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| + | {{CiteButton}} |
| + | {{#seo: |
| + | |title=Chhardi Chikitsa |
| + | |titlemode=append |
| + | |keywords=atisara, diarrhea, ama, nirama, sangrahi treatment, pichcha basti,Ayurveda, Indian system of medicine, charak samhita. |
| + | |description=Chikitsa Sthana Chapter 20. Management of Chhardi (vomiting) |
| + | |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg |
| + | |image_alt=charak samhita |
| + | |type=article |
| + | }} |
| + | <big>'''[[Chikitsa Sthana]] Chapter 20. Management of Chhardi (vomiting) </big>''' |
| {{Infobox | | {{Infobox |
| |title = Chhardi Chikitsa | | |title = Chhardi Chikitsa |
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| |label5 = Other Sections | | |label5 = Other Sections |
| |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]] | | |data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]] |
− | | + | |label6 = Translator and commentator |
− | |header3 = | + | |data6 = Murthy A.R.V., Jani D. |
− | | + | |label7 = Reviewer |
| + | |data7 = Prasad B.S. |
| + | |label8 = Editors |
| + | |data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]] |
| + | |label9 = Year of publication |
| + | |data9 = 2020 |
| + | |label10 = Publisher |
| + | |data10 = [[Charak Samhita Research, Training and Skill Development Centre]] |
| + | |label11 = DOI |
| + | |data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.021 10.47468/CSNE.2020.e01.s06.021] |
| }} | | }} |
| | | |
− | ==[[Chikitsa Sthana]] Chapter 20, Chapter on the Management of ''Chhardi'' (vomiting) ==
| + | <big>'''Abstract </big>''' |
− | | + | <p style='text-align:justify;'>''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. |
− | === Abstract === | + | </p> |
− | | |
− | ''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 ''doshas'' 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. | |
− | | |
| '''Keywords''': ''Chhardi chikitsa, chhardi,'' vomiting, emesis | | '''Keywords''': ''Chhardi chikitsa, chhardi,'' vomiting, emesis |
| | | |
− | === Introduction ===
| |
| | | |
− | After explaining the [[Atisara Chikitsa]] (treatment of diarrhea), there is 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'')<ref>Shastri Suderashan, Madhava Nidana of Madhavakara, Chardi -15 Madhukosh Tika. 4th Edition, 1975, Chaukhamba Sanskrit Series, Varanasi</ref>. The other words like ''chhardah, chhardana, chhardi, chhardika,'' etc. are considered as the synonyms of ''chhardi''.<ref>Charaka chandrika Hindi Vyakhya- Visheshs Vaktavya by Bramhanand Tripathi on Charaka Samhita Chikitsa Sthana 20/1-1</ref> The words ''chhardi'' and ''vamana'', both are used in the sense of vomiting but have basic difference. ''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 ''doshas'' 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 excretary mechanism.<ref>Shastri Ambika Dutt, Sushruta Samhita, Hindi commentary by Kaviraj 5th Edition, 1982, Chaukhamba Sanskrit Series, Varanasi, Susruta Shareera 5/ 10</ref> The one is adhomārga (excretion through downword channel) for which the description of ''atisara'' is given in previous chapter and the other one is ''urdhvabhaga'' (excretion through 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.<ref>Charaka Samhita: [[Ayurveda]] Dipika Commentry by Chakrapani Chaukhamba Sankshrit Series, Varanasi Vimanasthana 5/7-3.</ref> 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.<ref>Charaka Samhita: [[Ayurveda]] Dipika Commentry by Chakrapani Chaukhamba Sankshrit Series, Varanasi, Vimana sthana 5/25.</ref> The curative treatment focuses on pharmacotherapy depending upon ''dosha'' dominance and mild ''samshodhana'' (expelling out the vitiated ''dosha''). | + | == Introduction == |
| + | <div style="text-align:justify;"> |
| + | 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'')<ref>Madhavakara. Chardi praarana verse 15, In:Shastri Suderashan,editor, Madhava Nidanam (Roga vinischaya). 4th ed. Varanasi: Chaukhamba Sanskrit Series,1975.pp--</ref>. The other words like ''chhardah, chhardana, chhardi, chhardika,'' etc. are considered as the synonyms of ''chhardi''.<ref>Charak. Chikitsa Sthana, Cha.20 Chhardi Chikitsa Adhyaya. In: Bramhanand Tripathi Editor. Charak Samhita.,? ed. Varanasi: Chaukhamba Sanskrit Pratisthan,2015. p.?.</ref> 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.<ref>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.?.</ref> 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.<ref>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</ref> 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.<ref>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</ref> The curative treatment focuses on pharmacotherapy depending upon [[dosha]] dominance and mild ''samshodhana'' (expelling out the vitiated [[dosha]]). |
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− | === Sanskrit Text, Transliteration and English Translation ===
| + | == Sanskrit Text, Transliteration and English Translation == |
| + | <div class="mw-collapsible mw-collapsed"> |
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| अथातश्छर्दिचिकित्सितं व्याख्यास्यामः||१|| | | अथातश्छर्दिचिकित्सितं व्याख्यास्यामः||१|| |
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| इति ह स्माह भगवानात्रेयः||२|| | | इति ह स्माह भगवानात्रेयः||२|| |
| + | <div class="mw-collapsible-content"> |
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| athātaśchardicikitsitaṁ vyākhyāsyāmaḥ||1|| | | athātaśchardicikitsitaṁ vyākhyāsyāmaḥ||1|| |
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| iti ha smAha bhagavAnAtreyaH||2|| | | iti ha smAha bhagavAnAtreyaH||2|| |
| + | </div></div> |
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− | We shall now expound the chapter entitled “the management of ''chhardi'' (vomiting)”. Thus, said Lord Atreya. [1-2]
| + | Now we shall expound the chapter "Chhardi chikitsa" (Management of vomiting). Thus said Lord Atreya. [1-2] |
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| यशस्विनं ब्रह्मतपोद्युतिभ्यां ज्वलन्तमग्न्यर्कसमप्रभावम्| | | यशस्विनं ब्रह्मतपोद्युतिभ्यां ज्वलन्तमग्न्यर्कसमप्रभावम्| |
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| पुनर्वसुं भूतहिते निविष्टं पप्रच्छ शिष्योऽत्रिजमग्निवेशः||३|| | | पुनर्वसुं भूतहिते निविष्टं पप्रच्छ शिष्योऽत्रिजमग्निवेशः||३|| |
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| yaśasvinaṁ brahmatapōdyutibhyāṁ jvalantamagnyarkasamaprabhāvam| | | yaśasvinaṁ brahmatapōdyutibhyāṁ jvalantamagnyarkasamaprabhāvam| |
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| punarvasuM bhUtahite niviShTaM papraccha shiShyo~atrijamagniveshaH||3|| | | punarvasuM bhUtahite niviShTaM papraccha shiShyo~atrijamagniveshaH||3|| |
| + | </div></div> |
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| 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] | | 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] |
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− | ==== Queries by Agnivesha ====
| + | === Queries by Agnivesha === |
| + | <div class="mw-collapsible mw-collapsed"> |
