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Line 21: − + − + − + + + + + + + + + + + + + − ==[[Chikitsa Sthana]] Chapter 15, Chapter on Management of Grahani (Digestive Disorders)==+ − − === Abstract === − − [[Grahani Chikitsa]] consists of three parts. The first part explains the concept of normal digestion process. The second part describes the abnormal digestion and third part is about diseases caused by abnormality of digestive fire and its interaction with proximal intestine or ''grahani''. These disorders are called ''grahanidosha''. − − − + − + − + Line 33:
Line 50: − + + − === Introduction === + + − + − + − + − + − + − + − + − + − + − + + − ===Sanskrit Text, Transliteration and English Translation===+ + + Line 74:
Line 96: + + + − Now we shall describe the chapter on the management of ''grahani dosha'', so said respectable Atreya [1-2]+ − + − ==== Importance of ''dehagni'' ==== + Line 90:
Line 115: + − + + + Line 104:
Line 132: + + + Line 118:
Line 149: + − + − ==== Process of digestion-first phase ====+ + Line 134:
Line 167: + Line 158:
Line 192: + − + − ==== Three states of digestion and provoking ''dosha'' ====+ + − + Line 174:
Line 210: + Line 189:
Line 226: − + Line 198:
Line 235: + − + − + − + − + − ==== Second phase of digestion by ''pancha-mahabhuta'' ====+ + + Line 218:
Line 258: + − + + + Line 232:
Line 275: + − + + + Line 246:
Line 292: + − + − ==== Third phase of digestion and metabolism at level of ''dhatu'' ====+ + + Line 262:
Line 311: + − + + + Line 276:
Line 328: + − + − ==== ''Upadhatu'' (metabolic products) ====+ + + Line 292:
Line 347: + − + − ==== ''Mala'' formed at tissue level metabolism ====+ + Line 306:
Line 363: + Line 326:
Line 384: + − + − ==== Modes of transformation ====+ + − + + + − + + + Line 350:
Line 414: + − + + Line 378:
Line 444: + Line 418:
Line 485: + − + − + − ==== Formation of ''rasa'' and ''rakta'' ====+ + Line 432:
Line 501: + Line 448:
Line 518: + − + − ==== Formation of ''mamsa dhatu'' ====+ + + Line 466:
Line 539: + − + − ==== Formation of ''meda dhatu'' ====+ + + + − + − ==== Formation of ''asthi dhatu'' ====+ + + Line 492:
Line 571: + − + − ==== Formation of ''majja dhatu'' ====+ + + Line 508:
Line 590: + − + − ==== Formation of ''shukra dhatu'' ====+ + Line 526:
Line 610: + Line 554:
Line 639: + − + − ==== Continuous circulation of ''rasa'' all over the body ====+ + + Line 570:
Line 658: + − + − ==== Significance of ''Kha-Vaigunya'' (abnormality in body system) in causing disease state ====+ + + Line 586:
Line 677: + − + + + + − + + + + − ==== Significance of ''jatharagni'' ====+ + + Line 618:
Line 718: + + − + + Line 632:
Line 735: + − ==== Initiation of ''grahani dosha'' ====+ + + Line 648:
Line 754: + − ==== Causes of vitiation of ''agni'' ====+ + Line 664:
Line 772: + Line 688:
Line 797: + − + − + − ==== Signs and symptoms of ''ajirna''(indigestion) ====+ + Line 702:
Line 813: + Line 718:
Line 830: + − ==== Associated disorders of ''annavisha'' ====+ + Line 734:
Line 848: + Line 758:
Line 873: + − + − + − ==== Effects of ''Vishamagni'' (irregular ''agni'')and ''tikshanagni''( excessive ''agni'') ====+ + + Line 778:
Line 896: + − + − ==== ''Samagni'' ====+ + + + + + − If ''agni'' is ''sama'' i.e. in balanced condition and correct diet regimen (as explained in Ca. Su. 5 and Ca.Vi.1/21) are also followed then there is proper digestion of food which helps in maintaining proper balance within the ''dhatu'' [50½]+ + − ==== ''Durbala'' (weak) ''agni'' ==== − + + − ==== ''Grahani gada''(diseases of ''grahani'') ====+ + Line 814:
Line 940: + Line 838:
Line 965: + Line 843:
Line 971: − ==== Premonitory symptoms of ''Grahani gada'' ====+ + + Line 856:
Line 986: + − ==== Functions of ''grahani'' ====+ + Line 868:
Line 1,000: + Line 884:
Line 1,017: + − + − ==== Four types of ''grahani'' disease ====+ + + Line 900:
Line 1,036: + − + − ==== Causes of ''vataja grahani'' ====+ + Line 910:
Line 1,048: + Line 922:
Line 1,061: + − + − ==== Symptoms of ''vataja grahani'' ====+ + Line 944:
Line 1,085: + Line 980:
Line 1,122: + Line 989:
Line 1,132: − ==== Causes of ''pittaja grahani'' ====+ + + Line 1,002:
Line 1,147: − + − + + − ==== Symptoms of ''pittaja grahani'' ====+ + + Line 1,018:
Line 1,166: + − + − ==== Causes of ''kaphaja grahani'' ====+ + + Line 1,034:
Line 1,185: + − + − ==== Symptoms of ''kaphaja grahani'' ====+ + Line 1,050:
Line 1,203: + Line 1,074:
Line 1,228: + + + Line 1,088:
Line 1,245: + − ==== ''Sannipataja grahani'' ====+ + + Line 1,108:
Line 1,268: + − + − ==== ''Vamana'' in ''grahanidosha'' ====+ + Line 1,120:
Line 1,282: + Line 1,136:
Line 1,299: + − + − ==== Treatment of ''leena dosha'' ====+ + + Line 1,152:
Line 1,318: + − + − ==== ''Panchakoladi shritam and peya'' ====+ + + Line 1,168:
Line 1,337: + − + + + Line 1,182:
Line 1,354: + − + − ==== ''Niruha basti'' ====+ + + Line 1,198:
Line 1,373: + − + − ==== ''Virechana'' ====+ + + Line 1,214:
Line 1,392: + − + − ==== ''Anuvasana basti'' ====+ + + Line 1,230:
Line 1,411: + − + + + Line 1,244:
Line 1,428: + − + − ==== ''Dashamooladya ghrita''====+ + Line 1,270:
Line 1,456: + Line 1,314:
Line 1,501: + − + − ==== ''Tryushanadya ghrita'' ====+ + Line 1,324:
Line 1,513: + Line 1,336:
Line 1,526: + − ==== ''Panchamooladya ghrita'' and ''choorna'' ====+ + Line 1,366:
Line 1,558: + Line 1,418:
Line 1,611: + − + − + − ==== Examination of feces ====+ + + Line 1,440:
Line 1,636: + − + + + Line 1,454:
Line 1,653: + − + − ==== ''Chitrakadya gutika'' ====+ + Line 1,468:
Line 1,669: + Line 1,488:
Line 1,690: + − ==== Recipes for ''pachana'' of ''ama'' ====+ + + Line 1,504:
Line 1,709: + − + + Line 1,512:
Line 1,719: + Line 1,524:
Line 1,732: + + + + − + + Line 1,542:
Line 1,755: + Line 1,558:
Line 1,772: + − ==== Recipe for ''pitta-kapha grahani'' ====+ + Line 1,570:
Line 1,786: + Line 1,586:
Line 1,803: + − + + + Line 1,600:
Line 1,820: + + Line 1,610:
Line 1,832: + Line 1,626:
Line 1,849: + − + − ==== ''Marichadya choorna'' ====+ + Line 1,644:
Line 1,869: + Line 1,672:
Line 1,898: + − + + Line 1,682:
Line 1,910: + Line 1,698:
Line 1,927: + − ==== Five types of ''yavagu'' ====+ + Line 1,714:
Line 1,945: + Line 1,738:
Line 1,970: + − ==== Beverages ====+ + Line 1,750:
Line 1,984: + Line 1,766:
Line 2,001: + − + − ==== Qualities and benefits of buttermilk ====+ + Line 1,784:
Line 2,021: + Line 1,808:
Line 2,046: + − + − ==== ''Takrarishtha'' ====+ + Line 1,822:
Line 2,062: + Line 1,842:
Line 2,083: + − ==== Management of ''pitta'' dominant ''grahani'' ====+ + + Line 1,858:
Line 2,102: + − + − ==== Diet after ''shodhana'' ====+ + Line 1,870:
Line 2,116: + Line 1,886:
Line 2,133: + − + − + − ==== ''Chandanadya ghrita'' ====+ + Line 1,908:
Line 2,157: + Line 1,940:
Line 2,190: + − + + + + − + − ==== ''Nagaradya churna'' ====+ + Line 1,964:
Line 2,219: + Line 1,992:
Line 2,248: + − ==== ''Bhunimbadya churna'' ====+ + Line 2,006:
Line 2,264: + Line 2,026:
Line 2,285: + + Line 2,040:
Line 2,301: + Line 2,064:
Line 2,326: + − ==== ''Kiratadya churna'' ====+ + Line 2,086:
Line 2,350: + Line 2,122:
Line 2,387: + − ==== Treatment of ''kaphaja grahani'' ====+ + + Line 2,138:
Line 2,406: + − + + Line 2,148:
Line 2,418: + Line 2,164:
Line 2,435: + + Line 2,174:
Line 2,447: + Line 2,190:
Line 2,464: + − ==== ''Madhukasava'' ====+ + Line 2,212:
Line 2,488: + Line 2,248:
Line 2,525: + − + + Line 2,258:
Line 2,537: + Line 2,274:
Line 2,554: + Line 2,279:
Line 2,560: − ==== ''Duralabhasava'' ====+ + Line 2,298:
Line 2,580: + Line 2,334:
Line 2,617: + − + − ==== ''Moolasava'' ====+ + Line 2,356:
Line 2,641: + Line 2,392:
Line 2,678: + − + − ==== ''Pindasava'' ====+ + Line 2,410:
Line 2,698: + Line 2,438:
Line 2,727: + − ==== ''Madhvarishtha'' ====+ + Line 2,464:
Line 2,755: + Line 2,508:
Line 2,800: + − + + Line 2,520:
Line 2,814: + Line 2,538:
Line 2,833: + − + − + + + + − + − ==== ''Ksharaghrita'' ====+ + Line 2,562:
Line 2,862: + Line 2,582:
Line 2,883: + + Line 2,600:
Line 2,903: + Line 2,632:
Line 2,936: + − + − ==== ''Kshara'' preparations ====+ + Line 2,644:
Line 2,950: + Line 2,660:
Line 2,967: + + Line 2,672:
Line 2,981: + Line 2,688:
Line 2,998: + + + Line 2,702:
Line 3,015: + + + Line 2,716:
Line 3,032: + − ==== ''Ksharagudika'' ====+ + Line 2,734:
Line 3,052: + Line 2,762:
Line 3,081: + − ==== ''Chaturtha-kshara'' ====+ + Line 2,776:
Line 3,097: + Line 2,796:
Line 3,118: + − ==== ''Panchamakshara'' ====+ + Line 2,826:
Line 3,150: + Line 2,878:
Line 3,203: + − + − ==== Treatment of ''tridoshaja grahani''====+ + Line 2,892:
Line 3,219: + Line 2,908:
Line 3,236: + − + − + + Line 2,920:
Line 3,250: + Line 2,936:
Line 3,267: + − + − ==== Treatment of various states of disease and ''dosha'' aggravation ====+ + + Line 2,952:
Line 3,286: + − + + + Line 2,968:
Line 3,305: + − + + + Line 2,982:
Line 3,322: + − + + + Line 2,996:
Line 3,339: + − + + Line 3,008:
Line 3,353: + Line 3,028:
Line 3,374: + − + + + Line 3,044:
Line 3,393: + + + + − + + + Line 3,068:
Line 3,423: + + + Line 3,082:
Line 3,440: + − + + Line 3,090:
Line 3,450: + Line 3,100:
Line 3,461: + − + + Line 3,110:
Line 3,473: + Line 3,128:
Line 3,492: + − ==== Factors affecting status of ''agni'' ====+ + + Line 3,144:
Line 3,511: + + Line 3,152:
Line 3,521: + Line 3,164:
Line 3,534: + + Line 3,180:
Line 3,552: + Line 3,208:
Line 3,581: + Line 3,213:
Line 3,587: − + − ==== ''Samprapti'' of ''atyagni'' ====+ + Line 3,228:
Line 3,603: − + + Line 3,248:
Line 3,624: − + − + + + Line 3,264:
Line 3,642: + Line 3,292:
Line 3,671: + Line 3,297:
Line 3,677: − ==== Management of ''atyagni'' ====+ + Line 3,306:
Line 3,687: + Line 3,322:
Line 3,704: + + Line 3,330:
Line 3,714: + Line 3,342:
Line 3,727: + + + Line 3,356:
Line 3,744: + + Line 3,370:
Line 3,760: + Line 3,394:
Line 3,785: + + Line 3,404:
Line 3,797: + Line 3,416:
Line 3,810: + − + + Line 3,428:
Line 3,824: + Line 3,452:
Line 3,849: + − + − + − ==== Improper dietary habits ====+ + Line 3,468:
Line 3,867: + Line 3,488:
Line 3,888: + Line 3,497:
Line 3,898: − ==== Variation in digestion as per day-night cycle ====+ + Line 3,508:
Line 3,910: + Line 3,528:
Line 3,931: + − + + Line 3,536:
Line 3,941: + Line 3,548:
Line 3,954: + + Line 3,562:
Line 3,970: + Line 3,586:
Line 3,995: + − + − ==== Summary ====+ + Line 3,616:
Line 4,027: + Line 3,668:
Line 4,080: + Line 3,675:
Line 4,088: − + − + Line 3,682:
Line 4,095: + + Line 3,694:
Line 4,109: + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − + − ==== Importance of ''agni'' ====+ − + − + − ==== Role of ''vata'' in digestion ====+ − + − ==== ''Dhatvagni'' ====+ − + − + − ==== Three stages of digestion ====+ − + − + − + − + − ==== Formation of the seven ''dhatus'' ====+ − + + − + − + − + − + − + − + − + − + − + − ==== The process of nourishment of ''dhatu'' ====+ − + − ==== ''Ksheera-dadhi nyaya'' (milk curdling analogy) ====+ − + − ==== ''Khalekapota nyaya'' (analogy of pigeons picking up the choicest grains) ====+ − + − ==== ''Kedari-kulya nyaya'' (analogy of irrigation) ====+ − + Line 3,813:
Line 4,230: − + − + − ==== Causes of ''grahani'' disorder ====+ − + − + − + − + − + Line 3,835:
Line 4,252: − ==== Effect on immunity ====+ − + − + − + − ==== Equilibrium of ''agni'' ====+ − + − + − + − ==== Clinical features ====+ Line 3,867:
Line 4,284: − + − + − + − + Line 3,883:
Line 4,300: − + − + Line 3,907:
Line 4,324: − + − + Line 3,919:
Line 4,336: − + − + − + Line 3,931:
Line 4,348: − + Line 3,939:
Line 4,356: − + − + − + − + − + − + − + − + − + Line 3,969:
Line 4,386: − + Line 3,977:
Line 4,394: − ==== Current clinical practices ====+ Line 4,110:
Line 4,527: − + − === References ===+ + +
→Areas of Further Research
{{#seo:
|title=Grahani Chikitsa
|titlemode=append
|keywords=Digestion in Ayurveda, metabolism in Ayurveda, jatharagni, bhutagni, dhatvagni, grahani, grahanidosha, grahani roga, annavisha, atyagni, samashana, vishamashana, adhyashana, Ayurveda, charak samhita, Indian system of medicine.
|description=Chikitsa Sthana Chapter 15. Management of Grahani (Diseases of digestion and metabolism)
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
|image_alt=charak samhita
|type=article
}}
<big>'''[[Chikitsa Sthana]] Chapter 15. Management of Grahani (Diseases of digestion and metabolism) </big>'''
{{Infobox
{{Infobox
|title = Grahani Chikitsa
|title = Grahani Chikitsa
|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 = Patwardhan K., Ojha S.N.,Upadhyaya W., Samant A.
|label7 = Reviewer
|data7 = Dharmadhikari A., Kajaria D.
|label8 = Editors
|data8 = Singh G., Goyal M., Deole Y.S., 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.s06.016 10.47468/CSNE.2020.e01.s06.016]
}}
}}
<big>'''Abstract </big>'''
<div style="text-align:justify;">
[[Grahani Chikitsa]] consists of three parts. The first part explains the concept of normal digestion process. The second part describes the abnormal digestion and third part is about diseases caused by abnormality of digestive factors and its interaction with proximal intestine or ''grahani''. These disorders are called ''grahanidosha''.
''Agni'' (digestive and metabolic agents), based on their specific functions of conversion of food into biological elements of the body are classified into thirteen types. First, the ''jatharagni'' is most important because it is the initiator of digestive process and it strengthens the digestive ability of other twelve ''agnis''. Five ''bhutagnis'' transform the ''panchmahabhauika'' components of ''ahara rasa'' created by ''jatharagni'' into different structures of the body. Seven ''dhatvagnis'' create seven tissues elements(''[[dhatu]]'').
''Agni'' (digestive and metabolic agents), based on their specific functions of conversion of food into biological elements of the body are classified into thirteen types. First, the ''jatharagni'' is most important because it is the initiator of digestive process and it strengthens the digestive ability of other twelve ''agnis''. Five ''bhutagnis'' transform the ''panchmahabhauika'' components of ''ahara rasa'' created by ''jatharagni'' into different structures of the body. Seven ''dhatvagnis'' create seven tissues elements(''dhatu'').
''Jatharagni'' initiates the first phase of digestion process by conversion of food into nutrient fluid (''ahara rasa''). This nutrient fluid is further trifurcated into three biological substances ''kapha, pitta'' and ''vata'' in three stages to ''madhura, amla'' and ''katu awastha paka'' respectively. This biofluid is separated into excretable waste or impure products by ''samana vata'' in ''grahani'' (middle part of GI Tract) and useful, pure circulable products. ''Samana vata'' analyzes and separates the useful products (''prasada'') and waste (''kitta''). Useful products get absorbed by ''rasayani'' (villi) of the intestine, sent to the micro channels (''srotas'') by ''vyanvata'', simutaneouly, to the entire body. Waste products are excreted out by ''apana vayu'' through urine, feces and sweat.
''Jatharagni'' initiates the first phase of digestion process by conversion of food into nutrient fluid (''ahara rasa''). This nutrient fluid is further trifurcated into three biological substances ''[[kapha]], [[pitta]]'' and ''[[vata]]'' in three stages to ''madhura, amla'' and ''katu awastha paka'' respectively. This biofluid is separated into excretable waste or impure products by ''samana vata'' in ''grahani'' (middle part of GI Tract) and useful, pure circulable products. ''Samana vata'' analyzes and separates the useful products (''prasada'') and waste (''kitta''). Useful products get absorbed by ''rasayani'' (villi) of the intestine, sent to the micro channels (''srotas'') by ''vyanvata'', simutaneouly, to the entire body. Waste products are excreted out by ''apana vayu'' through urine, feces and sweat.
Now second and third phase of digestion process occur simultaneously in the ''srotas'' (microchannels). Five ''bhutagnis'' work on the formation of anatomical structure of the body from respective ''panchamahabhuta'' in the form of micro channels, by digesting needful components present in biofluid. Each gross and subtle particle of body is ''panchabhautika'', but each one is having different proportion of ''mahabhuta''.
Now second and third phase of digestion process occur simultaneously in the ''srotas'' (microchannels). Five ''bhutagnis'' work on the formation of anatomical structure of the body from respective ''[[panchamahabhuta]]'' in the form of micro channels, by digesting needful components present in biofluid. Each gross and subtle particle of body is ''[[panchabhautika]]'', but each one is having different proportion of ''[[mahabhuta]]''.
Now the third phase of digestion is processed in seven micro channels (''srotas'') specified for seven body tissues (''dhatu'') for the formation of body tissues by their specific seven tissue transformers (''dhatvagnis'') Excreable waste products are carried out by three excreatory channels as feces, urine and sweat, along with sub tissues and sub excreta of sensory organs.
Now the third phase of digestion is processed in seven micro channels (''srotas'') specified for seven body tissues (''[[dhatu]]'') for the formation of body tissues by their specific seven tissue transformers (''dhatvagnis'') Excreable waste products are carried out by three excreatory channels as feces, urine and sweat, along with sub tissues and sub excreta of sensory organs.
Second part of this chapter explains the etiopathology of abnormal digestion, and formation of intermediate products as seed cause of various diseases in the form of ''ama, shukta'' and ''amavisha''.
Second part of this chapter explains the etiopathology of abnormal digestion, and formation of intermediate products as seed cause of various diseases in the form of ''ama, shukta'' and ''amavisha''.
Third part explicates the etiopathology, types, symptoms and treatments of ''grahanidosha'' as a syndrome of various digestive disorders. The chapter sums up in defining abnormal dietary habits.
Third part explicates the etiopathology, types, symptoms and treatments of ''grahanidosha'' as a syndrome of various digestive disorders. The chapter sums up in defining abnormal dietary habits.
'''Keywords''': Digestion in Ayurveda, metabolism in Ayurveda, ''jatharagni, bhutagni, dhatvagni, grahani, grahanidosha, grahani roga, annavisha, atyagni, samashana, viṣamaśana, adhyashana''.
'''Keywords''': Digestion in [[Ayurveda]], metabolism in [[Ayurveda]], ''jatharagni, bhutagni, dhatvagni, grahani, grahanidosha, grahani roga, annavisha, atyagni, samashana, vishamashana, adhyashana''.
</div>
== Introduction ==
<div style="text-align:justify;">
[[Grahani Chikitsa]] is one of the most important chapters of this compendium because most of the diseases originate from disorders of digestion. This chapter is described after ''arsha roga'' (hemorrhoids) because pathophysiology of ''arsha'' influences ''agni'' and before [[Panduroga Chikitsa]] because ''grahani roga'' influences ''panduroga''. The initial portion of this chapter discusses the details of the physiological process of digestion and metabolism in human body. ''Agni'', being the fundamental factor in maintaining health and in producing diseases, has been described in detail. The chapter begins with explanation of importance of normally functioning ''agni'' and then goes on to explain the various aspects of digestion, metabolism and tissue nourishment.
[[Grahani Chikitsa]] is one of the most important chapters of this compendium because most of the diseases originate from disorders of digestion. This chapter is described after ''arsha roga'' (hemorrhoids) because pathophysiology of ''arsha'' influences ''agni'' and before [[Panduroga Chikitsa]] because ''grahani roga'' influences ''panduroga''. The initial portion of this chapter discusses the details of the physiological process of digestion and metabolism in human body. ''Agni'', being the fundamental factor in maintaining health and in producing diseases, has been described in detail. The chapter begins with explanation of importance of normally functioning ''agni'' and then goes on to explain the various aspects of digestion, metabolism and tissue nourishment.
Different theories of tissue nourishment as explained by the commentators play a crucial role in the entire process. The concept of ''upadhatu'' and ''dhatumala'' has also been dealt with. These descriptions are followed by the pathophysiology of ''grahanidosha'' syndrome and its management. This chapter underscores that the knowledge of physiology is crucial in understanding the pathophysiology and therapeutics of a disease.
Different theories of tissue nourishment as explained by the commentators play a crucial role in the entire process. The concept of ''upadhatu'' and ''dhatumala'' has also been dealt with. These descriptions are followed by the pathophysiology of ''grahanidosha'' syndrome and its management. This chapter underscores that the knowledge of physiology is crucial in understanding the pathophysiology and therapeutics of a disease.
Protection of ''agni'' is very essential in treatment of all diseases.(Chakrapani Ca.Ci.14/244-246 )''Arsha, atisara'' and ''grahanidosha'' are said to be ''paraspara hetu'' which means one disease becomes cause for another disease(Ca.Ci.14/244) e.g. in patients with chronic colitis, intestinal polyps are seen, in patients suffering from diarrhea colitis is observed. Therefore, one finds interrelation between these disorders and as explained earlier, special precaution should be taken with respect to ''agni bala''.
Protection of ''agni'' is very essential in treatment of all diseases.[Chakrapani,Cha.Sa.[[ Chikitsa Sthana ]]14/244-246 ]''Arsha, atisara'' and ''grahanidosha'' are said to be ''paraspara hetu'' which means one disease becomes cause for another disease[Cha.Sa. [[ Chikitsa Sthana ]]14/244] e.g. in patients with chronic colitis, intestinal polyps are seen, in patients suffering from diarrhea colitis is observed. Therefore, one finds interrelation between these disorders and as explained earlier, special precaution should be taken with respect to ''agni bala''.
Certain drugs like ''chitraka'' (Plumbago zeylanica), ''pippali'' (Piper longum), ''pippalimula'' (root of Piper longum), ''shunthi'' (Zingiber officinale), ''nagakesara, haridra, danti, duralabha, haritaki'' etc have been used in combinations with other drugs for the treatment of ''arsha'' considering the concept of ''agnibala vriddhi'' and ''vata anulomanam'' (facilitating passage of ''vata'') and the same drugs have been used in ''grahani chikitsa'' with the same concept. Charak explains that all the above three diseases are caused by ''agnimandya'' and if increase in ''agni'' is done then relief in the disease takes place. (Chakrapani Ca.Ci.14/244-246)
Certain drugs like ''chitraka'' (Plumbago zeylanica), ''pippali'' (Piper longum), ''pippalimula'' (root of Piper longum), ''shunthi'' (Zingiber officinale), ''nagakesara, haridra, danti, duralabha, haritaki'' etc have been used in combinations with other drugs for the treatment of ''arsha'' considering the concept of ''agnibala vriddhi'' and ''vata anulomanam'' (facilitating passage of ''[[vata]]'') and the same drugs have been used in ''grahani chikitsa'' with the same concept. Charak explains that all the above three diseases are caused by ''agnimandya'' and if increase in ''agni'' is done then relief in the disease takes place. [Chakrapani Cha.Sa.[[Chikitsa Sthana]] 14/244-246]
Further, ''vata'' is said to be ''agnisakha'' i.e. ''agnibala'' depends on ''vata''. ''Vatakshaya'' or ''prakopa'' results in ''agnimandya''. Therefore, ''anna, pana'' and ''ausadha'' which bring about ''vata anulomana'' are very useful in treatment of diseases like ''arsha'' and ''grahani dosha''.
Further, ''[[vata]]'' is said to be ''agnisakha'' i.e. ''agnibala'' depends on ''[[vata]]''. ''Vatakshaya'' or ''prakopa'' results in ''agnimandya''. Therefore, ''anna, pana'' and ''ausadha'' which bring about ''vata anulomana'' are very useful in treatment of diseases like ''arsha'' and ''grahani dosha''.
''Vata anulomanam'' means to facilitate the ''gati'' (motion) of ''vata'' downwards to anus. Among five types of ''vata, samana'' and ''apana'' have major role in diseases like ''arsha, atisara'' and ''grahanidosha''. Obstruction to movement of ''vata'' (''avarudha gati'') or diarrhea (''atisaraṇa'') leads to ''agni kshaya''. ''Avarudha gati'' is the cause for ''vibandha'' (constipation), ''malavibandha'' (obstruction to feces) along with ''pravahana'' (urge to defecate) which increases the intra-lumen pressure leading to incompetency of valves in rectal veins leading to their varicosity which causes hemorrhoids where as ''atisarana'' (diarrhea) causes increased motility of intestine. Hence ''vata anulomanam'' should not be understood as ''virechana'' or laxation but regularization of ''vata gati'' so that there is no ''avarodha'' or ''atisarana''. The same concept of ''vata anulomana'' is also mentioned in [[Grahani Chikitsa]].(Ca.Ci.14/247)
''Vata anulomanam'' means to facilitate the ''gati'' (motion) of ''[[vata]]'' downwards to anus. Among five types of ''[[vata]], samana'' and ''apana'' have major role in diseases like ''arsha, atisara'' and ''grahanidosha''. Obstruction to movement of ''[[vata]]'' (''avarudha gati'') or diarrhea (''atisaraṇa'') leads to ''agni kshaya''. ''Avarudha gati'' is the cause for ''vibandha'' (constipation), ''malavibandha'' (obstruction to feces) along with ''pravahana'' (urge to defecate) which increases the intra-lumen pressure leading to incompetency of valves in rectal veins leading to their varicosity which causes hemorrhoids where as ''atisarana'' (diarrhea) causes increased motility of intestine. Hence ''vata anulomanam'' should not be understood as ''[[virechana]]'' or laxation but regularization of ''[[vata]] gati'' so that there is no ''avarodha'' or ''atisarana''. The same concept of ''vata anulomana'' is also mentioned in [[Grahani Chikitsa]].[Cha.Sa. [[Chikitsa Sthana]] 14/247]
Therefore, the line of treatment used in ''arsha'' with regard to ''agni bala'' and ''vata anulomanam'' is basically similar to that of ''grahanidosha'' hence Charak has explained [[Grahani Chikitsa]] after [[Arsha Chikitsa]].( Chakrapani Ca.Ci.15/1) Charak could have restricted the name of chapter to [[Grahani Chikitsa]] i.e. treatment of the ''avayava grahani'' whereas he has increased the scope of chapter by using the word ''grahanidosha''.(Chakrapani Ca.Ci.15/1).
Therefore, the line of treatment used in ''arsha'' with regard to ''agni bala'' and ''vata anulomanam'' is basically similar to that of ''grahanidosha'' hence Charak has explained [[Grahani Chikitsa]] after [[Arsha Chikitsa]].[Chakrapani Cha.Sa.[[Chikitsa Sthana]]15/1] Charak could have restricted the name of chapter to [[Grahani Chikitsa]] i.e. treatment of the ''avayava grahani'' whereas he has increased the scope of chapter by using the word ''grahanidosha''.[Chakrapani, Cha.Sa. [[Chikitsa Sthana]] 15/1].
There is always an inter-relationship between ''avayava'' (organ) and ''avayavi'' (part of organ) or ''ashraya''(seat) and ''ashrayi'' (seated). Either of the one has an impact on the other, hence if ''grahaniavayava'' is in normal state then ''agni'' the ''avayavi'' functions normally and vice versa also holds true, whereas if ''dusti'' of ''grahani'' takes place ''agni vaishamyata'' (imbalance) is seen e.g. ileitis, wherein digestion is hampered. ''Grahani'' is the seat for ''jatharagni''. (Ca.Ci.15 /56) ''Agni'' is responsible for ''ayu'' (longevity of life), ''varna'' (complexion), ''bala'' (strength), ''svasthya'' (health), ''utsaha'' (enthusiasm), ''upachaya'' (proper metabolism), ''prabha'' (glow) and ''oja'' (core energy). ''Prakrita agni'' (normal digestive power) is essential for long and healthy life while, vitiated ''agni'' is responsible for ''roga avastha''(disease).(Ca. Ci. 15/3-4)
There is always an inter-relationship between ''avayava'' (organ) and ''avayavi'' (part of organ) or ''ashraya''(seat) and ''ashrayi'' (seated). Either of the one has an impact on the other, hence if ''grahaniavayava'' is in normal state then ''agni'' the ''avayavi'' functions normally and vice versa also holds true, whereas if ''dusti'' of ''grahani'' takes place ''agni vaishamyata'' (imbalance) is seen e.g. ileitis, wherein digestion is hampered. ''Grahani'' is the seat for ''jatharagni''. [Cha.Sa.[[Chikitsa Sthana]] 15 /56] ''Agni'' is responsible for ''ayu'' (longevity of life), ''varna'' (complexion), ''bala'' (strength), ''svasthya'' (health), ''utsaha'' (enthusiasm), ''upachaya'' (proper metabolism), ''prabha'' (glow) and ''[[oja]]'' (core energy). ''Prakrita agni'' (normal digestive power) is essential for long and healthy life while, vitiated ''agni'' is responsible for ''roga avastha''(disease).[Cha. Sa. [[Chikitsa Sthana]] 15/3-4]
In this chapter, Charak describes formation of body tissues in detail with the role of ''ahara'' which is supplied continuously to maintain homeostasis. ''Vyana vata'' is promoter of ''rasa raktadi'' circulation.( Ca. Ci. 15/36) It transports ''rasa raktadi drava'' ''dhatu'' throughout body continuously and as per metabolic demand. This explanation shows that closed circulation in human was known to Charak.
In this chapter, Charak describes formation of body tissues in detail with the role of ''ahara'' which is supplied continuously to maintain homeostasis. ''Vyana vata'' is promoter of ''[[rasa]] [[rakta]]di'' circulation.[ Cha. Sa. [[Chikitsa Sthana]] 15/36] It transports ''[[rasa]] [[rakta]]di drava'' ''[[dhatu]]'' throughout body continuously and as per metabolic demand. This explanation shows that closed circulation in human was known to Charak.
''Grahani'' is prime place where digestion and absorption of ''ahara rasa'' takes place. ''Ahara rasa'' provides nutrition for the ''rasadi sapta dhatu'', along-with three ''sharirika dosha'' and three ''manasika dosha''. Nourishment of ''sattva, raja'' and ''tama'' is influenced by ''sattvika, rajasika'' and ''tamasika ahara''. ''Tamasika'' and ''rajasika ahara'' suppresses ''sattva guna'' thereby causing ''alpa sattva'' in individual, a common predisposing factor of psychiatric disorders for e.g. ''alpa sattva'' as mentioned in ''unmada'' (Ca. Ci. 9/5)In ''vataja grahanivyadhishanka'' (feeling of suffering from disease) manifests in patients with ''alpa sattva''.
''Grahani'' is prime place where digestion and absorption of ''ahara rasa'' takes place. ''Ahara rasa'' provides nutrition for the ''[[rasa]]di sapta [[dhatu]]'', along-with three ''sharirika [[dosha]]'' and three ''manasika dosha''. Nourishment of ''[[sattva]], [[raja]]'' and ''[[tama]]'' is influenced by ''sattvika, rajasika'' and ''tamasika ahara''. ''Tamasika'' and ''rajasika ahara'' suppresses ''[[sattva]] [[guna]]'' thereby causing ''alpa sattva'' in individual, a common predisposing factor of psychiatric disorders for e.g. ''alpa sattva'' as mentioned in ''unmada'' [Cha.Sa [[Chikitsa Sthana]] 9/5] In ''vataja grahanivyadhishanka'' (feeling of suffering from disease) manifests in patients with ''alpa sattva''.
Homeostasis at cellular level and gross level is maintained by ''vata, pitta'' and ''kapha'' in which digestive and metabolic contributions are due to ''agni''. This chapter has been dedicated to ''agni'' to understand the manner in which it gets vitiated by ''dosha'' and accordingly the line of treatment for the ''agni dosha'' is explained. As the functions of ''agni'' take place in ''grahani'' hence disease related to ''grahani'' has been given the name.
Homeostasis at cellular level and gross level is maintained by ''[[vata]], [[pitta]]'' and ''[[kapha]]'' in which digestive and metabolic contributions are due to ''agni''. This chapter has been dedicated to ''agni'' to understand the manner in which it gets vitiated by ''[[dosha]]'' and accordingly the line of treatment for the ''agni dosha'' is explained. As the functions of ''agni'' take place in ''grahani'' hence disease related to ''grahani'' has been given the name.
Secondly, ''pandu roga'' is due to ''alpata'' of ''raktaposhaka sara bhaga'' (Chakrapani Ca. Ci. 16/3-7) and, one of the main causes of this ''alpata'' is mal-digestion and mal-absorption which takes place in ''grahani''. It is well known fact, that various contributory factors for blood formation have their absorption in gastrointestinal tract such as folic acid, vitamin B12, iron, etc which if not absorbed causes anemia this is the reason why Charak has placed this chapter in between ''arsha'' and ''pandu roga''.
Secondly, ''pandu roga'' is due to ''alpata'' of ''raktaposhaka sara bhaga'' [Chakrapani, Cha. Sa. [[Chikitsa Sthana]] 16/3-7] and, one of the main causes of this ''alpata'' is mal-digestion and mal-absorption which takes place in ''grahani''. It is well known fact, that various contributory factors for blood formation have their absorption in gastrointestinal tract such as folic acid, vitamin B12, iron, etc which if not absorbed causes anemia this is the reason why Charak has placed this chapter in between ''arsha'' and ''pandu roga''.
</div>
== Sanskrit Text, Transliteration and English Translation ==
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अथातो ग्रहणीदोषचिकित्सितं व्याख्यास्यामः||१||
अथातो ग्रहणीदोषचिकित्सितं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
इति ह स्माह भगवानात्रेयः||२||
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athātō Grahaṇī dōṣacikitsitaṁ vyākhyāsyāmaḥ||1||
athātō Grahaṇī dōṣacikitsitaṁ vyākhyāsyāmaḥ||1||
iti ha smAha bhagavAnAtreyaH||2||
iti ha smAha bhagavAnAtreyaH||2||
</div></div>
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Now we shall expound the chapter "Grahani Chikitsa" (Management of diseases of digestion and metabolism). Thus said Lord Atreya. [1-2]
=== Importance of ''dehagni'' ===
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आयुर्वर्णो बलं स्वास्थ्यमुत्साहोपचयौ प्रभा|
आयुर्वर्णो बलं स्वास्थ्यमुत्साहोपचयौ प्रभा|
ओजस्तेजोऽग्नयः प्राणाश्चोक्ता देहाग्निहेतुकाः||३||
ओजस्तेजोऽग्नयः प्राणाश्चोक्ता देहाग्निहेतुकाः||३||
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āyurvarṇō balaṁ svāsthyamutsāhōpacayau prabhā|
āyurvarṇō balaṁ svāsthyamutsāhōpacayau prabhā|
ojastejo~agnayaH prANAshcoktA dehAgnihetukAH||3||
ojastejo~agnayaH prANAshcoktA dehAgnihetukAH||3||
</div></div>
''Dehagni'' (all the entities in the body that are responsible for digestion and metabolism) is the fundamental causative agent for longevity, normal complexion, normal strength, good health, motivation, normal growth, normal luster, normal ''ojas'', normal body temperature and various other forms of ''agni''. Even the existence of an individual is said to be because of ''dehagni'' [3]
''Dehagni'' (all the entities in the body that are responsible for digestion and metabolism) is the fundamental causative agent for longevity, normal complexion, normal strength, good health, motivation, normal growth, normal luster, normal ''[[ojas]]'', normal body temperature and various other forms of ''agni''. Even the existence of an individual is said to be because of ''dehagni'' [3]
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शान्तेऽग्नौ म्रियते, युक्ते चिरं जीवत्यनामयः|
शान्तेऽग्नौ म्रियते, युक्ते चिरं जीवत्यनामयः|
रोगी स्याद्विकृते, मूलमग्निस्तस्मान्निरुच्यते||४||
रोगी स्याद्विकृते, मूलमग्निस्तस्मान्निरुच्यते||४||
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śāntē'gnau mriyatē, yuktē ciraṁ jīvatyanāmayaḥ|
śāntē'gnau mriyatē, yuktē ciraṁ jīvatyanāmayaḥ|
rogI syAdvikRute, mUlamagnistasmAnnirucyate||4||
rogI syAdvikRute, mUlamagnistasmAnnirucyate||4||
</div></div>
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]
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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यदन्नं देहधात्वोजोबलवर्णादिपोषकम्|
यदन्नं देहधात्वोजोबलवर्णादिपोषकम्|
तत्राग्निर्हेतुराहारान्न ह्यपक्वाद्रसादयः||५||
तत्राग्निर्हेतुराहारान्न ह्यपक्वाद्रसादयः||५||
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yadannaṁ dēhadhātvōjōbalavarṇādipōṣakam|
yadannaṁ dēhadhātvōjōbalavarṇādipōṣakam|
tatrAgnirheturAhArAnna hyapakvAdrasAdayaH||5||
tatrAgnirheturAhArAnna hyapakvAdrasAdayaH||5||
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The food one consumes becomes capable of nourishing the body tissues and of promoting the ''ojas'' (vital essence), strength, complexion etc., only in the presence of normally functioning ''agni''. In the absence of normal digestion (and metabolism), the normal body tissues such as ''rasa'' cannot be formed nor nourished [5]
The food one consumes becomes capable of nourishing the body tissues and of promoting the ''[[ojas]]'' (vital essence), strength, complexion etc., only in the presence of normally functioning ''agni''. In the absence of normal digestion (and metabolism), the normal body tissues such as ''[[rasa]]'' cannot be formed nor nourished [5]
=== Process of digestion-first phase ===
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अन्नमादानकर्मा तु प्राणः कोष्ठं प्रकर्षति|
अन्नमादानकर्मा तु प्राणः कोष्ठं प्रकर्षति|
पचत्यग्निर्यथा स्थाल्यामोदनायाम्बुतण्डुलम्||८||
पचत्यग्निर्यथा स्थाल्यामोदनायाम्बुतण्डुलम्||८||
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annamādānakarmā tu prāṇaḥ kōṣṭhaṁ prakarṣati|
annamādānakarmā tu prāṇaḥ kōṣṭhaṁ prakarṣati|
pacatyagniryathA sthAlyAmodanAyAmbutaNDulam||8||
pacatyagniryathA sthAlyAmodanAyAmbutaNDulam||8||
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The ingested food is carried to ''koshtha'' by ''prana vata''. The food disintegrates because of the liquids, and further it becomes soft because of the fatty substances. The ''samana vata'', that has an inherent ability to intensify the ''agni,'' intensifies the digestive enzymes and properly digests the food that one consumes timely and in an appropriate quantity, thus leading to longevity. This process of digestion by ''agni'' in the gut which leads to the formation of ''rasa'' and ''mala'' is comparable to the process of cooking of the raw rice kept in an earthen vessel containing water on a fire [6-8]
The ingested food is carried to ''koshtha'' by ''prana vata''. The food disintegrates because of the liquids, and further it becomes soft because of the fatty substances. The ''samana vata'', that has an inherent ability to intensify the ''agni,'' intensifies the digestive enzymes and properly digests the food that one consumes timely and in an appropriate quantity, thus leading to longevity. This process of digestion by ''agni'' in the gut which leads to the formation of ''[[rasa]]'' and ''[[mala]]'' is comparable to the process of cooking of the raw rice kept in an earthen vessel containing water on a fire [6-8]
=== Three states of digestion and provoking ''[[dosha]]'' ===
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अन्नस्य भुक्तमात्रस्य षड्रसस्य प्रपाकतः|
अन्नस्य भुक्तमात्रस्य षड्रसस्य प्रपाकतः|
मधुराद्यात् कफो भावात् फेनभूत [४] उदीर्यते||९||
मधुराद्यात् कफो भावात् फेनभूत उदीर्यते||९||
परं तु पच्यमानस्य विदग्धस्याम्लभावतः|
परं तु पच्यमानस्य विदग्धस्याम्लभावतः|
परिपिण्डितपक्वस्य वायुः स्यात् कटुभावतः||११||
परिपिण्डितपक्वस्य वायुः स्यात् कटुभावतः||११||
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annasya bhuktamātrasya ṣaḍrasasya prapākataḥ|
annasya bhuktamātrasya ṣaḍrasasya prapākataḥ|
annasya bhuktamAtrasya ShaDrasasya prapAkataH|
annasya bhuktamAtrasya ShaDrasasya prapAkataH|
madhurAdyAt kapho bhAvAt phenabhUta [4] udIryate||9||
madhurAdyAt kapho bhAvAt phenabhUta udIryate||9||
paraM tu pacyamAnasya vidagdhasyAmlabhAvataH|
paraM tu pacyamAnasya vidagdhasyAmlabhAvataH|
paripiNDitapakvasya vAyuH syAt kaTubhAvataH||11||
paripiNDitapakvasya vAyuH syAt kaTubhAvataH||11||
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As soon as the food that has all the six tastes is consumed, it undergoes the first stage of digestion known as ''madhura'' (sweet) state during which ''kapha'' is produced which is like froth. Afterwards, while the food undergoing digestion is in its partially digested form, it attains ''amla'' (sour) state.
