Difference between revisions of "Prasrita Yogiyam Siddhi"

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{{#seo:
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|title=Prasrita Yogiyam Siddhi
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|titlemode=append
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|keywords=atisara, basti, doshanulomana, grahi, karsha, karmanaviplutanam, niruha, pachana, Panchakarma, prasrita, prastha, snehabasti, vyapat, enema in delicate persons, complication of Panchakarma,Ayurveda, Indian system of medicine, charak samhita.
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|description=Siddhi Sthana Chapter 8. Standardized therapeutic enema formulations in a dose of ''Prasrita'' Unit
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|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
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|image_alt=charak samhita
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|type=article
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}}
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<big>'''[[Siddhi Sthana]] Chapter 8. Standardized therapeutic enema formulations in a dose of ''Prasrita'' Unit'''</big>
 
{{Infobox
 
{{Infobox
 
|title =  Prasrita Yogiyam Siddhi
 
|title =  Prasrita Yogiyam Siddhi
Line 4: Line 15:
 
|data1 = [[Siddhi Sthana]] Chapter 8
 
|data1 = [[Siddhi Sthana]] Chapter 8
 
|label2 = Preceding Chapter
 
|label2 = Preceding Chapter
|data2 = [[Vamana Virechana Vyapat Siddhi]]
+
|data2 = [[Bastivyapat Siddhi]]
 
|label4 = Succeeding Chapter
 
|label4 = Succeeding Chapter
 
|data4 = [[Trimarmiya Siddhi]]
 
|data4 = [[Trimarmiya Siddhi]]
 
|label5 = Other Sections
 
|label5 = Other Sections
 
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]],  [[Sharira Sthana]],  [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]
 
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]],  [[Sharira Sthana]],  [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]
 
+
|label6 = Translator and commentator
|header3 =  
+
|data6 = Gupta S.N.
 
+
|label7 = Reviewer
 +
|data7  = Panse A.
 +
|label8 = Editors
 +
|data8  = Thakar A. B., Mangalasseri P., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
 +
|label9 = Year of publication
 +
|data9 =  2020
 +
|label10 = Publisher
 +
|data10 =  [[Charak Samhita Research, Training and Skill Development Centre]]
 +
|label11 = DOI
 +
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s08.009 10.47468/CSNE.2020.e01.s08.009]
 
}}
 
}}
 +
<big>''' Abstract </big>'''
 +
<p style="text-align:justify;">This chapter describes recipes of ''prasritayogiya bastis'' (enema formulation in which ingredients are measured in unit of ''prasrita''). ''Prasrita'' is a measurement, which is approximately equal to 100 millilitre.  Nine types of ''[[basti]]'' therapies for various clinical conditions including ''prameha'' (urinary disorders including diabetes), ''abhishyanda'' (oozing), ''kushtha'' (skin diseases), ''krimi'' (worm infestation), ''mutrakrichchra'' (dysuria) and alike are described. ''Atisara'', a clinical condition characterized by frequent defecation with altered composition and consistency of stool is described in detail. ''Atisara'' has various forms depending upon involvement of six morbid components in the pathogenesis viz. ''ama'' (stool with undigested material), ''shakrita'' (stool only), ''[[vata]]'' (with dominant flatulence), ''asrik'' (stool with blood), ''[[pitta]]'' and ''[[kapha]]''. Different recipes of ''[[basti]]'', oral medicaments and food preparations are described to treat these ''atisara'' conditions. These remedies are practically quite useful in several modern diseases like ulcerative colitis and irritable bowel syndrome.
 +
<br/>
 +
'''Keywords''':  ''atisara, [[basti]], doshanulomana, grahi, karsha, karmanaviplutanam, niruha, [[pachana]],'' [[Panchakarma]], ''prasrita, prastha,  snehabasti, vyapat,'' enema in delicate persons, complication of [[Panchakarma]].
 +
</p>
  
==([[Siddhi Sthana]] Chapter 8, Chapter on Successful ''basti'' formulations in ''Prasrita'' Unit) ==
 
  
=== Abstract ===
+
== Introduction ==
 +
<div style="text-align:justify;">
 +
There are two main types of ''[[basti]]'' according to the composition and the action. ''Anuvasana basti'' is composed of unctuous substance and it is to be retained for minimum nine hours. ''Asthapana basti'' contains mainly decoction with least oil and is evacuated after few minutes. ''[[Basti]]'' is administered through ano-rectal route and acting through the ''pakvashaya'' (colon). It is useful in several diseases particularly [[vata]] disorders having roots in ''pakvashaya''. It is claimed to be half a treatment or even a complete treatment by ancient practitioners<ref>Charak. Siddhi Sthana, Cha.1 Kalpana Siddhi Adhyaya verse 38-40. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi:Munshiram Manoharlal publishers pvt. Ltd; 1981; P 683-684.</ref>. It is not only a procedure of ''[[shodhana]]'' but also providing a recto-colonic route of drug administration.
  
This chapter describes recipes of ''prasritayogiya bastis'' (enema formulation in which ingredients are measured in unit of ''prasrita''). ''Prasrita'' is a measurement, which is approximately equal to 100 milliliter.  Nine types of ''basti'' therapies for various clinical conditions including ''prameha'' (urinary disorders including diabetes), ''abhishyanda'' (oozing), ''kushtha'' (skin diseases), ''krimi'' (worm infestation), ''mutrakrichchra'' (dysuria) and alike are described. ''Atisara'', a clinical condition characterized by frequent defecation with altered composition and consistency of stool is described in detail. ''Atisara'' has various forms depending upon involvement of six morbid components in the pathogenesis viz. ''ama'' (stool with undigested material), ''shakrita'' (stool only), ''vata'' (with dominant flatulence), ''asrik'' (stool with blood), ''pitta'' and ''kapha''. Different recipes of ''basti'', oral medicaments and food preparations are described to treat these ''atisara'' conditions. These remedies are practically quite useful in several modern diseases like ulcerative colitis and irritable bowel syndrome.
+
Previous chapter ([[Bastivyapat Siddhi]]) deals with the ''vyapat'' (complications) arising due to faulty application of ''[[basti]]s''. Present chapter begins with the treatment of those patients who developed complications as a result of faulty application of therapies (''karmana viplutanam'') and for the tender persons who are not able to tolerate strong measures. For this purpose, chapter describes mild form of ''niruha bastis''. The ingredients of these ''[[basti]]s'' are measured in the unit of ''prasrita''. Therefore the name of the chapter is [[Prasrita Yogiyam Siddhi]]. The unit ''prasrita'' is equal to two ''palas'', which is approximately equal to 100 milliliter (1 ''pala''= approx. 50 ml).<ref>Chakrapani, Charak. Siddhi Sthana, Cha.8 Bastivyapad Siddhi ver.04. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed.New Delhi:Munshiram Manoharlal publishers pvt. Ltd; 1981; P 713</ref><ref>Agnihotri Avadhabihari; Bhaiṣajyakalpanā Vijñāna; Chaukhamba orientalia publication, 6th edition, 2006, P 7-20</ref>
  
