /> दीर्घकालस्थितं ग्रन्थिं भिन्द्याद्वा भेषजैरिमैः ||१२७|| <br /> <br /> मूलकानां कुलत्थानां यूषैः सक्षारदाडिमैः | <br /> <br /> गोधूमान्नैर्यवान्नैर्वा ससीधुमधुशर्करैः ||१२८|| <br /> <br /> सक्षौद्रेर्वारुणीमण्डैर्मातुलुङ्गरसान्वितैः | <br /> <br /> त्रिफलायाः प्रयोगैश्च पिप्पलीक्षौद्रसंयुतैः ||१२९|| <br /> <br /> मुस्तभल्लातशक्तूनां प्रयोगैर्माक्षिकस्य च | <br /> <br /> देवदारुगुडूच्योश्च प्रयोगैर्गिरिजस्य च ||१३०|| <br /> <br /> धूमैर्विरेकैः शिरसः पूर्वोक्तैर्गुल्मभेदनैः | <br /> <br /> अयोलवणपाषाणहेमताम्रप्रपीडनैः ||१३१||<br /> <br /> आभिः क्रियाभिः सिद्धाभिर्विविधाभिर्बली स्थिरः | <br /> <br /> ग्रन्थिः पाषाणकठिनो यदा नैवोपशाम्यति ||१३२|| <br /> <br /> अथास्य दाहः क्षारेण शरैर्हेम्नाऽथ वा हितः | <br /> <br /> पाकिभिः पाचयित्वा वा पाटयित्वा समुद्धरेत् ||१३३|| <br /> <br /> मोक्षयेद्बहुशश्चास्य रक्तमुत्क्लेशमागतम् | <br /> <br /> पुनश्चापहृते रक्ते वातश्लेष्मजिदौषधम् ||१३४|| <br /> <br /> धूमो विरेकः शिरसः स्वेदनं परिमर्दनम् | <br /> <br /> अप्रशाम्यति दोषे च पाचनं वा प्रशस्यते ||१३५|| <br /> <br /> प्रक्लिन्नं दाहपाकाभ्यां भिषक् शोधनरोपणैः | <br /> <br /> बाह्यैश्चाभ्यन्तरैश्चैव व्रणवत् समुपाचरेत् ||१३६||<br /> <br /> कम्पिल्लकं विडङ्गानि दार्वीं कारञ्जकं फलम् | <br /> <br /> पिष्ट्वा तैलं विपक्तव्यं ग्रन्थिव्रणचिकित्सितम् ||१३७|| <br /> <br /> द्विव्रणीयोपदिष्टेन कर्मणा चाप्युपाचरेत् | <br /> <br /> देशकालविभागज्ञो व्रणान् वीसर्पजान् बुधः ||१३८|| <br /> <br /> इति ग्रन्थिविसर्पचिकित्सा | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> raktapittōttaraṁ dr̥ṣṭvā granthivīsarpamāditaḥ| <br /> <br /> rūkṣaṇairlaṅghanaiḥ sēkaiḥ pradēhaiḥ pāñcavalkalaiḥ||118|| <br /> <br /> sirāmōkṣairjalaukōbhirvamanaiḥ savirēcanaiḥ| <br /> <br /> ghr̥taiḥ [1] kaṣāyatiktaiśca kālajñaḥ samupācarēt||119|| <br /> <br /> ūrdhvaṁ cādhaśca śuddhāya raktē cāpyavasēcitē| <br /> <br /> vātaślēṣmaharaṁ karma granthivīsarpiṇē hitam||120|| <br /> <br /> utkārikābhiruṣṇābhirupanāhaḥ praśasyatē| <br /> <br /> snigdhābhirvēśavārairvā granthivīsarpaśūlinām||121|| <br /> <br /> daśamūlōpasiddhēna tailēnōṣṇēna sēcayēt| <br /> <br /> kuṣṭhatailēna cōṣṇēna pākyakṣārayutēna ca||122|| <br /> <br /> gōmūtraiḥ patraniryūhairuṣṇairvā pariṣēcayēt| <br /> <br /> sukhōṣṇayā pradihyādvā piṣṭayā cāśvagandhayā||123|| <br /> <br /> śuṣkamūlakakalkēna naktamālatvacā'pi vā| <br /> <br /> bibhītakatvacāṁ vā'pi [2] kalkēnōṣṇēna lēpayēt||124|| <br /> <br /> balāṁ nāgabalāṁ pathyāṁ bhūrjagranthiṁ bibhītakam| <br /> <br /> vaṁśapatrāṇyagnimanthaṁ kuryādgranthipralēpanam||125|| <br /> <br /> dantī citrakamūlatvak sudhārkapayasī guḍaḥ| <br /> <br /> bhallātakāsthi kāsīsaṁ lēpō bhindyācchilāmapi||126|| <br /> <br /> bahirmārgāsthitaṁ granthiṁ kiṁ punaḥ kaphasambhavam| <br /> <br /> dīrghakālasthitaṁ granthiṁ bhindyādvā bhēṣajairimaiḥ||127|| <br /> <br /> mūlakānāṁ kulatthānāṁ yūṣaiḥ sakṣāradāḍimaiḥ| <br /> <br /> gōdhūmānnairyavānnairvā sasīdhumadhuśarkaraiḥ||128|| <br /> <br /> sakṣaudrairvāruṇīmaṇḍairmātuluṅgarasānvitaiḥ| <br /> <br /> triphalāyāḥ prayōgaiśca pippalīkṣaudrasaṁyutaiḥ||129|| <br /> <br /> mustābhallātaśaktūnāṁ prayōgairmākṣikasya ca| <br /> <br /> dēvadāruguḍūcyōśca prayōgairgirijasya ca||130|| <br /> <br /> dhūmairvirēkaiḥ śirasaḥ pūrvōktairgulmabhēdanaiḥ|<br /> <br /> ayōlavaṇapāṣāṇahēmatāmraprapīḍanaiḥ||131|| <br /> <br /> ābhiḥ kriyābhiḥ siddhābhirvividhābhirbalī sthiraḥ| <br /> <br /> granthiḥ pāṣāṇakaṭhinō yadā naivōpaśāmyati||132|| <br /> <br /> athāsya dāhaḥ kṣārēṇa śarairhēmnā'tha [3] vā hitaḥ| <br /> <br /> pākibhiḥ pācayitvā vā pāṭayitvā samuddharēt||133|| <br /> <br /> mōkṣayēdbahuśaścāsya raktamutklēśamāgatam| <br /> <br /> punaścāpahr̥tē [4] raktē vātaślēṣmajidauṣadham||134|| <br /> <br /> dhūmō virēkaḥ śirasaḥ svēdanaṁ parimardanam| <br /> <br /> apraśāmyati dōṣē ca pācanaṁ [5] vā praśasyatē||135|| <br /> <br /> praklinnaṁ dāhapākābhyāṁ bhiṣak śōdhanarōpaṇaiḥ| <br /> <br /> bāhyaiścābhyantaraiścaiva vraṇavat samupācarēt||136|| <br /> <br /> kampillakaṁ viḍaṅgāni dārvīṁ kārañjakaṁ phalam| <br /> <br /> piṣṭvā tailaṁ vipaktavyaṁ granthivraṇacikitsitam||137|| <br /> <br /> dvivraṇīyōpadiṣṭēna karmaṇā cāpyupācarēt| <br /> <br /> dēśakālavibhāgajñō vraṇān vīsarpajān budhaḥ||138|| <br /> <br /> iti granthivisarpacikitsā| <br /> <br /> raktapittottaraM dRuShTvA granthivIsarpamAditaH| <br /> <br /> rūkṣaNairla~gghanaiH sekaiH pradehaiH pA~jcavalkalaiH||118||<br /> <br /> sirAmokShairjalaukobhirvamanaiH savirecanaiH| <br /> <br /> ghRutaiH [1] kaShAyatiktaishca kAlaj~jaH samupAcaret||119|| <br /> <br /> UrdhvaM cAdhashca shuddhAya rakte cApyavasecite| <br /> <br /> vātashleShmaharaM karma granthivIsarpiNe hitam||120|| <br /> <br /> utkArikAbhiruShNAbhirupanAhaH prashasyate| <br /> <br /> snigdhAbhirveshavArairvA granthivIsarpashUlinAm||121|| <br /> <br /> dashamUlopasiddhena tailenoShNena secayet| <br /> <br /> kuShThatailena coShNena pAkyakShArayutena ca||122|| <br /> <br /> gomUtraiH patraniryUhairuShNairvA pariShecayet| <br /> <br /> sukhoShNayA pradihyAdvA piShTayA cAshvagandhayA||123|| <br /> <br /> shuShkamUlakakalkena naktamAlatvacA~api vA| <br /> <br /> bibhItakatvacAM vA~api [2] kalkenoShNena lepayet||124|| <br /> <br /> balAM nAgabalAM pathyAM bhUrjagranthiM bibhItakam| <br /> <br /> vaMshapatrANyagnimanthaM kuryAdgranthipralepanam||125|| <br /> <br /> dantI citrakamUlatvak sudhArkapayasI guDaH| <br /> <br /> bhallAtakAsthi kAsIsaM lepo bhindyAcchilAmapi||126|| <br /> <br /> bahirmArgAsthitaM granthiM kiM punaH kaphasambhavam| <br /> <br /> dIrghakAlasthitaM granthiM bhindyAdvA bheShajairimaiH||127|| <br /> <br /> mUlakAnAM kulatthAnAM yUShaiH sakShAradADimaiH| <br /> <br /> godhUmAnnairyavAnnairvA sasIdhumadhusharkaraiH||128|| <br /> <br /> sakShaudrairvAruNImaNDairmAtulu~ggarasAnvitaiH| <br /> <br /> triphalAyAH prayōgaishca pippalIkShaudrasaMyutaiH||129|| <br /> <br /> mustābhallAtashaktUnAM prayōgairmAkShikasya ca| <br /> <br /> devadAruguDUcyoshca prayōgairgirijasya ca||130|| <br /> <br /> dhUmairvirekaiH shirasaH pUrvoktairgulmabhedanaiH| <br /> <br /> ayolavaNapAShANahematAmraprapIDanaiH||131|| <br /> <br /> AbhiH kriyAbhiH siddhAbhirvividhAbhirbalI sthiraH| <br /> <br /> granthiH pAShANakaThino yadA naivopashAmyati||132|| <br /> <br /> athAsya dAhaH kShAreNa sharairhemnA~atha [3] vA hitaH| <br /> <br /> pAkibhiH pAcayitvA vA pATayitvA samuddharet||133|| <br /> <br /> mokShayedbahushashcAsya raktamutkleshamAgatam| <br /> <br /> punashcApahRute [4] rakte vātashleShmajidauShadham||134|| <br /> <br /> dhUmo virekaH shirasaH svedanaM parimardanam| <br /> <br /> aprashAmyati doShe ca pAcanaM [5] vA prashasyate||135|| <br /> <br /> praklinnaM dAhapAkAbhyAM bhiShak sōdhanaropaNaiH| <br /> <br /> bAhyaishcAbhyantaraishcaiva vraNavat samupAcaret||136|| <br /> <br /> kampillakaM viDa~ggAni dArvIM kAra~jjakaM phalam| <br /> <br /> piShTvA tailaM vipaktavyaM granthivraNacikitsitam||137|| <br /> <br /> dvivraNIyopadiShTena karmaNA cApyupAcaret| <br /> <br /> deshakAlavibhAgaj~jo vraNAn vIsarpajAn budhaH||138|| <br /> <br /> iti granthivisarpacikitsA| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''granthi visarpa'', on inspection is predominant in [[rakta]] [[pitta]]; the physician experienced in timely management should treat the case with [[rukshana]] (de-oleation), [[langhana]] (lightening therapy), ''seka'' (affusion), and ''pradeha'' (external application) of ''panchavalka, siramoksha'' (blood letting), ''jalauka'' (leech therapy), [[vamana]] (emesis therapy), [[virechana]] (purgation therapy) and ''kashaya- tikta'' (astringent and bitter) ghee preparations. <br /> <br /> After cleansing of body by [[vamana]] and [[virechana]], [[rakta]] mokshana should be administered and the measures alleviating [[vata]]-[[kapha]] are beneficial.<br /> <br /> When there is pain in ''granthi visarpa, upanaha'' (hot poultice) of warm and unctuous ''utkarika'' (medicinal pancake) or ''vesavara'' (medicated meat) application on the affected part is beneficial.<br /> <br /> The warm oil prepared from ''dashamoola'' (roots of ten plants) should be sprinkled on the affected part. Warm ''kustha'' (costus) oil added with ''pakya kshara'' (prepared medicinal alkali) or warm cow’s urine or decoction of [[vata]] [[kapha]]hara leaves should be used as affusion on the affected part.<br /> <br /> The warm paste of ''ashvagandha'' (Withania somnifera) should be applied as ''pradeha'' on the affected part. <br /> <br /> The warm paste of dried ''mulaka'' (Raphanus sativus) or bark of ''naktamala'' (Pongamia pinnata) or bark of ''bibhitaka'' (Terminalia bellirica) should be applied externally as a ''lepa'' on the affected part. ''Bala'' (Sida cordifolia Linn), ''nagabala'' (Grewia hirsuta), ''pathya'' (Terminalia chebula), ''bhurjagranthi'' (betula bhojpatra), ''bibhitaka'' (Terminalia bellirica), ''vamsha'' leaves (bambusa vulgaris) and ''agnimantha'' (Premna mucronata) should be applied as ''pralepa'' on ''granthi''.<br /> <br /> ''Danti'' (Baliospermum montanum), bark of ''chitraka'' root (Plumbago zeylanica Linn), latex of ''snuhi'' (Euphoria nerrifolia) and ''arka'' (Calatropis gigantean), jaggery, seed of ''bhallataka'' (Semecarpus anacardium linn) and ''kasisa'' (green vitriol) application as a ''lepa'' breaks even a stone, then what to speak of the nodules caused by [[kapha]] and situated in external regions of body. Long standing ''granthi'' should be broken by the use of the internal medications such as ''Yusha'' of ''mulaka'' (Raphanus sativus) and ''kullatha'' (Macrotyloma uniflorum.) added with ''kshara'' (prepared alkali) and ''dadima'' (Punica granatum), food prepared from ''godhum'' and ''yava'' with ''sidhu'', honey and sugar, ''varuni'' scum with honey and ''matulung'' juice (Citrus medica), use of ''triphala'' with ''pippali'' (Piper longum linn) and honey, ''musta'' (Cyperus rotundus linn) or ''bhallataka saktu'' (Semecarpus anacardium linn) and honey, ''devadaru'' (Cedrus deodara), ''guduchi'' (Tinospora cordifolia) and ''girija'' (Asphaltum punjabianum).<br /> <br /> ''Dhuma, shirovirechana,'' measures described to break the ''gulma'' in [[Gulma Chikitsa]] chapter, as well as iron, salt, stone, gold and copper should be used for ''prapidana'' (compression) of ''granthi''.<br /> <br /> If ''granthi'' is strong, firm and stony hard and not responding to all these proven methods of treatment then it is better to be cauterized with ''kshara'' (medicinal alkali) or hot metal arrow or hot gold or after making it suppurate by applying suitable suppurative medications one should open and extract. <br /> <br /> Besides, vitiated blood should be eliminated, frequently followed administration of [[vata]] and [[kapha]] pacifying medicines, ''dhuma'' (fumigation therapy), ''shirovechana'' (errhine therapy), [[swedana]](sudation) and ''parimardana'' (pressure method). If [[dosha]] do not pacify, [[pachana]] (suppuration) treatment is beneficial. When the ''granthi'' is decomposed with ''agni'' and suppuration then physician should treat it with external and internal ''shodhana'' (cleansing) and ''ropana'' (healing) as described in ''Vrana Chikitsa''.<br /> <br /> ''Kampillaka'' (Mallotus philippinensis), ''vidanga'' (Embelia ribes Burm), ''daruharidra'' (Berberis aristata) and ''karanja'' fruit (Pongamia pinnata), the paste of all these drugs should be used to prepare oil which is indicated in the treatment of ''granthi vrina''.<br /> <br /> The intelligent physician may also treat the ''visarpa'' as per the guidelines described in [[Dwivraniya Chikitsa]] chapter.<br /> <br /> Thus ends the description of the treatment of ''granthi visarpa''.[118-138]<br /> <br /> === Treatment of ''galaganda'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> य एव विधिरुद्दिष्टो ग्रन्थीनां विनिवृत्तये | <br /> <br /> स एव गलगण्डानां कफजानां निवृत्तये ||१३९|| <br /> <br /> गलगण्डास्तु वातोत्था ये कफानुगता नृणाम् | <br /> <br /> घृतक्षीरकषायाणामभ्यासान्न भवन्ति ते ||१४०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ya ēva vidhiruddiṣṭō granthīnāṁ vinivr̥ttayē| <br /> <br /> sa ēva galagaṇḍānāṁ kaphajānāṁ nivr̥ttayē||139|| <br /> <br /> galagaṇḍāstu vātōtthā yē kaphānugatā [1] nr̥ṇām| <br /> <br /> ghr̥takṣīrakaṣāyāṇāmabhyāsānna bhavanti tē||140|| <br /> <br /> ya eva vidhiruddiShTo granthInAM vinivRuttaye| <br /> <br /> sa eva galagaNDAnAM kaphajAnAM nivRuttaye||139|| <br /> <br /> galagaNDAstu vAtotthA ye kaphAnugatA [1] nRuNAm| <br /> <br /> ghRutakShIrakaShAyANAmabhyAsAnna bhavanti te||140|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The line of treatment of ''granthi'' should be applied for the treatment of [[kapha]]ja galganda''. <br /> <br /> The ''vatika galaganda'' associated with [[kapha]] may be cured by regular use of ghee, milk and decoction preparations.[139-140]<br /> <br /> === Importance of ''raktamokshana'' in ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यानीहोक्तानि कर्माणि विसर्पाणां निवृत्तये | <br /> <br /> एकतस्तानि सर्वाणि रक्तमोक्षणमेकतः ||१४१|| <br /> <br /> विसर्पो न ह्यसंसृष्टो रक्तपित्तेन जायते | <br /> <br /> तस्मात् साधारणं सर्वमुक्तमेतच्चिकित्सितम् ||१४२|| <br /> <br /> विशेषो दोषवैषम्यान्न च नोक्तः समासतः | <br /> <br /> समासव्यासनिर्दिष्टां क्रियां विद्वानुपाचरेत् ||१४३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yānīhōktāni karmāṇi visarpāṇāṁ nivr̥ttayē| <br /> <br /> ēkatastāni sarvāṇi raktamōkṣaṇamēkataḥ||141|| <br /> <br /> visarpō na hyasaṁsr̥ṣṭō raktapittēna jāyatē| <br /> <br /> tasmāt sādhāraṇaṁ sarvamuktamētaccikitsitam||142|| <br /> <br /> viśēṣō dōṣavaiṣamyānna ca nōktaḥ samāsataḥ| <br /> <br /> samāsavyāsanirdiṣṭāṁ [1] kriyāṁ vidvānupācarēt||143|| <br /> <br /> yAnIhoktAni karmANi visarpANAM nivRuttaye| <br /> <br /> ekatastAni sarvANi raktamokShaNamekataH||141|| <br /> <br /> visarpo na hyasaMsRuShTo raktapittena jAyate| <br /> <br /> tasmAt sAdhAraNaM sarvamuktametaccikitsitam||142||<br /> <br /> visheSho dōṣavaiShamyAnna ca noktaH samAsataH| <br /> <br /> samAsavyAsanirdiShTAM [1] kriyAM vidvAnupAcaret||143|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If all the therapeutic measures described here as curative of ''visarpa'' be put on one side and ''raktamokshana'' on other, they will be found equal. <br /> <br /> ''Visarpa'' never occurs without the association of the [[rakta]] and [[pitta]] hence entirely general treatment has been described. It does not mean that line of treatment as per other [[dosha]] predominance is not explained here. Thus, the therapeutic measures both in general and specific cases are described both in brief and in detail. The expert physician should administer these therapies appropriately.[141-143]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकाः- <br /> <br /> निरुक्तं नामभेदाश्च दोषा दूष्याणि हेतवः | <br /> <br /> आश्रयो मार्गतश्चैव विसर्पगुरुलाघवम् ||१४४|| <br /> <br /> लिङ्गान्युपद्रवा ये च यल्लक्षण उपद्रवः | <br /> <br /> साध्यत्वं, न च, साध्यानां साधनं च यथाक्रमम् ||१४५|| <br /> <br /> इति पिप्रक्षवे सिद्धिमग्निवेशाय धीमते | <br /> <br /> पुनर्वसुरुवाचेदं विसर्पाणां चिकित्सितम् ||१४६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkāḥ- <br /> <br /> niruktaṁ nāmabhēdāśca dōṣā dūṣyāṇi hētavaḥ| <br /> <br /> āśrayō mārgataścaiva visarpagurulāghavam||144|| <br /> <br /> liṅgānyupadravā yē ca yallakṣaṇa upadravaḥ| <br /> <br /> sādhyatvaṁ, na ca, sādhyānāṁ sādhanaṁ ca yathākramam||145|| <br /> <br /> iti piprakṣavē siddhimagnivēśāya dhīmatē| <br /> <br /> punarvasuruvācēdaṁ visarpāṇāṁ cikitsitam||146|| <br /> <br /> tatra shlokAH- <br /> <br /> niruktaM nAmabhedAshca dōṣa dUShyANi hetavaH| <br /> <br /> Ashrayo mArgatashcaiva visarpagurulAghavam||144|| <br /> <br /> li~ggAnyupadravA ye ca yallakShaNa upadravaH| <br /> <br /> sAdhyatvaM, na ca, sAdhyAnAM sAdhanaM ca yathAkramam||145|| <br /> <br /> iti piprakShave siddhimagniveshAya dhImate| <br /> <br /> punarvasuruvAcedaM visarpANAM cikitsitam||146||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now the summing up verses –<br /> <br /> Derivation,synonyms, classification, [[dosha]], dushya, etiology, the habitat, the severe and mild gradation, symptoms and signs, complications, the nature of complications, prognosis and treatment of curable ones. All these aspects has been explained by Punarvasu Atreya for the inquisitive and intelligent Agnivesha under the treatment of ''visarpa''. [144-146]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते चिकित्सास्थाने <br /> <br /> विसर्पचिकित्सितं नामैकविंशोऽध्यायः ||२१||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē cikitsāsthānē <br /> <br /> visarpacikitsitaṁ nāmaikaviṁśō'dhyāyaḥ||21|| <br /> <br /> ityagniveshakRute tantre carakapratisaMskRute cikitsAsthAne <br /> <br /> visarpacikitsitaM nAmaikaviMsho~adhyAyaH||21|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus ends the twenty first chapter on treatment of ''visarpa'' in [[Chikitsa Sthana]] in the treatise composed by Agnivesha and redacted by Charak.[21]<br /> <br /> == Tattva Vimarsha (Fundamental Principles) == <br /> <br /> *Seven elements are involved in the pathogenesis of ''visarpa'' viz., [[rakta]], lasika, tvak, [[mamsa dhatu]], [[vata]], [[pitta]] and [[kapha]]. <br /> *''Visarpa'' is acute spreading disease and fatal in nature. General etiological factors of ''visarpa'' are diet and life style related, injury, poisons, toxins, burns etc., some of these cause vitiation of [[dosha]] and ''khavaigunya'' (disease prone condition) in [[dhatu]] and some cause direct vitiation of [[dosha]] and [[dhatu]] leading to ''visarpa''. Hence favorable condition for infection or disease phenomenon occurs at first therefore, diet and lifestyle related factors are important preventive measures.<br /> *Excess intake of salt, sour, pungent, hot articles lead to vitiation of [[rakta]] first and then lead to ''visarpa''. <br /> *''Visarpa'' is manifested externally, internally or in both pathways. Severity of disease increases respectively in these cases. <br /> *Classification and pathogenesis of ''visarpa'' is based upon involvement of [[dosha]] as per their severity. Treatment protocol is designed for primarily involved predominant [[dosha]]. If the ''visarpa'' is caused with ama dosha (the state of incomplete transformation) and is located in ''kaphasthana'' (in thorax and upper body parts), then [[langhana]] (fasting therapy), [[vamana]] (emesis) therapy, ''tikta'' (bitter) drugs internally and application of paste of drugs with dry and cold properties externally is beneficial. <br /> *The same treatment should be adopted in case of association of ''ama'' and location in [[pitta]] sthana (abdomen and middle parts of body). In addition, ''raktamokshana'' (blood letting) and [[virechana]] (therapeutic purgation therapy) are specially indicated. <br /> *If ''sama'' (with ''ama dosha'') ''visarpa'' occurs from ''vatashaya'' (pelvis and lower part of body) dry measures are indicated in the beginning. Even in association with [[rakta]]-[[pitta]], unction measure is not regarded as beneficial in the beginning. <br /> *In [[vata]]ja visarpa and ''paittika visarpa'' of mild aggravated [[dosha]], tiktaka ghritam'' is beneficial. But if the [[pitta]] [[dosha]] is excessively aggravated then [[virechana]] should be given. <br /> *In the condition of excessively aggravated [[dosha]], ghee should not be given at first, which does not cause [[virechana]]. Because non purgating ghee occlude the [[dosha]] resulting in decomposed skin, flesh and blood. Hence in ''visarpa, virechana'' followed by ''raktamokshana'' is recommended because the disorder is located in blood.<br /> *If [[dosha]] in ''shakha'' (body elements) vitiate the blood, then [[rakta]]mokshana should be administered first. The physician should use ''vishana'' (deer horn) in [[vata]] dominance, ''jalauka'' (Hirudinea medicinalis) in [[pitta]] dominance and ''alabu'' (lagenaria siceraria) in [[kapha]] dominance for blood letting or physician should perform ''siravyadha'' (blood letting through vein) promptly from the adjacent vein to the affected part, without which ''rakta kleda'' (putrifying blood content) gives rise to decomposed skin, flesh and ligaments.<br /> *External application in the form of ''pralepa, pradeha'' and ''alepana'' (local applications of pastes) are to be used repeatedly for treatment of external lesions in ''visarpa''. The guidelines shall be followed for local applications. <br /> *Diet articles with sweet, bitter, cooling and blood pacifying properties is prescribed in the treatment of ''visarpa''.<br /> *''Vidahi'' (that causes burning) and ''viruddha'' (mutually contradictory or incompatible) diet, day sleep, anger, exercise, exposure to sun heat, fire and fast winds are contraindicated in ''visarpa''.<br /> *Predominantly ''shita'' (cool) measures are prescribed in [[pitta]] dominant condition, ''ruksha'' in [[kapha]] dominant condition and ''snigdha'' in [[vata]] dominant condition of ''visarpa''. In ''agni visarpa, [[vata]]-[[pitta]] pacifying measures are beneficial and in ''kardama visarpa'' mostly [[kapha]] [[pitta]] alleviating measures should be administered.<br /> *The ''granthi visarpa'', on inspection is predominant in [[rakta]] [[pitta]], the physician experienced in timely management should treat the case with [[rukshana]] (de-oleation), [[langhana]] (lightening therapy), ''seka'' (affusion), and ''pradeha'' (external application) of ''panchavalka, siramoksha'' (blood letting), ''jalauka'' (leech therapy), [[vamana]] (emesis therapy), [[virechana]] (purgation therapy) and ''kashaya- tikta'' (astringent and bitter) ghee preparations. After cleansing of body by [[vamana]] and [[virechana]], [[rakta]] mokshana should be administered and the measures alleviating [[vata]]-[[kapha]] are beneficial.<br /> *The same line of treatment of ''granthi'' should be applied for the treatment of [[kapha]]ja galganda''. The ''vatika galaganda'' associated with [[kapha]] may be cured by regular use of ghee, milk and decoction preparations.<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> <br /> === Causative factors of ''visarpa'' in contemporary era ===<br /> <br /> Modern point of view ''visarpa'' is generally caused by a variety of infections. As per Punarvasu Atreya, the general etiological factors of ''visarpa'' are diet and lifestyle, injury, poisons, toxins, burns etc; some of these cause vitiation of [[dosha]] and ''khavaigunya'' (disease prone condition) in [[dhatu]] and some cause direct vitiation of [[dosha]] and [[dhatu]] leading to ''visarpa''. This is confusing to the new scholars. Atreya's understanding of etiology is more specific because favorable condition for infection occurs at first then infection therefore diet and lifestyle related factors are described in detail and in the beginning. In treatment plan this concept of favorable environment should be considered. Change in internal body environment is possible by ''shodhana'' therapy and ''aushadha'' along with treatment of infection. <br /> <br /> === Pathophysiology of ''Visarpa'' [flow chart] ===<br /> <br /> [[File:Visarpa1.png]]<br /> <br /> <br /> === Common clinical conditions considered under ''visarpa'' ===<br /> <br /> ''Visarpa'' is acute and extensive spreading in nature. As ''kushtha'' is chronic in nature and ''visarpa'' is acute therefore spreading ''kushtha'' should not be interpreted as visarpa. It is observed that ''visarpa'' interpretation to allopath disorders is very confusing to the scholars. It is difficult to label ''visarpa'' as a single entity. For proper interpretation, experienced intelligent expert in emergency treatments is required and diagnostic research in this direction is challenge to the researchers.<br /> <br /> Clinical manifestation of ''vatika visarpa'' suggests ''bahih-srita visarpa'' and generally observed in acute skin infections (erysipelas etc.) and is curable with prompt management. <br /> <br /> ''Paittika visarpa'' symptoms are suggestive of severe skin disease (erysipelas, extensive herpes, burns etc.) and are curable with appropriate management. <br /> <br /> [[Kapha]]ja visarpa appears as progressively but gradually spreading ailment, suggestive of acute skin infection (erysipelas etc.) and is curable. <br /> <br /> ''Agni visarpa'' is a serious infection of skin and lead to septicemia like condition. ''Agnivisarpa'' with the signs and symptoms described here is a serious ailment and is incurable. This ailment may be cured if vitals are not involved. <br /> <br /> The name ''kardam visarpa'' is because the affected part appears like ''kardam'' (mud). The clinical picture of ''kardam'' described here is serious skin infection, necrotizing the adjacent structures (Necrotizing Fasciitis, gangrene etc.) and is incurable. The curable variant should be considered ''agnivisarpa''. <br /> <br /> ''Granthi visarpa'' is a serious ailment (B cell lymphoma etc.) and associated with complications is incurable. <br /> <br /> ''Sannipatik visarpa'' is a very serious manifestation of ''visarpa'' and is ''ubhaya-samsrita''. This is like a very serious manifestation of sepsis and is not treatable. <br /> <br /> === Current clinical practices in management of ''visarpa'' ===<br /> <br /> ==== Experience based ====<br /> <br /> Prognostic assessment of disease is very important while treating acute disorders. Majority of ''visarpa'' cases are having bad prognosis as per experience of Punarvasu Atreya. Even though some cases of curable ''bahihsrita visarpa'' may become incurable and fatal if not treated early and promptly. Quick diagnosis of life threatening conditions and prompt life saving management in intensive care unit is required in ''visarpa'' disorder.<br /> <br /> It is already stated that there are serious diseases which are curable but they cause death if not treated. ''Agni'' and kardam ''visarpa'' are curable only by the most effective therapeutic measures. ''Antahsrita'' and ''ubhaysamsrita visarpa'' are incurable or sometimes may be cured by most experienced, intelligent physician with most appropriate timely approach in intensive care unit. ''Bahihsrita'' curable ''visarpa'' may convert into ''ubhayasamsrita'' if not treated appropriately. <br /> <br /> ''Shodhana'' and ''shamana'' therapy is described for curable ''visarpa'' and maximum ''visarpa'' cases are incurable. This is challenge to the researchers to apply ''shodhana'' and ''shamana'' therapy in incurable emergency cases along with life saving management to cure the incurable ones.<br /> <br /> ==== Evidence based studies ====<br /> <br /> ''Visarpa'' is acute and fatal in nature and maximum [[Ayurveda]] hospitals have limited facilities for emergency managements. Some of clinicians are treating self limiting minor cases of herpes as a ''visarpa'' following the treatment of [[pitta]]ja visarpa. A case study on effect of Ayurvedic management in oro-facial herpes was conducted. The diagnosed case of oro-facial herpes in 72-year-old male patient was treated with medicines of bitter taste (tikta rasa) internally, diet regimen, anulomana variety of therapeutic purgation (virechana) and topical application of cold (sheeta)-dry(ruksha) medicines(lepa). The case is observed symptom free after a total period of 164 days.&lt;ref&gt;Mutnali K, Roopa BJ, Shivaprasad T, Yadav R. Ayurveda management of oro-facial herpes: a case report. J Ayurveda Integr Med. 2020 Jul-Sep;11(3):357-359. doi: 10.1016/j.jaim.2020.06.003. Epub 2020 Aug 4. PMID: 32768346; PMCID: PMC7527852.&lt;/ref&gt;<br /> <br /> === Researches done on ''visarpa'' ===<br /> <br /> Considerable research work is not carried out on ''visarpa'' by [[Ayurveda]] researchers. This is due to acute and fatal nature of this disease and [[Ayurveda]] research centers are not well equipped for emergency managements. Hence it is necessary to work in the direction to treat such incurable fatal condition. Initially research work on this disease may be carried out in collaboration with well equipped intensive care unit and experts in emergency managements. Researchers may work by combining algorithmic [[Ayurveda]] treatment with allopath. Incurable and fatal cases of ''visarpa'' experienced by Punarvasu Atreya may be cured with early appropriate management in intensive care unit due to advances in drug research and technology. <br /> <br /> === Further reading ===<br /> <br /> #Charak, Chikitsa Sthana, chap 21 Visarpa Chikitsa Adhyaya. In:Vaidya Yadavaji Trikamji Aacharya, Editor, Charak samhita, 2nd edition, Varanasi;Chaukhamba Sanskrit Sansthan,1990;228.<br /> #Chakrapani,Charak,Chikitsa Sthana, Chap 21 Visarpa Chikitsa Adhyaya, 2nd edition,Varanasi; Chaukhamba Sanskrit Sansthan, 1990; 225.<br /> #Charak,Cikitsa Sthana,Chap 21 Visarpa Cikitsitam. In: Pt. Dutta R, editor. Charak Samhita, 2nd ed., 2003 reprint, Varanasi: Chaukhambha Bharti Academy; 2003. p. 231. <br /> #Charak,Chikitsa Sthana, Chap 21 Visarpa Chikitsa Adhyaya,In:Kashiram Shastri and Gorakhnath Chaturvedi, editors. Charak Samhita,(Hindi traslation) Part II. Varanasi: Chaukhambha Bharati Academy; Reprint 2005. p. 235. <br /> #Charak, Chikitsa Sthana, Visarpa Cikitsitam,21, In: Vd. Khushvaha HS,editors,Charak Samhita Ayushi hindi commentary, 1 st edition, Chaukhambha Orientalia Publisher, Varanasi, 2009;224. <br /> #Chakrapani, Charak, Cikitsa Sthana, Chap 21 Visarpa Cikitsitam. In: Vd. Yadavaji T. A.,Editor, Charak Samhita, 1 st edition, Varanasi;Chaukhambha Orientalia Publications, 2001;227. <br /> #Sushruta. Cikitsa Sthana, 17. Visarpanadisthanaroga Chikitsitam Adhyaya In: Vaidya Yadavji Trikamji Acharaya, Narayan Ram Acharaya, editors. Sushruta Samhita,?ed, Varanasi: Chaukhambha Orientalia; 2007. p. 321. <br /> #Susruta, Nidana sthana,cha 10, Visarpanadisthanaroga Nidana In:Kaviraj Ambikadutt Shastri,editor, Sushruta Samhita, 11 th ed. Varanasi: Chaukhambha Sanskrit Sansthan; 1998. p. 129. <br /> #Vagbhata, Ashtanga Sangraha, Cikitsa Sthana, 20,Visarpa chikitsitam Adhyaya. translated to English by Prof. Murthy KR, 9 th edition,Varanasi; Chaukhambha Orientalia Publisher,2005;229. <br /> #Vagbhata, Ashtanga Sangraha, Nidana Sthana, 13, Pandurogakamalasophavisarpa Nidanam Adhyaya. translated to English by Prof. Murthy KR, 9 th edition, Varanasi,Chaukhambha Orientalia Publisher, 2005; 229. <br /> #Vagbhata, Ashtanga Hridyam ,Cikitsa Sthana,18. Visarpa chikitsitam Adhyaya .Translated to English by Prof. K.R. Shrikanth Murthy, 7 th ed., Vol. 1. Varanasi: Chaukhambha Krishnadas Academy; 2010. p. 221. <br /> #Vagbhata,Ashtanga Hridyam , Nidana Sthana, Chap 13 Pandurogasophavisarpa Nidana.Translated by Prof. K.R. Shrikanth Murthy, 7 th ed., Vol. 1. Varanasi: Chaukhambha Krishnadas Academy; 2010. p. 221. &lt;/div&gt;<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References == <br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Visarpa_Chikitsa&diff=45389 2025-11-18T04:28:54Z

<p>Agnivesha: /* Introduction */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Visarpa Chikitsa<br /> |titlemode=append<br /> |keywords=Visarpa, Parisarpa, Erysepalas, Gangrene, Septicaemia, Sepsis, Fulminant spreading skin infections,Ayurveda, Indian system of medicine, charak samhita. <br /> |description=Chikitsa Sthana Chapter 21. Management of Visarpa (acute spreading erysepalas)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 21. Management of Visarpa (acute spreading erysepalas)&lt;/big&gt;'''<br /> {{Infobox<br /> |title = Visarpa Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 21<br /> |label2 = Preceding Chapter<br /> |data2 = [[Chhardi Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Trishna Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Kendre M.<br /> |label7 = Reviewer <br /> |data7 = Ojha S.N.<br /> |label8 = Editors <br /> |data8 = Ojha S.N., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.022 10.47468/CSNE.2020.e01.s06.022]<br /> }}<br /> &lt;big&gt;'''Abstract &lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;This chapter deals with detailed description of etiopathogenesis, classification and management principles of ''visarpa''. This is acute disease with a quick spread involving mainly skin, blood, lymph and muscle tissue due to vitiation of all three [[dosha]]. Disease is clinically presented in three pathways viz. external, internal and both. Based on the involvement of dominant [[dosha]], it is classified into seven types. Prognosis and treatment duration of disease is proportionate to degree of involvement of [[dosha]] and affected internal organs. As the basic nature of disease is [[rakta]] and [[pitta]] dominant, management is focused on body purification treatments especially therapeutic purgation, blood letting, fasting therapy, medicated ghee, use of bitter drugs and various external applications having soothing and cooling effect. Guidelines for external application in the form of ''pralepa, pradeha'' and ''alepa'' are enlisted in the chapter. Blood letting is emphasized as most important treatment in ''visarpa''. <br /> &lt;br/&gt;<br /> '''Keywords''': ''Visarpa, Parisarpa,'' Erysepalas, Gangrene, Septicaemia, Sepsis, Fulminant spreading skin infections.<br /> &lt;/p&gt;<br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> The twenty first chapter is named [[Visarpa Chikitsa]]. The term ''visarpa'' has two parts viz., ''vi'' and ''sarpa''- ''vi'' stands for ''vividha'' meaning ‘various’ (ways) and ''sarpa'' stands for ''sarpan'' means ‘spreading’. Erythematous, pustular, glandular etc. lesions which spread rapidly in localized or generalized pattern are known as ''visarpa'' [ Cha.Sa. [[Chikitsa Sthana]] 21/11, Chakrapani]. This aliment is also called ''parisarpa''. The prefix ''pari'' stands for ''paritah'' or ''sarvatah'' meaning all over. The disease which spreads all over the body is called ''visarpa''. [Cha. Sa.[[ Chikitsa Sthana]] 21/11, Chakrapani]. This indicates that ''visarpa'' is an umbrella term used for acute spreading disorders caused due to vitiation of [[rakta]]. <br /> <br /> In this chapter Atreya answers the queries about ''visarpa'' derivation, synonyms, classification, [[dosha]], dushya,etiology, habitat, gradation, symptoms, complications, prognosis and treatment of curable ones. The chapter follows that of [Cha. Sa. [[Chhardi Chikitsa|Chhardi]] Chikitsa ] because suppression of chhardi (vomiting) causes [[Rakta dhatu|rakta]] dushti(vitiation of blood) leading to visarpa indicating that [[Rakta dhatu|rakta]] (blood) vitiating factors and vitiation of rakta is an important basic underlying phenomenon prior to the visarpa.<br /> <br /> ''Visarpa'' is acute, spreading and fatal in nature leading to death if not treated promptly. On location basis this is classified into ''bahih-shrita'' (externally situated), ''antah-shrita'' (internally situated) and ''ubhayasam shrita'' (all over situated). ''Bahih-shrita visarpa'' is fulminant, spreading skin and flesh infection with symptoms and signs of inflammatory edema, blisters, ulcers, fever, pain etc. and is curable. ''Antah-shrita visarpa'' involves internal vital organs with mild septicaemia and is curable before complications. ''Ubhayasamshrita visarpa'' has advanced manifestations of both types spreading all over body with severe septicaemia and is fatal.<br /> <br /> ''Visarpa'' never occurs without association of [[rakta]] and [[pitta]], hence general treatment of ''visarpa'' is described by considering [[rakta]] and [[pitta]] vitiation. Specific treatments are described by considering particular [[dosha]] involvement. <br /> Various etiological factors of ''visarpa'' are diet, life style, injury, poison, toxin, burn etc. vitiates [[rakta]] as well as [[dosha]] ([[vata]], [[pitta]] and [[kapha]]) and other [[dhatu]] (body elements) leading to fulminant disease requiring urgent medical care.<br /> <br /> Seven components are involved in the pathogenesis of ''visarpa'' viz., [[rakta]] (blood), ''lasika'' (lymph), ''tvak'' (skin), [[mamsa dhatu]] (flesh), [[vata]], [[pitta'' and ''kapha''. Same components are associated with ''kushtha'' (various skin disorders) but clinical presentation of both the diseases is different because etiological factors act different. As ''kushtha'' is chronic in nature and ''visarpa'' is acute in nature[Cha. Sa. [[Chikitsa Sthana]] 21/15,Chakrapani] therefore spreading ''kushtha'' should not be interpreted as ''visarpa''. <br /> <br /> It is also classified into ''vatika, paittika, slaishmika, agni visarpa, kardam visarpa, granthi visarpa'' and ''sannipatik'' on [[dosha]] basis. ''Bahih-shrita visarpa'' involves exterior part i.e. Skin, flesh, etc. of the body having symptoms like inflammatory oedema, blisters, ulcers, fever, pain etc. and is curable. ''Agni visarpa'' and ''kardam visarpa'' may be cured with appropriate timely management otherwise negligence leads to death of the patient. ''Granthi visarpa'' should be treated before complications otherwise it becomes incurable. ''Sannipatika visarpa'' is a severe manifestation of the disease leading to death.[Cha. Sa. [[Chikitsa Sthana]] 21/42] <br /> <br /> In ''visarpa, shodhana'' therapy has given prime importance because ''rakta kleda'' (putrificatory ingredient) and [[dosha]] vitiation is at higher level hence ''samana'' (pacification) therapy is not very effective. ''Visarpa'' never occurs without association of [[rakta]] and [[pitta]]. Hence general treatment of ''visarpa'' is described by considering [[rakta]] and [[pitta]] vitiation. Specific treatments are described as per the involvement of [[dosha]]. Single ''raktamokshana'' (blood letting) treatment is equal to all of other treatments described for ''visarpa''. [Cha. Sa. [[Chikitsa Sthana]] 21/141-143]. <br /> <br /> ''Kshataja visarpa'' is another variety mentioned additionally in Sushruta Samhita. The later texts followed the same description with addition of some medications.<br /> &lt;/div&gt;<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातो विसर्पचिकित्सितं व्याख्यास्यामः ||१||<br /> <br /> इति ह स्माह भगवानात्रेयः ||२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātō visarpacikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2|| <br /> <br /> athAto visarpacikitsitaM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> Now we shall expound the chapter &quot;Visarpa Chikitsa&quot; (Management of acute spreading erysepalas). Thus said Lord Atreya. [1-2] <br /> <br /> === Agnivesha’s queries on ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कैलासे किन्नराकीर्णे बहुप्रस्रवणौषधे | <br /> <br /> पादपैर्विविधैः स्निग्धैर्नित्यं कुसुमसम्पदा ||३|| <br /> <br /> वमद्भिर्मधुरान् गन्धान् सर्वतः स्वभ्यलङ्कृते | <br /> <br /> विहरन्तं जितात्मानमात्रेयमृषिवन्दितम् ||४|| <br /> <br /> महर्षिभिः परिवृतं सर्वभूतहिते रतम् | <br /> <br /> अग्निवेशो गुरुं काले विनयादिदमुक्तवान् ||५|| <br /> <br /> भगवन्! दारुणं रोगमाशीविषविषोपमम् | <br /> <br /> विसर्पन्तं शरीरेषु देहिनामुपलक्षये ||६|| <br /> <br /> सहसैव नरास्तेन परीताः शीघ्रकारिणा | <br /> <br /> विनश्यन्त्यनुपक्रान्तास्तत्र नः संशयो महान् ||७|| <br /> <br /> स नाम्ना केन विज्ञेयः सञ्ज्ञितः केन हेतुना | <br /> <br /> कतिभेदः कियद्धातुः किन्निदानः किमाश्रयः ||८|| <br /> <br /> सुखसाध्यः कृच्छ्रसाध्यो ज्ञेयो यश्चानुपक्रमः | <br /> <br /> कथं कैर्लक्षणैः किं च भगवन्! तस्य भेषजम् ||९|| <br /> <br /> तदग्निवेशस्य वचः श्रुत्वाऽऽत्रेयः पुनर्वसुः | <br /> <br /> यथावदखिलं सर्वं प्रोवाच मुनिसत्तमः ||१०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kailāsē kinnarākīrṇē bahuprasravaṇauṣadhē| <br /> <br /> pādapairvividhaiḥ snigdhairnityaṁ kusumasampadā||3|| <br /> <br /> vamadbhirmadhurān gandhān sarvātaḥ svabhyalaṅkr̥tē| <br /> <br /> viharantaṁ jitātmānamātrēyamr̥ṣivanditam||4|| <br /> <br /> maharṣibhiḥ parivr̥taṁ sarvabhūtahitē ratam| <br /> <br /> agnivēśō guruṁ kālē vinayādidamuktavān||5|| <br /> <br /> bhagavan! dāruṇaṁ rōgamāśīviṣaviṣōpamam| <br /> <br /> visarpantaṁ śarīrēṣu dēhināmupalakṣayē||6|| <br /> <br /> sahasaiva narāstēna parītāḥ śīghrakāriṇā| <br /> <br /> vinaśyantyanupakrāntāstatra naḥ saṁśayō mahān||7|| <br /> <br /> sa nāmnā kēna vijñēyaḥ sañjñitaḥ kēna hētunā| <br /> <br /> katibhēdaḥ kiyaddhātuḥ kinnidānaḥ kimāśrayaḥ||8|| <br /> <br /> sukhasādhyaḥ kr̥cchrasādhyō jñēyō yaścānupakramaḥ| <br /> <br /> kathaṁ kairlakṣaṇaiḥ kiṁ ca bhagavan! tasya bhēṣajam||9|| <br /> <br /> tadagnivēśasya vacaḥ śrutvā''trēyaḥ punarvasuḥ| <br /> <br /> yathāvadakhilaṁ sarvaṁ prōvāca munisattamaḥ||10||<br /> <br /> kailAse kinnarAkIrNe bahuprasravaNauShadhe| <br /> <br /> pAdapairvividhaiH snigdhairnityaM kusumasampadA||3||<br /> <br /> vamadbhirmadhurAn gandhAn sarvātaH svabhyala~gkRute| <br /> <br /> viharantaM jitAtmAnamAtreyamRuShivanditam||4|| <br /> <br /> maharShibhiH parivRutaM sarvabhUtahite ratam| <br /> <br /> agnivesho guruM kAle vinayAdidamuktavAn||5|| <br /> <br /> bhagavan! dAruNaM rōgamAshIviShaviShopamam| <br /> <br /> visarpantaM sharIreShu dehinAmupalakShaye||6|| <br /> <br /> sahasaiva narAstena parItAH shIghrakAriNA| <br /> <br /> vinashyantyanupakrAntAstatra naH saMshayo mahAn||7|| <br /> <br /> sa nAmnA kena vij~jeyaH sa~jj~jitaH kena hetunA| <br /> <br /> katibhedaH kiyaddhātuH kinnidAnaH kimAshrayaH||8|| <br /> <br /> sukhasAdhyaH kRucchrasAdhyo j~jeyo yashcAnupakramaH| <br /> <br /> kathaM kairlakShaNaiH kiM ca bhagavan! tasya bheShajam||9|| <br /> <br /> tadagniveshasya vacaH shrutvA~a~atreyaH punarvasuH| <br /> <br /> yathAvadakhilaM sarvaM provAca munisattamaH||10|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In the Kailas region inhabited by ''kinnaras'', having numerous water streams and medicinal plants with ever emitting sweet pleasant (''ishat gandha'') aroma by their wealth of flowers, Atreya who had great self-control, was surrounded by great sages and engaged in welfare of all creatures. Then Agnivesha choosing the appropriate time asked politely to his enlightened teacher, <br /> “Oh Lord, I observe the acute emergency disease in the body of human being which spreads with the virulence of snake-venom. Those human who are afflicted by this acute fulminating disease succumb to death quickly, unless treated promptly. We are in great need of enlightenment concerning this disease. <br /> <br /> By which name should it be known? Why does it derive its name? What are its varieties? Which body elements are involved in its pathogenesis? What is its etiology? Where is its location? How to understand its prognosis i.e. easy curable, difficult to cure and incurable? What are the signs and symptoms of this disease? And O worshipful one! What is the method of its treatment?”<br /> Having heard the queries of Agnivesha, Atreya Punarvasu, the foremost among the sages, explained all the relevant details of the disease ''visarpa''. [3-10]<br /> <br /> === Definition of ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विविधं सर्पति यतो विसर्पस्तेन स स्मृतः | <br /> <br /> परिसर्पोऽथवा नाम्ना सर्वतः परिसर्पणात् ||११||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vividhaṁ sarpati yatō visarpastēna sa smr̥taḥ| <br /> <br /> parisarpō'thavā nāmnā sarvātaḥ parisarpaṇāt||11|| <br /> <br /> vividhaM sarpati yato visarpastena sa smRutaH| <br /> <br /> parisarpo~athavA nAmnA sarvātaH parisarpaNAt||11|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> It spreads in various ways hence known as ''visarpa''. It is also called ''parisarpa'' due to its extensive spreading.[11]<br /> <br /> === Classification ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स च सप्तविधो दोषैर्विज्ञेयः सप्तधातुकः | <br /> <br /> पृथक् त्रयस्त्रिभिश्चैको विसर्पो द्वन्द्वजास्त्रयः ||१२|| <br /> <br /> वातिकः पैत्तिकश्चैव कफजः सान्निपातिकः | <br /> <br /> चत्वार एते विसर्पा वक्ष्यन्ते द्वन्द्वजास्त्रयः ||१३|| <br /> <br /> आग्नेयो वातपित्ताभ्यां ग्रन्थ्याख्यः कफवातजः | <br /> <br /> यस्तु कर्दमको घोरः स पित्तकफसम्भवः ||१४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sa ca saptavidhō dōṣairvijñēyaḥ saptadhātukaḥ| <br /> <br /> pr̥thak trayastribhiścaikō visarpō dvandvajāstrayaḥ||12|| <br /> <br /> vātikaḥ paittikaścaiva kaphajaḥ sānnipātikaḥ| <br /> <br /> catvāra ētē visarpā vakṣyantē dvandvajāstrayaḥ||13|| <br /> <br /> āgnēyō vātapittābhyāṁ granthyākhyaḥ kaphavātajaḥ| <br /> <br /> yastu kardamakō ghōraḥ sa pittakaphasambhavaḥ||14|| <br /> <br /> sa ca saptavidho dōṣairvij~jeyaH saptadhātukaH| <br /> <br /> pRuthak trayastribhishcaiko visarpo dvandvajAstrayaH||12|| <br /> <br /> vAtikaH paittikashcaiva kaphajaH sAnnipAtikaH| <br /> <br /> catvAra ete visarpA vakShyante dvandvajAstrayaH||13|| <br /> <br /> Agneyo vātapittAbhyAM granthyAkhyaH kaphavātajaH| <br /> <br /> yastu kardamako ghoraH sa pittakaphasambhavaH||14|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Visarpa'' is of seven types as per [[dosha]] basis and it involves seven body elements.<br /> <br /> Three types of ''visarpa'' are due to the morbidity of individual [[dosha]]; one variety is due to the morbidity of all the three [[dosha]] and three varieties are due to the morbidity of any of the two [[dosha]]. <br /> <br /> ''Vatika, paittika, kaphaja'' and ''sannipatik'' these are the four varieties of ''visarpa'' and the remaining three varieties viz., [[vata]]-[[pitta]]ja, [[kapha]]-[[vata]]ja and [[pitta]]-[[kapha]]ja type will now be described.<br /> <br /> The variety due to morbid [[vata]]-[[pitta]] is agnivisarpa, [[kapha]]-[[vata]] cause ''granthi visarpa'' and [[pitta]]-[[kapha]] leads to serious condition known as ''kardamaka visarpa''. [12-14]<br /> <br /> === Vitiated factors ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रक्तं लसीकात्वङ्मांसं दूष्यं दोषास्त्रयो मलाः | <br /> <br /> विसर्पाणां समुत्पत्तौ विज्ञेयाः सप्त धातवः ||१५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> raktaṁ lasīkā tvaṅmāṁsaṁ dūṣyaṁ dōṣāstrayō malāḥ| <br /> <br /> visarpāṇāṁ samutpattau vijñēyāḥ sapta dhātavaḥ||15||<br /> <br /> raktaM lasIkA tva~gmAMsaM dUShyaM dōṣastrayo malAH| <br /> <br /> visarpANAM samutpattau vij~jeyAH sapta dhAtavaH||15|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Blood, lymph, skin, flesh and three [[dosha]], these seven elements are involved in the pathogenesis of ''visarpa'' of all kinds. [15]<br /> <br /> === Etiology ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> लवणाम्लकटष्णानां रसानामतिसेवनात् | <br /> <br /> दध्यम्लमस्तुशुक्तानां सुरासौवीरकस्य च ||१६|| <br /> <br /> व्यापन्नबहुमद्योष्णरागषाडवसेवनात् | <br /> <br /> शाकानां हरितानां च सेवनाच्च विदाहिनाम् ||१७|| <br /> <br /> कूर्चिकानां किलाटानां सेवनान्मन्दकस्य च | <br /> <br /> दध्नः शाण्डाकिपूर्वाणामासुतानां च सेवनात् ||१८||<br /> <br /> तिलमाषकुलत्थानां तैलानां पैष्टिकस्य च | <br /> <br /> ग्राम्यानूपौदकानां च मांसानां लशुनस्य च ||१९|| <br /> <br /> प्रक्लिन्नानामसात्म्यानां विरुद्धानां च सेवनात् |<br /> <br /> अत्यादानाद्दिवास्वप्नादजीर्णाध्यशनात् क्षतात् ||२०||<br /> <br /> क्षतबन्धप्रपतनाद्धर्मकर्मातिसेवनात् [१] | <br /> <br /> विषवाताग्निदोषाच्च विसर्पाणां समुद्भवः ||२१|| <br /> <br /> एतैर्निदानैर्व्यामिश्रैः कुपिता मारुतादयः | <br /> <br /> दूष्यान् सन्दूष्य रक्तादीन् विसर्पन्त्यहिताशिनाम् ||२२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> lavaṇāmlakaṭūṣṇānāṁ rasānāmatisēvanāt| <br /> <br /> dadhyamlamastuśuktānāṁ surāsauvīrakasya ca||16|| <br /> <br /> vyāpannabahumadyōṣṇarāgaṣāḍavasēvanāt| <br /> <br /> śākānāṁ haritānāṁ ca sēvanācca vidāhinām||17|| <br /> <br /> kūrcikānāṁ kilāṭānāṁ sēvanānmandakasya ca| <br /> <br /> dadhnaḥ śāṇḍākipūrvāṇāmāsutānāṁ ca sēvanāt||18|| <br /> <br /> tilamāṣakulatthānāṁ tailānāṁ paiṣṭikasya ca| <br /> <br /> grāmyānūpaudakānāṁ ca māṁsānāṁ laśunasya ca||19|| <br /> <br /> praklinnānāmasātmyānāṁ viruddhānāṁ ca sēvanāt| <br /> <br /> atyādānāddivāsvapnādajīrṇādhyaśanāt kṣatāt||20|| <br /> <br /> kṣatabandhaprapatanāddharmakarmātisēvanāt [1] | <br /> <br /> viṣavātāgnidōṣācca visarpāṇāṁ samudbhavaḥ||21|| <br /> <br /> ētairnidānairvyāmiśraiḥ kupitā mārutādayaḥ| <br /> <br /> dūṣyān sandūṣya raktādīn visarpantyahitāśinām||22|| <br /> <br /> lavaNAmlakaTUShNAnAM rasAnAmatisevanAt| <br /> <br /> dadhyamlamastushuktAnAM surAsauvIrakasya ca||16|| <br /> <br /> vyApannabahumadyoShNarAgaShADavasevanAt| <br /> <br /> shAkAnAM haritAnAM ca sevanAcca vidAhinAm||17|| <br /> <br /> kUrcikAnAM kilATAnAM sevanAnmandakasya ca| <br /> <br /> dadhnaH shANDAkipUrvANAmAsutAnAM ca sevanAt||18|| <br /> <br /> tilamAShakulatthAnAM tailAnAM paiShTikasya ca| <br /> <br /> grAmyAnUpaudakAnAM ca mAMsAnAM lashunasya ca||19|| <br /> <br /> praklinnAnAmasAtmyAnAM viruddhAnAM ca sevanAt| <br /> <br /> atyAdAnAddivAsvapnAdajIrNAdhyashanAt kShatAt||20||<br /> <br /> kShatabandhaprapatanAddharmakarmAtisevanAt [1] | <br /> <br /> viShavātagnidōṣacca visarpANAM samudbhavaH||21|| <br /> <br /> etairnidAnairvyAmishraiH kupitA mArutAdayaH| <br /> <br /> dUShyAn sandUShya raktAdIn visarpantyahitAshinAm||22|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The following are the causative factors of the ''visarpa'':<br /> <br /> Excessive indulgence in ''lavana'' (salt), ''amla'' (sour), ''katu'' (pungent) and ''ushna'' (hot ingredients); as also in ''amla dadhi'' (sour curd), ''dadhi mastu'' (whey), ''shukta'' (vinegars), ''sura'' (type of liquor) and ''sauviraka'' (type of wine); the use of ''vyapanna madya'' (contaminated wine) or excessive liquor or heat inducing ''raga'' (condiments) and ''sadava'' (confectionery), the use of ''vidahi'' (causes burning), ''shaka'' (vegetables) and ''harita'' (''lashunadi harita'' group ''dravya''), ''kilata'' (cheese), ''kurchika'' (inspissated milk) and ''mandaka'' (immature curd), the use of ''sandaki'' (fermented wine), as also of ''paistika'' (one made up of ''pistamai padarth'' or pastries) and oils made of sesame, black gram and horse gram, the use of flesh of domesticated, wet land and aquatic animals and garlic, the use of the ''praklinna'' (putrified food), ''asatmya'' (unwholesome) and ''viruddha'' (mutually contradictory ingredients), over eating, sleeping during day time, ''ajirnashana'' (eating during indigestion), ''adhyashana'' (eating food immediately after the meal); ''kshatat'' (traumatic injury), ''kshata'' (wounds), ''bandha'' (ligatures), ''prapatana'' (trauma due to falls) over exposure to sun, strainful work, poisons, poisonous air,burns etc.<br /> <br /> By combination of above mentioned etiological factors, the provoked [[vata]]di [[dosha]] affect the susceptible body elements such as [[rakta]], lasika etc. and spread in the body in those indulged in unwholesome diet. [16-22]<br /> <br /> === Pathways of spreading the disease ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बहिःश्रितः श्रितश्चान्तस्तथा चोभयसंश्रितः | <br /> <br /> विसर्पो बलमेतेषां ज्ञेयं गुरु यथोत्तरम् ||२३|| <br /> <br /> बहिर्मार्गाश्रितं साध्यमसाध्यमुभयाश्रितम् | <br /> <br /> विसर्पं दारुणं विद्यात् सुकृच्छ्रं त्वन्तराश्रयम् ||२४|| <br /> <br /> अन्तःप्रकुपिता दोषा विसर्पन्त्यन्तराश्रये | <br /> <br /> बहिर्बहिःप्रकुपिताः सर्वत्रोभयसंश्रिताः ||२५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bahiḥśritaḥ śritaścāntastathā cōbhayasaṁśritaḥ| <br /> <br /> visarpō balamētēṣāṁ jñēyaṁ guru yathōttaram||23|| <br /> <br /> bahirmārgāśritaṁ sādhyamasādhyamubhayāśritam| <br /> <br /> visarpaṁ dāruṇaṁ vidyāt sukr̥cchraṁ tvantarāśrayam||24|| <br /> <br /> antaḥprakupitā dōṣā visarpantyantarāśrayē| <br /> <br /> bahirbahiḥprakupitāḥ sarvatrōbhayasaṁśritāḥ||25||<br /> <br /> bahiHshritaH shritashcAntastathA cobhayasaMshritaH| <br /> <br /> visarpo balameteShAM j~jeyaM guru yathottaram||23|| <br /> <br /> bahirmArgAshritaM sAdhyamasAdhyamubhayAshritam| <br /> <br /> visarpaM dAruNaM vidyAt sukRucchraM tvantarAshrayam||24|| <br /> <br /> antaHprakupitA dōṣa visarpantyantarAshraye| <br /> <br /> bahirbahiHprakupitAH sarvatrobhayasaMshritAH||25||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Externally situated (pathogenesis in shakha, [[rasa dhatu]]and [[rakta dhatu]]), internally situated (pathogenesis in internal organs and other [[dhatu]]) and situated in both (externally as well as internally) pathways ''visarpa'' is to be known more and more serious consecutively. <br /> <br /> Externally situated ''visarpa'' is curable, internally situated ''visarpa'' is very serious and difficult to cure whereas externally as well as internally situated type is incurable.<br /> <br /> The humors provoked in internal regions spreads internally, if provoked in external regions spreads externally and if provoked in both regions spreads all over the body.[23-25]<br /> <br /> === Causes and features of internal and external ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मर्मोपघातात् सम्मोहादयनानां विघट्टनात् | <br /> <br /> तृष्णातियोगाद्वेगानां विषमाणां प्रवर्तनात् ||२६|| <br /> <br /> विद्याद्विसर्पमन्तर्जमाशु चाग्निबलक्षयात् | <br /> <br /> अतो विपर्ययाद्बाह्यमन्यैर्विद्यात् स्वलक्षणैः ||२७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> marmōpaghātāt sammōhādayanānāṁ vighaṭṭanāt| <br /> <br /> tr̥ṣṇātiyōgādvēgānāṁ viṣamāṇāṁ pravartanāt||26|| <br /> <br /> vidyādvisarpamantarjamāśu cāgnibalakṣayāt| <br /> <br /> atō viparyayādbāhyamanyairvidyāt svalakṣaṇaiḥ||27||<br /> <br /> marmopaghAtAt sammohAdayanAnAM vighaTTanAt| <br /> <br /> tRuShNAtiyōgadvegAnAM viShamANAM pravartanAt||26|| <br /> <br /> vidyAdvisarpamantarjamAshu cAgnibalakShayAt| <br /> <br /> ato viparyayAdbAhyamanyairvidyAt svalakShaNaiH||27||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Affliction of vital organs, impaired consciousness, impaired circulation, morbid thirst and impaired natural urges and sudden reduction in digestive as well as immune power of body is known as ''antah-visarpa''. ''Bahih-visarpa'' should be understood by the external manifestations appearing on skin flesh etc. and by their own specific symptoms. [26-27]<br /> <br /> === Bad prognostic features ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यस्य सर्वाणि लिङ्गानि बलवद्यस्यकारणम् | <br /> <br /> यस्य चोपद्रवाः कष्टा मर्मगो यश्च हन्ति सः ||२८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yasya sarvāṇi liṅgāni balavadyasya kāraṇam| <br /> <br /> yasya cōpadravāḥ kaṣṭā marmagō yaśca hanti saḥ||28|| <br /> <br /> yasya sarvANi li~ggAni balavadyasya kAraNam| <br /> <br /> yasya copadravAH kaShTA marmago yashca hanti saH||28|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Visarpa'' manifesting with all signs and symptoms, having strong etiological factors, which is associated with formidable complications and that situates as well as affects vital parts, proves fatal.[28]<br /> &lt;/div&gt;<br /> === Etio-pathogeneis and clinical features of [[vata]] dominant ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रूक्षोष्णैः केवलो वायुः पूरणैर्वा समावृतः |<br /> <br /> प्रदुष्टो दूषयन् दूष्यान् विसर्पति यथाबलम् ||२९||<br /> <br /> तस्य रूपाणि- भ्रमदवथुपिपासानिस्तोदशूलाङ्गमर्दोद्वेष्टनकम्पज्वरतमककासास्थिसन्धिभेदविश्लेषणवेपनारोचकाविपाकाश्चक्षुषोराकुलत्वमस्रागमनं पिपीलिकासञ्चार इव चाङ्गेषु, यस्मिंश्चावकाशे विसर्पो विसर्पति [१] सोऽवकाशः श्यावारुणाभासः श्वयथुमान् निस्तोदभेदशूलायामसङ्कोचहर्षस्फुरणैरतिमात्रं प्रपीड्यते, अनुपक्रान्तश्चोपचीयते शीघ्रभेदैः स्फोटकैस्तनुभिररुणाभैः श्यावैर्वा तनुविशदारुणाल्पास्रावैः, विबद्धवातमूत्रपुरीषश्च भवति, निदानोक्तानि चास्य नोपशेरते विपरीतानि चोपशेरत इति वातविसर्पः ||३०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rūkṣōṣṇaiḥ kēvalō vāyuḥ pūraṇairvā samāvr̥taḥ| <br /> <br /> praduṣṭō dūṣayan dūṣyān visarpati yathābalam||29|| <br /> <br /> tasya rūpāṇi- bhramadavathupipāsānistōdaśūlāṅgamardōdvēṣṭanakampajvaratamaka-kāsāsthisandhibhēdaviślēṣaṇavēpanārōcakāvipākāścakṣuṣōrākulatvamasrāgamanaṁ pipīlikāsañcāra ivacāṅgēṣu, yasmiṁścāvakāśē visarpō visarpati [1] sō'vakāśaḥ śyāvāruṇābhāsaḥ śvayathumānnistōdabhēdaśūlāyāmasaṅkōcaharṣasphuraṇairatimātraṁ prapīḍyatē, anupakrāntaścōpacīyatēśīghrabhēdaiḥ sphōṭakaistanubhiraruṇābhaiḥ śyāvairvā tanuviśadāruṇālpāsrāvaiḥ,vibaddhavātamūtrapurīṣaśca bhavati, nidānōktāni cāsya nōpaśēratē viparītāni cōpaśērata itivātavisarpaḥ||30||<br /> <br /> rUkShoShNaiH kevalo vAyuH pUraNairvA samAvRutaH| <br /> <br /> praduShTo dUShayan dUShyAn visarpati yathAbalam||29|| <br /> <br /> tasya rUpANi- bhramadavathupipAsAnistodashUlA~ggamardodveShTanakampajvaratamaka-kAsAsthisandhibhedavishleShaNavepanArocakAvipAkAshcakShuShorAkulatvamasrAgamanaMpipIlikAsa~jcAra iva cA~ggeShu, yasmiMshcAvakAshe visarpo visarpati [1] so~avakAshaHshyAvAruNAbhAsaH shvayathumAn nistodabhedashUlAyAmasa~gkocaharShasphuraNairatimAtraMprapIDyate, anupakrAntashcopacIyate shIghrabhedaiH sphoTakaistanubhiraruNAbhaiH shyAvairvātanuvishadAruNAlpAsrAvaiH, vibaddhavātamUtrapurIShashca bhavati, nidAnoktAni cAsya nopasherateviparItAni copasherata iti vātavisarpaH||30||<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> [[Vayu]] aggravated by ununctuous and hot ingredients or by the obstruction due to vitiated [[dosha]], impairs the body elements and spreads in proportion to its strength. <br /> <br /> Its signs and symptoms are giddiness, burning sensation, excessive thirst, pricking sensation, severe pain, body ache, cramps, shivering, fever, feeling of entering in darkness, cough, breaking and splitting pains in the bones and joints, looseness in joints, trembling, anorexia, indigestion, congestion of the eyes, lacrimation and paresthesia; the region where the inflammation is spreading becomes blackish and reddish in color and edematous. The patient suffers from severe pricking, splitting or aching pain in the part affected as also extension and contractions of the parts, horripilation and quivering. If not treated it gives rise to quick bursting small blackish or reddish blisters with thin clear reddish and scanty discharge. The patient also suffers from the retention of flatus, urine and feces. Etiological factors do not suit and the contrary ones suit the patient, this is [[vata]] dominant ''visarpa''. [29-30]<br /> &lt;/div&gt;<br /> === Etio-pathogeneis and clinical features of [[pitta]] dominant ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तमुष्णोपचारेण विदाह्यम्लाशनैश्चितम् | <br /> <br /> दूष्यान् सन्दूष्य धमनीः [१] पूरयन् वै विसर्पति ||३१||<br /> <br /> तस्य रूपाणि- ज्वरस्तृष्णा मूर्च्छा मोहश्छर्दिररोचकोऽङ्गभेदः स्वेदोऽतिमात्रमन्तर्दाहः प्रलापः शिरोरुक् चक्षुषोराकुलत्वमस्वप्नमरतिर्भ्रमः शीतवातवारितर्षोऽतिमात्रं हरितहारिद्रनेत्रमूत्रवर्चस्त्वं हरितहारिद्ररूपदर्शनं च, यस्मिंश्चावकाशे विसर्पोऽनुसर्पति सोऽवकाशस्ताम्रहरितहारिद्रनीलकृष्णरक्तानां वर्णानामन्यतमं पुष्यति, सोत्सेधैश्चातिमात्रं दाहसम्भेदनपरीतैः स्फोटकैरुपचीयते तुल्यवर्णास्रावैश्चिरपाकैश्च, निदानोक्तानि चास्य नोपशेरते विपरीतानि चोपशेरत इति पित्तविसर्पः ||३२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pittamuṣṇōpacārēṇa vidāhyamlāśanaiścitam| <br /> <br /> dūṣyān sandūṣya dhamanīḥ [1] pūrayan vai visarpati||31|| <br /> <br /> tasya rūpāṇi- jvarastr̥ṣṇā mūrcchā mōhaśchardirarōcakō'ṅgabhēdaḥ svēdō'timātramantardāhaḥ pralāpaḥśirōruk cakṣuṣōrākulatvamasvapnamaratirbhramaḥ śītavātavāritarṣō'timātraṁharitahāridranētramūtravarcastvaṁ haritahāridrarūpadarśanaṁ ca, yasmiṁścāvakāśē visarpō'nusarpatisō'vakāśastāmraharitahāridranīlakr̥ṣṇaraktānāṁ varṇānāmanyatamaṁ puṣyati, sōtsēdhaiścātimātraṁdāhasambhēdanaparītaiḥ sphōṭakairupacīyatē tulyavarṇāsrāvaiścirapākaiśca, nidānōktāni cāsyanōpaśēratē viparītāni cōpaśērata iti pittavisarpaḥ||32|| <br /> <br /> pittamuShNopacAreNa vidAhyamlAshanaishcitam| <br /> <br /> dUShyAn sandUShya dhamanIH [1] pUrayan vai visarpati||31|| <br /> <br /> tasya rUpANi- jvarastRuShNA mUrcchA mohashchardirarocako~a~ggabhedaHsvedo~atimAtramantardAhaH pralApaH shiroruk cakShuShorAkulatvamasvapnamaratirbhramaHshItavātavAritarSho~atimAtraM haritahAridranetramUtravarcastvaM haritahAridrarUpadarshanaM ca,yasmiMshcAvakAshe visarpo~anusarpati so~avakAshastAmraharitahAridranIlakRuShNaraktAnAMvarNAnAmanyatamaM puShyati, sotsedhaishcAtimAtraM dAhasambhedanaparItaiH sphoTakairupacIyatetulyavarNAsrAvaishcirapAkaishca, nidAnoktAni cAsya nopasherate viparItAni copasherata itipittavisarpaH||32|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> The [[pitta]] aggravated by the use of hot regimen, by eating irritant and sour foods vitiates the susceptible body elements and by feeling the vessels, begins to spread.<br /> <br /> Its signs and symptoms are fever, morbid thirst, fainting, disturbed consciousness, vomiting, anorexia, breaking body ache, excessive perspiration, burning, delirium, headache, congestion of the eyes, insomnia, restlessness, giddiness, excessive desire for cold air and water. Greenish or yellowish coloration of eyes, urine and feces, objects visualizes green and yellow. In the region where the ''visarpa'' spreads, becomes coppery, greenish, yellowish, bluish, blackish, reddish color. Affected part becomes excessively edematous and full of pustules, having intense burning and tearing pain, suppurating quickly and discharging fluid of similar color.<br /> <br /> The etiological factors do no suit and the contrary ones suit the patient. This is [[pitta]] dominant ''visarpa''. [31-32]<br /> &lt;/div&gt;<br /> === Etio-pathogeneis and clinical features of [[kapha]] dominant ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्वाद्वम्ललवणस्निग्धगुर्वन्नस्वप्नसञ्चितः | <br /> <br /> कफः सन्दूषयन् दूष्यान् कृच्छ्रमङ्गे विसर्पति ||३३|| <br /> <br /> तस्य रूपाणि- शीतकः शीतज्वरो गौरवं निद्रा तन्द्राऽरोचको मधुरास्यत्वमास्योपलेपो निष्ठीविका छर्दिरालस्यं स्तैमित्यमग्निनाशो दौर्बल्यं च, यस्मिंश्चावकाशे विसर्पोऽनुसर्पति सोऽवकाशः श्वयथुमान् पाण्डुर्नातिरक्तः स्नेहसुप्तिस्तम्भगौरवैरन्वितोऽल्पवेदनः कृच्छ्रपाकैश्चिरकारिभिर्बहुलत्वगुपलेपैः स्फोटः श्वेतपाण्डुभिरनुबध्यते, प्रभिन्नस्तु श्वेतं पिच्छिलं तन्तुमद्धनमनुबद्धं स्निग्धमास्रावं स्रवति, ऊर्ध्वं च गुरुभिः स्थिरैर्जालावततैः स्निग्धैर्बहुलत्वगुपलेपैर्व्रणैरनुबध्यतेऽनुषङ्गी च भवति, श्वेतनखनयनवदनत्वङ्मूत्रवर्चस्त्वं, निदानोक्तानि चास्य नोपशेरते विपरीतानि चोपशेरत इति श्लेष्मविसर्पः ||३४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> svādvamlalavaṇasnigdhagurvannasvapnasañcitaḥ| <br /> <br /> kaphaḥ sandūṣayan dūṣyān kr̥cchramaṅgē visarpati||33|| <br /> <br /> tasya rūpāṇi- śītakaḥ śītajvarō gauravaṁ nidrā tandrā'rōcakō madhurāsyatvamāsyōpalēpō niṣṭhīvikāchardirālasyaṁ staimityamagnināśō daurbalyaṁ ca, yasmiṁścāvakāśē visarpō'nusarpati sō'vakāśaḥśvayathumān pāṇḍurnātiraktaḥ snēhasuptistambhagauravairanvitō'lpavēdanaḥkr̥cchrapākaiścirakāribhirbahulatvagupalēpaiḥ sphōṭaḥ śvētapāṇḍubhiranubadhyatē, prabhinnastu śvētaṁpicchilaṁ tantumaddhanamanubaddhaṁ snigdhamāsrāvaṁ sravati, ūrdhvaṁ ca gurubhiḥsthirairjālāvātataiḥ snigdhairbahulatvagupalēpairvraṇairanubadhyatē'nuṣaṅgī ca bhavati,śvētanakhanayanavadanatvaṅmūtravarcastvaṁ, nidānōktāni cāsya nōpaśēratē viparītāni cōpaśērata itiślēṣmavisarpaḥ||34|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> [[Kapha]] excessively accumulated due to intake of sweet, sour, salt, unctuous and heavy foods, and also by excessive sleep, vitiates the susceptible body elements and spreads with slow speed in the body. <br /> <br /> Its signs and symptoms are chills, fever with chills, heaviness, excess sleep, drowsiness, adherence of sticky material in the mouth, excess spitting, vomiting, lassitude, timidity, loss of appetite and prostration. The region where the disease spreads becomes edematous, pallor or slight red, unctuous, numbness, rigidness, heaviness and slight pain. It suppurates hardly and chronic in nature. It is studded with eruptions which are covered with a thick skin and having white pale color. When burst, they discharge white, slimy, fibrinous, dense, sticky and viscid discharge from it. Thereafter it is followed by the ulcers which are heavy, deep seated, surrounded by capillary network, unctuous and covered with many skin scabs. These ulcers are chronic in nature. The nails, eyes, face, skin, urine and faces of the patient appear pale. The etiological factors do no suit and the contrary ones suit the patient. This is [[kapha]]ja visarpa''. [33-34]<br /> &lt;/div&gt;<br /> === Etio-pathogenesis and clinical features of [[vata]]-[[pitta]] dominant ''agni visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वातपित्तं प्रकुपितमतिमात्रं स्वहेतुभिः | <br /> <br /> परस्परं लब्धबलं दहद्गात्रं विसर्पति ||३५|| <br /> <br /> तदुपतापादातुरः सर्वशरीरमङ्गारैरिवाकीर्यमाणं मन्यते, छर्द्यतीसारमूर्च्छादाहमोहज्वरतमकारोचकास्थिसन्धिभेदतृष्णाविपाकाङ्गभेदादिभिश्चाभिभूयते, यं यं चावकाशं विसर्पोऽनुसर्पति सोऽवकाशः शान्ताङ्गारप्रकाशोऽतिरक्तो वा भवति, अग्निदग्धप्रकारैश्च स्फोटैरुपचीयते, स शीघ्रगत्वादाश्वेव मर्मानुसारी भवति, मर्मणि चोपतप्ते पवनोऽतिबलो भिनत्त्यङ्गान्यतिमात्रं प्रमोहयति सञ्ज्ञां, हिक्काश्वासौ जनयति, नाशयति निद्रां, स नष्टनिद्रः प्रमूढसञ्ज्ञो व्यथितचेता न क्वचन सुखमुपलभते, अरतिपरीतः स्थानादासनाच्छय्यां क्रान्तुमिच्छति, क्लिष्टभूयिष्ठश्चाशु निद्रां भजति, दुर्बलो दुःखप्रबोधश्च भवति; तमेवंविधमग्निविसर्पपरीतमचिकित्स्यं विद्यात् ||३६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vātapittaṁ prakupitamatimātraṁ svahētubhiḥ| <br /> <br /> parasparaṁ labdhabalaṁ dahadgātraṁ visarpati||35||<br /> <br /> tadupatāpādāturaḥ sarvaśarīramaṅgārairivākīryamāṇaṁ manyatē,chardyatīsāramūrcchādāhamōhajvaratamakārōcakāsthisandhibhēdatr̥ṣṇāvipākāṅgabhēdādibhiścābhibhūyatē,yaṁ yaṁ cāvakāśaṁ visarpō'nusarpati sō'vakāśaḥ śāntāṅgāraprakāśō'tiraktō vā bhavati,agnidagdhaprakāraiśca sphōṭairupacīyatē, sa śīghragatvādāśvēva marmānusārī bhavati, marmaṇi cōpataptēpavanō'tibalō bhinattyaṅgānyatimātraṁ pramōhayati sañjñāṁ, hikkāśvāsau janayati, nāśayati nidrāṁ, sanaṣṭanidraḥ pramūḍhasañjñō vyathitacētā na kvacana sukhamupalabhatē, aratiparītaḥsthānādāsanācchayyāṁ krāntumicchati, kliṣṭabhūyiṣṭhaścāśu nidrāṁ bhajati, durbalō duḥkhaprabōdhaścabhavati; tamēvaṁvidhamagnivisarpaparītamacikitsyaṁ vidyāt||36||<br /> <br /> vātapittaM prakupitamatimAtraM svahetubhiH| <br /> <br /> parasparaM labdhabalaM dahadgAtraM visarpati||35|| <br /> <br /> tadupatApAdAturaH sarvasharIrama~ggArairivAkIryamANaM manyate,chardyatIsAramUrcchAdAhamohajvaratamakArocakAsthisandhibhedatRuShNAvipAkA~ggabhedAdibhishcAbhibhUyate,yaM yaM cAvakAshaM visarpo~anusarpati so~avakAshaH shAntA~ggAraprakAsho~atirakto vA bhavati,agnidagdhaprakAraishca sphoTairupacIyate, sa shIghragatvAdAshveva marmAnusArI bhavati, marmaNi copataptepavano~atibalo bhinattya~ggAnyatimAtraM pramohayati sa~jj~jAM, hikkAshvAsau janayati, nAshayati nidrAM, sanaShTanidraH pramUDhasa~jj~jo vyathitacetA na kvacana sukhamupalabhate, aratiparItaH sthAnAdAsanAcchayyAMkrAntumicchati, kliShTabhUyiShThashcAshu nidrAM bhajati, durbalo duHkhaprabodhashca bhavati;tamevaMvidhamagnivisarpaparItamacikitsyaM vidyAt||36|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> When ''vata-pitta'' vitiated severely due to their respective etiological factors and strengthened mutually, spreads producing severe burning pain in the body. <br /> <br /> The patient affected with this type of ''visarpa'' feels as if his body is sprinkled with flaming coals. He suffers from vomiting, diarrhea, fainting, burning sensation, disturbed consciousness, fever, feeling of darkness, anorexia, breaking pain in bones and joints, morbid thirst, indigestion, breaking body pain etc. The part where the disease spreads looks like extinguished charcoal or blood like red, affected region gets covered with blisters like those caused by burns. Due to its rapid progress, it soon spreads to vital regions. When the vital parts gets affected, the [[vata]] which is excessively aggravated causes extensive disintegration of the tissues and leads to disturbed consciousness, produces hiccup, dyspnea and insomnia. That sleepless patient with disturbed consciousness and miserable mind does not get relief anywhere. He becomes restless in standing, seating and desires to lie on bed, thus exceedingly exhausted due to pain soon falls into deep sleep. Being debilitated, he is aroused from this state with difficulty. One suffering from ''agni-visarpa'' is to be regarded as incurable.[35-36]<br /> &lt;/div&gt;<br /> === Etio-pathogenesis and clinical features of [[kapha]]-[[pitta]] dominant ''kardam visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कफपित्तं प्रकुपित्तं बलवत् स्वेन हेतुना | <br /> <br /> विसर्पत्येकदेशे तु प्रक्लेदयति देहिनम् ||३७||<br /> <br /> तद्विकाराः- शीतज्वरः शिरोगुरुत्वं दाहः स्तैमित्यमङ्गावसदनं निद्रा तन्द्रा मोहोऽन्नद्वेषः प्रलापोऽग्निनाशो दौर्बल्यमस्थिभेदो मूर्च्छा पिपासा स्रोतसां प्रलेपो जाड्यमिन्द्रियाणां प्रायोपवेशनमङ्गविक्षेपोऽङ्गमर्दोऽरतिरौत्सुक्यं चोपजायते, प्रायश्चामाशये विसर्पत्यलसक एकदेशग्राही च, यस्मिंश्चावकाशे विसर्पो विसर्पति सोऽवकाशो रक्तपीतपाण्डुपिडकावकीर्ण इव मेचकाभः कालो मलिनः स्निग्धो बहूष्मा गुरुः स्तिमितवेदनः श्वयथुमान् गम्भीरपाको निरास्रावः शीघ्रक्लेदः स्विन्नक्लिन्नपूतिमांसत्वक् क्रमेणाल्परुक् परामृष्टोऽवदीर्यते कर्दम इवावपीडितोऽन्तरं प्रयच्छत्युपक्लिन्नपूतिमांसत्यागी सिरास्नायुसन्दर्शी कुणपगन्धी च भवति सञ्ज्ञास्मृतिहन्ता च; तं कर्दमविसर्पपरीतमचिकित्स्यं विद्यात् ||३८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaphapittaṁ prakupittaṁ balavat svēna hētunā| <br /> <br /> visarpatyēkadēśē tu praklēdayati dēhinam||37|| <br /> <br /> tadvikārāḥ- śītajvaraḥ śirōgurutvaṁ dāhaḥ staimityamaṅgāvasadanaṁ nidrā tandrā mōhō'nnadvēṣaḥpralāpō'gnināśō daurbalyamasthibhēdō mūrcchā pipāsā srōtasāṁ pralēpō jāḍyamindriyāṇāṁprāyōpavēśanamaṅgavikṣēpō'ṅgamardō'ratirautsukyaṁ cōpajāyatē, prāyaścāmāśayē visarpatyalasakaēkadēśagrāhī ca, yasmiṁścāvakāśē visarpō visarpati sō'vakāśō raktapītapāṇḍupiḍakāvakīrṇa ivamēcakābhaḥ kālō malinaḥ snigdhō bahūṣmā guruḥ stimitavēdanaḥ śvayathumān gambhīrapākō nirāsrāvaḥśīghraklēdaḥ svinnaklinnapūtimāṁsatvak kramēṇālparuk parāmr̥ṣṭō'vadīryatē kardama ivāvapīḍitō'ntaraṁprayacchatyupaklinnapūtimāṁsatyāgī sirāsnāyusandarśī kuṇapagandhī ca bhavati sañjñāsmr̥tihantā ca;taṁ kardamavisarpaparītamacikitsyaṁ vidyāt||38||<br /> <br /> kaphapittaM prakupittaM balavat svena hetunA| <br /> <br /> visarpatyekadeshe tu prakledayati dehinam||37|| <br /> <br /> tadvikArAH- shItajvaraH shirogurutvaM dAhaH staimityama~ggAvasadanaM nidrA tandrAmoho~annadveShaH pralApo~agninAsho daurbalyamasthibhedo mUrcchA pipAsA srotasAM pralepojADyamindriyANAM prAyopaveshanama~ggavikShepo~a~ggamardo~aratirautsukyaM copajAyate,prAyashcAmAshaye visarpatyalasaka ekadeshagrAhI ca, yasmiMshcAvakAshe visarpo visarpatiso~avakAsho raktapItapANDupiDakAvakIrNa iva mecakAbhaH kAlo malinaH snigdho bahUShmA guruHstimitavedanaH shvayathumAn gambhIrapAko nirAsrAvaH shIghrakledaH svinnaklinnapUtimAMsatvakkrameNAlparuk parAmRuShTo~avadIryate kardama ivAvapIDito~antaraMprayacchatyupaklinnapUtimAMsatyAgI sirAsnAyusandarshI kuNapagandhI ca bhavati sa~jj~jAsmRutihantAca; taM kardamavisarpaparItamacikitsyaM vidyAt||38|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> Excessively aggravated [[kapha]] [[pitta]] due to their respective etiological factors, spreads in the body causing suppuration of the tissues in particular part. <br /> <br /> Its signs and symptoms are fever with chills, heaviness of the head, burning sensation, timidity, prostration, excessive sleep, drowsiness, disturbed consciousness, food dislike, delirium, loss of appetite, weakness, breaking pain in bones, fainting, morbid thirst, adhesions of sticky material in channels, dullness of the senses, mostly seating, abnormal movements of limbs, body pain, restlessness, anxiety, often it spreads to ''amashaya''. It is localized and spreads with slow speed.<br /> <br /> The part where the disease spreads looks as if filled with reddish, yellowish, pale eruptions. The affected part becomes muddy, black, dirty, unctuous, excess hot, heavy, dull aching, edematous, with deep seated suppuration, having no discharge, rapidly become sloughy, sweated suppurated, having putrid flesh and skin, gradual little pain, when touched bursts and gives space on pressing, throws out decomposed and putrefied flesh, shows blood vessels, ligaments and has cadaverous smell and causes disturbed consciousness as well as memory. This is called ''kardam visarpa'' and is incurable. [37-38]<br /> &lt;/div&gt;<br /> === Etio-pathogenesis and clinical features of [[kapha]] [[vata]] dominant ''granthi visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्थिरगुरुकठिनमधुरशीतस्निग्धान्नपानाभिष्यन्दिसेविनामव्यायामादिसेविनामप्रतिक <br /> र्मशीलानां श्लेष्मा वायुश्च प्रकोपमापद्यते, तावुभौ दुष्टप्रवृद्धावतिबलौ प्रदूष्य दूष्यान् विसर्पाय कल्पेते; तत्र वायुः श्लेष्मणा विबद्धमार्गस्तमेव श्लेष्माणमनेकधा भिन्दन् क्रमेण ग्रन्थिमालां कृच्छ्रपाकसाध्यां कफाशये सञ्जनयति, उत्सन्नरक्तस्य वा प्रदूष्य रक्तं सिरास्नायुमांसत्वगाश्रितं ग्रन्थीनां मालां कुरुते तीव्ररुजानां स्थूलानामणूनां वा दीर्घवृत्तरक्तानां, तदुपतापाज्ज्वरातिसारकासहिक्काश्वासशोषप्रमोहवैवर्ण्यारोचकाविपाकप्रसेकच्छ <br /> र्दिर्मूर्च्छाङ्गभङ्गनिद्रारतिसदनाद्याः प्रादुर्भवन्त्युपद्रवाः; स एतैरुपद्रुतः सर्वकर्मणां विषयमतिपतितो विवर्जनीयो भवतीति ग्रन्थिविसर्पः ||३९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sthiragurukaṭhinamadhuraśītasnigdhānnapānābhiṣyandisēvināmavyāyāmādisēvināmapratikarmaśīlānāṁślēṣmā vāyuśca prakōpamāpadyatē, tāvubhau duṣṭapravr̥ddhāvatibalau pradūṣya dūṣyān visarpāyakalpētē; tatra vāyuḥ ślēṣmaṇā vibaddhamārgastamēva ślēṣmāṇamanēkadhā bhindan kramēṇagranthimālāṁ kr̥cchrapākasādhyāṁ kaphāśayē sañjanayati, utsannaraktasya vā pradūṣya raktaṁsirāsnāyumāṁsatvagāśritaṁ granthīnāṁ mālāṁ kurutē tīvrarujānāṁ sthūlānāmaṇūnāṁ vādīrghavr̥ttaraktānāṁ, tadupatāpājjvarātisārakāsahikkāśvāsaśōṣapramōhavaivarṇyārōcakāvipākaprasēkacchardirmūrcchāṅgabhaṅganidrāratisadanādyāḥprādurbhavantyupadravāḥ; sa ētairupadrutaḥ sarvakarmaṇāṁ viṣayamatipatitō vivarjanīyō bhavatītigranthivisarpaḥ||39|| <br /> <br /> sthiragurukaThinamadhurashItasnigdhAnnapAnAbhiShyandisevinAmavyAyAmAdisevinAmapratikarmashIlAnAMshleShmA vAyushca prakopamApadyate, tAvubhau duShTapravRuddhAvatibalau pradUShya dUShyAnvisarpAya kalpete; tatra vAyuH shleShmaNA vibaddhamArgastameva shleShmANamanekadhA bhindankrameNa granthimAlAM kRucchrapAkasAdhyAMkaphAshaye sa~jjanayati, utsannaraktasya vA pradUShyaraktaM sirAsnAyumAMsatvagAshritaM granthInAM mAlAM kurute tIvrarujAnAM sthUlAnAmaNUnAM vAdIrghavRuttaraktAnAM, tadupatApAjjvarAtisArakAsahikkAshvAsashoSha-pramohavaivarNyArocakAvipAkaprasekacchardirmUrcchA~ggabha~gganidrAratisadanAdyAHprAdurbhavantyupadravAH; sa etairupadrutaH sarvakarmaNAM viShayamatipatito vivarjanIyo bhavatItigranthivisarpaH||39|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> [[Kapha]] and [[vata]] gets vitiated due to the use of firm, heavy, hard, sweet, cold, unctuous, and ''abhishyandi'' (which increase discharges and cause obstruction) ingredients of diet, lack of physical exercise etc. not following preventive seasonal [[Panchakarma]] purification. Deranged excessively, aggravated, powerful both [[kapha]] and [[vata]] vitiates the susceptible body elements giving rise to ''granthi visarpa''. Thereafter the [[vata]] being occluded by [[kapha]] in its progress and disintegrates [[kapha]] in many ways and gradually giving rise to chain of glands, hardly suppurating and difficult to cure, in the habitats of [[kapha]].<br /> <br /> In a person having aggravated blood, vitiated [[kapha]]-[[pitta]] provoke blood giving rise to a series of glandular enlargements which are exceedingly painful, large or small or elongated or round and of red color, located in blood vessels, ligaments, flesh and skin. Being afflicted, complications arise like fever, diarrhea, cough, hiccup, dyspnea, emaciation disturbed consciousness, abnormal complexion, anorexia, indigestion, excess salivation, vomiting, fainting, breaking pain in body , excessive sleep, restlessness, malaise, the patient associated with these complications goes beyond the reach of all remedial measures and as such is rejectable. This is ''granthi visarpa''.[39]<br /> <br /> === ''Upadrava'' (complications) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> उपद्रवस्तु खलु रोगोत्तरकालजो रोगाश्रयो रोग एव स्थूलोऽणुर्वा, रोगात् पश्चाज्जायत इत्युपद्रवसञ्ज्ञः| <br /> तत्र प्रधानो व्याधिः, व्याधेर्गुणभूत [१] उपद्रवः, तस्य प्रायः प्रधानप्रशमे प्रशमो भवति | <br /> स तु पीडाकरतरो भवति पश्चादुत्पद्यमानो व्याधिपरिक्लिष्टशरीरत्वात्; तस्मादुपद्रवं त्वरमाणोऽभिबाधेत ||४०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> upadravastu khalu rōgōttarakālajō rōgāśrayō rōga ēva sthūlō'ṇurvā, rōgāt paścājjāyataityupadravasañjñaḥ| <br /> tatra pradhānō vyādhiḥ, vyādhērguṇabhūta [1] upadravaḥ, tasya prāyaḥ pradhānapraśamē praśamōbhavati| <br /> sa tu pīḍākaratarō bhavati paścādutpadyamānō vyādhiparikliṣṭaśarīratvāt; tasmādupadravaṁtvaramāṇō'bhibādhēta||40|| <br /> <br /> upadravastu khalu rogottarakAlajo rōgashrayo rōga eva sthUlo~aNurvA, rōgat pashcAjjAyataityupadravasa~jj~jaH| <br /> tatra pradhAno vyAdhiH, vyAdherguNabhUta [1] upadravaH, tasya prAyaH pradhAnaprashame prashamobhavati| <br /> sa tu pIDAkarataro bhavati pashcAdutpadyamAno vyAdhiparikliShTasharIratvAt; tasmAdupadravaMtvaramANo~abhibAdheta||40|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Upadrava'' (complication) is disorder itself, outsized or undersized manifesting in the later period of a disease and rooted in the same (disease). ''Upadrava'' is so named because it manifests after the disease. Hence the main disease is primary and complication is secondary, it is generally pacified when the main disease gets pacified. It is more troublesome than the main disease itself, because it appears in the later stages of disease when the body is already weakened. Hence, one should treat the complications very promptly.[40]<br /> <br /> === Severity of ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सर्वायतनसमुत्थं सर्वलिङ्गव्यापिनं सर्वधात्वनुसारिणमाशुकारिणं महात्ययिकमिति सन्निपातविसर्पमचिकित्स्यं विद्यात् ||४१||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sarvāyatanasamutthaṁ sarvaliṅgavyāpinaṁ sarvadhātvanusāriṇamāśukāriṇaṁ mahātyayikamitisannipātavisarpamacikitsyaṁ vidyāt||41|| <br /> <br /> sarvAyatanasamutthaM sarvali~ggavyApinaM sarvadhAtvanusAriNamAshukAriNaM mahAtyayikamitisannipAtavisarpamacikitsyaM vidyAt||41||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''visarpa'' which is caused by all etiological factors, manifesting with all signs and symptoms, spreads in all body elements very rapidly and great disastrous is known as ''sannipataja visarpa'' and is not treatable. [41]<br /> &lt;/div&gt;<br /> === Prognosis of ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र वातपित्तश्लेष्मनिमित्ता विसर्पास्त्रयः साध्या भवन्ति; अग्निकर्दमाख्यौ पुनरनुपसृष्टे मर्मणि अनुपगते वा सिरास्नायुमांसक्लेदे साधारणक्रियाभिरुभावेवाभ्यस्यमानौ प्रशान्तिमापद्येयाताम्, अनादरोपक्रान्तः पुनस्तयोरन्यतरो हन्याद्देहमाश्वेवाशीविषवत्; तथा ग्रन्थिविसर्पमजातोपद्रवमारभेत चिकित्सितुम्, उपद्रवोपद्रुतं त्वेनं परिहरेत्; सन्निपातजं तु सर्वधात्वनुसारित्वादाशुकारित्वाद्विरुद्धोपक्रमत्वाच्चासाध्यं विद्यात् ||४२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra vātapittaślēṣmanimittā visarpāstrayaḥ sādhyā bhavanti; agnikardamākhyau punaranupasr̥ṣṭēmarmaṇi anupagatē vā sirāsnāyumāṁsaklēdē sādhāraṇakriyābhirubhāvēvābhyasyamānaupraśāntimāpadyēyātām, anādarōpakrāntaḥ punastayōranyatarō hanyāddēhamāśvēvāśīviṣavat; tathāgranthivisarpamajātōpadravamārabhēta cikitsitum, upadravōpadrutaṁ tvēnaṁ pariharēt; sannipātajaṁ tusarvadhātvanusāritvādāśukāritvādviruddhōpakramatvāccāsādhyaṁ vidyāt||42|| <br /> <br /> tatra vātapittashleShmanimittA visarpAstrayaH sAdhyA bhavanti; agnikardamAkhyau punaranupasRuShTemarmaNi anupagate vA sirAsnAyumAMsaklede sAdhAraNakriyAbhirubhAvevAbhyasyamAnauprashAntimApadyeyAtAm, anAdaropakrAntaH punastayoranyataro hanyAddehamAshvevAshIviShavat;tathA granthivisarpamajAtopadravamArabheta cikitsitum, upadravopadrutaM tvenaM pariharet;sannipAtajaM tu sarvadhAtvanusAritvAdAshukAritvAdviruddhopakramatvAccAsAdhyaM vidyAt||42|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> Among all types of ''visarpa vatik'', ''paittik'' and [[kapha]]ja these three are curable. ''Agni'' and ''kardam visarpa'' not spreading to vital organs and causing no suppuration of the vessels, ligaments and muscles can be pacified by the general treatment of ''visarpa''. When managed with negligence both may cause death of patients like snake venom. ''Granthi visarpa'' should be treated before complications has arisen, otherwise should be rejected. ''Sannipataja visarpa'' should be taken as incurable because of it is spreading to all [[dhatu]], very fulminant and refractory to treatment.[42]<br /> <br /> === Principles of treatment ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र साध्यानां साधनमनुव्याख्यास्यामः ||४३|| <br /> <br /> लङ्घनोल्लेखने शस्ते तिक्तकानां च सेवनम् | <br /> <br /> कफस्थानगते सामे रूक्षशीतैः प्रलेपयेत् ||४४||<br /> <br /> पित्तस्थानगतेऽप्येतत् सामे कुर्याच्चिकित्सितम् | <br /> <br /> शोणितस्यावसेकं च विरेकं च विशेषतः ||४५|| <br /> <br /> मारुताशयसम्भूतेऽप्यादितः स्याद्विरूक्षणम् | <br /> <br /> रक्तपित्तान्वयेऽप्यादौ स्नेहनं न हितं मतम् ||४६|| <br /> <br /> वातोल्बणे तिक्तघृतं पैत्तिके च प्रशस्यते | <br /> <br /> लघुदोषे, महादोषे पैत्तिके स्याद्विरेचनम् ||४७|| <br /> <br /> न घृतं बहुदोषाय देयं यन्न [१] विरेचयेत् | <br /> <br /> तेन दोषो ह्युपष्टब्धस्त्वङ्मांसरुधिरं पचेत् ||४८|| <br /> <br /> तस्माद्विरेकमेवादौ शस्तं विद्याद्विसर्पिणः | <br /> <br /> रुधिरस्यावसेकं च तद्ध्यस्याश्रयसञ्ज्ञितम् ||४९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra sādhyānāṁ sādhanamanuvyākhyāsyāmaḥ||43|| <br /> <br /> laṅghanōllēkhanē śastē tiktakānāṁ ca sēvanam| <br /> <br /> kaphasthānagatē sāmē rūkṣaśītaiḥ pralēpayēt||44|| <br /> <br /> pittasthānagatē'pyētat sāmē kuryāccikitsitam| <br /> <br /> śōṇitasyāvasēkaṁ ca virēkaṁ ca viśēṣataḥ||45||<br /> <br /> mārutāśayasambhūtē'pyāditaḥ syādvirūkṣaṇam| <br /> <br /> raktapittānvayē'pyādau snēhanaṁ na hitaṁ matam||46|| <br /> <br /> vātōlbaṇē tiktaghr̥taṁ paittikē ca praśasyatē| <br /> <br /> laghudōṣē, mahādōṣē paittikē syādvirēcanam||47|| <br /> <br /> na ghr̥taṁ bahudōṣāya dēyaṁ yanna [1] virēcayēt| <br /> <br /> tēna dōṣō hyupaṣṭabdhastvaṅmāṁsarudhiraṁ pacēt||48|| <br /> <br /> tasmādvirēkamēvādau śastaṁ vidyādvisarpiṇaḥ| <br /> <br /> rudhirasyāvasēkaṁ ca taddhyasyāśrayasañjñitam||49|| <br /> <br /> tatra sAdhyAnAM sAdhanamanuvyAkhyAsyAmaH||43|| <br /> <br /> la~gghanollekhane shaste tiktakAnAM ca sevanam| <br /> <br /> kaphasthAnagate sAme rūkṣashItaiH pralepayet||44|| <br /> <br /> pittasthAnagate~apyetat sAme kuryAccikitsitam| <br /> <br /> shoNitasyAvasekaM ca virekaM ca visheShataH||45|| <br /> <br /> mArutAshayasambhUte~apyAditaH syAdvirūkṣaNam| <br /> <br /> raktapittAnvaye~apyAdau snehanaM na hitaM matam||46||<br /> <br /> vAtolbaNe tiktaghRutaM paittike ca prashasyate| <br /> <br /> laghudoShe, mahAdoShe paittike syAdvirecanam||47||<br /> <br /> na ghRutaM bahudōṣaya deyaM yanna [1] virecayet| <br /> <br /> tena doSho hyupaShTabdhastva~gmAMsarudhiraM pacet||48|| <br /> <br /> tasmAdvirekamevAdau shastaM vidyAdvisarpiNaH| <br /> <br /> rudhirasyAvasekaM ca taddhyasyAshrayasa~jj~jitam||49|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now the treatment of the curable varieties of ''visarpa'' will be described. <br /> <br /> If the ''visarpa'' is caused with ama [[dosha]]([[dosha]] in the state of incomplete transformation) and is located in [[kapha]]sthana (in thorax and upper body parts), then [[langhana]] (fasting therapy), [[vamana]] (emesis) therapy, ''tikta'' (bitter) drugs internally and application of paste of drugs with dry and cold properties externally is beneficial. <br /> <br /> The same treatment should be adopted in case of association of ''ama'' and location in [[pitta]] sthana (abdomen and middle parts of body). <br /> <br /> In addition, [[rakta]]mokshana (blood letting) and [[virechana]] (purgation therapy) are specially indicated. <br /> <br /> If ''sama'' (with ama [[dosha]]) ''visarpa'' is arouse from ''vatashaya'' (pelvis and lower part of body) ununctuous measures are indicated in the beginning. Even in association with [[rakta]]-[[pitta]] uncting measure is not regarded as beneficial in the beginning. <br /> <br /> In [[vata]]ja visarpa and paittika visarpa of mild aggravated [[dosha]] tiktaka ghritam is beneficial. But if the [[pitta]] [[dosha]] is excessively aggravated then [[virechana]] should be given. <br /> <br /> In the condition of excessively aggravated [[dosha]], ghee should not be given at first which does not cause [[virechana]]. Because non purgating ghee occlude the [[dosha]] resulting in decomposed skin, flesh and blood. Hence in visarpa, [[virechana]] followed by [[rakta]]mokshana is recommended because the disorder is located in blood.[43-49]<br /> <br /> === Formulations used in ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इति वीसर्पनुत् प्रोक्तं समासेन चिकित्सितम् | <br /> <br /> एतदेव पुनः सर्वं व्यासतः सम्प्रवक्ष्यते ||५०|| <br /> <br /> मदनं मधुकं निम्बं वत्सकस्य फलानि च | <br /> <br /> वमनं सम्प्रदातव्यं विसर्पे कफपित्तजे ||५१|| <br /> <br /> पटोलपिचुमर्दाभ्यां पिप्पल्या मदनेन च | <br /> <br /> विसर्पे वमनं शस्तं तथा चेन्द्रयवैः सह ||५२|| <br /> <br /> यांश्च योगान् प्रवक्ष्याभि कल्पेषु कफपित्तिनाम् | <br /> <br /> विसर्पिणां प्रयोज्यास्ते दोषनिर्हरणाः शिवाः ||५३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> iti vīsarpanut prōktaṁ samāsēna cikitsitam| <br /> <br /> ētadēva punaḥ sarvaṁ vyāsataḥ sampravakṣyatē||50|| <br /> <br /> madanaṁ madhukaṁ nimbaṁ vatsakasya phalāni ca| <br /> <br /> vamanaṁ sampradātavyaṁ visarpē kaphapittajē||51|| <br /> <br /> paṭōlapicumardābhyāṁ pippalyā madanēna ca| <br /> <br /> visarpē vamanaṁ śastaṁ tathā cēndrayavaiḥ saha||52|| <br /> <br /> yāṁśca yōgān pravakṣyābhi kalpēṣu kaphapittinām| <br /> <br /> visarpiṇāṁ prayōjyāstē dōṣanirharaṇāḥ śivāḥ||53|| <br /> <br /> iti vIsarpanut proktaM samAsena cikitsitam| <br /> <br /> etadeva punaH sarvaM vyAsataH sampravakShyate||50|| <br /> <br /> madanaM madhukaM nimbaM vatsakasya phalAni ca| <br /> <br /> vamanaM sampradAtavyaM visarpe kaphapittaje||51|| <br /> <br /> patōlapicumardAbhyAM pippalyA madanena ca| <br /> <br /> visarpe vamanaM shastaM tathA cendrayavaiH saha||52|| <br /> <br /> yAMshca yōgan pravakShyAbhi kalpeShu kaphapittinAm| <br /> <br /> visarpiNAM prayojyAste dōṣanirharaNAH shivAH||53||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus the treatment principles of ''visarpa'' have been described in brief. The same is being detailed further. <br /> <br /> In [[kapha]] [[pitta]]ja visarpa, [[vamana]] should be given with the ''madana'' (Randia spinosa), ''madhuka'' (Glycyrrhiza glabra Linn), ''nimba'' (Azadirachta indica), and fruits of ''vatsaka'' (Holarrhena antidysenterica Linn). <br /> <br /> In visarpa [[vamana]] is beneficial with ''patola'' (Trichosanthes dioica Roxb), ''pichumarda'' (Azadirachta indica), ''pippali'' (Piper longum linn), ''madana'' (Randia spinosa) and ''indrayava'' (Holarrhena antidysenterica Linn). <br /> <br /> Further, all those formulations which will be described in ''kalpasthana'' in connection with the disorders of [[kapha]] [[pitta]] should be used for the patients of ''visarpa'' as well because they are eliminative of morbid [[dosha]] and are beneficial.[50-53]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मुस्तनिम्बपटोलानां चन्दनोत्पलयोरपि | <br /> <br /> सारिवामलकोशीरमुस्तानां वा विचक्षणः ||५४|| <br /> <br /> कषायान् पाययेद्वैद्यः सिद्धान् वीसर्पनाशनान् | <br /> <br /> किराततिक्तकं लोध्रं चन्दनं सदुरालभम् ||५५|| <br /> <br /> नागरं पद्मकिञ्जल्कमुत्पलं सबिभीतकम् | <br /> <br /> मधुकं नागपुष्पं च दद्याद्वीसर्पशान्तये ||५६|| <br /> <br /> प्रपौण्डरीकं मधुकं पद्मकिञ्जल्कमुत्पलम् | <br /> <br /> नागपुष्पं च लोध्रं च तेनैव विधिना पिबेत् ||५७|| <br /> <br /> द्राक्षां पर्पटकं शुण्ठीं गुडूचीं धन्वयासकम् | <br /> <br /> निशापर्युषितं दद्यात्तृष्णावीसर्पशान्तये ||५८|| <br /> <br /> पटोलं पिचुमर्दं च दार्वीं कटुकरोहिणीम् | <br /> <br /> यष्ट्याह्वां त्रायमाणां च दद्याद्वीसर्पशान्तये ||५९|| <br /> <br /> पटोलादिकषायं वा पिबेत्त्रिफलया सह | <br /> <br /> मसूरविदलैर्युक्तं घृतमिश्रं प्रदापयेत् ||६०|| <br /> <br /> पटोलपत्रमुद्गानां रसमामलकस्य च | <br /> <br /> पाययेत घृतोन्मिश्रं नरं वीसर्पपीडितम् ||६१||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mustānimbapaṭōlānāṁ candanōtpalayōrapi| <br /> <br /> sārivāmalakōśīramustānāṁ vā vicakṣaṇaḥ||54|| <br /> <br /> kaṣāyān pāyayēdvaidyaḥ siddhān vīsarpanāśanān| <br /> <br /> kirātatiktakaṁ lōdhraṁ candanaṁ sadurālabham||55|| <br /> <br /> nāgaraṁ padmakiñjalkamutpalaṁ sabibhītakam| <br /> <br /> madhukaṁ nāgapuṣpaṁ ca dadyādvīsarpaśāntayē||56|| <br /> <br /> prapauṇḍarīkaṁ madhukaṁ padmakiñjalkamutpalam| <br /> <br /> nāgapuṣpaṁ ca lōdhraṁ ca tēnaiva vidhinā pibēt||57|| <br /> <br /> drākṣāṁ parpaṭakaṁ śuṇṭhīṁ guḍūcīṁ dhanvayāsakam| <br /> <br /> niśāparyuṣitaṁ dadyāttr̥ṣṇāvīsarpaśāntayē||58|| <br /> <br /> paṭōlaṁ picumardaṁ ca dārvīṁ kaṭukarōhiṇīm| <br /> <br /> yaṣṭyāhvāṁ trāyamāṇāṁ ca dadyādvīsarpaśāntayē||59|| <br /> <br /> paṭōlādikaṣāyaṁ vā pibēttriphalayā saha| <br /> <br /> masūravidalairyuktaṁ ghr̥tamiśraṁ pradāpayēt||60|| <br /> <br /> paṭōlapatramudgānāṁ rasamāmalakasya ca| <br /> <br /> pāyayēta ghr̥tōnmiśraṁ naraṁ vīsarpapīḍitam||61|| <br /> <br /> mustānimbapatōlanAM candanotpalayorapi| <br /> <br /> sArivAmalakoshIramustānAM vA vicakShaNaH||54|| <br /> <br /> kaShAyAn pAyayedvaidyaH siddhAn vIsarpanAshanAn| <br /> <br /> kirAtatiktakaM lōdhraM candanaM sadurAlabham||55|| <br /> <br /> nAgaraM padmaki~jjalkamutpalaM sabibhItakam| <br /> <br /> madhukaM nAgapuShpaM ca dadyAdvIsarpashAntaye||56|| <br /> <br /> prapauNDarIkaM madhukaM padmaki~jjalkamutpalam| <br /> <br /> nAgapuShpaM ca lōdhraM ca tenaiva vidhinA pibet||57|| <br /> <br /> drAkShAM parpaTakaM shuNThIM guDUcIM dhanvayAsakam| <br /> <br /> nishAparyuShitaM dadyAttRuShNAvIsarpashAntaye||58|| <br /> <br /> patōlaM picumardaM ca dArvIM kaTukarōhinim| <br /> <br /> yaShTyAhvAM trAyamANAM ca dadyAdvIsarpashAntaye||59|| <br /> <br /> patōladikaShAyaM vA pibettriphalayA saha|<br /> <br /> masUravidalairyuktaM ghRutamishraM pradApayet||60|| <br /> <br /> patōlapatramudgAnAM rasamAmalakasya ca| <br /> <br /> pAyayeta ghRutonmishraM naraM vIsarpapIDitam||61||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The skillful physician should administer the decoctions of tested efficacy for the cure of ''visarpa'' made up of ''musta'' (Cyperus rotundus linn), ''nimba'' (Azadirachta indica) and ''patola'' (Trichosanthes dioica Roxb) or ''chandana'' (Santalum album linn) and utpal (Nymphaea nouchali) or ''sariva'' (Hemidesmus indicus), ''amalaki'' (Emblica officinalis), ''ushira'' (Vetiveria zizanioidis Linn) and ''musta'' (Cyperus rotundus linn). <br /> <br /> ''Kiratatikta'' (Swertia chirayita), ''lodhra'' (Symplocos racemosa), ''chandana'' (Santalum album linn), ''duralabha'' (Fagonia cretica), ''shunthi'' (Zingiber officinale), ''padmakinjalka'' (Prunus cerasoides), ''utpala'' (Nymphaea nouchali), ''bibhitaka'' (Terminalia bellirica), ''madhuka'' (Glycyrrhiza glabra Linn) and ''nagapushpa'' (Mesua ferrea Linn), this formulation physician may administer for the alleviation of ''visarpa''. <br /> <br /> ''Prapaundrika'' (Nelumbo nucifera), ''madhuka'' (Glycyrrhiza glabra Linn), ''padmakinjalka'' (Prunus cerasoides), ''utpala'' (Nymphaea nouchali), ''nagapuspa'' (Mesua ferrea Linn), and ''lodhra'' (Symplocos racemosa), should be taken by the above method. <br /> <br /> ''Draksha'' (Vitis vinifera Linn), ''parpataka'' (Carthmus tinctorius), ''shunthi'' (Zingiber officinale), ''guduchi'' (Tinospora cordifolia) and ''dhanvayasa'' (fagonia cretica) kept for the whole night in the water (''shitakashaya''), should be administered to alleviate morbid thirst and ''visarpa''. <br /> <br /> ''Patola'' (Trichosanthes dioica Roxb.), ''pichumarda'' (Azadirachta indica), ''darvi'' (Berberis aristata), ''katuki'' (Picrorhiza kurroa), ''rohini'' (Terminalia chebula), ''yasti'' (Glycyrrhiza glabra Linn.), and ''trayamana'' (Gentiana kurroo) should be administered to alleviate ''visarpa''. <br /> <br /> Physician should administer ''patoladi kashaya'' with ''triphala'' (''Haritaki'' -Terminalia chebula, ''Bibhitaki''-Terminalia bellirica, and ''amalaki''- Emblica officinalis) and ''masur'' (lentil pulse) mixed with ghee. <br /> <br /> Physician should administer ''patola patra'' (Trichosanthes dioica Roxb.), ''mudga'' (green gram) and ''amalaki'' juice (Emblica officinalis) mixed with ghee. [54-61]<br /> <br /> === Formulations for [[dosha]] situated in koshtha, [[pitta]] dominant ''visarpa'' and [[virechana]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यच्च सर्पिर्महातिक्तं पित्तकुष्ठनिबर्हणम् | <br /> <br /> निर्दिष्टं तदपि प्राज्ञो दद्याद्वीसर्पशान्तये ||६२|| <br /> <br /> त्रायमाणाघृतं सिद्धं गौल्मिके यदुदाहृतम् | <br /> <br /> विसर्पाणां प्रशान्त्यर्थं दद्यात्तदपि बुद्धिमान् ||६३|| <br /> <br /> त्रिवृच्चूर्णं समालोड्य सर्पिषा पयसाऽपि वा |<br /> <br /> घर्माम्बुना वा संयोज्य मृद्वीकानां रसेन वा ||६४|| <br /> <br /> विरेकार्थं प्रयोक्तव्यं सिद्धं वीसर्पनाशनम् | <br /> <br /> त्रायमाणाशृतं वाऽपि पयो दद्याद्विरेचनम् ||६५|| <br /> <br /> त्रिफलारससंयुक्तं सर्पिस्त्रिवृतया सह | <br /> <br /> प्रयोक्तव्यं विरेकार्थं विसर्पज्वरनाशनम् ||६६|| <br /> <br /> रसमामलकानां वा घृतमिश्रं प्रदापयेत् | <br /> <br /> स एव गुरुकोष्ठाय त्रिवृच्चूर्णयुतो हितः ||६७||<br /> <br /> दोषे कोष्ठगते भूय एतत् कुर्याच्चिकित्सितम् |68|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yacca sarpirmahātiktaṁ pittakuṣṭhanibarhaṇam| <br /> <br /> nirdiṣṭaṁ tadapi prājñō dadyādvīsarpaśāntayē||62|| <br /> <br /> trāyamāṇāghr̥taṁ siddhaṁ gaulmikē yadudāhr̥tam| <br /> <br /> visarpāṇāṁ praśāntyarthaṁ dadyāttadapi buddhimān||63|| <br /> <br /> trivr̥ccūrṇaṁ samālōḍya sarpiṣā payasā'pi vā| <br /> <br /> gharmāmbunā vā saṁyōjya mr̥dvīkānāṁ rasēna vā||64|| <br /> <br /> virēkārthaṁ prayōktavyaṁ siddhaṁ vīsarpanāśanam| <br /> <br /> trāyamāṇāśr̥taṁ vā'pi payō dadyādvirēcanam||65|| <br /> <br /> triphalārasasaṁyuktaṁ sarpistrivr̥tayā saha| <br /> <br /> prayōktavyaṁ virēkārthaṁ visarpajvaranāśanam||66|| <br /> <br /> rasamāmalakānāṁ vā ghr̥tamiśraṁ pradāpayēt| <br /> <br /> sa ēva gurukōṣṭhāya trivr̥ccūrṇayutō hitaḥ||67|| <br /> <br /> dōṣē kōṣṭhagatē bhūya ētat kuryāccikitsitam|68| <br /> <br /> yacca sarpirmahAtiktaM pittakuShThanibarhaNam| <br /> <br /> nirdiShTaM tadapi prAj~jo dadyAdvIsarpashAntaye||62|| <br /> <br /> trAyamANAghRutaM siddhaM gaulmike yadudAhRutam| <br /> <br /> visarpANAM prashAntyarthaM dadyAttadapi buddhimAn||63|| <br /> <br /> trivRuccUrNaM samAloDya sarpiShA payasA~api vA| <br /> <br /> gharmAmbunA vA saMyojya mRudvIkAnAM rasena vA||64|| <br /> <br /> virekArthaM prayoktavyaM siddhaM vIsarpanAshanam| <br /> <br /> trAyamANAshRutaM vA~api payo dadyAdvirecanam||65|| <br /> <br /> triphalArasasaMyuktaM sarpistrivRutayA saha| <br /> <br /> prayoktavyaM virekArthaM visarpajvaranAshanam||66|| <br /> <br /> rasamAmalakAnAM vA ghRutamishraM pradApayet| <br /> <br /> sa eva gurukoShThAya trivRuccUrNayuto hitaH||67|| <br /> <br /> doShe koShThagate bhUya etat kuryAccikitsitam|68| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''mahatikta ghritam'' indicated in ''paittika kustha'' should also be given by the intelligent physician for the alleviation of ''visarpa''. <br /> <br /> ''Trayamana ghritam'' of tested efficacy mentioned in the treatment of ''gulma'' should be administered by the brilliant physician to alleviate ''visarpa''. <br /> <br /> The powder of ''trivritta'' (Operculina turpethum Linn) mixed with ghee or milk or hot water or ''mridvika'' (Vitis vinifera Linn) juice should be administered for [[virechana]] and is tested to alleviate ''visarpa'' or ''trayamana'' (Gentiana kurroo) decocted with milk should be given for [[virechana]]. <br /> <br /> The decoction of ''triphala'' (''Haritaki, Bibhitaki'' and ''Amalaki'') mixed with ghee and ''trivritta'' (Operculina turpethum Linn) and used for [[virechana]] to alleviate ''visarpa'' and ''jwara''.<br /> <br /> The juice of ''amalaki'' (Emblica officinalis) mixed with ghee should be administered in ''visarpa'' patient of heavy bowel the same preparation mixed with ''trivritta'' (Operculina turpethum Linn) powder is beneficial. <br /> <br /> When the morbid [[dosha]] are situated in ''kostha'' (internally), these measures should be administered.[62-67]<br /> <br /> === Formulations for [[dosha]] situated in ''shakha'' and modes of blood letting ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शाखादुष्टे तु रुधिरे रक्तमेवादितो हरेत् ||६८|| <br /> <br /> भिषग्वातान्वितं रक्तं विषाणेन विनिर्हरेत् | <br /> <br /> पित्तान्वितं जलौकोभिः, कफान्वितमलाबुभिः ||६९|| <br /> <br /> यथासन्नं विकारस्य व्यधयेदाशु वा सिराम् | <br /> <br /> त्वङ्मांसस्नायुसङ्क्लेदो रक्तक्लेदाद्धि जायते ||७०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śākhāduṣṭē tu rudhirē raktamēvāditō harēt||68|| <br /> <br /> bhiṣagvātānvitaṁ raktaṁ viṣāṇēna vinirharēt| <br /> <br /> pittānvitaṁ jalaukōbhiḥ, kaphānvitamalābubhiḥ||69|| <br /> <br /> yathāsannaṁ vikārasya vyadhayēdāśu vā sirām| <br /> <br /> tvaṅmāṁsasnāyusaṅklēdō raktaklēdāddhi jāyatē||70|| <br /> <br /> shAkhAduShTe tu rudhire raktamevAdito haret||68|| <br /> <br /> bhiShagvātanvitaM raktaM viShANena vinirharet| <br /> <br /> pittAnvitaM jalaukobhiH, kaphAnvitamalAbubhiH||69|| <br /> <br /> yathAsannaM vikArasya vyadhayedAshu vA sirAm| <br /> <br /> tva~gmAMsasnAyusa~gkledo raktakledAddhi jAyate||70||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If [[dosha]] in ''shakha'' (body elements) vitiate the blood then ''raktamokshana'' should be administered at first. The physician should use ''vishana'' (deer horn) in [[vata]] dominance, ''jalauka'' (Hirudinea medicinalis) in [[pitta]] dominance and ''alabu'' (lagenaria siceraria) in [[kapha]] dominance for blood letting or physician should perform ''siravyadha'' (blood letting through vein) promptly from the adjacent vein to the affected part, without which ''rakta kleda'' (putrifying blood content) gives rise to decomposed skin, flesh and ligaments. [68-70]<br /> <br /> === External applications ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अन्तःशरीरे [१] संशुद्धे दोषे त्वङ्मांससंश्रिते | <br /> <br /> आदितो वाऽल्पदोषाणां क्रिया बाह्या प्रवक्ष्यते ||७१||<br /> <br /> उदुम्बरत्वङ्मधुकं पद्मकिञ्जल्कमुत्पलम् | <br /> <br /> नागपुष्पं प्रियङ्गुश्च प्रदेहः सघृतो हितः ||७२||<br /> <br /> न्यग्रोधपादास्तरुणाः कदलीगर्भसंयुताः | <br /> <br /> बिसग्रन्थिश्च लेपः स्याच्छतधौतघृताप्लुतः ||७३||<br /> <br /> कालीयं मधुकं हेम वन्यं चन्दनपद्मकौ | <br /> <br /> एला मृणालं फलिनी प्रलेपः स्याद्धृताप्लुतः ||७४|| <br /> <br /> शाद्वलं च मृणालं च शङ्खं चन्दनमुत्पलम् |<br /> <br /> वेतसस्य च मूलानि प्रदेहः स्यात् सतण्डुलः ||७५||<br /> <br /> सारिवा पद्मकिञ्जल्कमुशीरं नीलमुत्पलम् | <br /> <br /> मञ्जिष्ठा चन्दनं लोध्रमभया च प्रलेपनम् ||७६|| <br /> <br /> नलदं च हरेणुश्च लोध्रं मधुकपद्मकौ [२] |<br /> <br /> दूर्वा सर्जरसश्चैव सघृतं स्यात् प्रलेपनम् ||७७||<br /> <br /> यावकाः सक्तवश्चैव सर्पिषा सह योजिताः | <br /> <br /> प्रदेहो मधुकं वीरा सघृता यवसक्तवः ||७८|| <br /> <br /> बलामुत्पलशालूकं वीरामगुरुचन्दनम् | <br /> <br /> कुर्यादालेपनं वैद्यो मृणालं च बिसान्वितम् ||७९||<br /> <br /> यवचूर्णं समधुकं सघृतं च प्रलेपनम् | <br /> <br /> हरेणवो मसुराश्च समुद्गाः श्वेतशालयः ||८०|| <br /> <br /> पृथक् पृथक् प्रदेहाः स्युः सर्वे वा सर्पिषा सह | <br /> <br /> पद्मिनीकर्दमः शीतो मौक्तिकं पिष्टमेव वा ||८१|| <br /> <br /> शङ्खः प्रवालः शुक्तिर्वा गैरिकं वा घृताप्लुतम् | <br /> <br /> (पृथगेते प्रदेहाश्च हिता ज्ञेया विसर्पिणाम् [३] ) | <br /> <br /> प्रपौण्डरीकं मधुकं बला शालूकमुत्पलम् ||८२|| <br /> <br /> न्यग्रोधपत्रदुग्धीके सघृतं स्यात् प्रलेपनम् | <br /> <br /> बिसानि च मृणालं च सघृताश्च कशेरुकाः ||८३|| <br /> <br /> शतावरीविदार्योश्च कन्दौ धौतघृताप्लुतौ | <br /> <br /> शैवालं नलमूलानि गोजिह्वा वृषकर्णिका ||८४|| <br /> <br /> इन्द्राणिशाकं सघृतं शिरीषत्वग्बलाघृतम् [४] | <br /> <br /> न्यग्रोधोदुम्बरप्लक्षवेतसाश्वत्थपल्लवैः ||८५|| <br /> <br /> त्वक्कल्कैर्बहुसर्पिर्भिः शीतैरालेपनं हितम् | <br /> <br /> प्रदेहाः सर्व एवैते वातपित्तोल्बणे [५] शुभाः ||८६||<br /> <br /> सकफे [६] तु प्रवक्ष्यामि प्रदेहानपरान् हितान् | <br /> <br /> त्रिफलां पद्मकोशीरं समङ्गां करवीरकम् ||८७|| <br /> <br /> नलमूलान्यनन्तां च प्रदेहमुपकल्पयेत् | <br /> <br /> खदिरं सप्तपर्णं च मुस्तमारग्वधं धवम् ||८८|| <br /> <br /> कुरण्टकं देवदारु दद्यादालेपनं भिषक् | <br /> <br /> आरग्वधस्य पत्राणि त्वचं श्लेष्मातकस्य च ||८९|| <br /> <br /> इन्द्राणिशाकं काकाह्वां शिरीषकुसुमानि च | <br /> <br /> शैवालं नलमूलानि वीरां गन्धप्रियङ्गुकाम् ||९०|| <br /> <br /> त्रिफलां मधुकं वीरां शिरीषकुसुमानि च | <br /> <br /> प्रपौण्डरीकं ह्रीबेरं दार्वीत्वङ्मधुकं बलाम् ||९१|| <br /> <br /> पृथगालेपनं कुर्याद्द्वन्द्वशः सर्वशोऽपि वा | <br /> <br /> प्रदेहाः सर्व एवैते देयाः स्वल्पघृताप्लुताः ||९२|| <br /> <br /> वातपित्तोल्बणे ये तु प्रदेहास्ते घृताधिकाः | <br /> <br /> घृतेन शतधौतेन प्रदिह्यात् केवलेन वा ||९३|| <br /> <br /> घृतमण्डेन शीतेन पयसा मधुकाम्बुना | <br /> <br /> पञ्चवल्ककषायेण सेचयेच्छीतलेन वा ||९४|| <br /> <br /> वातासृक्पित्तबहुलं विसर्पं बहुशो भिषक् | <br /> <br /> सेचनास्ते प्रदेहा ये त एव घृतसाधनाः ||९५|| <br /> <br /> ते चूर्णयोगा वीसर्पव्रणानामवचूर्णनाः | <br /> <br /> दूर्वास्वरससिद्धं च घृतं स्याद्व्रणरोपणम् ||९६|| <br /> <br /> दार्वीत्वङूमधुकं लोध्रं केशरं चावचूर्णनम् | <br /> <br /> पटोलः पिचुमर्दश्च त्रिफला मधुकोत्पले ||९७|| <br /> <br /> एतत् प्रक्षालनं सर्पिर्व्रणचूर्णं प्रलेपनम् |<br /> <br /> प्रदेहाः सर्व एवैते कर्तव्याः सम्प्रसादनाः [१] ||९८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> antaḥśarīrē [1] saṁśuddhē dōṣē tvaṅmāṁsasaṁśritē| <br /> <br /> āditō vā'lpadōṣāṇāṁ kriyā bāhyā pravakṣyatē||71||<br /> <br /> udumbaratvaṅmadhukaṁ padmakiñjalkamutpalam| <br /> <br /> nāgapuṣpaṁ priyaṅguśca pradēhaḥ saghr̥tō hitaḥ||72|| <br /> <br /> nyagrōdhapādāstaruṇāḥ kadalīgarbhasaṁyutāḥ| <br /> <br /> bisagranthiśca lēpaḥ syācchatadhautaghr̥tāplutaḥ||73|| <br /> <br /> kālīyaṁ madhukaṁ hēma vanyaṁ candanapadmakau| <br /> <br /> ēlā mr̥ṇālaṁ phalinī pralēpaḥ syāddhr̥tāplutaḥ||74|| <br /> <br /> śādvalaṁ ca mr̥ṇālaṁ ca śaṅkhaṁ candanamutpalam| <br /> <br /> vētasasya ca mūlāni pradēhaḥ syāt sataṇḍulaḥ||75|| <br /> <br /> sārivā padmakiñjalkamuśīraṁ nīlamutpalam| <br /> <br /> mañjiṣṭhā candanaṁ lōdhramabhayā ca pralēpanam||76|| <br /> <br /> naladaṁ ca harēṇuśca lōdhraṁ madhukapadmakau [2] |<br /> <br /> dūrvā sarjarasaścaiva saghr̥taṁ syāt pralēpanam||77|| <br /> <br /> yāvakāḥ saktavaścaiva sarpiṣā saha yōjitāḥ| <br /> <br /> pradēhō madhukaṁ vīrā saghr̥tā yavasaktavaḥ||78|| <br /> <br /> balāmutpalaśālūkaṁ vīrāmagurucandanam| <br /> <br /> kuryādālēpanaṁ vaidyō mr̥ṇālaṁ ca bisānvitam||79|| <br /> <br /> yavacūrṇaṁ samadhukaṁ saghr̥taṁ ca pralēpanam| <br /> <br /> harēṇavō masurāśca samudgāḥ śvētaśālayaḥ||80|| <br /> <br /> pr̥thak pr̥thak pradēhāḥ syuḥ sarvē vā sarpiṣā saha| <br /> <br /> padminīkardamaḥ śītō mauktikaṁ piṣṭamēva vā||81|| <br /> <br /> śaṅkhaḥ pravālaḥ śuktirvā gairikaṁ vā ghr̥tāplutam| <br /> <br /> (pr̥thagētē pradēhāśca hitā jñēyā visarpiṇām [3] )| <br /> <br /> prapauṇḍarīkaṁ madhukaṁ balā śālūkamutpalam||82|| <br /> <br /> nyagrōdhapatradugdhīkē saghr̥taṁ syāt pralēpanam| <br /> <br /> bisāni ca mr̥ṇālaṁ ca saghr̥tāśca kaśērukāḥ||83|| <br /> <br /> śatāvarīvidāryōśca kandau dhautaghr̥tāplutau| <br /> <br /> śaivālaṁ nalamūlāni gōjihvā vr̥ṣakarṇikā||84|| <br /> <br /> indrāṇiśākaṁ saghr̥taṁ śirīṣatvagbalāghr̥tam [4] | <br /> <br /> nyagrōdhōdumbaraplakṣavētasāśvatthapallavaiḥ||85|| <br /> <br /> tvakkalkairbahusarpirbhiḥ śītairālēpanaṁ hitam| <br /> <br /> pradēhāḥ sarva ēvaitē vātapittōlbaṇē [5] śubhāḥ||86|| <br /> <br /> sakaphē [6] tu pravakṣyāmi pradēhānaparān hitān| <br /> <br /> triphalāṁ padmakōśīraṁ samaṅgāṁ karavīrakam||87|| <br /> <br /> nalamūlānyanantāṁ ca pradēhamupakalpayēt| <br /> <br /> khadiraṁ saptaparṇaṁ ca mustāmāragvadhaṁ dhavam||88|| <br /> <br /> kuraṇṭakaṁ dēvadāru dadyādālēpanaṁ bhiṣak| <br /> <br /> āragvadhasya patrāṇi tvacaṁ ślēṣmātakasya ca||89|| <br /> <br /> indrāṇiśākaṁ kākāhvāṁ śirīṣakusumāni ca| <br /> <br /> śaivālaṁ nalamūlāni vīrāṁ gandhapriyaṅgukām||90|| <br /> <br /> triphalāṁ madhukaṁ vīrāṁ śirīṣakusumāni ca| <br /> <br /> prapauṇḍarīkaṁ hrībēraṁ dārvītvaṅmadhukaṁ balām||91|| <br /> <br /> pr̥thagālēpanaṁ kuryāddvandvaśaḥ sarvaśō'pi vā| <br /> <br /> pradēhāḥ sarva ēvaitē dēyāḥ svalpaghr̥tāplutāḥ||92|| <br /> <br /> vātapittōlbaṇē yē tu pradēhāstē ghr̥tādhikāḥ| <br /> <br /> ghr̥tēna śatadhautēna pradihyāt kēvalēna vā||93|| <br /> <br /> ghr̥tamaṇḍēna śītēna payasā madhukāmbunā| <br /> <br /> pañcavalkakaṣāyēṇa sēcayēcchītalēna vā||94|| <br /> <br /> vātāsr̥kpittabahulaṁ visarpaṁ bahuśō bhiṣak| <br /> <br /> sēcanāstē pradēhā yē ta ēva ghr̥tasādhanāḥ||95|| <br /> <br /> tē cūrṇayōgā vīsarpavraṇānāmavacūrṇanāḥ| <br /> <br /> dūrvāsvarasasiddhaṁ ca ghr̥taṁ syādvraṇarōpaṇam||96|| <br /> <br /> dārvītvaṅmadhukaṁ lōdhraṁ kēśaraṁ cāvacūrṇanam| <br /> <br /> paṭōlaḥ picumardaśca triphalā madhukōtpalē||97|| <br /> <br /> ētat prakṣālanaṁ sarpirvraṇacūrṇaṁ pralēpanam|98|<br /> <br /> antaHsharIre [1] saMshuddhe doShe tva~gmAMsasaMshrite| <br /> <br /> Adito vA~alpadōṣaNAM kriyA bAhyA pravakShyate||71|| <br /> <br /> udumbaratva~gmadhukaM padmaki~jjalkamutpalam| <br /> <br /> nAgapuShpaM priya~ggushca pradehaH saghRuto hitaH||72|| <br /> <br /> nyagrodhapAdAstaruNAH kadalIgarbhasaMyutAH| <br /> <br /> bisagranthishca lepaH syAcchatadhautaghRutAplutaH||73|| <br /> <br /> kAlIyaM madhukaM hema vanyaM candanapadmakau| <br /> <br /> elA mRuNAlaM phalinI pralepaH syAddhRutAplutaH||74|| <br /> <br /> shAdvalaM ca mRuNAlaM ca sha~gkhaM candanamutpalam| <br /> <br /> vetasasya ca mUlAni pradehaH syAt sataNDulaH||75|| <br /> <br /> sArivA padmaki~jjalkamushIraM nIlamutpalam| <br /> <br /> ma~jjiShThA candanaM lōdhramabhayA ca pralepanam||76|| <br /> <br /> naladaM ca hareNushca lōdhraM madhukapadmakau [2] | <br /> <br /> dUrvA sarjarasashcaiva saghRutaM syAt pralepanam||77|| <br /> <br /> yAvakAH saktavashcaiva sarpiShA saha yojitAH| <br /> <br /> pradeho madhukaM vIrA saghRutA yavasaktavaH||78|| <br /> <br /> balAmutpalashAlUkaM vIrAmagurucandanam| <br /> <br /> kuryAdAlepanaM vaidyo mRuNAlaM ca bisAnvitam||79|| <br /> <br /> yavacUrNaM samadhukaM saghRutaM ca pralepanam| <br /> <br /> hareNavo masurAshca samudgAH shvetashAlayaH||80|| <br /> <br /> pRuthak pRuthak pradehAH syuH sarve vA sarpiShA saha| <br /> <br /> padminIkardamaH shIto mauktikaM piShTameva vA||81|| <br /> <br /> sha~gkhaH pravAlaH shuktirvA gairikaM vA ghRutAplutam| <br /> <br /> (pRuthagete pradehAshca hitA j~jeyA visarpiNAm [3] )| <br /> <br /> prapauNDarIkaM madhukaM balA shAlUkamutpalam||82|| <br /> <br /> nyagrodhapatradugdhIke saghRutaM syAt pralepanam| <br /> <br /> bisAni ca mRuNAlaM ca saghRutAshca kasherukAH||83|| <br /> <br /> shatAvarIvidAryoshca kandau dhautaghRutAplutau| <br /> <br /> shaivAlaM nalamUlAni gojihvA vRuShakarNikA||84|| <br /> <br /> indrANishAkaM saghRutaM shirIShatvagbalAghRutam [4] | <br /> <br /> nyagrodhodumbaraplakShavetasAshvatthapallavaiH||85|| <br /> <br /> tvakkalkairbahusarpirbhiH shItairAlepanaM hitam| <br /> <br /> pradehAH sarva evaite vātapittolbaNe [5] shubhAH||86|| <br /> <br /> sakaphe [6] tu pravakShyAmi pradehAnaparAn hitAn| <br /> <br /> triphalAM padmakoshIraM sama~ggAM karavIrakam||87|| <br /> <br /> nalamUlAnyanantAM ca pradehamupakalpayet| <br /> <br /> khadiraM saptaparNaM ca mustāmAragvadhaM dhavam||88|| <br /> <br /> kuraNTakaM devadAru dadyAdAlepanaM bhiShak| <br /> <br /> Aragvadhasya patrANi tvacaM shleShmAtakasya ca||89|| <br /> <br /> indrANishAkaM kAkAhvAM shirIShakusumAni ca| <br /> <br /> shaivAlaM nalamUlAni vIrAM gandhapriya~ggukAm||90|| <br /> <br /> triphalAM madhukaM vIrAM shirIShakusumAni ca| <br /> <br /> prapauNDarIkaM hrIberaM dArvItva~gmadhukaM balAm||91|| <br /> <br /> pRuthagAlepanaM kuryAddvandvashaH sarvasho~api vA| <br /> <br /> pradehAH sarva evaite deyAH svalpaghRutAplutAH||92|| <br /> <br /> vātapittolbaNe ye tu pradehAste ghRutAdhikAH| <br /> <br /> ghRutena shatadhautena pradihyAt kevalena vA||93|| <br /> <br /> ghRutamaNDena shItena payasA madhukAmbunA| <br /> <br /> pa~jcavalkakaShAyeNa secayecchItalena vA||94|| <br /> <br /> vātasRukpittabahulaM visarpaM bahusho bhiShak| <br /> <br /> secanAste pradehA ye ta eva ghRutasAdhanAH||95|| <br /> <br /> te cUrNayōga vIsarpavraNAnAmavacUrNanAH| <br /> <br /> dUrvAsvarasasiddhaM ca ghRutaM syAdvraNaropaNam||96|| <br /> <br /> dArvItva~gmadhukaM lōdhraM kesharaM cAvacUrNanam| <br /> <br /> patōlaH picumardashca triphalA madhukotpale||97|| <br /> <br /> etat prakShAlanaM sarpirvraNacUrNaM pralepanam|98| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After the body is cleansed internally (systemic) and morbid [[dosha]] remains in the skin and flesh (external tissues), or [[dosha]] morbidity is little, the external treatment to be carried out will now be described. <br /> <br /> The bark of ''udumbara'' (Ficus glomerata), ''madhuka'' (Glycyrrhiza glabra Linn), ''padmakinjalka'' (Prunas cerasoides), ''utpala'' (Nymphaea nouchali), ''nagapuspa'' (Mesua ferrea Linn) and ''priyangu'' (Callicarpa macrophylla) mixed with ghee and applied externally as ''pradeha'' and is beneficial. <br /> <br /> The tender adventitious roots of ''nyagrodha'' (Ficus bengalensis Linn), pith of ''kadali'' (Musa paradisiaca Linn.) and rhizome of lotus should be mixed with ghee washed hundred times and is applied externally as a ''lepa''.<br /> <br /> The ''kaliyaka'' (Santalum album Linn), ''madhuka'' (Glycyrrhiza glabra Linn), ''hema'' (calophyllum inophyllum), ''vanya'' (cyperus esculentus), ''chandana'' (Santalum album Linn), ''padmaka'' (Prunas cerasoides), ''ela'' (Elettaria cardamomum), ''mrnala'' (Nelumbo nucifera) and ''phalini'' (Callicarpa macrophylla) should be mixed with ghee and is applied externally as a ''pralepa''. <br /> <br /> The roots ''shadvala'' (Elymus repens), ''mrnala'' (Nelumbo nucifera), ''shankha'' (conch shells), ''chandana'' (Santalum album Linn), ''utpala'' (Nymphaea nouchali), ''vetas'' (Salix caprea Linn) and ''tandula'' (rice) should be applied externally as a ''pradeha''. <br /> ''Sariva'' (Hemidesmus indicus), ''padmakinjalka'' (Prunas cerasoides), ''ushira'' (Vetiveria zizanioidis), ''nila utpala'' (Nymphaea caerulea), ''manjistha'' (Rubia cordifolia), ''chandana'' (Santalum album Linn), ''lodhra'' (symplocos racemosa) and ''abhaya'' (Terminalia chebula) should be applied externally as ''pralepa''. <br /> <br /> ''Nalada'' (Vetiveria zizanioidis), ''harenu'' (Vitex negundo Linn), ''lodhra'' (Symplocos racemosa), ''madhuka'' (Glycyrrhiza glabra Linn), ''padmaka'' (Prunas cerasoides), ''durva'' (Cynodon dactylon) and ''sarjarasa'' (Shorea robusta) should be mixed with ghee and used externally as a ''pralepa''.<br /> <br /> The gruel prepared of barley or roasted flour of cereals should be mixed with ghee and also ''madhuka'' (Glycyrrhiza glabra Linn), ''vira'' (Pueraria tuberose) and ''yavasaktu'' mixed with ghee should be used externally as a ''pradeha''. <br /> <br /> The physician should use mixture of ''bala'' (Sida cordifolia Linn), ''utpala'' (Nymphaea nouchali), ''shaluka'' (Asparagus racemosus), ''vira'' (Pueraria tuberose), ''aguru'' (Aquilaria agallocha), ''chandana'' (Santalum album Linn), ''mrnala'' (stalk) and ''bisa'' (tubers of Nelumbo nucifera) externally as ''alepan'' (local application as a smear or thick paste or coating). <br /> <br /> The powder of barley mixed with honey and ghee should be used externally as a ''pralepa'' (application as thin paste). <br /> <br /> ''Harenu'' (Pisum sativum), ''masura'' (Lens culinaris), ''mudga'' (Vigna radiata) and white ''shali'' rice should be mixed with ghee individually or in combination and used externally as a ''pradeha'' (application as a poultice).<br /> <br /> The cooling mud at the root of lotus, pearls or rice flour or conch shells, coral, oyster shell and ochre should be mixed with ghee separately and beneficial externally as a ''pradeha'' in ''visarpa''.<br /> <br /> ''Prapaundarika'' (Nelumbo nucifera), ''madhuka'' (Glycyrrhiza glabra Linn), ''bala'' (Sida cordifolia), ''shaluka'' (Asparagus racemosus), ''utpala'' (Nymphaea nouchali), ''nyagrodha'' (Ficus bengalensis Linn) and ''dugdhika'' (Euphorbia hirta Linn.) mixed with ghee should be used externally as a ''pralepan''. <br /> <br /> The ''bisa'' (lotus fibres), ''mrnala'' (lotus stalks) and ''kasheruka'' (Cyperus esculentus) mixed with ghee. The ''shatavari'' (Asparagus racemosus) and ''vidarikand'' (Pueraria tuberose) mixed with washed ghee.<br /> <br /> The ''shaival'' (moss), root of ''nala'' (phragmites australis), ''gojihva'' (Amorphophallus paeoniifolius), ''vrsa karnika'' (Calystegia soldanella) and ''indranishaka'' (Vitex agnus-castus) mixed with ghee.<br /> <br /> The bark of ''sirisa'' (Albizzia lebbeck) and ''bala'' (Sida cordifolia Linn) mixed with ghee. ''Nyagrodha'' (Ficus bengalensis Linn), ''udumbar'' (Ficus glomerata), ''plaksha'' (Ficus sycomorus), ''vetas'' (Salix caprea Linn), ''asvattha'' (Ficus religiosa) leaves and bark mixed with ample ghee used as a cold ''alepan'' is beneficial. <br /> <br /> All these external applications are beneficial in [[vata]] [[pitta]] predominant ''visarpa''. <br /> <br /> Other external applications useful in [[kapha]] predominant ''visarpa'' will be described here after. ''Triphala'' (''haritaki, bibhitaki'' and ''amalaki''), ''padmaka'' (Prunas cerasoides), ''usir'' (Vetiveria zizanioidis Linn), ''samanga'' (Mimosa pudica), ''karviraka'' (Nerium indicum), root of ''nala'' (Phragmites australis) and ''ananta'' (hemidesmus indicus) should be used externally as a ''pradeha''. <br /> <br /> ''Khadira'' (Acacia catechu), ''saptaparna'' (Alstonia scholaris), ''musta'' (Cyperus rotundus linn), ''aragvadha'' (Cassia fistula Linn), ''dhava'' (Anogeissus latifolia, Wall). ''Kurantaka'' (Lawsonia inermis) and ''devdaru'' (Cedrus deodar) should be applied externally as a ''pradeha''.<br /> <br /> ''Aragvadha'' leaves (Cassia fistula Linn.) and ''sleshmantak'' bark (Cordia dichotoma), ''indrani shak'' (Vitex negundo Linn), ''kakahva'' (Canvalia gladiata) and ''sirisa'' flowers (Albizia lebbeck Linn.), ''saivala'' (Spirogyra maxima) root of ''nala'' (Phragmites australis), ''veera'' (Pueraria tuberose) and ''gandpriyangu'' (Callicarpa macrophylla), ''triphala'' (''Haritaki, Bibhitaki'' and ''Amalaki''), ''madhuka'' (Glycyrrhiza glabra Linn), ''prapaundrika'' (nelumbo nucifera), ''hribera'' (Pavonia odorata), bark of ''darvi'' (Berberis aristata), and ''bala'' (Sida cordifolia Linn.) - these should be applied singly, dually or collectively as a ''pradeha''. All these external applications should be mixed with small quantity of ghee. In [[vata]] [[pitta]] predominant condition these preparations should be mixed with profuse quantity of ghee.<br /> <br /> The applications of ''shatdhaut ghrita'' as ''pradeha'' or effuse with cold ghee scum, or cold milk or cold decoction of ''madhuka'' (Glycyrrhiza glabra Linn), or ''panchavalka'' (bark of ''nygrodha, udumbara, asvattha, plaksa'' and ''vetasa''), the physician should use frequently in [[vata]], [[rakta]] and [[pitta]] predominant ''visarpa''.<br /> <br /> The external application mentioned as ''pradeha'' may also be used for sprinkling or for preparation ''ghrita yoga'' or ''churna yoga'' used for dusting in wounds of ''visarpa'', ghee cooked with ''durva'' juice promotes wound healing.<br /> <br /> Bark of ''daruharidra'' (Berberis aristata), ''madhuka'' (Glycyrrhiza glabra Linn), ''lodhra'' (Symplocos racemosa) and ''keshara'' (Crocus sativus Linn), powder may be used for dusting the ulcers. ''Patola'' (Trichosanthes dioica Roxb), ''pichumarda'' (Azadirachta indica), ''triphala'' (''haritaki, bibhitaki'' and ''amalaki''), ''madhuka'' (Glycyrrhiza glabra Linn) and ''utpala'' (Nymphaea nouchali), these ingredients may be used to prepare decoction for cleansing the ulcers or to prepare ''ghrita'' or to prepare powder for dusting the ulcers or to prepare ''pralepa''.<br /> <br /> All these external applications as ''pradeha'' should be used for ''samprasadana'' (cleansing and pacifying the blood). [71-98]<br /> <br /> === Guidelines for local application and its types ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षणे क्षणे प्रयोक्तव्याः पूर्वमुद्धृत्य लेपनम् | <br /> <br /> अधावनोद्धृते पूर्वे प्रदेहा बहुशोऽघनाः ||९९|| <br /> <br /> देयाः प्रदेहाः कफजे पर्याधानोद्धृते घनाः | <br /> <br /> त्रिभागाङ्गुष्ठमात्रः स्यात् प्रलेपः कल्कपेषितः ||१००|| <br /> <br /> नातिस्निग्धो न रूक्षश्च न पिण्डो न द्रवः समः |<br /> <br /> न च पर्युषितं लेपं कदाचिदवचारयेत् ||१०१|| <br /> <br /> न च तेनैव लेपेन पुनर्जातु प्रलेपयेत् | <br /> <br /> क्लेदवीसर्पशूलानि सोष्णाभावात् प्रवर्तयेत् ||१०२|| <br /> <br /> लेपो ह्युपरि पट्टस्य कृतः स्वेदयति व्रणम् | <br /> <br /> स्वेदजाः पिडकास्तस्य कण्डूश्चैवोपजायते ||१०३|| <br /> <br /> उपर्युपरि लेपस्य लेपो यद्यवचार्यते | <br /> <br /> तानेव दोषाञ्जनयेत् पट्टस्योपरि यान् कृतः ||१०४|| <br /> <br /> अतिस्निग्धोऽतिद्रवश्च लेपो यद्यवचार्यते | <br /> <br /> त्वचि न श्लिष्यते सम्यङ्न दोषं शमयत्यपि ||१०५|| <br /> <br /> तन्वालिप्तं न कुर्वीत संशुष्को ह्यापुटायते | <br /> <br /> न चौषधिरसो व्याधिं प्राप्नोत्यपि च शुष्यति ||१०६|| <br /> <br /> तन्वालिप्तेन ये दोषास्तानेव जनयेद्भृशम् | <br /> <br /> संशुष्कः पीडयेद्व्याधिं निःस्नेहो ह्यवचारितः ||१०७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pradēhāḥ sarva ēvaitē kartavyāḥ samprasādanāḥ [1] ||98|| <br /> <br /> kṣaṇē kṣaṇē prayōktavyāḥ pūrvamuddhr̥tya lēpanam| <br /> <br /> adhāvanōddhr̥tē pūrvē pradēhā bahuśō'ghanāḥ||99|| <br /> <br /> dēyāḥ pradēhāḥ kaphajē paryādhānōddhr̥tē ghanāḥ| <br /> <br /> tribhāgāṅguṣṭhamātraḥ syāt pralēpaḥ kalkapēṣitaḥ||100|| <br /> <br /> nātisnigdhō na rūkṣaśca na piṇḍō na dravaḥ samaḥ| <br /> <br /> na ca paryuṣitaṁ lēpaṁ kadācidavacārayēt||101|| <br /> <br /> na ca tēnaiva lēpēna punarjātu pralēpayēt| <br /> <br /> klēdavīsarpaśūlāni sōṣṇābhāvāt pravartayēt||102|| <br /> <br /> lēpō hyupari paṭṭasya kr̥taḥ svēdayati vraṇam| <br /> <br /> svēdajāḥ piḍakāstasya kaṇḍūścaivōpajāyatē||103|| <br /> <br /> uparyupari lēpasya lēpō yadyavacāryatē| <br /> <br /> tānēva dōṣāñjanayēt paṭṭasyōpari yān kr̥taḥ||104|| <br /> <br /> atisnigdhō'tidravaśca lēpō yadyavacāryatē| <br /> <br /> tvaci na śliṣyatē samyaṅna dōṣaṁ śamayatyapi||105|| <br /> <br /> tanvāliptaṁ na kurvīta saṁśuṣkō hyāpuṭāyatē| <br /> <br /> na cauṣadhirasō vyādhiṁ prāpnōtyapi ca śuṣyati||106|| <br /> <br /> tanvāliptēna yē dōṣāstānēva janayēdbhr̥śam| <br /> <br /> saṁśuṣkaḥ pīḍayēdvyādhiṁ niḥsnēhō hyavacāritaḥ||107|| <br /> <br /> pradehAH sarva evaite kartavyAH samprasAdanAH [1] ||98|| <br /> <br /> kShaNe kShaNe prayoktavyAH pUrvamuddhRutya lepanam| <br /> <br /> adhAvanoddhRute pUrve pradehA bahusho~aghanAH||99|| <br /> <br /> deyAH pradehAH kaphaje paryAdhAnoddhRute ghanAH| <br /> <br /> tribhAgA~gguShThamAtraH syAt pralepaH kalkapeShitaH||100|| <br /> <br /> nAtisnigdho na rūkṣashca na piNDo na dravaH samaH| <br /> <br /> na ca paryuShitaM lepaM kadAcidavacArayet||101|| <br /> <br /> na ca tenaiva lepena punarjAtu pralepayet| <br /> <br /> kledavIsarpashUlAni soShNAbhAvAt pravartayet||102|| <br /> <br /> lepo hyupari paTTasya kRutaH svedayati vraNam| <br /> <br /> svedajAH piDakAstasya kaNDUshcaivopajAyate||103|| <br /> <br /> uparyupari lepasya lepo yadyavacAryate| <br /> <br /> tAneva dōṣa~jjanayet paTTasyopari yAn kRutaH||104|| <br /> <br /> atisnigdho~atidravashca lepo yadyavacAryate| <br /> <br /> tvaci na shliShyate samya~gna dōṣaM shamayatyapi||105|| <br /> <br /> tanvAliptaM na kurvIta saMshuShko hyApuTAyate| <br /> <br /> na cauShadhiraso vyAdhiM prApnotyapi ca shuShyati||106|| <br /> <br /> tanvAliptena ye dōṣastAneva janayedbhRusham| <br /> <br /> saMshuShkaH pIDayedvyAdhiM niHsneho hyavacAritaH||107|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> These ''lepa'' (local applications of pastes) are to be used repeatedly after removing the previous applied ''lepa''.<br /> <br /> Thin ''predeha'' should be applied as thick paste repeatedly after removing the previous one, but without washing it. <br /> <br /> In [[kapha]]ja visarpa, pradeha should be repeatedly applied as thick paste after removing the previous dried paste.<br /> <br /> The ''pralepa'' should be prepared as ''kalka'' (micronized paste) and applied of thickness equal to one third of the thumb. <br /> <br /> A ''pralepa'' should be neither too unctuous nor too dry, neither too solid nor too liquid, but of the right consistency. <br /> <br /> The stale ''lepa'' should never be used for application; the previously used ''lepa'' should not be used again for application, because it causes accumulation of heat leading to ''kleda'' (putrification), ''visarpa'' (spread of disease) and pain.<br /> <br /> The ''pralepa'' smeared over a piece of cloth, and that cloth is used for application on wound, it sudates the wound and consequently ''swedaja pidaka'' (boils) and itching are induced. <br /> <br /> If the ''pralepa'' is applied without removing the previous ''pralepa'', it produces same adverse effects as those mentioned above in the case of applications over the bandage. <br /> <br /> The ''pralepa'' applied externally that is either too unctuous or too fluid does not adhere properly and therefore cannot alleviate the diseased condition. <br /> <br /> Thin ''lepa'' should not be applied because while drying develops cracks and medicinal property of ''lepa'' does not penetrates properly in the affected part as it dries up quickly.<br /> <br /> If the ''pralepa'' is applied without mixing ghee, it produces same but in excess adverse effects as described for thin ''pralepa''. While getting dried up this ''pralepa'' leads to aggravation of disease manifestation. [99-107]<br /> <br /> === Diet recipes for treatment of ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अन्नपानानि वक्ष्यामि विसर्पाणां निवृत्तये | <br /> <br /> लङ्घितेभ्यो हितो मन्थो रूक्षः सक्षौद्रशर्करः ||१०८|| <br /> <br /> मधुरः किञ्चिदम्लो वा दाडिमामलकान्वितः | <br /> <br /> सपरूषकमृद्वीकः सखर्जूरः शृताम्बुना ||१०९|| <br /> <br /> तर्पणैर्यवशालीनां सस्नेहा चावलेहिका | <br /> <br /> जीर्णे पुराणशालीनां यूषैर्भुञ्जीत भोजनम् ||११०|| <br /> <br /> मुद्गान्मसूरांश्चणकान् यूषार्थमुपकल्पयेत् | <br /> <br /> अनम्लान् दाडिमाम्लान् वा पटोलामलकैः सह ||१११|| <br /> <br /> जाङ्गलानां च मांसानां रसांस्तस्योपकल्पयेत् | <br /> <br /> रूक्षान् परूषकद्राक्षादाडिमामलकान्वितान् ||११२|| <br /> <br /> रक्ताः श्वेता महाह्वाश्च शालयः षष्टिकैः सह | <br /> <br /> भोजनार्थे प्रशस्यन्ते पुराणाः सुपरिस्रुताः ||११३|| <br /> <br /> यवगोधूमशालीनां सात्म्यान्येव प्रदापयेत् | <br /> <br /> येषां नात्युचितः शालिर्नरा ये च कफाधिकाः ||११४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> annapānāni vakṣyāmi visarpāṇāṁ nivr̥ttayē| <br /> <br /> laṅghitēbhyō hitō manthō rūkṣaḥ sakṣaudraśarkaraḥ||108|| <br /> <br /> madhuraḥ kiñcidamlō vā dāḍimāmalakānvitaḥ| <br /> <br /> saparūṣakamr̥dvīkaḥ sakharjūraḥ śr̥tāmbunā||109|| <br /> <br /> tarpaṇairyavaśālīnāṁ sasnēhā cāvalēhikā| <br /> <br /> jīrṇē purāṇaśālīnāṁ yūṣairbhuñjīta bhōjanam||110|| <br /> <br /> mudgānmasūrāṁścaṇakān yūṣārthamupakalpayēt| <br /> <br /> anamlān dāḍimāmlān vā paṭōlāmalakaiḥ saha||111|| <br /> <br /> jāṅgalānāṁ ca māṁsānāṁ rasāṁstasyōpakalpayēt| <br /> <br /> rūkṣān parūṣakadrākṣādāḍimāmalakānvitān||112|| <br /> <br /> raktāḥ śvētā mahāhvāśca śālayaḥ ṣaṣṭikaiḥ saha| <br /> <br /> bhōjanārthē praśasyantē purāṇāḥ suparisrutāḥ||113|| <br /> <br /> yavagōdhūmaśālīnāṁ sātmyānyēva pradāpayēt| <br /> <br /> yēṣāṁ nātyucitaḥ śālirnarā yē ca kaphādhikāḥ||114|| <br /> <br /> annapAnAni vakShyAmi visarpANAM nivRuttaye| <br /> <br /> la~gghitebhyo hito mantho rūkṣaH sakShaudrasharkaraH||108|| <br /> <br /> madhuraH ki~jcidamlo vA dADimAmalakAnvitaH| <br /> <br /> saparUShakamRudvIkaH sakharjUraH shRutAmbunA||109|| <br /> <br /> tarpaNairyavashAlInAM sasnehA cAvalehikA| <br /> <br /> jIrNe purANashAlInAM yUShairbhu~jjIta bhojanam||110|| <br /> <br /> mudgAnmasUrAMshcaNakAn yUShArthamupakalpayet| <br /> <br /> anamlAn dADimAmlAn vA patōlamalakaiH saha||111|| <br /> <br /> jA~ggalAnAM ca mAMsAnAM rasAMstasyopakalpayet| <br /> <br /> rūkṣan parUShakadrAkShAdADimAmalakAnvitAn||112|| <br /> <br /> raktAH shvetA mahAhvAshca shAlayaH ShaShTikaiH saha| <br /> <br /> bhojanArthe prashasyante purANAH suparisrutAH||113|| <br /> <br /> yavagodhUmashAlInAM sAtmyAnyeva pradApayet| <br /> <br /> yeShAM nAtyucitaH shAlirnarA ye ca kaphAdhikAH||114|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The diet regimen helps to alleviate ''visarpa'' is described here after.<br /> <br /> In the beginning [[langhana]] (fasting therapy) should be given. There after use of ''mantha'' (roasted flour mixed with water in specific proportion and kept for specific time) is beneficial. The ''mantha'' should be without unctus ingredients and added with honey and sugar. It becomes sweet sour in taste due to mixing of ''dadima'' (Punica granatum Linn.) or ''amalaki'' (Emblica officinalis) and ''parushaka'' or ''mrdvika'' (Vitis vinifera Linn) or ''kharjura'' (Phoenix sylvestris) and boiled water should be used to prepare ''mantha''. <br /> <br /> Thereafter linctus made of the flour of roasted barley and ''shali'' rice and mixed with ghee should be given in the form of ''avalehika''. After digestion of ''avalehika'', one should take old ''shali'' rice with soup of green gram or lentils or Bengal gram, soured or not soured with pomegranates and added with ''patola'' (Trichosanthes dioica Roxb) and ''amalaki''. He may also take meat soup of wild animals without ghee and added with ''parushaka'' or ''draksha'' or ''dadima'' or ''amalaki''. Red or white or extra long variety of ''shastika'' rice, which are old, well boiled and residual water should be completely drained, it is beneficial food. <br /> <br /> The persons who have predominance of [[kapha]] and not suited to rice should be given the preparation of barley or wheat or ''purana shali'' which is suitable.[108-114]<br /> <br /> === Contra-indications in ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विदाहीन्यन्नपानानि विरुद्धं स्वपनं दिवा | <br /> <br /> क्रोधव्यायामसूर्याग्निप्रवातांश्च विवर्जयेत् ||११५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vidāhīnyannapānāni viruddhaṁ svapanaṁ divā| <br /> <br /> krōdhavyāyāmasūryāgnipravātāṁśca vivarjayēt||115|| <br /> <br /> vidAhInyannapAnAni viruddhaM svapanaM divA| <br /> <br /> krodhavyAyAmasUryAgnipravātaMshca vivarjayet||115|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient should avoid the ''vidahi'' (that causes burning) and ''viruddha'' (mutually contradictory or incompatible) diet, day sleep, anger, exercise, exposure to sun heat, fire and fast winds.[115]<br /> <br /> === General guidelines of treatment ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कुर्याच्चिकित्सितादस्माच्छीतप्रायाणि पैत्तिके | <br /> <br /> रूक्षप्रायाणि कफजे स्नैहिकान्यनिलात्मके ||११६||<br /> <br /> वातपित्तप्रशमनमग्निवीसर्पणे हितम् | <br /> <br /> कफपित्तप्रशमनं प्रायः कर्दमसञ्ज्ञिते ||११७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kuryāccikitsitādasmācchītaprāyāṇi paittikē| <br /> <br /> rūkṣaprāyāṇi kaphajē snaihikānyanilātmakē||116|| <br /> <br /> vātapittapraśamanamagnivīsarpaṇē hitam| <br /> <br /> kaphapittapraśamanaṁ prāyaḥ kardamasañjñitē||117||<br /> <br /> kuryAccikitsitAdasmAcchItaprAyANi paittike| <br /> <br /> rūkṣaprAyANi kaphaje snaihikAnyanilAtmake||116|| <br /> <br /> vātapittaprashamanamagnivIsarpaNe hitam| <br /> <br /> kaphapittaprashamanaM prAyaH kardamasa~jj~jite||117||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Of these measures, predominantly ''sheeta'' (cool) measures are prescribed in [[pitta]] dominant condition, ''ruksha'' in [[kapha]] dominant condition and ''snigdha'' in [[vata]] dominant condition of ''visarpa''.<br /> <br /> In agni visarpa, [[vata]]-[[pitta]] pacifying measures are beneficial and in ''kardama visarpa'' mostly [[kapha]] [[pitta]] alleviating measures should be administered.[116-117]<br /> <br /> === Treatment of ''granthi visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रक्तपित्तोत्तरं दृष्ट्वा ग्रन्थिवीसर्पमादितः | <br /> <br /> रूक्षणैर्लङ्घनैः सेकैः प्रदेहैः पाञ्चवल्कलैः ||११८|| <br /> <br /> सिरामोक्षैर्जलौकोभिर्वमनैः सविरेचनैः | <br /> <br /> घृतैः कषायतिक्तैश्च कालज्ञः समुपाचरेत् ||११९||<br /> <br /> ऊर्ध्वं चाधश्च शुद्धाय रक्ते चाप्यवसेचिते | <br /> <br /> वातश्लेष्महरं कर्म ग्रन्थिवीसर्पिणे हितम् ||१२०||<br /> <br /> उत्कारिकाभिरुष्णाभिरुपनाहःप्रशस्यते| <br /> <br /> स्निग्धाभिर्वेशवारैर्वा ग्रन्थिवीसर्पशूलिनाम् ||१२१|| <br /> <br /> दशमूलोपसिद्धेन तैलेनोष्णेन सेचयेत् |<br /> <br /> कुष्ठतैलेन चोष्णेन पाक्यक्षारयुतेन च ||१२२||<br /> <br /> गोमूत्रैः पत्रनिर्यूहैरुष्णैर्वा परिषेचयेत् | <br /> <br /> सुखोष्णया प्रदिह्याद्वा पिष्टया चाश्वगन्धया ||१२३|| <br /> <br /> शुष्कमूलककल्केन नक्तमालत्वचाऽपि वा | <br /> <br /> बिभीतकत्वचां वाऽपि कल्केनोष्णेन लेपयेत् ||१२४|| <br /> <br /> बलां नागबलां पथ्यां भूर्जग्रन्थिं बिभीतकम् | <br /> <br /> वंशपत्राण्यग्निमन्थं कुर्याद्ग्रन्थिप्रलेपनम् ||१२५|| <br /> <br /> दन्ती चित्रकमूलत्वक् सुधार्कपयसी गुडः | <br /> <br /> भल्लातकास्थि कासीसं लेपो भिन्द्याच्छिलामपि ||१२६|| <br /> <br /> बहिर्मार्गास्थितं ग्रन्थिं किं पुनः कफसम्भवम् | <br /> <br /> दीर्घकालस्थितं ग्रन्थिं भिन्द्याद्वा भेषजैरिमैः ||१२७|| <br /> <br /> मूलकानां कुलत्थानां यूषैः सक्षारदाडिमैः | <br /> <br /> गोधूमान्नैर्यवान्नैर्वा ससीधुमधुशर्करैः ||१२८|| <br /> <br /> सक्षौद्रेर्वारुणीमण्डैर्मातुलुङ्गरसान्वितैः | <br /> <br /> त्रिफलायाः प्रयोगैश्च पिप्पलीक्षौद्रसंयुतैः ||१२९|| <br /> <br /> मुस्तभल्लातशक्तूनां प्रयोगैर्माक्षिकस्य च | <br /> <br /> देवदारुगुडूच्योश्च प्रयोगैर्गिरिजस्य च ||१३०|| <br /> <br /> धूमैर्विरेकैः शिरसः पूर्वोक्तैर्गुल्मभेदनैः | <br /> <br /> अयोलवणपाषाणहेमताम्रप्रपीडनैः ||१३१||<br /> <br /> आभिः क्रियाभिः सिद्धाभिर्विविधाभिर्बली स्थिरः | <br /> <br /> ग्रन्थिः पाषाणकठिनो यदा नैवोपशाम्यति ||१३२|| <br /> <br /> अथास्य दाहः क्षारेण शरैर्हेम्नाऽथ वा हितः | <br /> <br /> पाकिभिः पाचयित्वा वा पाटयित्वा समुद्धरेत् ||१३३|| <br /> <br /> मोक्षयेद्बहुशश्चास्य रक्तमुत्क्लेशमागतम् | <br /> <br /> पुनश्चापहृते रक्ते वातश्लेष्मजिदौषधम् ||१३४|| <br /> <br /> धूमो विरेकः शिरसः स्वेदनं परिमर्दनम् | <br /> <br /> अप्रशाम्यति दोषे च पाचनं वा प्रशस्यते ||१३५|| <br /> <br /> प्रक्लिन्नं दाहपाकाभ्यां भिषक् शोधनरोपणैः | <br /> <br /> बाह्यैश्चाभ्यन्तरैश्चैव व्रणवत् समुपाचरेत् ||१३६||<br /> <br /> कम्पिल्लकं विडङ्गानि दार्वीं कारञ्जकं फलम् | <br /> <br /> पिष्ट्वा तैलं विपक्तव्यं ग्रन्थिव्रणचिकित्सितम् ||१३७|| <br /> <br /> द्विव्रणीयोपदिष्टेन कर्मणा चाप्युपाचरेत् | <br /> <br /> देशकालविभागज्ञो व्रणान् वीसर्पजान् बुधः ||१३८|| <br /> <br /> इति ग्रन्थिविसर्पचिकित्सा | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> raktapittōttaraṁ dr̥ṣṭvā granthivīsarpamāditaḥ| <br /> <br /> rūkṣaṇairlaṅghanaiḥ sēkaiḥ pradēhaiḥ pāñcavalkalaiḥ||118|| <br /> <br /> sirāmōkṣairjalaukōbhirvamanaiḥ savirēcanaiḥ| <br /> <br /> ghr̥taiḥ [1] kaṣāyatiktaiśca kālajñaḥ samupācarēt||119|| <br /> <br /> ūrdhvaṁ cādhaśca śuddhāya raktē cāpyavasēcitē| <br /> <br /> vātaślēṣmaharaṁ karma granthivīsarpiṇē hitam||120|| <br /> <br /> utkārikābhiruṣṇābhirupanāhaḥ praśasyatē| <br /> <br /> snigdhābhirvēśavārairvā granthivīsarpaśūlinām||121|| <br /> <br /> daśamūlōpasiddhēna tailēnōṣṇēna sēcayēt| <br /> <br /> kuṣṭhatailēna cōṣṇēna pākyakṣārayutēna ca||122|| <br /> <br /> gōmūtraiḥ patraniryūhairuṣṇairvā pariṣēcayēt| <br /> <br /> sukhōṣṇayā pradihyādvā piṣṭayā cāśvagandhayā||123|| <br /> <br /> śuṣkamūlakakalkēna naktamālatvacā'pi vā| <br /> <br /> bibhītakatvacāṁ vā'pi [2] kalkēnōṣṇēna lēpayēt||124|| <br /> <br /> balāṁ nāgabalāṁ pathyāṁ bhūrjagranthiṁ bibhītakam| <br /> <br /> vaṁśapatrāṇyagnimanthaṁ kuryādgranthipralēpanam||125|| <br /> <br /> dantī citrakamūlatvak sudhārkapayasī guḍaḥ| <br /> <br /> bhallātakāsthi kāsīsaṁ lēpō bhindyācchilāmapi||126|| <br /> <br /> bahirmārgāsthitaṁ granthiṁ kiṁ punaḥ kaphasambhavam| <br /> <br /> dīrghakālasthitaṁ granthiṁ bhindyādvā bhēṣajairimaiḥ||127|| <br /> <br /> mūlakānāṁ kulatthānāṁ yūṣaiḥ sakṣāradāḍimaiḥ| <br /> <br /> gōdhūmānnairyavānnairvā sasīdhumadhuśarkaraiḥ||128|| <br /> <br /> sakṣaudrairvāruṇīmaṇḍairmātuluṅgarasānvitaiḥ| <br /> <br /> triphalāyāḥ prayōgaiśca pippalīkṣaudrasaṁyutaiḥ||129|| <br /> <br /> mustābhallātaśaktūnāṁ prayōgairmākṣikasya ca| <br /> <br /> dēvadāruguḍūcyōśca prayōgairgirijasya ca||130|| <br /> <br /> dhūmairvirēkaiḥ śirasaḥ pūrvōktairgulmabhēdanaiḥ|<br /> <br /> ayōlavaṇapāṣāṇahēmatāmraprapīḍanaiḥ||131|| <br /> <br /> ābhiḥ kriyābhiḥ siddhābhirvividhābhirbalī sthiraḥ| <br /> <br /> granthiḥ pāṣāṇakaṭhinō yadā naivōpaśāmyati||132|| <br /> <br /> athāsya dāhaḥ kṣārēṇa śarairhēmnā'tha [3] vā hitaḥ| <br /> <br /> pākibhiḥ pācayitvā vā pāṭayitvā samuddharēt||133|| <br /> <br /> mōkṣayēdbahuśaścāsya raktamutklēśamāgatam| <br /> <br /> punaścāpahr̥tē [4] raktē vātaślēṣmajidauṣadham||134|| <br /> <br /> dhūmō virēkaḥ śirasaḥ svēdanaṁ parimardanam| <br /> <br /> apraśāmyati dōṣē ca pācanaṁ [5] vā praśasyatē||135|| <br /> <br /> praklinnaṁ dāhapākābhyāṁ bhiṣak śōdhanarōpaṇaiḥ| <br /> <br /> bāhyaiścābhyantaraiścaiva vraṇavat samupācarēt||136|| <br /> <br /> kampillakaṁ viḍaṅgāni dārvīṁ kārañjakaṁ phalam| <br /> <br /> piṣṭvā tailaṁ vipaktavyaṁ granthivraṇacikitsitam||137|| <br /> <br /> dvivraṇīyōpadiṣṭēna karmaṇā cāpyupācarēt| <br /> <br /> dēśakālavibhāgajñō vraṇān vīsarpajān budhaḥ||138|| <br /> <br /> iti granthivisarpacikitsā| <br /> <br /> raktapittottaraM dRuShTvA granthivIsarpamAditaH| <br /> <br /> rūkṣaNairla~gghanaiH sekaiH pradehaiH pA~jcavalkalaiH||118||<br /> <br /> sirAmokShairjalaukobhirvamanaiH savirecanaiH| <br /> <br /> ghRutaiH [1] kaShAyatiktaishca kAlaj~jaH samupAcaret||119|| <br /> <br /> UrdhvaM cAdhashca shuddhAya rakte cApyavasecite| <br /> <br /> vātashleShmaharaM karma granthivIsarpiNe hitam||120|| <br /> <br /> utkArikAbhiruShNAbhirupanAhaH prashasyate| <br /> <br /> snigdhAbhirveshavArairvA granthivIsarpashUlinAm||121|| <br /> <br /> dashamUlopasiddhena tailenoShNena secayet| <br /> <br /> kuShThatailena coShNena pAkyakShArayutena ca||122|| <br /> <br /> gomUtraiH patraniryUhairuShNairvA pariShecayet| <br /> <br /> sukhoShNayA pradihyAdvA piShTayA cAshvagandhayA||123|| <br /> <br /> shuShkamUlakakalkena naktamAlatvacA~api vA| <br /> <br /> bibhItakatvacAM vA~api [2] kalkenoShNena lepayet||124|| <br /> <br /> balAM nAgabalAM pathyAM bhUrjagranthiM bibhItakam| <br /> <br /> vaMshapatrANyagnimanthaM kuryAdgranthipralepanam||125|| <br /> <br /> dantI citrakamUlatvak sudhArkapayasI guDaH| <br /> <br /> bhallAtakAsthi kAsIsaM lepo bhindyAcchilAmapi||126|| <br /> <br /> bahirmArgAsthitaM granthiM kiM punaH kaphasambhavam| <br /> <br /> dIrghakAlasthitaM granthiM bhindyAdvA bheShajairimaiH||127|| <br /> <br /> mUlakAnAM kulatthAnAM yUShaiH sakShAradADimaiH| <br /> <br /> godhUmAnnairyavAnnairvA sasIdhumadhusharkaraiH||128|| <br /> <br /> sakShaudrairvAruNImaNDairmAtulu~ggarasAnvitaiH| <br /> <br /> triphalAyAH prayōgaishca pippalIkShaudrasaMyutaiH||129|| <br /> <br /> mustābhallAtashaktUnAM prayōgairmAkShikasya ca| <br /> <br /> devadAruguDUcyoshca prayōgairgirijasya ca||130|| <br /> <br /> dhUmairvirekaiH shirasaH pUrvoktairgulmabhedanaiH| <br /> <br /> ayolavaNapAShANahematAmraprapIDanaiH||131|| <br /> <br /> AbhiH kriyAbhiH siddhAbhirvividhAbhirbalI sthiraH| <br /> <br /> granthiH pAShANakaThino yadA naivopashAmyati||132|| <br /> <br /> athAsya dAhaH kShAreNa sharairhemnA~atha [3] vA hitaH| <br /> <br /> pAkibhiH pAcayitvA vA pATayitvA samuddharet||133|| <br /> <br /> mokShayedbahushashcAsya raktamutkleshamAgatam| <br /> <br /> punashcApahRute [4] rakte vātashleShmajidauShadham||134|| <br /> <br /> dhUmo virekaH shirasaH svedanaM parimardanam| <br /> <br /> aprashAmyati doShe ca pAcanaM [5] vA prashasyate||135|| <br /> <br /> praklinnaM dAhapAkAbhyAM bhiShak sōdhanaropaNaiH| <br /> <br /> bAhyaishcAbhyantaraishcaiva vraNavat samupAcaret||136|| <br /> <br /> kampillakaM viDa~ggAni dArvIM kAra~jjakaM phalam| <br /> <br /> piShTvA tailaM vipaktavyaM granthivraNacikitsitam||137|| <br /> <br /> dvivraNIyopadiShTena karmaNA cApyupAcaret| <br /> <br /> deshakAlavibhAgaj~jo vraNAn vIsarpajAn budhaH||138|| <br /> <br /> iti granthivisarpacikitsA| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''granthi visarpa'', on inspection is predominant in [[rakta]] [[pitta]]; the physician experienced in timely management should treat the case with [[rukshana]] (de-oleation), [[langhana]] (lightening therapy), ''seka'' (affusion), and ''pradeha'' (external application) of ''panchavalka, siramoksha'' (blood letting), ''jalauka'' (leech therapy), [[vamana]] (emesis therapy), [[virechana]] (purgation therapy) and ''kashaya- tikta'' (astringent and bitter) ghee preparations. <br /> <br /> After cleansing of body by [[vamana]] and [[virechana]], [[rakta]] mokshana should be administered and the measures alleviating [[vata]]-[[kapha]] are beneficial.<br /> <br /> When there is pain in ''granthi visarpa, upanaha'' (hot poultice) of warm and unctuous ''utkarika'' (medicinal pancake) or ''vesavara'' (medicated meat) application on the affected part is beneficial.<br /> <br /> The warm oil prepared from ''dashamoola'' (roots of ten plants) should be sprinkled on the affected part. Warm ''kustha'' (costus) oil added with ''pakya kshara'' (prepared medicinal alkali) or warm cow’s urine or decoction of [[vata]] [[kapha]]hara leaves should be used as affusion on the affected part.<br /> <br /> The warm paste of ''ashvagandha'' (Withania somnifera) should be applied as ''pradeha'' on the affected part. <br /> <br /> The warm paste of dried ''mulaka'' (Raphanus sativus) or bark of ''naktamala'' (Pongamia pinnata) or bark of ''bibhitaka'' (Terminalia bellirica) should be applied externally as a ''lepa'' on the affected part. ''Bala'' (Sida cordifolia Linn), ''nagabala'' (Grewia hirsuta), ''pathya'' (Terminalia chebula), ''bhurjagranthi'' (betula bhojpatra), ''bibhitaka'' (Terminalia bellirica), ''vamsha'' leaves (bambusa vulgaris) and ''agnimantha'' (Premna mucronata) should be applied as ''pralepa'' on ''granthi''.<br /> <br /> ''Danti'' (Baliospermum montanum), bark of ''chitraka'' root (Plumbago zeylanica Linn), latex of ''snuhi'' (Euphoria nerrifolia) and ''arka'' (Calatropis gigantean), jaggery, seed of ''bhallataka'' (Semecarpus anacardium linn) and ''kasisa'' (green vitriol) application as a ''lepa'' breaks even a stone, then what to speak of the nodules caused by [[kapha]] and situated in external regions of body. Long standing ''granthi'' should be broken by the use of the internal medications such as ''Yusha'' of ''mulaka'' (Raphanus sativus) and ''kullatha'' (Macrotyloma uniflorum.) added with ''kshara'' (prepared alkali) and ''dadima'' (Punica granatum), food prepared from ''godhum'' and ''yava'' with ''sidhu'', honey and sugar, ''varuni'' scum with honey and ''matulung'' juice (Citrus medica), use of ''triphala'' with ''pippali'' (Piper longum linn) and honey, ''musta'' (Cyperus rotundus linn) or ''bhallataka saktu'' (Semecarpus anacardium linn) and honey, ''devadaru'' (Cedrus deodara), ''guduchi'' (Tinospora cordifolia) and ''girija'' (Asphaltum punjabianum).<br /> <br /> ''Dhuma, shirovirechana,'' measures described to break the ''gulma'' in [[Gulma Chikitsa]] chapter, as well as iron, salt, stone, gold and copper should be used for ''prapidana'' (compression) of ''granthi''.<br /> <br /> If ''granthi'' is strong, firm and stony hard and not responding to all these proven methods of treatment then it is better to be cauterized with ''kshara'' (medicinal alkali) or hot metal arrow or hot gold or after making it suppurate by applying suitable suppurative medications one should open and extract. <br /> <br /> Besides, vitiated blood should be eliminated, frequently followed administration of [[vata]] and [[kapha]] pacifying medicines, ''dhuma'' (fumigation therapy), ''shirovechana'' (errhine therapy), [[swedana]](sudation) and ''parimardana'' (pressure method). If [[dosha]] do not pacify, [[pachana]] (suppuration) treatment is beneficial. When the ''granthi'' is decomposed with ''agni'' and suppuration then physician should treat it with external and internal ''shodhana'' (cleansing) and ''ropana'' (healing) as described in ''Vrana Chikitsa''.<br /> <br /> ''Kampillaka'' (Mallotus philippinensis), ''vidanga'' (Embelia ribes Burm), ''daruharidra'' (Berberis aristata) and ''karanja'' fruit (Pongamia pinnata), the paste of all these drugs should be used to prepare oil which is indicated in the treatment of ''granthi vrina''.<br /> <br /> The intelligent physician may also treat the ''visarpa'' as per the guidelines described in [[Dwivraniya Chikitsa]] chapter.<br /> <br /> Thus ends the description of the treatment of ''granthi visarpa''.[118-138]<br /> <br /> === Treatment of ''galaganda'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> य एव विधिरुद्दिष्टो ग्रन्थीनां विनिवृत्तये | <br /> <br /> स एव गलगण्डानां कफजानां निवृत्तये ||१३९|| <br /> <br /> गलगण्डास्तु वातोत्था ये कफानुगता नृणाम् | <br /> <br /> घृतक्षीरकषायाणामभ्यासान्न भवन्ति ते ||१४०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ya ēva vidhiruddiṣṭō granthīnāṁ vinivr̥ttayē| <br /> <br /> sa ēva galagaṇḍānāṁ kaphajānāṁ nivr̥ttayē||139|| <br /> <br /> galagaṇḍāstu vātōtthā yē kaphānugatā [1] nr̥ṇām| <br /> <br /> ghr̥takṣīrakaṣāyāṇāmabhyāsānna bhavanti tē||140|| <br /> <br /> ya eva vidhiruddiShTo granthInAM vinivRuttaye| <br /> <br /> sa eva galagaNDAnAM kaphajAnAM nivRuttaye||139|| <br /> <br /> galagaNDAstu vAtotthA ye kaphAnugatA [1] nRuNAm| <br /> <br /> ghRutakShIrakaShAyANAmabhyAsAnna bhavanti te||140|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The line of treatment of ''granthi'' should be applied for the treatment of [[kapha]]ja galganda''. <br /> <br /> The ''vatika galaganda'' associated with [[kapha]] may be cured by regular use of ghee, milk and decoction preparations.[139-140]<br /> <br /> === Importance of ''raktamokshana'' in ''visarpa'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यानीहोक्तानि कर्माणि विसर्पाणां निवृत्तये | <br /> <br /> एकतस्तानि सर्वाणि रक्तमोक्षणमेकतः ||१४१|| <br /> <br /> विसर्पो न ह्यसंसृष्टो रक्तपित्तेन जायते | <br /> <br /> तस्मात् साधारणं सर्वमुक्तमेतच्चिकित्सितम् ||१४२|| <br /> <br /> विशेषो दोषवैषम्यान्न च नोक्तः समासतः | <br /> <br /> समासव्यासनिर्दिष्टां क्रियां विद्वानुपाचरेत् ||१४३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yānīhōktāni karmāṇi visarpāṇāṁ nivr̥ttayē| <br /> <br /> ēkatastāni sarvāṇi raktamōkṣaṇamēkataḥ||141|| <br /> <br /> visarpō na hyasaṁsr̥ṣṭō raktapittēna jāyatē| <br /> <br /> tasmāt sādhāraṇaṁ sarvamuktamētaccikitsitam||142|| <br /> <br /> viśēṣō dōṣavaiṣamyānna ca nōktaḥ samāsataḥ| <br /> <br /> samāsavyāsanirdiṣṭāṁ [1] kriyāṁ vidvānupācarēt||143|| <br /> <br /> yAnIhoktAni karmANi visarpANAM nivRuttaye| <br /> <br /> ekatastAni sarvANi raktamokShaNamekataH||141|| <br /> <br /> visarpo na hyasaMsRuShTo raktapittena jAyate| <br /> <br /> tasmAt sAdhAraNaM sarvamuktametaccikitsitam||142||<br /> <br /> visheSho dōṣavaiShamyAnna ca noktaH samAsataH| <br /> <br /> samAsavyAsanirdiShTAM [1] kriyAM vidvAnupAcaret||143|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If all the therapeutic measures described here as curative of ''visarpa'' be put on one side and ''raktamokshana'' on other, they will be found equal. <br /> <br /> ''Visarpa'' never occurs without the association of the [[rakta]] and [[pitta]] hence entirely general treatment has been described. It does not mean that line of treatment as per other [[dosha]] predominance is not explained here. Thus, the therapeutic measures both in general and specific cases are described both in brief and in detail. The expert physician should administer these therapies appropriately.[141-143]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकाः- <br /> <br /> निरुक्तं नामभेदाश्च दोषा दूष्याणि हेतवः | <br /> <br /> आश्रयो मार्गतश्चैव विसर्पगुरुलाघवम् ||१४४|| <br /> <br /> लिङ्गान्युपद्रवा ये च यल्लक्षण उपद्रवः | <br /> <br /> साध्यत्वं, न च, साध्यानां साधनं च यथाक्रमम् ||१४५|| <br /> <br /> इति पिप्रक्षवे सिद्धिमग्निवेशाय धीमते | <br /> <br /> पुनर्वसुरुवाचेदं विसर्पाणां चिकित्सितम् ||१४६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkāḥ- <br /> <br /> niruktaṁ nāmabhēdāśca dōṣā dūṣyāṇi hētavaḥ| <br /> <br /> āśrayō mārgataścaiva visarpagurulāghavam||144|| <br /> <br /> liṅgānyupadravā yē ca yallakṣaṇa upadravaḥ| <br /> <br /> sādhyatvaṁ, na ca, sādhyānāṁ sādhanaṁ ca yathākramam||145|| <br /> <br /> iti piprakṣavē siddhimagnivēśāya dhīmatē| <br /> <br /> punarvasuruvācēdaṁ visarpāṇāṁ cikitsitam||146|| <br /> <br /> tatra shlokAH- <br /> <br /> niruktaM nAmabhedAshca dōṣa dUShyANi hetavaH| <br /> <br /> Ashrayo mArgatashcaiva visarpagurulAghavam||144|| <br /> <br /> li~ggAnyupadravA ye ca yallakShaNa upadravaH| <br /> <br /> sAdhyatvaM, na ca, sAdhyAnAM sAdhanaM ca yathAkramam||145|| <br /> <br /> iti piprakShave siddhimagniveshAya dhImate| <br /> <br /> punarvasuruvAcedaM visarpANAM cikitsitam||146||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now the summing up verses –<br /> <br /> Derivation,synonyms, classification, [[dosha]], dushya, etiology, the habitat, the severe and mild gradation, symptoms and signs, complications, the nature of complications, prognosis and treatment of curable ones. All these aspects has been explained by Punarvasu Atreya for the inquisitive and intelligent Agnivesha under the treatment of ''visarpa''. [144-146]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते चिकित्सास्थाने <br /> <br /> विसर्पचिकित्सितं नामैकविंशोऽध्यायः ||२१||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē cikitsāsthānē <br /> <br /> visarpacikitsitaṁ nāmaikaviṁśō'dhyāyaḥ||21|| <br /> <br /> ityagniveshakRute tantre carakapratisaMskRute cikitsAsthAne <br /> <br /> visarpacikitsitaM nAmaikaviMsho~adhyAyaH||21|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus ends the twenty first chapter on treatment of ''visarpa'' in [[Chikitsa Sthana]] in the treatise composed by Agnivesha and redacted by Charak.[21]<br /> <br /> == Tattva Vimarsha (Fundamental Principles) == <br /> <br /> *Seven elements are involved in the pathogenesis of ''visarpa'' viz., [[rakta]], lasika, tvak, [[mamsa dhatu]], [[vata]], [[pitta]] and [[kapha]]. <br /> *''Visarpa'' is acute spreading disease and fatal in nature. General etiological factors of ''visarpa'' are diet and life style related, injury, poisons, toxins, burns etc., some of these cause vitiation of [[dosha]] and ''khavaigunya'' (disease prone condition) in [[dhatu]] and some cause direct vitiation of [[dosha]] and [[dhatu]] leading to ''visarpa''. Hence favorable condition for infection or disease phenomenon occurs at first therefore, diet and lifestyle related factors are important preventive measures.<br /> *Excess intake of salt, sour, pungent, hot articles lead to vitiation of [[rakta]] first and then lead to ''visarpa''. <br /> *''Visarpa'' is manifested externally, internally or in both pathways. Severity of disease increases respectively in these cases. <br /> *Classification and pathogenesis of ''visarpa'' is based upon involvement of [[dosha]] as per their severity. Treatment protocol is designed for primarily involved predominant [[dosha]]. If the ''visarpa'' is caused with ama dosha (the state of incomplete transformation) and is located in ''kaphasthana'' (in thorax and upper body parts), then [[langhana]] (fasting therapy), [[vamana]] (emesis) therapy, ''tikta'' (bitter) drugs internally and application of paste of drugs with dry and cold properties externally is beneficial. <br /> *The same treatment should be adopted in case of association of ''ama'' and location in [[pitta]] sthana (abdomen and middle parts of body). In addition, ''raktamokshana'' (blood letting) and [[virechana]] (therapeutic purgation therapy) are specially indicated. <br /> *If ''sama'' (with ''ama dosha'') ''visarpa'' occurs from ''vatashaya'' (pelvis and lower part of body) dry measures are indicated in the beginning. Even in association with [[rakta]]-[[pitta]], unction measure is not regarded as beneficial in the beginning. <br /> *In [[vata]]ja visarpa and ''paittika visarpa'' of mild aggravated [[dosha]], tiktaka ghritam'' is beneficial. But if the [[pitta]] [[dosha]] is excessively aggravated then [[virechana]] should be given. <br /> *In the condition of excessively aggravated [[dosha]], ghee should not be given at first, which does not cause [[virechana]]. Because non purgating ghee occlude the [[dosha]] resulting in decomposed skin, flesh and blood. Hence in ''visarpa, virechana'' followed by ''raktamokshana'' is recommended because the disorder is located in blood.<br /> *If [[dosha]] in ''shakha'' (body elements) vitiate the blood, then [[rakta]]mokshana should be administered first. The physician should use ''vishana'' (deer horn) in [[vata]] dominance, ''jalauka'' (Hirudinea medicinalis) in [[pitta]] dominance and ''alabu'' (lagenaria siceraria) in [[kapha]] dominance for blood letting or physician should perform ''siravyadha'' (blood letting through vein) promptly from the adjacent vein to the affected part, without which ''rakta kleda'' (putrifying blood content) gives rise to decomposed skin, flesh and ligaments.<br /> *External application in the form of ''pralepa, pradeha'' and ''alepana'' (local applications of pastes) are to be used repeatedly for treatment of external lesions in ''visarpa''. The guidelines shall be followed for local applications. <br /> *Diet articles with sweet, bitter, cooling and blood pacifying properties is prescribed in the treatment of ''visarpa''.<br /> *''Vidahi'' (that causes burning) and ''viruddha'' (mutually contradictory or incompatible) diet, day sleep, anger, exercise, exposure to sun heat, fire and fast winds are contraindicated in ''visarpa''.<br /> *Predominantly ''shita'' (cool) measures are prescribed in [[pitta]] dominant condition, ''ruksha'' in [[kapha]] dominant condition and ''snigdha'' in [[vata]] dominant condition of ''visarpa''. In ''agni visarpa, [[vata]]-[[pitta]] pacifying measures are beneficial and in ''kardama visarpa'' mostly [[kapha]] [[pitta]] alleviating measures should be administered.<br /> *The ''granthi visarpa'', on inspection is predominant in [[rakta]] [[pitta]], the physician experienced in timely management should treat the case with [[rukshana]] (de-oleation), [[langhana]] (lightening therapy), ''seka'' (affusion), and ''pradeha'' (external application) of ''panchavalka, siramoksha'' (blood letting), ''jalauka'' (leech therapy), [[vamana]] (emesis therapy), [[virechana]] (purgation therapy) and ''kashaya- tikta'' (astringent and bitter) ghee preparations. After cleansing of body by [[vamana]] and [[virechana]], [[rakta]] mokshana should be administered and the measures alleviating [[vata]]-[[kapha]] are beneficial.<br /> *The same line of treatment of ''granthi'' should be applied for the treatment of [[kapha]]ja galganda''. The ''vatika galaganda'' associated with [[kapha]] may be cured by regular use of ghee, milk and decoction preparations.<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> <br /> === Causative factors of ''visarpa'' in contemporary era ===<br /> <br /> Modern point of view ''visarpa'' is generally caused by a variety of infections. As per Punarvasu Atreya, the general etiological factors of ''visarpa'' are diet and lifestyle, injury, poisons, toxins, burns etc; some of these cause vitiation of [[dosha]] and ''khavaigunya'' (disease prone condition) in [[dhatu]] and some cause direct vitiation of [[dosha]] and [[dhatu]] leading to ''visarpa''. This is confusing to the new scholars. Atreya's understanding of etiology is more specific because favorable condition for infection occurs at first then infection therefore diet and lifestyle related factors are described in detail and in the beginning. In treatment plan this concept of favorable environment should be considered. Change in internal body environment is possible by ''shodhana'' therapy and ''aushadha'' along with treatment of infection. <br /> <br /> === Pathophysiology of ''Visarpa'' [flow chart] ===<br /> <br /> [[File:Visarpa1.png]]<br /> <br /> <br /> === Common clinical conditions considered under ''visarpa'' ===<br /> <br /> ''Visarpa'' is acute and extensive spreading in nature. As ''kushtha'' is chronic in nature and ''visarpa'' is acute therefore spreading ''kushtha'' should not be interpreted as visarpa. It is observed that ''visarpa'' interpretation to allopath disorders is very confusing to the scholars. It is difficult to label ''visarpa'' as a single entity. For proper interpretation, experienced intelligent expert in emergency treatments is required and diagnostic research in this direction is challenge to the researchers.<br /> <br /> Clinical manifestation of ''vatika visarpa'' suggests ''bahih-srita visarpa'' and generally observed in acute skin infections (erysipelas etc.) and is curable with prompt management. <br /> <br /> ''Paittika visarpa'' symptoms are suggestive of severe skin disease (erysipelas, extensive herpes, burns etc.) and are curable with appropriate management. <br /> <br /> [[Kapha]]ja visarpa appears as progressively but gradually spreading ailment, suggestive of acute skin infection (erysipelas etc.) and is curable. <br /> <br /> ''Agni visarpa'' is a serious infection of skin and lead to septicemia like condition. ''Agnivisarpa'' with the signs and symptoms described here is a serious ailment and is incurable. This ailment may be cured if vitals are not involved. <br /> <br /> The name ''kardam visarpa'' is because the affected part appears like ''kardam'' (mud). The clinical picture of ''kardam'' described here is serious skin infection, necrotizing the adjacent structures (Necrotizing Fasciitis, gangrene etc.) and is incurable. The curable variant should be considered ''agnivisarpa''. <br /> <br /> ''Granthi visarpa'' is a serious ailment (B cell lymphoma etc.) and associated with complications is incurable. <br /> <br /> ''Sannipatik visarpa'' is a very serious manifestation of ''visarpa'' and is ''ubhaya-samsrita''. This is like a very serious manifestation of sepsis and is not treatable. <br /> <br /> === Current clinical practices in management of ''visarpa'' ===<br /> <br /> ==== Experience based ====<br /> <br /> Prognostic assessment of disease is very important while treating acute disorders. Majority of ''visarpa'' cases are having bad prognosis as per experience of Punarvasu Atreya. Even though some cases of curable ''bahihsrita visarpa'' may become incurable and fatal if not treated early and promptly. Quick diagnosis of life threatening conditions and prompt life saving management in intensive care unit is required in ''visarpa'' disorder.<br /> <br /> It is already stated that there are serious diseases which are curable but they cause death if not treated. ''Agni'' and kardam ''visarpa'' are curable only by the most effective therapeutic measures. ''Antahsrita'' and ''ubhaysamsrita visarpa'' are incurable or sometimes may be cured by most experienced, intelligent physician with most appropriate timely approach in intensive care unit. ''Bahihsrita'' curable ''visarpa'' may convert into ''ubhayasamsrita'' if not treated appropriately. <br /> <br /> ''Shodhana'' and ''shamana'' therapy is described for curable ''visarpa'' and maximum ''visarpa'' cases are incurable. This is challenge to the researchers to apply ''shodhana'' and ''shamana'' therapy in incurable emergency cases along with life saving management to cure the incurable ones.<br /> <br /> ==== Evidence based studies ====<br /> <br /> ''Visarpa'' is acute and fatal in nature and maximum [[Ayurveda]] hospitals have limited facilities for emergency managements. Some of clinicians are treating self limiting minor cases of herpes as a ''visarpa'' following the treatment of [[pitta]]ja visarpa. A case study on effect of Ayurvedic management in oro-facial herpes was conducted. The diagnosed case of oro-facial herpes in 72-year-old male patient was treated with medicines of bitter taste (tikta rasa) internally, diet regimen, anulomana variety of therapeutic purgation (virechana) and topical application of cold (sheeta)-dry(ruksha) medicines(lepa). The case is observed symptom free after a total period of 164 days.&lt;ref&gt;Mutnali K, Roopa BJ, Shivaprasad T, Yadav R. Ayurveda management of oro-facial herpes: a case report. J Ayurveda Integr Med. 2020 Jul-Sep;11(3):357-359. doi: 10.1016/j.jaim.2020.06.003. Epub 2020 Aug 4. PMID: 32768346; PMCID: PMC7527852.&lt;/ref&gt;<br /> <br /> === Researches done on ''visarpa'' ===<br /> <br /> Considerable research work is not carried out on ''visarpa'' by [[Ayurveda]] researchers. This is due to acute and fatal nature of this disease and [[Ayurveda]] research centers are not well equipped for emergency managements. Hence it is necessary to work in the direction to treat such incurable fatal condition. Initially research work on this disease may be carried out in collaboration with well equipped intensive care unit and experts in emergency managements. Researchers may work by combining algorithmic [[Ayurveda]] treatment with allopath. Incurable and fatal cases of ''visarpa'' experienced by Punarvasu Atreya may be cured with early appropriate management in intensive care unit due to advances in drug research and technology. <br /> <br /> === Further reading ===<br /> <br /> #Charak, Chikitsa Sthana, chap 21 Visarpa Chikitsa Adhyaya. In:Vaidya Yadavaji Trikamji Aacharya, Editor, Charak samhita, 2nd edition, Varanasi;Chaukhamba Sanskrit Sansthan,1990;228.<br /> #Chakrapani,Charak,Chikitsa Sthana, Chap 21 Visarpa Chikitsa Adhyaya, 2nd edition,Varanasi; Chaukhamba Sanskrit Sansthan, 1990; 225.<br /> #Charak,Cikitsa Sthana,Chap 21 Visarpa Cikitsitam. In: Pt. Dutta R, editor. Charak Samhita, 2nd ed., 2003 reprint, Varanasi: Chaukhambha Bharti Academy; 2003. p. 231. <br /> #Charak,Chikitsa Sthana, Chap 21 Visarpa Chikitsa Adhyaya,In:Kashiram Shastri and Gorakhnath Chaturvedi, editors. Charak Samhita,(Hindi traslation) Part II. Varanasi: Chaukhambha Bharati Academy; Reprint 2005. p. 235. <br /> #Charak, Chikitsa Sthana, Visarpa Cikitsitam,21, In: Vd. Khushvaha HS,editors,Charak Samhita Ayushi hindi commentary, 1 st edition, Chaukhambha Orientalia Publisher, Varanasi, 2009;224. <br /> #Chakrapani, Charak, Cikitsa Sthana, Chap 21 Visarpa Cikitsitam. In: Vd. Yadavaji T. A.,Editor, Charak Samhita, 1 st edition, Varanasi;Chaukhambha Orientalia Publications, 2001;227. <br /> #Sushruta. Cikitsa Sthana, 17. Visarpanadisthanaroga Chikitsitam Adhyaya In: Vaidya Yadavji Trikamji Acharaya, Narayan Ram Acharaya, editors. Sushruta Samhita,?ed, Varanasi: Chaukhambha Orientalia; 2007. p. 321. <br /> #Susruta, Nidana sthana,cha 10, Visarpanadisthanaroga Nidana In:Kaviraj Ambikadutt Shastri,editor, Sushruta Samhita, 11 th ed. Varanasi: Chaukhambha Sanskrit Sansthan; 1998. p. 129. <br /> #Vagbhata, Ashtanga Sangraha, Cikitsa Sthana, 20,Visarpa chikitsitam Adhyaya. translated to English by Prof. Murthy KR, 9 th edition,Varanasi; Chaukhambha Orientalia Publisher,2005;229. <br /> #Vagbhata, Ashtanga Sangraha, Nidana Sthana, 13, Pandurogakamalasophavisarpa Nidanam Adhyaya. translated to English by Prof. Murthy KR, 9 th edition, Varanasi,Chaukhambha Orientalia Publisher, 2005; 229. <br /> #Vagbhata, Ashtanga Hridyam ,Cikitsa Sthana,18. Visarpa chikitsitam Adhyaya .Translated to English by Prof. K.R. Shrikanth Murthy, 7 th ed., Vol. 1. Varanasi: Chaukhambha Krishnadas Academy; 2010. p. 221. <br /> #Vagbhata,Ashtanga Hridyam , Nidana Sthana, Chap 13 Pandurogasophavisarpa Nidana.Translated by Prof. K.R. Shrikanth Murthy, 7 th ed., Vol. 1. Varanasi: Chaukhambha Krishnadas Academy; 2010. p. 221. &lt;/div&gt;<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References == <br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Chhardi_Chikitsa&diff=45388 2025-11-17T07:02:25Z

<p>Agnivesha: /* Bad prognostic symptoms */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Chhardi Chikitsa<br /> |titlemode=append<br /> |keywords=atisara, diarrhea, ama, nirama, sangrahi treatment, pichcha basti,Ayurveda, Indian system of medicine, charak samhita. <br /> |description=Chikitsa Sthana Chapter 20. Management of Chhardi (vomiting)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 20. Management of Chhardi (vomiting) &lt;/big&gt;'''<br /> {{Infobox<br /> |title = Chhardi Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 20<br /> |label2 = Preceding Chapter<br /> |data2 = [[Atisara Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Visarpa Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Murthy A.R.V., Jani D.<br /> |label7 = Reviewer <br /> |data7 = Prasad B.S.<br /> |label8 = Editors<br /> |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.021 10.47468/CSNE.2020.e01.s06.021]<br /> }}<br /> <br /> &lt;big&gt;'''Abstract &lt;/big&gt;'''<br /> &lt;p style='text-align:justify;'&gt;''Chhardi'' (vomiting), is a common gastrointestinal disorder characterized by bouts of vomiting, nausea, pain and black outs. The causative factors of ''chhardi'' can be categorized under dietary, lifestyle and psychological factors. Dietary factors include excessive ''upavasa'' (starvation), over intake of ''vidahi'' or ''snigdha-guru dravya'' (drugs which are very acrid, unctuous and heavy to digest), etc. Lifestyle aspects include excessive exercise, ''divasvapna'' (day sleep), etc. whereas the psychological stressors like excess worries, grief, anger, fear can precipitate it. ''Amashaya'' (stomach) and ''rasayani'' (channels) are the sites of origin of ''chhardi''. Vitiated [[dosha]] accumulate in ''amashaya'' and ''rasayani'' and are thrown out forcefully from the upper part of body causing ''pida'' (pain) to ''urdhva avayavas'' (organs situated above supraclavicular region). Comprehensive management includes avoidance of etiological factors with pharmacological treatment through medicament as well as non-pharmacological methods. <br /> &lt;/p&gt;<br /> '''Keywords''': ''Chhardi chikitsa, chhardi,'' vomiting, emesis<br /> <br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> After explaining the [[Atisara Chikitsa]] (treatment of diarrhea), there is a description of [[Chhardi Chikitsa]]. The word ''chhardi'' is derived from the root ''chhard vamane''. The word ''chhad'' means gripping (''avritta'' or ''achhadana'') and ''ard'' means pain (''peedha'')&lt;ref&gt;Madhavakara. Chardi praarana verse 15, In:Shastri Suderashan,editor, Madhava Nidanam (Roga vinischaya). 4th ed. Varanasi: Chaukhamba Sanskrit Series,1975.pp--&lt;/ref&gt;. The other words like ''chhardah, chhardana, chhardi, chhardika,'' etc. are considered as the synonyms of ''chhardi''.&lt;ref&gt;Charak. Chikitsa Sthana, Cha.20 Chhardi Chikitsa Adhyaya. In: Bramhanand Tripathi Editor. Charak Samhita.,? ed. Varanasi: Chaukhamba Sanskrit Pratisthan,2015. p.?.&lt;/ref&gt; The words ''chhardi'' and [[vamana]], both are used in the sense of vomiting but have basic differences. ''Chhardi'' is a pathological condition where the sufferer is exposed to particular predisposing factors for vomiting and as a result, suffers from the particular condition called ''chhardi''. On the other hand [[vamana]] is one of the purification therapies of [[Panchakarma]] (five purification procedures in [[Ayurveda]]) where the physician intends to induce vomiting to expel out vitiated [[kapha]] and [[pitta]]. In general, the vitiated [[dosha]] accumulate in stomach and are thrown out from the body through various channels. There are two major channels from which the body generally does such excretory mechanism.&lt;ref&gt;Sushruta. Sharira Sthana, Cha.5 Shareerasankhyavyakarana Sharira Adhyaya verse 10. In: Kaviraj Shastri Ambika Dutt, Editors. Sushruta Samhita. 5th ed. Varanasi: Chaukhamba Sanskrit Series,1982. p.?.&lt;/ref&gt; The one is adhomārga (excretion through downward channel) for which the description of ''atisara'' is given in previous chapter and the other one is ''urdhvabhaga'' (excretion through the upward channel) where the description of ''chhardi'' is discussed here. ''Chhardi'' comes under the category of ''koshtha rasayani shrita vyadhi'' (diseases of GI tract) whose roots are in ''mahasrotas'' (GI tract) and ''manovaha'' (mind) ''srotasa''. The ''amashaya'' and ''rasayani'' are the involved ''avayavas'' (organs) in this disease.&lt;ref&gt;Chakrapani, Charak. Vimana Sthana, Cha.5 Srotovimna Adhyaya ver.7-3. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.1st ed. Varanasi: Krishnadas Academy;2000.p.4&lt;/ref&gt; The management of this disease is by the pharmacological treatment through various herbs/combinations, dietary modifications and psychological counseling. The preventive aspect includes avoidance of causative factors and enhancement in psychological strength to specific items/factors.&lt;ref&gt;Chakrapani, Charak. Vimana Sthana, Cha.5 Srotovimna Adhyaya ver.25. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.1st ed. Varanasi: Krishnadas Academy;2000.p.4&lt;/ref&gt; The curative treatment focuses on pharmacotherapy depending upon [[dosha]] dominance and mild ''samshodhana'' (expelling out the vitiated [[dosha]]).<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातश्छर्दिचिकित्सितं व्याख्यास्यामः||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः||२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātaśchardicikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2|| <br /> <br /> athAtashchardicikitsitaM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now we shall expound the chapter &quot;Chhardi chikitsa&quot; (Management of vomiting). Thus said Lord Atreya. [1-2]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यशस्विनं ब्रह्मतपोद्युतिभ्यां ज्वलन्तमग्न्यर्कसमप्रभावम्| <br /> <br /> पुनर्वसुं भूतहिते निविष्टं पप्रच्छ शिष्योऽत्रिजमग्निवेशः||३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yaśasvinaṁ brahmatapōdyutibhyāṁ jvalantamagnyarkasamaprabhāvam| <br /> <br /> punarvasuṁ bhūtahitē niviṣṭaṁ papraccha śiṣyō'trijamagnivēśaḥ||3||<br /> <br /> yashasvinaM brahmatapodyutibhyAM jvalantamagnyarkasamaprabhAvam| <br /> <br /> punarvasuM bhUtahite niviShTaM papraccha shiShyo~atrijamagniveshaH||3||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Agnivesha the disciple asked Punarvasu, the illustratious son of Atri, who was engrossed in the thinking of the well-being of humanity and who was dazzling with luster of divine knowledge and penance, who was endowed with the brilliance like that of fire and the sun, and who was dedicated to the well-being of all living beings [3]<br /> <br /> === Queries by Agnivesha ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> याश्छर्दयः पञ्च पुरा त्वयोक्ता रोगाधिकारे भिषजां वरिष्ठ!| <br /> <br /> तासां चिकित्सां सनिदानलिङ्गां यथावदाचक्ष्व नृणां हितार्थम्||४|| <br /> <br /> तदग्निवेशस्य वचो निशम्य प्रीतो भिषक्श्रेष्ठ इदं जगाद| <br /> <br /> याश्छर्दयः पञ्च पुरा मयोक्तास्ता विस्तरेण ब्रुवतो निबोध||५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yāśchardayaḥ pañca purā tvayōktā rōgādhikārē bhiṣajāṁ variṣṭha!|<br /> <br /> tāsāṁ cikitsāṁ sanidānaliṅgāṁ yathāvadācakṣva nr̥ṇāṁ hitārtham||4|| <br /> <br /> tadagnivēśasya vacō niśamya prītō bhiṣakśrēṣṭha idaṁ jagāda| <br /> <br /> yāśchardayaḥ pañca purā mayōktāstā vistarēṇa bruvatō nibōdha||5||<br /> <br /> yAshchardayaH pa~jca purA tvayoktA rogAdhikAre bhiShajAM variShTha!| <br /> <br /> tAsAM cikitsAM sanidAnali~ggAM yathAvadAcakShva nRuNAM hitArtham||4||<br /> <br /> tadagniveshasya vaco nishamya prIto bhiShakshreShTha idaM jagAda| <br /> <br /> yAshchardayaH pa~jca purA mayoktAstA vistareNa bruvato nibodha||5|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Oh! Revered Physician, please describe the treatment of the five types of ''chhardi'' (vomiting) mentioned by you earlier in the context of the enumeration of diseases (in Sutra 19:3-4) along with their etiology, signs and symptoms comprehensively, for the sake of well-being of humanity.<br /> <br /> Having heard Agnivesha and being pleased the best among physicians Punarvasu Atreya said “I shall now expound all the five types of vomiting (briefly) stated earlier, in greater details. Listen to me.&quot; [4-5]<br /> <br /> === Classification and premonitory symptoms ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दोषैः पृथक्त्रिप्रभवाश्चतस्रो [१] द्बिष्टार्थयोगादपि पञ्चमी स्यात्| <br /> <br /> तासां हृदुत्क्लेशकफप्रसेकौ द्वेषोऽशने चैव हि पूर्वरूपम्||६| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dōṣaiḥ pr̥thaktriprabhavāścatasrō dbiṣṭārthayōgādapi pañcamī syāt|<br /> <br /> tāsāṁ hr̥dutklēśakaphaprasēkau dvēṣō'śanē caiva hi pūrvarūpam||6||<br /> <br /> doShaiH pRuthaktriprabhavAshcatasro [1] dbiShTArthayogAdapi pa~jcamI syAt|6| <br /> <br /> tAsAM hRudutkleshakaphaprasekau dveSho~ashane caiva hi pUrvarUpam||6|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Chhardi'' (vomiting) is of five types; three types of vomiting caused by a [[dosha]] each i.e. vatika, paittika, [[kapha]]ja, fourth is ''sannipatika'' and fifth is ''dvistartha-yogaja-chhardi'' (that results from contact with unpleasant sense objects).<br /> The premonitory signs and symptoms of ''chhardi'' (vomiting) are nausea, excessive salivation and aversion to food [6]<br /> <br /> === [[Vata]]ja chhardi ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> व्यायामतीक्ष्णौषधशोकरोगभयोपवासाद्यतिकर्शितस्य| <br /> <br /> वायुर्महास्रोतसि सम्प्रवृद्ध उत्क्लेश्य दोषांस्तत ऊर्ध्वमस्यन्||७|| <br /> <br /> आमाशयोत्क्लेशकृतां च मर्म प्रपीडयंश्छर्दिमुदीरयेत्तु| <br /> <br /> हृत्पार्श्वपीडामुखशोषमूर्धनाभ्यर्तिकासस्वरभेदतोदैः||८|| <br /> <br /> उद्गारशब्दप्रबलं सफेनं विच्छिन्नकृष्णं तनुकं कषायम्| <br /> <br /> कृच्छ्रेण चाल्पं महता च वेगेनार्तोऽनिलाच्छर्दयतीह दुःखम्||९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vyāyāmatīkṣṇauṣadhaśōkarōgabhayōpavāsādyatikarśitasya| <br /> <br /> vāyurmahāsrōtasi sampravr̥ddha utklēśya dōṣāṁstata ūrdhvamasyan||7|| <br /> <br /> āmāśayōtklēśakr̥tāṁ ca marma prapīḍayaṁśchardimudīrayēttu| <br /> <br /> hr̥tpārśvapīḍāmukhaśōṣamūrdhanābhyartikāsasvarabhēdatōdaiḥ||8|| <br /> <br /> udgāraśabdaprabalaṁ saphēnaṁ vicchinnakr̥ṣṇaṁ tanukaṁ kaṣāyam| <br /> <br /> kr̥cchrēṇa cālpaṁ mahatā ca vēgēnārtō'nilācchardayatīha duḥkham||9||<br /> <br /> vyAyAmatIkShNauShadhashokarogabhayopavAsAdyatikarshitasya| <br /> <br /> vAyurmahAsrotasi [1] sampravRuddha utkleshya doShAMstata Urdhvamasyan||7|| <br /> <br /> AmAshayotkleshakRutAM ca marma prapIDayaMshchardimudIrayettu| <br /> <br /> hRutpArshvapIDAmukhashoShamUrdhanAbhyartikAsasvarabhedatodaiH||8|| <br /> <br /> udgArashabdaprabalaM saphenaM vicchinnakRuShNaM tanukaM kaShAyam| <br /> <br /> kRucchreNa cAlpaM mahatA ca vegenArto~anilAcchardayatIha duHkham||9||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In a person extremely emaciated because of excess exercise, chronic disease, excessive intake of ''tikshna'' (sharply acting) medicines (of high potency), and indulging in grief, fear, excess fasting, etc. [[vata]] gets excessively aggravated in the ''maha-srotas'' (gastrointestinal tract), vitiates the local [[dosha]] and pushes them upwards. These [[dosha]] cause agitation in the ''amashaya'' (stomach), and after afflicting the ''marma'' (vital organs-heart) gives rise to ''chhardi'' (vomiting). This [[vata]]ja type of vomiting is characterized by the following signs and symptoms: <br /> #Pain in the cardiac region and flanks; <br /> #Dryness of the mouth; <br /> #Pain in the head and umbilical region; <br /> #Cough, hoarseness of voice and pricking pain; <br /> #Eructation with loud noise; <br /> #Vomiting of material which is frothy, scattered, black in color, thin and astringent; <br /> #The urge for vomiting is forceful, but patient vomits only in small quantities with pain; <br /> #The patient feels miserable [7-9]<br /> <br /> === [[Pitta]]ja chhardi ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अजीर्णकट्वम्लविदाह्यशीतैरामाशये पित्तमुदीर्णवेगम्| <br /> <br /> रसायनीभिर्विसृतं प्रपीड्य मर्मोर्ध्वमागम्य वमिं करोति||१०|| <br /> <br /> मूर्च्छापिपासामुखशोषमूर्धताल्वक्षिसन्तापतमोभ्रमार्तः| <br /> <br /> पीतं भृशोष्णं हरितं सतिक्तं धूम्रं च पित्तेन वमेत् सदाहम्||११||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ajīrṇakaṭvamlavidāhyaśītairāmāśayē pittamudīrṇavēgam| <br /> <br /> rasāyanībhirvisr̥taṁ prapīḍya marmōrdhvamāgamya vamiṁ karōti||10|| <br /> <br /> mūrcchāpipāsāmukhaśōṣamūrdhatālvakṣisantāpatamōbhramārtaḥ| <br /> <br /> pītaṁ bhr̥śōṣṇaṁ haritaṁ satiktaṁ dhūmraṁ ca pittēna vamēt sadāham||11|| <br /> <br /> ajIrNakaTvamlavidAhyashItairAmAshaye pittamudIrNavegam| <br /> <br /> rasAyanIbhirvisRutaM prapIDya marmordhvamAgamya vamiM karoti||10|| <br /> <br /> mUrcchApipAsAmukhashoShamUrdhatAlvakShisantApatamobhramArtaH| <br /> <br /> pItaM bhRushoShNaM haritaM satiktaM dhUmraM ca pittena vamet sadAham||11|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As a result of indigestion, taking pungent, sour, ''vidahi'' (which cause burning sensation) and hot potency food, the [[pitta]] in the stomach gets aggravated. This aggravated [[pitta]] spreads through the ''rasayani'' (channels) and stresses the vital organs located in the upper part of the body which results in vomiting: <br /> <br /> The signs and symptoms of this [[pitta]]ja type of ''chhardi'' (vomiting) are: <br /> #Fainting, morbid thirst and parching of mouth; <br /> #Burning (or heating) sensation in the head, palate and eyes; <br /> #A feeling as if the patient is entering into darkness: <br /> #Giddiness; <br /> #Vomitus is yellow, excessively hot, green, bitter and smoky in appearance with burning sensation [10-11]<br /> <br /> === [[Kapha]]ja chhardi ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्निग्धातिगुर्वामविदाहिभोज्यैः स्वप्नादिभिश्चैव कफोऽतिवृद्धः| <br /> <br /> उरः शिरो मर्म रसायनीश्च सर्वाः समावृत्य वमिं करोति||१२|| <br /> <br /> तन्द्रास्यमाधुर्यकफप्रसेकसन्तोषनिद्रारुचिगौरवार्तः| <br /> <br /> स्निग्धं घनं स्वादु कफाद्विशुद्धं सलोमहर्षोऽल्परुजं वमेत्तु||१३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snigdhātigurvāmavidāhibhōjyaiḥ svapnādibhiścaiva kaphō'tivr̥ddhaḥ| <br /> <br /> uraḥ śirō marma rasāyanīśca sarvāḥ samāvr̥tya vamiṁ karōti||12|| <br /> <br /> tandrāsyamādhuryakaphaprasēkasantōṣanidrārucigauravārtaḥ| <br /> <br /> snigdhaṁ ghanaṁ svādu kaphādviśuddhaṁ salōmaharṣō'lparujaṁ vamēttu||13|| <br /> <br /> snigdhAtigurvAmavidAhibhojyaiH svapnAdibhishcaiva kapho~ativRuddhaH| <br /> <br /> uraH shiro marma rasAyanIshca sarvAH samAvRutya vamiM karoti||12|| <br /> <br /> tandrAsyamAdhuryakaphaprasekasantoShanidrArucigauravArtaH| <br /> <br /> snigdhaM ghanaM svAdu kaphAdvishuddhaM salomaharSho~alparujaM vamettu||13||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As a result of the intake of unctuous, excessively heavy to digest, ''ama'' (raw/uncooked) and ''vidahi'' (causing burning sensation) food and because of excessive sleep and similar other factors, [[kapha]] gets excessively aggravated. This [[kapha]] occludes the chest, head, vital organs and all the (concerned) channels to cause ''chhardi'' (vomiting). The signs and symptoms of this [[kapha]]ja type of ''chhardi'' are as follows:<br /> #Drowsiness, sweetness in the mouth and salivation; <br /> #Sense of satiety, sleep, anorexia and heaviness; <br /> #Vomitus is unctuous, dense, sweet and devoid of any undesirable smell; and is associated with horripilation and slight pain [12-13]<br /> <br /> === Tri[[dosha]]ja chhardi ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> समश्नतः सर्वरसान् प्रसक्तमामप्रदोषर्तुविपर्ययैश्च| <br /> <br /> सर्वे प्रकोपं युगपत् प्रपन्नाश्छर्दिं त्रिदोषां जनयन्ति दोषाः||१४|| <br /> <br /> शूलाविपाकारुचिदाहतृष्णाश्वासप्रमोहप्रबला प्रसक्तम्| <br /> <br /> छर्दिस्त्रिदोषाल्लवणाम्लनीलसान्द्रोष्णरक्तं वमतां नृणां स्यात्||१५|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> samaśnataḥ sarvarasān prasaktamāmapradōṣartuviparyayaiśca|<br /> <br /> sarvē prakōpaṁ yugapat prapannāśchardiṁ tridōṣāṁ janayanti dōṣāḥ||14|| <br /> <br /> śūlāvipākārucidāhatr̥ṣṇāśvāsapramōhaprabalā prasaktam| <br /> <br /> chardistridōṣāllavaṇāmlanīlasāndrōṣṇaraktaṁ vamatāṁ nr̥ṇāṁ syāt||15|| <br /> <br /> samashnataH sarvarasAn prasaktamAmapradoShartuviparyayaishca| <br /> <br /> sarve prakopaM yugapat prapannAshchardiM tridoShAM janayanti doShAH||14|| <br /> <br /> shUlAvipAkArucidAhatRuShNAshvAsapramohaprabalA prasaktam| <br /> <br /> chardistridoShAllavaNAmlanIlasAndroShNaraktaM vamatAM nRuNAM syAt||15||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Because of constant indulgence in diet consisting of wholesome and unwholesome diet together, having all categories of taste together because of ''ama-dosha'' (ailments caused by improper digestion) and because of seasonal perversions, all the three [[dosha]] get simultaneously aggravated and cause ''sannipatika chhardi''.<br /> <br /> The signs and symptoms of this type of vomiting are as follows: <br /> #Colic pain, indigestion, anorexia, burning sensation, morbid thirst, dyspnea and fainting spells that are severe and persistent; <br /> #Vomitus is salty, sour, blue, dense, hot and reddish [14-15]<br /> <br /> === Bad prognostic symptoms ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विट्स्वेदमूत्राम्बुवहानि वायुः स्रोतांसि संरुध्य यदोर्ध्वमेति| <br /> <br /> उत्सन्नदोषस्य समाचितं तं दोषं समुद्धूय नरस्य कोष्ठात्||१६|| <br /> <br /> विण्मूत्रयोस्तत् समवर्णगन्धं तृट्श्वासहिक्कार्तियुतं प्रसक्तम्| <br /> <br /> प्रच्छर्दयेद्दुष्टमिहातिवेगात्तयाऽर्दितश्चाशु विनाशमेति||१७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> viṭsvēdamūtrāmbuvahāni vāyuḥ srōtāṁsi saṁrudhya yadōrdhvamēti| <br /> <br /> utsannadōṣasya samācitaṁ taṁ dōṣaṁ samuddhūya narasya kōṣṭhāt||16|| <br /> <br /> viṇmūtrayōstat samavarṇagandhaṁ tr̥ṭśvāsahikkārtiyutaṁ prasaktam| <br /> <br /> pracchardayēdduṣṭamihātivēgāttayā'rditaścāśu vināśamēti||17|| <br /> <br /> viTsvedamUtrAmbuvahAni vAyuH srotAMsi saMrudhya yadordhvameti| <br /> <br /> utsannadoShasya samAcitaM taM doShaM samuddhUya narasya koShThAt||16|| <br /> <br /> viNmUtrayostat samavarNagandhaM tRuTshvAsahikkArtiyutaM prasaktam| <br /> <br /> pracchardayedduShTamihAtivegAttayA~arditashcAshu vinAshameti||17|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When the morbid [[vata]] occludes the channels carrying feces, sweat, urine and body fluids and moves upwards, then the morbid matter from the [[koshtha]] (gastrointestinal tract), gets incited to cause vomiting, that has the following characteristics:<br /> #Vomitus having color and odor of the feces and urine; <br /> #Persistent thirst, dyspnea hiccup and pain <br /> #Vomiting of foul smelling or ''dusta'' (putrid material); and <br /> #Bouts of vomiting ejected with great force. <br /> <br /> Such a patient succumbs to death quickly [16-17]<br /> <br /> === ''Dvishtharthasamyogaja chhardi'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्विष्टप्रतीपाशुचिपूत्यमेध्यबीभत्सगन्धाशनदर्शनैश्च| <br /> <br /> यच्छर्दयेत्तप्तमना मनोध्नैर्द्विष्टार्थसंयोगभवा मता सा||१८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dviṣṭapratīpāśucipūtyamēdhyabībhatsagandhāśanadarśanaiśca| <br /> <br /> yacchardayēttaptamanā manōdhnairdviṣṭārthasaṁyōgabhavā matā sā||18||<br /> <br /> dviShTapratIpAshucipUtyamedhyabIbhatsagandhAshanadarshanaishca| <br /> <br /> yacchardayettaptamanA manodhnairdviShTArthasaMyogabhavA matA sA||18||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As a result of mental disgust occasioned by senses contact with despicable, antagonistic, unclean, putrid, unholy and loathsome odors, diet or sights, the ''chhardi''(vomiting) is known as vomiting induced by contact with hateful things [18]<br /> <br /> === Symptoms of incurable ''chhardi'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षीणस्य या छर्दिरतिप्रवृद्धा सोपद्रवा शोणितपूययुक्ता| <br /> <br /> सचन्द्रिकां तां प्रवदन्त्यसाध्यां साध्यां चिकित्सेदनुपद्रवां च||१९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣīṇasya yā chardiratipravr̥ddhā sōpadravā śōṇitapūyayuktā| <br /> <br /> sacandrikāṁ tāṁ pravadantyasādhyāṁ sādhyāṁ cikitsēdanupadravāṁ ca||19|| <br /> <br /> kShINasya yA chardiratipravRuddhA sopadravA shoNitapUyayuktA| <br /> <br /> sacandrikAM tAM pravadantyasAdhyAM sAdhyAM cikitsedanupadravAM ca||19|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Vomiting that occurs in an emaciated person, that continues incessantly, that is associated with complications, and vomitus that contains blood, pus and ''chandrika'' (circular shiny patches with variegated color) is incurable. The physician should treat only curable types that are not associated with complications [19]<br /> <br /> === Principles of treatment ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आमाशयोत्क्लेशभवा हि सर्वाश्छर्द्यो मता लङ्घनमेव तस्मात्| <br /> <br /> प्राक्कारयेन्मारुतजां विमुच्य संशोधनं वा कफपित्तहारि||२०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> āmāśayōtklēśabhavā hi sarvāśchardyō matā laṅghanamēva tasmāt| <br /> <br /> prākkārayēnmārutajāṁ vimucya saṁśōdhanaṁ vā kaphapittahāri||20|| <br /> <br /> AmAshayotkleshabhavA hi sarvAshchardyo matA la~gghanameva tasmAt| <br /> <br /> prAkkArayenmArutajAM vimucya saMshodhanaM vA kaphapittahAri||20|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As all the types of vomiting are considered originating from the agitations of the [[dosha]] in the stomach, fasting therapy should first be prescribed or purificatory procedure curative of [[kapha]] and [[pitta]] should be administered except in cases of [[vata]] dominance. [20]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चूर्णानि लिह्यान्मधुनाऽभयानां हृद्यानि वा यानि विरेचनानि| <br /> <br /> मद्यैः पयोभिश्च युतानि युक्त्या नयन्त्यधो दोषमुदीर्णमूर्ध्वम्||२१|| <br /> <br /> वल्लीफलाद्यैर्वमनं पिबेद्वा यो दुर्बलस्तं शमनैश्चिकित्सेत्| <br /> <br /> रसैर्मनोज्ञैर्लघुभिर्विशुष्कैर्भक्ष्यैः सभोज्यैर्विविधैश्च पानैः||२२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> cūrṇāni lihyānmadhunā'bhayānāṁ hr̥dyāni vā yāni virēcanāni| <br /> <br /> madyaiḥ payōbhiśca yutāni yuktyā nayantyadhō dōṣamudīrṇamūrdhvam||21|| <br /> <br /> vallīphalādyairvamanaṁ pibēdvā yō durbalastaṁ śamanaiścikitsēt| <br /> <br /> rasairmanōjñairlaghubhirviśuṣkairbhakṣyaiḥ sabhōjyairvividhaiśca pānaiḥ||22||<br /> <br /> cUrNAni lihyAnmadhunA~abhayAnAM hRudyAni vA yAni virecanAni| <br /> <br /> madyaiH payobhishca yutAni yuktyA nayantyadho doShamudIrNamUrdhvam||21|| <br /> <br /> vallIphalAdyairvamanaM pibedvA yo durbalastaM shamanaishcikitset| <br /> <br /> rasairmanoj~jairlaghubhirvishuShkairbhakShyaiH sabhojyairvividhaishca pAnaiH||22||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient shall take powder of ''abhaya'' (chebulic myrobalans) with honey or such other palatable purgatives skillfully combined with ''madya'' (alcohol) or ''dugdha'' (milk). These recipes cause downward movement of the aggravated ''doshas'' that are impelled to move upwards. <br /> <br /> Patient may also be given emetic therapy prepared of the drugs of the ''valliphala'' (group of cucurbitaceous fruits), etc. or if the patient is weak, then he should be treated with pacification therapy through delicious soups and light as well as dry food articles for diet along with various kinds of drinks [21-22]<br /> <br /> === Treatment of [[vata]]ja chhardi ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सुसंस्कृतास्तित्तिरिबर्हिलावरसा व्यपोहन्त्यनिलप्रवृत्ताम्|<br /> <br /> छर्दिं तथा कोलकुलत्थधान्यबिल्वादिमूलाम्लयवैश्च यूषः||२३||<br /> <br /> वातात्मिकायां हृदयद्रवार्तो नरः पिबेत् सैन्धववद्धृतं तु|<br /> <br /> सिद्धं तथा धान्यकनागराभ्यां दध्ना च तोयेन च दाडिमस्य||२४||<br /> <br /> व्योषेण युक्तां लवणैस्त्रिभिश्च घृतस्य मात्रामथवा विदध्यात्|<br /> <br /> स्निग्धानि हृद्यानि च भोजनानि रसैः सयूषैर्दधिदाडिमाम्लैः||२५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> susaṁskr̥tāstittiribarhilāvarasā vyapōhantyanilapravr̥ttām| <br /> <br /> chardiṁ tathā kōlakulatthadhānyabilvādimūlāmlayavaiśca yūṣaḥ||23|| <br /> <br /> vātātmikāyāṁ [1] hr̥dayadravārtō naraḥ pibēt saindhavavaddhr̥taṁ tu| <br /> <br /> siddhaṁ tathā dhānyakanāgarābhyāṁ dadhnā ca tōyēna ca dāḍimasya||24|| <br /> <br /> vyōṣēṇa yuktāṁ lavaṇaistribhiśca ghr̥tasya mātrāmathavā vidadhyāt| <br /> <br /> snigdhāni hr̥dyāni ca bhōjanāni rasaiḥ sayūṣairdadhidāḍimāmlaiḥ||25|| <br /> <br /> SusamskrutAstittiribrhilAvrasA vyapohantyanilapravRuttAm| <br /> <br /> chardiM tathA kolakulatthadhAnyabilvAdimUlAmlayavaishca yUShaH||23||<br /> <br /> vAtAtmikAyAM hRudayadravArto naraH pibet saindhavavaddhRutaM tu|<br /> <br /> siddhaM tathA dhAnyakanAgarAbhyAM dadhnA ca toyena ca dADimasya||24||<br /> <br /> vyoSheNa yuktAM lavaNaistribhishca ghRutasya mAtrAmathavA vidadhyAt|<br /> <br /> snigdhAni hRudyAni ca bhojanAni rasaiH sayUShairdadhidADimAmlaiH||25||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The following recipes are useful in [[vata]]ja type of vomiting (''chhardi''): <br /> #The meat juice of ''tittiri'' (partridge), ''barhi'' and ''lava'' (common quail); <br /> #Vegetable soup prepared out of ''kola'' (Zyziphus jujuba), ''kulattha'' (horse gram/Dolichos biflorus), ''dhanya'' (coriander fruit/coriandrum sativum ), group of roots of ''bilva'' (Bilva-Bengal quince/''bael'' fruit/Aegle marmelos), etc. (''syonaka'' (Oroxylem indicum) , ''gambhari'' (Gmelina arborea), ''patala'' (Trumpet/Stereospermum chelonoides), ''ganikarika'' (Premna integrifolia)), ''amla'' (sour substances) and ''yava'' (barley/Hordeum vulgare); <br /> #If the patient is suffering from vomiting of ''vata'' type of ''chhardi'' that is associated with ''hriddrava'' (palpitation), then may take ghee with rock salt. <br /> #Ghee cooked with ''dhanyaka'' (coriander), ''nagara'' (dry zingiber/ginger/Zingiber officinale), ''dadhi''(curd) and the juice of ''dadima'' (pomegranate/Punica granatum); <br /> #Ghee mixed with the powder of ''trikatu'' (''shunthi, pippali'' and ''maricha'') and three salts viz. ''saindhava'' (rock salt), ''sauvarchala'' (black salt) and ''vida'' (''pakyam'')); <br /> #The diet consisting of unctuous and palatable food, meat soups, vegetable-soup, curd sour ''dadima'' (pomegranate/Punica granatum) [23-25]<br /> <br /> === Treatment of [[pitta]]ja chhardi ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तात्मिकायामनुलोमनार्थं द्राक्षाविदारीक्षुरसैस्त्रिवृत् स्यात्| <br /> <br /> कफाशयस्थं त्वतिमात्रवृद्धं पित्तं हरेत् स्वादुभिरूर्ध्वमेव||२६|| <br /> <br /> शुद्धाय काले मधुशर्कराभ्यां लाजैश्च मन्थं यदि वाऽपि पेयाम्| <br /> <br /> प्रदापयेन्मुद्गरसेन वाऽपि शाल्योदनं जाङ्गलजै रसैर्वा||२७|| <br /> <br /> सितोपलामाक्षिकपिप्पलीभिः कुल्माषलाजायवसक्तुगृञ्जान्| <br /> <br /> खर्जूरमांसान्यथ नारिकेलं द्राक्षामथो वा बदराणि लिह्यात्||२८|| <br /> <br /> स्रोतोजलाजोत्पलकोलमज्जचूर्णानि लिह्यान्मधुनाऽभयां च| <br /> <br /> कोलास्थिमज्जाञ्जनमक्षिकाविड्लाजासितामागधिकाकणान् वा||२९|| <br /> <br /> द्राक्षारसं वाऽपि पिबेत् सुशीतं मृद्भृष्टलोष्टप्रभवं जलं वा| <br /> <br /> जम्ब्वाम्रयोः पल्लवजं कषायं पिबेत् सुशीतं मधुसंयुतं वा||३०|| <br /> <br /> निशि स्थितं वारि समुद्गकृष्णं सोशीरधान्यं चणकोदकं वा| <br /> <br /> गवेधुकामूलजलं गुडूच्या जलं पिबेदिक्षुरसं पयो वा||३१|| <br /> <br /> सेव्यं पिबेत् काञ्चनगैरिकं वा सबालकं तण्डुलधावनेन| <br /> <br /> धात्रीरसेनोत्तमचन्दनं वा तृष्णावमिघ्नानि समाक्षिकाणि||३२|| <br /> <br /> कल्कं तथा चन्दनचव्यमांसीद्राक्षोत्तमाबालकगैरिकाणाम्| <br /> <br /> शीताम्बुना गैरिकशालिचूर्णं मूर्वां तथा तण्डुलधावनेन||३३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pittātmikāyāmanulōmanārthaṁ drākṣāvidārīkṣurasaistrivr̥t syāt| <br /> <br /> kaphāśayasthaṁ tvatimātravr̥ddhaṁ pittaṁ harēt svādubhirūrdhvamēva||26|| <br /> <br /> śuddhāya kālē madhuśarkarābhyāṁ lājaiśca manthaṁ yadi vā'pi pēyām| <br /> <br /> pradāpayēnmudgarasēna vā'pi śālyōdanaṁ jāṅgalajai rasairvā||27|| <br /> <br /> sitōpalāmākṣikapippalībhiḥ kulmāṣalājāyavasaktugr̥ñjān| <br /> <br /> kharjūramāṁsānyatha nārikēlaṁ drākṣāmathō vā badarāṇi lihyāt||28|| <br /> <br /> srōtōjalājōtpalakōlamajjacūrṇāni lihyānmadhunā'bhayāṁ ca| <br /> <br /> kōlāsthimajjāñjanamakṣikāviḍlājāsitāmāgadhikākaṇān vā||29|| <br /> <br /> drākṣārasaṁ vā'pi pibēt suśītaṁ mr̥dbhr̥ṣṭalōṣṭaprabhavaṁ jalaṁ vā| <br /> <br /> jambvāmrayōḥ pallavajaṁ kaṣāyaṁ pibēt suśītaṁ madhusaṁyutaṁ vā||30|| <br /> <br /> niśi sthitaṁ vāri samudgakr̥ṣṇaṁ sōśīradhānyaṁ caṇakōdakaṁ vā| <br /> <br /> gavēdhukāmūlajalaṁ guḍūcyā jalaṁ pibēdikṣurasaṁ payō vā||31|| <br /> <br /> sēvyaṁ pibēt kāñcanagairikaṁ vā sabālakaṁ taṇḍuladhāvanēna| <br /> <br /> dhātrīrasēnōttamacandanaṁ vā tr̥ṣṇāvamighnāni samākṣikāṇi||32|| <br /> <br /> kalkaṁ tathā candanacavyamāṁsīdrākṣōttamābālakagairikāṇām| <br /> <br /> śītāmbunā gairikaśālicūrṇaṁ mūrvāṁ tathā taṇḍuladhāvanēna||33|| <br /> <br /> pittAtmikAyAmanulomanArthaM drAkShAvidArIkShurasaistrivRut syAt| <br /> <br /> kaphAshayasthaM tvatimAtravRuddhaM pittaM haret svAdubhirUrdhvameva||26|| <br /> <br /> shuddhAya kAle madhusharkarAbhyAM lAjaishca manthaM yadi vA~api peyAm| <br /> <br /> pradApayenmudgarasena vA~api shAlyodanaM jA~ggalajai rasairvA||27|| <br /> <br /> sitopalAmAkShikapippalIbhiH kulmAShalAjAyavasaktugRu~jjAn| <br /> <br /> kharjUramAMsAnyatha nArikelaM drAkShAmatho vA badarANi lihyAt||28|| <br /> <br /> srotojalAjotpalakolamajjacUrNAni lihyAnmadhunA~abhayAM ca| <br /> <br /> kolAsthimajjA~jjanamakShikAviDlAjAsitAmAgadhikAkaNAn vA||29|| <br /> <br /> drAkShArasaM vA~api pibet sushItaM mRudbhRuShTaloShTaprabhavaM jalaM vA| <br /> <br /> jambvAmrayoH pallavajaM kaShAyaM pibet sushItaM madhusaMyutaM vA||30|| <br /> <br /> nishi sthitaM vAri samudgakRuShNaM soshIradhAnyaM caNakodakaM vA| <br /> <br /> gavedhukAmUlajalaM guDUcyA jalaM pibedikShurasaM payo vA||31|| <br /> <br /> sevyaM pibet kA~jcanagairikaM vA sabAlakaM taNDuladhAvanena| <br /> <br /> dhAtrIrasenottamacandanaM vA tRuShNAvamighnAni samAkShikANi||32|| <br /> <br /> kalkaM tathA candanacavyamAMsIdrAkShottamAbAlakagairikANAm| <br /> <br /> shItAmbunA gairikashAlicUrNaM mUrvAM tathA taNDuladhAvanena||33||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient of [[pitta]]ja type of ''chhardi'' should be given ''trivrit'' (Operculina turpethum) along with the juice of ''draksha'' (grapes/Vitis vinifera), ''vidari'' (Purera tuberosa) and ''ikshu'' (sugar-cane/Saccharaum officinarum) for causing downward movement of the morbid matter (laxation). When aggravated pitta is located in site of [[kapha]] (chest/stomach), then drugs having sweet taste should be administered for elimination of [[pitta]] (through emetic therapy). <br /> <br /> After this purificatory therapy patient should be given at proper time ''laja-mantha'' (flour of popped-rice diluted in water) or ''laja-peya'' (thin gruel made of popped-rice) along with honey and sugar. The patient may also be given boiled shāli type of rice along with the soup of ''mudga'' (green gram/Phaseolus aureus) or the meat juice of ''jangala'' creatures (animals inhabiting in arid zone). <br /> <br /> The following recipes are also advocated in this context:<br /> #''Kulmasha'', the paste of boiled ''mudga'' (green gram/Phaseolus aureus), ''masura'' (lentil/ Ervum lens), etc., ''laja'' (popped paddy), ''yava-saktu'' (flour of roasted barley), ''grunja'' (boiled barley along with its supernatant segment), or the pulp of ''kharjura'' (date/Phoenix sylvestris), ''narikela'' (coconut/Cocos nucifera), ''draksha'' (grapes/Vitis vinifera) or ''badara'' (Zyziphus jujuba) should be made to a linctus by adding ''sitopala'' (sugar having big crystals), honey and ''pippali'' (long pepper/Piper longum).<br /> #The water of fountain, ''laja'' (popped paddy), ''utpala'' (Nymphaea stellata) and the pulp of ''kola'' (Zyziphus jujuba) be made into linctus by adding honey, and given.<br /> #''Abhaya'' (chebulic myrobalan) with honey may also be taken. <br /> #The seed-pulp of ''kola'' (Zyziphus jujuba), ''anjana'' (''srotonjana''), ''makshika vit'' (excreta of house- fly), ''laja'' (popped paddy), sugar and grains of ''pippali'' mixed with honey. <br /> #The patient may drink cooled grape juice or cooled water prepared with baked clay or earth. <br /> #The patient may be given the cooled decoction of the tender leaves of ''jambu'' (Syzygium cumini) and ''amra'' (mango/Mangifera indica) by adding honey. <br /> #The following things kept overnight should be taken: <br /> ##Water with ''mudga'' (green gram/Phaseolus aureus) and ''pippali'' (long pepper/ Piper longum),<br /> ##Water with ''usheera'' (cuscus grass/Viteveria zizanioides) and ''dhanyaka'' (coriander/Coriandrum sativum), <br /> ##Water with ''chanaka'' (bengal gram/gram/chick pea/Cicer arietinum), <br /> ##Water with root of ''gavedhuka'' (Adlay/Jobs tears/Coix lachryma),<br /> ##Water with ''guduchi'' (Tinospora cordifolia),<br /> ###The patient may be given sugar-cane-juice or milk to drink.<br /> #The following recipes are useful in morbid thirst and vomiting: <br /> ##The powder of ''sevya'' (Cuscus grass/Viteveria zizanioides) and ''kanchana-gairika'' (Hematite, Fe2O3) along with ''tandulodaka'' (rice-water); <br /> ##The powder of ''sevya'' and ''balaka'' (Coleus vettiveroides) along with ''tandulodaka'' (rice-water); <br /> ##The paste of white variety of ''chandana'' (sandal wood) mixed with the juice of ''amalaki'' (emblic myrobalan/Emblica officinale) along with honey. <br /> #The following recipes also useful in ''paittika'' type of vomiting: <br /> ##The paste of ''chandana'' (sandal wood/Santalum album), ''chavya'' (Piper chaba/Piper officinarum), ''mamsi'' (Indian nard/nardus root/Nardostachys jatamansi), ''draksha'' (grapes/Vitis vinifera) of good quality, ''balaka'' (Coleus vettiveroides) and ''gairika'' (Hematite, Fe2O3); <br /> ##Powder of ''gairika'' (Hematite, Fe2O3) and ''shali'' rice along with cold water; <br /> ##Powder of ''murva'' (Marsdenia tenacissima / sansevieria roxburghiana) along with ''tandulodaka'' (rice-water)[26-33]<br /> <br /> === Treatment of [[kapha]]ja chhardi ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कफात्मिकायां वमनं प्रशस्तं सपिप्पलीसर्षपनिम्बतोयैः| <br /> <br /> पिण्डीतकैः सैन्धवसम्प्रयुक्तैर्वम्यां कफामाशयशोधनार्थम्||३४|| <br /> <br /> गोधूमशालीन् सयवान् पुराणान् यूषैः पटोलामृतचित्रकाणाम्| <br /> <br /> व्योषस्य निम्बस्य च तक्रसिद्धैर्यूषैः फलाम्लैः कटुभिस्तथाऽद्यात्||३५|| <br /> <br /> रसांश्च शूल्यानि च जाङ्गलानां मांसानि जीर्णान्मधुसीध्वरिष्टान्| <br /> <br /> रागांस्तथा षाडवपानकानि द्राक्षाकपित्थैः फलपूरकैश्च||३६|| <br /> <br /> मुद्गान्मसूरांश्चणकान् कलायान् भृष्टान् युतान्नागरमाक्षिकाभ्याम्| <br /> <br /> लिह्यात्तथैव त्रिफलाविडङ्गचूर्णं विडङ्गप्लवयोरथो [१] वा||३७|| <br /> <br /> सजाम्बवं वा बदराम्लचूर्णं [२] मुस्तायुतां कर्कटकस्य शृङ्गीम्| <br /> <br /> दुरालभां वा मधुसम्प्रयुक्तां लिह्यात् कफच्छर्दिविनिग्रहार्थम्||३८|| <br /> <br /> मनःशिलायाः फलपूरकस्य रसैः कपित्थस्य च पिप्पलीनाम्| <br /> <br /> क्षौद्रेण चूर्णं मरिचैश्च युक्तं लिहञ्जयेच्छर्दिमुदीर्णवेगाम्||३९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaphātmikāyāṁ vamanaṁ praśastaṁ sapippalīsarṣapanimbatōyaiḥ| <br /> <br /> piṇḍītakaiḥ saindhavasamprayuktairvamyāṁ kaphāmāśayaśōdhanārtham||34|| <br /> <br /> gōdhūmaśālīn sayavān purāṇān yūṣaiḥ paṭōlāmr̥tacitrakāṇām| <br /> <br /> vyōṣasya nimbasya ca takrasiddhairyūṣaiḥ phalāmlaiḥ kaṭubhistathā'dyāt||35|| <br /> <br /> rasāṁśca śūlyāni ca jāṅgalānāṁ māṁsāni jīrṇānmadhusīdhvariṣṭān| <br /> <br /> rāgāṁstathā ṣāḍavapānakāni drākṣākapitthaiḥ phalapūrakaiśca||36|| <br /> <br /> mudgānmasūrāṁścaṇakān kalāyān bhr̥ṣṭān yutānnāgaramākṣikābhyām| <br /> <br /> lihyāttathaiva triphalāviḍaṅgacūrṇaṁ viḍaṅgaplavayōrathō vā||37|| <br /> <br /> sajāmbavaṁ vā badarāmlacūrṇaṁ mustāyutāṁ karkaṭakasya śr̥ṅgīm| <br /> <br /> durālabhāṁ vā madhusamprayuktāṁ lihyāt kaphacchardivinigrahārtham||38|| <br /> <br /> manaḥśilāyāḥ phalapūrakasya rasaiḥ kapitthasya ca pippalīnām| <br /> <br /> kṣaudrēṇa cūrṇaṁ maricaiśca yuktaṁ lihañjayēcchardimudīrṇavēgām||39||<br /> <br /> kaphAtmikAyAM vamanaM prashastaM sapippalIsarShapanimbatoyaiH| <br /> <br /> piNDItakaiH saindhavasamprayuktairvamyAM kaphAmAshayashodhanArtham||34|| <br /> <br /> godhUmashAlIn sayavAn purANAn yUShaiH paTolAmRutacitrakANAm| <br /> <br /> vyoShasya nimbasya ca takrasiddhairyUShaiH phalAmlaiH kaTubhistathA~adyAt||35|| <br /> <br /> rasAMshca shUlyAni ca jA~ggalAnAM mAMsAni jIrNAnmadhusIdhvariShTAn| <br /> <br /> rAgAMstathA ShADavapAnakAni drAkShAkapitthaiH phalapUrakaishca||36|| <br /> <br /> mudgAnmasUrAMshcaNakAn kalAyAn bhRuShTAn yutAnnAgaramAkShikAbhyAm| <br /> <br /> lihyAttathaiva triphalAviDa~ggacUrNaM viDa~ggaplavayoratho [1] vA||37|| <br /> <br /> sajAmbavaM vA badarAmlacUrNaM [2] mustAyutAM karkaTakasya shRu~ggIm| <br /> <br /> durAlabhAM vA madhusamprayuktAM lihyAt kaphacchardivinigrahArtham||38|| <br /> <br /> manaHshilAyAH phalapUrakasya rasaiH kapitthasya ca pippalInAm| <br /> <br /> kShaudreNa cUrNaM maricaishca yuktaM liha~jjayecchardimudIrNavegAm||39||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Vamana'' (therapeutic emesis) is supposed to be the most suitable therapy in [[kapha]]ja type of ''chhardi'' (vomiting). In order to clean the seat of [[kapha]] and ''amashaya'', the patient should be given the decoction of ''pippali, sarsapa'' (yellow sarson/Indian colza/Brassica campestris) and ''nimba'' (neem tree/Margosa/Indian lilac/Azadirachta indica) added with powder of ''pinditaka'' (madanaphala/emetic nut/bushy gardenia/Randia dumetorum) and ''saindhava'' (rock-salt). <br /> <br /> The patient should be given old wheat, rice and barley along with <br /> #Vegetable soup of ''patola'' (Trichosanthes dioica), <br /> #''Amrita'' (Tinospora cordifolia) and <br /> #''Chitraka'' (Ceylon leadwort/ white leadwort/Plumbago zeylanica) or <br /> #with the soup of ''trikatu'' (three spices) and neem prepared with butter milk, or <br /> #Soup of sour fruits along with pungent drugs. <br /> <br /> The patient should also take the meat juices and roasted flesh of ''jangala'' creature (animals inhabiting arid zone), old honey, ''sidhu'' (alcohol prepared of sugar-cane-juice) and ''arishta'' (a type of alcoholic drink); and ''raga'' (condiments), shādava (pickles) and ''panaka'' (syrup) prepared of ''draksha'' (grapes) and ''phala-puraka'' (citrion/Citrus medica). <br /> <br /> The patient should take following three recipes mixed with ''shunthi'' (dry zingiber) and honey: <br /> #Roasted ''mudga'' (green gram), ''masura'' (lentil/Ervum lens), ''chanaka'' (bengal gram/Gram/ chick pea/Cicer arietinum) and ''kalaya'' (peas/Pisum sativum) <br /> #''Triphala'' (''haritaki, bibhitaka'' and ''amalaka''), and ''vidanga'' (babreng fruits/embelia ribes)<br /> #''Vidanga'' (babreng fruits/embelia ribes) and ''plava'' (nut grass/Cyperys rotundus) <br /> <br /> The following recipes should be taken mixed with the honey <br /> #''Jambu'' (Syzygium cumini) and sour fruits of ''badara'' (Zizyphus jujuba) <br /> #''Musta'' (nut grass/Cyperus rotundus)and ''karkata-shringi'' (Pistacia integerrima)<br /> #''Duralabha'' (Fegonia cretica). <br /> <br /> The forcefully generated urge of vomiting can be controlled with the following regims <br /> #Purified ''manahsila'' (red arsenic) with the juice of ''bijapuraka'' (citrion/Citrus medica), <br /> #''Pippali'' (long piper/Piper longum) mixed with the juice of ''kapittha'' (Feronia limonia)<br /> #''Maricha'' (black pepper/Piper nigrum) with honey [34-39]<br /> <br /> === Treatment of ''sannipatika chhardi'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यैषा पृथक्त्वेन मया क्रियोक्ता तां सन्निपातेऽपि समस्य [१] बुद्ध्या| <br /> <br /> दोषर्तुरोगाग्निबलान्यवेक्ष्य प्रयोजयेच्छास्त्रविदप्रमत्तः||४०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yaiṣā pr̥thaktvēna mayā kriyōktā tāṁ sannipātē'pi samasya buddhyā| <br /> <br /> dōṣarturōgāgnibalānyavēkṣya prayōjayēcchāstravidapramattaḥ||40||<br /> <br /> yaiShA pRuthaktvena mayA kriyoktA tAM sannipAte~api samasya [1] buddhyA| <br /> <br /> doSharturogAgnibalAnyavekShya prayojayecchAstravidapramattaH||40||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Judicious synthesis of the separate lines of treatment indicated by me for the derangement of individual humors should be employed by the learned physician for the patient suffering from ''sannipatika chhardi'' after carefully examining the relative preponderance of the [[dosha]] involved, the season when the disease has occurred, the stage of the disease and the power of digestion of the patient [40]<br /> <br /> === Treatment of ''dvishtarathasamyogaja (manobhighataja) chhardi'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मनोभिघाते तु मनोनुकूला वाचः समाश्वासनहर्षणानि| <br /> <br /> लोकप्रसिद्धाः श्रुतयो वयस्याः शृङ्गारिकाश्चैव हिता विहाराः||४१|| <br /> <br /> गन्धा विचित्रा मनसोऽनुकूला मृत्पुष्पशुक्ताम्लफलादिकानाम्| <br /> <br /> शाकानि भोज्यान्यथ पानकानि सुसंस्कृताः षाडवरागलेहाः||४२|| <br /> <br /> यूषा रसाः काम्बलिका खडाश्च मांसानि धाना विविधाश्च भक्ष्याः|<br /> <br /> फलानि मूलानि च गन्धवर्णरसैरुपेतानि वमिं जयन्ति||४३|| <br /> <br /> गन्धं रसं स्पर्शमथापि शब्दं रूपं च यद्यत् प्रियमप्यसात्म्यम्| <br /> <br /> तदेव दद्यात् प्रशमाय तस्यास्तज्जो हि रोगः सुख एव जेतुम्||४४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> manōbhighātē tu manōnukūlā vācaḥ samāśvāsanaharṣaṇāni| <br /> <br /> lōkaprasiddhāḥ śrutayō vayasyāḥ śr̥ṅgārikāścaiva hitā vihārāḥ||41|| <br /> <br /> gandhā vicitrā manasō'nukūlā mr̥tpuṣpaśuktāmlaphalādikānām| <br /> <br /> śākāni bhōjyānyatha pānakāni susaṁskr̥tāḥ ṣāḍavarāgalēhāḥ||42|| <br /> <br /> yūṣā rasāḥ kāmbalikā khaḍāśca māṁsāni dhānā vividhāśca bhakṣyāḥ| <br /> <br /> phalāni mūlāni ca gandhavarṇarasairupētāni vamiṁ jayanti||43|| <br /> <br /> gandhaṁ rasaṁ sparśamathāpi śabdaṁ rūpaṁ ca yadyat priyamapyasātmyam| <br /> <br /> tadēva dadyāt praśamāya tasyāstajjō hi rōgaḥ sukha ēva jētum||44||<br /> <br /> manobhighAte tu manonukUlA vAcaH samAshvAsanaharShaNAni| <br /> <br /> lokaprasiddhAH shrutayo vayasyAH shRu~ggArikAshcaiva hitA vihArAH||41|| <br /> <br /> gandhA vicitrA manaso~anukUlA mRutpuShpashuktAmlaphalAdikAnAm| <br /> <br /> shAkAni bhojyAnyatha pAnakAni susaMskRutAH ShADavarAgalehAH||42|| <br /> <br /> yUShA rasAH kAmbalikA khaDAshca mAMsAni dhAnA vividhAshca bhakShyAH| <br /> <br /> phalAni mUlAni ca gandhavarNarasairupetAni vamiM jayanti||43|| <br /> <br /> gandhaM rasaM sparshamathApi shabdaM rUpaM ca yadyat priyamapyasAtmyam| <br /> <br /> tadeva dadyAt prashamAya tasyAstajjo hi rogaH sukha eva jetum||44||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In case of vomiting caused by mental disgust the following measures should be resorted to: <br /> #Words which are pleasing and comforting, counseling and encouraging <br /> #Popular legends and stories, congenial companions and pleasant wholesome diversions, amorous and wholesome regimens (games); <br /> #Odor of various types of pleasing perfumes emanating from the earth, flowers, vinegar (''sukta'') and sour fruits<br /> #Well prepared vegetables, articles of food drinks, ''sadavas'' (pickles), ''raga'' (condiments) and ''lehas'' (preparations in the form of linctus or jam), ''yusha'' (Vegetable-soups), ''rasa'' (meat-soups), ''kambalika'' (sour curry of fish and meat), ''khada'' (sour drinks prepared of fruits), ''mamsa dhana'' (meat preparations), ''bhakshya'' (popped cereals), different eatables, fruits and roots having pleasant odor, color and taste will win over the vomiting caused by mental disgust. <br /> #In general, whatever odor, taste, contact, sound or sights those are pleasing to such patients should be given though otherwise unsuitable and unwholesome because in this way disease can be treated easily [41-44]<br /> <br /> === Treatment of complications ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> छर्द्युत्थितानां च चिकित्सितात् स्वाच्चिकित्सितं कार्यमुपद्रवाणाम्| <br /> <br /> अतिप्रवृत्तासु विरेचनस्य कर्मातियोगे विहितं विधेयम्||४५|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> chardyutthitānāṁ ca cikitsitāt svāccikitsitaṁ kāryamupadravāṇām| <br /> <br /> atipravr̥ttāsu virēcanasya karmātiyōgē vihitaṁ vidhēyam||45||<br /> <br /> chardyutthitAnAM ca cikitsitAt svAccikitsitaM kAryamupadravANAm| <br /> <br /> atipravRuttAsu virecanasya karmAtiyoge vihitaM vidheyam||45|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The treatment of complications arising from vomiting should be done according to the lines suggested in respect of each of those ailments. In case of excessive vomiting; treatment that is suggested in [Cha. Sa.[[Siddhi Sthana]] 6/52-56] for excessive purgation should be carried out [45]<br /> <br /> === Treatment of chronic ''chhardi'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वमिप्रसङ्गात् पवनोऽप्यवश्यं धातुक्षयाद्धृद्धिमुपैति तस्मात्| <br /> <br /> चिरप्रवृत्तास्वनिलापहानि कार्याण्युपस्तम्भनबृंहणानि||४६|| <br /> <br /> सर्पिर्गुडाः क्षीरविधिर्घृतानि कल्याणकत्र्यूषणजीवनानि| <br /> <br /> वृष्यास्तथा मांसरसाः सलेहाश्चिरप्रसक्तां च वमिं जयन्ति||४७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vamiprasaṅgāt pavanō'pyavaśyaṁ dhātukṣayāddhr̥ddhimupaiti tasmāt|<br /> <br /> cirapravr̥ttāsvanilāpahāni kāryāṇyupastambhanabr̥ṁhaṇāni||46|| <br /> <br /> sarpirguḍāḥ kṣīravidhirghr̥tāni kalyāṇakatryūṣaṇajīvanāni| <br /> <br /> vr̥ṣyāstathā māṁsarasāḥ salēhāściraprasaktāṁ ca vamiṁ jayanti||47|| <br /> <br /> vamiprasa~ggAt pavano~apyavashyaM dhAtukShayAddhRuddhimupaiti tasmAt| <br /> <br /> cirapravRuttAsvanilApahAni kAryANyupastambhanabRuMhaNAni||46|| <br /> <br /> sarpirguDAH kShIravidhirghRutAni kalyANakatryUShaNajIvanAni| <br /> <br /> vRuShyAstathA mAMsarasAH salehAshciraprasaktAM ca vamiM jayanti||47|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In persistent vomiting vāta invariably gets aggravated because of loss of tissue elements. Therefore, in case of chronic vomiting medications that are bulk promoting, [[vata]] pacifying, ''upastambhana'' (astringents) and [[brimhana]] (nutritive) should be administered.<br /> <br /> The following recipes are useful in chronic type of vomiting.<br /> <br /> ''Sarpirguda'' [Cha. Sa. [[Chikitsa Sthana]] 11/50-77], ''kshira-vidhi'' (milk boiled by adding [[vata]]-alleviating drugs), ''kalyanaka-ghrita'' [Cha. Sa. [[Chikitsa Sthana]] 9/33-42], ''tryushana-ghrita'' [ Cha. Sa. [[Chikitsa Sthana]] 18/39-42], ''jivaniya-ghrita'' [Cha. Sa. [[Chikitsa Sthana]] 29/55-57], ''vrishya'' (virilific) recipes, ''mamsarasa'' (meat soup) and ''lehya'' like ''chyavanprasha'' (linctuses) [46-47]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकः- <br /> <br /> हेतुं सङ्ख्यां लक्षणमुपद्रवान् साध्यतां न योगांश्च| <br /> <br /> छर्दीनां प्रशमार्थं प्राह चिकित्सितं मुनिवर्यः||४८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkaḥ- <br /> <br /> hētuṁ saṅkhyāṁ lakṣaṇamupadravān sādhyatāṁ na yōgāṁśca| <br /> <br /> chardīnāṁ praśamārthaṁ prāha cikitsitaṁ munivaryaḥ||48|| <br /> <br /> tatra shlokaH- <br /> <br /> hetuM sa~gkhyAM lakShaNamupadravAn sAdhyatAM na yogAMshca| <br /> <br /> chardInAM prashamArthaM prAha cikitsitaM munivaryaH||48|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> To sum up, in this chapter the predisposing factors, numerals of the vomiting, symptoms, complications, prognosis, formulations and other measures of management for the relief of vomiting are described by the foremost of the sages [48]<br /> <br /> Thus the section on therapeutics in the treatise compiled by Agnivesha redacted by Charaka and reconstructed by Dridhabala as it was not available.<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *''Chhardi'' (vomiting) can be either caused by vitiation of endogenous [[dosha]] or by exogenous factors like in ''dvistartha-yogaja-chhardi'' (that results from contact with unpleasant sense objects).<br /> *The [[dosha]] vitiation due to their own specific causative factors lead to irritation of stomach, spread through ''rasayani'' (channels carrying rasa) resulting in ''chhardi''. Different types of ''chhardi'' shall be diagnosed based on the specific etio-pathogenesis and clinical presentation. <br /> *Mind and sense objects play significant role in pathogenesis of ''chhardi'' due to exposure to unwholesome objects. <br /> *The prognosis of ''chhardi'' depends upon strength of patient, bouts, presence of associated disorders and complications, contents of vomitus. <br /> *All the types of vomiting are considered originating from the agitations of the [[dosha]] in the stomach. Therefore, fasting therapy is first principle of treatment. Purification therapies of [[kapha]] and [[pitta]] are administered to expel out vitiated [[dosha]]. These therapies are contraindicated in cases of [[vata]] dominance. The choice of therapy depends upon strength of patient and type of vitiated [[dosha]]. <br /> *The drugs having nutritive properties, carminative, [[dosha]] pacifying actions are prescribed in the treatment of ''chhardi''. <br /> *Sublingual, pleasant tasting linctus, mild purgative to open the channel to lower G I tract.<br /> *During initial stage of ''chhardi'', because of irritated stomach, anti-emetic treatment is not advised. Soothing, taste enhancing and nutritive liquid substances should be given. Mind diverting and entertaining activities are also advised.<br /> *The treatment of complications arising from vomiting should be done according to the lines suggested in respect of each of those ailments.<br /> *In persistent vomiting [[vata]] invariably gets aggravated because of loss of tissue elements. Therefore, in case of chronic vomiting medications that are bulk promoting, [[vata]] pacifying, ''upastambhana'' (astringents) and [[brimhana]] (nutritive) should be administered.<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> <br /> === Pathogenesis ===<br /> <br /> ''Mahasrotus'' (gastrointestinal tract) has two parts, upper part is ''annavaha srotus'' and lower part is [[purisha]]vaha srotus. ''Atisara'' is related to [[purisha]]vaha srotus and ''chhardi'' is to ''annavaha srotus''. Etiological factors of ''chhardi'' are irritating food and practices to ''amashaya'' (stomach). They are [[vata]] vitiating, impairing ''annavaha srotus''. Even before the digestion process starts the food comes out because of action of ''urdhvavata'' or ''udanavata'', therefore, there is no involvement of [[agni]]. ''Chhardi'' is a defense mechanism to expel the toxins out of the stomach. There is vacuum created by repeated expulsion of stomach contents and ''rasayinis''(villi) instead of their normal function of absorption, they start secreting body fluids into to the stomach. <br /> <br /> === Types of ''chhardi'' ===<br /> <br /> Diseases are classified according to the dominance of [[dosha]]-involved and their mutual amalgamation, which are of four types. The 5th type of ''chhardi'' (''dwishtarthayoga'') is due to aversive food related to the involvement of ''panchagyanendriyas'' (five sense organs) and their ''vishaya upalabdhi'' [Cha. Sa. [[Sutra Sthana]] 1/54] (perceivance of senses). The contact through ''rupa'' (visible) or ''rasa'' (taste) or ''gandha'' (smell) or ''sparsha'' (touch) or ''shabda'' (hear) or in combination with each other, stimulates body mechanism which results in ''dwistarthayoga chhardi'' (vomiting due to aversion). One cannot exclude the role of ''manah'' (mind) as predisposing factor in causing ''dwistarthayoga chhardi''. <br /> <br /> ''Douhruda janita'' (pregnancy induced vomitting), ''satmya prakopaja'' (vomiting due to inadequacy of substances) and ''krimija'' (vomiting due to microbial infection) type of ''chhardi'' are other causes of ''chhardi''.&lt;ref&gt;Sushruta. Sushruta Samhita . In: Kaviraj Shastri Ambika Dutt, Editors. 5th ed. Varanasi: Chaukhambha Sanskrit Series;1982. p.?.&lt;/ref&gt; <br /> <br /> ==== [[Vata]]ja chhardi ==== <br /> <br /> There are many factors that increase [[vata]] in the ''sharira'' .&lt;ref&gt; Sushruta. Sutra sthana cha 21 Vranaprashna Adhyaya verse 19. In: Kaviraj Shastri Ambika Dutt, editors, 5th Edition, Varanasi : Chaukhamba Sanskrit Series,1982.&lt;/ref&gt; Particular ''ahara'' (food), ''vihara'' (lifestyle) and mental factors increase [[vata]] and its ''gunas'' (properties). This aggravation of [[vata]] gunas like ''rukshata'' (dryness), ''laghuta'' (lightness), etc. plays a role in causing [[vata]]ja chhardi. [ Cha. Sa. [[Sutra Sthana]] 1/59] [[dosha]] conjugate (''sammurchhana'' [ Cha. Sa.[[Sutra Sthana]] 18/46] with a particular organ (''mahasrotas, amashaya, marma'' (vital organ), ''urdhwabhaga'' (upper trunk, etc) as ''dushyas'' (affected [[dhatu]]) to cause [[vata]]ja chhardi (as ''utkshepana'' (upward movement), ''adhahkshepana'' (downward movement), etc are the ''karmas'' (actions) of [[vayu]])-(7-9).<br /> <br /> ==== [[Pitta]]ja chhardi ====<br /> <br /> ''Nidanas'' of [[pitta]]prakopaka increase [[pitta]] in nature &lt;ref&gt; Sushruta, Sutra sthana c21/21 Hindi commentary by Kaviraj, Shastri Ambika Dutt, 5th Edition, 1982, Chaukhamba Sanskrit Series, Varanasi &lt;/ref&gt;and cause provocation of ''gunas'' like ''ushna'' (hot), ''tikshna'' (sharp), ''snigdha'' (unctous), etc. [ Cha. Sa. [[Sutra Sthana]] 1/60] in the body. This aggravated ''pitta'' joins (''sammurchhana'') with a particular organ (''rasayani, amashaya, marma, urdhwabhaga,'' etc) as ''dushyas''. The conjugation of [[dosha]] and ''dushya'' has affinity towards ''urdhwabhaga'' which results in [[pitta]]ja chhardi (10-11).<br /> <br /> ==== [[Kapha]]ja chhardi ====<br /> <br /> ''Nidanas'' of [[kapha]]prakopaka increase [[kapha]] in nature which causes provocation of [[guna]] like ''guru'' (heavyness), ''sheeta'' (coldness), ''manda'' (slowness), etc. [ Cha. Sa.[[Sutra Sthana]] 1/60] in the body. This aggravated [[kapha]] joins (''sammurchhana'') with a particular organ (''urah'' (chest), ''shirah'' (head), ''rasayani marma, urdhwabhaga,'' etc.) as ''dushyas''. This amalgamation of [[dosha]] and ''dushya'' has affinity towards ''urdhwabhaga'' which results in [[kapha]]ja chhardi(12-13).<br /> <br /> ==== ''Sannipataja chhardi'' ====<br /> <br /> Intake of diet containing all ''rasas'' or tastes ideal but the intake of food with imbalances in ''rasas'' leads to the vitiation of ''tridoshas''[Cha.Sa.Sutra Sthana 26/90-101]and causes ''sannipataja chhardi'' which has varied manifestations covering broad signs of ''tridosha'' involvement ( verses 14-15). <br /> <br /> The ''sama-varna-gandha'' (color &amp; smell similar to) of vomitus is due to conjugation with [[purisha]] (stool) and [[mutra]] (urine). This conjugation indicates involvement of multiple ''srotasas'' and have tendency towards ''asadhyata'' (incurable)[Cha. Sa. [[Vimana Sthana]] 5/3] ( verses 16-17).<br /> <br /> Excessive loss of any [[dhatu]] ([[rasa dhatu]]-[[rakta]]-vasa, etc) due to physical exercise or [[vamana]] vega'' (bouts) or arising out of any complications in the form of diseases like ''kasa'' (cough), ''shwasa'' (asthama), ''jwara'' (fever)&lt;ref&gt;Madhavakara. Madhava Nidanam (Roga vinischaya) cha 15. Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--&lt;/ref&gt;, etc. are considered to be life threatening.<br /> <br /> === Treatment ===<br /> <br /> *[[Langhana]] becomes the first line of treatment in ''chhardi'' as ''shamana chikitsa'' (pacificatory treatment). ''Samshodha'' can be preferred where [[dosha]] are in ''utklishtha'' stage and ready to be expelled out. [[Vamana]] is recommended when [[dosha]] are accumulated in ''amashaya'' or ''amashayottha'' (originating from stomach or upper gastro-intestinal tract). Whereas [[virechana]] is recommended in case of post-''amashayottha'' (in lower gastro-intestinal tract) accumulated [[dosha]], considering nearest route of ''samshodhana''. The choice of drugs should be done as per the [[dosha]]nashakatva(capacity to subside the vitiated [[dosha]]) ( verse 20).<br /> *''Haritaki'' is known for its laxative action (''anulomaneeya''). It not only ''tridoshahara'' but also possesses many more qualities [Cha. Sa. [[Chikitsa Sthana]] 1/1/29-34] which can be helpful for ''samprapti vighanatana'' (breaking pathogenesis) in ''chhardi''. The choice of ''hridaya dravya'' (liking to mind) is recommended in ''chhardi'' which should be given with ''madya'' (alcohol) and ''dugdha'' (cow milk) as an ''anupana''. ''Madya'' due to its specific [[guna]][Cha.Sa. [[Sutra Sthana]] 27/ 193-195] results in quick absorption of the ''dravya'' and hastens the mode of action. ''Dugdha'' (cow milk) along with many other qualities [ Cha. Sa.[[Sutra Sthana]] 27/217-18] is naturally ''saraka'' (purgative) in nature which makes ''anulomana gati'' (natural movements) of [[vayu]]. <br /> *As the [[dosha]] are already in ''utklishta avastha''(stage of aggravation or ready to come out), the choice of ''valliphala'' for [[vamana]] is considered as a ''mridu'' (mild). On the other hand if the patient is weak and cannot tolerate the [[vamana]] effort, ''shamana chikitsa'' should be considered. The treatment planning should be done keeping ''manah'' as center point. The diet or ''pathya'' should be a ''manah prasannakara'' (mind pleasing) [ Cha. Sa.[[Chikitsa Sthana]] 20/ 41-42] . It should be preferably ''mamsarasa'', dry food or liquid diet which is easily digestible ( verses 21-22). <br /> *In [[vata]]ja chhardi, ''laghu susanskrita mamsarasa'' (processed meat soup) is helpful in easy digestion and gives strength due to [[vata]] pacifying property. The ''yusha'' prepared from ''amlarasatmaka'' (sour taste) is not only [[vata]] pacifying but also stimulates the heart and leads to ''anulomana gati'' of [[vayu]]. ''Ghrita'' as ''sanskaranuvartana'' (synergistically increases the properties of associated drugs) [ Cha. Sa.[[Sutra Sthana]] 27/231-32] and [ Cha. Sa. [[Sutra Sthana]] 13/13] can be beneficial in [[vata]]ja hridroga.<br /> *If the aggravated [[dosha]] are in distal part of ''amashaya'' (post- ''amashaya'') the nearest route to remove [[pitta]] is through [[virechana]] procedure. If the aggravated [[pitta]] is in ''amashaya'' then the nearest route to remove [[pitta]] is through [[vamana]]. Both these procedures should be adopted in ''balavana rogi'' (physically strong patient) judiciously clubbing with proper ''samsarjana krama'' (protocol after purification procedure) to prevent aggravation of [[vata]] [[dosha]]. <br /> *For ''shamana'' treatment the selection of drugs should be [[pitta]] pacifying, ''manapralhadakara'' (mind pleasing) and ''balya'' (strength of patient) criteria. The mechanism of action of these drugs can be through ''hetu viparita'' (anti-etiology), ''vyadhi viparita'' (anti-disease) or ''hetu-vyadhi veeparita chikitsa'' (anti-cause &amp; disease treatment). <br /> *For [[kapha]]ja chhardi chikitsa, as the [[dosha]] are situated in ''kaphashaya'' (''amashaya / ura'') the nearest and ideal route is [[vamana]]. The choice of ''dravyas'' for [[vamana]] should be [[kapha]]hara'' like ''pippali, sarshapa, nimbatoya, madanaphala,'' etc. The choice of treatment is based on aggravated ''dosha, sanchayasthana'' (place of accumulation), ''sannikrishtha marga'' (nearest route), ''dosha-shamaka guna'' of ''dravyas'', etc. <br /> *Various types of ''yusha, ragashadava, panaka'' [ Cha. Sa. [[Sutra Sthana]] 27/279-281] are ''kaphahara, madhura-amlarasatmaka'' (sweet &amp; sour), ''deepaneeya-pachaneeya'' (appetizer &amp; digestant) in nature. <br /> *For ''chhardinigrahana'' (anti-emetic group), the drugs should be ''kashaya rasatmaka'' (astringent taste), ''sheetaveerya'' (cool potency) and [[kapha]]ghna ([[kapha]] alleviators) in nature. The ''manahshiladi yoga'' (a formulation) is considered to be ''vyadhiviparitarthakari'' (anti-disease) measures.<br /> *In case of ''dwistarthayoga chhardi'' (vomiting due to hate/ aversion), the treatment includes ''ashvasana'' (assurance), ''vartalapa'' (conversation), ''mitramandali'' (friend circle), ''mananusarena ahara-vihara'' (preferable food &amp; lifestyle). By doing so one can easily overcome the disease for the time being and once the ''vegavastha'' (vomiting bouts) is overcome, actual conceptual treatment can be adopted. <br /> *The ''vegakalina'' or chronic ''chhardi'', whether mild or severe, involves constant irritation of involved body parts/systems which leads to poor nourishment of [[dhatu]] resulting in [[dhatu]]ksheenata. Such a long term [[dhatu]]kshaya (loss of [[dhatu]]) increases [[vata]] in the body. The management should be purely [[vata]]shamaka treatment especially [[stambhana]] (which restricts the [[vamana]] vega) in combination with [[brimhana]] (nourishment to [[dhatu]]).<br /> <br /> The selection of drugs plays very important role here. Most of the dravyas mentioned here are ''vichitrapratyarabhadha'' (extraordinary) in nature which achieve [[stambhana]] but would not increase [[vata]]. The description about ''sarpiguda'' (a formulation), ''kalyanaka ghrita'' (a formulation), ''vrishya yoga'' (a formulation), ''avalehas'' (a formulation) etc. are the desired formulations for the management may have synergistic action.<br /> <br /> === Current clinical practice for management of chhardi (referred from Chikitsa Pradeep page 25) ===<br /> {|class=&quot;wikitable&quot;<br /> !scope = &quot;col&quot;| Type<br /> !scope = &quot;col&quot;| Medicine<br /> !scope = &quot;col&quot;| Dosage<br /> !scope = &quot;col&quot;| Time<br /> !scope = &quot;col&quot;| ''Anupana''<br /> |-<br /> | [[Vata]] dominant and [[vata]]-[[pitta]] dominant<br /> | ''Shankha bhasma''<br /> | 60-120 mg<br /> | Frequently<br /> | ''Nimbu Panaka'' (lemon water)<br /> |-<br /> |[[Pitta]] dominant<br /> | ''Sutashekhara kalpa''<br /> | 500-1000 mg<br /> | Frequently<br /> | ''Dadimavaleha''<br /> |-<br /> | [[Kapha]] dominant<br /> | ''Mayu piccha mashi''<br /> | 1 - 3 gms<br /> | Frequently<br /> | ''Ardrakavaleha''<br /> |-<br /> | Tri[[dosha]]ja<br /> | ''Brihad vata chintamani''<br /> | 50 - 100 mg<br /> | Frequently<br /> | ''Ardraka swarasa'' + sugar + honey<br /> |-<br /> | ''Dauhridaja'' (in pregnancy)<br /> | ''Swarnashekhara'' mixture<br /> | 250-500 mg<br /> | After meals<br /> | ''Ardraka swarasa'' + ''Nimbu swarasa'' + rock salt<br /> |-<br /> | ''Krimija''<br /> | ''Vidanga-yavani phanta''<br /> | 20-40 ml<br /> | Empty stomach, two times<br /> | ''-''<br /> |}<br /> <br /> === Further researches ===<br /> Many parenteral and oral medicines are available in conventional medical systems for management of dehydration and emergency conditions. The ayurveada drugs listed in this chaper need to be researched further for evaluating their efficacy specifically in conditions where the parenteral administration is contra-indicated and in case of drug intorerance.<br /> &lt;/div&gt;<br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References ==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Chhardi_Chikitsa&diff=45387 2025-11-17T06:33:46Z