As soon as the food that has all the six tastes is consumed, it undergoes the first stage of digestion known as ''madhura'' (sweet) state during which ''[[kapha]]'' is produced which is like froth. Afterwards, while the food undergoing digestion is in its partially digested form, it attains ''amla'' (sour) state.
When the semi-digested food leaves the stomach, the release of liquid form of pitta known as ''accha-pitta'' occurs.
When the semi-digested food leaves the stomach, the release of liquid form of [[pitta]] known as ''accha-pitta'' occurs.
When the ''pakva'' part (the non-absorbable remnant part after the absorption of the nutrients), reaches the ''pakvashaya'' (the colon), the drying effect of ''agni'' converts it into a solid mass. There also occurs the release of ''vata'' which is ''katu'' (pungent) state [9-11]
When the ''pakva'' part (the non-absorbable remnant part after the absorption of the nutrients), reaches the ''pakvashaya'' (the colon), the drying effect of ''agni'' converts it into a solid mass. There also occurs the release of ''[[vata]]'' which is ''katu'' (pungent) state [9-11]
=== Second phase of digestion by ''[[panchamahabhuta]]'' ===
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अन्नमिष्टं ह्युपहितमिष्टैर्गन्धादिभिः पृथक्|
अन्नमिष्टं ह्युपहितमिष्टैर्गन्धादिभिः पृथक्|
देहे प्रीणाति गन्धादीन् घ्राणादीनीन्द्रियाणि च||१२||
देहे प्रीणाति गन्धादीन् घ्राणादीनीन्द्रियाणि च||१२||
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annamiṣṭaṁ hyupahitamiṣṭairgandhādibhiḥ pr̥thak|
annamiṣṭaṁ hyupahitamiṣṭairgandhādibhiḥ pr̥thak|
dehe prINAti gandhAdIn ghrANAdInIndriyANi [2] ca||12||
dehe prINAti gandhAdIn ghrANAdInIndriyANi [2] ca||12||
</div></div>
The food that possesses pleasant smell (taste, appearance, consistency,) etc., nourishes the similar entities in the body such as the sensory organs of smell by ''gandha'' etc (e.g. taste, vision, touch etc senses by respective ''mahabhuta'') [12]
The food that possesses pleasant smell (taste, appearance, consistency,) etc., nourishes the similar entities in the body such as the sensory organs of smell by ''gandha'' etc (e.g. taste, vision, touch etc senses by respective ''[[mahabhuta]]'') [12]
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भौमाप्याग्नेयवायव्याः पञ्चोष्माणः सनाभसाः|
भौमाप्याग्नेयवायव्याः पञ्चोष्माणः सनाभसाः|
पञ्चाहारगुणान्स्वान्स्वान्पार्थिवादीन्पचन्ति हि||१३||
पञ्चाहारगुणान्स्वान्स्वान्पार्थिवादीन्पचन्ति हि||१३||
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bhaumāpyāgnēyavāyavyāḥ pañcōṣmāṇaḥ sanābhasāḥ|
bhaumāpyāgnēyavāyavyāḥ pañcōṣmāṇaḥ sanābhasāḥ|
pa~jcAhAraguNAnsvAnsvAnpArthivAdInpacanti hi||13||
pa~jcAhAraguNAnsvAnsvAnpArthivAdInpacanti hi||13||
</div></div>
There are five types of ''agni'' namely, ''bhauma, apya, agneya, vayavya'' and ''nabhasa''. These five ''bhutagni'' are one of each ''mahabhuta'' transform/metabolize those components of the food that are homologous to them in their composition of structure of human organism. (such as ''parthiva, apya'' etc) [13]
There are five types of ''agni'' namely, ''bhauma, apya, agneya, vayavya'' and ''nabhasa''. These five ''bhutagni'' are one of each ''[[mahabhuta]]'' transform/metabolize those components of the food that are homologous to them in their composition of structure of human organism. (such as ''parthiva, apya'' etc) [13]
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यथास्वं स्वं च पुष्णन्ति देहे द्रव्यगुणाः पृथक्|
यथास्वं स्वं च पुष्णन्ति देहे द्रव्यगुणाः पृथक्|
पार्थिवाः पार्थिवानेव शेषाः शेषांश्च कृत्स्नशः||१४||
पार्थिवाः पार्थिवानेव शेषाः शेषांश्च कृत्स्नशः||१४||
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yathāsvaṁ svaṁ ca puṣṇanti dēhē dravyaguṇāḥ pr̥thak|
yathāsvaṁ svaṁ ca puṣṇanti dēhē dravyaguṇāḥ pr̥thak|
pArthivAH pArthivAneva sheShAH sheShAMshca kRutsnashaH||14||
pArthivAH pArthivAneva sheShAH sheShAMshca kRutsnashaH||14||
</div></div>
Specific categories of entities in the body having specific attributes can be nourished by only those substances that belong to the same category having those same attributes. This means that ''parthiva'' entities in the body (one that is dominated by ''prithvi mahabhuta'' in its composition) can be nourished only by the ''parthiva'' substances in the food and so on. The same rule applies to the whole body [14]
Specific categories of entities in the body having specific attributes can be nourished by only those substances that belong to the same category having those same attributes. This means that ''parthiva'' entities in the body (one that is dominated by ''[[prithvi mahabhuta]]'' in its composition) can be nourished only by the ''parthiva'' substances in the food and so on. The same rule applies to the whole body [14]
=== Third phase of digestion and metabolism at level of ''[[dhatu]]'' ===
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सप्तभिर्देहधातारो धातवो द्विविधं पुनः|
सप्तभिर्देहधातारो धातवो द्विविधं पुनः|
यथास्वमग्निभिः पाकं यान्ति किट्टप्रसादवत् ||१५||
यथास्वमग्निभिः पाकं यान्ति किट्टप्रसादवत् ||१५||
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saptabhirdēhadhātārō dhātavō dvividhaṁ punaḥ|
saptabhirdēhadhātārō dhātavō dvividhaṁ punaḥ|
yathAsvamagnibhiH pAkaM yAnti kiTTaprasAdavat [1] ||15||
yathAsvamagnibhiH pAkaM yAnti kiTTaprasAdavat [1] ||15||
</div></div>
Further, the seven components that sustain the body, known as ''dhatu'' (tissues), are metabolized/transformed into two kinds of products known as ''sara'' (nutrition) and ''kitta'' (waste). This process is the function of seven specific entities known as ''dhatvagni''; each ''dhatvagni'' is specific for its corresponding ''dhatu'' [15]
Further, the seven components that sustain the body, known as ''[[dhatu]]'' (tissues), are metabolized/transformed into two kinds of products known as ''sara'' (nutrition) and ''kitta'' (waste). This process is the function of seven specific entities known as ''dhatvagni''; each ''dhatvagni'' is specific for its corresponding ''[[dhatu]]'' [15]
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रसाद्रक्तं ततो मांसं मांसान्मेदस्ततोऽस्थि च|
रसाद्रक्तं ततो मांसं मांसान्मेदस्ततोऽस्थि च|
अस्थ्नो मज्जा ततः शुक्रं शुक्राद्गर्भः प्रसादजः||१६||
अस्थ्नो मज्जा ततः शुक्रं शुक्राद्गर्भः प्रसादजः||१६||
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rasādraktaṁ tatō māṁsaṁ māṁsānmēdastatō'sthi ca|
rasādraktaṁ tatō māṁsaṁ māṁsānmēdastatō'sthi ca|
asthno majjA tataH shukraM shukrAdgarbhaH prasAdajaH||16||
asthno majjA tataH shukraM shukrAdgarbhaH prasAdajaH||16||
</div></div>
''Rakta'' is produced after ''rasa'' and then ''mamsa''. After ''mamsa'' the ''medas'' is formed and then ''asthi'' is produced. After ''asthi'' the ''majja'' is derived and then ''shukra'' is produced and finally fine ''shukra'' leads to ''garbha'' [16]
''[[Rakta]]'' is produced after ''[[rasa]]'' and then ''[[mamsa]]''. After ''[[mamsa]]'' the ''[[medas]]'' is formed and then ''[[asthi]]'' is produced. After ''[[asthi]]'' the ''[[majja]]'' is derived and then ''[[shukra]]'' is produced and finally fine ''[[shukra]]'' leads to ''[[garbha]]'' [16]
=== ''Upadhatu'' (metabolic products) ===
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रसात् स्तन्यं ततो रक्तमसृजः कण्डराः सिराः|
रसात् स्तन्यं ततो रक्तमसृजः कण्डराः सिराः|
मांसाद्वसा त्वचः षट् च मेदसः स्नायुसम्भवः||१७||
मांसाद्वसा त्वचः षट् च मेदसः स्नायुसम्भवः||१७||
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rasāt stanyaṁ tatō raktamasr̥jaḥ kaṇḍarāḥ sirāḥ|
rasāt stanyaṁ tatō raktamasr̥jaḥ kaṇḍarāḥ sirāḥ|
mAMsAdvasA tvacaH ShaT ca medasaH snAyusambhavaH [3] ||17||
mAMsAdvasA tvacaH ShaT ca medasaH snAyusambhavaH [3] ||17||
</div></div>
''Stanya'' (breast milk) and the menstrual blood are derived after rasa. ''Kandara'' (tendon) and ''sira''(vein) are derived after ''rakta''. ''Vasa''(fat) and the six layers of ''tvacha'' (skin) are derived after ''mamsa'' (muscle) and ''snayu''(ligament) are derived after ''medas'' (adipose tissue) [17]
''Stanya'' (breast milk) and the menstrual blood are derived after rasa. ''Kandara'' (tendon) and ''sira''(vein) are derived after ''[[rakta]]''. ''Vasa''(muscle fat) and the six layers of ''tvacha'' (skin) are derived after ''[[mamsa]]'' (muscle) and ''snayu''(ligament) are derived after ''[[medas]]'' (adipose tissue) [17]
=== ''[[Mala]]'' formed at tissue level metabolism ===
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किट्टमन्नस्य विण्मूत्रं, रसस्य तु कफोऽसृजः|
किट्टमन्नस्य विण्मूत्रं, रसस्य तु कफोऽसृजः|
परस्परोपसंस्तब्धा धातुस्नेहपरम्परा |
परस्परोपसंस्तब्धा धातुस्नेहपरम्परा |
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kiṭṭamannasya viṇmūtraṁ, rasasya tu kaphō'sr̥jaḥ|
kiṭṭamannasya viṇmūtraṁ, rasasya tu kaphō'sr̥jaḥ|
parasparopasaMstabdhA dhAtusnehaparamparA [5] |
parasparopasaMstabdhA dhAtusnehaparamparA [5] |
</div></div>
The feces and the urine are the ''kitta'' (non-nutrient portion/waste portion/byproduct) of ingested food. The ''kitta'' of ''rasa'' is ''mala-kapha'' (excretions). ''Mala-pitta'' (bile pigment) is the ''kitta'' of ''rakta''. ''Kha-mala'' (the wastes accumulated in the hollow structures of the body such as external ears and nostrils) are the ''kitta'' of ''mamsa''. ''Sweda'' (sweat) is the ''mala'' of ''medas''. ''Kesha'' (hairs on the head) and ''loma'' (body hair) are the ''mala'' of ''asthi''. The ''mala'' of ''majja'' is the oily excretion of the eye and the skin (sebum). Thus, the ''dhatus'' continuously undergo two kinds of transformation: ''prasada'' (nutrient portion) and ''kitta'' (non-nutrient portion). This entire sequence of transformation and metabolism of ''dhatu'' is thus inter dependent [18-19½]
The feces and the urine are the ''kitta'' (non-nutrient portion/waste portion/byproduct) of ingested food. The ''kitta'' of ''[[rasa]]'' is ''[[mala]]-[[kapha]]'' (excretions). ''[[Mala]]-[[pitta]]'' (bile pigment) is the ''kitta'' of ''[[rakta]]''. ''Kha-mala'' (the wastes accumulated in the hollow structures of the body such as external ears and nostrils) are the ''kitta'' of ''[[mamsa]]''. ''Sweda'' (sweat) is the ''[[mala]]'' of ''[[medas]]''. ''Kesha'' (hairs on the head) and ''loma'' (body hair) are the ''[[mala]]'' of ''[[asthi]]''. The ''[[mala]]'' of ''[[majja]]'' is the oily excretion of the eye and the skin (sebum). Thus, the ''[[dhatu]]s'' continuously undergo two kinds of transformation: ''prasada'' (nutrient portion) and ''kitta'' (non-nutrient portion). This entire sequence of transformation and metabolism of ''[[dhatu]]'' is thus inter dependent [18-19½]
=== Modes of transformation ===
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वृष्यादीनां प्रभावस्तु पुष्णाति बलमाशु हि||२०||
वृष्यादीनां प्रभावस्तु पुष्णाति बलमाशु हि||२०||
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vr̥ṣyādīnāṁ prabhāvastu puṣṇāti balamāśu hi||20||
vr̥ṣyādīnāṁ prabhāvastu puṣṇāti balamāśu hi||20||
vRuShyAdInAM prabhAvastu puShNAti balamAshu hi||20||
vRuShyAdInAM prabhAvastu puShNAti balamAshu hi||20||
</div></div>
''Vrishya'' substance (the substance that promotes sexual vigor) nourishes the ''shukra'' immediately due to its specific influential effect (''prabhava'') [20]
''Vrishya'' substance (the substance that promotes sexual vigor) nourishes the ''[[shukra]]'' immediately due to its specific influential effect (''prabhava'') [20]
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षड्भिः केचिदहोरात्रैरिच्छन्ति परिवर्तनम्|
षड्भिः केचिदहोरात्रैरिच्छन्ति परिवर्तनम्|
सन्तत्या भोज्यधातूनां परिवृत्तिस्तु चक्रवत्||२१||
सन्तत्या भोज्यधातूनां परिवृत्तिस्तु चक्रवत्||२१||
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ṣaḍbhiḥ kēcidahōrātrairicchanti parivartanam|
ṣaḍbhiḥ kēcidahōrātrairicchanti parivartanam|
santatyA bhojyadhAtUnAM parivRuttistu cakravat||21||
santatyA bhojyadhAtUnAM parivRuttistu cakravat||21||
</div></div>
Some scholars believe that the conversion of ''rasa'' up to ''shukra'' occurs in a span of six days and six nights. This process of transformation of nourishing portion of the digested food is continuous similar to rotating wheel [21]
Some scholars believe that the conversion of ''[[rasa]]'' up to ''[[shukra]]'' occurs in a span of six days and six nights. This process of transformation of nourishing portion of the digested food is continuous similar to rotating wheel [21]
Note: Adulterated Verses:
Note: Adulterated Verses:
Verses from 22 to 35 are available in the text in bracket and Chakrapani has also not offered the commentary on these verses, hence these verses are considered as adulterated.
Verses from 22 to 35 are available in the text in bracket and Chakrapani has also not offered the commentary on these verses, hence these verses are considered as adulterated.
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(इत्युक्तवन्तमाचार्यं शिष्यस्त्विदमचोदयत्|
(इत्युक्तवन्तमाचार्यं शिष्यस्त्विदमचोदयत्|
छिद्रं न दृश्यतेऽस्थ्नां च तन्निःसरति वा कथम्|
छिद्रं न दृश्यतेऽस्थ्नां च तन्निःसरति वा कथम्|
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(ityuktavantamācāryaṁ śiṣyastvidamacōdayat|
(ityuktavantamācāryaṁ śiṣyastvidamacōdayat|
sarvadehagataM shukraM pravadanti manIShiNaH|
sarvadehagataM shukraM pravadanti manIShiNaH|
</div></div>
(After listening to the above explanation by his teacher, the student asked the following doubt:
(After listening to the above explanation by his teacher, the student asked the following doubt:
How is it that ''rakta'' is formed in the body out of ''rasa,'' though being different from it? ''Rasa'' is in fact colorless, and how does it attain the red color of ''rakta''? How is it that a solid structure such as ''mamsa'' is formed out of ''rakta'' which is a fluid by its nature? How is it that, again, from the ''mamsa'', which is solid, a fluid substance such as ''meda'' is formed?
How is it that ''[[rakta]]'' is formed in the body out of ''[[rasa]],'' though being different from it? ''[[Rasa]]'' is in fact colorless, and how does it attain the red color of ''[[rakta]]''? How is it that a solid structure such as ''[[mamsa]]'' is formed out of ''[[rakta]]'' which is a fluid by its nature? How is it that, again, from the ''[[mamsa]]'', which is solid, a fluid substance such as ''[[meda]]'' is formed?
How is it that a rough ''asthi'' is formed out of smooth structures such as ''mamsa'' and ''meda''? How does the soft and fatty ''majja'' form out of rough structures such as ''asthi''? If at all ''shukra'', which is present everywhere in the body is formed out of ''majja'' that is located inside the ''asthi'', how does it come out as one cannot see pores on ''asthi''? [22-26]
How is it that a rough ''[[asthi]]'' is formed out of smooth structures such as ''[[mamsa]]'' and ''[[meda]]''? How does the soft and fatty ''[[majja]]'' form out of rough structures such as ''[[asthi]]''? If at all ''[[shukra]]'', which is present everywhere in the body is formed out of ''[[majja]]'' that is located inside the ''[[asthi]]'', how does it come out as one cannot see pores on ''[[asthi]]''? [22-26]
=== Formation of ''[[rasa]]'' and ''[[rakta]]'' ===
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एवमुक्तस्तु शिष्येण गुरुः प्राहेदमुत्तरम्||२७||
एवमुक्तस्तु शिष्येण गुरुः प्राहेदमुत्तरम्||२७||
पित्तोष्मणः स रागेण रसो रक्तत्वमृच्छति||२८||
पित्तोष्मणः स रागेण रसो रक्तत्वमृच्छति||२८||
<div class="mw-collapsible-content">
ēvamuktastu śiṣyēṇa guruḥ prāhēdamuttaram||27||
ēvamuktastu śiṣyēṇa guruḥ prāhēdamuttaram||27||
pittoShmaNaH sa rAgeNa raso raktatvamRucchati||28||
pittoShmaNaH sa rAgeNa raso raktatvamRucchati||28||
</div></div>
After listening to the query raised by the student, the teacher replied as follows:
After listening to the query raised by the student, the teacher replied as follows:
The nourishment fluid formed, known as ''rasa'', undergoes transformation by the ''ushma'' (heat) of ''pitta'' and gets converted into the red colored tissue known as ''rakta'' [27-28]
The nourishment fluid formed, known as ''[[rasa]]'', undergoes transformation by the ''ushma'' (heat) of ''[[pitta]]'' and gets converted into the red colored tissue known as ''[[rakta]]'' [27-28]
=== Formation of ''[[mamsa dhatu]]'' ===
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वाय्वम्बुतेजसा रक्तमूष्मणा चाभिसंयुतम्|
वाय्वम्बुतेजसा रक्तमूष्मणा चाभिसंयुतम्|
स्थिरतां प्राप्य मांसं स्यात् स्वोष्मणा पक्वमेव तत् ||२९||
स्थिरतां प्राप्य मांसं स्यात् स्वोष्मणा पक्वमेव तत् ||२९||
<div class="mw-collapsible-content">
vāyvambutējasā raktamūṣmaṇā cābhisaṁyutam|
vāyvambutējasā raktamūṣmaṇā cābhisaṁyutam|
sthiratAM prApya mAMsaM syAt svoShmaNA pakvameva tat [9] ||29||
sthiratAM prApya mAMsaM syAt svoShmaNA pakvameva tat [9] ||29||
</div></div>
Due to the action of heat along with the ''vata, ambu'' (water) and ''tejas,'' the ''rakta'' is converted into stable ''mamsa,'' after being acted upon by its own ''agni'' (''mamsadhatvagni'') [29]
Due to the action of heat along with the ''[[vata]], ambu'' (water) and ''[[teja]]s,'' the ''[[rakta]]'' is converted into stable ''[[mamsa]],'' after being acted upon by its own ''agni'' (''mamsadhatvagni'') [29]
=== Formation of ''[[meda dhatu]]'' ===
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स्वतेजोऽम्बुगुणस्निग्धोद्रिक्तं मेदोऽभिजायते|
स्वतेजोऽम्बुगुणस्निग्धोद्रिक्तं मेदोऽभिजायते|
<div class="mw-collapsible-content">
svatējō'mbuguṇasnigdhōdriktaṁ mēdō'bhijāyatē|
svatējō'mbuguṇasnigdhōdriktaṁ mēdō'bhijāyatē|
svatejo~ambuguNasnigdhodriktaM medo~abhijAyate|
svatejo~ambuguNasnigdhodriktaM medo~abhijAyate|
</div></div>
Because of the action of ''medo-dhatvagni'' on the excessively dominant ''snigdha'' attribute of aṃbu, the ''medo-dhatu'' is formed [29½]
Because of the action of ''medo-dhatvagni'' on the excessively dominant ''snigdha'' attribute of aṃbu, the ''[[medo dhatu]]'' is formed [29½]
=== Formation of ''[[asthi dhatu]]'' ===
<div class="mw-collapsible mw-collapsed">
पृथिव्यग्न्यनिलादीनां सङ्घातः स्वोष्मणा कृतः||३०||
पृथिव्यग्न्यनिलादीनां सङ्घातः स्वोष्मणा कृतः||३०||
खरत्वं प्रकरोत्यस्य जायतेऽस्थि ततो नृणाम्|
खरत्वं प्रकरोत्यस्य जायतेऽस्थि ततो नृणाम्|
<div class="mw-collapsible-content">
pr̥thivyagnyanilādīnāṁ saṅghātaḥ svōṣmaṇā kr̥taḥ||30||
pr̥thivyagnyanilādīnāṁ saṅghātaḥ svōṣmaṇā kr̥taḥ||30||
kharatvaM prakarotyasya jAyate~asthi tato nRuNAm|
kharatvaM prakarotyasya jAyate~asthi tato nRuNAm|
</div></div>
Because of the action of ''asthi dhātvagni'' on the aggregation of ''prithvi, agni'' and ''anila'', roughness is attained during the formation of the ''asthi'' [30]
Because of the action of ''asthi dhātvagni'' on the aggregation of ''[[prithvi]], [[agni]]'' and ''anila'', roughness is attained during the formation of the ''[[asthi]]'' [30]
=== Formation of ''[[majja dhatu]]'' ===
<div class="mw-collapsible mw-collapsed">
करोति तत्र सौषिर्यमस्थ्नां मध्ये समीरणः||३१||
करोति तत्र सौषिर्यमस्थ्नां मध्ये समीरणः||३१||
मेदसस्तानि पूर्यन्ते स्नेहो मज्जा ततः स्मृतः|
मेदसस्तानि पूर्यन्ते स्नेहो मज्जा ततः स्मृतः|
<div class="mw-collapsible-content">
karōti tatra sauṣiryamasthnāṁ madhyē samīraṇaḥ||31||
karōti tatra sauṣiryamasthnāṁ madhyē samīraṇaḥ||31||
medasastAni pUryante sneho majjA tataH smRutaH|
medasastAni pUryante sneho majjA tataH smRutaH|
</div></div>
''Vata'' produces hollowness inside the ''asthi dhatu'', and after which, these hollow cavities get filled up by fatty tissue which is known as ''majja'' [31]
''[[Vata]]'' produces hollowness inside the ''[[asthi dhatu]]'', and after which, these hollow cavities get filled up by fatty tissue which is known as ''[[majja]]'' [31]
=== Formation of ''[[shukra dhatu]]'' ===
<div class="mw-collapsible mw-collapsed">
तस्मान्मज्ज्ञस्तु यः स्नेहः शुक्रं सञ्जायते ततः||३२||
तस्मान्मज्ज्ञस्तु यः स्नेहः शुक्रं सञ्जायते ततः||३२||
बस्तौ सम्भृत्य निर्याति स्थलान्निम्नादिवोदकम्)||३५||
बस्तौ सम्भृत्य निर्याति स्थलान्निम्नादिवोदकम्)||३५||
<div class="mw-collapsible-content">
tasmānmajjñastu yaḥ snēhaḥ śukraṁ sañjāyatē tataḥ||32||
tasmānmajjñastu yaḥ snēhaḥ śukraṁ sañjāyatē tataḥ||32||
bastau sambhRutya niryAti sthalAnnimnAdivodakam)||35||
bastau sambhRutya niryAti sthalAnnimnAdivodakam)||35||
</div></div>
The ''sneha'' (fatty) portion of ''majja'' produces shukra. The porosity in the ''asthi'' is produced because of the factors such as ''vata'' and ''akasha.'' ''Shukra'' comes out of ''asthi'' through these pores just as the water comes out of a new earthen vessel. Through the channels known as ''shukravaha srotamsi'', this ''shukra'' spreads all over the body. This ''shukra'' is discharged through the urethra (which is connected to the urinary bladder) because of several factors such as sexual excitation, reflex activities (''vega''), and mental determination (''samkalpa''). Just as the ghee moves out with ease when heated, the ''shukra'' too, is discharged due to the heat liberated during the sexual activity. This process of seminal discharge is comparable with the movement of water from a place of lower altitude to a place of higher altitude) [32-35]
The ''sneha'' (fatty) portion of ''[[majja]]'' produces shukra. The porosity in the ''[[asthi]]'' is produced because of the factors such as ''[[vata]]'' and ''akasha.'' ''[[Shukra]]'' comes out of ''[[asthi]]'' through these pores just as the water comes out of a new earthen vessel. Through the channels known as ''shukravaha srotamsi'', this ''[[shukra]]'' spreads all over the body. This ''[[shukra]]'' is discharged through the urethra (which is connected to the urinary bladder) because of several factors such as sexual excitation, reflex activities (''vega''), and mental determination (''samkalpa''). Just as the ghee moves out with ease when heated, the ''[[shukra]]'' too, is discharged due to the heat liberated during the sexual activity. This process of seminal discharge is comparable with the movement of water from a place of lower altitude to a place of higher altitude) [32-35]
=== Continuous circulation of ''[[rasa]]'' all over the body ===
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व्यानेन रसधातुर्हि विक्षेपोचितकर्मणा|
व्यानेन रसधातुर्हि विक्षेपोचितकर्मणा|
युगपत् सर्वतोऽजस्रं देहे विक्षिप्यते सदा||३६||
युगपत् सर्वतोऽजस्रं देहे विक्षिप्यते सदा||३६||
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vyānēna rasadhāturhi vikṣēpōcitakarmaṇā|
vyānēna rasadhāturhi vikṣēpōcitakarmaṇā|
yugapat sarvato~ajasraM dehe vikShipyate sadA||36||
yugapat sarvato~ajasraM dehe vikShipyate sadA||36||
</div></div>
Because of being forcefully propelled (out of the heart) by the action of ''vyana vata'', the ''rasa dhatu'' spreads all over the body simultaneously, continuously and for the entire life [36]
Because of being forcefully propelled (out of the heart) by the action of ''vyana vata'', the ''[[rasa dhatu]]'' spreads all over the body simultaneously, continuously and for the entire life [36]
=== Significance of ''Kha-Vaigunya'' (abnormality in body system) in causing disease state ===
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क्षिप्यमाणः खवैगुण्याद्रसः सज्जति यत्र सः|
क्षिप्यमाणः खवैगुण्याद्रसः सज्जति यत्र सः|
करोति विकृतिं तत्र खे वर्षमिव तोयदः||३७||
करोति विकृतिं तत्र खे वर्षमिव तोयदः||३७||
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kṣipyamāṇaḥ khavaiguṇyādrasaḥ sajjati yatra saḥ|
kṣipyamāṇaḥ khavaiguṇyādrasaḥ sajjati yatra saḥ|
karoti [12] vikRutiM tatra khe varShamiva toyadaH||37||
karoti [12] vikRutiM tatra khe varShamiva toyadaH||37||
</div></div>
Wherever the ''rasa'' experiences obstacle due to abnormality in ''srotas, rasa'' readily produces disease in that very same location. This process is comparable with that of the clouds producing rainfall in a localized region that is favorable for rainfall [37]
Wherever the ''[[rasa]]'' experiences obstacle due to abnormality in ''srotas, [[rasa]]'' readily produces disease in that very same location. This process is comparable with that of the clouds producing rainfall in a localized region that is favorable for rainfall [37]
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दोषाणामपि चैवं स्यादेकदेशप्रकोपणम् |
दोषाणामपि चैवं स्यादेकदेशप्रकोपणम् |
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dōṣāṇāmapi caivaṁ syādēkadēśaprakōpaṇam |
dōṣāṇāmapi caivaṁ syādēkadēśaprakōpaṇam |
doShANAmapi caivaM syAdekadeshaprakopaNam [13] |
doShANAmapi caivaM syAdekadeshaprakopaNam [13] |
</div></div>
This principle is applicable even in case of ''dosha'', where ''ekadesha prakopa'' (abnormal increase at a local site) occurs [37½]
This principle is applicable even in case of ''[[dosha]]'', where ''ekadesha prakopa'' (abnormal increase at a local site) occurs [37½]
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इति भौतिकधात्वन्नपक्तॄणां कर्म भाषितम्||३८||
इति भौतिकधात्वन्नपक्तॄणां कर्म भाषितम्||३८||
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iti bhautikadhātvannapaktr̥̄ṇāṁ karma bhāṣitam||38||
iti bhautikadhātvannapaktr̥̄ṇāṁ karma bhāṣitam||38||
iti bhautikadhAtvannapaktRUNAM karma bhAShitam||38||
iti bhautikadhAtvannapaktRUNAM karma bhAShitam||38||
</div></div>
Thus ends the description of the physiological functions of ''bhutagni, dhatvagni'' and ''jatharagni'' [38]
Thus ends the description of the physiological functions of ''bhutagni, dhatvagni'' and ''jatharagni'' [38]
=== Significance of ''jatharagni'' ===
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अन्नस्य पक्ता सर्वेषां पक्तॄणामधिपो मतः|
अन्नस्य पक्ता सर्वेषां पक्तॄणामधिपो मतः|
तन्मूलास्ते हि तद्वृद्धिक्षयवृद्धिक्षयात्मकाः||३९||
तन्मूलास्ते हि तद्वृद्धिक्षयवृद्धिक्षयात्मकाः||३९||
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annasya paktā sarvēṣāṁ paktr̥̄ṇāmadhipō mataḥ|
annasya paktā sarvēṣāṁ paktr̥̄ṇāmadhipō mataḥ|
tanmUlAste hi tadvRuddhikShayavRuddhikShayAtmakAH||39||
tanmUlAste hi tadvRuddhikShayavRuddhikShayAtmakAH||39||
</div></div>
''Jatharagni'' is known as the King among all the forms of ''agni''. The intensification and diminution of all other forms of ''agni'' is in fact dependent on ''jatharagni'' [39]
''Jatharagni'' is known as the King among all the forms of ''agni''. The intensification and diminution of all other forms of ''agni'' is in fact dependent on ''jatharagni'' [39]
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तस्मात्तं विधिवद्युक्तैरन्नपानेन्धनैर्हितैः|
तस्मात्तं विधिवद्युक्तैरन्नपानेन्धनैर्हितैः|
पालयेत् प्रयतस्तस्य स्थितौ ह्ययुर्बलस्थितिः||४०||
पालयेत् प्रयतस्तस्य स्थितौ ह्ययुर्बलस्थितिः||४०||
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tasmāttaṁ vidhivadyuktairannapānēndhanairhitaiḥ|
tasmāttaṁ vidhivadyuktairannapānēndhanairhitaiḥ|
pAlayet prayatastasya sthitau hyayurbalasthitiH||40||
pAlayet prayatastasya sthitau hyayurbalasthitiH||40||
</div></div>
An individual should take utmost care to maintain the ''agni'' by providing fuel in the form of food and drinks which should be taken as per the rules mentioned, because life and strength of an individual depends on ''agni'' [40]
An individual should take utmost care to maintain the ''agni'' by providing fuel in the form of food and drinks which should be taken as per the rules mentioned, because life and strength of an individual depends on ''agni'' [40]
=== Initiation of ''grahani dosha'' ===
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यो हि भुङ्क्ते विधिं त्याक्त्वा ग्रहणीदोषजान् गदान्|
यो हि भुङ्क्ते विधिं त्याक्त्वा ग्रहणीदोषजान् गदान्|
स लौल्याल्लभते शीघ्रं, वक्ष्यन्तेऽतः परं तु ते||४१||
स लौल्याल्लभते शीघ्रं, वक्ष्यन्तेऽतः परं तु ते||४१||
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yō hi bhuṅktē vidhiṁ tyāktvā Grahaṇī dōṣajān gadān|
yō hi bhuṅktē vidhiṁ tyāktvā Grahaṇī dōṣajān gadān|
sa laulyAllabhate shIghraM, vakShyante~ataH paraM tu te||41||
sa laulyAllabhate shIghraM, vakShyante~ataH paraM tu te||41||
</div></div>
If an individual indulges in food without following the rules and regulation of diet intake, then he quickly suffers from diseases caused by the vitiation of ''grahani'' because of his greedy habits. Such diseases are being described henceforth [41]
If an individual indulges in food without following the rules and regulation of diet intake, then he quickly suffers from diseases caused by the vitiation of ''grahani'' because of his greedy habits. Such diseases are being described henceforth [41]
=== Causes of vitiation of ''agni'' ===
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अभोजनादजीर्णातिभोजनाद्विषमाशनात्|
अभोजनादजीर्णातिभोजनाद्विषमाशनात्|
अपच्यमानं शुक्तत्वं यात्यन्नं विषरूपताम् ||४४||
अपच्यमानं शुक्तत्वं यात्यन्नं विषरूपताम् ||४४||
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abhōjanādajīrṇātibhōjanādviṣamāśanāt|
abhōjanādajīrṇātibhōjanādviṣamāśanāt|
apacyamAnaM shuktatvaM yAtyannaM viSharUpatAm [14] ||44||
apacyamAnaM shuktatvaM yAtyannaM viSharUpatAm [14] ||44||
</div></div>
Excessive starvation, indulging in food intake although there is indigestion, overeating, irregular habit of eating, eating unwholesome food, indulging in food which is heavy to digest or having excessive nutritional value, food which is having cold qualities or eating chilled or frozen items, food which is dry in nature or food which brings about emaciation, contaminated food, perversion of procedures like ''vamana, virechana'' and ''sneha'', emaciation of body due to disease, sudden migration to unsuitable place and of time and of season, suppression of natural urges are causes for vitiation of ''agni''. Thus, vitiated ''agni'' is unable to digest even the light food. [42-43]
Excessive starvation, indulging in food intake although there is indigestion, overeating, irregular habit of eating, eating unwholesome food, indulging in food which is heavy to digest or having excessive nutritional value, food which is having cold qualities or eating chilled or frozen items, food which is dry in nature or food which brings about emaciation, contaminated food, perversion of procedures like ''[[vamana]], [[virechana]]'' and ''sneha'', emaciation of body due to disease, sudden migration to unsuitable place and of time and of season, suppression of natural urges are causes for vitiation of ''agni''. Thus, vitiated ''agni'' is unable to digest even the light food. [42-43]
This vitiated digestive agent forms an intermediate substance called ''ama'', which turns sour (''shukta'') during fermentation and finaly turns in poisonous substance (''amavisha'') [44]
This vitiated digestive agent forms an intermediate substance called ''ama'', which turns sour (''shukta'') during fermentation and finally turns in poisonous substance (''amavisha'') [44]
=== Signs and symptoms of ''ajirna''(indigestion) ===
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तस्य लिङ्गमजीर्णस्य विष्टम्भः सदनं तथा|
तस्य लिङ्गमजीर्णस्य विष्टम्भः सदनं तथा|
अरोचकोऽविपाकश्च, घोरमन्नविषं च तत्||४६||
अरोचकोऽविपाकश्च, घोरमन्नविषं च तत्||४६||
<div class="mw-collapsible-content">
tasya liṅgāmajīrṇasya viṣṭambhaḥ sadanaṁ tathā|
tasya liṅgāmajīrṇasya viṣṭambhaḥ sadanaṁ tathā|
arocako~avipAkashca, ghoramannaviShaM ca tat||46||
arocako~avipAkashca, ghoramannaviShaM ca tat||46||
</div></div>
This poisonous substance (''amavisha'') manifests clinical features like flatulence, uncomfortable physical and mental miseries, headache, altered consciousness, giddiness, stiffness of back and lumbar region, yawning, body-ache, malaise, morbid thirst, fever, vomiting, tenesmus, anorexia and indigestion and it is similar to antigenic poison. [45-46]
This poisonous substance (''amavisha'') manifests clinical features like flatulence, uncomfortable physical and mental miseries, headache, altered consciousness, giddiness, stiffness of back and lumbar region, yawning, body-ache, malaise, morbid thirst, fever, vomiting, tenesmus, anorexia and indigestion and it is similar to antigenic poison. [45-46]
=== Associated disorders of ''annavisha'' ===
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संसृज्यमानं पित्तेन दाहं तृष्णां मुखामयान्|
संसृज्यमानं पित्तेन दाहं तृष्णां मुखामयान्|
रसादिभिश्च संसृष्टं कुर्याद्रोगान् रसादिजान्||४९||
रसादिभिश्च संसृष्टं कुर्याद्रोगान् रसादिजान्||४९||
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saṁsr̥jyamānaṁ pittēna dāhaṁ tr̥ṣṇāṁ mukhāmayān|
saṁsr̥jyamānaṁ pittēna dāhaṁ tr̥ṣṇāṁ mukhāmayān|
rasAdibhishca saMsRuShTaM kuryAdrogAn rasAdijAn||49||
rasAdibhishca saMsRuShTaM kuryAdrogAn rasAdijAn||49||
</div></div>
The ''annavisha'' when associated with ''pitta'' causes ''daha'', morbid thirst, oral diseases, ''amlapitta'' (acid peptic disorders) and various other ''pitta'' related disorders.