'''Keywords''':  ''atisara, basti, doshanulomana, grahi, karsha, karmanaviplutanam, niruha, pachana,'' [[Panchakarma]], ''prasrita, prastha,  snehabasti, vyapat,'' enema in delicate persons, complication of [[Panchakarma]].
+
== Sanskrit text, Transliteration and English Translation ==
 
+
<div class="mw-collapsible mw-collapsed">
=== Introduction ===
 
 
 
There are two main types of ''basti'' according to the composition and the action. ''Anuvasana basti'' is composed of unctuous substance and it is to be retained for minimum nine hours. ''Asthapana basti'' contains mainly decoction with least oil and is evacuated after few minutes. ''Basti'' is administered through ano-rectal route and acting through the ''pakvashaya'' (colon). It is useful in several diseases particularly vata disorders having roots in ''pakvashaya''. It is claimed to be half a treatment or even a complete treatment by ancient practitioners (Ca.Si.1/38-40)[ ]. It is not only a procedure of ''shodhana'' but also providing a recto-colonic route of drug administration.
 
 
 
Previous chapter ([[Bastivyapat Siddhi]]) deals with the ''vyapat'' (complications) arising due to faulty application of ''bastis''. Present chapter begins with the treatment of those patients who developed complications as a result of faulty application of therapies (''karmana viplutanam'') and for the tender persons who are not able to tolerate strong measures. For this purpose, chapter describes mild form of ''niruha bastis''. The ingredients of these ''bastis'' are measured in the unit of ''prasrita''. Therefore the name of the chapter is [[Prasrita Yogiyam Siddhi]]. The unit ''prasrita'' is equal to two ''palas'', which is approximately equal to 100 milliliter (1 ''pala''= approx. 50 ml). [ ],[ ].
 
 
 
===Sanskrit text, Transliteration and English Translation===
 
  
 
अथातः प्रासृतयोगीयां सिद्धिं व्याख्यास्यामः||१||  
 
अथातः प्रासृतयोगीयां सिद्धिं व्याख्यास्यामः||१||  
  
 
इति ह स्माह भगवानात्रेयः||२||
 
इति ह स्माह भगवानात्रेयः||२||
 +
<div class="mw-collapsible-content">
  
 
Athātaḥ prāsṛtayōgīyāṁ siddhiṁ vyākhyāsyāmaḥ ||1||  
 
Athātaḥ prāsṛtayōgīyāṁ siddhiṁ vyākhyāsyāmaḥ ||1||  
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iti ha smAha bhagavAnAtreyaH||2||
 
iti ha smAha bhagavAnAtreyaH||2||
 +
</div></div>
 +
 +
Now we shall expound the chapter "Prasrita Yogiyam Siddhi" (Standardized therapeutic enema formulations in a dose of ''Prasrita'' Unit). Thus said Lord Atreya. [1-2]
  
Now, we shall discuss the chapter [[Prasrita Yogiyam Siddhi]] (the chapter of [[Siddhi Sthana]] which describes the ''basti'' procedures with recipes having ingredients measured in the unit ''prasrita''). Thus, said Lord Atreya. [1-2]
+
Note: The chapter describes the formulations having ingredients measured in the unit ''prasrita''(approximately equal to 100 millilitre).
  
==== Objective of ''prasrita basti'' ====
+
=== Objective of ''prasrita basti'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
अथेमान् सुकुमाराणां निरूहान् स्नेहनान् मृदून्|  
 
अथेमान् सुकुमाराणां निरूहान् स्नेहनान् मृदून्|  
 +
 
कर्मणा विप्लुतानां च वक्ष्यामि प्रसृतैः पृथक्||३||  
 
कर्मणा विप्लुतानां च वक्ष्यामि प्रसृतैः पृथक्||३||  
 +
<div class="mw-collapsible-content">
  
 
athēmān sukumārāṇāṁ nirūhān snēhanān  mṛdūn|  
 
athēmān sukumārāṇāṁ nirūhān snēhanān  mṛdūn|  
 +
 
karmaṇā viplutānāṁ ca vakṣyāmi prasṛtaiḥ pṛthak||3||
 
karmaṇā viplutānāṁ ca vakṣyāmi prasṛtaiḥ pṛthak||3||
  
 
athemAn sukumArANAM nirUhAn snehanAn mRudUn|  
 
athemAn sukumArANAM nirUhAn snehanAn mRudUn|  
 +
 
karmaNA viplutAnAM ca vakShyAmi prasRutaiH pRuthak||3||
 
karmaNA viplutAnAM ca vakShyAmi prasRutaiH pRuthak||3||
 +
</div></div>
  
Now, I (Atreya) shall explain oleaginous and mild form of ''niruha bastis'', for the tender persons and the patients suffered from complications as a result of therapies. Composition of those will be in the unit of ''prasrita''. [3]
+
Now, I (Atreya) shall explain oleaginous and mild form of ''niruha [[basti]]s'', for the tender persons and the patients suffered from complications as a result of therapies. Composition of those will be in the unit of ''prasrita''. [3]
  
==== ''Pancha prasritiki Basti''-I ====
+
=== ''Pancha prasritiki Basti''-I ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
क्षीराद्द्वौ प्रसृतौ कार्यौ मधुतैलघृतात्त्रयः|  
 
