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Herewith, fifteenth chapter related to Grahaṇī Chikitsā which was unavailable as part of Chikitsā Sthāna of Agnivesha Tantra supplemented by Dr̥ḍhabala has been completed (15).
 
Herewith, fifteenth chapter related to Grahaṇī Chikitsā which was unavailable as part of Chikitsā Sthāna of Agnivesha Tantra supplemented by Dr̥ḍhabala has been completed (15).
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=== Tatva Vimarsha ===
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=== ''Tattva Vimarsha'' ===
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Dehāgni (all the entities in the body that are responsible for digestion and metabolism) is the fundamental causative agent for longevity, normal complexion, normal strength, good health, motivation, normal growth, normal luster, normal ojas, normal body temperature and various other forms of agni. Even the existence of an individual is said to be because of dehāgni (3).
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*Dehāgni (all the entities in the body that are responsible for digestion and metabolism) is the fundamental causative agent for longevity, normal complexion, normal strength, good health, motivation, normal growth, normal luster, normal ojas, normal body temperature and various other forms of agni. Even the existence of an individual is said to be because of dehāgni (3).
When the agni stops functioning, the individual dies; if the agni functions normally, the individual can lead a healthy and long life. .  Similarly, if the agni becomes abnormal, the individual suffers from various diseases; and hence, the agni is said to be the root cause of health and longevity (4).
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*When the agni stops functioning, the individual dies; if the agni functions normally, the individual can lead a healthy and long life. .  Similarly, if the agni becomes abnormal, the individual suffers from various diseases; and hence, the agni is said to be the root cause of health and longevity (4).
Normal functioning of agni is essential to make the consumed food capable of nourishing the body tissues and of promoting the ojas (vital essence), strength, complexion etc. In the absence of normal digestion (and metabolism), the normal body tissues such as rasa cannot be formed nor nourished (5).
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*Normal functioning of agni is essential to make the consumed food capable of nourishing the body tissues and of promoting the ojas (vital essence), strength, complexion etc. In the absence of normal digestion (and metabolism), the normal body tissues such as rasa cannot be formed nor nourished (5).
Vata dosha, specifically prana vata and samana vata play significant role in process of digestion and metabolism.  
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*Vata dosha, specifically prana vata and samana vata play significant role in process of digestion and metabolism.  
Three doshas are produced in three consequent stages of digestion after consumption of food. Kapha is produced in first stage of madhura avasthapaka; pitta in second stage of amla avasthapaka and vata is produced in third stage of katu avasthapaka. The site of production and time of production of dosha is in sequence as the process of digestion proceeds. Increase or decrease in quantity of dosha depends upon similarity or dis-similarity of basic composition of food consumed.  
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*Three doshas are produced in three consequent stages of digestion after consumption of food. Kapha is produced in first stage of madhura avasthapaka; pitta in second stage of amla avasthapaka and vata is produced in third stage of katu avasthapaka. The site of production and time of production of dosha is in sequence as the process of digestion proceeds. Increase or decrease in quantity of dosha depends upon similarity or dis-similarity of basic composition of food consumed.  
The first phase of digestion is carried out by jatharagni, second phase by bhutagni and third phase by dhatvagni. These are different levels of action of agni where various digestive and metabolic processes take place.  
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*The first phase of digestion is carried out by jatharagni, second phase by bhutagni and third phase by dhatvagni. These are different levels of action of agni where various digestive and metabolic processes take place.  
During the processing by dhatvagni, Stanya (breast milk) and the menstrual blood are derived after rasa. Kaṇḍarā (tendon) and sirā(vein) are derived after rakta. Vasā(fat) and the six layers of tvachā (skin) are derived after māṃsa (muscle) and snāyu(ligament) are derived after medas (adipose tissue) (17).
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*During the processing by dhatvagni, Stanya (breast milk) and the menstrual blood are derived after rasa. Kaṇḍarā (tendon) and sirā(vein) are derived after rakta. Vasā(fat) and the six layers of tvachā (skin) are derived after māṃsa (muscle) and snāyu(ligament) are derived after medas (adipose tissue) (17).
The faeces and the urine are the kiṭṭa (non-nutrient portion/waste portion/byproduct) of ingested food. The kiṭṭa of rasa is mala-kapha (excretions). Mala-pitta (bile pigment) is the kiṭṭa of rakta. Kha-mala (the wastes accumulated in the hollow structures of the body such as external ears and nostrils) are the kiṭṭa of māṃsa. Sweda (sweat) is the mala of medas. Keśa (hairs on the head) and loma (body hair) are the mala of asthi. The mala of majjā is the oily excretion of the eye and the skin (sebum). Thus, the dhātus continuously undergo two kinds of transformation: prasāda (nutrient portion) and kiṭṭa (non-nutrient portion). This entire sequence of transformation and metabolism of dhātu is thus inter dependent (18-19½ ).