The ''annavisha'' when associated with ''[[pitta]]'' causes ''daha'', morbid thirst, oral diseases, ''amlapitta'' (acid peptic disorders) and various other ''[[pitta]]'' related disorders.
The same ''annavisha'' when gets associated with ''kapha'' it leads to condition like ''yakshma'' (pthiasis), ''peenas'' (coryza) and ''prameha'' (20 types of diabetes) and various other ''kaphaja'' disorders, whereas several ''vatika'' disease are caused by association of ''vata'' with the ''annavisha''.
The same ''annavisha'' when gets associated with ''[[kapha]]'' it leads to condition like ''yakshma'' (pthiasis), ''peenas'' (coryza) and ''prameha'' (20 types of diabetes) and various other ''[[kapha]]ja'' disorders, whereas several ''vatika'' disease are caused by association of ''[[vata]]'' with the ''annavisha''.
The ''annavisha'' when enters renal system, urine related disorders occur; similarly, ''kukshigata roga'' (ailments related to abdomen) have their origin when ''sakrita'' (feces) is involved. ''Rasadi pradoshaja vikara'' (tissue related ailments) occur when ''rasadi srotas'' are involved [47-49]
The ''annavisha'' when enters renal system, urine related disorders occur; similarly, ''kukshigata roga'' (ailments related to abdomen) have their origin when ''sakrita'' (feces) is involved. ''Rasadi pradoshaja vikara'' (tissue related ailments) occur when ''rasadi srotas'' are involved [47-49]
=== Effects of ''Vishamagni'' (irregular ''agni'')and ''tikshanagni''( excessive ''agni'') ===
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विषमो धातुवैषम्यं करोति विषमं पचन्|
विषमो धातुवैषम्यं करोति विषमं पचन्|
तीक्ष्णो मन्देन्धनो धातून् विशोषयति पावकः||५०||
तीक्ष्णो मन्देन्धनो धातून् विशोषयति पावकः||५०||
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viṣamō dhātuvaiṣamyaṁ karōti viṣāmaṁ pacan|
viṣamō dhātuvaiṣamyaṁ karōti viṣāmaṁ pacan|
tIkShNo mandendhano dhAtUn vishoShayati pAvakaH||50||
tIkShNo mandendhano dhAtUn vishoShayati pAvakaH||50||
</div></div>
The ''vishamagni'' (improper ''agni'') causes irregularity in digestion and therefore defective formation of ''dhatu'' takes place whereas, ''tikshanagni'' (excessive ''agni'') when associated with little quantity of fuel (in the form of food) causes depletion of ''dhatu'' (tissue elements) [50]
The ''vishamagni'' (improper ''agni'') causes irregularity in digestion and therefore defective formation of ''[[dhatu]]'' takes place whereas, ''tikshanagni'' (excessive ''agni'') when associated with little quantity of fuel (in the form of food) causes depletion of ''[[dhatu]]'' (tissue elements) [50]
=== ''Samagni'' ===
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युक्तं भुक्तवतो युक्तो धातुसाम्यं समं पचन्|
युक्तं भुक्तवतो युक्तो धातुसाम्यं समं पचन्|
<div class="mw-collapsible-content">
yuktaṁ bhuktavatō yuktō dhātusāmyaṁ sāmaṁ pacan|
yuktaṁ bhuktavatō yuktō dhātusāmyaṁ sāmaṁ pacan|
yuktaM bhuktavato yukto dhAtusAmyaM samaM pacan|
yuktaM bhuktavato yukto dhAtusAmyaM samaM pacan|
</div></div>
If ''agni'' is ''sama'' i.e. in balanced condition and correct diet regimen (as explained in [Cha.Sa.[[Sutra Sthana]] 5] and [Cha.Sa.[[Vimana Sthana]] 1/21] are also followed then there is proper digestion of food which helps in maintaining proper balance within the ''[[dhatu]]'' [50½]
=== ''Durbala'' (weak) ''agni'' ===
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दुर्बलो विदहत्यन्नं तद्यात्यूर्ध्वमधोऽपि वा||५१||
दुर्बलो विदहत्यन्नं तद्यात्यूर्ध्वमधोऽपि वा||५१||
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durbalō vidahatyannaṁ tadyātyūrdhvāmadhō'pi vā||51||
durbalō vidahatyannaṁ tadyātyūrdhvāmadhō'pi vā||51||
durbalo vidahatyannaM tadyAtyUrdhvamadho~api vA||51||
durbalo vidahatyannaM tadyAtyUrdhvamadho~api vA||51||
</div></div>
''Durbala'' (weak) ''agni'' brings about partial digestion of food. These partially digested bio substances then enter in circulation, which may move either in upward or downward direction [51]
''Durbala'' (weak) ''agni'' brings about partial digestion of food. These partially digested bio substances then enter in circulation, which may move either in upward or downward direction [51]
=== ''Grahani gada''(diseases of ''grahani'') ===
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अधस्तु पक्वमामं वा प्रवृत्तं ग्रहणीगदः|
अधस्तु पक्वमामं वा प्रवृत्तं ग्रहणीगदः|
लोहामगन्धिस्तिक्ताम्ल [१७] उद्गारश्चास्य जायते||५४||
लोहामगन्धिस्तिक्ताम्ल [१७] उद्गारश्चास्य जायते||५४||
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adhastu pakvamāmaṁ vā pravr̥ttaṁ Grahaṇī gadaḥ|
adhastu pakvamāmaṁ vā pravr̥ttaṁ Grahaṇī gadaḥ|
lohAmagandhistiktAmla [17] udgArashcAsya jAyate||54||
lohAmagandhistiktAmla [17] udgArashcAsya jAyate||54||
</div></div>
When partially digested and partially undigested bio substances moves downward in gastrointestinal tract it produces a disorder known as ''grahanigada''. In this particular stage the entire food material remains in the state of ''vidagdha'' state (partially transformed/sour).
When partially digested and partially undigested bio substances moves downward in gastrointestinal tract it produces a disorder known as ''grahanigada''. In this particular stage the entire food material remains in the state of ''vidagdha'' state (partially transformed/sour).
In this condition the individual may pass stools in excessive quantity or frequency wherein stools may be loose, with thin consistency or in the form of pellet like stool/bound stool (''vibaddham'') and morbid thirst, anorexia, distaste, excessive watering of mouth, blackout, edema of legs and hands, pain in bones and finger joints, vomiting, fever, eructation having either metallic smell or undigested food and having bitter or sour taste are observed [52-54]
In this condition the individual may pass stools in excessive quantity or frequency wherein stools may be loose, with thin consistency or in the form of pellet like stool/bound stool (''vibaddham'') and morbid thirst, anorexia, distaste, excessive watering of mouth, blackout, edema of legs and hands, pain in bones and finger joints, vomiting, fever, eructation having either metallic smell or undigested food and having bitter or sour taste are observed [52-54]
=== Premonitory symptoms of ''Grahani gada'' ===
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पूर्वरूपं तु तस्येदं तृष्णाऽऽलस्यं बलक्षयः|
पूर्वरूपं तु तस्येदं तृष्णाऽऽलस्यं बलक्षयः|
विदाहोऽन्नस्य पाकश्च चिरात् कायस्य गौरवम्||५५||
विदाहोऽन्नस्य पाकश्च चिरात् कायस्य गौरवम्||५५||
<div class="mw-collapsible-content">
pūrvarūpaṁ tu tasyēdaṁ tr̥ṣṇā''lasyaṁ balakṣayaḥ|
pūrvarūpaṁ tu tasyēdaṁ tr̥ṣṇā''lasyaṁ balakṣayaḥ|
vidAho~annasya pAkashca cirAt kAyasya gauravam||55||
vidAho~annasya pAkashca cirAt kAyasya gauravam||55||
</div></div>
Premonitory signs and symptoms are thirst, malaise, diminution of strength, burning sensation; delay in digestion and heaviness in body [55]
Premonitory signs and symptoms are thirst, malaise, diminution of strength, burning sensation; delay in digestion and heaviness in body [55]
=== Functions of ''grahani'' ===
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अग्न्यधिष्ठानमन्नस्य ग्रहणाद्ग्रहणी मता|
अग्न्यधिष्ठानमन्नस्य ग्रहणाद्ग्रहणी मता|
दुर्बलाग्निबला दुष्टा [१९] त्वाममेव विमुञ्चति||५७||
दुर्बलाग्निबला दुष्टा [१९] त्वाममेव विमुञ्चति||५७||
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agnyadhiṣṭhānāmannasya grahaṇādGrahaṇī matā|
agnyadhiṣṭhānāmannasya grahaṇādGrahaṇī matā|
durbalAgnibalA duShTA [19] tvAmameva vimu~jcati||57||
durbalAgnibalA duShTA [19] tvAmameva vimu~jcati||57||
</div></div>
''Grahani'' is seat of ''agni'' and it is so called since it holds/retains the food (for proper digestion and assimilation). It holds the food just above the umbilical region and it is supported and nourished by the ''agni''. ''Grahani'' with help of ''agni'' holds the undigested food and pushes forward digested food, but when ''agni'' becomes weak and vitiated due to ''vidagdha ahara murchita dosha'' (afflicted by improperly digested food) i.e ''sama dosha''(''dosha'' associated with ''ama'') it vitiates the ''grahani'' and releases food in the form of ''ama'' i.e. undigested form [56-57]
''Grahani'' is seat of ''agni'' and it is so called since it holds/retains the food (for proper digestion and assimilation). It holds the food just above the umbilical region and it is supported and nourished by the ''agni''. ''Grahani'' with help of ''agni'' holds the undigested food and pushes forward digested food, but when ''agni'' becomes weak and vitiated due to ''vidagdha ahara murchita dosha'' (afflicted by improperly digested food) i.e ''sama dosha''(''[[dosha]]'' associated with ''ama'') it vitiates the ''grahani'' and releases food in the form of ''ama'' i.e. undigested form [56-57]
=== Four types of ''grahani'' disease ===
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वातात् पित्तात् कफाच्च स्यात्तद्रोगस्त्रिभ्य एव च|
वातात् पित्तात् कफाच्च स्यात्तद्रोगस्त्रिभ्य एव च|
हेतुं लिङ्गं रूपभेदाञ् शृणु तस्य पृथक् पृथक्||५८||
हेतुं लिङ्गं रूपभेदाञ् शृणु तस्य पृथक् पृथक्||५८||
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vātāt pittāt kaphācca syāttadrōgastribhya ēva ca|
vātāt pittāt kaphācca syāttadrōgastribhya ēva ca|
hetuM li~ggaM rUpabhedA~j [21] shRuNu tasya pRuthak pRuthak||58||
hetuM li~ggaM rUpabhedA~j [21] shRuNu tasya pRuthak pRuthak||58||
</div></div>
''Grahani'' is classified into four types viz ''vataja, pittaja, kaphaja'' and ''sannipataja''. On the basis of the classification, etiological factors, symptoms and signs are being mentioned one by one [58]
''Grahani'' is classified into four types viz ''[[vata]]ja, [[pitta]]ja, [[kapha]]ja'' and ''sannipataja''. On the basis of the classification, etiological factors, symptoms and signs are being mentioned one by one [58]
=== Causes of ''[[vata]]ja grahani'' ===
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कटुतिक्तकषायातिरूक्षशीतलभोजनैः|
कटुतिक्तकषायातिरूक्षशीतलभोजनैः|
करोति कुपितो मन्दमग्निं सञ्छाद्य मारुतः [२२] |
करोति कुपितो मन्दमग्निं सञ्छाद्य मारुतः [२२] |
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kaṭutiktakaṣāyātirūkṣaśītalabhōjanaiḥ|
kaṭutiktakaṣāyātirūkṣaśītalabhōjanaiḥ|
karoti kupito mandamagniM sa~jchAdya mArutaH [22] |
karoti kupito mandamagniM sa~jchAdya mArutaH [22] |
</div></div>
Excessive indulgence in diet having ''katu'' (pungent), ''tikta'' (bitter), ''kashaya'' (astringent) dominant food, which is dry in nature or having absorptive or emaciative qualities; cold, chilled or frozen items, eating quantitatively less amount of food, suppression of natural urges and excessive sexual intercourse contribute to aggravation of ''vata dosha'' which encompass the ''agni'' causing suppression of ''agni'' [59½]
Excessive indulgence in diet having ''katu'' (pungent), ''tikta'' (bitter), ''kashaya'' (astringent) dominant food, which is dry in nature or having absorptive or emaciative qualities; cold, chilled or frozen items, eating quantitatively less amount of food, suppression of natural urges and excessive sexual intercourse contribute to aggravation of ''[[vata dosha]]'' which encompass the ''agni'' causing suppression of ''agni'' [59½]
=== Symptoms of ''[[vata]]ja grahani'' ===
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तस्यान्नं पच्यते दुःखं शुक्तपाकं खराङ्गता||६०||
तस्यान्नं पच्यते दुःखं शुक्तपाकं खराङ्गता||६०||
पुनः पुनः सृजेद्वर्चः कासश्वासार्दितोऽनिलात्||६४||
पुनः पुनः सृजेद्वर्चः कासश्वासार्दितोऽनिलात्||६४||
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tasyānnaṁ pacyatē duḥkhaṁ śuktapākaṁ kharāṅgatā||60||
tasyānnaṁ pacyatē duḥkhaṁ śuktapākaṁ kharāṅgatā||60||
punaH punaH sRujedvarcaH kAsashvAsArdito~anilAt||64||
punaH punaH sRujedvarcaH kAsashvAsArdito~anilAt||64||
</div></div>
Symptoms of ''vatika grahani'' are as follows:
Symptoms of ''vatika grahani'' are as follows:
Stools are evacuated with difficulty and consume time. Feces are either watery, dry, small sized associated with flatus and undigested food. Frequency of stool is increased and patient may suffer from cough and breathing difficulty [60-64]
Stools are evacuated with difficulty and consume time. Feces are either watery, dry, small sized associated with flatus and undigested food. Frequency of stool is increased and patient may suffer from cough and breathing difficulty [60-64]
=== Causes of ''[[pitta]]ja grahani'' ===
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कट्वजीर्णविदाह्यम्लक्षाराद्यैः पित्तमुल्बणम्|
कट्वजीर्णविदाह्यम्लक्षाराद्यैः पित्तमुल्बणम्|
अग्निमाप्लावयद्धन्ति [२३] जलं तप्तमिवानलम्||६५||
अग्निमाप्लावयद्धन्ति [२३] जलं तप्तमिवानलम्||६५||
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kaṭvajīrṇavidāhyamlakṣārādyaiḥ Pittamulbaṇam|
kaṭvajīrṇavidāhyamlakṣārādyaiḥ Pittamulbaṇam|
agnimAplAvayaddhanti [23] jalaM taptamivAnalam||65||
agnimAplAvayaddhanti [23] jalaM taptamivAnalam||65||
</div></div>
''Katu'' (spicy), ''ajeerna'' (undigestable food), ''vidahi'' (food causing eructation), ''amla'' (sour), ''kshara'' (alkali) and other food items which aggravate ''pitta'' are causes for ''pittaja grahani''. The aggravated ''pitta'' hampers the function of ''agni'' similar to condition wherein hot water extinguishes fire [65]
''Katu'' (spicy), ''ajeerna'' (undigestable food), ''vidahi'' (food causing eructation), ''amla'' (sour), ''kshara'' (alkali) and other food items which aggravate ''pitta'' are causes for ''[[pitta]]ja grahani''. The aggravated ''[[pitta]]'' hampers the function of ''agni'' similar to condition wherein hot water extinguishes fire [65]
=== Symptoms of ''[[pitta]]ja grahani'' ===
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सोऽजीर्णं नीलपीताभं पीताभः सार्यते द्रवम्|
सोऽजीर्णं नीलपीताभं पीताभः सार्यते द्रवम्|
पूत्यम्लोद्गारहृत्कण्ठदाहारुचितृडर्दितः||६६||
पूत्यम्लोद्गारहृत्कण्ठदाहारुचितृडर्दितः||६६||
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sō'jīrṇaṁ nīlapītābhaṁ pītābhaḥ sāryatē dravam|
sō'jīrṇaṁ nīlapītābhaṁ pītābhaḥ sāryatē dravam|
pUtyamlodgArahRutkaNThadAhArucitRuDarditaH||66||
pUtyamlodgArahRutkaNThadAhArucitRuDarditaH||66||
</div></div>
The stools have undigested food particles having either bluish-yellowish tinge or yellow in color and are loose/watery. The eructions have foul smell and sour taste, there is burning sensation in the cardiac region (retro-sternal) and throat, anorexia and thirst are the symptoms of ''pittaja grahani'' [66]
The stools have undigested food particles having either bluish-yellowish tinge or yellow in color and are loose/watery. The eructions have foul smell and sour taste, there is burning sensation in the cardiac region (retro-sternal) and throat, anorexia and thirst are the symptoms of ''[[pitta]]ja grahani'' [66]
=== Causes of ''[[kapha]]ja grahani'' ===
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गुर्वतिस्निग्धशीतादिभोजनादतिभोजनात्|
गुर्वतिस्निग्धशीतादिभोजनादतिभोजनात्|
भुक्तमात्रस्य च स्वप्नाद्धन्त्यग्निं कुपितः कफः||६७||
भुक्तमात्रस्य च स्वप्नाद्धन्त्यग्निं कुपितः कफः||६७||
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gurvatisnigdhaśītādibhōjanādatibhōjanāt|
gurvatisnigdhaśītādibhōjanādatibhōjanāt|
bhuktamAtrasya ca svapnAddhantyagniM kupitaH kaphaH||67||
bhuktamAtrasya ca svapnAddhantyagniM kupitaH kaphaH||67||
</div></div>
Heavy to digest or excessively unctuous foods, frozen or chilled items or food having cold nature or food which has qualities similar to ''kapha'', excessive intake of food and sleeping just after the meals hamper the function of ''agni'' and simultaneously vitiates ''kapha'' [67]
Heavy to digest or excessively unctuous foods, frozen or chilled items or food having cold nature or food which has qualities similar to ''[[kapha]]'', excessive intake of food and sleeping just after the meals hamper the function of ''agni'' and simultaneously vitiates ''[[kapha]]'' [67]
=== Symptoms of ''[[kapha]]ja grahani'' ===
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तस्यान्नं पच्यते दुःखं हृल्लासच्छर्द्यरोचकाः|
तस्यान्नं पच्यते दुःखं हृल्लासच्छर्द्यरोचकाः|
अकृशस्यापि दौर्बल्यमालस्यं च कफात्मके||७०||
अकृशस्यापि दौर्बल्यमालस्यं च कफात्मके||७०||
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tasyānnaṁ pacyatē duḥkhaṁ hr̥llāsacchardyarōcakāḥ|
tasyānnaṁ pacyatē duḥkhaṁ hr̥llāsacchardyarōcakāḥ|
akRushasyApi daurbalyamAlasyaM ca kaphAtmake||70||
akRushasyApi daurbalyamAlasyaM ca kaphAtmake||70||
</div></div>
Food is digested with difficulty, nausea, vomiting and anorexia are its symptoms. The other symptoms are feeling of coated mouth and sweet taste, has cough, increased tendency to spit, ''pinasa'' (nasal discharge), feeling of heaviness in chest, feeling as if there is no movement in abdomen, heavy abdomen, eructation with foul smelling and sweet taste; patient does not feel enthusiastic and there is suppression of libido. Stools are mixed with undigested items and mucous and are heavy; although patient is not emaciated still he feels weakness and laziness [68-70]
Food is digested with difficulty, nausea, vomiting and anorexia are its symptoms. The other symptoms are feeling of coated mouth and sweet taste, has cough, increased tendency to spit, ''pinasa'' (nasal discharge), feeling of heaviness in chest, feeling as if there is no movement in abdomen, heavy abdomen, eructation with foul smelling and sweet taste; patient does not feel enthusiastic and there is suppression of libido. Stools are mixed with undigested items and mucous and are heavy; although patient is not emaciated still he feels weakness and laziness [68-70]
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यश्चाग्निः पूर्वमुद्दिष्टो रोगानीके चतुर्विधः|
यश्चाग्निः पूर्वमुद्दिष्टो रोगानीके चतुर्विधः|
तं चापि ग्रहणीदोषं समवर्जं प्रचक्ष्महे||७१||
तं चापि ग्रहणीदोषं समवर्जं प्रचक्ष्महे||७१||
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yaścāgniḥ pūrvamuddiṣṭō rōgānīkē caturvidhaḥ|
yaścāgniḥ pūrvamuddiṣṭō rōgānīkē caturvidhaḥ|
taM cApi grahaNIdoShaM samavarjaM pracakShmahe||71||
taM cApi grahaNIdoShaM samavarjaM pracakShmahe||71||
</div></div>
Four types of ''agni'' have been previously explained in [[Roganika Vimana]]. Except ''samagni'' other three types of ''agni'' contribute to the ''grahani dosha'' [71]
Four types of ''agni'' have been previously explained in [[Roganika Vimana]]. Except ''samagni'' other three types of ''agni'' contribute to the ''grahani dosha'' [71]
=== ''Sannipataja grahani'' ===
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पृथग्वातादिनिर्दिष्टहेतुलिङ्गसमागमे|
पृथग्वातादिनिर्दिष्टहेतुलिङ्गसमागमे|
त्रिदोषं निर्दिशेत्तेषां भेषजं [२४] शृण्वतः परम्||७२||
त्रिदोषं निर्दिशेत्तेषां भेषजं [२४] शृण्वतः परम्||७२||
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pr̥thagvātādinirdiṣṭahētuliṅgasamāgamē|
pr̥thagvātādinirdiṣṭahētuliṅgasamāgamē|
shRuNvataH param||72||
shRuNvataH param||72||
</div></div>
''Sannipataja grahani'' occurs by simultaneous vitiation of ''vata, pitta'' and ''kapha''. In such conditions etiological factors, symptoms and signs are of all the three ''dosha'' appear. Hereafter treatment of ''grahanidosha'' is expounded [72]
''Sannipataja grahani'' occurs by simultaneous vitiation of ''[[vata]], [[pitta]]'' and ''[[kapha]]''. In such conditions etiological factors, symptoms and signs are of all the three ''[[dosha]]'' appear. Hereafter treatment of ''grahanidosha'' is expounded [72]
=== ''[[Vamana]]'' in ''grahanidosha'' ===
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ग्रहणीमाश्रितं दोषं विदग्धाहारमूर्च्छितम्|
ग्रहणीमाश्रितं दोषं विदग्धाहारमूर्च्छितम्|
फलानां वा कषायेण पिप्पलीसर्षपैस्तथा||७४||
फलानां वा कषायेण पिप्पलीसर्षपैस्तथा||७४||
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Grahaṇī māśritaṁ dōṣaṁ vidagdhāhāramūrcchitam|
Grahaṇī māśritaṁ dōṣaṁ vidagdhāhāramūrcchitam|
phalAnAM vA kaShAyeNa pippalIsarShapaistathA||74||
phalAnAM vA kaShAyeNa pippalIsarShapaistathA||74||
</div></div>
When the ''doshas'' are located in ''grahani'' and are associated with incomplete digested food then ''vishtambha'' (constipation), excessive salivation, bodyache, burning sensation, anorexia and heaviness is felt by patient which are symptoms of ''ama'' and in such a condition ''vamana'' (emetic therapy) with lukewarm water or with decoction of ''madanaphala'' (Randia spinosa), ''pippali'' (Piper longum) and ''sarshapa'' (Brassica campestris) should be administered [73-74]
When the ''[[dosha]]s'' are located in ''grahani'' and are associated with incomplete digested food then ''vishtambha'' (constipation), excessive salivation, bodyache, burning sensation, anorexia and heaviness is felt by patient which are symptoms of ''ama'' and in such a condition ''[[vamana]]'' (emetic therapy) with lukewarm water or with decoction of ''madanaphala'' (Randia spinosa), ''pippali'' (Piper longum) and ''sarshapa'' (Brassica campestris) should be administered [73-74]
=== Treatment of ''leena [[dosha]]'' ===
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लीनं पक्वाशयस्थं वाऽऽप्यामं स्राव्यं सदीपनैः|
लीनं पक्वाशयस्थं वाऽऽप्यामं स्राव्यं सदीपनैः|
शरीरानुगते सामे रसे लङ्घनपाचनम्||७५||
शरीरानुगते सामे रसे लङ्घनपाचनम्||७५||
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līnaṁ pakvāśayasthaṁ vā''pyāmaṁ srāvyaṁ sadīpanaiḥ|
līnaṁ pakvāśayasthaṁ vā''pyāmaṁ srāvyaṁ sadīpanaiḥ|
sharIrAnugate sAme rase la~gghanapAcanam||75||
sharIrAnugate sAme rase la~gghanapAcanam||75||
</div></div>
If the ''ama'' is in ''pakvashaya'' and in ''anutklishtha'' (stuck, not ready to come out) condition then ''stravana'' (increasing secretion) with ''deepana dravyas'' should be administered whereas if ama gets absorbed along with ''rasa dhatu'' and if it pervades throughout the body then ''langhana'' and ''pachana'' should be advised [75]
If the ''ama'' is in ''pakvashaya'' and in ''anutklishtha'' (stuck, not ready to come out) condition then ''stravana'' (increasing secretion) with ''[[deepana]] dravyas'' should be administered whereas if ama gets absorbed along with ''[[rasa dhatu]]'' and if it pervades throughout the body then ''[[langhana]]'' and ''[[pachana]]'' should be advised [75]
=== ''Panchakoladi shritam and peya'' ===
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विशुद्धामाशयायास्मै पञ्चकोलादिभिः शृतम्|
विशुद्धामाशयायास्मै पञ्चकोलादिभिः शृतम्|
दद्यात् पेयादि लघ्वन्नं पुनर्योगांश्च दीपनान्||७६||
दद्यात् पेयादि लघ्वन्नं पुनर्योगांश्च दीपनान्||७६||
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viśuddhāmāśayāyāsmai pañcakōlādibhiḥ śr̥tam|
viśuddhāmāśayāyāsmai pañcakōlādibhiḥ śr̥tam|
dadyAt peyAdi laghvannaM punaryogAMshca dIpanAn||76||
dadyAt peyAdi laghvannaM punaryogAMshca dIpanAn||76||
</div></div>
After cleansing of ''amashaya'', liquid gruel of rice (''peya'') fortified with ''panchakola'' etc. drugs should be administered. Light and easy to digest food along with ''deepana'' drugs may be given [76]
After cleansing of ''amashaya'', liquid gruel of rice (''peya'') fortified with ''panchakola'' etc. drugs should be administered. Light and easy to digest food along with ''[[deepana]]'' drugs may be given [76]
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ज्ञात्वा तु परिपक्वामं मारुतग्रहणीगदम्|
ज्ञात्वा तु परिपक्वामं मारुतग्रहणीगदम्|
दीपनीययुतं सर्पिः पाययेताल्पशो भिषक्||७७||
दीपनीययुतं सर्पिः पाययेताल्पशो भिषक्||७७||
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jñātvā tu paripakvāmaṁ mārutaGrahaṇī gadam|
jñātvā tu paripakvāmaṁ mārutaGrahaṇī gadam|
dIpanIyayutaM sarpiH pAyayetAlpasho bhiShak||77||
dIpanIyayutaM sarpiH pAyayetAlpasho bhiShak||77||
</div></div>
In patients with ''vataja grahani'' after ascertaining that ''ama'' is digested, medicated ghee starting with very minimum quantity prepared from ''deepaneeya gana'' be administered [Ca.Su.4/9/6]- [77]
In patients with ''[[vata]]ja grahani'' after ascertaining that ''ama'' is digested, medicated ghee starting with very minimum quantity prepared from ''deepaneeya gana'' be administered [Cha.Sa.[[Sutra Sthana ]]4/9/6]- [77]
=== ''Niruha [[basti]]'' ===
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किञ्चित्सन्धुक्षिते त्वग्नौ सक्तविण्मूत्रमारुतम्|
किञ्चित्सन्धुक्षिते त्वग्नौ सक्तविण्मूत्रमारुतम्|
द्व्यहं त्र्यहं वा संस्नेह्य स्विन्नाभ्यक्तं निरूहयेत्||७८||
द्व्यहं त्र्यहं वा संस्नेह्य स्विन्नाभ्यक्तं निरूहयेत्||७८||
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kiñcitsandhukṣitē tvagnau saktaviṇmūtramārutam|
kiñcitsandhukṣitē tvagnau saktaviṇmūtramārutam|
dvyahaM tryahaM vA saMsnehya svinnAbhyaktaM nirUhayet||78||
dvyahaM tryahaM vA saMsnehya svinnAbhyaktaM nirUhayet||78||
</div></div>
As stimulation of ''agni'' is observed and still if patient finds difficulty in passing stool, urine and flatus then in such condition every two or three days ''niruha basti'' should be administered after proper ''snehana'' and ''swedana'' [78]
As stimulation of ''agni'' is observed and still if patient finds difficulty in passing stool, urine and flatus then in such condition every two or three days ''niruha [[basti]]'' should be administered after proper ''[[snehana]]'' and ''[[swedana]]'' [78]
=== ''[[Virechana]]'' ===
<div class="mw-collapsible mw-collapsed">
तत एरण्डतैलेन सर्पिषा तैल्वकेन वा|
तत एरण्डतैलेन सर्पिषा तैल्वकेन वा|
सक्षारेणानिले शान्ते स्रस्तदोषं विरेचयेत्||७९||
सक्षारेणानिले शान्ते स्रस्तदोषं विरेचयेत्||७९||
<div class="mw-collapsible-content">
tata ēraṇḍatailēna sarpiṣā tailvakēna vā|
tata ēraṇḍatailēna sarpiṣā tailvakēna vā|
sakShAreNAnile shAnte srastadoShaM virecayet||79||
sakShAreNAnile shAnte srastadoShaM virecayet||79||
</div></div>
After ''niruha'', the ''strasta dosha'' (''dosha'' ready to come out) should be cleaned with purgative drugs like ''eranda taila'' (castor oil) or ''tilvaka ghrita'' mixed with ''kshara'' (medicine with alkaline nature) [79]
After ''niruha'', the ''strasta dosha'' (''[[dosha]]'' ready to come out) should be cleaned with purgative drugs like ''eranda taila'' (castor oil) or ''tilvaka ghrita'' mixed with ''kshara'' (medicine with alkaline nature) [79]
=== ''Anuvasana [[basti]]'' ===
<div class="mw-collapsible mw-collapsed">
शुद्धं रूक्षाशयं बद्धवर्चसं चानुवासयेत्|
शुद्धं रूक्षाशयं बद्धवर्चसं चानुवासयेत्|
दीपनीयाम्लवातघ्नसिद्धातैलेन मात्रया||८०||
दीपनीयाम्लवातघ्नसिद्धातैलेन मात्रया||८०||
<div class="mw-collapsible-content">
śuddhaṁ rūkṣāśayaṁ baddhavarcasaṁ cānuvāsayēt|
śuddhaṁ rūkṣāśayaṁ baddhavarcasaṁ cānuvāsayēt|
dIpanIyAmlavAtaghnasiddhAtailena mAtrayA||80||
dIpanIyAmlavAtaghnasiddhAtailena mAtrayA||80||
</div></div>
After ''shodhana'' of intestine if ''rukshata'' and ''baddha'' (pellet-like) stools are seen then ''anuvasana basti'' with ''taila'' fortified with ''deepana'' drugs having sour and ''vata'' alleviating action may be administered [80]
After ''[[shodhana]]'' of intestine if ''rukshata'' and ''baddha'' (pellet-like) stools are seen then ''anuvasana [[basti]]'' with ''taila'' fortified with ''[[deepana]]'' drugs having sour and ''[[vata]]'' alleviating action may be administered [80]
<div class="mw-collapsible mw-collapsed">
निरूढं च विरिक्तं च सम्यक् चैवानुवासितम्|
निरूढं च विरिक्तं च सम्यक् चैवानुवासितम्|
लघ्वन्नं प्रतिसम्भुक्तं सर्पिरभ्यासयेत् पुनः||८१||
लघ्वन्नं प्रतिसम्भुक्तं सर्पिरभ्यासयेत् पुनः||८१||
<div class="mw-collapsible-content">
nirūḍhaṁ ca viriktaṁ ca samyak caivānuvāsitam|
nirūḍhaṁ ca viriktaṁ ca samyak caivānuvāsitam|
laghvannaM pratisambhuktaM sarpirabhyAsayet punaH||81||
laghvannaM pratisambhuktaM sarpirabhyAsayet punaH||81||
</div></div>
After appropriate administration of ''niruha, virechana'' and ''anuvasana'', light diet should be taken daily and ghee should be taken repeatedly [81]
After appropriate administration of ''niruha, [[virechana]]'' and ''anuvasana'', light diet should be taken daily and ghee should be taken repeatedly [81]
=== ''Dashamooladya ghrita''===
<div class="mw-collapsible mw-collapsed">
द्वे पञ्चमूले सरलं देवदारु सनागरम्|
द्वे पञ्चमूले सरलं देवदारु सनागरम्|
इति दशमूलाद्यं घृतम्
इति दशमूलाद्यं घृतम्
<div class="mw-collapsible-content">
dvē pañcamūlē saralaṁ dēvadāru sanāgaram|
dvē pañcamūlē saralaṁ dēvadāru sanāgaram|
iti dashamUlAdyaM ghRutam
iti dashamUlAdyaM ghRutam
</div></div>
Boil the ''svarasa'' of two ''panchamoola'' (''brihat'' and ''laghu''), ''sarala'' ((''trivrita'') Operculina turpethum), ''devadaru'' (Cedrus deodara), ''nagara'' (Zingiber officinale), ''pippali'' (Piper longum), ''pippalimoola, chitraka'' (Plumbago zeylanica), ''gajapippali'' (Piper retofractum), ''sanabeeja'' (seeds of Crotalaria juncea), barley, ''kola, kulatta'' and ''susavi'' (Woodfordia fruticosa) with ''aranala, dadhimanda'' or ''sauviraka''. After one fourth reductions add one ''adhaka'' (3.073 kg) of ghee and ''svarjikakshara'' and ''yavashukakshara'' as per ''yukti pramana'' i.e. either in small quantity or at the time of ''ghrita siddhi lakshana'' alongwith ''saindhava'' (rock salt), ''audbhida'' (salts derived from plants), ''samudra'' (table salt), ''bidha'' (red granular salt), ''romaka, sauvarchala'' and ''pakya'' (''pakaja'') types of salt in two ''pala'' quantity each (96 gm each). After preparation, it may be administered up to one ''prasrita'' i.e. 96 gm. It increases ''agni'', strength and complexion and helps in alleviation of ''vata'' and thus digestion of food [82-86]
Boil the ''svarasa'' of two ''panchamoola'' (''brihat'' and ''laghu''), ''sarala'' ((''trivrita'') Operculina turpethum), ''devadaru'' (Cedrus deodara), ''nagara'' (Zingiber officinale), ''pippali'' (Piper longum), ''pippalimoola, chitraka'' (Plumbago zeylanica), ''gajapippali'' (Piper retofractum), ''sanabeeja'' (seeds of Crotalaria juncea), barley, ''kola, kulatta'' and ''susavi'' (Woodfordia fruticosa) with ''aranala, dadhimanda'' or ''sauviraka''. After one fourth reductions add one ''adhaka'' (3.073 kg) of ghee and ''svarjikakshara'' and ''yavashukakshara'' as per ''yukti pramana'' i.e. either in small quantity or at the time of ''ghrita siddhi lakshana'' alongwith ''saindhava'' (rock salt), ''audbhida'' (salts derived from plants), ''samudra'' (table salt), ''bidha'' (red granular salt), ''romaka, sauvarchala'' and ''pakya'' (''pakaja'') types of salt in two ''pala'' quantity each (96 gm each). After preparation, it may be administered up to one ''prasrita'' i.e. 96 gm. It increases ''agni'', strength and complexion and helps in alleviation of ''[[vata]]'' and thus digestion of food [82-86]
=== ''Tryushanadya ghrita'' ===
<div class="mw-collapsible mw-collapsed">
त्र्यूषणत्रिफलाकल्के बिल्वमात्रे गुडात् पले|
त्र्यूषणत्रिफलाकल्के बिल्वमात्रे गुडात् पले|
इति त्र्यूषणाद्यं घृतम्
इति त्र्यूषणाद्यं घृतम्
<div class="mw-collapsible-content">
tryūṣaṇatriphalākalkē bilvamātrē guḍāt palē|
tryūṣaṇatriphalākalkē bilvamātrē guḍāt palē|
iti tryUShaNAdyaM ghRutam
iti tryUShaNAdyaM ghRutam
</div></div>
Prepare paste of ''trikatu'' and ''triphala'' in quantity of one ''bilva'' and add one ''pala'' (48g) of jaggery and do ''sneha siddhi'' by adding eight ''palas'' (384 gm) of ghee. This medicated ''ghrita'' is indicated in ''mandagni'' i.e. low digestive power [87]
Prepare paste of ''trikatu'' and ''triphala'' in quantity of one ''bilva'' and add one ''pala'' (48g) of jaggery and do ''sneha siddhi'' by adding eight ''palas'' (384 gm) of ghee. This medicated ''ghrita'' is indicated in ''mandagni'' i.e. low digestive power [87]
=== ''Panchamooladya ghrita'' and ''choorna'' ===
<div class="mw-collapsible mw-collapsed">
पञ्चमूलाभयाव्योषपिप्पलीमूलसैन्धवैः|
पञ्चमूलाभयाव्योषपिप्पलीमूलसैन्धवैः|
इति पञ्चमूलाद्यं घृतं चूर्णं च
इति पञ्चमूलाद्यं घृतं चूर्णं च
<div class="mw-collapsible-content">
pañcamūlābhayāvyōṣapippalīmūlasaindhavaiḥ|
pañcamūlābhayāvyōṣapippalīmūlasaindhavaiḥ|
iti pa~jcamUlAdyaM ghRutaM cUrNaM ca
iti pa~jcamUlAdyaM ghRutaM cUrNaM ca
</div></div>
Make paste of ''panchamoola'' (''bilva, shyonaka, gambhari, patala'' and ''gambharika''), ''abhaya'', ''trikatu, pippalimoola, saindhava, rasna,'' two ''kshara'' (''sarjika'' and ''yavakshara''), ''ajaji, vidanga'' and ''sati'' and prepare medicated ghee with ''sukta,'' juice of ''matulunga'' and ''ardraka, suṣkamoolaka, kolambu, chukrika,'' pomengranate, butter milk, ''mastu'' (supplement liquid portion in the curd/yoghurt), ''suramanda'' (indigenous beer beverage prepared from fermented cereals) ''sauviraka'' (acidic fermented liquid obtained from wheat), ''tushodaka'' (fermented liquid using the coarse grains of barley) and ''kanji'' (fermented liquid).
Make paste of ''panchamoola'' (''bilva, shyonaka, gambhari, patala'' and ''gambharika''), ''abhaya'', ''trikatu, pippalimoola, saindhava, rasna,'' two ''kshara'' (''sarjika'' and ''yavakshara''), ''ajaji, vidanga'' and ''sati'' and prepare medicated ghee with ''sukta,'' juice of ''matulunga'' and ''ardraka, suṣkamoolaka, kolambu, chukrika,'' pomengranate, butter milk, ''mastu'' (supplement liquid portion in the curd/yoghurt), ''suramanda'' (indigenous beer beverage prepared from fermented cereals) ''sauviraka'' (acidic fermented liquid obtained from wheat), ''tushodaka'' (fermented liquid using the coarse grains of barley) and ''kanji'' (fermented liquid).