<p>Agnivesha: /* Vataja chhardi */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Chhardi Chikitsa<br /> |titlemode=append<br /> |keywords=atisara, diarrhea, ama, nirama, sangrahi treatment, pichcha basti,Ayurveda, Indian system of medicine, charak samhita. <br /> |description=Chikitsa Sthana Chapter 20. Management of Chhardi (vomiting)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 20. Management of Chhardi (vomiting) &lt;/big&gt;'''<br /> {{Infobox<br /> |title = Chhardi Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 20<br /> |label2 = Preceding Chapter<br /> |data2 = [[Atisara Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Visarpa Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Murthy A.R.V., Jani D.<br /> |label7 = Reviewer <br /> |data7 = Prasad B.S.<br /> |label8 = Editors<br /> |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.021 10.47468/CSNE.2020.e01.s06.021]<br /> }}<br /> <br /> &lt;big&gt;'''Abstract &lt;/big&gt;'''<br /> &lt;p style='text-align:justify;'&gt;''Chhardi'' (vomiting), is a common gastrointestinal disorder characterized by bouts of vomiting, nausea, pain and black outs. The causative factors of ''chhardi'' can be categorized under dietary, lifestyle and psychological factors. Dietary factors include excessive ''upavasa'' (starvation), over intake of ''vidahi'' or ''snigdha-guru dravya'' (drugs which are very acrid, unctuous and heavy to digest), etc. Lifestyle aspects include excessive exercise, ''divasvapna'' (day sleep), etc. whereas the psychological stressors like excess worries, grief, anger, fear can precipitate it. ''Amashaya'' (stomach) and ''rasayani'' (channels) are the sites of origin of ''chhardi''. Vitiated [[dosha]] accumulate in ''amashaya'' and ''rasayani'' and are thrown out forcefully from the upper part of body causing ''pida'' (pain) to ''urdhva avayavas'' (organs situated above supraclavicular region). Comprehensive management includes avoidance of etiological factors with pharmacological treatment through medicament as well as non-pharmacological methods. <br /> &lt;/p&gt;<br /> '''Keywords''': ''Chhardi chikitsa, chhardi,'' vomiting, emesis<br /> <br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> After explaining the [[Atisara Chikitsa]] (treatment of diarrhea), there is a description of [[Chhardi Chikitsa]]. The word ''chhardi'' is derived from the root ''chhard vamane''. The word ''chhad'' means gripping (''avritta'' or ''achhadana'') and ''ard'' means pain (''peedha'')&lt;ref&gt;Madhavakara. Chardi praarana verse 15, In:Shastri Suderashan,editor, Madhava Nidanam (Roga vinischaya). 4th ed. Varanasi: Chaukhamba Sanskrit Series,1975.pp--&lt;/ref&gt;. The other words like ''chhardah, chhardana, chhardi, chhardika,'' etc. are considered as the synonyms of ''chhardi''.&lt;ref&gt;Charak. Chikitsa Sthana, Cha.20 Chhardi Chikitsa Adhyaya. In: Bramhanand Tripathi Editor. Charak Samhita.,? ed. Varanasi: Chaukhamba Sanskrit Pratisthan,2015. p.?.&lt;/ref&gt; The words ''chhardi'' and [[vamana]], both are used in the sense of vomiting but have basic differences. ''Chhardi'' is a pathological condition where the sufferer is exposed to particular predisposing factors for vomiting and as a result, suffers from the particular condition called ''chhardi''. On the other hand [[vamana]] is one of the purification therapies of [[Panchakarma]] (five purification procedures in [[Ayurveda]]) where the physician intends to induce vomiting to expel out vitiated [[kapha]] and [[pitta]]. In general, the vitiated [[dosha]] accumulate in stomach and are thrown out from the body through various channels. There are two major channels from which the body generally does such excretory mechanism.&lt;ref&gt;Sushruta. Sharira Sthana, Cha.5 Shareerasankhyavyakarana Sharira Adhyaya verse 10. In: Kaviraj Shastri Ambika Dutt, Editors. Sushruta Samhita. 5th ed. Varanasi: Chaukhamba Sanskrit Series,1982. p.?.&lt;/ref&gt; The one is adhomārga (excretion through downward channel) for which the description of ''atisara'' is given in previous chapter and the other one is ''urdhvabhaga'' (excretion through the upward channel) where the description of ''chhardi'' is discussed here. ''Chhardi'' comes under the category of ''koshtha rasayani shrita vyadhi'' (diseases of GI tract) whose roots are in ''mahasrotas'' (GI tract) and ''manovaha'' (mind) ''srotasa''. The ''amashaya'' and ''rasayani'' are the involved ''avayavas'' (organs) in this disease.&lt;ref&gt;Chakrapani, Charak. Vimana Sthana, Cha.5 Srotovimna Adhyaya ver.7-3. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.1st ed. Varanasi: Krishnadas Academy;2000.p.4&lt;/ref&gt; The management of this disease is by the pharmacological treatment through various herbs/combinations, dietary modifications and psychological counseling. The preventive aspect includes avoidance of causative factors and enhancement in psychological strength to specific items/factors.&lt;ref&gt;Chakrapani, Charak. Vimana Sthana, Cha.5 Srotovimna Adhyaya ver.25. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.1st ed. Varanasi: Krishnadas Academy;2000.p.4&lt;/ref&gt; The curative treatment focuses on pharmacotherapy depending upon [[dosha]] dominance and mild ''samshodhana'' (expelling out the vitiated [[dosha]]).<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातश्छर्दिचिकित्सितं व्याख्यास्यामः||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः||२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātaśchardicikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2|| <br /> <br /> athAtashchardicikitsitaM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now we shall expound the chapter &quot;Chhardi chikitsa&quot; (Management of vomiting). Thus said Lord Atreya. [1-2]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यशस्विनं ब्रह्मतपोद्युतिभ्यां ज्वलन्तमग्न्यर्कसमप्रभावम्| <br /> <br /> पुनर्वसुं भूतहिते निविष्टं पप्रच्छ शिष्योऽत्रिजमग्निवेशः||३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yaśasvinaṁ brahmatapōdyutibhyāṁ jvalantamagnyarkasamaprabhāvam| <br /> <br /> punarvasuṁ bhūtahitē niviṣṭaṁ papraccha śiṣyō'trijamagnivēśaḥ||3||<br /> <br /> yashasvinaM brahmatapodyutibhyAM jvalantamagnyarkasamaprabhAvam| <br /> <br /> punarvasuM bhUtahite niviShTaM papraccha shiShyo~atrijamagniveshaH||3||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Agnivesha the disciple asked Punarvasu, the illustratious son of Atri, who was engrossed in the thinking of the well-being of humanity and who was dazzling with luster of divine knowledge and penance, who was endowed with the brilliance like that of fire and the sun, and who was dedicated to the well-being of all living beings [3]<br /> <br /> === Queries by Agnivesha ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> याश्छर्दयः पञ्च पुरा त्वयोक्ता रोगाधिकारे भिषजां वरिष्ठ!| <br /> <br /> तासां चिकित्सां सनिदानलिङ्गां यथावदाचक्ष्व नृणां हितार्थम्||४|| <br /> <br /> तदग्निवेशस्य वचो निशम्य प्रीतो भिषक्श्रेष्ठ इदं जगाद| <br /> <br /> याश्छर्दयः पञ्च पुरा मयोक्तास्ता विस्तरेण ब्रुवतो निबोध||५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yāśchardayaḥ pañca purā tvayōktā rōgādhikārē bhiṣajāṁ variṣṭha!|<br /> <br /> tāsāṁ cikitsāṁ sanidānaliṅgāṁ yathāvadācakṣva nr̥ṇāṁ hitārtham||4|| <br /> <br /> tadagnivēśasya vacō niśamya prītō bhiṣakśrēṣṭha idaṁ jagāda| <br /> <br /> yāśchardayaḥ pañca purā mayōktāstā vistarēṇa bruvatō nibōdha||5||<br /> <br /> yAshchardayaH pa~jca purA tvayoktA rogAdhikAre bhiShajAM variShTha!| <br /> <br /> tAsAM cikitsAM sanidAnali~ggAM yathAvadAcakShva nRuNAM hitArtham||4||<br /> <br /> tadagniveshasya vaco nishamya prIto bhiShakshreShTha idaM jagAda| <br /> <br /> yAshchardayaH pa~jca purA mayoktAstA vistareNa bruvato nibodha||5|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Oh! Revered Physician, please describe the treatment of the five types of ''chhardi'' (vomiting) mentioned by you earlier in the context of the enumeration of diseases (in Sutra 19:3-4) along with their etiology, signs and symptoms comprehensively, for the sake of well-being of humanity.<br /> <br /> Having heard Agnivesha and being pleased the best among physicians Punarvasu Atreya said “I shall now expound all the five types of vomiting (briefly) stated earlier, in greater details. Listen to me.&quot; [4-5]<br /> <br /> === Classification and premonitory symptoms ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दोषैः पृथक्त्रिप्रभवाश्चतस्रो [१] द्बिष्टार्थयोगादपि पञ्चमी स्यात्| <br /> <br /> तासां हृदुत्क्लेशकफप्रसेकौ द्वेषोऽशने चैव हि पूर्वरूपम्||६| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dōṣaiḥ pr̥thaktriprabhavāścatasrō dbiṣṭārthayōgādapi pañcamī syāt|<br /> <br /> tāsāṁ hr̥dutklēśakaphaprasēkau dvēṣō'śanē caiva hi pūrvarūpam||6||<br /> <br /> doShaiH pRuthaktriprabhavAshcatasro [1] dbiShTArthayogAdapi pa~jcamI syAt|6| <br /> <br /> tAsAM hRudutkleshakaphaprasekau dveSho~ashane caiva hi pUrvarUpam||6|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Chhardi'' (vomiting) is of five types; three types of vomiting caused by a [[dosha]] each i.e. vatika, paittika, [[kapha]]ja, fourth is ''sannipatika'' and fifth is ''dvistartha-yogaja-chhardi'' (that results from contact with unpleasant sense objects).<br /> The premonitory signs and symptoms of ''chhardi'' (vomiting) are nausea, excessive salivation and aversion to food [6]<br /> <br /> === [[Vata]]ja chhardi ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> व्यायामतीक्ष्णौषधशोकरोगभयोपवासाद्यतिकर्शितस्य| <br /> <br /> वायुर्महास्रोतसि सम्प्रवृद्ध उत्क्लेश्य दोषांस्तत ऊर्ध्वमस्यन्||७|| <br /> <br /> आमाशयोत्क्लेशकृतां च मर्म प्रपीडयंश्छर्दिमुदीरयेत्तु| <br /> <br /> हृत्पार्श्वपीडामुखशोषमूर्धनाभ्यर्तिकासस्वरभेदतोदैः||८|| <br /> <br /> उद्गारशब्दप्रबलं सफेनं विच्छिन्नकृष्णं तनुकं कषायम्| <br /> <br /> कृच्छ्रेण चाल्पं महता च वेगेनार्तोऽनिलाच्छर्दयतीह दुःखम्||९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vyāyāmatīkṣṇauṣadhaśōkarōgabhayōpavāsādyatikarśitasya| <br /> <br /> vāyurmahāsrōtasi sampravr̥ddha utklēśya dōṣāṁstata ūrdhvamasyan||7|| <br /> <br /> āmāśayōtklēśakr̥tāṁ ca marma prapīḍayaṁśchardimudīrayēttu| <br /> <br /> hr̥tpārśvapīḍāmukhaśōṣamūrdhanābhyartikāsasvarabhēdatōdaiḥ||8|| <br /> <br /> udgāraśabdaprabalaṁ saphēnaṁ vicchinnakr̥ṣṇaṁ tanukaṁ kaṣāyam| <br /> <br /> kr̥cchrēṇa cālpaṁ mahatā ca vēgēnārtō'nilācchardayatīha duḥkham||9||<br /> <br /> vyAyAmatIkShNauShadhashokarogabhayopavAsAdyatikarshitasya| <br /> <br /> vAyurmahAsrotasi [1] sampravRuddha utkleshya doShAMstata Urdhvamasyan||7|| <br /> <br /> AmAshayotkleshakRutAM ca marma prapIDayaMshchardimudIrayettu| <br /> <br /> hRutpArshvapIDAmukhashoShamUrdhanAbhyartikAsasvarabhedatodaiH||8|| <br /> <br /> udgArashabdaprabalaM saphenaM vicchinnakRuShNaM tanukaM kaShAyam| <br /> <br /> kRucchreNa cAlpaM mahatA ca vegenArto~anilAcchardayatIha duHkham||9||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In a person extremely emaciated because of excess exercise, chronic disease, excessive intake of ''tikshna'' (sharply acting) medicines (of high potency), and indulging in grief, fear, excess fasting, etc. [[vata]] gets excessively aggravated in the ''maha-srotas'' (gastrointestinal tract), vitiates the local [[dosha]] and pushes them upwards. These [[dosha]] cause agitation in the ''amashaya'' (stomach), and after afflicting the ''marma'' (vital organs-heart) gives rise to ''chhardi'' (vomiting). This [[vata]]ja type of vomiting is characterized by the following signs and symptoms: <br /> #Pain in the cardiac region and flanks; <br /> #Dryness of the mouth; <br /> #Pain in the head and umbilical region; <br /> #Cough, hoarseness of voice and pricking pain; <br /> #Eructation with loud noise; <br /> #Vomiting of material which is frothy, scattered, black in color, thin and astringent; <br /> #The urge for vomiting is forceful, but patient vomits only in small quantities with pain; <br /> #The patient feels miserable [7-9]<br /> <br /> === [[Pitta]]ja chhardi ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अजीर्णकट्वम्लविदाह्यशीतैरामाशये पित्तमुदीर्णवेगम्| <br /> <br /> रसायनीभिर्विसृतं प्रपीड्य मर्मोर्ध्वमागम्य वमिं करोति||१०|| <br /> <br /> मूर्च्छापिपासामुखशोषमूर्धताल्वक्षिसन्तापतमोभ्रमार्तः| <br /> <br /> पीतं भृशोष्णं हरितं सतिक्तं धूम्रं च पित्तेन वमेत् सदाहम्||११||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ajīrṇakaṭvamlavidāhyaśītairāmāśayē pittamudīrṇavēgam| <br /> <br /> rasāyanībhirvisr̥taṁ prapīḍya marmōrdhvamāgamya vamiṁ karōti||10|| <br /> <br /> mūrcchāpipāsāmukhaśōṣamūrdhatālvakṣisantāpatamōbhramārtaḥ| <br /> <br /> pītaṁ bhr̥śōṣṇaṁ haritaṁ satiktaṁ dhūmraṁ ca pittēna vamēt sadāham||11|| <br /> <br /> ajIrNakaTvamlavidAhyashItairAmAshaye pittamudIrNavegam| <br /> <br /> rasAyanIbhirvisRutaM prapIDya marmordhvamAgamya vamiM karoti||10|| <br /> <br /> mUrcchApipAsAmukhashoShamUrdhatAlvakShisantApatamobhramArtaH| <br /> <br /> pItaM bhRushoShNaM haritaM satiktaM dhUmraM ca pittena vamet sadAham||11|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As a result of indigestion, taking pungent, sour, ''vidahi'' (which cause burning sensation) and hot potency food, the [[pitta]] in the stomach gets aggravated. This aggravated [[pitta]] spreads through the ''rasayani'' (channels) and stresses the vital organs located in the upper part of the body which results in vomiting: <br /> <br /> The signs and symptoms of this [[pitta]]ja type of ''chhardi'' (vomiting) are: <br /> #Fainting, morbid thirst and parching of mouth; <br /> #Burning (or heating) sensation in the head, palate and eyes; <br /> #A feeling as if the patient is entering into darkness: <br /> #Giddiness; <br /> #Vomitus is yellow, excessively hot, green, bitter and smoky in appearance with burning sensation [10-11]<br /> <br /> === [[Kapha]]ja chhardi ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्निग्धातिगुर्वामविदाहिभोज्यैः स्वप्नादिभिश्चैव कफोऽतिवृद्धः| <br /> <br /> उरः शिरो मर्म रसायनीश्च सर्वाः समावृत्य वमिं करोति||१२|| <br /> <br /> तन्द्रास्यमाधुर्यकफप्रसेकसन्तोषनिद्रारुचिगौरवार्तः| <br /> <br /> स्निग्धं घनं स्वादु कफाद्विशुद्धं सलोमहर्षोऽल्परुजं वमेत्तु||१३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snigdhātigurvāmavidāhibhōjyaiḥ svapnādibhiścaiva kaphō'tivr̥ddhaḥ| <br /> <br /> uraḥ śirō marma rasāyanīśca sarvāḥ samāvr̥tya vamiṁ karōti||12|| <br /> <br /> tandrāsyamādhuryakaphaprasēkasantōṣanidrārucigauravārtaḥ| <br /> <br /> snigdhaṁ ghanaṁ svādu kaphādviśuddhaṁ salōmaharṣō'lparujaṁ vamēttu||13|| <br /> <br /> snigdhAtigurvAmavidAhibhojyaiH svapnAdibhishcaiva kapho~ativRuddhaH| <br /> <br /> uraH shiro marma rasAyanIshca sarvAH samAvRutya vamiM karoti||12|| <br /> <br /> tandrAsyamAdhuryakaphaprasekasantoShanidrArucigauravArtaH| <br /> <br /> snigdhaM ghanaM svAdu kaphAdvishuddhaM salomaharSho~alparujaM vamettu||13||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As a result of the intake of unctuous, excessively heavy to digest, ''ama'' (raw/uncooked) and ''vidahi'' (causing burning sensation) food and because of excessive sleep and similar other factors, [[kapha]] gets excessively aggravated. This [[kapha]] occludes the chest, head, vital organs and all the (concerned) channels to cause ''chhardi'' (vomiting). The signs and symptoms of this [[kapha]]ja type of ''chhardi'' are as follows:<br /> #Drowsiness, sweetness in the mouth and salivation; <br /> #Sense of satiety, sleep, anorexia and heaviness; <br /> #Vomitus is unctuous, dense, sweet and devoid of any undesirable smell; and is associated with horripilation and slight pain [12-13]<br /> <br /> === Tri[[dosha]]ja chhardi ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> समश्नतः सर्वरसान् प्रसक्तमामप्रदोषर्तुविपर्ययैश्च| <br /> <br /> सर्वे प्रकोपं युगपत् प्रपन्नाश्छर्दिं त्रिदोषां जनयन्ति दोषाः||१४|| <br /> <br /> शूलाविपाकारुचिदाहतृष्णाश्वासप्रमोहप्रबला प्रसक्तम्| <br /> <br /> छर्दिस्त्रिदोषाल्लवणाम्लनीलसान्द्रोष्णरक्तं वमतां नृणां स्यात्||१५|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> samaśnataḥ sarvarasān prasaktamāmapradōṣartuviparyayaiśca|<br /> <br /> sarvē prakōpaṁ yugapat prapannāśchardiṁ tridōṣāṁ janayanti dōṣāḥ||14|| <br /> <br /> śūlāvipākārucidāhatr̥ṣṇāśvāsapramōhaprabalā prasaktam| <br /> <br /> chardistridōṣāllavaṇāmlanīlasāndrōṣṇaraktaṁ vamatāṁ nr̥ṇāṁ syāt||15|| <br /> <br /> samashnataH sarvarasAn prasaktamAmapradoShartuviparyayaishca| <br /> <br /> sarve prakopaM yugapat prapannAshchardiM tridoShAM janayanti doShAH||14|| <br /> <br /> shUlAvipAkArucidAhatRuShNAshvAsapramohaprabalA prasaktam| <br /> <br /> chardistridoShAllavaNAmlanIlasAndroShNaraktaM vamatAM nRuNAM syAt||15||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Because of constant indulgence in diet consisting of wholesome and unwholesome diet together, having all categories of taste together because of ''ama-dosha'' (ailments caused by improper digestion) and because of seasonal perversions, all the three [[dosha]] get simultaneously aggravated and cause ''sannipatika chhardi''.<br /> <br /> The signs and symptoms of this type of vomiting are as follows: <br /> #Colic pain, indigestion, anorexia, burning sensation, morbid thirst, dyspnea and fainting spells that are severe and persistent; <br /> #Vomitus is salty, sour, blue, dense, hot and reddish [14-15]<br /> <br /> === Bad prognostic symptoms ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विट्स्वेदमूत्राम्बुवहानि वायुः स्रोतांसि संरुध्य यदोर्ध्वमेति| <br /> <br /> उत्सन्नदोषस्य समाचितं तं दोषं समुद्धूय नरस्य कोष्ठात्||१६|| <br /> <br /> विण्मूत्रयोस्तत् समवर्णगन्धं तृट्श्वासहिक्कार्तियुतं प्रसक्तम्| <br /> <br /> प्रच्छर्दयेद्दुष्टमिहातिवेगात्तयाऽर्दितश्चाशु विनाशमेति||१७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> viṭsvēdamūtrāmbuvahāni vāyuḥ srōtāṁsi saṁrudhya yadōrdhvamēti| <br /> <br /> utsannadōṣasya samācitaṁ taṁ dōṣaṁ samuddhūya narasya kōṣṭhāt||16|| <br /> <br /> viṇmūtrayōstat samavarṇagandhaṁ tr̥ṭśvāsahikkārtiyutaṁ prasaktam| <br /> <br /> pracchardayēdduṣṭamihātivēgāttayā'rditaścāśu vināśamēti||17|| <br /> <br /> viTsvedamUtrAmbuvahAni vAyuH srotAMsi saMrudhya yadordhvameti| <br /> <br /> utsannadoShasya samAcitaM taM doShaM samuddhUya narasya koShThAt||16|| <br /> <br /> viNmUtrayostat samavarNagandhaM tRuTshvAsahikkArtiyutaM prasaktam| <br /> <br /> pracchardayedduShTamihAtivegAttayA~arditashcAshu vinAshameti||17|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When the morbid [[vata]] occludes the channels carrying faeces, sweat, urine and body fluids and moves upwards, then the morbid matter from the ''koshtha'' (gastrointestinal tract), gets incited to cause vomiting, that has the following characteristics:<br /> #Vomitus having color and odor of the feces and urine; <br /> #Persistent thirst, dyspnea hiccup and pain <br /> #Vomiting of foul smelling or ''dusta'' (putrid material); and <br /> #Bouts of vomiting ejected with great force. <br /> <br /> Such a patient succumbs to death quickly [16-17]<br /> <br /> === ''Dvishtharthasamyogaja chhardi'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्विष्टप्रतीपाशुचिपूत्यमेध्यबीभत्सगन्धाशनदर्शनैश्च| <br /> <br /> यच्छर्दयेत्तप्तमना मनोध्नैर्द्विष्टार्थसंयोगभवा मता सा||१८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dviṣṭapratīpāśucipūtyamēdhyabībhatsagandhāśanadarśanaiśca| <br /> <br /> yacchardayēttaptamanā manōdhnairdviṣṭārthasaṁyōgabhavā matā sā||18||<br /> <br /> dviShTapratIpAshucipUtyamedhyabIbhatsagandhAshanadarshanaishca| <br /> <br /> yacchardayettaptamanA manodhnairdviShTArthasaMyogabhavA matA sA||18||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As a result of mental disgust occasioned by senses contact with despicable, antagonistic, unclean, putrid, unholy and loathsome odors, diet or sights, the ''chhardi''(vomiting) is known as vomiting induced by contact with hateful things [18]<br /> <br /> === Symptoms of incurable ''chhardi'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षीणस्य या छर्दिरतिप्रवृद्धा सोपद्रवा शोणितपूययुक्ता| <br /> <br /> सचन्द्रिकां तां प्रवदन्त्यसाध्यां साध्यां चिकित्सेदनुपद्रवां च||१९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣīṇasya yā chardiratipravr̥ddhā sōpadravā śōṇitapūyayuktā| <br /> <br /> sacandrikāṁ tāṁ pravadantyasādhyāṁ sādhyāṁ cikitsēdanupadravāṁ ca||19|| <br /> <br /> kShINasya yA chardiratipravRuddhA sopadravA shoNitapUyayuktA| <br /> <br /> sacandrikAM tAM pravadantyasAdhyAM sAdhyAM cikitsedanupadravAM ca||19|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Vomiting that occurs in an emaciated person, that continues incessantly, that is associated with complications, and vomitus that contains blood, pus and ''chandrika'' (circular shiny patches with variegated color) is incurable. The physician should treat only curable types that are not associated with complications [19]<br /> <br /> === Principles of treatment ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आमाशयोत्क्लेशभवा हि सर्वाश्छर्द्यो मता लङ्घनमेव तस्मात्| <br /> <br /> प्राक्कारयेन्मारुतजां विमुच्य संशोधनं वा कफपित्तहारि||२०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> āmāśayōtklēśabhavā hi sarvāśchardyō matā laṅghanamēva tasmāt| <br /> <br /> prākkārayēnmārutajāṁ vimucya saṁśōdhanaṁ vā kaphapittahāri||20|| <br /> <br /> AmAshayotkleshabhavA hi sarvAshchardyo matA la~gghanameva tasmAt| <br /> <br /> prAkkArayenmArutajAM vimucya saMshodhanaM vA kaphapittahAri||20|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As all the types of vomiting are considered originating from the agitations of the [[dosha]] in the stomach, fasting therapy should first be prescribed or purificatory procedure curative of [[kapha]] and [[pitta]] should be administered except in cases of [[vata]] dominance. [20]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चूर्णानि लिह्यान्मधुनाऽभयानां हृद्यानि वा यानि विरेचनानि| <br /> <br /> मद्यैः पयोभिश्च युतानि युक्त्या नयन्त्यधो दोषमुदीर्णमूर्ध्वम्||२१|| <br /> <br /> वल्लीफलाद्यैर्वमनं पिबेद्वा यो दुर्बलस्तं शमनैश्चिकित्सेत्| <br /> <br /> रसैर्मनोज्ञैर्लघुभिर्विशुष्कैर्भक्ष्यैः सभोज्यैर्विविधैश्च पानैः||२२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> cūrṇāni lihyānmadhunā'bhayānāṁ hr̥dyāni vā yāni virēcanāni| <br /> <br /> madyaiḥ payōbhiśca yutāni yuktyā nayantyadhō dōṣamudīrṇamūrdhvam||21|| <br /> <br /> vallīphalādyairvamanaṁ pibēdvā yō durbalastaṁ śamanaiścikitsēt| <br /> <br /> rasairmanōjñairlaghubhirviśuṣkairbhakṣyaiḥ sabhōjyairvividhaiśca pānaiḥ||22||<br /> <br /> cUrNAni lihyAnmadhunA~abhayAnAM hRudyAni vA yAni virecanAni| <br /> <br /> madyaiH payobhishca yutAni yuktyA nayantyadho doShamudIrNamUrdhvam||21|| <br /> <br /> vallIphalAdyairvamanaM pibedvA yo durbalastaM shamanaishcikitset| <br /> <br /> rasairmanoj~jairlaghubhirvishuShkairbhakShyaiH sabhojyairvividhaishca pAnaiH||22||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient shall take powder of ''abhaya'' (chebulic myrobalans) with honey or such other palatable purgatives skillfully combined with ''madya'' (alcohol) or ''dugdha'' (milk). These recipes cause downward movement of the aggravated ''doshas'' that are impelled to move upwards. <br /> <br /> Patient may also be given emetic therapy prepared of the drugs of the ''valliphala'' (group of cucurbitaceous fruits), etc. or if the patient is weak, then he should be treated with pacification therapy through delicious soups and light as well as dry food articles for diet along with various kinds of drinks [21-22]<br /> <br /> === Treatment of [[vata]]ja chhardi ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सुसंस्कृतास्तित्तिरिबर्हिलावरसा व्यपोहन्त्यनिलप्रवृत्ताम्|<br /> <br /> छर्दिं तथा कोलकुलत्थधान्यबिल्वादिमूलाम्लयवैश्च यूषः||२३||<br /> <br /> वातात्मिकायां हृदयद्रवार्तो नरः पिबेत् सैन्धववद्धृतं तु|<br /> <br /> सिद्धं तथा धान्यकनागराभ्यां दध्ना च तोयेन च दाडिमस्य||२४||<br /> <br /> व्योषेण युक्तां लवणैस्त्रिभिश्च घृतस्य मात्रामथवा विदध्यात्|<br /> <br /> स्निग्धानि हृद्यानि च भोजनानि रसैः सयूषैर्दधिदाडिमाम्लैः||२५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> susaṁskr̥tāstittiribarhilāvarasā vyapōhantyanilapravr̥ttām| <br /> <br /> chardiṁ tathā kōlakulatthadhānyabilvādimūlāmlayavaiśca yūṣaḥ||23|| <br /> <br /> vātātmikāyāṁ [1] hr̥dayadravārtō naraḥ pibēt saindhavavaddhr̥taṁ tu| <br /> <br /> siddhaṁ tathā dhānyakanāgarābhyāṁ dadhnā ca tōyēna ca dāḍimasya||24|| <br /> <br /> vyōṣēṇa yuktāṁ lavaṇaistribhiśca ghr̥tasya mātrāmathavā vidadhyāt| <br /> <br /> snigdhāni hr̥dyāni ca bhōjanāni rasaiḥ sayūṣairdadhidāḍimāmlaiḥ||25|| <br /> <br /> SusamskrutAstittiribrhilAvrasA vyapohantyanilapravRuttAm| <br /> <br /> chardiM tathA kolakulatthadhAnyabilvAdimUlAmlayavaishca yUShaH||23||<br /> <br /> vAtAtmikAyAM hRudayadravArto naraH pibet saindhavavaddhRutaM tu|<br /> <br /> siddhaM tathA dhAnyakanAgarAbhyAM dadhnA ca toyena ca dADimasya||24||<br /> <br /> vyoSheNa yuktAM lavaNaistribhishca ghRutasya mAtrAmathavA vidadhyAt|<br /> <br /> snigdhAni hRudyAni ca bhojanAni rasaiH sayUShairdadhidADimAmlaiH||25||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The following recipes are useful in [[vata]]ja type of vomiting (''chhardi''): <br /> #The meat juice of ''tittiri'' (partridge), ''barhi'' and ''lava'' (common quail); <br /> #Vegetable soup prepared out of ''kola'' (Zyziphus jujuba), ''kulattha'' (horse gram/Dolichos biflorus), ''dhanya'' (coriander fruit/coriandrum sativum ), group of roots of ''bilva'' (Bilva-Bengal quince/''bael'' fruit/Aegle marmelos), etc. (''syonaka'' (Oroxylem indicum) , ''gambhari'' (Gmelina arborea), ''patala'' (Trumpet/Stereospermum chelonoides), ''ganikarika'' (Premna integrifolia)), ''amla'' (sour substances) and ''yava'' (barley/Hordeum vulgare); <br /> #If the patient is suffering from vomiting of ''vata'' type of ''chhardi'' that is associated with ''hriddrava'' (palpitation), then may take ghee with rock salt. <br /> #Ghee cooked with ''dhanyaka'' (coriander), ''nagara'' (dry zingiber/ginger/Zingiber officinale), ''dadhi''(curd) and the juice of ''dadima'' (pomegranate/Punica granatum); <br /> #Ghee mixed with the powder of ''trikatu'' (''shunthi, pippali'' and ''maricha'') and three salts viz. ''saindhava'' (rock salt), ''sauvarchala'' (black salt) and ''vida'' (''pakyam'')); <br /> #The diet consisting of unctuous and palatable food, meat soups, vegetable-soup, curd sour ''dadima'' (pomegranate/Punica granatum) [23-25]<br /> <br /> === Treatment of [[pitta]]ja chhardi ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तात्मिकायामनुलोमनार्थं द्राक्षाविदारीक्षुरसैस्त्रिवृत् स्यात्| <br /> <br /> कफाशयस्थं त्वतिमात्रवृद्धं पित्तं हरेत् स्वादुभिरूर्ध्वमेव||२६|| <br /> <br /> शुद्धाय काले मधुशर्कराभ्यां लाजैश्च मन्थं यदि वाऽपि पेयाम्| <br /> <br /> प्रदापयेन्मुद्गरसेन वाऽपि शाल्योदनं जाङ्गलजै रसैर्वा||२७|| <br /> <br /> सितोपलामाक्षिकपिप्पलीभिः कुल्माषलाजायवसक्तुगृञ्जान्| <br /> <br /> खर्जूरमांसान्यथ नारिकेलं द्राक्षामथो वा बदराणि लिह्यात्||२८|| <br /> <br /> स्रोतोजलाजोत्पलकोलमज्जचूर्णानि लिह्यान्मधुनाऽभयां च| <br /> <br /> कोलास्थिमज्जाञ्जनमक्षिकाविड्लाजासितामागधिकाकणान् वा||२९|| <br /> <br /> द्राक्षारसं वाऽपि पिबेत् सुशीतं मृद्भृष्टलोष्टप्रभवं जलं वा| <br /> <br /> जम्ब्वाम्रयोः पल्लवजं कषायं पिबेत् सुशीतं मधुसंयुतं वा||३०|| <br /> <br /> निशि स्थितं वारि समुद्गकृष्णं सोशीरधान्यं चणकोदकं वा| <br /> <br /> गवेधुकामूलजलं गुडूच्या जलं पिबेदिक्षुरसं पयो वा||३१|| <br /> <br /> सेव्यं पिबेत् काञ्चनगैरिकं वा सबालकं तण्डुलधावनेन| <br /> <br /> धात्रीरसेनोत्तमचन्दनं वा तृष्णावमिघ्नानि समाक्षिकाणि||३२|| <br /> <br /> कल्कं तथा चन्दनचव्यमांसीद्राक्षोत्तमाबालकगैरिकाणाम्| <br /> <br /> शीताम्बुना गैरिकशालिचूर्णं मूर्वां तथा तण्डुलधावनेन||३३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pittātmikāyāmanulōmanārthaṁ drākṣāvidārīkṣurasaistrivr̥t syāt| <br /> <br /> kaphāśayasthaṁ tvatimātravr̥ddhaṁ pittaṁ harēt svādubhirūrdhvamēva||26|| <br /> <br /> śuddhāya kālē madhuśarkarābhyāṁ lājaiśca manthaṁ yadi vā'pi pēyām| <br /> <br /> pradāpayēnmudgarasēna vā'pi śālyōdanaṁ jāṅgalajai rasairvā||27|| <br /> <br /> sitōpalāmākṣikapippalībhiḥ kulmāṣalājāyavasaktugr̥ñjān| <br /> <br /> kharjūramāṁsānyatha nārikēlaṁ drākṣāmathō vā badarāṇi lihyāt||28|| <br /> <br /> srōtōjalājōtpalakōlamajjacūrṇāni lihyānmadhunā'bhayāṁ ca| <br /> <br /> kōlāsthimajjāñjanamakṣikāviḍlājāsitāmāgadhikākaṇān vā||29|| <br /> <br /> drākṣārasaṁ vā'pi pibēt suśītaṁ mr̥dbhr̥ṣṭalōṣṭaprabhavaṁ jalaṁ vā| <br /> <br /> jambvāmrayōḥ pallavajaṁ kaṣāyaṁ pibēt suśītaṁ madhusaṁyutaṁ vā||30|| <br /> <br /> niśi sthitaṁ vāri samudgakr̥ṣṇaṁ sōśīradhānyaṁ caṇakōdakaṁ vā| <br /> <br /> gavēdhukāmūlajalaṁ guḍūcyā jalaṁ pibēdikṣurasaṁ payō vā||31|| <br /> <br /> sēvyaṁ pibēt kāñcanagairikaṁ vā sabālakaṁ taṇḍuladhāvanēna| <br /> <br /> dhātrīrasēnōttamacandanaṁ vā tr̥ṣṇāvamighnāni samākṣikāṇi||32|| <br /> <br /> kalkaṁ tathā candanacavyamāṁsīdrākṣōttamābālakagairikāṇām| <br /> <br /> śītāmbunā gairikaśālicūrṇaṁ mūrvāṁ tathā taṇḍuladhāvanēna||33|| <br /> <br /> pittAtmikAyAmanulomanArthaM drAkShAvidArIkShurasaistrivRut syAt| <br /> <br /> kaphAshayasthaM tvatimAtravRuddhaM pittaM haret svAdubhirUrdhvameva||26|| <br /> <br /> shuddhAya kAle madhusharkarAbhyAM lAjaishca manthaM yadi vA~api peyAm| <br /> <br /> pradApayenmudgarasena vA~api shAlyodanaM jA~ggalajai rasairvA||27|| <br /> <br /> sitopalAmAkShikapippalIbhiH kulmAShalAjAyavasaktugRu~jjAn| <br /> <br /> kharjUramAMsAnyatha nArikelaM drAkShAmatho vA badarANi lihyAt||28|| <br /> <br /> srotojalAjotpalakolamajjacUrNAni lihyAnmadhunA~abhayAM ca| <br /> <br /> kolAsthimajjA~jjanamakShikAviDlAjAsitAmAgadhikAkaNAn vA||29|| <br /> <br /> drAkShArasaM vA~api pibet sushItaM mRudbhRuShTaloShTaprabhavaM jalaM vA| <br /> <br /> jambvAmrayoH pallavajaM kaShAyaM pibet sushItaM madhusaMyutaM vA||30|| <br /> <br /> nishi sthitaM vAri samudgakRuShNaM soshIradhAnyaM caNakodakaM vA| <br /> <br /> gavedhukAmUlajalaM guDUcyA jalaM pibedikShurasaM payo vA||31|| <br /> <br /> sevyaM pibet kA~jcanagairikaM vA sabAlakaM taNDuladhAvanena| <br /> <br /> dhAtrIrasenottamacandanaM vA tRuShNAvamighnAni samAkShikANi||32|| <br /> <br /> kalkaM tathA candanacavyamAMsIdrAkShottamAbAlakagairikANAm| <br /> <br /> shItAmbunA gairikashAlicUrNaM mUrvAM tathA taNDuladhAvanena||33||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient of [[pitta]]ja type of ''chhardi'' should be given ''trivrit'' (Operculina turpethum) along with the juice of ''draksha'' (grapes/Vitis vinifera), ''vidari'' (Purera tuberosa) and ''ikshu'' (sugar-cane/Saccharaum officinarum) for causing downward movement of the morbid matter (laxation). When aggravated pitta is located in site of [[kapha]] (chest/stomach), then drugs having sweet taste should be administered for elimination of [[pitta]] (through emetic therapy). <br /> <br /> After this purificatory therapy patient should be given at proper time ''laja-mantha'' (flour of popped-rice diluted in water) or ''laja-peya'' (thin gruel made of popped-rice) along with honey and sugar. The patient may also be given boiled shāli type of rice along with the soup of ''mudga'' (green gram/Phaseolus aureus) or the meat juice of ''jangala'' creatures (animals inhabiting in arid zone). <br /> <br /> The following recipes are also advocated in this context:<br /> #''Kulmasha'', the paste of boiled ''mudga'' (green gram/Phaseolus aureus), ''masura'' (lentil/ Ervum lens), etc., ''laja'' (popped paddy), ''yava-saktu'' (flour of roasted barley), ''grunja'' (boiled barley along with its supernatant segment), or the pulp of ''kharjura'' (date/Phoenix sylvestris), ''narikela'' (coconut/Cocos nucifera), ''draksha'' (grapes/Vitis vinifera) or ''badara'' (Zyziphus jujuba) should be made to a linctus by adding ''sitopala'' (sugar having big crystals), honey and ''pippali'' (long pepper/Piper longum).<br /> #The water of fountain, ''laja'' (popped paddy), ''utpala'' (Nymphaea stellata) and the pulp of ''kola'' (Zyziphus jujuba) be made into linctus by adding honey, and given.<br /> #''Abhaya'' (chebulic myrobalan) with honey may also be taken. <br /> #The seed-pulp of ''kola'' (Zyziphus jujuba), ''anjana'' (''srotonjana''), ''makshika vit'' (excreta of house- fly), ''laja'' (popped paddy), sugar and grains of ''pippali'' mixed with honey. <br /> #The patient may drink cooled grape juice or cooled water prepared with baked clay or earth. <br /> #The patient may be given the cooled decoction of the tender leaves of ''jambu'' (Syzygium cumini) and ''amra'' (mango/Mangifera indica) by adding honey. <br /> #The following things kept overnight should be taken: <br /> ##Water with ''mudga'' (green gram/Phaseolus aureus) and ''pippali'' (long pepper/ Piper longum),<br /> ##Water with ''usheera'' (cuscus grass/Viteveria zizanioides) and ''dhanyaka'' (coriander/Coriandrum sativum), <br /> ##Water with ''chanaka'' (bengal gram/gram/chick pea/Cicer arietinum), <br /> ##Water with root of ''gavedhuka'' (Adlay/Jobs tears/Coix lachryma),<br /> ##Water with ''guduchi'' (Tinospora cordifolia),<br /> ###The patient may be given sugar-cane-juice or milk to drink.<br /> #The following recipes are useful in morbid thirst and vomiting: <br /> ##The powder of ''sevya'' (Cuscus grass/Viteveria zizanioides) and ''kanchana-gairika'' (Hematite, Fe2O3) along with ''tandulodaka'' (rice-water); <br /> ##The powder of ''sevya'' and ''balaka'' (Coleus vettiveroides) along with ''tandulodaka'' (rice-water); <br /> ##The paste of white variety of ''chandana'' (sandal wood) mixed with the juice of ''amalaki'' (emblic myrobalan/Emblica officinale) along with honey. <br /> #The following recipes also useful in ''paittika'' type of vomiting: <br /> ##The paste of ''chandana'' (sandal wood/Santalum album), ''chavya'' (Piper chaba/Piper officinarum), ''mamsi'' (Indian nard/nardus root/Nardostachys jatamansi), ''draksha'' (grapes/Vitis vinifera) of good quality, ''balaka'' (Coleus vettiveroides) and ''gairika'' (Hematite, Fe2O3); <br /> ##Powder of ''gairika'' (Hematite, Fe2O3) and ''shali'' rice along with cold water; <br /> ##Powder of ''murva'' (Marsdenia tenacissima / sansevieria roxburghiana) along with ''tandulodaka'' (rice-water)[26-33]<br /> <br /> === Treatment of [[kapha]]ja chhardi ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कफात्मिकायां वमनं प्रशस्तं सपिप्पलीसर्षपनिम्बतोयैः| <br /> <br /> पिण्डीतकैः सैन्धवसम्प्रयुक्तैर्वम्यां कफामाशयशोधनार्थम्||३४|| <br /> <br /> गोधूमशालीन् सयवान् पुराणान् यूषैः पटोलामृतचित्रकाणाम्| <br /> <br /> व्योषस्य निम्बस्य च तक्रसिद्धैर्यूषैः फलाम्लैः कटुभिस्तथाऽद्यात्||३५|| <br /> <br /> रसांश्च शूल्यानि च जाङ्गलानां मांसानि जीर्णान्मधुसीध्वरिष्टान्| <br /> <br /> रागांस्तथा षाडवपानकानि द्राक्षाकपित्थैः फलपूरकैश्च||३६|| <br /> <br /> मुद्गान्मसूरांश्चणकान् कलायान् भृष्टान् युतान्नागरमाक्षिकाभ्याम्| <br /> <br /> लिह्यात्तथैव त्रिफलाविडङ्गचूर्णं विडङ्गप्लवयोरथो [१] वा||३७|| <br /> <br /> सजाम्बवं वा बदराम्लचूर्णं [२] मुस्तायुतां कर्कटकस्य शृङ्गीम्| <br /> <br /> दुरालभां वा मधुसम्प्रयुक्तां लिह्यात् कफच्छर्दिविनिग्रहार्थम्||३८|| <br /> <br /> मनःशिलायाः फलपूरकस्य रसैः कपित्थस्य च पिप्पलीनाम्| <br /> <br /> क्षौद्रेण चूर्णं मरिचैश्च युक्तं लिहञ्जयेच्छर्दिमुदीर्णवेगाम्||३९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaphātmikāyāṁ vamanaṁ praśastaṁ sapippalīsarṣapanimbatōyaiḥ| <br /> <br /> piṇḍītakaiḥ saindhavasamprayuktairvamyāṁ kaphāmāśayaśōdhanārtham||34|| <br /> <br /> gōdhūmaśālīn sayavān purāṇān yūṣaiḥ paṭōlāmr̥tacitrakāṇām| <br /> <br /> vyōṣasya nimbasya ca takrasiddhairyūṣaiḥ phalāmlaiḥ kaṭubhistathā'dyāt||35|| <br /> <br /> rasāṁśca śūlyāni ca jāṅgalānāṁ māṁsāni jīrṇānmadhusīdhvariṣṭān| <br /> <br /> rāgāṁstathā ṣāḍavapānakāni drākṣākapitthaiḥ phalapūrakaiśca||36|| <br /> <br /> mudgānmasūrāṁścaṇakān kalāyān bhr̥ṣṭān yutānnāgaramākṣikābhyām| <br /> <br /> lihyāttathaiva triphalāviḍaṅgacūrṇaṁ viḍaṅgaplavayōrathō vā||37|| <br /> <br /> sajāmbavaṁ vā badarāmlacūrṇaṁ mustāyutāṁ karkaṭakasya śr̥ṅgīm| <br /> <br /> durālabhāṁ vā madhusamprayuktāṁ lihyāt kaphacchardivinigrahārtham||38|| <br /> <br /> manaḥśilāyāḥ phalapūrakasya rasaiḥ kapitthasya ca pippalīnām| <br /> <br /> kṣaudrēṇa cūrṇaṁ maricaiśca yuktaṁ lihañjayēcchardimudīrṇavēgām||39||<br /> <br /> kaphAtmikAyAM vamanaM prashastaM sapippalIsarShapanimbatoyaiH| <br /> <br /> piNDItakaiH saindhavasamprayuktairvamyAM kaphAmAshayashodhanArtham||34|| <br /> <br /> godhUmashAlIn sayavAn purANAn yUShaiH paTolAmRutacitrakANAm| <br /> <br /> vyoShasya nimbasya ca takrasiddhairyUShaiH phalAmlaiH kaTubhistathA~adyAt||35|| <br /> <br /> rasAMshca shUlyAni ca jA~ggalAnAM mAMsAni jIrNAnmadhusIdhvariShTAn| <br /> <br /> rAgAMstathA ShADavapAnakAni drAkShAkapitthaiH phalapUrakaishca||36|| <br /> <br /> mudgAnmasUrAMshcaNakAn kalAyAn bhRuShTAn yutAnnAgaramAkShikAbhyAm| <br /> <br /> lihyAttathaiva triphalAviDa~ggacUrNaM viDa~ggaplavayoratho [1] vA||37|| <br /> <br /> sajAmbavaM vA badarAmlacUrNaM [2] mustAyutAM karkaTakasya shRu~ggIm| <br /> <br /> durAlabhAM vA madhusamprayuktAM lihyAt kaphacchardivinigrahArtham||38|| <br /> <br /> manaHshilAyAH phalapUrakasya rasaiH kapitthasya ca pippalInAm| <br /> <br /> kShaudreNa cUrNaM maricaishca yuktaM liha~jjayecchardimudIrNavegAm||39||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Vamana'' (therapeutic emesis) is supposed to be the most suitable therapy in [[kapha]]ja type of ''chhardi'' (vomiting). In order to clean the seat of [[kapha]] and ''amashaya'', the patient should be given the decoction of ''pippali, sarsapa'' (yellow sarson/Indian colza/Brassica campestris) and ''nimba'' (neem tree/Margosa/Indian lilac/Azadirachta indica) added with powder of ''pinditaka'' (madanaphala/emetic nut/bushy gardenia/Randia dumetorum) and ''saindhava'' (rock-salt). <br /> <br /> The patient should be given old wheat, rice and barley along with <br /> #Vegetable soup of ''patola'' (Trichosanthes dioica), <br /> #''Amrita'' (Tinospora cordifolia) and <br /> #''Chitraka'' (Ceylon leadwort/ white leadwort/Plumbago zeylanica) or <br /> #with the soup of ''trikatu'' (three spices) and neem prepared with butter milk, or <br /> #Soup of sour fruits along with pungent drugs. <br /> <br /> The patient should also take the meat juices and roasted flesh of ''jangala'' creature (animals inhabiting arid zone), old honey, ''sidhu'' (alcohol prepared of sugar-cane-juice) and ''arishta'' (a type of alcoholic drink); and ''raga'' (condiments), shādava (pickles) and ''panaka'' (syrup) prepared of ''draksha'' (grapes) and ''phala-puraka'' (citrion/Citrus medica). <br /> <br /> The patient should take following three recipes mixed with ''shunthi'' (dry zingiber) and honey: <br /> #Roasted ''mudga'' (green gram), ''masura'' (lentil/Ervum lens), ''chanaka'' (bengal gram/Gram/ chick pea/Cicer arietinum) and ''kalaya'' (peas/Pisum sativum) <br /> #''Triphala'' (''haritaki, bibhitaka'' and ''amalaka''), and ''vidanga'' (babreng fruits/embelia ribes)<br /> #''Vidanga'' (babreng fruits/embelia ribes) and ''plava'' (nut grass/Cyperys rotundus) <br /> <br /> The following recipes should be taken mixed with the honey <br /> #''Jambu'' (Syzygium cumini) and sour fruits of ''badara'' (Zizyphus jujuba) <br /> #''Musta'' (nut grass/Cyperus rotundus)and ''karkata-shringi'' (Pistacia integerrima)<br /> #''Duralabha'' (Fegonia cretica). <br /> <br /> The forcefully generated urge of vomiting can be controlled with the following regims <br /> #Purified ''manahsila'' (red arsenic) with the juice of ''bijapuraka'' (citrion/Citrus medica), <br /> #''Pippali'' (long piper/Piper longum) mixed with the juice of ''kapittha'' (Feronia limonia)<br /> #''Maricha'' (black pepper/Piper nigrum) with honey [34-39]<br /> <br /> === Treatment of ''sannipatika chhardi'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यैषा पृथक्त्वेन मया क्रियोक्ता तां सन्निपातेऽपि समस्य [१] बुद्ध्या| <br /> <br /> दोषर्तुरोगाग्निबलान्यवेक्ष्य प्रयोजयेच्छास्त्रविदप्रमत्तः||४०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yaiṣā pr̥thaktvēna mayā kriyōktā tāṁ sannipātē'pi samasya buddhyā| <br /> <br /> dōṣarturōgāgnibalānyavēkṣya prayōjayēcchāstravidapramattaḥ||40||<br /> <br /> yaiShA pRuthaktvena mayA kriyoktA tAM sannipAte~api samasya [1] buddhyA| <br /> <br /> doSharturogAgnibalAnyavekShya prayojayecchAstravidapramattaH||40||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Judicious synthesis of the separate lines of treatment indicated by me for the derangement of individual humors should be employed by the learned physician for the patient suffering from ''sannipatika chhardi'' after carefully examining the relative preponderance of the [[dosha]] involved, the season when the disease has occurred, the stage of the disease and the power of digestion of the patient [40]<br /> <br /> === Treatment of ''dvishtarathasamyogaja (manobhighataja) chhardi'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मनोभिघाते तु मनोनुकूला वाचः समाश्वासनहर्षणानि| <br /> <br /> लोकप्रसिद्धाः श्रुतयो वयस्याः शृङ्गारिकाश्चैव हिता विहाराः||४१|| <br /> <br /> गन्धा विचित्रा मनसोऽनुकूला मृत्पुष्पशुक्ताम्लफलादिकानाम्| <br /> <br /> शाकानि भोज्यान्यथ पानकानि सुसंस्कृताः षाडवरागलेहाः||४२|| <br /> <br /> यूषा रसाः काम्बलिका खडाश्च मांसानि धाना विविधाश्च भक्ष्याः|<br /> <br /> फलानि मूलानि च गन्धवर्णरसैरुपेतानि वमिं जयन्ति||४३|| <br /> <br /> गन्धं रसं स्पर्शमथापि शब्दं रूपं च यद्यत् प्रियमप्यसात्म्यम्| <br /> <br /> तदेव दद्यात् प्रशमाय तस्यास्तज्जो हि रोगः सुख एव जेतुम्||४४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> manōbhighātē tu manōnukūlā vācaḥ samāśvāsanaharṣaṇāni| <br /> <br /> lōkaprasiddhāḥ śrutayō vayasyāḥ śr̥ṅgārikāścaiva hitā vihārāḥ||41|| <br /> <br /> gandhā vicitrā manasō'nukūlā mr̥tpuṣpaśuktāmlaphalādikānām| <br /> <br /> śākāni bhōjyānyatha pānakāni susaṁskr̥tāḥ ṣāḍavarāgalēhāḥ||42|| <br /> <br /> yūṣā rasāḥ kāmbalikā khaḍāśca māṁsāni dhānā vividhāśca bhakṣyāḥ| <br /> <br /> phalāni mūlāni ca gandhavarṇarasairupētāni vamiṁ jayanti||43|| <br /> <br /> gandhaṁ rasaṁ sparśamathāpi śabdaṁ rūpaṁ ca yadyat priyamapyasātmyam| <br /> <br /> tadēva dadyāt praśamāya tasyāstajjō hi rōgaḥ sukha ēva jētum||44||<br /> <br /> manobhighAte tu manonukUlA vAcaH samAshvAsanaharShaNAni| <br /> <br /> lokaprasiddhAH shrutayo vayasyAH shRu~ggArikAshcaiva hitA vihArAH||41|| <br /> <br /> gandhA vicitrA manaso~anukUlA mRutpuShpashuktAmlaphalAdikAnAm| <br /> <br /> shAkAni bhojyAnyatha pAnakAni susaMskRutAH ShADavarAgalehAH||42|| <br /> <br /> yUShA rasAH kAmbalikA khaDAshca mAMsAni dhAnA vividhAshca bhakShyAH| <br /> <br /> phalAni mUlAni ca gandhavarNarasairupetAni vamiM jayanti||43|| <br /> <br /> gandhaM rasaM sparshamathApi shabdaM rUpaM ca yadyat priyamapyasAtmyam| <br /> <br /> tadeva dadyAt prashamAya tasyAstajjo hi rogaH sukha eva jetum||44||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In case of vomiting caused by mental disgust the following measures should be resorted to: <br /> #Words which are pleasing and comforting, counseling and encouraging <br /> #Popular legends and stories, congenial companions and pleasant wholesome diversions, amorous and wholesome regimens (games); <br /> #Odor of various types of pleasing perfumes emanating from the earth, flowers, vinegar (''sukta'') and sour fruits<br /> #Well prepared vegetables, articles of food drinks, ''sadavas'' (pickles), ''raga'' (condiments) and ''lehas'' (preparations in the form of linctus or jam), ''yusha'' (Vegetable-soups), ''rasa'' (meat-soups), ''kambalika'' (sour curry of fish and meat), ''khada'' (sour drinks prepared of fruits), ''mamsa dhana'' (meat preparations), ''bhakshya'' (popped cereals), different eatables, fruits and roots having pleasant odor, color and taste will win over the vomiting caused by mental disgust. <br /> #In general, whatever odor, taste, contact, sound or sights those are pleasing to such patients should be given though otherwise unsuitable and unwholesome because in this way disease can be treated easily [41-44]<br /> <br /> === Treatment of complications ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> छर्द्युत्थितानां च चिकित्सितात् स्वाच्चिकित्सितं कार्यमुपद्रवाणाम्| <br /> <br /> अतिप्रवृत्तासु विरेचनस्य कर्मातियोगे विहितं विधेयम्||४५|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> chardyutthitānāṁ ca cikitsitāt svāccikitsitaṁ kāryamupadravāṇām| <br /> <br /> atipravr̥ttāsu virēcanasya karmātiyōgē vihitaṁ vidhēyam||45||<br /> <br /> chardyutthitAnAM ca cikitsitAt svAccikitsitaM kAryamupadravANAm| <br /> <br /> atipravRuttAsu virecanasya karmAtiyoge vihitaM vidheyam||45|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The treatment of complications arising from vomiting should be done according to the lines suggested in respect of each of those ailments. In case of excessive vomiting; treatment that is suggested in [Cha. Sa.[[Siddhi Sthana]] 6/52-56] for excessive purgation should be carried out [45]<br /> <br /> === Treatment of chronic ''chhardi'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वमिप्रसङ्गात् पवनोऽप्यवश्यं धातुक्षयाद्धृद्धिमुपैति तस्मात्| <br /> <br /> चिरप्रवृत्तास्वनिलापहानि कार्याण्युपस्तम्भनबृंहणानि||४६|| <br /> <br /> सर्पिर्गुडाः क्षीरविधिर्घृतानि कल्याणकत्र्यूषणजीवनानि| <br /> <br /> वृष्यास्तथा मांसरसाः सलेहाश्चिरप्रसक्तां च वमिं जयन्ति||४७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vamiprasaṅgāt pavanō'pyavaśyaṁ dhātukṣayāddhr̥ddhimupaiti tasmāt|<br /> <br /> cirapravr̥ttāsvanilāpahāni kāryāṇyupastambhanabr̥ṁhaṇāni||46|| <br /> <br /> sarpirguḍāḥ kṣīravidhirghr̥tāni kalyāṇakatryūṣaṇajīvanāni| <br /> <br /> vr̥ṣyāstathā māṁsarasāḥ salēhāściraprasaktāṁ ca vamiṁ jayanti||47|| <br /> <br /> vamiprasa~ggAt pavano~apyavashyaM dhAtukShayAddhRuddhimupaiti tasmAt| <br /> <br /> cirapravRuttAsvanilApahAni kAryANyupastambhanabRuMhaNAni||46|| <br /> <br /> sarpirguDAH kShIravidhirghRutAni kalyANakatryUShaNajIvanAni| <br /> <br /> vRuShyAstathA mAMsarasAH salehAshciraprasaktAM ca vamiM jayanti||47|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In persistent vomiting vāta invariably gets aggravated because of loss of tissue elements. Therefore, in case of chronic vomiting medications that are bulk promoting, [[vata]] pacifying, ''upastambhana'' (astringents) and [[brimhana]] (nutritive) should be administered.<br /> <br /> The following recipes are useful in chronic type of vomiting.<br /> <br /> ''Sarpirguda'' [Cha. Sa. [[Chikitsa Sthana]] 11/50-77], ''kshira-vidhi'' (milk boiled by adding [[vata]]-alleviating drugs), ''kalyanaka-ghrita'' [Cha. Sa. [[Chikitsa Sthana]] 9/33-42], ''tryushana-ghrita'' [ Cha. Sa. [[Chikitsa Sthana]] 18/39-42], ''jivaniya-ghrita'' [Cha. Sa. [[Chikitsa Sthana]] 29/55-57], ''vrishya'' (virilific) recipes, ''mamsarasa'' (meat soup) and ''lehya'' like ''chyavanprasha'' (linctuses) [46-47]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकः- <br /> <br /> हेतुं सङ्ख्यां लक्षणमुपद्रवान् साध्यतां न योगांश्च| <br /> <br /> छर्दीनां प्रशमार्थं प्राह चिकित्सितं मुनिवर्यः||४८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkaḥ- <br /> <br /> hētuṁ saṅkhyāṁ lakṣaṇamupadravān sādhyatāṁ na yōgāṁśca| <br /> <br /> chardīnāṁ praśamārthaṁ prāha cikitsitaṁ munivaryaḥ||48|| <br /> <br /> tatra shlokaH- <br /> <br /> hetuM sa~gkhyAM lakShaNamupadravAn sAdhyatAM na yogAMshca| <br /> <br /> chardInAM prashamArthaM prAha cikitsitaM munivaryaH||48|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> To sum up, in this chapter the predisposing factors, numerals of the vomiting, symptoms, complications, prognosis, formulations and other measures of management for the relief of vomiting are described by the foremost of the sages [48]<br /> <br /> Thus the section on therapeutics in the treatise compiled by Agnivesha redacted by Charaka and reconstructed by Dridhabala as it was not available.<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *''Chhardi'' (vomiting) can be either caused by vitiation of endogenous [[dosha]] or by exogenous factors like in ''dvistartha-yogaja-chhardi'' (that results from contact with unpleasant sense objects).<br /> *The [[dosha]] vitiation due to their own specific causative factors lead to irritation of stomach, spread through ''rasayani'' (channels carrying rasa) resulting in ''chhardi''. Different types of ''chhardi'' shall be diagnosed based on the specific etio-pathogenesis and clinical presentation. <br /> *Mind and sense objects play significant role in pathogenesis of ''chhardi'' due to exposure to unwholesome objects. <br /> *The prognosis of ''chhardi'' depends upon strength of patient, bouts, presence of associated disorders and complications, contents of vomitus. <br /> *All the types of vomiting are considered originating from the agitations of the [[dosha]] in the stomach. Therefore, fasting therapy is first principle of treatment. Purification therapies of [[kapha]] and [[pitta]] are administered to expel out vitiated [[dosha]]. These therapies are contraindicated in cases of [[vata]] dominance. The choice of therapy depends upon strength of patient and type of vitiated [[dosha]]. <br /> *The drugs having nutritive properties, carminative, [[dosha]] pacifying actions are prescribed in the treatment of ''chhardi''. <br /> *Sublingual, pleasant tasting linctus, mild purgative to open the channel to lower G I tract.<br /> *During initial stage of ''chhardi'', because of irritated stomach, anti-emetic treatment is not advised. Soothing, taste enhancing and nutritive liquid substances should be given. Mind diverting and entertaining activities are also advised.<br /> *The treatment of complications arising from vomiting should be done according to the lines suggested in respect of each of those ailments.<br /> *In persistent vomiting [[vata]] invariably gets aggravated because of loss of tissue elements. Therefore, in case of chronic vomiting medications that are bulk promoting, [[vata]] pacifying, ''upastambhana'' (astringents) and [[brimhana]] (nutritive) should be administered.<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> <br /> === Pathogenesis ===<br /> <br /> ''Mahasrotus'' (gastrointestinal tract) has two parts, upper part is ''annavaha srotus'' and lower part is [[purisha]]vaha srotus. ''Atisara'' is related to [[purisha]]vaha srotus and ''chhardi'' is to ''annavaha srotus''. Etiological factors of ''chhardi'' are irritating food and practices to ''amashaya'' (stomach). They are [[vata]] vitiating, impairing ''annavaha srotus''. Even before the digestion process starts the food comes out because of action of ''urdhvavata'' or ''udanavata'', therefore, there is no involvement of [[agni]]. ''Chhardi'' is a defense mechanism to expel the toxins out of the stomach. There is vacuum created by repeated expulsion of stomach contents and ''rasayinis''(villi) instead of their normal function of absorption, they start secreting body fluids into to the stomach. <br /> <br /> === Types of ''chhardi'' ===<br /> <br /> Diseases are classified according to the dominance of [[dosha]]-involved and their mutual amalgamation, which are of four types. The 5th type of ''chhardi'' (''dwishtarthayoga'') is due to aversive food related to the involvement of ''panchagyanendriyas'' (five sense organs) and their ''vishaya upalabdhi'' [Cha. Sa. [[Sutra Sthana]] 1/54] (perceivance of senses). The contact through ''rupa'' (visible) or ''rasa'' (taste) or ''gandha'' (smell) or ''sparsha'' (touch) or ''shabda'' (hear) or in combination with each other, stimulates body mechanism which results in ''dwistarthayoga chhardi'' (vomiting due to aversion). One cannot exclude the role of ''manah'' (mind) as predisposing factor in causing ''dwistarthayoga chhardi''. <br /> <br /> ''Douhruda janita'' (pregnancy induced vomitting), ''satmya prakopaja'' (vomiting due to inadequacy of substances) and ''krimija'' (vomiting due to microbial infection) type of ''chhardi'' are other causes of ''chhardi''.&lt;ref&gt;Sushruta. Sushruta Samhita . In: Kaviraj Shastri Ambika Dutt, Editors. 5th ed. Varanasi: Chaukhambha Sanskrit Series;1982. p.?.&lt;/ref&gt; <br /> <br /> ==== [[Vata]]ja chhardi ==== <br /> <br /> There are many factors that increase [[vata]] in the ''sharira'' .&lt;ref&gt; Sushruta. Sutra sthana cha 21 Vranaprashna Adhyaya verse 19. In: Kaviraj Shastri Ambika Dutt, editors, 5th Edition, Varanasi : Chaukhamba Sanskrit Series,1982.&lt;/ref&gt; Particular ''ahara'' (food), ''vihara'' (lifestyle) and mental factors increase [[vata]] and its ''gunas'' (properties). This aggravation of [[vata]] gunas like ''rukshata'' (dryness), ''laghuta'' (lightness), etc. plays a role in causing [[vata]]ja chhardi. [ Cha. Sa. [[Sutra Sthana]] 1/59] [[dosha]] conjugate (''sammurchhana'' [ Cha. Sa.[[Sutra Sthana]] 18/46] with a particular organ (''mahasrotas, amashaya, marma'' (vital organ), ''urdhwabhaga'' (upper trunk, etc) as ''dushyas'' (affected [[dhatu]]) to cause [[vata]]ja chhardi (as ''utkshepana'' (upward movement), ''adhahkshepana'' (downward movement), etc are the ''karmas'' (actions) of [[vayu]])-(7-9).<br /> <br /> ==== [[Pitta]]ja chhardi ====<br /> <br /> ''Nidanas'' of [[pitta]]prakopaka increase [[pitta]] in nature &lt;ref&gt; Sushruta, Sutra sthana c21/21 Hindi commentary by Kaviraj, Shastri Ambika Dutt, 5th Edition, 1982, Chaukhamba Sanskrit Series, Varanasi &lt;/ref&gt;and cause provocation of ''gunas'' like ''ushna'' (hot), ''tikshna'' (sharp), ''snigdha'' (unctous), etc. [ Cha. Sa. [[Sutra Sthana]] 1/60] in the body. This aggravated ''pitta'' joins (''sammurchhana'') with a particular organ (''rasayani, amashaya, marma, urdhwabhaga,'' etc) as ''dushyas''. The conjugation of [[dosha]] and ''dushya'' has affinity towards ''urdhwabhaga'' which results in [[pitta]]ja chhardi (10-11).<br /> <br /> ==== [[Kapha]]ja chhardi ====<br /> <br /> ''Nidanas'' of [[kapha]]prakopaka increase [[kapha]] in nature which causes provocation of [[guna]] like ''guru'' (heavyness), ''sheeta'' (coldness), ''manda'' (slowness), etc. [ Cha. Sa.[[Sutra Sthana]] 1/60] in the body. This aggravated [[kapha]] joins (''sammurchhana'') with a particular organ (''urah'' (chest), ''shirah'' (head), ''rasayani marma, urdhwabhaga,'' etc.) as ''dushyas''. This amalgamation of [[dosha]] and ''dushya'' has affinity towards ''urdhwabhaga'' which results in [[kapha]]ja chhardi(12-13).<br /> <br /> ==== ''Sannipataja chhardi'' ====<br /> <br /> Intake of diet containing all ''rasas'' or tastes ideal but the intake of food with imbalances in ''rasas'' leads to the vitiation of ''tridoshas''[Cha.Sa.Sutra Sthana 26/90-101]and causes ''sannipataja chhardi'' which has varied manifestations covering broad signs of ''tridosha'' involvement ( verses 14-15). <br /> <br /> The ''sama-varna-gandha'' (color &amp; smell similar to) of vomitus is due to conjugation with [[purisha]] (stool) and [[mutra]] (urine). This conjugation indicates involvement of multiple ''srotasas'' and have tendency towards ''asadhyata'' (incurable)[Cha. Sa. [[Vimana Sthana]] 5/3] ( verses 16-17).<br /> <br /> Excessive loss of any [[dhatu]] ([[rasa dhatu]]-[[rakta]]-vasa, etc) due to physical exercise or [[vamana]] vega'' (bouts) or arising out of any complications in the form of diseases like ''kasa'' (cough), ''shwasa'' (asthama), ''jwara'' (fever)&lt;ref&gt;Madhavakara. Madhava Nidanam (Roga vinischaya) cha 15. Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--&lt;/ref&gt;, etc. are considered to be life threatening.<br /> <br /> === Treatment ===<br /> <br /> *[[Langhana]] becomes the first line of treatment in ''chhardi'' as ''shamana chikitsa'' (pacificatory treatment). ''Samshodha'' can be preferred where [[dosha]] are in ''utklishtha'' stage and ready to be expelled out. [[Vamana]] is recommended when [[dosha]] are accumulated in ''amashaya'' or ''amashayottha'' (originating from stomach or upper gastro-intestinal tract). Whereas [[virechana]] is recommended in case of post-''amashayottha'' (in lower gastro-intestinal tract) accumulated [[dosha]], considering nearest route of ''samshodhana''. The choice of drugs should be done as per the [[dosha]]nashakatva(capacity to subside the vitiated [[dosha]]) ( verse 20).<br /> *''Haritaki'' is known for its laxative action (''anulomaneeya''). It not only ''tridoshahara'' but also possesses many more qualities [Cha. Sa. [[Chikitsa Sthana]] 1/1/29-34] which can be helpful for ''samprapti vighanatana'' (breaking pathogenesis) in ''chhardi''. The choice of ''hridaya dravya'' (liking to mind) is recommended in ''chhardi'' which should be given with ''madya'' (alcohol) and ''dugdha'' (cow milk) as an ''anupana''. ''Madya'' due to its specific [[guna]][Cha.Sa. [[Sutra Sthana]] 27/ 193-195] results in quick absorption of the ''dravya'' and hastens the mode of action. ''Dugdha'' (cow milk) along with many other qualities [ Cha. Sa.[[Sutra Sthana]] 27/217-18] is naturally ''saraka'' (purgative) in nature which makes ''anulomana gati'' (natural movements) of [[vayu]]. <br /> *As the [[dosha]] are already in ''utklishta avastha''(stage of aggravation or ready to come out), the choice of ''valliphala'' for [[vamana]] is considered as a ''mridu'' (mild). On the other hand if the patient is weak and cannot tolerate the [[vamana]] effort, ''shamana chikitsa'' should be considered. The treatment planning should be done keeping ''manah'' as center point. The diet or ''pathya'' should be a ''manah prasannakara'' (mind pleasing) [ Cha. Sa.[[Chikitsa Sthana]] 20/ 41-42] . It should be preferably ''mamsarasa'', dry food or liquid diet which is easily digestible ( verses 21-22). <br /> *In [[vata]]ja chhardi, ''laghu susanskrita mamsarasa'' (processed meat soup) is helpful in easy digestion and gives strength due to [[vata]] pacifying property. The ''yusha'' prepared from ''amlarasatmaka'' (sour taste) is not only [[vata]] pacifying but also stimulates the heart and leads to ''anulomana gati'' of [[vayu]]. ''Ghrita'' as ''sanskaranuvartana'' (synergistically increases the properties of associated drugs) [ Cha. Sa.[[Sutra Sthana]] 27/231-32] and [ Cha. Sa. [[Sutra Sthana]] 13/13] can be beneficial in [[vata]]ja hridroga.<br /> *If the aggravated [[dosha]] are in distal part of ''amashaya'' (post- ''amashaya'') the nearest route to remove [[pitta]] is through [[virechana]] procedure. If the aggravated [[pitta]] is in ''amashaya'' then the nearest route to remove [[pitta]] is through [[vamana]]. Both these procedures should be adopted in ''balavana rogi'' (physically strong patient) judiciously clubbing with proper ''samsarjana krama'' (protocol after purification procedure) to prevent aggravation of [[vata]] [[dosha]]. <br /> *For ''shamana'' treatment the selection of drugs should be [[pitta]] pacifying, ''manapralhadakara'' (mind pleasing) and ''balya'' (strength of patient) criteria. The mechanism of action of these drugs can be through ''hetu viparita'' (anti-etiology), ''vyadhi viparita'' (anti-disease) or ''hetu-vyadhi veeparita chikitsa'' (anti-cause &amp; disease treatment). <br /> *For [[kapha]]ja chhardi chikitsa, as the [[dosha]] are situated in ''kaphashaya'' (''amashaya / ura'') the nearest and ideal route is [[vamana]]. The choice of ''dravyas'' for [[vamana]] should be [[kapha]]hara'' like ''pippali, sarshapa, nimbatoya, madanaphala,'' etc. The choice of treatment is based on aggravated ''dosha, sanchayasthana'' (place of accumulation), ''sannikrishtha marga'' (nearest route), ''dosha-shamaka guna'' of ''dravyas'', etc. <br /> *Various types of ''yusha, ragashadava, panaka'' [ Cha. Sa. [[Sutra Sthana]] 27/279-281] are ''kaphahara, madhura-amlarasatmaka'' (sweet &amp; sour), ''deepaneeya-pachaneeya'' (appetizer &amp; digestant) in nature. <br /> *For ''chhardinigrahana'' (anti-emetic group), the drugs should be ''kashaya rasatmaka'' (astringent taste), ''sheetaveerya'' (cool potency) and [[kapha]]ghna ([[kapha]] alleviators) in nature. The ''manahshiladi yoga'' (a formulation) is considered to be ''vyadhiviparitarthakari'' (anti-disease) measures.<br /> *In case of ''dwistarthayoga chhardi'' (vomiting due to hate/ aversion), the treatment includes ''ashvasana'' (assurance), ''vartalapa'' (conversation), ''mitramandali'' (friend circle), ''mananusarena ahara-vihara'' (preferable food &amp; lifestyle). By doing so one can easily overcome the disease for the time being and once the ''vegavastha'' (vomiting bouts) is overcome, actual conceptual treatment can be adopted. <br /> *The ''vegakalina'' or chronic ''chhardi'', whether mild or severe, involves constant irritation of involved body parts/systems which leads to poor nourishment of [[dhatu]] resulting in [[dhatu]]ksheenata. Such a long term [[dhatu]]kshaya (loss of [[dhatu]]) increases [[vata]] in the body. The management should be purely [[vata]]shamaka treatment especially [[stambhana]] (which restricts the [[vamana]] vega) in combination with [[brimhana]] (nourishment to [[dhatu]]).<br /> <br /> The selection of drugs plays very important role here. Most of the dravyas mentioned here are ''vichitrapratyarabhadha'' (extraordinary) in nature which achieve [[stambhana]] but would not increase [[vata]]. The description about ''sarpiguda'' (a formulation), ''kalyanaka ghrita'' (a formulation), ''vrishya yoga'' (a formulation), ''avalehas'' (a formulation) etc. are the desired formulations for the management may have synergistic action.<br /> <br /> === Current clinical practice for management of chhardi (referred from Chikitsa Pradeep page 25) ===<br /> {|class=&quot;wikitable&quot;<br /> !scope = &quot;col&quot;| Type<br /> !scope = &quot;col&quot;| Medicine<br /> !scope = &quot;col&quot;| Dosage<br /> !scope = &quot;col&quot;| Time<br /> !scope = &quot;col&quot;| ''Anupana''<br /> |-<br /> | [[Vata]] dominant and [[vata]]-[[pitta]] dominant<br /> | ''Shankha bhasma''<br /> | 60-120 mg<br /> | Frequently<br /> | ''Nimbu Panaka'' (lemon water)<br /> |-<br /> |[[Pitta]] dominant<br /> | ''Sutashekhara kalpa''<br /> | 500-1000 mg<br /> | Frequently<br /> | ''Dadimavaleha''<br /> |-<br /> | [[Kapha]] dominant<br /> | ''Mayu piccha mashi''<br /> | 1 - 3 gms<br /> | Frequently<br /> | ''Ardrakavaleha''<br /> |-<br /> | Tri[[dosha]]ja<br /> | ''Brihad vata chintamani''<br /> | 50 - 100 mg<br /> | Frequently<br /> | ''Ardraka swarasa'' + sugar + honey<br /> |-<br /> | ''Dauhridaja'' (in pregnancy)<br /> | ''Swarnashekhara'' mixture<br /> | 250-500 mg<br /> | After meals<br /> | ''Ardraka swarasa'' + ''Nimbu swarasa'' + rock salt<br /> |-<br /> | ''Krimija''<br /> | ''Vidanga-yavani phanta''<br /> | 20-40 ml<br /> | Empty stomach, two times<br /> | ''-''<br /> |}<br /> <br /> === Further researches ===<br /> Many parenteral and oral medicines are available in conventional medical systems for management of dehydration and emergency conditions. The ayurveada drugs listed in this chaper need to be researched further for evaluating their efficacy specifically in conditions where the parenteral administration is contra-indicated and in case of drug intorerance.<br /> &lt;/div&gt;<br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References ==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Atisara_Chikitsa&diff=45386 2025-11-12T06:06:14Z

<p>Agnivesha: /* Sannipataja atisara */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Atisara Chikitsa<br /> |titlemode=append<br /> |keywords=atisara, diarrhea, ama, nirama, sangrahi treatment, pichcha basti,Ayurveda, Indian system of medicine, charak samhita. <br /> |description=Chikitsa Sthana Chapter 19. Management of Atisara (diarrhea and associated disorders)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 19. Management of Atisara (diarrhea and associated disorders)&lt;/big&gt;'''<br /> {{Infobox<br /> |title = Atisara Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 19<br /> |label2 = Preceding Chapter<br /> |data2 = [[Kasa Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Chhardi Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Byadgi P.S., Dube N.<br /> |label7 = Reviewer <br /> |data7 = Prasad B.S.<br /> |label8 = Editors<br /> |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.020 10.47468/CSNE.2020.e01.s06.020]<br /> }}<br /> <br /> &lt;big&gt;''' Abstract &lt;/big&gt;'''<br /> &lt;p style='text-align:justify;'&gt;The chapter on [[Atisara Chikitsa]] (management of diarrhea) traces the historical origin of the disorder since the Vedic period and attributes it to eating of heavy and hot foods specially meat products. There are six types of diarrhea, three of which are caused by single [[dosha]] ([[vata]]ja, [[pitta]]ja and [[kapha]]ja) while a fourth is caused by the combination of all the three [[dosha]]. The fifth and sixth types are caused due to psychological factors such as fear and grief. Some of these variants could be further classified based on their constituents, e.g., [[vata]]ja atisara (diarrhea caused due to [[vata]] [[dosha]]) is further divided into ''ama'' and ''nirama atisara'' (with or without mucoid substances diarrhea) and it has been emphasized not to stop the lose motions in initial or ''ama'' stage. <br /> &lt;br/&gt;<br /> The etiology, pathology, signs and symptoms of each of these six types of diarrhea, along with their prognosis have been detailed here.The principles of treatment and complications associated with diarrhea, such as bleeding, suppuration, ulceration and prolapsed anus are also described along with various measures to tackle the problems effectively. <br /> &lt;br/&gt;<br /> ''Sangrahi'' (astringent or anti-diarrheals) therapies are not advisable in the initial stage of the disease because of presence of ''ama'' inside the body. Instead, mild laxative should be given to eliminate the accumulated [[dosha]]. Diarrhea should be allowed to continue and should not be stopped by constipating or bowel binding drugs. The patients shall be managed with light to digest, nutritive and liquid diet regimen which enhances the power of [[agni]] as well as it helps to stop diarrhea. &lt;/p&gt;<br /> <br /> '''Keywords''': atisara, diarrhea, ama, nirama, sangrahi treatment, pichcha [[basti]].<br /> <br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> ''Grahani'' and ''atisara'' - both manifest due to the vitiation of [[agni]] and share common features of impairment of digestion resulting in indigestion and loose motions. Therefore, this chapter should logically precede or succeed the chapter on ''grahani''. But it is described three chapters after that on ''grahani''. The reason for this unusual sequencing of these topics is that since ''pandu'' is a common symptom and sequelae of the malabsorption syndrome (''grahani''), the chapter on ''pandu'' follows ''grahani''. Now, dyspnea (''shwasa'') is a major symptom of ''pandu,'' and thus, follows the chapter on ''pandu''. Similarly, chapter on ''kasa'' (cough) follows ''shwasa'' because of their relationship. That explains the sequencing of ''grahani'' and ''atisara'' in [[Charak Samhita]].<br /> <br /> [[Ayurveda]] considers ''atisara'' as a defense mechanism of the body to eject out any toxic material from it. Therefore, it is recommended that in ''amaja'' (or initial) state loose motions should not be checked. After evacuation of toxins from the body, fasting and digestive drugs are prescribed as a cure for milder forms of diarrhea. However, for other types of diarrhea, various preparations, diet and [[basti]] are advised. Piccha[[basti]] (mucilegue type of medicated enema) is prescribed particularly if blood accompanies the stool. Appropriate treatments for ulcer, suppuration of anus and prolapse of anus are dealt with, since these accompany the more complex forms of diarrhea. <br /> <br /> ''Atisara'' leads to the depletion of water and beneficial salts, causing dehydration in the body. This provokes [[vata]], and therefore requires taking special care of [[vata]], particularly if, the ''atisara'' is caused by all the three [[dosha]]. Hydration of the body by means of oral administration of milk, buttermilk and various liquid preparations is advised. Goat’s milk is very useful in bloody diarrhea.The treatment of cholera and other dehydrating diarrheal diseases was revolutionized by the promotion of oral rehydration solution (ORS), the efficacy of which depends on the fact that glucose-facilitated absorption of sodium and water in the small intestine remains intact in the presence of cholera toxin. Where indicated, appropriate antimicrobial agents can shorten the duration of illness from 3–4 days to 24–36 h, hence it should be started depending on the course of illness. Adequate prophylaxis measures should be taken to prevent the infectious diarrhoea.<br /> &lt;/div&gt;<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातोऽतीसारचिकित्सितं व्याख्यास्यामः||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः||२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātō'tīsāracikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2|| <br /> <br /> athAto~atIsAracikitsitaM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> Now we shall expound the chapter &quot;Atisara chikitsa&quot; (Management of diarrhea and associated disorders). Thus said Lord Atreya. [1-2]<br /> &lt;/div&gt;<br /> === Query by Agnivesha ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भगवन्तंखल्वात्रेयंकृताह्निकंहुताग्निहोत्रमासीनमृषिगणपरिवृतमुत्तरेहिमवतःपार्श्वेविनयादुपेत्याभिवाद्यचाग्निवेशउवाच- <br /> भगवन्! अतीसारस्यप्रागुत्पत्तिनिमित्तलक्षणोपशमनानिप्रजानुग्रहार्थमाख्यातुमर्हसीति ||३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhagavantaṁ khalvātrēyaṁ kr̥tāhnikaṁ hutāgnihōtramāsīnamr̥ṣigaṇaparivr̥tamuttarē himavataḥ pārśvēvinayādupētyābhivādya cāgnivēśa uvāca<br /> bhagavan! atīsārasya prāgutpattinimittalakṣaṇōpaśamanāniprajānugrahārthamākhyātumarhasīti||3||<br /> <br /> bhagavantaM khalvAtreyaM kRutAhnikaM hutAgnihotramAsInamRuShigaNaparivRutamuttare himavataHpArshve vinayAdupetyAbhivAdya cAgnivesha uvAca- <br /> bhagavan! atIsArasyaprAgutpattinimittalakShaNopashamanAni prajAnugrahArthamAkhyAtumarhasIti||3|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> On one occasion, when Lord Atreya was sitting on the northern slope of the Himalayas surrounded by the sages after completing his daily worship and oblations to the fire, Agnivesha approached him, offered his humble salutations to him, and requested him to expound the origin, etiology, signs and symptoms, and treatment of ''atisara'' (diarrhea) for the well-being of humanity [3]<br /> &lt;/div&gt;<br /> === Historical origins of ''atisara'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथभगवान्पुनर्वसुरात्रेयस्तदग्निवेशवचनमनुनिशम्योवाच- श्रूयतामग्निवेश! सर्वमेतदखिलेनव्याख्यायमानम् | &lt;br /&gt;<br /> आदिकालेखलुयज्ञेषुपशवःसमालभनीयाबभूवुर्नालम्भायप्रक्रियन्तेस्म | &lt;br /&gt;<br /> ततोदक्षयज्ञंप्रत्यवरकालंमनोःपुत्राणांनरिष्यन्नाभागेक्ष्वाकुनृगशर्यात्यादीनांक्रतुषुपशूनामेवाभ्यनुज्ञानात्पशवःप्रोक्षणमवापुः | &lt;br /&gt;<br /> अतश्चप्रत्यवरकालंपृषध्रेणदीर्घसत्रेणयजतापशूनामलाभाद्गवामालम्भःप्रवर्तितः | &lt;br /&gt;<br /> तंदृष्ट्वाप्रव्यथिताभूतगणाः, तेषांचोपयोगादुपाकृतानांगवांगौरवादौष्ण्यादसात्म्यत्वादशस्तोपयोगाच्चोपहताग्नीनामुपहतमनसां[१]चातीसारःपूर्वमुत्पन्नःपृषध्रयज्ञे ||४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> atha bhagavān punarvasurātrēyastadagnivēśavacanamanuniśamyōvāca- śrūyatāmagnivēśa!sarvamētadakhilēna vyākhyāyamānam| &lt;br /&gt;<br /> ādikālē khalu yajñēṣu paśavaḥ samālabhanīyā babhūvurnālambhāya prakriyantē sma| &lt;br /&gt;<br /> tatō dakṣayajñaṁ pratyavarakālaṁ manōḥ putrāṇāṁ nariṣyannābhāgēkṣvākunr̥gaśaryātyādīnāṁ kratuṣupaśūnāmēvābhyanujñānāt paśavaḥ prōkṣaṇamavāpuḥ| &lt;br /&gt;<br /> ataśca pratyavarakālaṁ pr̥ṣadhrēṇa dīrghasatrēṇa yajatā paśūnāmalābhādgavāmālambhaḥ pravartitaḥ| &lt;br /&gt;<br /> taṁ dr̥ṣṭvā pravyathitā bhūtagaṇāḥ, tēṣāṁ cōpayōgādupākr̥tānāṁ gavāṁgauravādauṣṇyādasātmyatvādaśastōpayōgāccōpahatāgnīnāmupahatamanasāṁ [1] cātīsāraḥpūrvamutpannaḥ pr̥ṣadhrayajñē||4|| &lt;br /&gt;<br /> <br /> atha bhagavAn punarvasurAtreyastadagniveshavacanamanunishamyovAca- shrUyatAmagnivesha!sarvametadakhilena vyAkhyAyamAnam| &lt;br /&gt;<br /> AdikAle khalu yaj~jeShu pashavaH samAlabhanIyA babhUvurnAlambhAya prakriyante sma| &lt;br /&gt;<br /> tato dakShayaj~jaM pratyavarakAlaM manoH putrANAMnariShyannAbhAgekShvAkunRugasharyAtyAdInAM kratuShu pashUnAmevAbhyanuj~jAnAt pashavaHprokShaNamavApuH| &lt;br /&gt;<br /> atashca pratyavarakAlaM pRuShadhreNa dIrghasatreNa yajatA pashUnAmalAbhAdgavAmAlambhaHpravartitaH| &lt;br /&gt;<br /> taM dRuShTvA pravyathitA bhUtagaNAH, teShAM copayogAdupAkRutAnAM gavAMgauravAdauShNyAdasAtmyatvAdashastopayogAccopahatAgnInAmupahatamanasAM [1] cAtIsAraHpUrvamutpannaH pRuShadhrayaj~je||4|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> After consideration of the above submission of Agnivesha, Lord Punarvasu said, “O Agnivesha, listen to me. I shall give a detailed response to your question. <br /> <br /> In the Vedic age/ancient times, sacrificial animals used to get released in the wild soon after the recitation of the sacrificial mantras, and these animals were not killed during the course of the sacrifice (''yajna''). However, in the subsequent periods following the reign of Daksha Prajapati, the sons of Manu named Narishyana, Nabhag, Ikshvaku, Nriga, and Sharyati, sacrifice of these animals became a part of the ''yajna'' (sacrificial ritual) at their instinctive acquiescence. After that, during the sacrifice over a long course of time performed by Prushadra (name of a king), as goats were not obtainable, even the sacred cows were also offered up for sacrifice. This deviation bewildered (or disturbed) all of humanity leading to grief. When the flesh of these sanctified cows were eaten, by the heavy, hot and incompatible to human nature properties of their flesh, as well as the use of what was not prescribed by the scriptures, the people started suffering from the loss of their ability to digest and losing their mental equilibrium, resulting in ''atisara'' (diarrhea). Thus, diarrhea originated from the ''yajna'' performed by Prushadhra [4] <br /> &lt;/div&gt;<br /> === [[Vata]]ja atisara===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथावरकालंवातलस्यवातातपव्यायामात्रनिषेविणोरूक्षाल्पप्रमिताशिनस्तीक्ष्णमद्यव्यवायनित्यस्योदावर्तयतश्चवेगान्वायुःप्रकोपमापद्यते, पक्ताचोपहन्यते; सवायुःकुपितोऽग्नावुपहतेमूत्रस्वेदौपुरीषाशयमुपहृत्य, ताभ्यांपुरीषंद्रवीकृत्य, अतीसारायप्रकल्पते | &lt;br /&gt;<br /> तस्यरूपाणि- विज्जलमामंविप्लुतमवसादिरूक्षंद्रवंसशूलमामगन्धमीषच्छब्दमशब्दंवाविबद्धमूत्रवातमतिसार्यतेपुरीषं, वायुश्चान्तःकोष्ठेसशब्दशूलस्तिर्यक्चरतिविबद्धइत्यामातिसारोवातात् | &lt;br /&gt;<br /> पक्वंवाविबद्धमल्पाल्पंसशब्दंसशूलफेनपिच्छापरिकर्तिकंहृष्टरोमाविनिःश्वसञ्शुष्कमुखःकट्यूरुत्रिकजानुपृष्ठपार्श्वशूलीभ्रष्टगुदोमुहुर्मुहुर्विग्रथितमुपवेश्यतेपुरीषंवातात्; तमाहुरनुग्रथितमित्येके, वातानुग्रथितवर्चस्त्वात् ||५||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athāvarakālaṁ vātalasya vātātapavyāyāmātimātraniṣēviṇōrūkṣālpapramitāśinastīkṣṇamadyavyavāyanityasyōdāvartayataśca vēgān vāyuḥ prakōpamāpadyatē, paktācōpahanyatē; sa vāyuḥ kupitō'gnāvupahatē mūtrasvēdau purīṣāśayamupahr̥tya, tābhyāṁ purīṣaṁdravīkr̥tya, atīsārāya prakalpatē| &lt;br /&gt;<br /> tasya rūpāṇivijjalamāmaṁ viplutamavasādi rūkṣaṁ dravaṁ saśūlamāmagandhamīṣacchabdamaśabdaṁvā vibaddhamūtravātamatisāryatē purīṣaṁ, vāyuścāntaḥkōṣṭhē saśabdaśūlastiryak carati vibaddhaityāmātisārō vātāt| &lt;br /&gt;<br /> pakvaṁ vā vibaddhamalpālpaṁ saśabdaṁ saśūlaphēnapicchāparikartikaṁ hr̥ṣṭarōmā viniḥśvasañśuṣkamukhaḥ kaṭyūrutrikajānupr̥ṣṭhapārśvaśūlī bhraṣṭagudō muhurmuhurvigrathitamupavēśyatē purīṣaṁvātāt; tamāhuranugrathitamityēkē, vātānugrathitavarcastvāt||5|| &lt;br /&gt;<br /> <br /> athAvarakAlaM vAtalasya vAtAtapavyAyAmAtimAtraniSheviNorUkShAlpapramitAshinastIkShNamadyavyavAyanityasyodAvartayatashca vegAn vAyuHprakopamApadyate, paktA copahanyate; sa vAyuH kupito~agnAvupahate mUtrasvedaupurIShAshayamupahRutya, tAbhyAM purIShaM dravIkRutya, atIsArAya prakalpate| &lt;br /&gt;<br /> tasya rUpANi- vijjalamAmaM viplutamavasAdi rUkShaM dravaMsashUlamAmagandhamIShacchabdamashabdaM vA vibaddhamUtravAtamatisAryate purIShaM,vAyushcAntaHkoShThe sashabdashUlastiryak carati vibaddha ityAmAtisAro vAtAt| &lt;br /&gt;<br /> pakvaM vA vibaddhamalpAlpaM sashabdaM sashUlaphenapicchAparikartikaM hRuShTaromA viniHshvasa~jshuShkamukhaH kaTyUrutrikajAnupRuShThapArshvashUlI bhraShTagudomuhurmuhurvigrathitamupaveshyate purIShaM vAtAt; tamAhuranugrathitamityeke,vAtAnugrathitavarcastvAt||5|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> *[[Vata]] dominant ''atisara'' occurs if a person with [[vata]] dominant constitution indulges in following: Exposure to strong wind, excess sunlight, and physical exercise;<br /> *Indulgence in dry and rough or less quantities of food (''pramitashana'') or irregular meals or strong alcoholic drinks or excessive sexual intercourse; and<br /> *Suppression of natural urges.<br /> <br /> The above factors aggravate [[vata]], afflicting the power of digestion (or, reducing the [[agni]]). With the depletion of [[agni]], the aggravated [[vata]] forces urine and sweat to the colon (''purishashaya''), liquefying the stool and manifesting [[vata]]ja atisara.<br /> <br /> [[Vata]]ja amaja atisara (early stages of [[vata]]ja atisara):<br /> <br /> The early signs and symptoms of [[vata]]ja amaja atisara are as follows:<br /> *The stool is slimy and has mucus (''ama'');<br /> *The stool floats on water;<br /> *The stool, when placed over the earth, gets soaked;<br /> *The stool is rough (i.e., not oily) and liquid;<br /> *Evacuation of stool is accompanied with colic pain;<br /> *The stool smells like undigested food;<br /> *Evacuation of stool is associated with little or no sound;<br /> *Evacuation of the stool is not accompanied with flatus and urine; and<br /> *The aggravated ''vata'' (flatus) moves in the ''koshtha'' (gastrointestinal tract) obliquely along with gurgling sound, causing colic pain.<br /> <br /> The above mentioned signs and symptoms pertain to the ''ama'' stage (primary or immature stage) of the [[vata]]ja atisara.<br /> <br /> [[Vata]]ja niramaja atisara (advanced stage of [[vata]]ja atisara):<br /> <br /> In the ''pakva'' stage (advanced or mature stage) of [[vata]]ja atisara, the signs and symptoms manifested are as follows: <br /> *The patient evacuates hard stool in small quantities;<br /> *The evacuation of stool is associated with sound and colic pain;<br /> *The stool is frothy and slimy; <br /> *The patient suffers from griping pain, horripilation, groaning, dryness of the mouth, pain in the lumbar region, thighs, sacral region, knees, back and sides of the chest, and prolapse of the rectum; and<br /> *Evacuates scybalous stool frequently.<br /> <br /> According to some physicians, this type of diarrhea is also called ''anugrathita-atisara'' because of evacuation the scybalous stool. [5] <br /> &lt;/div&gt;<br /> <br /> ===[[Pitta]]ja atisara===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तलस्यपुनरम्ललवणकटुकक्षारोष्णतीक्ष्णातिमात्रनिषेविणःप्रतताग्निसूर्यसन्तापोष्णमारुतोपहतगात्रस्यक्रोधेर्ष्याबहुलस्यपित्तंप्रकोपमापद्यते | &lt;br /&gt;<br /> तत्प्रकुपितंद्रवत्वादूष्माणमुपहत्यपुरीषाशयविसृतमौष्ण्याद्द्रवत्वात्सरत्वाच्चभित्त्वापुरीषमतिसारायप्रकल्पते | &lt;br /&gt;<br /> तस्यरूपाणि- हारिद्रंहरितंनीलंकृष्णंरक्तपित्तोपहितमतिदुर्गन्धमतिसार्यते[१]पुरीषं, तृष्णादाह स्वेद मूर्च्छाशूलब्रध्नसन्तापपाकपरीतइतिपित्तातिसारः ||६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pittalasya punaramlalavaṇakaṭukakṣārōṣṇatīkṣṇātimātraniṣēviṇaḥpratatāgnisūryasantāpōṣṇamārutōpahatagātrasya krōdhērṣyābahulasya pittaṁ prakōpamāpadyatē| &lt;br /&gt;<br /> tat prakupitaṁ dravatvādūṣmāṇamupahatya purīṣāśayavisr̥tamauṣṇyād dravatvāt saratvācca bhittvāpurīṣamatisārāya prakalpatē| &lt;br /&gt;<br /> tasya rūpāṇi- hāridraṁ haritaṁ nīlaṁ <br /> kr̥ṣṇaṁ raktapittōpahitamatidurgandhamatisāryatē [1] purīṣaṁ,tr̥ṣṇādāhasvēdamūrcchāśūlabradhnasantāpapākaparīta iti pittātisāraḥ||6|| &lt;br /&gt;<br /> <br /> pittalasya punaramlalavaNakaTukakShAroShNatIkShNAtimAtraniSheviNaHpratatAgnisUryasantApoShNamArutopahatagAtrasya krodherShyAbahulasya pittaM prakopamApadyate| &lt;br /&gt;<br /> tat prakupitaM dravatvAdUShmANamupahatya purIShAshayavisRutamauShNyAd dravatvAt saratvAccabhittvA purIShamatisArAya prakalpate| &lt;br /&gt;<br /> tasya rUpANi- hAridraM haritaM nIlaM <br /> kRuShNaM raktapittopahitamatidurgandhamatisAryate [1] purIShaM,tRuShNAdAhasvedamUrcchAshUlabradhnasantApapAkaparIta iti pittAtisAraH||6|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> A person of [[pitta]]ja constitution, by indulging in the following etiological factors, gets afflicted by [[pitta]]ja atisara:<br /> *Excessive intake of sour, saline, pungent, alkaline (''kshara''), hot and sharp (''teekshna'') ingredients;<br /> *Affliction of the body by excessive exposure to the heat of strong fire, hot rays of the sun and hot wind; and<br /> *Excessive disposition to negative emotions such as anger, jealousy, etc.<br /> <br /> Due to the above mentioned factors, [[pitta]] gets aggravated, in turn suppressing the power of [[agni]] (digestion) on account of its liquidity and reaches the colon, disintegrates the stool because of its heat, liquidity and mobility leading to the manifestation of [[pitta]]ja atisara.<br /> <br /> The signs and symptoms of [[pitta]]ja atisara are as follows:<br /> *The patient experiences frequent loose motions which are either yellow, green, blue or black in color;<br /> *The stool is mixed with blood and bile, and is excessively foul smelling; <br /> *The patient suffers from morbid thirst, burning sensation, excessive sweating, fainting, colic pain and hot sensation; and<br /> *There is suppuration of the anus [6]<br /> &lt;/div&gt;<br /> <br /> === [[Kapha]]ja atisara===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> श्लेष्मलस्यतुगुरुमधुरशीतस्निग्धोपसेविनःसम्पूरकस्याचिन्तयतोदिवास्वप्नपरस्यालसस्यश्लेष्माप्रकोपमापद्यते | &lt;br /&gt;<br /> सस्वभावाद्गुरुमधुरशीतस्निग्धःस्रस्तोऽग्निमुपहत्य सौम्यस्वभावात्पुरीषाशयमुपहत्यो पक्लेद्यपुरीषमतिसारायकल्पते | &lt;br /&gt;<br /> तस्यरूपाणि- स्निग्धंश्वेतंपिच्छिलंतन्तुमदामंगुरुदुर्गन्धंश्लेष्मोपहितमनुबद्धशूलमल्पाल्पमभीक्ष्णमतिसार्यतेसप्रवाहिकं, गुरूदरगुदबस्तिवङ्क्षणदेशःकृतेऽप्यकृतसञ्ज्ञःसलोमहर्षःसोत्क्लेशोनिद्रालस्यपरीतःसदनोऽन्नद्वेषीचेतिश्लेष्मातिसारः ||७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ślēṣmalasya tu gurumadhuraśītasnigdhōpasēvinaḥ sampūrakasyācintayatō divāsvapnaparasyālasasyaślēṣmā prakōpamāpadyatē| &lt;br /&gt;<br /> sa svabhāvād gurumadhuraśītasnigdhaḥ srastō'gnimupahatya saumyasvabhāvātpurīṣāśayamupahatyōpaklēdya purīṣamatisārāya kalpatē| &lt;br /&gt;<br /> tasya rūpāṇi- snigdhaṁ śvētaṁ picchilaṁ tantumadāmaṁ guru durgandhaṁślēṣmōpahitamanubaddhaśūlamalpālpamabhīkṣṇamatisāryatē sapravāhikaṁ,gurūdaragudabastivaṅkṣaṇadēśaḥ kr̥tē'pyakr̥tasañjñaḥ salōmaharṣaḥ sōtklēśō nidrālasyaparītaḥsadanō'nnadvēṣī cēti ślēṣmātisāraḥ||7|| &lt;br /&gt;<br /> <br /> shleShmalasya tu gurumadhurashItasnigdhopasevinaH sampUrakasyAcintayatodivAsvapnaparasyAlasasya shleShmA prakopamApadyate| &lt;br /&gt;<br /> sa svabhAvAd gurumadhurashItasnigdhaH srasto~agnimupahatya saumyasvabhAvAtpurIShAshayamupahatyopakledya purIShamatisArAya kalpate| &lt;br /&gt;<br /> tasya rUpANi- snigdhaM shvetaM picchilaM tantumadAmaM guru durgandhaMshleShmopahitamanubaddhashUlamalpAlpamabhIkShNamatisAryate sapravAhikaM,gurUdaragudabastiva~gkShaNadeshaH kRute~apyakRutasa~jj~jaH salomaharShaH sotkleshonidrAlasyaparItaH sadano~annadveShI ceti shleShmAtisAraH||7|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> A person of [[kapha]]ja type of constitution indulging in the following factors experiences the manifestation of [[kapha]]ja atisara:<br /> *Consumption of heavy, sweet, cold and unctuous ingredients in excess;<br /> *Inactivity of the mind and indolence; and<br /> *Habitually sleeping during the day time.<br /> <br /> Because of the above mentioned factors, [[kapha]] gets aggravated. It moves downwards due to its nature (i.e heavy, sweet, cold and unctuous) and afflicts the [[agni]] (power of digestion) on account of its natural cooling property (which is contradictory to the heating effect of [[agni]]). Thereafter, having arrived at the colon, it liquefies the stool to cause [[kapha]]ja atisara.<br /> <br /> The signs and symptoms of [[kapha]]ja atisara (diarrhea) are as follows:<br /> *The stool is unctuous, white, slimy, fibrous, mixed with mucus as well as undigested food particles, heavy, foul-smelling and mixed with phlegm;<br /> *The patient suffers from continuous, griping, colic pain<br /> *The patient evacuates stool frequently in small quantities;<br /> *The patient suffers from heaviness in the abdomen, in the region of urinary bladder and in the pelvic region;<br /> *The patient feels the urge for passing stool even after having evacuated; and<br /> *Suffers from horripilation, nausea, excessive sleep, indolence, prostration and dislike for food.<br /> <br /> These are the specific features of [[kapha]]ja atisara. [7]<br /> &lt;/div&gt;<br /> <br /> === Sannipataja atisara ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> अतिशीतस्निग्धरूक्षोष्णगुरुखरकठिनविषमविरुद्धासात्म्यभोजनादभोजनात्कालातीतभोजनाद्यत्किञ्चिदभ्यवहरणात्प्रदुष्टमद्यपानीयपानादतिमद्यपानादसंशोधनात्प्रतिकर्मणां<br /> विषमगमनादनुपचाराज्ज्वलनादित्यपवनसलिलातिसेवनादस्वप्ना-दतिस्वप्नाद्वेगविधारणादृतुविपर्ययादयथाबलमारम्भाद्भयशोकचित्तोद्वेगातियोगात्कृमि<br /> शोषज्वरार्शोविकारातिकर्षणाद्वाव्यापन्नाग्नेस्त्रयोदोषाः<br /> प्रकुपिताभूयएवाग्निमुपहत्यपक्वाशयमनुप्रविश्यातीसारंसर्वदोषलिङ्गंजनयन्ति ||८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> atiśītasnigdharūkṣōṣṇagurukharakaṭhinaviṣamaviruddhāsātmyabhōjanādabhōjanāt kālātītabhōjanādyatkiñcidabhyavaharaṇāt praduṣṭamadyapānīyapānādatimadyapānādasaṁśōdhanāt pratikarmaṇāṁviṣamagamanādanupacārājjvalanādityapavanasalilātisēvanādasvapnā-datisvapnādvēgavidhāraṇādr̥tuviparyayādayathābalamārambhādbhayaśōkacittōdvēgātiyōgātkr̥miśōṣajvarārśōvikārātikarṣaṇādvā vyāpannāgnēstrayō dōṣāḥ prakupitā bhūya ēvāgnimupahatyapakvāśayamanupraviśyātīsāraṁ sarvadōṣaliṅgaṁ janayanti||8|| <br /> <br /> atishItasnigdharUkShoShNagurukharakaThinaviShamaviruddhAsAtmyabhojanAdabhojanAtkAlAtItabhojanAd yatki~jcidabhyavaharaNAtpraduShTamadyapAnIyapAnAdatimadyapAnAdasaMshodhanAt pratikarmaNAMviShamagamanAdanupacArAjjvalanAdityapavanasalilAtisevanAdasvapnA-datisvapnAdvegavidhAraNAdRutuviparyayAdayathAbalamArambhAdbhayashokacittodvegAtiyogAtkRumishoShajvarArshovikArAtikarShaNAdvA vyApannAgnestrayo doShAH prakupitA bhUyaevAgnimupahatya pakvAshayamanupravishyAtIsAraM sarvadoShali~ggaM janayanti||8|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> The causative factors of ''sannipataja atisara'' (diarrhea caused by the simultaneous vitiation of all the three [[dosha]]) are as follows: <br /> *Intake of excessively cold, unctuous, ununctuous, hot, heavy, coarse and hard ingredients;<br /> *Intake of irregular meals, ingredients of food having mutually contradictory properties and unwholesome food;<br /> *Intake of food long after the scheduled time;<br /> *Intake of food without caring for its wholesomeness or otherwise;<br /> *Drinking alcohol and other drinks which are “polluted”, toxic or harmful;<br /> *Drinking alcohol in excess; <br /> *Not resorting to elimination therapies (in appropriate seasons);<br /> *Inappropriate administration or non-administration of therapeutics; <br /> *Excessive exposure to fire, hot rays of the sun, strong wind and bath etc., in strong current of water;<br /> *Not sleeping or sleeping in excess;<br /> *Suppression of natural urges; <br /> *Not resorting to appropriate regimens during different seasons,<br /> *Over-courageous attitude;<br /> *Excessive exposure to fear, grief and anxiety; and <br /> *Excessive emaciation due to worm-infection, consumption, fever and piles (bleeding).<br /> <br /> Because of the above mentioned causative factors, [[agni]] (power of digestion) gets vitiated as a result of which all the three [[dosha]] get aggravated. These aggravated [[dosha]] in turn further afflict the [[agni]], and having entered into ''pakvashaya'' (colon) cause ''sannipataja atisara''. [8]<br /> &lt;/div&gt;<br /> <br /> === Signs and symptoms of ''sannipataja atisara'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अपिचशोणितादीन्धातूनतिप्रकृष्टं[१]दूषयन्तोधातुदोषस्वभावकृतानतीसारवर्णानुपदर्शयन्ति | &lt;br /&gt;<br /> तत्रशोणितादिषुधातुष्वतिप्रदुष्टेषुहारिद्रहरितनीलमाञ्जिष्ठमांसधावनसन्निकाशंरक्तंकृष्णंश्वेतंवराहभेदःसदृशमनुबद्धवेदनमवेदनंवासमासव्यत्यासादुपवेश्यतेशकृद्ग्रथितमामंसकृत्, सकृदपिपक्वमनतिक्षीणमांसशोणितबलोमन्दाग्निर्विहतमुखरसश्च; तादृशमातुरंकृच्छ्रसाध्यंविद्यात् | &lt;br /&gt;<br /> एभिर्वर्णैरतिसार्यमाणंसोपद्रवमातुरमसाध्योऽयमितिप्रत्याचक्षीत; तद्यथा- पक्वशोणिताभं[२]यकृत्खण्डोपमंमेदोमांसोदकसन्निकाशंदधिघृतमज्जतैलवसाक्षीरवेसवाराभमतिनीलमतिरक्तमतिकृष्णमुदकमिवाच्छंपुनर्मेचकाभमतिस्निग्धं<br /> हरितनीलकषायवर्णंकर्बुरमाविलंपिच्छिलंतन्तुमदामंचन्द्रकोपगतमतिकुणपपूतिपूयगन्ध्यामाममत्स्यगन्धिमक्षिकाकान्तं[३]कुथितबहुधातुस्रावमल्पपुरीषमपुरीषंवाऽतिसार्यमाणं<br /> तृष्णादाहज्वरभ्रमतमकहिक्काश्वासानुबन्धमतिवेदनमवेदनंवास्रस्तपक्वगुदंपतितगुदवलिंमुक्तनालमतिक्षीणबलमांसशोणितं<br /> सर्वपर्वास्थिशूलिनमरोचकारतिप्रलापसम्मोहपरीतंसहसोपरतविकारमतिसारिणमचिकित्स्यंविद्यात्; इतिसन्निपातातिसारः ||९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> api ca śōṇitādīn dhātūnatiprakr̥ṣṭaṁ [1] dūṣayantō dhātudōṣasvabhāvakr̥tānatīsāravarṇānupadarśayanti| &lt;br /&gt;<br /> tatra śōṇitādiṣu dhātuṣvatipraduṣṭēṣu hāridraharitanīlamāñjiṣṭhamāṁsadhāvanasannikāśaṁ raktaṁkr̥ṣṇaṁ śvētaṁ varāhabhēdaḥsadr̥śamanubaddhavēdanamavēdanaṁ vā samāsavyatyāsādupavēśyatēśakr̥d grathitamāmaṁ sakr̥t, sakr̥dapi <br /> pakvamanatikṣīṇamāṁsaśōṇitabalō mandāgnirvihatamukharasaśca;tādr̥śamāturaṁ kr̥cchrasādhyaṁ vidyāt| &lt;br /&gt;<br /> ēbhirvarṇairatisāryamāṇaṁ sōpadravamāturamasādhyō'yamiti pratyācakṣīta; tadyathā- pakvaśōṇitābhaṁ[2] yakr̥tkhaṇḍōpamaṁ mēdōmāṁsōdakasannikāśaṁdadhighr̥tamajjatailavasākṣīravēsavārābhamatinīlamatiraktamatikr̥ṣṇamudakamivācchaṁpunarmēcakābhamatisnigdhaṁ haritanīlakaṣāyavarṇaṁ karburamāvilaṁ picchilaṁ tantumadāmaṁcandrakōpagatamatikuṇapapūtipūyagandhyāmāmamatsyagandhi makṣikākāntaṁ [3]kuthitabahudhātusrāvamalpapurīṣamapurīṣaṁ vā'tisāryamāṇaṁtr̥ṣṇādāhajvarabhramatamakahikkāśvāsānubandhamativēdanamavēdanaṁ vā srastapakvagudaṁpatitagudavaliṁ muktanālamatikṣīṇabalamāṁsaśōṇitaṁsarvaparvāsthiśūlinamarōcakāratipralāpasammōhaparītaṁ sahasōparatavikāramatisāriṇamacikitsyaṁvidyāt; iti sannipātātisāraḥ||9||<br /> <br /> api ca shoNitAdIn dhAtUnatiprakRuShTaM [1] dUShayantodhAtudoShasvabhAvakRutAnatIsAravarNAnupadarshayanti| &lt;br /&gt;<br /> tatra shoNitAdiShu dhAtuShvatipraduShTeShu hAridraharitanIlamA~jjiShThamAMsadhAvanasannikAshaMraktaM kRuShNaM shvetaM varAhabhedaHsadRushamanubaddhavedanamavedanaM vAsamAsavyatyAsAdupaveshyate shakRud grathitamAmaM sakRut, sakRudapipakvamanatikShINamAMsashoNitabalo mandAgnirvihatamukharasashca; tAdRushamAturaMkRucchrasAdhyaM vidyAt| &lt;br /&gt;<br /> ebhirvarNairatisAryamANaM sopadravamAturamasAdhyo~ayamiti pratyAcakShIta; tadyathA-pakvashoNitAbhaM [2] yakRutkhaNDopamaM medomAMsodakasannikAshaMdadhighRutamajjatailavasAkShIravesavArAbhamatinIlamatiraktamatikRuShNamudakamivAcchaMpunarmecakAbhamatisnigdhaM haritanIlakaShAyavarNaM karburamAvilaM picchilaM tantumadAmaMcandrakopagatamatikuNapapUtipUyagandhyAmAmamatsyagandhi makShikAkAntaM [3]kuthitabahudhAtusrAvamalpapurIShamapurIShaM vA~atisAryamANaMtRuShNAdAhajvarabhramatamakahikkAshvAsAnubandhamativedanamavedanaM vA srastapakvagudaMpatitagudavaliM muktanAlamatikShINabalamAMsashoNitaMsarvaparvAsthishUlinamarocakAratipralApasammohaparItaM sahasoparatavikAramatisAriNamacikitsyaMvidyAt; iti sannipAtAtisAraH||9|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> The three aggravated [[dosha]] cause excessive vitiation of [[dhatu]] (tissue elements, e.g., [[rakta]] (blood)), resulting in the appearance of different colors (in the stool). The nature of these colors depends upon the nature of the vitiated [[dhatu]] and [[dosha]]. <br /> <br /> If the [[dhatu]] like [[rakta]]] are excessively vitiated then the following signs and symptoms are manifested:<br /> *The patient passes stool having yellow (like the color of turmeric), green, blue, reddish (like the color of ''manjistha''), pink (like the color of water in which meat is washed), red, black, white and yellowish (like the color of pig-fat) in color;<br /> *The patient suffers from continuous pain or may be free from any pain (in the abdomen). The above mentioned signs and symptoms may be manifested in their entirety or only some of these may be manifested. <br /> *Sometimes, the patient may pass scybalous stool, sometimes it may be mixed with mucus (''ama'') and sometimes, the stool may be free from mucus (''pakva'');<br /> *There is depletion of the muscle tissue, blood and strength;<br /> *The power of digestion ([[agni]]) of the patient is suppressed; and<br /> *There is impairment of the taste in the mouth of the patient.<br /> <br /> Such a patient is difficult to cure (''krichchra-sadhya''). <br /> <br /> The patient becomes incurable (''asadhya''), if the diarrhea is associated with the colors and complications as follows: <br /> *The color of stool is like dark blood (melena), piece of liver, appearance like washing of fat or flesh, curd,ghee, marrow, fat, milk and ''vesavara''(minced meat); or dark blue, dark red, dark black, or clear like water.<br /> *The stool is exceedingly greasy; or green, blue, saffron color; <br /> *Certain patients passes the stool with turbidity, slimy, fibrous, mixed with mucus and spotted with ''chandraka'' (colored patches circular in shape and shining like moon); <br /> *The stool has exceedingly bad smell like that of a dead body or it is exceedingly putrid in smell or the stool bears the smell of undigested products or it is like (raw) fish; <br /> *The stool attracts flies in excess; <br /> *The stool contains slough and tissue elements in excess; <br /> *The stool contains less or no fecal matter; <br /> *The patient continuously suffers from morbid thirst, burning sensation, fever, giddiness, fainting, hiccup, asthma, excessive pain or no pain; <br /> *There is prolapse and inflammation of the anal canal or the anal sphincters come out of their sites or the whole of the rectum comes out (''mukta-nala''); <br /> *There is excessive loss of strength, muscle tissue and blood; <br /> *There is pain in all the joints and bones; and <br /> *There is sudden cessation of the signs and symptoms of the disease.<br /> <br /> Such a patient should be rejected for the treatment (as it is incurable). [9]<br /> &lt;/div&gt;<br /> <br /> === Guidelines for starting treatment ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तमसाध्यतामसम्प्राप्तंचिकित्सेद्यथाप्रधानोपक्रमेणहेतूपशयदोषविशेषपरीक्षयाचेति ||१०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tamasādhyatāmasamprāptaṁ cikitsēd yathāpradhānōpakramēṇa hētūpaśayadōṣaviśēṣaparīkṣayācēti||10||<br /> <br /> tamasAdhyatAmasamprAptaM cikitsed yathApradhAnopakrameNa hetUpashayadoShavisheShaparIkShayAceti||10|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> The patient who has not yet reached the stage of absolute incurability should be properly treated after the examination of causative factors, ''upashaya'' (pacifying factors) and nature of the aggravation of specific [[dosha]]. In this condition, the most aggravated [[dosha]] should be treated in the beginning followed by the treatment of the other less aggravated [[dosha]]. [10]<br /> &lt;/div&gt;<br /> <br /> === Exogenous (psychological) diarrhea ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आगन्तूद्वावतीसारौमानसौभयशोकजौ | &lt;br /&gt;<br /> तत्तयोर्लक्षणंवायोर्यदतीसारलक्षणम् ||११||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> āgantū dvāvatīsārau mānasau bhayaśōkajau| &lt;br /&gt;<br /> tattayōrlakṣaṇaṁ vāyōryadatīsāralakṣaṇam||11|| &lt;br /&gt;<br /> <br /> AgantU dvAvatIsArau mAnasau bhayashokajau| &lt;br /&gt;<br /> tattayorlakShaNaM vAyoryadatIsAralakShaNam||11||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> The exogenous type of ''atisara'' (diarrhea) is of mental origin and is of two types. One of these is caused by fear and the other is caused by grief. Their signs and symptoms are similar to those of the ''vatika'' type of ''atisara''. Thus ''atisara'' or diarrhea is of two types, viz., ''nija'' or endogenous (like [[vata]]ja, [[pitta]]ja, [[kapha]]ja and ''sannipataja atisara'' and ''agantuja/manasa'' or exogenous [11]<br /> &lt;/div&gt;<br /> <br /> === Management of exogenous (psychological) diarrhea ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मारुतोभयशोकाभ्यांशीघ्रंहिपरिकुप्यति | &lt;br /&gt;<br /> तयोःक्रियावातहरीहर्षणाश्वासनानिच ||१२|| &lt;br /&gt;<br /> <br /> इत्युक्ताःषडतीसाराः, साध्यानांसाधनंत्वतः | &lt;br /&gt;<br /> प्रवक्ष्याम्यनुपूर्वेणयथावत्तन्निबोधत ||१३||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mārutō bhayaśōkābhyāṁ śīghraṁ hi parikupyati| &lt;br /&gt;<br /> tayōḥ kriyā vātaharī harṣaṇāśvāsanāni ca||12|| &lt;br /&gt;<br /> <br /> ityuktāḥ ṣaḍatīsārāḥ, sādhyānāṁ sādhanaṁ tvataḥ| &lt;br /&gt;<br /> pravakṣyāmyanupūrvēṇa yathāvattannibōdhata||13||&lt;br /&gt;<br /> <br /> mAruto bhayashokAbhyAM shIghraM hi parikupyati| &lt;br /&gt;<br /> tayoH kriyA vAtaharI harShaNAshvAsanAni ca||12|| &lt;br /&gt;<br /> <br /> ityuktAH ShaDatIsArAH, sAdhyAnAM sAdhanaM tvataH| &lt;br /&gt;<br /> pravakShyAmyanupUrveNa yathAvattannibodhata||13|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> The following therapies help to cure ''agantuja/manasa'' or exogenous:<br /> <br /> Both fear and grief causes aggravation of [[vata]] instantaneously. [[Vata]] alleviating drugs and therapies should be administered for the treatment of exogenous ''atisara''. The patient suffering from diarrhea caused by fear (''bhayaja'') should be exhilarated. The patient suffering from diarrhea caused by ''shoka'' (grief) should be consoled [12-13] <br /> &lt;/div&gt;<br /> <br /> === Principles of treatment ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दोषाःसन्निचितायस्यविदग्धाहारमूर्च्छिताः | &lt;br /&gt;<br /> अतीसारायकल्पन्तेभूयस्तान्सम्प्रवर्तयेत् ||१४|| &lt;br /&gt;<br /> <br /> नतुसङ्ग्रहणंदेयंपूर्वमामातिसारिणे | &lt;br /&gt;<br /> विबध्यमानाःप्राग्दोषाजनयन्त्यामयान्बहून् ||१५|| &lt;br /&gt;<br /> <br /> दण्डकालसकाध्मानग्रहण्यर्शोगदांस्तथा | &lt;br /&gt;<br /> शोथपाण्ड्वामयप्लीहकुष्ठगुल्मोदरज्वरान् ||१६|| &lt;br /&gt;<br /> <br /> तस्मादुपेक्षेतोत्क्लिष्टान्वर्तमानान्स्वयंमलान् | &lt;br /&gt;<br /> कृच्छ्रंवावहतांदद्यादभयांसम्प्रवर्तिनीम् ||१७|| &lt;br /&gt;<br /> <br /> तयाप्रवाहितेदोषेप्रशाम्यत्युदरामयः | &lt;br /&gt;<br /> जायतेदेहलघुताजठराग्निश्चवर्धते ||१८|| &lt;br /&gt;<br /> <br /> प्रमथ्यांमध्यदोषाणांदद्याद्दीपनपाचनीम् | &lt;br /&gt;<br /> लङ्घनंचाल्पदोषाणांप्रशस्तमतिसारिणाम् ||१९||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dōṣāḥ sannicitā yasya vidagdhāhāramūrcchitāḥ| &lt;br /&gt;<br /> atīsārāya kalpantē bhūyastān sampravartayēt||14||&lt;br /&gt;<br /> <br /> na tu saṅgrahaṇaṁ dēyaṁ pūrvamāmātisāriṇē| &lt;br /&gt;<br /> vibadhyamānāḥ prāgdōṣā janayantyāmayān bahūn||15|| &lt;br /&gt;<br /> <br /> daṇḍakālasakādhmānagrahaṇyarśōgadāṁstathā| &lt;br /&gt;<br /> śōthapāṇḍvāmayaplīhakuṣṭhagulmōdarajvarān||16|| &lt;br /&gt;<br /> <br /> tasmādupēkṣētōtkliṣṭān vartamānān svayaṁ malān| &lt;br /&gt;<br /> kr̥cchraṁ vā vahatāṁ dadyādabhayāṁ sampravartinīm||17||&lt;br /&gt; <br /> <br /> tayā pravāhitē dōṣē praśāmyatyudarāmayaḥ| &lt;br /&gt;<br /> jāyatē dēhalaghutā jaṭharāgniśca vardhatē||18|| &lt;br /&gt;<br /> <br /> pramathyāṁ madhyadōṣāṇāṁ dadyāddīpanapācanīm| &lt;br /&gt;<br /> laṅghanaṁ cālpadōṣāṇāṁ praśastamatisāriṇām||19|| &lt;br /&gt;<br /> <br /> doShAH sannicitA yasya vidagdhAhAramUrcchitAH| &lt;br /&gt;<br /> atIsArAya kalpante bhUyastAn sampravartayet||14|| &lt;br /&gt;<br /> <br /> na tu sa~ggrahaNaM deyaM pUrvamAmAtisAriNe| &lt;br /&gt;<br /> vibadhyamAnAH prAgdoShA janayantyAmayAn bahUn||15|| &lt;br /&gt;<br /> <br /> daNDakAlasakAdhmAnagrahaNyarshogadAMstathA| &lt;br /&gt;<br /> shothapANDvAmayaplIhakuShThagulmodarajvarAn||16|| &lt;br /&gt;<br /> <br /> tasmAdupekShetotkliShTAn vartamAnAn svayaM malAn| &lt;br /&gt;<br /> kRucchraM vA vahatAM dadyAdabhayAM sampravartinIm||17|| &lt;br /&gt;<br /> <br /> tayA pravAhite doShe prashAmyatyudarAmayaH| &lt;br /&gt;<br /> jAyate dehalaghutA jaTharAgnishca vardhate||18|| &lt;br /&gt;<br /> <br /> pramathyAM madhyadoShANAM dadyAddIpanapAcanIm| &lt;br /&gt;<br /> la~gghanaM cAlpadoShANAM prashastamatisAriNAm||19|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> The following principles of treatment are used in management of ''atisara'':<br /> <br /> *When the diarrhea is caused by the accumulated (aggravated) [[dosha]] impelled by ''vidagdha'' (fermentation of undigested) food, the patient should be given laxative to eliminate the [[dosha]]. <br /> *In the initial state i.e. ''ama'' (primary or immature) of diarrhea, stopping or binding therapies are never indicated.<br /> *Administration of such bowel-binding therapies in the initial stage obstructs the movement and elimination of the already aggravated [[dosha]] leading to complications like ''dandakalasaka'' (obstruction to intestinal peristalsis), ''adhmana'' (flatulence), ''grahani roga'' (digestive disorders like sprue syndrome), piles, fistula-in-ano, edema, anemia, splenic disorders, ''kushtha'' (obstinate skin diseases including leprosy), ''gulma'' (abdominal lumps), ''udara roga'' (obstinate abdominal diseases including ascites) and fever. <br /> *Hence, the physician should ignore the downward movement of the detached (''utklishta'') morbid matter, which is moving downwards on its own. <br /> *Diarrhea should be allowed to continue and should not be stopped by constipating medicines. <br /> *If the diarrhea is associated with griping pain (difficulty in evacuating), then ''haritaki'' should be given as a mild laxative. <br /> *Once the morbid matter is eliminated through downward movement then this abdominal disease (diarrhea) gets cured, the body becomes light and the power of [[agni]] becomes strong.<br /> *Moderately aggravated [[dosha]] should be managed by ''pramathya'' (a type of decoction of drugs) which stimulates the power of digestion ([[dipana]]) and which is carminative ([[pachana]]) should be administered. Slightly aggravated [[dosha]] should be managed by [[langhana]] (fasting therapy) [14-19].<br /> <br /> === Recipes of ''pramathya'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पिप्पलीनागरंधान्यंभूतीकमभयावचा | &lt;br /&gt;<br /> ह्रीवेरंभद्रमुस्तानिबिल्वंनागरधान्यकम् ||२०|| &lt;br /&gt;<br /> <br /> पृश्निपर्णीश्वदंष्ट्राचसमङ्गाकण्टकारिका | &lt;br /&gt;<br /> तिस्रःप्रमथ्याविहिताःश्लोकार्धैरतिसारिणाम् ||२१|| &lt;br /&gt;<br /> <br /> वचाप्रतिविषाभ्यांवामुस्तपर्पटकेनवा | &lt;br /&gt;<br /> ह्रीवेरशृङ्गवेराभ्यांपक्वंवापाययेज्जलम् ||२२||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pippalī nāgaraṁ dhānyaṁ bhūtīkamabhayā vacā| &lt;br /&gt;<br /> hrīvēraṁ bhadramustāni bilvaṁ nāgaradhānyakam||20||&lt;br /&gt; <br /> <br /> pr̥śniparṇī śvadaṁṣṭrā ca samaṅgā kaṇṭakārikā| &lt;br /&gt;<br /> tisraḥ pramathyā vihitāḥ ślōkārdhairatisāriṇām||21|| &lt;br /&gt;<br /> <br /> vacāprativiṣābhyāṁ vā mustaparpaṭakēna vā| &lt;br /&gt;<br /> hrīvēraśr̥ṅgavērābhyāṁ pakvaṁ vā pāyayējjalam||22|| &lt;br /&gt;<br /> <br /> pippalI nAgaraM dhAnyaM bhUtIkamabhayA vacA| &lt;br /&gt;<br /> hrIveraM bhadramustAni bilvaM nAgaradhAnyakam||20|| &lt;br /&gt;<br /> <br /> pRushniparNI shvadaMShTrA ca sama~ggA kaNTakArikA| &lt;br /&gt;<br /> tisraH pramathyA vihitAH shlokArdhairatisAriNAm||21|| &lt;br /&gt;<br /> <br /> vacAprativiShAbhyAM vA mustaparpaTakena vA| &lt;br /&gt;<br /> hrIverashRu~ggaverAbhyAM pakvaM vA pAyayejjalam||22||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Three recipes of ''pramathya'' which are useful in the treatment of diarrhea are as follow:<br /> <br /> *Decoction of ''pippali, nagara, dhanyaka, bhutika, abhaya'' and ''vacha'' for [[vata]]ja atisara''<br /> *Decoction of ''hrivera, bhadra-musta, bilva, nagara'' and ''dhanyaka'' for [[pitta]]ja atisara'')<br /> *Decoction of ''prashniparni, svadamstra, samanga'' and ''kantakarika'' for [[kapha]]ja atisara''<br /> *Decoction of ''vacha'' and ''prativisha'' for [[vata]]ja atisara''<br /> *Decoction of ''musta'' and ''parpataka'' for [[pitta]]ja atisara''<br /> *Decoction of ''hrivera'' and ''sringavera'' for [[kapha]]ja atisara'' <br /> <br /> [Note: Decoction should be prepared as per the procedure described for ''sandanga-paniya'' in C.S.Ci.3-145.] [20-22]<br /> <br /> === Diet and drinks for ''atisara'' patient ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> युक्तेऽन्नकालेक्षुत्क्षामंलघून्यन्नानिभोजयेत् | &lt;br /&gt;<br /> तथासशीघ्रमाप्नोतिरुचिमग्निबलंबलम् ||२३|| &lt;br /&gt;<br /> <br /> तक्रेणावन्तिसोमेनयवाग्वातर्पणेनवा | &lt;br /&gt;<br /> सुरयामधुनाचादौयथासात्म्यमुपाचरेत् ||२४|| &lt;br /&gt;<br /> <br /> यवागूभिर्विलेपीभिःखडैर्यूषैरसौदनैः | &lt;br /&gt;<br /> दीपनग्राहिसंयुक्तैःक्रमश्चस्यादतःपरम् ||२५||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yuktē'nnakālē kṣutkṣāmaṁ laghūnyannāni bhōjayēt| &lt;br /&gt;<br /> tathā sa śīghramāpnōti rucimagnibalaṁ balam||23|| &lt;br /&gt;<br /> <br /> takrēṇāvantisōmēna yavāgvā tarpaṇēna vā| &lt;br /&gt;<br /> surayā madhunā cādau yathāsātmyamupācarēt||24||&lt;br /&gt; <br /> <br /> yavāgūbhirvilēpībhiḥ khaḍairyūṣai rasaudanaiḥ| &lt;br /&gt;<br /> dīpanagrāhisaṁyuktaiḥ kramaśca syādataḥ param||25||&lt;br /&gt;<br /> <br /> yukte~annakAle kShutkShAmaM laghUnyannAni bhojayet| &lt;br /&gt;<br /> tathA sa shIghramApnoti rucimagnibalaM balam||23|| &lt;br /&gt;<br /> <br /> takreNAvantisomena yavAgvA tarpaNena vA| &lt;br /&gt;<br /> surayA madhunA cAdau yathAsAtmyamupAcaret||24||&lt;br /&gt; <br /> <br /> yavAgUbhirvilepIbhiH khaDairyUShai rasaudanaiH| &lt;br /&gt;<br /> dIpanagrAhisaMyuktaiH kramashca syAdataH param||25|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> *At appropriate meal time, if the patient feels hungry, light food should be given to eat. It enhances the appetite and stimulates agni and as a result the strength is promoted immediately.<br /> *Depending upon the wholesomeness ([[satmya]]) of the patient, light food along with buttermilk or ''kanji'' (a sour drink), ''yavagu'' (thick gruel), ''tarpana'' (roasted flour of serials mixed with water), or alcoholic drink or honey should be given. Then gradually ''yavagu'' (thick gruel), ''vilepi'' (a sticky gruel), ''khanda'' (a sour appetiser), ''yusha'' (vegetable soup) and boiled rice mixed with meat soup which are prepared by adding digestive, stimulants and astringent (constipative) drugs should be given. <br /> <br /> Ingredients which are [[dipana]] (digestive stimulant) and ''grahi'' (constipating) are described in [Cha. Sa. [[Sutra Sthana]] 4/9 ] should be administered [23-25]<br /> <br /> === Treatment of [[vata]]ja atisara ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शालपर्णींपृश्निपर्णींबृहतींकण्टकारिकाम् | &lt;br /&gt;<br /> बलांश्वदंष्ट्रांबिल्वानिपाठांनागरधान्यकम् ||२६|| &lt;br /&gt;<br /> <br /> शटींपलाशंहपुषांवचांजीरकपिप्पलीम् | &lt;br /&gt;<br /> यवानींपिप्पलीमूलंचित्रकंहस्तिपिप्पलीम् ||२७||&lt;br /&gt; <br /> <br /> वृक्षाम्लंदाडिमाम्लंचसहिङ्गुबिडसैन्धवम् | &lt;br /&gt;<br /> प्रयोजयेदन्नपानेविधिनासूपकल्पितम् ||२८|| &lt;br /&gt;<br /> <br /> वातश्लेष्महरोह्येषगणोदीपनपाचनः | &lt;br /&gt;<br /> ग्राहीबल्योरोचनश्चतस्माच्छस्तोऽतिसारिणाम् ||२९||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śālaparṇīṁ pr̥śniparṇīṁ br̥hatīṁ kaṇṭakārikām| &lt;br /&gt;<br /> balāṁ śvadaṁṣṭrāṁ bilvāni pāṭhāṁ nāgaradhānyakam||26|| &lt;br /&gt;<br /> <br /> śaṭīṁ palāśaṁ hapuṣāṁ vacāṁ jīrakapippalīm| &lt;br /&gt;<br /> yavānīṁ pippalīmūlaṁ citrakaṁ hastipippalīm||27|| &lt;br /&gt;<br /> <br /> vr̥kṣāmlaṁ dāḍimāmlaṁ ca sahiṅgu biḍasaindhavam| &lt;br /&gt;<br /> prayōjayēdannapānē vidhinā sūpakalpitam||28|| &lt;br /&gt;<br /> <br /> vātaślēṣmaharō hyēṣa gaṇō dīpanapācanaḥ| &lt;br /&gt;<br /> grāhī balyō rōcanaśca tasmācchastō'tisāriṇām||29|| &lt;br /&gt;<br /> <br /> shAlaparNIM pRushniparNIM bRuhatIM kaNTakArikAm| &lt;br /&gt;<br /> balAM shvadaMShTrAM bilvAni pAThAM nAgaradhAnyakam||26|| &lt;br /&gt;<br /> <br /> shaTIM palAshaM hapuShAM vacAM jIrakapippalIm| &lt;br /&gt;<br /> yavAnIM pippalImUlaM citrakaM hastipippalIm||27|| &lt;br /&gt;<br /> <br /> vRukShAmlaM dADimAmlaM ca sahi~ggu biDasaindhavam| &lt;br /&gt;<br /> prayojayedannapAne vidhinA sUpakalpitam||28|| &lt;br /&gt;<br /> <br /> vAtashleShmaharo hyeSha gaNo dIpanapAcanaH| &lt;br /&gt;<br /> grAhI balyo rocanashca tasmAcchasto~atisAriNAm||29|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The following drugs are useful for the cure of [[vata]]ja atisara(diarrhea):<br /> *''Shalaparni, prashniparni, brhati, kantakarika, bala, svadamstra, bilva, patha, nagara, dhanyaka, shati, palasha, hapusha, vacha, jiraka, pippali, yavani, pippali-mula, chitraka, hastipippali, vrikshamla, sour pomegranate, hingu, vida'' and ''saindhava''-these ingredients should be appropriately used in processing food preparations. <br /> *Drugs belonging to the [[vata]] and [[kapha]]' alleviative group and those drugs which are [[dipana]] (digestive stimulant), [[pachana]] (carminative), ''grahi'' (constipating), ''balya'' (promoter of strength) and ''rochana'' (appetizer) should be prescribed. [26-29]<br /> <br /> === Management of diarrhea associated with pain ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आमेपरिणतेयस्तुविबद्धमतिसार्यते | &lt;br /&gt; <br /> सशूलपिच्छमल्पाल्पंबहुशःसप्रवाहिकम् ||३०|| &lt;br /&gt;<br /> <br /> यूषेणमूलकानांतंबदराणामथापिवा | &lt;br /&gt;<br /> उपोदिकायाःक्षीरिण्यायवान्यावास्तुकस्यवा ||३१|| &lt;br /&gt;<br /> <br /> सुवर्चलायाश्चञ्चोर्वाशाकेनावल्गुजस्यवा | &lt;br /&gt;<br /> शट्याःकर्कारुकाणांवाजीवन्त्याश्चिर्भटस्यवा ||३२|| &lt;br /&gt;<br /> <br /> लोणिकायाःसपाठायाःशुष्कशाकेनवापुनः | &lt;br /&gt;<br /> दधिदाडिमसिद्धेनबहुस्नेहेनभोजयेत् ||३३||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> āmē pariṇatē yastu vibaddhamatisāryatē| &lt;br /&gt;<br /> saśūlapicchamalpālpaṁ bahuśaḥ sapravāhikam||30||&lt;br /&gt;<br /> <br /> yūṣēṇa mūlakānāṁ taṁ badarāṇāmathāpi vā| &lt;br /&gt;<br /> upōdikāyāḥ kṣīriṇyā yavānyā vāstukasya vā||31|| &lt;br /&gt;<br /> <br /> suvarcalāyāścañcōrvā śākēnāvalgujasya vā| &lt;br /&gt;<br /> śaṭyāḥ karkārukāṇāṁ vā jīvantyāścirbhaṭasya vā||32|| &lt;br /&gt;<br /> <br /> lōṇikāyāḥ sapāṭhāyāḥ śuṣkaśākēna vā punaḥ| &lt;br /&gt;<br /> dadhidāḍimasiddhēna bahusnēhēna bhōjayēt||33|| &lt;br /&gt;<br /> <br /> Ame pariNate yastu vibaddhamatisAryate| &lt;br /&gt;<br /> sashUlapicchamalpAlpaM bahushaH sapravAhikam||30|| &lt;br /&gt;<br /> <br /> yUSheNa mUlakAnAM taM badarANAmathApi vA| &lt;br /&gt;<br /> upodikAyAH kShIriNyA yavAnyA vAstukasya vA||31||&lt;br /&gt; <br /> <br /> suvarcalAyAshca~jcorvA shAkenAvalgujasya vA| &lt;br /&gt;<br /> shaTyAH karkArukANAM vA jIvantyAshcirbhaTasya vA||32|| &lt;br /&gt;<br /> <br /> loNikAyAH sapAThAyAH shuShkashAkena vA punaH| &lt;br /&gt;<br /> dadhidADimasiddhena bahusnehena bhojayet||33|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After the maturity of ''ama'' (product of indigestion), if the patient experiences loose motions along with scybalous feces associated with colic pain and mucus very frequently in small quantities, and if there is griping pain, then he should be given food along with the soup of ''mulaka, badara, upodikā, kshirini, yavāni, vāstuka, suvarchala, chanchu'' (''nadika''), leaves of ''avalguja, shati, karkaruka, jivanti, chirbhata'' (karkati), ''lonika, patha'' or ''shushka-shaka'' (''kasamarda'' according to Chakrapani). These soups should be cooked along with curd (yogurt) and ''dadima'', and added with ghee in copious quantities [30-33]<br /> <br /> === Treatment of ''pravahika'' (dysentery) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कल्कःस्याद्बालबिल्वानांतिलकल्कश्चतत्समः | &lt;br /&gt;<br /> दध्नःसरोऽम्लस्नेहाद्यःखडोहन्यात्प्रवाहिकाम् ||३४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kalkaḥ syādbālabilvānāṁ tilakalkaśca tatsamaḥ| &lt;br /&gt;<br /> dadhnaḥ sarō'mlasnēhādyaḥ khaḍō hanyāt pravāhikām||34|| &lt;br /&gt;<br /> <br /> kalkaH syAdbAlabilvAnAM tilakalkashca tatsamaH| &lt;br /&gt;<br /> dadhnaH saro~amlasnehAdyaH khaDo hanyAt pravAhikAm||34|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The following ''khada'' (a sour appetizer) cures ''pravahika'' (dysentery):<br /> <br /> *It is prepared by adding the paste of tender fruits of ''bilva'', equal quantities of the paste of sesame, cream of sour curd and copious quantities of ghee [34].<br /> <br /> === Treatment of ''varcha-kshaya'' (scanty formation of stool) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यवानांमुद्गमाषाणांशालीनांचतिलस्यच | &lt;br /&gt;<br /> कोलानांबालबिल्वानांधान्ययूषंप्रकल्पयेत् ||३५|| &lt;br /&gt;<br /> <br /> ऐकध्यंयमकेभृष्टंदधिदाडिमसारिकम् | &lt;br /&gt;<br /> वर्चःक्षयेशुष्कमुखंशाल्यन्नंतेनभोजयेत् ||३६|| &lt;br /&gt;<br /> <br /> दध्नःसरंवायमकेभृष्टंसगुडनागरम् | &lt;br /&gt;<br /> सुरांवायमकेभृष्टांव्यञ्जनार्थेप्रदापयेत् ||३७|| &lt;br /&gt;<br /> <br /> फलाम्लंयमकेभृष्टंयूषंगृञ्जनकस्यवा | &lt;br /&gt;<br /> लोपाकरसमम्लंवास्निग्धाम्लंकच्छपस्यवा ||३८|| &lt;br /&gt;<br /> <br /> बर्हितित्तिरिदक्षाणांवर्तकानांतथारसाः | &lt;br /&gt;<br /> स्निग्धाम्लाःशालयश्चाग्र्यावर्चःक्षयरुजापहाः ||३९|| &lt;br /&gt;<br /> <br /> अन्तराधिरसंपूत्वारक्तंमेषस्यचोभयम् | &lt;br /&gt;<br /> पचेद्दाडिमसाराम्लंसधान्यस्नेहनागरम् ||४०|| &lt;br /&gt;<br /> <br /> ओदनं[१]रक्तशालीनांतेनाद्यात्प्रपिबेच्चतत् | &lt;br /&gt;<br /> तथावर्चःक्षयकृतैर्व्याधिभिर्विप्रमुच्यते ||४१||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yavānāṁ mudgamāṣāṇāṁ śālīnāṁ ca tilasya ca| &lt;br /&gt;<br /> kōlānāṁ bālabilvānāṁ dhānyayūṣaṁ prakalpayēt||35|| &lt;br /&gt;<br /> <br /> aikadhyaṁ yamakē bhr̥ṣṭaṁ dadhidāḍimasārikam| &lt;br /&gt;<br /> varcaḥkṣayē śuṣkamukhaṁ śālyannaṁ tēna bhōjayēt||36|| &lt;br /&gt;<br /> <br /> dadhnaḥ saraṁ vā yamakē bhr̥ṣṭaṁ saguḍanāgaram| &lt;br /&gt;<br /> surāṁ vā yamakē bhr̥ṣṭāṁ vyañjanārthē pradāpayēt||37|| &lt;br /&gt;<br /> <br /> phalāmlaṁ yamakē bhr̥ṣṭaṁ yūṣaṁ gr̥ñjanakasya vā| &lt;br /&gt;<br /> lōpākarasamamlaṁ vā snigdhāmlaṁ kacchapasya vā||38|| &lt;br /&gt;<br /> <br /> barhitittiridakṣāṇāṁ vartakānāṁ tathā rasāḥ| &lt;br /&gt;<br /> snigdhāmlāḥ śālayaścāgryā varcaḥkṣayarujāpahāḥ||39|| &lt;br /&gt;<br /> <br /> antarādhirasaṁ pūtvā raktaṁ mēṣasya cōbhayam| &lt;br /&gt;<br /> pacēddāḍimasārāmlaṁ sadhānyasnēhanāgaram||40|| &lt;br /&gt;<br /> <br /> ōdanaṁ [1] raktaśālīnāṁ tēnādyāt prapibēcca tat| &lt;br /&gt;<br /> tathā varcaḥkṣayakr̥tairvyādhibhirvipramucyatē||41|| &lt;br /&gt;<br /> <br /> yavAnAM mudgamAShANAM shAlInAM ca tilasya ca| &lt;br /&gt;<br /> kolAnAM bAlabilvAnAM dhAnyayUShaM prakalpayet||35|| &lt;br /&gt;<br /> <br /> aikadhyaM yamake bhRuShTaM dadhidADimasArikam| &lt;br /&gt;<br /> varcaHkShaye shuShkamukhaM shAlyannaM tena bhojayet||36|| &lt;br /&gt;<br /> <br /> dadhnaH saraM vA yamake bhRuShTaM saguDanAgaram| &lt;br /&gt;<br /> surAM vA yamake bhRuShTAM vya~jjanArthe pradApayet||37|| &lt;br /&gt;<br /> <br /> phalAmlaM yamake bhRuShTaM yUShaM gRu~jjanakasya vA| &lt;br /&gt;<br /> lopAkarasamamlaM vA snigdhAmlaM kacchapasya vA||38|| &lt;br /&gt;<br /> <br /> barhitittiridakShANAM vartakAnAM tathA rasAH| &lt;br /&gt;<br /> snigdhAmlAH shAlayashcAgryA varcaHkShayarujApahAH||39|| &lt;br /&gt;<br /> <br /> antarAdhirasaM pUtvA raktaM meShasya cobhayam| &lt;br /&gt;<br /> paceddADimasArAmlaM sadhAnyasnehanAgaram||40|| &lt;br /&gt;<br /> <br /> odanaM [1] raktashAlInAM tenAdyAt prapibecca tat| &lt;br /&gt;<br /> tathA varcaHkShayakRutairvyAdhibhirvipramucyate||41||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If there is ''varcha-kshaya'' (scanty stool), then the patient should be given the following recipes:<br /> *If there is ''varcha-kshaya'' (scanty stool) and dryness of the mouth, then the patient should be given ''dhanya-yusha'' (a type of soup prepared of cereals and pulses) made of ''yava, mudga, masha'', and ''shali'' type of rice, sesame seeds, ''kola'' and tender fruits of ''bilva'', sizzled with ''yamaka'' (ghee and oil) taken together with curd and the extract of ''dadima''. One should take boiled shāli rice along with this soup.<br /> *Cream of curd sizzled with ghee and oil, and mixed with jaggery and ''shunthi'', alcohol sizzled with ghee and oil, sour fruits sizzled with ghee and oil, soup of ''granjanaka'', meat soup of ''lopaka'' added with sour ingredients, meat soup of ''kachchapa'' added with ghee and sour ingredients, or the soup of the meat of ''barhi, tittiri, daksha'' or ''vartaka''. These soups should be used as ''vyanjana'' (side-dish).<br /> *The red variety of ''shali'' rice boiled by adding ghee and sour ingredients. <br /> *The meat soup of the trunk of sheep should be added with its blood and sizzled by adding the extract of ''dadima, dhanya'', ghee and ''nagara''. This soup should be used for boiling red variety of ''shali'' rice. Intake of this cooked rice and drinking this soup make the patient free from the ailments caused by ''varcha-kshaya'' (scanty stool) [35-41]<br /> <br /> === Treatment of prolapse of rectum ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुदनिःसरणेशूलेपानमम्लस्यसर्पिषः | &lt;br /&gt;<br /> प्रशस्यतेनिरामाणामथवाऽप्यनुवासनम् ||४२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gudaniḥsaraṇē śūlē pānamamlasya sarpiṣaḥ| &lt;br /&gt;<br /> praśasyatē nirāmāṇāmathavā'pyanuvāsanam||42|| &lt;br /&gt;<br /> <br /> gudaniHsaraNe shUle pAnamamlasya sarpiShaH| &lt;br /&gt;<br /> prashasyate nirAmANAmathavA~apyanuvAsanam||42|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If there is prolapse of rectum and colic pain, and if the diarrhea is free from ''ama'', then the patient should be given medicated ghee prepared with sour drugs or ''anuvasana'' (unctuous enema). [42]<br /> <br /> === ''Changeri ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चाङ्गेरीकोलदध्यम्लनागरक्षारसंयुतम् | &lt;br /&gt;<br /> घृतमुत्क्वथितंपेयंगुदभ्रंशरुजापहम् ||४३|| &lt;br /&gt;<br /> इतिचाङ्गेरीघृतम् | &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> cāṅgērīkōladadhyamlanāgarakṣārasaṁyutam| &lt;br /&gt;<br /> ghr̥tamutkvathitaṁ pēyaṁ gudabhraṁśarujāpaham||43|| &lt;br /&gt;<br /> iti cāṅgērīghr̥tam| &lt;br /&gt;<br /> <br /> cA~ggerIkoladadhyamlanAgarakShArasaMyutam| &lt;br /&gt;<br /> ghRutamutkvathitaM peyaM gudabhraMsharujApaham||43|| &lt;br /&gt;<br /> iti cA~ggerIghRutam| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Ghee should be cooked with the juice of ''changeri'', decoction of ''kola'' and sour curd, and the paste of ''nagara'' and ''kshara'' (alkali preparation). Intake of this medicated ghee cures ailments caused by prolapse of rectum. Thus, ends the description of ''changeri-ghrita'' [43].<br /> <br /> === ''Chavyadi ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सचव्यपिप्पलीमूलंसव्योषविडदाडिमम् |&lt;br /&gt; <br /> पेयमम्लंघृतंयुक्त्यासधान्याजाजिचित्रकम् ||४४||&lt;br /&gt; <br /> <br /> इतिगुदभ्रंशेचव्यादिघृतम् | &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sacavyapippalīmūlaṁ savyōṣaviḍadāḍimam| &lt;br /&gt;<br /> pēyamamlaṁ ghr̥taṁ yuktyā sadhānyājājicitrakam||44|| &lt;br /&gt;<br /> <br /> iti gudabhraṁśē cavyādighr̥tam| &lt;br /&gt;<br /> <br /> sacavyapippalImUlaM savyoShaviDadADimam| &lt;br /&gt;<br /> peyamamlaM ghRutaM yuktyA sadhAnyAjAjicitrakam||44|| &lt;br /&gt;<br /> <br /> iti gudabhraMshe cavyAdighRutam| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Ghee should be cooked with the sour ingredients (juice of ''changeri'', decoction of ''kola'' and sour curd), and the pastes of ''chavya'', ''pippali-mula, shunthi, pippali, maricha, vida'' and ''dadima''. Intake of this medicated ghee should be done along with ''dhanya, ajaji'' and ''chitraka'' in appropriate quantities (for curing prolapse of rectum)<br /> <br /> Thus, ends the description of ''chavyadi -ghrita'' for prolapsed rectum [44].<br /> <br /> === ''Anuvasana basti'' in prolapse of rectum ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दशमूलोपसिद्धंवासबिल्वमनुवासनम् | &lt;br /&gt;<br /> शटीशताह्वाबिल्वैर्वावचयाचित्रकेणवा ||४५|| &lt;br /&gt;<br /> <br /> इतिगुदभ्रंशेऽनुवासनम् &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> daśamūlōpasiddhaṁ vā sabilvamanuvāsanam| &lt;br /&gt;<br /> śaṭīśatāhvābilvairvā vacayā citrakēṇa vā||45|| &lt;br /&gt;<br /> <br /> iti gudabhraṁśē'nuvāsanam| &lt;br /&gt;<br /> <br /> dashamUlopasiddhaM vA sabilvamanuvAsanam| &lt;br /&gt;<br /> shaTIshatAhvAbilvairvA vacayA citrakeNa vA||45||&lt;br /&gt;<br /> <br /> iti gudabhraMshe~anuvAsanam| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> For the cure of prolapse rectum, anuvasana [[basti]] (oil-based enema therapy) should be administered with the following recipes:<br /> *''Dashamoola'' cooked with fat; <br /> *''Bilva'' cooked with fat:<br /> *''Shati, shatahva'' or ''bilva'' cooked in fat; <br /> *Vacha cooked with fat; and<br /> *Chitraka cooked with fat [45].<br /> <br /> === Management of strangulated prolapsed rectum ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्तब्धभ्रष्टगुदेपूर्वंस्नेहस्वेदौप्रयोजयेत् | &lt;br /&gt;<br /> सुस्विन्नंतंमृदूभूतंपिचुनासम्प्रवेशयेत् ||४६||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> stabdhabhraṣṭagudē pūrvaṁ snēhasvēdau prayōjayēt| &lt;br /&gt;<br /> susvinnaṁ taṁ mr̥dūbhūtaṁ picunā sampravēśayēt||46||&lt;br /&gt;<br /> <br /> stabdhabhraShTagude pUrvaM snehasvedau prayojayet| &lt;br /&gt;<br /> susvinnaM taM mRudUbhUtaM picunA sampraveshayet||46|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the prolapsed rectum becomes stiff or strangulated, and does not go inside of its own, then oil should be applied over it and fomentation should be given. Thereafter, when the prolapsed rectum is well fomented and has become soft, then with the help of a cotton pad (or pad made of thick cloth) it should be pushed inside and restored to its original place [46].<br /> <br /> === Use of medicated milk ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विबद्धवातवर्चास्तुबहुशूलप्रवाहिकः | &lt;br /&gt;<br /> सरक्तपिच्छस्तृष्णार्तःक्षीरसौहित्यमर्हति ||४७|| &lt;br /&gt;<br /> <br /> यमकस्योपरिक्षीरंधारोष्णंवापिबेन्नरः | &lt;br /&gt;<br /> शृतमेरण्डमूलेनबालबिल्वेनवापयः[१] ||४८|| &lt;br /&gt;<br /> <br /> एवंक्षीरप्रयोगेणरक्तंपिच्छाचशाम्यति | &lt;br /&gt;<br /> शूलंप्रवाहिकाचैवविबन्धश्चोपशाम्यति ||४९||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vibaddhavātavarcāstu bahuśūlapravāhikaḥ| &lt;br /&gt;<br /> saraktapicchastr̥ṣṇārtaḥ kṣīrasauhityamarhati||47|| &lt;br /&gt;<br /> <br /> yamakasyōpari kṣīraṁ dhārōṣṇaṁ vā pibēnnaraḥ| &lt;br /&gt;<br /> śr̥tamēraṇḍamūlēna bālabilvēna vā payaḥ [1] ||48|| &lt;br /&gt;<br /> <br /> ēvaṁ kṣīraprayōgēṇa raktaṁ picchā ca śāmyati| &lt;br /&gt;<br /> śūlaṁ pravāhikā caiva vibandhaścōpaśāmyati||49|| &lt;br /&gt;<br /> <br /> vibaddhavAtavarcAstu bahushUlapravAhikaH| &lt;br /&gt;<br /> saraktapicchastRuShNArtaH kShIrasauhityamarhati||47|| &lt;br /&gt;<br /> <br /> yamakasyopari kShIraM dhAroShNaM vA pibennaraH| &lt;br /&gt;<br /> shRutameraNDamUlena bAlabilvena vA payaH [1] ||48|| &lt;br /&gt;<br /> <br /> evaM kShIraprayogeNa raktaM picchA ca shAmyati| &lt;br /&gt;<br /> shUlaM pravAhikA caiva vibandhashcopashAmyati||49|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the movement of flatus and stool is blocked(constipated), if the patient suffers from various kinds of pain, if the patient passes blood and mucus, and if the patient is thirsty, then adequate quantity of milk should be administered. Such a patient should be given ''yamaka'' (ghee and oil mixed together), and thereafter, lukewarm milk collected directly from the udder (''dharoshna'').<br /> <br /> Milk boiled with the root of castor or tender fruit of ''bilva'' may also be given in the above mentioned condition. By the intake of the recipes of medicated ghee mentioned above, bleeding and mucus discharge from the anus stops. These recipes also cure colic pain, dysentery and constipation [47-49]<br /> <br /> === Treatment of [[pitta]]ja atisara ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तातिसारंपुनर्निदानोपशयाकृतिभिरामान्वयमुपलभ्ययथाबलंलङ्घनपाचनाभ्यामुपाचरेत् | &lt;br /&gt;<br /> तृष्यतस्तुमुस्तपर्पटकोशीरसारिवाचन्दनकिराततिक्तकोदीच्यवारिभिरुपचारः | &lt;br /&gt;<br /> लङ्घितस्यचाहारकालेबलातिबलासूर्पपर्णीशालपर्णीपृश्निपर्णीबृहतीकण्टकारिकाशतावरीश्वदंष्ट्रानिर्यूहसंयुक्तेनयथासात्म्यंयवागूमण्डादिनातर्पणादिनावाक्रमेणोपचारः | &lt;br /&gt;<br /> मुद्गमसूरहरेणुमकुष्ठकाढकीयूषैर्वालावकपिञ्जलशशहरिणैणकालपुच्छकरसैरीषदम्लैरनम्लैर्वाक्रमशोऽग्निंसन्धुक्षयेत् | &lt;br /&gt;<br /> अनुबन्धेत्वस्यदीपनीयपाचनीयोपशमनीयसङ्ग्रहणीयान्योगान्सम्प्रयोजयेदिति ||५०|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pittātisāraṁ punarnidānōpaśayākr̥tibhirāmānvayamupalabhya yathābalaṁlaṅghanapācanābhyāmupācarēt| &lt;br /&gt;<br /> tr̥ṣyatastu mustaparpaṭakōśīrasārivācandanakirātatiktakōdīcyavāribhirupacāraḥ| &lt;br /&gt;<br /> laṅghitasya cāhārakālēbalātibalāsūrpaparṇīśālaparṇīpr̥śniparṇībr̥hatīkaṇṭakārikāśatāvarīśvadaṁṣṭrāniryūhasaṁyuktēnayathāsātmyaṁ yavāgūmaṇḍādinā tarpaṇādinā vā kramēṇōpacāraḥ| &lt;br /&gt;<br /> mudgamasūraharēṇumakuṣṭhakāḍhakīyūṣairvālāvakapiñjalaśaśahariṇaiṇakālapucchakarasairīṣadamlairanamlairvā kramaśō'gniṁ sandhukṣayēt| &lt;br /&gt;<br /> anubandhē tvasya dīpanīyapācanīyōpaśamanīyasaṅgrahaṇīyān yōgān samprayōjayēditi||50||&lt;br /&gt;<br /> <br /> pittAtisAraM punarnidAnopashayAkRutibhirAmAnvayamupalabhya yathAbalaMla~gghanapAcanAbhyAmupAcaret| &lt;br /&gt;<br /> tRuShyatastu mustaparpaTakoshIrasArivAcandanakirAtatiktakodIcyavAribhirupacAraH| &lt;br /&gt;<br /> la~gghitasya cAhArakAlebalAtibalAsUrpaparNIshAlaparNIpRushniparNIbRuhatIkaNTakArikAshatAvarIshvadaMShTrAniryUhasaMyuktenayathAsAtmyaM yavAgUmaNDAdinA tarpaNAdinA vA krameNopacAraH| &lt;br /&gt;<br /> mudgamasUrahareNumakuShThakADhakIyUShairvAlAvakapi~jjalashashahariNaiNakAlapucchakarasairIShadamlairanamlairvA kramasho~agniM sandhukShayet|&lt;br /&gt; <br /> anubandhe tvasya dIpanIyapAcanIyopashamanIyasa~ggrahaNIyAn yogAn samprayojayediti||50|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> For the cure of [[pitta]]ja atisara, the following therapy should be administered: <br /> *If [[pitta]]ja atisara (diarrhea) patient is also afflicted with ''ama'' which can be determined by causative factors, ''upachaya'' (habituation), and signs and symptoms, then the patient should be given [[langhana]] (fasting therapy) and [[pachana]] (carminative therapy) appropriate to the strength of the patient.<br /> *If the patient is thirsty, then the decoction of ''musta, parpataka, ushira, sariva, chandana, kiratatiktaka'' and ''udichya'' should be given to drink. <br /> *After the proper fasting therapy, during meal time, the patient should be gradually given ''yavagu'' (thick gruel), ''manda'' (a type of thin gruel) and ''tarpana'' (roasted flour of cereals added with water) or decoction prepared (according to the procedure suggested for ''shadanga-paniya''[Cha.Sa. [[Chikitsa Sthana]] 3/ 145-146] of ''bala, atibala, surpa-parni'' (''mudga-parni'' and ''mansa-parni''), ''shala-parni, prashni-parni, brahati, kantakari, shatavari'' and ''shvadanshtra''.<br /> <br /> *[[Agni]] (power of digestion) should be stimulated gradually with the vegetable soup of ''mudga, masura, harenu, makustha'' and ''adhaki'' or with the soup of the meat of ''lava, kapinjala, shasha, harina, ena'' and ''kalapuchcha''. These vegetable soups and meat soups may or may not be sour. <br /> <br /> *If the [[pitta]]ja atisara persists even after the administration of the above mentioned measures, then the patient should be treated with recipes which are ''dipaniya'' (digestive stimulant), ''pachaniya'' (carminative), ''upashamaniya'' ([[dosha]]-alleviator) and ''sangrahaniya'' (constipating). [50]<br /> <br /> === Recipes for [[pitta]]ja atisara ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सक्षौद्रातिविषंपिष्ट्वावत्सकस्यफलत्वचम् | &lt;br /&gt;<br /> पिबेत्पित्तातिसारघ्नंतण्डुलोदकसंयुतम् ||५१|| &lt;br /&gt;<br /> <br /> किराततिक्तकोमुस्तंवत्सकःसरसाञ्जनः | &lt;br /&gt;<br /> बिल्वंदारुहरिद्रात्वक्ह्रीबेरंसदुरालभम् ||५२|| &lt;br /&gt;<br /> <br /> चन्दनंचमृणालंचनागरंलोध्रमुत्पलम् | &lt;br /&gt;<br /> तिलामोचरसोलोध्रंसमङ्गाकमलोत्पलम् ||५३|| &lt;br /&gt;<br /> <br /> उत्पलंधातकीपुष्पंदाडिमत्वङ्महौषधम् | &lt;br /&gt;<br /> कट्फलंनागरंपाठाजम्ब्वाम्रास्थिदुरालभाः ||५४|| &lt;br /&gt;<br /> <br /> योगाःषडेतेसक्षौद्रास्तण्डुलोदकसंयुताः | &lt;br /&gt;<br /> पेयाःपित्तातिसारघ्नाःश्लोकार्धेननिदर्शिताः ||५५|| &lt;br /&gt;<br /> <br /> जीर्णोषधानांशस्यन्तेयथायोगंप्रकल्पितैः | &lt;br /&gt;<br /> रसैःसाङ्ग्राहिकैर्युक्ताःपुराणारक्तशालयः ||५६||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sakṣaudrātiviṣaṁ piṣṭvā vatsakasya phalatvacam| &lt;br /&gt;<br /> pibēt pittātisāraghnaṁ taṇḍulōdakasaṁyutam||51|| &lt;br /&gt;<br /> <br /> kirātatiktakō mustaṁ vatsakaḥ sarasāñjanaḥ| &lt;br /&gt;<br /> bilvaṁ dāruharidrā tvak hrībēraṁ sadurālabham||52|| &lt;br /&gt;<br /> <br /> candanaṁ ca mr̥ṇālaṁ ca nāgaraṁ lōdhramutpalam| &lt;br /&gt;<br /> tilā mōcarasō lōdhraṁ samaṅgā kamalōtpalam||53|| &lt;br /&gt;<br /> <br /> utpalaṁ dhātakīpuṣpaṁ dāḍimatvaṅmahauṣadham| &lt;br /&gt;<br /> kaṭphalaṁ nāgaraṁ pāṭhā jambvāmrāsthidurālabhāḥ||54|| &lt;br /&gt;<br /> <br /> yōgāḥ ṣaḍētē sakṣaudrāstaṇḍulōdakasaṁyutāḥ| &lt;br /&gt;<br /> pēyāḥ pittātisāraghnāḥ ślōkārdhēna nidarśitāḥ||55|| &lt;br /&gt;<br /> <br /> jīrṇōṣadhānāṁ śasyantē yathāyōgaṁ prakalpitaiḥ| &lt;br /&gt;<br /> rasaiḥ sāṅgrāhikairyuktāḥ purāṇā raktaśālayaḥ||56|| &lt;br /&gt;<br /> <br /> sakShaudrAtiviShaM piShTvA vatsakasya phalatvacam| &lt;br /&gt;<br /> pibet pittAtisAraghnaM taNDulodakasaMyutam||51|| &lt;br /&gt;<br /> <br /> kirAtatiktako mustaM vatsakaH sarasA~jjanaH| &lt;br /&gt;<br /> bilvaM dAruharidrA tvak hrIberaM sadurAlabham||52|| &lt;br /&gt;<br /> <br /> candanaM ca mRuNAlaM ca nAgaraM lodhramutpalam| &lt;br /&gt;<br /> tilA mocaraso lodhraM sama~ggA kamalotpalam||53|| &lt;br /&gt;<br /> <br /> utpalaM dhAtakIpuShpaM dADimatva~gmahauShadham| &lt;br /&gt;<br /> kaTphalaM nAgaraM pAThA jambvAmrAsthidurAlabhAH||54|| &lt;br /&gt;<br /> <br /> yogAH ShaDete sakShaudrAstaNDulodakasaMyutAH| &lt;br /&gt;<br /> peyAH pittAtisAraghnAH shlokArdhena nidarshitAH||55|| &lt;br /&gt;<br /> <br /> jIrNoShadhAnAM shasyante yathAyogaM prakalpitaiH| &lt;br /&gt;<br /> rasaiH sA~ggrAhikairyuktAH purANA raktashAlayaH||56|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The following recipes are useful in curing [[pitta]]ja atisara:<br /> *The fruit and bark of ''vatsaka'' should be added with ''ativisha'' and honey. It should be taken along with rice-water (''tandulodaka''). <br /> The following recipes should be taken along with honey and rice-water (''tandulodaka'').<br /> *Powder of ''kiratatiktaka, musta, vatsaka'' and ''rasanjana''.<br /> *Powder of ''bilva, dāruharidra, tvak, hribera'' and ''duralabha''<br /> *Powder of ''chandana, mranāla, nagara, lodhra'' and ''utpala''<br /> *Powder of ''tila, mocha-rasa, lodhra, samanga, kamala'' and ''utpala''<br /> *Powder of ''utpala, dhataki''(flower), ''dadima,tvak'' and ''mahaushadha''<br /> *''Katphala, nagara, patha,'' seed-pulp of ''jambu'' and ''amra'', and ''duralabha''. Once the above mentioned recipes are digested, the patient should be given to eat red variety of rice harvested in earlier seasons, along with appropriately cooked meat-soup added with constipating drugs [51-56]<br /> <br /> === Administration of milk ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तातिसारोदीपाग्नेःक्षिप्रंसमुपशाम्यति | &lt;br /&gt;<br /> अजाक्षीरप्रयोगेणबलंवर्णश्चवर्धते ||५७|| &lt;br /&gt;<br /> <br /> बहुदोषस्यदीप्ताग्नेःसप्राणस्यनतिष्ठति | &lt;br /&gt;<br /> पैत्तिकोयद्यतीसारःपयसातंविरेचयेत् ||५८|| &lt;br /&gt;<br /> <br /> पलाशफलनिर्यूहंपयसासहपाययेत् | &lt;br /&gt;<br /> ततोऽनुपाययेत्कोष्णंक्षीरमेवयथाबलम् ||५९|| &lt;br /&gt;<br /> <br /> प्रवाहितेतेनमलेप्रशाम्यत्युदरामयः | &lt;br /&gt;<br /> पलाशवत्प्रयोज्यावात्रायमाणाविशोधिनी ||६०|| &lt;br /&gt;<br /> <br /> सांसर्ग्यांक्रियमाणायांशूलंयद्यनुवर्तते | &lt;br /&gt;<br /> स्रुतदोषस्यतंशीघ्रंयथावदनुवासयेत् ||६१|| &lt;br /&gt;<br /> <br /> शतपुष्पावरीभ्यांचपयसामधुकेनच | &lt;br /&gt;<br /> तैलपादंघृतंसिद्धंसबिल्वमनुवासनम् ||६२||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pittātisārō dīpāgnēḥ kṣipraṁ samupaśāmyati| &lt;br /&gt;<br /> ajākṣīraprayōgēṇa balaṁ varṇaśca vardhatē||57|| &lt;br /&gt;<br /> <br /> bahudōṣasya dīptāgnēḥ saprāṇasya na tiṣṭhati| &lt;br /&gt;<br /> paittikō yadyatīsāraḥ payasā taṁ virēcayēt||58|| &lt;br /&gt;<br /> <br /> palāśaphalaniryūhaṁ payasā saha pāyayēt| &lt;br /&gt;<br /> tatō'nupāyayēt kōṣṇaṁ kṣīramēva yathābalam||59|| &lt;br /&gt;<br /> <br /> pravāhitē tēna malē praśāmyatyudarāmayaḥ| &lt;br /&gt;<br /> palāśavat prayōjyā vā trāyamāṇā viśōdhinī||60|| &lt;br /&gt;<br /> <br /> sāṁsargyāṁ kriyamāṇāyāṁ śūlaṁ yadyanuvartatē| &lt;br /&gt;<br /> srutadōṣasya taṁ śīghraṁ yathāvadanuvāsayēt||61|| &lt;br /&gt;<br /> <br /> śatapuṣpāvarībhyāṁ ca payasā madhukēna ca| &lt;br /&gt;<br /> tailapādaṁ ghr̥taṁ siddhaṁ sabilvamanuvāsanam||62|| &lt;br /&gt;<br /> <br /> pittAtisAro dIpAgneH kShipraM samupashAmyati| &lt;br /&gt;<br /> ajAkShIraprayogeNa balaM varNashca vardhate||57|| &lt;br /&gt;<br /> <br /> bahudoShasya dIptAgneH saprANasya na tiShThati| &lt;br /&gt;<br /> paittiko yadyatIsAraH payasA taM virecayet||58|| &lt;br /&gt;<br /> <br /> palAshaphalaniryUhaM payasA saha pAyayet| &lt;br /&gt;<br /> tato~anupAyayet koShNaM kShIrameva yathAbalam||59|| &lt;br /&gt;<br /> <br /> pravAhite tena male prashAmyatyudarAmayaH| &lt;br /&gt;<br /> palAshavat prayojyA vA trAyamANA vishodhinI||60|| &lt;br /&gt;<br /> <br /> sAMsargyAM kriyamANAyAM shUlaM yadyanuvartate| &lt;br /&gt;<br /> srutadoShasya taM shIghraM yathAvadanuvAsayet||61|| &lt;br /&gt;<br /> <br /> shatapuShpAvarIbhyAM ca payasA madhukena ca| &lt;br /&gt;<br /> tailapAdaM ghRutaM siddhaM sabilvamanuvAsanam||62||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> *Goat-milk administered to a patient having strong power of digestion cures [[pitta]]ja atisara and promotes strength as well as complexion.<br /> *Due to excessive aggravation of [[dosha]], if the [[pitta]]ja atisara is not cured and if the patient has strong power of digestion and vitality, then laxative therapy with milk should be given. <br /> *Decoction of the fruit of ''palasha'' along with milk should be given. Later, depending upon the strength of the patient, lukewarm milk should be given. This will restore bowel movement and control the ''atisara''. Decoction of ''trayamana'' along with milk should be given. Later, depending upon the strength of the patient lukewarm milk should be given. This will restore bowel movement and control the ''atisara''.<br /> <br /> Anuvasana [[basti]] (medicated untuous enema):<br /> <br /> *During the course of ''sansarjana-krama'' (gradual administration of light food) after purification therapy if the colic pain persists, then anuvasana [[basti]] therapy should be administered immediately because morbid matter is already eliminated. <br /> <br /> ''Satapushpadi'' ghee is advised for anuvasana [[basti]] [57-62].<br /> <br /> === Piccha [[basti]] (slimy medicated enema) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कृतानुवासनस्यास्यकृतसंसर्जनस्यच | &lt;br /&gt;<br /> वर्ततेयद्यतीसारःपिच्छाबस्तिरतःपरम् ||६३|| &lt;br /&gt;<br /> <br /> परिवेष्ट्यकुशैरार्द्रैरार्द्रवृन्तानिशाल्मलेः | &lt;br /&gt;<br /> कृष्णमृत्तिकयाऽऽलिप्यस्वेदयेद्गोमयाग्निना ||६४|| &lt;br /&gt;<br /> <br /> सुशुष्कांमृत्तिकांज्ञात्वातानिवृन्तानिशाल्मलेः | &lt;br /&gt;<br /> शृतेपयसिमृद्नीयादापोथ्योलूखलेततः ||६५|| &lt;br /&gt;<br /> <br /> पिण्डंमुष्टिसमंप्रस्थेतत्पूतंतैलसर्पिषोः | &lt;br /&gt;<br /> स्नेहितं[१]मात्रयायुक्तंकल्केनमधुकस्यच ||६६|| &lt;br /&gt;<br /> <br /> बस्तिमभ्यक्तगात्रायदद्यात्प्रत्यागतेततः | &lt;br /&gt;<br /> स्नात्वाभुञ्जीतपयसाजाङ्गलानांरसेनवा ||६७|| &lt;br /&gt;<br /> <br /> पित्तातिसारज्वरशोथगुल्मजीर्णातिसारग्रहणीप्रदोषान् | &lt;br /&gt;<br /> जयत्ययंशीघ्रमतिप्रवृद्धान्विरेचनास्थापनयोश्चबस्तिः[२] ||६८||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kr̥tānuvāsanasyāsya kr̥tasaṁsarjanasya ca| &lt;br /&gt;<br /> vartatē yadyatīsāraḥ picchābastirataḥ param||63|| &lt;br /&gt;<br /> <br /> parivēṣṭya kuśairārdrairārdravr̥ntāni śālmalēḥ| &lt;br /&gt;<br /> kr̥ṣṇamr̥ttikayā''lipya svēdayēdgōmayāgninā||64|| &lt;br /&gt;<br /> <br /> suśuṣkāṁ mr̥ttikāṁ jñātvā tāni vr̥ntāni śālmalēḥ| &lt;br /&gt;<br /> śr̥tē payasi mr̥dnīyādāpōthyōlūkhalē tataḥ||65|| &lt;br /&gt;<br /> <br /> piṇḍaṁ muṣṭisamaṁ prasthē tat pūtaṁ tailasarpiṣōḥ| &lt;br /&gt;<br /> snēhitaṁ [1] mātrayā yuktaṁ kalkēna madhukasya ca||66|| &lt;br /&gt;<br /> <br /> bastimabhyaktagātrāya dadyāt pratyāgatē tataḥ| &lt;br /&gt;<br /> snātvā bhuñjīta payasā jāṅgalānāṁ rasēna vā||67|| &lt;br /&gt;<br /> <br /> pittātisārajvaraśōthagulmajīrṇātisāragrahaṇīpradōṣān| &lt;br /&gt;<br /> jayatyayaṁ śīghramatipravr̥ddhān virēcanāsthāpanayōśca bastiḥ [2] ||68||&lt;br /&gt;<br /> <br /> kRutAnuvAsanasyAsya kRutasaMsarjanasya ca| &lt;br /&gt;<br /> vartate yadyatIsAraH picchAbastirataH param||63|| &lt;br /&gt;<br /> <br /> pariveShTya kushairArdrairArdravRuntAni shAlmaleH| &lt;br /&gt;<br /> kRuShNamRuttikayA~a~alipya svedayedgomayAgninA||64|| &lt;br /&gt;<br /> <br /> sushuShkAM mRuttikAM j~jAtvA tAni vRuntAni shAlmaleH| &lt;br /&gt;<br /> shRute payasi mRudnIyAdApothyolUkhale tataH||65|| &lt;br /&gt;<br /> <br /> piNDaM muShTisamaM prasthe tat pUtaM tailasarpiShoH| &lt;br /&gt;<br /> snehitaM [1] mAtrayA yuktaM kalkena madhukasya ca||66|| &lt;br /&gt;<br /> <br /> bastimabhyaktagAtrAya dadyAt pratyAgate tataH| &lt;br /&gt;<br /> snAtvA bhu~jjIta payasA jA~ggalAnAM rasena vA||67|| &lt;br /&gt;<br /> <br /> pittAtisArajvarashothagulmajIrNAtisAragrahaNIpradoShAn| &lt;br /&gt;<br /> jayatyayaM shIghramatipravRuddhAn virecanAsthApanayoshca bastiH [2] ||68|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If diarrhea persists in spite of the administration of anuvasana [[basti]] and observing the ''samsarjana-krama'' (gradual administration of lighter to heavier food) then piccha [[basti]] (mucilaginous type of medicated enema) should be given.<br /> <br /> Green stalks of ''shalmali'' should be covered with green ''kusha'' and tied. This bundle is then smeared with the mud of black soil and placed over cow-dung fire. After the mud is dried up, the stalks of ''shalmali'' is removed. These stalks are then triturated in a pestle and mortar. One ''mushti'' (''pala'' or handful) of this paste should be mixed with one ''prastha'' of boiled milk and filtered. In this milk, oil, ghee and paste of ''madhuka'' are added in adequate quantity. This recipe is used for the medicated enema to be given to the patient after massaging the body with oil. When the nasty material comes out, the patient should take bath and thereafter take food along with either milk or the meat soup of the wild animals. This piccha-[[basti]] (mucilaginous enema) cures ''paittika'' type of diarrhea, fever, edema, ''gulma'' (abdominal lumps), chronic diarrhea, ''grahani'' (digestive disorders) and the acute complications of purgation as well as of asthapana [[basti]] [63-68]<br /> <br /> === ''Raktatisara'' (bloody diarrhoea) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तातिसारीयस्त्वेतांक्रियांमुक्त्वानिषेवते |&lt;br /&gt;<br /> पित्तलान्यन्नपानानितस्यपित्तंमहाबलम् ||६९|| &lt;br /&gt;<br /> <br /> कुर्याद्रक्तातिसारंतुरक्तमाशुप्रदूषयेत् | &lt;br /&gt;<br /> तृष्णांशूलंविदाहंचगुदपाकंचदारुणम् ||७०||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pittātisārī yastvētāṁ kriyāṁ muktvā niṣēvatē| &lt;br /&gt;<br /> pittalānyannapānāni tasya pittaṁ mahābalam||69|| &lt;br /&gt;<br /> <br /> kuryādraktātisāraṁ tu raktamāśu pradūṣayēt| &lt;br /&gt;<br /> tr̥ṣṇāṁ śūlaṁ vidāhaṁ ca gudapākaṁ ca dāruṇam||70||&lt;br /&gt; <br /> <br /> pittAtisArI yastvetAM kriyAM muktvA niShevate| &lt;br /&gt;<br /> pittalAnyannapAnAni tasya pittaM mahAbalam||69|| &lt;br /&gt;<br /> <br /> kuryAdraktAtisAraM tu raktamAshu pradUShayet| &lt;br /&gt;<br /> tRuShNAM shUlaM vidAhaM ca gudapAkaM ca dAruNam||70||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If a [[pitta]]ja atisara patient does not follow the therapeutic measures and resorts to such foods and drinks which cause aggravation of [[pitta]], then the excessively provoked [[pitta]] causes ''raktatisara'' and instantaneous vitiation of [[rakta]] (blood). This leads to serious complications like morbid thirst, colic pain, burning sensation and suppuration of the anus. It can also manifest itself directly on account of excessive aggravation of [[pitta]] and vitiation of blood [69-70]<br /> <br /> === Treatment of ''raktatisara'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्रच्छागंपयःशस्तंशीतंसमधुशर्करम् | &lt;br /&gt;<br /> पानार्थंभोजनार्थंचगुदप्रक्षालनेतथा ||७१|| &lt;br /&gt;<br /> <br /> ओदनंरक्तशालीनांपयसातेनभोजयेत् | &lt;br /&gt;<br /> रसैःपारावतादीनांघृतभृष्टैःसशर्करैः ||७२|| &lt;br /&gt;<br /> <br /> शशपक्षिमृगाणांचशीतानांधन्वचारिणाम् | &lt;br /&gt;<br /> रसैरनम्लैःसघृतैर्भोजयेत्तंसशर्करैः ||७३|| &lt;br /&gt;<br /> <br /> रुधिरंमार्गमाजंवाघृतभृष्टंप्रशस्यते | &lt;br /&gt;<br /> काश्मर्यफलयूषोवाकिञ्चिदम्लःसशर्करः ||७४|| &lt;br /&gt;<br /> <br /> नीलोत्पलंमोचरसंसमङ्गापद्मकेशरम् | &lt;br /&gt;<br /> अजाक्षीरयुतंदद्याज्जीर्णेचपयसौदनम् ||७५|| &lt;br /&gt;<br /> <br /> दुर्बलंपाययित्वावातस्यैवोपरिभोजयेत् | &lt;br /&gt;<br /> प्राग्भक्तंनवनीतंवादद्यात्समधुशर्करम् ||७६||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra cchāgaṁ payaḥ śastaṁ śītaṁ samadhuśarkaram| &lt;br /&gt;<br /> pānārthaṁ bhōjanārthaṁ ca gudaprakṣālanē tathā||71|| &lt;br /&gt;<br /> <br /> ōdanaṁ raktaśālīnāṁ payasā tēna bhōjayēt| &lt;br /&gt;<br /> rasaiḥ pārāvatādīnāṁ ghr̥tabhr̥ṣṭaiḥ saśarkaraiḥ||72|| &lt;br /&gt;<br /> <br /> śaśapakṣimr̥gāṇāṁ ca śītānāṁ dhanvacāriṇām| &lt;br /&gt;<br /> rasairanamlaiḥ saghr̥tairbhōjayēttaṁ saśarkaraiḥ||73|| &lt;br /&gt;<br /> <br /> rudhiraṁ mārgamājaṁ vā ghr̥tabhr̥ṣṭaṁ praśasyatē| &lt;br /&gt;<br /> kāśmaryaphalayūṣō vā kiñcidamlaḥ saśarkaraḥ||74|| &lt;br /&gt;<br /> <br /> nīlōtpalaṁ mōcarasaṁ samaṅgā padmakēśaram| &lt;br /&gt;<br /> ajākṣīrayutaṁ dadyājjīrṇē ca payasaudanam||75|| &lt;br /&gt;<br /> <br /> durbalaṁ pāyayitvā vā tasyaivōpari bhōjayēt| &lt;br /&gt;<br /> prāgbhaktaṁ navanītaṁ vā dadyāt samadhuśarkaram||76|| &lt;br /&gt;<br /> <br /> tatra cchAgaM payaH shastaM shItaM samadhusharkaram| &lt;br /&gt;<br /> pAnArthaM bhojanArthaM ca gudaprakShAlane tathA||71|| &lt;br /&gt;<br /> <br /> odanaM raktashAlInAM payasA tena bhojayet| &lt;br /&gt;<br /> rasaiH pArAvatAdInAM ghRutabhRuShTaiH sasharkaraiH||72|| &lt;br /&gt;<br /> <br /> shashapakShimRugANAM ca shItAnAM dhanvacAriNAm| &lt;br /&gt;<br /> rasairanamlaiH saghRutairbhojayettaM sasharkaraiH||73||&lt;br /&gt;<br /> <br /> rudhiraM mArgamAjaM vA ghRutabhRuShTaM prashasyate| &lt;br /&gt;<br /> kAshmaryaphalayUSho vA ki~jcidamlaH sasharkaraH||74|| &lt;br /&gt;<br /> <br /> nIlotpalaM mocarasaM sama~ggA padmakesharam| &lt;br /&gt;<br /> ajAkShIrayutaM dadyAjjIrNe ca payasaudanam||75|| &lt;br /&gt;<br /> <br /> durbalaM pAyayitvA vA tasyaivopari bhojayet| &lt;br /&gt;<br /> prAgbhaktaM navanItaM vA dadyAt samadhusharkaram||76|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> For the treatment of ''raktatisara'', the following therapy should be administered:<br /> *Goat’s milk is very useful. It should be used, when cooled, with honey and sugar for drink, along with food, and for washing the anal region.<br /> *Goat’s milk along with the boiled rice of red variety of ''shali'' should be given.<br /> *The boiled rice may also be given along with the soup of the meat of ''paravata'', etc., sizzled with ghee and mixed with sugar. The soup of the meat having cooling effect like that of rabbits, birds and deer inhabiting deserts should be sizzled with ghee, mixed with sugar should be given. It may be ensured that these soups are free from any sour ingredients.<br /> *The blood of deer or goat, sizzled with ghee is also very useful.<br /> *The soup of the fruits of ''kashmarya'', made slightly sour and mixed with sugar should be given.<br /> *The powder of ''nilotpala, mocharasa, samanga'' and ''padmakeshara'' should be administered along with the goat’s milk. After the digestion of this potion, the patient should be given rice with milk. If the patient is weak, then food can be given to him even before the above mentioned potion is digested.<br /> *Butter along with honey and sugar may be given before meals [71-76].<br /> <br /> === Measures to alleviate bleeding in ''raktatisara'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्राश्यक्षीरोत्थितंसर्पिःकपिञ्जलरसाशनः | &lt;br /&gt;<br /> त्र्यहादारोग्यमाप्नोतिपयसाक्षीरभुक्तथा ||७७|| &lt;br /&gt;<br /> <br /> पीत्वाशतावरीकल्कंपयसाक्षीरभुग्जयेत् | &lt;br /&gt;<br /> रक्तातिसारंपीत्वावातयासिद्धंघृतंनरः ||७८|| &lt;br /&gt;<br /> <br /> घृतंयवागूमण्डेनकुटजस्यफलैःशृतम् | &lt;br /&gt;<br /> पेयंतस्यानुपातव्यापेयारक्तोपशान्तये ||७९||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> prāśya kṣīrōtthitaṁ sarpiḥ kapiñjalarasāśanaḥ| &lt;br /&gt;<br /> tryahādārōgyamāpnōti payasā kṣīrabhuk tathā||77|| &lt;br /&gt;<br /> <br /> pītvā śatāvarīkalkaṁ payasā kṣīrabhugjayēt| &lt;br /&gt;<br /> raktātisāraṁ pītvā vā tayā siddhaṁ ghr̥taṁ naraḥ||78|| &lt;br /&gt;<br /> <br /> ghr̥taṁ yavāgūmaṇḍēna kuṭajasya phalaiḥ śr̥tam| &lt;br /&gt;<br /> pēyaṁ tasyānu pātavyā pēyā raktōpaśāntayē||79|| &lt;br /&gt;<br /> <br /> prAshya kShIrotthitaM sarpiH kapi~jjalarasAshanaH| &lt;br /&gt;<br /> tryahAdArogyamApnoti payasA kShIrabhuk tathA||77|| &lt;br /&gt;<br /> <br /> pItvA shatAvarIkalkaM payasA kShIrabhugjayet| &lt;br /&gt;<br /> raktAtisAraM pItvA vA tayA siddhaM ghRutaM naraH||78|| &lt;br /&gt;<br /> <br /> ghRutaM yavAgUmaNDena kuTajasya phalaiH shRutam| &lt;br /&gt;<br /> peyaM tasyAnu pAtavyA peyA raktopashAntaye||79|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> *After taking ghee collected from the cream of milk along with milk, the patient should take the meat soup of ''kapinjala''. During this therapy, he should take milk in adequate quantity. It cures ''raktatisara'' in three days.<br /> *While consuming milk as food (drink), the patient should take the paste of ''shatavari'' mixed with milk. He may also take ghee boiled with the paste of ''shatavari''. <br /> *Consumption of ghee cooked by adding the paste of fruits of ''kutaja'', along with the scum (upper part) of ''yavagu'', and followed by intake of ''peya'' (thin gruel) is advised [77-79].<br /> <br /> === Treatment of ''sannipataja atisara'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्वक्चदारुहरिद्रायाःकुटजस्यफलानिच | &lt;br /&gt;<br /> पिप्पलीशृङ्गवेरंचद्राक्षाकटुकरोहिणी ||८०|| &lt;br /&gt;<br /> <br /> षड्भिरेतैर्घृतंसिद्धंपेयामण्डावचारितम् | &lt;br /&gt;<br /> अतीसारंजयेच्छीघ्रंत्रिदोषमपिदारुणम् ||८१||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tvak ca dāruharidrāyāḥ kuṭajasya phalāni ca| &lt;br /&gt;<br /> pippalī śr̥ṅgavēraṁ ca drākṣā kaṭukarōhiṇī||80|| &lt;br /&gt;<br /> <br /> ṣaḍbhirētairghr̥taṁ siddhaṁ pēyāmaṇḍāvacāritam| &lt;br /&gt;<br /> atīsāraṁ jayēcchīghraṁ tridōṣamapi dāruṇam||81|| &lt;br /&gt;<br /> <br /> tvak ca dAruharidrAyAH kuTajasya phalAni ca| &lt;br /&gt;<br /> pippalI shRu~ggaveraM ca drAkShA kaTukarohiNI||80||&lt;br /&gt;<br /> <br /> ShaDbhiretairghRutaM siddhaM peyAmaNDAvacAritam| &lt;br /&gt;<br /> atIsAraM jayecchIghraM tridoShamapi dAruNam||81|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Ghee should be cooked by adding the six drugs, viz., the bark of ''daru-haridra'', fruits of ''kutaja, pippali, shringavera, draksa'' and ''katukarohini''. Intake of ''peya'' (thin gruel) and ''manda'' (very thin gruel) along with this medicated ghee cures a serious type of diarrhea even if caused by ''sannipata'' (simultaneous aggravation of all the three [[dosha]]).[80-81]<br /> <br /> === Hemostatic recipes ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कृष्णमृन्मधुकंशङ्खंरुधिरंतण्डुलोदकम् | &lt;br /&gt;<br /> पीतमेकत्रसक्षौद्रंरक्तसङ्ग्रहणंपरम् ||८२|| &lt;br /&gt;<br /> <br /> पीतःप्रियङ्गुकाकल्कःसक्षौद्रस्तण्डुलाम्भसा | &lt;br /&gt;<br /> रक्तस्रावंजयेच्छीघ्रंधन्वमांसरसाशिनः ||८३|| &lt;br /&gt;<br /> <br /> कल्कस्तिलानांकृष्णानांशर्करापञ्चभागिकः | &lt;br /&gt;<br /> आजेनपयसापीतःसद्योरक्तंनियच्छति ||८४||&lt;br /&gt;<br /> <br /> पलंवत्सकबीजस्यश्रपयित्वारसंपिबेत् | &lt;br /&gt;<br /> योरसाशीजयेच्छीघ्रंसपैत्तंजठरामयम् ||८५|| &lt;br /&gt;<br /> <br /> पीत्वासशर्कराक्षौद्रंचन्दनंतण्डुलाम्भसा | &lt;br /&gt;<br /> दाहतृष्णाप्रमेहेभ्योरक्तस्रावाच्चमुच्यते ||८६||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kr̥ṣṇamr̥nmadhukaṁ śaṅkhaṁ rudhiraṁ taṇḍulōdakam| &lt;br /&gt;<br /> pītamēkatra sakṣaudraṁ raktasaṅgrahaṇaṁ param||82|| &lt;br /&gt;<br /> <br /> pītaḥ priyaṅgukākalkaḥ sakṣaudrastaṇḍulāmbhasā| &lt;br /&gt;<br /> raktasrāvaṁ jayēcchīghraṁ dhanvamāṁsarasāśinaḥ||83|| &lt;br /&gt;<br /> <br /> kalkastilānāṁ kr̥ṣṇānāṁ śarkarāpañcabhāgikaḥ| &lt;br /&gt;<br /> ājēna payasā pītaḥ sadyō raktaṁ niyacchati||84|| &lt;br /&gt;<br /> <br /> palaṁ vatsakabījasya śrapayitvā rasaṁ pibēt| &lt;br /&gt;<br /> yō rasāśī jayēcchīghraṁ sa paittaṁ jaṭharāmayam||85|| &lt;br /&gt;<br /> <br /> pītvā saśarkarākṣaudraṁ candanaṁ taṇḍulāmbhasā| &lt;br /&gt;<br /> dāhatr̥ṣṇāpramēhēbhyō raktasrāvācca mucyatē||86|| &lt;br /&gt;<br /> <br /> kRuShNamRunmadhukaM sha~gkhaM rudhiraM taNDulodakam| &lt;br /&gt;<br /> pItamekatra sakShaudraM raktasa~ggrahaNaM param||82|| &lt;br /&gt;<br /> <br /> pItaH priya~ggukAkalkaH sakShaudrastaNDulAmbhasA| &lt;br /&gt;<br /> raktasrAvaM jayecchIghraM dhanvamAMsarasAshinaH||83|| &lt;br /&gt;<br /> <br /> kalkastilAnAM kRuShNAnAM sharkarApa~jcabhAgikaH| &lt;br /&gt;<br /> Ajena payasA pItaH sadyo raktaM niyacchati||84|| &lt;br /&gt;<br /> <br /> palaM vatsakabIjasya shrapayitvA rasaM pibet| &lt;br /&gt;<br /> yo rasAshI jayecchIghraM sa paittaM jaTharAmayam||85|| &lt;br /&gt;<br /> <br /> pItvA sasharkarAkShaudraM candanaM taNDulAmbhasA| &lt;br /&gt;<br /> dAhatRuShNApramehebhyo raktasrAvAcca mucyate||86|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> *Intake of ''krishnamrita'' (black earth), ''madhuka, shankha, rudhira'' (blood or ''kesara'') and rice-water, mixed with honey controls bleeding instantaneously.<br /> *The paste of ''priyangu'' should be added with rice-water (''tandulambu''). Intake of this, while taking the soup of the meat of animals inhabiting arid zone, in food, controls bleeding instantaneously.<br /> *One part of the paste of the black variety of ''tila'' should be added with four parts of sugar. Intake of this potion along with the goat’s milk checks bleeding instantaneously. <br /> *Intake of the decoction of the seeds of ''vatsaka'', while taking meat-soup as food, cures [[pitta]]ja disorders of abdomen (''jathara'').<br /> *Intake of ''chandana'' along with rice-water, mixed with sugar and honey cures burning sensation, morbid thirst, ''prameha'' and bleeding [82-86].<br /> <br /> === Treatment of anal suppuration ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुदोबहुभिरुत्थानैर्यस्यपित्तेनपच्यते | &lt;br /&gt;<br /> सेचयेत्तंसुशीतेनपटोलमधुकाम्बुना ||८७|| &lt;br /&gt;<br /> <br /> पञ्चवल्कमधूकानांरसैरिक्षुरसैर्घृतैः | &lt;br /&gt;<br /> छागैर्गव्यैःपयोभिर्वाशर्कराक्षौद्रसंयुतैः ||८८||&lt;br /&gt;<br /> <br /> प्रक्षालनानांकल्कैर्वाससर्पिष्कैःप्रलेपयेत् | &lt;br /&gt;<br /> एषांवासुकृतैश्चूर्णैस्तंगुदंप्रतिसारयेत् ||८९|| &lt;br /&gt;<br /> <br /> धातकीलोध्रचूर्णैर्वासमांशैःप्रतिसारयेत् | &lt;br /&gt;<br /> तथास्रवतिनोरक्तंगुदंतैःप्रतिसारितम् ||९०|| &lt;br /&gt;<br /> <br /> पक्वताप्रशमंयातिवेदनाचोपशाम्यति | &lt;br /&gt;<br /> यथोक्तैःसेचनैःशीतैःशोणितेऽतिस्रवत्यपि ||९१|| &lt;br /&gt;<br /> <br /> गुदवङ्क्षणकट्यूरुसेचयेद्घृतभावितम् | &lt;br /&gt;<br /> चन्दनाद्येनतैलेनशतधौतेनसर्पिषा ||९२|| &lt;br /&gt;<br /> <br /> कार्पाससङ्गृहीतेनसेचयेद्गुदवङ्क्षणम् |९३| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gudō bahubhirutthānairyasya pittēna pacyatē| &lt;br /&gt;<br /> sēcayēttaṁ suśītēna paṭōlamadhukāmbunā||87|| &lt;br /&gt;<br /> <br /> pañcavalkamadhūkānāṁ rasairikṣurasairghr̥taiḥ| &lt;br /&gt;<br /> chāgairgavyaiḥ payōbhirvā śarkarākṣaudrasaṁyutaiḥ||88|| &lt;br /&gt; <br /> <br /> prakṣālanānāṁ kalkairvā sasarpiṣkaiḥ pralēpayēt| &lt;br /&gt;<br /> ēṣāṁ vā sukr̥taiścūrṇaistaṁ gudaṁ prAtisārayēt||89|| &lt;br /&gt;<br /> <br /> dhātakīlōdhracūrṇairvā samāṁśaiḥ prAtisārayēt| &lt;br /&gt;<br /> tathā sravati nō raktaṁ gudaṁ taiḥ pratisāritam||90||&lt;br /&gt;<br /> <br /> pakvatā praśamaṁ yāti vēdanā cōpaśāmyati| &lt;br /&gt;<br /> yathōktaiḥ sēcanaiḥ śītaiḥ śōṇitē'tisravatyapi||91|| &lt;br /&gt;<br /> <br /> gudavaṅkṣaṇakaṭyūru sēcayēdghr̥tabhāvitam| &lt;br /&gt;<br /> candanādyēna tailēna śatadhautēna sarpiṣā||92|| &lt;br /&gt;<br /> <br /> kārpāsasaṅgr̥hītēna sēcayēdgudavaṅkṣaṇam|93| &lt;br /&gt;<br /> <br /> gudo bahubhirutthAnairyasya pittena pacyate| &lt;br /&gt;<br /> secayettaM sushItena paTolamadhukAmbunA||87|| &lt;br /&gt;<br /> <br /> pa~jcavalkamadhUkAnAM rasairikShurasairghRutaiH| &lt;br /&gt;<br /> chAgairgavyaiH payobhirvA sharkarAkShaudrasaMyutaiH||88|| &lt;br /&gt;<br /> <br /> prakShAlanAnAM kalkairvA sasarpiShkaiH pralepayet| &lt;br /&gt;<br /> eShAM vA sukRutaishcUrNaistaM gudaM pratisArayet||89|| &lt;br /&gt;<br /> <br /> dhAtakIlodhracUrNairvA samAMshaiH pratisArayet| &lt;br /&gt;<br /> tathA sravati no raktaM gudaM taiH pratisAritam||90|| &lt;br /&gt;<br /> <br /> pakvatA prashamaM yAti vedanA copashAmyati| &lt;br /&gt;<br /> yathoktaiH secanaiH shItaiH shoNite~atisravatyapi||91|| &lt;br /&gt;<br /> <br /> gudava~gkShaNakaTyUru secayedghRutabhAvitam| &lt;br /&gt;<br /> candanAdyena tailena shatadhautena sarpiShA||92|| &lt;br /&gt;<br /> <br /> kArpAsasa~ggRuhItena secayedgudava~gkShaNam|93| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Aggravated [[pitta]] suppurates the anus due to frequent evacuation of stool. The anus of such a patient should be sprinkled and applied with the following recipes which stops bleeding and pacifies suppuration and pain.<br /> *Exceedingly cold decoction of ''patola'' and ''madhuka''<br /> *Decoction of ''pancha-valkala'' (barks of ''nyagrodha, udumbara, ashvattha, parisa'' and ''plaksha'') or sugar-cane juice. Milk or ghee of goat or cow mixed with sugar and honey. The paste of drugs mentioned above for washing (sprinkling over) the anus may be mixed with ghee and applied over the suppurated anus. The powder of the above mentioned drugs may also be used for ''pratisarana'' (dusting) over the suppurated anus.<br /> *The powder of ''dhataki'' and ''lodhra'', taken in equal quantities, may be used for dusting over the suppurated anus.<br /> *If there is excessive bleeding (from the anus), the cold decoction of the above mentioned drugs should be impregnated with ghee, and sprinkled over the anal region, pelvic region, lumbar region and thighs. <br /> *Excessive bleeding should be controlled with a cotton pad soaked with ''chandanadya-taila''[Cha.Sa. [[Chikitsa Sthana]] 3-258] or ''satadhauta-ghrita'' (ghee washed with cold water for one hundred times), and the oil or ghee; squeeze this pad over the anal and pelvic regions [87-92 ½]<br /> <br /> === Pichcha-[[basti]](mucilaginous enema) for dysentery ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अल्पाल्पंबहुशोरक्तंसशूलमुपवेश्यते ||९३|| &lt;br /&gt;<br /> <br /> यदावायुर्विबद्धश्चकृच्छ्रंचरतिवानवा | &lt;br /&gt;<br /> पिञ्छाबस्तिंतदातस्ययथोक्तमुपकल्पयेत् ||९४|| &lt;br /&gt;<br /> <br /> प्रपौण्डरीकसिद्धेनसर्पिषाचानुवासयेत् | &lt;br /&gt;<br /> प्रायशोदुर्बलगुदाश्चिरकालातिसारिणः ||९५|| &lt;br /&gt;<br /> <br /> तस्मादभीक्ष्णशस्तेषांगुदेस्नेहंप्रयोजयेत् |९६| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> alpālpaṁ bahuśō raktaṁ saśūlamupavēśyatē||93|| &lt;br /&gt;<br /> <br /> yadā vāyurvibaddhaśca kr̥cchraṁ carati vā na vā| &lt;br /&gt;<br /> picchābastiṁ tadā tasya yathōktamupakalpayēt||94|| &lt;br /&gt;<br /> <br /> prapauṇḍarīkasiddhēna sarpiṣā cānuvāsayēt| &lt;br /&gt;<br /> prāyaśō durbalagudāścirakālātisāriṇaḥ||95|| &lt;br /&gt;<br /> <br /> tasmādabhīkṣṇaśastēṣāṁ gudē snēhaṁ prayōjayēt|96| &lt;br /&gt;<br /> <br /> alpAlpaM bahusho raktaM sashUlamupaveshyate||93|| &lt;br /&gt;<br /> <br /> yadA vAyurvibaddhashca kRucchraM carati vA na vA| &lt;br /&gt;<br /> picchAbastiM tadA tasya yathoktamupakalpayet||94|| &lt;br /&gt;<br /> <br /> prapauNDarIkasiddhena sarpiShA cAnuvAsayet| &lt;br /&gt;<br /> prAyasho durbalagudAshcirakAlAtisAriNaH||95|| &lt;br /&gt;<br /> <br /> tasmAdabhIkShNashasteShAM gude snehaM prayojayet|96| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When the movement of the aggravated vata (flatus) gets obstructed or moves with difficulty or seizing of [[vata]] inside the abdomen, then the patient voids blood frequently in small quantities which is associated with pain. Piccha-[[basti]] should be administered to such patients. This type of patient may also be managed by anuvasana [[basti]] given with medicated ghee prepared with ''prapaundarika''. Because of chronic diarrhea, the anus of the patient generally becomes weak. Therefore cotton soaked in medicated ghee should be inserted into the anus frequently or anuvasana [[basti]] with medicated ghee is given [93-95½ ].<br /> <br /> === Medicated enema and recipes of linctus ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पवनोऽतिप्रवृत्तोहिस्वेस्थानेलभतेऽधिकम् ||९६|| &lt;br /&gt;<br /> <br /> बलंतस्यसपित्तस्यजयार्थेबस्तिरुत्तमः | &lt;br /&gt;<br /> रक्तंविट्सहितंपूर्वंपश्चाद्वायोऽतिसार्यते ||९७|| &lt;br /&gt;<br /> <br /> शतावरीघृतंतस्यलेहार्थमुपकल्पयेत् | &lt;br /&gt;<br /> शर्करार्धांशिकंलीढंनवनीतंनवोद्धृतम् ||९८|| &lt;br /&gt;<br /> <br /> क्षौद्रपादंजयेच्छीघ्रंतंविकारंहिताशिनः | &lt;br /&gt;<br /> न्यग्रोधोदुम्बराश्वत्थशुङ्गानापोथ्यवासयेत् ||९९|| &lt;br /&gt;<br /> <br /> अहोरात्रंजलेतप्तेघृतंतेनाम्भसापचेत् | &lt;br /&gt;<br /> तदर्धशर्करायुक्तंलिह्यात्सक्षौद्रपादिकम् ||१००|| &lt;br /&gt;<br /> <br /> अधोवायदिवाऽप्यूर्ध्वंयस्यरक्तंप्रवर्तते |१०१| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pavanō'tipravr̥ttō hi svē sthānē labhatē'dhikam||96|| &lt;br /&gt;<br /> <br /> balaṁ tasya sapittasya jayārthē bastiruttamaḥ| &lt;br /&gt;<br /> raktaṁ viṭsahitaṁ pūrvaṁ paścādvā yō'tisāryatē||97|| &lt;br /&gt;<br /> <br /> śatāvarīghr̥taṁ tasya lēhārthamupakalpayēt| &lt;br /&gt;<br /> śarkarārdhāṁśikaṁ līḍhaṁ navanītaṁ navōddhr̥tam||98|| &lt;br /&gt;<br /> <br /> kṣaudrapādaṁ jayēcchīghraṁ taṁ vikāraṁ hitāśinaḥ| &lt;br /&gt;<br /> nyagrōdhōdumbarāśvatthaśuṅgānāpōthya vāsayēt||99|| &lt;br /&gt;<br /> <br /> ahōrātraṁ jalē taptē ghr̥taṁ tēnāmbhasā pacēt| &lt;br /&gt;<br /> tadardhaśarkarāyuktaṁ lihyāt sakṣaudrapādikam||100|| &lt;br /&gt;<br /> <br /> adhō vā yadi vā'pyūrdhvaṁ yasya raktaṁ pravartatē|101| &lt;br /&gt;<br /> <br /> pavano~atipravRutto hi sve sthAne labhate~adhikam||96|| &lt;br /&gt;<br /> <br /> balaM tasya sapittasya jayArthe bastiruttamaH| &lt;br /&gt;<br /> raktaM viTsahitaM pUrvaM pashcAdvA yo~atisAryate||97|| &lt;br /&gt;<br /> <br /> shatAvarIghRutaM tasya lehArthamupakalpayet| &lt;br /&gt;<br /> sharkarArdhAMshikaM lIDhaM navanItaM navoddhRutam||98|| &lt;br /&gt;<br /> <br /> kShaudrapAdaM jayecchIghraM taM vikAraM hitAshinaH| &lt;br /&gt;<br /> nyagrodhodumbarAshvatthashu~ggAnApothya vAsayet||99|| &lt;br /&gt;<br /> <br /> ahorAtraM jale tapte ghRutaM tenAmbhasA pacet| &lt;br /&gt;<br /> tadardhasharkarAyuktaM lihyAt sakShaudrapAdikam||100|| &lt;br /&gt;<br /> <br /> adho vA yadi vA~apyUrdhvaM yasya raktaM pravartate|101| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> *The aggravated vata becomes stronger in its own site in ''atisara'' patients. For the pacification of aggravated [[vata]] associated with [[pitta]] (which takes place in bloody diarrhea), [[basti]] (both the ''anuvasana'' and ''niruha'' types) is the best therapy.<br /> *If bleeding takes place before evacuating the stool or after evacuation of stool (i.e., a case of ''raktatisara''), then ''shatavari-ghrita'' [Cha.Sa. [[Chikitsa Sthana]] 30/64-69] in the form of linctus should be given.<br /> *Intake of freshly collected butter along with half the quantity of sugar and one fourth quantity of honey cures the above mentioned ailments. While taking this potion, the patient should take wholesome food. Adventitious roots of ''nyagrodha, udumbara'' and ''ashvattha'' should be crushed and kept soaked in hot water for twenty four hours. Ghee should be cooked along with this water. This medicated ghee should be added with half the quantity of sugar and one fourth in quantity of honey, and taken in the form of linctus. It cures ''raktatisara'', associated with bleeding either before or after the passing of stool [96-100½]<br /> <br /> === Suppuration of anal sphincters ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यस्त्वेवंदुर्बलोमोहात्पित्तलान्येवसेवते ||१०१|| &lt;br /&gt;<br /> <br /> दारुणंसवलीपाकंप्राप्यशीघ्रंविपद्यते |१०२|&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yastvēvaṁ durbalō mōhāt pittalānyēva sēvatē||101|| &lt;br /&gt;<br /> <br /> dāruṇaṁ sa valīpākaṁ prāpya śīghraṁ vipadyatē|102| &lt;br /&gt;<br /> <br /> yastvevaM durbalo mohAt pittalAnyeva sevate||101|| &lt;br /&gt;<br /> <br /> dAruNaM sa valIpAkaM prApya shIghraM vipadyate|102| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A patient who has become weak because of ''raktatisara'', if indulges in [[pitta]]-aggravating ingredients out of ignorance, then the anal sphincters gets suppurated. This is a serious condition leading to instantaneous death [101½].<br /> <br /> === Treatment of [[kapha]]ja atisara ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> श्लेष्मातिसारेप्रथमंहितंलङ्घनपाचनम् ||१०२|| &lt;br /&gt;<br /> <br /> योज्यश्चामातिसारघ्नोयथोक्तोदीपनोगणः | &lt;br /&gt;<br /> लङ्घितस्यानुपूर्व्यांचकृतायांननिवर्तते ||१०३|| &lt;br /&gt;<br /> <br /> कफजोयद्यतीसारःकफघ्नैस्तमुपाचरेत् | &lt;br /&gt; <br /> बिल्वंकर्कटिकामुस्तमभयाविश्वभेषजम् ||१०४|| &lt;br /&gt;<br /> <br /> वचाविडङ्गंभूतीकंधान्यकंदेवदारुच | &lt;br /&gt;<br /> कुष्ठंसातिविषापाठाचव्यंकटुकरोहिणी ||१०५|| &lt;br /&gt;<br /> <br /> पिप्पलीपिप्पलीमूलंचित्रकंहस्तिपिप्पली | &lt;br /&gt;<br /> योगाञ्छ्लोकार्धविहितांश्चतुरस्तान्प्रयोजयेत् ||१०६|| &lt;br /&gt;<br /> <br /> शृताञ्छ्लेष्मातिसारेषुकायाग्निबलवर्धनान् | &lt;br /&gt;<br /> अजाजीमसितांपाठांनागरंमरिचानिच ||१०७|| &lt;br /&gt;<br /> <br /> धातकीद्विगुणंदद्यान्मातुलुङ्गरसाप्लुतम् | &lt;br /&gt;<br /> रसाञ्जनंसातिविषंकुटजस्यफलानिच ||१०८|| &lt;br /&gt;<br /> <br /> धातकीद्विगुणंदद्यात्पातुंसक्षौद्रनागरम् | &lt;br /&gt;<br /> धातकीनागरंबिल्वंलोध्रंपद्मस्यकेशरम् ||१०९|| &lt;br /&gt;<br /> <br /> जम्बूत्वङ्नागरंधान्यंपाठामोचरसोबला | &lt;br /&gt;<br /> समङ्गाधातकीबिल्वमध्यंजम्ब्वाम्रयोस्त्वचः ||११०|| &lt;br /&gt;<br /> <br /> कपित्थानिविडङ्गानिनागरंमरिचानिच | &lt;br /&gt;<br /> चाङ्गेरीकोलतक्राम्लांश्चतुरस्तान्कफोत्तरे ||१११|| &lt;br /&gt;<br /> <br /> श्लोकार्धविहितान्दद्यात्सस्नेहलवणान्खडान् | &lt;br /&gt;<br /> कपित्थमध्यंलीढ्वातुसव्योषक्षौद्रशर्करम् ||११२|| &lt;br /&gt;<br /> <br /> कट्फलंमधुयुक्तंवामुच्यतेजठरामयात् |११३| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ślēṣmātisārē prathamaṁ hitaṁ laṅghanapācanam||102|| &lt;br /&gt;<br /> <br /> yōjyaścāmātisāraghnō yathōktō dīpanō gaṇaḥ| &lt;br /&gt;<br /> laṅghitasyānupūrvyāṁ ca kr̥tāyāṁ na nivartatē||103|| &lt;br /&gt;<br /> <br /> kaphajō yadyatīsāraḥ kaphaghnaistamupācarēt &lt;br /&gt;<br /> bilvaṁ karkaṭikā mustamabhayā viśvabhēṣajam||104|| &lt;br /&gt;<br /> <br /> vacā viḍaṅgaṁ bhūtīkaṁ dhānyakaṁ dēvadāru ca| &lt;br /&gt;<br /> kuṣṭhaṁ sātiviṣā pāṭhā cavyaṁ kaṭukarōhiṇī||105|| &lt;br /&gt;<br /> <br /> pippalī pippalīmūlaṁ citrakaṁ hastipippalī| &lt;br /&gt;<br /> yōgāñchlōkārdhavihitāṁścaturastān prayōjayēt||106|| &lt;br /&gt;<br /> <br /> śr̥tāñchlēṣmātisārēṣu kāyāgnibalavardhanān| &lt;br /&gt;<br /> ajājīmasitāṁ pāṭhāṁ nāgaraṁ maricāni ca||107|| &lt;br /&gt;<br /> <br /> dhātakīdviguṇaṁ dadyānmātuluṅgarasāplutam| &lt;br /&gt;<br /> rasāñjanaṁ sātiviṣaṁ kuṭajasya phalāni ca||108|| &lt;br /&gt;<br /> <br /> dhātakīdviguṇaṁ dadyāt pātuṁ sakṣaudranāgaram| &lt;br /&gt;<br /> dhātakī nāgaraṁ bilvaṁ lōdhraṁ padmasya kēśaram||109|| &lt;br /&gt;<br /> <br /> jambūtvaṅnāgaraṁ dhānyaṁ pāṭhā mōcarasō balā| &lt;br /&gt;<br /> samaṅgā dhātakī bilvamadhyaṁ jambvāmrayōstvacaḥ||110|| &lt;br /&gt;<br /> <br /> kapitthāni viḍaṅgāni nāgaraṁ maricāni ca| &lt;br /&gt;<br /> cāṅgērīkōlatakrāmlāṁścaturastān kaphōttarē||111|| &lt;br /&gt;<br /> <br /> ślōkārdhavihitān dadyāt sasnēhalavaṇān khaḍān| &lt;br /&gt;<br /> kapitthamadhyaṁ līḍhvā tu savyōṣakṣaudraśarkaram||112|| &lt;br /&gt;<br /> <br /> kaṭphalaṁ madhuyuktaṁ vā mucyatē jaṭharāmayāt|113| &lt;br /&gt;<br /> <br /> shleShmAtisAre prathamaM hitaM la~gghanapAcanam||102|| &lt;br /&gt;<br /> <br /> yojyashcAmAtisAraghno yathokto dIpano gaNaH| &lt;br /&gt;<br /> la~gghitasyAnupUrvyAM ca kRutAyAM na nivartate||103|| &lt;br /&gt;<br /> <br /> kaphajo yadyatIsAraH kaphaghnaistamupAcaret|104| &lt;br /&gt;<br /> <br /> bilvaM karkaTikA mustamabhayA vishvabheShajam||104|| &lt;br /&gt;<br /> <br /> vacA viDa~ggaM bhUtIkaM dhAnyakaM devadAru ca| &lt;br /&gt;<br /> kuShThaM sAtiviShA pAThA cavyaM kaTukarohiNI||105|| &lt;br /&gt;<br /> <br /> pippalI pippalImUlaM citrakaM hastipippalI| &lt;br /&gt;<br /> yogA~jchlokArdhavihitAMshcaturastAn prayojayet||106|| &lt;br /&gt;<br /> <br /> shRutA~jchleShmAtisAreShu kAyAgnibalavardhanAn| &lt;br /&gt;<br /> ajAjImasitAM pAThAM nAgaraM maricAni ca||107|| &lt;br /&gt;<br /> <br /> dhAtakIdviguNaM dadyAnmAtulu~ggarasAplutam| &lt;br /&gt;<br /> rasA~jjanaM sAtiviShaM kuTajasya phalAni ca||108|| &lt;br /&gt;<br /> <br /> dhAtakIdviguNaM dadyAt pAtuM sakShaudranAgaram| &lt;br /&gt;<br /> dhAtakI nAgaraM bilvaM lodhraM padmasya kesharam||109|| &lt;br /&gt;<br /> <br /> jambUtva~gnAgaraM dhAnyaM pAThA mocaraso balA| &lt;br /&gt;<br /> sama~ggA dhAtakI bilvamadhyaM jambvAmrayostvacaH||110|| &lt;br /&gt;<br /> <br /> kapitthAni viDa~ggAni nAgaraM maricAni ca| &lt;br /&gt;<br /> cA~ggerIkolatakrAmlAMshcaturastAn kaphottare||111|| &lt;br /&gt;<br /> <br /> shlokArdhavihitAn dadyAt sasnehalavaNAn khaDAn| &lt;br /&gt;<br /> kapitthamadhyaM lIDhvA tu savyoShakShaudrasharkaram||112|| &lt;br /&gt;<br /> <br /> kaTphalaM madhuyuktaM vA mucyate jaTharAmayAt|113| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> For the cure of [[kapha]]ja atisara, following therapy and recipes should be administered:<br /> *Fasting ([[langhana]]) and carminative ([[pachana]]) therapies should be administered in the beginning. <br /> *The group of drugs which stimulates the power of digestion ([[dipana]]-gana) which is prescribed for the treatment of ''ama-atisara'' should be given.<br /> *If the [[kapha]]ja atisara persists even after the administration of the above mentioned measures, then the patient should be given [[kapha]] alleviating therapies.<br /> *The following four decoctions cure [[kapha]]ja atisara as well as promotes ''kayagni'' (power of digestion and metabolism)<br /> **Decoction of ''bilva, karkatika, musta, abhaya'' and ''vishva-bheshaja''(''shunthi'')<br /> **Decoction of ''vacha, vidanga, bhutika, dhanyaka'' and ''devadaru''<br /> **Decoction of ''kushtha, ativisha, pātha, chavya'' and ''katukarohini''<br /> **Decoction of ''pippali, pippali-mula, chitraka'' and ''gajapippali''<br /> *Administration of the recipe containing one part each of black variety of ''ajaji, pachana, nagara'' and ''maricha'' and two parts of ''dhataki'' along with profuse quantity of lime juice.<br /> *One part each of ''rasanjana, ativisha'' and fruits of ''kutaja'', and two parts of ''dhataki'' should be added with honey and ginger. This potion should be given to drink.<br /> *For the treatment of [[kapha]]ja atisara, the following four recipes should be given in the form of ''khada'' (a type of sour drink which stimulates the power of digestion). ''Dhataki, nagara, bilva, lodhra'' and ''padmakesara''; bark of ''jambu, nagara, dhanya, patha, mocha-rasa'' and ''bala''; ''samanga, dhataki,'' pulp of ''bilva'' and the bark of ''jambu'' and ''amra''; and ''kapittha, vidanga, nagara'' and ''maricha''.<br /> <br /> The above mentioned recipes should be added with the sour juice of ''changeri'' and ''kola'' and butter-milk and given to the patient after adding ghee and salt.<br /> <br /> *Intake of the pulp of ''kapittha'' along with ''shunthi, pippali, maricha,'' honey and sugar, or ''katphala'' along with honey cures diseases of digestive system (''jathara'').<br /> *Intake of ''pippali'' along with honey, or butter-milk added with the powder of ''chitraka'' or the powder of the tender fruits of ''bilva'' cures diseases of digestive system [102-112½].<br /> <br /> === Management of complications of ''atisara'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कणांमधुयुतांपीत्वातक्रंपीत्वासचित्रकम् ||११३|| &lt;br /&gt;<br /> <br /> जग्ध्वावाबालबिल्वानिमुच्यतेजठरामयात् | &lt;br /&gt;<br /> बालबिल्वंगुडंतैलंपिप्पलींविश्वभेषजम् | &lt;br /&gt;<br /> लिह्याद्वातेप्रतिहतेसशूलःसप्रवाहिकः ||११४|| &lt;br /&gt;<br /> <br /> भोज्यंमूलकषायेणवातघ्नैश्चोपसेवनैः | &lt;br /&gt;<br /> वातातिसारविहितैर्यूषैर्मांसरसैःखडैः ||११५|| &lt;br /&gt;<br /> <br /> पूर्वोक्तमम्लसर्पिर्वाषट्पलंवायथाबलम् | &lt;br /&gt;<br /> पुराणंवाघृतंदद्याद्यवागूमण्डमिश्रितम् ||११६||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṇāṁ madhuyutāṁ pītvā takraṁ pītvā sacitrakam||113|| &lt;br /&gt;<br /> <br /> jagdhvā vā bālabilvāni mucyatē jaṭharāmayāt| &lt;br /&gt;<br /> bālabilvaṁ guḍaṁ tailaṁ pippalīṁ viśvabhēṣajam| &lt;br /&gt;<br /> lihyādvātē pratihatē saśūlaḥ sapravāhikaḥ||114|| &lt;br /&gt;<br /> <br /> bhōjyaṁ mūlakaṣāyēṇa vātaghnaiścōpasēvanaiḥ| &lt;br /&gt;<br /> vātātisāravihitairyūṣairmāṁsarasaiḥ khaḍaiḥ||115|| &lt;br /&gt;<br /> <br /> pūrvōktamamlasarpirvā ṣaṭpalaṁ vā yathābalam| &lt;br /&gt;<br /> purāṇaṁ vā ghr̥taṁ dadyādyavāgūmaṇḍamiśritam||116|| &lt;br /&gt;<br /> <br /> kaNAM madhuyutAM pItvA takraM pItvA sacitrakam||113|| &lt;br /&gt;<br /> <br /> jagdhvA vA bAlabilvAni mucyate jaTharAmayAt| &lt;br /&gt;<br /> bAlabilvaM guDaM tailaM pippalIM vishvabheShajam| &lt;br /&gt;<br /> lihyAdvAte pratihate sashUlaH sapravAhikaH||114|| &lt;br /&gt;<br /> <br /> bhojyaM mUlakaShAyeNa vAtaghnaishcopasevanaiH| &lt;br /&gt;<br /> vAtAtisAravihitairyUShairmAMsarasaiH khaDaiH||115|| &lt;br /&gt;<br /> <br /> pUrvoktamamlasarpirvA ShaTpalaM vA yathAbalam| &lt;br /&gt;<br /> purANaM vA ghRutaM dadyAdyavAgUmaNDamishritam||116|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> *If the movement of vata (flatus) is obstructed resulting in colic pain and dysentery, then the patient should be given tender fruits of ''bilva'', jaggery, oil, ''pippali'' and ''shunthi''.<br /> *Diet prepared with [[vata]] alleviating ingredients along with the vegetable soup, meat soup and ''khada'' (a type of sour drink) described under [[vata]]ja atisara should be given. <br /> *Sour medicated ghee like ''changeri ghrita'' or ''shatpala ghrita'' [Cha.Sa. [[Chikitsa Sthana]] 5/ 147-148 ] or (ten years) old ghee mixed with ''yavagu'' (thick gruel) and ''manda'' (thin gruel) should be given [113-116].<br /> <br /> === Piccha-[[basti]] and anuvasana-[[basti]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वातश्लेष्मविबन्धेवाकफेवाऽतिस्रवत्यपि | &lt;br /&gt;<br /> शूलेप्रवाहिकायांवापिच्छाबस्तिंप्रयोजयेत् ||११७|| &lt;br /&gt;<br /> <br /> पिप्पलीबिल्वकुष्ठानांशताह्वावचयोरपि | &lt;br /&gt;<br /> कल्कैःसलवणैर्युक्तंपूर्वोक्तंसन्निधापयेत् ||११८|| &lt;br /&gt;<br /> <br /> प्रत्यागतेसुखंस्नातंकृताहारंदिनात्यये | &lt;br /&gt;<br /> बिल्वतैलेनमतिमान्सुखोष्णेनानुवासयेत् ||११९|| &lt;br /&gt;<br /> <br /> वचान्तैरथवाकल्कैस्तैलंपक्त्वाऽनुवासयेत् | &lt;br /&gt;<br /> बहुशःकफवातार्तस्तथासलभतेसुखम् ||१२०||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vātaślēṣmavibandhē vā kaphē vā'tisravatyapi| &lt;br /&gt;<br /> śūlē pravāhikāyāṁ vā picchābastiṁ prayōjayēt||117|| &lt;br /&gt;<br /> <br /> pippalībilvakuṣṭhānāṁ śatāhvāvacayōrapi| &lt;br /&gt;<br /> kalkaiḥ salavaṇairyuktaṁ pūrvōktaṁ sannidhāpayēt||118|| &lt;br /&gt;<br /> <br /> pratyāgatē sukhaṁ snātaṁ kr̥tāhāraṁ dinātyayē| &lt;br /&gt;<br /> bilvatailēna matimānsukhōṣṇēnānuvāsayēt||119|| &lt;br /&gt;<br /> <br /> vacāntairathavā kalkaistailaṁ paktvā'nuvāsayēt| &lt;br /&gt;<br /> bahuśaḥ kaphavātārtastathā sa labhatē sukham||120||&lt;br /&gt;<br /> <br /> vAtashleShmavibandhe vA kaphe vA~atisravatyapi| &lt;br /&gt;<br /> shUle pravAhikAyAM vA picchAbastiM prayojayet||117|| &lt;br /&gt;<br /> <br /> pippalIbilvakuShThAnAM shatAhvAvacayorapi| &lt;br /&gt;<br /> kalkaiH salavaNairyuktaM pUrvoktaM sannidhApayet||118|| &lt;br /&gt;<br /> <br /> pratyAgate sukhaM snAtaM kRutAhAraM dinAtyaye| &lt;br /&gt;<br /> bilvatailena matimAnsukhoShNenAnuvAsayet||119|| &lt;br /&gt;<br /> <br /> vacAntairathavA kalkaistailaM paktvA~anuvAsayet| &lt;br /&gt;<br /> bahushaH kaphavAtArtastathA sa labhate sukham||120|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> For the cure of [[kapha]]ja and [[vata]]ja-predominant ''atisara'', the following therapy and recipes should be administered:<br /> *If [[vata]] and [[kapha]] are obstructed in the ''mahasrotas'', if there is excessive evacuation of [[kapha]] (mucus) and if there is colic pain as well as dysentery, then piccha-[[basti]] (mucilaginous enema) should be administered. <br /> *Piccha-[[basti]] should be prepared of the paste of ''pippali, bilva, kustha, shatahva'' and ''vacha'' by adding salt.<br /> *Patient feels comfortable after the ingredients of pichcha-[[basti]] come out of the rectum and then patient should be advised to take bath followed by intake of food. Anuvasana [[basti]] with lukewarm oil of ''bilva'' [Cha.Sa.[[Siddhi Sthana]] 4/ 4-7] should be given in the afternoon.The anuvasana [[basti]] can also be given frequently with the oil cooked with the paste of ''pippali, bilva, kushtha, shatahva'' and ''vacha'' [117-120].<br /> <br /> === Need for immediate control of [[vata]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्वेस्थानेमारुतोऽवश्यंवर्धतेकफसङ्क्षये | &lt;br /&gt;<br /> सवृद्धःसहसाहन्यात्तस्मात्तंत्वरयाजयेत् ||१२१||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> svē sthānē mārutō'vaśyaṁ vardhatē kaphasaṅkṣayē| &lt;br /&gt;<br /> sa vr̥ddhaḥ sahasā hanyāttasmāttaṁ tvarayā jayēt||121||&lt;br /&gt;<br /> <br /> sve sthAne mAruto~avashyaM vardhate kaphasa~gkShaye| &lt;br /&gt;<br /> sa vRuddhaH sahasA hanyAttasmAttaM tvarayA jayet||121|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When [[kapha]] gets reduced because of the above mentioned therapeutic measures, the [[vata]] undoubtedly gets aggravated in its own location (colon). This aggravated [[vata]] may cause instantaneous death and hence should be controlled without delay [121]<br /> <br /> === Principle of treatment of ''sannipataja atisara'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वातस्यानुजयेत्पित्तं, पित्तस्यानुजयेत्कफम् | &lt;br /&gt;<br /> त्रयाणांवाजयेत्पूर्वंयोभवेद्बलवत्तमः ||१२२||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vātasyānu jayēt pittaṁ, pittasyānu jayēt kapham| &lt;br /&gt;<br /> trayāṇāṁ vā jayēt pūrvaṁ yō bhavēdbalavattamaḥ||122|| &lt;br /&gt;<br /> <br /> vAtasyAnu jayet pittaM, pittasyAnu jayet kapham| &lt;br /&gt;<br /> trayANAM vA jayet pUrvaM yo bhavedbalavattamaH||122|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> For the cure of ''sannipataja atisara,'' following therapy and recipes should be administered: <br /> *The aggravated [[vata]] should be pacified first followed by the alleviation of the aggravated [[pitta]] followed by alleviation of [[kapha]].<br /> *Alternatively, the most aggravated one should be controlled first followed by the treatment of the remaining two [[dosha]] [122].<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्रश्लोकः- <br /> <br /> प्रागुत्पत्तिनिमित्तानिलक्षणंसाध्यतानच | &lt;br /&gt;<br /> क्रियाचावस्थिकीसिद्धानिर्दिष्टाह्यतिसारिणाम् ||१२३||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkaḥ- <br /> <br /> prāgutpattinimittāni lakṣaṇaṁ sādhyatā na ca| &lt;br /&gt;<br /> kriyā cāvasthikī siddhā nirdiṣṭā hyatisāriṇām||123||&lt;br /&gt;<br /> <br /> tatra shlokaH- <br /> <br /> prAgutpattinimittAni lakShaNaM sAdhyatA na ca| &lt;br /&gt;<br /> kriyA cAvasthikI siddhA nirdiShTA hyatisAriNAm||123||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In this chapter, the following topics in respect of the patient suffering from ''atisara'' (diarrhea) are described:<br /> *Historical origin of ''atisara''<br /> *Etiology of different types of ''atisara''<br /> *Signs and symptoms of ''atisara''<br /> *Curability and incurability of ''atisara''<br /> *Effective treatment for different stages of ''atisara'' [123].<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृतेतन्त्रेचरकप्रतिसंस्कृतेचिकित्सास्थानेऽतिसारचिकित्सितंनामैकोनविंशोऽध्यायः ||१९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē cikitsāsthānē'tisāracikitsitaṁ nāmaikōnaviṁśō'dhyāyaḥ||19|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus, ends the nineteenth chapter of [[Chikitsa Sthana]] (section on the treatment of diseases) dealing with the treatment of ''atisara'' (diarrhea) in the work of Agnivesha as redacted by Charak [19]<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *''Atisara'' is caused by intake of heavy to digest, excessively hot and food that is incompatible to the body, impairment of [[agni]] and mind. The body reacts to expel out the incompatible material out of gut in the form of ''atisara''. <br /> *There are five categories of etio-pathological factors for ''atisara'':<br /> #Reduced [[agni]], <br /> #Vitiated [[vata]] and its sub types ''samana'' and ''apana''. <br /> #Vitiated body fluids. <br /> #Vitiated ''purishavaha srotas'' (lower gastro-intestinal tract) and organs of excretion. <br /> #Fear and grief (mental).<br /> *Interaction of [[Prakriti]] (basic constitution) and the diet and lifestyle of similar properties (as that of [[dosha]] [[Prakriti]]) makes the person susceptible for ''atisara''. <br /> *The exogenous factors like consumption of intoxicating beverages, exposure to '''krimi''' (bacteria and parasites), other diseases like ''shosha, jwara, arsha'' influence all the above factors and three [[dosha]] to cause ''sannipatik atisara'' (diarrhea) which includes bloody diarrhea.<br /> *If spicy, hot, dry food in large quantity is ingested when [[agni]] is low, undigested food becomes waste product and samana [[vata]] sends it to excretory channels where ''apana vayu'' increases the motility of ''purishavaha srotas'' to excretes these large waste products, frequently. <br /> *To fill this vacuum created by expulsion of wastes, the body fluids shift to the gut and get expelled out as ''atisara''/diarrhea causing dehydration.Thus after involvement of ''purishavaha srotasa'' ( lower GIT), ''udakavaha srotasa'' (body fluids) is also predominantly involved in pathogenesis of ''atisara''. <br /> *Fear and grief are two important mental factors leading to ''atisara''. The presentation and treatment of this ''atisara'' is similar to [[vata]] dominant ''atisara''. The fear shall be treated with ''harshana''(exhilaration) treatment and grief shall be treated with ''ashwasana'' (consolation) therapy. <br /> *The endogenous ''atisara'' shall be treated after proper assessment of dominant [[dosha]], causative factors and pacifying factors, <br /> *At the initial stage of ''atisara'' when undigested food is being expelled, ''stambhan'' (anti diarrheal treatment) is strictly contraindicated. If ''stambhana'' is given, it leads to various complications. Mild laxatives like ''haritaki'' shall be administered for evacuating the [[mala]] (accumulated undigested wastes). [[Deepana]] and [[pachana]] (stimulation of [[agni]] for digestion and metabolism) should be given with light nutritive liquid foods. After restoration of [[agni]], [[stambhana]] is given and care should taken to keep [[vata]] balanced.<br /> *In case of prolapse of rectum, medicated ghee processed with sour herbs or ''anuvasana'' (unctuous enema) is prescribed. <br /> *Various states of ''atisara'' like that mixed with mucous, blood, associated with colic pain shall be treated with pichcha [[basti]] (mucilaginous enema). <br /> *When [[kapha]] gets reduced because of the above mentioned therapeutic measures, the [[vata]] is aggravated in its own location (colon). This aggravated [[vata]] must be immediately treated as it may cause instantaneous death.<br /> *In case of ''sannipataja atisara'', at first the aggravated [[vata]] shall be pacified followed by [[pitta]] and [[kapha]]. Alternatively, the most aggravated one should be controlled first followed by the treatment of the remaining two [[dosha]].<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> <br /> The disease ''atisara'' resembles the clinical condition of diarrhea and is defined as the passage of frequent, liquid stools (usually of more than 200 g of stool) daily. In the most severe instances of ''atisara'', incontinence is a commonly observed symptom. Diarrhea, among adults, could broadly be categorized as sudden onset(acute), or chronic diarrhea that could last for 14 days or more.<br /> <br /> === Acute (sudden onset) diarrhea ===<br /> <br /> This is most common variant and in over 90% of cases is infectious, caused due to ingestion of contaminated food or water. Other causes may include drug induced especially antibiotics, diverticulitis, ischemia, radiation enterocholitis, food allergies or initial presentation of various gastrointestinal diseases.<br /> <br /> === Chronic (or relapsing) diarrhea &lt;ref&gt;Patient Education: Chronic Diarrhea among adults, UptoDate<br /> (https://www.uptodate.com/contents/chronic-diarrhea-in-adults-beyond-the-basics?topicRef=4021&amp;source=see_link)<br /> &lt;/ref&gt; === <br /> Defined as loose stools (occurring three or more times a day) that last for weeks. A most common variant is the Irritable Bowel Syndrome (IBS). Chronic diarrhea could be a symptom of an inflammatory bowel disease like Crohn's Disease, ulcerative colitis, malabsorption syndrome, metabolic or endocrine disorders, food allergies, laxative abuse, neoplasm, or reaction to certain medications.<br /> <br /> Careful assessment of the patient's medical history, physical examination, CBC, electrolytes, stool and urine examination are initial tests advised to help assess the underlying causes. Further specialised investigations may be needed depending upon the condition of patient.<br /> <br /> === Pathophysiological factors of endogenous diarrhea ===<br /> <br /> * [[Dosha]]: [[Vata]] dominant three [[dosha]] <br /> * [[Dhatu]] (vitiated factors): Udaka (body fluid), [[Rasa dhatu]] <br /> * [[Mala]] kriya affected: [[Purisha]] (defecation) <br /> * Status of [[agni]]: Manda (poor) <br /> * Origin of disease: Pakwashaya (large intestine) <br /> * Sites of vitiation: large intestine <br /> * Sites of clinical presentation: rectum and anus <br /> * Srotasa involved: Purishavaha srotasa and udakavaha srotasa <br /> * Type of samprapti: atipravritti (excess discharge)<br /> <br /> === Management protocol of endogenous diarrhea ===<br /> <br /> ==== Assessment of strength of patient ====<br /> <br /> Excess dehydration in case of diarrhea can lead to serious complications. Hence the strength of the patient should be assessed first for severity of dehydration. This helps to design treatment protocol. Vital parameters including pulse rate, its volume, blood pressure, heart rate shall be examined. <br /> <br /> ==== Subjective and objective parameters ====<br /> <br /> Frequency of bowel more than three times a day with stool weight less than 200 grams with more watery content are considered as diarrhea. The quantity is less in [[vata]] dominance, medium in [[pitta]] dominance and more in [[kapha]] dominant. Frequency is more in [[vata]] dominance, medium in [[pitta]] dominance and less in [[kapha]] dominance. The consistency of stool also differs according to [[dosha]] dominance as described in the text.[[Purisha]] pariksha (stool examination) is researched further in view of frequency, consistency, smell, its specific gravity in water to determine the ''ama'' and ''nirama'' status of [[purisha]].<br /> [[File:Atisara.png]]<br /> <br /> === Prevention of ''atisara'' ===<br /> ==== ''Atisara'' can be prevented by following measures ====<br /> #Avoiding causative factors <br /> #Strengthening [[agni]] (digestive processes) by following dietary rules<br /> #Observing body purification treatments as per [[Prakriti]] and season<br /> <br /> ==== Current clinical management in [[Ayurveda]] practice ====<br /> *'''Principles of treatment''': [[deepana]], grahi, [[pachana]], buttermilk <br /> *'''Main drugs''': ''kutaja, ahiphena, bhanga, bhallataka, bilva''<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| Type<br /> ! scope=&quot;col&quot;| Formulation<br /> ! scope=&quot;col&quot;| Dose<br /> ! scope=&quot;col&quot;| Time<br /> ! scope=&quot;col&quot;| ''Anupana''<br /> |-<br /> | rowspan=&quot;2&quot;|[[Vata]] and [[kapha]] dominant<br /> | ''Jatiphaladi–bhallataka guti'' <br /> | 60-120 mg<br /> | Before meals, two times<br /> | Buttermilk<br /> |-<br /> | ''Sanjivani vati'' <br /> | 60-250 mg<br /> | Before meals<br /> | Buttermilk<br /> |-<br /> |[[Pitta]] and [[kapha]] dominant<br /> | ''Kutaja kalpa'' <br /> | 60-120 mg<br /> | Before meals, two times<br /> | Ricewater with Buttermilk<br /> |-<br /> |[[Rakta]]ja<br /> | ''Shatavaryadi kwatha'' <br /> | 25-40 ml<br /> | Empty stomach<br /> | ''-''<br /> |-<br /> |rowspan = &quot;3&quot;|''Pravahika''(dysentry)<br /> | ''Isabgola'' seeds (cold effusion with sugar) <br /> | 5-10 ml<br /> | Morning and night, two times<br /> | ''-''<br /> |-<br /> | ''Ahiphena kalpa'' <br /> | 125-250 mg<br /> | Morning and night, two times<br /> | ''kutajavaleha''<br /> |-<br /> | ''Kutaja parpati'' <br /> | 250-1000 mg<br /> | Empty stomach<br /> | Honey<br /> |-<br /> |rowspan = &quot;3&quot;|Chronic<br /> | ''Dhanya panchaka churna'' <br /> | 10-25 mg<br /> | Between meals<br /> | ''Bilvavaleha''<br /> |-<br /> | ''Shatpala ghee'' <br /> | 10-25 ml<br /> | Before meals<br /> | Buttermilk or hot water<br /> |-<br /> | ''Bilwadi tailam'' <br /> | 10-25 grams<br /> | Before meals<br /> | Buttermilk<br /> |}<br /> <br /> ==== Researches on ''atisara'' and medicines ====<br /> A combination of ''musta'' (cyperus rotundus), ''ativisha'' (aconitum heterophyllum), ''kutaja'' (holarrhena antidysenterica), ''chitraka'' (plumbago zeylanica) and ''bilva'' (Aegle marmelos) was found effective in management of ''atisara''.&lt;ref&gt;Sridhar B.N., Gopakumar K., Jaya N. Mustadi yoga-A new preparation for treatment of atisara. Aryavaidyan,10(4).May-July 1997;222-225. &lt;/ref&gt; <br /> <br /> ''Kutaja'' is widely used and first preferred drug in management of ''atisara''. It is mainly indicated in conditions of vitiated [[kapha]]-[[pitta]] and as a ''sangrahi'' (styptic) and ''shoshana'' (absorbent)(Charak sutra 25/40). In an in-vitro study, sterile double dilution aqueous extract of ''kutaja'' was found effective to inhibit growth of E. coli, staphylococcus aureus, salmonella Typhi.&lt;ref&gt;Shrivastava Niraj, Saxena Varsha. Antibacterial activity of Kutaja(Holarrhena antidysenterica Linn.) in childhood diarrhea:-In vitro study. The Pharma Innovation Journal 2015;4(4):97-99 .&lt;/ref&gt; Thus ''kutaja'' can be used for all purpose in management of ''atisara''. <br /> <br /> Nitin Salve and Debendranath Mishra studied the botanical identification of plants described in text Madhava chikitsa for the treatment of diarrhea.&lt;ref&gt;Nitin Salve, Debendranath Mishra. Botanical identification of plants described in text Madhava chikitsa for the treatment of diarrhoea. Anc Sci Life.2016 Apr-Jun:35(4):195-200 &lt;/ref&gt; <br /> <br /> The conditions like ulcerative colitis, irritable bowel syndrome, acute diarrhea are considered under the umbrella of ''atisara''.<br /> <br /> In a study on 43 patients of ulcerative colitis, Patel M.V.et.al observed 80% reduction in signs and symptoms of ulcerative colitis by Ayurvedic treatment. The treatment included ''udumbara kwatha'' combination of ''lodhra, musta, nagakeshara,mukta panchamrita rasa, kutaja ghana vati'' and udumbara kwatha [[basti]]. It also highlighted disease modifying effect and reduction in use of steroidal drugs in the patients. &lt;ref&gt;Patel M.V.,Patel K.B., Gupta S.N. Effects of Ayurvedic treatment on forty three patients of ulcerative colitis. AYU,Oct-Dec 2010,31(4), 478-481.&lt;/ref&gt; <br /> <br /> A study found that a combination of ''nagarmotha'' (Cyperus rotundus L.), ''indrayava'' (Holarrhena antidysenterica (L.) Wall.), ''nagakeshara'' (Mesua ferrea L.), ''madhuyashti'' (Glycyrrhiza glabra L.), and ''amalaki'' (Emblica officinalis Gaertn.) powders, along with ''dadimashtaka choorna, shankha bhasma, mustarista'' and ''dhanyapanchaka kvatha'' showed significant response in case of ''pravahika'' (irritable bowel syndrome). &lt;ref&gt;Pooja BA, Bhatted S. Ayurvedic management of Pravahika – A case report. Ayu 2015;36:410-2. &lt;/ref&gt; <br /> <br /> In another study, ''bilwadileha'' showed significant relief in management of irritable bowel syndrome. &lt;ref&gt;Tiwari R, Pandya DH, Baghel MS. Clinical evaluation of Bilvadileha in the management of irritable bowel syndrome. AYU [serial online] 2013 [cited 2018 Jun 12];34:368-72. Available from: http://www.ayujournal.org/text.asp?2013/34/4/368/127717&lt;/ref&gt; <br /> <br /> In a study, ''vatasakadi'' syrup was observed 70 % effective in treatment of ''atisara'' in children as compared to ''bala-chaturbhadra'' syrup.&lt;ref&gt;Shah Kiran. A Comparative Study of Vatsakadi Syrup &amp; Balachaturbhadra Syrup in Management Balatisara with reference to Diarrhea, Int. J. Ayu. Alt. Med., 2014; 2(1):28-33.&lt;/ref&gt;<br /> <br /> === Management of exogenous diarrhea/''atisara'' ===<br /> <br /> #Diarrhea due to mental factors: These patients need counseling along with therapeutic management of diarrhea as discussed above.<br /> #Infectious diarrhea or bacterial food poisoning: The practitioner/physician should proceed with the treatment of the disease with information obtained from the history, stool examination, and evaluation of dehydration severity.<br /> #Watery diarrhea usually indicates a defect in water absorption. However, there are other categories of watery diarrhea caused due to the dysregulation of intestinal function, endocrine dysfunction (including hypothyroidism), tumors (by obstructing bowel). Another category of watery diarrhea is idiopathic secretory diarrhea. These categories largely are termed chronic inflammatory diarrhea. Based on the result of examining the patient’s history thoroughly, the physician should prescribe a course of treatment as well as dietary regimen.&lt;ref&gt;Schiller Lawrence, Sellin Joseph, Pardi Darrell, Chronic Diarrhea:Diagnosis and Management, Clinical Gastroenterology and Hepatology, 2017, 15:182-193&lt;/ref&gt; <br /> #Fatty diarrhea, like watery diarrhea, indicates poor absorption of fat and other nutrients<br /> #Dysentery (passage of bloody stools) or fever (&gt;37.8°C) should be treated with antibacterial drugs<br /> #Vomiting, minimal diarrhea should be treated with Bismuth subsalicylate. <br /> #Diarrhea in infants (&lt;2 years old) should be treated with fluids and electrolytes (oral rehydration solution, pedialyte, lytren); continue feeding, especially with breast milk; seek medical attention for moderate dehydration, fever lasting &gt;24 h, bloody stools, or diarrhea lasting more than several days.<br /> <br /> '''Note'''<br /> <br /> Loperamide should not be used by patients with fever or dysentery because its use may prolong diarrhea in patients with infection due to Shigella or other invasive organisms.<br /> <br /> === Important guidelines and precautions for diarrhea management ===<br /> <br /> The World Health Organization , beginning 2002, recommended a “reduced osmolarity/reduced-salt” Oral Rehydration Solution (ORS) to adequately rehydrate the patient, which is key to treating any case of diarrhea.&lt;ref&gt;WHO Press Release, 8 May 2002, http://www.who.int/mediacentre/news/releases/release35/en/&lt;/ref&gt; The Centers for Disease Control and Prevention (CDC) considers rehydration as “the cornerstone of treatment of cholera”.&lt;ref&gt;https://www.cdc.gov/cholera/treatment/rehydration-therapy.html&lt;/ref&gt; CDC also recommends other treatment alternatives, based on recent studies in Bangladesh and other areas affected by cholera, such as zinc treatment.&lt;ref&gt;https://www.cdc.gov/cholera/treatment/zinc-treatment.html&lt;/ref&gt; Severe cases need to take a recourse of antibiotics, though there are instances of resistance to tetracycline and other antimicrobial agents .&lt;ref&gt; https://www.cdc.gov/cholera/treatment/antibiotic-treatment.html&lt;/ref&gt;<br /> <br /> === List of research on review of ''atisara'' ===<br /> <br /> #Uikey R, Kar AC. A review on Purisha Pariksha in [[Ayurveda]]. AYU [serial online] 2015 [cited 2018 Jun 12];36:125-9. Available from: http://www.ayujournal.org/text.asp?2015/36/2/125/175536<br /> #Patil Dhiraj, Babel Sadhana, Chitte Sanjay. Atisaar (Diarrhea): A Review based on [[Ayurveda]] and modern perspective. WJPMR, 2017,3(7), 227-229 available from http://www.wjpmr.com/ downloaded on 12/06/2018 <br /> #S Durgalakshmi, Pious Uthara Anu, Ajantha. An Overview on Nidana Panchaka of Atisara (Diarrhea). IAMJ: Volume 3(8); August. 2015 available from http://www.iamj.in/current_issue/images/upload/2419_2425.pdf downloaded on 12/06/2018<br /> <br /> === Research Areas ===<br /> <br /> *Though there are many anti-diarrheal and ant-dysentery medicines are available in conventional systems of medicine, the immediate stoppage of diarrhoea may lead to complications as mentioned in the text. Therefore a survey study is needed to examine the prevalence of such complications caused by stoppage of diarrhea.<br /> *The rehydrating effect of ''pramathya'' (decoctions), ''peya'' (liquid gruel), sour processing media like ''dadima, changeri,'' buttermilk used in the treatment of ''atisara'' need to be investigated further. <br /> *More researches are needed to study effect of [[Ayurveda]] medicines in chronic diarrhea and psycho somatic disease like irritable bowel syndrome.<br /> <br /> <br /> === Further reading ===<br /> <br /> #Charak Samhita (700 BC) with English Translation and Critical exposition (Volume IV). Sharma R.K. and Dash B., Chaukhambha Sanskrit Series Office, Varanasi.pages-202-242<br /> #Valiathan, M.S. (2009): Legacy of Charak, Sushruta, Vagbhata, Orient Longman, Chennai.<br /> #Sushruta. Sushruta Samhita. Volume III, Uttarasthana, translated by Prof. K.R. Srikatha Murthy, Varanasi, Chaukhambha Orientalia; 2005.p.223-250.<br /> #Parameswarappa’s ĀyurvedÍya Vikriti Vijñāna and Roga Vijñāna by Dr. P.S. Byadgi. Volume II, pages-431-446<br /> #Davidson’s Principles of practice of medicine, 21th Ed. (2007) Ed. by Nicholas A. Boon., Nicki R. College, Brain R. Walker, Pub. Churchill Livingstone Elsevier, London Elsevier. Pages-302-304<br /> #Harrison’s principles of internal medicine 17th Ed. (2008) Ed. by Fauci Kasper D.L., A.S., Longo D.L., Braunwal Eugene, Hauser S.J., Jameson J.L.. Joseph Loscalzo., Pub. MacGraw-Hill USA, Chapter 128. Acute Infectious Diarrheal Diseases and Bacterial Food Poisoning <br /> #Harrison’s principles of internal medicine 17th Ed. (2008) Ed. by Fauci Kasper D.L., A.S., Longo D.L., Braunwal Eugene, Hauser S.J., Jameson J.L.. Joseph Loscalzo., Pub. MacGraw-Hill USA, Vol.-2, Chapter 338.<br /> &lt;/div&gt;<br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References ==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Rajas&diff=45385 2025-11-11T15:58:43Z

<p>Agnivesha: /* Relation between food and rajas guna */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Rajas<br /> |titlemode=append<br /> |keywords=Rajas in ayurveda, Rajas meaning, Rajas, Charak Samhita, Bhojani M.K., Jain Rahul, Joglekar Aishwarya, Basisht G., Deole Y.S., rajas guna, rajas dominance, rajasika, hyperactivity, disorders in mental health, charak samhita online, indian systems of medicine<br /> |description=The term 'rajas' literally means the active quality of mind.<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term 'rajas' literally means the active quality of [[Manas|mind]]. It is among the [[Triguna|triguna]](three fundamental qualities). [A.S. [[Sutra Sthana|Sutra Sthana]] 1/29] It is characterized by enthusiasm, activity, and interest. Intellectual constitution, bio categorization, or body-[[Manas|mind]] categorization is a fundamental concept in [[Ayurveda|ayurveda]]. Every individual has unique physical, physiological, and psychological attributes. [[Ayurveda|Ayurveda]] provides a structure to help understand an individual's mental composition. The differences among the individuals can be easily understood by understanding the concept of [[Sharira|sharira]] and [[Manas prakriti|manas prakriti]] (somatic and psychic composition). The concept of the [[Manas|manas]] in [[Ayurveda|ayurveda]] includes details of psychology, [[Manas|mind]], and mental [[Health|health]]. Characteristics of [[Manas|mana (mind)]] are three in number viz. [[Sattva|sattva]], rajas, and [[Tamas|tamas]]. These three represent consciousness, activity, and inertia, respectively. When any one of these three is found dominant in an individual, that reflects the individual's nature. In [https://en.wikipedia.org/wiki/Bhagavad_Gita Shreemad bhagwat Geeta], three character qualities or the [[Triguna|triguna]] are described in detail. [[Sattva|Sattva]], rajas, and [[Tamas|tamas]] are described as [[Triguna|triguna]] of [[Prakriti|prakriti]]&lt;ref name=&quot;ref1&quot;&gt;A. C. Bhaktivedanta Swami Prabhupāda, 1972. Bhagavad-gītā as it is. Bhaktivedanta Book Trust, New York &lt;/ref&gt; <br /> # [[Sattva|Sattva guna]] is the trait of intelligence or light, which is the trait of complete stability.<br /> # Rajas [[Guna|guna]] represents action, motion or ignorance. <br /> # [[Tamas|Tamas guna]] represents inactivity and darkness.<br /> These three initial characteristics work in unison, forming all the substances in this universe. Rajas [[Guna|guna]] is responsible for the activity of any object in the universe[Su.Sa.[[Sharira Sthana]]1/9] and Sankhya ideology. It represents action, creation, and passion. Hence it is one of the attributes of the [[Manas|mind]].[Chakrapani on Cha.Sa. [[Sutra Sthana]] 1/57] [Cha.Sa. [[Sutra Sthana]] 8/5] &lt;br/&gt;This article describes the concept of rajas [[Guna|guna]] and its importance in healthcare practices. &lt;/p&gt;<br /> {{Infobox <br /> |title = Contributors <br /> |label1 = Section/Chapter <br /> |data1 = Concepts / [[Rajas]] <br /> |label2 = Authors <br /> |data2 = Bhojani M.K.&lt;sup&gt;1&lt;/sup&gt;, &lt;br/&gt;Jain Rahul&lt;sup&gt;1&lt;/sup&gt;, &lt;br/&gt;Joglekar Aishwarya &lt;sup&gt;2&lt;/sup&gt; <br /> |label3 = Reviewer <br /> |data3 = [[Gopal Basisht|Basisht G.]]&lt;sup&gt;3&lt;/sup&gt; <br /> |label4 = Editor <br /> |data4 = [[Yogesh Deole|Deole Y.S.]]&lt;sup&gt;4&lt;/sup&gt; <br /> |label5 = Affiliations <br /> |data5 = &lt;sup&gt;1&lt;/sup&gt; Department of Kriya Sharira, A.I.I.A. , New Delhi, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt; Department of Samhita Siddhanta, D. Y. Patil college of Ayurved and research centre, Pune, India &lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A. &lt;br/&gt;&lt;sup&gt;4&lt;/sup&gt; Department of Kayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabhvidya Nagar, Anand, Gujarat, India <br /> |label6 = Correspondence email <br /> |data6 = meera.samhita@aiia.gov.in, &lt;br/&gt;carakasamhita@gmail.com <br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India <br /> |label8 = Date of publication: <br /> |data8 = March 02, 2023 <br /> |label9 = DOI <br /> |data9= {{DoiWithLink}} <br /> }}<br /> == Synonyms ==<br /> &lt;p style='text-align:justify;'&gt;Shabdakalpadruma mentions multiple synonyms of the term 'raja' such as action, mutation, excitement. Some other meaning of the word rajas in other contexts are paraga (pollens), strikusuma (menstrual blood), dhuli(dust) etc., change, creation, generation, and passion.&lt;ref name=&quot;ref2&quot;&gt;Radhakantadeva, Vasu, V., &amp; VASU, H.Śabdakalpadrumah ,(1886)Page No. 83, Available from https://www.sanskritlexicon.unikoeln.de/scans/cslapidev/servepdf.php?dict=skd&amp;page=4-083 &lt;/ref&gt; In the present context, rajas as [[Guna|guna]] of [[Prakriti|prakriti]] (as mentioned in Sankhya Philosophy and Bhagwadgeeta) and [[Manas|mana]] (according to [[Ayurveda|ayurveda]]) is considered. &lt;/p&gt;<br /> <br /> == Etymology ==<br /> &lt;p style='text-align:justify;'&gt;The word rajas is acquired from two terms, 'ranja' (means to be attached or devoted to) and 'asunnalopah' (something), rajas is bound with the sansara, it refers to attachments, desires, greed and who doesn't have satisfaction in [[Ayu|life]].&lt;ref name=&quot;ref3&quot;&gt;Radhakantadeva, Vasu, V., &amp; VASU, H.Śabdakalpadrumah ,(1886)Page No. 83, Available fromhttps://www.sanskritlexicon.unikoeln.de/scans/cslapidev/servepdf.php?dict=skd&amp;page=4-083 &lt;/ref&gt; &lt;br/&gt;Rajas [[Guna|guna]] is the quality representing activity, variability and urgency, second of the three [[Guna|guna]]. [Monnier Williams dictionary]&lt;ref name=&quot;ref4&quot;&gt;Monier-Williams, M. Page No.828 , (1872), Available from https://www.sanskrit-lexicon.uni-koeln.de/scans/csl-apidev/servepdf.php?dict=mw72&amp;page=0828 &lt;/ref&gt; &lt;/p&gt;<br /> <br /> == Characteristics ==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Rajas [[Guna|guna]] is chala (mobile), upasthambaka (supporting/encouraging), pravrittikara in nature (explained in detail on the part of the philosophical aspect of rajas [[Guna|guna]]) [Sankhyakarika]&lt;ref name=&quot;ref5&quot;&gt;Ishwarkrishna, Sankhyakarika with Abhinavarajlakshmi Bhashya by Gaudapada and hindi translation by Sitaramshashtri and Prof. Balashashta,Sankhyakarika number 12-13 , printed 2019 , Chaukhambha Surbharati Prakashana , Varanasi , Page No.52-55 &lt;/ref&gt;<br /> * Rajas dominant individuals are bound with [[Dosha|doshas]], active, greedy, rosha amsha (anger/wrath) [Cha.Sa.[[Sharira Sthana]] 4/36].<br /> * Rajas dominant individuals have qualities such as cunningness, unhappiness (dukkha), selfishness, cruelty, self-appraisal, anger, and desirousness. [Su.Sa.Sharira Sthana 1/18]<br /> * Ashtanga Sangraha has considered [[Sattva|sattva]], rajas, [[Tamas|tamas as]] mahaguna. [A.S. Sutra Sthana 1/29]&lt;/p&gt;<br /> <br /> == Description of rajas dominance in Shreemad Bhagavad Geeta ==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Rajas dominant individuals are bound with samsara (the indefinitely repeated cycles of birth, misery and death), attachments, desires, and greed and don't have [[Ayu|life]] satisfaction. [Shreemadbhagwat Geeta, Gunatraya vibhaga Yoga, 14/7-17] &lt;br/&gt;Following are the characters of rajas [[Guna|guna]]: <br /> # Ragatmaka: leads to attachment to material happiness and sexual urges <br /> # Trishna samudbhava: derived from excessive desire and ambition<br /> # Karmasangena badhnati jeevam: binds the soul through attachment to actions<br /> # Lobha: greediness <br /> # Pravritti: excess involvement<br /> # Arambha: commencement of different karma or actions <br /> # Karmanamashama spruha: Excessively driven towards<br /> # Dukkha: cause of sorrow and unhappiness &lt;/p&gt;<br /> <br /> == Rajas guna and [[panchamahabhuta]] relations ==<br /> &lt;p style='text-align:justify;'&gt;[[Vayu mahabhuta|Vayu mahabhuta]] is dominant in rajas [[Guna|guna]], with chalatva (movement) as common quality. [[Agni mahabhuta|Agni mahabhuta]] is dominant in [[Sattva|sattva]] and rajas [[Guna|guna]]. They have common qualities like prakashatva (illumination) and chalatva (movement).[Su.Sa. Sharira Sthana 1/20], [Dalhana on Su.Sa. Sharira Sthana 1/20] Thus, it can be stated that the [[Dravya|dravya]] with [[Vayu mahabhuta|vayu]] and [[agni mahabhuta]] constitution dominate rajas [[Guna|guna]]. &lt;/p&gt;<br /> <br /> == Rajas and [[vata dosha]] ==<br /> &lt;p style='text-align:justify;'&gt;[[Vata dosha]] is dominant in rajas guna (rajas bahula). [Su.Sa. [[Nidana Sthana]] 1/8] Sharangadhara has also termed the [[vata dosha]] to be rajas guna dominant.&lt;ref name=&quot;ref6&quot;&gt;Sharangdhar, Sharangdhar Samhita with English translation by Dr Srikantha Murthy, Kalidakakhyana Shariram Adhyaya,5/26, Prathama Khanda,Sixth Edition, 2006, Chaukhambha orientalia, Varanasi, Page No. 23 &lt;/ref&gt; &lt;/p&gt;<br /> <br /> == Relation between food and rajas guna ==<br /> &lt;p style='text-align:justify;'&gt;The Bhagwat Geeta mentions different types of diet preferred by individuals of sattvika, rajasika, and tamasika constitution.[Shreemadbhagwat Geeta, Gunatraya vibhaga Yoga, 14th Chapter] The individuals with rajasika constitution are fond of food with [[Katu|pungent (katu)]], [[Amla|sour]], [[Lavana|salty]], and hot. This food is tikshna (sharp, pungent), excessively dry (ruksha), and causes a burning sensation in abdomen and gastrointestinal tract (vidahinah).These foods can cause mental suffering (dukkha, shoka) and affliction with different [[Vyadhi|diseases]] (amayam). Thus, the rajas dominance can be determined by the type of food he prefers to eat. &lt;/p&gt;<br /> <br /> == [[Manas prakriti]] and types of rajasika constitution ==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The predominance of a particular [[Guna|guna]] in [[Manas|mind]] impacts the psychological constitution. This becomes the predominant [[Manas prakriti|manas prakriti]] or psychic trait of the person.[Cha. Sa. [[Sutra Sthana|Sutra Sthana]] 8/5-6] Three types namely sattvika, rajasika and tamasika based on the predominance of particular [[Guna|guna]] are described.[Cha.Sa. [[Sharira Sthana]] 3/13] The rajasika constitution develops due to &quot;roshansha&quot; or dominance of anger, hyperactivity and negative emotions. It is broadly classified into six sub-types as follows: <br /> &lt;ol&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Asura (traits resembling negative personalities): &lt;span style=&quot;font-weight:normal&quot;&gt;This type of people are brave (shura), cruel (chanda), jealous of others (asuyaka), having prosperity (aishvaryavat), deceitful (aupadhika), having terrifying personality (rudra), merciless (ananukrosha), selfish/ self-indulged (atmapujaka) in nature. [Cha. Sa. [[Sharira Sthana|Sharira Sthana]] 4] &lt;/span&gt;&lt;/li&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Rakshasa (traits resembling extra human characteristics): &lt;span style=&quot;font-weight:normal&quot;&gt;This type of person are intolerant (amarshina), show anger most of the time (anubandha kopa), aggressive or violent (chhidraharin), cruel (krura), fondness towards food (ahara atimatraruchi), love eating meat (amishapriyatama), excessive sleep (swapnabahula), hard worker (ayasabahula), jealous (irshyu) in nature. [Cha. Sa. [[Sharira Sthana|Sharira Sthana]] 4] &lt;/span&gt;&lt;/li&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Paishacha (traits like a dead body): &lt;span style=&quot;font-weight:normal&quot;&gt;This individual consumes excess food (mahashana), fond of female attention (straina), love company of female (strirahaskama), have unrestricted food intake (mahashana),have unclean habits (ashuchi), don't bother about cleanliness (shuchidveshina),cowardly (bhiru), makes others frightful or intimidate others (bhishayitram), have unusual diet and lifestyle in comparison to others (vikrita vihara ahara shila), in nature. [Cha. Sa. [[Sharira Sthana|Sharira Sthana]] 4] &lt;/span&gt;&lt;/li&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Sarpa (traits like snake): &lt;span style=&quot;font-weight:normal&quot;&gt;This type of people are fearless when they are angry (kruddhasura), frightful when not angry (akruddhabhiru),hard workers (ayasabahula), very sharp in activities (tikshna),always lives in fear (santrasra gochara),loves eating food and activities (ahara vihara para), in nature. [Cha. Sa. [[Sharira Sthana|Sharira Sthana]] 4] &lt;/span&gt;&lt;/li&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Praita (traits like a dead body): &lt;span style=&quot;font-weight:normal&quot;&gt;This type of people love eating food a lot (aharakama),always in suffering (atidukhashil acharopachara), jealous of other people (asuyaka),have no discrimination in behavior (asamvibhagina), very greedy(atilolupa),don't like to perform any work (akarmasila) in nature. [Cha. Sa. [[Sharira Sthana|Sharira Sthana]] 4] &lt;/span&gt;&lt;/li&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Shakuna (traits of bird): &lt;span style=&quot;font-weight:normal&quot;&gt;This type of person shows devotion for passion (anushaktakama), overindulge in food and activities (ajastramaharaviharapara), unstable conduct (anavasthitatva),very intolerant (amarshana), not interested in acquiring things(asamcaya), in nature. [Cha. Sa. [[Sharira Sthana|Sharira Sthana]] 4] &lt;/span&gt;&lt;/li&gt;&lt;/ol&gt; <br /> Vagbhata states that rajasika individuals are characterized by bahubhashitva (excessive talkativeness), [[Manas|mana]](excessive ego), krodha(anger), dambha (rebelness), matsar (dvesha). [A.H.Sharira Sthana 3/7] &lt;br/&gt;The difference observed in an individual's activities is due to karma (previous deeds of the person).[Cha. Sa. [[Sharira Sthana]] 2/36] &lt;br/&gt;Kashyapa has described seven types of rajasika or krodhaja sattva, where the yaksha sattva is additionally mentioned.&lt;ref name=&quot;ref7&quot;&gt;Kashyapa. Kashyapa Samhita. Edited by P. V. Tewari. Reprint. Varanasi: Chaukhambha vishvabharati;2008. &lt;/ref&gt; [Ka.Sa. Sutra Sthana 28/24] The features of rajasika sattva, as explained by kashyapa are stated as below: <br /> # Engaged in charity (dananityata) <br /> # Excessive sleep (atishayana) <br /> # Loves wearing ornaments (alankarapriyatva) <br /> # Excess intake of food and drinks (atipanabhojana) <br /> # Excess indulgence in sexual activity (atimaithuna) <br /> # Loves eating (prabhakshana) <br /> # Excessive greed (nityopetampramuditam) <br /> &lt;/p&gt;<br /> == Relation between [[triguna]] and [[nidra]] ==<br /> {| class=&quot;wikitable&quot;<br /> ! Guna<br /> ! Nidra<br /> ! Rationale<br /> |-<br /> | [[Sattva|Sattva]]<br /> | Mid-night <br /> | Alertness of [[Manas|mind]] <br /> |-<br /> | Rajas<br /> | Day or night <br /> | Flickering (chanchala) <br /> |-<br /> | [[Tamas|Tamas]]<br /> | Day and night <br /> | Excess [[Kapha dosha|kapha]]([[Avarana|avarana]]) <br /> |-<br /> |}<br /> &lt;p style='text-align:justify;'&gt;[[Tamas|Tamas guna]] is the leading cause of sleep, [[Sattva|sattva guna]] is the cause of awakening, and rajas [[Guna|guna]] is the cause of the manifestation of dreams or a hyperactive [[Manas|mind]]. Rajas guna is responsible for the occurrence of [[Swapna|dreams (swapna)]] in an individual, with either good or bad consequences.[Su.Sa. Sharira Sthana 4/36] &lt;/p&gt;<br /> <br /> == Relation between prana and rajas guna ==<br /> &lt;p style='text-align:justify;'&gt;[[Sattva|Sattva]], rajas, and [[Tamas|tamas]] are listed among twelve vital entities in [[Sharira|body]] (dwadashaprana). [Su.Sa. Sharira Sthana 4/3] &lt;/p&gt;<br /> <br /> == Assessment of rajas guna ==<br /> &lt;p style='text-align:justify;'&gt;Rajas [[Guna|guna]] is assessed by means of inference from [[Anumana pramana|anumana pramana]]. It can be assessed by the presence of sanga (attachment) to different situations or individuals.[Cha.Sa. [[Vimana Sthana]] 4/8] It is inferred as excessive sexual indulgence and other pleasures.[Chakrapani on Cha.Sa. [[Vimana Sthana]] 4/8] The excessive expressions of feelings of desire in an individual can be related to rajas [[Guna|guna]]. &lt;/p&gt;<br /> <br /> == Importance in prevention of diseases/ maintenance of health ==<br /> &lt;p style='text-align:justify;'&gt;The dominance of rajas [[Guna|guna]] has an impact on the psyche of an individual. The individual with rajas dominant psyche needs stimulation or motivation from others to cope with the circumstances.[Su.Sa. Sutra Sthana 35/38] Hence the rajas dominant individuals are termed as those with mediocre mental strength (madhyama manobala). [Dalhana on Su.Sa. Sutra Sthana 35/38] Hence, like the [[Sharira|sharira]] [[Prakriti|prakriti]] (somatic constitution), the [[Manas prakriti|manas prakriti]] (psychological constitution) also plays a vital role in determining an individual's characteristics contributing to a person's mental [[Health|health]] status. [[Manas prakriti|Manas prakriti]] is termed as [[Guna|guna]] [[Prakriti|prakriti]] or maha prakriti. [Su.Sa. Sharira Sthana 4/98-99] The assessment of rajas [[Guna|guna]] dominance in an individual can help understand the psychological status and susceptibility to mental [[Health|health]] disorders. &lt;br/&gt;Rajas [[Guna|guna]] is also a determinant of vitality seated in the [[Marma|marma]] or vital points of the [[Sharira|body]].[Su.Sa. Sharira Sthana 6/35] Thus, the normalcy of rajas is essential in properly functioning the vital [[Sharira|body]] organs. &lt;br/&gt;An individual devoid of rajas and [[Tamas|tamas]], is called 'apta' or one with authoritative and authentic knowledge. [Cha.Sa. [[Sutra Sthana|Sutra Sthana]] 11/18-19] Excess of rajas [[Guna|guna]] can lead to biasedness or altered knowledge in an individual. One who is vigilant towards maintaining [[Health|health]] and consuming a beneficial diet is termed 'parikshaka'. When he is afflicted with rajas [[Guna|guna]] falls prey to various [[Vyadhi|diseases]]. A wholesome diet and lifestyle is advised considering the status of three [[Guna|guna]]. [A.S. [[Sutra Sthana|Sutra Sthana]] 3/30] If not followed, the rajas-[[Tamas|tamas]] originated [[Vyadhi|diseases]] occur in such individuals due to intellectual defects ([[Prajnaparadha|prajnaparadha]]). [Cha.Sa.[[Sutra Sthana|Sutra Sthana]] 28/36-38] &lt;br/&gt;Rajasika individuals tend to consume alcohol more frequently depending on mental strength and can reach the advanced states of excessive intoxication, alcohol dependency, and addiction more quickly than the sattvika individuals. Hence, one must consider the mental strength and type of alcohol (madya) before consumption.[Cha. Sa. [[Chikitsa Sthana]] 24/68-69, 79] &lt;br/&gt;Thus, the balance of [[Triguna|triguna]] especially rajas [[Guna|guna]], should be considered for maintaining mental [[Health|health]] and avoiding psychological and psychosomatic disorders. &lt;/p&gt;<br /> <br /> == Importance in diagnosis and occurrence of diseases ==<br /> &lt;p style='text-align:justify;'&gt;Rajas and [[Tamas|tamas guna]] are termed as the [[Manas|manas]] [[Dosha|dosha]]. They are responsible for the occurrence of various mental disorders.[Cha.Sa. [[Sutra Sthana|Sutra Sthana]] 1/57, 25/11, Cha.Sa. [[Vimana Sthana]] 6/6, A.H. Sutra Sthana 1/21, Dalhana on Su.Sa. Sutra Sthana 1/4] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;The disorders are of two types: rajas dominant and [[tamas]] dominant. [Cha.Sa. [[Nidana Sthana]] 1/4] The flickering nature of rajas [[guna]] makes it responsible for initiating pathogenesis and stimulating [[tamas]] in the manifestation of [[Vyadhi|disease]]. It is thus termed an initiator (pravartaka). [[Tamas]] cannot proceed without the stimulation of rajas [[guna]].[Cha.Sa. [[Vimana Sthana|VimanaSthana]] 6/9] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Rajas [[guna]] and [[vata dosha]] play an important role in the spreading stage of [[dosha]] (prasara avastha) in six stages of pathogenesis ([[shatkriyakala]]).[Su.Sa. Sutra Sthana 21/28] Rajas and [[Tamas|tamas guna]] work in unison (anubandha) in the occurrence of [[Vyadhi|diseases]].[Cha.Sa. [[Vimana Sthana]] 6/9] Rajas and [[tamas]] [[guna]] lead to the occurrence of conditions like kama(lust), krodha(anger), lobha(greed), irshya(jealousy), maana(ego), mada(intoxication), shoka(excessive sadness/ unhappiness), chittodvega(anxiety), bhaya(fear), harsha(excessive joyousness) etc. These can get afflicted along with [[sharira]] [[dosha]] to cause various [[Vyadhi|diseases]] and psychosomatic disorders. [Chakrapani on Cha.Sa. [[Vimana Sthana]] 6/8] &lt;br /&gt;Vertigo occurs due to the dominance of rajas [[guna]], [[pitta dosha]], and [[vata dosha]].[Su.Sa. Sharira Sthana 4/56] Rajas guna is also pivotal in [[Unmada Chikitsa|unmada]] and [[Apasmara Chikitsa|apasmara]] [[Vyadhi|diseases]].[Su.Sa. Uttar Tantra 61/4, Cha. Sa. [[Nidana Sthana]] 8/4, Cha.Sa. [[Chikitsa Sthana]] 10/4] Atattvabhinivesha is grave condition caused by the vitiation of rajas and [[Tamas|tamas guna]].[Cha.Sa. Chiktsa Sthana 10/59] &lt;br /&gt;Similarly the rajas and [[tamas]] individuals fall prey to [[Vyadhi|disease]] after reaching the advanced stages of intoxication ([[Madatyaya Chikitsa|madatyaya]]).[A.H.Nidana Sthana 6/5] [Cha.Sa. [[Chikitsa Sthana|ChikitsaSthana]] 24/46] Rajasika individuals are affected more quickly. [Cha. Sa. [[Chikitsa Sthana]] 24/55] Rajas and [[tamas]] are involved in the pathogenesis of mada (intoxication)- murccha (syncope)- sanyasa (coma) conditions.[A.H. Nidana Sthana 6/25] Similarly, in the historical description regarding the occurrence of rajayakshma, the prominence of rajas guna was observed in soma(moon).[Cha. Sa. [[Chikitsa Sthana]] 8/7] It suggests the excess indulgence in activities to affect [[health]] and can lead to degenerative [[Vyadhi|diseases]]. &lt;/p&gt;<br /> <br /> == Concept of rajas from a philosophical point ofview ==<br /> &lt;p style='text-align:justify;'&gt;The theory of [[Triguna|triguna]] is fundamentally based on evolution as per both [[Ayurveda|ayurveda]] and Sankhya philosophy. The [[Prakriti|prakriti]] is considered trigunatmaka. Hence its 'vikara' or expressions are also 'trigunatmaka' in nature. Thus, whole universe is constituted from the derivatives of [[Triguna|triguna]] (srishtiutpatti).[Su.Sa. Sutra Sthana 24/8] Rajas guna, along with [[Sattva|sattva]] and [[Tamas|tamas guna]] also plays a vital role in the perception of this philosophical aspect. It is responsible for the generation, creation, and mutation of the srishti or universe. Rajas being active is responsible for stimulating both [[Sattva|sattva]] and [[Tamas|tamas guna]] in taijasa ahankara leading to the development of different vikara or the components of the universe. [Dalhana on Su.Sa. Sharira Sthana 1/4] The alliance or association of [[Purusha|purusha]] with the 24tattva carries on as long as rajas and [[Tamas|tamas]] are afflicted with it leading to [[Rashipurusha|rashipurusha]] (combination of 24 elements). The liberation from the effect (of rajas and [[Tamas|tamas]]) by supremacy of [[Sattva|sattva]] leads to freedom of [[Purusha|purusha]] i.e. moksha or salvation to get freedom from its alliance with the tattva. [Cha.Sa. [[Sharira Sthana]] 1/36] [Cha.Sa. [[Sharira Sthana]] 1/142]. Thus, the moksha is described as a state of [[Sattva|sattva]] predominance with absolute absence of rajas and [[Tamas|tamas]]. [Cha.Sa. [[Sharira Sthana]] 1/142] The rajas is thus termed as [[karana]] or cause for gati (speed) and pravritti (trend).[Cha.Sa. [[Sharira Sthana]] 2/38] &lt;br/&gt;Sankhya philosophy [Sankhyakarika 12-14] also focuses on the study of [[Triguna|triguna]] where the rajas is representing apriti (dukkha or sorrow), pravritti (initiation, stimulation), upastambhakam (stimulator), chala (active, in motion). Thus, the study of rajas guna is necessary to understand the process of srishti utpatti, [[Rashipurusha|rashi-purusha]], moksha which form the philosophical basis of [[Ayurveda|ayurveda]]. &lt;/p&gt;<br /> <br /> == Rajas guna involvement in functioning of [[triguna]] ==<br /> &lt;p style='text-align:justify;'&gt;The working of the [[Triguna|triguna]] can be easily understood by two basic laws related to manasika [[Dosha|doshas]]/[[Guna|gunas]]. The three [[Guna|guṇa]] always remain in dynamic interaction (mithunavritti). These three forces remain involved (anyonyaashraya) and interact with each other in a variety of circumstances (anyonyaabhibhava). Rajas and [[Tamas|tamas]] survive in the presence of [[Sattva|sattva]]; [[Tamas|tamas]] and [[Sattva|sattva]] are put in motion in the field of rajas, while [[Sattva|sattva]] and rajas blend in the field of [[Tamas|tamas]]. The core of the three qualities is their interconnection. These contradictory entities also help in the functioning of one another. Rajas guna is thus the stimulator and initiator of all the actions.[Sankhyakarika13]&lt;ref name=&quot;ref8&quot;&gt;Ishwarkrishna, Sankhyakarika with Abhinavarajlakshmi Bhashya by Gaudapada and hindi translation by Sitaramshashtri and Prof. Balashashta,Sankhyakarika number 12-13 , printed 2019 , Chaukhambha Surbharati Prakashana , Varanasi , Page No.52-55 &lt;/ref&gt; &lt;/p&gt;<br /> <br /> == Treatment insights in the management of rajas dominant disorders ==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As mentioned earlier, the pathology of rajas [[Guna|guna]] can be an important factor in the occurrence of various mental disorders ([[Manas|manas]] [[vyadhi]]). [[Ayurveda|Ayurveda]] focuses on a holistic approach to balance [[Triguna|triguna]] and promote mental [[Health|health]]. Following measures can be undertaken for [[Vyadhi|diseases]] involving the pathology of rajas [[Guna|guna]]. <br /> &lt;ol&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Manasika vegadharana (restraining psychological urges): &lt;span style=&quot;font-weight:normal&quot;&gt;Psychological urges like lobha (greed), shoka (sorrow), bhaya(fright), irshya(envious), dwesha(hate), raga(infatuation), ahankara(ego), nirlajja (indecency) etc. need to be controlled for the avoidance of mental [[Health|health]] conditions. [Cha. Sa. [[Sutra Sthana|Sutra Sthana]] 7/25-29] &lt;/span&gt;&lt;/li&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Daivavyapashraya chikitsa (spiritual therapy): &lt;span style=&quot;font-weight:normal&quot;&gt;It is divine therapy. It includes chanting &amp; listening to different types of mantras, homa-havana (rituals, offerings made to holy fire), [[Upavasa|upavasa (fasting)]], divya-aushadhi, mani dhaaran (use of prestigious stones), mangala(auspicious ceremony), upahara (gifts) niyama (following of auspicious and spiritual rules), pranipata (respect of almighty). This helps activate the [[Sattva|sattva's]] normal functioning and alleviate the vitiated [[Tamas|tamas]] and rajas. &lt;/span&gt;&lt;/li&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Sattvavajaya chikitsa(psychotherapy): &lt;span style=&quot;font-weight:normal&quot;&gt;Regulation of [[Manas|mind]] is the main aim of this therapy, by diversion of emotions, assurance, proper guidance, controlled thought process, patience, etc. &lt;/span&gt;&lt;/li&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Yuktivyapashraya chikitsa (medicinal and diet therapy): &lt;span style=&quot;font-weight:normal&quot;&gt;Use of medicines (internal and external or both) and [[Ahara|ahara(food)]]. This is further classified into 2 types: &lt;/span&gt;&lt;/li&gt;<br /> &lt;ol style=&quot;list-style-type:lower-alpha&quot;&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Shamana karma (pacification therapy): &lt;span style=&quot;font-weight:normal&quot;&gt;This treatment alleviates the [[Dosha|dosha]] vitiation affecting the vitiation of rajas [[Guna|guna]] in the [[Sharira|body]]. There are so many medicines described for treating mental illness. Few of them are described below: &lt;/span&gt;&lt;/li&gt;<br /> &lt;ul&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Single herbs: &lt;span style=&quot;font-weight:normal&quot;&gt;Mandukaparni (Centella asiatica Linn.), Shankhapushpi (Convolvulas pleuricaulis) etc.[Ch. Sa. [[Chikitsa Sthana]] 1/30-31] &lt;/span&gt;&lt;/li&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Use of medicated ghrita([[Ghee|ghee]]) preparations: &lt;span style=&quot;font-weight:normal&quot;&gt;Mahapaishachika ghrita, Brahmi ghrita, Lashunadi ghrita.[Ch. Sa. [[Chikitsa Sthana]] 10/17-25] Mahakalyanaka ghrita, Kalyanaka ghrita, Purana ghrita, Prapurana ghrita etc. [Cha. Sa. [[Chikitsa Sthana]]. 9/35-61]. &lt;/span&gt;&lt;/li&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Rasa aushadhi: &lt;span style=&quot;font-weight:normal&quot;&gt;Smritisagar rasa [Yogratnakar, Apasamara Chikitsa], Unmadagajankusha rasa [Bhaishajya Ratnavali, Unmada Rogadhikar] According to [[Ayurveda|Ayurveda]], the nervous system is governed by [[Vata dosha]]. An imbalance of [[Vata dosha|Vata Dosha]] leads to poor mental alertness. These drugs alone or in combination helps to improve mental alertness when used on a regular basis. Some evidence based published research works are: &lt;/span&gt;&lt;/li&gt;<br /> &lt;ul style=&quot;list-style: '- ';&quot;&gt;<br /> &lt;li&gt;A clinical study on effect of Brahmi Ghrita on Depression by Dr. Yogesh S. Deole, H.M. Chandola.&lt;ref name=&quot;ref9&quot;&gt;Deole Yogesh S, Chandola H M. A Clinical Study on Effect of Brahmi Ghrita on Depression. Ayu. 29 (4),2008: Available from https://www.ayujournal.org/citation.asp?issn=0974-8520;year=2008;volume=29;issue=4;spage=207;epage=214;aulast=Deole;type=0;aid=Ayu_2008_29_4_207_68757&lt;/ref&gt;&lt;/li&gt;<br /> &lt;li&gt;Ayurvedic Medical importance of Shankhapushpi: potential cognition boosting herb by Shifali Thakur, Hemlata Kaurav.&lt;ref name=&quot;ref10&quot;&gt; Thakur Shifali, Kurav H. available from https://www.researchgate.net/publication/353910690_AYURVEDIC_MEDICINAL_IMPORTANCE_OF_SHANKHPUSHPI_CONVOLVULUS_PLURICAULIS_POTENTAIL_COGNITION_BOOSTING_HERB&lt;/ref&gt;&lt;/li&gt;&lt;/ul&gt;&lt;/ul&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;[[Shodhana|Shodhana]] (purification procedures): &lt;span style=&quot;font-weight:normal&quot;&gt;Removal of the aggravated [[Dosha|dosha]] ultimately leads to a state of equilibrium in the [[Sharira|body]], as the vitiated [[Dosha|dosha]] can worsen the functioning of [[Triguna|triguna]]. [[Panchakarma|Panchakarma]] procedures like [[Vamana|vamana]], [[Virechana|virechana]], [[Nasya|nasya]], [[Asthapana basti|niruha]], [[Anuvasana|anuvasana]] are mentioned for treating mental illness. [Ch. Sa. [[Chikitsa Sthana]] 10/61] &lt;/span&gt;&lt;/li&gt;&lt;/ol&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Naisthiki chikitsa: &lt;span style=&quot;font-weight:normal&quot;&gt;Eliminating upadha (ambitions) and desires, which are the leading cause of mental illness, is the most important measure. Elimination of cravings leads to the eradication of all the [[Vyadhi|diseases]] which are associated with the [[Manas|mind]]. This is the ultimate treatment process. &lt;/span&gt;&lt;/li&gt;<br /> &lt;li style=&quot;font-weight:bold&quot;&gt;Yoga: &lt;span style=&quot;font-weight:normal&quot;&gt;By practicing ashtanga yoga (yama, niyama, asana, pranayama, pratyahara, dharana, [[Dhyana|dhyana]] and [[Samadhi|samadhi]]), one can achieve the state of equilibrium . This increases the [[Sattva|sattva guna]], decreases rajas and [[Tamas|tamas guna]], and helps balance the [[Manas|mind]]. &lt;/span&gt;&lt;/li&gt;&lt;/ol&gt;&lt;/p&gt;<br /> <br /> == Previous researches on rajas guna ==<br /> &lt;p style='text-align:justify;'&gt;The literature review suggests that the concept of [[Triguna|triguna]] is extensively studied in the light of Indian philosophy, assessment of personality, assessment of mental constitution, role of [[Triguna|triguna]] in occurrence of various mental [[Health|health]] conditions, impact of [[Triguna|triguna]] in performance at workplace etc. by both [[Ayurveda|ayurveda]] and contemporary sciences. Few such works are listed as given below: <br /> &lt;ol&gt;&lt;li&gt;Enhancing workplace well-being by understanding the three personality types, [[Sattva|sattva]], rajas, and [[Tamas|tamas]], according to Samkhya is done by Dr.Modh.&lt;ref name=&quot;ref11&quot;&gt;Modh, S. (2020). Enhancing Workplace Well-Being Through Understanding the Three Personality Types: Sattva, Rajas, and Tamas According to Samkhya. In: Dhiman, S. (eds) The Palgrave Handbook of Workplace Well-Being. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-02470-3_22-1 &lt;/ref&gt; The researcher has considered these three important measures to determine individual performance at their workplace. It is observed that the rajasika individuals suffer from complaints of dilemma and ethical issues at the workplace compared to sattvika individuals. &lt;/li&gt;<br /> &lt;li&gt;Jayant Narayan and Venkant R. Krishnan studied the impact of sattva and rajas on transformational leadership and karma yoga. The study revealed that two rajas dimensions' namely attribution and right and wrong reduce karma yoga.&lt;ref name=&quot;ref12&quot;&gt;Narayanan J, Krishnan V. Impact of Sattva and Rajas Gunas on Transformational Leadership and Karma Yoga. Journal of Indian Psychology. 2003 Jul 1;21:1–11. &lt;/ref&gt;&lt;/li&gt;<br /> &lt;li&gt;A randomized control trial of the effect of yogas on [[Guna|gunas]] (personality) and self-esteem in normal healthy volunteers is done by Sudheer Deshpande, HR Nagendra, and RaghuramNagarathna.&lt;ref name=&quot;ref13&quot;&gt;Deshpande S, Nagendra H R, Raghuram N. A randomized control trial of the effect of yoga on Gunas (personality) and Self esteem in normal healthy volunteers. Int J Yoga [serial online] 2009 [cited 2023 Jan 5];2:13-21. Available from: https://www.ijoy.org.in/text.asp?2009/2/1/13/43287 &lt;/ref&gt; This study showed a reduction in rajas guna in females and contrary to previous study conducted by Dasa.&lt;ref name=&quot;ref14&quot;&gt;Dasa DG. Effects of the Hare Krsna Maha Mantra on Stress, Depression, and the Three Gunas .VNN Vaishnava News, Org Networh VNN4267. [cited in 1999]. Available from: http://www.vnn.org/usa/US9907/US10-4267.html. &lt;/ref&gt; &lt;/li&gt;<br /> &lt;li&gt;Sharma M.et.al. assessed the effect of sattvika, rajasika, and tamasika factors on anxiety levels in cases and controls. The rajasika individuals were linked to impaired quality of [[Ayu|life]] in these individuals.&lt;ref name=&quot;ref15&quot;&gt;Sharma MP, Salvi D, Sharma M. Sattva, Rajas and Tamas Factors and Quality of [[Ayu|Life]] in Patients with Anxiety Disorders: A Preliminary Investigation. Psychological Studies. 2012 Dec 1;57. &lt;/ref&gt; &lt;/li&gt;<br /> &lt;li&gt;A study of the relationship between [[Triguna|triguna]] and cattellian factors of personality done by Lakhwinder Singh. The study shows that the rajas [[Guna|guna]] denotes passionate, excitable, and aggressive states of [[Manas|mind]].&lt;ref name=&quot;ref16&quot;&gt;Singh L. A study of relationship between Triguna and Cattellian Factors of Personality. 2008. &lt;/ref&gt;&lt;/li&gt;<br /> &lt;li&gt;A cross-sectional research study was focused on the relationship between three [[Guna|gunas]]-[[Sattva|sattva]], rajas, [[tamas]] with [[Ayu|life]] satisfaction and perceived stress. This study showed individuals with rajasika personality correlated positively with perceived stress and negatively with [[Ayu|life]] satisfaction.&lt;ref name=&quot;ref17&quot;&gt;Sharma S, Bhargav PH, Singh P, Bhargav H, Varambally S. Relationship between Vedic personality traits(Sattva, Rajas, and Tamas) with life satisfaction and perceived stress in healthy university students: A cross‑sectional study. AYU 2021;42:39‑44. &lt;/ref&gt;&lt;/li&gt;<br /> &lt;li&gt;A study was conducted on formulating a new three-energy framework of personality for conflict analysis and resolution based on [[Triguna|triguna]] concept of Bhagavad Gita It depicted rajasika energy is considered as dynamic energy. Rajasika individuals were said to have active energy, is excessively passionate, ruthless, and motivated.&lt;ref name=&quot;ref18&quot;&gt;Modh S. Formulating a New Three Energy Framework of Personality for Conflict Analysis and Resolution based on Triguna Concept of Bhagavad Gita. Journal of Human Values. 2014 Oct 1;20:153–65. &lt;/ref&gt; &lt;/li&gt;&lt;/ol&gt;<br /> Modern researchers conceptualize the definitions and manifestations of [[Triguna|triguna]] in human nature. A few of these are summarized as given in the table below&lt;ref name=&quot;ref19&quot;&gt;Singh L. A study of relationship between [[Triguna|Triguna]] and Cattellian factors of personality. Unpublished dissertation, Kurukshetra University, Haryana, India. 2008 Dec. &lt;/ref&gt;: <br /> {| class=&quot;wikitable&quot;<br /> ! Author &amp; Year <br /> ! Qualities of Rajas Guna explained <br /> |-<br /> | Uma, 1969&lt;ref name=&quot;ref20&quot;&gt;Parameswaran, E.G. (1969). Indian Psychology-The Need for Break Through, AnAttempt. Research Bulletin, 5, 75-80. &lt;/ref&gt;<br /> | <br /> * Lack of control over emotions <br /> * Anxiety <br /> * Greed and Desires <br /> * Bad qualities <br /> * Over activeness <br /> * Impurity <br /> |-<br /> | Pathak et al. 1992&lt;ref name=&quot;ref21&quot;&gt;Pathak N. S., Bhatt I. D., Sharma R. (1992). Manual for classifying personality on tri-dimensions of gunas: An Indian approach. Indian Journal of Behaviour, 16, 1-14. &lt;/ref&gt; <br /> | Activity &lt;br/&gt;Pain <br /> |-<br /> | Mathew, 1995&lt;ref name=&quot;ref22&quot;&gt;Mathew IAS Rating Scale Manual. University of Kerala, Kerala <br /> (12) (PDF) The relationship between The Triguna and Five Factor Model of Personality. Available from: https://www.researchgate.net/publication/301293334_The_relationship_between_The_Triguna_and_Five_Factor_Model_of_Personality [accessed Jan 06 2023]. &lt;/ref&gt; <br /> | <br /> * Maladjustmenttendencies <br /> * Over Activation <br /> * Restless <br /> * Uncontrolled energy <br /> * High drive <br /> * Inability to remain silent or alone <br /> * Extrovert <br /> |-<br /> | Maruthamet.al, 1998&lt;ref name=&quot;ref23&quot;&gt;Marutham, P., Balodhi, J. P., &amp; Mishra, H. (1998). Sattva, Rajas, Tamas (SRT)Inventory. <br /> <br /> NIMHANS Journal, 15-19. &lt;/ref&gt; <br /> | <br /> * Motion <br /> * Passion <br /> * Activity <br /> |-<br /> | Wolf, 1998&lt;ref name=&quot;ref24&quot;&gt;Wolf, D. B. (1998). The Vedic Personality Inventory; a study of gunas. Journal of Indian psychology, 16 (1). 26 – 43. &lt;/ref&gt; <br /> | <br /> * Dissatisfaction <br /> * Envy <br /> * Materialistic mentality <br /> * Mental imbalance <br /> * Anger <br /> * Arrogance <br /> |-<br /> |} &lt;/p&gt;<br /> <br /> == Scales for assessment of rajas guna ==<br /> &lt;ol&gt;&lt;li&gt;Vedicpersonalityinventory&lt;ref name=&quot;ref25&quot;&gt;Dasa DG. The Vedic Personality Inventory. In 1999 [cited 2023 Jan 9]. Available from: https://www.semanticscholar.org/paper/The-Vedic-Personality-Inventory-Dasa/e58c6437c63da16b570f734e95d894612cc61e61 &lt;/ref&gt; &lt;/li&gt;<br /> &lt;li&gt;MysoreTrigunaScale&lt;ref name=&quot;ref26&quot;&gt;S. S, Murthy CGV. Development and Standardization of Mysore Triguna Scale. SAGE Open [Internet]. 2012 Jan 1 [cited 2023 Jan 9];2(1):2158244012436564. Available from: https://doi.org/10.1177/2158244012436564 &lt;/ref&gt;&lt;/li&gt;<br /> &lt;li&gt;Triguna Scale of personality&lt;ref name=&quot;ref27&quot;&gt;Mohan V, Sandhu S. Development of scale to measure Sattvic, Rajasic and Tamasic Guna. Journal of the Indian Academy of Applied Psychology. 1986 Jul 1;12:46–52. &lt;/ref&gt;&lt;/li&gt;<br /> &lt;li&gt;Advanced Triguna scale [Shilpa D., 2011] &lt;ref name=&quot;ref28&quot;&gt;Shilpa S.* C.G. Venkatesha Murthy,Assessment-of-traits-and-types-IJP-2014.pdf [Internet]. [cited 2023 Jan 9]. Available from: https://analytics.swayam.life/wp-content/uploads/2021/02/Assessment-of-traits-and-types-IJP-2014.pdf &lt;/ref&gt;&lt;/li&gt;<br /> &lt;li&gt;Self–Rating [[Ayurveda|Ayurveda]] Scale to Measure the Manasika [[Prakriti|Prakriti]] of the Children&lt;ref name=&quot;ref29&quot;&gt;Suchitra S, Nagendra H. A Self–Rating Ayurveda Scale to Measure the Manasika [[Prakriti|Prakriti]] of Children. Global Journal of Medical research Interdisciplinary, Volume 13 Issue 7 Version 1.0 Year 2013 , Page No.42-47 &lt;/ref&gt;&lt;/li&gt;<br /> &lt;li&gt;A Psychometric Analysis of the Three Gunas&lt;ref name=&quot;ref30&quot;&gt;Wolf DB. A Psychometric Analysis of the Three Gunas. Psychol Rep [Internet]. 1999 Jun [cited 2023 Jan 9];84(3_suppl):1379–90. Available from: http://journals.sagepub.com/doi/10.2466/pr0.1999.84.3c.1379 &lt;/ref&gt;&lt;/li&gt;&lt;/ol&gt;<br /> These scales are used to assess the [[Triguna|Trigunas]], the concept is taken from the Indian intellectual tradition and [[Ayurveda|Ayurveda]], many psychometric procedures used in the validation process. <br /> <br /> == Future scope of research ==<br /> &lt;p style='text-align:justify;'&gt;The [[Triguna|triguna]] concept has immense scope for research to reveal its utility in various dimensions of [[Health|health]]. Systematic review of the available research work can be helpful for a deeper understanding of rajas guna in different domains of mental [[Health|health]], personality, psychometric assessment, and philosophy.&lt;/p&gt;<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References ==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Pandu_Chikitsa&diff=45384 2025-11-01T06:09:08Z