क्षीराद्द्वौ प्रसृतौ कार्यौ मधुतैलघृतात्त्रयः|  
 +
 
खजेन मथितो बस्तिर्वातघ्नो बलवर्णकृत्||४||  
 
खजेन मथितो बस्तिर्वातघ्नो बलवर्णकृत्||४||  
 +
<div class="mw-collapsible-content">
  
 
kṣīrāddvau prasṛtau kāryau madhutailaghṛtāttrayaḥ|  
 
kṣīrāddvau prasṛtau kāryau madhutailaghṛtāttrayaḥ|  
 +
 
khajēna mathitō bastirvātaghno balavarṇakṛt||4||  
 
khajēna mathitō bastirvātaghno balavarṇakṛt||4||  
  
 
kShIrAddvau prasRutau kAryau madhutailaghRutAttrayaH|  
 
kShIrAddvau prasRutau kAryau madhutailaghRutAttrayaH|  
 +
 
khajena mathito bastirvAtaghno balavarNakRut||4||  
 
khajena mathito bastirvAtaghno balavarNakRut||4||  
 +
</div></div>
  
Two ''prasritas'' of milk and three ''prasritas'' of ''madhu'' (honey), ''taila'' (sesame oil) and ''ghrita'' (clarified butter) are taken together and churned with a churning stick. This ''basti'' eliminates ''vata'', and promotes strength as well as complexion. [4]
+
Two ''prasritas'' of milk and three ''prasritas'' of ''madhu'' (honey), ''taila'' (sesame oil) and ''ghrita'' (clarified butter) are taken together and churned with a churning stick. This ''[[basti]]'' eliminates ''[[vata]]'', and promotes strength as well as complexion. [4]
  
==== ''Ashta-prasritiki basti'' ====
+
=== ''Ashta-prasritiki basti'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
एकैकः प्रसृतस्तैलप्रसन्नाक्षौद्रसर्पिषाम्|  
 
एकैकः प्रसृतस्तैलप्रसन्नाक्षौद्रसर्पिषाम्|  
 +
 
बिल्वादिमूलक्वाथाद्द्वौ कौलत्थाद्द्वौ स वातनुत्||५||  
 
बिल्वादिमूलक्वाथाद्द्वौ कौलत्थाद्द्वौ स वातनुत्||५||  
 +
<div class="mw-collapsible-content">
  
 
ēkaikaḥ prasṛtastailaprasannākṣaudrasarpiṣām|  
 
ēkaikaḥ prasṛtastailaprasannākṣaudrasarpiṣām|  
 +
 
bilvādimūlakvāthāddvau kaulatthāddvau sa vātanut||5||  
 
bilvādimūlakvāthāddvau kaulatthāddvau sa vātanut||5||  
  
 
ekaikaH prasRutastailaprasannAkShaudrasarpiShAm|  
 
ekaikaH prasRutastailaprasannAkShaudrasarpiShAm|  
 +
 
bilvAdimUlakvAthAddvau kaulatthAddvau sa vAtanut||5||  
 
bilvAdimUlakvAthAddvau kaulatthAddvau sa vAtanut||5||  
 +
</div></div>
  
''Basti'', composed of one ''prasrita'' each of ''taila'' (sesame oil), ''prasanna''(supernatant part of ''sura''- a type of alcoholic preparation), ''kshaudra'' (honey) and ''ghrita'' (clarified butter) and two ''prasritas'' each of the decoctions of roots of ''bilvadi'' (a group of plants that begins with ''bilva''-Aegle marmelos Carr.) as well as two ''prasritas'' of ''kulattha'' (Phaseolus biflorus Linn.), antagonizes ''vata''. [5]
+
''[[Basti]]'', composed of one ''prasrita'' each of ''taila'' (sesame oil), ''prasanna''(supernatant part of ''sura''- a type of alcoholic preparation), ''kshaudra'' (honey) and ''ghrita'' (clarified butter) and two ''prasritas'' each of the decoctions of roots of ''bilvadi'' (a group of plants that begins with ''bilva''-Aegle marmelos Carr.) as well as two ''prasritas'' of ''kulattha'' (Phaseolus biflorus Linn.), antagonizes ''[[vata]]''. [5]
  
==== ''Nava--prasritiki basti'' ====
+
=== ''Nava--prasritiki basti'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
पञ्चमूलरसात् पञ्च द्वौ तैलात् क्षौद्रसर्पिषोः|  
 
पञ्चमूलरसात् पञ्च द्वौ तैलात् क्षौद्रसर्पिषोः|  
 +
 
एकैकः प्रसृतो बस्तिः स्नेहनीयोऽनिलापहः||६||
 
एकैकः प्रसृतो बस्तिः स्नेहनीयोऽनिलापहः||६||
 +
<div class="mw-collapsible-content">
  
pañcamūlarasāt pañca dvau tailāt kṣaudrasarpiṣoḥ|  
+
pañcamūlarasāt pañca dvau tailāt kṣaudrasarpiṣoḥ|
 +
 
ēkaikaḥ prasṛto bastiḥ snēhanīyō'nilāpahaḥ||6||
 
ēkaikaḥ prasṛto bastiḥ snēhanīyō'nilāpahaḥ||6||
  
 
pa~jcamUlarasAt pa~jca dvau tailAt kShaudrasarpiShoH|  
 
pa~jcamUlarasAt pa~jca dvau tailAt kShaudrasarpiShoH|  
 +
 
ekaikaH prasRuto bastiH snehanIyo~anilApahaH||6||
 
ekaikaH prasRuto bastiH snehanIyo~anilApahaH||6||
 +
</div></div>
  
''Basti'' prepared with five ''prasritas'' of the decoction of ''panchamula'' (''bilva, shyonaka, gambhari, patala'' and ''agnimantha''), two ''prasritas'' of ''taila'' (sesame oil) and one ''prasrita'' each of ''kshaudra'' (honey) as well as ''sarpi'' (''ghrita''), oleates (the body) and expels ''vata''. [6]
+
''[[Basti]]'' prepared with five ''prasritas'' of the decoction of ''panchamula'' (''bilva, shyonaka, gambhari, patala'' and ''agnimantha''), two ''prasritas'' of ''taila'' (sesame oil) and one ''prasrita'' each of ''kshaudra'' (honey) as well as ''sarpi'' (''ghrita''), oleates (the body) and expels ''[[vata]]''. [6]
  
==== ''Chatu-prasritiki basti''-I ====
+
=== ''Chatu-prasritiki basti''-I ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
सैन्धवार्धाक्ष एकैकः क्षौद्रतैलपयोघृतात्|  
 