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| याश्छर्दयः पञ्च पुरा त्वयोक्ता रोगाधिकारे भिषजां वरिष्ठ!| | | याश्छर्दयः पञ्च पुरा त्वयोक्ता रोगाधिकारे भिषजां वरिष्ठ!| |
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| याश्छर्दयः पञ्च पुरा मयोक्तास्ता विस्तरेण ब्रुवतो निबोध||५|| | | याश्छर्दयः पञ्च पुरा मयोक्तास्ता विस्तरेण ब्रुवतो निबोध||५|| |
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| yāśchardayaḥ pañca purā tvayōktā rōgādhikārē bhiṣajāṁ variṣṭha!| | | yāśchardayaḥ pañca purā tvayōktā rōgādhikārē bhiṣajāṁ variṣṭha!| |
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| yAshchardayaH pa~jca purA mayoktAstA vistareNa bruvato nibodha||5|| | | yAshchardayaH pa~jca purA mayoktAstA vistareNa bruvato nibodha||5|| |
| + | </div></div> |
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| 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. | | 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. |
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| 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." [4-5] | | 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." [4-5] |
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− | ==== Classification and premonitory symptoms ====
| + | === Classification and premonitory symptoms === |
| + | <div class="mw-collapsible mw-collapsed"> |
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| दोषैः पृथक्त्रिप्रभवाश्चतस्रो [१] द्बिष्टार्थयोगादपि पञ्चमी स्यात्| | | दोषैः पृथक्त्रिप्रभवाश्चतस्रो [१] द्बिष्टार्थयोगादपि पञ्चमी स्यात्| |
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| तासां हृदुत्क्लेशकफप्रसेकौ द्वेषोऽशने चैव हि पूर्वरूपम्||६| | | तासां हृदुत्क्लेशकफप्रसेकौ द्वेषोऽशने चैव हि पूर्वरूपम्||६| |
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| dōṣaiḥ pr̥thaktriprabhavāścatasrō dbiṣṭārthayōgādapi pañcamī syāt| | | dōṣaiḥ pr̥thaktriprabhavāścatasrō dbiṣṭārthayōgādapi pañcamī syāt| |
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| tAsAM hRudutkleshakaphaprasekau dveSho~ashane caiva hi pUrvarUpam||6|| | | tAsAM hRudutkleshakaphaprasekau dveSho~ashane caiva hi pUrvarUpam||6|| |
| + | </div></div> |
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− | ''Chhardi'' (vomiting) is of five types; three types of vomiting caused by a ''dosha'' each i.e. ''vatika, paittika, kaphaja,'' fourth is ''sannipatika'' and fifth is ''dvistartha-yogaja-chhardi'' (that results from contact with unpleasant sense objects). | + | ''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). |
| The premonitory signs and symptoms of ''chhardi'' (vomiting) are nausea, excessive salivation and aversion to food [6] | | The premonitory signs and symptoms of ''chhardi'' (vomiting) are nausea, excessive salivation and aversion to food [6] |
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− | ==== ''Vataja chhardi'' ==== | + | === [[Vata]]ja chhardi === |
| + | <div class="mw-collapsible mw-collapsed"> |
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| व्यायामतीक्ष्णौषधशोकरोगभयोपवासाद्यतिकर्शितस्य| | | व्यायामतीक्ष्णौषधशोकरोगभयोपवासाद्यतिकर्शितस्य| |
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| कृच्छ्रेण चाल्पं महता च वेगेनार्तोऽनिलाच्छर्दयतीह दुःखम्||९|| | | कृच्छ्रेण चाल्पं महता च वेगेनार्तोऽनिलाच्छर्दयतीह दुःखम्||९|| |
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| vyāyāmatīkṣṇauṣadhaśōkarōgabhayōpavāsādyatikarśitasya| | | vyāyāmatīkṣṇauṣadhaśōkarōgabhayōpavāsādyatikarśitasya| |
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| kRucchreNa cAlpaM mahatA ca vegenArto~anilAcchardayatIha duHkham||9|| | | kRucchreNa cAlpaM mahatA ca vegenArto~anilAcchardayatIha duHkham||9|| |
| + | </div></div> |
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− | In a person extremely emaciated because of disease, excessive intake of medicines having ''tikshna'' (sharply acting) attributes and indulging in grief, fear, fasting, etc. ''vata'' gets excessively aggravated in the ''maha-srotas'' (gastrointestinal tract), vitiates the local ''doshas'' and pushes them upwards. These ''doshas'' cause agitation in the ''amashaya'' (stomach), and after afflicting the ''marma'' (vital organs-heart) gives rise to ''chhardi'' (vomiting). This ''vataja'' type of vomiting is characterized by the following signs and symptoms: | + | In a person extremely emaciated because of disease, excessive intake of medicines having ''tikshna'' (sharply acting) attributes and indulging in grief, fear, 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: |
| #Pain in the cardiac region and flanks; | | #Pain in the cardiac region and flanks; |
| #Dryness of the mouth; | | #Dryness of the mouth; |
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| #The patient feels miserable [7-9] | | #The patient feels miserable [7-9] |
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− | ==== ''Pittaja chhardi'' ==== | + | === [[Pitta]]ja chhardi === |
| + | <div class="mw-collapsible mw-collapsed"> |
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| अजीर्णकट्वम्लविदाह्यशीतैरामाशये पित्तमुदीर्णवेगम्| | | अजीर्णकट्वम्लविदाह्यशीतैरामाशये पित्तमुदीर्णवेगम्| |
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| पीतं भृशोष्णं हरितं सतिक्तं धूम्रं च पित्तेन वमेत् सदाहम्||११|| | | पीतं भृशोष्णं हरितं सतिक्तं धूम्रं च पित्तेन वमेत् सदाहम्||११|| |
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| ajīrṇakaṭvamlavidāhyaśītairāmāśayē pittamudīrṇavēgam| | | ajīrṇakaṭvamlavidāhyaśītairāmāśayē pittamudīrṇavēgam| |
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| pItaM bhRushoShNaM haritaM satiktaM dhUmraM ca pittena vamet sadAham||11|| | | pItaM bhRushoShNaM haritaM satiktaM dhUmraM ca pittena vamet sadAham||11|| |
| + | </div></div> |
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− | As a result of intake of food before the previous meal is digested, or taking pungent, sour, ''vidahi'' (which cause burning sensation) and cold diet, 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: | + | As a result of intake of food before the previous meal is digested, or taking pungent, sour, ''vidahi'' (which cause burning sensation) and cold diet, 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: |
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− | The signs and symptoms of this ''pittaja'' type of ''chhardi'' (vomiting) are: | + | The signs and symptoms of this [[pitta]]ja type of ''chhardi'' (vomiting) are: |
| #Fainting, morbid thirst and parching of mouth; | | #Fainting, morbid thirst and parching of mouth; |
| #Burning (or heating) sensation in the head, palate and eyes; | | #Burning (or heating) sensation in the head, palate and eyes; |
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| #Vomitus is yellow, excessively hot, green, bitter and smoky in appearance with burning sensation [10-11] | | #Vomitus is yellow, excessively hot, green, bitter and smoky in appearance with burning sensation [10-11] |
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− | ==== ''Kaphaja chhardi'' ==== | + | === [[Kapha]]ja chhardi === |
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| स्निग्धातिगुर्वामविदाहिभोज्यैः स्वप्नादिभिश्चैव कफोऽतिवृद्धः| | | स्निग्धातिगुर्वामविदाहिभोज्यैः स्वप्नादिभिश्चैव कफोऽतिवृद्धः| |