<p>Agnivesha: /* Potential areas /scope for further research */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Pandu Chikitsa<br /> |titlemode=append<br /> |keywords=Pandu roga, kamala, koshthashakhashrita kamala, shakhashrita kamala, panaka, kumbhakamala, haleemaka, anemia, jaundice, Ayurveda, Indian system of medicine, charak samhita. iron deficiency anaemia, blood deficiency <br /> |description=Chikitsa Sthana Chapter 16. Management of Pandu (Anemia and diseases due to blood deficiency)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 16. Management of Pandu (Anemia and diseases due to blood deficiency)&lt;/big&gt;'''<br /> {{Infobox<br /> |title = Pandu Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 16<br /> |label2 = Preceding Chapter<br /> |data2 = [[Grahani Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Hikka Shwasa Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Kar A.C., Rai S., Aladoriya N., [[Yogesh Deole|Deole Y. S.]]<br /> |label7 = Reviewer <br /> |data7 = Ojha S.N.<br /> |label8 = Editors<br /> |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.017 10.47468/CSNE.2020.e01.s06.017]<br /> }}<br /> &lt;big&gt;'''Abstract &lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;''Pandu roga'' (resembling with anemia) is characterized by pallor which is associated with different colors according to [[dosha]] involved. Besides ''pandu roga'', this chapter also describes two types of ''kamala'' (jaundice) which are two other associated diseases, caused by predominance of [[pitta]] [[dosha]] which causes alteration in normal colors of the body. The chapter describes general etiology, pathogenesis, symptoms etc of ''pandu roga'' (anemia) as well as each of its five types viz. [[vata]], [[pitta]], [[kapha]], sannipataja and ''mrittika-bhakshana'' (clay eating) ''pandu''. After describing general principle of treatment of ''pandu'' and ''kamala'', detailed treatment of each of the conditions mentioned above along with ''pathya'' (recommended diet) and apathya (prohibited diet) are given. <br /> &lt;br/&gt;<br /> '''Keywords''': Pandu roga, kamala, koshthashakhashrita kamala, shakhashrita kamala, panaka, kumbhakamala, haleemaka, anemia, jaundice<br /> &lt;/p&gt;<br /> <br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> After the description of ''grahani dosha'', the chapter on ''pandu roga'' is given, as the causative factors of ''pandu roga'' are quite similar to that of ''grahani dosha''. Probably it is because that the various gastrointestinal problems can also lead to development of ''pandu roga''. The chapter deals with general discoloration of the body such as pallor, yellowish, greenish and whitish discoloration which is seen in skin, eyes, lips, face, nails, urine feces etc. <br /> <br /> ''Kamala'' (jaundice) and ''haleemaka'' (severe obstructive jaundice) have also been included in this chapter as they are also characterized by the discoloration and may relate to ''pandu roga''. ''Kamala'' is of two types, ''swatantra'' (primary) and ''partantra'' (secondary). The etiological factors of ''primary kamala'' are described later. Secondary ''kamala'' develops in chronic phase of ''pandu'' in which vitiated [[pitta]] is seated in [[rasa dhatu]] and in kamala, [[pitta]] goes deeper in [[rakta dhatu]] and continues to go deeper in [[mamsa dhatu]] and [[meda dhatu]], then it is called ''haleemaka'' and ''kumbha kamala'' respectively. <br /> <br /> ''Kamala'' is of two types in repect to location, ''shakhshrita kamala'' located in body tissues in the form of obstructed [[pitta]] and ''koshthashrita kamala'', localized to gut and can be easily removed by purgation while ''shakhashrita kamala'' needs to be brought to gut for removal.<br /> &lt;/div&gt;<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातः पाण्डुरोगचिकित्सितं व्याख्यास्यामः||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः||२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātaḥ pāṇḍurōgacikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2||<br /> <br /> athAtaH pANDurogacikitsitaM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2||<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt; <br /> Now we shall expound the chapter &quot;Pandu Chikitsa&quot; (Management of Anemia and diseases due to blood deficiency). Thus said Lord Atreya. [1-2]<br /> <br /> === Five types of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगाः स्मृताः पञ्च वातपित्तकफैस्त्रयः| <br /> <br /> चतुर्थः सन्निपातेन पञ्चमो भक्षणान्मृदः||३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgāḥ smr̥tāḥ pañca VātaPittaKaphaistrayaḥ| <br /> <br /> caturthaḥ sannipātēna pañcamō bhakṣaṇānmr̥daḥ||3|| <br /> <br /> pANDurogAH smRutAH pa~jca vAtapittakaphaistrayaH| <br /> <br /> caturthaH sannipAtena pa~jcamo bhakShaNAnmRudaH||3||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Pandu roga is classified into five types as vatika, paittika, [[kapha]]ja, tri[[dosha]]ja and mrittika bhakshhana janya pandu [3]<br /> <br /> === Pathogenesis of pandu ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दोषाः पित्तप्रधानास्तु यस्य कुप्यन्ति धातुषु| <br /> <br /> शैथिल्यं तस्य धातूनां गौरवं चोपजायते||४|| <br /> <br /> ततो वर्णबलस्नेहा ये चान्येऽप्योजसो गुणाः| <br /> <br /> व्रजन्ति क्षयमत्यर्थं दोषदूष्यप्रदूषणात्||५|| <br /> <br /> सोऽल्परक्तोऽल्पमेदस्को निःसारः शिथिलेन्द्रियः| <br /> <br /> वैवर्ण्यं भजते, तस्य हेतुं शृणु सलक्षणम्||६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dōṣāḥ Pittapradhānāstu yasya kupyanti Dhātuṣu| <br /> <br /> śaithilyaṁ tasya dhātūnāṁ gauravaṁ cōpajāyatē||4|| <br /> <br /> tatō varṇabalasnēhā yē cānyē'pyōjasō guṇāḥ| <br /> <br /> vrajanti kṣayamatyarthaṁ dōṣadūṣyapradūṣaṇāt||5|| <br /> <br /> sō'lparaktō'lpamēdaskō niḥsāraḥ śithilēndriyaḥ| <br /> <br /> vaivarṇyaṁ bhajatē, tasya hētuṁ śr̥ṇu salakṣaṇam||6|| <br /> <br /> doShAH pittapradhAnAstu yasya kupyanti dhAtuShu| <br /> <br /> shaithilyaM tasya dhAtUnAM gauravaM copajAyate||4|| <br /> <br /> tato varNabalasnehA ye cAnye~apyojaso guNAH| <br /> <br /> vrajanti kShayamatyarthaM doShadUShyapradUShaNAt||5|| <br /> <br /> so~alparakto~alpamedasko niHsAraH shithilendriyaH| <br /> <br /> vaivarNyaM bhajate, tasya hetuM shRuNu salakShaNam||6||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Aggravated [[pitta]] predominant [[dosha]] vitiates the [[dhatu]]. This vitiation of [[dhatu]] cause sluggishnesss (''shithilata'') and heaviness (''gaurava'') in the [[dhatu]] resulting in diminution of complexion (''varna''), strength (''bala''), unctuousness (''sneha'') and the qualities of [[ojas]]. Thus, the person develops diminished blood (''rakta'') and the fatty tissue ([[meda dhatu]]) and absence of the vitality of all the tissues (''nihsara'') decreases functional status of sense organs (''sithilendriyah'') and discoloration of the body. [[Hetu]] (etiological factors and pathogenesis) and the sign and symptoms of the disease will be explained hereafter [4-6]<br /> <br /> === General etio-pathogenesis of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षाराम्ललवणात्युष्णविरुद्धासात्म्यभोजनात्| <br /> <br /> निष्पावमाषपिण्याकतिलतैलनिषेवणात्||७|| <br /> <br /> विदग्धेऽन्ने दिवास्वप्नाद्व्यायामान्मैथुनात्तथा| <br /> <br /> प्रतिकर्मर्तुवैषम्याद्वेगानां च विधारणात्||८|| <br /> <br /> कामचिन्ताभयक्रोधशोकोपहतचेतसः| <br /> <br /> समुदीर्णं यदा पित्तं हृदये समवस्थितम्||९|| <br /> <br /> वायुना बलिना क्षिप्तं सम्प्राप्य धमनीर्दश| <br /> <br /> प्रपन्नं केवलं देहं त्वङ्मांसान्तरमाश्रितम्||१०|| <br /> <br /> प्रदूष्य कफवातासृक्त्वङ्मांसानि करोति तत्| <br /> <br /> पाण्डुहारिद्रहरितान् वर्णान् बहुविधांस्त्वचि||११|| <br /> <br /> स पाण्डुरोग इत्युक्तः ...|१२| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣārāmlalavaṇātyuṣṇaviruddhāsātmyabhōjanāt| <br /> <br /> niṣpāvamāṣapiṇyākatilatailaniṣēvaṇāt||7|| <br /> <br /> vidagdhē'nnē divāsvapnādvyāyāmānmaithunāttathā| <br /> <br /> pratikarmartuvaiṣamyādvēgānāṁ ca vidhāraṇāt||8|| <br /> <br /> kāmacintābhayakrōdhaśōkōpahatacētasaḥ| <br /> <br /> samudīrṇaṁ yadā Pittaṁ hr̥dayē samavasthitam||9|| <br /> <br /> vāyunā balinā kṣiptaṁ samprāpya dhamanīrdaśa| <br /> <br /> prapannaṁ kēvalaṁ dēhaṁ tvaṅmāṁsāntaramāśritam||10|| <br /> <br /> pradūṣya Kaphavātāsr̥ktvaṅmāṁsāni karōti tat| <br /> <br /> pāṇḍuhāridraharitān varṇān bahuvidhāṁstvaci||11|| <br /> <br /> sa pāṇḍurōga ityuktaḥ ...|12| <br /> <br /> kShArAmlalavaNAtyuShNaviruddhAsAtmyabhojanAt| <br /> <br /> niShpAvamAShapiNyAkatilatailaniShevaNAt||7|| <br /> <br /> vidagdhe~anne divAsvapnAdvyAyAmAnmaithunAttathA| <br /> <br /> pratikarmartuvaiShamyAdvegAnAM ca vidhAraNAt||8|| <br /> <br /> kAmacintAbhayakrodhashokopahatacetasaH| <br /> <br /> samudIrNaM yadA pittaM hRudaye samavasthitam||9|| <br /> <br /> vAyunA balinA kShiptaM samprApya dhamanIrdasha| <br /> <br /> prapannaM kevalaM dehaM tva~gmAMsAntaramAshritam||10|| <br /> <br /> pradUShya kaphavAtAsRuktva~gmAMsAni karoti tat| <br /> <br /> pANDuhAridraharitAn varNAn bahuvidhAMstvaci||11|| <br /> <br /> sa pANDuroga ityuktaH ...|12| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Followings are the etiological factors of ''pandu'':<br /> *The (excessive) intake of alkaline, sour, saline, hot and mutually contradictory foods, unwholesome food, ''nishpava'' (a type of pulses), ''masha, pinyaka'' (oil cake) and ''tila'' oil; <br /> *Indulging in day sleep, performing exercise and sex before digestion of the food;<br /> *Improper administration of [[Panchakarma]] measures (''pratikarma vaishamya'') and the disobedience of the seasonal regimens (''ritu vaishamya'') <br /> *Suppression of the natural urges<br /> *Affliction of mind with passion, worry, fear, anger, grief<br /> <br /> Indulgence in the above factors aggravates [[pitta]] seated in the cardiac region and then this [[pitta]] is forcefully propelled by the [[vata]] into the ten ''dhamanis'' (attached to the heart) and further into the whole body. There, it gets located in between the ''tvacha'' (skin) and the [[mamsa dhatu]] (flesh) and additionally vitiates the [[kapha]], [[vata]], [[rakta]], tvacha and [[mamsa dhatu]] resulting in the development of various discolorations in the body like ''pandu'' (pale), ''haridra'' (yellow),and ''harita'' (green). This is called as ''pandu roga'' [7-11½]<br /> <br /> === Premonitory symptoms ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> .. तस्य लिङ्गं भविष्यतः| <br /> <br /> हृदयस्पन्दनं रौक्ष्यं स्वेदाभावः श्रमस्तथा||१२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ... tasya liṅgaṁ bhaviṣyataḥ| <br /> <br /> hr̥dayaspandanaṁ raukṣyaṁ svēdābhāvaḥ śramastathā||12||<br /> <br /> ... tasya li~ggaM bhaviShyataH| <br /> <br /> hRudayaspandanaM raukShyaM svedAbhAvaH shramastathA||12||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The premonitory symptoms of the disease are palpitations, ununctuousness, absence of sweating and fatigue [12]<br /> <br /> === General symptoms of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सम्भूतेऽस्मिन् भवेत् सर्वः कर्णक्ष्वेडी हतानलः| <br /> <br /> दुर्बलः सदनोऽन्नद्विट् श्रमभ्रमनिपीडितः||१३|| <br /> <br /> गात्रशूलज्वरश्वासगौरवारुचिमान्नरः| <br /> <br /> मृदितैरिव गात्रैश्च पीडितोन्मथितैरिव||१४|| <br /> <br /> शूनाक्षिकूटो हरितः शीर्णलोमा हतप्रभः| <br /> <br /> कोपनः शिशिरद्वेषी निद्रालुः ष्ठीवनोऽल्पवाक्||१५|| <br /> <br /> पिण्डिकोद्वेष्टकट्यूरुपादरुक्सदनानि च| <br /> <br /> भवन्त्यारोहणायासैर्विशेषश्चास्य [१] वक्ष्यते||१६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sambhūtē'smin bhavēt sarvaḥ karṇakṣvēḍī hatānalaḥ| <br /> <br /> durbalaḥ sadanō'nnadviṭ śramabhramanipīḍitaḥ||13|| <br /> <br /> gātraśūlajvaraśvāsagauravārucimānnaraḥ| <br /> <br /> mr̥ditairiva gātraiśca pīḍitōnmathitairiva||14|| <br /> <br /> śūnākṣikūṭō haritaḥ śīrṇalōmā hataprabhaḥ| <br /> <br /> kōpanaḥ śiśiradvēṣī nidrāluḥ ṣṭhīvanō'lpavāk||15|| <br /> <br /> piṇḍikōdvēṣṭakaṭyūrupādaruksadanāni ca| <br /> <br /> bhavantyārōhaṇāyāsairviśēṣaścāsya [1] vakṣyatē||16|| <br /> <br /> sambhUte~asmin bhavet sarvaH karNakShveDI hatAnalaH| <br /> <br /> durbalaH sadano~annadviT shramabhramanipIDitaH||13|| <br /> <br /> gAtrashUlajvarashvAsagauravArucimAnnaraH| <br /> <br /> mRuditairiva gAtraishca pIDitonmathitairiva||14|| <br /> <br /> shUnAkShikUTo haritaH shIrNalomA hataprabhaH| <br /> <br /> kopanaH shishiradveShI nidrAluH ShThIvano~alpavAk||15|| <br /> <br /> piNDikodveShTakaTyUrupAdaruksadanAni ca| <br /> <br /> bhavantyArohaNAyAsairvisheShashcAsya [1] vakShyate||16|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> On developing ''pandu roga'' the patients have the symptoms of tinnitus, low digestion, weakness, prostration, disliking for food, fatigue, giddiness, pain in the body, fever, dyspnea, heaviness and anorexia. The patient feels as if the limbs are being kneaded, pressed or churned; develops peri-orbital swelling, greenish complexion and falling of body hair. The person loses his body luster, becomes irritable, dislikes cold things, feels sleepy, spits in excess, avoids speaking, suffers from cramps in the calf region and experiences excessive fatigue as well as pain and weakness in the lumbar region, thighs and feet specifically by exertion while climbing [13-16]<br /> <br /> The signs and symptoms specific to each variety of ''pandu'' will be described henceforth.<br /> <br /> === ''Vatika pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आहारैरुपचारैश्च वातलैः कुपितोऽनिलः| <br /> <br /> जनयेत्कृष्णपाण्डुत्वं [१] तथा रूक्षारुणाङ्गताम्||१७|| <br /> <br /> अङ्गमर्दं रुजं तोदं कम्पं पार्श्वशिरोरुजम्| <br /> <br /> वर्चःशोषास्यवैरस्यशोफानाहबलक्षयान्||१८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> āhārairupacāraiśca Vātalaiḥ kupitō'nilaḥ| <br /> <br /> janayētkr̥ṣṇapāṇḍutvaṁ [1] tathā rūkṣāruṇāṅgatām||17|| <br /> <br /> aṅgamardaṁ rujaṁ tōdaṁ kampaṁ pārśvaśirōrujam| <br /> <br /> varcaḥśōṣāsyavairasyaśōphānāhabalakṣayān||18|| <br /> <br /> AhArairupacAraishca vAtalaiH kupito~anilaH| <br /> <br /> janayetkRuShNapANDutvaM [1] tathA rUkShAruNA~ggatAm||17|| <br /> <br /> a~ggamardaM rujaM todaM kampaM pArshvashirorujam| <br /> <br /> varcaHshoShAsyavairasyashophAnAhabalakShayAn||18|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Indulging in [[vata]] increasing diet and regimens aggravates [[vata]] leading to ''vatika pandu roga''. The skin of the patient becomes blackish dawn colored and ununctuous. Its other symptoms are malaise, ache, pricking pain, tremor, pain in both the sides of the chest, headache; dried feces, distaste in the mouth; swelling, gaseous distention of the abdomen and weakness [17-18]<br /> <br /> === ''Paittika pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तलस्याचितं पित्तं यथोक्तैः स्वैः प्रकोपणैः| <br /> <br /> दूषयित्वा तु रक्तादीन् पाण्डुरोगाय कल्पते||१९|| <br /> <br /> स पीतो हरिताभो वा ज्वरदाहसमन्वितः| <br /> <br /> तृष्णामूर्च्छापिपासार्तः [१] पीतमूत्रशकृन्नरः||२०|| <br /> <br /> स्वेदनः शीतकामश्च न चान्नमभिनन्दति| <br /> <br /> कटुकास्यो न चास्योष्णमुपशेतेऽम्लमेव च||२१|| <br /> <br /> उद्गारोऽम्लो विदाहश्च विदग्धेऽन्नेऽस्य जायते| <br /> <br /> दौर्गन्ध्यं भिन्नवर्चस्त्वं दौर्बल्यं तम एव च||२२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> Pittalasyācitaṁ Pittaṁ yathōktaiḥ svaiḥ prakōpaṇaiḥ| <br /> <br /> dūṣayitvā tu raktādīn pāṇḍurōgāya kalpatē||19|| <br /> <br /> sa pītō haritābhō vā jvaradāhasamanvitaḥ| <br /> <br /> tr̥ṣṇāmūrcchāpipāsārtaḥ [1] pītamūtraśakr̥nnaraḥ||20|| <br /> <br /> svēdanaḥ śītakāmaśca na cānnamabhinandati| <br /> <br /> kaṭukāsyō na cāsyōṣṇamupaśētē'mlamēva ca||21|| <br /> <br /> udgārō'mlō vidāhaśca vidagdhē'nnē'sya jāyatē| <br /> <br /> daurgandhyaṁ bhinnavarcastvaṁ daurbalyaṁ tama ēva ca||22|| <br /> <br /> pittalasyAcitaM pittaM yathoktaiH svaiH prakopaNaiH| <br /> <br /> dUShayitvA tu raktAdIn pANDurogAya kalpate||19|| <br /> <br /> sa pIto haritAbho vA jvaradAhasamanvitaH| <br /> <br /> tRuShNAmUrcchApipAsArtaH [1] pItamUtrashakRunnaraH||20|| <br /> <br /> svedanaH shItakAmashca na cAnnamabhinandati| <br /> <br /> kaTukAsyo na cAsyoShNamupashete~amlameva ca||21|| <br /> <br /> udgAro~amlo vidAhashca vidagdhe~anne~asya jAyate| <br /> <br /> daurgandhyaM bhinnavarcastvaM daurbalyaM tama eva ca||22||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> [[Pitta]] gets aggravated by indulging in [[pitta]] vitiating ''nidanas'' (diet and regimens) which by involving the blood etc. causes [[pitta]]ja pandu. Its symptoms are, change in complexion to yellowish/greenish, fever, burning sensation; morbid thirst and fainting; excessive perspiration and longing for cold things and environment. The person does not relish food, develops pungent taste, disfavors hot and sour things; gets sour eructations associated with burning sensation due to impaired digestion of food; emits foul smell from mouth; the urine and stool become yellow in color, has loose motions and develops weakness and fainting [19-22]<br /> <br /> === [[Kapha]]ja pandu ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विवृद्धः श्लेष्मलैः श्लेष्मा पाण्डुरोगं स पूर्ववत्| <br /> <br /> करोति गौरवं तन्द्रा छर्दिं श्वेतावभासताम्||२३|| <br /> <br /> प्रसेकं लोमहर्षं च सादं मूर्च्छां भ्रमं क्लमम्| <br /> <br /> श्वासं कासं तथाऽऽलस्यमरुचिं वाक्स्वरग्रहम्||२४|| <br /> <br /> शुक्लमूत्राक्षिवर्चस्त्वं कटुरूक्षोष्णकामताम्| <br /> <br /> श्वयथुं मधुरास्यत्वमिति [१] पाण्ड्वामयः कफात्||२५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vivr̥ddhaḥ ślēṣmalaiḥ ślēṣmā pāṇḍurōgaṁ sa pūrvavat| <br /> <br /> karōti gauravaṁ tandrā chardiṁ śvētāvabhāsatām||23|| <br /> <br /> prasēkaṁ lōmaharṣaṁ ca sādaṁ mūrcchāṁ bhramaṁ klamam| <br /> <br /> śvāsaṁ kāsaṁ tathā''lasyamaruciṁ vāksvaragraham||24|| <br /> <br /> śuklamūtrākṣivarcastvaṁ kaṭurūkṣōṣṇakāmatām| <br /> <br /> śvayathuṁ madhurāsyatvamiti [1] pāṇḍvāmayaḥ kaphāt||25|| <br /> <br /> vivRuddhaH shleShmalaiH shleShmA pANDurogaM sa pUrvavat| <br /> <br /> karoti gauravaM tandrA chardiM shvetAvabhAsatAm||23|| <br /> <br /> prasekaM lomaharShaM ca sAdaM mUrcchAM bhramaM klamam| <br /> <br /> shvAsaM kAsaM tathA~a~alasyamaruciM vAksvaragraham||24|| <br /> <br /> shuklamUtrAkShivarcastvaM kaTurUkShoShNakAmatAm| <br /> <br /> shvayathuM madhurAsyatvamiti [1] pANDvAmayaH kaphAt||25|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Aggravated [[kapha]] by indulging in [[kapha]] increasing diet and regimen gives rise to [[kapha]]ja pandu roga through the pathogenesis described earlier. The sign and symptoms of [[kapha]]ja pandu are heaviness, drowsiness, vomiting, whitish complexion, salivation, horripilation, prostration, fainting, giddiness, mental fatigue, dyspnea, cough, laziness, anorexia, obstruction in speech and voice, whitish coloration of the eyes, urine and feces; longing for pungent, ununctuous and hot things; and develops edema and sweet taste in the mouth [23-25]<br /> <br /> === ''Tridoshaja pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सर्वान्नसेविनः सर्वे दुष्टा दोषास्त्रिदोषजम्| <br /> त्रिदोषलिङ्गं कुर्वन्ति पाण्डुरोगं सुदुःसहम्||२६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sarvānnasēvinaḥ sarvē duṣṭā dōṣāstridōṣajam| <br /> tridōṣaliṅgaṁ kurvanti pāṇḍurōgaṁ suduḥsaham||26|| <br /> <br /> sarvAnnasevinaH sarve duShTA doShAstridoShajam| <br /> tridoShali~ggaM kurvanti pANDurogaM suduHsaham||26|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Indulging in the etiological factors of all the three types of ''pandu'' leads to aggravation of the three [[dosha]] resulting in ''tridoshaja pandu'' with the features of all the three types of ''pandu roga''. This type of ''pandu'' causes much distress to the patient. [26]<br /> <br /> === ''Mrittika bhakshana pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मृत्तिकादनशीलस्य कुप्यत्यन्यतमो मलः| <br /> कषाया मारुतं, पित्तमूषरा, मधुरा कफम्||२७|| <br /> <br /> कोपयेन्मृद्रसादींश्च रौक्ष्याद्भुक्तं विरूक्षयेत् [१] | <br /> पूरयत्यविपक्वैव स्रोतांसि निरुणद्धि च||२८|| <br /> <br /> इन्द्रियाणां बलं हत्वा तेजो वीर्यौजसी तथा| <br /> पाण्डुरोगं करोत्याशु बलवर्णाग्निनाशनम्||२९|| <br /> <br /> शूनगण्डाक्षिकूटभ्रूः [२] शूनपान्नाभिमेहनः| <br /> क्रिमिकोष्ठोऽतिसार्येत मलं सासृक् कफान्वितम्||३०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mr̥ttikādanaśīlasya kupyatyanyatamō malaḥ| <br /> kaṣāyā mārutaṁ, Pittamūṣarā, madhurā Kapham||27|| <br /> <br /> kōpayēnmr̥drasādīṁśca raukṣyādbhuktaṁ virūkṣayēt [1] | <br /> pūrayatyavipakvaiva srōtāṁsi niruṇaddhi ca||28|| <br /> <br /> indriyāṇāṁ balaṁ hatvā tējō vīryaujasī tathā| <br /> pāṇḍurōgaṁ karōtyāśu balavarṇāgnināśanam||29|| <br /> <br /> śūnagaṇḍākṣikūṭabhrūḥ [2] śūnapānnābhimēhanaḥ| <br /> krimikōṣṭhō'tisāryēta malaṁ sāsr̥k kaphānvitam||30|| <br /> <br /> mRuttikAdanashIlasya kupyatyanyatamo malaH| <br /> kaShAyA mArutaM, pittamUSharA, madhurA kapham||27|| <br /> <br /> kopayenmRudrasAdIMshca raukShyAdbhuktaM virUkShayet [1] | <br /> pUrayatyavipakvaiva srotAMsi niruNaddhi ca||28|| <br /> <br /> indriyANAM balaM hatvA tejo vIryaujasI tathA| <br /> pANDurogaM karotyAshu balavarNAgninAshanam||29|| <br /> <br /> shUnagaNDAkShikUTabhrUH [2] shUnapAnnAbhimehanaH| <br /> krimikoShTho~atisAryeta malaM sAsRuk kaphAnvitam||30|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Person indulging in the habitual consumption of clay (''mrittika'') gets [[dosha]] aggravated according to the taste of mud viz. astringent mud aggravates [[vata]], saline and alkaline mud aggravates [[pitta]] and sweet mud aggravates [[kapha]] [[dosha]]. The clay further because of its ununctuousness causes dryness in the [[rasa]] (nutrients of the digested food). The clay due to its undigestable nature fills and blocks the channels of circulation leading to decrease in the sharpness of the senses, luster, energy and [[ojas]] (vital essence of the tissues). This quickly manifesting ''pandu'' results in the loss of strength, complexion and digestive power. Its clinical features are edema of the cheeks, peri orbital edema and edema on the eyebrows area, feet, umbilical region and the pudendum; infestation of worms in the [[koshtha]] (gastrointestinal tract) and loose motions, the stool associated with blood and mucus. [27-30]<br /> <br /> === Prognosis of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगश्चिरोत्पन्नः खरीभूतो न सिध्यति| <br /> कालप्रकर्षाच्छूनो [१] ना यश्च पीतानि पश्यति||३१|| <br /> <br /> बद्धाल्पविट्कं सकफं हरितं योऽतिसार्यते| <br /> दीनः श्वेतातिदिग्धाङ्गश्छर्दिमूर्च्छातृषार्दितः||३२|| <br /> <br /> स नास्त्यसृक्क्षयाद्यश्च पाण्डुः श्वेतत्वमाप्नुयात्| <br /> इति पञ्चविधस्योक्तं पाण्डुरोगस्य लक्षणम्||३३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgaścirōtpannaḥ kharībhūtō na sidhyati| <br /> kālaprakarṣācchūnō [1] nā yaśca pītāni paśyati||31|| <br /> <br /> baddhālpaviṭkaṁ saKaphaṁ haritaṁ yō'tisāryatē| <br /> dīnaḥ śvētātidigdhāṅgaśchardimūrcchātr̥ṣārditaḥ||32|| <br /> <br /> sa nāstyasr̥kkṣayādyaśca pāṇḍuḥ śvētatvamāpnuyāt| <br /> iti pañcavidhasyōktaṁ pāṇḍurōgasya lakṣaṇam||33|| <br /> <br /> pANDurogashcirotpannaH kharIbhUto na sidhyati| <br /> kAlaprakarShAcchUno [1] nA yashca pItAni pashyati||31|| <br /> <br /> baddhAlpaviTkaM sakaphaM haritaM yo~atisAryate| <br /> dInaH shvetAtidigdhA~ggashchardimUrcchAtRuShArditaH||32|| <br /> <br /> sa nAstyasRukkShayAdyashca pANDuH shvetatvamApnuyAt| <br /> iti pa~jcavidhasyoktaM pANDurogasya lakShaNam||33||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Chronic ''pandu roga'' is incurable. Other symptoms indicating the incurability are appearance of excessive dryness and edema; patient visualizes everything as yellow; passes very hard stool or less amount of stool or passes loose stool associated with mucus and green in color; feels exceedingly prostrated; body becomes excessively white as if be smeared with whiteness; has vomiting, fainting and excessive thirst and when the patient develops excessive whiteness in the body as a result of loss of blood.<br /> <br /> Thus, the signs and symptoms of all the five type of ''pandu roga'' have been described. [31-33]<br /> <br /> === ''Koshthashakhashraya kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगी तु योऽत्यर्थं पित्तलानि निषेवते| <br /> तस्य पित्तमसृग्मांसं दग्ध्वा रोगाय कल्पते||३४|| <br /> <br /> हारिद्रनेत्रः स भृशं हारिद्रत्वङ्नखाननः| <br /> रक्तपीतशकृन्मूत्रो भेकवर्णो हतेन्द्रियः||३५|| <br /> <br /> दाहाविपाकदौर्बल्यसदनारुचिकर्षितः| <br /> कामला बहुपित्तैषा कोष्ठशाखाश्रया मता||३६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgī tu yō'tyarthaṁ Pittalāni niṣēvatē| <br /> tasya Pittamasr̥gmāṁsaṁ dagdhvā rōgāya kalpatē||34|| <br /> <br /> hāridranētraḥ sa bhr̥śaṁ hāridratvaṅnakhānanaḥ| <br /> Rakta pītaśakr̥nmūtrō bhēkavarṇō hatēndriyaḥ||35|| <br /> <br /> dāhāvipākadaurbalyasadanārucikarṣitaḥ| <br /> kāmalā bahuPittaiṣā kōṣṭhaśākhāśrayā matā||36|| <br /> <br /> pANDurogI tu yo~atyarthaM pittalAni niShevate| <br /> tasya pittamasRugmAMsaM dagdhvA rogAya kalpate||34|| <br /> <br /> hAridranetraH sa bhRushaM hAridratva~gnakhAnanaH| <br /> raktapItashakRunmUtro bhekavarNo hatendriyaH||35|| <br /> <br /> dAhAvipAkadaurbalyasadanArucikarShitaH| <br /> kAmalA bahupittaiShA koShThashAkhAshrayA matA||36|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If a patient of ''pandu roga'' excessively follows [[pitta]] vitiating diet and regimen, the [[pitta]] so aggravated by involving the [[rakta]] and the [[mamsa dhatu]] causes ''kamala''. Its clinical features are the eyes, skin, nails and face of the patient become exceedingly yellow; stool and urine become reddish-yellow in color; complexion develops a color similar to that of a frog (found in rainy season); the senses get impaired; has burning sensation, indigestion, weakness, prostration and anorexia. This ''kamala'' is caused by excess of [[pitta]] is known as ''koshthashakhashrita'' [34-36]<br /> <br /> === ''Kumbha kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कालान्तरात् खरीभूता कृच्छ्रा स्यात् कुम्भकामला| 36½ |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kālāntarāt kharībhūtā kr̥cchrā syāt kumbhakāmalā| 36½|<br /> <br /> kAlAntarAt kharIbhUtA kRucchrA syAt kumbhakAmalA| 36½|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> With the due course of time the disease (''kamala'') becomes deep seated (''kharibhuta'') resulting in excessive dryness of the body or afflicted tissue and thus becomes difficult to cure. This condition is called ''kumbha kamala'' [36½]<br /> <br /> === Bad prognostic symptoms of ''kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कृष्णपीतशकृन्मूत्रो [१] भृशं शूनश्च मानवः||३७||<br /> <br /> सरक्ताक्षिमुखच्छर्दिविण्मूत्रो यश्च ताम्यति| <br /> दाहारुचितृषानाहतन्द्रामोहसमन्वितः||३८|| <br /> <br /> नष्टाग्निसञ्ज्ञः क्षिप्रं हि कामलावान् विपद्यते|38½| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kr̥ṣṇapītaśakr̥nmūtrō [1] bhr̥śaṁ śūnaśca mānavaḥ||37|| <br /> <br /> saraktākṣimukhacchardiviṇmūtrō yaśca tāmyati| <br /> dāhārucitr̥ṣānāhatandrāmōhasamanvitaḥ||38|| <br /> <br /> naṣṭāgnisañjñaḥ kṣipraṁ hi kāmalāvān vipadyatē|38½|<br /> <br /> kRuShNapItashakRunmUtro [1] bhRushaM shUnashca mAnavaH||37|| <br /> <br /> saraktAkShimukhacchardiviNmUtro yashca tAmyati| <br /> dAhArucitRuShAnAhatandrAmohasamanvitaH||38|| <br /> <br /> naShTAgnisa~jj~jaH kShipraM hi kAmalAvAn vipadyate|38½| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the stool and urine of the patient (of ''kamala'') become black and yellow; develops excessive edema; eyes and face becomes red colored; vomit, stool and urine are mixed with blood; the patient feels like going in darkness; has burning sensation, anorexia, morbid thirst, constipation, drowsiness and fainting; and the person looses his [[agni]] and consciousness; such patient may succumb to death quickly [37-38½]<br /> <br /> === Principles of treatment ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> साध्यानामितरेषां तु प्रवक्ष्यामि चिकित्सितम्||३९|| <br /> <br /> तत्र पाण्ड्वामयी स्निग्धस्तीक्ष्णैरूर्ध्वानुलोमिकैः| <br /> संशोध्यो मृदुभिस्तिक्तैः कामली तु विरेचनैः||४०|| <br /> <br /> ताभ्यां संशुद्धकोष्ठाभ्यां पथ्यान्यन्नानि दापयेत्| <br /> शालीन् सयवगोधूमान् पुराणान् यूषसंहितान्||४१|| <br /> <br /> मुद्गाढकीमसूरैश्च जाङ्गलैश्च रसैर्हितैः| <br /> यथादोषं विशिष्टं च तयोर्भैषज्यमाचरेत्||४२|| <br /> <br /> पञ्चगव्यं महातिक्तं कल्याणकमथापि वा| <br /> स्नेहनार्थं घृतं दद्यात् कामलापाण्डुरोगिणे||४३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sādhyānāmitarēṣāṁ tu pravakṣyāmi cikitsitam||39|| <br /> <br /> tatra pāṇḍvāmayī snigdhastīkṣṇairūrdhvānulōmikaiḥ| <br /> saṁśōdhyō mr̥dubhistiktaiḥ kāmalī tu virēcanaiḥ||40|| <br /> <br /> tābhyāṁ saṁśuddhakōṣṭhābhyāṁ pathyānyannāni dāpayēt| <br /> śālīn sayavagōdhūmān purāṇān yūṣasaṁhitān||41|| <br /> <br /> mudgāḍhakīmasūraiśca jāṅgalaiśca rasairhitaiḥ| <br /> yathādōṣaṁ viśiṣṭaṁ ca tayōrbhaiṣajyamācarēt||42|| <br /> <br /> pañcagavyaṁ mahātiktaṁ kalyāṇakamathāpi vā| <br /> snēhanārthaṁ ghr̥taṁ dadyāt kāmalāpāṇḍurōgiṇē||43|| <br /> <br /> sAdhyAnAmitareShAM tu pravakShyAmi cikitsitam||39|| <br /> <br /> tatra pANDvAmayI snigdhastIkShNairUrdhvAnulomikaiH| <br /> saMshodhyo mRudubhistiktaiH kAmalI tu virecanaiH||40|| <br /> <br /> tAbhyAM saMshuddhakoShThAbhyAM pathyAnyannAni dApayet| <br /> shAlIn sayavagodhUmAn purANAn yUShasaMhitAn||41|| <br /> <br /> mudgADhakImasUraishca jA~ggalaishca rasairhitaiH| <br /> yathAdoShaM vishiShTaM ca tayorbhaiShajyamAcaret||42|| <br /> <br /> pa~jcagavyaM mahAtiktaM kalyANakamathApi vA| <br /> snehanArthaM ghRutaM dadyAt kAmalApANDurogiNe||43|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now, the treatment for the curable types of ''pandu roga'' is being described here:<br /> <br /> The patient suffering from the ''pandu'' should first be given strong (''tikshna'') emetic and purgation therapies after the administration of internal oleation ([[snehana]]) for cleansing of the body (''shodhana''). <br /> <br /> On the other hand, patient of ''kamala'' should be given mild purgation therapy with bitter drugs. After the cleansing of the ''koshtha'' by the above procedures the patient of both of these diseases should be given wholesome food consisting of old ''shali'' rice, barley and wheat mixed with the ''yusha'' (vegetable soup) of ''mudga, adhaki'' and ''masura'', and the ''rasa'' (meat soup) of animals inhabiting the arid zone. <br /> <br /> On the basis of the aggravated [[dosha]] specific medicines are to be administered to the patients of these two categories (which will be described later in the chapter). For the oleation of the patient of ''pandu'' and ''kamala panchagavya ghrita, mahatikta ghrita'' and ''kalyanaka ghrita'' should be given [39-43]<br /> <br /> === ''Dadimadya ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दाडिमात् कुडवो धान्यात् कुडवार्धं पलं पलम्| <br /> चित्रकाच्छृङ्गवेराच्च पिप्पल्यष्टमिका तथा||४४|| <br /> <br /> तैः कल्कैर्विंशतिपलं घृतस्य सलिलाढके|<br /> सिद्धं हृत्पाण्डुगुल्मार्शःप्लीहवातकफार्तिनुत्||४५|| <br /> <br /> दीपनं श्वासकासघ्नं मूढवाते च शस्यते| <br /> दुःखप्रसविनीनां च वन्ध्यानां चैव गर्भदम्||४६|| <br /> <br /> इति दाडिमाद्यं घृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dāḍimāt kuḍavō dhānyāt kuḍavārdhaṁ palaṁ palam| <br /> citrakācchr̥ṅgavērācca pippalyaṣṭamikā tathā||44|| <br /> <br /> taiḥ kalkairviṁśatipalaṁ ghr̥tasya salilāḍhakē| <br /> siddhaṁ hr̥tpāṇḍugulmārśaḥplīhaVātakaphārtinut||45|| <br /> <br /> dīpanaṁ śvāsakāsaghnaṁ mūḍhavātē ca śasyatē| <br /> duḥkhaprasavinīnāṁ ca vandhyānāṁ caiva garbhadam||46|| <br /> <br /> iti dāḍimādyaṁ ghr̥tam| <br /> <br /> dADimAt kuDavo dhAnyAt kuDavArdhaM palaM palam| <br /> citrakAcchRu~ggaverAcca pippalyaShTamikA tathA||44|| <br /> <br /> taiH kalkairviMshatipalaM ghRutasya salilADhake| <br /> siddhaM hRutpANDugulmArshaHplIhavAtakaphArtinut||45|| <br /> <br /> dIpanaM shvAsakAsaghnaM mUDhavAte ca shasyate| <br /> duHkhaprasavinInAM ca vandhyAnAM caiva garbhadam||46|| <br /> <br /> iti dADimAdyaM ghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take twenty ''pala'' of ghee, one ''adhaka'' of water and add to it the paste prepared of one ''kudava'' of ''dadima'', half ''kudava'' of ''dhanya'', one ''pala'' each of ''chitraka'' and ''sringavera'' and one ''ashtamika'' (two ''karsha'') of ''pippali'' and prepare ghee as per method of ''sneha paka''.This medicated ghee stimulates the power of digestion. It cures heart disease, anemia, gulma, hemorrhoids, spleenomegaly and disorders of [[vata]] and [[kapha]].It is also useful for curing asthma, bronchitis, ''mudha-vata'' (claudication of [[vata]]) and ''duhkha-prasava'' (difficult labor). It also helps a sterile woman to get offspring.<br /> <br /> Thus, ends the description of ''dadimadyaghrita'' [44-46]<br /> <br /> === ''Katukadyam ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कटुका रोहिणी मुस्तं हरिद्रे वत्सकात् पलम्| <br /> पटोलं चन्दनं मूर्वा त्रायमाणा दुरालभा||४७|| <br /> <br /> कृष्णा पर्पटको निम्बो भूनिम्बो देवदारु च| <br /> तैः कार्षिकैर्घृतप्रस्थः सिद्धः क्षीरचतुर्गुणः||४८|| <br /> <br /> रक्तपित्तं ज्वरं दाहं श्वयथुं स भगन्दरम्| <br /> अर्शांस्यसृग्दरं चैव हन्ति विस्फोटकांस्तथा||४९|| <br /> <br /> इति कटुकाद्यं घृतम्|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭukā rōhiṇī mustaṁ haridrē vatsakāt palam| <br /> paṭōlaṁ candanaṁ mūrvā trāyamāṇā durālabhā||47|| <br /> <br /> kr̥ṣṇā parpaṭakō nimbō bhūnimbō dēvadāru ca| <br /> taiḥ kārṣikairghr̥taprasthaḥ siddhaḥ kṣīracaturguṇaḥ||48|| <br /> <br /> Rakta Pittaṁ jvaraṁ dāhaṁ śvayathuṁ sa bhagandaram| <br /> arśāṁsyasr̥gdaraṁ caiva hanti visphōṭakāṁstathā||49|| <br /> <br /> iti Kaṭukādyam Ghritam| <br /> <br /> kaTukA rohiNI mustaM haridre vatsakAt palam| <br /> paTolaM candanaM mUrvA trAyamANA durAlabhA||47|| <br /> <br /> kRuShNA parpaTako nimbo bhUnimbo devadAru ca| <br /> taiH kArShikairghRutaprasthaH siddhaH kShIracaturguNaH||48|| <br /> <br /> raktapittaM jvaraM dAhaM shvayathuM sa bhagandaram| <br /> arshAMsyasRugdaraM caiva hanti visphoTakAMstathA||49|| <br /> <br /> iti kaTukAdyaM ghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''pala'' each of ''katukarohini, musta, haridra, daruharidra, vatsaka'' in paste form, one ''karsha'' of each of ''patola, chandana, murva, trayamana, duralabha, krishna, parpataka, nimba, bhūnimba, devadaru'' should be added to one ''prastha'' of ''ghrita'' and four ''prasthas'' of milk. This medicated ghee cures ''raktapitta, jwara, daha, svayathu, bhagandara, arsha, asrigadara'' and ''visphotaka''. Thus described ''katukadya ghritam'' [47-49]<br /> <br /> === ''Pathya ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पथ्याशतरसे पथ्यावृन्तार्धशतकल्कवान्| <br /> प्रस्थः सिद्धो घृतात् पेयः स पाण्ड्वामयगुल्मनुत्||५०|| <br /> <br /> इति पथ्याघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pathyāśatarasē pathyāvr̥ntārdhaśatakalkavān| <br /> prasthaḥ siddhō ghr̥tāt pēyaḥ sa pāṇḍvāmayagulmanut||50|| <br /> <br /> iti pathyāghr̥tam|<br /> <br /> pathyAshatarase pathyAvRuntArdhashatakalkavAn| <br /> prasthaH siddho ghRutAt peyaH sa pANDvAmayagulmanut||50|| <br /> <br /> iti pathyAghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The decoction of one hundred fruits of ''haritaki'' and the paste of fifty stalks of ''haritaki'' fruits should be added to one ''prastha'' of ghee and cooked. This medicated ghee cures ''pandu'' and ''gulma'' [50]<br /> <br /> === ''Danti ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दन्त्याश्चतुष्पलरसे पिष्टैर्दन्तीशलाटुभिः| <br /> तद्वत्प्रस्थो घृतात्सिद्धः प्लीहपाण्ड्वर्तिशोफजित्||५१|| <br /> <br /> इति दन्तीघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dantyāścatuṣpalarasē piṣṭairdantīśalāṭubhiḥ| <br /> tadvatprasthō ghr̥tātsiddhaḥ plīhapāṇḍvartiśōphajit||51|| <br /> <br /> iti dantīghr̥tam| <br /> <br /> dantyAshcatuShpalarase piShTairdantIshalATubhiH| <br /> tadvatprastho ghRutAtsiddhaH plIhapANDvartishophajit||51|| <br /> <br /> iti dantIghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of ghee should be cooked by adding (one ''prastha'' of) the decoction of four ''palas'' of ''danti'' and the paste of the green fruits of ''danti''. Intake of this medicated ghee cures ''pleeha'' (splenic disorders), ''pandu'' and edema [51]<br /> <br /> === ''Drakshaghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुराणसर्पिषः प्रस्थो द्राक्षार्धप्रस्थसाधितः| <br /> कामलागुल्मपाण्ड्वर्तिज्वरमेहोदरापहः||५२|| <br /> <br /> इति द्राक्षाघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> purāṇasarpiṣaḥ prasthō drākṣārdhaprasthasādhitaḥ| <br /> kāmalāgulmapāṇḍvartijvaramēhōdarāpahaḥ||52|| <br /> <br /> iti drākṣāghr̥tam| <br /> <br /> purANasarpiShaH prastho drAkShArdhaprasthasAdhitaH| <br /> kAmalAgulmapANDvartijvaramehodarApahaH||52|| <br /> <br /> iti drAkShAghRutam|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of old ghee should be added to half a ''prastha'' of ''draksha'' and cooked. This medicated ghee cures ''kamala, gulma, pandu, jwara, meha'' (polyuria) and ''udara roga'' (generalized abdominal enlargement)[52]<br /> <br /> === ''Haridradi ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> हरिद्रात्रिफलानिम्बबलामधुकसाधितम्| <br /> सक्षीरं माहिषं सर्पिः कामलाहरमुत्तमम्||५३|| <br /> <br /> इति हरिद्रादिघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> haridrātriphalānimbabalāmadhukasādhitam| <br /> sakṣīraṁ māhiṣaṁ sarpiḥ kāmalāharamuttamam||53||<br /> <br /> iti haridrādighr̥tam|<br /> <br /> haridrAtriphalAnimbabalAmadhukasAdhitam| <br /> sakShIraM mAhiShaM sarpiH kAmalAharamuttamam||53||<br /> <br /> iti haridrAdighRutam|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Ghrita'' prepared with ''haridra, triphala, nimba, balā, madhuka'' and buffalo’s milk and ghee is an excellent cure for ''kamala'' [53]<br /> <br /> === ''Darvyadi ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गोमूत्रे द्विगुणे दार्व्याः कल्काक्षद्वयसाधितः| <br /> दार्व्याः पञ्चपलक्वाथे कल्के कालीयके परः||५४|| <br /> <br /> माहिषात् सर्पिषः प्रस्थः पूर्वः पूर्वे परे परः|५५| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gōmūtrē dviguṇē dārvyāḥ kalkākṣadvayasādhitaḥ| <br /> dārvyāḥ pañcapalakvāthē kalkē kālīyakē paraḥ||54|| <br /> <br /> māhiṣāt sarpiṣaḥ prasthaḥ pūrvaḥ pūrvē parē paraḥ|55|<br /> <br /> gomUtre dviguNe dArvyAH kalkAkShadvayasAdhitaH| <br /> dArvyAH pa~jcapalakvAthe kalke kAlIyake paraH||54|| <br /> <br /> mAhiShAt sarpiShaH prasthaH pUrvaH pUrve pare paraH|55|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of buffalo’s ghee prepared by adding two ''prasthas'' of cow’s urine and the paste of two ''aksha'' of the paste of ''darvi'' as per ''sneha kalpana'' cures ''pandu roga''.<br /> <br /> One ''prastha'' of buffalo’s ghee prepared by adding with the decoction of five ''palas'' of ''darvi'' and the paste of ''kaleeyaka'' as per ''sneha kalpana'' cures ''kamala'' [54-55]<br /> <br /> === Preparations for ''pandu roga'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्नेहैरेभिरुपक्रम्य स्निग्धं मत्वा विरेचयेत्||५५|| <br /> <br /> पयसा मूत्रयुक्तेन बहुशः केवलेन वा| <br /> दन्तीफलरसे कोष्णे काश्मर्याञ्जलिना शृतम्||५६|| <br /> <br /> द्राक्षाञ्जलिं मृदित्वा वा दद्यात् पाण्ड्वामयापहम्| <br /> द्विशर्करं त्रिवृच्चूर्णं पलार्धं पैत्तिकः पिबेत्||५७|| <br /> <br /> कफपाण्डुस्तु गोमूत्रक्लिन्नयुक्तां [१] हरीतकीम्| <br /> आरग्वधं [२] रसेनेक्षोर्विदार्यामलकस्य च||५८||<br /> <br /> सत्र्यूषणं बिल्वपत्रं पिबेन्ना कामलापहम्| <br /> दन्त्यर्धपलकल्कं वा द्विगुडं शीतवारिणा||५९|| <br /> <br /> कामली त्रिवृतां वाऽपि त्रिफलाया रसैः पिबेत्| <br /> विशालात्रिफलामुस्तकुष्ठदारुकलिङ्गकान्||६०|| <br /> <br /> कार्षिकानर्धकर्षांशां कुर्यादतिविषां तथा| <br /> कर्षौ मधुरसाया द्वौ सर्वमेतत् [३] सुखाम्बुना||६१|| <br /> <br /> मृदितं तं रसं पूतं पीत्वा लिह्याच्च मध्वनु| <br /> कासं श्वासं ज्वरं दाहं पाण्डुरोगमरोचकम्||६२|| <br /> <br /> गुल्मानाहामवातांश्च रक्तपित्तं च नाशयेत्| <br /> त्रिफलाया गुडूच्या वा दार्व्या निम्बस्य वा रसम्||६३|| <br /> <br /> शीतं मधुयुतं प्रातः कामलार्तः पिबेन्नरः| <br /> क्षीरमूत्रं पिबेत् पक्षं गव्यं माहिषमेव वा||६४|| <br /> <br /> पाण्डुर्गोमूत्रयुक्तं वा सप्ताहं त्रिफलारसम्| <br /> तरुजान् ज्वलितान्मूत्रे निर्वाप्यामृद्य चाङ्कुरान्||६५|| <br /> <br /> मातुलुङ्गस्य तत् पूतं पाण्डुशोथहरं पिबेत्| <br /> स्वर्णक्षीरी त्रिवृच्छ्यामे भद्रदारु सनागरम्||६६|| <br /> <br /> गोमूत्राञ्जलिना पिष्टं मूत्रे वा क्वथितं पिबेत्| <br /> क्षीरमेभिः शृतं वाऽपि पिबेद्दोषानुलोमनम्||६७|| <br /> <br /> हरीतकीं प्रयोगेण गोमूत्रेणाथवा पिबेत्| <br /> जीर्णे क्षीरेण भुञ्जीत रसेन मधुरेण वा||६८|| <br /> <br /> सप्तरात्रं गवां मूत्रे भावितं वाऽप्ययोरजः| <br /> पाण्डुरोगप्रशान्त्यर्थं पयसा पाययेद्भिषक्||६९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snēhairēbhirupakramya snigdhaṁ matvā virēcayēt||55|| <br /> <br /> payasā mūtrayuktēna bahuśaḥ kēvalēna vā| <br /> dantīphalarasē kōṣṇē kāśmaryāñjalinā śr̥tam||56|| <br /> <br /> drākṣāñjaliṁ mr̥ditvā vā dadyāt pāṇḍvāmayāpaham| <br /> dviśarkaraṁ trivr̥ccūrṇaṁ palārdhaṁ paittikaḥ pibēt||57|| <br /> <br /> Kaphapāṇḍustu gōmūtraklinnayuktāṁ [1] harītakīm| <br /> āragvadhaṁ [2] rasēnēkṣōrvidāryāmalakasya ca||58|| <br /> <br /> satryūṣaṇaṁ bilvapatraṁ pibēnnā kāmalāpaham| <br /> dantyardhapalakalkaṁ vā dviguḍaṁ śītavāriṇā||59|| <br /> <br /> kāmalī trivr̥tāṁ vā'pi triphalāyā rasaiḥ pibēt| <br /> viśālātriphalāmustakuṣṭhadārukaliṅgakān||60|| <br /> <br /> kārṣikānardhakarṣāṁśāṁ kuryādativiṣāṁ tathā| <br /> karṣau madhurasāyā dvau sarvamētat [3] sukhāmbunā||61|| <br /> <br /> mr̥ditaṁ taṁ rasaṁ pūtaṁ pītvā lihyācca madhvanu| <br /> kāsaṁ śvāsaṁ jvaraṁ dāhaṁ pāṇḍurōgamarōcakam||62|| <br /> <br /> gulmānāhāmavātāṁśca Rakta Pittaṁ ca nāśayēt| <br /> triphalāyā guḍūcyā vā dārvyā nimbasya vā rasam||63|| <br /> <br /> śītaṁ madhuyutaṁ prātaḥ kāmalārtaḥ pibēnnaraḥ| <br /> kṣīramūtraṁ pibēt pakṣaṁ gavyaṁ māhiṣamēva vā||64|| <br /> <br /> pāṇḍurgōmūtrayuktaṁ vā saptāhaṁ triphalārasam| <br /> tarujān jvalitānmūtrē nirvāpyāmr̥dya cāṅkurān||65|| <br /> <br /> mātuluṅgasya tat pūtaṁ pāṇḍuśōthaharaṁ pibēt| <br /> svarṇakṣīrī trivr̥cchyāmē bhadradāru sanāgaram||66|| <br /> <br /> gōmūtrāñjalinā piṣṭaṁ mūtrē vā kvathitaṁ pibēt| <br /> kṣīramēbhiḥ śr̥taṁ vā'pi pibēddōṣānulōmanam||67|| <br /> <br /> harītakīṁ prayōgēṇa gōmūtrēṇāthavā pibēt| <br /> jīrṇē kṣīrēṇa bhuñjīta rasēna madhurēṇa vā||68|| <br /> <br /> saptarātraṁ gavāṁ mūtrē bhāvitaṁ vā'pyayōrajaḥ| <br /> pāṇḍurōgapraśāntyarthaṁ payasā pāyayēdbhiṣak||69||<br /> <br /> snehairebhirupakramya snigdhaM matvA virecayet||55|| <br /> <br /> payasA mUtrayuktena bahushaH kevalena vA| <br /> dantIphalarase koShNe kAshmaryA~jjalinA shRutam||56|| <br /> <br /> drAkShA~jjaliM mRuditvA vA dadyAt pANDvAmayApaham| <br /> dvisharkaraM trivRuccUrNaM palArdhaM paittikaH pibet||57|| <br /> <br /> kaphapANDustu gomUtraklinnayuktAM [1] harItakIm| <br /> AragvadhaM [2] rasenekShorvidAryAmalakasya ca||58|| <br /> <br /> satryUShaNaM bilvapatraM pibennA kAmalApaham| <br /> dantyardhapalakalkaM vA dviguDaM shItavAriNA||59|| <br /> <br /> kAmalI trivRutAM vA~api triphalAyA rasaiH pibet| <br /> vishAlAtriphalAmustakuShThadArukali~ggakAn||60|| <br /> <br /> kArShikAnardhakarShAMshAM kuryAdativiShAM tathA| <br /> karShau madhurasAyA dvau sarvametat [3] sukhAmbunA||61|| <br /> <br /> mRuditaM taM rasaM pUtaM pItvA lihyAcca madhvanu| <br /> kAsaM shvAsaM jvaraM dAhaM pANDurogamarocakam||62|| <br /> <br /> gulmAnAhAmavAtAMshca raktapittaM ca nAshayet| <br /> triphalAyA guDUcyA vA dArvyA nimbasya vA rasam||63||<br /> <br /> shItaM madhuyutaM prAtaH kAmalArtaH pibennaraH| <br /> kShIramUtraM pibet pakShaM gavyaM mAhiShameva vA||64|| <br /> <br /> pANDurgomUtrayuktaM vA saptAhaM triphalArasam| <br /> tarujAn jvalitAnmUtre nirvApyAmRudya cA~gkurAn||65|| <br /> <br /> mAtulu~ggasya tat pUtaM pANDushothaharaM pibet| <br /> svarNakShIrI trivRucchyAme bhadradAru sanAgaram||66|| <br /> <br /> gomUtrA~jjalinA piShTaM mUtre vA kvathitaM pibet| <br /> kShIramebhiH shRutaM vA~api pibeddoShAnulomanam||67|| <br /> <br /> harItakIM prayogeNa gomUtreNAthavA pibet| <br /> jIrNe kShIreNa bhu~jjIta rasena madhureNa vA||68|| <br /> <br /> saptarAtraM gavAM mUtre bhAvitaM vA~apyayorajaH| <br /> pANDurogaprashAntyarthaM payasA pAyayedbhiShak||69|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After proper oleation of the patient with the internal administration of the above described medicated ''ghrita,'' the patient should be given frequent medication with the following recipes: <br /> <br /> Milk with cow’s urine or milk alone or lukewarm infusion of ''danti'' sprinkled with the powder of one ''anjali'' of ''kashmarya'' or mixed with the paste of one ''anjali'' (handful) of ''draksha''; all these drugs cure ''pandu roga'' in general.<br /> <br /> The patient suffering from ''paittika pandu'' should take half ''pala'' of ''trivitta'' mixed with one ''pala'' of sugar; <br /> <br /> ''Kaphaja'' type of ''pandu'' patient should take ''haritaki churna'' immersed in cow’s urine. <br /> <br /> ''Kamala'' patient should take ''aragvadha'' along with the juice of sugarcane, ''vidari, amalaki'' to which ''sunthi, maricha, pippali'' and ''bilva'' leaves have been added; or may take the paste of half ''pala'' of ''danti'' mixed with one ''pala'' of jaggery along with cold water; or may take ''trivritta'' along with decoction of ''triphala''. <br /> <br /> ''Vishaladi phanta'' – One ''karsha'' each of ''vishala, haritaki, bibhitaka, amalaki, musta, kushtha, devadaru'' and ''kalingaka''; half ''karsha'' of ''ativisha'', two ''karsha'' of ''madhurasa'' (''murva'') should be made to a paste by triturating with lukewarm water and strained. The patient should take honey after taking this infusion. This ''phanta'' cures cough, dyspnea, fever, burning sensation, ''pandu roga'', anorexia, ''gulma'' (lumps in abdomen), ''anaha'' (gaseous distention of the abdomen), ''amavata'' (joint disorders caused by ''ama''), and ''raktapitta'' (bleeding disorders).<br /> <br /> Other drugs which are useful for these ailments are as follows: <br /> *''Kamala'' patients should take the decoction of ''triphala, guduchi, devadaru,'' or ''nimba'' after cooling and adding honey in the morning.<br /> *''Pandu'' patient may take the milk or urine of either cow or buffalo for one fortnight.<br /> *''Pandu'' patient may drink the decoction of ''triphala'' along with cow’s urine for one week.<br /> *Patient suffering from ''pandu'' and ''sopha'' (edema) should drink the liquid obtained by straining the paste of tender branches of ''matulunga'' set afire and then immersed in cow’s urine.<br /> *''Suvarnakshiri, trivritta, syama-trivritta, bhadradaru'' and ''nagara'' should be triturated by adding one ''anjali'' of cow’s urine or should be made to a decoction by adding cow’s urine. The above mentioned drugs may also be boiled with milk. The drinking of these drugs brings about the downward motion of the ''doshas'' causing ''pandu''.<br /> *Then again, the patient suffering from ''pandu roga'' should take a course of ''haritaki'' with cow’s urine (for seven days) and then should take food either with milk or sweetened meat soup, and <br /> *Physicians should give ''lauha bhasma'' impregnated for seven nights with cow’s urine along with milk for the alleviation of ''pandu roga'' [55-69]<br /> <br /> === ''Navayasa churnam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्र्यूषणत्रिफलामुस्तविडङ्गचित्रकाः समाः| <br /> नवायोरजसो भागास्तच्चूर्णं क्षौद्रसर्पिषा||७०|| <br /> <br /> भक्षयेत् पाण्डुहृद्रोगकुष्ठार्शःकामलापहम्| <br /> नवायसमिदं चूर्णं कृष्णात्रेयेण भाषितम्||७१|| <br /> <br /> इति नवायसचूर्णम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tryūṣaṇatriphalāmustaviḍaṅgacitrakāḥ samāḥ| <br /> navāyōrajasō bhāgāstaccūrṇaṁ kṣaudrasarpiṣā||70|| <br /> <br /> bhakṣayēt pāṇḍuhr̥drōgakuṣṭhārśaḥkāmalāpaham| <br /> navāyasamidaṁ cūrṇaṁ kr̥ṣṇātrēyēṇa bhāṣitam||71|| <br /> <br /> iti navāyasacūrṇam| <br /> <br /> tryUShaNatriphalAmustaviDa~ggacitrakAH samAH| <br /> navAyorajaso bhAgAstaccUrNaM kShaudrasarpiShA||70|| <br /> <br /> bhakShayet pANDuhRudrogakuShThArshaHkAmalApaham| <br /> navAyasamidaM cUrNaM kRuShNAtreyeNa bhAShitam||71|| <br /> <br /> iti navAyasacUrNam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take ''sunthi, pippali, maricha, haritaki, bibhitaki, amalaki, musta, vidanga'' and ''chitraka'' in one part each and nine parts of ''lauha bhasma'' and mix together. Intake of this recipe along with honey and ghee cures anemia, heart diseases, ''kushtha'' (group of skin diseases), ''arsha'' (hemorrhoids) and ''kamala''. This medicine propounded by ''krishnatreya'' is called ''navayasa churna'' [70-71]<br /> <br /> === ''Mandura vataka'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुडनागरमण्डूरतिलांशान्मानतः समान्| <br /> पिप्पलीद्विगुणां कुर्याद्गुटिकां पाण्डुरोगिणे||७२|| <br /> <br /> त्र्यूषणं त्रिफला मुस्तं विडङ्गं चव्यचित्रकौ| <br /> दार्वीत्वङ्माक्षिको धातुर्ग्रन्थिकं देवदारु च||७३|| <br /> <br /> एतान् द्विपलिकान्भागांश्चूर्णं कुर्यात् पृथक् पृथक्| <br /> मण्डूरं द्विगुणं चूर्णाच्छुद्धमञ्जनसन्निभम्||७४|| <br /> <br /> गोमूत्रेऽष्टगुणे पक्त्वा तस्मिंस्तत् प्रक्षिपेत्ततः| <br /> उदुम्बरसमान्कृत्वा वटकांस्तान् यथाग्नि ना||७५|| <br /> <br /> उपयुञ्जीत तक्रेण सात्म्यं जीर्णे च भोजनम्| <br /> मण्डूरवटका ह्येते प्राणदाः पाण्डुरोगिणाम्||७६|| <br /> <br /> कुष्ठान्यजीर्णकं शोथमूरुस्तम्भं कफामयान्| <br /> अर्शांसि कामलां मेहं प्लीहानं शमयन्ति च||७७|| <br /> <br /> इति मण्डूरवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> guḍanāgaramaṇḍūratilāṁśānmānataḥ samān| <br /> pippalīdviguṇāṁ kuryādguṭikāṁ pāṇḍurōgiṇē||72|| <br /> <br /> tryūṣaṇaṁ triphalā mustaṁ viḍaṅgaṁ cavyacitrakau| <br /> dārvītvaṅmākṣikō Dhāturgranthikaṁ dēvadāru ca||73|| <br /> <br /> ētān dvipalikānbhāgāṁścūrṇaṁ kuryāt pr̥thak pr̥thak| <br /> maṇḍūraṁ dviguṇaṁ cūrṇācchuddhamañjanasannibham||74|| <br /> <br /> gōmūtrē'ṣṭaguṇē paktvā tasmiṁstat prakṣipēttataḥ| <br /> udumbarasamānkr̥tvā vaṭakāṁstān yathāgni nā||75|| <br /> <br /> upayuñjīta takrēṇa sātmyaṁ jīrṇē ca bhōjanam| <br /> maṇḍūravaṭakā hyētē prāṇadāḥ pāṇḍurōgiṇām||76|| <br /> <br /> kuṣṭhānyajīrṇakaṁ śōthamūrustambhaṁ kaphāmayān| <br /> arśāṁsi kāmalāṁ mēhaṁ plīhānaṁ śamayanti ca||77|| <br /> <br /> iti maṇḍūravaṭakāḥ| <br /> <br /> guDanAgaramaNDUratilAMshAnmAnataH samAn| <br /> pippalIdviguNAM kuryAdguTikAM pANDurogiNe||72|| <br /> <br /> tryUShaNaM triphalA mustaM viDa~ggaM cavyacitrakau| <br /> dArvItva~gmAkShiko dhAturgranthikaM devadAru ca||73|| <br /> <br /> etAn dvipalikAnbhAgAMshcUrNaM kuryAt pRuthak pRuthak| <br /> maNDUraM dviguNaM cUrNAcchuddhama~jjanasannibham||74|| <br /> <br /> gomUtre~aShTaguNe paktvA tasmiMstat prakShipettataH| <br /> udumbarasamAnkRutvA vaTakAMstAn yathAgni nA||75|| <br /> <br /> upayu~jjIta takreNa sAtmyaM jIrNe ca bhojanam| <br /> maNDUravaTakA hyete prANadAH pANDurogiNAm||76|| <br /> <br /> kuShThAnyajIrNakaM shothamUrustambhaM kaphAmayAn| <br /> arshAMsi kAmalAM mehaM plIhAnaM shamayanti ca||77|| <br /> <br /> iti maNDUravaTakAH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Mandura vataka'' – jaggery, ''shunthi, mandura'' and ''tila'' in one part each along with two parts of ''pippali'' should be triturated and made in the form of pills. This medicine is suitable for the treatment of the patients with ''pandu roga''.<br /> <br /> ''Shunthi, pippali, maricha, haritaki, bibhitaki, amalaki, musta, vidanga, chavya, chitraka,'' bark of ''daruharidra, makshika'' (copper pyrite), ''pippalimoola'' and ''devadaru'' in the quantity of two ''pala'' each should be made to powders separately.<br /> <br /> ''Mandura bhasma'' which is dark in color like collyrium, should be cooked by adding eight times of cow’s urine and the powders of the above drugs should be mixed to this. ''Vatakas'' (large sized pills) of the size of ''udumbara'' should be made out of this combination. This should be taken by the patient in the appropriate doses according to his [[agni]] (power of digestion and metabolism) along with butter milk. The patient should take wholesome food after its digestion. These pills named as ''mandura vataka'' are the life givers for the patients of ''pandu''. It also cures ''kushtha, ajeerna'' (indigestion), ''sotha'' (edema), ''urustambha'' (stiffening of the thighs), disease caused by aggravation of the [[kapha]], arsha'' (hemorrhoids), ''kamala'' (jaundice), ''meha'' (polyuria) and ''pleeha'' (splenic diseases).<br /> <br /> Thus ends the description of two types of ''mandura vataka''.[72-77]<br /> <br /> === ''Tapayadi lauha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ताप्याद्रिजतुरूप्यायोमलाः पञ्चपलाः पृथक्| <br /> चित्रकत्रिफलाव्योषविडङ्गैः पलिकैः सह||७८|| <br /> <br /> शर्कराष्टपलोन्मिश्राश्चूर्णिता मधुनाऽऽप्लुताः| <br /> अभ्यस्यास्त्वक्षमात्रा हि जीर्णे हितमिताशिना||७९|| <br /> <br /> कुलत्थकाकमाच्यादिकपोतपरिहारिणा|८०| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tāpyādrijaturūpyāyōmalāḥ pañcapalāḥ pr̥thak| <br /> citrakatriphalāvyōṣaviḍaṅgaiḥ palikaiḥ saha||78|| <br /> <br /> śarkarāṣṭapalōnmiśrāścūrṇitā madhunā''plutāḥ| <br /> abhyasyāstvakṣamātrā hi jīrṇē hitamitāśinā||79|| <br /> <br /> kulatthakākamācyādikapōtaparihāriṇā|80| <br /> <br /> tApyAdrijaturUpyAyomalAH pa~jcapalAH pRuthak| <br /> citrakatriphalAvyoShaviDa~ggaiH palikaiH saha||78|| <br /> <br /> sharkarAShTapalonmishrAshcUrNitA madhunA~a~aplutAH| <br /> abhyasyAstvakShamAtrA hi jIrNe hitamitAshinA||79|| <br /> <br /> kulatthakAkamAcyAdikapotaparihAriNA|80|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Tapyadi yoga'' – ''Tapya, shilajatu,'' silver, ''mandura'' in the amount of five ''pala'' each should be added to one ''pala'' each of ''chitraka, haritaki, bibhitaka, amalaki, sunthi, pippali, maricha'' and ''vidanga''; and eight ''pala'' of sugar. This recipe should be taken by the patient habitually (by a ''pandu rogi'') in the dose of one ''karsha'' along with adequate amount of honey. After the digestion of this drug the patient should take wholesome food in small quantity and should avoid using ''kulattha, kakamachi'' etc. and pigeon meat [78-80]<br /> <br /> === ''Yogaraja'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिफलायास्त्रयो भागास्त्रयस्त्रिकटुकस्य च||८०|| <br /> <br /> भागश्चित्रकमूलस्य विडङ्गानां तथैव च| <br /> पञ्चाश्मजतुनो भागास्तथा रूप्यमलस्य च||८१|| <br /> <br /> माक्षिकस्य च शुद्धस्य लौहस्य रजसस्तथा| <br /> अष्टौ भागाः सितायाश्च तत्सर्वं सूक्ष्मचूर्णितम्||८२|| <br /> <br /> माक्षिकेणाप्लुतं स्थाप्यमायसे भाजने शुभे| <br /> उदुम्बरसमां मात्रां ततः खादेद्यथाग्नि ना||८३|| <br /> <br /> दिने दिने प्रयुञ्जीत जीर्णे भोज्यं यथेप्सितम्| <br /> वर्जयित्वा कुलत्थानि काकमाचीं कपोतकम्||८४||<br /> <br /> योगराज इति ख्यातो योगोऽयममृतोपमः| <br /> रसायनमिदं श्रेष्ठं सर्वरोगहरं शिवम्||८५|| <br /> <br /> पाण्डुरोगं विषं कासं यक्ष्माणं विषमज्वरम्| <br /> कुष्ठान्यजीर्णकं मेहं शोषं श्वासमरोचकम्||८६|| <br /> <br /> विशेषाद्धन्त्यपस्मारं कामलां गुदजानि च| <br /> <br /> इति योगराजः|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> triphalāyāstrayō bhāgāstrayastrikaṭukasya ca||80|| <br /> <br /> bhāgaścitrakamūlasya viḍaṅgānāṁ tathaiva ca| <br /> pañcāśmajatunō bhāgāstathā rūpyamalasya ca||81|| <br /> <br /> mākṣikasya ca śuddhasya lauhasya rajasastathā| <br /> aṣṭau bhāgāḥ sitāyāśca tatsarvaṁ sūkṣmacūrṇitam||82|| <br /> <br /> mākṣikēṇāplutaṁ sthāpyamāyasē bhājanē śubhē| <br /> udumbarasamāṁ mātrāṁ tataḥ khādēdyathāgni nā||83|| <br /> <br /> dinē dinē prayuñjīta jīrṇē bhōjyaṁ yathēpsitam| <br /> varjayitvā kulatthāni kākamācīṁ kapōtakam||84|| <br /> <br /> yōgarāja iti khyātō yōgō'yamamr̥tōpamaḥ| <br /> rasāyanamidaṁ śrēṣṭhaṁ sarvarōgaharaṁ śivam||85|| <br /> <br /> pāṇḍurōgaṁ viṣaṁ kāsaṁ yakṣmāṇaṁ viṣamajvaram| <br /> kuṣṭhānyajīrṇakaṁ mēhaṁ śōṣaṁ śvāsamarōcakam||86|| <br /> <br /> viśēṣāddhantyapasmāraṁ kāmalāṁ gudajāni ca| <br /> <br /> iti yōgarājaḥ| <br /> <br /> triphalAyAstrayo bhAgAstrayastrikaTukasya ca||80|| <br /> <br /> bhAgashcitrakamUlasya viDa~ggAnAM tathaiva ca| <br /> pa~jcAshmajatuno bhAgAstathA rUpyamalasya ca||81|| <br /> <br /> mAkShikasya ca shuddhasya lauhasya rajasastathA| <br /> aShTau bhAgAH sitAyAshca tatsarvaM sUkShmacUrNitam||82|| <br /> <br /> mAkShikeNAplutaM sthApyamAyase bhAjane shubhe| <br /> udumbarasamAM mAtrAM tataH khAdedyathAgni nA||83|| <br /> <br /> dine dine prayu~jjIta jIrNe bhojyaM yathepsitam| <br /> varjayitvA kulatthAni kAkamAcIM kapotakam||84|| <br /> <br /> yogarAja iti khyAto yogo~ayamamRutopamaH| <br /> rasAyanamidaM shreShThaM sarvarogaharaM shivam||85|| <br /> <br /> pANDurogaM viShaM kAsaM yakShmANaM viShamajvaram| <br /> kuShThAnyajIrNakaM mehaM shoShaM shvAsamarocakam||86|| <br /> <br /> visheShAddhantyapasmAraM kAmalAM gudajAni ca| <br /> <br /> iti yogarAjaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Yogaraja'' – ''harītaki, bibhitaki, amalaki, shunthi, pippali, maricha, chitraka moola'' (root) and ''vidanga'' in the amount of one part each; five parts each of ''shilajatu, raupya mala'' (silver), purified ''makshika'' and ''lauha bhasma''; eight parts of sugar – all should be made to a fine powder and mixed with adequate amount of honey and kept in clean iron jar. This recipe should be taken by the patient in a quantity equal to a fruit of ''udumbara'' according to the power of digestion every day and should be given the desired food excluding ''kulattha, kakamachi'' etc. and pigeon meat; only after the digestion of the taken drug. This ambrosia like recipe is called ''yogaraja''. It is an excellent rejuvenative recipe which cures all diseases and bestows auspiciousness. It specially cures ''pandu'', poisoning, ''kasa, yakshma, vishama jwara'' (irregular fevers), ''ajeerna, meha, soshha, swasa, aruchi, apasmara'' (epilepsy), ''kamala'' and ''arsha''.<br /> <br /> Thus ends the description of ''yogaraja'' [80-86]<br /> <br /> === Various formulations ===<br /> <br /> === Shilajatu Vataka ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कौटजत्रिफलानिम्बपटोलघननागरैः||८७|| <br /> <br /> भावितानि दशाहानि रसैर्द्वित्रिगुणानि वा| <br /> शिलाजतुपलान्यष्टौ तावती सितशर्करा||८८||<br /> <br /> त्वक्क्षीरी पिप्पली धात्री कर्कटाख्या पलोन्मिता| <br /> <br /> निदिग्ध्याः फलमूलाभ्यां पलं युक्त्या त्रिगन्धकम्| <br /> <br /> चूर्णितं मधुनः कुर्यात् त्रिपलेनाक्षिकान् गुडान्| <br /> दाडिमाम्बुपयःपक्षिरसतोयसुरासवान्||९०|| <br /> <br /> तान् भक्षयित्वाऽनुपिबेन्निरन्नो भुक्त एव वा| <br /> पाण्डुकुष्ठज्वरप्लीहतमकार्शोभगन्दरान्||९१|| <br /> <br /> पूतिहृच्छुक्रमूत्राग्निदोषशोषगरोदरान् [१] | <br /> कासासृग्दरपित्तासृक्शोथगुल्मगलामयान्||९२|| <br /> <br /> ते च सर्वव्रणान् हन्युः सर्वरोगहराः शिवाः| <br /> <br /> इति शिलाजतुवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> kauṭajatriphalānimbapaṭōlaghananāgaraiḥ||87|| <br /> <br /> bhāvitāni daśāhāni rasairdvitriguṇāni vā| <br /> śilājatupalānyaṣṭau tāvatī sitaśarkarā||88|| <br /> <br /> tvakkṣīrī pippalī dhātrī karkaṭākhyā palōnmitā| <br /> <br /> nidigdhyāḥ phalamūlābhyāṁ palaṁ yuktyā trigandhakam| <br /> <br /> cūrṇitaṁ madhunaḥ kuryāt tripalēnākṣikān guḍān| <br /> dāḍimāmbupayaḥpakṣirasatōyasurāsavān||90|| <br /> <br /> tān bhakṣayitvā'nupibēnnirannō bhukta ēva vā| <br /> pāṇḍukuṣṭhajvaraplīhatamakārśōbhagandarān||91|| <br /> <br /> pūtihr̥cchukramūtrāgnidōṣaśōṣagarōdarān [1] | <br /> kāsāsr̥gdarapittāsr̥kśōthagulmagalāmayān||92|| <br /> <br /> tē ca sarvavraṇān hanyuḥ sarvarōgaharāḥ śivāḥ| <br /> <br /> iti śilājatuvaṭakāḥ| <br /> <br /> kauTajatriphalAnimbapaTolaghananAgaraiH||87|| <br /> <br /> bhAvitAni dashAhAni rasairdvitriguNAni vA| <br /> shilAjatupalAnyaShTau tAvatI sitasharkarA||88|| <br /> <br /> tvakkShIrI pippalI dhAtrI karkaTAkhyA palonmitA| <br /> <br /> nidigdhyAH phalamUlAbhyAM palaM yuktyA trigandhakam| <br /> <br /> cUrNitaM madhunaH kuryAt tripalenAkShikAn guDAn| <br /> dADimAmbupayaHpakShirasatoyasurAsavAn||90|| <br /> <br /> tAn bhakShayitvA~anupibenniranno bhukta eva vA| <br /> pANDukuShThajvaraplIhatamakArshobhagandarAn||91|| <br /> <br /> pUtihRucchukramUtrAgnidoShashoShagarodarAn [1] | <br /> kAsAsRugdarapittAsRukshothagulmagalAmayAn||92|| <br /> <br /> te ca sarvavraNAn hanyuH sarvarogaharAH shivAH| <br /> <br /> iti shilAjatuvaTakAH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> ''Shilajatu vataka'' – Eight ''pala'' of ''shilajatu'' impregnated for ten, twenty or thirty days with the decoction of fruit of ''kutaja, haritaki, bibhitaka, amalaki, nimba, patola, ghana'' and ''nagara''. Eight ''pala'' of sugar and one ''pala'' each of ''tvakakshiri, pippali, dhatri'' and ''karkatashringi''; half ''pala'' each of the fruit and root of ''nidigdhika'' and adequate powder of ''tvaka, ela'' and ''patra'' should be added to this ''shilajatu''. ''Vataka'' (large sized pills) of one ''aksha'' each should be prepared by adding three ''pala'' of honey to this powder. These pills can be taken on either empty stomach or after having food. The patient should drink the juice of ''dadima'' (pomegranate), milk, meat soup of birds, water, alcohol, ''asava'' (medicated wine) after taking this medicine. It cures ''pandu, kushtha, jwara, pleeha, tamaka svasa, arsha, bhagandara'' (fistula in ano), ''puti'' (putrified ulcers), ''hridroga'' (heart diseases), ''shukra dosha'' (diseases of semen), ''mutra dosha'' (diseases of urine), and ''agni dosha'' (diseases of digestion), ''sosha'' (consumption), ''gara'' (poisoning), ''udara, kasa, asrigdara'' (menorrhagia), ''raktapitta'' (bleeding disorders), ''sotha, gulma, galamayana'' (diseases of the throats) and all types of ''vrana'' (wounds). It cures all types of diseases and bestows auspiciousness. Thus, ends the description of ''shilajatu vataka.'' [87-92]<br /> <br /> === Punarnava Mandura ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुनर्नवा त्रिवृद्व्योषविडङ्गं दारु चित्रकम्||९३|| <br /> <br /> कुष्ठं हरिद्रे त्रिफला दन्ती चव्यं कलिङ्गकाः| <br /> पिप्पली [२] पिप्पलीमूलं मुस्तं चेति पलोन्मितम्||९४|| <br /> <br /> मण्डूरं द्विगुणं चूर्णाद्गोमूत्रे द्व्याढके पचेत्| <br /> कोलवद्गुटिकाः कृत्वा तक्रेणालोड्य ना पिबेत्||९५|| <br /> <br /> ताः पाण्डुरोगान् प्लीहानमर्शांसि विषमज्वरम्| <br /> श्वयथुं ग्रहणीदोषं हन्युः कुष्ठं क्रिमींस्तथा||९६|| <br /> <br /> इति पुनर्नवामण्डूरम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> punarnavā trivr̥dvyōṣaviḍaṅgaṁ dāru citrakam||93|| <br /> <br /> kuṣṭhaṁ haridrē triphalā dantī cavyaṁ kaliṅgakāḥ| <br /> pippalī [2] pippalīmūlaṁ mustaṁ cēti palōnmitam||94|| <br /> <br /> maṇḍūraṁ dviguṇaṁ cūrṇādgōmūtrē dvyāḍhakē pacēt| <br /> kōlavadguṭikāḥ kr̥tvā takrēṇālōḍya nā pibēt||95|| <br /> <br /> tāḥ pāṇḍurōgān plīhānamarśāṁsi viṣamajvaram| <br /> śvayathuṁ grahaṇīdōṣaṁ hanyuḥ kuṣṭhaṁ krimīṁstathā||96|| <br /> <br /> iti punarnavāmaṇḍūram|<br /> <br /> punarnavA trivRudvyoShaviDa~ggaM dAru citrakam||93|| <br /> <br /> kuShThaM haridre triphalA dantI cavyaM kali~ggakAH| <br /> pippalI [2] pippalImUlaM mustaM ceti palonmitam||94|| <br /> <br /> maNDUraM dviguNaM cUrNAdgomUtre dvyADhake pacet| <br /> kolavadguTikAH kRutvA takreNAloDya nA pibet||95|| <br /> <br /> tAH pANDurogAn plIhAnamarshAMsi viShamajvaram| <br /> shvayathuM grahaNIdoShaM hanyuH kuShThaM krimIMstathA||96|| <br /> <br /> iti punarnavAmaNDUram| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Powder of one ''pala'' each of ''punarnava, trivritta, sunthi, pippali, maricha, vidanga, devadaru, chitraka, kushtha, haridra, daruharidra, haritaki, bibhitaka, amalaki, danti, chavya, kālingaka, pippalī, pippalimoola'' and ''musta''; and forty ''pala'' of ''mandura bhasma'' (rust of iron) coked in two ''adhaka'' of cow’s urine and made in the form of ''gutika'' of the size of ''kola''. These pills should be taken with butter milk. It cures ''pandu, pleeha, arsha, vishama jwara, sotha, grahanidosha'' (sprue syndrome, irritable bowel syndrome), ''kushtha'' and ''krimi'' (parasitic infestation). Thus, ends the description of ''punarnava mandura''.[93-96]<br /> <br /> === Darvyadi leha and other two recipes ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दार्वीत्वक् त्रिफला व्योषं विडङ्गमयसो रजः| <br /> मधुसर्पिर्युतं लिह्यात् कामलापाण्डुरोगवान्||९७|| <br /> <br /> तुल्या अयोरजःपथ्याहरिद्राः क्षौद्रसर्पिषा| <br /> चूर्णिताः कामली लिह्याद्गुडक्षौद्रेण वाऽभयाः||९८|| <br /> <br /> त्रिफला द्वे हरिद्रे च कटुरोहिण्ययोरजः| <br /> चूर्णितं क्षौद्रसर्पिर्भ्यां स लेहः कामलापहः||९९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> dārvītvak triphalā vyōṣaṁ viḍaṅgamayasō rajaḥ| <br /> madhusarpiryutaṁ lihyāt kāmalāpāṇḍurōgavān||97|| <br /> <br /> tulyā ayōrajaḥpathyāharidrāḥ kṣaudrasarpiṣā| <br /> cūrṇitāḥ kāmalī lihyādguḍakṣaudrēṇa vā'bhayāḥ||98|| <br /> <br /> triphalā dvē haridrē ca kaṭurōhiṇyayōrajaḥ| <br /> cūrṇitaṁ kṣaudrasarpirbhyāṁ sa lēhaḥ kāmalāpahaḥ||99|| <br /> <br /> dArvItvak triphalA vyoShaM viDa~ggamayaso rajaH| <br /> madhusarpiryutaM lihyAt kAmalApANDurogavAn||97|| <br /> <br /> tulyA ayorajaHpathyAharidrAH kShaudrasarpiShA| <br /> cUrNitAH kAmalI lihyAdguDakShaudreNa vA~abhayAH||98|| <br /> <br /> triphalA dve haridre ca kaTurohiNyayorajaH| <br /> cUrNitaM kShaudrasarpirbhyAM sa lehaH kAmalApahaH||99|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Powder of the bark of daruharidra, haritaki, bibhitaka, amalaki, pippali, sunthi, maricha, vidanga and lauha bhasma mixed with ghee and honey, taken as a linctus by the patients suffering from ''pandu'' and ''kamala''.<br /> <br /> Two other recipes – Patients suffering from ''kamala'' should take the powder of one part each of ''lauha bhasma, haritaki'' and ''haridra'' along with honey and ghee and may also take the linctus of the powder of ''abhaya'' prepared by mixing with jaggery and honey. [97-99]<br /> <br /> === ''Dhatryavaleha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्विपलांशां तुगाक्षीरीं नागरं मधुयष्टिकाम्| <br /> प्रास्थिकीं पिप्पलीं द्राक्षां शर्करार्धतुलां शुभाम्||१००|| <br /> <br /> धात्रीफलरसद्रोणे चूर्णितं लेहवत् पचेत्| <br /> शीतं मधुप्रस्थयुतं लिह्यात् पाणितलं ततः||१०१|| <br /> <br /> हन्त्येष कामलां पित्तं पाण्डुं कासं हलीमकम्| <br /> <br /> इति धात्र्यवलेहः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dvipalāṁśāṁ tugākṣīrīṁ nāgaraṁ madhuyaṣṭikām| <br /> prāsthikīṁ pippalīṁ drākṣāṁ śarkarārDhātulāṁ śubhām||100|| <br /> <br /> dhātrīphalarasadrōṇē cūrṇitaṁ lēhavat pacēt| <br /> śītaṁ madhuprasthayutaṁ lihyāt pāṇitalaṁ tataḥ||101|| <br /> <br /> hantyēṣa kāmalāṁ Pittaṁ pāṇḍuṁ kāsaṁ halīmakam| <br /> <br /> iti dhātryavalēhaḥ| <br /> <br /> dvipalAMshAM tugAkShIrIM nAgaraM madhuyaShTikAm| <br /> prAsthikIM pippalIM drAkShAM sharkarArdhatulAM shubhAm||100|| <br /> <br /> dhAtrIphalarasadroNe cUrNitaM lehavat pacet| <br /> shItaM madhuprasthayutaM lihyAt pANitalaM tataH||101|| <br /> <br /> hantyeSha kAmalAM pittaM pANDuM kAsaM halImakam| <br /> <br /> iti dhAtryavalehaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Dhatryavaleha'' – ''Vanshalochana, sunthi, maduyashti'' powders, each in two ''pala''; one ''prastha'' each of ''pippali'' and ''draksha''; and half a ''tula'' of sugar crystal added with one ''drona'' of ''amalaki'' fruit juice and cooked till it changes into linctus form. One ''prastha'' of honey is added to it after it cools down. Intake of one ''panitala'' of this linctus cures ''kamala, [[pitta]] vikaras, pandu, kasa'' and ''haleemaka'' [100-101]<br /> <br /> === ''Mandura vatakah'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्र्यूषणं त्रिफला चव्यं चित्रको देवदारु च||१०२|| <br /> <br /> विडङ्गान्यथ मुस्तं च वत्सकं चेति चूर्णयेत्| <br /> मण्डूरतुल्यं तच्चूर्णं गोमूत्रेऽष्टगुणे पचेत्||१०३|| <br /> <br /> शनैः सिद्धास्तथा शीताः कार्याः कर्षसमा गुडाः| <br /> यथाग्नि भक्षणीयास्ते प्लीहपाण्ड्वामयापहाः||१०४||<br /> <br /> ग्रहण्यर्शोनुदश्चैव तक्रवाट्याशिनः स्मृताः| <br /> <br /> इति मण्डूरवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tryūṣaṇaṁ triphalā cavyaṁ citrakō dēvadāru ca||102|| <br /> <br /> viḍaṅgānyatha mustaṁ ca vatsakaṁ cēti cūrṇayēt| <br /> maṇḍūratulyaṁ taccūrṇaṁ gōmūtrē'ṣṭaguṇē pacēt||103|| <br /> <br /> śanaiḥ siddhāstathā śītāḥ kāryāḥ karṣasamā guḍāḥ| <br /> yathāgni bhakṣaṇīyāstē plīhapāṇḍvāmayāpahāḥ||104|| <br /> <br /> grahaṇyarśōnudaścaiva takravāṭyāśinaḥ smr̥tāḥ| <br /> <br /> iti maṇḍūravaṭakāḥ| <br /> <br /> tryUShaNaM triphalA cavyaM citrako devadAru ca||102|| <br /> <br /> viDa~ggAnyatha mustaM ca vatsakaM ceti cUrNayet| <br /> maNDUratulyaM taccUrNaM gomUtre~aShTaguNe pacet||103|| <br /> <br /> shanaiH siddhAstathA shItAH kAryAH karShasamA guDAH| <br /> yathAgni bhakShaNIyAste plIhapANDvAmayApahAH||104|| <br /> <br /> grahaNyarshonudashcaiva takravATyAshinaH smRutAH| <br /> <br /> iti maNDUravaTakAH|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Mandura Vataka''-II: ''Shunthi, pippali, maricha, haritaki, bibhitaka, amalaki, chavya, chitraka, devadaru, vidanga, musta'' and ''vatsaka'' in one part each, made in the form of powder and added to equal quantity (12 parts) of ''mandura bhasma'', should then be boiled by adding eight times of cow’s urine over mild fire. After the recipe cools pills of one ''aksha'' each should be prepared and taken according to the power of digestion. This cures ''pleeha, pandu, grahani,'' and ''arsha''. The patient should take buttermilk and ''vatya'' (a roasted barley preperation) while taking this pill [102-104]<br /> <br /> === ''Gaudo arishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मञ्जिष्ठा रजनी द्राक्षा बलामूलान्ययोरजः||१०५|| <br /> <br /> लोध्रं चैतेषु गौडः स्यादरिष्टः पाण्डुरोगिणाम्| <br /> <br /> इति गौडोऽरिष्टः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mañjiṣṭhā rajanī drākṣā balāmūlānyayōrajaḥ||105|| <br /> <br /> lōdhraṁ caitēṣu gauḍaḥ syādariṣṭaḥ pāṇḍurōgiṇām| <br /> <br /> iti gauḍō'riṣṭaḥ| <br /> <br /> ma~jjiShThA rajanI drAkShA balAmUlAnyayorajaH||105|| <br /> <br /> lodhraM caiteShu gauDaH syAdariShTaH pANDurogiNAm| <br /> <br /> iti gauDo~ariShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Manjishtha, rajani, draksha, bala moola'' (roots), ''lauha bhasma'', and ''lodhra'' should be added to jaggery and processed according to the method prescribed for ''arishta''. It is called ''gaudo-arishta'' and is useful for the patients suffering from ''pandu roga'' [105]<br /> <br /> === ''Beejakarishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बीजकात्षोडशपलं त्रिफलायाश्च विंशतिः||१०६|| <br /> <br /> द्राक्षायाः पञ्च लाक्षायाः सप्त द्रोणे जलस्य तत्| <br /> साध्यं पादावशेषे तु पूतशेषे समावपेत्||१०७|| <br /> <br /> शर्करायास्तुलां प्रस्थं माक्षिकस्य च कार्षिकम्| <br /> व्योषं व्याघ्रनखोशीरं क्रमुकं सैलवालुकम्||१०८|| <br /> <br /> मधुकं कुष्ठमित्येतच्चूर्णितं घृतभाजने| <br /> यवेषु दशरात्रं तद्ग्रीष्मे द्विः शिशिरे स्थितम्||१०९|| <br /> <br /> पिबेत्तद्ग्रहणीपाण्डुरोगार्शःशोथगुल्मनुत्| <br /> मूत्रकृच्छ्राश्मरीमेहकामलासन्निपातजित्||११०|| <br /> <br /> बीजकारिष्ट इत्येष आत्रेयेण प्रकीर्तितः| <br /> <br /> इति बीजकारिष्टः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bījakātṣōḍaśapalaṁ triphalāyāśca viṁśatiḥ||106|| <br /> <br /> drākṣāyāḥ pañca lākṣāyāḥ sapta drōṇē jalasya tat| <br /> sādhyaṁ pādāvaśēṣē tu pūtaśēṣē samāvapēt||107|| <br /> <br /> śarkarāyāstulāṁ prasthaṁ mākṣikasya ca kārṣikam| <br /> vyōṣaṁ vyāghranakhōśīraṁ kramukaṁ sailavālukam||108|| <br /> <br /> madhukaṁ kuṣṭhamityētaccūrṇitaṁ ghr̥tabhājanē| <br /> yavēṣu daśarātraṁ tadgrīṣmē dviḥ śiśirē sthitam||109|| <br /> <br /> pibēttadgrahaṇīpāṇḍurōgārśaḥśōthagulmanut| <br /> mūtrakr̥cchrāśmarīmēhakāmalāsannipātajit||110|| <br /> <br /> bījakāriṣṭa ityēṣa ātrēyēṇa prakīrtitaḥ| <br /> <br /> iti bījakāriṣṭaḥ| <br /> <br /> bIjakAtShoDashapalaM triphalAyAshca viMshatiH||106|| <br /> <br /> drAkShAyAH pa~jca lAkShAyAH sapta droNe jalasya tat| <br /> sAdhyaM pAdAvasheShe tu pUtasheShe samAvapet||107|| <br /> <br /> sharkarAyAstulAM prasthaM mAkShikasya ca kArShikam| <br /> vyoShaM vyAghranakhoshIraM kramukaM sailavAlukam||108|| <br /> <br /> madhukaM kuShThamityetaccUrNitaM ghRutabhAjane| <br /> yaveShu dasharAtraM tadgrIShme dviH shishire sthitam||109|| <br /> <br /> pibettadgrahaNIpANDurogArshaHshothagulmanut| <br /> mUtrakRucchrAshmarImehakAmalAsannipAtajit||110|| <br /> <br /> bIjakAriShTa ityeSha AtreyeNa prakIrtitaH| <br /> <br /> iti bIjakAriShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Beejaka'' taken in the amount of sixteen ''pala'', twenty ''pala'' of ''triphala,'' five pala of ''draksha'' and seven ''pala'' of ''laksha'' are added to one ''drona'' of water and boiled till one fourth of water remains. Water should then be taken out by straining. One ''tula'' of sugar, one ''pala'' of honey and one ''pala'' powder of each of the ''shunthi, pippali, maricha, vyaghranakha, kramuka, elavaluka, madhuka'' and ''kushtha'' are added to the above made decoction and the potion be stored in a jar smeared with ghee kept inside a barley heap for ten nights during summer and for twenty nights in winter. Intake of this potion cures ''grahani, pandu, arsha, sotha, gulma, mutra krichha'' (dysuria), ''ashmari'' (stones in the urinary tract), ''meha, kamala'' and diseases caused by all the three [[dosha]]. This is called ''beejaka arishta'' and it was propounded by Atreya.<br /> <br /> Thus, ends the description of ''beejaka arishta'' [106-110]<br /> <br /> === ''Dhatryarishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> धात्रीफलसहस्रे द्वे पीडयित्वा रसं तु तम्||१११|| <br /> <br /> क्षौद्राष्टांशेन संयुक्तं कृष्णार्धकुडवेन च| <br /> शर्करार्धतुलोन्मिश्रं पक्षं स्निग्धघटे स्थितम्||११२|| <br /> <br /> प्रपिबेन्मात्रया प्रातर्जीर्णे हितमिताशनः| <br /> कामलापाण्डुहृद्रोगवातासृग्विषमज्वरान्||११३||<br /> <br /> कासहिक्कारुचिश्वासांश्चैषोऽरिष्टः प्रणाशयेत्| <br /> <br /> इति धात्र्यरिष्टः <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dhātrīphalasahasrē dvē pīḍayitvā rasaṁ tu tam||111|| <br /> <br /> kṣaudrāṣṭāṁśēna saṁyuktaṁ kr̥ṣṇārdhakuḍavēna ca| <br /> śarkarārDhātulōnmiśraṁ pakṣaṁ snigdhaghaṭē sthitam||112|| <br /> <br /> prapibēnmātrayā prātarjīrṇē hitamitāśanaḥ| <br /> kāmalāpāṇḍuhr̥drōgavātāsr̥gviṣamajvarān||113|| <br /> <br /> kāsahikkāruciśvāsāṁścaiṣō'riṣṭaḥ praṇāśayēt| <br /> <br /> iti dhātryariṣṭaḥ| <br /> <br /> dhAtrIphalasahasre dve pIDayitvA rasaM tu tam||111|| <br /> <br /> kShaudrAShTAMshena saMyuktaM kRuShNArdhakuDavena ca| <br /> sharkarArdhatulonmishraM pakShaM snigdhaghaTe sthitam||112|| <br /> <br /> prapibenmAtrayA prAtarjIrNe hitamitAshanaH| <br /> kAmalApANDuhRudrogavAtAsRugviShamajvarAn||113|| <br /> <br /> kAsahikkArucishvAsAMshcaiSho~ariShTaH praNAshayet| <br /> <br /> iti dhAtryariShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Dhatryarishta'' - Two thousand fruits of ''amalaki'' should be crushed and the juice extracted should be mixed with one eighth the quantity of honey, half ''kudava'' of ''pippali'' and half ''tula'' of sugar. It should then be kept in an earthern jar smeared with ghee for one fortnight. It should be taken in appropriate dose in the morning and the patient should take wholesome food in small quantity after the digestion of the drug. This ''arishta'' cures ''kamala, pandu, hridroga, vatarakta, vishama jwara, kasa, hikka, aruchi'' and ''svasa''. Thus, ends the description of ''dhatrya arishta'' [111-113]<br /> <br /> === Medicated water ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्थिरादिभिः शृतं तोयं पानाहारे प्रशस्यते||११४|| <br /> <br /> पाण्डूनां, कामलार्तानां मृद्वीकामलकीरसः|११५| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sthirādibhiḥ śr̥taṁ tōyaṁ pānāhārē praśasyatē||114|| <br /> <br /> pāṇḍūnāṁ, kāmalārtānāṁ mr̥dvīkāmalakīrasaḥ|115| <br /> <br /> sthirAdibhiH shRutaM toyaM pAnAhAre prashasyate||114|| <br /> <br /> pANDUnAM, kAmalArtAnAM mRudvIkAmalakIrasaH|115|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Water boiled with the drugs belonging to ''sthiradi'' group is useful for drinking and the preparation of foods for ''pandu rogi''; while the patient of ''kamala'' should use the juice of ''draksha'' and ''amalaki rasa'' [114-115]<br /> <br /> === Principles of treatment according to [[dosha]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगप्रशान्त्यर्थमिति प्रोक्तं महर्षिणा||११५|| <br /> <br /> विकल्प्यमेतद्भिषजा पृथग्दोषबलं प्रति| <br /> वातिके स्नेहभूयिष्ठं, पैत्तिके तिक्तशीतलम्||११६|| <br /> <br /> श्लैष्मिके कटुतिक्तोष्णं [१] , विमिश्रं सान्निपातिके|११७|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgapraśāntyarthamiti prōktaṁ maharṣiṇā||115|| <br /> <br /> vikalpyamētadbhiṣajā pr̥thagdōṣabalaṁ prati| <br /> vātikē snēhabhūyiṣṭhaṁ, paittikē tiktaśītalam||116|| <br /> <br /> ślaiṣmikē kaṭutiktōṣṇaṁ [1] , vimiśraṁ sānnipātikē|117| <br /> <br /> pANDurogaprashAntyarthamiti proktaM maharShiNA||115|| <br /> <br /> vikalpyametadbhiShajA pRuthagdoShabalaM prati| <br /> vAtike snehabhUyiShThaM, paittike tiktashItalam||116|| <br /> <br /> shlaiShmike kaTutiktoShNaM [1] , vimishraM sAnnipAtike|117|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The above mentioned drugs are described for the cure of ''pandu roga'' by the great sage (Punarvasu Atreya). The physician should make suitable changes (combinations and permutations) in the above depending upon the strength of the [[dosha]] in the patient. <br /> <br /> The therapy should be dominated by unctuous drugs (oil, ghee etc) for ''vatika'' type of ''pandu''; by bitter and cooling drugs for ''paittika'' type and by pungent, bitter and hot drugs for [[kapha]]ja type of ''pandu'' [115-117]<br /> <br /> === Treatment of ''mrittika bhakshanajanya pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> निपातयेच्छरीरात्तु मृत्तिकां भक्षितां भिषक्||११७|| <br /> <br /> युक्तिज्ञः शोधनैस्तीक्ष्णैः प्रसमीक्ष्य बलाबलम्| <br /> शुद्धकायस्य सर्पींषि बलाधानानि योजयेत्||११८|| <br /> <br /> व्योषं बिल्वं हरिद्रे द्वे त्रिफला द्वे पुनर्नवे| <br /> मुस्तान्ययोरजः पाठा विडङ्गं देवदारु च||११९|| <br /> <br /> वृश्चिकाली च भार्गी च सक्षीरैस्तैः [१] समैर्घृतम्| <br /> साधयित्वा पिबेद्युक्त्या नरो मृद्दोषपीडितः||१२०|| <br /> <br /> तद्वत् केशरयष्ट्याह्वपिप्पलीक्षारशाद्वलैः| <br /> मृद्भक्षणादातुरस्य लौल्यादविनिवर्तिनः||१२१|| <br /> <br /> द्वेष्यार्थं भावितां कामं दद्यात्तद्दोषनाशनैः| <br /> विङ्गैलातिविषया निम्बपत्रेण पाठया||१२२|| <br /> <br /> वार्ताकैः कटुरोहिण्या कौटजैर्मूर्वयाऽपि वा|१२३| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nipātayēccharīrāttu mr̥ttikāṁ bhakṣitāṁ bhiṣak||117|| <br /> <br /> yuktijñaḥ śōdhanaistīkṣṇaiḥ prasamīkṣya balābalam| <br /> śuddhakāyasya sarpīṁṣi balādhānāni yōjayēt||118|| <br /> <br /> vyōṣaṁ bilvaṁ haridrē dvē triphalā dvē punarnavē| <br /> mustānyayōrajaḥ pāṭhā viḍaṅgaṁ dēvadāru ca||119|| <br /> <br /> vr̥ścikālī ca bhārgī ca sakṣīraistaiḥ [1] samairghr̥tam| <br /> sādhayitvā pibēdyuktyā narō mr̥ddōṣapīḍitaḥ||120|| <br /> <br /> tadvat kēśarayaṣṭyāhvapippalīkṣāraśādvalaiḥ| <br /> mr̥dbhakṣaṇādāturasya laulyādavinivartinaḥ||121|| <br /> <br /> dvēṣyārthaṁ bhāvitāṁ kāmaṁ dadyāttaddōṣanāśanaiḥ| <br /> viṅgailātiviṣayā nimbapatrēṇa pāṭhayā||122|| <br /> <br /> vārtākaiḥ kaṭurōhiṇyā kauṭajairmūrvayā'pi vā|123| <br /> <br /> nipAtayeccharIrAttu mRuttikAM bhakShitAM bhiShak||117|| <br /> <br /> yuktij~jaH shodhanaistIkShNaiH prasamIkShya balAbalam| <br /> shuddhakAyasya sarpIMShi balAdhAnAni yojayet||118|| <br /> <br /> vyoShaM bilvaM haridre dve triphalA dve punarnave| <br /> mustAnyayorajaH pAThA viDa~ggaM devadAru ca||119|| <br /> <br /> vRushcikAlI ca bhArgI ca sakShIraistaiH [1] samairghRutam| <br /> sAdhayitvA pibedyuktyA naro mRuddoShapIDitaH||120|| <br /> <br /> tadvat kesharayaShTyAhvapippalIkShArashAdvalaiH| <br /> mRudbhakShaNAdAturasya laulyAdavinivartinaH||121|| <br /> <br /> dveShyArthaM bhAvitAM kAmaM dadyAttaddoShanAshanaiH| <br /> vi~ggailAtiviShayA nimbapatreNa pAThayA||122|| <br /> <br /> vArtAkaiH kaTurohiNyA kauTajairmUrvayA~api vA|123|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A physician well versed in therapeutics, should give the patient strong elimination therapy, keeping in view the strength of the patient, in order to remove the swallowed mud from the body. After the body is cleansed, different types of medicated ghee should be prescribed to the patient for promotion of strength.<br /> <br /> Ghee prepared with ''shunthi, pippali, maricha, bilva, haridra, daruharidra, haritaki, bibhitaka, amalaki, sveta'' and ''rakta punarnava, musta, lauha bhasma, patha, vidanga, devadaru, vrishchikali, bhargi'' and milk should be appropriately taken by the patient who suffers from anemia because of eating clay. <br /> <br /> Likewise, ghee prepared with ''keshara, yashtamadhu, pippali, kshara'' (alkali preperation) and ''sadvala'' may be given to the patient suffering from ''mrittika bhakshana janya pandu''. <br /> <br /> If the patient is unable to give up his clay swallowing habits, he should be given clay impregnated with ''vidanga, ela, ativisha,'' neem leaves, ''patha, varataka, katurohini, kutaja'' or ''murva'' with a view of creating an aversion to clay. These drugs also counter act the adverse effects of eating clay. [117-123]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यथादोषं प्रकुर्वीत भैषज्यं पाण्डुरोगिणाम्||१२३|| <br /> <br /> क्रियाविशेष एषोऽस्य मतो हेतुविशेषतः|१२४| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yathādōṣaṁ prakurvīta bhaiṣajyaṁ pāṇḍurōgiṇām||123|| <br /> <br /> kriyāviśēṣa ēṣō'sya matō hētuviśēṣataḥ|124| <br /> <br /> yathAdoShaM prakurvIta bhaiShajyaM pANDurogiNAm||123|| <br /> <br /> kriyAvisheSha eSho~asya mato hetuvisheShataH|124| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Different types of treatment should be given to the patient suffering from ''mrittika bhakshana janya pandu'', according to the different types of [[dosha]] aggravated. However, due to the specific type of etiological factor involved (clay eating), this type of ''pandu'' needs special type of treatment [123-124]<br /> <br /> === ''Shakhashrita kamala'' (''kamala'' in body tissue with obstructive pathology) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तिलपिष्टनिभं यस्तु वर्चः सृजति कामली||१२४||<br /> <br /> श्लेष्मणा रुद्धमार्गं तत् पित्तं कफहरैर्जयेत्| <br /> रूक्षशीतगुरुस्वादुव्यायामैर्वेगनिग्रहैः||१२५|| <br /> <br /> कफसम्मूर्च्छितो वायुः स्थानात् पित्तं क्षिपेद्बली| <br /> हारिद्रनेत्रमूत्रत्वक् श्वेतवर्चास्तदा नरः||१२६|| <br /> <br /> भवेत् साटोपविष्टम्भो गुरुणा हृदयेन च| <br /> दौर्बल्याल्पाग्निपार्श्वार्तिहिक्काश्वासारुचिज्वरैः||१२७|| <br /> <br /> क्रमेणाल्पेऽनुसज्येत [१] पित्ते शाखासमाश्रिते|१२८|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tilapiṣṭanibhaṁ yastu varcaḥ sr̥jati kāmalī||124|| <br /> <br /> ślēṣmaṇā ruddhamārgaṁ tat Pittaṁ Kaphaharairjayēt| <br /> rūkṣaśītagurusvāduvyāyāmairvēganigrahaiḥ||125|| <br /> <br /> Kaphasammūrcchitō vāyuḥ sthānāt Pittaṁ kṣipēdbalī| <br /> hāridranētramūtratvak śvētavarcāstadā naraḥ||126|| <br /> <br /> bhavēt sāṭōpaviṣṭambhō guruṇā hr̥dayēna ca| <br /> daurbalyālpāgnipārśvārtihikkāśvāsārucijvaraiḥ||127|| <br /> <br /> kramēṇālpē'nusajyēta [1] pittē śākhāsamāśritē|128| <br /> <br /> tilapiShTanibhaM yastu varcaH sRujati kAmalI||124|| <br /> <br /> shleShmaNA ruddhamArgaM tat pittaM kaphaharairjayet| <br /> rUkShashItagurusvAduvyAyAmairveganigrahaiH||125|| <br /> <br /> kaphasammUrcchito vAyuH sthAnAt pittaM kShipedbalI| <br /> hAridranetramUtratvak shvetavarcAstadA naraH||126|| <br /> <br /> bhavet sATopaviShTambho guruNA hRudayena ca| <br /> daurbalyAlpAgnipArshvArtihikkAshvAsArucijvaraiH||127|| <br /> <br /> krameNAlpe~anusajyeta [1] pitte shAkhAsamAshrite|128| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A patient of ''kamala'' if passes stools of the color of sesame paste (''tila pishta nibhama''), then it denotes obstruction in the passage of [[pitta]] by the [[kapha]]. Therefore, the [[pitta]] of such patient should be won by administration of drugs which also eliminate [[kapha]]. <br /> <br /> The excess usage of ununctuous, cold and sweet ingredients; excessive exercise; suppression of the natural urges leads to the the aggravation of [[vata]] infilterated with [[kapha]] and the displacement of [[pitta]] from its site, resulting in the development of the following features: <br /> <br /> The eyes, skin and urine of the patient become yellow while his stools become white in color. Additionally, the patients suffer from ''atopa'' (tympanitis), ''vishtambha'' (constipation associated with flatulence),and heaviness in the cardiac region, due to the displacement of [[pitta]] in the peripheral tissues (''shakha''), there is diminution in the flow of [[pitta]] (to the gastrointestinal tract) resulting in the gradual development of weakness, ''agnimandya'' (low digestion), ''parshva'' (pain in the sides of chest), ''hikka'' (hiccups), ''shvasa'' (dyspnea), ''aruchi'' (anorexia) and ''jwara'' [124-128]<br /> <br /> === Treatment of ''shakhashriat kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बर्हितित्तिरिदक्षाणां रूक्षाम्लैः कटुकै रसैः||१२८|| <br /> <br /> शुष्कमूलककौलत्थैर्यूषैश्चान्नानि भोजयेत्| <br /> मातुलुङ्गरसं क्षौद्रपिप्पलीमरिचान्वितम्||१२९|| <br /> <br /> सनागरं पिबेत् पित्तं तथाऽस्यैति स्वमाशयम्|१३०|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> barhitittiridakṣāṇāṁ rūkṣāmlaiḥ kaṭukai rasaiḥ||128|| <br /> <br /> śuṣkamūlakakaulatthairyūṣaiścānnāni bhōjayēt| <br /> mātuluṅgarasaṁ kṣaudrapippalīmaricānvitam||129|| <br /> <br /> sanāgaraṁ pibēt Pittaṁ tathā'syaiti svamāśayam|130| <br /> <br /> barhitittiridakShANAM rUkShAmlaiH kaTukai rasaiH||128|| <br /> <br /> shuShkamUlakakaulatthairyUShaishcAnnAni bhojayet| <br /> mAtulu~ggarasaM kShaudrapippalImaricAnvitam||129|| <br /> <br /> sanAgaraM pibet pittaM tathA~asyaiti svamAshayam|130|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient suffering from from ''shakhashrita kamala'' should be given food along with the soup of the meat of peacock, ''tittira'' (partridge), ''daksha'' (rooster) sizzled with ununctuous, sour and pungent articles; and vegetable soups of dry ''mulaka'' (radish) and ''kulattha''. The patient should also be given the juice of ''matulunga'' mixed with honey, ''pippali, maricha'' and ''shunthi'' for bringing the [[pitta]] to its own course [128-130]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कटुतीक्ष्णोष्णलवणैर्भृशाम्लैश्चाप्युपक्रमः||१३०|| <br /> <br /> आपित्तरागाच्छकृतो [१] वायोश्चाप्रशमाद्भवेत्| <br /> स्वस्थानमागते पित्ते पुरीषे पित्तरञ्जिते||१३१|| <br /> <br /> निवृत्तोपद्रवस्य स्यात् पूर्वः कामलिको विधिः|१३२|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭutīkṣṇōṣṇalavaṇairbhr̥śāmlaiścāpyupakramaḥ||130|| <br /> <br /> āPittarāgācchakr̥tō [1] vāyōścāpraśamādbhavēt| <br /> svasthānamāgatē pittē purīṣē Pittarañjitē||131|| <br /> <br /> nivr̥ttōpadravasya syāt pūrvaḥ kāmalikō vidhiḥ|132| <br /> <br /> kaTutIkShNoShNalavaNairbhRushAmlaishcApyupakramaH||130|| <br /> <br /> ApittarAgAcchakRuto [1] vAyoshcAprashamAdbhavet| <br /> svasthAnamAgate pitte purIShe pittara~jjite||131|| <br /> <br /> nivRuttopadravasya syAt pUrvaH kAmaliko vidhiH|132| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Katu'' (pungent), ''teekshna'' (sharp), ''ushna'' (hot), ''lavana'' (saline) and extremely ''amla'' (sour) drugs should be continued till the stool of the patient acquires the color of [[pitta]] and the [[vata]] gets alleviated. When the [[pitta]] returns to its own habitat, the stool gets colored with [[pitta]] and the patient is relieved of complications, then further, the line of treatment described earlier for the treatment of ''kamala'' (''koshthashrita'') should be used [130-132]<br /> <br /> === ''Haleemaka'' (obstructive jaundice) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यदा तु पाण्डोर्वर्णः स्याद्धरितश्यावपीतकः||१३२|| <br /> <br /> बलोत्साहक्षयस्तन्द्रा मन्द्राग्नित्वं मृदुज्वरः| <br /> स्त्रीष्वहर्षोऽङ्गमर्दश्च श्वासस्तृष्णाऽरुचिर्भ्रमः||१३३|| <br /> <br /> हलीमकं तदा तस्य विद्यादनिलपित्ततः|१३४| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yadā tu pāṇḍōrvarṇaḥ syāddharitaśyāvapītakaḥ||132|| <br /> <br /> balōtsāhakṣayastandrā mandrāgnitvaṁ mr̥dujvaraḥ| <br /> strīṣvaharṣō'ṅgamardaśca śvāsastr̥ṣṇā'rucirbhramaḥ||133|| <br /> <br /> halīmakaṁ tadā tasya vidyādanilaPittataḥ|134| <br /> <br /> yadA tu pANDorvarNaH syAddharitashyAvapItakaH||132|| <br /> <br /> balotsAhakShayastandrA mandrAgnitvaM mRudujvaraH| <br /> strIShvaharSho~a~ggamardashca shvAsastRuShNA~arucirbhramaH||133|| <br /> <br /> halImakaM tadA tasya vidyAdanilapittataH|134| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If a patient suffering from ''pandu'' develops green, black or yellow color and suffers from diminution of strength and enthusiasm; drowsiness, ''agnimandya'' (low digestion), mild fever, lack of libido (''strisu aharsho''), ''angamarda'' (malaise/ body ache), dyspnea, ''trishna'' (morbid thirst), anorexia and giddiness, the ailment is called ''haleemaka'' and is caused by the aggravation of [[vata]] and [[pitta]] [[dosha]] [132-134]<br /> <br /> === Treatment of ''haleemaka'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुडूचीस्वरसक्षीरसाधितं माहिषं घृतम्||१३४|| <br /> <br /> स पिबेत्त्रिवृतां स्निग्धो रसेनामलकस्य तु| <br /> विरिक्तो मधुरप्रायं भजेत् पित्तानिलापहम्||१३५|| <br /> <br /> द्राक्षालेहं च पूर्वोक्तं सर्पींषि मधुराणि च| <br /> यापनान् क्षीरबस्तींश्च शीलयेत्सानुवासनान्||१३६|| <br /> <br /> मार्द्वीकारिष्टयोगांश्च पिबेद्युक्त्याऽग्निवृद्धये| <br /> कासिकं चाभयालेहं पिप्पलीं मधुकं बलाम्||१३७|| <br /> <br /> पयसा च प्रयुञ्जीत यथादोषं यथाबलम्|१३८| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> guḍūcīsvarasakṣīrasādhitaṁ māhiṣaṁ ghr̥tam||134|| <br /> <br /> sa pibēttrivr̥tāṁ snigdhō rasēnāmalakasya tu| <br /> viriktō madhuraprāyaṁ bhajēt pittānilāpaham||135|| <br /> <br /> drākṣālēhaṁ ca pūrvōktaṁ sarpīṁṣi madhurāṇi ca| <br /> yāpanān kṣīrabastīṁśca śīlayētsānuvāsanān||136|| <br /> <br /> mārdvīkāriṣṭayōgāṁśca pibēdyuktyā'gnivr̥ddhayē| <br /> kāsikaṁ cābhayālēhaṁ pippalīṁ madhukaṁ balām||137|| <br /> <br /> payasā ca prayuñjīta yathādōṣaṁ yathābalam|138| <br /> <br /> guDUcIsvarasakShIrasAdhitaM mAhiShaM ghRutam||134|| <br /> <br /> sa pibettrivRutAM snigdho rasenAmalakasya tu| <br /> virikto madhuraprAyaM bhajet pittAnilApaham||135|| <br /> <br /> drAkShAlehaM ca pUrvoktaM sarpIMShi madhurANi ca| <br /> yApanAn kShIrabastIMshca shIlayetsAnuvAsanAn||136|| <br /> <br /> mArdvIkAriShTayogAMshca pibedyuktyA~agnivRuddhaye| <br /> kAsikaM cAbhayAlehaM pippalIM madhukaM balAm||137|| <br /> <br /> payasA ca prayu~jjIta yathAdoShaM yathAbalam|138| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Patients suffering from ''haleemaka'' should take the recipe prepared from buffalo ghee by adding the juice of ''guduchi'' and milk.<br /> <br /> After oleation with this oil the patient should take ''trivritta'' mixed with the juice of ''amalaki'' which causes purgation. <br /> <br /> Thereafter food and drinks which are dominated by sweet taste and are alleviators of [[pitta]] and [[kapha]] should be given.<br /> <br /> The patient should take ''drakshaleha'' described earlier (vide verse 100-102 in this chapter in the name of ''dhatryavaleha'') and recipes of medicated ghee prepared by boiling with sweet drugs (vide verse 51-52). The patient should habitually indulge in taking different types of yapana [[basti]] (a type of medicated enema), kshara [[basti]] and anuvasana [[basti]] discussed in [ Cha. Sa. [[Siddhi Sthana]] ]. He should also take different recipes of ''arishta'' prepared from grapes (''draksharishta'') for the promotion of power of digestion. ''Abhaya leha'' described in the treatment of ''kasa'' [Cha. Sa. [[Chikitsa Sthana]] 18/57-62] may also be taken. Alternatively the patient may also take ''pippali, madhuka'' and ''bala'' along with milk depending upon the [[dosha]] aggravated and the strength of the patient [134-138]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकौ- <br /> <br /> पाण्डोः पञ्चविधस्योक्तं हेतुलक्षणभेषजम्||१३८|| <br /> <br /> कामला द्विविधा तेषां साध्यासाध्यत्वमेव च| <br /> <br /> तेषां विकल्पो यश्चान्यो महाव्याधिर्हलीमकः| <br /> तस्य चोक्तं समासेन व्यञ्जनं सचिकित्सितम्||१३९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkau- <br /> <br /> pāṇḍōḥ pañcavidhasyōktaṁ hētulakṣaṇabhēṣajam||138|| <br /> <br /> kāmalā dvividhā tēṣāṁ sādhyāsādhyatvamēva ca| <br /> <br /> tēṣāṁ vikalpō yaścānyō mahāvyādhirhalīmakaḥ| <br /> tasya cōktaṁ samāsēna vyañjanaṁ sacikitsitam||139||<br /> <br /> tatra shlokau- <br /> <br /> pANDoH pa~jcavidhasyoktaM hetulakShaNabheShajam||138|| <br /> <br /> kAmalA dvividhA teShAM sAdhyAsAdhyatvameva ca| <br /> <br /> teShAM vikalpo yashcAnyo mahAvyAdhirhalImakaH| <br /> tasya coktaM samAsena vya~jjanaM sacikitsitam||139|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> To sum up, the topics discussed in this chapter are:<br /> *Five types of ''pandu'' along with the etiology, signs and symptoms; and treatment<br /> *Two types of ''kamala'' and their curability as well as incurability<br /> *Different varieties of ''kamala''<br /> *''Haleemaka'', which is a serious disease along with its signs and symptoms; and treatment [138-139]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने <br /> पाण्डुरोगचिकित्सितं नाम षोडशोऽध्यायः||१४0|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē <br /> pāṇḍurōgacikitsitaṁ nāma ṣōḍaśō'dhyāyaḥ||140||<br /> <br /> ityagniveshakRute tantre~aprApte dRuDhabalasampUrite cikitsAsthAne <br /> pANDurogacikitsitaM nAma ShoDasho~adhyAyaH||16|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus ends the sixteenth chapter in [[Chikitsa Sthana]] dealing with the treatment of ''pandu roga'' in the work of Agnivesha which was redacted by Charaka and because of its unavailability was supplemented by Dridhabala [140]<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *The important pathological factors in ''pandu'' are aggravated three [[dosha]] with dominant [[pitta]] leading to slow metabolism at level of blood ([[rakta dhatu]]), the fatty tissue [[meda dhatu]]) and [[ojas]] qualities (affecting the vitality). <br /> *The dietary factors like alkaline, sour, saline, hot and mutually contradictory foods, unwholesome food, ''nishpava'' (a type of pulses), ''masha, pinyaka'' (oil cake) and ''tila'' oil; lifestyle factors like indulging in day sleep, performing exercise and sex before digestion of the food, disobedience of the seasonal regimens (''ritu vaishamya''), suppression of the natural urges; iatrogenic factors like Improper administration of [[Panchakarma]] measures (''pratikarma vaishamya'') and the psychological factors like affliction of mind with passion, worry, fear, anger, grief are responsible for ''pandu''. <br /> *Heart and circulatory system are involved in the pathogenesis of ''pandu'' which is presented at the sites of skin and [[mamsa dhatu]] (flesh).<br /> *The specific features are observed as per the [[dosha]] dominance in pathogenesis. <br /> *Person indulging in the habitual consumption of clay (''mrittika'') gets [[dosha]] aggravated according to the taste of mud viz. astringent mud aggravates [[vata]], saline and alkaline mud aggravates [[pitta]] and sweet mud aggravates [[kapha]] [[dosha]]. These factors cause ''pandu'' by affecting the [[dhatu]] and [[ojas]]. <br /> *Chronic ''pandu roga'' is incurable. The prognosis depends upon involvement of [[dhatu] and its intensity. <br /> *If a patient of ''pandu roga'' excessively consumes [[pitta]] vitiating diet and regimen, the aggravated [[pitta]] causes ''kamala'' by involving the [[rakta]] and the [[mamsa dhatu]]. <br /> *First principle of management of ''pandu'' is administration of internal oleation ([[snehana]]) followed by strong (''teekshna'') emetic and purgation therapies for cleansing of the body (''shodhana''). In patients of ''kamala'', mild purgation therapy with bitter drugs is advised.<br /> *''Kamala'' is of two types: ''Koshtha-shaksha shrita'' and ''shakhashrita''. In ''koshtha-shakhashrita kamala'' there is excess increase in [[pitta]]. <br /> *In ''shakhashrita kamala'', [[pitta]] is obstructed by [[kapha]] and improperly circulated by [[vata]]. Therefore the treatment principles differ in both. <br /> *In ''koshtha-shaksha shrita kamala'', mild purgation is administered with bitter drugs with a focus on pacification of[[pitta]]. <br /> *In ''shakhashrita kamala'', principles of management are pacification of [[kapha]], and ''anulomana'' of [[vata]] to derive [[pitta]] to its own natural site. Therefore ''ruksha, amla, katu'' drugs are used in the treatment. <br /> *Suitable changes (combinations and permutations) in the treatment should be prescribed depending upon the strength of the [[dosha]] in the patient. The therapy should be dominated by unctuous drugs (oil, ghee etc) for ''vatika'' type of ''pandu''; by bitter and cooling drugs for ''paittika'' type and by pungent, bitter and hot drugs for [[kapha]]ja type of ''pandu''.<br /> *Strong elimination therapy is advised to remove the swallowed mud from the body after considering the strength of the patient. After the body is cleansed, different types of medicated ghee should be prescribed to the patient for promotion of strength. <br /> *''Haleemaka'' and is caused by the aggravation of [[vata]] and [[pitta]] [[dosha]]. Hence the treatment focus on pacification of [[vata]] and [[pitta]] [[dosha]].<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> === Pathological factors ===<br /> *[[Dosha]]: [[Pitta]] dominant three [[dosha]], sadhaka and ranjak [[pitta]], vyana and samana [[vata]], avalambak and kledaka [[kapha]] <br /> *[[Dhatu]](vitiated factors): [[Rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] <br /> *Status of [[agni]]/ dhatwagni/bhutagni: ''Manda'' at [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] level <br /> *Origin of disease: Heart and channels, Liver and spleen <br /> *Sites of vitiation: All body <br /> *Sites of clinical presentation: All body specifically skin and subcutaneous tissues <br /> *Srotas involved :Rasavaha, Raktavaha <br /> *Type of ''samprapti'' : ''Avarodha'' and ''kshaya'' <br /> *Basic principles of treatment: ''Shodhana'' (mainly [[virechana]]) and ''shamana'' (mainly [[pitta]] shamana) as per [[dosha]] dominance<br /> <br /> === General considerations ===<br /> ''Pandu'' can be related with the disorders of improper formation of blood tissue due to vitiation of [[pitta]] [[dosha]]. [[Pitta]] [[dosha]] is considered to be responsible for all digestion, transformation and metabolism processes in the body. Therefore, the disorders like anemia, nutritional deficiency are mainly considered under ''pandu roga''. The disorders which include pathologies of impaired metabolism and formation of plasma, blood, muscles and fat can also be referred under the umbrella of ''pandu roga''. These include thyroid function disorders, hematological disorders like thalessemia, jaundice etc.<br /> <br /> === Etiological factors observed in present era ===<br /> ==== Diet ==== <br /> The dietary factors that cause vitiation of [[pitta]] [[dosha]] and poor nutritional status of [[rakta dhatu]] are enlisted to cause ''pandu''. These include the items having sour, salt, pungent taste, hot potency, alkaline nature, mutually contradictory and unwholesome food. These shall be avoided to prevent ''pandu''. <br /> *Food with sour taste (''amla ahara'') includes sour curd, lemons, citric acid, pickles, and food with preservatives as jams, cold drinks, sauces, tamarind etc. <br /> *''Lavana ahara'' may be taken as food with excess salts or with salt added in packaged food or as pickles, chutneys etc.<br /> *''Madya'' includes alcoholic beverages as rum, beer, whisky, vodka etc.<br /> *''Kshara'' includes soda used in diet, cold drinks and beverages. <br /> *''Ati tikshna ahara'' includes as excessively spicy,pungent items as ''chhole, chaats, pakode, panipuri, chaaps, rajma,'' spicy vegetables and other dishes.<br /> *''Ati ushna'' includes food articles which are either very hot as tea, coffee etc. or which increase the metabolic activities of the body or also as very hot temperature.<br /> *''Mrittika bhakshana'' is considered as either oral ingestion of mud or use of articles contaminated with mud as unclean hands and fingers or as improperly washed vegetables or eatables.<br /> *''Asatmya bhojana'' may include food items that are not adopted or suited. It may be considered as sudden change of food style or habit or also as junk food used today, as they are not beneficial. <br /> <br /> Some scientific studies have proven the role of some of the ''aharaja'' factors in the causation of ''panduroga'' as tea (considered as ''ati ushna nidana'') has been proved to cause iron deficiency anemia by interfering with the absorption of iron. Similarly ''madya'' (alcohols) cause megaloblastic anemia by hampering the folate absorption.<br /> <br /> ==== Lifestyle ==== <br /> <br /> Excess day time sleep, exercise beyond one’s capacity and at improper time can lead to ''pandu''. Therefore, proper quality sleep and proper exercise are preventive measures for ''pandu''.<br /> <br /> ==== Psychological factors ==== <br /> <br /> Passion, worry, fear, anger and grief can affect digestion leading to poor nutritional status. Hence blissful state of mind is needed for proper nutrition. Rai and Kar in their observational study showed that worries, fear and grief are major etiological factors for iron deficiency anemia. These factors cause significant reduction of serum and bone marrow, while inhibiting the process of erythropoiesis. The inflammatory mediators such as IL-6, hepcidin are mediators in this pathology originated from grief and fear.&lt;ref&gt;Rai Shalini, Kar Anukul C. A review of role of psychological factors in the etiopathogenesis of Pandu roga with reference to iron deficiency anemia.Ayu,2016 Jan-March,31(1):18-21. &lt;/ref&gt;<br /> <br /> ==== Iatrogenic factors ==== <br /> <br /> Improper administration of oleation therapy and [[Panchakarma]] procedures can lead to ''pandu''.<br /> <br /> ==== Pathophysiology ====<br /> [[File:Pandu.png|500px|thumb]] <br /> The cardinal feature of pandu is appearance of pallor on skin of the patient. Complexion and luster of skin is maintained by [[rasa dhatu]] and [[rakta dhatu]]. The texture is maintained by [[mamsa dhatu]]. Unctuousness is maintained by [[meda dhatu]]. These four [[dhatu]] are important for maintaining the natural appearance of skin. In ''pandu'', the vitiated [[pitta]], due to its hot and sharply acting properties, impairs digestion process at [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] leading to their poor formation. The [[rasa dhatu]] transport channels originate in the heart and its vessels. The origin of channels of [[rakta]] is in the liver and spleen. Therefore, symptoms related to cardio-vascular system and hematological system. <br /> <br /> The sequential nourishment of [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] is impaired leading to poor quality tissues. Thus, overall functions of these systems are disturbed in ''pandu''. <br /> <br /> The type of pathogenesis includes formation of same [[dhatu]] (improperly formed tissues) due to poor digestive and metabolic processes at the above mentioned levels. Therefore, the treatment principle includes correction of this impairment.<br /> <br /> ==== Clinical features and conditions resembling the disease ====<br /> <br /> '''Premonitory symptoms''': Palpitations, dryness, lack of sweating, fatigue. <br /> <br /> '''Signs''': Decrease in complexion, strength, unctuousness and vitality are observed in ''pandu''. <br /> <br /> Various features related to that are categorized below:<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs<br /> ! scope=&quot;col&quot;| Symptoms Manifested<br /> |-<br /> | 1<br /> | ''Varnakshaya'' (depletion of complexion) <br /> | Discoloration of skin, poor lustre, pallor, yellowish, dark yellow skin <br /> |-<br /> | 2<br /> | ''Balakshaya'' (depletion of strength) <br /> | Weakness, fatigue<br /> |-<br /> | 3<br /> | ''Snehakshaya'' (depletion of unctuousness) <br /> | Dryness, poor quality of tissues <br /> |-<br /> | 4<br /> | ''Ojakshaya'' (depletion of vitality)<br /> | Fearfulness, excess worries, impaired sensations, lack of concentration, poor appearance <br /> |}<br /> <br /> The following clinical features are observed in ''pandu''. The involvement of [[dosha]], dushya and channels are as given in the following table:<br /> <br /> ==== Signs ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs<br /> ! scope=&quot;col&quot;| [[Dosha]]<br /> ! scope=&quot;col&quot;| ''Dushya''<br /> ! scope=&quot;col&quot;| ''Srotas''<br /> |-<br /> | 1<br /> | ''Dhatushaithilya'' (laxity of tissues)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 2<br /> | [[Dhatu]] gaurava (heaviness in tissues)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 3<br /> | ''Varnakshaya'' (poor complexion)<br /> | [[Vata]], [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 4<br /> | ''Balakshaya'' (poor strength)<br /> | [[Vata]],[[Pitta]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 5<br /> | ''Snehakshaya'' (depletion of unctuousness)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rakta dhatu]], [[Meda dhatu]]<br /> | ''Raktavaha, Medavaha''<br /> |-<br /> | 6<br /> | [[Oja]]gunakshaya'' (depletion of vitality)<br /> | [[Vata]], [[Pitta]]<br /> | Sapta [[dhatu]]<br /> | ''Saptadhatu vaha''<br /> |-<br /> | 7<br /> | ''Raktalpata'' (poor quality and less blood)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 8<br /> | ''Medalpata'' (poor quality and less fats) <br /> | [[Vata]], [[Pitta]]<br /> | [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 9<br /> | ''Nihasarta'' (poor quality tissues) <br /> | Tri[[dosha]]<br /> | Sapta[[dhatu]]<br /> | ''Saptadhatu vaha''<br /> |-<br /> | 10<br /> | ''Shithilendriya'' (impairment of senses) <br /> | Tri[[dosha]]<br /> | Sapta[[dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 11<br /> | ''Vaivarnya'' (discoloration) <br /> | [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 12<br /> | ''Panduta'' (pallor) <br /> | [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |}<br /> <br /> ==== Symptoms ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Symptoms<br /> ! scope=&quot;col&quot;| [[Dosha]]<br /> ! scope=&quot;col&quot;| ''Dushya''<br /> ! scope=&quot;col&quot;| ''Srotas''<br /> |-<br /> | 1<br /> | ''Karnakshweda'' (tinnitus)<br /> | [[Vata]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 2<br /> | ''Hatanala'' (poor digestion)<br /> | [[Kapha]], [[Vata]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 3<br /> | ''Daurbalya'' (weakness)<br /> | [[Vata]], [[Pitta]]<br /> | Sapta[[dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 4<br /> | ''Sadana'' (bodyache)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 5<br /> | ''Annadwesha'' (anorexia)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 6<br /> | ''Shrama'' (overworked, fatigue)<br /> | [[Vata]]<br /> |[[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 7<br /> | ''Bhrama'' (vertigo)<br /> | [[Vata]], [[Pitta]]<br /> | [[Majja dhatu]]<br /> | ''Majjavaha''<br /> |-<br /> | 8<br /> | ''Gatrashoola'' (pain)<br /> | [[Vata]]<br /> | [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 9<br /> | ''Jwara'' (feverishness)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]], Sweda<br /> | ''Rasavaha, Swedavaha''<br /> |-<br /> | 10<br /> | ''Shwasa'' (dyspnea)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha, Pranavaha''<br /> |-<br /> | 11<br /> | ''Gaurava'' (heaviness)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 12<br /> | ''Aruchi'' (aversion to food)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 13<br /> | ''Mridit iv gatrata'' (kneading pain)<br /> | [[Vata]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 14<br /> | ''Pidita unmathit gatrata'' (churning, pressing pain)<br /> | [[Vata]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 15<br /> | ''Akshikutashotha'' (pre-orbital swelling)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 16<br /> | ''Harita lomata'' (greenish body hair)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 17<br /> | ''Shirnalomata'' (falling body hair)<br /> | [[Vata]],[[Pitta]]<br /> | [[Asthi dhatu]]<br /> | ''Asthivaha''<br /> |-<br /> | 18<br /> | ''Hatprabhatva'' (poor luster)<br /> | [[Pitta]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 19<br /> | ''Kopana'' (irritability)<br /> | [[Pitta]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 20<br /> | ''Shishiradwesha'' (disliking cold)<br /> | [[Vata]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 21<br /> | ''Nindraluta'' (excessive sleepiness)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 22<br /> | ''Sthivanadhikya'' (excessive sputum)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 23<br /> | ''Alpawaka'' (less speaking)<br /> | [[Vata]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 24<br /> | ''Pindikodweshtanam'' (pain in calf muscles)<br /> | [[Vata]]<br /> | [[Rakta dhatu]],[[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 25<br /> | ''Katiurupadaruka Sadana'' (pain in legs, thighs, and the lumbar region)<br /> | [[Vata]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 26<br /> | ''Arohaneayasa'' (dyspnea on climbing)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |}<br /> <br /> ==== Differentiating features of ''dosha'' dominance ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! colspan=&quot;3&quot;|Changes in color and texture manifested in the whole body and its parts<br /> |-<br /> ! scope=&quot;col&quot;| ''Vata'' dominant ''pandu''<br /> ! scope=&quot;col&quot;| ''Pitta'' dominant ''pandu''<br /> ! scope=&quot;col&quot;| ''Kapha'' dominant ''pandu''<br /> |-<br /> | Blackish or dark reddish discoloration of the skin, blood vessels, nails, face and eyes<br /> | Yellowish discoloration of skin, the skin, blood vessels, nails, face and eyes<br /> | Whitishness discoloration of skin, the skin, blood vessels, nails, face and eyes<br /> |-<br /> ! colspan=&quot;3&quot;|Features related to urine and stool<br /> |-<br /> | Blackish urine &amp; stool, dry stools<br /> | Yellowish colored urine &amp; stool, foul smelling and loose stools <br /> | Whitishness in the urine &amp; stool <br /> |-<br /> ! colspan=&quot;3&quot;|Features related to ''agni''<br /> |-<br /> | Tastelessness in the mouth<br /> | Pungent taste in mouth<br /> | Sweet taste in the mouth<br /> |-<br /> | rowspan=&quot;6&quot;|Abdominal distension<br /> | Does not relish food<br /> | Anorexia<br /> |-<br /> | rowspan=&quot;2&quot;|Improper digestion of food<br /> | Heaviness<br /> |-<br /> | Excessive salivation<br /> |-<br /> | Sour Eructation<br /> | Laziness<br /> |-<br /> | Eructation associated with burning sensation<br /> | rowspan=&quot;2&quot;| Vomiting<br /> |-<br /> | Burning Sensation<br /> |-<br /> ! colspan=&quot;3&quot;|Other features<br /> |-<br /> | Pain in the body, pricking pain<br /> | Increased body temperature<br /> | Drowsiness<br /> |-<br /> | Tremor<br /> | Excessive thirst<br /> | Horripilation<br /> |-<br /> | Headache<br /> | Fainting due to excessive thirst/coma<br /> | Mental fatigue<br /> |-<br /> | Weakness<br /> | Profuse sweating<br /> | Fainting<br /> |-<br /> | Pain in the sides of the chest<br /> | rowspan = &quot;2&quot;| Weakness<br /> | Prostration<br /> |-<br /> | Giddiness<br /> |Inability to speak<br /> |-<br /> | Swelling/Edema<br /> | Feeling of darkness in front of eyes<br /> | Cough, Dyspnea, Edema<br /> |-<br /> ! colspan=&quot;3&quot;|Likings and Dislikings<br /> |-<br /> | <br /> | Longing for cold things and environment<br /> | Likings for pungent items<br /> |-<br /> |<br /> | Dislike for hot food and atmosphere; also, do not suit the patient<br /> | Likings for ununctuous things<br /> |-<br /> |<br /> | Dislike for sour food; also, do not suit the patient<br /> | Likings for hot things<br /> |}<br /> <br /> ==== Consequences of [[dhatu]] kshaya ====<br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Pathological event<br /> ! scope=&quot;col&quot;| Consequence<br /> ! scope=&quot;col&quot;| Objectivity<br /> |-<br /> | 1<br /> | [[Rasa dhatu]] kshaya<br /> | Decrease in quality tissue that nourish blood or required for formation of blood<br /> | Deficiency in factors required for erythropoietin like vitamin B12, Vitamin K, iron, transferin, ferritin, protein like hemochrome which give red color to blood, electrolyte Na+, K+, Ca++, Mg+, H+, Cl-, albumin, globulins, glucose, amino acid, nucleic acids and lipoprotein, endocrine secretions regulating fluid metabolism <br /> |-<br /> | 2<br /> | [[Rakta dhatu]] kshaya<br /> | Decrease in quality and volume of blood and further decrease in factors required for formation of [[mamsa dhatu]](muscles) <br /> | Decrease in volume of whole blood, hematocrit percentage, endocrine secretions regulating blood metabolism <br /> |-<br /> | 3<br /> | [[Mamsa dhatu]] kshaya<br /> | Decrease in quality and volume of muscles and further decrease in factors required for formation of [[mamsa dhatu]](muscles)<br /> | Decrease in muscle proteins, endocrine secretions regulating muscle metabolism <br /> |-<br /> | 4<br /> | [[Meda dhatu]] kshaya<br /> | Decrease in quality and volume of fats and lipids and further decrease in factors required for formation of [[asthi dhatu]](bones)<br /> | Decrease in lipids, endocrine secretions regulating lipid metabolism <br /> |}<br /> <br /> ==== List of diseases with features as observed in ''pandu'' ====<br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs and Symptoms<br /> ! scope=&quot;col&quot;| Diseases<br /> |-<br /> | 1<br /> | Blackish discoloration of the skin<br /> | Megaloblastic anemias (Vitamin B12 and folic acid deficiency) as reversible melanin skin hyperpigmentation which develops mainly over the knuckles<br /> |-<br /> | 2<br /> | Reddish discoloration of body parts<br /> | Development of petechiae, echymosis or bruises on the body due to thrombocytopenia associated with anemia (as in Aplastic anemias). Anemia due to Addison’s disease (increased tanning)<br /> |-<br /> | 3<br /> | Dry skin or body<br /> | Megaloblastic anemias due to the abnormal proliferation of epithelial cell surfaces. Anemia due to hypothyroid states<br /> |-<br /> | 4<br /> | Reddish or Blackish discoloration in eyes, face and nails<br /> | Body parts due to spontaneous bleeding manifestations, pernicious anemia <br /> |-<br /> | 5<br /> | Blackish urine<br /> | Cola colored urine in various types of intravascular hemolytic anemias when the plasma hemoglobin exceeds the haptoglobin binding capacity<br /> |-<br /> | 6<br /> | Blackish stool/melena <br /> | Gastrointestinal bleeding responsible for anemias - may be due to any ulcers or worm infestations or any other cause<br /> |-<br /> | 7<br /> | Dryness of stool or constipation<br /> | Megaloblastic anemias and anemia due to hypothyroidism<br /> |-<br /> | 8<br /> | &quot;Pins and needles&quot; sensation<br /> | pernicious anemias as well as in megaloblastic anemias<br /> |-<br /> | 9<br /> | Tremors<br /> | Cobalamin deficiency which causes peripheral neuropathy and degeneration of the posterior and pyramidal tracts of the spinal cord<br /> |-<br /> | 10<br /> | Loss of taste/distaste<br /> | Pernicious anemia<br /> |-<br /> | 11<br /> | Bodyache<br /> | Hemolytic anemia, hypothyroidism<br /> |}<br /> <br /> The observations of resemblance with diseases in conventional system of medicine show that all types of anemia specially megaloblastic anemia, pernicious anemia, hypothyroidism, haemolytic anemia can be considered under umbrella of ''pandu''. The objective parameters used for these disorders can be utilized for research on efficacy of [[Ayurveda]] therapies in management of ''pandu''.<br /> <br /> === ''Kamala'' ===<br /> <br /> In the second part of the chapter ''pandu, kamala'' is elaborately described. If a person suffering from ''pandu'' follows [[pitta]] provoking diet and lifestyle, he suffers from ''kamala''. This shows ''kamala'' is consequence of ''pandu'' or ''pandu'' is essential causative factor for ''kamala''. This shows the relation of jaundice originated due to hemolytic anemia. In other types of jaundice, this notion is not observed in practice. ''Kamala'' can occur without ''pandu''. (Su.Utt.44/9, A.Hri.Ni.13/15-17)<br /> <br /> Yellowish discoloration of sclera, skin, face, nails, and urine associated with constitutional symptoms like anorexia, debility, indigestion, loss of physical strength is called ''Kamala''.<br /> <br /> ==== Types of ''kamala'' ====<br /> <br /> ==== 1. ''Shakhashrita Kamala/Alpa'' [[pitta]] (''Dhatu ashrita'') ====<br /> <br /> The passage of [[pitta]] is obstructed by vitiated [[kapha]] and not allowing [[pitta]] to enter ''kostha'', it will cause excess of [[pitta]] in body tissues in ''Shakhasrita Kamala''. This involves the obstructive pathologies at hepatic circulation. As the [[pitta]] cannot enter the gastro-intestinal tract, it leads to clay colored stools. In obstructive jaundice, bilirubin has no access to the intestine and it is the reason for pale stools. <br /> <br /> This description of stools being clay colored, but the urine being yellow shows that they were very close in concept to the modern day physiopathology of obstructive jaundice especially hepatocellular ones (wherein due to an inability of the bile to pass into the gastrointestinal tract it circulates into the blood and the conjugated bilirubin being water soluble fraction is filtered and passes out into the urine). Further the description of [[pitta]] being the bi-product of [[rakta]] is also very similar to the fact of bile being produced as a result of Red Blood Cell destruction. The most common cause is gall stones in the common bile duct and pancreatic cancer in the head of pancreas. Also, a group of parasites known as liver flukes can live in common bile duct causing obstructive jaundice. Biliary atresia, cholanjiocarcinoma, pancreatitis, cholestasis of pregnancy and pancreatic pseudocysts are causes for obstruction of bile flow into the duodenum.<br /> <br /> ==== 2. ''Kostha Shakhashrita Kamala/bahu'' [[pitta]] (''Maha Srotasashrita'') ====<br /> <br /> ''Bahupitta kamala'' or ''Kostha-shakhasrita kamala'' mostly resembles the pre-hepatic and hepatocellular jaundice. Pre-hepatic jaundice is caused by anything which causes haemolysis. Pre-hepatic cause include severe malaria, certain genetic diseases such as sickle cell anemia, spherocytosis, thalassemia, pyruvate kinase deficiency and glucose 6-phospate dehydrogenase (G6PD) deficiency, which lead to increased destruction of red cells and therefore hemolytic jaundice. Hepato-cellular Jaundice can be caused by acute or chronic hepatitis, hepatotoxicity, cirrhosis, drug induced hepatitis and alcoholic liver disease.<br /> <br /> === ''Haleemaka'' ===<br /> <br /> ''Haleemaka'' is a further stage of ''pandu''. Reduced oxygen carrying capacity of blood (reduced ''jeevan karma'') causes depletion of strength and work capacity. This further leads to lack of libido and bodyache. Condition resembles cholestasis. Bile stasis and back pressure leads to liver failure which leads to the further symptoms of ''halimaka'' or sclerosing cholangitis. It is characterized by severe fatigue (''bala utsaha hani''), jaundice (''harita pita meda''), dark urine, cirrhosis, portal hypertension and hepato-megaly.<br /> <br /> === ''Panaki'' ===<br /> <br /> ''Panaki'', another disease in same context of ''halimaka'', explains the condition of malabsorption especially of fat due to lack of bile juice in digestion due to obstruction which leads to steatorrhoea (''bhinna varcha''). Reduced fat absorption leads to deficiency of fat soluble vitamins such as A, D, E and K.<br /> <br /> === ''Kumbha Kamala'' ===<br /> <br /> The description of ''kumbha kamala'' denotes the advanced stage of ''Kostha-shakhasrita kamala'' wherein the main seat of pathology is situated somewhere in the gastro-intestinal tract. ''Kumbha'' is one of the synonyms of ''koshtha''. Edema is described as one of the important clinical features of ''kumbha kamala'' (Su. Utt. 44).<br /> <br /> Both types of ''kamala'', if not treated convert into difficult to treat and hardened skin. ''Kumbha kamala'' could also refer to the presentation of the patient having distended abdomen i.e. ascitis, which is one of the important clinical feature of liver diseases, which are also the main cause of jaundice. <br /> <br /> Liver is the main seat for a number of functions and when it gets severely deranged the liver functions are affected. The clinical picture of ''kumbha kamala'' corresponds to these as observed below:<br /> <br /> *The production of majority of proteins as albumin, few globulins, cerulo-plasmin etc., is hampered leading to edema in the various body parts (''Bhrusham Shoonam cha Manavaḥ'') and dryness in the body.<br /> *The coagulation profile gets affected leading to increased prothrombin time, the presentation of esophageal varices, bleeding per rectum etc. Here the same features have been described as ''sarakta akshi mukha, chhardi vida mootra'' meaning blood seen or coming out of the eyes, mouth or in the vomitus (esophageal varices), through the stool (haemorrhoids) or through the urine.<br /> *The derangement of liver structure in these diseases leads to some presentation of obstructive jaundice with yellow urine (''peeta mootrata'').<br /> *The stage of altered consciousness has also been described as ''tandra moha samanvita'' (acting as if sleepy or having altered perception - semiconscious state).<br /> *The stage of hepatic coma has also been described as ''nashta sangya'' means the person is not able to recognise and perceive anything – unconscious state (''Sangya Nama Grahanena'').<br /> *The excessive dryness (''kharibhuta'') is generally due to increased bile salts deposition leading to pruritus and dryness of skin. This dryness further leads to the hardness.<br /> *As liver disorders progress, coagulatory defects begin leading to upper G.I. track bleed causing black stools/''malena''(''Krishna shakrita''). Secondly conjugated bilirubin which does not enter intestine becomes urobilinogen giving urine dark color (''krishna mutra'').<br /> *Excessive edema is observed all over body. Cirrhosis of the liver is a condition that causes reduction in plasma protein concentration. Cirrhosis means development of large amounts of fibrous tissue among the liver parenchymal cells. One result is failure of these cells to produce sufficient plasma proteins, leading to decreased plasma colloid osmotic pressure and the generalized edema that goes with this condition. Another way that liver cirrhosis causes edema is that the liver fibrosis sometimes compresses the abdominal portal venous drainage vessels as they pass through the liver before emptying back into the general circulation. Blockage of this portal venous outflow raises capillary hydrostatic pressure throughout the gastrointestinal area and further increases filtration of fluid out of the plasma into the intra-abdominal areas. When this occurs, the combined effects of decreased plasma protein concentration and high portal capillary pressures cause transudation of large amounts of fluid and protein into the abdominal cavity, a condition referred to as ascites.<br /> *Hematemesis/bleeding in eyes,per rectum, hematuria (''Sarakta akshi mukha chhardi vinamutra'') explains the bleeding disorders which begin in late hepatic disorders. <br /> *Fainting (''tamah pravesha'') is due to reduced cerebral perfusion due to various causes like gastrointestinal bleed, electrolyte or metabolic disturbance.<br /> *Drowsiness (''tandra''), confusion (''moha'') are further symptoms of hepatic encephalopathy. Neuropsychological findings are experienced in all phases of hepatic encephalopathy. It is experienced as forgetfulness, mild confusion and irritability, inversed sleep pattern followed by lethargy and personality changes. The third stage is marked with worsened confusion and in fourth stage is coma. ''Mada, Murchha'' and ''sanyasa'' are mentioned earlier as disorders due to vitiated blood in [[Vidhishonitiya Adhyaya]].<br /> <br /> === Management of Diseases (Treatment Protocols) ===<br /> ==== Current clinical practices in treatment of ''pandu'' and ''kamala'' ( referred from Chikitsa Pradeep) ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| Type<br /> ! scope=&quot;col&quot;| Medicine<br /> ! scope=&quot;col&quot;| Dose<br /> ! scope=&quot;col&quot;| Time<br /> ! scope=&quot;col&quot;| ''Anupana''<br /> |-<br /> |rowspan = &quot;3&quot;|[[Vata]] dominant ''pandu''<br /> | ''Mahayogaraja samira mixture''<br /> | 120-480 mg<br /> | After meals <br /> | Ghee (''dadimadi'') + honey<br /> |-<br /> | ''Tiktaka ghritam''<br /> | 10-40 ml<br /> | After meals <br /> | Hot water<br /> |-<br /> | ''Navajivana rasa''<br /> | 120-200 mg<br /> | After meals <br /> | Milk<br /> |-<br /> | rowspan = &quot;2&quot;|[[Pitta]] dominant ''pandu''<br /> | ''Tapyadi lauha'' mixture<br /> | 250 - 600 mg<br /> | After meals <br /> | Dadimadi ghee + udumbaravaleha<br /> |-<br /> | ''Vasadi'' decoction<br /> | 20 - 40 ml<br /> | After meals <br /> | Honey<br /> |-<br /> | [[Kapha]] dominant ''pandu''<br /> | ''Gomutra Haritaki'' mixture<br /> | 600 mg - 3 grams<br /> | After meals <br /> | Honey + juice of castor leaves<br /> |-<br /> | ''Mrittika bhakshana janya''<br /> | ''Gomutra Haritaki'' mixture<br /> | 600 mg - 3 grams<br /> | After meals<br /> | ''Kumari Asava''<br /> |-<br /> | rowspan=&quot;2&quot;|''Riddha Patha Kamala''<br /> | ''Ichha bhedi rasa''<br /> | 120 - 180 mg<br /> | Early morning one time<br /> | Lemon juice<br /> |-<br /> | ''Suta shekhara kalpa''<br /> | 120 - 250 mg<br /> | After meals<br /> | Milk + sugar<br /> |-<br /> | ''Koshtha ashrita kamala''<br /> | colspan=&quot;4&quot;|As like ''pitta'' dominant ''pandu''<br /> |}<br /> <br /> ==== Evidence based clinical practices ====<br /> <br /> *In a study carried out by Shazi L. and Thakar A., Amalaki [[rasayana]] was found effective in management of iron deficiency anemia. However the efficacy was equal in clinical parameters and less in biochemical parameters in comparison to conventional drugs a combination of folic acid and ferrous sulphate. &lt;ref&gt; Shaizi Layeeq, Thakar A.B. Clinical efficacy of Amalaki rasayana in the management of pandu(iron deficiency anemia). Ayu.2015.July-Sep.36(3):290-297. &lt;/ref&gt; <br /> *''Punarnava mandura'' was found effective as ''panduhara'' and [[rasayana]] in patients of geriatric anemia and can counteract most of the pathological manifestations related to ''pandu roga'' in old age (geriatric anemia)&lt;ref&gt;Pandya M.G. Dave A.R. A clinical study of punarnava mandura in the management of pandu roga in old age (geriatric anemia).Ayu,2014 July-Sept; 35(3);252-260. &lt;/ref&gt;. In another study on pregnant females, ''punarnava mandura'' and ''dhatri lauha'' are found effective in management of anemia during pregnancy.&lt;ref&gt;Khandelwal D.A, Donga S.B.,Dei L.P. Clinical efficacy of punarnava mandura and dhatri lauha in the management of garbhini pandu (anemia in pregnancy) Ayu,2015 Oct-Dec;36(4); 397-403. &lt;/ref&gt;<br /> *A herbomineral formulation ''Trikatrayadi Lauha'' suspension was observed an effective, well-tolerated, and clinically safe formulation for the management of Iron deficiency anemia in children.&lt;ref&gt;Kumar A, Garai AK. A clinical study on Pandu Roga, iron deficiency anemia, with Trikatrayadi Lauha suspension in children. J [[Ayurveda]] Integr Med 2012;3:215-22.&lt;/ref&gt; Khan et.al. observed that the same formulation was observed effective to relieve the signs and symptoms of ''pandu'' in comparison to standard control drug (Fersolate-CM). ''Trikatrayadi lauha'' provided significant improvement on Hbgm%, RBC, PCV, MCV, serum iron, percent transferrin saturation and to decrease TIBC. Therefore ''Trikatrayadi Lauha'' can be used in ''Panduroga'' or IDA as a safe hematinic drug.&lt;ref&gt;Khan Subir kumar, Vyas S.N. Chandola H.M. Efficacy of Trikatrayadi lauha in Pandu roga with reference to iron deficiency anemia. Ayu 2012. Jan-Mar, 33(1):62-67.&lt;/ref&gt; <br /> *Tewari et.al. studied the ethnopharmacological approaches to the therapy of jaundice&lt;ref&gt;Tewari D, Mocan A, Parvanov ED, Sah AN, Nabavi SM, Huminiecki L, Ma ZF, Lee YY, Horba´nczuk JO and Atanasov AG (2017) Ethnopharmacological Approaches for Therapy of Jaundice: Part I. Front. Pharmacol. 8:518. doi: 10.3389/fphar.2017.00518&lt;/ref&gt; and highly used plant species from acanthaceae,euphorbiaceae, asteraceae, combretaceae and fabaceae family in the management of jaundice. The team of researchers elaborately studied hystorical perspective of jaundice, its pathophysiology and enlisted 207 herbs used in management of jaundice.&lt;ref&gt;Tewari D, Mocan A, Parvanov ED, Sah AN, Nabavi SM, Huminiecki L, Ma ZF, Lee YY, Horba´nczuk JO and Atanasov AG (2017) Ethnopharmacological Approaches for Therapy of Jaundice: Part II. Highly Used Plant Species from Acanthaceae, Euphorbiaceae, Asteraceae, Combretaceae, and Fabaceae Families. Front. Pharmacol. 8:519. doi: 10.3389/fphar.2017.00519&lt;/ref&gt;<br /> <br /> === Research studies on ''pandu'' ===<br /> <br /> Some studies are available on the internet which depict the efficacy of various Ayurvedic drugs having iron (in the form of ''lauha'' and ''mandura'') compounds in the management of ''pandu'': <br /> #Sarkar PK, Prajapati PK, Choudhary AK, Shukla VJ, Ravishankar B. Haematinic Evaluation of Lauha Bhasma and Mandura Bhasma on HgCl2-induced Anemia in Rats. Indian J Pharm Sci 2007;69:791-5.<br /> #Sarkar PK. A Comparative Pharmaceutico-pharmaco-clinical study of Lauha Bhasma and Mandura Bhasma w.s.r. to its Pāndu-hara Effect, MD thesis. I.P.G.T. &amp; R.A. Jamnagar: Gujrat [[Ayurveda]] University; 2005. <br /> #Garai A, Rai M, Kumar A. Role of an Ayurvedic Compound (Panduhara Yoga) in the Management of Iron Deficiency Anaemia in Children. Ayu 2009;30:469-74.<br /> #Gupta V, Reddy KR. Experimental Studies of Lohasava. Aryavaidyan 2007;21:87-94.<br /> #Sarkar PK, Prajapati PK, Shukla VJ, Ravishankar B, Choudhary AK. Toxicity and recovery studies of two Ayurvedic preparations of iron. Indian J Exp Biol 2009;47:987-92.<br /> #Devarshi P, Kanse A, Kanse R, Mane S, Patil S, Varute AT. Effect of Mandura Bhasma on lipolytic Activities of Liver, Kidney and Adipose Tissue of Albino Rat During CCl4 Induced hepatic Injury. J Biosci 1986;10:227-34.<br /> #Pandit S, Biswas TK, Debnath PK, Saha AV, Chowdhury U, Shaw BP, et al. Chemical and pharmacological evaluation of different Ayurvedic preparations of iron. J Ethnopharmacology 1999;65:149-56.<br /> #Dinesh C. Sharma, Deepa Chandiramani, Manminder Riyat and Praveen Sharma. Scientific evaluation of some ayurvedic preparations for correction of iron deficiency and anemia. Indian Journal of Clinical Biochemistry, 2007 / 22 (2) 123-128<br /> #Ambika Das, PA03.17. A clinical evaluation of Punarnavadi Mandura and Dadimadi Ghritha in management of Pandu (Iron defeciency anaemia), Ancient Science of Life 2013; 32 (s2):86<br /> <br /> One of the studies (Sharma D.C, 2007) report that the Ayurvedic preparations were found equally effective as the allopathic compound in the management of iron deficiency anemia and the fact that the side effects were almost nil establishes them to be even superior.<br /> <br /> The modes of action of drugs and procedures as stated in this chapter, which is without iron, have not been studied much in anemia. Though, some of the preparations described in anemia have been found very useful in the management of other types of anemia as sickle cell anemia,&lt;ref&gt;Macmillan Keith, A herbomineral composition for the treatment of Sickle Cell disease. Retrieved from tgs.freshpatents.com&lt;/ref&gt; aplastic anemia,&lt;ref&gt;Subhash singh, Shiv Kumar Singh and Narendra Kumar Singh. Aaplastic anaemia, complete cure, ayurvedic way – case report. International Journal Of Basic And Applied Medical Sciences Issn: 2277-2103 (Online) An Online International Journal Available At http://www.cibtech.org/jms.htm 2013 vol. 3 (1) january-april, pp.242-246/subhash et al.&lt;/ref&gt; etc.<br /> <br /> So, further studies need to be done in order to know the efficacy of these drugs and mechanisms in the various types of anemia.<br /> <br /> === Principle of treatment for ''kamala'' ===<br /> <br /> The management of ''kamala'' by the drugs stated in the chapter has been found to show good results but the mechanism of their action is still not clear. Practically few studies are available on the net which prove the efficacy of ''Ayurvedic'' compounds in the management of hepatocellular jaundice. &lt;ref&gt;Nirmal kumar and Anil kumar singh. Phalatrikadi kvatha - an ayurvedic hepatoprotective drug. International journal of research in pharmacy and chemistry.2013, 3(3) Available online at www.ijrpc.com&lt;/ref&gt;<br /> <br /> === List of Research Works done ===<br /> <br /> === IPGT&amp;RA, Jamnagar ===<br /> <br /> #Chaudhary sudhakar (1958): Pandu Roga Nidana.<br /> #Mishra N. K. (1959): A clinical study of Pandu Roga.<br /> #Bhattacharya R. C. (1965): Pandu Roga Par Paradamruta Teekshana Laugh Karyanvekshana<br /> #Ojha N.H.(1966): Abhraka Bhasma Ka Pandu Roga Par Karyanvekshana.<br /> #Pillai K.D.R. (1974): Study of effect of Swarna Makshika Bhasma on Pandu.<br /> #Jha Prabhakar (1974): Swayama Lauha Bhasma Ka Pandu Roga Par Kriyatamaka Adhyayana.<br /> #Sharada B.D.(1975) : Effect of Yogaraja on Garbhavasthajanya Pandu.<br /> #Gopalkrishana (1986): Lauha Bhasma on Pandu with special reference to its Media.<br /> #M.S.Trivedi (1992): Effect of Yogaraja Rasayana in Garbhavsthajanya Pandu.<br /> #Nargunde Rajeshri (1997): A comparative Phaemaco-clinical Study of Shudha Kasisa Churna and Kasisa Bhasma on PANDU. <br /> #Jain Sangeeta (2000): A study on Pandu Roga w.s.r. to ANAEMIA and Its Management with Shodhana and Yogaraja Rasayana.<br /> #Sarkar P K (2005): A comparative pharmaco-pharmaceutico Clinical study of lauha bhasma and mandura bhasma w.s.r. to Panduhara effects.<br /> <br /> === Banaras Hindu University, Varanasi ===<br /> <br /> #Trivedi R D (1979):Hematological and clinical stubby in pandu.<br /> #Malhotra E. N. (1983): Management of Garbhavasthajnya Pandu with Mandura Bhasma.<br /> #Nandkishore (1985): Clinical Assessment of Navayasa Lauha in Management of Pandu.<br /> #Chauhana A. P. S. (1985): Role of Manduradi Ghanvati in Pandu Roga.<br /> #Dixit A. K. (1994): Clinical study in Yogaraja Rasayana on Pandu.<br /> #Singh S. N. (1996): A study on aetio pathogenesis of Pandu Roga w s r to its Samprapti Vighatan by Makshika.<br /> #Agrawal N. Assessment of Effect of Mandura Bhasma in Iron Deficiency Anemia in Children, MD thesis. P.G. Department of Kaumarbhritya. Varanasi: IMS, B.H.U; 2007. <br /> <br /> === National Institute of [[Ayurveda]], Jaipur and others ===<br /> <br /> #Tyagi R. M. (1980): Pandu Roga Evam Vajra Vatak Mandura .<br /> #B. C. Sharma (1985): Pandu Roga Samprapti Vivechana.<br /> #R. K. Sharma (1994): Pandu Roga Mandura Bhasma Ka Chikitsatmaka Adhyayan.<br /> #Meena R. K. (1994): Guduchi in Pandu Roga.<br /> #Joshi N. (2005): Pharmaceutical, Pharmacological and Toxicological Study of Various Lauha Preparations(Kalpa) w.s.r. to Iron Deficiency Anaemia, M.D. Thesis. P. G. Department of Rasa Shastra and Bhaishajya Kalpana, Jaipur.<br /> #Kumath V. (2006): A Comprehensive Study of Haritaki with Special Reference to the Efficacy of Terminalia chebula Retz. on pandu Roga, MD thesis. P. G. Department. of Dravyaguna, Government. Ujjain, Madhya Pradesh: Autonomous Dhanvantari [[Ayurveda]] College and Hospital; 2006.<br /> <br /> === Potential areas /scope for further research ===<br /> <br /> The following drugs referred in management of ''pandu'' need to be researched more for providing evidences of its efficacy in anemia and related disorders in comparison to conventional management: <br /> #Dadimadya ghritam<br /> #Katukadyam ghritam<br /> #Pathya ghritam<br /> #Danti ghritam<br /> #Draksha ghritam<br /> #Haridradi ghritam<br /> #Darvyadi ghritam<br /> #Navayasa churnam<br /> #Mandura vataka<br /> #Tapyadi lauha<br /> #Yogaraja<br /> #Punarnava Mandura<br /> #Darvyadi leha<br /> #Dhatryavaleha<br /> #Gaudo arishata<br /> #Bijakarishta<br /> #Dhatryarishta<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References ==<br /> &lt;/div&gt;<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Pandu_Chikitsa&diff=45383 2025-11-01T05:31:28Z

<p>Agnivesha: /* Treatment of mrittika bhakshanajanya pandu */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Pandu Chikitsa<br /> |titlemode=append<br /> |keywords=Pandu roga, kamala, koshthashakhashrita kamala, shakhashrita kamala, panaka, kumbhakamala, haleemaka, anemia, jaundice, Ayurveda, Indian system of medicine, charak samhita. iron deficiency anaemia, blood deficiency <br /> |description=Chikitsa Sthana Chapter 16. Management of Pandu (Anemia and diseases due to blood deficiency)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 16. Management of Pandu (Anemia and diseases due to blood deficiency)&lt;/big&gt;'''<br /> {{Infobox<br /> |title = Pandu Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 16<br /> |label2 = Preceding Chapter<br /> |data2 = [[Grahani Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Hikka Shwasa Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Kar A.C., Rai S., Aladoriya N., [[Yogesh Deole|Deole Y. S.]]<br /> |label7 = Reviewer <br /> |data7 = Ojha S.N.<br /> |label8 = Editors<br /> |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.017 10.47468/CSNE.2020.e01.s06.017]<br /> }}<br /> &lt;big&gt;'''Abstract &lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;''Pandu roga'' (resembling with anemia) is characterized by pallor which is associated with different colors according to [[dosha]] involved. Besides ''pandu roga'', this chapter also describes two types of ''kamala'' (jaundice) which are two other associated diseases, caused by predominance of [[pitta]] [[dosha]] which causes alteration in normal colors of the body. The chapter describes general etiology, pathogenesis, symptoms etc of ''pandu roga'' (anemia) as well as each of its five types viz. [[vata]], [[pitta]], [[kapha]], sannipataja and ''mrittika-bhakshana'' (clay eating) ''pandu''. After describing general principle of treatment of ''pandu'' and ''kamala'', detailed treatment of each of the conditions mentioned above along with ''pathya'' (recommended diet) and apathya (prohibited diet) are given. <br /> &lt;br/&gt;<br /> '''Keywords''': Pandu roga, kamala, koshthashakhashrita kamala, shakhashrita kamala, panaka, kumbhakamala, haleemaka, anemia, jaundice<br /> &lt;/p&gt;<br /> <br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> After the description of ''grahani dosha'', the chapter on ''pandu roga'' is given, as the causative factors of ''pandu roga'' are quite similar to that of ''grahani dosha''. Probably it is because that the various gastrointestinal problems can also lead to development of ''pandu roga''. The chapter deals with general discoloration of the body such as pallor, yellowish, greenish and whitish discoloration which is seen in skin, eyes, lips, face, nails, urine feces etc. <br /> <br /> ''Kamala'' (jaundice) and ''haleemaka'' (severe obstructive jaundice) have also been included in this chapter as they are also characterized by the discoloration and may relate to ''pandu roga''. ''Kamala'' is of two types, ''swatantra'' (primary) and ''partantra'' (secondary). The etiological factors of ''primary kamala'' are described later. Secondary ''kamala'' develops in chronic phase of ''pandu'' in which vitiated [[pitta]] is seated in [[rasa dhatu]] and in kamala, [[pitta]] goes deeper in [[rakta dhatu]] and continues to go deeper in [[mamsa dhatu]] and [[meda dhatu]], then it is called ''haleemaka'' and ''kumbha kamala'' respectively. <br /> <br /> ''Kamala'' is of two types in repect to location, ''shakhshrita kamala'' located in body tissues in the form of obstructed [[pitta]] and ''koshthashrita kamala'', localized to gut and can be easily removed by purgation while ''shakhashrita kamala'' needs to be brought to gut for removal.<br /> &lt;/div&gt;<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातः पाण्डुरोगचिकित्सितं व्याख्यास्यामः||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः||२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātaḥ pāṇḍurōgacikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2||<br /> <br /> athAtaH pANDurogacikitsitaM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2||<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt; <br /> Now we shall expound the chapter &quot;Pandu Chikitsa&quot; (Management of Anemia and diseases due to blood deficiency). Thus said Lord Atreya. [1-2]<br /> <br /> === Five types of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगाः स्मृताः पञ्च वातपित्तकफैस्त्रयः| <br /> <br /> चतुर्थः सन्निपातेन पञ्चमो भक्षणान्मृदः||३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgāḥ smr̥tāḥ pañca VātaPittaKaphaistrayaḥ| <br /> <br /> caturthaḥ sannipātēna pañcamō bhakṣaṇānmr̥daḥ||3|| <br /> <br /> pANDurogAH smRutAH pa~jca vAtapittakaphaistrayaH| <br /> <br /> caturthaH sannipAtena pa~jcamo bhakShaNAnmRudaH||3||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Pandu roga is classified into five types as vatika, paittika, [[kapha]]ja, tri[[dosha]]ja and mrittika bhakshhana janya pandu [3]<br /> <br /> === Pathogenesis of pandu ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दोषाः पित्तप्रधानास्तु यस्य कुप्यन्ति धातुषु| <br /> <br /> शैथिल्यं तस्य धातूनां गौरवं चोपजायते||४|| <br /> <br /> ततो वर्णबलस्नेहा ये चान्येऽप्योजसो गुणाः| <br /> <br /> व्रजन्ति क्षयमत्यर्थं दोषदूष्यप्रदूषणात्||५|| <br /> <br /> सोऽल्परक्तोऽल्पमेदस्को निःसारः शिथिलेन्द्रियः| <br /> <br /> वैवर्ण्यं भजते, तस्य हेतुं शृणु सलक्षणम्||६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dōṣāḥ Pittapradhānāstu yasya kupyanti Dhātuṣu| <br /> <br /> śaithilyaṁ tasya dhātūnāṁ gauravaṁ cōpajāyatē||4|| <br /> <br /> tatō varṇabalasnēhā yē cānyē'pyōjasō guṇāḥ| <br /> <br /> vrajanti kṣayamatyarthaṁ dōṣadūṣyapradūṣaṇāt||5|| <br /> <br /> sō'lparaktō'lpamēdaskō niḥsāraḥ śithilēndriyaḥ| <br /> <br /> vaivarṇyaṁ bhajatē, tasya hētuṁ śr̥ṇu salakṣaṇam||6|| <br /> <br /> doShAH pittapradhAnAstu yasya kupyanti dhAtuShu| <br /> <br /> shaithilyaM tasya dhAtUnAM gauravaM copajAyate||4|| <br /> <br /> tato varNabalasnehA ye cAnye~apyojaso guNAH| <br /> <br /> vrajanti kShayamatyarthaM doShadUShyapradUShaNAt||5|| <br /> <br /> so~alparakto~alpamedasko niHsAraH shithilendriyaH| <br /> <br /> vaivarNyaM bhajate, tasya hetuM shRuNu salakShaNam||6||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Aggravated [[pitta]] predominant [[dosha]] vitiates the [[dhatu]]. This vitiation of [[dhatu]] cause sluggishnesss (''shithilata'') and heaviness (''gaurava'') in the [[dhatu]] resulting in diminution of complexion (''varna''), strength (''bala''), unctuousness (''sneha'') and the qualities of [[ojas]]. Thus, the person develops diminished blood (''rakta'') and the fatty tissue ([[meda dhatu]]) and absence of the vitality of all the tissues (''nihsara'') decreases functional status of sense organs (''sithilendriyah'') and discoloration of the body. [[Hetu]] (etiological factors and pathogenesis) and the sign and symptoms of the disease will be explained hereafter [4-6]<br /> <br /> === General etio-pathogenesis of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षाराम्ललवणात्युष्णविरुद्धासात्म्यभोजनात्| <br /> <br /> निष्पावमाषपिण्याकतिलतैलनिषेवणात्||७|| <br /> <br /> विदग्धेऽन्ने दिवास्वप्नाद्व्यायामान्मैथुनात्तथा| <br /> <br /> प्रतिकर्मर्तुवैषम्याद्वेगानां च विधारणात्||८|| <br /> <br /> कामचिन्ताभयक्रोधशोकोपहतचेतसः| <br /> <br /> समुदीर्णं यदा पित्तं हृदये समवस्थितम्||९|| <br /> <br /> वायुना बलिना क्षिप्तं सम्प्राप्य धमनीर्दश| <br /> <br /> प्रपन्नं केवलं देहं त्वङ्मांसान्तरमाश्रितम्||१०|| <br /> <br /> प्रदूष्य कफवातासृक्त्वङ्मांसानि करोति तत्| <br /> <br /> पाण्डुहारिद्रहरितान् वर्णान् बहुविधांस्त्वचि||११|| <br /> <br /> स पाण्डुरोग इत्युक्तः ...|१२| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣārāmlalavaṇātyuṣṇaviruddhāsātmyabhōjanāt| <br /> <br /> niṣpāvamāṣapiṇyākatilatailaniṣēvaṇāt||7|| <br /> <br /> vidagdhē'nnē divāsvapnādvyāyāmānmaithunāttathā| <br /> <br /> pratikarmartuvaiṣamyādvēgānāṁ ca vidhāraṇāt||8|| <br /> <br /> kāmacintābhayakrōdhaśōkōpahatacētasaḥ| <br /> <br /> samudīrṇaṁ yadā Pittaṁ hr̥dayē samavasthitam||9|| <br /> <br /> vāyunā balinā kṣiptaṁ samprāpya dhamanīrdaśa| <br /> <br /> prapannaṁ kēvalaṁ dēhaṁ tvaṅmāṁsāntaramāśritam||10|| <br /> <br /> pradūṣya Kaphavātāsr̥ktvaṅmāṁsāni karōti tat| <br /> <br /> pāṇḍuhāridraharitān varṇān bahuvidhāṁstvaci||11|| <br /> <br /> sa pāṇḍurōga ityuktaḥ ...|12| <br /> <br /> kShArAmlalavaNAtyuShNaviruddhAsAtmyabhojanAt| <br /> <br /> niShpAvamAShapiNyAkatilatailaniShevaNAt||7|| <br /> <br /> vidagdhe~anne divAsvapnAdvyAyAmAnmaithunAttathA| <br /> <br /> pratikarmartuvaiShamyAdvegAnAM ca vidhAraNAt||8|| <br /> <br /> kAmacintAbhayakrodhashokopahatacetasaH| <br /> <br /> samudIrNaM yadA pittaM hRudaye samavasthitam||9|| <br /> <br /> vAyunA balinA kShiptaM samprApya dhamanIrdasha| <br /> <br /> prapannaM kevalaM dehaM tva~gmAMsAntaramAshritam||10|| <br /> <br /> pradUShya kaphavAtAsRuktva~gmAMsAni karoti tat| <br /> <br /> pANDuhAridraharitAn varNAn bahuvidhAMstvaci||11|| <br /> <br /> sa pANDuroga ityuktaH ...|12| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Followings are the etiological factors of ''pandu'':<br /> *The (excessive) intake of alkaline, sour, saline, hot and mutually contradictory foods, unwholesome food, ''nishpava'' (a type of pulses), ''masha, pinyaka'' (oil cake) and ''tila'' oil; <br /> *Indulging in day sleep, performing exercise and sex before digestion of the food;<br /> *Improper administration of [[Panchakarma]] measures (''pratikarma vaishamya'') and the disobedience of the seasonal regimens (''ritu vaishamya'') <br /> *Suppression of the natural urges<br /> *Affliction of mind with passion, worry, fear, anger, grief<br /> <br /> Indulgence in the above factors aggravates [[pitta]] seated in the cardiac region and then this [[pitta]] is forcefully propelled by the [[vata]] into the ten ''dhamanis'' (attached to the heart) and further into the whole body. There, it gets located in between the ''tvacha'' (skin) and the [[mamsa dhatu]] (flesh) and additionally vitiates the [[kapha]], [[vata]], [[rakta]], tvacha and [[mamsa dhatu]] resulting in the development of various discolorations in the body like ''pandu'' (pale), ''haridra'' (yellow),and ''harita'' (green). This is called as ''pandu roga'' [7-11½]<br /> <br /> === Premonitory symptoms ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> .. तस्य लिङ्गं भविष्यतः| <br /> <br /> हृदयस्पन्दनं रौक्ष्यं स्वेदाभावः श्रमस्तथा||१२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ... tasya liṅgaṁ bhaviṣyataḥ| <br /> <br /> hr̥dayaspandanaṁ raukṣyaṁ svēdābhāvaḥ śramastathā||12||<br /> <br /> ... tasya li~ggaM bhaviShyataH| <br /> <br /> hRudayaspandanaM raukShyaM svedAbhAvaH shramastathA||12||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The premonitory symptoms of the disease are palpitations, ununctuousness, absence of sweating and fatigue [12]<br /> <br /> === General symptoms of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सम्भूतेऽस्मिन् भवेत् सर्वः कर्णक्ष्वेडी हतानलः| <br /> <br /> दुर्बलः सदनोऽन्नद्विट् श्रमभ्रमनिपीडितः||१३|| <br /> <br /> गात्रशूलज्वरश्वासगौरवारुचिमान्नरः| <br /> <br /> मृदितैरिव गात्रैश्च पीडितोन्मथितैरिव||१४|| <br /> <br /> शूनाक्षिकूटो हरितः शीर्णलोमा हतप्रभः| <br /> <br /> कोपनः शिशिरद्वेषी निद्रालुः ष्ठीवनोऽल्पवाक्||१५|| <br /> <br /> पिण्डिकोद्वेष्टकट्यूरुपादरुक्सदनानि च| <br /> <br /> भवन्त्यारोहणायासैर्विशेषश्चास्य [१] वक्ष्यते||१६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sambhūtē'smin bhavēt sarvaḥ karṇakṣvēḍī hatānalaḥ| <br /> <br /> durbalaḥ sadanō'nnadviṭ śramabhramanipīḍitaḥ||13|| <br /> <br /> gātraśūlajvaraśvāsagauravārucimānnaraḥ| <br /> <br /> mr̥ditairiva gātraiśca pīḍitōnmathitairiva||14|| <br /> <br /> śūnākṣikūṭō haritaḥ śīrṇalōmā hataprabhaḥ| <br /> <br /> kōpanaḥ śiśiradvēṣī nidrāluḥ ṣṭhīvanō'lpavāk||15|| <br /> <br /> piṇḍikōdvēṣṭakaṭyūrupādaruksadanāni ca| <br /> <br /> bhavantyārōhaṇāyāsairviśēṣaścāsya [1] vakṣyatē||16|| <br /> <br /> sambhUte~asmin bhavet sarvaH karNakShveDI hatAnalaH| <br /> <br /> durbalaH sadano~annadviT shramabhramanipIDitaH||13|| <br /> <br /> gAtrashUlajvarashvAsagauravArucimAnnaraH| <br /> <br /> mRuditairiva gAtraishca pIDitonmathitairiva||14|| <br /> <br /> shUnAkShikUTo haritaH shIrNalomA hataprabhaH| <br /> <br /> kopanaH shishiradveShI nidrAluH ShThIvano~alpavAk||15|| <br /> <br /> piNDikodveShTakaTyUrupAdaruksadanAni ca| <br /> <br /> bhavantyArohaNAyAsairvisheShashcAsya [1] vakShyate||16|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> On developing ''pandu roga'' the patients have the symptoms of tinnitus, low digestion, weakness, prostration, disliking for food, fatigue, giddiness, pain in the body, fever, dyspnea, heaviness and anorexia. The patient feels as if the limbs are being kneaded, pressed or churned; develops peri-orbital swelling, greenish complexion and falling of body hair. The person loses his body luster, becomes irritable, dislikes cold things, feels sleepy, spits in excess, avoids speaking, suffers from cramps in the calf region and experiences excessive fatigue as well as pain and weakness in the lumbar region, thighs and feet specifically by exertion while climbing [13-16]<br /> <br /> The signs and symptoms specific to each variety of ''pandu'' will be described henceforth.<br /> <br /> === ''Vatika pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आहारैरुपचारैश्च वातलैः कुपितोऽनिलः| <br /> <br /> जनयेत्कृष्णपाण्डुत्वं [१] तथा रूक्षारुणाङ्गताम्||१७|| <br /> <br /> अङ्गमर्दं रुजं तोदं कम्पं पार्श्वशिरोरुजम्| <br /> <br /> वर्चःशोषास्यवैरस्यशोफानाहबलक्षयान्||१८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> āhārairupacāraiśca Vātalaiḥ kupitō'nilaḥ| <br /> <br /> janayētkr̥ṣṇapāṇḍutvaṁ [1] tathā rūkṣāruṇāṅgatām||17|| <br /> <br /> aṅgamardaṁ rujaṁ tōdaṁ kampaṁ pārśvaśirōrujam| <br /> <br /> varcaḥśōṣāsyavairasyaśōphānāhabalakṣayān||18|| <br /> <br /> AhArairupacAraishca vAtalaiH kupito~anilaH| <br /> <br /> janayetkRuShNapANDutvaM [1] tathA rUkShAruNA~ggatAm||17|| <br /> <br /> a~ggamardaM rujaM todaM kampaM pArshvashirorujam| <br /> <br /> varcaHshoShAsyavairasyashophAnAhabalakShayAn||18|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Indulging in [[vata]] increasing diet and regimens aggravates [[vata]] leading to ''vatika pandu roga''. The skin of the patient becomes blackish dawn colored and ununctuous. Its other symptoms are malaise, ache, pricking pain, tremor, pain in both the sides of the chest, headache; dried feces, distaste in the mouth; swelling, gaseous distention of the abdomen and weakness [17-18]<br /> <br /> === ''Paittika pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तलस्याचितं पित्तं यथोक्तैः स्वैः प्रकोपणैः| <br /> <br /> दूषयित्वा तु रक्तादीन् पाण्डुरोगाय कल्पते||१९|| <br /> <br /> स पीतो हरिताभो वा ज्वरदाहसमन्वितः| <br /> <br /> तृष्णामूर्च्छापिपासार्तः [१] पीतमूत्रशकृन्नरः||२०|| <br /> <br /> स्वेदनः शीतकामश्च न चान्नमभिनन्दति| <br /> <br /> कटुकास्यो न चास्योष्णमुपशेतेऽम्लमेव च||२१|| <br /> <br /> उद्गारोऽम्लो विदाहश्च विदग्धेऽन्नेऽस्य जायते| <br /> <br /> दौर्गन्ध्यं भिन्नवर्चस्त्वं दौर्बल्यं तम एव च||२२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> Pittalasyācitaṁ Pittaṁ yathōktaiḥ svaiḥ prakōpaṇaiḥ| <br /> <br /> dūṣayitvā tu raktādīn pāṇḍurōgāya kalpatē||19|| <br /> <br /> sa pītō haritābhō vā jvaradāhasamanvitaḥ| <br /> <br /> tr̥ṣṇāmūrcchāpipāsārtaḥ [1] pītamūtraśakr̥nnaraḥ||20|| <br /> <br /> svēdanaḥ śītakāmaśca na cānnamabhinandati| <br /> <br /> kaṭukāsyō na cāsyōṣṇamupaśētē'mlamēva ca||21|| <br /> <br /> udgārō'mlō vidāhaśca vidagdhē'nnē'sya jāyatē| <br /> <br /> daurgandhyaṁ bhinnavarcastvaṁ daurbalyaṁ tama ēva ca||22|| <br /> <br /> pittalasyAcitaM pittaM yathoktaiH svaiH prakopaNaiH| <br /> <br /> dUShayitvA tu raktAdIn pANDurogAya kalpate||19|| <br /> <br /> sa pIto haritAbho vA jvaradAhasamanvitaH| <br /> <br /> tRuShNAmUrcchApipAsArtaH [1] pItamUtrashakRunnaraH||20|| <br /> <br /> svedanaH shItakAmashca na cAnnamabhinandati| <br /> <br /> kaTukAsyo na cAsyoShNamupashete~amlameva ca||21|| <br /> <br /> udgAro~amlo vidAhashca vidagdhe~anne~asya jAyate| <br /> <br /> daurgandhyaM bhinnavarcastvaM daurbalyaM tama eva ca||22||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> [[Pitta]] gets aggravated by indulging in [[pitta]] vitiating ''nidanas'' (diet and regimens) which by involving the blood etc. causes [[pitta]]ja pandu. Its symptoms are, change in complexion to yellowish/greenish, fever, burning sensation; morbid thirst and fainting; excessive perspiration and longing for cold things and environment. The person does not relish food, develops pungent taste, disfavors hot and sour things; gets sour eructations associated with burning sensation due to impaired digestion of food; emits foul smell from mouth; the urine and stool become yellow in color, has loose motions and develops weakness and fainting [19-22]<br /> <br /> === [[Kapha]]ja pandu ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विवृद्धः श्लेष्मलैः श्लेष्मा पाण्डुरोगं स पूर्ववत्| <br /> <br /> करोति गौरवं तन्द्रा छर्दिं श्वेतावभासताम्||२३|| <br /> <br /> प्रसेकं लोमहर्षं च सादं मूर्च्छां भ्रमं क्लमम्| <br /> <br /> श्वासं कासं तथाऽऽलस्यमरुचिं वाक्स्वरग्रहम्||२४|| <br /> <br /> शुक्लमूत्राक्षिवर्चस्त्वं कटुरूक्षोष्णकामताम्| <br /> <br /> श्वयथुं मधुरास्यत्वमिति [१] पाण्ड्वामयः कफात्||२५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vivr̥ddhaḥ ślēṣmalaiḥ ślēṣmā pāṇḍurōgaṁ sa pūrvavat| <br /> <br /> karōti gauravaṁ tandrā chardiṁ śvētāvabhāsatām||23|| <br /> <br /> prasēkaṁ lōmaharṣaṁ ca sādaṁ mūrcchāṁ bhramaṁ klamam| <br /> <br /> śvāsaṁ kāsaṁ tathā''lasyamaruciṁ vāksvaragraham||24|| <br /> <br /> śuklamūtrākṣivarcastvaṁ kaṭurūkṣōṣṇakāmatām| <br /> <br /> śvayathuṁ madhurāsyatvamiti [1] pāṇḍvāmayaḥ kaphāt||25|| <br /> <br /> vivRuddhaH shleShmalaiH shleShmA pANDurogaM sa pUrvavat| <br /> <br /> karoti gauravaM tandrA chardiM shvetAvabhAsatAm||23|| <br /> <br /> prasekaM lomaharShaM ca sAdaM mUrcchAM bhramaM klamam| <br /> <br /> shvAsaM kAsaM tathA~a~alasyamaruciM vAksvaragraham||24|| <br /> <br /> shuklamUtrAkShivarcastvaM kaTurUkShoShNakAmatAm| <br /> <br /> shvayathuM madhurAsyatvamiti [1] pANDvAmayaH kaphAt||25|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Aggravated [[kapha]] by indulging in [[kapha]] increasing diet and regimen gives rise to [[kapha]]ja pandu roga through the pathogenesis described earlier. The sign and symptoms of [[kapha]]ja pandu are heaviness, drowsiness, vomiting, whitish complexion, salivation, horripilation, prostration, fainting, giddiness, mental fatigue, dyspnea, cough, laziness, anorexia, obstruction in speech and voice, whitish coloration of the eyes, urine and feces; longing for pungent, ununctuous and hot things; and develops edema and sweet taste in the mouth [23-25]<br /> <br /> === ''Tridoshaja pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सर्वान्नसेविनः सर्वे दुष्टा दोषास्त्रिदोषजम्| <br /> त्रिदोषलिङ्गं कुर्वन्ति पाण्डुरोगं सुदुःसहम्||२६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sarvānnasēvinaḥ sarvē duṣṭā dōṣāstridōṣajam| <br /> tridōṣaliṅgaṁ kurvanti pāṇḍurōgaṁ suduḥsaham||26|| <br /> <br /> sarvAnnasevinaH sarve duShTA doShAstridoShajam| <br /> tridoShali~ggaM kurvanti pANDurogaM suduHsaham||26|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Indulging in the etiological factors of all the three types of ''pandu'' leads to aggravation of the three [[dosha]] resulting in ''tridoshaja pandu'' with the features of all the three types of ''pandu roga''. This type of ''pandu'' causes much distress to the patient. [26]<br /> <br /> === ''Mrittika bhakshana pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मृत्तिकादनशीलस्य कुप्यत्यन्यतमो मलः| <br /> कषाया मारुतं, पित्तमूषरा, मधुरा कफम्||२७|| <br /> <br /> कोपयेन्मृद्रसादींश्च रौक्ष्याद्भुक्तं विरूक्षयेत् [१] | <br /> पूरयत्यविपक्वैव स्रोतांसि निरुणद्धि च||२८|| <br /> <br /> इन्द्रियाणां बलं हत्वा तेजो वीर्यौजसी तथा| <br /> पाण्डुरोगं करोत्याशु बलवर्णाग्निनाशनम्||२९|| <br /> <br /> शूनगण्डाक्षिकूटभ्रूः [२] शूनपान्नाभिमेहनः| <br /> क्रिमिकोष्ठोऽतिसार्येत मलं सासृक् कफान्वितम्||३०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mr̥ttikādanaśīlasya kupyatyanyatamō malaḥ| <br /> kaṣāyā mārutaṁ, Pittamūṣarā, madhurā Kapham||27|| <br /> <br /> kōpayēnmr̥drasādīṁśca raukṣyādbhuktaṁ virūkṣayēt [1] | <br /> pūrayatyavipakvaiva srōtāṁsi niruṇaddhi ca||28|| <br /> <br /> indriyāṇāṁ balaṁ hatvā tējō vīryaujasī tathā| <br /> pāṇḍurōgaṁ karōtyāśu balavarṇāgnināśanam||29|| <br /> <br /> śūnagaṇḍākṣikūṭabhrūḥ [2] śūnapānnābhimēhanaḥ| <br /> krimikōṣṭhō'tisāryēta malaṁ sāsr̥k kaphānvitam||30|| <br /> <br /> mRuttikAdanashIlasya kupyatyanyatamo malaH| <br /> kaShAyA mArutaM, pittamUSharA, madhurA kapham||27|| <br /> <br /> kopayenmRudrasAdIMshca raukShyAdbhuktaM virUkShayet [1] | <br /> pUrayatyavipakvaiva srotAMsi niruNaddhi ca||28|| <br /> <br /> indriyANAM balaM hatvA tejo vIryaujasI tathA| <br /> pANDurogaM karotyAshu balavarNAgninAshanam||29|| <br /> <br /> shUnagaNDAkShikUTabhrUH [2] shUnapAnnAbhimehanaH| <br /> krimikoShTho~atisAryeta malaM sAsRuk kaphAnvitam||30|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Person indulging in the habitual consumption of clay (''mrittika'') gets [[dosha]] aggravated according to the taste of mud viz. astringent mud aggravates [[vata]], saline and alkaline mud aggravates [[pitta]] and sweet mud aggravates [[kapha]] [[dosha]]. The clay further because of its ununctuousness causes dryness in the [[rasa]] (nutrients of the digested food). The clay due to its undigestable nature fills and blocks the channels of circulation leading to decrease in the sharpness of the senses, luster, energy and [[ojas]] (vital essence of the tissues). This quickly manifesting ''pandu'' results in the loss of strength, complexion and digestive power. Its clinical features are edema of the cheeks, peri orbital edema and edema on the eyebrows area, feet, umbilical region and the pudendum; infestation of worms in the [[koshtha]] (gastrointestinal tract) and loose motions, the stool associated with blood and mucus. [27-30]<br /> <br /> === Prognosis of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगश्चिरोत्पन्नः खरीभूतो न सिध्यति| <br /> कालप्रकर्षाच्छूनो [१] ना यश्च पीतानि पश्यति||३१|| <br /> <br /> बद्धाल्पविट्कं सकफं हरितं योऽतिसार्यते| <br /> दीनः श्वेतातिदिग्धाङ्गश्छर्दिमूर्च्छातृषार्दितः||३२|| <br /> <br /> स नास्त्यसृक्क्षयाद्यश्च पाण्डुः श्वेतत्वमाप्नुयात्| <br /> इति पञ्चविधस्योक्तं पाण्डुरोगस्य लक्षणम्||३३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgaścirōtpannaḥ kharībhūtō na sidhyati| <br /> kālaprakarṣācchūnō [1] nā yaśca pītāni paśyati||31|| <br /> <br /> baddhālpaviṭkaṁ saKaphaṁ haritaṁ yō'tisāryatē| <br /> dīnaḥ śvētātidigdhāṅgaśchardimūrcchātr̥ṣārditaḥ||32|| <br /> <br /> sa nāstyasr̥kkṣayādyaśca pāṇḍuḥ śvētatvamāpnuyāt| <br /> iti pañcavidhasyōktaṁ pāṇḍurōgasya lakṣaṇam||33|| <br /> <br /> pANDurogashcirotpannaH kharIbhUto na sidhyati| <br /> kAlaprakarShAcchUno [1] nA yashca pItAni pashyati||31|| <br /> <br /> baddhAlpaviTkaM sakaphaM haritaM yo~atisAryate| <br /> dInaH shvetAtidigdhA~ggashchardimUrcchAtRuShArditaH||32|| <br /> <br /> sa nAstyasRukkShayAdyashca pANDuH shvetatvamApnuyAt| <br /> iti pa~jcavidhasyoktaM pANDurogasya lakShaNam||33||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Chronic ''pandu roga'' is incurable. Other symptoms indicating the incurability are appearance of excessive dryness and edema; patient visualizes everything as yellow; passes very hard stool or less amount of stool or passes loose stool associated with mucus and green in color; feels exceedingly prostrated; body becomes excessively white as if be smeared with whiteness; has vomiting, fainting and excessive thirst and when the patient develops excessive whiteness in the body as a result of loss of blood.<br /> <br /> Thus, the signs and symptoms of all the five type of ''pandu roga'' have been described. [31-33]<br /> <br /> === ''Koshthashakhashraya kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगी तु योऽत्यर्थं पित्तलानि निषेवते| <br /> तस्य पित्तमसृग्मांसं दग्ध्वा रोगाय कल्पते||३४|| <br /> <br /> हारिद्रनेत्रः स भृशं हारिद्रत्वङ्नखाननः| <br /> रक्तपीतशकृन्मूत्रो भेकवर्णो हतेन्द्रियः||३५|| <br /> <br /> दाहाविपाकदौर्बल्यसदनारुचिकर्षितः| <br /> कामला बहुपित्तैषा कोष्ठशाखाश्रया मता||३६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgī tu yō'tyarthaṁ Pittalāni niṣēvatē| <br /> tasya Pittamasr̥gmāṁsaṁ dagdhvā rōgāya kalpatē||34|| <br /> <br /> hāridranētraḥ sa bhr̥śaṁ hāridratvaṅnakhānanaḥ| <br /> Rakta pītaśakr̥nmūtrō bhēkavarṇō hatēndriyaḥ||35|| <br /> <br /> dāhāvipākadaurbalyasadanārucikarṣitaḥ| <br /> kāmalā bahuPittaiṣā kōṣṭhaśākhāśrayā matā||36|| <br /> <br /> pANDurogI tu yo~atyarthaM pittalAni niShevate| <br /> tasya pittamasRugmAMsaM dagdhvA rogAya kalpate||34|| <br /> <br /> hAridranetraH sa bhRushaM hAridratva~gnakhAnanaH| <br /> raktapItashakRunmUtro bhekavarNo hatendriyaH||35|| <br /> <br /> dAhAvipAkadaurbalyasadanArucikarShitaH| <br /> kAmalA bahupittaiShA koShThashAkhAshrayA matA||36|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If a patient of ''pandu roga'' excessively follows [[pitta]] vitiating diet and regimen, the [[pitta]] so aggravated by involving the [[rakta]] and the [[mamsa dhatu]] causes ''kamala''. Its clinical features are the eyes, skin, nails and face of the patient become exceedingly yellow; stool and urine become reddish-yellow in color; complexion develops a color similar to that of a frog (found in rainy season); the senses get impaired; has burning sensation, indigestion, weakness, prostration and anorexia. This ''kamala'' is caused by excess of [[pitta]] is known as ''koshthashakhashrita'' [34-36]<br /> <br /> === ''Kumbha kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कालान्तरात् खरीभूता कृच्छ्रा स्यात् कुम्भकामला| 36½ |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kālāntarāt kharībhūtā kr̥cchrā syāt kumbhakāmalā| 36½|<br /> <br /> kAlAntarAt kharIbhUtA kRucchrA syAt kumbhakAmalA| 36½|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> With the due course of time the disease (''kamala'') becomes deep seated (''kharibhuta'') resulting in excessive dryness of the body or afflicted tissue and thus becomes difficult to cure. This condition is called ''kumbha kamala'' [36½]<br /> <br /> === Bad prognostic symptoms of ''kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कृष्णपीतशकृन्मूत्रो [१] भृशं शूनश्च मानवः||३७||<br /> <br /> सरक्ताक्षिमुखच्छर्दिविण्मूत्रो यश्च ताम्यति| <br /> दाहारुचितृषानाहतन्द्रामोहसमन्वितः||३८|| <br /> <br /> नष्टाग्निसञ्ज्ञः क्षिप्रं हि कामलावान् विपद्यते|38½| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kr̥ṣṇapītaśakr̥nmūtrō [1] bhr̥śaṁ śūnaśca mānavaḥ||37|| <br /> <br /> saraktākṣimukhacchardiviṇmūtrō yaśca tāmyati| <br /> dāhārucitr̥ṣānāhatandrāmōhasamanvitaḥ||38|| <br /> <br /> naṣṭāgnisañjñaḥ kṣipraṁ hi kāmalāvān vipadyatē|38½|<br /> <br /> kRuShNapItashakRunmUtro [1] bhRushaM shUnashca mAnavaH||37|| <br /> <br /> saraktAkShimukhacchardiviNmUtro yashca tAmyati| <br /> dAhArucitRuShAnAhatandrAmohasamanvitaH||38|| <br /> <br /> naShTAgnisa~jj~jaH kShipraM hi kAmalAvAn vipadyate|38½| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the stool and urine of the patient (of ''kamala'') become black and yellow; develops excessive edema; eyes and face becomes red colored; vomit, stool and urine are mixed with blood; the patient feels like going in darkness; has burning sensation, anorexia, morbid thirst, constipation, drowsiness and fainting; and the person looses his [[agni]] and consciousness; such patient may succumb to death quickly [37-38½]<br /> <br /> === Principles of treatment ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> साध्यानामितरेषां तु प्रवक्ष्यामि चिकित्सितम्||३९|| <br /> <br /> तत्र पाण्ड्वामयी स्निग्धस्तीक्ष्णैरूर्ध्वानुलोमिकैः| <br /> संशोध्यो मृदुभिस्तिक्तैः कामली तु विरेचनैः||४०|| <br /> <br /> ताभ्यां संशुद्धकोष्ठाभ्यां पथ्यान्यन्नानि दापयेत्| <br /> शालीन् सयवगोधूमान् पुराणान् यूषसंहितान्||४१|| <br /> <br /> मुद्गाढकीमसूरैश्च जाङ्गलैश्च रसैर्हितैः| <br /> यथादोषं विशिष्टं च तयोर्भैषज्यमाचरेत्||४२|| <br /> <br /> पञ्चगव्यं महातिक्तं कल्याणकमथापि वा| <br /> स्नेहनार्थं घृतं दद्यात् कामलापाण्डुरोगिणे||४३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sādhyānāmitarēṣāṁ tu pravakṣyāmi cikitsitam||39|| <br /> <br /> tatra pāṇḍvāmayī snigdhastīkṣṇairūrdhvānulōmikaiḥ| <br /> saṁśōdhyō mr̥dubhistiktaiḥ kāmalī tu virēcanaiḥ||40|| <br /> <br /> tābhyāṁ saṁśuddhakōṣṭhābhyāṁ pathyānyannāni dāpayēt| <br /> śālīn sayavagōdhūmān purāṇān yūṣasaṁhitān||41|| <br /> <br /> mudgāḍhakīmasūraiśca jāṅgalaiśca rasairhitaiḥ| <br /> yathādōṣaṁ viśiṣṭaṁ ca tayōrbhaiṣajyamācarēt||42|| <br /> <br /> pañcagavyaṁ mahātiktaṁ kalyāṇakamathāpi vā| <br /> snēhanārthaṁ ghr̥taṁ dadyāt kāmalāpāṇḍurōgiṇē||43|| <br /> <br /> sAdhyAnAmitareShAM tu pravakShyAmi cikitsitam||39|| <br /> <br /> tatra pANDvAmayI snigdhastIkShNairUrdhvAnulomikaiH| <br /> saMshodhyo mRudubhistiktaiH kAmalI tu virecanaiH||40|| <br /> <br /> tAbhyAM saMshuddhakoShThAbhyAM pathyAnyannAni dApayet| <br /> shAlIn sayavagodhUmAn purANAn yUShasaMhitAn||41|| <br /> <br /> mudgADhakImasUraishca jA~ggalaishca rasairhitaiH| <br /> yathAdoShaM vishiShTaM ca tayorbhaiShajyamAcaret||42|| <br /> <br /> pa~jcagavyaM mahAtiktaM kalyANakamathApi vA| <br /> snehanArthaM ghRutaM dadyAt kAmalApANDurogiNe||43|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now, the treatment for the curable types of ''pandu roga'' is being described here:<br /> <br /> The patient suffering from the ''pandu'' should first be given strong (''tikshna'') emetic and purgation therapies after the administration of internal oleation ([[snehana]]) for cleansing of the body (''shodhana''). <br /> <br /> On the other hand, patient of ''kamala'' should be given mild purgation therapy with bitter drugs. After the cleansing of the ''koshtha'' by the above procedures the patient of both of these diseases should be given wholesome food consisting of old ''shali'' rice, barley and wheat mixed with the ''yusha'' (vegetable soup) of ''mudga, adhaki'' and ''masura'', and the ''rasa'' (meat soup) of animals inhabiting the arid zone. <br /> <br /> On the basis of the aggravated [[dosha]] specific medicines are to be administered to the patients of these two categories (which will be described later in the chapter). For the oleation of the patient of ''pandu'' and ''kamala panchagavya ghrita, mahatikta ghrita'' and ''kalyanaka ghrita'' should be given [39-43]<br /> <br /> === ''Dadimadya ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दाडिमात् कुडवो धान्यात् कुडवार्धं पलं पलम्| <br /> चित्रकाच्छृङ्गवेराच्च पिप्पल्यष्टमिका तथा||४४|| <br /> <br /> तैः कल्कैर्विंशतिपलं घृतस्य सलिलाढके|<br /> सिद्धं हृत्पाण्डुगुल्मार्शःप्लीहवातकफार्तिनुत्||४५|| <br /> <br /> दीपनं श्वासकासघ्नं मूढवाते च शस्यते| <br /> दुःखप्रसविनीनां च वन्ध्यानां चैव गर्भदम्||४६|| <br /> <br /> इति दाडिमाद्यं घृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dāḍimāt kuḍavō dhānyāt kuḍavārdhaṁ palaṁ palam| <br /> citrakācchr̥ṅgavērācca pippalyaṣṭamikā tathā||44|| <br /> <br /> taiḥ kalkairviṁśatipalaṁ ghr̥tasya salilāḍhakē| <br /> siddhaṁ hr̥tpāṇḍugulmārśaḥplīhaVātakaphārtinut||45|| <br /> <br /> dīpanaṁ śvāsakāsaghnaṁ mūḍhavātē ca śasyatē| <br /> duḥkhaprasavinīnāṁ ca vandhyānāṁ caiva garbhadam||46|| <br /> <br /> iti dāḍimādyaṁ ghr̥tam| <br /> <br /> dADimAt kuDavo dhAnyAt kuDavArdhaM palaM palam| <br /> citrakAcchRu~ggaverAcca pippalyaShTamikA tathA||44|| <br /> <br /> taiH kalkairviMshatipalaM ghRutasya salilADhake| <br /> siddhaM hRutpANDugulmArshaHplIhavAtakaphArtinut||45|| <br /> <br /> dIpanaM shvAsakAsaghnaM mUDhavAte ca shasyate| <br /> duHkhaprasavinInAM ca vandhyAnAM caiva garbhadam||46|| <br /> <br /> iti dADimAdyaM ghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take twenty ''pala'' of ghee, one ''adhaka'' of water and add to it the paste prepared of one ''kudava'' of ''dadima'', half ''kudava'' of ''dhanya'', one ''pala'' each of ''chitraka'' and ''sringavera'' and one ''ashtamika'' (two ''karsha'') of ''pippali'' and prepare ghee as per method of ''sneha paka''.This medicated ghee stimulates the power of digestion. It cures heart disease, anemia, gulma, hemorrhoids, spleenomegaly and disorders of [[vata]] and [[kapha]].It is also useful for curing asthma, bronchitis, ''mudha-vata'' (claudication of [[vata]]) and ''duhkha-prasava'' (difficult labor). It also helps a sterile woman to get offspring.<br /> <br /> Thus, ends the description of ''dadimadyaghrita'' [44-46]<br /> <br /> === ''Katukadyam ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कटुका रोहिणी मुस्तं हरिद्रे वत्सकात् पलम्| <br /> पटोलं चन्दनं मूर्वा त्रायमाणा दुरालभा||४७|| <br /> <br /> कृष्णा पर्पटको निम्बो भूनिम्बो देवदारु च| <br /> तैः कार्षिकैर्घृतप्रस्थः सिद्धः क्षीरचतुर्गुणः||४८|| <br /> <br /> रक्तपित्तं ज्वरं दाहं श्वयथुं स भगन्दरम्| <br /> अर्शांस्यसृग्दरं चैव हन्ति विस्फोटकांस्तथा||४९|| <br /> <br /> इति कटुकाद्यं घृतम्|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭukā rōhiṇī mustaṁ haridrē vatsakāt palam| <br /> paṭōlaṁ candanaṁ mūrvā trāyamāṇā durālabhā||47|| <br /> <br /> kr̥ṣṇā parpaṭakō nimbō bhūnimbō dēvadāru ca| <br /> taiḥ kārṣikairghr̥taprasthaḥ siddhaḥ kṣīracaturguṇaḥ||48|| <br /> <br /> Rakta Pittaṁ jvaraṁ dāhaṁ śvayathuṁ sa bhagandaram| <br /> arśāṁsyasr̥gdaraṁ caiva hanti visphōṭakāṁstathā||49|| <br /> <br /> iti Kaṭukādyam Ghritam| <br /> <br /> kaTukA rohiNI mustaM haridre vatsakAt palam| <br /> paTolaM candanaM mUrvA trAyamANA durAlabhA||47|| <br /> <br /> kRuShNA parpaTako nimbo bhUnimbo devadAru ca| <br /> taiH kArShikairghRutaprasthaH siddhaH kShIracaturguNaH||48|| <br /> <br /> raktapittaM jvaraM dAhaM shvayathuM sa bhagandaram| <br /> arshAMsyasRugdaraM caiva hanti visphoTakAMstathA||49|| <br /> <br /> iti kaTukAdyaM ghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''pala'' each of ''katukarohini, musta, haridra, daruharidra, vatsaka'' in paste form, one ''karsha'' of each of ''patola, chandana, murva, trayamana, duralabha, krishna, parpataka, nimba, bhūnimba, devadaru'' should be added to one ''prastha'' of ''ghrita'' and four ''prasthas'' of milk. This medicated ghee cures ''raktapitta, jwara, daha, svayathu, bhagandara, arsha, asrigadara'' and ''visphotaka''. Thus described ''katukadya ghritam'' [47-49]<br /> <br /> === ''Pathya ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पथ्याशतरसे पथ्यावृन्तार्धशतकल्कवान्| <br /> प्रस्थः सिद्धो घृतात् पेयः स पाण्ड्वामयगुल्मनुत्||५०|| <br /> <br /> इति पथ्याघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pathyāśatarasē pathyāvr̥ntārdhaśatakalkavān| <br /> prasthaḥ siddhō ghr̥tāt pēyaḥ sa pāṇḍvāmayagulmanut||50|| <br /> <br /> iti pathyāghr̥tam|<br /> <br /> pathyAshatarase pathyAvRuntArdhashatakalkavAn| <br /> prasthaH siddho ghRutAt peyaH sa pANDvAmayagulmanut||50|| <br /> <br /> iti pathyAghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The decoction of one hundred fruits of ''haritaki'' and the paste of fifty stalks of ''haritaki'' fruits should be added to one ''prastha'' of ghee and cooked. This medicated ghee cures ''pandu'' and ''gulma'' [50]<br /> <br /> === ''Danti ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दन्त्याश्चतुष्पलरसे पिष्टैर्दन्तीशलाटुभिः| <br /> तद्वत्प्रस्थो घृतात्सिद्धः प्लीहपाण्ड्वर्तिशोफजित्||५१|| <br /> <br /> इति दन्तीघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dantyāścatuṣpalarasē piṣṭairdantīśalāṭubhiḥ| <br /> tadvatprasthō ghr̥tātsiddhaḥ plīhapāṇḍvartiśōphajit||51|| <br /> <br /> iti dantīghr̥tam| <br /> <br /> dantyAshcatuShpalarase piShTairdantIshalATubhiH| <br /> tadvatprastho ghRutAtsiddhaH plIhapANDvartishophajit||51|| <br /> <br /> iti dantIghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of ghee should be cooked by adding (one ''prastha'' of) the decoction of four ''palas'' of ''danti'' and the paste of the green fruits of ''danti''. Intake of this medicated ghee cures ''pleeha'' (splenic disorders), ''pandu'' and edema [51]<br /> <br /> === ''Drakshaghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुराणसर्पिषः प्रस्थो द्राक्षार्धप्रस्थसाधितः| <br /> कामलागुल्मपाण्ड्वर्तिज्वरमेहोदरापहः||५२|| <br /> <br /> इति द्राक्षाघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> purāṇasarpiṣaḥ prasthō drākṣārdhaprasthasādhitaḥ| <br /> kāmalāgulmapāṇḍvartijvaramēhōdarāpahaḥ||52|| <br /> <br /> iti drākṣāghr̥tam| <br /> <br /> purANasarpiShaH prastho drAkShArdhaprasthasAdhitaH| <br /> kAmalAgulmapANDvartijvaramehodarApahaH||52|| <br /> <br /> iti drAkShAghRutam|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of old ghee should be added to half a ''prastha'' of ''draksha'' and cooked. This medicated ghee cures ''kamala, gulma, pandu, jwara, meha'' (polyuria) and ''udara roga'' (generalized abdominal enlargement)[52]<br /> <br /> === ''Haridradi ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> हरिद्रात्रिफलानिम्बबलामधुकसाधितम्| <br /> सक्षीरं माहिषं सर्पिः कामलाहरमुत्तमम्||५३|| <br /> <br /> इति हरिद्रादिघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> haridrātriphalānimbabalāmadhukasādhitam| <br /> sakṣīraṁ māhiṣaṁ sarpiḥ kāmalāharamuttamam||53||<br /> <br /> iti haridrādighr̥tam|<br /> <br /> haridrAtriphalAnimbabalAmadhukasAdhitam| <br /> sakShIraM mAhiShaM sarpiH kAmalAharamuttamam||53||<br /> <br /> iti haridrAdighRutam|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Ghrita'' prepared with ''haridra, triphala, nimba, balā, madhuka'' and buffalo’s milk and ghee is an excellent cure for ''kamala'' [53]<br /> <br /> === ''Darvyadi ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गोमूत्रे द्विगुणे दार्व्याः कल्काक्षद्वयसाधितः| <br /> दार्व्याः पञ्चपलक्वाथे कल्के कालीयके परः||५४|| <br /> <br /> माहिषात् सर्पिषः प्रस्थः पूर्वः पूर्वे परे परः|५५| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gōmūtrē dviguṇē dārvyāḥ kalkākṣadvayasādhitaḥ| <br /> dārvyāḥ pañcapalakvāthē kalkē kālīyakē paraḥ||54|| <br /> <br /> māhiṣāt sarpiṣaḥ prasthaḥ pūrvaḥ pūrvē parē paraḥ|55|<br /> <br /> gomUtre dviguNe dArvyAH kalkAkShadvayasAdhitaH| <br /> dArvyAH pa~jcapalakvAthe kalke kAlIyake paraH||54|| <br /> <br /> mAhiShAt sarpiShaH prasthaH pUrvaH pUrve pare paraH|55|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of buffalo’s ghee prepared by adding two ''prasthas'' of cow’s urine and the paste of two ''aksha'' of the paste of ''darvi'' as per ''sneha kalpana'' cures ''pandu roga''.<br /> <br /> One ''prastha'' of buffalo’s ghee prepared by adding with the decoction of five ''palas'' of ''darvi'' and the paste of ''kaleeyaka'' as per ''sneha kalpana'' cures ''kamala'' [54-55]<br /> <br /> === Preparations for ''pandu roga'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्नेहैरेभिरुपक्रम्य स्निग्धं मत्वा विरेचयेत्||५५|| <br /> <br /> पयसा मूत्रयुक्तेन बहुशः केवलेन वा| <br /> दन्तीफलरसे कोष्णे काश्मर्याञ्जलिना शृतम्||५६|| <br /> <br /> द्राक्षाञ्जलिं मृदित्वा वा दद्यात् पाण्ड्वामयापहम्| <br /> द्विशर्करं त्रिवृच्चूर्णं पलार्धं पैत्तिकः पिबेत्||५७|| <br /> <br /> कफपाण्डुस्तु गोमूत्रक्लिन्नयुक्तां [१] हरीतकीम्| <br /> आरग्वधं [२] रसेनेक्षोर्विदार्यामलकस्य च||५८||<br /> <br /> सत्र्यूषणं बिल्वपत्रं पिबेन्ना कामलापहम्| <br /> दन्त्यर्धपलकल्कं वा द्विगुडं शीतवारिणा||५९|| <br /> <br /> कामली त्रिवृतां वाऽपि त्रिफलाया रसैः पिबेत्| <br /> विशालात्रिफलामुस्तकुष्ठदारुकलिङ्गकान्||६०|| <br /> <br /> कार्षिकानर्धकर्षांशां कुर्यादतिविषां तथा| <br /> कर्षौ मधुरसाया द्वौ सर्वमेतत् [३] सुखाम्बुना||६१|| <br /> <br /> मृदितं तं रसं पूतं पीत्वा लिह्याच्च मध्वनु| <br /> कासं श्वासं ज्वरं दाहं पाण्डुरोगमरोचकम्||६२|| <br /> <br /> गुल्मानाहामवातांश्च रक्तपित्तं च नाशयेत्| <br /> त्रिफलाया गुडूच्या वा दार्व्या निम्बस्य वा रसम्||६३|| <br /> <br /> शीतं मधुयुतं प्रातः कामलार्तः पिबेन्नरः| <br /> क्षीरमूत्रं पिबेत् पक्षं गव्यं माहिषमेव वा||६४|| <br /> <br /> पाण्डुर्गोमूत्रयुक्तं वा सप्ताहं त्रिफलारसम्| <br /> तरुजान् ज्वलितान्मूत्रे निर्वाप्यामृद्य चाङ्कुरान्||६५|| <br /> <br /> मातुलुङ्गस्य तत् पूतं पाण्डुशोथहरं पिबेत्| <br /> स्वर्णक्षीरी त्रिवृच्छ्यामे भद्रदारु सनागरम्||६६|| <br /> <br /> गोमूत्राञ्जलिना पिष्टं मूत्रे वा क्वथितं पिबेत्| <br /> क्षीरमेभिः शृतं वाऽपि पिबेद्दोषानुलोमनम्||६७|| <br /> <br /> हरीतकीं प्रयोगेण गोमूत्रेणाथवा पिबेत्| <br /> जीर्णे क्षीरेण भुञ्जीत रसेन मधुरेण वा||६८|| <br /> <br /> सप्तरात्रं गवां मूत्रे भावितं वाऽप्ययोरजः| <br /> पाण्डुरोगप्रशान्त्यर्थं पयसा पाययेद्भिषक्||६९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snēhairēbhirupakramya snigdhaṁ matvā virēcayēt||55|| <br /> <br /> payasā mūtrayuktēna bahuśaḥ kēvalēna vā| <br /> dantīphalarasē kōṣṇē kāśmaryāñjalinā śr̥tam||56|| <br /> <br /> drākṣāñjaliṁ mr̥ditvā vā dadyāt pāṇḍvāmayāpaham| <br /> dviśarkaraṁ trivr̥ccūrṇaṁ palārdhaṁ paittikaḥ pibēt||57|| <br /> <br /> Kaphapāṇḍustu gōmūtraklinnayuktāṁ [1] harītakīm| <br /> āragvadhaṁ [2] rasēnēkṣōrvidāryāmalakasya ca||58|| <br /> <br /> satryūṣaṇaṁ bilvapatraṁ pibēnnā kāmalāpaham| <br /> dantyardhapalakalkaṁ vā dviguḍaṁ śītavāriṇā||59|| <br /> <br /> kāmalī trivr̥tāṁ vā'pi triphalāyā rasaiḥ pibēt| <br /> viśālātriphalāmustakuṣṭhadārukaliṅgakān||60|| <br /> <br /> kārṣikānardhakarṣāṁśāṁ kuryādativiṣāṁ tathā| <br /> karṣau madhurasāyā dvau sarvamētat [3] sukhāmbunā||61|| <br /> <br /> mr̥ditaṁ taṁ rasaṁ pūtaṁ pītvā lihyācca madhvanu| <br /> kāsaṁ śvāsaṁ jvaraṁ dāhaṁ pāṇḍurōgamarōcakam||62|| <br /> <br /> gulmānāhāmavātāṁśca Rakta Pittaṁ ca nāśayēt| <br /> triphalāyā guḍūcyā vā dārvyā nimbasya vā rasam||63|| <br /> <br /> śītaṁ madhuyutaṁ prātaḥ kāmalārtaḥ pibēnnaraḥ| <br /> kṣīramūtraṁ pibēt pakṣaṁ gavyaṁ māhiṣamēva vā||64|| <br /> <br /> pāṇḍurgōmūtrayuktaṁ vā saptāhaṁ triphalārasam| <br /> tarujān jvalitānmūtrē nirvāpyāmr̥dya cāṅkurān||65|| <br /> <br /> mātuluṅgasya tat pūtaṁ pāṇḍuśōthaharaṁ pibēt| <br /> svarṇakṣīrī trivr̥cchyāmē bhadradāru sanāgaram||66|| <br /> <br /> gōmūtrāñjalinā piṣṭaṁ mūtrē vā kvathitaṁ pibēt| <br /> kṣīramēbhiḥ śr̥taṁ vā'pi pibēddōṣānulōmanam||67|| <br /> <br /> harītakīṁ prayōgēṇa gōmūtrēṇāthavā pibēt| <br /> jīrṇē kṣīrēṇa bhuñjīta rasēna madhurēṇa vā||68|| <br /> <br /> saptarātraṁ gavāṁ mūtrē bhāvitaṁ vā'pyayōrajaḥ| <br /> pāṇḍurōgapraśāntyarthaṁ payasā pāyayēdbhiṣak||69||<br /> <br /> snehairebhirupakramya snigdhaM matvA virecayet||55|| <br /> <br /> payasA mUtrayuktena bahushaH kevalena vA| <br /> dantIphalarase koShNe kAshmaryA~jjalinA shRutam||56|| <br /> <br /> drAkShA~jjaliM mRuditvA vA dadyAt pANDvAmayApaham| <br /> dvisharkaraM trivRuccUrNaM palArdhaM paittikaH pibet||57|| <br /> <br /> kaphapANDustu gomUtraklinnayuktAM [1] harItakIm| <br /> AragvadhaM [2] rasenekShorvidAryAmalakasya ca||58|| <br /> <br /> satryUShaNaM bilvapatraM pibennA kAmalApaham| <br /> dantyardhapalakalkaM vA dviguDaM shItavAriNA||59|| <br /> <br /> kAmalI trivRutAM vA~api triphalAyA rasaiH pibet| <br /> vishAlAtriphalAmustakuShThadArukali~ggakAn||60|| <br /> <br /> kArShikAnardhakarShAMshAM kuryAdativiShAM tathA| <br /> karShau madhurasAyA dvau sarvametat [3] sukhAmbunA||61|| <br /> <br /> mRuditaM taM rasaM pUtaM pItvA lihyAcca madhvanu| <br /> kAsaM shvAsaM jvaraM dAhaM pANDurogamarocakam||62|| <br /> <br /> gulmAnAhAmavAtAMshca raktapittaM ca nAshayet| <br /> triphalAyA guDUcyA vA dArvyA nimbasya vA rasam||63||<br /> <br /> shItaM madhuyutaM prAtaH kAmalArtaH pibennaraH| <br /> kShIramUtraM pibet pakShaM gavyaM mAhiShameva vA||64|| <br /> <br /> pANDurgomUtrayuktaM vA saptAhaM triphalArasam| <br /> tarujAn jvalitAnmUtre nirvApyAmRudya cA~gkurAn||65|| <br /> <br /> mAtulu~ggasya tat pUtaM pANDushothaharaM pibet| <br /> svarNakShIrI trivRucchyAme bhadradAru sanAgaram||66|| <br /> <br /> gomUtrA~jjalinA piShTaM mUtre vA kvathitaM pibet| <br /> kShIramebhiH shRutaM vA~api pibeddoShAnulomanam||67|| <br /> <br /> harItakIM prayogeNa gomUtreNAthavA pibet| <br /> jIrNe kShIreNa bhu~jjIta rasena madhureNa vA||68|| <br /> <br /> saptarAtraM gavAM mUtre bhAvitaM vA~apyayorajaH| <br /> pANDurogaprashAntyarthaM payasA pAyayedbhiShak||69|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After proper oleation of the patient with the internal administration of the above described medicated ''ghrita,'' the patient should be given frequent medication with the following recipes: <br /> <br /> Milk with cow’s urine or milk alone or lukewarm infusion of ''danti'' sprinkled with the powder of one ''anjali'' of ''kashmarya'' or mixed with the paste of one ''anjali'' (handful) of ''draksha''; all these drugs cure ''pandu roga'' in general.<br /> <br /> The patient suffering from ''paittika pandu'' should take half ''pala'' of ''trivitta'' mixed with one ''pala'' of sugar; <br /> <br /> ''Kaphaja'' type of ''pandu'' patient should take ''haritaki churna'' immersed in cow’s urine. <br /> <br /> ''Kamala'' patient should take ''aragvadha'' along with the juice of sugarcane, ''vidari, amalaki'' to which ''sunthi, maricha, pippali'' and ''bilva'' leaves have been added; or may take the paste of half ''pala'' of ''danti'' mixed with one ''pala'' of jaggery along with cold water; or may take ''trivritta'' along with decoction of ''triphala''. <br /> <br /> ''Vishaladi phanta'' – One ''karsha'' each of ''vishala, haritaki, bibhitaka, amalaki, musta, kushtha, devadaru'' and ''kalingaka''; half ''karsha'' of ''ativisha'', two ''karsha'' of ''madhurasa'' (''murva'') should be made to a paste by triturating with lukewarm water and strained. The patient should take honey after taking this infusion. This ''phanta'' cures cough, dyspnea, fever, burning sensation, ''pandu roga'', anorexia, ''gulma'' (lumps in abdomen), ''anaha'' (gaseous distention of the abdomen), ''amavata'' (joint disorders caused by ''ama''), and ''raktapitta'' (bleeding disorders).<br /> <br /> Other drugs which are useful for these ailments are as follows: <br /> *''Kamala'' patients should take the decoction of ''triphala, guduchi, devadaru,'' or ''nimba'' after cooling and adding honey in the morning.<br /> *''Pandu'' patient may take the milk or urine of either cow or buffalo for one fortnight.<br /> *''Pandu'' patient may drink the decoction of ''triphala'' along with cow’s urine for one week.<br /> *Patient suffering from ''pandu'' and ''sopha'' (edema) should drink the liquid obtained by straining the paste of tender branches of ''matulunga'' set afire and then immersed in cow’s urine.<br /> *''Suvarnakshiri, trivritta, syama-trivritta, bhadradaru'' and ''nagara'' should be triturated by adding one ''anjali'' of cow’s urine or should be made to a decoction by adding cow’s urine. The above mentioned drugs may also be boiled with milk. The drinking of these drugs brings about the downward motion of the ''doshas'' causing ''pandu''.<br /> *Then again, the patient suffering from ''pandu roga'' should take a course of ''haritaki'' with cow’s urine (for seven days) and then should take food either with milk or sweetened meat soup, and <br /> *Physicians should give ''lauha bhasma'' impregnated for seven nights with cow’s urine along with milk for the alleviation of ''pandu roga'' [55-69]<br /> <br /> === ''Navayasa churnam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्र्यूषणत्रिफलामुस्तविडङ्गचित्रकाः समाः| <br /> नवायोरजसो भागास्तच्चूर्णं क्षौद्रसर्पिषा||७०|| <br /> <br /> भक्षयेत् पाण्डुहृद्रोगकुष्ठार्शःकामलापहम्| <br /> नवायसमिदं चूर्णं कृष्णात्रेयेण भाषितम्||७१|| <br /> <br /> इति नवायसचूर्णम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tryūṣaṇatriphalāmustaviḍaṅgacitrakāḥ samāḥ| <br /> navāyōrajasō bhāgāstaccūrṇaṁ kṣaudrasarpiṣā||70|| <br /> <br /> bhakṣayēt pāṇḍuhr̥drōgakuṣṭhārśaḥkāmalāpaham| <br /> navāyasamidaṁ cūrṇaṁ kr̥ṣṇātrēyēṇa bhāṣitam||71|| <br /> <br /> iti navāyasacūrṇam| <br /> <br /> tryUShaNatriphalAmustaviDa~ggacitrakAH samAH| <br /> navAyorajaso bhAgAstaccUrNaM kShaudrasarpiShA||70|| <br /> <br /> bhakShayet pANDuhRudrogakuShThArshaHkAmalApaham| <br /> navAyasamidaM cUrNaM kRuShNAtreyeNa bhAShitam||71|| <br /> <br /> iti navAyasacUrNam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take ''sunthi, pippali, maricha, haritaki, bibhitaki, amalaki, musta, vidanga'' and ''chitraka'' in one part each and nine parts of ''lauha bhasma'' and mix together. Intake of this recipe along with honey and ghee cures anemia, heart diseases, ''kushtha'' (group of skin diseases), ''arsha'' (hemorrhoids) and ''kamala''. This medicine propounded by ''krishnatreya'' is called ''navayasa churna'' [70-71]<br /> <br /> === ''Mandura vataka'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुडनागरमण्डूरतिलांशान्मानतः समान्| <br /> पिप्पलीद्विगुणां कुर्याद्गुटिकां पाण्डुरोगिणे||७२|| <br /> <br /> त्र्यूषणं त्रिफला मुस्तं विडङ्गं चव्यचित्रकौ| <br /> दार्वीत्वङ्माक्षिको धातुर्ग्रन्थिकं देवदारु च||७३|| <br /> <br /> एतान् द्विपलिकान्भागांश्चूर्णं कुर्यात् पृथक् पृथक्| <br /> मण्डूरं द्विगुणं चूर्णाच्छुद्धमञ्जनसन्निभम्||७४|| <br /> <br /> गोमूत्रेऽष्टगुणे पक्त्वा तस्मिंस्तत् प्रक्षिपेत्ततः| <br /> उदुम्बरसमान्कृत्वा वटकांस्तान् यथाग्नि ना||७५|| <br /> <br /> उपयुञ्जीत तक्रेण सात्म्यं जीर्णे च भोजनम्| <br /> मण्डूरवटका ह्येते प्राणदाः पाण्डुरोगिणाम्||७६|| <br /> <br /> कुष्ठान्यजीर्णकं शोथमूरुस्तम्भं कफामयान्| <br /> अर्शांसि कामलां मेहं प्लीहानं शमयन्ति च||७७|| <br /> <br /> इति मण्डूरवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> guḍanāgaramaṇḍūratilāṁśānmānataḥ samān| <br /> pippalīdviguṇāṁ kuryādguṭikāṁ pāṇḍurōgiṇē||72|| <br /> <br /> tryūṣaṇaṁ triphalā mustaṁ viḍaṅgaṁ cavyacitrakau| <br /> dārvītvaṅmākṣikō Dhāturgranthikaṁ dēvadāru ca||73|| <br /> <br /> ētān dvipalikānbhāgāṁścūrṇaṁ kuryāt pr̥thak pr̥thak| <br /> maṇḍūraṁ dviguṇaṁ cūrṇācchuddhamañjanasannibham||74|| <br /> <br /> gōmūtrē'ṣṭaguṇē paktvā tasmiṁstat prakṣipēttataḥ| <br /> udumbarasamānkr̥tvā vaṭakāṁstān yathāgni nā||75|| <br /> <br /> upayuñjīta takrēṇa sātmyaṁ jīrṇē ca bhōjanam| <br /> maṇḍūravaṭakā hyētē prāṇadāḥ pāṇḍurōgiṇām||76|| <br /> <br /> kuṣṭhānyajīrṇakaṁ śōthamūrustambhaṁ kaphāmayān| <br /> arśāṁsi kāmalāṁ mēhaṁ plīhānaṁ śamayanti ca||77|| <br /> <br /> iti maṇḍūravaṭakāḥ| <br /> <br /> guDanAgaramaNDUratilAMshAnmAnataH samAn| <br /> pippalIdviguNAM kuryAdguTikAM pANDurogiNe||72|| <br /> <br /> tryUShaNaM triphalA mustaM viDa~ggaM cavyacitrakau| <br /> dArvItva~gmAkShiko dhAturgranthikaM devadAru ca||73|| <br /> <br /> etAn dvipalikAnbhAgAMshcUrNaM kuryAt pRuthak pRuthak| <br /> maNDUraM dviguNaM cUrNAcchuddhama~jjanasannibham||74|| <br /> <br /> gomUtre~aShTaguNe paktvA tasmiMstat prakShipettataH| <br /> udumbarasamAnkRutvA vaTakAMstAn yathAgni nA||75|| <br /> <br /> upayu~jjIta takreNa sAtmyaM jIrNe ca bhojanam| <br /> maNDUravaTakA hyete prANadAH pANDurogiNAm||76|| <br /> <br /> kuShThAnyajIrNakaM shothamUrustambhaM kaphAmayAn| <br /> arshAMsi kAmalAM mehaM plIhAnaM shamayanti ca||77|| <br /> <br /> iti maNDUravaTakAH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Mandura vataka'' – jaggery, ''shunthi, mandura'' and ''tila'' in one part each along with two parts of ''pippali'' should be triturated and made in the form of pills. This medicine is suitable for the treatment of the patients with ''pandu roga''.<br /> <br /> ''Shunthi, pippali, maricha, haritaki, bibhitaki, amalaki, musta, vidanga, chavya, chitraka,'' bark of ''daruharidra, makshika'' (copper pyrite), ''pippalimoola'' and ''devadaru'' in the quantity of two ''pala'' each should be made to powders separately.<br /> <br /> ''Mandura bhasma'' which is dark in color like collyrium, should be cooked by adding eight times of cow’s urine and the powders of the above drugs should be mixed to this. ''Vatakas'' (large sized pills) of the size of ''udumbara'' should be made out of this combination. This should be taken by the patient in the appropriate doses according to his [[agni]] (power of digestion and metabolism) along with butter milk. The patient should take wholesome food after its digestion. These pills named as ''mandura vataka'' are the life givers for the patients of ''pandu''. It also cures ''kushtha, ajeerna'' (indigestion), ''sotha'' (edema), ''urustambha'' (stiffening of the thighs), disease caused by aggravation of the [[kapha]], arsha'' (hemorrhoids), ''kamala'' (jaundice), ''meha'' (polyuria) and ''pleeha'' (splenic diseases).<br /> <br /> Thus ends the description of two types of ''mandura vataka''.[72-77]<br /> <br /> === ''Tapayadi lauha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ताप्याद्रिजतुरूप्यायोमलाः पञ्चपलाः पृथक्| <br /> चित्रकत्रिफलाव्योषविडङ्गैः पलिकैः सह||७८|| <br /> <br /> शर्कराष्टपलोन्मिश्राश्चूर्णिता मधुनाऽऽप्लुताः| <br /> अभ्यस्यास्त्वक्षमात्रा हि जीर्णे हितमिताशिना||७९|| <br /> <br /> कुलत्थकाकमाच्यादिकपोतपरिहारिणा|८०| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tāpyādrijaturūpyāyōmalāḥ pañcapalāḥ pr̥thak| <br /> citrakatriphalāvyōṣaviḍaṅgaiḥ palikaiḥ saha||78|| <br /> <br /> śarkarāṣṭapalōnmiśrāścūrṇitā madhunā''plutāḥ| <br /> abhyasyāstvakṣamātrā hi jīrṇē hitamitāśinā||79|| <br /> <br /> kulatthakākamācyādikapōtaparihāriṇā|80| <br /> <br /> tApyAdrijaturUpyAyomalAH pa~jcapalAH pRuthak| <br /> citrakatriphalAvyoShaviDa~ggaiH palikaiH saha||78|| <br /> <br /> sharkarAShTapalonmishrAshcUrNitA madhunA~a~aplutAH| <br /> abhyasyAstvakShamAtrA hi jIrNe hitamitAshinA||79|| <br /> <br /> kulatthakAkamAcyAdikapotaparihAriNA|80|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Tapyadi yoga'' – ''Tapya, shilajatu,'' silver, ''mandura'' in the amount of five ''pala'' each should be added to one ''pala'' each of ''chitraka, haritaki, bibhitaka, amalaki, sunthi, pippali, maricha'' and ''vidanga''; and eight ''pala'' of sugar. This recipe should be taken by the patient habitually (by a ''pandu rogi'') in the dose of one ''karsha'' along with adequate amount of honey. After the digestion of this drug the patient should take wholesome food in small quantity and should avoid using ''kulattha, kakamachi'' etc. and pigeon meat [78-80]<br /> <br /> === ''Yogaraja'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिफलायास्त्रयो भागास्त्रयस्त्रिकटुकस्य च||८०|| <br /> <br /> भागश्चित्रकमूलस्य विडङ्गानां तथैव च| <br /> पञ्चाश्मजतुनो भागास्तथा रूप्यमलस्य च||८१|| <br /> <br /> माक्षिकस्य च शुद्धस्य लौहस्य रजसस्तथा| <br /> अष्टौ भागाः सितायाश्च तत्सर्वं सूक्ष्मचूर्णितम्||८२|| <br /> <br /> माक्षिकेणाप्लुतं स्थाप्यमायसे भाजने शुभे| <br /> उदुम्बरसमां मात्रां ततः खादेद्यथाग्नि ना||८३|| <br /> <br /> दिने दिने प्रयुञ्जीत जीर्णे भोज्यं यथेप्सितम्| <br /> वर्जयित्वा कुलत्थानि काकमाचीं कपोतकम्||८४||<br /> <br /> योगराज इति ख्यातो योगोऽयममृतोपमः| <br /> रसायनमिदं श्रेष्ठं सर्वरोगहरं शिवम्||८५|| <br /> <br /> पाण्डुरोगं विषं कासं यक्ष्माणं विषमज्वरम्| <br /> कुष्ठान्यजीर्णकं मेहं शोषं श्वासमरोचकम्||८६|| <br /> <br /> विशेषाद्धन्त्यपस्मारं कामलां गुदजानि च| <br /> <br /> इति योगराजः|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> triphalāyāstrayō bhāgāstrayastrikaṭukasya ca||80|| <br /> <br /> bhāgaścitrakamūlasya viḍaṅgānāṁ tathaiva ca| <br /> pañcāśmajatunō bhāgāstathā rūpyamalasya ca||81|| <br /> <br /> mākṣikasya ca śuddhasya lauhasya rajasastathā| <br /> aṣṭau bhāgāḥ sitāyāśca tatsarvaṁ sūkṣmacūrṇitam||82|| <br /> <br /> mākṣikēṇāplutaṁ sthāpyamāyasē bhājanē śubhē| <br /> udumbarasamāṁ mātrāṁ tataḥ khādēdyathāgni nā||83|| <br /> <br /> dinē dinē prayuñjīta jīrṇē bhōjyaṁ yathēpsitam| <br /> varjayitvā kulatthāni kākamācīṁ kapōtakam||84|| <br /> <br /> yōgarāja iti khyātō yōgō'yamamr̥tōpamaḥ| <br /> rasāyanamidaṁ śrēṣṭhaṁ sarvarōgaharaṁ śivam||85|| <br /> <br /> pāṇḍurōgaṁ viṣaṁ kāsaṁ yakṣmāṇaṁ viṣamajvaram| <br /> kuṣṭhānyajīrṇakaṁ mēhaṁ śōṣaṁ śvāsamarōcakam||86|| <br /> <br /> viśēṣāddhantyapasmāraṁ kāmalāṁ gudajāni ca| <br /> <br /> iti yōgarājaḥ| <br /> <br /> triphalAyAstrayo bhAgAstrayastrikaTukasya ca||80|| <br /> <br /> bhAgashcitrakamUlasya viDa~ggAnAM tathaiva ca| <br /> pa~jcAshmajatuno bhAgAstathA rUpyamalasya ca||81|| <br /> <br /> mAkShikasya ca shuddhasya lauhasya rajasastathA| <br /> aShTau bhAgAH sitAyAshca tatsarvaM sUkShmacUrNitam||82|| <br /> <br /> mAkShikeNAplutaM sthApyamAyase bhAjane shubhe| <br /> udumbarasamAM mAtrAM tataH khAdedyathAgni nA||83|| <br /> <br /> dine dine prayu~jjIta jIrNe bhojyaM yathepsitam| <br /> varjayitvA kulatthAni kAkamAcIM kapotakam||84|| <br /> <br /> yogarAja iti khyAto yogo~ayamamRutopamaH| <br /> rasAyanamidaM shreShThaM sarvarogaharaM shivam||85|| <br /> <br /> pANDurogaM viShaM kAsaM yakShmANaM viShamajvaram| <br /> kuShThAnyajIrNakaM mehaM shoShaM shvAsamarocakam||86|| <br /> <br /> visheShAddhantyapasmAraM kAmalAM gudajAni ca| <br /> <br /> iti yogarAjaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Yogaraja'' – ''harītaki, bibhitaki, amalaki, shunthi, pippali, maricha, chitraka moola'' (root) and ''vidanga'' in the amount of one part each; five parts each of ''shilajatu, raupya mala'' (silver), purified ''makshika'' and ''lauha bhasma''; eight parts of sugar – all should be made to a fine powder and mixed with adequate amount of honey and kept in clean iron jar. This recipe should be taken by the patient in a quantity equal to a fruit of ''udumbara'' according to the power of digestion every day and should be given the desired food excluding ''kulattha, kakamachi'' etc. and pigeon meat; only after the digestion of the taken drug. This ambrosia like recipe is called ''yogaraja''. It is an excellent rejuvenative recipe which cures all diseases and bestows auspiciousness. It specially cures ''pandu'', poisoning, ''kasa, yakshma, vishama jwara'' (irregular fevers), ''ajeerna, meha, soshha, swasa, aruchi, apasmara'' (epilepsy), ''kamala'' and ''arsha''.<br /> <br /> Thus ends the description of ''yogaraja'' [80-86]<br /> <br /> === Various formulations ===<br /> <br /> === Shilajatu Vataka ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कौटजत्रिफलानिम्बपटोलघननागरैः||८७|| <br /> <br /> भावितानि दशाहानि रसैर्द्वित्रिगुणानि वा| <br /> शिलाजतुपलान्यष्टौ तावती सितशर्करा||८८||<br /> <br /> त्वक्क्षीरी पिप्पली धात्री कर्कटाख्या पलोन्मिता| <br /> <br /> निदिग्ध्याः फलमूलाभ्यां पलं युक्त्या त्रिगन्धकम्| <br /> <br /> चूर्णितं मधुनः कुर्यात् त्रिपलेनाक्षिकान् गुडान्| <br /> दाडिमाम्बुपयःपक्षिरसतोयसुरासवान्||९०|| <br /> <br /> तान् भक्षयित्वाऽनुपिबेन्निरन्नो भुक्त एव वा| <br /> पाण्डुकुष्ठज्वरप्लीहतमकार्शोभगन्दरान्||९१|| <br /> <br /> पूतिहृच्छुक्रमूत्राग्निदोषशोषगरोदरान् [१] | <br /> कासासृग्दरपित्तासृक्शोथगुल्मगलामयान्||९२|| <br /> <br /> ते च सर्वव्रणान् हन्युः सर्वरोगहराः शिवाः| <br /> <br /> इति शिलाजतुवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> kauṭajatriphalānimbapaṭōlaghananāgaraiḥ||87|| <br /> <br /> bhāvitāni daśāhāni rasairdvitriguṇāni vā| <br /> śilājatupalānyaṣṭau tāvatī sitaśarkarā||88|| <br /> <br /> tvakkṣīrī pippalī dhātrī karkaṭākhyā palōnmitā| <br /> <br /> nidigdhyāḥ phalamūlābhyāṁ palaṁ yuktyā trigandhakam| <br /> <br /> cūrṇitaṁ madhunaḥ kuryāt tripalēnākṣikān guḍān| <br /> dāḍimāmbupayaḥpakṣirasatōyasurāsavān||90|| <br /> <br /> tān bhakṣayitvā'nupibēnnirannō bhukta ēva vā| <br /> pāṇḍukuṣṭhajvaraplīhatamakārśōbhagandarān||91|| <br /> <br /> pūtihr̥cchukramūtrāgnidōṣaśōṣagarōdarān [1] | <br /> kāsāsr̥gdarapittāsr̥kśōthagulmagalāmayān||92|| <br /> <br /> tē ca sarvavraṇān hanyuḥ sarvarōgaharāḥ śivāḥ| <br /> <br /> iti śilājatuvaṭakāḥ| <br /> <br /> kauTajatriphalAnimbapaTolaghananAgaraiH||87|| <br /> <br /> bhAvitAni dashAhAni rasairdvitriguNAni vA| <br /> shilAjatupalAnyaShTau tAvatI sitasharkarA||88|| <br /> <br /> tvakkShIrI pippalI dhAtrI karkaTAkhyA palonmitA| <br /> <br /> nidigdhyAH phalamUlAbhyAM palaM yuktyA trigandhakam| <br /> <br /> cUrNitaM madhunaH kuryAt tripalenAkShikAn guDAn| <br /> dADimAmbupayaHpakShirasatoyasurAsavAn||90|| <br /> <br /> tAn bhakShayitvA~anupibenniranno bhukta eva vA| <br /> pANDukuShThajvaraplIhatamakArshobhagandarAn||91|| <br /> <br /> pUtihRucchukramUtrAgnidoShashoShagarodarAn [1] | <br /> kAsAsRugdarapittAsRukshothagulmagalAmayAn||92|| <br /> <br /> te ca sarvavraNAn hanyuH sarvarogaharAH shivAH| <br /> <br /> iti shilAjatuvaTakAH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> ''Shilajatu vataka'' – Eight ''pala'' of ''shilajatu'' impregnated for ten, twenty or thirty days with the decoction of fruit of ''kutaja, haritaki, bibhitaka, amalaki, nimba, patola, ghana'' and ''nagara''. Eight ''pala'' of sugar and one ''pala'' each of ''tvakakshiri, pippali, dhatri'' and ''karkatashringi''; half ''pala'' each of the fruit and root of ''nidigdhika'' and adequate powder of ''tvaka, ela'' and ''patra'' should be added to this ''shilajatu''. ''Vataka'' (large sized pills) of one ''aksha'' each should be prepared by adding three ''pala'' of honey to this powder. These pills can be taken on either empty stomach or after having food. The patient should drink the juice of ''dadima'' (pomegranate), milk, meat soup of birds, water, alcohol, ''asava'' (medicated wine) after taking this medicine. It cures ''pandu, kushtha, jwara, pleeha, tamaka svasa, arsha, bhagandara'' (fistula in ano), ''puti'' (putrified ulcers), ''hridroga'' (heart diseases), ''shukra dosha'' (diseases of semen), ''mutra dosha'' (diseases of urine), and ''agni dosha'' (diseases of digestion), ''sosha'' (consumption), ''gara'' (poisoning), ''udara, kasa, asrigdara'' (menorrhagia), ''raktapitta'' (bleeding disorders), ''sotha, gulma, galamayana'' (diseases of the throats) and all types of ''vrana'' (wounds). It cures all types of diseases and bestows auspiciousness. Thus, ends the description of ''shilajatu vataka.'' [87-92]<br /> <br /> === Punarnava Mandura ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुनर्नवा त्रिवृद्व्योषविडङ्गं दारु चित्रकम्||९३|| <br /> <br /> कुष्ठं हरिद्रे त्रिफला दन्ती चव्यं कलिङ्गकाः| <br /> पिप्पली [२] पिप्पलीमूलं मुस्तं चेति पलोन्मितम्||९४|| <br /> <br /> मण्डूरं द्विगुणं चूर्णाद्गोमूत्रे द्व्याढके पचेत्| <br /> कोलवद्गुटिकाः कृत्वा तक्रेणालोड्य ना पिबेत्||९५|| <br /> <br /> ताः पाण्डुरोगान् प्लीहानमर्शांसि विषमज्वरम्| <br /> श्वयथुं ग्रहणीदोषं हन्युः कुष्ठं क्रिमींस्तथा||९६|| <br /> <br /> इति पुनर्नवामण्डूरम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> punarnavā trivr̥dvyōṣaviḍaṅgaṁ dāru citrakam||93|| <br /> <br /> kuṣṭhaṁ haridrē triphalā dantī cavyaṁ kaliṅgakāḥ| <br /> pippalī [2] pippalīmūlaṁ mustaṁ cēti palōnmitam||94|| <br /> <br /> maṇḍūraṁ dviguṇaṁ cūrṇādgōmūtrē dvyāḍhakē pacēt| <br /> kōlavadguṭikāḥ kr̥tvā takrēṇālōḍya nā pibēt||95|| <br /> <br /> tāḥ pāṇḍurōgān plīhānamarśāṁsi viṣamajvaram| <br /> śvayathuṁ grahaṇīdōṣaṁ hanyuḥ kuṣṭhaṁ krimīṁstathā||96|| <br /> <br /> iti punarnavāmaṇḍūram|<br /> <br /> punarnavA trivRudvyoShaviDa~ggaM dAru citrakam||93|| <br /> <br /> kuShThaM haridre triphalA dantI cavyaM kali~ggakAH| <br /> pippalI [2] pippalImUlaM mustaM ceti palonmitam||94|| <br /> <br /> maNDUraM dviguNaM cUrNAdgomUtre dvyADhake pacet| <br /> kolavadguTikAH kRutvA takreNAloDya nA pibet||95|| <br /> <br /> tAH pANDurogAn plIhAnamarshAMsi viShamajvaram| <br /> shvayathuM grahaNIdoShaM hanyuH kuShThaM krimIMstathA||96|| <br /> <br /> iti punarnavAmaNDUram| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Powder of one ''pala'' each of ''punarnava, trivritta, sunthi, pippali, maricha, vidanga, devadaru, chitraka, kushtha, haridra, daruharidra, haritaki, bibhitaka, amalaki, danti, chavya, kālingaka, pippalī, pippalimoola'' and ''musta''; and forty ''pala'' of ''mandura bhasma'' (rust of iron) coked in two ''adhaka'' of cow’s urine and made in the form of ''gutika'' of the size of ''kola''. These pills should be taken with butter milk. It cures ''pandu, pleeha, arsha, vishama jwara, sotha, grahanidosha'' (sprue syndrome, irritable bowel syndrome), ''kushtha'' and ''krimi'' (parasitic infestation). Thus, ends the description of ''punarnava mandura''.[93-96]<br /> <br /> === Darvyadi leha and other two recipes ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दार्वीत्वक् त्रिफला व्योषं विडङ्गमयसो रजः| <br /> मधुसर्पिर्युतं लिह्यात् कामलापाण्डुरोगवान्||९७|| <br /> <br /> तुल्या अयोरजःपथ्याहरिद्राः क्षौद्रसर्पिषा| <br /> चूर्णिताः कामली लिह्याद्गुडक्षौद्रेण वाऽभयाः||९८|| <br /> <br /> त्रिफला द्वे हरिद्रे च कटुरोहिण्ययोरजः| <br /> चूर्णितं क्षौद्रसर्पिर्भ्यां स लेहः कामलापहः||९९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> dārvītvak triphalā vyōṣaṁ viḍaṅgamayasō rajaḥ| <br /> madhusarpiryutaṁ lihyāt kāmalāpāṇḍurōgavān||97|| <br /> <br /> tulyā ayōrajaḥpathyāharidrāḥ kṣaudrasarpiṣā| <br /> cūrṇitāḥ kāmalī lihyādguḍakṣaudrēṇa vā'bhayāḥ||98|| <br /> <br /> triphalā dvē haridrē ca kaṭurōhiṇyayōrajaḥ| <br /> cūrṇitaṁ kṣaudrasarpirbhyāṁ sa lēhaḥ kāmalāpahaḥ||99|| <br /> <br /> dArvItvak triphalA vyoShaM viDa~ggamayaso rajaH| <br /> madhusarpiryutaM lihyAt kAmalApANDurogavAn||97|| <br /> <br /> tulyA ayorajaHpathyAharidrAH kShaudrasarpiShA| <br /> cUrNitAH kAmalI lihyAdguDakShaudreNa vA~abhayAH||98|| <br /> <br /> triphalA dve haridre ca kaTurohiNyayorajaH| <br /> cUrNitaM kShaudrasarpirbhyAM sa lehaH kAmalApahaH||99|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Powder of the bark of daruharidra, haritaki, bibhitaka, amalaki, pippali, sunthi, maricha, vidanga and lauha bhasma mixed with ghee and honey, taken as a linctus by the patients suffering from ''pandu'' and ''kamala''.<br /> <br /> Two other recipes – Patients suffering from ''kamala'' should take the powder of one part each of ''lauha bhasma, haritaki'' and ''haridra'' along with honey and ghee and may also take the linctus of the powder of ''abhaya'' prepared by mixing with jaggery and honey. [97-99]<br /> <br /> === ''Dhatryavaleha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्विपलांशां तुगाक्षीरीं नागरं मधुयष्टिकाम्| <br /> प्रास्थिकीं पिप्पलीं द्राक्षां शर्करार्धतुलां शुभाम्||१००|| <br /> <br /> धात्रीफलरसद्रोणे चूर्णितं लेहवत् पचेत्| <br /> शीतं मधुप्रस्थयुतं लिह्यात् पाणितलं ततः||१०१|| <br /> <br /> हन्त्येष कामलां पित्तं पाण्डुं कासं हलीमकम्| <br /> <br /> इति धात्र्यवलेहः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dvipalāṁśāṁ tugākṣīrīṁ nāgaraṁ madhuyaṣṭikām| <br /> prāsthikīṁ pippalīṁ drākṣāṁ śarkarārDhātulāṁ śubhām||100|| <br /> <br /> dhātrīphalarasadrōṇē cūrṇitaṁ lēhavat pacēt| <br /> śītaṁ madhuprasthayutaṁ lihyāt pāṇitalaṁ tataḥ||101|| <br /> <br /> hantyēṣa kāmalāṁ Pittaṁ pāṇḍuṁ kāsaṁ halīmakam| <br /> <br /> iti dhātryavalēhaḥ| <br /> <br /> dvipalAMshAM tugAkShIrIM nAgaraM madhuyaShTikAm| <br /> prAsthikIM pippalIM drAkShAM sharkarArdhatulAM shubhAm||100|| <br /> <br /> dhAtrIphalarasadroNe cUrNitaM lehavat pacet| <br /> shItaM madhuprasthayutaM lihyAt pANitalaM tataH||101|| <br /> <br /> hantyeSha kAmalAM pittaM pANDuM kAsaM halImakam| <br /> <br /> iti dhAtryavalehaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Dhatryavaleha'' – ''Vanshalochana, sunthi, maduyashti'' powders, each in two ''pala''; one ''prastha'' each of ''pippali'' and ''draksha''; and half a ''tula'' of sugar crystal added with one ''drona'' of ''amalaki'' fruit juice and cooked till it changes into linctus form. One ''prastha'' of honey is added to it after it cools down. Intake of one ''panitala'' of this linctus cures ''kamala, [[pitta]] vikaras, pandu, kasa'' and ''haleemaka'' [100-101]<br /> <br /> === ''Mandura vatakah'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्र्यूषणं त्रिफला चव्यं चित्रको देवदारु च||१०२|| <br /> <br /> विडङ्गान्यथ मुस्तं च वत्सकं चेति चूर्णयेत्| <br /> मण्डूरतुल्यं तच्चूर्णं गोमूत्रेऽष्टगुणे पचेत्||१०३|| <br /> <br /> शनैः सिद्धास्तथा शीताः कार्याः कर्षसमा गुडाः| <br /> यथाग्नि भक्षणीयास्ते प्लीहपाण्ड्वामयापहाः||१०४||<br /> <br /> ग्रहण्यर्शोनुदश्चैव तक्रवाट्याशिनः स्मृताः| <br /> <br /> इति मण्डूरवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tryūṣaṇaṁ triphalā cavyaṁ citrakō dēvadāru ca||102|| <br /> <br /> viḍaṅgānyatha mustaṁ ca vatsakaṁ cēti cūrṇayēt| <br /> maṇḍūratulyaṁ taccūrṇaṁ gōmūtrē'ṣṭaguṇē pacēt||103|| <br /> <br /> śanaiḥ siddhāstathā śītāḥ kāryāḥ karṣasamā guḍāḥ| <br /> yathāgni bhakṣaṇīyāstē plīhapāṇḍvāmayāpahāḥ||104|| <br /> <br /> grahaṇyarśōnudaścaiva takravāṭyāśinaḥ smr̥tāḥ| <br /> <br /> iti maṇḍūravaṭakāḥ| <br /> <br /> tryUShaNaM triphalA cavyaM citrako devadAru ca||102|| <br /> <br /> viDa~ggAnyatha mustaM ca vatsakaM ceti cUrNayet| <br /> maNDUratulyaM taccUrNaM gomUtre~aShTaguNe pacet||103|| <br /> <br /> shanaiH siddhAstathA shItAH kAryAH karShasamA guDAH| <br /> yathAgni bhakShaNIyAste plIhapANDvAmayApahAH||104|| <br /> <br /> grahaNyarshonudashcaiva takravATyAshinaH smRutAH| <br /> <br /> iti maNDUravaTakAH|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Mandura Vataka''-II: ''Shunthi, pippali, maricha, haritaki, bibhitaka, amalaki, chavya, chitraka, devadaru, vidanga, musta'' and ''vatsaka'' in one part each, made in the form of powder and added to equal quantity (12 parts) of ''mandura bhasma'', should then be boiled by adding eight times of cow’s urine over mild fire. After the recipe cools pills of one ''aksha'' each should be prepared and taken according to the power of digestion. This cures ''pleeha, pandu, grahani,'' and ''arsha''. The patient should take buttermilk and ''vatya'' (a roasted barley preperation) while taking this pill [102-104]<br /> <br /> === ''Gaudo arishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मञ्जिष्ठा रजनी द्राक्षा बलामूलान्ययोरजः||१०५|| <br /> <br /> लोध्रं चैतेषु गौडः स्यादरिष्टः पाण्डुरोगिणाम्| <br /> <br /> इति गौडोऽरिष्टः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mañjiṣṭhā rajanī drākṣā balāmūlānyayōrajaḥ||105|| <br /> <br /> lōdhraṁ caitēṣu gauḍaḥ syādariṣṭaḥ pāṇḍurōgiṇām| <br /> <br /> iti gauḍō'riṣṭaḥ| <br /> <br /> ma~jjiShThA rajanI drAkShA balAmUlAnyayorajaH||105|| <br /> <br /> lodhraM caiteShu gauDaH syAdariShTaH pANDurogiNAm| <br /> <br /> iti gauDo~ariShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Manjishtha, rajani, draksha, bala moola'' (roots), ''lauha bhasma'', and ''lodhra'' should be added to jaggery and processed according to the method prescribed for ''arishta''. It is called ''gaudo-arishta'' and is useful for the patients suffering from ''pandu roga'' [105]<br /> <br /> === ''Beejakarishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बीजकात्षोडशपलं त्रिफलायाश्च विंशतिः||१०६|| <br /> <br /> द्राक्षायाः पञ्च लाक्षायाः सप्त द्रोणे जलस्य तत्| <br /> साध्यं पादावशेषे तु पूतशेषे समावपेत्||१०७|| <br /> <br /> शर्करायास्तुलां प्रस्थं माक्षिकस्य च कार्षिकम्| <br /> व्योषं व्याघ्रनखोशीरं क्रमुकं सैलवालुकम्||१०८|| <br /> <br /> मधुकं कुष्ठमित्येतच्चूर्णितं घृतभाजने| <br /> यवेषु दशरात्रं तद्ग्रीष्मे द्विः शिशिरे स्थितम्||१०९|| <br /> <br /> पिबेत्तद्ग्रहणीपाण्डुरोगार्शःशोथगुल्मनुत्| <br /> मूत्रकृच्छ्राश्मरीमेहकामलासन्निपातजित्||११०|| <br /> <br /> बीजकारिष्ट इत्येष आत्रेयेण प्रकीर्तितः| <br /> <br /> इति बीजकारिष्टः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bījakātṣōḍaśapalaṁ triphalāyāśca viṁśatiḥ||106|| <br /> <br /> drākṣāyāḥ pañca lākṣāyāḥ sapta drōṇē jalasya tat| <br /> sādhyaṁ pādāvaśēṣē tu pūtaśēṣē samāvapēt||107|| <br /> <br /> śarkarāyāstulāṁ prasthaṁ mākṣikasya ca kārṣikam| <br /> vyōṣaṁ vyāghranakhōśīraṁ kramukaṁ sailavālukam||108|| <br /> <br /> madhukaṁ kuṣṭhamityētaccūrṇitaṁ ghr̥tabhājanē| <br /> yavēṣu daśarātraṁ tadgrīṣmē dviḥ śiśirē sthitam||109|| <br /> <br /> pibēttadgrahaṇīpāṇḍurōgārśaḥśōthagulmanut| <br /> mūtrakr̥cchrāśmarīmēhakāmalāsannipātajit||110|| <br /> <br /> bījakāriṣṭa ityēṣa ātrēyēṇa prakīrtitaḥ| <br /> <br /> iti bījakāriṣṭaḥ| <br /> <br /> bIjakAtShoDashapalaM triphalAyAshca viMshatiH||106|| <br /> <br /> drAkShAyAH pa~jca lAkShAyAH sapta droNe jalasya tat| <br /> sAdhyaM pAdAvasheShe tu pUtasheShe samAvapet||107|| <br /> <br /> sharkarAyAstulAM prasthaM mAkShikasya ca kArShikam| <br /> vyoShaM vyAghranakhoshIraM kramukaM sailavAlukam||108|| <br /> <br /> madhukaM kuShThamityetaccUrNitaM ghRutabhAjane| <br /> yaveShu dasharAtraM tadgrIShme dviH shishire sthitam||109|| <br /> <br /> pibettadgrahaNIpANDurogArshaHshothagulmanut| <br /> mUtrakRucchrAshmarImehakAmalAsannipAtajit||110|| <br /> <br /> bIjakAriShTa ityeSha AtreyeNa prakIrtitaH| <br /> <br /> iti bIjakAriShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Beejaka'' taken in the amount of sixteen ''pala'', twenty ''pala'' of ''triphala,'' five pala of ''draksha'' and seven ''pala'' of ''laksha'' are added to one ''drona'' of water and boiled till one fourth of water remains. Water should then be taken out by straining. One ''tula'' of sugar, one ''pala'' of honey and one ''pala'' powder of each of the ''shunthi, pippali, maricha, vyaghranakha, kramuka, elavaluka, madhuka'' and ''kushtha'' are added to the above made decoction and the potion be stored in a jar smeared with ghee kept inside a barley heap for ten nights during summer and for twenty nights in winter. Intake of this potion cures ''grahani, pandu, arsha, sotha, gulma, mutra krichha'' (dysuria), ''ashmari'' (stones in the urinary tract), ''meha, kamala'' and diseases caused by all the three [[dosha]]. This is called ''beejaka arishta'' and it was propounded by Atreya.<br /> <br /> Thus, ends the description of ''beejaka arishta'' [106-110]<br /> <br /> === ''Dhatryarishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> धात्रीफलसहस्रे द्वे पीडयित्वा रसं तु तम्||१११|| <br /> <br /> क्षौद्राष्टांशेन संयुक्तं कृष्णार्धकुडवेन च| <br /> शर्करार्धतुलोन्मिश्रं पक्षं स्निग्धघटे स्थितम्||११२|| <br /> <br /> प्रपिबेन्मात्रया प्रातर्जीर्णे हितमिताशनः| <br /> कामलापाण्डुहृद्रोगवातासृग्विषमज्वरान्||११३||<br /> <br /> कासहिक्कारुचिश्वासांश्चैषोऽरिष्टः प्रणाशयेत्| <br /> <br /> इति धात्र्यरिष्टः <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dhātrīphalasahasrē dvē pīḍayitvā rasaṁ tu tam||111|| <br /> <br /> kṣaudrāṣṭāṁśēna saṁyuktaṁ kr̥ṣṇārdhakuḍavēna ca| <br /> śarkarārDhātulōnmiśraṁ pakṣaṁ snigdhaghaṭē sthitam||112|| <br /> <br /> prapibēnmātrayā prātarjīrṇē hitamitāśanaḥ| <br /> kāmalāpāṇḍuhr̥drōgavātāsr̥gviṣamajvarān||113|| <br /> <br /> kāsahikkāruciśvāsāṁścaiṣō'riṣṭaḥ praṇāśayēt| <br /> <br /> iti dhātryariṣṭaḥ| <br /> <br /> dhAtrIphalasahasre dve pIDayitvA rasaM tu tam||111|| <br /> <br /> kShaudrAShTAMshena saMyuktaM kRuShNArdhakuDavena ca| <br /> sharkarArdhatulonmishraM pakShaM snigdhaghaTe sthitam||112|| <br /> <br /> prapibenmAtrayA prAtarjIrNe hitamitAshanaH| <br /> kAmalApANDuhRudrogavAtAsRugviShamajvarAn||113|| <br /> <br /> kAsahikkArucishvAsAMshcaiSho~ariShTaH praNAshayet| <br /> <br /> iti dhAtryariShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Dhatryarishta'' - Two thousand fruits of ''amalaki'' should be crushed and the juice extracted should be mixed with one eighth the quantity of honey, half ''kudava'' of ''pippali'' and half ''tula'' of sugar. It should then be kept in an earthern jar smeared with ghee for one fortnight. It should be taken in appropriate dose in the morning and the patient should take wholesome food in small quantity after the digestion of the drug. This ''arishta'' cures ''kamala, pandu, hridroga, vatarakta, vishama jwara, kasa, hikka, aruchi'' and ''svasa''. Thus, ends the description of ''dhatrya arishta'' [111-113]<br /> <br /> === Medicated water ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्थिरादिभिः शृतं तोयं पानाहारे प्रशस्यते||११४|| <br /> <br /> पाण्डूनां, कामलार्तानां मृद्वीकामलकीरसः|११५| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sthirādibhiḥ śr̥taṁ tōyaṁ pānāhārē praśasyatē||114|| <br /> <br /> pāṇḍūnāṁ, kāmalārtānāṁ mr̥dvīkāmalakīrasaḥ|115| <br /> <br /> sthirAdibhiH shRutaM toyaM pAnAhAre prashasyate||114|| <br /> <br /> pANDUnAM, kAmalArtAnAM mRudvIkAmalakIrasaH|115|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Water boiled with the drugs belonging to ''sthiradi'' group is useful for drinking and the preparation of foods for ''pandu rogi''; while the patient of ''kamala'' should use the juice of ''draksha'' and ''amalaki rasa'' [114-115]<br /> <br /> === Principles of treatment according to [[dosha]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगप्रशान्त्यर्थमिति प्रोक्तं महर्षिणा||११५|| <br /> <br /> विकल्प्यमेतद्भिषजा पृथग्दोषबलं प्रति| <br /> वातिके स्नेहभूयिष्ठं, पैत्तिके तिक्तशीतलम्||११६|| <br /> <br /> श्लैष्मिके कटुतिक्तोष्णं [१] , विमिश्रं सान्निपातिके|११७|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgapraśāntyarthamiti prōktaṁ maharṣiṇā||115|| <br /> <br /> vikalpyamētadbhiṣajā pr̥thagdōṣabalaṁ prati| <br /> vātikē snēhabhūyiṣṭhaṁ, paittikē tiktaśītalam||116|| <br /> <br /> ślaiṣmikē kaṭutiktōṣṇaṁ [1] , vimiśraṁ sānnipātikē|117| <br /> <br /> pANDurogaprashAntyarthamiti proktaM maharShiNA||115|| <br /> <br /> vikalpyametadbhiShajA pRuthagdoShabalaM prati| <br /> vAtike snehabhUyiShThaM, paittike tiktashItalam||116|| <br /> <br /> shlaiShmike kaTutiktoShNaM [1] , vimishraM sAnnipAtike|117|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The above mentioned drugs are described for the cure of ''pandu roga'' by the great sage (Punarvasu Atreya). The physician should make suitable changes (combinations and permutations) in the above depending upon the strength of the [[dosha]] in the patient. <br /> <br /> The therapy should be dominated by unctuous drugs (oil, ghee etc) for ''vatika'' type of ''pandu''; by bitter and cooling drugs for ''paittika'' type and by pungent, bitter and hot drugs for [[kapha]]ja type of ''pandu'' [115-117]<br /> <br /> === Treatment of ''mrittika bhakshanajanya pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> निपातयेच्छरीरात्तु मृत्तिकां भक्षितां भिषक्||११७|| <br /> <br /> युक्तिज्ञः शोधनैस्तीक्ष्णैः प्रसमीक्ष्य बलाबलम्| <br /> शुद्धकायस्य सर्पींषि बलाधानानि योजयेत्||११८|| <br /> <br /> व्योषं बिल्वं हरिद्रे द्वे त्रिफला द्वे पुनर्नवे| <br /> मुस्तान्ययोरजः पाठा विडङ्गं देवदारु च||११९|| <br /> <br /> वृश्चिकाली च भार्गी च सक्षीरैस्तैः [१] समैर्घृतम्| <br /> साधयित्वा पिबेद्युक्त्या नरो मृद्दोषपीडितः||१२०|| <br /> <br /> तद्वत् केशरयष्ट्याह्वपिप्पलीक्षारशाद्वलैः| <br /> मृद्भक्षणादातुरस्य लौल्यादविनिवर्तिनः||१२१|| <br /> <br /> द्वेष्यार्थं भावितां कामं दद्यात्तद्दोषनाशनैः| <br /> विङ्गैलातिविषया निम्बपत्रेण पाठया||१२२|| <br /> <br /> वार्ताकैः कटुरोहिण्या कौटजैर्मूर्वयाऽपि वा|१२३| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nipātayēccharīrāttu mr̥ttikāṁ bhakṣitāṁ bhiṣak||117|| <br /> <br /> yuktijñaḥ śōdhanaistīkṣṇaiḥ prasamīkṣya balābalam| <br /> śuddhakāyasya sarpīṁṣi balādhānāni yōjayēt||118|| <br /> <br /> vyōṣaṁ bilvaṁ haridrē dvē triphalā dvē punarnavē| <br /> mustānyayōrajaḥ pāṭhā viḍaṅgaṁ dēvadāru ca||119|| <br /> <br /> vr̥ścikālī ca bhārgī ca sakṣīraistaiḥ [1] samairghr̥tam| <br /> sādhayitvā pibēdyuktyā narō mr̥ddōṣapīḍitaḥ||120|| <br /> <br /> tadvat kēśarayaṣṭyāhvapippalīkṣāraśādvalaiḥ| <br /> mr̥dbhakṣaṇādāturasya laulyādavinivartinaḥ||121|| <br /> <br /> dvēṣyārthaṁ bhāvitāṁ kāmaṁ dadyāttaddōṣanāśanaiḥ| <br /> viṅgailātiviṣayā nimbapatrēṇa pāṭhayā||122|| <br /> <br /> vārtākaiḥ kaṭurōhiṇyā kauṭajairmūrvayā'pi vā|123| <br /> <br /> nipAtayeccharIrAttu mRuttikAM bhakShitAM bhiShak||117|| <br /> <br /> yuktij~jaH shodhanaistIkShNaiH prasamIkShya balAbalam| <br /> shuddhakAyasya sarpIMShi balAdhAnAni yojayet||118|| <br /> <br /> vyoShaM bilvaM haridre dve triphalA dve punarnave| <br /> mustAnyayorajaH pAThA viDa~ggaM devadAru ca||119|| <br /> <br /> vRushcikAlI ca bhArgI ca sakShIraistaiH [1] samairghRutam| <br /> sAdhayitvA pibedyuktyA naro mRuddoShapIDitaH||120|| <br /> <br /> tadvat kesharayaShTyAhvapippalIkShArashAdvalaiH| <br /> mRudbhakShaNAdAturasya laulyAdavinivartinaH||121|| <br /> <br /> dveShyArthaM bhAvitAM kAmaM dadyAttaddoShanAshanaiH| <br /> vi~ggailAtiviShayA nimbapatreNa pAThayA||122|| <br /> <br /> vArtAkaiH kaTurohiNyA kauTajairmUrvayA~api vA|123|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A physician well versed in therapeutics, should give the patient strong elimination therapy, keeping in view the strength of the patient, in order to remove the swallowed mud from the body. After the body is cleansed, different types of medicated ghee should be prescribed to the patient for promotion of strength.<br /> <br /> Ghee prepared with ''shunthi, pippali, maricha, bilva, haridra, daruharidra, haritaki, bibhitaka, amalaki, sveta'' and ''rakta punarnava, musta, lauha bhasma, patha, vidanga, devadaru, vrishchikali, bhargi'' and milk should be appropriately taken by the patient who suffers from anemia because of eating clay. <br /> <br /> Likewise, ghee prepared with ''keshara, yashtamadhu, pippali, kshara'' (alkali preperation) and ''sadvala'' may be given to the patient suffering from ''mrittika bhakshana janya pandu''. <br /> <br /> If the patient is unable to give up his clay swallowing habits, he should be given clay impregnated with ''vidanga, ela, ativisha,'' neem leaves, ''patha, varataka, katurohini, kutaja'' or ''murva'' with a view of creating an aversion to clay. These drugs also counter act the adverse effects of eating clay. [117-123]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यथादोषं प्रकुर्वीत भैषज्यं पाण्डुरोगिणाम्||१२३|| <br /> <br /> क्रियाविशेष एषोऽस्य मतो हेतुविशेषतः|१२४| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yathādōṣaṁ prakurvīta bhaiṣajyaṁ pāṇḍurōgiṇām||123|| <br /> <br /> kriyāviśēṣa ēṣō'sya matō hētuviśēṣataḥ|124| <br /> <br /> yathAdoShaM prakurvIta bhaiShajyaM pANDurogiNAm||123|| <br /> <br /> kriyAvisheSha eSho~asya mato hetuvisheShataH|124| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Different types of treatment should be given to the patient suffering from ''mrittika bhakshana janya pandu'', according to the different types of [[dosha]] aggravated. However, due to the specific type of etiological factor involved (clay eating), this type of ''pandu'' needs special type of treatment [123-124]<br /> <br /> === ''Shakhashrita kamala'' (''kamala'' in body tissue with obstructive pathology) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तिलपिष्टनिभं यस्तु वर्चः सृजति कामली||१२४||<br /> <br /> श्लेष्मणा रुद्धमार्गं तत् पित्तं कफहरैर्जयेत्| <br /> रूक्षशीतगुरुस्वादुव्यायामैर्वेगनिग्रहैः||१२५|| <br /> <br /> कफसम्मूर्च्छितो वायुः स्थानात् पित्तं क्षिपेद्बली| <br /> हारिद्रनेत्रमूत्रत्वक् श्वेतवर्चास्तदा नरः||१२६|| <br /> <br /> भवेत् साटोपविष्टम्भो गुरुणा हृदयेन च| <br /> दौर्बल्याल्पाग्निपार्श्वार्तिहिक्काश्वासारुचिज्वरैः||१२७|| <br /> <br /> क्रमेणाल्पेऽनुसज्येत [१] पित्ते शाखासमाश्रिते|१२८|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tilapiṣṭanibhaṁ yastu varcaḥ sr̥jati kāmalī||124|| <br /> <br /> ślēṣmaṇā ruddhamārgaṁ tat Pittaṁ Kaphaharairjayēt| <br /> rūkṣaśītagurusvāduvyāyāmairvēganigrahaiḥ||125|| <br /> <br /> Kaphasammūrcchitō vāyuḥ sthānāt Pittaṁ kṣipēdbalī| <br /> hāridranētramūtratvak śvētavarcāstadā naraḥ||126|| <br /> <br /> bhavēt sāṭōpaviṣṭambhō guruṇā hr̥dayēna ca| <br /> daurbalyālpāgnipārśvārtihikkāśvāsārucijvaraiḥ||127|| <br /> <br /> kramēṇālpē'nusajyēta [1] pittē śākhāsamāśritē|128| <br /> <br /> tilapiShTanibhaM yastu varcaH sRujati kAmalI||124|| <br /> <br /> shleShmaNA ruddhamArgaM tat pittaM kaphaharairjayet| <br /> rUkShashItagurusvAduvyAyAmairveganigrahaiH||125|| <br /> <br /> kaphasammUrcchito vAyuH sthAnAt pittaM kShipedbalI| <br /> hAridranetramUtratvak shvetavarcAstadA naraH||126|| <br /> <br /> bhavet sATopaviShTambho guruNA hRudayena ca| <br /> daurbalyAlpAgnipArshvArtihikkAshvAsArucijvaraiH||127|| <br /> <br /> krameNAlpe~anusajyeta [1] pitte shAkhAsamAshrite|128| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A patient of ''kamala'' if passes stools of the color of sesame paste (''tila pishta nibhama''), then it denotes obstruction in the passage of [[pitta]] by the [[kapha]]. Therefore, the [[pitta]] of such patient should be won by administration of drugs which also eliminate [[kapha]]. <br /> <br /> The excess usage of ununctuous, cold and sweet ingredients; excessive exercise; suppression of the natural urges leads to the the aggravation of [[vata]] infilterated with [[kapha]] and the displacement of [[pitta]] from its site, resulting in the development of the following features: <br /> <br /> The eyes, skin and urine of the patient become yellow while his stools become white in color. Additionally, the patients suffer from ''atopa'' (tympanitis), ''vishtambha'' (constipation associated with flatulence),and heaviness in the cardiac region, due to the displacement of [[pitta]] in the peripheral tissues (''shakha''), there is diminution in the flow of [[pitta]] (to the gastrointestinal tract) resulting in the gradual development of weakness, ''agnimandya'' (low digestion), ''parshva'' (pain in the sides of chest), ''hikka'' (hiccups), ''shvasa'' (dyspnea), ''aruchi'' (anorexia) and ''jwara'' [124-128]<br /> <br /> === Treatment of ''shakhashriat kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बर्हितित्तिरिदक्षाणां रूक्षाम्लैः कटुकै रसैः||१२८|| <br /> <br /> शुष्कमूलककौलत्थैर्यूषैश्चान्नानि भोजयेत्| <br /> मातुलुङ्गरसं क्षौद्रपिप्पलीमरिचान्वितम्||१२९|| <br /> <br /> सनागरं पिबेत् पित्तं तथाऽस्यैति स्वमाशयम्|१३०|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> barhitittiridakṣāṇāṁ rūkṣāmlaiḥ kaṭukai rasaiḥ||128|| <br /> <br /> śuṣkamūlakakaulatthairyūṣaiścānnāni bhōjayēt| <br /> mātuluṅgarasaṁ kṣaudrapippalīmaricānvitam||129|| <br /> <br /> sanāgaraṁ pibēt Pittaṁ tathā'syaiti svamāśayam|130| <br /> <br /> barhitittiridakShANAM rUkShAmlaiH kaTukai rasaiH||128|| <br /> <br /> shuShkamUlakakaulatthairyUShaishcAnnAni bhojayet| <br /> mAtulu~ggarasaM kShaudrapippalImaricAnvitam||129|| <br /> <br /> sanAgaraM pibet pittaM tathA~asyaiti svamAshayam|130|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient suffering from from ''shakhashrita kamala'' should be given food along with the soup of the meat of peacock, ''tittira'' (partridge), ''daksha'' (rooster) sizzled with ununctuous, sour and pungent articles; and vegetable soups of dry ''mulaka'' (radish) and ''kulattha''. The patient should also be given the juice of ''matulunga'' mixed with honey, ''pippali, maricha'' and ''shunthi'' for bringing the [[pitta]] to its own course [128-130]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कटुतीक्ष्णोष्णलवणैर्भृशाम्लैश्चाप्युपक्रमः||१३०|| <br /> <br /> आपित्तरागाच्छकृतो [१] वायोश्चाप्रशमाद्भवेत्| <br /> स्वस्थानमागते पित्ते पुरीषे पित्तरञ्जिते||१३१|| <br /> <br /> निवृत्तोपद्रवस्य स्यात् पूर्वः कामलिको विधिः|१३२|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭutīkṣṇōṣṇalavaṇairbhr̥śāmlaiścāpyupakramaḥ||130|| <br /> <br /> āPittarāgācchakr̥tō [1] vāyōścāpraśamādbhavēt| <br /> svasthānamāgatē pittē purīṣē Pittarañjitē||131|| <br /> <br /> nivr̥ttōpadravasya syāt pūrvaḥ kāmalikō vidhiḥ|132| <br /> <br /> kaTutIkShNoShNalavaNairbhRushAmlaishcApyupakramaH||130|| <br /> <br /> ApittarAgAcchakRuto [1] vAyoshcAprashamAdbhavet| <br /> svasthAnamAgate pitte purIShe pittara~jjite||131|| <br /> <br /> nivRuttopadravasya syAt pUrvaH kAmaliko vidhiH|132| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Katu'' (pungent), ''teekshna'' (sharp), ''ushna'' (hot), ''lavana'' (saline) and extremely ''amla'' (sour) drugs should be continued till the stool of the patient acquires the color of [[pitta]] and the [[vata]] gets alleviated. When the [[pitta]] returns to its own habitat, the stool gets colored with [[pitta]] and the patient is relieved of complications, then further, the line of treatment described earlier for the treatment of ''kamala'' (''koshthashrita'') should be used [130-132]<br /> <br /> === ''Haleemaka'' (obstructive jaundice) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यदा तु पाण्डोर्वर्णः स्याद्धरितश्यावपीतकः||१३२|| <br /> <br /> बलोत्साहक्षयस्तन्द्रा मन्द्राग्नित्वं मृदुज्वरः| <br /> स्त्रीष्वहर्षोऽङ्गमर्दश्च श्वासस्तृष्णाऽरुचिर्भ्रमः||१३३|| <br /> <br /> हलीमकं तदा तस्य विद्यादनिलपित्ततः|१३४| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yadā tu pāṇḍōrvarṇaḥ syāddharitaśyāvapītakaḥ||132|| <br /> <br /> balōtsāhakṣayastandrā mandrāgnitvaṁ mr̥dujvaraḥ| <br /> strīṣvaharṣō'ṅgamardaśca śvāsastr̥ṣṇā'rucirbhramaḥ||133|| <br /> <br /> halīmakaṁ tadā tasya vidyādanilaPittataḥ|134| <br /> <br /> yadA tu pANDorvarNaH syAddharitashyAvapItakaH||132|| <br /> <br /> balotsAhakShayastandrA mandrAgnitvaM mRudujvaraH| <br /> strIShvaharSho~a~ggamardashca shvAsastRuShNA~arucirbhramaH||133|| <br /> <br /> halImakaM tadA tasya vidyAdanilapittataH|134| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If a patient suffering from ''pandu'' develops green, black or yellow color and suffers from diminution of strength and enthusiasm; drowsiness, ''agnimandya'' (low digestion), mild fever, lack of libido (''strisu aharsho''), ''angamarda'' (malaise/ body ache), dyspnea, ''trishna'' (morbid thirst), anorexia and giddiness, the ailment is called ''haleemaka'' and is caused by the aggravation of [[vata]] and [[pitta]] [[dosha]] [132-134]<br /> <br /> === Treatment of ''haleemaka'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुडूचीस्वरसक्षीरसाधितं माहिषं घृतम्||१३४|| <br /> <br /> स पिबेत्त्रिवृतां स्निग्धो रसेनामलकस्य तु| <br /> विरिक्तो मधुरप्रायं भजेत् पित्तानिलापहम्||१३५|| <br /> <br /> द्राक्षालेहं च पूर्वोक्तं सर्पींषि मधुराणि च| <br /> यापनान् क्षीरबस्तींश्च शीलयेत्सानुवासनान्||१३६|| <br /> <br /> मार्द्वीकारिष्टयोगांश्च पिबेद्युक्त्याऽग्निवृद्धये| <br /> कासिकं चाभयालेहं पिप्पलीं मधुकं बलाम्||१३७|| <br /> <br /> पयसा च प्रयुञ्जीत यथादोषं यथाबलम्|१३८| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> guḍūcīsvarasakṣīrasādhitaṁ māhiṣaṁ ghr̥tam||134|| <br /> <br /> sa pibēttrivr̥tāṁ snigdhō rasēnāmalakasya tu| <br /> viriktō madhuraprāyaṁ bhajēt pittānilāpaham||135|| <br /> <br /> drākṣālēhaṁ ca pūrvōktaṁ sarpīṁṣi madhurāṇi ca| <br /> yāpanān kṣīrabastīṁśca śīlayētsānuvāsanān||136|| <br /> <br /> mārdvīkāriṣṭayōgāṁśca pibēdyuktyā'gnivr̥ddhayē| <br /> kāsikaṁ cābhayālēhaṁ pippalīṁ madhukaṁ balām||137|| <br /> <br /> payasā ca prayuñjīta yathādōṣaṁ yathābalam|138| <br /> <br /> guDUcIsvarasakShIrasAdhitaM mAhiShaM ghRutam||134|| <br /> <br /> sa pibettrivRutAM snigdho rasenAmalakasya tu| <br /> virikto madhuraprAyaM bhajet pittAnilApaham||135|| <br /> <br /> drAkShAlehaM ca pUrvoktaM sarpIMShi madhurANi ca| <br /> yApanAn kShIrabastIMshca shIlayetsAnuvAsanAn||136|| <br /> <br /> mArdvIkAriShTayogAMshca pibedyuktyA~agnivRuddhaye| <br /> kAsikaM cAbhayAlehaM pippalIM madhukaM balAm||137|| <br /> <br /> payasA ca prayu~jjIta yathAdoShaM yathAbalam|138| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Patients suffering from ''haleemaka'' should take the recipe prepared from buffalo ghee by adding the juice of ''guduchi'' and milk.<br /> <br /> After oleation with this oil the patient should take ''trivritta'' mixed with the juice of ''amalaki'' which causes purgation. <br /> <br /> Thereafter food and drinks which are dominated by sweet taste and are alleviators of [[pitta]] and [[kapha]] should be given.<br /> <br /> The patient should take ''drakshaleha'' described earlier (vide verse 100-102 in this chapter in the name of ''dhatryavaleha'') and recipes of medicated ghee prepared by boiling with sweet drugs (vide verse 51-52). The patient should habitually indulge in taking different types of yapana [[basti]] (a type of medicated enema), kshara [[basti]] and anuvasana [[basti]] discussed in [ Cha. Sa. [[Siddhi Sthana]] ]. He should also take different recipes of ''arishta'' prepared from grapes (''draksharishta'') for the promotion of power of digestion. ''Abhaya leha'' described in the treatment of ''kasa'' [Cha. Sa. [[Chikitsa Sthana]] 18/57-62] may also be taken. Alternatively the patient may also take ''pippali, madhuka'' and ''bala'' along with milk depending upon the [[dosha]] aggravated and the strength of the patient [134-138]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकौ- <br /> <br /> पाण्डोः पञ्चविधस्योक्तं हेतुलक्षणभेषजम्||१३८|| <br /> <br /> कामला द्विविधा तेषां साध्यासाध्यत्वमेव च| <br /> <br /> तेषां विकल्पो यश्चान्यो महाव्याधिर्हलीमकः| <br /> तस्य चोक्तं समासेन व्यञ्जनं सचिकित्सितम्||१३९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkau- <br /> <br /> pāṇḍōḥ pañcavidhasyōktaṁ hētulakṣaṇabhēṣajam||138|| <br /> <br /> kāmalā dvividhā tēṣāṁ sādhyāsādhyatvamēva ca| <br /> <br /> tēṣāṁ vikalpō yaścānyō mahāvyādhirhalīmakaḥ| <br /> tasya cōktaṁ samāsēna vyañjanaṁ sacikitsitam||139||<br /> <br /> tatra shlokau- <br /> <br /> pANDoH pa~jcavidhasyoktaM hetulakShaNabheShajam||138|| <br /> <br /> kAmalA dvividhA teShAM sAdhyAsAdhyatvameva ca| <br /> <br /> teShAM vikalpo yashcAnyo mahAvyAdhirhalImakaH| <br /> tasya coktaM samAsena vya~jjanaM sacikitsitam||139|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> To sum up, the topics discussed in this chapter are:<br /> *Five types of ''pandu'' along with the etiology, signs and symptoms; and treatment<br /> *Two types of ''kamala'' and their curability as well as incurability<br /> *Different varieties of ''kamala''<br /> *''Haleemaka'', which is a serious disease along with its signs and symptoms; and treatment [138-139]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने <br /> पाण्डुरोगचिकित्सितं नाम षोडशोऽध्यायः||१४0|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē <br /> pāṇḍurōgacikitsitaṁ nāma ṣōḍaśō'dhyāyaḥ||140||<br /> <br /> ityagniveshakRute tantre~aprApte dRuDhabalasampUrite cikitsAsthAne <br /> pANDurogacikitsitaM nAma ShoDasho~adhyAyaH||16|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus ends the sixteenth chapter in [[Chikitsa Sthana]] dealing with the treatment of ''pandu roga'' in the work of Agnivesha which was redacted by Charaka and because of its unavailability was supplemented by Dridhabala [140]<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *The important pathological factors in ''pandu'' are aggravated three [[dosha]] with dominant [[pitta]] leading to slow metabolism at level of blood ([[rakta dhatu]]), the fatty tissue [[meda dhatu]]) and [[ojas]] qualities (affecting the vitality). <br /> *The dietary factors like alkaline, sour, saline, hot and mutually contradictory foods, unwholesome food, ''nishpava'' (a type of pulses), ''masha, pinyaka'' (oil cake) and ''tila'' oil; lifestyle factors like indulging in day sleep, performing exercise and sex before digestion of the food, disobedience of the seasonal regimens (''ritu vaishamya''), suppression of the natural urges; iatrogenic factors like Improper administration of [[Panchakarma]] measures (''pratikarma vaishamya'') and the psychological factors like affliction of mind with passion, worry, fear, anger, grief are responsible for ''pandu''. <br /> *Heart and circulatory system are involved in the pathogenesis of ''pandu'' which is presented at the sites of skin and [[mamsa dhatu]] (flesh).<br /> *The specific features are observed as per the [[dosha]] dominance in pathogenesis. <br /> *Person indulging in the habitual consumption of clay (''mrittika'') gets [[dosha]] aggravated according to the taste of mud viz. astringent mud aggravates [[vata]], saline and alkaline mud aggravates [[pitta]] and sweet mud aggravates [[kapha]] [[dosha]]. These factors cause ''pandu'' by affecting the [[dhatu]] and [[ojas]]. <br /> *Chronic ''pandu roga'' is incurable. The prognosis depends upon involvement of [[dhatu] and its intensity. <br /> *If a patient of ''pandu roga'' excessively consumes [[pitta]] vitiating diet and regimen, the aggravated [[pitta]] causes ''kamala'' by involving the [[rakta]] and the [[mamsa dhatu]]. <br /> *First principle of management of ''pandu'' is administration of internal oleation ([[snehana]]) followed by strong (''teekshna'') emetic and purgation therapies for cleansing of the body (''shodhana''). In patients of ''kamala'', mild purgation therapy with bitter drugs is advised.<br /> *''Kamala'' is of two types: ''Koshtha-shaksha shrita'' and ''shakhashrita''. In ''koshtha-shakhashrita kamala'' there is excess increase in [[pitta]]. <br /> *In ''shakhashrita kamala'', [[pitta]] is obstructed by [[kapha]] and improperly circulated by [[vata]]. Therefore the treatment principles differ in both. <br /> *In ''koshtha-shaksha shrita kamala'', mild purgation is administered with bitter drugs with a focus on pacification of[[pitta]]. <br /> *In ''shakhashrita kamala'', principles of management are pacification of [[kapha]], and ''anulomana'' of [[vata]] to derive [[pitta]] to its own natural site. Therefore ''ruksha, amla, katu'' drugs are used in the treatment. <br /> *Suitable changes (combinations and permutations) in the treatment should be prescribed depending upon the strength of the [[dosha]] in the patient. The therapy should be dominated by unctuous drugs (oil, ghee etc) for ''vatika'' type of ''pandu''; by bitter and cooling drugs for ''paittika'' type and by pungent, bitter and hot drugs for [[kapha]]ja type of ''pandu''.<br /> *Strong elimination therapy is advised to remove the swallowed mud from the body after considering the strength of the patient. After the body is cleansed, different types of medicated ghee should be prescribed to the patient for promotion of strength. <br /> *''Haleemaka'' and is caused by the aggravation of [[vata]] and [[pitta]] [[dosha]]. Hence the treatment focus on pacification of [[vata]] and [[pitta]] [[dosha]].<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> === Pathological factors ===<br /> *[[Dosha]]: [[Pitta]] dominant three [[dosha]], sadhaka and ranjak [[pitta]], vyana and samana [[vata]], avalambak and kledaka [[kapha]] <br /> *[[Dhatu]](vitiated factors): [[Rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] <br /> *Status of [[agni]]/ dhatwagni/bhutagni: ''Manda'' at [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] level <br /> *Origin of disease: Heart and channels, Liver and spleen <br /> *Sites of vitiation: All body <br /> *Sites of clinical presentation: All body specifically skin and subcutaneous tissues <br /> *Srotas involved :Rasavaha, Raktavaha <br /> *Type of ''samprapti'' : ''Avarodha'' and ''kshaya'' <br /> *Basic principles of treatment: ''Shodhana'' (mainly [[virechana]]) and ''shamana'' (mainly [[pitta]] shamana) as per [[dosha]] dominance<br /> <br /> === General considerations ===<br /> ''Pandu'' can be related with the disorders of improper formation of blood tissue due to vitiation of [[pitta]] [[dosha]]. [[Pitta]] [[dosha]] is considered to be responsible for all digestion, transformation and metabolism processes in the body. Therefore, the disorders like anemia, nutritional deficiency are mainly considered under ''pandu roga''. The disorders which include pathologies of impaired metabolism and formation of plasma, blood, muscles and fat can also be referred under the umbrella of ''pandu roga''. These include thyroid function disorders, hematological disorders like thalessemia, jaundice etc.<br /> <br /> === Etiological factors observed in present era ===<br /> ==== Diet ==== <br /> The dietary factors that cause vitiation of [[pitta]] [[dosha]] and poor nutritional status of [[rakta dhatu]] are enlisted to cause ''pandu''. These include the items having sour, salt, pungent taste, hot potency, alkaline nature, mutually contradictory and unwholesome food. These shall be avoided to prevent ''pandu''. <br /> *Food with sour taste (''amla ahara'') includes sour curd, lemons, citric acid, pickles, and food with preservatives as jams, cold drinks, sauces, tamarind etc. <br /> *''Lavana ahara'' may be taken as food with excess salts or with salt added in packaged food or as pickles, chutneys etc.<br /> *''Madya'' includes alcoholic beverages as rum, beer, whisky, vodka etc.<br /> *''Kshara'' includes soda used in diet, cold drinks and beverages. <br /> *''Ati tikshna ahara'' includes as excessively spicy,pungent items as ''chhole, chaats, pakode, panipuri, chaaps, rajma,'' spicy vegetables and other dishes.<br /> *''Ati ushna'' includes food articles which are either very hot as tea, coffee etc. or which increase the metabolic activities of the body or also as very hot temperature.<br /> *''Mrittika bhakshana'' is considered as either oral ingestion of mud or use of articles contaminated with mud as unclean hands and fingers or as improperly washed vegetables or eatables.<br /> *''Asatmya bhojana'' may include food items that are not adopted or suited. It may be considered as sudden change of food style or habit or also as junk food used today, as they are not beneficial. <br /> <br /> Some scientific studies have proven the role of some of the ''aharaja'' factors in the causation of ''panduroga'' as tea (considered as ''ati ushna nidana'') has been proved to cause iron deficiency anemia by interfering with the absorption of iron. Similarly ''madya'' (alcohols) cause megaloblastic anemia by hampering the folate absorption.<br /> <br /> ==== Lifestyle ==== <br /> <br /> Excess day time sleep, exercise beyond one’s capacity and at improper time can lead to ''pandu''. Therefore, proper quality sleep and proper exercise are preventive measures for ''pandu''.<br /> <br /> ==== Psychological factors ==== <br /> <br /> Passion, worry, fear, anger and grief can affect digestion leading to poor nutritional status. Hence blissful state of mind is needed for proper nutrition. Rai and Kar in their observational study showed that worries, fear and grief are major etiological factors for iron deficiency anemia. These factors cause significant reduction of serum and bone marrow, while inhibiting the process of erythropoiesis. The inflammatory mediators such as IL-6, hepcidin are mediators in this pathology originated from grief and fear.&lt;ref&gt;Rai Shalini, Kar Anukul C. A review of role of psychological factors in the etiopathogenesis of Pandu roga with reference to iron deficiency anemia.Ayu,2016 Jan-March,31(1):18-21. &lt;/ref&gt;<br /> <br /> ==== Iatrogenic factors ==== <br /> <br /> Improper administration of oleation therapy and [[Panchakarma]] procedures can lead to ''pandu''.<br /> <br /> ==== Pathophysiology ====<br /> [[File:Pandu.png|500px|thumb]] <br /> The cardinal feature of pandu is appearance of pallor on skin of the patient. Complexion and luster of skin is maintained by [[rasa dhatu]] and [[rakta dhatu]]. The texture is maintained by [[mamsa dhatu]]. Unctuousness is maintained by [[meda dhatu]]. These four [[dhatu]] are important for maintaining the natural appearance of skin. In ''pandu'', the vitiated [[pitta]], due to its hot and sharply acting properties, impairs digestion process at [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] leading to their poor formation. The [[rasa dhatu]] transport channels originate in the heart and its vessels. The origin of channels of [[rakta]] is in the liver and spleen. Therefore, symptoms related to cardio-vascular system and hematological system. <br /> <br /> The sequential nourishment of [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] is impaired leading to poor quality tissues. Thus, overall functions of these systems are disturbed in ''pandu''. <br /> <br /> The type of pathogenesis includes formation of same [[dhatu]] (improperly formed tissues) due to poor digestive and metabolic processes at the above mentioned levels. Therefore, the treatment principle includes correction of this impairment.<br /> <br /> ==== Clinical features and conditions resembling the disease ====<br /> <br /> '''Premonitory symptoms''': Palpitations, dryness, lack of sweating, fatigue. <br /> <br /> '''Signs''': Decrease in complexion, strength, unctuousness and vitality are observed in ''pandu''. <br /> <br /> Various features related to that are categorized below:<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs<br /> ! scope=&quot;col&quot;| Symptoms Manifested<br /> |-<br /> | 1<br /> | ''Varnakshaya'' (depletion of complexion) <br /> | Discoloration of skin, poor lustre, pallor, yellowish, dark yellow skin <br /> |-<br /> | 2<br /> | ''Balakshaya'' (depletion of strength) <br /> | Weakness, fatigue<br /> |-<br /> | 3<br /> | ''Snehakshaya'' (depletion of unctuousness) <br /> | Dryness, poor quality of tissues <br /> |-<br /> | 4<br /> | ''Ojakshaya'' (depletion of vitality)<br /> | Fearfulness, excess worries, impaired sensations, lack of concentration, poor appearance <br /> |}<br /> <br /> The following clinical features are observed in ''pandu''. The involvement of [[dosha]], dushya and channels are as given in the following table:<br /> <br /> ==== Signs ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs<br /> ! scope=&quot;col&quot;| [[Dosha]]<br /> ! scope=&quot;col&quot;| ''Dushya''<br /> ! scope=&quot;col&quot;| ''Srotas''<br /> |-<br /> | 1<br /> | ''Dhatushaithilya'' (laxity of tissues)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 2<br /> | [[Dhatu]] gaurava (heaviness in tissues)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 3<br /> | ''Varnakshaya'' (poor complexion)<br /> | [[Vata]], [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 4<br /> | ''Balakshaya'' (poor strength)<br /> | [[Vata]],[[Pitta]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 5<br /> | ''Snehakshaya'' (depletion of unctuousness)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rakta dhatu]], [[Meda dhatu]]<br /> | ''Raktavaha, Medavaha''<br /> |-<br /> | 6<br /> | [[Oja]]gunakshaya'' (depletion of vitality)<br /> | [[Vata]], [[Pitta]]<br /> | Sapta [[dhatu]]<br /> | ''Saptadhatu vaha''<br /> |-<br /> | 7<br /> | ''Raktalpata'' (poor quality and less blood)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 8<br /> | ''Medalpata'' (poor quality and less fats) <br /> | [[Vata]], [[Pitta]]<br /> | [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 9<br /> | ''Nihasarta'' (poor quality tissues) <br /> | Tri[[dosha]]<br /> | Sapta[[dhatu]]<br /> | ''Saptadhatu vaha''<br /> |-<br /> | 10<br /> | ''Shithilendriya'' (impairment of senses) <br /> | Tri[[dosha]]<br /> | Sapta[[dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 11<br /> | ''Vaivarnya'' (discoloration) <br /> | [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 12<br /> | ''Panduta'' (pallor) <br /> | [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |}<br /> <br /> ==== Symptoms ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Symptoms<br /> ! scope=&quot;col&quot;| [[Dosha]]<br /> ! scope=&quot;col&quot;| ''Dushya''<br /> ! scope=&quot;col&quot;| ''Srotas''<br /> |-<br /> | 1<br /> | ''Karnakshweda'' (tinnitus)<br /> | [[Vata]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 2<br /> | ''Hatanala'' (poor digestion)<br /> | [[Kapha]], [[Vata]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 3<br /> | ''Daurbalya'' (weakness)<br /> | [[Vata]], [[Pitta]]<br /> | Sapta[[dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 4<br /> | ''Sadana'' (bodyache)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 5<br /> | ''Annadwesha'' (anorexia)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 6<br /> | ''Shrama'' (overworked, fatigue)<br /> | [[Vata]]<br /> |[[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 7<br /> | ''Bhrama'' (vertigo)<br /> | [[Vata]], [[Pitta]]<br /> | [[Majja dhatu]]<br /> | ''Majjavaha''<br /> |-<br /> | 8<br /> | ''Gatrashoola'' (pain)<br /> | [[Vata]]<br /> | [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 9<br /> | ''Jwara'' (feverishness)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]], Sweda<br /> | ''Rasavaha, Swedavaha''<br /> |-<br /> | 10<br /> | ''Shwasa'' (dyspnea)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha, Pranavaha''<br /> |-<br /> | 11<br /> | ''Gaurava'' (heaviness)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 12<br /> | ''Aruchi'' (aversion to food)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 13<br /> | ''Mridit iv gatrata'' (kneading pain)<br /> | [[Vata]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 14<br /> | ''Pidita unmathit gatrata'' (churning, pressing pain)<br /> | [[Vata]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 15<br /> | ''Akshikutashotha'' (pre-orbital swelling)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 16<br /> | ''Harita lomata'' (greenish body hair)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 17<br /> | ''Shirnalomata'' (falling body hair)<br /> | [[Vata]],[[Pitta]]<br /> | [[Asthi dhatu]]<br /> | ''Asthivaha''<br /> |-<br /> | 18<br /> | ''Hatprabhatva'' (poor luster)<br /> | [[Pitta]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 19<br /> | ''Kopana'' (irritability)<br /> | [[Pitta]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 20<br /> | ''Shishiradwesha'' (disliking cold)<br /> | [[Vata]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 21<br /> | ''Nindraluta'' (excessive sleepiness)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 22<br /> | ''Sthivanadhikya'' (excessive sputum)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 23<br /> | ''Alpawaka'' (less speaking)<br /> | [[Vata]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 24<br /> | ''Pindikodweshtanam'' (pain in calf muscles)<br /> | [[Vata]]<br /> | [[Rakta dhatu]],[[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 25<br /> | ''Katiurupadaruka Sadana'' (pain in legs, thighs, and the lumbar region)<br /> | [[Vata]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 26<br /> | ''Arohaneayasa'' (dyspnea on climbing)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |}<br /> <br /> ==== Differentiating features of ''dosha'' dominance ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! colspan=&quot;3&quot;|Changes in color and texture manifested in the whole body and its parts<br /> |-<br /> ! scope=&quot;col&quot;| ''Vata'' dominant ''pandu''<br /> ! scope=&quot;col&quot;| ''Pitta'' dominant ''pandu''<br /> ! scope=&quot;col&quot;| ''Kapha'' dominant ''pandu''<br /> |-<br /> | Blackish or dark reddish discoloration of the skin, blood vessels, nails, face and eyes<br /> | Yellowish discoloration of skin, the skin, blood vessels, nails, face and eyes<br /> | Whitishness discoloration of skin, the skin, blood vessels, nails, face and eyes<br /> |-<br /> ! colspan=&quot;3&quot;|Features related to urine and stool<br /> |-<br /> | Blackish urine &amp; stool, dry stools<br /> | Yellowish colored urine &amp; stool, foul smelling and loose stools <br /> | Whitishness in the urine &amp; stool <br /> |-<br /> ! colspan=&quot;3&quot;|Features related to ''agni''<br /> |-<br /> | Tastelessness in the mouth<br /> | Pungent taste in mouth<br /> | Sweet taste in the mouth<br /> |-<br /> | rowspan=&quot;6&quot;|Abdominal distension<br /> | Does not relish food<br /> | Anorexia<br /> |-<br /> | rowspan=&quot;2&quot;|Improper digestion of food<br /> | Heaviness<br /> |-<br /> | Excessive salivation<br /> |-<br /> | Sour Eructation<br /> | Laziness<br /> |-<br /> | Eructation associated with burning sensation<br /> | rowspan=&quot;2&quot;| Vomiting<br /> |-<br /> | Burning Sensation<br /> |-<br /> ! colspan=&quot;3&quot;|Other features<br /> |-<br /> | Pain in the body, pricking pain<br /> | Increased body temperature<br /> | Drowsiness<br /> |-<br /> | Tremor<br /> | Excessive thirst<br /> | Horripilation<br /> |-<br /> | Headache<br /> | Fainting due to excessive thirst/coma<br /> | Mental fatigue<br /> |-<br /> | Weakness<br /> | Profuse sweating<br /> | Fainting<br /> |-<br /> | Pain in the sides of the chest<br /> | rowspan = &quot;2&quot;| Weakness<br /> | Prostration<br /> |-<br /> | Giddiness<br /> |Inability to speak<br /> |-<br /> | Swelling/Edema<br /> | Feeling of darkness in front of eyes<br /> | Cough, Dyspnea, Edema<br /> |-<br /> ! colspan=&quot;3&quot;|Likings and Dislikings<br /> |-<br /> | <br /> | Longing for cold things and environment<br /> | Likings for pungent items<br /> |-<br /> |<br /> | Dislike for hot food and atmosphere; also, do not suit the patient<br /> | Likings for ununctuous things<br /> |-<br /> |<br /> | Dislike for sour food; also, do not suit the patient<br /> | Likings for hot things<br /> |}<br /> <br /> ==== Consequences of [[dhatu]] kshaya ====<br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Pathological event<br /> ! scope=&quot;col&quot;| Consequence<br /> ! scope=&quot;col&quot;| Objectivity<br /> |-<br /> | 1<br /> | [[Rasa dhatu]] kshaya<br /> | Decrease in quality tissue that nourish blood or required for formation of blood<br /> | Deficiency in factors required for erythropoietin like vitamin B12, Vitamin K, iron, transferin, ferritin, protein like hemochrome which give red color to blood, electrolyte Na+, K+, Ca++, Mg+, H+, Cl-, albumin, globulins, glucose, amino acid, nucleic acids and lipoprotein, endocrine secretions regulating fluid metabolism <br /> |-<br /> | 2<br /> | [[Rakta dhatu]] kshaya<br /> | Decrease in quality and volume of blood and further decrease in factors required for formation of [[mamsa dhatu]](muscles) <br /> | Decrease in volume of whole blood, hematocrit percentage, endocrine secretions regulating blood metabolism <br /> |-<br /> | 3<br /> | [[Mamsa dhatu]] kshaya<br /> | Decrease in quality and volume of muscles and further decrease in factors required for formation of [[mamsa dhatu]](muscles)<br /> | Decrease in muscle proteins, endocrine secretions regulating muscle metabolism <br /> |-<br /> | 4<br /> | [[Meda dhatu]] kshaya<br /> | Decrease in quality and volume of fats and lipids and further decrease in factors required for formation of [[asthi dhatu]](bones)<br /> | Decrease in lipids, endocrine secretions regulating lipid metabolism <br /> |}<br /> <br /> ==== List of diseases with features as observed in ''pandu'' ====<br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs and Symptoms<br /> ! scope=&quot;col&quot;| Diseases<br /> |-<br /> | 1<br /> | Blackish discoloration of the skin<br /> | Megaloblastic anemias (Vitamin B12 and folic acid deficiency) as reversible melanin skin hyperpigmentation which develops mainly over the knuckles<br /> |-<br /> | 2<br /> | Reddish discoloration of body parts<br /> | Development of petechiae, echymosis or bruises on the body due to thrombocytopenia associated with anemia (as in Aplastic anemias). Anemia due to Addison’s disease (increased tanning)<br /> |-<br /> | 3<br /> | Dry skin or body<br /> | Megaloblastic anemias due to the abnormal proliferation of epithelial cell surfaces. Anemia due to hypothyroid states<br /> |-<br /> | 4<br /> | Reddish or Blackish discoloration in eyes, face and nails<br /> | Body parts due to spontaneous bleeding manifestations, pernicious anemia <br /> |-<br /> | 5<br /> | Blackish urine<br /> | Cola colored urine in various types of intravascular hemolytic anemias when the plasma hemoglobin exceeds the haptoglobin binding capacity<br /> |-<br /> | 6<br /> | Blackish stool/melena <br /> | Gastrointestinal bleeding responsible for anemias - may be due to any ulcers or worm infestations or any other cause<br /> |-<br /> | 7<br /> | Dryness of stool or constipation<br /> | Megaloblastic anemias and anemia due to hypothyroidism<br /> |-<br /> | 8<br /> | &quot;Pins and needles&quot; sensation<br /> | pernicious anemias as well as in megaloblastic anemias<br /> |-<br /> | 9<br /> | Tremors<br /> | Cobalamin deficiency which causes peripheral neuropathy and degeneration of the posterior and pyramidal tracts of the spinal cord<br /> |-<br /> | 10<br /> | Loss of taste/distaste<br /> | Pernicious anemia<br /> |-<br /> | 11<br /> | Bodyache<br /> | Hemolytic anemia, hypothyroidism<br /> |}<br /> <br /> The observations of resemblance with diseases in conventional system of medicine show that all types of anemia specially megaloblastic anemia, pernicious anemia, hypothyroidism, haemolytic anemia can be considered under umbrella of ''pandu''. The objective parameters used for these disorders can be utilized for research on efficacy of [[Ayurveda]] therapies in management of ''pandu''.<br /> <br /> === ''Kamala'' ===<br /> <br /> In the second part of the chapter ''pandu, kamala'' is elaborately described. If a person suffering from ''pandu'' follows [[pitta]] provoking diet and lifestyle, he suffers from ''kamala''. This shows ''kamala'' is consequence of ''pandu'' or ''pandu'' is essential causative factor for ''kamala''. This shows the relation of jaundice originated due to hemolytic anemia. In other types of jaundice, this notion is not observed in practice. ''Kamala'' can occur without ''pandu''. (Su.Utt.44/9, A.Hri.Ni.13/15-17)<br /> <br /> Yellowish discoloration of sclera, skin, face, nails, and urine associated with constitutional symptoms like anorexia, debility, indigestion, loss of physical strength is called ''Kamala''.<br /> <br /> ==== Types of ''kamala'' ====<br /> <br /> ==== 1. ''Shakhashrita Kamala/Alpa'' [[pitta]] (''Dhatu ashrita'') ====<br /> <br /> The passage of [[pitta]] is obstructed by vitiated [[kapha]] and not allowing [[pitta]] to enter ''kostha'', it will cause excess of [[pitta]] in body tissues in ''Shakhasrita Kamala''. This involves the obstructive pathologies at hepatic circulation. As the [[pitta]] cannot enter the gastro-intestinal tract, it leads to clay colored stools. In obstructive jaundice, bilirubin has no access to the intestine and it is the reason for pale stools. <br /> <br /> This description of stools being clay colored, but the urine being yellow shows that they were very close in concept to the modern day physiopathology of obstructive jaundice especially hepatocellular ones (wherein due to an inability of the bile to pass into the gastrointestinal tract it circulates into the blood and the conjugated bilirubin being water soluble fraction is filtered and passes out into the urine). Further the description of [[pitta]] being the bi-product of [[rakta]] is also very similar to the fact of bile being produced as a result of Red Blood Cell destruction. The most common cause is gall stones in the common bile duct and pancreatic cancer in the head of pancreas. Also, a group of parasites known as liver flukes can live in common bile duct causing obstructive jaundice. Biliary atresia, cholanjiocarcinoma, pancreatitis, cholestasis of pregnancy and pancreatic pseudocysts are causes for obstruction of bile flow into the duodenum.<br /> <br /> ==== 2. ''Kostha Shakhashrita Kamala/bahu'' [[pitta]] (''Maha Srotasashrita'') ====<br /> <br /> ''Bahupitta kamala'' or ''Kostha-shakhasrita kamala'' mostly resembles the pre-hepatic and hepatocellular jaundice. Pre-hepatic jaundice is caused by anything which causes haemolysis. Pre-hepatic cause include severe malaria, certain genetic diseases such as sickle cell anemia, spherocytosis, thalassemia, pyruvate kinase deficiency and glucose 6-phospate dehydrogenase (G6PD) deficiency, which lead to increased destruction of red cells and therefore hemolytic jaundice. Hepato-cellular Jaundice can be caused by acute or chronic hepatitis, hepatotoxicity, cirrhosis, drug induced hepatitis and alcoholic liver disease.<br /> <br /> === ''Haleemaka'' ===<br /> <br /> ''Haleemaka'' is a further stage of ''pandu''. Reduced oxygen carrying capacity of blood (reduced ''jeevan karma'') causes depletion of strength and work capacity. This further leads to lack of libido and bodyache. Condition resembles cholestasis. Bile stasis and back pressure leads to liver failure which leads to the further symptoms of ''halimaka'' or sclerosing cholangitis. It is characterized by severe fatigue (''bala utsaha hani''), jaundice (''harita pita meda''), dark urine, cirrhosis, portal hypertension and hepato-megaly.<br /> <br /> === ''Panaki'' ===<br /> <br /> ''Panaki'', another disease in same context of ''halimaka'', explains the condition of malabsorption especially of fat due to lack of bile juice in digestion due to obstruction which leads to steatorrhoea (''bhinna varcha''). Reduced fat absorption leads to deficiency of fat soluble vitamins such as A, D, E and K.<br /> <br /> === ''Kumbha Kamala'' ===<br /> <br /> The description of ''kumbha kamala'' denotes the advanced stage of ''Kostha-shakhasrita kamala'' wherein the main seat of pathology is situated somewhere in the gastro-intestinal tract. ''Kumbha'' is one of the synonyms of ''koshtha''. Edema is described as one of the important clinical features of ''kumbha kamala'' (Su. Utt. 44).<br /> <br /> Both types of ''kamala'', if not treated convert into difficult to treat and hardened skin. ''Kumbha kamala'' could also refer to the presentation of the patient having distended abdomen i.e. ascitis, which is one of the important clinical feature of liver diseases, which are also the main cause of jaundice. <br /> <br /> Liver is the main seat for a number of functions and when it gets severely deranged the liver functions are affected. The clinical picture of ''kumbha kamala'' corresponds to these as observed below:<br /> <br /> *The production of majority of proteins as albumin, few globulins, cerulo-plasmin etc., is hampered leading to edema in the various body parts (''Bhrusham Shoonam cha Manavaḥ'') and dryness in the body.<br /> *The coagulation profile gets affected leading to increased prothrombin time, the presentation of esophageal varices, bleeding per rectum etc. Here the same features have been described as ''sarakta akshi mukha, chhardi vida mootra'' meaning blood seen or coming out of the eyes, mouth or in the vomitus (esophageal varices), through the stool (haemorrhoids) or through the urine.<br /> *The derangement of liver structure in these diseases leads to some presentation of obstructive jaundice with yellow urine (''peeta mootrata'').<br /> *The stage of altered consciousness has also been described as ''tandra moha samanvita'' (acting as if sleepy or having altered perception - semiconscious state).<br /> *The stage of hepatic coma has also been described as ''nashta sangya'' means the person is not able to recognise and perceive anything – unconscious state (''Sangya Nama Grahanena'').<br /> *The excessive dryness (''kharibhuta'') is generally due to increased bile salts deposition leading to pruritus and dryness of skin. This dryness further leads to the hardness.<br /> *As liver disorders progress, coagulatory defects begin leading to upper G.I. track bleed causing black stools/''malena''(''Krishna shakrita''). Secondly conjugated bilirubin which does not enter intestine becomes urobilinogen giving urine dark color (''krishna mutra'').<br /> *Excessive edema is observed all over body. Cirrhosis of the liver is a condition that causes reduction in plasma protein concentration. Cirrhosis means development of large amounts of fibrous tissue among the liver parenchymal cells. One result is failure of these cells to produce sufficient plasma proteins, leading to decreased plasma colloid osmotic pressure and the generalized edema that goes with this condition. Another way that liver cirrhosis causes edema is that the liver fibrosis sometimes compresses the abdominal portal venous drainage vessels as they pass through the liver before emptying back into the general circulation. Blockage of this portal venous outflow raises capillary hydrostatic pressure throughout the gastrointestinal area and further increases filtration of fluid out of the plasma into the intra-abdominal areas. When this occurs, the combined effects of decreased plasma protein concentration and high portal capillary pressures cause transudation of large amounts of fluid and protein into the abdominal cavity, a condition referred to as ascites.<br /> *Hematemesis/bleeding in eyes,per rectum, hematuria (''Sarakta akshi mukha chhardi vinamutra'') explains the bleeding disorders which begin in late hepatic disorders. <br /> *Fainting (''tamah pravesha'') is due to reduced cerebral perfusion due to various causes like gastrointestinal bleed, electrolyte or metabolic disturbance.<br /> *Drowsiness (''tandra''), confusion (''moha'') are further symptoms of hepatic encephalopathy. Neuropsychological findings are experienced in all phases of hepatic encephalopathy. It is experienced as forgetfulness, mild confusion and irritability, inversed sleep pattern followed by lethargy and personality changes. The third stage is marked with worsened confusion and in fourth stage is coma. ''Mada, Murchha'' and ''sanyasa'' are mentioned earlier as disorders due to vitiated blood in [[Vidhishonitiya Adhyaya]].<br /> <br /> === Management of Diseases (Treatment Protocols) ===<br /> ==== Current clinical practices in treatment of ''pandu'' and ''kamala'' ( referred from Chikitsa Pradeep) ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| Type<br /> ! scope=&quot;col&quot;| Medicine<br /> ! scope=&quot;col&quot;| Dose<br /> ! scope=&quot;col&quot;| Time<br /> ! scope=&quot;col&quot;| ''Anupana''<br /> |-<br /> |rowspan = &quot;3&quot;|[[Vata]] dominant ''pandu''<br /> | ''Mahayogaraja samira mixture''<br /> | 120-480 mg<br /> | After meals <br /> | Ghee (''dadimadi'') + honey<br /> |-<br /> | ''Tiktaka ghritam''<br /> | 10-40 ml<br /> | After meals <br /> | Hot water<br /> |-<br /> | ''Navajivana rasa''<br /> | 120-200 mg<br /> | After meals <br /> | Milk<br /> |-<br /> | rowspan = &quot;2&quot;|[[Pitta]] dominant ''pandu''<br /> | ''Tapyadi lauha'' mixture<br /> | 250 - 600 mg<br /> | After meals <br /> | Dadimadi ghee + udumbaravaleha<br /> |-<br /> | ''Vasadi'' decoction<br /> | 20 - 40 ml<br /> | After meals <br /> | Honey<br /> |-<br /> | [[Kapha]] dominant ''pandu''<br /> | ''Gomutra Haritaki'' mixture<br /> | 600 mg - 3 grams<br /> | After meals <br /> | Honey + juice of castor leaves<br /> |-<br /> | ''Mrittika bhakshana janya''<br /> | ''Gomutra Haritaki'' mixture<br /> | 600 mg - 3 grams<br /> | After meals<br /> | ''Kumari Asava''<br /> |-<br /> | rowspan=&quot;2&quot;|''Riddha Patha Kamala''<br /> | ''Ichha bhedi rasa''<br /> | 120 - 180 mg<br /> | Early morning one time<br /> | Lemon juice<br /> |-<br /> | ''Suta shekhara kalpa''<br /> | 120 - 250 mg<br /> | After meals<br /> | Milk + sugar<br /> |-<br /> | ''Koshtha ashrita kamala''<br /> | colspan=&quot;4&quot;|As like ''pitta'' dominant ''pandu''<br /> |}<br /> <br /> ==== Evidence based clinical practices ====<br /> <br /> *In a study carried out by Shazi L. and Thakar A., Amalaki [[rasayana]] was found effective in management of iron deficiency anemia. However the efficacy was equal in clinical parameters and less in biochemical parameters in comparison to conventional drugs a combination of folic acid and ferrous sulphate. &lt;ref&gt; Shaizi Layeeq, Thakar A.B. Clinical efficacy of Amalaki rasayana in the management of pandu(iron deficiency anemia). Ayu.2015.July-Sep.36(3):290-297. &lt;/ref&gt; <br /> *''Punarnava mandura'' was found effective as ''panduhara'' and [[rasayana]] in patients of geriatric anemia and can counteract most of the pathological manifestations related to ''pandu roga'' in old age (geriatric anemia)&lt;ref&gt;Pandya M.G. Dave A.R. A clinical study of punarnava mandura in the management of pandu roga in old age (geriatric anemia).Ayu,2014 July-Sept; 35(3);252-260. &lt;/ref&gt;. In another study on pregnant females, ''punarnava mandura'' and ''dhatri lauha'' are found effective in management of anemia during pregnancy.&lt;ref&gt;Khandelwal D.A, Donga S.B.,Dei L.P. Clinical efficacy of punarnava mandura and dhatri lauha in the management of garbhini pandu (anemia in pregnancy) Ayu,2015 Oct-Dec;36(4); 397-403. &lt;/ref&gt;<br /> *A herbomineral formulation ''Trikatrayadi Lauha'' suspension was observed an effective, well-tolerated, and clinically safe formulation for the management of Iron deficiency anemia in children.&lt;ref&gt;Kumar A, Garai AK. A clinical study on Pandu Roga, iron deficiency anemia, with Trikatrayadi Lauha suspension in children. J [[Ayurveda]] Integr Med 2012;3:215-22.&lt;/ref&gt; Khan et.al. observed that the same formulation was observed effective to relieve the signs and symptoms of ''pandu'' in comparison to standard control drug (Fersolate-CM). ''Trikatrayadi lauha'' provided significant improvement on Hbgm%, RBC, PCV, MCV, serum iron, percent transferrin saturation and to decrease TIBC. Therefore ''Trikatrayadi Lauha'' can be used in ''Panduroga'' or IDA as a safe hematinic drug.&lt;ref&gt;Khan Subir kumar, Vyas S.N. Chandola H.M. Efficacy of Trikatrayadi lauha in Pandu roga with reference to iron deficiency anemia. Ayu 2012. Jan-Mar, 33(1):62-67.&lt;/ref&gt; <br /> *Tewari et.al. studied the ethnopharmacological approaches to the therapy of jaundice&lt;ref&gt;Tewari D, Mocan A, Parvanov ED, Sah AN, Nabavi SM, Huminiecki L, Ma ZF, Lee YY, Horba´nczuk JO and Atanasov AG (2017) Ethnopharmacological Approaches for Therapy of Jaundice: Part I. Front. Pharmacol. 8:518. doi: 10.3389/fphar.2017.00518&lt;/ref&gt; and highly used plant species from acanthaceae,euphorbiaceae, asteraceae, combretaceae and fabaceae family in the management of jaundice. The team of researchers elaborately studied hystorical perspective of jaundice, its pathophysiology and enlisted 207 herbs used in management of jaundice.&lt;ref&gt;Tewari D, Mocan A, Parvanov ED, Sah AN, Nabavi SM, Huminiecki L, Ma ZF, Lee YY, Horba´nczuk JO and Atanasov AG (2017) Ethnopharmacological Approaches for Therapy of Jaundice: Part II. Highly Used Plant Species from Acanthaceae, Euphorbiaceae, Asteraceae, Combretaceae, and Fabaceae Families. Front. Pharmacol. 8:519. doi: 10.3389/fphar.2017.00519&lt;/ref&gt;<br /> <br /> === Research studies on ''pandu'' ===<br /> <br /> Some studies are available on the internet which depict the efficacy of various Ayurvedic drugs having iron (in the form of ''lauha'' and ''mandura'') compounds in the management of ''pandu'': <br /> #Sarkar PK, Prajapati PK, Choudhary AK, Shukla VJ, Ravishankar B. Haematinic Evaluation of Lauha Bhasma and Mandura Bhasma on HgCl2-induced Anemia in Rats. Indian J Pharm Sci 2007;69:791-5.<br /> #Sarkar PK. A Comparative Pharmaceutico-pharmaco-clinical study of Lauha Bhasma and Mandura Bhasma w.s.r. to its Pāndu-hara Effect, MD thesis. I.P.G.T. &amp; R.A. Jamnagar: Gujrat [[Ayurveda]] University; 2005. <br /> #Garai A, Rai M, Kumar A. Role of an Ayurvedic Compound (Panduhara Yoga) in the Management of Iron Deficiency Anaemia in Children. Ayu 2009;30:469-74.<br /> #Gupta V, Reddy KR. Experimental Studies of Lohasava. Aryavaidyan 2007;21:87-94.<br /> #Sarkar PK, Prajapati PK, Shukla VJ, Ravishankar B, Choudhary AK. Toxicity and recovery studies of two Ayurvedic preparations of iron. Indian J Exp Biol 2009;47:987-92.<br /> #Devarshi P, Kanse A, Kanse R, Mane S, Patil S, Varute AT. Effect of Mandura Bhasma on lipolytic Activities of Liver, Kidney and Adipose Tissue of Albino Rat During CCl4 Induced hepatic Injury. J Biosci 1986;10:227-34.<br /> #Pandit S, Biswas TK, Debnath PK, Saha AV, Chowdhury U, Shaw BP, et al. Chemical and pharmacological evaluation of different Ayurvedic preparations of iron. J Ethnopharmacology 1999;65:149-56.<br /> #Dinesh C. Sharma, Deepa Chandiramani, Manminder Riyat and Praveen Sharma. Scientific evaluation of some ayurvedic preparations for correction of iron deficiency and anemia. Indian Journal of Clinical Biochemistry, 2007 / 22 (2) 123-128<br /> #Ambika Das, PA03.17. A clinical evaluation of Punarnavadi Mandura and Dadimadi Ghritha in management of Pandu (Iron defeciency anaemia), Ancient Science of Life 2013; 32 (s2):86<br /> <br /> One of the studies (Sharma D.C, 2007) report that the Ayurvedic preparations were found equally effective as the allopathic compound in the management of iron deficiency anemia and the fact that the side effects were almost nil establishes them to be even superior.<br /> <br /> The modes of action of drugs and procedures as stated in this chapter, which is without iron, have not been studied much in anemia. Though, some of the preparations described in anemia have been found very useful in the management of other types of anemia as sickle cell anemia,&lt;ref&gt;Macmillan Keith, A herbomineral composition for the treatment of Sickle Cell disease. Retrieved from tgs.freshpatents.com&lt;/ref&gt; aplastic anemia,&lt;ref&gt;Subhash singh, Shiv Kumar Singh and Narendra Kumar Singh. Aaplastic anaemia, complete cure, ayurvedic way – case report. International Journal Of Basic And Applied Medical Sciences Issn: 2277-2103 (Online) An Online International Journal Available At http://www.cibtech.org/jms.htm 2013 vol. 3 (1) january-april, pp.242-246/subhash et al.&lt;/ref&gt; etc.<br /> <br /> So, further studies need to be done in order to know the efficacy of these drugs and mechanisms in the various types of anemia.<br /> <br /> === Principle of treatment for ''kamala'' ===<br /> <br /> The management of ''kamala'' by the drugs stated in the chapter has been found to show good results but the mechanism of their action is still not clear. Practically few studies are available on the net which prove the efficacy of ''Ayurvedic'' compounds in the management of hepatocellular jaundice. &lt;ref&gt;Nirmal kumar and Anil kumar singh. Phalatrikadi kvatha - an ayurvedic hepatoprotective drug. International journal of research in pharmacy and chemistry.2013, 3(3) Available online at www.ijrpc.com&lt;/ref&gt;<br /> <br /> === List of Research Works done ===<br /> <br /> === IPGT&amp;RA, Jamnagar ===<br /> <br /> #Chaudhary sudhakar (1958): Pandu Roga Nidana.<br /> #Mishra N. K. (1959): A clinical study of Pandu Roga.<br /> #Bhattacharya R. C. (1965): Pandu Roga Par Paradamruta Teekshana Laugh Karyanvekshana<br /> #Ojha N.H.(1966): Abhraka Bhasma Ka Pandu Roga Par Karyanvekshana.<br /> #Pillai K.D.R. (1974): Study of effect of Swarna Makshika Bhasma on Pandu.<br /> #Jha Prabhakar (1974): Swayama Lauha Bhasma Ka Pandu Roga Par Kriyatamaka Adhyayana.<br /> #Sharada B.D.(1975) : Effect of Yogaraja on Garbhavasthajanya Pandu.<br /> #Gopalkrishana (1986): Lauha Bhasma on Pandu with special reference to its Media.<br /> #M.S.Trivedi (1992): Effect of Yogaraja Rasayana in Garbhavsthajanya Pandu.<br /> #Nargunde Rajeshri (1997): A comparative Phaemaco-clinical Study of Shudha Kasisa Churna and Kasisa Bhasma on PANDU. <br /> #Jain Sangeeta (2000): A study on Pandu Roga w.s.r. to ANAEMIA and Its Management with Shodhana and Yogaraja Rasayana.<br /> #Sarkar P K (2005): A comparative pharmaco-pharmaceutico Clinical study of lauha bhasma and mandura bhasma w.s.r. to Panduhara effects.<br /> <br /> === Banaras Hindu University, Varanasi ===<br /> <br /> #Trivedi R D (1979):Hematological and clinical stubby in pandu.<br /> #Malhotra E. N. (1983): Management of Garbhavasthajnya Pandu with Mandura Bhasma.<br /> #Nandkishore (1985): Clinical Assessment of Navayasa Lauha in Management of Pandu.<br /> #Chauhana A. P. S. (1985): Role of Manduradi Ghanvati in Pandu Roga.<br /> #Dixit A. K. (1994): Clinical study in Yogaraja Rasayana on Pandu.<br /> #Singh S. N. (1996): A study on aetio pathogenesis of Pandu Roga w s r to its Samprapti Vighatan by Makshika.<br /> #Agrawal N. Assessment of Effect of Mandura Bhasma in Iron Deficiency Anemia in Children, MD thesis. P.G. Department of Kaumarbhritya. Varanasi: IMS, B.H.U; 2007. <br /> <br /> === National Institute of [[Ayurveda]], Jaipur and others ===<br /> <br /> #Tyagi R. M. (1980): Pandu Roga Evam Vajra Vatak Mandura .<br /> #B. C. Sharma (1985): Pandu Roga Samprapti Vivechana.<br /> #R. K. Sharma (1994): Pandu Roga Mandura Bhasma Ka Chikitsatmaka Adhyayan.<br /> #Meena R. K. (1994): Guduchi in Pandu Roga.<br /> #Joshi N. (2005): Pharmaceutical, Pharmacological and Toxicological Study of Various Lauha Preparations(Kalpa) w.s.r. to Iron Deficiency Anaemia, M.D. Thesis. P. G. Department of Rasa Shastra and Bhaishajya Kalpana, Jaipur.<br /> #Kumath V. (2006): A Comprehensive Study of Haritaki with Special Reference to the Efficacy of Terminalia chebula Retz. on pandu Roga, MD thesis. P. G. Department. of Dravyaguna, Government. Ujjain, Madhya Pradesh: Autonomous Dhanvantari [[Ayurveda]] College and Hospital; 2006.<br /> <br /> === Potential areas /scope for further research ===<br /> <br /> The following drugs referred in management of ''pandu'' need to be researched more for providing evidences of its efficacy in anemia and related disorders in comparison to conventional management: <br /> #''Dadimadya ghritam''<br /> #''Katukadyam ghritam''<br /> #''Pathyaghritam''<br /> #''Danti ghritam''<br /> #''Drakshaghritam''<br /> #''Haridradi ghritam''<br /> #''Darvyadi ghritam''<br /> #''Navayasa churnam''<br /> #''Manduravataka''<br /> #''Tapyadi lauha''<br /> #''Yogaraja''<br /> #''Punarnava Mandura''<br /> #''Darvyadi leha''<br /> #''Dhatryavaleha''<br /> #''Manduravatakah''<br /> #''Gaudo arishah''<br /> #''Bijakarisha''<br /> #''Dhatryarishta''<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References ==<br /> &lt;/div&gt;<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Pandu_Chikitsa&diff=45382 2025-11-01T05:27:41Z