सैन्धवार्धाक्ष एकैकः क्षौद्रतैलपयोघृतात्|  
 +
 
प्रसृतो  हपुषाकर्षो निरूहः शुक्रकृत् परम्||७||
 
प्रसृतो  हपुषाकर्षो निरूहः शुक्रकृत् परम्||७||
 +
<div class="mw-collapsible-content">
  
 
saindhavārdhākṣa ēkaikaḥ kṣaudratailapayōghṛtāt|  
 
saindhavārdhākṣa ēkaikaḥ kṣaudratailapayōghṛtāt|  
 +
 
prasṛtō  hapuṣākarṣō nirūhaḥ śukrakṛt param||7||
 
prasṛtō  hapuṣākarṣō nirūhaḥ śukrakṛt param||7||
  
 
saindhavArdhAkSha ekaikaH kShaudratailapayoghRutAt|  
 
saindhavArdhAkSha ekaikaH kShaudratailapayoghRutAt|  
 +
 
prasRuto  hapuShAkarSho nirUhaH shukrakRut param||7||
 
prasRuto  hapuShAkarSho nirUhaH shukrakRut param||7||
 +
</div></div>
  
Nirūha basti, prepared with half akṣa (about 6 grams) of saindhava (rock salt) one prasṛta each of honey, sesame oil, milk, and ghṛta, and one karṣa (about 12 grams) of hapuṣā (Juniperus communis Linn.), is an excellent promoter of śukra. (7)
+
''Niruha basti'', prepared with half ''aksha'' (about 6 grams) of ''saindhava'' (rock salt) one ''prasrita'' each of honey, sesame oil, milk, and ''ghrita'', and one ''karsha'' (about 12 grams) of ''hapusha'' (Juniperus communis Linn.), is an excellent promoter of ''shukra''. [7]
  
==== ''Panchatikta niruha basti'' ====
+
=== ''Panchatikta niruha basti'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
पटोलनिम्बभूनिम्बरास्नासप्तच्छदाम्भसः|  
 
पटोलनिम्बभूनिम्बरास्नासप्तच्छदाम्भसः|  
 +
 
चत्वारः प्रसृता एको घृतात् सर्षपकल्कितः||८||  
 
चत्वारः प्रसृता एको घृतात् सर्षपकल्कितः||८||  
 +
 
निरूहः पञ्चतिक्तोऽयं मेहाभिष्यन्दकुष्ठनुत्  |९|
 
निरूहः पञ्चतिक्तोऽयं मेहाभिष्यन्दकुष्ठनुत्  |९|
 +
<div class="mw-collapsible-content">
 +
 
paṭōlanimbabhūnimbarāsnāsaptacchadāmbhasaḥ|  
 
paṭōlanimbabhūnimbarāsnāsaptacchadāmbhasaḥ|  
 +
 
catvāraḥ prasṛtā ēkō ghṛtāt sarṣapakalkitaḥ||8||  
 
catvāraḥ prasṛtā ēkō ghṛtāt sarṣapakalkitaḥ||8||  
 +
 
nirūhaḥ pañcatiktō'yaṁ mēhābhiṣyandakuṣṭhanut  |9|
 
nirūhaḥ pañcatiktō'yaṁ mēhābhiṣyandakuṣṭhanut  |9|
  
 
paTolanimbabhUnimbarAsnAsaptacchadAmbhasaH|  
 
paTolanimbabhUnimbarAsnAsaptacchadAmbhasaH|  
 +
 
catvAraH prasRutA eko ghRutAt sarShapakalkitaH||8||  
 
catvAraH prasRutA eko ghRutAt sarShapakalkitaH||8||  
 +
 
nirUhaH pa~jcatikto~ayaM mehAbhiShyandakuShThanut |9|
 
nirUhaH pa~jcatikto~ayaM mehAbhiShyandakuShThanut |9|
 +
</div></div>
  
A basti prepared by mixing four prasṛtas of decoction of paṭōla (Trichosanthes dioica Roxb.), nimba (Azadirachta indica A.Juss.), bhūnimba (Andrographis paniculata Nees.), rāsnā (Pluchea lanceolata Oliver &Hiern.), saptacchadā (Alstonia scholaris R.Br.); one prasṛta of ghṛta, mixed with a kalka (paste) of sarṣapa (Brassica campestris Linn.) is known as pañchatikta nirūha and is acting against prameha, abhiṣyanda and kuṣṭha. (8-8½)
+
A ''[[basti]]'' prepared by mixing four ''prasritas'' of decoction of ''patola'' (Trichosanthes dioica Roxb.), ''nimba'' (Azadirachta indica A.Juss.), ''bhunimba'' (Andrographis paniculata Nees.), ''rasna'' (Pluchea lanceolata Oliver &Hiern.), ''saptacchada'' (Alstonia scholaris R.Br.); one ''prasrita'' of ''ghrita'', mixed with a ''kalka'' (paste) of ''sarshapa'' (Brassica campestris Linn.) is known as ''panchatikta niruha'' and is acting against ''prameha, abhishyanda'' and ''kushtha''. [8-8½]
  
Note: The quantity of kalka of sarṣapa is not mentioned in the above recipe. According to commentary of Cakrapāṇi on this verse, it may be decided. [ ] In the nirūha basti with an amount of twelve prasṛtas, the amount of kalka is usually two palas (about100gms).  In present recipe, the amount is five prasṛtas and therefore the amount of kalka of sarṣapa would be about 40 gms. This principle is applicable in latter recipes also where the amount of kalka is not mentioned.
+
'''Note''': The quantity of ''kalka'' of ''sarshapa'' is not mentioned in the above recipe. According to commentary of Chakrapani on this verse, it may be decided.<ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.8-9. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.</ref>
 +
In the ''niruha basti'' with an amount of twelve ''prasritas'', the amount of ''kalka'' is usually two ''palas'' (about 100 gms).  In present recipe, the amount is five ''prasritas'' and therefore the amount of ''kalka'' of ''sarshapa'' would be about 40 gms. This principle is applicable in latter recipes also where the amount of ''kalka'' is not mentioned.
  