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| स्निग्धं घनं स्वादु कफाद्विशुद्धं सलोमहर्षोऽल्परुजं वमेत्तु||१३|| | | स्निग्धं घनं स्वादु कफाद्विशुद्धं सलोमहर्षोऽल्परुजं वमेत्तु||१३|| |
| + | <div class="mw-collapsible-content"> |
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| snigdhātigurvāmavidāhibhōjyaiḥ svapnādibhiścaiva kaphō'tivr̥ddhaḥ| | | snigdhātigurvāmavidāhibhōjyaiḥ svapnādibhiścaiva kaphō'tivr̥ddhaḥ| |
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| | | |
| snigdhaM ghanaM svAdu kaphAdvishuddhaM salomaharSho~alparujaM vamettu||13|| | | snigdhaM ghanaM svAdu kaphAdvishuddhaM salomaharSho~alparujaM vamettu||13|| |
| + | </div></div> |
| | | |
− | As a result of the intake of unctuous, excessively heavy, ''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 ''kaphaja'' type of ''chhardi'' are as follows: | + | As a result of the intake of unctuous, excessively heavy, ''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: |
| #Drowsiness, sweetness in the mouth and salivation; | | #Drowsiness, sweetness in the mouth and salivation; |
| #Sense of satiety, sleep, anorexia and heaviness; | | #Sense of satiety, sleep, anorexia and heaviness; |
| #Vomitus is unctuous, dense, sweet and devoid of any undesirable smell; and is associated with horripilation and slight pain [12-13] | | #Vomitus is unctuous, dense, sweet and devoid of any undesirable smell; and is associated with horripilation and slight pain [12-13] |
| | | |
− | ==== ''Tridoshaja chhardi'' ==== | + | === Tri[[dosha]]ja chhardi === |
| + | <div class="mw-collapsible mw-collapsed"> |
| | | |
| समश्नतः सर्वरसान् प्रसक्तमामप्रदोषर्तुविपर्ययैश्च| | | समश्नतः सर्वरसान् प्रसक्तमामप्रदोषर्तुविपर्ययैश्च| |
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| | | |
| छर्दिस्त्रिदोषाल्लवणाम्लनीलसान्द्रोष्णरक्तं वमतां नृणां स्यात्||१५|| | | छर्दिस्त्रिदोषाल्लवणाम्लनीलसान्द्रोष्णरक्तं वमतां नृणां स्यात्||१५|| |
| + | <div class="mw-collapsible-content"> |
| | | |
| samaśnataḥ sarvarasān prasaktamāmapradōṣartuviparyayaiśca| | | samaśnataḥ sarvarasān prasaktamāmapradōṣartuviparyayaiśca| |
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| | | |
| chardistridoShAllavaNAmlanIlasAndroShNaraktaM vamatAM nRuNAM syAt||15|| | | chardistridoShAllavaNAmlanIlasAndroShNaraktaM vamatAM nRuNAM syAt||15|| |
| + | </div></div> |
| | | |
− | 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 ''doshas'' get simultaneously aggravated and cause ''sannipatika chhardi''. | + | 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''. |
| | | |
| The signs and symptoms of this type of vomiting are as follows: | | The signs and symptoms of this type of vomiting are as follows: |
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| #Vomitus is salty, sour, blue, dense, hot and reddish [14-15] | | #Vomitus is salty, sour, blue, dense, hot and reddish [14-15] |
| | | |
− | ==== Bad prognostic symptoms ====
| + | === Bad prognostic symptoms === |
| + | <div class="mw-collapsible mw-collapsed"> |
| | | |
| विट्स्वेदमूत्राम्बुवहानि वायुः स्रोतांसि संरुध्य यदोर्ध्वमेति| | | विट्स्वेदमूत्राम्बुवहानि वायुः स्रोतांसि संरुध्य यदोर्ध्वमेति| |
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| | | |
| प्रच्छर्दयेद्दुष्टमिहातिवेगात्तयाऽर्दितश्चाशु विनाशमेति||१७|| | | प्रच्छर्दयेद्दुष्टमिहातिवेगात्तयाऽर्दितश्चाशु विनाशमेति||१७|| |
| + | <div class="mw-collapsible-content"> |
| | | |
| viṭsvēdamūtrāmbuvahāni vāyuḥ srōtāṁsi saṁrudhya yadōrdhvamēti| | | viṭsvēdamūtrāmbuvahāni vāyuḥ srōtāṁsi saṁrudhya yadōrdhvamēti| |
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| | | |
| pracchardayedduShTamihAtivegAttayA~arditashcAshu vinAshameti||17|| | | pracchardayedduShTamihAtivegAttayA~arditashcAshu vinAshameti||17|| |
| + | </div></div> |
| | | |
− | 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: | + | 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: |
| #Vomitus having color and odor of the feces and urine; | | #Vomitus having color and odor of the feces and urine; |
| #Persistent thirst, dyspnea hiccup and pain | | #Persistent thirst, dyspnea hiccup and pain |
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| Such a patient succumbs to death quickly [16-17] | | Such a patient succumbs to death quickly [16-17] |
| | | |
− | ==== ''Dvishtharthasamyogaja chhardi'' ====
| + | === ''Dvishtharthasamyogaja chhardi'' === |
| + | <div class="mw-collapsible mw-collapsed"> |
| | | |
| द्विष्टप्रतीपाशुचिपूत्यमेध्यबीभत्सगन्धाशनदर्शनैश्च| | | द्विष्टप्रतीपाशुचिपूत्यमेध्यबीभत्सगन्धाशनदर्शनैश्च| |
| | | |
| यच्छर्दयेत्तप्तमना मनोध्नैर्द्विष्टार्थसंयोगभवा मता सा||१८|| | | यच्छर्दयेत्तप्तमना मनोध्नैर्द्विष्टार्थसंयोगभवा मता सा||१८|| |
| + | <div class="mw-collapsible-content"> |
| | | |
| dviṣṭapratīpāśucipūtyamēdhyabībhatsagandhāśanadarśanaiśca| | | dviṣṭapratīpāśucipūtyamēdhyabībhatsagandhāśanadarśanaiśca| |
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| | | |
| yacchardayettaptamanA manodhnairdviShTArthasaMyogabhavA matA sA||18|| | | yacchardayettaptamanA manodhnairdviShTArthasaMyogabhavA matA sA||18|| |
| + | </div></div> |
| | | |
| 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] | | 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] |
| | | |
− | ==== Symptoms of incurable ''chhardi'' ====
| + | === Symptoms of incurable ''chhardi'' === |
− | | + | <div class="mw-collapsible mw-collapsed"> |
| + | |
| क्षीणस्य या छर्दिरतिप्रवृद्धा सोपद्रवा शोणितपूययुक्ता| | | क्षीणस्य या छर्दिरतिप्रवृद्धा सोपद्रवा शोणितपूययुक्ता| |
| | | |
| सचन्द्रिकां तां प्रवदन्त्यसाध्यां साध्यां चिकित्सेदनुपद्रवां च||१९|| | | सचन्द्रिकां तां प्रवदन्त्यसाध्यां साध्यां चिकित्सेदनुपद्रवां च||१९|| |
| + | <div class="mw-collapsible-content"> |
| | | |
| kṣīṇasya yā chardiratipravr̥ddhā sōpadravā śōṇitapūyayuktā| | | kṣīṇasya yā chardiratipravr̥ddhā sōpadravā śōṇitapūyayuktā| |
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| | | |
| sacandrikAM tAM pravadantyasAdhyAM sAdhyAM cikitsedanupadravAM ca||19|| | | sacandrikAM tAM pravadantyasAdhyAM sAdhyAM cikitsedanupadravAM ca||19|| |
| + | </div></div> |
| | | |
| 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] | | 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] |
| | | |
− | ==== Principles of treatment ====
| + | === Principles of treatment === |
| + | <div class="mw-collapsible mw-collapsed"> |
| | | |
| आमाशयोत्क्लेशभवा हि सर्वाश्छर्द्यो मता लङ्घनमेव तस्मात्| | | आमाशयोत्क्लेशभवा हि सर्वाश्छर्द्यो मता लङ्घनमेव तस्मात्| |
| | | |
| प्राक्कारयेन्मारुतजां विमुच्य संशोधनं वा कफपित्तहारि||२०|| | | प्राक्कारयेन्मारुतजां विमुच्य संशोधनं वा कफपित्तहारि||२०|| |
| + | <div class="mw-collapsible-content"> |
| | | |
| āmāśayōtklēśabhavā hi sarvāśchardyō matā laṅghanamēva tasmāt| | | āmāśayōtklēśabhavā hi sarvāśchardyō matā laṅghanamēva tasmāt| |
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| | | |
| prAkkArayenmArutajAM vimucya saMshodhanaM vA kaphapittahAri||20|| | | prAkkArayenmArutajAM vimucya saMshodhanaM vA kaphapittahAri||20|| |
| + | </div></div> |
| | | |