<p>Agnivesha: /* Tridoshaja pandu */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Pandu Chikitsa<br /> |titlemode=append<br /> |keywords=Pandu roga, kamala, koshthashakhashrita kamala, shakhashrita kamala, panaka, kumbhakamala, haleemaka, anemia, jaundice, Ayurveda, Indian system of medicine, charak samhita. iron deficiency anaemia, blood deficiency <br /> |description=Chikitsa Sthana Chapter 16. Management of Pandu (Anemia and diseases due to blood deficiency)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 16. Management of Pandu (Anemia and diseases due to blood deficiency)&lt;/big&gt;'''<br /> {{Infobox<br /> |title = Pandu Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 16<br /> |label2 = Preceding Chapter<br /> |data2 = [[Grahani Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Hikka Shwasa Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Kar A.C., Rai S., Aladoriya N., [[Yogesh Deole|Deole Y. S.]]<br /> |label7 = Reviewer <br /> |data7 = Ojha S.N.<br /> |label8 = Editors<br /> |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.017 10.47468/CSNE.2020.e01.s06.017]<br /> }}<br /> &lt;big&gt;'''Abstract &lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;''Pandu roga'' (resembling with anemia) is characterized by pallor which is associated with different colors according to [[dosha]] involved. Besides ''pandu roga'', this chapter also describes two types of ''kamala'' (jaundice) which are two other associated diseases, caused by predominance of [[pitta]] [[dosha]] which causes alteration in normal colors of the body. The chapter describes general etiology, pathogenesis, symptoms etc of ''pandu roga'' (anemia) as well as each of its five types viz. [[vata]], [[pitta]], [[kapha]], sannipataja and ''mrittika-bhakshana'' (clay eating) ''pandu''. After describing general principle of treatment of ''pandu'' and ''kamala'', detailed treatment of each of the conditions mentioned above along with ''pathya'' (recommended diet) and apathya (prohibited diet) are given. <br /> &lt;br/&gt;<br /> '''Keywords''': Pandu roga, kamala, koshthashakhashrita kamala, shakhashrita kamala, panaka, kumbhakamala, haleemaka, anemia, jaundice<br /> &lt;/p&gt;<br /> <br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> After the description of ''grahani dosha'', the chapter on ''pandu roga'' is given, as the causative factors of ''pandu roga'' are quite similar to that of ''grahani dosha''. Probably it is because that the various gastrointestinal problems can also lead to development of ''pandu roga''. The chapter deals with general discoloration of the body such as pallor, yellowish, greenish and whitish discoloration which is seen in skin, eyes, lips, face, nails, urine feces etc. <br /> <br /> ''Kamala'' (jaundice) and ''haleemaka'' (severe obstructive jaundice) have also been included in this chapter as they are also characterized by the discoloration and may relate to ''pandu roga''. ''Kamala'' is of two types, ''swatantra'' (primary) and ''partantra'' (secondary). The etiological factors of ''primary kamala'' are described later. Secondary ''kamala'' develops in chronic phase of ''pandu'' in which vitiated [[pitta]] is seated in [[rasa dhatu]] and in kamala, [[pitta]] goes deeper in [[rakta dhatu]] and continues to go deeper in [[mamsa dhatu]] and [[meda dhatu]], then it is called ''haleemaka'' and ''kumbha kamala'' respectively. <br /> <br /> ''Kamala'' is of two types in repect to location, ''shakhshrita kamala'' located in body tissues in the form of obstructed [[pitta]] and ''koshthashrita kamala'', localized to gut and can be easily removed by purgation while ''shakhashrita kamala'' needs to be brought to gut for removal.<br /> &lt;/div&gt;<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातः पाण्डुरोगचिकित्सितं व्याख्यास्यामः||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः||२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātaḥ pāṇḍurōgacikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2||<br /> <br /> athAtaH pANDurogacikitsitaM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2||<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt; <br /> Now we shall expound the chapter &quot;Pandu Chikitsa&quot; (Management of Anemia and diseases due to blood deficiency). Thus said Lord Atreya. [1-2]<br /> <br /> === Five types of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगाः स्मृताः पञ्च वातपित्तकफैस्त्रयः| <br /> <br /> चतुर्थः सन्निपातेन पञ्चमो भक्षणान्मृदः||३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgāḥ smr̥tāḥ pañca VātaPittaKaphaistrayaḥ| <br /> <br /> caturthaḥ sannipātēna pañcamō bhakṣaṇānmr̥daḥ||3|| <br /> <br /> pANDurogAH smRutAH pa~jca vAtapittakaphaistrayaH| <br /> <br /> caturthaH sannipAtena pa~jcamo bhakShaNAnmRudaH||3||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Pandu roga is classified into five types as vatika, paittika, [[kapha]]ja, tri[[dosha]]ja and mrittika bhakshhana janya pandu [3]<br /> <br /> === Pathogenesis of pandu ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दोषाः पित्तप्रधानास्तु यस्य कुप्यन्ति धातुषु| <br /> <br /> शैथिल्यं तस्य धातूनां गौरवं चोपजायते||४|| <br /> <br /> ततो वर्णबलस्नेहा ये चान्येऽप्योजसो गुणाः| <br /> <br /> व्रजन्ति क्षयमत्यर्थं दोषदूष्यप्रदूषणात्||५|| <br /> <br /> सोऽल्परक्तोऽल्पमेदस्को निःसारः शिथिलेन्द्रियः| <br /> <br /> वैवर्ण्यं भजते, तस्य हेतुं शृणु सलक्षणम्||६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dōṣāḥ Pittapradhānāstu yasya kupyanti Dhātuṣu| <br /> <br /> śaithilyaṁ tasya dhātūnāṁ gauravaṁ cōpajāyatē||4|| <br /> <br /> tatō varṇabalasnēhā yē cānyē'pyōjasō guṇāḥ| <br /> <br /> vrajanti kṣayamatyarthaṁ dōṣadūṣyapradūṣaṇāt||5|| <br /> <br /> sō'lparaktō'lpamēdaskō niḥsāraḥ śithilēndriyaḥ| <br /> <br /> vaivarṇyaṁ bhajatē, tasya hētuṁ śr̥ṇu salakṣaṇam||6|| <br /> <br /> doShAH pittapradhAnAstu yasya kupyanti dhAtuShu| <br /> <br /> shaithilyaM tasya dhAtUnAM gauravaM copajAyate||4|| <br /> <br /> tato varNabalasnehA ye cAnye~apyojaso guNAH| <br /> <br /> vrajanti kShayamatyarthaM doShadUShyapradUShaNAt||5|| <br /> <br /> so~alparakto~alpamedasko niHsAraH shithilendriyaH| <br /> <br /> vaivarNyaM bhajate, tasya hetuM shRuNu salakShaNam||6||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Aggravated [[pitta]] predominant [[dosha]] vitiates the [[dhatu]]. This vitiation of [[dhatu]] cause sluggishnesss (''shithilata'') and heaviness (''gaurava'') in the [[dhatu]] resulting in diminution of complexion (''varna''), strength (''bala''), unctuousness (''sneha'') and the qualities of [[ojas]]. Thus, the person develops diminished blood (''rakta'') and the fatty tissue ([[meda dhatu]]) and absence of the vitality of all the tissues (''nihsara'') decreases functional status of sense organs (''sithilendriyah'') and discoloration of the body. [[Hetu]] (etiological factors and pathogenesis) and the sign and symptoms of the disease will be explained hereafter [4-6]<br /> <br /> === General etio-pathogenesis of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षाराम्ललवणात्युष्णविरुद्धासात्म्यभोजनात्| <br /> <br /> निष्पावमाषपिण्याकतिलतैलनिषेवणात्||७|| <br /> <br /> विदग्धेऽन्ने दिवास्वप्नाद्व्यायामान्मैथुनात्तथा| <br /> <br /> प्रतिकर्मर्तुवैषम्याद्वेगानां च विधारणात्||८|| <br /> <br /> कामचिन्ताभयक्रोधशोकोपहतचेतसः| <br /> <br /> समुदीर्णं यदा पित्तं हृदये समवस्थितम्||९|| <br /> <br /> वायुना बलिना क्षिप्तं सम्प्राप्य धमनीर्दश| <br /> <br /> प्रपन्नं केवलं देहं त्वङ्मांसान्तरमाश्रितम्||१०|| <br /> <br /> प्रदूष्य कफवातासृक्त्वङ्मांसानि करोति तत्| <br /> <br /> पाण्डुहारिद्रहरितान् वर्णान् बहुविधांस्त्वचि||११|| <br /> <br /> स पाण्डुरोग इत्युक्तः ...|१२| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣārāmlalavaṇātyuṣṇaviruddhāsātmyabhōjanāt| <br /> <br /> niṣpāvamāṣapiṇyākatilatailaniṣēvaṇāt||7|| <br /> <br /> vidagdhē'nnē divāsvapnādvyāyāmānmaithunāttathā| <br /> <br /> pratikarmartuvaiṣamyādvēgānāṁ ca vidhāraṇāt||8|| <br /> <br /> kāmacintābhayakrōdhaśōkōpahatacētasaḥ| <br /> <br /> samudīrṇaṁ yadā Pittaṁ hr̥dayē samavasthitam||9|| <br /> <br /> vāyunā balinā kṣiptaṁ samprāpya dhamanīrdaśa| <br /> <br /> prapannaṁ kēvalaṁ dēhaṁ tvaṅmāṁsāntaramāśritam||10|| <br /> <br /> pradūṣya Kaphavātāsr̥ktvaṅmāṁsāni karōti tat| <br /> <br /> pāṇḍuhāridraharitān varṇān bahuvidhāṁstvaci||11|| <br /> <br /> sa pāṇḍurōga ityuktaḥ ...|12| <br /> <br /> kShArAmlalavaNAtyuShNaviruddhAsAtmyabhojanAt| <br /> <br /> niShpAvamAShapiNyAkatilatailaniShevaNAt||7|| <br /> <br /> vidagdhe~anne divAsvapnAdvyAyAmAnmaithunAttathA| <br /> <br /> pratikarmartuvaiShamyAdvegAnAM ca vidhAraNAt||8|| <br /> <br /> kAmacintAbhayakrodhashokopahatacetasaH| <br /> <br /> samudIrNaM yadA pittaM hRudaye samavasthitam||9|| <br /> <br /> vAyunA balinA kShiptaM samprApya dhamanIrdasha| <br /> <br /> prapannaM kevalaM dehaM tva~gmAMsAntaramAshritam||10|| <br /> <br /> pradUShya kaphavAtAsRuktva~gmAMsAni karoti tat| <br /> <br /> pANDuhAridraharitAn varNAn bahuvidhAMstvaci||11|| <br /> <br /> sa pANDuroga ityuktaH ...|12| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Followings are the etiological factors of ''pandu'':<br /> *The (excessive) intake of alkaline, sour, saline, hot and mutually contradictory foods, unwholesome food, ''nishpava'' (a type of pulses), ''masha, pinyaka'' (oil cake) and ''tila'' oil; <br /> *Indulging in day sleep, performing exercise and sex before digestion of the food;<br /> *Improper administration of [[Panchakarma]] measures (''pratikarma vaishamya'') and the disobedience of the seasonal regimens (''ritu vaishamya'') <br /> *Suppression of the natural urges<br /> *Affliction of mind with passion, worry, fear, anger, grief<br /> <br /> Indulgence in the above factors aggravates [[pitta]] seated in the cardiac region and then this [[pitta]] is forcefully propelled by the [[vata]] into the ten ''dhamanis'' (attached to the heart) and further into the whole body. There, it gets located in between the ''tvacha'' (skin) and the [[mamsa dhatu]] (flesh) and additionally vitiates the [[kapha]], [[vata]], [[rakta]], tvacha and [[mamsa dhatu]] resulting in the development of various discolorations in the body like ''pandu'' (pale), ''haridra'' (yellow),and ''harita'' (green). This is called as ''pandu roga'' [7-11½]<br /> <br /> === Premonitory symptoms ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> .. तस्य लिङ्गं भविष्यतः| <br /> <br /> हृदयस्पन्दनं रौक्ष्यं स्वेदाभावः श्रमस्तथा||१२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ... tasya liṅgaṁ bhaviṣyataḥ| <br /> <br /> hr̥dayaspandanaṁ raukṣyaṁ svēdābhāvaḥ śramastathā||12||<br /> <br /> ... tasya li~ggaM bhaviShyataH| <br /> <br /> hRudayaspandanaM raukShyaM svedAbhAvaH shramastathA||12||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The premonitory symptoms of the disease are palpitations, ununctuousness, absence of sweating and fatigue [12]<br /> <br /> === General symptoms of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सम्भूतेऽस्मिन् भवेत् सर्वः कर्णक्ष्वेडी हतानलः| <br /> <br /> दुर्बलः सदनोऽन्नद्विट् श्रमभ्रमनिपीडितः||१३|| <br /> <br /> गात्रशूलज्वरश्वासगौरवारुचिमान्नरः| <br /> <br /> मृदितैरिव गात्रैश्च पीडितोन्मथितैरिव||१४|| <br /> <br /> शूनाक्षिकूटो हरितः शीर्णलोमा हतप्रभः| <br /> <br /> कोपनः शिशिरद्वेषी निद्रालुः ष्ठीवनोऽल्पवाक्||१५|| <br /> <br /> पिण्डिकोद्वेष्टकट्यूरुपादरुक्सदनानि च| <br /> <br /> भवन्त्यारोहणायासैर्विशेषश्चास्य [१] वक्ष्यते||१६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sambhūtē'smin bhavēt sarvaḥ karṇakṣvēḍī hatānalaḥ| <br /> <br /> durbalaḥ sadanō'nnadviṭ śramabhramanipīḍitaḥ||13|| <br /> <br /> gātraśūlajvaraśvāsagauravārucimānnaraḥ| <br /> <br /> mr̥ditairiva gātraiśca pīḍitōnmathitairiva||14|| <br /> <br /> śūnākṣikūṭō haritaḥ śīrṇalōmā hataprabhaḥ| <br /> <br /> kōpanaḥ śiśiradvēṣī nidrāluḥ ṣṭhīvanō'lpavāk||15|| <br /> <br /> piṇḍikōdvēṣṭakaṭyūrupādaruksadanāni ca| <br /> <br /> bhavantyārōhaṇāyāsairviśēṣaścāsya [1] vakṣyatē||16|| <br /> <br /> sambhUte~asmin bhavet sarvaH karNakShveDI hatAnalaH| <br /> <br /> durbalaH sadano~annadviT shramabhramanipIDitaH||13|| <br /> <br /> gAtrashUlajvarashvAsagauravArucimAnnaraH| <br /> <br /> mRuditairiva gAtraishca pIDitonmathitairiva||14|| <br /> <br /> shUnAkShikUTo haritaH shIrNalomA hataprabhaH| <br /> <br /> kopanaH shishiradveShI nidrAluH ShThIvano~alpavAk||15|| <br /> <br /> piNDikodveShTakaTyUrupAdaruksadanAni ca| <br /> <br /> bhavantyArohaNAyAsairvisheShashcAsya [1] vakShyate||16|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> On developing ''pandu roga'' the patients have the symptoms of tinnitus, low digestion, weakness, prostration, disliking for food, fatigue, giddiness, pain in the body, fever, dyspnea, heaviness and anorexia. The patient feels as if the limbs are being kneaded, pressed or churned; develops peri-orbital swelling, greenish complexion and falling of body hair. The person loses his body luster, becomes irritable, dislikes cold things, feels sleepy, spits in excess, avoids speaking, suffers from cramps in the calf region and experiences excessive fatigue as well as pain and weakness in the lumbar region, thighs and feet specifically by exertion while climbing [13-16]<br /> <br /> The signs and symptoms specific to each variety of ''pandu'' will be described henceforth.<br /> <br /> === ''Vatika pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आहारैरुपचारैश्च वातलैः कुपितोऽनिलः| <br /> <br /> जनयेत्कृष्णपाण्डुत्वं [१] तथा रूक्षारुणाङ्गताम्||१७|| <br /> <br /> अङ्गमर्दं रुजं तोदं कम्पं पार्श्वशिरोरुजम्| <br /> <br /> वर्चःशोषास्यवैरस्यशोफानाहबलक्षयान्||१८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> āhārairupacāraiśca Vātalaiḥ kupitō'nilaḥ| <br /> <br /> janayētkr̥ṣṇapāṇḍutvaṁ [1] tathā rūkṣāruṇāṅgatām||17|| <br /> <br /> aṅgamardaṁ rujaṁ tōdaṁ kampaṁ pārśvaśirōrujam| <br /> <br /> varcaḥśōṣāsyavairasyaśōphānāhabalakṣayān||18|| <br /> <br /> AhArairupacAraishca vAtalaiH kupito~anilaH| <br /> <br /> janayetkRuShNapANDutvaM [1] tathA rUkShAruNA~ggatAm||17|| <br /> <br /> a~ggamardaM rujaM todaM kampaM pArshvashirorujam| <br /> <br /> varcaHshoShAsyavairasyashophAnAhabalakShayAn||18|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Indulging in [[vata]] increasing diet and regimens aggravates [[vata]] leading to ''vatika pandu roga''. The skin of the patient becomes blackish dawn colored and ununctuous. Its other symptoms are malaise, ache, pricking pain, tremor, pain in both the sides of the chest, headache; dried feces, distaste in the mouth; swelling, gaseous distention of the abdomen and weakness [17-18]<br /> <br /> === ''Paittika pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तलस्याचितं पित्तं यथोक्तैः स्वैः प्रकोपणैः| <br /> <br /> दूषयित्वा तु रक्तादीन् पाण्डुरोगाय कल्पते||१९|| <br /> <br /> स पीतो हरिताभो वा ज्वरदाहसमन्वितः| <br /> <br /> तृष्णामूर्च्छापिपासार्तः [१] पीतमूत्रशकृन्नरः||२०|| <br /> <br /> स्वेदनः शीतकामश्च न चान्नमभिनन्दति| <br /> <br /> कटुकास्यो न चास्योष्णमुपशेतेऽम्लमेव च||२१|| <br /> <br /> उद्गारोऽम्लो विदाहश्च विदग्धेऽन्नेऽस्य जायते| <br /> <br /> दौर्गन्ध्यं भिन्नवर्चस्त्वं दौर्बल्यं तम एव च||२२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> Pittalasyācitaṁ Pittaṁ yathōktaiḥ svaiḥ prakōpaṇaiḥ| <br /> <br /> dūṣayitvā tu raktādīn pāṇḍurōgāya kalpatē||19|| <br /> <br /> sa pītō haritābhō vā jvaradāhasamanvitaḥ| <br /> <br /> tr̥ṣṇāmūrcchāpipāsārtaḥ [1] pītamūtraśakr̥nnaraḥ||20|| <br /> <br /> svēdanaḥ śītakāmaśca na cānnamabhinandati| <br /> <br /> kaṭukāsyō na cāsyōṣṇamupaśētē'mlamēva ca||21|| <br /> <br /> udgārō'mlō vidāhaśca vidagdhē'nnē'sya jāyatē| <br /> <br /> daurgandhyaṁ bhinnavarcastvaṁ daurbalyaṁ tama ēva ca||22|| <br /> <br /> pittalasyAcitaM pittaM yathoktaiH svaiH prakopaNaiH| <br /> <br /> dUShayitvA tu raktAdIn pANDurogAya kalpate||19|| <br /> <br /> sa pIto haritAbho vA jvaradAhasamanvitaH| <br /> <br /> tRuShNAmUrcchApipAsArtaH [1] pItamUtrashakRunnaraH||20|| <br /> <br /> svedanaH shItakAmashca na cAnnamabhinandati| <br /> <br /> kaTukAsyo na cAsyoShNamupashete~amlameva ca||21|| <br /> <br /> udgAro~amlo vidAhashca vidagdhe~anne~asya jAyate| <br /> <br /> daurgandhyaM bhinnavarcastvaM daurbalyaM tama eva ca||22||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> [[Pitta]] gets aggravated by indulging in [[pitta]] vitiating ''nidanas'' (diet and regimens) which by involving the blood etc. causes [[pitta]]ja pandu. Its symptoms are, change in complexion to yellowish/greenish, fever, burning sensation; morbid thirst and fainting; excessive perspiration and longing for cold things and environment. The person does not relish food, develops pungent taste, disfavors hot and sour things; gets sour eructations associated with burning sensation due to impaired digestion of food; emits foul smell from mouth; the urine and stool become yellow in color, has loose motions and develops weakness and fainting [19-22]<br /> <br /> === [[Kapha]]ja pandu ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विवृद्धः श्लेष्मलैः श्लेष्मा पाण्डुरोगं स पूर्ववत्| <br /> <br /> करोति गौरवं तन्द्रा छर्दिं श्वेतावभासताम्||२३|| <br /> <br /> प्रसेकं लोमहर्षं च सादं मूर्च्छां भ्रमं क्लमम्| <br /> <br /> श्वासं कासं तथाऽऽलस्यमरुचिं वाक्स्वरग्रहम्||२४|| <br /> <br /> शुक्लमूत्राक्षिवर्चस्त्वं कटुरूक्षोष्णकामताम्| <br /> <br /> श्वयथुं मधुरास्यत्वमिति [१] पाण्ड्वामयः कफात्||२५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vivr̥ddhaḥ ślēṣmalaiḥ ślēṣmā pāṇḍurōgaṁ sa pūrvavat| <br /> <br /> karōti gauravaṁ tandrā chardiṁ śvētāvabhāsatām||23|| <br /> <br /> prasēkaṁ lōmaharṣaṁ ca sādaṁ mūrcchāṁ bhramaṁ klamam| <br /> <br /> śvāsaṁ kāsaṁ tathā''lasyamaruciṁ vāksvaragraham||24|| <br /> <br /> śuklamūtrākṣivarcastvaṁ kaṭurūkṣōṣṇakāmatām| <br /> <br /> śvayathuṁ madhurāsyatvamiti [1] pāṇḍvāmayaḥ kaphāt||25|| <br /> <br /> vivRuddhaH shleShmalaiH shleShmA pANDurogaM sa pUrvavat| <br /> <br /> karoti gauravaM tandrA chardiM shvetAvabhAsatAm||23|| <br /> <br /> prasekaM lomaharShaM ca sAdaM mUrcchAM bhramaM klamam| <br /> <br /> shvAsaM kAsaM tathA~a~alasyamaruciM vAksvaragraham||24|| <br /> <br /> shuklamUtrAkShivarcastvaM kaTurUkShoShNakAmatAm| <br /> <br /> shvayathuM madhurAsyatvamiti [1] pANDvAmayaH kaphAt||25|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Aggravated [[kapha]] by indulging in [[kapha]] increasing diet and regimen gives rise to [[kapha]]ja pandu roga through the pathogenesis described earlier. The sign and symptoms of [[kapha]]ja pandu are heaviness, drowsiness, vomiting, whitish complexion, salivation, horripilation, prostration, fainting, giddiness, mental fatigue, dyspnea, cough, laziness, anorexia, obstruction in speech and voice, whitish coloration of the eyes, urine and feces; longing for pungent, ununctuous and hot things; and develops edema and sweet taste in the mouth [23-25]<br /> <br /> === ''Tridoshaja pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सर्वान्नसेविनः सर्वे दुष्टा दोषास्त्रिदोषजम्| <br /> त्रिदोषलिङ्गं कुर्वन्ति पाण्डुरोगं सुदुःसहम्||२६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sarvānnasēvinaḥ sarvē duṣṭā dōṣāstridōṣajam| <br /> tridōṣaliṅgaṁ kurvanti pāṇḍurōgaṁ suduḥsaham||26|| <br /> <br /> sarvAnnasevinaH sarve duShTA doShAstridoShajam| <br /> tridoShali~ggaM kurvanti pANDurogaM suduHsaham||26|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Indulging in the etiological factors of all the three types of ''pandu'' leads to aggravation of the three [[dosha]] resulting in ''tridoshaja pandu'' with the features of all the three types of ''pandu roga''. This type of ''pandu'' causes much distress to the patient. [26]<br /> <br /> === ''Mrittika bhakshana pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मृत्तिकादनशीलस्य कुप्यत्यन्यतमो मलः| <br /> कषाया मारुतं, पित्तमूषरा, मधुरा कफम्||२७|| <br /> <br /> कोपयेन्मृद्रसादींश्च रौक्ष्याद्भुक्तं विरूक्षयेत् [१] | <br /> पूरयत्यविपक्वैव स्रोतांसि निरुणद्धि च||२८|| <br /> <br /> इन्द्रियाणां बलं हत्वा तेजो वीर्यौजसी तथा| <br /> पाण्डुरोगं करोत्याशु बलवर्णाग्निनाशनम्||२९|| <br /> <br /> शूनगण्डाक्षिकूटभ्रूः [२] शूनपान्नाभिमेहनः| <br /> क्रिमिकोष्ठोऽतिसार्येत मलं सासृक् कफान्वितम्||३०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mr̥ttikādanaśīlasya kupyatyanyatamō malaḥ| <br /> kaṣāyā mārutaṁ, Pittamūṣarā, madhurā Kapham||27|| <br /> <br /> kōpayēnmr̥drasādīṁśca raukṣyādbhuktaṁ virūkṣayēt [1] | <br /> pūrayatyavipakvaiva srōtāṁsi niruṇaddhi ca||28|| <br /> <br /> indriyāṇāṁ balaṁ hatvā tējō vīryaujasī tathā| <br /> pāṇḍurōgaṁ karōtyāśu balavarṇāgnināśanam||29|| <br /> <br /> śūnagaṇḍākṣikūṭabhrūḥ [2] śūnapānnābhimēhanaḥ| <br /> krimikōṣṭhō'tisāryēta malaṁ sāsr̥k kaphānvitam||30|| <br /> <br /> mRuttikAdanashIlasya kupyatyanyatamo malaH| <br /> kaShAyA mArutaM, pittamUSharA, madhurA kapham||27|| <br /> <br /> kopayenmRudrasAdIMshca raukShyAdbhuktaM virUkShayet [1] | <br /> pUrayatyavipakvaiva srotAMsi niruNaddhi ca||28|| <br /> <br /> indriyANAM balaM hatvA tejo vIryaujasI tathA| <br /> pANDurogaM karotyAshu balavarNAgninAshanam||29|| <br /> <br /> shUnagaNDAkShikUTabhrUH [2] shUnapAnnAbhimehanaH| <br /> krimikoShTho~atisAryeta malaM sAsRuk kaphAnvitam||30|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Person indulging in the habitual consumption of clay (''mrittika'') gets [[dosha]] aggravated according to the taste of mud viz. astringent mud aggravates [[vata]], saline and alkaline mud aggravates [[pitta]] and sweet mud aggravates [[kapha]] [[dosha]]. The clay further because of its ununctuousness causes dryness in the [[rasa]] (nutrients of the digested food). The clay due to its undigestable nature fills and blocks the channels of circulation leading to decrease in the sharpness of the senses, luster, energy and [[ojas]] (vital essence of the tissues). This quickly manifesting ''pandu'' results in the loss of strength, complexion and digestive power. Its clinical features are edema of the cheeks, peri orbital edema and edema on the eyebrows area, feet, umbilical region and the pudendum; infestation of worms in the [[koshtha]] (gastrointestinal tract) and loose motions, the stool associated with blood and mucus. [27-30]<br /> <br /> === Prognosis of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगश्चिरोत्पन्नः खरीभूतो न सिध्यति| <br /> कालप्रकर्षाच्छूनो [१] ना यश्च पीतानि पश्यति||३१|| <br /> <br /> बद्धाल्पविट्कं सकफं हरितं योऽतिसार्यते| <br /> दीनः श्वेतातिदिग्धाङ्गश्छर्दिमूर्च्छातृषार्दितः||३२|| <br /> <br /> स नास्त्यसृक्क्षयाद्यश्च पाण्डुः श्वेतत्वमाप्नुयात्| <br /> इति पञ्चविधस्योक्तं पाण्डुरोगस्य लक्षणम्||३३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgaścirōtpannaḥ kharībhūtō na sidhyati| <br /> kālaprakarṣācchūnō [1] nā yaśca pītāni paśyati||31|| <br /> <br /> baddhālpaviṭkaṁ saKaphaṁ haritaṁ yō'tisāryatē| <br /> dīnaḥ śvētātidigdhāṅgaśchardimūrcchātr̥ṣārditaḥ||32|| <br /> <br /> sa nāstyasr̥kkṣayādyaśca pāṇḍuḥ śvētatvamāpnuyāt| <br /> iti pañcavidhasyōktaṁ pāṇḍurōgasya lakṣaṇam||33|| <br /> <br /> pANDurogashcirotpannaH kharIbhUto na sidhyati| <br /> kAlaprakarShAcchUno [1] nA yashca pItAni pashyati||31|| <br /> <br /> baddhAlpaviTkaM sakaphaM haritaM yo~atisAryate| <br /> dInaH shvetAtidigdhA~ggashchardimUrcchAtRuShArditaH||32|| <br /> <br /> sa nAstyasRukkShayAdyashca pANDuH shvetatvamApnuyAt| <br /> iti pa~jcavidhasyoktaM pANDurogasya lakShaNam||33||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Chronic ''pandu roga'' is incurable. Other symptoms indicating the incurability are appearance of excessive dryness and edema; patient visualizes everything as yellow; passes very hard stool or less amount of stool or passes loose stool associated with mucus and green in color; feels exceedingly prostrated; body becomes excessively white as if be smeared with whiteness; has vomiting, fainting and excessive thirst and when the patient develops excessive whiteness in the body as a result of loss of blood.<br /> <br /> Thus, the signs and symptoms of all the five type of ''pandu roga'' have been described. [31-33]<br /> <br /> === ''Koshthashakhashraya kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगी तु योऽत्यर्थं पित्तलानि निषेवते| <br /> तस्य पित्तमसृग्मांसं दग्ध्वा रोगाय कल्पते||३४|| <br /> <br /> हारिद्रनेत्रः स भृशं हारिद्रत्वङ्नखाननः| <br /> रक्तपीतशकृन्मूत्रो भेकवर्णो हतेन्द्रियः||३५|| <br /> <br /> दाहाविपाकदौर्बल्यसदनारुचिकर्षितः| <br /> कामला बहुपित्तैषा कोष्ठशाखाश्रया मता||३६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgī tu yō'tyarthaṁ Pittalāni niṣēvatē| <br /> tasya Pittamasr̥gmāṁsaṁ dagdhvā rōgāya kalpatē||34|| <br /> <br /> hāridranētraḥ sa bhr̥śaṁ hāridratvaṅnakhānanaḥ| <br /> Rakta pītaśakr̥nmūtrō bhēkavarṇō hatēndriyaḥ||35|| <br /> <br /> dāhāvipākadaurbalyasadanārucikarṣitaḥ| <br /> kāmalā bahuPittaiṣā kōṣṭhaśākhāśrayā matā||36|| <br /> <br /> pANDurogI tu yo~atyarthaM pittalAni niShevate| <br /> tasya pittamasRugmAMsaM dagdhvA rogAya kalpate||34|| <br /> <br /> hAridranetraH sa bhRushaM hAridratva~gnakhAnanaH| <br /> raktapItashakRunmUtro bhekavarNo hatendriyaH||35|| <br /> <br /> dAhAvipAkadaurbalyasadanArucikarShitaH| <br /> kAmalA bahupittaiShA koShThashAkhAshrayA matA||36|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If a patient of ''pandu roga'' excessively follows [[pitta]] vitiating diet and regimen, the [[pitta]] so aggravated by involving the [[rakta]] and the [[mamsa dhatu]] causes ''kamala''. Its clinical features are the eyes, skin, nails and face of the patient become exceedingly yellow; stool and urine become reddish-yellow in color; complexion develops a color similar to that of a frog (found in rainy season); the senses get impaired; has burning sensation, indigestion, weakness, prostration and anorexia. This ''kamala'' is caused by excess of [[pitta]] is known as ''koshthashakhashrita'' [34-36]<br /> <br /> === ''Kumbha kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कालान्तरात् खरीभूता कृच्छ्रा स्यात् कुम्भकामला| 36½ |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kālāntarāt kharībhūtā kr̥cchrā syāt kumbhakāmalā| 36½|<br /> <br /> kAlAntarAt kharIbhUtA kRucchrA syAt kumbhakAmalA| 36½|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> With the due course of time the disease (''kamala'') becomes deep seated (''kharibhuta'') resulting in excessive dryness of the body or afflicted tissue and thus becomes difficult to cure. This condition is called ''kumbha kamala'' [36½]<br /> <br /> === Bad prognostic symptoms of ''kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कृष्णपीतशकृन्मूत्रो [१] भृशं शूनश्च मानवः||३७||<br /> <br /> सरक्ताक्षिमुखच्छर्दिविण्मूत्रो यश्च ताम्यति| <br /> दाहारुचितृषानाहतन्द्रामोहसमन्वितः||३८|| <br /> <br /> नष्टाग्निसञ्ज्ञः क्षिप्रं हि कामलावान् विपद्यते|38½| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kr̥ṣṇapītaśakr̥nmūtrō [1] bhr̥śaṁ śūnaśca mānavaḥ||37|| <br /> <br /> saraktākṣimukhacchardiviṇmūtrō yaśca tāmyati| <br /> dāhārucitr̥ṣānāhatandrāmōhasamanvitaḥ||38|| <br /> <br /> naṣṭāgnisañjñaḥ kṣipraṁ hi kāmalāvān vipadyatē|38½|<br /> <br /> kRuShNapItashakRunmUtro [1] bhRushaM shUnashca mAnavaH||37|| <br /> <br /> saraktAkShimukhacchardiviNmUtro yashca tAmyati| <br /> dAhArucitRuShAnAhatandrAmohasamanvitaH||38|| <br /> <br /> naShTAgnisa~jj~jaH kShipraM hi kAmalAvAn vipadyate|38½| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the stool and urine of the patient (of ''kamala'') become black and yellow; develops excessive edema; eyes and face becomes red colored; vomit, stool and urine are mixed with blood; the patient feels like going in darkness; has burning sensation, anorexia, morbid thirst, constipation, drowsiness and fainting; and the person looses his [[agni]] and consciousness; such patient may succumb to death quickly [37-38½]<br /> <br /> === Principles of treatment ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> साध्यानामितरेषां तु प्रवक्ष्यामि चिकित्सितम्||३९|| <br /> <br /> तत्र पाण्ड्वामयी स्निग्धस्तीक्ष्णैरूर्ध्वानुलोमिकैः| <br /> संशोध्यो मृदुभिस्तिक्तैः कामली तु विरेचनैः||४०|| <br /> <br /> ताभ्यां संशुद्धकोष्ठाभ्यां पथ्यान्यन्नानि दापयेत्| <br /> शालीन् सयवगोधूमान् पुराणान् यूषसंहितान्||४१|| <br /> <br /> मुद्गाढकीमसूरैश्च जाङ्गलैश्च रसैर्हितैः| <br /> यथादोषं विशिष्टं च तयोर्भैषज्यमाचरेत्||४२|| <br /> <br /> पञ्चगव्यं महातिक्तं कल्याणकमथापि वा| <br /> स्नेहनार्थं घृतं दद्यात् कामलापाण्डुरोगिणे||४३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sādhyānāmitarēṣāṁ tu pravakṣyāmi cikitsitam||39|| <br /> <br /> tatra pāṇḍvāmayī snigdhastīkṣṇairūrdhvānulōmikaiḥ| <br /> saṁśōdhyō mr̥dubhistiktaiḥ kāmalī tu virēcanaiḥ||40|| <br /> <br /> tābhyāṁ saṁśuddhakōṣṭhābhyāṁ pathyānyannāni dāpayēt| <br /> śālīn sayavagōdhūmān purāṇān yūṣasaṁhitān||41|| <br /> <br /> mudgāḍhakīmasūraiśca jāṅgalaiśca rasairhitaiḥ| <br /> yathādōṣaṁ viśiṣṭaṁ ca tayōrbhaiṣajyamācarēt||42|| <br /> <br /> pañcagavyaṁ mahātiktaṁ kalyāṇakamathāpi vā| <br /> snēhanārthaṁ ghr̥taṁ dadyāt kāmalāpāṇḍurōgiṇē||43|| <br /> <br /> sAdhyAnAmitareShAM tu pravakShyAmi cikitsitam||39|| <br /> <br /> tatra pANDvAmayI snigdhastIkShNairUrdhvAnulomikaiH| <br /> saMshodhyo mRudubhistiktaiH kAmalI tu virecanaiH||40|| <br /> <br /> tAbhyAM saMshuddhakoShThAbhyAM pathyAnyannAni dApayet| <br /> shAlIn sayavagodhUmAn purANAn yUShasaMhitAn||41|| <br /> <br /> mudgADhakImasUraishca jA~ggalaishca rasairhitaiH| <br /> yathAdoShaM vishiShTaM ca tayorbhaiShajyamAcaret||42|| <br /> <br /> pa~jcagavyaM mahAtiktaM kalyANakamathApi vA| <br /> snehanArthaM ghRutaM dadyAt kAmalApANDurogiNe||43|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now, the treatment for the curable types of ''pandu roga'' is being described here:<br /> <br /> The patient suffering from the ''pandu'' should first be given strong (''tikshna'') emetic and purgation therapies after the administration of internal oleation ([[snehana]]) for cleansing of the body (''shodhana''). <br /> <br /> On the other hand, patient of ''kamala'' should be given mild purgation therapy with bitter drugs. After the cleansing of the ''koshtha'' by the above procedures the patient of both of these diseases should be given wholesome food consisting of old ''shali'' rice, barley and wheat mixed with the ''yusha'' (vegetable soup) of ''mudga, adhaki'' and ''masura'', and the ''rasa'' (meat soup) of animals inhabiting the arid zone. <br /> <br /> On the basis of the aggravated [[dosha]] specific medicines are to be administered to the patients of these two categories (which will be described later in the chapter). For the oleation of the patient of ''pandu'' and ''kamala panchagavya ghrita, mahatikta ghrita'' and ''kalyanaka ghrita'' should be given [39-43]<br /> <br /> === ''Dadimadya ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दाडिमात् कुडवो धान्यात् कुडवार्धं पलं पलम्| <br /> चित्रकाच्छृङ्गवेराच्च पिप्पल्यष्टमिका तथा||४४|| <br /> <br /> तैः कल्कैर्विंशतिपलं घृतस्य सलिलाढके|<br /> सिद्धं हृत्पाण्डुगुल्मार्शःप्लीहवातकफार्तिनुत्||४५|| <br /> <br /> दीपनं श्वासकासघ्नं मूढवाते च शस्यते| <br /> दुःखप्रसविनीनां च वन्ध्यानां चैव गर्भदम्||४६|| <br /> <br /> इति दाडिमाद्यं घृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dāḍimāt kuḍavō dhānyāt kuḍavārdhaṁ palaṁ palam| <br /> citrakācchr̥ṅgavērācca pippalyaṣṭamikā tathā||44|| <br /> <br /> taiḥ kalkairviṁśatipalaṁ ghr̥tasya salilāḍhakē| <br /> siddhaṁ hr̥tpāṇḍugulmārśaḥplīhaVātakaphārtinut||45|| <br /> <br /> dīpanaṁ śvāsakāsaghnaṁ mūḍhavātē ca śasyatē| <br /> duḥkhaprasavinīnāṁ ca vandhyānāṁ caiva garbhadam||46|| <br /> <br /> iti dāḍimādyaṁ ghr̥tam| <br /> <br /> dADimAt kuDavo dhAnyAt kuDavArdhaM palaM palam| <br /> citrakAcchRu~ggaverAcca pippalyaShTamikA tathA||44|| <br /> <br /> taiH kalkairviMshatipalaM ghRutasya salilADhake| <br /> siddhaM hRutpANDugulmArshaHplIhavAtakaphArtinut||45|| <br /> <br /> dIpanaM shvAsakAsaghnaM mUDhavAte ca shasyate| <br /> duHkhaprasavinInAM ca vandhyAnAM caiva garbhadam||46|| <br /> <br /> iti dADimAdyaM ghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take twenty ''pala'' of ghee, one ''adhaka'' of water and add to it the paste prepared of one ''kudava'' of ''dadima'', half ''kudava'' of ''dhanya'', one ''pala'' each of ''chitraka'' and ''sringavera'' and one ''ashtamika'' (two ''karsha'') of ''pippali'' and prepare ghee as per method of ''sneha paka''.This medicated ghee stimulates the power of digestion. It cures heart disease, anemia, gulma, hemorrhoids, spleenomegaly and disorders of [[vata]] and [[kapha]].It is also useful for curing asthma, bronchitis, ''mudha-vata'' (claudication of [[vata]]) and ''duhkha-prasava'' (difficult labor). It also helps a sterile woman to get offspring.<br /> <br /> Thus, ends the description of ''dadimadyaghrita'' [44-46]<br /> <br /> === ''Katukadyam ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कटुका रोहिणी मुस्तं हरिद्रे वत्सकात् पलम्| <br /> पटोलं चन्दनं मूर्वा त्रायमाणा दुरालभा||४७|| <br /> <br /> कृष्णा पर्पटको निम्बो भूनिम्बो देवदारु च| <br /> तैः कार्षिकैर्घृतप्रस्थः सिद्धः क्षीरचतुर्गुणः||४८|| <br /> <br /> रक्तपित्तं ज्वरं दाहं श्वयथुं स भगन्दरम्| <br /> अर्शांस्यसृग्दरं चैव हन्ति विस्फोटकांस्तथा||४९|| <br /> <br /> इति कटुकाद्यं घृतम्|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭukā rōhiṇī mustaṁ haridrē vatsakāt palam| <br /> paṭōlaṁ candanaṁ mūrvā trāyamāṇā durālabhā||47|| <br /> <br /> kr̥ṣṇā parpaṭakō nimbō bhūnimbō dēvadāru ca| <br /> taiḥ kārṣikairghr̥taprasthaḥ siddhaḥ kṣīracaturguṇaḥ||48|| <br /> <br /> Rakta Pittaṁ jvaraṁ dāhaṁ śvayathuṁ sa bhagandaram| <br /> arśāṁsyasr̥gdaraṁ caiva hanti visphōṭakāṁstathā||49|| <br /> <br /> iti Kaṭukādyam Ghritam| <br /> <br /> kaTukA rohiNI mustaM haridre vatsakAt palam| <br /> paTolaM candanaM mUrvA trAyamANA durAlabhA||47|| <br /> <br /> kRuShNA parpaTako nimbo bhUnimbo devadAru ca| <br /> taiH kArShikairghRutaprasthaH siddhaH kShIracaturguNaH||48|| <br /> <br /> raktapittaM jvaraM dAhaM shvayathuM sa bhagandaram| <br /> arshAMsyasRugdaraM caiva hanti visphoTakAMstathA||49|| <br /> <br /> iti kaTukAdyaM ghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''pala'' each of ''katukarohini, musta, haridra, daruharidra, vatsaka'' in paste form, one ''karsha'' of each of ''patola, chandana, murva, trayamana, duralabha, krishna, parpataka, nimba, bhūnimba, devadaru'' should be added to one ''prastha'' of ''ghrita'' and four ''prasthas'' of milk. This medicated ghee cures ''raktapitta, jwara, daha, svayathu, bhagandara, arsha, asrigadara'' and ''visphotaka''. Thus described ''katukadya ghritam'' [47-49]<br /> <br /> === ''Pathya ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पथ्याशतरसे पथ्यावृन्तार्धशतकल्कवान्| <br /> प्रस्थः सिद्धो घृतात् पेयः स पाण्ड्वामयगुल्मनुत्||५०|| <br /> <br /> इति पथ्याघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pathyāśatarasē pathyāvr̥ntārdhaśatakalkavān| <br /> prasthaḥ siddhō ghr̥tāt pēyaḥ sa pāṇḍvāmayagulmanut||50|| <br /> <br /> iti pathyāghr̥tam|<br /> <br /> pathyAshatarase pathyAvRuntArdhashatakalkavAn| <br /> prasthaH siddho ghRutAt peyaH sa pANDvAmayagulmanut||50|| <br /> <br /> iti pathyAghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The decoction of one hundred fruits of ''haritaki'' and the paste of fifty stalks of ''haritaki'' fruits should be added to one ''prastha'' of ghee and cooked. This medicated ghee cures ''pandu'' and ''gulma'' [50]<br /> <br /> === ''Danti ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दन्त्याश्चतुष्पलरसे पिष्टैर्दन्तीशलाटुभिः| <br /> तद्वत्प्रस्थो घृतात्सिद्धः प्लीहपाण्ड्वर्तिशोफजित्||५१|| <br /> <br /> इति दन्तीघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dantyāścatuṣpalarasē piṣṭairdantīśalāṭubhiḥ| <br /> tadvatprasthō ghr̥tātsiddhaḥ plīhapāṇḍvartiśōphajit||51|| <br /> <br /> iti dantīghr̥tam| <br /> <br /> dantyAshcatuShpalarase piShTairdantIshalATubhiH| <br /> tadvatprastho ghRutAtsiddhaH plIhapANDvartishophajit||51|| <br /> <br /> iti dantIghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of ghee should be cooked by adding (one ''prastha'' of) the decoction of four ''palas'' of ''danti'' and the paste of the green fruits of ''danti''. Intake of this medicated ghee cures ''pleeha'' (splenic disorders), ''pandu'' and edema [51]<br /> <br /> === ''Drakshaghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुराणसर्पिषः प्रस्थो द्राक्षार्धप्रस्थसाधितः| <br /> कामलागुल्मपाण्ड्वर्तिज्वरमेहोदरापहः||५२|| <br /> <br /> इति द्राक्षाघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> purāṇasarpiṣaḥ prasthō drākṣārdhaprasthasādhitaḥ| <br /> kāmalāgulmapāṇḍvartijvaramēhōdarāpahaḥ||52|| <br /> <br /> iti drākṣāghr̥tam| <br /> <br /> purANasarpiShaH prastho drAkShArdhaprasthasAdhitaH| <br /> kAmalAgulmapANDvartijvaramehodarApahaH||52|| <br /> <br /> iti drAkShAghRutam|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of old ghee should be added to half a ''prastha'' of ''draksha'' and cooked. This medicated ghee cures ''kamala, gulma, pandu, jwara, meha'' (polyuria) and ''udara roga'' (generalized abdominal enlargement)[52]<br /> <br /> === ''Haridradi ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> हरिद्रात्रिफलानिम्बबलामधुकसाधितम्| <br /> सक्षीरं माहिषं सर्पिः कामलाहरमुत्तमम्||५३|| <br /> <br /> इति हरिद्रादिघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> haridrātriphalānimbabalāmadhukasādhitam| <br /> sakṣīraṁ māhiṣaṁ sarpiḥ kāmalāharamuttamam||53||<br /> <br /> iti haridrādighr̥tam|<br /> <br /> haridrAtriphalAnimbabalAmadhukasAdhitam| <br /> sakShIraM mAhiShaM sarpiH kAmalAharamuttamam||53||<br /> <br /> iti haridrAdighRutam|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Ghrita'' prepared with ''haridra, triphala, nimba, balā, madhuka'' and buffalo’s milk and ghee is an excellent cure for ''kamala'' [53]<br /> <br /> === ''Darvyadi ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गोमूत्रे द्विगुणे दार्व्याः कल्काक्षद्वयसाधितः| <br /> दार्व्याः पञ्चपलक्वाथे कल्के कालीयके परः||५४|| <br /> <br /> माहिषात् सर्पिषः प्रस्थः पूर्वः पूर्वे परे परः|५५| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gōmūtrē dviguṇē dārvyāḥ kalkākṣadvayasādhitaḥ| <br /> dārvyāḥ pañcapalakvāthē kalkē kālīyakē paraḥ||54|| <br /> <br /> māhiṣāt sarpiṣaḥ prasthaḥ pūrvaḥ pūrvē parē paraḥ|55|<br /> <br /> gomUtre dviguNe dArvyAH kalkAkShadvayasAdhitaH| <br /> dArvyAH pa~jcapalakvAthe kalke kAlIyake paraH||54|| <br /> <br /> mAhiShAt sarpiShaH prasthaH pUrvaH pUrve pare paraH|55|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of buffalo’s ghee prepared by adding two ''prasthas'' of cow’s urine and the paste of two ''aksha'' of the paste of ''darvi'' as per ''sneha kalpana'' cures ''pandu roga''.<br /> <br /> One ''prastha'' of buffalo’s ghee prepared by adding with the decoction of five ''palas'' of ''darvi'' and the paste of ''kaleeyaka'' as per ''sneha kalpana'' cures ''kamala'' [54-55]<br /> <br /> === Preparations for ''pandu roga'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्नेहैरेभिरुपक्रम्य स्निग्धं मत्वा विरेचयेत्||५५|| <br /> <br /> पयसा मूत्रयुक्तेन बहुशः केवलेन वा| <br /> दन्तीफलरसे कोष्णे काश्मर्याञ्जलिना शृतम्||५६|| <br /> <br /> द्राक्षाञ्जलिं मृदित्वा वा दद्यात् पाण्ड्वामयापहम्| <br /> द्विशर्करं त्रिवृच्चूर्णं पलार्धं पैत्तिकः पिबेत्||५७|| <br /> <br /> कफपाण्डुस्तु गोमूत्रक्लिन्नयुक्तां [१] हरीतकीम्| <br /> आरग्वधं [२] रसेनेक्षोर्विदार्यामलकस्य च||५८||<br /> <br /> सत्र्यूषणं बिल्वपत्रं पिबेन्ना कामलापहम्| <br /> दन्त्यर्धपलकल्कं वा द्विगुडं शीतवारिणा||५९|| <br /> <br /> कामली त्रिवृतां वाऽपि त्रिफलाया रसैः पिबेत्| <br /> विशालात्रिफलामुस्तकुष्ठदारुकलिङ्गकान्||६०|| <br /> <br /> कार्षिकानर्धकर्षांशां कुर्यादतिविषां तथा| <br /> कर्षौ मधुरसाया द्वौ सर्वमेतत् [३] सुखाम्बुना||६१|| <br /> <br /> मृदितं तं रसं पूतं पीत्वा लिह्याच्च मध्वनु| <br /> कासं श्वासं ज्वरं दाहं पाण्डुरोगमरोचकम्||६२|| <br /> <br /> गुल्मानाहामवातांश्च रक्तपित्तं च नाशयेत्| <br /> त्रिफलाया गुडूच्या वा दार्व्या निम्बस्य वा रसम्||६३|| <br /> <br /> शीतं मधुयुतं प्रातः कामलार्तः पिबेन्नरः| <br /> क्षीरमूत्रं पिबेत् पक्षं गव्यं माहिषमेव वा||६४|| <br /> <br /> पाण्डुर्गोमूत्रयुक्तं वा सप्ताहं त्रिफलारसम्| <br /> तरुजान् ज्वलितान्मूत्रे निर्वाप्यामृद्य चाङ्कुरान्||६५|| <br /> <br /> मातुलुङ्गस्य तत् पूतं पाण्डुशोथहरं पिबेत्| <br /> स्वर्णक्षीरी त्रिवृच्छ्यामे भद्रदारु सनागरम्||६६|| <br /> <br /> गोमूत्राञ्जलिना पिष्टं मूत्रे वा क्वथितं पिबेत्| <br /> क्षीरमेभिः शृतं वाऽपि पिबेद्दोषानुलोमनम्||६७|| <br /> <br /> हरीतकीं प्रयोगेण गोमूत्रेणाथवा पिबेत्| <br /> जीर्णे क्षीरेण भुञ्जीत रसेन मधुरेण वा||६८|| <br /> <br /> सप्तरात्रं गवां मूत्रे भावितं वाऽप्ययोरजः| <br /> पाण्डुरोगप्रशान्त्यर्थं पयसा पाययेद्भिषक्||६९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snēhairēbhirupakramya snigdhaṁ matvā virēcayēt||55|| <br /> <br /> payasā mūtrayuktēna bahuśaḥ kēvalēna vā| <br /> dantīphalarasē kōṣṇē kāśmaryāñjalinā śr̥tam||56|| <br /> <br /> drākṣāñjaliṁ mr̥ditvā vā dadyāt pāṇḍvāmayāpaham| <br /> dviśarkaraṁ trivr̥ccūrṇaṁ palārdhaṁ paittikaḥ pibēt||57|| <br /> <br /> Kaphapāṇḍustu gōmūtraklinnayuktāṁ [1] harītakīm| <br /> āragvadhaṁ [2] rasēnēkṣōrvidāryāmalakasya ca||58|| <br /> <br /> satryūṣaṇaṁ bilvapatraṁ pibēnnā kāmalāpaham| <br /> dantyardhapalakalkaṁ vā dviguḍaṁ śītavāriṇā||59|| <br /> <br /> kāmalī trivr̥tāṁ vā'pi triphalāyā rasaiḥ pibēt| <br /> viśālātriphalāmustakuṣṭhadārukaliṅgakān||60|| <br /> <br /> kārṣikānardhakarṣāṁśāṁ kuryādativiṣāṁ tathā| <br /> karṣau madhurasāyā dvau sarvamētat [3] sukhāmbunā||61|| <br /> <br /> mr̥ditaṁ taṁ rasaṁ pūtaṁ pītvā lihyācca madhvanu| <br /> kāsaṁ śvāsaṁ jvaraṁ dāhaṁ pāṇḍurōgamarōcakam||62|| <br /> <br /> gulmānāhāmavātāṁśca Rakta Pittaṁ ca nāśayēt| <br /> triphalāyā guḍūcyā vā dārvyā nimbasya vā rasam||63|| <br /> <br /> śītaṁ madhuyutaṁ prātaḥ kāmalārtaḥ pibēnnaraḥ| <br /> kṣīramūtraṁ pibēt pakṣaṁ gavyaṁ māhiṣamēva vā||64|| <br /> <br /> pāṇḍurgōmūtrayuktaṁ vā saptāhaṁ triphalārasam| <br /> tarujān jvalitānmūtrē nirvāpyāmr̥dya cāṅkurān||65|| <br /> <br /> mātuluṅgasya tat pūtaṁ pāṇḍuśōthaharaṁ pibēt| <br /> svarṇakṣīrī trivr̥cchyāmē bhadradāru sanāgaram||66|| <br /> <br /> gōmūtrāñjalinā piṣṭaṁ mūtrē vā kvathitaṁ pibēt| <br /> kṣīramēbhiḥ śr̥taṁ vā'pi pibēddōṣānulōmanam||67|| <br /> <br /> harītakīṁ prayōgēṇa gōmūtrēṇāthavā pibēt| <br /> jīrṇē kṣīrēṇa bhuñjīta rasēna madhurēṇa vā||68|| <br /> <br /> saptarātraṁ gavāṁ mūtrē bhāvitaṁ vā'pyayōrajaḥ| <br /> pāṇḍurōgapraśāntyarthaṁ payasā pāyayēdbhiṣak||69||<br /> <br /> snehairebhirupakramya snigdhaM matvA virecayet||55|| <br /> <br /> payasA mUtrayuktena bahushaH kevalena vA| <br /> dantIphalarase koShNe kAshmaryA~jjalinA shRutam||56|| <br /> <br /> drAkShA~jjaliM mRuditvA vA dadyAt pANDvAmayApaham| <br /> dvisharkaraM trivRuccUrNaM palArdhaM paittikaH pibet||57|| <br /> <br /> kaphapANDustu gomUtraklinnayuktAM [1] harItakIm| <br /> AragvadhaM [2] rasenekShorvidAryAmalakasya ca||58|| <br /> <br /> satryUShaNaM bilvapatraM pibennA kAmalApaham| <br /> dantyardhapalakalkaM vA dviguDaM shItavAriNA||59|| <br /> <br /> kAmalI trivRutAM vA~api triphalAyA rasaiH pibet| <br /> vishAlAtriphalAmustakuShThadArukali~ggakAn||60|| <br /> <br /> kArShikAnardhakarShAMshAM kuryAdativiShAM tathA| <br /> karShau madhurasAyA dvau sarvametat [3] sukhAmbunA||61|| <br /> <br /> mRuditaM taM rasaM pUtaM pItvA lihyAcca madhvanu| <br /> kAsaM shvAsaM jvaraM dAhaM pANDurogamarocakam||62|| <br /> <br /> gulmAnAhAmavAtAMshca raktapittaM ca nAshayet| <br /> triphalAyA guDUcyA vA dArvyA nimbasya vA rasam||63||<br /> <br /> shItaM madhuyutaM prAtaH kAmalArtaH pibennaraH| <br /> kShIramUtraM pibet pakShaM gavyaM mAhiShameva vA||64|| <br /> <br /> pANDurgomUtrayuktaM vA saptAhaM triphalArasam| <br /> tarujAn jvalitAnmUtre nirvApyAmRudya cA~gkurAn||65|| <br /> <br /> mAtulu~ggasya tat pUtaM pANDushothaharaM pibet| <br /> svarNakShIrI trivRucchyAme bhadradAru sanAgaram||66|| <br /> <br /> gomUtrA~jjalinA piShTaM mUtre vA kvathitaM pibet| <br /> kShIramebhiH shRutaM vA~api pibeddoShAnulomanam||67|| <br /> <br /> harItakIM prayogeNa gomUtreNAthavA pibet| <br /> jIrNe kShIreNa bhu~jjIta rasena madhureNa vA||68|| <br /> <br /> saptarAtraM gavAM mUtre bhAvitaM vA~apyayorajaH| <br /> pANDurogaprashAntyarthaM payasA pAyayedbhiShak||69|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After proper oleation of the patient with the internal administration of the above described medicated ''ghrita,'' the patient should be given frequent medication with the following recipes: <br /> <br /> Milk with cow’s urine or milk alone or lukewarm infusion of ''danti'' sprinkled with the powder of one ''anjali'' of ''kashmarya'' or mixed with the paste of one ''anjali'' (handful) of ''draksha''; all these drugs cure ''pandu roga'' in general.<br /> <br /> The patient suffering from ''paittika pandu'' should take half ''pala'' of ''trivitta'' mixed with one ''pala'' of sugar; <br /> <br /> ''Kaphaja'' type of ''pandu'' patient should take ''haritaki churna'' immersed in cow’s urine. <br /> <br /> ''Kamala'' patient should take ''aragvadha'' along with the juice of sugarcane, ''vidari, amalaki'' to which ''sunthi, maricha, pippali'' and ''bilva'' leaves have been added; or may take the paste of half ''pala'' of ''danti'' mixed with one ''pala'' of jaggery along with cold water; or may take ''trivritta'' along with decoction of ''triphala''. <br /> <br /> ''Vishaladi phanta'' – One ''karsha'' each of ''vishala, haritaki, bibhitaka, amalaki, musta, kushtha, devadaru'' and ''kalingaka''; half ''karsha'' of ''ativisha'', two ''karsha'' of ''madhurasa'' (''murva'') should be made to a paste by triturating with lukewarm water and strained. The patient should take honey after taking this infusion. This ''phanta'' cures cough, dyspnea, fever, burning sensation, ''pandu roga'', anorexia, ''gulma'' (lumps in abdomen), ''anaha'' (gaseous distention of the abdomen), ''amavata'' (joint disorders caused by ''ama''), and ''raktapitta'' (bleeding disorders).<br /> <br /> Other drugs which are useful for these ailments are as follows: <br /> *''Kamala'' patients should take the decoction of ''triphala, guduchi, devadaru,'' or ''nimba'' after cooling and adding honey in the morning.<br /> *''Pandu'' patient may take the milk or urine of either cow or buffalo for one fortnight.<br /> *''Pandu'' patient may drink the decoction of ''triphala'' along with cow’s urine for one week.<br /> *Patient suffering from ''pandu'' and ''sopha'' (edema) should drink the liquid obtained by straining the paste of tender branches of ''matulunga'' set afire and then immersed in cow’s urine.<br /> *''Suvarnakshiri, trivritta, syama-trivritta, bhadradaru'' and ''nagara'' should be triturated by adding one ''anjali'' of cow’s urine or should be made to a decoction by adding cow’s urine. The above mentioned drugs may also be boiled with milk. The drinking of these drugs brings about the downward motion of the ''doshas'' causing ''pandu''.<br /> *Then again, the patient suffering from ''pandu roga'' should take a course of ''haritaki'' with cow’s urine (for seven days) and then should take food either with milk or sweetened meat soup, and <br /> *Physicians should give ''lauha bhasma'' impregnated for seven nights with cow’s urine along with milk for the alleviation of ''pandu roga'' [55-69]<br /> <br /> === ''Navayasa churnam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्र्यूषणत्रिफलामुस्तविडङ्गचित्रकाः समाः| <br /> नवायोरजसो भागास्तच्चूर्णं क्षौद्रसर्पिषा||७०|| <br /> <br /> भक्षयेत् पाण्डुहृद्रोगकुष्ठार्शःकामलापहम्| <br /> नवायसमिदं चूर्णं कृष्णात्रेयेण भाषितम्||७१|| <br /> <br /> इति नवायसचूर्णम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tryūṣaṇatriphalāmustaviḍaṅgacitrakāḥ samāḥ| <br /> navāyōrajasō bhāgāstaccūrṇaṁ kṣaudrasarpiṣā||70|| <br /> <br /> bhakṣayēt pāṇḍuhr̥drōgakuṣṭhārśaḥkāmalāpaham| <br /> navāyasamidaṁ cūrṇaṁ kr̥ṣṇātrēyēṇa bhāṣitam||71|| <br /> <br /> iti navāyasacūrṇam| <br /> <br /> tryUShaNatriphalAmustaviDa~ggacitrakAH samAH| <br /> navAyorajaso bhAgAstaccUrNaM kShaudrasarpiShA||70|| <br /> <br /> bhakShayet pANDuhRudrogakuShThArshaHkAmalApaham| <br /> navAyasamidaM cUrNaM kRuShNAtreyeNa bhAShitam||71|| <br /> <br /> iti navAyasacUrNam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take ''sunthi, pippali, maricha, haritaki, bibhitaki, amalaki, musta, vidanga'' and ''chitraka'' in one part each and nine parts of ''lauha bhasma'' and mix together. Intake of this recipe along with honey and ghee cures anemia, heart diseases, ''kushtha'' (group of skin diseases), ''arsha'' (hemorrhoids) and ''kamala''. This medicine propounded by ''krishnatreya'' is called ''navayasa churna'' [70-71]<br /> <br /> === ''Mandura vataka'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुडनागरमण्डूरतिलांशान्मानतः समान्| <br /> पिप्पलीद्विगुणां कुर्याद्गुटिकां पाण्डुरोगिणे||७२|| <br /> <br /> त्र्यूषणं त्रिफला मुस्तं विडङ्गं चव्यचित्रकौ| <br /> दार्वीत्वङ्माक्षिको धातुर्ग्रन्थिकं देवदारु च||७३|| <br /> <br /> एतान् द्विपलिकान्भागांश्चूर्णं कुर्यात् पृथक् पृथक्| <br /> मण्डूरं द्विगुणं चूर्णाच्छुद्धमञ्जनसन्निभम्||७४|| <br /> <br /> गोमूत्रेऽष्टगुणे पक्त्वा तस्मिंस्तत् प्रक्षिपेत्ततः| <br /> उदुम्बरसमान्कृत्वा वटकांस्तान् यथाग्नि ना||७५|| <br /> <br /> उपयुञ्जीत तक्रेण सात्म्यं जीर्णे च भोजनम्| <br /> मण्डूरवटका ह्येते प्राणदाः पाण्डुरोगिणाम्||७६|| <br /> <br /> कुष्ठान्यजीर्णकं शोथमूरुस्तम्भं कफामयान्| <br /> अर्शांसि कामलां मेहं प्लीहानं शमयन्ति च||७७|| <br /> <br /> इति मण्डूरवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> guḍanāgaramaṇḍūratilāṁśānmānataḥ samān| <br /> pippalīdviguṇāṁ kuryādguṭikāṁ pāṇḍurōgiṇē||72|| <br /> <br /> tryūṣaṇaṁ triphalā mustaṁ viḍaṅgaṁ cavyacitrakau| <br /> dārvītvaṅmākṣikō Dhāturgranthikaṁ dēvadāru ca||73|| <br /> <br /> ētān dvipalikānbhāgāṁścūrṇaṁ kuryāt pr̥thak pr̥thak| <br /> maṇḍūraṁ dviguṇaṁ cūrṇācchuddhamañjanasannibham||74|| <br /> <br /> gōmūtrē'ṣṭaguṇē paktvā tasmiṁstat prakṣipēttataḥ| <br /> udumbarasamānkr̥tvā vaṭakāṁstān yathāgni nā||75|| <br /> <br /> upayuñjīta takrēṇa sātmyaṁ jīrṇē ca bhōjanam| <br /> maṇḍūravaṭakā hyētē prāṇadāḥ pāṇḍurōgiṇām||76|| <br /> <br /> kuṣṭhānyajīrṇakaṁ śōthamūrustambhaṁ kaphāmayān| <br /> arśāṁsi kāmalāṁ mēhaṁ plīhānaṁ śamayanti ca||77|| <br /> <br /> iti maṇḍūravaṭakāḥ| <br /> <br /> guDanAgaramaNDUratilAMshAnmAnataH samAn| <br /> pippalIdviguNAM kuryAdguTikAM pANDurogiNe||72|| <br /> <br /> tryUShaNaM triphalA mustaM viDa~ggaM cavyacitrakau| <br /> dArvItva~gmAkShiko dhAturgranthikaM devadAru ca||73|| <br /> <br /> etAn dvipalikAnbhAgAMshcUrNaM kuryAt pRuthak pRuthak| <br /> maNDUraM dviguNaM cUrNAcchuddhama~jjanasannibham||74|| <br /> <br /> gomUtre~aShTaguNe paktvA tasmiMstat prakShipettataH| <br /> udumbarasamAnkRutvA vaTakAMstAn yathAgni nA||75|| <br /> <br /> upayu~jjIta takreNa sAtmyaM jIrNe ca bhojanam| <br /> maNDUravaTakA hyete prANadAH pANDurogiNAm||76|| <br /> <br /> kuShThAnyajIrNakaM shothamUrustambhaM kaphAmayAn| <br /> arshAMsi kAmalAM mehaM plIhAnaM shamayanti ca||77|| <br /> <br /> iti maNDUravaTakAH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Mandura vataka'' – jaggery, ''shunthi, mandura'' and ''tila'' in one part each along with two parts of ''pippali'' should be triturated and made in the form of pills. This medicine is suitable for the treatment of the patients with ''pandu roga''.<br /> <br /> ''Shunthi, pippali, maricha, haritaki, bibhitaki, amalaki, musta, vidanga, chavya, chitraka,'' bark of ''daruharidra, makshika'' (copper pyrite), ''pippalimoola'' and ''devadaru'' in the quantity of two ''pala'' each should be made to powders separately.<br /> <br /> ''Mandura bhasma'' which is dark in color like collyrium, should be cooked by adding eight times of cow’s urine and the powders of the above drugs should be mixed to this. ''Vatakas'' (large sized pills) of the size of ''udumbara'' should be made out of this combination. This should be taken by the patient in the appropriate doses according to his [[agni]] (power of digestion and metabolism) along with butter milk. The patient should take wholesome food after its digestion. These pills named as ''mandura vataka'' are the life givers for the patients of ''pandu''. It also cures ''kushtha, ajeerna'' (indigestion), ''sotha'' (edema), ''urustambha'' (stiffening of the thighs), disease caused by aggravation of the [[kapha]], arsha'' (hemorrhoids), ''kamala'' (jaundice), ''meha'' (polyuria) and ''pleeha'' (splenic diseases).<br /> <br /> Thus ends the description of two types of ''mandura vataka''.[72-77]<br /> <br /> === ''Tapayadi lauha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ताप्याद्रिजतुरूप्यायोमलाः पञ्चपलाः पृथक्| <br /> चित्रकत्रिफलाव्योषविडङ्गैः पलिकैः सह||७८|| <br /> <br /> शर्कराष्टपलोन्मिश्राश्चूर्णिता मधुनाऽऽप्लुताः| <br /> अभ्यस्यास्त्वक्षमात्रा हि जीर्णे हितमिताशिना||७९|| <br /> <br /> कुलत्थकाकमाच्यादिकपोतपरिहारिणा|८०| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tāpyādrijaturūpyāyōmalāḥ pañcapalāḥ pr̥thak| <br /> citrakatriphalāvyōṣaviḍaṅgaiḥ palikaiḥ saha||78|| <br /> <br /> śarkarāṣṭapalōnmiśrāścūrṇitā madhunā''plutāḥ| <br /> abhyasyāstvakṣamātrā hi jīrṇē hitamitāśinā||79|| <br /> <br /> kulatthakākamācyādikapōtaparihāriṇā|80| <br /> <br /> tApyAdrijaturUpyAyomalAH pa~jcapalAH pRuthak| <br /> citrakatriphalAvyoShaviDa~ggaiH palikaiH saha||78|| <br /> <br /> sharkarAShTapalonmishrAshcUrNitA madhunA~a~aplutAH| <br /> abhyasyAstvakShamAtrA hi jIrNe hitamitAshinA||79|| <br /> <br /> kulatthakAkamAcyAdikapotaparihAriNA|80|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Tapyadi yoga'' – ''Tapya, shilajatu,'' silver, ''mandura'' in the amount of five ''pala'' each should be added to one ''pala'' each of ''chitraka, haritaki, bibhitaka, amalaki, sunthi, pippali, maricha'' and ''vidanga''; and eight ''pala'' of sugar. This recipe should be taken by the patient habitually (by a ''pandu rogi'') in the dose of one ''karsha'' along with adequate amount of honey. After the digestion of this drug the patient should take wholesome food in small quantity and should avoid using ''kulattha, kakamachi'' etc. and pigeon meat [78-80]<br /> <br /> === ''Yogaraja'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिफलायास्त्रयो भागास्त्रयस्त्रिकटुकस्य च||८०|| <br /> <br /> भागश्चित्रकमूलस्य विडङ्गानां तथैव च| <br /> पञ्चाश्मजतुनो भागास्तथा रूप्यमलस्य च||८१|| <br /> <br /> माक्षिकस्य च शुद्धस्य लौहस्य रजसस्तथा| <br /> अष्टौ भागाः सितायाश्च तत्सर्वं सूक्ष्मचूर्णितम्||८२|| <br /> <br /> माक्षिकेणाप्लुतं स्थाप्यमायसे भाजने शुभे| <br /> उदुम्बरसमां मात्रां ततः खादेद्यथाग्नि ना||८३|| <br /> <br /> दिने दिने प्रयुञ्जीत जीर्णे भोज्यं यथेप्सितम्| <br /> वर्जयित्वा कुलत्थानि काकमाचीं कपोतकम्||८४||<br /> <br /> योगराज इति ख्यातो योगोऽयममृतोपमः| <br /> रसायनमिदं श्रेष्ठं सर्वरोगहरं शिवम्||८५|| <br /> <br /> पाण्डुरोगं विषं कासं यक्ष्माणं विषमज्वरम्| <br /> कुष्ठान्यजीर्णकं मेहं शोषं श्वासमरोचकम्||८६|| <br /> <br /> विशेषाद्धन्त्यपस्मारं कामलां गुदजानि च| <br /> <br /> इति योगराजः|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> triphalāyāstrayō bhāgāstrayastrikaṭukasya ca||80|| <br /> <br /> bhāgaścitrakamūlasya viḍaṅgānāṁ tathaiva ca| <br /> pañcāśmajatunō bhāgāstathā rūpyamalasya ca||81|| <br /> <br /> mākṣikasya ca śuddhasya lauhasya rajasastathā| <br /> aṣṭau bhāgāḥ sitāyāśca tatsarvaṁ sūkṣmacūrṇitam||82|| <br /> <br /> mākṣikēṇāplutaṁ sthāpyamāyasē bhājanē śubhē| <br /> udumbarasamāṁ mātrāṁ tataḥ khādēdyathāgni nā||83|| <br /> <br /> dinē dinē prayuñjīta jīrṇē bhōjyaṁ yathēpsitam| <br /> varjayitvā kulatthāni kākamācīṁ kapōtakam||84|| <br /> <br /> yōgarāja iti khyātō yōgō'yamamr̥tōpamaḥ| <br /> rasāyanamidaṁ śrēṣṭhaṁ sarvarōgaharaṁ śivam||85|| <br /> <br /> pāṇḍurōgaṁ viṣaṁ kāsaṁ yakṣmāṇaṁ viṣamajvaram| <br /> kuṣṭhānyajīrṇakaṁ mēhaṁ śōṣaṁ śvāsamarōcakam||86|| <br /> <br /> viśēṣāddhantyapasmāraṁ kāmalāṁ gudajāni ca| <br /> <br /> iti yōgarājaḥ| <br /> <br /> triphalAyAstrayo bhAgAstrayastrikaTukasya ca||80|| <br /> <br /> bhAgashcitrakamUlasya viDa~ggAnAM tathaiva ca| <br /> pa~jcAshmajatuno bhAgAstathA rUpyamalasya ca||81|| <br /> <br /> mAkShikasya ca shuddhasya lauhasya rajasastathA| <br /> aShTau bhAgAH sitAyAshca tatsarvaM sUkShmacUrNitam||82|| <br /> <br /> mAkShikeNAplutaM sthApyamAyase bhAjane shubhe| <br /> udumbarasamAM mAtrAM tataH khAdedyathAgni nA||83|| <br /> <br /> dine dine prayu~jjIta jIrNe bhojyaM yathepsitam| <br /> varjayitvA kulatthAni kAkamAcIM kapotakam||84|| <br /> <br /> yogarAja iti khyAto yogo~ayamamRutopamaH| <br /> rasAyanamidaM shreShThaM sarvarogaharaM shivam||85|| <br /> <br /> pANDurogaM viShaM kAsaM yakShmANaM viShamajvaram| <br /> kuShThAnyajIrNakaM mehaM shoShaM shvAsamarocakam||86|| <br /> <br /> visheShAddhantyapasmAraM kAmalAM gudajAni ca| <br /> <br /> iti yogarAjaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Yogaraja'' – ''harītaki, bibhitaki, amalaki, shunthi, pippali, maricha, chitraka moola'' (root) and ''vidanga'' in the amount of one part each; five parts each of ''shilajatu, raupya mala'' (silver), purified ''makshika'' and ''lauha bhasma''; eight parts of sugar – all should be made to a fine powder and mixed with adequate amount of honey and kept in clean iron jar. This recipe should be taken by the patient in a quantity equal to a fruit of ''udumbara'' according to the power of digestion every day and should be given the desired food excluding ''kulattha, kakamachi'' etc. and pigeon meat; only after the digestion of the taken drug. This ambrosia like recipe is called ''yogaraja''. It is an excellent rejuvenative recipe which cures all diseases and bestows auspiciousness. It specially cures ''pandu'', poisoning, ''kasa, yakshma, vishama jwara'' (irregular fevers), ''ajeerna, meha, soshha, swasa, aruchi, apasmara'' (epilepsy), ''kamala'' and ''arsha''.<br /> <br /> Thus ends the description of ''yogaraja'' [80-86]<br /> <br /> === Various formulations ===<br /> <br /> === Shilajatu Vataka ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कौटजत्रिफलानिम्बपटोलघननागरैः||८७|| <br /> <br /> भावितानि दशाहानि रसैर्द्वित्रिगुणानि वा| <br /> शिलाजतुपलान्यष्टौ तावती सितशर्करा||८८||<br /> <br /> त्वक्क्षीरी पिप्पली धात्री कर्कटाख्या पलोन्मिता| <br /> <br /> निदिग्ध्याः फलमूलाभ्यां पलं युक्त्या त्रिगन्धकम्| <br /> <br /> चूर्णितं मधुनः कुर्यात् त्रिपलेनाक्षिकान् गुडान्| <br /> दाडिमाम्बुपयःपक्षिरसतोयसुरासवान्||९०|| <br /> <br /> तान् भक्षयित्वाऽनुपिबेन्निरन्नो भुक्त एव वा| <br /> पाण्डुकुष्ठज्वरप्लीहतमकार्शोभगन्दरान्||९१|| <br /> <br /> पूतिहृच्छुक्रमूत्राग्निदोषशोषगरोदरान् [१] | <br /> कासासृग्दरपित्तासृक्शोथगुल्मगलामयान्||९२|| <br /> <br /> ते च सर्वव्रणान् हन्युः सर्वरोगहराः शिवाः| <br /> <br /> इति शिलाजतुवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> kauṭajatriphalānimbapaṭōlaghananāgaraiḥ||87|| <br /> <br /> bhāvitāni daśāhāni rasairdvitriguṇāni vā| <br /> śilājatupalānyaṣṭau tāvatī sitaśarkarā||88|| <br /> <br /> tvakkṣīrī pippalī dhātrī karkaṭākhyā palōnmitā| <br /> <br /> nidigdhyāḥ phalamūlābhyāṁ palaṁ yuktyā trigandhakam| <br /> <br /> cūrṇitaṁ madhunaḥ kuryāt tripalēnākṣikān guḍān| <br /> dāḍimāmbupayaḥpakṣirasatōyasurāsavān||90|| <br /> <br /> tān bhakṣayitvā'nupibēnnirannō bhukta ēva vā| <br /> pāṇḍukuṣṭhajvaraplīhatamakārśōbhagandarān||91|| <br /> <br /> pūtihr̥cchukramūtrāgnidōṣaśōṣagarōdarān [1] | <br /> kāsāsr̥gdarapittāsr̥kśōthagulmagalāmayān||92|| <br /> <br /> tē ca sarvavraṇān hanyuḥ sarvarōgaharāḥ śivāḥ| <br /> <br /> iti śilājatuvaṭakāḥ| <br /> <br /> kauTajatriphalAnimbapaTolaghananAgaraiH||87|| <br /> <br /> bhAvitAni dashAhAni rasairdvitriguNAni vA| <br /> shilAjatupalAnyaShTau tAvatI sitasharkarA||88|| <br /> <br /> tvakkShIrI pippalI dhAtrI karkaTAkhyA palonmitA| <br /> <br /> nidigdhyAH phalamUlAbhyAM palaM yuktyA trigandhakam| <br /> <br /> cUrNitaM madhunaH kuryAt tripalenAkShikAn guDAn| <br /> dADimAmbupayaHpakShirasatoyasurAsavAn||90|| <br /> <br /> tAn bhakShayitvA~anupibenniranno bhukta eva vA| <br /> pANDukuShThajvaraplIhatamakArshobhagandarAn||91|| <br /> <br /> pUtihRucchukramUtrAgnidoShashoShagarodarAn [1] | <br /> kAsAsRugdarapittAsRukshothagulmagalAmayAn||92|| <br /> <br /> te ca sarvavraNAn hanyuH sarvarogaharAH shivAH| <br /> <br /> iti shilAjatuvaTakAH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> ''Shilajatu vataka'' – Eight ''pala'' of ''shilajatu'' impregnated for ten, twenty or thirty days with the decoction of fruit of ''kutaja, haritaki, bibhitaka, amalaki, nimba, patola, ghana'' and ''nagara''. Eight ''pala'' of sugar and one ''pala'' each of ''tvakakshiri, pippali, dhatri'' and ''karkatashringi''; half ''pala'' each of the fruit and root of ''nidigdhika'' and adequate powder of ''tvaka, ela'' and ''patra'' should be added to this ''shilajatu''. ''Vataka'' (large sized pills) of one ''aksha'' each should be prepared by adding three ''pala'' of honey to this powder. These pills can be taken on either empty stomach or after having food. The patient should drink the juice of ''dadima'' (pomegranate), milk, meat soup of birds, water, alcohol, ''asava'' (medicated wine) after taking this medicine. It cures ''pandu, kushtha, jwara, pleeha, tamaka svasa, arsha, bhagandara'' (fistula in ano), ''puti'' (putrified ulcers), ''hridroga'' (heart diseases), ''shukra dosha'' (diseases of semen), ''mutra dosha'' (diseases of urine), and ''agni dosha'' (diseases of digestion), ''sosha'' (consumption), ''gara'' (poisoning), ''udara, kasa, asrigdara'' (menorrhagia), ''raktapitta'' (bleeding disorders), ''sotha, gulma, galamayana'' (diseases of the throats) and all types of ''vrana'' (wounds). It cures all types of diseases and bestows auspiciousness. Thus, ends the description of ''shilajatu vataka.'' [87-92]<br /> <br /> === Punarnava Mandura ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुनर्नवा त्रिवृद्व्योषविडङ्गं दारु चित्रकम्||९३|| <br /> <br /> कुष्ठं हरिद्रे त्रिफला दन्ती चव्यं कलिङ्गकाः| <br /> पिप्पली [२] पिप्पलीमूलं मुस्तं चेति पलोन्मितम्||९४|| <br /> <br /> मण्डूरं द्विगुणं चूर्णाद्गोमूत्रे द्व्याढके पचेत्| <br /> कोलवद्गुटिकाः कृत्वा तक्रेणालोड्य ना पिबेत्||९५|| <br /> <br /> ताः पाण्डुरोगान् प्लीहानमर्शांसि विषमज्वरम्| <br /> श्वयथुं ग्रहणीदोषं हन्युः कुष्ठं क्रिमींस्तथा||९६|| <br /> <br /> इति पुनर्नवामण्डूरम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> punarnavā trivr̥dvyōṣaviḍaṅgaṁ dāru citrakam||93|| <br /> <br /> kuṣṭhaṁ haridrē triphalā dantī cavyaṁ kaliṅgakāḥ| <br /> pippalī [2] pippalīmūlaṁ mustaṁ cēti palōnmitam||94|| <br /> <br /> maṇḍūraṁ dviguṇaṁ cūrṇādgōmūtrē dvyāḍhakē pacēt| <br /> kōlavadguṭikāḥ kr̥tvā takrēṇālōḍya nā pibēt||95|| <br /> <br /> tāḥ pāṇḍurōgān plīhānamarśāṁsi viṣamajvaram| <br /> śvayathuṁ grahaṇīdōṣaṁ hanyuḥ kuṣṭhaṁ krimīṁstathā||96|| <br /> <br /> iti punarnavāmaṇḍūram|<br /> <br /> punarnavA trivRudvyoShaviDa~ggaM dAru citrakam||93|| <br /> <br /> kuShThaM haridre triphalA dantI cavyaM kali~ggakAH| <br /> pippalI [2] pippalImUlaM mustaM ceti palonmitam||94|| <br /> <br /> maNDUraM dviguNaM cUrNAdgomUtre dvyADhake pacet| <br /> kolavadguTikAH kRutvA takreNAloDya nA pibet||95|| <br /> <br /> tAH pANDurogAn plIhAnamarshAMsi viShamajvaram| <br /> shvayathuM grahaNIdoShaM hanyuH kuShThaM krimIMstathA||96|| <br /> <br /> iti punarnavAmaNDUram| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Powder of one ''pala'' each of ''punarnava, trivritta, sunthi, pippali, maricha, vidanga, devadaru, chitraka, kushtha, haridra, daruharidra, haritaki, bibhitaka, amalaki, danti, chavya, kālingaka, pippalī, pippalimoola'' and ''musta''; and forty ''pala'' of ''mandura bhasma'' (rust of iron) coked in two ''adhaka'' of cow’s urine and made in the form of ''gutika'' of the size of ''kola''. These pills should be taken with butter milk. It cures ''pandu, pleeha, arsha, vishama jwara, sotha, grahanidosha'' (sprue syndrome, irritable bowel syndrome), ''kushtha'' and ''krimi'' (parasitic infestation). Thus, ends the description of ''punarnava mandura''.[93-96]<br /> <br /> === Darvyadi leha and other two recipes ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दार्वीत्वक् त्रिफला व्योषं विडङ्गमयसो रजः| <br /> मधुसर्पिर्युतं लिह्यात् कामलापाण्डुरोगवान्||९७|| <br /> <br /> तुल्या अयोरजःपथ्याहरिद्राः क्षौद्रसर्पिषा| <br /> चूर्णिताः कामली लिह्याद्गुडक्षौद्रेण वाऽभयाः||९८|| <br /> <br /> त्रिफला द्वे हरिद्रे च कटुरोहिण्ययोरजः| <br /> चूर्णितं क्षौद्रसर्पिर्भ्यां स लेहः कामलापहः||९९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> dārvītvak triphalā vyōṣaṁ viḍaṅgamayasō rajaḥ| <br /> madhusarpiryutaṁ lihyāt kāmalāpāṇḍurōgavān||97|| <br /> <br /> tulyā ayōrajaḥpathyāharidrāḥ kṣaudrasarpiṣā| <br /> cūrṇitāḥ kāmalī lihyādguḍakṣaudrēṇa vā'bhayāḥ||98|| <br /> <br /> triphalā dvē haridrē ca kaṭurōhiṇyayōrajaḥ| <br /> cūrṇitaṁ kṣaudrasarpirbhyāṁ sa lēhaḥ kāmalāpahaḥ||99|| <br /> <br /> dArvItvak triphalA vyoShaM viDa~ggamayaso rajaH| <br /> madhusarpiryutaM lihyAt kAmalApANDurogavAn||97|| <br /> <br /> tulyA ayorajaHpathyAharidrAH kShaudrasarpiShA| <br /> cUrNitAH kAmalI lihyAdguDakShaudreNa vA~abhayAH||98|| <br /> <br /> triphalA dve haridre ca kaTurohiNyayorajaH| <br /> cUrNitaM kShaudrasarpirbhyAM sa lehaH kAmalApahaH||99|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Powder of the bark of daruharidra, haritaki, bibhitaka, amalaki, pippali, sunthi, maricha, vidanga and lauha bhasma mixed with ghee and honey, taken as a linctus by the patients suffering from ''pandu'' and ''kamala''.<br /> <br /> Two other recipes – Patients suffering from ''kamala'' should take the powder of one part each of ''lauha bhasma, haritaki'' and ''haridra'' along with honey and ghee and may also take the linctus of the powder of ''abhaya'' prepared by mixing with jaggery and honey. [97-99]<br /> <br /> === ''Dhatryavaleha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्विपलांशां तुगाक्षीरीं नागरं मधुयष्टिकाम्| <br /> प्रास्थिकीं पिप्पलीं द्राक्षां शर्करार्धतुलां शुभाम्||१००|| <br /> <br /> धात्रीफलरसद्रोणे चूर्णितं लेहवत् पचेत्| <br /> शीतं मधुप्रस्थयुतं लिह्यात् पाणितलं ततः||१०१|| <br /> <br /> हन्त्येष कामलां पित्तं पाण्डुं कासं हलीमकम्| <br /> <br /> इति धात्र्यवलेहः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dvipalāṁśāṁ tugākṣīrīṁ nāgaraṁ madhuyaṣṭikām| <br /> prāsthikīṁ pippalīṁ drākṣāṁ śarkarārDhātulāṁ śubhām||100|| <br /> <br /> dhātrīphalarasadrōṇē cūrṇitaṁ lēhavat pacēt| <br /> śītaṁ madhuprasthayutaṁ lihyāt pāṇitalaṁ tataḥ||101|| <br /> <br /> hantyēṣa kāmalāṁ Pittaṁ pāṇḍuṁ kāsaṁ halīmakam| <br /> <br /> iti dhātryavalēhaḥ| <br /> <br /> dvipalAMshAM tugAkShIrIM nAgaraM madhuyaShTikAm| <br /> prAsthikIM pippalIM drAkShAM sharkarArdhatulAM shubhAm||100|| <br /> <br /> dhAtrIphalarasadroNe cUrNitaM lehavat pacet| <br /> shItaM madhuprasthayutaM lihyAt pANitalaM tataH||101|| <br /> <br /> hantyeSha kAmalAM pittaM pANDuM kAsaM halImakam| <br /> <br /> iti dhAtryavalehaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Dhatryavaleha'' – ''Vanshalochana, sunthi, maduyashti'' powders, each in two ''pala''; one ''prastha'' each of ''pippali'' and ''draksha''; and half a ''tula'' of sugar crystal added with one ''drona'' of ''amalaki'' fruit juice and cooked till it changes into linctus form. One ''prastha'' of honey is added to it after it cools down. Intake of one ''panitala'' of this linctus cures ''kamala, [[pitta]] vikaras, pandu, kasa'' and ''haleemaka'' [100-101]<br /> <br /> === ''Mandura vatakah'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्र्यूषणं त्रिफला चव्यं चित्रको देवदारु च||१०२|| <br /> <br /> विडङ्गान्यथ मुस्तं च वत्सकं चेति चूर्णयेत्| <br /> मण्डूरतुल्यं तच्चूर्णं गोमूत्रेऽष्टगुणे पचेत्||१०३|| <br /> <br /> शनैः सिद्धास्तथा शीताः कार्याः कर्षसमा गुडाः| <br /> यथाग्नि भक्षणीयास्ते प्लीहपाण्ड्वामयापहाः||१०४||<br /> <br /> ग्रहण्यर्शोनुदश्चैव तक्रवाट्याशिनः स्मृताः| <br /> <br /> इति मण्डूरवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tryūṣaṇaṁ triphalā cavyaṁ citrakō dēvadāru ca||102|| <br /> <br /> viḍaṅgānyatha mustaṁ ca vatsakaṁ cēti cūrṇayēt| <br /> maṇḍūratulyaṁ taccūrṇaṁ gōmūtrē'ṣṭaguṇē pacēt||103|| <br /> <br /> śanaiḥ siddhāstathā śītāḥ kāryāḥ karṣasamā guḍāḥ| <br /> yathāgni bhakṣaṇīyāstē plīhapāṇḍvāmayāpahāḥ||104|| <br /> <br /> grahaṇyarśōnudaścaiva takravāṭyāśinaḥ smr̥tāḥ| <br /> <br /> iti maṇḍūravaṭakāḥ| <br /> <br /> tryUShaNaM triphalA cavyaM citrako devadAru ca||102|| <br /> <br /> viDa~ggAnyatha mustaM ca vatsakaM ceti cUrNayet| <br /> maNDUratulyaM taccUrNaM gomUtre~aShTaguNe pacet||103|| <br /> <br /> shanaiH siddhAstathA shItAH kAryAH karShasamA guDAH| <br /> yathAgni bhakShaNIyAste plIhapANDvAmayApahAH||104|| <br /> <br /> grahaNyarshonudashcaiva takravATyAshinaH smRutAH| <br /> <br /> iti maNDUravaTakAH|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Mandura Vataka''-II: ''Shunthi, pippali, maricha, haritaki, bibhitaka, amalaki, chavya, chitraka, devadaru, vidanga, musta'' and ''vatsaka'' in one part each, made in the form of powder and added to equal quantity (12 parts) of ''mandura bhasma'', should then be boiled by adding eight times of cow’s urine over mild fire. After the recipe cools pills of one ''aksha'' each should be prepared and taken according to the power of digestion. This cures ''pleeha, pandu, grahani,'' and ''arsha''. The patient should take buttermilk and ''vatya'' (a roasted barley preperation) while taking this pill [102-104]<br /> <br /> === ''Gaudo arishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मञ्जिष्ठा रजनी द्राक्षा बलामूलान्ययोरजः||१०५|| <br /> <br /> लोध्रं चैतेषु गौडः स्यादरिष्टः पाण्डुरोगिणाम्| <br /> <br /> इति गौडोऽरिष्टः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mañjiṣṭhā rajanī drākṣā balāmūlānyayōrajaḥ||105|| <br /> <br /> lōdhraṁ caitēṣu gauḍaḥ syādariṣṭaḥ pāṇḍurōgiṇām| <br /> <br /> iti gauḍō'riṣṭaḥ| <br /> <br /> ma~jjiShThA rajanI drAkShA balAmUlAnyayorajaH||105|| <br /> <br /> lodhraM caiteShu gauDaH syAdariShTaH pANDurogiNAm| <br /> <br /> iti gauDo~ariShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Manjishtha, rajani, draksha, bala moola'' (roots), ''lauha bhasma'', and ''lodhra'' should be added to jaggery and processed according to the method prescribed for ''arishta''. It is called ''gaudo-arishta'' and is useful for the patients suffering from ''pandu roga'' [105]<br /> <br /> === ''Beejakarishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बीजकात्षोडशपलं त्रिफलायाश्च विंशतिः||१०६|| <br /> <br /> द्राक्षायाः पञ्च लाक्षायाः सप्त द्रोणे जलस्य तत्| <br /> साध्यं पादावशेषे तु पूतशेषे समावपेत्||१०७|| <br /> <br /> शर्करायास्तुलां प्रस्थं माक्षिकस्य च कार्षिकम्| <br /> व्योषं व्याघ्रनखोशीरं क्रमुकं सैलवालुकम्||१०८|| <br /> <br /> मधुकं कुष्ठमित्येतच्चूर्णितं घृतभाजने| <br /> यवेषु दशरात्रं तद्ग्रीष्मे द्विः शिशिरे स्थितम्||१०९|| <br /> <br /> पिबेत्तद्ग्रहणीपाण्डुरोगार्शःशोथगुल्मनुत्| <br /> मूत्रकृच्छ्राश्मरीमेहकामलासन्निपातजित्||११०|| <br /> <br /> बीजकारिष्ट इत्येष आत्रेयेण प्रकीर्तितः| <br /> <br /> इति बीजकारिष्टः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bījakātṣōḍaśapalaṁ triphalāyāśca viṁśatiḥ||106|| <br /> <br /> drākṣāyāḥ pañca lākṣāyāḥ sapta drōṇē jalasya tat| <br /> sādhyaṁ pādāvaśēṣē tu pūtaśēṣē samāvapēt||107|| <br /> <br /> śarkarāyāstulāṁ prasthaṁ mākṣikasya ca kārṣikam| <br /> vyōṣaṁ vyāghranakhōśīraṁ kramukaṁ sailavālukam||108|| <br /> <br /> madhukaṁ kuṣṭhamityētaccūrṇitaṁ ghr̥tabhājanē| <br /> yavēṣu daśarātraṁ tadgrīṣmē dviḥ śiśirē sthitam||109|| <br /> <br /> pibēttadgrahaṇīpāṇḍurōgārśaḥśōthagulmanut| <br /> mūtrakr̥cchrāśmarīmēhakāmalāsannipātajit||110|| <br /> <br /> bījakāriṣṭa ityēṣa ātrēyēṇa prakīrtitaḥ| <br /> <br /> iti bījakāriṣṭaḥ| <br /> <br /> bIjakAtShoDashapalaM triphalAyAshca viMshatiH||106|| <br /> <br /> drAkShAyAH pa~jca lAkShAyAH sapta droNe jalasya tat| <br /> sAdhyaM pAdAvasheShe tu pUtasheShe samAvapet||107|| <br /> <br /> sharkarAyAstulAM prasthaM mAkShikasya ca kArShikam| <br /> vyoShaM vyAghranakhoshIraM kramukaM sailavAlukam||108|| <br /> <br /> madhukaM kuShThamityetaccUrNitaM ghRutabhAjane| <br /> yaveShu dasharAtraM tadgrIShme dviH shishire sthitam||109|| <br /> <br /> pibettadgrahaNIpANDurogArshaHshothagulmanut| <br /> mUtrakRucchrAshmarImehakAmalAsannipAtajit||110|| <br /> <br /> bIjakAriShTa ityeSha AtreyeNa prakIrtitaH| <br /> <br /> iti bIjakAriShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Beejaka'' taken in the amount of sixteen ''pala'', twenty ''pala'' of ''triphala,'' five pala of ''draksha'' and seven ''pala'' of ''laksha'' are added to one ''drona'' of water and boiled till one fourth of water remains. Water should then be taken out by straining. One ''tula'' of sugar, one ''pala'' of honey and one ''pala'' powder of each of the ''shunthi, pippali, maricha, vyaghranakha, kramuka, elavaluka, madhuka'' and ''kushtha'' are added to the above made decoction and the potion be stored in a jar smeared with ghee kept inside a barley heap for ten nights during summer and for twenty nights in winter. Intake of this potion cures ''grahani, pandu, arsha, sotha, gulma, mutra krichha'' (dysuria), ''ashmari'' (stones in the urinary tract), ''meha, kamala'' and diseases caused by all the three [[dosha]]. This is called ''beejaka arishta'' and it was propounded by Atreya.<br /> <br /> Thus, ends the description of ''beejaka arishta'' [106-110]<br /> <br /> === ''Dhatryarishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> धात्रीफलसहस्रे द्वे पीडयित्वा रसं तु तम्||१११|| <br /> <br /> क्षौद्राष्टांशेन संयुक्तं कृष्णार्धकुडवेन च| <br /> शर्करार्धतुलोन्मिश्रं पक्षं स्निग्धघटे स्थितम्||११२|| <br /> <br /> प्रपिबेन्मात्रया प्रातर्जीर्णे हितमिताशनः| <br /> कामलापाण्डुहृद्रोगवातासृग्विषमज्वरान्||११३||<br /> <br /> कासहिक्कारुचिश्वासांश्चैषोऽरिष्टः प्रणाशयेत्| <br /> <br /> इति धात्र्यरिष्टः <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dhātrīphalasahasrē dvē pīḍayitvā rasaṁ tu tam||111|| <br /> <br /> kṣaudrāṣṭāṁśēna saṁyuktaṁ kr̥ṣṇārdhakuḍavēna ca| <br /> śarkarārDhātulōnmiśraṁ pakṣaṁ snigdhaghaṭē sthitam||112|| <br /> <br /> prapibēnmātrayā prātarjīrṇē hitamitāśanaḥ| <br /> kāmalāpāṇḍuhr̥drōgavātāsr̥gviṣamajvarān||113|| <br /> <br /> kāsahikkāruciśvāsāṁścaiṣō'riṣṭaḥ praṇāśayēt| <br /> <br /> iti dhātryariṣṭaḥ| <br /> <br /> dhAtrIphalasahasre dve pIDayitvA rasaM tu tam||111|| <br /> <br /> kShaudrAShTAMshena saMyuktaM kRuShNArdhakuDavena ca| <br /> sharkarArdhatulonmishraM pakShaM snigdhaghaTe sthitam||112|| <br /> <br /> prapibenmAtrayA prAtarjIrNe hitamitAshanaH| <br /> kAmalApANDuhRudrogavAtAsRugviShamajvarAn||113|| <br /> <br /> kAsahikkArucishvAsAMshcaiSho~ariShTaH praNAshayet| <br /> <br /> iti dhAtryariShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Dhatryarishta'' - Two thousand fruits of ''amalaki'' should be crushed and the juice extracted should be mixed with one eighth the quantity of honey, half ''kudava'' of ''pippali'' and half ''tula'' of sugar. It should then be kept in an earthern jar smeared with ghee for one fortnight. It should be taken in appropriate dose in the morning and the patient should take wholesome food in small quantity after the digestion of the drug. This ''arishta'' cures ''kamala, pandu, hridroga, vatarakta, vishama jwara, kasa, hikka, aruchi'' and ''svasa''. Thus, ends the description of ''dhatrya arishta'' [111-113]<br /> <br /> === Medicated water ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्थिरादिभिः शृतं तोयं पानाहारे प्रशस्यते||११४|| <br /> <br /> पाण्डूनां, कामलार्तानां मृद्वीकामलकीरसः|११५| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sthirādibhiḥ śr̥taṁ tōyaṁ pānāhārē praśasyatē||114|| <br /> <br /> pāṇḍūnāṁ, kāmalārtānāṁ mr̥dvīkāmalakīrasaḥ|115| <br /> <br /> sthirAdibhiH shRutaM toyaM pAnAhAre prashasyate||114|| <br /> <br /> pANDUnAM, kAmalArtAnAM mRudvIkAmalakIrasaH|115|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Water boiled with the drugs belonging to ''sthiradi'' group is useful for drinking and the preparation of foods for ''pandu rogi''; while the patient of ''kamala'' should use the juice of ''draksha'' and ''amalaki rasa'' [114-115]<br /> <br /> === Principles of treatment according to [[dosha]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगप्रशान्त्यर्थमिति प्रोक्तं महर्षिणा||११५|| <br /> <br /> विकल्प्यमेतद्भिषजा पृथग्दोषबलं प्रति| <br /> वातिके स्नेहभूयिष्ठं, पैत्तिके तिक्तशीतलम्||११६|| <br /> <br /> श्लैष्मिके कटुतिक्तोष्णं [१] , विमिश्रं सान्निपातिके|११७|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgapraśāntyarthamiti prōktaṁ maharṣiṇā||115|| <br /> <br /> vikalpyamētadbhiṣajā pr̥thagdōṣabalaṁ prati| <br /> vātikē snēhabhūyiṣṭhaṁ, paittikē tiktaśītalam||116|| <br /> <br /> ślaiṣmikē kaṭutiktōṣṇaṁ [1] , vimiśraṁ sānnipātikē|117| <br /> <br /> pANDurogaprashAntyarthamiti proktaM maharShiNA||115|| <br /> <br /> vikalpyametadbhiShajA pRuthagdoShabalaM prati| <br /> vAtike snehabhUyiShThaM, paittike tiktashItalam||116|| <br /> <br /> shlaiShmike kaTutiktoShNaM [1] , vimishraM sAnnipAtike|117|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The above mentioned drugs are described for the cure of ''pandu roga'' by the great sage (Punarvasu Atreya). The physician should make suitable changes (combinations and permutations) in the above depending upon the strength of the [[dosha]] in the patient. <br /> <br /> The therapy should be dominated by unctuous drugs (oil, ghee etc) for ''vatika'' type of ''pandu''; by bitter and cooling drugs for ''paittika'' type and by pungent, bitter and hot drugs for [[kapha]]ja type of ''pandu'' [115-117]<br /> <br /> === Treatment of ''mrittika bhakshanajanya pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> निपातयेच्छरीरात्तु मृत्तिकां भक्षितां भिषक्||११७|| <br /> <br /> युक्तिज्ञः शोधनैस्तीक्ष्णैः प्रसमीक्ष्य बलाबलम्| <br /> शुद्धकायस्य सर्पींषि बलाधानानि योजयेत्||११८|| <br /> <br /> व्योषं बिल्वं हरिद्रे द्वे त्रिफला द्वे पुनर्नवे| <br /> मुस्तान्ययोरजः पाठा विडङ्गं देवदारु च||११९|| <br /> <br /> वृश्चिकाली च भार्गी च सक्षीरैस्तैः [१] समैर्घृतम्| <br /> साधयित्वा पिबेद्युक्त्या नरो मृद्दोषपीडितः||१२०|| <br /> <br /> तद्वत् केशरयष्ट्याह्वपिप्पलीक्षारशाद्वलैः| <br /> मृद्भक्षणादातुरस्य लौल्यादविनिवर्तिनः||१२१|| <br /> <br /> द्वेष्यार्थं भावितां कामं दद्यात्तद्दोषनाशनैः| <br /> विङ्गैलातिविषया निम्बपत्रेण पाठया||१२२|| <br /> <br /> वार्ताकैः कटुरोहिण्या कौटजैर्मूर्वयाऽपि वा|१२३| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nipātayēccharīrāttu mr̥ttikāṁ bhakṣitāṁ bhiṣak||117|| <br /> <br /> yuktijñaḥ śōdhanaistīkṣṇaiḥ prasamīkṣya balābalam| <br /> śuddhakāyasya sarpīṁṣi balādhānāni yōjayēt||118|| <br /> <br /> vyōṣaṁ bilvaṁ haridrē dvē triphalā dvē punarnavē| <br /> mustānyayōrajaḥ pāṭhā viḍaṅgaṁ dēvadāru ca||119|| <br /> <br /> vr̥ścikālī ca bhārgī ca sakṣīraistaiḥ [1] samairghr̥tam| <br /> sādhayitvā pibēdyuktyā narō mr̥ddōṣapīḍitaḥ||120|| <br /> <br /> tadvat kēśarayaṣṭyāhvapippalīkṣāraśādvalaiḥ| <br /> mr̥dbhakṣaṇādāturasya laulyādavinivartinaḥ||121|| <br /> <br /> dvēṣyārthaṁ bhāvitāṁ kāmaṁ dadyāttaddōṣanāśanaiḥ| <br /> viṅgailātiviṣayā nimbapatrēṇa pāṭhayā||122|| <br /> <br /> vārtākaiḥ kaṭurōhiṇyā kauṭajairmūrvayā'pi vā|123| <br /> <br /> nipAtayeccharIrAttu mRuttikAM bhakShitAM bhiShak||117|| <br /> <br /> yuktij~jaH shodhanaistIkShNaiH prasamIkShya balAbalam| <br /> shuddhakAyasya sarpIMShi balAdhAnAni yojayet||118|| <br /> <br /> vyoShaM bilvaM haridre dve triphalA dve punarnave| <br /> mustAnyayorajaH pAThA viDa~ggaM devadAru ca||119|| <br /> <br /> vRushcikAlI ca bhArgI ca sakShIraistaiH [1] samairghRutam| <br /> sAdhayitvA pibedyuktyA naro mRuddoShapIDitaH||120|| <br /> <br /> tadvat kesharayaShTyAhvapippalIkShArashAdvalaiH| <br /> mRudbhakShaNAdAturasya laulyAdavinivartinaH||121|| <br /> <br /> dveShyArthaM bhAvitAM kAmaM dadyAttaddoShanAshanaiH| <br /> vi~ggailAtiviShayA nimbapatreNa pAThayA||122|| <br /> <br /> vArtAkaiH kaTurohiNyA kauTajairmUrvayA~api vA|123|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A physician well versed in therapeutics, should give the patient strong elimination therapy, keeping in view the strength of the patient, in order to remove the swallowed mud from the body. After the body is cleansed, different types of medicated ghee should be prescribed to the patient for promotion of strength.<br /> <br /> Ghee prepared with ''shunthi, pippali, maricha, bilva, haridra, daruharidra, haritaki, bibhitaka, amalaki, sveta'' and ''rakta punarnava, musta, lauha bhasma, patha, vidanga, devadaru, vrishchikali, bhargi'' and milk should be appropriately taken by the patient who suffers from anemia because of eating clay. <br /> <br /> Likewise, ghee prepared with ''keshara, yashtamadhu, pippali, kshara'' (alkali preperation) and ''sadvala'' may be given to the patient suffering from ''mrittika bhakshana janya pandu''. <br /> <br /> If the patient is unable to give up his clay swallowing habits, he should be given clay impregnated with ''vidanga, ela, ativisha,'' neem leaves, ''patha, varataka, katurohiṇī, kutaja'' or ''murva'' with a view of creating an aversion to clay. These drugs also counter act the adverse effects of eating clay. [117-123]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यथादोषं प्रकुर्वीत भैषज्यं पाण्डुरोगिणाम्||१२३|| <br /> <br /> क्रियाविशेष एषोऽस्य मतो हेतुविशेषतः|१२४| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yathādōṣaṁ prakurvīta bhaiṣajyaṁ pāṇḍurōgiṇām||123|| <br /> <br /> kriyāviśēṣa ēṣō'sya matō hētuviśēṣataḥ|124| <br /> <br /> yathAdoShaM prakurvIta bhaiShajyaM pANDurogiNAm||123|| <br /> <br /> kriyAvisheSha eSho~asya mato hetuvisheShataH|124| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Different types of treatment should be given to the patient suffering from ''mrittika bhakshana janya pandu'', according to the different types of [[dosha]] aggravated. However, due to the specific type of etiological factor involved (clay eating), this type of ''pandu'' needs special type of treatment [123-124]<br /> <br /> === ''Shakhashrita kamala'' (''kamala'' in body tissue with obstructive pathology) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तिलपिष्टनिभं यस्तु वर्चः सृजति कामली||१२४||<br /> <br /> श्लेष्मणा रुद्धमार्गं तत् पित्तं कफहरैर्जयेत्| <br /> रूक्षशीतगुरुस्वादुव्यायामैर्वेगनिग्रहैः||१२५|| <br /> <br /> कफसम्मूर्च्छितो वायुः स्थानात् पित्तं क्षिपेद्बली| <br /> हारिद्रनेत्रमूत्रत्वक् श्वेतवर्चास्तदा नरः||१२६|| <br /> <br /> भवेत् साटोपविष्टम्भो गुरुणा हृदयेन च| <br /> दौर्बल्याल्पाग्निपार्श्वार्तिहिक्काश्वासारुचिज्वरैः||१२७|| <br /> <br /> क्रमेणाल्पेऽनुसज्येत [१] पित्ते शाखासमाश्रिते|१२८|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tilapiṣṭanibhaṁ yastu varcaḥ sr̥jati kāmalī||124|| <br /> <br /> ślēṣmaṇā ruddhamārgaṁ tat Pittaṁ Kaphaharairjayēt| <br /> rūkṣaśītagurusvāduvyāyāmairvēganigrahaiḥ||125|| <br /> <br /> Kaphasammūrcchitō vāyuḥ sthānāt Pittaṁ kṣipēdbalī| <br /> hāridranētramūtratvak śvētavarcāstadā naraḥ||126|| <br /> <br /> bhavēt sāṭōpaviṣṭambhō guruṇā hr̥dayēna ca| <br /> daurbalyālpāgnipārśvārtihikkāśvāsārucijvaraiḥ||127|| <br /> <br /> kramēṇālpē'nusajyēta [1] pittē śākhāsamāśritē|128| <br /> <br /> tilapiShTanibhaM yastu varcaH sRujati kAmalI||124|| <br /> <br /> shleShmaNA ruddhamArgaM tat pittaM kaphaharairjayet| <br /> rUkShashItagurusvAduvyAyAmairveganigrahaiH||125|| <br /> <br /> kaphasammUrcchito vAyuH sthAnAt pittaM kShipedbalI| <br /> hAridranetramUtratvak shvetavarcAstadA naraH||126|| <br /> <br /> bhavet sATopaviShTambho guruNA hRudayena ca| <br /> daurbalyAlpAgnipArshvArtihikkAshvAsArucijvaraiH||127|| <br /> <br /> krameNAlpe~anusajyeta [1] pitte shAkhAsamAshrite|128| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A patient of ''kamala'' if passes stools of the color of sesame paste (''tila pishta nibhama''), then it denotes obstruction in the passage of [[pitta]] by the [[kapha]]. Therefore, the [[pitta]] of such patient should be won by administration of drugs which also eliminate [[kapha]]. <br /> <br /> The excess usage of ununctuous, cold and sweet ingredients; excessive exercise; suppression of the natural urges leads to the the aggravation of [[vata]] infilterated with [[kapha]] and the displacement of [[pitta]] from its site, resulting in the development of the following features: <br /> <br /> The eyes, skin and urine of the patient become yellow while his stools become white in color. Additionally, the patients suffer from ''atopa'' (tympanitis), ''vishtambha'' (constipation associated with flatulence),and heaviness in the cardiac region, due to the displacement of [[pitta]] in the peripheral tissues (''shakha''), there is diminution in the flow of [[pitta]] (to the gastrointestinal tract) resulting in the gradual development of weakness, ''agnimandya'' (low digestion), ''parshva'' (pain in the sides of chest), ''hikka'' (hiccups), ''shvasa'' (dyspnea), ''aruchi'' (anorexia) and ''jwara'' [124-128]<br /> <br /> === Treatment of ''shakhashriat kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बर्हितित्तिरिदक्षाणां रूक्षाम्लैः कटुकै रसैः||१२८|| <br /> <br /> शुष्कमूलककौलत्थैर्यूषैश्चान्नानि भोजयेत्| <br /> मातुलुङ्गरसं क्षौद्रपिप्पलीमरिचान्वितम्||१२९|| <br /> <br /> सनागरं पिबेत् पित्तं तथाऽस्यैति स्वमाशयम्|१३०|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> barhitittiridakṣāṇāṁ rūkṣāmlaiḥ kaṭukai rasaiḥ||128|| <br /> <br /> śuṣkamūlakakaulatthairyūṣaiścānnāni bhōjayēt| <br /> mātuluṅgarasaṁ kṣaudrapippalīmaricānvitam||129|| <br /> <br /> sanāgaraṁ pibēt Pittaṁ tathā'syaiti svamāśayam|130| <br /> <br /> barhitittiridakShANAM rUkShAmlaiH kaTukai rasaiH||128|| <br /> <br /> shuShkamUlakakaulatthairyUShaishcAnnAni bhojayet| <br /> mAtulu~ggarasaM kShaudrapippalImaricAnvitam||129|| <br /> <br /> sanAgaraM pibet pittaM tathA~asyaiti svamAshayam|130|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient suffering from from ''shakhashrita kamala'' should be given food along with the soup of the meat of peacock, ''tittira'' (partridge), ''daksha'' (rooster) sizzled with ununctuous, sour and pungent articles; and vegetable soups of dry ''mulaka'' (radish) and ''kulattha''. The patient should also be given the juice of ''matulunga'' mixed with honey, ''pippali, maricha'' and ''shunthi'' for bringing the [[pitta]] to its own course [128-130]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कटुतीक्ष्णोष्णलवणैर्भृशाम्लैश्चाप्युपक्रमः||१३०|| <br /> <br /> आपित्तरागाच्छकृतो [१] वायोश्चाप्रशमाद्भवेत्| <br /> स्वस्थानमागते पित्ते पुरीषे पित्तरञ्जिते||१३१|| <br /> <br /> निवृत्तोपद्रवस्य स्यात् पूर्वः कामलिको विधिः|१३२|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭutīkṣṇōṣṇalavaṇairbhr̥śāmlaiścāpyupakramaḥ||130|| <br /> <br /> āPittarāgācchakr̥tō [1] vāyōścāpraśamādbhavēt| <br /> svasthānamāgatē pittē purīṣē Pittarañjitē||131|| <br /> <br /> nivr̥ttōpadravasya syāt pūrvaḥ kāmalikō vidhiḥ|132| <br /> <br /> kaTutIkShNoShNalavaNairbhRushAmlaishcApyupakramaH||130|| <br /> <br /> ApittarAgAcchakRuto [1] vAyoshcAprashamAdbhavet| <br /> svasthAnamAgate pitte purIShe pittara~jjite||131|| <br /> <br /> nivRuttopadravasya syAt pUrvaH kAmaliko vidhiH|132| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Katu'' (pungent), ''teekshna'' (sharp), ''ushna'' (hot), ''lavana'' (saline) and extremely ''amla'' (sour) drugs should be continued till the stool of the patient acquires the color of [[pitta]] and the [[vata]] gets alleviated. When the [[pitta]] returns to its own habitat, the stool gets colored with [[pitta]] and the patient is relieved of complications, then further, the line of treatment described earlier for the treatment of ''kamala'' (''koshthashrita'') should be used [130-132]<br /> <br /> === ''Haleemaka'' (obstructive jaundice) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यदा तु पाण्डोर्वर्णः स्याद्धरितश्यावपीतकः||१३२|| <br /> <br /> बलोत्साहक्षयस्तन्द्रा मन्द्राग्नित्वं मृदुज्वरः| <br /> स्त्रीष्वहर्षोऽङ्गमर्दश्च श्वासस्तृष्णाऽरुचिर्भ्रमः||१३३|| <br /> <br /> हलीमकं तदा तस्य विद्यादनिलपित्ततः|१३४| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yadā tu pāṇḍōrvarṇaḥ syāddharitaśyāvapītakaḥ||132|| <br /> <br /> balōtsāhakṣayastandrā mandrāgnitvaṁ mr̥dujvaraḥ| <br /> strīṣvaharṣō'ṅgamardaśca śvāsastr̥ṣṇā'rucirbhramaḥ||133|| <br /> <br /> halīmakaṁ tadā tasya vidyādanilaPittataḥ|134| <br /> <br /> yadA tu pANDorvarNaH syAddharitashyAvapItakaH||132|| <br /> <br /> balotsAhakShayastandrA mandrAgnitvaM mRudujvaraH| <br /> strIShvaharSho~a~ggamardashca shvAsastRuShNA~arucirbhramaH||133|| <br /> <br /> halImakaM tadA tasya vidyAdanilapittataH|134| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If a patient suffering from ''pandu'' develops green, black or yellow color and suffers from diminution of strength and enthusiasm; drowsiness, ''agnimandya'' (low digestion), mild fever, lack of libido (''strisu aharsho''), ''angamarda'' (malaise/ body ache), dyspnea, ''trishna'' (morbid thirst), anorexia and giddiness, the ailment is called ''haleemaka'' and is caused by the aggravation of [[vata]] and [[pitta]] [[dosha]] [132-134]<br /> <br /> === Treatment of ''haleemaka'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुडूचीस्वरसक्षीरसाधितं माहिषं घृतम्||१३४|| <br /> <br /> स पिबेत्त्रिवृतां स्निग्धो रसेनामलकस्य तु| <br /> विरिक्तो मधुरप्रायं भजेत् पित्तानिलापहम्||१३५|| <br /> <br /> द्राक्षालेहं च पूर्वोक्तं सर्पींषि मधुराणि च| <br /> यापनान् क्षीरबस्तींश्च शीलयेत्सानुवासनान्||१३६|| <br /> <br /> मार्द्वीकारिष्टयोगांश्च पिबेद्युक्त्याऽग्निवृद्धये| <br /> कासिकं चाभयालेहं पिप्पलीं मधुकं बलाम्||१३७|| <br /> <br /> पयसा च प्रयुञ्जीत यथादोषं यथाबलम्|१३८| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> guḍūcīsvarasakṣīrasādhitaṁ māhiṣaṁ ghr̥tam||134|| <br /> <br /> sa pibēttrivr̥tāṁ snigdhō rasēnāmalakasya tu| <br /> viriktō madhuraprāyaṁ bhajēt pittānilāpaham||135|| <br /> <br /> drākṣālēhaṁ ca pūrvōktaṁ sarpīṁṣi madhurāṇi ca| <br /> yāpanān kṣīrabastīṁśca śīlayētsānuvāsanān||136|| <br /> <br /> mārdvīkāriṣṭayōgāṁśca pibēdyuktyā'gnivr̥ddhayē| <br /> kāsikaṁ cābhayālēhaṁ pippalīṁ madhukaṁ balām||137|| <br /> <br /> payasā ca prayuñjīta yathādōṣaṁ yathābalam|138| <br /> <br /> guDUcIsvarasakShIrasAdhitaM mAhiShaM ghRutam||134|| <br /> <br /> sa pibettrivRutAM snigdho rasenAmalakasya tu| <br /> virikto madhuraprAyaM bhajet pittAnilApaham||135|| <br /> <br /> drAkShAlehaM ca pUrvoktaM sarpIMShi madhurANi ca| <br /> yApanAn kShIrabastIMshca shIlayetsAnuvAsanAn||136|| <br /> <br /> mArdvIkAriShTayogAMshca pibedyuktyA~agnivRuddhaye| <br /> kAsikaM cAbhayAlehaM pippalIM madhukaM balAm||137|| <br /> <br /> payasA ca prayu~jjIta yathAdoShaM yathAbalam|138| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Patients suffering from ''haleemaka'' should take the recipe prepared from buffalo ghee by adding the juice of ''guduchi'' and milk.<br /> <br /> After oleation with this oil the patient should take ''trivritta'' mixed with the juice of ''amalaki'' which causes purgation. <br /> <br /> Thereafter food and drinks which are dominated by sweet taste and are alleviators of [[pitta]] and [[kapha]] should be given.<br /> <br /> The patient should take ''drakshaleha'' described earlier (vide verse 100-102 in this chapter in the name of ''dhatryavaleha'') and recipes of medicated ghee prepared by boiling with sweet drugs (vide verse 51-52). The patient should habitually indulge in taking different types of yapana [[basti]] (a type of medicated enema), kshara [[basti]] and anuvasana [[basti]] discussed in [ Cha. Sa. [[Siddhi Sthana]] ]. He should also take different recipes of ''arishta'' prepared from grapes (''draksharishta'') for the promotion of power of digestion. ''Abhaya leha'' described in the treatment of ''kasa'' [Cha. Sa. [[Chikitsa Sthana]] 18/57-62] may also be taken. Alternatively the patient may also take ''pippali, madhuka'' and ''bala'' along with milk depending upon the [[dosha]] aggravated and the strength of the patient [134-138]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकौ- <br /> <br /> पाण्डोः पञ्चविधस्योक्तं हेतुलक्षणभेषजम्||१३८|| <br /> <br /> कामला द्विविधा तेषां साध्यासाध्यत्वमेव च| <br /> <br /> तेषां विकल्पो यश्चान्यो महाव्याधिर्हलीमकः| <br /> तस्य चोक्तं समासेन व्यञ्जनं सचिकित्सितम्||१३९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkau- <br /> <br /> pāṇḍōḥ pañcavidhasyōktaṁ hētulakṣaṇabhēṣajam||138|| <br /> <br /> kāmalā dvividhā tēṣāṁ sādhyāsādhyatvamēva ca| <br /> <br /> tēṣāṁ vikalpō yaścānyō mahāvyādhirhalīmakaḥ| <br /> tasya cōktaṁ samāsēna vyañjanaṁ sacikitsitam||139||<br /> <br /> tatra shlokau- <br /> <br /> pANDoH pa~jcavidhasyoktaM hetulakShaNabheShajam||138|| <br /> <br /> kAmalA dvividhA teShAM sAdhyAsAdhyatvameva ca| <br /> <br /> teShAM vikalpo yashcAnyo mahAvyAdhirhalImakaH| <br /> tasya coktaM samAsena vya~jjanaM sacikitsitam||139|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> To sum up, the topics discussed in this chapter are:<br /> *Five types of ''pandu'' along with the etiology, signs and symptoms; and treatment<br /> *Two types of ''kamala'' and their curability as well as incurability<br /> *Different varieties of ''kamala''<br /> *''Haleemaka'', which is a serious disease along with its signs and symptoms; and treatment [138-139]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने <br /> पाण्डुरोगचिकित्सितं नाम षोडशोऽध्यायः||१४0|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē <br /> pāṇḍurōgacikitsitaṁ nāma ṣōḍaśō'dhyāyaḥ||140||<br /> <br /> ityagniveshakRute tantre~aprApte dRuDhabalasampUrite cikitsAsthAne <br /> pANDurogacikitsitaM nAma ShoDasho~adhyAyaH||16|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus ends the sixteenth chapter in [[Chikitsa Sthana]] dealing with the treatment of ''pandu roga'' in the work of Agnivesha which was redacted by Charaka and because of its unavailability was supplemented by Dridhabala [140]<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *The important pathological factors in ''pandu'' are aggravated three [[dosha]] with dominant [[pitta]] leading to slow metabolism at level of blood ([[rakta dhatu]]), the fatty tissue [[meda dhatu]]) and [[ojas]] qualities (affecting the vitality). <br /> *The dietary factors like alkaline, sour, saline, hot and mutually contradictory foods, unwholesome food, ''nishpava'' (a type of pulses), ''masha, pinyaka'' (oil cake) and ''tila'' oil; lifestyle factors like indulging in day sleep, performing exercise and sex before digestion of the food, disobedience of the seasonal regimens (''ritu vaishamya''), suppression of the natural urges; iatrogenic factors like Improper administration of [[Panchakarma]] measures (''pratikarma vaishamya'') and the psychological factors like affliction of mind with passion, worry, fear, anger, grief are responsible for ''pandu''. <br /> *Heart and circulatory system are involved in the pathogenesis of ''pandu'' which is presented at the sites of skin and [[mamsa dhatu]] (flesh).<br /> *The specific features are observed as per the [[dosha]] dominance in pathogenesis. <br /> *Person indulging in the habitual consumption of clay (''mrittika'') gets [[dosha]] aggravated according to the taste of mud viz. astringent mud aggravates [[vata]], saline and alkaline mud aggravates [[pitta]] and sweet mud aggravates [[kapha]] [[dosha]]. These factors cause ''pandu'' by affecting the [[dhatu]] and [[ojas]]. <br /> *Chronic ''pandu roga'' is incurable. The prognosis depends upon involvement of [[dhatu] and its intensity. <br /> *If a patient of ''pandu roga'' excessively consumes [[pitta]] vitiating diet and regimen, the aggravated [[pitta]] causes ''kamala'' by involving the [[rakta]] and the [[mamsa dhatu]]. <br /> *First principle of management of ''pandu'' is administration of internal oleation ([[snehana]]) followed by strong (''teekshna'') emetic and purgation therapies for cleansing of the body (''shodhana''). In patients of ''kamala'', mild purgation therapy with bitter drugs is advised.<br /> *''Kamala'' is of two types: ''Koshtha-shaksha shrita'' and ''shakhashrita''. In ''koshtha-shakhashrita kamala'' there is excess increase in [[pitta]]. <br /> *In ''shakhashrita kamala'', [[pitta]] is obstructed by [[kapha]] and improperly circulated by [[vata]]. Therefore the treatment principles differ in both. <br /> *In ''koshtha-shaksha shrita kamala'', mild purgation is administered with bitter drugs with a focus on pacification of[[pitta]]. <br /> *In ''shakhashrita kamala'', principles of management are pacification of [[kapha]], and ''anulomana'' of [[vata]] to derive [[pitta]] to its own natural site. Therefore ''ruksha, amla, katu'' drugs are used in the treatment. <br /> *Suitable changes (combinations and permutations) in the treatment should be prescribed depending upon the strength of the [[dosha]] in the patient. The therapy should be dominated by unctuous drugs (oil, ghee etc) for ''vatika'' type of ''pandu''; by bitter and cooling drugs for ''paittika'' type and by pungent, bitter and hot drugs for [[kapha]]ja type of ''pandu''.<br /> *Strong elimination therapy is advised to remove the swallowed mud from the body after considering the strength of the patient. After the body is cleansed, different types of medicated ghee should be prescribed to the patient for promotion of strength. <br /> *''Haleemaka'' and is caused by the aggravation of [[vata]] and [[pitta]] [[dosha]]. Hence the treatment focus on pacification of [[vata]] and [[pitta]] [[dosha]].<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> === Pathological factors ===<br /> *[[Dosha]]: [[Pitta]] dominant three [[dosha]], sadhaka and ranjak [[pitta]], vyana and samana [[vata]], avalambak and kledaka [[kapha]] <br /> *[[Dhatu]](vitiated factors): [[Rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] <br /> *Status of [[agni]]/ dhatwagni/bhutagni: ''Manda'' at [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] level <br /> *Origin of disease: Heart and channels, Liver and spleen <br /> *Sites of vitiation: All body <br /> *Sites of clinical presentation: All body specifically skin and subcutaneous tissues <br /> *Srotas involved :Rasavaha, Raktavaha <br /> *Type of ''samprapti'' : ''Avarodha'' and ''kshaya'' <br /> *Basic principles of treatment: ''Shodhana'' (mainly [[virechana]]) and ''shamana'' (mainly [[pitta]] shamana) as per [[dosha]] dominance<br /> <br /> === General considerations ===<br /> ''Pandu'' can be related with the disorders of improper formation of blood tissue due to vitiation of [[pitta]] [[dosha]]. [[Pitta]] [[dosha]] is considered to be responsible for all digestion, transformation and metabolism processes in the body. Therefore, the disorders like anemia, nutritional deficiency are mainly considered under ''pandu roga''. The disorders which include pathologies of impaired metabolism and formation of plasma, blood, muscles and fat can also be referred under the umbrella of ''pandu roga''. These include thyroid function disorders, hematological disorders like thalessemia, jaundice etc.<br /> <br /> === Etiological factors observed in present era ===<br /> ==== Diet ==== <br /> The dietary factors that cause vitiation of [[pitta]] [[dosha]] and poor nutritional status of [[rakta dhatu]] are enlisted to cause ''pandu''. These include the items having sour, salt, pungent taste, hot potency, alkaline nature, mutually contradictory and unwholesome food. These shall be avoided to prevent ''pandu''. <br /> *Food with sour taste (''amla ahara'') includes sour curd, lemons, citric acid, pickles, and food with preservatives as jams, cold drinks, sauces, tamarind etc. <br /> *''Lavana ahara'' may be taken as food with excess salts or with salt added in packaged food or as pickles, chutneys etc.<br /> *''Madya'' includes alcoholic beverages as rum, beer, whisky, vodka etc.<br /> *''Kshara'' includes soda used in diet, cold drinks and beverages. <br /> *''Ati tikshna ahara'' includes as excessively spicy,pungent items as ''chhole, chaats, pakode, panipuri, chaaps, rajma,'' spicy vegetables and other dishes.<br /> *''Ati ushna'' includes food articles which are either very hot as tea, coffee etc. or which increase the metabolic activities of the body or also as very hot temperature.<br /> *''Mrittika bhakshana'' is considered as either oral ingestion of mud or use of articles contaminated with mud as unclean hands and fingers or as improperly washed vegetables or eatables.<br /> *''Asatmya bhojana'' may include food items that are not adopted or suited. It may be considered as sudden change of food style or habit or also as junk food used today, as they are not beneficial. <br /> <br /> Some scientific studies have proven the role of some of the ''aharaja'' factors in the causation of ''panduroga'' as tea (considered as ''ati ushna nidana'') has been proved to cause iron deficiency anemia by interfering with the absorption of iron. Similarly ''madya'' (alcohols) cause megaloblastic anemia by hampering the folate absorption.<br /> <br /> ==== Lifestyle ==== <br /> <br /> Excess day time sleep, exercise beyond one’s capacity and at improper time can lead to ''pandu''. Therefore, proper quality sleep and proper exercise are preventive measures for ''pandu''.<br /> <br /> ==== Psychological factors ==== <br /> <br /> Passion, worry, fear, anger and grief can affect digestion leading to poor nutritional status. Hence blissful state of mind is needed for proper nutrition. Rai and Kar in their observational study showed that worries, fear and grief are major etiological factors for iron deficiency anemia. These factors cause significant reduction of serum and bone marrow, while inhibiting the process of erythropoiesis. The inflammatory mediators such as IL-6, hepcidin are mediators in this pathology originated from grief and fear.&lt;ref&gt;Rai Shalini, Kar Anukul C. A review of role of psychological factors in the etiopathogenesis of Pandu roga with reference to iron deficiency anemia.Ayu,2016 Jan-March,31(1):18-21. &lt;/ref&gt;<br /> <br /> ==== Iatrogenic factors ==== <br /> <br /> Improper administration of oleation therapy and [[Panchakarma]] procedures can lead to ''pandu''.<br /> <br /> ==== Pathophysiology ====<br /> [[File:Pandu.png|500px|thumb]] <br /> The cardinal feature of pandu is appearance of pallor on skin of the patient. Complexion and luster of skin is maintained by [[rasa dhatu]] and [[rakta dhatu]]. The texture is maintained by [[mamsa dhatu]]. Unctuousness is maintained by [[meda dhatu]]. These four [[dhatu]] are important for maintaining the natural appearance of skin. In ''pandu'', the vitiated [[pitta]], due to its hot and sharply acting properties, impairs digestion process at [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] leading to their poor formation. The [[rasa dhatu]] transport channels originate in the heart and its vessels. The origin of channels of [[rakta]] is in the liver and spleen. Therefore, symptoms related to cardio-vascular system and hematological system. <br /> <br /> The sequential nourishment of [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] is impaired leading to poor quality tissues. Thus, overall functions of these systems are disturbed in ''pandu''. <br /> <br /> The type of pathogenesis includes formation of same [[dhatu]] (improperly formed tissues) due to poor digestive and metabolic processes at the above mentioned levels. Therefore, the treatment principle includes correction of this impairment.<br /> <br /> ==== Clinical features and conditions resembling the disease ====<br /> <br /> '''Premonitory symptoms''': Palpitations, dryness, lack of sweating, fatigue. <br /> <br /> '''Signs''': Decrease in complexion, strength, unctuousness and vitality are observed in ''pandu''. <br /> <br /> Various features related to that are categorized below:<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs<br /> ! scope=&quot;col&quot;| Symptoms Manifested<br /> |-<br /> | 1<br /> | ''Varnakshaya'' (depletion of complexion) <br /> | Discoloration of skin, poor lustre, pallor, yellowish, dark yellow skin <br /> |-<br /> | 2<br /> | ''Balakshaya'' (depletion of strength) <br /> | Weakness, fatigue<br /> |-<br /> | 3<br /> | ''Snehakshaya'' (depletion of unctuousness) <br /> | Dryness, poor quality of tissues <br /> |-<br /> | 4<br /> | ''Ojakshaya'' (depletion of vitality)<br /> | Fearfulness, excess worries, impaired sensations, lack of concentration, poor appearance <br /> |}<br /> <br /> The following clinical features are observed in ''pandu''. The involvement of [[dosha]], dushya and channels are as given in the following table:<br /> <br /> ==== Signs ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs<br /> ! scope=&quot;col&quot;| [[Dosha]]<br /> ! scope=&quot;col&quot;| ''Dushya''<br /> ! scope=&quot;col&quot;| ''Srotas''<br /> |-<br /> | 1<br /> | ''Dhatushaithilya'' (laxity of tissues)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 2<br /> | [[Dhatu]] gaurava (heaviness in tissues)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 3<br /> | ''Varnakshaya'' (poor complexion)<br /> | [[Vata]], [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 4<br /> | ''Balakshaya'' (poor strength)<br /> | [[Vata]],[[Pitta]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 5<br /> | ''Snehakshaya'' (depletion of unctuousness)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rakta dhatu]], [[Meda dhatu]]<br /> | ''Raktavaha, Medavaha''<br /> |-<br /> | 6<br /> | [[Oja]]gunakshaya'' (depletion of vitality)<br /> | [[Vata]], [[Pitta]]<br /> | Sapta [[dhatu]]<br /> | ''Saptadhatu vaha''<br /> |-<br /> | 7<br /> | ''Raktalpata'' (poor quality and less blood)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 8<br /> | ''Medalpata'' (poor quality and less fats) <br /> | [[Vata]], [[Pitta]]<br /> | [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 9<br /> | ''Nihasarta'' (poor quality tissues) <br /> | Tri[[dosha]]<br /> | Sapta[[dhatu]]<br /> | ''Saptadhatu vaha''<br /> |-<br /> | 10<br /> | ''Shithilendriya'' (impairment of senses) <br /> | Tri[[dosha]]<br /> | Sapta[[dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 11<br /> | ''Vaivarnya'' (discoloration) <br /> | [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 12<br /> | ''Panduta'' (pallor) <br /> | [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |}<br /> <br /> ==== Symptoms ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Symptoms<br /> ! scope=&quot;col&quot;| [[Dosha]]<br /> ! scope=&quot;col&quot;| ''Dushya''<br /> ! scope=&quot;col&quot;| ''Srotas''<br /> |-<br /> | 1<br /> | ''Karnakshweda'' (tinnitus)<br /> | [[Vata]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 2<br /> | ''Hatanala'' (poor digestion)<br /> | [[Kapha]], [[Vata]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 3<br /> | ''Daurbalya'' (weakness)<br /> | [[Vata]], [[Pitta]]<br /> | Sapta[[dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 4<br /> | ''Sadana'' (bodyache)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 5<br /> | ''Annadwesha'' (anorexia)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 6<br /> | ''Shrama'' (overworked, fatigue)<br /> | [[Vata]]<br /> |[[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 7<br /> | ''Bhrama'' (vertigo)<br /> | [[Vata]], [[Pitta]]<br /> | [[Majja dhatu]]<br /> | ''Majjavaha''<br /> |-<br /> | 8<br /> | ''Gatrashoola'' (pain)<br /> | [[Vata]]<br /> | [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 9<br /> | ''Jwara'' (feverishness)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]], Sweda<br /> | ''Rasavaha, Swedavaha''<br /> |-<br /> | 10<br /> | ''Shwasa'' (dyspnea)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha, Pranavaha''<br /> |-<br /> | 11<br /> | ''Gaurava'' (heaviness)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 12<br /> | ''Aruchi'' (aversion to food)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 13<br /> | ''Mridit iv gatrata'' (kneading pain)<br /> | [[Vata]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 14<br /> | ''Pidita unmathit gatrata'' (churning, pressing pain)<br /> | [[Vata]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 15<br /> | ''Akshikutashotha'' (pre-orbital swelling)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 16<br /> | ''Harita lomata'' (greenish body hair)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 17<br /> | ''Shirnalomata'' (falling body hair)<br /> | [[Vata]],[[Pitta]]<br /> | [[Asthi dhatu]]<br /> | ''Asthivaha''<br /> |-<br /> | 18<br /> | ''Hatprabhatva'' (poor luster)<br /> | [[Pitta]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 19<br /> | ''Kopana'' (irritability)<br /> | [[Pitta]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 20<br /> | ''Shishiradwesha'' (disliking cold)<br /> | [[Vata]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 21<br /> | ''Nindraluta'' (excessive sleepiness)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 22<br /> | ''Sthivanadhikya'' (excessive sputum)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 23<br /> | ''Alpawaka'' (less speaking)<br /> | [[Vata]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 24<br /> | ''Pindikodweshtanam'' (pain in calf muscles)<br /> | [[Vata]]<br /> | [[Rakta dhatu]],[[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 25<br /> | ''Katiurupadaruka Sadana'' (pain in legs, thighs, and the lumbar region)<br /> | [[Vata]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 26<br /> | ''Arohaneayasa'' (dyspnea on climbing)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |}<br /> <br /> ==== Differentiating features of ''dosha'' dominance ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! colspan=&quot;3&quot;|Changes in color and texture manifested in the whole body and its parts<br /> |-<br /> ! scope=&quot;col&quot;| ''Vata'' dominant ''pandu''<br /> ! scope=&quot;col&quot;| ''Pitta'' dominant ''pandu''<br /> ! scope=&quot;col&quot;| ''Kapha'' dominant ''pandu''<br /> |-<br /> | Blackish or dark reddish discoloration of the skin, blood vessels, nails, face and eyes<br /> | Yellowish discoloration of skin, the skin, blood vessels, nails, face and eyes<br /> | Whitishness discoloration of skin, the skin, blood vessels, nails, face and eyes<br /> |-<br /> ! colspan=&quot;3&quot;|Features related to urine and stool<br /> |-<br /> | Blackish urine &amp; stool, dry stools<br /> | Yellowish colored urine &amp; stool, foul smelling and loose stools <br /> | Whitishness in the urine &amp; stool <br /> |-<br /> ! colspan=&quot;3&quot;|Features related to ''agni''<br /> |-<br /> | Tastelessness in the mouth<br /> | Pungent taste in mouth<br /> | Sweet taste in the mouth<br /> |-<br /> | rowspan=&quot;6&quot;|Abdominal distension<br /> | Does not relish food<br /> | Anorexia<br /> |-<br /> | rowspan=&quot;2&quot;|Improper digestion of food<br /> | Heaviness<br /> |-<br /> | Excessive salivation<br /> |-<br /> | Sour Eructation<br /> | Laziness<br /> |-<br /> | Eructation associated with burning sensation<br /> | rowspan=&quot;2&quot;| Vomiting<br /> |-<br /> | Burning Sensation<br /> |-<br /> ! colspan=&quot;3&quot;|Other features<br /> |-<br /> | Pain in the body, pricking pain<br /> | Increased body temperature<br /> | Drowsiness<br /> |-<br /> | Tremor<br /> | Excessive thirst<br /> | Horripilation<br /> |-<br /> | Headache<br /> | Fainting due to excessive thirst/coma<br /> | Mental fatigue<br /> |-<br /> | Weakness<br /> | Profuse sweating<br /> | Fainting<br /> |-<br /> | Pain in the sides of the chest<br /> | rowspan = &quot;2&quot;| Weakness<br /> | Prostration<br /> |-<br /> | Giddiness<br /> |Inability to speak<br /> |-<br /> | Swelling/Edema<br /> | Feeling of darkness in front of eyes<br /> | Cough, Dyspnea, Edema<br /> |-<br /> ! colspan=&quot;3&quot;|Likings and Dislikings<br /> |-<br /> | <br /> | Longing for cold things and environment<br /> | Likings for pungent items<br /> |-<br /> |<br /> | Dislike for hot food and atmosphere; also, do not suit the patient<br /> | Likings for ununctuous things<br /> |-<br /> |<br /> | Dislike for sour food; also, do not suit the patient<br /> | Likings for hot things<br /> |}<br /> <br /> ==== Consequences of [[dhatu]] kshaya ====<br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Pathological event<br /> ! scope=&quot;col&quot;| Consequence<br /> ! scope=&quot;col&quot;| Objectivity<br /> |-<br /> | 1<br /> | [[Rasa dhatu]] kshaya<br /> | Decrease in quality tissue that nourish blood or required for formation of blood<br /> | Deficiency in factors required for erythropoietin like vitamin B12, Vitamin K, iron, transferin, ferritin, protein like hemochrome which give red color to blood, electrolyte Na+, K+, Ca++, Mg+, H+, Cl-, albumin, globulins, glucose, amino acid, nucleic acids and lipoprotein, endocrine secretions regulating fluid metabolism <br /> |-<br /> | 2<br /> | [[Rakta dhatu]] kshaya<br /> | Decrease in quality and volume of blood and further decrease in factors required for formation of [[mamsa dhatu]](muscles) <br /> | Decrease in volume of whole blood, hematocrit percentage, endocrine secretions regulating blood metabolism <br /> |-<br /> | 3<br /> | [[Mamsa dhatu]] kshaya<br /> | Decrease in quality and volume of muscles and further decrease in factors required for formation of [[mamsa dhatu]](muscles)<br /> | Decrease in muscle proteins, endocrine secretions regulating muscle metabolism <br /> |-<br /> | 4<br /> | [[Meda dhatu]] kshaya<br /> | Decrease in quality and volume of fats and lipids and further decrease in factors required for formation of [[asthi dhatu]](bones)<br /> | Decrease in lipids, endocrine secretions regulating lipid metabolism <br /> |}<br /> <br /> ==== List of diseases with features as observed in ''pandu'' ====<br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs and Symptoms<br /> ! scope=&quot;col&quot;| Diseases<br /> |-<br /> | 1<br /> | Blackish discoloration of the skin<br /> | Megaloblastic anemias (Vitamin B12 and folic acid deficiency) as reversible melanin skin hyperpigmentation which develops mainly over the knuckles<br /> |-<br /> | 2<br /> | Reddish discoloration of body parts<br /> | Development of petechiae, echymosis or bruises on the body due to thrombocytopenia associated with anemia (as in Aplastic anemias). Anemia due to Addison’s disease (increased tanning)<br /> |-<br /> | 3<br /> | Dry skin or body<br /> | Megaloblastic anemias due to the abnormal proliferation of epithelial cell surfaces. Anemia due to hypothyroid states<br /> |-<br /> | 4<br /> | Reddish or Blackish discoloration in eyes, face and nails<br /> | Body parts due to spontaneous bleeding manifestations, pernicious anemia <br /> |-<br /> | 5<br /> | Blackish urine<br /> | Cola colored urine in various types of intravascular hemolytic anemias when the plasma hemoglobin exceeds the haptoglobin binding capacity<br /> |-<br /> | 6<br /> | Blackish stool/melena <br /> | Gastrointestinal bleeding responsible for anemias - may be due to any ulcers or worm infestations or any other cause<br /> |-<br /> | 7<br /> | Dryness of stool or constipation<br /> | Megaloblastic anemias and anemia due to hypothyroidism<br /> |-<br /> | 8<br /> | &quot;Pins and needles&quot; sensation<br /> | pernicious anemias as well as in megaloblastic anemias<br /> |-<br /> | 9<br /> | Tremors<br /> | Cobalamin deficiency which causes peripheral neuropathy and degeneration of the posterior and pyramidal tracts of the spinal cord<br /> |-<br /> | 10<br /> | Loss of taste/distaste<br /> | Pernicious anemia<br /> |-<br /> | 11<br /> | Bodyache<br /> | Hemolytic anemia, hypothyroidism<br /> |}<br /> <br /> The observations of resemblance with diseases in conventional system of medicine show that all types of anemia specially megaloblastic anemia, pernicious anemia, hypothyroidism, haemolytic anemia can be considered under umbrella of ''pandu''. The objective parameters used for these disorders can be utilized for research on efficacy of [[Ayurveda]] therapies in management of ''pandu''.<br /> <br /> === ''Kamala'' ===<br /> <br /> In the second part of the chapter ''pandu, kamala'' is elaborately described. If a person suffering from ''pandu'' follows [[pitta]] provoking diet and lifestyle, he suffers from ''kamala''. This shows ''kamala'' is consequence of ''pandu'' or ''pandu'' is essential causative factor for ''kamala''. This shows the relation of jaundice originated due to hemolytic anemia. In other types of jaundice, this notion is not observed in practice. ''Kamala'' can occur without ''pandu''. (Su.Utt.44/9, A.Hri.Ni.13/15-17)<br /> <br /> Yellowish discoloration of sclera, skin, face, nails, and urine associated with constitutional symptoms like anorexia, debility, indigestion, loss of physical strength is called ''Kamala''.<br /> <br /> ==== Types of ''kamala'' ====<br /> <br /> ==== 1. ''Shakhashrita Kamala/Alpa'' [[pitta]] (''Dhatu ashrita'') ====<br /> <br /> The passage of [[pitta]] is obstructed by vitiated [[kapha]] and not allowing [[pitta]] to enter ''kostha'', it will cause excess of [[pitta]] in body tissues in ''Shakhasrita Kamala''. This involves the obstructive pathologies at hepatic circulation. As the [[pitta]] cannot enter the gastro-intestinal tract, it leads to clay colored stools. In obstructive jaundice, bilirubin has no access to the intestine and it is the reason for pale stools. <br /> <br /> This description of stools being clay colored, but the urine being yellow shows that they were very close in concept to the modern day physiopathology of obstructive jaundice especially hepatocellular ones (wherein due to an inability of the bile to pass into the gastrointestinal tract it circulates into the blood and the conjugated bilirubin being water soluble fraction is filtered and passes out into the urine). Further the description of [[pitta]] being the bi-product of [[rakta]] is also very similar to the fact of bile being produced as a result of Red Blood Cell destruction. The most common cause is gall stones in the common bile duct and pancreatic cancer in the head of pancreas. Also, a group of parasites known as liver flukes can live in common bile duct causing obstructive jaundice. Biliary atresia, cholanjiocarcinoma, pancreatitis, cholestasis of pregnancy and pancreatic pseudocysts are causes for obstruction of bile flow into the duodenum.<br /> <br /> ==== 2. ''Kostha Shakhashrita Kamala/bahu'' [[pitta]] (''Maha Srotasashrita'') ====<br /> <br /> ''Bahupitta kamala'' or ''Kostha-shakhasrita kamala'' mostly resembles the pre-hepatic and hepatocellular jaundice. Pre-hepatic jaundice is caused by anything which causes haemolysis. Pre-hepatic cause include severe malaria, certain genetic diseases such as sickle cell anemia, spherocytosis, thalassemia, pyruvate kinase deficiency and glucose 6-phospate dehydrogenase (G6PD) deficiency, which lead to increased destruction of red cells and therefore hemolytic jaundice. Hepato-cellular Jaundice can be caused by acute or chronic hepatitis, hepatotoxicity, cirrhosis, drug induced hepatitis and alcoholic liver disease.<br /> <br /> === ''Haleemaka'' ===<br /> <br /> ''Haleemaka'' is a further stage of ''pandu''. Reduced oxygen carrying capacity of blood (reduced ''jeevan karma'') causes depletion of strength and work capacity. This further leads to lack of libido and bodyache. Condition resembles cholestasis. Bile stasis and back pressure leads to liver failure which leads to the further symptoms of ''halimaka'' or sclerosing cholangitis. It is characterized by severe fatigue (''bala utsaha hani''), jaundice (''harita pita meda''), dark urine, cirrhosis, portal hypertension and hepato-megaly.<br /> <br /> === ''Panaki'' ===<br /> <br /> ''Panaki'', another disease in same context of ''halimaka'', explains the condition of malabsorption especially of fat due to lack of bile juice in digestion due to obstruction which leads to steatorrhoea (''bhinna varcha''). Reduced fat absorption leads to deficiency of fat soluble vitamins such as A, D, E and K.<br /> <br /> === ''Kumbha Kamala'' ===<br /> <br /> The description of ''kumbha kamala'' denotes the advanced stage of ''Kostha-shakhasrita kamala'' wherein the main seat of pathology is situated somewhere in the gastro-intestinal tract. ''Kumbha'' is one of the synonyms of ''koshtha''. Edema is described as one of the important clinical features of ''kumbha kamala'' (Su. Utt. 44).<br /> <br /> Both types of ''kamala'', if not treated convert into difficult to treat and hardened skin. ''Kumbha kamala'' could also refer to the presentation of the patient having distended abdomen i.e. ascitis, which is one of the important clinical feature of liver diseases, which are also the main cause of jaundice. <br /> <br /> Liver is the main seat for a number of functions and when it gets severely deranged the liver functions are affected. The clinical picture of ''kumbha kamala'' corresponds to these as observed below:<br /> <br /> *The production of majority of proteins as albumin, few globulins, cerulo-plasmin etc., is hampered leading to edema in the various body parts (''Bhrusham Shoonam cha Manavaḥ'') and dryness in the body.<br /> *The coagulation profile gets affected leading to increased prothrombin time, the presentation of esophageal varices, bleeding per rectum etc. Here the same features have been described as ''sarakta akshi mukha, chhardi vida mootra'' meaning blood seen or coming out of the eyes, mouth or in the vomitus (esophageal varices), through the stool (haemorrhoids) or through the urine.<br /> *The derangement of liver structure in these diseases leads to some presentation of obstructive jaundice with yellow urine (''peeta mootrata'').<br /> *The stage of altered consciousness has also been described as ''tandra moha samanvita'' (acting as if sleepy or having altered perception - semiconscious state).<br /> *The stage of hepatic coma has also been described as ''nashta sangya'' means the person is not able to recognise and perceive anything – unconscious state (''Sangya Nama Grahanena'').<br /> *The excessive dryness (''kharibhuta'') is generally due to increased bile salts deposition leading to pruritus and dryness of skin. This dryness further leads to the hardness.<br /> *As liver disorders progress, coagulatory defects begin leading to upper G.I. track bleed causing black stools/''malena''(''Krishna shakrita''). Secondly conjugated bilirubin which does not enter intestine becomes urobilinogen giving urine dark color (''krishna mutra'').<br /> *Excessive edema is observed all over body. Cirrhosis of the liver is a condition that causes reduction in plasma protein concentration. Cirrhosis means development of large amounts of fibrous tissue among the liver parenchymal cells. One result is failure of these cells to produce sufficient plasma proteins, leading to decreased plasma colloid osmotic pressure and the generalized edema that goes with this condition. Another way that liver cirrhosis causes edema is that the liver fibrosis sometimes compresses the abdominal portal venous drainage vessels as they pass through the liver before emptying back into the general circulation. Blockage of this portal venous outflow raises capillary hydrostatic pressure throughout the gastrointestinal area and further increases filtration of fluid out of the plasma into the intra-abdominal areas. When this occurs, the combined effects of decreased plasma protein concentration and high portal capillary pressures cause transudation of large amounts of fluid and protein into the abdominal cavity, a condition referred to as ascites.<br /> *Hematemesis/bleeding in eyes,per rectum, hematuria (''Sarakta akshi mukha chhardi vinamutra'') explains the bleeding disorders which begin in late hepatic disorders. <br /> *Fainting (''tamah pravesha'') is due to reduced cerebral perfusion due to various causes like gastrointestinal bleed, electrolyte or metabolic disturbance.<br /> *Drowsiness (''tandra''), confusion (''moha'') are further symptoms of hepatic encephalopathy. Neuropsychological findings are experienced in all phases of hepatic encephalopathy. It is experienced as forgetfulness, mild confusion and irritability, inversed sleep pattern followed by lethargy and personality changes. The third stage is marked with worsened confusion and in fourth stage is coma. ''Mada, Murchha'' and ''sanyasa'' are mentioned earlier as disorders due to vitiated blood in [[Vidhishonitiya Adhyaya]].<br /> <br /> === Management of Diseases (Treatment Protocols) ===<br /> ==== Current clinical practices in treatment of ''pandu'' and ''kamala'' ( referred from Chikitsa Pradeep) ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| Type<br /> ! scope=&quot;col&quot;| Medicine<br /> ! scope=&quot;col&quot;| Dose<br /> ! scope=&quot;col&quot;| Time<br /> ! scope=&quot;col&quot;| ''Anupana''<br /> |-<br /> |rowspan = &quot;3&quot;|[[Vata]] dominant ''pandu''<br /> | ''Mahayogaraja samira mixture''<br /> | 120-480 mg<br /> | After meals <br /> | Ghee (''dadimadi'') + honey<br /> |-<br /> | ''Tiktaka ghritam''<br /> | 10-40 ml<br /> | After meals <br /> | Hot water<br /> |-<br /> | ''Navajivana rasa''<br /> | 120-200 mg<br /> | After meals <br /> | Milk<br /> |-<br /> | rowspan = &quot;2&quot;|[[Pitta]] dominant ''pandu''<br /> | ''Tapyadi lauha'' mixture<br /> | 250 - 600 mg<br /> | After meals <br /> | Dadimadi ghee + udumbaravaleha<br /> |-<br /> | ''Vasadi'' decoction<br /> | 20 - 40 ml<br /> | After meals <br /> | Honey<br /> |-<br /> | [[Kapha]] dominant ''pandu''<br /> | ''Gomutra Haritaki'' mixture<br /> | 600 mg - 3 grams<br /> | After meals <br /> | Honey + juice of castor leaves<br /> |-<br /> | ''Mrittika bhakshana janya''<br /> | ''Gomutra Haritaki'' mixture<br /> | 600 mg - 3 grams<br /> | After meals<br /> | ''Kumari Asava''<br /> |-<br /> | rowspan=&quot;2&quot;|''Riddha Patha Kamala''<br /> | ''Ichha bhedi rasa''<br /> | 120 - 180 mg<br /> | Early morning one time<br /> | Lemon juice<br /> |-<br /> | ''Suta shekhara kalpa''<br /> | 120 - 250 mg<br /> | After meals<br /> | Milk + sugar<br /> |-<br /> | ''Koshtha ashrita kamala''<br /> | colspan=&quot;4&quot;|As like ''pitta'' dominant ''pandu''<br /> |}<br /> <br /> ==== Evidence based clinical practices ====<br /> <br /> *In a study carried out by Shazi L. and Thakar A., Amalaki [[rasayana]] was found effective in management of iron deficiency anemia. However the efficacy was equal in clinical parameters and less in biochemical parameters in comparison to conventional drugs a combination of folic acid and ferrous sulphate. &lt;ref&gt; Shaizi Layeeq, Thakar A.B. Clinical efficacy of Amalaki rasayana in the management of pandu(iron deficiency anemia). Ayu.2015.July-Sep.36(3):290-297. &lt;/ref&gt; <br /> *''Punarnava mandura'' was found effective as ''panduhara'' and [[rasayana]] in patients of geriatric anemia and can counteract most of the pathological manifestations related to ''pandu roga'' in old age (geriatric anemia)&lt;ref&gt;Pandya M.G. Dave A.R. A clinical study of punarnava mandura in the management of pandu roga in old age (geriatric anemia).Ayu,2014 July-Sept; 35(3);252-260. &lt;/ref&gt;. In another study on pregnant females, ''punarnava mandura'' and ''dhatri lauha'' are found effective in management of anemia during pregnancy.&lt;ref&gt;Khandelwal D.A, Donga S.B.,Dei L.P. Clinical efficacy of punarnava mandura and dhatri lauha in the management of garbhini pandu (anemia in pregnancy) Ayu,2015 Oct-Dec;36(4); 397-403. &lt;/ref&gt;<br /> *A herbomineral formulation ''Trikatrayadi Lauha'' suspension was observed an effective, well-tolerated, and clinically safe formulation for the management of Iron deficiency anemia in children.&lt;ref&gt;Kumar A, Garai AK. A clinical study on Pandu Roga, iron deficiency anemia, with Trikatrayadi Lauha suspension in children. J [[Ayurveda]] Integr Med 2012;3:215-22.&lt;/ref&gt; Khan et.al. observed that the same formulation was observed effective to relieve the signs and symptoms of ''pandu'' in comparison to standard control drug (Fersolate-CM). ''Trikatrayadi lauha'' provided significant improvement on Hbgm%, RBC, PCV, MCV, serum iron, percent transferrin saturation and to decrease TIBC. Therefore ''Trikatrayadi Lauha'' can be used in ''Panduroga'' or IDA as a safe hematinic drug.&lt;ref&gt;Khan Subir kumar, Vyas S.N. Chandola H.M. Efficacy of Trikatrayadi lauha in Pandu roga with reference to iron deficiency anemia. Ayu 2012. Jan-Mar, 33(1):62-67.&lt;/ref&gt; <br /> *Tewari et.al. studied the ethnopharmacological approaches to the therapy of jaundice&lt;ref&gt;Tewari D, Mocan A, Parvanov ED, Sah AN, Nabavi SM, Huminiecki L, Ma ZF, Lee YY, Horba´nczuk JO and Atanasov AG (2017) Ethnopharmacological Approaches for Therapy of Jaundice: Part I. Front. Pharmacol. 8:518. doi: 10.3389/fphar.2017.00518&lt;/ref&gt; and highly used plant species from acanthaceae,euphorbiaceae, asteraceae, combretaceae and fabaceae family in the management of jaundice. The team of researchers elaborately studied hystorical perspective of jaundice, its pathophysiology and enlisted 207 herbs used in management of jaundice.&lt;ref&gt;Tewari D, Mocan A, Parvanov ED, Sah AN, Nabavi SM, Huminiecki L, Ma ZF, Lee YY, Horba´nczuk JO and Atanasov AG (2017) Ethnopharmacological Approaches for Therapy of Jaundice: Part II. Highly Used Plant Species from Acanthaceae, Euphorbiaceae, Asteraceae, Combretaceae, and Fabaceae Families. Front. Pharmacol. 8:519. doi: 10.3389/fphar.2017.00519&lt;/ref&gt;<br /> <br /> === Research studies on ''pandu'' ===<br /> <br /> Some studies are available on the internet which depict the efficacy of various Ayurvedic drugs having iron (in the form of ''lauha'' and ''mandura'') compounds in the management of ''pandu'': <br /> #Sarkar PK, Prajapati PK, Choudhary AK, Shukla VJ, Ravishankar B. Haematinic Evaluation of Lauha Bhasma and Mandura Bhasma on HgCl2-induced Anemia in Rats. Indian J Pharm Sci 2007;69:791-5.<br /> #Sarkar PK. A Comparative Pharmaceutico-pharmaco-clinical study of Lauha Bhasma and Mandura Bhasma w.s.r. to its Pāndu-hara Effect, MD thesis. I.P.G.T. &amp; R.A. Jamnagar: Gujrat [[Ayurveda]] University; 2005. <br /> #Garai A, Rai M, Kumar A. Role of an Ayurvedic Compound (Panduhara Yoga) in the Management of Iron Deficiency Anaemia in Children. Ayu 2009;30:469-74.<br /> #Gupta V, Reddy KR. Experimental Studies of Lohasava. Aryavaidyan 2007;21:87-94.<br /> #Sarkar PK, Prajapati PK, Shukla VJ, Ravishankar B, Choudhary AK. Toxicity and recovery studies of two Ayurvedic preparations of iron. Indian J Exp Biol 2009;47:987-92.<br /> #Devarshi P, Kanse A, Kanse R, Mane S, Patil S, Varute AT. Effect of Mandura Bhasma on lipolytic Activities of Liver, Kidney and Adipose Tissue of Albino Rat During CCl4 Induced hepatic Injury. J Biosci 1986;10:227-34.<br /> #Pandit S, Biswas TK, Debnath PK, Saha AV, Chowdhury U, Shaw BP, et al. Chemical and pharmacological evaluation of different Ayurvedic preparations of iron. J Ethnopharmacology 1999;65:149-56.<br /> #Dinesh C. Sharma, Deepa Chandiramani, Manminder Riyat and Praveen Sharma. Scientific evaluation of some ayurvedic preparations for correction of iron deficiency and anemia. Indian Journal of Clinical Biochemistry, 2007 / 22 (2) 123-128<br /> #Ambika Das, PA03.17. A clinical evaluation of Punarnavadi Mandura and Dadimadi Ghritha in management of Pandu (Iron defeciency anaemia), Ancient Science of Life 2013; 32 (s2):86<br /> <br /> One of the studies (Sharma D.C, 2007) report that the Ayurvedic preparations were found equally effective as the allopathic compound in the management of iron deficiency anemia and the fact that the side effects were almost nil establishes them to be even superior.<br /> <br /> The modes of action of drugs and procedures as stated in this chapter, which is without iron, have not been studied much in anemia. Though, some of the preparations described in anemia have been found very useful in the management of other types of anemia as sickle cell anemia,&lt;ref&gt;Macmillan Keith, A herbomineral composition for the treatment of Sickle Cell disease. Retrieved from tgs.freshpatents.com&lt;/ref&gt; aplastic anemia,&lt;ref&gt;Subhash singh, Shiv Kumar Singh and Narendra Kumar Singh. Aaplastic anaemia, complete cure, ayurvedic way – case report. International Journal Of Basic And Applied Medical Sciences Issn: 2277-2103 (Online) An Online International Journal Available At http://www.cibtech.org/jms.htm 2013 vol. 3 (1) january-april, pp.242-246/subhash et al.&lt;/ref&gt; etc.<br /> <br /> So, further studies need to be done in order to know the efficacy of these drugs and mechanisms in the various types of anemia.<br /> <br /> === Principle of treatment for ''kamala'' ===<br /> <br /> The management of ''kamala'' by the drugs stated in the chapter has been found to show good results but the mechanism of their action is still not clear. Practically few studies are available on the net which prove the efficacy of ''Ayurvedic'' compounds in the management of hepatocellular jaundice. &lt;ref&gt;Nirmal kumar and Anil kumar singh. Phalatrikadi kvatha - an ayurvedic hepatoprotective drug. International journal of research in pharmacy and chemistry.2013, 3(3) Available online at www.ijrpc.com&lt;/ref&gt;<br /> <br /> === List of Research Works done ===<br /> <br /> === IPGT&amp;RA, Jamnagar ===<br /> <br /> #Chaudhary sudhakar (1958): Pandu Roga Nidana.<br /> #Mishra N. K. (1959): A clinical study of Pandu Roga.<br /> #Bhattacharya R. C. (1965): Pandu Roga Par Paradamruta Teekshana Laugh Karyanvekshana<br /> #Ojha N.H.(1966): Abhraka Bhasma Ka Pandu Roga Par Karyanvekshana.<br /> #Pillai K.D.R. (1974): Study of effect of Swarna Makshika Bhasma on Pandu.<br /> #Jha Prabhakar (1974): Swayama Lauha Bhasma Ka Pandu Roga Par Kriyatamaka Adhyayana.<br /> #Sharada B.D.(1975) : Effect of Yogaraja on Garbhavasthajanya Pandu.<br /> #Gopalkrishana (1986): Lauha Bhasma on Pandu with special reference to its Media.<br /> #M.S.Trivedi (1992): Effect of Yogaraja Rasayana in Garbhavsthajanya Pandu.<br /> #Nargunde Rajeshri (1997): A comparative Phaemaco-clinical Study of Shudha Kasisa Churna and Kasisa Bhasma on PANDU. <br /> #Jain Sangeeta (2000): A study on Pandu Roga w.s.r. to ANAEMIA and Its Management with Shodhana and Yogaraja Rasayana.<br /> #Sarkar P K (2005): A comparative pharmaco-pharmaceutico Clinical study of lauha bhasma and mandura bhasma w.s.r. to Panduhara effects.<br /> <br /> === Banaras Hindu University, Varanasi ===<br /> <br /> #Trivedi R D (1979):Hematological and clinical stubby in pandu.<br /> #Malhotra E. N. (1983): Management of Garbhavasthajnya Pandu with Mandura Bhasma.<br /> #Nandkishore (1985): Clinical Assessment of Navayasa Lauha in Management of Pandu.<br /> #Chauhana A. P. S. (1985): Role of Manduradi Ghanvati in Pandu Roga.<br /> #Dixit A. K. (1994): Clinical study in Yogaraja Rasayana on Pandu.<br /> #Singh S. N. (1996): A study on aetio pathogenesis of Pandu Roga w s r to its Samprapti Vighatan by Makshika.<br /> #Agrawal N. Assessment of Effect of Mandura Bhasma in Iron Deficiency Anemia in Children, MD thesis. P.G. Department of Kaumarbhritya. Varanasi: IMS, B.H.U; 2007. <br /> <br /> === National Institute of [[Ayurveda]], Jaipur and others ===<br /> <br /> #Tyagi R. M. (1980): Pandu Roga Evam Vajra Vatak Mandura .<br /> #B. C. Sharma (1985): Pandu Roga Samprapti Vivechana.<br /> #R. K. Sharma (1994): Pandu Roga Mandura Bhasma Ka Chikitsatmaka Adhyayan.<br /> #Meena R. K. (1994): Guduchi in Pandu Roga.<br /> #Joshi N. (2005): Pharmaceutical, Pharmacological and Toxicological Study of Various Lauha Preparations(Kalpa) w.s.r. to Iron Deficiency Anaemia, M.D. Thesis. P. G. Department of Rasa Shastra and Bhaishajya Kalpana, Jaipur.<br /> #Kumath V. (2006): A Comprehensive Study of Haritaki with Special Reference to the Efficacy of Terminalia chebula Retz. on pandu Roga, MD thesis. P. G. Department. of Dravyaguna, Government. Ujjain, Madhya Pradesh: Autonomous Dhanvantari [[Ayurveda]] College and Hospital; 2006.<br /> <br /> === Potential areas /scope for further research ===<br /> <br /> The following drugs referred in management of ''pandu'' need to be researched more for providing evidences of its efficacy in anemia and related disorders in comparison to conventional management: <br /> #''Dadimadya ghritam''<br /> #''Katukadyam ghritam''<br /> #''Pathyaghritam''<br /> #''Danti ghritam''<br /> #''Drakshaghritam''<br /> #''Haridradi ghritam''<br /> #''Darvyadi ghritam''<br /> #''Navayasa churnam''<br /> #''Manduravataka''<br /> #''Tapyadi lauha''<br /> #''Yogaraja''<br /> #''Punarnava Mandura''<br /> #''Darvyadi leha''<br /> #''Dhatryavaleha''<br /> #''Manduravatakah''<br /> #''Gaudo arishah''<br /> #''Bijakarisha''<br /> #''Dhatryarishta''<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References ==<br /> &lt;/div&gt;<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Pandu_Chikitsa&diff=45381 2025-11-01T05:27:10Z

