Changes

== Tattva Vimarsha (Fundamental Principles) ==

== Tattva Vimarsha (Fundamental Principles) ==

*''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''.  

*''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''.  

*There are five categories of etio-pathological factors for ''atisara'':

*There are five categories of etio-pathological factors for ''atisara'':

#Reduced ''agni'',  

#Reduced [[agni]],  

#Vitiated ''vata'' and its sub types ''samana'' and ''apana''.  

#Vitiated [[vata]] and its sub types ''samana'' and ''apana''.  

#Vitiated body fluids.  

#Vitiated body fluids.  

#Vitiated  ''purishavaha srotas'' (lower gastro-intestinal tract) and organs of excretion.  

#Vitiated  ''purishavaha srotas'' (lower gastro-intestinal tract) and organs of excretion.  

#Fear and grief (mental).

#Fear and grief (mental).

*Interaction of ''prakriti'' (basic constitution) and the diet and lifestyle of similar properties (as that of ''dosha prakriti'') makes the person susceptible for ''atisara''.   

*Interaction of [[Prakriti]] (basic constitution) and the diet and lifestyle of similar properties (as that of [[dosha]] [[Prakriti]]) makes the person susceptible for ''atisara''.   

*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.

*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.

*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.  

*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.  

*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''.  

*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''.  

*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.     

*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.     

*The endogenous ''atisara'' shall be treated after proper assessment of dominant ''dosha'', causative factors and pacifying factors,   

*The endogenous ''atisara'' shall be treated after proper assessment of dominant [[dosha]], causative factors and pacifying factors,   

*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, stambhan'' is given and care should taken to keep ''vata'' balanced.

*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.

*In case of prolapse of rectum, medicated ghee processed with sour herbs or ''anuvasana'' (unctuous enema) is prescribed.   

*In case of prolapse of rectum, medicated ghee processed with sour herbs or ''anuvasana'' (unctuous enema) is prescribed.   

*Various states of ''atisara'' like that mixed with mucous, blood, associated with colic pain shall be treated with ''pichcha basti'' (mucilaginous enema).  

*Various states of ''atisara'' like that mixed with mucous, blood, associated with colic pain shall be treated with pichcha [[basti]] (mucilaginous enema).  

*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.

*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.

*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''.

*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]].

== Vidhi Vimarsha (Applied Inferences ) ==

== Vidhi Vimarsha (Applied Inferences ) ==