==== ''Shat-prasritika basti'' ====
+
=== ''Shat-prasritika basti'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
विडङ्गत्रिफलाशिग्रुफलमुस्ताखुपर्णिजात्||९||  
 
विडङ्गत्रिफलाशिग्रुफलमुस्ताखुपर्णिजात्||९||  
 +
 
कषायात् प्रसृताः पञ्च तैलादेको विमथ्य तान्|  
 
कषायात् प्रसृताः पञ्च तैलादेको विमथ्य तान्|  
 +
 
विडङ्गपिप्पलीकल्को निरूहः क्रिमिनाशनः||१०||
 
विडङ्गपिप्पलीकल्को निरूहः क्रिमिनाशनः||१०||
viḍaṅgatriphalāśigruphalamustākhuparṇijāt||9||  
+
<div class="mw-collapsible-content">
 +
 
 +
viḍaṅgatriphalāśigruphalamustākhuparṇijāt||9||
 +
 
kaṣāyāt  prasṛtāḥ pañca tailādēkō vimathya tān|  
 
kaṣāyāt  prasṛtāḥ pañca tailādēkō vimathya tān|  
 +
 
viḍaṅgapippalīkalkō nirūhaḥ krimināśanaḥ||10||
 
viḍaṅgapippalīkalkō nirūhaḥ krimināśanaḥ||10||
  
 
viDa~ggatriphalAshigruphalamustAkhuparNijAt||9||  
 
viDa~ggatriphalAshigruphalamustAkhuparNijAt||9||  
kaShAyAt  prasRutAH pa~jca tailAdeko vimathya tAn|  
+
 
 +
kaShAyAt  prasRutAH pa~jca tailAdeko vimathya tAn|
 +
 
viDa~ggapippalIkalko nirUhaH kriminAshanaH||10||
 
viDa~ggapippalIkalko nirUhaH kriminAshanaH||10||
 +
</div></div>
  
Five prasṛtas of decoction of viḍaṅga (Embelia ribes Burm.), triphalā (a combination of three fruits viz. Emblica officinalis Gaertn, terminalia chebula Retz. and terminalia belerica Roxb.), śigru (Moringa oleifera Linn.), madanaphala (Randia dumetorum Lam.), mustā (Cyperus rotundus Linn.) and ākhuparṇi (Merremia emarginata Burm.) and one prasṛta of tila taila (sesame oil) churned together with a paste of viḍaṅga (Embelia ribes Burm.) and pippalī (Piper longum Linn.) is krimināśana nirūha (nirūha acting against parasites) (9-10)
+
Five ''prasritas'' of decoction of ''vidanga'' (Embelia ribes Burm.), ''triphala'' (a combination of three fruits viz. Emblica officinalis Gaertn, terminalia chebula Retz. and terminalia belerica Roxb.), ''shigru'' (Moringa oleifera Linn.), ''madanaphala'' (Randia dumetorum Lam.), ''musta'' (Cyperus rotundus Linn.) and ''akhuparni'' (Merremia emarginata Burm.) and one ''prasrita'' of ''tila taila'' (sesame oil) churned together with a paste of ''vidanga'' (Embelia ribes Burm.) and ''pippali'' (Piper longum Linn.) is ''kriminashana niruha'' (''niruha'' acting against parasites) [9-10]
  
==== ''Sapta-prasritika basti'' ====
+
=== ''Sapta-prasritika basti'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
पयस्येक्षुस्थिरारास्नाविदारीक्षौद्रसर्पिषाम्|  
 
पयस्येक्षुस्थिरारास्नाविदारीक्षौद्रसर्पिषाम्|  
 +
 
एकैकः प्रसृतो बस्तिः कृष्णाकल्को वृषत्वकृत्||११||  
 
एकैकः प्रसृतो बस्तिः कृष्णाकल्को वृषत्वकृत्||११||  
 +
<div class="mw-collapsible-content">
  
 
payasyēkṣusthirārāsnāvidārīkṣaudrasarpiṣām|  
 
payasyēkṣusthirārāsnāvidārīkṣaudrasarpiṣām|  
 +
 
ēkaikaḥ prasṛtō bastiḥ kṛṣṇākalkō vṛṣatvakṛt||11||  
 
ēkaikaḥ prasṛtō bastiḥ kṛṣṇākalkō vṛṣatvakṛt||11||  
  
 
payasyekShusthirArAsnAvidArIkShaudrasarpiShAm|  
 
payasyekShusthirArAsnAvidArIkShaudrasarpiShAm|  
 +
 
ekaikaH prasRuto bastiH kRuShNAkalko vRuShatvakRut||11||  
 
ekaikaH prasRuto bastiH kRuShNAkalko vRuShatvakRut||11||  
 +
</div></div>
  
Basti prepared with decoction of one prasṛta of each of payasyā (Fritillaria roylei Hook.), ikṣu (Saccharum officinarum Linn.), sthirā (Desmodium gangeticum DC.), rāsnā (Pluchea lanceolata Oliver&Hiern.) and vidārī (Pueraria tuberosa DC.); one prasṛta each of honey and ghṛta, and paste of pippalī (Piper longum Linn.) is vṛṣya (enhancing libido and sexual vigour). (11)
+
''[[Basti]]'' prepared with decoction of one ''prasrita'' of each of ''payasya'' (Fritillaria roylei Hook.), ''ikshu'' (Saccharum officinarum Linn.), ''sthira'' (Desmodium gangeticum DC.), ''rasna'' (Pluchea lanceolata Oliver & Hiern.) and ''vidari'' (Pueraria tuberosa DC.); one ''prasrita'' each of honey and ''ghrita'', and paste of ''pippali'' (Piper longum Linn.) is ''vrishya'' (enhancing libido and sexual vigour). [11]
 +
 
 +
=== ''Chatu-prasritika basti''-II ===
 +
<div class="mw-collapsible mw-collapsed">
  
Chatu-prasrutika basti-II:
 