<p>Agnivesha: /* Prognosis of pandu */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Pandu Chikitsa<br /> |titlemode=append<br /> |keywords=Pandu roga, kamala, koshthashakhashrita kamala, shakhashrita kamala, panaka, kumbhakamala, haleemaka, anemia, jaundice, Ayurveda, Indian system of medicine, charak samhita. iron deficiency anaemia, blood deficiency <br /> |description=Chikitsa Sthana Chapter 16. Management of Pandu (Anemia and diseases due to blood deficiency)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 16. Management of Pandu (Anemia and diseases due to blood deficiency)&lt;/big&gt;'''<br /> {{Infobox<br /> |title = Pandu Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 16<br /> |label2 = Preceding Chapter<br /> |data2 = [[Grahani Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Hikka Shwasa Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Kar A.C., Rai S., Aladoriya N., [[Yogesh Deole|Deole Y. S.]]<br /> |label7 = Reviewer <br /> |data7 = Ojha S.N.<br /> |label8 = Editors<br /> |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.017 10.47468/CSNE.2020.e01.s06.017]<br /> }}<br /> &lt;big&gt;'''Abstract &lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;''Pandu roga'' (resembling with anemia) is characterized by pallor which is associated with different colors according to [[dosha]] involved. Besides ''pandu roga'', this chapter also describes two types of ''kamala'' (jaundice) which are two other associated diseases, caused by predominance of [[pitta]] [[dosha]] which causes alteration in normal colors of the body. The chapter describes general etiology, pathogenesis, symptoms etc of ''pandu roga'' (anemia) as well as each of its five types viz. [[vata]], [[pitta]], [[kapha]], sannipataja and ''mrittika-bhakshana'' (clay eating) ''pandu''. After describing general principle of treatment of ''pandu'' and ''kamala'', detailed treatment of each of the conditions mentioned above along with ''pathya'' (recommended diet) and apathya (prohibited diet) are given. <br /> &lt;br/&gt;<br /> '''Keywords''': Pandu roga, kamala, koshthashakhashrita kamala, shakhashrita kamala, panaka, kumbhakamala, haleemaka, anemia, jaundice<br /> &lt;/p&gt;<br /> <br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> After the description of ''grahani dosha'', the chapter on ''pandu roga'' is given, as the causative factors of ''pandu roga'' are quite similar to that of ''grahani dosha''. Probably it is because that the various gastrointestinal problems can also lead to development of ''pandu roga''. The chapter deals with general discoloration of the body such as pallor, yellowish, greenish and whitish discoloration which is seen in skin, eyes, lips, face, nails, urine feces etc. <br /> <br /> ''Kamala'' (jaundice) and ''haleemaka'' (severe obstructive jaundice) have also been included in this chapter as they are also characterized by the discoloration and may relate to ''pandu roga''. ''Kamala'' is of two types, ''swatantra'' (primary) and ''partantra'' (secondary). The etiological factors of ''primary kamala'' are described later. Secondary ''kamala'' develops in chronic phase of ''pandu'' in which vitiated [[pitta]] is seated in [[rasa dhatu]] and in kamala, [[pitta]] goes deeper in [[rakta dhatu]] and continues to go deeper in [[mamsa dhatu]] and [[meda dhatu]], then it is called ''haleemaka'' and ''kumbha kamala'' respectively. <br /> <br /> ''Kamala'' is of two types in repect to location, ''shakhshrita kamala'' located in body tissues in the form of obstructed [[pitta]] and ''koshthashrita kamala'', localized to gut and can be easily removed by purgation while ''shakhashrita kamala'' needs to be brought to gut for removal.<br /> &lt;/div&gt;<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातः पाण्डुरोगचिकित्सितं व्याख्यास्यामः||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः||२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātaḥ pāṇḍurōgacikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2||<br /> <br /> athAtaH pANDurogacikitsitaM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2||<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt; <br /> Now we shall expound the chapter &quot;Pandu Chikitsa&quot; (Management of Anemia and diseases due to blood deficiency). Thus said Lord Atreya. [1-2]<br /> <br /> === Five types of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगाः स्मृताः पञ्च वातपित्तकफैस्त्रयः| <br /> <br /> चतुर्थः सन्निपातेन पञ्चमो भक्षणान्मृदः||३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgāḥ smr̥tāḥ pañca VātaPittaKaphaistrayaḥ| <br /> <br /> caturthaḥ sannipātēna pañcamō bhakṣaṇānmr̥daḥ||3|| <br /> <br /> pANDurogAH smRutAH pa~jca vAtapittakaphaistrayaH| <br /> <br /> caturthaH sannipAtena pa~jcamo bhakShaNAnmRudaH||3||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Pandu roga is classified into five types as vatika, paittika, [[kapha]]ja, tri[[dosha]]ja and mrittika bhakshhana janya pandu [3]<br /> <br /> === Pathogenesis of pandu ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दोषाः पित्तप्रधानास्तु यस्य कुप्यन्ति धातुषु| <br /> <br /> शैथिल्यं तस्य धातूनां गौरवं चोपजायते||४|| <br /> <br /> ततो वर्णबलस्नेहा ये चान्येऽप्योजसो गुणाः| <br /> <br /> व्रजन्ति क्षयमत्यर्थं दोषदूष्यप्रदूषणात्||५|| <br /> <br /> सोऽल्परक्तोऽल्पमेदस्को निःसारः शिथिलेन्द्रियः| <br /> <br /> वैवर्ण्यं भजते, तस्य हेतुं शृणु सलक्षणम्||६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dōṣāḥ Pittapradhānāstu yasya kupyanti Dhātuṣu| <br /> <br /> śaithilyaṁ tasya dhātūnāṁ gauravaṁ cōpajāyatē||4|| <br /> <br /> tatō varṇabalasnēhā yē cānyē'pyōjasō guṇāḥ| <br /> <br /> vrajanti kṣayamatyarthaṁ dōṣadūṣyapradūṣaṇāt||5|| <br /> <br /> sō'lparaktō'lpamēdaskō niḥsāraḥ śithilēndriyaḥ| <br /> <br /> vaivarṇyaṁ bhajatē, tasya hētuṁ śr̥ṇu salakṣaṇam||6|| <br /> <br /> doShAH pittapradhAnAstu yasya kupyanti dhAtuShu| <br /> <br /> shaithilyaM tasya dhAtUnAM gauravaM copajAyate||4|| <br /> <br /> tato varNabalasnehA ye cAnye~apyojaso guNAH| <br /> <br /> vrajanti kShayamatyarthaM doShadUShyapradUShaNAt||5|| <br /> <br /> so~alparakto~alpamedasko niHsAraH shithilendriyaH| <br /> <br /> vaivarNyaM bhajate, tasya hetuM shRuNu salakShaNam||6||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Aggravated [[pitta]] predominant [[dosha]] vitiates the [[dhatu]]. This vitiation of [[dhatu]] cause sluggishnesss (''shithilata'') and heaviness (''gaurava'') in the [[dhatu]] resulting in diminution of complexion (''varna''), strength (''bala''), unctuousness (''sneha'') and the qualities of [[ojas]]. Thus, the person develops diminished blood (''rakta'') and the fatty tissue ([[meda dhatu]]) and absence of the vitality of all the tissues (''nihsara'') decreases functional status of sense organs (''sithilendriyah'') and discoloration of the body. [[Hetu]] (etiological factors and pathogenesis) and the sign and symptoms of the disease will be explained hereafter [4-6]<br /> <br /> === General etio-pathogenesis of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षाराम्ललवणात्युष्णविरुद्धासात्म्यभोजनात्| <br /> <br /> निष्पावमाषपिण्याकतिलतैलनिषेवणात्||७|| <br /> <br /> विदग्धेऽन्ने दिवास्वप्नाद्व्यायामान्मैथुनात्तथा| <br /> <br /> प्रतिकर्मर्तुवैषम्याद्वेगानां च विधारणात्||८|| <br /> <br /> कामचिन्ताभयक्रोधशोकोपहतचेतसः| <br /> <br /> समुदीर्णं यदा पित्तं हृदये समवस्थितम्||९|| <br /> <br /> वायुना बलिना क्षिप्तं सम्प्राप्य धमनीर्दश| <br /> <br /> प्रपन्नं केवलं देहं त्वङ्मांसान्तरमाश्रितम्||१०|| <br /> <br /> प्रदूष्य कफवातासृक्त्वङ्मांसानि करोति तत्| <br /> <br /> पाण्डुहारिद्रहरितान् वर्णान् बहुविधांस्त्वचि||११|| <br /> <br /> स पाण्डुरोग इत्युक्तः ...|१२| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣārāmlalavaṇātyuṣṇaviruddhāsātmyabhōjanāt| <br /> <br /> niṣpāvamāṣapiṇyākatilatailaniṣēvaṇāt||7|| <br /> <br /> vidagdhē'nnē divāsvapnādvyāyāmānmaithunāttathā| <br /> <br /> pratikarmartuvaiṣamyādvēgānāṁ ca vidhāraṇāt||8|| <br /> <br /> kāmacintābhayakrōdhaśōkōpahatacētasaḥ| <br /> <br /> samudīrṇaṁ yadā Pittaṁ hr̥dayē samavasthitam||9|| <br /> <br /> vāyunā balinā kṣiptaṁ samprāpya dhamanīrdaśa| <br /> <br /> prapannaṁ kēvalaṁ dēhaṁ tvaṅmāṁsāntaramāśritam||10|| <br /> <br /> pradūṣya Kaphavātāsr̥ktvaṅmāṁsāni karōti tat| <br /> <br /> pāṇḍuhāridraharitān varṇān bahuvidhāṁstvaci||11|| <br /> <br /> sa pāṇḍurōga ityuktaḥ ...|12| <br /> <br /> kShArAmlalavaNAtyuShNaviruddhAsAtmyabhojanAt| <br /> <br /> niShpAvamAShapiNyAkatilatailaniShevaNAt||7|| <br /> <br /> vidagdhe~anne divAsvapnAdvyAyAmAnmaithunAttathA| <br /> <br /> pratikarmartuvaiShamyAdvegAnAM ca vidhAraNAt||8|| <br /> <br /> kAmacintAbhayakrodhashokopahatacetasaH| <br /> <br /> samudIrNaM yadA pittaM hRudaye samavasthitam||9|| <br /> <br /> vAyunA balinA kShiptaM samprApya dhamanIrdasha| <br /> <br /> prapannaM kevalaM dehaM tva~gmAMsAntaramAshritam||10|| <br /> <br /> pradUShya kaphavAtAsRuktva~gmAMsAni karoti tat| <br /> <br /> pANDuhAridraharitAn varNAn bahuvidhAMstvaci||11|| <br /> <br /> sa pANDuroga ityuktaH ...|12| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Followings are the etiological factors of ''pandu'':<br /> *The (excessive) intake of alkaline, sour, saline, hot and mutually contradictory foods, unwholesome food, ''nishpava'' (a type of pulses), ''masha, pinyaka'' (oil cake) and ''tila'' oil; <br /> *Indulging in day sleep, performing exercise and sex before digestion of the food;<br /> *Improper administration of [[Panchakarma]] measures (''pratikarma vaishamya'') and the disobedience of the seasonal regimens (''ritu vaishamya'') <br /> *Suppression of the natural urges<br /> *Affliction of mind with passion, worry, fear, anger, grief<br /> <br /> Indulgence in the above factors aggravates [[pitta]] seated in the cardiac region and then this [[pitta]] is forcefully propelled by the [[vata]] into the ten ''dhamanis'' (attached to the heart) and further into the whole body. There, it gets located in between the ''tvacha'' (skin) and the [[mamsa dhatu]] (flesh) and additionally vitiates the [[kapha]], [[vata]], [[rakta]], tvacha and [[mamsa dhatu]] resulting in the development of various discolorations in the body like ''pandu'' (pale), ''haridra'' (yellow),and ''harita'' (green). This is called as ''pandu roga'' [7-11½]<br /> <br /> === Premonitory symptoms ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> .. तस्य लिङ्गं भविष्यतः| <br /> <br /> हृदयस्पन्दनं रौक्ष्यं स्वेदाभावः श्रमस्तथा||१२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ... tasya liṅgaṁ bhaviṣyataḥ| <br /> <br /> hr̥dayaspandanaṁ raukṣyaṁ svēdābhāvaḥ śramastathā||12||<br /> <br /> ... tasya li~ggaM bhaviShyataH| <br /> <br /> hRudayaspandanaM raukShyaM svedAbhAvaH shramastathA||12||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The premonitory symptoms of the disease are palpitations, ununctuousness, absence of sweating and fatigue [12]<br /> <br /> === General symptoms of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सम्भूतेऽस्मिन् भवेत् सर्वः कर्णक्ष्वेडी हतानलः| <br /> <br /> दुर्बलः सदनोऽन्नद्विट् श्रमभ्रमनिपीडितः||१३|| <br /> <br /> गात्रशूलज्वरश्वासगौरवारुचिमान्नरः| <br /> <br /> मृदितैरिव गात्रैश्च पीडितोन्मथितैरिव||१४|| <br /> <br /> शूनाक्षिकूटो हरितः शीर्णलोमा हतप्रभः| <br /> <br /> कोपनः शिशिरद्वेषी निद्रालुः ष्ठीवनोऽल्पवाक्||१५|| <br /> <br /> पिण्डिकोद्वेष्टकट्यूरुपादरुक्सदनानि च| <br /> <br /> भवन्त्यारोहणायासैर्विशेषश्चास्य [१] वक्ष्यते||१६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sambhūtē'smin bhavēt sarvaḥ karṇakṣvēḍī hatānalaḥ| <br /> <br /> durbalaḥ sadanō'nnadviṭ śramabhramanipīḍitaḥ||13|| <br /> <br /> gātraśūlajvaraśvāsagauravārucimānnaraḥ| <br /> <br /> mr̥ditairiva gātraiśca pīḍitōnmathitairiva||14|| <br /> <br /> śūnākṣikūṭō haritaḥ śīrṇalōmā hataprabhaḥ| <br /> <br /> kōpanaḥ śiśiradvēṣī nidrāluḥ ṣṭhīvanō'lpavāk||15|| <br /> <br /> piṇḍikōdvēṣṭakaṭyūrupādaruksadanāni ca| <br /> <br /> bhavantyārōhaṇāyāsairviśēṣaścāsya [1] vakṣyatē||16|| <br /> <br /> sambhUte~asmin bhavet sarvaH karNakShveDI hatAnalaH| <br /> <br /> durbalaH sadano~annadviT shramabhramanipIDitaH||13|| <br /> <br /> gAtrashUlajvarashvAsagauravArucimAnnaraH| <br /> <br /> mRuditairiva gAtraishca pIDitonmathitairiva||14|| <br /> <br /> shUnAkShikUTo haritaH shIrNalomA hataprabhaH| <br /> <br /> kopanaH shishiradveShI nidrAluH ShThIvano~alpavAk||15|| <br /> <br /> piNDikodveShTakaTyUrupAdaruksadanAni ca| <br /> <br /> bhavantyArohaNAyAsairvisheShashcAsya [1] vakShyate||16|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> On developing ''pandu roga'' the patients have the symptoms of tinnitus, low digestion, weakness, prostration, disliking for food, fatigue, giddiness, pain in the body, fever, dyspnea, heaviness and anorexia. The patient feels as if the limbs are being kneaded, pressed or churned; develops peri-orbital swelling, greenish complexion and falling of body hair. The person loses his body luster, becomes irritable, dislikes cold things, feels sleepy, spits in excess, avoids speaking, suffers from cramps in the calf region and experiences excessive fatigue as well as pain and weakness in the lumbar region, thighs and feet specifically by exertion while climbing [13-16]<br /> <br /> The signs and symptoms specific to each variety of ''pandu'' will be described henceforth.<br /> <br /> === ''Vatika pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आहारैरुपचारैश्च वातलैः कुपितोऽनिलः| <br /> <br /> जनयेत्कृष्णपाण्डुत्वं [१] तथा रूक्षारुणाङ्गताम्||१७|| <br /> <br /> अङ्गमर्दं रुजं तोदं कम्पं पार्श्वशिरोरुजम्| <br /> <br /> वर्चःशोषास्यवैरस्यशोफानाहबलक्षयान्||१८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> āhārairupacāraiśca Vātalaiḥ kupitō'nilaḥ| <br /> <br /> janayētkr̥ṣṇapāṇḍutvaṁ [1] tathā rūkṣāruṇāṅgatām||17|| <br /> <br /> aṅgamardaṁ rujaṁ tōdaṁ kampaṁ pārśvaśirōrujam| <br /> <br /> varcaḥśōṣāsyavairasyaśōphānāhabalakṣayān||18|| <br /> <br /> AhArairupacAraishca vAtalaiH kupito~anilaH| <br /> <br /> janayetkRuShNapANDutvaM [1] tathA rUkShAruNA~ggatAm||17|| <br /> <br /> a~ggamardaM rujaM todaM kampaM pArshvashirorujam| <br /> <br /> varcaHshoShAsyavairasyashophAnAhabalakShayAn||18|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Indulging in [[vata]] increasing diet and regimens aggravates [[vata]] leading to ''vatika pandu roga''. The skin of the patient becomes blackish dawn colored and ununctuous. Its other symptoms are malaise, ache, pricking pain, tremor, pain in both the sides of the chest, headache; dried feces, distaste in the mouth; swelling, gaseous distention of the abdomen and weakness [17-18]<br /> <br /> === ''Paittika pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तलस्याचितं पित्तं यथोक्तैः स्वैः प्रकोपणैः| <br /> <br /> दूषयित्वा तु रक्तादीन् पाण्डुरोगाय कल्पते||१९|| <br /> <br /> स पीतो हरिताभो वा ज्वरदाहसमन्वितः| <br /> <br /> तृष्णामूर्च्छापिपासार्तः [१] पीतमूत्रशकृन्नरः||२०|| <br /> <br /> स्वेदनः शीतकामश्च न चान्नमभिनन्दति| <br /> <br /> कटुकास्यो न चास्योष्णमुपशेतेऽम्लमेव च||२१|| <br /> <br /> उद्गारोऽम्लो विदाहश्च विदग्धेऽन्नेऽस्य जायते| <br /> <br /> दौर्गन्ध्यं भिन्नवर्चस्त्वं दौर्बल्यं तम एव च||२२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> Pittalasyācitaṁ Pittaṁ yathōktaiḥ svaiḥ prakōpaṇaiḥ| <br /> <br /> dūṣayitvā tu raktādīn pāṇḍurōgāya kalpatē||19|| <br /> <br /> sa pītō haritābhō vā jvaradāhasamanvitaḥ| <br /> <br /> tr̥ṣṇāmūrcchāpipāsārtaḥ [1] pītamūtraśakr̥nnaraḥ||20|| <br /> <br /> svēdanaḥ śītakāmaśca na cānnamabhinandati| <br /> <br /> kaṭukāsyō na cāsyōṣṇamupaśētē'mlamēva ca||21|| <br /> <br /> udgārō'mlō vidāhaśca vidagdhē'nnē'sya jāyatē| <br /> <br /> daurgandhyaṁ bhinnavarcastvaṁ daurbalyaṁ tama ēva ca||22|| <br /> <br /> pittalasyAcitaM pittaM yathoktaiH svaiH prakopaNaiH| <br /> <br /> dUShayitvA tu raktAdIn pANDurogAya kalpate||19|| <br /> <br /> sa pIto haritAbho vA jvaradAhasamanvitaH| <br /> <br /> tRuShNAmUrcchApipAsArtaH [1] pItamUtrashakRunnaraH||20|| <br /> <br /> svedanaH shItakAmashca na cAnnamabhinandati| <br /> <br /> kaTukAsyo na cAsyoShNamupashete~amlameva ca||21|| <br /> <br /> udgAro~amlo vidAhashca vidagdhe~anne~asya jAyate| <br /> <br /> daurgandhyaM bhinnavarcastvaM daurbalyaM tama eva ca||22||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> [[Pitta]] gets aggravated by indulging in [[pitta]] vitiating ''nidanas'' (diet and regimens) which by involving the blood etc. causes [[pitta]]ja pandu. Its symptoms are, change in complexion to yellowish/greenish, fever, burning sensation; morbid thirst and fainting; excessive perspiration and longing for cold things and environment. The person does not relish food, develops pungent taste, disfavors hot and sour things; gets sour eructations associated with burning sensation due to impaired digestion of food; emits foul smell from mouth; the urine and stool become yellow in color, has loose motions and develops weakness and fainting [19-22]<br /> <br /> === [[Kapha]]ja pandu ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विवृद्धः श्लेष्मलैः श्लेष्मा पाण्डुरोगं स पूर्ववत्| <br /> <br /> करोति गौरवं तन्द्रा छर्दिं श्वेतावभासताम्||२३|| <br /> <br /> प्रसेकं लोमहर्षं च सादं मूर्च्छां भ्रमं क्लमम्| <br /> <br /> श्वासं कासं तथाऽऽलस्यमरुचिं वाक्स्वरग्रहम्||२४|| <br /> <br /> शुक्लमूत्राक्षिवर्चस्त्वं कटुरूक्षोष्णकामताम्| <br /> <br /> श्वयथुं मधुरास्यत्वमिति [१] पाण्ड्वामयः कफात्||२५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vivr̥ddhaḥ ślēṣmalaiḥ ślēṣmā pāṇḍurōgaṁ sa pūrvavat| <br /> <br /> karōti gauravaṁ tandrā chardiṁ śvētāvabhāsatām||23|| <br /> <br /> prasēkaṁ lōmaharṣaṁ ca sādaṁ mūrcchāṁ bhramaṁ klamam| <br /> <br /> śvāsaṁ kāsaṁ tathā''lasyamaruciṁ vāksvaragraham||24|| <br /> <br /> śuklamūtrākṣivarcastvaṁ kaṭurūkṣōṣṇakāmatām| <br /> <br /> śvayathuṁ madhurāsyatvamiti [1] pāṇḍvāmayaḥ kaphāt||25|| <br /> <br /> vivRuddhaH shleShmalaiH shleShmA pANDurogaM sa pUrvavat| <br /> <br /> karoti gauravaM tandrA chardiM shvetAvabhAsatAm||23|| <br /> <br /> prasekaM lomaharShaM ca sAdaM mUrcchAM bhramaM klamam| <br /> <br /> shvAsaM kAsaM tathA~a~alasyamaruciM vAksvaragraham||24|| <br /> <br /> shuklamUtrAkShivarcastvaM kaTurUkShoShNakAmatAm| <br /> <br /> shvayathuM madhurAsyatvamiti [1] pANDvAmayaH kaphAt||25|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Aggravated [[kapha]] by indulging in [[kapha]] increasing diet and regimen gives rise to [[kapha]]ja pandu roga through the pathogenesis described earlier. The sign and symptoms of [[kapha]]ja pandu are heaviness, drowsiness, vomiting, whitish complexion, salivation, horripilation, prostration, fainting, giddiness, mental fatigue, dyspnea, cough, laziness, anorexia, obstruction in speech and voice, whitish coloration of the eyes, urine and feces; longing for pungent, ununctuous and hot things; and develops edema and sweet taste in the mouth [23-25]<br /> <br /> === ''Tridoshaja pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सर्वान्नसेविनः सर्वे दुष्टा दोषास्त्रिदोषजम्| <br /> त्रिदोषलिङ्गं कुर्वन्ति पाण्डुरोगं सुदुःसहम्||२६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sarvānnasēvinaḥ sarvē duṣṭā dōṣāstridōṣajam| <br /> tridōṣaliṅgaṁ kurvanti pāṇḍurōgaṁ suduḥsaham||26|| <br /> <br /> sarvAnnasevinaH sarve duShTA doShAstridoShajam| <br /> tridoShali~ggaM kurvanti pANDurogaM suduHsaham||26|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Indulging in the etiological factors of all the three types of ''pandu'' leads to aggravation of the three [[dosha]] resulting in ''tridoshaja pandu'' with the features of all the three types of ''pandu roga''. This type of ''pandu'' causes much distress to the patient [26]<br /> <br /> === ''Mrittika bhakshana pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मृत्तिकादनशीलस्य कुप्यत्यन्यतमो मलः| <br /> कषाया मारुतं, पित्तमूषरा, मधुरा कफम्||२७|| <br /> <br /> कोपयेन्मृद्रसादींश्च रौक्ष्याद्भुक्तं विरूक्षयेत् [१] | <br /> पूरयत्यविपक्वैव स्रोतांसि निरुणद्धि च||२८|| <br /> <br /> इन्द्रियाणां बलं हत्वा तेजो वीर्यौजसी तथा| <br /> पाण्डुरोगं करोत्याशु बलवर्णाग्निनाशनम्||२९|| <br /> <br /> शूनगण्डाक्षिकूटभ्रूः [२] शूनपान्नाभिमेहनः| <br /> क्रिमिकोष्ठोऽतिसार्येत मलं सासृक् कफान्वितम्||३०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mr̥ttikādanaśīlasya kupyatyanyatamō malaḥ| <br /> kaṣāyā mārutaṁ, Pittamūṣarā, madhurā Kapham||27|| <br /> <br /> kōpayēnmr̥drasādīṁśca raukṣyādbhuktaṁ virūkṣayēt [1] | <br /> pūrayatyavipakvaiva srōtāṁsi niruṇaddhi ca||28|| <br /> <br /> indriyāṇāṁ balaṁ hatvā tējō vīryaujasī tathā| <br /> pāṇḍurōgaṁ karōtyāśu balavarṇāgnināśanam||29|| <br /> <br /> śūnagaṇḍākṣikūṭabhrūḥ [2] śūnapānnābhimēhanaḥ| <br /> krimikōṣṭhō'tisāryēta malaṁ sāsr̥k kaphānvitam||30|| <br /> <br /> mRuttikAdanashIlasya kupyatyanyatamo malaH| <br /> kaShAyA mArutaM, pittamUSharA, madhurA kapham||27|| <br /> <br /> kopayenmRudrasAdIMshca raukShyAdbhuktaM virUkShayet [1] | <br /> pUrayatyavipakvaiva srotAMsi niruNaddhi ca||28|| <br /> <br /> indriyANAM balaM hatvA tejo vIryaujasI tathA| <br /> pANDurogaM karotyAshu balavarNAgninAshanam||29|| <br /> <br /> shUnagaNDAkShikUTabhrUH [2] shUnapAnnAbhimehanaH| <br /> krimikoShTho~atisAryeta malaM sAsRuk kaphAnvitam||30|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Person indulging in the habitual consumption of clay (''mrittika'') gets [[dosha]] aggravated according to the taste of mud viz. astringent mud aggravates [[vata]], saline and alkaline mud aggravates [[pitta]] and sweet mud aggravates [[kapha]] [[dosha]]. The clay further because of its ununctuousness causes dryness in the [[rasa]] (nutrients of the digested food). The clay due to its undigestable nature fills and blocks the channels of circulation leading to decrease in the sharpness of the senses, luster, energy and [[ojas]] (vital essence of the tissues). This quickly manifesting ''pandu'' results in the loss of strength, complexion and digestive power. Its clinical features are edema of the cheeks, peri orbital edema and edema on the eyebrows area, feet, umbilical region and the pudendum; infestation of worms in the [[koshtha]] (gastrointestinal tract) and loose motions, the stool associated with blood and mucus. [27-30]<br /> <br /> === Prognosis of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगश्चिरोत्पन्नः खरीभूतो न सिध्यति| <br /> कालप्रकर्षाच्छूनो [१] ना यश्च पीतानि पश्यति||३१|| <br /> <br /> बद्धाल्पविट्कं सकफं हरितं योऽतिसार्यते| <br /> दीनः श्वेतातिदिग्धाङ्गश्छर्दिमूर्च्छातृषार्दितः||३२|| <br /> <br /> स नास्त्यसृक्क्षयाद्यश्च पाण्डुः श्वेतत्वमाप्नुयात्| <br /> इति पञ्चविधस्योक्तं पाण्डुरोगस्य लक्षणम्||३३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgaścirōtpannaḥ kharībhūtō na sidhyati| <br /> kālaprakarṣācchūnō [1] nā yaśca pītāni paśyati||31|| <br /> <br /> baddhālpaviṭkaṁ saKaphaṁ haritaṁ yō'tisāryatē| <br /> dīnaḥ śvētātidigdhāṅgaśchardimūrcchātr̥ṣārditaḥ||32|| <br /> <br /> sa nāstyasr̥kkṣayādyaśca pāṇḍuḥ śvētatvamāpnuyāt| <br /> iti pañcavidhasyōktaṁ pāṇḍurōgasya lakṣaṇam||33|| <br /> <br /> pANDurogashcirotpannaH kharIbhUto na sidhyati| <br /> kAlaprakarShAcchUno [1] nA yashca pItAni pashyati||31|| <br /> <br /> baddhAlpaviTkaM sakaphaM haritaM yo~atisAryate| <br /> dInaH shvetAtidigdhA~ggashchardimUrcchAtRuShArditaH||32|| <br /> <br /> sa nAstyasRukkShayAdyashca pANDuH shvetatvamApnuyAt| <br /> iti pa~jcavidhasyoktaM pANDurogasya lakShaNam||33||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Chronic ''pandu roga'' is incurable. Other symptoms indicating the incurability are appearance of excessive dryness and edema; patient visualizes everything as yellow; passes very hard stool or less amount of stool or passes loose stool associated with mucus and green in color; feels exceedingly prostrated; body becomes excessively white as if be smeared with whiteness; has vomiting, fainting and excessive thirst and when the patient develops excessive whiteness in the body as a result of loss of blood.<br /> <br /> Thus, the signs and symptoms of all the five type of ''pandu roga'' have been described. [31-33]<br /> <br /> === ''Koshthashakhashraya kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगी तु योऽत्यर्थं पित्तलानि निषेवते| <br /> तस्य पित्तमसृग्मांसं दग्ध्वा रोगाय कल्पते||३४|| <br /> <br /> हारिद्रनेत्रः स भृशं हारिद्रत्वङ्नखाननः| <br /> रक्तपीतशकृन्मूत्रो भेकवर्णो हतेन्द्रियः||३५|| <br /> <br /> दाहाविपाकदौर्बल्यसदनारुचिकर्षितः| <br /> कामला बहुपित्तैषा कोष्ठशाखाश्रया मता||३६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgī tu yō'tyarthaṁ Pittalāni niṣēvatē| <br /> tasya Pittamasr̥gmāṁsaṁ dagdhvā rōgāya kalpatē||34|| <br /> <br /> hāridranētraḥ sa bhr̥śaṁ hāridratvaṅnakhānanaḥ| <br /> Rakta pītaśakr̥nmūtrō bhēkavarṇō hatēndriyaḥ||35|| <br /> <br /> dāhāvipākadaurbalyasadanārucikarṣitaḥ| <br /> kāmalā bahuPittaiṣā kōṣṭhaśākhāśrayā matā||36|| <br /> <br /> pANDurogI tu yo~atyarthaM pittalAni niShevate| <br /> tasya pittamasRugmAMsaM dagdhvA rogAya kalpate||34|| <br /> <br /> hAridranetraH sa bhRushaM hAridratva~gnakhAnanaH| <br /> raktapItashakRunmUtro bhekavarNo hatendriyaH||35|| <br /> <br /> dAhAvipAkadaurbalyasadanArucikarShitaH| <br /> kAmalA bahupittaiShA koShThashAkhAshrayA matA||36|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If a patient of ''pandu roga'' excessively follows [[pitta]] vitiating diet and regimen, the [[pitta]] so aggravated by involving the [[rakta]] and the [[mamsa dhatu]] causes ''kamala''. Its clinical features are the eyes, skin, nails and face of the patient become exceedingly yellow; stool and urine become reddish-yellow in color; complexion develops a color similar to that of a frog (found in rainy season); the senses get impaired; has burning sensation, indigestion, weakness, prostration and anorexia. This ''kamala'' is caused by excess of [[pitta]] is known as ''koshthashakhashrita'' [34-36]<br /> <br /> === ''Kumbha kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कालान्तरात् खरीभूता कृच्छ्रा स्यात् कुम्भकामला| 36½ |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kālāntarāt kharībhūtā kr̥cchrā syāt kumbhakāmalā| 36½|<br /> <br /> kAlAntarAt kharIbhUtA kRucchrA syAt kumbhakAmalA| 36½|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> With the due course of time the disease (''kamala'') becomes deep seated (''kharibhuta'') resulting in excessive dryness of the body or afflicted tissue and thus becomes difficult to cure. This condition is called ''kumbha kamala'' [36½]<br /> <br /> === Bad prognostic symptoms of ''kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कृष्णपीतशकृन्मूत्रो [१] भृशं शूनश्च मानवः||३७||<br /> <br /> सरक्ताक्षिमुखच्छर्दिविण्मूत्रो यश्च ताम्यति| <br /> दाहारुचितृषानाहतन्द्रामोहसमन्वितः||३८|| <br /> <br /> नष्टाग्निसञ्ज्ञः क्षिप्रं हि कामलावान् विपद्यते|38½| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kr̥ṣṇapītaśakr̥nmūtrō [1] bhr̥śaṁ śūnaśca mānavaḥ||37|| <br /> <br /> saraktākṣimukhacchardiviṇmūtrō yaśca tāmyati| <br /> dāhārucitr̥ṣānāhatandrāmōhasamanvitaḥ||38|| <br /> <br /> naṣṭāgnisañjñaḥ kṣipraṁ hi kāmalāvān vipadyatē|38½|<br /> <br /> kRuShNapItashakRunmUtro [1] bhRushaM shUnashca mAnavaH||37|| <br /> <br /> saraktAkShimukhacchardiviNmUtro yashca tAmyati| <br /> dAhArucitRuShAnAhatandrAmohasamanvitaH||38|| <br /> <br /> naShTAgnisa~jj~jaH kShipraM hi kAmalAvAn vipadyate|38½| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the stool and urine of the patient (of ''kamala'') become black and yellow; develops excessive edema; eyes and face becomes red colored; vomit, stool and urine are mixed with blood; the patient feels like going in darkness; has burning sensation, anorexia, morbid thirst, constipation, drowsiness and fainting; and the person looses his [[agni]] and consciousness; such patient may succumb to death quickly [37-38½]<br /> <br /> === Principles of treatment ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> साध्यानामितरेषां तु प्रवक्ष्यामि चिकित्सितम्||३९|| <br /> <br /> तत्र पाण्ड्वामयी स्निग्धस्तीक्ष्णैरूर्ध्वानुलोमिकैः| <br /> संशोध्यो मृदुभिस्तिक्तैः कामली तु विरेचनैः||४०|| <br /> <br /> ताभ्यां संशुद्धकोष्ठाभ्यां पथ्यान्यन्नानि दापयेत्| <br /> शालीन् सयवगोधूमान् पुराणान् यूषसंहितान्||४१|| <br /> <br /> मुद्गाढकीमसूरैश्च जाङ्गलैश्च रसैर्हितैः| <br /> यथादोषं विशिष्टं च तयोर्भैषज्यमाचरेत्||४२|| <br /> <br /> पञ्चगव्यं महातिक्तं कल्याणकमथापि वा| <br /> स्नेहनार्थं घृतं दद्यात् कामलापाण्डुरोगिणे||४३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sādhyānāmitarēṣāṁ tu pravakṣyāmi cikitsitam||39|| <br /> <br /> tatra pāṇḍvāmayī snigdhastīkṣṇairūrdhvānulōmikaiḥ| <br /> saṁśōdhyō mr̥dubhistiktaiḥ kāmalī tu virēcanaiḥ||40|| <br /> <br /> tābhyāṁ saṁśuddhakōṣṭhābhyāṁ pathyānyannāni dāpayēt| <br /> śālīn sayavagōdhūmān purāṇān yūṣasaṁhitān||41|| <br /> <br /> mudgāḍhakīmasūraiśca jāṅgalaiśca rasairhitaiḥ| <br /> yathādōṣaṁ viśiṣṭaṁ ca tayōrbhaiṣajyamācarēt||42|| <br /> <br /> pañcagavyaṁ mahātiktaṁ kalyāṇakamathāpi vā| <br /> snēhanārthaṁ ghr̥taṁ dadyāt kāmalāpāṇḍurōgiṇē||43|| <br /> <br /> sAdhyAnAmitareShAM tu pravakShyAmi cikitsitam||39|| <br /> <br /> tatra pANDvAmayI snigdhastIkShNairUrdhvAnulomikaiH| <br /> saMshodhyo mRudubhistiktaiH kAmalI tu virecanaiH||40|| <br /> <br /> tAbhyAM saMshuddhakoShThAbhyAM pathyAnyannAni dApayet| <br /> shAlIn sayavagodhUmAn purANAn yUShasaMhitAn||41|| <br /> <br /> mudgADhakImasUraishca jA~ggalaishca rasairhitaiH| <br /> yathAdoShaM vishiShTaM ca tayorbhaiShajyamAcaret||42|| <br /> <br /> pa~jcagavyaM mahAtiktaM kalyANakamathApi vA| <br /> snehanArthaM ghRutaM dadyAt kAmalApANDurogiNe||43|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now, the treatment for the curable types of ''pandu roga'' is being described here:<br /> <br /> The patient suffering from the ''pandu'' should first be given strong (''tikshna'') emetic and purgation therapies after the administration of internal oleation ([[snehana]]) for cleansing of the body (''shodhana''). <br /> <br /> On the other hand, patient of ''kamala'' should be given mild purgation therapy with bitter drugs. After the cleansing of the ''koshtha'' by the above procedures the patient of both of these diseases should be given wholesome food consisting of old ''shali'' rice, barley and wheat mixed with the ''yusha'' (vegetable soup) of ''mudga, adhaki'' and ''masura'', and the ''rasa'' (meat soup) of animals inhabiting the arid zone. <br /> <br /> On the basis of the aggravated [[dosha]] specific medicines are to be administered to the patients of these two categories (which will be described later in the chapter). For the oleation of the patient of ''pandu'' and ''kamala panchagavya ghrita, mahatikta ghrita'' and ''kalyanaka ghrita'' should be given [39-43]<br /> <br /> === ''Dadimadya ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दाडिमात् कुडवो धान्यात् कुडवार्धं पलं पलम्| <br /> चित्रकाच्छृङ्गवेराच्च पिप्पल्यष्टमिका तथा||४४|| <br /> <br /> तैः कल्कैर्विंशतिपलं घृतस्य सलिलाढके|<br /> सिद्धं हृत्पाण्डुगुल्मार्शःप्लीहवातकफार्तिनुत्||४५|| <br /> <br /> दीपनं श्वासकासघ्नं मूढवाते च शस्यते| <br /> दुःखप्रसविनीनां च वन्ध्यानां चैव गर्भदम्||४६|| <br /> <br /> इति दाडिमाद्यं घृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dāḍimāt kuḍavō dhānyāt kuḍavārdhaṁ palaṁ palam| <br /> citrakācchr̥ṅgavērācca pippalyaṣṭamikā tathā||44|| <br /> <br /> taiḥ kalkairviṁśatipalaṁ ghr̥tasya salilāḍhakē| <br /> siddhaṁ hr̥tpāṇḍugulmārśaḥplīhaVātakaphārtinut||45|| <br /> <br /> dīpanaṁ śvāsakāsaghnaṁ mūḍhavātē ca śasyatē| <br /> duḥkhaprasavinīnāṁ ca vandhyānāṁ caiva garbhadam||46|| <br /> <br /> iti dāḍimādyaṁ ghr̥tam| <br /> <br /> dADimAt kuDavo dhAnyAt kuDavArdhaM palaM palam| <br /> citrakAcchRu~ggaverAcca pippalyaShTamikA tathA||44|| <br /> <br /> taiH kalkairviMshatipalaM ghRutasya salilADhake| <br /> siddhaM hRutpANDugulmArshaHplIhavAtakaphArtinut||45|| <br /> <br /> dIpanaM shvAsakAsaghnaM mUDhavAte ca shasyate| <br /> duHkhaprasavinInAM ca vandhyAnAM caiva garbhadam||46|| <br /> <br /> iti dADimAdyaM ghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take twenty ''pala'' of ghee, one ''adhaka'' of water and add to it the paste prepared of one ''kudava'' of ''dadima'', half ''kudava'' of ''dhanya'', one ''pala'' each of ''chitraka'' and ''sringavera'' and one ''ashtamika'' (two ''karsha'') of ''pippali'' and prepare ghee as per method of ''sneha paka''.This medicated ghee stimulates the power of digestion. It cures heart disease, anemia, gulma, hemorrhoids, spleenomegaly and disorders of [[vata]] and [[kapha]].It is also useful for curing asthma, bronchitis, ''mudha-vata'' (claudication of [[vata]]) and ''duhkha-prasava'' (difficult labor). It also helps a sterile woman to get offspring.<br /> <br /> Thus, ends the description of ''dadimadyaghrita'' [44-46]<br /> <br /> === ''Katukadyam ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कटुका रोहिणी मुस्तं हरिद्रे वत्सकात् पलम्| <br /> पटोलं चन्दनं मूर्वा त्रायमाणा दुरालभा||४७|| <br /> <br /> कृष्णा पर्पटको निम्बो भूनिम्बो देवदारु च| <br /> तैः कार्षिकैर्घृतप्रस्थः सिद्धः क्षीरचतुर्गुणः||४८|| <br /> <br /> रक्तपित्तं ज्वरं दाहं श्वयथुं स भगन्दरम्| <br /> अर्शांस्यसृग्दरं चैव हन्ति विस्फोटकांस्तथा||४९|| <br /> <br /> इति कटुकाद्यं घृतम्|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭukā rōhiṇī mustaṁ haridrē vatsakāt palam| <br /> paṭōlaṁ candanaṁ mūrvā trāyamāṇā durālabhā||47|| <br /> <br /> kr̥ṣṇā parpaṭakō nimbō bhūnimbō dēvadāru ca| <br /> taiḥ kārṣikairghr̥taprasthaḥ siddhaḥ kṣīracaturguṇaḥ||48|| <br /> <br /> Rakta Pittaṁ jvaraṁ dāhaṁ śvayathuṁ sa bhagandaram| <br /> arśāṁsyasr̥gdaraṁ caiva hanti visphōṭakāṁstathā||49|| <br /> <br /> iti Kaṭukādyam Ghritam| <br /> <br /> kaTukA rohiNI mustaM haridre vatsakAt palam| <br /> paTolaM candanaM mUrvA trAyamANA durAlabhA||47|| <br /> <br /> kRuShNA parpaTako nimbo bhUnimbo devadAru ca| <br /> taiH kArShikairghRutaprasthaH siddhaH kShIracaturguNaH||48|| <br /> <br /> raktapittaM jvaraM dAhaM shvayathuM sa bhagandaram| <br /> arshAMsyasRugdaraM caiva hanti visphoTakAMstathA||49|| <br /> <br /> iti kaTukAdyaM ghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''pala'' each of ''katukarohini, musta, haridra, daruharidra, vatsaka'' in paste form, one ''karsha'' of each of ''patola, chandana, murva, trayamana, duralabha, krishna, parpataka, nimba, bhūnimba, devadaru'' should be added to one ''prastha'' of ''ghrita'' and four ''prasthas'' of milk. This medicated ghee cures ''raktapitta, jwara, daha, svayathu, bhagandara, arsha, asrigadara'' and ''visphotaka''. Thus described ''katukadya ghritam'' [47-49]<br /> <br /> === ''Pathya ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पथ्याशतरसे पथ्यावृन्तार्धशतकल्कवान्| <br /> प्रस्थः सिद्धो घृतात् पेयः स पाण्ड्वामयगुल्मनुत्||५०|| <br /> <br /> इति पथ्याघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pathyāśatarasē pathyāvr̥ntārdhaśatakalkavān| <br /> prasthaḥ siddhō ghr̥tāt pēyaḥ sa pāṇḍvāmayagulmanut||50|| <br /> <br /> iti pathyāghr̥tam|<br /> <br /> pathyAshatarase pathyAvRuntArdhashatakalkavAn| <br /> prasthaH siddho ghRutAt peyaH sa pANDvAmayagulmanut||50|| <br /> <br /> iti pathyAghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The decoction of one hundred fruits of ''haritaki'' and the paste of fifty stalks of ''haritaki'' fruits should be added to one ''prastha'' of ghee and cooked. This medicated ghee cures ''pandu'' and ''gulma'' [50]<br /> <br /> === ''Danti ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दन्त्याश्चतुष्पलरसे पिष्टैर्दन्तीशलाटुभिः| <br /> तद्वत्प्रस्थो घृतात्सिद्धः प्लीहपाण्ड्वर्तिशोफजित्||५१|| <br /> <br /> इति दन्तीघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dantyāścatuṣpalarasē piṣṭairdantīśalāṭubhiḥ| <br /> tadvatprasthō ghr̥tātsiddhaḥ plīhapāṇḍvartiśōphajit||51|| <br /> <br /> iti dantīghr̥tam| <br /> <br /> dantyAshcatuShpalarase piShTairdantIshalATubhiH| <br /> tadvatprastho ghRutAtsiddhaH plIhapANDvartishophajit||51|| <br /> <br /> iti dantIghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of ghee should be cooked by adding (one ''prastha'' of) the decoction of four ''palas'' of ''danti'' and the paste of the green fruits of ''danti''. Intake of this medicated ghee cures ''pleeha'' (splenic disorders), ''pandu'' and edema [51]<br /> <br /> === ''Drakshaghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुराणसर्पिषः प्रस्थो द्राक्षार्धप्रस्थसाधितः| <br /> कामलागुल्मपाण्ड्वर्तिज्वरमेहोदरापहः||५२|| <br /> <br /> इति द्राक्षाघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> purāṇasarpiṣaḥ prasthō drākṣārdhaprasthasādhitaḥ| <br /> kāmalāgulmapāṇḍvartijvaramēhōdarāpahaḥ||52|| <br /> <br /> iti drākṣāghr̥tam| <br /> <br /> purANasarpiShaH prastho drAkShArdhaprasthasAdhitaH| <br /> kAmalAgulmapANDvartijvaramehodarApahaH||52|| <br /> <br /> iti drAkShAghRutam|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of old ghee should be added to half a ''prastha'' of ''draksha'' and cooked. This medicated ghee cures ''kamala, gulma, pandu, jwara, meha'' (polyuria) and ''udara roga'' (generalized abdominal enlargement)[52]<br /> <br /> === ''Haridradi ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> हरिद्रात्रिफलानिम्बबलामधुकसाधितम्| <br /> सक्षीरं माहिषं सर्पिः कामलाहरमुत्तमम्||५३|| <br /> <br /> इति हरिद्रादिघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> haridrātriphalānimbabalāmadhukasādhitam| <br /> sakṣīraṁ māhiṣaṁ sarpiḥ kāmalāharamuttamam||53||<br /> <br /> iti haridrādighr̥tam|<br /> <br /> haridrAtriphalAnimbabalAmadhukasAdhitam| <br /> sakShIraM mAhiShaM sarpiH kAmalAharamuttamam||53||<br /> <br /> iti haridrAdighRutam|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Ghrita'' prepared with ''haridra, triphala, nimba, balā, madhuka'' and buffalo’s milk and ghee is an excellent cure for ''kamala'' [53]<br /> <br /> === ''Darvyadi ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गोमूत्रे द्विगुणे दार्व्याः कल्काक्षद्वयसाधितः| <br /> दार्व्याः पञ्चपलक्वाथे कल्के कालीयके परः||५४|| <br /> <br /> माहिषात् सर्पिषः प्रस्थः पूर्वः पूर्वे परे परः|५५| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gōmūtrē dviguṇē dārvyāḥ kalkākṣadvayasādhitaḥ| <br /> dārvyāḥ pañcapalakvāthē kalkē kālīyakē paraḥ||54|| <br /> <br /> māhiṣāt sarpiṣaḥ prasthaḥ pūrvaḥ pūrvē parē paraḥ|55|<br /> <br /> gomUtre dviguNe dArvyAH kalkAkShadvayasAdhitaH| <br /> dArvyAH pa~jcapalakvAthe kalke kAlIyake paraH||54|| <br /> <br /> mAhiShAt sarpiShaH prasthaH pUrvaH pUrve pare paraH|55|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of buffalo’s ghee prepared by adding two ''prasthas'' of cow’s urine and the paste of two ''aksha'' of the paste of ''darvi'' as per ''sneha kalpana'' cures ''pandu roga''.<br /> <br /> One ''prastha'' of buffalo’s ghee prepared by adding with the decoction of five ''palas'' of ''darvi'' and the paste of ''kaleeyaka'' as per ''sneha kalpana'' cures ''kamala'' [54-55]<br /> <br /> === Preparations for ''pandu roga'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्नेहैरेभिरुपक्रम्य स्निग्धं मत्वा विरेचयेत्||५५|| <br /> <br /> पयसा मूत्रयुक्तेन बहुशः केवलेन वा| <br /> दन्तीफलरसे कोष्णे काश्मर्याञ्जलिना शृतम्||५६|| <br /> <br /> द्राक्षाञ्जलिं मृदित्वा वा दद्यात् पाण्ड्वामयापहम्| <br /> द्विशर्करं त्रिवृच्चूर्णं पलार्धं पैत्तिकः पिबेत्||५७|| <br /> <br /> कफपाण्डुस्तु गोमूत्रक्लिन्नयुक्तां [१] हरीतकीम्| <br /> आरग्वधं [२] रसेनेक्षोर्विदार्यामलकस्य च||५८||<br /> <br /> सत्र्यूषणं बिल्वपत्रं पिबेन्ना कामलापहम्| <br /> दन्त्यर्धपलकल्कं वा द्विगुडं शीतवारिणा||५९|| <br /> <br /> कामली त्रिवृतां वाऽपि त्रिफलाया रसैः पिबेत्| <br /> विशालात्रिफलामुस्तकुष्ठदारुकलिङ्गकान्||६०|| <br /> <br /> कार्षिकानर्धकर्षांशां कुर्यादतिविषां तथा| <br /> कर्षौ मधुरसाया द्वौ सर्वमेतत् [३] सुखाम्बुना||६१|| <br /> <br /> मृदितं तं रसं पूतं पीत्वा लिह्याच्च मध्वनु| <br /> कासं श्वासं ज्वरं दाहं पाण्डुरोगमरोचकम्||६२|| <br /> <br /> गुल्मानाहामवातांश्च रक्तपित्तं च नाशयेत्| <br /> त्रिफलाया गुडूच्या वा दार्व्या निम्बस्य वा रसम्||६३|| <br /> <br /> शीतं मधुयुतं प्रातः कामलार्तः पिबेन्नरः| <br /> क्षीरमूत्रं पिबेत् पक्षं गव्यं माहिषमेव वा||६४|| <br /> <br /> पाण्डुर्गोमूत्रयुक्तं वा सप्ताहं त्रिफलारसम्| <br /> तरुजान् ज्वलितान्मूत्रे निर्वाप्यामृद्य चाङ्कुरान्||६५|| <br /> <br /> मातुलुङ्गस्य तत् पूतं पाण्डुशोथहरं पिबेत्| <br /> स्वर्णक्षीरी त्रिवृच्छ्यामे भद्रदारु सनागरम्||६६|| <br /> <br /> गोमूत्राञ्जलिना पिष्टं मूत्रे वा क्वथितं पिबेत्| <br /> क्षीरमेभिः शृतं वाऽपि पिबेद्दोषानुलोमनम्||६७|| <br /> <br /> हरीतकीं प्रयोगेण गोमूत्रेणाथवा पिबेत्| <br /> जीर्णे क्षीरेण भुञ्जीत रसेन मधुरेण वा||६८|| <br /> <br /> सप्तरात्रं गवां मूत्रे भावितं वाऽप्ययोरजः| <br /> पाण्डुरोगप्रशान्त्यर्थं पयसा पाययेद्भिषक्||६९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snēhairēbhirupakramya snigdhaṁ matvā virēcayēt||55|| <br /> <br /> payasā mūtrayuktēna bahuśaḥ kēvalēna vā| <br /> dantīphalarasē kōṣṇē kāśmaryāñjalinā śr̥tam||56|| <br /> <br /> drākṣāñjaliṁ mr̥ditvā vā dadyāt pāṇḍvāmayāpaham| <br /> dviśarkaraṁ trivr̥ccūrṇaṁ palārdhaṁ paittikaḥ pibēt||57|| <br /> <br /> Kaphapāṇḍustu gōmūtraklinnayuktāṁ [1] harītakīm| <br /> āragvadhaṁ [2] rasēnēkṣōrvidāryāmalakasya ca||58|| <br /> <br /> satryūṣaṇaṁ bilvapatraṁ pibēnnā kāmalāpaham| <br /> dantyardhapalakalkaṁ vā dviguḍaṁ śītavāriṇā||59|| <br /> <br /> kāmalī trivr̥tāṁ vā'pi triphalāyā rasaiḥ pibēt| <br /> viśālātriphalāmustakuṣṭhadārukaliṅgakān||60|| <br /> <br /> kārṣikānardhakarṣāṁśāṁ kuryādativiṣāṁ tathā| <br /> karṣau madhurasāyā dvau sarvamētat [3] sukhāmbunā||61|| <br /> <br /> mr̥ditaṁ taṁ rasaṁ pūtaṁ pītvā lihyācca madhvanu| <br /> kāsaṁ śvāsaṁ jvaraṁ dāhaṁ pāṇḍurōgamarōcakam||62|| <br /> <br /> gulmānāhāmavātāṁśca Rakta Pittaṁ ca nāśayēt| <br /> triphalāyā guḍūcyā vā dārvyā nimbasya vā rasam||63|| <br /> <br /> śītaṁ madhuyutaṁ prātaḥ kāmalārtaḥ pibēnnaraḥ| <br /> kṣīramūtraṁ pibēt pakṣaṁ gavyaṁ māhiṣamēva vā||64|| <br /> <br /> pāṇḍurgōmūtrayuktaṁ vā saptāhaṁ triphalārasam| <br /> tarujān jvalitānmūtrē nirvāpyāmr̥dya cāṅkurān||65|| <br /> <br /> mātuluṅgasya tat pūtaṁ pāṇḍuśōthaharaṁ pibēt| <br /> svarṇakṣīrī trivr̥cchyāmē bhadradāru sanāgaram||66|| <br /> <br /> gōmūtrāñjalinā piṣṭaṁ mūtrē vā kvathitaṁ pibēt| <br /> kṣīramēbhiḥ śr̥taṁ vā'pi pibēddōṣānulōmanam||67|| <br /> <br /> harītakīṁ prayōgēṇa gōmūtrēṇāthavā pibēt| <br /> jīrṇē kṣīrēṇa bhuñjīta rasēna madhurēṇa vā||68|| <br /> <br /> saptarātraṁ gavāṁ mūtrē bhāvitaṁ vā'pyayōrajaḥ| <br /> pāṇḍurōgapraśāntyarthaṁ payasā pāyayēdbhiṣak||69||<br /> <br /> snehairebhirupakramya snigdhaM matvA virecayet||55|| <br /> <br /> payasA mUtrayuktena bahushaH kevalena vA| <br /> dantIphalarase koShNe kAshmaryA~jjalinA shRutam||56|| <br /> <br /> drAkShA~jjaliM mRuditvA vA dadyAt pANDvAmayApaham| <br /> dvisharkaraM trivRuccUrNaM palArdhaM paittikaH pibet||57|| <br /> <br /> kaphapANDustu gomUtraklinnayuktAM [1] harItakIm| <br /> AragvadhaM [2] rasenekShorvidAryAmalakasya ca||58|| <br /> <br /> satryUShaNaM bilvapatraM pibennA kAmalApaham| <br /> dantyardhapalakalkaM vA dviguDaM shItavAriNA||59|| <br /> <br /> kAmalI trivRutAM vA~api triphalAyA rasaiH pibet| <br /> vishAlAtriphalAmustakuShThadArukali~ggakAn||60|| <br /> <br /> kArShikAnardhakarShAMshAM kuryAdativiShAM tathA| <br /> karShau madhurasAyA dvau sarvametat [3] sukhAmbunA||61|| <br /> <br /> mRuditaM taM rasaM pUtaM pItvA lihyAcca madhvanu| <br /> kAsaM shvAsaM jvaraM dAhaM pANDurogamarocakam||62|| <br /> <br /> gulmAnAhAmavAtAMshca raktapittaM ca nAshayet| <br /> triphalAyA guDUcyA vA dArvyA nimbasya vA rasam||63||<br /> <br /> shItaM madhuyutaM prAtaH kAmalArtaH pibennaraH| <br /> kShIramUtraM pibet pakShaM gavyaM mAhiShameva vA||64|| <br /> <br /> pANDurgomUtrayuktaM vA saptAhaM triphalArasam| <br /> tarujAn jvalitAnmUtre nirvApyAmRudya cA~gkurAn||65|| <br /> <br /> mAtulu~ggasya tat pUtaM pANDushothaharaM pibet| <br /> svarNakShIrI trivRucchyAme bhadradAru sanAgaram||66|| <br /> <br /> gomUtrA~jjalinA piShTaM mUtre vA kvathitaM pibet| <br /> kShIramebhiH shRutaM vA~api pibeddoShAnulomanam||67|| <br /> <br /> harItakIM prayogeNa gomUtreNAthavA pibet| <br /> jIrNe kShIreNa bhu~jjIta rasena madhureNa vA||68|| <br /> <br /> saptarAtraM gavAM mUtre bhAvitaM vA~apyayorajaH| <br /> pANDurogaprashAntyarthaM payasA pAyayedbhiShak||69|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After proper oleation of the patient with the internal administration of the above described medicated ''ghrita,'' the patient should be given frequent medication with the following recipes: <br /> <br /> Milk with cow’s urine or milk alone or lukewarm infusion of ''danti'' sprinkled with the powder of one ''anjali'' of ''kashmarya'' or mixed with the paste of one ''anjali'' (handful) of ''draksha''; all these drugs cure ''pandu roga'' in general.<br /> <br /> The patient suffering from ''paittika pandu'' should take half ''pala'' of ''trivitta'' mixed with one ''pala'' of sugar; <br /> <br /> ''Kaphaja'' type of ''pandu'' patient should take ''haritaki churna'' immersed in cow’s urine. <br /> <br /> ''Kamala'' patient should take ''aragvadha'' along with the juice of sugarcane, ''vidari, amalaki'' to which ''sunthi, maricha, pippali'' and ''bilva'' leaves have been added; or may take the paste of half ''pala'' of ''danti'' mixed with one ''pala'' of jaggery along with cold water; or may take ''trivritta'' along with decoction of ''triphala''. <br /> <br /> ''Vishaladi phanta'' – One ''karsha'' each of ''vishala, haritaki, bibhitaka, amalaki, musta, kushtha, devadaru'' and ''kalingaka''; half ''karsha'' of ''ativisha'', two ''karsha'' of ''madhurasa'' (''murva'') should be made to a paste by triturating with lukewarm water and strained. The patient should take honey after taking this infusion. This ''phanta'' cures cough, dyspnea, fever, burning sensation, ''pandu roga'', anorexia, ''gulma'' (lumps in abdomen), ''anaha'' (gaseous distention of the abdomen), ''amavata'' (joint disorders caused by ''ama''), and ''raktapitta'' (bleeding disorders).<br /> <br /> Other drugs which are useful for these ailments are as follows: <br /> *''Kamala'' patients should take the decoction of ''triphala, guduchi, devadaru,'' or ''nimba'' after cooling and adding honey in the morning.<br /> *''Pandu'' patient may take the milk or urine of either cow or buffalo for one fortnight.<br /> *''Pandu'' patient may drink the decoction of ''triphala'' along with cow’s urine for one week.<br /> *Patient suffering from ''pandu'' and ''sopha'' (edema) should drink the liquid obtained by straining the paste of tender branches of ''matulunga'' set afire and then immersed in cow’s urine.<br /> *''Suvarnakshiri, trivritta, syama-trivritta, bhadradaru'' and ''nagara'' should be triturated by adding one ''anjali'' of cow’s urine or should be made to a decoction by adding cow’s urine. The above mentioned drugs may also be boiled with milk. The drinking of these drugs brings about the downward motion of the ''doshas'' causing ''pandu''.<br /> *Then again, the patient suffering from ''pandu roga'' should take a course of ''haritaki'' with cow’s urine (for seven days) and then should take food either with milk or sweetened meat soup, and <br /> *Physicians should give ''lauha bhasma'' impregnated for seven nights with cow’s urine along with milk for the alleviation of ''pandu roga'' [55-69]<br /> <br /> === ''Navayasa churnam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्र्यूषणत्रिफलामुस्तविडङ्गचित्रकाः समाः| <br /> नवायोरजसो भागास्तच्चूर्णं क्षौद्रसर्पिषा||७०|| <br /> <br /> भक्षयेत् पाण्डुहृद्रोगकुष्ठार्शःकामलापहम्| <br /> नवायसमिदं चूर्णं कृष्णात्रेयेण भाषितम्||७१|| <br /> <br /> इति नवायसचूर्णम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tryūṣaṇatriphalāmustaviḍaṅgacitrakāḥ samāḥ| <br /> navāyōrajasō bhāgāstaccūrṇaṁ kṣaudrasarpiṣā||70|| <br /> <br /> bhakṣayēt pāṇḍuhr̥drōgakuṣṭhārśaḥkāmalāpaham| <br /> navāyasamidaṁ cūrṇaṁ kr̥ṣṇātrēyēṇa bhāṣitam||71|| <br /> <br /> iti navāyasacūrṇam| <br /> <br /> tryUShaNatriphalAmustaviDa~ggacitrakAH samAH| <br /> navAyorajaso bhAgAstaccUrNaM kShaudrasarpiShA||70|| <br /> <br /> bhakShayet pANDuhRudrogakuShThArshaHkAmalApaham| <br /> navAyasamidaM cUrNaM kRuShNAtreyeNa bhAShitam||71|| <br /> <br /> iti navAyasacUrNam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take ''sunthi, pippali, maricha, haritaki, bibhitaki, amalaki, musta, vidanga'' and ''chitraka'' in one part each and nine parts of ''lauha bhasma'' and mix together. Intake of this recipe along with honey and ghee cures anemia, heart diseases, ''kushtha'' (group of skin diseases), ''arsha'' (hemorrhoids) and ''kamala''. This medicine propounded by ''krishnatreya'' is called ''navayasa churna'' [70-71]<br /> <br /> === ''Mandura vataka'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुडनागरमण्डूरतिलांशान्मानतः समान्| <br /> पिप्पलीद्विगुणां कुर्याद्गुटिकां पाण्डुरोगिणे||७२|| <br /> <br /> त्र्यूषणं त्रिफला मुस्तं विडङ्गं चव्यचित्रकौ| <br /> दार्वीत्वङ्माक्षिको धातुर्ग्रन्थिकं देवदारु च||७३|| <br /> <br /> एतान् द्विपलिकान्भागांश्चूर्णं कुर्यात् पृथक् पृथक्| <br /> मण्डूरं द्विगुणं चूर्णाच्छुद्धमञ्जनसन्निभम्||७४|| <br /> <br /> गोमूत्रेऽष्टगुणे पक्त्वा तस्मिंस्तत् प्रक्षिपेत्ततः| <br /> उदुम्बरसमान्कृत्वा वटकांस्तान् यथाग्नि ना||७५|| <br /> <br /> उपयुञ्जीत तक्रेण सात्म्यं जीर्णे च भोजनम्| <br /> मण्डूरवटका ह्येते प्राणदाः पाण्डुरोगिणाम्||७६|| <br /> <br /> कुष्ठान्यजीर्णकं शोथमूरुस्तम्भं कफामयान्| <br /> अर्शांसि कामलां मेहं प्लीहानं शमयन्ति च||७७|| <br /> <br /> इति मण्डूरवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> guḍanāgaramaṇḍūratilāṁśānmānataḥ samān| <br /> pippalīdviguṇāṁ kuryādguṭikāṁ pāṇḍurōgiṇē||72|| <br /> <br /> tryūṣaṇaṁ triphalā mustaṁ viḍaṅgaṁ cavyacitrakau| <br /> dārvītvaṅmākṣikō Dhāturgranthikaṁ dēvadāru ca||73|| <br /> <br /> ētān dvipalikānbhāgāṁścūrṇaṁ kuryāt pr̥thak pr̥thak| <br /> maṇḍūraṁ dviguṇaṁ cūrṇācchuddhamañjanasannibham||74|| <br /> <br /> gōmūtrē'ṣṭaguṇē paktvā tasmiṁstat prakṣipēttataḥ| <br /> udumbarasamānkr̥tvā vaṭakāṁstān yathāgni nā||75|| <br /> <br /> upayuñjīta takrēṇa sātmyaṁ jīrṇē ca bhōjanam| <br /> maṇḍūravaṭakā hyētē prāṇadāḥ pāṇḍurōgiṇām||76|| <br /> <br /> kuṣṭhānyajīrṇakaṁ śōthamūrustambhaṁ kaphāmayān| <br /> arśāṁsi kāmalāṁ mēhaṁ plīhānaṁ śamayanti ca||77|| <br /> <br /> iti maṇḍūravaṭakāḥ| <br /> <br /> guDanAgaramaNDUratilAMshAnmAnataH samAn| <br /> pippalIdviguNAM kuryAdguTikAM pANDurogiNe||72|| <br /> <br /> tryUShaNaM triphalA mustaM viDa~ggaM cavyacitrakau| <br /> dArvItva~gmAkShiko dhAturgranthikaM devadAru ca||73|| <br /> <br /> etAn dvipalikAnbhAgAMshcUrNaM kuryAt pRuthak pRuthak| <br /> maNDUraM dviguNaM cUrNAcchuddhama~jjanasannibham||74|| <br /> <br /> gomUtre~aShTaguNe paktvA tasmiMstat prakShipettataH| <br /> udumbarasamAnkRutvA vaTakAMstAn yathAgni nA||75|| <br /> <br /> upayu~jjIta takreNa sAtmyaM jIrNe ca bhojanam| <br /> maNDUravaTakA hyete prANadAH pANDurogiNAm||76|| <br /> <br /> kuShThAnyajIrNakaM shothamUrustambhaM kaphAmayAn| <br /> arshAMsi kAmalAM mehaM plIhAnaM shamayanti ca||77|| <br /> <br /> iti maNDUravaTakAH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Mandura vataka'' – jaggery, ''shunthi, mandura'' and ''tila'' in one part each along with two parts of ''pippali'' should be triturated and made in the form of pills. This medicine is suitable for the treatment of the patients with ''pandu roga''.<br /> <br /> ''Shunthi, pippali, maricha, haritaki, bibhitaki, amalaki, musta, vidanga, chavya, chitraka,'' bark of ''daruharidra, makshika'' (copper pyrite), ''pippalimoola'' and ''devadaru'' in the quantity of two ''pala'' each should be made to powders separately.<br /> <br /> ''Mandura bhasma'' which is dark in color like collyrium, should be cooked by adding eight times of cow’s urine and the powders of the above drugs should be mixed to this. ''Vatakas'' (large sized pills) of the size of ''udumbara'' should be made out of this combination. This should be taken by the patient in the appropriate doses according to his [[agni]] (power of digestion and metabolism) along with butter milk. The patient should take wholesome food after its digestion. These pills named as ''mandura vataka'' are the life givers for the patients of ''pandu''. It also cures ''kushtha, ajeerna'' (indigestion), ''sotha'' (edema), ''urustambha'' (stiffening of the thighs), disease caused by aggravation of the [[kapha]], arsha'' (hemorrhoids), ''kamala'' (jaundice), ''meha'' (polyuria) and ''pleeha'' (splenic diseases).<br /> <br /> Thus ends the description of two types of ''mandura vataka''.[72-77]<br /> <br /> === ''Tapayadi lauha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ताप्याद्रिजतुरूप्यायोमलाः पञ्चपलाः पृथक्| <br /> चित्रकत्रिफलाव्योषविडङ्गैः पलिकैः सह||७८|| <br /> <br /> शर्कराष्टपलोन्मिश्राश्चूर्णिता मधुनाऽऽप्लुताः| <br /> अभ्यस्यास्त्वक्षमात्रा हि जीर्णे हितमिताशिना||७९|| <br /> <br /> कुलत्थकाकमाच्यादिकपोतपरिहारिणा|८०| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tāpyādrijaturūpyāyōmalāḥ pañcapalāḥ pr̥thak| <br /> citrakatriphalāvyōṣaviḍaṅgaiḥ palikaiḥ saha||78|| <br /> <br /> śarkarāṣṭapalōnmiśrāścūrṇitā madhunā''plutāḥ| <br /> abhyasyāstvakṣamātrā hi jīrṇē hitamitāśinā||79|| <br /> <br /> kulatthakākamācyādikapōtaparihāriṇā|80| <br /> <br /> tApyAdrijaturUpyAyomalAH pa~jcapalAH pRuthak| <br /> citrakatriphalAvyoShaviDa~ggaiH palikaiH saha||78|| <br /> <br /> sharkarAShTapalonmishrAshcUrNitA madhunA~a~aplutAH| <br /> abhyasyAstvakShamAtrA hi jIrNe hitamitAshinA||79|| <br /> <br /> kulatthakAkamAcyAdikapotaparihAriNA|80|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Tapyadi yoga'' – ''Tapya, shilajatu,'' silver, ''mandura'' in the amount of five ''pala'' each should be added to one ''pala'' each of ''chitraka, haritaki, bibhitaka, amalaki, sunthi, pippali, maricha'' and ''vidanga''; and eight ''pala'' of sugar. This recipe should be taken by the patient habitually (by a ''pandu rogi'') in the dose of one ''karsha'' along with adequate amount of honey. After the digestion of this drug the patient should take wholesome food in small quantity and should avoid using ''kulattha, kakamachi'' etc. and pigeon meat [78-80]<br /> <br /> === ''Yogaraja'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिफलायास्त्रयो भागास्त्रयस्त्रिकटुकस्य च||८०|| <br /> <br /> भागश्चित्रकमूलस्य विडङ्गानां तथैव च| <br /> पञ्चाश्मजतुनो भागास्तथा रूप्यमलस्य च||८१|| <br /> <br /> माक्षिकस्य च शुद्धस्य लौहस्य रजसस्तथा| <br /> अष्टौ भागाः सितायाश्च तत्सर्वं सूक्ष्मचूर्णितम्||८२|| <br /> <br /> माक्षिकेणाप्लुतं स्थाप्यमायसे भाजने शुभे| <br /> उदुम्बरसमां मात्रां ततः खादेद्यथाग्नि ना||८३|| <br /> <br /> दिने दिने प्रयुञ्जीत जीर्णे भोज्यं यथेप्सितम्| <br /> वर्जयित्वा कुलत्थानि काकमाचीं कपोतकम्||८४||<br /> <br /> योगराज इति ख्यातो योगोऽयममृतोपमः| <br /> रसायनमिदं श्रेष्ठं सर्वरोगहरं शिवम्||८५|| <br /> <br /> पाण्डुरोगं विषं कासं यक्ष्माणं विषमज्वरम्| <br /> कुष्ठान्यजीर्णकं मेहं शोषं श्वासमरोचकम्||८६|| <br /> <br /> विशेषाद्धन्त्यपस्मारं कामलां गुदजानि च| <br /> <br /> इति योगराजः|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> triphalāyāstrayō bhāgāstrayastrikaṭukasya ca||80|| <br /> <br /> bhāgaścitrakamūlasya viḍaṅgānāṁ tathaiva ca| <br /> pañcāśmajatunō bhāgāstathā rūpyamalasya ca||81|| <br /> <br /> mākṣikasya ca śuddhasya lauhasya rajasastathā| <br /> aṣṭau bhāgāḥ sitāyāśca tatsarvaṁ sūkṣmacūrṇitam||82|| <br /> <br /> mākṣikēṇāplutaṁ sthāpyamāyasē bhājanē śubhē| <br /> udumbarasamāṁ mātrāṁ tataḥ khādēdyathāgni nā||83|| <br /> <br /> dinē dinē prayuñjīta jīrṇē bhōjyaṁ yathēpsitam| <br /> varjayitvā kulatthāni kākamācīṁ kapōtakam||84|| <br /> <br /> yōgarāja iti khyātō yōgō'yamamr̥tōpamaḥ| <br /> rasāyanamidaṁ śrēṣṭhaṁ sarvarōgaharaṁ śivam||85|| <br /> <br /> pāṇḍurōgaṁ viṣaṁ kāsaṁ yakṣmāṇaṁ viṣamajvaram| <br /> kuṣṭhānyajīrṇakaṁ mēhaṁ śōṣaṁ śvāsamarōcakam||86|| <br /> <br /> viśēṣāddhantyapasmāraṁ kāmalāṁ gudajāni ca| <br /> <br /> iti yōgarājaḥ| <br /> <br /> triphalAyAstrayo bhAgAstrayastrikaTukasya ca||80|| <br /> <br /> bhAgashcitrakamUlasya viDa~ggAnAM tathaiva ca| <br /> pa~jcAshmajatuno bhAgAstathA rUpyamalasya ca||81|| <br /> <br /> mAkShikasya ca shuddhasya lauhasya rajasastathA| <br /> aShTau bhAgAH sitAyAshca tatsarvaM sUkShmacUrNitam||82|| <br /> <br /> mAkShikeNAplutaM sthApyamAyase bhAjane shubhe| <br /> udumbarasamAM mAtrAM tataH khAdedyathAgni nA||83|| <br /> <br /> dine dine prayu~jjIta jIrNe bhojyaM yathepsitam| <br /> varjayitvA kulatthAni kAkamAcIM kapotakam||84|| <br /> <br /> yogarAja iti khyAto yogo~ayamamRutopamaH| <br /> rasAyanamidaM shreShThaM sarvarogaharaM shivam||85|| <br /> <br /> pANDurogaM viShaM kAsaM yakShmANaM viShamajvaram| <br /> kuShThAnyajIrNakaM mehaM shoShaM shvAsamarocakam||86|| <br /> <br /> visheShAddhantyapasmAraM kAmalAM gudajAni ca| <br /> <br /> iti yogarAjaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Yogaraja'' – ''harītaki, bibhitaki, amalaki, shunthi, pippali, maricha, chitraka moola'' (root) and ''vidanga'' in the amount of one part each; five parts each of ''shilajatu, raupya mala'' (silver), purified ''makshika'' and ''lauha bhasma''; eight parts of sugar – all should be made to a fine powder and mixed with adequate amount of honey and kept in clean iron jar. This recipe should be taken by the patient in a quantity equal to a fruit of ''udumbara'' according to the power of digestion every day and should be given the desired food excluding ''kulattha, kakamachi'' etc. and pigeon meat; only after the digestion of the taken drug. This ambrosia like recipe is called ''yogaraja''. It is an excellent rejuvenative recipe which cures all diseases and bestows auspiciousness. It specially cures ''pandu'', poisoning, ''kasa, yakshma, vishama jwara'' (irregular fevers), ''ajeerna, meha, soshha, swasa, aruchi, apasmara'' (epilepsy), ''kamala'' and ''arsha''.<br /> <br /> Thus ends the description of ''yogaraja'' [80-86]<br /> <br /> === Various formulations ===<br /> <br /> === Shilajatu Vataka ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कौटजत्रिफलानिम्बपटोलघननागरैः||८७|| <br /> <br /> भावितानि दशाहानि रसैर्द्वित्रिगुणानि वा| <br /> शिलाजतुपलान्यष्टौ तावती सितशर्करा||८८||<br /> <br /> त्वक्क्षीरी पिप्पली धात्री कर्कटाख्या पलोन्मिता| <br /> <br /> निदिग्ध्याः फलमूलाभ्यां पलं युक्त्या त्रिगन्धकम्| <br /> <br /> चूर्णितं मधुनः कुर्यात् त्रिपलेनाक्षिकान् गुडान्| <br /> दाडिमाम्बुपयःपक्षिरसतोयसुरासवान्||९०|| <br /> <br /> तान् भक्षयित्वाऽनुपिबेन्निरन्नो भुक्त एव वा| <br /> पाण्डुकुष्ठज्वरप्लीहतमकार्शोभगन्दरान्||९१|| <br /> <br /> पूतिहृच्छुक्रमूत्राग्निदोषशोषगरोदरान् [१] | <br /> कासासृग्दरपित्तासृक्शोथगुल्मगलामयान्||९२|| <br /> <br /> ते च सर्वव्रणान् हन्युः सर्वरोगहराः शिवाः| <br /> <br /> इति शिलाजतुवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> kauṭajatriphalānimbapaṭōlaghananāgaraiḥ||87|| <br /> <br /> bhāvitāni daśāhāni rasairdvitriguṇāni vā| <br /> śilājatupalānyaṣṭau tāvatī sitaśarkarā||88|| <br /> <br /> tvakkṣīrī pippalī dhātrī karkaṭākhyā palōnmitā| <br /> <br /> nidigdhyāḥ phalamūlābhyāṁ palaṁ yuktyā trigandhakam| <br /> <br /> cūrṇitaṁ madhunaḥ kuryāt tripalēnākṣikān guḍān| <br /> dāḍimāmbupayaḥpakṣirasatōyasurāsavān||90|| <br /> <br /> tān bhakṣayitvā'nupibēnnirannō bhukta ēva vā| <br /> pāṇḍukuṣṭhajvaraplīhatamakārśōbhagandarān||91|| <br /> <br /> pūtihr̥cchukramūtrāgnidōṣaśōṣagarōdarān [1] | <br /> kāsāsr̥gdarapittāsr̥kśōthagulmagalāmayān||92|| <br /> <br /> tē ca sarvavraṇān hanyuḥ sarvarōgaharāḥ śivāḥ| <br /> <br /> iti śilājatuvaṭakāḥ| <br /> <br /> kauTajatriphalAnimbapaTolaghananAgaraiH||87|| <br /> <br /> bhAvitAni dashAhAni rasairdvitriguNAni vA| <br /> shilAjatupalAnyaShTau tAvatI sitasharkarA||88|| <br /> <br /> tvakkShIrI pippalI dhAtrI karkaTAkhyA palonmitA| <br /> <br /> nidigdhyAH phalamUlAbhyAM palaM yuktyA trigandhakam| <br /> <br /> cUrNitaM madhunaH kuryAt tripalenAkShikAn guDAn| <br /> dADimAmbupayaHpakShirasatoyasurAsavAn||90|| <br /> <br /> tAn bhakShayitvA~anupibenniranno bhukta eva vA| <br /> pANDukuShThajvaraplIhatamakArshobhagandarAn||91|| <br /> <br /> pUtihRucchukramUtrAgnidoShashoShagarodarAn [1] | <br /> kAsAsRugdarapittAsRukshothagulmagalAmayAn||92|| <br /> <br /> te ca sarvavraNAn hanyuH sarvarogaharAH shivAH| <br /> <br /> iti shilAjatuvaTakAH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> ''Shilajatu vataka'' – Eight ''pala'' of ''shilajatu'' impregnated for ten, twenty or thirty days with the decoction of fruit of ''kutaja, haritaki, bibhitaka, amalaki, nimba, patola, ghana'' and ''nagara''. Eight ''pala'' of sugar and one ''pala'' each of ''tvakakshiri, pippali, dhatri'' and ''karkatashringi''; half ''pala'' each of the fruit and root of ''nidigdhika'' and adequate powder of ''tvaka, ela'' and ''patra'' should be added to this ''shilajatu''. ''Vataka'' (large sized pills) of one ''aksha'' each should be prepared by adding three ''pala'' of honey to this powder. These pills can be taken on either empty stomach or after having food. The patient should drink the juice of ''dadima'' (pomegranate), milk, meat soup of birds, water, alcohol, ''asava'' (medicated wine) after taking this medicine. It cures ''pandu, kushtha, jwara, pleeha, tamaka svasa, arsha, bhagandara'' (fistula in ano), ''puti'' (putrified ulcers), ''hridroga'' (heart diseases), ''shukra dosha'' (diseases of semen), ''mutra dosha'' (diseases of urine), and ''agni dosha'' (diseases of digestion), ''sosha'' (consumption), ''gara'' (poisoning), ''udara, kasa, asrigdara'' (menorrhagia), ''raktapitta'' (bleeding disorders), ''sotha, gulma, galamayana'' (diseases of the throats) and all types of ''vrana'' (wounds). It cures all types of diseases and bestows auspiciousness. Thus, ends the description of ''shilajatu vataka.'' [87-92]<br /> <br /> === Punarnava Mandura ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुनर्नवा त्रिवृद्व्योषविडङ्गं दारु चित्रकम्||९३|| <br /> <br /> कुष्ठं हरिद्रे त्रिफला दन्ती चव्यं कलिङ्गकाः| <br /> पिप्पली [२] पिप्पलीमूलं मुस्तं चेति पलोन्मितम्||९४|| <br /> <br /> मण्डूरं द्विगुणं चूर्णाद्गोमूत्रे द्व्याढके पचेत्| <br /> कोलवद्गुटिकाः कृत्वा तक्रेणालोड्य ना पिबेत्||९५|| <br /> <br /> ताः पाण्डुरोगान् प्लीहानमर्शांसि विषमज्वरम्| <br /> श्वयथुं ग्रहणीदोषं हन्युः कुष्ठं क्रिमींस्तथा||९६|| <br /> <br /> इति पुनर्नवामण्डूरम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> punarnavā trivr̥dvyōṣaviḍaṅgaṁ dāru citrakam||93|| <br /> <br /> kuṣṭhaṁ haridrē triphalā dantī cavyaṁ kaliṅgakāḥ| <br /> pippalī [2] pippalīmūlaṁ mustaṁ cēti palōnmitam||94|| <br /> <br /> maṇḍūraṁ dviguṇaṁ cūrṇādgōmūtrē dvyāḍhakē pacēt| <br /> kōlavadguṭikāḥ kr̥tvā takrēṇālōḍya nā pibēt||95|| <br /> <br /> tāḥ pāṇḍurōgān plīhānamarśāṁsi viṣamajvaram| <br /> śvayathuṁ grahaṇīdōṣaṁ hanyuḥ kuṣṭhaṁ krimīṁstathā||96|| <br /> <br /> iti punarnavāmaṇḍūram|<br /> <br /> punarnavA trivRudvyoShaviDa~ggaM dAru citrakam||93|| <br /> <br /> kuShThaM haridre triphalA dantI cavyaM kali~ggakAH| <br /> pippalI [2] pippalImUlaM mustaM ceti palonmitam||94|| <br /> <br /> maNDUraM dviguNaM cUrNAdgomUtre dvyADhake pacet| <br /> kolavadguTikAH kRutvA takreNAloDya nA pibet||95|| <br /> <br /> tAH pANDurogAn plIhAnamarshAMsi viShamajvaram| <br /> shvayathuM grahaNIdoShaM hanyuH kuShThaM krimIMstathA||96|| <br /> <br /> iti punarnavAmaNDUram| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Powder of one ''pala'' each of ''punarnava, trivritta, sunthi, pippali, maricha, vidanga, devadaru, chitraka, kushtha, haridra, daruharidra, haritaki, bibhitaka, amalaki, danti, chavya, kālingaka, pippalī, pippalimoola'' and ''musta''; and forty ''pala'' of ''mandura bhasma'' (rust of iron) coked in two ''adhaka'' of cow’s urine and made in the form of ''gutika'' of the size of ''kola''. These pills should be taken with butter milk. It cures ''pandu, pleeha, arsha, vishama jwara, sotha, grahanidosha'' (sprue syndrome, irritable bowel syndrome), ''kushtha'' and ''krimi'' (parasitic infestation). Thus, ends the description of ''punarnava mandura''.[93-96]<br /> <br /> === Darvyadi leha and other two recipes ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दार्वीत्वक् त्रिफला व्योषं विडङ्गमयसो रजः| <br /> मधुसर्पिर्युतं लिह्यात् कामलापाण्डुरोगवान्||९७|| <br /> <br /> तुल्या अयोरजःपथ्याहरिद्राः क्षौद्रसर्पिषा| <br /> चूर्णिताः कामली लिह्याद्गुडक्षौद्रेण वाऽभयाः||९८|| <br /> <br /> त्रिफला द्वे हरिद्रे च कटुरोहिण्ययोरजः| <br /> चूर्णितं क्षौद्रसर्पिर्भ्यां स लेहः कामलापहः||९९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> dārvītvak triphalā vyōṣaṁ viḍaṅgamayasō rajaḥ| <br /> madhusarpiryutaṁ lihyāt kāmalāpāṇḍurōgavān||97|| <br /> <br /> tulyā ayōrajaḥpathyāharidrāḥ kṣaudrasarpiṣā| <br /> cūrṇitāḥ kāmalī lihyādguḍakṣaudrēṇa vā'bhayāḥ||98|| <br /> <br /> triphalā dvē haridrē ca kaṭurōhiṇyayōrajaḥ| <br /> cūrṇitaṁ kṣaudrasarpirbhyāṁ sa lēhaḥ kāmalāpahaḥ||99|| <br /> <br /> dArvItvak triphalA vyoShaM viDa~ggamayaso rajaH| <br /> madhusarpiryutaM lihyAt kAmalApANDurogavAn||97|| <br /> <br /> tulyA ayorajaHpathyAharidrAH kShaudrasarpiShA| <br /> cUrNitAH kAmalI lihyAdguDakShaudreNa vA~abhayAH||98|| <br /> <br /> triphalA dve haridre ca kaTurohiNyayorajaH| <br /> cUrNitaM kShaudrasarpirbhyAM sa lehaH kAmalApahaH||99|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Powder of the bark of daruharidra, haritaki, bibhitaka, amalaki, pippali, sunthi, maricha, vidanga and lauha bhasma mixed with ghee and honey, taken as a linctus by the patients suffering from ''pandu'' and ''kamala''.<br /> <br /> Two other recipes – Patients suffering from ''kamala'' should take the powder of one part each of ''lauha bhasma, haritaki'' and ''haridra'' along with honey and ghee and may also take the linctus of the powder of ''abhaya'' prepared by mixing with jaggery and honey. [97-99]<br /> <br /> === ''Dhatryavaleha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्विपलांशां तुगाक्षीरीं नागरं मधुयष्टिकाम्| <br /> प्रास्थिकीं पिप्पलीं द्राक्षां शर्करार्धतुलां शुभाम्||१००|| <br /> <br /> धात्रीफलरसद्रोणे चूर्णितं लेहवत् पचेत्| <br /> शीतं मधुप्रस्थयुतं लिह्यात् पाणितलं ततः||१०१|| <br /> <br /> हन्त्येष कामलां पित्तं पाण्डुं कासं हलीमकम्| <br /> <br /> इति धात्र्यवलेहः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dvipalāṁśāṁ tugākṣīrīṁ nāgaraṁ madhuyaṣṭikām| <br /> prāsthikīṁ pippalīṁ drākṣāṁ śarkarārDhātulāṁ śubhām||100|| <br /> <br /> dhātrīphalarasadrōṇē cūrṇitaṁ lēhavat pacēt| <br /> śītaṁ madhuprasthayutaṁ lihyāt pāṇitalaṁ tataḥ||101|| <br /> <br /> hantyēṣa kāmalāṁ Pittaṁ pāṇḍuṁ kāsaṁ halīmakam| <br /> <br /> iti dhātryavalēhaḥ| <br /> <br /> dvipalAMshAM tugAkShIrIM nAgaraM madhuyaShTikAm| <br /> prAsthikIM pippalIM drAkShAM sharkarArdhatulAM shubhAm||100|| <br /> <br /> dhAtrIphalarasadroNe cUrNitaM lehavat pacet| <br /> shItaM madhuprasthayutaM lihyAt pANitalaM tataH||101|| <br /> <br /> hantyeSha kAmalAM pittaM pANDuM kAsaM halImakam| <br /> <br /> iti dhAtryavalehaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Dhatryavaleha'' – ''Vanshalochana, sunthi, maduyashti'' powders, each in two ''pala''; one ''prastha'' each of ''pippali'' and ''draksha''; and half a ''tula'' of sugar crystal added with one ''drona'' of ''amalaki'' fruit juice and cooked till it changes into linctus form. One ''prastha'' of honey is added to it after it cools down. Intake of one ''panitala'' of this linctus cures ''kamala, [[pitta]] vikaras, pandu, kasa'' and ''haleemaka'' [100-101]<br /> <br /> === ''Mandura vatakah'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्र्यूषणं त्रिफला चव्यं चित्रको देवदारु च||१०२|| <br /> <br /> विडङ्गान्यथ मुस्तं च वत्सकं चेति चूर्णयेत्| <br /> मण्डूरतुल्यं तच्चूर्णं गोमूत्रेऽष्टगुणे पचेत्||१०३|| <br /> <br /> शनैः सिद्धास्तथा शीताः कार्याः कर्षसमा गुडाः| <br /> यथाग्नि भक्षणीयास्ते प्लीहपाण्ड्वामयापहाः||१०४||<br /> <br /> ग्रहण्यर्शोनुदश्चैव तक्रवाट्याशिनः स्मृताः| <br /> <br /> इति मण्डूरवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tryūṣaṇaṁ triphalā cavyaṁ citrakō dēvadāru ca||102|| <br /> <br /> viḍaṅgānyatha mustaṁ ca vatsakaṁ cēti cūrṇayēt| <br /> maṇḍūratulyaṁ taccūrṇaṁ gōmūtrē'ṣṭaguṇē pacēt||103|| <br /> <br /> śanaiḥ siddhāstathā śītāḥ kāryāḥ karṣasamā guḍāḥ| <br /> yathāgni bhakṣaṇīyāstē plīhapāṇḍvāmayāpahāḥ||104|| <br /> <br /> grahaṇyarśōnudaścaiva takravāṭyāśinaḥ smr̥tāḥ| <br /> <br /> iti maṇḍūravaṭakāḥ| <br /> <br /> tryUShaNaM triphalA cavyaM citrako devadAru ca||102|| <br /> <br /> viDa~ggAnyatha mustaM ca vatsakaM ceti cUrNayet| <br /> maNDUratulyaM taccUrNaM gomUtre~aShTaguNe pacet||103|| <br /> <br /> shanaiH siddhAstathA shItAH kAryAH karShasamA guDAH| <br /> yathAgni bhakShaNIyAste plIhapANDvAmayApahAH||104|| <br /> <br /> grahaNyarshonudashcaiva takravATyAshinaH smRutAH| <br /> <br /> iti maNDUravaTakAH|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Mandura Vataka''-II: ''Shunthi, pippali, maricha, haritaki, bibhitaka, amalaki, chavya, chitraka, devadaru, vidanga, musta'' and ''vatsaka'' in one part each, made in the form of powder and added to equal quantity (12 parts) of ''mandura bhasma'', should then be boiled by adding eight times of cow’s urine over mild fire. After the recipe cools pills of one ''aksha'' each should be prepared and taken according to the power of digestion. This cures ''pleeha, pandu, grahani,'' and ''arsha''. The patient should take buttermilk and ''vatya'' (a roasted barley preperation) while taking this pill [102-104]<br /> <br /> === ''Gaudo arishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मञ्जिष्ठा रजनी द्राक्षा बलामूलान्ययोरजः||१०५|| <br /> <br /> लोध्रं चैतेषु गौडः स्यादरिष्टः पाण्डुरोगिणाम्| <br /> <br /> इति गौडोऽरिष्टः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mañjiṣṭhā rajanī drākṣā balāmūlānyayōrajaḥ||105|| <br /> <br /> lōdhraṁ caitēṣu gauḍaḥ syādariṣṭaḥ pāṇḍurōgiṇām| <br /> <br /> iti gauḍō'riṣṭaḥ| <br /> <br /> ma~jjiShThA rajanI drAkShA balAmUlAnyayorajaH||105|| <br /> <br /> lodhraM caiteShu gauDaH syAdariShTaH pANDurogiNAm| <br /> <br /> iti gauDo~ariShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Manjishtha, rajani, draksha, bala moola'' (roots), ''lauha bhasma'', and ''lodhra'' should be added to jaggery and processed according to the method prescribed for ''arishta''. It is called ''gaudo-arishta'' and is useful for the patients suffering from ''pandu roga'' [105]<br /> <br /> === ''Beejakarishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बीजकात्षोडशपलं त्रिफलायाश्च विंशतिः||१०६|| <br /> <br /> द्राक्षायाः पञ्च लाक्षायाः सप्त द्रोणे जलस्य तत्| <br /> साध्यं पादावशेषे तु पूतशेषे समावपेत्||१०७|| <br /> <br /> शर्करायास्तुलां प्रस्थं माक्षिकस्य च कार्षिकम्| <br /> व्योषं व्याघ्रनखोशीरं क्रमुकं सैलवालुकम्||१०८|| <br /> <br /> मधुकं कुष्ठमित्येतच्चूर्णितं घृतभाजने| <br /> यवेषु दशरात्रं तद्ग्रीष्मे द्विः शिशिरे स्थितम्||१०९|| <br /> <br /> पिबेत्तद्ग्रहणीपाण्डुरोगार्शःशोथगुल्मनुत्| <br /> मूत्रकृच्छ्राश्मरीमेहकामलासन्निपातजित्||११०|| <br /> <br /> बीजकारिष्ट इत्येष आत्रेयेण प्रकीर्तितः| <br /> <br /> इति बीजकारिष्टः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bījakātṣōḍaśapalaṁ triphalāyāśca viṁśatiḥ||106|| <br /> <br /> drākṣāyāḥ pañca lākṣāyāḥ sapta drōṇē jalasya tat| <br /> sādhyaṁ pādāvaśēṣē tu pūtaśēṣē samāvapēt||107|| <br /> <br /> śarkarāyāstulāṁ prasthaṁ mākṣikasya ca kārṣikam| <br /> vyōṣaṁ vyāghranakhōśīraṁ kramukaṁ sailavālukam||108|| <br /> <br /> madhukaṁ kuṣṭhamityētaccūrṇitaṁ ghr̥tabhājanē| <br /> yavēṣu daśarātraṁ tadgrīṣmē dviḥ śiśirē sthitam||109|| <br /> <br /> pibēttadgrahaṇīpāṇḍurōgārśaḥśōthagulmanut| <br /> mūtrakr̥cchrāśmarīmēhakāmalāsannipātajit||110|| <br /> <br /> bījakāriṣṭa ityēṣa ātrēyēṇa prakīrtitaḥ| <br /> <br /> iti bījakāriṣṭaḥ| <br /> <br /> bIjakAtShoDashapalaM triphalAyAshca viMshatiH||106|| <br /> <br /> drAkShAyAH pa~jca lAkShAyAH sapta droNe jalasya tat| <br /> sAdhyaM pAdAvasheShe tu pUtasheShe samAvapet||107|| <br /> <br /> sharkarAyAstulAM prasthaM mAkShikasya ca kArShikam| <br /> vyoShaM vyAghranakhoshIraM kramukaM sailavAlukam||108|| <br /> <br /> madhukaM kuShThamityetaccUrNitaM ghRutabhAjane| <br /> yaveShu dasharAtraM tadgrIShme dviH shishire sthitam||109|| <br /> <br /> pibettadgrahaNIpANDurogArshaHshothagulmanut| <br /> mUtrakRucchrAshmarImehakAmalAsannipAtajit||110|| <br /> <br /> bIjakAriShTa ityeSha AtreyeNa prakIrtitaH| <br /> <br /> iti bIjakAriShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Beejaka'' taken in the amount of sixteen ''pala'', twenty ''pala'' of ''triphala,'' five pala of ''draksha'' and seven ''pala'' of ''laksha'' are added to one ''drona'' of water and boiled till one fourth of water remains. Water should then be taken out by straining. One ''tula'' of sugar, one ''pala'' of honey and one ''pala'' powder of each of the ''shunthi, pippali, maricha, vyaghranakha, kramuka, elavaluka, madhuka'' and ''kushtha'' are added to the above made decoction and the potion be stored in a jar smeared with ghee kept inside a barley heap for ten nights during summer and for twenty nights in winter. Intake of this potion cures ''grahani, pandu, arsha, sotha, gulma, mutra krichha'' (dysuria), ''ashmari'' (stones in the urinary tract), ''meha, kamala'' and diseases caused by all the three [[dosha]]. This is called ''beejaka arishta'' and it was propounded by Atreya.<br /> <br /> Thus, ends the description of ''beejaka arishta'' [106-110]<br /> <br /> === ''Dhatryarishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> धात्रीफलसहस्रे द्वे पीडयित्वा रसं तु तम्||१११|| <br /> <br /> क्षौद्राष्टांशेन संयुक्तं कृष्णार्धकुडवेन च| <br /> शर्करार्धतुलोन्मिश्रं पक्षं स्निग्धघटे स्थितम्||११२|| <br /> <br /> प्रपिबेन्मात्रया प्रातर्जीर्णे हितमिताशनः| <br /> कामलापाण्डुहृद्रोगवातासृग्विषमज्वरान्||११३||<br /> <br /> कासहिक्कारुचिश्वासांश्चैषोऽरिष्टः प्रणाशयेत्| <br /> <br /> इति धात्र्यरिष्टः <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dhātrīphalasahasrē dvē pīḍayitvā rasaṁ tu tam||111|| <br /> <br /> kṣaudrāṣṭāṁśēna saṁyuktaṁ kr̥ṣṇārdhakuḍavēna ca| <br /> śarkarārDhātulōnmiśraṁ pakṣaṁ snigdhaghaṭē sthitam||112|| <br /> <br /> prapibēnmātrayā prātarjīrṇē hitamitāśanaḥ| <br /> kāmalāpāṇḍuhr̥drōgavātāsr̥gviṣamajvarān||113|| <br /> <br /> kāsahikkāruciśvāsāṁścaiṣō'riṣṭaḥ praṇāśayēt| <br /> <br /> iti dhātryariṣṭaḥ| <br /> <br /> dhAtrIphalasahasre dve pIDayitvA rasaM tu tam||111|| <br /> <br /> kShaudrAShTAMshena saMyuktaM kRuShNArdhakuDavena ca| <br /> sharkarArdhatulonmishraM pakShaM snigdhaghaTe sthitam||112|| <br /> <br /> prapibenmAtrayA prAtarjIrNe hitamitAshanaH| <br /> kAmalApANDuhRudrogavAtAsRugviShamajvarAn||113|| <br /> <br /> kAsahikkArucishvAsAMshcaiSho~ariShTaH praNAshayet| <br /> <br /> iti dhAtryariShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Dhatryarishta'' - Two thousand fruits of ''amalaki'' should be crushed and the juice extracted should be mixed with one eighth the quantity of honey, half ''kudava'' of ''pippali'' and half ''tula'' of sugar. It should then be kept in an earthern jar smeared with ghee for one fortnight. It should be taken in appropriate dose in the morning and the patient should take wholesome food in small quantity after the digestion of the drug. This ''arishta'' cures ''kamala, pandu, hridroga, vatarakta, vishama jwara, kasa, hikka, aruchi'' and ''svasa''. Thus, ends the description of ''dhatrya arishta'' [111-113]<br /> <br /> === Medicated water ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्थिरादिभिः शृतं तोयं पानाहारे प्रशस्यते||११४|| <br /> <br /> पाण्डूनां, कामलार्तानां मृद्वीकामलकीरसः|११५| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sthirādibhiḥ śr̥taṁ tōyaṁ pānāhārē praśasyatē||114|| <br /> <br /> pāṇḍūnāṁ, kāmalārtānāṁ mr̥dvīkāmalakīrasaḥ|115| <br /> <br /> sthirAdibhiH shRutaM toyaM pAnAhAre prashasyate||114|| <br /> <br /> pANDUnAM, kAmalArtAnAM mRudvIkAmalakIrasaH|115|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Water boiled with the drugs belonging to ''sthiradi'' group is useful for drinking and the preparation of foods for ''pandu rogi''; while the patient of ''kamala'' should use the juice of ''draksha'' and ''amalaki rasa'' [114-115]<br /> <br /> === Principles of treatment according to [[dosha]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगप्रशान्त्यर्थमिति प्रोक्तं महर्षिणा||११५|| <br /> <br /> विकल्प्यमेतद्भिषजा पृथग्दोषबलं प्रति| <br /> वातिके स्नेहभूयिष्ठं, पैत्तिके तिक्तशीतलम्||११६|| <br /> <br /> श्लैष्मिके कटुतिक्तोष्णं [१] , विमिश्रं सान्निपातिके|११७|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgapraśāntyarthamiti prōktaṁ maharṣiṇā||115|| <br /> <br /> vikalpyamētadbhiṣajā pr̥thagdōṣabalaṁ prati| <br /> vātikē snēhabhūyiṣṭhaṁ, paittikē tiktaśītalam||116|| <br /> <br /> ślaiṣmikē kaṭutiktōṣṇaṁ [1] , vimiśraṁ sānnipātikē|117| <br /> <br /> pANDurogaprashAntyarthamiti proktaM maharShiNA||115|| <br /> <br /> vikalpyametadbhiShajA pRuthagdoShabalaM prati| <br /> vAtike snehabhUyiShThaM, paittike tiktashItalam||116|| <br /> <br /> shlaiShmike kaTutiktoShNaM [1] , vimishraM sAnnipAtike|117|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The above mentioned drugs are described for the cure of ''pandu roga'' by the great sage (Punarvasu Atreya). The physician should make suitable changes (combinations and permutations) in the above depending upon the strength of the [[dosha]] in the patient. <br /> <br /> The therapy should be dominated by unctuous drugs (oil, ghee etc) for ''vatika'' type of ''pandu''; by bitter and cooling drugs for ''paittika'' type and by pungent, bitter and hot drugs for [[kapha]]ja type of ''pandu'' [115-117]<br /> <br /> === Treatment of ''mrittika bhakshanajanya pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> निपातयेच्छरीरात्तु मृत्तिकां भक्षितां भिषक्||११७|| <br /> <br /> युक्तिज्ञः शोधनैस्तीक्ष्णैः प्रसमीक्ष्य बलाबलम्| <br /> शुद्धकायस्य सर्पींषि बलाधानानि योजयेत्||११८|| <br /> <br /> व्योषं बिल्वं हरिद्रे द्वे त्रिफला द्वे पुनर्नवे| <br /> मुस्तान्ययोरजः पाठा विडङ्गं देवदारु च||११९|| <br /> <br /> वृश्चिकाली च भार्गी च सक्षीरैस्तैः [१] समैर्घृतम्| <br /> साधयित्वा पिबेद्युक्त्या नरो मृद्दोषपीडितः||१२०|| <br /> <br /> तद्वत् केशरयष्ट्याह्वपिप्पलीक्षारशाद्वलैः| <br /> मृद्भक्षणादातुरस्य लौल्यादविनिवर्तिनः||१२१|| <br /> <br /> द्वेष्यार्थं भावितां कामं दद्यात्तद्दोषनाशनैः| <br /> विङ्गैलातिविषया निम्बपत्रेण पाठया||१२२|| <br /> <br /> वार्ताकैः कटुरोहिण्या कौटजैर्मूर्वयाऽपि वा|१२३| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nipātayēccharīrāttu mr̥ttikāṁ bhakṣitāṁ bhiṣak||117|| <br /> <br /> yuktijñaḥ śōdhanaistīkṣṇaiḥ prasamīkṣya balābalam| <br /> śuddhakāyasya sarpīṁṣi balādhānāni yōjayēt||118|| <br /> <br /> vyōṣaṁ bilvaṁ haridrē dvē triphalā dvē punarnavē| <br /> mustānyayōrajaḥ pāṭhā viḍaṅgaṁ dēvadāru ca||119|| <br /> <br /> vr̥ścikālī ca bhārgī ca sakṣīraistaiḥ [1] samairghr̥tam| <br /> sādhayitvā pibēdyuktyā narō mr̥ddōṣapīḍitaḥ||120|| <br /> <br /> tadvat kēśarayaṣṭyāhvapippalīkṣāraśādvalaiḥ| <br /> mr̥dbhakṣaṇādāturasya laulyādavinivartinaḥ||121|| <br /> <br /> dvēṣyārthaṁ bhāvitāṁ kāmaṁ dadyāttaddōṣanāśanaiḥ| <br /> viṅgailātiviṣayā nimbapatrēṇa pāṭhayā||122|| <br /> <br /> vārtākaiḥ kaṭurōhiṇyā kauṭajairmūrvayā'pi vā|123| <br /> <br /> nipAtayeccharIrAttu mRuttikAM bhakShitAM bhiShak||117|| <br /> <br /> yuktij~jaH shodhanaistIkShNaiH prasamIkShya balAbalam| <br /> shuddhakAyasya sarpIMShi balAdhAnAni yojayet||118|| <br /> <br /> vyoShaM bilvaM haridre dve triphalA dve punarnave| <br /> mustAnyayorajaH pAThA viDa~ggaM devadAru ca||119|| <br /> <br /> vRushcikAlI ca bhArgI ca sakShIraistaiH [1] samairghRutam| <br /> sAdhayitvA pibedyuktyA naro mRuddoShapIDitaH||120|| <br /> <br /> tadvat kesharayaShTyAhvapippalIkShArashAdvalaiH| <br /> mRudbhakShaNAdAturasya laulyAdavinivartinaH||121|| <br /> <br /> dveShyArthaM bhAvitAM kAmaM dadyAttaddoShanAshanaiH| <br /> vi~ggailAtiviShayA nimbapatreNa pAThayA||122|| <br /> <br /> vArtAkaiH kaTurohiNyA kauTajairmUrvayA~api vA|123|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A physician well versed in therapeutics, should give the patient strong elimination therapy, keeping in view the strength of the patient, in order to remove the swallowed mud from the body. After the body is cleansed, different types of medicated ghee should be prescribed to the patient for promotion of strength.<br /> <br /> Ghee prepared with ''shunthi, pippali, maricha, bilva, haridra, daruharidra, haritaki, bibhitaka, amalaki, sveta'' and ''rakta punarnava, musta, lauha bhasma, patha, vidanga, devadaru, vrishchikali, bhargi'' and milk should be appropriately taken by the patient who suffers from anemia because of eating clay. <br /> <br /> Likewise, ghee prepared with ''keshara, yashtamadhu, pippali, kshara'' (alkali preperation) and ''sadvala'' may be given to the patient suffering from ''mrittika bhakshana janya pandu''. <br /> <br /> If the patient is unable to give up his clay swallowing habits, he should be given clay impregnated with ''vidanga, ela, ativisha,'' neem leaves, ''patha, varataka, katurohiṇī, kutaja'' or ''murva'' with a view of creating an aversion to clay. These drugs also counter act the adverse effects of eating clay. [117-123]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यथादोषं प्रकुर्वीत भैषज्यं पाण्डुरोगिणाम्||१२३|| <br /> <br /> क्रियाविशेष एषोऽस्य मतो हेतुविशेषतः|१२४| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yathādōṣaṁ prakurvīta bhaiṣajyaṁ pāṇḍurōgiṇām||123|| <br /> <br /> kriyāviśēṣa ēṣō'sya matō hētuviśēṣataḥ|124| <br /> <br /> yathAdoShaM prakurvIta bhaiShajyaM pANDurogiNAm||123|| <br /> <br /> kriyAvisheSha eSho~asya mato hetuvisheShataH|124| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Different types of treatment should be given to the patient suffering from ''mrittika bhakshana janya pandu'', according to the different types of [[dosha]] aggravated. However, due to the specific type of etiological factor involved (clay eating), this type of ''pandu'' needs special type of treatment [123-124]<br /> <br /> === ''Shakhashrita kamala'' (''kamala'' in body tissue with obstructive pathology) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तिलपिष्टनिभं यस्तु वर्चः सृजति कामली||१२४||<br /> <br /> श्लेष्मणा रुद्धमार्गं तत् पित्तं कफहरैर्जयेत्| <br /> रूक्षशीतगुरुस्वादुव्यायामैर्वेगनिग्रहैः||१२५|| <br /> <br /> कफसम्मूर्च्छितो वायुः स्थानात् पित्तं क्षिपेद्बली| <br /> हारिद्रनेत्रमूत्रत्वक् श्वेतवर्चास्तदा नरः||१२६|| <br /> <br /> भवेत् साटोपविष्टम्भो गुरुणा हृदयेन च| <br /> दौर्बल्याल्पाग्निपार्श्वार्तिहिक्काश्वासारुचिज्वरैः||१२७|| <br /> <br /> क्रमेणाल्पेऽनुसज्येत [१] पित्ते शाखासमाश्रिते|१२८|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tilapiṣṭanibhaṁ yastu varcaḥ sr̥jati kāmalī||124|| <br /> <br /> ślēṣmaṇā ruddhamārgaṁ tat Pittaṁ Kaphaharairjayēt| <br /> rūkṣaśītagurusvāduvyāyāmairvēganigrahaiḥ||125|| <br /> <br /> Kaphasammūrcchitō vāyuḥ sthānāt Pittaṁ kṣipēdbalī| <br /> hāridranētramūtratvak śvētavarcāstadā naraḥ||126|| <br /> <br /> bhavēt sāṭōpaviṣṭambhō guruṇā hr̥dayēna ca| <br /> daurbalyālpāgnipārśvārtihikkāśvāsārucijvaraiḥ||127|| <br /> <br /> kramēṇālpē'nusajyēta [1] pittē śākhāsamāśritē|128| <br /> <br /> tilapiShTanibhaM yastu varcaH sRujati kAmalI||124|| <br /> <br /> shleShmaNA ruddhamArgaM tat pittaM kaphaharairjayet| <br /> rUkShashItagurusvAduvyAyAmairveganigrahaiH||125|| <br /> <br /> kaphasammUrcchito vAyuH sthAnAt pittaM kShipedbalI| <br /> hAridranetramUtratvak shvetavarcAstadA naraH||126|| <br /> <br /> bhavet sATopaviShTambho guruNA hRudayena ca| <br /> daurbalyAlpAgnipArshvArtihikkAshvAsArucijvaraiH||127|| <br /> <br /> krameNAlpe~anusajyeta [1] pitte shAkhAsamAshrite|128| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A patient of ''kamala'' if passes stools of the color of sesame paste (''tila pishta nibhama''), then it denotes obstruction in the passage of [[pitta]] by the [[kapha]]. Therefore, the [[pitta]] of such patient should be won by administration of drugs which also eliminate [[kapha]]. <br /> <br /> The excess usage of ununctuous, cold and sweet ingredients; excessive exercise; suppression of the natural urges leads to the the aggravation of [[vata]] infilterated with [[kapha]] and the displacement of [[pitta]] from its site, resulting in the development of the following features: <br /> <br /> The eyes, skin and urine of the patient become yellow while his stools become white in color. Additionally, the patients suffer from ''atopa'' (tympanitis), ''vishtambha'' (constipation associated with flatulence),and heaviness in the cardiac region, due to the displacement of [[pitta]] in the peripheral tissues (''shakha''), there is diminution in the flow of [[pitta]] (to the gastrointestinal tract) resulting in the gradual development of weakness, ''agnimandya'' (low digestion), ''parshva'' (pain in the sides of chest), ''hikka'' (hiccups), ''shvasa'' (dyspnea), ''aruchi'' (anorexia) and ''jwara'' [124-128]<br /> <br /> === Treatment of ''shakhashriat kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बर्हितित्तिरिदक्षाणां रूक्षाम्लैः कटुकै रसैः||१२८|| <br /> <br /> शुष्कमूलककौलत्थैर्यूषैश्चान्नानि भोजयेत्| <br /> मातुलुङ्गरसं क्षौद्रपिप्पलीमरिचान्वितम्||१२९|| <br /> <br /> सनागरं पिबेत् पित्तं तथाऽस्यैति स्वमाशयम्|१३०|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> barhitittiridakṣāṇāṁ rūkṣāmlaiḥ kaṭukai rasaiḥ||128|| <br /> <br /> śuṣkamūlakakaulatthairyūṣaiścānnāni bhōjayēt| <br /> mātuluṅgarasaṁ kṣaudrapippalīmaricānvitam||129|| <br /> <br /> sanāgaraṁ pibēt Pittaṁ tathā'syaiti svamāśayam|130| <br /> <br /> barhitittiridakShANAM rUkShAmlaiH kaTukai rasaiH||128|| <br /> <br /> shuShkamUlakakaulatthairyUShaishcAnnAni bhojayet| <br /> mAtulu~ggarasaM kShaudrapippalImaricAnvitam||129|| <br /> <br /> sanAgaraM pibet pittaM tathA~asyaiti svamAshayam|130|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient suffering from from ''shakhashrita kamala'' should be given food along with the soup of the meat of peacock, ''tittira'' (partridge), ''daksha'' (rooster) sizzled with ununctuous, sour and pungent articles; and vegetable soups of dry ''mulaka'' (radish) and ''kulattha''. The patient should also be given the juice of ''matulunga'' mixed with honey, ''pippali, maricha'' and ''shunthi'' for bringing the [[pitta]] to its own course [128-130]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कटुतीक्ष्णोष्णलवणैर्भृशाम्लैश्चाप्युपक्रमः||१३०|| <br /> <br /> आपित्तरागाच्छकृतो [१] वायोश्चाप्रशमाद्भवेत्| <br /> स्वस्थानमागते पित्ते पुरीषे पित्तरञ्जिते||१३१|| <br /> <br /> निवृत्तोपद्रवस्य स्यात् पूर्वः कामलिको विधिः|१३२|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭutīkṣṇōṣṇalavaṇairbhr̥śāmlaiścāpyupakramaḥ||130|| <br /> <br /> āPittarāgācchakr̥tō [1] vāyōścāpraśamādbhavēt| <br /> svasthānamāgatē pittē purīṣē Pittarañjitē||131|| <br /> <br /> nivr̥ttōpadravasya syāt pūrvaḥ kāmalikō vidhiḥ|132| <br /> <br /> kaTutIkShNoShNalavaNairbhRushAmlaishcApyupakramaH||130|| <br /> <br /> ApittarAgAcchakRuto [1] vAyoshcAprashamAdbhavet| <br /> svasthAnamAgate pitte purIShe pittara~jjite||131|| <br /> <br /> nivRuttopadravasya syAt pUrvaH kAmaliko vidhiH|132| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Katu'' (pungent), ''teekshna'' (sharp), ''ushna'' (hot), ''lavana'' (saline) and extremely ''amla'' (sour) drugs should be continued till the stool of the patient acquires the color of [[pitta]] and the [[vata]] gets alleviated. When the [[pitta]] returns to its own habitat, the stool gets colored with [[pitta]] and the patient is relieved of complications, then further, the line of treatment described earlier for the treatment of ''kamala'' (''koshthashrita'') should be used [130-132]<br /> <br /> === ''Haleemaka'' (obstructive jaundice) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यदा तु पाण्डोर्वर्णः स्याद्धरितश्यावपीतकः||१३२|| <br /> <br /> बलोत्साहक्षयस्तन्द्रा मन्द्राग्नित्वं मृदुज्वरः| <br /> स्त्रीष्वहर्षोऽङ्गमर्दश्च श्वासस्तृष्णाऽरुचिर्भ्रमः||१३३|| <br /> <br /> हलीमकं तदा तस्य विद्यादनिलपित्ततः|१३४| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yadā tu pāṇḍōrvarṇaḥ syāddharitaśyāvapītakaḥ||132|| <br /> <br /> balōtsāhakṣayastandrā mandrāgnitvaṁ mr̥dujvaraḥ| <br /> strīṣvaharṣō'ṅgamardaśca śvāsastr̥ṣṇā'rucirbhramaḥ||133|| <br /> <br /> halīmakaṁ tadā tasya vidyādanilaPittataḥ|134| <br /> <br /> yadA tu pANDorvarNaH syAddharitashyAvapItakaH||132|| <br /> <br /> balotsAhakShayastandrA mandrAgnitvaM mRudujvaraH| <br /> strIShvaharSho~a~ggamardashca shvAsastRuShNA~arucirbhramaH||133|| <br /> <br /> halImakaM tadA tasya vidyAdanilapittataH|134| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If a patient suffering from ''pandu'' develops green, black or yellow color and suffers from diminution of strength and enthusiasm; drowsiness, ''agnimandya'' (low digestion), mild fever, lack of libido (''strisu aharsho''), ''angamarda'' (malaise/ body ache), dyspnea, ''trishna'' (morbid thirst), anorexia and giddiness, the ailment is called ''haleemaka'' and is caused by the aggravation of [[vata]] and [[pitta]] [[dosha]] [132-134]<br /> <br /> === Treatment of ''haleemaka'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुडूचीस्वरसक्षीरसाधितं माहिषं घृतम्||१३४|| <br /> <br /> स पिबेत्त्रिवृतां स्निग्धो रसेनामलकस्य तु| <br /> विरिक्तो मधुरप्रायं भजेत् पित्तानिलापहम्||१३५|| <br /> <br /> द्राक्षालेहं च पूर्वोक्तं सर्पींषि मधुराणि च| <br /> यापनान् क्षीरबस्तींश्च शीलयेत्सानुवासनान्||१३६|| <br /> <br /> मार्द्वीकारिष्टयोगांश्च पिबेद्युक्त्याऽग्निवृद्धये| <br /> कासिकं चाभयालेहं पिप्पलीं मधुकं बलाम्||१३७|| <br /> <br /> पयसा च प्रयुञ्जीत यथादोषं यथाबलम्|१३८| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> guḍūcīsvarasakṣīrasādhitaṁ māhiṣaṁ ghr̥tam||134|| <br /> <br /> sa pibēttrivr̥tāṁ snigdhō rasēnāmalakasya tu| <br /> viriktō madhuraprāyaṁ bhajēt pittānilāpaham||135|| <br /> <br /> drākṣālēhaṁ ca pūrvōktaṁ sarpīṁṣi madhurāṇi ca| <br /> yāpanān kṣīrabastīṁśca śīlayētsānuvāsanān||136|| <br /> <br /> mārdvīkāriṣṭayōgāṁśca pibēdyuktyā'gnivr̥ddhayē| <br /> kāsikaṁ cābhayālēhaṁ pippalīṁ madhukaṁ balām||137|| <br /> <br /> payasā ca prayuñjīta yathādōṣaṁ yathābalam|138| <br /> <br /> guDUcIsvarasakShIrasAdhitaM mAhiShaM ghRutam||134|| <br /> <br /> sa pibettrivRutAM snigdho rasenAmalakasya tu| <br /> virikto madhuraprAyaM bhajet pittAnilApaham||135|| <br /> <br /> drAkShAlehaM ca pUrvoktaM sarpIMShi madhurANi ca| <br /> yApanAn kShIrabastIMshca shIlayetsAnuvAsanAn||136|| <br /> <br /> mArdvIkAriShTayogAMshca pibedyuktyA~agnivRuddhaye| <br /> kAsikaM cAbhayAlehaM pippalIM madhukaM balAm||137|| <br /> <br /> payasA ca prayu~jjIta yathAdoShaM yathAbalam|138| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Patients suffering from ''haleemaka'' should take the recipe prepared from buffalo ghee by adding the juice of ''guduchi'' and milk.<br /> <br /> After oleation with this oil the patient should take ''trivritta'' mixed with the juice of ''amalaki'' which causes purgation. <br /> <br /> Thereafter food and drinks which are dominated by sweet taste and are alleviators of [[pitta]] and [[kapha]] should be given.<br /> <br /> The patient should take ''drakshaleha'' described earlier (vide verse 100-102 in this chapter in the name of ''dhatryavaleha'') and recipes of medicated ghee prepared by boiling with sweet drugs (vide verse 51-52). The patient should habitually indulge in taking different types of yapana [[basti]] (a type of medicated enema), kshara [[basti]] and anuvasana [[basti]] discussed in [ Cha. Sa. [[Siddhi Sthana]] ]. He should also take different recipes of ''arishta'' prepared from grapes (''draksharishta'') for the promotion of power of digestion. ''Abhaya leha'' described in the treatment of ''kasa'' [Cha. Sa. [[Chikitsa Sthana]] 18/57-62] may also be taken. Alternatively the patient may also take ''pippali, madhuka'' and ''bala'' along with milk depending upon the [[dosha]] aggravated and the strength of the patient [134-138]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकौ- <br /> <br /> पाण्डोः पञ्चविधस्योक्तं हेतुलक्षणभेषजम्||१३८|| <br /> <br /> कामला द्विविधा तेषां साध्यासाध्यत्वमेव च| <br /> <br /> तेषां विकल्पो यश्चान्यो महाव्याधिर्हलीमकः| <br /> तस्य चोक्तं समासेन व्यञ्जनं सचिकित्सितम्||१३९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkau- <br /> <br /> pāṇḍōḥ pañcavidhasyōktaṁ hētulakṣaṇabhēṣajam||138|| <br /> <br /> kāmalā dvividhā tēṣāṁ sādhyāsādhyatvamēva ca| <br /> <br /> tēṣāṁ vikalpō yaścānyō mahāvyādhirhalīmakaḥ| <br /> tasya cōktaṁ samāsēna vyañjanaṁ sacikitsitam||139||<br /> <br /> tatra shlokau- <br /> <br /> pANDoH pa~jcavidhasyoktaM hetulakShaNabheShajam||138|| <br /> <br /> kAmalA dvividhA teShAM sAdhyAsAdhyatvameva ca| <br /> <br /> teShAM vikalpo yashcAnyo mahAvyAdhirhalImakaH| <br /> tasya coktaM samAsena vya~jjanaM sacikitsitam||139|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> To sum up, the topics discussed in this chapter are:<br /> *Five types of ''pandu'' along with the etiology, signs and symptoms; and treatment<br /> *Two types of ''kamala'' and their curability as well as incurability<br /> *Different varieties of ''kamala''<br /> *''Haleemaka'', which is a serious disease along with its signs and symptoms; and treatment [138-139]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने <br /> पाण्डुरोगचिकित्सितं नाम षोडशोऽध्यायः||१४0|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē <br /> pāṇḍurōgacikitsitaṁ nāma ṣōḍaśō'dhyāyaḥ||140||<br /> <br /> ityagniveshakRute tantre~aprApte dRuDhabalasampUrite cikitsAsthAne <br /> pANDurogacikitsitaM nAma ShoDasho~adhyAyaH||16|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus ends the sixteenth chapter in [[Chikitsa Sthana]] dealing with the treatment of ''pandu roga'' in the work of Agnivesha which was redacted by Charaka and because of its unavailability was supplemented by Dridhabala [140]<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *The important pathological factors in ''pandu'' are aggravated three [[dosha]] with dominant [[pitta]] leading to slow metabolism at level of blood ([[rakta dhatu]]), the fatty tissue [[meda dhatu]]) and [[ojas]] qualities (affecting the vitality). <br /> *The dietary factors like alkaline, sour, saline, hot and mutually contradictory foods, unwholesome food, ''nishpava'' (a type of pulses), ''masha, pinyaka'' (oil cake) and ''tila'' oil; lifestyle factors like indulging in day sleep, performing exercise and sex before digestion of the food, disobedience of the seasonal regimens (''ritu vaishamya''), suppression of the natural urges; iatrogenic factors like Improper administration of [[Panchakarma]] measures (''pratikarma vaishamya'') and the psychological factors like affliction of mind with passion, worry, fear, anger, grief are responsible for ''pandu''. <br /> *Heart and circulatory system are involved in the pathogenesis of ''pandu'' which is presented at the sites of skin and [[mamsa dhatu]] (flesh).<br /> *The specific features are observed as per the [[dosha]] dominance in pathogenesis. <br /> *Person indulging in the habitual consumption of clay (''mrittika'') gets [[dosha]] aggravated according to the taste of mud viz. astringent mud aggravates [[vata]], saline and alkaline mud aggravates [[pitta]] and sweet mud aggravates [[kapha]] [[dosha]]. These factors cause ''pandu'' by affecting the [[dhatu]] and [[ojas]]. <br /> *Chronic ''pandu roga'' is incurable. The prognosis depends upon involvement of [[dhatu] and its intensity. <br /> *If a patient of ''pandu roga'' excessively consumes [[pitta]] vitiating diet and regimen, the aggravated [[pitta]] causes ''kamala'' by involving the [[rakta]] and the [[mamsa dhatu]]. <br /> *First principle of management of ''pandu'' is administration of internal oleation ([[snehana]]) followed by strong (''teekshna'') emetic and purgation therapies for cleansing of the body (''shodhana''). In patients of ''kamala'', mild purgation therapy with bitter drugs is advised.<br /> *''Kamala'' is of two types: ''Koshtha-shaksha shrita'' and ''shakhashrita''. In ''koshtha-shakhashrita kamala'' there is excess increase in [[pitta]]. <br /> *In ''shakhashrita kamala'', [[pitta]] is obstructed by [[kapha]] and improperly circulated by [[vata]]. Therefore the treatment principles differ in both. <br /> *In ''koshtha-shaksha shrita kamala'', mild purgation is administered with bitter drugs with a focus on pacification of[[pitta]]. <br /> *In ''shakhashrita kamala'', principles of management are pacification of [[kapha]], and ''anulomana'' of [[vata]] to derive [[pitta]] to its own natural site. Therefore ''ruksha, amla, katu'' drugs are used in the treatment. <br /> *Suitable changes (combinations and permutations) in the treatment should be prescribed depending upon the strength of the [[dosha]] in the patient. The therapy should be dominated by unctuous drugs (oil, ghee etc) for ''vatika'' type of ''pandu''; by bitter and cooling drugs for ''paittika'' type and by pungent, bitter and hot drugs for [[kapha]]ja type of ''pandu''.<br /> *Strong elimination therapy is advised to remove the swallowed mud from the body after considering the strength of the patient. After the body is cleansed, different types of medicated ghee should be prescribed to the patient for promotion of strength. <br /> *''Haleemaka'' and is caused by the aggravation of [[vata]] and [[pitta]] [[dosha]]. Hence the treatment focus on pacification of [[vata]] and [[pitta]] [[dosha]].<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> === Pathological factors ===<br /> *[[Dosha]]: [[Pitta]] dominant three [[dosha]], sadhaka and ranjak [[pitta]], vyana and samana [[vata]], avalambak and kledaka [[kapha]] <br /> *[[Dhatu]](vitiated factors): [[Rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] <br /> *Status of [[agni]]/ dhatwagni/bhutagni: ''Manda'' at [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] level <br /> *Origin of disease: Heart and channels, Liver and spleen <br /> *Sites of vitiation: All body <br /> *Sites of clinical presentation: All body specifically skin and subcutaneous tissues <br /> *Srotas involved :Rasavaha, Raktavaha <br /> *Type of ''samprapti'' : ''Avarodha'' and ''kshaya'' <br /> *Basic principles of treatment: ''Shodhana'' (mainly [[virechana]]) and ''shamana'' (mainly [[pitta]] shamana) as per [[dosha]] dominance<br /> <br /> === General considerations ===<br /> ''Pandu'' can be related with the disorders of improper formation of blood tissue due to vitiation of [[pitta]] [[dosha]]. [[Pitta]] [[dosha]] is considered to be responsible for all digestion, transformation and metabolism processes in the body. Therefore, the disorders like anemia, nutritional deficiency are mainly considered under ''pandu roga''. The disorders which include pathologies of impaired metabolism and formation of plasma, blood, muscles and fat can also be referred under the umbrella of ''pandu roga''. These include thyroid function disorders, hematological disorders like thalessemia, jaundice etc.<br /> <br /> === Etiological factors observed in present era ===<br /> ==== Diet ==== <br /> The dietary factors that cause vitiation of [[pitta]] [[dosha]] and poor nutritional status of [[rakta dhatu]] are enlisted to cause ''pandu''. These include the items having sour, salt, pungent taste, hot potency, alkaline nature, mutually contradictory and unwholesome food. These shall be avoided to prevent ''pandu''. <br /> *Food with sour taste (''amla ahara'') includes sour curd, lemons, citric acid, pickles, and food with preservatives as jams, cold drinks, sauces, tamarind etc. <br /> *''Lavana ahara'' may be taken as food with excess salts or with salt added in packaged food or as pickles, chutneys etc.<br /> *''Madya'' includes alcoholic beverages as rum, beer, whisky, vodka etc.<br /> *''Kshara'' includes soda used in diet, cold drinks and beverages. <br /> *''Ati tikshna ahara'' includes as excessively spicy,pungent items as ''chhole, chaats, pakode, panipuri, chaaps, rajma,'' spicy vegetables and other dishes.<br /> *''Ati ushna'' includes food articles which are either very hot as tea, coffee etc. or which increase the metabolic activities of the body or also as very hot temperature.<br /> *''Mrittika bhakshana'' is considered as either oral ingestion of mud or use of articles contaminated with mud as unclean hands and fingers or as improperly washed vegetables or eatables.<br /> *''Asatmya bhojana'' may include food items that are not adopted or suited. It may be considered as sudden change of food style or habit or also as junk food used today, as they are not beneficial. <br /> <br /> Some scientific studies have proven the role of some of the ''aharaja'' factors in the causation of ''panduroga'' as tea (considered as ''ati ushna nidana'') has been proved to cause iron deficiency anemia by interfering with the absorption of iron. Similarly ''madya'' (alcohols) cause megaloblastic anemia by hampering the folate absorption.<br /> <br /> ==== Lifestyle ==== <br /> <br /> Excess day time sleep, exercise beyond one’s capacity and at improper time can lead to ''pandu''. Therefore, proper quality sleep and proper exercise are preventive measures for ''pandu''.<br /> <br /> ==== Psychological factors ==== <br /> <br /> Passion, worry, fear, anger and grief can affect digestion leading to poor nutritional status. Hence blissful state of mind is needed for proper nutrition. Rai and Kar in their observational study showed that worries, fear and grief are major etiological factors for iron deficiency anemia. These factors cause significant reduction of serum and bone marrow, while inhibiting the process of erythropoiesis. The inflammatory mediators such as IL-6, hepcidin are mediators in this pathology originated from grief and fear.&lt;ref&gt;Rai Shalini, Kar Anukul C. A review of role of psychological factors in the etiopathogenesis of Pandu roga with reference to iron deficiency anemia.Ayu,2016 Jan-March,31(1):18-21. &lt;/ref&gt;<br /> <br /> ==== Iatrogenic factors ==== <br /> <br /> Improper administration of oleation therapy and [[Panchakarma]] procedures can lead to ''pandu''.<br /> <br /> ==== Pathophysiology ====<br /> [[File:Pandu.png|500px|thumb]] <br /> The cardinal feature of pandu is appearance of pallor on skin of the patient. Complexion and luster of skin is maintained by [[rasa dhatu]] and [[rakta dhatu]]. The texture is maintained by [[mamsa dhatu]]. Unctuousness is maintained by [[meda dhatu]]. These four [[dhatu]] are important for maintaining the natural appearance of skin. In ''pandu'', the vitiated [[pitta]], due to its hot and sharply acting properties, impairs digestion process at [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] leading to their poor formation. The [[rasa dhatu]] transport channels originate in the heart and its vessels. The origin of channels of [[rakta]] is in the liver and spleen. Therefore, symptoms related to cardio-vascular system and hematological system. <br /> <br /> The sequential nourishment of [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] is impaired leading to poor quality tissues. Thus, overall functions of these systems are disturbed in ''pandu''. <br /> <br /> The type of pathogenesis includes formation of same [[dhatu]] (improperly formed tissues) due to poor digestive and metabolic processes at the above mentioned levels. Therefore, the treatment principle includes correction of this impairment.<br /> <br /> ==== Clinical features and conditions resembling the disease ====<br /> <br /> '''Premonitory symptoms''': Palpitations, dryness, lack of sweating, fatigue. <br /> <br /> '''Signs''': Decrease in complexion, strength, unctuousness and vitality are observed in ''pandu''. <br /> <br /> Various features related to that are categorized below:<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs<br /> ! scope=&quot;col&quot;| Symptoms Manifested<br /> |-<br /> | 1<br /> | ''Varnakshaya'' (depletion of complexion) <br /> | Discoloration of skin, poor lustre, pallor, yellowish, dark yellow skin <br /> |-<br /> | 2<br /> | ''Balakshaya'' (depletion of strength) <br /> | Weakness, fatigue<br /> |-<br /> | 3<br /> | ''Snehakshaya'' (depletion of unctuousness) <br /> | Dryness, poor quality of tissues <br /> |-<br /> | 4<br /> | ''Ojakshaya'' (depletion of vitality)<br /> | Fearfulness, excess worries, impaired sensations, lack of concentration, poor appearance <br /> |}<br /> <br /> The following clinical features are observed in ''pandu''. The involvement of [[dosha]], dushya and channels are as given in the following table:<br /> <br /> ==== Signs ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs<br /> ! scope=&quot;col&quot;| [[Dosha]]<br /> ! scope=&quot;col&quot;| ''Dushya''<br /> ! scope=&quot;col&quot;| ''Srotas''<br /> |-<br /> | 1<br /> | ''Dhatushaithilya'' (laxity of tissues)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 2<br /> | [[Dhatu]] gaurava (heaviness in tissues)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 3<br /> | ''Varnakshaya'' (poor complexion)<br /> | [[Vata]], [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 4<br /> | ''Balakshaya'' (poor strength)<br /> | [[Vata]],[[Pitta]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 5<br /> | ''Snehakshaya'' (depletion of unctuousness)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rakta dhatu]], [[Meda dhatu]]<br /> | ''Raktavaha, Medavaha''<br /> |-<br /> | 6<br /> | [[Oja]]gunakshaya'' (depletion of vitality)<br /> | [[Vata]], [[Pitta]]<br /> | Sapta [[dhatu]]<br /> | ''Saptadhatu vaha''<br /> |-<br /> | 7<br /> | ''Raktalpata'' (poor quality and less blood)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 8<br /> | ''Medalpata'' (poor quality and less fats) <br /> | [[Vata]], [[Pitta]]<br /> | [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 9<br /> | ''Nihasarta'' (poor quality tissues) <br /> | Tri[[dosha]]<br /> | Sapta[[dhatu]]<br /> | ''Saptadhatu vaha''<br /> |-<br /> | 10<br /> | ''Shithilendriya'' (impairment of senses) <br /> | Tri[[dosha]]<br /> | Sapta[[dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 11<br /> | ''Vaivarnya'' (discoloration) <br /> | [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 12<br /> | ''Panduta'' (pallor) <br /> | [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |}<br /> <br /> ==== Symptoms ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Symptoms<br /> ! scope=&quot;col&quot;| [[Dosha]]<br /> ! scope=&quot;col&quot;| ''Dushya''<br /> ! scope=&quot;col&quot;| ''Srotas''<br /> |-<br /> | 1<br /> | ''Karnakshweda'' (tinnitus)<br /> | [[Vata]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 2<br /> | ''Hatanala'' (poor digestion)<br /> | [[Kapha]], [[Vata]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 3<br /> | ''Daurbalya'' (weakness)<br /> | [[Vata]], [[Pitta]]<br /> | Sapta[[dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 4<br /> | ''Sadana'' (bodyache)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 5<br /> | ''Annadwesha'' (anorexia)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 6<br /> | ''Shrama'' (overworked, fatigue)<br /> | [[Vata]]<br /> |[[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 7<br /> | ''Bhrama'' (vertigo)<br /> | [[Vata]], [[Pitta]]<br /> | [[Majja dhatu]]<br /> | ''Majjavaha''<br /> |-<br /> | 8<br /> | ''Gatrashoola'' (pain)<br /> | [[Vata]]<br /> | [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 9<br /> | ''Jwara'' (feverishness)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]], Sweda<br /> | ''Rasavaha, Swedavaha''<br /> |-<br /> | 10<br /> | ''Shwasa'' (dyspnea)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha, Pranavaha''<br /> |-<br /> | 11<br /> | ''Gaurava'' (heaviness)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 12<br /> | ''Aruchi'' (aversion to food)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 13<br /> | ''Mridit iv gatrata'' (kneading pain)<br /> | [[Vata]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 14<br /> | ''Pidita unmathit gatrata'' (churning, pressing pain)<br /> | [[Vata]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 15<br /> | ''Akshikutashotha'' (pre-orbital swelling)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 16<br /> | ''Harita lomata'' (greenish body hair)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 17<br /> | ''Shirnalomata'' (falling body hair)<br /> | [[Vata]],[[Pitta]]<br /> | [[Asthi dhatu]]<br /> | ''Asthivaha''<br /> |-<br /> | 18<br /> | ''Hatprabhatva'' (poor luster)<br /> | [[Pitta]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 19<br /> | ''Kopana'' (irritability)<br /> | [[Pitta]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 20<br /> | ''Shishiradwesha'' (disliking cold)<br /> | [[Vata]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 21<br /> | ''Nindraluta'' (excessive sleepiness)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 22<br /> | ''Sthivanadhikya'' (excessive sputum)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 23<br /> | ''Alpawaka'' (less speaking)<br /> | [[Vata]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 24<br /> | ''Pindikodweshtanam'' (pain in calf muscles)<br /> | [[Vata]]<br /> | [[Rakta dhatu]],[[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 25<br /> | ''Katiurupadaruka Sadana'' (pain in legs, thighs, and the lumbar region)<br /> | [[Vata]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 26<br /> | ''Arohaneayasa'' (dyspnea on climbing)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |}<br /> <br /> ==== Differentiating features of ''dosha'' dominance ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! colspan=&quot;3&quot;|Changes in color and texture manifested in the whole body and its parts<br /> |-<br /> ! scope=&quot;col&quot;| ''Vata'' dominant ''pandu''<br /> ! scope=&quot;col&quot;| ''Pitta'' dominant ''pandu''<br /> ! scope=&quot;col&quot;| ''Kapha'' dominant ''pandu''<br /> |-<br /> | Blackish or dark reddish discoloration of the skin, blood vessels, nails, face and eyes<br /> | Yellowish discoloration of skin, the skin, blood vessels, nails, face and eyes<br /> | Whitishness discoloration of skin, the skin, blood vessels, nails, face and eyes<br /> |-<br /> ! colspan=&quot;3&quot;|Features related to urine and stool<br /> |-<br /> | Blackish urine &amp; stool, dry stools<br /> | Yellowish colored urine &amp; stool, foul smelling and loose stools <br /> | Whitishness in the urine &amp; stool <br /> |-<br /> ! colspan=&quot;3&quot;|Features related to ''agni''<br /> |-<br /> | Tastelessness in the mouth<br /> | Pungent taste in mouth<br /> | Sweet taste in the mouth<br /> |-<br /> | rowspan=&quot;6&quot;|Abdominal distension<br /> | Does not relish food<br /> | Anorexia<br /> |-<br /> | rowspan=&quot;2&quot;|Improper digestion of food<br /> | Heaviness<br /> |-<br /> | Excessive salivation<br /> |-<br /> | Sour Eructation<br /> | Laziness<br /> |-<br /> | Eructation associated with burning sensation<br /> | rowspan=&quot;2&quot;| Vomiting<br /> |-<br /> | Burning Sensation<br /> |-<br /> ! colspan=&quot;3&quot;|Other features<br /> |-<br /> | Pain in the body, pricking pain<br /> | Increased body temperature<br /> | Drowsiness<br /> |-<br /> | Tremor<br /> | Excessive thirst<br /> | Horripilation<br /> |-<br /> | Headache<br /> | Fainting due to excessive thirst/coma<br /> | Mental fatigue<br /> |-<br /> | Weakness<br /> | Profuse sweating<br /> | Fainting<br /> |-<br /> | Pain in the sides of the chest<br /> | rowspan = &quot;2&quot;| Weakness<br /> | Prostration<br /> |-<br /> | Giddiness<br /> |Inability to speak<br /> |-<br /> | Swelling/Edema<br /> | Feeling of darkness in front of eyes<br /> | Cough, Dyspnea, Edema<br /> |-<br /> ! colspan=&quot;3&quot;|Likings and Dislikings<br /> |-<br /> | <br /> | Longing for cold things and environment<br /> | Likings for pungent items<br /> |-<br /> |<br /> | Dislike for hot food and atmosphere; also, do not suit the patient<br /> | Likings for ununctuous things<br /> |-<br /> |<br /> | Dislike for sour food; also, do not suit the patient<br /> | Likings for hot things<br /> |}<br /> <br /> ==== Consequences of [[dhatu]] kshaya ====<br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Pathological event<br /> ! scope=&quot;col&quot;| Consequence<br /> ! scope=&quot;col&quot;| Objectivity<br /> |-<br /> | 1<br /> | [[Rasa dhatu]] kshaya<br /> | Decrease in quality tissue that nourish blood or required for formation of blood<br /> | Deficiency in factors required for erythropoietin like vitamin B12, Vitamin K, iron, transferin, ferritin, protein like hemochrome which give red color to blood, electrolyte Na+, K+, Ca++, Mg+, H+, Cl-, albumin, globulins, glucose, amino acid, nucleic acids and lipoprotein, endocrine secretions regulating fluid metabolism <br /> |-<br /> | 2<br /> | [[Rakta dhatu]] kshaya<br /> | Decrease in quality and volume of blood and further decrease in factors required for formation of [[mamsa dhatu]](muscles) <br /> | Decrease in volume of whole blood, hematocrit percentage, endocrine secretions regulating blood metabolism <br /> |-<br /> | 3<br /> | [[Mamsa dhatu]] kshaya<br /> | Decrease in quality and volume of muscles and further decrease in factors required for formation of [[mamsa dhatu]](muscles)<br /> | Decrease in muscle proteins, endocrine secretions regulating muscle metabolism <br /> |-<br /> | 4<br /> | [[Meda dhatu]] kshaya<br /> | Decrease in quality and volume of fats and lipids and further decrease in factors required for formation of [[asthi dhatu]](bones)<br /> | Decrease in lipids, endocrine secretions regulating lipid metabolism <br /> |}<br /> <br /> ==== List of diseases with features as observed in ''pandu'' ====<br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs and Symptoms<br /> ! scope=&quot;col&quot;| Diseases<br /> |-<br /> | 1<br /> | Blackish discoloration of the skin<br /> | Megaloblastic anemias (Vitamin B12 and folic acid deficiency) as reversible melanin skin hyperpigmentation which develops mainly over the knuckles<br /> |-<br /> | 2<br /> | Reddish discoloration of body parts<br /> | Development of petechiae, echymosis or bruises on the body due to thrombocytopenia associated with anemia (as in Aplastic anemias). Anemia due to Addison’s disease (increased tanning)<br /> |-<br /> | 3<br /> | Dry skin or body<br /> | Megaloblastic anemias due to the abnormal proliferation of epithelial cell surfaces. Anemia due to hypothyroid states<br /> |-<br /> | 4<br /> | Reddish or Blackish discoloration in eyes, face and nails<br /> | Body parts due to spontaneous bleeding manifestations, pernicious anemia <br /> |-<br /> | 5<br /> | Blackish urine<br /> | Cola colored urine in various types of intravascular hemolytic anemias when the plasma hemoglobin exceeds the haptoglobin binding capacity<br /> |-<br /> | 6<br /> | Blackish stool/melena <br /> | Gastrointestinal bleeding responsible for anemias - may be due to any ulcers or worm infestations or any other cause<br /> |-<br /> | 7<br /> | Dryness of stool or constipation<br /> | Megaloblastic anemias and anemia due to hypothyroidism<br /> |-<br /> | 8<br /> | &quot;Pins and needles&quot; sensation<br /> | pernicious anemias as well as in megaloblastic anemias<br /> |-<br /> | 9<br /> | Tremors<br /> | Cobalamin deficiency which causes peripheral neuropathy and degeneration of the posterior and pyramidal tracts of the spinal cord<br /> |-<br /> | 10<br /> | Loss of taste/distaste<br /> | Pernicious anemia<br /> |-<br /> | 11<br /> | Bodyache<br /> | Hemolytic anemia, hypothyroidism<br /> |}<br /> <br /> The observations of resemblance with diseases in conventional system of medicine show that all types of anemia specially megaloblastic anemia, pernicious anemia, hypothyroidism, haemolytic anemia can be considered under umbrella of ''pandu''. The objective parameters used for these disorders can be utilized for research on efficacy of [[Ayurveda]] therapies in management of ''pandu''.<br /> <br /> === ''Kamala'' ===<br /> <br /> In the second part of the chapter ''pandu, kamala'' is elaborately described. If a person suffering from ''pandu'' follows [[pitta]] provoking diet and lifestyle, he suffers from ''kamala''. This shows ''kamala'' is consequence of ''pandu'' or ''pandu'' is essential causative factor for ''kamala''. This shows the relation of jaundice originated due to hemolytic anemia. In other types of jaundice, this notion is not observed in practice. ''Kamala'' can occur without ''pandu''. (Su.Utt.44/9, A.Hri.Ni.13/15-17)<br /> <br /> Yellowish discoloration of sclera, skin, face, nails, and urine associated with constitutional symptoms like anorexia, debility, indigestion, loss of physical strength is called ''Kamala''.<br /> <br /> ==== Types of ''kamala'' ====<br /> <br /> ==== 1. ''Shakhashrita Kamala/Alpa'' [[pitta]] (''Dhatu ashrita'') ====<br /> <br /> The passage of [[pitta]] is obstructed by vitiated [[kapha]] and not allowing [[pitta]] to enter ''kostha'', it will cause excess of [[pitta]] in body tissues in ''Shakhasrita Kamala''. This involves the obstructive pathologies at hepatic circulation. As the [[pitta]] cannot enter the gastro-intestinal tract, it leads to clay colored stools. In obstructive jaundice, bilirubin has no access to the intestine and it is the reason for pale stools. <br /> <br /> This description of stools being clay colored, but the urine being yellow shows that they were very close in concept to the modern day physiopathology of obstructive jaundice especially hepatocellular ones (wherein due to an inability of the bile to pass into the gastrointestinal tract it circulates into the blood and the conjugated bilirubin being water soluble fraction is filtered and passes out into the urine). Further the description of [[pitta]] being the bi-product of [[rakta]] is also very similar to the fact of bile being produced as a result of Red Blood Cell destruction. The most common cause is gall stones in the common bile duct and pancreatic cancer in the head of pancreas. Also, a group of parasites known as liver flukes can live in common bile duct causing obstructive jaundice. Biliary atresia, cholanjiocarcinoma, pancreatitis, cholestasis of pregnancy and pancreatic pseudocysts are causes for obstruction of bile flow into the duodenum.<br /> <br /> ==== 2. ''Kostha Shakhashrita Kamala/bahu'' [[pitta]] (''Maha Srotasashrita'') ====<br /> <br /> ''Bahupitta kamala'' or ''Kostha-shakhasrita kamala'' mostly resembles the pre-hepatic and hepatocellular jaundice. Pre-hepatic jaundice is caused by anything which causes haemolysis. Pre-hepatic cause include severe malaria, certain genetic diseases such as sickle cell anemia, spherocytosis, thalassemia, pyruvate kinase deficiency and glucose 6-phospate dehydrogenase (G6PD) deficiency, which lead to increased destruction of red cells and therefore hemolytic jaundice. Hepato-cellular Jaundice can be caused by acute or chronic hepatitis, hepatotoxicity, cirrhosis, drug induced hepatitis and alcoholic liver disease.<br /> <br /> === ''Haleemaka'' ===<br /> <br /> ''Haleemaka'' is a further stage of ''pandu''. Reduced oxygen carrying capacity of blood (reduced ''jeevan karma'') causes depletion of strength and work capacity. This further leads to lack of libido and bodyache. Condition resembles cholestasis. Bile stasis and back pressure leads to liver failure which leads to the further symptoms of ''halimaka'' or sclerosing cholangitis. It is characterized by severe fatigue (''bala utsaha hani''), jaundice (''harita pita meda''), dark urine, cirrhosis, portal hypertension and hepato-megaly.<br /> <br /> === ''Panaki'' ===<br /> <br /> ''Panaki'', another disease in same context of ''halimaka'', explains the condition of malabsorption especially of fat due to lack of bile juice in digestion due to obstruction which leads to steatorrhoea (''bhinna varcha''). Reduced fat absorption leads to deficiency of fat soluble vitamins such as A, D, E and K.<br /> <br /> === ''Kumbha Kamala'' ===<br /> <br /> The description of ''kumbha kamala'' denotes the advanced stage of ''Kostha-shakhasrita kamala'' wherein the main seat of pathology is situated somewhere in the gastro-intestinal tract. ''Kumbha'' is one of the synonyms of ''koshtha''. Edema is described as one of the important clinical features of ''kumbha kamala'' (Su. Utt. 44).<br /> <br /> Both types of ''kamala'', if not treated convert into difficult to treat and hardened skin. ''Kumbha kamala'' could also refer to the presentation of the patient having distended abdomen i.e. ascitis, which is one of the important clinical feature of liver diseases, which are also the main cause of jaundice. <br /> <br /> Liver is the main seat for a number of functions and when it gets severely deranged the liver functions are affected. The clinical picture of ''kumbha kamala'' corresponds to these as observed below:<br /> <br /> *The production of majority of proteins as albumin, few globulins, cerulo-plasmin etc., is hampered leading to edema in the various body parts (''Bhrusham Shoonam cha Manavaḥ'') and dryness in the body.<br /> *The coagulation profile gets affected leading to increased prothrombin time, the presentation of esophageal varices, bleeding per rectum etc. Here the same features have been described as ''sarakta akshi mukha, chhardi vida mootra'' meaning blood seen or coming out of the eyes, mouth or in the vomitus (esophageal varices), through the stool (haemorrhoids) or through the urine.<br /> *The derangement of liver structure in these diseases leads to some presentation of obstructive jaundice with yellow urine (''peeta mootrata'').<br /> *The stage of altered consciousness has also been described as ''tandra moha samanvita'' (acting as if sleepy or having altered perception - semiconscious state).<br /> *The stage of hepatic coma has also been described as ''nashta sangya'' means the person is not able to recognise and perceive anything – unconscious state (''Sangya Nama Grahanena'').<br /> *The excessive dryness (''kharibhuta'') is generally due to increased bile salts deposition leading to pruritus and dryness of skin. This dryness further leads to the hardness.<br /> *As liver disorders progress, coagulatory defects begin leading to upper G.I. track bleed causing black stools/''malena''(''Krishna shakrita''). Secondly conjugated bilirubin which does not enter intestine becomes urobilinogen giving urine dark color (''krishna mutra'').<br /> *Excessive edema is observed all over body. Cirrhosis of the liver is a condition that causes reduction in plasma protein concentration. Cirrhosis means development of large amounts of fibrous tissue among the liver parenchymal cells. One result is failure of these cells to produce sufficient plasma proteins, leading to decreased plasma colloid osmotic pressure and the generalized edema that goes with this condition. Another way that liver cirrhosis causes edema is that the liver fibrosis sometimes compresses the abdominal portal venous drainage vessels as they pass through the liver before emptying back into the general circulation. Blockage of this portal venous outflow raises capillary hydrostatic pressure throughout the gastrointestinal area and further increases filtration of fluid out of the plasma into the intra-abdominal areas. When this occurs, the combined effects of decreased plasma protein concentration and high portal capillary pressures cause transudation of large amounts of fluid and protein into the abdominal cavity, a condition referred to as ascites.<br /> *Hematemesis/bleeding in eyes,per rectum, hematuria (''Sarakta akshi mukha chhardi vinamutra'') explains the bleeding disorders which begin in late hepatic disorders. <br /> *Fainting (''tamah pravesha'') is due to reduced cerebral perfusion due to various causes like gastrointestinal bleed, electrolyte or metabolic disturbance.<br /> *Drowsiness (''tandra''), confusion (''moha'') are further symptoms of hepatic encephalopathy. Neuropsychological findings are experienced in all phases of hepatic encephalopathy. It is experienced as forgetfulness, mild confusion and irritability, inversed sleep pattern followed by lethargy and personality changes. The third stage is marked with worsened confusion and in fourth stage is coma. ''Mada, Murchha'' and ''sanyasa'' are mentioned earlier as disorders due to vitiated blood in [[Vidhishonitiya Adhyaya]].<br /> <br /> === Management of Diseases (Treatment Protocols) ===<br /> ==== Current clinical practices in treatment of ''pandu'' and ''kamala'' ( referred from Chikitsa Pradeep) ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| Type<br /> ! scope=&quot;col&quot;| Medicine<br /> ! scope=&quot;col&quot;| Dose<br /> ! scope=&quot;col&quot;| Time<br /> ! scope=&quot;col&quot;| ''Anupana''<br /> |-<br /> |rowspan = &quot;3&quot;|[[Vata]] dominant ''pandu''<br /> | ''Mahayogaraja samira mixture''<br /> | 120-480 mg<br /> | After meals <br /> | Ghee (''dadimadi'') + honey<br /> |-<br /> | ''Tiktaka ghritam''<br /> | 10-40 ml<br /> | After meals <br /> | Hot water<br /> |-<br /> | ''Navajivana rasa''<br /> | 120-200 mg<br /> | After meals <br /> | Milk<br /> |-<br /> | rowspan = &quot;2&quot;|[[Pitta]] dominant ''pandu''<br /> | ''Tapyadi lauha'' mixture<br /> | 250 - 600 mg<br /> | After meals <br /> | Dadimadi ghee + udumbaravaleha<br /> |-<br /> | ''Vasadi'' decoction<br /> | 20 - 40 ml<br /> | After meals <br /> | Honey<br /> |-<br /> | [[Kapha]] dominant ''pandu''<br /> | ''Gomutra Haritaki'' mixture<br /> | 600 mg - 3 grams<br /> | After meals <br /> | Honey + juice of castor leaves<br /> |-<br /> | ''Mrittika bhakshana janya''<br /> | ''Gomutra Haritaki'' mixture<br /> | 600 mg - 3 grams<br /> | After meals<br /> | ''Kumari Asava''<br /> |-<br /> | rowspan=&quot;2&quot;|''Riddha Patha Kamala''<br /> | ''Ichha bhedi rasa''<br /> | 120 - 180 mg<br /> | Early morning one time<br /> | Lemon juice<br /> |-<br /> | ''Suta shekhara kalpa''<br /> | 120 - 250 mg<br /> | After meals<br /> | Milk + sugar<br /> |-<br /> | ''Koshtha ashrita kamala''<br /> | colspan=&quot;4&quot;|As like ''pitta'' dominant ''pandu''<br /> |}<br /> <br /> ==== Evidence based clinical practices ====<br /> <br /> *In a study carried out by Shazi L. and Thakar A., Amalaki [[rasayana]] was found effective in management of iron deficiency anemia. However the efficacy was equal in clinical parameters and less in biochemical parameters in comparison to conventional drugs a combination of folic acid and ferrous sulphate. &lt;ref&gt; Shaizi Layeeq, Thakar A.B. Clinical efficacy of Amalaki rasayana in the management of pandu(iron deficiency anemia). Ayu.2015.July-Sep.36(3):290-297. &lt;/ref&gt; <br /> *''Punarnava mandura'' was found effective as ''panduhara'' and [[rasayana]] in patients of geriatric anemia and can counteract most of the pathological manifestations related to ''pandu roga'' in old age (geriatric anemia)&lt;ref&gt;Pandya M.G. Dave A.R. A clinical study of punarnava mandura in the management of pandu roga in old age (geriatric anemia).Ayu,2014 July-Sept; 35(3);252-260. &lt;/ref&gt;. In another study on pregnant females, ''punarnava mandura'' and ''dhatri lauha'' are found effective in management of anemia during pregnancy.&lt;ref&gt;Khandelwal D.A, Donga S.B.,Dei L.P. Clinical efficacy of punarnava mandura and dhatri lauha in the management of garbhini pandu (anemia in pregnancy) Ayu,2015 Oct-Dec;36(4); 397-403. &lt;/ref&gt;<br /> *A herbomineral formulation ''Trikatrayadi Lauha'' suspension was observed an effective, well-tolerated, and clinically safe formulation for the management of Iron deficiency anemia in children.&lt;ref&gt;Kumar A, Garai AK. A clinical study on Pandu Roga, iron deficiency anemia, with Trikatrayadi Lauha suspension in children. J [[Ayurveda]] Integr Med 2012;3:215-22.&lt;/ref&gt; Khan et.al. observed that the same formulation was observed effective to relieve the signs and symptoms of ''pandu'' in comparison to standard control drug (Fersolate-CM). ''Trikatrayadi lauha'' provided significant improvement on Hbgm%, RBC, PCV, MCV, serum iron, percent transferrin saturation and to decrease TIBC. Therefore ''Trikatrayadi Lauha'' can be used in ''Panduroga'' or IDA as a safe hematinic drug.&lt;ref&gt;Khan Subir kumar, Vyas S.N. Chandola H.M. Efficacy of Trikatrayadi lauha in Pandu roga with reference to iron deficiency anemia. Ayu 2012. Jan-Mar, 33(1):62-67.&lt;/ref&gt; <br /> *Tewari et.al. studied the ethnopharmacological approaches to the therapy of jaundice&lt;ref&gt;Tewari D, Mocan A, Parvanov ED, Sah AN, Nabavi SM, Huminiecki L, Ma ZF, Lee YY, Horba´nczuk JO and Atanasov AG (2017) Ethnopharmacological Approaches for Therapy of Jaundice: Part I. Front. Pharmacol. 8:518. doi: 10.3389/fphar.2017.00518&lt;/ref&gt; and highly used plant species from acanthaceae,euphorbiaceae, asteraceae, combretaceae and fabaceae family in the management of jaundice. The team of researchers elaborately studied hystorical perspective of jaundice, its pathophysiology and enlisted 207 herbs used in management of jaundice.&lt;ref&gt;Tewari D, Mocan A, Parvanov ED, Sah AN, Nabavi SM, Huminiecki L, Ma ZF, Lee YY, Horba´nczuk JO and Atanasov AG (2017) Ethnopharmacological Approaches for Therapy of Jaundice: Part II. Highly Used Plant Species from Acanthaceae, Euphorbiaceae, Asteraceae, Combretaceae, and Fabaceae Families. Front. Pharmacol. 8:519. doi: 10.3389/fphar.2017.00519&lt;/ref&gt;<br /> <br /> === Research studies on ''pandu'' ===<br /> <br /> Some studies are available on the internet which depict the efficacy of various Ayurvedic drugs having iron (in the form of ''lauha'' and ''mandura'') compounds in the management of ''pandu'': <br /> #Sarkar PK, Prajapati PK, Choudhary AK, Shukla VJ, Ravishankar B. Haematinic Evaluation of Lauha Bhasma and Mandura Bhasma on HgCl2-induced Anemia in Rats. Indian J Pharm Sci 2007;69:791-5.<br /> #Sarkar PK. A Comparative Pharmaceutico-pharmaco-clinical study of Lauha Bhasma and Mandura Bhasma w.s.r. to its Pāndu-hara Effect, MD thesis. I.P.G.T. &amp; R.A. Jamnagar: Gujrat [[Ayurveda]] University; 2005. <br /> #Garai A, Rai M, Kumar A. Role of an Ayurvedic Compound (Panduhara Yoga) in the Management of Iron Deficiency Anaemia in Children. Ayu 2009;30:469-74.<br /> #Gupta V, Reddy KR. Experimental Studies of Lohasava. Aryavaidyan 2007;21:87-94.<br /> #Sarkar PK, Prajapati PK, Shukla VJ, Ravishankar B, Choudhary AK. Toxicity and recovery studies of two Ayurvedic preparations of iron. Indian J Exp Biol 2009;47:987-92.<br /> #Devarshi P, Kanse A, Kanse R, Mane S, Patil S, Varute AT. Effect of Mandura Bhasma on lipolytic Activities of Liver, Kidney and Adipose Tissue of Albino Rat During CCl4 Induced hepatic Injury. J Biosci 1986;10:227-34.<br /> #Pandit S, Biswas TK, Debnath PK, Saha AV, Chowdhury U, Shaw BP, et al. Chemical and pharmacological evaluation of different Ayurvedic preparations of iron. J Ethnopharmacology 1999;65:149-56.<br /> #Dinesh C. Sharma, Deepa Chandiramani, Manminder Riyat and Praveen Sharma. Scientific evaluation of some ayurvedic preparations for correction of iron deficiency and anemia. Indian Journal of Clinical Biochemistry, 2007 / 22 (2) 123-128<br /> #Ambika Das, PA03.17. A clinical evaluation of Punarnavadi Mandura and Dadimadi Ghritha in management of Pandu (Iron defeciency anaemia), Ancient Science of Life 2013; 32 (s2):86<br /> <br /> One of the studies (Sharma D.C, 2007) report that the Ayurvedic preparations were found equally effective as the allopathic compound in the management of iron deficiency anemia and the fact that the side effects were almost nil establishes them to be even superior.<br /> <br /> The modes of action of drugs and procedures as stated in this chapter, which is without iron, have not been studied much in anemia. Though, some of the preparations described in anemia have been found very useful in the management of other types of anemia as sickle cell anemia,&lt;ref&gt;Macmillan Keith, A herbomineral composition for the treatment of Sickle Cell disease. Retrieved from tgs.freshpatents.com&lt;/ref&gt; aplastic anemia,&lt;ref&gt;Subhash singh, Shiv Kumar Singh and Narendra Kumar Singh. Aaplastic anaemia, complete cure, ayurvedic way – case report. International Journal Of Basic And Applied Medical Sciences Issn: 2277-2103 (Online) An Online International Journal Available At http://www.cibtech.org/jms.htm 2013 vol. 3 (1) january-april, pp.242-246/subhash et al.&lt;/ref&gt; etc.<br /> <br /> So, further studies need to be done in order to know the efficacy of these drugs and mechanisms in the various types of anemia.<br /> <br /> === Principle of treatment for ''kamala'' ===<br /> <br /> The management of ''kamala'' by the drugs stated in the chapter has been found to show good results but the mechanism of their action is still not clear. Practically few studies are available on the net which prove the efficacy of ''Ayurvedic'' compounds in the management of hepatocellular jaundice. &lt;ref&gt;Nirmal kumar and Anil kumar singh. Phalatrikadi kvatha - an ayurvedic hepatoprotective drug. International journal of research in pharmacy and chemistry.2013, 3(3) Available online at www.ijrpc.com&lt;/ref&gt;<br /> <br /> === List of Research Works done ===<br /> <br /> === IPGT&amp;RA, Jamnagar ===<br /> <br /> #Chaudhary sudhakar (1958): Pandu Roga Nidana.<br /> #Mishra N. K. (1959): A clinical study of Pandu Roga.<br /> #Bhattacharya R. C. (1965): Pandu Roga Par Paradamruta Teekshana Laugh Karyanvekshana<br /> #Ojha N.H.(1966): Abhraka Bhasma Ka Pandu Roga Par Karyanvekshana.<br /> #Pillai K.D.R. (1974): Study of effect of Swarna Makshika Bhasma on Pandu.<br /> #Jha Prabhakar (1974): Swayama Lauha Bhasma Ka Pandu Roga Par Kriyatamaka Adhyayana.<br /> #Sharada B.D.(1975) : Effect of Yogaraja on Garbhavasthajanya Pandu.<br /> #Gopalkrishana (1986): Lauha Bhasma on Pandu with special reference to its Media.<br /> #M.S.Trivedi (1992): Effect of Yogaraja Rasayana in Garbhavsthajanya Pandu.<br /> #Nargunde Rajeshri (1997): A comparative Phaemaco-clinical Study of Shudha Kasisa Churna and Kasisa Bhasma on PANDU. <br /> #Jain Sangeeta (2000): A study on Pandu Roga w.s.r. to ANAEMIA and Its Management with Shodhana and Yogaraja Rasayana.<br /> #Sarkar P K (2005): A comparative pharmaco-pharmaceutico Clinical study of lauha bhasma and mandura bhasma w.s.r. to Panduhara effects.<br /> <br /> === Banaras Hindu University, Varanasi ===<br /> <br /> #Trivedi R D (1979):Hematological and clinical stubby in pandu.<br /> #Malhotra E. N. (1983): Management of Garbhavasthajnya Pandu with Mandura Bhasma.<br /> #Nandkishore (1985): Clinical Assessment of Navayasa Lauha in Management of Pandu.<br /> #Chauhana A. P. S. (1985): Role of Manduradi Ghanvati in Pandu Roga.<br /> #Dixit A. K. (1994): Clinical study in Yogaraja Rasayana on Pandu.<br /> #Singh S. N. (1996): A study on aetio pathogenesis of Pandu Roga w s r to its Samprapti Vighatan by Makshika.<br /> #Agrawal N. Assessment of Effect of Mandura Bhasma in Iron Deficiency Anemia in Children, MD thesis. P.G. Department of Kaumarbhritya. Varanasi: IMS, B.H.U; 2007. <br /> <br /> === National Institute of [[Ayurveda]], Jaipur and others ===<br /> <br /> #Tyagi R. M. (1980): Pandu Roga Evam Vajra Vatak Mandura .<br /> #B. C. Sharma (1985): Pandu Roga Samprapti Vivechana.<br /> #R. K. Sharma (1994): Pandu Roga Mandura Bhasma Ka Chikitsatmaka Adhyayan.<br /> #Meena R. K. (1994): Guduchi in Pandu Roga.<br /> #Joshi N. (2005): Pharmaceutical, Pharmacological and Toxicological Study of Various Lauha Preparations(Kalpa) w.s.r. to Iron Deficiency Anaemia, M.D. Thesis. P. G. Department of Rasa Shastra and Bhaishajya Kalpana, Jaipur.<br /> #Kumath V. (2006): A Comprehensive Study of Haritaki with Special Reference to the Efficacy of Terminalia chebula Retz. on pandu Roga, MD thesis. P. G. Department. of Dravyaguna, Government. Ujjain, Madhya Pradesh: Autonomous Dhanvantari [[Ayurveda]] College and Hospital; 2006.<br /> <br /> === Potential areas /scope for further research ===<br /> <br /> The following drugs referred in management of ''pandu'' need to be researched more for providing evidences of its efficacy in anemia and related disorders in comparison to conventional management: <br /> #''Dadimadya ghritam''<br /> #''Katukadyam ghritam''<br /> #''Pathyaghritam''<br /> #''Danti ghritam''<br /> #''Drakshaghritam''<br /> #''Haridradi ghritam''<br /> #''Darvyadi ghritam''<br /> #''Navayasa churnam''<br /> #''Manduravataka''<br /> #''Tapyadi lauha''<br /> #''Yogaraja''<br /> #''Punarnava Mandura''<br /> #''Darvyadi leha''<br /> #''Dhatryavaleha''<br /> #''Manduravatakah''<br /> #''Gaudo arishah''<br /> #''Bijakarisha''<br /> #''Dhatryarishta''<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References ==<br /> &lt;/div&gt;<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Pandu_Chikitsa&diff=45380 2025-11-01T05:26:36Z

<p>Agnivesha: /* Mrittika bhakshana pandu */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Pandu Chikitsa<br /> |titlemode=append<br /> |keywords=Pandu roga, kamala, koshthashakhashrita kamala, shakhashrita kamala, panaka, kumbhakamala, haleemaka, anemia, jaundice, Ayurveda, Indian system of medicine, charak samhita. iron deficiency anaemia, blood deficiency <br /> |description=Chikitsa Sthana Chapter 16. Management of Pandu (Anemia and diseases due to blood deficiency)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 16. Management of Pandu (Anemia and diseases due to blood deficiency)&lt;/big&gt;'''<br /> {{Infobox<br /> |title = Pandu Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 16<br /> |label2 = Preceding Chapter<br /> |data2 = [[Grahani Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Hikka Shwasa Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Kar A.C., Rai S., Aladoriya N., [[Yogesh Deole|Deole Y. S.]]<br /> |label7 = Reviewer <br /> |data7 = Ojha S.N.<br /> |label8 = Editors<br /> |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.017 10.47468/CSNE.2020.e01.s06.017]<br /> }}<br /> &lt;big&gt;'''Abstract &lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;''Pandu roga'' (resembling with anemia) is characterized by pallor which is associated with different colors according to [[dosha]] involved. Besides ''pandu roga'', this chapter also describes two types of ''kamala'' (jaundice) which are two other associated diseases, caused by predominance of [[pitta]] [[dosha]] which causes alteration in normal colors of the body. The chapter describes general etiology, pathogenesis, symptoms etc of ''pandu roga'' (anemia) as well as each of its five types viz. [[vata]], [[pitta]], [[kapha]], sannipataja and ''mrittika-bhakshana'' (clay eating) ''pandu''. After describing general principle of treatment of ''pandu'' and ''kamala'', detailed treatment of each of the conditions mentioned above along with ''pathya'' (recommended diet) and apathya (prohibited diet) are given. <br /> &lt;br/&gt;<br /> '''Keywords''': Pandu roga, kamala, koshthashakhashrita kamala, shakhashrita kamala, panaka, kumbhakamala, haleemaka, anemia, jaundice<br /> &lt;/p&gt;<br /> <br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> After the description of ''grahani dosha'', the chapter on ''pandu roga'' is given, as the causative factors of ''pandu roga'' are quite similar to that of ''grahani dosha''. Probably it is because that the various gastrointestinal problems can also lead to development of ''pandu roga''. The chapter deals with general discoloration of the body such as pallor, yellowish, greenish and whitish discoloration which is seen in skin, eyes, lips, face, nails, urine feces etc. <br /> <br /> ''Kamala'' (jaundice) and ''haleemaka'' (severe obstructive jaundice) have also been included in this chapter as they are also characterized by the discoloration and may relate to ''pandu roga''. ''Kamala'' is of two types, ''swatantra'' (primary) and ''partantra'' (secondary). The etiological factors of ''primary kamala'' are described later. Secondary ''kamala'' develops in chronic phase of ''pandu'' in which vitiated [[pitta]] is seated in [[rasa dhatu]] and in kamala, [[pitta]] goes deeper in [[rakta dhatu]] and continues to go deeper in [[mamsa dhatu]] and [[meda dhatu]], then it is called ''haleemaka'' and ''kumbha kamala'' respectively. <br /> <br /> ''Kamala'' is of two types in repect to location, ''shakhshrita kamala'' located in body tissues in the form of obstructed [[pitta]] and ''koshthashrita kamala'', localized to gut and can be easily removed by purgation while ''shakhashrita kamala'' needs to be brought to gut for removal.<br /> &lt;/div&gt;<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातः पाण्डुरोगचिकित्सितं व्याख्यास्यामः||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः||२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātaḥ pāṇḍurōgacikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2||<br /> <br /> athAtaH pANDurogacikitsitaM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2||<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt; <br /> Now we shall expound the chapter &quot;Pandu Chikitsa&quot; (Management of Anemia and diseases due to blood deficiency). Thus said Lord Atreya. [1-2]<br /> <br /> === Five types of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगाः स्मृताः पञ्च वातपित्तकफैस्त्रयः| <br /> <br /> चतुर्थः सन्निपातेन पञ्चमो भक्षणान्मृदः||३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgāḥ smr̥tāḥ pañca VātaPittaKaphaistrayaḥ| <br /> <br /> caturthaḥ sannipātēna pañcamō bhakṣaṇānmr̥daḥ||3|| <br /> <br /> pANDurogAH smRutAH pa~jca vAtapittakaphaistrayaH| <br /> <br /> caturthaH sannipAtena pa~jcamo bhakShaNAnmRudaH||3||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Pandu roga is classified into five types as vatika, paittika, [[kapha]]ja, tri[[dosha]]ja and mrittika bhakshhana janya pandu [3]<br /> <br /> === Pathogenesis of pandu ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दोषाः पित्तप्रधानास्तु यस्य कुप्यन्ति धातुषु| <br /> <br /> शैथिल्यं तस्य धातूनां गौरवं चोपजायते||४|| <br /> <br /> ततो वर्णबलस्नेहा ये चान्येऽप्योजसो गुणाः| <br /> <br /> व्रजन्ति क्षयमत्यर्थं दोषदूष्यप्रदूषणात्||५|| <br /> <br /> सोऽल्परक्तोऽल्पमेदस्को निःसारः शिथिलेन्द्रियः| <br /> <br /> वैवर्ण्यं भजते, तस्य हेतुं शृणु सलक्षणम्||६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dōṣāḥ Pittapradhānāstu yasya kupyanti Dhātuṣu| <br /> <br /> śaithilyaṁ tasya dhātūnāṁ gauravaṁ cōpajāyatē||4|| <br /> <br /> tatō varṇabalasnēhā yē cānyē'pyōjasō guṇāḥ| <br /> <br /> vrajanti kṣayamatyarthaṁ dōṣadūṣyapradūṣaṇāt||5|| <br /> <br /> sō'lparaktō'lpamēdaskō niḥsāraḥ śithilēndriyaḥ| <br /> <br /> vaivarṇyaṁ bhajatē, tasya hētuṁ śr̥ṇu salakṣaṇam||6|| <br /> <br /> doShAH pittapradhAnAstu yasya kupyanti dhAtuShu| <br /> <br /> shaithilyaM tasya dhAtUnAM gauravaM copajAyate||4|| <br /> <br /> tato varNabalasnehA ye cAnye~apyojaso guNAH| <br /> <br /> vrajanti kShayamatyarthaM doShadUShyapradUShaNAt||5|| <br /> <br /> so~alparakto~alpamedasko niHsAraH shithilendriyaH| <br /> <br /> vaivarNyaM bhajate, tasya hetuM shRuNu salakShaNam||6||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Aggravated [[pitta]] predominant [[dosha]] vitiates the [[dhatu]]. This vitiation of [[dhatu]] cause sluggishnesss (''shithilata'') and heaviness (''gaurava'') in the [[dhatu]] resulting in diminution of complexion (''varna''), strength (''bala''), unctuousness (''sneha'') and the qualities of [[ojas]]. Thus, the person develops diminished blood (''rakta'') and the fatty tissue ([[meda dhatu]]) and absence of the vitality of all the tissues (''nihsara'') decreases functional status of sense organs (''sithilendriyah'') and discoloration of the body. [[Hetu]] (etiological factors and pathogenesis) and the sign and symptoms of the disease will be explained hereafter [4-6]<br /> <br /> === General etio-pathogenesis of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षाराम्ललवणात्युष्णविरुद्धासात्म्यभोजनात्| <br /> <br /> निष्पावमाषपिण्याकतिलतैलनिषेवणात्||७|| <br /> <br /> विदग्धेऽन्ने दिवास्वप्नाद्व्यायामान्मैथुनात्तथा| <br /> <br /> प्रतिकर्मर्तुवैषम्याद्वेगानां च विधारणात्||८|| <br /> <br /> कामचिन्ताभयक्रोधशोकोपहतचेतसः| <br /> <br /> समुदीर्णं यदा पित्तं हृदये समवस्थितम्||९|| <br /> <br /> वायुना बलिना क्षिप्तं सम्प्राप्य धमनीर्दश| <br /> <br /> प्रपन्नं केवलं देहं त्वङ्मांसान्तरमाश्रितम्||१०|| <br /> <br /> प्रदूष्य कफवातासृक्त्वङ्मांसानि करोति तत्| <br /> <br /> पाण्डुहारिद्रहरितान् वर्णान् बहुविधांस्त्वचि||११|| <br /> <br /> स पाण्डुरोग इत्युक्तः ...|१२| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣārāmlalavaṇātyuṣṇaviruddhāsātmyabhōjanāt| <br /> <br /> niṣpāvamāṣapiṇyākatilatailaniṣēvaṇāt||7|| <br /> <br /> vidagdhē'nnē divāsvapnādvyāyāmānmaithunāttathā| <br /> <br /> pratikarmartuvaiṣamyādvēgānāṁ ca vidhāraṇāt||8|| <br /> <br /> kāmacintābhayakrōdhaśōkōpahatacētasaḥ| <br /> <br /> samudīrṇaṁ yadā Pittaṁ hr̥dayē samavasthitam||9|| <br /> <br /> vāyunā balinā kṣiptaṁ samprāpya dhamanīrdaśa| <br /> <br /> prapannaṁ kēvalaṁ dēhaṁ tvaṅmāṁsāntaramāśritam||10|| <br /> <br /> pradūṣya Kaphavātāsr̥ktvaṅmāṁsāni karōti tat| <br /> <br /> pāṇḍuhāridraharitān varṇān bahuvidhāṁstvaci||11|| <br /> <br /> sa pāṇḍurōga ityuktaḥ ...|12| <br /> <br /> kShArAmlalavaNAtyuShNaviruddhAsAtmyabhojanAt| <br /> <br /> niShpAvamAShapiNyAkatilatailaniShevaNAt||7|| <br /> <br /> vidagdhe~anne divAsvapnAdvyAyAmAnmaithunAttathA| <br /> <br /> pratikarmartuvaiShamyAdvegAnAM ca vidhAraNAt||8|| <br /> <br /> kAmacintAbhayakrodhashokopahatacetasaH| <br /> <br /> samudIrNaM yadA pittaM hRudaye samavasthitam||9|| <br /> <br /> vAyunA balinA kShiptaM samprApya dhamanIrdasha| <br /> <br /> prapannaM kevalaM dehaM tva~gmAMsAntaramAshritam||10|| <br /> <br /> pradUShya kaphavAtAsRuktva~gmAMsAni karoti tat| <br /> <br /> pANDuhAridraharitAn varNAn bahuvidhAMstvaci||11|| <br /> <br /> sa pANDuroga ityuktaH ...|12| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Followings are the etiological factors of ''pandu'':<br /> *The (excessive) intake of alkaline, sour, saline, hot and mutually contradictory foods, unwholesome food, ''nishpava'' (a type of pulses), ''masha, pinyaka'' (oil cake) and ''tila'' oil; <br /> *Indulging in day sleep, performing exercise and sex before digestion of the food;<br /> *Improper administration of [[Panchakarma]] measures (''pratikarma vaishamya'') and the disobedience of the seasonal regimens (''ritu vaishamya'') <br /> *Suppression of the natural urges<br /> *Affliction of mind with passion, worry, fear, anger, grief<br /> <br /> Indulgence in the above factors aggravates [[pitta]] seated in the cardiac region and then this [[pitta]] is forcefully propelled by the [[vata]] into the ten ''dhamanis'' (attached to the heart) and further into the whole body. There, it gets located in between the ''tvacha'' (skin) and the [[mamsa dhatu]] (flesh) and additionally vitiates the [[kapha]], [[vata]], [[rakta]], tvacha and [[mamsa dhatu]] resulting in the development of various discolorations in the body like ''pandu'' (pale), ''haridra'' (yellow),and ''harita'' (green). This is called as ''pandu roga'' [7-11½]<br /> <br /> === Premonitory symptoms ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> .. तस्य लिङ्गं भविष्यतः| <br /> <br /> हृदयस्पन्दनं रौक्ष्यं स्वेदाभावः श्रमस्तथा||१२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ... tasya liṅgaṁ bhaviṣyataḥ| <br /> <br /> hr̥dayaspandanaṁ raukṣyaṁ svēdābhāvaḥ śramastathā||12||<br /> <br /> ... tasya li~ggaM bhaviShyataH| <br /> <br /> hRudayaspandanaM raukShyaM svedAbhAvaH shramastathA||12||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The premonitory symptoms of the disease are palpitations, ununctuousness, absence of sweating and fatigue [12]<br /> <br /> === General symptoms of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सम्भूतेऽस्मिन् भवेत् सर्वः कर्णक्ष्वेडी हतानलः| <br /> <br /> दुर्बलः सदनोऽन्नद्विट् श्रमभ्रमनिपीडितः||१३|| <br /> <br /> गात्रशूलज्वरश्वासगौरवारुचिमान्नरः| <br /> <br /> मृदितैरिव गात्रैश्च पीडितोन्मथितैरिव||१४|| <br /> <br /> शूनाक्षिकूटो हरितः शीर्णलोमा हतप्रभः| <br /> <br /> कोपनः शिशिरद्वेषी निद्रालुः ष्ठीवनोऽल्पवाक्||१५|| <br /> <br /> पिण्डिकोद्वेष्टकट्यूरुपादरुक्सदनानि च| <br /> <br /> भवन्त्यारोहणायासैर्विशेषश्चास्य [१] वक्ष्यते||१६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sambhūtē'smin bhavēt sarvaḥ karṇakṣvēḍī hatānalaḥ| <br /> <br /> durbalaḥ sadanō'nnadviṭ śramabhramanipīḍitaḥ||13|| <br /> <br /> gātraśūlajvaraśvāsagauravārucimānnaraḥ| <br /> <br /> mr̥ditairiva gātraiśca pīḍitōnmathitairiva||14|| <br /> <br /> śūnākṣikūṭō haritaḥ śīrṇalōmā hataprabhaḥ| <br /> <br /> kōpanaḥ śiśiradvēṣī nidrāluḥ ṣṭhīvanō'lpavāk||15|| <br /> <br /> piṇḍikōdvēṣṭakaṭyūrupādaruksadanāni ca| <br /> <br /> bhavantyārōhaṇāyāsairviśēṣaścāsya [1] vakṣyatē||16|| <br /> <br /> sambhUte~asmin bhavet sarvaH karNakShveDI hatAnalaH| <br /> <br /> durbalaH sadano~annadviT shramabhramanipIDitaH||13|| <br /> <br /> gAtrashUlajvarashvAsagauravArucimAnnaraH| <br /> <br /> mRuditairiva gAtraishca pIDitonmathitairiva||14|| <br /> <br /> shUnAkShikUTo haritaH shIrNalomA hataprabhaH| <br /> <br /> kopanaH shishiradveShI nidrAluH ShThIvano~alpavAk||15|| <br /> <br /> piNDikodveShTakaTyUrupAdaruksadanAni ca| <br /> <br /> bhavantyArohaNAyAsairvisheShashcAsya [1] vakShyate||16|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> On developing ''pandu roga'' the patients have the symptoms of tinnitus, low digestion, weakness, prostration, disliking for food, fatigue, giddiness, pain in the body, fever, dyspnea, heaviness and anorexia. The patient feels as if the limbs are being kneaded, pressed or churned; develops peri-orbital swelling, greenish complexion and falling of body hair. The person loses his body luster, becomes irritable, dislikes cold things, feels sleepy, spits in excess, avoids speaking, suffers from cramps in the calf region and experiences excessive fatigue as well as pain and weakness in the lumbar region, thighs and feet specifically by exertion while climbing [13-16]<br /> <br /> The signs and symptoms specific to each variety of ''pandu'' will be described henceforth.<br /> <br /> === ''Vatika pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आहारैरुपचारैश्च वातलैः कुपितोऽनिलः| <br /> <br /> जनयेत्कृष्णपाण्डुत्वं [१] तथा रूक्षारुणाङ्गताम्||१७|| <br /> <br /> अङ्गमर्दं रुजं तोदं कम्पं पार्श्वशिरोरुजम्| <br /> <br /> वर्चःशोषास्यवैरस्यशोफानाहबलक्षयान्||१८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> āhārairupacāraiśca Vātalaiḥ kupitō'nilaḥ| <br /> <br /> janayētkr̥ṣṇapāṇḍutvaṁ [1] tathā rūkṣāruṇāṅgatām||17|| <br /> <br /> aṅgamardaṁ rujaṁ tōdaṁ kampaṁ pārśvaśirōrujam| <br /> <br /> varcaḥśōṣāsyavairasyaśōphānāhabalakṣayān||18|| <br /> <br /> AhArairupacAraishca vAtalaiH kupito~anilaH| <br /> <br /> janayetkRuShNapANDutvaM [1] tathA rUkShAruNA~ggatAm||17|| <br /> <br /> a~ggamardaM rujaM todaM kampaM pArshvashirorujam| <br /> <br /> varcaHshoShAsyavairasyashophAnAhabalakShayAn||18|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Indulging in [[vata]] increasing diet and regimens aggravates [[vata]] leading to ''vatika pandu roga''. The skin of the patient becomes blackish dawn colored and ununctuous. Its other symptoms are malaise, ache, pricking pain, tremor, pain in both the sides of the chest, headache; dried feces, distaste in the mouth; swelling, gaseous distention of the abdomen and weakness [17-18]<br /> <br /> === ''Paittika pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पित्तलस्याचितं पित्तं यथोक्तैः स्वैः प्रकोपणैः| <br /> <br /> दूषयित्वा तु रक्तादीन् पाण्डुरोगाय कल्पते||१९|| <br /> <br /> स पीतो हरिताभो वा ज्वरदाहसमन्वितः| <br /> <br /> तृष्णामूर्च्छापिपासार्तः [१] पीतमूत्रशकृन्नरः||२०|| <br /> <br /> स्वेदनः शीतकामश्च न चान्नमभिनन्दति| <br /> <br /> कटुकास्यो न चास्योष्णमुपशेतेऽम्लमेव च||२१|| <br /> <br /> उद्गारोऽम्लो विदाहश्च विदग्धेऽन्नेऽस्य जायते| <br /> <br /> दौर्गन्ध्यं भिन्नवर्चस्त्वं दौर्बल्यं तम एव च||२२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> Pittalasyācitaṁ Pittaṁ yathōktaiḥ svaiḥ prakōpaṇaiḥ| <br /> <br /> dūṣayitvā tu raktādīn pāṇḍurōgāya kalpatē||19|| <br /> <br /> sa pītō haritābhō vā jvaradāhasamanvitaḥ| <br /> <br /> tr̥ṣṇāmūrcchāpipāsārtaḥ [1] pītamūtraśakr̥nnaraḥ||20|| <br /> <br /> svēdanaḥ śītakāmaśca na cānnamabhinandati| <br /> <br /> kaṭukāsyō na cāsyōṣṇamupaśētē'mlamēva ca||21|| <br /> <br /> udgārō'mlō vidāhaśca vidagdhē'nnē'sya jāyatē| <br /> <br /> daurgandhyaṁ bhinnavarcastvaṁ daurbalyaṁ tama ēva ca||22|| <br /> <br /> pittalasyAcitaM pittaM yathoktaiH svaiH prakopaNaiH| <br /> <br /> dUShayitvA tu raktAdIn pANDurogAya kalpate||19|| <br /> <br /> sa pIto haritAbho vA jvaradAhasamanvitaH| <br /> <br /> tRuShNAmUrcchApipAsArtaH [1] pItamUtrashakRunnaraH||20|| <br /> <br /> svedanaH shItakAmashca na cAnnamabhinandati| <br /> <br /> kaTukAsyo na cAsyoShNamupashete~amlameva ca||21|| <br /> <br /> udgAro~amlo vidAhashca vidagdhe~anne~asya jAyate| <br /> <br /> daurgandhyaM bhinnavarcastvaM daurbalyaM tama eva ca||22||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> [[Pitta]] gets aggravated by indulging in [[pitta]] vitiating ''nidanas'' (diet and regimens) which by involving the blood etc. causes [[pitta]]ja pandu. Its symptoms are, change in complexion to yellowish/greenish, fever, burning sensation; morbid thirst and fainting; excessive perspiration and longing for cold things and environment. The person does not relish food, develops pungent taste, disfavors hot and sour things; gets sour eructations associated with burning sensation due to impaired digestion of food; emits foul smell from mouth; the urine and stool become yellow in color, has loose motions and develops weakness and fainting [19-22]<br /> <br /> === [[Kapha]]ja pandu ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विवृद्धः श्लेष्मलैः श्लेष्मा पाण्डुरोगं स पूर्ववत्| <br /> <br /> करोति गौरवं तन्द्रा छर्दिं श्वेतावभासताम्||२३|| <br /> <br /> प्रसेकं लोमहर्षं च सादं मूर्च्छां भ्रमं क्लमम्| <br /> <br /> श्वासं कासं तथाऽऽलस्यमरुचिं वाक्स्वरग्रहम्||२४|| <br /> <br /> शुक्लमूत्राक्षिवर्चस्त्वं कटुरूक्षोष्णकामताम्| <br /> <br /> श्वयथुं मधुरास्यत्वमिति [१] पाण्ड्वामयः कफात्||२५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vivr̥ddhaḥ ślēṣmalaiḥ ślēṣmā pāṇḍurōgaṁ sa pūrvavat| <br /> <br /> karōti gauravaṁ tandrā chardiṁ śvētāvabhāsatām||23|| <br /> <br /> prasēkaṁ lōmaharṣaṁ ca sādaṁ mūrcchāṁ bhramaṁ klamam| <br /> <br /> śvāsaṁ kāsaṁ tathā''lasyamaruciṁ vāksvaragraham||24|| <br /> <br /> śuklamūtrākṣivarcastvaṁ kaṭurūkṣōṣṇakāmatām| <br /> <br /> śvayathuṁ madhurāsyatvamiti [1] pāṇḍvāmayaḥ kaphāt||25|| <br /> <br /> vivRuddhaH shleShmalaiH shleShmA pANDurogaM sa pUrvavat| <br /> <br /> karoti gauravaM tandrA chardiM shvetAvabhAsatAm||23|| <br /> <br /> prasekaM lomaharShaM ca sAdaM mUrcchAM bhramaM klamam| <br /> <br /> shvAsaM kAsaM tathA~a~alasyamaruciM vAksvaragraham||24|| <br /> <br /> shuklamUtrAkShivarcastvaM kaTurUkShoShNakAmatAm| <br /> <br /> shvayathuM madhurAsyatvamiti [1] pANDvAmayaH kaphAt||25|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Aggravated [[kapha]] by indulging in [[kapha]] increasing diet and regimen gives rise to [[kapha]]ja pandu roga through the pathogenesis described earlier. The sign and symptoms of [[kapha]]ja pandu are heaviness, drowsiness, vomiting, whitish complexion, salivation, horripilation, prostration, fainting, giddiness, mental fatigue, dyspnea, cough, laziness, anorexia, obstruction in speech and voice, whitish coloration of the eyes, urine and feces; longing for pungent, ununctuous and hot things; and develops edema and sweet taste in the mouth [23-25]<br /> <br /> === ''Tridoshaja pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सर्वान्नसेविनः सर्वे दुष्टा दोषास्त्रिदोषजम्| <br /> त्रिदोषलिङ्गं कुर्वन्ति पाण्डुरोगं सुदुःसहम्||२६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sarvānnasēvinaḥ sarvē duṣṭā dōṣāstridōṣajam| <br /> tridōṣaliṅgaṁ kurvanti pāṇḍurōgaṁ suduḥsaham||26|| <br /> <br /> sarvAnnasevinaH sarve duShTA doShAstridoShajam| <br /> tridoShali~ggaM kurvanti pANDurogaM suduHsaham||26|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Indulging in the etiological factors of all the three types of ''pandu'' leads to aggravation of the three [[dosha]] resulting in ''tridoshaja pandu'' with the features of all the three types of ''pandu roga''. This type of ''pandu'' causes much distress to the patient [26]<br /> <br /> === ''Mrittika bhakshana pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मृत्तिकादनशीलस्य कुप्यत्यन्यतमो मलः| <br /> कषाया मारुतं, पित्तमूषरा, मधुरा कफम्||२७|| <br /> <br /> कोपयेन्मृद्रसादींश्च रौक्ष्याद्भुक्तं विरूक्षयेत् [१] | <br /> पूरयत्यविपक्वैव स्रोतांसि निरुणद्धि च||२८|| <br /> <br /> इन्द्रियाणां बलं हत्वा तेजो वीर्यौजसी तथा| <br /> पाण्डुरोगं करोत्याशु बलवर्णाग्निनाशनम्||२९|| <br /> <br /> शूनगण्डाक्षिकूटभ्रूः [२] शूनपान्नाभिमेहनः| <br /> क्रिमिकोष्ठोऽतिसार्येत मलं सासृक् कफान्वितम्||३०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mr̥ttikādanaśīlasya kupyatyanyatamō malaḥ| <br /> kaṣāyā mārutaṁ, Pittamūṣarā, madhurā Kapham||27|| <br /> <br /> kōpayēnmr̥drasādīṁśca raukṣyādbhuktaṁ virūkṣayēt [1] | <br /> pūrayatyavipakvaiva srōtāṁsi niruṇaddhi ca||28|| <br /> <br /> indriyāṇāṁ balaṁ hatvā tējō vīryaujasī tathā| <br /> pāṇḍurōgaṁ karōtyāśu balavarṇāgnināśanam||29|| <br /> <br /> śūnagaṇḍākṣikūṭabhrūḥ [2] śūnapānnābhimēhanaḥ| <br /> krimikōṣṭhō'tisāryēta malaṁ sāsr̥k kaphānvitam||30|| <br /> <br /> mRuttikAdanashIlasya kupyatyanyatamo malaH| <br /> kaShAyA mArutaM, pittamUSharA, madhurA kapham||27|| <br /> <br /> kopayenmRudrasAdIMshca raukShyAdbhuktaM virUkShayet [1] | <br /> pUrayatyavipakvaiva srotAMsi niruNaddhi ca||28|| <br /> <br /> indriyANAM balaM hatvA tejo vIryaujasI tathA| <br /> pANDurogaM karotyAshu balavarNAgninAshanam||29|| <br /> <br /> shUnagaNDAkShikUTabhrUH [2] shUnapAnnAbhimehanaH| <br /> krimikoShTho~atisAryeta malaM sAsRuk kaphAnvitam||30|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Person indulging in the habitual consumption of clay (''mrittika'') gets [[dosha]] aggravated according to the taste of mud viz. astringent mud aggravates [[vata]], saline and alkaline mud aggravates [[pitta]] and sweet mud aggravates [[kapha]] [[dosha]]. The clay further because of its ununctuousness causes dryness in the [[rasa]] (nutrients of the digested food). The clay due to its undigestable nature fills and blocks the channels of circulation leading to decrease in the sharpness of the senses, luster, energy and [[ojas]] (vital essence of the tissues). This quickly manifesting ''pandu'' results in the loss of strength, complexion and digestive power. Its clinical features are edema of the cheeks, peri orbital edema and edema on the eyebrows area, feet, umbilical region and the pudendum; infestation of worms in the [[koshtha]] (gastrointestinal tract) and loose motions, the stool associated with blood and mucus. [27-30]<br /> <br /> === Prognosis of ''pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगश्चिरोत्पन्नः खरीभूतो न सिध्यति| <br /> कालप्रकर्षाच्छूनो [१] ना यश्च पीतानि पश्यति||३१|| <br /> <br /> बद्धाल्पविट्कं सकफं हरितं योऽतिसार्यते| <br /> दीनः श्वेतातिदिग्धाङ्गश्छर्दिमूर्च्छातृषार्दितः||३२|| <br /> <br /> स नास्त्यसृक्क्षयाद्यश्च पाण्डुः श्वेतत्वमाप्नुयात्| <br /> इति पञ्चविधस्योक्तं पाण्डुरोगस्य लक्षणम्||३३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgaścirōtpannaḥ kharībhūtō na sidhyati| <br /> kālaprakarṣācchūnō [1] nā yaśca pītāni paśyati||31|| <br /> <br /> baddhālpaviṭkaṁ saKaphaṁ haritaṁ yō'tisāryatē| <br /> dīnaḥ śvētātidigdhāṅgaśchardimūrcchātr̥ṣārditaḥ||32|| <br /> <br /> sa nāstyasr̥kkṣayādyaśca pāṇḍuḥ śvētatvamāpnuyāt| <br /> iti pañcavidhasyōktaṁ pāṇḍurōgasya lakṣaṇam||33|| <br /> <br /> pANDurogashcirotpannaH kharIbhUto na sidhyati| <br /> kAlaprakarShAcchUno [1] nA yashca pItAni pashyati||31|| <br /> <br /> baddhAlpaviTkaM sakaphaM haritaM yo~atisAryate| <br /> dInaH shvetAtidigdhA~ggashchardimUrcchAtRuShArditaH||32|| <br /> <br /> sa nAstyasRukkShayAdyashca pANDuH shvetatvamApnuyAt| <br /> iti pa~jcavidhasyoktaM pANDurogasya lakShaNam||33||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Chronic ''pandu roga'' is incurable. Other symptoms indicating the incurability are appearance of excessive dryness and edema; patient visualizes everything as yellow; passes very hard stool or less amount of stool or passes loose stool associated with mucus and green in color; feels exceedingly prostrated; body becomes excessively white as if be smeared with whiteness; has vomiting, fainting and excessive thirst and when the patient develops excessive whiteness in the body as a result of loss of blood.<br /> <br /> Thus, the signs and symptoms of all the five type of ''pandu roga'' have been described [31-33]<br /> <br /> === ''Koshthashakhashraya kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगी तु योऽत्यर्थं पित्तलानि निषेवते| <br /> तस्य पित्तमसृग्मांसं दग्ध्वा रोगाय कल्पते||३४|| <br /> <br /> हारिद्रनेत्रः स भृशं हारिद्रत्वङ्नखाननः| <br /> रक्तपीतशकृन्मूत्रो भेकवर्णो हतेन्द्रियः||३५|| <br /> <br /> दाहाविपाकदौर्बल्यसदनारुचिकर्षितः| <br /> कामला बहुपित्तैषा कोष्ठशाखाश्रया मता||३६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgī tu yō'tyarthaṁ Pittalāni niṣēvatē| <br /> tasya Pittamasr̥gmāṁsaṁ dagdhvā rōgāya kalpatē||34|| <br /> <br /> hāridranētraḥ sa bhr̥śaṁ hāridratvaṅnakhānanaḥ| <br /> Rakta pītaśakr̥nmūtrō bhēkavarṇō hatēndriyaḥ||35|| <br /> <br /> dāhāvipākadaurbalyasadanārucikarṣitaḥ| <br /> kāmalā bahuPittaiṣā kōṣṭhaśākhāśrayā matā||36|| <br /> <br /> pANDurogI tu yo~atyarthaM pittalAni niShevate| <br /> tasya pittamasRugmAMsaM dagdhvA rogAya kalpate||34|| <br /> <br /> hAridranetraH sa bhRushaM hAridratva~gnakhAnanaH| <br /> raktapItashakRunmUtro bhekavarNo hatendriyaH||35|| <br /> <br /> dAhAvipAkadaurbalyasadanArucikarShitaH| <br /> kAmalA bahupittaiShA koShThashAkhAshrayA matA||36|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If a patient of ''pandu roga'' excessively follows [[pitta]] vitiating diet and regimen, the [[pitta]] so aggravated by involving the [[rakta]] and the [[mamsa dhatu]] causes ''kamala''. Its clinical features are the eyes, skin, nails and face of the patient become exceedingly yellow; stool and urine become reddish-yellow in color; complexion develops a color similar to that of a frog (found in rainy season); the senses get impaired; has burning sensation, indigestion, weakness, prostration and anorexia. This ''kamala'' is caused by excess of [[pitta]] is known as ''koshthashakhashrita'' [34-36]<br /> <br /> === ''Kumbha kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कालान्तरात् खरीभूता कृच्छ्रा स्यात् कुम्भकामला| 36½ |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kālāntarāt kharībhūtā kr̥cchrā syāt kumbhakāmalā| 36½|<br /> <br /> kAlAntarAt kharIbhUtA kRucchrA syAt kumbhakAmalA| 36½|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> With the due course of time the disease (''kamala'') becomes deep seated (''kharibhuta'') resulting in excessive dryness of the body or afflicted tissue and thus becomes difficult to cure. This condition is called ''kumbha kamala'' [36½]<br /> <br /> === Bad prognostic symptoms of ''kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कृष्णपीतशकृन्मूत्रो [१] भृशं शूनश्च मानवः||३७||<br /> <br /> सरक्ताक्षिमुखच्छर्दिविण्मूत्रो यश्च ताम्यति| <br /> दाहारुचितृषानाहतन्द्रामोहसमन्वितः||३८|| <br /> <br /> नष्टाग्निसञ्ज्ञः क्षिप्रं हि कामलावान् विपद्यते|38½| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kr̥ṣṇapītaśakr̥nmūtrō [1] bhr̥śaṁ śūnaśca mānavaḥ||37|| <br /> <br /> saraktākṣimukhacchardiviṇmūtrō yaśca tāmyati| <br /> dāhārucitr̥ṣānāhatandrāmōhasamanvitaḥ||38|| <br /> <br /> naṣṭāgnisañjñaḥ kṣipraṁ hi kāmalāvān vipadyatē|38½|<br /> <br /> kRuShNapItashakRunmUtro [1] bhRushaM shUnashca mAnavaH||37|| <br /> <br /> saraktAkShimukhacchardiviNmUtro yashca tAmyati| <br /> dAhArucitRuShAnAhatandrAmohasamanvitaH||38|| <br /> <br /> naShTAgnisa~jj~jaH kShipraM hi kAmalAvAn vipadyate|38½| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the stool and urine of the patient (of ''kamala'') become black and yellow; develops excessive edema; eyes and face becomes red colored; vomit, stool and urine are mixed with blood; the patient feels like going in darkness; has burning sensation, anorexia, morbid thirst, constipation, drowsiness and fainting; and the person looses his [[agni]] and consciousness; such patient may succumb to death quickly [37-38½]<br /> <br /> === Principles of treatment ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> साध्यानामितरेषां तु प्रवक्ष्यामि चिकित्सितम्||३९|| <br /> <br /> तत्र पाण्ड्वामयी स्निग्धस्तीक्ष्णैरूर्ध्वानुलोमिकैः| <br /> संशोध्यो मृदुभिस्तिक्तैः कामली तु विरेचनैः||४०|| <br /> <br /> ताभ्यां संशुद्धकोष्ठाभ्यां पथ्यान्यन्नानि दापयेत्| <br /> शालीन् सयवगोधूमान् पुराणान् यूषसंहितान्||४१|| <br /> <br /> मुद्गाढकीमसूरैश्च जाङ्गलैश्च रसैर्हितैः| <br /> यथादोषं विशिष्टं च तयोर्भैषज्यमाचरेत्||४२|| <br /> <br /> पञ्चगव्यं महातिक्तं कल्याणकमथापि वा| <br /> स्नेहनार्थं घृतं दद्यात् कामलापाण्डुरोगिणे||४३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sādhyānāmitarēṣāṁ tu pravakṣyāmi cikitsitam||39|| <br /> <br /> tatra pāṇḍvāmayī snigdhastīkṣṇairūrdhvānulōmikaiḥ| <br /> saṁśōdhyō mr̥dubhistiktaiḥ kāmalī tu virēcanaiḥ||40|| <br /> <br /> tābhyāṁ saṁśuddhakōṣṭhābhyāṁ pathyānyannāni dāpayēt| <br /> śālīn sayavagōdhūmān purāṇān yūṣasaṁhitān||41|| <br /> <br /> mudgāḍhakīmasūraiśca jāṅgalaiśca rasairhitaiḥ| <br /> yathādōṣaṁ viśiṣṭaṁ ca tayōrbhaiṣajyamācarēt||42|| <br /> <br /> pañcagavyaṁ mahātiktaṁ kalyāṇakamathāpi vā| <br /> snēhanārthaṁ ghr̥taṁ dadyāt kāmalāpāṇḍurōgiṇē||43|| <br /> <br /> sAdhyAnAmitareShAM tu pravakShyAmi cikitsitam||39|| <br /> <br /> tatra pANDvAmayI snigdhastIkShNairUrdhvAnulomikaiH| <br /> saMshodhyo mRudubhistiktaiH kAmalI tu virecanaiH||40|| <br /> <br /> tAbhyAM saMshuddhakoShThAbhyAM pathyAnyannAni dApayet| <br /> shAlIn sayavagodhUmAn purANAn yUShasaMhitAn||41|| <br /> <br /> mudgADhakImasUraishca jA~ggalaishca rasairhitaiH| <br /> yathAdoShaM vishiShTaM ca tayorbhaiShajyamAcaret||42|| <br /> <br /> pa~jcagavyaM mahAtiktaM kalyANakamathApi vA| <br /> snehanArthaM ghRutaM dadyAt kAmalApANDurogiNe||43|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now, the treatment for the curable types of ''pandu roga'' is being described here:<br /> <br /> The patient suffering from the ''pandu'' should first be given strong (''tikshna'') emetic and purgation therapies after the administration of internal oleation ([[snehana]]) for cleansing of the body (''shodhana''). <br /> <br /> On the other hand, patient of ''kamala'' should be given mild purgation therapy with bitter drugs. After the cleansing of the ''koshtha'' by the above procedures the patient of both of these diseases should be given wholesome food consisting of old ''shali'' rice, barley and wheat mixed with the ''yusha'' (vegetable soup) of ''mudga, adhaki'' and ''masura'', and the ''rasa'' (meat soup) of animals inhabiting the arid zone. <br /> <br /> On the basis of the aggravated [[dosha]] specific medicines are to be administered to the patients of these two categories (which will be described later in the chapter). For the oleation of the patient of ''pandu'' and ''kamala panchagavya ghrita, mahatikta ghrita'' and ''kalyanaka ghrita'' should be given [39-43]<br /> <br /> === ''Dadimadya ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दाडिमात् कुडवो धान्यात् कुडवार्धं पलं पलम्| <br /> चित्रकाच्छृङ्गवेराच्च पिप्पल्यष्टमिका तथा||४४|| <br /> <br /> तैः कल्कैर्विंशतिपलं घृतस्य सलिलाढके|<br /> सिद्धं हृत्पाण्डुगुल्मार्शःप्लीहवातकफार्तिनुत्||४५|| <br /> <br /> दीपनं श्वासकासघ्नं मूढवाते च शस्यते| <br /> दुःखप्रसविनीनां च वन्ध्यानां चैव गर्भदम्||४६|| <br /> <br /> इति दाडिमाद्यं घृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dāḍimāt kuḍavō dhānyāt kuḍavārdhaṁ palaṁ palam| <br /> citrakācchr̥ṅgavērācca pippalyaṣṭamikā tathā||44|| <br /> <br /> taiḥ kalkairviṁśatipalaṁ ghr̥tasya salilāḍhakē| <br /> siddhaṁ hr̥tpāṇḍugulmārśaḥplīhaVātakaphārtinut||45|| <br /> <br /> dīpanaṁ śvāsakāsaghnaṁ mūḍhavātē ca śasyatē| <br /> duḥkhaprasavinīnāṁ ca vandhyānāṁ caiva garbhadam||46|| <br /> <br /> iti dāḍimādyaṁ ghr̥tam| <br /> <br /> dADimAt kuDavo dhAnyAt kuDavArdhaM palaM palam| <br /> citrakAcchRu~ggaverAcca pippalyaShTamikA tathA||44|| <br /> <br /> taiH kalkairviMshatipalaM ghRutasya salilADhake| <br /> siddhaM hRutpANDugulmArshaHplIhavAtakaphArtinut||45|| <br /> <br /> dIpanaM shvAsakAsaghnaM mUDhavAte ca shasyate| <br /> duHkhaprasavinInAM ca vandhyAnAM caiva garbhadam||46|| <br /> <br /> iti dADimAdyaM ghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take twenty ''pala'' of ghee, one ''adhaka'' of water and add to it the paste prepared of one ''kudava'' of ''dadima'', half ''kudava'' of ''dhanya'', one ''pala'' each of ''chitraka'' and ''sringavera'' and one ''ashtamika'' (two ''karsha'') of ''pippali'' and prepare ghee as per method of ''sneha paka''.This medicated ghee stimulates the power of digestion. It cures heart disease, anemia, gulma, hemorrhoids, spleenomegaly and disorders of [[vata]] and [[kapha]].It is also useful for curing asthma, bronchitis, ''mudha-vata'' (claudication of [[vata]]) and ''duhkha-prasava'' (difficult labor). It also helps a sterile woman to get offspring.<br /> <br /> Thus, ends the description of ''dadimadyaghrita'' [44-46]<br /> <br /> === ''Katukadyam ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कटुका रोहिणी मुस्तं हरिद्रे वत्सकात् पलम्| <br /> पटोलं चन्दनं मूर्वा त्रायमाणा दुरालभा||४७|| <br /> <br /> कृष्णा पर्पटको निम्बो भूनिम्बो देवदारु च| <br /> तैः कार्षिकैर्घृतप्रस्थः सिद्धः क्षीरचतुर्गुणः||४८|| <br /> <br /> रक्तपित्तं ज्वरं दाहं श्वयथुं स भगन्दरम्| <br /> अर्शांस्यसृग्दरं चैव हन्ति विस्फोटकांस्तथा||४९|| <br /> <br /> इति कटुकाद्यं घृतम्|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭukā rōhiṇī mustaṁ haridrē vatsakāt palam| <br /> paṭōlaṁ candanaṁ mūrvā trāyamāṇā durālabhā||47|| <br /> <br /> kr̥ṣṇā parpaṭakō nimbō bhūnimbō dēvadāru ca| <br /> taiḥ kārṣikairghr̥taprasthaḥ siddhaḥ kṣīracaturguṇaḥ||48|| <br /> <br /> Rakta Pittaṁ jvaraṁ dāhaṁ śvayathuṁ sa bhagandaram| <br /> arśāṁsyasr̥gdaraṁ caiva hanti visphōṭakāṁstathā||49|| <br /> <br /> iti Kaṭukādyam Ghritam| <br /> <br /> kaTukA rohiNI mustaM haridre vatsakAt palam| <br /> paTolaM candanaM mUrvA trAyamANA durAlabhA||47|| <br /> <br /> kRuShNA parpaTako nimbo bhUnimbo devadAru ca| <br /> taiH kArShikairghRutaprasthaH siddhaH kShIracaturguNaH||48|| <br /> <br /> raktapittaM jvaraM dAhaM shvayathuM sa bhagandaram| <br /> arshAMsyasRugdaraM caiva hanti visphoTakAMstathA||49|| <br /> <br /> iti kaTukAdyaM ghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''pala'' each of ''katukarohini, musta, haridra, daruharidra, vatsaka'' in paste form, one ''karsha'' of each of ''patola, chandana, murva, trayamana, duralabha, krishna, parpataka, nimba, bhūnimba, devadaru'' should be added to one ''prastha'' of ''ghrita'' and four ''prasthas'' of milk. This medicated ghee cures ''raktapitta, jwara, daha, svayathu, bhagandara, arsha, asrigadara'' and ''visphotaka''. Thus described ''katukadya ghritam'' [47-49]<br /> <br /> === ''Pathya ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पथ्याशतरसे पथ्यावृन्तार्धशतकल्कवान्| <br /> प्रस्थः सिद्धो घृतात् पेयः स पाण्ड्वामयगुल्मनुत्||५०|| <br /> <br /> इति पथ्याघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pathyāśatarasē pathyāvr̥ntārdhaśatakalkavān| <br /> prasthaḥ siddhō ghr̥tāt pēyaḥ sa pāṇḍvāmayagulmanut||50|| <br /> <br /> iti pathyāghr̥tam|<br /> <br /> pathyAshatarase pathyAvRuntArdhashatakalkavAn| <br /> prasthaH siddho ghRutAt peyaH sa pANDvAmayagulmanut||50|| <br /> <br /> iti pathyAghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The decoction of one hundred fruits of ''haritaki'' and the paste of fifty stalks of ''haritaki'' fruits should be added to one ''prastha'' of ghee and cooked. This medicated ghee cures ''pandu'' and ''gulma'' [50]<br /> <br /> === ''Danti ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दन्त्याश्चतुष्पलरसे पिष्टैर्दन्तीशलाटुभिः| <br /> तद्वत्प्रस्थो घृतात्सिद्धः प्लीहपाण्ड्वर्तिशोफजित्||५१|| <br /> <br /> इति दन्तीघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dantyāścatuṣpalarasē piṣṭairdantīśalāṭubhiḥ| <br /> tadvatprasthō ghr̥tātsiddhaḥ plīhapāṇḍvartiśōphajit||51|| <br /> <br /> iti dantīghr̥tam| <br /> <br /> dantyAshcatuShpalarase piShTairdantIshalATubhiH| <br /> tadvatprastho ghRutAtsiddhaH plIhapANDvartishophajit||51|| <br /> <br /> iti dantIghRutam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of ghee should be cooked by adding (one ''prastha'' of) the decoction of four ''palas'' of ''danti'' and the paste of the green fruits of ''danti''. Intake of this medicated ghee cures ''pleeha'' (splenic disorders), ''pandu'' and edema [51]<br /> <br /> === ''Drakshaghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुराणसर्पिषः प्रस्थो द्राक्षार्धप्रस्थसाधितः| <br /> कामलागुल्मपाण्ड्वर्तिज्वरमेहोदरापहः||५२|| <br /> <br /> इति द्राक्षाघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> purāṇasarpiṣaḥ prasthō drākṣārdhaprasthasādhitaḥ| <br /> kāmalāgulmapāṇḍvartijvaramēhōdarāpahaḥ||52|| <br /> <br /> iti drākṣāghr̥tam| <br /> <br /> purANasarpiShaH prastho drAkShArdhaprasthasAdhitaH| <br /> kAmalAgulmapANDvartijvaramehodarApahaH||52|| <br /> <br /> iti drAkShAghRutam|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of old ghee should be added to half a ''prastha'' of ''draksha'' and cooked. This medicated ghee cures ''kamala, gulma, pandu, jwara, meha'' (polyuria) and ''udara roga'' (generalized abdominal enlargement)[52]<br /> <br /> === ''Haridradi ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> हरिद्रात्रिफलानिम्बबलामधुकसाधितम्| <br /> सक्षीरं माहिषं सर्पिः कामलाहरमुत्तमम्||५३|| <br /> <br /> इति हरिद्रादिघृतम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> haridrātriphalānimbabalāmadhukasādhitam| <br /> sakṣīraṁ māhiṣaṁ sarpiḥ kāmalāharamuttamam||53||<br /> <br /> iti haridrādighr̥tam|<br /> <br /> haridrAtriphalAnimbabalAmadhukasAdhitam| <br /> sakShIraM mAhiShaM sarpiH kAmalAharamuttamam||53||<br /> <br /> iti haridrAdighRutam|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Ghrita'' prepared with ''haridra, triphala, nimba, balā, madhuka'' and buffalo’s milk and ghee is an excellent cure for ''kamala'' [53]<br /> <br /> === ''Darvyadi ghritam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गोमूत्रे द्विगुणे दार्व्याः कल्काक्षद्वयसाधितः| <br /> दार्व्याः पञ्चपलक्वाथे कल्के कालीयके परः||५४|| <br /> <br /> माहिषात् सर्पिषः प्रस्थः पूर्वः पूर्वे परे परः|५५| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gōmūtrē dviguṇē dārvyāḥ kalkākṣadvayasādhitaḥ| <br /> dārvyāḥ pañcapalakvāthē kalkē kālīyakē paraḥ||54|| <br /> <br /> māhiṣāt sarpiṣaḥ prasthaḥ pūrvaḥ pūrvē parē paraḥ|55|<br /> <br /> gomUtre dviguNe dArvyAH kalkAkShadvayasAdhitaH| <br /> dArvyAH pa~jcapalakvAthe kalke kAlIyake paraH||54|| <br /> <br /> mAhiShAt sarpiShaH prasthaH pUrvaH pUrve pare paraH|55|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of buffalo’s ghee prepared by adding two ''prasthas'' of cow’s urine and the paste of two ''aksha'' of the paste of ''darvi'' as per ''sneha kalpana'' cures ''pandu roga''.<br /> <br /> One ''prastha'' of buffalo’s ghee prepared by adding with the decoction of five ''palas'' of ''darvi'' and the paste of ''kaleeyaka'' as per ''sneha kalpana'' cures ''kamala'' [54-55]<br /> <br /> === Preparations for ''pandu roga'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्नेहैरेभिरुपक्रम्य स्निग्धं मत्वा विरेचयेत्||५५|| <br /> <br /> पयसा मूत्रयुक्तेन बहुशः केवलेन वा| <br /> दन्तीफलरसे कोष्णे काश्मर्याञ्जलिना शृतम्||५६|| <br /> <br /> द्राक्षाञ्जलिं मृदित्वा वा दद्यात् पाण्ड्वामयापहम्| <br /> द्विशर्करं त्रिवृच्चूर्णं पलार्धं पैत्तिकः पिबेत्||५७|| <br /> <br /> कफपाण्डुस्तु गोमूत्रक्लिन्नयुक्तां [१] हरीतकीम्| <br /> आरग्वधं [२] रसेनेक्षोर्विदार्यामलकस्य च||५८||<br /> <br /> सत्र्यूषणं बिल्वपत्रं पिबेन्ना कामलापहम्| <br /> दन्त्यर्धपलकल्कं वा द्विगुडं शीतवारिणा||५९|| <br /> <br /> कामली त्रिवृतां वाऽपि त्रिफलाया रसैः पिबेत्| <br /> विशालात्रिफलामुस्तकुष्ठदारुकलिङ्गकान्||६०|| <br /> <br /> कार्षिकानर्धकर्षांशां कुर्यादतिविषां तथा| <br /> कर्षौ मधुरसाया द्वौ सर्वमेतत् [३] सुखाम्बुना||६१|| <br /> <br /> मृदितं तं रसं पूतं पीत्वा लिह्याच्च मध्वनु| <br /> कासं श्वासं ज्वरं दाहं पाण्डुरोगमरोचकम्||६२|| <br /> <br /> गुल्मानाहामवातांश्च रक्तपित्तं च नाशयेत्| <br /> त्रिफलाया गुडूच्या वा दार्व्या निम्बस्य वा रसम्||६३|| <br /> <br /> शीतं मधुयुतं प्रातः कामलार्तः पिबेन्नरः| <br /> क्षीरमूत्रं पिबेत् पक्षं गव्यं माहिषमेव वा||६४|| <br /> <br /> पाण्डुर्गोमूत्रयुक्तं वा सप्ताहं त्रिफलारसम्| <br /> तरुजान् ज्वलितान्मूत्रे निर्वाप्यामृद्य चाङ्कुरान्||६५|| <br /> <br /> मातुलुङ्गस्य तत् पूतं पाण्डुशोथहरं पिबेत्| <br /> स्वर्णक्षीरी त्रिवृच्छ्यामे भद्रदारु सनागरम्||६६|| <br /> <br /> गोमूत्राञ्जलिना पिष्टं मूत्रे वा क्वथितं पिबेत्| <br /> क्षीरमेभिः शृतं वाऽपि पिबेद्दोषानुलोमनम्||६७|| <br /> <br /> हरीतकीं प्रयोगेण गोमूत्रेणाथवा पिबेत्| <br /> जीर्णे क्षीरेण भुञ्जीत रसेन मधुरेण वा||६८|| <br /> <br /> सप्तरात्रं गवां मूत्रे भावितं वाऽप्ययोरजः| <br /> पाण्डुरोगप्रशान्त्यर्थं पयसा पाययेद्भिषक्||६९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snēhairēbhirupakramya snigdhaṁ matvā virēcayēt||55|| <br /> <br /> payasā mūtrayuktēna bahuśaḥ kēvalēna vā| <br /> dantīphalarasē kōṣṇē kāśmaryāñjalinā śr̥tam||56|| <br /> <br /> drākṣāñjaliṁ mr̥ditvā vā dadyāt pāṇḍvāmayāpaham| <br /> dviśarkaraṁ trivr̥ccūrṇaṁ palārdhaṁ paittikaḥ pibēt||57|| <br /> <br /> Kaphapāṇḍustu gōmūtraklinnayuktāṁ [1] harītakīm| <br /> āragvadhaṁ [2] rasēnēkṣōrvidāryāmalakasya ca||58|| <br /> <br /> satryūṣaṇaṁ bilvapatraṁ pibēnnā kāmalāpaham| <br /> dantyardhapalakalkaṁ vā dviguḍaṁ śītavāriṇā||59|| <br /> <br /> kāmalī trivr̥tāṁ vā'pi triphalāyā rasaiḥ pibēt| <br /> viśālātriphalāmustakuṣṭhadārukaliṅgakān||60|| <br /> <br /> kārṣikānardhakarṣāṁśāṁ kuryādativiṣāṁ tathā| <br /> karṣau madhurasāyā dvau sarvamētat [3] sukhāmbunā||61|| <br /> <br /> mr̥ditaṁ taṁ rasaṁ pūtaṁ pītvā lihyācca madhvanu| <br /> kāsaṁ śvāsaṁ jvaraṁ dāhaṁ pāṇḍurōgamarōcakam||62|| <br /> <br /> gulmānāhāmavātāṁśca Rakta Pittaṁ ca nāśayēt| <br /> triphalāyā guḍūcyā vā dārvyā nimbasya vā rasam||63|| <br /> <br /> śītaṁ madhuyutaṁ prātaḥ kāmalārtaḥ pibēnnaraḥ| <br /> kṣīramūtraṁ pibēt pakṣaṁ gavyaṁ māhiṣamēva vā||64|| <br /> <br /> pāṇḍurgōmūtrayuktaṁ vā saptāhaṁ triphalārasam| <br /> tarujān jvalitānmūtrē nirvāpyāmr̥dya cāṅkurān||65|| <br /> <br /> mātuluṅgasya tat pūtaṁ pāṇḍuśōthaharaṁ pibēt| <br /> svarṇakṣīrī trivr̥cchyāmē bhadradāru sanāgaram||66|| <br /> <br /> gōmūtrāñjalinā piṣṭaṁ mūtrē vā kvathitaṁ pibēt| <br /> kṣīramēbhiḥ śr̥taṁ vā'pi pibēddōṣānulōmanam||67|| <br /> <br /> harītakīṁ prayōgēṇa gōmūtrēṇāthavā pibēt| <br /> jīrṇē kṣīrēṇa bhuñjīta rasēna madhurēṇa vā||68|| <br /> <br /> saptarātraṁ gavāṁ mūtrē bhāvitaṁ vā'pyayōrajaḥ| <br /> pāṇḍurōgapraśāntyarthaṁ payasā pāyayēdbhiṣak||69||<br /> <br /> snehairebhirupakramya snigdhaM matvA virecayet||55|| <br /> <br /> payasA mUtrayuktena bahushaH kevalena vA| <br /> dantIphalarase koShNe kAshmaryA~jjalinA shRutam||56|| <br /> <br /> drAkShA~jjaliM mRuditvA vA dadyAt pANDvAmayApaham| <br /> dvisharkaraM trivRuccUrNaM palArdhaM paittikaH pibet||57|| <br /> <br /> kaphapANDustu gomUtraklinnayuktAM [1] harItakIm| <br /> AragvadhaM [2] rasenekShorvidAryAmalakasya ca||58|| <br /> <br /> satryUShaNaM bilvapatraM pibennA kAmalApaham| <br /> dantyardhapalakalkaM vA dviguDaM shItavAriNA||59|| <br /> <br /> kAmalI trivRutAM vA~api triphalAyA rasaiH pibet| <br /> vishAlAtriphalAmustakuShThadArukali~ggakAn||60|| <br /> <br /> kArShikAnardhakarShAMshAM kuryAdativiShAM tathA| <br /> karShau madhurasAyA dvau sarvametat [3] sukhAmbunA||61|| <br /> <br /> mRuditaM taM rasaM pUtaM pItvA lihyAcca madhvanu| <br /> kAsaM shvAsaM jvaraM dAhaM pANDurogamarocakam||62|| <br /> <br /> gulmAnAhAmavAtAMshca raktapittaM ca nAshayet| <br /> triphalAyA guDUcyA vA dArvyA nimbasya vA rasam||63||<br /> <br /> shItaM madhuyutaM prAtaH kAmalArtaH pibennaraH| <br /> kShIramUtraM pibet pakShaM gavyaM mAhiShameva vA||64|| <br /> <br /> pANDurgomUtrayuktaM vA saptAhaM triphalArasam| <br /> tarujAn jvalitAnmUtre nirvApyAmRudya cA~gkurAn||65|| <br /> <br /> mAtulu~ggasya tat pUtaM pANDushothaharaM pibet| <br /> svarNakShIrI trivRucchyAme bhadradAru sanAgaram||66|| <br /> <br /> gomUtrA~jjalinA piShTaM mUtre vA kvathitaM pibet| <br /> kShIramebhiH shRutaM vA~api pibeddoShAnulomanam||67|| <br /> <br /> harItakIM prayogeNa gomUtreNAthavA pibet| <br /> jIrNe kShIreNa bhu~jjIta rasena madhureNa vA||68|| <br /> <br /> saptarAtraM gavAM mUtre bhAvitaM vA~apyayorajaH| <br /> pANDurogaprashAntyarthaM payasA pAyayedbhiShak||69|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After proper oleation of the patient with the internal administration of the above described medicated ''ghrita,'' the patient should be given frequent medication with the following recipes: <br /> <br /> Milk with cow’s urine or milk alone or lukewarm infusion of ''danti'' sprinkled with the powder of one ''anjali'' of ''kashmarya'' or mixed with the paste of one ''anjali'' (handful) of ''draksha''; all these drugs cure ''pandu roga'' in general.<br /> <br /> The patient suffering from ''paittika pandu'' should take half ''pala'' of ''trivitta'' mixed with one ''pala'' of sugar; <br /> <br /> ''Kaphaja'' type of ''pandu'' patient should take ''haritaki churna'' immersed in cow’s urine. <br /> <br /> ''Kamala'' patient should take ''aragvadha'' along with the juice of sugarcane, ''vidari, amalaki'' to which ''sunthi, maricha, pippali'' and ''bilva'' leaves have been added; or may take the paste of half ''pala'' of ''danti'' mixed with one ''pala'' of jaggery along with cold water; or may take ''trivritta'' along with decoction of ''triphala''. <br /> <br /> ''Vishaladi phanta'' – One ''karsha'' each of ''vishala, haritaki, bibhitaka, amalaki, musta, kushtha, devadaru'' and ''kalingaka''; half ''karsha'' of ''ativisha'', two ''karsha'' of ''madhurasa'' (''murva'') should be made to a paste by triturating with lukewarm water and strained. The patient should take honey after taking this infusion. This ''phanta'' cures cough, dyspnea, fever, burning sensation, ''pandu roga'', anorexia, ''gulma'' (lumps in abdomen), ''anaha'' (gaseous distention of the abdomen), ''amavata'' (joint disorders caused by ''ama''), and ''raktapitta'' (bleeding disorders).<br /> <br /> Other drugs which are useful for these ailments are as follows: <br /> *''Kamala'' patients should take the decoction of ''triphala, guduchi, devadaru,'' or ''nimba'' after cooling and adding honey in the morning.<br /> *''Pandu'' patient may take the milk or urine of either cow or buffalo for one fortnight.<br /> *''Pandu'' patient may drink the decoction of ''triphala'' along with cow’s urine for one week.<br /> *Patient suffering from ''pandu'' and ''sopha'' (edema) should drink the liquid obtained by straining the paste of tender branches of ''matulunga'' set afire and then immersed in cow’s urine.<br /> *''Suvarnakshiri, trivritta, syama-trivritta, bhadradaru'' and ''nagara'' should be triturated by adding one ''anjali'' of cow’s urine or should be made to a decoction by adding cow’s urine. The above mentioned drugs may also be boiled with milk. The drinking of these drugs brings about the downward motion of the ''doshas'' causing ''pandu''.<br /> *Then again, the patient suffering from ''pandu roga'' should take a course of ''haritaki'' with cow’s urine (for seven days) and then should take food either with milk or sweetened meat soup, and <br /> *Physicians should give ''lauha bhasma'' impregnated for seven nights with cow’s urine along with milk for the alleviation of ''pandu roga'' [55-69]<br /> <br /> === ''Navayasa churnam'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्र्यूषणत्रिफलामुस्तविडङ्गचित्रकाः समाः| <br /> नवायोरजसो भागास्तच्चूर्णं क्षौद्रसर्पिषा||७०|| <br /> <br /> भक्षयेत् पाण्डुहृद्रोगकुष्ठार्शःकामलापहम्| <br /> नवायसमिदं चूर्णं कृष्णात्रेयेण भाषितम्||७१|| <br /> <br /> इति नवायसचूर्णम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tryūṣaṇatriphalāmustaviḍaṅgacitrakāḥ samāḥ| <br /> navāyōrajasō bhāgāstaccūrṇaṁ kṣaudrasarpiṣā||70|| <br /> <br /> bhakṣayēt pāṇḍuhr̥drōgakuṣṭhārśaḥkāmalāpaham| <br /> navāyasamidaṁ cūrṇaṁ kr̥ṣṇātrēyēṇa bhāṣitam||71|| <br /> <br /> iti navāyasacūrṇam| <br /> <br /> tryUShaNatriphalAmustaviDa~ggacitrakAH samAH| <br /> navAyorajaso bhAgAstaccUrNaM kShaudrasarpiShA||70|| <br /> <br /> bhakShayet pANDuhRudrogakuShThArshaHkAmalApaham| <br /> navAyasamidaM cUrNaM kRuShNAtreyeNa bhAShitam||71|| <br /> <br /> iti navAyasacUrNam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take ''sunthi, pippali, maricha, haritaki, bibhitaki, amalaki, musta, vidanga'' and ''chitraka'' in one part each and nine parts of ''lauha bhasma'' and mix together. Intake of this recipe along with honey and ghee cures anemia, heart diseases, ''kushtha'' (group of skin diseases), ''arsha'' (hemorrhoids) and ''kamala''. This medicine propounded by ''krishnatreya'' is called ''navayasa churna'' [70-71]<br /> <br /> === ''Mandura vataka'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुडनागरमण्डूरतिलांशान्मानतः समान्| <br /> पिप्पलीद्विगुणां कुर्याद्गुटिकां पाण्डुरोगिणे||७२|| <br /> <br /> त्र्यूषणं त्रिफला मुस्तं विडङ्गं चव्यचित्रकौ| <br /> दार्वीत्वङ्माक्षिको धातुर्ग्रन्थिकं देवदारु च||७३|| <br /> <br /> एतान् द्विपलिकान्भागांश्चूर्णं कुर्यात् पृथक् पृथक्| <br /> मण्डूरं द्विगुणं चूर्णाच्छुद्धमञ्जनसन्निभम्||७४|| <br /> <br /> गोमूत्रेऽष्टगुणे पक्त्वा तस्मिंस्तत् प्रक्षिपेत्ततः| <br /> उदुम्बरसमान्कृत्वा वटकांस्तान् यथाग्नि ना||७५|| <br /> <br /> उपयुञ्जीत तक्रेण सात्म्यं जीर्णे च भोजनम्| <br /> मण्डूरवटका ह्येते प्राणदाः पाण्डुरोगिणाम्||७६|| <br /> <br /> कुष्ठान्यजीर्णकं शोथमूरुस्तम्भं कफामयान्| <br /> अर्शांसि कामलां मेहं प्लीहानं शमयन्ति च||७७|| <br /> <br /> इति मण्डूरवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> guḍanāgaramaṇḍūratilāṁśānmānataḥ samān| <br /> pippalīdviguṇāṁ kuryādguṭikāṁ pāṇḍurōgiṇē||72|| <br /> <br /> tryūṣaṇaṁ triphalā mustaṁ viḍaṅgaṁ cavyacitrakau| <br /> dārvītvaṅmākṣikō Dhāturgranthikaṁ dēvadāru ca||73|| <br /> <br /> ētān dvipalikānbhāgāṁścūrṇaṁ kuryāt pr̥thak pr̥thak| <br /> maṇḍūraṁ dviguṇaṁ cūrṇācchuddhamañjanasannibham||74|| <br /> <br /> gōmūtrē'ṣṭaguṇē paktvā tasmiṁstat prakṣipēttataḥ| <br /> udumbarasamānkr̥tvā vaṭakāṁstān yathāgni nā||75|| <br /> <br /> upayuñjīta takrēṇa sātmyaṁ jīrṇē ca bhōjanam| <br /> maṇḍūravaṭakā hyētē prāṇadāḥ pāṇḍurōgiṇām||76|| <br /> <br /> kuṣṭhānyajīrṇakaṁ śōthamūrustambhaṁ kaphāmayān| <br /> arśāṁsi kāmalāṁ mēhaṁ plīhānaṁ śamayanti ca||77|| <br /> <br /> iti maṇḍūravaṭakāḥ| <br /> <br /> guDanAgaramaNDUratilAMshAnmAnataH samAn| <br /> pippalIdviguNAM kuryAdguTikAM pANDurogiNe||72|| <br /> <br /> tryUShaNaM triphalA mustaM viDa~ggaM cavyacitrakau| <br /> dArvItva~gmAkShiko dhAturgranthikaM devadAru ca||73|| <br /> <br /> etAn dvipalikAnbhAgAMshcUrNaM kuryAt pRuthak pRuthak| <br /> maNDUraM dviguNaM cUrNAcchuddhama~jjanasannibham||74|| <br /> <br /> gomUtre~aShTaguNe paktvA tasmiMstat prakShipettataH| <br /> udumbarasamAnkRutvA vaTakAMstAn yathAgni nA||75|| <br /> <br /> upayu~jjIta takreNa sAtmyaM jIrNe ca bhojanam| <br /> maNDUravaTakA hyete prANadAH pANDurogiNAm||76|| <br /> <br /> kuShThAnyajIrNakaM shothamUrustambhaM kaphAmayAn| <br /> arshAMsi kAmalAM mehaM plIhAnaM shamayanti ca||77|| <br /> <br /> iti maNDUravaTakAH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Mandura vataka'' – jaggery, ''shunthi, mandura'' and ''tila'' in one part each along with two parts of ''pippali'' should be triturated and made in the form of pills. This medicine is suitable for the treatment of the patients with ''pandu roga''.<br /> <br /> ''Shunthi, pippali, maricha, haritaki, bibhitaki, amalaki, musta, vidanga, chavya, chitraka,'' bark of ''daruharidra, makshika'' (copper pyrite), ''pippalimoola'' and ''devadaru'' in the quantity of two ''pala'' each should be made to powders separately.<br /> <br /> ''Mandura bhasma'' which is dark in color like collyrium, should be cooked by adding eight times of cow’s urine and the powders of the above drugs should be mixed to this. ''Vatakas'' (large sized pills) of the size of ''udumbara'' should be made out of this combination. This should be taken by the patient in the appropriate doses according to his [[agni]] (power of digestion and metabolism) along with butter milk. The patient should take wholesome food after its digestion. These pills named as ''mandura vataka'' are the life givers for the patients of ''pandu''. It also cures ''kushtha, ajeerna'' (indigestion), ''sotha'' (edema), ''urustambha'' (stiffening of the thighs), disease caused by aggravation of the [[kapha]], arsha'' (hemorrhoids), ''kamala'' (jaundice), ''meha'' (polyuria) and ''pleeha'' (splenic diseases).<br /> <br /> Thus ends the description of two types of ''mandura vataka''.[72-77]<br /> <br /> === ''Tapayadi lauha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ताप्याद्रिजतुरूप्यायोमलाः पञ्चपलाः पृथक्| <br /> चित्रकत्रिफलाव्योषविडङ्गैः पलिकैः सह||७८|| <br /> <br /> शर्कराष्टपलोन्मिश्राश्चूर्णिता मधुनाऽऽप्लुताः| <br /> अभ्यस्यास्त्वक्षमात्रा हि जीर्णे हितमिताशिना||७९|| <br /> <br /> कुलत्थकाकमाच्यादिकपोतपरिहारिणा|८०| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tāpyādrijaturūpyāyōmalāḥ pañcapalāḥ pr̥thak| <br /> citrakatriphalāvyōṣaviḍaṅgaiḥ palikaiḥ saha||78|| <br /> <br /> śarkarāṣṭapalōnmiśrāścūrṇitā madhunā''plutāḥ| <br /> abhyasyāstvakṣamātrā hi jīrṇē hitamitāśinā||79|| <br /> <br /> kulatthakākamācyādikapōtaparihāriṇā|80| <br /> <br /> tApyAdrijaturUpyAyomalAH pa~jcapalAH pRuthak| <br /> citrakatriphalAvyoShaviDa~ggaiH palikaiH saha||78|| <br /> <br /> sharkarAShTapalonmishrAshcUrNitA madhunA~a~aplutAH| <br /> abhyasyAstvakShamAtrA hi jIrNe hitamitAshinA||79|| <br /> <br /> kulatthakAkamAcyAdikapotaparihAriNA|80|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Tapyadi yoga'' – ''Tapya, shilajatu,'' silver, ''mandura'' in the amount of five ''pala'' each should be added to one ''pala'' each of ''chitraka, haritaki, bibhitaka, amalaki, sunthi, pippali, maricha'' and ''vidanga''; and eight ''pala'' of sugar. This recipe should be taken by the patient habitually (by a ''pandu rogi'') in the dose of one ''karsha'' along with adequate amount of honey. After the digestion of this drug the patient should take wholesome food in small quantity and should avoid using ''kulattha, kakamachi'' etc. and pigeon meat [78-80]<br /> <br /> === ''Yogaraja'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिफलायास्त्रयो भागास्त्रयस्त्रिकटुकस्य च||८०|| <br /> <br /> भागश्चित्रकमूलस्य विडङ्गानां तथैव च| <br /> पञ्चाश्मजतुनो भागास्तथा रूप्यमलस्य च||८१|| <br /> <br /> माक्षिकस्य च शुद्धस्य लौहस्य रजसस्तथा| <br /> अष्टौ भागाः सितायाश्च तत्सर्वं सूक्ष्मचूर्णितम्||८२|| <br /> <br /> माक्षिकेणाप्लुतं स्थाप्यमायसे भाजने शुभे| <br /> उदुम्बरसमां मात्रां ततः खादेद्यथाग्नि ना||८३|| <br /> <br /> दिने दिने प्रयुञ्जीत जीर्णे भोज्यं यथेप्सितम्| <br /> वर्जयित्वा कुलत्थानि काकमाचीं कपोतकम्||८४||<br /> <br /> योगराज इति ख्यातो योगोऽयममृतोपमः| <br /> रसायनमिदं श्रेष्ठं सर्वरोगहरं शिवम्||८५|| <br /> <br /> पाण्डुरोगं विषं कासं यक्ष्माणं विषमज्वरम्| <br /> कुष्ठान्यजीर्णकं मेहं शोषं श्वासमरोचकम्||८६|| <br /> <br /> विशेषाद्धन्त्यपस्मारं कामलां गुदजानि च| <br /> <br /> इति योगराजः|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> triphalāyāstrayō bhāgāstrayastrikaṭukasya ca||80|| <br /> <br /> bhāgaścitrakamūlasya viḍaṅgānāṁ tathaiva ca| <br /> pañcāśmajatunō bhāgāstathā rūpyamalasya ca||81|| <br /> <br /> mākṣikasya ca śuddhasya lauhasya rajasastathā| <br /> aṣṭau bhāgāḥ sitāyāśca tatsarvaṁ sūkṣmacūrṇitam||82|| <br /> <br /> mākṣikēṇāplutaṁ sthāpyamāyasē bhājanē śubhē| <br /> udumbarasamāṁ mātrāṁ tataḥ khādēdyathāgni nā||83|| <br /> <br /> dinē dinē prayuñjīta jīrṇē bhōjyaṁ yathēpsitam| <br /> varjayitvā kulatthāni kākamācīṁ kapōtakam||84|| <br /> <br /> yōgarāja iti khyātō yōgō'yamamr̥tōpamaḥ| <br /> rasāyanamidaṁ śrēṣṭhaṁ sarvarōgaharaṁ śivam||85|| <br /> <br /> pāṇḍurōgaṁ viṣaṁ kāsaṁ yakṣmāṇaṁ viṣamajvaram| <br /> kuṣṭhānyajīrṇakaṁ mēhaṁ śōṣaṁ śvāsamarōcakam||86|| <br /> <br /> viśēṣāddhantyapasmāraṁ kāmalāṁ gudajāni ca| <br /> <br /> iti yōgarājaḥ| <br /> <br /> triphalAyAstrayo bhAgAstrayastrikaTukasya ca||80|| <br /> <br /> bhAgashcitrakamUlasya viDa~ggAnAM tathaiva ca| <br /> pa~jcAshmajatuno bhAgAstathA rUpyamalasya ca||81|| <br /> <br /> mAkShikasya ca shuddhasya lauhasya rajasastathA| <br /> aShTau bhAgAH sitAyAshca tatsarvaM sUkShmacUrNitam||82|| <br /> <br /> mAkShikeNAplutaM sthApyamAyase bhAjane shubhe| <br /> udumbarasamAM mAtrAM tataH khAdedyathAgni nA||83|| <br /> <br /> dine dine prayu~jjIta jIrNe bhojyaM yathepsitam| <br /> varjayitvA kulatthAni kAkamAcIM kapotakam||84|| <br /> <br /> yogarAja iti khyAto yogo~ayamamRutopamaH| <br /> rasAyanamidaM shreShThaM sarvarogaharaM shivam||85|| <br /> <br /> pANDurogaM viShaM kAsaM yakShmANaM viShamajvaram| <br /> kuShThAnyajIrNakaM mehaM shoShaM shvAsamarocakam||86|| <br /> <br /> visheShAddhantyapasmAraM kAmalAM gudajAni ca| <br /> <br /> iti yogarAjaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Yogaraja'' – ''harītaki, bibhitaki, amalaki, shunthi, pippali, maricha, chitraka moola'' (root) and ''vidanga'' in the amount of one part each; five parts each of ''shilajatu, raupya mala'' (silver), purified ''makshika'' and ''lauha bhasma''; eight parts of sugar – all should be made to a fine powder and mixed with adequate amount of honey and kept in clean iron jar. This recipe should be taken by the patient in a quantity equal to a fruit of ''udumbara'' according to the power of digestion every day and should be given the desired food excluding ''kulattha, kakamachi'' etc. and pigeon meat; only after the digestion of the taken drug. This ambrosia like recipe is called ''yogaraja''. It is an excellent rejuvenative recipe which cures all diseases and bestows auspiciousness. It specially cures ''pandu'', poisoning, ''kasa, yakshma, vishama jwara'' (irregular fevers), ''ajeerna, meha, soshha, swasa, aruchi, apasmara'' (epilepsy), ''kamala'' and ''arsha''.<br /> <br /> Thus ends the description of ''yogaraja'' [80-86]<br /> <br /> === Various formulations ===<br /> <br /> === Shilajatu Vataka ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कौटजत्रिफलानिम्बपटोलघननागरैः||८७|| <br /> <br /> भावितानि दशाहानि रसैर्द्वित्रिगुणानि वा| <br /> शिलाजतुपलान्यष्टौ तावती सितशर्करा||८८||<br /> <br /> त्वक्क्षीरी पिप्पली धात्री कर्कटाख्या पलोन्मिता| <br /> <br /> निदिग्ध्याः फलमूलाभ्यां पलं युक्त्या त्रिगन्धकम्| <br /> <br /> चूर्णितं मधुनः कुर्यात् त्रिपलेनाक्षिकान् गुडान्| <br /> दाडिमाम्बुपयःपक्षिरसतोयसुरासवान्||९०|| <br /> <br /> तान् भक्षयित्वाऽनुपिबेन्निरन्नो भुक्त एव वा| <br /> पाण्डुकुष्ठज्वरप्लीहतमकार्शोभगन्दरान्||९१|| <br /> <br /> पूतिहृच्छुक्रमूत्राग्निदोषशोषगरोदरान् [१] | <br /> कासासृग्दरपित्तासृक्शोथगुल्मगलामयान्||९२|| <br /> <br /> ते च सर्वव्रणान् हन्युः सर्वरोगहराः शिवाः| <br /> <br /> इति शिलाजतुवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> kauṭajatriphalānimbapaṭōlaghananāgaraiḥ||87|| <br /> <br /> bhāvitāni daśāhāni rasairdvitriguṇāni vā| <br /> śilājatupalānyaṣṭau tāvatī sitaśarkarā||88|| <br /> <br /> tvakkṣīrī pippalī dhātrī karkaṭākhyā palōnmitā| <br /> <br /> nidigdhyāḥ phalamūlābhyāṁ palaṁ yuktyā trigandhakam| <br /> <br /> cūrṇitaṁ madhunaḥ kuryāt tripalēnākṣikān guḍān| <br /> dāḍimāmbupayaḥpakṣirasatōyasurāsavān||90|| <br /> <br /> tān bhakṣayitvā'nupibēnnirannō bhukta ēva vā| <br /> pāṇḍukuṣṭhajvaraplīhatamakārśōbhagandarān||91|| <br /> <br /> pūtihr̥cchukramūtrāgnidōṣaśōṣagarōdarān [1] | <br /> kāsāsr̥gdarapittāsr̥kśōthagulmagalāmayān||92|| <br /> <br /> tē ca sarvavraṇān hanyuḥ sarvarōgaharāḥ śivāḥ| <br /> <br /> iti śilājatuvaṭakāḥ| <br /> <br /> kauTajatriphalAnimbapaTolaghananAgaraiH||87|| <br /> <br /> bhAvitAni dashAhAni rasairdvitriguNAni vA| <br /> shilAjatupalAnyaShTau tAvatI sitasharkarA||88|| <br /> <br /> tvakkShIrI pippalI dhAtrI karkaTAkhyA palonmitA| <br /> <br /> nidigdhyAH phalamUlAbhyAM palaM yuktyA trigandhakam| <br /> <br /> cUrNitaM madhunaH kuryAt tripalenAkShikAn guDAn| <br /> dADimAmbupayaHpakShirasatoyasurAsavAn||90|| <br /> <br /> tAn bhakShayitvA~anupibenniranno bhukta eva vA| <br /> pANDukuShThajvaraplIhatamakArshobhagandarAn||91|| <br /> <br /> pUtihRucchukramUtrAgnidoShashoShagarodarAn [1] | <br /> kAsAsRugdarapittAsRukshothagulmagalAmayAn||92|| <br /> <br /> te ca sarvavraNAn hanyuH sarvarogaharAH shivAH| <br /> <br /> iti shilAjatuvaTakAH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> ''Shilajatu vataka'' – Eight ''pala'' of ''shilajatu'' impregnated for ten, twenty or thirty days with the decoction of fruit of ''kutaja, haritaki, bibhitaka, amalaki, nimba, patola, ghana'' and ''nagara''. Eight ''pala'' of sugar and one ''pala'' each of ''tvakakshiri, pippali, dhatri'' and ''karkatashringi''; half ''pala'' each of the fruit and root of ''nidigdhika'' and adequate powder of ''tvaka, ela'' and ''patra'' should be added to this ''shilajatu''. ''Vataka'' (large sized pills) of one ''aksha'' each should be prepared by adding three ''pala'' of honey to this powder. These pills can be taken on either empty stomach or after having food. The patient should drink the juice of ''dadima'' (pomegranate), milk, meat soup of birds, water, alcohol, ''asava'' (medicated wine) after taking this medicine. It cures ''pandu, kushtha, jwara, pleeha, tamaka svasa, arsha, bhagandara'' (fistula in ano), ''puti'' (putrified ulcers), ''hridroga'' (heart diseases), ''shukra dosha'' (diseases of semen), ''mutra dosha'' (diseases of urine), and ''agni dosha'' (diseases of digestion), ''sosha'' (consumption), ''gara'' (poisoning), ''udara, kasa, asrigdara'' (menorrhagia), ''raktapitta'' (bleeding disorders), ''sotha, gulma, galamayana'' (diseases of the throats) and all types of ''vrana'' (wounds). It cures all types of diseases and bestows auspiciousness. Thus, ends the description of ''shilajatu vataka.'' [87-92]<br /> <br /> === Punarnava Mandura ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुनर्नवा त्रिवृद्व्योषविडङ्गं दारु चित्रकम्||९३|| <br /> <br /> कुष्ठं हरिद्रे त्रिफला दन्ती चव्यं कलिङ्गकाः| <br /> पिप्पली [२] पिप्पलीमूलं मुस्तं चेति पलोन्मितम्||९४|| <br /> <br /> मण्डूरं द्विगुणं चूर्णाद्गोमूत्रे द्व्याढके पचेत्| <br /> कोलवद्गुटिकाः कृत्वा तक्रेणालोड्य ना पिबेत्||९५|| <br /> <br /> ताः पाण्डुरोगान् प्लीहानमर्शांसि विषमज्वरम्| <br /> श्वयथुं ग्रहणीदोषं हन्युः कुष्ठं क्रिमींस्तथा||९६|| <br /> <br /> इति पुनर्नवामण्डूरम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> punarnavā trivr̥dvyōṣaviḍaṅgaṁ dāru citrakam||93|| <br /> <br /> kuṣṭhaṁ haridrē triphalā dantī cavyaṁ kaliṅgakāḥ| <br /> pippalī [2] pippalīmūlaṁ mustaṁ cēti palōnmitam||94|| <br /> <br /> maṇḍūraṁ dviguṇaṁ cūrṇādgōmūtrē dvyāḍhakē pacēt| <br /> kōlavadguṭikāḥ kr̥tvā takrēṇālōḍya nā pibēt||95|| <br /> <br /> tāḥ pāṇḍurōgān plīhānamarśāṁsi viṣamajvaram| <br /> śvayathuṁ grahaṇīdōṣaṁ hanyuḥ kuṣṭhaṁ krimīṁstathā||96|| <br /> <br /> iti punarnavāmaṇḍūram|<br /> <br /> punarnavA trivRudvyoShaviDa~ggaM dAru citrakam||93|| <br /> <br /> kuShThaM haridre triphalA dantI cavyaM kali~ggakAH| <br /> pippalI [2] pippalImUlaM mustaM ceti palonmitam||94|| <br /> <br /> maNDUraM dviguNaM cUrNAdgomUtre dvyADhake pacet| <br /> kolavadguTikAH kRutvA takreNAloDya nA pibet||95|| <br /> <br /> tAH pANDurogAn plIhAnamarshAMsi viShamajvaram| <br /> shvayathuM grahaNIdoShaM hanyuH kuShThaM krimIMstathA||96|| <br /> <br /> iti punarnavAmaNDUram| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Powder of one ''pala'' each of ''punarnava, trivritta, sunthi, pippali, maricha, vidanga, devadaru, chitraka, kushtha, haridra, daruharidra, haritaki, bibhitaka, amalaki, danti, chavya, kālingaka, pippalī, pippalimoola'' and ''musta''; and forty ''pala'' of ''mandura bhasma'' (rust of iron) coked in two ''adhaka'' of cow’s urine and made in the form of ''gutika'' of the size of ''kola''. These pills should be taken with butter milk. It cures ''pandu, pleeha, arsha, vishama jwara, sotha, grahanidosha'' (sprue syndrome, irritable bowel syndrome), ''kushtha'' and ''krimi'' (parasitic infestation). Thus, ends the description of ''punarnava mandura''.[93-96]<br /> <br /> === Darvyadi leha and other two recipes ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दार्वीत्वक् त्रिफला व्योषं विडङ्गमयसो रजः| <br /> मधुसर्पिर्युतं लिह्यात् कामलापाण्डुरोगवान्||९७|| <br /> <br /> तुल्या अयोरजःपथ्याहरिद्राः क्षौद्रसर्पिषा| <br /> चूर्णिताः कामली लिह्याद्गुडक्षौद्रेण वाऽभयाः||९८|| <br /> <br /> त्रिफला द्वे हरिद्रे च कटुरोहिण्ययोरजः| <br /> चूर्णितं क्षौद्रसर्पिर्भ्यां स लेहः कामलापहः||९९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> dārvītvak triphalā vyōṣaṁ viḍaṅgamayasō rajaḥ| <br /> madhusarpiryutaṁ lihyāt kāmalāpāṇḍurōgavān||97|| <br /> <br /> tulyā ayōrajaḥpathyāharidrāḥ kṣaudrasarpiṣā| <br /> cūrṇitāḥ kāmalī lihyādguḍakṣaudrēṇa vā'bhayāḥ||98|| <br /> <br /> triphalā dvē haridrē ca kaṭurōhiṇyayōrajaḥ| <br /> cūrṇitaṁ kṣaudrasarpirbhyāṁ sa lēhaḥ kāmalāpahaḥ||99|| <br /> <br /> dArvItvak triphalA vyoShaM viDa~ggamayaso rajaH| <br /> madhusarpiryutaM lihyAt kAmalApANDurogavAn||97|| <br /> <br /> tulyA ayorajaHpathyAharidrAH kShaudrasarpiShA| <br /> cUrNitAH kAmalI lihyAdguDakShaudreNa vA~abhayAH||98|| <br /> <br /> triphalA dve haridre ca kaTurohiNyayorajaH| <br /> cUrNitaM kShaudrasarpirbhyAM sa lehaH kAmalApahaH||99|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Powder of the bark of daruharidra, haritaki, bibhitaka, amalaki, pippali, sunthi, maricha, vidanga and lauha bhasma mixed with ghee and honey, taken as a linctus by the patients suffering from ''pandu'' and ''kamala''.<br /> <br /> Two other recipes – Patients suffering from ''kamala'' should take the powder of one part each of ''lauha bhasma, haritaki'' and ''haridra'' along with honey and ghee and may also take the linctus of the powder of ''abhaya'' prepared by mixing with jaggery and honey. [97-99]<br /> <br /> === ''Dhatryavaleha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्विपलांशां तुगाक्षीरीं नागरं मधुयष्टिकाम्| <br /> प्रास्थिकीं पिप्पलीं द्राक्षां शर्करार्धतुलां शुभाम्||१००|| <br /> <br /> धात्रीफलरसद्रोणे चूर्णितं लेहवत् पचेत्| <br /> शीतं मधुप्रस्थयुतं लिह्यात् पाणितलं ततः||१०१|| <br /> <br /> हन्त्येष कामलां पित्तं पाण्डुं कासं हलीमकम्| <br /> <br /> इति धात्र्यवलेहः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dvipalāṁśāṁ tugākṣīrīṁ nāgaraṁ madhuyaṣṭikām| <br /> prāsthikīṁ pippalīṁ drākṣāṁ śarkarārDhātulāṁ śubhām||100|| <br /> <br /> dhātrīphalarasadrōṇē cūrṇitaṁ lēhavat pacēt| <br /> śītaṁ madhuprasthayutaṁ lihyāt pāṇitalaṁ tataḥ||101|| <br /> <br /> hantyēṣa kāmalāṁ Pittaṁ pāṇḍuṁ kāsaṁ halīmakam| <br /> <br /> iti dhātryavalēhaḥ| <br /> <br /> dvipalAMshAM tugAkShIrIM nAgaraM madhuyaShTikAm| <br /> prAsthikIM pippalIM drAkShAM sharkarArdhatulAM shubhAm||100|| <br /> <br /> dhAtrIphalarasadroNe cUrNitaM lehavat pacet| <br /> shItaM madhuprasthayutaM lihyAt pANitalaM tataH||101|| <br /> <br /> hantyeSha kAmalAM pittaM pANDuM kAsaM halImakam| <br /> <br /> iti dhAtryavalehaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Dhatryavaleha'' – ''Vanshalochana, sunthi, maduyashti'' powders, each in two ''pala''; one ''prastha'' each of ''pippali'' and ''draksha''; and half a ''tula'' of sugar crystal added with one ''drona'' of ''amalaki'' fruit juice and cooked till it changes into linctus form. One ''prastha'' of honey is added to it after it cools down. Intake of one ''panitala'' of this linctus cures ''kamala, [[pitta]] vikaras, pandu, kasa'' and ''haleemaka'' [100-101]<br /> <br /> === ''Mandura vatakah'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्र्यूषणं त्रिफला चव्यं चित्रको देवदारु च||१०२|| <br /> <br /> विडङ्गान्यथ मुस्तं च वत्सकं चेति चूर्णयेत्| <br /> मण्डूरतुल्यं तच्चूर्णं गोमूत्रेऽष्टगुणे पचेत्||१०३|| <br /> <br /> शनैः सिद्धास्तथा शीताः कार्याः कर्षसमा गुडाः| <br /> यथाग्नि भक्षणीयास्ते प्लीहपाण्ड्वामयापहाः||१०४||<br /> <br /> ग्रहण्यर्शोनुदश्चैव तक्रवाट्याशिनः स्मृताः| <br /> <br /> इति मण्डूरवटकाः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tryūṣaṇaṁ triphalā cavyaṁ citrakō dēvadāru ca||102|| <br /> <br /> viḍaṅgānyatha mustaṁ ca vatsakaṁ cēti cūrṇayēt| <br /> maṇḍūratulyaṁ taccūrṇaṁ gōmūtrē'ṣṭaguṇē pacēt||103|| <br /> <br /> śanaiḥ siddhāstathā śītāḥ kāryāḥ karṣasamā guḍāḥ| <br /> yathāgni bhakṣaṇīyāstē plīhapāṇḍvāmayāpahāḥ||104|| <br /> <br /> grahaṇyarśōnudaścaiva takravāṭyāśinaḥ smr̥tāḥ| <br /> <br /> iti maṇḍūravaṭakāḥ| <br /> <br /> tryUShaNaM triphalA cavyaM citrako devadAru ca||102|| <br /> <br /> viDa~ggAnyatha mustaM ca vatsakaM ceti cUrNayet| <br /> maNDUratulyaM taccUrNaM gomUtre~aShTaguNe pacet||103|| <br /> <br /> shanaiH siddhAstathA shItAH kAryAH karShasamA guDAH| <br /> yathAgni bhakShaNIyAste plIhapANDvAmayApahAH||104|| <br /> <br /> grahaNyarshonudashcaiva takravATyAshinaH smRutAH| <br /> <br /> iti maNDUravaTakAH|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Mandura Vataka''-II: ''Shunthi, pippali, maricha, haritaki, bibhitaka, amalaki, chavya, chitraka, devadaru, vidanga, musta'' and ''vatsaka'' in one part each, made in the form of powder and added to equal quantity (12 parts) of ''mandura bhasma'', should then be boiled by adding eight times of cow’s urine over mild fire. After the recipe cools pills of one ''aksha'' each should be prepared and taken according to the power of digestion. This cures ''pleeha, pandu, grahani,'' and ''arsha''. The patient should take buttermilk and ''vatya'' (a roasted barley preperation) while taking this pill [102-104]<br /> <br /> === ''Gaudo arishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मञ्जिष्ठा रजनी द्राक्षा बलामूलान्ययोरजः||१०५|| <br /> <br /> लोध्रं चैतेषु गौडः स्यादरिष्टः पाण्डुरोगिणाम्| <br /> <br /> इति गौडोऽरिष्टः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mañjiṣṭhā rajanī drākṣā balāmūlānyayōrajaḥ||105|| <br /> <br /> lōdhraṁ caitēṣu gauḍaḥ syādariṣṭaḥ pāṇḍurōgiṇām| <br /> <br /> iti gauḍō'riṣṭaḥ| <br /> <br /> ma~jjiShThA rajanI drAkShA balAmUlAnyayorajaH||105|| <br /> <br /> lodhraM caiteShu gauDaH syAdariShTaH pANDurogiNAm| <br /> <br /> iti gauDo~ariShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Manjishtha, rajani, draksha, bala moola'' (roots), ''lauha bhasma'', and ''lodhra'' should be added to jaggery and processed according to the method prescribed for ''arishta''. It is called ''gaudo-arishta'' and is useful for the patients suffering from ''pandu roga'' [105]<br /> <br /> === ''Beejakarishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बीजकात्षोडशपलं त्रिफलायाश्च विंशतिः||१०६|| <br /> <br /> द्राक्षायाः पञ्च लाक्षायाः सप्त द्रोणे जलस्य तत्| <br /> साध्यं पादावशेषे तु पूतशेषे समावपेत्||१०७|| <br /> <br /> शर्करायास्तुलां प्रस्थं माक्षिकस्य च कार्षिकम्| <br /> व्योषं व्याघ्रनखोशीरं क्रमुकं सैलवालुकम्||१०८|| <br /> <br /> मधुकं कुष्ठमित्येतच्चूर्णितं घृतभाजने| <br /> यवेषु दशरात्रं तद्ग्रीष्मे द्विः शिशिरे स्थितम्||१०९|| <br /> <br /> पिबेत्तद्ग्रहणीपाण्डुरोगार्शःशोथगुल्मनुत्| <br /> मूत्रकृच्छ्राश्मरीमेहकामलासन्निपातजित्||११०|| <br /> <br /> बीजकारिष्ट इत्येष आत्रेयेण प्रकीर्तितः| <br /> <br /> इति बीजकारिष्टः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bījakātṣōḍaśapalaṁ triphalāyāśca viṁśatiḥ||106|| <br /> <br /> drākṣāyāḥ pañca lākṣāyāḥ sapta drōṇē jalasya tat| <br /> sādhyaṁ pādāvaśēṣē tu pūtaśēṣē samāvapēt||107|| <br /> <br /> śarkarāyāstulāṁ prasthaṁ mākṣikasya ca kārṣikam| <br /> vyōṣaṁ vyāghranakhōśīraṁ kramukaṁ sailavālukam||108|| <br /> <br /> madhukaṁ kuṣṭhamityētaccūrṇitaṁ ghr̥tabhājanē| <br /> yavēṣu daśarātraṁ tadgrīṣmē dviḥ śiśirē sthitam||109|| <br /> <br /> pibēttadgrahaṇīpāṇḍurōgārśaḥśōthagulmanut| <br /> mūtrakr̥cchrāśmarīmēhakāmalāsannipātajit||110|| <br /> <br /> bījakāriṣṭa ityēṣa ātrēyēṇa prakīrtitaḥ| <br /> <br /> iti bījakāriṣṭaḥ| <br /> <br /> bIjakAtShoDashapalaM triphalAyAshca viMshatiH||106|| <br /> <br /> drAkShAyAH pa~jca lAkShAyAH sapta droNe jalasya tat| <br /> sAdhyaM pAdAvasheShe tu pUtasheShe samAvapet||107|| <br /> <br /> sharkarAyAstulAM prasthaM mAkShikasya ca kArShikam| <br /> vyoShaM vyAghranakhoshIraM kramukaM sailavAlukam||108|| <br /> <br /> madhukaM kuShThamityetaccUrNitaM ghRutabhAjane| <br /> yaveShu dasharAtraM tadgrIShme dviH shishire sthitam||109|| <br /> <br /> pibettadgrahaNIpANDurogArshaHshothagulmanut| <br /> mUtrakRucchrAshmarImehakAmalAsannipAtajit||110|| <br /> <br /> bIjakAriShTa ityeSha AtreyeNa prakIrtitaH| <br /> <br /> iti bIjakAriShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Beejaka'' taken in the amount of sixteen ''pala'', twenty ''pala'' of ''triphala,'' five pala of ''draksha'' and seven ''pala'' of ''laksha'' are added to one ''drona'' of water and boiled till one fourth of water remains. Water should then be taken out by straining. One ''tula'' of sugar, one ''pala'' of honey and one ''pala'' powder of each of the ''shunthi, pippali, maricha, vyaghranakha, kramuka, elavaluka, madhuka'' and ''kushtha'' are added to the above made decoction and the potion be stored in a jar smeared with ghee kept inside a barley heap for ten nights during summer and for twenty nights in winter. Intake of this potion cures ''grahani, pandu, arsha, sotha, gulma, mutra krichha'' (dysuria), ''ashmari'' (stones in the urinary tract), ''meha, kamala'' and diseases caused by all the three [[dosha]]. This is called ''beejaka arishta'' and it was propounded by Atreya.<br /> <br /> Thus, ends the description of ''beejaka arishta'' [106-110]<br /> <br /> === ''Dhatryarishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> धात्रीफलसहस्रे द्वे पीडयित्वा रसं तु तम्||१११|| <br /> <br /> क्षौद्राष्टांशेन संयुक्तं कृष्णार्धकुडवेन च| <br /> शर्करार्धतुलोन्मिश्रं पक्षं स्निग्धघटे स्थितम्||११२|| <br /> <br /> प्रपिबेन्मात्रया प्रातर्जीर्णे हितमिताशनः| <br /> कामलापाण्डुहृद्रोगवातासृग्विषमज्वरान्||११३||<br /> <br /> कासहिक्कारुचिश्वासांश्चैषोऽरिष्टः प्रणाशयेत्| <br /> <br /> इति धात्र्यरिष्टः <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dhātrīphalasahasrē dvē pīḍayitvā rasaṁ tu tam||111|| <br /> <br /> kṣaudrāṣṭāṁśēna saṁyuktaṁ kr̥ṣṇārdhakuḍavēna ca| <br /> śarkarārDhātulōnmiśraṁ pakṣaṁ snigdhaghaṭē sthitam||112|| <br /> <br /> prapibēnmātrayā prātarjīrṇē hitamitāśanaḥ| <br /> kāmalāpāṇḍuhr̥drōgavātāsr̥gviṣamajvarān||113|| <br /> <br /> kāsahikkāruciśvāsāṁścaiṣō'riṣṭaḥ praṇāśayēt| <br /> <br /> iti dhātryariṣṭaḥ| <br /> <br /> dhAtrIphalasahasre dve pIDayitvA rasaM tu tam||111|| <br /> <br /> kShaudrAShTAMshena saMyuktaM kRuShNArdhakuDavena ca| <br /> sharkarArdhatulonmishraM pakShaM snigdhaghaTe sthitam||112|| <br /> <br /> prapibenmAtrayA prAtarjIrNe hitamitAshanaH| <br /> kAmalApANDuhRudrogavAtAsRugviShamajvarAn||113|| <br /> <br /> kAsahikkArucishvAsAMshcaiSho~ariShTaH praNAshayet| <br /> <br /> iti dhAtryariShTaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Dhatryarishta'' - Two thousand fruits of ''amalaki'' should be crushed and the juice extracted should be mixed with one eighth the quantity of honey, half ''kudava'' of ''pippali'' and half ''tula'' of sugar. It should then be kept in an earthern jar smeared with ghee for one fortnight. It should be taken in appropriate dose in the morning and the patient should take wholesome food in small quantity after the digestion of the drug. This ''arishta'' cures ''kamala, pandu, hridroga, vatarakta, vishama jwara, kasa, hikka, aruchi'' and ''svasa''. Thus, ends the description of ''dhatrya arishta'' [111-113]<br /> <br /> === Medicated water ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्थिरादिभिः शृतं तोयं पानाहारे प्रशस्यते||११४|| <br /> <br /> पाण्डूनां, कामलार्तानां मृद्वीकामलकीरसः|११५| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sthirādibhiḥ śr̥taṁ tōyaṁ pānāhārē praśasyatē||114|| <br /> <br /> pāṇḍūnāṁ, kāmalārtānāṁ mr̥dvīkāmalakīrasaḥ|115| <br /> <br /> sthirAdibhiH shRutaM toyaM pAnAhAre prashasyate||114|| <br /> <br /> pANDUnAM, kAmalArtAnAM mRudvIkAmalakIrasaH|115|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Water boiled with the drugs belonging to ''sthiradi'' group is useful for drinking and the preparation of foods for ''pandu rogi''; while the patient of ''kamala'' should use the juice of ''draksha'' and ''amalaki rasa'' [114-115]<br /> <br /> === Principles of treatment according to [[dosha]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पाण्डुरोगप्रशान्त्यर्थमिति प्रोक्तं महर्षिणा||११५|| <br /> <br /> विकल्प्यमेतद्भिषजा पृथग्दोषबलं प्रति| <br /> वातिके स्नेहभूयिष्ठं, पैत्तिके तिक्तशीतलम्||११६|| <br /> <br /> श्लैष्मिके कटुतिक्तोष्णं [१] , विमिश्रं सान्निपातिके|११७|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāṇḍurōgapraśāntyarthamiti prōktaṁ maharṣiṇā||115|| <br /> <br /> vikalpyamētadbhiṣajā pr̥thagdōṣabalaṁ prati| <br /> vātikē snēhabhūyiṣṭhaṁ, paittikē tiktaśītalam||116|| <br /> <br /> ślaiṣmikē kaṭutiktōṣṇaṁ [1] , vimiśraṁ sānnipātikē|117| <br /> <br /> pANDurogaprashAntyarthamiti proktaM maharShiNA||115|| <br /> <br /> vikalpyametadbhiShajA pRuthagdoShabalaM prati| <br /> vAtike snehabhUyiShThaM, paittike tiktashItalam||116|| <br /> <br /> shlaiShmike kaTutiktoShNaM [1] , vimishraM sAnnipAtike|117|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The above mentioned drugs are described for the cure of ''pandu roga'' by the great sage (Punarvasu Atreya). The physician should make suitable changes (combinations and permutations) in the above depending upon the strength of the [[dosha]] in the patient. <br /> <br /> The therapy should be dominated by unctuous drugs (oil, ghee etc) for ''vatika'' type of ''pandu''; by bitter and cooling drugs for ''paittika'' type and by pungent, bitter and hot drugs for [[kapha]]ja type of ''pandu'' [115-117]<br /> <br /> === Treatment of ''mrittika bhakshanajanya pandu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> निपातयेच्छरीरात्तु मृत्तिकां भक्षितां भिषक्||११७|| <br /> <br /> युक्तिज्ञः शोधनैस्तीक्ष्णैः प्रसमीक्ष्य बलाबलम्| <br /> शुद्धकायस्य सर्पींषि बलाधानानि योजयेत्||११८|| <br /> <br /> व्योषं बिल्वं हरिद्रे द्वे त्रिफला द्वे पुनर्नवे| <br /> मुस्तान्ययोरजः पाठा विडङ्गं देवदारु च||११९|| <br /> <br /> वृश्चिकाली च भार्गी च सक्षीरैस्तैः [१] समैर्घृतम्| <br /> साधयित्वा पिबेद्युक्त्या नरो मृद्दोषपीडितः||१२०|| <br /> <br /> तद्वत् केशरयष्ट्याह्वपिप्पलीक्षारशाद्वलैः| <br /> मृद्भक्षणादातुरस्य लौल्यादविनिवर्तिनः||१२१|| <br /> <br /> द्वेष्यार्थं भावितां कामं दद्यात्तद्दोषनाशनैः| <br /> विङ्गैलातिविषया निम्बपत्रेण पाठया||१२२|| <br /> <br /> वार्ताकैः कटुरोहिण्या कौटजैर्मूर्वयाऽपि वा|१२३| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nipātayēccharīrāttu mr̥ttikāṁ bhakṣitāṁ bhiṣak||117|| <br /> <br /> yuktijñaḥ śōdhanaistīkṣṇaiḥ prasamīkṣya balābalam| <br /> śuddhakāyasya sarpīṁṣi balādhānāni yōjayēt||118|| <br /> <br /> vyōṣaṁ bilvaṁ haridrē dvē triphalā dvē punarnavē| <br /> mustānyayōrajaḥ pāṭhā viḍaṅgaṁ dēvadāru ca||119|| <br /> <br /> vr̥ścikālī ca bhārgī ca sakṣīraistaiḥ [1] samairghr̥tam| <br /> sādhayitvā pibēdyuktyā narō mr̥ddōṣapīḍitaḥ||120|| <br /> <br /> tadvat kēśarayaṣṭyāhvapippalīkṣāraśādvalaiḥ| <br /> mr̥dbhakṣaṇādāturasya laulyādavinivartinaḥ||121|| <br /> <br /> dvēṣyārthaṁ bhāvitāṁ kāmaṁ dadyāttaddōṣanāśanaiḥ| <br /> viṅgailātiviṣayā nimbapatrēṇa pāṭhayā||122|| <br /> <br /> vārtākaiḥ kaṭurōhiṇyā kauṭajairmūrvayā'pi vā|123| <br /> <br /> nipAtayeccharIrAttu mRuttikAM bhakShitAM bhiShak||117|| <br /> <br /> yuktij~jaH shodhanaistIkShNaiH prasamIkShya balAbalam| <br /> shuddhakAyasya sarpIMShi balAdhAnAni yojayet||118|| <br /> <br /> vyoShaM bilvaM haridre dve triphalA dve punarnave| <br /> mustAnyayorajaH pAThA viDa~ggaM devadAru ca||119|| <br /> <br /> vRushcikAlI ca bhArgI ca sakShIraistaiH [1] samairghRutam| <br /> sAdhayitvA pibedyuktyA naro mRuddoShapIDitaH||120|| <br /> <br /> tadvat kesharayaShTyAhvapippalIkShArashAdvalaiH| <br /> mRudbhakShaNAdAturasya laulyAdavinivartinaH||121|| <br /> <br /> dveShyArthaM bhAvitAM kAmaM dadyAttaddoShanAshanaiH| <br /> vi~ggailAtiviShayA nimbapatreNa pAThayA||122|| <br /> <br /> vArtAkaiH kaTurohiNyA kauTajairmUrvayA~api vA|123|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A physician well versed in therapeutics, should give the patient strong elimination therapy, keeping in view the strength of the patient, in order to remove the swallowed mud from the body. After the body is cleansed, different types of medicated ghee should be prescribed to the patient for promotion of strength.<br /> <br /> Ghee prepared with ''shunthi, pippali, maricha, bilva, haridra, daruharidra, haritaki, bibhitaka, amalaki, sveta'' and ''rakta punarnava, musta, lauha bhasma, patha, vidanga, devadaru, vrishchikali, bhargi'' and milk should be appropriately taken by the patient who suffers from anemia because of eating clay. <br /> <br /> Likewise, ghee prepared with ''keshara, yashtamadhu, pippali, kshara'' (alkali preperation) and ''sadvala'' may be given to the patient suffering from ''mrittika bhakshana janya pandu''. <br /> <br /> If the patient is unable to give up his clay swallowing habits, he should be given clay impregnated with ''vidanga, ela, ativisha,'' neem leaves, ''patha, varataka, katurohiṇī, kutaja'' or ''murva'' with a view of creating an aversion to clay. These drugs also counter act the adverse effects of eating clay. [117-123]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यथादोषं प्रकुर्वीत भैषज्यं पाण्डुरोगिणाम्||१२३|| <br /> <br /> क्रियाविशेष एषोऽस्य मतो हेतुविशेषतः|१२४| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yathādōṣaṁ prakurvīta bhaiṣajyaṁ pāṇḍurōgiṇām||123|| <br /> <br /> kriyāviśēṣa ēṣō'sya matō hētuviśēṣataḥ|124| <br /> <br /> yathAdoShaM prakurvIta bhaiShajyaM pANDurogiNAm||123|| <br /> <br /> kriyAvisheSha eSho~asya mato hetuvisheShataH|124| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Different types of treatment should be given to the patient suffering from ''mrittika bhakshana janya pandu'', according to the different types of [[dosha]] aggravated. However, due to the specific type of etiological factor involved (clay eating), this type of ''pandu'' needs special type of treatment [123-124]<br /> <br /> === ''Shakhashrita kamala'' (''kamala'' in body tissue with obstructive pathology) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तिलपिष्टनिभं यस्तु वर्चः सृजति कामली||१२४||<br /> <br /> श्लेष्मणा रुद्धमार्गं तत् पित्तं कफहरैर्जयेत्| <br /> रूक्षशीतगुरुस्वादुव्यायामैर्वेगनिग्रहैः||१२५|| <br /> <br /> कफसम्मूर्च्छितो वायुः स्थानात् पित्तं क्षिपेद्बली| <br /> हारिद्रनेत्रमूत्रत्वक् श्वेतवर्चास्तदा नरः||१२६|| <br /> <br /> भवेत् साटोपविष्टम्भो गुरुणा हृदयेन च| <br /> दौर्बल्याल्पाग्निपार्श्वार्तिहिक्काश्वासारुचिज्वरैः||१२७|| <br /> <br /> क्रमेणाल्पेऽनुसज्येत [१] पित्ते शाखासमाश्रिते|१२८|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tilapiṣṭanibhaṁ yastu varcaḥ sr̥jati kāmalī||124|| <br /> <br /> ślēṣmaṇā ruddhamārgaṁ tat Pittaṁ Kaphaharairjayēt| <br /> rūkṣaśītagurusvāduvyāyāmairvēganigrahaiḥ||125|| <br /> <br /> Kaphasammūrcchitō vāyuḥ sthānāt Pittaṁ kṣipēdbalī| <br /> hāridranētramūtratvak śvētavarcāstadā naraḥ||126|| <br /> <br /> bhavēt sāṭōpaviṣṭambhō guruṇā hr̥dayēna ca| <br /> daurbalyālpāgnipārśvārtihikkāśvāsārucijvaraiḥ||127|| <br /> <br /> kramēṇālpē'nusajyēta [1] pittē śākhāsamāśritē|128| <br /> <br /> tilapiShTanibhaM yastu varcaH sRujati kAmalI||124|| <br /> <br /> shleShmaNA ruddhamArgaM tat pittaM kaphaharairjayet| <br /> rUkShashItagurusvAduvyAyAmairveganigrahaiH||125|| <br /> <br /> kaphasammUrcchito vAyuH sthAnAt pittaM kShipedbalI| <br /> hAridranetramUtratvak shvetavarcAstadA naraH||126|| <br /> <br /> bhavet sATopaviShTambho guruNA hRudayena ca| <br /> daurbalyAlpAgnipArshvArtihikkAshvAsArucijvaraiH||127|| <br /> <br /> krameNAlpe~anusajyeta [1] pitte shAkhAsamAshrite|128| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> A patient of ''kamala'' if passes stools of the color of sesame paste (''tila pishta nibhama''), then it denotes obstruction in the passage of [[pitta]] by the [[kapha]]. Therefore, the [[pitta]] of such patient should be won by administration of drugs which also eliminate [[kapha]]. <br /> <br /> The excess usage of ununctuous, cold and sweet ingredients; excessive exercise; suppression of the natural urges leads to the the aggravation of [[vata]] infilterated with [[kapha]] and the displacement of [[pitta]] from its site, resulting in the development of the following features: <br /> <br /> The eyes, skin and urine of the patient become yellow while his stools become white in color. Additionally, the patients suffer from ''atopa'' (tympanitis), ''vishtambha'' (constipation associated with flatulence),and heaviness in the cardiac region, due to the displacement of [[pitta]] in the peripheral tissues (''shakha''), there is diminution in the flow of [[pitta]] (to the gastrointestinal tract) resulting in the gradual development of weakness, ''agnimandya'' (low digestion), ''parshva'' (pain in the sides of chest), ''hikka'' (hiccups), ''shvasa'' (dyspnea), ''aruchi'' (anorexia) and ''jwara'' [124-128]<br /> <br /> === Treatment of ''shakhashriat kamala'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बर्हितित्तिरिदक्षाणां रूक्षाम्लैः कटुकै रसैः||१२८|| <br /> <br /> शुष्कमूलककौलत्थैर्यूषैश्चान्नानि भोजयेत्| <br /> मातुलुङ्गरसं क्षौद्रपिप्पलीमरिचान्वितम्||१२९|| <br /> <br /> सनागरं पिबेत् पित्तं तथाऽस्यैति स्वमाशयम्|१३०|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> barhitittiridakṣāṇāṁ rūkṣāmlaiḥ kaṭukai rasaiḥ||128|| <br /> <br /> śuṣkamūlakakaulatthairyūṣaiścānnāni bhōjayēt| <br /> mātuluṅgarasaṁ kṣaudrapippalīmaricānvitam||129|| <br /> <br /> sanāgaraṁ pibēt Pittaṁ tathā'syaiti svamāśayam|130| <br /> <br /> barhitittiridakShANAM rUkShAmlaiH kaTukai rasaiH||128|| <br /> <br /> shuShkamUlakakaulatthairyUShaishcAnnAni bhojayet| <br /> mAtulu~ggarasaM kShaudrapippalImaricAnvitam||129|| <br /> <br /> sanAgaraM pibet pittaM tathA~asyaiti svamAshayam|130|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient suffering from from ''shakhashrita kamala'' should be given food along with the soup of the meat of peacock, ''tittira'' (partridge), ''daksha'' (rooster) sizzled with ununctuous, sour and pungent articles; and vegetable soups of dry ''mulaka'' (radish) and ''kulattha''. The patient should also be given the juice of ''matulunga'' mixed with honey, ''pippali, maricha'' and ''shunthi'' for bringing the [[pitta]] to its own course [128-130]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कटुतीक्ष्णोष्णलवणैर्भृशाम्लैश्चाप्युपक्रमः||१३०|| <br /> <br /> आपित्तरागाच्छकृतो [१] वायोश्चाप्रशमाद्भवेत्| <br /> स्वस्थानमागते पित्ते पुरीषे पित्तरञ्जिते||१३१|| <br /> <br /> निवृत्तोपद्रवस्य स्यात् पूर्वः कामलिको विधिः|१३२|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭutīkṣṇōṣṇalavaṇairbhr̥śāmlaiścāpyupakramaḥ||130|| <br /> <br /> āPittarāgācchakr̥tō [1] vāyōścāpraśamādbhavēt| <br /> svasthānamāgatē pittē purīṣē Pittarañjitē||131|| <br /> <br /> nivr̥ttōpadravasya syāt pūrvaḥ kāmalikō vidhiḥ|132| <br /> <br /> kaTutIkShNoShNalavaNairbhRushAmlaishcApyupakramaH||130|| <br /> <br /> ApittarAgAcchakRuto [1] vAyoshcAprashamAdbhavet| <br /> svasthAnamAgate pitte purIShe pittara~jjite||131|| <br /> <br /> nivRuttopadravasya syAt pUrvaH kAmaliko vidhiH|132| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Katu'' (pungent), ''teekshna'' (sharp), ''ushna'' (hot), ''lavana'' (saline) and extremely ''amla'' (sour) drugs should be continued till the stool of the patient acquires the color of [[pitta]] and the [[vata]] gets alleviated. When the [[pitta]] returns to its own habitat, the stool gets colored with [[pitta]] and the patient is relieved of complications, then further, the line of treatment described earlier for the treatment of ''kamala'' (''koshthashrita'') should be used [130-132]<br /> <br /> === ''Haleemaka'' (obstructive jaundice) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यदा तु पाण्डोर्वर्णः स्याद्धरितश्यावपीतकः||१३२|| <br /> <br /> बलोत्साहक्षयस्तन्द्रा मन्द्राग्नित्वं मृदुज्वरः| <br /> स्त्रीष्वहर्षोऽङ्गमर्दश्च श्वासस्तृष्णाऽरुचिर्भ्रमः||१३३|| <br /> <br /> हलीमकं तदा तस्य विद्यादनिलपित्ततः|१३४| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yadā tu pāṇḍōrvarṇaḥ syāddharitaśyāvapītakaḥ||132|| <br /> <br /> balōtsāhakṣayastandrā mandrāgnitvaṁ mr̥dujvaraḥ| <br /> strīṣvaharṣō'ṅgamardaśca śvāsastr̥ṣṇā'rucirbhramaḥ||133|| <br /> <br /> halīmakaṁ tadā tasya vidyādanilaPittataḥ|134| <br /> <br /> yadA tu pANDorvarNaH syAddharitashyAvapItakaH||132|| <br /> <br /> balotsAhakShayastandrA mandrAgnitvaM mRudujvaraH| <br /> strIShvaharSho~a~ggamardashca shvAsastRuShNA~arucirbhramaH||133|| <br /> <br /> halImakaM tadA tasya vidyAdanilapittataH|134| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If a patient suffering from ''pandu'' develops green, black or yellow color and suffers from diminution of strength and enthusiasm; drowsiness, ''agnimandya'' (low digestion), mild fever, lack of libido (''strisu aharsho''), ''angamarda'' (malaise/ body ache), dyspnea, ''trishna'' (morbid thirst), anorexia and giddiness, the ailment is called ''haleemaka'' and is caused by the aggravation of [[vata]] and [[pitta]] [[dosha]] [132-134]<br /> <br /> === Treatment of ''haleemaka'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुडूचीस्वरसक्षीरसाधितं माहिषं घृतम्||१३४|| <br /> <br /> स पिबेत्त्रिवृतां स्निग्धो रसेनामलकस्य तु| <br /> विरिक्तो मधुरप्रायं भजेत् पित्तानिलापहम्||१३५|| <br /> <br /> द्राक्षालेहं च पूर्वोक्तं सर्पींषि मधुराणि च| <br /> यापनान् क्षीरबस्तींश्च शीलयेत्सानुवासनान्||१३६|| <br /> <br /> मार्द्वीकारिष्टयोगांश्च पिबेद्युक्त्याऽग्निवृद्धये| <br /> कासिकं चाभयालेहं पिप्पलीं मधुकं बलाम्||१३७|| <br /> <br /> पयसा च प्रयुञ्जीत यथादोषं यथाबलम्|१३८| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> guḍūcīsvarasakṣīrasādhitaṁ māhiṣaṁ ghr̥tam||134|| <br /> <br /> sa pibēttrivr̥tāṁ snigdhō rasēnāmalakasya tu| <br /> viriktō madhuraprāyaṁ bhajēt pittānilāpaham||135|| <br /> <br /> drākṣālēhaṁ ca pūrvōktaṁ sarpīṁṣi madhurāṇi ca| <br /> yāpanān kṣīrabastīṁśca śīlayētsānuvāsanān||136|| <br /> <br /> mārdvīkāriṣṭayōgāṁśca pibēdyuktyā'gnivr̥ddhayē| <br /> kāsikaṁ cābhayālēhaṁ pippalīṁ madhukaṁ balām||137|| <br /> <br /> payasā ca prayuñjīta yathādōṣaṁ yathābalam|138| <br /> <br /> guDUcIsvarasakShIrasAdhitaM mAhiShaM ghRutam||134|| <br /> <br /> sa pibettrivRutAM snigdho rasenAmalakasya tu| <br /> virikto madhuraprAyaM bhajet pittAnilApaham||135|| <br /> <br /> drAkShAlehaM ca pUrvoktaM sarpIMShi madhurANi ca| <br /> yApanAn kShIrabastIMshca shIlayetsAnuvAsanAn||136|| <br /> <br /> mArdvIkAriShTayogAMshca pibedyuktyA~agnivRuddhaye| <br /> kAsikaM cAbhayAlehaM pippalIM madhukaM balAm||137|| <br /> <br /> payasA ca prayu~jjIta yathAdoShaM yathAbalam|138| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Patients suffering from ''haleemaka'' should take the recipe prepared from buffalo ghee by adding the juice of ''guduchi'' and milk.<br /> <br /> After oleation with this oil the patient should take ''trivritta'' mixed with the juice of ''amalaki'' which causes purgation. <br /> <br /> Thereafter food and drinks which are dominated by sweet taste and are alleviators of [[pitta]] and [[kapha]] should be given.<br /> <br /> The patient should take ''drakshaleha'' described earlier (vide verse 100-102 in this chapter in the name of ''dhatryavaleha'') and recipes of medicated ghee prepared by boiling with sweet drugs (vide verse 51-52). The patient should habitually indulge in taking different types of yapana [[basti]] (a type of medicated enema), kshara [[basti]] and anuvasana [[basti]] discussed in [ Cha. Sa. [[Siddhi Sthana]] ]. He should also take different recipes of ''arishta'' prepared from grapes (''draksharishta'') for the promotion of power of digestion. ''Abhaya leha'' described in the treatment of ''kasa'' [Cha. Sa. [[Chikitsa Sthana]] 18/57-62] may also be taken. Alternatively the patient may also take ''pippali, madhuka'' and ''bala'' along with milk depending upon the [[dosha]] aggravated and the strength of the patient [134-138]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकौ- <br /> <br /> पाण्डोः पञ्चविधस्योक्तं हेतुलक्षणभेषजम्||१३८|| <br /> <br /> कामला द्विविधा तेषां साध्यासाध्यत्वमेव च| <br /> <br /> तेषां विकल्पो यश्चान्यो महाव्याधिर्हलीमकः| <br /> तस्य चोक्तं समासेन व्यञ्जनं सचिकित्सितम्||१३९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkau- <br /> <br /> pāṇḍōḥ pañcavidhasyōktaṁ hētulakṣaṇabhēṣajam||138|| <br /> <br /> kāmalā dvividhā tēṣāṁ sādhyāsādhyatvamēva ca| <br /> <br /> tēṣāṁ vikalpō yaścānyō mahāvyādhirhalīmakaḥ| <br /> tasya cōktaṁ samāsēna vyañjanaṁ sacikitsitam||139||<br /> <br /> tatra shlokau- <br /> <br /> pANDoH pa~jcavidhasyoktaM hetulakShaNabheShajam||138|| <br /> <br /> kAmalA dvividhA teShAM sAdhyAsAdhyatvameva ca| <br /> <br /> teShAM vikalpo yashcAnyo mahAvyAdhirhalImakaH| <br /> tasya coktaM samAsena vya~jjanaM sacikitsitam||139|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> To sum up, the topics discussed in this chapter are:<br /> *Five types of ''pandu'' along with the etiology, signs and symptoms; and treatment<br /> *Two types of ''kamala'' and their curability as well as incurability<br /> *Different varieties of ''kamala''<br /> *''Haleemaka'', which is a serious disease along with its signs and symptoms; and treatment [138-139]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने <br /> पाण्डुरोगचिकित्सितं नाम षोडशोऽध्यायः||१४0|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē <br /> pāṇḍurōgacikitsitaṁ nāma ṣōḍaśō'dhyāyaḥ||140||<br /> <br /> ityagniveshakRute tantre~aprApte dRuDhabalasampUrite cikitsAsthAne <br /> pANDurogacikitsitaM nAma ShoDasho~adhyAyaH||16|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus ends the sixteenth chapter in [[Chikitsa Sthana]] dealing with the treatment of ''pandu roga'' in the work of Agnivesha which was redacted by Charaka and because of its unavailability was supplemented by Dridhabala [140]<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *The important pathological factors in ''pandu'' are aggravated three [[dosha]] with dominant [[pitta]] leading to slow metabolism at level of blood ([[rakta dhatu]]), the fatty tissue [[meda dhatu]]) and [[ojas]] qualities (affecting the vitality). <br /> *The dietary factors like alkaline, sour, saline, hot and mutually contradictory foods, unwholesome food, ''nishpava'' (a type of pulses), ''masha, pinyaka'' (oil cake) and ''tila'' oil; lifestyle factors like indulging in day sleep, performing exercise and sex before digestion of the food, disobedience of the seasonal regimens (''ritu vaishamya''), suppression of the natural urges; iatrogenic factors like Improper administration of [[Panchakarma]] measures (''pratikarma vaishamya'') and the psychological factors like affliction of mind with passion, worry, fear, anger, grief are responsible for ''pandu''. <br /> *Heart and circulatory system are involved in the pathogenesis of ''pandu'' which is presented at the sites of skin and [[mamsa dhatu]] (flesh).<br /> *The specific features are observed as per the [[dosha]] dominance in pathogenesis. <br /> *Person indulging in the habitual consumption of clay (''mrittika'') gets [[dosha]] aggravated according to the taste of mud viz. astringent mud aggravates [[vata]], saline and alkaline mud aggravates [[pitta]] and sweet mud aggravates [[kapha]] [[dosha]]. These factors cause ''pandu'' by affecting the [[dhatu]] and [[ojas]]. <br /> *Chronic ''pandu roga'' is incurable. The prognosis depends upon involvement of [[dhatu] and its intensity. <br /> *If a patient of ''pandu roga'' excessively consumes [[pitta]] vitiating diet and regimen, the aggravated [[pitta]] causes ''kamala'' by involving the [[rakta]] and the [[mamsa dhatu]]. <br /> *First principle of management of ''pandu'' is administration of internal oleation ([[snehana]]) followed by strong (''teekshna'') emetic and purgation therapies for cleansing of the body (''shodhana''). In patients of ''kamala'', mild purgation therapy with bitter drugs is advised.<br /> *''Kamala'' is of two types: ''Koshtha-shaksha shrita'' and ''shakhashrita''. In ''koshtha-shakhashrita kamala'' there is excess increase in [[pitta]]. <br /> *In ''shakhashrita kamala'', [[pitta]] is obstructed by [[kapha]] and improperly circulated by [[vata]]. Therefore the treatment principles differ in both. <br /> *In ''koshtha-shaksha shrita kamala'', mild purgation is administered with bitter drugs with a focus on pacification of[[pitta]]. <br /> *In ''shakhashrita kamala'', principles of management are pacification of [[kapha]], and ''anulomana'' of [[vata]] to derive [[pitta]] to its own natural site. Therefore ''ruksha, amla, katu'' drugs are used in the treatment. <br /> *Suitable changes (combinations and permutations) in the treatment should be prescribed depending upon the strength of the [[dosha]] in the patient. The therapy should be dominated by unctuous drugs (oil, ghee etc) for ''vatika'' type of ''pandu''; by bitter and cooling drugs for ''paittika'' type and by pungent, bitter and hot drugs for [[kapha]]ja type of ''pandu''.<br /> *Strong elimination therapy is advised to remove the swallowed mud from the body after considering the strength of the patient. After the body is cleansed, different types of medicated ghee should be prescribed to the patient for promotion of strength. <br /> *''Haleemaka'' and is caused by the aggravation of [[vata]] and [[pitta]] [[dosha]]. Hence the treatment focus on pacification of [[vata]] and [[pitta]] [[dosha]].<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> === Pathological factors ===<br /> *[[Dosha]]: [[Pitta]] dominant three [[dosha]], sadhaka and ranjak [[pitta]], vyana and samana [[vata]], avalambak and kledaka [[kapha]] <br /> *[[Dhatu]](vitiated factors): [[Rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] <br /> *Status of [[agni]]/ dhatwagni/bhutagni: ''Manda'' at [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] level <br /> *Origin of disease: Heart and channels, Liver and spleen <br /> *Sites of vitiation: All body <br /> *Sites of clinical presentation: All body specifically skin and subcutaneous tissues <br /> *Srotas involved :Rasavaha, Raktavaha <br /> *Type of ''samprapti'' : ''Avarodha'' and ''kshaya'' <br /> *Basic principles of treatment: ''Shodhana'' (mainly [[virechana]]) and ''shamana'' (mainly [[pitta]] shamana) as per [[dosha]] dominance<br /> <br /> === General considerations ===<br /> ''Pandu'' can be related with the disorders of improper formation of blood tissue due to vitiation of [[pitta]] [[dosha]]. [[Pitta]] [[dosha]] is considered to be responsible for all digestion, transformation and metabolism processes in the body. Therefore, the disorders like anemia, nutritional deficiency are mainly considered under ''pandu roga''. The disorders which include pathologies of impaired metabolism and formation of plasma, blood, muscles and fat can also be referred under the umbrella of ''pandu roga''. These include thyroid function disorders, hematological disorders like thalessemia, jaundice etc.<br /> <br /> === Etiological factors observed in present era ===<br /> ==== Diet ==== <br /> The dietary factors that cause vitiation of [[pitta]] [[dosha]] and poor nutritional status of [[rakta dhatu]] are enlisted to cause ''pandu''. These include the items having sour, salt, pungent taste, hot potency, alkaline nature, mutually contradictory and unwholesome food. These shall be avoided to prevent ''pandu''. <br /> *Food with sour taste (''amla ahara'') includes sour curd, lemons, citric acid, pickles, and food with preservatives as jams, cold drinks, sauces, tamarind etc. <br /> *''Lavana ahara'' may be taken as food with excess salts or with salt added in packaged food or as pickles, chutneys etc.<br /> *''Madya'' includes alcoholic beverages as rum, beer, whisky, vodka etc.<br /> *''Kshara'' includes soda used in diet, cold drinks and beverages. <br /> *''Ati tikshna ahara'' includes as excessively spicy,pungent items as ''chhole, chaats, pakode, panipuri, chaaps, rajma,'' spicy vegetables and other dishes.<br /> *''Ati ushna'' includes food articles which are either very hot as tea, coffee etc. or which increase the metabolic activities of the body or also as very hot temperature.<br /> *''Mrittika bhakshana'' is considered as either oral ingestion of mud or use of articles contaminated with mud as unclean hands and fingers or as improperly washed vegetables or eatables.<br /> *''Asatmya bhojana'' may include food items that are not adopted or suited. It may be considered as sudden change of food style or habit or also as junk food used today, as they are not beneficial. <br /> <br /> Some scientific studies have proven the role of some of the ''aharaja'' factors in the causation of ''panduroga'' as tea (considered as ''ati ushna nidana'') has been proved to cause iron deficiency anemia by interfering with the absorption of iron. Similarly ''madya'' (alcohols) cause megaloblastic anemia by hampering the folate absorption.<br /> <br /> ==== Lifestyle ==== <br /> <br /> Excess day time sleep, exercise beyond one’s capacity and at improper time can lead to ''pandu''. Therefore, proper quality sleep and proper exercise are preventive measures for ''pandu''.<br /> <br /> ==== Psychological factors ==== <br /> <br /> Passion, worry, fear, anger and grief can affect digestion leading to poor nutritional status. Hence blissful state of mind is needed for proper nutrition. Rai and Kar in their observational study showed that worries, fear and grief are major etiological factors for iron deficiency anemia. These factors cause significant reduction of serum and bone marrow, while inhibiting the process of erythropoiesis. The inflammatory mediators such as IL-6, hepcidin are mediators in this pathology originated from grief and fear.&lt;ref&gt;Rai Shalini, Kar Anukul C. A review of role of psychological factors in the etiopathogenesis of Pandu roga with reference to iron deficiency anemia.Ayu,2016 Jan-March,31(1):18-21. &lt;/ref&gt;<br /> <br /> ==== Iatrogenic factors ==== <br /> <br /> Improper administration of oleation therapy and [[Panchakarma]] procedures can lead to ''pandu''.<br /> <br /> ==== Pathophysiology ====<br /> [[File:Pandu.png|500px|thumb]] <br /> The cardinal feature of pandu is appearance of pallor on skin of the patient. Complexion and luster of skin is maintained by [[rasa dhatu]] and [[rakta dhatu]]. The texture is maintained by [[mamsa dhatu]]. Unctuousness is maintained by [[meda dhatu]]. These four [[dhatu]] are important for maintaining the natural appearance of skin. In ''pandu'', the vitiated [[pitta]], due to its hot and sharply acting properties, impairs digestion process at [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] leading to their poor formation. The [[rasa dhatu]] transport channels originate in the heart and its vessels. The origin of channels of [[rakta]] is in the liver and spleen. Therefore, symptoms related to cardio-vascular system and hematological system. <br /> <br /> The sequential nourishment of [[rasa dhatu]], [[rakta dhatu]], [[mamsa dhatu]] and [[meda dhatu]] is impaired leading to poor quality tissues. Thus, overall functions of these systems are disturbed in ''pandu''. <br /> <br /> The type of pathogenesis includes formation of same [[dhatu]] (improperly formed tissues) due to poor digestive and metabolic processes at the above mentioned levels. Therefore, the treatment principle includes correction of this impairment.<br /> <br /> ==== Clinical features and conditions resembling the disease ====<br /> <br /> '''Premonitory symptoms''': Palpitations, dryness, lack of sweating, fatigue. <br /> <br /> '''Signs''': Decrease in complexion, strength, unctuousness and vitality are observed in ''pandu''. <br /> <br /> Various features related to that are categorized below:<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs<br /> ! scope=&quot;col&quot;| Symptoms Manifested<br /> |-<br /> | 1<br /> | ''Varnakshaya'' (depletion of complexion) <br /> | Discoloration of skin, poor lustre, pallor, yellowish, dark yellow skin <br /> |-<br /> | 2<br /> | ''Balakshaya'' (depletion of strength) <br /> | Weakness, fatigue<br /> |-<br /> | 3<br /> | ''Snehakshaya'' (depletion of unctuousness) <br /> | Dryness, poor quality of tissues <br /> |-<br /> | 4<br /> | ''Ojakshaya'' (depletion of vitality)<br /> | Fearfulness, excess worries, impaired sensations, lack of concentration, poor appearance <br /> |}<br /> <br /> The following clinical features are observed in ''pandu''. The involvement of [[dosha]], dushya and channels are as given in the following table:<br /> <br /> ==== Signs ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs<br /> ! scope=&quot;col&quot;| [[Dosha]]<br /> ! scope=&quot;col&quot;| ''Dushya''<br /> ! scope=&quot;col&quot;| ''Srotas''<br /> |-<br /> | 1<br /> | ''Dhatushaithilya'' (laxity of tissues)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 2<br /> | [[Dhatu]] gaurava (heaviness in tissues)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 3<br /> | ''Varnakshaya'' (poor complexion)<br /> | [[Vata]], [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 4<br /> | ''Balakshaya'' (poor strength)<br /> | [[Vata]],[[Pitta]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 5<br /> | ''Snehakshaya'' (depletion of unctuousness)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rakta dhatu]], [[Meda dhatu]]<br /> | ''Raktavaha, Medavaha''<br /> |-<br /> | 6<br /> | [[Oja]]gunakshaya'' (depletion of vitality)<br /> | [[Vata]], [[Pitta]]<br /> | Sapta [[dhatu]]<br /> | ''Saptadhatu vaha''<br /> |-<br /> | 7<br /> | ''Raktalpata'' (poor quality and less blood)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 8<br /> | ''Medalpata'' (poor quality and less fats) <br /> | [[Vata]], [[Pitta]]<br /> | [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 9<br /> | ''Nihasarta'' (poor quality tissues) <br /> | Tri[[dosha]]<br /> | Sapta[[dhatu]]<br /> | ''Saptadhatu vaha''<br /> |-<br /> | 10<br /> | ''Shithilendriya'' (impairment of senses) <br /> | Tri[[dosha]]<br /> | Sapta[[dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 11<br /> | ''Vaivarnya'' (discoloration) <br /> | [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 12<br /> | ''Panduta'' (pallor) <br /> | [[Pitta]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |}<br /> <br /> ==== Symptoms ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Symptoms<br /> ! scope=&quot;col&quot;| [[Dosha]]<br /> ! scope=&quot;col&quot;| ''Dushya''<br /> ! scope=&quot;col&quot;| ''Srotas''<br /> |-<br /> | 1<br /> | ''Karnakshweda'' (tinnitus)<br /> | [[Vata]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 2<br /> | ''Hatanala'' (poor digestion)<br /> | [[Kapha]], [[Vata]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 3<br /> | ''Daurbalya'' (weakness)<br /> | [[Vata]], [[Pitta]]<br /> | Sapta[[dhatu]]<br /> | ''Rasavaha, Raktavaha''<br /> |-<br /> | 4<br /> | ''Sadana'' (bodyache)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 5<br /> | ''Annadwesha'' (anorexia)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 6<br /> | ''Shrama'' (overworked, fatigue)<br /> | [[Vata]]<br /> |[[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 7<br /> | ''Bhrama'' (vertigo)<br /> | [[Vata]], [[Pitta]]<br /> | [[Majja dhatu]]<br /> | ''Majjavaha''<br /> |-<br /> | 8<br /> | ''Gatrashoola'' (pain)<br /> | [[Vata]]<br /> | [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 9<br /> | ''Jwara'' (feverishness)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]], Sweda<br /> | ''Rasavaha, Swedavaha''<br /> |-<br /> | 10<br /> | ''Shwasa'' (dyspnea)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha, Pranavaha''<br /> |-<br /> | 11<br /> | ''Gaurava'' (heaviness)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 12<br /> | ''Aruchi'' (aversion to food)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 13<br /> | ''Mridit iv gatrata'' (kneading pain)<br /> | [[Vata]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 14<br /> | ''Pidita unmathit gatrata'' (churning, pressing pain)<br /> | [[Vata]]<br /> | [[Rasa dhatu]],[[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 15<br /> | ''Akshikutashotha'' (pre-orbital swelling)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 16<br /> | ''Harita lomata'' (greenish body hair)<br /> | [[Pitta]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 17<br /> | ''Shirnalomata'' (falling body hair)<br /> | [[Vata]],[[Pitta]]<br /> | [[Asthi dhatu]]<br /> | ''Asthivaha''<br /> |-<br /> | 18<br /> | ''Hatprabhatva'' (poor luster)<br /> | [[Pitta]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 19<br /> | ''Kopana'' (irritability)<br /> | [[Pitta]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 20<br /> | ''Shishiradwesha'' (disliking cold)<br /> | [[Vata]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 21<br /> | ''Nindraluta'' (excessive sleepiness)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 22<br /> | ''Sthivanadhikya'' (excessive sputum)<br /> | [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |-<br /> | 23<br /> | ''Alpawaka'' (less speaking)<br /> | [[Vata]]<br /> | [[Rakta dhatu]]<br /> | ''Raktavaha''<br /> |-<br /> | 24<br /> | ''Pindikodweshtanam'' (pain in calf muscles)<br /> | [[Vata]]<br /> | [[Rakta dhatu]],[[Mamsa dhatu]]<br /> | ''Raktavaha, Mamsavaha''<br /> |-<br /> | 25<br /> | ''Katiurupadaruka Sadana'' (pain in legs, thighs, and the lumbar region)<br /> | [[Vata]]<br /> | [[Rasa dhatu]], [[Rakta dhatu]], [[Mamsa dhatu]]<br /> | ''Rasavaha, Raktavaha, Mamsavaha''<br /> |-<br /> | 26<br /> | ''Arohaneayasa'' (dyspnea on climbing)<br /> | [[Vata]], [[Kapha]]<br /> | [[Rasa dhatu]]<br /> | ''Rasavaha''<br /> |}<br /> <br /> ==== Differentiating features of ''dosha'' dominance ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! colspan=&quot;3&quot;|Changes in color and texture manifested in the whole body and its parts<br /> |-<br /> ! scope=&quot;col&quot;| ''Vata'' dominant ''pandu''<br /> ! scope=&quot;col&quot;| ''Pitta'' dominant ''pandu''<br /> ! scope=&quot;col&quot;| ''Kapha'' dominant ''pandu''<br /> |-<br /> | Blackish or dark reddish discoloration of the skin, blood vessels, nails, face and eyes<br /> | Yellowish discoloration of skin, the skin, blood vessels, nails, face and eyes<br /> | Whitishness discoloration of skin, the skin, blood vessels, nails, face and eyes<br /> |-<br /> ! colspan=&quot;3&quot;|Features related to urine and stool<br /> |-<br /> | Blackish urine &amp; stool, dry stools<br /> | Yellowish colored urine &amp; stool, foul smelling and loose stools <br /> | Whitishness in the urine &amp; stool <br /> |-<br /> ! colspan=&quot;3&quot;|Features related to ''agni''<br /> |-<br /> | Tastelessness in the mouth<br /> | Pungent taste in mouth<br /> | Sweet taste in the mouth<br /> |-<br /> | rowspan=&quot;6&quot;|Abdominal distension<br /> | Does not relish food<br /> | Anorexia<br /> |-<br /> | rowspan=&quot;2&quot;|Improper digestion of food<br /> | Heaviness<br /> |-<br /> | Excessive salivation<br /> |-<br /> | Sour Eructation<br /> | Laziness<br /> |-<br /> | Eructation associated with burning sensation<br /> | rowspan=&quot;2&quot;| Vomiting<br /> |-<br /> | Burning Sensation<br /> |-<br /> ! colspan=&quot;3&quot;|Other features<br /> |-<br /> | Pain in the body, pricking pain<br /> | Increased body temperature<br /> | Drowsiness<br /> |-<br /> | Tremor<br /> | Excessive thirst<br /> | Horripilation<br /> |-<br /> | Headache<br /> | Fainting due to excessive thirst/coma<br /> | Mental fatigue<br /> |-<br /> | Weakness<br /> | Profuse sweating<br /> | Fainting<br /> |-<br /> | Pain in the sides of the chest<br /> | rowspan = &quot;2&quot;| Weakness<br /> | Prostration<br /> |-<br /> | Giddiness<br /> |Inability to speak<br /> |-<br /> | Swelling/Edema<br /> | Feeling of darkness in front of eyes<br /> | Cough, Dyspnea, Edema<br /> |-<br /> ! colspan=&quot;3&quot;|Likings and Dislikings<br /> |-<br /> | <br /> | Longing for cold things and environment<br /> | Likings for pungent items<br /> |-<br /> |<br /> | Dislike for hot food and atmosphere; also, do not suit the patient<br /> | Likings for ununctuous things<br /> |-<br /> |<br /> | Dislike for sour food; also, do not suit the patient<br /> | Likings for hot things<br /> |}<br /> <br /> ==== Consequences of [[dhatu]] kshaya ====<br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Pathological event<br /> ! scope=&quot;col&quot;| Consequence<br /> ! scope=&quot;col&quot;| Objectivity<br /> |-<br /> | 1<br /> | [[Rasa dhatu]] kshaya<br /> | Decrease in quality tissue that nourish blood or required for formation of blood<br /> | Deficiency in factors required for erythropoietin like vitamin B12, Vitamin K, iron, transferin, ferritin, protein like hemochrome which give red color to blood, electrolyte Na+, K+, Ca++, Mg+, H+, Cl-, albumin, globulins, glucose, amino acid, nucleic acids and lipoprotein, endocrine secretions regulating fluid metabolism <br /> |-<br /> | 2<br /> | [[Rakta dhatu]] kshaya<br /> | Decrease in quality and volume of blood and further decrease in factors required for formation of [[mamsa dhatu]](muscles) <br /> | Decrease in volume of whole blood, hematocrit percentage, endocrine secretions regulating blood metabolism <br /> |-<br /> | 3<br /> | [[Mamsa dhatu]] kshaya<br /> | Decrease in quality and volume of muscles and further decrease in factors required for formation of [[mamsa dhatu]](muscles)<br /> | Decrease in muscle proteins, endocrine secretions regulating muscle metabolism <br /> |-<br /> | 4<br /> | [[Meda dhatu]] kshaya<br /> | Decrease in quality and volume of fats and lipids and further decrease in factors required for formation of [[asthi dhatu]](bones)<br /> | Decrease in lipids, endocrine secretions regulating lipid metabolism <br /> |}<br /> <br /> ==== List of diseases with features as observed in ''pandu'' ====<br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Signs and Symptoms<br /> ! scope=&quot;col&quot;| Diseases<br /> |-<br /> | 1<br /> | Blackish discoloration of the skin<br /> | Megaloblastic anemias (Vitamin B12 and folic acid deficiency) as reversible melanin skin hyperpigmentation which develops mainly over the knuckles<br /> |-<br /> | 2<br /> | Reddish discoloration of body parts<br /> | Development of petechiae, echymosis or bruises on the body due to thrombocytopenia associated with anemia (as in Aplastic anemias). Anemia due to Addison’s disease (increased tanning)<br /> |-<br /> | 3<br /> | Dry skin or body<br /> | Megaloblastic anemias due to the abnormal proliferation of epithelial cell surfaces. Anemia due to hypothyroid states<br /> |-<br /> | 4<br /> | Reddish or Blackish discoloration in eyes, face and nails<br /> | Body parts due to spontaneous bleeding manifestations, pernicious anemia <br /> |-<br /> | 5<br /> | Blackish urine<br /> | Cola colored urine in various types of intravascular hemolytic anemias when the plasma hemoglobin exceeds the haptoglobin binding capacity<br /> |-<br /> | 6<br /> | Blackish stool/melena <br /> | Gastrointestinal bleeding responsible for anemias - may be due to any ulcers or worm infestations or any other cause<br /> |-<br /> | 7<br /> | Dryness of stool or constipation<br /> | Megaloblastic anemias and anemia due to hypothyroidism<br /> |-<br /> | 8<br /> | &quot;Pins and needles&quot; sensation<br /> | pernicious anemias as well as in megaloblastic anemias<br /> |-<br /> | 9<br /> | Tremors<br /> | Cobalamin deficiency which causes peripheral neuropathy and degeneration of the posterior and pyramidal tracts of the spinal cord<br /> |-<br /> | 10<br /> | Loss of taste/distaste<br /> | Pernicious anemia<br /> |-<br /> | 11<br /> | Bodyache<br /> | Hemolytic anemia, hypothyroidism<br /> |}<br /> <br /> The observations of resemblance with diseases in conventional system of medicine show that all types of anemia specially megaloblastic anemia, pernicious anemia, hypothyroidism, haemolytic anemia can be considered under umbrella of ''pandu''. The objective parameters used for these disorders can be utilized for research on efficacy of [[Ayurveda]] therapies in management of ''pandu''.<br /> <br /> === ''Kamala'' ===<br /> <br /> In the second part of the chapter ''pandu, kamala'' is elaborately described. If a person suffering from ''pandu'' follows [[pitta]] provoking diet and lifestyle, he suffers from ''kamala''. This shows ''kamala'' is consequence of ''pandu'' or ''pandu'' is essential causative factor for ''kamala''. This shows the relation of jaundice originated due to hemolytic anemia. In other types of jaundice, this notion is not observed in practice. ''Kamala'' can occur without ''pandu''. (Su.Utt.44/9, A.Hri.Ni.13/15-17)<br /> <br /> Yellowish discoloration of sclera, skin, face, nails, and urine associated with constitutional symptoms like anorexia, debility, indigestion, loss of physical strength is called ''Kamala''.<br /> <br /> ==== Types of ''kamala'' ====<br /> <br /> ==== 1. ''Shakhashrita Kamala/Alpa'' [[pitta]] (''Dhatu ashrita'') ====<br /> <br /> The passage of [[pitta]] is obstructed by vitiated [[kapha]] and not allowing [[pitta]] to enter ''kostha'', it will cause excess of [[pitta]] in body tissues in ''Shakhasrita Kamala''. This involves the obstructive pathologies at hepatic circulation. As the [[pitta]] cannot enter the gastro-intestinal tract, it leads to clay colored stools. In obstructive jaundice, bilirubin has no access to the intestine and it is the reason for pale stools. <br /> <br /> This description of stools being clay colored, but the urine being yellow shows that they were very close in concept to the modern day physiopathology of obstructive jaundice especially hepatocellular ones (wherein due to an inability of the bile to pass into the gastrointestinal tract it circulates into the blood and the conjugated bilirubin being water soluble fraction is filtered and passes out into the urine). Further the description of [[pitta]] being the bi-product of [[rakta]] is also very similar to the fact of bile being produced as a result of Red Blood Cell destruction. The most common cause is gall stones in the common bile duct and pancreatic cancer in the head of pancreas. Also, a group of parasites known as liver flukes can live in common bile duct causing obstructive jaundice. Biliary atresia, cholanjiocarcinoma, pancreatitis, cholestasis of pregnancy and pancreatic pseudocysts are causes for obstruction of bile flow into the duodenum.<br /> <br /> ==== 2. ''Kostha Shakhashrita Kamala/bahu'' [[pitta]] (''Maha Srotasashrita'') ====<br /> <br /> ''Bahupitta kamala'' or ''Kostha-shakhasrita kamala'' mostly resembles the pre-hepatic and hepatocellular jaundice. Pre-hepatic jaundice is caused by anything which causes haemolysis. Pre-hepatic cause include severe malaria, certain genetic diseases such as sickle cell anemia, spherocytosis, thalassemia, pyruvate kinase deficiency and glucose 6-phospate dehydrogenase (G6PD) deficiency, which lead to increased destruction of red cells and therefore hemolytic jaundice. Hepato-cellular Jaundice can be caused by acute or chronic hepatitis, hepatotoxicity, cirrhosis, drug induced hepatitis and alcoholic liver disease.<br /> <br /> === ''Haleemaka'' ===<br /> <br /> ''Haleemaka'' is a further stage of ''pandu''. Reduced oxygen carrying capacity of blood (reduced ''jeevan karma'') causes depletion of strength and work capacity. This further leads to lack of libido and bodyache. Condition resembles cholestasis. Bile stasis and back pressure leads to liver failure which leads to the further symptoms of ''halimaka'' or sclerosing cholangitis. It is characterized by severe fatigue (''bala utsaha hani''), jaundice (''harita pita meda''), dark urine, cirrhosis, portal hypertension and hepato-megaly.<br /> <br /> === ''Panaki'' ===<br /> <br /> ''Panaki'', another disease in same context of ''halimaka'', explains the condition of malabsorption especially of fat due to lack of bile juice in digestion due to obstruction which leads to steatorrhoea (''bhinna varcha''). Reduced fat absorption leads to deficiency of fat soluble vitamins such as A, D, E and K.<br /> <br /> === ''Kumbha Kamala'' ===<br /> <br /> The description of ''kumbha kamala'' denotes the advanced stage of ''Kostha-shakhasrita kamala'' wherein the main seat of pathology is situated somewhere in the gastro-intestinal tract. ''Kumbha'' is one of the synonyms of ''koshtha''. Edema is described as one of the important clinical features of ''kumbha kamala'' (Su. Utt. 44).<br /> <br /> Both types of ''kamala'', if not treated convert into difficult to treat and hardened skin. ''Kumbha kamala'' could also refer to the presentation of the patient having distended abdomen i.e. ascitis, which is one of the important clinical feature of liver diseases, which are also the main cause of jaundice. <br /> <br /> Liver is the main seat for a number of functions and when it gets severely deranged the liver functions are affected. The clinical picture of ''kumbha kamala'' corresponds to these as observed below:<br /> <br /> *The production of majority of proteins as albumin, few globulins, cerulo-plasmin etc., is hampered leading to edema in the various body parts (''Bhrusham Shoonam cha Manavaḥ'') and dryness in the body.<br /> *The coagulation profile gets affected leading to increased prothrombin time, the presentation of esophageal varices, bleeding per rectum etc. Here the same features have been described as ''sarakta akshi mukha, chhardi vida mootra'' meaning blood seen or coming out of the eyes, mouth or in the vomitus (esophageal varices), through the stool (haemorrhoids) or through the urine.<br /> *The derangement of liver structure in these diseases leads to some presentation of obstructive jaundice with yellow urine (''peeta mootrata'').<br /> *The stage of altered consciousness has also been described as ''tandra moha samanvita'' (acting as if sleepy or having altered perception - semiconscious state).<br /> *The stage of hepatic coma has also been described as ''nashta sangya'' means the person is not able to recognise and perceive anything – unconscious state (''Sangya Nama Grahanena'').<br /> *The excessive dryness (''kharibhuta'') is generally due to increased bile salts deposition leading to pruritus and dryness of skin. This dryness further leads to the hardness.<br /> *As liver disorders progress, coagulatory defects begin leading to upper G.I. track bleed causing black stools/''malena''(''Krishna shakrita''). Secondly conjugated bilirubin which does not enter intestine becomes urobilinogen giving urine dark color (''krishna mutra'').<br /> *Excessive edema is observed all over body. Cirrhosis of the liver is a condition that causes reduction in plasma protein concentration. Cirrhosis means development of large amounts of fibrous tissue among the liver parenchymal cells. One result is failure of these cells to produce sufficient plasma proteins, leading to decreased plasma colloid osmotic pressure and the generalized edema that goes with this condition. Another way that liver cirrhosis causes edema is that the liver fibrosis sometimes compresses the abdominal portal venous drainage vessels as they pass through the liver before emptying back into the general circulation. Blockage of this portal venous outflow raises capillary hydrostatic pressure throughout the gastrointestinal area and further increases filtration of fluid out of the plasma into the intra-abdominal areas. When this occurs, the combined effects of decreased plasma protein concentration and high portal capillary pressures cause transudation of large amounts of fluid and protein into the abdominal cavity, a condition referred to as ascites.<br /> *Hematemesis/bleeding in eyes,per rectum, hematuria (''Sarakta akshi mukha chhardi vinamutra'') explains the bleeding disorders which begin in late hepatic disorders. <br /> *Fainting (''tamah pravesha'') is due to reduced cerebral perfusion due to various causes like gastrointestinal bleed, electrolyte or metabolic disturbance.<br /> *Drowsiness (''tandra''), confusion (''moha'') are further symptoms of hepatic encephalopathy. Neuropsychological findings are experienced in all phases of hepatic encephalopathy. It is experienced as forgetfulness, mild confusion and irritability, inversed sleep pattern followed by lethargy and personality changes. The third stage is marked with worsened confusion and in fourth stage is coma. ''Mada, Murchha'' and ''sanyasa'' are mentioned earlier as disorders due to vitiated blood in [[Vidhishonitiya Adhyaya]].<br /> <br /> === Management of Diseases (Treatment Protocols) ===<br /> ==== Current clinical practices in treatment of ''pandu'' and ''kamala'' ( referred from Chikitsa Pradeep) ====<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| Type<br /> ! scope=&quot;col&quot;| Medicine<br /> ! scope=&quot;col&quot;| Dose<br /> ! scope=&quot;col&quot;| Time<br /> ! scope=&quot;col&quot;| ''Anupana''<br /> |-<br /> |rowspan = &quot;3&quot;|[[Vata]] dominant ''pandu''<br /> | ''Mahayogaraja samira mixture''<br /> | 120-480 mg<br /> | After meals <br /> | Ghee (''dadimadi'') + honey<br /> |-<br /> | ''Tiktaka ghritam''<br /> | 10-40 ml<br /> | After meals <br /> | Hot water<br /> |-<br /> | ''Navajivana rasa''<br /> | 120-200 mg<br /> | After meals <br /> | Milk<br /> |-<br /> | rowspan = &quot;2&quot;|[[Pitta]] dominant ''pandu''<br /> | ''Tapyadi lauha'' mixture<br /> | 250 - 600 mg<br /> | After meals <br /> | Dadimadi ghee + udumbaravaleha<br /> |-<br /> | ''Vasadi'' decoction<br /> | 20 - 40 ml<br /> | After meals <br /> | Honey<br /> |-<br /> | [[Kapha]] dominant ''pandu''<br /> | ''Gomutra Haritaki'' mixture<br /> | 600 mg - 3 grams<br /> | After meals <br /> | Honey + juice of castor leaves<br /> |-<br /> | ''Mrittika bhakshana janya''<br /> | ''Gomutra Haritaki'' mixture<br /> | 600 mg - 3 grams<br /> | After meals<br /> | ''Kumari Asava''<br /> |-<br /> | rowspan=&quot;2&quot;|''Riddha Patha Kamala''<br /> | ''Ichha bhedi rasa''<br /> | 120 - 180 mg<br /> | Early morning one time<br /> | Lemon juice<br /> |-<br /> | ''Suta shekhara kalpa''<br /> | 120 - 250 mg<br /> | After meals<br /> | Milk + sugar<br /> |-<br /> | ''Koshtha ashrita kamala''<br /> | colspan=&quot;4&quot;|As like ''pitta'' dominant ''pandu''<br /> |}<br /> <br /> ==== Evidence based clinical practices ====<br /> <br /> *In a study carried out by Shazi L. and Thakar A., Amalaki [[rasayana]] was found effective in management of iron deficiency anemia. However the efficacy was equal in clinical parameters and less in biochemical parameters in comparison to conventional drugs a combination of folic acid and ferrous sulphate. &lt;ref&gt; Shaizi Layeeq, Thakar A.B. Clinical efficacy of Amalaki rasayana in the management of pandu(iron deficiency anemia). Ayu.2015.July-Sep.36(3):290-297. &lt;/ref&gt; <br /> *''Punarnava mandura'' was found effective as ''panduhara'' and [[rasayana]] in patients of geriatric anemia and can counteract most of the pathological manifestations related to ''pandu roga'' in old age (geriatric anemia)&lt;ref&gt;Pandya M.G. Dave A.R. A clinical study of punarnava mandura in the management of pandu roga in old age (geriatric anemia).Ayu,2014 July-Sept; 35(3);252-260. &lt;/ref&gt;. In another study on pregnant females, ''punarnava mandura'' and ''dhatri lauha'' are found effective in management of anemia during pregnancy.&lt;ref&gt;Khandelwal D.A, Donga S.B.,Dei L.P. Clinical efficacy of punarnava mandura and dhatri lauha in the management of garbhini pandu (anemia in pregnancy) Ayu,2015 Oct-Dec;36(4); 397-403. &lt;/ref&gt;<br /> *A herbomineral formulation ''Trikatrayadi Lauha'' suspension was observed an effective, well-tolerated, and clinically safe formulation for the management of Iron deficiency anemia in children.&lt;ref&gt;Kumar A, Garai AK. A clinical study on Pandu Roga, iron deficiency anemia, with Trikatrayadi Lauha suspension in children. J [[Ayurveda]] Integr Med 2012;3:215-22.&lt;/ref&gt; Khan et.al. observed that the same formulation was observed effective to relieve the signs and symptoms of ''pandu'' in comparison to standard control drug (Fersolate-CM). ''Trikatrayadi lauha'' provided significant improvement on Hbgm%, RBC, PCV, MCV, serum iron, percent transferrin saturation and to decrease TIBC. Therefore ''Trikatrayadi Lauha'' can be used in ''Panduroga'' or IDA as a safe hematinic drug.&lt;ref&gt;Khan Subir kumar, Vyas S.N. Chandola H.M. Efficacy of Trikatrayadi lauha in Pandu roga with reference to iron deficiency anemia. Ayu 2012. Jan-Mar, 33(1):62-67.&lt;/ref&gt; <br /> *Tewari et.al. studied the ethnopharmacological approaches to the therapy of jaundice&lt;ref&gt;Tewari D, Mocan A, Parvanov ED, Sah AN, Nabavi SM, Huminiecki L, Ma ZF, Lee YY, Horba´nczuk JO and Atanasov AG (2017) Ethnopharmacological Approaches for Therapy of Jaundice: Part I. Front. Pharmacol. 8:518. doi: 10.3389/fphar.2017.00518&lt;/ref&gt; and highly used plant species from acanthaceae,euphorbiaceae, asteraceae, combretaceae and fabaceae family in the management of jaundice. The team of researchers elaborately studied hystorical perspective of jaundice, its pathophysiology and enlisted 207 herbs used in management of jaundice.&lt;ref&gt;Tewari D, Mocan A, Parvanov ED, Sah AN, Nabavi SM, Huminiecki L, Ma ZF, Lee YY, Horba´nczuk JO and Atanasov AG (2017) Ethnopharmacological Approaches for Therapy of Jaundice: Part II. Highly Used Plant Species from Acanthaceae, Euphorbiaceae, Asteraceae, Combretaceae, and Fabaceae Families. Front. Pharmacol. 8:519. doi: 10.3389/fphar.2017.00519&lt;/ref&gt;<br /> <br /> === Research studies on ''pandu'' ===<br /> <br /> Some studies are available on the internet which depict the efficacy of various Ayurvedic drugs having iron (in the form of ''lauha'' and ''mandura'') compounds in the management of ''pandu'': <br /> #Sarkar PK, Prajapati PK, Choudhary AK, Shukla VJ, Ravishankar B. Haematinic Evaluation of Lauha Bhasma and Mandura Bhasma on HgCl2-induced Anemia in Rats. Indian J Pharm Sci 2007;69:791-5.<br /> #Sarkar PK. A Comparative Pharmaceutico-pharmaco-clinical study of Lauha Bhasma and Mandura Bhasma w.s.r. to its Pāndu-hara Effect, MD thesis. I.P.G.T. &amp; R.A. Jamnagar: Gujrat [[Ayurveda]] University; 2005. <br /> #Garai A, Rai M, Kumar A. Role of an Ayurvedic Compound (Panduhara Yoga) in the Management of Iron Deficiency Anaemia in Children. Ayu 2009;30:469-74.<br /> #Gupta V, Reddy KR. Experimental Studies of Lohasava. Aryavaidyan 2007;21:87-94.<br /> #Sarkar PK, Prajapati PK, Shukla VJ, Ravishankar B, Choudhary AK. Toxicity and recovery studies of two Ayurvedic preparations of iron. Indian J Exp Biol 2009;47:987-92.<br /> #Devarshi P, Kanse A, Kanse R, Mane S, Patil S, Varute AT. Effect of Mandura Bhasma on lipolytic Activities of Liver, Kidney and Adipose Tissue of Albino Rat During CCl4 Induced hepatic Injury. J Biosci 1986;10:227-34.<br /> #Pandit S, Biswas TK, Debnath PK, Saha AV, Chowdhury U, Shaw BP, et al. Chemical and pharmacological evaluation of different Ayurvedic preparations of iron. J Ethnopharmacology 1999;65:149-56.<br /> #Dinesh C. Sharma, Deepa Chandiramani, Manminder Riyat and Praveen Sharma. Scientific evaluation of some ayurvedic preparations for correction of iron deficiency and anemia. Indian Journal of Clinical Biochemistry, 2007 / 22 (2) 123-128<br /> #Ambika Das, PA03.17. A clinical evaluation of Punarnavadi Mandura and Dadimadi Ghritha in management of Pandu (Iron defeciency anaemia), Ancient Science of Life 2013; 32 (s2):86<br /> <br /> One of the studies (Sharma D.C, 2007) report that the Ayurvedic preparations were found equally effective as the allopathic compound in the management of iron deficiency anemia and the fact that the side effects were almost nil establishes them to be even superior.<br /> <br /> The modes of action of drugs and procedures as stated in this chapter, which is without iron, have not been studied much in anemia. Though, some of the preparations described in anemia have been found very useful in the management of other types of anemia as sickle cell anemia,&lt;ref&gt;Macmillan Keith, A herbomineral composition for the treatment of Sickle Cell disease. Retrieved from tgs.freshpatents.com&lt;/ref&gt; aplastic anemia,&lt;ref&gt;Subhash singh, Shiv Kumar Singh and Narendra Kumar Singh. Aaplastic anaemia, complete cure, ayurvedic way – case report. International Journal Of Basic And Applied Medical Sciences Issn: 2277-2103 (Online) An Online International Journal Available At http://www.cibtech.org/jms.htm 2013 vol. 3 (1) january-april, pp.242-246/subhash et al.&lt;/ref&gt; etc.<br /> <br /> So, further studies need to be done in order to know the efficacy of these drugs and mechanisms in the various types of anemia.<br /> <br /> === Principle of treatment for ''kamala'' ===<br /> <br /> The management of ''kamala'' by the drugs stated in the chapter has been found to show good results but the mechanism of their action is still not clear. Practically few studies are available on the net which prove the efficacy of ''Ayurvedic'' compounds in the management of hepatocellular jaundice. &lt;ref&gt;Nirmal kumar and Anil kumar singh. Phalatrikadi kvatha - an ayurvedic hepatoprotective drug. International journal of research in pharmacy and chemistry.2013, 3(3) Available online at www.ijrpc.com&lt;/ref&gt;<br /> <br /> === List of Research Works done ===<br /> <br /> === IPGT&amp;RA, Jamnagar ===<br /> <br /> #Chaudhary sudhakar (1958): Pandu Roga Nidana.<br /> #Mishra N. K. (1959): A clinical study of Pandu Roga.<br /> #Bhattacharya R. C. (1965): Pandu Roga Par Paradamruta Teekshana Laugh Karyanvekshana<br /> #Ojha N.H.(1966): Abhraka Bhasma Ka Pandu Roga Par Karyanvekshana.<br /> #Pillai K.D.R. (1974): Study of effect of Swarna Makshika Bhasma on Pandu.<br /> #Jha Prabhakar (1974): Swayama Lauha Bhasma Ka Pandu Roga Par Kriyatamaka Adhyayana.<br /> #Sharada B.D.(1975) : Effect of Yogaraja on Garbhavasthajanya Pandu.<br /> #Gopalkrishana (1986): Lauha Bhasma on Pandu with special reference to its Media.<br /> #M.S.Trivedi (1992): Effect of Yogaraja Rasayana in Garbhavsthajanya Pandu.<br /> #Nargunde Rajeshri (1997): A comparative Phaemaco-clinical Study of Shudha Kasisa Churna and Kasisa Bhasma on PANDU. <br /> #Jain Sangeeta (2000): A study on Pandu Roga w.s.r. to ANAEMIA and Its Management with Shodhana and Yogaraja Rasayana.<br /> #Sarkar P K (2005): A comparative pharmaco-pharmaceutico Clinical study of lauha bhasma and mandura bhasma w.s.r. to Panduhara effects.<br /> <br /> === Banaras Hindu University, Varanasi ===<br /> <br /> #Trivedi R D (1979):Hematological and clinical stubby in pandu.<br /> #Malhotra E. N. (1983): Management of Garbhavasthajnya Pandu with Mandura Bhasma.<br /> #Nandkishore (1985): Clinical Assessment of Navayasa Lauha in Management of Pandu.<br /> #Chauhana A. P. S. (1985): Role of Manduradi Ghanvati in Pandu Roga.<br /> #Dixit A. K. (1994): Clinical study in Yogaraja Rasayana on Pandu.<br /> #Singh S. N. (1996): A study on aetio pathogenesis of Pandu Roga w s r to its Samprapti Vighatan by Makshika.<br /> #Agrawal N. Assessment of Effect of Mandura Bhasma in Iron Deficiency Anemia in Children, MD thesis. P.G. Department of Kaumarbhritya. Varanasi: IMS, B.H.U; 2007. <br /> <br /> === National Institute of [[Ayurveda]], Jaipur and others ===<br /> <br /> #Tyagi R. M. (1980): Pandu Roga Evam Vajra Vatak Mandura .<br /> #B. C. Sharma (1985): Pandu Roga Samprapti Vivechana.<br /> #R. K. Sharma (1994): Pandu Roga Mandura Bhasma Ka Chikitsatmaka Adhyayan.<br /> #Meena R. K. (1994): Guduchi in Pandu Roga.<br /> #Joshi N. (2005): Pharmaceutical, Pharmacological and Toxicological Study of Various Lauha Preparations(Kalpa) w.s.r. to Iron Deficiency Anaemia, M.D. Thesis. P. G. Department of Rasa Shastra and Bhaishajya Kalpana, Jaipur.<br /> #Kumath V. (2006): A Comprehensive Study of Haritaki with Special Reference to the Efficacy of Terminalia chebula Retz. on pandu Roga, MD thesis. P. G. Department. of Dravyaguna, Government. Ujjain, Madhya Pradesh: Autonomous Dhanvantari [[Ayurveda]] College and Hospital; 2006.<br /> <br /> === Potential areas /scope for further research ===<br /> <br /> The following drugs referred in management of ''pandu'' need to be researched more for providing evidences of its efficacy in anemia and related disorders in comparison to conventional management: <br /> #''Dadimadya ghritam''<br /> #''Katukadyam ghritam''<br /> #''Pathyaghritam''<br /> #''Danti ghritam''<br /> #''Drakshaghritam''<br /> #''Haridradi ghritam''<br /> #''Darvyadi ghritam''<br /> #''Navayasa churnam''<br /> #''Manduravataka''<br /> #''Tapyadi lauha''<br /> #''Yogaraja''<br /> #''Punarnava Mandura''<br /> #''Darvyadi leha''<br /> #''Dhatryavaleha''<br /> #''Manduravatakah''<br /> #''Gaudo arishah''<br /> #''Bijakarisha''<br /> #''Dhatryarishta''<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References ==<br /> &lt;/div&gt;<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Grahani_Chikitsa&diff=45379 2025-10-31T11:08:25Z