The medicated ghee helps in digestion and increase strength of ''agni'' and cures colicky pain, ''gulma, udara'', asthma and cough. It also pacifies ''vata'' and ''kapha''. ''Beejapuraka svarasa'' can also be used for ''sneha siddhi''.
The medicated ghee helps in digestion and increase strength of ''agni'' and cures colicky pain, ''gulma, udara'', asthma and cough. It also pacifies ''[[vata]]'' and ''[[kapha]]''. ''Beejapuraka svarasa'' can also be used for ''sneha siddhi''.
''Taila siddhi'' with above medicine may be used for ''abhyanga'' (massage) and the ''choorna'' used in above preparation may be taken with lukewarm water.
''Taila siddhi'' with above medicine may be used for ''abhyanga'' (massage) and the ''choorna'' used in above preparation may be taken with lukewarm water.
In condition such as ''kapha avrite vata'' (''vata'' occluded by ''kapha''), ''sama kapha'' and ''vata'' aggravated due to ''kapha'' give the above ''choorna'' for digestion and to stimulate ''agni''. The medicine is known as ''panchamooladyam ghritam choornam'' [88-93]
In condition such as ''kapha avrite vata'' (''[[vata]]'' occluded by ''[[kapha]]''), ''sama [[kapha]]'' and ''[[vata]]'' aggravated due to ''[[kapha]]'' give the above ''choorna'' for digestion and to stimulate ''agni''. The medicine is known as ''panchamooladyam ghritam choornam'' [88-93]
=== Examination of feces ===
<div class="mw-collapsible mw-collapsed">
मज्जत्यामा गुरुत्वाद्विट् पक्वा तूत्प्लवते जले|
मज्जत्यामा गुरुत्वाद्विट् पक्वा तूत्प्लवते जले|
विनाऽतिद्रवसङ्घातशैत्यश्लेष्मप्रदूषणात्||९४||
विनाऽतिद्रवसङ्घातशैत्यश्लेष्मप्रदूषणात्||९४||
<div class="mw-collapsible-content">
majjatyāmā gurutvādviṭ pakvā tūtplavatē jalē|
majjatyāmā gurutvādviṭ pakvā tūtplavatē jalē|
vinA~atidravasa~gghAtashaityashleShmapradUShaNAt||94||
vinA~atidravasa~gghAtashaityashleShmapradUShaNAt||94||
</div></div>
''Sama mala'' (stools) sinks into water due to ''gurutva'' (heaviness) of ''ama'' whereas ''pakva'' or ''nirama mala'' floats over the water; provided the stools consistency is not watery or not very compact and if not vitiated by ''sheeta guna'' and ''kapha'' [94]
''Sama mala'' (stools) sinks into water due to ''gurutva'' (heaviness) of ''ama'' whereas ''pakva'' or ''nirama mala'' floats over the water; provided the stools consistency is not watery or not very compact and if not vitiated by ''sheeta [[guna]]'' and ''[[kapha]]'' [94]
<div class="mw-collapsible mw-collapsed">
परीक्ष्यैवं पुरा सामं निरामं चामदोषिणम्|
परीक्ष्यैवं पुरा सामं निरामं चामदोषिणम्|
विधिनोपाचरेत् सम्यक् पाचनेनेतरेण वा||९५||
विधिनोपाचरेत् सम्यक् पाचनेनेतरेण वा||९५||
<div class="mw-collapsible-content">
parīkṣyaivaṁ purā sāmaṁ nirāmaṁ cāmadōṣiṇam|
parīkṣyaivaṁ purā sāmaṁ nirāmaṁ cāmadōṣiṇam|
vidhinopAcaret samyak pAcanenetareNa vA||95||
vidhinopAcaret samyak pAcanenetareNa vA||95||
</div></div>
Patient should be evaluated for ''amadosha'' whether ''samata'' or ''niramta'' is present or not and then appropriately treated with ''pachana'' etc. treatment [95]
Patient should be evaluated for ''amadosha'' whether ''samata'' or ''niramta'' is present or not and then appropriately treated with ''[[pachana]]'' etc. treatment [95]
=== ''Chitrakadya gutika'' ===
<div class="mw-collapsible mw-collapsed">
चित्रकं पिप्पलीमूलं द्वौ क्षारौ लवणानि च|
चित्रकं पिप्पलीमूलं द्वौ क्षारौ लवणानि च|
इति चित्रकाद्या गुटिका
इति चित्रकाद्या गुटिका
<div class="mw-collapsible-content">
citrakaṁ pippalīmūlaṁ dvau kṣārau lavaṇāni ca|
citrakaṁ pippalīmūlaṁ dvau kṣārau lavaṇāni ca|
iti citrakAdyA guTikA
iti citrakAdyA guTikA
</div></div>
''Chitraka, pippalimoola,'' two ''kshara'' (''yavakshara'' and ''sarjikshara''), salt, ''trikatu, hingu, ajamoda'' and ''chavya'' are mixed together and trichurated with either ''matulunga svarasa'' or ''dadima svarasa'' and tablets are prepared. This ''chitrakadya guthi'' is useful for digestion of ''ama'' and stimulation of the ''agni'' [96-97]
''Chitraka, pippalimoola,'' two ''kshara'' (''yavakshara'' and ''sarjikshara''), salt, ''trikatu, hingu, ajamoda'' and ''chavya'' are mixed together and trichurated with either ''matulunga svarasa'' or ''dadima svarasa'' and tablets are prepared. This ''chitrakadya guthi'' is useful for digestion of ''ama'' and stimulation of the ''agni'' [96-97]
=== Recipes for ''[[pachana]]'' of ''ama'' ===
<div class="mw-collapsible mw-collapsed">
नागरातिविषामुस्तक्वाथः स्यादामपाचनः|
नागरातिविषामुस्तक्वाथः स्यादामपाचनः|
मुस्तान्तकल्कः पथ्या वा नागरं चोष्णवारिणा||९८||
मुस्तान्तकल्कः पथ्या वा नागरं चोष्णवारिणा||९८||
<div class="mw-collapsible-content">
nāgarātiviṣāmustakvāthaḥ syādāmapācanaḥ|
nāgarātiviṣāmustakvāthaḥ syādāmapācanaḥ|
mustAntakalkaH pathyA vA nAgaraM coShNavAriNA||98||
mustAntakalkaH pathyA vA nAgaraM coShNavAriNA||98||
</div></div>
''Shunthi, ativisha'' and ''musta'' decoction helps in ''pachana'' of ''ama''. ''Kalka'' (paste) of ''shunthi, ativisha'' and ''musta'' or ''haritaki'' or ''shunthi'' alongwith warm water also does ''ama pachana'' [98]
''Shunthi, ativisha'' and ''musta'' decoction helps in ''[[pachana]]'' of ''ama''. ''Kalka'' (paste) of ''shunthi, ativisha'' and ''musta'' or ''haritaki'' or ''shunthi'' alongwith warm water also does ''ama pachana'' [98]
<div class="mw-collapsible mw-collapsed">
देवदारुवचामुस्तनागरातिविषाभयाः|
देवदारुवचामुस्तनागरातिविषाभयाः|
वर्चस्यामे सशूले च पिबेद्वा दाडिमाम्बुना|
वर्चस्यामे सशूले च पिबेद्वा दाडिमाम्बुना|
<div class="mw-collapsible-content">
dēvadāruvacāmustanāgarātiviṣābhayāḥ|
dēvadāruvacāmustanāgarātiviṣābhayāḥ|
varcasyAme sashUle ca pibedvA dADimAmbunA|
varcasyAme sashUle ca pibedvA dADimAmbunA|
</div></div>
Soak powder of ''devadaru, vacha, musta, nagara, ativisha'' and ''haritaki'' in ''varuni'' (fermented liquid obtained from palm trees like dates) and take with warm water without adding salt or be taken with juice of ''dadima'' in condition wherein there is colicky pain along with mucus or undigested food in stool [99-99½]
Soak powder of ''devadaru, vacha, musta, nagara, ativisha'' and ''haritaki'' in ''varuni'' (fermented liquid obtained from palm trees like dates) and take with warm water without adding salt or be taken with juice of ''dadima'' in condition wherein there is colicky pain along with mucus or undigested food in stool [99-99½]
<div class="mw-collapsible mw-collapsed">
विडेन [२९] लवणं पिष्टं बिल्वं चित्रकनागरम्||१००||
विडेन [२९] लवणं पिष्टं बिल्वं चित्रकनागरम्||१००||
सामे वा सकफे वाते कोष्ठशूलकरे पिबेत्|
सामे वा सकफे वाते कोष्ठशूलकरे पिबेत्|
<div class="mw-collapsible-content">
viḍēna [29] lavaṇaṁ piṣṭaṁ bilvaṁ citrakanāgaram||100||
viḍēna [29] lavaṇaṁ piṣṭaṁ bilvaṁ citrakanāgaram||100||
sāmē vā sakaphē vātē kōṣṭhaśūlakarē pibēt|
sāmē vā sakaphē vātē kōṣṭhaśūlakarē pibēt|
</div></div>
Paste of ''bilva, chitraka'' and ''nagara'' should be added with ''vida lavana'' and administered in ''sama'' stool or mucus in stool and pain in abdomen due to vāta aggravation [100]
Paste of ''bilva, chitraka'' and ''nagara'' should be added with ''vida lavana'' and administered in ''sama'' stool or mucus in stool and pain in abdomen due to [[vata]] aggravation [100]
<div class="mw-collapsible mw-collapsed">
कलिङ्गहिङ्ग्वतिविषावचासौवर्चलाभयाः||१०१||
कलिङ्गहिङ्ग्वतिविषावचासौवर्चलाभयाः||१०१||
पथ्यासौवर्चलाजाजीचूर्णं मरिचसंयुतम्||१०२||
पथ्यासौवर्चलाजाजीचूर्णं मरिचसंयुतम्||१०२||
<div class="mw-collapsible-content">
kaliṅgahiṅgvativiṣāvacāsauvarcalābhayāḥ||101||
kaliṅgahiṅgvativiṣāvacāsauvarcalābhayāḥ||101||
pathyAsauvarcalAjAjIcUrNaM maricasaMyutam||102||
pathyAsauvarcalAjAjIcUrNaM maricasaMyutam||102||
</div></div>
''Kalinga, hingu, ativisha, vacha, sauvarchala'' and ''haritaki'' with warm water is useful in vomiting, ''arshogranthi'' (analpolyp with pellet stool) and pain in abdomen. Similarly, combination of ''haritaki, sauvarchala'' and ''ajaji'' along with maricha can be used for same condition [101-102]
''Kalinga, hingu, ativisha, vacha, sauvarchala'' and ''haritaki'' with warm water is useful in vomiting, ''arshogranthi'' (analpolyp with pellet stool) and pain in abdomen. Similarly, combination of ''haritaki, sauvarchala'' and ''ajaji'' along with maricha can be used for same condition [101-102]
=== Recipe for ''[[pitta]]-[[kapha]] grahani'' ===
<div class="mw-collapsible mw-collapsed">
अभयां पिप्पलीमूलं वचां कटुकरोहिणीम्|
अभयां पिप्पलीमूलं वचां कटुकरोहिणीम्|
पित्तश्लेष्माभिभृतायां ग्रहण्यां शूलनुद्धितम्||१०४||
पित्तश्लेष्माभिभृतायां ग्रहण्यां शूलनुद्धितम्||१०४||
<div class="mw-collapsible-content">
abhayāṁ pippalīmūlaṁ vacāṁ kaṭukarōhiṇīm|
abhayāṁ pippalīmūlaṁ vacāṁ kaṭukarōhiṇīm|
pittashleShmAbhibhRutAyAM grahaNyAM shUlanuddhitam||104||
pittashleShmAbhibhRutAyAM grahaNyAM shUlanuddhitam||104||
</div></div>
Decoction of the ''haritaki, pippalimoola, vacha, katukarohineem, patha,'' seeds of ''kutaja, chitraka, vishvabheshaja'' (''sunthi'') or ''choorna'' of the above contents should be administered with warm water. It is helpful when colic pain is associated with ''pitta-kapha'' dominant ''grahani'' [103-104]
Decoction of the ''haritaki, pippalimoola, vacha, katukarohineem, patha,'' seeds of ''kutaja, chitraka, vishvabheshaja'' (''sunthi'') or ''choorna'' of the above contents should be administered with warm water. It is helpful when colic pain is associated with ''[[pitta]]-[[kapha]]'' dominant ''grahani'' [103-104]
<div class="mw-collapsible mw-collapsed">
सामे सातिविषं व्योषं लवणक्षारहिङ्गु च|
सामे सातिविषं व्योषं लवणक्षारहिङ्गु च|
निःक्वाथ्य पाययेच्चूर्णं कृत्वा वा कोष्णवारिणा||१०५||
निःक्वाथ्य पाययेच्चूर्णं कृत्वा वा कोष्णवारिणा||१०५||
<div class="mw-collapsible-content">
sāmē sātiviṣaṁ vyōṣaṁ lavaṇakṣārahiṅgu ca|
sāmē sātiviṣaṁ vyōṣaṁ lavaṇakṣārahiṅgu ca|
niHkvAthya pAyayeccUrNaM kRutvA vA koShNavAriNA||105||
niHkvAthya pAyayeccUrNaM kRutvA vA koShNavAriNA||105||
</div></div>
In ''ama'' condition, decoction of ''ativisha, trikatu, lavana, kshara'' (''yavakshara'') and ''hingu'' may be given or powders of above medicines with warm water may be administered [105]
In ''ama'' condition, decoction of ''ativisha, trikatu, lavana, kshara'' (''yavakshara'') and ''hingu'' may be given or powders of above medicines with warm water may be administered [105]
<div class="mw-collapsible mw-collapsed">
पिप्पलीं नागरं पाठां सारिवां बृहतीद्वयम्|
पिप्पलीं नागरं पाठां सारिवां बृहतीद्वयम्|
पिबेदग्निविवृद्ध्यर्थं कोष्ठवातहरं नरः||१०७||
पिबेदग्निविवृद्ध्यर्थं कोष्ठवातहरं नरः||१०७||
<div class="mw-collapsible-content">
pippalīṁ nāgaraṁ pāṭhāṁ sārivāṁ br̥hatīdvayam|
pippalīṁ nāgaraṁ pāṭhāṁ sārivāṁ br̥hatīdvayam|
pibedagnivivRuddhyarthaM koShThavAtaharaM naraH||107||
pibedagnivivRuddhyarthaM koShThavAtaharaM naraH||107||
</div></div>
''Choorna'' of ''pippali, nagara, patha, sariva, brihatidvayam'' (''brihati, kantakari''), ''chitraka,'' seeds of ''kutaja'', five types of ''lavana'', along with ''yavakshara,'' curd, hot water and different types of fermented liquids such as ''kanji, sauviraka'' etc is taken for increasing the power of ''agni'' and to eliminate the ''vata'' in abdomen [106-107]
''Choorna'' of ''pippali, nagara, patha, sariva, brihatidvayam'' (''brihati, kantakari''), ''chitraka,'' seeds of ''kutaja'', five types of ''lavana'', along with ''yavakshara,'' curd, hot water and different types of fermented liquids such as ''kanji, sauviraka'' etc is taken for increasing the power of ''agni'' and to eliminate the ''[[vata]]'' in abdomen [106-107]
=== ''Marichadya choorna'' ===
<div class="mw-collapsible mw-collapsed">
मरिचं कुञ्चिकाम्बष्ठावृक्षाम्लाः कुडवाः पृथक्|
मरिचं कुञ्चिकाम्बष्ठावृक्षाम्लाः कुडवाः पृथक्|
इति मरिचाद्यं चूर्णम्
इति मरिचाद्यं चूर्णम्
<div class="mw-collapsible-content">
maricaṁ kuñcikāmbaṣṭhāvr̥kṣāmlāḥ kuḍavāḥ pr̥thak|
maricaṁ kuñcikāmbaṣṭhāvr̥kṣāmlāḥ kuḍavāḥ pr̥thak|
iti maricAdyaM cUrNam
iti maricAdyaM cUrNam
</div></div>
''Marichadyam choornam'' contains one ''kudava'' (192 gm) of ''maricha, kunchika, ambashtha'' (''patha''), ''vrikshamlah'', ten ''pala'' (480 gm) of ''amlavetas,'' half ''pala'' (24 gm) each of ''sauvarchala, bidha, pakya, yavakshara, saindhava, sathi, pushkaramoola, hingu'' and ''hingushivatika'' (''vamsapatri''). It is useful in ''vata'' dominant ''grahani'' and anorexia [108-110]
''Marichadyam choornam'' contains one ''kudava'' (192 gm) of ''maricha, kunchika, ambashtha'' (''patha''), ''vrikshamlah'', ten ''pala'' (480 gm) of ''amlavetas,'' half ''pala'' (24 gm) each of ''sauvarchala, bidha, pakya, yavakshara, saindhava, sathi, pushkaramoola, hingu'' and ''hingushivatika'' (''vamsapatri''). It is useful in ''[[vata]]'' dominant ''grahani'' and anorexia [108-110]
<div class="mw-collapsible mw-collapsed">
चतुर्णां प्रस्थमम्लानां त्र्यूषणस्य पलत्रयम्|
चतुर्णां प्रस्थमम्लानां त्र्यूषणस्य पलत्रयम्|
कासाजीर्णारुचिश्वासाहृत्पाण्ड्वामयशूलनुत्|
कासाजीर्णारुचिश्वासाहृत्पाण्ड्वामयशूलनुत्|
<div class="mw-collapsible-content">
caturṇāṁ prasthāmamlānāṁ tryūṣaṇasya palatrayam|
caturṇāṁ prasthāmamlānāṁ tryūṣaṇasya palatrayam|
kAsAjIrNArucishvAsAhRutpANDvAmayashUlanut|
kAsAjIrNArucishvAsAhRutpANDvAmayashUlanut|
</div></div>
Make powder of one ''prastha'' (768 gm) of four ''amla'' drugs, three ''pala'' (144 gm) of ''trikatu'', four ''pala'' (192 gm) of ''lavana'' (''saindhava'') and eight ''pala'' (384 gm) of sugar and mix together. It is to be taken with vegetable preparations such as soup cooked food and ''raga'' for cure of cough, indigestion, anorexia, dyspnea, heart disease, anemia and pain in abdomen [111]
Make powder of one ''prastha'' (768 gm) of four ''amla'' drugs, three ''pala'' (144 gm) of ''trikatu'', four ''pala'' (192 gm) of ''lavana'' (''saindhava'') and eight ''pala'' (384 gm) of sugar and mix together. It is to be taken with vegetable preparations such as soup cooked food and ''raga'' for cure of cough, indigestion, anorexia, dyspnea, heart disease, anemia and pain in abdomen [111]
=== Five types of ''yavagu'' ===
<div class="mw-collapsible mw-collapsed">
चव्यत्वक्पिप्पलीमूलधातकीव्योषचित्रकान्||११२||
चव्यत्वक्पिप्पलीमूलधातकीव्योषचित्रकान्||११२||
सर्वातिसारग्रहणीगुल्मार्शःप्लीहनाशिनी|
सर्वातिसारग्रहणीगुल्मार्शःप्लीहनाशिनी|
<div class="mw-collapsible-content">
cavyatvakpippalīmūladhātakīvyōṣacitrakān||112||
cavyatvakpippalīmūladhātakīvyōṣacitrakān||112||
sarvAtisAragrahaNIgulmArshaHplIhanAshinI|
sarvAtisAragrahaNIgulmArshaHplIhanAshinI|
</div></div>
Make paste of ''chavya, tvak, pippalīmūla, dhātakī, trikatu, chitraka, kapittha, bilva, pāṭhā, sālmali, gajapippalī, slōdbhēda'' (''shilajeet'') and ''ajājī,'' each taken in quantity equal to ''badara'' (about 6 gm). Fry it in ghee and prepare ''yavāgu'' by adding curd or ''svarasa'' of ''kapittha'' or ''chukrikā'' or ''vrikshāmla'' or ''dadima''. It helps in curing all types of ''atisara, grahani, gulma, arsha'' and ''pleeha'' disease [112-114]
Make paste of ''chavya, tvak, pippalīmūla, dhātakī, trikatu, chitraka, kapittha, bilva, pāṭhā, sālmali, gajapippalī, slōdbhēda'' (''shilajeet'') and ''ajājī,'' each taken in quantity equal to ''badara'' (about 6 gm). Fry it in ghee and prepare ''yavāgu'' by adding curd or ''svarasa'' of ''kapittha'' or ''chukrikā'' or ''vrikshāmla'' or ''dadima''. It helps in curing all types of ''atisara, grahani, gulma, arsha'' and ''pleeha'' disease [112-114]
=== Beverages ===
<div class="mw-collapsible mw-collapsed">
पञ्चकोलकयूषश्च मूलकानां च सोषणः||११५||
पञ्चकोलकयूषश्च मूलकानां च सोषणः||११५||
तक्रारनालमद्यानि पानायारिष्ट एव च|
तक्रारनालमद्यानि पानायारिष्ट एव च|
<div class="mw-collapsible-content">
pañcakōlakayūṣaśca mūlakānāṁ ca sōṣaṇaḥ||115||
pañcakōlakayūṣaśca mūlakānāṁ ca sōṣaṇaḥ||115||
takrAranAlamadyAni pAnAyAriShTa eva ca|
takrAranAlamadyAni pAnAyAriShTa eva ca|
</div></div>
Fortified soup with ''panchakola'' or soup of ''mulaka'' with ''maricha'' or medicated soup prepared from animals inhabiting in arid land added with ghee, ''dadima, takra, amla dravyas'' or soup of animals that eat other animals fortified with medicines having ''deepana'' qualities be given for drink.
Fortified soup with ''panchakola'' or soup of ''mulaka'' with ''maricha'' or medicated soup prepared from animals inhabiting in arid land added with ghee, ''dadima, takra, amla dravyas'' or soup of animals that eat other animals fortified with medicines having ''[[deepana]]'' qualities be given for drink.
Patient may be given buttermilk, ''aranala'' (sour drink), ''madya'' (medicated alcohol) and ''arishtha'' as liquid diets [115-116]
Patient may be given buttermilk, ''aranala'' (sour drink), ''madya'' (medicated alcohol) and ''arishtha'' as liquid diets [115-116]
=== Qualities and benefits of buttermilk ===
<div class="mw-collapsible mw-collapsed">
तक्रं तु ग्रहणीदोषे दीपनग्राहिलाघवात्||११७||
तक्रं तु ग्रहणीदोषे दीपनग्राहिलाघवात्||११७||
विहिता ग्रहणीदोषे सर्वशस्तान् प्रयोजयेत्|
विहिता ग्रहणीदोषे सर्वशस्तान् प्रयोजयेत्|
<div class="mw-collapsible-content">
takraṁ tu Grahaṇī dōṣē dīpanagrāhilāghavāt||117||
takraṁ tu Grahaṇī dōṣē dīpanagrāhilāghavāt||117||
vihitA grahaNIdoShe sarvashastAn prayojayet|
vihitA grahaNIdoShe sarvashastAn prayojayet|
</div></div>
Buttermilk due to its ''dīpana, grahi'' (substances which increases appetite and digestive power and absorb fluid from the stool) and easy to digest actions is very useful in ''grahanidosha''. It is ''madhura'' in ''vipaka'' therefore reduces ''pitta''; due to ''kashaya'' (astringent) taste, ''ushna virya'' (hot potency), ''vikashi'' and ''ruksha guna'' it is useful in ''kapha'' dominated disorders and due to ''madhura'' and ''amla rasa, sandra guna'' it reduces ''vata''. Freshly churned butter milk does not cause burning sensation; therefore, buttermilk is very useful in treatment of ''udara, arśa'' and all ''grahanidosha'' [117-119]
Buttermilk due to its ''[[deepana]], grahi'' (substances which increases appetite and digestive power and absorb fluid from the stool) and easy to digest actions is very useful in ''grahanidosha''. It is ''madhura'' in ''vipaka'' therefore reduces ''[[pitta]]''; due to ''kashaya'' (astringent) taste, ''ushna virya'' (hot potency), ''vikashi'' and ''ruksha [[guna]]'' it is useful in ''[[kapha]]'' dominated disorders and due to ''madhura'' and ''amla rasa, sandra guna'' it reduces ''[[vata]]''. Freshly churned butter milk does not cause burning sensation; therefore, buttermilk is very useful in treatment of ''udara, arśa'' and all ''grahanidosha'' [117-119]
=== ''Takrarishtha'' ===
<div class="mw-collapsible mw-collapsed">
यवान्यामलके पथ्या मरिचं त्रिपलंशिकम्||१२०||
यवान्यामलके पथ्या मरिचं त्रिपलंशिकम्||१२०||
इति तक्रारिष्टः
इति तक्रारिष्टः
<div class="mw-collapsible-content">
yavānyāmalakē pathyā maricaṁ tripalaṁśikam||120||
yavānyāmalakē pathyā maricaṁ tripalaṁśikam||120||
iti takrAriShTaH
iti takrAriShTaH
</div></div>
Take ''yavani, amalaki, haritaki'' and ''maricha'' each in three ''pala'' (144 gm) and ''pancha-lavana'' in one ''pala'' (48 gm) and powder together and add buttermilk to it and ferment till sour taste is obtained. This preparation called ''takrarishtha'' stimulates the digestive power and relieves ''sotha, gulma, arsha, krimi, prameha'' and ''udara roga'' [120-121]
Take ''yavani, amalaki, haritaki'' and ''maricha'' each in three ''pala'' (144 gm) and ''pancha-lavana'' in one ''pala'' (48 gm) and powder together and add buttermilk to it and ferment till sour taste is obtained. This preparation called ''takrarishtha'' stimulates the digestive power and relieves ''sotha, gulma, arsha, krimi, prameha'' and ''udara roga'' [120-121]
=== Management of ''[[pitta]]'' dominant ''grahani'' ===
<div class="mw-collapsible mw-collapsed">
स्वस्थानगतमुत्क्लिष्टमग्निनिर्वापकं भिषक्|
स्वस्थानगतमुत्क्लिष्टमग्निनिर्वापकं भिषक्|
पित्तं ज्ञात्वा विरेकेण निर्हरेद्वमनेन वा||१२२||
पित्तं ज्ञात्वा विरेकेण निर्हरेद्वमनेन वा||१२२||
<div class="mw-collapsible-content">
svasthānagatamutkliṣṭāmAgninirvāpakaṁ bhiṣak|
svasthānagatamutkliṣṭāmAgninirvāpakaṁ bhiṣak|
pittaM j~jAtvA virekeNa nirharedvamanena vA||122||
pittaM j~jAtvA virekeNa nirharedvamanena vA||122||
</div></div>
If ''agnimandyata'' is due to ''utklishtha'' (ready to come out) ''pitta'' in its own place then in such a situation ''virechana'' or ''vamana'' should be administered for removal of ''pitta'' [122]
If ''agnimandyata'' is due to ''utklishtha'' (ready to come out) ''[[pitta]]'' in its own place then in such a situation ''[[virechana]]'' or ''[[vamana]]'' should be administered for removal of ''[[pitta]]'' [122]
=== Diet after ''[[shodhana]]'' ===
<div class="mw-collapsible mw-collapsed">
अविदाहिभिरन्नैश्च लघुभिस्तिक्तसंयुतैः|
अविदाहिभिरन्नैश्च लघुभिस्तिक्तसंयुतैः|
तस्याग्निं दीपयेच्चूर्णैः सर्पिर्भिश्चापि तिक्तकैः||१२४||
तस्याग्निं दीपयेच्चूर्णैः सर्पिर्भिश्चापि तिक्तकैः||१२४||
<div class="mw-collapsible-content">
avidāhibhirannaiśca laghubhistiktasaṁyutaiḥ|
avidāhibhirannaiśca laghubhistiktasaṁyutaiḥ|
tasyAgniM dIpayeccUrNaiH sarpirbhishcApi tiktakaiH||124||
tasyAgniM dIpayeccUrNaiH sarpirbhishcApi tiktakaiH||124||
</div></div>
After proper ''shodhana'', diet which does not cause burning sensation, which is easy to digest and added with ingredients having bitter taste should be taken. Soup of animals of arid zone, soup of cereals such as ''mudga'', etc. and ''khada'' should be given.
After proper ''[[shodhana]]'', diet which does not cause burning sensation, which is easy to digest and added with ingredients having bitter taste should be taken. Soup of animals of arid zone, soup of cereals such as ''mudga'', etc. and ''khada'' should be given.
Pomegranate having sour taste should be taken along with ghee, ''deepana'' and ''grahi dravyas''. With help of powders of ''deepaniya'' drugs and ghee fortified with bitter drugs, the digestive power should be increased (123-124).
Pomegranate having sour taste should be taken along with ghee, ''[[deepana]]'' and ''grahi dravyas''. With help of powders of ''deepaniya'' drugs and ghee fortified with bitter drugs, the digestive power should be increased (123-124).
=== ''Chandanadya ghrita'' ===
<div class="mw-collapsible mw-collapsed">
चन्दनं पद्मकोशीरं पाठां मूर्वां कुटन्नटम्|
चन्दनं पद्मकोशीरं पाठां मूर्वां कुटन्नटम्|
इति चन्दनाद्यं घृतम्
इति चन्दनाद्यं घृतम्
<div class="mw-collapsible-content">
candanaṁ padmakōśīraṁ pāṭhāṁ mūrvāṁ kuṭannaṭam|
candanaṁ padmakōśīraṁ pāṭhāṁ mūrvāṁ kuṭannaṭam|
iti candanAdyaM ghRutam
iti candanAdyaM ghRutam
</div></div>
Take two ''pala'' (96 gm) each of ''chandana, padmaka, usheera, patha, murva, kuthannatha'' (''kaivarta musta''), ''shadhgrantha'' (''vacha''), ''sariva, asphota'' (''aspurmallika''), ''saptaparna, aṭarushakana'' (''vasa''), ''patola, udumbara, ashvattha, vata, plaksa, kapeetana'' (''gandha musta''), ''kathuki, musta'' and ''nimba'' and prepare decoction by adding one ''drona'' (12.228 Kg) of water with 1/4th reduction. ''Ghrita siddhi'' is done adding one ''prastha'' (96 gm) of ghee to the above decoction and paste of one ''aksa'' (12 gm) each of ''kiratatikta, indrayava, vira, pippalī'' and ''utpala'' is added. This medicated ghee is known as ''chandanadya ghrita'' and is indicated in ''pittaja grahani'' [125-127]
Take two ''pala'' (96 gm) each of ''chandana, padmaka, usheera, patha, murva, kuthannatha'' (''kaivarta musta''), ''shadhgrantha'' (''vacha''), ''sariva, asphota'' (''aspurmallika''), ''saptaparna, aṭarushakana'' (''vasa''), ''patola, udumbara, ashvattha, vata, plaksa, kapeetana'' (''gandha musta''), ''kathuki, musta'' and ''nimba'' and prepare decoction by adding one ''drona'' (12.228 Kg) of water with 1/4th reduction. ''Ghrita siddhi'' is done adding one ''prastha'' (96 gm) of ghee to the above decoction and paste of one ''aksa'' (12 gm) each of ''kiratatikta, indrayava, vira, pippalī'' and ''utpala'' is added. This medicated ghee is known as ''chandanadya ghrita'' and is indicated in ''[[pitta]]ja grahani'' [125-127]
<div class="mw-collapsible mw-collapsed">
तिक्तकं यद्घृतं चोक्तं कौष्ठिके तच्च दापयेत्||१२८||
तिक्तकं यद्घृतं चोक्तं कौष्ठिके तच्च दापयेत्||१२८||
<div class="mw-collapsible-content">
tiktakaṁ yadghr̥taṁ cōktaṁ kauṣṭhikē tacca dāpayēt||128||
tiktakaṁ yadghr̥taṁ cōktaṁ kauṣṭhikē tacca dāpayēt||128||
</div></div>
''Tikta ghrita'' as mentioned in [[Kushtha Chikitsa]] [Ca.Ci.7/140-150] may also be prescribed in ''pittaja grahani'' [128]
''Tikta ghrita'' as mentioned in [[Kushtha Chikitsa]] [Cha. Sa. [[Chikitsa Sthana]] 7/140-150] may also be prescribed in ''[[pitta]]ja grahani'' [128]
=== ''Nagaradya churna'' ===
<div class="mw-collapsible mw-collapsed">
नागरातिविषे मुस्तं धातकीं च रसाञ्जनम्|
नागरातिविषे मुस्तं धातकीं च रसाञ्जनम्|
इति नागराद्यं चूर्णम्
इति नागराद्यं चूर्णम्
<div class="mw-collapsible-content">
nāgarātiviṣē mustaṁ dhātakīṁ ca rasāñjanam|
nāgarātiviṣē mustaṁ dhātakīṁ ca rasāñjanam|
iti nAgarAdyaM cUrNam
iti nAgarAdyaM cUrNam
</div></div>
Take equal quantity of ''nagara, ativisha, musta, dhataki, rasanjana,'' bark and fruit of ''vatsaka, bilva, patha'' and ''katuki'' and powder together, is known as ''nagaradya churna'' explained by ''krishnatreyena''. It is to be taken along with honey and ''tandulodaka'' (rice water, prepared cold) by patient suffering from ''paittika grahani'' with bloody stools, hemorrhoids, pain in anal area and dysentery. [129-131]
Take equal quantity of ''nagara, ativisha, musta, dhataki, rasanjana,'' bark and fruit of ''vatsaka, bilva, patha'' and ''katuki'' and powder together, is known as ''nagaradya churna'' explained by ''krishnatreyena''. It is to be taken along with honey and ''tandulodaka'' (rice water, prepared cold) by patient suffering from ''paittika grahani'' with bloody stools, hemorrhoids, pain in anal area and dysentery. [129-131]
=== ''Bhunimbadya churna'' ===
<div class="mw-collapsible mw-collapsed">
भूनिम्बकटुकाव्योषमुस्तकेन्द्रयवान् समान्|
भूनिम्बकटुकाव्योषमुस्तकेन्द्रयवान् समान्|
इति भूनिम्बाद्यं चूर्णम्
इति भूनिम्बाद्यं चूर्णम्
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bhūnimbakaṭukāvyōṣamustakēndrayavān samān|
bhūnimbakaṭukāvyōṣamustakēndrayavān samān|
iti bhUnimbAdyaM cUrNam
iti bhUnimbAdyaM cUrNam
</div></div>
''Bhunimba, kutaki, trikatu, musta'' and ''indrayava'' are taken in equal quantity. Two parts of ''chitraka'' and 16 parts of bark and ''vatsaka'' are taken together and powdered. The combination is called as ''bhunimbadya churna'' is advised with jaggery and cold water as ''anupana'' in ''grahani dosha, gulma, kamala, jwara, pandu, prameha, aruchi'' and ''atisara'' [132-133]
''Bhunimba, kutaki, trikatu, musta'' and ''indrayava'' are taken in equal quantity. Two parts of ''chitraka'' and 16 parts of bark and ''vatsaka'' are taken together and powdered. The combination is called as ''bhunimbadya churna'' is advised with jaggery and cold water as ''anupana'' in ''grahani dosha, gulma, kamala, jwara, pandu, prameha, aruchi'' and ''atisara'' [132-133]
<div class="mw-collapsible mw-collapsed">
वचामतिविषां पाठां सप्तपर्णं रसाञ्जनम्|
वचामतिविषां पाठां सप्तपर्णं रसाञ्जनम्|
तद्रोगशममन्विच्छन् भूनिम्बाद्येन योजयेत्||१३६||
तद्रोगशममन्विच्छन् भूनिम्बाद्येन योजयेत्||१३६||
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vacāmativiṣāṁ pāṭhāṁ saptaparṇaṁ rasāñjanam|
vacāmativiṣāṁ pāṭhāṁ saptaparṇaṁ rasāñjanam|
tadrogashamamanvicchan bhUnimbAdyena yojayet||136||
tadrogashamamanvicchan bhUnimbAdyena yojayet||136||
</div></div>
The combination of ''vacha, ativisha, patha, saptaparna, rasanjana, syonaka, udeechya, kathvanga'' (type of ''syonaka'' having small fruits), bark of ''vatsaka, duralabha, darvi, parpataka, patha, yavani, madhushigru,'' leaf of ''patola, siddhartha, yuthika,'' fresh new leaf of ''jati,'' seeds of ''jambu'' and ''amra'', pulp of ''bilva'' and leaves and fruits of ''nimba'' is useful in all condition as mentioned for ''bhunimbadya churna'' [134-136]
The combination of ''vacha, ativisha, patha, saptaparna, rasanjana, syonaka, udeechya, kathvanga'' (type of ''syonaka'' having small fruits), bark of ''vatsaka, duralabha, darvi, parpataka, patha, yavani, madhushigru,'' leaf of ''patola, siddhartha, yuthika,'' fresh new leaf of ''jati,'' seeds of ''jambu'' and ''amra'', pulp of ''bilva'' and leaves and fruits of ''nimba'' is useful in all condition as mentioned for ''bhunimbadya churna'' [134-136]
=== ''Kiratadya churna'' ===
<div class="mw-collapsible mw-collapsed">
किराततिक्तः षड्ग्रन्था त्रायमाणा कटुत्रिकम्|
किराततिक्तः षड्ग्रन्था त्रायमाणा कटुत्रिकम्|
इति किराताद्यं चूर्णम्
इति किराताद्यं चूर्णम्
<div class="mw-collapsible-content">
kirātatiktaḥ ṣaḍgranthā trāyamāṇā kaṭutrikam|
kirātatiktaḥ ṣaḍgranthā trāyamāṇā kaṭutrikam|
iti kirAtAdyaM cUrNam
iti kirAtAdyaM cUrNam
</div></div>
Mix powder of ''kiratatikta, shadgrantha, trayamana, trikatu, chandana, padmaka, usheera,'' bark of ''darvi, katurohini,'' bark and fruit of ''kutaja, mushta, yavani, devadaru, patola,'' leaves of ''nimba, ela, saurashtra, ativisha, tvak,'' seeds of ''madhushigru, murva'' and ''parpataka'' and prescribe it as linctus prepared with honey or may be taken with water or alcoholic preparation. This preparation is known as ''kiratadyam churna'' whih cures ''hridaya roga, pandu, grahaniroga, gulma, shula, aruchi, jwara, kamala, sannipatika'' type of diarrhea and eight types of ''mukharoga'' [137-140]
Mix powder of ''kiratatikta, shadgrantha, trayamana, trikatu, chandana, padmaka, usheera,'' bark of ''darvi, katurohini,'' bark and fruit of ''kutaja, mushta, yavani, devadaru, patola,'' leaves of ''nimba, ela, saurashtra, ativisha, tvak,'' seeds of ''madhushigru, murva'' and ''parpataka'' and prescribe it as linctus prepared with honey or may be taken with water or alcoholic preparation. This preparation is known as ''kiratadyam churna'' whih cures ''hridaya roga, pandu, grahaniroga, gulma, shula, aruchi, jwara, kamala, sannipatika'' type of diarrhea and eight types of ''mukharoga'' [137-140]
=== Treatment of ''[[kapha]]ja grahani'' ===
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ग्रहण्यां श्लेष्मदुष्टायां वमितस्य यथाविधि|
ग्रहण्यां श्लेष्मदुष्टायां वमितस्य यथाविधि|
कट्वम्ललवणक्षारैस्तिक्तैश्चाग्निं विवर्धयेत्||१४१||
कट्वम्ललवणक्षारैस्तिक्तैश्चाग्निं विवर्धयेत्||१४१||
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grahaṇyāṁ ślēṣmaduṣṭāyāṁ vamitasya yathāvidhi|
grahaṇyāṁ ślēṣmaduṣṭāyāṁ vamitasya yathāvidhi|
kaTvamlalavaNakShAraistiktaishcAgniM vivardhayet||141||
kaTvamlalavaNakShAraistiktaishcAgniM vivardhayet||141||
</div></div>
In ''kaphaja grahani'' first administer ''vamana'' and then increase ''agni'' (digestive power) with help of drugs having ''katu, amla, lavana, kshara'' and ''tikta rasa'' [141]
In ''[[kapha]]ja grahani'' first administer ''[[vamana]]'' and then increase ''agni'' (digestive power) with help of drugs having ''katu, amla, lavana, kshara'' and ''tikta rasa'' [141]
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पलाशं चित्रकं चव्यं मातुलुङ्गं हरीतकीम्|
पलाशं चित्रकं चव्यं मातुलुङ्गं हरीतकीम्|
पानीयार्थं प्रयुञ्जीत यवागूं तैश्च साधयेत्||१४३||
पानीयार्थं प्रयुञ्जीत यवागूं तैश्च साधयेत्||१४३||
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palāśaṁ citrakaṁ cavyaṁ mātuluṅgaṁ harītakīm|
palāśaṁ citrakaṁ cavyaṁ mātuluṅgaṁ harītakīm|
pAnIyArthaM prayu~jjIta yavAgUM taishca sAdhayet||143||
pAnIyArthaM prayu~jjIta yavAgUM taishca sAdhayet||143||
</div></div>
''Palasha, chitraka, chavya, matulunga, haritaki pippali, pippalimoola, patha, nagara'' and ''dhanyaka'' are taken each in 12 gm and decoction is prepared in one 768 ml of water and reduced to one fourth. This decoction is administered as a ''paniya'' (drink) or ''yavagu'' (gruel) prepared using this decoction [142-143]
''Palasha, chitraka, chavya, matulunga, haritaki pippali, pippalimoola, patha, nagara'' and ''dhanyaka'' are taken each in 12 gm and decoction is prepared in one 768 ml of water and reduced to one fourth. This decoction is administered as a ''paniya'' (drink) or ''yavagu'' (gruel) prepared using this decoction [142-143]
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शुष्कमूलकयूषेण कौलत्थेनाथवा पुनः|
शुष्कमूलकयूषेण कौलत्थेनाथवा पुनः|
मदिरां मध्वरिष्टं वा निगदं सीधुमेव वा||१४५||
मदिरां मध्वरिष्टं वा निगदं सीधुमेव वा||१४५||
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śuṣkamūlakayūṣēṇa kaulatthēnāthavā punaḥ|
śuṣkamūlakayūṣēṇa kaulatthēnāthavā punaḥ|
madirAM madhvariShTaM vA nigadaM sIdhumeva vA||145||
madirAM madhvariShTaM vA nigadaM sIdhumeva vA||145||
</div></div>
Soup of dried radish or ''kulatha'' is to be given regularly and repeatedly. Food which is easy to digest should be fortified with ''katu, amla, kshara'' and ''lavana rasa''. Patient should take such foods which are easy to digest, along with buttermilk slightly sour or ''takrarishtha, madira'' (medicated alcoholic preparation), ''madhvarishtha'' or well prepared ''seedhu'' [144-145]
Soup of dried radish or ''kulatha'' is to be given regularly and repeatedly. Food which is easy to digest should be fortified with ''katu, amla, kshara'' and ''lavana rasa''. Patient should take such foods which are easy to digest, along with buttermilk slightly sour or ''takrarishtha, madira'' (medicated alcoholic preparation), ''madhvarishtha'' or well prepared ''seedhu'' [144-145]
=== ''Madhukasava'' ===
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द्रोणं मधूकपुष्पाणां विडङ्गानां ततोऽर्धतः|
द्रोणं मधूकपुष्पाणां विडङ्गानां ततोऽर्धतः|
इति मधूकासवः
इति मधूकासवः
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drōṇaṁ madhūkapuṣpāṇāṁ viḍaṅgānāṁ tatō'rdhataḥ|
drōṇaṁ madhūkapuṣpāṇāṁ viḍaṅgānāṁ tatō'rdhataḥ|
iti madhUkAsavaH
iti madhUkAsavaH
</div></div>
Take one ''drona'' (12.22 kg/l) flowers of ''madhuka,'' half ''drona'' (6.11 kg/l) of ''vidanga, chitraka'' half of ''vidanga'' i.e. 1/4th ''drona'' (3.05 kg/l), ''bhallataka'' one ''adhaka'' (3.073 kg) and eight ''pala'' (384 gm) of ''manjishtha'' and mix with three ''drona'' (36.66 kg/l) of water and reduce to one ''drona'' (12.22 L) and after the decoction comes to room temperature add half ''adhaka'' (1.53 kg) of honey. Keep this preparation in a pot lined with paste of ''ela, mrinala, agaru'' and ''chandana'' and store for period of one month till ''asava siddhi'' occurs. This preparation is called ''madhukasava'' and is useful in ''grahani,'' helps empowering of ''agni,'' promotes nutrition and normalizes ''kapha'' and ''pitta''. It is indicated in ''shotha, kushtha, kilasa'' and ''prameha'' [146-149]
Take one ''drona'' (12.22 kg/l) flowers of ''madhuka,'' half ''drona'' (6.11 kg/l) of ''vidanga, chitraka'' half of ''vidanga'' i.e. 1/4th ''drona'' (3.05 kg/l), ''bhallataka'' one ''adhaka'' (3.073 kg) and eight ''pala'' (384 gm) of ''manjishtha'' and mix with three ''drona'' (36.66 kg/l) of water and reduce to one ''drona'' (12.22 L) and after the decoction comes to room temperature add half ''adhaka'' (1.53 kg) of honey. Keep this preparation in a pot lined with paste of ''ela, mrinala, agaru'' and ''chandana'' and store for period of one month till ''asava siddhi'' occurs. This preparation is called ''madhukasava'' and is useful in ''grahani,'' helps empowering of ''agni,'' promotes nutrition and normalizes ''[[kapha]]'' and ''[[pitta]]''. It is indicated in ''shotha, kushtha, kilasa'' and ''prameha'' [146-149]
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मधूकपुष्पस्वरसं शृतमर्धक्षयीकृतम्|
मधूकपुष्पस्वरसं शृतमर्धक्षयीकृतम्|
तद्वद्द्राक्षेक्षुखर्जूरस्वरसानासुतान् [३४] पिबेत्||१५१||
तद्वद्द्राक्षेक्षुखर्जूरस्वरसानासुतान् [३४] पिबेत्||१५१||
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madhūkapuṣpasvarasaṁ śr̥tāmardhakṣayīkr̥tam|
madhūkapuṣpasvarasaṁ śr̥tāmardhakṣayīkr̥tam|
tadvaddrAkShekShukharjUrasvarasAnAsutAn [34] pibet||151||
tadvaddrAkShekShukharjUrasvarasAnAsutAn [34] pibet||151||
</div></div>
Boil ''svarasa'' of flowers of ''madhuka'' till reduced to half the quantity. When cooled one fourth of honey is added and kept for fermentation as mentioned above. This preparation relieves all types of ''grahani dosha'' provided patient takes ''pathya ahara''.