− | As all the types of vomiting are considered originating from the agitations of the ''doshas'' 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] | + | 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] |
| + | <div class="mw-collapsible mw-collapsed"> |
| | | |
| चूर्णानि लिह्यान्मधुनाऽभयानां हृद्यानि वा यानि विरेचनानि| | | चूर्णानि लिह्यान्मधुनाऽभयानां हृद्यानि वा यानि विरेचनानि| |
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| | | |
| रसैर्मनोज्ञैर्लघुभिर्विशुष्कैर्भक्ष्यैः सभोज्यैर्विविधैश्च पानैः||२२|| | | रसैर्मनोज्ञैर्लघुभिर्विशुष्कैर्भक्ष्यैः सभोज्यैर्विविधैश्च पानैः||२२|| |
| + | <div class="mw-collapsible-content"> |
| | | |
| cūrṇāni lihyānmadhunā'bhayānāṁ hr̥dyāni vā yāni virēcanāni| | | cūrṇāni lihyānmadhunā'bhayānāṁ hr̥dyāni vā yāni virēcanāni| |
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| | | |
| rasairmanoj~jairlaghubhirvishuShkairbhakShyaiH sabhojyairvividhaishca pAnaiH||22|| | | rasairmanoj~jairlaghubhirvishuShkairbhakShyaiH sabhojyairvividhaishca pAnaiH||22|| |
| + | </div></div> |
| | | |
| 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. | | 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. |
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| 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] | | 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] |
| | | |
− | ==== Treatment of ''vataja chhardi'' ====
| + | === Treatment of [[vata]]ja chhardi === |
| + | <div class="mw-collapsible mw-collapsed"> |
| | | |
| सुसंस्कृतास्तित्तिरिबर्हिलावरसा व्यपोहन्त्यनिलप्रवृत्ताम्| | | सुसंस्कृतास्तित्तिरिबर्हिलावरसा व्यपोहन्त्यनिलप्रवृत्ताम्| |
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| | | |
| स्निग्धानि हृद्यानि च भोजनानि रसैः सयूषैर्दधिदाडिमाम्लैः||२५|| | | स्निग्धानि हृद्यानि च भोजनानि रसैः सयूषैर्दधिदाडिमाम्लैः||२५|| |
| + | <div class="mw-collapsible-content"> |
| | | |
| susaṁskr̥tāstittiribarhilāvarasā vyapōhantyanilapravr̥ttām| | | susaṁskr̥tāstittiribarhilāvarasā vyapōhantyanilapravr̥ttām| |
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| | | |
| snigdhAni hRudyAni ca bhojanAni rasaiH sayUShairdadhidADimAmlaiH||25|| | | snigdhAni hRudyAni ca bhojanAni rasaiH sayUShairdadhidADimAmlaiH||25|| |
| + | </div></div> |
| | | |
− | The following recipes are useful in ''vataja'' type of vomiting (''chhardi''): | + | The following recipes are useful in [[vata]]ja type of vomiting (''chhardi''): |
| #The meat juice of ''tittiri'' (partridge), ''barhi'' and ''lava'' (common quail); | | #The meat juice of ''tittiri'' (partridge), ''barhi'' and ''lava'' (common quail); |
| #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); | | #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); |
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| #The diet consisting of unctuous and palatable food, meat soups, vegetable-soup, curd sour ''dadima'' (pomegranate/Punica granatum) [23-25] | | #The diet consisting of unctuous and palatable food, meat soups, vegetable-soup, curd sour ''dadima'' (pomegranate/Punica granatum) [23-25] |
| | | |
− | ==== Treatment of ''pittaja chhardi'' ====
| + | === Treatment of [[pitta]]ja chhardi === |
| + | <div class="mw-collapsible mw-collapsed"> |
| | | |
| पित्तात्मिकायामनुलोमनार्थं द्राक्षाविदारीक्षुरसैस्त्रिवृत् स्यात्| | | पित्तात्मिकायामनुलोमनार्थं द्राक्षाविदारीक्षुरसैस्त्रिवृत् स्यात्| |
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| | | |
| शीताम्बुना गैरिकशालिचूर्णं मूर्वां तथा तण्डुलधावनेन||३३|| | | शीताम्बुना गैरिकशालिचूर्णं मूर्वां तथा तण्डुलधावनेन||३३|| |
| + | <div class="mw-collapsible-content"> |
| | | |
| pittātmikāyāmanulōmanārthaṁ drākṣāvidārīkṣurasaistrivr̥t syāt| | | pittātmikāyāmanulōmanārthaṁ drākṣāvidārīkṣurasaistrivr̥t syāt| |
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| | | |
| shItAmbunA gairikashAlicUrNaM mUrvAM tathA taNDuladhAvanena||33|| | | shItAmbunA gairikashAlicUrNaM mUrvAM tathA taNDuladhAvanena||33|| |
| + | </div></div> |
| | | |
− | The patient of ''pittaja'' 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). | + | 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). |
| | | |
| 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). | | 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). |
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| ##Powder of ''murva'' (Marsdenia tenacissima / sansevieria roxburghiana) along with ''tandulodaka'' (rice-water)[26-33] | | ##Powder of ''murva'' (Marsdenia tenacissima / sansevieria roxburghiana) along with ''tandulodaka'' (rice-water)[26-33] |
| | | |
− | ==== Treatment of ''kaphaja chhardi'' ====
| + | === Treatment of [[kapha]]ja chhardi === |
| + | <div class="mw-collapsible mw-collapsed"> |
| | | |
| कफात्मिकायां वमनं प्रशस्तं सपिप्पलीसर्षपनिम्बतोयैः| | | कफात्मिकायां वमनं प्रशस्तं सपिप्पलीसर्षपनिम्बतोयैः| |
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| | | |
| क्षौद्रेण चूर्णं मरिचैश्च युक्तं लिहञ्जयेच्छर्दिमुदीर्णवेगाम्||३९|| | | क्षौद्रेण चूर्णं मरिचैश्च युक्तं लिहञ्जयेच्छर्दिमुदीर्णवेगाम्||३९|| |
| + | <div class="mw-collapsible-content"> |
| | | |
| kaphātmikāyāṁ vamanaṁ praśastaṁ sapippalīsarṣapanimbatōyaiḥ| | | kaphātmikāyāṁ vamanaṁ praśastaṁ sapippalīsarṣapanimbatōyaiḥ| |
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| | | |
| kShaudreNa cUrNaM maricaishca yuktaM liha~jjayecchardimudIrNavegAm||39|| | | kShaudreNa cUrNaM maricaishca yuktaM liha~jjayecchardimudIrNavegAm||39|| |
| + | </div></div> |
| | | |
− | ''Vamana'' (therapeutic emesis) is supposed to be the most suitable therapy in ''kaphaja'' 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). | + | ''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). |
| | | |
| The patient should be given old wheat, rice and barley along with | | The patient should be given old wheat, rice and barley along with |
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| #''Maricha'' (black pepper/Piper nigrum) with honey [34-39] | | #''Maricha'' (black pepper/Piper nigrum) with honey [34-39] |
| | | |
− | ==== Treatment of ''sannipatika chhardi'' ====
| + | === Treatment of ''sannipatika chhardi'' === |
| + | <div class="mw-collapsible mw-collapsed"> |
| | | |
| यैषा पृथक्त्वेन मया क्रियोक्ता तां सन्निपातेऽपि समस्य [१] बुद्ध्या| | | यैषा पृथक्त्वेन मया क्रियोक्ता तां सन्निपातेऽपि समस्य [१] बुद्ध्या| |
| | | |
| दोषर्तुरोगाग्निबलान्यवेक्ष्य प्रयोजयेच्छास्त्रविदप्रमत्तः||४०|| | | दोषर्तुरोगाग्निबलान्यवेक्ष्य प्रयोजयेच्छास्त्रविदप्रमत्तः||४०|| |
| + | <div class="mw-collapsible-content"> |
| | | |
| yaiṣā pr̥thaktvēna mayā kriyōktā tāṁ sannipātē'pi samasya buddhyā| | | yaiṣā pr̥thaktvēna mayā kriyōktā tāṁ sannipātē'pi samasya buddhyā| |
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| | | |
| doSharturogAgnibalAnyavekShya prayojayecchAstravidapramattaH||40|| | | doSharturogAgnibalAnyavekShya prayojayecchAstravidapramattaH||40|| |
| + | </div></div> |
| | | |
− | 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 ''doshas'' involved, the season when the disease has occurred, the stage of the disease and the power of digestion of the patient [40] | + | 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] |
| | | |
− | ==== Treatment of ''dvishtarathasamyogaja (manobhighataja) chhardi'' ====