<p>Agnivesha: /* Dhatvagni */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Grahani Chikitsa<br /> |titlemode=append<br /> |keywords=Digestion in Ayurveda, metabolism in Ayurveda, jatharagni, bhutagni, dhatvagni, grahani, grahanidosha, grahani roga, annavisha, atyagni, samashana, vishamashana, adhyashana, Ayurveda, charak samhita, Indian system of medicine,Patwardhan K., Ojha S.N.,Upadhyaya W., Samant A., Dharmadhikari A., Kajaria D.,Singh G., Goyal M., Deole Y.S., Basisht G., dietary guidelines, digestion and metabolism in Ayurveda, indigestion, nutrition, nourishment<br /> |description=Chikitsa Sthana Chapter 15. Management of Grahani (Diseases of digestion and metabolism)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 15. Management of Grahani (Diseases of digestion and metabolism) &lt;/big&gt;'''<br /> {{Infobox<br /> |title = Grahani Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 15<br /> |label2 = Preceding Chapter<br /> |data2 = [[Arsha Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Pandu Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Patwardhan K., Ojha S.N., Upadhyaya W., Samant A.<br /> |label7 = Reviewer <br /> |data7 = Dharmadhikari A., Kajaria D.<br /> |label8 = Editors<br /> |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.016 10.47468/CSNE.2020.e01.s06.016]<br /> }}<br /> &lt;big&gt;'''Abstract &lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;[[Grahani Chikitsa]] consists of three parts. The first part explains the concept of normal digestion process. The second part describes the abnormal digestion and third part is about diseases caused by abnormality of digestive factors and its interaction with proximal intestine or ''grahani''. These disorders are called ''grahanidosha''. <br /> &lt;br/&gt;<br /> [[agni]] (digestive and metabolic agents), based on their specific functions of conversion of food into biological elements of the body are classified into thirteen types. First, the ''jatharagni'' is most important because it is the initiator of digestive process and it strengthens the digestive ability of other twelve ''agnis''. Five ''bhutagnis'' transform the ''panchmahabhauika'' components of ''ahara rasa'' created by ''jatharagni'' into different structures of the body. Seven ''dhatvagnis'' create seven tissues elements(''[[dhatu]]'').<br /> &lt;br/&gt;<br /> ''Jatharagni'' initiates the first phase of digestion process by conversion of food into nutrient fluid (''ahara rasa''). This nutrient fluid is further trifurcated into three biological substances ''[[kapha]], [[pitta]]'' and ''[[vata]]'' in three stages to ''madhura, amla'' and ''katu awastha paka'' respectively. This biofluid is separated into excretable waste or impure products by ''samana vata'' in ''grahani'' (middle part of GI Tract) and useful, pure circulable products. ''Samana vata'' analyzes and separates the useful products (''prasada'') and waste (''kitta''). Useful products get absorbed by ''rasayani'' (villi) of the intestine, sent to the micro channels (''srotas'') by ''vyanvata'', simutaneouly, to the entire body. Waste products are excreted out by ''apana vayu'' through urine, feces and sweat. <br /> &lt;br/&gt;<br /> Now second and third phase of digestion process occur simultaneously in the ''srotas'' (microchannels). Five ''bhutagnis'' work on the formation of anatomical structure of the body from respective ''[[panchamahabhuta]]'' in the form of micro channels, by digesting needful components present in biofluid. Each gross and subtle particle of body is ''[[panchabhautika]]'', but each one is having different proportion of ''[[mahabhuta]]''. <br /> &lt;br/&gt;<br /> Now the third phase of digestion is processed in seven micro channels (''srotas'') specified for seven body tissues (''[[dhatu]]'') for the formation of body tissues by their specific seven tissue transformers (''dhatvagnis'') Excreable waste products are carried out by three excreatory channels as feces, urine and sweat, along with sub tissues and sub excreta of sensory organs.<br /> &lt;br/&gt;<br /> Second part of this chapter explains the etiopathology of abnormal digestion, and formation of intermediate products as seed cause of various diseases in the form of ''ama, shukta'' and ''amavisha''.<br /> &lt;br/&gt;<br /> Third part explicates the etiopathology, types, symptoms and treatments of ''grahanidosha'' as a syndrome of various digestive disorders. The chapter sums up in defining abnormal dietary habits. <br /> &lt;br/&gt;<br /> '''Keywords''': Digestion in [[Ayurveda]], metabolism in [[Ayurveda]], ''jatharagni, bhutagni, dhatvagni, grahani, grahanidosha, grahani roga, annavisha, atyagni, samashana, vishamashana, adhyashana''.<br /> &lt;/p&gt;<br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> [[Grahani Chikitsa]] is one of the most important chapters of this compendium because most of the diseases originate from disorders of digestion. This chapter is described after ''arsha roga'' (hemorrhoids) because pathophysiology of ''arsha'' influences [[agni]] and before [[Panduroga Chikitsa]] because ''grahani roga'' influences ''pandu roga''. The initial portion of this chapter discusses the details of the physiological process of digestion and metabolism in human body. [[Agni]], being the fundamental factor in maintaining health and in producing diseases, has been described in detail. The chapter begins with explanation of importance of normally functioning [[agni]] and then goes on to explain the various aspects of digestion, metabolism and tissue nourishment.<br /> <br /> Different theories of tissue nourishment as explained by the commentators play a crucial role in the entire process. The concept of [[upadhatu]] and ''dhatumala'' has also been dealt with. These descriptions are followed by the pathophysiology of ''grahanidosha'' syndrome and its management. This chapter underscores that the knowledge of physiology is crucial in understanding the pathophysiology and therapeutics of a disease.<br /> <br /> Protection of [[agni]] is very essential in treatment of all diseases.[Chakrapani,Cha.Sa.[[ Chikitsa Sthana ]]14/244-246 ]''Arsha, atisara'' and ''grahanidosha'' are said to be ''paraspara [[hetu]]'' which means one disease becomes cause for another disease[Cha.Sa. [[ Chikitsa Sthana ]]14/244] e.g. in patients with chronic colitis, intestinal polyps are seen, in patients suffering from diarrhea colitis is observed. Therefore, one finds interrelation between these disorders and as explained earlier, special precaution should be taken with respect to ''agni bala''. <br /> <br /> Certain drugs like ''chitraka'' (Plumbago zeylanica), ''pippali'' (Piper longum), ''pippalimula'' (root of Piper longum), ''shunthi'' (Zingiber officinale), ''nagakesara, haridra, danti, duralabha, haritaki'' etc have been used in combinations with other drugs for the treatment of ''arsha'' considering the concept of ''agnibala vriddhi'' and ''vata anulomanam'' (facilitating passage of ''[[vata]]'') and the same drugs have been used in ''grahani chikitsa'' with the same concept. Charak explains that all the above three diseases are caused by ''agnimandya'' and if increase in [[agni]] is done then relief in the disease takes place. [Chakrapani Cha.Sa.[[Chikitsa Sthana]] 14/244-246]<br /> <br /> Further, ''[[vata]]'' is said to be ''agnisakha'' i.e. ''agnibala'' depends on ''[[vata]]''. ''Vatakshaya'' or ''prakopa'' results in ''agnimandya''. Therefore, ''anna, pana'' and ''aushadha'' which bring about ''vata anulomana'' are very useful in treatment of diseases like ''arsha'' and ''grahani dosha''. <br /> <br /> ''Vata anulomanam'' means to facilitate the ''gati'' (motion) of ''[[vata]]'' downwards to anus. Among five types of ''[[vata]], samana'' and ''apana'' have major role in diseases like ''arsha, atisara'' and ''grahanidosha''. Obstruction to movement of ''[[vata]]'' (''avarudha gati'') or diarrhea (''atisaraṇa'') leads to ''agni kshaya''. ''Avarudha gati'' is the cause for ''vibandha'' (constipation), ''malavibandha'' (obstruction to feces) along with ''pravahana'' (urge to defecate) which increases the intra-lumen pressure leading to incompetency of valves in rectal veins leading to their varicosity which causes hemorrhoids where as ''atisarana'' (diarrhea) causes increased motility of intestine. Hence ''vata anulomanam'' should not be understood as ''[[virechana]]'' or laxation but regularization of ''[[vata]] gati'' so that there is no ''avarodha'' or ''atisarana''. The same concept of ''vata anulomana'' is also mentioned in [[Grahani Chikitsa]].[Cha.Sa. [[Chikitsa Sthana]] 14/247]<br /> <br /> Therefore, the line of treatment used in ''arsha'' with regard to ''agni bala'' and ''vata anulomanam'' is basically similar to that of ''grahanidosha'' hence Charak has explained [[Grahani Chikitsa]] after [[Arsha Chikitsa]].[Chakrapani Cha.Sa.[[Chikitsa Sthana]]15/1] Charak could have restricted the name of chapter to [[Grahani Chikitsa]] i.e. treatment of the ''avayava grahani'' whereas he has increased the scope of chapter by using the word ''grahanidosha''.[Chakrapani, Cha.Sa. [[Chikitsa Sthana]] 15/1].<br /> <br /> There is always an inter-relationship between ''avayava'' (organ) and ''avayavi'' (part of organ) or ''ashraya''(seat) and ''ashrayi'' (seated). Either of the one has an impact on the other, hence if ''grahaniavayava'' is in normal state then [[agni]] the ''avayavi'' functions normally and vice versa also holds true, whereas if ''dusti'' of ''grahani'' takes place ''agni vaishamyata'' (imbalance) is seen e.g. ileitis, wherein digestion is hampered. ''Grahani'' is the seat for ''jatharagni''. [Cha.Sa.[[Chikitsa Sthana]] 15 /56] [[Agni]] is responsible for [[ayu]] (longevity of life), [[varna]] (complexion), [[bala]] (strength), [[swasthya]] (health), ''utsaha'' (enthusiasm), ''upachaya'' (proper metabolism), ''prabha'' (glow) and ''[[oja]]'' (core energy). ''Prakrita [[agni]]'' (normal digestive power) is essential for long and healthy life while, vitiated [[agni]] is responsible for ''roga avastha''(disease).[Cha. Sa. [[Chikitsa Sthana]] 15/3-4] <br /> <br /> In this chapter, Charak describes formation of body tissues in detail with the role of [[ahara]] which is supplied continuously to maintain homeostasis. ''Vyana vata'' is promoter of ''[[rasa]] [[rakta]]di'' circulation.[ Cha. Sa. [[Chikitsa Sthana]] 15/36] It transports ''[[rasa]] [[rakta]]di drava'' ''[[dhatu]]'' throughout body continuously and as per metabolic demand. This explanation shows that closed circulation in human was known to Charak.<br /> <br /> ''Grahani'' is prime place where digestion and absorption of ''ahara rasa'' takes place. ''Ahara rasa'' provides nutrition for the ''[[rasa]]di sapta [[dhatu]]'', along-with three ''sharirika [[dosha]]'' and three ''manasika dosha''. Nourishment of ''[[sattva]], [[raja]]'' and ''[[tama]]'' is influenced by ''sattvika, rajasika'' and ''tamasika ahara''. ''Tamasika'' and ''rajasika ahara'' suppresses ''[[sattva]] [[guna]]'' thereby causing ''alpa sattva'' in individual, a common predisposing factor of psychiatric disorders for e.g. ''alpa sattva'' as mentioned in ''unmada'' [Cha.Sa [[Chikitsa Sthana]] 9/5] In ''vataja grahanivyadhishanka'' (feeling of suffering from disease) manifests in patients with ''alpa sattva''. <br /> <br /> Homeostasis at cellular level and gross level is maintained by ''[[vata]], [[pitta]]'' and ''[[kapha]]'' in which digestive and metabolic contributions are due to [[agni]]. This chapter has been dedicated to [[agni]] to understand the manner in which it gets vitiated by ''[[dosha]]'' and accordingly the line of treatment for the ''agni dosha'' is explained. As the functions of [[agni]] take place in ''grahani'' hence disease related to ''grahani'' has been given the name.<br /> <br /> Secondly, ''pandu roga'' is due to ''alpata'' of ''raktaposhaka sara bhaga'' [Chakrapani, Cha. Sa. [[Chikitsa Sthana]] 16/3-7] and, one of the main causes of this ''alpata'' is mal-digestion and mal-absorption which takes place in ''grahani''. It is well known fact, that various contributory factors for blood formation have their absorption in gastrointestinal tract such as folic acid, vitamin B12, iron, etc which if not absorbed causes anemia this is the reason why Charak has placed this chapter in between ''arsha'' and ''pandu roga''.<br /> &lt;/div&gt;<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातो ग्रहणीदोषचिकित्सितं व्याख्यास्यामः||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः||२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātō Grahaṇī dōṣacikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2||<br /> <br /> athAto grahaNIdoShacikitsitaM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2||<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> Now we shall expound the chapter &quot;Grahani Chikitsa&quot; (Management of diseases of digestion and metabolism). Thus said Lord Atreya. [1-2]<br /> <br /> === Importance of ''dehagni'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आयुर्वर्णो बलं स्वास्थ्यमुत्साहोपचयौ प्रभा| <br /> <br /> ओजस्तेजोऽग्नयः प्राणाश्चोक्ता देहाग्निहेतुकाः||३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> āyurvarṇō balaṁ svāsthyamutsāhōpacayau prabhā| <br /> <br /> ōjastējō'gnayaḥ prāṇāścōktā dēhāgnihētukāḥ||3|| <br /> <br /> AyurvarNo balaM svAsthyamutsAhopacayau prabhA| <br /> <br /> ojastejo~agnayaH prANAshcoktA dehAgnihetukAH||3|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> [[Dehagni]] (all the entities in the body that are responsible for digestion and metabolism) is the fundamental causative agent for longevity, normal complexion, normal strength, good health, motivation, normal growth, normal luster, normal ''[[ojas]]'', normal body temperature and various other forms of [[agni]]. Even the existence of an individual is said to be because of [[dehagni]]. [3]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शान्तेऽग्नौ म्रियते, युक्ते चिरं जीवत्यनामयः| <br /> <br /> रोगी स्याद्विकृते, मूलमग्निस्तस्मान्निरुच्यते||४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śāntē'gnau mriyatē, yuktē ciraṁ jīvatyanāmayaḥ| <br /> <br /> rōgī syādvikr̥tē, mūlamAgnistasmānnirucyatē||4||<br /> <br /> shAnte~agnau mriyate, yukte ciraM jIvatyanAmayaH| <br /> <br /> rogI syAdvikRute, mUlamagnistasmAnnirucyate||4||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When the [[agni]] stops functioning, the individual dies; if the [[agni]] functions normally, the individual can lead a healthy and long life. Similarly, if the [[agni]] becomes abnormal, the individual suffers from various diseases; and hence, the [[agni]] is said to be the root cause of health and longevity [4]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यदन्नं देहधात्वोजोबलवर्णादिपोषकम्| <br /> <br /> तत्राग्निर्हेतुराहारान्न ह्यपक्वाद्रसादयः||५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yadannaṁ dēhadhātvōjōbalavarṇādipōṣakam| <br /> <br /> tatrāgnirhēturāhārānna hyapakvādrasādayaḥ||5||<br /> <br /> yadannaM dehadhAtvojobalavarNAdipoShakam| <br /> <br /> tatrAgnirheturAhArAnna hyapakvAdrasAdayaH||5||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The food one consumes becomes capable of nourishing the body tissues and of promoting the ''[[ojas]]'' (vital essence), strength, complexion etc., only in the presence of normally functioning [[agni]]. In the absence of normal digestion (and metabolism), the normal body tissues such as ''[[rasa]]'' cannot be formed nor nourished [5]<br /> <br /> === Process of digestion-first phase ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अन्नमादानकर्मा तु प्राणः कोष्ठं प्रकर्षति| <br /> <br /> तद्द्रवैर्भिन्नसङ्घातं स्नेहेन मृदुतां गतम्||६|| <br /> <br /> समानेनावधूतोऽग्निरुदर्यः पवनोद्वहः| <br /> <br /> काले भुक्तं समं सम्यक् पचत्यायुर्विवृद्धये||७|| <br /> <br /> एवं रसमलायान्नमाशयस्थमधः स्थितः| <br /> <br /> पचत्यग्निर्यथा स्थाल्यामोदनायाम्बुतण्डुलम्||८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> annamādānakarmā tu prāṇaḥ kōṣṭhaṁ prakarṣati| <br /> <br /> taddravairbhinnasaṅghātaṁ snēhēna mr̥dutāṁ gatam||6|| <br /> <br /> samānēnāvadhūtō'gnirudaryaḥ [1] pavanōdvahaḥ| <br /> <br /> kālē bhuktaṁ samaṁ samyak pacatyāyurvivr̥ddhayē||7|| <br /> <br /> ēvaṁ rasamalāyānnamāśayasthamadhaḥ sthitaḥ| <br /> <br /> pacatyAgniryathā sthālyāmōdanāyāmbutaṇḍulam||8||<br /> <br /> annamAdAnakarmA tu prANaH koShThaM prakarShati| <br /> <br /> taddravairbhinnasa~gghAtaM snehena mRudutAM gatam||6|| <br /> <br /> samAnenAvadhUto~agnirudaryaH [1] pavanodvahaH| <br /> <br /> kAle bhuktaM samaM samyak pacatyAyurvivRuddhaye||7|| <br /> <br /> evaM rasamalAyAnnamAshayasthamadhaH sthitaH| <br /> <br /> pacatyagniryathA sthAlyAmodanAyAmbutaNDulam||8||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ingested food is carried to ''koshtha'' by ''prana vata''. The food disintegrates because of the liquids, and further it becomes soft because of the fatty substances. The ''samana vata'', that has an inherent ability to intensify the ''agni,'' intensifies the digestive enzymes and properly digests the food that one consumes timely and in an appropriate quantity, thus leading to longevity. This process of digestion by [[agni]] in the gut which leads to the formation of ''[[rasa]]'' and ''[[mala]]'' is comparable to the process of cooking of the raw rice kept in an earthen vessel containing water on a fire [6-8]<br /> <br /> === Three states of digestion and provoking ''[[dosha]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अन्नस्य भुक्तमात्रस्य षड्रसस्य प्रपाकतः| <br /> <br /> मधुराद्यात् कफो भावात् फेनभूत उदीर्यते||९|| <br /> <br /> परं तु पच्यमानस्य विदग्धस्याम्लभावतः| <br /> <br /> आशयाच्च्यवमानस्य पित्तमच्छमुदीर्यते||१०|| <br /> <br /> पक्वाशयं तु प्राप्तस्य शोष्यमाणस्य वह्निना| <br /> <br /> परिपिण्डितपक्वस्य वायुः स्यात् कटुभावतः||११||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> annasya bhuktamātrasya ṣaḍrasasya prapākataḥ| <br /> <br /> madhurādyāt kaphō bhāvāt phēnabhūta udīryatē||9|| <br /> <br /> paraṁ tu pacyamānasya vidagdhasyāmlabhāvataḥ| <br /> <br /> āśayāccyavamānasya Pittamacchamudīryatē||10|| <br /> <br /> pakvāśayaṁ tu prāptasya śōṣyamāṇasya vahninā| <br /> <br /> paripiṇḍitapakvasya Vātaḥ syāt kaṭubhāvataḥ||11||<br /> <br /> annasya bhuktamAtrasya ShaDrasasya prapAkataH| <br /> <br /> madhurAdyAt kapho bhAvAt phenabhUta udIryate||9|| <br /> <br /> paraM tu pacyamAnasya vidagdhasyAmlabhAvataH| <br /> <br /> AshayAccyavamAnasya pittamacchamudIryate||10|| <br /> <br /> pakvAshayaM tu prAptasya shoShyamANasya vahninA| <br /> <br /> paripiNDitapakvasya vAyuH syAt kaTubhAvataH||11||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As soon as the food that has all the six tastes is consumed, it undergoes the first stage of digestion known as ''madhura'' (sweet) state during which ''[[kapha]]'' is produced which is like froth. Afterwards, while the food undergoing digestion is in its partially digested form, it attains ''amla'' (sour) state. <br /> <br /> When the semi-digested food leaves the stomach, the release of liquid form of [[pitta]] known as ''accha-pitta'' occurs.<br /> <br /> When the ''pakva'' part (the non-absorbable remnant part after the absorption of the nutrients), reaches the ''pakvashaya'' (the colon), the drying effect of [[agni]] converts it into a solid mass. There also occurs the release of ''[[vata]]'' which is ''katu'' (pungent) state [9-11]<br /> <br /> === Second phase of digestion by ''[[panchamahabhuta]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अन्नमिष्टं ह्युपहितमिष्टैर्गन्धादिभिः पृथक्| <br /> <br /> देहे प्रीणाति गन्धादीन् घ्राणादीनीन्द्रियाणि च||१२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> annamiṣṭaṁ hyupahitamiṣṭairgandhādibhiḥ pr̥thak| <br /> <br /> dēhē prīṇāti gandhādīn ghrāṇādīnīndriyāṇi ca||12||<br /> <br /> annamiShTaM hyupahitamiShTairgandhAdibhiH [1] pRuthak| <br /> <br /> dehe prINAti gandhAdIn ghrANAdInIndriyANi [2] ca||12||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The food that possesses pleasant smell (taste, appearance, consistency,) etc., nourishes the similar entities in the body such as the sensory organs of smell by ''gandha'' etc (e.g. taste, vision, touch etc senses by respective ''[[mahabhuta]]'') [12]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भौमाप्याग्नेयवायव्याः पञ्चोष्माणः सनाभसाः| <br /> <br /> पञ्चाहारगुणान्स्वान्स्वान्पार्थिवादीन्पचन्ति हि||१३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhaumāpyāgnēyavāyavyāḥ pañcōṣmāṇaḥ sanābhasāḥ| <br /> <br /> pañcāhāraguṇānsvānsvānpārthivādīnpacanti hi||13||<br /> <br /> bhaumApyAgneyavAyavyAH pa~jcoShmANaH sanAbhasAH| <br /> <br /> pa~jcAhAraguNAnsvAnsvAnpArthivAdInpacanti hi||13||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> There are five types of [[agni]] namely, ''bhauma, apya, agneya, vayavya'' and ''nabhasa''. These five ''bhutagni'' are one of each ''[[mahabhuta]]'' transform/metabolize those components of the food that are homologous to them in their composition of structure of human organism. (such as ''parthiva, apya'' etc) [13]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यथास्वं स्वं च पुष्णन्ति देहे द्रव्यगुणाः पृथक्| <br /> <br /> पार्थिवाः पार्थिवानेव शेषाः शेषांश्च कृत्स्नशः||१४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yathāsvaṁ svaṁ ca puṣṇanti dēhē dravyaguṇāḥ pr̥thak| <br /> <br /> pārthivāḥ pārthivānēva śēṣāḥ śēṣāṁśca kr̥tsnaśaḥ||14||<br /> <br /> yathAsvaM svaM ca puShNanti dehe dravyaguNAH pRuthak| <br /> <br /> pArthivAH pArthivAneva sheShAH sheShAMshca kRutsnashaH||14||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Specific categories of entities in the body having specific attributes can be nourished by only those substances that belong to the same category having those same attributes. This means that ''parthiva'' entities in the body (one that is dominated by ''[[prithvi mahabhuta]]'' in its composition) can be nourished only by the ''parthiva'' substances in the food and so on. The same rule applies to the whole body [14]<br /> <br /> === Third phase of digestion and metabolism at level of ''[[dhatu]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सप्तभिर्देहधातारो धातवो द्विविधं पुनः| <br /> <br /> यथास्वमग्निभिः पाकं यान्ति किट्टप्रसादवत् ||१५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> saptabhirdēhadhātārō dhātavō dvividhaṁ punaḥ| <br /> <br /> yathāsvamAgnibhiḥ pākaṁ yānti kiṭṭaprasādavat ||15||<br /> <br /> saptabhirdehadhAtAro dhAtavo dvividhaM punaH| <br /> <br /> yathAsvamagnibhiH pAkaM yAnti kiTTaprasAdavat [1] ||15||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Further, the seven components that sustain the body, known as ''[[dhatu]]'' (tissues), are metabolized/transformed into two kinds of products known as ''sara'' (nutrition) and ''kitta'' (waste). This process is the function of seven specific entities known as ''dhatvagni''; each ''dhatvagni'' is specific for its corresponding ''[[dhatu]]'' [15]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रसाद्रक्तं ततो मांसं मांसान्मेदस्ततोऽस्थि च| <br /> <br /> अस्थ्नो मज्जा ततः शुक्रं शुक्राद्गर्भः प्रसादजः||१६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rasādraktaṁ tatō māṁsaṁ māṁsānmēdastatō'sthi ca| <br /> <br /> asthnō majjā tataḥ śukraṁ śukrādgarbhaḥ prasādajaḥ||16||<br /> <br /> rasAdraktaM tato mAMsaM mAMsAnmedastato~asthi ca| <br /> <br /> asthno majjA tataH shukraM shukrAdgarbhaH prasAdajaH||16||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Rakta]]'' is produced after ''[[rasa]]'' and then ''[[mamsa]]''. After ''[[mamsa]]'' the ''[[medas]]'' is formed and then ''[[asthi]]'' is produced. After ''[[asthi]]'' the ''[[majja]]'' is derived and then ''[[shukra]]'' is produced and finally fine ''[[shukra]]'' leads to ''[[garbha]]'' [16]<br /> <br /> === ''Upadhatu'' (metabolic products) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रसात् स्तन्यं ततो रक्तमसृजः कण्डराः सिराः| <br /> <br /> मांसाद्वसा त्वचः षट् च मेदसः स्नायुसम्भवः||१७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rasāt stanyaṁ tatō raktamasr̥jaḥ kaṇḍarāḥ sirāḥ| <br /> <br /> māṁsādvasā tvacaḥ ṣaṭ ca mēdasaḥ snāyusambhavaḥ ||17||<br /> <br /> rasAt stanyaM tato [2] raktamasRujaH kaNDarAH sirAH| <br /> <br /> mAMsAdvasA tvacaH ShaT ca medasaH snAyusambhavaH [3] ||17||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Stanya'' (breast milk) and the menstrual blood are derived after rasa. ''Kandara'' (tendon) and ''sira''(vein) are derived after ''[[rakta]]''. ''Vasa''(muscle fat) and the six layers of ''tvacha'' (skin) are derived after ''[[mamsa]]'' (muscle) and ''snayu''(ligament) are derived after ''[[medas]]'' (adipose tissue) [17]<br /> <br /> === ''[[Mala]]'' formed at tissue level metabolism ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> किट्टमन्नस्य विण्मूत्रं, रसस्य तु कफोऽसृजः| <br /> <br /> पित्तं, मांसस्य खमला, मलः स्वेदस्तु मेदसः||१८|| <br /> <br /> स्यात्किट्टं केशलोमास्थ्नो, मज्ज्ञः स्नेहोऽक्षिविट्त्वचाम्| <br /> <br /> प्रसादकिट्टे धातूनां पाकादेवंविधर्च्छतः ||१९|| <br /> <br /> परस्परोपसंस्तब्धा धातुस्नेहपरम्परा |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kiṭṭamannasya viṇmūtraṁ, rasasya tu kaphō'sr̥jaḥ| <br /> <br /> Pittaṁ, māṁsasya khamalā, malaḥ svēdastu mēdasaḥ||18|| <br /> <br /> syātkiṭṭaṁ kēśalōmāsthnō, majjñaḥ snēhō'kṣiviṭtvacām| <br /> <br /> prasādakiṭṭē dhātūnāṁ pākādēvaṁvidharcchataḥ ||19|| <br /> <br /> parasparōpasaṁstabdhā dhātusnēhaparamparā |<br /> <br /> kiTTamannasya viNmUtraM, rasasya tu kapho~asRujaH| <br /> <br /> pittaM, mAMsasya khamalA, malaH svedastu medasaH||18|| <br /> <br /> syAtkiTTaM keshalomAsthno, majj~jaH sneho~akShiviTtvacAm| <br /> <br /> prasAdakiTTe dhAtUnAM pAkAdevaMvidharcchataH [4] ||19|| <br /> <br /> parasparopasaMstabdhA dhAtusnehaparamparA [5] |<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The feces and the urine are the ''kitta'' (non-nutrient portion/waste portion/byproduct) of ingested food. The ''kitta'' of ''[[rasa]]'' is ''[[mala]]-[[kapha]]'' (excretions). ''[[Mala]]-[[pitta]]'' (bile pigment) is the ''kitta'' of ''[[rakta]]''. ''Kha-mala'' (the wastes accumulated in the hollow structures of the body such as external ears and nostrils) are the ''kitta'' of ''[[mamsa]]''. ''Sweda'' (sweat) is the ''[[mala]]'' of ''[[medas]]''. ''Kesha'' (hairs on the head) and ''loma'' (body hair) are the ''[[mala]]'' of ''[[asthi]]''. The ''[[mala]]'' of ''[[majja]]'' is the oily excretion of the eye and the skin (sebum). Thus, the ''[[dhatu]]s'' continuously undergo two kinds of transformation: ''prasada'' (nutrient portion) and ''kitta'' (non-nutrient portion). This entire sequence of transformation and metabolism of ''[[dhatu]]'' is thus inter dependent [18-19½]<br /> <br /> === Modes of transformation ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वृष्यादीनां प्रभावस्तु पुष्णाति बलमाशु हि||२०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vr̥ṣyādīnāṁ prabhāvastu puṣṇāti balamāśu hi||20|| <br /> <br /> vRuShyAdInAM prabhAvastu puShNAti balamAshu hi||20|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Vrishya'' substance (the substance that promotes sexual vigor) nourishes the ''[[shukra]]'' immediately due to its specific influential effect (''prabhava'') [20]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> षड्भिः केचिदहोरात्रैरिच्छन्ति परिवर्तनम्| <br /> <br /> सन्तत्या भोज्यधातूनां परिवृत्तिस्तु चक्रवत्||२१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ṣaḍbhiḥ kēcidahōrātrairicchanti parivartanam| <br /> <br /> santatyā bhōjyadhātūnāṁ parivr̥ttistu cakravat||21||<br /> <br /> ShaDbhiH kecidahorAtrairicchanti parivartanam| <br /> <br /> santatyA bhojyadhAtUnAM parivRuttistu cakravat||21|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Some scholars believe that the conversion of ''[[rasa]]'' up to ''[[shukra]]'' occurs in a span of six days and six nights. This process of transformation of nourishing portion of the digested food is continuous similar to rotating wheel [21]<br /> <br /> Note: Adulterated Verses:<br /> <br /> Verses from 22 to 35 are available in the text in bracket and Chakrapani has also not offered the commentary on these verses, hence these verses are considered as adulterated. <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> (इत्युक्तवन्तमाचार्यं शिष्यस्त्विदमचोदयत्| <br /> <br /> रसाद्रक्तं विसदृशात् कथं देहेऽभिजायते||२२|| <br /> <br /> रसस्य च न रागोऽस्ति स कथं याति रक्तताम्| <br /> <br /> द्रवाद्रक्तात्स्थिरं मांसं कथं तज्जायते नृणाम्||२३|| <br /> <br /> द्रवधातोः स्थिरान्मांसान्मेदसः सम्भवः कथम्| <br /> <br /> श्लक्ष्णाभ्यां मांसमेदोभ्यां खरत्वं कथमस्थिषु||२४|| <br /> <br /> खरेष्वस्थिषु मज्जा च केन स्निग्धो मृदुस्तथा| <br /> <br /> मज्ज्ञश्च परिणामेन यदि शुक्रं प्रवर्तते||२५|| <br /> <br /> सर्वदेहगतं शुक्रं प्रवदन्ति मनीषिणः| <br /> <br /> तथाऽस्थिमध्यमज्ज्ञश्च शुक्रं भवति देहिनाम्||२६|| <br /> <br /> छिद्रं न दृश्यतेऽस्थ्नां च तन्निःसरति वा कथम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> (ityuktavantamācāryaṁ śiṣyastvidamacōdayat| <br /> <br /> rasādraktaṁ visadr̥śāt kathaṁ dēhē'bhijāyatē||22|| <br /> <br /> rasasya ca na rāgō'sti sa kathaṁ yāti raktatām| <br /> <br /> dravādraktātsthiraṁ māṁsaṁ kathaṁ tajjāyatē nr̥ṇām||23|| <br /> <br /> dravadhātōḥ sthirānmāṁsānmēdasaḥ sambhavaḥ katham| <br /> <br /> ślakṣṇābhyāṁ māṁsamēdōbhyāṁ kharatvaṁ kathamasthiṣu||24|| <br /> <br /> kharēṣvasthiṣu majjā ca kēna snigdhō mr̥dustathā| <br /> <br /> majjñaśca pariṇāmēna yadi śukraṁ pravartatē||25|| <br /> <br /> sarvadēhagataṁ śukraṁ pravadanti manīṣiṇaḥ| <br /> <br /> tathā'sthimadhyamajjñaśca śukraṁ bhavati dēhinām||26|| <br /> <br /> chidraṁ na dr̥śyatē'sthnāṁ ca tanniḥsarati vā katham| <br /> <br /> (ityuktavantamAcAryaM [6] shiShyastvidamacodayat| <br /> <br /> rasAdraktaM visadRushAt [7] kathaM dehe~abhijAyate||22|| <br /> <br /> rasasya ca na rAgo~asti sa kathaM yAti raktatAm| <br /> <br /> dravAdraktAtsthiraM mAMsaM kathaM tajjAyate nRuNAm||23|| <br /> <br /> dravadhAtoH [8] sthirAnmAMsAnmedasaH sambhavaH katham| <br /> <br /> shlakShNAbhyAM mAMsamedobhyAM kharatvaM kathamasthiShu||24|| <br /> <br /> khareShvasthiShu majjA ca kena snigdho mRudustathA| <br /> <br /> majj~jashca pariNAmena yadi shukraM pravartate||25|| <br /> <br /> sarvadehagataM shukraM pravadanti manIShiNaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> (After listening to the above explanation by his teacher, the student asked the following doubt:<br /> <br /> How is it that ''[[rakta]]'' is formed in the body out of ''[[rasa]],'' though being different from it? ''[[Rasa]]'' is in fact colorless, and how does it attain the red color of ''[[rakta]]''? How is it that a solid structure such as ''[[mamsa]]'' is formed out of ''[[rakta]]'' which is a fluid by its nature? How is it that, again, from the ''[[mamsa]]'', which is solid, a fluid substance such as ''[[meda]]'' is formed? <br /> <br /> How is it that a rough ''[[asthi]]'' is formed out of smooth structures such as ''[[mamsa]]'' and ''[[meda]]''? How does the soft and fatty ''[[majja]]'' form out of rough structures such as ''[[asthi]]''? If at all ''[[shukra]]'', which is present everywhere in the body is formed out of ''[[majja]]'' that is located inside the ''[[asthi]]'', how does it come out as one cannot see pores on ''[[asthi]]''? [22-26]<br /> <br /> === Formation of ''[[rasa]]'' and ''[[rakta]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> एवमुक्तस्तु शिष्येण गुरुः प्राहेदमुत्तरम्||२७|| <br /> <br /> तेजो रसानां सर्वेषां मनुजानां यदुच्यते| <br /> <br /> पित्तोष्मणः स रागेण रसो रक्तत्वमृच्छति||२८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ēvamuktastu śiṣyēṇa guruḥ prāhēdamuttaram||27|| <br /> <br /> tējō rasānāṁ sarvēṣāṁ manujānāṁ yaducyatē|<br /> <br /> pittōṣmaṇaḥ sa rāgēṇa rasō raktatvamr̥cchati||28|| <br /> <br /> tathA~asthimadhyamajj~jashca shukraM bhavati dehinAm||26|| <br /> <br /> chidraM na dRushyate~asthnAM ca tanniHsarati vA katham| <br /> <br /> evamuktastu shiShyeNa guruH prAhedamuttaram||27|| <br /> <br /> tejo rasAnAM sarveShAM manujAnAM yaducyate| <br /> <br /> pittoShmaNaH sa rAgeNa raso raktatvamRucchati||28|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After listening to the query raised by the student, the teacher replied as follows:<br /> <br /> The nourishment fluid formed, known as ''[[rasa]]'', undergoes transformation by the ''ushma'' (heat) of ''[[pitta]]'' and gets converted into the red colored tissue known as ''[[rakta]]'' [27-28]<br /> <br /> === Formation of ''[[mamsa dhatu]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वाय्वम्बुतेजसा रक्तमूष्मणा चाभिसंयुतम्| <br /> <br /> स्थिरतां प्राप्य मांसं स्यात् स्वोष्मणा पक्वमेव तत् ||२९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vāyvambutējasā raktamūṣmaṇā cābhisaṁyutam| <br /> <br /> sthiratāṁ prāpya māṁsaṁ syāt svōṣmaṇā pakvamēva tat ||29|| <br /> <br /> vAyvambutejasA raktamUShmaNA cAbhisaMyutam| <br /> <br /> sthiratAM prApya mAMsaM syAt svoShmaNA pakvameva tat [9] ||29|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Due to the action of heat along with the ''[[vata]], ambu'' (water) and ''[[teja]]s,'' the ''[[rakta]]'' is converted into stable ''[[mamsa]],'' after being acted upon by its own [[agni]] (''mamsadhatvagni'') [29]<br /> <br /> === Formation of ''[[meda dhatu]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्वतेजोऽम्बुगुणस्निग्धोद्रिक्तं मेदोऽभिजायते| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> svatējō'mbuguṇasnigdhōdriktaṁ mēdō'bhijāyatē| <br /> <br /> svatejo~ambuguNasnigdhodriktaM medo~abhijAyate| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Because of the action of ''medo-dhatvagni'' on the excessively dominant ''snigdha'' attribute of aṃbu, the [[meda dhatu]] is formed [29½]<br /> <br /> === Formation of ''[[asthi dhatu]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पृथिव्यग्न्यनिलादीनां सङ्घातः स्वोष्मणा कृतः||३०|| <br /> <br /> खरत्वं प्रकरोत्यस्य जायतेऽस्थि ततो नृणाम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pr̥thivyagnyanilādīnāṁ saṅghātaḥ svōṣmaṇā kr̥taḥ||30|| <br /> <br /> kharatvaṁ prakarōtyasya jāyatē'sthi tatō nr̥ṇām| <br /> <br /> pRuthivyagnyanilAdInAM sa~gghAtaH svoShmaNA [10] kRutaH||30|| <br /> <br /> kharatvaM prakarotyasya jAyate~asthi tato nRuNAm| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Because of the action of ''asthi dhātvagni'' on the aggregation of ''[[prithvi]], [[agni]]'' and ''anila'', roughness is attained during the formation of the ''[[asthi]]'' [30]<br /> <br /> === Formation of ''[[majja dhatu]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> करोति तत्र सौषिर्यमस्थ्नां मध्ये समीरणः||३१|| <br /> <br /> मेदसस्तानि पूर्यन्ते स्नेहो मज्जा ततः स्मृतः|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> karōti tatra sauṣiryamasthnāṁ madhyē samīraṇaḥ||31|| <br /> <br /> mēdasastāni pūryantē snēhō majjā tataḥ smr̥taḥ| <br /> <br /> karoti tatra sauShiryamasthnAM madhye samIraNaH||31|| <br /> <br /> medasastAni pUryante sneho majjA tataH smRutaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Vata]]'' produces hollowness inside the ''[[asthi dhatu]]'', and after which, these hollow cavities get filled up by fatty tissue which is known as ''[[majja]]'' [31]<br /> <br /> === Formation of ''[[shukra dhatu]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तस्मान्मज्ज्ञस्तु यः स्नेहः शुक्रं सञ्जायते ततः||३२|| <br /> <br /> वाय्वाकाशादिभिर्भावैः सौषिर्यं जायतेऽस्थिषु| <br /> <br /> तेन स्रवति तच्छुक्रं नवात् कुम्भादिवोदकम्||३३|| <br /> <br /> स्रोतोभिः स्यन्दते देहात् समन्ताच्छुक्रवाहिभिः | <br /> <br /> हर्षेणोदीरितं वेगात् सङ्कल्पाच्च मनोभवात्||३४|| <br /> <br /> विलीनं घृतवद्व्यायामोष्मणा स्थानविच्युतम्| <br /> <br /> बस्तौ सम्भृत्य निर्याति स्थलान्निम्नादिवोदकम्)||३५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tasmānmajjñastu yaḥ snēhaḥ śukraṁ sañjāyatē tataḥ||32|| <br /> <br /> vāyvākāśādibhirbhāvaiḥ sauṣiryaṁ jāyatē'sthiṣu| <br /> <br /> tēna sravati tacchukraṁ navāt kumbhādivōdakam||33|| <br /> <br /> srōtōbhiḥ syandatē dēhāt samantācchukravāhibhiḥ | <br /> <br /> harṣēṇōdīritaṁ vēgāt saṅkalpācca manōbhavāt||34|| <br /> <br /> vilīnaṁ ghr̥tavadvyāyāmōṣmaṇā sthānavicyutam| <br /> <br /> bastau sambhr̥tya niryāti sthalānnimnādivōdakam)||35||<br /> <br /> tasmAnmajj~jastu yaH snehaH shukraM sa~jjAyate tataH||32|| <br /> <br /> vAyvAkAshAdibhirbhAvaiH sauShiryaM jAyate~asthiShu| <br /> <br /> tena sravati tacchukraM navAt kumbhAdivodakam||33|| <br /> <br /> srotobhiH syandate dehAt samantAcchukravAhibhiH [11] |<br /> <br /> harSheNodIritaM vegAt sa~gkalpAcca manobhavAt||34|| <br /> <br /> vilInaM ghRutavadvyAyAmoShmaNA sthAnavicyutam| <br /> <br /> bastau sambhRutya niryAti sthalAnnimnAdivodakam)||35||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''sneha'' (fatty) portion of ''[[majja]]'' produces shukra. The porosity in the ''[[asthi]]'' is produced because of the factors such as ''[[vata]]'' and ''akasha.'' ''[[Shukra]]'' comes out of ''[[asthi]]'' through these pores just as the water comes out of a new earthen vessel. Through the channels known as ''shukravaha srotamsi'', this ''[[shukra]]'' spreads all over the body. This ''[[shukra]]'' is discharged through the urethra (which is connected to the urinary bladder) because of several factors such as sexual excitation, reflex activities (''vega''), and mental determination (''samkalpa''). Just as the ghee moves out with ease when heated, the ''[[shukra]]'' too, is discharged due to the heat liberated during the sexual activity. This process of seminal discharge is comparable with the movement of water from a place of lower altitude to a place of higher altitude) [32-35]<br /> <br /> === Continuous circulation of ''[[rasa]]'' all over the body ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> व्यानेन रसधातुर्हि विक्षेपोचितकर्मणा| <br /> <br /> युगपत् सर्वतोऽजस्रं देहे विक्षिप्यते सदा||३६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vyānēna rasadhāturhi vikṣēpōcitakarmaṇā| <br /> <br /> yugapat sarvatō'jasraṁ dēhē vikṣipyatē sadā||36|| <br /> <br /> vyAnena rasadhAturhi vikShepocitakarmaNA| <br /> <br /> yugapat sarvato~ajasraM dehe vikShipyate sadA||36|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Because of being forcefully propelled (out of the heart) by the action of ''vyana vata'', the ''[[rasa dhatu]]'' spreads all over the body simultaneously, continuously and for the entire life [36]<br /> <br /> === Significance of ''Kha-Vaigunya'' (abnormality in body system) in causing disease state ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षिप्यमाणः खवैगुण्याद्रसः सज्जति यत्र सः| <br /> <br /> करोति विकृतिं तत्र खे वर्षमिव तोयदः||३७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣipyamāṇaḥ khavaiguṇyādrasaḥ sajjati yatra saḥ| <br /> <br /> karōti vikr̥tiṁ tatra khē varṣamiva tōyadaḥ||37|| <br /> <br /> kShipyamANaH khavaiguNyAdrasaH sajjati yatra saH| <br /> <br /> karoti [12] vikRutiM tatra khe varShamiva toyadaH||37|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Wherever the ''[[rasa]]'' experiences obstacle due to abnormality in ''srotas, [[rasa]]'' readily produces disease in that very same location. This process is comparable with that of the clouds producing rainfall in a localized region that is favorable for rainfall [37]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दोषाणामपि चैवं स्यादेकदेशप्रकोपणम् |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dōṣāṇāmapi caivaṁ syādēkadēśaprakōpaṇam |<br /> <br /> doShANAmapi caivaM syAdekadeshaprakopaNam [13] |<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> This principle is applicable even in case of ''[[dosha]]'', where ''ekadesha prakopa'' (abnormal increase at a local site) occurs [37½]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इति भौतिकधात्वन्नपक्तॄणां कर्म भाषितम्||३८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> iti bhautikadhātvannapaktr̥̄ṇāṁ karma bhāṣitam||38|| <br /> <br /> iti bhautikadhAtvannapaktRUNAM karma bhAShitam||38|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus ends the description of the physiological functions of ''bhutagni, dhatvagni'' and ''jatharagni'' [38]<br /> <br /> === Significance of ''jatharagni'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अन्नस्य पक्ता सर्वेषां पक्तॄणामधिपो मतः| <br /> <br /> तन्मूलास्ते हि तद्वृद्धिक्षयवृद्धिक्षयात्मकाः||३९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> annasya paktā sarvēṣāṁ paktr̥̄ṇāmadhipō mataḥ| <br /> <br /> tanmūlāstē hi tadvr̥ddhikṣayavr̥ddhikṣayātmakāḥ||39|| <br /> <br /> annasya paktA sarveShAM paktRUNAmadhipo mataH| <br /> <br /> tanmUlAste hi tadvRuddhikShayavRuddhikShayAtmakAH||39|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Jatharagni'' is known as the King among all the forms of [[agni]]. The intensification and diminution of all other forms of [[agni]] is in fact dependent on ''jatharagni'' [39]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तस्मात्तं विधिवद्युक्तैरन्नपानेन्धनैर्हितैः| <br /> <br /> पालयेत् प्रयतस्तस्य स्थितौ ह्ययुर्बलस्थितिः||४०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tasmāttaṁ vidhivadyuktairannapānēndhanairhitaiḥ| <br /> <br /> pālayēt prayatastasya sthitau hyayurbalasthitiḥ||40|| <br /> <br /> tasmAttaM vidhivadyuktairannapAnendhanairhitaiH| <br /> <br /> pAlayet prayatastasya sthitau hyayurbalasthitiH||40|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> An individual should take utmost care to maintain the [[agni]] by providing fuel in the form of food and drinks which should be taken as per the rules mentioned, because life and strength of an individual depends on [[agni]] [40]<br /> <br /> === Initiation of ''grahani dosha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यो हि भुङ्क्ते विधिं त्याक्त्वा ग्रहणीदोषजान् गदान्| <br /> <br /> स लौल्याल्लभते शीघ्रं, वक्ष्यन्तेऽतः परं तु ते||४१||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yō hi bhuṅktē vidhiṁ tyāktvā Grahaṇī dōṣajān gadān| <br /> <br /> sa laulyāllabhatē śīghraṁ, vakṣyantē'taḥ paraṁ tu tē||41||<br /> <br /> yo hi bhu~gkte vidhiM tyAktvA grahaNIdoShajAn gadAn| <br /> <br /> sa laulyAllabhate shIghraM, vakShyante~ataH paraM tu te||41||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If an individual indulges in food without following the rules and regulation of diet intake, then he quickly suffers from diseases caused by the vitiation of ''grahani'' because of his greedy habits. Such diseases are being described henceforth [41]<br /> <br /> === Causes of vitiation of [[agni]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अभोजनादजीर्णातिभोजनाद्विषमाशनात्|<br /> <br /> असात्म्यगुरुशीतातिरूक्षसन्दुष्टभोजनात्||४२|| <br /> <br /> विरेकवमनस्नेहविभ्रमाद्व्याधिकर्षणात्| <br /> <br /> देशकालर्तुवैषम्याद्वेगानां च विधारणात्||४३|| <br /> <br /> दुष्यत्यग्निः, स दुष्टोऽन्नं न तत् पचति लघ्वपि| <br /> <br /> अपच्यमानं शुक्तत्वं यात्यन्नं विषरूपताम् ||४४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> abhōjanādajīrṇātibhōjanādviṣamāśanāt| <br /> <br /> asātmyaguruśītātirūkṣasanduṣṭabhōjanāt||42|| <br /> <br /> virēkavāmanasnēhavibhramādvyādhikarṣaṇāt| <br /> <br /> dēśakālartuvaiṣamyādvēgānāṁ ca vidhāraṇāt||43||<br /> <br /> duṣyatyāgniḥ, sa duṣṭō'nnaṁ na tat pacati laghvapi| <br /> <br /> apacyamānaṁ śuktatvaṁ yātyannaṁ viṣarūpatām ||44|| <br /> <br /> abhojanAdajIrNAtibhojanAdviShamAshanAt| <br /> <br /> asAtmyagurushItAtirUkShasanduShTabhojanAt||42|| <br /> <br /> virekavamanasnehavibhramAdvyAdhikarShaNAt| <br /> <br /> deshakAlartuvaiShamyAdvegAnAM ca vidhAraNAt||43|| <br /> <br /> duShyatyagniH, sa duShTo~annaM na tat pacati laghvapi| <br /> <br /> apacyamAnaM shuktatvaM yAtyannaM viSharUpatAm [14] ||44||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Excessive starvation, indulging in food intake although there is indigestion, overeating, irregular habit of eating, eating unwholesome food, indulging in food which is heavy to digest or having excessive nutritional value, food which is having cold qualities or eating chilled or frozen items, food which is dry in nature or food which brings about emaciation, contaminated food, perversion of procedures like ''[[vamana]], [[virechana]]'' and ''sneha'', emaciation of body due to disease, sudden migration to unsuitable place and of time and of season, suppression of natural urges are causes for vitiation of [[agni]]. Thus, vitiated [[agni]] is unable to digest even the light food. [42-43]<br /> <br /> This vitiated digestive agent forms an intermediate substance called ''ama'', which turns sour (''shukta'') during fermentation and finally turns in poisonous substance (''amavisha'') [44]<br /> <br /> === Signs and symptoms of ''ajirna''(indigestion) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तस्य लिङ्गमजीर्णस्य विष्टम्भः सदनं तथा| <br /> <br /> शिरसो रुक् च मूर्च्छा च भ्रमः पृष्ठकटिग्रहः||४५|| <br /> <br /> जृम्भाऽङ्गमर्दस्तृष्णा च ज्वरश्छर्दिः प्रवाहणम्| <br /> <br /> अरोचकोऽविपाकश्च, घोरमन्नविषं च तत्||४६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tasya liṅgāmajīrṇasya viṣṭambhaḥ sadanaṁ tathā| <br /> <br /> śirasō ruk ca mūrcchā ca bhrāmaḥ pr̥ṣṭhakaṭigrahaḥ||45|| <br /> <br /> jr̥mbhā'ṅgāmardastr̥ṣṇā ca jvaraśchardiḥ pravāhaṇam| <br /> <br /> arōcakō'vipākaśca, ghōrāmannaviṣaṁ ca tat||46|| <br /> <br /> tasya li~ggamajIrNasya viShTambhaH sadanaM tathA| <br /> <br /> shiraso ruk ca mUrcchA ca bhramaH pRuShThakaTigrahaH||45|| <br /> <br /> jRumbhA~a~ggamardastRuShNA ca jvarashchardiH pravAhaNam|<br /> <br /> arocako~avipAkashca, ghoramannaviShaM ca tat||46|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> This poisonous substance (''amavisha'') manifests clinical features like flatulence, uncomfortable physical and mental miseries, headache, altered consciousness, giddiness, stiffness of back and lumbar region, yawning, body-ache, malaise, morbid thirst, fever, vomiting, tenesmus, anorexia and indigestion and it is similar to antigenic poison. [45-46]<br /> <br /> === Associated disorders of ''annavisha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> संसृज्यमानं पित्तेन दाहं तृष्णां मुखामयान्| <br /> <br /> जनयत्यम्लपित्तं च पित्तजांश्चापरान् गदान्||४७|| <br /> <br /> यक्ष्मपीनसमेहादीन् कफजान् कफसङ्गतम्| <br /> <br /> करोति वातसंसृष्टं वातजांश्च गदान् बहून्||४८|| <br /> <br /> मूत्ररोगांश्च मूत्रस्थं कुक्षिरोगान् शकृद्गतम्| <br /> <br /> रसादिभिश्च संसृष्टं कुर्याद्रोगान् रसादिजान्||४९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> saṁsr̥jyamānaṁ pittēna dāhaṁ tr̥ṣṇāṁ mukhāmayān| <br /> <br /> janayatyamlaPitta ṁ ca Pitta jāṁścāparān gadān||47|| <br /> <br /> yakṣmapīnasamēhādīn kaphajān kaphasaṅgatam| <br /> <br /> karōti Vātasaṁsr̥ṣṭaṁ Vātajāṁśca gadān bahūn||48|| <br /> <br /> mūtrarōgāṁśca mūtrasthaṁ kukṣirōgān śakr̥dgatam| <br /> <br /> rasādibhiśca saṁsr̥ṣṭaṁ kuryādrōgān rasādijān||49||<br /> <br /> saMsRujyamAnaM [15] pittena dAhaM tRuShNAM mukhAmayAn| <br /> <br /> janayatyamlapittaM ca pittajAMshcAparAn gadAn||47|| <br /> <br /> yakShmapInasamehAdIn kaphajAn kaphasa~ggatam| <br /> <br /> karoti vAtasaMsRuShTaM vAtajAMshca [16] gadAn bahUn||48|| <br /> <br /> mUtrarogAMshca mUtrasthaM kukShirogAn shakRudgatam| <br /> <br /> rasAdibhishca saMsRuShTaM kuryAdrogAn rasAdijAn||49||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''annavisha'' when associated with ''[[pitta]]'' causes ''daha'', morbid thirst, oral diseases, ''amlapitta'' (acid peptic disorders) and various other ''[[pitta]]'' related disorders.<br /> <br /> The same ''annavisha'' when gets associated with ''[[kapha]]'' it leads to condition like ''yakshma'' (pthiasis), ''peenas'' (coryza) and ''prameha'' (20 types of diabetes) and various other ''[[kapha]]ja'' disorders, whereas several ''vatika'' disease are caused by association of ''[[vata]]'' with the ''annavisha''. <br /> <br /> The ''annavisha'' when enters renal system, urine related disorders occur; similarly, ''kukshigata roga'' (ailments related to abdomen) have their origin when ''sakrita'' (feces) is involved. ''Rasadi pradoshaja vikara'' (tissue related ailments) occur when ''rasadi srotas'' are involved [47-49]<br /> <br /> === Effects of ''Vishamagni'' (irregular [[agni]])and ''tikshanagni''( excessive [[agni]]) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विषमो धातुवैषम्यं करोति विषमं पचन्| <br /> <br /> तीक्ष्णो मन्देन्धनो धातून् विशोषयति पावकः||५०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> viṣamō dhātuvaiṣamyaṁ karōti viṣāmaṁ pacan| <br /> <br /> tīkṣṇō mandēndhanō dhātūn viśōṣayati pāvakaḥ||50||<br /> <br /> viShamo dhAtuvaiShamyaM karoti viShamaM pacan| <br /> <br /> tIkShNo mandendhano dhAtUn vishoShayati pAvakaH||50||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''vishamagni'' (improper [[agni]]) causes irregularity in digestion and therefore defective formation of ''[[dhatu]]'' takes place whereas, ''tikshanagni'' (excessive [[agni]]) when associated with little quantity of fuel (in the form of food) causes depletion of ''[[dhatu]]'' (tissue elements) [50]<br /> <br /> === ''Samagni'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> युक्तं भुक्तवतो युक्तो धातुसाम्यं समं पचन्|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yuktaṁ bhuktavatō yuktō dhātusāmyaṁ sāmaṁ pacan|<br /> <br /> yuktaM bhuktavato yukto dhAtusAmyaM samaM pacan|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If [[agni]] is ''sama'' i.e. in balanced condition and correct diet regimen (as explained in [Cha.Sa.[[Sutra Sthana]] 5] and [Cha.Sa.[[Vimana Sthana]] 1/21] are also followed then there is proper digestion of food which helps in maintaining proper balance within the ''[[dhatu]]'' [50½]<br /> <br /> === ''Durbala'' (weak) [[agni]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दुर्बलो विदहत्यन्नं तद्यात्यूर्ध्वमधोऽपि वा||५१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> durbalō vidahatyannaṁ tadyātyūrdhvāmadhō'pi vā||51|| <br /> <br /> durbalo vidahatyannaM tadyAtyUrdhvamadho~api vA||51|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Durbala'' (weak) [[agni]] brings about partial digestion of food. These partially digested bio substances then enter in circulation, which may move either in upward or downward direction [51]<br /> <br /> === ''Grahani gada''(diseases of ''grahani'') ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अधस्तु पक्वमामं वा प्रवृत्तं ग्रहणीगदः| <br /> <br /> उच्यते सर्वमेवान्नं प्रायो ह्यस्य विदह्यते||५२|| <br /> <br /> अतिसृष्टं विबद्धं वा द्रवं तदुपदिश्यते| <br /> <br /> तृष्णारोचकवैरस्यप्रसेकतमकान्वितः||५३|| <br /> <br /> शूनपादकरः सास्थिपर्वरुक् छर्दनं ज्वरः| <br /> <br /> लोहामगन्धिस्तिक्ताम्ल [१७] उद्गारश्चास्य जायते||५४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> adhastu pakvamāmaṁ vā pravr̥ttaṁ Grahaṇī gadaḥ| <br /> <br /> ucyatē sarvamēvānnaṁ prāyō hyasya vidahyatē||52||<br /> <br /> atisr̥ṣṭaṁ vibaddhaṁ vā dravaṁ tadupadiśyatē| <br /> <br /> tr̥ṣṇārōcakavairasyaprasēkatāmakānvitaḥ||53|| <br /> <br /> śūnapādakaraḥ sāsthiparvaruk chardanaṁ jvaraḥ| <br /> <br /> lōhāmagandhistiktāmla [17] udgāraścāsya jāyatē||54||<br /> <br /> adhastu pakvamAmaM vA pravRuttaM grahaNIgadaH| <br /> <br /> ucyate sarvamevAnnaM prAyo hyasya vidahyate||52|| <br /> <br /> atisRuShTaM vibaddhaM vA dravaM tadupadishyate| <br /> <br /> tRuShNArocakavairasyaprasekatamakAnvitaH||53|| <br /> <br /> shUnapAdakaraH sAsthiparvaruk chardanaM jvaraH| <br /> <br /> lohAmagandhistiktAmla [17] udgArashcAsya jAyate||54||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When partially digested and partially undigested bio substances moves downward in gastrointestinal tract it produces a disorder known as ''grahanigada''. In this particular stage the entire food material remains in the state of ''vidagdha'' state (partially transformed/sour).<br /> <br /> In this condition the individual may pass stools in excessive quantity or frequency wherein stools may be loose, with thin consistency or in the form of pellet like stool/bound stool (''vibaddham'') and morbid thirst, anorexia, distaste, excessive watering of mouth, blackout, edema of legs and hands, pain in bones and finger joints, vomiting, fever, eructation having either metallic smell or undigested food and having bitter or sour taste are observed [52-54]<br /> <br /> === Premonitory symptoms of ''Grahani gada'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पूर्वरूपं तु तस्येदं तृष्णाऽऽलस्यं बलक्षयः| <br /> <br /> विदाहोऽन्नस्य पाकश्च चिरात् कायस्य गौरवम्||५५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pūrvarūpaṁ tu tasyēdaṁ tr̥ṣṇā''lasyaṁ balakṣayaḥ| <br /> <br /> vidāhō'nnasya pākaśca cirāt kāyasya gauravam||55||<br /> <br /> pUrvarUpaM tu tasyedaM tRuShNA~a~alasyaM balakShayaH| <br /> <br /> vidAho~annasya pAkashca cirAt kAyasya gauravam||55||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Premonitory signs and symptoms are thirst, malaise, diminution of strength, burning sensation; delay in digestion and heaviness in body [55]<br /> <br /> === Functions of ''grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अग्न्यधिष्ठानमन्नस्य ग्रहणाद्ग्रहणी मता| <br /> <br /> नाभेरुपर्यह्यग्निबलेनोपष्टब्धोपबृंहिता [१८] ||५६|| <br /> <br /> अपक्वं धारत्यन्नं पक्वं सृजति पार्श्वतः| <br /> <br /> दुर्बलाग्निबला दुष्टा [१९] त्वाममेव विमुञ्चति||५७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> agnyadhiṣṭhānāmannasya grahaṇādGrahaṇī matā| <br /> <br /> nābhēruparyahyAgnibalēnōpaṣṭabdhōpabr̥ṁhitā [18] ||56|| <br /> <br /> apakvaṁ dhāratyannaṁ pakvaṁ sr̥jati pārśvataḥ| <br /> <br /> durbalāgnibalā duṣṭā [19] tvāmamēva vimuñcati||57||<br /> <br /> agnyadhiShThAnamannasya grahaNAdgrahaNI matA| <br /> <br /> nAbheruparyahyagnibalenopaShTabdhopabRuMhitA [18] ||56|| <br /> <br /> apakvaM dhAratyannaM pakvaM sRujati pArshvataH| <br /> <br /> durbalAgnibalA duShTA [19] tvAmameva vimu~jcati||57||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Grahani'' is seat of [[agni]] and it is so called since it holds/retains the food (for proper digestion and assimilation). It holds the food just above the umbilical region and it is supported and nourished by the [[agni]]. ''Grahani'' with help of [[agni]] holds the undigested food and pushes forward digested food, but when [[agni]] becomes weak and vitiated due to ''vidagdha ahara murchita dosha'' (afflicted by improperly digested food) i.e ''sama dosha''(''[[dosha]]'' associated with ''ama'') it vitiates the ''grahani'' and releases food in the form of ''ama'' i.e. undigested form [56-57]<br /> <br /> === Four types of ''grahani'' disease ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वातात् पित्तात् कफाच्च स्यात्तद्रोगस्त्रिभ्य एव च| <br /> <br /> हेतुं लिङ्गं रूपभेदाञ् शृणु तस्य पृथक् पृथक्||५८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vātāt pittāt kaphācca syāttadrōgastribhya ēva ca| <br /> <br /> hētuṁ liṅgaṁ rūpabhēdāñ śr̥ṇu tasya pr̥thak pr̥thak||58|| <br /> <br /> vAtAt pittAt kaphAcca syAttadrogastribhya eva ca| <br /> <br /> hetuM li~ggaM rUpabhedA~j [21] shRuNu tasya pRuthak pRuthak||58|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Grahani'' is classified into four types viz ''[[vata]]ja, [[pitta]]ja, [[kapha]]ja'' and ''sannipataja''. On the basis of the classification, etiological factors, symptoms and signs are being mentioned one by one [58]<br /> <br /> === Causes of ''[[vata]]ja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कटुतिक्तकषायातिरूक्षशीतलभोजनैः| <br /> <br /> प्रमितानशनात्यध्ववेगनिग्रहमैथुनैः||५९|| <br /> <br /> करोति कुपितो मन्दमग्निं सञ्छाद्य मारुतः [२२] | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭutiktakaṣāyātirūkṣaśītalabhōjanaiḥ| <br /> <br /> pramitānaśanātyadhvavēganigrahāmaithunaiḥ||59|| <br /> <br /> karōti kupitō mandāmAgniṁ sañchādya mārutaḥ [22] | <br /> <br /> kaTutiktakaShAyAtirUkShashItalabhojanaiH| <br /> <br /> pramitAnashanAtyadhvaveganigrahamaithunaiH||59|| <br /> <br /> karoti kupito mandamagniM sa~jchAdya mArutaH [22] | <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Excessive indulgence in diet having ''katu'' (pungent), ''tikta'' (bitter), ''kashaya'' (astringent) dominant food, which is dry in nature or having absorptive or emaciative qualities; cold, chilled or frozen items, eating quantitatively less amount of food, suppression of natural urges and excessive sexual intercourse contribute to aggravation of ''[[vata dosha]]'' which encompass the [[agni]] causing suppression of [[agni]] [59½]<br /> <br /> === Symptoms of ''[[vata]]ja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तस्यान्नं पच्यते दुःखं शुक्तपाकं खराङ्गता||६०||<br /> <br /> कण्ठास्यशोषः क्षुत्तृष्णा तिमिरं कर्णयोः स्वनः| <br /> <br /> पार्श्वोरुवङ्क्षणग्रीवारुजोऽभीक्ष्णं विसूचिका||६१|| <br /> <br /> हृत्पीडा कार्श्यदौर्बल्यं वैरस्यं परिकर्तिका| <br /> <br /> गृद्धिः सर्वरसानां च मनसः सदनं तथा||६२|| <br /> <br /> जीर्णे जीर्यति चाध्मानं भुक्ते स्वास्थ्यमुपैति च| <br /> <br /> स वातगुल्महृद्रोगप्लीहाशङ्की च मानवः||६३|| <br /> <br /> चिरादुःखं द्रवं शुष्कं तन्वामं शब्दफेनवत्| <br /> <br /> पुनः पुनः सृजेद्वर्चः कासश्वासार्दितोऽनिलात्||६४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tasyānnaṁ pacyatē duḥkhaṁ śuktapākaṁ kharāṅgatā||60|| <br /> <br /> kaṇṭhāsyaśōṣaḥ kṣuttr̥ṣṇā timiraṁ karṇayōḥ svanaḥ| <br /> <br /> pārśvōruvaṅkṣaṇagrīvārujō'bhīkṣṇaṁ visūcikā||61|| <br /> <br /> hr̥tpīḍā kārśyadaurbalyaṁ vairasyaṁ parikartikā| <br /> <br /> gr̥ddhiḥ sarvarasānāṁ ca manasaḥ sadanaṁ tathā||62|| <br /> <br /> jīrṇē jīryati cādhmānaṁ bhuktē svāsthyamupaiti ca| <br /> <br /> sa Vātagulmahr̥drōgaplīhāśaṅkī ca mānavaḥ||63|| <br /> <br /> cirāduḥkhaṁ dravaṁ śuṣkaṁ tanvāmaṁ śabdaphēnavat| <br /> <br /> punaḥ punaḥ sr̥jēdvarcaḥ kāsaśvāsārditō'nilāt||64|| <br /> <br /> tasyAnnaM pacyate duHkhaM shuktapAkaM kharA~ggatA||60|| <br /> <br /> kaNThAsyashoShaH kShuttRuShNA timiraM karNayoH svanaH| <br /> <br /> pArshvoruva~gkShaNagrIvArujo~abhIkShNaM visUcikA||61|| <br /> <br /> hRutpIDA kArshyadaurbalyaM vairasyaM parikartikA| <br /> <br /> gRuddhiH sarvarasAnAM ca manasaH sadanaM tathA||62|| <br /> <br /> jIrNe jIryati cAdhmAnaM bhukte svAsthyamupaiti ca| <br /> <br /> sa vAtagulmahRudrogaplIhAsha~gkI ca mAnavaH||63|| <br /> <br /> cirAduHkhaM dravaM shuShkaM tanvAmaM shabdaphenavat| <br /> <br /> punaH punaH sRujedvarcaH kAsashvAsArdito~anilAt||64|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Symptoms of ''vatika grahani'' are as follows:<br /> <br /> Food is not easily digested and gets fermented (leading to sourness), roughness of skin, dryness of throat and mouth, craving for food and thirst is increased, ''timira'' (blurred vision), tinnitus, continuous pain in flanks, thighs, pelvis, neck region, ''vishuchika'' (piercing pain all over the body with vomiting and diarhea), chest pain/discomfort in cardiac region, emaciation, weakness, distaste, cutting pain, craving for sweets, sour and saline food (''madhuradi rasa''), reduced mental strength, ''adhmana'' (distention of abdomen) occurs during digestion and after completion of digestion whereas the patient feels abdominal comfort just after eating the food. <br /> <br /> Patient expresses repeated doubts that he is suffering from ''vatika'' disorders, ''gulma'' (abdominal tumor), heart disease and splenomegaly. <br /> <br /> Stools are evacuated with difficulty and consume time. Feces are either watery, dry, small sized associated with flatus and undigested food. Frequency of stool is increased and patient may suffer from cough and breathing difficulty [60-64]<br /> <br /> === Causes of ''[[pitta]]ja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कट्वजीर्णविदाह्यम्लक्षाराद्यैः पित्तमुल्बणम्| <br /> <br /> अग्निमाप्लावयद्धन्ति [२३] जलं तप्तमिवानलम्||६५|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭvajīrṇavidāhyamlakṣārādyaiḥ Pittamulbaṇam| <br /> <br /> Agnimāplāvayaddhanti [23] jalaṁ taptamivānalam||65|| <br /> <br /> kaTvajIrNavidAhyamlakShArAdyaiH pittamulbaNam| <br /> <br /> agnimAplAvayaddhanti [23] jalaM taptamivAnalam||65||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Katu'' (spicy), ''ajeerna'' (undigestable food), ''vidahi'' (food causing eructation), ''amla'' (sour), ''kshara'' (alkali) and other food items which aggravate ''pitta'' are causes for ''[[pitta]]ja grahani''. The aggravated ''[[pitta]]'' hampers the function of [[agni]] similar to condition wherein hot water extinguishes fire [65]<br /> <br /> === Symptoms of ''[[pitta]]ja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सोऽजीर्णं नीलपीताभं पीताभः सार्यते द्रवम्| <br /> <br /> पूत्यम्लोद्गारहृत्कण्ठदाहारुचितृडर्दितः||६६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sō'jīrṇaṁ nīlapītābhaṁ pītābhaḥ sāryatē dravam| <br /> <br /> pūtyamlōdgārahr̥tkaṇṭhadāhārucitr̥ḍarditaḥ||66|| <br /> <br /> so~ajIrNaM nIlapItAbhaM pItAbhaH sAryate dravam| <br /> <br /> pUtyamlodgArahRutkaNThadAhArucitRuDarditaH||66|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The stools have undigested food particles having either bluish-yellowish tinge or yellow in color and are loose/watery. The eructions have foul smell and sour taste, there is burning sensation in the cardiac region (retro-sternal) and throat, anorexia and thirst are the symptoms of ''[[pitta]]ja grahani'' [66]<br /> <br /> === Causes of ''[[kapha]]ja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुर्वतिस्निग्धशीतादिभोजनादतिभोजनात्| <br /> <br /> भुक्तमात्रस्य च स्वप्नाद्धन्त्यग्निं कुपितः कफः||६७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gurvatisnigdhaśītādibhōjanādatibhōjanāt| <br /> <br /> bhuktamātrasya ca svapnāddhantyAgniṁ kupitaḥ kaphaḥ||67|| <br /> <br /> gurvatisnigdhashItAdibhojanAdatibhojanAt| <br /> <br /> bhuktamAtrasya ca svapnAddhantyagniM kupitaH kaphaH||67|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Heavy to digest or excessively unctuous foods, frozen or chilled items or food having cold nature or food which has qualities similar to ''[[kapha]]'', excessive intake of food and sleeping just after the meals hamper the function of [[agni]] and simultaneously vitiates ''[[kapha]]'' [67]<br /> <br /> === Symptoms of ''[[kapha]]ja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तस्यान्नं पच्यते दुःखं हृल्लासच्छर्द्यरोचकाः| <br /> <br /> आस्योपदेहमाधुर्यकासष्ठीवनपीनसाः||६८|| <br /> <br /> हृदयं मन्यते स्त्यानमुदरं स्तिमितं गुरु| <br /> <br /> दुष्टो मधुर उद्गारः सदनं स्त्रीष्वहर्षणम्||६९|| <br /> <br /> भिन्नामश्लेष्मसंसृष्टगुरुवर्चःप्रवर्तनम्| <br /> <br /> अकृशस्यापि दौर्बल्यमालस्यं च कफात्मके||७०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tasyānnaṁ pacyatē duḥkhaṁ hr̥llāsacchardyarōcakāḥ| <br /> <br /> āsyōpadēhamādhuryakāsaṣṭhīvanapīnasāḥ||68|| <br /> <br /> hr̥dayaṁ manyatē styānamudaraṁ stimitaṁ guru| <br /> <br /> duṣṭō madhura udgāraḥ sadanaṁ strīṣvaharṣaṇam||69|| <br /> <br /> bhinnāmaślēṣmasaṁsr̥ṣṭaguruvarcaḥpravartanam| <br /> <br /> akr̥śasyāpi daurbalyamālasyaṁ ca kaphātmakē||70|| <br /> <br /> tasyAnnaM pacyate duHkhaM hRullAsacchardyarocakAH| <br /> <br /> AsyopadehamAdhuryakAsaShThIvanapInasAH||68|| <br /> <br /> hRudayaM manyate styAnamudaraM stimitaM guru| <br /> <br /> duShTo madhura udgAraH sadanaM strIShvaharShaNam||69|| <br /> <br /> bhinnAmashleShmasaMsRuShTaguruvarcaHpravartanam| <br /> <br /> akRushasyApi daurbalyamAlasyaM ca kaphAtmake||70|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Food is digested with difficulty, nausea, vomiting and anorexia are its symptoms. The other symptoms are feeling of coated mouth and sweet taste, has cough, increased tendency to spit, ''pinasa'' (nasal discharge), feeling of heaviness in chest, feeling as if there is no movement in abdomen, heavy abdomen, eructation with foul smelling and sweet taste; patient does not feel enthusiastic and there is suppression of libido. Stools are mixed with undigested items and mucous and are heavy; although patient is not emaciated still he feels weakness and laziness [68-70]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यश्चाग्निः पूर्वमुद्दिष्टो रोगानीके चतुर्विधः| <br /> <br /> तं चापि ग्रहणीदोषं समवर्जं प्रचक्ष्महे||७१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yaścāgniḥ pūrvamuddiṣṭō rōgānīkē caturvidhaḥ| <br /> <br /> taṁ cāpi Grahaṇī dōṣaṁ sāmavarjaṁ pracakṣmahē||71|| <br /> <br /> yashcAgniH pUrvamuddiShTo rogAnIke caturvidhaH| <br /> <br /> taM cApi grahaNIdoShaM samavarjaM pracakShmahe||71|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Four types of [[agni]] have been previously explained in [[Roganika Vimana]]. Except ''samagni'' other three types of [[agni]] contribute to the ''grahani dosha'' [71]<br /> <br /> === ''Sannipataja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पृथग्वातादिनिर्दिष्टहेतुलिङ्गसमागमे| <br /> <br /> त्रिदोषं निर्दिशेत्तेषां भेषजं [२४] शृण्वतः परम्||७२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pr̥thagvātādinirdiṣṭahētuliṅgasamāgamē| <br /> <br /> tridōṣaṁ nirdiśēttēṣāṁ bhēṣajaṁ [24] <br /> <br /> śr̥ṇVātaḥ param||72||<br /> <br /> pRuthagvAtAdinirdiShTahetuli~ggasamAgame| <br /> <br /> tridoShaM nirdishetteShAM bheShajaM [24] <br /> <br /> shRuNvataH param||72||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Sannipataja grahani'' occurs by simultaneous vitiation of ''[[vata]], [[pitta]]'' and ''[[kapha]]''. In such conditions etiological factors, symptoms and signs are of all the three ''[[dosha]]'' appear. Hereafter treatment of ''grahanidosha'' is expounded [72]<br /> <br /> === ''[[Vamana]]'' in ''grahanidosha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ग्रहणीमाश्रितं दोषं विदग्धाहारमूर्च्छितम्| <br /> <br /> सविष्टम्भप्रसेकार्तिविदाहारुचिगौरवैः||७३||<br /> <br /> आमलिङ्गान्वितं दृष्ट्वा सुखोष्णेनाम्बुनोद्धरेत्| <br /> <br /> फलानां वा कषायेण पिप्पलीसर्षपैस्तथा||७४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> Grahaṇī māśritaṁ dōṣaṁ vidagdhāhāramūrcchitam| <br /> <br /> saviṣṭambhaprasēkārtividāhārucigauravaiḥ||73|| <br /> <br /> āmaliṅgānvitaṁ dr̥ṣṭvā sukhōṣṇēnāmbunōddharēt| <br /> <br /> phalānāṁ vā kaṣāyēṇa pippalīsarṣapaistathā||74||<br /> <br /> grahaNImAshritaM doShaM vidagdhAhAramUrcchitam| <br /> <br /> saviShTambhaprasekArtividAhArucigauravaiH||73|| <br /> <br /> Amali~ggAnvitaM dRuShTvA sukhoShNenAmbunoddharet| <br /> <br /> phalAnAM vA kaShAyeNa pippalIsarShapaistathA||74|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When the ''[[dosha]]s'' are located in ''grahani'' and are associated with incomplete digested food then ''vishtambha'' (constipation), excessive salivation, bodyache, burning sensation, anorexia and heaviness is felt by patient which are symptoms of ''ama'' and in such a condition ''[[vamana]]'' (emetic therapy) with lukewarm water or with decoction of ''madanaphala'' (Randia spinosa), ''pippali'' (Piper longum) and ''sarshapa'' (Brassica campestris) should be administered [73-74]<br /> <br /> === Treatment of ''leena [[dosha]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> लीनं पक्वाशयस्थं वाऽऽप्यामं स्राव्यं सदीपनैः| <br /> <br /> शरीरानुगते सामे रसे लङ्घनपाचनम्||७५|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> līnaṁ pakvāśayasthaṁ vā''pyāmaṁ srāvyaṁ sadīpanaiḥ| <br /> <br /> śarīrānugatē sāmē rasē laṅghanapācanam||75|| <br /> <br /> lInaM pakvAshayasthaM vA~a~apyAmaM srAvyaM sadIpanaiH| <br /> <br /> sharIrAnugate sAme rase la~gghanapAcanam||75|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the ''ama'' is in ''pakvashaya'' and in ''anutklishtha'' (stuck, not ready to come out) condition then ''stravana'' (increasing secretion) with ''[[deepana]] dravyas'' should be administered whereas if ama gets absorbed along with ''[[rasa dhatu]]'' and if it pervades throughout the body then ''[[langhana]]'' and ''[[pachana]]'' should be advised [75]<br /> <br /> === ''Panchakoladi shritam and peya'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विशुद्धामाशयायास्मै पञ्चकोलादिभिः शृतम्| <br /> <br /> दद्यात् पेयादि लघ्वन्नं पुनर्योगांश्च दीपनान्||७६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> viśuddhāmāśayāyāsmai pañcakōlādibhiḥ śr̥tam| <br /> <br /> dadyāt pēyādi laghvannaṁ punaryōgāṁśca dīpanān||76|| <br /> <br /> vishuddhAmAshayAyAsmai pa~jcakolAdibhiH shRutam| <br /> <br /> dadyAt peyAdi laghvannaM punaryogAMshca dIpanAn||76|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After cleansing of ''amashaya'', liquid gruel of rice (''peya'') fortified with ''panchakola'' etc. drugs should be administered. Light and easy to digest food along with ''[[deepana]]'' drugs may be given [76]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ज्ञात्वा तु परिपक्वामं मारुतग्रहणीगदम्| <br /> <br /> दीपनीययुतं सर्पिः पाययेताल्पशो भिषक्||७७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> jñātvā tu paripakvāmaṁ mārutaGrahaṇī gadam| <br /> <br /> dīpanīyayutaṁ sarpiḥ pāyayētālpaśō bhiṣak||77|| <br /> <br /> j~jAtvA tu paripakvAmaM mArutagrahaNIgadam| <br /> <br /> dIpanIyayutaM sarpiH pAyayetAlpasho bhiShak||77|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In patients with ''[[vata]]ja grahani'' after ascertaining that ''ama'' is digested, medicated ghee starting with very minimum quantity prepared from ''deepaneeya gana'' be administered [Cha.Sa.[[Sutra Sthana ]]4/9/6]- [77]<br /> <br /> === ''Niruha [[basti]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> किञ्चित्सन्धुक्षिते त्वग्नौ सक्तविण्मूत्रमारुतम्| <br /> <br /> द्व्यहं त्र्यहं वा संस्नेह्य स्विन्नाभ्यक्तं निरूहयेत्||७८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kiñcitsandhukṣitē tvagnau saktaviṇmūtramārutam| <br /> <br /> dvyahaṁ tryahaṁ vā saṁsnēhya svinnābhyaktaṁ nirūhayēt||78|| <br /> <br /> ki~jcitsandhukShite tvagnau saktaviNmUtramArutam| <br /> <br /> dvyahaM tryahaM vA saMsnehya svinnAbhyaktaM nirUhayet||78|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As stimulation of [[agni]] is observed and still if patient finds difficulty in passing stool, urine and flatus then in such condition every two or three days ''niruha [[basti]]'' should be administered after proper ''[[snehana]]'' and ''[[swedana]]'' [78]<br /> <br /> === ''[[Virechana]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत एरण्डतैलेन सर्पिषा तैल्वकेन वा| <br /> <br /> सक्षारेणानिले शान्ते स्रस्तदोषं विरेचयेत्||७९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tata ēraṇḍatailēna sarpiṣā tailvakēna vā| <br /> <br /> sakṣārēṇānilē śāntē srastadōṣaṁ virēcayēt||79|| <br /> <br /> tata eraNDatailena sarpiShA tailvakena vA| <br /> <br /> sakShAreNAnile shAnte srastadoShaM virecayet||79|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After ''niruha'', the ''strasta dosha'' (''[[dosha]]'' ready to come out) should be cleaned with purgative drugs like ''eranda taila'' (castor oil) or ''tilvaka ghrita'' mixed with ''kshara'' (medicine with alkaline nature) [79]<br /> <br /> === ''Anuvasana [[basti]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शुद्धं रूक्षाशयं बद्धवर्चसं चानुवासयेत्| <br /> <br /> दीपनीयाम्लवातघ्नसिद्धातैलेन मात्रया||८०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śuddhaṁ rūkṣāśayaṁ baddhavarcasaṁ cānuvāsayēt| <br /> <br /> dīpanīyāmlaVātaghnasiddhātailēna mātrayā||80|| <br /> <br /> shuddhaM rUkShAshayaM baddhavarcasaM cAnuvAsayet| <br /> <br /> dIpanIyAmlavAtaghnasiddhAtailena mAtrayA||80|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After ''[[shodhana]]'' of intestine if ''rukshata'' and ''baddha'' (pellet-like) stools are seen then ''anuvasana [[basti]]'' with ''taila'' fortified with ''[[deepana]]'' drugs having sour and ''[[vata]]'' alleviating action may be administered [80]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> निरूढं च विरिक्तं च सम्यक् चैवानुवासितम्| <br /> <br /> लघ्वन्नं प्रतिसम्भुक्तं सर्पिरभ्यासयेत् पुनः||८१||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nirūḍhaṁ ca viriktaṁ ca samyak caivānuvāsitam| <br /> <br /> laghvannaṁ pratisambhuktaṁ sarpirabhyāsayēt punaḥ||81||<br /> <br /> nirUDhaM ca viriktaM ca samyak caivAnuvAsitam| <br /> <br /> laghvannaM pratisambhuktaM sarpirabhyAsayet punaH||81||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After appropriate administration of ''niruha, [[virechana]]'' and ''anuvasana'', light diet should be taken daily and ghee should be taken repeatedly [81]<br /> <br /> === ''Dashamooladya ghrita''===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्वे पञ्चमूले सरलं देवदारु सनागरम्| <br /> <br /> पिप्पलीं पिप्पलीमूलं चित्रकं हस्तिपिप्पलीम्||८२|| <br /> <br /> शणबीजं यवान् कोलन् कुलत्थान् सुषवीं तथा [२७] |<br /> <br /> पाचयेदारनालेन दध्ना सौवीरकेण वा||८३|| <br /> <br /> चतुर्भागावशेषेण पचेत्तेन घृताढकम्| <br /> <br /> स्वर्जिकायावशूकाख्यौ क्षारौ दत्त्वा च युक्तितः||८४|| <br /> <br /> सैन्धवौद्भिदसामुद्रबिडानां रोमकस्य च| <br /> <br /> ससौवर्चलपाक्यानां भागान्द्विपलिकान् पृथक्||८५|| <br /> <br /> विनीय चूर्णितान् तस्मात् पाययेत् प्रसृतं बुधः| <br /> <br /> करोत्यग्निं बलं वर्णं वातघ्नं भुक्तपाचनम्||८६|| <br /> <br /> इति दशमूलाद्यं घृतम्<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dvē pañcamūlē saralaṁ dēvadāru sanāgaram| <br /> <br /> pippalīṁ pippalīmūlaṁ citrakaṁ hastipippalīm||82|| <br /> <br /> śaṇabījaṁ yavān kōlan kulatthān suṣavīṁ tathā [27] | <br /> <br /> pācayēdāranālēna dadhnā sauvīrakēṇa vā||83|| <br /> <br /> caturbhāgāvaśēṣēṇa pacēttēna ghr̥tāḍhakam| <br /> <br /> svarjikāyāvaśūkākhyau kṣārau dattvā ca yuktitaḥ||84|| <br /> <br /> saindhavaudbhidasāmudrabiḍānāṁ rōmakasya ca| <br /> <br /> sasauvarcalapākyānāṁ bhāgāndvipalikān pr̥thak||85|| <br /> <br /> vinīya cūrṇitān tasmāt pāyayēt prasr̥taṁ budhaḥ| <br /> <br /> karōtyAgniṁ balaṁ varṇaṁ Vātaghnaṁ bhuktapācanam||86|| <br /> <br /> iti daśamūlādyaṁ ghr̥tam<br /> <br /> dve pa~jcamUle saralaM devadAru sanAgaram| <br /> <br /> pippalIM pippalImUlaM citrakaM hastipippalIm||82|| <br /> <br /> shaNabIjaM yavAn kolan kulatthAn suShavIM tathA [27] | <br /> <br /> pAcayedAranAlena dadhnA sauvIrakeNa vA||83|| <br /> <br /> caturbhAgAvasheSheNa pacettena ghRutADhakam| <br /> <br /> svarjikAyAvashUkAkhyau kShArau dattvA ca yuktitaH||84|| <br /> <br /> saindhavaudbhidasAmudrabiDAnAM romakasya ca| <br /> <br /> sasauvarcalapAkyAnAM bhAgAndvipalikAn pRuthak||85|| <br /> <br /> vinIya cUrNitAn tasmAt pAyayet prasRutaM budhaH| <br /> <br /> karotyagniM balaM varNaM vAtaghnaM bhuktapAcanam||86|| <br /> <br /> iti dashamUlAdyaM ghRutam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Boil the ''svarasa'' of two ''panchamoola'' (''brihat'' and ''laghu''), ''sarala'' ((''trivrita'') Operculina turpethum), ''devadaru'' (Cedrus deodara), ''nagara'' (Zingiber officinale), ''pippali'' (Piper longum), ''pippalimoola, chitraka'' (Plumbago zeylanica), ''gajapippali'' (Piper retofractum), ''sanabeeja'' (seeds of Crotalaria juncea), barley, ''kola, kulatta'' and ''susavi'' (Woodfordia fruticosa) with ''aranala, dadhimanda'' or ''sauviraka''. After one fourth reductions add one ''adhaka'' (3.073 kg) of ghee and ''svarjikakshara'' and ''yavashukakshara'' as per ''yukti pramana'' i.e. either in small quantity or at the time of ''ghrita siddhi lakshana'' alongwith ''saindhava'' (rock salt), ''audbhida'' (salts derived from plants), ''samudra'' (table salt), ''bidha'' (red granular salt), ''romaka, sauvarchala'' and ''pakya'' (''pakaja'') types of salt in two ''pala'' quantity each (96 gm each). After preparation, it may be administered up to one ''prasrita'' i.e. 96 gm. It increases [[agni]], strength and complexion and helps in alleviation of ''[[vata]]'' and thus digestion of food [82-86]<br /> <br /> === ''Tryushanadya ghrita'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्र्यूषणत्रिफलाकल्के बिल्वमात्रे गुडात् पले| <br /> <br /> सर्पिषोऽष्टपलं पक्त्वा मात्रां मन्दानलः पिबेत्||८७|| <br /> <br /> इति त्र्यूषणाद्यं घृतम्<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tryūṣaṇatriphalākalkē bilvamātrē guḍāt palē| <br /> <br /> sarpiṣō'ṣṭapalaṁ paktvā mātrāṁ mandānalaḥ pibēt||87|| <br /> <br /> iti tryūṣaṇādyaṁ ghr̥tam<br /> <br /> tryUShaNatriphalAkalke bilvamAtre guDAt pale| <br /> <br /> sarpiSho~aShTapalaM paktvA mAtrAM mandAnalaH pibet||87|| <br /> <br /> iti tryUShaNAdyaM ghRutam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Prepare paste of ''trikatu'' and ''triphala'' in quantity of one ''bilva'' and add one ''pala'' (48g) of jaggery and do ''sneha siddhi'' by adding eight ''palas'' (384 gm) of ghee. This medicated ''ghrita'' is indicated in ''mandagni'' i.e. low digestive power [87]<br /> <br /> === ''Panchamooladya ghrita'' and ''choorna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पञ्चमूलाभयाव्योषपिप्पलीमूलसैन्धवैः| <br /> <br /> रास्नाक्षारद्वयाजाजीविडङ्गशटिभिर्घृतम्||८८|| <br /> <br /> शुक्तेन मातुलुङ्गस्य स्वरसेनार्द्रकस्य च| <br /> <br /> शुष्कमूलककोलाम्बुचुक्रिकादाडिमस्य च||८९|| <br /> <br /> तक्रमस्तुसुरामण्डसौवीरकतुषोदकैः| <br /> <br /> काञ्जिकेन च तत् पक्वमग्निदीप्तिकरं परम्||९०|| <br /> <br /> शूलगुल्मोदरश्वासकासानिलकफापहम्| <br /> <br /> सबीजपूरकरसं सिद्धं वा पाययेद्घृतम्||९१|| <br /> <br /> सिद्धमभ्यञ्जनार्थं च तैलमेतैः प्रयोजयेत्| <br /> <br /> एतेषामौषधानां वा पिबेच्चूर्णं सुखाम्बुना||९२|| <br /> <br /> वाते श्लेष्मावृते सामे कफे वा वायुनोद्धते| <br /> <br /> दद्याच्चूर्णं पाचनार्थमग्निसन्दीपनं परम्||९३|| <br /> <br /> इति पञ्चमूलाद्यं घृतं चूर्णं च<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pañcamūlābhayāvyōṣapippalīmūlasaindhavaiḥ| <br /> <br /> rāsnākṣāradvayājājīviḍaṅgaśaṭibhirghr̥tam||88|| <br /> <br /> śuktēna mātuluṅgasya svarasēnārdrakasya ca| <br /> <br /> śuṣkamūlakakōlāmbucukrikādāḍimasya ca||89|| <br /> <br /> takrāmastusurāmaṇḍasauvīrakatuṣōdakaiḥ| <br /> <br /> kāñjikēna ca tat pakvāmAgnidīptikaraṁ param||90|| <br /> <br /> śūlagulmōdaraśvāsakāsānilakaphāpaham| <br /> <br /> sabījapūrakarasaṁ siddhaṁ vā pāyayēdghr̥tam||91|| <br /> <br /> siddhāmabhyañjanārthaṁ ca tailamētaiḥ prayōjayēt| <br /> <br /> ētēṣāmauṣadhānāṁ vā pibēccūrṇaṁ sukhāmbunā||92|| <br /> <br /> vātē ślēṣmāvr̥tē sāmē kaphē vā Vātanōddhatē| <br /> <br /> dadyāccūrṇaṁ pācanārthāmAgnisandīpanaṁ param||93||<br /> <br /> iti pañcamūlādyaṁ ghr̥taṁ cūrṇaṁ ca<br /> <br /> pa~jcamUlAbhayAvyoShapippalImUlasaindhavaiH| <br /> <br /> rAsnAkShAradvayAjAjIviDa~ggashaTibhirghRutam||88|| <br /> <br /> shuktena mAtulu~ggasya svarasenArdrakasya ca| <br /> <br /> shuShkamUlakakolAmbucukrikAdADimasya ca||89|| <br /> <br /> takramastusurAmaNDasauvIrakatuShodakaiH| <br /> <br /> kA~jjikena ca tat pakvamagnidIptikaraM param||90|| <br /> <br /> shUlagulmodarashvAsakAsAnilakaphApaham| <br /> <br /> sabIjapUrakarasaM siddhaM vA pAyayedghRutam||91|| <br /> <br /> siddhamabhya~jjanArthaM ca tailametaiH prayojayet| <br /> <br /> eteShAmauShadhAnAM vA pibeccUrNaM sukhAmbunA||92|| <br /> <br /> vAte shleShmAvRute sAme kaphe vA vAyunoddhate| <br /> <br /> dadyAccUrNaM pAcanArthamagnisandIpanaM param||93|| <br /> <br /> iti pa~jcamUlAdyaM ghRutaM cUrNaM ca<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make paste of ''panchamoola'' (''bilva, shyonaka, gambhari, patala'' and ''gambharika''), ''abhaya'', ''trikatu, pippalimoola, saindhava, rasna,'' two ''kshara'' (''sarjika'' and ''yavakshara''), ''ajaji, vidanga'' and ''sati'' and prepare medicated ghee with ''sukta,'' juice of ''matulunga'' and ''ardraka, suṣkamoolaka, kolambu, chukrika,'' pomengranate, butter milk, ''mastu'' (supplement liquid portion in the curd/yoghurt), ''suramanda'' (indigenous beer beverage prepared from fermented cereals) ''sauviraka'' (acidic fermented liquid obtained from wheat), ''tushodaka'' (fermented liquid using the coarse grains of barley) and ''kanji'' (fermented liquid). <br /> <br /> The medicated ghee helps in digestion and increase strength of [[agni]] and cures colicky pain, ''gulma, udara'', asthma and cough. It also pacifies ''[[vata]]'' and ''[[kapha]]''. ''Beejapuraka svarasa'' can also be used for ''sneha siddhi''.<br /> <br /> ''Taila siddhi'' with above medicine may be used for ''abhyanga'' (massage) and the ''choorna'' used in above preparation may be taken with lukewarm water.<br /> <br /> In condition such as ''kapha avrite vata'' (''[[vata]]'' occluded by ''[[kapha]]''), ''sama [[kapha]]'' and ''[[vata]]'' aggravated due to ''[[kapha]]'' give the above ''choorna'' for digestion and to stimulate [[agni]]. The medicine is known as ''panchamooladyam ghritam choornam'' [88-93]<br /> <br /> === Examination of feces ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मज्जत्यामा गुरुत्वाद्विट् पक्वा तूत्प्लवते जले| <br /> <br /> विनाऽतिद्रवसङ्घातशैत्यश्लेष्मप्रदूषणात्||९४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> majjatyāmā gurutvādviṭ pakvā tūtplavatē jalē| <br /> <br /> vinā'tidravasaṅghātaśaityaślēṣmapradūṣaṇāt||94|| <br /> <br /> majjatyAmA gurutvAdviT pakvA tUtplavate jale| <br /> <br /> vinA~atidravasa~gghAtashaityashleShmapradUShaNAt||94|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Sama mala'' (stools) sinks into water due to ''gurutva'' (heaviness) of ''ama'' whereas ''pakva'' or ''nirama mala'' floats over the water; provided the stools consistency is not watery or not very compact and if not vitiated by ''sheeta [[guna]]'' and ''[[kapha]]'' [94]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> परीक्ष्यैवं पुरा सामं निरामं चामदोषिणम्| <br /> <br /> विधिनोपाचरेत् सम्यक् पाचनेनेतरेण वा||९५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> parīkṣyaivaṁ purā sāmaṁ nirāmaṁ cāmadōṣiṇam| <br /> <br /> vidhinōpācarēt samyak pācanēnētarēṇa vā||95||<br /> <br /> parIkShyaivaM purA sAmaM nirAmaM cAmadoShiNam| <br /> <br /> vidhinopAcaret samyak pAcanenetareNa vA||95||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Patient should be evaluated for ''amadosha'' whether ''samata'' or ''niramta'' is present or not and then appropriately treated with ''[[pachana]]'' etc. treatment [95]<br /> <br /> === ''Chitrakadya gutika'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चित्रकं पिप्पलीमूलं द्वौ क्षारौ लवणानि च| <br /> <br /> व्योषं हिङ्ग्वजमोदां च चव्यं चैकत्र चूर्णयेत्||९६|| <br /> <br /> गुटिका मातुलुङ्गस्य दाडिमस्य रसेन वा| <br /> <br /> कृता विपाचयत्यामं दीपयत्याशु चानलम्||९७|| <br /> <br /> इति चित्रकाद्या गुटिका<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> citrakaṁ pippalīmūlaṁ dvau kṣārau lavaṇāni ca| <br /> <br /> vyōṣaṁ hiṅgvajamōdāṁ ca cavyaṁ caikatra cūrṇayēt||96|| <br /> <br /> guṭikā mātuluṅgasya dāḍimasya rasēna vā| <br /> <br /> kr̥tā vipācayatyāmaṁ dīpayatyāśu cālanam||97|| <br /> <br /> iti citrakādyā guṭikā<br /> <br /> citrakaM pippalImUlaM dvau kShArau lavaNAni ca| <br /> <br /> vyoShaM hi~ggvajamodAM ca cavyaM caikatra cUrNayet||96|| <br /> <br /> guTikA mAtulu~ggasya dADimasya rasena vA| <br /> <br /> kRutA vipAcayatyAmaM dIpayatyAshu cAlanam||97||<br /> <br /> iti citrakAdyA guTikA<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Chitraka, pippalimoola,'' two ''kshara'' (''yavakshara'' and ''sarjikshara''), salt, ''trikatu, hingu, ajamoda'' and ''chavya'' are mixed together and trichurated with either ''matulunga svarasa'' or ''dadima svarasa'' and tablets are prepared. This ''chitrakadya guthi'' is useful for digestion of ''ama'' and stimulation of the [[agni]] [96-97]<br /> <br /> === Recipes for ''[[pachana]]'' of ''ama'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नागरातिविषामुस्तक्वाथः स्यादामपाचनः| <br /> <br /> मुस्तान्तकल्कः पथ्या वा नागरं चोष्णवारिणा||९८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nāgarātiviṣāmustakvāthaḥ syādāmapācanaḥ| <br /> <br /> mustāntakalkaḥ pathyā vā nāgaraṁ cōṣṇavāriṇā||98|| <br /> <br /> nAgarAtiviShAmustakvAthaH syAdAmapAcanaH| <br /> <br /> mustAntakalkaH pathyA vA nAgaraM coShNavAriNA||98|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Shunthi, ativisha'' and ''musta'' decoction helps in ''[[pachana]]'' of ''ama''. ''Kalka'' (paste) of ''shunthi, ativisha'' and ''musta'' or ''haritaki'' or ''shunthi'' alongwith warm water also does ''ama pachana'' [98]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> देवदारुवचामुस्तनागरातिविषाभयाः| <br /> <br /> वारुण्यामासुतास्तोये कोष्णे वाऽलवणाः पिबेत्||९९||<br /> <br /> वर्चस्यामे सशूले च पिबेद्वा दाडिमाम्बुना| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dēvadāruvacāmustanāgarātiviṣābhayāḥ| <br /> <br /> vāruṇyāmāsutāstōyē kōṣṇē vā'lavaṇāḥ pibēt||99||<br /> <br /> varcasyāmē saśūlē ca pibēdvā dāḍimāmbunā|<br /> <br /> devadAruvacAmustanAgarAtiviShAbhayAH| <br /> <br /> vAruNyAmAsutAstoye koShNe vA~alavaNAH pibet||99|| <br /> <br /> varcasyAme sashUle ca pibedvA dADimAmbunA| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Soak powder of ''devadaru, vacha, musta, nagara, ativisha'' and ''haritaki'' in ''varuni'' (fermented liquid obtained from palm trees like dates) and take with warm water without adding salt or be taken with juice of ''dadima'' in condition wherein there is colicky pain along with mucus or undigested food in stool [99-99½]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विडेन [२९] लवणं पिष्टं बिल्वं चित्रकनागरम्||१००|| <br /> <br /> सामे वा सकफे वाते कोष्ठशूलकरे पिबेत्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> viḍēna [29] lavaṇaṁ piṣṭaṁ bilvaṁ citrakanāgaram||100|| <br /> <br /> sāmē vā sakaphē vātē kōṣṭhaśūlakarē pibēt| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Paste of ''bilva, chitraka'' and ''nagara'' should be added with ''vida lavana'' and administered in ''sama'' stool or mucus in stool and pain in abdomen due to [[vata]] aggravation [100]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कलिङ्गहिङ्ग्वतिविषावचासौवर्चलाभयाः||१०१|| <br /> <br /> छर्द्यर्शोग्रन्थिशूलेषु पिबेदुष्णेन वारिणा| <br /> <br /> पथ्यासौवर्चलाजाजीचूर्णं मरिचसंयुतम्||१०२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaliṅgahiṅgvativiṣāvacāsauvarcalābhayāḥ||101|| <br /> <br /> chardyarśōgranthiśūlēṣu pibēduṣṇēna vāriṇā| <br /> <br /> pathyāsauvarcalājājīcūrṇaṁ maricasaṁyutam||102|| <br /> <br /> viDena [29] lavaNaM piShTaM bilvaM citrakanAgaram||100|| <br /> <br /> sAme vA sakaphe vAte koShThashUlakare pibet| <br /> <br /> kali~ggahi~ggvativiShAvacAsauvarcalAbhayAH||101|| <br /> <br /> chardyarshogranthishUleShu pibeduShNena vAriNA| <br /> <br /> pathyAsauvarcalAjAjIcUrNaM maricasaMyutam||102|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Kalinga, hingu, ativisha, vacha, sauvarchala'' and ''haritaki'' with warm water is useful in vomiting, ''arshogranthi'' (analpolyp with pellet stool) and pain in abdomen. Similarly, combination of ''haritaki, sauvarchala'' and ''ajaji'' along with maricha can be used for same condition [101-102]<br /> <br /> === Recipe for ''[[pitta]]-[[kapha]] grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अभयां पिप्पलीमूलं वचां कटुकरोहिणीम्| <br /> <br /> पाठां वत्सकबीजानि चित्रकं विश्वभेषजम्||१०३|| <br /> <br /> पिबेन्निष्क्वाथ्य चूर्णं वा कृत्वा कोष्णेन वारिणा| <br /> <br /> पित्तश्लेष्माभिभृतायां ग्रहण्यां शूलनुद्धितम्||१०४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> abhayāṁ pippalīmūlaṁ vacāṁ kaṭukarōhiṇīm| <br /> <br /> pāṭhāṁ vatsakabījāni citrakaṁ viśvabhēṣajam||103|| <br /> <br /> pibēnniṣkvāthya cūrṇaṁ vā kr̥tvā kōṣṇēna vāriṇā| <br /> <br /> Pitta ślēṣmābhibhr̥tāyāṁ grahaṇyāṁ śūlanuddhitam||104|| <br /> <br /> abhayAM pippalImUlaM vacAM kaTukarohiNIm| <br /> <br /> pAThAM vatsakabIjAni citrakaM vishvabheShajam||103|| <br /> <br /> pibenniShkvAthya cUrNaM vA kRutvA koShNena vAriNA| <br /> <br /> pittashleShmAbhibhRutAyAM grahaNyAM shUlanuddhitam||104|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Decoction of the ''haritaki, pippalimoola, vacha, katukarohineem, patha,'' seeds of ''kutaja, chitraka, vishvabheshaja'' (''sunthi'') or ''choorna'' of the above contents should be administered with warm water. It is helpful when colic pain is associated with ''[[pitta]]-[[kapha]]'' dominant ''grahani'' [103-104]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सामे सातिविषं व्योषं लवणक्षारहिङ्गु च| <br /> <br /> निःक्वाथ्य पाययेच्चूर्णं कृत्वा वा कोष्णवारिणा||१०५|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sāmē sātiviṣaṁ vyōṣaṁ lavaṇakṣārahiṅgu ca| <br /> <br /> niḥkvāthya pāyayēccūrṇaṁ kr̥tvā vā kōṣṇavāriṇā||105|| <br /> <br /> sAme sAtiviShaM vyoShaM lavaNakShArahi~ggu ca| <br /> <br /> niHkvAthya pAyayeccUrNaM kRutvA vA koShNavAriNA||105|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''ama'' condition, decoction of ''ativisha, trikatu, lavana, kshara'' (''yavakshara'') and ''hingu'' may be given or powders of above medicines with warm water may be administered [105]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पिप्पलीं नागरं पाठां सारिवां बृहतीद्वयम्| <br /> <br /> चित्रकं कौटजं बीजं लवणान्यथ पञ्च च||१०६|| <br /> <br /> तच्चूर्णं सयवक्षारं दध्युष्णाम्बुसुरादिभिः| <br /> <br /> पिबेदग्निविवृद्ध्यर्थं कोष्ठवातहरं नरः||१०७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pippalīṁ nāgaraṁ pāṭhāṁ sārivāṁ br̥hatīdvayam| <br /> <br /> citrakaṁ kauṭajaṁ bījaṁ lavaṇānyatha pañca ca||106|| <br /> <br /> taccūrṇaṁ sayavakṣāraṁ dadhyuṣṇāmbusurādibhiḥ| <br /> <br /> pibēdAgnivivr̥ddhyarthaṁ kōṣṭhaVātaharaṁ naraḥ||107|| <br /> <br /> pippalIM nAgaraM pAThAM sArivAM bRuhatIdvayam| <br /> <br /> citrakaM kauTajaM bIjaM lavaNAnyatha pa~jca ca||106|| <br /> <br /> taccUrNaM sayavakShAraM dadhyuShNAmbusurAdibhiH| <br /> <br /> pibedagnivivRuddhyarthaM koShThavAtaharaM naraH||107|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Choorna'' of ''pippali, nagara, patha, sariva, brihatidvayam'' (''brihati, kantakari''), ''chitraka,'' seeds of ''kutaja'', five types of ''lavana'', along with ''yavakshara,'' curd, hot water and different types of fermented liquids such as ''kanji, sauviraka'' etc is taken for increasing the power of [[agni]] and to eliminate the ''[[vata]]'' in abdomen [106-107]<br /> <br /> === ''Marichadya choorna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मरिचं कुञ्चिकाम्बष्ठावृक्षाम्लाः कुडवाः पृथक्| <br /> <br /> पलानि [३०] दश चाम्लस्य वेतसस्य पलार्धिकम्||१०८|| <br /> <br /> सौवर्चलं बिडं पाक्यं यवक्षारः ससैन्धवः| <br /> <br /> शटीपुष्करमूलानि हिङ्गु हिङ्गुशिवाटिका||१०९|| <br /> <br /> तत् सर्वमेकतः सूक्ष्मं चूर्णं कृत्वा प्रयोजयेत्| <br /> <br /> हितं वाताभिभूतायां ग्रहण्यामरुचौ तथा||११०|| <br /> <br /> इति मरिचाद्यं चूर्णम्<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> maricaṁ kuñcikāmbaṣṭhāvr̥kṣāmlāḥ kuḍavāḥ pr̥thak| <br /> <br /> palāni [30] daśa cāmlasya vētasasya palārdhikam||108|| <br /> <br /> sauvarcalaṁ biḍaṁ pākyaṁ yavakṣāraḥ sasaindhavaḥ| <br /> <br /> śaṭīpuṣkaramūlāni hiṅgu hiṅguśivāṭikā||109|| <br /> <br /> tat sarvamēkataḥ sūkṣmaṁ cūrṇaṁ kr̥tvā prayōjayēt| <br /> <br /> hitaṁ vātābhibhūtāyāṁ grahaṇyāmarucau tathā||110|| <br /> <br /> iti maricādyaṁ cūrṇam<br /> <br /> maricaM ku~jcikAmbaShThAvRukShAmlAH kuDavAH pRuthak| <br /> <br /> palAni [30] dasha cAmlasya vetasasya palArdhikam||108|| <br /> <br /> sauvarcalaM biDaM pAkyaM yavakShAraH sasaindhavaH| <br /> <br /> shaTIpuShkaramUlAni hi~ggu hi~ggushivATikA||109|| <br /> <br /> tat sarvamekataH sUkShmaM cUrNaM kRutvA prayojayet| <br /> <br /> hitaM vAtAbhibhUtAyAM grahaNyAmarucau tathA||110|| <br /> <br /> iti maricAdyaM cUrNam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Marichadyam choornam'' contains one ''kudava'' (192 gm) of ''maricha, kunchika, ambashtha'' (''patha''), ''vrikshamlah'', ten ''pala'' (480 gm) of ''amlavetas,'' half ''pala'' (24 gm) each of ''sauvarchala, bidha, pakya, yavakshara, saindhava, sathi, pushkaramoola, hingu'' and ''hingushivatika'' (''vamsapatri''). It is useful in ''[[vata]]'' dominant ''grahani'' and anorexia [108-110]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चतुर्णां प्रस्थमम्लानां त्र्यूषणस्य पलत्रयम्| <br /> <br /> लवणानां च चत्वारि शर्करायाः पलाष्टकम्| <br /> <br /> सञ्चूर्ण्य शाकसूपान्नरागादिष्ववचारयेत्||१११|| <br /> <br /> कासाजीर्णारुचिश्वासाहृत्पाण्ड्वामयशूलनुत्|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> caturṇāṁ prasthāmamlānāṁ tryūṣaṇasya palatrayam| <br /> <br /> lavaṇānāṁ ca catvāri śarkarāyāḥ palāṣṭakam| <br /> <br /> sañcūrṇya śākasūpānnarāgādiṣvavacārayēt||111|| <br /> <br /> kāsājīrṇāruciśvāsāhr̥tpāṇḍvāmayaśūlanut|<br /> <br /> caturNAM prasthamamlAnAM tryUShaNasya palatrayam| <br /> <br /> lavaNAnAM ca catvAri sharkarAyAH palAShTakam| <br /> <br /> sa~jcUrNya shAkasUpAnnarAgAdiShvavacArayet||111|| <br /> <br /> kAsAjIrNArucishvAsAhRutpANDvAmayashUlanut|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make powder of one ''prastha'' (768 gm) of four ''amla'' drugs, three ''pala'' (144 gm) of ''trikatu'', four ''pala'' (192 gm) of ''lavana'' (''saindhava'') and eight ''pala'' (384 gm) of sugar and mix together. It is to be taken with vegetable preparations such as soup cooked food and ''raga'' for cure of cough, indigestion, anorexia, dyspnea, heart disease, anemia and pain in abdomen [111]<br /> <br /> === Five types of ''yavagu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चव्यत्वक्पिप्पलीमूलधातकीव्योषचित्रकान्||११२|| <br /> <br /> कपित्थं बिल्वमम्बष्ठां शाल्मलं हस्तिपिप्पलीम्| <br /> <br /> शिलोद्भेदं तथाऽजाजीं पिष्ट्वा बदरसम्मितम्||११३|| <br /> <br /> परिभर्ज्य घृते दध्ना यवागूं साधयेद्भिषक्|<br /> <br /> रसैः कपित्थचुक्रीकावृक्षाम्लैर्दाडिमस्य च||११४|| <br /> <br /> सर्वातिसारग्रहणीगुल्मार्शःप्लीहनाशिनी| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> cavyatvakpippalīmūladhātakīvyōṣacitrakān||112|| <br /> <br /> kapitthaṁ bilvāmambaṣṭhāṁ śālmalaṁ hastipippalīm| <br /> <br /> śilōdbhēdaṁ tathā'jājīṁ piṣṭvā badarasammitam||113|| <br /> <br /> paribharjya ghr̥tē dadhnā yavāgūṁ sādhayēdbhiṣak| <br /> <br /> rasaiḥ kapitthacukrīkāvr̥kṣāmlairdāḍimasya ca||114|| <br /> <br /> sarvātisāragrahaṇī gulmārśaḥplīhanāśinī| <br /> <br /> cavyatvakpippalImUladhAtakIvyoShacitrakAn||112|| <br /> <br /> kapitthaM bilvamambaShThAM shAlmalaM hastipippalIm| <br /> <br /> shilodbhedaM tathA~ajAjIM piShTvA badarasammitam||113|| <br /> <br /> paribharjya ghRute dadhnA yavAgUM sAdhayedbhiShak| <br /> <br /> rasaiH kapitthacukrIkAvRukShAmlairdADimasya ca||114|| <br /> <br /> sarvAtisAragrahaNIgulmArshaHplIhanAshinI| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make paste of ''chavya, tvak, pippalīmūla, dhātakī, trikatu, chitraka, kapittha, bilva, pāṭhā, sālmali, gajapippalī, slōdbhēda'' (''shilajeet'') and ''ajājī,'' each taken in quantity equal to ''badara'' (about 6 gm). Fry it in ghee and prepare ''yavāgu'' by adding curd or ''svarasa'' of ''kapittha'' or ''chukrikā'' or ''vrikshāmla'' or ''dadima''. It helps in curing all types of ''atisara, grahani, gulma, arsha'' and ''pleeha'' disease [112-114]<br /> <br /> === Beverages ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पञ्चकोलकयूषश्च मूलकानां च सोषणः||११५|| <br /> <br /> स्निग्धो दाडिमतक्राम्लो जाङ्गलः संस्कृतो रसः| <br /> <br /> क्रव्यादस्वरसः शस्तो भोजनार्थे सदीपनः||११६|| <br /> <br /> तक्रारनालमद्यानि पानायारिष्ट एव च|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pañcakōlakayūṣaśca mūlakānāṁ ca sōṣaṇaḥ||115|| <br /> <br /> snigdhō dāḍimatakrāmlō jāṅgalaḥ saṁskr̥tō rasaḥ| <br /> <br /> kravyādasvarasaḥ śastō bhōjanārthē sadīpanaḥ||116|| <br /> <br /> takrāranālāmadyāni pānāyāriṣṭa ēva ca|<br /> <br /> pa~jcakolakayUShashca mUlakAnAM ca soShaNaH||115|| <br /> <br /> snigdho dADimatakrAmlo jA~ggalaH saMskRuto rasaH| <br /> <br /> kravyAdasvarasaH shasto bhojanArthe sadIpanaH||116|| <br /> <br /> takrAranAlamadyAni pAnAyAriShTa eva ca|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Fortified soup with ''panchakola'' or soup of ''mulaka'' with ''maricha'' or medicated soup prepared from animals inhabiting in arid land added with ghee, ''dadima, takra, amla dravyas'' or soup of animals that eat other animals fortified with medicines having ''[[deepana]]'' qualities be given for drink.<br /> <br /> Patient may be given buttermilk, ''aranala'' (sour drink), ''madya'' (medicated alcohol) and ''arishtha'' as liquid diets [115-116]<br /> <br /> === Qualities and benefits of buttermilk ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तक्रं तु ग्रहणीदोषे दीपनग्राहिलाघवात्||११७|| <br /> <br /> श्रेष्ठं मधुरपाकित्वान्न च पित्तं प्रकोपयेत्| <br /> <br /> कषायोष्णविकाशित्वाद्रौक्ष्याच्चैव कफे हितम्||११८|| <br /> <br /> वाते स्वाद्वम्लसान्द्रत्वात् सद्यस्कमविदाहि तत्| <br /> <br /> तस्मात् तक्रप्रयोगा ये जठराणां तथाऽर्शसाम्||११९|| <br /> <br /> विहिता ग्रहणीदोषे सर्वशस्तान् प्रयोजयेत्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> takraṁ tu Grahaṇī dōṣē dīpanagrāhilāghavāt||117|| <br /> <br /> śrēṣṭhaṁ madhurapākitvānna ca Pittaṁ prakōpayēt| <br /> <br /> kaṣāyōṣṇavikāśitvādraukṣyāccaiva kaphē hitam||118|| <br /> <br /> vātē svādvamlasāndratvāt sadyaskāmavidāhi tat| <br /> <br /> tasmāt takraprayōgā yē jaṭharāṇāṁ tathā'rśasām||119|| <br /> <br /> vihitā Grahaṇī dōṣē sarvaśastān prayōjayēt| <br /> <br /> takraM tu grahaNIdoShe dIpanagrAhilAghavAt||117|| <br /> <br /> shreShThaM madhurapAkitvAnna ca pittaM prakopayet| <br /> <br /> kaShAyoShNavikAshitvAdraukShyAccaiva kaphe hitam||118|| <br /> <br /> vAte svAdvamlasAndratvAt sadyaskamavidAhi tat| <br /> <br /> tasmAt takraprayogA ye jaTharANAM tathA~arshasAm||119|| <br /> <br /> vihitA grahaNIdoShe sarvashastAn prayojayet| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Buttermilk due to its ''[[deepana]], grahi'' (substances which increases appetite and digestive power and absorb fluid from the stool) and easy to digest actions is very useful in ''grahanidosha''. It is ''madhura'' in ''vipaka'' therefore reduces ''[[pitta]]''; due to ''kashaya'' (astringent) taste, ''ushna virya'' (hot potency), ''vikashi'' and ''ruksha [[guna]]'' it is useful in ''[[kapha]]'' dominated disorders and due to ''madhura'' and ''amla rasa, sandra guna'' it reduces ''[[vata]]''. Freshly churned butter milk does not cause burning sensation; therefore, buttermilk is very useful in treatment of ''udara, arśa'' and all ''grahanidosha'' [117-119]<br /> <br /> === ''Takrarishtha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यवान्यामलके पथ्या मरिचं त्रिपलंशिकम्||१२०|| <br /> <br /> लवणानि पलांशानि पञ्च चैकत्र चूर्णयेत्| <br /> <br /> तक्रे तदासुतं [३१] जातं तक्रारिष्टं पिबेन्नरः| <br /> <br /> दीपनं शोथगुल्मार्शःक्रिमिमेहोदरापहम्||१२१|| <br /> <br /> इति तक्रारिष्टः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yavānyāmalakē pathyā maricaṁ tripalaṁśikam||120|| <br /> <br /> lavaṇāni palāṁśāni pañca caikatra cūrṇayēt| <br /> <br /> takrē tadāsutaṁ [31] jātaṁ takrāriṣṭaṁ pibēnnaraḥ| <br /> <br /> dīpanaṁ śōthagulmārśaḥkrimimēhōdarāpaham||121|| <br /> <br /> iti takrāriṣṭaḥ<br /> <br /> yavAnyAmalake pathyA maricaM tripalaMshikam||120|| <br /> <br /> lavaNAni palAMshAni pa~jca caikatra cUrNayet| <br /> <br /> takre tadAsutaM [31] jAtaM takrAriShTaM pibennaraH| <br /> <br /> dIpanaM shothagulmArshaHkrimimehodarApaham||121|| <br /> <br /> iti takrAriShTaH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take ''yavani, amalaki, haritaki'' and ''maricha'' each in three ''pala'' (144 gm) and ''pancha-lavana'' in one ''pala'' (48 gm) and powder together and add buttermilk to it and ferment till sour taste is obtained. This preparation called ''takrarishtha'' stimulates the digestive power and relieves ''sotha, gulma, arsha, krimi, prameha'' and ''udara roga'' [120-121]<br /> <br /> === Management of ''[[pitta]]'' dominant ''grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्वस्थानगतमुत्क्लिष्टमग्निनिर्वापकं भिषक्| <br /> <br /> पित्तं ज्ञात्वा विरेकेण निर्हरेद्वमनेन वा||१२२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> svasthānagatamutkliṣṭāmAgninirvāpakaṁ bhiṣak| <br /> <br /> Pittaṁ jñātvā virēkēṇa nirharēdvāmanēna vā||122||<br /> <br /> svasthAnagatamutkliShTamagninirvApakaM bhiShak| <br /> <br /> pittaM j~jAtvA virekeNa nirharedvamanena vA||122|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If ''agnimandyata'' is due to ''utklishtha'' (ready to come out) ''[[pitta]]'' in its own place then in such a situation ''[[virechana]]'' or ''[[vamana]]'' should be administered for removal of ''[[pitta]]'' [122]<br /> <br /> === Diet after ''[[shodhana]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अविदाहिभिरन्नैश्च लघुभिस्तिक्तसंयुतैः| <br /> <br /> जाङ्गलानां रसैर्यूषैर्मुद्गादीनां खडैरपि||१२३|| <br /> <br /> दाडिमाम्लैः ससर्पिष्कैर्दीपनग्राहिसंयुतैः| <br /> <br /> तस्याग्निं दीपयेच्चूर्णैः सर्पिर्भिश्चापि तिक्तकैः||१२४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> avidāhibhirannaiśca laghubhistiktasaṁyutaiḥ| <br /> <br /> jāṅgalānāṁ rasairyūṣairmudgādīnāṁ khaḍairapi||123|| <br /> <br /> dāḍimāmlaiḥ sasarpiṣkairdīpanagrāhisaṁyutaiḥ| <br /> <br /> tasyāgniṁ dīpayēccūrṇaiḥ sarpirbhiścāpi tiktakaiḥ||124||<br /> <br /> avidAhibhirannaishca laghubhistiktasaMyutaiH| <br /> <br /> jA~ggalAnAM rasairyUShairmudgAdInAM khaDairapi||123|| <br /> <br /> dADimAmlaiH sasarpiShkairdIpanagrAhisaMyutaiH| <br /> <br /> tasyAgniM dIpayeccUrNaiH sarpirbhishcApi tiktakaiH||124||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After proper ''[[shodhana]]'', diet which does not cause burning sensation, which is easy to digest and added with ingredients having bitter taste should be taken. Soup of animals of arid zone, soup of cereals such as ''mudga'', etc. and ''khada'' should be given. <br /> <br /> Pomegranate having sour taste should be taken along with ghee, ''[[deepana]]'' and ''grahi dravyas''. With help of powders of ''deepaniya'' drugs and ghee fortified with bitter drugs, the digestive power should be increased (123-124).<br /> <br /> === ''Chandanadya ghrita'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चन्दनं पद्मकोशीरं पाठां मूर्वां कुटन्नटम्| <br /> <br /> षड्ग्रन्थासारिवास्फोतासप्तपर्णाटरूषकान्||१२५|| <br /> <br /> पटोलोदुम्बराश्वत्थवटप्लक्षकपीतनान्| <br /> <br /> कटुकां रोहिणीं मुस्तं निम्बं च द्विपलांशिकम्||१२६|| <br /> <br /> द्रोणेऽपां साधयेत् पादशेषे प्रस्थं घृतात् पचेत्| <br /> <br /> किराततिक्तेन्द्रयववीरामागधिकोत्पलैः||१२७|| <br /> <br /> कल्कैरक्षसमैः पेयं तत् पित्तग्रहणीगदे| <br /> <br /> इति चन्दनाद्यं घृतम्<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> candanaṁ padmakōśīraṁ pāṭhāṁ mūrvāṁ kuṭannaṭam| <br /> <br /> ṣaḍgranthāsārivāsphōtāsaptaparṇāṭarūṣakān||125|| <br /> <br /> paṭōlōdumbarāśvatthavaṭaplakṣakapītanān| <br /> <br /> kaṭukāṁ rōhiṇīṁ mustaṁ nimbaṁ ca dvipalāṁśikam||126|| <br /> <br /> drōṇē'pāṁ sādhayēt pādaśēṣē prasthaṁ ghr̥tāt pacēt| <br /> <br /> kirātatiktēndrayavavīrāmāgadhikōtpalaiḥ||127|| <br /> <br /> kalkairakṣasāmaiḥ pēyaṁ tat Pitta Grahaṇī gadē| <br /> <br /> iti candanādyaṁ ghr̥tam<br /> <br /> candanaM padmakoshIraM pAThAM mUrvAM kuTannaTam| <br /> <br /> ShaDgranthAsArivAsphotAsaptaparNATarUShakAn||125|| <br /> <br /> paTolodumbarAshvatthavaTaplakShakapItanAn| <br /> <br /> kaTukAM rohiNIM mustaM nimbaM ca dvipalAMshikam||126|| <br /> <br /> droNe~apAM sAdhayet pAdasheShe prasthaM ghRutAt pacet| <br /> <br /> kirAtatiktendrayavavIrAmAgadhikotpalaiH||127|| <br /> <br /> kalkairakShasamaiH peyaM tat pittagrahaNIgade| <br /> <br /> iti candanAdyaM ghRutam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take two ''pala'' (96 gm) each of ''chandana, padmaka, usheera, patha, murva, kuthannatha'' (''kaivarta musta''), ''shadhgrantha'' (''vacha''), ''sariva, asphota'' (''aspurmallika''), ''saptaparna, aṭarushakana'' (''vasa''), ''patola, udumbara, ashvattha, vata, plaksa, kapeetana'' (''gandha musta''), ''kathuki, musta'' and ''nimba'' and prepare decoction by adding one ''drona'' (12.228 Kg) of water with 1/4th reduction. ''Ghrita siddhi'' is done adding one ''prastha'' (96 gm) of ghee to the above decoction and paste of one ''aksa'' (12 gm) each of ''kiratatikta, indrayava, vira, pippalī'' and ''utpala'' is added. This medicated ghee is known as ''chandanadya ghrita'' and is indicated in ''[[pitta]]ja grahani'' [125-127]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तिक्तकं यद्घृतं चोक्तं कौष्ठिके तच्च दापयेत्||१२८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tiktakaṁ yadghr̥taṁ cōktaṁ kauṣṭhikē tacca dāpayēt||128|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Tikta ghrita'' as mentioned in [[Kushtha Chikitsa]] [Cha. Sa. [[Chikitsa Sthana]] 7/140-150] may also be prescribed in ''[[pitta]]ja grahani'' [128]<br /> <br /> === ''Nagaradya churna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नागरातिविषे मुस्तं धातकीं च रसाञ्जनम्| <br /> <br /> वत्सकत्वक्फलं बिल्वं पाठां कटुकरोहिणीम्||१२९|| <br /> <br /> पिबेत् समांशं तच्चूर्णं सक्षौद्रं तण्डुलाम्बुना| <br /> <br /> पैत्तिके ग्रहणीदोषे रक्तं यच्चोपवेश्यते||१३०|| <br /> <br /> अर्शांसि च गुदे शूलं जयेच्चैव प्रवाहिकाम्| <br /> <br /> नागराद्यमिदं चूर्णं कृष्णात्रेयेण पूजितम्||१३१|| <br /> <br /> इति नागराद्यं चूर्णम्<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nāgarātiviṣē mustaṁ dhātakīṁ ca rasāñjanam| <br /> <br /> vatsakatvakphalaṁ bilvaṁ pāṭhāṁ kaṭukarōhiṇīm||129|| <br /> <br /> pibēt samāṁśaṁ taccūrṇaṁ sakṣaudraṁ taṇḍulāmbunā| <br /> <br /> paittikē Grahaṇī dōṣē raktaṁ yaccōpavēśyatē||130|| <br /> <br /> arśāṁsi ca gudē śūlaṁ jayēccaiva pravāhikām| <br /> <br /> nāgarādyamidaṁ cūrṇaṁ kr̥ṣṇātrēyēṇa pūjitam||131|| <br /> <br /> iti nāgarādyaṁ cūrṇam<br /> <br /> nAgarAtiviShe mustaM dhAtakIM ca rasA~jjanam| <br /> <br /> vatsakatvakphalaM bilvaM pAThAM kaTukarohiNIm||129|| <br /> <br /> pibet samAMshaM taccUrNaM sakShaudraM taNDulAmbunA| <br /> <br /> paittike grahaNIdoShe raktaM yaccopaveshyate||130|| <br /> <br /> arshAMsi ca gude shUlaM jayeccaiva pravAhikAm| <br /> <br /> nAgarAdyamidaM cUrNaM kRuShNAtreyeNa pUjitam||131|| <br /> <br /> iti nAgarAdyaM cUrNam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take equal quantity of ''nagara, ativisha, musta, dhataki, rasanjana,'' bark and fruit of ''vatsaka, bilva, patha'' and ''katuki'' and powder together, is known as ''nagaradya churna'' explained by ''krishnatreyena''. It is to be taken along with honey and ''tandulodaka'' (rice water, prepared cold) by patient suffering from ''paittika grahani'' with bloody stools, hemorrhoids, pain in anal area and dysentery. [129-131]<br /> <br /> === ''Bhunimbadya churna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भूनिम्बकटुकाव्योषमुस्तकेन्द्रयवान् समान्| <br /> <br /> द्वौ चित्रकाद्वत्सकत्वग्भागान् षोडश चूर्णयेत्||१३२|| <br /> <br /> गुडशीताम्बुना पीतं ग्रहणीदोषगुल्मनुत्| <br /> <br /> कामलाज्वरपाण्डुत्वमेहारुच्यतिसारनुत्||१३३|| <br /> <br /> इति भूनिम्बाद्यं चूर्णम्<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhūnimbakaṭukāvyōṣamustakēndrayavān samān| <br /> <br /> dvau citrakādvatsakatvagbhāgān ṣōḍaśa cūrṇayēt||132|| <br /> <br /> guḍaśītāmbunā pītaṁ Grahaṇī dōṣagulmanut| <br /> <br /> kāmalājvarapāṇḍutvamēhārucyatisāranut||133|| <br /> <br /> iti bhūnimbādyaṁ cūrṇam<br /> <br /> bhUnimbakaTukAvyoShamustakendrayavAn samAn| <br /> <br /> dvau citrakAdvatsakatvagbhAgAn ShoDasha cUrNayet||132|| <br /> <br /> guDashItAmbunA pItaM grahaNIdoShagulmanut| <br /> <br /> kAmalAjvarapANDutvamehArucyatisAranut||133||<br /> <br /> iti bhUnimbAdyaM cUrNam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Bhunimba, kutaki, trikatu, musta'' and ''indrayava'' are taken in equal quantity. Two parts of ''chitraka'' and 16 parts of bark and ''vatsaka'' are taken together and powdered. The combination is called as ''bhunimbadya churna'' is advised with jaggery and cold water as ''anupana'' in ''grahani dosha, gulma, kamala, jwara, pandu, prameha, aruchi'' and ''atisara'' [132-133]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वचामतिविषां पाठां सप्तपर्णं रसाञ्जनम्| <br /> <br /> स्योनाकोदीच्यकट्वङ्गवत्सकत्वग्दुरालभाः||१३४|| <br /> <br /> दार्वीं पर्पटकं पाठां यवानीं मधुशिग्रुकम्| <br /> <br /> पटोलपत्रं सिद्धार्थान् यूथिकां जातिपल्लवान्||१३५|| <br /> <br /> जम्ब्वाम्रबिल्वमध्यानि निम्बशाकफलानि च| <br /> <br /> तद्रोगशममन्विच्छन् भूनिम्बाद्येन योजयेत्||१३६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vacāmativiṣāṁ pāṭhāṁ saptaparṇaṁ rasāñjanam| <br /> <br /> syōnākōdīcyakaṭvaṅgavatsakatvagdurālabhāḥ||134|| <br /> <br /> dārvīṁ parpaṭakaṁ pāṭhāṁ yavānīṁ madhuśigrukam| <br /> <br /> paṭōlapatraṁ siddhārthān yūthikāṁ jātipallavān||135|| <br /> <br /> jambvāmrabilvāmadhyāni nimbaśākaphalāni ca| <br /> <br /> tadrōgaśāmamanvicchan bhūnimbādyēna yōjayēt||136|| <br /> <br /> vacAmativiShAM pAThAM saptaparNaM rasA~jjanam| <br /> <br /> syonAkodIcyakaTva~ggavatsakatvagdurAlabhAH||134|| <br /> <br /> dArvIM parpaTakaM pAThAM yavAnIM madhushigrukam| <br /> <br /> paTolapatraM siddhArthAn yUthikAM jAtipallavAn||135|| <br /> <br /> jambvAmrabilvamadhyAni nimbashAkaphalAni ca| <br /> <br /> tadrogashamamanvicchan bhUnimbAdyena yojayet||136|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The combination of ''vacha, ativisha, patha, saptaparna, rasanjana, syonaka, udeechya, kathvanga'' (type of ''syonaka'' having small fruits), bark of ''vatsaka, duralabha, darvi, parpataka, patha, yavani, madhushigru,'' leaf of ''patola, siddhartha, yuthika,'' fresh new leaf of ''jati,'' seeds of ''jambu'' and ''amra'', pulp of ''bilva'' and leaves and fruits of ''nimba'' is useful in all condition as mentioned for ''bhunimbadya churna'' [134-136]<br /> <br /> === ''Kiratadya churna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> किराततिक्तः षड्ग्रन्था त्रायमाणा कटुत्रिकम्| <br /> <br /> चन्दनं पद्मकोशीरं दार्वीत्वक् कटुरोहिणी||१३७|| <br /> <br /> कुटजत्वक्फलं मुस्तं यवानी देवदारु च| <br /> <br /> पटोलनिम्बपत्रैलासौराष्ट्रयतिविषात्वचः||१३८|| <br /> <br /> मधुशिग्रोश्च बीजानि मूर्वा पर्पटकस्तथा| <br /> <br /> तच्चूर्णं मधुना लेह्यं पेयं मद्यैर्जलेन वा||१३९|| <br /> <br /> हृत्पाण्डुग्रहणीरोगगुल्मशूलारुचिज्वरान्| <br /> <br /> कामलां सन्निपातं च मुखरोगांश्च नाशयेत्||१४०|| <br /> <br /> इति किराताद्यं चूर्णम्<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kirātatiktaḥ ṣaḍgranthā trāyamāṇā kaṭutrikam| <br /> <br /> candanaṁ padmakōśīraṁ dārvītvak kaṭurōhiṇī||137|| <br /> <br /> kuṭajatvakphalaṁ mustaṁ yavānī dēvadāru ca| <br /> <br /> paṭōlanimbapatrailāsaurāṣṭrayativiṣātvacaḥ||138|| <br /> <br /> madhuśigrōśca bījāni mūrvā parpaṭakastathā| <br /> <br /> taccūrṇaṁ madhunā lēhyaṁ pēyaṁ madyairjalēna vā||139|| <br /> <br /> hr̥tpāṇḍuGrahaṇī rōgagulmaśūlārucijvarān| <br /> <br /> kāmalāṁ sannipātaṁ ca mukharōgāṁśca nāśayēt||140|| <br /> <br /> iti kirātādyaṁ cūrṇam<br /> <br /> kirAtatiktaH ShaDgranthA trAyamANA kaTutrikam| <br /> <br /> candanaM padmakoshIraM dArvItvak kaTurohiNI||137|| <br /> <br /> kuTajatvakphalaM mustaM yavAnI devadAru ca| <br /> <br /> paTolanimbapatrailAsaurAShTrayativiShAtvacaH||138|| <br /> <br /> madhushigroshca bIjAni mUrvA parpaTakastathA| <br /> <br /> taccUrNaM madhunA lehyaM peyaM madyairjalena vA||139|| <br /> <br /> hRutpANDugrahaNIrogagulmashUlArucijvarAn| <br /> <br /> kAmalAM sannipAtaM ca mukharogAMshca nAshayet||140|| <br /> <br /> iti kirAtAdyaM cUrNam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Mix powder of ''kiratatikta, shadgrantha, trayamana, trikatu, chandana, padmaka, usheera,'' bark of ''darvi, katurohini,'' bark and fruit of ''kutaja, mushta, yavani, devadaru, patola,'' leaves of ''nimba, ela, saurashtra, ativisha, tvak,'' seeds of ''madhushigru, murva'' and ''parpataka'' and prescribe it as linctus prepared with honey or may be taken with water or alcoholic preparation. This preparation is known as ''kiratadyam churna'' whih cures ''hridaya roga, pandu, grahaniroga, gulma, shula, aruchi, jwara, kamala, sannipatika'' type of diarrhea and eight types of ''mukharoga'' [137-140]<br /> <br /> === Treatment of ''[[kapha]]ja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ग्रहण्यां श्लेष्मदुष्टायां वमितस्य यथाविधि| <br /> <br /> कट्वम्ललवणक्षारैस्तिक्तैश्चाग्निं विवर्धयेत्||१४१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> grahaṇyāṁ ślēṣmaduṣṭāyāṁ vamitasya yathāvidhi| <br /> <br /> kaṭvamlalavaṇakṣāraistiktaiścāgniṁ vivardhayēt||141|| <br /> <br /> grahaNyAM shleShmaduShTAyAM vamitasya yathAvidhi| <br /> <br /> kaTvamlalavaNakShAraistiktaishcAgniM vivardhayet||141|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''[[kapha]]ja grahani'' first administer ''[[vamana]]'' and then increase [[agni]] (digestive power) with help of drugs having ''katu, amla, lavana, kshara'' and ''tikta rasa'' [141]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पलाशं चित्रकं चव्यं मातुलुङ्गं हरीतकीम्| <br /> <br /> पिप्पलीं पिप्पलीमूलं पाठां नागरधान्यकम्||१४२|| <br /> <br /> कार्षिकाण्युदकप्रस्थे पक्त्वा पादावशेषितम्| <br /> <br /> पानीयार्थं प्रयुञ्जीत यवागूं तैश्च साधयेत्||१४३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> palāśaṁ citrakaṁ cavyaṁ mātuluṅgaṁ harītakīm| <br /> <br /> pippalīṁ pippalīmūlaṁ pāṭhāṁ nāgaradhānyakam||142|| <br /> <br /> kārṣikāṇyudakaprasthē paktvā pādāvaśēṣitam| <br /> <br /> pānīyārthaṁ prayuñjīta yavāgūṁ taiśca sādhayēt||143|| <br /> <br /> palAshaM citrakaM cavyaM mAtulu~ggaM harItakIm| <br /> <br /> pippalIM pippalImUlaM pAThAM nAgaradhAnyakam||142|| <br /> <br /> kArShikANyudakaprasthe paktvA pAdAvasheShitam| <br /> <br /> pAnIyArthaM prayu~jjIta yavAgUM taishca sAdhayet||143|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Palasha, chitraka, chavya, matulunga, haritaki pippali, pippalimoola, patha, nagara'' and ''dhanyaka'' are taken each in 12 gm and decoction is prepared in one 768 ml of water and reduced to one fourth. This decoction is administered as a ''paniya'' (drink) or ''yavagu'' (gruel) prepared using this decoction [142-143]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शुष्कमूलकयूषेण कौलत्थेनाथवा पुनः| <br /> <br /> कट्वम्लक्षारपटुना लघून्यन्नानि भोजयेत्||१४४|| <br /> <br /> अम्लं चानु पिबेत्तक्रं तक्रारिष्टमथापि वा| <br /> <br /> मदिरां मध्वरिष्टं वा निगदं सीधुमेव वा||१४५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śuṣkamūlakayūṣēṇa kaulatthēnāthavā punaḥ| <br /> <br /> kaṭvamlakṣārapaṭunā laghūnyannāni bhōjayēt||144||<br /> <br /> amlaṁ cānu pibēttakraṁ takrāriṣṭāmathāpi vā| <br /> <br /> madirāṁ madhvariṣṭaṁ vā nigadaṁ sīdhumēva vā||145||<br /> <br /> shuShkamUlakayUSheNa kaulatthenAthavA punaH| <br /> <br /> kaTvamlakShArapaTunA laghUnyannAni bhojayet||144|| <br /> <br /> amlaM cAnu pibettakraM takrAriShTamathApi vA| <br /> <br /> madirAM madhvariShTaM vA nigadaM sIdhumeva vA||145||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Soup of dried radish or ''kulatha'' is to be given regularly and repeatedly. Food which is easy to digest should be fortified with ''katu, amla, kshara'' and ''lavana rasa''. Patient should take such foods which are easy to digest, along with buttermilk slightly sour or ''takrarishtha, madira'' (medicated alcoholic preparation), ''madhvarishtha'' or well prepared ''seedhu'' [144-145]<br /> <br /> === ''Madhukasava'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्रोणं मधूकपुष्पाणां विडङ्गानां ततोऽर्धतः| <br /> <br /> चित्रकस्य ततोऽर्धं स्यात्तथा भल्लातकाढकम्||१४६|| <br /> <br /> मञ्जिष्ठाष्टपलं [३२] चैव त्रिद्रोणेऽपां विपाचयेत्| <br /> <br /> द्रोणशेषं तु तच्छीतं मध्वर्धाढकसंयुतम्||१४७|| <br /> <br /> एलामृणालागुरुभिश्चन्दनेन च रूषिते| <br /> <br /> कुम्भे मासस्थितं जातमासवं तं प्रयोजयेत्||१४८||<br /> <br /> ग्रहणीं दीपयत्येव बृंहणः [३३] कफपित्तजित्| <br /> <br /> शोथं कुष्ठं किलासं च प्रमेहांश्च प्रणाशयेत्||१४९|| <br /> <br /> इति मधूकासवः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> drōṇaṁ madhūkapuṣpāṇāṁ viḍaṅgānāṁ tatō'rdhataḥ| <br /> <br /> citrakasya tatō'rdhaṁ syāttathā bhallātakāḍhakam||146|| <br /> <br /> mañjiṣṭhāṣṭapalaṁ [32] caiva tridrōṇē'pāṁ vipācayēt| <br /> <br /> drōṇaśēṣaṁ tu tacchītaṁ madhvardhāḍhakasaṁyutam||147|| <br /> <br /> ēlāmr̥ṇālāgurubhiścandanēna ca rūṣitē| <br /> <br /> kumbhē māsasthitaṁ jātamāsavaṁ taṁ prayōjayēt||148|| <br /> <br /> Grahaṇī ṁ dīpayatyēva br̥ṁhaṇaḥ [33] kaphaPittajit| <br /> <br /> śōthaṁ kuṣṭhaṁ kilāsaṁ ca pramēhāṁśca praṇāśayēt||149|| <br /> <br /> iti madhūkāsavaḥ<br /> <br /> droNaM madhUkapuShpANAM viDa~ggAnAM tato~ardhataH| <br /> <br /> citrakasya tato~ardhaM syAttathA bhallAtakADhakam||146|| <br /> <br /> ma~jjiShThAShTapalaM [32] caiva tridroNe~apAM vipAcayet| <br /> <br /> droNasheShaM tu tacchItaM madhvardhADhakasaMyutam||147|| <br /> <br /> elAmRuNAlAgurubhishcandanena ca rUShite| <br /> <br /> kumbhe mAsasthitaM jAtamAsavaM taM prayojayet||148|| <br /> <br /> grahaNIM dIpayatyeva bRuMhaNaH [33] kaphapittajit| <br /> <br /> shothaM kuShThaM kilAsaM ca pramehAMshca praNAshayet||149|| <br /> <br /> iti madhUkAsavaH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take one ''drona'' (12.22 kg/l) flowers of ''madhuka,'' half ''drona'' (6.11 kg/l) of ''vidanga, chitraka'' half of ''vidanga'' i.e. 1/4th ''drona'' (3.05 kg/l), ''bhallataka'' one ''adhaka'' (3.073 kg) and eight ''pala'' (384 gm) of ''manjishtha'' and mix with three ''drona'' (36.66 kg/l) of water and reduce to one ''drona'' (12.22 L) and after the decoction comes to room temperature add half ''adhaka'' (1.53 kg) of honey. Keep this preparation in a pot lined with paste of ''ela, mrinala, agaru'' and ''chandana'' and store for period of one month till ''asava siddhi'' occurs. This preparation is called ''madhukasava'' and is useful in ''grahani,'' helps empowering of ''agni,'' promotes nutrition and normalizes ''[[kapha]]'' and ''[[pitta]]''. It is indicated in ''shotha, kushtha, kilasa'' and ''prameha'' [146-149]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मधूकपुष्पस्वरसं शृतमर्धक्षयीकृतम्| <br /> <br /> क्षौद्रपादयुतं शीतं पूर्ववत् सन्निधापयेत्||१५०|| <br /> <br /> तं पिबन् ग्रहणीदोषाञ्जयेत् सर्वान् हिताशनः| <br /> <br /> तद्वद्द्राक्षेक्षुखर्जूरस्वरसानासुतान् [३४] पिबेत्||१५१||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> madhūkapuṣpasvarasaṁ śr̥tāmardhakṣayīkr̥tam| <br /> <br /> kṣaudrapādayutaṁ śītaṁ pūrvavat sannidhāpayēt||150|| <br /> <br /> taṁ piban Grahaṇī dōṣāñjayēt sarvān hitāśanaḥ| <br /> <br /> tadvaddrākṣēkṣukharjūrasvarasānāsutān [34] pibēt||151||<br /> <br /> madhUkapuShpasvarasaM shRutamardhakShayIkRutam| <br /> <br /> kShaudrapAdayutaM shItaM pUrvavat sannidhApayet||150|| <br /> <br /> taM piban grahaNIdoShA~jjayet sarvAn hitAshanaH| <br /> <br /> tadvaddrAkShekShukharjUrasvarasAnAsutAn [34] pibet||151||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Boil ''svarasa'' of flowers of ''madhuka'' till reduced to half the quantity. When cooled one fourth of honey is added and kept for fermentation as mentioned above. This preparation relieves all types of ''grahani dosha'' provided patient takes ''pathya ahara''. <br /> <br /> In the same manner fermentation of ''svarasa'' of ''draksha'' (grapes), sugarcane and date palm is helpful for the patient [150-151]<br /> <br /> === ''Duralabhasava'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्रस्थौ दुरालभाया द्वौ पस्थमामलकस्य च| <br /> <br /> दन्तीचित्रकमुष्टी [३५] द्वे प्रत्यग्रं चाभयाशतम्||१५२|| <br /> <br /> चतुर्द्रोणेऽम्भसः पक्त्वा शीतं द्रोणावशेषितम्| <br /> <br /> सगुडद्विशतं पूतं मधुनः कुडवायुतम्||१५३|| <br /> <br /> तद्वत् प्रियङ्गोः पिप्पल्या विडङ्गानां च चूर्णितैः| <br /> <br /> कुडवैर्घृतकुम्भस्थं पक्षाज्जातं ततः पिबेत्||१५४|| <br /> <br /> ग्रहणीपाण्डुरोगार्शःकुष्ठवीसर्पमेहनुत्| <br /> <br /> स्वरवर्णकरश्चैष रक्तपित्तकफापहः||१५५|| <br /> <br /> इति दुरालभासवः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> prasthau durālabhāyā dvau prasthamāmalakasya ca| <br /> <br /> dantīcitrakamuṣṭī [35] dvē pratyagraṁ cābhayāśatam||152|| <br /> <br /> caturdrōṇē'mbhasaḥ paktvā śītaṁ drōṇāvaśēṣitam| <br /> <br /> saguḍadviśataṁ pūtaṁ madhunaḥ kuḍaVātatam||153|| <br /> <br /> tadvat priyaṅgōḥ pippalyā viḍaṅgānāṁ ca cūrṇitaiḥ| <br /> <br /> kuḍavairghr̥takumbhasthaṁ pakṣājjātaṁ tataḥ pibēt||154|| <br /> <br /> Grahaṇī pāṇḍurōgārśaḥkuṣṭhavīsarpamēhanut| <br /> <br /> svaravarṇakaraścaiṣa raktaPittakaphāpahaḥ||155|| <br /> <br /> iti durālabhāsavaḥ<br /> <br /> prasthau durAlabhAyA dvau pasthamAmalakasya ca| <br /> <br /> dantIcitrakamuShTI [35] dve pratyagraM cAbhayAshatam||152|| <br /> <br /> caturdroNe~ambhasaH paktvA shItaM droNAvasheShitam| <br /> <br /> saguDadvishataM pUtaM madhunaH kuDavAyutam||153|| <br /> <br /> tadvat priya~ggoH pippalyA viDa~ggAnAM ca cUrNitaiH| <br /> <br /> kuDavairghRutakumbhasthaM pakShAjjAtaM tataH pibet||154|| <br /> <br /> grahaNIpANDurogArshaHkuShThavIsarpamehanut| <br /> <br /> svaravarNakarashcaiSha raktapittakaphApahaH||155|| <br /> <br /> iti durAlabhAsavaH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Boil two ''prastha'' (1.53 kg) each of ''duralabha'' and ''amalaki'', one ''mushthi'' each of ''danti'' and ''chitraka'' and two hundred matured fruits of ''haritaki'' in four ''drona'' (48.88 kg/l) of water and reduce to one ''drona'' (12.228 kg/l). When it comes to room temperature add two hundred ''pala'' (9600 gm) of jaggery and one ''kudava'' (192 gm) of honey as well as powder of ''priyangu, pippali'' and ''vidanga'' each in one ''kudava'' (192 gm) and keep in jar pasted with ghee on the inner wall for period of fifteen days. This preparation is known as ''duralabhasava'' and is indicated in ''grahani, pandu, arsha, kushtha, visarpa'' and ''prameha''. It promotes voice and complexion and cures ''raktapitta'' and other ''[[kapha]]ja'' disorders [152-155]<br /> <br /> === ''Moolasava'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> हरिद्रा पञ्चमूले द्वे वीरर्षभकजीवकम्| <br /> <br /> एषां [३६] पञ्चपलान् भागांश्चतुर्द्रोणेऽम्भसः पचेत्||१५६|| <br /> <br /> द्रोणशेषे रसे पूते गुडस्य द्विशतं भिषक्| <br /> <br /> चूर्णितान् कुडवार्धांशान् प्रक्षिपेच्च समाक्षिकान्||१५७|| <br /> <br /> प्रियङ्गुमुस्तमञ्जिष्ठाविडङ्गमधुकप्लवान्| <br /> <br /> लोध्रं शाबरकं चैव मासार्धस्थं पिबेत्तु तम्||१५८|| <br /> <br /> एष मूलासवः सिद्धो दीपनो रक्तपित्तजित्| <br /> <br /> आनाहकफहृद्रोगपाण्डुरोगाङ्गसादनुत्||१५९|| <br /> <br /> इति मूलासवः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> haridrā pañcamūlē dvē vīrarṣabhakajīvakam| <br /> <br /> ēṣāṁ [36] pañcapalān bhāgāṁścaturdrōṇē'mbhasaḥ pacēt||156|| <br /> <br /> drōṇaśēṣē rasē pūtē guḍasya dviśataṁ bhiṣak| <br /> <br /> cūrṇitān kuḍavārdhāṁśān prakṣipēcca samākṣikān||157|| <br /> <br /> priyaṅgumustāmañjiṣṭhāviḍaṅgāmadhukaplavān| <br /> <br /> lōdhraṁ śābarakaṁ caiva māsārdhasthaṁ pibēttu tam||158|| <br /> <br /> ēṣa mūlāsavaḥ siddhō dīpanō raktaPitta jit| <br /> <br /> ānāhakaphahr̥drōgapāṇḍurōgāṅgasādanut||159|| <br /> <br /> iti mūlāsavaḥ<br /> <br /> haridrA pa~jcamUle dve vIrarShabhakajIvakam| <br /> <br /> eShAM [36] pa~jcapalAn bhAgAMshcaturdroNe~ambhasaH pacet||156|| <br /> <br /> droNasheShe rase pUte guDasya dvishataM bhiShak| <br /> <br /> cUrNitAn kuDavArdhAMshAn prakShipecca samAkShikAn||157|| <br /> <br /> priya~ggumustama~jjiShThAviDa~ggamadhukaplavAn| <br /> <br /> lodhraM shAbarakaM caiva mAsArdhasthaM pibettu tam||158|| <br /> <br /> eSha mUlAsavaH siddho dIpano raktapittajit| <br /> <br /> AnAhakaphahRudrogapANDurogA~ggasAdanut||159|| <br /> <br /> iti mUlAsavaH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Boil five ''pala'' (240 gm) each of ''haridra,'' two types of ''panchamoola'' i.e. ''brihat'' and ''laghu panchamoola, veera'' (''shatavari''), ''rishabhaka, jeevaka'' in four ''drona'' (48.88 kg/l) of water and reduce to one ''drona'' (12.22 kg/l); to this add two hundred ''pala'' (9600 gm) of jaggery and half ''kudava'' (96 gm) of honey as well as powders of ''priyangu, musta, manjishtha, vidanga, madhuka, plava,'' and ''sabaraka lodhra'' and fermented for a fortnight. This ''mulasava'' does ''[[deepana]]'' and is effective in ''raktapitta, anaha, [[kapha]]ja vikara, hridroga, pandu'' and ''angasada'' [156-159]<br /> <br /> === ''Pindasava'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्रास्थिकं [३७] पिप्पलीं पिष्ट्वा गुडं मध्यं बिभीतकात्| <br /> <br /> उदकप्रस्थसंयुक्तं यवपल्ले निधापयेत्||१६०|| <br /> <br /> तस्मात् पलं सुजातात्तु सलिलाञ्जलिसंयुतम्| <br /> <br /> पिबेत्पिण्डासवो ह्येष रोगानीकविनाशनः||१६१|| <br /> <br /> स्वस्थोऽप्येनं पिबेन्मासं नरः स्निग्धरसाशनः [३८] | <br /> <br /> इच्छंस्तेषामनुत्पत्तिं रोगाणां येऽत्र कीर्तिताः||१६२||<br /> <br /> इति पिण्डासवः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> prāsthikaṁ [37] pippalīṁ piṣṭvā guḍaṁ madhyaṁ bibhītakāt| <br /> <br /> udakaprasthasaṁyuktaṁ yavapallē nidhāpayēt||160|| <br /> <br /> tasmāt palaṁ sujātāttu salilāñjalisaṁyutam| <br /> <br /> pibētpiṇḍāsavō hyēṣa rōgānīkavināśanaḥ||161|| <br /> <br /> svasthō'pyēnaṁ pibēnmāsaṁ naraḥ snigdharasāśanaḥ [38] | <br /> <br /> icchaṁstēṣāmanutpattiṁ rōgāṇāṁ yē'tra kīrtitāḥ||162|| <br /> <br /> iti piṇḍāsavaḥ<br /> <br /> prAsthikaM [37] pippalIM piShTvA guDaM madhyaM bibhItakAt| <br /> <br /> udakaprasthasaMyuktaM yavapalle nidhApayet||160|| <br /> <br /> tasmAt palaM sujAtAttu salilA~jjalisaMyutam| <br /> <br /> pibetpiNDAsavo hyeSha rogAnIkavinAshanaH||161|| <br /> <br /> svastho~apyenaM pibenmAsaM naraH snigdharasAshanaH [38] | <br /> <br /> icchaMsteShAmanutpattiM rogANAM ye~atra kIrtitAH||162|| <br /> <br /> iti piNDAsavaH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of ''pippali'' is mixed with jaggery and seed pulp of ''bibhitaki'' and to it one ''prastha'' of water is added and kept in a vessel covered with ''yava'' (barley) for fermentation; this is called as ''pindasava''. One ''pala'' (48 gm) of ''pindasava'' is mixed with one ''anjali'' (192 gm) of water and is given to patient. It is helpful in earlier mentioned disorders. Even a healthy person may take this preparation for period of one month and take unctuous and liquid diet (mainly soups). It helps in prevention of genesis of disease [160-162]<br /> <br /> === ''Madhvarishtha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नवे पिप्पलिमध्वाक्ते कलसेऽगुरुधूपिते| <br /> <br /> मध्वाढकं जलसमं चूर्णानीमानि दापयेत्||१६३|| <br /> <br /> कुडवार्धं विडङ्गानां पिप्पल्याः कुडवं तथा| <br /> <br /> चतुर्थिकांशां त्वक्क्षीरीं केशरं मरिचानि च||१६४|| <br /> <br /> त्वगेलापत्रकशटीक्रमुकातिविषाघनान्| <br /> <br /> हरेण्वेल्वालुतेजोह्वापिप्पलीमूलचित्रकान्||१६५|| <br /> <br /> कार्षिकांस्तत् स्थितं मासमत ऊर्ध्वं प्रयोजयेत्| <br /> <br /> मन्दं सन्दपयत्यग्निं करोति विषमं समम्||१६६|| <br /> <br /> हृत्पाण्डुग्रहणीरोगकुष्ठार्शःश्वयथुज्वरान्| <br /> <br /> वातश्लेष्मामयांश्चान्यान्मध्वरिष्टो व्यपोहति||१६७|| <br /> <br /> इति मध्वरिष्टः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> navē pippalīmadhvāktē kalasē'gurudhūpitē| <br /> <br /> madhvāḍhakaṁ jalasāmaṁ cūrṇānīmāni dāpayēt||163|| <br /> <br /> kuḍavārdhaṁ viḍaṅgānāṁ pippalyāḥ kuḍavaṁ tathā| <br /> <br /> caturthikāṁśāṁ tvakkṣīrīṁ kēśaraṁ maricāni ca||164|| <br /> <br /> tvagēlāpatrakaśaṭīkramukātiviṣāghanān| <br /> <br /> harēṇvēlvālutējōhvāpippalīmūlacitrakān||165|| <br /> <br /> kārṣikāṁstat sthitaṁ māsāmata ūrdhvaṁ prayōjayēt| <br /> <br /> mandaṁ sandapayatyāgniṁ karōti viṣāmaṁ sāmam||166|| <br /> <br /> hr̥tpāṇḍuGrahaṇī rōgakuṣṭhārśaḥśvayathujvarān| <br /> <br /> Vātaślēṣmāmayāṁścānyānmadhvariṣṭō vyapōhati||167|| <br /> <br /> iti madhvariṣṭaḥ<br /> <br /> nave pippalimadhvAkte kalase~agurudhUpite| <br /> <br /> madhvADhakaM jalasamaM cUrNAnImAni dApayet||163|| <br /> <br /> kuDavArdhaM viDa~ggAnAM pippalyAH kuDavaM tathA| <br /> <br /> caturthikAMshAM tvakkShIrIM kesharaM maricAni ca||164|| <br /> <br /> tvagelApatrakashaTIkramukAtiviShAghanAn| <br /> <br /> hareNvelvAlutejohvApippalImUlacitrakAn||165|| <br /> <br /> kArShikAMstat sthitaM mAsamata UrdhvaM prayojayet| <br /> <br /> mandaM sandapayatyagniM karoti viShamaM samam||166|| <br /> <br /> hRutpANDugrahaNIrogakuShThArshaHshvayathujvarAn| <br /> <br /> vAtashleShmAmayAMshcAnyAnmadhvariShTo vyapohati||167|| <br /> <br /> iti madhvariShTaH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> New earthen pot should be pasted internally by ''pippali'' and honey and fumigated with ''aguru''. One ''adhaka'' (3.073 kg) of honey and equal quantity of water should be added. To this add half ''kudava'' (1.53 kg) of powder of ''vidanga'' and one ''kudava'' (192 gm) of ''pippali,'' one fourth ''kudava'' (48 gm) of ''vamsha'' and one ''karsha'' (12 gm) each of ''tvak, ela, keshara, maricha, patra, sati, kramuka, ativisha, ghana'' (''chandana''), ''harenu, elvaluka, tejohva, pippalimoola'' and ''chitraka'' and fermented for period of one month and later on administered. It stimulates the power of digestion and regularizes the ''vishama agni''. It is useful in ''hridroga, pandu, grahani, kushtha, arsha, shvayathu, jwara'' and other disorders caused by ''[[vata]]'' and '' [[kapha dosha]]''. Thus, completes description of ''madhvariṣṭa'' [163-167]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> समूलां पिप्पलीं क्षारौ द्वौ पञ्च लवणानि च| <br /> <br /> मातुलुङ्गाभयारास्नाशटीमरिचनागरम्||१६८|| <br /> <br /> कृत्वा समांशं तच्चूर्णं पिबेत् प्रातः सुखाम्बुना| <br /> <br /> श्लेष्मिके ग्रहणीदोषे बलवर्णाग्निवर्धनम्||१६९|| <br /> <br /> एतैरेवौषधैः सिद्धं सर्पिः पेयं समारुते| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> samūlāṁ pippalīṁ kṣārau dvau pañca lavaṇāni ca| <br /> <br /> mātuluṅgābhayārāsnāśaṭīmaricanāgaram||168|| <br /> <br /> kr̥tvā samāṁśaṁ taccūrṇaṁ pibēt prātaḥ sukhāmbunā| <br /> <br /> ślēṣmikē Grahaṇī dōṣē balavarṇāgnivardhanam||169|| <br /> <br /> samUlAM pippalIM kShArau dvau pa~jca lavaNAni ca| <br /> <br /> mAtulu~ggAbhayArAsnAshaTImaricanAgaram||168|| <br /> <br /> kRutvA samAMshaM taccUrNaM pibet prAtaH sukhAmbunA| <br /> <br /> shleShmike grahaNIdoShe balavarNAgnivardhanam||169|| <br /> <br /> etairevauShadhaiH siddhaM sarpiH peyaM samArute| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Pippali, pippalimoola,'' two types of ''kshara'' (''yavakshara, svarjikakshara''), five types of ''lavana, matulunga, haritaki, rasna, saṭi, maricha'' and ''nagara'' are taken in equal quantity and powdered and administered with warm water early in the morning. It cures ''[[kapha]]ja grahani dosha'' and improves ''bala,'' complexion and [[agni]].<br /> <br /> ''Ghrita'' fortified with above medicines is useful in ''[[kapha]]'' associated with ''[[vata]]ja grahanidosha'' [168-169]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गौल्मिके षट्पलं प्रोक्तं भल्लातकघृतं च यत्||१७०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gaulmikē ṣaṭpalaṁ prōktaṁ bhallātakaghr̥taṁ ca yat||170||<br /> <br /> gaulmike ShaTpalaM proktaM bhallAtakaghRutaM ca yat||170||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Satpala ghrita'' [Cha.Sa. [[Chikitsa Sthana]]. 5/147-148] and ''bhallataka ghrita'' [Cha.Sa.[[ Chikitsa Sthana ]]5/143-146] as explained in [[Gulma Chikitsa]] may also be administered [170]<br /> <br /> === ''Ksharaghrita'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बिडं कालोत्थलवणं सर्जिकायवशूकजम्| <br /> <br /> सप्तलां कण्टकारीं च चित्रकं चेति दाहयेत्||१७१|| <br /> <br /> सप्तकृत्वः स्रुतस्यास्य क्षारस्य [३९] द्व्याढकेन तु| <br /> <br /> आढकं सर्पिषः पक्त्वा पिबेदग्निविवर्धनम्||१७२|| <br /> <br /> इति क्षारघृत<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> biḍaṁ kālōtthalavaṇaṁ sarjikāyavaśūkajam| <br /> <br /> saptalāṁ kaṇṭakārīṁ ca citrakaṁ cēti dāhayēt||171|| <br /> <br /> saptakr̥tvaḥ srutasyāsya kṣārasya [39] dvyāḍhakēna tu| <br /> <br /> āḍhakaṁ sarpiṣaḥ paktvā pibēdAgnivivardhanam||172|| <br /> <br /> iti kṣāraghr̥tam <br /> <br /> biDaM kAlotthalavaNaM sarjikAyavashUkajam| <br /> <br /> saptalAM kaNTakArIM ca citrakaM ceti dAhayet||171|| <br /> <br /> saptakRutvaH srutasyAsya kShArasya [39] dvyADhakena tu| <br /> <br /> ADhakaM sarpiShaH paktvA pibedagnivivardhanam||172|| <br /> <br /> iti kShAraghRutam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Bida lavana, kalottha lavana, sarjikakshara, yavakshara, saptala, kanthakari'' and ''chitraka'' are burned together and later on mixed in water and filtered seven times. One ''adhaka'' (3.073 kg) of this ''kshara'' is added to one ''adhaka'' (3.073 kg) of ''ghrita'' and ''sneha siddhi'' is done. This ''ksharaghrita'' is indicated for increasing the digestive power [171-172]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> समूलां पिप्पलीं पाठां चव्येन्द्रयवनागरम्| <br /> <br /> चित्रकातिविषे हिङ्गु श्वदंष्ट्रां कटुरोहिणीम्||१७३|| <br /> <br /> वचां च कार्षिकं पञ्चलवणानां पलानि च| <br /> <br /> दध्नः प्रस्थद्वये तैलसर्पिषोः कुडवद्वये||१७४|| <br /> <br /> खण्डीकृतानि निष्क्वाथ्य शनैरन्तर्गते रसे| <br /> <br /> अन्तर्धूमं ततो दग्धवा चूर्णं कृत्वा घृताप्लुतम्||१७५|| <br /> <br /> पिबेत् पाणितलं तस्मिञ्जीर्णे स्यान्मधुराशनः| <br /> <br /> वातश्लेष्मामयान्सर्वान्हन्याद्विषगरांश्च सः||१७६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> samūlāṁ pippalīṁ pāṭhāṁ cavyēndrayavanāgaram| <br /> <br /> citrakātiviṣē hiṅgu śvadaṁṣṭrāṁ kaṭurōhiṇīm||173||<br /> <br /> vacāṁ ca kārṣikaṁ pañcalavaṇānāṁ palāni ca| <br /> <br /> dadhnaḥ prasthadvayē tailasarpiṣōḥ kuḍavadvayē||174|| <br /> <br /> khaṇḍīkr̥tāni niṣkvāthya śanairantargatē rasē| <br /> <br /> antardhūmaṁ tatō dagdhavā cūrṇaṁ kr̥tvā ghr̥tāplutam||175|| <br /> <br /> pibēt pāṇitalaṁ tasmiñjīrṇē syānmadhurāśanaḥ| <br /> <br /> Vātaślēṣmāmayānsarvānhanyādviṣagarāṁśca saḥ||176|| <br /> <br /> samUlAM pippalIM pAThAM cavyendrayavanAgaram| <br /> <br /> citrakAtiviShe hi~ggu shvadaMShTrAM kaTurohiNIm||173|| <br /> <br /> vacAM ca kArShikaM pa~jcalavaNAnAM palAni ca| <br /> <br /> dadhnaH prasthadvaye tailasarpiShoH kuDavadvaye||174|| <br /> <br /> khaNDIkRutAni niShkvAthya shanairantargate rase| <br /> <br /> antardhUmaM tato dagdhavA cUrNaM kRutvA ghRutAplutam||175||<br /> <br /> pibet pANitalaM tasmi~jjIrNe syAnmadhurAshanaH| <br /> <br /> vAtashleShmAmayAnsarvAnhanyAdviShagarAMshca saH||176|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Pippali, pippalimoola, patha, chavya, indrayava, nagara, chitraka, ativisha, hingu, svadamishthra'' (''gokshura''), ''katurohini'' and ''vacha'' are taken in one ''karsha'' (12 gm) quantity each. To this one ''pala'' (12 gm) of ''panchalavana'' is added along with two ''prastha'' of curds and two ''kudava'' (384 gm) of ''taila'' and ''ghrita''. The combination is boiled till water is completely evaporated. It is again burned by ''antaradhooma'' method and the end product is powdered and mixed with ghee its dosage is one ''panitala'' and when medicine gets digested patient is advised to take sweet diet. It is indicated in ''[[vata]] [[kapha]]ja'' disorders and in ''visha'' and ''gara visha'' [173-176]<br /> <br /> === ''Kshara'' preparations ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भल्लातकं त्रिकटुकं त्रिफलां लवणत्रयम्| <br /> <br /> अन्तर्धूमं द्विपलिकं गोपुरीषाग्निना दहेत्||१७७|| <br /> <br /> स क्षारः सर्पिषा पीतो भोज्ये वाऽप्यवचूर्णितः| <br /> <br /> हृत्पाण्डुग्रहणीदोषगुल्मोदावर्तशूलनुत्||१७८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhallātakaṁ trikaṭukaṁ triphalāṁ lavaṇatrayam| <br /> <br /> antardhūmaṁ dvipalikaṁ gōpurīṣāgninā dahēt||177||<br /> <br /> sa kṣāraḥ sarpiṣā pītō bhōjyē vā'pyavacūrṇitaḥ|<br /> <br /> hr̥tpāṇḍuGrahaṇī dōṣagulmōdāvartaśūlanut||178||<br /> <br /> bhallAtakaM trikaTukaM triphalAM lavaNatrayam| <br /> <br /> antardhUmaM dvipalikaM gopurIShAgninA dahet||177|| <br /> <br /> sa kShAraH sarpiShA pIto bhojye vA~apyavacUrNitaH| <br /> <br /> hRutpANDugrahaNIdoShagulmodAvartashUlanut||178||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Bhallataka, trikaṭu, triphala,'' three types of ''lavana'' (''saindhva, sauvarchala'' and ''bida'') should be burned by ''antaradhooma'' method with help of cow dung cakes. This ''kshara'' should be administered with ghee or by sprinkling over prepared food.<br /> <br /> It is indicated in ''hridroga, pandu, grahanidosha, gulma, udavarta'' and pain (especially spasmodic pain)[177-178]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दुरालभां करञ्जौ द्वौ सप्तपर्णं सवत्सकम्| <br /> <br /> षड्ग्रन्थां मदनं मूर्वां पाठामारग्वधं तथा||१७९|| <br /> <br /> गोमूत्रेण समांशानि कृत्वा चूर्णानि दाहयेत्| <br /> <br /> दग्ध्वा च तं पिबेत् क्षारं ग्रहणीबलवर्धनम्||१८०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> durālabhāṁ karañjau dvau saptaparṇaṁ savatsakam| <br /> <br /> ṣaḍgranthāṁ madanaṁ mūrvāṁ pāṭhāmāragvadhaṁ tathā||179|| <br /> <br /> gōmūtrēṇa samāṁśāni kr̥tvā cūrṇāni dāhayēt| <br /> <br /> dagdhvā ca taṁ pibēt kṣāraṁ Grahaṇī balavardhanam||180||<br /> <br /> durAlabhAM kara~jjau dvau saptaparNaM savatsakam| <br /> <br /> ShaDgranthAM madanaM mUrvAM pAThAmAragvadhaM tathA||179|| <br /> <br /> gomUtreNa samAMshAni kRutvA cUrNAni dAhayet| <br /> <br /> dagdhvA ca taM pibet kShAraM grahaNIbalavardhanam||180||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Duralabha'', two types of ''karanja'' (''karanja, lata karanja''), ''saptaparna, vatsaka, sadgrantha'' (''vacha''), ''madanaphala, murva, patha'' and ''aragvadha'' should be mixed with equal quantity of ''gomutra'' and boiled and prepared as per ''kshara kalpana''. This ''kshara'' increases ''bala'' of ''grahani'' i.e. of [[agni]] [179-180]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भूनिम्बं रोहिणीं तिक्तां पटोलं निम्बपर्पटम्| <br /> <br /> दहेन्माहिषमूत्रेण क्षार एषोऽग्निवर्धनः||१८१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhūnimbaṁ rōhiṇīṁ tiktāṁ paṭōlaṁ nimbaparpaṭam| <br /> <br /> dahēnmāhiṣamūtrēṇa kṣāra ēṣō'gnivardhanaḥ||181|| <br /> <br /> bhUnimbaM rohiNIM tiktAM paTolaM nimbaparpaTam|<br /> <br /> dahenmAhiShamUtreNa kShAra eSho~agnivardhanaH||181|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Bhunimba, kutaki, tikta, patola, nimba'' and ''parpataka'' are burned with buffalo urine and prepared as per ''kshara kalpana''. Such ''kshara'' promotes ''agnibala'' [181]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्वे हरिद्रे वचा कुष्ठं चित्रकः कटुरोहिणी| <br /> <br /> मुस्तं च बस्तमूत्रेण दहेत् क्षारोऽग्निवर्धनः||१८२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dvē haridrē vacā kuṣṭhaṁ citrakaḥ kaṭurōhiṇī| <br /> <br /> mustaṁ ca bastamūtrēṇa dahēt kṣārō'gnivardhanaḥ||182||<br /> <br /> dve haridre vacA kuShThaM citrakaH kaTurohiNI| <br /> <br /> mustaM ca bastamUtreNa dahet kShAro~agnivardhanaH||182||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Two types of ''haridra'' (''haridra'' and ''daruharidra''), ''vacha, kuṣṭha, chitraka, kutaki'' and ''musta'' after mixing in goat's urine are burned and ''kshara'' is prepared as per ''kshara kalpana''. It helps in increasing ''agnibala'' [182]<br /> <br /> === ''Ksharagudika'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चतुष्पलं सुधाकाण्डात्त्रिपलं लवणत्रयात्| <br /> <br /> वार्ताकीकुडवं चार्कादष्टौ द्वे चित्रकात् पले||१८३|| <br /> <br /> दग्धानि वार्ताकुरसे गुटिका भोजनोत्तराः| <br /> <br /> भुक्तं भुक्तं पचन्त्याशु कासश्वासार्शसां हिताः||१८४|| <br /> <br /> विसूचिकाप्रतिश्यायहृद्रोगशमनाश्च ताः| <br /> <br /> इत्येषा क्षारगुटिका कृष्णात्रेयेण कीर्तिता||१८५|| <br /> <br /> इति क्षारगुडिका<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> catuṣpalaṁ sudhākāṇḍāttripalaṁ lavaṇatrayāt| <br /> <br /> vārtākīkuḍavaṁ cārkādaṣṭau dvē citrakāt palē||183|| <br /> <br /> dagdhāni vārtākurasē guṭikā bhōjanōttarāḥ| <br /> <br /> bhuktaṁ bhuktaṁ pacantyāśu kāsaśvāsārśasāṁ hitāḥ||184|| <br /> <br /> visūcikāpratiśyāyahr̥drōgaśāmanāśca tāḥ| <br /> <br /> ityēṣā kṣāraguṭikā kr̥ṣṇātrēyēṇa kīrtitā||185|| <br /> <br /> iti kṣāraguḍikā<br /> <br /> catuShpalaM sudhAkANDAttripalaM lavaNatrayAt| <br /> <br /> vArtAkIkuDavaM cArkAdaShTau dve citrakAt pale||183||<br /> <br /> dagdhAni vArtAkurase guTikA bhojanottarAH| <br /> <br /> bhuktaM bhuktaM pacantyAshu kAsashvAsArshasAM hitAH||184|| <br /> <br /> visUcikApratishyAyahRudrogashamanAshca tAH| <br /> <br /> ityeShA kShAraguTikA kRuShNAtreyeNa kIrtitA||185|| <br /> <br /> iti kShAraguDikA<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Four ''pala'' (192 gm) of stems of ''sudha'', three ''pala'' (144 gm) of three types of ''lavana'' i.e. one ''pala'' (48 gm) each of ''saindhava, sauvarchala'' and ''bida'', one ''kudava'' (192 gm) of ''vartaki,'' eight ''pala'' (388 gm) of ''arka'' and two ''pala'' (96 gm) of ''chitraka'' are burned and the ''kshara'' thus prepared is triturated with ''svarasa'' of ''vartaku'' and pills are prepared. Its administration after food helps in quick digestion and useful in ''kasa, shvasa, arsha, vishuchika, pratishyaya'' and ''hridroga''. This preparation is called ''ksharagudika'' and is propounded by ''krishnatre'' [183-185]<br /> <br /> === ''Chaturtha-kshara'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वत्सकातिविषे पाठां दुःस्पर्शां हिङ्गु चित्रकम्| <br /> <br /> चूर्णीकृत्य पलाशाग्रक्षारे मूत्रस्रुते पचेत्||१८६|| <br /> <br /> आयसे भाजने सान्द्रात्तस्मात् [४०] कोलं सुखाम्बुना| <br /> <br /> मद्यैर्वा ग्रहणीदोषशोथार्शःपाण्डुमान् पिबेत्||१८७|| <br /> <br /> इति चतुर्थक्षारः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vatsakātiviṣē pāṭhāṁ duḥsparśāṁ hiṅgu citrakam| <br /> <br /> cūrṇīkr̥tya palāśāgrakṣārē mūtrasrutē pacēt||186|| <br /> <br /> āyasē bhājanē sāndrāttasmāt [40] kōlaṁ sukhāmbunā| <br /> <br /> madyairvā Grahaṇī dōṣaśōthārśaḥpāṇḍumān pibēt||187|| <br /> <br /> iti caturthakṣāraḥ<br /> <br /> vatsakAtiviShe pAThAM duHsparshAM hi~ggu citrakam| <br /> <br /> cUrNIkRutya palAshAgrakShAre mUtrasrute pacet||186|| <br /> <br /> Ayase bhAjane sAndrAttasmAt [40] kolaM sukhAmbunA| <br /> <br /> madyairvA grahaNIdoShashothArshaHpANDumAn pibet||187|| <br /> <br /> iti caturthakShAraH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Vatsaka, ativisha, patha, duhasparsha, hingu'' and ''chitraka'' should be powdered together and mixed with ''palashagrakshara''. It is cooked in cow’s urine in an iron pan till it becomes semisolid. Its dosage is one ''kola'' (6 gm) to be taken with lukewarm water or with ''madya'' (medicated alcohol). It is indicated in ''grahanidosha, shotha, arsha'' and ''pandu''. The preparation is known as ''chaturtha kshara'' [186-187]<br /> <br /> === ''Panchamakshara'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिफलां कटभीं चव्यं बिल्वमध्यमयोरजः| <br /> <br /> रोहिणीं कटुकां मुस्तं कुष्ठं पाठां च हिङ्गु च||१८८|| <br /> <br /> मधुकं मुष्ककयवक्षारौ त्रिकटुकं वचाम्| <br /> <br /> विडङ्गं पिप्पलीमूलं स्वर्जिकां निम्बचित्रकौ||१८९|| <br /> <br /> मूर्वाजमोदेन्द्रयवान् गुडूचीं देवदारु च| <br /> <br /> कार्षिकं लवणानां च पञ्चानां पलिकान्पृथक्||१९०|| <br /> <br /> भागान् दध्नि त्रिकुडवे घृततैलेन मूर्च्छितम्| <br /> <br /> अन्तर्धूमं शनैर्दग्ध्वा तस्मात् पाणितलं पिबेत्||१९१|| <br /> <br /> सर्पिषा कफवातार्शोग्रहणीपाण्डुरोगवान्| <br /> <br /> प्लीहमूत्रग्रहश्वासहिक्काकासक्रिमिज्वरान्||१९२|| <br /> <br /> शोषातिसारौ श्वयथुं प्रमेहानाहहृद्ग्रहान्| <br /> <br /> हन्यात् सर्वविषं [४१] चैव क्षारोऽग्निजननो वरः||१९३|| <br /> <br /> जीर्णे रसैर्वा मधुरैरश्नीयात् पयसाऽपि वाइति पञ्चमक्षारः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> triphalāṁ kaṭabhīṁ cavyaṁ bilvāmadhyāmayōrajaḥ| <br /> <br /> rōhiṇīṁ kaṭukāṁ mustaṁ kuṣṭhaṁ pāṭhāṁ ca hiṅgu ca||188|| <br /> <br /> madhukaṁ muṣkakayavakṣārau trikaṭukaṁ vacām| <br /> <br /> viḍaṅgaṁ pippalīmūlaṁ svarjikāṁ nimbacitrakau||189|| <br /> <br /> mūrvājamōdēndrayavān guḍūcīṁ dēvadāru ca| <br /> <br /> kārṣikaṁ lavaṇānāṁ ca pañcānāṁ palikānpr̥thak||190|| <br /> <br /> bhāgān dadhni trikuḍavē ghr̥tatailēna mūrcchitam| <br /> <br /> antardhūmaṁ śanairdagdhvā tasmāt pāṇitalaṁ pibēt||191|| <br /> <br /> sarpiṣā kaphavātārśōGrahaṇī pāṇḍurōgavān| <br /> <br /> plīhamūtragrahaśvāsahikkākāsakrimijvarān||192|| <br /> <br /> śōṣātisārau śvayathuṁ pramēhānāhahr̥dgrahān| <br /> <br /> hanyāt sarvaviṣaṁ [41] caiva kṣārō'gnijananō varaḥ||193|| <br /> <br /> jīrṇē rasairvā madhurairaśnīyāt payasā'pi vāiti pañcāmakṣāraḥ<br /> <br /> triphalAM kaTabhIM cavyaM bilvamadhyamayorajaH| <br /> <br /> rohiNIM kaTukAM mustaM kuShThaM pAThAM ca hi~ggu ca||188|| <br /> <br /> madhukaM muShkakayavakShArau trikaTukaM vacAm| <br /> <br /> viDa~ggaM pippalImUlaM svarjikAM nimbacitrakau||189|| <br /> <br /> mUrvAjamodendrayavAn guDUcIM devadAru ca| <br /> <br /> kArShikaM lavaNAnAM ca pa~jcAnAM palikAnpRuthak||190|| <br /> <br /> bhAgAn dadhni trikuDave ghRutatailena mUrcchitam| <br /> <br /> antardhUmaM shanairdagdhvA tasmAt pANitalaM pibet||191|| <br /> <br /> sarpiShA kaphavAtArshograhaNIpANDurogavAn| <br /> <br /> plIhamUtragrahashvAsahikkAkAsakrimijvarAn||192|| <br /> <br /> shoShAtisArau shvayathuM pramehAnAhahRudgrahAn| <br /> <br /> hanyAt sarvaviShaM [41] caiva kShAro~agnijanano varaH||193|| <br /> <br /> jIrNe rasairvA madhurairashnIyAt payasA~api vAiti pa~jcamakShAraH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Triphala, kaṭabhi, chavya,'' pulp of ''bilva'', powder of ''ayoraja'' (''mandura''), ''katutki, musta, kushtha, patha, hingu, madhuka, kshara'' of ''muskaka'' and ''yavakshara, trikatu, vacha, vidanga, pippalimoola, svarjikakshara, nimba, chitraka, murva, ajamoda, indrayava, guḍuchi'' and ''devadaru'' are taken in one ''karsha'' (12 gm) quantity and one ''pala'' each of five salts are taken. All are mixed with three ''kudavas'' (576 gm) of ''dadhi, ghrita'' and ''taila''. The mixture is burned by ''antardhooma'' method. One ''panitala'' is the dose which is given with ghee. It is indicated in ''[[kapha]]'' and ''[[vata]]ja arsha, grahani, pandu, pleeha, mutragraha, svasa, hikka, kasa, krimi, jwara, sosha, atisara, sotha, prameha, anaha, hridgraha'' and in all types of toxicity.<br /> <br /> It is one among the best stimulants of [[agni]]. Once the medicine is digested ''mamsarasa'' or sweet diet or milk should be administered. This ends the explanation of the ''panchamakshara'' [188-193]<br /> <br /> === Treatment of ''tridoshaja grahani''===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिदोषे विधिविद्वैद्यः पञ्च कर्माणि कारयेत्||१९४|| <br /> <br /> घृतक्षारासवारिष्टान् दद्याच्चाग्निविवर्धनान्| <br /> <br /> क्रिया या चानिलादीनां निर्दिष्टा ग्रहणीं प्रति||१९५|| <br /> <br /> व्यत्यासात्तां समस्तां वा कुर्याद्दोषविशेषवित्|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tridōṣē vidhividvaidyaḥ pañca karmāṇi kārayēt||194|| <br /> <br /> ghr̥takṣārāsavāriṣṭān dadyāccāgnivivardhanān| <br /> <br /> kriyā yā cānilādīnāṁ nirdiṣṭā Grahaṇī ṁ prati||195|| <br /> <br /> vyatyāsāttāṁ sāmastāṁ vā kuryāddōṣaviśēṣavit|<br /> <br /> tridoShe vidhividvaidyaH pa~jca karmANi kArayet||194|| <br /> <br /> ghRutakShArAsavAriShTAn dadyAccAgnivivardhanAn| <br /> <br /> kriyA yA cAnilAdInAM nirdiShTA grahaNIM prati||195|| <br /> <br /> vyatyAsAttAM samastAM vA kuryAddoShavisheShavit|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''tridoshaja grahani, [[Panchakarma]]'' should be carried out as per predominance of ''[[dosha]]''. Various ghee, ''kshara, asava'' and ''arishtha'' preparation useful in stimulation of [[agni]] should be administered.<br /> <br /> Previously described line of treatment for ''[[vata]]ja'' etc ''grahani'' should be accordingly followed. This line of treatment should be done either separately or jointly after finding the predominance of ''[[dosha]]'' [194-195]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्नेहनं स्वेदनं शुद्धिर्लङ्घनं दीपनं च यत्||१९६|| <br /> <br /> चूर्णानि लवणक्षारमध्वरिष्टसुरासवाः| <br /> <br /> विविधास्तक्रयोगाश्च दीपनानां च सर्पिषाम्||१९७|| <br /> <br /> ग्रहणीरोगिभिः सेव्याः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snēhanaṁ svēdanaṁ śuddhirlaṅghanaṁ dīpanaṁ ca yat||196|| <br /> <br /> cūrṇāni lavaṇakṣārāmadhvariṣṭasurāsavāḥ| <br /> <br /> vividhāstakrayōgāśca dīpanānāṁ ca sarpiṣām||197|| <br /> <br /> Grahaṇī rōgibhiḥ sēvyāḥ<br /> <br /> snehanaM svedanaM shuddhirla~gghanaM dIpanaM ca yat||196|| <br /> <br /> cUrNAni lavaNakShAramadhvariShTasurAsavAH| <br /> <br /> vividhAstakrayogAshca dIpanAnAM ca sarpiShAm||197|| <br /> <br /> grahaNIrogibhiH sevyAH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Snehana]], [[swedana]], [[shodhana]], [[langhana]], [[deepana]],'' various powder preparation of ''lavana, kshara, madhvarishtha, surasava,'' various ''takra'' preparation, ''deepaniya ghrita'' are to be prescribed to the ''grahanidosha'' patient [196-197]<br /> <br /> === Treatment of various states of disease and ''[[dosha]]'' aggravation ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्रियां चावस्थिकीं शृणु| <br /> <br /> ष्ठीवनं श्लैष्मिके रूक्षं दीपनं तिक्तसंयुतम्||१९८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kriyāṁ cāvasthikīṁ śr̥ṇu| <br /> <br /> ṣṭhīvanaṁ ślaiṣmikē rūkṣaṁ dīpanaṁ tiktasaṁyutam||198|| <br /> <br /> kriyAM cAvasthikIM shRuNu| <br /> <br /> ShThIvanaM shlaiShmike rUkShaM dIpanaM tiktasaMyutam||198|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Henceforth treatment as per condition is being mentioned.<br /> <br /> In ''[[kapha]]ja grahani'' if there is excess sputum, then ''ruksha'' (ununctuous) and ''[[deepana]]'' drugs having bitter taste should be administered [198]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सकृद्रूक्षं सकृत्स्निग्धं कृशे बहुकफे हितम्| <br /> <br /> परीक्ष्यामं शरीरस्य दीपनं स्नेहसंयुतम्||१९९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sakr̥drūkṣaṁ sakr̥tsnigdhaṁ kr̥śē bahukaphē hitam|<br /> <br /> parīkṣyāmaṁ śarīrasya dīpanaṁ snēhasaṁyutam||199||<br /> <br /> sakRudrUkShaM sakRutsnigdhaM kRushe bahukaphe hitam| <br /> <br /> parIkShyAmaM sharIrasya dIpanaM snehasaMyutam||199|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If patient is weak, but ''[[kapha]]'' is excessive then alternately ununctous and unctuous therapies should be administered repeatedly. After complete examination; if ''[[pachana]]'' of ''ama'' has taken place than administer ghee fortified by ''deepaniya'' medicines [199] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दीपनं बहुपित्तस्य तिक्तं मधुरसंयुतम्|<br /> <br /> बहुवातस्य तु स्नेहलवणाम्लयुतं हितम्||२००|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dīpanaṁ bahuPittasya tiktaṁ madhurasaṁyutam| <br /> <br /> bahuVātasya tu snēhalavaṇāmlayutaṁ hitam||200||<br /> <br /> dIpanaM bahupittasya tiktaM madhurasaMyutam| <br /> <br /> bahuvAtasya tu snehalavaNAmlayutaM hitam||200|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If ''[[pitta]]'' is aggravated then ''[[deepana]]'' drugs having bitter taste along with medicines having sweet taste should be administered whereas if ''[[vata]]'' is aggravated then ''deepaniya'' drugs along with ''sneha, lavana'' and ''amla'' dominated drugs should be administered [200]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सन्धुक्षति तथा वह्निरेषां विधिवदिन्धनैः|<br /> <br /> स्नेहमेव परं विद्याद्दुर्बलानलदीपनम्||२०१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sandhukṣati tathā vahnirēṣāṁ vidhivadindhanaiḥ|<br /> <br /> snēhamēva paraṁ vidyāddurbalānaladīpanam||201|| <br /> <br /> sandhukShati tathA vahnireShAM vidhivadindhanaiH| <br /> <br /> snehameva paraM vidyAddurbalAnaladIpanam||201|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Proper management as mentioned in earlier verses stimulates the [[agni]] (digestive power). ''Sneha'' is the best among the ''[[deepana]] dravya'' which helps in stimulating the inefficient [[agni]] [201]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नालं स्नेहसमिद्धस्य शमायान्नं सुगुर्वपि| <br /> <br /> मन्दाग्निरविपक्वं तु पुरीषं योऽतिसार्यते||२०२|| <br /> <br /> दीपनीयौषधैर्युक्तां घृतमात्रां पिबेत्तु सः|<br /> <br /> तया समानः पवनः प्रसन्नो [४२] मार्गमास्थितः||२०३||<br /> <br /> अग्नेः समीपचारित्वादाशु प्रकुरुते बलम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nālaṁ snēhasamiddhasya śamāyānnaṁ sugurvapi| <br /> <br /> mandāgniravipakvaṁ tu purīṣaṁ yō'tisāryatē||202|| <br /> <br /> dīpanīyauṣadhairyuktāṁ ghr̥tamātrāṁ pibēttu saḥ| <br /> <br /> tayā samānaḥ pavanaḥ prasannō [42] mārgamāsthitaḥ||203|| <br /> <br /> agnēḥ samīpacāritvādāśu prakurutē balam| <br /> <br /> nAlaM snehasamiddhasya shamAyAnnaM sugurvapi| <br /> <br /> mandAgniravipakvaM tu purIShaM yo~atisAryate||202|| <br /> <br /> dIpanIyauShadhairyuktAM ghRutamAtrAM pibettu saH| <br /> <br /> tayA samAnaH pavanaH prasanno [42] mArgamAsthitaH||203|| <br /> <br /> agneH samIpacAritvAdAshu prakurute balam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the patient has inefficient digestive power and voids undigested food in excess in stools or frequency of motions is more, then appropriate quantity of ''ghrita'' fortified by ''[[deepana]]'' medicines should again be given. Thus, ''samana vata'' is regularized and moves in its normal tract. As ''samana vata'' is associated with [[agni]] it instantaneously promotes the strength of [[agni]]. <br /> <br /> Digestive power thus stimulated by ''ghrita'' cannot be suppressed even by heavy meals [202-203]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> काठिन्याद्यः पुरीषं तु कृच्छ्रान्मुञ्चति मानवः||२०४|| <br /> <br /> सघृतं लवणैर्युक्तं नरोऽन्नावग्रहं पिबेत्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kāṭhinyādyaḥ purīṣaṁ tu kr̥cchrānmuñcati mānavaḥ||204|| <br /> <br /> saghr̥taṁ lavaṇairyuktaṁ narō'nnāvagrahaṁ pibēt| <br /> <br /> kAThinyAdyaH purIShaM tu kRucchrAnmu~jcati mAnavaH||204|| <br /> <br /> saghRutaM lavaNairyuktaM naro~annAvagrahaM pibet| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If patient finds difficulty in evacuation of stools due to hardness in stools then salt mixed ''ghrita'' should be administered in between the food.<br /> <br /> ('''Note''':''Lavana rasa'' has ''vata anulomana'' action and also increases secretions, therefore hardness of stool is reduced and stools are easily evacuated) [204]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रौक्ष्यान्मन्दे पिबेत्सर्पिस्तैलं वा दीपनैर्युतम्||२०५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> raukṣyānmandē pibētsarpistailaṁ vā dīpanairyutam||205||<br /> <br /> raukShyAnmande pibetsarpistailaM vA dIpanairyutam||205||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If [[agni]] is suppressed due to ''ruksha [[guna]]'' then either ''ghrita'' or ''taila'' fortified with ''deepaniya'' drugs should be administered [205]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अतिस्नेहात्तु मन्देऽग्नौ चूर्णारिष्टासवा हिताः| <br /> <br /> भिन्ने गुदोपलेपात्तु मले तैलसुरासवाः||२०६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> atisnēhāttu mandē'gnau cūrṇāriṣṭāsavā hitāḥ| <br /> <br /> bhinnē gudōpalēpāttu malē tailasurāsavāḥ||206|| <br /> <br /> atisnehAttu mande~agnau cUrNAriShTAsavA hitAH| <br /> <br /> bhinne gudopalepAttu male tailasurAsavAH||206|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If excessive intake of ''sneha'' is cause for ''agnimandya'' then powder preparation, ''arishta asava'' as mentioned earlier are beneficial; whereas if anal area gets adhered by unformed stools then ''taila, sura'' and ''asava'' preparation should be administered [206]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> उदावर्तात्तु मन्देऽग्नौ निरूहाः स्नेहबस्तयः| <br /> <br /> दोषवृद्ध्या तु मन्देऽग्नौ शुद्धो दोषविधिं चरेत्||२०७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> udāvartāttu mandē'gnau nirūhāḥ snēhabastayaḥ| <br /> <br /> dōṣavr̥ddhyā tu mandē'gnau śuddhō dōṣavidhiṁ carēt||207|| <br /> <br /> udAvartAttu mande~agnau nirUhAH snehabastayaH| <br /> <br /> doShavRuddhyA tu mande~agnau shuddho doShavidhiM caret||207|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If ''udavarta'' (mis-peristalsis) is responsible for suppression of [[agni]] then ''niruha'' and ''sneha [[basti]]'' should be administered; whereas if ''[[dosha]] vriddhi'' is the cause for suppression of [[agni]] then ''[[shodhana]]'' as per ''[[dosha]]'' is indicated [207]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> व्याधियुक्तस्य मन्दे तु सर्पिरेवाग्निदीपनम्| <br /> <br /> उपवासाच्च मन्देऽग्नौ यवागूभिः पिबेद्घृतम्||२०८|| <br /> <br /> अन्नावपीडितं बल्यं दीपनं बृंहणं च तत्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vyādhiyuktasya mandē tu sarpirēvāgnidīpanam| <br /> <br /> upavāsācca mandē'gnau yavāgūbhiḥ pibēdghr̥tam||208|| <br /> <br /> annāvapīḍitaṁ balyaṁ dīpanaṁ br̥ṁhaṇaṁ ca tat| <br /> <br /> vyAdhiyuktasya mande tu sarpirevAgnidIpanam| <br /> <br /> upavAsAcca mande~agnau yavAgUbhiH pibedghRutam||208|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If suppression of [[agni]] has taken place due to diseases than ''ghrita'' is best for ''agni [[deepana]]'' but if fasting is the causes of [[agni]] suppression than ''yavagu'' (gruel) along with ''ghrita'' should be taken. ''Ghrita'' when taken in between the meal, it increases the strength, stimulates the digestion and nourishes the body [208]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दीर्घकालप्रसङ्गात्तु क्षामक्षीणकृशान्नरान्||२०९|| <br /> <br /> प्रसहानां रसैः साम्लैर्भोजयेत् पिशिताशिनाम्| <br /> <br /> लघु, तीक्ष्णोष्णशोधित्वाद्दीपयन्त्याशु तेऽनलम्||२१०|| <br /> <br /> मांसोपचितमांसत्वात्तथाऽऽशुतरबृंहणाः|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dīrghakālaprasaṅgāttu kṣāmakṣīṇakr̥śānnarān||209|| <br /> <br /> prasahānāṁ rasaiḥ sāmlairbhōjayēt piśitāśinām| <br /> <br /> laghu, tīkṣṇōṣṇaśōdhitvāddīpayantyāśu tē'nalam||210|| <br /> <br /> māṁsōpacitamāṁsatvāttathā''śutarabr̥ṁhaṇāḥ|<br /> <br /> annAvapIDitaM balyaM dIpanaM bRuMhaNaM ca tat| <br /> <br /> dIrghakAlaprasa~ggAttu kShAmakShINakRushAnnarAn||209|| <br /> <br /> prasahAnAM rasaiH sAmlairbhojayet pishitAshinAm| <br /> <br /> laghu, tIkShNoShNashodhitvAddIpayantyAshu te~analam||210|| <br /> <br /> mAMsopacitamAMsatvAttathA~a~ashutarabRuMhaNAH|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If ''agnimandya'' has been chronic and patient has become indolent, weak and emaciated then soup of ''prasaha'' group of animals (animals who snatch their food) fortified with ''amla'' drugs is advised. As this meat soups are light for digestion having penetrating, hot, purifying qualities stimulates the [[agni]]. Further as the animals feed on other animals their meat ''mamsa'' is well nourished and compact therefore causes quick nourishment [209-210]<br /> <br /> === Factors affecting status of [[agni]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नाभोजनेन कायाग्निर्दीप्यते नातिभोजनात्||२११|| <br /> <br /> यथा निरिन्धनो वह्निरल्पो वाऽतीन्धनावृतः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nābhōjanēna kāyāgnirdīpyatē nātibhōjanāt||211|| <br /> <br /> yathā nirindhanō vahniralpō vā'tīndhanāvr̥taḥ| <br /> <br /> nAbhojanena kAyAgnirdIpyate nAtibhojanAt||211|| <br /> <br /> yathA nirindhano vahniralpo vA~atIndhanAvRutaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Fasting or over eating does not stimulate [[agni]], as like fire in environment is extinguished if there is no fuel supply or if excessive fuel covers the [[agni]]. [211]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्नेहान्नविधिभिश्चित्रैश्चूर्णारिष्टसुरासवैः ||२१२|| <br /> <br /> सम्यक्प्रयुक्तैर्भिषजा बलमग्नेः प्रवर्धते| <br /> <br /> यथा हि सारदार्वग्निः स्थिरः सन्तिष्ठते चिरम्||२१३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snēhānnavidhibhiścitraiścūrṇāriṣṭasurāsavaiḥ [44] ||212|| <br /> <br /> samyakprayuktairbhiṣajā balāmagnēḥ pravardhatē| <br /> <br /> yathā hi sāradārvAgniḥ sthiraḥ santiṣṭhatē ciram||213||<br /> <br /> snehAnnavidhibhishcitraishcUrNAriShTasurAsavaiH [44] ||212|| <br /> <br /> samyakprayuktairbhiShajA balamagneH pravardhate| <br /> <br /> yathA hi sAradArvagniH sthiraH santiShThate ciram||213|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Proper intake of ''sneha'', followed by eating proper food preparations as well as appropriate use of various ''churna, arishtha, sura'' and ''asava'' along with proper medication as per condition, enhances the power of [[agni]] similar to the environmental fire which remains stable for long duration when good hard wood catches fire [212-213]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्नेहान्नविधिभिस्तद्वदन्तरग्निर्भवेत् स्थिरः| <br /> <br /> हितं जीर्णे मितं चाश्नंश्चिरमारोग्यमश्नुते||२१४|| <br /> <br /> अवैषम्येण धातूनामग्निवृद्धौ यतेत ना| <br /> <br /> समैर्दोषैः समो मध्ये देहस्योष्माऽग्निसंस्थितः||२१५|| <br /> <br /> पचत्यन्नं तदारोग्यपुष्ट्यायुर्बलवृद्धये| <br /> <br /> दोषैर्मन्दोऽतिवृद्धो वा विषमैर्जनयेद्गदान्||२१६|| <br /> <br /> वाच्यं मन्दस्य तत्रोक्तमतिवृद्धस्य वक्ष्यते|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snēhānnavidhibhistadvadantarAgnirbhavēt sthiraḥ| <br /> <br /> hitaṁ jīrṇē mitaṁ cāśnaṁściramārōgyāmaśnutē||214|| <br /> <br /> avaiṣamyēṇa dhātūnāmAgnivr̥ddhau yatēta nā| <br /> <br /> sāmairdōṣaiḥ samō madhyē dēhasyōṣmā'gnisaṁsthitaḥ||215|| <br /> <br /> pacatyannaṁ tadārōgyapuṣṭyāyurbalavr̥ddhayē| <br /> <br /> dōṣairmandō'tivr̥ddhō vā viṣāmairjanayēdgadān||216|| <br /> <br /> vācyaṁ mandasya tatrōktam ativr̥ddhasya vakṣyatē|<br /> <br /> snehAnnavidhibhistadvadantaragnirbhavet sthiraH| <br /> <br /> hitaM jIrNe mitaM cAshnaMshciramArogyamashnute||214|| <br /> <br /> avaiShamyeNa dhAtUnAmagnivRuddhau yateta nA| <br /> <br /> samairdoShaiH samo madhye dehasyoShmA~agnisaMsthitaH||215|| <br /> <br /> pacatyannaM tadArogyapuShTyAyurbalavRuddhaye| <br /> <br /> doShairmando~ativRuddho vA viShamairjanayedgadAn||216|| <br /> <br /> vAcyaM mandasya tatroktamativRuddhasya vakShyate| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Intake of food mixed with ''sneha'' and as per dietetic rules and regulation stabilizes the digestive power. <br /> <br /> Eating wholesome diet in appropriate quantity after previously eaten food is digested helps in maintaining good health for long duration. <br /> <br /> A person should workout so that ''agni vriddhi'' takes place without disturbing the balance of ''[[dhatu]]s''. Such [[agni]] digests the food, maintains health and nourishment, promotes longevity and increases strength. The same ''[[dosha]]'' when vitiated causes ''mandagni, tikshnagni'' and ''vishamagni'' and such a vitiated [[agni]] gives rise to various diseases. <br /> <br /> Management of ''mandagni'' has been explained previously henceforth management of ''ativriddha agni'' will be explained [214-216]<br /> <br /> === ''Samprapti'' of ''atyagni'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नरे क्षीणकफे पित्तं कुपितं मारुतानुगम्||२१७|| <br /> <br /> स्वोष्मणा पावकस्थाने बलमग्नेः प्रयच्छति| <br /> <br /> तदा लब्धबलो देहे विरूक्षे सानिलोऽनलः||२१८|| <br /> <br /> परिभूय पचत्यन्नं तैक्ष्ण्यादाशु मुहुर्मुहुः| <br /> <br /> पक्त्वाऽन्नं स ततो धातूञ्छोणितादीन् पचत्यपि||२१९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> narē kṣīṇakaphē Pittaṁ kupitaṁ mārutānugam||217|| <br /> <br /> svōṣmaṇā pāvakasthānē balāmagnēḥ prayacchati| <br /> <br /> tadā labdhabalō dēhē virūkṣē sānilō'nalaḥ||218|| <br /> <br /> paribhūya pacatyannaṁ taikṣṇyādāśu muhurmuhuḥ| <br /> <br /> paktvā'nnaṁ sa tatō dhātūñchōṇitādīn pacatyapi||219||<br /> <br /> nare kShINakaphe pittaM kupitaM mArutAnugam||217|| <br /> <br /> svoShmaNA pAvakasthAne balamagneH prayacchati| <br /> <br /> tadA labdhabalo dehe virUkShe sAnilo~analaH||218|| <br /> <br /> paribhUya pacatyannaM taikShNyAdAshu muhurmuhuH| <br /> <br /> paktvA~annaM sa tato dhAtU~jchoNitAdIn pacatyapi||219|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Person having diminished ''[[kapha]]'', aggravated ''[[pitta]]'' and associated ''[[vata]]'' leads to increase in the ''ushma'' of [[agni]] resulting in enhancing the capacity and power of [[agni]]. In such patient if the body is already undernourished, ''[[vata]]'' increases which further strengths the [[agni]] wherein both, together with help of ''tikshna [[guna]]'' digests the food even if taken frequently. After digestion of food, the increased [[agni]] starts digesting ''[[rakta]]'', etc ''[[dhatu]]s'' also [217-219]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ततो दौर्बल्यमातङ्कान्मृत्युं चोपनयेन्नरम्| <br /> <br /> भुक्तेऽन्ने लभते शान्तिं जीर्णमात्रे प्रताम्यति||२२०|| <br /> <br /> तृट्श्वासदाहमूर्च्छाद्या व्याधयोऽत्यग्निसम्भवाः| <br /> <br /> तमत्यग्निं गुरुस्निग्धशीतैर्मधुरविज्जलैः||२२१|| <br /> <br /> अन्नपानैर्नयेच्छान्तिं दीप्तमग्निमिवाम्बुभिः| <br /> <br /> मुहुर्मुहुरजीर्णेऽपि भोज्यान्यस्योपहारयेत्||२२२|| <br /> <br /> निरिन्धनोऽन्तरं लब्ध्वा यथैनं न विपादयेत्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatō daurbalyamātaṅkānmr̥tyuṁ cōpanayēnnaram| <br /> <br /> bhuktē'nnē labhatē śāntiṁ jīrṇamātrē pratāmyati||220|| <br /> <br /> tr̥ṭśvāsadāhamūrcchādyā vyādhayō'tyAgnisambhavāḥ| <br /> <br /> tāmatyāgniṁ gurusnigdhaśītairmadhuravijjalaiḥ||221||<br /> <br /> annapānairnayēcchāntiṁ dīptāmAgnimivāmbubhiḥ| <br /> <br /> muhurmuhurajīrṇē'pi bhōjyānyasyōpahārayēt||222|| <br /> <br /> nirindhanō'ntaraṁ labdhvā yathainaṁ na vipādayēt| <br /> <br /> tato daurbalyamAta~gkAnmRutyuM copanayennaram| <br /> <br /> bhukte~anne labhate shAntiM jIrNamAtre pratAmyati||220|| <br /> <br /> tRuTshvAsadAhamUrcchAdyA vyAdhayo~atyagnisambhavAH| <br /> <br /> tamatyagniM gurusnigdhashItairmadhuravijjalaiH||221|| <br /> <br /> annapAnairnayecchAntiM dIptamagnimivAmbubhiH| <br /> <br /> muhurmuhurajIrNe~api bhojyAnyasyopahArayet||222|| <br /> <br /> nirindhano~antaraM labdhvA yathainaM na vipAdayet| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Consequently, the patient becomes weak and death may occur due to disease. The patient feels better on consuming the food but feels worn out along with blackouts when food is digested. Morbid thirst, dyspnea, burning sensation, fainting etc are observed in disease caused due to ''atyagni''. <br /> <br /> Digestive power can be pacified by taking foods and drinks which are heavy to digest, unctuous, cold, sweet and liquid same way as fire is extinguishes by water in nature. The patient should be administered food at regular interval although previously eaten meal is undigested so that ''atyagni'' due to lack of fuel does not digest the tissues [220-222]<br /> <br /> === Management of ''atyagni'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पायसं कृशरां स्निग्धं पैष्टिकं गुडवैकृतम्||२२३|| <br /> <br /> अद्यात्तथौदकानूपपिशितानि भृतानि च| <br /> <br /> मत्स्यान्विशेषतः श्लक्ष्णान्स्थिरतोयचरांस्तथा||२२४|| <br /> <br /> आविकं च भृतं मांसमद्यादत्यग्निनाशनम् [४६] | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāyasaṁ kr̥śarāṁ snigdhaṁ paiṣṭikaṁ guḍavaikr̥tam||223|| <br /> <br /> adyāttathaudakānūpapiśitāni bhr̥tāni ca| <br /> <br /> matsyānviśēṣataḥ ślakṣṇānsthiratōyacarāṁstathā||224|| <br /> <br /> āvikaṁ ca bhr̥taṁ māṁsāmadyādatyāgnināśanam [46] | <br /> <br /> pAyasaM kRusharAM snigdhaM paiShTikaM guDavaikRutam||223||<br /> <br /> adyAttathaudakAnUpapishitAni bhRutAni ca| <br /> <br /> matsyAnvisheShataH shlakShNAnsthiratoyacarAMstathA||224|| <br /> <br /> AvikaM ca bhRutaM mAMsamadyAdatyagninAshanam [46] | <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Payasa'' (milk pudding), ''krishara'' (thick gruel prepared of rice and lentils), ''snigdha'' (unctuous), ''paiṣṭika'' (resembling flour paste), various jaggery products, meat of aquatic animals or marshy area especially fish which is mainly in smooth (not salty) and stable water and roasted meat of sheep may be given to pacify the ''atyagni'' [223-224]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यवागूं समधूच्छिष्टां घृतं वा क्षुधितः पिबेत्||२२५|| <br /> <br /> गोधूमचूर्णमन्थं वा व्यधयित्वा सिरां पिबेत्| <br /> <br /> पयो वा शर्करासर्पिर्जीवनीयौषधैः शृतम्||२२६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yavāgūṁ sāmadhūcchiṣṭāṁ ghr̥taṁ vā kṣudhitaḥ pibēt||225||<br /> <br /> gōdhūmacūrṇāmanthaṁ vā vyadhayitvā sirāṁ pibēt| <br /> <br /> payō vā śarkarāsarpirjīvanīyauṣadhaiḥ śr̥tam||226|| <br /> <br /> yavAgUM samadhUcchiShTAM ghRutaM vA kShudhitaH pibet||225|| <br /> <br /> godhUmacUrNamanthaM vA vyadhayitvA sirAM pibet| <br /> <br /> payo vA sharkarAsarpirjIvanIyauShadhaiH shRutam||226|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Yavagu'' (thick gruel) mixed with bee wax or ''ghrita'' should be given whenever patient feels hungry. ''Mantha'' prepared from wheat flour or venesection may be advised. Milk medicated with ''jeevaniya'' group of drugs along with sugar and ''ghrita'' may be given [225-226]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> फलानां तैलयोनीनामुत्क्रुञ्चाश्च [४७] सशर्कराः| <br /> <br /> मार्दवं जनयन्त्यग्नेः स्निग्धा मांसरसास्तथा||२२७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> phalānāṁ tailayōnīnāmutkruñcāśca [47] saśarkarāḥ| <br /> <br /> mārdavaṁ janayantyagnēḥ snigdhā māṁsarasāstathā||227|| <br /> <br /> phalAnAM tailayonInAmutkru~jcAshca [47] sasharkarAH| <br /> <br /> mArdavaM janayantyagneH snigdhA mAMsarasAstathA||227|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Paste of fruits, substances containing oil like ''tila'' (sesame seeds) with sugar and meat soup with ghee pacifies the [[agni]] [227]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पिबेच्छीताम्बुना सर्पिर्मधूच्छिष्टेन संयुतम्| <br /> <br /> गोधूमचूर्णं पयसा ससर्पिष्कं पिबेन्नरः||२२८|| <br /> <br /> आनूपरससिद्धान् वा त्रीन् स्नेहांस्तैलवर्जितान्| <br /> <br /> पयसा सम्मितं [४८] चापि घनं त्रिस्नेहसंयुतम्||२२९|| <br /> <br /> नारिस्तन्येन संयुक्तां पिबेदौदुम्बरीं त्वचम्| <br /> <br /> ताभ्यां वा पायसं सिद्धमद्यादत्यग्निशान्तये||२३०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pibēcchītāmbunā sarpirmadhūcchiṣṭēna saṁyutam| <br /> <br /> gōdhūmacūrṇaṁ payasā sasarpiṣkaṁ pibēnnaraḥ||228|| <br /> <br /> ānūparasasiddhān vā trīn snēhāṁstailavarjitān| <br /> <br /> payasā sammitaṁ [48] cāpi ghanaṁ trisnēhasaṁyutam||229|| <br /> <br /> nāristanyēna saṁyuktāṁ pibēdaudumbarīṁ tvacam| <br /> <br /> tābhyāṁ vā pāyasaṁ siddhāmadyādatyāgniśāntayē||230|| <br /> <br /> pibecchItAmbunA sarpirmadhUcchiShTena saMyutam| <br /> <br /> godhUmacUrNaM payasA sasarpiShkaM pibennaraH||228|| <br /> <br /> AnUparasasiddhAn vA trIn snehAMstailavarjitAn| <br /> <br /> payasA sammitaM [48] cApi ghanaM trisnehasaMyutam||229|| <br /> <br /> nAristanyena saMyuktAM pibedaudumbarIM tvacam| <br /> <br /> tAbhyAM vA pAyasaM siddhamadyAdatyagnishAntaye||230|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient should take ''ghrita'' with beeswax along with cold water as ''anupana''. Patient may take wheat flour with milk and ghee.<br /> <br /> Patient may be advised to take three ''sneha'' i.e. ghee, abinal fat, bone-marrow fortified with meat soup of animals residing in marshy areas. Milk mixed with wheat flour and curd along with three ''sneha'' (''ghrita, vasa, majja'') may be given. Bark of ''udumbara'' mixed with human milk and milk pudding prepared from ''udumbara'' and human milk helps in pacifying the ''atyagni'' [228-230]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> श्यामात्रिवृद्विपक्वं वा पयो दद्याद्विरेचनम्| <br /> <br /> असकृत् पित्तशान्त्यर्थं पायसप्रतिभोजनम्||२३१|| <br /> <br /> प्रसमीक्ष्य भिषक् प्राज्ञस्तस्मै दद्याद्विधानवित्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śyāmātrivr̥dvipakvaṁ vā payō dadyādvirēcanam| <br /> <br /> asakr̥t Pitta śāntyarthaṁ pāyasapratibhōjanam||231|| <br /> <br /> prasamīkṣya bhiṣak prājñastasmai dadyādvidhānavit| <br /> <br /> shyAmAtrivRudvipakvaM vA payo dadyAdvirecanam| <br /> <br /> asakRut pittashAntyarthaM pAyasapratibhojanam||231|| <br /> <br /> prasamIkShya bhiShak prAj~jastasmai dadyAdvidhAnavit| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Milk medicated with ''syama'' and ''trivritta'' may be advised for ''[[virechana]]'' for alleviating the ''[[pitta]]'' followed by diet of milk pudding. Expert physician should follow the line of treatment after proper examination of patient [231]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यत्किञ्चिन्मधुरं मेद्यं श्लेष्मलं गुरुभोजनम्||२३२|| <br /> <br /> सर्वं तदत्यग्निहितं भुक्त्वा प्रस्वपनं दिवा| <br /> <br /> मेद्यान्यन्नानि योऽत्यग्नावप्रतान्तः [४९] समश्नुते||२३३|| <br /> <br /> न तन्निमित्तं व्यसनं लभते पुष्टिमेव च| <br /> <br /> कफे वृद्धे जिते पित्ते मारुते चानलः समः||२३४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yatkiñcinmadhuraṁ mēdyaṁ ślēṣmalaṁ gurubhōjanam||232|| <br /> <br /> sarvaṁ tadatyāgnihitaṁ bhuktvā prasvapanaṁ divā| <br /> <br /> mēdyānyannāni yō'tyagnāvapratāntaḥ [49] sāmaśnutē||233|| <br /> <br /> na tannimittaṁ vyasanaṁ labhatē puṣṭimēva ca| <br /> <br /> kaphē vr̥ddhē jitē pittē mārutē cānalaḥ sāmaḥ||234|| <br /> <br /> sāmadhātōḥ pacatyannaṁ puṣṭyāyurbalavr̥ddhayē|<br /> <br /> yatki~jcinmadhuraM medyaM shleShmalaM gurubhojanam||232|| <br /> <br /> sarvaM tadatyagnihitaM bhuktvA prasvapanaM divA| <br /> <br /> medyAnyannAni yo~atyagnAvapratAntaH [49] samashnute||233|| <br /> <br /> na tannimittaM vyasanaM labhate puShTimeva ca| <br /> <br /> kaphe vRuddhe jite pitte mArute cAnalaH samaH||234|| <br /> <br /> samadhAtoH pacatyannaM puShTyAyurbalavRuddhaye|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Foods which are sweet in taste, fatty, increases ''[[kapha]]'' and heavy to digest should be given. All food items are good for ''atyagni'' and sleeping after meals during day time is beneficial in ''atyagni''. Patient who takes fatty diet even though he is not hungry does not succumb to death. If he is suffering from ''atyagni'' on the other hand such diet pattern is nutritional. Whenever due to medication and diet, ''[[kapha]]'' is increased; it subdues ''[[pitta]]'' and ''[[vata]]'' and normalizes the [[agni]].<br /> <br /> When ''[[dhatu]]s'' are in equilibrium ''anna'' gets digested resulting in increase in nutrition, longevity and strength [232-234]<br /> <br /> === Improper dietary habits ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भवन्ति चात्र- <br /> <br /> पथ्यापथ्यमिहैकत्र भुक्तं समशनं मतम्||२३५|| <br /> <br /> विषमं बहु वाऽल्पं वाऽप्यप्राप्तातीतकालयोः| <br /> <br /> भुक्तं पूर्वान्नशेषे तु पुनरध्यशनं मतम्||२३६|| <br /> <br /> त्रीण्यप्येतानि मृत्युं वा घोरान् व्याधीन्सृजन्ति वा| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhavanti cātra- <br /> <br /> pathyāpathyamihaikatra bhuktaṁ sāmaśanaṁ matam||235|| <br /> <br /> viṣāmaṁ bahu vā'lpaṁ vā'pyaprāptātītakālayōḥ| <br /> <br /> bhuktaṁ pūrvānnaśēṣē tu punaradhyaśanaṁ matam||236|| <br /> <br /> trīṇyapyētāni mr̥tyuṁ vā ghōrān vyādhīnsr̥janti vā| <br /> <br /> bhavanti cAtra- <br /> <br /> pathyApathyamihaikatra bhuktaM samashanaM matam||235|| <br /> <br /> viShamaM bahu vA~alpaM vA~apyaprAptAtItakAlayoH| <br /> <br /> bhuktaM pUrvAnnasheShe tu punaradhyashanaM matam||236|| <br /> <br /> trINyapyetAni mRutyuM vA ghorAn vyAdhInsRujanti vA| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Taking of wholesome and unwholesome foods together in diet is known as ''samashana''.<br /> <br /> ''Vishamashana'' is defined as taking food either in excess quantity or very little quantity and also if taken before or after appropriate time. <br /> <br /> ''Adhyashana'' is having food even though previously eaten food is not yet digested.<br /> <br /> All the above three are causes for death or give rise to serious disorders [235-236]<br /> <br /> === Variation in digestion as per day-night cycle ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्रातराशे त्वजीर्णेऽपि सायमाशो न दुष्यति||२३७|| <br /> <br /> दिवा प्रबुध्यतेऽर्केण हृदयं पुण्डरीकवत्| <br /> <br /> तस्मिन्विबुद्धे स्रोतांसि स्फुटत्वं यान्ति सर्वशः||२३८|| <br /> <br /> व्यायामाच्च विहाराच्च विक्षिप्तत्वाच्च चेतसः| <br /> <br /> न क्लेदमुपगच्छन्ति दिवा तेनास्य धातवः||२३९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> prātarāśē tvajīrṇē'pi sāyamāśō na duṣyati||237|| <br /> <br /> divā prabudhyatē'rkēṇa hr̥dayaṁ puṇḍarīkavat| <br /> <br /> tasminvibuddhē srōtāṁsi sphuṭatvaṁ yānti sarvaśaḥ||238|| <br /> <br /> vyāyāmācca vihārācca vikṣiptatvācca cētasaḥ| <br /> <br /> na klēdamupagacchanti divā tēnāsya dhātavaḥ||239|| <br /> <br /> prAtarAshe tvajIrNe~api sAyamAsho na duShyati||237|| <br /> <br /> divA prabudhyate~arkeNa hRudayaM puNDarIkavat| <br /> <br /> tasminvibuddhe srotAMsi sphuTatvaM yAnti sarvashaH||238|| <br /> <br /> vyAyAmAcca vihArAcca vikShiptatvAcca cetasaH| <br /> <br /> na kledamupagacchanti divA tenAsya dhAtavaH||239|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If morning eaten food is undigested and still if anyone takes evening food it may not be more vitiative since in day time all the ''srotas'' (channels) are dilated and heart is active similar to the lotus which blossoms with sunrise. During daytime, exercise, other physical and mental activities (cause heart to pump blood properly to) prevent the genesis of ''kleda'' (excess moisture) in various ''[[dhatu]]s'' [237-239]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अक्लिन्नेष्वन्नमासिक्तमन्यत्तेषु न दुष्यति| <br /> <br /> अविदग्ध इव क्षीरे क्षीरमन्यद्विमिश्रितम्||२४०|| <br /> <br /> नैव दूष्यति तेनैव समं सम्पद्यते यथा| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> aklinnēṣvannamāsiktāmanyattēṣu na duṣyati| <br /> <br /> avidagdha iva kṣīrē kṣīrāmanyadvimiśritam||240|| <br /> <br /> naiva dūṣyati tēnaiva sāmaṁ sampadyatē yathā| <br /> <br /> aklinneShvannamAsiktamanyatteShu na duShyati| <br /> <br /> avidagdha iva kShIre kShIramanyadvimishritam||240|| <br /> <br /> naiva dUShyati tenaiva samaM sampadyate yathA| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As unspoiled milk when mixed with fresh milk, the mixture does not get spoiled and will get uniformly mixed, so is the condition when in daytime previously eaten food although not digested still a person can digest another meal [240]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रात्रौ तु हृदये म्लाने संवृतेष्वयनेषु च| <br /> <br /> यान्ति कोष्ठे परिक्लेदं संवृते देहधातवः||२४१|| <br /> <br /> क्लिन्नेष्वन्यदपक्वेषु तेष्वासिक्तं प्रदुष्यति| <br /> <br /> विदग्धेषु पयःस्वन्यत् पयस्तप्तमिवार्पितम्||२४२|| <br /> <br /> नैशेष्वाहारजातेषु नाविपक्वेषु बुद्धिमान्| <br /> <br /> तस्मादन्यत्समश्नीयात्पालयिष्यन्बलायुषी||२४३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rātrau tu hr̥dayē mlānē saṁvr̥tēṣvayanēṣu ca| <br /> <br /> yānti kōṣṭhē pariklēdaṁ saṁvr̥tē dēhadhātavaḥ||241|| <br /> <br /> klinnēṣvanyadapakvēṣu tēṣvāsiktaṁ praduṣyati| <br /> <br /> vidagdhēṣu payaḥsvanyat payastaptamivārpitam||242|| <br /> <br /> naiśēṣvāhārajātēṣu nāvipakvēṣu buddhimān| <br /> <br /> tasmādanyatsāmaśnīyātpālayiṣyanbalāyuṣī||243||<br /> <br /> rAtrau tu hRudaye mlAne saMvRuteShvayaneShu ca| <br /> <br /> yAnti koShThe parikledaM saMvRute dehadhAtavaH||241|| <br /> <br /> klinneShvanyadapakveShu teShvAsiktaM praduShyati| <br /> <br /> vidagdheShu payaHsvanyat payastaptamivArpitam||242|| <br /> <br /> naisheShvAhArajAteShu nAvipakveShu buddhimAn| <br /> <br /> tasmAdanyatsamashnIyAtpAlayiShyanbalAyuShI||243||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In the night, the channels are closed, so is the heart which functions at slow rate as demand is less, the ''apakva ahara rasa'' increases in viscosity; thus ''ama'' adheres to the ''[[dhatu]]s'' and if another food is taken the indigestion causes more ''apakva ahara rasa'' causing disease. The condition resembles, wherein uncooked milk mixed with warm milk gets spoiled. Therefore, a wise person should not take meals if food taken at night is not digested; this will surely effect strength and life of a person [241-243]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकाः- <br /> <br /> अन्तरग्निगुणा देहं यथा धारयते च सः| <br /> <br /> यथाऽन्नं पच्यते यांश्च यथाऽऽहारः करोत्यपि||२४४||<br /> <br /> येऽग्नयो यांश्च पुष्यन्ति यावन्तो ये पचन्ति यान्| <br /> <br /> रसादीनां क्रमोत्पत्तिर्मलानां तेभ्य एव च||२४५|| <br /> <br /> वृष्याणामाशुकृद्धेतुर्धातुकालोद्भवक्रमः| <br /> <br /> रोगैकदेशकृद्धेतुरन्तरग्निर्यथाऽधिकः||२४६|| <br /> <br /> प्रदुष्यति यथा दुष्टो यान् रोगाञ्जनयत्यपि| <br /> <br /> ग्रहणी या यथा [५३] यच्च ग्रहणीदोषलक्षणम्||२४७|| <br /> <br /> पूर्वरूपं पृथक् चैव व्यञ्जनं सचिकित्सितम्| <br /> <br /> चतुर्विधस्य निर्दिष्टं तथा चावस्थिकी क्रिया||२४८|| <br /> <br /> जायते च यथाऽत्यग्निर्यच्च तस्य चिकित्सितम्| <br /> <br /> उक्तवानिह तत् सर्वं ग्रहणीदोषके मुनिः||२४९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkāḥ- <br /> <br /> antarAgniguṇā dēhaṁ yathā dhārayatē ca saḥ| <br /> <br /> yathā'nnaṁ pacyatē yāṁśca yathā''hāraḥ karōtyapi||244|| <br /> <br /> yē'gnayō yāṁśca puṣyanti yāvantō yē pacanti yān| <br /> <br /> rasādīnāṁ kramōtpattirmalānāṁ tēbhya ēva ca||245|| <br /> <br /> vr̥ṣyāṇāmāśukr̥ddhēturdhātukālōdbhavakrāmaḥ| <br /> <br /> rōgaikadēśakr̥ddhēturantarAgniryathā'dhikaḥ||246|| <br /> <br /> praduṣyati yathā duṣṭō yān rōgāñjanayatyapi| <br /> <br /> Grahaṇī yā yathā [53] yacca Grahaṇī dōṣalakṣaṇam||247|| <br /> <br /> pūrvarūpaṁ pr̥thak caiva vyañjanaṁ sacikitsitam| <br /> <br /> caturvidhasya nirdiṣṭaṁ tathā cāvasthikī kriyā||248|| <br /> <br /> jāyatē ca yathā'tyAgniryacca tasya cikitsitam| <br /> <br /> uktavāniha tat sarvaṁ Grahaṇī dōṣakē muniḥ||249||<br /> <br /> tatra shlokAH- <br /> <br /> antaragniguNA dehaM yathA dhArayate ca saH| <br /> <br /> yathA~annaM pacyate yAMshca yathA~a~ahAraH karotyapi||244|| <br /> <br /> ye~agnayo yAMshca puShyanti yAvanto ye pacanti yAn| <br /> <br /> rasAdInAM kramotpattirmalAnAM tebhya eva ca||245|| <br /> <br /> vRuShyANAmAshukRuddheturdhAtukAlodbhavakramaH| <br /> <br /> rogaikadeshakRuddheturantaragniryathA~adhikaH||246|| <br /> <br /> praduShyati yathA duShTo yAn rogA~jjanayatyapi| <br /> <br /> grahaNI yA yathA [53] yacca grahaNIdoShalakShaNam||247|| <br /> <br /> pUrvarUpaM pRuthak caiva vya~jjanaM sacikitsitam| <br /> <br /> caturvidhasya nirdiShTaM tathA cAvasthikI kriyA||248||<br /> <br /> jAyate ca yathA~atyagniryacca tasya cikitsitam| <br /> <br /> uktavAniha tat sarvaM grahaNIdoShake muniH||249||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> To conclude, this chapter has addressed the following points:<br /> #Qualities of ''antaragni'', <br /> #Manner in which [[agni]] does ''dharana'' (sustenance) of the body, <br /> #Manner in which food is digested, <br /> #How digested food functions? <br /> #How different types of [[agni]] does nutrition after digesting the fuel? <br /> #Development of ''[[rasa]]di [[dhatu]]s'' and their associated waste products after digestions at ''[[dhatu]]'' level (tissue level)<br /> #How aphrodisiacs act instantly and time taken for the ''[[dhatu]]'' formation and order of development?<br /> #Reason why diseases are located in one part of the body and role of ''antaragni'' in disease formation, <br /> #Diseases caused by abnormal [[agni]] <br /> #Definition of ''grahani'' and sign and symptoms of ''grahani dosha'', <br /> #Premonitory symptoms along with four types of ''grahani dosha'' their signs and symptoms with treatment as per various condition, <br /> #How condition of ''atyagni'' is generated and its treatment. [244-249]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने <br /> <br /> ग्रहणीचिकित्सितं नाम पञ्चदशोऽध्यायः||१५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityAgnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē <br /> <br /> Grahaṇī cikitsitaṁ nāma pañcadaśō'dhyāyaḥ||15||<br /> <br /> ityagniveshakRute tantre~aprApte dRuDhabalasampUrite cikitsAsthAne <br /> <br /> grahaNIcikitsitaM nAma pa~jcadasho~adhyAyaH||15||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Herewith, fifteenth chapter related to [[Grahani Chikitsa]] which was unavailable as part of [[Chikitsa Sthana]] of Agnivesha Tantra supplemented by Dridhabala has been completed (15).<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *''Dehagni'' (all the entities in the body that are responsible for digestion and metabolism) is the fundamental causative agent for longevity, normal complexion, normal strength, good health, motivation, normal growth, normal luster, normal ''[[ojas]]'', normal body temperature and various other forms of [[agni]]. Even the existence of an individual is said to be because of ''dehagni'' (3).<br /> *When the [[agni]] stops functioning, the individual dies; if the [[agni]] functions normally, the individual can lead a healthy and long life. Similarly, if the [[agni]] becomes abnormal, the individual suffers from various diseases; and hence, the [[agni]] is said to be the root cause of health and longevity (4).<br /> *Normal functioning of [[agni]] is essential to make the consumed food capable of nourishing the body tissues and of promoting the ''[[ojas]]'' (vital essence), strength, complexion etc. In the absence of normal digestion (and metabolism), the normal body tissues such as ''[[rasa]]'' cannot be formed nor nourished (5).<br /> *''[[Vata dosha]]'', specifically ''prana vata'' and ''samana vata'' play significant role in process of digestion and metabolism. <br /> *Three ''[[dosha]]s'' are produced in three consequent stages of digestion after consumption of food. ''[[Kapha]]'' is produced in first stage of ''madhura avasthapaka''; pitta in second stage of ''amla avasthapaka'' and ''[[vata]]'' is produced in third stage of ''katu avasthapaka''. The site of production and time of production of ''[[dosha]]'' is in sequence as the process of digestion proceeds. Increase or decrease in quantity of ''[[dosha]]'' depends upon similarity or dis-similarity of basic composition of food consumed. <br /> *The first phase of digestion is carried out by ''jatharagni'', second phase by ''bhutagni'' and third phase by ''dhatvagni''. These are different levels of action of [[agni]] where various digestive and metabolic processes take place. <br /> *During the processing by ''dhatvagni, stanya'' (breast milk) and the menstrual blood are derived after ''[[rasa]]''. ''Kandara'' (tendon) and ''sira''(vein) are derived after ''[[rakta]]''. ''Vasa''(fat) and the six layers of ''tvacha'' (skin) are derived after ''[[mamsa]]'' (muscle) and ''snayu''(ligament) are derived after ''[[meda]]s'' (adipose tissue) (17).<br /> *The feces and the urine are the ''kitta'' (non-nutrient portion/waste portion/byproduct) of ingested food. The ''kiṭṭa'' of ''[[rasa]]'' is ''mala-[[kapha]]'' (excretions). ''Mala-[[pitta]]'' (bile pigment) is the ''kitta'' of ''[[rakta]]''. ''Kha-mala'' (the wastes accumulated in the hollow structures of the body such as external ears and nostrils) are the ''kitta'' of ''[[mamsa]]''. ''Sweda'' (sweat) is the ''[[mala]]'' of ''[[medas]]''. ''Kesha'' (hairs on the head) and ''loma'' (body hair) are the ''[[mala]]'' of ''[[asthi]]''. The ''[[mala]]'' of ''[majja]]'' is the oily excretion of the eye and the skin (sebum). Thus, the ''[[dhatu]]s'' continuously undergo two kinds of transformation: ''prasada'' (nutrient portion) and ''kitta'' (non-nutrient portion). This entire sequence of transformation and metabolism of ''[[dhatu]]'' is thus inter dependent (18-19½ ).<br /> *Disorders of various factors mentioned above shall be treated after considering the original ''[[dhatu]]'' from which the factor is derived. <br /> *''Vyana vata'' forcefully propels the ''[[rasa dhatu]]'' out of the heart and spreads it all over the body simultaneously, continuously and for the entire life (36).<br /> *Disease is produced only at the site of abnormality of body systems. <br /> *Life and strength of an individual depends on [[agni]] hence one should take utmost care to maintain the [[agni]] by providing fuel in the form of food and drinks which should be taken as per the rules mentioned. (40)<br /> *If the rules of diet and dietary habits are not followed due to greed, then disease of ''grahani'' occurs. <br /> *The ''anna-visha'' (toxins) produced due to improper digestion and metabolism causes diseases at the sites of affliction. <br /> *The ''vishamagni'' (improper [[agni]]) causes irregularity in digestion and therefore defective formation of ''[[dhatu]]'' takes place. Whereas, ''teekshnagni'' (excessive [[agni]]) when associated with little quantity of fuel (in the form of food) causes depletion of ''[[dhatu]]'' (tissue elements) (50).<br /> *The digestive disorder of ''grahani'' can lead to secondary disorders related with other body systems along with digestive system. <br /> *''Grahani'' disease is classified into four types viz ''[[vata]]ja, [[pitta]]ja, [[kapha]]ja'' and ''sannipataja'' depending upon the dominance of ''[[dosha]]'' and on the basis of the classification, etiological factors, symptoms and signs are varied.<br /> *When the ''[[dosha]]s'' are located in ''grahani'' and are associated with incomplete digested food then ''[[vamana]]'' (emetic therapy) is advised. <br /> *If the ''ama'' is in ''pakvashaya'' and in ''anutklishta'' (stuck, not ready to come out) condition, then ''stravana'' (increasing secretion) with ''[[deepana]] dravyas'' should be administered. <br /> *If ''ama'' gets absorbed along with ''[[rasa dhatu]]'' and if it pervades throughout the body then ''[[langhana]]'' and ''[[pachana]]'' should be advised.<br /> *Various purification procedures are advised as per the state of ''[[dosha]]'' aggravation and site of affliction in disease. Ghee processed with digestive stimulant drugs,sour media like buttermilk is advised. <br /> *Patient should be evaluated for ''amadosha'' whether ''samata'' or ''niramta'' is present or not and then appropriately treated with ''[[pachana]]'' etc. treatment (95).<br /> *Buttermilk due to its ''[[deepana]], grahi'' (substances which increases appetite and digestive power and absorb fluid from the stool) and easy to digest actions is very useful in ''grahanidosha''.<br /> *''[[Vata]]'' dominant ''grahani'' shall be treated with ''[[basti]], [[virechana]]'' and unctuous preparations. <br /> *If ''[[pitta]]'' is dominant in its own place then ''[[virechana]]'' or ''[[vamana]]'' should be administered for removal of ''[[pitta]]'' (122).<br /> *In ''[[kapha]]ja grahani'', ''[[vamana]]'' and then drugs having ''katu, amla, lavana, kshara'' and ''tikta rasa'' shall be administered to increase [[agni]] (digestive power) (141).<br /> *In ''tridoshaja grahani'', [[Panchakarma]] should be carried out as per predominance of ''[[dosha]]''. Various ghee, ''kshara'', ''asava'' and ''arishta'' preparation useful in stimulation of [[agni]] should be administered.<br /> *''Sneha'' is the best among the ''[[deepana]] dravya'' which helps in stimulating the inefficient [[agni]] (201)<br /> *Fasting or over eating doesn’t stimulate [[agni]]. Proper intake of ''sneha'', followed by eating proper food preparations as well as appropriate use of various ''churna, arishta, sura'' and ''asava'' along with proper medication as per condition, enhances the power of [[agni]].<br /> *''Atyagni'' is caused by diminished ''[[kapha]]'', aggravated ''[[pitta]]'' and associated ''[[vata]]''. This leads to emaciation if proper food is not consumed. Excessively increased digestive power can be pacified by taking foods and drinks which are heavy to digest, unctuous, cold, sweet and liquid. <br /> *''Samashana'' is taking wholesome and unwholesome foods together in diet. ''Vishamashana'' is taking food either in excess quantity or very little quantity and also if taken before or after appropriate time. ''Adhyashana'' is having food even though previously eaten food is not yet digested. All the above three are causes for death or give rise to serious disorders (235-236).<br /> *If morning eaten food is undigested and still if anyone takes evening food, it may not be more vitiative since in day time all the ''srotas'' (channels) are dilated and heart is active similar to the lotus which blossoms with sunrise. During daytime, exercise, other physical and mental activities (cause heart to pump blood properly to) prevent the genesis of ''kleda'' (excess moisture) in various ''[[dhatu]]s''. In the night, the channels are closed, so is the heart which functions at slow rate as demand is less, the ''apakva ahara rasa'' increases in viscosity; thus ''ama'' adheres to the ''[[dhatu]]s'' and if another food is taken in the morning the indigestion causes more ''apakva ahara rasa'' causing disease.<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> <br /> === Importance of [[agni]] ===<br /> <br /> The functions of gut are vital for maintenance and preservation of health. ''Grahani'' is the seat of ''jatharagni'', which is the initiator of digestive process and strengthens the other 12 ''agnis''. ''Jatharagni'' transforms food into biological substance (''ahara rasa'') which is further trifurcated into ''madhura, amla'' and ''katu avastha paka'' which gets transformed into three biological energies ''[[kapha]], [[pitta]]'' and ''[[vata]]'' respectively. From the physiological point of view, the ''jatharagni'' or the active form of ''pachaka pitta'' is responsible for the digestion of all kinds of foods in the gut. Therefore, this should include all amylolytic, proteolytic and lipolytic enzymes secreted by various kinds of exocrine glands in the gut, which actually cause digestion, i.e., breaking down of different macromolecules into their constituent units.<br /> <br /> There are five ''bhutagnis'' and their function is to metabolize ''panchabhautic'' components of the food that are homologous to them in their composition. For instance, ''bhauma agni'' acts on the component that is ''bhauma'' or ''parthiva'' in its composition. ''Bhutagnis'' act on the products of digestion (''jatharagni paka''), hence, must be acting after the absorption of the nutrients, but before the action of ''dhatvagni''. The major site where the absorbed nutrients undergo biochemical transformation is in the liver, which plays an important role in metabolism, wherein several processes such as trans-amination, de-amination, beta-oxidation of fatty acids, glycolysis etc. take place. Therefore, the overall intermediary metabolism (involving fats, carbohydrates and proteins) can be understood as the functioning of the ''bhutagni''.<br /> <br /> ''Dhatvagni'' acts at tissue-level (in fact, at cellular level) upon the products of ''bhutagni paka'' and are responsible for the building of the respective ''[[dhatu]]s''. In other words, the bio-energetic processes of a cell seem to be under the regulation of ''dhatvagni''. For instance, the common product of intermediary metabolism (involving fats, carbohydrates and proteins) is Acetyl-Co-A, which enters into Kreb’s cycle in the mitochondria of a cell. This is followed by electron transfer and oxidative phosphorylation. &lt;ref&gt;Chatterjea MN, Shinde Rana. In:Textbook of Medical Biochemistry. ISBN: 9788184481341. DOI: 10.5005/jp/books/10917. Edition:7/e. 2007. Pages: 824&lt;/ref&gt; It is interesting to note that the Kreb’s cycle is also known as the ‘final common pathway’ in the process of catabolism of carbohydrates, proteins and fats. However, for the entry of amino acids, glucose and fatty acids into the cell, certain other factors such as hormones too are needed. For instance, insulin promotes the transportation of glucose, amino acids and fatty acids into the cell. Therefore, all these hormones (such as insulin, growth hormone, thyroid hormones, testosterone etc.) that promote the transportation of various nutrients into the cells, along with the enzymes participating in the Kreb’s cycle are to be included under the term ''dhatvagni''.<br /> <br /> Thus, the three major stages of the catabolism (involving fats, carbohydrates and proteins) i.e. digestion, intermediary metabolism and Kreb’s cycle - seem to represent the three sets of ''agnis,'' viz., ''jatharagni, bhutagni'' and ''dhatvagni'' respectively.<br /> <br /> === Role of ''[[vata]]'' in digestion ===<br /> <br /> ''Samana vayu'' separates nutritive (''prasad'') and waste (''kitta'') part from ''ahara rasa''. Nutritive part is circulated to entire body after absorption through ''rasayini'' (villi) by ''vyana vayu''. Waste part is excreted as feces, urine and sweat through their excretory channels by ''apana vata''. Absorbed nutritive substances circulate all over the body through seven specific micro channels of each of the seven ''[[dhatu]]s''.<br /> <br /> === [[Dhatvagni]] ===<br /> <br /> Each ''[[dhatu]]'' has its own transforming [[agni]] and [[srotas]]. [[Srotas]] or micro channels have two functions of carrying and transforming the tissues with the help of their specific [[dhatvagni]]. Five [[bhutagni]]s, one for each ''[[mahabhuta]]'', transform five ''bhautic'' elements into the body tissues and organs. Seven [[dhatvagni]] or tissue transformers, form the tissue elements of seven ''[[dhatu]]s'' by their needed nutrients. After formation of ''[[dhatu]'', the microchannels permeates them into the organs for functioning. During this transformation process, [[upadhatu]] or subtissues and ''dhatumala'' or waste products are formed. [[Upadhatu]]s of ''[[rasa dhatu]]'' is breast milk; menstrual blood is ''upadhatu'' of ''[[rakta]]''; tendons and six layers of skin are [[upadhatu]] of ''[[mamsa dhatu]]'' etc.<br /> <br /> Apart from digestion, the gut performs various other significant functions as well. The gut has its own protective mechanism in the form of gut-associated lymphoid tissue, which prevents the entry of pathogens into the bloodstream. The micro-biota in the gut serves vital functions related to various aspects of health. The enteric nervous system of the gut has its own functional significance and has been proven to be very closely associated with the central nervous system functions. The gut secretes several hormone-like substances that are helpful in regulating long-term energy balance. All the factors mentioned are either directly or indirectly dependent on these functional domains of the gut. &lt;ref&gt;W I Khan, J E Ghia. Gut hormones: emerging role in immune activation and inflammation. Clin Exp Immunol. 2010 July; 161(1): 19–27&lt;/ref&gt; &lt;ref&gt;Andrew L. Kau, Philip P. Ahern, Nicholas W. Griffin, Andrew L. Goodman, Jeffrey I. Gordon. Human nutrition, the gut microbiome, and immune system: envisioning the future. Nature. 2011 June 15; 474(7351): 327–336. doi: 10.1038/nature10213&lt;/ref&gt; Other forms of [[agni]] in this context are indicative of [[bhutagni]] and [[dhatvagni]], which in turn, are functionally dependent on [[jatharagni]]. [[Prana]] in this context may stand for all types of ''[[vata]]'' as well.<br /> <br /> === Three stages of digestion ===<br /> <br /> There are three stages of digestion in the gut. The first stage (''madhura'') takes place in the upper gastro-intestinal tract, i.e., inside the esophagus and stomach; the second stage (''amla'') takes place in the middle portion of the gut, i.e., in the small intestine; and the last stage (''katu'') takes place in the colon. <br /> <br /> The froth-like ''[[kapha]]'' seems to be the thick mucus that covers the entire stomach, providing a protective coating that prevents the gastric mucosa being digested and damaged due to the acid-pepsin mixture.<br /> <br /> ''Accha [[pitta]]'' is ‘liquid’ in nature, released in the duodenum and can be correlated with bile. <br /> <br /> ''Pachaka pitta'' has the functional site between ''amashaya'' (stomach) and ''pakvashaya'' (colon), which is indicative of small intestine. It is composed of five ''[[mahabhuta]]s'' but the ''[[agni mahabhuta]]'' is predominant; and hence, it becomes devoid of fluidity and therefore is also known as [[agni]]. It splits the food into sāra (nutritive) and ''kitta'' (non-nutritive) portions.&lt;ref&gt;Vagbhata. Sutra Sthana, Cha.12 Doshabhediya Adhyaya verse 10-12. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.&lt;/ref&gt;<br /> <br /> ''Sara'' of the food is the minutest fraction (''parama sukshma''). This portion reaches the heart in the form of ''ahara rasa''. From the heart, it then gets re-distributed into 24 pulsatile vessels to be carried into the whole body.&lt;ref&gt;Sushruta. Sutra Sthana, Cha.14 Shonitavarnaniya Adhyaya verse 3. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1&lt;/ref&gt;<br /> <br /> The portion that reaches the colon is the one that is designated as ''kitta''. During the third stage of digestion, there occurs the solidification of fecal matter and formation of certain pungent gases such as ammonia, methane, hydrogen sulfide etc. The term ''pakva'' in this context indicates ''pakva mala''; not ''pakva ahara'' (Verse 9-11).<br /> <br /> === Formation of the seven ''[[dhatu]]s'' ===<br /> <br /> ''[[Rasa]], [[rakta]], [[mamsa]], [[meda]], [[asthi]], [[majja]]'' and ''[[shukra]]'' are the seven fundamental entities that sustain the human body. These can be called ‘tissues’ for the sake of convenience, though some of them are not tissues in a strict sense. It will be pertinent to look into these individual entities at this stage to understand what they really are in terms of anatomy.&lt;ref&gt;Patwardhan K. Human Physiology in Ayurveda. Varanasi, India: Chaukhambha Orientalia, 2013, Jiakrishnadas series no. 134.&lt;/ref&gt; <br /> <br /> ''[[Rasa]]'': A colorless fluid that gets ejected out of the heart and nourishes the entire body. <br /> <br /> ''[[Rakta]]'': The red colored fraction that is formed in liver and spleen after the action of ''ranjaka pitta'' on ''[[rasa]]''. It is essential for life and its function is to supply the life principle (''jeeva'').<br /> <br /> ''[[Rasa]]'' and ''[[rakta]]'' together form what is generally known as blood: ''[[rakta]]'' being the red fraction (red blood corpuscles) and ''[[rasa]]'' being the colorless fluid (plasma). <br /> <br /> ''[[Mamsa]]'': The correct translation of this term would be ‘flesh’. Flesh generally means all kinds of muscles and also the parenchyma of the different viscera such as thyroid, liver, spleen, kidneys etc. <br /> <br /> ''[[Medas]]'': This generally stands for fatty tissue, however, it is to be noted that it is of two types: ''Baddha'' (bound, stable, fixed, stored) and ''abaddha'' (free, unbound). The ''baddha'' form, therefore, must include the stored fat in the form of adipose tissue; and the ''abaddha'' form must include the circulating lipids such as cholesterol, LDL, HDL etc.<br /> <br /> ''[[Asthi]]'': Though the term ''[[asthi]]'' generally stands for bony tissue, it may in some contexts, include all such relatively hard structures that resist easy decaying, viz., teeth, nails and hair.<br /> <br /> ''[[Majja]]'': Generally, the substance that fills all the bony cavities is called ''[[majja]]''. However, the brain substance that fills the cranial cavity too, must be included in ''[[majja]]''. Therefore, ''[[majja]]'' is of two types: ''asthigata'' (bony) and ''mastakagata'' (cranial).<br /> <br /> ''[[Shukra]]'': The term ''[[shukra]]'' has been described to be of two forms in [[Ayurveda]] textbooks: <br /> #The one that is ejaculated during the process of mating, which is responsible for fertilization of ovum and thus embryogenesis.<br /> #The one that is formed from ''[[majja]]'' (the tissue that fills the bony cavities) which in turn circulates all over the body both in males and females. Reproduction is the function of this second form of ''[[shukra]]'' too. Therefore, on careful examination, it seems that the first form of ''[[shukra]]'' stands for the semen in general and for sperms in particular; and, the second form of ''[[shukra]]'' stands for hypothalamo-pituitary-gonadal axis of hormones that circulate all over the body.<br /> <br /> === The process of nourishment of ''[[dhatu]]'' ===<br /> <br /> The process of nourishment of ''[[dhatu]]s'' is explained by three analogies: ''Ksheera-dadhi'' (milk curdling analogy), ''khalekapota'' (analogy of pigeons picking up the choicest grains) and ''kedari-kulya'' (irrigation analogy).<br /> <br /> === ''Ksheera-dadhi nyaya'' (milk curdling analogy) ===<br /> <br /> According to this analogy, the nourishment of a ''[[dhatu]]'' takes place according to the rule of conversion (of one substance into another). Just as the milk is converted into different forms (from milk to curd, curd to butter, butter to ghee) successively, the preceding ''[[dhatu]]'' too is converted into the next one. The sequence of this conversion is as follows: ''[[rasa]], [[rakta]], [[mamsa]], [[meda]], [[asthi]], [[majja]]'' and ''[[shukra]]'' in the same order. <br /> <br /> The transformation of various substances that takes place due to various biochemical reactions could be one way of understanding this analogy. For instance, the process of glycolysis involves different enzymes acting on different substrates at different steps and converting them from one to another. The ability of one kind of stem cell derived from one tissue in giving rise to different forms of cell types of different tissues is known. The response of mesenchymal stem cells to certain stimuli such as hypoxia in the form of migration and tissue regeneration is also known, which can further support this analogy.<br /> <br /> === ''Khalekapota nyaya'' (analogy of pigeons picking up the choicest grains) ===<br /> <br /> According to this analogy, the nourishment of different ''[[dhatu]]s'' takes place according to the rule of selectivity. Just as the pigeons coming from far off places, picking up the grains of their choice from the granary (a storehouse for thrashed grain, ''khala'') and flying back to their destination, the different ''[[dhatu]]s'' too, pick up the required nourishment from the common nutrient pool known as ''[[rasa]]''. The ''[[dhatu]]'' that is situated nearer to ''[[rasa]]'' is nourished first and the remaining later, just as the pigeon from a nearer place gets a chance to pick up grains quickly in the given analogy.<br /> <br /> In this analogy, the choice that the pigeons have in picking up the grain (selectivity) and the energy they spend in the process of obtaining grains (actively) are the vital features. The tissue metabolism can influence the extent of vasodilatation and thus its own perfusion. This is known as auto-regulation of blood supply. Similarly, the specific kind of tissue has affinity for specific nutrient and other substances. For example, the calcium gets deposited normally in bones, but not in the mucous membranes. Similarly, vitamin B-12 is stored in liver and not in other tissues.<br /> <br /> === ''Kedari-kulya nyaya'' (analogy of irrigation) ===<br /> <br /> According to this analogy, the nourishment of ''[[dhatu]]'' takes place according to the rule of irrigation. Just as the ''kulyas'' (small canals / trenches / channels) receive water from the ''kedarika'' (the bigger water reservoir) and then irrigate the nearest field first, the ''[[rasa]]'' too, nourishes the ''[[dhatu]]s'' in a sequential fashion depending on the location of the ''[[dhatu]]''.<br /> <br /> The anatomical location of a cell in the body can influence the amount of perfusion it receives. For instance, the apical regions of the lungs are less perfused than the other areas of the lung, and hence, are susceptible to be affected in some infectious conditions such as tuberculosis. Similarly, the hepatocytes that surround the central vein in a hepatic lobule are more susceptible to hypoxic injury than those situated in the periphery. Sub-endocardial region of the heart is, in the same manner, is more susceptible to ischemia than the epicardial region.<br /> <br /> Another important feature to be noted in this analogy is the passive flow of water from higher altitude to lower altitude, where no external energy is spent. This is in contrast to the pigeons expending their energy to pick up the grains of their choice actively. It is interesting to note the process of transportation of substances across the cell membrane, which has been divided into two major types: active transport and passive transport (Verse-16).<br /> <br /> Bilirubin is a metabolic byproduct of heme portion of the hemoglobin. This is secreted into bile juice in the liver which is in turn released during the process of digestion. Features of [[pitta]] ''vriddhi'' therefore, are yellowish discoloration of sclera, skin, urine and feces. Mucous is rich in water that is derived from extracellular fluid while it is being formed. The cerumen, sebum, and other similar external secretions perform some functions such as providing a waxy protective layer. Sweat and urine share similarities in function as well as composition. Therefore, ''vrikka'' mentioned as the site of origin of ''medavaha srotas'' makes sense when one considers ''sweda'' as the ''[[mala]]'' of ''[[meda]]''. Hair and bones share similarity when it comes to the power to resist easy biodegradation. They also grow weaker in old age. Therefore, hair are the ''[[mala]]'' of ''[[asthi]]'' (Verse 19).<br /> <br /> Circulating provoked ''[[dosha]]'' settles in a tissue whose channels are defective (''kha-vaigunya'') and perfuce the lesion. This pathogenesis has been compared with rain production. The obstruction to the moving ''[[rasa]]'' by the abnormality of ''srotas,'' results in causation of disease, just as the obstruction to the cloud laden monsoon winds by the tall mountains results in the causation of rainfall (Verse 37).<br /> <br /> === Causes of ''grahani'' disorder ===<br /> <br /> ''Abhojana'' (starvation) leads to increase in ''[[vata]]'' and in turn ''agnimandya''.[Cha. Sa. [[Vimana Sthana]] 2/7] Starvation and protein malnutrition disrupts the normal indigenous gastrointestinal tract micro-flora and impairs host antibacterial defenses. Both starvation and protein malnutrition increases the cecal levels of gram negative enteric bacilli and decrease the level of lactobacillus and promote growth of anaerobes that in turn disturb the gut flora. Gut flora also known as gut microbiome has a unique role in digestion and absorption. Once the gut microbiome gets vitiated it leads to indigestion and malabsorption.<br /> <br /> ''Atibhojana'' (excessive intake) causes provocation of all the ''[[dosha]]'' and thereby causing ''agnimandya''. Protein rich diet or fat laden diet or excessive diet takes longer time for emptying of stomach. Longer stay of food explains increase of acidic pH. Therefore, whenever such chyme enters the duodenum the liver and pancreas need to increase secretion of alkali pH. Repeated, such dietary habits lead to indigestion. Further increase of alkali pH causes reduced transit time in small intestine leading to the symptoms like diarrhea. Diet which is ''atiguru'' (heavy) and indulging ''vishamashana''( irregular food habit) will have similar effect. ''Atiruksha ahara'' or diet has low protein value. Protein malnutrition leads to decrease of enzyme secretion as proteins are the building blocks of enzymes. ''Asatmya desha, kala, ritu'' only explain the dietary changes which dramatically alter the balance of bacteria in the gut on daily basis. Research shows that these fluctuations could lead to various digestive and absorptive problems. ''Dushita bhojana'' or contaminated food reacts directly with intestinal flora disturbing their quantitative and qualitative growth causing indigestion. Intake of unctuous substances in ''sama [[pitta]]'' condition leads to ''grahani dosha'' and various other disorders.[ Cha. Sa. [[Sutra Sthana]] 13/76] Emaciation due to disease also has its own impact on digestion. ''Mandagni'' is a causative factor for all diseases but if patient continuously indulges in ''apathya'' then complications may increase or the prognosis turns bad. <br /> <br /> Suppression of manifested natural urges may have impact on nervous system resulting in effect either on enzymatic secretion or on the hormonal secretion. These factors have role in digestion and absorption as may be understood in case of ''adhovata'' (accumulation of ''[[vata]]'' in rectum and pelvic region) and ''[[purisha]] vegadharana'' (suppression of urge of defecation), wherein regular urge suppression disturbs the intestinal pro-kinetic movement.[Cha. Sa. [[Sutra Sthana ]] 7/ 6,8,12] Disturbed pro-kinesia increases the transit time leading to the change in pH which further has its impact on electrolytes and enzymatic secretion leading to reduced digestive power (''agnimandya''). <br /> <br /> Further ''kshudha vegadharana'' (avoiding sense of hunger) effect will be similar to ''abhojana'' (not eating). It may also be noted that repeated ''kshudha vegadharana'' leads to atrophy of the stomach which further weakens the perception of hunger which is controlled by the percentage of the stomach that remains empty similar to the explanation given by Charak that excessive fasting leads to diminution in [[agni]].[Cha.Sa. [[Sutra Sthana]] 22/37] ''Trishna vegadharana'' (avoiding thirst) leads to reduced fluid balance in the body. <br /> <br /> Nearly seven liters of water is secreted during various gastrointestinal secretions. Reduced water intake in long term will reduce gastrointestinal secretion leading to impaired digestion. <br /> <br /> Abnormal digestion is from faulty food habits and unwholesome diet, that causes ''jatharagni dushti'' or vitiation of digestive power. The improperly digested food turns into toxic substance called aamavisha, basic cause of most diseases. If ''amavisha'' associates with any balanced ''[[dosha]]'' or healthy ''[[dhatu]]'', they turn pathogenic. ''Grahanidosha'' is an important example of ''amavisha'' and ''agnidushti''.<br /> <br /> ''Grahanidosha'' is of four types. It starts with inflammation of elementary canal at different places and is called by different names e.g gastritis, duodenitis and colitis. In the second stage erosions and ulcers develop. In third stage mental symptoms like anxiety, illusions, fear, and IBS like symptoms. Fourth stage is ''sannipatic'' with clinical features resembling ulcerative colitis.<br /> <br /> Treatment of ''grahanidosha'' is to enhance ''jatharagni, bhutagni'' and ''dhatvagni'' which encompasses the whole digestive process. Food and drinks are also medicated depending upon the patient and the stage of disease, for extended period of time.<br /> <br /> === Effect on immunity ===<br /> <br /> ''Prayatna'' (effort), ''urja'' (energy) and ''bala'' (strength) are the role played by ''[[vata]], [[pitta]]'' and ''[[kapha]]'' in building up of immunity. When the ''[[dosha]]'' gets vitiated ''prayatna, urja'' and ''bala'' are hampered leading to suppression of immunity. <br /> <br /> Exogenous and endogenous factors vitiate the [[dosha]] which when associated with ama produce either local or systemic disorders. <br /> <br /> ''Tridosha'' play role in impairing immunity and depending on the dominance of a particular ''[[dosha]]'' they are classified as ''[[vata]]ja, [[pitta]]ka'' and ''[[kapha]]ja'' disorders.[Cha.Sa. [[Sutra Sthana]] 28/7]<br /> <br /> === Equilibrium of [[agni]] ===<br /> <br /> [[Agni]] should be associated with balance of ''[[vata]], [[pitta]]'' and ''[[kapha]]'' or ''samagni''. Digestive enzyme secretion is controlled by sympathetic and parasympathetic nerve supply. ''Samagni'' may be compared with balanced state of sympathetic/ parasympathetic activity which explains the role of balanced or ''samana vata''. It may also be noted that ''prana vata'' and ''apana vata'' also have impact on balancing the normal status of [[agni]].<br /> <br /> Acidic and alkaline pH of digestive secretions explains the balanced ''[[pitta]]''. Modern science explains specific range of pH of digestive secretions e.g. pancreatic juice has pH in range of 7.1 – 8.2 that buffers acidic gastric juice in chyme, stops the action of pepsin from the stomach and creates proper pH for action of digestive enzymes in small intestine. Specific pH of gastric juice is essential to convert pepsinogen into pepsin, an active form of proteolytic enzyme thus improper pH will cause variation in digestion.<br /> <br /> Mucosal resistance explains role of ''[[kapha]]'' in maintaining ''samagni''. Intact mucosal lining is present in stomach and small intestine. Breach in mucosal lining causes gastritis, burning sensation etc whereas increased size of mucosal cells alters the pH thereby a balanced ''[[kapha]]'' plays essential role in ''samagni''. Role of prostaglandins to maintain gastric mucosal resistance to prevent the action of HCl in gastric mucosa is to be considered as part of ''kledaka kapha'' as sodium bicarbonate and mucus is secreted by prostaglandins. Drugs which inhibit prostaglandins e.g. aspirin, impairs gastric mucosal barriers leading to gastritis, duodenitis and peptic ulcers.<br /> <br /> === Clinical features ===<br /> <br /> ''Arochaka'' (aversion to food), ''vairasya'' (distaste), ''praseka'' (excessive salivation) are general gastrointestinal manifestations of indigestion. ''Tamaka'' or blackout occurs due to nutritional deficiency. Mal-absorption causes diarrhea which leads to decrease in circulating liquid, a cause of hypo-tension a reason for blackout. Impaired absorption of iron, folate, vit. B12 leads to anemia which may be the cause for blackout (''tamakanvitah''). Resulting anemia and electrolyte depletion (particularly K+) leads to weakness. <br /> #Peripheral neuropathy due to Vit. B12 and thiamine deficiency <br /> #Dermatitis due to deficiency of Vit. A, Zinc and essential fatty acid <br /> #Night Blindness/Xeropthalmia due to Vit A mal-absorption.<br /> #Bleeding due to Vit K malabsorption and hypo prothrombinemia<br /> #Anemia impaired absorption of iron, folate, and vitamin B12<br /> #Amenorrhea, decreased libido due to protein depletion decreased calories and secondary hypo-pituitarism. <br /> #Tetany, paresthesia due to calcium and magnesium mal-absorption <br /> #Glossitis, cheilosis, stomatitis due to deficiency of iron, Vit B12, folate and Vit A (Verse 52-54).<br /> <br /> Spices are basically a combination of acids. When too much of these acids are introduced in gastrointestinal tract which has its own acidic contents it starts damaging the mucosal lining of walls of gastrointestinal tract. It also reduces the pH thus activation of enzyme is hampered leading to indigestion.<br /> <br /> Etiological factors as mentioned in the text have impact mainly on the neural stimulation of digestive secretions affecting the flow of gastrointestinal secretions into the gastrointestinal tract thereby hampering the digestion.<br /> <br /> Hence it is explained that aggravated ''[[vata]]'' encompasses the [[agni]]. Altered canalicular functions hampers digestion, easily understood in primary biliary cirrhosis wherein biliary secretion is restricted. Atrophy of gastric mucosa reduces HCl secretion causing indigestion. The gastric gland contains three types of exocrine gland cells that secrete their products into stomach lumen.''Srotasam kharatvam'' (hardness in channels) quality of ''tikta rasa'' destroys the exocrine gland cell reducing their secretions. Gastric glands include a type of enteroendocrine cell, the G cell which is located mainly in the pyloric antrum and secretes the hormone gastrin into the blood stream which stimulates parietal cells to secrete HCl and chief cells to secrete pepsinogen, it also contracts the lower esophageal sphincter, increases motility of the stomach and relaxes pyloric sphincter. <br /> <br /> G cells when get destroyed the above action of ''[[kapha]]'', in turn, [[agni]] is hampered so also contraction and relaxation karma of ''[[vata]]'' is vitiated.<br /> <br /> Further ''kashaya rasa'' reduces peristaltic movements called as mixing waves which reduces the maceration and mixing of food with secretions of gastric glands, thus improper chyme is formed. Deficiency of gastrointestinal secretions due to damage to the glands or canaliculi or intestine may be mostly considered as having [[vata]]ja origin. Loss of ''pravartana karma'' is to be understood where the transport of secretions is hampered (except in obstructive pathology where ''[[kapha]]'' to be considered). Hartnup’s syndrome a defect in neutral amino acid transport and cystinuria a defect in dibasic amino acid transport explain the rare genetic disorders (''Bija Dusti'') involved in protein digestion absorption.<br /> <br /> Further due to ''[[vata]] prakopa'', intestinal activity is increased which is manifested as malabsorption. For e.g. lactose intolerance is related to rate of gastric emptying. Symptoms are more likely when gastric emptying is rapid than when gastric emptying is slower. Therefore it is more likely that skim milk will be associated with symptoms of lactose intolerance than with whole milk as rate of gastric emptying is more rapid in skim milk. Milk proteins, particularly caseins have appropriate amino acids composition for growth and development of young. <br /> <br /> Caseins are highly digestible in intestine and high quality source of amino acids. Most of whey proteins are relatively less digestible in intestine, although all of them are digested to some degree. When substantial whey proteins are not digested fully, some of intact protein may stimulate a localized intestinal or systemic immune response this is due to beta lactoglobullin referred to milk protein allergy. Similarly, diarrhea observed following subtotal gastrectomy is often a result of lactose intolerance as gastric emptying is accelerated in patients with gastrojejunostomy, rapid small intestinal transit time develops symptoms of lactose intolerance. <br /> <br /> ''Kanthasya-shosah'' (dryness of mouth also known as xerostomia) occurs due to diminish salivary gland secretion. <br /> <br /> Primary cause being fluid loss through diarrhea secondarily it may be association of Sjogren's syndrome with autoimmune disease like primary biliary cirrhosis ~ a secondary Sjogrens syndrome. In this syndrome involvement of other exocrine glands occur leading to diminished secretion of exocrine glands of the gastrointestinal tract, leading to esophageal mucosal atrophy, atrophic gastritis and subclinical pancreatitis. <br /> <br /> Increased appetite (''Kshudha'') is seen because of a negative feedback due to malabsorption or it may be understood under ''rasasheshajeerna''. <br /> <br /> ''Trishna'' is manifested due to increased ''ruksha [[guna]]'' of ''[[vata]]'' and decreased ''jaladi ansha'' due to diarrhea and low fluid intake. <br /> <br /> ''Timira'' (blurred vision) results from vitamin A malabsorption and anemia.<br /> <br /> Tinnitus is a symptom also found in ''Pandu'' (anemia)[Cha. Sa. [[Chikitsa Sthana]] 15/61], which is observed due to malabsorption of essential elements like vitamin B12.<br /> <br /> Pain in flanks, thigh, pelvis, cervical area occurs due to calcium and Vitamin D malabsorption. Pain is also contributed by protein deficiency due to low nutritional diet, osteoporosis, anemia and decrease lactic acid neutralization due to reduce peripheral circulation. <br /> <br /> Whipple’s disease is chronic multisystem disease associated with diarrhea, steatorrhea, weight loss, arthralgia and CNS and cardiac problems caused due to tropheryma whipple. <br /> <br /> ''Hritpeedha'' is chest discomfort or chest pain which may be resultant of anemia but most probably due to gastro-esophageal reflux disease. <br /> <br /> Malabsorption may be for single entity or for various minerals and vitamins and may lead to emaciation and weakness. <br /> <br /> ''Vairasyam'' (distaste) is probably because of taste projections to the hypothalamus and limbic system, there is a strong link between the taste and pleasant and unpleasant emotions. ''Parikartika'' (cutting pain) is due to ''shushka-mala pravritti'' (pellet stools) which causes pressure and rupture of anal-mucosal lining that may lead to cutting pain.<br /> <br /> Craving for all types of food (''griddhih sarvarasanam'') is seen due to malabsorption of various elements, mineral and vitamins causing deficiency of the essential requirements of elements. The negative feedback system creates the craving for essential elements which is presented in the form of craving for all six ''rasa''. ''Rasa'' should be understood for food which will fulfill the requirements.<br /> <br /> Mood disorders are observed due to depletion of essential vitamins, mineral and other elements. Electrolyte difference creates confusion which may be the cause for ''mano avasada''.<br /> <br /> Bloating of abdomen is manifested while digestion is in process or after digestion is completed because of indigestion that causes abnormal growth of gut microbiome. Bacterial fermentation of unabsorbed carbohydrates leads to flatus. Carbohydrates metabolism occurs in small and large intestine therefore the symptom occurs during ''Jeerne jeeryati chadhmanam'' i.e. during and after the process of digestion. Once the patient takes food, circulation towards stomach is increased and digestive activity in the colon is reduced thus carbohydrate metabolism is depressed reducing the formation of flatus in rectum thereby reducing the bloating of abdomen.<br /> <br /> Patient doubts as if he may be suffering from following of the disorders like ''vatavikara, gulma, hridroga'' and ''pleeha''. Due to formation of flatus and later on bloating of abdomen makes the patient feel he is suffering from ''vatika'' disorders related to gastrointestinal tract. Especially ''gulma'' since the patient feels the movement of flatus, so doubts about ''gulma''. <br /> <br /> ''Ushna'' and ''teekshna [[guna]]'' of ''[[pitta]]'' trigger inflammatory response by irritating the intestinal mucosa. <br /> <br /> Indigestion causes depletion of beneficial gut bacteria thus breakdown in the balance between the putative protective and harmful intestinal bacteria leads to chronic inflammation. <br /> <br /> Antigenic nature of endogenous factors can be understood when helpful bacteria and ''ushna, teekshna [[guna]]'' of [[pitta dosha]] trigger inflammatory response leading to autoimmune pathogenesis.<br /> <br /> In case of hypersecretion of gastrin in gastrinoma (Zollingers – Ellison Syndrome) stimulate the parietal cells of the stomach to secrete acid to their maximal capacity and increase the parietal cell mass three to six fold. The acid output may be so great that it reaches the upper small intestine reducing the luminal pH to two or less.<br /> <br /> Pancreatic lipase is inactivated and bile acids are precipitated. It results in diarrhea and steatorrhea. Subtotal villous atrophy occurs due to hyper-secretion which may cause malabsorption. Excessive gastrointestinal secretions cause derangement in fluid and electrolyte transport across the entero-colonic mucosa leading to diarrhea. They are characterized clinically by watery, large volume fecal outputs that are typically painless and persist with fasting because there is no malabsorbed solute; stool osmolalirity is accounted for normal endogenous electrolytes with no fecal osmotic gap.<br /> <br /> Other than excessive secretion, condition like ileal dysfunction caused by either Crohn’s disease or surgical resection results in a decrease in bile acid re absorption in the ileum and an increase in the delivery of bile acids to the large intestine. The resultant is a diarrhea with or without steatorrhea. It becomes a cause for mal-absorption syndrome. <br /> <br /> Inflammatory Bowel Disease needs consideration in ''[[pitta]]ja grahani''. Exogenous factors trigger inflammatory response that the mucosal immune system may fail to control. With mild inflammation the mucosa is erythematous and in severe condition the mucosa becomes hemorrhagic, edematous and ulcerated (Verse 65).<br /> <br /> Loose motions (''Drava Mala Pravritti'') are mainly due to excessive secretion of bile juice (''Drava [[guna]]'' of ''[[pitta]]''). Excessive secretion may be due excessive formation in liver or decrease absorption in the intestine.<br /> <br /> Bile acids are not present in the diet but are synthesized in the liver by a series of enzymatic steps that also include cholesterol catabolism. Bile acids are either primary or secondary. Primary bile acids are synthesized in the liver from cholesterol and secondary bile acids are synthesized from primary bile acids in the intestine by colonic bacterial enzymes. Bile acids are primarily absorbed by active, sodium dependent process that is located exclusively in the ileum; secondly bile acids can also be absorbed to a lesser extent by non carrier mediated transport processes in the jejunum, ileum and colon. Conjugated bile acids that enter the colon are de-conjugated by colonic bacterial enzyme to unconjugated bile acids and are rapidly absorbed. Colonic bacterial enzymes also dehydroxylate bile acids to secondary bile acids, thus if exogenous factors like diet as discussed above disturb the colonic bacterial growth than bile acids are not absorbed. A decrease in the amount of bile acids returning to the liver from the intestine is associated with an increase in bile acids synthesis/cholesterol catabolism, which helps keep bile acid pool size relatively constant. Defects in any of the steps of the enterohepatic circulation of bile acids can result in decrease in duodenal concentration of conjugated bile acids as a result steatorrhea. Thus steatorrhea can be caused by abnormalities in bile acid synthesis and excretion, their physical state in the intestinal lumen and reabsorption. The bile gives the yellowish nature to the stools (Verse 66).<br /> <br /> ''Guru, snigdha'' and ''seeta ahara'' is dominated by ''[[prithvi]]'' and ''[[jala mahabhuta]]'', these qualities help in reducing the impact of ''[[agni mahabhuta]]'' thus causing ''jatharagni mandyata'' resulting in indigestion leading to formation ''ama''. Such ''ama'' is responsible for ''[[dosha]] prakopa''.&lt;ref&gt; Madhavakara. Madhava Nidanam (Roga vinischaya) Chap 2, jwara Adhyaya, Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--&lt;/ref&gt;<br /> <br /> ''Klinna''(moist), ''guru, pishtanna''(malt), ''abhishyandi''(which increases secretions) ''ahara''(food) and ''adhyashana''(over eating) are source for extra calories. Fast foods are defined as any food that contributes little or no nutrient values to the diet, but instead provides excess calories and fat. Common foods include salted snack foods, gum, sweet desserts, fried fast foods, carbonated beverages and candy.<br /> <br /> Diets rich in trans-fatty acids like deep fried fast food, cake mixes, chips and packed cookies, all have inclusion in ''guru, pishtanna, vishtambi''(causing obstruction) ''ahara''. People consuming ''snigdha ahara'' (fatty food) and have sedentary lifestyle with very little energy expenditure, and most fat is stored. The above two concepts explain why ''agnimandya'' and ''ajeerna'' have been mentioned after taking heavy food. Excessive heavy food (''guru ahara'') slows down emptying of stomach (''samana vata karma'' is hampered) and enzymes are not secreted into lumen (''pitta'' action hampered) causing ''agnimandya''.<br /> <br /> Substances of ''seeta veerya'' causes constriction reducing the secretion (''[[stambhana]]'') of gastrointestinal juices thus hampering lipase activity therefore leading to steatorrhea. <br /> <br /> Further heavy meals increase the transit time causing functional stasis which may cause bacterial overgrowth syndrome. Sleeping just after meals may also lead to functional stasis (further study required). Peristalses are also reduced with heavy meals and sleeping after meals causes bacterial overgrowth. Bacteria deconjugate conjugated bile acids and as a result intraduodenal concentration of bile acids will be reduced resulting in steatorrhoea and macrocytic anemia. Bacterial overgrowth also occurs with stasis from a blind loop, small bowel diverticulum or dysmotility. <br /> <br /> Postmucosal lymphatic obstruction- The pathophysiology of this condition which is due to the rare congenital intestinal lymphangectasia or due to acquired lymphatic obstruction secondary to trauma, tumor or infections, leads to the unique constellation of fat malabsorption with enteric loss of protein (often causing edema) and lymphocytopenia. Carbohydrates and amino acid absorption are preserved (Verse 67).<br /> <br /> Nausea and vomiting are both caused by stimulation at one of the four sites: the gastrointestinal tract, the vestibular system, the chemoreceptor trigger zone and the cerebral cortex. Nausea and vomiting occurs due to disturbed gastric motility caused by heavy meal and delayed gastric emptying. The same is the cause for heavy abdomen and eructation with foul smell and sweet taste. As the food stays for long time in gastrointestinal tract blood flow increases centrally and reduces the enthusiasm and decrease in libido. The sluggish activity of gastrointestinal tract causes symptoms such as absence of movement in the abdomen (''udaram stimitam guru''). The heavy abdomen puts pressure on the diaphragm causing symptoms of heaviness in chest (''hridayam manyate styanam'').<br /> <br /> Bacterial overgrowth due to undigested ''guru, klinna, snigdha'' and ''abhishyandi ahara'' causes increased mucoid secretion, thus formed stool is not observed instead ''bhinnamashleshma-samsrishta varcha''(loose stools with ''ama'' and ''[[kapha]]'') is seen; which is also cause for heaviness of stools (''guru-varchah-pravartanam'') Due to diet pattern and sedentary lifestyle there is accumulation of fat (obesity) but due to decrease protein absorption and malabsorption of essential elements patient feels weakness and laziness without weight loss (Verse 68-70).<br /> <br /> Normalcy of ''[[vata]] [[pitta]]'' and ''[[kapha]]'' keeps the [[agni]] in balanced condition, it means that a specific pH is maintained (''[[pitta]]''); secretion, transportation and villi movement are normal (''[[vata]]'') and mucosal bed secretes normal mucus and is healthy (''[[kapha]]''), thus maintains ''samagni'' or a normal digestive process (Verse 71).<br /> <br /> Protein losing enteropathy is increased protein loss into the gastrointestinal tract which is classified into three groups.<br /> <br /> #Mucosal ulceration; there is protein loss by exudation across damaged mucosa e.g. Ulcerative colitis, peptic ulcer, gastro intestinal carcinoma. In such cases dominance of ''[[pitta dosha]]'' needs to be considered.<br /> #Non ulcerated mucosa but evidence of mucosal damage; Protein loss primarily represents loss across epithelia with altered permeability e.g. celiac sprue and menetrier’s disease in small intestine and stomach respectively, ''[[vata dosha]]'' and/or ''[[kapha dosha]]'' dominance should be considered.<br /> #Lymphatic dysfunction, represents either primary lymphatic disease or secondary to partial lymphatic obstruction that may occur as a result of enlarged lymph nodes or cardiac disease. Patient with increased protein loss into gastrointestinal tract due to lymphatic obstruction often have steatorrhea and diarrhea. The steatorrhea is a result of altered lymphatic flow as lipid containing chylomicrons exit from intestinal epithelial cells via intestinal lymphatic’s which may be compared with flow of ''ahara rasa'' and/ or presence of ''[[vata]]'' and ''[[kapha]]''.<br /> <br /> Genetic factors (''bija dushti'') almost all patients with celiac sprue express the HLA-DQ2 allele. Environmental factor, gliadin a component of gluten that is present in wheat, barley and rye contributes to the disease. Immunologic component (''prayatna, bala'' and ''urja'' of ''[[vata]], [[kapha]]'' and ''[[pitta]]'' respectively), serum antibodies – IgA antigliadin, IgA antiendomyasial and IgA antibodies and IgG antibodies are present. In addition, gliadin peptides may interact with gliadin specific T cells that may either mediate tissue injury or induce the release of one or more cytokines that cause tissue injury (Verse 72).<br /> <br /> Further research shows that incase of uncontrolled growth of gut microbiome, flushing of gut reduces both psycho-somatic symptoms. ''[[Shodhana]]'' therapy not only flushes the vitiated gut microbiome but also flushes out the substrata due to which growth of microbiome is controlled (Verse 73-74).<br /> <br /> ''Kshara'' has been advised along with ''tilvaka sneha; kshara'' has alkaline pH. In duodenum and small intestine, enzymes with alkaline pH are secreted. ''Ushna, teekshna'' and ''laghu [[guna]]'' help in digestion. ''Kledayati ado paschata visoshayati''[Cha.Sa.[[ Vimana Sthana]] 1/17 ] i.e. secretion are first increased and later on absorbed is very essential in ''grahani dosha''. Both these actions help in secretion of digestive enzymes thereby increasing [[agni]] and by absorption correct the malabsorption. Therefore use of ''kshara'' is more in ''grahani dosha'' and ''gulma'' (Verse 79).<br /> <br /> ''Aranala''(a fermented preparation), ''dadhimanda''(curd whey) or ''sauviraka'' are all fermented liquids. Fermented liquids contain probiotic organisms. Probiotic foods are produced by chemical action of lactic acid, bacteria, yeast or combination of both. These useful microorganisms help in breaking down carbohydrates, sugars making them easily digestible. Probiotics improves absorption of nutrients; improve synthesis of vitamins, essential fatty acids and enhance nutritional qualities of food grains. Fermented foods increase the absorption of vital minerals from gastrointestinal tract thus preventing mineral deficiencies and also treat the diarrhea. It explains the role of helpful gut microbiome (Verse 82-86). Use of fermented products explains the concept of gut microbiome and use of ''kshara'' and ''amla'' drug for maintaining pH (Verse 88-93).<br /> <br /> ''[[Vamana]]'' (medicated emesis) reduces gastro-paresis by emptying the gastrointestinal contents (Verse 101-102).<br /> <br /> Fermented liquids are rich source of gut microbiome which will help to replace the unhealthy microbiome. These fermented liquids also help to balance the pH of the gastrointestinal tract. Further study is required to decide impact of above mentioned liquid diet on pH and specific enzymes (Verse 115-116). <br /> <br /> One cup of buttermilk contains 152 calories and 8.11 grams of fat, of which 4.65 grams are saturated, 282 milligrams of calcium and 127 international units of vitamin D. The vitamin also helps to maintain normal phosphorus levels. Phosphorus is another nutrient that contributes to bone health (Verse 117-119).<br /> <br /> ''Samana vata'' regularizes the secretion of pancreatic and intestinal enzymes. Initially the enzymes are in zymogens (inactive form). ''Samana vata'' helps in conversion of zymogens into active enzymes so all the factors which help in stimulating exocytosis can be considered as functional components of ''samana vata.'' Once ''samana vata'' is stimulated efficiently the digestive process becomes intact to digest all types of nutrients (Verse 202-203 -1/2).<br /> <br /> Hyperthyroidism is one of the causes for hypermetabolic disorders but extra thyroidal causes are also important. Hypermetabolism typically occurs after significant injury to the body. Infections, sepsis, burns, multiple traumas, fever, long bone fractures, prolonged steroid therapy, pheocromocytoma, surgery and bone marrow transplants. Hypermetabolism may occur particularly in the brain after traumatic brain injury (Verse 217-219).<br /> <br /> Hypermetabolism is accompanied by a variety of internal and external symptoms most notably extreme weight loss. External symptoms of hypermetabolism may include anemia, fatigue, elevated heart rate, irregular heartbeat, insomnia, shortness of breath, dysautonomia, muscle weakness, excessive sweating while internal symptoms include peripheral insulin resistance, elevated catabolism of proteins, carbohydrates triglycerides and negative nitrogen in the body. <br /> <br /> In this context there is increased function due to excess secretion of thyroid hormones. Thyroid hormones act as catabolic hormones and promote calorigenesis and develops hypermetabolic state which may result in gluconeogenesis, lipolysis and glycogenolysis causing decreased muscle mass and weight loss. Metabolic rate is enhanced, because of vitiated ''[[pitta]]'' and associated ''[[vata]]''. <br /> <br /> This is the condition where increased appetite with weight loss is seen due to insufficient supply of nutrients in relation to ''agnibala''. Thyroid storm/ thyroid-toxic crisis is rare and life threatening exacerbation of hyperthyroidism, accompanied by fever, delirium, seizures, vomiting, diarrhea and jaundice. Death may occur due to cardiac failure, arrhythmia and hyperthermia. <br /> <br /> Management requires intensive monitoring, supportive care, identification of the precipitating causes (stroke, infection, trauma, diabetic ketoacidosis, surgery and radio iodine treatment), and measures that reduce thyroid hormone synthesis (Verse 220-222½).<br /> <br /> ''Kleda'' can also be considered as inter-mediory product of metabolism like ketones, pyruvate, lactate which are well utilized in active/healthy persons as fuel and therefore does not cause inflammation/disease process (Verse 237-239).<br /> <br /> === Current clinical practices ===<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Name<br /> ! scope=&quot;col&quot;| Dose<br /> ! scope=&quot;col&quot;| Time of Administration<br /> ! scope=&quot;col&quot;| Anupana<br /> |-<br /> | 1<br /> | ''Chitrakadi Vati''<br /> | 250-500 mg<br /> | Between meals <br /> | Buttermilk or lukewarm water <br /> |-<br /> | 2<br /> | ''Shankha Vati''<br /> | 250-500 mg<br /> | Between meals <br /> | Buttermilk or lukewarm water<br /> |-<br /> | 3<br /> | ''Lashunadi Vati''<br /> | 250-500 mg<br /> | Between meals <br /> | Buttermilk or lukewarm water <br /> |-<br /> | 4<br /> | ''Hingvadi Vati''<br /> | 250-500 mg<br /> | Between meals <br /> | Buttermilk or lukewarm water <br /> |-<br /> | 5<br /> | ''Shiva Kshana Pachana Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Buttermilk or lukewarm water<br /> |-<br /> | 6<br /> | ''Hingvashtaka Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Buttermilk or lukewarm water <br /> |-<br /> | 7<br /> | ''Bhunimbadi Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 8<br /> | ''Avipattikara Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 9<br /> | ''Lavana Bhaskar Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Buttermilk or lukewarm water<br /> |-<br /> | 10<br /> | ''Swadishta Virechana Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 11<br /> | ''Nagaradi Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Buttermilk and lukewarm water<br /> |-<br /> | 12<br /> | ''Dadimashtaka Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Nimbu panaka and lukewarm water<br /> |-<br /> | 13<br /> | ''Pippalyasava''<br /> | 10 - 40 ml<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 14<br /> | ''Jeerakadyarishta''<br /> | 10 - 40 ml<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 15<br /> | ''Abhayarishta''<br /> | 10 - 40 ml<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 16<br /> | ''Takrarishta''<br /> | 10 - 40 ml<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 17<br /> | ''Chitrakadi ghrita''<br /> | 5 - 40 ml<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 18<br /> | ''Dadimadi ghrita''<br /> | 5 - 40 ml<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 19<br /> | ''Kiratadi churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Honey or lukewarm water<br /> |-<br /> | 20<br /> | ''Marichyadi churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Buttermilk or lukewarm water<br /> |}<br /> <br /> === Areas of Further Research ===<br /> <br /> *To study ''asava'' and ''arishta'' in relation with gut microbial flora. <br /> *To understand concept of ''ama'' with relation to autoimmune diseases.<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References ==<br /> &lt;/div&gt;<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Grahani_Chikitsa&diff=45378 2025-10-31T10:59:57Z