 
चत्वारस्तैलगोमूत्रदधिमण्डाम्लकाञ्जिकात्|  
 
चत्वारस्तैलगोमूत्रदधिमण्डाम्लकाञ्जिकात्|  
 +
 
प्रसृताः सर्षपैः कल्कैर्विट्सङ्गानाहभेदनः ||१२||
 
प्रसृताः सर्षपैः कल्कैर्विट्सङ्गानाहभेदनः ||१२||
 +
<div class="mw-collapsible-content">
 +
 
catvārastailagōmūtradadhimaṇḍāmlakāñjikāt  
 
catvārastailagōmūtradadhimaṇḍāmlakāñjikāt  
 +
 
prasṛtāḥ sarṣapaiḥ kalkairviṭsaṅgānāhabhēdanaḥ  ||12||
 
prasṛtāḥ sarṣapaiḥ kalkairviṭsaṅgānāhabhēdanaḥ  ||12||
 +
 
catvArastailagomUtradadhimaNDAmlakA~jjikAt|  
 
catvArastailagomUtradadhimaNDAmlakA~jjikAt|  
 +
 
prasRutAH sarShapaiH kalkairviTsa~ggAnAhabhedanaH ||12||
 
prasRutAH sarShapaiH kalkairviTsa~ggAnAhabhedanaH ||12||
 +
</div></div>
  
Basti prepared with a total of four prasṛtas of tila taila (sesame oil), cow’s urine, dadhimaṇḍa (whey) and amlakāñjī (fermented sour gruel) mixed with a paste of sarṣapa (Brassica campestris Linn.) relieves the stagnation of stool and constipation. (12)
+
''[[Basti]]'' prepared with a total of four ''prasritas'' of ''tila taila'' (sesame oil), cow’s urine, ''dadhimanda'' (whey) and ''amlakanji'' (fermented sour gruel) mixed with a paste of ''sarshapa'' (Brassica campestris Linn.) relieves the stagnation of stool and constipation. [12]
  
Pancha-prasrutika basti-II:
+
=== ''Pancha-prasritika basti''-II ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
श्वदंष्ट्राश्मभिदेरण्डरसात्तैलात् सुरासवात्|  
 
श्वदंष्ट्राश्मभिदेरण्डरसात्तैलात् सुरासवात्|  
 +
 
प्रसृताः पञ्च यष्ट्याह्वकौन्तीमागधिकासिताः||१३||  
 
प्रसृताः पञ्च यष्ट्याह्वकौन्तीमागधिकासिताः||१३||  
 +
 
कल्कः स्यान्मूत्रकृच्छ्रे तु सानाहे बस्तिरुत्तमः|  
 
कल्कः स्यान्मूत्रकृच्छ्रे तु सानाहे बस्तिरुत्तमः|  
 +
 
एते सलवणाः कोष्णा निरूहाः प्रसृतैर्नव||१४||
 
एते सलवणाः कोष्णा निरूहाः प्रसृतैर्नव||१४||
 +
<div class="mw-collapsible-content">
 +
 
śvadaṁṣṭrāśmabhidēraṇḍarasāttailāt surāsavāt|  
 
śvadaṁṣṭrāśmabhidēraṇḍarasāttailāt surāsavāt|  
prasṛtāḥ pañca yaṣṭyāhvakauntīmāgadhikāsitāḥ||13||  
+
 
 +
prasṛtāḥ pañca yaṣṭyāhvakauntīmāgadhikāsitāḥ||13||
 +
 
kalkaḥ  syānmūtrakṛcchrē tu sānāhē bastiruttamaḥ|  
 
kalkaḥ  syānmūtrakṛcchrē tu sānāhē bastiruttamaḥ|  
 +
 
ētē salavaṇāḥ kōṣṇā nirūhāḥ prasṛtairnava||14||
 
ētē salavaṇāḥ kōṣṇā nirūhāḥ prasṛtairnava||14||
  
 
shvadaMShTrAshmabhideraNDarasAttailAt surAsavAt|  
 
shvadaMShTrAshmabhideraNDarasAttailAt surAsavAt|  
 +
 
prasRutAH pa~jca yaShTyAhvakauntImAgadhikAsitAH||13||  
 
prasRutAH pa~jca yaShTyAhvakauntImAgadhikAsitAH||13||  
 +
 
kalkaH syAnmUtrakRucchre tu sAnAhe bastiruttamaH|  
 
kalkaH syAnmUtrakRucchre tu sAnAhe bastiruttamaH|  
 +
 
ete salavaNAH koShNA nirUhAH prasRutairnava||14||
 
ete salavaNAH koShNA nirUhAH prasRutairnava||14||
 +
</div></div>
  
Basti prepared with five prasṛtas decoction of śvadaṁṣṭrā (Tribulus terrestris Linn.), aśmabhida (Bergenia ligulata Wall.), eraṇḍa (Ricinus communis Linn.) together, taila and surāsava (an alcoholic preparation) added with paste of yaṣṭi (Glycyrrhiza glabra Linn.), kauntī (Piper aurantiacum Wall.), māgadhikā (Piper longum Linn.) and sitāḥ (sugar candy) is useful in mūtrakṛcchra (a condition characterized by difficult and painful micturition) and ānāha (constipation). These nine prasṛta bastis are given with salt and moderately warm. (13-14)
+
''[[Basti]]'' prepared with five ''prasritas'' decoction of ''shvadamshtra'' (Tribulus terrestris Linn.), ''ashmabhida'' (Bergenia ligulata Wall.), ''eranda'' (Ricinus communis Linn.) together, ''taila'' and ''surasava'' (an alcoholic preparation) added with paste of ''yashti'' (Glycyrrhiza glabra Linn.), ''kaunti'' (Piper aurantiacum Wall.), ''magadhika'' (Piper longum Linn.) and ''sitah'' (sugar candy) is useful in ''mutrakricchra'' (a condition characterized by difficult and painful micturition) and ''anaha'' (constipation). These nine ''prasrita bastis'' are given with salt and moderately warm. [13-14]
 +
 
 +
=== Treatment of stagnated ''[[basti]]'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
Treatment of stagnated basti:
 
 
मृदुबस्तिजडीभूते तीक्ष्णोऽन्यो बस्तिरिष्यते|  
 
मृदुबस्तिजडीभूते तीक्ष्णोऽन्यो बस्तिरिष्यते|  
तीक्ष्णैर्विकर्षिते स्वादु प्रत्यास्थापनमिष्यते ||१५||
+
 
 +
तीक्ष्णैर्विकर्षिते स्वादु प्रत्यास्थापनमिष्यते ||१५||
 +
<div class="mw-collapsible-content">
 +
 
 
mṛdubastijaḍībhūtē tīkṣṇō'nyō bastiriṣyatē|  
 
mṛdubastijaḍībhūtē tīkṣṇō'nyō bastiriṣyatē|  
 +
 
tīkṣṇairvikarṣitē svādu pratyāsthāpanamiṣyatē [1] ||15||
 
tīkṣṇairvikarṣitē svādu pratyāsthāpanamiṣyatē [1] ||15||
  
 
mRudubastijaDIbhUte tIkShNo~anyo bastiriShyate|  
 
mRudubastijaDIbhUte tIkShNo~anyo bastiriShyate|  
 +
 
tIkShNairvikarShite svAdu pratyAsthApanamiShyate  ||15||
 
tIkShNairvikarShite svAdu pratyAsthApanamiShyate  ||15||
 +
</div></div>
  
If a mṛdubasti (mild acting basti) gets stagnated, that needs another tīkṣṇa basti (strong and sharp acting basti). One, who is emaciated because of strong bastis, requires āsthāpana basti prepared with madhura (sweet) substances. (15)
+
If a ''mridubasti'' (mild acting ''[[basti]]'') gets stagnated, that needs another ''teekshna basti'' (strong and sharp acting ''[[basti]]''). One, who is emaciated because of strong ''[[basti]]s'', requires ''asthapana [[basti]]'' prepared with ''madhura'' (sweet) substances. [15]
  