| + | === Treatment of ''dvishtarathasamyogaja (manobhighataja) chhardi'' === |
| + | <div class="mw-collapsible mw-collapsed"> |
| | | |
| मनोभिघाते तु मनोनुकूला वाचः समाश्वासनहर्षणानि| | | मनोभिघाते तु मनोनुकूला वाचः समाश्वासनहर्षणानि| |
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| | | |
| तदेव दद्यात् प्रशमाय तस्यास्तज्जो हि रोगः सुख एव जेतुम्||४४|| | | तदेव दद्यात् प्रशमाय तस्यास्तज्जो हि रोगः सुख एव जेतुम्||४४|| |
| + | <div class="mw-collapsible-content"> |
| | | |
| manōbhighātē tu manōnukūlā vācaḥ samāśvāsanaharṣaṇāni| | | manōbhighātē tu manōnukūlā vācaḥ samāśvāsanaharṣaṇāni| |
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| | | |
| tadeva dadyAt prashamAya tasyAstajjo hi rogaH sukha eva jetum||44|| | | tadeva dadyAt prashamAya tasyAstajjo hi rogaH sukha eva jetum||44|| |
| + | </div></div> |
| | | |
| In case of vomiting caused by mental disgust the following measures should be resorted to: | | In case of vomiting caused by mental disgust the following measures should be resorted to: |
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| #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] | | #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] |
| | | |
− | ==== Treatment of complications ====
| + | === Treatment of complications === |
| + | <div class="mw-collapsible mw-collapsed"> |
| | | |
| छर्द्युत्थितानां च चिकित्सितात् स्वाच्चिकित्सितं कार्यमुपद्रवाणाम्| | | छर्द्युत्थितानां च चिकित्सितात् स्वाच्चिकित्सितं कार्यमुपद्रवाणाम्| |
| | | |
| अतिप्रवृत्तासु विरेचनस्य कर्मातियोगे विहितं विधेयम्||४५|| | | अतिप्रवृत्तासु विरेचनस्य कर्मातियोगे विहितं विधेयम्||४५|| |
| + | <div class="mw-collapsible-content"> |
| | | |
| chardyutthitānāṁ ca cikitsitāt svāccikitsitaṁ kāryamupadravāṇām| | | chardyutthitānāṁ ca cikitsitāt svāccikitsitaṁ kāryamupadravāṇām| |
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| | | |
| atipravRuttAsu virecanasya karmAtiyoge vihitaM vidheyam||45|| | | atipravRuttAsu virecanasya karmAtiyoge vihitaM vidheyam||45|| |
| + | </div></div> |
| | | |
− | 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 [[Siddhi Sthana]] (6/52-56) for excessive purgation should be carried out [45] | + | 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] |
| | | |
− | ==== Treatment of chronic ''chhardi'' ====
| + | === Treatment of chronic ''chhardi'' === |
| + | <div class="mw-collapsible mw-collapsed"> |
| | | |
| वमिप्रसङ्गात् पवनोऽप्यवश्यं धातुक्षयाद्धृद्धिमुपैति तस्मात्| | | वमिप्रसङ्गात् पवनोऽप्यवश्यं धातुक्षयाद्धृद्धिमुपैति तस्मात्| |
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| | | |
| वृष्यास्तथा मांसरसाः सलेहाश्चिरप्रसक्तां च वमिं जयन्ति||४७|| | | वृष्यास्तथा मांसरसाः सलेहाश्चिरप्रसक्तां च वमिं जयन्ति||४७|| |
| + | <div class="mw-collapsible-content"> |
| | | |
| vamiprasaṅgāt pavanō'pyavaśyaṁ dhātukṣayāddhr̥ddhimupaiti tasmāt| | | vamiprasaṅgāt pavanō'pyavaśyaṁ dhātukṣayāddhr̥ddhimupaiti tasmāt| |
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| | | |
| vRuShyAstathA mAMsarasAH salehAshciraprasaktAM ca vamiM jayanti||47|| | | vRuShyAstathA mAMsarasAH salehAshciraprasaktAM ca vamiM jayanti||47|| |
| + | </div></div> |
| | | |
− | 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. | + | 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. |
| | | |
| The following recipes are useful in chronic type of vomiting. | | The following recipes are useful in chronic type of vomiting. |
| | | |
− | ''Sarpirguda'' (Chikitsa 11:50-77), ''kshira-vidhi'' (milk boiled by adding ''vata''-alleviating drugs), ''kalyanaka-ghrita'' (Chikitsa 9:33-42), ''tryushana-ghrita'' (Chikitsa 18:39-42), ''jivaniya-ghrita'' (Chikitsa 29:55-57), ''vrishya'' (virilific) recipes, ''mamsarasa'' (meat soup) and ''lehya'' like ''chyavanprasha'' (linctuses) [46-47] | + | ''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] |
| | | |
− | ==== Summary ====
| + | === Summary === |
| + | <div class="mw-collapsible mw-collapsed"> |
| | | |
| तत्र श्लोकः- | | तत्र श्लोकः- |
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| | | |
| छर्दीनां प्रशमार्थं प्राह चिकित्सितं मुनिवर्यः||४८|| | | छर्दीनां प्रशमार्थं प्राह चिकित्सितं मुनिवर्यः||४८|| |
| + | <div class="mw-collapsible-content"> |
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| tatra ślōkaḥ- | | tatra ślōkaḥ- |
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| chardInAM prashamArthaM prAha cikitsitaM munivaryaH||48|| | | chardInAM prashamArthaM prAha cikitsitaM munivaryaH||48|| |
| + | </div></div> |
| | | |
| 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] | | 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] |
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| Thus the section on therapeutics in the treatise compiled by Agnivesha redacted by Charaka and reconstructed by Dridhabala as it was not available. | | Thus the section on therapeutics in the treatise compiled by Agnivesha redacted by Charaka and reconstructed by Dridhabala as it was not available. |
| | | |
− | === ''Tattva Vimarsha'' / Fundamental Principles=== | + | == Tattva Vimarsha (Fundamental Principles) == |
| | | |
− | *''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). | + | *''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). |
− | *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. | + | *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. |
| *Mind and sense objects play significant role in pathogenesis of ''chhardi'' due to exposure to unwholesome objects. | | *Mind and sense objects play significant role in pathogenesis of ''chhardi'' due to exposure to unwholesome objects. |
| *The prognosis of ''chhardi'' depends upon strength of patient, bouts, presence of associated disorders and complications, contents of vomitus. | | *The prognosis of ''chhardi'' depends upon strength of patient, bouts, presence of associated disorders and complications, contents of vomitus. |
− | *All the types of vomiting are considered originating from the agitations of the ''doshas'' in the stomach. Therefore, fasting therapy is first principle of treatment. Purification therapies of ''kapha'' and ''pitta'' are administered to expel out vitiated ''doshas''. These therapies are contraindicated in cases of ''vata'' dominance. The choice of therapy depends upon strength of patient and type of vitiated ''dosha''. | + | *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]]. |
− | *The drugs having nutritive properties, carminative, ''dosha'' pacifying actions are prescribed in the treatment of ''chhardi''. | + | *The drugs having nutritive properties, carminative, [[dosha]] pacifying actions are prescribed in the treatment of ''chhardi''. |
| *Sublingual, pleasant tasting linctus, mild purgative to open the channel to lower G I tract. | | *Sublingual, pleasant tasting linctus, mild purgative to open the channel to lower G I tract. |
| *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. | | *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. |