<p>Agnivesha: /* Effect on immunity */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Grahani Chikitsa<br /> |titlemode=append<br /> |keywords=Digestion in Ayurveda, metabolism in Ayurveda, jatharagni, bhutagni, dhatvagni, grahani, grahanidosha, grahani roga, annavisha, atyagni, samashana, vishamashana, adhyashana, Ayurveda, charak samhita, Indian system of medicine,Patwardhan K., Ojha S.N.,Upadhyaya W., Samant A., Dharmadhikari A., Kajaria D.,Singh G., Goyal M., Deole Y.S., Basisht G., dietary guidelines, digestion and metabolism in Ayurveda, indigestion, nutrition, nourishment<br /> |description=Chikitsa Sthana Chapter 15. Management of Grahani (Diseases of digestion and metabolism)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 15. Management of Grahani (Diseases of digestion and metabolism) &lt;/big&gt;'''<br /> {{Infobox<br /> |title = Grahani Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 15<br /> |label2 = Preceding Chapter<br /> |data2 = [[Arsha Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Pandu Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Patwardhan K., Ojha S.N., Upadhyaya W., Samant A.<br /> |label7 = Reviewer <br /> |data7 = Dharmadhikari A., Kajaria D.<br /> |label8 = Editors<br /> |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI <br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.016 10.47468/CSNE.2020.e01.s06.016]<br /> }}<br /> &lt;big&gt;'''Abstract &lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;[[Grahani Chikitsa]] consists of three parts. The first part explains the concept of normal digestion process. The second part describes the abnormal digestion and third part is about diseases caused by abnormality of digestive factors and its interaction with proximal intestine or ''grahani''. These disorders are called ''grahanidosha''. <br /> &lt;br/&gt;<br /> [[agni]] (digestive and metabolic agents), based on their specific functions of conversion of food into biological elements of the body are classified into thirteen types. First, the ''jatharagni'' is most important because it is the initiator of digestive process and it strengthens the digestive ability of other twelve ''agnis''. Five ''bhutagnis'' transform the ''panchmahabhauika'' components of ''ahara rasa'' created by ''jatharagni'' into different structures of the body. Seven ''dhatvagnis'' create seven tissues elements(''[[dhatu]]'').<br /> &lt;br/&gt;<br /> ''Jatharagni'' initiates the first phase of digestion process by conversion of food into nutrient fluid (''ahara rasa''). This nutrient fluid is further trifurcated into three biological substances ''[[kapha]], [[pitta]]'' and ''[[vata]]'' in three stages to ''madhura, amla'' and ''katu awastha paka'' respectively. This biofluid is separated into excretable waste or impure products by ''samana vata'' in ''grahani'' (middle part of GI Tract) and useful, pure circulable products. ''Samana vata'' analyzes and separates the useful products (''prasada'') and waste (''kitta''). Useful products get absorbed by ''rasayani'' (villi) of the intestine, sent to the micro channels (''srotas'') by ''vyanvata'', simutaneouly, to the entire body. Waste products are excreted out by ''apana vayu'' through urine, feces and sweat. <br /> &lt;br/&gt;<br /> Now second and third phase of digestion process occur simultaneously in the ''srotas'' (microchannels). Five ''bhutagnis'' work on the formation of anatomical structure of the body from respective ''[[panchamahabhuta]]'' in the form of micro channels, by digesting needful components present in biofluid. Each gross and subtle particle of body is ''[[panchabhautika]]'', but each one is having different proportion of ''[[mahabhuta]]''. <br /> &lt;br/&gt;<br /> Now the third phase of digestion is processed in seven micro channels (''srotas'') specified for seven body tissues (''[[dhatu]]'') for the formation of body tissues by their specific seven tissue transformers (''dhatvagnis'') Excreable waste products are carried out by three excreatory channels as feces, urine and sweat, along with sub tissues and sub excreta of sensory organs.<br /> &lt;br/&gt;<br /> Second part of this chapter explains the etiopathology of abnormal digestion, and formation of intermediate products as seed cause of various diseases in the form of ''ama, shukta'' and ''amavisha''.<br /> &lt;br/&gt;<br /> Third part explicates the etiopathology, types, symptoms and treatments of ''grahanidosha'' as a syndrome of various digestive disorders. The chapter sums up in defining abnormal dietary habits. <br /> &lt;br/&gt;<br /> '''Keywords''': Digestion in [[Ayurveda]], metabolism in [[Ayurveda]], ''jatharagni, bhutagni, dhatvagni, grahani, grahanidosha, grahani roga, annavisha, atyagni, samashana, vishamashana, adhyashana''.<br /> &lt;/p&gt;<br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> [[Grahani Chikitsa]] is one of the most important chapters of this compendium because most of the diseases originate from disorders of digestion. This chapter is described after ''arsha roga'' (hemorrhoids) because pathophysiology of ''arsha'' influences [[agni]] and before [[Panduroga Chikitsa]] because ''grahani roga'' influences ''pandu roga''. The initial portion of this chapter discusses the details of the physiological process of digestion and metabolism in human body. [[Agni]], being the fundamental factor in maintaining health and in producing diseases, has been described in detail. The chapter begins with explanation of importance of normally functioning [[agni]] and then goes on to explain the various aspects of digestion, metabolism and tissue nourishment.<br /> <br /> Different theories of tissue nourishment as explained by the commentators play a crucial role in the entire process. The concept of [[upadhatu]] and ''dhatumala'' has also been dealt with. These descriptions are followed by the pathophysiology of ''grahanidosha'' syndrome and its management. This chapter underscores that the knowledge of physiology is crucial in understanding the pathophysiology and therapeutics of a disease.<br /> <br /> Protection of [[agni]] is very essential in treatment of all diseases.[Chakrapani,Cha.Sa.[[ Chikitsa Sthana ]]14/244-246 ]''Arsha, atisara'' and ''grahanidosha'' are said to be ''paraspara [[hetu]]'' which means one disease becomes cause for another disease[Cha.Sa. [[ Chikitsa Sthana ]]14/244] e.g. in patients with chronic colitis, intestinal polyps are seen, in patients suffering from diarrhea colitis is observed. Therefore, one finds interrelation between these disorders and as explained earlier, special precaution should be taken with respect to ''agni bala''. <br /> <br /> Certain drugs like ''chitraka'' (Plumbago zeylanica), ''pippali'' (Piper longum), ''pippalimula'' (root of Piper longum), ''shunthi'' (Zingiber officinale), ''nagakesara, haridra, danti, duralabha, haritaki'' etc have been used in combinations with other drugs for the treatment of ''arsha'' considering the concept of ''agnibala vriddhi'' and ''vata anulomanam'' (facilitating passage of ''[[vata]]'') and the same drugs have been used in ''grahani chikitsa'' with the same concept. Charak explains that all the above three diseases are caused by ''agnimandya'' and if increase in [[agni]] is done then relief in the disease takes place. [Chakrapani Cha.Sa.[[Chikitsa Sthana]] 14/244-246]<br /> <br /> Further, ''[[vata]]'' is said to be ''agnisakha'' i.e. ''agnibala'' depends on ''[[vata]]''. ''Vatakshaya'' or ''prakopa'' results in ''agnimandya''. Therefore, ''anna, pana'' and ''aushadha'' which bring about ''vata anulomana'' are very useful in treatment of diseases like ''arsha'' and ''grahani dosha''. <br /> <br /> ''Vata anulomanam'' means to facilitate the ''gati'' (motion) of ''[[vata]]'' downwards to anus. Among five types of ''[[vata]], samana'' and ''apana'' have major role in diseases like ''arsha, atisara'' and ''grahanidosha''. Obstruction to movement of ''[[vata]]'' (''avarudha gati'') or diarrhea (''atisaraṇa'') leads to ''agni kshaya''. ''Avarudha gati'' is the cause for ''vibandha'' (constipation), ''malavibandha'' (obstruction to feces) along with ''pravahana'' (urge to defecate) which increases the intra-lumen pressure leading to incompetency of valves in rectal veins leading to their varicosity which causes hemorrhoids where as ''atisarana'' (diarrhea) causes increased motility of intestine. Hence ''vata anulomanam'' should not be understood as ''[[virechana]]'' or laxation but regularization of ''[[vata]] gati'' so that there is no ''avarodha'' or ''atisarana''. The same concept of ''vata anulomana'' is also mentioned in [[Grahani Chikitsa]].[Cha.Sa. [[Chikitsa Sthana]] 14/247]<br /> <br /> Therefore, the line of treatment used in ''arsha'' with regard to ''agni bala'' and ''vata anulomanam'' is basically similar to that of ''grahanidosha'' hence Charak has explained [[Grahani Chikitsa]] after [[Arsha Chikitsa]].[Chakrapani Cha.Sa.[[Chikitsa Sthana]]15/1] Charak could have restricted the name of chapter to [[Grahani Chikitsa]] i.e. treatment of the ''avayava grahani'' whereas he has increased the scope of chapter by using the word ''grahanidosha''.[Chakrapani, Cha.Sa. [[Chikitsa Sthana]] 15/1].<br /> <br /> There is always an inter-relationship between ''avayava'' (organ) and ''avayavi'' (part of organ) or ''ashraya''(seat) and ''ashrayi'' (seated). Either of the one has an impact on the other, hence if ''grahaniavayava'' is in normal state then [[agni]] the ''avayavi'' functions normally and vice versa also holds true, whereas if ''dusti'' of ''grahani'' takes place ''agni vaishamyata'' (imbalance) is seen e.g. ileitis, wherein digestion is hampered. ''Grahani'' is the seat for ''jatharagni''. [Cha.Sa.[[Chikitsa Sthana]] 15 /56] [[Agni]] is responsible for [[ayu]] (longevity of life), [[varna]] (complexion), [[bala]] (strength), [[swasthya]] (health), ''utsaha'' (enthusiasm), ''upachaya'' (proper metabolism), ''prabha'' (glow) and ''[[oja]]'' (core energy). ''Prakrita [[agni]]'' (normal digestive power) is essential for long and healthy life while, vitiated [[agni]] is responsible for ''roga avastha''(disease).[Cha. Sa. [[Chikitsa Sthana]] 15/3-4] <br /> <br /> In this chapter, Charak describes formation of body tissues in detail with the role of [[ahara]] which is supplied continuously to maintain homeostasis. ''Vyana vata'' is promoter of ''[[rasa]] [[rakta]]di'' circulation.[ Cha. Sa. [[Chikitsa Sthana]] 15/36] It transports ''[[rasa]] [[rakta]]di drava'' ''[[dhatu]]'' throughout body continuously and as per metabolic demand. This explanation shows that closed circulation in human was known to Charak.<br /> <br /> ''Grahani'' is prime place where digestion and absorption of ''ahara rasa'' takes place. ''Ahara rasa'' provides nutrition for the ''[[rasa]]di sapta [[dhatu]]'', along-with three ''sharirika [[dosha]]'' and three ''manasika dosha''. Nourishment of ''[[sattva]], [[raja]]'' and ''[[tama]]'' is influenced by ''sattvika, rajasika'' and ''tamasika ahara''. ''Tamasika'' and ''rajasika ahara'' suppresses ''[[sattva]] [[guna]]'' thereby causing ''alpa sattva'' in individual, a common predisposing factor of psychiatric disorders for e.g. ''alpa sattva'' as mentioned in ''unmada'' [Cha.Sa [[Chikitsa Sthana]] 9/5] In ''vataja grahanivyadhishanka'' (feeling of suffering from disease) manifests in patients with ''alpa sattva''. <br /> <br /> Homeostasis at cellular level and gross level is maintained by ''[[vata]], [[pitta]]'' and ''[[kapha]]'' in which digestive and metabolic contributions are due to [[agni]]. This chapter has been dedicated to [[agni]] to understand the manner in which it gets vitiated by ''[[dosha]]'' and accordingly the line of treatment for the ''agni dosha'' is explained. As the functions of [[agni]] take place in ''grahani'' hence disease related to ''grahani'' has been given the name.<br /> <br /> Secondly, ''pandu roga'' is due to ''alpata'' of ''raktaposhaka sara bhaga'' [Chakrapani, Cha. Sa. [[Chikitsa Sthana]] 16/3-7] and, one of the main causes of this ''alpata'' is mal-digestion and mal-absorption which takes place in ''grahani''. It is well known fact, that various contributory factors for blood formation have their absorption in gastrointestinal tract such as folic acid, vitamin B12, iron, etc which if not absorbed causes anemia this is the reason why Charak has placed this chapter in between ''arsha'' and ''pandu roga''.<br /> &lt;/div&gt;<br /> <br /> == Sanskrit Text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातो ग्रहणीदोषचिकित्सितं व्याख्यास्यामः||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः||२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātō Grahaṇī dōṣacikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2||<br /> <br /> athAto grahaNIdoShacikitsitaM vyAkhyAsyAmaH||1|| <br /> <br /> iti ha smAha bhagavAnAtreyaH||2||<br /> &lt;/div&gt;&lt;/div&gt;<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> Now we shall expound the chapter &quot;Grahani Chikitsa&quot; (Management of diseases of digestion and metabolism). Thus said Lord Atreya. [1-2]<br /> <br /> === Importance of ''dehagni'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आयुर्वर्णो बलं स्वास्थ्यमुत्साहोपचयौ प्रभा| <br /> <br /> ओजस्तेजोऽग्नयः प्राणाश्चोक्ता देहाग्निहेतुकाः||३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> āyurvarṇō balaṁ svāsthyamutsāhōpacayau prabhā| <br /> <br /> ōjastējō'gnayaḥ prāṇāścōktā dēhāgnihētukāḥ||3|| <br /> <br /> AyurvarNo balaM svAsthyamutsAhopacayau prabhA| <br /> <br /> ojastejo~agnayaH prANAshcoktA dehAgnihetukAH||3|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> [[Dehagni]] (all the entities in the body that are responsible for digestion and metabolism) is the fundamental causative agent for longevity, normal complexion, normal strength, good health, motivation, normal growth, normal luster, normal ''[[ojas]]'', normal body temperature and various other forms of [[agni]]. Even the existence of an individual is said to be because of [[dehagni]]. [3]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शान्तेऽग्नौ म्रियते, युक्ते चिरं जीवत्यनामयः| <br /> <br /> रोगी स्याद्विकृते, मूलमग्निस्तस्मान्निरुच्यते||४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śāntē'gnau mriyatē, yuktē ciraṁ jīvatyanāmayaḥ| <br /> <br /> rōgī syādvikr̥tē, mūlamAgnistasmānnirucyatē||4||<br /> <br /> shAnte~agnau mriyate, yukte ciraM jIvatyanAmayaH| <br /> <br /> rogI syAdvikRute, mUlamagnistasmAnnirucyate||4||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When the [[agni]] stops functioning, the individual dies; if the [[agni]] functions normally, the individual can lead a healthy and long life. Similarly, if the [[agni]] becomes abnormal, the individual suffers from various diseases; and hence, the [[agni]] is said to be the root cause of health and longevity [4]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यदन्नं देहधात्वोजोबलवर्णादिपोषकम्| <br /> <br /> तत्राग्निर्हेतुराहारान्न ह्यपक्वाद्रसादयः||५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yadannaṁ dēhadhātvōjōbalavarṇādipōṣakam| <br /> <br /> tatrāgnirhēturāhārānna hyapakvādrasādayaḥ||5||<br /> <br /> yadannaM dehadhAtvojobalavarNAdipoShakam| <br /> <br /> tatrAgnirheturAhArAnna hyapakvAdrasAdayaH||5||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The food one consumes becomes capable of nourishing the body tissues and of promoting the ''[[ojas]]'' (vital essence), strength, complexion etc., only in the presence of normally functioning [[agni]]. In the absence of normal digestion (and metabolism), the normal body tissues such as ''[[rasa]]'' cannot be formed nor nourished [5]<br /> <br /> === Process of digestion-first phase ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अन्नमादानकर्मा तु प्राणः कोष्ठं प्रकर्षति| <br /> <br /> तद्द्रवैर्भिन्नसङ्घातं स्नेहेन मृदुतां गतम्||६|| <br /> <br /> समानेनावधूतोऽग्निरुदर्यः पवनोद्वहः| <br /> <br /> काले भुक्तं समं सम्यक् पचत्यायुर्विवृद्धये||७|| <br /> <br /> एवं रसमलायान्नमाशयस्थमधः स्थितः| <br /> <br /> पचत्यग्निर्यथा स्थाल्यामोदनायाम्बुतण्डुलम्||८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> annamādānakarmā tu prāṇaḥ kōṣṭhaṁ prakarṣati| <br /> <br /> taddravairbhinnasaṅghātaṁ snēhēna mr̥dutāṁ gatam||6|| <br /> <br /> samānēnāvadhūtō'gnirudaryaḥ [1] pavanōdvahaḥ| <br /> <br /> kālē bhuktaṁ samaṁ samyak pacatyāyurvivr̥ddhayē||7|| <br /> <br /> ēvaṁ rasamalāyānnamāśayasthamadhaḥ sthitaḥ| <br /> <br /> pacatyAgniryathā sthālyāmōdanāyāmbutaṇḍulam||8||<br /> <br /> annamAdAnakarmA tu prANaH koShThaM prakarShati| <br /> <br /> taddravairbhinnasa~gghAtaM snehena mRudutAM gatam||6|| <br /> <br /> samAnenAvadhUto~agnirudaryaH [1] pavanodvahaH| <br /> <br /> kAle bhuktaM samaM samyak pacatyAyurvivRuddhaye||7|| <br /> <br /> evaM rasamalAyAnnamAshayasthamadhaH sthitaH| <br /> <br /> pacatyagniryathA sthAlyAmodanAyAmbutaNDulam||8||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ingested food is carried to ''koshtha'' by ''prana vata''. The food disintegrates because of the liquids, and further it becomes soft because of the fatty substances. The ''samana vata'', that has an inherent ability to intensify the ''agni,'' intensifies the digestive enzymes and properly digests the food that one consumes timely and in an appropriate quantity, thus leading to longevity. This process of digestion by [[agni]] in the gut which leads to the formation of ''[[rasa]]'' and ''[[mala]]'' is comparable to the process of cooking of the raw rice kept in an earthen vessel containing water on a fire [6-8]<br /> <br /> === Three states of digestion and provoking ''[[dosha]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अन्नस्य भुक्तमात्रस्य षड्रसस्य प्रपाकतः| <br /> <br /> मधुराद्यात् कफो भावात् फेनभूत उदीर्यते||९|| <br /> <br /> परं तु पच्यमानस्य विदग्धस्याम्लभावतः| <br /> <br /> आशयाच्च्यवमानस्य पित्तमच्छमुदीर्यते||१०|| <br /> <br /> पक्वाशयं तु प्राप्तस्य शोष्यमाणस्य वह्निना| <br /> <br /> परिपिण्डितपक्वस्य वायुः स्यात् कटुभावतः||११||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> annasya bhuktamātrasya ṣaḍrasasya prapākataḥ| <br /> <br /> madhurādyāt kaphō bhāvāt phēnabhūta udīryatē||9|| <br /> <br /> paraṁ tu pacyamānasya vidagdhasyāmlabhāvataḥ| <br /> <br /> āśayāccyavamānasya Pittamacchamudīryatē||10|| <br /> <br /> pakvāśayaṁ tu prāptasya śōṣyamāṇasya vahninā| <br /> <br /> paripiṇḍitapakvasya Vātaḥ syāt kaṭubhāvataḥ||11||<br /> <br /> annasya bhuktamAtrasya ShaDrasasya prapAkataH| <br /> <br /> madhurAdyAt kapho bhAvAt phenabhUta udIryate||9|| <br /> <br /> paraM tu pacyamAnasya vidagdhasyAmlabhAvataH| <br /> <br /> AshayAccyavamAnasya pittamacchamudIryate||10|| <br /> <br /> pakvAshayaM tu prAptasya shoShyamANasya vahninA| <br /> <br /> paripiNDitapakvasya vAyuH syAt kaTubhAvataH||11||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As soon as the food that has all the six tastes is consumed, it undergoes the first stage of digestion known as ''madhura'' (sweet) state during which ''[[kapha]]'' is produced which is like froth. Afterwards, while the food undergoing digestion is in its partially digested form, it attains ''amla'' (sour) state. <br /> <br /> When the semi-digested food leaves the stomach, the release of liquid form of [[pitta]] known as ''accha-pitta'' occurs.<br /> <br /> When the ''pakva'' part (the non-absorbable remnant part after the absorption of the nutrients), reaches the ''pakvashaya'' (the colon), the drying effect of [[agni]] converts it into a solid mass. There also occurs the release of ''[[vata]]'' which is ''katu'' (pungent) state [9-11]<br /> <br /> === Second phase of digestion by ''[[panchamahabhuta]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अन्नमिष्टं ह्युपहितमिष्टैर्गन्धादिभिः पृथक्| <br /> <br /> देहे प्रीणाति गन्धादीन् घ्राणादीनीन्द्रियाणि च||१२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> annamiṣṭaṁ hyupahitamiṣṭairgandhādibhiḥ pr̥thak| <br /> <br /> dēhē prīṇāti gandhādīn ghrāṇādīnīndriyāṇi ca||12||<br /> <br /> annamiShTaM hyupahitamiShTairgandhAdibhiH [1] pRuthak| <br /> <br /> dehe prINAti gandhAdIn ghrANAdInIndriyANi [2] ca||12||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The food that possesses pleasant smell (taste, appearance, consistency,) etc., nourishes the similar entities in the body such as the sensory organs of smell by ''gandha'' etc (e.g. taste, vision, touch etc senses by respective ''[[mahabhuta]]'') [12]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भौमाप्याग्नेयवायव्याः पञ्चोष्माणः सनाभसाः| <br /> <br /> पञ्चाहारगुणान्स्वान्स्वान्पार्थिवादीन्पचन्ति हि||१३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhaumāpyāgnēyavāyavyāḥ pañcōṣmāṇaḥ sanābhasāḥ| <br /> <br /> pañcāhāraguṇānsvānsvānpārthivādīnpacanti hi||13||<br /> <br /> bhaumApyAgneyavAyavyAH pa~jcoShmANaH sanAbhasAH| <br /> <br /> pa~jcAhAraguNAnsvAnsvAnpArthivAdInpacanti hi||13||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> There are five types of [[agni]] namely, ''bhauma, apya, agneya, vayavya'' and ''nabhasa''. These five ''bhutagni'' are one of each ''[[mahabhuta]]'' transform/metabolize those components of the food that are homologous to them in their composition of structure of human organism. (such as ''parthiva, apya'' etc) [13]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यथास्वं स्वं च पुष्णन्ति देहे द्रव्यगुणाः पृथक्| <br /> <br /> पार्थिवाः पार्थिवानेव शेषाः शेषांश्च कृत्स्नशः||१४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yathāsvaṁ svaṁ ca puṣṇanti dēhē dravyaguṇāḥ pr̥thak| <br /> <br /> pārthivāḥ pārthivānēva śēṣāḥ śēṣāṁśca kr̥tsnaśaḥ||14||<br /> <br /> yathAsvaM svaM ca puShNanti dehe dravyaguNAH pRuthak| <br /> <br /> pArthivAH pArthivAneva sheShAH sheShAMshca kRutsnashaH||14||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Specific categories of entities in the body having specific attributes can be nourished by only those substances that belong to the same category having those same attributes. This means that ''parthiva'' entities in the body (one that is dominated by ''[[prithvi mahabhuta]]'' in its composition) can be nourished only by the ''parthiva'' substances in the food and so on. The same rule applies to the whole body [14]<br /> <br /> === Third phase of digestion and metabolism at level of ''[[dhatu]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सप्तभिर्देहधातारो धातवो द्विविधं पुनः| <br /> <br /> यथास्वमग्निभिः पाकं यान्ति किट्टप्रसादवत् ||१५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> saptabhirdēhadhātārō dhātavō dvividhaṁ punaḥ| <br /> <br /> yathāsvamAgnibhiḥ pākaṁ yānti kiṭṭaprasādavat ||15||<br /> <br /> saptabhirdehadhAtAro dhAtavo dvividhaM punaH| <br /> <br /> yathAsvamagnibhiH pAkaM yAnti kiTTaprasAdavat [1] ||15||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Further, the seven components that sustain the body, known as ''[[dhatu]]'' (tissues), are metabolized/transformed into two kinds of products known as ''sara'' (nutrition) and ''kitta'' (waste). This process is the function of seven specific entities known as ''dhatvagni''; each ''dhatvagni'' is specific for its corresponding ''[[dhatu]]'' [15]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रसाद्रक्तं ततो मांसं मांसान्मेदस्ततोऽस्थि च| <br /> <br /> अस्थ्नो मज्जा ततः शुक्रं शुक्राद्गर्भः प्रसादजः||१६||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rasādraktaṁ tatō māṁsaṁ māṁsānmēdastatō'sthi ca| <br /> <br /> asthnō majjā tataḥ śukraṁ śukrādgarbhaḥ prasādajaḥ||16||<br /> <br /> rasAdraktaM tato mAMsaM mAMsAnmedastato~asthi ca| <br /> <br /> asthno majjA tataH shukraM shukrAdgarbhaH prasAdajaH||16||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Rakta]]'' is produced after ''[[rasa]]'' and then ''[[mamsa]]''. After ''[[mamsa]]'' the ''[[medas]]'' is formed and then ''[[asthi]]'' is produced. After ''[[asthi]]'' the ''[[majja]]'' is derived and then ''[[shukra]]'' is produced and finally fine ''[[shukra]]'' leads to ''[[garbha]]'' [16]<br /> <br /> === ''Upadhatu'' (metabolic products) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रसात् स्तन्यं ततो रक्तमसृजः कण्डराः सिराः| <br /> <br /> मांसाद्वसा त्वचः षट् च मेदसः स्नायुसम्भवः||१७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rasāt stanyaṁ tatō raktamasr̥jaḥ kaṇḍarāḥ sirāḥ| <br /> <br /> māṁsādvasā tvacaḥ ṣaṭ ca mēdasaḥ snāyusambhavaḥ ||17||<br /> <br /> rasAt stanyaM tato [2] raktamasRujaH kaNDarAH sirAH| <br /> <br /> mAMsAdvasA tvacaH ShaT ca medasaH snAyusambhavaH [3] ||17||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Stanya'' (breast milk) and the menstrual blood are derived after rasa. ''Kandara'' (tendon) and ''sira''(vein) are derived after ''[[rakta]]''. ''Vasa''(muscle fat) and the six layers of ''tvacha'' (skin) are derived after ''[[mamsa]]'' (muscle) and ''snayu''(ligament) are derived after ''[[medas]]'' (adipose tissue) [17]<br /> <br /> === ''[[Mala]]'' formed at tissue level metabolism ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> किट्टमन्नस्य विण्मूत्रं, रसस्य तु कफोऽसृजः| <br /> <br /> पित्तं, मांसस्य खमला, मलः स्वेदस्तु मेदसः||१८|| <br /> <br /> स्यात्किट्टं केशलोमास्थ्नो, मज्ज्ञः स्नेहोऽक्षिविट्त्वचाम्| <br /> <br /> प्रसादकिट्टे धातूनां पाकादेवंविधर्च्छतः ||१९|| <br /> <br /> परस्परोपसंस्तब्धा धातुस्नेहपरम्परा |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kiṭṭamannasya viṇmūtraṁ, rasasya tu kaphō'sr̥jaḥ| <br /> <br /> Pittaṁ, māṁsasya khamalā, malaḥ svēdastu mēdasaḥ||18|| <br /> <br /> syātkiṭṭaṁ kēśalōmāsthnō, majjñaḥ snēhō'kṣiviṭtvacām| <br /> <br /> prasādakiṭṭē dhātūnāṁ pākādēvaṁvidharcchataḥ ||19|| <br /> <br /> parasparōpasaṁstabdhā dhātusnēhaparamparā |<br /> <br /> kiTTamannasya viNmUtraM, rasasya tu kapho~asRujaH| <br /> <br /> pittaM, mAMsasya khamalA, malaH svedastu medasaH||18|| <br /> <br /> syAtkiTTaM keshalomAsthno, majj~jaH sneho~akShiviTtvacAm| <br /> <br /> prasAdakiTTe dhAtUnAM pAkAdevaMvidharcchataH [4] ||19|| <br /> <br /> parasparopasaMstabdhA dhAtusnehaparamparA [5] |<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The feces and the urine are the ''kitta'' (non-nutrient portion/waste portion/byproduct) of ingested food. The ''kitta'' of ''[[rasa]]'' is ''[[mala]]-[[kapha]]'' (excretions). ''[[Mala]]-[[pitta]]'' (bile pigment) is the ''kitta'' of ''[[rakta]]''. ''Kha-mala'' (the wastes accumulated in the hollow structures of the body such as external ears and nostrils) are the ''kitta'' of ''[[mamsa]]''. ''Sweda'' (sweat) is the ''[[mala]]'' of ''[[medas]]''. ''Kesha'' (hairs on the head) and ''loma'' (body hair) are the ''[[mala]]'' of ''[[asthi]]''. The ''[[mala]]'' of ''[[majja]]'' is the oily excretion of the eye and the skin (sebum). Thus, the ''[[dhatu]]s'' continuously undergo two kinds of transformation: ''prasada'' (nutrient portion) and ''kitta'' (non-nutrient portion). This entire sequence of transformation and metabolism of ''[[dhatu]]'' is thus inter dependent [18-19½]<br /> <br /> === Modes of transformation ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वृष्यादीनां प्रभावस्तु पुष्णाति बलमाशु हि||२०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vr̥ṣyādīnāṁ prabhāvastu puṣṇāti balamāśu hi||20|| <br /> <br /> vRuShyAdInAM prabhAvastu puShNAti balamAshu hi||20|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Vrishya'' substance (the substance that promotes sexual vigor) nourishes the ''[[shukra]]'' immediately due to its specific influential effect (''prabhava'') [20]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> षड्भिः केचिदहोरात्रैरिच्छन्ति परिवर्तनम्| <br /> <br /> सन्तत्या भोज्यधातूनां परिवृत्तिस्तु चक्रवत्||२१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ṣaḍbhiḥ kēcidahōrātrairicchanti parivartanam| <br /> <br /> santatyā bhōjyadhātūnāṁ parivr̥ttistu cakravat||21||<br /> <br /> ShaDbhiH kecidahorAtrairicchanti parivartanam| <br /> <br /> santatyA bhojyadhAtUnAM parivRuttistu cakravat||21|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Some scholars believe that the conversion of ''[[rasa]]'' up to ''[[shukra]]'' occurs in a span of six days and six nights. This process of transformation of nourishing portion of the digested food is continuous similar to rotating wheel [21]<br /> <br /> Note: Adulterated Verses:<br /> <br /> Verses from 22 to 35 are available in the text in bracket and Chakrapani has also not offered the commentary on these verses, hence these verses are considered as adulterated. <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> (इत्युक्तवन्तमाचार्यं शिष्यस्त्विदमचोदयत्| <br /> <br /> रसाद्रक्तं विसदृशात् कथं देहेऽभिजायते||२२|| <br /> <br /> रसस्य च न रागोऽस्ति स कथं याति रक्तताम्| <br /> <br /> द्रवाद्रक्तात्स्थिरं मांसं कथं तज्जायते नृणाम्||२३|| <br /> <br /> द्रवधातोः स्थिरान्मांसान्मेदसः सम्भवः कथम्| <br /> <br /> श्लक्ष्णाभ्यां मांसमेदोभ्यां खरत्वं कथमस्थिषु||२४|| <br /> <br /> खरेष्वस्थिषु मज्जा च केन स्निग्धो मृदुस्तथा| <br /> <br /> मज्ज्ञश्च परिणामेन यदि शुक्रं प्रवर्तते||२५|| <br /> <br /> सर्वदेहगतं शुक्रं प्रवदन्ति मनीषिणः| <br /> <br /> तथाऽस्थिमध्यमज्ज्ञश्च शुक्रं भवति देहिनाम्||२६|| <br /> <br /> छिद्रं न दृश्यतेऽस्थ्नां च तन्निःसरति वा कथम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> (ityuktavantamācāryaṁ śiṣyastvidamacōdayat| <br /> <br /> rasādraktaṁ visadr̥śāt kathaṁ dēhē'bhijāyatē||22|| <br /> <br /> rasasya ca na rāgō'sti sa kathaṁ yāti raktatām| <br /> <br /> dravādraktātsthiraṁ māṁsaṁ kathaṁ tajjāyatē nr̥ṇām||23|| <br /> <br /> dravadhātōḥ sthirānmāṁsānmēdasaḥ sambhavaḥ katham| <br /> <br /> ślakṣṇābhyāṁ māṁsamēdōbhyāṁ kharatvaṁ kathamasthiṣu||24|| <br /> <br /> kharēṣvasthiṣu majjā ca kēna snigdhō mr̥dustathā| <br /> <br /> majjñaśca pariṇāmēna yadi śukraṁ pravartatē||25|| <br /> <br /> sarvadēhagataṁ śukraṁ pravadanti manīṣiṇaḥ| <br /> <br /> tathā'sthimadhyamajjñaśca śukraṁ bhavati dēhinām||26|| <br /> <br /> chidraṁ na dr̥śyatē'sthnāṁ ca tanniḥsarati vā katham| <br /> <br /> (ityuktavantamAcAryaM [6] shiShyastvidamacodayat| <br /> <br /> rasAdraktaM visadRushAt [7] kathaM dehe~abhijAyate||22|| <br /> <br /> rasasya ca na rAgo~asti sa kathaM yAti raktatAm| <br /> <br /> dravAdraktAtsthiraM mAMsaM kathaM tajjAyate nRuNAm||23|| <br /> <br /> dravadhAtoH [8] sthirAnmAMsAnmedasaH sambhavaH katham| <br /> <br /> shlakShNAbhyAM mAMsamedobhyAM kharatvaM kathamasthiShu||24|| <br /> <br /> khareShvasthiShu majjA ca kena snigdho mRudustathA| <br /> <br /> majj~jashca pariNAmena yadi shukraM pravartate||25|| <br /> <br /> sarvadehagataM shukraM pravadanti manIShiNaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> (After listening to the above explanation by his teacher, the student asked the following doubt:<br /> <br /> How is it that ''[[rakta]]'' is formed in the body out of ''[[rasa]],'' though being different from it? ''[[Rasa]]'' is in fact colorless, and how does it attain the red color of ''[[rakta]]''? How is it that a solid structure such as ''[[mamsa]]'' is formed out of ''[[rakta]]'' which is a fluid by its nature? How is it that, again, from the ''[[mamsa]]'', which is solid, a fluid substance such as ''[[meda]]'' is formed? <br /> <br /> How is it that a rough ''[[asthi]]'' is formed out of smooth structures such as ''[[mamsa]]'' and ''[[meda]]''? How does the soft and fatty ''[[majja]]'' form out of rough structures such as ''[[asthi]]''? If at all ''[[shukra]]'', which is present everywhere in the body is formed out of ''[[majja]]'' that is located inside the ''[[asthi]]'', how does it come out as one cannot see pores on ''[[asthi]]''? [22-26]<br /> <br /> === Formation of ''[[rasa]]'' and ''[[rakta]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> एवमुक्तस्तु शिष्येण गुरुः प्राहेदमुत्तरम्||२७|| <br /> <br /> तेजो रसानां सर्वेषां मनुजानां यदुच्यते| <br /> <br /> पित्तोष्मणः स रागेण रसो रक्तत्वमृच्छति||२८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ēvamuktastu śiṣyēṇa guruḥ prāhēdamuttaram||27|| <br /> <br /> tējō rasānāṁ sarvēṣāṁ manujānāṁ yaducyatē|<br /> <br /> pittōṣmaṇaḥ sa rāgēṇa rasō raktatvamr̥cchati||28|| <br /> <br /> tathA~asthimadhyamajj~jashca shukraM bhavati dehinAm||26|| <br /> <br /> chidraM na dRushyate~asthnAM ca tanniHsarati vA katham| <br /> <br /> evamuktastu shiShyeNa guruH prAhedamuttaram||27|| <br /> <br /> tejo rasAnAM sarveShAM manujAnAM yaducyate| <br /> <br /> pittoShmaNaH sa rAgeNa raso raktatvamRucchati||28|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After listening to the query raised by the student, the teacher replied as follows:<br /> <br /> The nourishment fluid formed, known as ''[[rasa]]'', undergoes transformation by the ''ushma'' (heat) of ''[[pitta]]'' and gets converted into the red colored tissue known as ''[[rakta]]'' [27-28]<br /> <br /> === Formation of ''[[mamsa dhatu]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वाय्वम्बुतेजसा रक्तमूष्मणा चाभिसंयुतम्| <br /> <br /> स्थिरतां प्राप्य मांसं स्यात् स्वोष्मणा पक्वमेव तत् ||२९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vāyvambutējasā raktamūṣmaṇā cābhisaṁyutam| <br /> <br /> sthiratāṁ prāpya māṁsaṁ syāt svōṣmaṇā pakvamēva tat ||29|| <br /> <br /> vAyvambutejasA raktamUShmaNA cAbhisaMyutam| <br /> <br /> sthiratAM prApya mAMsaM syAt svoShmaNA pakvameva tat [9] ||29|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Due to the action of heat along with the ''[[vata]], ambu'' (water) and ''[[teja]]s,'' the ''[[rakta]]'' is converted into stable ''[[mamsa]],'' after being acted upon by its own [[agni]] (''mamsadhatvagni'') [29]<br /> <br /> === Formation of ''[[meda dhatu]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्वतेजोऽम्बुगुणस्निग्धोद्रिक्तं मेदोऽभिजायते| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> svatējō'mbuguṇasnigdhōdriktaṁ mēdō'bhijāyatē| <br /> <br /> svatejo~ambuguNasnigdhodriktaM medo~abhijAyate| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Because of the action of ''medo-dhatvagni'' on the excessively dominant ''snigdha'' attribute of aṃbu, the [[meda dhatu]] is formed [29½]<br /> <br /> === Formation of ''[[asthi dhatu]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पृथिव्यग्न्यनिलादीनां सङ्घातः स्वोष्मणा कृतः||३०|| <br /> <br /> खरत्वं प्रकरोत्यस्य जायतेऽस्थि ततो नृणाम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pr̥thivyagnyanilādīnāṁ saṅghātaḥ svōṣmaṇā kr̥taḥ||30|| <br /> <br /> kharatvaṁ prakarōtyasya jāyatē'sthi tatō nr̥ṇām| <br /> <br /> pRuthivyagnyanilAdInAM sa~gghAtaH svoShmaNA [10] kRutaH||30|| <br /> <br /> kharatvaM prakarotyasya jAyate~asthi tato nRuNAm| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Because of the action of ''asthi dhātvagni'' on the aggregation of ''[[prithvi]], [[agni]]'' and ''anila'', roughness is attained during the formation of the ''[[asthi]]'' [30]<br /> <br /> === Formation of ''[[majja dhatu]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> करोति तत्र सौषिर्यमस्थ्नां मध्ये समीरणः||३१|| <br /> <br /> मेदसस्तानि पूर्यन्ते स्नेहो मज्जा ततः स्मृतः|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> karōti tatra sauṣiryamasthnāṁ madhyē samīraṇaḥ||31|| <br /> <br /> mēdasastāni pūryantē snēhō majjā tataḥ smr̥taḥ| <br /> <br /> karoti tatra sauShiryamasthnAM madhye samIraNaH||31|| <br /> <br /> medasastAni pUryante sneho majjA tataH smRutaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Vata]]'' produces hollowness inside the ''[[asthi dhatu]]'', and after which, these hollow cavities get filled up by fatty tissue which is known as ''[[majja]]'' [31]<br /> <br /> === Formation of ''[[shukra dhatu]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तस्मान्मज्ज्ञस्तु यः स्नेहः शुक्रं सञ्जायते ततः||३२|| <br /> <br /> वाय्वाकाशादिभिर्भावैः सौषिर्यं जायतेऽस्थिषु| <br /> <br /> तेन स्रवति तच्छुक्रं नवात् कुम्भादिवोदकम्||३३|| <br /> <br /> स्रोतोभिः स्यन्दते देहात् समन्ताच्छुक्रवाहिभिः | <br /> <br /> हर्षेणोदीरितं वेगात् सङ्कल्पाच्च मनोभवात्||३४|| <br /> <br /> विलीनं घृतवद्व्यायामोष्मणा स्थानविच्युतम्| <br /> <br /> बस्तौ सम्भृत्य निर्याति स्थलान्निम्नादिवोदकम्)||३५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tasmānmajjñastu yaḥ snēhaḥ śukraṁ sañjāyatē tataḥ||32|| <br /> <br /> vāyvākāśādibhirbhāvaiḥ sauṣiryaṁ jāyatē'sthiṣu| <br /> <br /> tēna sravati tacchukraṁ navāt kumbhādivōdakam||33|| <br /> <br /> srōtōbhiḥ syandatē dēhāt samantācchukravāhibhiḥ | <br /> <br /> harṣēṇōdīritaṁ vēgāt saṅkalpācca manōbhavāt||34|| <br /> <br /> vilīnaṁ ghr̥tavadvyāyāmōṣmaṇā sthānavicyutam| <br /> <br /> bastau sambhr̥tya niryāti sthalānnimnādivōdakam)||35||<br /> <br /> tasmAnmajj~jastu yaH snehaH shukraM sa~jjAyate tataH||32|| <br /> <br /> vAyvAkAshAdibhirbhAvaiH sauShiryaM jAyate~asthiShu| <br /> <br /> tena sravati tacchukraM navAt kumbhAdivodakam||33|| <br /> <br /> srotobhiH syandate dehAt samantAcchukravAhibhiH [11] |<br /> <br /> harSheNodIritaM vegAt sa~gkalpAcca manobhavAt||34|| <br /> <br /> vilInaM ghRutavadvyAyAmoShmaNA sthAnavicyutam| <br /> <br /> bastau sambhRutya niryAti sthalAnnimnAdivodakam)||35||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''sneha'' (fatty) portion of ''[[majja]]'' produces shukra. The porosity in the ''[[asthi]]'' is produced because of the factors such as ''[[vata]]'' and ''akasha.'' ''[[Shukra]]'' comes out of ''[[asthi]]'' through these pores just as the water comes out of a new earthen vessel. Through the channels known as ''shukravaha srotamsi'', this ''[[shukra]]'' spreads all over the body. This ''[[shukra]]'' is discharged through the urethra (which is connected to the urinary bladder) because of several factors such as sexual excitation, reflex activities (''vega''), and mental determination (''samkalpa''). Just as the ghee moves out with ease when heated, the ''[[shukra]]'' too, is discharged due to the heat liberated during the sexual activity. This process of seminal discharge is comparable with the movement of water from a place of lower altitude to a place of higher altitude) [32-35]<br /> <br /> === Continuous circulation of ''[[rasa]]'' all over the body ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> व्यानेन रसधातुर्हि विक्षेपोचितकर्मणा| <br /> <br /> युगपत् सर्वतोऽजस्रं देहे विक्षिप्यते सदा||३६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vyānēna rasadhāturhi vikṣēpōcitakarmaṇā| <br /> <br /> yugapat sarvatō'jasraṁ dēhē vikṣipyatē sadā||36|| <br /> <br /> vyAnena rasadhAturhi vikShepocitakarmaNA| <br /> <br /> yugapat sarvato~ajasraM dehe vikShipyate sadA||36|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Because of being forcefully propelled (out of the heart) by the action of ''vyana vata'', the ''[[rasa dhatu]]'' spreads all over the body simultaneously, continuously and for the entire life [36]<br /> <br /> === Significance of ''Kha-Vaigunya'' (abnormality in body system) in causing disease state ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षिप्यमाणः खवैगुण्याद्रसः सज्जति यत्र सः| <br /> <br /> करोति विकृतिं तत्र खे वर्षमिव तोयदः||३७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣipyamāṇaḥ khavaiguṇyādrasaḥ sajjati yatra saḥ| <br /> <br /> karōti vikr̥tiṁ tatra khē varṣamiva tōyadaḥ||37|| <br /> <br /> kShipyamANaH khavaiguNyAdrasaH sajjati yatra saH| <br /> <br /> karoti [12] vikRutiM tatra khe varShamiva toyadaH||37|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Wherever the ''[[rasa]]'' experiences obstacle due to abnormality in ''srotas, [[rasa]]'' readily produces disease in that very same location. This process is comparable with that of the clouds producing rainfall in a localized region that is favorable for rainfall [37]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दोषाणामपि चैवं स्यादेकदेशप्रकोपणम् |<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dōṣāṇāmapi caivaṁ syādēkadēśaprakōpaṇam |<br /> <br /> doShANAmapi caivaM syAdekadeshaprakopaNam [13] |<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> This principle is applicable even in case of ''[[dosha]]'', where ''ekadesha prakopa'' (abnormal increase at a local site) occurs [37½]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इति भौतिकधात्वन्नपक्तॄणां कर्म भाषितम्||३८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> iti bhautikadhātvannapaktr̥̄ṇāṁ karma bhāṣitam||38|| <br /> <br /> iti bhautikadhAtvannapaktRUNAM karma bhAShitam||38|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus ends the description of the physiological functions of ''bhutagni, dhatvagni'' and ''jatharagni'' [38]<br /> <br /> === Significance of ''jatharagni'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अन्नस्य पक्ता सर्वेषां पक्तॄणामधिपो मतः| <br /> <br /> तन्मूलास्ते हि तद्वृद्धिक्षयवृद्धिक्षयात्मकाः||३९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> annasya paktā sarvēṣāṁ paktr̥̄ṇāmadhipō mataḥ| <br /> <br /> tanmūlāstē hi tadvr̥ddhikṣayavr̥ddhikṣayātmakāḥ||39|| <br /> <br /> annasya paktA sarveShAM paktRUNAmadhipo mataH| <br /> <br /> tanmUlAste hi tadvRuddhikShayavRuddhikShayAtmakAH||39|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Jatharagni'' is known as the King among all the forms of [[agni]]. The intensification and diminution of all other forms of [[agni]] is in fact dependent on ''jatharagni'' [39]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तस्मात्तं विधिवद्युक्तैरन्नपानेन्धनैर्हितैः| <br /> <br /> पालयेत् प्रयतस्तस्य स्थितौ ह्ययुर्बलस्थितिः||४०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tasmāttaṁ vidhivadyuktairannapānēndhanairhitaiḥ| <br /> <br /> pālayēt prayatastasya sthitau hyayurbalasthitiḥ||40|| <br /> <br /> tasmAttaM vidhivadyuktairannapAnendhanairhitaiH| <br /> <br /> pAlayet prayatastasya sthitau hyayurbalasthitiH||40|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> An individual should take utmost care to maintain the [[agni]] by providing fuel in the form of food and drinks which should be taken as per the rules mentioned, because life and strength of an individual depends on [[agni]] [40]<br /> <br /> === Initiation of ''grahani dosha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यो हि भुङ्क्ते विधिं त्याक्त्वा ग्रहणीदोषजान् गदान्| <br /> <br /> स लौल्याल्लभते शीघ्रं, वक्ष्यन्तेऽतः परं तु ते||४१||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yō hi bhuṅktē vidhiṁ tyāktvā Grahaṇī dōṣajān gadān| <br /> <br /> sa laulyāllabhatē śīghraṁ, vakṣyantē'taḥ paraṁ tu tē||41||<br /> <br /> yo hi bhu~gkte vidhiM tyAktvA grahaNIdoShajAn gadAn| <br /> <br /> sa laulyAllabhate shIghraM, vakShyante~ataH paraM tu te||41||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If an individual indulges in food without following the rules and regulation of diet intake, then he quickly suffers from diseases caused by the vitiation of ''grahani'' because of his greedy habits. Such diseases are being described henceforth [41]<br /> <br /> === Causes of vitiation of [[agni]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अभोजनादजीर्णातिभोजनाद्विषमाशनात्|<br /> <br /> असात्म्यगुरुशीतातिरूक्षसन्दुष्टभोजनात्||४२|| <br /> <br /> विरेकवमनस्नेहविभ्रमाद्व्याधिकर्षणात्| <br /> <br /> देशकालर्तुवैषम्याद्वेगानां च विधारणात्||४३|| <br /> <br /> दुष्यत्यग्निः, स दुष्टोऽन्नं न तत् पचति लघ्वपि| <br /> <br /> अपच्यमानं शुक्तत्वं यात्यन्नं विषरूपताम् ||४४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> abhōjanādajīrṇātibhōjanādviṣamāśanāt| <br /> <br /> asātmyaguruśītātirūkṣasanduṣṭabhōjanāt||42|| <br /> <br /> virēkavāmanasnēhavibhramādvyādhikarṣaṇāt| <br /> <br /> dēśakālartuvaiṣamyādvēgānāṁ ca vidhāraṇāt||43||<br /> <br /> duṣyatyāgniḥ, sa duṣṭō'nnaṁ na tat pacati laghvapi| <br /> <br /> apacyamānaṁ śuktatvaṁ yātyannaṁ viṣarūpatām ||44|| <br /> <br /> abhojanAdajIrNAtibhojanAdviShamAshanAt| <br /> <br /> asAtmyagurushItAtirUkShasanduShTabhojanAt||42|| <br /> <br /> virekavamanasnehavibhramAdvyAdhikarShaNAt| <br /> <br /> deshakAlartuvaiShamyAdvegAnAM ca vidhAraNAt||43|| <br /> <br /> duShyatyagniH, sa duShTo~annaM na tat pacati laghvapi| <br /> <br /> apacyamAnaM shuktatvaM yAtyannaM viSharUpatAm [14] ||44||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Excessive starvation, indulging in food intake although there is indigestion, overeating, irregular habit of eating, eating unwholesome food, indulging in food which is heavy to digest or having excessive nutritional value, food which is having cold qualities or eating chilled or frozen items, food which is dry in nature or food which brings about emaciation, contaminated food, perversion of procedures like ''[[vamana]], [[virechana]]'' and ''sneha'', emaciation of body due to disease, sudden migration to unsuitable place and of time and of season, suppression of natural urges are causes for vitiation of [[agni]]. Thus, vitiated [[agni]] is unable to digest even the light food. [42-43]<br /> <br /> This vitiated digestive agent forms an intermediate substance called ''ama'', which turns sour (''shukta'') during fermentation and finally turns in poisonous substance (''amavisha'') [44]<br /> <br /> === Signs and symptoms of ''ajirna''(indigestion) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तस्य लिङ्गमजीर्णस्य विष्टम्भः सदनं तथा| <br /> <br /> शिरसो रुक् च मूर्च्छा च भ्रमः पृष्ठकटिग्रहः||४५|| <br /> <br /> जृम्भाऽङ्गमर्दस्तृष्णा च ज्वरश्छर्दिः प्रवाहणम्| <br /> <br /> अरोचकोऽविपाकश्च, घोरमन्नविषं च तत्||४६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tasya liṅgāmajīrṇasya viṣṭambhaḥ sadanaṁ tathā| <br /> <br /> śirasō ruk ca mūrcchā ca bhrāmaḥ pr̥ṣṭhakaṭigrahaḥ||45|| <br /> <br /> jr̥mbhā'ṅgāmardastr̥ṣṇā ca jvaraśchardiḥ pravāhaṇam| <br /> <br /> arōcakō'vipākaśca, ghōrāmannaviṣaṁ ca tat||46|| <br /> <br /> tasya li~ggamajIrNasya viShTambhaH sadanaM tathA| <br /> <br /> shiraso ruk ca mUrcchA ca bhramaH pRuShThakaTigrahaH||45|| <br /> <br /> jRumbhA~a~ggamardastRuShNA ca jvarashchardiH pravAhaNam|<br /> <br /> arocako~avipAkashca, ghoramannaviShaM ca tat||46|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> This poisonous substance (''amavisha'') manifests clinical features like flatulence, uncomfortable physical and mental miseries, headache, altered consciousness, giddiness, stiffness of back and lumbar region, yawning, body-ache, malaise, morbid thirst, fever, vomiting, tenesmus, anorexia and indigestion and it is similar to antigenic poison. [45-46]<br /> <br /> === Associated disorders of ''annavisha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> संसृज्यमानं पित्तेन दाहं तृष्णां मुखामयान्| <br /> <br /> जनयत्यम्लपित्तं च पित्तजांश्चापरान् गदान्||४७|| <br /> <br /> यक्ष्मपीनसमेहादीन् कफजान् कफसङ्गतम्| <br /> <br /> करोति वातसंसृष्टं वातजांश्च गदान् बहून्||४८|| <br /> <br /> मूत्ररोगांश्च मूत्रस्थं कुक्षिरोगान् शकृद्गतम्| <br /> <br /> रसादिभिश्च संसृष्टं कुर्याद्रोगान् रसादिजान्||४९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> saṁsr̥jyamānaṁ pittēna dāhaṁ tr̥ṣṇāṁ mukhāmayān| <br /> <br /> janayatyamlaPitta ṁ ca Pitta jāṁścāparān gadān||47|| <br /> <br /> yakṣmapīnasamēhādīn kaphajān kaphasaṅgatam| <br /> <br /> karōti Vātasaṁsr̥ṣṭaṁ Vātajāṁśca gadān bahūn||48|| <br /> <br /> mūtrarōgāṁśca mūtrasthaṁ kukṣirōgān śakr̥dgatam| <br /> <br /> rasādibhiśca saṁsr̥ṣṭaṁ kuryādrōgān rasādijān||49||<br /> <br /> saMsRujyamAnaM [15] pittena dAhaM tRuShNAM mukhAmayAn| <br /> <br /> janayatyamlapittaM ca pittajAMshcAparAn gadAn||47|| <br /> <br /> yakShmapInasamehAdIn kaphajAn kaphasa~ggatam| <br /> <br /> karoti vAtasaMsRuShTaM vAtajAMshca [16] gadAn bahUn||48|| <br /> <br /> mUtrarogAMshca mUtrasthaM kukShirogAn shakRudgatam| <br /> <br /> rasAdibhishca saMsRuShTaM kuryAdrogAn rasAdijAn||49||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''annavisha'' when associated with ''[[pitta]]'' causes ''daha'', morbid thirst, oral diseases, ''amlapitta'' (acid peptic disorders) and various other ''[[pitta]]'' related disorders.<br /> <br /> The same ''annavisha'' when gets associated with ''[[kapha]]'' it leads to condition like ''yakshma'' (pthiasis), ''peenas'' (coryza) and ''prameha'' (20 types of diabetes) and various other ''[[kapha]]ja'' disorders, whereas several ''vatika'' disease are caused by association of ''[[vata]]'' with the ''annavisha''. <br /> <br /> The ''annavisha'' when enters renal system, urine related disorders occur; similarly, ''kukshigata roga'' (ailments related to abdomen) have their origin when ''sakrita'' (feces) is involved. ''Rasadi pradoshaja vikara'' (tissue related ailments) occur when ''rasadi srotas'' are involved [47-49]<br /> <br /> === Effects of ''Vishamagni'' (irregular [[agni]])and ''tikshanagni''( excessive [[agni]]) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विषमो धातुवैषम्यं करोति विषमं पचन्| <br /> <br /> तीक्ष्णो मन्देन्धनो धातून् विशोषयति पावकः||५०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> viṣamō dhātuvaiṣamyaṁ karōti viṣāmaṁ pacan| <br /> <br /> tīkṣṇō mandēndhanō dhātūn viśōṣayati pāvakaḥ||50||<br /> <br /> viShamo dhAtuvaiShamyaM karoti viShamaM pacan| <br /> <br /> tIkShNo mandendhano dhAtUn vishoShayati pAvakaH||50||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''vishamagni'' (improper [[agni]]) causes irregularity in digestion and therefore defective formation of ''[[dhatu]]'' takes place whereas, ''tikshanagni'' (excessive [[agni]]) when associated with little quantity of fuel (in the form of food) causes depletion of ''[[dhatu]]'' (tissue elements) [50]<br /> <br /> === ''Samagni'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> युक्तं भुक्तवतो युक्तो धातुसाम्यं समं पचन्|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yuktaṁ bhuktavatō yuktō dhātusāmyaṁ sāmaṁ pacan|<br /> <br /> yuktaM bhuktavato yukto dhAtusAmyaM samaM pacan|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If [[agni]] is ''sama'' i.e. in balanced condition and correct diet regimen (as explained in [Cha.Sa.[[Sutra Sthana]] 5] and [Cha.Sa.[[Vimana Sthana]] 1/21] are also followed then there is proper digestion of food which helps in maintaining proper balance within the ''[[dhatu]]'' [50½]<br /> <br /> === ''Durbala'' (weak) [[agni]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दुर्बलो विदहत्यन्नं तद्यात्यूर्ध्वमधोऽपि वा||५१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> durbalō vidahatyannaṁ tadyātyūrdhvāmadhō'pi vā||51|| <br /> <br /> durbalo vidahatyannaM tadyAtyUrdhvamadho~api vA||51|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Durbala'' (weak) [[agni]] brings about partial digestion of food. These partially digested bio substances then enter in circulation, which may move either in upward or downward direction [51]<br /> <br /> === ''Grahani gada''(diseases of ''grahani'') ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अधस्तु पक्वमामं वा प्रवृत्तं ग्रहणीगदः| <br /> <br /> उच्यते सर्वमेवान्नं प्रायो ह्यस्य विदह्यते||५२|| <br /> <br /> अतिसृष्टं विबद्धं वा द्रवं तदुपदिश्यते| <br /> <br /> तृष्णारोचकवैरस्यप्रसेकतमकान्वितः||५३|| <br /> <br /> शूनपादकरः सास्थिपर्वरुक् छर्दनं ज्वरः| <br /> <br /> लोहामगन्धिस्तिक्ताम्ल [१७] उद्गारश्चास्य जायते||५४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> adhastu pakvamāmaṁ vā pravr̥ttaṁ Grahaṇī gadaḥ| <br /> <br /> ucyatē sarvamēvānnaṁ prāyō hyasya vidahyatē||52||<br /> <br /> atisr̥ṣṭaṁ vibaddhaṁ vā dravaṁ tadupadiśyatē| <br /> <br /> tr̥ṣṇārōcakavairasyaprasēkatāmakānvitaḥ||53|| <br /> <br /> śūnapādakaraḥ sāsthiparvaruk chardanaṁ jvaraḥ| <br /> <br /> lōhāmagandhistiktāmla [17] udgāraścāsya jāyatē||54||<br /> <br /> adhastu pakvamAmaM vA pravRuttaM grahaNIgadaH| <br /> <br /> ucyate sarvamevAnnaM prAyo hyasya vidahyate||52|| <br /> <br /> atisRuShTaM vibaddhaM vA dravaM tadupadishyate| <br /> <br /> tRuShNArocakavairasyaprasekatamakAnvitaH||53|| <br /> <br /> shUnapAdakaraH sAsthiparvaruk chardanaM jvaraH| <br /> <br /> lohAmagandhistiktAmla [17] udgArashcAsya jAyate||54||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When partially digested and partially undigested bio substances moves downward in gastrointestinal tract it produces a disorder known as ''grahanigada''. In this particular stage the entire food material remains in the state of ''vidagdha'' state (partially transformed/sour).<br /> <br /> In this condition the individual may pass stools in excessive quantity or frequency wherein stools may be loose, with thin consistency or in the form of pellet like stool/bound stool (''vibaddham'') and morbid thirst, anorexia, distaste, excessive watering of mouth, blackout, edema of legs and hands, pain in bones and finger joints, vomiting, fever, eructation having either metallic smell or undigested food and having bitter or sour taste are observed [52-54]<br /> <br /> === Premonitory symptoms of ''Grahani gada'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पूर्वरूपं तु तस्येदं तृष्णाऽऽलस्यं बलक्षयः| <br /> <br /> विदाहोऽन्नस्य पाकश्च चिरात् कायस्य गौरवम्||५५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pūrvarūpaṁ tu tasyēdaṁ tr̥ṣṇā''lasyaṁ balakṣayaḥ| <br /> <br /> vidāhō'nnasya pākaśca cirāt kāyasya gauravam||55||<br /> <br /> pUrvarUpaM tu tasyedaM tRuShNA~a~alasyaM balakShayaH| <br /> <br /> vidAho~annasya pAkashca cirAt kAyasya gauravam||55||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Premonitory signs and symptoms are thirst, malaise, diminution of strength, burning sensation; delay in digestion and heaviness in body [55]<br /> <br /> === Functions of ''grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अग्न्यधिष्ठानमन्नस्य ग्रहणाद्ग्रहणी मता| <br /> <br /> नाभेरुपर्यह्यग्निबलेनोपष्टब्धोपबृंहिता [१८] ||५६|| <br /> <br /> अपक्वं धारत्यन्नं पक्वं सृजति पार्श्वतः| <br /> <br /> दुर्बलाग्निबला दुष्टा [१९] त्वाममेव विमुञ्चति||५७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> agnyadhiṣṭhānāmannasya grahaṇādGrahaṇī matā| <br /> <br /> nābhēruparyahyAgnibalēnōpaṣṭabdhōpabr̥ṁhitā [18] ||56|| <br /> <br /> apakvaṁ dhāratyannaṁ pakvaṁ sr̥jati pārśvataḥ| <br /> <br /> durbalāgnibalā duṣṭā [19] tvāmamēva vimuñcati||57||<br /> <br /> agnyadhiShThAnamannasya grahaNAdgrahaNI matA| <br /> <br /> nAbheruparyahyagnibalenopaShTabdhopabRuMhitA [18] ||56|| <br /> <br /> apakvaM dhAratyannaM pakvaM sRujati pArshvataH| <br /> <br /> durbalAgnibalA duShTA [19] tvAmameva vimu~jcati||57||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Grahani'' is seat of [[agni]] and it is so called since it holds/retains the food (for proper digestion and assimilation). It holds the food just above the umbilical region and it is supported and nourished by the [[agni]]. ''Grahani'' with help of [[agni]] holds the undigested food and pushes forward digested food, but when [[agni]] becomes weak and vitiated due to ''vidagdha ahara murchita dosha'' (afflicted by improperly digested food) i.e ''sama dosha''(''[[dosha]]'' associated with ''ama'') it vitiates the ''grahani'' and releases food in the form of ''ama'' i.e. undigested form [56-57]<br /> <br /> === Four types of ''grahani'' disease ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वातात् पित्तात् कफाच्च स्यात्तद्रोगस्त्रिभ्य एव च| <br /> <br /> हेतुं लिङ्गं रूपभेदाञ् शृणु तस्य पृथक् पृथक्||५८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vātāt pittāt kaphācca syāttadrōgastribhya ēva ca| <br /> <br /> hētuṁ liṅgaṁ rūpabhēdāñ śr̥ṇu tasya pr̥thak pr̥thak||58|| <br /> <br /> vAtAt pittAt kaphAcca syAttadrogastribhya eva ca| <br /> <br /> hetuM li~ggaM rUpabhedA~j [21] shRuNu tasya pRuthak pRuthak||58|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Grahani'' is classified into four types viz ''[[vata]]ja, [[pitta]]ja, [[kapha]]ja'' and ''sannipataja''. On the basis of the classification, etiological factors, symptoms and signs are being mentioned one by one [58]<br /> <br /> === Causes of ''[[vata]]ja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कटुतिक्तकषायातिरूक्षशीतलभोजनैः| <br /> <br /> प्रमितानशनात्यध्ववेगनिग्रहमैथुनैः||५९|| <br /> <br /> करोति कुपितो मन्दमग्निं सञ्छाद्य मारुतः [२२] | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭutiktakaṣāyātirūkṣaśītalabhōjanaiḥ| <br /> <br /> pramitānaśanātyadhvavēganigrahāmaithunaiḥ||59|| <br /> <br /> karōti kupitō mandāmAgniṁ sañchādya mārutaḥ [22] | <br /> <br /> kaTutiktakaShAyAtirUkShashItalabhojanaiH| <br /> <br /> pramitAnashanAtyadhvaveganigrahamaithunaiH||59|| <br /> <br /> karoti kupito mandamagniM sa~jchAdya mArutaH [22] | <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Excessive indulgence in diet having ''katu'' (pungent), ''tikta'' (bitter), ''kashaya'' (astringent) dominant food, which is dry in nature or having absorptive or emaciative qualities; cold, chilled or frozen items, eating quantitatively less amount of food, suppression of natural urges and excessive sexual intercourse contribute to aggravation of ''[[vata dosha]]'' which encompass the [[agni]] causing suppression of [[agni]] [59½]<br /> <br /> === Symptoms of ''[[vata]]ja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तस्यान्नं पच्यते दुःखं शुक्तपाकं खराङ्गता||६०||<br /> <br /> कण्ठास्यशोषः क्षुत्तृष्णा तिमिरं कर्णयोः स्वनः| <br /> <br /> पार्श्वोरुवङ्क्षणग्रीवारुजोऽभीक्ष्णं विसूचिका||६१|| <br /> <br /> हृत्पीडा कार्श्यदौर्बल्यं वैरस्यं परिकर्तिका| <br /> <br /> गृद्धिः सर्वरसानां च मनसः सदनं तथा||६२|| <br /> <br /> जीर्णे जीर्यति चाध्मानं भुक्ते स्वास्थ्यमुपैति च| <br /> <br /> स वातगुल्महृद्रोगप्लीहाशङ्की च मानवः||६३|| <br /> <br /> चिरादुःखं द्रवं शुष्कं तन्वामं शब्दफेनवत्| <br /> <br /> पुनः पुनः सृजेद्वर्चः कासश्वासार्दितोऽनिलात्||६४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tasyānnaṁ pacyatē duḥkhaṁ śuktapākaṁ kharāṅgatā||60|| <br /> <br /> kaṇṭhāsyaśōṣaḥ kṣuttr̥ṣṇā timiraṁ karṇayōḥ svanaḥ| <br /> <br /> pārśvōruvaṅkṣaṇagrīvārujō'bhīkṣṇaṁ visūcikā||61|| <br /> <br /> hr̥tpīḍā kārśyadaurbalyaṁ vairasyaṁ parikartikā| <br /> <br /> gr̥ddhiḥ sarvarasānāṁ ca manasaḥ sadanaṁ tathā||62|| <br /> <br /> jīrṇē jīryati cādhmānaṁ bhuktē svāsthyamupaiti ca| <br /> <br /> sa Vātagulmahr̥drōgaplīhāśaṅkī ca mānavaḥ||63|| <br /> <br /> cirāduḥkhaṁ dravaṁ śuṣkaṁ tanvāmaṁ śabdaphēnavat| <br /> <br /> punaḥ punaḥ sr̥jēdvarcaḥ kāsaśvāsārditō'nilāt||64|| <br /> <br /> tasyAnnaM pacyate duHkhaM shuktapAkaM kharA~ggatA||60|| <br /> <br /> kaNThAsyashoShaH kShuttRuShNA timiraM karNayoH svanaH| <br /> <br /> pArshvoruva~gkShaNagrIvArujo~abhIkShNaM visUcikA||61|| <br /> <br /> hRutpIDA kArshyadaurbalyaM vairasyaM parikartikA| <br /> <br /> gRuddhiH sarvarasAnAM ca manasaH sadanaM tathA||62|| <br /> <br /> jIrNe jIryati cAdhmAnaM bhukte svAsthyamupaiti ca| <br /> <br /> sa vAtagulmahRudrogaplIhAsha~gkI ca mAnavaH||63|| <br /> <br /> cirAduHkhaM dravaM shuShkaM tanvAmaM shabdaphenavat| <br /> <br /> punaH punaH sRujedvarcaH kAsashvAsArdito~anilAt||64|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Symptoms of ''vatika grahani'' are as follows:<br /> <br /> Food is not easily digested and gets fermented (leading to sourness), roughness of skin, dryness of throat and mouth, craving for food and thirst is increased, ''timira'' (blurred vision), tinnitus, continuous pain in flanks, thighs, pelvis, neck region, ''vishuchika'' (piercing pain all over the body with vomiting and diarhea), chest pain/discomfort in cardiac region, emaciation, weakness, distaste, cutting pain, craving for sweets, sour and saline food (''madhuradi rasa''), reduced mental strength, ''adhmana'' (distention of abdomen) occurs during digestion and after completion of digestion whereas the patient feels abdominal comfort just after eating the food. <br /> <br /> Patient expresses repeated doubts that he is suffering from ''vatika'' disorders, ''gulma'' (abdominal tumor), heart disease and splenomegaly. <br /> <br /> Stools are evacuated with difficulty and consume time. Feces are either watery, dry, small sized associated with flatus and undigested food. Frequency of stool is increased and patient may suffer from cough and breathing difficulty [60-64]<br /> <br /> === Causes of ''[[pitta]]ja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कट्वजीर्णविदाह्यम्लक्षाराद्यैः पित्तमुल्बणम्| <br /> <br /> अग्निमाप्लावयद्धन्ति [२३] जलं तप्तमिवानलम्||६५|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaṭvajīrṇavidāhyamlakṣārādyaiḥ Pittamulbaṇam| <br /> <br /> Agnimāplāvayaddhanti [23] jalaṁ taptamivānalam||65|| <br /> <br /> kaTvajIrNavidAhyamlakShArAdyaiH pittamulbaNam| <br /> <br /> agnimAplAvayaddhanti [23] jalaM taptamivAnalam||65||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Katu'' (spicy), ''ajeerna'' (undigestable food), ''vidahi'' (food causing eructation), ''amla'' (sour), ''kshara'' (alkali) and other food items which aggravate ''pitta'' are causes for ''[[pitta]]ja grahani''. The aggravated ''[[pitta]]'' hampers the function of [[agni]] similar to condition wherein hot water extinguishes fire [65]<br /> <br /> === Symptoms of ''[[pitta]]ja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सोऽजीर्णं नीलपीताभं पीताभः सार्यते द्रवम्| <br /> <br /> पूत्यम्लोद्गारहृत्कण्ठदाहारुचितृडर्दितः||६६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sō'jīrṇaṁ nīlapītābhaṁ pītābhaḥ sāryatē dravam| <br /> <br /> pūtyamlōdgārahr̥tkaṇṭhadāhārucitr̥ḍarditaḥ||66|| <br /> <br /> so~ajIrNaM nIlapItAbhaM pItAbhaH sAryate dravam| <br /> <br /> pUtyamlodgArahRutkaNThadAhArucitRuDarditaH||66|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The stools have undigested food particles having either bluish-yellowish tinge or yellow in color and are loose/watery. The eructions have foul smell and sour taste, there is burning sensation in the cardiac region (retro-sternal) and throat, anorexia and thirst are the symptoms of ''[[pitta]]ja grahani'' [66]<br /> <br /> === Causes of ''[[kapha]]ja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुर्वतिस्निग्धशीतादिभोजनादतिभोजनात्| <br /> <br /> भुक्तमात्रस्य च स्वप्नाद्धन्त्यग्निं कुपितः कफः||६७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gurvatisnigdhaśītādibhōjanādatibhōjanāt| <br /> <br /> bhuktamātrasya ca svapnāddhantyAgniṁ kupitaḥ kaphaḥ||67|| <br /> <br /> gurvatisnigdhashItAdibhojanAdatibhojanAt| <br /> <br /> bhuktamAtrasya ca svapnAddhantyagniM kupitaH kaphaH||67|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Heavy to digest or excessively unctuous foods, frozen or chilled items or food having cold nature or food which has qualities similar to ''[[kapha]]'', excessive intake of food and sleeping just after the meals hamper the function of [[agni]] and simultaneously vitiates ''[[kapha]]'' [67]<br /> <br /> === Symptoms of ''[[kapha]]ja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तस्यान्नं पच्यते दुःखं हृल्लासच्छर्द्यरोचकाः| <br /> <br /> आस्योपदेहमाधुर्यकासष्ठीवनपीनसाः||६८|| <br /> <br /> हृदयं मन्यते स्त्यानमुदरं स्तिमितं गुरु| <br /> <br /> दुष्टो मधुर उद्गारः सदनं स्त्रीष्वहर्षणम्||६९|| <br /> <br /> भिन्नामश्लेष्मसंसृष्टगुरुवर्चःप्रवर्तनम्| <br /> <br /> अकृशस्यापि दौर्बल्यमालस्यं च कफात्मके||७०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tasyānnaṁ pacyatē duḥkhaṁ hr̥llāsacchardyarōcakāḥ| <br /> <br /> āsyōpadēhamādhuryakāsaṣṭhīvanapīnasāḥ||68|| <br /> <br /> hr̥dayaṁ manyatē styānamudaraṁ stimitaṁ guru| <br /> <br /> duṣṭō madhura udgāraḥ sadanaṁ strīṣvaharṣaṇam||69|| <br /> <br /> bhinnāmaślēṣmasaṁsr̥ṣṭaguruvarcaḥpravartanam| <br /> <br /> akr̥śasyāpi daurbalyamālasyaṁ ca kaphātmakē||70|| <br /> <br /> tasyAnnaM pacyate duHkhaM hRullAsacchardyarocakAH| <br /> <br /> AsyopadehamAdhuryakAsaShThIvanapInasAH||68|| <br /> <br /> hRudayaM manyate styAnamudaraM stimitaM guru| <br /> <br /> duShTo madhura udgAraH sadanaM strIShvaharShaNam||69|| <br /> <br /> bhinnAmashleShmasaMsRuShTaguruvarcaHpravartanam| <br /> <br /> akRushasyApi daurbalyamAlasyaM ca kaphAtmake||70|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Food is digested with difficulty, nausea, vomiting and anorexia are its symptoms. The other symptoms are feeling of coated mouth and sweet taste, has cough, increased tendency to spit, ''pinasa'' (nasal discharge), feeling of heaviness in chest, feeling as if there is no movement in abdomen, heavy abdomen, eructation with foul smelling and sweet taste; patient does not feel enthusiastic and there is suppression of libido. Stools are mixed with undigested items and mucous and are heavy; although patient is not emaciated still he feels weakness and laziness [68-70]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यश्चाग्निः पूर्वमुद्दिष्टो रोगानीके चतुर्विधः| <br /> <br /> तं चापि ग्रहणीदोषं समवर्जं प्रचक्ष्महे||७१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yaścāgniḥ pūrvamuddiṣṭō rōgānīkē caturvidhaḥ| <br /> <br /> taṁ cāpi Grahaṇī dōṣaṁ sāmavarjaṁ pracakṣmahē||71|| <br /> <br /> yashcAgniH pUrvamuddiShTo rogAnIke caturvidhaH| <br /> <br /> taM cApi grahaNIdoShaM samavarjaM pracakShmahe||71|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Four types of [[agni]] have been previously explained in [[Roganika Vimana]]. Except ''samagni'' other three types of [[agni]] contribute to the ''grahani dosha'' [71]<br /> <br /> === ''Sannipataja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पृथग्वातादिनिर्दिष्टहेतुलिङ्गसमागमे| <br /> <br /> त्रिदोषं निर्दिशेत्तेषां भेषजं [२४] शृण्वतः परम्||७२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pr̥thagvātādinirdiṣṭahētuliṅgasamāgamē| <br /> <br /> tridōṣaṁ nirdiśēttēṣāṁ bhēṣajaṁ [24] <br /> <br /> śr̥ṇVātaḥ param||72||<br /> <br /> pRuthagvAtAdinirdiShTahetuli~ggasamAgame| <br /> <br /> tridoShaM nirdishetteShAM bheShajaM [24] <br /> <br /> shRuNvataH param||72||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Sannipataja grahani'' occurs by simultaneous vitiation of ''[[vata]], [[pitta]]'' and ''[[kapha]]''. In such conditions etiological factors, symptoms and signs are of all the three ''[[dosha]]'' appear. Hereafter treatment of ''grahanidosha'' is expounded [72]<br /> <br /> === ''[[Vamana]]'' in ''grahanidosha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ग्रहणीमाश्रितं दोषं विदग्धाहारमूर्च्छितम्| <br /> <br /> सविष्टम्भप्रसेकार्तिविदाहारुचिगौरवैः||७३||<br /> <br /> आमलिङ्गान्वितं दृष्ट्वा सुखोष्णेनाम्बुनोद्धरेत्| <br /> <br /> फलानां वा कषायेण पिप्पलीसर्षपैस्तथा||७४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> Grahaṇī māśritaṁ dōṣaṁ vidagdhāhāramūrcchitam| <br /> <br /> saviṣṭambhaprasēkārtividāhārucigauravaiḥ||73|| <br /> <br /> āmaliṅgānvitaṁ dr̥ṣṭvā sukhōṣṇēnāmbunōddharēt| <br /> <br /> phalānāṁ vā kaṣāyēṇa pippalīsarṣapaistathā||74||<br /> <br /> grahaNImAshritaM doShaM vidagdhAhAramUrcchitam| <br /> <br /> saviShTambhaprasekArtividAhArucigauravaiH||73|| <br /> <br /> Amali~ggAnvitaM dRuShTvA sukhoShNenAmbunoddharet| <br /> <br /> phalAnAM vA kaShAyeNa pippalIsarShapaistathA||74|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> When the ''[[dosha]]s'' are located in ''grahani'' and are associated with incomplete digested food then ''vishtambha'' (constipation), excessive salivation, bodyache, burning sensation, anorexia and heaviness is felt by patient which are symptoms of ''ama'' and in such a condition ''[[vamana]]'' (emetic therapy) with lukewarm water or with decoction of ''madanaphala'' (Randia spinosa), ''pippali'' (Piper longum) and ''sarshapa'' (Brassica campestris) should be administered [73-74]<br /> <br /> === Treatment of ''leena [[dosha]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> लीनं पक्वाशयस्थं वाऽऽप्यामं स्राव्यं सदीपनैः| <br /> <br /> शरीरानुगते सामे रसे लङ्घनपाचनम्||७५|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> līnaṁ pakvāśayasthaṁ vā''pyāmaṁ srāvyaṁ sadīpanaiḥ| <br /> <br /> śarīrānugatē sāmē rasē laṅghanapācanam||75|| <br /> <br /> lInaM pakvAshayasthaM vA~a~apyAmaM srAvyaM sadIpanaiH| <br /> <br /> sharIrAnugate sAme rase la~gghanapAcanam||75|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the ''ama'' is in ''pakvashaya'' and in ''anutklishtha'' (stuck, not ready to come out) condition then ''stravana'' (increasing secretion) with ''[[deepana]] dravyas'' should be administered whereas if ama gets absorbed along with ''[[rasa dhatu]]'' and if it pervades throughout the body then ''[[langhana]]'' and ''[[pachana]]'' should be advised [75]<br /> <br /> === ''Panchakoladi shritam and peya'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विशुद्धामाशयायास्मै पञ्चकोलादिभिः शृतम्| <br /> <br /> दद्यात् पेयादि लघ्वन्नं पुनर्योगांश्च दीपनान्||७६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> viśuddhāmāśayāyāsmai pañcakōlādibhiḥ śr̥tam| <br /> <br /> dadyāt pēyādi laghvannaṁ punaryōgāṁśca dīpanān||76|| <br /> <br /> vishuddhAmAshayAyAsmai pa~jcakolAdibhiH shRutam| <br /> <br /> dadyAt peyAdi laghvannaM punaryogAMshca dIpanAn||76|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After cleansing of ''amashaya'', liquid gruel of rice (''peya'') fortified with ''panchakola'' etc. drugs should be administered. Light and easy to digest food along with ''[[deepana]]'' drugs may be given [76]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ज्ञात्वा तु परिपक्वामं मारुतग्रहणीगदम्| <br /> <br /> दीपनीययुतं सर्पिः पाययेताल्पशो भिषक्||७७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> jñātvā tu paripakvāmaṁ mārutaGrahaṇī gadam| <br /> <br /> dīpanīyayutaṁ sarpiḥ pāyayētālpaśō bhiṣak||77|| <br /> <br /> j~jAtvA tu paripakvAmaM mArutagrahaNIgadam| <br /> <br /> dIpanIyayutaM sarpiH pAyayetAlpasho bhiShak||77|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In patients with ''[[vata]]ja grahani'' after ascertaining that ''ama'' is digested, medicated ghee starting with very minimum quantity prepared from ''deepaneeya gana'' be administered [Cha.Sa.[[Sutra Sthana ]]4/9/6]- [77]<br /> <br /> === ''Niruha [[basti]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> किञ्चित्सन्धुक्षिते त्वग्नौ सक्तविण्मूत्रमारुतम्| <br /> <br /> द्व्यहं त्र्यहं वा संस्नेह्य स्विन्नाभ्यक्तं निरूहयेत्||७८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kiñcitsandhukṣitē tvagnau saktaviṇmūtramārutam| <br /> <br /> dvyahaṁ tryahaṁ vā saṁsnēhya svinnābhyaktaṁ nirūhayēt||78|| <br /> <br /> ki~jcitsandhukShite tvagnau saktaviNmUtramArutam| <br /> <br /> dvyahaM tryahaM vA saMsnehya svinnAbhyaktaM nirUhayet||78|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As stimulation of [[agni]] is observed and still if patient finds difficulty in passing stool, urine and flatus then in such condition every two or three days ''niruha [[basti]]'' should be administered after proper ''[[snehana]]'' and ''[[swedana]]'' [78]<br /> <br /> === ''[[Virechana]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत एरण्डतैलेन सर्पिषा तैल्वकेन वा| <br /> <br /> सक्षारेणानिले शान्ते स्रस्तदोषं विरेचयेत्||७९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tata ēraṇḍatailēna sarpiṣā tailvakēna vā| <br /> <br /> sakṣārēṇānilē śāntē srastadōṣaṁ virēcayēt||79|| <br /> <br /> tata eraNDatailena sarpiShA tailvakena vA| <br /> <br /> sakShAreNAnile shAnte srastadoShaM virecayet||79|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After ''niruha'', the ''strasta dosha'' (''[[dosha]]'' ready to come out) should be cleaned with purgative drugs like ''eranda taila'' (castor oil) or ''tilvaka ghrita'' mixed with ''kshara'' (medicine with alkaline nature) [79]<br /> <br /> === ''Anuvasana [[basti]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शुद्धं रूक्षाशयं बद्धवर्चसं चानुवासयेत्| <br /> <br /> दीपनीयाम्लवातघ्नसिद्धातैलेन मात्रया||८०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śuddhaṁ rūkṣāśayaṁ baddhavarcasaṁ cānuvāsayēt| <br /> <br /> dīpanīyāmlaVātaghnasiddhātailēna mātrayā||80|| <br /> <br /> shuddhaM rUkShAshayaM baddhavarcasaM cAnuvAsayet| <br /> <br /> dIpanIyAmlavAtaghnasiddhAtailena mAtrayA||80|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After ''[[shodhana]]'' of intestine if ''rukshata'' and ''baddha'' (pellet-like) stools are seen then ''anuvasana [[basti]]'' with ''taila'' fortified with ''[[deepana]]'' drugs having sour and ''[[vata]]'' alleviating action may be administered [80]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> निरूढं च विरिक्तं च सम्यक् चैवानुवासितम्| <br /> <br /> लघ्वन्नं प्रतिसम्भुक्तं सर्पिरभ्यासयेत् पुनः||८१||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nirūḍhaṁ ca viriktaṁ ca samyak caivānuvāsitam| <br /> <br /> laghvannaṁ pratisambhuktaṁ sarpirabhyāsayēt punaḥ||81||<br /> <br /> nirUDhaM ca viriktaM ca samyak caivAnuvAsitam| <br /> <br /> laghvannaM pratisambhuktaM sarpirabhyAsayet punaH||81||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After appropriate administration of ''niruha, [[virechana]]'' and ''anuvasana'', light diet should be taken daily and ghee should be taken repeatedly [81]<br /> <br /> === ''Dashamooladya ghrita''===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्वे पञ्चमूले सरलं देवदारु सनागरम्| <br /> <br /> पिप्पलीं पिप्पलीमूलं चित्रकं हस्तिपिप्पलीम्||८२|| <br /> <br /> शणबीजं यवान् कोलन् कुलत्थान् सुषवीं तथा [२७] |<br /> <br /> पाचयेदारनालेन दध्ना सौवीरकेण वा||८३|| <br /> <br /> चतुर्भागावशेषेण पचेत्तेन घृताढकम्| <br /> <br /> स्वर्जिकायावशूकाख्यौ क्षारौ दत्त्वा च युक्तितः||८४|| <br /> <br /> सैन्धवौद्भिदसामुद्रबिडानां रोमकस्य च| <br /> <br /> ससौवर्चलपाक्यानां भागान्द्विपलिकान् पृथक्||८५|| <br /> <br /> विनीय चूर्णितान् तस्मात् पाययेत् प्रसृतं बुधः| <br /> <br /> करोत्यग्निं बलं वर्णं वातघ्नं भुक्तपाचनम्||८६|| <br /> <br /> इति दशमूलाद्यं घृतम्<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dvē pañcamūlē saralaṁ dēvadāru sanāgaram| <br /> <br /> pippalīṁ pippalīmūlaṁ citrakaṁ hastipippalīm||82|| <br /> <br /> śaṇabījaṁ yavān kōlan kulatthān suṣavīṁ tathā [27] | <br /> <br /> pācayēdāranālēna dadhnā sauvīrakēṇa vā||83|| <br /> <br /> caturbhāgāvaśēṣēṇa pacēttēna ghr̥tāḍhakam| <br /> <br /> svarjikāyāvaśūkākhyau kṣārau dattvā ca yuktitaḥ||84|| <br /> <br /> saindhavaudbhidasāmudrabiḍānāṁ rōmakasya ca| <br /> <br /> sasauvarcalapākyānāṁ bhāgāndvipalikān pr̥thak||85|| <br /> <br /> vinīya cūrṇitān tasmāt pāyayēt prasr̥taṁ budhaḥ| <br /> <br /> karōtyAgniṁ balaṁ varṇaṁ Vātaghnaṁ bhuktapācanam||86|| <br /> <br /> iti daśamūlādyaṁ ghr̥tam<br /> <br /> dve pa~jcamUle saralaM devadAru sanAgaram| <br /> <br /> pippalIM pippalImUlaM citrakaM hastipippalIm||82|| <br /> <br /> shaNabIjaM yavAn kolan kulatthAn suShavIM tathA [27] | <br /> <br /> pAcayedAranAlena dadhnA sauvIrakeNa vA||83|| <br /> <br /> caturbhAgAvasheSheNa pacettena ghRutADhakam| <br /> <br /> svarjikAyAvashUkAkhyau kShArau dattvA ca yuktitaH||84|| <br /> <br /> saindhavaudbhidasAmudrabiDAnAM romakasya ca| <br /> <br /> sasauvarcalapAkyAnAM bhAgAndvipalikAn pRuthak||85|| <br /> <br /> vinIya cUrNitAn tasmAt pAyayet prasRutaM budhaH| <br /> <br /> karotyagniM balaM varNaM vAtaghnaM bhuktapAcanam||86|| <br /> <br /> iti dashamUlAdyaM ghRutam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Boil the ''svarasa'' of two ''panchamoola'' (''brihat'' and ''laghu''), ''sarala'' ((''trivrita'') Operculina turpethum), ''devadaru'' (Cedrus deodara), ''nagara'' (Zingiber officinale), ''pippali'' (Piper longum), ''pippalimoola, chitraka'' (Plumbago zeylanica), ''gajapippali'' (Piper retofractum), ''sanabeeja'' (seeds of Crotalaria juncea), barley, ''kola, kulatta'' and ''susavi'' (Woodfordia fruticosa) with ''aranala, dadhimanda'' or ''sauviraka''. After one fourth reductions add one ''adhaka'' (3.073 kg) of ghee and ''svarjikakshara'' and ''yavashukakshara'' as per ''yukti pramana'' i.e. either in small quantity or at the time of ''ghrita siddhi lakshana'' alongwith ''saindhava'' (rock salt), ''audbhida'' (salts derived from plants), ''samudra'' (table salt), ''bidha'' (red granular salt), ''romaka, sauvarchala'' and ''pakya'' (''pakaja'') types of salt in two ''pala'' quantity each (96 gm each). After preparation, it may be administered up to one ''prasrita'' i.e. 96 gm. It increases [[agni]], strength and complexion and helps in alleviation of ''[[vata]]'' and thus digestion of food [82-86]<br /> <br /> === ''Tryushanadya ghrita'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्र्यूषणत्रिफलाकल्के बिल्वमात्रे गुडात् पले| <br /> <br /> सर्पिषोऽष्टपलं पक्त्वा मात्रां मन्दानलः पिबेत्||८७|| <br /> <br /> इति त्र्यूषणाद्यं घृतम्<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tryūṣaṇatriphalākalkē bilvamātrē guḍāt palē| <br /> <br /> sarpiṣō'ṣṭapalaṁ paktvā mātrāṁ mandānalaḥ pibēt||87|| <br /> <br /> iti tryūṣaṇādyaṁ ghr̥tam<br /> <br /> tryUShaNatriphalAkalke bilvamAtre guDAt pale| <br /> <br /> sarpiSho~aShTapalaM paktvA mAtrAM mandAnalaH pibet||87|| <br /> <br /> iti tryUShaNAdyaM ghRutam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Prepare paste of ''trikatu'' and ''triphala'' in quantity of one ''bilva'' and add one ''pala'' (48g) of jaggery and do ''sneha siddhi'' by adding eight ''palas'' (384 gm) of ghee. This medicated ''ghrita'' is indicated in ''mandagni'' i.e. low digestive power [87]<br /> <br /> === ''Panchamooladya ghrita'' and ''choorna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पञ्चमूलाभयाव्योषपिप्पलीमूलसैन्धवैः| <br /> <br /> रास्नाक्षारद्वयाजाजीविडङ्गशटिभिर्घृतम्||८८|| <br /> <br /> शुक्तेन मातुलुङ्गस्य स्वरसेनार्द्रकस्य च| <br /> <br /> शुष्कमूलककोलाम्बुचुक्रिकादाडिमस्य च||८९|| <br /> <br /> तक्रमस्तुसुरामण्डसौवीरकतुषोदकैः| <br /> <br /> काञ्जिकेन च तत् पक्वमग्निदीप्तिकरं परम्||९०|| <br /> <br /> शूलगुल्मोदरश्वासकासानिलकफापहम्| <br /> <br /> सबीजपूरकरसं सिद्धं वा पाययेद्घृतम्||९१|| <br /> <br /> सिद्धमभ्यञ्जनार्थं च तैलमेतैः प्रयोजयेत्| <br /> <br /> एतेषामौषधानां वा पिबेच्चूर्णं सुखाम्बुना||९२|| <br /> <br /> वाते श्लेष्मावृते सामे कफे वा वायुनोद्धते| <br /> <br /> दद्याच्चूर्णं पाचनार्थमग्निसन्दीपनं परम्||९३|| <br /> <br /> इति पञ्चमूलाद्यं घृतं चूर्णं च<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pañcamūlābhayāvyōṣapippalīmūlasaindhavaiḥ| <br /> <br /> rāsnākṣāradvayājājīviḍaṅgaśaṭibhirghr̥tam||88|| <br /> <br /> śuktēna mātuluṅgasya svarasēnārdrakasya ca| <br /> <br /> śuṣkamūlakakōlāmbucukrikādāḍimasya ca||89|| <br /> <br /> takrāmastusurāmaṇḍasauvīrakatuṣōdakaiḥ| <br /> <br /> kāñjikēna ca tat pakvāmAgnidīptikaraṁ param||90|| <br /> <br /> śūlagulmōdaraśvāsakāsānilakaphāpaham| <br /> <br /> sabījapūrakarasaṁ siddhaṁ vā pāyayēdghr̥tam||91|| <br /> <br /> siddhāmabhyañjanārthaṁ ca tailamētaiḥ prayōjayēt| <br /> <br /> ētēṣāmauṣadhānāṁ vā pibēccūrṇaṁ sukhāmbunā||92|| <br /> <br /> vātē ślēṣmāvr̥tē sāmē kaphē vā Vātanōddhatē| <br /> <br /> dadyāccūrṇaṁ pācanārthāmAgnisandīpanaṁ param||93||<br /> <br /> iti pañcamūlādyaṁ ghr̥taṁ cūrṇaṁ ca<br /> <br /> pa~jcamUlAbhayAvyoShapippalImUlasaindhavaiH| <br /> <br /> rAsnAkShAradvayAjAjIviDa~ggashaTibhirghRutam||88|| <br /> <br /> shuktena mAtulu~ggasya svarasenArdrakasya ca| <br /> <br /> shuShkamUlakakolAmbucukrikAdADimasya ca||89|| <br /> <br /> takramastusurAmaNDasauvIrakatuShodakaiH| <br /> <br /> kA~jjikena ca tat pakvamagnidIptikaraM param||90|| <br /> <br /> shUlagulmodarashvAsakAsAnilakaphApaham| <br /> <br /> sabIjapUrakarasaM siddhaM vA pAyayedghRutam||91|| <br /> <br /> siddhamabhya~jjanArthaM ca tailametaiH prayojayet| <br /> <br /> eteShAmauShadhAnAM vA pibeccUrNaM sukhAmbunA||92|| <br /> <br /> vAte shleShmAvRute sAme kaphe vA vAyunoddhate| <br /> <br /> dadyAccUrNaM pAcanArthamagnisandIpanaM param||93|| <br /> <br /> iti pa~jcamUlAdyaM ghRutaM cUrNaM ca<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make paste of ''panchamoola'' (''bilva, shyonaka, gambhari, patala'' and ''gambharika''), ''abhaya'', ''trikatu, pippalimoola, saindhava, rasna,'' two ''kshara'' (''sarjika'' and ''yavakshara''), ''ajaji, vidanga'' and ''sati'' and prepare medicated ghee with ''sukta,'' juice of ''matulunga'' and ''ardraka, suṣkamoolaka, kolambu, chukrika,'' pomengranate, butter milk, ''mastu'' (supplement liquid portion in the curd/yoghurt), ''suramanda'' (indigenous beer beverage prepared from fermented cereals) ''sauviraka'' (acidic fermented liquid obtained from wheat), ''tushodaka'' (fermented liquid using the coarse grains of barley) and ''kanji'' (fermented liquid). <br /> <br /> The medicated ghee helps in digestion and increase strength of [[agni]] and cures colicky pain, ''gulma, udara'', asthma and cough. It also pacifies ''[[vata]]'' and ''[[kapha]]''. ''Beejapuraka svarasa'' can also be used for ''sneha siddhi''.<br /> <br /> ''Taila siddhi'' with above medicine may be used for ''abhyanga'' (massage) and the ''choorna'' used in above preparation may be taken with lukewarm water.<br /> <br /> In condition such as ''kapha avrite vata'' (''[[vata]]'' occluded by ''[[kapha]]''), ''sama [[kapha]]'' and ''[[vata]]'' aggravated due to ''[[kapha]]'' give the above ''choorna'' for digestion and to stimulate [[agni]]. The medicine is known as ''panchamooladyam ghritam choornam'' [88-93]<br /> <br /> === Examination of feces ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मज्जत्यामा गुरुत्वाद्विट् पक्वा तूत्प्लवते जले| <br /> <br /> विनाऽतिद्रवसङ्घातशैत्यश्लेष्मप्रदूषणात्||९४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> majjatyāmā gurutvādviṭ pakvā tūtplavatē jalē| <br /> <br /> vinā'tidravasaṅghātaśaityaślēṣmapradūṣaṇāt||94|| <br /> <br /> majjatyAmA gurutvAdviT pakvA tUtplavate jale| <br /> <br /> vinA~atidravasa~gghAtashaityashleShmapradUShaNAt||94|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Sama mala'' (stools) sinks into water due to ''gurutva'' (heaviness) of ''ama'' whereas ''pakva'' or ''nirama mala'' floats over the water; provided the stools consistency is not watery or not very compact and if not vitiated by ''sheeta [[guna]]'' and ''[[kapha]]'' [94]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> परीक्ष्यैवं पुरा सामं निरामं चामदोषिणम्| <br /> <br /> विधिनोपाचरेत् सम्यक् पाचनेनेतरेण वा||९५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> parīkṣyaivaṁ purā sāmaṁ nirāmaṁ cāmadōṣiṇam| <br /> <br /> vidhinōpācarēt samyak pācanēnētarēṇa vā||95||<br /> <br /> parIkShyaivaM purA sAmaM nirAmaM cAmadoShiNam| <br /> <br /> vidhinopAcaret samyak pAcanenetareNa vA||95||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Patient should be evaluated for ''amadosha'' whether ''samata'' or ''niramta'' is present or not and then appropriately treated with ''[[pachana]]'' etc. treatment [95]<br /> <br /> === ''Chitrakadya gutika'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चित्रकं पिप्पलीमूलं द्वौ क्षारौ लवणानि च| <br /> <br /> व्योषं हिङ्ग्वजमोदां च चव्यं चैकत्र चूर्णयेत्||९६|| <br /> <br /> गुटिका मातुलुङ्गस्य दाडिमस्य रसेन वा| <br /> <br /> कृता विपाचयत्यामं दीपयत्याशु चानलम्||९७|| <br /> <br /> इति चित्रकाद्या गुटिका<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> citrakaṁ pippalīmūlaṁ dvau kṣārau lavaṇāni ca| <br /> <br /> vyōṣaṁ hiṅgvajamōdāṁ ca cavyaṁ caikatra cūrṇayēt||96|| <br /> <br /> guṭikā mātuluṅgasya dāḍimasya rasēna vā| <br /> <br /> kr̥tā vipācayatyāmaṁ dīpayatyāśu cālanam||97|| <br /> <br /> iti citrakādyā guṭikā<br /> <br /> citrakaM pippalImUlaM dvau kShArau lavaNAni ca| <br /> <br /> vyoShaM hi~ggvajamodAM ca cavyaM caikatra cUrNayet||96|| <br /> <br /> guTikA mAtulu~ggasya dADimasya rasena vA| <br /> <br /> kRutA vipAcayatyAmaM dIpayatyAshu cAlanam||97||<br /> <br /> iti citrakAdyA guTikA<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Chitraka, pippalimoola,'' two ''kshara'' (''yavakshara'' and ''sarjikshara''), salt, ''trikatu, hingu, ajamoda'' and ''chavya'' are mixed together and trichurated with either ''matulunga svarasa'' or ''dadima svarasa'' and tablets are prepared. This ''chitrakadya guthi'' is useful for digestion of ''ama'' and stimulation of the [[agni]] [96-97]<br /> <br /> === Recipes for ''[[pachana]]'' of ''ama'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नागरातिविषामुस्तक्वाथः स्यादामपाचनः| <br /> <br /> मुस्तान्तकल्कः पथ्या वा नागरं चोष्णवारिणा||९८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nāgarātiviṣāmustakvāthaḥ syādāmapācanaḥ| <br /> <br /> mustāntakalkaḥ pathyā vā nāgaraṁ cōṣṇavāriṇā||98|| <br /> <br /> nAgarAtiviShAmustakvAthaH syAdAmapAcanaH| <br /> <br /> mustAntakalkaH pathyA vA nAgaraM coShNavAriNA||98|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Shunthi, ativisha'' and ''musta'' decoction helps in ''[[pachana]]'' of ''ama''. ''Kalka'' (paste) of ''shunthi, ativisha'' and ''musta'' or ''haritaki'' or ''shunthi'' alongwith warm water also does ''ama pachana'' [98]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> देवदारुवचामुस्तनागरातिविषाभयाः| <br /> <br /> वारुण्यामासुतास्तोये कोष्णे वाऽलवणाः पिबेत्||९९||<br /> <br /> वर्चस्यामे सशूले च पिबेद्वा दाडिमाम्बुना| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dēvadāruvacāmustanāgarātiviṣābhayāḥ| <br /> <br /> vāruṇyāmāsutāstōyē kōṣṇē vā'lavaṇāḥ pibēt||99||<br /> <br /> varcasyāmē saśūlē ca pibēdvā dāḍimāmbunā|<br /> <br /> devadAruvacAmustanAgarAtiviShAbhayAH| <br /> <br /> vAruNyAmAsutAstoye koShNe vA~alavaNAH pibet||99|| <br /> <br /> varcasyAme sashUle ca pibedvA dADimAmbunA| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Soak powder of ''devadaru, vacha, musta, nagara, ativisha'' and ''haritaki'' in ''varuni'' (fermented liquid obtained from palm trees like dates) and take with warm water without adding salt or be taken with juice of ''dadima'' in condition wherein there is colicky pain along with mucus or undigested food in stool [99-99½]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विडेन [२९] लवणं पिष्टं बिल्वं चित्रकनागरम्||१००|| <br /> <br /> सामे वा सकफे वाते कोष्ठशूलकरे पिबेत्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> viḍēna [29] lavaṇaṁ piṣṭaṁ bilvaṁ citrakanāgaram||100|| <br /> <br /> sāmē vā sakaphē vātē kōṣṭhaśūlakarē pibēt| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Paste of ''bilva, chitraka'' and ''nagara'' should be added with ''vida lavana'' and administered in ''sama'' stool or mucus in stool and pain in abdomen due to [[vata]] aggravation [100]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कलिङ्गहिङ्ग्वतिविषावचासौवर्चलाभयाः||१०१|| <br /> <br /> छर्द्यर्शोग्रन्थिशूलेषु पिबेदुष्णेन वारिणा| <br /> <br /> पथ्यासौवर्चलाजाजीचूर्णं मरिचसंयुतम्||१०२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaliṅgahiṅgvativiṣāvacāsauvarcalābhayāḥ||101|| <br /> <br /> chardyarśōgranthiśūlēṣu pibēduṣṇēna vāriṇā| <br /> <br /> pathyāsauvarcalājājīcūrṇaṁ maricasaṁyutam||102|| <br /> <br /> viDena [29] lavaNaM piShTaM bilvaM citrakanAgaram||100|| <br /> <br /> sAme vA sakaphe vAte koShThashUlakare pibet| <br /> <br /> kali~ggahi~ggvativiShAvacAsauvarcalAbhayAH||101|| <br /> <br /> chardyarshogranthishUleShu pibeduShNena vAriNA| <br /> <br /> pathyAsauvarcalAjAjIcUrNaM maricasaMyutam||102|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Kalinga, hingu, ativisha, vacha, sauvarchala'' and ''haritaki'' with warm water is useful in vomiting, ''arshogranthi'' (analpolyp with pellet stool) and pain in abdomen. Similarly, combination of ''haritaki, sauvarchala'' and ''ajaji'' along with maricha can be used for same condition [101-102]<br /> <br /> === Recipe for ''[[pitta]]-[[kapha]] grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अभयां पिप्पलीमूलं वचां कटुकरोहिणीम्| <br /> <br /> पाठां वत्सकबीजानि चित्रकं विश्वभेषजम्||१०३|| <br /> <br /> पिबेन्निष्क्वाथ्य चूर्णं वा कृत्वा कोष्णेन वारिणा| <br /> <br /> पित्तश्लेष्माभिभृतायां ग्रहण्यां शूलनुद्धितम्||१०४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> abhayāṁ pippalīmūlaṁ vacāṁ kaṭukarōhiṇīm| <br /> <br /> pāṭhāṁ vatsakabījāni citrakaṁ viśvabhēṣajam||103|| <br /> <br /> pibēnniṣkvāthya cūrṇaṁ vā kr̥tvā kōṣṇēna vāriṇā| <br /> <br /> Pitta ślēṣmābhibhr̥tāyāṁ grahaṇyāṁ śūlanuddhitam||104|| <br /> <br /> abhayAM pippalImUlaM vacAM kaTukarohiNIm| <br /> <br /> pAThAM vatsakabIjAni citrakaM vishvabheShajam||103|| <br /> <br /> pibenniShkvAthya cUrNaM vA kRutvA koShNena vAriNA| <br /> <br /> pittashleShmAbhibhRutAyAM grahaNyAM shUlanuddhitam||104|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Decoction of the ''haritaki, pippalimoola, vacha, katukarohineem, patha,'' seeds of ''kutaja, chitraka, vishvabheshaja'' (''sunthi'') or ''choorna'' of the above contents should be administered with warm water. It is helpful when colic pain is associated with ''[[pitta]]-[[kapha]]'' dominant ''grahani'' [103-104]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सामे सातिविषं व्योषं लवणक्षारहिङ्गु च| <br /> <br /> निःक्वाथ्य पाययेच्चूर्णं कृत्वा वा कोष्णवारिणा||१०५|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sāmē sātiviṣaṁ vyōṣaṁ lavaṇakṣārahiṅgu ca| <br /> <br /> niḥkvāthya pāyayēccūrṇaṁ kr̥tvā vā kōṣṇavāriṇā||105|| <br /> <br /> sAme sAtiviShaM vyoShaM lavaNakShArahi~ggu ca| <br /> <br /> niHkvAthya pAyayeccUrNaM kRutvA vA koShNavAriNA||105|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''ama'' condition, decoction of ''ativisha, trikatu, lavana, kshara'' (''yavakshara'') and ''hingu'' may be given or powders of above medicines with warm water may be administered [105]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पिप्पलीं नागरं पाठां सारिवां बृहतीद्वयम्| <br /> <br /> चित्रकं कौटजं बीजं लवणान्यथ पञ्च च||१०६|| <br /> <br /> तच्चूर्णं सयवक्षारं दध्युष्णाम्बुसुरादिभिः| <br /> <br /> पिबेदग्निविवृद्ध्यर्थं कोष्ठवातहरं नरः||१०७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pippalīṁ nāgaraṁ pāṭhāṁ sārivāṁ br̥hatīdvayam| <br /> <br /> citrakaṁ kauṭajaṁ bījaṁ lavaṇānyatha pañca ca||106|| <br /> <br /> taccūrṇaṁ sayavakṣāraṁ dadhyuṣṇāmbusurādibhiḥ| <br /> <br /> pibēdAgnivivr̥ddhyarthaṁ kōṣṭhaVātaharaṁ naraḥ||107|| <br /> <br /> pippalIM nAgaraM pAThAM sArivAM bRuhatIdvayam| <br /> <br /> citrakaM kauTajaM bIjaM lavaNAnyatha pa~jca ca||106|| <br /> <br /> taccUrNaM sayavakShAraM dadhyuShNAmbusurAdibhiH| <br /> <br /> pibedagnivivRuddhyarthaM koShThavAtaharaM naraH||107|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Choorna'' of ''pippali, nagara, patha, sariva, brihatidvayam'' (''brihati, kantakari''), ''chitraka,'' seeds of ''kutaja'', five types of ''lavana'', along with ''yavakshara,'' curd, hot water and different types of fermented liquids such as ''kanji, sauviraka'' etc is taken for increasing the power of [[agni]] and to eliminate the ''[[vata]]'' in abdomen [106-107]<br /> <br /> === ''Marichadya choorna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मरिचं कुञ्चिकाम्बष्ठावृक्षाम्लाः कुडवाः पृथक्| <br /> <br /> पलानि [३०] दश चाम्लस्य वेतसस्य पलार्धिकम्||१०८|| <br /> <br /> सौवर्चलं बिडं पाक्यं यवक्षारः ससैन्धवः| <br /> <br /> शटीपुष्करमूलानि हिङ्गु हिङ्गुशिवाटिका||१०९|| <br /> <br /> तत् सर्वमेकतः सूक्ष्मं चूर्णं कृत्वा प्रयोजयेत्| <br /> <br /> हितं वाताभिभूतायां ग्रहण्यामरुचौ तथा||११०|| <br /> <br /> इति मरिचाद्यं चूर्णम्<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> maricaṁ kuñcikāmbaṣṭhāvr̥kṣāmlāḥ kuḍavāḥ pr̥thak| <br /> <br /> palāni [30] daśa cāmlasya vētasasya palārdhikam||108|| <br /> <br /> sauvarcalaṁ biḍaṁ pākyaṁ yavakṣāraḥ sasaindhavaḥ| <br /> <br /> śaṭīpuṣkaramūlāni hiṅgu hiṅguśivāṭikā||109|| <br /> <br /> tat sarvamēkataḥ sūkṣmaṁ cūrṇaṁ kr̥tvā prayōjayēt| <br /> <br /> hitaṁ vātābhibhūtāyāṁ grahaṇyāmarucau tathā||110|| <br /> <br /> iti maricādyaṁ cūrṇam<br /> <br /> maricaM ku~jcikAmbaShThAvRukShAmlAH kuDavAH pRuthak| <br /> <br /> palAni [30] dasha cAmlasya vetasasya palArdhikam||108|| <br /> <br /> sauvarcalaM biDaM pAkyaM yavakShAraH sasaindhavaH| <br /> <br /> shaTIpuShkaramUlAni hi~ggu hi~ggushivATikA||109|| <br /> <br /> tat sarvamekataH sUkShmaM cUrNaM kRutvA prayojayet| <br /> <br /> hitaM vAtAbhibhUtAyAM grahaNyAmarucau tathA||110|| <br /> <br /> iti maricAdyaM cUrNam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Marichadyam choornam'' contains one ''kudava'' (192 gm) of ''maricha, kunchika, ambashtha'' (''patha''), ''vrikshamlah'', ten ''pala'' (480 gm) of ''amlavetas,'' half ''pala'' (24 gm) each of ''sauvarchala, bidha, pakya, yavakshara, saindhava, sathi, pushkaramoola, hingu'' and ''hingushivatika'' (''vamsapatri''). It is useful in ''[[vata]]'' dominant ''grahani'' and anorexia [108-110]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चतुर्णां प्रस्थमम्लानां त्र्यूषणस्य पलत्रयम्| <br /> <br /> लवणानां च चत्वारि शर्करायाः पलाष्टकम्| <br /> <br /> सञ्चूर्ण्य शाकसूपान्नरागादिष्ववचारयेत्||१११|| <br /> <br /> कासाजीर्णारुचिश्वासाहृत्पाण्ड्वामयशूलनुत्|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> caturṇāṁ prasthāmamlānāṁ tryūṣaṇasya palatrayam| <br /> <br /> lavaṇānāṁ ca catvāri śarkarāyāḥ palāṣṭakam| <br /> <br /> sañcūrṇya śākasūpānnarāgādiṣvavacārayēt||111|| <br /> <br /> kāsājīrṇāruciśvāsāhr̥tpāṇḍvāmayaśūlanut|<br /> <br /> caturNAM prasthamamlAnAM tryUShaNasya palatrayam| <br /> <br /> lavaNAnAM ca catvAri sharkarAyAH palAShTakam| <br /> <br /> sa~jcUrNya shAkasUpAnnarAgAdiShvavacArayet||111|| <br /> <br /> kAsAjIrNArucishvAsAhRutpANDvAmayashUlanut|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make powder of one ''prastha'' (768 gm) of four ''amla'' drugs, three ''pala'' (144 gm) of ''trikatu'', four ''pala'' (192 gm) of ''lavana'' (''saindhava'') and eight ''pala'' (384 gm) of sugar and mix together. It is to be taken with vegetable preparations such as soup cooked food and ''raga'' for cure of cough, indigestion, anorexia, dyspnea, heart disease, anemia and pain in abdomen [111]<br /> <br /> === Five types of ''yavagu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चव्यत्वक्पिप्पलीमूलधातकीव्योषचित्रकान्||११२|| <br /> <br /> कपित्थं बिल्वमम्बष्ठां शाल्मलं हस्तिपिप्पलीम्| <br /> <br /> शिलोद्भेदं तथाऽजाजीं पिष्ट्वा बदरसम्मितम्||११३|| <br /> <br /> परिभर्ज्य घृते दध्ना यवागूं साधयेद्भिषक्|<br /> <br /> रसैः कपित्थचुक्रीकावृक्षाम्लैर्दाडिमस्य च||११४|| <br /> <br /> सर्वातिसारग्रहणीगुल्मार्शःप्लीहनाशिनी| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> cavyatvakpippalīmūladhātakīvyōṣacitrakān||112|| <br /> <br /> kapitthaṁ bilvāmambaṣṭhāṁ śālmalaṁ hastipippalīm| <br /> <br /> śilōdbhēdaṁ tathā'jājīṁ piṣṭvā badarasammitam||113|| <br /> <br /> paribharjya ghr̥tē dadhnā yavāgūṁ sādhayēdbhiṣak| <br /> <br /> rasaiḥ kapitthacukrīkāvr̥kṣāmlairdāḍimasya ca||114|| <br /> <br /> sarvātisāragrahaṇī gulmārśaḥplīhanāśinī| <br /> <br /> cavyatvakpippalImUladhAtakIvyoShacitrakAn||112|| <br /> <br /> kapitthaM bilvamambaShThAM shAlmalaM hastipippalIm| <br /> <br /> shilodbhedaM tathA~ajAjIM piShTvA badarasammitam||113|| <br /> <br /> paribharjya ghRute dadhnA yavAgUM sAdhayedbhiShak| <br /> <br /> rasaiH kapitthacukrIkAvRukShAmlairdADimasya ca||114|| <br /> <br /> sarvAtisAragrahaNIgulmArshaHplIhanAshinI| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make paste of ''chavya, tvak, pippalīmūla, dhātakī, trikatu, chitraka, kapittha, bilva, pāṭhā, sālmali, gajapippalī, slōdbhēda'' (''shilajeet'') and ''ajājī,'' each taken in quantity equal to ''badara'' (about 6 gm). Fry it in ghee and prepare ''yavāgu'' by adding curd or ''svarasa'' of ''kapittha'' or ''chukrikā'' or ''vrikshāmla'' or ''dadima''. It helps in curing all types of ''atisara, grahani, gulma, arsha'' and ''pleeha'' disease [112-114]<br /> <br /> === Beverages ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पञ्चकोलकयूषश्च मूलकानां च सोषणः||११५|| <br /> <br /> स्निग्धो दाडिमतक्राम्लो जाङ्गलः संस्कृतो रसः| <br /> <br /> क्रव्यादस्वरसः शस्तो भोजनार्थे सदीपनः||११६|| <br /> <br /> तक्रारनालमद्यानि पानायारिष्ट एव च|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pañcakōlakayūṣaśca mūlakānāṁ ca sōṣaṇaḥ||115|| <br /> <br /> snigdhō dāḍimatakrāmlō jāṅgalaḥ saṁskr̥tō rasaḥ| <br /> <br /> kravyādasvarasaḥ śastō bhōjanārthē sadīpanaḥ||116|| <br /> <br /> takrāranālāmadyāni pānāyāriṣṭa ēva ca|<br /> <br /> pa~jcakolakayUShashca mUlakAnAM ca soShaNaH||115|| <br /> <br /> snigdho dADimatakrAmlo jA~ggalaH saMskRuto rasaH| <br /> <br /> kravyAdasvarasaH shasto bhojanArthe sadIpanaH||116|| <br /> <br /> takrAranAlamadyAni pAnAyAriShTa eva ca|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Fortified soup with ''panchakola'' or soup of ''mulaka'' with ''maricha'' or medicated soup prepared from animals inhabiting in arid land added with ghee, ''dadima, takra, amla dravyas'' or soup of animals that eat other animals fortified with medicines having ''[[deepana]]'' qualities be given for drink.<br /> <br /> Patient may be given buttermilk, ''aranala'' (sour drink), ''madya'' (medicated alcohol) and ''arishtha'' as liquid diets [115-116]<br /> <br /> === Qualities and benefits of buttermilk ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तक्रं तु ग्रहणीदोषे दीपनग्राहिलाघवात्||११७|| <br /> <br /> श्रेष्ठं मधुरपाकित्वान्न च पित्तं प्रकोपयेत्| <br /> <br /> कषायोष्णविकाशित्वाद्रौक्ष्याच्चैव कफे हितम्||११८|| <br /> <br /> वाते स्वाद्वम्लसान्द्रत्वात् सद्यस्कमविदाहि तत्| <br /> <br /> तस्मात् तक्रप्रयोगा ये जठराणां तथाऽर्शसाम्||११९|| <br /> <br /> विहिता ग्रहणीदोषे सर्वशस्तान् प्रयोजयेत्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> takraṁ tu Grahaṇī dōṣē dīpanagrāhilāghavāt||117|| <br /> <br /> śrēṣṭhaṁ madhurapākitvānna ca Pittaṁ prakōpayēt| <br /> <br /> kaṣāyōṣṇavikāśitvādraukṣyāccaiva kaphē hitam||118|| <br /> <br /> vātē svādvamlasāndratvāt sadyaskāmavidāhi tat| <br /> <br /> tasmāt takraprayōgā yē jaṭharāṇāṁ tathā'rśasām||119|| <br /> <br /> vihitā Grahaṇī dōṣē sarvaśastān prayōjayēt| <br /> <br /> takraM tu grahaNIdoShe dIpanagrAhilAghavAt||117|| <br /> <br /> shreShThaM madhurapAkitvAnna ca pittaM prakopayet| <br /> <br /> kaShAyoShNavikAshitvAdraukShyAccaiva kaphe hitam||118|| <br /> <br /> vAte svAdvamlasAndratvAt sadyaskamavidAhi tat| <br /> <br /> tasmAt takraprayogA ye jaTharANAM tathA~arshasAm||119|| <br /> <br /> vihitA grahaNIdoShe sarvashastAn prayojayet| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Buttermilk due to its ''[[deepana]], grahi'' (substances which increases appetite and digestive power and absorb fluid from the stool) and easy to digest actions is very useful in ''grahanidosha''. It is ''madhura'' in ''vipaka'' therefore reduces ''[[pitta]]''; due to ''kashaya'' (astringent) taste, ''ushna virya'' (hot potency), ''vikashi'' and ''ruksha [[guna]]'' it is useful in ''[[kapha]]'' dominated disorders and due to ''madhura'' and ''amla rasa, sandra guna'' it reduces ''[[vata]]''. Freshly churned butter milk does not cause burning sensation; therefore, buttermilk is very useful in treatment of ''udara, arśa'' and all ''grahanidosha'' [117-119]<br /> <br /> === ''Takrarishtha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यवान्यामलके पथ्या मरिचं त्रिपलंशिकम्||१२०|| <br /> <br /> लवणानि पलांशानि पञ्च चैकत्र चूर्णयेत्| <br /> <br /> तक्रे तदासुतं [३१] जातं तक्रारिष्टं पिबेन्नरः| <br /> <br /> दीपनं शोथगुल्मार्शःक्रिमिमेहोदरापहम्||१२१|| <br /> <br /> इति तक्रारिष्टः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yavānyāmalakē pathyā maricaṁ tripalaṁśikam||120|| <br /> <br /> lavaṇāni palāṁśāni pañca caikatra cūrṇayēt| <br /> <br /> takrē tadāsutaṁ [31] jātaṁ takrāriṣṭaṁ pibēnnaraḥ| <br /> <br /> dīpanaṁ śōthagulmārśaḥkrimimēhōdarāpaham||121|| <br /> <br /> iti takrāriṣṭaḥ<br /> <br /> yavAnyAmalake pathyA maricaM tripalaMshikam||120|| <br /> <br /> lavaNAni palAMshAni pa~jca caikatra cUrNayet| <br /> <br /> takre tadAsutaM [31] jAtaM takrAriShTaM pibennaraH| <br /> <br /> dIpanaM shothagulmArshaHkrimimehodarApaham||121|| <br /> <br /> iti takrAriShTaH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take ''yavani, amalaki, haritaki'' and ''maricha'' each in three ''pala'' (144 gm) and ''pancha-lavana'' in one ''pala'' (48 gm) and powder together and add buttermilk to it and ferment till sour taste is obtained. This preparation called ''takrarishtha'' stimulates the digestive power and relieves ''sotha, gulma, arsha, krimi, prameha'' and ''udara roga'' [120-121]<br /> <br /> === Management of ''[[pitta]]'' dominant ''grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्वस्थानगतमुत्क्लिष्टमग्निनिर्वापकं भिषक्| <br /> <br /> पित्तं ज्ञात्वा विरेकेण निर्हरेद्वमनेन वा||१२२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> svasthānagatamutkliṣṭāmAgninirvāpakaṁ bhiṣak| <br /> <br /> Pittaṁ jñātvā virēkēṇa nirharēdvāmanēna vā||122||<br /> <br /> svasthAnagatamutkliShTamagninirvApakaM bhiShak| <br /> <br /> pittaM j~jAtvA virekeNa nirharedvamanena vA||122|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If ''agnimandyata'' is due to ''utklishtha'' (ready to come out) ''[[pitta]]'' in its own place then in such a situation ''[[virechana]]'' or ''[[vamana]]'' should be administered for removal of ''[[pitta]]'' [122]<br /> <br /> === Diet after ''[[shodhana]]'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अविदाहिभिरन्नैश्च लघुभिस्तिक्तसंयुतैः| <br /> <br /> जाङ्गलानां रसैर्यूषैर्मुद्गादीनां खडैरपि||१२३|| <br /> <br /> दाडिमाम्लैः ससर्पिष्कैर्दीपनग्राहिसंयुतैः| <br /> <br /> तस्याग्निं दीपयेच्चूर्णैः सर्पिर्भिश्चापि तिक्तकैः||१२४||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> avidāhibhirannaiśca laghubhistiktasaṁyutaiḥ| <br /> <br /> jāṅgalānāṁ rasairyūṣairmudgādīnāṁ khaḍairapi||123|| <br /> <br /> dāḍimāmlaiḥ sasarpiṣkairdīpanagrāhisaṁyutaiḥ| <br /> <br /> tasyāgniṁ dīpayēccūrṇaiḥ sarpirbhiścāpi tiktakaiḥ||124||<br /> <br /> avidAhibhirannaishca laghubhistiktasaMyutaiH| <br /> <br /> jA~ggalAnAM rasairyUShairmudgAdInAM khaDairapi||123|| <br /> <br /> dADimAmlaiH sasarpiShkairdIpanagrAhisaMyutaiH| <br /> <br /> tasyAgniM dIpayeccUrNaiH sarpirbhishcApi tiktakaiH||124||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> After proper ''[[shodhana]]'', diet which does not cause burning sensation, which is easy to digest and added with ingredients having bitter taste should be taken. Soup of animals of arid zone, soup of cereals such as ''mudga'', etc. and ''khada'' should be given. <br /> <br /> Pomegranate having sour taste should be taken along with ghee, ''[[deepana]]'' and ''grahi dravyas''. With help of powders of ''deepaniya'' drugs and ghee fortified with bitter drugs, the digestive power should be increased (123-124).<br /> <br /> === ''Chandanadya ghrita'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चन्दनं पद्मकोशीरं पाठां मूर्वां कुटन्नटम्| <br /> <br /> षड्ग्रन्थासारिवास्फोतासप्तपर्णाटरूषकान्||१२५|| <br /> <br /> पटोलोदुम्बराश्वत्थवटप्लक्षकपीतनान्| <br /> <br /> कटुकां रोहिणीं मुस्तं निम्बं च द्विपलांशिकम्||१२६|| <br /> <br /> द्रोणेऽपां साधयेत् पादशेषे प्रस्थं घृतात् पचेत्| <br /> <br /> किराततिक्तेन्द्रयववीरामागधिकोत्पलैः||१२७|| <br /> <br /> कल्कैरक्षसमैः पेयं तत् पित्तग्रहणीगदे| <br /> <br /> इति चन्दनाद्यं घृतम्<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> candanaṁ padmakōśīraṁ pāṭhāṁ mūrvāṁ kuṭannaṭam| <br /> <br /> ṣaḍgranthāsārivāsphōtāsaptaparṇāṭarūṣakān||125|| <br /> <br /> paṭōlōdumbarāśvatthavaṭaplakṣakapītanān| <br /> <br /> kaṭukāṁ rōhiṇīṁ mustaṁ nimbaṁ ca dvipalāṁśikam||126|| <br /> <br /> drōṇē'pāṁ sādhayēt pādaśēṣē prasthaṁ ghr̥tāt pacēt| <br /> <br /> kirātatiktēndrayavavīrāmāgadhikōtpalaiḥ||127|| <br /> <br /> kalkairakṣasāmaiḥ pēyaṁ tat Pitta Grahaṇī gadē| <br /> <br /> iti candanādyaṁ ghr̥tam<br /> <br /> candanaM padmakoshIraM pAThAM mUrvAM kuTannaTam| <br /> <br /> ShaDgranthAsArivAsphotAsaptaparNATarUShakAn||125|| <br /> <br /> paTolodumbarAshvatthavaTaplakShakapItanAn| <br /> <br /> kaTukAM rohiNIM mustaM nimbaM ca dvipalAMshikam||126|| <br /> <br /> droNe~apAM sAdhayet pAdasheShe prasthaM ghRutAt pacet| <br /> <br /> kirAtatiktendrayavavIrAmAgadhikotpalaiH||127|| <br /> <br /> kalkairakShasamaiH peyaM tat pittagrahaNIgade| <br /> <br /> iti candanAdyaM ghRutam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take two ''pala'' (96 gm) each of ''chandana, padmaka, usheera, patha, murva, kuthannatha'' (''kaivarta musta''), ''shadhgrantha'' (''vacha''), ''sariva, asphota'' (''aspurmallika''), ''saptaparna, aṭarushakana'' (''vasa''), ''patola, udumbara, ashvattha, vata, plaksa, kapeetana'' (''gandha musta''), ''kathuki, musta'' and ''nimba'' and prepare decoction by adding one ''drona'' (12.228 Kg) of water with 1/4th reduction. ''Ghrita siddhi'' is done adding one ''prastha'' (96 gm) of ghee to the above decoction and paste of one ''aksa'' (12 gm) each of ''kiratatikta, indrayava, vira, pippalī'' and ''utpala'' is added. This medicated ghee is known as ''chandanadya ghrita'' and is indicated in ''[[pitta]]ja grahani'' [125-127]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तिक्तकं यद्घृतं चोक्तं कौष्ठिके तच्च दापयेत्||१२८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tiktakaṁ yadghr̥taṁ cōktaṁ kauṣṭhikē tacca dāpayēt||128|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Tikta ghrita'' as mentioned in [[Kushtha Chikitsa]] [Cha. Sa. [[Chikitsa Sthana]] 7/140-150] may also be prescribed in ''[[pitta]]ja grahani'' [128]<br /> <br /> === ''Nagaradya churna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नागरातिविषे मुस्तं धातकीं च रसाञ्जनम्| <br /> <br /> वत्सकत्वक्फलं बिल्वं पाठां कटुकरोहिणीम्||१२९|| <br /> <br /> पिबेत् समांशं तच्चूर्णं सक्षौद्रं तण्डुलाम्बुना| <br /> <br /> पैत्तिके ग्रहणीदोषे रक्तं यच्चोपवेश्यते||१३०|| <br /> <br /> अर्शांसि च गुदे शूलं जयेच्चैव प्रवाहिकाम्| <br /> <br /> नागराद्यमिदं चूर्णं कृष्णात्रेयेण पूजितम्||१३१|| <br /> <br /> इति नागराद्यं चूर्णम्<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nāgarātiviṣē mustaṁ dhātakīṁ ca rasāñjanam| <br /> <br /> vatsakatvakphalaṁ bilvaṁ pāṭhāṁ kaṭukarōhiṇīm||129|| <br /> <br /> pibēt samāṁśaṁ taccūrṇaṁ sakṣaudraṁ taṇḍulāmbunā| <br /> <br /> paittikē Grahaṇī dōṣē raktaṁ yaccōpavēśyatē||130|| <br /> <br /> arśāṁsi ca gudē śūlaṁ jayēccaiva pravāhikām| <br /> <br /> nāgarādyamidaṁ cūrṇaṁ kr̥ṣṇātrēyēṇa pūjitam||131|| <br /> <br /> iti nāgarādyaṁ cūrṇam<br /> <br /> nAgarAtiviShe mustaM dhAtakIM ca rasA~jjanam| <br /> <br /> vatsakatvakphalaM bilvaM pAThAM kaTukarohiNIm||129|| <br /> <br /> pibet samAMshaM taccUrNaM sakShaudraM taNDulAmbunA| <br /> <br /> paittike grahaNIdoShe raktaM yaccopaveshyate||130|| <br /> <br /> arshAMsi ca gude shUlaM jayeccaiva pravAhikAm| <br /> <br /> nAgarAdyamidaM cUrNaM kRuShNAtreyeNa pUjitam||131|| <br /> <br /> iti nAgarAdyaM cUrNam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take equal quantity of ''nagara, ativisha, musta, dhataki, rasanjana,'' bark and fruit of ''vatsaka, bilva, patha'' and ''katuki'' and powder together, is known as ''nagaradya churna'' explained by ''krishnatreyena''. It is to be taken along with honey and ''tandulodaka'' (rice water, prepared cold) by patient suffering from ''paittika grahani'' with bloody stools, hemorrhoids, pain in anal area and dysentery. [129-131]<br /> <br /> === ''Bhunimbadya churna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भूनिम्बकटुकाव्योषमुस्तकेन्द्रयवान् समान्| <br /> <br /> द्वौ चित्रकाद्वत्सकत्वग्भागान् षोडश चूर्णयेत्||१३२|| <br /> <br /> गुडशीताम्बुना पीतं ग्रहणीदोषगुल्मनुत्| <br /> <br /> कामलाज्वरपाण्डुत्वमेहारुच्यतिसारनुत्||१३३|| <br /> <br /> इति भूनिम्बाद्यं चूर्णम्<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhūnimbakaṭukāvyōṣamustakēndrayavān samān| <br /> <br /> dvau citrakādvatsakatvagbhāgān ṣōḍaśa cūrṇayēt||132|| <br /> <br /> guḍaśītāmbunā pītaṁ Grahaṇī dōṣagulmanut| <br /> <br /> kāmalājvarapāṇḍutvamēhārucyatisāranut||133|| <br /> <br /> iti bhūnimbādyaṁ cūrṇam<br /> <br /> bhUnimbakaTukAvyoShamustakendrayavAn samAn| <br /> <br /> dvau citrakAdvatsakatvagbhAgAn ShoDasha cUrNayet||132|| <br /> <br /> guDashItAmbunA pItaM grahaNIdoShagulmanut| <br /> <br /> kAmalAjvarapANDutvamehArucyatisAranut||133||<br /> <br /> iti bhUnimbAdyaM cUrNam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Bhunimba, kutaki, trikatu, musta'' and ''indrayava'' are taken in equal quantity. Two parts of ''chitraka'' and 16 parts of bark and ''vatsaka'' are taken together and powdered. The combination is called as ''bhunimbadya churna'' is advised with jaggery and cold water as ''anupana'' in ''grahani dosha, gulma, kamala, jwara, pandu, prameha, aruchi'' and ''atisara'' [132-133]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वचामतिविषां पाठां सप्तपर्णं रसाञ्जनम्| <br /> <br /> स्योनाकोदीच्यकट्वङ्गवत्सकत्वग्दुरालभाः||१३४|| <br /> <br /> दार्वीं पर्पटकं पाठां यवानीं मधुशिग्रुकम्| <br /> <br /> पटोलपत्रं सिद्धार्थान् यूथिकां जातिपल्लवान्||१३५|| <br /> <br /> जम्ब्वाम्रबिल्वमध्यानि निम्बशाकफलानि च| <br /> <br /> तद्रोगशममन्विच्छन् भूनिम्बाद्येन योजयेत्||१३६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vacāmativiṣāṁ pāṭhāṁ saptaparṇaṁ rasāñjanam| <br /> <br /> syōnākōdīcyakaṭvaṅgavatsakatvagdurālabhāḥ||134|| <br /> <br /> dārvīṁ parpaṭakaṁ pāṭhāṁ yavānīṁ madhuśigrukam| <br /> <br /> paṭōlapatraṁ siddhārthān yūthikāṁ jātipallavān||135|| <br /> <br /> jambvāmrabilvāmadhyāni nimbaśākaphalāni ca| <br /> <br /> tadrōgaśāmamanvicchan bhūnimbādyēna yōjayēt||136|| <br /> <br /> vacAmativiShAM pAThAM saptaparNaM rasA~jjanam| <br /> <br /> syonAkodIcyakaTva~ggavatsakatvagdurAlabhAH||134|| <br /> <br /> dArvIM parpaTakaM pAThAM yavAnIM madhushigrukam| <br /> <br /> paTolapatraM siddhArthAn yUthikAM jAtipallavAn||135|| <br /> <br /> jambvAmrabilvamadhyAni nimbashAkaphalAni ca| <br /> <br /> tadrogashamamanvicchan bhUnimbAdyena yojayet||136|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The combination of ''vacha, ativisha, patha, saptaparna, rasanjana, syonaka, udeechya, kathvanga'' (type of ''syonaka'' having small fruits), bark of ''vatsaka, duralabha, darvi, parpataka, patha, yavani, madhushigru,'' leaf of ''patola, siddhartha, yuthika,'' fresh new leaf of ''jati,'' seeds of ''jambu'' and ''amra'', pulp of ''bilva'' and leaves and fruits of ''nimba'' is useful in all condition as mentioned for ''bhunimbadya churna'' [134-136]<br /> <br /> === ''Kiratadya churna'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> किराततिक्तः षड्ग्रन्था त्रायमाणा कटुत्रिकम्| <br /> <br /> चन्दनं पद्मकोशीरं दार्वीत्वक् कटुरोहिणी||१३७|| <br /> <br /> कुटजत्वक्फलं मुस्तं यवानी देवदारु च| <br /> <br /> पटोलनिम्बपत्रैलासौराष्ट्रयतिविषात्वचः||१३८|| <br /> <br /> मधुशिग्रोश्च बीजानि मूर्वा पर्पटकस्तथा| <br /> <br /> तच्चूर्णं मधुना लेह्यं पेयं मद्यैर्जलेन वा||१३९|| <br /> <br /> हृत्पाण्डुग्रहणीरोगगुल्मशूलारुचिज्वरान्| <br /> <br /> कामलां सन्निपातं च मुखरोगांश्च नाशयेत्||१४०|| <br /> <br /> इति किराताद्यं चूर्णम्<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kirātatiktaḥ ṣaḍgranthā trāyamāṇā kaṭutrikam| <br /> <br /> candanaṁ padmakōśīraṁ dārvītvak kaṭurōhiṇī||137|| <br /> <br /> kuṭajatvakphalaṁ mustaṁ yavānī dēvadāru ca| <br /> <br /> paṭōlanimbapatrailāsaurāṣṭrayativiṣātvacaḥ||138|| <br /> <br /> madhuśigrōśca bījāni mūrvā parpaṭakastathā| <br /> <br /> taccūrṇaṁ madhunā lēhyaṁ pēyaṁ madyairjalēna vā||139|| <br /> <br /> hr̥tpāṇḍuGrahaṇī rōgagulmaśūlārucijvarān| <br /> <br /> kāmalāṁ sannipātaṁ ca mukharōgāṁśca nāśayēt||140|| <br /> <br /> iti kirātādyaṁ cūrṇam<br /> <br /> kirAtatiktaH ShaDgranthA trAyamANA kaTutrikam| <br /> <br /> candanaM padmakoshIraM dArvItvak kaTurohiNI||137|| <br /> <br /> kuTajatvakphalaM mustaM yavAnI devadAru ca| <br /> <br /> paTolanimbapatrailAsaurAShTrayativiShAtvacaH||138|| <br /> <br /> madhushigroshca bIjAni mUrvA parpaTakastathA| <br /> <br /> taccUrNaM madhunA lehyaM peyaM madyairjalena vA||139|| <br /> <br /> hRutpANDugrahaNIrogagulmashUlArucijvarAn| <br /> <br /> kAmalAM sannipAtaM ca mukharogAMshca nAshayet||140|| <br /> <br /> iti kirAtAdyaM cUrNam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Mix powder of ''kiratatikta, shadgrantha, trayamana, trikatu, chandana, padmaka, usheera,'' bark of ''darvi, katurohini,'' bark and fruit of ''kutaja, mushta, yavani, devadaru, patola,'' leaves of ''nimba, ela, saurashtra, ativisha, tvak,'' seeds of ''madhushigru, murva'' and ''parpataka'' and prescribe it as linctus prepared with honey or may be taken with water or alcoholic preparation. This preparation is known as ''kiratadyam churna'' whih cures ''hridaya roga, pandu, grahaniroga, gulma, shula, aruchi, jwara, kamala, sannipatika'' type of diarrhea and eight types of ''mukharoga'' [137-140]<br /> <br /> === Treatment of ''[[kapha]]ja grahani'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ग्रहण्यां श्लेष्मदुष्टायां वमितस्य यथाविधि| <br /> <br /> कट्वम्ललवणक्षारैस्तिक्तैश्चाग्निं विवर्धयेत्||१४१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> grahaṇyāṁ ślēṣmaduṣṭāyāṁ vamitasya yathāvidhi| <br /> <br /> kaṭvamlalavaṇakṣāraistiktaiścāgniṁ vivardhayēt||141|| <br /> <br /> grahaNyAM shleShmaduShTAyAM vamitasya yathAvidhi| <br /> <br /> kaTvamlalavaNakShAraistiktaishcAgniM vivardhayet||141|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''[[kapha]]ja grahani'' first administer ''[[vamana]]'' and then increase [[agni]] (digestive power) with help of drugs having ''katu, amla, lavana, kshara'' and ''tikta rasa'' [141]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पलाशं चित्रकं चव्यं मातुलुङ्गं हरीतकीम्| <br /> <br /> पिप्पलीं पिप्पलीमूलं पाठां नागरधान्यकम्||१४२|| <br /> <br /> कार्षिकाण्युदकप्रस्थे पक्त्वा पादावशेषितम्| <br /> <br /> पानीयार्थं प्रयुञ्जीत यवागूं तैश्च साधयेत्||१४३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> palāśaṁ citrakaṁ cavyaṁ mātuluṅgaṁ harītakīm| <br /> <br /> pippalīṁ pippalīmūlaṁ pāṭhāṁ nāgaradhānyakam||142|| <br /> <br /> kārṣikāṇyudakaprasthē paktvā pādāvaśēṣitam| <br /> <br /> pānīyārthaṁ prayuñjīta yavāgūṁ taiśca sādhayēt||143|| <br /> <br /> palAshaM citrakaM cavyaM mAtulu~ggaM harItakIm| <br /> <br /> pippalIM pippalImUlaM pAThAM nAgaradhAnyakam||142|| <br /> <br /> kArShikANyudakaprasthe paktvA pAdAvasheShitam| <br /> <br /> pAnIyArthaM prayu~jjIta yavAgUM taishca sAdhayet||143|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Palasha, chitraka, chavya, matulunga, haritaki pippali, pippalimoola, patha, nagara'' and ''dhanyaka'' are taken each in 12 gm and decoction is prepared in one 768 ml of water and reduced to one fourth. This decoction is administered as a ''paniya'' (drink) or ''yavagu'' (gruel) prepared using this decoction [142-143]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शुष्कमूलकयूषेण कौलत्थेनाथवा पुनः| <br /> <br /> कट्वम्लक्षारपटुना लघून्यन्नानि भोजयेत्||१४४|| <br /> <br /> अम्लं चानु पिबेत्तक्रं तक्रारिष्टमथापि वा| <br /> <br /> मदिरां मध्वरिष्टं वा निगदं सीधुमेव वा||१४५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śuṣkamūlakayūṣēṇa kaulatthēnāthavā punaḥ| <br /> <br /> kaṭvamlakṣārapaṭunā laghūnyannāni bhōjayēt||144||<br /> <br /> amlaṁ cānu pibēttakraṁ takrāriṣṭāmathāpi vā| <br /> <br /> madirāṁ madhvariṣṭaṁ vā nigadaṁ sīdhumēva vā||145||<br /> <br /> shuShkamUlakayUSheNa kaulatthenAthavA punaH| <br /> <br /> kaTvamlakShArapaTunA laghUnyannAni bhojayet||144|| <br /> <br /> amlaM cAnu pibettakraM takrAriShTamathApi vA| <br /> <br /> madirAM madhvariShTaM vA nigadaM sIdhumeva vA||145||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Soup of dried radish or ''kulatha'' is to be given regularly and repeatedly. Food which is easy to digest should be fortified with ''katu, amla, kshara'' and ''lavana rasa''. Patient should take such foods which are easy to digest, along with buttermilk slightly sour or ''takrarishtha, madira'' (medicated alcoholic preparation), ''madhvarishtha'' or well prepared ''seedhu'' [144-145]<br /> <br /> === ''Madhukasava'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्रोणं मधूकपुष्पाणां विडङ्गानां ततोऽर्धतः| <br /> <br /> चित्रकस्य ततोऽर्धं स्यात्तथा भल्लातकाढकम्||१४६|| <br /> <br /> मञ्जिष्ठाष्टपलं [३२] चैव त्रिद्रोणेऽपां विपाचयेत्| <br /> <br /> द्रोणशेषं तु तच्छीतं मध्वर्धाढकसंयुतम्||१४७|| <br /> <br /> एलामृणालागुरुभिश्चन्दनेन च रूषिते| <br /> <br /> कुम्भे मासस्थितं जातमासवं तं प्रयोजयेत्||१४८||<br /> <br /> ग्रहणीं दीपयत्येव बृंहणः [३३] कफपित्तजित्| <br /> <br /> शोथं कुष्ठं किलासं च प्रमेहांश्च प्रणाशयेत्||१४९|| <br /> <br /> इति मधूकासवः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> drōṇaṁ madhūkapuṣpāṇāṁ viḍaṅgānāṁ tatō'rdhataḥ| <br /> <br /> citrakasya tatō'rdhaṁ syāttathā bhallātakāḍhakam||146|| <br /> <br /> mañjiṣṭhāṣṭapalaṁ [32] caiva tridrōṇē'pāṁ vipācayēt| <br /> <br /> drōṇaśēṣaṁ tu tacchītaṁ madhvardhāḍhakasaṁyutam||147|| <br /> <br /> ēlāmr̥ṇālāgurubhiścandanēna ca rūṣitē| <br /> <br /> kumbhē māsasthitaṁ jātamāsavaṁ taṁ prayōjayēt||148|| <br /> <br /> Grahaṇī ṁ dīpayatyēva br̥ṁhaṇaḥ [33] kaphaPittajit| <br /> <br /> śōthaṁ kuṣṭhaṁ kilāsaṁ ca pramēhāṁśca praṇāśayēt||149|| <br /> <br /> iti madhūkāsavaḥ<br /> <br /> droNaM madhUkapuShpANAM viDa~ggAnAM tato~ardhataH| <br /> <br /> citrakasya tato~ardhaM syAttathA bhallAtakADhakam||146|| <br /> <br /> ma~jjiShThAShTapalaM [32] caiva tridroNe~apAM vipAcayet| <br /> <br /> droNasheShaM tu tacchItaM madhvardhADhakasaMyutam||147|| <br /> <br /> elAmRuNAlAgurubhishcandanena ca rUShite| <br /> <br /> kumbhe mAsasthitaM jAtamAsavaM taM prayojayet||148|| <br /> <br /> grahaNIM dIpayatyeva bRuMhaNaH [33] kaphapittajit| <br /> <br /> shothaM kuShThaM kilAsaM ca pramehAMshca praNAshayet||149|| <br /> <br /> iti madhUkAsavaH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take one ''drona'' (12.22 kg/l) flowers of ''madhuka,'' half ''drona'' (6.11 kg/l) of ''vidanga, chitraka'' half of ''vidanga'' i.e. 1/4th ''drona'' (3.05 kg/l), ''bhallataka'' one ''adhaka'' (3.073 kg) and eight ''pala'' (384 gm) of ''manjishtha'' and mix with three ''drona'' (36.66 kg/l) of water and reduce to one ''drona'' (12.22 L) and after the decoction comes to room temperature add half ''adhaka'' (1.53 kg) of honey. Keep this preparation in a pot lined with paste of ''ela, mrinala, agaru'' and ''chandana'' and store for period of one month till ''asava siddhi'' occurs. This preparation is called ''madhukasava'' and is useful in ''grahani,'' helps empowering of ''agni,'' promotes nutrition and normalizes ''[[kapha]]'' and ''[[pitta]]''. It is indicated in ''shotha, kushtha, kilasa'' and ''prameha'' [146-149]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मधूकपुष्पस्वरसं शृतमर्धक्षयीकृतम्| <br /> <br /> क्षौद्रपादयुतं शीतं पूर्ववत् सन्निधापयेत्||१५०|| <br /> <br /> तं पिबन् ग्रहणीदोषाञ्जयेत् सर्वान् हिताशनः| <br /> <br /> तद्वद्द्राक्षेक्षुखर्जूरस्वरसानासुतान् [३४] पिबेत्||१५१||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> madhūkapuṣpasvarasaṁ śr̥tāmardhakṣayīkr̥tam| <br /> <br /> kṣaudrapādayutaṁ śītaṁ pūrvavat sannidhāpayēt||150|| <br /> <br /> taṁ piban Grahaṇī dōṣāñjayēt sarvān hitāśanaḥ| <br /> <br /> tadvaddrākṣēkṣukharjūrasvarasānāsutān [34] pibēt||151||<br /> <br /> madhUkapuShpasvarasaM shRutamardhakShayIkRutam| <br /> <br /> kShaudrapAdayutaM shItaM pUrvavat sannidhApayet||150|| <br /> <br /> taM piban grahaNIdoShA~jjayet sarvAn hitAshanaH| <br /> <br /> tadvaddrAkShekShukharjUrasvarasAnAsutAn [34] pibet||151||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Boil ''svarasa'' of flowers of ''madhuka'' till reduced to half the quantity. When cooled one fourth of honey is added and kept for fermentation as mentioned above. This preparation relieves all types of ''grahani dosha'' provided patient takes ''pathya ahara''. <br /> <br /> In the same manner fermentation of ''svarasa'' of ''draksha'' (grapes), sugarcane and date palm is helpful for the patient [150-151]<br /> <br /> === ''Duralabhasava'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्रस्थौ दुरालभाया द्वौ पस्थमामलकस्य च| <br /> <br /> दन्तीचित्रकमुष्टी [३५] द्वे प्रत्यग्रं चाभयाशतम्||१५२|| <br /> <br /> चतुर्द्रोणेऽम्भसः पक्त्वा शीतं द्रोणावशेषितम्| <br /> <br /> सगुडद्विशतं पूतं मधुनः कुडवायुतम्||१५३|| <br /> <br /> तद्वत् प्रियङ्गोः पिप्पल्या विडङ्गानां च चूर्णितैः| <br /> <br /> कुडवैर्घृतकुम्भस्थं पक्षाज्जातं ततः पिबेत्||१५४|| <br /> <br /> ग्रहणीपाण्डुरोगार्शःकुष्ठवीसर्पमेहनुत्| <br /> <br /> स्वरवर्णकरश्चैष रक्तपित्तकफापहः||१५५|| <br /> <br /> इति दुरालभासवः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> prasthau durālabhāyā dvau prasthamāmalakasya ca| <br /> <br /> dantīcitrakamuṣṭī [35] dvē pratyagraṁ cābhayāśatam||152|| <br /> <br /> caturdrōṇē'mbhasaḥ paktvā śītaṁ drōṇāvaśēṣitam| <br /> <br /> saguḍadviśataṁ pūtaṁ madhunaḥ kuḍaVātatam||153|| <br /> <br /> tadvat priyaṅgōḥ pippalyā viḍaṅgānāṁ ca cūrṇitaiḥ| <br /> <br /> kuḍavairghr̥takumbhasthaṁ pakṣājjātaṁ tataḥ pibēt||154|| <br /> <br /> Grahaṇī pāṇḍurōgārśaḥkuṣṭhavīsarpamēhanut| <br /> <br /> svaravarṇakaraścaiṣa raktaPittakaphāpahaḥ||155|| <br /> <br /> iti durālabhāsavaḥ<br /> <br /> prasthau durAlabhAyA dvau pasthamAmalakasya ca| <br /> <br /> dantIcitrakamuShTI [35] dve pratyagraM cAbhayAshatam||152|| <br /> <br /> caturdroNe~ambhasaH paktvA shItaM droNAvasheShitam| <br /> <br /> saguDadvishataM pUtaM madhunaH kuDavAyutam||153|| <br /> <br /> tadvat priya~ggoH pippalyA viDa~ggAnAM ca cUrNitaiH| <br /> <br /> kuDavairghRutakumbhasthaM pakShAjjAtaM tataH pibet||154|| <br /> <br /> grahaNIpANDurogArshaHkuShThavIsarpamehanut| <br /> <br /> svaravarNakarashcaiSha raktapittakaphApahaH||155|| <br /> <br /> iti durAlabhAsavaH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Boil two ''prastha'' (1.53 kg) each of ''duralabha'' and ''amalaki'', one ''mushthi'' each of ''danti'' and ''chitraka'' and two hundred matured fruits of ''haritaki'' in four ''drona'' (48.88 kg/l) of water and reduce to one ''drona'' (12.228 kg/l). When it comes to room temperature add two hundred ''pala'' (9600 gm) of jaggery and one ''kudava'' (192 gm) of honey as well as powder of ''priyangu, pippali'' and ''vidanga'' each in one ''kudava'' (192 gm) and keep in jar pasted with ghee on the inner wall for period of fifteen days. This preparation is known as ''duralabhasava'' and is indicated in ''grahani, pandu, arsha, kushtha, visarpa'' and ''prameha''. It promotes voice and complexion and cures ''raktapitta'' and other ''[[kapha]]ja'' disorders [152-155]<br /> <br /> === ''Moolasava'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> हरिद्रा पञ्चमूले द्वे वीरर्षभकजीवकम्| <br /> <br /> एषां [३६] पञ्चपलान् भागांश्चतुर्द्रोणेऽम्भसः पचेत्||१५६|| <br /> <br /> द्रोणशेषे रसे पूते गुडस्य द्विशतं भिषक्| <br /> <br /> चूर्णितान् कुडवार्धांशान् प्रक्षिपेच्च समाक्षिकान्||१५७|| <br /> <br /> प्रियङ्गुमुस्तमञ्जिष्ठाविडङ्गमधुकप्लवान्| <br /> <br /> लोध्रं शाबरकं चैव मासार्धस्थं पिबेत्तु तम्||१५८|| <br /> <br /> एष मूलासवः सिद्धो दीपनो रक्तपित्तजित्| <br /> <br /> आनाहकफहृद्रोगपाण्डुरोगाङ्गसादनुत्||१५९|| <br /> <br /> इति मूलासवः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> haridrā pañcamūlē dvē vīrarṣabhakajīvakam| <br /> <br /> ēṣāṁ [36] pañcapalān bhāgāṁścaturdrōṇē'mbhasaḥ pacēt||156|| <br /> <br /> drōṇaśēṣē rasē pūtē guḍasya dviśataṁ bhiṣak| <br /> <br /> cūrṇitān kuḍavārdhāṁśān prakṣipēcca samākṣikān||157|| <br /> <br /> priyaṅgumustāmañjiṣṭhāviḍaṅgāmadhukaplavān| <br /> <br /> lōdhraṁ śābarakaṁ caiva māsārdhasthaṁ pibēttu tam||158|| <br /> <br /> ēṣa mūlāsavaḥ siddhō dīpanō raktaPitta jit| <br /> <br /> ānāhakaphahr̥drōgapāṇḍurōgāṅgasādanut||159|| <br /> <br /> iti mūlāsavaḥ<br /> <br /> haridrA pa~jcamUle dve vIrarShabhakajIvakam| <br /> <br /> eShAM [36] pa~jcapalAn bhAgAMshcaturdroNe~ambhasaH pacet||156|| <br /> <br /> droNasheShe rase pUte guDasya dvishataM bhiShak| <br /> <br /> cUrNitAn kuDavArdhAMshAn prakShipecca samAkShikAn||157|| <br /> <br /> priya~ggumustama~jjiShThAviDa~ggamadhukaplavAn| <br /> <br /> lodhraM shAbarakaM caiva mAsArdhasthaM pibettu tam||158|| <br /> <br /> eSha mUlAsavaH siddho dIpano raktapittajit| <br /> <br /> AnAhakaphahRudrogapANDurogA~ggasAdanut||159|| <br /> <br /> iti mUlAsavaH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Boil five ''pala'' (240 gm) each of ''haridra,'' two types of ''panchamoola'' i.e. ''brihat'' and ''laghu panchamoola, veera'' (''shatavari''), ''rishabhaka, jeevaka'' in four ''drona'' (48.88 kg/l) of water and reduce to one ''drona'' (12.22 kg/l); to this add two hundred ''pala'' (9600 gm) of jaggery and half ''kudava'' (96 gm) of honey as well as powders of ''priyangu, musta, manjishtha, vidanga, madhuka, plava,'' and ''sabaraka lodhra'' and fermented for a fortnight. This ''mulasava'' does ''[[deepana]]'' and is effective in ''raktapitta, anaha, [[kapha]]ja vikara, hridroga, pandu'' and ''angasada'' [156-159]<br /> <br /> === ''Pindasava'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्रास्थिकं [३७] पिप्पलीं पिष्ट्वा गुडं मध्यं बिभीतकात्| <br /> <br /> उदकप्रस्थसंयुक्तं यवपल्ले निधापयेत्||१६०|| <br /> <br /> तस्मात् पलं सुजातात्तु सलिलाञ्जलिसंयुतम्| <br /> <br /> पिबेत्पिण्डासवो ह्येष रोगानीकविनाशनः||१६१|| <br /> <br /> स्वस्थोऽप्येनं पिबेन्मासं नरः स्निग्धरसाशनः [३८] | <br /> <br /> इच्छंस्तेषामनुत्पत्तिं रोगाणां येऽत्र कीर्तिताः||१६२||<br /> <br /> इति पिण्डासवः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> prāsthikaṁ [37] pippalīṁ piṣṭvā guḍaṁ madhyaṁ bibhītakāt| <br /> <br /> udakaprasthasaṁyuktaṁ yavapallē nidhāpayēt||160|| <br /> <br /> tasmāt palaṁ sujātāttu salilāñjalisaṁyutam| <br /> <br /> pibētpiṇḍāsavō hyēṣa rōgānīkavināśanaḥ||161|| <br /> <br /> svasthō'pyēnaṁ pibēnmāsaṁ naraḥ snigdharasāśanaḥ [38] | <br /> <br /> icchaṁstēṣāmanutpattiṁ rōgāṇāṁ yē'tra kīrtitāḥ||162|| <br /> <br /> iti piṇḍāsavaḥ<br /> <br /> prAsthikaM [37] pippalIM piShTvA guDaM madhyaM bibhItakAt| <br /> <br /> udakaprasthasaMyuktaM yavapalle nidhApayet||160|| <br /> <br /> tasmAt palaM sujAtAttu salilA~jjalisaMyutam| <br /> <br /> pibetpiNDAsavo hyeSha rogAnIkavinAshanaH||161|| <br /> <br /> svastho~apyenaM pibenmAsaM naraH snigdharasAshanaH [38] | <br /> <br /> icchaMsteShAmanutpattiM rogANAM ye~atra kIrtitAH||162|| <br /> <br /> iti piNDAsavaH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One ''prastha'' of ''pippali'' is mixed with jaggery and seed pulp of ''bibhitaki'' and to it one ''prastha'' of water is added and kept in a vessel covered with ''yava'' (barley) for fermentation; this is called as ''pindasava''. One ''pala'' (48 gm) of ''pindasava'' is mixed with one ''anjali'' (192 gm) of water and is given to patient. It is helpful in earlier mentioned disorders. Even a healthy person may take this preparation for period of one month and take unctuous and liquid diet (mainly soups). It helps in prevention of genesis of disease [160-162]<br /> <br /> === ''Madhvarishtha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नवे पिप्पलिमध्वाक्ते कलसेऽगुरुधूपिते| <br /> <br /> मध्वाढकं जलसमं चूर्णानीमानि दापयेत्||१६३|| <br /> <br /> कुडवार्धं विडङ्गानां पिप्पल्याः कुडवं तथा| <br /> <br /> चतुर्थिकांशां त्वक्क्षीरीं केशरं मरिचानि च||१६४|| <br /> <br /> त्वगेलापत्रकशटीक्रमुकातिविषाघनान्| <br /> <br /> हरेण्वेल्वालुतेजोह्वापिप्पलीमूलचित्रकान्||१६५|| <br /> <br /> कार्षिकांस्तत् स्थितं मासमत ऊर्ध्वं प्रयोजयेत्| <br /> <br /> मन्दं सन्दपयत्यग्निं करोति विषमं समम्||१६६|| <br /> <br /> हृत्पाण्डुग्रहणीरोगकुष्ठार्शःश्वयथुज्वरान्| <br /> <br /> वातश्लेष्मामयांश्चान्यान्मध्वरिष्टो व्यपोहति||१६७|| <br /> <br /> इति मध्वरिष्टः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> navē pippalīmadhvāktē kalasē'gurudhūpitē| <br /> <br /> madhvāḍhakaṁ jalasāmaṁ cūrṇānīmāni dāpayēt||163|| <br /> <br /> kuḍavārdhaṁ viḍaṅgānāṁ pippalyāḥ kuḍavaṁ tathā| <br /> <br /> caturthikāṁśāṁ tvakkṣīrīṁ kēśaraṁ maricāni ca||164|| <br /> <br /> tvagēlāpatrakaśaṭīkramukātiviṣāghanān| <br /> <br /> harēṇvēlvālutējōhvāpippalīmūlacitrakān||165|| <br /> <br /> kārṣikāṁstat sthitaṁ māsāmata ūrdhvaṁ prayōjayēt| <br /> <br /> mandaṁ sandapayatyāgniṁ karōti viṣāmaṁ sāmam||166|| <br /> <br /> hr̥tpāṇḍuGrahaṇī rōgakuṣṭhārśaḥśvayathujvarān| <br /> <br /> Vātaślēṣmāmayāṁścānyānmadhvariṣṭō vyapōhati||167|| <br /> <br /> iti madhvariṣṭaḥ<br /> <br /> nave pippalimadhvAkte kalase~agurudhUpite| <br /> <br /> madhvADhakaM jalasamaM cUrNAnImAni dApayet||163|| <br /> <br /> kuDavArdhaM viDa~ggAnAM pippalyAH kuDavaM tathA| <br /> <br /> caturthikAMshAM tvakkShIrIM kesharaM maricAni ca||164|| <br /> <br /> tvagelApatrakashaTIkramukAtiviShAghanAn| <br /> <br /> hareNvelvAlutejohvApippalImUlacitrakAn||165|| <br /> <br /> kArShikAMstat sthitaM mAsamata UrdhvaM prayojayet| <br /> <br /> mandaM sandapayatyagniM karoti viShamaM samam||166|| <br /> <br /> hRutpANDugrahaNIrogakuShThArshaHshvayathujvarAn| <br /> <br /> vAtashleShmAmayAMshcAnyAnmadhvariShTo vyapohati||167|| <br /> <br /> iti madhvariShTaH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> New earthen pot should be pasted internally by ''pippali'' and honey and fumigated with ''aguru''. One ''adhaka'' (3.073 kg) of honey and equal quantity of water should be added. To this add half ''kudava'' (1.53 kg) of powder of ''vidanga'' and one ''kudava'' (192 gm) of ''pippali,'' one fourth ''kudava'' (48 gm) of ''vamsha'' and one ''karsha'' (12 gm) each of ''tvak, ela, keshara, maricha, patra, sati, kramuka, ativisha, ghana'' (''chandana''), ''harenu, elvaluka, tejohva, pippalimoola'' and ''chitraka'' and fermented for period of one month and later on administered. It stimulates the power of digestion and regularizes the ''vishama agni''. It is useful in ''hridroga, pandu, grahani, kushtha, arsha, shvayathu, jwara'' and other disorders caused by ''[[vata]]'' and '' [[kapha dosha]]''. Thus, completes description of ''madhvariṣṭa'' [163-167]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> समूलां पिप्पलीं क्षारौ द्वौ पञ्च लवणानि च| <br /> <br /> मातुलुङ्गाभयारास्नाशटीमरिचनागरम्||१६८|| <br /> <br /> कृत्वा समांशं तच्चूर्णं पिबेत् प्रातः सुखाम्बुना| <br /> <br /> श्लेष्मिके ग्रहणीदोषे बलवर्णाग्निवर्धनम्||१६९|| <br /> <br /> एतैरेवौषधैः सिद्धं सर्पिः पेयं समारुते| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> samūlāṁ pippalīṁ kṣārau dvau pañca lavaṇāni ca| <br /> <br /> mātuluṅgābhayārāsnāśaṭīmaricanāgaram||168|| <br /> <br /> kr̥tvā samāṁśaṁ taccūrṇaṁ pibēt prātaḥ sukhāmbunā| <br /> <br /> ślēṣmikē Grahaṇī dōṣē balavarṇāgnivardhanam||169|| <br /> <br /> samUlAM pippalIM kShArau dvau pa~jca lavaNAni ca| <br /> <br /> mAtulu~ggAbhayArAsnAshaTImaricanAgaram||168|| <br /> <br /> kRutvA samAMshaM taccUrNaM pibet prAtaH sukhAmbunA| <br /> <br /> shleShmike grahaNIdoShe balavarNAgnivardhanam||169|| <br /> <br /> etairevauShadhaiH siddhaM sarpiH peyaM samArute| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Pippali, pippalimoola,'' two types of ''kshara'' (''yavakshara, svarjikakshara''), five types of ''lavana, matulunga, haritaki, rasna, saṭi, maricha'' and ''nagara'' are taken in equal quantity and powdered and administered with warm water early in the morning. It cures ''[[kapha]]ja grahani dosha'' and improves ''bala,'' complexion and [[agni]].<br /> <br /> ''Ghrita'' fortified with above medicines is useful in ''[[kapha]]'' associated with ''[[vata]]ja grahanidosha'' [168-169]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गौल्मिके षट्पलं प्रोक्तं भल्लातकघृतं च यत्||१७०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gaulmikē ṣaṭpalaṁ prōktaṁ bhallātakaghr̥taṁ ca yat||170||<br /> <br /> gaulmike ShaTpalaM proktaM bhallAtakaghRutaM ca yat||170||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Satpala ghrita'' [Cha.Sa. [[Chikitsa Sthana]]. 5/147-148] and ''bhallataka ghrita'' [Cha.Sa.[[ Chikitsa Sthana ]]5/143-146] as explained in [[Gulma Chikitsa]] may also be administered [170]<br /> <br /> === ''Ksharaghrita'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बिडं कालोत्थलवणं सर्जिकायवशूकजम्| <br /> <br /> सप्तलां कण्टकारीं च चित्रकं चेति दाहयेत्||१७१|| <br /> <br /> सप्तकृत्वः स्रुतस्यास्य क्षारस्य [३९] द्व्याढकेन तु| <br /> <br /> आढकं सर्पिषः पक्त्वा पिबेदग्निविवर्धनम्||१७२|| <br /> <br /> इति क्षारघृत<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> biḍaṁ kālōtthalavaṇaṁ sarjikāyavaśūkajam| <br /> <br /> saptalāṁ kaṇṭakārīṁ ca citrakaṁ cēti dāhayēt||171|| <br /> <br /> saptakr̥tvaḥ srutasyāsya kṣārasya [39] dvyāḍhakēna tu| <br /> <br /> āḍhakaṁ sarpiṣaḥ paktvā pibēdAgnivivardhanam||172|| <br /> <br /> iti kṣāraghr̥tam <br /> <br /> biDaM kAlotthalavaNaM sarjikAyavashUkajam| <br /> <br /> saptalAM kaNTakArIM ca citrakaM ceti dAhayet||171|| <br /> <br /> saptakRutvaH srutasyAsya kShArasya [39] dvyADhakena tu| <br /> <br /> ADhakaM sarpiShaH paktvA pibedagnivivardhanam||172|| <br /> <br /> iti kShAraghRutam<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Bida lavana, kalottha lavana, sarjikakshara, yavakshara, saptala, kanthakari'' and ''chitraka'' are burned together and later on mixed in water and filtered seven times. One ''adhaka'' (3.073 kg) of this ''kshara'' is added to one ''adhaka'' (3.073 kg) of ''ghrita'' and ''sneha siddhi'' is done. This ''ksharaghrita'' is indicated for increasing the digestive power [171-172]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> समूलां पिप्पलीं पाठां चव्येन्द्रयवनागरम्| <br /> <br /> चित्रकातिविषे हिङ्गु श्वदंष्ट्रां कटुरोहिणीम्||१७३|| <br /> <br /> वचां च कार्षिकं पञ्चलवणानां पलानि च| <br /> <br /> दध्नः प्रस्थद्वये तैलसर्पिषोः कुडवद्वये||१७४|| <br /> <br /> खण्डीकृतानि निष्क्वाथ्य शनैरन्तर्गते रसे| <br /> <br /> अन्तर्धूमं ततो दग्धवा चूर्णं कृत्वा घृताप्लुतम्||१७५|| <br /> <br /> पिबेत् पाणितलं तस्मिञ्जीर्णे स्यान्मधुराशनः| <br /> <br /> वातश्लेष्मामयान्सर्वान्हन्याद्विषगरांश्च सः||१७६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> samūlāṁ pippalīṁ pāṭhāṁ cavyēndrayavanāgaram| <br /> <br /> citrakātiviṣē hiṅgu śvadaṁṣṭrāṁ kaṭurōhiṇīm||173||<br /> <br /> vacāṁ ca kārṣikaṁ pañcalavaṇānāṁ palāni ca| <br /> <br /> dadhnaḥ prasthadvayē tailasarpiṣōḥ kuḍavadvayē||174|| <br /> <br /> khaṇḍīkr̥tāni niṣkvāthya śanairantargatē rasē| <br /> <br /> antardhūmaṁ tatō dagdhavā cūrṇaṁ kr̥tvā ghr̥tāplutam||175|| <br /> <br /> pibēt pāṇitalaṁ tasmiñjīrṇē syānmadhurāśanaḥ| <br /> <br /> Vātaślēṣmāmayānsarvānhanyādviṣagarāṁśca saḥ||176|| <br /> <br /> samUlAM pippalIM pAThAM cavyendrayavanAgaram| <br /> <br /> citrakAtiviShe hi~ggu shvadaMShTrAM kaTurohiNIm||173|| <br /> <br /> vacAM ca kArShikaM pa~jcalavaNAnAM palAni ca| <br /> <br /> dadhnaH prasthadvaye tailasarpiShoH kuDavadvaye||174|| <br /> <br /> khaNDIkRutAni niShkvAthya shanairantargate rase| <br /> <br /> antardhUmaM tato dagdhavA cUrNaM kRutvA ghRutAplutam||175||<br /> <br /> pibet pANitalaM tasmi~jjIrNe syAnmadhurAshanaH| <br /> <br /> vAtashleShmAmayAnsarvAnhanyAdviShagarAMshca saH||176|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Pippali, pippalimoola, patha, chavya, indrayava, nagara, chitraka, ativisha, hingu, svadamishthra'' (''gokshura''), ''katurohini'' and ''vacha'' are taken in one ''karsha'' (12 gm) quantity each. To this one ''pala'' (12 gm) of ''panchalavana'' is added along with two ''prastha'' of curds and two ''kudava'' (384 gm) of ''taila'' and ''ghrita''. The combination is boiled till water is completely evaporated. It is again burned by ''antaradhooma'' method and the end product is powdered and mixed with ghee its dosage is one ''panitala'' and when medicine gets digested patient is advised to take sweet diet. It is indicated in ''[[vata]] [[kapha]]ja'' disorders and in ''visha'' and ''gara visha'' [173-176]<br /> <br /> === ''Kshara'' preparations ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भल्लातकं त्रिकटुकं त्रिफलां लवणत्रयम्| <br /> <br /> अन्तर्धूमं द्विपलिकं गोपुरीषाग्निना दहेत्||१७७|| <br /> <br /> स क्षारः सर्पिषा पीतो भोज्ये वाऽप्यवचूर्णितः| <br /> <br /> हृत्पाण्डुग्रहणीदोषगुल्मोदावर्तशूलनुत्||१७८||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhallātakaṁ trikaṭukaṁ triphalāṁ lavaṇatrayam| <br /> <br /> antardhūmaṁ dvipalikaṁ gōpurīṣāgninā dahēt||177||<br /> <br /> sa kṣāraḥ sarpiṣā pītō bhōjyē vā'pyavacūrṇitaḥ|<br /> <br /> hr̥tpāṇḍuGrahaṇī dōṣagulmōdāvartaśūlanut||178||<br /> <br /> bhallAtakaM trikaTukaM triphalAM lavaNatrayam| <br /> <br /> antardhUmaM dvipalikaM gopurIShAgninA dahet||177|| <br /> <br /> sa kShAraH sarpiShA pIto bhojye vA~apyavacUrNitaH| <br /> <br /> hRutpANDugrahaNIdoShagulmodAvartashUlanut||178||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Bhallataka, trikaṭu, triphala,'' three types of ''lavana'' (''saindhva, sauvarchala'' and ''bida'') should be burned by ''antaradhooma'' method with help of cow dung cakes. This ''kshara'' should be administered with ghee or by sprinkling over prepared food.<br /> <br /> It is indicated in ''hridroga, pandu, grahanidosha, gulma, udavarta'' and pain (especially spasmodic pain)[177-178]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दुरालभां करञ्जौ द्वौ सप्तपर्णं सवत्सकम्| <br /> <br /> षड्ग्रन्थां मदनं मूर्वां पाठामारग्वधं तथा||१७९|| <br /> <br /> गोमूत्रेण समांशानि कृत्वा चूर्णानि दाहयेत्| <br /> <br /> दग्ध्वा च तं पिबेत् क्षारं ग्रहणीबलवर्धनम्||१८०||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> durālabhāṁ karañjau dvau saptaparṇaṁ savatsakam| <br /> <br /> ṣaḍgranthāṁ madanaṁ mūrvāṁ pāṭhāmāragvadhaṁ tathā||179|| <br /> <br /> gōmūtrēṇa samāṁśāni kr̥tvā cūrṇāni dāhayēt| <br /> <br /> dagdhvā ca taṁ pibēt kṣāraṁ Grahaṇī balavardhanam||180||<br /> <br /> durAlabhAM kara~jjau dvau saptaparNaM savatsakam| <br /> <br /> ShaDgranthAM madanaM mUrvAM pAThAmAragvadhaM tathA||179|| <br /> <br /> gomUtreNa samAMshAni kRutvA cUrNAni dAhayet| <br /> <br /> dagdhvA ca taM pibet kShAraM grahaNIbalavardhanam||180||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Duralabha'', two types of ''karanja'' (''karanja, lata karanja''), ''saptaparna, vatsaka, sadgrantha'' (''vacha''), ''madanaphala, murva, patha'' and ''aragvadha'' should be mixed with equal quantity of ''gomutra'' and boiled and prepared as per ''kshara kalpana''. This ''kshara'' increases ''bala'' of ''grahani'' i.e. of [[agni]] [179-180]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भूनिम्बं रोहिणीं तिक्तां पटोलं निम्बपर्पटम्| <br /> <br /> दहेन्माहिषमूत्रेण क्षार एषोऽग्निवर्धनः||१८१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhūnimbaṁ rōhiṇīṁ tiktāṁ paṭōlaṁ nimbaparpaṭam| <br /> <br /> dahēnmāhiṣamūtrēṇa kṣāra ēṣō'gnivardhanaḥ||181|| <br /> <br /> bhUnimbaM rohiNIM tiktAM paTolaM nimbaparpaTam|<br /> <br /> dahenmAhiShamUtreNa kShAra eSho~agnivardhanaH||181|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Bhunimba, kutaki, tikta, patola, nimba'' and ''parpataka'' are burned with buffalo urine and prepared as per ''kshara kalpana''. Such ''kshara'' promotes ''agnibala'' [181]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्वे हरिद्रे वचा कुष्ठं चित्रकः कटुरोहिणी| <br /> <br /> मुस्तं च बस्तमूत्रेण दहेत् क्षारोऽग्निवर्धनः||१८२||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dvē haridrē vacā kuṣṭhaṁ citrakaḥ kaṭurōhiṇī| <br /> <br /> mustaṁ ca bastamūtrēṇa dahēt kṣārō'gnivardhanaḥ||182||<br /> <br /> dve haridre vacA kuShThaM citrakaH kaTurohiNI| <br /> <br /> mustaM ca bastamUtreNa dahet kShAro~agnivardhanaH||182||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Two types of ''haridra'' (''haridra'' and ''daruharidra''), ''vacha, kuṣṭha, chitraka, kutaki'' and ''musta'' after mixing in goat's urine are burned and ''kshara'' is prepared as per ''kshara kalpana''. It helps in increasing ''agnibala'' [182]<br /> <br /> === ''Ksharagudika'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चतुष्पलं सुधाकाण्डात्त्रिपलं लवणत्रयात्| <br /> <br /> वार्ताकीकुडवं चार्कादष्टौ द्वे चित्रकात् पले||१८३|| <br /> <br /> दग्धानि वार्ताकुरसे गुटिका भोजनोत्तराः| <br /> <br /> भुक्तं भुक्तं पचन्त्याशु कासश्वासार्शसां हिताः||१८४|| <br /> <br /> विसूचिकाप्रतिश्यायहृद्रोगशमनाश्च ताः| <br /> <br /> इत्येषा क्षारगुटिका कृष्णात्रेयेण कीर्तिता||१८५|| <br /> <br /> इति क्षारगुडिका<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> catuṣpalaṁ sudhākāṇḍāttripalaṁ lavaṇatrayāt| <br /> <br /> vārtākīkuḍavaṁ cārkādaṣṭau dvē citrakāt palē||183|| <br /> <br /> dagdhāni vārtākurasē guṭikā bhōjanōttarāḥ| <br /> <br /> bhuktaṁ bhuktaṁ pacantyāśu kāsaśvāsārśasāṁ hitāḥ||184|| <br /> <br /> visūcikāpratiśyāyahr̥drōgaśāmanāśca tāḥ| <br /> <br /> ityēṣā kṣāraguṭikā kr̥ṣṇātrēyēṇa kīrtitā||185|| <br /> <br /> iti kṣāraguḍikā<br /> <br /> catuShpalaM sudhAkANDAttripalaM lavaNatrayAt| <br /> <br /> vArtAkIkuDavaM cArkAdaShTau dve citrakAt pale||183||<br /> <br /> dagdhAni vArtAkurase guTikA bhojanottarAH| <br /> <br /> bhuktaM bhuktaM pacantyAshu kAsashvAsArshasAM hitAH||184|| <br /> <br /> visUcikApratishyAyahRudrogashamanAshca tAH| <br /> <br /> ityeShA kShAraguTikA kRuShNAtreyeNa kIrtitA||185|| <br /> <br /> iti kShAraguDikA<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Four ''pala'' (192 gm) of stems of ''sudha'', three ''pala'' (144 gm) of three types of ''lavana'' i.e. one ''pala'' (48 gm) each of ''saindhava, sauvarchala'' and ''bida'', one ''kudava'' (192 gm) of ''vartaki,'' eight ''pala'' (388 gm) of ''arka'' and two ''pala'' (96 gm) of ''chitraka'' are burned and the ''kshara'' thus prepared is triturated with ''svarasa'' of ''vartaku'' and pills are prepared. Its administration after food helps in quick digestion and useful in ''kasa, shvasa, arsha, vishuchika, pratishyaya'' and ''hridroga''. This preparation is called ''ksharagudika'' and is propounded by ''krishnatre'' [183-185]<br /> <br /> === ''Chaturtha-kshara'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> वत्सकातिविषे पाठां दुःस्पर्शां हिङ्गु चित्रकम्| <br /> <br /> चूर्णीकृत्य पलाशाग्रक्षारे मूत्रस्रुते पचेत्||१८६|| <br /> <br /> आयसे भाजने सान्द्रात्तस्मात् [४०] कोलं सुखाम्बुना| <br /> <br /> मद्यैर्वा ग्रहणीदोषशोथार्शःपाण्डुमान् पिबेत्||१८७|| <br /> <br /> इति चतुर्थक्षारः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vatsakātiviṣē pāṭhāṁ duḥsparśāṁ hiṅgu citrakam| <br /> <br /> cūrṇīkr̥tya palāśāgrakṣārē mūtrasrutē pacēt||186|| <br /> <br /> āyasē bhājanē sāndrāttasmāt [40] kōlaṁ sukhāmbunā| <br /> <br /> madyairvā Grahaṇī dōṣaśōthārśaḥpāṇḍumān pibēt||187|| <br /> <br /> iti caturthakṣāraḥ<br /> <br /> vatsakAtiviShe pAThAM duHsparshAM hi~ggu citrakam| <br /> <br /> cUrNIkRutya palAshAgrakShAre mUtrasrute pacet||186|| <br /> <br /> Ayase bhAjane sAndrAttasmAt [40] kolaM sukhAmbunA| <br /> <br /> madyairvA grahaNIdoShashothArshaHpANDumAn pibet||187|| <br /> <br /> iti caturthakShAraH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Vatsaka, ativisha, patha, duhasparsha, hingu'' and ''chitraka'' should be powdered together and mixed with ''palashagrakshara''. It is cooked in cow’s urine in an iron pan till it becomes semisolid. Its dosage is one ''kola'' (6 gm) to be taken with lukewarm water or with ''madya'' (medicated alcohol). It is indicated in ''grahanidosha, shotha, arsha'' and ''pandu''. The preparation is known as ''chaturtha kshara'' [186-187]<br /> <br /> === ''Panchamakshara'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिफलां कटभीं चव्यं बिल्वमध्यमयोरजः| <br /> <br /> रोहिणीं कटुकां मुस्तं कुष्ठं पाठां च हिङ्गु च||१८८|| <br /> <br /> मधुकं मुष्ककयवक्षारौ त्रिकटुकं वचाम्| <br /> <br /> विडङ्गं पिप्पलीमूलं स्वर्जिकां निम्बचित्रकौ||१८९|| <br /> <br /> मूर्वाजमोदेन्द्रयवान् गुडूचीं देवदारु च| <br /> <br /> कार्षिकं लवणानां च पञ्चानां पलिकान्पृथक्||१९०|| <br /> <br /> भागान् दध्नि त्रिकुडवे घृततैलेन मूर्च्छितम्| <br /> <br /> अन्तर्धूमं शनैर्दग्ध्वा तस्मात् पाणितलं पिबेत्||१९१|| <br /> <br /> सर्पिषा कफवातार्शोग्रहणीपाण्डुरोगवान्| <br /> <br /> प्लीहमूत्रग्रहश्वासहिक्काकासक्रिमिज्वरान्||१९२|| <br /> <br /> शोषातिसारौ श्वयथुं प्रमेहानाहहृद्ग्रहान्| <br /> <br /> हन्यात् सर्वविषं [४१] चैव क्षारोऽग्निजननो वरः||१९३|| <br /> <br /> जीर्णे रसैर्वा मधुरैरश्नीयात् पयसाऽपि वाइति पञ्चमक्षारः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> triphalāṁ kaṭabhīṁ cavyaṁ bilvāmadhyāmayōrajaḥ| <br /> <br /> rōhiṇīṁ kaṭukāṁ mustaṁ kuṣṭhaṁ pāṭhāṁ ca hiṅgu ca||188|| <br /> <br /> madhukaṁ muṣkakayavakṣārau trikaṭukaṁ vacām| <br /> <br /> viḍaṅgaṁ pippalīmūlaṁ svarjikāṁ nimbacitrakau||189|| <br /> <br /> mūrvājamōdēndrayavān guḍūcīṁ dēvadāru ca| <br /> <br /> kārṣikaṁ lavaṇānāṁ ca pañcānāṁ palikānpr̥thak||190|| <br /> <br /> bhāgān dadhni trikuḍavē ghr̥tatailēna mūrcchitam| <br /> <br /> antardhūmaṁ śanairdagdhvā tasmāt pāṇitalaṁ pibēt||191|| <br /> <br /> sarpiṣā kaphavātārśōGrahaṇī pāṇḍurōgavān| <br /> <br /> plīhamūtragrahaśvāsahikkākāsakrimijvarān||192|| <br /> <br /> śōṣātisārau śvayathuṁ pramēhānāhahr̥dgrahān| <br /> <br /> hanyāt sarvaviṣaṁ [41] caiva kṣārō'gnijananō varaḥ||193|| <br /> <br /> jīrṇē rasairvā madhurairaśnīyāt payasā'pi vāiti pañcāmakṣāraḥ<br /> <br /> triphalAM kaTabhIM cavyaM bilvamadhyamayorajaH| <br /> <br /> rohiNIM kaTukAM mustaM kuShThaM pAThAM ca hi~ggu ca||188|| <br /> <br /> madhukaM muShkakayavakShArau trikaTukaM vacAm| <br /> <br /> viDa~ggaM pippalImUlaM svarjikAM nimbacitrakau||189|| <br /> <br /> mUrvAjamodendrayavAn guDUcIM devadAru ca| <br /> <br /> kArShikaM lavaNAnAM ca pa~jcAnAM palikAnpRuthak||190|| <br /> <br /> bhAgAn dadhni trikuDave ghRutatailena mUrcchitam| <br /> <br /> antardhUmaM shanairdagdhvA tasmAt pANitalaM pibet||191|| <br /> <br /> sarpiShA kaphavAtArshograhaNIpANDurogavAn| <br /> <br /> plIhamUtragrahashvAsahikkAkAsakrimijvarAn||192|| <br /> <br /> shoShAtisArau shvayathuM pramehAnAhahRudgrahAn| <br /> <br /> hanyAt sarvaviShaM [41] caiva kShAro~agnijanano varaH||193|| <br /> <br /> jIrNe rasairvA madhurairashnIyAt payasA~api vAiti pa~jcamakShAraH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Triphala, kaṭabhi, chavya,'' pulp of ''bilva'', powder of ''ayoraja'' (''mandura''), ''katutki, musta, kushtha, patha, hingu, madhuka, kshara'' of ''muskaka'' and ''yavakshara, trikatu, vacha, vidanga, pippalimoola, svarjikakshara, nimba, chitraka, murva, ajamoda, indrayava, guḍuchi'' and ''devadaru'' are taken in one ''karsha'' (12 gm) quantity and one ''pala'' each of five salts are taken. All are mixed with three ''kudavas'' (576 gm) of ''dadhi, ghrita'' and ''taila''. The mixture is burned by ''antardhooma'' method. One ''panitala'' is the dose which is given with ghee. It is indicated in ''[[kapha]]'' and ''[[vata]]ja arsha, grahani, pandu, pleeha, mutragraha, svasa, hikka, kasa, krimi, jwara, sosha, atisara, sotha, prameha, anaha, hridgraha'' and in all types of toxicity.<br /> <br /> It is one among the best stimulants of [[agni]]. Once the medicine is digested ''mamsarasa'' or sweet diet or milk should be administered. This ends the explanation of the ''panchamakshara'' [188-193]<br /> <br /> === Treatment of ''tridoshaja grahani''===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> त्रिदोषे विधिविद्वैद्यः पञ्च कर्माणि कारयेत्||१९४|| <br /> <br /> घृतक्षारासवारिष्टान् दद्याच्चाग्निविवर्धनान्| <br /> <br /> क्रिया या चानिलादीनां निर्दिष्टा ग्रहणीं प्रति||१९५|| <br /> <br /> व्यत्यासात्तां समस्तां वा कुर्याद्दोषविशेषवित्|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tridōṣē vidhividvaidyaḥ pañca karmāṇi kārayēt||194|| <br /> <br /> ghr̥takṣārāsavāriṣṭān dadyāccāgnivivardhanān| <br /> <br /> kriyā yā cānilādīnāṁ nirdiṣṭā Grahaṇī ṁ prati||195|| <br /> <br /> vyatyāsāttāṁ sāmastāṁ vā kuryāddōṣaviśēṣavit|<br /> <br /> tridoShe vidhividvaidyaH pa~jca karmANi kArayet||194|| <br /> <br /> ghRutakShArAsavAriShTAn dadyAccAgnivivardhanAn| <br /> <br /> kriyA yA cAnilAdInAM nirdiShTA grahaNIM prati||195|| <br /> <br /> vyatyAsAttAM samastAM vA kuryAddoShavisheShavit|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''tridoshaja grahani, [[Panchakarma]]'' should be carried out as per predominance of ''[[dosha]]''. Various ghee, ''kshara, asava'' and ''arishtha'' preparation useful in stimulation of [[agni]] should be administered.<br /> <br /> Previously described line of treatment for ''[[vata]]ja'' etc ''grahani'' should be accordingly followed. This line of treatment should be done either separately or jointly after finding the predominance of ''[[dosha]]'' [194-195]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्नेहनं स्वेदनं शुद्धिर्लङ्घनं दीपनं च यत्||१९६|| <br /> <br /> चूर्णानि लवणक्षारमध्वरिष्टसुरासवाः| <br /> <br /> विविधास्तक्रयोगाश्च दीपनानां च सर्पिषाम्||१९७|| <br /> <br /> ग्रहणीरोगिभिः सेव्याः<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snēhanaṁ svēdanaṁ śuddhirlaṅghanaṁ dīpanaṁ ca yat||196|| <br /> <br /> cūrṇāni lavaṇakṣārāmadhvariṣṭasurāsavāḥ| <br /> <br /> vividhāstakrayōgāśca dīpanānāṁ ca sarpiṣām||197|| <br /> <br /> Grahaṇī rōgibhiḥ sēvyāḥ<br /> <br /> snehanaM svedanaM shuddhirla~gghanaM dIpanaM ca yat||196|| <br /> <br /> cUrNAni lavaNakShAramadhvariShTasurAsavAH| <br /> <br /> vividhAstakrayogAshca dIpanAnAM ca sarpiShAm||197|| <br /> <br /> grahaNIrogibhiH sevyAH<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Snehana]], [[swedana]], [[shodhana]], [[langhana]], [[deepana]],'' various powder preparation of ''lavana, kshara, madhvarishtha, surasava,'' various ''takra'' preparation, ''deepaniya ghrita'' are to be prescribed to the ''grahanidosha'' patient [196-197]<br /> <br /> === Treatment of various states of disease and ''[[dosha]]'' aggravation ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्रियां चावस्थिकीं शृणु| <br /> <br /> ष्ठीवनं श्लैष्मिके रूक्षं दीपनं तिक्तसंयुतम्||१९८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kriyāṁ cāvasthikīṁ śr̥ṇu| <br /> <br /> ṣṭhīvanaṁ ślaiṣmikē rūkṣaṁ dīpanaṁ tiktasaṁyutam||198|| <br /> <br /> kriyAM cAvasthikIM shRuNu| <br /> <br /> ShThIvanaM shlaiShmike rUkShaM dIpanaM tiktasaMyutam||198|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Henceforth treatment as per condition is being mentioned.<br /> <br /> In ''[[kapha]]ja grahani'' if there is excess sputum, then ''ruksha'' (ununctuous) and ''[[deepana]]'' drugs having bitter taste should be administered [198]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सकृद्रूक्षं सकृत्स्निग्धं कृशे बहुकफे हितम्| <br /> <br /> परीक्ष्यामं शरीरस्य दीपनं स्नेहसंयुतम्||१९९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sakr̥drūkṣaṁ sakr̥tsnigdhaṁ kr̥śē bahukaphē hitam|<br /> <br /> parīkṣyāmaṁ śarīrasya dīpanaṁ snēhasaṁyutam||199||<br /> <br /> sakRudrUkShaM sakRutsnigdhaM kRushe bahukaphe hitam| <br /> <br /> parIkShyAmaM sharIrasya dIpanaM snehasaMyutam||199|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If patient is weak, but ''[[kapha]]'' is excessive then alternately ununctous and unctuous therapies should be administered repeatedly. After complete examination; if ''[[pachana]]'' of ''ama'' has taken place than administer ghee fortified by ''deepaniya'' medicines [199] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दीपनं बहुपित्तस्य तिक्तं मधुरसंयुतम्|<br /> <br /> बहुवातस्य तु स्नेहलवणाम्लयुतं हितम्||२००|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dīpanaṁ bahuPittasya tiktaṁ madhurasaṁyutam| <br /> <br /> bahuVātasya tu snēhalavaṇāmlayutaṁ hitam||200||<br /> <br /> dIpanaM bahupittasya tiktaM madhurasaMyutam| <br /> <br /> bahuvAtasya tu snehalavaNAmlayutaM hitam||200|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If ''[[pitta]]'' is aggravated then ''[[deepana]]'' drugs having bitter taste along with medicines having sweet taste should be administered whereas if ''[[vata]]'' is aggravated then ''deepaniya'' drugs along with ''sneha, lavana'' and ''amla'' dominated drugs should be administered [200]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सन्धुक्षति तथा वह्निरेषां विधिवदिन्धनैः|<br /> <br /> स्नेहमेव परं विद्याद्दुर्बलानलदीपनम्||२०१|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sandhukṣati tathā vahnirēṣāṁ vidhivadindhanaiḥ|<br /> <br /> snēhamēva paraṁ vidyāddurbalānaladīpanam||201|| <br /> <br /> sandhukShati tathA vahnireShAM vidhivadindhanaiH| <br /> <br /> snehameva paraM vidyAddurbalAnaladIpanam||201|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Proper management as mentioned in earlier verses stimulates the [[agni]] (digestive power). ''Sneha'' is the best among the ''[[deepana]] dravya'' which helps in stimulating the inefficient [[agni]] [201]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नालं स्नेहसमिद्धस्य शमायान्नं सुगुर्वपि| <br /> <br /> मन्दाग्निरविपक्वं तु पुरीषं योऽतिसार्यते||२०२|| <br /> <br /> दीपनीयौषधैर्युक्तां घृतमात्रां पिबेत्तु सः|<br /> <br /> तया समानः पवनः प्रसन्नो [४२] मार्गमास्थितः||२०३||<br /> <br /> अग्नेः समीपचारित्वादाशु प्रकुरुते बलम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nālaṁ snēhasamiddhasya śamāyānnaṁ sugurvapi| <br /> <br /> mandāgniravipakvaṁ tu purīṣaṁ yō'tisāryatē||202|| <br /> <br /> dīpanīyauṣadhairyuktāṁ ghr̥tamātrāṁ pibēttu saḥ| <br /> <br /> tayā samānaḥ pavanaḥ prasannō [42] mārgamāsthitaḥ||203|| <br /> <br /> agnēḥ samīpacāritvādāśu prakurutē balam| <br /> <br /> nAlaM snehasamiddhasya shamAyAnnaM sugurvapi| <br /> <br /> mandAgniravipakvaM tu purIShaM yo~atisAryate||202|| <br /> <br /> dIpanIyauShadhairyuktAM ghRutamAtrAM pibettu saH| <br /> <br /> tayA samAnaH pavanaH prasanno [42] mArgamAsthitaH||203|| <br /> <br /> agneH samIpacAritvAdAshu prakurute balam| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the patient has inefficient digestive power and voids undigested food in excess in stools or frequency of motions is more, then appropriate quantity of ''ghrita'' fortified by ''[[deepana]]'' medicines should again be given. Thus, ''samana vata'' is regularized and moves in its normal tract. As ''samana vata'' is associated with [[agni]] it instantaneously promotes the strength of [[agni]]. <br /> <br /> Digestive power thus stimulated by ''ghrita'' cannot be suppressed even by heavy meals [202-203]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> काठिन्याद्यः पुरीषं तु कृच्छ्रान्मुञ्चति मानवः||२०४|| <br /> <br /> सघृतं लवणैर्युक्तं नरोऽन्नावग्रहं पिबेत्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kāṭhinyādyaḥ purīṣaṁ tu kr̥cchrānmuñcati mānavaḥ||204|| <br /> <br /> saghr̥taṁ lavaṇairyuktaṁ narō'nnāvagrahaṁ pibēt| <br /> <br /> kAThinyAdyaH purIShaM tu kRucchrAnmu~jcati mAnavaH||204|| <br /> <br /> saghRutaM lavaNairyuktaM naro~annAvagrahaM pibet| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If patient finds difficulty in evacuation of stools due to hardness in stools then salt mixed ''ghrita'' should be administered in between the food.<br /> <br /> ('''Note''':''Lavana rasa'' has ''vata anulomana'' action and also increases secretions, therefore hardness of stool is reduced and stools are easily evacuated) [204]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रौक्ष्यान्मन्दे पिबेत्सर्पिस्तैलं वा दीपनैर्युतम्||२०५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> raukṣyānmandē pibētsarpistailaṁ vā dīpanairyutam||205||<br /> <br /> raukShyAnmande pibetsarpistailaM vA dIpanairyutam||205||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If [[agni]] is suppressed due to ''ruksha [[guna]]'' then either ''ghrita'' or ''taila'' fortified with ''deepaniya'' drugs should be administered [205]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अतिस्नेहात्तु मन्देऽग्नौ चूर्णारिष्टासवा हिताः| <br /> <br /> भिन्ने गुदोपलेपात्तु मले तैलसुरासवाः||२०६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> atisnēhāttu mandē'gnau cūrṇāriṣṭāsavā hitāḥ| <br /> <br /> bhinnē gudōpalēpāttu malē tailasurāsavāḥ||206|| <br /> <br /> atisnehAttu mande~agnau cUrNAriShTAsavA hitAH| <br /> <br /> bhinne gudopalepAttu male tailasurAsavAH||206|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If excessive intake of ''sneha'' is cause for ''agnimandya'' then powder preparation, ''arishta asava'' as mentioned earlier are beneficial; whereas if anal area gets adhered by unformed stools then ''taila, sura'' and ''asava'' preparation should be administered [206]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> उदावर्तात्तु मन्देऽग्नौ निरूहाः स्नेहबस्तयः| <br /> <br /> दोषवृद्ध्या तु मन्देऽग्नौ शुद्धो दोषविधिं चरेत्||२०७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> udāvartāttu mandē'gnau nirūhāḥ snēhabastayaḥ| <br /> <br /> dōṣavr̥ddhyā tu mandē'gnau śuddhō dōṣavidhiṁ carēt||207|| <br /> <br /> udAvartAttu mande~agnau nirUhAH snehabastayaH| <br /> <br /> doShavRuddhyA tu mande~agnau shuddho doShavidhiM caret||207|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If ''udavarta'' (mis-peristalsis) is responsible for suppression of [[agni]] then ''niruha'' and ''sneha [[basti]]'' should be administered; whereas if ''[[dosha]] vriddhi'' is the cause for suppression of [[agni]] then ''[[shodhana]]'' as per ''[[dosha]]'' is indicated [207]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> व्याधियुक्तस्य मन्दे तु सर्पिरेवाग्निदीपनम्| <br /> <br /> उपवासाच्च मन्देऽग्नौ यवागूभिः पिबेद्घृतम्||२०८|| <br /> <br /> अन्नावपीडितं बल्यं दीपनं बृंहणं च तत्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vyādhiyuktasya mandē tu sarpirēvāgnidīpanam| <br /> <br /> upavāsācca mandē'gnau yavāgūbhiḥ pibēdghr̥tam||208|| <br /> <br /> annāvapīḍitaṁ balyaṁ dīpanaṁ br̥ṁhaṇaṁ ca tat| <br /> <br /> vyAdhiyuktasya mande tu sarpirevAgnidIpanam| <br /> <br /> upavAsAcca mande~agnau yavAgUbhiH pibedghRutam||208|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If suppression of [[agni]] has taken place due to diseases than ''ghrita'' is best for ''agni [[deepana]]'' but if fasting is the causes of [[agni]] suppression than ''yavagu'' (gruel) along with ''ghrita'' should be taken. ''Ghrita'' when taken in between the meal, it increases the strength, stimulates the digestion and nourishes the body [208]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दीर्घकालप्रसङ्गात्तु क्षामक्षीणकृशान्नरान्||२०९|| <br /> <br /> प्रसहानां रसैः साम्लैर्भोजयेत् पिशिताशिनाम्| <br /> <br /> लघु, तीक्ष्णोष्णशोधित्वाद्दीपयन्त्याशु तेऽनलम्||२१०|| <br /> <br /> मांसोपचितमांसत्वात्तथाऽऽशुतरबृंहणाः|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dīrghakālaprasaṅgāttu kṣāmakṣīṇakr̥śānnarān||209|| <br /> <br /> prasahānāṁ rasaiḥ sāmlairbhōjayēt piśitāśinām| <br /> <br /> laghu, tīkṣṇōṣṇaśōdhitvāddīpayantyāśu tē'nalam||210|| <br /> <br /> māṁsōpacitamāṁsatvāttathā''śutarabr̥ṁhaṇāḥ|<br /> <br /> annAvapIDitaM balyaM dIpanaM bRuMhaNaM ca tat| <br /> <br /> dIrghakAlaprasa~ggAttu kShAmakShINakRushAnnarAn||209|| <br /> <br /> prasahAnAM rasaiH sAmlairbhojayet pishitAshinAm| <br /> <br /> laghu, tIkShNoShNashodhitvAddIpayantyAshu te~analam||210|| <br /> <br /> mAMsopacitamAMsatvAttathA~a~ashutarabRuMhaNAH|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If ''agnimandya'' has been chronic and patient has become indolent, weak and emaciated then soup of ''prasaha'' group of animals (animals who snatch their food) fortified with ''amla'' drugs is advised. As this meat soups are light for digestion having penetrating, hot, purifying qualities stimulates the [[agni]]. Further as the animals feed on other animals their meat ''mamsa'' is well nourished and compact therefore causes quick nourishment [209-210]<br /> <br /> === Factors affecting status of [[agni]] ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नाभोजनेन कायाग्निर्दीप्यते नातिभोजनात्||२११|| <br /> <br /> यथा निरिन्धनो वह्निरल्पो वाऽतीन्धनावृतः| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> nābhōjanēna kāyāgnirdīpyatē nātibhōjanāt||211|| <br /> <br /> yathā nirindhanō vahniralpō vā'tīndhanāvr̥taḥ| <br /> <br /> nAbhojanena kAyAgnirdIpyate nAtibhojanAt||211|| <br /> <br /> yathA nirindhano vahniralpo vA~atIndhanAvRutaH| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Fasting or over eating does not stimulate [[agni]], as like fire in environment is extinguished if there is no fuel supply or if excessive fuel covers the [[agni]]. [211]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्नेहान्नविधिभिश्चित्रैश्चूर्णारिष्टसुरासवैः ||२१२|| <br /> <br /> सम्यक्प्रयुक्तैर्भिषजा बलमग्नेः प्रवर्धते| <br /> <br /> यथा हि सारदार्वग्निः स्थिरः सन्तिष्ठते चिरम्||२१३|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snēhānnavidhibhiścitraiścūrṇāriṣṭasurāsavaiḥ [44] ||212|| <br /> <br /> samyakprayuktairbhiṣajā balāmagnēḥ pravardhatē| <br /> <br /> yathā hi sāradārvAgniḥ sthiraḥ santiṣṭhatē ciram||213||<br /> <br /> snehAnnavidhibhishcitraishcUrNAriShTasurAsavaiH [44] ||212|| <br /> <br /> samyakprayuktairbhiShajA balamagneH pravardhate| <br /> <br /> yathA hi sAradArvagniH sthiraH santiShThate ciram||213|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Proper intake of ''sneha'', followed by eating proper food preparations as well as appropriate use of various ''churna, arishtha, sura'' and ''asava'' along with proper medication as per condition, enhances the power of [[agni]] similar to the environmental fire which remains stable for long duration when good hard wood catches fire [212-213]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्नेहान्नविधिभिस्तद्वदन्तरग्निर्भवेत् स्थिरः| <br /> <br /> हितं जीर्णे मितं चाश्नंश्चिरमारोग्यमश्नुते||२१४|| <br /> <br /> अवैषम्येण धातूनामग्निवृद्धौ यतेत ना| <br /> <br /> समैर्दोषैः समो मध्ये देहस्योष्माऽग्निसंस्थितः||२१५|| <br /> <br /> पचत्यन्नं तदारोग्यपुष्ट्यायुर्बलवृद्धये| <br /> <br /> दोषैर्मन्दोऽतिवृद्धो वा विषमैर्जनयेद्गदान्||२१६|| <br /> <br /> वाच्यं मन्दस्य तत्रोक्तमतिवृद्धस्य वक्ष्यते|<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> snēhānnavidhibhistadvadantarAgnirbhavēt sthiraḥ| <br /> <br /> hitaṁ jīrṇē mitaṁ cāśnaṁściramārōgyāmaśnutē||214|| <br /> <br /> avaiṣamyēṇa dhātūnāmAgnivr̥ddhau yatēta nā| <br /> <br /> sāmairdōṣaiḥ samō madhyē dēhasyōṣmā'gnisaṁsthitaḥ||215|| <br /> <br /> pacatyannaṁ tadārōgyapuṣṭyāyurbalavr̥ddhayē| <br /> <br /> dōṣairmandō'tivr̥ddhō vā viṣāmairjanayēdgadān||216|| <br /> <br /> vācyaṁ mandasya tatrōktam ativr̥ddhasya vakṣyatē|<br /> <br /> snehAnnavidhibhistadvadantaragnirbhavet sthiraH| <br /> <br /> hitaM jIrNe mitaM cAshnaMshciramArogyamashnute||214|| <br /> <br /> avaiShamyeNa dhAtUnAmagnivRuddhau yateta nA| <br /> <br /> samairdoShaiH samo madhye dehasyoShmA~agnisaMsthitaH||215|| <br /> <br /> pacatyannaM tadArogyapuShTyAyurbalavRuddhaye| <br /> <br /> doShairmando~ativRuddho vA viShamairjanayedgadAn||216|| <br /> <br /> vAcyaM mandasya tatroktamativRuddhasya vakShyate| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Intake of food mixed with ''sneha'' and as per dietetic rules and regulation stabilizes the digestive power. <br /> <br /> Eating wholesome diet in appropriate quantity after previously eaten food is digested helps in maintaining good health for long duration. <br /> <br /> A person should workout so that ''agni vriddhi'' takes place without disturbing the balance of ''[[dhatu]]s''. Such [[agni]] digests the food, maintains health and nourishment, promotes longevity and increases strength. The same ''[[dosha]]'' when vitiated causes ''mandagni, tikshnagni'' and ''vishamagni'' and such a vitiated [[agni]] gives rise to various diseases. <br /> <br /> Management of ''mandagni'' has been explained previously henceforth management of ''ativriddha agni'' will be explained [214-216]<br /> <br /> === ''Samprapti'' of ''atyagni'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> नरे क्षीणकफे पित्तं कुपितं मारुतानुगम्||२१७|| <br /> <br /> स्वोष्मणा पावकस्थाने बलमग्नेः प्रयच्छति| <br /> <br /> तदा लब्धबलो देहे विरूक्षे सानिलोऽनलः||२१८|| <br /> <br /> परिभूय पचत्यन्नं तैक्ष्ण्यादाशु मुहुर्मुहुः| <br /> <br /> पक्त्वाऽन्नं स ततो धातूञ्छोणितादीन् पचत्यपि||२१९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> narē kṣīṇakaphē Pittaṁ kupitaṁ mārutānugam||217|| <br /> <br /> svōṣmaṇā pāvakasthānē balāmagnēḥ prayacchati| <br /> <br /> tadā labdhabalō dēhē virūkṣē sānilō'nalaḥ||218|| <br /> <br /> paribhūya pacatyannaṁ taikṣṇyādāśu muhurmuhuḥ| <br /> <br /> paktvā'nnaṁ sa tatō dhātūñchōṇitādīn pacatyapi||219||<br /> <br /> nare kShINakaphe pittaM kupitaM mArutAnugam||217|| <br /> <br /> svoShmaNA pAvakasthAne balamagneH prayacchati| <br /> <br /> tadA labdhabalo dehe virUkShe sAnilo~analaH||218|| <br /> <br /> paribhUya pacatyannaM taikShNyAdAshu muhurmuhuH| <br /> <br /> paktvA~annaM sa tato dhAtU~jchoNitAdIn pacatyapi||219|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Person having diminished ''[[kapha]]'', aggravated ''[[pitta]]'' and associated ''[[vata]]'' leads to increase in the ''ushma'' of [[agni]] resulting in enhancing the capacity and power of [[agni]]. In such patient if the body is already undernourished, ''[[vata]]'' increases which further strengths the [[agni]] wherein both, together with help of ''tikshna [[guna]]'' digests the food even if taken frequently. After digestion of food, the increased [[agni]] starts digesting ''[[rakta]]'', etc ''[[dhatu]]s'' also [217-219]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ततो दौर्बल्यमातङ्कान्मृत्युं चोपनयेन्नरम्| <br /> <br /> भुक्तेऽन्ने लभते शान्तिं जीर्णमात्रे प्रताम्यति||२२०|| <br /> <br /> तृट्श्वासदाहमूर्च्छाद्या व्याधयोऽत्यग्निसम्भवाः| <br /> <br /> तमत्यग्निं गुरुस्निग्धशीतैर्मधुरविज्जलैः||२२१|| <br /> <br /> अन्नपानैर्नयेच्छान्तिं दीप्तमग्निमिवाम्बुभिः| <br /> <br /> मुहुर्मुहुरजीर्णेऽपि भोज्यान्यस्योपहारयेत्||२२२|| <br /> <br /> निरिन्धनोऽन्तरं लब्ध्वा यथैनं न विपादयेत्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatō daurbalyamātaṅkānmr̥tyuṁ cōpanayēnnaram| <br /> <br /> bhuktē'nnē labhatē śāntiṁ jīrṇamātrē pratāmyati||220|| <br /> <br /> tr̥ṭśvāsadāhamūrcchādyā vyādhayō'tyAgnisambhavāḥ| <br /> <br /> tāmatyāgniṁ gurusnigdhaśītairmadhuravijjalaiḥ||221||<br /> <br /> annapānairnayēcchāntiṁ dīptāmAgnimivāmbubhiḥ| <br /> <br /> muhurmuhurajīrṇē'pi bhōjyānyasyōpahārayēt||222|| <br /> <br /> nirindhanō'ntaraṁ labdhvā yathainaṁ na vipādayēt| <br /> <br /> tato daurbalyamAta~gkAnmRutyuM copanayennaram| <br /> <br /> bhukte~anne labhate shAntiM jIrNamAtre pratAmyati||220|| <br /> <br /> tRuTshvAsadAhamUrcchAdyA vyAdhayo~atyagnisambhavAH| <br /> <br /> tamatyagniM gurusnigdhashItairmadhuravijjalaiH||221|| <br /> <br /> annapAnairnayecchAntiM dIptamagnimivAmbubhiH| <br /> <br /> muhurmuhurajIrNe~api bhojyAnyasyopahArayet||222|| <br /> <br /> nirindhano~antaraM labdhvA yathainaM na vipAdayet| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Consequently, the patient becomes weak and death may occur due to disease. The patient feels better on consuming the food but feels worn out along with blackouts when food is digested. Morbid thirst, dyspnea, burning sensation, fainting etc are observed in disease caused due to ''atyagni''. <br /> <br /> Digestive power can be pacified by taking foods and drinks which are heavy to digest, unctuous, cold, sweet and liquid same way as fire is extinguishes by water in nature. The patient should be administered food at regular interval although previously eaten meal is undigested so that ''atyagni'' due to lack of fuel does not digest the tissues [220-222]<br /> <br /> === Management of ''atyagni'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पायसं कृशरां स्निग्धं पैष्टिकं गुडवैकृतम्||२२३|| <br /> <br /> अद्यात्तथौदकानूपपिशितानि भृतानि च| <br /> <br /> मत्स्यान्विशेषतः श्लक्ष्णान्स्थिरतोयचरांस्तथा||२२४|| <br /> <br /> आविकं च भृतं मांसमद्यादत्यग्निनाशनम् [४६] | <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pāyasaṁ kr̥śarāṁ snigdhaṁ paiṣṭikaṁ guḍavaikr̥tam||223|| <br /> <br /> adyāttathaudakānūpapiśitāni bhr̥tāni ca| <br /> <br /> matsyānviśēṣataḥ ślakṣṇānsthiratōyacarāṁstathā||224|| <br /> <br /> āvikaṁ ca bhr̥taṁ māṁsāmadyādatyāgnināśanam [46] | <br /> <br /> pAyasaM kRusharAM snigdhaM paiShTikaM guDavaikRutam||223||<br /> <br /> adyAttathaudakAnUpapishitAni bhRutAni ca| <br /> <br /> matsyAnvisheShataH shlakShNAnsthiratoyacarAMstathA||224|| <br /> <br /> AvikaM ca bhRutaM mAMsamadyAdatyagninAshanam [46] | <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Payasa'' (milk pudding), ''krishara'' (thick gruel prepared of rice and lentils), ''snigdha'' (unctuous), ''paiṣṭika'' (resembling flour paste), various jaggery products, meat of aquatic animals or marshy area especially fish which is mainly in smooth (not salty) and stable water and roasted meat of sheep may be given to pacify the ''atyagni'' [223-224]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यवागूं समधूच्छिष्टां घृतं वा क्षुधितः पिबेत्||२२५|| <br /> <br /> गोधूमचूर्णमन्थं वा व्यधयित्वा सिरां पिबेत्| <br /> <br /> पयो वा शर्करासर्पिर्जीवनीयौषधैः शृतम्||२२६|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yavāgūṁ sāmadhūcchiṣṭāṁ ghr̥taṁ vā kṣudhitaḥ pibēt||225||<br /> <br /> gōdhūmacūrṇāmanthaṁ vā vyadhayitvā sirāṁ pibēt| <br /> <br /> payō vā śarkarāsarpirjīvanīyauṣadhaiḥ śr̥tam||226|| <br /> <br /> yavAgUM samadhUcchiShTAM ghRutaM vA kShudhitaH pibet||225|| <br /> <br /> godhUmacUrNamanthaM vA vyadhayitvA sirAM pibet| <br /> <br /> payo vA sharkarAsarpirjIvanIyauShadhaiH shRutam||226|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''Yavagu'' (thick gruel) mixed with bee wax or ''ghrita'' should be given whenever patient feels hungry. ''Mantha'' prepared from wheat flour or venesection may be advised. Milk medicated with ''jeevaniya'' group of drugs along with sugar and ''ghrita'' may be given [225-226]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> फलानां तैलयोनीनामुत्क्रुञ्चाश्च [४७] सशर्कराः| <br /> <br /> मार्दवं जनयन्त्यग्नेः स्निग्धा मांसरसास्तथा||२२७|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> phalānāṁ tailayōnīnāmutkruñcāśca [47] saśarkarāḥ| <br /> <br /> mārdavaṁ janayantyagnēḥ snigdhā māṁsarasāstathā||227|| <br /> <br /> phalAnAM tailayonInAmutkru~jcAshca [47] sasharkarAH| <br /> <br /> mArdavaM janayantyagneH snigdhA mAMsarasAstathA||227|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Paste of fruits, substances containing oil like ''tila'' (sesame seeds) with sugar and meat soup with ghee pacifies the [[agni]] [227]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पिबेच्छीताम्बुना सर्पिर्मधूच्छिष्टेन संयुतम्| <br /> <br /> गोधूमचूर्णं पयसा ससर्पिष्कं पिबेन्नरः||२२८|| <br /> <br /> आनूपरससिद्धान् वा त्रीन् स्नेहांस्तैलवर्जितान्| <br /> <br /> पयसा सम्मितं [४८] चापि घनं त्रिस्नेहसंयुतम्||२२९|| <br /> <br /> नारिस्तन्येन संयुक्तां पिबेदौदुम्बरीं त्वचम्| <br /> <br /> ताभ्यां वा पायसं सिद्धमद्यादत्यग्निशान्तये||२३०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pibēcchītāmbunā sarpirmadhūcchiṣṭēna saṁyutam| <br /> <br /> gōdhūmacūrṇaṁ payasā sasarpiṣkaṁ pibēnnaraḥ||228|| <br /> <br /> ānūparasasiddhān vā trīn snēhāṁstailavarjitān| <br /> <br /> payasā sammitaṁ [48] cāpi ghanaṁ trisnēhasaṁyutam||229|| <br /> <br /> nāristanyēna saṁyuktāṁ pibēdaudumbarīṁ tvacam| <br /> <br /> tābhyāṁ vā pāyasaṁ siddhāmadyādatyāgniśāntayē||230|| <br /> <br /> pibecchItAmbunA sarpirmadhUcchiShTena saMyutam| <br /> <br /> godhUmacUrNaM payasA sasarpiShkaM pibennaraH||228|| <br /> <br /> AnUparasasiddhAn vA trIn snehAMstailavarjitAn| <br /> <br /> payasA sammitaM [48] cApi ghanaM trisnehasaMyutam||229|| <br /> <br /> nAristanyena saMyuktAM pibedaudumbarIM tvacam| <br /> <br /> tAbhyAM vA pAyasaM siddhamadyAdatyagnishAntaye||230|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient should take ''ghrita'' with beeswax along with cold water as ''anupana''. Patient may take wheat flour with milk and ghee.<br /> <br /> Patient may be advised to take three ''sneha'' i.e. ghee, abinal fat, bone-marrow fortified with meat soup of animals residing in marshy areas. Milk mixed with wheat flour and curd along with three ''sneha'' (''ghrita, vasa, majja'') may be given. Bark of ''udumbara'' mixed with human milk and milk pudding prepared from ''udumbara'' and human milk helps in pacifying the ''atyagni'' [228-230]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> श्यामात्रिवृद्विपक्वं वा पयो दद्याद्विरेचनम्| <br /> <br /> असकृत् पित्तशान्त्यर्थं पायसप्रतिभोजनम्||२३१|| <br /> <br /> प्रसमीक्ष्य भिषक् प्राज्ञस्तस्मै दद्याद्विधानवित्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śyāmātrivr̥dvipakvaṁ vā payō dadyādvirēcanam| <br /> <br /> asakr̥t Pitta śāntyarthaṁ pāyasapratibhōjanam||231|| <br /> <br /> prasamīkṣya bhiṣak prājñastasmai dadyādvidhānavit| <br /> <br /> shyAmAtrivRudvipakvaM vA payo dadyAdvirecanam| <br /> <br /> asakRut pittashAntyarthaM pAyasapratibhojanam||231|| <br /> <br /> prasamIkShya bhiShak prAj~jastasmai dadyAdvidhAnavit| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Milk medicated with ''syama'' and ''trivritta'' may be advised for ''[[virechana]]'' for alleviating the ''[[pitta]]'' followed by diet of milk pudding. Expert physician should follow the line of treatment after proper examination of patient [231]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यत्किञ्चिन्मधुरं मेद्यं श्लेष्मलं गुरुभोजनम्||२३२|| <br /> <br /> सर्वं तदत्यग्निहितं भुक्त्वा प्रस्वपनं दिवा| <br /> <br /> मेद्यान्यन्नानि योऽत्यग्नावप्रतान्तः [४९] समश्नुते||२३३|| <br /> <br /> न तन्निमित्तं व्यसनं लभते पुष्टिमेव च| <br /> <br /> कफे वृद्धे जिते पित्ते मारुते चानलः समः||२३४|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yatkiñcinmadhuraṁ mēdyaṁ ślēṣmalaṁ gurubhōjanam||232|| <br /> <br /> sarvaṁ tadatyāgnihitaṁ bhuktvā prasvapanaṁ divā| <br /> <br /> mēdyānyannāni yō'tyagnāvapratāntaḥ [49] sāmaśnutē||233|| <br /> <br /> na tannimittaṁ vyasanaṁ labhatē puṣṭimēva ca| <br /> <br /> kaphē vr̥ddhē jitē pittē mārutē cānalaḥ sāmaḥ||234|| <br /> <br /> sāmadhātōḥ pacatyannaṁ puṣṭyāyurbalavr̥ddhayē|<br /> <br /> yatki~jcinmadhuraM medyaM shleShmalaM gurubhojanam||232|| <br /> <br /> sarvaM tadatyagnihitaM bhuktvA prasvapanaM divA| <br /> <br /> medyAnyannAni yo~atyagnAvapratAntaH [49] samashnute||233|| <br /> <br /> na tannimittaM vyasanaM labhate puShTimeva ca| <br /> <br /> kaphe vRuddhe jite pitte mArute cAnalaH samaH||234|| <br /> <br /> samadhAtoH pacatyannaM puShTyAyurbalavRuddhaye|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Foods which are sweet in taste, fatty, increases ''[[kapha]]'' and heavy to digest should be given. All food items are good for ''atyagni'' and sleeping after meals during day time is beneficial in ''atyagni''. Patient who takes fatty diet even though he is not hungry does not succumb to death. If he is suffering from ''atyagni'' on the other hand such diet pattern is nutritional. Whenever due to medication and diet, ''[[kapha]]'' is increased; it subdues ''[[pitta]]'' and ''[[vata]]'' and normalizes the [[agni]].<br /> <br /> When ''[[dhatu]]s'' are in equilibrium ''anna'' gets digested resulting in increase in nutrition, longevity and strength [232-234]<br /> <br /> === Improper dietary habits ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भवन्ति चात्र- <br /> <br /> पथ्यापथ्यमिहैकत्र भुक्तं समशनं मतम्||२३५|| <br /> <br /> विषमं बहु वाऽल्पं वाऽप्यप्राप्तातीतकालयोः| <br /> <br /> भुक्तं पूर्वान्नशेषे तु पुनरध्यशनं मतम्||२३६|| <br /> <br /> त्रीण्यप्येतानि मृत्युं वा घोरान् व्याधीन्सृजन्ति वा| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhavanti cātra- <br /> <br /> pathyāpathyamihaikatra bhuktaṁ sāmaśanaṁ matam||235|| <br /> <br /> viṣāmaṁ bahu vā'lpaṁ vā'pyaprāptātītakālayōḥ| <br /> <br /> bhuktaṁ pūrvānnaśēṣē tu punaradhyaśanaṁ matam||236|| <br /> <br /> trīṇyapyētāni mr̥tyuṁ vā ghōrān vyādhīnsr̥janti vā| <br /> <br /> bhavanti cAtra- <br /> <br /> pathyApathyamihaikatra bhuktaM samashanaM matam||235|| <br /> <br /> viShamaM bahu vA~alpaM vA~apyaprAptAtItakAlayoH| <br /> <br /> bhuktaM pUrvAnnasheShe tu punaradhyashanaM matam||236|| <br /> <br /> trINyapyetAni mRutyuM vA ghorAn vyAdhInsRujanti vA| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Taking of wholesome and unwholesome foods together in diet is known as ''samashana''.<br /> <br /> ''Vishamashana'' is defined as taking food either in excess quantity or very little quantity and also if taken before or after appropriate time. <br /> <br /> ''Adhyashana'' is having food even though previously eaten food is not yet digested.<br /> <br /> All the above three are causes for death or give rise to serious disorders [235-236]<br /> <br /> === Variation in digestion as per day-night cycle ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्रातराशे त्वजीर्णेऽपि सायमाशो न दुष्यति||२३७|| <br /> <br /> दिवा प्रबुध्यतेऽर्केण हृदयं पुण्डरीकवत्| <br /> <br /> तस्मिन्विबुद्धे स्रोतांसि स्फुटत्वं यान्ति सर्वशः||२३८|| <br /> <br /> व्यायामाच्च विहाराच्च विक्षिप्तत्वाच्च चेतसः| <br /> <br /> न क्लेदमुपगच्छन्ति दिवा तेनास्य धातवः||२३९|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> prātarāśē tvajīrṇē'pi sāyamāśō na duṣyati||237|| <br /> <br /> divā prabudhyatē'rkēṇa hr̥dayaṁ puṇḍarīkavat| <br /> <br /> tasminvibuddhē srōtāṁsi sphuṭatvaṁ yānti sarvaśaḥ||238|| <br /> <br /> vyāyāmācca vihārācca vikṣiptatvācca cētasaḥ| <br /> <br /> na klēdamupagacchanti divā tēnāsya dhātavaḥ||239|| <br /> <br /> prAtarAshe tvajIrNe~api sAyamAsho na duShyati||237|| <br /> <br /> divA prabudhyate~arkeNa hRudayaM puNDarIkavat| <br /> <br /> tasminvibuddhe srotAMsi sphuTatvaM yAnti sarvashaH||238|| <br /> <br /> vyAyAmAcca vihArAcca vikShiptatvAcca cetasaH| <br /> <br /> na kledamupagacchanti divA tenAsya dhAtavaH||239|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If morning eaten food is undigested and still if anyone takes evening food it may not be more vitiative since in day time all the ''srotas'' (channels) are dilated and heart is active similar to the lotus which blossoms with sunrise. During daytime, exercise, other physical and mental activities (cause heart to pump blood properly to) prevent the genesis of ''kleda'' (excess moisture) in various ''[[dhatu]]s'' [237-239]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अक्लिन्नेष्वन्नमासिक्तमन्यत्तेषु न दुष्यति| <br /> <br /> अविदग्ध इव क्षीरे क्षीरमन्यद्विमिश्रितम्||२४०|| <br /> <br /> नैव दूष्यति तेनैव समं सम्पद्यते यथा| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> aklinnēṣvannamāsiktāmanyattēṣu na duṣyati| <br /> <br /> avidagdha iva kṣīrē kṣīrāmanyadvimiśritam||240|| <br /> <br /> naiva dūṣyati tēnaiva sāmaṁ sampadyatē yathā| <br /> <br /> aklinneShvannamAsiktamanyatteShu na duShyati| <br /> <br /> avidagdha iva kShIre kShIramanyadvimishritam||240|| <br /> <br /> naiva dUShyati tenaiva samaM sampadyate yathA| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> As unspoiled milk when mixed with fresh milk, the mixture does not get spoiled and will get uniformly mixed, so is the condition when in daytime previously eaten food although not digested still a person can digest another meal [240]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रात्रौ तु हृदये म्लाने संवृतेष्वयनेषु च| <br /> <br /> यान्ति कोष्ठे परिक्लेदं संवृते देहधातवः||२४१|| <br /> <br /> क्लिन्नेष्वन्यदपक्वेषु तेष्वासिक्तं प्रदुष्यति| <br /> <br /> विदग्धेषु पयःस्वन्यत् पयस्तप्तमिवार्पितम्||२४२|| <br /> <br /> नैशेष्वाहारजातेषु नाविपक्वेषु बुद्धिमान्| <br /> <br /> तस्मादन्यत्समश्नीयात्पालयिष्यन्बलायुषी||२४३||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rātrau tu hr̥dayē mlānē saṁvr̥tēṣvayanēṣu ca| <br /> <br /> yānti kōṣṭhē pariklēdaṁ saṁvr̥tē dēhadhātavaḥ||241|| <br /> <br /> klinnēṣvanyadapakvēṣu tēṣvāsiktaṁ praduṣyati| <br /> <br /> vidagdhēṣu payaḥsvanyat payastaptamivārpitam||242|| <br /> <br /> naiśēṣvāhārajātēṣu nāvipakvēṣu buddhimān| <br /> <br /> tasmādanyatsāmaśnīyātpālayiṣyanbalāyuṣī||243||<br /> <br /> rAtrau tu hRudaye mlAne saMvRuteShvayaneShu ca| <br /> <br /> yAnti koShThe parikledaM saMvRute dehadhAtavaH||241|| <br /> <br /> klinneShvanyadapakveShu teShvAsiktaM praduShyati| <br /> <br /> vidagdheShu payaHsvanyat payastaptamivArpitam||242|| <br /> <br /> naisheShvAhArajAteShu nAvipakveShu buddhimAn| <br /> <br /> tasmAdanyatsamashnIyAtpAlayiShyanbalAyuShI||243||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In the night, the channels are closed, so is the heart which functions at slow rate as demand is less, the ''apakva ahara rasa'' increases in viscosity; thus ''ama'' adheres to the ''[[dhatu]]s'' and if another food is taken the indigestion causes more ''apakva ahara rasa'' causing disease. The condition resembles, wherein uncooked milk mixed with warm milk gets spoiled. Therefore, a wise person should not take meals if food taken at night is not digested; this will surely effect strength and life of a person [241-243]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकाः- <br /> <br /> अन्तरग्निगुणा देहं यथा धारयते च सः| <br /> <br /> यथाऽन्नं पच्यते यांश्च यथाऽऽहारः करोत्यपि||२४४||<br /> <br /> येऽग्नयो यांश्च पुष्यन्ति यावन्तो ये पचन्ति यान्| <br /> <br /> रसादीनां क्रमोत्पत्तिर्मलानां तेभ्य एव च||२४५|| <br /> <br /> वृष्याणामाशुकृद्धेतुर्धातुकालोद्भवक्रमः| <br /> <br /> रोगैकदेशकृद्धेतुरन्तरग्निर्यथाऽधिकः||२४६|| <br /> <br /> प्रदुष्यति यथा दुष्टो यान् रोगाञ्जनयत्यपि| <br /> <br /> ग्रहणी या यथा [५३] यच्च ग्रहणीदोषलक्षणम्||२४७|| <br /> <br /> पूर्वरूपं पृथक् चैव व्यञ्जनं सचिकित्सितम्| <br /> <br /> चतुर्विधस्य निर्दिष्टं तथा चावस्थिकी क्रिया||२४८|| <br /> <br /> जायते च यथाऽत्यग्निर्यच्च तस्य चिकित्सितम्| <br /> <br /> उक्तवानिह तत् सर्वं ग्रहणीदोषके मुनिः||२४९||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkāḥ- <br /> <br /> antarAgniguṇā dēhaṁ yathā dhārayatē ca saḥ| <br /> <br /> yathā'nnaṁ pacyatē yāṁśca yathā''hāraḥ karōtyapi||244|| <br /> <br /> yē'gnayō yāṁśca puṣyanti yāvantō yē pacanti yān| <br /> <br /> rasādīnāṁ kramōtpattirmalānāṁ tēbhya ēva ca||245|| <br /> <br /> vr̥ṣyāṇāmāśukr̥ddhēturdhātukālōdbhavakrāmaḥ| <br /> <br /> rōgaikadēśakr̥ddhēturantarAgniryathā'dhikaḥ||246|| <br /> <br /> praduṣyati yathā duṣṭō yān rōgāñjanayatyapi| <br /> <br /> Grahaṇī yā yathā [53] yacca Grahaṇī dōṣalakṣaṇam||247|| <br /> <br /> pūrvarūpaṁ pr̥thak caiva vyañjanaṁ sacikitsitam| <br /> <br /> caturvidhasya nirdiṣṭaṁ tathā cāvasthikī kriyā||248|| <br /> <br /> jāyatē ca yathā'tyAgniryacca tasya cikitsitam| <br /> <br /> uktavāniha tat sarvaṁ Grahaṇī dōṣakē muniḥ||249||<br /> <br /> tatra shlokAH- <br /> <br /> antaragniguNA dehaM yathA dhArayate ca saH| <br /> <br /> yathA~annaM pacyate yAMshca yathA~a~ahAraH karotyapi||244|| <br /> <br /> ye~agnayo yAMshca puShyanti yAvanto ye pacanti yAn| <br /> <br /> rasAdInAM kramotpattirmalAnAM tebhya eva ca||245|| <br /> <br /> vRuShyANAmAshukRuddheturdhAtukAlodbhavakramaH| <br /> <br /> rogaikadeshakRuddheturantaragniryathA~adhikaH||246|| <br /> <br /> praduShyati yathA duShTo yAn rogA~jjanayatyapi| <br /> <br /> grahaNI yA yathA [53] yacca grahaNIdoShalakShaNam||247|| <br /> <br /> pUrvarUpaM pRuthak caiva vya~jjanaM sacikitsitam| <br /> <br /> caturvidhasya nirdiShTaM tathA cAvasthikI kriyA||248||<br /> <br /> jAyate ca yathA~atyagniryacca tasya cikitsitam| <br /> <br /> uktavAniha tat sarvaM grahaNIdoShake muniH||249||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> To conclude, this chapter has addressed the following points:<br /> #Qualities of ''antaragni'', <br /> #Manner in which [[agni]] does ''dharana'' (sustenance) of the body, <br /> #Manner in which food is digested, <br /> #How digested food functions? <br /> #How different types of [[agni]] does nutrition after digesting the fuel? <br /> #Development of ''[[rasa]]di [[dhatu]]s'' and their associated waste products after digestions at ''[[dhatu]]'' level (tissue level)<br /> #How aphrodisiacs act instantly and time taken for the ''[[dhatu]]'' formation and order of development?<br /> #Reason why diseases are located in one part of the body and role of ''antaragni'' in disease formation, <br /> #Diseases caused by abnormal [[agni]] <br /> #Definition of ''grahani'' and sign and symptoms of ''grahani dosha'', <br /> #Premonitory symptoms along with four types of ''grahani dosha'' their signs and symptoms with treatment as per various condition, <br /> #How condition of ''atyagni'' is generated and its treatment. [244-249]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने <br /> <br /> ग्रहणीचिकित्सितं नाम पञ्चदशोऽध्यायः||१५||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityAgnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē <br /> <br /> Grahaṇī cikitsitaṁ nāma pañcadaśō'dhyāyaḥ||15||<br /> <br /> ityagniveshakRute tantre~aprApte dRuDhabalasampUrite cikitsAsthAne <br /> <br /> grahaNIcikitsitaM nAma pa~jcadasho~adhyAyaH||15||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Herewith, fifteenth chapter related to [[Grahani Chikitsa]] which was unavailable as part of [[Chikitsa Sthana]] of Agnivesha Tantra supplemented by Dridhabala has been completed (15).<br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *''Dehagni'' (all the entities in the body that are responsible for digestion and metabolism) is the fundamental causative agent for longevity, normal complexion, normal strength, good health, motivation, normal growth, normal luster, normal ''[[ojas]]'', normal body temperature and various other forms of [[agni]]. Even the existence of an individual is said to be because of ''dehagni'' (3).<br /> *When the [[agni]] stops functioning, the individual dies; if the [[agni]] functions normally, the individual can lead a healthy and long life. Similarly, if the [[agni]] becomes abnormal, the individual suffers from various diseases; and hence, the [[agni]] is said to be the root cause of health and longevity (4).<br /> *Normal functioning of [[agni]] is essential to make the consumed food capable of nourishing the body tissues and of promoting the ''[[ojas]]'' (vital essence), strength, complexion etc. In the absence of normal digestion (and metabolism), the normal body tissues such as ''[[rasa]]'' cannot be formed nor nourished (5).<br /> *''[[Vata dosha]]'', specifically ''prana vata'' and ''samana vata'' play significant role in process of digestion and metabolism. <br /> *Three ''[[dosha]]s'' are produced in three consequent stages of digestion after consumption of food. ''[[Kapha]]'' is produced in first stage of ''madhura avasthapaka''; pitta in second stage of ''amla avasthapaka'' and ''[[vata]]'' is produced in third stage of ''katu avasthapaka''. The site of production and time of production of ''[[dosha]]'' is in sequence as the process of digestion proceeds. Increase or decrease in quantity of ''[[dosha]]'' depends upon similarity or dis-similarity of basic composition of food consumed. <br /> *The first phase of digestion is carried out by ''jatharagni'', second phase by ''bhutagni'' and third phase by ''dhatvagni''. These are different levels of action of [[agni]] where various digestive and metabolic processes take place. <br /> *During the processing by ''dhatvagni, stanya'' (breast milk) and the menstrual blood are derived after ''[[rasa]]''. ''Kandara'' (tendon) and ''sira''(vein) are derived after ''[[rakta]]''. ''Vasa''(fat) and the six layers of ''tvacha'' (skin) are derived after ''[[mamsa]]'' (muscle) and ''snayu''(ligament) are derived after ''[[meda]]s'' (adipose tissue) (17).<br /> *The feces and the urine are the ''kitta'' (non-nutrient portion/waste portion/byproduct) of ingested food. The ''kiṭṭa'' of ''[[rasa]]'' is ''mala-[[kapha]]'' (excretions). ''Mala-[[pitta]]'' (bile pigment) is the ''kitta'' of ''[[rakta]]''. ''Kha-mala'' (the wastes accumulated in the hollow structures of the body such as external ears and nostrils) are the ''kitta'' of ''[[mamsa]]''. ''Sweda'' (sweat) is the ''[[mala]]'' of ''[[medas]]''. ''Kesha'' (hairs on the head) and ''loma'' (body hair) are the ''[[mala]]'' of ''[[asthi]]''. The ''[[mala]]'' of ''[majja]]'' is the oily excretion of the eye and the skin (sebum). Thus, the ''[[dhatu]]s'' continuously undergo two kinds of transformation: ''prasada'' (nutrient portion) and ''kitta'' (non-nutrient portion). This entire sequence of transformation and metabolism of ''[[dhatu]]'' is thus inter dependent (18-19½ ).<br /> *Disorders of various factors mentioned above shall be treated after considering the original ''[[dhatu]]'' from which the factor is derived. <br /> *''Vyana vata'' forcefully propels the ''[[rasa dhatu]]'' out of the heart and spreads it all over the body simultaneously, continuously and for the entire life (36).<br /> *Disease is produced only at the site of abnormality of body systems. <br /> *Life and strength of an individual depends on [[agni]] hence one should take utmost care to maintain the [[agni]] by providing fuel in the form of food and drinks which should be taken as per the rules mentioned. (40)<br /> *If the rules of diet and dietary habits are not followed due to greed, then disease of ''grahani'' occurs. <br /> *The ''anna-visha'' (toxins) produced due to improper digestion and metabolism causes diseases at the sites of affliction. <br /> *The ''vishamagni'' (improper [[agni]]) causes irregularity in digestion and therefore defective formation of ''[[dhatu]]'' takes place. Whereas, ''teekshnagni'' (excessive [[agni]]) when associated with little quantity of fuel (in the form of food) causes depletion of ''[[dhatu]]'' (tissue elements) (50).<br /> *The digestive disorder of ''grahani'' can lead to secondary disorders related with other body systems along with digestive system. <br /> *''Grahani'' disease is classified into four types viz ''[[vata]]ja, [[pitta]]ja, [[kapha]]ja'' and ''sannipataja'' depending upon the dominance of ''[[dosha]]'' and on the basis of the classification, etiological factors, symptoms and signs are varied.<br /> *When the ''[[dosha]]s'' are located in ''grahani'' and are associated with incomplete digested food then ''[[vamana]]'' (emetic therapy) is advised. <br /> *If the ''ama'' is in ''pakvashaya'' and in ''anutklishta'' (stuck, not ready to come out) condition, then ''stravana'' (increasing secretion) with ''[[deepana]] dravyas'' should be administered. <br /> *If ''ama'' gets absorbed along with ''[[rasa dhatu]]'' and if it pervades throughout the body then ''[[langhana]]'' and ''[[pachana]]'' should be advised.<br /> *Various purification procedures are advised as per the state of ''[[dosha]]'' aggravation and site of affliction in disease. Ghee processed with digestive stimulant drugs,sour media like buttermilk is advised. <br /> *Patient should be evaluated for ''amadosha'' whether ''samata'' or ''niramta'' is present or not and then appropriately treated with ''[[pachana]]'' etc. treatment (95).<br /> *Buttermilk due to its ''[[deepana]], grahi'' (substances which increases appetite and digestive power and absorb fluid from the stool) and easy to digest actions is very useful in ''grahanidosha''.<br /> *''[[Vata]]'' dominant ''grahani'' shall be treated with ''[[basti]], [[virechana]]'' and unctuous preparations. <br /> *If ''[[pitta]]'' is dominant in its own place then ''[[virechana]]'' or ''[[vamana]]'' should be administered for removal of ''[[pitta]]'' (122).<br /> *In ''[[kapha]]ja grahani'', ''[[vamana]]'' and then drugs having ''katu, amla, lavana, kshara'' and ''tikta rasa'' shall be administered to increase [[agni]] (digestive power) (141).<br /> *In ''tridoshaja grahani'', [[Panchakarma]] should be carried out as per predominance of ''[[dosha]]''. Various ghee, ''kshara'', ''asava'' and ''arishta'' preparation useful in stimulation of [[agni]] should be administered.<br /> *''Sneha'' is the best among the ''[[deepana]] dravya'' which helps in stimulating the inefficient [[agni]] (201)<br /> *Fasting or over eating doesn’t stimulate [[agni]]. Proper intake of ''sneha'', followed by eating proper food preparations as well as appropriate use of various ''churna, arishta, sura'' and ''asava'' along with proper medication as per condition, enhances the power of [[agni]].<br /> *''Atyagni'' is caused by diminished ''[[kapha]]'', aggravated ''[[pitta]]'' and associated ''[[vata]]''. This leads to emaciation if proper food is not consumed. Excessively increased digestive power can be pacified by taking foods and drinks which are heavy to digest, unctuous, cold, sweet and liquid. <br /> *''Samashana'' is taking wholesome and unwholesome foods together in diet. ''Vishamashana'' is taking food either in excess quantity or very little quantity and also if taken before or after appropriate time. ''Adhyashana'' is having food even though previously eaten food is not yet digested. All the above three are causes for death or give rise to serious disorders (235-236).<br /> *If morning eaten food is undigested and still if anyone takes evening food, it may not be more vitiative since in day time all the ''srotas'' (channels) are dilated and heart is active similar to the lotus which blossoms with sunrise. During daytime, exercise, other physical and mental activities (cause heart to pump blood properly to) prevent the genesis of ''kleda'' (excess moisture) in various ''[[dhatu]]s''. In the night, the channels are closed, so is the heart which functions at slow rate as demand is less, the ''apakva ahara rasa'' increases in viscosity; thus ''ama'' adheres to the ''[[dhatu]]s'' and if another food is taken in the morning the indigestion causes more ''apakva ahara rasa'' causing disease.<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> <br /> === Importance of [[agni]] ===<br /> <br /> The functions of gut are vital for maintenance and preservation of health. ''Grahani'' is the seat of ''jatharagni'', which is the initiator of digestive process and strengthens the other 12 ''agnis''. ''Jatharagni'' transforms food into biological substance (''ahara rasa'') which is further trifurcated into ''madhura, amla'' and ''katu avastha paka'' which gets transformed into three biological energies ''[[kapha]], [[pitta]]'' and ''[[vata]]'' respectively. From the physiological point of view, the ''jatharagni'' or the active form of ''pachaka pitta'' is responsible for the digestion of all kinds of foods in the gut. Therefore, this should include all amylolytic, proteolytic and lipolytic enzymes secreted by various kinds of exocrine glands in the gut, which actually cause digestion, i.e., breaking down of different macromolecules into their constituent units.<br /> <br /> There are five ''bhutagnis'' and their function is to metabolize ''panchabhautic'' components of the food that are homologous to them in their composition. For instance, ''bhauma agni'' acts on the component that is ''bhauma'' or ''parthiva'' in its composition. ''Bhutagnis'' act on the products of digestion (''jatharagni paka''), hence, must be acting after the absorption of the nutrients, but before the action of ''dhatvagni''. The major site where the absorbed nutrients undergo biochemical transformation is in the liver, which plays an important role in metabolism, wherein several processes such as trans-amination, de-amination, beta-oxidation of fatty acids, glycolysis etc. take place. Therefore, the overall intermediary metabolism (involving fats, carbohydrates and proteins) can be understood as the functioning of the ''bhutagni''.<br /> <br /> ''Dhatvagni'' acts at tissue-level (in fact, at cellular level) upon the products of ''bhutagni paka'' and are responsible for the building of the respective ''[[dhatu]]s''. In other words, the bio-energetic processes of a cell seem to be under the regulation of ''dhatvagni''. For instance, the common product of intermediary metabolism (involving fats, carbohydrates and proteins) is Acetyl-Co-A, which enters into Kreb’s cycle in the mitochondria of a cell. This is followed by electron transfer and oxidative phosphorylation. &lt;ref&gt;Chatterjea MN, Shinde Rana. In:Textbook of Medical Biochemistry. ISBN: 9788184481341. DOI: 10.5005/jp/books/10917. Edition:7/e. 2007. Pages: 824&lt;/ref&gt; It is interesting to note that the Kreb’s cycle is also known as the ‘final common pathway’ in the process of catabolism of carbohydrates, proteins and fats. However, for the entry of amino acids, glucose and fatty acids into the cell, certain other factors such as hormones too are needed. For instance, insulin promotes the transportation of glucose, amino acids and fatty acids into the cell. Therefore, all these hormones (such as insulin, growth hormone, thyroid hormones, testosterone etc.) that promote the transportation of various nutrients into the cells, along with the enzymes participating in the Kreb’s cycle are to be included under the term ''dhatvagni''.<br /> <br /> Thus, the three major stages of the catabolism (involving fats, carbohydrates and proteins) i.e. digestion, intermediary metabolism and Kreb’s cycle - seem to represent the three sets of ''agnis,'' viz., ''jatharagni, bhutagni'' and ''dhatvagni'' respectively.<br /> <br /> === Role of ''[[vata]]'' in digestion ===<br /> <br /> ''Samana vayu'' separates nutritive (''prasad'') and waste (''kitta'') part from ''ahara rasa''. Nutritive part is circulated to entire body after absorption through ''rasayini'' (villi) by ''vyana vayu''. Waste part is excreted as feces, urine and sweat through their excretory channels by ''apana vata''. Absorbed nutritive substances circulate all over the body through seven specific micro channels of each of the seven ''[[dhatu]]s''.<br /> <br /> === ''Dhatvagni'' ===<br /> <br /> Each ''[[dhatu]]'' has its own transforming [[agni]] and ''srotas''. ''Srotas'' or micro channels have two functions of carrying and transforming the tissues with the help of their specific ''dhatvagni''. Five ''bhutagnis'', one for each ''[[mahabhuta]]'', transform five ''bhautic'' elements into the body tissues and organs. Seven ''dhatvagni'' or tissue transformers, form the tissue elements of seven ''[[dhatu]]s'' by their needed nutrients. After formation of ''[[dhatu]'', the microchannels permeates them into the organs for functioning. During this transformation process, ''upadhatu'' or subtissues and ''dhatumala'' or waste products are formed. ''Updhatus'' of ''[[rasa dhatu]]'' is breast milk; menstrual blood is ''upadhatu'' of ''[[rakta]]''; tendons and six layers of skin are ''upadhatu'' of ''[[mamsa dhatu]]'' etc.<br /> <br /> Apart from digestion, the gut performs various other significant functions as well. The gut has its own protective mechanism in the form of gut-associated lymphoid tissue, which prevents the entry of pathogens into the bloodstream. The micro-biota in the gut serves vital functions related to various aspects of health. The enteric nervous system of the gut has its own functional significance and has been proven to be very closely associated with the central nervous system functions. The gut secretes several hormone-like substances that are helpful in regulating long-term energy balance. All the factors mentioned are either directly or indirectly dependent on these functional domains of the gut. &lt;ref&gt;W I Khan, J E Ghia. Gut hormones: emerging role in immune activation and inflammation. Clin Exp Immunol. 2010 July; 161(1): 19–27&lt;/ref&gt; &lt;ref&gt;Andrew L. Kau, Philip P. Ahern, Nicholas W. Griffin, Andrew L. Goodman, Jeffrey I. Gordon. Human nutrition, the gut microbiome, and immune system: envisioning the future. Nature. 2011 June 15; 474(7351): 327–336. doi: 10.1038/nature10213&lt;/ref&gt; Other forms of [[agni]] in this context are indicative of ''bhutagni'' and ''dhatvagni'', which in turn, are functionally dependent on ''jatharagni''. ''Prana'' in this context may stand for all types of ''[[vata]]'' as well.<br /> <br /> === Three stages of digestion ===<br /> <br /> There are three stages of digestion in the gut. The first stage (''madhura'') takes place in the upper gastro-intestinal tract, i.e., inside the esophagus and stomach; the second stage (''amla'') takes place in the middle portion of the gut, i.e., in the small intestine; and the last stage (''katu'') takes place in the colon. <br /> <br /> The froth-like ''[[kapha]]'' seems to be the thick mucus that covers the entire stomach, providing a protective coating that prevents the gastric mucosa being digested and damaged due to the acid-pepsin mixture.<br /> <br /> ''Accha [[pitta]]'' is ‘liquid’ in nature, released in the duodenum and can be correlated with bile. <br /> <br /> ''Pachaka pitta'' has the functional site between ''amashaya'' (stomach) and ''pakvashaya'' (colon), which is indicative of small intestine. It is composed of five ''[[mahabhuta]]s'' but the ''[[agni mahabhuta]]'' is predominant; and hence, it becomes devoid of fluidity and therefore is also known as [[agni]]. It splits the food into sāra (nutritive) and ''kitta'' (non-nutritive) portions.&lt;ref&gt;Vagbhata. Sutra Sthana, Cha.12 Doshabhediya Adhyaya verse 10-12. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.&lt;/ref&gt;<br /> <br /> ''Sara'' of the food is the minutest fraction (''parama sukshma''). This portion reaches the heart in the form of ''ahara rasa''. From the heart, it then gets re-distributed into 24 pulsatile vessels to be carried into the whole body.&lt;ref&gt;Sushruta. Sutra Sthana, Cha.14 Shonitavarnaniya Adhyaya verse 3. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1&lt;/ref&gt;<br /> <br /> The portion that reaches the colon is the one that is designated as ''kitta''. During the third stage of digestion, there occurs the solidification of fecal matter and formation of certain pungent gases such as ammonia, methane, hydrogen sulfide etc. The term ''pakva'' in this context indicates ''pakva mala''; not ''pakva ahara'' (Verse 9-11).<br /> <br /> === Formation of the seven ''[[dhatu]]s'' ===<br /> <br /> ''[[Rasa]], [[rakta]], [[mamsa]], [[meda]], [[asthi]], [[majja]]'' and ''[[shukra]]'' are the seven fundamental entities that sustain the human body. These can be called ‘tissues’ for the sake of convenience, though some of them are not tissues in a strict sense. It will be pertinent to look into these individual entities at this stage to understand what they really are in terms of anatomy.&lt;ref&gt;Patwardhan K. Human Physiology in Ayurveda. Varanasi, India: Chaukhambha Orientalia, 2013, Jiakrishnadas series no. 134.&lt;/ref&gt; <br /> <br /> ''[[Rasa]]'': A colorless fluid that gets ejected out of the heart and nourishes the entire body. <br /> <br /> ''[[Rakta]]'': The red colored fraction that is formed in liver and spleen after the action of ''ranjaka pitta'' on ''[[rasa]]''. It is essential for life and its function is to supply the life principle (''jeeva'').<br /> <br /> ''[[Rasa]]'' and ''[[rakta]]'' together form what is generally known as blood: ''[[rakta]]'' being the red fraction (red blood corpuscles) and ''[[rasa]]'' being the colorless fluid (plasma). <br /> <br /> ''[[Mamsa]]'': The correct translation of this term would be ‘flesh’. Flesh generally means all kinds of muscles and also the parenchyma of the different viscera such as thyroid, liver, spleen, kidneys etc. <br /> <br /> ''[[Medas]]'': This generally stands for fatty tissue, however, it is to be noted that it is of two types: ''Baddha'' (bound, stable, fixed, stored) and ''abaddha'' (free, unbound). The ''baddha'' form, therefore, must include the stored fat in the form of adipose tissue; and the ''abaddha'' form must include the circulating lipids such as cholesterol, LDL, HDL etc.<br /> <br /> ''[[Asthi]]'': Though the term ''[[asthi]]'' generally stands for bony tissue, it may in some contexts, include all such relatively hard structures that resist easy decaying, viz., teeth, nails and hair.<br /> <br /> ''[[Majja]]'': Generally, the substance that fills all the bony cavities is called ''[[majja]]''. However, the brain substance that fills the cranial cavity too, must be included in ''[[majja]]''. Therefore, ''[[majja]]'' is of two types: ''asthigata'' (bony) and ''mastakagata'' (cranial).<br /> <br /> ''[[Shukra]]'': The term ''[[shukra]]'' has been described to be of two forms in [[Ayurveda]] textbooks: <br /> #The one that is ejaculated during the process of mating, which is responsible for fertilization of ovum and thus embryogenesis.<br /> #The one that is formed from ''[[majja]]'' (the tissue that fills the bony cavities) which in turn circulates all over the body both in males and females. Reproduction is the function of this second form of ''[[shukra]]'' too. Therefore, on careful examination, it seems that the first form of ''[[shukra]]'' stands for the semen in general and for sperms in particular; and, the second form of ''[[shukra]]'' stands for hypothalamo-pituitary-gonadal axis of hormones that circulate all over the body.<br /> <br /> === The process of nourishment of ''[[dhatu]]'' ===<br /> <br /> The process of nourishment of ''[[dhatu]]s'' is explained by three analogies: ''Ksheera-dadhi'' (milk curdling analogy), ''khalekapota'' (analogy of pigeons picking up the choicest grains) and ''kedari-kulya'' (irrigation analogy).<br /> <br /> === ''Ksheera-dadhi nyaya'' (milk curdling analogy) ===<br /> <br /> According to this analogy, the nourishment of a ''[[dhatu]]'' takes place according to the rule of conversion (of one substance into another). Just as the milk is converted into different forms (from milk to curd, curd to butter, butter to ghee) successively, the preceding ''[[dhatu]]'' too is converted into the next one. The sequence of this conversion is as follows: ''[[rasa]], [[rakta]], [[mamsa]], [[meda]], [[asthi]], [[majja]]'' and ''[[shukra]]'' in the same order. <br /> <br /> The transformation of various substances that takes place due to various biochemical reactions could be one way of understanding this analogy. For instance, the process of glycolysis involves different enzymes acting on different substrates at different steps and converting them from one to another. The ability of one kind of stem cell derived from one tissue in giving rise to different forms of cell types of different tissues is known. The response of mesenchymal stem cells to certain stimuli such as hypoxia in the form of migration and tissue regeneration is also known, which can further support this analogy.<br /> <br /> === ''Khalekapota nyaya'' (analogy of pigeons picking up the choicest grains) ===<br /> <br /> According to this analogy, the nourishment of different ''[[dhatu]]s'' takes place according to the rule of selectivity. Just as the pigeons coming from far off places, picking up the grains of their choice from the granary (a storehouse for thrashed grain, ''khala'') and flying back to their destination, the different ''[[dhatu]]s'' too, pick up the required nourishment from the common nutrient pool known as ''[[rasa]]''. The ''[[dhatu]]'' that is situated nearer to ''[[rasa]]'' is nourished first and the remaining later, just as the pigeon from a nearer place gets a chance to pick up grains quickly in the given analogy.<br /> <br /> In this analogy, the choice that the pigeons have in picking up the grain (selectivity) and the energy they spend in the process of obtaining grains (actively) are the vital features. The tissue metabolism can influence the extent of vasodilatation and thus its own perfusion. This is known as auto-regulation of blood supply. Similarly, the specific kind of tissue has affinity for specific nutrient and other substances. For example, the calcium gets deposited normally in bones, but not in the mucous membranes. Similarly, vitamin B-12 is stored in liver and not in other tissues.<br /> <br /> === ''Kedari-kulya nyaya'' (analogy of irrigation) ===<br /> <br /> According to this analogy, the nourishment of ''[[dhatu]]'' takes place according to the rule of irrigation. Just as the ''kulyas'' (small canals / trenches / channels) receive water from the ''kedarika'' (the bigger water reservoir) and then irrigate the nearest field first, the ''[[rasa]]'' too, nourishes the ''[[dhatu]]s'' in a sequential fashion depending on the location of the ''[[dhatu]]''.<br /> <br /> The anatomical location of a cell in the body can influence the amount of perfusion it receives. For instance, the apical regions of the lungs are less perfused than the other areas of the lung, and hence, are susceptible to be affected in some infectious conditions such as tuberculosis. Similarly, the hepatocytes that surround the central vein in a hepatic lobule are more susceptible to hypoxic injury than those situated in the periphery. Sub-endocardial region of the heart is, in the same manner, is more susceptible to ischemia than the epicardial region.<br /> <br /> Another important feature to be noted in this analogy is the passive flow of water from higher altitude to lower altitude, where no external energy is spent. This is in contrast to the pigeons expending their energy to pick up the grains of their choice actively. It is interesting to note the process of transportation of substances across the cell membrane, which has been divided into two major types: active transport and passive transport (Verse-16).<br /> <br /> Bilirubin is a metabolic byproduct of heme portion of the hemoglobin. This is secreted into bile juice in the liver which is in turn released during the process of digestion. Features of [[pitta]] ''vriddhi'' therefore, are yellowish discoloration of sclera, skin, urine and feces. Mucous is rich in water that is derived from extracellular fluid while it is being formed. The cerumen, sebum, and other similar external secretions perform some functions such as providing a waxy protective layer. Sweat and urine share similarities in function as well as composition. Therefore, ''vrikka'' mentioned as the site of origin of ''medavaha srotas'' makes sense when one considers ''sweda'' as the ''[[mala]]'' of ''[[meda]]''. Hair and bones share similarity when it comes to the power to resist easy biodegradation. They also grow weaker in old age. Therefore, hair are the ''[[mala]]'' of ''[[asthi]]'' (Verse 19).<br /> <br /> Circulating provoked ''[[dosha]]'' settles in a tissue whose channels are defective (''kha-vaigunya'') and perfuce the lesion. This pathogenesis has been compared with rain production. The obstruction to the moving ''[[rasa]]'' by the abnormality of ''srotas,'' results in causation of disease, just as the obstruction to the cloud laden monsoon winds by the tall mountains results in the causation of rainfall (Verse 37).<br /> <br /> === Causes of ''grahani'' disorder ===<br /> <br /> ''Abhojana'' (starvation) leads to increase in ''[[vata]]'' and in turn ''agnimandya''.[Cha. Sa. [[Vimana Sthana]] 2/7] Starvation and protein malnutrition disrupts the normal indigenous gastrointestinal tract micro-flora and impairs host antibacterial defenses. Both starvation and protein malnutrition increases the cecal levels of gram negative enteric bacilli and decrease the level of lactobacillus and promote growth of anaerobes that in turn disturb the gut flora. Gut flora also known as gut microbiome has a unique role in digestion and absorption. Once the gut microbiome gets vitiated it leads to indigestion and malabsorption.<br /> <br /> ''Atibhojana'' (excessive intake) causes provocation of all the ''[[dosha]]'' and thereby causing ''agnimandya''. Protein rich diet or fat laden diet or excessive diet takes longer time for emptying of stomach. Longer stay of food explains increase of acidic pH. Therefore, whenever such chyme enters the duodenum the liver and pancreas need to increase secretion of alkali pH. Repeated, such dietary habits lead to indigestion. Further increase of alkali pH causes reduced transit time in small intestine leading to the symptoms like diarrhea. Diet which is ''atiguru'' (heavy) and indulging ''vishamashana''( irregular food habit) will have similar effect. ''Atiruksha ahara'' or diet has low protein value. Protein malnutrition leads to decrease of enzyme secretion as proteins are the building blocks of enzymes. ''Asatmya desha, kala, ritu'' only explain the dietary changes which dramatically alter the balance of bacteria in the gut on daily basis. Research shows that these fluctuations could lead to various digestive and absorptive problems. ''Dushita bhojana'' or contaminated food reacts directly with intestinal flora disturbing their quantitative and qualitative growth causing indigestion. Intake of unctuous substances in ''sama [[pitta]]'' condition leads to ''grahani dosha'' and various other disorders.[ Cha. Sa. [[Sutra Sthana]] 13/76] Emaciation due to disease also has its own impact on digestion. ''Mandagni'' is a causative factor for all diseases but if patient continuously indulges in ''apathya'' then complications may increase or the prognosis turns bad. <br /> <br /> Suppression of manifested natural urges may have impact on nervous system resulting in effect either on enzymatic secretion or on the hormonal secretion. These factors have role in digestion and absorption as may be understood in case of ''adhovata'' (accumulation of ''[[vata]]'' in rectum and pelvic region) and ''[[purisha]] vegadharana'' (suppression of urge of defecation), wherein regular urge suppression disturbs the intestinal pro-kinetic movement.[Cha. Sa. [[Sutra Sthana ]] 7/ 6,8,12] Disturbed pro-kinesia increases the transit time leading to the change in pH which further has its impact on electrolytes and enzymatic secretion leading to reduced digestive power (''agnimandya''). <br /> <br /> Further ''kshudha vegadharana'' (avoiding sense of hunger) effect will be similar to ''abhojana'' (not eating). It may also be noted that repeated ''kshudha vegadharana'' leads to atrophy of the stomach which further weakens the perception of hunger which is controlled by the percentage of the stomach that remains empty similar to the explanation given by Charak that excessive fasting leads to diminution in [[agni]].[Cha.Sa. [[Sutra Sthana]] 22/37] ''Trishna vegadharana'' (avoiding thirst) leads to reduced fluid balance in the body. <br /> <br /> Nearly seven liters of water is secreted during various gastrointestinal secretions. Reduced water intake in long term will reduce gastrointestinal secretion leading to impaired digestion. <br /> <br /> Abnormal digestion is from faulty food habits and unwholesome diet, that causes ''jatharagni dushti'' or vitiation of digestive power. The improperly digested food turns into toxic substance called aamavisha, basic cause of most diseases. If ''amavisha'' associates with any balanced ''[[dosha]]'' or healthy ''[[dhatu]]'', they turn pathogenic. ''Grahanidosha'' is an important example of ''amavisha'' and ''agnidushti''.<br /> <br /> ''Grahanidosha'' is of four types. It starts with inflammation of elementary canal at different places and is called by different names e.g gastritis, duodenitis and colitis. In the second stage erosions and ulcers develop. In third stage mental symptoms like anxiety, illusions, fear, and IBS like symptoms. Fourth stage is ''sannipatic'' with clinical features resembling ulcerative colitis.<br /> <br /> Treatment of ''grahanidosha'' is to enhance ''jatharagni, bhutagni'' and ''dhatvagni'' which encompasses the whole digestive process. Food and drinks are also medicated depending upon the patient and the stage of disease, for extended period of time.<br /> <br /> === Effect on immunity ===<br /> <br /> ''Prayatna'' (effort), ''urja'' (energy) and ''bala'' (strength) are the role played by ''[[vata]], [[pitta]]'' and ''[[kapha]]'' in building up of immunity. When the ''[[dosha]]'' gets vitiated ''prayatna, urja'' and ''bala'' are hampered leading to suppression of immunity. <br /> <br /> Exogenous and endogenous factors vitiate the [[dosha]] which when associated with ama produce either local or systemic disorders. <br /> <br /> ''Tridosha'' play role in impairing immunity and depending on the dominance of a particular ''[[dosha]]'' they are classified as ''[[vata]]ja, [[pitta]]ka'' and ''[[kapha]]ja'' disorders.[Cha.Sa. [[Sutra Sthana]] 28/7]<br /> <br /> === Equilibrium of [[agni]] ===<br /> <br /> [[Agni]] should be associated with balance of ''[[vata]], [[pitta]]'' and ''[[kapha]]'' or ''samagni''. Digestive enzyme secretion is controlled by sympathetic and parasympathetic nerve supply. ''Samagni'' may be compared with balanced state of sympathetic/ parasympathetic activity which explains the role of balanced or ''samana vata''. It may also be noted that ''prana vata'' and ''apana vata'' also have impact on balancing the normal status of [[agni]].<br /> <br /> Acidic and alkaline pH of digestive secretions explains the balanced ''[[pitta]]''. Modern science explains specific range of pH of digestive secretions e.g. pancreatic juice has pH in range of 7.1 – 8.2 that buffers acidic gastric juice in chyme, stops the action of pepsin from the stomach and creates proper pH for action of digestive enzymes in small intestine. Specific pH of gastric juice is essential to convert pepsinogen into pepsin, an active form of proteolytic enzyme thus improper pH will cause variation in digestion.<br /> <br /> Mucosal resistance explains role of ''[[kapha]]'' in maintaining ''samagni''. Intact mucosal lining is present in stomach and small intestine. Breach in mucosal lining causes gastritis, burning sensation etc whereas increased size of mucosal cells alters the pH thereby a balanced ''[[kapha]]'' plays essential role in ''samagni''. Role of prostaglandins to maintain gastric mucosal resistance to prevent the action of HCl in gastric mucosa is to be considered as part of ''kledaka kapha'' as sodium bicarbonate and mucus is secreted by prostaglandins. Drugs which inhibit prostaglandins e.g. aspirin, impairs gastric mucosal barriers leading to gastritis, duodenitis and peptic ulcers.<br /> <br /> === Clinical features ===<br /> <br /> ''Arochaka'' (aversion to food), ''vairasya'' (distaste), ''praseka'' (excessive salivation) are general gastrointestinal manifestations of indigestion. ''Tamaka'' or blackout occurs due to nutritional deficiency. Mal-absorption causes diarrhea which leads to decrease in circulating liquid, a cause of hypo-tension a reason for blackout. Impaired absorption of iron, folate, vit. B12 leads to anemia which may be the cause for blackout (''tamakanvitah''). Resulting anemia and electrolyte depletion (particularly K+) leads to weakness. <br /> #Peripheral neuropathy due to Vit. B12 and thiamine deficiency <br /> #Dermatitis due to deficiency of Vit. A, Zinc and essential fatty acid <br /> #Night Blindness/Xeropthalmia due to Vit A mal-absorption.<br /> #Bleeding due to Vit K malabsorption and hypo prothrombinemia<br /> #Anemia impaired absorption of iron, folate, and vitamin B12<br /> #Amenorrhea, decreased libido due to protein depletion decreased calories and secondary hypo-pituitarism. <br /> #Tetany, paresthesia due to calcium and magnesium mal-absorption <br /> #Glossitis, cheilosis, stomatitis due to deficiency of iron, Vit B12, folate and Vit A (Verse 52-54).<br /> <br /> Spices are basically a combination of acids. When too much of these acids are introduced in gastrointestinal tract which has its own acidic contents it starts damaging the mucosal lining of walls of gastrointestinal tract. It also reduces the pH thus activation of enzyme is hampered leading to indigestion.<br /> <br /> Etiological factors as mentioned in the text have impact mainly on the neural stimulation of digestive secretions affecting the flow of gastrointestinal secretions into the gastrointestinal tract thereby hampering the digestion.<br /> <br /> Hence it is explained that aggravated ''[[vata]]'' encompasses the [[agni]]. Altered canalicular functions hampers digestion, easily understood in primary biliary cirrhosis wherein biliary secretion is restricted. Atrophy of gastric mucosa reduces HCl secretion causing indigestion. The gastric gland contains three types of exocrine gland cells that secrete their products into stomach lumen.''Srotasam kharatvam'' (hardness in channels) quality of ''tikta rasa'' destroys the exocrine gland cell reducing their secretions. Gastric glands include a type of enteroendocrine cell, the G cell which is located mainly in the pyloric antrum and secretes the hormone gastrin into the blood stream which stimulates parietal cells to secrete HCl and chief cells to secrete pepsinogen, it also contracts the lower esophageal sphincter, increases motility of the stomach and relaxes pyloric sphincter. <br /> <br /> G cells when get destroyed the above action of ''[[kapha]]'', in turn, [[agni]] is hampered so also contraction and relaxation karma of ''[[vata]]'' is vitiated.<br /> <br /> Further ''kashaya rasa'' reduces peristaltic movements called as mixing waves which reduces the maceration and mixing of food with secretions of gastric glands, thus improper chyme is formed. Deficiency of gastrointestinal secretions due to damage to the glands or canaliculi or intestine may be mostly considered as having [[vata]]ja origin. Loss of ''pravartana karma'' is to be understood where the transport of secretions is hampered (except in obstructive pathology where ''[[kapha]]'' to be considered). Hartnup’s syndrome a defect in neutral amino acid transport and cystinuria a defect in dibasic amino acid transport explain the rare genetic disorders (''Bija Dusti'') involved in protein digestion absorption.<br /> <br /> Further due to ''[[vata]] prakopa'', intestinal activity is increased which is manifested as malabsorption. For e.g. lactose intolerance is related to rate of gastric emptying. Symptoms are more likely when gastric emptying is rapid than when gastric emptying is slower. Therefore it is more likely that skim milk will be associated with symptoms of lactose intolerance than with whole milk as rate of gastric emptying is more rapid in skim milk. Milk proteins, particularly caseins have appropriate amino acids composition for growth and development of young. <br /> <br /> Caseins are highly digestible in intestine and high quality source of amino acids. Most of whey proteins are relatively less digestible in intestine, although all of them are digested to some degree. When substantial whey proteins are not digested fully, some of intact protein may stimulate a localized intestinal or systemic immune response this is due to beta lactoglobullin referred to milk protein allergy. Similarly, diarrhea observed following subtotal gastrectomy is often a result of lactose intolerance as gastric emptying is accelerated in patients with gastrojejunostomy, rapid small intestinal transit time develops symptoms of lactose intolerance. <br /> <br /> ''Kanthasya-shosah'' (dryness of mouth also known as xerostomia) occurs due to diminish salivary gland secretion. <br /> <br /> Primary cause being fluid loss through diarrhea secondarily it may be association of Sjogren's syndrome with autoimmune disease like primary biliary cirrhosis ~ a secondary Sjogrens syndrome. In this syndrome involvement of other exocrine glands occur leading to diminished secretion of exocrine glands of the gastrointestinal tract, leading to esophageal mucosal atrophy, atrophic gastritis and subclinical pancreatitis. <br /> <br /> Increased appetite (''Kshudha'') is seen because of a negative feedback due to malabsorption or it may be understood under ''rasasheshajeerna''. <br /> <br /> ''Trishna'' is manifested due to increased ''ruksha [[guna]]'' of ''[[vata]]'' and decreased ''jaladi ansha'' due to diarrhea and low fluid intake. <br /> <br /> ''Timira'' (blurred vision) results from vitamin A malabsorption and anemia.<br /> <br /> Tinnitus is a symptom also found in ''Pandu'' (anemia)[Cha. Sa. [[Chikitsa Sthana]] 15/61], which is observed due to malabsorption of essential elements like vitamin B12.<br /> <br /> Pain in flanks, thigh, pelvis, cervical area occurs due to calcium and Vitamin D malabsorption. Pain is also contributed by protein deficiency due to low nutritional diet, osteoporosis, anemia and decrease lactic acid neutralization due to reduce peripheral circulation. <br /> <br /> Whipple’s disease is chronic multisystem disease associated with diarrhea, steatorrhea, weight loss, arthralgia and CNS and cardiac problems caused due to tropheryma whipple. <br /> <br /> ''Hritpeedha'' is chest discomfort or chest pain which may be resultant of anemia but most probably due to gastro-esophageal reflux disease. <br /> <br /> Malabsorption may be for single entity or for various minerals and vitamins and may lead to emaciation and weakness. <br /> <br /> ''Vairasyam'' (distaste) is probably because of taste projections to the hypothalamus and limbic system, there is a strong link between the taste and pleasant and unpleasant emotions. ''Parikartika'' (cutting pain) is due to ''shushka-mala pravritti'' (pellet stools) which causes pressure and rupture of anal-mucosal lining that may lead to cutting pain.<br /> <br /> Craving for all types of food (''griddhih sarvarasanam'') is seen due to malabsorption of various elements, mineral and vitamins causing deficiency of the essential requirements of elements. The negative feedback system creates the craving for essential elements which is presented in the form of craving for all six ''rasa''. ''Rasa'' should be understood for food which will fulfill the requirements.<br /> <br /> Mood disorders are observed due to depletion of essential vitamins, mineral and other elements. Electrolyte difference creates confusion which may be the cause for ''mano avasada''.<br /> <br /> Bloating of abdomen is manifested while digestion is in process or after digestion is completed because of indigestion that causes abnormal growth of gut microbiome. Bacterial fermentation of unabsorbed carbohydrates leads to flatus. Carbohydrates metabolism occurs in small and large intestine therefore the symptom occurs during ''Jeerne jeeryati chadhmanam'' i.e. during and after the process of digestion. Once the patient takes food, circulation towards stomach is increased and digestive activity in the colon is reduced thus carbohydrate metabolism is depressed reducing the formation of flatus in rectum thereby reducing the bloating of abdomen.<br /> <br /> Patient doubts as if he may be suffering from following of the disorders like ''vatavikara, gulma, hridroga'' and ''pleeha''. Due to formation of flatus and later on bloating of abdomen makes the patient feel he is suffering from ''vatika'' disorders related to gastrointestinal tract. Especially ''gulma'' since the patient feels the movement of flatus, so doubts about ''gulma''. <br /> <br /> ''Ushna'' and ''teekshna [[guna]]'' of ''[[pitta]]'' trigger inflammatory response by irritating the intestinal mucosa. <br /> <br /> Indigestion causes depletion of beneficial gut bacteria thus breakdown in the balance between the putative protective and harmful intestinal bacteria leads to chronic inflammation. <br /> <br /> Antigenic nature of endogenous factors can be understood when helpful bacteria and ''ushna, teekshna [[guna]]'' of [[pitta dosha]] trigger inflammatory response leading to autoimmune pathogenesis.<br /> <br /> In case of hypersecretion of gastrin in gastrinoma (Zollingers – Ellison Syndrome) stimulate the parietal cells of the stomach to secrete acid to their maximal capacity and increase the parietal cell mass three to six fold. The acid output may be so great that it reaches the upper small intestine reducing the luminal pH to two or less.<br /> <br /> Pancreatic lipase is inactivated and bile acids are precipitated. It results in diarrhea and steatorrhea. Subtotal villous atrophy occurs due to hyper-secretion which may cause malabsorption. Excessive gastrointestinal secretions cause derangement in fluid and electrolyte transport across the entero-colonic mucosa leading to diarrhea. They are characterized clinically by watery, large volume fecal outputs that are typically painless and persist with fasting because there is no malabsorbed solute; stool osmolalirity is accounted for normal endogenous electrolytes with no fecal osmotic gap.<br /> <br /> Other than excessive secretion, condition like ileal dysfunction caused by either Crohn’s disease or surgical resection results in a decrease in bile acid re absorption in the ileum and an increase in the delivery of bile acids to the large intestine. The resultant is a diarrhea with or without steatorrhea. It becomes a cause for mal-absorption syndrome. <br /> <br /> Inflammatory Bowel Disease needs consideration in ''[[pitta]]ja grahani''. Exogenous factors trigger inflammatory response that the mucosal immune system may fail to control. With mild inflammation the mucosa is erythematous and in severe condition the mucosa becomes hemorrhagic, edematous and ulcerated (Verse 65).<br /> <br /> Loose motions (''Drava Mala Pravritti'') are mainly due to excessive secretion of bile juice (''Drava [[guna]]'' of ''[[pitta]]''). Excessive secretion may be due excessive formation in liver or decrease absorption in the intestine.<br /> <br /> Bile acids are not present in the diet but are synthesized in the liver by a series of enzymatic steps that also include cholesterol catabolism. Bile acids are either primary or secondary. Primary bile acids are synthesized in the liver from cholesterol and secondary bile acids are synthesized from primary bile acids in the intestine by colonic bacterial enzymes. Bile acids are primarily absorbed by active, sodium dependent process that is located exclusively in the ileum; secondly bile acids can also be absorbed to a lesser extent by non carrier mediated transport processes in the jejunum, ileum and colon. Conjugated bile acids that enter the colon are de-conjugated by colonic bacterial enzyme to unconjugated bile acids and are rapidly absorbed. Colonic bacterial enzymes also dehydroxylate bile acids to secondary bile acids, thus if exogenous factors like diet as discussed above disturb the colonic bacterial growth than bile acids are not absorbed. A decrease in the amount of bile acids returning to the liver from the intestine is associated with an increase in bile acids synthesis/cholesterol catabolism, which helps keep bile acid pool size relatively constant. Defects in any of the steps of the enterohepatic circulation of bile acids can result in decrease in duodenal concentration of conjugated bile acids as a result steatorrhea. Thus steatorrhea can be caused by abnormalities in bile acid synthesis and excretion, their physical state in the intestinal lumen and reabsorption. The bile gives the yellowish nature to the stools (Verse 66).<br /> <br /> ''Guru, snigdha'' and ''seeta ahara'' is dominated by ''[[prithvi]]'' and ''[[jala mahabhuta]]'', these qualities help in reducing the impact of ''[[agni mahabhuta]]'' thus causing ''jatharagni mandyata'' resulting in indigestion leading to formation ''ama''. Such ''ama'' is responsible for ''[[dosha]] prakopa''.&lt;ref&gt; Madhavakara. Madhava Nidanam (Roga vinischaya) Chap 2, jwara Adhyaya, Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--&lt;/ref&gt;<br /> <br /> ''Klinna''(moist), ''guru, pishtanna''(malt), ''abhishyandi''(which increases secretions) ''ahara''(food) and ''adhyashana''(over eating) are source for extra calories. Fast foods are defined as any food that contributes little or no nutrient values to the diet, but instead provides excess calories and fat. Common foods include salted snack foods, gum, sweet desserts, fried fast foods, carbonated beverages and candy.<br /> <br /> Diets rich in trans-fatty acids like deep fried fast food, cake mixes, chips and packed cookies, all have inclusion in ''guru, pishtanna, vishtambi''(causing obstruction) ''ahara''. People consuming ''snigdha ahara'' (fatty food) and have sedentary lifestyle with very little energy expenditure, and most fat is stored. The above two concepts explain why ''agnimandya'' and ''ajeerna'' have been mentioned after taking heavy food. Excessive heavy food (''guru ahara'') slows down emptying of stomach (''samana vata karma'' is hampered) and enzymes are not secreted into lumen (''pitta'' action hampered) causing ''agnimandya''.<br /> <br /> Substances of ''seeta veerya'' causes constriction reducing the secretion (''[[stambhana]]'') of gastrointestinal juices thus hampering lipase activity therefore leading to steatorrhea. <br /> <br /> Further heavy meals increase the transit time causing functional stasis which may cause bacterial overgrowth syndrome. Sleeping just after meals may also lead to functional stasis (further study required). Peristalses are also reduced with heavy meals and sleeping after meals causes bacterial overgrowth. Bacteria deconjugate conjugated bile acids and as a result intraduodenal concentration of bile acids will be reduced resulting in steatorrhoea and macrocytic anemia. Bacterial overgrowth also occurs with stasis from a blind loop, small bowel diverticulum or dysmotility. <br /> <br /> Postmucosal lymphatic obstruction- The pathophysiology of this condition which is due to the rare congenital intestinal lymphangectasia or due to acquired lymphatic obstruction secondary to trauma, tumor or infections, leads to the unique constellation of fat malabsorption with enteric loss of protein (often causing edema) and lymphocytopenia. Carbohydrates and amino acid absorption are preserved (Verse 67).<br /> <br /> Nausea and vomiting are both caused by stimulation at one of the four sites: the gastrointestinal tract, the vestibular system, the chemoreceptor trigger zone and the cerebral cortex. Nausea and vomiting occurs due to disturbed gastric motility caused by heavy meal and delayed gastric emptying. The same is the cause for heavy abdomen and eructation with foul smell and sweet taste. As the food stays for long time in gastrointestinal tract blood flow increases centrally and reduces the enthusiasm and decrease in libido. The sluggish activity of gastrointestinal tract causes symptoms such as absence of movement in the abdomen (''udaram stimitam guru''). The heavy abdomen puts pressure on the diaphragm causing symptoms of heaviness in chest (''hridayam manyate styanam'').<br /> <br /> Bacterial overgrowth due to undigested ''guru, klinna, snigdha'' and ''abhishyandi ahara'' causes increased mucoid secretion, thus formed stool is not observed instead ''bhinnamashleshma-samsrishta varcha''(loose stools with ''ama'' and ''[[kapha]]'') is seen; which is also cause for heaviness of stools (''guru-varchah-pravartanam'') Due to diet pattern and sedentary lifestyle there is accumulation of fat (obesity) but due to decrease protein absorption and malabsorption of essential elements patient feels weakness and laziness without weight loss (Verse 68-70).<br /> <br /> Normalcy of ''[[vata]] [[pitta]]'' and ''[[kapha]]'' keeps the [[agni]] in balanced condition, it means that a specific pH is maintained (''[[pitta]]''); secretion, transportation and villi movement are normal (''[[vata]]'') and mucosal bed secretes normal mucus and is healthy (''[[kapha]]''), thus maintains ''samagni'' or a normal digestive process (Verse 71).<br /> <br /> Protein losing enteropathy is increased protein loss into the gastrointestinal tract which is classified into three groups.<br /> <br /> #Mucosal ulceration; there is protein loss by exudation across damaged mucosa e.g. Ulcerative colitis, peptic ulcer, gastro intestinal carcinoma. In such cases dominance of ''[[pitta dosha]]'' needs to be considered.<br /> #Non ulcerated mucosa but evidence of mucosal damage; Protein loss primarily represents loss across epithelia with altered permeability e.g. celiac sprue and menetrier’s disease in small intestine and stomach respectively, ''[[vata dosha]]'' and/or ''[[kapha dosha]]'' dominance should be considered.<br /> #Lymphatic dysfunction, represents either primary lymphatic disease or secondary to partial lymphatic obstruction that may occur as a result of enlarged lymph nodes or cardiac disease. Patient with increased protein loss into gastrointestinal tract due to lymphatic obstruction often have steatorrhea and diarrhea. The steatorrhea is a result of altered lymphatic flow as lipid containing chylomicrons exit from intestinal epithelial cells via intestinal lymphatic’s which may be compared with flow of ''ahara rasa'' and/ or presence of ''[[vata]]'' and ''[[kapha]]''.<br /> <br /> Genetic factors (''bija dushti'') almost all patients with celiac sprue express the HLA-DQ2 allele. Environmental factor, gliadin a component of gluten that is present in wheat, barley and rye contributes to the disease. Immunologic component (''prayatna, bala'' and ''urja'' of ''[[vata]], [[kapha]]'' and ''[[pitta]]'' respectively), serum antibodies – IgA antigliadin, IgA antiendomyasial and IgA antibodies and IgG antibodies are present. In addition, gliadin peptides may interact with gliadin specific T cells that may either mediate tissue injury or induce the release of one or more cytokines that cause tissue injury (Verse 72).<br /> <br /> Further research shows that incase of uncontrolled growth of gut microbiome, flushing of gut reduces both psycho-somatic symptoms. ''[[Shodhana]]'' therapy not only flushes the vitiated gut microbiome but also flushes out the substrata due to which growth of microbiome is controlled (Verse 73-74).<br /> <br /> ''Kshara'' has been advised along with ''tilvaka sneha; kshara'' has alkaline pH. In duodenum and small intestine, enzymes with alkaline pH are secreted. ''Ushna, teekshna'' and ''laghu [[guna]]'' help in digestion. ''Kledayati ado paschata visoshayati''[Cha.Sa.[[ Vimana Sthana]] 1/17 ] i.e. secretion are first increased and later on absorbed is very essential in ''grahani dosha''. Both these actions help in secretion of digestive enzymes thereby increasing [[agni]] and by absorption correct the malabsorption. Therefore use of ''kshara'' is more in ''grahani dosha'' and ''gulma'' (Verse 79).<br /> <br /> ''Aranala''(a fermented preparation), ''dadhimanda''(curd whey) or ''sauviraka'' are all fermented liquids. Fermented liquids contain probiotic organisms. Probiotic foods are produced by chemical action of lactic acid, bacteria, yeast or combination of both. These useful microorganisms help in breaking down carbohydrates, sugars making them easily digestible. Probiotics improves absorption of nutrients; improve synthesis of vitamins, essential fatty acids and enhance nutritional qualities of food grains. Fermented foods increase the absorption of vital minerals from gastrointestinal tract thus preventing mineral deficiencies and also treat the diarrhea. It explains the role of helpful gut microbiome (Verse 82-86). Use of fermented products explains the concept of gut microbiome and use of ''kshara'' and ''amla'' drug for maintaining pH (Verse 88-93).<br /> <br /> ''[[Vamana]]'' (medicated emesis) reduces gastro-paresis by emptying the gastrointestinal contents (Verse 101-102).<br /> <br /> Fermented liquids are rich source of gut microbiome which will help to replace the unhealthy microbiome. These fermented liquids also help to balance the pH of the gastrointestinal tract. Further study is required to decide impact of above mentioned liquid diet on pH and specific enzymes (Verse 115-116). <br /> <br /> One cup of buttermilk contains 152 calories and 8.11 grams of fat, of which 4.65 grams are saturated, 282 milligrams of calcium and 127 international units of vitamin D. The vitamin also helps to maintain normal phosphorus levels. Phosphorus is another nutrient that contributes to bone health (Verse 117-119).<br /> <br /> ''Samana vata'' regularizes the secretion of pancreatic and intestinal enzymes. Initially the enzymes are in zymogens (inactive form). ''Samana vata'' helps in conversion of zymogens into active enzymes so all the factors which help in stimulating exocytosis can be considered as functional components of ''samana vata.'' Once ''samana vata'' is stimulated efficiently the digestive process becomes intact to digest all types of nutrients (Verse 202-203 -1/2).<br /> <br /> Hyperthyroidism is one of the causes for hypermetabolic disorders but extra thyroidal causes are also important. Hypermetabolism typically occurs after significant injury to the body. Infections, sepsis, burns, multiple traumas, fever, long bone fractures, prolonged steroid therapy, pheocromocytoma, surgery and bone marrow transplants. Hypermetabolism may occur particularly in the brain after traumatic brain injury (Verse 217-219).<br /> <br /> Hypermetabolism is accompanied by a variety of internal and external symptoms most notably extreme weight loss. External symptoms of hypermetabolism may include anemia, fatigue, elevated heart rate, irregular heartbeat, insomnia, shortness of breath, dysautonomia, muscle weakness, excessive sweating while internal symptoms include peripheral insulin resistance, elevated catabolism of proteins, carbohydrates triglycerides and negative nitrogen in the body. <br /> <br /> In this context there is increased function due to excess secretion of thyroid hormones. Thyroid hormones act as catabolic hormones and promote calorigenesis and develops hypermetabolic state which may result in gluconeogenesis, lipolysis and glycogenolysis causing decreased muscle mass and weight loss. Metabolic rate is enhanced, because of vitiated ''[[pitta]]'' and associated ''[[vata]]''. <br /> <br /> This is the condition where increased appetite with weight loss is seen due to insufficient supply of nutrients in relation to ''agnibala''. Thyroid storm/ thyroid-toxic crisis is rare and life threatening exacerbation of hyperthyroidism, accompanied by fever, delirium, seizures, vomiting, diarrhea and jaundice. Death may occur due to cardiac failure, arrhythmia and hyperthermia. <br /> <br /> Management requires intensive monitoring, supportive care, identification of the precipitating causes (stroke, infection, trauma, diabetic ketoacidosis, surgery and radio iodine treatment), and measures that reduce thyroid hormone synthesis (Verse 220-222½).<br /> <br /> ''Kleda'' can also be considered as inter-mediory product of metabolism like ketones, pyruvate, lactate which are well utilized in active/healthy persons as fuel and therefore does not cause inflammation/disease process (Verse 237-239).<br /> <br /> === Current clinical practices ===<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| S.No.<br /> ! scope=&quot;col&quot;| Name<br /> ! scope=&quot;col&quot;| Dose<br /> ! scope=&quot;col&quot;| Time of Administration<br /> ! scope=&quot;col&quot;| Anupana<br /> |-<br /> | 1<br /> | ''Chitrakadi Vati''<br /> | 250-500 mg<br /> | Between meals <br /> | Buttermilk or lukewarm water <br /> |-<br /> | 2<br /> | ''Shankha Vati''<br /> | 250-500 mg<br /> | Between meals <br /> | Buttermilk or lukewarm water<br /> |-<br /> | 3<br /> | ''Lashunadi Vati''<br /> | 250-500 mg<br /> | Between meals <br /> | Buttermilk or lukewarm water <br /> |-<br /> | 4<br /> | ''Hingvadi Vati''<br /> | 250-500 mg<br /> | Between meals <br /> | Buttermilk or lukewarm water <br /> |-<br /> | 5<br /> | ''Shiva Kshana Pachana Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Buttermilk or lukewarm water<br /> |-<br /> | 6<br /> | ''Hingvashtaka Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Buttermilk or lukewarm water <br /> |-<br /> | 7<br /> | ''Bhunimbadi Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 8<br /> | ''Avipattikara Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 9<br /> | ''Lavana Bhaskar Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Buttermilk or lukewarm water<br /> |-<br /> | 10<br /> | ''Swadishta Virechana Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 11<br /> | ''Nagaradi Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Buttermilk and lukewarm water<br /> |-<br /> | 12<br /> | ''Dadimashtaka Churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Nimbu panaka and lukewarm water<br /> |-<br /> | 13<br /> | ''Pippalyasava''<br /> | 10 - 40 ml<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 14<br /> | ''Jeerakadyarishta''<br /> | 10 - 40 ml<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 15<br /> | ''Abhayarishta''<br /> | 10 - 40 ml<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 16<br /> | ''Takrarishta''<br /> | 10 - 40 ml<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 17<br /> | ''Chitrakadi ghrita''<br /> | 5 - 40 ml<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 18<br /> | ''Dadimadi ghrita''<br /> | 5 - 40 ml<br /> | Between meals <br /> | Lukewarm water<br /> |-<br /> | 19<br /> | ''Kiratadi churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Honey or lukewarm water<br /> |-<br /> | 20<br /> | ''Marichyadi churna''<br /> | 1 - 5 grams<br /> | Between meals <br /> | Buttermilk or lukewarm water<br /> |}<br /> <br /> === Areas of Further Research ===<br /> <br /> *To study ''asava'' and ''arishta'' in relation with gut microbial flora. <br /> *To understand concept of ''ama'' with relation to autoimmune diseases.<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> == References ==<br /> &lt;/div&gt;<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Dehagni&diff=45377 2025-10-29T07:10:30Z

<p>Agnivesha: Redirected page to Agni</p> <hr /> <div>#REDIRECT [[Agni]]</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Dehagni&diff=45376 2025-10-29T07:09:34Z

<p>Agnivesha: Created page with &quot;Agni&quot;</p> <hr /> <div>[[Agni]]</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Panduroga_Chikitsa&diff=45375 2025-10-29T06:49:48Z

<p>Agnivesha: Created page with &quot;Pandu Chikitsa Adhyaya&quot;</p> <hr /> <div>[[Pandu Chikitsa Adhyaya]]</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Kurchika&diff=45374 2025-10-29T06:43:19Z

<p>Agnivesha: </p> <hr /> <div>Kurchika (also spelled koorcika) is a milk product. Milk is heated and mixed with buttermilk or curd to obtain a uniformly semi-solid substance.<br /> <br /> <br /> See more <br /> <br /> https://www.wisdomlib.org/definition/kurcika</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Kurchika&diff=45373 2025-10-29T06:42:34Z

<p>Agnivesha: Created page with &quot;Kurchika (also spelled koorcika) is a milk product. Milk is heated and mixed with buttermilk or curd to obtain a uniformly semi-solid substance.&quot;</p> <hr /> <div>Kurchika (also spelled koorcika) is a milk product. Milk is heated and mixed with buttermilk or curd to obtain a uniformly semi-solid substance.</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Shvayathu_Chikitsa&diff=45372 2025-10-29T06:41:03Z