 +
=== Treatment of ''guda-daha'' (burning sensation in anus) ===
 +
<div class="mw-collapsible mw-collapsed">
  
Treatment of guda-daha (burning sensation in anus):
 
 
वातोपसृष्टस्योष्णैः स्युर्गुददाहादयो यदि|  
 
वातोपसृष्टस्योष्णैः स्युर्गुददाहादयो यदि|  
 +
 
द्राक्षाम्बुना त्रिवृत्कल्कं दद्याद्दोषानुलोमनम्||१६||  
 
द्राक्षाम्बुना त्रिवृत्कल्कं दद्याद्दोषानुलोमनम्||१६||  
 +
 
तद्धि पित्तशकृद्वातान् हृत्वा दाहादिकाञ्जयेत्|  
 
तद्धि पित्तशकृद्वातान् हृत्वा दाहादिकाञ्जयेत्|  
 +
 
शुद्धश्चापि पिबेच्छीतां यवागूं शर्करायुताम्||१७||
 
शुद्धश्चापि पिबेच्छीतां यवागूं शर्करायुताम्||१७||
 +
<div class="mw-collapsible-content">
 +
 
vātōpasṛṣṭasyōṣṇaiḥ syurgudadāhādayō  yadi|  
 
vātōpasṛṣṭasyōṣṇaiḥ syurgudadāhādayō  yadi|  
 +
 
drākṣāmbunā trivṛtkalkaṁ dadyāddōṣānulōmanam||16||  
 
drākṣāmbunā trivṛtkalkaṁ dadyāddōṣānulōmanam||16||  
 +
 
taddhi pittaśakṛdvātān hṛtvā dāhādikāñjayēt|  
 
taddhi pittaśakṛdvātān hṛtvā dāhādikāñjayēt|  
 +
 
śuddhaścāpi pibēcchītāṁ yavāgūṁ śarkarāyutām||17||
 
śuddhaścāpi pibēcchītāṁ yavāgūṁ śarkarāyutām||17||
  
 
vAtopasRuShTasyoShNaiH syurgudadAhAdayoyadi|  
 
vAtopasRuShTasyoShNaiH syurgudadAhAdayoyadi|  
 +
 
drAkShAmbunA trivRutkalkaM dadyAddoShAnulomanam||16||  
 
drAkShAmbunA trivRutkalkaM dadyAddoShAnulomanam||16||  
 +
 
taddhi pittashakRudvAtAn hRutvA dAhAdikA~jjayet|  
 
taddhi pittashakRudvAtAn hRutvA dAhAdikA~jjayet|  
 +
 
shuddhashcApi pibecchItAM yavAgUM sharkarAyutAm||17||
 
shuddhashcApi pibecchItAM yavAgUM sharkarAyutAm||17||
 +
</div></div>
  
If a patient with vāta disorder suffers from anorectal burning (and other similar pitta-related symptoms) due to (administration of) hot bastis, a mixture of drākṣāmbu (grape juice or decoction of raisins) and trivṛtkalka (paste of Operculina turpethum Linn.), which is doṣānulōmana (bringing the movement of doṣa in right direction) is given. This relieves burning sensation and similar conditions by expelling the pitta, stool and vāta. After the body is cleansed, the patient has to take cold yavāgu added with sugar. (16-17)
+
If a patient with ''[[vata]]'' disorder suffers from anorectal burning (and other similar ''[[pitta]]''-related symptoms) due to (administration of) hot ''[[basti]]s'', a mixture of ''drakshambu'' (grape juice or decoction of raisins) and ''trivritkalka'' (paste of Operculina turpethum Linn.), which is ''doshanulshmana'' (bringing the movement of ''[[dosha]]'' in right direction) is given. This relieves burning sensation and similar conditions by expelling the ''[[pitta]]'', stool and ''[[vata]]''. After the body is cleansed, the patient has to take cold ''yavagu'' added with sugar. [16-17]
  
Treatment of mala kshaya (depletion of stool) :
+
=== Treatment of ''mala kshaya'' (depletion of stool) ===
अथवाऽतिविरिक्तः स्यात् क्षीणविट्कः स भक्षयेत्|  
+
<div class="mw-collapsible mw-collapsed">
 +
 
 +
अथवाऽतिविरिक्तः स्यात् क्षीणविट्कः स भक्षयेत्|
 +
 
माषयूषेण कुल्माषान् पिबेन्मध्वथवा  सुराम्||१८||
 
माषयूषेण कुल्माषान् पिबेन्मध्वथवा  सुराम्||१८||
 +
<div class="mw-collapsible-content">
 +
 
athavā'tiviriktaḥ syāt kṣīṇaviṭkaḥ sa bhakṣayēt  
 
athavā'tiviriktaḥ syāt kṣīṇaviṭkaḥ sa bhakṣayēt  
 +
 
māṣayūṣēṇa kulmāṣān pibēnmadhvathavā  surām||18||
 
māṣayūṣēṇa kulmāṣān pibēnmadhvathavā  surām||18||
  
 
athavA~ativiriktaH syAt kShINaviTkaH sa bhakShayet|  
 
athavA~ativiriktaH syAt kShINaviTkaH sa bhakShayet|  
 +
 
mAShayUSheNa kulmAShAn pibenmadhvathavA surAm||18||
 
mAShayUSheNa kulmAShAn pibenmadhvathavA surAm||18||
 +
</div></div>
  
On the other hand, if a patient has excessive purgation and suffers from depletion of stool (and other essential body components e.g. fluids), he or she has to take kulmāṣa (half cooked grains) with māṣayūṣa (soup of Phaseolus mungo Linn.), or surā (an alcoholic preparation) or honey. (18)
+
On the other hand, if a patient has excessive purgation and suffers from depletion of stool (and other essential body components e.g. fluids), he or she has to take ''kulmasha'' (half cooked grains) with ''mashayoosha'' (soup of Phaseolus mungo Linn.), or ''sura'' (an alcoholic preparation) or honey. [18]
  