| *The treatment of complications arising from vomiting should be done according to the lines suggested in respect of each of those ailments. | | *The treatment of complications arising from vomiting should be done according to the lines suggested in respect of each of those ailments. |
− | *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. | + | *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. |
| | | |
− | === ''Vidhi Vimarsha'' / Applied Inferences=== | + | == Vidhi Vimarsha (Applied Inferences ) == |
| | | |
− | ==== Pathogenesis ====
| + | === Pathogenesis === |
| | | |
− | ''Mahasrotus'' (gastrointestinal tract) has two parts, upper part is ''annavaha srotus'' and lower part is ''purishvaha srotus''. ''Atisara'' is related to ''purishvaha 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. | + | ''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. |
| | | |
− | ==== Types of ''chhardi'' ====
| + | === Types of ''chhardi'' === |
| | | |
− | Diseases are classified according to the dominance of ''doshas''-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 su 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''. | + | 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''. |
| | | |
− | ''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''.<ref>Shastri Ambika Dutt, Sushruta Samhita, Hindi commentary by Kaviraj 5th Edition, 1982, Chaukhamba Sanskrit Series, Varanasi</ref> | + | ''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''.<ref>Sushruta. Sushruta Samhita . In: Kaviraj Shastri Ambika Dutt, Editors. 5th ed. Varanasi: Chaukhambha Sanskrit Series;1982. p.?.</ref> |
| | | |
− | ===== ''Vataja chhardi'' ===== | + | ==== [[Vata]]ja chhardi ==== |
| | | |
− | There are many factors that increase ''vata'' in the ''sharira'' .<ref>Shastri Ambika Dutt, Sushruta Samhita, Sutra sthana 21/19. Hindi commentary by Kaviraj 5th Edition, 1982, Chaukhamba Sanskrit Series, Varanasi </ref> 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 ''vataja chhardi''. ([[Sutra Sthana]] 1/59) ''doshas'' conjugate (''sammurchhana'' ([[Sutra Sthana]] 18/46) with a particular organ (''mahasrotas, amashaya, marma'' (vital organ), ''urdhwabhaga'' (upper trunk, etc) as ''dushyas'' (affected ''dhatus'') to cause ''vataja chhardi'' (as ''utkshepana'' (upward movement), ''adhahkshepana'' (downward movement), etc are the ''karmas'' (actions) of ''vayu'')-(7-9). | + | There are many factors that increase [[vata]] in the ''sharira'' .<ref> Sushruta. Sutra sthana cha 21 Vranaprashna Adhyaya verse 19. In: Kaviraj Shastri Ambika Dutt, editors, 5th Edition, Varanasi : Chaukhamba Sanskrit Series,1982.</ref> 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). |
| | | |
− | ===== ''Pittaja chhardi'' ===== | + | ==== [[Pitta]]ja chhardi ==== |
| | | |
− | ''Nidanas'' of ''pittaprakopaka'' increase ''pitta'' in nature <ref>Shastri Ambika Dutt, Sushruta Samhita, Sutra sthana 21/21 Hindi commentary by Kaviraj 5th Edition, 1982, Chaukhamba Sanskrit Series, Varanasi </ref>and cause provocation of ''gunas'' like ''ushna'' (hot), ''tikshna'' (sharp), ''snigdha'' (unctous), etc. ([[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 ''pittaja chhardi'' (10-11). | + | ''Nidanas'' of [[pitta]]prakopaka increase [[pitta]] in nature <ref> Sushruta, Sutra sthana c21/21 Hindi commentary by Kaviraj, Shastri Ambika Dutt, 5th Edition, 1982, Chaukhamba Sanskrit Series, Varanasi </ref>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). |
| | | |
− | ===== ''Kaphaja chhardi'' ===== | + | ==== [[Kapha]]ja chhardi ==== |
| | | |
− | ''Nidanas'' of ''kaphaprakopaka'' increase ''kapha'' in nature which causes provocation of ''gunas'' like ''guru'' (heavyness), ''sheeta'' (coldness), ''manda'' (slowness), etc. ([[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 ''kaphaja chhardi'' (12-13). | + | ''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). |
| | | |
− | ===== ''Sannipataja chhardi'' =====
| + | ==== ''Sannipataja chhardi'' ==== |
| | | |
− | Intake of diet containing all ''rasas'' or tastes ideal but the intake of food with imbalances in ''rasas'' leads to the vitiation of ''tridoshas''(Ch.Su.26/90-101)and causes ''sannipataja chhardi'' which has varied manifestations covering broad signs of ''tridosha'' involvement ( verses 14-15). | + | 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). |
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− | The ''sama-varna-gandha'' (color & 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)([[Vimana Sthana]] 5/3) ( verses 16-17). | + | The ''sama-varna-gandha'' (color & 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). |
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− | Excessive loss of any ''dhatu'' (''rasa-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)<ref>Shastri Suderashan, Madhava Nidana of Madhavakara, 4th Edition, 1975, Chaukhamba Sanskrit Series, Varanasi, Ma. Ni 15</ref>, etc. are considered to be life threatening. | + | 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)<ref>Madhavakara. Madhava Nidanam (Roga vinischaya) cha 15. Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--</ref>, etc. are considered to be life threatening. |
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− | ==== Treatment ====
| + | === Treatment === |
| | | |
− | *''Langhana'' becomes the first line of treatment in ''chhardi'' as ''shamana chikitsa'' (pacificatory treatment). ''Samshodha'' can be preferred where ''doshas'' are in ''utklishtha'' stage and ready to be expelled out. ''Vamana'' is recommended when ''doshas'' 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 ''doshas'', considering nearest route of ''samshodhana''. The choice of drugs should be done as per the ''doshanashakatva'' (capacity to subside the vitiated ''doshas'') ( verse 20). | + | *[[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). |
− | *''Haritaki'' is known for its laxative action (''anulomaneeya''). It not only ''tridoshahara'' but also possesses many more qualities ([[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. Su. 27/ 193-195) results in quick absorption of the ''dravya'' and hastens the mode of action. ''Dugdha'' (cow milk) along with many other qualities ([[Sutra Sthana]] 27/217-18) is naturally ''saraka'' (purgative) in nature which makes ''anulomana gati'' (natural movements) of ''vayu''. | + | *''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]]. |
− | *As the ''doshas'' 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) ([[Chikitsa Sthana]] 20/ 41-42) . It should be preferably ''mamsarasa'', dry food or liquid diet which is easily digestible ( verses 21-22). | + | *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). |
− | *In ''vataja 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) ([[Sutra Sthana]] 27/231-32 and 13/13) can be beneficial in ''vataja hridroga''. | + | *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. |
− | *If the aggravated ''doshas'' 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''. | + | *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]]. |
− | *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 & disease treatment). | + | *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 & disease treatment). |