Boil ''svarasa'' of flowers of ''madhuka'' till reduced to half the quantity. When cooled one fourth of honey is added and kept for fermentation as mentioned above. This preparation relieves all types of ''grahani dosha'' provided patient takes ''pathya ahara''.
In the same manner fermentation of ''svarasa'' of ''draksha'' (grapes), sugarcane and date palm is helpful for the patient [150-151]
In the same manner fermentation of ''svarasa'' of ''draksha'' (grapes), sugarcane and date palm is helpful for the patient [150-151]
=== ''Duralabhasava'' ===
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प्रस्थौ दुरालभाया द्वौ पस्थमामलकस्य च|
प्रस्थौ दुरालभाया द्वौ पस्थमामलकस्य च|
इति दुरालभासवः
इति दुरालभासवः
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prasthau durālabhāyā dvau prasthamāmalakasya ca|
prasthau durālabhāyā dvau prasthamāmalakasya ca|
iti durAlabhAsavaH
iti durAlabhAsavaH
</div></div>
Boil two ''prastha'' (1.53 kg) each of ''duralabha'' and ''amalaki'', one ''mushthi'' each of ''danti'' and ''chitraka'' and two hundred matured fruits of ''haritaki'' in four ''drona'' (48.88 kg/l) of water and reduce to one ''drona'' (12.228 kg/l). When it comes to room temperature add two hundred ''pala'' (9600 gm) of jaggery and one ''kudava'' (192 gm) of honey as well as powder of ''priyangu, pippali'' and ''vidanga'' each in one ''kudava'' (192 gm) and keep in jar pasted with ghee on the inner wall for period of fifteen days. This preparation is known as ''duralabhasava'' and is indicated in ''grahani, pandu, arsha, kushtha, visarpa'' and ''prameha''. It promotes voice and complexion and cures ''raktapitta'' and other ''kaphaja'' disorders [152-155]
Boil two ''prastha'' (1.53 kg) each of ''duralabha'' and ''amalaki'', one ''mushthi'' each of ''danti'' and ''chitraka'' and two hundred matured fruits of ''haritaki'' in four ''drona'' (48.88 kg/l) of water and reduce to one ''drona'' (12.228 kg/l). When it comes to room temperature add two hundred ''pala'' (9600 gm) of jaggery and one ''kudava'' (192 gm) of honey as well as powder of ''priyangu, pippali'' and ''vidanga'' each in one ''kudava'' (192 gm) and keep in jar pasted with ghee on the inner wall for period of fifteen days. This preparation is known as ''duralabhasava'' and is indicated in ''grahani, pandu, arsha, kushtha, visarpa'' and ''prameha''. It promotes voice and complexion and cures ''raktapitta'' and other ''[[kapha]]ja'' disorders [152-155]
=== ''Moolasava'' ===
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हरिद्रा पञ्चमूले द्वे वीरर्षभकजीवकम्|
हरिद्रा पञ्चमूले द्वे वीरर्षभकजीवकम्|
इति मूलासवः
इति मूलासवः
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haridrā pañcamūlē dvē vīrarṣabhakajīvakam|
haridrā pañcamūlē dvē vīrarṣabhakajīvakam|
iti mUlAsavaH
iti mUlAsavaH
</div></div>
Boil five ''pala'' (240 gm) each of ''haridra,'' two types of ''panchamoola'' i.e. ''brihat'' and ''laghu panchamoola, veera'' (''shatavari''), ''rishabhaka, jeevaka'' in four ''drona'' (48.88 kg/l) of water and reduce to one ''drona'' (12.22 kg/l); to this add two hundred ''pala'' (9600 gm) of jaggery and half ''kudava'' (96 gm) of honey as well as powders of ''priyangu, musta, manjishtha, vidanga, madhuka, plava,'' and ''sabaraka lodhra'' and fermented for a fortnight. This ''mulasava'' does ''deepana'' and is effective in ''raktapitta, anaha, kaphaja vikara, hridroga, pandu'' and ''angasada'' [156-159]
Boil five ''pala'' (240 gm) each of ''haridra,'' two types of ''panchamoola'' i.e. ''brihat'' and ''laghu panchamoola, veera'' (''shatavari''), ''rishabhaka, jeevaka'' in four ''drona'' (48.88 kg/l) of water and reduce to one ''drona'' (12.22 kg/l); to this add two hundred ''pala'' (9600 gm) of jaggery and half ''kudava'' (96 gm) of honey as well as powders of ''priyangu, musta, manjishtha, vidanga, madhuka, plava,'' and ''sabaraka lodhra'' and fermented for a fortnight. This ''mulasava'' does ''[[deepana]]'' and is effective in ''raktapitta, anaha, [[kapha]]ja vikara, hridroga, pandu'' and ''angasada'' [156-159]
=== ''Pindasava'' ===
<div class="mw-collapsible mw-collapsed">
प्रास्थिकं [३७] पिप्पलीं पिष्ट्वा गुडं मध्यं बिभीतकात्|
प्रास्थिकं [३७] पिप्पलीं पिष्ट्वा गुडं मध्यं बिभीतकात्|
इति पिण्डासवः
इति पिण्डासवः
<div class="mw-collapsible-content">
prāsthikaṁ [37] pippalīṁ piṣṭvā guḍaṁ madhyaṁ bibhītakāt|
prāsthikaṁ [37] pippalīṁ piṣṭvā guḍaṁ madhyaṁ bibhītakāt|
iti piNDAsavaH
iti piNDAsavaH
</div></div>
One ''prastha'' of ''pippali'' is mixed with jaggery and seed pulp of ''bibhitaki'' and to it one ''prastha'' of water is added and kept in a vessel covered with ''yava'' (barley) for fermentation; this is called as ''pindasava''. One ''pala'' (48 gm) of ''pindasava'' is mixed with one ''anjali'' (192 gm) of water and is given to patient. It is helpful in earlier mentioned disorders. Even a healthy person may take this preparation for period of one month and take unctuous and liquid diet (mainly soups). It helps in prevention of genesis of disease [160-162]
One ''prastha'' of ''pippali'' is mixed with jaggery and seed pulp of ''bibhitaki'' and to it one ''prastha'' of water is added and kept in a vessel covered with ''yava'' (barley) for fermentation; this is called as ''pindasava''. One ''pala'' (48 gm) of ''pindasava'' is mixed with one ''anjali'' (192 gm) of water and is given to patient. It is helpful in earlier mentioned disorders. Even a healthy person may take this preparation for period of one month and take unctuous and liquid diet (mainly soups). It helps in prevention of genesis of disease [160-162]
=== ''Madhvarishtha'' ===
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नवे पिप्पलिमध्वाक्ते कलसेऽगुरुधूपिते|
नवे पिप्पलिमध्वाक्ते कलसेऽगुरुधूपिते|
इति मध्वरिष्टः
इति मध्वरिष्टः
<div class="mw-collapsible-content">
navē pippalīmadhvāktē kalasē'gurudhūpitē|
navē pippalīmadhvāktē kalasē'gurudhūpitē|
iti madhvariShTaH
iti madhvariShTaH
</div></div>
New earthen pot should be pasted internally by ''pippali'' and honey and fumigated with ''aguru''. One ''adhaka'' (3.073 kg) of honey and equal quantity of water should be added. To this add half ''kudava'' (1.53 kg) of powder of ''vidanga'' and one ''kudava'' (192 gm) of ''pippali,'' one fourth ''kudava'' (48 gm) of ''vamsha'' and one ''karsha'' (12 gm) each of ''tvak, ela, keshara, maricha, patra, sati, kramuka, ativisha, ghana'' (''chandana''), ''harenu, elvaluka, tejohva, pippalimoola'' and ''chitraka'' and fermented for period of one month and later on administered. It stimulates the power of digestion and regularizes the ''vishama agni''. It is useful in ''hridroga, pandu, grahani, kushtha, arsha, shvayathu, jwara'' and other disorders caused by ''vata'' and '' kapha dosha''. Thus, completes description of ''madhvariṣṭa'' [163-167]
New earthen pot should be pasted internally by ''pippali'' and honey and fumigated with ''aguru''. One ''adhaka'' (3.073 kg) of honey and equal quantity of water should be added. To this add half ''kudava'' (1.53 kg) of powder of ''vidanga'' and one ''kudava'' (192 gm) of ''pippali,'' one fourth ''kudava'' (48 gm) of ''vamsha'' and one ''karsha'' (12 gm) each of ''tvak, ela, keshara, maricha, patra, sati, kramuka, ativisha, ghana'' (''chandana''), ''harenu, elvaluka, tejohva, pippalimoola'' and ''chitraka'' and fermented for period of one month and later on administered. It stimulates the power of digestion and regularizes the ''vishama agni''. It is useful in ''hridroga, pandu, grahani, kushtha, arsha, shvayathu, jwara'' and other disorders caused by ''[[vata]]'' and '' [[kapha dosha]]''. Thus, completes description of ''madhvariṣṭa'' [163-167]
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समूलां पिप्पलीं क्षारौ द्वौ पञ्च लवणानि च|
समूलां पिप्पलीं क्षारौ द्वौ पञ्च लवणानि च|
एतैरेवौषधैः सिद्धं सर्पिः पेयं समारुते|
एतैरेवौषधैः सिद्धं सर्पिः पेयं समारुते|
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samūlāṁ pippalīṁ kṣārau dvau pañca lavaṇāni ca|
samūlāṁ pippalīṁ kṣārau dvau pañca lavaṇāni ca|
etairevauShadhaiH siddhaM sarpiH peyaM samArute|
etairevauShadhaiH siddhaM sarpiH peyaM samArute|
</div></div>
''Pippali, pippalimoola,'' two types of ''kshara'' (''yavakshara, svarjikakshara''), five types of ''lavana, matulunga, haritaki, rasna, saṭi, maricha'' and ''nagara'' are taken in equal quantity and powdered and administered with warm water early in the morning. It cures ''kaphaja grahani dosha'' and improves ''bala,'' complexion and ''agni''.
''Pippali, pippalimoola,'' two types of ''kshara'' (''yavakshara, svarjikakshara''), five types of ''lavana, matulunga, haritaki, rasna, saṭi, maricha'' and ''nagara'' are taken in equal quantity and powdered and administered with warm water early in the morning. It cures ''[[kapha]]ja grahani dosha'' and improves ''bala,'' complexion and ''agni''.
''Ghrita'' fortified with above medicines is useful in ''kapha'' associated with ''vataja grahanidosha'' [168-169]
''Ghrita'' fortified with above medicines is useful in ''[[kapha]]'' associated with ''[[vata]]ja grahanidosha'' [168-169]
<div class="mw-collapsible mw-collapsed">
गौल्मिके षट्पलं प्रोक्तं भल्लातकघृतं च यत्||१७०||
गौल्मिके षट्पलं प्रोक्तं भल्लातकघृतं च यत्||१७०||
<div class="mw-collapsible-content">
gaulmikē ṣaṭpalaṁ prōktaṁ bhallātakaghr̥taṁ ca yat||170||
gaulmikē ṣaṭpalaṁ prōktaṁ bhallātakaghr̥taṁ ca yat||170||
gaulmike ShaTpalaM proktaM bhallAtakaghRutaM ca yat||170||
gaulmike ShaTpalaM proktaM bhallAtakaghRutaM ca yat||170||
</div></div>
''Satpala ghrita'' (Ca.Ci. 5/147-148) and ''bhallataka ghrita'' (Ca.Ci.5/143-146) as explained in [[Gulma Chikitsa]] may also be administered [170]
''Satpala ghrita'' [Cha.Sa. [[Chikitsa Sthana]]. 5/147-148] and ''bhallataka ghrita'' [Cha.Sa.[[ Chikitsa Sthana ]]5/143-146] as explained in [[Gulma Chikitsa]] may also be administered [170]
=== ''Ksharaghrita'' ===
<div class="mw-collapsible mw-collapsed">
बिडं कालोत्थलवणं सर्जिकायवशूकजम्|
बिडं कालोत्थलवणं सर्जिकायवशूकजम्|
इति क्षारघृत
इति क्षारघृत
<div class="mw-collapsible-content">
biḍaṁ kālōtthalavaṇaṁ sarjikāyavaśūkajam|
biḍaṁ kālōtthalavaṇaṁ sarjikāyavaśūkajam|
iti kShAraghRutam
iti kShAraghRutam
</div></div>
''Bida lavana, kalottha lavana, sarjikakshara, yavakshara, saptala, kanthakari'' and ''chitraka'' are burned together and later on mixed in water and filtered seven times. One ''adhaka'' (3.073 kg) of this ''kshara'' is added to one ''adhaka'' (3.073 kg) of ''ghrita'' and ''sneha siddhi'' is done. This ''ksharaghrita'' is indicated for increasing the digestive power [171-172]
''Bida lavana, kalottha lavana, sarjikakshara, yavakshara, saptala, kanthakari'' and ''chitraka'' are burned together and later on mixed in water and filtered seven times. One ''adhaka'' (3.073 kg) of this ''kshara'' is added to one ''adhaka'' (3.073 kg) of ''ghrita'' and ''sneha siddhi'' is done. This ''ksharaghrita'' is indicated for increasing the digestive power [171-172]
<div class="mw-collapsible mw-collapsed">
समूलां पिप्पलीं पाठां चव्येन्द्रयवनागरम्|
समूलां पिप्पलीं पाठां चव्येन्द्रयवनागरम्|
वातश्लेष्मामयान्सर्वान्हन्याद्विषगरांश्च सः||१७६||
वातश्लेष्मामयान्सर्वान्हन्याद्विषगरांश्च सः||१७६||
<div class="mw-collapsible-content">
samūlāṁ pippalīṁ pāṭhāṁ cavyēndrayavanāgaram|
samūlāṁ pippalīṁ pāṭhāṁ cavyēndrayavanāgaram|
vAtashleShmAmayAnsarvAnhanyAdviShagarAMshca saH||176||
vAtashleShmAmayAnsarvAnhanyAdviShagarAMshca saH||176||
</div></div>
''Pippali, pippalimoola, patha, chavya, indrayava, nagara, chitraka, ativisha, hingu, svadamishthra'' (''gokshura''), ''katurohini'' and ''vacha'' are taken in one ''karsha'' (12 gm) quantity each. To this one ''pala'' (12 gm) of ''panchalavana'' is added along with two ''prastha'' of curds and two ''kudava'' (384 gm) of ''taila'' and ''ghrita''. The combination is boiled till water is completely evaporated. It is again burned by ''antaradhooma'' method and the end product is powdered and mixed with ghee its dosage is one ''panitala'' and when medicine gets digested patient is advised to take sweet diet. It is indicated in ''vata kaphaja'' disorders and in ''visha'' and ''gara visha'' [173-176]
''Pippali, pippalimoola, patha, chavya, indrayava, nagara, chitraka, ativisha, hingu, svadamishthra'' (''gokshura''), ''katurohini'' and ''vacha'' are taken in one ''karsha'' (12 gm) quantity each. To this one ''pala'' (12 gm) of ''panchalavana'' is added along with two ''prastha'' of curds and two ''kudava'' (384 gm) of ''taila'' and ''ghrita''. The combination is boiled till water is completely evaporated. It is again burned by ''antaradhooma'' method and the end product is powdered and mixed with ghee its dosage is one ''panitala'' and when medicine gets digested patient is advised to take sweet diet. It is indicated in ''[[vata]] [[kapha]]ja'' disorders and in ''visha'' and ''gara visha'' [173-176]
=== ''Kshara'' preparations ===
<div class="mw-collapsible mw-collapsed">
भल्लातकं त्रिकटुकं त्रिफलां लवणत्रयम्|
भल्लातकं त्रिकटुकं त्रिफलां लवणत्रयम्|
हृत्पाण्डुग्रहणीदोषगुल्मोदावर्तशूलनुत्||१७८||
हृत्पाण्डुग्रहणीदोषगुल्मोदावर्तशूलनुत्||१७८||
<div class="mw-collapsible-content">
bhallātakaṁ trikaṭukaṁ triphalāṁ lavaṇatrayam|
bhallātakaṁ trikaṭukaṁ triphalāṁ lavaṇatrayam|
hRutpANDugrahaNIdoShagulmodAvartashUlanut||178||
hRutpANDugrahaNIdoShagulmodAvartashUlanut||178||
</div></div>
''Bhallataka, trikaṭu, triphala,'' three types of ''lavana'' (''saindhva, sauvarchala'' and ''bida'') should be burned by ''antaradhooma'' method with help of cow dung cakes. This ''kshara'' should be administered with ghee or by sprinkling over prepared food.
''Bhallataka, trikaṭu, triphala,'' three types of ''lavana'' (''saindhva, sauvarchala'' and ''bida'') should be burned by ''antaradhooma'' method with help of cow dung cakes. This ''kshara'' should be administered with ghee or by sprinkling over prepared food.
It is indicated in ''hridroga, pandu, grahanidosha, gulma, udavarta'' and pain (especially spasmodic pain)[177-178]
It is indicated in ''hridroga, pandu, grahanidosha, gulma, udavarta'' and pain (especially spasmodic pain)[177-178]
<div class="mw-collapsible mw-collapsed">
दुरालभां करञ्जौ द्वौ सप्तपर्णं सवत्सकम्|
दुरालभां करञ्जौ द्वौ सप्तपर्णं सवत्सकम्|
दग्ध्वा च तं पिबेत् क्षारं ग्रहणीबलवर्धनम्||१८०||
दग्ध्वा च तं पिबेत् क्षारं ग्रहणीबलवर्धनम्||१८०||
<div class="mw-collapsible-content">
durālabhāṁ karañjau dvau saptaparṇaṁ savatsakam|
durālabhāṁ karañjau dvau saptaparṇaṁ savatsakam|
dagdhvA ca taM pibet kShAraM grahaNIbalavardhanam||180||
dagdhvA ca taM pibet kShAraM grahaNIbalavardhanam||180||
</div></div>
''Duralabha'', two types of ''karanja'' (''karanja, lata karanja''), ''saptaparna, vatsaka, sadgrantha'' (''vacha''), ''madanaphala, murva, patha'' and ''aragvadha'' should be mixed with equal quantity of ''gomutra'' and boiled and prepared as per ''kshara kalpana''. This ''kshara'' increases ''bala'' of ''grahani'' i.e. of ''agni'' [179-180]
''Duralabha'', two types of ''karanja'' (''karanja, lata karanja''), ''saptaparna, vatsaka, sadgrantha'' (''vacha''), ''madanaphala, murva, patha'' and ''aragvadha'' should be mixed with equal quantity of ''gomutra'' and boiled and prepared as per ''kshara kalpana''. This ''kshara'' increases ''bala'' of ''grahani'' i.e. of ''agni'' [179-180]
<div class="mw-collapsible mw-collapsed">
भूनिम्बं रोहिणीं तिक्तां पटोलं निम्बपर्पटम्|
भूनिम्बं रोहिणीं तिक्तां पटोलं निम्बपर्पटम्|
दहेन्माहिषमूत्रेण क्षार एषोऽग्निवर्धनः||१८१||
दहेन्माहिषमूत्रेण क्षार एषोऽग्निवर्धनः||१८१||
<div class="mw-collapsible-content">
bhūnimbaṁ rōhiṇīṁ tiktāṁ paṭōlaṁ nimbaparpaṭam|
bhūnimbaṁ rōhiṇīṁ tiktāṁ paṭōlaṁ nimbaparpaṭam|
dahenmAhiShamUtreNa kShAra eSho~agnivardhanaH||181||
dahenmAhiShamUtreNa kShAra eSho~agnivardhanaH||181||
</div></div>
''Bhunimba, kutaki, tikta, patola, nimba'' and ''parpataka'' are burned with buffalo urine and prepared as per ''kshara kalpana''. Such ''kshara'' promotes ''agnibala'' [181]
''Bhunimba, kutaki, tikta, patola, nimba'' and ''parpataka'' are burned with buffalo urine and prepared as per ''kshara kalpana''. Such ''kshara'' promotes ''agnibala'' [181]
<div class="mw-collapsible mw-collapsed">
द्वे हरिद्रे वचा कुष्ठं चित्रकः कटुरोहिणी|
द्वे हरिद्रे वचा कुष्ठं चित्रकः कटुरोहिणी|
मुस्तं च बस्तमूत्रेण दहेत् क्षारोऽग्निवर्धनः||१८२||
मुस्तं च बस्तमूत्रेण दहेत् क्षारोऽग्निवर्धनः||१८२||
<div class="mw-collapsible-content">
dvē haridrē vacā kuṣṭhaṁ citrakaḥ kaṭurōhiṇī|
dvē haridrē vacā kuṣṭhaṁ citrakaḥ kaṭurōhiṇī|
mustaM ca bastamUtreNa dahet kShAro~agnivardhanaH||182||
mustaM ca bastamUtreNa dahet kShAro~agnivardhanaH||182||
</div></div>
Two types of ''haridra'' (''haridra'' and ''daruharidra''), ''vacha, kuṣṭha, chitraka, kutaki'' and ''musta'' after mixing in goat's urine are burned and ''kshara'' is prepared as per ''kshara kalpana''. It helps in increasing ''agnibala'' [182]
Two types of ''haridra'' (''haridra'' and ''daruharidra''), ''vacha, kuṣṭha, chitraka, kutaki'' and ''musta'' after mixing in goat's urine are burned and ''kshara'' is prepared as per ''kshara kalpana''. It helps in increasing ''agnibala'' [182]
=== ''Ksharagudika'' ===
<div class="mw-collapsible mw-collapsed">
चतुष्पलं सुधाकाण्डात्त्रिपलं लवणत्रयात्|
चतुष्पलं सुधाकाण्डात्त्रिपलं लवणत्रयात्|
इति क्षारगुडिका
इति क्षारगुडिका
<div class="mw-collapsible-content">
catuṣpalaṁ sudhākāṇḍāttripalaṁ lavaṇatrayāt|
catuṣpalaṁ sudhākāṇḍāttripalaṁ lavaṇatrayāt|
iti kShAraguDikA
iti kShAraguDikA
</div></div>
Four ''pala'' (192 gm) of stems of ''sudha'', three ''pala'' (144 gm) of three types of ''lavana'' i.e. one ''pala'' (48 gm) each of ''saindhava, sauvarchala'' and ''bida'', one ''kudava'' (192 gm) of ''vartaki,'' eight ''pala'' (388 gm) of ''arka'' and two ''pala'' (96 gm) of ''chitraka'' are burned and the ''kshara'' thus prepared is triturated with ''svarasa'' of ''vartaku'' and pills are prepared. Its administration after food helps in quick digestion and useful in ''kasa, shvasa, arsha, vishuchika, pratishyaya'' and ''hridroga''. This preparation is called ''ksharagudika'' and is propounded by ''krishnatre'' [183-185]
Four ''pala'' (192 gm) of stems of ''sudha'', three ''pala'' (144 gm) of three types of ''lavana'' i.e. one ''pala'' (48 gm) each of ''saindhava, sauvarchala'' and ''bida'', one ''kudava'' (192 gm) of ''vartaki,'' eight ''pala'' (388 gm) of ''arka'' and two ''pala'' (96 gm) of ''chitraka'' are burned and the ''kshara'' thus prepared is triturated with ''svarasa'' of ''vartaku'' and pills are prepared. Its administration after food helps in quick digestion and useful in ''kasa, shvasa, arsha, vishuchika, pratishyaya'' and ''hridroga''. This preparation is called ''ksharagudika'' and is propounded by ''krishnatre'' [183-185]
=== ''Chaturtha-kshara'' ===
<div class="mw-collapsible mw-collapsed">
वत्सकातिविषे पाठां दुःस्पर्शां हिङ्गु चित्रकम्|
वत्सकातिविषे पाठां दुःस्पर्शां हिङ्गु चित्रकम्|
इति चतुर्थक्षारः
इति चतुर्थक्षारः
<div class="mw-collapsible-content">
vatsakātiviṣē pāṭhāṁ duḥsparśāṁ hiṅgu citrakam|
vatsakātiviṣē pāṭhāṁ duḥsparśāṁ hiṅgu citrakam|
iti caturthakShAraH
iti caturthakShAraH
</div></div>
''Vatsaka, ativisha, patha, duhasparsha, hingu'' and ''chitraka'' should be powdered together and mixed with ''palashagrakshara''. It is cooked in cow’s urine in an iron pan till it becomes semisolid. Its dosage is one ''kola'' (6 gm) to be taken with lukewarm water or with ''madya'' (medicated alcohol). It is indicated in ''grahanidosha, shotha, arsha'' and ''pandu''. The preparation is known as ''chaturtha kshara'' [186-187]
''Vatsaka, ativisha, patha, duhasparsha, hingu'' and ''chitraka'' should be powdered together and mixed with ''palashagrakshara''. It is cooked in cow’s urine in an iron pan till it becomes semisolid. Its dosage is one ''kola'' (6 gm) to be taken with lukewarm water or with ''madya'' (medicated alcohol). It is indicated in ''grahanidosha, shotha, arsha'' and ''pandu''. The preparation is known as ''chaturtha kshara'' [186-187]
=== ''Panchamakshara'' ===
<div class="mw-collapsible mw-collapsed">
त्रिफलां कटभीं चव्यं बिल्वमध्यमयोरजः|
त्रिफलां कटभीं चव्यं बिल्वमध्यमयोरजः|
जीर्णे रसैर्वा मधुरैरश्नीयात् पयसाऽपि वाइति पञ्चमक्षारः
जीर्णे रसैर्वा मधुरैरश्नीयात् पयसाऽपि वाइति पञ्चमक्षारः
<div class="mw-collapsible-content">
triphalāṁ kaṭabhīṁ cavyaṁ bilvāmadhyāmayōrajaḥ|
triphalāṁ kaṭabhīṁ cavyaṁ bilvāmadhyāmayōrajaḥ|
jIrNe rasairvA madhurairashnIyAt payasA~api vAiti pa~jcamakShAraH
jIrNe rasairvA madhurairashnIyAt payasA~api vAiti pa~jcamakShAraH
</div></div>
''Triphala, kaṭabhi, chavya,'' pulp of ''bilva'', powder of ''ayoraja'' (''mandura''), ''katutki, musta, kushtha, patha, hingu, madhuka, kshara'' of ''muskaka'' and ''yavakshara, trikatu, vacha, vidanga, pippalimoola, svarjikakshara, nimba, chitraka, murva, ajamoda, indrayava, guḍuchi'' and ''devadaru'' are taken in one ''karsha'' (12 gm) quantity and one ''pala'' each of five salts are taken. All are mixed with three ''kudavas'' (576 gm) of ''dadhi, ghrita'' and ''taila''. The mixture is burned by ''antardhooma'' method. One ''panitala'' is the dose which is given with ghee. It is indicated in ''kapha'' and ''vataja arsha, grahani, pandu, pleeha, mutragraha, svasa, hikka, kasa, krimi, jwara, sosha, atisara, sotha, prameha, anaha, hridgraha'' and in all types of toxicity.
''Triphala, kaṭabhi, chavya,'' pulp of ''bilva'', powder of ''ayoraja'' (''mandura''), ''katutki, musta, kushtha, patha, hingu, madhuka, kshara'' of ''muskaka'' and ''yavakshara, trikatu, vacha, vidanga, pippalimoola, svarjikakshara, nimba, chitraka, murva, ajamoda, indrayava, guḍuchi'' and ''devadaru'' are taken in one ''karsha'' (12 gm) quantity and one ''pala'' each of five salts are taken. All are mixed with three ''kudavas'' (576 gm) of ''dadhi, ghrita'' and ''taila''. The mixture is burned by ''antardhooma'' method. One ''panitala'' is the dose which is given with ghee. It is indicated in ''[[kapha]]'' and ''[[vata]]ja arsha, grahani, pandu, pleeha, mutragraha, svasa, hikka, kasa, krimi, jwara, sosha, atisara, sotha, prameha, anaha, hridgraha'' and in all types of toxicity.
It is one among the best stimulants of ''agni''. Once the medicine is digested ''mamsarasa'' or sweet diet or milk should be administered. This ends the explanation of the ''panchamakshara'' [188-193]
It is one among the best stimulants of ''agni''. Once the medicine is digested ''mamsarasa'' or sweet diet or milk should be administered. This ends the explanation of the ''panchamakshara'' [188-193]
=== Treatment of ''tridoshaja grahani''===
<div class="mw-collapsible mw-collapsed">
त्रिदोषे विधिविद्वैद्यः पञ्च कर्माणि कारयेत्||१९४||
त्रिदोषे विधिविद्वैद्यः पञ्च कर्माणि कारयेत्||१९४||
व्यत्यासात्तां समस्तां वा कुर्याद्दोषविशेषवित्|
व्यत्यासात्तां समस्तां वा कुर्याद्दोषविशेषवित्|
<div class="mw-collapsible-content">
tridōṣē vidhividvaidyaḥ pañca karmāṇi kārayēt||194||
tridōṣē vidhividvaidyaḥ pañca karmāṇi kārayēt||194||
vyatyAsAttAM samastAM vA kuryAddoShavisheShavit|
vyatyAsAttAM samastAM vA kuryAddoShavisheShavit|
</div></div>
In ''tridoshaja grahani, [[Panchakarma]]'' should be carried out as per predominance of ''dosha''. Various ghee, ''kshara, asava'' and ''arishtha'' preparation useful in stimulation of ''agni'' should be administered.
In ''tridoshaja grahani, [[Panchakarma]]'' should be carried out as per predominance of ''[[dosha]]''. Various ghee, ''kshara, asava'' and ''arishtha'' preparation useful in stimulation of ''agni'' should be administered.
Previously described line of treatment for ''vataja'' etc ''grahani'' should be accordingly followed. This line of treatment should be done either separately or jointly after finding the predominance of ''dosha'' [194-195]
Previously described line of treatment for ''[[vata]]ja'' etc ''grahani'' should be accordingly followed. This line of treatment should be done either separately or jointly after finding the predominance of ''[[dosha]]'' [194-195]
<div class="mw-collapsible mw-collapsed">
स्नेहनं स्वेदनं शुद्धिर्लङ्घनं दीपनं च यत्||१९६||
स्नेहनं स्वेदनं शुद्धिर्लङ्घनं दीपनं च यत्||१९६||
ग्रहणीरोगिभिः सेव्याः
ग्रहणीरोगिभिः सेव्याः
<div class="mw-collapsible-content">
snēhanaṁ svēdanaṁ śuddhirlaṅghanaṁ dīpanaṁ ca yat||196||
snēhanaṁ svēdanaṁ śuddhirlaṅghanaṁ dīpanaṁ ca yat||196||
grahaNIrogibhiH sevyAH
grahaNIrogibhiH sevyAH
</div></div>
''Snehana, swedana, shodhana, langhana, deepana,'' various powder preparation of ''lavana, kshara, madhvarishtha, surasava,'' various ''takra'' preparation, ''deepaniya ghrita'' are to be prescribed to the ''grahanidosha'' patient [196-197]
''[[Snehana]], [[swedana]], [[shodhana]], [[langhana]], [[deepana]],'' various powder preparation of ''lavana, kshara, madhvarishtha, surasava,'' various ''takra'' preparation, ''deepaniya ghrita'' are to be prescribed to the ''grahanidosha'' patient [196-197]
=== Treatment of various states of disease and ''[[dosha]]'' aggravation ===
<div class="mw-collapsible mw-collapsed">
क्रियां चावस्थिकीं शृणु|
क्रियां चावस्थिकीं शृणु|
ष्ठीवनं श्लैष्मिके रूक्षं दीपनं तिक्तसंयुतम्||१९८||
ष्ठीवनं श्लैष्मिके रूक्षं दीपनं तिक्तसंयुतम्||१९८||
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kriyāṁ cāvasthikīṁ śr̥ṇu|
kriyāṁ cāvasthikīṁ śr̥ṇu|
ShThIvanaM shlaiShmike rUkShaM dIpanaM tiktasaMyutam||198||
ShThIvanaM shlaiShmike rUkShaM dIpanaM tiktasaMyutam||198||
</div></div>
Henceforth treatment as per condition is being mentioned.
Henceforth treatment as per condition is being mentioned.