<p>Agnivesha: /* Gandeeradyarishta */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Shvayathu Chikitsa<br /> |titlemode=append<br /> |keywords=Shvayathu, shotha, shopha, edema, swelling, langhana, amapachana, shodhana, Ayurveda, charak samhita, Indian system of medicine.<br /> |description=Chikitsa Sthana Chapter 12. Management of Shvayathu (Various types of Swellings)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 12. Management of Shvayathu (Various types of Swellings) &lt;/big&gt;'''<br /> {{Infobox<br /> |title = Shvayathu Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 12<br /> |label2 = Preceding Chapter<br /> |data2 = [[Kshatakshina Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Udara Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Goyal M.<br /> |label7 = Reviewer <br /> |data7 = Singh G.<br /> |label8 = Editors <br /> |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI<br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.013 10.47468/CSNE.2020.e01.s06.013]<br /> }}<br /> &lt;big&gt;'''Abstract&lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;This chapter deals with the treatment of various types of swellings like generalized edema and local eruptions including pustules, nodules and tumors. The etiological factors for these swellings can be endogenous (''nija'') or exogenous (''agantuja''). In all types of swellings, three ''[[dosha]]s'' are involved but it is named according to the dominance of the ''[[dosha]]''. After describing general symptoms and signs of the swelling, specific symptoms and signs of ''[[vata]], [[pitta]]'' and ''[[kapha]]'' as well as of incurable and curable swellings are explained. <br /> &lt;br/&gt;<br /> Line of treatment depends upon type of swelling as well as involved parts of the body; wholesome and unwholesome diet and lifestyle for the benefit of the patient is explained. Detailed treatments along with drug preparations, internal and external therapeutic measures are discussed according to ''[[vata]], [[pitta]]'' and ''[[kapha]]'' types of swelling. <br /> &lt;br/&gt;<br /> Local swellings occurring in the various parts of the body in the form of papules, pustules, nodules, tumors etc are described in the last part of the chapter. It includes ''shaluka'' (quinsy), ''Bidalika'' (Ludwig’s angina), ''Taluvidradhi'' (palatal abscess), ''Upajihivika'' (superficial glossitis), ''Upakusha'' (gingivitis) and ''Danta-Vidradhi'' (dental abscess) which occurs in buccal cavity and generally included in Śālākya specialty. ''Galaganda'' is goiter and ''gandamala'' and ''granthi'' are mainly related with various types of swellings of lymph nodes. ''Arbuda'' (tumor), ''alaji'' (inflammation of eye), ''akshata'' (whitlow), ''vidarika'' (lymphadenitis), ''visphotaka'' (eruption), ''kaksha'' (herpes zoster), ''romantika'' (measles), ''masurika'' (chickenpox), ''bradhna'' (hernia), ''bhagandara'' (fistula-in-ano), ''shleepada'' (elephantiasis), ''jalakagardabha'' (acute sprading inflammation), ''abhighataja'' (traumatic) and ''vishaja'' (poisonous) swellings along with their medical treatment and wherever necessary surgical measures are also described. Difference and similarity between ''granthi'' and ''arbuda'' are also mentioned.<br /> &lt;br/&gt;<br /> '''Keywords''': ''Shvayathu, shotha, shopha,'' edema, swelling, ''[[langhana]], ama[[pachana]], [[shodhana]]''. &lt;/p&gt;<br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> This chapter on [[Shvayathu Chikitsa]] (treatment of swelling) follows the chapter on ''kshata-kshina'' because in both the diseases vital organs are involved. ''Charaka'' defines ''shvayathu'' as bulging (''utsedha'') from the skin and this chapter mainly deals with the management of various types of general swellings and local swellings such as ''pidika'' (papules and pustules), nodules (including ''gandhamala''), large swellings like [[galaganda]] (goiter), tumor etc are also described. <br /> <br /> Chapter 18th of [[Sutra Sthana]] deals with diagnostic aspects of swelling under the name of ''[[trishothiya]]''. Therein the word ''shopha'' is frequently used for shotha. Thus, the words ''shvayathu, shotha'' and ''shopha'' are used as synonyms and all denote edema or swelling. For inflammatory swelling Sushruta has used the word ''vrana-shotha''.<br /> <br /> In the [[Sutra Sthana]], Charaka classified ''shotha'' in many ways but in this chapter which is mainly on the treatment, only those classifications are given which are important from treatment point of view, such as three types according to ''[[dosha]]'' viz, ''[[vata]], [[pitta]]'' and ''[[kapha]]''; two types viz. ''nija'' (endogenous) and ''agantuja'' (exogenous) as well as ''ekanga'' (local) and ''sarvanga'' (generalized ) types.<br /> <br /> == Sanskrit text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातः श्वयथुचिकित्सितं व्याख्यास्यामः||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः||२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātaḥ śvayathucikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2||<br /> <br /> athAtaH shvayathucikitsitaM vyAkhyAsyAmaH||1||<br /> <br /> iti ha smAha bhagavAnAtreyaH||2||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now we shall expound the chapter &quot;Shvayathu chikitsa&quot; (Management of different types of swelling). Thus said Lord Atreya. [1-2]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भिषग्वरिष्ठं सुरसिद्धजुष्टं मुनीन्द्रमत्र्यात्मजमग्निवेशः| &lt;br /&gt;<br /> महागदस्य श्वयथोर्यथावत् प्रकोपरूपप्रशमानपृच्छत्||३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhiṣagvariṣṭhaṁ surasiddhajuṣṭaṁ munīndramatryātmajamagnivēśaḥ| &lt;br /&gt;<br /> mahāgadasya śvayathōryathāvat prakōparūpapraśamānapr̥cchat||3||&lt;br /&gt;<br /> <br /> bhiShagvariShThaM surasiddhajuShTaM munIndramatryAtmajamagniveshaH| &lt;br /&gt;<br /> mahAgadasya shvayathoryathAvat prakoparUpaprashamAnapRucchat||3||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Agnivesha approached the best physician and great sage, the son of Atri sitting midst of gods and saints and requested him to elaborate on the etiology, signs and symptoms and treatment of the major disease- ''shvayathu'' [3]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तस्मै जगादागदवेदसिन्धुप्रवर्तनाद्रिप्रवरोऽत्रिजस्तान्| &lt;br /&gt;<br /> वातादिभेदात्त्रिविधस्य सम्यङ्निजानिजैकाङ्गजसर्वजस्य||४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tasmai jagādāgadavēdasindhupravartanādripravarō'trijastān| &lt;br /&gt;<br /> vātādibhēdāttrividhasya samyaṅnijānijaikāṅgajasarvajasya||4||&lt;br /&gt;<br /> <br /> tasmai jagAdAgadavedasindhupravartanAdripravaro~atrijastAn| &lt;br /&gt;<br /> vAtAdibhedAttrividhasya samya~gnijAnijaikA~ggajasarvajasya||4||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Sage Atreya who is like Himalaya from which flows out the Indus of the science of healing, fully expounded the subject of swellings of three types based on ''tridosha, nija'' and ''agantuja'' based on etiology and ''ekanga'' and ''sarvanga'' type according to location [4]<br /> <br /> === Causative factors of ''nija'' (endogenous) swelling/edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शुद्ध्यामयाभक्तकृशाबलानां क्षाराम्लतीक्ष्णोष्णगुरूपसेवा| &lt;br /&gt;<br /> दध्याममृच्छाकविरोधिदुष्टगरोपसृष्टान्ननिषेवणं च||५|| &lt;br /&gt;<br /> <br /> अर्शांस्यचेष्टा न च देहशुद्धिर्मर्मोपघातो विषमा प्रसूतिः| &lt;br /&gt;<br /> मिथ्योपचारः प्रतिकर्मणां च निजस्य हेतुः श्वयथोः प्रदिष्टः||६||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śuddhyāmayābhaktakr̥śābalānāṁ kṣārāmlatīkṣṇōṣṇagurūpasēvā| &lt;br /&gt;<br /> dadhyāmamr̥cchākavirōdhiduṣṭagarōpasr̥ṣṭānnaniṣēvaṇaṁ ca||5|| &lt;br /&gt;<br /> <br /> arśāṁsyacēṣṭā na ca dēhaśuddhirmarmōpaghātō viṣamā prasūtiḥ| &lt;br /&gt;<br /> mithyōpacāraḥ pratikarmaṇāṁ ca nijasya hētuḥ śvayathōḥ pradiṣṭaḥ||6||&lt;br /&gt;<br /> <br /> shuddhyAmayAbhaktakRushAbalAnAM kShArAmlatIkShNoShNagurUpasevA| &lt;br /&gt;<br /> dadhyAmamRucchAkavirodhiduShTagaropasRuShTAnnaniShevaNaM ca||5|| &lt;br /&gt;<br /> <br /> arshAMsyaceShTA na ca dehashuddhirmarmopaghAto viShamA prasUtiH| &lt;br /&gt;<br /> mithyopacAraH pratikarmaNAM ca nijasya hetuH shvayathoH pradiShTaH||6||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Excessive use of ''kshara'' (alkali) or food articles having sour, sharply acting, hot and heavy properties by an emaciated or weak person due to excessive ''[[shodhana]]'', fasting or disease. <br /> <br /> Excessive intake of curd, raw food articles, soil, leafy vegetables, mutually contradictory food articles (''virodhi''), spoiled or mixed with toxic substance (such as pesticide), or a person suffering from piles, having sedentary life style, nonperforming of ''[[shodhana]]'' therapy even if indicated, injury to vital organs (''marma''), abnormal delivery, due to improper treatment and as complication of improper purification treatment [5-6]<br /> <br /> === Causative factors of ''agantuka'' (exogenous) swelling ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बाह्यास्त्वचो दूषयिताऽभिघातः काष्ठाश्मशस्त्राग्निविषायसाद्यैः [१] | <br /> <br /> आगन्तुहेतुःत्रिविधो निजश्च सर्वार्धगात्रावयवाश्रितत्वात्||७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bāhyāstvacō dūṣayitā'bhighātaḥ kāṣṭhāśmaśastrāgniviṣāyasādyaiḥ [1] | <br /> <br /> āgantuhētuḥ trividhō nijaśca sarvārdhagātrāvayavāśritatvāt||7||<br /> <br /> bAhyAstvaco dUShayitA~abhighAtaH kAShThAshmashastrAgniviShAyasAdyaiH | <br /> <br /> AgantuhetuH trividho nijashca sarvArdhagAtrAvayavAshritatvAt||7||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> External causative factors of swelling are trauma to skin with wood, stone, weapon, fire, poison etc. <br /> <br /> Endogenous swelling is of three types i.e. of whole body, half body or limited to one part or organ [7]<br /> <br /> === Pathogenesis of swelling ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बाह्याः सिराः प्राप्य यदा कफासृक्पित्तानि सन्दूषयतीह वायुः| &lt;br /&gt;<br /> तैर्बद्धमार्गः स तदा विसर्पन्नुत्सेधलिङ्गं श्वयथुं करोति||८|| &lt;br /&gt;<br /> <br /> उरःस्थितैरूर्ध्वमधस्तु [१] वायोः स्थानस्थितैर्मध्यगतैस्तु मध्ये| &lt;br /&gt;<br /> सर्वाङ्गगः सर्वगतैः क्वचित्स्थैर्दोषैः क्वचित् स्याच्छ्वयथुस्तदाख्यः||९||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bāhyāḥ sirāḥ prāpya yadā kaphāsr̥kpittāni sandūṣayatīha vāyuḥ| &lt;br /&gt;<br /> tairbaddhamārgaḥ sa tadā visarpannutsēdhaliṅgaṁ śvayathuṁ karōti||8|| &lt;br /&gt;<br /> <br /> uraḥsthitairūrdhvamadhastu [1] vāyōḥ sthānasthitairmadhyagataistu madhyē| &lt;br /&gt;<br /> sarvāṅgagaḥ sarvagataiḥ kvacitsthairdōṣaiḥ kvacit syācchvayathustadākhyaḥ||9||&lt;br /&gt;<br /> <br /> bAhyAH sirAH prApya yadA kaphAsRukpittAni sandUShayatIha vAyuH| &lt;br /&gt;<br /> tairbaddhamArgaH sa tadA visarpannutsedhali~ggaM shvayathuM karoti||8||&lt;br /&gt;<br /> <br /> uraHsthitairUrdhvamadhastu [1] vAyoH sthAnasthitairmadhyagataistu madhye| &lt;br /&gt;<br /> sarvA~ggagaH sarvagataiH kvacitsthairdoShaiH kvacit syAcchvayathustadAkhyaH||9||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Morbid ''[[vata]]'' is obstructed by vitiated ''[[kapha]], [[rakta]]'' and ''[[pitta]]'' aggravated at the site of peripheral superficial vessels. This vitiated ''[[vata]]'' (due to obstruction) spreads to the various places causing swelling as its cardinal symptom. <br /> <br /> If the ''[[vata]]'' lodges in the chest, then it causes edema of upper parts of the body; if it lodges in its own place i.e. lower parts then it causes edema of lower parts and if it lodges in middle then it causes edema of middle parts.<br /> <br /> If ''[[vata]]'' spreads in the entire body then it causes edema all over the body but if it lodges in one place then it causes local swelling of that part or organ. These swellings are named after the particular region that it affects [8-9]<br /> <br /> === Prodromal symptoms of edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ऊष्मा तथा स्याद्दवथुः सिराणामायाम इत्येव च पूर्वरूपम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ūṣmā tathā syāddavathuḥ sirāṇāmāyāma ityēva ca pūrvarūpam| <br /> <br /> UShmA tathA syAddavathuH sirANAmAyAma ityeva ca pUrvarUpam|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Rise in temperature, burning sensation as if burnt by fire and dilation of the vessels are the prodromal symptoms of swelling [9½]<br /> <br /> === ''Tridoshaja'' nature of all swellings ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सर्वस्त्रिदोषोऽधिकदोषलिङ्गैस्तच्छब्दमभ्येति भिषग्जितं च||१०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sarvastridōṣō'dhikadōṣaliṅgaistacchabdamabhyēti bhiṣagjitaṁ ca||10||<br /> <br /> sarvastridoSho~adhikadoShali~ggaistacchabdamabhyeti bhiShagjitaM ca||10||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> All types of swelling are produced by involvement of all the three ''[[dosha]]'' but they are named based on the predominance of that particular ''[[dosha]]''. The line of treatment is also according to the dominant ''[[dosha]]'' [10]<br /> <br /> === General symptoms of swelling ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सगौरवं स्यादनवस्थितत्वं सोत्सेधमुष्माऽथ सिरातनुत्वम्| &lt;br /&gt;<br /> सलोमहर्षाऽङ्गविवर्णता च सामान्यलिङ्गं श्वयथोः प्रदिष्टम्||११|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sagauravaṁ syādanavasthitatvaṁ sōtsēdhamuṣmā'tha sirātanutvam| &lt;br /&gt;<br /> salōmaharṣā'ṅgavivarṇatā ca sāmānyaliṅgaṁ śvayathōḥ pradiṣṭam||11||&lt;br /&gt;<br /> <br /> sagauravaM syAdanavasthitatvaM sotsedhamuShmA~atha sirAtanutvam| &lt;br /&gt;<br /> salomaharShA~a~ggavivarNatA ca sAmAnyali~ggaM shvayathoH pradiShTam||11||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Heaviness, movability, bulging, heat, thinning of the vessels, horripilation and discoloration of the affected skin are the general signs and symptoms of edema [11] <br /> <br /> === Symptoms of ''[[vata]]ja'' dominant edema/swelling ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चलस्तनुत्वक्परुषोऽरुणोऽसितः प्रसुप्तिहर्षार्तियुतोऽनिमित्ततः| &lt;br /&gt;<br /> प्रशाम्यति प्रोन्नमति प्रपीडितो दिवाबली च श्वयथुः समीरणात्||१२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> calastanutvakparuṣō'ruṇō'sitaḥ prasuptiharṣārtiyutō'nimittataḥ| &lt;br /&gt;<br /> praśāmyati prōnnamati prapīḍitō divābalī ca śvayathuḥ samīraṇāt||12||&lt;br /&gt;<br /> <br /> calastanutvakparuSho~aruNo~asitaH prasuptiharShArtiyuto~animittataH| &lt;br /&gt;<br /> prashAmyati pronnamati prapIDito divAbalI ca shvayathuH samIraNAt||12||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Skin of the effected part in ''[[vata]]'' dominant swelling becomes thin and rough and dry (''parusha''), dusky-brown colored with horripilation and feeling of numbness and discomfort. The swelling is moveable and pitting on pressure but it attains normal position immediately, increases during the day time and often subsides without appreciable reason [12]<br /> <br /> === Symptoms of ''[[pitta]]'' dominant swelling (inflammation) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मृदुः सगन्धोऽसितपीतरागवान् भ्रमज्वरस्वेदतृषामदान्वितः| &lt;br /&gt;<br /> य उष्यते स्पर्शरुगक्षिरागकृत् [१] स पित्तशोथो भृशदाहपाकवान्||१३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mr̥duḥ sagandhō'sitapītarāgavān bhramajvarasvēdatr̥ṣāmadānvitaḥ| &lt;br /&gt;<br /> ya uṣyatē sparśarugakṣirāgakr̥t [1] sa pittaśōthō bhr̥śadāhapākavān||13||&lt;br /&gt;<br /> <br /> mRuduH sagandho~asitapItarAgavAn bhramajvarasvedatRuShAmadAnvitaH| &lt;br /&gt;<br /> ya uShyate sparsharugakShirAgakRut [1] sa pittashotho bhRushadAhapAkavAn||13||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''[[pitta]]''-dominant swelling is soft, painful to touch, with specific odor and blackish, yellow or red colored skin and has tendency of turning to abscess. It is accompanied with excessive burning sensation, fever, perspiration, giddiness, thirst, redness in eyes and intoxication [13] <br /> <br /> === Symptoms of ''[[kapha]]''-dominant edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुरुः स्थिरः पाण्डुररोचकान्वितः प्रसेकनिद्रावमिवह्निमान्द्यकृत्| &lt;br /&gt;<br /> स कृच्छ्रजन्मप्रशमो निपीडितो न चोन्नमेद्रात्रिबली कफात्मकः||१४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> guruḥ sthiraḥ pāṇḍurarōcakānvitaḥ prasēkanidrāvamivahnimāndyakr̥t| &lt;br /&gt;<br /> sa kr̥cchrajanmapraśamō nipīḍitō na cōnnamēdrātribalī kaphātmakaḥ||14||&lt;br /&gt;<br /> <br /> guruH sthiraH pANDurarocakAnvitaH prasekanidrAvamivahnimAndyakRut| &lt;br /&gt;<br /> sa kRucchrajanmaprashamo nipIDito na connamedrAtribalI kaphAtmakaH||14||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Kapha]]''-dominant swelling is heavy and firm/immovable. It is associated with anemia, anorexia, low digestion, water-brash, vomiting and sleepiness. It appears and disappears very slowly and on pressing it takes long time to attain its normal position and increases at the night time [14]<br /> <br /> === Symptoms of bad prognostic of edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कृशस्य रोगैरबलस्य यो भवेदुपद्रवैर्वा वमिपूर्वकैर्युतः| &lt;br /&gt;<br /> स हन्ति मर्मानुगतोऽथ राजिमान् परिस्रवेद्धीनबलस्य सर्वगः||१५|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kr̥śasya rōgairabalasya yō bhavēdupadravairvā vamipūrvakairyutaḥ| &lt;br /&gt;<br /> sa hanti marmānugatō'tha rājimān parisravēddhīnabalasya sarvagaḥ||15||&lt;br /&gt;<br /> <br /> kRushasya rogairabalasya yo bhavedupadravairvA vamipUrvakairyutaH| &lt;br /&gt;<br /> sa hanti marmAnugato~atha rAjimAn parisraveddhInabalasya sarvagaH||15||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The edema/swelling of the patient, whose body is emaciated and weakened by a disease or is debilitated, or having complications or associated with vomiting, involving vital organs or whole body or spread with prominent vessels or in which profuse discharge oozes out, leads to death [15]<br /> <br /> === Symptoms of easily curable swelling ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अहीनमांसस्य य एकदोषजो नवो बलस्थस्य सुखः स साधने| &lt;br /&gt;<br /> निदानदोषर्तुविपर्ययक्रमैरुपाचरेत्तं बलदोषकालवित्||१६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ahīnamāṁsasya ya ēkadōṣajō navō balasthasya sukhaḥ sa sādhanē|&lt;br /&gt; <br /> nidānadōṣartuviparyayakramairupācarēttaṁ baladōṣakālavit||16||&lt;br /&gt;<br /> <br /> ahInamAMsasya ya ekadoShajo navo balasthasya sukhaH sa sAdhane|&lt;br /&gt;<br /> nidAnadoShartuviparyayakramairupAcarettaM baladoShakAlavit||16||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The swelling of a patient who is neither emaciated nor weak; that involved single ''[[dosha]]'' or is of recent origin is easily curable.<br /> The physician expert in the knowledge of strength, ''[[dosha]]'' and proper time of treatment should treat the curable patients by prescribing such measures which are opposite to cause, ''[[dosha]]'' and season [16]<br /> <br /> === Principles of treatment of edema/swelling ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथामजं लङ्घनपाचनक्रमैर्विशोधनैरुल्बणदोषमादितः| &lt;br /&gt;<br /> शिरोगतं शीर्षविरेचनैरधो [४] विरेचनैरूर्ध्वहरैस्तथोर्ध्वजम्||१७|| &lt;br /&gt;<br /> <br /> उपाचरेत् स्नेहभवं विरूक्षणैः प्रकल्पयेत् स्नेहविधिं च रूक्षजे| &lt;br /&gt;<br /> विबद्धविट्केऽनिलजे निरूहणं घृतं तु पित्तानिलजे सतिक्तकम्||१८|| &lt;br /&gt;<br /> <br /> पयश्च मूर्च्छारतिदाहतर्षिते विशोधनीये तु समूत्रमिष्यते| &lt;br /&gt;<br /> कफोत्थितं क्षारकटूष्णसंयुतैः समूत्रतक्रासवयुक्तिभिर्जयेत्||१९|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athāmajaṁ laṅghanapācanakramairviśōdhanairulbaṇadōṣamāditaḥ| &lt;br /&gt;<br /> śirōgataṁ śīrṣavirēcanairadhō [4] virēcanairūrdhvaharaistathōrdhvajam||17|| &lt;br /&gt;<br /> <br /> upācarēt snēhabhavaṁ virūkṣaṇaiḥ prakalpayēt snēhavidhiṁ ca rūkṣajē| &lt;br /&gt;<br /> vibaddhaviṭkē'nilajē nirūhaṇaṁ ghr̥taṁ tu pittānilajē satiktakam||18|| &lt;br /&gt;<br /> <br /> payaśca mūrcchāratidāhatarṣitē viśōdhanīyē tu samūtramiṣyatē| &lt;br /&gt;<br /> kaphōtthitaṁ kṣārakaṭūṣṇasaṁyutaiḥ samūtratakrāsavayuktibhirjayēt||19||&lt;br /&gt;<br /> <br /> athAmajaM la~gghanapAcanakramairvishodhanairulbaNadoShamAditaH| &lt;br /&gt;<br /> shirogataM shIrShavirecanairadho [4] virecanairUrdhvaharaistathordhvajam||17|| &lt;br /&gt;<br /> <br /> upAcaret snehabhavaM virUkShaNaiH prakalpayet snehavidhiM ca rUkShaje| &lt;br /&gt;<br /> vibaddhaviTke~anilaje nirUhaNaM ghRutaM tu pittAnilaje satiktakam||18|| &lt;br /&gt;<br /> <br /> payashca mUrcchAratidAhatarShite vishodhanIye tu samUtramiShyate| &lt;br /&gt;<br /> kaphotthitaM kShArakaTUShNasaMyutaiH samUtratakrAsavayuktibhirjayet||19||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If swelling is associated with ''ama'' it should be managed first by prescribing lightening therapy (''[[langhana]]'') and digestive drugs and only then ''[[shodhana]]'' therapy should be undertaken according to dominant ''[[dosha]]''. General lines of treatment of ''[[dosha]]ja'' swelling are as follows:<br /> <br /> *If it involves head then ''shiro-virechana'' is prescribed;<br /> *If it involves lower parts of the body then ''[[virechana]]'' (therapeutic purgation) is prescribed;<br /> *If it involves upper parts of the body then ''[[vamana]]'' (therapeutic emesis)is prescribed;<br /> *If it is caused by unctuous then ''[[rukshana]]'' (drying) therapy is done;<br /> *If it is caused by un-unctuous (''ruksha'') then unctuous (''[[snehana]]'') therapy is done;<br /> *If ''[[vata]]'' swelling is associated with constipation then it should be treated with ''niruha [[basti]]'';<br /> *If it is caused by ''[[vata]]-[[pitta]]'' then it should be treated with ghee prepared with bitter drugs;<br /> *If the patient is suffering from associated symptoms such as fainting, pain, burning sensation and thirst then it should be treated with intake of milk;<br /> *If the patient is suffering from swelling where ''[[shodhana]]'' is required then milk mixed with cow’s urine should be given.<br /> *If the patient is suffering from ''[[kapha]]'' swelling then ''kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are given [17-19]<br /> <br /> === ''Apathya'' (unwholesome) for swelling/edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ग्राम्याब्जानूपं पिशितमबलं शुष्कशाकं नवान्नं &lt;br /&gt;<br /> गौडं पिष्टान्नं दधि तिलकृतं [५] विज्जलं [६] मद्यमम्लम्| &lt;br /&gt;<br /> धाना वल्लूरं समशनमथो गुर्वसात्म्यं विदाहि &lt;br /&gt;<br /> स्वप्नं चारात्रौ श्वयथुगदवान् वर्जयेन्मैथुनं च||२०|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> grāmyābjānūpaṁ piśitamabalaṁ śuṣkaśākaṁ navānnaṁ &lt;br /&gt;<br /> gauḍaṁ piṣṭānnaṁ dadhi tilakr̥taṁ [5] vijjalaṁ [6] madyamamlam| &lt;br /&gt;<br /> dhānā vallūraṁ samaśanamathō gurvasātmyaṁ vidāhi &lt;br /&gt;<br /> svapnaṁ cārātrau śvayathugadavān varjayēnmaithunaṁ ca||20||&lt;br /&gt;<br /> <br /> grAmyAbjAnUpaM pishitamabalaM shuShkashAkaM navAnnaM &lt;br /&gt;<br /> gauDaM piShTAnnaM dadhi tilakRutaM [5] vijjalaM [6] madyamamlam| &lt;br /&gt;<br /> dhAnA vallUraM samashanamatho gurvasAtmyaM vidAhi &lt;br /&gt;<br /> svapnaM cArAtrau shvayathugadavAn varjayenmaithunaM ca||20||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Meat of domestic, aquatic and wet-land animals or weak animals; dry vegetables, fresh grains, molasses, fine flour products, curd, products of sesame, slimy and sour food articles, wine, roasted barley, dried meat, ''samashana'' (taking of mixture of wholesome and unwholesome food), taking of unwholesome, heavy and irritant diet articles, day sleep and sexual acts should be avoided by the patient of edema/swelling [20]<br /> <br /> === ''Vyoshadi churna'' for ''[[kapha]]'' swelling/edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> व्योषं त्रिवृत्तिक्तकरोहिणी च सायोरजस्का त्रिफलारसेन| &lt;br /&gt;<br /> पीतं कफोत्थं शमयेत्तु शोफं गव्येन मूत्रेण हरीतकी च||२१|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vyōṣaṁ trivr̥ttiktakarōhiṇī ca sāyōrajaskā triphalārasēna| &lt;br /&gt;<br /> pītaṁ kaphōtthaṁ śamayēttu śōphaṁ gavyēna mūtrēṇa harītakī ca||21|| &lt;br /&gt;<br /> <br /> vyoShaM trivRuttiktakarohiNI ca sAyorajaskA triphalArasena| &lt;br /&gt;<br /> pItaM kaphotthaM shamayettu shophaM gavyena mUtreNa harItakI ca||21|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Mixture of powders of ''trikatu, trivrit, katuka'' and ''lauha-bhasma'' taken with juice of ''triphala''; or ''haritaki'' powder taken by mixing with cow’s urine relieves ''[[kapha]]'' edema/swelling [21]<br /> <br /> === Remedy for ''tridoshaja'' edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> हरीतकीनागरदेवदारु सुखाम्बुयुक्तं सपुनर्नवं वा| &lt;br /&gt;<br /> सर्वं पिबेत्त्रिष्वपि मूत्रयुक्तं स्नातश्च जीर्णे पयसाऽन्नमद्यात्||२२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> harītakīnāgaradēvadāru sukhāmbuyuktaṁ sapunarnavaṁ vā| &lt;br /&gt;<br /> sarvaṁ pibēttriṣvapi mūtrayuktaṁ snātaśca jīrṇē payasā'nnamadyāt||22||&lt;br /&gt;<br /> <br /> harItakInAgaradevadAru sukhAmbuyuktaM sapunarnavaM vA| &lt;br /&gt;<br /> sarvaM pibettriShvapi mUtrayuktaM snAtashca jIrNe payasA~annamadyAt||22||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Mixture of ''haritaki'', dried ginger and ''devadaru'' taken with lukewarm water, or ''punarnava'' mixed with all the above drugs taken with cow‘s urine relieves swelling produced by all the three ''[[dosha]]''. On digestion of the drug and after taking bath, the patient should take food with milk [22]<br /> <br /> === Remedy for ''[[vata]]'' edema/swelling ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुनर्नवानागरमुस्तकल्कान् प्रस्थेन धीरः पयसाऽक्षमात्रान्| &lt;br /&gt;<br /> मयूरकं मागधिकां समूलां सनागरां वा प्रपिबेत् सवाते||२३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> punarnavānāgaramustakalkān prasthēna dhīraḥ payasā'kṣamātrān| &lt;br /&gt;<br /> mayūrakaṁ māgadhikāṁ samūlāṁ sanāgarāṁ vā prapibēt savātē||23|| &lt;br /&gt;<br /> <br /> punarnavAnAgaramustakalkAn prasthena dhIraH payasA~akShamAtrAn| &lt;br /&gt;<br /> mayUrakaM mAgadhikAM samUlAM sanAgarAM vA prapibet savAte||23|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The 500 ml of milk prepared with paste of 10 gm each ''punarnava'', dried ginger and ''mustaka''; or milk prepared with ''mayuraka, pippalimula'' and dried ginger taken orally relieves swelling due to ''[[vata]]'' [23]<br /> <br /> === Remedy for ''[[vata]]-[[pitta]]'' swelling/edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दन्तीत्रिवृत्त्र्यूषणचित्रकैर्वा पयः शृतं दोषहरं पिबेन्ना| &lt;br /&gt;<br /> द्विप्रस्थमात्रं तु पलार्धिकैस्तैरर्धावशिष्टं पवने सपित्ते||२४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dantītrivr̥ttryūṣaṇacitrakairvā payaḥ śr̥taṁ dōṣaharaṁ pibēnnā| &lt;br /&gt;<br /> dviprasthamātraṁ tu palārdhikaistairardhāvaśiṣṭaṁ pavanē sapittē||24|| &lt;br /&gt;<br /> <br /> dantItrivRuttryUShaNacitrakairvA payaH shRutaM doShaharaM pibennA| &lt;br /&gt;<br /> dviprasthamAtraM tu palArdhikaistairardhAvashiShTaM pavane sapitte||24|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One liter of milk prepared with 20 gm each of ''danti, trivrit, trikatu'' and ''chitraka'' added with one liter of water reduced to half, taken orally relieves edema caused by combination of ''[[vata]]'' and ''[[pitta]]'' [24]<br /> <br /> === General remedies for edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सशुण्ठिपीतद्रुरसं प्रयोज्यं श्यामोरुबूकोषणसाधितं वा| &lt;br /&gt;<br /> त्वग्दारुवर्षाभुमहौषधैर्वा गुडूचिकानागरदन्तिभिर्वा||२५|| &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> saśuṇṭhipītadrurasaṁ prayōjyaṁ śyāmōrubūkōṣaṇasādhitaṁ vā| &lt;br /&gt;<br /> tvagdāruvarṣābhumahauṣadhairvā guḍūcikānāgaradantibhirvā||25|| &lt;br /&gt;<br /> <br /> sashuNThipItadrurasaM prayojyaM shyAmorubUkoShaNasAdhitaM vA| &lt;br /&gt;<br /> tvagdAruvarShAbhumahauShadhairvA guDUcikAnAgaradantibhirvA||25|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Milk prepared with dry ginger and ''daruharidra'' or prepared with ''shyama'', castor root and black pepper, or prepared with cinnamon, ''devadaru, punarnava'' and dry ginger; or prepared with ''guduchi'', dry ginger and ''danti''; taken orally relieves edema [25]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सप्ताहमौष्ट्रं त्वथवाऽपि मासं पयः पिबेद्भोजनवारिवर्जी| &lt;br /&gt;<br /> गव्यं समूत्रं महिषीपयो वा क्षीराशनो मूत्रमथो गवां वा||२६|| &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> saptāhamauṣṭraṁ tvathavā'pi māsaṁ payaḥ pibēdbhōjanavārivarjī| &lt;br /&gt;<br /> gavyaṁ samūtraṁ mahiṣīpayō vā kṣīrāśanō mūtramathō gavāṁ vā||26|| &lt;br /&gt;<br /> <br /> saptAhamauShTraM tvathavA~api mAsaM payaH pibedbhojanavArivarjI| &lt;br /&gt;<br /> gavyaM samUtraM mahiShIpayo vA kShIrAshano mUtramatho gavAM vA||26|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient by avoiding all other food and drinks if remains only on camel’s milk for a week or month or similarly remains on cow’s milk mixed with equal quantity of cow’s urine or on buffalo’s milk mixed with an equal quantity of cow’s urine or other milk with cow’s urine, then edema is cured [26] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तक्रं पिबेद्वा गुरुभिन्नवर्चाः सव्योषसौवर्चलमाक्षिकं च| &lt;br /&gt;<br /> गुडाभयां वा गुडनागरं वा सदोषभिन्नामविबद्धवर्चाः||२७|| &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> takraṁ pibēdvā gurubhinnavarcāḥ savyōṣasauvarcalamākṣikaṁ ca| &lt;br /&gt;<br /> guḍābhayāṁ vā guḍanāgaraṁ vā sadōṣabhinnāmavibaddhavarcāḥ||27|| &lt;br /&gt;<br /> <br /> takraM pibedvA gurubhinnavarcAH savyoShasauvarcalamAkShikaM ca| &lt;br /&gt;<br /> guDAbhayAM vA guDanAgaraM vA sadoShabhinnAmavibaddhavarcAH||27|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Patient of edema if passes heavy (with mucous) and loose stools may drink butter milk mixed with ''trikatu, sauvarchala''-salt and honey; or if the stool is morbid, loose, with ''ama'' or hard stool, then jaggery and ''haritaki'' or jaggery with dry ginger are given [27] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विड्वातसङ्गे पयसा रसैर्वा प्राग्भक्तमद्यादुरुबूकतैलम् [७] | <br /> <br /> स्रोतोविबन्धेऽग्निरुचिप्रणाशे मद्यान्यरिष्टांश्च पिबेत् सुजातान्||२८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> viḍvātasaṅgē payasā rasairvā prāgbhaktamadyādurubūkatailam [7] | <br /> <br /> srōtōvibandhē'gnirucipraṇāśē madyānyariṣṭāṁśca pibēt sujātān||28||<br /> <br /> viDvAtasa~gge payasA rasairvA prAgbhaktamadyAdurubUkatailam [7] |<br /> <br /> srotovibandhe~agnirucipraNAshe madyAnyariShTAMshca pibet sujAtAn||28|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If there is retention of feces and flatus, the patient may be given castor oil with milk or with meat-soup before meal; and if there is occlusion of channels or loss of digestion power and appetite, then the patient may be given simple or medicated wines [28]<br /> <br /> === ''Gandeeradyarishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गण्डीरभल्लातकचित्रकांश्च व्योषं विडङ्गं बृहतीद्वयं च| &lt;br /&gt;<br /> द्विप्रस्थिकं गोमयपावकेन द्रोणे पचेत् कूर्चिकमस्तुनस्तु [८] ||२९|| &lt;br /&gt;<br /> <br /> त्रिभागशेषं च सुपूतशीतं द्रोणेन तत् प्राकृतमस्तुना च| &lt;br /&gt;<br /> सितोपलायाश्च शतेन युक्तं लिप्ते घटे चित्रकपिप्पलीनाम्||३०|| &lt;br /&gt;<br /> <br /> वैहायसे स्थापितमादशाहात् प्रयोजयंस्तद्विनिहन्ति शोफान्| &lt;br /&gt;<br /> भगन्दरार्शःक्रिमिकुष्ठमेहान् वैवर्ण्यकार्श्यानिलहिक्कनं च||३१|| &lt;br /&gt;<br /> <br /> इति गण्डीराद्यरिष्टः &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gaṇḍīrabhallātakacitrakāṁśca vyōṣaṁ viḍaṅgaṁ br̥hatīdvayaṁ ca| &lt;br /&gt;<br /> dviprasthikaṁ gōmayapāvakēna drōṇē pacēt kūrcikamastunastu [8] ||29|| &lt;br /&gt;<br /> <br /> tribhāgaśēṣaṁ ca supūtaśītaṁ drōṇēna tat prākr̥tamastunā ca| &lt;br /&gt;<br /> sitōpalāyāśca śatēna yuktaṁ liptē ghaṭē citrakapippalīnām||30|| &lt;br /&gt;<br /> <br /> vaihāyasē sthāpitamādaśāhāt prayōjayaṁstadvinihanti śōphān| &lt;br /&gt;<br /> bhagandarārśaḥkrimikuṣṭhamēhān vaivarṇyakārśyānilahikkanaṁ ca||31|| &lt;br /&gt;<br /> <br /> iti gaṇḍīrādyariṣṭaḥ &lt;br /&gt;<br /> <br /> gaNDIrabhallAtakacitrakAMshca vyoShaM viDa~ggaM bRuhatIdvayaM ca| &lt;br /&gt;<br /> dviprasthikaM gomayapAvakena droNe pacet kUrcikamastunastu [8] ||29|| &lt;br /&gt;<br /> <br /> tribhAgasheShaM ca supUtashItaM droNena tat prAkRutamastunA ca| &lt;br /&gt;<br /> sitopalAyAshca shatena yuktaM lipte ghaTe citrakapippalInAm||30|| &lt;br /&gt;<br /> <br /> vaihAyase sthApitamAdashAhAt prayojayaMstadvinihanti shophAn| &lt;br /&gt;<br /> bhagandarArshaHkrimikuShThamehAn vaivarNyakArshyAnilahikkanaM ca||31|| &lt;br /&gt;<br /> <br /> iti gaNDIrAdyariShTaH &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take 1.280 Kg of ''gandeera, bhallataka, chitraka, trikatu, vidnaga, kantakari'' and ''brihati'' and add 1.024 Kg of [[kurchika]]-mastu (prepared by adding hot water in paneer) and boil on cow-dung fire till one-third remains and then filter. On cooling add to it 1.024 Kg natural-''mastu'' (prepared by adding water in curd), 4 kg of sugar-candy and put in a pitcher lined with paste of ''chitraka'' and ''pippali'' and leave this pot at a high-open place for 10 days for fermentation to prepare ''arishta''. <br /> <br /> Oral administration of ''gandeeradyarishtha'' cures edema, fistula-in-ano, piles, helminthiasis, ''kushtha''(obstinate skin diseases), polyuria, discoloration, emaciation and hiccup due to ''[[vata]]''. Thus ''gandeeradyarishtha'' is described [29-31]<br /> <br /> === ''Ashtashato arishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> काश्मर्यधात्रीमरिचाभयाक्षद्राक्षाफलानां [९] च सपिप्पलीनाम्| &lt;br /&gt;<br /> शतं शतं जीर्णगुडात्तुलां [१०] च सङ्क्षुद्य कुम्भे मधुना प्रलिप्ते||३२|| &lt;br /&gt;<br /> <br /> सप्ताहमुष्णे द्विगुणं तु शीते स्थितं जलद्रोणयुतं पिबेन्ना| &lt;br /&gt;<br /> शोफान् विबन्धान् कफवातजांश्च निहन्त्यरिष्टोऽष्टशतोऽग्निकृच्च||३३|| &lt;br /&gt;<br /> <br /> इत्यष्टशतोऽरिष्टः &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kāśmaryadhātrīmaricābhayākṣadrākṣāphalānāṁ [9] ca sapippalīnām| &lt;br /&gt;<br /> śataṁ śataṁ jīrṇaguḍāttulāṁ [10] ca saṅkṣudya kumbhē madhunā praliptē||32|| &lt;br /&gt;<br /> <br /> saptāhamuṣṇē dviguṇaṁ tu śītē sthitaṁ jaladrōṇayutaṁ pibēnnā| &lt;br /&gt;<br /> śōphān vibandhān kaphavātajāṁśca nihantyariṣṭō'ṣṭaśatō'gnikr̥cca||33|| &lt;br /&gt;<br /> <br /> ityaṣṭaśatō'riṣṭaḥ &lt;br /&gt;<br /> <br /> kAshmaryadhAtrImaricAbhayAkShadrAkShAphalAnAM [9] ca sapippalInAm| &lt;br /&gt;<br /> shataM shataM jIrNaguDAttulAM [10] ca sa~gkShudya kumbhe madhunA pralipte||32|| &lt;br /&gt;<br /> <br /> saptAhamuShNe dviguNaM tu shIte sthitaM jaladroNayutaM pibennA| &lt;br /&gt;<br /> shophAn vibandhAn kaphavAtajAMshca nihantyariShTo~aShTashato~agnikRucca||33|| &lt;br /&gt;<br /> <br /> ityaShTashato~ariShTaH &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take 100 ''pala'' each of ''kashmarya, amalaki,'' black pepper, ''haritaki, vibhitaki, pippali'' and grapes, add to it 100 ''pala'' of old jaggery and two ''drona'' of water, then put the mixture in a vessel lined with honey for 7 days in summer or for 14 days in winter for fermentation. Thus fermented ''asava'' is known as ''ashtashato-arishtha''. Its oral administration cures edema and constipation due to ''[[kapha]]'' and ''[[vata]]'' and stimulates digestion and metabolism (''agni''). Thus ''ashthato-arishta'' is described [32-33]<br /> <br /> === ''Punarnavadi arishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुनर्नवे द्वे च बले सपाठे दन्तीं [११] गुडूचीमथ चित्रकं च| &lt;br /&gt;<br /> निदिग्धिकां च त्रिपलानि पक्त्वा द्रोणावशेषे सलिले ततस्तम्||३४|| &lt;br /&gt;<br /> <br /> पूत्वा रसं द्वे च गुडात् पुराणात्तुले मधुप्रस्थयुतं सुशीतम्| &lt;br /&gt;<br /> मासं निदध्याद्घृतभाजनस्थं पल्ले यवानां परतस्तु मासात्||३५|| &lt;br /&gt;<br /> <br /> चूर्णीकृतैरर्धपलांशिकैस्तं पत्रत्वगेलामरिचाम्बुलोहैः [१२] | &lt;br /&gt;<br /> गन्धान्वितं क्षौद्रघृतप्रदिग्धे जीर्णे पिबेद् व्याधिबलं समीक्ष्य||३६|| &lt;br /&gt;<br /> <br /> हृत्पाण्डुरोगं श्वयथुं प्रवृद्धं प्लीहज्वरारोचकमेहगुल्मान्| &lt;br /&gt;<br /> भगन्दरं षड्जठराणि कासं श्वासं ग्रहण्यामयकुष्ठकण्डूः||३७|| &lt;br /&gt;<br /> <br /> शाखानिलं बद्धपुरीषतां च हिक्कां किलासं च हलीमकं च| &lt;br /&gt;<br /> क्षिप्रं जयेद्वर्णबलायुरोजस्तेजोन्वितो मांसरसान्नभोजी||३८|| &lt;br /&gt;<br /> <br /> इति पुनर्नवाद्यरिष्टः &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> punarnavē dvē ca balē sapāṭhē dantīṁ [11] guḍūcīmatha citrakaṁ ca|&lt;br /&gt; <br /> nidigdhikāṁ ca tripalāni paktvā drōṇāvaśēṣē salilē tatastam||34|| &lt;br /&gt;<br /> <br /> pūtvā rasaṁ dvē ca guḍāt purāṇāttulē madhuprasthayutaṁ suśītam| &lt;br /&gt;<br /> māsaṁ nidadhyādghr̥tabhājanasthaṁ pallē yavānāṁ paratastu māsāt||35||&lt;br /&gt;<br /> <br /> cūrṇīkr̥tairardhapalāṁśikaistaṁ patratvagēlāmaricāmbulōhaiḥ [12] | &lt;br /&gt;<br /> gandhānvitaṁ kṣaudraghr̥tapradigdhē jīrṇē pibēd vyādhibalaṁ samīkṣya||36|| &lt;br /&gt;<br /> <br /> hr̥tpāṇḍurōgaṁ śvayathuṁ pravr̥ddhaṁ plīhajvarārōcakamēhagulmān| &lt;br /&gt;<br /> bhagandaraṁ ṣaḍjaṭharāṇi kāsaṁ śvāsaṁ grahaṇyāmayakuṣṭhakaṇḍūḥ||37|| &lt;br /&gt;<br /> <br /> śākhānilaṁ baddhapurīṣatāṁ ca hikkāṁ kilāsaṁ ca halīmakaṁ ca| &lt;br /&gt;<br /> kṣipraṁ jayēdvarṇabalāyurōjastējōnvitō māṁsarasānnabhōjī||38|| &lt;br /&gt;<br /> <br /> iti punarnavādyariṣṭaḥ &lt;br /&gt;<br /> <br /> punarnave dve ca bale sapAThe dantIM [11] guDUcImatha citrakaM ca| &lt;br /&gt;<br /> nidigdhikAM ca tripalAni paktvA droNAvasheShe salile tatastam||34||&lt;br /&gt;<br /> <br /> pUtvA rasaM dve ca guDAt purANAttule madhuprasthayutaM sushItam| &lt;br /&gt;<br /> mAsaM nidadhyAdghRutabhAjanasthaM palle yavAnAM paratastu mAsAt||35|| &lt;br /&gt;<br /> <br /> cUrNIkRutairardhapalAMshikaistaM patratvagelAmaricAmbulohaiH [12] | &lt;br /&gt;<br /> gandhAnvitaM kShaudraghRutapradigdhe jIrNe pibed vyAdhibalaM samIkShya ||36|| &lt;br /&gt;<br /> <br /> hRutpANDurogaM shvayathuM pravRuddhaM plIhajvarArocakamehagulmAn| &lt;br /&gt;<br /> bhagandaraM ShaDjaTharANi kAsaM shvAsaM grahaNyAmayakuShThakaNDUH ||37|| &lt;br /&gt;<br /> <br /> shAkhAnilaM baddhapurIShatAM ca hikkAM kilAsaM ca halImakaM ca| &lt;br /&gt;<br /> kShipraM jayedvarNabalAyurojastejonvito mAMsarasAnnabhojI||38||&lt;br /&gt;<br /> <br /> iti punarnavAdyariShTaH &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make a decoction of 120 gm each of two types of ''punarnavā, balā, pāṭhā, dantī, guḍūchī, chitraka, kantakāri'' and ''triphalā'' by adding water (about 4.1 liters) and reducing it to 1.024 liter. Add to this decoction 8 kg of jaggery and 640 gm of honey and keep it in a vessel lined with ghee and place it in a heap of barley for a month. Thereafter to make it fragrant, add 20 gm powders each of ''tejapatra'', cinnamon, cardamom, black pepper, couscous and iron ''bhasma'' and store in a pot lined with honey and ghee. It is to be taken after the digestion of the meal in a dose according to the strength of the disease. In diet, food with meat soup may be given.<br /> <br /> It provides quick cure in heart disease, anemia, severe edema, splenic disorders, fever, anorexia, polyuria, ''gulma'', fistula-in-ano, six types of ''udararoga'', cough, dyspnea, assimilation disorders (''grahani''), dermatosis (''kushtha''), pruritis, ''[[vata]]'' disorders of limbs, constipation, hiccup, leukoderma and ''halimaka'' (greenish coloration of skin). It also improves complexion, strength, [[ojas]] and vitality. Thus ''punarnavadi arishta'' is described [34-38]<br /> <br /> === ''Triphaladyarishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> फलत्रिकं दीप्यकचित्रकौ च सपिप्पलीलोहरजो विडङ्गम्| &lt;br /&gt;<br /> चूर्णीकृतं कौडविकं द्विरंशं क्षौद्रं पुराणस्य तुलां गुडस्य||३९|| &lt;br /&gt;<br /> <br /> मासं निदध्याद्घृतभाजनस्थं यवेषु तानेव निहन्ति रोगान्| &lt;br /&gt;<br /> ये चार्शसां पाण्डुविकारिणां च प्रोक्ता हिताः शोफिषु तेऽप्यरिष्टाः||४०|| &lt;br /&gt;<br /> <br /> इति त्रिफलाद्यरिष्टः &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> phalatrikaṁ dīpyakacitrakau ca sapippalīlōharajō viḍaṅgam| &lt;br /&gt;<br /> cūrṇīkr̥taṁ kauḍavikaṁ dviraṁśaṁ kṣaudraṁ purāṇasya tulāṁ guḍasya||39|| &lt;br /&gt;<br /> <br /> māsaṁ nidadhyādghr̥tabhājanasthaṁ yavēṣu tānēva nihanti rōgān| &lt;br /&gt;<br /> yē cārśasāṁ pāṇḍuvikāriṇāṁ ca prōktā hitāḥ śōphiṣu tē'pyariṣṭāḥ||40|| &lt;br /&gt;<br /> <br /> iti triphalādyariṣṭaḥ &lt;br /&gt;<br /> <br /> phalatrikaM dIpyakacitrakau ca sapippalIloharajo viDa~ggam| &lt;br /&gt;<br /> cUrNIkRutaM kauDavikaM dviraMshaM kShaudraM purANasya tulAM guDasya||39|| &lt;br /&gt;<br /> <br /> mAsaM nidadhyAdghRutabhAjanasthaM yaveShu tAneva nihanti rogAn| &lt;br /&gt;<br /> ye cArshasAM pANDuvikAriNAM ca proktA hitAH shophiShu te~apyariShTAH||40|| &lt;br /&gt;<br /> <br /> iti triphalAdyariShTaH &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make decoction from the coarse powder of 160 gm each of ''triphala, ajawan, chitraka, pippali,'' iron bhasma and ''vidanga''. To this decoction add 320 ml of honey and 4 kg of jaggery and put it in a vessel lined with ghee and place in a heap of barley for a month. Its oral administration cures all the diseases mentioned above. Thus ''triphaladyarishtha'' is described.<br /> <br /> The ''asava'' and ''arishtha'' mentioned for the treatment of piles and anemia are also beneficial for relieving the edema [39-40]<br /> <br /> === Powder preparations for edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कृष्णा सपाठा गजपिप्पली च निदिग्धिका चित्रकनागरे च| &lt;br /&gt;<br /> सपिप्पलीमूलरजन्यजाजीमुस्तं च चूर्णं सुखतोयपीतम्||४१|| &lt;br /&gt;<br /> <br /> हन्यात्त्रिदोषं चिरजं च शोफं कल्कश्च भूनिम्बमहौषधस्य| &lt;br /&gt;<br /> अयोरजस्त्र्यूषणयावशूकचूर्णं च पीतं त्रिफलारसेन||४२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kr̥ṣṇā sapāṭhā gajapippalī ca nidigdhikā citrakanāgarē ca| &lt;br /&gt;<br /> sapippalīmūlarajanyajājīmustaṁ ca cūrṇaṁ sukhatōyapītam||41|| &lt;br /&gt;<br /> <br /> hanyāttridōṣaṁ cirajaṁ ca śōphaṁ kalkaśca bhūnimbamahauṣadhasya| &lt;br /&gt;<br /> ayōrajastryūṣaṇayāvaśūkacūrṇaṁ ca pītaṁ triphalārasēna||42||&lt;br /&gt;<br /> <br /> kRuShNA sapAThA gajapippalI ca nidigdhikA citrakanAgare ca| &lt;br /&gt;<br /> sapippalImUlarajanyajAjImustaM ca cUrNaM sukhatoyapItam||41|| &lt;br /&gt;<br /> <br /> hanyAttridoShaM cirajaM ca shophaM kalkashca bhUnimbamahauShadhasya| &lt;br /&gt;<br /> ayorajastryUShaNayAvashUkacUrNaM ca pItaM triphalArasena||42||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Use of any one of the following powder preparations cures chronic edema caused by all the three ''[[dosha]]'':<br /> <br /> The mixture of the powders of ''pippali, pippalimula, pāthā, gajapippali,'' cumin, ''kantakāri, chitraka,'' dried ginger, turmeric, cumin and ''mustaka'' taken with lukewarm water, or paste of ''bhumyāmalaki'' and dried ginger taken with lukewarm water or <br /> ''bhasma'' of iron, ''trikatu'' and ''yavakshara'' taken with decoction of ''triphala'' [41-42]<br /> <br /> === ''Ksharagudika'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षारद्वयं स्याल्लवणानि चत्वार्ययोरजो व्योषफलत्रिके च| &lt;br /&gt;<br /> सपिप्पलीमूलविडङ्गसारं मुस्ताजमोदामरदारुबिल्वम्||४३|| &lt;br /&gt;<br /> <br /> कलिङ्गकाश्चित्रकमूलपाठे यष्ट्याह्वयं सातिविषं पलांशम्| &lt;br /&gt;<br /> सहिङ्गुकर्षं त्वणुशुष्कचूर्णं द्रोणं तथा मूलकशुण्ठकानाम्||४४|| &lt;br /&gt;<br /> <br /> स्याद्भस्मनस्तत् सलिलेन साध्यमालोड्य यावद्घनमप्रदग्धम्| &lt;br /&gt;<br /> स्त्यानं ततः कोलसमां तु मात्रां कृत्वा सुशुष्कां विधिनोपयुञ्ज्यात्||४५|| &lt;br /&gt;<br /> <br /> प्लीहोदरश्वित्रहलीमकार्शःपाण्ड्वामयारोचकशोषशोफान्| &lt;br /&gt;<br /> विसूचिकागुल्मगराश्मरीश्च सश्वासकासाः प्रणुदेत् सकुष्ठाः||४६|| &lt;br /&gt;<br /> <br /> इति क्षारगुडिका &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣāradvayaṁ syāllavaṇāni catvāryayōrajō vyōṣaphalatrikē ca| &lt;br /&gt;<br /> sapippalīmūlaviḍaṅgasāraṁ mustājamōdāmaradārubilvam||43|| &lt;br /&gt;<br /> <br /> kaliṅgakāścitrakamūlapāṭhē yaṣṭyāhvayaṁ sātiviṣaṁ palāṁśam| &lt;br /&gt;<br /> sahiṅgukarṣaṁ tvaṇuśuṣkacūrṇaṁ drōṇaṁ tathā mūlakaśuṇṭhakānām||44|| &lt;br /&gt;<br /> <br /> syādbhasmanastat salilēna sādhyamālōḍya yāvadghanamapradagdham| &lt;br /&gt;<br /> styānaṁ tataḥ kōlasamāṁ tu mātrāṁ kr̥tvā suśuṣkāṁ vidhinōpayuñjyāt||45||&lt;br /&gt;<br /> <br /> plīhōdaraśvitrahalīmakārśaḥpāṇḍvāmayārōcakaśōṣaśōphān| &lt;br /&gt;<br /> visūcikāgulmagarāśmarīśca saśvāsakāsāḥ praṇudēt sakuṣṭhāḥ||46|| &lt;br /&gt;<br /> <br /> iti kṣāraguḍikā || &lt;br /&gt;<br /> <br /> kShAradvayaM syAllavaNAni catvAryayorajo vyoShaphalatrike ca| &lt;br /&gt;<br /> sapippalImUlaviDa~ggasAraM mustAjamodAmaradArubilvam||43|| &lt;br /&gt;<br /> <br /> kali~ggakAshcitrakamUlapAThe yaShTyAhvayaM sAtiviShaM palAMsham| &lt;br /&gt;<br /> sahi~ggukarShaM tvaNushuShkacUrNaM droNaM tathA mUlakashuNThakAnAm||44|| &lt;br /&gt;<br /> <br /> syAdbhasmanastat salilena sAdhyamAloDya yAvadghanamapradagdham| &lt;br /&gt;<br /> styAnaM tataH kolasamAM tu mAtrAM kRutvA sushuShkAM vidhinopayu~jjyAt||45|| &lt;br /&gt;<br /> <br /> plIhodarashvitrahalImakArshaHpANDvAmayArocakashoShashophAn| &lt;br /&gt;<br /> visUcikAgulmagarAshmarIshca sashvAsakAsAH praNudet sakuShThAH||46|| &lt;br /&gt;<br /> <br /> iti kShAraguDikA &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take 40 gm fine powder each of ''svarajjikā'' and ''yava-kshara'', four varieties of salt, iron ''bhasma, trikatu, triphala, pippalimula,'' pealed seeds of ''vidanga, mustaka, ajamodā, devadāru, bilva, indrayava,'' root of ''chitraka, pāthā, ativishā'' and liquorice; 10 gm of asafetida and 1.024 Kg of dried radish and dried ginger. Add water to it and heat the mixture till it becomes thick taking care that it should not seared and from it make pills of 5 gm each and dry them. <br /> <br /> Properly administered pills cure splenomegaly, leukoderma, ''halimaka'' (greenish coloration of the skin), piles, anemia, anorexia, emaciation, edema, gastroenteritis, ''gulma'', synthetic poisoning, lithiasis, dyspnea, cough and dermatosis. Thus ''ksharagudika'' is described [43-46]<br /> <br /> === Course of ''gud-adraka'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्रयोजयेदार्द्रकनागरं वा तुल्यं गुडेनार्धपलाभिवृद्ध्या| &lt;br /&gt;<br /> मात्रा परं पञ्चपलानि मासं जीर्णे पयो यूषरसाश्च भक्तम्||४७||&lt;br /&gt;<br /> <br /> गुल्मोदरार्शःश्वयथुप्रमेहाञ् श्वासप्रतिश्यालसकाविपाकान्| &lt;br /&gt;<br /> सकामलाशोषमनोविकारान् कासं कफं चैव जयेत् प्रयोगः||४८|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> prayōjayēdārdrakanāgaraṁ vā tulyaṁ guḍēnārdhapalābhivr̥ddhyā| &lt;br /&gt;<br /> mātrā paraṁ pañcapalāni māsaṁ jīrṇē payō yūṣarasāśca bhaktam||47|| &lt;br /&gt;<br /> <br /> gulmōdarārśaḥśvayathupramēhāñ śvāsapratiśyālasakāvipākān| &lt;br /&gt;<br /> sakāmalāśōṣamanōvikārān kāsaṁ kaphaṁ caiva jayēt prayōgaḥ||48||&lt;br /&gt;<br /> <br /> prayojayedArdrakanAgaraM vA tulyaM guDenArdhapalAbhivRuddhyA| &lt;br /&gt;<br /> mAtrA paraM pa~jcapalAni mAsaM jIrNe payo yUSharasAshca bhaktam||47|| &lt;br /&gt;<br /> <br /> gulmodarArshaHshvayathupramehA~j shvAsapratishyAlasakAvipAkAn| &lt;br /&gt;<br /> sakAmalAshoShamanovikArAn kAsaM kaphaM caiva jayet prayogaH||48||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Mix equal quantity of jaggery and ginger and take it in 20 gm dose initially and then increase its dose by 20 gm daily till the dose becomes 200 gm per day. Then this dose is to be continued for the remaining days of the month. During this treatment, on digestion of the drug, rice gruel and milk or meat soup should be given to eat. <br /> <br /> The one month course cures ''gulma, udararoga,'' piles, edema, polyuria, dyspnea, coryza, cough, ''alasaka,'' indigestion, jaundice, consumption, mental disorders and [[kapha]] disorders [47-48]<br /> <br /> === Course of ''shilajatu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रसस्तथैवार्द्रकनागरस्य पेयोऽथ जीर्णे पयसाऽन्नमद्यात्| &lt;br /&gt;<br /> जत्वश्मजं [१३] च त्रिफलारसेन हन्यात्त्रिदोषं श्वयथुं प्रसह्य||४९|| &lt;br /&gt;<br /> <br /> इति शिलाजतुप्रयोगः &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rasastathaivārdrakanāgarasya pēyō'tha jīrṇē payasā'nnamadyāt| &lt;br /&gt;<br /> jatvaśmajaṁ [13] ca triphalārasēna hanyāttridōṣaṁ śvayathuṁ prasahya||49|| &lt;br /&gt;<br /> <br /> iti śilājatuprayōgaḥ &lt;br /&gt;<br /> <br /> rasastathaivArdrakanAgarasya peyo~atha jIrNe payasA~annamadyAt| &lt;br /&gt;<br /> jatvashmajaM [13] ca triphalArasena hanyAttridoShaM shvayathuM prasahya||49|| &lt;br /&gt;<br /> <br /> iti shilAjatuprayogaH &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Similarly juice of ginger may be taken with ''shilajatu'' for one month in the doses and manner mentioned above. On getting the hunger food should be taken with milk.<br /> <br /> A month’s course of ''shilājatu'' with juice of ''triphalā'' will completely cure the edema/swelling caused by all the three ''[[dosha]]''. Thus course of ''shilājatu'' is described [49]<br /> <br /> === ''Kamsa haritaki'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्विपञ्चमूलस्य पचेत् कषाये कंसेऽभयानां च शतं गुडस्य| &lt;br /&gt;<br /> लेहे सुसिद्धेऽथ विनीय चूर्णं व्योषं त्रिसौगन्ध्यमुषास्थिते च||५०|| &lt;br /&gt;<br /> <br /> प्रस्थार्धमात्रं मधुनः सुशीते किञ्चिच्च चूर्णादपि यावशूकात्| &lt;br /&gt;<br /> एकाभयां प्राश्य ततश्च लेहाच्छुक्तिं निहन्ति श्वयथुं प्रवृद्धम्||५१|| &lt;br /&gt;<br /> <br /> श्वासज्वरारोचकमेहगुल्मप्लीहत्रिदोषोदरपाण्डुरोगान्| &lt;br /&gt;<br /> कार्श्यामवातावसृगम्लपित्तवैवर्ण्यमूत्रानिलशुक्रदोषान्||५२|| &lt;br /&gt;<br /> <br /> इति कंसहरीतकी &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dvipañcamūlasya pacēt kaṣāyē kaṁsē'bhayānāṁ ca śataṁ guḍasya| &lt;br /&gt;<br /> lēhē susiddhē'tha vinīya cūrṇaṁ vyōṣaṁ trisaugandhyamuṣāsthitē ca||50|| &lt;br /&gt;<br /> <br /> prasthārdhamātraṁ madhunaḥ suśītē kiñcicca cūrṇādapi yāvaśūkāt| &lt;br /&gt;<br /> ēkābhayāṁ prāśya tataśca lēhācchuktiṁ nihanti śvayathuṁ pravr̥ddham||51|| &lt;br /&gt;<br /> <br /> śvāsajvarārōcakamēhagulmaplīhatridōṣōdarapāṇḍurōgān| &lt;br /&gt;<br /> kārśyāmavātāvasr̥gamlapittavaivarṇyamūtrānilaśukradōṣān||52|| &lt;br /&gt;<br /> <br /> iti kaṁsaharītakī &lt;br /&gt;<br /> <br /> dvipa~jcamUlasya pacet kaShAye kaMse~abhayAnAM ca shataM guDasya| &lt;br /&gt;<br /> lehe susiddhe~atha vinIya cUrNaM vyoShaM trisaugandhyamuShAsthite ca||50|| &lt;br /&gt;<br /> <br /> prasthArdhamAtraM madhunaH sushIte ki~jcicca cUrNAdapi yAvashUkAt| &lt;br /&gt;<br /> ekAbhayAM prAshya tatashca lehAcchuktiM nihanti shvayathuM pravRuddham||51|| &lt;br /&gt;<br /> <br /> shvAsajvarArocakamehagulmaplIhatridoShodarapANDurogAn| &lt;br /&gt;<br /> kArshyAmavAtAvasRugamlapittavaivarNyamUtrAnilashukradoShAn||52|| &lt;br /&gt;<br /> <br /> iti kaMsaharItakI &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make 2.56 liter decoction of ''dashamula'' and add to it ''haritaki'' 100 in number and 4.0 kg of jaggery and powder of ''trikatu'' and ''trijata'' (three aromatics- leaves and bark of cinnamon and cardamom). Leave it overnight and next morning on cooling adds 320 gm of honey and little quantity of ''yavakshara''. <br /> <br /> Take it in the dose of 10 gm along with one ''haritaki''. It will cure severe edema and also dyspnea, fever, anorexia, polyuria, ''gulma'', splenic-disorders, ''sannipātika-udararoga,'' anemia, emaciation, rheumatoid arthritis, bleeding disorders, hyperchlorhydria, discoloration of skin and ''[[vata]]'' disorders of urine and semen. Thus ''kaṁsaharītakī'' is described [50-52]<br /> <br /> === Patoladi kashaya ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पटोलमूलामरदारुदन्तीत्रायन्तिपिप्पल्यभयाविशालाः| &lt;br /&gt;<br /> यष्ट्याह्वयं तिक्तकरोहिणी च सचन्दना स्यान्निचुलानि दार्वी||५३|| &lt;br /&gt;<br /> <br /> कर्षोन्मितैस्तैः क्वथितः कषायो घृतेन पेयः कुडवेन युक्तः| &lt;br /&gt;<br /> वीसर्पदाहज्वरसन्निपाततृष्णाविषाणि श्वयथुं च हन्ति||५४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> paṭōlamūlāmaradārudantītrāyantipippalyabhayāviśālāḥ| &lt;br /&gt;<br /> yaṣṭyāhvayaṁ tiktakarōhiṇī ca sacandanā syānniculāni dārvī||53|| &lt;br /&gt;<br /> <br /> karṣōnmitaistaiḥ kvathitaḥ kaṣāyō ghr̥tēna pēyaḥ kuḍavēna yuktaḥ| &lt;br /&gt;<br /> vīsarpadāhajvarasannipātatr̥ṣṇāviṣāṇi śvayathuṁ ca hanti||54||&lt;br /&gt;<br /> <br /> paTolamUlAmaradArudantItrAyantipippalyabhayAvishAlAH| &lt;br /&gt;<br /> yaShTyAhvayaM tiktakarohiNI ca sacandanA syAnniculAni dArvI||53|| &lt;br /&gt;<br /> <br /> karShonmitaistaiH kvathitaH kaShAyo ghRutena peyaH kuDavena yuktaH| &lt;br /&gt;<br /> vIsarpadAhajvarasannipAtatRuShNAviShANi shvayathuM ca hanti||54||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make decoction of 10 gm each of roots of ''patola, devadāru, danti, trāyamānā, pippali, haritaki, indrāyana,'' liquorices, sandal wood, ''katukā, dāruhridrā'' and ''samudraphala''. This decoction should be taken with 160 gm of ghee. It cures ''visarpa'' (erysipelas), burning sensation, fever, ''sannipāta'' thirst, poisoning and edema [53-54]<br /> <br /> === ''Chitraka ghrita'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सचित्रकं [१४] धान्ययवान्यजाजीसौवर्चलं त्र्यूषणवेतसाम्लम्| &lt;br /&gt;<br /> बिल्वात् फलं दाडिमयावशूकौ सपिप्पलीमूलमथापि चव्यम्||५५|| &lt;br /&gt;<br /> <br /> पिष्ट्वाऽक्षमात्राणि जलाढकेन पक्त्वा घृतप्रस्थमथ प्रयुञ्ज्यात्| &lt;br /&gt;<br /> अर्शांसि गुल्मं श्वयथुं कृच्छ्रं निहन्ति वह्निं च करोति दीप्तम्||५६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sacitrakaṁ [14] dhānyayavānyajājīsauvarcalaṁ tryūṣaṇavētasāmlam| &lt;br /&gt;<br /> b0ilvāt phalaṁ dāḍimayāvaśūkau sapippalīmūlamathāpi cavyam||55|| &lt;br /&gt;<br /> <br /> piṣṭvā'kṣamātrāṇi jalāḍhakēna paktvā ghr̥taprasthamatha prayuñjyāt| &lt;br /&gt;<br /> arśāṁsi gulmaṁ śvayathuṁ ca kr̥cchraṁ nihanti vahniṁ ca karōti dīptam||56|| &lt;br /&gt;<br /> <br /> sacitrakaM [14] dhAnyayavAnyajAjIsauvarcalaM tryUShaNavetasAmlam| &lt;br /&gt;<br /> bilvAt phalaM dADimayAvashUkau sapippalImUlamathApi cavyam||55|| &lt;br /&gt;<br /> <br /> piShTvA~akShamAtrANi jalADhakena paktvA ghRutaprasthamatha prayu~jjyAt|&lt;br /&gt; <br /> arshAMsi gulmaM shvayathuM ca kRucchraM nihanti vahniM ca karoti dIptam||56||&lt;br /&gt; <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make paste of 10 gm each of ''chitraka,'' coriander, ajawan, cumin, ''sauvarchala''-salt, ''trikatu, amlavetasa, bilva,'' pomegranate, ''yavakṣāra, pippalimula'' and ''chavya''; add to it 640 gm of ghee and 2.56 liter of water. Prepare ''ghrita'' as per ''sneha pāka'' method. <br /> <br /> Oral administration of ''chitraka'' ghee cures edema/swelling even if it is difficult to cure as well as piles and ''gulma'' and stimulate the digestion and metabolism (''agni''). [55-56]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पिबेद्घृतं वाऽष्टगुणाम्बुसिद्धं सचित्रकक्षारमुदारवीर्यम्| &lt;br /&gt;<br /> कल्याणकं वाऽपि सपञ्चगव्यं तिक्तं महद्वाऽप्यथ तिक्तकं वा||५७|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pibēdghr̥taṁ vā'ṣṭaguṇāmbusiddhaṁ sacitrakakṣāramudāravīryam| &lt;br /&gt;<br /> kalyāṇakaṁ vā'pi sapañcagavyaṁ tiktaṁ mahadvā'pyatha tiktakaṁ vā||57||&lt;br /&gt;<br /> <br /> pibedghRutaM vA~aShTaguNAmbusiddhaM sacitrakakShAramudAravIryam| &lt;br /&gt;<br /> kalyANakaM vA~api sapa~jcagavyaM tiktaM mahadvA~apyatha tiktakaM vA||57||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Prepare a ''ghrita'' with eight times of water with paste of ''chitraka'' and ''yavakshara''. It has great potency. The patient may also take the ''kalyānaka ghrita'' or ''panchagavya ghrita'' or ''mahātikta ghrita'' or ''tikta ghrita'' [57] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षीरं घटे चित्रककल्कलिप्ते दध्यागतं साधु विमथ्य तेन| &lt;br /&gt;<br /> तज्जं घृतं चित्रकमूलगर्भं तक्रेण सिद्धं श्वयथुघ्नमग्र्यम्||५८|| &lt;br /&gt;<br /> <br /> अर्शोऽतिसारानिलगुल्ममेहांश्चैतन्निहन्त्यग्निबलप्रदं [१५] च| &lt;br /&gt;<br /> तक्रेण चाद्यात् सघृतेन तेन भोज्यानि सिद्धामथवा यवागूम्||५९|| &lt;br /&gt;<br /> <br /> इति चित्रकघृतम् &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣīraṁ ghaṭē citrakakalkaliptē dadhyāgataṁ sādhu vimathya tēna| &lt;br /&gt;<br /> tajjaṁ ghr̥taṁ citrakamūlagarbhaṁ takrēṇa siddhaṁ śvayathughnamagryam||58|| &lt;br /&gt;<br /> <br /> arśō'tisārānilagulmamēhāṁścaitannihantyagnibalapradaṁ [15] ca| &lt;br /&gt;<br /> takrēṇa cādyāt saghr̥tēna tēna bhōjyāni siddhāmathavā yavāgūm||59|| &lt;br /&gt;<br /> <br /> iti citrakaghr̥tam &lt;br /&gt;<br /> <br /> kShIraM ghaTe citrakakalkalipte dadhyAgataM sAdhu vimathya tena| &lt;br /&gt;<br /> tajjaM ghRutaM citrakamUlagarbhaM takreNa siddhaM shvayathughnamagryam||58|| &lt;br /&gt;<br /> <br /> arsho~atisArAnilagulmamehAMshcaitannihantyagnibalapradaM [15] ca| &lt;br /&gt;<br /> takreNa cAdyAt saghRutena tena bhojyAni siddhAmathavA yavAgUm||59|| &lt;br /&gt;<br /> <br /> iti citrakaghRutam &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Put milk in a pot coated with paste of ''chitraka'' and curdle it. Churn this curd well to get butter which is heated to ghee. Add to the ghee all the buttermilk (which contains mixed ''chitraka'' also) from the pot and prepare the medicated ''ghrita''. It is best to cure edema. It also provides relief in piles, diarrhea, ''[[vata]]-gulma'', polyuria and stimulates digestion and metabolism (''agni''). <br /> <br /> During the treatment the diet should be taken with buttermilk prepared as above with ''chitraka'' along with ghee prepared from the above butter or gruels prepared with this butter milk and ghee. Thus ''chitraka ghrita'' is described [58-59]<br /> <br /> === Yavagu preparations ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> जीवन्त्यजाजीशटिपुष्कराह्वैः सकारवीचित्रकबिल्वमध्यैः| &lt;br /&gt;<br /> सयावशूकैर्बदरप्रमाणैर्वृक्षाम्लयुक्ता घृततैलभृष्टा||६०|| &lt;br /&gt;<br /> <br /> अर्शोऽतिसारानिलगुल्मशोफहृद्रोगमन्दाग्निहिता यवागूः| &lt;br /&gt;<br /> या पञ्चकोलैर्विधिनैव [१६] तेन सिद्धा भवेत् सा च समा तयैव||६१|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> jīvantyajājīśaṭipuṣkarāhvaiḥ sakāravīcitrakabilvamadhyaiḥ| &lt;br /&gt;<br /> sayāvaśūkairbadarapramāṇairvr̥kṣāmlayuktā ghr̥tatailabhr̥ṣṭā||60|| &lt;br /&gt;<br /> <br /> arśō'tisārānilagulmaśōphahr̥drōgamandāgnihitā yavāgūḥ| &lt;br /&gt;<br /> yā pañcakōlairvidhinaiva [16] tēna siddhā bhavēt sā ca samā tayaiva||61|| &lt;br /&gt;<br /> <br /> jIvantyajAjIshaTipuShkarAhvaiH sakAravIcitrakabilvamadhyaiH| &lt;br /&gt;<br /> sayAvashUkairbadarapramANairvRukShAmlayuktA ghRutatailabhRuShTA||60|| &lt;br /&gt;<br /> <br /> arsho~atisArAnilagulmashophahRudrogamandAgnihitA yavAgUH| &lt;br /&gt;<br /> yA pa~jcakolairvidhinaiva [16] tena siddhA bhavet sA ca samA tayaiva||61|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take 5 gm each of ''jivanti,'' cumin, ''saṭi, pushkarmula, karvi'' (celery), ''chitraka, bilva'' and ''yavakashara,'' make a medicated gruel (''yavāgu'') and then fry it in ghee and oil. This gruel taken by adding ''vrikshamla'' cures piles, diarrhea, ''[[vata]] gulma'', edema, heart disease and low digestion. <br /> <br /> The medicated ''yavāgu'' (gruel) similarly prepared with ''panchakola'' also gives the same relief as mentioned above (60-61).<br /> <br /> === ''Pathya'' (wholesome food) for ''shotha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कुलत्थयूषश्च सपिप्पलीको मौद्गश्च सत्र्यूषणयावशूकः| &lt;br /&gt;<br /> रसस्तथा विष्किरजाङ्गलानां सकूर्मगोधाशिखिशल्लकानाम्||६२|| &lt;br /&gt;<br /> <br /> सुवर्चला गृञ्जनकं पटोलं सवायसीमूलकवेत्रनिम्बम्| &lt;br /&gt;<br /> शाकार्थिनां शाकमिति प्रशस्तं भोज्ये पुराणश्च यवः सशालिः||६३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kulatthayūṣaśca sapippalīkō maudgaśca satryūṣaṇayāvaśūkaḥ| &lt;br /&gt;<br /> rasastathā viṣkirajāṅgalānāṁ sakūrmagōdhāśikhiśallakānām||62|| &lt;br /&gt;<br /> <br /> suvarcalā gr̥ñjanakaṁ paṭōlaṁ savāyasīmūlakavētranimbam| &lt;br /&gt;<br /> śākārthināṁ śākamiti praśastaṁ bhōjyē purāṇaśca yavaḥ saśāliḥ||63||&lt;br /&gt;<br /> <br /> kulatthayUShashca sapippalIko maudgashca satryUShaNayAvashUkaH| &lt;br /&gt;<br /> rasastathA viShkirajA~ggalAnAM sakUrmagodhAshikhishallakAnAm||62|| &lt;br /&gt;<br /> <br /> suvarcalA gRu~jjanakaM paTolaM savAyasImUlakavetranimbam| &lt;br /&gt;<br /> shAkArthinAM shAkamiti prashastaM bhojye purANashca yavaH sashAliH||63||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Followings diet articles are wholesome for the patient of edema/swelling:<br /> *Soup of ''kulattha'' mixed with long piper<br /> *Soup of ''munga'' mixed with ''trikatu'' and ''yavakshara''<br /> *Meat soup of gallinaceous and wild creatures,<br /> *Meat soup of tortoise, iguana, peacock and pangolin,<br /> *Vegetables such as heliotrope, turnip, ''makoya'' (wild snake gourd), radish, ''vetra, neem'' and ''patola''<br /> *Old ''shali rice'' and old barley [62-63]<br /> <br /> === External applications ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आभ्यन्तरं भेषजमुक्तमेतद्बर्हिर्हितं यच्छृणु तद्यथावत्| &lt;br /&gt;<br /> स्नेहान् प्रदेहान् परिषेचनानि स्वेदांश्च वातप्रबलस्य कुर्यात्||६४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ābhyantaraṁ bhēṣajamuktamētadbarhirhitaṁ yacchr̥ṇu tadyathāvat| &lt;br /&gt;<br /> snēhān pradēhān pariṣēcanāni svēdāṁśca vātaprabalasya kuryāt||64|| &lt;br /&gt;<br /> <br /> AbhyantaraM bheShajamuktametadbarhirhitaM yacchRuNu tadyathAvat| &lt;br /&gt;<br /> snehAn pradehAn pariShecanAni svedAMshca vAtaprabalasya kuryAt||64|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus internal preparations have been described. Now external preparations beneficial for the patient of swelling will be described. ''[[Snehana]], [[swedana]],'' smearing with pastes and effusions should be done in a patient having dominance of ''[[vata]]'' swelling [64]<br /> <br /> === ''Shaileyadi taila'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शैलेयकुष्ठागुरुदारुकौन्तीत्वक्पद्मकैलाम्बुपलाशमुस्तैः| &lt;br /&gt;<br /> प्रियङ्गुथौणेयकहेममांसीतालीशपत्रप्लवपत्रधान्यैः||६५|| &lt;br /&gt;<br /> <br /> श्रीवेष्टकध्यामकपिप्पलीभिः स्पृक्कानखैश्चैव यथोपलाभम्| &lt;br /&gt;<br /> वातान्वितेऽभ्यङ्गमुशन्ति तैलं सिद्धं सुपिष्टैरपि च प्रदेहम्||६६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śailēyakuṣṭhāgurudārukauntītvakpadmakailāmbupalāśamustaiḥ| &lt;br /&gt;<br /> priyaṅguthauṇēyakahēmamāṁsītālīśapatraplavapatradhānyaiḥ||65|| &lt;br /&gt;<br /> <br /> śrīvēṣṭakadhyāmakapippalībhiḥ spr̥kkānakhaiścaiva yathōpalābham| &lt;br /&gt;<br /> vātānvitē'bhyaṅgamuśanti tailaṁ siddhaṁ supiṣṭairapi ca pradēham||66|| &lt;br /&gt;<br /> <br /> shaileyakuShThAgurudArukauntItvakpadmakailAmbupalAshamustaiH| &lt;br /&gt;<br /> priya~gguthauNeyakahemamAMsItAlIshapatraplavapatradhAnyaiH||65|| &lt;br /&gt;<br /> <br /> shrIveShTakadhyAmakapippalIbhiH spRukkAnakhaishcaiva yathopalAbham| &lt;br /&gt;<br /> vAtAnvite~abhya~ggamushanti tailaM siddhaM supiShTairapi ca pradeham||66||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take ''kuṣṭha, aguru, devadāru, kaunti,'' cinnamon, ''padmaka,'' cardamom, ''sugandhabālā, palāśa, mustaka, priyangu, thauneyaka, nāgakeśara, jatāmāmsi, tālisapatra, plava, tejapatra,'' coriander, ''sriveshtaka, dhyāmaka,'' piper longum, ''sprikkā'' and ''nakha''. Make paste of all or as much as drugs available and prepare medicated oil from it. In ''[[vata]]'' edema, do massage with this oil. Alternatively make paste of the entire drugs and apply on the body of the patient as smear [65-66] <br /> <br /> === Medicated water for bath ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> जलैश्च वासार्ककरञ्जशिग्रुकाश्मर्यपत्रार्जकजैश्च सिद्धैः| &lt;br /&gt;<br /> स्विन्नो मृदूष्णै रवितप्ततोयैः स्नातश्च गन्धैरनुलेपनीयः||६७|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> jalaiśca vāsārkakarañjaśigrukāśmaryapatrārjakajaiśca siddhaiḥ| &lt;br /&gt;<br /> svinnō mr̥dūṣṇai ravitaptatōyaiḥ snātaśca gandhairanulēpanīyaḥ||67||&lt;br /&gt;<br /> <br /> jalaishca vAsArkakara~jjashigrukAshmaryapatrArjakajaishca [17] siddhaiH| &lt;br /&gt;<br /> svinno mRudUShNai [18] ravitaptatoyaiH snAtashca gandhairanulepanIyaH||67||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Add leaves of ''vāsā, arka, karanja, sigru, kashmarya'' and holy basil in hot water and take sudation with this tolerably hot water. Then the patient should take bath with water heated in sun and apply aromatics on the body [67]<br /> <br /> === External application in ''[[pitta]]'' dominance ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सवेतसाः क्षीरवतां द्रुमाणां त्वचः समञ्जिष्ठलतामृणालाः| &lt;br /&gt;<br /> सचन्दनाः पद्मकवालकौ च पैत्ते प्रदेहस्तु सतैलपाकः||६८|| &lt;br /&gt;<br /> <br /> आक्तस्य तेनाम्बु रविप्रतप्तं सचन्दनं साभयपद्मकं च| &lt;br /&gt;<br /> स्नाने हितं क्षीरवतां कषायः क्षीरोदकं चन्दनलेपनं च||६९|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> savētasāḥ kṣīravatāṁ drumāṇāṁ tvacaḥ samañjiṣṭhalatāmr̥ṇālāḥ| &lt;br /&gt;<br /> sacandanāḥ padmakavālakau ca paittē pradēhastu satailapākaḥ||68|| &lt;br /&gt;<br /> <br /> āktasya tēnāmbu raviprataptaṁ sacandanaṁ sābhayapadmakaṁ ca| &lt;br /&gt;<br /> snānē hitaṁ kṣīravatāṁ kaṣāyaḥ kṣīrōdakaṁ candanalēpanaṁ ca||69||&lt;br /&gt;<br /> <br /> savetasAH kShIravatAM drumANAM tvacaH sama~jjiShThalatAmRuNAlAH| &lt;br /&gt;<br /> sacandanAH padmakavAlakau ca paitte pradehastu satailapAkaH||68|| &lt;br /&gt;<br /> <br /> Aktasya tenAmbu raviprataptaM sacandanaM sAbhayapadmakaM ca| &lt;br /&gt;<br /> snAne hitaM kShIravatAM kaShAyaH kShIrodakaM candanalepanaM ca||69||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Prepare medicated oil from ''vetasa, manjiṣhthā, mrināla,'' sandal, ''padmaka'' and ''khasha'' and bark of latex-exuding plants. Apply this oil on the body to relieve ''[[pitta]]'' swelling. Thereafter, bathing with medicated water prepared with sandal, ''khaśa'' and ''padmaka'' and heated by sun rays or with water prepared with latex-exuding plants or water mixed with milk is beneficial. Smearing with paste of sandalwood is also beneficial [68-69] <br /> <br /> === External application in ''[[kapha]]'' dominance ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कफे तु कृष्णासिकतापुराणपिण्याकशिग्रुत्वगुमाप्रलेपः| &lt;br /&gt;<br /> कुलत्थशुण्ठीजलमूत्रसेकश्चण्डागुरुभ्यामनुलेपनं च||७०|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaphē tu kr̥ṣṇāsikatāpurāṇapiṇyākaśigrutvagumāpralēpaḥ| &lt;br /&gt;<br /> kulatthaśuṇṭhījalamūtrasēkaścaṇḍāgurubhyāmanulēpanaṁ ca||70|| &lt;br /&gt;<br /> <br /> kaphe tu kRuShNAsikatApurANapiNyAkashigrutvagumApralepaH| &lt;br /&gt;<br /> kulatthashuNThIjalamUtrasekashcaNDAgurubhyAmanulepanaM ca||70|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''[[kapha]]'' dominant edema, application of paste of long pepper, sand, old oil-cake, bark of drum-stick and linseed is advised. <br /> Effusion with decoction of ''kulattha'' (hoarse gram), dry ginger and cow’s urine followed by anointing of the body with paste of sandal and ''aguru'' is also beneficial (70). <br /> <br /> === External application in burning sensation ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बिभीतकानां फलमध्यलेपः सर्वेषु दाहार्तिहरः प्रदिष्टः| &lt;br /&gt;<br /> यष्ट्याह्वमुस्तैः सकपित्थपत्रैः सचन्दनैस्तत्पिडकासु लेपः||७१|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bibhītakānāṁ phalamadhyalēpaḥ sarvēṣu dāhārtiharaḥ pradiṣṭaḥ| &lt;br /&gt;<br /> yaṣṭyāhvamustaiḥ sakapitthapatraiḥ sacandanaistatpiḍakāsu lēpaḥ||71|| &lt;br /&gt;<br /> <br /> bibhItakAnAM phalamadhyalepaH sarveShu dAhArtiharaH pradiShTaH| &lt;br /&gt;<br /> yaShTyAhvamustaiH sakapitthapatraiH sacandanaistatpiDakAsu lepaH||71|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In all types of swelling, smearing with paste of fruit of ''vibhitaka'' is recommended to cure burning sensation and discomfort. <br /> The topical application of paste of leaves of ''kapittha'' (wood apple), sandal, liquorices and ''mustaka'' provides relief in papules [71] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रास्नावृषार्कत्रिफलाविडङ्गं शिग्रुत्वचो मूषिकपर्णिका च| &lt;br /&gt;<br /> निम्बार्जकौ व्याघ्रनखः सदूर्वा सुवर्चला तिक्तकरोहिणी च||७२|| &lt;br /&gt;<br /> <br /> सकाकमाची बृहती सकुष्ठा पुनर्नवा चित्रकनागरे च| &lt;br /&gt;<br /> उन्मर्दनं शोफिषु मूत्रपिष्टं शस्तस्तथा मूलकतोयसेकः||७३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rāsnāvr̥ṣārkatriphalāviḍaṅgaṁ śigrutvacō mūṣikaparṇikā ca| &lt;br /&gt;<br /> nimbārjakau vyāghranakhaḥ sadūrvā suvarcalā tiktakarōhiṇī ca||72|| &lt;br /&gt;<br /> <br /> sakākamācī br̥hatī sakuṣṭhā punarnavā citrakanāgarē ca| &lt;br /&gt;<br /> unmardanaṁ śōphiṣu mūtrapiṣṭaṁ śastastathā mūlakatōyasēkaḥ||73||&lt;br /&gt;<br /> <br /> rAsnAvRuShArkatriphalAviDa~ggaM shigrutvaco mUShikaparNikA ca| &lt;br /&gt;<br /> nimbArjakau vyAghranakhaH sadUrvA suvarcalA tiktakarohiNI ca||72|| &lt;br /&gt;<br /> <br /> sakAkamAcI bRuhatI sakuShThA punarnavA citrakanAgare ca| &lt;br /&gt;<br /> unmardanaM shophiShu mUtrapiShTaM shastastathA mUlakatoyasekaH||73||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take ''rāsnā, vāsā, arka, triphalā, vidanga,'' bark of ''sigru, mushakaparni, neem,'' holy basin, nails of ''vyāghra'' (shell), ''durvā'', sunflower, ''katukā, kākamāchi, brihati, kuṣtha, punarnavā, chitraka'' and dry ginger and make paste with cow’s urine. ''Unmardana'' type of massage with it is beneficial for swelling. Also effusion done with water boiled with above drugs is beneficial [72-73]<br /> <br /> === Various types of local swellings ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शोफास्तु गात्रावयवाश्रिता ये ते स्थानदूष्याकृतिनामभेदात्| &lt;br /&gt;<br /> अनेकसङ्ख्याः कतिचिच्च तेषां निदर्शनार्थं गदतो निबोध||७४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śōphāstu gātrāvayavāśritā yē tē sthānadūṣyākr̥tināmabhēdāt| &lt;br /&gt;<br /> anēkasaṅkhyāḥ katicicca tēṣāṁ nidarśanārthaṁ gadatō nibōdha||74||&lt;br /&gt;<br /> <br /> shophAstu gAtrAvayavAshritA ye te sthAnadUShyAkRutinAmabhedAt| &lt;br /&gt;<br /> anekasa~gkhyAH [19] katicicca teShAM nidarshanArthaM gadato nibodha||74||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The swelling occurring in one limb or organ is of many types owing to their different classifications based on involved site, ''[[duṣhya]],'' shape and name. Listen to the descriptions of some of them being given as illustration [74] <br /> <br /> === ''Shira Shopha'' (cellulitis of head) and ''Salūka'' (quinsy) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दोषास्त्रयः स्वैः कुपिता निदानैः कुर्वन्ति शोफं शिरसः सुघोरम्|&lt;br /&gt;<br /> अन्तर्गले घुर्घुरिकान्वितं च शालूकमुच्छ्वासनिरोधकारि||७५|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dōṣāstrayaḥ svaiḥ kupitā nidānaiḥ kurvanti śōphaṁ śirasaḥ sughōram|&lt;br /&gt;<br /> antargalē ghurghurikānvitaṁ ca śālūkamucchvāsanirōdhakāri||75||&lt;br /&gt;<br /> <br /> doShAstrayaH svaiH kupitA nidAnaiH kurvanti shophaM shirasaH sughoram|&lt;br /&gt;<br /> antargale ghurghurikAnvitaM ca shAlUkamucchvAsanirodhakAri||75||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> All the three [[dosha]], provoked by indulging in their etiological factors produce severe inflammation of head. <br /> When it affects inside of the throat, it produces sālūka, which is accompanied with stertorous breathing and obstruction to expiration [75]<br /> <br /> === ''Bidalika'' (Ludwig’s angina) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गलस्य सन्धौ चिबुके गले च सदाहरागः श्वसनासु चोग्रः| &lt;br /&gt;<br /> शोफो भृशार्तिस्तु बिडालिका स्याद्धन्याद्गले चेद्वलयीकृता सा||७६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> galasya sandhau cibukē galē ca sadāharāgaḥ śvasanāsu cōgraḥ| &lt;br /&gt;<br /> śōphō bhr̥śārtistu biḍālikā syāddhanyādgalē cēdvalayīkr̥tā sā||76||&lt;br /&gt;<br /> <br /> galasya sandhau cibuke gale ca sadAharAgaH shvasanAsu [20] cograH| &lt;br /&gt;<br /> shopho bhRushArtistu biDAlikA [21] syAddhanyAdgale cedvalayIkRutA sA||76||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Acute swelling at the junction of throat behind the chin i.e. in trachea with redness and burning sensation in throat and causes obstruction to breathing with very much discomfort is known as ''biḍālikā''. It kills the patient if folds are formed in throat [76]<br /> <br /> === ''Talu-vidradhi'' (palatal abscess), ''upajihvika'' (superficial glossitis) and ''adhijihvikā'' (sub-lingual glossitis) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्यात्तालुविद्रध्यपि दाहरागपाकान्वितस्तालुनि सा त्रिदोषात्| &lt;br /&gt;<br /> जिह्वोपरिष्टादुपजिह्विका स्यात् कफादधस्तादधिजिह्विका च||७७|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> syāttāluvidradhyapi dāharāgapākānvitastāluni sā tridōṣāt| &lt;br /&gt;<br /> jihvōpariṣṭādupajihvikā syāt kaphādadhastādadhijihvikā ca||77|| &lt;br /&gt;<br /> <br /> syAttAluvidradhyapi dAharAgapAkAnvitastAluni sA tridoShAt| &lt;br /&gt;<br /> jihvopariShTAdupajihvikA syAt kaphAdadhastAdadhijihvikA ca||77|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Abscess in palate caused by ''tridosha'' with burning sensation, redness and pus formation is known as ''tālu-vidradhi''. <br /> <br /> Swelling due to ''[[kapha]]'' occurring on the upper part of tongue is called ''upajihvikā'' (acute superficial glossitis) and which occurs sublingual part is called a''dhijihvikā'' (sub lingual glossitis) [77] <br /> <br /> === ''Upakusha'' (gingivitis) and ''danta-vidradhi'' (dental abscess) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यो दन्तमांसेषु तु रक्तपित्तात् पाको भवेत् सोपकुशः प्रदिष्टः| &lt;br /&gt;<br /> स्याद्दन्तविद्रध्यपि दन्तमांसे शोफः कफाच्छोणितसञ्चयोत्थः||७८|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yō dantamāṁsēṣu tu raktapittāt pākō bhavēt sōpakuśaḥ pradiṣṭaḥ| &lt;br /&gt;<br /> syāddantavidradhyapi dantamāṁsē śōphaḥ kaphācchōṇitasañcayōtthaḥ||78||&lt;br /&gt;<br /> <br /> yo dantamAMseShu tu raktapittAt pAko bhavet sopakushaH pradiShTaH| &lt;br /&gt;<br /> syAddantavidradhyapi dantamAMse shophaH kaphAcchoNitasa~jcayotthaH||78||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Provoked ''[[rakta]]'' and ''[[pitta]]'' causes suppuration of the gums and it is called ''upakusha''. Accumulation of ''[[kapha]]'' and ''[[rakta]]'' produces elevated swelling in gums and it is known as ''danta-vidradhi'' [78]<br /> <br /> === ''Galaganḍa'' (goiter),''gandamala'' (cervical adenitis) and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गलस्य पार्श्वे गलगण्ड एकः स्याद्गण्डमाला बहुभिस्तु गण्डैः| &lt;br /&gt;<br /> साध्याः स्मृताः पीनसपार्श्वशूलकासज्वरच्छर्दियुतास्त्वसाध्याः||७९|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> galasya pārśvē galagaṇḍa ēkaḥ syādgaṇḍamālā bahubhistu gaṇḍaiḥ| &lt;br /&gt;<br /> sādhyāḥ smr̥tāḥ pīnasapārśvaśūlakāsajvaracchardiyutāstvasādhyāḥ||79|| &lt;br /&gt;<br /> <br /> galasya pArshve galagaNDa ekaH syAdgaNDamAlA bahubhistu gaNDaiH| &lt;br /&gt;<br /> sAdhyAH smRutAH pInasapArshvashUlakAsajvaracchardiyutAstvasAdhyAH||79|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Single glandular swelling on the (middle) of neck is called ''galagaṇḍa'' (goiter) but if there are many nodular swellings making a chain like appearance, is known as ''gandamālā''. Generally they are curable but if accompanied with coryza, pain in side of the chest, cough, fever and vomiting then they are incurable [79] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तेषां सिराकायशिरोविरेका धूमः पुराणस्य घृतस्य पानम्| &lt;br /&gt;<br /> स्याल्लङ्घनं वक्त्रभवेषु चापि प्रघर्षणं स्यात् कवलग्रहश्च||८०|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tēṣāṁ sirākāyaśirōvirēkā dhūmaḥ purāṇasya ghr̥tasya pānam| &lt;br /&gt;<br /> syāllaṅghanaṁ vaktrabhavēṣu cāpi pragharṣaṇaṁ syāt kavalagrahaśca||80||&lt;br /&gt;<br /> <br /> teShAM sirAkAyashirovirekA dhUmaH purANasya ghRutasya pAnam| &lt;br /&gt;<br /> syAlla~gghanaM vaktrabhaveShu cApi pragharShaNaM syAt kavalagrahashca||80||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In all the above mentioned conditions blood-letting, purgation, ''[[nasya]], dhuma'' (medicated smoking therapy) and intake of old ghee is beneficial. <br /> <br /> For the conditions specially affecting mouth, the line of treatment is ''[[langhana]]'' and rubbing with medicated powders and mouth washes (''kavala'') are beneficial [80]<br /> <br /> === ''Granthi'' (nodule) and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अङ्गैकदेशेष्वनिलादिभिः स्यात् स्वरूपधारी स्फुरणः सिराभिः| &lt;br /&gt;<br /> ग्रन्थिर्महान्मांसभवस्त्वनर्तिर्मेदोभवः स्निग्धतमश्चलश्च||८१|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> aṅgaikadēśēṣvanilādibhiḥ syāt svarūpadhārī sphuraṇaḥ sirābhiḥ| &lt;br /&gt;<br /> granthirmahānmāṁsabhavastvanartirmēdōbhavaḥ snigdhatamaścalaśca||81|| &lt;br /&gt;<br /> <br /> a~ggaikadesheShvanilAdibhiH syAt svarUpadhArI sphuraNaH sirAbhiH| &lt;br /&gt;<br /> granthirmahAnmAMsabhavastvanartirmedobhavaH snigdhatamashcalashca||81|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Swelling occurring in one organ or region due to ''[[vata]]'' or other ''[[dosha]]'' may be diagnosed on the basis of their characteristic symptoms. The swelling occurring in vessels are pulsating in nature. The nodular swelling occurring in muscles is large in size. Swelling of the adipose tissues is excessively unctuous and movable [81]<br /> <br /> === Surgical management of ''granthi'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> संशोधिते स्वेदितमश्मकाष्ठैः साङ्गुष्ठदण्डैर्विलयेदपक्वम्| &lt;br /&gt;<br /> विपाट्य चोद्धृत्य भिषक् सकोशं शस्त्रेण दग्ध्वा व्रणवच्चिकित्सेत्||८२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> saṁśōdhitē svēditamaśmakāṣṭhaiḥ sāṅguṣṭhadaṇḍairvilayēdapakvam| &lt;br /&gt;<br /> vipāṭya cōddhr̥tya bhiṣak sakōśaṁ śastrēṇa dagdhvā vraṇavaccikitsēt||82||&lt;br /&gt;<br /> <br /> saMshodhite sveditamashmakAShThaiH sA~gguShThadaNDairvilayedapakvam| &lt;br /&gt;<br /> vipATya coddhRutya bhiShak sakoshaM shastreNa dagdhvA vraNavaccikitset||82|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the tumor is non-suppurative then after purification therapy, local sudation of the swelling should be done. Then the physician should try to dissolve the swelling by rubbing with stone or wooden apparatus or with manipulation of thumb or of a rod. Then it should be cut open and take out the tumor with its capsule. Then it should be cauterized and treatment of regular wound should be adopted [82] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अदग्ध ईषत् परिशेषितश्च प्रयाति भूयोऽपि शनैर्विवृद्धिम्| &lt;br /&gt;<br /> तस्मादशेषः कुशलैः समन्ताच्छेद्यो भवेद्वीक्ष्य शरीरदेशान्||८३|| &lt;br /&gt;<br /> <br /> शेषे कृते पाकवशेन शीर्यात्ततः क्षतोत्थः प्रसरेद्विसर्पः| &lt;br /&gt;<br /> उपद्रवं तं प्रविचार्य तज्ज्ञस्तैर्भेषजैः पूर्वतरैर्यथोक्तैः||८४|| &lt;br /&gt;<br /> <br /> निवारयेदादित एव यत्नाद्विधानवित् स्वस्वविधिं विधाय| &lt;br /&gt;<br /> ततः क्रमेणास्य यथाविधानं व्रणं व्रणज्ञस्त्वरया चिकित्सेत्||८५|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> adagdha īṣat pariśēṣitaśca prayāti bhūyō'pi śanairvivr̥ddhim| &lt;br /&gt;<br /> tasmādaśēṣaḥ kuśalaiḥ samantācchēdyō bhavēdvīkṣya śarīradēśān||83|| &lt;br /&gt;<br /> <br /> śēṣē kr̥tē pākavaśēna śīryāttataḥ kṣatōtthaḥ prasarēdvisarpaḥ| &lt;br /&gt;<br /> upadravaṁ taṁ pravicārya tajjñastairbhēṣajaiḥ [22] pūrVātarairyathōktaiḥ||84|| &lt;br /&gt;<br /> <br /> nivārayēdādita [23] ēva yatnādvidhānavit svasvavidhiṁ vidhāya| &lt;br /&gt;<br /> tataḥ kramēṇāsya yathāvidhānaṁ vraṇaṁ vraṇajñastvarayā cikitsēt||85|| &lt;br /&gt;<br /> <br /> adagdha IShat parisheShitashca prayAti bhUyo~api shanairvivRuddhim| &lt;br /&gt;<br /> tasmAdasheShaH kushalaiH samantAcchedyo bhavedvIkShya sharIradeshAn||83|| &lt;br /&gt;<br /> <br /> sheShe kRute pAkavashena shIryAttataH kShatotthaH prasaredvisarpaH| &lt;br /&gt;<br /> upadravaM taM pravicArya tajj~jastairbheShajaiH [22] pUrvatarairyathoktaiH||84|| &lt;br /&gt;<br /> <br /> nivArayedAdita [23] eva yatnAdvidhAnavit svasvavidhiM vidhAya| &lt;br /&gt;<br /> tataH krameNAsya yathAvidhAnaM vraNaM vraNaj~jastvarayA cikitset||85|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the tumor is not properly cauterized or if some of its part is left out then it starts gradually increasing again. In that case it should be removed completely by opening from all sides by the skillful surgeon keeping in view the regional anatomy. If some portion is still left then it may suppurate and slough and may lead to complication of ''visarpa'' (erysipelas). The surgeon considering it as the severe complication first should try to treat it with great care by appropriate remedies described earlier. Therefore the wound specialist should quickly treat it in the prescribed manner following the appropriate line of treatment [83-85] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विवर्जयेत् कुक्ष्युदराश्रितं च तथा गले मर्मणि संश्रितं च| &lt;br /&gt;<br /> स्थूलः खरश्चापि भवेद्विवर्ज्यो यश्चापि बालस्थविराबलानाम्||८६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vivarjayēt kukṣyudarāśritaṁ ca tathā galē marmaṇi saṁśritaṁ ca| &lt;br /&gt;<br /> sthūlaḥ kharaścāpi bhavēdvivarjyō yaścāpi bālasthavirābalānām||86||&lt;br /&gt;<br /> <br /> vivarjayet kukShyudarAshritaM ca tathA gale marmaNi saMshritaM ca| &lt;br /&gt;<br /> sthUlaH kharashcApi bhavedvivarjyo yashcApi bAlasthavirAbalAnAm||86||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The tumors occurring in flanks, abdomen, in the throat and in vital organs are incurable. Similarly tumors of big size and indurated which occurs in children, aged and weak are also incurable [86]<br /> <br /> === Differential diagnosis of ''arbuda'' (tumor) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ग्रन्थ्यर्बुदानां च यतोऽविशेषः प्रदेशहेत्वाकृतिदोषदूष्यैः| &lt;br /&gt;<br /> ततश्चिकित्सेद्भिषगर्बुदानि विधानविद्ग्रन्थिचिकित्सितेन||८७|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> granthyarbudānāṁ ca yatō'viśēṣaḥ pradēśahētvākr̥tidōṣadūṣyaiḥ| &lt;br /&gt;<br /> tataścikitsēdbhiṣagarbudāni vidhānavidgranthicikitsitēna||87||&lt;br /&gt;<br /> <br /> granthyarbudAnAM ca yato~avisheShaH pradeshahetvAkRutidoShadUShyaiH| &lt;br /&gt;<br /> tatashcikitsedbhiShagarbudAni vidhAnavidgranthicikitsitena||87||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> There is no much difference in nodules and tumors with regards to site, causative factors, shape, ''[[dosha]]'' morbidity and ''[[dushya]]'' (susceptible tissues). Therefore, tumor specialist should treat the tumor on the line of nodules described above [87]<br /> <br /> === ''Alaji'' and ''akshata'' (whitlow)===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ताम्रा सशूला पिडका भवेद्या सा चालजी नाम परिस्रुताग्रा| &lt;br /&gt;<br /> शोफोऽक्षतश्चर्मनखान्तरे स्यान्मांसास्रदूषी भृशशीघ्रपाकः||८८|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tāmrā saśūlā piḍakā bhavēdyā sā cālajī nāma parisrutāgrā| &lt;br /&gt;<br /> śōphō'kṣataścarmanakhāntarē syānmāṁsāsradūṣī bhr̥śaśīghrapākaḥ||88||&lt;br /&gt;<br /> <br /> tAmrA sashUlA [25] piDakA bhavedyA sA cAlajI nAma parisrutAgrA| &lt;br /&gt;<br /> shopho~akShatashcarmanakhAntare [26] syAnmAMsAsradUShI bhRushashIghrapAkaH||88|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Appearing of copper colored papules with acute pain from which pus oozes out is known as alajī.<br /> The severe inflammation occurring by vitiating flesh and blood in the skin adjoining nail which suppurates quickly is known as akṣata [88]<br /> <br /> === ''Vidarika'' (lymphadenitis) and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ज्वरान्विता वङ्क्षणकक्षजा या वर्तिर्निरर्तिः कठिनायता च| &lt;br /&gt;<br /> विदारिका सा कफमारुताभ्यां तेषां यथादोषमुपक्रमः स्यात्||८९|| &lt;br /&gt;<br /> <br /> विस्रावणं पिण्डिकयोपनाहः पक्वेषु चैव व्रणवच्चिकित्सा| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> jvarānvitā vaṅkṣaṇakakṣajā yā vartirnirartiḥ kaṭhināyatā ca| &lt;br /&gt;<br /> vidārikā sā kaphamārutābhyāṁ tēṣāṁ yathādōṣamupakramaḥ syāt||89|| &lt;br /&gt;<br /> <br /> visrāvaṇaṁ piṇḍikayōpanāhaḥ pakvēṣu caiva vraṇavaccikitsā|&lt;br /&gt;<br /> <br /> jvarAnvitA va~gkShaNakakShajA yA vartirnirartiH kaThinAyatA ca| &lt;br /&gt;<br /> vidArikA sA kaphamArutAbhyAM teShAM yathAdoShamupakramaH syAt||89|| &lt;br /&gt;<br /> <br /> visrAvaNaM piNDikayopanAhaH pakveShu caiva vraNavaccikitsA|&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Painless cylindrical and hard swelling in the groin or axillary region accompanied with fever is known as ''vidārikā''. It occurs due to vitiation of ''[[kapha]]'' and ''[[vata]]'' and should be managed according to the treatment of these ''[[dosha]]'', which include bloodletting, ''pinda sweda, upanāha'' and on suppuration it should be treated on the line of abscess [89]<br /> <br /> === ''Visphotaka'' (eruption) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विस्फोटकाः सर्वशरीरगास्तु स्फोटाः [२७] सरागज्वरतर्षयुक्ताः||९०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> visphōṭakāḥ sarvaśarīragāstu sphōṭāḥ [27] sarāgajvaratarṣayuktāḥ||90|| <br /> <br /> visphoTakAH sarvasharIragAstu sphoTAH [27] sarAgajvaratarShayuktAH||90|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Red colored eruptions occurring all over the body along with fever and thirst are known as ''visphōṭaka'' (90).<br /> <br /> === ''Kaksha'' (herpes zoster) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यज्ञोपवीतप्रतिमाः प्रभूताः पित्तानिलाभ्यां जनितास्तु कक्षाः [२८] |<br /> <br /> याश्चापराः स्युः पिडकाः प्रकीर्णाः स्थूलाणुमध्या अपि पित्तजास्ताः||९१||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yajñōpavītapratimāḥ prabhūtāḥ pittānilābhyāṁ janitāstu kakṣāḥ [28] | <br /> <br /> yāścāparāḥ syuḥ piḍakāḥ prakīrṇāḥ sthūlāṇumadhyā api pittajāstāḥ||91|| <br /> <br /> yaj~jopavItapratimAH prabhUtAH pittAnilAbhyAM janitAstu kakShAH [28] | <br /> <br /> yAshcAparAH syuH piDakAH prakIrNAH sthUlANumadhyA api pittajAstAH||91|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Multiple eruptions occurring on the trunk due to ''[[pitta]]'' and ''[[vata]]'' where usually Hindu holy thread is worn, is known as ''kakṣā''. <br /> <br /> Other such types of eruptions (''pidikā'') whether big, medium or small are also due to ''[[pitta]]'' [91] <br /> <br /> === ''Romantika'' (measles) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षुद्रप्रमाणाः पिडकाः शरीरे सर्वाङ्गगाः सज्वरदाहतृष्णाः| &lt;br /&gt;<br /> कण्डूयुताः सारुचिसप्रसेका रोमान्तिकाः पित्तकफात् प्रदिष्टाः||९२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣudrapramāṇāḥ piḍakāḥ śarīrē sarvāṅgagāḥ sajvaradāhatr̥ṣṇāḥ| &lt;br /&gt;<br /> kaṇḍūyutāḥ sārucisaprasēkā rōmāntikāḥ pittakaphāt pradiṣṭāḥ||92|| &lt;br /&gt;<br /> <br /> kShudrapramANAH piDakAH sharIre sarvA~ggagAH sajvaradAhatRuShNAH| &lt;br /&gt;<br /> kaNDUyutAH sArucisaprasekA romAntikAH pittakaphAt pradiShTAH||92|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Small sized eruption all over the body due to pitta and kapha along with fever, burning sensation, thirst, itching, anorexia and salivation are known as romāntikā (measles) [92]<br /> <br /> === Masurika (chickenpox) and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> याः सर्वगात्रेषु मसूरमात्रा मसूरिकाः पित्तकफात् प्रदिष्टाः| &lt;br /&gt;<br /> वीसर्पशान्त्यै विहिता क्रिया या तां तेषु कुष्ठे च हितां विदध्यात्||९३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yāḥ sarvagātrēṣu masūramātrā masūrikāḥ pittakaphāt pradiṣṭāḥ| &lt;br /&gt;<br /> vīsarpaśāntyai vihitā kriyā yā tāṁ tēṣu kuṣṭhē ca hitāṁ vidadhyāt||93||&lt;br /&gt;<br /> <br /> yAH sarvagAtreShu masUramAtrA masUrikAH pittakaphAt pradiShTAH| &lt;br /&gt;<br /> vIsarpashAntyai vihitA kriyA yA tAM teShu [29] kuShThe ca hitAM vidadhyAt||93||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Eruptions similar to size and shape of lentil (''masura'') occurring all over the body due to ''[[pitta]]'' and ''[[kapha]]'' is known as ''masurikā''; the treatment described for ''visarpa'' should is also adopted for it. For ''visphotaka'' etc., treatment described for ''kuṣtha'' should be adopted [93]<br /> <br /> === ''Bradhna'' (hernia) and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ब्रध्नोऽनिलाद्यैर्वृषणे स्वलिङ्गैरन्त्रं निरेति प्रविशेन्मुहुश्च| &lt;br /&gt;<br /> मूत्रेण पूर्णं मृदु मेदसा चेत् स्निग्धं च विद्यात् कठिनं च शोथम्||९४|| &lt;br /&gt;<br /> <br /> विरेचनाभ्यङ्गनिरूहलेपाः पक्वेषु चैव व्रणवच्चिकित्सा| &lt;br /&gt;<br /> स्यान्मूत्रसेकः कफजं विपाट्य विशोध्य सीव्येद्व्रणवच्च पक्वम्||९५|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bradhnō'nilādyairvr̥ṣaṇē svaliṅgairantraṁ nirēti praviśēnmuhuśca| &lt;br /&gt;<br /> mūtrēṇa pūrṇaṁ mr̥du mēdasā cēt snigdhaṁ ca vidyāt kaṭhinaṁ ca śōtham||94|| &lt;br /&gt;<br /> <br /> virēcanābhyaṅganirūhalēpāḥ pakvēṣu caiva vraṇavaccikitsā| &lt;br /&gt;<br /> syānmūtrasēkaḥ kaphajaṁ vipāṭya viśōdhya sīvyēdvraṇavacca pakvam||95||&lt;br /&gt;<br /> <br /> bradhno~anilAdyairvRuShaNe [30] svali~ggairantraM nireti pravishenmuhushca| &lt;br /&gt;<br /> mUtreNa pUrNaM mRudu medasA cet snigdhaM ca vidyAt kaThinaM ca shotham||94|| &lt;br /&gt;<br /> <br /> virecanAbhya~gganirUhalepAH pakveShu caiva vraNavaccikitsA| &lt;br /&gt;<br /> syAnmUtrasekaH [31] kaphajaM vipATya vishodhya sIvyedvraNavacca pakvam||95|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Due to ''[[vata]]'' or other ''[[dosha]]'', the intestine frequently enters into scrotum and comes out and this condition is known as bradhna (hernia). <br /> <br /> If liquid (''mutra'') accumulates in scrotum then the swelling is soft (hydrocele).<br /> <br /> If fat accumulates in scrotum it is hard and unctuous. <br /> <br /> Its treatment is ''[[virechana]] karma'', oil massage, ''niruha [[basti]]'' and smearing of paste. If it suppurates then treatment of ulcer (''vrana'') should be adopted. <br /> <br /> If there is oozing of liquid (''[[mutra]]'') and the swelling is due to ''[[kapha]],'' then it should be open up, cleaned and sutured as per line of treatment of ulcer [94-95]<br /> <br /> === Bhagandara (fistula-in-ano) and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्रिम्यस्थिसूक्ष्मक्षणनव्यवायप्रवाहणान्युत्कटकाश्वपृष्ठैः | &lt;br /&gt;<br /> गुदस्य पार्श्वे पिडका भृशार्तिः पक्वप्रभिन्ना तु भगन्दरः स्यात्||९६|| &lt;br /&gt;<br /> <br /> विरेचनं चैषणपाटनं च विशुद्धमार्गस्य च तैलदाहः| &lt;br /&gt;<br /> स्यात् क्षारसूत्रेण सुपाचितेन छिन्नस्य चास्य व्रणवच्चिकित्सा||९७|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> krimyasthisūkṣmakṣaṇanavyavāyapravāhaṇānyutkaṭakāśvapr̥ṣṭhaiḥ | &lt;br /&gt;<br /> gudasya pārśvē piḍakā bhr̥śārtiḥ pakvaprabhinnā tu bhagandaraḥ syāt||96|| &lt;br /&gt;<br /> <br /> virēcanaṁ caiṣaṇapāṭanaṁ ca viśuddhamārgasya ca tailadāhaḥ| &lt;br /&gt;<br /> syāt kṣārasūtrēṇa supācitēna chinnasya cāsya vraṇavaccikitsā||97||&lt;br /&gt;<br /> <br /> krimyasthisUkShmakShaNanavyavAyapravAhaNAnyutkaTakAshvapRuShThaiH [33] | &lt;br /&gt;<br /> gudasya pArshve piDakA bhRushArtiH pakvaprabhinnA tu bhagandaraH syAt||96|| &lt;br /&gt;<br /> <br /> virecanaM caiShaNapATanaM ca vishuddhamArgasya ca tailadAhaH| &lt;br /&gt;<br /> syAt kShArasUtreNa supAcitena [34] chinnasya cAsya vraNavaccikitsA||97||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> On the lateral side of anus, a very painful pustule (''pidika'') occurs which suppurates and opens up; it is known as ''bhagandara'' (fistula-in-ano). It is caused by infection (''krimi''), injury with pointed object like bone leading to minute erosion, excessive sex, straining at defecation and friction due to sitting on hard seat of a horse or moving object. <br /> <br /> Its treatment is ''[[virechana]]'', probing, cutting and after cleansing cauterization with hot oil. If surgery is contraindicated then ''kshara-sutra'' should be applied and during and after cutting the track, routine line of management of ulcer is adopted [96-97]<br /> <br /> === ''Shlipada'' (elephantiasis) and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> जङ्घासु पिण्डीप्रपदोपरिष्टात् [३५] स्याच्छ्लीपदं मांसकफास्रदोषात्| &lt;br /&gt;<br /> सिराकफघ्नश्च विधिः समग्रस्तत्रेष्यते सर्षपलेपनं च||९८|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> jaṅghāsu piṇḍīprapadōpariṣṭāt [35] syācchlīpadaṁ māṁsakaphāsradōṣāt| &lt;br /&gt;<br /> sirākaphaghnaśca vidhiḥ samagrastatrēṣyatē sarṣapalēpanaṁ ca||98||&lt;br /&gt;<br /> <br /> ja~gghAsu piNDIprapadopariShTAt [35] syAcchlIpadaM mAMsakaphAsradoShAt| &lt;br /&gt;<br /> sirAkaphaghnashca vidhiH samagrastatreShyate sarShapalepanaM ca||98||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The provoked ''[[kapha]]'' and ''[[rakta]]'' by involving flesh causes edema which begins from the upper part of the foot and spreads up to calf-muscle or shank; it is known as ''shlipada'' (elephantiasis). Its treatment is vene-section and local application of paste of mustard-seed as well as all other anti-''[[kapha]]'' treatment [98]<br /> <br /> === ''Jalakagardabha'' and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मन्दास्तु पित्तप्रबलाः प्रदुष्टा दोषाः सुतीव्रं तनुरक्तपाकम्| &lt;br /&gt;<br /> कुर्वन्ति शोथं ज्वरतर्षयुक्तं विसर्पणं जालकगर्दभाख्यम्||९९|| &lt;br /&gt; <br /> <br /> विलङ्घनं रक्तविमोक्षणं च विरूक्षणं कायविशोधनं च| &lt;br /&gt;<br /> धात्रीप्रयोगाञ् शिशिरान् प्रदेहान् कुर्यात् सदा जालकगर्दभस्य||१००|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mandāstu pittaprabalāḥ praduṣṭā dōṣāḥ sutīvraṁ tanuraktapākam| &lt;br /&gt;<br /> kurvanti śōthaṁ jvaratarṣayuktaṁ visarpaṇaṁ jālakagardabhākhyam||99|| &lt;br /&gt;<br /> <br /> vilaṅghanaṁ raktavimōkṣaṇaṁ ca virūkṣaṇaṁ kāyaviśōdhanaṁ ca| &lt;br /&gt;<br /> dhātrīprayōgāñ śiśirān pradēhān kuryāt sadā jālakagardabhasya||100||&lt;br /&gt;<br /> <br /> mandAstu pittaprabalAH praduShTA doShAH sutIvraM tanuraktapAkam| &lt;br /&gt;<br /> kurvanti shothaM jvaratarShayuktaM visarpaNaM jAlakagardabhAkhyam||99|| &lt;br /&gt;<br /> <br /> vila~gghanaM raktavimokShaNaM ca virUkShaNaM kAyavishodhanaM ca| &lt;br /&gt;<br /> dhAtrIprayogA~j shishirAn pradehAn kuryAt sadA jAlakagardabhasya||100||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Mildly provoked ''[[dosha]]'' with dominance of ''[[pitta]]'' causes very acute inflammation which slightly bleeds and suppurates, has a tendency of quick spreading and is accompanied by fever and thirst is known as ''jalakagardabha''. <br /> <br /> Its treatment is ''[[langhana]]'' (lightening therapy), blood-letting, un-unctuous therapy, ''[[virechana]]'', use of ''amalaki'' and application of paste of drugs having cold potency [99-100]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> एवंविधांश्चाप्यपरान् परीक्ष्य शोथप्रकाराननिलादिलिङ्गैः| &lt;br /&gt;<br /> शान्तिं नयेद्दोषहरैर्यथास्वमालेपनच्छेदनभेददाहैः||१०१|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ēvaṁvidhāṁścāpyaparān parīkṣya śōthaprakārānanilādiliṅgaiḥ| &lt;br /&gt;<br /> śāntiṁ nayēddōṣaharairyathāsvamālēpanacchēdanabhēdadāhaiḥ||101||&lt;br /&gt;<br /> <br /> evaMvidhAMshcApyaparAn parIkShya shothaprakArAnanilAdili~ggaiH| &lt;br /&gt;<br /> shAntiM nayeddoShaharairyathAsvamAlepanacchedanabhedadAhaiH||101||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Other types of inflammatory swellings may be diagnosed on the basis of the characteristic symptoms of the involved ''[[vata]]'' and other ''[[dosha]]''. It may also be managed by prescribing the treatment of involved ''[[dosha]]'' as well as by application of paste, incision and excision [101]<br /> <br /> === General guidelines of management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्रायोऽभिघातादनिलः सरक्तः शोथं सरागं प्रकरोति तत्र| &lt;br /&gt;<br /> वीसर्पनुन्मारुतरक्तनुच्च कार्यं विषघ्नं विषजे च कर्म||१०२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> prāyō'bhighātādanilaḥ saraktaḥ śōthaṁ sarāgaṁ prakarōti tatra| &lt;br /&gt;<br /> vīsarpanunmārutaraktanucca kāryaṁ viṣaghnaṁ viṣajē ca karma||102||&lt;br /&gt;<br /> <br /> prAyo~abhighAtAdanilaH saraktaH shothaM sarAgaM prakaroti tatra| &lt;br /&gt;<br /> vIsarpanunmArutaraktanucca kAryaM viShaghnaM viShaje ca karma||102||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Generally external trauma causes reddish swelling due to provocation of ''[[vata]]'' and ''[[rakta]]''. It should be treated with drugs used for the treatment of ''visarpa'' and provoked ''[[vata]]'' and ''[[rakta]]''. <br /> <br /> If the swelling is caused by poisonous substances then it should be treated with anti-poison measures [102]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकः- <br /> <br /> त्रिविधस्य दोषभेदात् सर्वार्धावयवगात्रभेदाच्च| &lt;br /&gt;<br /> श्वयथोर्द्विविधस्य तथा लिङ्गानि चिकित्सितं चोक्तम्||१०३|| &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkaḥ- <br /> <br /> trividhasya dōṣabhēdāt sarvārdhāvayavagātrabhēdācca| &lt;br /&gt;<br /> śvayathōrdvividhasya tathā liṅgāni cikitsitaṁ cōktam||103|| &lt;br /&gt;<br /> <br /> tatra shlokaH- <br /> <br /> trividhasya doShabhedAt sarvArdhAvayavagAtrabhedAcca| &lt;br /&gt;<br /> shvayathordvividhasya [36] tathA li~ggAni cikitsitaM coktam||103|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Re-capitulatory verses-<br /> <br /> Three types of swelling as per involvement of [[dosha]]; classification of swelling according to involvement whole or half body or one part; exogenous and endogenous swelling; their symptoms and treatment have been described [103]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने <br /> श्वयथुचिकित्सितं नाम द्वादशोऽध्यायः||१२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē <br /> śvayathucikitsitaṁ nāma dvādaśō'dhyāyaḥ||12||<br /> <br /> ityagniveshakRute tantre~aprApte dRuDhabalasampUrite cikitsAsthAne <br /> shvayathucikitsitaM nAma dvAdasho~adhyAyaH||12||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus 12th chapter named [[Shvayathu Chikitsa]] in [[Chikitsa Sthana]] of treatise compiled by Agnivesha, revised by Charaka and unavailable part restored by Dridhabala is completed (12). <br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *''Shotha'' is caused by dietary causes like excessive use of ''kshara'' (alkali) or food articles having sour, sharply acting, hot and heavy properties by an emaciated or weak person due to excessive ''[[shodhana]]'', fasting or disease; excessive intake of curd, raw food articles, soil, leafy vegetables, mutually contradictory food articles (''virodhi''), spoiled or mixed with toxic substance (such as pesticide), or a person suffering from piles, having sedentary life style, nonperforming of ''[[shodhana]]'' therapy even if indicated, injury to vital organs (''marma''), abnormal delivery, due to improper treatment and as complication of improper purification treatment.<br /> *Exogenous causes include trauma or injuries of various types and have acute pathogenesis. <br /> *The pathogenesis of ''nija shotha'' includes obstruction of morbid vāta by vitiated ''[[kapha]], [[rakta]]'' and ''[[pitta]]'' at the site of peripheral superficial vessels. This vitiated ''[[vata]]'' (due to obstruction) spreads to the various places causing swelling as its cardinal symptom.<br /> *Rise in temperature, burning sensation as if burnt by fire and dilation of the vessels are the prodromal symptoms of swelling.<br /> *All types of swelling are produced by involvement of all the three ''[[dosha]]'' but they are named based on the predominance of that particular ''[[dosha]]''. The line of treatment is also according to the dominant ''[[dosha]]''.<br /> *The swelling in a patient who is neither emaciated nor weak; that involved single ''[[dosha]]'' or is of recent origin is easily curable.<br /> *If swelling is associated with ''ama'' it should be managed first by prescribing lightening therapy (''[[langhana]]'') and digestive drugs. Only after that ''[[shodhana]]'' therapy should be undertaken according to dominant ''[[dosha]]''. General lines of treatment of ''[[dosha]]ja'' swelling are as follows:<br /> **If it involves head then ''shiro-virechana'' is prescribed; <br /> **If it involves lower parts of the body then ''[[virechana]]'' (therapeutic purgation) is prescribed; <br /> **If it involves upper parts of the body then ''[[vamana]]'' (therapeutic emesis)is prescribed;<br /> **If it is caused by unctuous then ''[[rukshana]]'' (drying) therapy is done;<br /> **If it is caused by un-unctuous (''ruksha'') then unctuous (''[[snehana]]'') therapy is done;<br /> **If ''[[vata]]'' swelling is associated with constipation then it should be treated with ''niruha [[basti]]'';<br /> **If it is caused by ''[[vata]]-[[pitta]]'' then it should be treated with ghee prepared with bitter drugs;<br /> **If the patient is suffering from associated symptoms such as fainting, pain, burning sensation and thirst then it should be treated with intake of milk; <br /> **If the patient is suffering from swelling where ''[[shodhana]]'' is required then milk mixed with cow’s urine should be given; <br /> **If the patient is suffering from ''[[kapha]]'' swelling then ''kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are given.<br /> **Generally external trauma causes reddish swelling due to provocation of ''[[vata]]'' and ''[[rakta]]''. It should be treated with drugs used for the treatment of ''visarpa'' and provoked ''[[vata]]'' and ''[[rakta]]''. If the swelling is caused by poisonous substances then it should be treated with anti-poison measures (102).<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> <br /> === Derivation of term ===<br /> <br /> The word ''Shvayathu'' is derived from root ''Tuoshchi-Gati-Vriddhyoh''. ''Tuo'' is converted to ''Shvi'' indicating to increase (''Vriddhi'') and by adding ''Athuc Pratyaya'' the word ''Shvayathu'' is derived which literally means increased (3).<br /> <br /> === Pathogenesis ===<br /> <br /> In pathogenesis of ''shotha'' there is involvement of superficial veins (''Bahya shira''). Involvement of circulatory or lymphatic system is must in producing the ''shotha''.<br /> <br /> === Types of ''shotha'' ===<br /> <br /> ''[[Vata]] shotha'' is shifting in nature, pitting on pressure and increases in the day time and may vanish without visible cause. Further ''[[vata]]'' causes edema of the lower part of the body i. e feet and legs. All these characteristics of ''[[vata]] shotha'' are indicative cardiac edema. <br /> <br /> In day time due to various activities and fatigue ''[[vata]]'' gets increased leading to increase in the edema. From modern point of view, cardiac edema increases in the evening which is ''[[vata]] kala'' due to the day activities. ''[[Vata]] shotha'' is pitting on pressure but on removing the pressure it immediately takes its original shape.<br /> <br /> ''[[Pitta]] sopha'' begins from middle parts of the body and then spreads to the other parts and has yellow-reddish color&lt;ref&gt;Vagbhata. Nidana Sthana, Cha.13 Pandurogasophavisarpa Nidana Adhyaya verse 33. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4. &lt;/ref&gt;. Yellowish coloration indicates involvement of liver. Inflammatory swelling is related to ''[[pitta]]ja shotha'' . <br /> <br /> ''[[Kapha]] Shotha'' slightly pits on pressure but takes long time to attain its original position after removing the pressure and increases at night. It develops slowly and also takes long time to subside. ''[[Kapha]] shotha'' occurs in upper part of the body and the treatment of edema occurring on the upper part is ''[[vamana]]'' i.e. of ''[[kapha]]''. On this basis it can be said that which mainly includes face. Renal edema occurs on the face in the morning (noticed on awakening though increased in the night). Other important sign is it is hard and the serous discharge comes out on scratching the skin &lt;ref&gt;Vagbhata. Nidana Sthana, Cha.13 Pandurogasophavisarpa Nidana Adhyaya verse 35-36. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.&lt;/ref&gt;. This indicates that hard non-pitting edema of elephantiasis may also be included under it. Other symptom mentioned for ''[[kapha]]ja shotha'' that the patient like warm touch indicates towards edema found in hypothyroidism (14).<br /> <br /> === Complications ===<br /> <br /> Complications of ''shotha'' are vomiting, dyspnea, anorexia, thirst, fever, loose motions and weakness (Cha. Sa. [[Sutra Sthana]] chapter 18/18]. Sushruta mentions two additional complications viz. cough and hiccups.&lt;ref&gt;Sushruta. Chikitsa Sthana, Cha.23 Sopha Chikisitam Adhyaya verse 8-9. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.&lt;/ref&gt;(15)<br /> <br /> Sushruta classify general edema in five types viz., ''[[vata]], [[pitta]], [[kapha]], sannipata'' and ''vishaja''&lt;ref&gt;Sushruta. Chikitsa Sthana, Cha.23 Sopha Chikisitam Adhyaya verse 3. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.&lt;/ref&gt; but does not consider local swelling as the part of ''shopha'' because while defining swelling it is clearly mentioned that which occurs in the large part under the skin and flesh etc but is other than nodules (''granthi''), abscess (''vidradhi''), ''alaji'' etc is known as ''shopha'' &lt;ref&gt;Sushruta. Sutra Sthana, Cha.17 Amapkweshaneeya Adhyaya verse 3 In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.&lt;/ref&gt;<br /> <br /> Ashtangahridaya describes ''shopha'' in the chapter on ''panduroga'' (anemia) because it is a main complication of anemia. Nine types of ''shopha'' described therein are three single ''[[dosha]]'' type, three ''samsarga'' types, one ''tridoshaja'' and one each due to trauma and poison. In addition three new types of ''shopha'' viz. ''prithu'' (extensive), ''unnata'' (elevated) and ''grathita'' (compact) are also mentioned.&lt;ref&gt;Vagbhata. Nidana Sthana, Cha.13 Pandurogasophavisarpa Nidana Adhyaya verse 21-42. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4. &lt;/ref&gt;. <br /> <br /> Madhava Nidana followed Ashtangahridaya and describes nine types of ''shotha'' and does not describe localized ''shotha'' in this chapter on ''shotha'' &lt;ref&gt;Madhavakara. Madhava Nidanam (Roga vinischaya). Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--&lt;/ref&gt;.<br /> <br /> ''Charaka'' considers bulging (''utsedha'') from the skin as ''shvayathu'' therefore local swellings such as ''pidika'' (papules and pustules), nodules (including ''gandhamala''), ''galagandha'' (goiter), tumor etc are also described in this chapter. The probable modern equivalents are given in the bracket while describing these conditions in the text (74-100). <br /> <br /> Sushruta defines ''arbuda'' as a round and immovable growth produced by vitiated ''[[dosha]]'' by afflicting ''[[mamsa]]'' with mild pain but having deep roots and located in extensive area at the expense of tissue and causes swelling of the ''[[mamsa]]'' extensively. This ''arbuda'' (tumor) grows slowly and does not suppurate &lt;ref&gt;Sushruta. Nidana Sthana, Cha.11 Grandhiapachiarbudagalaganda Nidana Adhyaya verse 13-14 In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.&lt;/ref&gt;. But Charaka being a clinician does not consider much difference in the management of ''arbuda'' and ''granthi'' as their site, causative factors, shape, ''[[dosha]]'' morbidity and ''[[dushya]]'' (susceptible tissues) are about the same. However, it is clearly mentioned that ''arbuda'' should be managed by the expert surgeon only (87). <br /> <br /> Line of treatment, various procedures and preparations mentioned in this chapter for the management of various types of swellings are easy to administer and practical so should be practiced (16-73).<br /> <br /> === ''Shat-kriya-kala'' of ''shotha'' ===<br /> <br /> #''Sanchaya'' (Accumulation): This is the first stage of the disease where due to indulgence into the causative factors accumulation of concerned ''[[dosha]]'' occurs. During this stage increase in the normal functions of the ''[[dosha]]'' is noticed. <br /> #''Prakopa'' (Provocation): If the accumulated ''[[dosha]]'' are not properly taken care then they may go to the next stage of provocation. During this stage the ''prakopa'' symptoms of the involved ''[[dosha]]'' appear. <br /> #''Prasara'' (Spreading): In the stage of ''prasara'' the ''[[dosha]]'' leaves their normal site and starts circulating all over the body. <br /> #''Sthana-Smashrya'' (Localization): The circulating ''[[dosha]]'' interacts with such tissues which have some problem in their channels which may be anatomical, physiological or pathological. This phenomenon is ''[[dosha]]-[[dushya]]-samurchchana''. This localization of ''[[dosha]]'' leads to beginning of the pathogenesis of the disease and during this stage prodromal symptoms (''purva-rupa'') of the disease are produced. The prodromal symptoms of edema are heat, burning sensation and dilation of the vessels.<br /> #''Vyakti'' (Manifestation): If the disease is not managed at the stage of localization then the disease manifest with its specific symptoms. The symptoms of various types of edema are mentioned in the verses from 11 to 16 of this chapter. All or few symptoms mentioned for the disease may appear but if all the symptoms appear then the disease may become incurable and if few then it is easily curable. Moderate appearance of the symptom indicates its moderate prognosis. <br /> #''Bheda'' (Complications): If the disease is not properly treated even after it is fully manifestation then the complications may appear and the disease becomes difficult to cure or incurable. The seven complications of edema are vomiting, thirst, anorexia, dyspnea, fever, diarrhea and weakness [ Cha. Sa. [[Sutra Sthana]] 18/18].<br /> <br /> === Differential Diagnosis of ''shotha'' ===<br /> <br /> [[Ayurveda]] is a clinical science, therefore the classifications are also planned so that the disease can systematically be diagnosed on the basis of the symptoms. ''Shotha'' is a good example for it.<br /> <br /> ''Shotha'' has been defined as any abnormal elevation from the skin. First question to be asked to the patient whether there is any history of trauma, biting etc and if yes, then it is an ''agantuja shotha''. If there is a history of contact or taking poisonous substance then it is ''vishaja''.<br /> <br /> Hereafter it is to be confirmed that whether the swelling is localized or all over the body. If ''shotha'' is localized in single organ or site then it can be diagnosed on the basis of nature of the lesion such as papules, pustules, nodules, tumor etc. It is further diagnosed on the basis of shape, site etc. For example ''gandhamala'' is garland like and ''galagandha'' is scrotum like swelling in neck. ''Romantika'' has minute papules while ''masurika'' has lentil like papules and so on. Associated general features such as fever, thirst etc also helps in differential diagnosis. <br /> <br /> If ''shotha'' is generalized swelling then the point of its beginning is important e.g. ''[[pitta]] shopha'' starts from middle part of the abdomen, ''[[vata]]'' from the lower parts and ''[[kapha]]'' from upper parts of the body. The consideration of other characteristic features mentioned above will help in reaching the final diagnosis.<br /> <br /> For example moving, pitting on pressure, increasing in the day time and sometime subsides without appreciable cause etc help in reaching the diagnosis for ''[[vata]] shopha''.<br /> <br /> Swelling which is firm, slight pitting on pressure, increases in the night, takes long time to subside and is associated with low digestion, vomiting, anemia indicates towards ''[[kapha]] shotha''.<br /> <br /> Swelling which is soft, tender on touch, associated with change to yellow color, fever etc is ''[[pitta]] shotha''.<br /> <br /> Similarly causative factors can also be sorted out by asking whether it relates to food articles (curd, unripe fruits, spoiled, leafy vegetables) or its properties (excessive use of ''kshara'', sour, sharp, hot and heavy food articles), diet habit (fasting), sedentary life style, emaciation or weakness due to a disease or excessive ''[[shodhana]]'', contact to poisonous substances etc.<br /> <br /> === ''Chikitsa Sutra'' (Principles of treatment) ===<br /> <br /> [[Ayurveda]] gives very importance to ''ama''. Therefore, if ''ama'' is associated with swelling then first it should be managed by prescribing lightening therapy (''[[langhana]]'') and digestive drugs. After getting the ''nirama'' symptoms, ''[[shodhana]]'' therapy can be done according to dominant ''[[dosha]]''. It is the general rule for all types of swellings. <br /> <br /> ''Shiro-virechana'' is the choice of therapy for ''[[dosha]]'' situated in head. Therefore if the swelling involves the head then first ''[[nasya]]'' should be done. <br /> <br /> Chest and the upper parts are the main sites of ''[[kapha]]'' and for its removal, ''[[vamana]]'' therapy is best. Therefore if swelling is situated in upper parts or begins from upper parts and then spreads to other parts or it is ''[[kapha]]'' type then first of all ''[[vamana]]'' (emesis) therapy is prescribed. ''Kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are indicated after ''[[vamana]]'' therapy. If ''[[vamana]]'' therapy is not possible in the patient suffering from ''[[kapha]]'' swelling then these drugs may be given directly.<br /> <br /> Generally ''[[basti]]'' is not preferred for the treatment of swelling, but if ''[[vata]]'' swelling is associated with constipation then it should be treated with ''niruha [[basti]]''. Otherwise ''[[virechana]]'' is indicated for the swelling of lower part as well as of ''[[vata]]''.<br /> The local swellings with symptom of inflammation may be treated by following the general line of treatment as mentioned above and other measures mentioned while describing their treatment in this chapter. If it belongs to ''shalya'' or ''shalakya'' type specialties, then let it be treated by the experts of the specialty.<br /> <br /> === Clinical practices ===<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| Type<br /> ! scope=&quot;col&quot;| Formulations<br /> ! scope=&quot;col&quot;| Dosage<br /> ! scope=&quot;col&quot;| Time<br /> ! scope=&quot;col&quot;| ''Anupana''<br /> |-<br /> | ''[[Vata]]'' dominant<br /> | ''Harina shringa'' mixture<br /> | 60-120 mg<br /> | In between two meals<br /> | Honey + ''Dashamularishta'' + ''Punarnavasa''<br /> |-<br /> | ''[[Pitta]]'' dominant<br /> | ''Aarogya'' Mixture<br /> | 120-250 mg<br /> | In between two meals<br /> | Milk + ''saravadyasava'' + ''punarnavasava'' + ''vasakasava'<br /> |-<br /> | rowspan = &quot;3&quot;|''[[Kapha]]'' dominant<br /> | ''Gomutra Haritaki''<br /> | 1-3 grams<br /> | In between two meals<br /> | Cow urine, honey<br /> |-<br /> | ''Punarnava mandura'' <br /> | 250-500 mg<br /> | In between two meals<br /> | ''Punarnavasava''<br /> |-<br /> | ''Gudadraka Yoga''<br /> | 120-250 mg<br /> | In between two meals<br /> | Honey<br /> |}<br /> <br /> === Related Chapter ===<br /> <br /> * [[Trishothiya Adhyaya]]<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> &lt;/div&gt;<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha https://www.carakasamhitaonline.com/index.php?title=Shvayathu_Chikitsa&diff=45371 2025-10-29T06:40:24Z

<p>Agnivesha: /* Gandeeradyarishta */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title=Shvayathu Chikitsa<br /> |titlemode=append<br /> |keywords=Shvayathu, shotha, shopha, edema, swelling, langhana, amapachana, shodhana, Ayurveda, charak samhita, Indian system of medicine.<br /> |description=Chikitsa Sthana Chapter 12. Management of Shvayathu (Various types of Swellings)<br /> |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br /> |image_alt=charak samhita<br /> |type=article<br /> }}<br /> &lt;big&gt;'''[[Chikitsa Sthana]] Chapter 12. Management of Shvayathu (Various types of Swellings) &lt;/big&gt;'''<br /> {{Infobox<br /> |title = Shvayathu Chikitsa<br /> |label1 = Section/Chapter<br /> |data1 = [[Chikitsa Sthana]] Chapter 12<br /> |label2 = Preceding Chapter<br /> |data2 = [[Kshatakshina Chikitsa]]<br /> <br /> |label3= Succeeding Chapter<br /> |data3 = [[Udara Chikitsa]]<br /> |label5 = Other Sections<br /> |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br /> |label6 = Translator and commentator<br /> |data6 = Goyal M.<br /> |label7 = Reviewer <br /> |data7 = Singh G.<br /> |label8 = Editors <br /> |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br /> |label9 = Year of publication <br /> |data9 = 2020<br /> |label10 = Publisher <br /> |data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br /> |label11 = DOI<br /> |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.013 10.47468/CSNE.2020.e01.s06.013]<br /> }}<br /> &lt;big&gt;'''Abstract&lt;/big&gt;'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;This chapter deals with the treatment of various types of swellings like generalized edema and local eruptions including pustules, nodules and tumors. The etiological factors for these swellings can be endogenous (''nija'') or exogenous (''agantuja''). In all types of swellings, three ''[[dosha]]s'' are involved but it is named according to the dominance of the ''[[dosha]]''. After describing general symptoms and signs of the swelling, specific symptoms and signs of ''[[vata]], [[pitta]]'' and ''[[kapha]]'' as well as of incurable and curable swellings are explained. <br /> &lt;br/&gt;<br /> Line of treatment depends upon type of swelling as well as involved parts of the body; wholesome and unwholesome diet and lifestyle for the benefit of the patient is explained. Detailed treatments along with drug preparations, internal and external therapeutic measures are discussed according to ''[[vata]], [[pitta]]'' and ''[[kapha]]'' types of swelling. <br /> &lt;br/&gt;<br /> Local swellings occurring in the various parts of the body in the form of papules, pustules, nodules, tumors etc are described in the last part of the chapter. It includes ''shaluka'' (quinsy), ''Bidalika'' (Ludwig’s angina), ''Taluvidradhi'' (palatal abscess), ''Upajihivika'' (superficial glossitis), ''Upakusha'' (gingivitis) and ''Danta-Vidradhi'' (dental abscess) which occurs in buccal cavity and generally included in Śālākya specialty. ''Galaganda'' is goiter and ''gandamala'' and ''granthi'' are mainly related with various types of swellings of lymph nodes. ''Arbuda'' (tumor), ''alaji'' (inflammation of eye), ''akshata'' (whitlow), ''vidarika'' (lymphadenitis), ''visphotaka'' (eruption), ''kaksha'' (herpes zoster), ''romantika'' (measles), ''masurika'' (chickenpox), ''bradhna'' (hernia), ''bhagandara'' (fistula-in-ano), ''shleepada'' (elephantiasis), ''jalakagardabha'' (acute sprading inflammation), ''abhighataja'' (traumatic) and ''vishaja'' (poisonous) swellings along with their medical treatment and wherever necessary surgical measures are also described. Difference and similarity between ''granthi'' and ''arbuda'' are also mentioned.<br /> &lt;br/&gt;<br /> '''Keywords''': ''Shvayathu, shotha, shopha,'' edema, swelling, ''[[langhana]], ama[[pachana]], [[shodhana]]''. &lt;/p&gt;<br /> <br /> == Introduction ==<br /> &lt;div style=&quot;text-align:justify;&quot;&gt;<br /> This chapter on [[Shvayathu Chikitsa]] (treatment of swelling) follows the chapter on ''kshata-kshina'' because in both the diseases vital organs are involved. ''Charaka'' defines ''shvayathu'' as bulging (''utsedha'') from the skin and this chapter mainly deals with the management of various types of general swellings and local swellings such as ''pidika'' (papules and pustules), nodules (including ''gandhamala''), large swellings like [[galaganda]] (goiter), tumor etc are also described. <br /> <br /> Chapter 18th of [[Sutra Sthana]] deals with diagnostic aspects of swelling under the name of ''[[trishothiya]]''. Therein the word ''shopha'' is frequently used for shotha. Thus, the words ''shvayathu, shotha'' and ''shopha'' are used as synonyms and all denote edema or swelling. For inflammatory swelling Sushruta has used the word ''vrana-shotha''.<br /> <br /> In the [[Sutra Sthana]], Charaka classified ''shotha'' in many ways but in this chapter which is mainly on the treatment, only those classifications are given which are important from treatment point of view, such as three types according to ''[[dosha]]'' viz, ''[[vata]], [[pitta]]'' and ''[[kapha]]''; two types viz. ''nija'' (endogenous) and ''agantuja'' (exogenous) as well as ''ekanga'' (local) and ''sarvanga'' (generalized ) types.<br /> <br /> == Sanskrit text, Transliteration and English Translation ==<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथातः श्वयथुचिकित्सितं व्याख्यास्यामः||१|| <br /> <br /> इति ह स्माह भगवानात्रेयः||२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athātaḥ śvayathucikitsitaṁ vyākhyāsyāmaḥ||1|| <br /> <br /> iti ha smāha bhagavānātrēyaḥ||2||<br /> <br /> athAtaH shvayathucikitsitaM vyAkhyAsyAmaH||1||<br /> <br /> iti ha smAha bhagavAnAtreyaH||2||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Now we shall expound the chapter &quot;Shvayathu chikitsa&quot; (Management of different types of swelling). Thus said Lord Atreya. [1-2]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> भिषग्वरिष्ठं सुरसिद्धजुष्टं मुनीन्द्रमत्र्यात्मजमग्निवेशः| &lt;br /&gt;<br /> महागदस्य श्वयथोर्यथावत् प्रकोपरूपप्रशमानपृच्छत्||३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bhiṣagvariṣṭhaṁ surasiddhajuṣṭaṁ munīndramatryātmajamagnivēśaḥ| &lt;br /&gt;<br /> mahāgadasya śvayathōryathāvat prakōparūpapraśamānapr̥cchat||3||&lt;br /&gt;<br /> <br /> bhiShagvariShThaM surasiddhajuShTaM munIndramatryAtmajamagniveshaH| &lt;br /&gt;<br /> mahAgadasya shvayathoryathAvat prakoparUpaprashamAnapRucchat||3||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Agnivesha approached the best physician and great sage, the son of Atri sitting midst of gods and saints and requested him to elaborate on the etiology, signs and symptoms and treatment of the major disease- ''shvayathu'' [3]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तस्मै जगादागदवेदसिन्धुप्रवर्तनाद्रिप्रवरोऽत्रिजस्तान्| &lt;br /&gt;<br /> वातादिभेदात्त्रिविधस्य सम्यङ्निजानिजैकाङ्गजसर्वजस्य||४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tasmai jagādāgadavēdasindhupravartanādripravarō'trijastān| &lt;br /&gt;<br /> vātādibhēdāttrividhasya samyaṅnijānijaikāṅgajasarvajasya||4||&lt;br /&gt;<br /> <br /> tasmai jagAdAgadavedasindhupravartanAdripravaro~atrijastAn| &lt;br /&gt;<br /> vAtAdibhedAttrividhasya samya~gnijAnijaikA~ggajasarvajasya||4||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Sage Atreya who is like Himalaya from which flows out the Indus of the science of healing, fully expounded the subject of swellings of three types based on ''tridosha, nija'' and ''agantuja'' based on etiology and ''ekanga'' and ''sarvanga'' type according to location [4]<br /> <br /> === Causative factors of ''nija'' (endogenous) swelling/edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शुद्ध्यामयाभक्तकृशाबलानां क्षाराम्लतीक्ष्णोष्णगुरूपसेवा| &lt;br /&gt;<br /> दध्याममृच्छाकविरोधिदुष्टगरोपसृष्टान्ननिषेवणं च||५|| &lt;br /&gt;<br /> <br /> अर्शांस्यचेष्टा न च देहशुद्धिर्मर्मोपघातो विषमा प्रसूतिः| &lt;br /&gt;<br /> मिथ्योपचारः प्रतिकर्मणां च निजस्य हेतुः श्वयथोः प्रदिष्टः||६||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śuddhyāmayābhaktakr̥śābalānāṁ kṣārāmlatīkṣṇōṣṇagurūpasēvā| &lt;br /&gt;<br /> dadhyāmamr̥cchākavirōdhiduṣṭagarōpasr̥ṣṭānnaniṣēvaṇaṁ ca||5|| &lt;br /&gt;<br /> <br /> arśāṁsyacēṣṭā na ca dēhaśuddhirmarmōpaghātō viṣamā prasūtiḥ| &lt;br /&gt;<br /> mithyōpacāraḥ pratikarmaṇāṁ ca nijasya hētuḥ śvayathōḥ pradiṣṭaḥ||6||&lt;br /&gt;<br /> <br /> shuddhyAmayAbhaktakRushAbalAnAM kShArAmlatIkShNoShNagurUpasevA| &lt;br /&gt;<br /> dadhyAmamRucchAkavirodhiduShTagaropasRuShTAnnaniShevaNaM ca||5|| &lt;br /&gt;<br /> <br /> arshAMsyaceShTA na ca dehashuddhirmarmopaghAto viShamA prasUtiH| &lt;br /&gt;<br /> mithyopacAraH pratikarmaNAM ca nijasya hetuH shvayathoH pradiShTaH||6||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Excessive use of ''kshara'' (alkali) or food articles having sour, sharply acting, hot and heavy properties by an emaciated or weak person due to excessive ''[[shodhana]]'', fasting or disease. <br /> <br /> Excessive intake of curd, raw food articles, soil, leafy vegetables, mutually contradictory food articles (''virodhi''), spoiled or mixed with toxic substance (such as pesticide), or a person suffering from piles, having sedentary life style, nonperforming of ''[[shodhana]]'' therapy even if indicated, injury to vital organs (''marma''), abnormal delivery, due to improper treatment and as complication of improper purification treatment [5-6]<br /> <br /> === Causative factors of ''agantuka'' (exogenous) swelling ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बाह्यास्त्वचो दूषयिताऽभिघातः काष्ठाश्मशस्त्राग्निविषायसाद्यैः [१] | <br /> <br /> आगन्तुहेतुःत्रिविधो निजश्च सर्वार्धगात्रावयवाश्रितत्वात्||७||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bāhyāstvacō dūṣayitā'bhighātaḥ kāṣṭhāśmaśastrāgniviṣāyasādyaiḥ [1] | <br /> <br /> āgantuhētuḥ trividhō nijaśca sarvārdhagātrāvayavāśritatvāt||7||<br /> <br /> bAhyAstvaco dUShayitA~abhighAtaH kAShThAshmashastrAgniviShAyasAdyaiH | <br /> <br /> AgantuhetuH trividho nijashca sarvArdhagAtrAvayavAshritatvAt||7||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> External causative factors of swelling are trauma to skin with wood, stone, weapon, fire, poison etc. <br /> <br /> Endogenous swelling is of three types i.e. of whole body, half body or limited to one part or organ [7]<br /> <br /> === Pathogenesis of swelling ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बाह्याः सिराः प्राप्य यदा कफासृक्पित्तानि सन्दूषयतीह वायुः| &lt;br /&gt;<br /> तैर्बद्धमार्गः स तदा विसर्पन्नुत्सेधलिङ्गं श्वयथुं करोति||८|| &lt;br /&gt;<br /> <br /> उरःस्थितैरूर्ध्वमधस्तु [१] वायोः स्थानस्थितैर्मध्यगतैस्तु मध्ये| &lt;br /&gt;<br /> सर्वाङ्गगः सर्वगतैः क्वचित्स्थैर्दोषैः क्वचित् स्याच्छ्वयथुस्तदाख्यः||९||&lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bāhyāḥ sirāḥ prāpya yadā kaphāsr̥kpittāni sandūṣayatīha vāyuḥ| &lt;br /&gt;<br /> tairbaddhamārgaḥ sa tadā visarpannutsēdhaliṅgaṁ śvayathuṁ karōti||8|| &lt;br /&gt;<br /> <br /> uraḥsthitairūrdhvamadhastu [1] vāyōḥ sthānasthitairmadhyagataistu madhyē| &lt;br /&gt;<br /> sarvāṅgagaḥ sarvagataiḥ kvacitsthairdōṣaiḥ kvacit syācchvayathustadākhyaḥ||9||&lt;br /&gt;<br /> <br /> bAhyAH sirAH prApya yadA kaphAsRukpittAni sandUShayatIha vAyuH| &lt;br /&gt;<br /> tairbaddhamArgaH sa tadA visarpannutsedhali~ggaM shvayathuM karoti||8||&lt;br /&gt;<br /> <br /> uraHsthitairUrdhvamadhastu [1] vAyoH sthAnasthitairmadhyagataistu madhye| &lt;br /&gt;<br /> sarvA~ggagaH sarvagataiH kvacitsthairdoShaiH kvacit syAcchvayathustadAkhyaH||9||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Morbid ''[[vata]]'' is obstructed by vitiated ''[[kapha]], [[rakta]]'' and ''[[pitta]]'' aggravated at the site of peripheral superficial vessels. This vitiated ''[[vata]]'' (due to obstruction) spreads to the various places causing swelling as its cardinal symptom. <br /> <br /> If the ''[[vata]]'' lodges in the chest, then it causes edema of upper parts of the body; if it lodges in its own place i.e. lower parts then it causes edema of lower parts and if it lodges in middle then it causes edema of middle parts.<br /> <br /> If ''[[vata]]'' spreads in the entire body then it causes edema all over the body but if it lodges in one place then it causes local swelling of that part or organ. These swellings are named after the particular region that it affects [8-9]<br /> <br /> === Prodromal symptoms of edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ऊष्मा तथा स्याद्दवथुः सिराणामायाम इत्येव च पूर्वरूपम्| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ūṣmā tathā syāddavathuḥ sirāṇāmāyāma ityēva ca pūrvarūpam| <br /> <br /> UShmA tathA syAddavathuH sirANAmAyAma ityeva ca pUrvarUpam|<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Rise in temperature, burning sensation as if burnt by fire and dilation of the vessels are the prodromal symptoms of swelling [9½]<br /> <br /> === ''Tridoshaja'' nature of all swellings ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सर्वस्त्रिदोषोऽधिकदोषलिङ्गैस्तच्छब्दमभ्येति भिषग्जितं च||१०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sarvastridōṣō'dhikadōṣaliṅgaistacchabdamabhyēti bhiṣagjitaṁ ca||10||<br /> <br /> sarvastridoSho~adhikadoShali~ggaistacchabdamabhyeti bhiShagjitaM ca||10||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> All types of swelling are produced by involvement of all the three ''[[dosha]]'' but they are named based on the predominance of that particular ''[[dosha]]''. The line of treatment is also according to the dominant ''[[dosha]]'' [10]<br /> <br /> === General symptoms of swelling ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सगौरवं स्यादनवस्थितत्वं सोत्सेधमुष्माऽथ सिरातनुत्वम्| &lt;br /&gt;<br /> सलोमहर्षाऽङ्गविवर्णता च सामान्यलिङ्गं श्वयथोः प्रदिष्टम्||११|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sagauravaṁ syādanavasthitatvaṁ sōtsēdhamuṣmā'tha sirātanutvam| &lt;br /&gt;<br /> salōmaharṣā'ṅgavivarṇatā ca sāmānyaliṅgaṁ śvayathōḥ pradiṣṭam||11||&lt;br /&gt;<br /> <br /> sagauravaM syAdanavasthitatvaM sotsedhamuShmA~atha sirAtanutvam| &lt;br /&gt;<br /> salomaharShA~a~ggavivarNatA ca sAmAnyali~ggaM shvayathoH pradiShTam||11||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Heaviness, movability, bulging, heat, thinning of the vessels, horripilation and discoloration of the affected skin are the general signs and symptoms of edema [11] <br /> <br /> === Symptoms of ''[[vata]]ja'' dominant edema/swelling ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> चलस्तनुत्वक्परुषोऽरुणोऽसितः प्रसुप्तिहर्षार्तियुतोऽनिमित्ततः| &lt;br /&gt;<br /> प्रशाम्यति प्रोन्नमति प्रपीडितो दिवाबली च श्वयथुः समीरणात्||१२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> calastanutvakparuṣō'ruṇō'sitaḥ prasuptiharṣārtiyutō'nimittataḥ| &lt;br /&gt;<br /> praśāmyati prōnnamati prapīḍitō divābalī ca śvayathuḥ samīraṇāt||12||&lt;br /&gt;<br /> <br /> calastanutvakparuSho~aruNo~asitaH prasuptiharShArtiyuto~animittataH| &lt;br /&gt;<br /> prashAmyati pronnamati prapIDito divAbalI ca shvayathuH samIraNAt||12||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Skin of the effected part in ''[[vata]]'' dominant swelling becomes thin and rough and dry (''parusha''), dusky-brown colored with horripilation and feeling of numbness and discomfort. The swelling is moveable and pitting on pressure but it attains normal position immediately, increases during the day time and often subsides without appreciable reason [12]<br /> <br /> === Symptoms of ''[[pitta]]'' dominant swelling (inflammation) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मृदुः सगन्धोऽसितपीतरागवान् भ्रमज्वरस्वेदतृषामदान्वितः| &lt;br /&gt;<br /> य उष्यते स्पर्शरुगक्षिरागकृत् [१] स पित्तशोथो भृशदाहपाकवान्||१३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mr̥duḥ sagandhō'sitapītarāgavān bhramajvarasvēdatr̥ṣāmadānvitaḥ| &lt;br /&gt;<br /> ya uṣyatē sparśarugakṣirāgakr̥t [1] sa pittaśōthō bhr̥śadāhapākavān||13||&lt;br /&gt;<br /> <br /> mRuduH sagandho~asitapItarAgavAn bhramajvarasvedatRuShAmadAnvitaH| &lt;br /&gt;<br /> ya uShyate sparsharugakShirAgakRut [1] sa pittashotho bhRushadAhapAkavAn||13||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The ''[[pitta]]''-dominant swelling is soft, painful to touch, with specific odor and blackish, yellow or red colored skin and has tendency of turning to abscess. It is accompanied with excessive burning sensation, fever, perspiration, giddiness, thirst, redness in eyes and intoxication [13] <br /> <br /> === Symptoms of ''[[kapha]]''-dominant edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गुरुः स्थिरः पाण्डुररोचकान्वितः प्रसेकनिद्रावमिवह्निमान्द्यकृत्| &lt;br /&gt;<br /> स कृच्छ्रजन्मप्रशमो निपीडितो न चोन्नमेद्रात्रिबली कफात्मकः||१४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> guruḥ sthiraḥ pāṇḍurarōcakānvitaḥ prasēkanidrāvamivahnimāndyakr̥t| &lt;br /&gt;<br /> sa kr̥cchrajanmapraśamō nipīḍitō na cōnnamēdrātribalī kaphātmakaḥ||14||&lt;br /&gt;<br /> <br /> guruH sthiraH pANDurarocakAnvitaH prasekanidrAvamivahnimAndyakRut| &lt;br /&gt;<br /> sa kRucchrajanmaprashamo nipIDito na connamedrAtribalI kaphAtmakaH||14||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> ''[[Kapha]]''-dominant swelling is heavy and firm/immovable. It is associated with anemia, anorexia, low digestion, water-brash, vomiting and sleepiness. It appears and disappears very slowly and on pressing it takes long time to attain its normal position and increases at the night time [14]<br /> <br /> === Symptoms of bad prognostic of edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कृशस्य रोगैरबलस्य यो भवेदुपद्रवैर्वा वमिपूर्वकैर्युतः| &lt;br /&gt;<br /> स हन्ति मर्मानुगतोऽथ राजिमान् परिस्रवेद्धीनबलस्य सर्वगः||१५|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kr̥śasya rōgairabalasya yō bhavēdupadravairvā vamipūrvakairyutaḥ| &lt;br /&gt;<br /> sa hanti marmānugatō'tha rājimān parisravēddhīnabalasya sarvagaḥ||15||&lt;br /&gt;<br /> <br /> kRushasya rogairabalasya yo bhavedupadravairvA vamipUrvakairyutaH| &lt;br /&gt;<br /> sa hanti marmAnugato~atha rAjimAn parisraveddhInabalasya sarvagaH||15||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The edema/swelling of the patient, whose body is emaciated and weakened by a disease or is debilitated, or having complications or associated with vomiting, involving vital organs or whole body or spread with prominent vessels or in which profuse discharge oozes out, leads to death [15]<br /> <br /> === Symptoms of easily curable swelling ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अहीनमांसस्य य एकदोषजो नवो बलस्थस्य सुखः स साधने| &lt;br /&gt;<br /> निदानदोषर्तुविपर्ययक्रमैरुपाचरेत्तं बलदोषकालवित्||१६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ahīnamāṁsasya ya ēkadōṣajō navō balasthasya sukhaḥ sa sādhanē|&lt;br /&gt; <br /> nidānadōṣartuviparyayakramairupācarēttaṁ baladōṣakālavit||16||&lt;br /&gt;<br /> <br /> ahInamAMsasya ya ekadoShajo navo balasthasya sukhaH sa sAdhane|&lt;br /&gt;<br /> nidAnadoShartuviparyayakramairupAcarettaM baladoShakAlavit||16||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The swelling of a patient who is neither emaciated nor weak; that involved single ''[[dosha]]'' or is of recent origin is easily curable.<br /> The physician expert in the knowledge of strength, ''[[dosha]]'' and proper time of treatment should treat the curable patients by prescribing such measures which are opposite to cause, ''[[dosha]]'' and season [16]<br /> <br /> === Principles of treatment of edema/swelling ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अथामजं लङ्घनपाचनक्रमैर्विशोधनैरुल्बणदोषमादितः| &lt;br /&gt;<br /> शिरोगतं शीर्षविरेचनैरधो [४] विरेचनैरूर्ध्वहरैस्तथोर्ध्वजम्||१७|| &lt;br /&gt;<br /> <br /> उपाचरेत् स्नेहभवं विरूक्षणैः प्रकल्पयेत् स्नेहविधिं च रूक्षजे| &lt;br /&gt;<br /> विबद्धविट्केऽनिलजे निरूहणं घृतं तु पित्तानिलजे सतिक्तकम्||१८|| &lt;br /&gt;<br /> <br /> पयश्च मूर्च्छारतिदाहतर्षिते विशोधनीये तु समूत्रमिष्यते| &lt;br /&gt;<br /> कफोत्थितं क्षारकटूष्णसंयुतैः समूत्रतक्रासवयुक्तिभिर्जयेत्||१९|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> athāmajaṁ laṅghanapācanakramairviśōdhanairulbaṇadōṣamāditaḥ| &lt;br /&gt;<br /> śirōgataṁ śīrṣavirēcanairadhō [4] virēcanairūrdhvaharaistathōrdhvajam||17|| &lt;br /&gt;<br /> <br /> upācarēt snēhabhavaṁ virūkṣaṇaiḥ prakalpayēt snēhavidhiṁ ca rūkṣajē| &lt;br /&gt;<br /> vibaddhaviṭkē'nilajē nirūhaṇaṁ ghr̥taṁ tu pittānilajē satiktakam||18|| &lt;br /&gt;<br /> <br /> payaśca mūrcchāratidāhatarṣitē viśōdhanīyē tu samūtramiṣyatē| &lt;br /&gt;<br /> kaphōtthitaṁ kṣārakaṭūṣṇasaṁyutaiḥ samūtratakrāsavayuktibhirjayēt||19||&lt;br /&gt;<br /> <br /> athAmajaM la~gghanapAcanakramairvishodhanairulbaNadoShamAditaH| &lt;br /&gt;<br /> shirogataM shIrShavirecanairadho [4] virecanairUrdhvaharaistathordhvajam||17|| &lt;br /&gt;<br /> <br /> upAcaret snehabhavaM virUkShaNaiH prakalpayet snehavidhiM ca rUkShaje| &lt;br /&gt;<br /> vibaddhaviTke~anilaje nirUhaNaM ghRutaM tu pittAnilaje satiktakam||18|| &lt;br /&gt;<br /> <br /> payashca mUrcchAratidAhatarShite vishodhanIye tu samUtramiShyate| &lt;br /&gt;<br /> kaphotthitaM kShArakaTUShNasaMyutaiH samUtratakrAsavayuktibhirjayet||19||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If swelling is associated with ''ama'' it should be managed first by prescribing lightening therapy (''[[langhana]]'') and digestive drugs and only then ''[[shodhana]]'' therapy should be undertaken according to dominant ''[[dosha]]''. General lines of treatment of ''[[dosha]]ja'' swelling are as follows:<br /> <br /> *If it involves head then ''shiro-virechana'' is prescribed;<br /> *If it involves lower parts of the body then ''[[virechana]]'' (therapeutic purgation) is prescribed;<br /> *If it involves upper parts of the body then ''[[vamana]]'' (therapeutic emesis)is prescribed;<br /> *If it is caused by unctuous then ''[[rukshana]]'' (drying) therapy is done;<br /> *If it is caused by un-unctuous (''ruksha'') then unctuous (''[[snehana]]'') therapy is done;<br /> *If ''[[vata]]'' swelling is associated with constipation then it should be treated with ''niruha [[basti]]'';<br /> *If it is caused by ''[[vata]]-[[pitta]]'' then it should be treated with ghee prepared with bitter drugs;<br /> *If the patient is suffering from associated symptoms such as fainting, pain, burning sensation and thirst then it should be treated with intake of milk;<br /> *If the patient is suffering from swelling where ''[[shodhana]]'' is required then milk mixed with cow’s urine should be given.<br /> *If the patient is suffering from ''[[kapha]]'' swelling then ''kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are given [17-19]<br /> <br /> === ''Apathya'' (unwholesome) for swelling/edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ग्राम्याब्जानूपं पिशितमबलं शुष्कशाकं नवान्नं &lt;br /&gt;<br /> गौडं पिष्टान्नं दधि तिलकृतं [५] विज्जलं [६] मद्यमम्लम्| &lt;br /&gt;<br /> धाना वल्लूरं समशनमथो गुर्वसात्म्यं विदाहि &lt;br /&gt;<br /> स्वप्नं चारात्रौ श्वयथुगदवान् वर्जयेन्मैथुनं च||२०|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> grāmyābjānūpaṁ piśitamabalaṁ śuṣkaśākaṁ navānnaṁ &lt;br /&gt;<br /> gauḍaṁ piṣṭānnaṁ dadhi tilakr̥taṁ [5] vijjalaṁ [6] madyamamlam| &lt;br /&gt;<br /> dhānā vallūraṁ samaśanamathō gurvasātmyaṁ vidāhi &lt;br /&gt;<br /> svapnaṁ cārātrau śvayathugadavān varjayēnmaithunaṁ ca||20||&lt;br /&gt;<br /> <br /> grAmyAbjAnUpaM pishitamabalaM shuShkashAkaM navAnnaM &lt;br /&gt;<br /> gauDaM piShTAnnaM dadhi tilakRutaM [5] vijjalaM [6] madyamamlam| &lt;br /&gt;<br /> dhAnA vallUraM samashanamatho gurvasAtmyaM vidAhi &lt;br /&gt;<br /> svapnaM cArAtrau shvayathugadavAn varjayenmaithunaM ca||20||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Meat of domestic, aquatic and wet-land animals or weak animals; dry vegetables, fresh grains, molasses, fine flour products, curd, products of sesame, slimy and sour food articles, wine, roasted barley, dried meat, ''samashana'' (taking of mixture of wholesome and unwholesome food), taking of unwholesome, heavy and irritant diet articles, day sleep and sexual acts should be avoided by the patient of edema/swelling [20]<br /> <br /> === ''Vyoshadi churna'' for ''[[kapha]]'' swelling/edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> व्योषं त्रिवृत्तिक्तकरोहिणी च सायोरजस्का त्रिफलारसेन| &lt;br /&gt;<br /> पीतं कफोत्थं शमयेत्तु शोफं गव्येन मूत्रेण हरीतकी च||२१|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vyōṣaṁ trivr̥ttiktakarōhiṇī ca sāyōrajaskā triphalārasēna| &lt;br /&gt;<br /> pītaṁ kaphōtthaṁ śamayēttu śōphaṁ gavyēna mūtrēṇa harītakī ca||21|| &lt;br /&gt;<br /> <br /> vyoShaM trivRuttiktakarohiNI ca sAyorajaskA triphalArasena| &lt;br /&gt;<br /> pItaM kaphotthaM shamayettu shophaM gavyena mUtreNa harItakI ca||21|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Mixture of powders of ''trikatu, trivrit, katuka'' and ''lauha-bhasma'' taken with juice of ''triphala''; or ''haritaki'' powder taken by mixing with cow’s urine relieves ''[[kapha]]'' edema/swelling [21]<br /> <br /> === Remedy for ''tridoshaja'' edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> हरीतकीनागरदेवदारु सुखाम्बुयुक्तं सपुनर्नवं वा| &lt;br /&gt;<br /> सर्वं पिबेत्त्रिष्वपि मूत्रयुक्तं स्नातश्च जीर्णे पयसाऽन्नमद्यात्||२२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> harītakīnāgaradēvadāru sukhāmbuyuktaṁ sapunarnavaṁ vā| &lt;br /&gt;<br /> sarvaṁ pibēttriṣvapi mūtrayuktaṁ snātaśca jīrṇē payasā'nnamadyāt||22||&lt;br /&gt;<br /> <br /> harItakInAgaradevadAru sukhAmbuyuktaM sapunarnavaM vA| &lt;br /&gt;<br /> sarvaM pibettriShvapi mUtrayuktaM snAtashca jIrNe payasA~annamadyAt||22||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Mixture of ''haritaki'', dried ginger and ''devadaru'' taken with lukewarm water, or ''punarnava'' mixed with all the above drugs taken with cow‘s urine relieves swelling produced by all the three ''[[dosha]]''. On digestion of the drug and after taking bath, the patient should take food with milk [22]<br /> <br /> === Remedy for ''[[vata]]'' edema/swelling ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुनर्नवानागरमुस्तकल्कान् प्रस्थेन धीरः पयसाऽक्षमात्रान्| &lt;br /&gt;<br /> मयूरकं मागधिकां समूलां सनागरां वा प्रपिबेत् सवाते||२३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> punarnavānāgaramustakalkān prasthēna dhīraḥ payasā'kṣamātrān| &lt;br /&gt;<br /> mayūrakaṁ māgadhikāṁ samūlāṁ sanāgarāṁ vā prapibēt savātē||23|| &lt;br /&gt;<br /> <br /> punarnavAnAgaramustakalkAn prasthena dhIraH payasA~akShamAtrAn| &lt;br /&gt;<br /> mayUrakaM mAgadhikAM samUlAM sanAgarAM vA prapibet savAte||23|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The 500 ml of milk prepared with paste of 10 gm each ''punarnava'', dried ginger and ''mustaka''; or milk prepared with ''mayuraka, pippalimula'' and dried ginger taken orally relieves swelling due to ''[[vata]]'' [23]<br /> <br /> === Remedy for ''[[vata]]-[[pitta]]'' swelling/edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दन्तीत्रिवृत्त्र्यूषणचित्रकैर्वा पयः शृतं दोषहरं पिबेन्ना| &lt;br /&gt;<br /> द्विप्रस्थमात्रं तु पलार्धिकैस्तैरर्धावशिष्टं पवने सपित्ते||२४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dantītrivr̥ttryūṣaṇacitrakairvā payaḥ śr̥taṁ dōṣaharaṁ pibēnnā| &lt;br /&gt;<br /> dviprasthamātraṁ tu palārdhikaistairardhāvaśiṣṭaṁ pavanē sapittē||24|| &lt;br /&gt;<br /> <br /> dantItrivRuttryUShaNacitrakairvA payaH shRutaM doShaharaM pibennA| &lt;br /&gt;<br /> dviprasthamAtraM tu palArdhikaistairardhAvashiShTaM pavane sapitte||24|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> One liter of milk prepared with 20 gm each of ''danti, trivrit, trikatu'' and ''chitraka'' added with one liter of water reduced to half, taken orally relieves edema caused by combination of ''[[vata]]'' and ''[[pitta]]'' [24]<br /> <br /> === General remedies for edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सशुण्ठिपीतद्रुरसं प्रयोज्यं श्यामोरुबूकोषणसाधितं वा| &lt;br /&gt;<br /> त्वग्दारुवर्षाभुमहौषधैर्वा गुडूचिकानागरदन्तिभिर्वा||२५|| &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> saśuṇṭhipītadrurasaṁ prayōjyaṁ śyāmōrubūkōṣaṇasādhitaṁ vā| &lt;br /&gt;<br /> tvagdāruvarṣābhumahauṣadhairvā guḍūcikānāgaradantibhirvā||25|| &lt;br /&gt;<br /> <br /> sashuNThipItadrurasaM prayojyaM shyAmorubUkoShaNasAdhitaM vA| &lt;br /&gt;<br /> tvagdAruvarShAbhumahauShadhairvA guDUcikAnAgaradantibhirvA||25|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Milk prepared with dry ginger and ''daruharidra'' or prepared with ''shyama'', castor root and black pepper, or prepared with cinnamon, ''devadaru, punarnava'' and dry ginger; or prepared with ''guduchi'', dry ginger and ''danti''; taken orally relieves edema [25]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सप्ताहमौष्ट्रं त्वथवाऽपि मासं पयः पिबेद्भोजनवारिवर्जी| &lt;br /&gt;<br /> गव्यं समूत्रं महिषीपयो वा क्षीराशनो मूत्रमथो गवां वा||२६|| &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> saptāhamauṣṭraṁ tvathavā'pi māsaṁ payaḥ pibēdbhōjanavārivarjī| &lt;br /&gt;<br /> gavyaṁ samūtraṁ mahiṣīpayō vā kṣīrāśanō mūtramathō gavāṁ vā||26|| &lt;br /&gt;<br /> <br /> saptAhamauShTraM tvathavA~api mAsaM payaH pibedbhojanavArivarjI| &lt;br /&gt;<br /> gavyaM samUtraM mahiShIpayo vA kShIrAshano mUtramatho gavAM vA||26|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The patient by avoiding all other food and drinks if remains only on camel’s milk for a week or month or similarly remains on cow’s milk mixed with equal quantity of cow’s urine or on buffalo’s milk mixed with an equal quantity of cow’s urine or other milk with cow’s urine, then edema is cured [26] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तक्रं पिबेद्वा गुरुभिन्नवर्चाः सव्योषसौवर्चलमाक्षिकं च| &lt;br /&gt;<br /> गुडाभयां वा गुडनागरं वा सदोषभिन्नामविबद्धवर्चाः||२७|| &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> takraṁ pibēdvā gurubhinnavarcāḥ savyōṣasauvarcalamākṣikaṁ ca| &lt;br /&gt;<br /> guḍābhayāṁ vā guḍanāgaraṁ vā sadōṣabhinnāmavibaddhavarcāḥ||27|| &lt;br /&gt;<br /> <br /> takraM pibedvA gurubhinnavarcAH savyoShasauvarcalamAkShikaM ca| &lt;br /&gt;<br /> guDAbhayAM vA guDanAgaraM vA sadoShabhinnAmavibaddhavarcAH||27|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Patient of edema if passes heavy (with mucous) and loose stools may drink butter milk mixed with ''trikatu, sauvarchala''-salt and honey; or if the stool is morbid, loose, with ''ama'' or hard stool, then jaggery and ''haritaki'' or jaggery with dry ginger are given [27] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विड्वातसङ्गे पयसा रसैर्वा प्राग्भक्तमद्यादुरुबूकतैलम् [७] | <br /> <br /> स्रोतोविबन्धेऽग्निरुचिप्रणाशे मद्यान्यरिष्टांश्च पिबेत् सुजातान्||२८|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> viḍvātasaṅgē payasā rasairvā prāgbhaktamadyādurubūkatailam [7] | <br /> <br /> srōtōvibandhē'gnirucipraṇāśē madyānyariṣṭāṁśca pibēt sujātān||28||<br /> <br /> viDvAtasa~gge payasA rasairvA prAgbhaktamadyAdurubUkatailam [7] |<br /> <br /> srotovibandhe~agnirucipraNAshe madyAnyariShTAMshca pibet sujAtAn||28|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If there is retention of feces and flatus, the patient may be given castor oil with milk or with meat-soup before meal; and if there is occlusion of channels or loss of digestion power and appetite, then the patient may be given simple or medicated wines [28]<br /> <br /> === ''Gandeeradyarishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गण्डीरभल्लातकचित्रकांश्च व्योषं विडङ्गं बृहतीद्वयं च| &lt;br /&gt;<br /> द्विप्रस्थिकं गोमयपावकेन द्रोणे पचेत् कूर्चिकमस्तुनस्तु [८] ||२९|| &lt;br /&gt;<br /> <br /> त्रिभागशेषं च सुपूतशीतं द्रोणेन तत् प्राकृतमस्तुना च| &lt;br /&gt;<br /> सितोपलायाश्च शतेन युक्तं लिप्ते घटे चित्रकपिप्पलीनाम्||३०|| &lt;br /&gt;<br /> <br /> वैहायसे स्थापितमादशाहात् प्रयोजयंस्तद्विनिहन्ति शोफान्| &lt;br /&gt;<br /> भगन्दरार्शःक्रिमिकुष्ठमेहान् वैवर्ण्यकार्श्यानिलहिक्कनं च||३१|| &lt;br /&gt;<br /> <br /> इति गण्डीराद्यरिष्टः &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> gaṇḍīrabhallātakacitrakāṁśca vyōṣaṁ viḍaṅgaṁ br̥hatīdvayaṁ ca| &lt;br /&gt;<br /> dviprasthikaṁ gōmayapāvakēna drōṇē pacēt kūrcikamastunastu [8] ||29|| &lt;br /&gt;<br /> <br /> tribhāgaśēṣaṁ ca supūtaśītaṁ drōṇēna tat prākr̥tamastunā ca| &lt;br /&gt;<br /> sitōpalāyāśca śatēna yuktaṁ liptē ghaṭē citrakapippalīnām||30|| &lt;br /&gt;<br /> <br /> vaihāyasē sthāpitamādaśāhāt prayōjayaṁstadvinihanti śōphān| &lt;br /&gt;<br /> bhagandarārśaḥkrimikuṣṭhamēhān vaivarṇyakārśyānilahikkanaṁ ca||31|| &lt;br /&gt;<br /> <br /> iti gaṇḍīrādyariṣṭaḥ &lt;br /&gt;<br /> <br /> gaNDIrabhallAtakacitrakAMshca vyoShaM viDa~ggaM bRuhatIdvayaM ca| &lt;br /&gt;<br /> dviprasthikaM gomayapAvakena droNe pacet kUrcikamastunastu [8] ||29|| &lt;br /&gt;<br /> <br /> tribhAgasheShaM ca supUtashItaM droNena tat prAkRutamastunA ca| &lt;br /&gt;<br /> sitopalAyAshca shatena yuktaM lipte ghaTe citrakapippalInAm||30|| &lt;br /&gt;<br /> <br /> vaihAyase sthApitamAdashAhAt prayojayaMstadvinihanti shophAn| &lt;br /&gt;<br /> bhagandarArshaHkrimikuShThamehAn vaivarNyakArshyAnilahikkanaM ca||31|| &lt;br /&gt;<br /> <br /> iti gaNDIrAdyariShTaH &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take 1.280 Kg of ''gandeera, bhallataka, chitraka, trikatu, vidnaga, kantakari'' and ''brihati'' and add 1.024 Kg of ''kurchika-mastu'' (prepared by adding hot water in paneer) and boil on cow-dung fire till one-third remains and then filter. On cooling add to it 1.024 Kg natural-''mastu'' (prepared by adding water in curd), 4 kg of sugar-candy and put in a pitcher lined with paste of ''chitraka'' and ''pippali'' and leave this pot at a high-open place for 10 days for fermentation to prepare ''arishta''. <br /> <br /> Oral administration of ''gandeeradyarishtha'' cures edema, fistula-in-ano, piles, helminthiasis, ''kushtha''(obstinate skin diseases), polyuria, discoloration, emaciation and hiccup due to ''[[vata]]''. Thus ''gandeeradyarishtha'' is described [29-31]<br /> <br /> === ''Ashtashato arishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> काश्मर्यधात्रीमरिचाभयाक्षद्राक्षाफलानां [९] च सपिप्पलीनाम्| &lt;br /&gt;<br /> शतं शतं जीर्णगुडात्तुलां [१०] च सङ्क्षुद्य कुम्भे मधुना प्रलिप्ते||३२|| &lt;br /&gt;<br /> <br /> सप्ताहमुष्णे द्विगुणं तु शीते स्थितं जलद्रोणयुतं पिबेन्ना| &lt;br /&gt;<br /> शोफान् विबन्धान् कफवातजांश्च निहन्त्यरिष्टोऽष्टशतोऽग्निकृच्च||३३|| &lt;br /&gt;<br /> <br /> इत्यष्टशतोऽरिष्टः &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kāśmaryadhātrīmaricābhayākṣadrākṣāphalānāṁ [9] ca sapippalīnām| &lt;br /&gt;<br /> śataṁ śataṁ jīrṇaguḍāttulāṁ [10] ca saṅkṣudya kumbhē madhunā praliptē||32|| &lt;br /&gt;<br /> <br /> saptāhamuṣṇē dviguṇaṁ tu śītē sthitaṁ jaladrōṇayutaṁ pibēnnā| &lt;br /&gt;<br /> śōphān vibandhān kaphavātajāṁśca nihantyariṣṭō'ṣṭaśatō'gnikr̥cca||33|| &lt;br /&gt;<br /> <br /> ityaṣṭaśatō'riṣṭaḥ &lt;br /&gt;<br /> <br /> kAshmaryadhAtrImaricAbhayAkShadrAkShAphalAnAM [9] ca sapippalInAm| &lt;br /&gt;<br /> shataM shataM jIrNaguDAttulAM [10] ca sa~gkShudya kumbhe madhunA pralipte||32|| &lt;br /&gt;<br /> <br /> saptAhamuShNe dviguNaM tu shIte sthitaM jaladroNayutaM pibennA| &lt;br /&gt;<br /> shophAn vibandhAn kaphavAtajAMshca nihantyariShTo~aShTashato~agnikRucca||33|| &lt;br /&gt;<br /> <br /> ityaShTashato~ariShTaH &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take 100 ''pala'' each of ''kashmarya, amalaki,'' black pepper, ''haritaki, vibhitaki, pippali'' and grapes, add to it 100 ''pala'' of old jaggery and two ''drona'' of water, then put the mixture in a vessel lined with honey for 7 days in summer or for 14 days in winter for fermentation. Thus fermented ''asava'' is known as ''ashtashato-arishtha''. Its oral administration cures edema and constipation due to ''[[kapha]]'' and ''[[vata]]'' and stimulates digestion and metabolism (''agni''). Thus ''ashthato-arishta'' is described [32-33]<br /> <br /> === ''Punarnavadi arishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पुनर्नवे द्वे च बले सपाठे दन्तीं [११] गुडूचीमथ चित्रकं च| &lt;br /&gt;<br /> निदिग्धिकां च त्रिपलानि पक्त्वा द्रोणावशेषे सलिले ततस्तम्||३४|| &lt;br /&gt;<br /> <br /> पूत्वा रसं द्वे च गुडात् पुराणात्तुले मधुप्रस्थयुतं सुशीतम्| &lt;br /&gt;<br /> मासं निदध्याद्घृतभाजनस्थं पल्ले यवानां परतस्तु मासात्||३५|| &lt;br /&gt;<br /> <br /> चूर्णीकृतैरर्धपलांशिकैस्तं पत्रत्वगेलामरिचाम्बुलोहैः [१२] | &lt;br /&gt;<br /> गन्धान्वितं क्षौद्रघृतप्रदिग्धे जीर्णे पिबेद् व्याधिबलं समीक्ष्य||३६|| &lt;br /&gt;<br /> <br /> हृत्पाण्डुरोगं श्वयथुं प्रवृद्धं प्लीहज्वरारोचकमेहगुल्मान्| &lt;br /&gt;<br /> भगन्दरं षड्जठराणि कासं श्वासं ग्रहण्यामयकुष्ठकण्डूः||३७|| &lt;br /&gt;<br /> <br /> शाखानिलं बद्धपुरीषतां च हिक्कां किलासं च हलीमकं च| &lt;br /&gt;<br /> क्षिप्रं जयेद्वर्णबलायुरोजस्तेजोन्वितो मांसरसान्नभोजी||३८|| &lt;br /&gt;<br /> <br /> इति पुनर्नवाद्यरिष्टः &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> punarnavē dvē ca balē sapāṭhē dantīṁ [11] guḍūcīmatha citrakaṁ ca|&lt;br /&gt; <br /> nidigdhikāṁ ca tripalāni paktvā drōṇāvaśēṣē salilē tatastam||34|| &lt;br /&gt;<br /> <br /> pūtvā rasaṁ dvē ca guḍāt purāṇāttulē madhuprasthayutaṁ suśītam| &lt;br /&gt;<br /> māsaṁ nidadhyādghr̥tabhājanasthaṁ pallē yavānāṁ paratastu māsāt||35||&lt;br /&gt;<br /> <br /> cūrṇīkr̥tairardhapalāṁśikaistaṁ patratvagēlāmaricāmbulōhaiḥ [12] | &lt;br /&gt;<br /> gandhānvitaṁ kṣaudraghr̥tapradigdhē jīrṇē pibēd vyādhibalaṁ samīkṣya||36|| &lt;br /&gt;<br /> <br /> hr̥tpāṇḍurōgaṁ śvayathuṁ pravr̥ddhaṁ plīhajvarārōcakamēhagulmān| &lt;br /&gt;<br /> bhagandaraṁ ṣaḍjaṭharāṇi kāsaṁ śvāsaṁ grahaṇyāmayakuṣṭhakaṇḍūḥ||37|| &lt;br /&gt;<br /> <br /> śākhānilaṁ baddhapurīṣatāṁ ca hikkāṁ kilāsaṁ ca halīmakaṁ ca| &lt;br /&gt;<br /> kṣipraṁ jayēdvarṇabalāyurōjastējōnvitō māṁsarasānnabhōjī||38|| &lt;br /&gt;<br /> <br /> iti punarnavādyariṣṭaḥ &lt;br /&gt;<br /> <br /> punarnave dve ca bale sapAThe dantIM [11] guDUcImatha citrakaM ca| &lt;br /&gt;<br /> nidigdhikAM ca tripalAni paktvA droNAvasheShe salile tatastam||34||&lt;br /&gt;<br /> <br /> pUtvA rasaM dve ca guDAt purANAttule madhuprasthayutaM sushItam| &lt;br /&gt;<br /> mAsaM nidadhyAdghRutabhAjanasthaM palle yavAnAM paratastu mAsAt||35|| &lt;br /&gt;<br /> <br /> cUrNIkRutairardhapalAMshikaistaM patratvagelAmaricAmbulohaiH [12] | &lt;br /&gt;<br /> gandhAnvitaM kShaudraghRutapradigdhe jIrNe pibed vyAdhibalaM samIkShya ||36|| &lt;br /&gt;<br /> <br /> hRutpANDurogaM shvayathuM pravRuddhaM plIhajvarArocakamehagulmAn| &lt;br /&gt;<br /> bhagandaraM ShaDjaTharANi kAsaM shvAsaM grahaNyAmayakuShThakaNDUH ||37|| &lt;br /&gt;<br /> <br /> shAkhAnilaM baddhapurIShatAM ca hikkAM kilAsaM ca halImakaM ca| &lt;br /&gt;<br /> kShipraM jayedvarNabalAyurojastejonvito mAMsarasAnnabhojI||38||&lt;br /&gt;<br /> <br /> iti punarnavAdyariShTaH &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make a decoction of 120 gm each of two types of ''punarnavā, balā, pāṭhā, dantī, guḍūchī, chitraka, kantakāri'' and ''triphalā'' by adding water (about 4.1 liters) and reducing it to 1.024 liter. Add to this decoction 8 kg of jaggery and 640 gm of honey and keep it in a vessel lined with ghee and place it in a heap of barley for a month. Thereafter to make it fragrant, add 20 gm powders each of ''tejapatra'', cinnamon, cardamom, black pepper, couscous and iron ''bhasma'' and store in a pot lined with honey and ghee. It is to be taken after the digestion of the meal in a dose according to the strength of the disease. In diet, food with meat soup may be given.<br /> <br /> It provides quick cure in heart disease, anemia, severe edema, splenic disorders, fever, anorexia, polyuria, ''gulma'', fistula-in-ano, six types of ''udararoga'', cough, dyspnea, assimilation disorders (''grahani''), dermatosis (''kushtha''), pruritis, ''[[vata]]'' disorders of limbs, constipation, hiccup, leukoderma and ''halimaka'' (greenish coloration of skin). It also improves complexion, strength, [[ojas]] and vitality. Thus ''punarnavadi arishta'' is described [34-38]<br /> <br /> === ''Triphaladyarishta'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> फलत्रिकं दीप्यकचित्रकौ च सपिप्पलीलोहरजो विडङ्गम्| &lt;br /&gt;<br /> चूर्णीकृतं कौडविकं द्विरंशं क्षौद्रं पुराणस्य तुलां गुडस्य||३९|| &lt;br /&gt;<br /> <br /> मासं निदध्याद्घृतभाजनस्थं यवेषु तानेव निहन्ति रोगान्| &lt;br /&gt;<br /> ये चार्शसां पाण्डुविकारिणां च प्रोक्ता हिताः शोफिषु तेऽप्यरिष्टाः||४०|| &lt;br /&gt;<br /> <br /> इति त्रिफलाद्यरिष्टः &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> phalatrikaṁ dīpyakacitrakau ca sapippalīlōharajō viḍaṅgam| &lt;br /&gt;<br /> cūrṇīkr̥taṁ kauḍavikaṁ dviraṁśaṁ kṣaudraṁ purāṇasya tulāṁ guḍasya||39|| &lt;br /&gt;<br /> <br /> māsaṁ nidadhyādghr̥tabhājanasthaṁ yavēṣu tānēva nihanti rōgān| &lt;br /&gt;<br /> yē cārśasāṁ pāṇḍuvikāriṇāṁ ca prōktā hitāḥ śōphiṣu tē'pyariṣṭāḥ||40|| &lt;br /&gt;<br /> <br /> iti triphalādyariṣṭaḥ &lt;br /&gt;<br /> <br /> phalatrikaM dIpyakacitrakau ca sapippalIloharajo viDa~ggam| &lt;br /&gt;<br /> cUrNIkRutaM kauDavikaM dviraMshaM kShaudraM purANasya tulAM guDasya||39|| &lt;br /&gt;<br /> <br /> mAsaM nidadhyAdghRutabhAjanasthaM yaveShu tAneva nihanti rogAn| &lt;br /&gt;<br /> ye cArshasAM pANDuvikAriNAM ca proktA hitAH shophiShu te~apyariShTAH||40|| &lt;br /&gt;<br /> <br /> iti triphalAdyariShTaH &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make decoction from the coarse powder of 160 gm each of ''triphala, ajawan, chitraka, pippali,'' iron bhasma and ''vidanga''. To this decoction add 320 ml of honey and 4 kg of jaggery and put it in a vessel lined with ghee and place in a heap of barley for a month. Its oral administration cures all the diseases mentioned above. Thus ''triphaladyarishtha'' is described.<br /> <br /> The ''asava'' and ''arishtha'' mentioned for the treatment of piles and anemia are also beneficial for relieving the edema [39-40]<br /> <br /> === Powder preparations for edema ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कृष्णा सपाठा गजपिप्पली च निदिग्धिका चित्रकनागरे च| &lt;br /&gt;<br /> सपिप्पलीमूलरजन्यजाजीमुस्तं च चूर्णं सुखतोयपीतम्||४१|| &lt;br /&gt;<br /> <br /> हन्यात्त्रिदोषं चिरजं च शोफं कल्कश्च भूनिम्बमहौषधस्य| &lt;br /&gt;<br /> अयोरजस्त्र्यूषणयावशूकचूर्णं च पीतं त्रिफलारसेन||४२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kr̥ṣṇā sapāṭhā gajapippalī ca nidigdhikā citrakanāgarē ca| &lt;br /&gt;<br /> sapippalīmūlarajanyajājīmustaṁ ca cūrṇaṁ sukhatōyapītam||41|| &lt;br /&gt;<br /> <br /> hanyāttridōṣaṁ cirajaṁ ca śōphaṁ kalkaśca bhūnimbamahauṣadhasya| &lt;br /&gt;<br /> ayōrajastryūṣaṇayāvaśūkacūrṇaṁ ca pītaṁ triphalārasēna||42||&lt;br /&gt;<br /> <br /> kRuShNA sapAThA gajapippalI ca nidigdhikA citrakanAgare ca| &lt;br /&gt;<br /> sapippalImUlarajanyajAjImustaM ca cUrNaM sukhatoyapItam||41|| &lt;br /&gt;<br /> <br /> hanyAttridoShaM cirajaM ca shophaM kalkashca bhUnimbamahauShadhasya| &lt;br /&gt;<br /> ayorajastryUShaNayAvashUkacUrNaM ca pItaM triphalArasena||42||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Use of any one of the following powder preparations cures chronic edema caused by all the three ''[[dosha]]'':<br /> <br /> The mixture of the powders of ''pippali, pippalimula, pāthā, gajapippali,'' cumin, ''kantakāri, chitraka,'' dried ginger, turmeric, cumin and ''mustaka'' taken with lukewarm water, or paste of ''bhumyāmalaki'' and dried ginger taken with lukewarm water or <br /> ''bhasma'' of iron, ''trikatu'' and ''yavakshara'' taken with decoction of ''triphala'' [41-42]<br /> <br /> === ''Ksharagudika'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षारद्वयं स्याल्लवणानि चत्वार्ययोरजो व्योषफलत्रिके च| &lt;br /&gt;<br /> सपिप्पलीमूलविडङ्गसारं मुस्ताजमोदामरदारुबिल्वम्||४३|| &lt;br /&gt;<br /> <br /> कलिङ्गकाश्चित्रकमूलपाठे यष्ट्याह्वयं सातिविषं पलांशम्| &lt;br /&gt;<br /> सहिङ्गुकर्षं त्वणुशुष्कचूर्णं द्रोणं तथा मूलकशुण्ठकानाम्||४४|| &lt;br /&gt;<br /> <br /> स्याद्भस्मनस्तत् सलिलेन साध्यमालोड्य यावद्घनमप्रदग्धम्| &lt;br /&gt;<br /> स्त्यानं ततः कोलसमां तु मात्रां कृत्वा सुशुष्कां विधिनोपयुञ्ज्यात्||४५|| &lt;br /&gt;<br /> <br /> प्लीहोदरश्वित्रहलीमकार्शःपाण्ड्वामयारोचकशोषशोफान्| &lt;br /&gt;<br /> विसूचिकागुल्मगराश्मरीश्च सश्वासकासाः प्रणुदेत् सकुष्ठाः||४६|| &lt;br /&gt;<br /> <br /> इति क्षारगुडिका &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣāradvayaṁ syāllavaṇāni catvāryayōrajō vyōṣaphalatrikē ca| &lt;br /&gt;<br /> sapippalīmūlaviḍaṅgasāraṁ mustājamōdāmaradārubilvam||43|| &lt;br /&gt;<br /> <br /> kaliṅgakāścitrakamūlapāṭhē yaṣṭyāhvayaṁ sātiviṣaṁ palāṁśam| &lt;br /&gt;<br /> sahiṅgukarṣaṁ tvaṇuśuṣkacūrṇaṁ drōṇaṁ tathā mūlakaśuṇṭhakānām||44|| &lt;br /&gt;<br /> <br /> syādbhasmanastat salilēna sādhyamālōḍya yāvadghanamapradagdham| &lt;br /&gt;<br /> styānaṁ tataḥ kōlasamāṁ tu mātrāṁ kr̥tvā suśuṣkāṁ vidhinōpayuñjyāt||45||&lt;br /&gt;<br /> <br /> plīhōdaraśvitrahalīmakārśaḥpāṇḍvāmayārōcakaśōṣaśōphān| &lt;br /&gt;<br /> visūcikāgulmagarāśmarīśca saśvāsakāsāḥ praṇudēt sakuṣṭhāḥ||46|| &lt;br /&gt;<br /> <br /> iti kṣāraguḍikā || &lt;br /&gt;<br /> <br /> kShAradvayaM syAllavaNAni catvAryayorajo vyoShaphalatrike ca| &lt;br /&gt;<br /> sapippalImUlaviDa~ggasAraM mustAjamodAmaradArubilvam||43|| &lt;br /&gt;<br /> <br /> kali~ggakAshcitrakamUlapAThe yaShTyAhvayaM sAtiviShaM palAMsham| &lt;br /&gt;<br /> sahi~ggukarShaM tvaNushuShkacUrNaM droNaM tathA mUlakashuNThakAnAm||44|| &lt;br /&gt;<br /> <br /> syAdbhasmanastat salilena sAdhyamAloDya yAvadghanamapradagdham| &lt;br /&gt;<br /> styAnaM tataH kolasamAM tu mAtrAM kRutvA sushuShkAM vidhinopayu~jjyAt||45|| &lt;br /&gt;<br /> <br /> plIhodarashvitrahalImakArshaHpANDvAmayArocakashoShashophAn| &lt;br /&gt;<br /> visUcikAgulmagarAshmarIshca sashvAsakAsAH praNudet sakuShThAH||46|| &lt;br /&gt;<br /> <br /> iti kShAraguDikA &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take 40 gm fine powder each of ''svarajjikā'' and ''yava-kshara'', four varieties of salt, iron ''bhasma, trikatu, triphala, pippalimula,'' pealed seeds of ''vidanga, mustaka, ajamodā, devadāru, bilva, indrayava,'' root of ''chitraka, pāthā, ativishā'' and liquorice; 10 gm of asafetida and 1.024 Kg of dried radish and dried ginger. Add water to it and heat the mixture till it becomes thick taking care that it should not seared and from it make pills of 5 gm each and dry them. <br /> <br /> Properly administered pills cure splenomegaly, leukoderma, ''halimaka'' (greenish coloration of the skin), piles, anemia, anorexia, emaciation, edema, gastroenteritis, ''gulma'', synthetic poisoning, lithiasis, dyspnea, cough and dermatosis. Thus ''ksharagudika'' is described [43-46]<br /> <br /> === Course of ''gud-adraka'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्रयोजयेदार्द्रकनागरं वा तुल्यं गुडेनार्धपलाभिवृद्ध्या| &lt;br /&gt;<br /> मात्रा परं पञ्चपलानि मासं जीर्णे पयो यूषरसाश्च भक्तम्||४७||&lt;br /&gt;<br /> <br /> गुल्मोदरार्शःश्वयथुप्रमेहाञ् श्वासप्रतिश्यालसकाविपाकान्| &lt;br /&gt;<br /> सकामलाशोषमनोविकारान् कासं कफं चैव जयेत् प्रयोगः||४८|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> prayōjayēdārdrakanāgaraṁ vā tulyaṁ guḍēnārdhapalābhivr̥ddhyā| &lt;br /&gt;<br /> mātrā paraṁ pañcapalāni māsaṁ jīrṇē payō yūṣarasāśca bhaktam||47|| &lt;br /&gt;<br /> <br /> gulmōdarārśaḥśvayathupramēhāñ śvāsapratiśyālasakāvipākān| &lt;br /&gt;<br /> sakāmalāśōṣamanōvikārān kāsaṁ kaphaṁ caiva jayēt prayōgaḥ||48||&lt;br /&gt;<br /> <br /> prayojayedArdrakanAgaraM vA tulyaM guDenArdhapalAbhivRuddhyA| &lt;br /&gt;<br /> mAtrA paraM pa~jcapalAni mAsaM jIrNe payo yUSharasAshca bhaktam||47|| &lt;br /&gt;<br /> <br /> gulmodarArshaHshvayathupramehA~j shvAsapratishyAlasakAvipAkAn| &lt;br /&gt;<br /> sakAmalAshoShamanovikArAn kAsaM kaphaM caiva jayet prayogaH||48||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Mix equal quantity of jaggery and ginger and take it in 20 gm dose initially and then increase its dose by 20 gm daily till the dose becomes 200 gm per day. Then this dose is to be continued for the remaining days of the month. During this treatment, on digestion of the drug, rice gruel and milk or meat soup should be given to eat. <br /> <br /> The one month course cures ''gulma, udararoga,'' piles, edema, polyuria, dyspnea, coryza, cough, ''alasaka,'' indigestion, jaundice, consumption, mental disorders and [[kapha]] disorders [47-48]<br /> <br /> === Course of ''shilajatu'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रसस्तथैवार्द्रकनागरस्य पेयोऽथ जीर्णे पयसाऽन्नमद्यात्| &lt;br /&gt;<br /> जत्वश्मजं [१३] च त्रिफलारसेन हन्यात्त्रिदोषं श्वयथुं प्रसह्य||४९|| &lt;br /&gt;<br /> <br /> इति शिलाजतुप्रयोगः &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rasastathaivārdrakanāgarasya pēyō'tha jīrṇē payasā'nnamadyāt| &lt;br /&gt;<br /> jatvaśmajaṁ [13] ca triphalārasēna hanyāttridōṣaṁ śvayathuṁ prasahya||49|| &lt;br /&gt;<br /> <br /> iti śilājatuprayōgaḥ &lt;br /&gt;<br /> <br /> rasastathaivArdrakanAgarasya peyo~atha jIrNe payasA~annamadyAt| &lt;br /&gt;<br /> jatvashmajaM [13] ca triphalArasena hanyAttridoShaM shvayathuM prasahya||49|| &lt;br /&gt;<br /> <br /> iti shilAjatuprayogaH &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Similarly juice of ginger may be taken with ''shilajatu'' for one month in the doses and manner mentioned above. On getting the hunger food should be taken with milk.<br /> <br /> A month’s course of ''shilājatu'' with juice of ''triphalā'' will completely cure the edema/swelling caused by all the three ''[[dosha]]''. Thus course of ''shilājatu'' is described [49]<br /> <br /> === ''Kamsa haritaki'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> द्विपञ्चमूलस्य पचेत् कषाये कंसेऽभयानां च शतं गुडस्य| &lt;br /&gt;<br /> लेहे सुसिद्धेऽथ विनीय चूर्णं व्योषं त्रिसौगन्ध्यमुषास्थिते च||५०|| &lt;br /&gt;<br /> <br /> प्रस्थार्धमात्रं मधुनः सुशीते किञ्चिच्च चूर्णादपि यावशूकात्| &lt;br /&gt;<br /> एकाभयां प्राश्य ततश्च लेहाच्छुक्तिं निहन्ति श्वयथुं प्रवृद्धम्||५१|| &lt;br /&gt;<br /> <br /> श्वासज्वरारोचकमेहगुल्मप्लीहत्रिदोषोदरपाण्डुरोगान्| &lt;br /&gt;<br /> कार्श्यामवातावसृगम्लपित्तवैवर्ण्यमूत्रानिलशुक्रदोषान्||५२|| &lt;br /&gt;<br /> <br /> इति कंसहरीतकी &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dvipañcamūlasya pacēt kaṣāyē kaṁsē'bhayānāṁ ca śataṁ guḍasya| &lt;br /&gt;<br /> lēhē susiddhē'tha vinīya cūrṇaṁ vyōṣaṁ trisaugandhyamuṣāsthitē ca||50|| &lt;br /&gt;<br /> <br /> prasthārdhamātraṁ madhunaḥ suśītē kiñcicca cūrṇādapi yāvaśūkāt| &lt;br /&gt;<br /> ēkābhayāṁ prāśya tataśca lēhācchuktiṁ nihanti śvayathuṁ pravr̥ddham||51|| &lt;br /&gt;<br /> <br /> śvāsajvarārōcakamēhagulmaplīhatridōṣōdarapāṇḍurōgān| &lt;br /&gt;<br /> kārśyāmavātāvasr̥gamlapittavaivarṇyamūtrānilaśukradōṣān||52|| &lt;br /&gt;<br /> <br /> iti kaṁsaharītakī &lt;br /&gt;<br /> <br /> dvipa~jcamUlasya pacet kaShAye kaMse~abhayAnAM ca shataM guDasya| &lt;br /&gt;<br /> lehe susiddhe~atha vinIya cUrNaM vyoShaM trisaugandhyamuShAsthite ca||50|| &lt;br /&gt;<br /> <br /> prasthArdhamAtraM madhunaH sushIte ki~jcicca cUrNAdapi yAvashUkAt| &lt;br /&gt;<br /> ekAbhayAM prAshya tatashca lehAcchuktiM nihanti shvayathuM pravRuddham||51|| &lt;br /&gt;<br /> <br /> shvAsajvarArocakamehagulmaplIhatridoShodarapANDurogAn| &lt;br /&gt;<br /> kArshyAmavAtAvasRugamlapittavaivarNyamUtrAnilashukradoShAn||52|| &lt;br /&gt;<br /> <br /> iti kaMsaharItakI &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make 2.56 liter decoction of ''dashamula'' and add to it ''haritaki'' 100 in number and 4.0 kg of jaggery and powder of ''trikatu'' and ''trijata'' (three aromatics- leaves and bark of cinnamon and cardamom). Leave it overnight and next morning on cooling adds 320 gm of honey and little quantity of ''yavakshara''. <br /> <br /> Take it in the dose of 10 gm along with one ''haritaki''. It will cure severe edema and also dyspnea, fever, anorexia, polyuria, ''gulma'', splenic-disorders, ''sannipātika-udararoga,'' anemia, emaciation, rheumatoid arthritis, bleeding disorders, hyperchlorhydria, discoloration of skin and ''[[vata]]'' disorders of urine and semen. Thus ''kaṁsaharītakī'' is described [50-52]<br /> <br /> === Patoladi kashaya ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पटोलमूलामरदारुदन्तीत्रायन्तिपिप्पल्यभयाविशालाः| &lt;br /&gt;<br /> यष्ट्याह्वयं तिक्तकरोहिणी च सचन्दना स्यान्निचुलानि दार्वी||५३|| &lt;br /&gt;<br /> <br /> कर्षोन्मितैस्तैः क्वथितः कषायो घृतेन पेयः कुडवेन युक्तः| &lt;br /&gt;<br /> वीसर्पदाहज्वरसन्निपाततृष्णाविषाणि श्वयथुं च हन्ति||५४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> paṭōlamūlāmaradārudantītrāyantipippalyabhayāviśālāḥ| &lt;br /&gt;<br /> yaṣṭyāhvayaṁ tiktakarōhiṇī ca sacandanā syānniculāni dārvī||53|| &lt;br /&gt;<br /> <br /> karṣōnmitaistaiḥ kvathitaḥ kaṣāyō ghr̥tēna pēyaḥ kuḍavēna yuktaḥ| &lt;br /&gt;<br /> vīsarpadāhajvarasannipātatr̥ṣṇāviṣāṇi śvayathuṁ ca hanti||54||&lt;br /&gt;<br /> <br /> paTolamUlAmaradArudantItrAyantipippalyabhayAvishAlAH| &lt;br /&gt;<br /> yaShTyAhvayaM tiktakarohiNI ca sacandanA syAnniculAni dArvI||53|| &lt;br /&gt;<br /> <br /> karShonmitaistaiH kvathitaH kaShAyo ghRutena peyaH kuDavena yuktaH| &lt;br /&gt;<br /> vIsarpadAhajvarasannipAtatRuShNAviShANi shvayathuM ca hanti||54||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make decoction of 10 gm each of roots of ''patola, devadāru, danti, trāyamānā, pippali, haritaki, indrāyana,'' liquorices, sandal wood, ''katukā, dāruhridrā'' and ''samudraphala''. This decoction should be taken with 160 gm of ghee. It cures ''visarpa'' (erysipelas), burning sensation, fever, ''sannipāta'' thirst, poisoning and edema [53-54]<br /> <br /> === ''Chitraka ghrita'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सचित्रकं [१४] धान्ययवान्यजाजीसौवर्चलं त्र्यूषणवेतसाम्लम्| &lt;br /&gt;<br /> बिल्वात् फलं दाडिमयावशूकौ सपिप्पलीमूलमथापि चव्यम्||५५|| &lt;br /&gt;<br /> <br /> पिष्ट्वाऽक्षमात्राणि जलाढकेन पक्त्वा घृतप्रस्थमथ प्रयुञ्ज्यात्| &lt;br /&gt;<br /> अर्शांसि गुल्मं श्वयथुं कृच्छ्रं निहन्ति वह्निं च करोति दीप्तम्||५६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> sacitrakaṁ [14] dhānyayavānyajājīsauvarcalaṁ tryūṣaṇavētasāmlam| &lt;br /&gt;<br /> b0ilvāt phalaṁ dāḍimayāvaśūkau sapippalīmūlamathāpi cavyam||55|| &lt;br /&gt;<br /> <br /> piṣṭvā'kṣamātrāṇi jalāḍhakēna paktvā ghr̥taprasthamatha prayuñjyāt| &lt;br /&gt;<br /> arśāṁsi gulmaṁ śvayathuṁ ca kr̥cchraṁ nihanti vahniṁ ca karōti dīptam||56|| &lt;br /&gt;<br /> <br /> sacitrakaM [14] dhAnyayavAnyajAjIsauvarcalaM tryUShaNavetasAmlam| &lt;br /&gt;<br /> bilvAt phalaM dADimayAvashUkau sapippalImUlamathApi cavyam||55|| &lt;br /&gt;<br /> <br /> piShTvA~akShamAtrANi jalADhakena paktvA ghRutaprasthamatha prayu~jjyAt|&lt;br /&gt; <br /> arshAMsi gulmaM shvayathuM ca kRucchraM nihanti vahniM ca karoti dIptam||56||&lt;br /&gt; <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Make paste of 10 gm each of ''chitraka,'' coriander, ajawan, cumin, ''sauvarchala''-salt, ''trikatu, amlavetasa, bilva,'' pomegranate, ''yavakṣāra, pippalimula'' and ''chavya''; add to it 640 gm of ghee and 2.56 liter of water. Prepare ''ghrita'' as per ''sneha pāka'' method. <br /> <br /> Oral administration of ''chitraka'' ghee cures edema/swelling even if it is difficult to cure as well as piles and ''gulma'' and stimulate the digestion and metabolism (''agni''). [55-56]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> पिबेद्घृतं वाऽष्टगुणाम्बुसिद्धं सचित्रकक्षारमुदारवीर्यम्| &lt;br /&gt;<br /> कल्याणकं वाऽपि सपञ्चगव्यं तिक्तं महद्वाऽप्यथ तिक्तकं वा||५७|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> pibēdghr̥taṁ vā'ṣṭaguṇāmbusiddhaṁ sacitrakakṣāramudāravīryam| &lt;br /&gt;<br /> kalyāṇakaṁ vā'pi sapañcagavyaṁ tiktaṁ mahadvā'pyatha tiktakaṁ vā||57||&lt;br /&gt;<br /> <br /> pibedghRutaM vA~aShTaguNAmbusiddhaM sacitrakakShAramudAravIryam| &lt;br /&gt;<br /> kalyANakaM vA~api sapa~jcagavyaM tiktaM mahadvA~apyatha tiktakaM vA||57||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Prepare a ''ghrita'' with eight times of water with paste of ''chitraka'' and ''yavakshara''. It has great potency. The patient may also take the ''kalyānaka ghrita'' or ''panchagavya ghrita'' or ''mahātikta ghrita'' or ''tikta ghrita'' [57] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षीरं घटे चित्रककल्कलिप्ते दध्यागतं साधु विमथ्य तेन| &lt;br /&gt;<br /> तज्जं घृतं चित्रकमूलगर्भं तक्रेण सिद्धं श्वयथुघ्नमग्र्यम्||५८|| &lt;br /&gt;<br /> <br /> अर्शोऽतिसारानिलगुल्ममेहांश्चैतन्निहन्त्यग्निबलप्रदं [१५] च| &lt;br /&gt;<br /> तक्रेण चाद्यात् सघृतेन तेन भोज्यानि सिद्धामथवा यवागूम्||५९|| &lt;br /&gt;<br /> <br /> इति चित्रकघृतम् &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣīraṁ ghaṭē citrakakalkaliptē dadhyāgataṁ sādhu vimathya tēna| &lt;br /&gt;<br /> tajjaṁ ghr̥taṁ citrakamūlagarbhaṁ takrēṇa siddhaṁ śvayathughnamagryam||58|| &lt;br /&gt;<br /> <br /> arśō'tisārānilagulmamēhāṁścaitannihantyagnibalapradaṁ [15] ca| &lt;br /&gt;<br /> takrēṇa cādyāt saghr̥tēna tēna bhōjyāni siddhāmathavā yavāgūm||59|| &lt;br /&gt;<br /> <br /> iti citrakaghr̥tam &lt;br /&gt;<br /> <br /> kShIraM ghaTe citrakakalkalipte dadhyAgataM sAdhu vimathya tena| &lt;br /&gt;<br /> tajjaM ghRutaM citrakamUlagarbhaM takreNa siddhaM shvayathughnamagryam||58|| &lt;br /&gt;<br /> <br /> arsho~atisArAnilagulmamehAMshcaitannihantyagnibalapradaM [15] ca| &lt;br /&gt;<br /> takreNa cAdyAt saghRutena tena bhojyAni siddhAmathavA yavAgUm||59|| &lt;br /&gt;<br /> <br /> iti citrakaghRutam &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Put milk in a pot coated with paste of ''chitraka'' and curdle it. Churn this curd well to get butter which is heated to ghee. Add to the ghee all the buttermilk (which contains mixed ''chitraka'' also) from the pot and prepare the medicated ''ghrita''. It is best to cure edema. It also provides relief in piles, diarrhea, ''[[vata]]-gulma'', polyuria and stimulates digestion and metabolism (''agni''). <br /> <br /> During the treatment the diet should be taken with buttermilk prepared as above with ''chitraka'' along with ghee prepared from the above butter or gruels prepared with this butter milk and ghee. Thus ''chitraka ghrita'' is described [58-59]<br /> <br /> === Yavagu preparations ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> जीवन्त्यजाजीशटिपुष्कराह्वैः सकारवीचित्रकबिल्वमध्यैः| &lt;br /&gt;<br /> सयावशूकैर्बदरप्रमाणैर्वृक्षाम्लयुक्ता घृततैलभृष्टा||६०|| &lt;br /&gt;<br /> <br /> अर्शोऽतिसारानिलगुल्मशोफहृद्रोगमन्दाग्निहिता यवागूः| &lt;br /&gt;<br /> या पञ्चकोलैर्विधिनैव [१६] तेन सिद्धा भवेत् सा च समा तयैव||६१|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> jīvantyajājīśaṭipuṣkarāhvaiḥ sakāravīcitrakabilvamadhyaiḥ| &lt;br /&gt;<br /> sayāvaśūkairbadarapramāṇairvr̥kṣāmlayuktā ghr̥tatailabhr̥ṣṭā||60|| &lt;br /&gt;<br /> <br /> arśō'tisārānilagulmaśōphahr̥drōgamandāgnihitā yavāgūḥ| &lt;br /&gt;<br /> yā pañcakōlairvidhinaiva [16] tēna siddhā bhavēt sā ca samā tayaiva||61|| &lt;br /&gt;<br /> <br /> jIvantyajAjIshaTipuShkarAhvaiH sakAravIcitrakabilvamadhyaiH| &lt;br /&gt;<br /> sayAvashUkairbadarapramANairvRukShAmlayuktA ghRutatailabhRuShTA||60|| &lt;br /&gt;<br /> <br /> arsho~atisArAnilagulmashophahRudrogamandAgnihitA yavAgUH| &lt;br /&gt;<br /> yA pa~jcakolairvidhinaiva [16] tena siddhA bhavet sA ca samA tayaiva||61|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take 5 gm each of ''jivanti,'' cumin, ''saṭi, pushkarmula, karvi'' (celery), ''chitraka, bilva'' and ''yavakashara,'' make a medicated gruel (''yavāgu'') and then fry it in ghee and oil. This gruel taken by adding ''vrikshamla'' cures piles, diarrhea, ''[[vata]] gulma'', edema, heart disease and low digestion. <br /> <br /> The medicated ''yavāgu'' (gruel) similarly prepared with ''panchakola'' also gives the same relief as mentioned above (60-61).<br /> <br /> === ''Pathya'' (wholesome food) for ''shotha'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कुलत्थयूषश्च सपिप्पलीको मौद्गश्च सत्र्यूषणयावशूकः| &lt;br /&gt;<br /> रसस्तथा विष्किरजाङ्गलानां सकूर्मगोधाशिखिशल्लकानाम्||६२|| &lt;br /&gt;<br /> <br /> सुवर्चला गृञ्जनकं पटोलं सवायसीमूलकवेत्रनिम्बम्| &lt;br /&gt;<br /> शाकार्थिनां शाकमिति प्रशस्तं भोज्ये पुराणश्च यवः सशालिः||६३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kulatthayūṣaśca sapippalīkō maudgaśca satryūṣaṇayāvaśūkaḥ| &lt;br /&gt;<br /> rasastathā viṣkirajāṅgalānāṁ sakūrmagōdhāśikhiśallakānām||62|| &lt;br /&gt;<br /> <br /> suvarcalā gr̥ñjanakaṁ paṭōlaṁ savāyasīmūlakavētranimbam| &lt;br /&gt;<br /> śākārthināṁ śākamiti praśastaṁ bhōjyē purāṇaśca yavaḥ saśāliḥ||63||&lt;br /&gt;<br /> <br /> kulatthayUShashca sapippalIko maudgashca satryUShaNayAvashUkaH| &lt;br /&gt;<br /> rasastathA viShkirajA~ggalAnAM sakUrmagodhAshikhishallakAnAm||62|| &lt;br /&gt;<br /> <br /> suvarcalA gRu~jjanakaM paTolaM savAyasImUlakavetranimbam| &lt;br /&gt;<br /> shAkArthinAM shAkamiti prashastaM bhojye purANashca yavaH sashAliH||63||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Followings diet articles are wholesome for the patient of edema/swelling:<br /> *Soup of ''kulattha'' mixed with long piper<br /> *Soup of ''munga'' mixed with ''trikatu'' and ''yavakshara''<br /> *Meat soup of gallinaceous and wild creatures,<br /> *Meat soup of tortoise, iguana, peacock and pangolin,<br /> *Vegetables such as heliotrope, turnip, ''makoya'' (wild snake gourd), radish, ''vetra, neem'' and ''patola''<br /> *Old ''shali rice'' and old barley [62-63]<br /> <br /> === External applications ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> आभ्यन्तरं भेषजमुक्तमेतद्बर्हिर्हितं यच्छृणु तद्यथावत्| &lt;br /&gt;<br /> स्नेहान् प्रदेहान् परिषेचनानि स्वेदांश्च वातप्रबलस्य कुर्यात्||६४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ābhyantaraṁ bhēṣajamuktamētadbarhirhitaṁ yacchr̥ṇu tadyathāvat| &lt;br /&gt;<br /> snēhān pradēhān pariṣēcanāni svēdāṁśca vātaprabalasya kuryāt||64|| &lt;br /&gt;<br /> <br /> AbhyantaraM bheShajamuktametadbarhirhitaM yacchRuNu tadyathAvat| &lt;br /&gt;<br /> snehAn pradehAn pariShecanAni svedAMshca vAtaprabalasya kuryAt||64|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus internal preparations have been described. Now external preparations beneficial for the patient of swelling will be described. ''[[Snehana]], [[swedana]],'' smearing with pastes and effusions should be done in a patient having dominance of ''[[vata]]'' swelling [64]<br /> <br /> === ''Shaileyadi taila'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शैलेयकुष्ठागुरुदारुकौन्तीत्वक्पद्मकैलाम्बुपलाशमुस्तैः| &lt;br /&gt;<br /> प्रियङ्गुथौणेयकहेममांसीतालीशपत्रप्लवपत्रधान्यैः||६५|| &lt;br /&gt;<br /> <br /> श्रीवेष्टकध्यामकपिप्पलीभिः स्पृक्कानखैश्चैव यथोपलाभम्| &lt;br /&gt;<br /> वातान्वितेऽभ्यङ्गमुशन्ति तैलं सिद्धं सुपिष्टैरपि च प्रदेहम्||६६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śailēyakuṣṭhāgurudārukauntītvakpadmakailāmbupalāśamustaiḥ| &lt;br /&gt;<br /> priyaṅguthauṇēyakahēmamāṁsītālīśapatraplavapatradhānyaiḥ||65|| &lt;br /&gt;<br /> <br /> śrīvēṣṭakadhyāmakapippalībhiḥ spr̥kkānakhaiścaiva yathōpalābham| &lt;br /&gt;<br /> vātānvitē'bhyaṅgamuśanti tailaṁ siddhaṁ supiṣṭairapi ca pradēham||66|| &lt;br /&gt;<br /> <br /> shaileyakuShThAgurudArukauntItvakpadmakailAmbupalAshamustaiH| &lt;br /&gt;<br /> priya~gguthauNeyakahemamAMsItAlIshapatraplavapatradhAnyaiH||65|| &lt;br /&gt;<br /> <br /> shrIveShTakadhyAmakapippalIbhiH spRukkAnakhaishcaiva yathopalAbham| &lt;br /&gt;<br /> vAtAnvite~abhya~ggamushanti tailaM siddhaM supiShTairapi ca pradeham||66||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take ''kuṣṭha, aguru, devadāru, kaunti,'' cinnamon, ''padmaka,'' cardamom, ''sugandhabālā, palāśa, mustaka, priyangu, thauneyaka, nāgakeśara, jatāmāmsi, tālisapatra, plava, tejapatra,'' coriander, ''sriveshtaka, dhyāmaka,'' piper longum, ''sprikkā'' and ''nakha''. Make paste of all or as much as drugs available and prepare medicated oil from it. In ''[[vata]]'' edema, do massage with this oil. Alternatively make paste of the entire drugs and apply on the body of the patient as smear [65-66] <br /> <br /> === Medicated water for bath ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> जलैश्च वासार्ककरञ्जशिग्रुकाश्मर्यपत्रार्जकजैश्च सिद्धैः| &lt;br /&gt;<br /> स्विन्नो मृदूष्णै रवितप्ततोयैः स्नातश्च गन्धैरनुलेपनीयः||६७|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> jalaiśca vāsārkakarañjaśigrukāśmaryapatrārjakajaiśca siddhaiḥ| &lt;br /&gt;<br /> svinnō mr̥dūṣṇai ravitaptatōyaiḥ snātaśca gandhairanulēpanīyaḥ||67||&lt;br /&gt;<br /> <br /> jalaishca vAsArkakara~jjashigrukAshmaryapatrArjakajaishca [17] siddhaiH| &lt;br /&gt;<br /> svinno mRudUShNai [18] ravitaptatoyaiH snAtashca gandhairanulepanIyaH||67||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Add leaves of ''vāsā, arka, karanja, sigru, kashmarya'' and holy basil in hot water and take sudation with this tolerably hot water. Then the patient should take bath with water heated in sun and apply aromatics on the body [67]<br /> <br /> === External application in ''[[pitta]]'' dominance ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> सवेतसाः क्षीरवतां द्रुमाणां त्वचः समञ्जिष्ठलतामृणालाः| &lt;br /&gt;<br /> सचन्दनाः पद्मकवालकौ च पैत्ते प्रदेहस्तु सतैलपाकः||६८|| &lt;br /&gt;<br /> <br /> आक्तस्य तेनाम्बु रविप्रतप्तं सचन्दनं साभयपद्मकं च| &lt;br /&gt;<br /> स्नाने हितं क्षीरवतां कषायः क्षीरोदकं चन्दनलेपनं च||६९|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> savētasāḥ kṣīravatāṁ drumāṇāṁ tvacaḥ samañjiṣṭhalatāmr̥ṇālāḥ| &lt;br /&gt;<br /> sacandanāḥ padmakavālakau ca paittē pradēhastu satailapākaḥ||68|| &lt;br /&gt;<br /> <br /> āktasya tēnāmbu raviprataptaṁ sacandanaṁ sābhayapadmakaṁ ca| &lt;br /&gt;<br /> snānē hitaṁ kṣīravatāṁ kaṣāyaḥ kṣīrōdakaṁ candanalēpanaṁ ca||69||&lt;br /&gt;<br /> <br /> savetasAH kShIravatAM drumANAM tvacaH sama~jjiShThalatAmRuNAlAH| &lt;br /&gt;<br /> sacandanAH padmakavAlakau ca paitte pradehastu satailapAkaH||68|| &lt;br /&gt;<br /> <br /> Aktasya tenAmbu raviprataptaM sacandanaM sAbhayapadmakaM ca| &lt;br /&gt;<br /> snAne hitaM kShIravatAM kaShAyaH kShIrodakaM candanalepanaM ca||69||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Prepare medicated oil from ''vetasa, manjiṣhthā, mrināla,'' sandal, ''padmaka'' and ''khasha'' and bark of latex-exuding plants. Apply this oil on the body to relieve ''[[pitta]]'' swelling. Thereafter, bathing with medicated water prepared with sandal, ''khaśa'' and ''padmaka'' and heated by sun rays or with water prepared with latex-exuding plants or water mixed with milk is beneficial. Smearing with paste of sandalwood is also beneficial [68-69] <br /> <br /> === External application in ''[[kapha]]'' dominance ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> कफे तु कृष्णासिकतापुराणपिण्याकशिग्रुत्वगुमाप्रलेपः| &lt;br /&gt;<br /> कुलत्थशुण्ठीजलमूत्रसेकश्चण्डागुरुभ्यामनुलेपनं च||७०|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kaphē tu kr̥ṣṇāsikatāpurāṇapiṇyākaśigrutvagumāpralēpaḥ| &lt;br /&gt;<br /> kulatthaśuṇṭhījalamūtrasēkaścaṇḍāgurubhyāmanulēpanaṁ ca||70|| &lt;br /&gt;<br /> <br /> kaphe tu kRuShNAsikatApurANapiNyAkashigrutvagumApralepaH| &lt;br /&gt;<br /> kulatthashuNThIjalamUtrasekashcaNDAgurubhyAmanulepanaM ca||70|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In ''[[kapha]]'' dominant edema, application of paste of long pepper, sand, old oil-cake, bark of drum-stick and linseed is advised. <br /> Effusion with decoction of ''kulattha'' (hoarse gram), dry ginger and cow’s urine followed by anointing of the body with paste of sandal and ''aguru'' is also beneficial (70). <br /> <br /> === External application in burning sensation ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> बिभीतकानां फलमध्यलेपः सर्वेषु दाहार्तिहरः प्रदिष्टः| &lt;br /&gt;<br /> यष्ट्याह्वमुस्तैः सकपित्थपत्रैः सचन्दनैस्तत्पिडकासु लेपः||७१|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bibhītakānāṁ phalamadhyalēpaḥ sarvēṣu dāhārtiharaḥ pradiṣṭaḥ| &lt;br /&gt;<br /> yaṣṭyāhvamustaiḥ sakapitthapatraiḥ sacandanaistatpiḍakāsu lēpaḥ||71|| &lt;br /&gt;<br /> <br /> bibhItakAnAM phalamadhyalepaH sarveShu dAhArtiharaH pradiShTaH| &lt;br /&gt;<br /> yaShTyAhvamustaiH sakapitthapatraiH sacandanaistatpiDakAsu lepaH||71|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In all types of swelling, smearing with paste of fruit of ''vibhitaka'' is recommended to cure burning sensation and discomfort. <br /> The topical application of paste of leaves of ''kapittha'' (wood apple), sandal, liquorices and ''mustaka'' provides relief in papules [71] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> रास्नावृषार्कत्रिफलाविडङ्गं शिग्रुत्वचो मूषिकपर्णिका च| &lt;br /&gt;<br /> निम्बार्जकौ व्याघ्रनखः सदूर्वा सुवर्चला तिक्तकरोहिणी च||७२|| &lt;br /&gt;<br /> <br /> सकाकमाची बृहती सकुष्ठा पुनर्नवा चित्रकनागरे च| &lt;br /&gt;<br /> उन्मर्दनं शोफिषु मूत्रपिष्टं शस्तस्तथा मूलकतोयसेकः||७३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> rāsnāvr̥ṣārkatriphalāviḍaṅgaṁ śigrutvacō mūṣikaparṇikā ca| &lt;br /&gt;<br /> nimbārjakau vyāghranakhaḥ sadūrvā suvarcalā tiktakarōhiṇī ca||72|| &lt;br /&gt;<br /> <br /> sakākamācī br̥hatī sakuṣṭhā punarnavā citrakanāgarē ca| &lt;br /&gt;<br /> unmardanaṁ śōphiṣu mūtrapiṣṭaṁ śastastathā mūlakatōyasēkaḥ||73||&lt;br /&gt;<br /> <br /> rAsnAvRuShArkatriphalAviDa~ggaM shigrutvaco mUShikaparNikA ca| &lt;br /&gt;<br /> nimbArjakau vyAghranakhaH sadUrvA suvarcalA tiktakarohiNI ca||72|| &lt;br /&gt;<br /> <br /> sakAkamAcI bRuhatI sakuShThA punarnavA citrakanAgare ca| &lt;br /&gt;<br /> unmardanaM shophiShu mUtrapiShTaM shastastathA mUlakatoyasekaH||73||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Take ''rāsnā, vāsā, arka, triphalā, vidanga,'' bark of ''sigru, mushakaparni, neem,'' holy basin, nails of ''vyāghra'' (shell), ''durvā'', sunflower, ''katukā, kākamāchi, brihati, kuṣtha, punarnavā, chitraka'' and dry ginger and make paste with cow’s urine. ''Unmardana'' type of massage with it is beneficial for swelling. Also effusion done with water boiled with above drugs is beneficial [72-73]<br /> <br /> === Various types of local swellings ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> शोफास्तु गात्रावयवाश्रिता ये ते स्थानदूष्याकृतिनामभेदात्| &lt;br /&gt;<br /> अनेकसङ्ख्याः कतिचिच्च तेषां निदर्शनार्थं गदतो निबोध||७४|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> śōphāstu gātrāvayavāśritā yē tē sthānadūṣyākr̥tināmabhēdāt| &lt;br /&gt;<br /> anēkasaṅkhyāḥ katicicca tēṣāṁ nidarśanārthaṁ gadatō nibōdha||74||&lt;br /&gt;<br /> <br /> shophAstu gAtrAvayavAshritA ye te sthAnadUShyAkRutinAmabhedAt| &lt;br /&gt;<br /> anekasa~gkhyAH [19] katicicca teShAM nidarshanArthaM gadato nibodha||74||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The swelling occurring in one limb or organ is of many types owing to their different classifications based on involved site, ''[[duṣhya]],'' shape and name. Listen to the descriptions of some of them being given as illustration [74] <br /> <br /> === ''Shira Shopha'' (cellulitis of head) and ''Salūka'' (quinsy) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> दोषास्त्रयः स्वैः कुपिता निदानैः कुर्वन्ति शोफं शिरसः सुघोरम्|&lt;br /&gt;<br /> अन्तर्गले घुर्घुरिकान्वितं च शालूकमुच्छ्वासनिरोधकारि||७५|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> dōṣāstrayaḥ svaiḥ kupitā nidānaiḥ kurvanti śōphaṁ śirasaḥ sughōram|&lt;br /&gt;<br /> antargalē ghurghurikānvitaṁ ca śālūkamucchvāsanirōdhakāri||75||&lt;br /&gt;<br /> <br /> doShAstrayaH svaiH kupitA nidAnaiH kurvanti shophaM shirasaH sughoram|&lt;br /&gt;<br /> antargale ghurghurikAnvitaM ca shAlUkamucchvAsanirodhakAri||75||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> All the three [[dosha]], provoked by indulging in their etiological factors produce severe inflammation of head. <br /> When it affects inside of the throat, it produces sālūka, which is accompanied with stertorous breathing and obstruction to expiration [75]<br /> <br /> === ''Bidalika'' (Ludwig’s angina) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गलस्य सन्धौ चिबुके गले च सदाहरागः श्वसनासु चोग्रः| &lt;br /&gt;<br /> शोफो भृशार्तिस्तु बिडालिका स्याद्धन्याद्गले चेद्वलयीकृता सा||७६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> galasya sandhau cibukē galē ca sadāharāgaḥ śvasanāsu cōgraḥ| &lt;br /&gt;<br /> śōphō bhr̥śārtistu biḍālikā syāddhanyādgalē cēdvalayīkr̥tā sā||76||&lt;br /&gt;<br /> <br /> galasya sandhau cibuke gale ca sadAharAgaH shvasanAsu [20] cograH| &lt;br /&gt;<br /> shopho bhRushArtistu biDAlikA [21] syAddhanyAdgale cedvalayIkRutA sA||76||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Acute swelling at the junction of throat behind the chin i.e. in trachea with redness and burning sensation in throat and causes obstruction to breathing with very much discomfort is known as ''biḍālikā''. It kills the patient if folds are formed in throat [76]<br /> <br /> === ''Talu-vidradhi'' (palatal abscess), ''upajihvika'' (superficial glossitis) and ''adhijihvikā'' (sub-lingual glossitis) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> स्यात्तालुविद्रध्यपि दाहरागपाकान्वितस्तालुनि सा त्रिदोषात्| &lt;br /&gt;<br /> जिह्वोपरिष्टादुपजिह्विका स्यात् कफादधस्तादधिजिह्विका च||७७|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> syāttāluvidradhyapi dāharāgapākānvitastāluni sā tridōṣāt| &lt;br /&gt;<br /> jihvōpariṣṭādupajihvikā syāt kaphādadhastādadhijihvikā ca||77|| &lt;br /&gt;<br /> <br /> syAttAluvidradhyapi dAharAgapAkAnvitastAluni sA tridoShAt| &lt;br /&gt;<br /> jihvopariShTAdupajihvikA syAt kaphAdadhastAdadhijihvikA ca||77|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Abscess in palate caused by ''tridosha'' with burning sensation, redness and pus formation is known as ''tālu-vidradhi''. <br /> <br /> Swelling due to ''[[kapha]]'' occurring on the upper part of tongue is called ''upajihvikā'' (acute superficial glossitis) and which occurs sublingual part is called a''dhijihvikā'' (sub lingual glossitis) [77] <br /> <br /> === ''Upakusha'' (gingivitis) and ''danta-vidradhi'' (dental abscess) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यो दन्तमांसेषु तु रक्तपित्तात् पाको भवेत् सोपकुशः प्रदिष्टः| &lt;br /&gt;<br /> स्याद्दन्तविद्रध्यपि दन्तमांसे शोफः कफाच्छोणितसञ्चयोत्थः||७८|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yō dantamāṁsēṣu tu raktapittāt pākō bhavēt sōpakuśaḥ pradiṣṭaḥ| &lt;br /&gt;<br /> syāddantavidradhyapi dantamāṁsē śōphaḥ kaphācchōṇitasañcayōtthaḥ||78||&lt;br /&gt;<br /> <br /> yo dantamAMseShu tu raktapittAt pAko bhavet sopakushaH pradiShTaH| &lt;br /&gt;<br /> syAddantavidradhyapi dantamAMse shophaH kaphAcchoNitasa~jcayotthaH||78||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Provoked ''[[rakta]]'' and ''[[pitta]]'' causes suppuration of the gums and it is called ''upakusha''. Accumulation of ''[[kapha]]'' and ''[[rakta]]'' produces elevated swelling in gums and it is known as ''danta-vidradhi'' [78]<br /> <br /> === ''Galaganḍa'' (goiter),''gandamala'' (cervical adenitis) and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> गलस्य पार्श्वे गलगण्ड एकः स्याद्गण्डमाला बहुभिस्तु गण्डैः| &lt;br /&gt;<br /> साध्याः स्मृताः पीनसपार्श्वशूलकासज्वरच्छर्दियुतास्त्वसाध्याः||७९|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> galasya pārśvē galagaṇḍa ēkaḥ syādgaṇḍamālā bahubhistu gaṇḍaiḥ| &lt;br /&gt;<br /> sādhyāḥ smr̥tāḥ pīnasapārśvaśūlakāsajvaracchardiyutāstvasādhyāḥ||79|| &lt;br /&gt;<br /> <br /> galasya pArshve galagaNDa ekaH syAdgaNDamAlA bahubhistu gaNDaiH| &lt;br /&gt;<br /> sAdhyAH smRutAH pInasapArshvashUlakAsajvaracchardiyutAstvasAdhyAH||79|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Single glandular swelling on the (middle) of neck is called ''galagaṇḍa'' (goiter) but if there are many nodular swellings making a chain like appearance, is known as ''gandamālā''. Generally they are curable but if accompanied with coryza, pain in side of the chest, cough, fever and vomiting then they are incurable [79] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तेषां सिराकायशिरोविरेका धूमः पुराणस्य घृतस्य पानम्| &lt;br /&gt;<br /> स्याल्लङ्घनं वक्त्रभवेषु चापि प्रघर्षणं स्यात् कवलग्रहश्च||८०|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tēṣāṁ sirākāyaśirōvirēkā dhūmaḥ purāṇasya ghr̥tasya pānam| &lt;br /&gt;<br /> syāllaṅghanaṁ vaktrabhavēṣu cāpi pragharṣaṇaṁ syāt kavalagrahaśca||80||&lt;br /&gt;<br /> <br /> teShAM sirAkAyashirovirekA dhUmaH purANasya ghRutasya pAnam| &lt;br /&gt;<br /> syAlla~gghanaM vaktrabhaveShu cApi pragharShaNaM syAt kavalagrahashca||80||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> In all the above mentioned conditions blood-letting, purgation, ''[[nasya]], dhuma'' (medicated smoking therapy) and intake of old ghee is beneficial. <br /> <br /> For the conditions specially affecting mouth, the line of treatment is ''[[langhana]]'' and rubbing with medicated powders and mouth washes (''kavala'') are beneficial [80]<br /> <br /> === ''Granthi'' (nodule) and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अङ्गैकदेशेष्वनिलादिभिः स्यात् स्वरूपधारी स्फुरणः सिराभिः| &lt;br /&gt;<br /> ग्रन्थिर्महान्मांसभवस्त्वनर्तिर्मेदोभवः स्निग्धतमश्चलश्च||८१|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> aṅgaikadēśēṣvanilādibhiḥ syāt svarūpadhārī sphuraṇaḥ sirābhiḥ| &lt;br /&gt;<br /> granthirmahānmāṁsabhavastvanartirmēdōbhavaḥ snigdhatamaścalaśca||81|| &lt;br /&gt;<br /> <br /> a~ggaikadesheShvanilAdibhiH syAt svarUpadhArI sphuraNaH sirAbhiH| &lt;br /&gt;<br /> granthirmahAnmAMsabhavastvanartirmedobhavaH snigdhatamashcalashca||81|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Swelling occurring in one organ or region due to ''[[vata]]'' or other ''[[dosha]]'' may be diagnosed on the basis of their characteristic symptoms. The swelling occurring in vessels are pulsating in nature. The nodular swelling occurring in muscles is large in size. Swelling of the adipose tissues is excessively unctuous and movable [81]<br /> <br /> === Surgical management of ''granthi'' ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> संशोधिते स्वेदितमश्मकाष्ठैः साङ्गुष्ठदण्डैर्विलयेदपक्वम्| &lt;br /&gt;<br /> विपाट्य चोद्धृत्य भिषक् सकोशं शस्त्रेण दग्ध्वा व्रणवच्चिकित्सेत्||८२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> saṁśōdhitē svēditamaśmakāṣṭhaiḥ sāṅguṣṭhadaṇḍairvilayēdapakvam| &lt;br /&gt;<br /> vipāṭya cōddhr̥tya bhiṣak sakōśaṁ śastrēṇa dagdhvā vraṇavaccikitsēt||82||&lt;br /&gt;<br /> <br /> saMshodhite sveditamashmakAShThaiH sA~gguShThadaNDairvilayedapakvam| &lt;br /&gt;<br /> vipATya coddhRutya bhiShak sakoshaM shastreNa dagdhvA vraNavaccikitset||82|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the tumor is non-suppurative then after purification therapy, local sudation of the swelling should be done. Then the physician should try to dissolve the swelling by rubbing with stone or wooden apparatus or with manipulation of thumb or of a rod. Then it should be cut open and take out the tumor with its capsule. Then it should be cauterized and treatment of regular wound should be adopted [82] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> अदग्ध ईषत् परिशेषितश्च प्रयाति भूयोऽपि शनैर्विवृद्धिम्| &lt;br /&gt;<br /> तस्मादशेषः कुशलैः समन्ताच्छेद्यो भवेद्वीक्ष्य शरीरदेशान्||८३|| &lt;br /&gt;<br /> <br /> शेषे कृते पाकवशेन शीर्यात्ततः क्षतोत्थः प्रसरेद्विसर्पः| &lt;br /&gt;<br /> उपद्रवं तं प्रविचार्य तज्ज्ञस्तैर्भेषजैः पूर्वतरैर्यथोक्तैः||८४|| &lt;br /&gt;<br /> <br /> निवारयेदादित एव यत्नाद्विधानवित् स्वस्वविधिं विधाय| &lt;br /&gt;<br /> ततः क्रमेणास्य यथाविधानं व्रणं व्रणज्ञस्त्वरया चिकित्सेत्||८५|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> adagdha īṣat pariśēṣitaśca prayāti bhūyō'pi śanairvivr̥ddhim| &lt;br /&gt;<br /> tasmādaśēṣaḥ kuśalaiḥ samantācchēdyō bhavēdvīkṣya śarīradēśān||83|| &lt;br /&gt;<br /> <br /> śēṣē kr̥tē pākavaśēna śīryāttataḥ kṣatōtthaḥ prasarēdvisarpaḥ| &lt;br /&gt;<br /> upadravaṁ taṁ pravicārya tajjñastairbhēṣajaiḥ [22] pūrVātarairyathōktaiḥ||84|| &lt;br /&gt;<br /> <br /> nivārayēdādita [23] ēva yatnādvidhānavit svasvavidhiṁ vidhāya| &lt;br /&gt;<br /> tataḥ kramēṇāsya yathāvidhānaṁ vraṇaṁ vraṇajñastvarayā cikitsēt||85|| &lt;br /&gt;<br /> <br /> adagdha IShat parisheShitashca prayAti bhUyo~api shanairvivRuddhim| &lt;br /&gt;<br /> tasmAdasheShaH kushalaiH samantAcchedyo bhavedvIkShya sharIradeshAn||83|| &lt;br /&gt;<br /> <br /> sheShe kRute pAkavashena shIryAttataH kShatotthaH prasaredvisarpaH| &lt;br /&gt;<br /> upadravaM taM pravicArya tajj~jastairbheShajaiH [22] pUrvatarairyathoktaiH||84|| &lt;br /&gt;<br /> <br /> nivArayedAdita [23] eva yatnAdvidhAnavit svasvavidhiM vidhAya| &lt;br /&gt;<br /> tataH krameNAsya yathAvidhAnaM vraNaM vraNaj~jastvarayA cikitset||85|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> If the tumor is not properly cauterized or if some of its part is left out then it starts gradually increasing again. In that case it should be removed completely by opening from all sides by the skillful surgeon keeping in view the regional anatomy. If some portion is still left then it may suppurate and slough and may lead to complication of ''visarpa'' (erysipelas). The surgeon considering it as the severe complication first should try to treat it with great care by appropriate remedies described earlier. Therefore the wound specialist should quickly treat it in the prescribed manner following the appropriate line of treatment [83-85] <br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विवर्जयेत् कुक्ष्युदराश्रितं च तथा गले मर्मणि संश्रितं च| &lt;br /&gt;<br /> स्थूलः खरश्चापि भवेद्विवर्ज्यो यश्चापि बालस्थविराबलानाम्||८६|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> vivarjayēt kukṣyudarāśritaṁ ca tathā galē marmaṇi saṁśritaṁ ca| &lt;br /&gt;<br /> sthūlaḥ kharaścāpi bhavēdvivarjyō yaścāpi bālasthavirābalānām||86||&lt;br /&gt;<br /> <br /> vivarjayet kukShyudarAshritaM ca tathA gale marmaNi saMshritaM ca| &lt;br /&gt;<br /> sthUlaH kharashcApi bhavedvivarjyo yashcApi bAlasthavirAbalAnAm||86||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The tumors occurring in flanks, abdomen, in the throat and in vital organs are incurable. Similarly tumors of big size and indurated which occurs in children, aged and weak are also incurable [86]<br /> <br /> === Differential diagnosis of ''arbuda'' (tumor) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ग्रन्थ्यर्बुदानां च यतोऽविशेषः प्रदेशहेत्वाकृतिदोषदूष्यैः| &lt;br /&gt;<br /> ततश्चिकित्सेद्भिषगर्बुदानि विधानविद्ग्रन्थिचिकित्सितेन||८७|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> granthyarbudānāṁ ca yatō'viśēṣaḥ pradēśahētvākr̥tidōṣadūṣyaiḥ| &lt;br /&gt;<br /> tataścikitsēdbhiṣagarbudāni vidhānavidgranthicikitsitēna||87||&lt;br /&gt;<br /> <br /> granthyarbudAnAM ca yato~avisheShaH pradeshahetvAkRutidoShadUShyaiH| &lt;br /&gt;<br /> tatashcikitsedbhiShagarbudAni vidhAnavidgranthicikitsitena||87||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> There is no much difference in nodules and tumors with regards to site, causative factors, shape, ''[[dosha]]'' morbidity and ''[[dushya]]'' (susceptible tissues). Therefore, tumor specialist should treat the tumor on the line of nodules described above [87]<br /> <br /> === ''Alaji'' and ''akshata'' (whitlow)===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ताम्रा सशूला पिडका भवेद्या सा चालजी नाम परिस्रुताग्रा| &lt;br /&gt;<br /> शोफोऽक्षतश्चर्मनखान्तरे स्यान्मांसास्रदूषी भृशशीघ्रपाकः||८८|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tāmrā saśūlā piḍakā bhavēdyā sā cālajī nāma parisrutāgrā| &lt;br /&gt;<br /> śōphō'kṣataścarmanakhāntarē syānmāṁsāsradūṣī bhr̥śaśīghrapākaḥ||88||&lt;br /&gt;<br /> <br /> tAmrA sashUlA [25] piDakA bhavedyA sA cAlajI nAma parisrutAgrA| &lt;br /&gt;<br /> shopho~akShatashcarmanakhAntare [26] syAnmAMsAsradUShI bhRushashIghrapAkaH||88|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Appearing of copper colored papules with acute pain from which pus oozes out is known as alajī.<br /> The severe inflammation occurring by vitiating flesh and blood in the skin adjoining nail which suppurates quickly is known as akṣata [88]<br /> <br /> === ''Vidarika'' (lymphadenitis) and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ज्वरान्विता वङ्क्षणकक्षजा या वर्तिर्निरर्तिः कठिनायता च| &lt;br /&gt;<br /> विदारिका सा कफमारुताभ्यां तेषां यथादोषमुपक्रमः स्यात्||८९|| &lt;br /&gt;<br /> <br /> विस्रावणं पिण्डिकयोपनाहः पक्वेषु चैव व्रणवच्चिकित्सा| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> jvarānvitā vaṅkṣaṇakakṣajā yā vartirnirartiḥ kaṭhināyatā ca| &lt;br /&gt;<br /> vidārikā sā kaphamārutābhyāṁ tēṣāṁ yathādōṣamupakramaḥ syāt||89|| &lt;br /&gt;<br /> <br /> visrāvaṇaṁ piṇḍikayōpanāhaḥ pakvēṣu caiva vraṇavaccikitsā|&lt;br /&gt;<br /> <br /> jvarAnvitA va~gkShaNakakShajA yA vartirnirartiH kaThinAyatA ca| &lt;br /&gt;<br /> vidArikA sA kaphamArutAbhyAM teShAM yathAdoShamupakramaH syAt||89|| &lt;br /&gt;<br /> <br /> visrAvaNaM piNDikayopanAhaH pakveShu caiva vraNavaccikitsA|&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Painless cylindrical and hard swelling in the groin or axillary region accompanied with fever is known as ''vidārikā''. It occurs due to vitiation of ''[[kapha]]'' and ''[[vata]]'' and should be managed according to the treatment of these ''[[dosha]]'', which include bloodletting, ''pinda sweda, upanāha'' and on suppuration it should be treated on the line of abscess [89]<br /> <br /> === ''Visphotaka'' (eruption) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> विस्फोटकाः सर्वशरीरगास्तु स्फोटाः [२७] सरागज्वरतर्षयुक्ताः||९०|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> visphōṭakāḥ sarvaśarīragāstu sphōṭāḥ [27] sarāgajvaratarṣayuktāḥ||90|| <br /> <br /> visphoTakAH sarvasharIragAstu sphoTAH [27] sarAgajvaratarShayuktAH||90|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Red colored eruptions occurring all over the body along with fever and thirst are known as ''visphōṭaka'' (90).<br /> <br /> === ''Kaksha'' (herpes zoster) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> यज्ञोपवीतप्रतिमाः प्रभूताः पित्तानिलाभ्यां जनितास्तु कक्षाः [२८] |<br /> <br /> याश्चापराः स्युः पिडकाः प्रकीर्णाः स्थूलाणुमध्या अपि पित्तजास्ताः||९१||<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yajñōpavītapratimāḥ prabhūtāḥ pittānilābhyāṁ janitāstu kakṣāḥ [28] | <br /> <br /> yāścāparāḥ syuḥ piḍakāḥ prakīrṇāḥ sthūlāṇumadhyā api pittajāstāḥ||91|| <br /> <br /> yaj~jopavItapratimAH prabhUtAH pittAnilAbhyAM janitAstu kakShAH [28] | <br /> <br /> yAshcAparAH syuH piDakAH prakIrNAH sthUlANumadhyA api pittajAstAH||91|| <br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Multiple eruptions occurring on the trunk due to ''[[pitta]]'' and ''[[vata]]'' where usually Hindu holy thread is worn, is known as ''kakṣā''. <br /> <br /> Other such types of eruptions (''pidikā'') whether big, medium or small are also due to ''[[pitta]]'' [91] <br /> <br /> === ''Romantika'' (measles) ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्षुद्रप्रमाणाः पिडकाः शरीरे सर्वाङ्गगाः सज्वरदाहतृष्णाः| &lt;br /&gt;<br /> कण्डूयुताः सारुचिसप्रसेका रोमान्तिकाः पित्तकफात् प्रदिष्टाः||९२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> kṣudrapramāṇāḥ piḍakāḥ śarīrē sarvāṅgagāḥ sajvaradāhatr̥ṣṇāḥ| &lt;br /&gt;<br /> kaṇḍūyutāḥ sārucisaprasēkā rōmāntikāḥ pittakaphāt pradiṣṭāḥ||92|| &lt;br /&gt;<br /> <br /> kShudrapramANAH piDakAH sharIre sarvA~ggagAH sajvaradAhatRuShNAH| &lt;br /&gt;<br /> kaNDUyutAH sArucisaprasekA romAntikAH pittakaphAt pradiShTAH||92|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Small sized eruption all over the body due to pitta and kapha along with fever, burning sensation, thirst, itching, anorexia and salivation are known as romāntikā (measles) [92]<br /> <br /> === Masurika (chickenpox) and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> याः सर्वगात्रेषु मसूरमात्रा मसूरिकाः पित्तकफात् प्रदिष्टाः| &lt;br /&gt;<br /> वीसर्पशान्त्यै विहिता क्रिया या तां तेषु कुष्ठे च हितां विदध्यात्||९३|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> yāḥ sarvagātrēṣu masūramātrā masūrikāḥ pittakaphāt pradiṣṭāḥ| &lt;br /&gt;<br /> vīsarpaśāntyai vihitā kriyā yā tāṁ tēṣu kuṣṭhē ca hitāṁ vidadhyāt||93||&lt;br /&gt;<br /> <br /> yAH sarvagAtreShu masUramAtrA masUrikAH pittakaphAt pradiShTAH| &lt;br /&gt;<br /> vIsarpashAntyai vihitA kriyA yA tAM teShu [29] kuShThe ca hitAM vidadhyAt||93||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Eruptions similar to size and shape of lentil (''masura'') occurring all over the body due to ''[[pitta]]'' and ''[[kapha]]'' is known as ''masurikā''; the treatment described for ''visarpa'' should is also adopted for it. For ''visphotaka'' etc., treatment described for ''kuṣtha'' should be adopted [93]<br /> <br /> === ''Bradhna'' (hernia) and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> ब्रध्नोऽनिलाद्यैर्वृषणे स्वलिङ्गैरन्त्रं निरेति प्रविशेन्मुहुश्च| &lt;br /&gt;<br /> मूत्रेण पूर्णं मृदु मेदसा चेत् स्निग्धं च विद्यात् कठिनं च शोथम्||९४|| &lt;br /&gt;<br /> <br /> विरेचनाभ्यङ्गनिरूहलेपाः पक्वेषु चैव व्रणवच्चिकित्सा| &lt;br /&gt;<br /> स्यान्मूत्रसेकः कफजं विपाट्य विशोध्य सीव्येद्व्रणवच्च पक्वम्||९५|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> bradhnō'nilādyairvr̥ṣaṇē svaliṅgairantraṁ nirēti praviśēnmuhuśca| &lt;br /&gt;<br /> mūtrēṇa pūrṇaṁ mr̥du mēdasā cēt snigdhaṁ ca vidyāt kaṭhinaṁ ca śōtham||94|| &lt;br /&gt;<br /> <br /> virēcanābhyaṅganirūhalēpāḥ pakvēṣu caiva vraṇavaccikitsā| &lt;br /&gt;<br /> syānmūtrasēkaḥ kaphajaṁ vipāṭya viśōdhya sīvyēdvraṇavacca pakvam||95||&lt;br /&gt;<br /> <br /> bradhno~anilAdyairvRuShaNe [30] svali~ggairantraM nireti pravishenmuhushca| &lt;br /&gt;<br /> mUtreNa pUrNaM mRudu medasA cet snigdhaM ca vidyAt kaThinaM ca shotham||94|| &lt;br /&gt;<br /> <br /> virecanAbhya~gganirUhalepAH pakveShu caiva vraNavaccikitsA| &lt;br /&gt;<br /> syAnmUtrasekaH [31] kaphajaM vipATya vishodhya sIvyedvraNavacca pakvam||95|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Due to ''[[vata]]'' or other ''[[dosha]]'', the intestine frequently enters into scrotum and comes out and this condition is known as bradhna (hernia). <br /> <br /> If liquid (''mutra'') accumulates in scrotum then the swelling is soft (hydrocele).<br /> <br /> If fat accumulates in scrotum it is hard and unctuous. <br /> <br /> Its treatment is ''[[virechana]] karma'', oil massage, ''niruha [[basti]]'' and smearing of paste. If it suppurates then treatment of ulcer (''vrana'') should be adopted. <br /> <br /> If there is oozing of liquid (''[[mutra]]'') and the swelling is due to ''[[kapha]],'' then it should be open up, cleaned and sutured as per line of treatment of ulcer [94-95]<br /> <br /> === Bhagandara (fistula-in-ano) and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> क्रिम्यस्थिसूक्ष्मक्षणनव्यवायप्रवाहणान्युत्कटकाश्वपृष्ठैः | &lt;br /&gt;<br /> गुदस्य पार्श्वे पिडका भृशार्तिः पक्वप्रभिन्ना तु भगन्दरः स्यात्||९६|| &lt;br /&gt;<br /> <br /> विरेचनं चैषणपाटनं च विशुद्धमार्गस्य च तैलदाहः| &lt;br /&gt;<br /> स्यात् क्षारसूत्रेण सुपाचितेन छिन्नस्य चास्य व्रणवच्चिकित्सा||९७|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> krimyasthisūkṣmakṣaṇanavyavāyapravāhaṇānyutkaṭakāśvapr̥ṣṭhaiḥ | &lt;br /&gt;<br /> gudasya pārśvē piḍakā bhr̥śārtiḥ pakvaprabhinnā tu bhagandaraḥ syāt||96|| &lt;br /&gt;<br /> <br /> virēcanaṁ caiṣaṇapāṭanaṁ ca viśuddhamārgasya ca tailadāhaḥ| &lt;br /&gt;<br /> syāt kṣārasūtrēṇa supācitēna chinnasya cāsya vraṇavaccikitsā||97||&lt;br /&gt;<br /> <br /> krimyasthisUkShmakShaNanavyavAyapravAhaNAnyutkaTakAshvapRuShThaiH [33] | &lt;br /&gt;<br /> gudasya pArshve piDakA bhRushArtiH pakvaprabhinnA tu bhagandaraH syAt||96|| &lt;br /&gt;<br /> <br /> virecanaM caiShaNapATanaM ca vishuddhamArgasya ca tailadAhaH| &lt;br /&gt;<br /> syAt kShArasUtreNa supAcitena [34] chinnasya cAsya vraNavaccikitsA||97||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> On the lateral side of anus, a very painful pustule (''pidika'') occurs which suppurates and opens up; it is known as ''bhagandara'' (fistula-in-ano). It is caused by infection (''krimi''), injury with pointed object like bone leading to minute erosion, excessive sex, straining at defecation and friction due to sitting on hard seat of a horse or moving object. <br /> <br /> Its treatment is ''[[virechana]]'', probing, cutting and after cleansing cauterization with hot oil. If surgery is contraindicated then ''kshara-sutra'' should be applied and during and after cutting the track, routine line of management of ulcer is adopted [96-97]<br /> <br /> === ''Shlipada'' (elephantiasis) and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> जङ्घासु पिण्डीप्रपदोपरिष्टात् [३५] स्याच्छ्लीपदं मांसकफास्रदोषात्| &lt;br /&gt;<br /> सिराकफघ्नश्च विधिः समग्रस्तत्रेष्यते सर्षपलेपनं च||९८|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> jaṅghāsu piṇḍīprapadōpariṣṭāt [35] syācchlīpadaṁ māṁsakaphāsradōṣāt| &lt;br /&gt;<br /> sirākaphaghnaśca vidhiḥ samagrastatrēṣyatē sarṣapalēpanaṁ ca||98||&lt;br /&gt;<br /> <br /> ja~gghAsu piNDIprapadopariShTAt [35] syAcchlIpadaM mAMsakaphAsradoShAt| &lt;br /&gt;<br /> sirAkaphaghnashca vidhiH samagrastatreShyate sarShapalepanaM ca||98||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> The provoked ''[[kapha]]'' and ''[[rakta]]'' by involving flesh causes edema which begins from the upper part of the foot and spreads up to calf-muscle or shank; it is known as ''shlipada'' (elephantiasis). Its treatment is vene-section and local application of paste of mustard-seed as well as all other anti-''[[kapha]]'' treatment [98]<br /> <br /> === ''Jalakagardabha'' and its management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> मन्दास्तु पित्तप्रबलाः प्रदुष्टा दोषाः सुतीव्रं तनुरक्तपाकम्| &lt;br /&gt;<br /> कुर्वन्ति शोथं ज्वरतर्षयुक्तं विसर्पणं जालकगर्दभाख्यम्||९९|| &lt;br /&gt; <br /> <br /> विलङ्घनं रक्तविमोक्षणं च विरूक्षणं कायविशोधनं च| &lt;br /&gt;<br /> धात्रीप्रयोगाञ् शिशिरान् प्रदेहान् कुर्यात् सदा जालकगर्दभस्य||१००|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> mandāstu pittaprabalāḥ praduṣṭā dōṣāḥ sutīvraṁ tanuraktapākam| &lt;br /&gt;<br /> kurvanti śōthaṁ jvaratarṣayuktaṁ visarpaṇaṁ jālakagardabhākhyam||99|| &lt;br /&gt;<br /> <br /> vilaṅghanaṁ raktavimōkṣaṇaṁ ca virūkṣaṇaṁ kāyaviśōdhanaṁ ca| &lt;br /&gt;<br /> dhātrīprayōgāñ śiśirān pradēhān kuryāt sadā jālakagardabhasya||100||&lt;br /&gt;<br /> <br /> mandAstu pittaprabalAH praduShTA doShAH sutIvraM tanuraktapAkam| &lt;br /&gt;<br /> kurvanti shothaM jvaratarShayuktaM visarpaNaM jAlakagardabhAkhyam||99|| &lt;br /&gt;<br /> <br /> vila~gghanaM raktavimokShaNaM ca virUkShaNaM kAyavishodhanaM ca| &lt;br /&gt;<br /> dhAtrIprayogA~j shishirAn pradehAn kuryAt sadA jAlakagardabhasya||100||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Mildly provoked ''[[dosha]]'' with dominance of ''[[pitta]]'' causes very acute inflammation which slightly bleeds and suppurates, has a tendency of quick spreading and is accompanied by fever and thirst is known as ''jalakagardabha''. <br /> <br /> Its treatment is ''[[langhana]]'' (lightening therapy), blood-letting, un-unctuous therapy, ''[[virechana]]'', use of ''amalaki'' and application of paste of drugs having cold potency [99-100]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> एवंविधांश्चाप्यपरान् परीक्ष्य शोथप्रकाराननिलादिलिङ्गैः| &lt;br /&gt;<br /> शान्तिं नयेद्दोषहरैर्यथास्वमालेपनच्छेदनभेददाहैः||१०१|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ēvaṁvidhāṁścāpyaparān parīkṣya śōthaprakārānanilādiliṅgaiḥ| &lt;br /&gt;<br /> śāntiṁ nayēddōṣaharairyathāsvamālēpanacchēdanabhēdadāhaiḥ||101||&lt;br /&gt;<br /> <br /> evaMvidhAMshcApyaparAn parIkShya shothaprakArAnanilAdili~ggaiH| &lt;br /&gt;<br /> shAntiM nayeddoShaharairyathAsvamAlepanacchedanabhedadAhaiH||101||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Other types of inflammatory swellings may be diagnosed on the basis of the characteristic symptoms of the involved ''[[vata]]'' and other ''[[dosha]]''. It may also be managed by prescribing the treatment of involved ''[[dosha]]'' as well as by application of paste, incision and excision [101]<br /> <br /> === General guidelines of management ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> प्रायोऽभिघातादनिलः सरक्तः शोथं सरागं प्रकरोति तत्र| &lt;br /&gt;<br /> वीसर्पनुन्मारुतरक्तनुच्च कार्यं विषघ्नं विषजे च कर्म||१०२|| &lt;br /&gt;<br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> prāyō'bhighātādanilaḥ saraktaḥ śōthaṁ sarāgaṁ prakarōti tatra| &lt;br /&gt;<br /> vīsarpanunmārutaraktanucca kāryaṁ viṣaghnaṁ viṣajē ca karma||102||&lt;br /&gt;<br /> <br /> prAyo~abhighAtAdanilaH saraktaH shothaM sarAgaM prakaroti tatra| &lt;br /&gt;<br /> vIsarpanunmArutaraktanucca kAryaM viShaghnaM viShaje ca karma||102||&lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Generally external trauma causes reddish swelling due to provocation of ''[[vata]]'' and ''[[rakta]]''. It should be treated with drugs used for the treatment of ''visarpa'' and provoked ''[[vata]]'' and ''[[rakta]]''. <br /> <br /> If the swelling is caused by poisonous substances then it should be treated with anti-poison measures [102]<br /> <br /> === Summary ===<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> तत्र श्लोकः- <br /> <br /> त्रिविधस्य दोषभेदात् सर्वार्धावयवगात्रभेदाच्च| &lt;br /&gt;<br /> श्वयथोर्द्विविधस्य तथा लिङ्गानि चिकित्सितं चोक्तम्||१०३|| &lt;br /&gt; <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> tatra ślōkaḥ- <br /> <br /> trividhasya dōṣabhēdāt sarvārdhāvayavagātrabhēdācca| &lt;br /&gt;<br /> śvayathōrdvividhasya tathā liṅgāni cikitsitaṁ cōktam||103|| &lt;br /&gt;<br /> <br /> tatra shlokaH- <br /> <br /> trividhasya doShabhedAt sarvArdhAvayavagAtrabhedAcca| &lt;br /&gt;<br /> shvayathordvividhasya [36] tathA li~ggAni cikitsitaM coktam||103|| &lt;br /&gt;<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Re-capitulatory verses-<br /> <br /> Three types of swelling as per involvement of [[dosha]]; classification of swelling according to involvement whole or half body or one part; exogenous and endogenous swelling; their symptoms and treatment have been described [103]<br /> &lt;div class=&quot;mw-collapsible mw-collapsed&quot;&gt;<br /> <br /> इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने <br /> श्वयथुचिकित्सितं नाम द्वादशोऽध्यायः||१२|| <br /> &lt;div class=&quot;mw-collapsible-content&quot;&gt;<br /> <br /> ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē <br /> śvayathucikitsitaṁ nāma dvādaśō'dhyāyaḥ||12||<br /> <br /> ityagniveshakRute tantre~aprApte dRuDhabalasampUrite cikitsAsthAne <br /> shvayathucikitsitaM nAma dvAdasho~adhyAyaH||12||<br /> &lt;/div&gt;&lt;/div&gt;<br /> <br /> Thus 12th chapter named [[Shvayathu Chikitsa]] in [[Chikitsa Sthana]] of treatise compiled by Agnivesha, revised by Charaka and unavailable part restored by Dridhabala is completed (12). <br /> <br /> == Tattva Vimarsha (Fundamental Principles) ==<br /> <br /> *''Shotha'' is caused by dietary causes like excessive use of ''kshara'' (alkali) or food articles having sour, sharply acting, hot and heavy properties by an emaciated or weak person due to excessive ''[[shodhana]]'', fasting or disease; excessive intake of curd, raw food articles, soil, leafy vegetables, mutually contradictory food articles (''virodhi''), spoiled or mixed with toxic substance (such as pesticide), or a person suffering from piles, having sedentary life style, nonperforming of ''[[shodhana]]'' therapy even if indicated, injury to vital organs (''marma''), abnormal delivery, due to improper treatment and as complication of improper purification treatment.<br /> *Exogenous causes include trauma or injuries of various types and have acute pathogenesis. <br /> *The pathogenesis of ''nija shotha'' includes obstruction of morbid vāta by vitiated ''[[kapha]], [[rakta]]'' and ''[[pitta]]'' at the site of peripheral superficial vessels. This vitiated ''[[vata]]'' (due to obstruction) spreads to the various places causing swelling as its cardinal symptom.<br /> *Rise in temperature, burning sensation as if burnt by fire and dilation of the vessels are the prodromal symptoms of swelling.<br /> *All types of swelling are produced by involvement of all the three ''[[dosha]]'' but they are named based on the predominance of that particular ''[[dosha]]''. The line of treatment is also according to the dominant ''[[dosha]]''.<br /> *The swelling in a patient who is neither emaciated nor weak; that involved single ''[[dosha]]'' or is of recent origin is easily curable.<br /> *If swelling is associated with ''ama'' it should be managed first by prescribing lightening therapy (''[[langhana]]'') and digestive drugs. Only after that ''[[shodhana]]'' therapy should be undertaken according to dominant ''[[dosha]]''. General lines of treatment of ''[[dosha]]ja'' swelling are as follows:<br /> **If it involves head then ''shiro-virechana'' is prescribed; <br /> **If it involves lower parts of the body then ''[[virechana]]'' (therapeutic purgation) is prescribed; <br /> **If it involves upper parts of the body then ''[[vamana]]'' (therapeutic emesis)is prescribed;<br /> **If it is caused by unctuous then ''[[rukshana]]'' (drying) therapy is done;<br /> **If it is caused by un-unctuous (''ruksha'') then unctuous (''[[snehana]]'') therapy is done;<br /> **If ''[[vata]]'' swelling is associated with constipation then it should be treated with ''niruha [[basti]]'';<br /> **If it is caused by ''[[vata]]-[[pitta]]'' then it should be treated with ghee prepared with bitter drugs;<br /> **If the patient is suffering from associated symptoms such as fainting, pain, burning sensation and thirst then it should be treated with intake of milk; <br /> **If the patient is suffering from swelling where ''[[shodhana]]'' is required then milk mixed with cow’s urine should be given; <br /> **If the patient is suffering from ''[[kapha]]'' swelling then ''kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are given.<br /> **Generally external trauma causes reddish swelling due to provocation of ''[[vata]]'' and ''[[rakta]]''. It should be treated with drugs used for the treatment of ''visarpa'' and provoked ''[[vata]]'' and ''[[rakta]]''. If the swelling is caused by poisonous substances then it should be treated with anti-poison measures (102).<br /> <br /> == Vidhi Vimarsha (Applied Inferences ) ==<br /> <br /> === Derivation of term ===<br /> <br /> The word ''Shvayathu'' is derived from root ''Tuoshchi-Gati-Vriddhyoh''. ''Tuo'' is converted to ''Shvi'' indicating to increase (''Vriddhi'') and by adding ''Athuc Pratyaya'' the word ''Shvayathu'' is derived which literally means increased (3).<br /> <br /> === Pathogenesis ===<br /> <br /> In pathogenesis of ''shotha'' there is involvement of superficial veins (''Bahya shira''). Involvement of circulatory or lymphatic system is must in producing the ''shotha''.<br /> <br /> === Types of ''shotha'' ===<br /> <br /> ''[[Vata]] shotha'' is shifting in nature, pitting on pressure and increases in the day time and may vanish without visible cause. Further ''[[vata]]'' causes edema of the lower part of the body i. e feet and legs. All these characteristics of ''[[vata]] shotha'' are indicative cardiac edema. <br /> <br /> In day time due to various activities and fatigue ''[[vata]]'' gets increased leading to increase in the edema. From modern point of view, cardiac edema increases in the evening which is ''[[vata]] kala'' due to the day activities. ''[[Vata]] shotha'' is pitting on pressure but on removing the pressure it immediately takes its original shape.<br /> <br /> ''[[Pitta]] sopha'' begins from middle parts of the body and then spreads to the other parts and has yellow-reddish color&lt;ref&gt;Vagbhata. Nidana Sthana, Cha.13 Pandurogasophavisarpa Nidana Adhyaya verse 33. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4. &lt;/ref&gt;. Yellowish coloration indicates involvement of liver. Inflammatory swelling is related to ''[[pitta]]ja shotha'' . <br /> <br /> ''[[Kapha]] Shotha'' slightly pits on pressure but takes long time to attain its original position after removing the pressure and increases at night. It develops slowly and also takes long time to subside. ''[[Kapha]] shotha'' occurs in upper part of the body and the treatment of edema occurring on the upper part is ''[[vamana]]'' i.e. of ''[[kapha]]''. On this basis it can be said that which mainly includes face. Renal edema occurs on the face in the morning (noticed on awakening though increased in the night). Other important sign is it is hard and the serous discharge comes out on scratching the skin &lt;ref&gt;Vagbhata. Nidana Sthana, Cha.13 Pandurogasophavisarpa Nidana Adhyaya verse 35-36. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.&lt;/ref&gt;. This indicates that hard non-pitting edema of elephantiasis may also be included under it. Other symptom mentioned for ''[[kapha]]ja shotha'' that the patient like warm touch indicates towards edema found in hypothyroidism (14).<br /> <br /> === Complications ===<br /> <br /> Complications of ''shotha'' are vomiting, dyspnea, anorexia, thirst, fever, loose motions and weakness (Cha. Sa. [[Sutra Sthana]] chapter 18/18]. Sushruta mentions two additional complications viz. cough and hiccups.&lt;ref&gt;Sushruta. Chikitsa Sthana, Cha.23 Sopha Chikisitam Adhyaya verse 8-9. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.&lt;/ref&gt;(15)<br /> <br /> Sushruta classify general edema in five types viz., ''[[vata]], [[pitta]], [[kapha]], sannipata'' and ''vishaja''&lt;ref&gt;Sushruta. Chikitsa Sthana, Cha.23 Sopha Chikisitam Adhyaya verse 3. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.&lt;/ref&gt; but does not consider local swelling as the part of ''shopha'' because while defining swelling it is clearly mentioned that which occurs in the large part under the skin and flesh etc but is other than nodules (''granthi''), abscess (''vidradhi''), ''alaji'' etc is known as ''shopha'' &lt;ref&gt;Sushruta. Sutra Sthana, Cha.17 Amapkweshaneeya Adhyaya verse 3 In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.&lt;/ref&gt;<br /> <br /> Ashtangahridaya describes ''shopha'' in the chapter on ''panduroga'' (anemia) because it is a main complication of anemia. Nine types of ''shopha'' described therein are three single ''[[dosha]]'' type, three ''samsarga'' types, one ''tridoshaja'' and one each due to trauma and poison. In addition three new types of ''shopha'' viz. ''prithu'' (extensive), ''unnata'' (elevated) and ''grathita'' (compact) are also mentioned.&lt;ref&gt;Vagbhata. Nidana Sthana, Cha.13 Pandurogasophavisarpa Nidana Adhyaya verse 21-42. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4. &lt;/ref&gt;. <br /> <br /> Madhava Nidana followed Ashtangahridaya and describes nine types of ''shotha'' and does not describe localized ''shotha'' in this chapter on ''shotha'' &lt;ref&gt;Madhavakara. Madhava Nidanam (Roga vinischaya). Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--&lt;/ref&gt;.<br /> <br /> ''Charaka'' considers bulging (''utsedha'') from the skin as ''shvayathu'' therefore local swellings such as ''pidika'' (papules and pustules), nodules (including ''gandhamala''), ''galagandha'' (goiter), tumor etc are also described in this chapter. The probable modern equivalents are given in the bracket while describing these conditions in the text (74-100). <br /> <br /> Sushruta defines ''arbuda'' as a round and immovable growth produced by vitiated ''[[dosha]]'' by afflicting ''[[mamsa]]'' with mild pain but having deep roots and located in extensive area at the expense of tissue and causes swelling of the ''[[mamsa]]'' extensively. This ''arbuda'' (tumor) grows slowly and does not suppurate &lt;ref&gt;Sushruta. Nidana Sthana, Cha.11 Grandhiapachiarbudagalaganda Nidana Adhyaya verse 13-14 In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.&lt;/ref&gt;. But Charaka being a clinician does not consider much difference in the management of ''arbuda'' and ''granthi'' as their site, causative factors, shape, ''[[dosha]]'' morbidity and ''[[dushya]]'' (susceptible tissues) are about the same. However, it is clearly mentioned that ''arbuda'' should be managed by the expert surgeon only (87). <br /> <br /> Line of treatment, various procedures and preparations mentioned in this chapter for the management of various types of swellings are easy to administer and practical so should be practiced (16-73).<br /> <br /> === ''Shat-kriya-kala'' of ''shotha'' ===<br /> <br /> #''Sanchaya'' (Accumulation): This is the first stage of the disease where due to indulgence into the causative factors accumulation of concerned ''[[dosha]]'' occurs. During this stage increase in the normal functions of the ''[[dosha]]'' is noticed. <br /> #''Prakopa'' (Provocation): If the accumulated ''[[dosha]]'' are not properly taken care then they may go to the next stage of provocation. During this stage the ''prakopa'' symptoms of the involved ''[[dosha]]'' appear. <br /> #''Prasara'' (Spreading): In the stage of ''prasara'' the ''[[dosha]]'' leaves their normal site and starts circulating all over the body. <br /> #''Sthana-Smashrya'' (Localization): The circulating ''[[dosha]]'' interacts with such tissues which have some problem in their channels which may be anatomical, physiological or pathological. This phenomenon is ''[[dosha]]-[[dushya]]-samurchchana''. This localization of ''[[dosha]]'' leads to beginning of the pathogenesis of the disease and during this stage prodromal symptoms (''purva-rupa'') of the disease are produced. The prodromal symptoms of edema are heat, burning sensation and dilation of the vessels.<br /> #''Vyakti'' (Manifestation): If the disease is not managed at the stage of localization then the disease manifest with its specific symptoms. The symptoms of various types of edema are mentioned in the verses from 11 to 16 of this chapter. All or few symptoms mentioned for the disease may appear but if all the symptoms appear then the disease may become incurable and if few then it is easily curable. Moderate appearance of the symptom indicates its moderate prognosis. <br /> #''Bheda'' (Complications): If the disease is not properly treated even after it is fully manifestation then the complications may appear and the disease becomes difficult to cure or incurable. The seven complications of edema are vomiting, thirst, anorexia, dyspnea, fever, diarrhea and weakness [ Cha. Sa. [[Sutra Sthana]] 18/18].<br /> <br /> === Differential Diagnosis of ''shotha'' ===<br /> <br /> [[Ayurveda]] is a clinical science, therefore the classifications are also planned so that the disease can systematically be diagnosed on the basis of the symptoms. ''Shotha'' is a good example for it.<br /> <br /> ''Shotha'' has been defined as any abnormal elevation from the skin. First question to be asked to the patient whether there is any history of trauma, biting etc and if yes, then it is an ''agantuja shotha''. If there is a history of contact or taking poisonous substance then it is ''vishaja''.<br /> <br /> Hereafter it is to be confirmed that whether the swelling is localized or all over the body. If ''shotha'' is localized in single organ or site then it can be diagnosed on the basis of nature of the lesion such as papules, pustules, nodules, tumor etc. It is further diagnosed on the basis of shape, site etc. For example ''gandhamala'' is garland like and ''galagandha'' is scrotum like swelling in neck. ''Romantika'' has minute papules while ''masurika'' has lentil like papules and so on. Associated general features such as fever, thirst etc also helps in differential diagnosis. <br /> <br /> If ''shotha'' is generalized swelling then the point of its beginning is important e.g. ''[[pitta]] shopha'' starts from middle part of the abdomen, ''[[vata]]'' from the lower parts and ''[[kapha]]'' from upper parts of the body. The consideration of other characteristic features mentioned above will help in reaching the final diagnosis.<br /> <br /> For example moving, pitting on pressure, increasing in the day time and sometime subsides without appreciable cause etc help in reaching the diagnosis for ''[[vata]] shopha''.<br /> <br /> Swelling which is firm, slight pitting on pressure, increases in the night, takes long time to subside and is associated with low digestion, vomiting, anemia indicates towards ''[[kapha]] shotha''.<br /> <br /> Swelling which is soft, tender on touch, associated with change to yellow color, fever etc is ''[[pitta]] shotha''.<br /> <br /> Similarly causative factors can also be sorted out by asking whether it relates to food articles (curd, unripe fruits, spoiled, leafy vegetables) or its properties (excessive use of ''kshara'', sour, sharp, hot and heavy food articles), diet habit (fasting), sedentary life style, emaciation or weakness due to a disease or excessive ''[[shodhana]]'', contact to poisonous substances etc.<br /> <br /> === ''Chikitsa Sutra'' (Principles of treatment) ===<br /> <br /> [[Ayurveda]] gives very importance to ''ama''. Therefore, if ''ama'' is associated with swelling then first it should be managed by prescribing lightening therapy (''[[langhana]]'') and digestive drugs. After getting the ''nirama'' symptoms, ''[[shodhana]]'' therapy can be done according to dominant ''[[dosha]]''. It is the general rule for all types of swellings. <br /> <br /> ''Shiro-virechana'' is the choice of therapy for ''[[dosha]]'' situated in head. Therefore if the swelling involves the head then first ''[[nasya]]'' should be done. <br /> <br /> Chest and the upper parts are the main sites of ''[[kapha]]'' and for its removal, ''[[vamana]]'' therapy is best. Therefore if swelling is situated in upper parts or begins from upper parts and then spreads to other parts or it is ''[[kapha]]'' type then first of all ''[[vamana]]'' (emesis) therapy is prescribed. ''Kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are indicated after ''[[vamana]]'' therapy. If ''[[vamana]]'' therapy is not possible in the patient suffering from ''[[kapha]]'' swelling then these drugs may be given directly.<br /> <br /> Generally ''[[basti]]'' is not preferred for the treatment of swelling, but if ''[[vata]]'' swelling is associated with constipation then it should be treated with ''niruha [[basti]]''. Otherwise ''[[virechana]]'' is indicated for the swelling of lower part as well as of ''[[vata]]''.<br /> The local swellings with symptom of inflammation may be treated by following the general line of treatment as mentioned above and other measures mentioned while describing their treatment in this chapter. If it belongs to ''shalya'' or ''shalakya'' type specialties, then let it be treated by the experts of the specialty.<br /> <br /> === Clinical practices ===<br /> <br /> {| class=&quot;wikitable&quot;<br /> |-<br /> ! scope=&quot;col&quot;| Type<br /> ! scope=&quot;col&quot;| Formulations<br /> ! scope=&quot;col&quot;| Dosage<br /> ! scope=&quot;col&quot;| Time<br /> ! scope=&quot;col&quot;| ''Anupana''<br /> |-<br /> | ''[[Vata]]'' dominant<br /> | ''Harina shringa'' mixture<br /> | 60-120 mg<br /> | In between two meals<br /> | Honey + ''Dashamularishta'' + ''Punarnavasa''<br /> |-<br /> | ''[[Pitta]]'' dominant<br /> | ''Aarogya'' Mixture<br /> | 120-250 mg<br /> | In between two meals<br /> | Milk + ''saravadyasava'' + ''punarnavasava'' + ''vasakasava'<br /> |-<br /> | rowspan = &quot;3&quot;|''[[Kapha]]'' dominant<br /> | ''Gomutra Haritaki''<br /> | 1-3 grams<br /> | In between two meals<br /> | Cow urine, honey<br /> |-<br /> | ''Punarnava mandura'' <br /> | 250-500 mg<br /> | In between two meals<br /> | ''Punarnavasava''<br /> |-<br /> | ''Gudadraka Yoga''<br /> | 120-250 mg<br /> | In between two meals<br /> | Honey<br /> |}<br /> <br /> === Related Chapter ===<br /> <br /> * [[Trishothiya Adhyaya]]<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> &lt;/div&gt;<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Agnivesha