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*The faeces and the urine are the kiṭṭa (non-nutrient portion/waste portion/byproduct) of ingested food. The kiṭṭa of rasa is mala-kapha (excretions). Mala-pitta (bile pigment) is the kiṭṭa of rakta. Kha-mala (the wastes accumulated in the hollow structures of the body such as external ears and nostrils) are the kiṭṭa of māṃsa. Sweda (sweat) is the mala of medas. Keśa (hairs on the head) and loma (body hair) are the mala of asthi. The mala of majjā is the oily excretion of the eye and the skin (sebum). Thus, the dhātus continuously undergo two kinds of transformation: prasāda (nutrient portion) and kiṭṭa (non-nutrient portion). This entire sequence of transformation and metabolism of dhātu is thus inter dependent (18-19½ ).
Disorders of various factors mentioned above shall be treated after considering the original dhatu from which the factor is derived.  
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*Disorders of various factors mentioned above shall be treated after considering the original dhatu from which the factor is derived.  
Vyāna vāta forcefully propels the rasa dhātu out of the heart and spreads it all over the body simultaneously, continuously and for the entire life (36).
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*Vyāna vāta forcefully propels the rasa dhātu out of the heart and spreads it all over the body simultaneously, continuously and for the entire life (36).
Disease is produced only at the site of abnormality of body systems.  
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*Disease is produced only at the site of abnormality of body systems.  
Life and strength of an individual depends on agni hence one should take utmost care to maintain the agni by providing fuel in the form of food and drinks which should be taken as per the rules mentioned. (40)
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*Life and strength of an individual depends on agni hence one should take utmost care to maintain the agni by providing fuel in the form of food and drinks which should be taken as per the rules mentioned. (40)
If the rules of diet and dietary habits are not followed due to greed, then disease of grahani occurs.  
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*If the rules of diet and dietary habits are not followed due to greed, then disease of grahani occurs.  
The anna-visha (toxins) produced due to improper digestion and metabolism causes diseases at the sites of affliction.  
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*The anna-visha (toxins) produced due to improper digestion and metabolism causes diseases at the sites of affliction.  
The vishāmagni (improper agni) causes irregularity in digestion and therefore defective formation of dhātu takes place. Whereas, tīkṣṇāgni (excessive agni) when associated with little quantity of fuel (in the form of food) causes depletion of dhātu (tissue elements) (50).
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*The vishāmagni (improper agni) causes irregularity in digestion and therefore defective formation of dhātu takes place. Whereas, tīkṣṇāgni (excessive agni) when associated with little quantity of fuel (in the form of food) causes depletion of dhātu (tissue elements) (50).
The digestive disorder of grahani can lead to secondary disorders related with other body systems along with digestive system.  
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*The digestive disorder of grahani can lead to secondary disorders related with other body systems along with digestive system.  
Grahaṇī disease is classified into four types viz vātaja, pittaja, kaphaja and sannipātaja depending upon the dominance of dosha and on the basis of the classification, etiological factors, symptoms and signs are varied.
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*Grahaṇī disease is classified into four types viz vātaja, pittaja, kaphaja and sannipātaja depending upon the dominance of dosha and on the basis of the classification, etiological factors, symptoms and signs are varied.
When the dōṣhas are located in grahaṇī and are associated with incomplete digested food then vamana (emetic therapy) is advised.  
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*When the dōṣhas are located in grahaṇī and are associated with incomplete digested food then vamana (emetic therapy) is advised.  
If the ama is in pakvāśaya and in anutkliṣṭa (stuck, not ready to come out) condition, then stravan (increasing secretion) with dīpana dravyas should be administered.  
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*If the ama is in pakvāśaya and in anutkliṣṭa (stuck, not ready to come out) condition, then stravan (increasing secretion) with dīpana dravyas should be administered.  
If ama gets absorbed along with rasa dhātu and if it pervades throughout the body then laṅghana and pāchana should be advised.
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*If ama gets absorbed along with rasa dhātu and if it pervades throughout the body then laṅghana and pāchana should be advised.
Various purification procedures are advised as per the state of dosha aggravation and site of affliction in disease. Ghee processed with digestive stimulant drugs, sour media like buttermilk is advised.  
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*Various purification procedures are advised as per the state of dosha aggravation and site of affliction in disease. Ghee processed with digestive stimulant drugs, sour media like buttermilk is advised.  