In ''kaphaja grahani'' if there is excess sputum, then ''ruksha'' (ununctuous) and ''deepana'' drugs having bitter taste should be administered [198]
In ''[[kapha]]ja grahani'' if there is excess sputum, then ''ruksha'' (ununctuous) and ''[[deepana]]'' drugs having bitter taste should be administered [198]
<div class="mw-collapsible mw-collapsed">
सकृद्रूक्षं सकृत्स्निग्धं कृशे बहुकफे हितम्|
सकृद्रूक्षं सकृत्स्निग्धं कृशे बहुकफे हितम्|
परीक्ष्यामं शरीरस्य दीपनं स्नेहसंयुतम्||१९९||
परीक्ष्यामं शरीरस्य दीपनं स्नेहसंयुतम्||१९९||
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sakr̥drūkṣaṁ sakr̥tsnigdhaṁ kr̥śē bahukaphē hitam|
sakr̥drūkṣaṁ sakr̥tsnigdhaṁ kr̥śē bahukaphē hitam|
parIkShyAmaM sharIrasya dIpanaM snehasaMyutam||199||
parIkShyAmaM sharIrasya dIpanaM snehasaMyutam||199||
</div></div>
If patient is weak, but ''kapha'' is excessive then alternately ununctous and unctuous therapies should be administered repeatedly. After complete examination; if ''pachana'' of ''ama'' has taken place than administer ghee fortified by ''deepaniya'' medicines [199]
If patient is weak, but ''[[kapha]]'' is excessive then alternately ununctous and unctuous therapies should be administered repeatedly. After complete examination; if ''[[pachana]]'' of ''ama'' has taken place than administer ghee fortified by ''deepaniya'' medicines [199]
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दीपनं बहुपित्तस्य तिक्तं मधुरसंयुतम्|
दीपनं बहुपित्तस्य तिक्तं मधुरसंयुतम्|
बहुवातस्य तु स्नेहलवणाम्लयुतं हितम्||२००||
बहुवातस्य तु स्नेहलवणाम्लयुतं हितम्||२००||
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dīpanaṁ bahuPittasya tiktaṁ madhurasaṁyutam|
dīpanaṁ bahuPittasya tiktaṁ madhurasaṁyutam|
bahuvAtasya tu snehalavaNAmlayutaM hitam||200||
bahuvAtasya tu snehalavaNAmlayutaM hitam||200||
</div></div>
If ''pitta'' is aggravated then ''deepana'' drugs having bitter taste along with medicines having sweet taste should be administered whereas if ''vata'' is aggravated then ''deepaniya'' drugs along with ''sneha, lavana'' and ''amla'' dominated drugs should be administered [200]
If ''[[pitta]]'' is aggravated then ''[[deepana]]'' drugs having bitter taste along with medicines having sweet taste should be administered whereas if ''[[vata]]'' is aggravated then ''deepaniya'' drugs along with ''sneha, lavana'' and ''amla'' dominated drugs should be administered [200]
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सन्धुक्षति तथा वह्निरेषां विधिवदिन्धनैः|
सन्धुक्षति तथा वह्निरेषां विधिवदिन्धनैः|
स्नेहमेव परं विद्याद्दुर्बलानलदीपनम्||२०१||
स्नेहमेव परं विद्याद्दुर्बलानलदीपनम्||२०१||
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sandhukṣati tathā vahnirēṣāṁ vidhivadindhanaiḥ|
sandhukṣati tathā vahnirēṣāṁ vidhivadindhanaiḥ|
snehameva paraM vidyAddurbalAnaladIpanam||201||
snehameva paraM vidyAddurbalAnaladIpanam||201||
</div></div>
Proper management as mentioned in earlier verses stimulates the ''agni'' (digestive power). ''Sneha'' is the best among the ''deepana dravya'' which helps in stimulating the inefficient ''agni'' [201]
Proper management as mentioned in earlier verses stimulates the ''agni'' (digestive power). ''Sneha'' is the best among the ''[[deepana]] dravya'' which helps in stimulating the inefficient ''agni'' [201]
<div class="mw-collapsible mw-collapsed">
नालं स्नेहसमिद्धस्य शमायान्नं सुगुर्वपि|
नालं स्नेहसमिद्धस्य शमायान्नं सुगुर्वपि|
अग्नेः समीपचारित्वादाशु प्रकुरुते बलम्|
अग्नेः समीपचारित्वादाशु प्रकुरुते बलम्|
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nālaṁ snēhasamiddhasya śamāyānnaṁ sugurvapi|
nālaṁ snēhasamiddhasya śamāyānnaṁ sugurvapi|
agneH samIpacAritvAdAshu prakurute balam|
agneH samIpacAritvAdAshu prakurute balam|
</div></div>
If the patient has inefficient digestive power and voids undigested food in excess in stools or frequency of motions is more, then appropriate quantity of ''ghrita'' fortified by ''deepana'' medicines should again be given. Thus, ''samana vata'' is regularized and moves in its normal tract. As ''samana vata'' is associated with ''agni'' it instantaneously promotes the strength of ''agni''.
If the patient has inefficient digestive power and voids undigested food in excess in stools or frequency of motions is more, then appropriate quantity of ''ghrita'' fortified by ''[[deepana]]'' medicines should again be given. Thus, ''samana vata'' is regularized and moves in its normal tract. As ''samana vata'' is associated with ''agni'' it instantaneously promotes the strength of ''agni''.
Digestive power thus stimulated by ''ghrita'' cannot be suppressed even by heavy meals [202-203]
Digestive power thus stimulated by ''ghrita'' cannot be suppressed even by heavy meals [202-203]
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काठिन्याद्यः पुरीषं तु कृच्छ्रान्मुञ्चति मानवः||२०४||
काठिन्याद्यः पुरीषं तु कृच्छ्रान्मुञ्चति मानवः||२०४||
सघृतं लवणैर्युक्तं नरोऽन्नावग्रहं पिबेत्|
सघृतं लवणैर्युक्तं नरोऽन्नावग्रहं पिबेत्|
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kāṭhinyādyaḥ purīṣaṁ tu kr̥cchrānmuñcati mānavaḥ||204||
kāṭhinyādyaḥ purīṣaṁ tu kr̥cchrānmuñcati mānavaḥ||204||
saghRutaM lavaNairyuktaM naro~annAvagrahaM pibet|
saghRutaM lavaNairyuktaM naro~annAvagrahaM pibet|
</div></div>
If patient finds difficulty in evacuation of stools due to hardness in stools then salt mixed ''ghrita'' should be administered in between the food.
If patient finds difficulty in evacuation of stools due to hardness in stools then salt mixed ''ghrita'' should be administered in between the food.
('''Note''':''Lavana rasa'' has ''vata anulomana'' action and also increases secretions, therefore hardness of stool is reduced and stools are easily evacuated) [204]
('''Note''':''Lavana rasa'' has ''vata anulomana'' action and also increases secretions, therefore hardness of stool is reduced and stools are easily evacuated) [204]
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रौक्ष्यान्मन्दे पिबेत्सर्पिस्तैलं वा दीपनैर्युतम्||२०५||
रौक्ष्यान्मन्दे पिबेत्सर्पिस्तैलं वा दीपनैर्युतम्||२०५||
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raukṣyānmandē pibētsarpistailaṁ vā dīpanairyutam||205||
raukṣyānmandē pibētsarpistailaṁ vā dīpanairyutam||205||
raukShyAnmande pibetsarpistailaM vA dIpanairyutam||205||
raukShyAnmande pibetsarpistailaM vA dIpanairyutam||205||
</div></div>
If ''agni'' is suppressed due to ''ruksha guna'' then either ''ghrita'' or ''taila'' fortified with ''deepaniya'' drugs should be administered [205]
If ''agni'' is suppressed due to ''ruksha [[guna]]'' then either ''ghrita'' or ''taila'' fortified with ''deepaniya'' drugs should be administered [205]
<div class="mw-collapsible mw-collapsed">
अतिस्नेहात्तु मन्देऽग्नौ चूर्णारिष्टासवा हिताः|
अतिस्नेहात्तु मन्देऽग्नौ चूर्णारिष्टासवा हिताः|
भिन्ने गुदोपलेपात्तु मले तैलसुरासवाः||२०६||
भिन्ने गुदोपलेपात्तु मले तैलसुरासवाः||२०६||
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atisnēhāttu mandē'gnau cūrṇāriṣṭāsavā hitāḥ|
atisnēhāttu mandē'gnau cūrṇāriṣṭāsavā hitāḥ|
bhinne gudopalepAttu male tailasurAsavAH||206||
bhinne gudopalepAttu male tailasurAsavAH||206||
</div></div>
If excessive intake of ''sneha'' is cause for ''agnimandya'' then powder preparation, ''arishta asava'' as mentioned earlier are beneficial; whereas if anal area gets adhered by unformed stools then ''taila, sura'' and ''asava'' preparation should be administered [206]
If excessive intake of ''sneha'' is cause for ''agnimandya'' then powder preparation, ''arishta asava'' as mentioned earlier are beneficial; whereas if anal area gets adhered by unformed stools then ''taila, sura'' and ''asava'' preparation should be administered [206]
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उदावर्तात्तु मन्देऽग्नौ निरूहाः स्नेहबस्तयः|
उदावर्तात्तु मन्देऽग्नौ निरूहाः स्नेहबस्तयः|
दोषवृद्ध्या तु मन्देऽग्नौ शुद्धो दोषविधिं चरेत्||२०७||
दोषवृद्ध्या तु मन्देऽग्नौ शुद्धो दोषविधिं चरेत्||२०७||
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udāvartāttu mandē'gnau nirūhāḥ snēhabastayaḥ|
udāvartāttu mandē'gnau nirūhāḥ snēhabastayaḥ|
doShavRuddhyA tu mande~agnau shuddho doShavidhiM caret||207||
doShavRuddhyA tu mande~agnau shuddho doShavidhiM caret||207||
</div></div>
If ''udavarta'' (mis-peristalsis) is responsible for suppression of ''agni'' then ''niruha'' and ''sneha basti'' should be administered; whereas if ''dosha vriddhi'' is the cause for suppression of ''agni'' then ''shodhana'' as per ''dosha'' is indicated [207]
If ''udavarta'' (mis-peristalsis) is responsible for suppression of ''agni'' then ''niruha'' and ''sneha [[basti]]'' should be administered; whereas if ''[[dosha]] vriddhi'' is the cause for suppression of ''agni'' then ''[[shodhana]]'' as per ''[[dosha]]'' is indicated [207]
<div class="mw-collapsible mw-collapsed">
व्याधियुक्तस्य मन्दे तु सर्पिरेवाग्निदीपनम्|
व्याधियुक्तस्य मन्दे तु सर्पिरेवाग्निदीपनम्|
अन्नावपीडितं बल्यं दीपनं बृंहणं च तत्|
अन्नावपीडितं बल्यं दीपनं बृंहणं च तत्|
<div class="mw-collapsible-content">
vyādhiyuktasya mandē tu sarpirēvāgnidīpanam|
vyādhiyuktasya mandē tu sarpirēvāgnidīpanam|
upavAsAcca mande~agnau yavAgUbhiH pibedghRutam||208||
upavAsAcca mande~agnau yavAgUbhiH pibedghRutam||208||
</div></div>
If suppression of ''agni'' has taken place due to diseases than ''ghrita'' is best for ''agni deepana'' but if fasting is the causes of ''agni'' suppression than ''yavagu'' (gruel) along with ''ghrita'' should be taken. ''Ghrita'' when taken in between the meal, it increases the strength, stimulates the digestion and nourishes the body [208]
If suppression of ''agni'' has taken place due to diseases than ''ghrita'' is best for ''agni [[deepana]]'' but if fasting is the causes of ''agni'' suppression than ''yavagu'' (gruel) along with ''ghrita'' should be taken. ''Ghrita'' when taken in between the meal, it increases the strength, stimulates the digestion and nourishes the body [208]
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दीर्घकालप्रसङ्गात्तु क्षामक्षीणकृशान्नरान्||२०९||
दीर्घकालप्रसङ्गात्तु क्षामक्षीणकृशान्नरान्||२०९||
मांसोपचितमांसत्वात्तथाऽऽशुतरबृंहणाः|
मांसोपचितमांसत्वात्तथाऽऽशुतरबृंहणाः|
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dīrghakālaprasaṅgāttu kṣāmakṣīṇakr̥śānnarān||209||
dīrghakālaprasaṅgāttu kṣāmakṣīṇakr̥śānnarān||209||
mAMsopacitamAMsatvAttathA~a~ashutarabRuMhaNAH|
mAMsopacitamAMsatvAttathA~a~ashutarabRuMhaNAH|
</div></div>
If ''agnimandya'' has been chronic and patient has become indolent, weak and emaciated then soup of ''prasaha'' group of animals (animals who snatch their food) fortified with ''amla'' drugs is advised. As this meat soups are light for digestion having penetrating, hot, purifying qualities stimulates the ''agni''. Further as the animals feed on other animals their meat ''mamsa'' is well nourished and compact therefore causes quick nourishment [209-210]
If ''agnimandya'' has been chronic and patient has become indolent, weak and emaciated then soup of ''prasaha'' group of animals (animals who snatch their food) fortified with ''amla'' drugs is advised. As this meat soups are light for digestion having penetrating, hot, purifying qualities stimulates the ''agni''. Further as the animals feed on other animals their meat ''mamsa'' is well nourished and compact therefore causes quick nourishment [209-210]
=== Factors affecting status of ''agni'' ===
<div class="mw-collapsible mw-collapsed">
नाभोजनेन कायाग्निर्दीप्यते नातिभोजनात्||२११||
नाभोजनेन कायाग्निर्दीप्यते नातिभोजनात्||२११||
यथा निरिन्धनो वह्निरल्पो वाऽतीन्धनावृतः|
यथा निरिन्धनो वह्निरल्पो वाऽतीन्धनावृतः|
<div class="mw-collapsible-content">
nābhōjanēna kāyāgnirdīpyatē nātibhōjanāt||211||
nābhōjanēna kāyāgnirdīpyatē nātibhōjanāt||211||
yathA nirindhano vahniralpo vA~atIndhanAvRutaH|
yathA nirindhano vahniralpo vA~atIndhanAvRutaH|
</div></div>
Fasting or over eating does not stimulate ''agni'', as like fire in environment is extinguished if there is no fuel supply or if excessive fuel covers the ''agni''. [211]
Fasting or over eating does not stimulate ''agni'', as like fire in environment is extinguished if there is no fuel supply or if excessive fuel covers the ''agni''. [211]
<div class="mw-collapsible mw-collapsed">
स्नेहान्नविधिभिश्चित्रैश्चूर्णारिष्टसुरासवैः ||२१२||
स्नेहान्नविधिभिश्चित्रैश्चूर्णारिष्टसुरासवैः ||२१२||
यथा हि सारदार्वग्निः स्थिरः सन्तिष्ठते चिरम्||२१३||
यथा हि सारदार्वग्निः स्थिरः सन्तिष्ठते चिरम्||२१३||
<div class="mw-collapsible-content">
snēhānnavidhibhiścitraiścūrṇāriṣṭasurāsavaiḥ [44] ||212||
snēhānnavidhibhiścitraiścūrṇāriṣṭasurāsavaiḥ [44] ||212||
yathA hi sAradArvagniH sthiraH santiShThate ciram||213||
yathA hi sAradArvagniH sthiraH santiShThate ciram||213||
</div></div>
Proper intake of ''sneha'', followed by eating proper food preparations as well as appropriate use of various ''churna, arishtha, sura'' and ''asava'' along with proper medication as per condition, enhances the power of ''agni'' similar to the environmental fire which remains stable for long duration when good hard wood catches fire [212-213]
Proper intake of ''sneha'', followed by eating proper food preparations as well as appropriate use of various ''churna, arishtha, sura'' and ''asava'' along with proper medication as per condition, enhances the power of ''agni'' similar to the environmental fire which remains stable for long duration when good hard wood catches fire [212-213]
<div class="mw-collapsible mw-collapsed">
स्नेहान्नविधिभिस्तद्वदन्तरग्निर्भवेत् स्थिरः|
स्नेहान्नविधिभिस्तद्वदन्तरग्निर्भवेत् स्थिरः|
वाच्यं मन्दस्य तत्रोक्तमतिवृद्धस्य वक्ष्यते|
वाच्यं मन्दस्य तत्रोक्तमतिवृद्धस्य वक्ष्यते|
<div class="mw-collapsible-content">
snēhānnavidhibhistadvadantarAgnirbhavēt sthiraḥ|
snēhānnavidhibhistadvadantarAgnirbhavēt sthiraḥ|
vAcyaM mandasya tatroktamativRuddhasya vakShyate|
vAcyaM mandasya tatroktamativRuddhasya vakShyate|
</div></div>
Intake of food mixed with ''sneha'' and as per dietetic rules and regulation stabilizes the digestive power.
Intake of food mixed with ''sneha'' and as per dietetic rules and regulation stabilizes the digestive power.
Eating wholesome diet in appropriate quantity after previously eaten food is digested helps in maintaining good health for long duration.
Eating wholesome diet in appropriate quantity after previously eaten food is digested helps in maintaining good health for long duration.
A person should workout so that ''agni vriddhi'' takes place without disturbing the balance of ''dhatus''. Such ''agni'' digests the food, maintains health and nourishment, promotes longevity and increases strength. The same ''dosha'' when vitiated causes ''mandagni, tikshnagni'' and ''vishamagni'' and such a vitiated ''agni'' gives rise to various diseases.
A person should workout so that ''agni vriddhi'' takes place without disturbing the balance of ''[[dhatu]]s''. Such ''agni'' digests the food, maintains health and nourishment, promotes longevity and increases strength. The same ''[[dosha]]'' when vitiated causes ''mandagni, tikshnagni'' and ''vishamagni'' and such a vitiated ''agni'' gives rise to various diseases.
Management of ''mandagni'' has been explained previously henceforth management of ''ativriddha agni'' will be explained [214-216]
Management of ''mandagni'' has been explained previously henceforth management of ''ativriddha agni'' will be explained [214-216]
=== ''Samprapti'' of ''atyagni'' ===
<div class="mw-collapsible mw-collapsed">
नरे क्षीणकफे पित्तं कुपितं मारुतानुगम्||२१७||
नरे क्षीणकफे पित्तं कुपितं मारुतानुगम्||२१७||
पक्त्वाऽन्नं स ततो धातूञ्छोणितादीन् पचत्यपि||२१९||
पक्त्वाऽन्नं स ततो धातूञ्छोणितादीन् पचत्यपि||२१९||
<div class="mw-collapsible-content">
narē kṣīṇakaphē Pittaṁ kupitaṁ mārutānugam||217||
narē kṣīṇakaphē Pittaṁ kupitaṁ mārutānugam||217||
paktvA~annaM sa tato dhAtU~jchoNitAdIn pacatyapi||219||
paktvA~annaM sa tato dhAtU~jchoNitAdIn pacatyapi||219||
</div></div>
Person having diminished ''kapha'', aggravated ''pitta'' and associated ''vata'' leads to increase in the ''ushma'' of ''agni'' resulting in enhancing the capacity and power of ''agni''. In such patient if the body is already undernourished, ''vata'' increases which further strengths the ''agni'' wherein both, together with help of ''tikshna guna'' digests the food even if taken frequently. After digestion of food, the increased ''agni'' starts digesting ''rakta'', etc ''dhatus'' also [217-219]
Person having diminished ''[[kapha]]'', aggravated ''[[pitta]]'' and associated ''[[vata]]'' leads to increase in the ''ushma'' of ''agni'' resulting in enhancing the capacity and power of ''agni''. In such patient if the body is already undernourished, ''[[vata]]'' increases which further strengths the ''agni'' wherein both, together with help of ''tikshna [[guna]]'' digests the food even if taken frequently. After digestion of food, the increased ''agni'' starts digesting ''[[rakta]]'', etc ''[[dhatu]]s'' also [217-219]
<div class="mw-collapsible mw-collapsed">
ततो दौर्बल्यमातङ्कान्मृत्युं चोपनयेन्नरम्|
ततो दौर्बल्यमातङ्कान्मृत्युं चोपनयेन्नरम्|
निरिन्धनोऽन्तरं लब्ध्वा यथैनं न विपादयेत्|
निरिन्धनोऽन्तरं लब्ध्वा यथैनं न विपादयेत्|
<div class="mw-collapsible-content">
tatō daurbalyamātaṅkānmr̥tyuṁ cōpanayēnnaram|
tatō daurbalyamātaṅkānmr̥tyuṁ cōpanayēnnaram|
nirindhano~antaraM labdhvA yathainaM na vipAdayet|
nirindhano~antaraM labdhvA yathainaM na vipAdayet|
</div></div>
Consequently, the patient becomes weak and death may occur due to disease. The patient feels better on consuming the food but feels worn out along with blackouts when food is digested. Morbid thirst, dyspnea, burning sensation, fainting etc are observed in disease caused due to ''atyagni''.
Consequently, the patient becomes weak and death may occur due to disease. The patient feels better on consuming the food but feels worn out along with blackouts when food is digested. Morbid thirst, dyspnea, burning sensation, fainting etc are observed in disease caused due to ''atyagni''.
Digestive power can be pacified by taking foods and drinks which are heavy to digest, unctuous, cold, sweet and liquid same way as fire is extinguishes by water in nature. The patient should be administered food at regular interval although previously eaten meal is undigested so that ''atyagni'' due to lack of fuel does not digest the tissues [220-222]
Digestive power can be pacified by taking foods and drinks which are heavy to digest, unctuous, cold, sweet and liquid same way as fire is extinguishes by water in nature. The patient should be administered food at regular interval although previously eaten meal is undigested so that ''atyagni'' due to lack of fuel does not digest the tissues [220-222]
=== Management of ''atyagni'' ===
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पायसं कृशरां स्निग्धं पैष्टिकं गुडवैकृतम्||२२३||
पायसं कृशरां स्निग्धं पैष्टिकं गुडवैकृतम्||२२३||
आविकं च भृतं मांसमद्यादत्यग्निनाशनम् [४६] |
आविकं च भृतं मांसमद्यादत्यग्निनाशनम् [४६] |
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pāyasaṁ kr̥śarāṁ snigdhaṁ paiṣṭikaṁ guḍavaikr̥tam||223||
pāyasaṁ kr̥śarāṁ snigdhaṁ paiṣṭikaṁ guḍavaikr̥tam||223||
AvikaM ca bhRutaM mAMsamadyAdatyagninAshanam [46] |
AvikaM ca bhRutaM mAMsamadyAdatyagninAshanam [46] |
</div></div>
''Payasa'' (milk pudding), ''krishara'' (thick gruel prepared of rice and lentils), ''snigdha'' (unctuous), ''paiṣṭika'' (resembling flour paste), various jaggery products, meat of aquatic animals or marshy area especially fish which is mainly in smooth (not salty) and stable water and roasted meat of sheep may be given to pacify the ''atyagni'' [223-224]
''Payasa'' (milk pudding), ''krishara'' (thick gruel prepared of rice and lentils), ''snigdha'' (unctuous), ''paiṣṭika'' (resembling flour paste), various jaggery products, meat of aquatic animals or marshy area especially fish which is mainly in smooth (not salty) and stable water and roasted meat of sheep may be given to pacify the ''atyagni'' [223-224]
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यवागूं समधूच्छिष्टां घृतं वा क्षुधितः पिबेत्||२२५||
यवागूं समधूच्छिष्टां घृतं वा क्षुधितः पिबेत्||२२५||
पयो वा शर्करासर्पिर्जीवनीयौषधैः शृतम्||२२६||
पयो वा शर्करासर्पिर्जीवनीयौषधैः शृतम्||२२६||
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yavāgūṁ sāmadhūcchiṣṭāṁ ghr̥taṁ vā kṣudhitaḥ pibēt||225||
yavāgūṁ sāmadhūcchiṣṭāṁ ghr̥taṁ vā kṣudhitaḥ pibēt||225||
payo vA sharkarAsarpirjIvanIyauShadhaiH shRutam||226||
payo vA sharkarAsarpirjIvanIyauShadhaiH shRutam||226||
</div></div>
''Yavagu'' (thick gruel) mixed with bee wax or ''ghrita'' should be given whenever patient feels hungry. ''Mantha'' prepared from wheat flour or venesection may be advised. Milk medicated with ''jeevaniya'' group of drugs along with sugar and ''ghrita'' may be given [225-226]
''Yavagu'' (thick gruel) mixed with bee wax or ''ghrita'' should be given whenever patient feels hungry. ''Mantha'' prepared from wheat flour or venesection may be advised. Milk medicated with ''jeevaniya'' group of drugs along with sugar and ''ghrita'' may be given [225-226]
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फलानां तैलयोनीनामुत्क्रुञ्चाश्च [४७] सशर्कराः|
फलानां तैलयोनीनामुत्क्रुञ्चाश्च [४७] सशर्कराः|
मार्दवं जनयन्त्यग्नेः स्निग्धा मांसरसास्तथा||२२७||
मार्दवं जनयन्त्यग्नेः स्निग्धा मांसरसास्तथा||२२७||
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phalānāṁ tailayōnīnāmutkruñcāśca [47] saśarkarāḥ|
phalānāṁ tailayōnīnāmutkruñcāśca [47] saśarkarāḥ|
mArdavaM janayantyagneH snigdhA mAMsarasAstathA||227||
mArdavaM janayantyagneH snigdhA mAMsarasAstathA||227||
</div></div>
Paste of fruits, substances containing oil like ''tila'' (sesame seeds) with sugar and meat soup with ghee pacifies the ''agni'' [227]
Paste of fruits, substances containing oil like ''tila'' (sesame seeds) with sugar and meat soup with ghee pacifies the ''agni'' [227]
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पिबेच्छीताम्बुना सर्पिर्मधूच्छिष्टेन संयुतम्|
पिबेच्छीताम्बुना सर्पिर्मधूच्छिष्टेन संयुतम्|
ताभ्यां वा पायसं सिद्धमद्यादत्यग्निशान्तये||२३०||
ताभ्यां वा पायसं सिद्धमद्यादत्यग्निशान्तये||२३०||
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pibēcchītāmbunā sarpirmadhūcchiṣṭēna saṁyutam|
pibēcchītāmbunā sarpirmadhūcchiṣṭēna saṁyutam|
tAbhyAM vA pAyasaM siddhamadyAdatyagnishAntaye||230||
tAbhyAM vA pAyasaM siddhamadyAdatyagnishAntaye||230||
</div></div>
The patient should take ''ghrita'' with beeswax along with cold water as ''anupana''. Patient may take wheat flour with milk and ghee.
The patient should take ''ghrita'' with beeswax along with cold water as ''anupana''. Patient may take wheat flour with milk and ghee.
Patient may be advised to take three ''sneha'' i.e. ghee, abinal fat, bone-marrow fortified with meat soup of animals residing in marshy areas. Milk mixed with wheat flour and curd along with three ''sneha'' (''ghrita, vasa, majja'') may be given. Bark of ''udumbara'' mixed with human milk and milk pudding prepared from ''udumbara'' and human milk helps in pacifying the ''atyagni'' [228-230]
Patient may be advised to take three ''sneha'' i.e. ghee, abinal fat, bone-marrow fortified with meat soup of animals residing in marshy areas. Milk mixed with wheat flour and curd along with three ''sneha'' (''ghrita, vasa, majja'') may be given. Bark of ''udumbara'' mixed with human milk and milk pudding prepared from ''udumbara'' and human milk helps in pacifying the ''atyagni'' [228-230]
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श्यामात्रिवृद्विपक्वं वा पयो दद्याद्विरेचनम्|
श्यामात्रिवृद्विपक्वं वा पयो दद्याद्विरेचनम्|
प्रसमीक्ष्य भिषक् प्राज्ञस्तस्मै दद्याद्विधानवित्|
प्रसमीक्ष्य भिषक् प्राज्ञस्तस्मै दद्याद्विधानवित्|
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śyāmātrivr̥dvipakvaṁ vā payō dadyādvirēcanam|
śyāmātrivr̥dvipakvaṁ vā payō dadyādvirēcanam|
prasamIkShya bhiShak prAj~jastasmai dadyAdvidhAnavit|
prasamIkShya bhiShak prAj~jastasmai dadyAdvidhAnavit|
</div></div>
Milk medicated with ''syama'' and ''trivritta'' may be advised for ''virechana'' for alleviating the ''pitta'' followed by diet of milk pudding. Expert physician should follow the line of treatment after proper examination of patient [231]
Milk medicated with ''syama'' and ''trivritta'' may be advised for ''[[virechana]]'' for alleviating the ''[[pitta]]'' followed by diet of milk pudding. Expert physician should follow the line of treatment after proper examination of patient [231]
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यत्किञ्चिन्मधुरं मेद्यं श्लेष्मलं गुरुभोजनम्||२३२||
यत्किञ्चिन्मधुरं मेद्यं श्लेष्मलं गुरुभोजनम्||२३२||
कफे वृद्धे जिते पित्ते मारुते चानलः समः||२३४||
कफे वृद्धे जिते पित्ते मारुते चानलः समः||२३४||
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yatkiñcinmadhuraṁ mēdyaṁ ślēṣmalaṁ gurubhōjanam||232||
yatkiñcinmadhuraṁ mēdyaṁ ślēṣmalaṁ gurubhōjanam||232||
samadhAtoH pacatyannaM puShTyAyurbalavRuddhaye|
samadhAtoH pacatyannaM puShTyAyurbalavRuddhaye|
</div></div>
Foods which are sweet in taste, fatty, increases ''kapha'' and heavy to digest should be given. All food items are good for ''atyagni'' and sleeping after meals during day time is beneficial in ''atyagni''. Patient who takes fatty diet even though he is not hungry does not succumb to death. If he is suffering from ''atyagni'' on the other hand such diet pattern is nutritional. Whenever due to medication and diet, ''kapha'' is increased; it subdues ''pitta'' and ''vata'' and normalizes the ''agni''.
Foods which are sweet in taste, fatty, increases ''[[kapha]]'' and heavy to digest should be given. All food items are good for ''atyagni'' and sleeping after meals during day time is beneficial in ''atyagni''. Patient who takes fatty diet even though he is not hungry does not succumb to death. If he is suffering from ''atyagni'' on the other hand such diet pattern is nutritional. Whenever due to medication and diet, ''[[kapha]]'' is increased; it subdues ''[[pitta]]'' and ''[[vata]]'' and normalizes the ''agni''.
When ''dhatus'' are in equilibrium ''anna'' gets digested resulting in increase in nutrition, longevity and strength [232-234]
When ''[[dhatu]]s'' are in equilibrium ''anna'' gets digested resulting in increase in nutrition, longevity and strength [232-234]
=== Improper dietary habits ===
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भवन्ति चात्र-
भवन्ति चात्र-
त्रीण्यप्येतानि मृत्युं वा घोरान् व्याधीन्सृजन्ति वा|
त्रीण्यप्येतानि मृत्युं वा घोरान् व्याधीन्सृजन्ति वा|
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bhavanti cātra-
bhavanti cātra-
trINyapyetAni mRutyuM vA ghorAn vyAdhInsRujanti vA|
trINyapyetAni mRutyuM vA ghorAn vyAdhInsRujanti vA|
</div></div>
Taking of wholesome and unwholesome foods together in diet is known as ''samashana''.
Taking of wholesome and unwholesome foods together in diet is known as ''samashana''.
All the above three are causes for death or give rise to serious disorders [235-236]
All the above three are causes for death or give rise to serious disorders [235-236]
=== Variation in digestion as per day-night cycle ===
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प्रातराशे त्वजीर्णेऽपि सायमाशो न दुष्यति||२३७||
प्रातराशे त्वजीर्णेऽपि सायमाशो न दुष्यति||२३७||
न क्लेदमुपगच्छन्ति दिवा तेनास्य धातवः||२३९||
न क्लेदमुपगच्छन्ति दिवा तेनास्य धातवः||२३९||
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prātarāśē tvajīrṇē'pi sāyamāśō na duṣyati||237||
prātarāśē tvajīrṇē'pi sāyamāśō na duṣyati||237||
na kledamupagacchanti divA tenAsya dhAtavaH||239||
na kledamupagacchanti divA tenAsya dhAtavaH||239||
</div></div>
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 ''dhatus'' [237-239]
If morning eaten food is undigested and still if anyone takes evening food it may not be more vitiative since in day time all the ''srotas'' (channels) are dilated and heart is active similar to the lotus which blossoms with sunrise. During daytime, exercise, other physical and mental activities (cause heart to pump blood properly to) prevent the genesis of ''kleda'' (excess moisture) in various ''[[dhatu]]s'' [237-239]
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अक्लिन्नेष्वन्नमासिक्तमन्यत्तेषु न दुष्यति|
अक्लिन्नेष्वन्नमासिक्तमन्यत्तेषु न दुष्यति|
नैव दूष्यति तेनैव समं सम्पद्यते यथा|
नैव दूष्यति तेनैव समं सम्पद्यते यथा|
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aklinnēṣvannamāsiktāmanyattēṣu na duṣyati|
aklinnēṣvannamāsiktāmanyattēṣu na duṣyati|
naiva dUShyati tenaiva samaM sampadyate yathA|
naiva dUShyati tenaiva samaM sampadyate yathA|
</div></div>
As unspoiled milk when mixed with fresh milk, the mixture does not get spoiled and will get uniformly mixed, so is the condition when in daytime previously eaten food although not digested still a person can digest another meal [240]
As unspoiled milk when mixed with fresh milk, the mixture does not get spoiled and will get uniformly mixed, so is the condition when in daytime previously eaten food although not digested still a person can digest another meal [240]
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रात्रौ तु हृदये म्लाने संवृतेष्वयनेषु च|
रात्रौ तु हृदये म्लाने संवृतेष्वयनेषु च|
तस्मादन्यत्समश्नीयात्पालयिष्यन्बलायुषी||२४३||
तस्मादन्यत्समश्नीयात्पालयिष्यन्बलायुषी||२४३||
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rātrau tu hr̥dayē mlānē saṁvr̥tēṣvayanēṣu ca|
rātrau tu hr̥dayē mlānē saṁvr̥tēṣvayanēṣu ca|
tasmAdanyatsamashnIyAtpAlayiShyanbalAyuShI||243||
tasmAdanyatsamashnIyAtpAlayiShyanbalAyuShI||243||
</div></div>
In the night, the channels are closed, so is the heart which functions at slow rate as demand is less, the ''apakva ahara rasa'' increases in viscosity; thus ''ama'' adheres to the ''dhatus'' and if another food is taken the indigestion causes more ''apakva ahara rasa'' causing disease. The condition resembles, wherein uncooked milk mixed with warm milk gets spoiled. Therefore, a wise person should not take meals if food taken at night is not digested; this will surely effect strength and life of a person [241-243]
In the night, the channels are closed, so is the heart which functions at slow rate as demand is less, the ''apakva ahara rasa'' increases in viscosity; thus ''ama'' adheres to the ''[[dhatu]]s'' and if another food is taken the indigestion causes more ''apakva ahara rasa'' causing disease. The condition resembles, wherein uncooked milk mixed with warm milk gets spoiled. Therefore, a wise person should not take meals if food taken at night is not digested; this will surely effect strength and life of a person [241-243]
=== Summary ===
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तत्र श्लोकाः-
तत्र श्लोकाः-
उक्तवानिह तत् सर्वं ग्रहणीदोषके मुनिः||२४९||
उक्तवानिह तत् सर्वं ग्रहणीदोषके मुनिः||२४९||
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tatra ślōkāḥ-
tatra ślōkāḥ-
uktavAniha tat sarvaM grahaNIdoShake muniH||249||
uktavAniha tat sarvaM grahaNIdoShake muniH||249||
</div></div>
To conclude, this chapter has addressed the following points:
To conclude, this chapter has addressed the following points:
#How digested food functions?
#How digested food functions?
#How different types of ''agni'' does nutrition after digesting the fuel?
#How different types of ''agni'' does nutrition after digesting the fuel?
#Development of ''rasadi dhatus'' and their associated waste products after digestions at ''dhatu'' level (tissue level)
#Development of ''[[rasa]]di [[dhatu]]s'' and their associated waste products after digestions at ''[[dhatu]]'' level (tissue level)
#How aphrodisiacs act instantly and time taken for the ''dhatu'' formation and order of development?
#How aphrodisiacs act instantly and time taken for the ''[[dhatu]]'' formation and order of development?
#Reason why diseases are located in one part of the body and role of ''antaragni'' in disease formation,
#Reason why diseases are located in one part of the body and role of ''antaragni'' in disease formation,
#Diseases caused by abnormal ''agni''
#Diseases caused by abnormal ''agni''
#Premonitory symptoms along with four types of ''grahani dosha'' their signs and symptoms with treatment as per various condition,
#Premonitory symptoms along with four types of ''grahani dosha'' their signs and symptoms with treatment as per various condition,
#How condition of ''atyagni'' is generated and its treatment. [244-249]
#How condition of ''atyagni'' is generated and its treatment. [244-249]
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इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने
इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने
ग्रहणीचिकित्सितं नाम पञ्चदशोऽध्यायः||१५||
ग्रहणीचिकित्सितं नाम पञ्चदशोऽध्यायः||१५||
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ityAgnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē
ityAgnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē
grahaNIcikitsitaM nAma pa~jcadasho~adhyAyaH||15||
grahaNIcikitsitaM nAma pa~jcadasho~adhyAyaH||15||
</div></div>
Herewith, fifteenth chapter related to [[Grahani Chikitsa]] which was unavailable as part of [[Chikitsa Sthana]] of Agnivesha Tantra supplemented by Dridhabala has been completed (15).
Herewith, fifteenth chapter related to [[Grahani Chikitsa]] which was unavailable as part of [[Chikitsa Sthana]] of Agnivesha Tantra supplemented by Dridhabala has been completed (15).
=== ''Tattva Vimarsha'' ===
== Tattva Vimarsha (Fundamental Principles) ==
*''Dehagni'' (all the entities in the body that are responsible for digestion and metabolism) is the fundamental causative agent for longevity, normal complexion, normal strength, good health, motivation, normal growth, normal luster, normal ''ojas'', normal body temperature and various other forms of ''agni''. Even the existence of an individual is said to be because of ''dehagni'' (3).
*''Dehagni'' (all the entities in the body that are responsible for digestion and metabolism) is the fundamental causative agent for longevity, normal complexion, normal strength, good health, motivation, normal growth, normal luster, normal ''[[ojas]]'', normal body temperature and various other forms of ''agni''. Even the existence of an individual is said to be because of ''dehagni'' (3).
*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).
*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).
*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.
*''[[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.
*Three ''[[dosha]]s'' are produced in three consequent stages of digestion after consumption of food. ''[[Kapha]]'' is produced in first stage of ''madhura avasthapaka''; pitta in second stage of ''amla avasthapaka'' and ''[[vata]]'' is produced in third stage of ''katu avasthapaka''. The site of production and time of production of ''[[dosha]]'' is in sequence as the process of digestion proceeds. Increase or decrease in quantity of ''[[dosha]]'' depends upon similarity or dis-similarity of basic composition of food consumed.
*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.
*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''. ''Kandara'' (tendon) and ''sira''(vein) are derived after ''rakta''. ''Vasa''(fat) and the six layers of ''tvacha'' (skin) are derived after ''mamsa'' (muscle) and ''snayu''(ligament) are derived after ''medas'' (adipose tissue) (17).
*During the processing by ''dhatvagni, stanya'' (breast milk) and the menstrual blood are derived after ''[[rasa]]''. ''Kandara'' (tendon) and ''sira''(vein) are derived after ''[[rakta]]''. ''Vasa''(fat) and the six layers of ''tvacha'' (skin) are derived after ''[[mamsa]]'' (muscle) and ''snayu''(ligament) are derived after ''[[meda]]s'' (adipose tissue) (17).
*The feces and the urine are the ''kitta'' (non-nutrient portion/waste portion/byproduct) of ingested food. The ''kiṭṭa'' of ''rasa'' is ''mala-kapha'' (excretions). ''Mala-pitta'' (bile pigment) is the ''kitta'' of ''rakta''. ''Kha-mala'' (the wastes accumulated in the hollow structures of the body such as external ears and nostrils) are the ''kitta'' of ''mamsa''. ''Sweda'' (sweat) is the ''mala'' of ''medas''. ''Kesha'' (hairs on the head) and ''loma'' (body hair) are the ''mala'' of ''asthi''. The ''mala'' of ''majja'' is the oily excretion of the eye and the skin (sebum). Thus, the ''dhatus'' continuously undergo two kinds of transformation: ''prasada'' (nutrient portion) and ''kitta'' (non-nutrient portion). This entire sequence of transformation and metabolism of ''dhatu'' is thus inter dependent (18-19½ ).
*The feces and the urine are the ''kitta'' (non-nutrient portion/waste portion/byproduct) of ingested food. The ''kiṭṭa'' of ''[[rasa]]'' is ''mala-[[kapha]]'' (excretions). ''Mala-[[pitta]]'' (bile pigment) is the ''kitta'' of ''[[rakta]]''. ''Kha-mala'' (the wastes accumulated in the hollow structures of the body such as external ears and nostrils) are the ''kitta'' of ''[[mamsa]]''. ''Sweda'' (sweat) is the ''[[mala]]'' of ''[[medas]]''. ''Kesha'' (hairs on the head) and ''loma'' (body hair) are the ''[[mala]]'' of ''[[asthi]]''. The ''[[mala]]'' of ''[majja]]'' is the oily excretion of the eye and the skin (sebum). Thus, the ''[[dhatu]]s'' continuously undergo two kinds of transformation: ''prasada'' (nutrient portion) and ''kitta'' (non-nutrient portion). This entire sequence of transformation and metabolism of ''[[dhatu]]'' is thus inter dependent (18-19½ ).
*Disorders of various factors mentioned above shall be treated after considering the original ''dhatu'' from which the factor is derived.