− | *For ''kaphaja chhardi chikitsa'', as the ''doshas'' are situated in ''kaphashaya'' (''amashaya / ura'') the nearest and ideal route is ''vamana''. The choice of ''dravyas'' for ''vamana'' should be ''kaphahara'' 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. | + | *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. |
− | *Various types of ''yusha, ragashadava, panaka'' ([[Sutra Sthana]] 27/279-281) are ''kaphahara, madhura-amlarasatmaka'' (sweet & sour), ''deepaneeya-pachaneeya'' (appetizer & digestant) in nature. | + | *Various types of ''yusha, ragashadava, panaka'' [ Cha. Sa. [[Sutra Sthana]] 27/279-281] are ''kaphahara, madhura-amlarasatmaka'' (sweet & sour), ''deepaneeya-pachaneeya'' (appetizer & digestant) in nature. |
− | *For ''chhardinigrahana'' (anti-emetic group), the drugs should be ''kashaya rasatmaka'' (astringent taste), ''sheetaveerya'' (cool potency) and ''kaphaghna'' (''kapha'' alleviators) in nature. The ''manahshiladi yoga'' (a formulation) is considered to be ''vyadhiviparitarthakari'' (anti-disease) measures. | + | *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. |
| *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 & 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. | | *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 & 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. |
− | *The ''vegakalina'' or chronic ''chhardi'', whether mild or severe, involves constant irritation of involved body parts/systems which leads to poor nourishment of ''dhatus'' resulting in ''dhatuksheenata''. Such a long term ''dhatukshaya'' (loss of ''dhatus'') increases ''vata'' in the body. The management should be purely ''vatashamaka'' treatment especially ''stambhana'' (which restricts the ''vamana vega'') in combination with ''brimhana'' (nourishment to ''dhatus''). | + | *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]]). |
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− | 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. | + | 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. |
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− | ==== Current clinical practice for management of chhardi (referred from Chikitsa Pradeep page 25) ====
| + | === Current clinical practice for management of chhardi (referred from Chikitsa Pradeep page 25) === |
| {|class="wikitable" | | {|class="wikitable" |
| !scope = "col"| Type | | !scope = "col"| Type |
Line 845: |
Line 926: |
| !scope = "col"| ''Anupana'' | | !scope = "col"| ''Anupana'' |
| |- | | |- |
− | | ''Vata'' dominant and ''vata-pitta'' dominant | + | | [[Vata]] dominant and [[vata]]-[[pitta]] dominant |
| | ''Shankha bhasma'' | | | ''Shankha bhasma'' |
| | 60-120 mg | | | 60-120 mg |
Line 851: |
Line 932: |
| | ''Nimbu Panaka'' (lemon water) | | | ''Nimbu Panaka'' (lemon water) |
| |- | | |- |
− | | ''Pitta'' dominant | + | |[[Pitta]] dominant |
| | ''Sutashekhara kalpa'' | | | ''Sutashekhara kalpa'' |
| | 500-1000 mg | | | 500-1000 mg |
Line 857: |
Line 938: |
| | ''Dadimavaleha'' | | | ''Dadimavaleha'' |
| |- | | |- |
− | | ''Kapha'' dominant | + | | [[Kapha]] dominant |
| | ''Mayu piccha mashi'' | | | ''Mayu piccha mashi'' |
| | 1 - 3 gms | | | 1 - 3 gms |
Line 863: |
Line 944: |
| | ''Ardrakavaleha'' | | | ''Ardrakavaleha'' |
| |- | | |- |
− | | ''Tridoshaja'' | + | | Tri[[dosha]]ja |
| | ''Brihad vata chintamani'' | | | ''Brihad vata chintamani'' |
| | 50 - 100 mg | | | 50 - 100 mg |
Line 882: |
Line 963: |
| |} | | |} |
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− | ==== Further researches ====
| + | === Further researches === |
| 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. | | 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. |
| + | </div> |
| + | <big>'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''</big> |
| | | |
− | === Glossary ===
| + | == References == |
− | | |
− | #Āmāśayōtklēśabhavā (आमाशयोत्क्लेशभवा): originated from agitatied Doshas in stomach
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− | #Āmāśayōtklēśakr̥tāṁ (आमाशयोत्क्लेशकृतां ): morbid humor which are agitating Amasaya (stomach) and likely to come out
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− | #Āśuchipūtyamēdhyabībhatsagandhāśanadarśanaiśca (अशुचिपूत्यमेध्यबीभत्सगन्धाशन- दर्शनैश्च): contact with diet or sights having despicable, antagonistic unclean, putried, unholy and loathsome odor
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− | #Brahmatapōdyutibhyāṁ (ब्रह्मतपोद्युतिभ्यां): lustre of divine knowledge and penance
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− | #Chhardi (छर्दि): vomitting
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− | #Chhardīnāṁ Praśamārthaṁ (छर्दीनां प्रशमार्थं ): management for the relief of vomiting
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− | #Chhardiratipravr̥ddhā (छर्दिरतिप्रवृद्धा): incessantly vomiting
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− | #Chhardyutthitānāṁ (छर्द्युत्थितानां): treatment of complications arising from vomiting
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− | #Chikitsitāt Svachchikitsitaṁ (चिकित्सितात् स्वाच्चिकित्सितं): treatment should be done according to the lines suggested in respect of each of those ailments
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− | #Chirapravr̥ttāsvanilāpahāni (चिरप्रवृत्तास्वनिलापहानि ): chronic vomiting
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− | #Chūrṇāni Lihyān (चूर्णानि लिह्यान): powder with honey
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− | #Dhātukṣayāddhr̥ddhimupaiti (धातुक्षयाद्धृद्धिमुपैति): loss of tiussue elements
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− | #Dōṣarturōgāgnibalānyavēkṣya (दोषर्तुरोगाग्निबलान्यवेक्ष्य ): considering of preponderance of Dosas, season of occurring of the disease, digestive power and strength of patient
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− | #Durbalastaṁ Śamanaiścikitsēt (दुर्बलस्तं शमनैश्चिकित्सेत्): weak patient should be treated with pacification therapy
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− | #Dviṣṭapratīp (द्विष्टप्रतीप): mental disgust occasioned by sense
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− | #Hitā Vihārāḥ (हिता विहाराः): healthy life style
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− | #Hr̥tpārśvapīḍā (हृत्पार्श्वपीडा): pain in the cardiac region and sides of the chest
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− | #Jvalantamagnyarkasamaprabhāvam (ज्वलन्तमग्न्यर्कसमप्रभावम्): brilliance like that of fire and the sun
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− | #Kaphāmāśayaśōdhanārtham (कफामाशयशोधनार्थम्): to clean the seat of Kapha and Āmāshaya (stomach)
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− | #Kaphāśayasthaṁ Tvatimātravr̥Ddhaṁ (कफाशयस्थं त्वतिमात्रवृद्धं): aggravated Pitta is located in Kapahasthana (chest/stomach)
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− | #Kaphātmikāyāṁ Vamanaṁ Praśastaṁ (कफात्मिकायां वमनं प्रशस्तं):- Vamana (therapeutic emesis) is supposed to be the most suitable therapy in Kaphaja type