Patient should be evaluated for amadōṣa whether sāmatā or nirāmtā is present or not and then appropriately treated with pāchana etc. treatment (95).
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*Patient should be evaluated for amadōṣa whether sāmatā or nirāmtā is present or not and then appropriately treated with pāchana etc. treatment (95).
Buttermilk due to its dīpana, grāhi (substances which increases appetite and digestive power and absorb fluid from the stool) and easy to digest actions is very useful in grahaṇīdōṣha.
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*Buttermilk due to its dīpana, grāhi (substances which increases appetite and digestive power and absorb fluid from the stool) and easy to digest actions is very useful in grahaṇīdōṣha.
Vata dominant grahani shall be treated with basti, virechana and unctuous preparations.  
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*Vata dominant grahani shall be treated with basti, virechana and unctuous preparations.  
If pitta is dominant in its own place then virechana or vāmana should be administered for removal of pitta (122).
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*If pitta is dominant in its own place then virechana or vāmana should be administered for removal of pitta (122).
In kaphaja grahaṇī, vamana and then drugs having katu, amla, lavana, kṣāra and tikta rasa shall be administered to increase agni (digestive power) (141).
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*In kaphaja grahaṇī, vamana and then drugs having katu, amla, lavana, kṣāra and tikta rasa shall be administered to increase agni (digestive power) (141).
In tridōṣaja grahaṇī, panchakarma should be carried out as per predominancy of doṣha. Various ghee, kṣāra, asava and ariṣṭa preparation useful in stimulation of agni should be administered.
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*In tridōṣaja grahaṇī, panchakarma should be carried out as per predominancy of doṣha. Various ghee, kṣāra, asava and ariṣṭa preparation useful in stimulation of agni should be administered.
Sneha is the best among the dipana dravya which helps in stimulating the inefficient agni (201)
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*Sneha is the best among the dipana dravya which helps in stimulating the inefficient agni (201)
Fasting or over eating doesn’t stimulate agni. Proper intake of snēha, followed by eating proper food preparations as well as appropriate use of various chūrṇa, ariṣṭa, surā and asava along with proper medication as per condition, enhances the power of agni.
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*Fasting or over eating doesn’t stimulate agni. Proper intake of snēha, followed by eating proper food preparations as well as appropriate use of various chūrṇa, ariṣṭa, surā and asava along with proper medication as per condition, enhances the power of agni.
Atygni is caused by diminished kapha, aggravated pitta and associated vāta. This leads to emaciation if proper food is not consumed. Excessively increased digestive power can be pacified by taking foods and drinks which are heavy to digest, unctuous, cold, sweet and liquid.   
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*Atygni is caused by diminished kapha, aggravated pitta and associated vāta. This leads to emaciation if proper food is not consumed. Excessively increased digestive power can be pacified by taking foods and drinks which are heavy to digest, unctuous, cold, sweet and liquid.   
Samaśana  is taking wholesome and unwholesome foods together in diet. Viṣamaśana is taking food either in excess quantity or very little quantity and also if taken before or after appropriate time. Adhyaśana is having food even though previously eaten food is not yet digested. All the above three are causes for death or give rise to serious disorders (235-236).
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*Samaśana  is taking wholesome and unwholesome foods together in diet. Viṣamaśana is taking food either in excess quantity or very little quantity and also if taken before or after appropriate time. Adhyaśana is having food even though previously eaten food is not yet digested. All the above three are causes for death or give rise to serious disorders (235-236).
If morning eaten food is undigested and still if anyone takes evening food, it may not be more vitiative since in day time all the srotas (channels) are dilated and heart is active similar to the lotus which blossoms with sunrise. During daytime, exercise, other physical and mental activities (cause heart to pump blood properly to) prevent the genesis of kleda (excess moisture) in various dhātus. In the night, the channels are closed, so is the heart which functions at slow rate as demand is less, the apakva ahāra rasa increases in viscosity; thus ama adheres to the dhātus and if another food is taken in the morning the indigestion causes more apakva ahāra rasa causing disease.
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*If morning eaten food is undigested and still if anyone takes evening food, it may not be more vitiative since in day time all the srotas (channels) are dilated and heart is active similar to the lotus which blossoms with sunrise. During daytime, exercise, other physical and mental activities (cause heart to pump blood properly to) prevent the genesis of kleda (excess moisture) in various dhātus. In the night, the channels are closed, so is the heart which functions at slow rate as demand is less, the apakva ahāra rasa increases in viscosity; thus ama adheres to the dhātus and if another food is taken in the morning the indigestion causes more apakva ahāra rasa causing disease.
    
=== Vidhi Vimarsha ===
 
=== Vidhi Vimarsha ===

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