*Disorders of various factors mentioned above shall be treated after considering the original ''[[dhatu]]'' from which the factor is derived.
*''Vyana vata'' forcefully propels the ''rasa dhatu'' out of the heart and spreads it all over the body simultaneously, continuously and for the entire life (36).
*''Vyana vata'' forcefully propels the ''[[rasa dhatu]]'' out of the heart and spreads it all over the body simultaneously, continuously and for the entire life (36).
*Disease is produced only at the site of abnormality of body systems.
*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)
*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.
*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.
*The ''anna-visha'' (toxins) produced due to improper digestion and metabolism causes diseases at the sites of affliction.
*The ''vishamagni'' (improper ''agni'') causes irregularity in digestion and therefore defective formation of ''dhatu'' takes place. Whereas, ''teekshnagni'' (excessive ''agni'') when associated with little quantity of fuel (in the form of food) causes depletion of ''dhatu'' (tissue elements) (50).
*The ''vishamagni'' (improper ''agni'') causes irregularity in digestion and therefore defective formation of ''[[dhatu]]'' takes place. Whereas, ''teekshnagni'' (excessive ''agni'') when associated with little quantity of fuel (in the form of food) causes depletion of ''[[dhatu]]'' (tissue elements) (50).
*The digestive disorder of ''grahani'' can lead to secondary disorders related with other body systems along with digestive system.
*The digestive disorder of ''grahani'' can lead to secondary disorders related with other body systems along with digestive system.
*''Grahani'' disease is classified into four types viz ''vataja, pittaja, kaphaja'' and ''sannipataja'' depending upon the dominance of ''dosha'' and on the basis of the classification, etiological factors, symptoms and signs are varied.
*''Grahani'' disease is classified into four types viz ''[[vata]]ja, [[pitta]]ja, [[kapha]]ja'' and ''sannipataja'' depending upon the dominance of ''[[dosha]]'' and on the basis of the classification, etiological factors, symptoms and signs are varied.
*When the ''doshas'' are located in ''grahani'' and are associated with incomplete digested food then ''vamana'' (emetic therapy) is advised.
*When the ''[[dosha]]s'' are located in ''grahani'' and are associated with incomplete digested food then ''[[vamana]]'' (emetic therapy) is advised.
*If the ''ama'' is in ''pakvashaya'' and in ''anutklishta'' (stuck, not ready to come out) condition, then ''stravana'' (increasing secretion) with ''deepana dravyas'' should be administered.
*If the ''ama'' is in ''pakvashaya'' and in ''anutklishta'' (stuck, not ready to come out) condition, then ''stravana'' (increasing secretion) with ''[[deepana]] dravyas'' should be administered.
*If ''ama'' gets absorbed along with ''rasa dhatu'' and if it pervades throughout the body then ''langhana'' and ''pachana'' should be advised.
*If ''ama'' gets absorbed along with ''[[rasa dhatu]]'' and if it pervades throughout the body then ''[[langhana]]'' and ''[[pachana]]'' 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.
*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 ''amadosha'' whether ''samata'' or ''niramta'' is present or not and then appropriately treated with ''pachana'' etc. treatment (95).
*Patient should be evaluated for ''amadosha'' whether ''samata'' or ''niramta'' is present or not and then appropriately treated with ''[[pachana]]'' etc. treatment (95).
*Buttermilk due to its ''deepana, grahi'' (substances which increases appetite and digestive power and absorb fluid from the stool) and easy to digest actions is very useful in ''grahanidosha''.
*Buttermilk due to its ''[[deepana]], grahi'' (substances which increases appetite and digestive power and absorb fluid from the stool) and easy to digest actions is very useful in ''grahanidosha''.
*''Vata'' dominant ''grahani'' shall be treated with ''basti, virechana'' and unctuous preparations.
*''[[Vata]]'' dominant ''grahani'' shall be treated with ''[[basti]], [[virechana]]'' and unctuous preparations.
*If ''pitta'' is dominant in its own place then ''virechana'' or ''vamana'' should be administered for removal of ''pitta'' (122).
*If ''[[pitta]]'' is dominant in its own place then ''[[virechana]]'' or ''[[vamana]]'' should be administered for removal of ''[[pitta]]'' (122).
*In ''kaphaja grahani'', ''vamana'' and then drugs having ''katu, amla, lavana, kshara'' and ''tikta rasa'' shall be administered to increase ''agni'' (digestive power) (141).
*In ''[[kapha]]ja grahani'', ''[[vamana]]'' and then drugs having ''katu, amla, lavana, kshara'' and ''tikta rasa'' shall be administered to increase ''agni'' (digestive power) (141).
*In ''tridoshaja grahani'', [[Panchakarma]] should be carried out as per predominance of ''dosha''. Various ghee, ''kshara'', ''asava'' and ''arishta'' preparation useful in stimulation of ''agni'' should be administered.
*In ''tridoshaja grahani'', [[Panchakarma]] should be carried out as per predominance of ''[[dosha]]''. Various ghee, ''kshara'', ''asava'' and ''arishta'' preparation useful in stimulation of ''agni'' should be administered.
*''Sneha'' is the best among the ''deepana dravya'' which helps in stimulating the inefficient ''agni'' (201)
*''Sneha'' is the best among the ''[[deepana]] dravya'' which helps in stimulating the inefficient ''agni'' (201)
*Fasting or over eating doesn’t stimulate ''agni''. Proper intake of ''sneha'', followed by eating proper food preparations as well as appropriate use of various ''churna, arishta, sura'' and ''asava'' along with proper medication as per condition, enhances the power of ''agni''.
*Fasting or over eating doesn’t stimulate ''agni''. Proper intake of ''sneha'', followed by eating proper food preparations as well as appropriate use of various ''churna, arishta, sura'' and ''asava'' along with proper medication as per condition, enhances the power of ''agni''.
*''Atyagni'' is caused by diminished ''kapha'', aggravated ''pitta'' and associated ''vata''. This leads to emaciation if proper food is not consumed. Excessively increased digestive power can be pacified by taking foods and drinks which are heavy to digest, unctuous, cold, sweet and liquid.
*''Atyagni'' is caused by diminished ''[[kapha]]'', aggravated ''[[pitta]]'' and associated ''[[vata]]''. This leads to emaciation if proper food is not consumed. Excessively increased digestive power can be pacified by taking foods and drinks which are heavy to digest, unctuous, cold, sweet and liquid.
*''Samashana'' is taking wholesome and unwholesome foods together in diet. ''Vishamashana'' is taking food either in excess quantity or very little quantity and also if taken before or after appropriate time. ''Adhyashana'' is having food even though previously eaten food is not yet digested. All the above three are causes for death or give rise to serious disorders (235-236).
*''Samashana'' is taking wholesome and unwholesome foods together in diet. ''Vishamashana'' is taking food either in excess quantity or very little quantity and also if taken before or after appropriate time. ''Adhyashana'' is having food even though previously eaten food is not yet digested. All the above three are causes for death or give rise to serious disorders (235-236).
*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 ''dhatus''. In the night, the channels are closed, so is the heart which functions at slow rate as demand is less, the ''apakva ahara rasa'' increases in viscosity; thus ''ama'' adheres to the ''dhatus'' and if another food is taken in the morning the indigestion causes more ''apakva ahara rasa'' causing disease.
*If morning eaten food is undigested and still if anyone takes evening food, it may not be more vitiative since in day time all the ''srotas'' (channels) are dilated and heart is active similar to the lotus which blossoms with sunrise. During daytime, exercise, other physical and mental activities (cause heart to pump blood properly to) prevent the genesis of ''kleda'' (excess moisture) in various ''[[dhatu]]s''. In the night, the channels are closed, so is the heart which functions at slow rate as demand is less, the ''apakva ahara rasa'' increases in viscosity; thus ''ama'' adheres to the ''[[dhatu]]s'' and if another food is taken in the morning the indigestion causes more ''apakva ahara rasa'' causing disease.
=== ''Vidhi Vimarsha'' ===
== Vidhi Vimarsha (Applied Inferences ) ==
=== Importance of ''agni'' ===
The functions of gut are vital for maintenance and preservation of health. ''Grahani'' is the seat of ''jatharagni'', which is the initiator of digestive process and strengthens the other 12 ''agnis''. ''Jatharagni'' transforms food into biological substance (''ahara rasa'') which is further trifurcated into ''madhura, amla'' and ''katu avastha paka'' which gets transformed into three biological energies ''kapha, pitta'' and ''vata'' respectively. From the physiological point of view, the ''jatharagni'' or the active form of ''pachaka pitta'' is responsible for the digestion of all kinds of foods in the gut. Therefore, this should include all amylolytic, proteolytic and lipolytic enzymes secreted by various kinds of exocrine glands in the gut, which actually cause digestion, i.e., breaking down of different macromolecules into their constituent units.
The functions of gut are vital for maintenance and preservation of health. ''Grahani'' is the seat of ''jatharagni'', which is the initiator of digestive process and strengthens the other 12 ''agnis''. ''Jatharagni'' transforms food into biological substance (''ahara rasa'') which is further trifurcated into ''madhura, amla'' and ''katu avastha paka'' which gets transformed into three biological energies ''[[kapha]], [[pitta]]'' and ''[[vata]]'' respectively. From the physiological point of view, the ''jatharagni'' or the active form of ''pachaka pitta'' is responsible for the digestion of all kinds of foods in the gut. Therefore, this should include all amylolytic, proteolytic and lipolytic enzymes secreted by various kinds of exocrine glands in the gut, which actually cause digestion, i.e., breaking down of different macromolecules into their constituent units.
There are five ''bhutagnis'' and their function is to metabolize ''panchabhautic'' components of the food that are homologous to them in their composition. For instance, ''bhauma agni'' acts on the component that is ''bhauma'' or ''parthiva'' in its composition. ''Bhutagnis'' act on the products of digestion (''jatharagni paka''), hence, must be acting after the absorption of the nutrients, but before the action of ''dhatvagni''. The major site where the absorbed nutrients undergo biochemical transformation is in the liver, which plays an important role in metabolism, wherein several processes such as trans-amination, de-amination, beta-oxidation of fatty acids, glycolysis etc. take place. Therefore, the overall intermediary metabolism (involving fats, carbohydrates and proteins) can be understood as the functioning of the ''bhutagni''.
There are five ''bhutagnis'' and their function is to metabolize ''panchabhautic'' components of the food that are homologous to them in their composition. For instance, ''bhauma agni'' acts on the component that is ''bhauma'' or ''parthiva'' in its composition. ''Bhutagnis'' act on the products of digestion (''jatharagni paka''), hence, must be acting after the absorption of the nutrients, but before the action of ''dhatvagni''. The major site where the absorbed nutrients undergo biochemical transformation is in the liver, which plays an important role in metabolism, wherein several processes such as trans-amination, de-amination, beta-oxidation of fatty acids, glycolysis etc. take place. Therefore, the overall intermediary metabolism (involving fats, carbohydrates and proteins) can be understood as the functioning of the ''bhutagni''.
''Dhatvagni'' acts at tissue-level (in fact, at cellular level) upon the products of ''bhutagni paka'' and are responsible for the building of the respective ''dhatus''. In other words, the bio-energetic processes of a cell seem to be under the regulation of ''dhatvagni''. For instance, the common product of intermediary metabolism (involving fats, carbohydrates and proteins) is Acetyl-Co-A, which enters into Kreb’s cycle in the mitochondria of a cell. This is followed by electron transfer and oxidative phosphorylation. [ ] It is interesting to note that the Kreb’s cycle is also known as the ‘final common pathway’ in the process of catabolism of carbohydrates, proteins and fats. However, for the entry of amino acids, glucose and fatty acids into the cell, certain other factors such as hormones too are needed. For instance, insulin promotes the transportation of glucose, amino acids and fatty acids into the cell. Therefore, all these hormones (such as insulin, growth hormone, thyroid hormones, testosterone etc.) that promote the transportation of various nutrients into the cells, along with the enzymes participating in the Kreb’s cycle are to be included under the term ''dhatvagni''.
''Dhatvagni'' acts at tissue-level (in fact, at cellular level) upon the products of ''bhutagni paka'' and are responsible for the building of the respective ''[[dhatu]]s''. In other words, the bio-energetic processes of a cell seem to be under the regulation of ''dhatvagni''. For instance, the common product of intermediary metabolism (involving fats, carbohydrates and proteins) is Acetyl-Co-A, which enters into Kreb’s cycle in the mitochondria of a cell. This is followed by electron transfer and oxidative phosphorylation. <ref>Chatterjea MN, Shinde Rana. In:Textbook of Medical Biochemistry. ISBN: 9788184481341. DOI: 10.5005/jp/books/10917. Edition:7/e. 2007. Pages: 824</ref> It is interesting to note that the Kreb’s cycle is also known as the ‘final common pathway’ in the process of catabolism of carbohydrates, proteins and fats. However, for the entry of amino acids, glucose and fatty acids into the cell, certain other factors such as hormones too are needed. For instance, insulin promotes the transportation of glucose, amino acids and fatty acids into the cell. Therefore, all these hormones (such as insulin, growth hormone, thyroid hormones, testosterone etc.) that promote the transportation of various nutrients into the cells, along with the enzymes participating in the Kreb’s cycle are to be included under the term ''dhatvagni''.
Thus, the three major stages of the catabolism (involving fats, carbohydrates and proteins) i.e. digestion, intermediary metabolism and Kreb’s cycle - seem to represent the three sets of ''agnis,'' viz., ''jatharagni, bhutagni'' and ''dhatvagni'' respectively.
Thus, the three major stages of the catabolism (involving fats, carbohydrates and proteins) i.e. digestion, intermediary metabolism and Kreb’s cycle - seem to represent the three sets of ''agnis,'' viz., ''jatharagni, bhutagni'' and ''dhatvagni'' respectively.
=== Role of ''[[vata]]'' in digestion ===
''Samana vayu'' separates nutritive (''prasad'') and waste (''kitta'') part from ''ahara rasa''. Nutritive part is circulated to entire body after absorption through ''rasayini'' (villi) by ''vyana vayu''. Waste part is excreted as feces, urine and sweat through their excretory channels by ''apana vata''. Absorbed nutritive substances circulate all over the body through seven specific micro channels of each of the seven ''dhatus''.
''Samana vayu'' separates nutritive (''prasad'') and waste (''kitta'') part from ''ahara rasa''. Nutritive part is circulated to entire body after absorption through ''rasayini'' (villi) by ''vyana vayu''. Waste part is excreted as feces, urine and sweat through their excretory channels by ''apana vata''. Absorbed nutritive substances circulate all over the body through seven specific micro channels of each of the seven ''[[dhatu]]s''.
=== ''Dhatvagni'' ===
Each ''dhatu'' has its own transforming ''agni'' and ''srotas''. ''Srotas'' or micro channels have two functions of carrying and transforming the tissues with the help of their specific ''dhatvagni''. Five ''bhutagnis'', one for each ''mahabhuta'', transform five ''bhautic'' elements into the body tissues and organs. Seven ''dhatvagni'' or tissue transformers, form the tissue elements of seven ''dhatus'' by their needed nutrients. After formation of ''dhatu'', the microchannels permeates them into the organs for functioning. During this transformation process, ''upadhatu'' or subtissues and ''dhatumala'' or waste products are formed. ''Updhatus'' of ''rasa dhatu'' is breast milk, menstrual blood is ''upadhatu'' of ''rakta'' and tendons and six layers of skin is ''upadhatu'' of ''mamsa dhatu'' etc.
Each ''[[dhatu]]'' has its own transforming ''agni'' and ''srotas''. ''Srotas'' or micro channels have two functions of carrying and transforming the tissues with the help of their specific ''dhatvagni''. Five ''bhutagnis'', one for each ''[[mahabhuta]]'', transform five ''bhautic'' elements into the body tissues and organs. Seven ''dhatvagni'' or tissue transformers, form the tissue elements of seven ''[[dhatu]]s'' by their needed nutrients. After formation of ''[[dhatu]'', the microchannels permeates them into the organs for functioning. During this transformation process, ''upadhatu'' or subtissues and ''dhatumala'' or waste products are formed. ''Updhatus'' of ''[[rasa dhatu]]'' is breast milk; menstrual blood is ''upadhatu'' of ''[[rakta]]''; tendons and six layers of skin are ''upadhatu'' of ''[[mamsa dhatu]]'' etc.
Apart from digestion, the gut performs various other significant functions as well. The gut has its own protective mechanism in the form of gut-associated lymphoid tissue, which prevents the entry of pathogens into the bloodstream. The micro-biota in the gut serves vital functions related to various aspects of health. The enteric nervous system of the gut has its own functional significance and has been proven to be very closely associated with the central nervous system functions. The gut secretes several hormone-like substances that are helpful in regulating long-term energy balance. All the factors mentioned are either directly or indirectly dependent on these functional domains of the gut. [ ] [ ] Other forms of ''agni'' in this context are indicative of ''bhutagni'' and ''dhatvagni'', which in turn, are functionally dependent on ''jatharagni''. ''Prana'' in this context may stand for all types of ''vata'' as well.
Apart from digestion, the gut performs various other significant functions as well. The gut has its own protective mechanism in the form of gut-associated lymphoid tissue, which prevents the entry of pathogens into the bloodstream. The micro-biota in the gut serves vital functions related to various aspects of health. The enteric nervous system of the gut has its own functional significance and has been proven to be very closely associated with the central nervous system functions. The gut secretes several hormone-like substances that are helpful in regulating long-term energy balance. All the factors mentioned are either directly or indirectly dependent on these functional domains of the gut. <ref>W I Khan, J E Ghia. Gut hormones: emerging role in immune activation and inflammation. Clin Exp Immunol. 2010 July; 161(1): 19–27</ref> <ref>Andrew L. Kau, Philip P. Ahern, Nicholas W. Griffin, Andrew L. Goodman, Jeffrey I. Gordon. Human nutrition, the gut microbiome, and immune system: envisioning the future. Nature. 2011 June 15; 474(7351): 327–336. doi: 10.1038/nature10213</ref> Other forms of ''agni'' in this context are indicative of ''bhutagni'' and ''dhatvagni'', which in turn, are functionally dependent on ''jatharagni''. ''Prana'' in this context may stand for all types of ''[[vata]]'' as well.
=== Three stages of digestion ===
There are three stages of digestion in the gut. The first stage (''madhura'') takes place in the upper gastro-intestinal tract, i.e., inside the esophagus and stomach; the second stage (''amla'') takes place in the middle portion of the gut, i.e., in the small intestine; and the last stage (''katu'') takes place in the colon.
There are three stages of digestion in the gut. The first stage (''madhura'') takes place in the upper gastro-intestinal tract, i.e., inside the esophagus and stomach; the second stage (''amla'') takes place in the middle portion of the gut, i.e., in the small intestine; and the last stage (''katu'') takes place in the colon.
The froth-like ''kapha'' seems to be the thick mucus that covers the entire stomach, providing a protective coating that prevents the gastric mucosa being digested and damaged due to the acid-pepsin mixture.
The froth-like ''[[kapha]]'' seems to be the thick mucus that covers the entire stomach, providing a protective coating that prevents the gastric mucosa being digested and damaged due to the acid-pepsin mixture.
''Accha pitta'' is ‘liquid’ in nature, released in the duodenum and can be correlated with bile.
''Accha [[pitta]]'' is ‘liquid’ in nature, released in the duodenum and can be correlated with bile.
''Pachaka pitta'' has the functional site between ''amashaya'' (stomach) and ''pakvashaya'' (colon), which is indicative of small intestine. It is composed of five ''mahabhutas'' but the ''agni mahabhuta'' is predominant; and hence, it becomes devoid of fluidity and therefore is also known as ''agni''. It splits the food into sāra (nutritive) and ''kitta'' (non-nutritive) portions. (Ashtanga Hridaya, Sutra Sthana, 12/10-12).
''Pachaka pitta'' has the functional site between ''amashaya'' (stomach) and ''pakvashaya'' (colon), which is indicative of small intestine. It is composed of five ''[[mahabhuta]]s'' but the ''[[agni mahabhuta]]'' is predominant; and hence, it becomes devoid of fluidity and therefore is also known as ''agni''. It splits the food into sāra (nutritive) and ''kitta'' (non-nutritive) portions.<ref>Vagbhata. Sutra Sthana, Cha.12 Doshabhediya Adhyaya verse 10-12. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.</ref>
''Sara'' of the food is the minutest fraction (''parama sukshma''). This portion reaches the heart in the form of ''ahara rasa''. From the heart, it then gets re-distributed into 24 pulsatile vessels to be carried into the whole body. (Sushruta Samhita, Sutra Sthana, 14/3)
''Sara'' of the food is the minutest fraction (''parama sukshma''). This portion reaches the heart in the form of ''ahara rasa''. From the heart, it then gets re-distributed into 24 pulsatile vessels to be carried into the whole body.<ref>Sushruta. Sutra Sthana, Cha.14 Shonitavarnaniya Adhyaya verse 3. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1</ref>
The portion that reaches the colon is the one that is designated as ''kitta''. During the third stage of digestion, there occurs the solidification of fecal matter and formation of certain pungent gases such as ammonia, methane, hydrogen sulfide etc. The term ''pakva'' in this context indicates ''pakva mala''; not ''pakva ahara'' (Verse 9-11).
The portion that reaches the colon is the one that is designated as ''kitta''. During the third stage of digestion, there occurs the solidification of fecal matter and formation of certain pungent gases such as ammonia, methane, hydrogen sulfide etc. The term ''pakva'' in this context indicates ''pakva mala''; not ''pakva ahara'' (Verse 9-11).
=== Formation of the seven ''[[dhatu]]s'' ===
''Rasa, rakta, mamsa, meda, asthi, majja'' and ''shukra'' are the seven fundamental entities that sustain the human body. These can be called ‘tissues’ for the sake of convenience, though some of them are not tissues in a strict sense. It will be pertinent to look into these individual entities at this stage to understand what they really are in terms of anatomy. [ ]
''[[Rasa]], [[rakta]], [[mamsa]], [[meda]], [[asthi]], [[majja]]'' and ''[[shukra]]'' are the seven fundamental entities that sustain the human body. These can be called ‘tissues’ for the sake of convenience, though some of them are not tissues in a strict sense. It will be pertinent to look into these individual entities at this stage to understand what they really are in terms of anatomy.<ref>Patwardhan K. Human Physiology in Ayurveda. Varanasi, India: Chaukhambha Orientalia, 2013, Jiakrishnadas series no. 134.</ref>
''Rasa'': A colorless fluid that gets ejected out of the heart and nourishes the entire body.
''[[Rasa]]'': A colorless fluid that gets ejected out of the heart and nourishes the entire body.
''Rakta'': The red colored fraction that is formed in liver and spleen after the action of ''ranjaka pitta'' on ''rasa''. It is essential for life and its function is to supply the life principle (''jeeva'').
''[[Rakta]]'': The red colored fraction that is formed in liver and spleen after the action of ''ranjaka pitta'' on ''[[rasa]]''. It is essential for life and its function is to supply the life principle (''jeeva'').
''Rasa'' and ''rakta'' together form what is generally known as blood: ''rakta'' being the red fraction (red blood corpuscles) and ''rasa'' being the colorless fluid (plasma).
''[[Rasa]]'' and ''[[rakta]]'' together form what is generally known as blood: ''[[rakta]]'' being the red fraction (red blood corpuscles) and ''[[rasa]]'' being the colorless fluid (plasma).
''Mamsa'': The correct translation of this term would be ‘flesh’. Flesh generally means all kinds of muscles and also the parenchyma of the different viscera such as thyroid, liver, spleen, kidneys etc.
''[[Mamsa]]'': The correct translation of this term would be ‘flesh’. Flesh generally means all kinds of muscles and also the parenchyma of the different viscera such as thyroid, liver, spleen, kidneys etc.
''Medas'': This generally stands for fatty tissue, however, it is to be noted that it is of two types: ''Baddha'' (bound, stable, fixed, stored) and ''abaddha'' (free, unbound). The ''baddha'' form, therefore, must include the stored fat in the form of adipose tissue; and the ''abaddha'' form must include the circulating lipids such as cholesterol, LDL, HDL etc.
''[[Medas]]'': This generally stands for fatty tissue, however, it is to be noted that it is of two types: ''Baddha'' (bound, stable, fixed, stored) and ''abaddha'' (free, unbound). The ''baddha'' form, therefore, must include the stored fat in the form of adipose tissue; and the ''abaddha'' form must include the circulating lipids such as cholesterol, LDL, HDL etc.
''Asthi'': Though the term ''asthi'' generally stands for bony tissue, it may in some contexts, include all such relatively hard structures that resist easy decaying, viz., teeth, nails and hair.
''[[Asthi]]'': Though the term ''[[asthi]]'' generally stands for bony tissue, it may in some contexts, include all such relatively hard structures that resist easy decaying, viz., teeth, nails and hair.
''Majja'': Generally, the substance that fills all the bony cavities is called ''majja''. However, the brain substance that fills the cranial cavity too, must be included in ''majja''. Therefore, ''majja'' is of two types: ''asthigata'' (bony) and ''mastakagata'' (cranial).
''[[Majja]]'': Generally, the substance that fills all the bony cavities is called ''[[majja]]''. However, the brain substance that fills the cranial cavity too, must be included in ''[[majja]]''. Therefore, ''[[majja]]'' is of two types: ''asthigata'' (bony) and ''mastakagata'' (cranial).
''Shukra'': The term ''shukra'' has been described to be of two forms in Ayurveda textbooks:
''[[Shukra]]'': The term ''[[shukra]]'' has been described to be of two forms in [[Ayurveda]] textbooks:
#The one that is ejaculated during the process of mating, which is responsible for fertilization of ovum and thus embryogenesis.
#The one that is ejaculated during the process of mating, which is responsible for fertilization of ovum and thus embryogenesis.
#The one that is formed from ''majja'' (the tissue that fills the bony cavities) which in turn circulates all over the body both in males and females. Reproduction is the function of this second form of ''shukra'' too. Therefore, on careful examination, it seems that the first form of ''shukra'' stands for the semen in general and for sperms in particular; and, the second form of ''shukra'' stands for hypothalamo-pituitary-gonadal axis of hormones that circulate all over the body.
#The one that is formed from ''[[majja]]'' (the tissue that fills the bony cavities) which in turn circulates all over the body both in males and females. Reproduction is the function of this second form of ''[[shukra]]'' too. Therefore, on careful examination, it seems that the first form of ''[[shukra]]'' stands for the semen in general and for sperms in particular; and, the second form of ''[[shukra]]'' stands for hypothalamo-pituitary-gonadal axis of hormones that circulate all over the body.
=== The process of nourishment of ''[[dhatu]]'' ===
The process of nourishment of ''dhatus'' is explained by three analogies: ''Ksheera-dadhi'' (milk curdling analogy), ''khalekapota'' (analogy of pigeons picking up the choicest grains) and ''kedari-kulya'' (irrigation analogy).
The process of nourishment of ''[[dhatu]]s'' is explained by three analogies: ''Ksheera-dadhi'' (milk curdling analogy), ''khalekapota'' (analogy of pigeons picking up the choicest grains) and ''kedari-kulya'' (irrigation analogy).
=== ''Ksheera-dadhi nyaya'' (milk curdling analogy) ===
According to this analogy, the nourishment of a ''dhatu'' takes place according to the rule of conversion (of one substance into another). Just as the milk is converted into different forms (from milk to curd, curd to butter, butter to ghee) successively, the preceding ''dhatu'' too is converted into the next one. The sequence of this conversion is as follows: ''rasa, rakta, mamsa, meda, asthi, majja'' and ''shukra'' in the same order.
According to this analogy, the nourishment of a ''[[dhatu]]'' takes place according to the rule of conversion (of one substance into another). Just as the milk is converted into different forms (from milk to curd, curd to butter, butter to ghee) successively, the preceding ''[[dhatu]]'' too is converted into the next one. The sequence of this conversion is as follows: ''[[rasa]], [[rakta]], [[mamsa]], [[meda]], [[asthi]], [[majja]]'' and ''[[shukra]]'' in the same order.
The transformation of various substances that takes place due to various biochemical reactions could be one way of understanding this analogy. For instance, the process of glycolysis involves different enzymes acting on different substrates at different steps and converting them from one to another. The ability of one kind of stem cell derived from one tissue in giving rise to different forms of cell types of different tissues is known. The response of mesenchymal stem cells to certain stimuli such as hypoxia in the form of migration and tissue regeneration is also known, which can further support this analogy.
The transformation of various substances that takes place due to various biochemical reactions could be one way of understanding this analogy. For instance, the process of glycolysis involves different enzymes acting on different substrates at different steps and converting them from one to another. The ability of one kind of stem cell derived from one tissue in giving rise to different forms of cell types of different tissues is known. The response of mesenchymal stem cells to certain stimuli such as hypoxia in the form of migration and tissue regeneration is also known, which can further support this analogy.
=== ''Khalekapota nyaya'' (analogy of pigeons picking up the choicest grains) ===
According to this analogy, the nourishment of different ''dhatus'' takes place according to the rule of selectivity. Just as the pigeons coming from far off places, picking up the grains of their choice from the granary (a storehouse for thrashed grain, ''khala'') and flying back to their destination, the different ''dhatus'' too, pick up the required nourishment from the common nutrient pool known as ''rasa''. The ''dhatu'' that is situated nearer to ''rasa'' is nourished first and the remaining later, just as the pigeon from a nearer place gets a chance to pick up grains quickly in the given analogy.
According to this analogy, the nourishment of different ''[[dhatu]]s'' takes place according to the rule of selectivity. Just as the pigeons coming from far off places, picking up the grains of their choice from the granary (a storehouse for thrashed grain, ''khala'') and flying back to their destination, the different ''[[dhatu]]s'' too, pick up the required nourishment from the common nutrient pool known as ''[[rasa]]''. The ''[[dhatu]]'' that is situated nearer to ''[[rasa]]'' is nourished first and the remaining later, just as the pigeon from a nearer place gets a chance to pick up grains quickly in the given analogy.
In this analogy, the choice that the pigeons have in picking up the grain (selectivity) and the energy they spend in the process of obtaining grains (actively) are the vital features. The tissue metabolism can influence the extent of vasodilatation and thus its own perfusion. This is known as auto-regulation of blood supply. Similarly, the specific kind of tissue has affinity for specific nutrient and other substances. For example, the calcium gets deposited normally in bones, but not in the mucous membranes. Similarly, vitamin B-12 is stored in liver and not in other tissues.
In this analogy, the choice that the pigeons have in picking up the grain (selectivity) and the energy they spend in the process of obtaining grains (actively) are the vital features. The tissue metabolism can influence the extent of vasodilatation and thus its own perfusion. This is known as auto-regulation of blood supply. Similarly, the specific kind of tissue has affinity for specific nutrient and other substances. For example, the calcium gets deposited normally in bones, but not in the mucous membranes. Similarly, vitamin B-12 is stored in liver and not in other tissues.
=== ''Kedari-kulya nyaya'' (analogy of irrigation) ===
According to this analogy, the nourishment of ''dhatu'' takes place according to the rule of irrigation. Just as the ''kulyas'' (small canals / trenches / channels) receive water from the ''kedarika'' (the bigger water reservoir) and then irrigate the nearest field first, the ''rasa'' too, nourishes the ''dhatus'' in a sequential fashion depending on the location of the ''dhatu''.
According to this analogy, the nourishment of ''[[dhatu]]'' takes place according to the rule of irrigation. Just as the ''kulyas'' (small canals / trenches / channels) receive water from the ''kedarika'' (the bigger water reservoir) and then irrigate the nearest field first, the ''[[rasa]]'' too, nourishes the ''[[dhatu]]s'' in a sequential fashion depending on the location of the ''[[dhatu]]''.
The anatomical location of a cell in the body can influence the amount of perfusion it receives. For instance, the apical regions of the lungs are less perfused than the other areas of the lung, and hence, are susceptible to be affected in some infectious conditions such as tuberculosis. Similarly, the hepatocytes that surround the central vein in a hepatic lobule are more susceptible to hypoxic injury than those situated in the periphery. Sub-endocardial region of the heart is, in the same manner, is more susceptible to ischemia than the epicardial region.
The anatomical location of a cell in the body can influence the amount of perfusion it receives. For instance, the apical regions of the lungs are less perfused than the other areas of the lung, and hence, are susceptible to be affected in some infectious conditions such as tuberculosis. Similarly, the hepatocytes that surround the central vein in a hepatic lobule are more susceptible to hypoxic injury than those situated in the periphery. Sub-endocardial region of the heart is, in the same manner, is more susceptible to ischemia than the epicardial region.
Another important feature to be noted in this analogy is the passive flow of water from higher altitude to lower altitude, where no external energy is spent. This is in contrast to the pigeons expending their energy to pick up the grains of their choice actively. It is interesting to note the process of transportation of substances across the cell membrane, which has been divided into two major types: active transport and passive transport (Verse-16).
Another important feature to be noted in this analogy is the passive flow of water from higher altitude to lower altitude, where no external energy is spent. This is in contrast to the pigeons expending their energy to pick up the grains of their choice actively. It is interesting to note the process of transportation of substances across the cell membrane, which has been divided into two major types: active transport and passive transport (Verse-16).
Bilirubin is a metabolic byproduct of heme portion of the hemoglobin. This is secreted into bile juice in the liver which is in turn released during the process of digestion. Features of pitta ''vriddhi'' therefore, are yellowish discoloration of sclera, skin, urine and feces. Mucous is rich in water that is derived from extracellular fluid while it is being formed. The cerumen, sebum, and other similar external secretions perform some functions such as providing a waxy protective layer. Sweat and urine share similarities in function as well as composition. Therefore, ''vrikka'' mentioned as the site of origin of ''medavaha srotas'' makes sense when one considers ''sweda'' as the ''mala'' of ''meda''. Hair and bones share similarity when it comes to the power to resist easy biodegradation. They also grow weaker in old age. Therefore, hair are the ''mala'' of ''asthi'' (Verse 19).
Bilirubin is a metabolic byproduct of heme portion of the hemoglobin. This is secreted into bile juice in the liver which is in turn released during the process of digestion. Features of [[pitta]] ''vriddhi'' therefore, are yellowish discoloration of sclera, skin, urine and feces. Mucous is rich in water that is derived from extracellular fluid while it is being formed. The cerumen, sebum, and other similar external secretions perform some functions such as providing a waxy protective layer. Sweat and urine share similarities in function as well as composition. Therefore, ''vrikka'' mentioned as the site of origin of ''medavaha srotas'' makes sense when one considers ''sweda'' as the ''[[mala]]'' of ''[[meda]]''. Hair and bones share similarity when it comes to the power to resist easy biodegradation. They also grow weaker in old age. Therefore, hair are the ''[[mala]]'' of ''[[asthi]]'' (Verse 19).
Circulating provoked ''dosha'' settles in a tissue whose channels are defective (''kha-vaigunya'') and perfuce the lesion. This pathogenesis has been compared with rain production. The obstruction to the moving ''rasa'' by the abnormality of ''srotas,'' results in causation of disease, just as the obstruction to the cloud laden monsoon winds by the tall mountains results in the causation of rainfall (Verse 37).
Circulating provoked ''[[dosha]]'' settles in a tissue whose channels are defective (''kha-vaigunya'') and perfuce the lesion. This pathogenesis has been compared with rain production. The obstruction to the moving ''[[rasa]]'' by the abnormality of ''srotas,'' results in causation of disease, just as the obstruction to the cloud laden monsoon winds by the tall mountains results in the causation of rainfall (Verse 37).
=== Causes of ''grahani'' disorder ===
''Abhojana'' (starvation) leads to increase in ''vata'' and in turn ''agnimandya''.(Ca.Vi/ 2/7) Starvation and protein malnutrition disrupts the normal indigenous gastrointestinal tract micro-flora and impairs host antibacterial defenses. Both starvation and protein malnutrition increases the cecal levels of gram negative enteric bacilli and decrease the level of lactobacillus and promote growth of anaerobes that in turn disturb the gut flora. Gut flora also known as gut microbiome has a unique role in digestion and absorption. Once the gut microbiome gets vitiated it leads to indigestion and malabsorption.
''Abhojana'' (starvation) leads to increase in ''[[vata]]'' and in turn ''agnimandya''.[Cha. Sa. [[Vimana Sthana]] 2/7] Starvation and protein malnutrition disrupts the normal indigenous gastrointestinal tract micro-flora and impairs host antibacterial defenses. Both starvation and protein malnutrition increases the cecal levels of gram negative enteric bacilli and decrease the level of lactobacillus and promote growth of anaerobes that in turn disturb the gut flora. Gut flora also known as gut microbiome has a unique role in digestion and absorption. Once the gut microbiome gets vitiated it leads to indigestion and malabsorption.
''Atibhojana'' (excessive intake) causes provocation of all the ''dosha'' and thereby causing ''agnimandya''. Protein rich diet or fat laden diet or excessive diet takes longer time for emptying of stomach. Longer stay of food explains increase of acidic pH. Therefore, whenever such chyme enters the duodenum the liver and pancreas need to increase secretion of alkali pH. Repeated, such dietary habits lead to indigestion. Further increase of alkali pH causes reduced transit time in small intestine leading to the symptoms like diarrhea. Diet which is ''atiguru'' (heavy) and indulging ''vishamashana''( irregular food habit) will have similar effect. ''Atiruksha ahara'' or diet has low protein value. Protein malnutrition leads to decrease of enzyme secretion as proteins are the building blocks of enzymes. ''Asatmya desha, kala, ritu'' only explain the dietary changes which dramatically alter the balance of bacteria in the gut on daily basis. Research shows that these fluctuations could lead to various digestive and absorptive problems. ''Dushita bhojana'' or contaminated food reacts directly with intestinal flora disturbing their quantitative and qualitative growth causing indigestion. Intake of unctuous substances in ''sama pitta'' condition leads to ''grahani dosha'' and various other disorders.( Ca. Su 13/76 ) Emaciation due to disease also has its own impact on digestion. ''Mandagni'' is a causative factor for all diseases but if patient continuously indulges in ''apathya'' then complications may increase or the prognosis turns bad.
''Atibhojana'' (excessive intake) causes provocation of all the ''[[dosha]]'' and thereby causing ''agnimandya''. Protein rich diet or fat laden diet or excessive diet takes longer time for emptying of stomach. Longer stay of food explains increase of acidic pH. Therefore, whenever such chyme enters the duodenum the liver and pancreas need to increase secretion of alkali pH. Repeated, such dietary habits lead to indigestion. Further increase of alkali pH causes reduced transit time in small intestine leading to the symptoms like diarrhea. Diet which is ''atiguru'' (heavy) and indulging ''vishamashana''( irregular food habit) will have similar effect. ''Atiruksha ahara'' or diet has low protein value. Protein malnutrition leads to decrease of enzyme secretion as proteins are the building blocks of enzymes. ''Asatmya desha, kala, ritu'' only explain the dietary changes which dramatically alter the balance of bacteria in the gut on daily basis. Research shows that these fluctuations could lead to various digestive and absorptive problems. ''Dushita bhojana'' or contaminated food reacts directly with intestinal flora disturbing their quantitative and qualitative growth causing indigestion. Intake of unctuous substances in ''sama [[pitta]]'' condition leads to ''grahani dosha'' and various other disorders.[ Cha. Sa. [[Sutra Sthana]] 13/76] Emaciation due to disease also has its own impact on digestion. ''Mandagni'' is a causative factor for all diseases but if patient continuously indulges in ''apathya'' then complications may increase or the prognosis turns bad.
Suppression of manifested natural urges may have impact on nervous system resulting in effect either on enzymatic secretion or on the hormonal secretion.These factors have role in digestion and absorption as may be understood in case of ''adhovata'' (accumulation of ''vata'' in rectum and pelvic region) and ''purisha vegadharana'' (suppression of urge of defecation), wherein regular urge suppression disturbs the intestinal pro-kinetic movement.( Ca. Su. 7/ 6,8,12) Disturbed pro-kinesia increases the transit time leading to the change in pH which further has its impact on electrolytes and enzymatic secretion leading to reduced digestive power (''agnimandya'').