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− | #Kāryāṇyupastambhanabr̥ṁhaṇāni (कार्याण्युपस्तम्भनबृंहणानि): medications that are bulk promoting, anti-Vāta Upastambhana (anti-diarrhoeal) and Brimhana (nutritive)
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− | #Kāsasvarabhēdatōdaiḥ (कासस्वरभेदतोदैः): cough, hoarseness of voice and pricking pain
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− | #Kr̥cchrēṇa Cālpaṁ Mahatā (कृच्छ्रेण चाल्पं महता): vomiting urge is forceful, but the patient vomits only small quantity with pain
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− | #Kṣīṇasya (क्षीणस्य ): emaciated
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− | #Laṅghanamēva (लङ्घनमेव): fasting therapy
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− | #Lōkaprasiddhāḥ Śrutayō Vayasyāḥ (लोकप्रसिद्धाः श्रुतयो वयस्याः): Popular legends and stories and congenial companions
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− | #Manōbhighātē (मनोभिघाते): mental disgust
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− | #Manōnukūlā (मनोनुकूला): pleasing and conforting
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− | #Marma Prapīḍayaṁ (मर्म प्रपीडयं): afflicting the Marma (vital organs),
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− | #Mukhaśōṣa (मुखशोष): dryness of mouth
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− | #Mukhaśōṣa (मुखशोष): dryness of the mouth
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− | #Mūrcchā (मूर्च्छा): unconsciousness
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− | #Mūrdhanābhyarti (मूर्धनाभ्यर्ति): Pain in the head and umbilical region
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− | #Mūrdhatālvakṣisantāpa (मूर्धताल्वक्षिसन्ताप):- burning sensation in head, palates and eyes
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− | #Nayantyadhō Dōṣamudīrṇamūrdhvam (नयन्त्यधो दोषमुदीर्णमूर्ध्वम् ): downward movement of the aggravated Doshas that are impelled to move upwards
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− | #Pavanō'pyavaśyaṁ (पवनोऽप्यवश्यं): Vāta invariably gets agrevated
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− | #Pipāsā (पिपासा): thirst
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− | #Pittamudīrṇavēgam (पित्तमुदीर्णवेगम् ): the aggravated Pitta spreads rapidly
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− | #Pittātmikāyāmanulōmanārthaṁ (पित्तात्मिकायामनुलोमनार्थं): patient of Paittika Chhardi should be given laxatives to cause downward movement of the morbid matter
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− | #Prapīḍya Marmōrdhva (प्रपीड्य मर्मोर्ध्व): stresses vital organs of upper parts of the body
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− | #Pravadantyasādhyāṁ (प्रवदन्त्यसाध्यां): only curable types
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− | #Pr̥thaktriprabhavāścatasrō (पृथक्त्रिप्रभवाश्चतस्रो): kinds each of which is caused by a single morbid humor
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− | #Rasairmanōjñairlaghubhirviśuṣkairbhakṣyaiḥ (रसैर्मनोज्ञैर्लघुभिर्विशुष्कैर्भक्ष्यैः): delicious soups and light as well as dry food articles for diet
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− | #Rasāyanībhirvisr̥taṁ (रसायनीभिर्विसृतं ): spreads through the Rasāyani (channels)
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− | #Sabhōjyairvividhaiśca Pānaiḥ (सभोज्यैर्विविधैश्च पानैः): along with various kinds of drinks
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− | #Sacandrikāṁ (सचन्द्रिकां): vomitus that contains Chandrika (circular patches with variegated colour like that at the top of pea-cock feather)
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− | #Samaśnataḥ (समश्नतः): constant indulgence in diet/eating nixture of wholesome and unwholesome food
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− | #Samāśvāsanaharṣaṇāni (समाश्वासनहर्षणानि ): counseling and encouraging
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− | #Samavarṇagandhaṁ (समवर्णगन्धं): having similar colour and odour
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− | #Samāvr̥tya (समावृत्य): collectively
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− | #Saphēna Vicchinnakr̥ṣṇaṁ Tanukaṁ Kaṣāyam (सफेनं विच्छिन्नकृष्णं तनुकं कषायम् ): frothy, scattered, black, thin and astringent vomitus
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− | #Sarvāśchardyō (सर्वाश्छर्द्यो): all the varieties of vomiting
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− | #Sarvē Prakōpaṁ Yugapat (सर्वे प्रकोपं युगपत्): all the three Dosas get simultaneously aggravated
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− | #Śōka (शोक): grief
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− | #Śōṇitapūyayuktā (शोणितपूययुक्ता): vomitus that contains blood and pus
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− | #Sōpadravā (सोपद्रवा): associated with complications
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− | #Svapnādibhiścaiva (स्वप्नादिभिश्चैव ): sense of sleep
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− | #Tāṁ Sannipāta'pi Samasya Buddhyā (तां सन्निपातेऽपि समस्य बुद्ध्या): Sannipatika Chhardi patient should carefully be examined for the relative preponderance of involved Dosas
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− | #Tamōbhramārtaḥ (तमोभ्रमार्तः): feeling as entering into darkness
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− | #Tīkṣṇauṣadha (तीक्ष्णौषध): sharp medicine
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− | #Udgāraśabdaprabalaṁ (उद्गारशब्दप्रबलं): eructation with loud sound
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− | #Utklēśya (उत्क्लेश्य ): the morbid Doshas which are about to come out
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− | #Utsannadōṣasya Samācitaṁ (उत्सन्नदोषस्य समाचितं): morbid matter from the Kostha (gastro-intestinal tract) gets provoked
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− | #Vallīphalādyairvamanaṁ Pibēdvā (वल्लीफलाद्यैर्वमनं पिबेद्वा): emetic therapy prepared of the drugs of the Valliphala (group of cucurbitaceous fruits)
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− | #Vamiprasaṅgāt (वमिप्रसङ्गात्): persistant vomiting
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− | #Vāyuḥ Srōtāṁsi Saṁrudhya (वायुः स्रोतांसि संरुध्य): occlusion of channels by morbid Vāta
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− | #Viṭsvēdamūtrāmbuvahāni (विट्स्वेदमूत्राम्बुवहानि ): channels carrying faeces, sweat, urine and body fluids
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− | #Vyākhyā (व्याख्या): explanation
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− | #Vyāyāma (व्यायाम): physical excercise
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− | #Yaiṣā Pr̥thaktvēna Mayā Kriyōktā (यैषा पृथक्त्वेन मया क्रियोक्ता ): judicious synthesis of the separate lines of treatment
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− | === References ===
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