Suppression of manifested natural urges may have impact on nervous system resulting in effect either on enzymatic secretion or on the hormonal secretion. These factors have role in digestion and absorption as may be understood in case of ''adhovata'' (accumulation of ''[[vata]]'' in rectum and pelvic region) and ''[[purisha]] vegadharana'' (suppression of urge of defecation), wherein regular urge suppression disturbs the intestinal pro-kinetic movement.[Cha. Sa. [[Sutra Sthana ]] 7/ 6,8,12] Disturbed pro-kinesia increases the transit time leading to the change in pH which further has its impact on electrolytes and enzymatic secretion leading to reduced digestive power (''agnimandya'').
Further ''kshudha vegadharana'' (avoiding sense of hunger) effect will be similar to ''abhojana'' (not eating). It may also be noted that repeated ''kshudha vegadharana'' leads to atrophy of the stomach which further weakens the perception of hunger which is controlled by the percentage of the stomach that remains empty similar to the explanation given by Charak that excessive fasting leads to diminution in ''agni''.(Ca.Su.22/37) ''Trishna vegadharana'' (avoiding thirst) leads to reduced fluid balance in the body.
Further ''kshudha vegadharana'' (avoiding sense of hunger) effect will be similar to ''abhojana'' (not eating). It may also be noted that repeated ''kshudha vegadharana'' leads to atrophy of the stomach which further weakens the perception of hunger which is controlled by the percentage of the stomach that remains empty similar to the explanation given by Charak that excessive fasting leads to diminution in ''agni''.[Cha.Sa. [[Sutra Sthana]] 22/37] ''Trishna vegadharana'' (avoiding thirst) leads to reduced fluid balance in the body.
Nearly seven liters of water is secreted during various gastrointestinal secretions. Reduced water intake in long term will reduce gastrointestinal secretion leading to impaired digestion.
Nearly seven liters of water is secreted during various gastrointestinal secretions. Reduced water intake in long term will reduce gastrointestinal secretion leading to impaired digestion.
Abnormal digestion is from faulty food habits and unwholesome diet, that causes ''jatharagni dushti'' or vitiation of digestive power. The improperly digested food turns into toxic substance called aamavisha, basic cause of most diseases. If ''amavisha'' associates with any balanced ''dosha'' or healthy ''dhatu'', they turn pathogenic. ''Grahanidosha'' is an important example of ''amavisha'' and ''agnidushti''.
Abnormal digestion is from faulty food habits and unwholesome diet, that causes ''jatharagni dushti'' or vitiation of digestive power. The improperly digested food turns into toxic substance called aamavisha, basic cause of most diseases. If ''amavisha'' associates with any balanced ''[[dosha]]'' or healthy ''[[dhatu]]'', they turn pathogenic. ''Grahanidosha'' is an important example of ''amavisha'' and ''agnidushti''.
''Grahanidosha'' is of four types. It starts with inflammation of elementary canal at different places and is called by different names e.g gastritis, duodenitis and colitis. In the second stage erosions and ulcers develop. In third stage mental symptoms like anxiety, illusions, fear, and IBS like symptoms. Fourth stage is ''sannipatic'' with clinical features resembling ulcerative colitis.
''Grahanidosha'' is of four types. It starts with inflammation of elementary canal at different places and is called by different names e.g gastritis, duodenitis and colitis. In the second stage erosions and ulcers develop. In third stage mental symptoms like anxiety, illusions, fear, and IBS like symptoms. Fourth stage is ''sannipatic'' with clinical features resembling ulcerative colitis.
Treatment of ''grahanidosha'' is to enhance ''jatharagni, bhutagni'' and ''dhatvagni'' which encompasses the whole digestive process. Food and drinks are also medicated depending upon the patient and the stage of disease, for extended period of time.
Treatment of ''grahanidosha'' is to enhance ''jatharagni, bhutagni'' and ''dhatvagni'' which encompasses the whole digestive process. Food and drinks are also medicated depending upon the patient and the stage of disease, for extended period of time.
=== Effect on immunity ===
''Prayatna'' (effort), ''urja'' (energy) and ''bala'' (strength) are the role played by ''vata, pitta'' and ''kapha'' in building up of immunity. When the ''dosha'' gets vitiated ''prayatna, urja'' and ''bala'' are hampered leading to suppression of immunity.
''Prayatna'' (effort), ''urja'' (energy) and ''bala'' (strength) are the role played by ''[[vata]], [[pitta]]'' and ''[[kapha]]'' in building up of immunity. When the ''[[dosha]]'' gets vitiated ''prayatna, urja'' and ''bala'' are hampered leading to suppression of immunity.
Exogenous and endogenous factors vitiate the doṣha which when associated with ama produce either local or systemic disorders.
Exogenous and endogenous factors vitiate the [[doṣha]] which when associated with ama produce either local or systemic disorders.
''Tridosha'' play role in impairing immunity and depending on the dominance of a particular ''dosha'' they are classified as ''vataja, pittaka'' and ''kaphaja'' disorders.(Ca. Su. 28/7)
''Tridosha'' play role in impairing immunity and depending on the dominance of a particular ''[[dosha]]'' they are classified as ''[[vata]]ja, [[pitta]]ka'' and ''[[kapha]]ja'' disorders.[Cha.Sa. [[Sutra Sthana]] 28/7]
=== Equilibrium of ''agni'' ===
''Agni'' should be associated with balance of ''vata, pitta'' and ''kapha'' or ''samagni''. Digestive enzyme secretion is controlled by sympathetic and parasympathetic nerve supply. ''Samagni'' may be compared with balanced state of sympathetic/ parasympathetic activity which explains the role of balanced or ''samana vata''. It may also be noted that ''prana vata'' and ''apana vata'' also have impact on balancing the normal status of ''agni''.
''Agni'' should be associated with balance of ''[[vata]], [[pitta]]'' and ''[[kapha]]'' or ''samagni''. Digestive enzyme secretion is controlled by sympathetic and parasympathetic nerve supply. ''Samagni'' may be compared with balanced state of sympathetic/ parasympathetic activity which explains the role of balanced or ''samana vata''. It may also be noted that ''prana vata'' and ''apana vata'' also have impact on balancing the normal status of ''agni''.
Acidic and alkaline pH of digestive secretions explains the balanced ''pitta''. Modern science explains specific range of pH of digestive secretions e.g. pancreatic juice has pH in range of 7.1 – 8.2 that buffers acidic gastric juice in chyme, stops the action of pepsin from the stomach and creates proper pH for action of digestive enzymes in small intestine. Specific pH of gastric juice is essential to convert pepsinogen into pepsin, an active form of proteolytic enzyme thus improper pH will cause variation in digestion.
Acidic and alkaline pH of digestive secretions explains the balanced ''[[pitta]]''. Modern science explains specific range of pH of digestive secretions e.g. pancreatic juice has pH in range of 7.1 – 8.2 that buffers acidic gastric juice in chyme, stops the action of pepsin from the stomach and creates proper pH for action of digestive enzymes in small intestine. Specific pH of gastric juice is essential to convert pepsinogen into pepsin, an active form of proteolytic enzyme thus improper pH will cause variation in digestion.
Mucosal resistance explains role of ''kapha'' in maintaining ''samagni''. Intact mucosal lining is present in stomach and small intestine. Breach in mucosal lining causes gastritis, burning sensation etc whereas increased size of mucosal cells alters the pH thereby a balanced ''kapha'' plays essential role in ''samagni''. Role of prostaglandins to maintain gastric mucosal resistance to prevent the action of HCl in gastric mucosa is to be considered as part of ''kledaka kapha'' as sodium bicarbonate and mucus is secreted by prostaglandins. Drugs which inhibit prostaglandins e.g. aspirin, impairs gastric mucosal barriers leading to gastritis, duodenitis and peptic ulcers.
Mucosal resistance explains role of ''[[kapha]]'' in maintaining ''samagni''. Intact mucosal lining is present in stomach and small intestine. Breach in mucosal lining causes gastritis, burning sensation etc whereas increased size of mucosal cells alters the pH thereby a balanced ''[[kapha]]'' plays essential role in ''samagni''. Role of prostaglandins to maintain gastric mucosal resistance to prevent the action of HCl in gastric mucosa is to be considered as part of ''kledaka kapha'' as sodium bicarbonate and mucus is secreted by prostaglandins. Drugs which inhibit prostaglandins e.g. aspirin, impairs gastric mucosal barriers leading to gastritis, duodenitis and peptic ulcers.
=== Clinical features ===
''Arochaka'' (aversion to food), ''vairasya'' (distaste), ''praseka'' (excessive salivation) are general gastrointestinal manifestations of indigestion. ''Tamaka'' or blackout occurs due to nutritional deficiency. Mal-absorption causes diarrhea which leads to decrease in circulating liquid, a cause of hypo-tension a reason for blackout. Impaired absorption of iron, folate, vit. B12 leads to anemia which may be the cause for blackout (''tamakanvitah''). Resulting anemia and electrolyte depletion (particularly K+) leads to weakness.
''Arochaka'' (aversion to food), ''vairasya'' (distaste), ''praseka'' (excessive salivation) are general gastrointestinal manifestations of indigestion. ''Tamaka'' or blackout occurs due to nutritional deficiency. Mal-absorption causes diarrhea which leads to decrease in circulating liquid, a cause of hypo-tension a reason for blackout. Impaired absorption of iron, folate, vit. B12 leads to anemia which may be the cause for blackout (''tamakanvitah''). Resulting anemia and electrolyte depletion (particularly K+) leads to weakness.
Etiological factors as mentioned in the text have impact mainly on the neural stimulation of digestive secretions affecting the flow of gastrointestinal secretions into the gastrointestinal tract thereby hampering the digestion.
Etiological factors as mentioned in the text have impact mainly on the neural stimulation of digestive secretions affecting the flow of gastrointestinal secretions into the gastrointestinal tract thereby hampering the digestion.
Hence it is explained that aggravated ''vata'' encompasses the ''agni''. Altered canalicular functions hampers digestion, easily understood in primary biliary cirrhosis wherein biliary secretion is restricted. Atrophy of gastric mucosa reduces HCl secretion causing indigestion. The gastric gland contains three types of exocrine gland cells that secrete their products into stomach lumen.''Srotasam kharatvam'' (hardness in channels) quality of ''tikta rasa'' destroys the exocrine gland cell reducing their secretions. Gastric glands include a type of enteroendocrine cell, the G cell which is located mainly in the pyloric antrum and secretes the hormone gastrin into the blood stream which stimulates parietal cells to secrete HCl and chief cells to secrete pepsinogen, it also contracts the lower esophageal sphincter, increases motility of the stomach and relaxes pyloric sphincter.
Hence it is explained that aggravated ''[[vata]]'' encompasses the ''agni''. Altered canalicular functions hampers digestion, easily understood in primary biliary cirrhosis wherein biliary secretion is restricted. Atrophy of gastric mucosa reduces HCl secretion causing indigestion. The gastric gland contains three types of exocrine gland cells that secrete their products into stomach lumen.''Srotasam kharatvam'' (hardness in channels) quality of ''tikta rasa'' destroys the exocrine gland cell reducing their secretions. Gastric glands include a type of enteroendocrine cell, the G cell which is located mainly in the pyloric antrum and secretes the hormone gastrin into the blood stream which stimulates parietal cells to secrete HCl and chief cells to secrete pepsinogen, it also contracts the lower esophageal sphincter, increases motility of the stomach and relaxes pyloric sphincter.
G cells when get destroyed the above action of ''kapha'', in turn, ''agni'' is hampered so also contraction and relaxation karma of ''vata'' is vitiated.
G cells when get destroyed the above action of ''[[kapha]]'', in turn, ''agni'' is hampered so also contraction and relaxation karma of ''[[vata]]'' is vitiated.
Further ''kashaya rasa'' reduces peristaltic movements called as mixing waves which reduces the maceration and mixing of food with secretions of gastric glands, thus improper chyme is formed. Deficiency of gastrointestinal secretions due to damage to the glands or canaliculi or intestine may be mostly considered as having vātaja origin. Loss of ''pravartana karma'' is to be understood where the transport of secretions is hampered (except in obstructive pathology where ''kapha'' to be considered). Hartnup’s syndrome a defect in neutral amino acid transport and cystinuria a defect in dibasic amino acid transport explain the rare genetic disorders (''Bija Dusti'') involved in protein digestion absorption.
Further ''kashaya rasa'' reduces peristaltic movements called as mixing waves which reduces the maceration and mixing of food with secretions of gastric glands, thus improper chyme is formed. Deficiency of gastrointestinal secretions due to damage to the glands or canaliculi or intestine may be mostly considered as having [[vata]]ja origin. Loss of ''pravartana karma'' is to be understood where the transport of secretions is hampered (except in obstructive pathology where ''[[kapha]]'' to be considered). Hartnup’s syndrome a defect in neutral amino acid transport and cystinuria a defect in dibasic amino acid transport explain the rare genetic disorders (''Bija Dusti'') involved in protein digestion absorption.
Further due to ''vata prakopa'', intestinal activity is increased which is manifested as malabsorption. For e.g. lactose intolerance is related to rate of gastric emptying. Symptoms are more likely when gastric emptying is rapid than when gastric emptying is slower. Therefore it is more likely that skim milk will be associated with symptoms of lactose intolerance than with whole milk as rate of gastric emptying is more rapid in skim milk. Milk proteins, particularly caseins have appropriate amino acids composition for growth and development of young.
Further due to ''[[vata]] prakopa'', intestinal activity is increased which is manifested as malabsorption. For e.g. lactose intolerance is related to rate of gastric emptying. Symptoms are more likely when gastric emptying is rapid than when gastric emptying is slower. Therefore it is more likely that skim milk will be associated with symptoms of lactose intolerance than with whole milk as rate of gastric emptying is more rapid in skim milk. Milk proteins, particularly caseins have appropriate amino acids composition for growth and development of young.
Caseins are highly digestible in intestine and high quality source of amino acids. Most of whey proteins are relatively less digestible in intestine, although all of them are digested to some degree. When substantial whey proteins are not digested fully, some of intact protein may stimulate a localized intestinal or systemic immune response this is due to beta lactoglobullin referred to milk protein allergy. Similarly, diarrhea observed following subtotal gastrectomy is often a result of lactose intolerance as gastric emptying is accelerated in patients with gastrojejunostomy, rapid small intestinal transit time develops symptoms of lactose intolerance.
Caseins are highly digestible in intestine and high quality source of amino acids. Most of whey proteins are relatively less digestible in intestine, although all of them are digested to some degree. When substantial whey proteins are not digested fully, some of intact protein may stimulate a localized intestinal or systemic immune response this is due to beta lactoglobullin referred to milk protein allergy. Similarly, diarrhea observed following subtotal gastrectomy is often a result of lactose intolerance as gastric emptying is accelerated in patients with gastrojejunostomy, rapid small intestinal transit time develops symptoms of lactose intolerance.
Increased appetite (''Kshudha'') is seen because of a negative feedback due to malabsorption or it may be understood under ''rasasheshajeerna''.
Increased appetite (''Kshudha'') is seen because of a negative feedback due to malabsorption or it may be understood under ''rasasheshajeerna''.
''Trishna'' is manifested due to increased ''ruksha guna'' of ''vata'' and decreased ''jaladi ansha'' due to diarrhea and low fluid intake.
''Trishna'' is manifested due to increased ''ruksha [[guna]]'' of ''[[vata]]'' and decreased ''jaladi ansha'' due to diarrhea and low fluid intake.
''Timira'' (blurred vision) results from vitamin A malabsorption and anemia.
''Timira'' (blurred vision) results from vitamin A malabsorption and anemia.
Tinnitus is a symptom also found in ''Pandu'' (anemia)(Ca. Ci. 15/61), which is observed due to malabsorption of essential elements like vitamin B12.
Tinnitus is a symptom also found in ''Pandu'' (anemia)[Cha. Sa. [[Chikitsa Sthana]] 15/61], which is observed due to malabsorption of essential elements like vitamin B12.
Pain in flanks, thigh, pelvis, cervical area occurs due to calcium and Vitamin D malabsorption. Pain is also contributed by protein deficiency due to low nutritional diet, osteoporosis, anemia and decrease lactic acid neutralization due to reduce peripheral circulation.
Pain in flanks, thigh, pelvis, cervical area occurs due to calcium and Vitamin D malabsorption. Pain is also contributed by protein deficiency due to low nutritional diet, osteoporosis, anemia and decrease lactic acid neutralization due to reduce peripheral circulation.
Patient doubts as if he may be suffering from following of the disorders like ''vatavikara, gulma, hridroga'' and ''pleeha''. Due to formation of flatus and later on bloating of abdomen makes the patient feel he is suffering from ''vatika'' disorders related to gastrointestinal tract. Especially ''gulma'' since the patient feels the movement of flatus, so doubts about ''gulma''.
Patient doubts as if he may be suffering from following of the disorders like ''vatavikara, gulma, hridroga'' and ''pleeha''. Due to formation of flatus and later on bloating of abdomen makes the patient feel he is suffering from ''vatika'' disorders related to gastrointestinal tract. Especially ''gulma'' since the patient feels the movement of flatus, so doubts about ''gulma''.
''Ushna'' and ''teekshna guna'' of ''pitta'' trigger inflammatory response by irritating the intestinal mucosa.
''Ushna'' and ''teekshna [[guna]]'' of ''[[pitta]]'' trigger inflammatory response by irritating the intestinal mucosa.
Indigestion causes depletion of beneficial gut bacteria thus breakdown in the balance between the putative protective and harmful intestinal bacteria leads to chronic inflammation.
Indigestion causes depletion of beneficial gut bacteria thus breakdown in the balance between the putative protective and harmful intestinal bacteria leads to chronic inflammation.
Antigenic nature of endogenous factors can be understood when helpful bacteria and ''ushna, teekshna guna'' of ''kapha'' trigger inflammatory response leading to autoimmune pathogenesis.
Antigenic nature of endogenous factors can be understood when helpful bacteria and ''ushna, teekshna [[guna]]'' of [[pitta dosha]] trigger inflammatory response leading to autoimmune pathogenesis.
In case of hypersecretion of gastrin in gastrinoma (Zollingers – Ellison Syndrome) stimulate the parietal cells of the stomach to secrete acid to their maximal capacity and increase the parietal cell mass three to six fold. The acid output may be so great that it reaches the upper small intestine reducing the luminal pH to two or less.
In case of hypersecretion of gastrin in gastrinoma (Zollingers – Ellison Syndrome) stimulate the parietal cells of the stomach to secrete acid to their maximal capacity and increase the parietal cell mass three to six fold. The acid output may be so great that it reaches the upper small intestine reducing the luminal pH to two or less.
Other than excessive secretion, condition like ileal dysfunction caused by either Crohn’s disease or surgical resection results in a decrease in bile acid re absorption in the ileum and an increase in the delivery of bile acids to the large intestine. The resultant is a diarrhea with or without steatorrhea. It becomes a cause for mal-absorption syndrome.
Other than excessive secretion, condition like ileal dysfunction caused by either Crohn’s disease or surgical resection results in a decrease in bile acid re absorption in the ileum and an increase in the delivery of bile acids to the large intestine. The resultant is a diarrhea with or without steatorrhea. It becomes a cause for mal-absorption syndrome.
Inflammatory Bowel Disease needs consideration in ''pittaja grahani''. Exogenous factors trigger inflammatory response that the mucosal immune system may fail to control. With mild inflammation the mucosa is erythematous and in severe condition the mucosa becomes hemorrhagic, edematous and ulcerated (Verse 65).
Inflammatory Bowel Disease needs consideration in ''[[pitta]]ja grahani''. Exogenous factors trigger inflammatory response that the mucosal immune system may fail to control. With mild inflammation the mucosa is erythematous and in severe condition the mucosa becomes hemorrhagic, edematous and ulcerated (Verse 65).
Loose motions (''Drava Mala Pravritti'') are mainly due to excessive secretion of bile juice (''Drava guna'' of ''pitta''). Excessive secretion may be due excessive formation in liver or decrease absorption in the intestine.
Loose motions (''Drava Mala Pravritti'') are mainly due to excessive secretion of bile juice (''Drava [[guna]]'' of ''[[pitta]]''). Excessive secretion may be due excessive formation in liver or decrease absorption in the intestine.
Bile acids are not present in the diet but are synthesized in the liver by a series of enzymatic steps that also include cholesterol catabolism. Bile acids are either primary or secondary. Primary bile acids are synthesized in the liver from cholesterol and secondary bile acids are synthesized from primary bile acids in the intestine by colonic bacterial enzymes. Bile acids are primarily absorbed by active, sodium dependent process that is located exclusively in the ileum; secondly bile acids can also be absorbed to a lesser extent by non carrier mediated transport processes in the jejunum, ileum and colon. Conjugated bile acids that enter the colon are de-conjugated by colonic bacterial enzyme to unconjugated bile acids and are rapidly absorbed. Colonic bacterial enzymes also dehydroxylate bile acids to secondary bile acids, thus if exogenous factors like diet as discussed above disturb the colonic bacterial growth than bile acids are not absorbed. A decrease in the amount of bile acids returning to the liver from the intestine is associated with an increase in bile acids synthesis/cholesterol catabolism, which helps keep bile acid pool size relatively constant. Defects in any of the steps of the enterohepatic circulation of bile acids can result in decrease in duodenal concentration of conjugated bile acids as a result steatorrhea. Thus steatorrhea can be caused by abnormalities in bile acid synthesis and excretion, their physical state in the intestinal lumen and reabsorption. The bile gives the yellowish nature to the stools (Verse 66).
Bile acids are not present in the diet but are synthesized in the liver by a series of enzymatic steps that also include cholesterol catabolism. Bile acids are either primary or secondary. Primary bile acids are synthesized in the liver from cholesterol and secondary bile acids are synthesized from primary bile acids in the intestine by colonic bacterial enzymes. Bile acids are primarily absorbed by active, sodium dependent process that is located exclusively in the ileum; secondly bile acids can also be absorbed to a lesser extent by non carrier mediated transport processes in the jejunum, ileum and colon. Conjugated bile acids that enter the colon are de-conjugated by colonic bacterial enzyme to unconjugated bile acids and are rapidly absorbed. Colonic bacterial enzymes also dehydroxylate bile acids to secondary bile acids, thus if exogenous factors like diet as discussed above disturb the colonic bacterial growth than bile acids are not absorbed. A decrease in the amount of bile acids returning to the liver from the intestine is associated with an increase in bile acids synthesis/cholesterol catabolism, which helps keep bile acid pool size relatively constant. Defects in any of the steps of the enterohepatic circulation of bile acids can result in decrease in duodenal concentration of conjugated bile acids as a result steatorrhea. Thus steatorrhea can be caused by abnormalities in bile acid synthesis and excretion, their physical state in the intestinal lumen and reabsorption. The bile gives the yellowish nature to the stools (Verse 66).
''Guru, snigdha'' and ''seeta ahara'' is dominated by ''prithvi'' and ''jala mahabhuta'', these qualities help in reducing the impact of ''agni mahabhuta'' thus causing ''jatharagni mandyata'' resulting in indigestion leading to formation ''ama''. Such ''ama'' is responsible for ''dosha prakopa''.(Madhukoshatika Ma. Ni. Jwara adhyaya/2)
''Guru, snigdha'' and ''seeta ahara'' is dominated by ''[[prithvi]]'' and ''[[jala mahabhuta]]'', these qualities help in reducing the impact of ''[[agni mahabhuta]]'' thus causing ''jatharagni mandyata'' resulting in indigestion leading to formation ''ama''. Such ''ama'' is responsible for ''[[dosha]] prakopa''.<ref> Madhavakara. Madhava Nidanam (Roga vinischaya) Chap 2, jwara Adhyaya, Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--</ref>
''Klinna''(moist), ''guru, pishtanna''(malt), ''abhishyandi''(which increases secretions) ''ahara''(food) and ''adhyashana''(over eating) are source for extra calories. Fast foods are defined as any food that contributes little or no nutrient values to the diet, but instead provides excess calories and fat. Common foods include salted snack foods, gum, sweet desserts, fried fast foods, carbonated beverages and candy.
''Klinna''(moist), ''guru, pishtanna''(malt), ''abhishyandi''(which increases secretions) ''ahara''(food) and ''adhyashana''(over eating) are source for extra calories. Fast foods are defined as any food that contributes little or no nutrient values to the diet, but instead provides excess calories and fat. Common foods include salted snack foods, gum, sweet desserts, fried fast foods, carbonated beverages and candy.
Diets rich in trans-fatty acids like deep fried fast food, cake mixes, chips and packed cookies, all have inclusion in ''guru, pishtanna, vishtambi''(causing obstruction) ''ahara''. People consuming ''snigdha ahara'' (fatty food) and have sedentary lifestyle with very little energy expenditure, and most fat is stored. The above two concepts explain why ''agnimandya'' and ''ajeerna'' have been mentioned after taking heavy food. Excessive heavy food (''guru ahara'') slows down emptying of stomach (''samana vata karma'' is hampered) and enzymes are not secreted into lumen (''pitta'' action hampered) causing ''agnimandya''.
Diets rich in trans-fatty acids like deep fried fast food, cake mixes, chips and packed cookies, all have inclusion in ''guru, pishtanna, vishtambi''(causing obstruction) ''ahara''. People consuming ''snigdha ahara'' (fatty food) and have sedentary lifestyle with very little energy expenditure, and most fat is stored. The above two concepts explain why ''agnimandya'' and ''ajeerna'' have been mentioned after taking heavy food. Excessive heavy food (''guru ahara'') slows down emptying of stomach (''samana vata karma'' is hampered) and enzymes are not secreted into lumen (''pitta'' action hampered) causing ''agnimandya''.
Substances of ''seeta veerya'' causes constriction reducing the secretion (''stambhana'') of gastrointestinal juices thus hampering lipase activity therefore leading to steatorrhea.
Substances of ''seeta veerya'' causes constriction reducing the secretion (''[[stambhana]]'') of gastrointestinal juices thus hampering lipase activity therefore leading to steatorrhea.
Further heavy meals increase the transit time causing functional stasis which may cause bacterial overgrowth syndrome. Sleeping just after meals may also lead to functional stasis (further study required). Peristalses are also reduced with heavy meals and sleeping after meals causes bacterial overgrowth. Bacteria deconjugate conjugated bile acids and as a result intraduodenal concentration of bile acids will be reduced resulting in steatorrhoea and macrocytic anemia. Bacterial overgrowth also occurs with stasis from a blind loop, small bowel diverticulum or dysmotility.
Further heavy meals increase the transit time causing functional stasis which may cause bacterial overgrowth syndrome. Sleeping just after meals may also lead to functional stasis (further study required). Peristalses are also reduced with heavy meals and sleeping after meals causes bacterial overgrowth. Bacteria deconjugate conjugated bile acids and as a result intraduodenal concentration of bile acids will be reduced resulting in steatorrhoea and macrocytic anemia. Bacterial overgrowth also occurs with stasis from a blind loop, small bowel diverticulum or dysmotility.
Nausea and vomiting are both caused by stimulation at one of the four sites: the gastrointestinal tract, the vestibular system, the chemoreceptor trigger zone and the cerebral cortex. Nausea and vomiting occurs due to disturbed gastric motility caused by heavy meal and delayed gastric emptying. The same is the cause for heavy abdomen and eructation with foul smell and sweet taste. As the food stays for long time in gastrointestinal tract blood flow increases centrally and reduces the enthusiasm and decrease in libido. The sluggish activity of gastrointestinal tract causes symptoms such as absence of movement in the abdomen (''udaram stimitam guru''). The heavy abdomen puts pressure on the diaphragm causing symptoms of heaviness in chest (''hridayam manyate styanam'').
Nausea and vomiting are both caused by stimulation at one of the four sites: the gastrointestinal tract, the vestibular system, the chemoreceptor trigger zone and the cerebral cortex. Nausea and vomiting occurs due to disturbed gastric motility caused by heavy meal and delayed gastric emptying. The same is the cause for heavy abdomen and eructation with foul smell and sweet taste. As the food stays for long time in gastrointestinal tract blood flow increases centrally and reduces the enthusiasm and decrease in libido. The sluggish activity of gastrointestinal tract causes symptoms such as absence of movement in the abdomen (''udaram stimitam guru''). The heavy abdomen puts pressure on the diaphragm causing symptoms of heaviness in chest (''hridayam manyate styanam'').
Bacterial overgrowth due to undigested ''guru, klinna, snigdha'' and ''abhishyandi ahara'' causes increased mucoid secretion, thus formed stool is not observed instead ''bhinnamashleshma-samsrishta varcha''(loose stools with ''ama'' and ''kapha'') is seen; which is also cause for heaviness of stools (''guru-varchah-pravartanam'') Due to diet pattern and sedentary lifestyle there is accumulation of fat (obesity) but due to decrease protein absorption and malabsorption of essential elements patient feels weakness and laziness without weight loss (Verse 68-70).
Bacterial overgrowth due to undigested ''guru, klinna, snigdha'' and ''abhishyandi ahara'' causes increased mucoid secretion, thus formed stool is not observed instead ''bhinnamashleshma-samsrishta varcha''(loose stools with ''ama'' and ''[[kapha]]'') is seen; which is also cause for heaviness of stools (''guru-varchah-pravartanam'') Due to diet pattern and sedentary lifestyle there is accumulation of fat (obesity) but due to decrease protein absorption and malabsorption of essential elements patient feels weakness and laziness without weight loss (Verse 68-70).
Normalcy of ''vata pitta'' and ''kapha'' keeps the ''agni'' in balanced condition, it means that a specific pH is maintained (''pitta''); secretion, transportation and villi movement are normal (''vata'') and mucosal bed secretes normal mucus and is healthy (''kapha''), thus maintains ''samagni'' or a normal digestive process (Verse 71).
Normalcy of ''[[vata]] [[pitta]]'' and ''[[kapha]]'' keeps the ''agni'' in balanced condition, it means that a specific pH is maintained (''[[pitta]]''); secretion, transportation and villi movement are normal (''[[vata]]'') and mucosal bed secretes normal mucus and is healthy (''[[kapha]]''), thus maintains ''samagni'' or a normal digestive process (Verse 71).
Protein losing enteropathy is increased protein loss into the gastrointestinal tract which is classified into three groups.
Protein losing enteropathy is increased protein loss into the gastrointestinal tract which is classified into three groups.
#Mucosal ulceration; there is protein loss by exudation across damaged mucosa e.g. Ulcerative colitis, peptic ulcer, gastro intestinal carcinoma. In such cases dominance of ''pitta dosha'' needs to be considered.
#Mucosal ulceration; there is protein loss by exudation across damaged mucosa e.g. Ulcerative colitis, peptic ulcer, gastro intestinal carcinoma. In such cases dominance of ''[[pitta dosha]]'' needs to be considered.
#Non ulcerated mucosa but evidence of mucosal damage; Protein loss primarily represents loss across epithelia with altered permeability e.g. celiac sprue and menetrier’s disease in small intestine and stomach respectively, ''vata dosha'' and/or ''kapha dosha'' dominance should be considered.
#Non ulcerated mucosa but evidence of mucosal damage; Protein loss primarily represents loss across epithelia with altered permeability e.g. celiac sprue and menetrier’s disease in small intestine and stomach respectively, ''[[vata dosha]]'' and/or ''[[kapha dosha]]'' dominance should be considered.
#Lymphatic dysfunction, represents either primary lymphatic disease or secondary to partial lymphatic obstruction that may occur as a result of enlarged lymph nodes or cardiac disease. Patient with increased protein loss into gastrointestinal tract due to lymphatic obstruction often have steatorrhea and diarrhea. The steatorrhea is a result of altered lymphatic flow as lipid containing chylomicrons exit from intestinal epithelial cells via intestinal lymphatic’s which may be compared with flow of ''ahara rasa'' and/ or presence of ''vata'' and ''kapha''.
#Lymphatic dysfunction, represents either primary lymphatic disease or secondary to partial lymphatic obstruction that may occur as a result of enlarged lymph nodes or cardiac disease. Patient with increased protein loss into gastrointestinal tract due to lymphatic obstruction often have steatorrhea and diarrhea. The steatorrhea is a result of altered lymphatic flow as lipid containing chylomicrons exit from intestinal epithelial cells via intestinal lymphatic’s which may be compared with flow of ''ahara rasa'' and/ or presence of ''[[vata]]'' and ''[[kapha]]''.
Genetic factors (''bija dushti'') almost all patients with celiac sprue express the HLA-DQ2 allele. Environmental factor, gliadin a component of gluten that is present in wheat, barley and rye contributes to the disease. Immunologic component (''prayatna, bala'' and ''urja'' of ''vata, kapha'' and ''pitta'' respectively), serum antibodies – IgA antigliadin, IgA antiendomyasial and IgA antibodies and IgG antibodies are present. In addition, gliadin peptides may interact with gliadin specific T cells that may either mediate tissue injury or induce the release of one or more cytokines that cause tissue injury (Verse 72).
Genetic factors (''bija dushti'') almost all patients with celiac sprue express the HLA-DQ2 allele. Environmental factor, gliadin a component of gluten that is present in wheat, barley and rye contributes to the disease. Immunologic component (''prayatna, bala'' and ''urja'' of ''[[vata]], [[kapha]]'' and ''[[pitta]]'' respectively), serum antibodies – IgA antigliadin, IgA antiendomyasial and IgA antibodies and IgG antibodies are present. In addition, gliadin peptides may interact with gliadin specific T cells that may either mediate tissue injury or induce the release of one or more cytokines that cause tissue injury (Verse 72).
Further research shows that incase of uncontrolled growth of gut microbiome, flushing of gut reduces both psycho-somatic symptoms. ''Shodhana'' therapy not only flushes the vitiated gut microbiome but also flushes out the substrata due to which growth of microbiome is controlled (Verse 73-74).
Further research shows that incase of uncontrolled growth of gut microbiome, flushing of gut reduces both psycho-somatic symptoms. ''[[Shodhana]]'' therapy not only flushes the vitiated gut microbiome but also flushes out the substrata due to which growth of microbiome is controlled (Verse 73-74).
''Kshara'' has been advised along with ''tilvaka sneha; kshara'' has alkaline pH. In duodenum and small intestine, enzymes with alkaline pH are secreted. ''Ushna, teekshna'' and ''laghu guna'' help in digestion. ''Kledayati ado paschata visoshayati''(Ca. Vi. 1/17 ) i.e. secretion are first increased and later on absorbed is very essential in ''grahani dosha''. Both these actions help in secretion of digestive enzymes thereby increasing ''agni'' and by absorption correct the malabsorption. Therefore use of ''kshara'' is more in ''grahani dosha'' and ''gulma'' (Verse 79).
''Kshara'' has been advised along with ''tilvaka sneha; kshara'' has alkaline pH. In duodenum and small intestine, enzymes with alkaline pH are secreted. ''Ushna, teekshna'' and ''laghu [[guna]]'' help in digestion. ''Kledayati ado paschata visoshayati''[Cha.Sa.[[ Vimana Sthana]] 1/17 ] i.e. secretion are first increased and later on absorbed is very essential in ''grahani dosha''. Both these actions help in secretion of digestive enzymes thereby increasing ''agni'' and by absorption correct the malabsorption. Therefore use of ''kshara'' is more in ''grahani dosha'' and ''gulma'' (Verse 79).
''Aranala''(a fermented preparation), ''dadhimanda''(curd whey) or ''sauviraka'' are all fermented liquids. Fermented liquids contain probiotic organisms. Probiotic foods are produced by chemical action of lactic acid, bacteria, yeast or combination of both. These useful microorganisms help in breaking down carbohydrates, sugars making them easily digestible. Probiotics improves absorption of nutrients; improve synthesis of vitamins, essential fatty acids and enhance nutritional qualities of food grains. Fermented foods increase the absorption of vital minerals from gastrointestinal tract thus preventing mineral deficiencies and also treat the diarrhea. It explains the role of helpful gut microbiome (Verse 82-86). Use of fermented products explains the concept of gut microbiome and use of ''kshara'' and ''amla'' drug for maintaining pH (Verse 88-93).
''Aranala''(a fermented preparation), ''dadhimanda''(curd whey) or ''sauviraka'' are all fermented liquids. Fermented liquids contain probiotic organisms. Probiotic foods are produced by chemical action of lactic acid, bacteria, yeast or combination of both. These useful microorganisms help in breaking down carbohydrates, sugars making them easily digestible. Probiotics improves absorption of nutrients; improve synthesis of vitamins, essential fatty acids and enhance nutritional qualities of food grains. Fermented foods increase the absorption of vital minerals from gastrointestinal tract thus preventing mineral deficiencies and also treat the diarrhea. It explains the role of helpful gut microbiome (Verse 82-86). Use of fermented products explains the concept of gut microbiome and use of ''kshara'' and ''amla'' drug for maintaining pH (Verse 88-93).
''Vamana'' (medicated emesis) reduces gastro-paresis by emptying the gastrointestinal contents (Verse 101-102).
''[[Vamana]]'' (medicated emesis) reduces gastro-paresis by emptying the gastrointestinal contents (Verse 101-102).
Fermented liquids are rich source of gut microbiome which will help to replace the unhealthy microbiome. These fermented liquids also help to balance the pH of the gastrointestinal tract. Further study is required to decide impact of above mentioned liquid diet on pH and specific enzymes (Verse 115-116).
Fermented liquids are rich source of gut microbiome which will help to replace the unhealthy microbiome. These fermented liquids also help to balance the pH of the gastrointestinal tract. Further study is required to decide impact of above mentioned liquid diet on pH and specific enzymes (Verse 115-116).
Hypermetabolism is accompanied by a variety of internal and external symptoms most notably extreme weight loss. External symptoms of hypermetabolism may include anemia, fatigue, elevated heart rate, irregular heartbeat, insomnia, shortness of breath, dysautonomia, muscle weakness, excessive sweating while internal symptoms include peripheral insulin resistance, elevated catabolism of proteins, carbohydrates triglycerides and negative nitrogen in the body.
Hypermetabolism is accompanied by a variety of internal and external symptoms most notably extreme weight loss. External symptoms of hypermetabolism may include anemia, fatigue, elevated heart rate, irregular heartbeat, insomnia, shortness of breath, dysautonomia, muscle weakness, excessive sweating while internal symptoms include peripheral insulin resistance, elevated catabolism of proteins, carbohydrates triglycerides and negative nitrogen in the body.
In this context there is increased function due to excess secretion of thyroid hormones. Thyroid hormones act as catabolic hormones and promote calorigenesis and develops hypermetabolic state which may result in gluconeogenesis, lipolysis and glycogenolysis causing decreased muscle mass and weight loss. Metabolic rate is enhanced, because of vitiated ''pitta'' and associated ''vata''.
In this context there is increased function due to excess secretion of thyroid hormones. Thyroid hormones act as catabolic hormones and promote calorigenesis and develops hypermetabolic state which may result in gluconeogenesis, lipolysis and glycogenolysis causing decreased muscle mass and weight loss. Metabolic rate is enhanced, because of vitiated ''[[pitta]]'' and associated ''[[vata]]''.
This is the condition where increased appetite with weight loss is seen due to insufficient supply of nutrients in relation to ''agnibala''. Thyroid storm/ thyroid-toxic crisis is rare and life threatening exacerbation of hyperthyroidism, accompanied by fever, delirium, seizures, vomiting, diarrhea and jaundice. Death may occur due to cardiac failure, arrhythmia and hyperthermia.
This is the condition where increased appetite with weight loss is seen due to insufficient supply of nutrients in relation to ''agnibala''. Thyroid storm/ thyroid-toxic crisis is rare and life threatening exacerbation of hyperthyroidism, accompanied by fever, delirium, seizures, vomiting, diarrhea and jaundice. Death may occur due to cardiac failure, arrhythmia and hyperthermia.
''Kleda'' can also be considered as inter-mediory product of metabolism like ketones, pyruvate, lactate which are well utilized in active/healthy persons as fuel and therefore does not cause inflammation/disease process (Verse 237-239).
''Kleda'' can also be considered as inter-mediory product of metabolism like ketones, pyruvate, lactate which are well utilized in active/healthy persons as fuel and therefore does not cause inflammation/disease process (Verse 237-239).
=== Current clinical practices ===
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=== Areas of Further Research ===
=== Areas of Further Research ===
*To study ''asava'' and ''arishta'' in relation with microbioma.
*To study ''asava'' and ''arishta'' in relation with gut microbial flora.
*To understand concept of ''ama'' with relation to autoimmune diseases.
*To understand concept of ''ama'' with relation to autoimmune diseases.
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== References ==
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