Treatment of amaja shula (abdominal pain due to improper digestion):
+
=== Treatment of ''amaja shula'' (abdominal pain due to improper digestion) ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
सामं चेत् कुणपं शूलैरुपविशेदरोचकी|  
 
सामं चेत् कुणपं शूलैरुपविशेदरोचकी|  
 +
 
स घनातिविषाकुष्ठनतदारुवचाः पिबेत्||१९||
 
स घनातिविषाकुष्ठनतदारुवचाः पिबेत्||१९||
 +
<div class="mw-collapsible-content">
 +
 
sāmaṁ cēt kuṇapaṁ śūlairupaviśēdarōcakī|  
 
sāmaṁ cēt kuṇapaṁ śūlairupaviśēdarōcakī|  
 +
 
sa ghanātiviṣākuṣṭhanatadāruvacāḥ pibēt||19||
 
sa ghanātiviṣākuṣṭhanatadāruvacāḥ pibēt||19||
  
 
sAmaM cet kuNapaM shUlairupavishedarocakI|  
 
sAmaM cet kuNapaM shUlairupavishedarocakI|  
 +
 
sa ghanAtiviShAkuShThanatadAruvacAH pibet||19||  
 
sa ghanAtiviShAkuShThanatadAruvacAH pibet||19||  
(A decoction of) mustā (Cyperus rotundus Linn.), ativiṣā (Aconitum heterophyllum wall.), kuṣṭha (Saussurea lappa C.B.Clarke.), nata (Valeriana wallichii DC.), dāru (Cedrus deodara Roxb.) and vacā (Acorus calamus Linn.) is recommended to a patient with loss of appetite, passing sāma stool (containing āma) smelling like a dead (decomposing) body and with abdominal pain. (19)
+
</div></div>
 +
 
 +
(A decoction of) ''musta'' (Cyperus rotundus Linn.), ''ativisha'' (Aconitum heterophyllum wall.), ''kushtha'' (Saussurea lappa C.B.Clarke.), ''nata'' (Valeriana wallichii DC.), ''daru'' (Cedrus deodara Roxb.) and ''vacha'' (Acorus calamus Linn.) is recommended to a patient with loss of appetite, passing ''sama'' stool (i.e., stool containing ''ama'') smelling like a dead (decomposing) body and with abdominal pain. [19]
  
 
+
=== Treatment of ''atisara'' (diarrhea) ===
Treatment of atisara (diarrhea):
+
<div class="mw-collapsible mw-collapsed">
  
 
शकृद्वातमसृक् पित्तं कफं वा योऽतिसार्यते|  
 
शकृद्वातमसृक् पित्तं कफं वा योऽतिसार्यते|  
 +
 
पक्वं , तत्र स्ववर्गीयैर्बस्तिः श्रेष्ठं भिषग्जितम्||२०||
 
पक्वं , तत्र स्ववर्गीयैर्बस्तिः श्रेष्ठं भिषग्जितम्||२०||
 +
<div class="mw-collapsible-content">
 +
 
śakṛdvātamasṛk pittaṁ kaphaṁ vā yō'tisāryatē|  
 
śakṛdvātamasṛk pittaṁ kaphaṁ vā yō'tisāryatē|  
pakvaṁ , tatra svavargīyairbastiḥ śrēṣṭhaṁ bhiṣagjitam||20||
+
 
 +
pakvaṁ , tatra svavargīyairbastiḥ śrēṣṭhaṁ bhiṣagjitam||20||
  
 
shakRudvAtamasRuk pittaM kaphaM vA yo~atisAryate|  
 
shakRudvAtamasRuk pittaM kaphaM vA yo~atisAryate|  
 +
 
pakvaM , tatra svavargIyairbastiH shreShThaM bhiShagjitam||20||
 
pakvaM , tatra svavargIyairbastiH shreShThaM bhiShagjitam||20||
 +
</div></div>
  
When a patient has pakva atisāra (without undigested material) passing śakṛt (stool), vāta, asṛk (blood), pitta or kapha then basti prepared with a specific group of medicines acting against each of these pathologies is best measure. (20)
+
When a patient has ''pakva atisara'' (without undigested material) passing ''shakrita'' (stool), ''[[vata]], asrika'' (blood), ''[[pitta]]'' or ''[[kapha]]'', then ''[[basti]]'' prepared with a specific group of medicines acting against each of these pathologies is best measure. [20]
 +
 
 +
=== Six types of ''atisara'' and its common complications ===
 +
<div class="mw-collapsible mw-collapsed">
  
Six types of atisara and its common complications:
 
 
षण्णामेषां द्विसंसर्गात् त्रिंशद्भेदा भवन्ति तु|  
 
षण्णामेषां द्विसंसर्गात् त्रिंशद्भेदा भवन्ति तु|  
 +
 
केवलैः सह षट्त्रिंशद्विद्यात् सोपद्रवानपि||२१||
 
केवलैः सह षट्त्रिंशद्विद्यात् सोपद्रवानपि||२१||
 +
 
शूलप्रवाहिकाध्मानपरिकर्त्यरुचिज्वरान्|  
 
शूलप्रवाहिकाध्मानपरिकर्त्यरुचिज्वरान्|  
 +
 
तृष्णोष्णदाहमूर्च्छादींश्चैषां विद्यादुपद्रवान्||२२||
 
तृष्णोष्णदाहमूर्च्छादींश्चैषां विद्यादुपद्रवान्||२२||
 +
<div class="mw-collapsible-content">
  
 
ṣaṇṇāmēṣāṁ dvisaṁsargāt triṁśadbhēdā bhavanti tu|  
 
ṣaṇṇāmēṣāṁ dvisaṁsargāt triṁśadbhēdā bhavanti tu|  
 +
 
kēvalaiḥ saha ṣaṭtriṁśadvidyāt sōpadravānapi||21||
 
kēvalaiḥ saha ṣaṭtriṁśadvidyāt sōpadravānapi||21||
 +
 
śūlapravāhikādhmānaparikartyarucijvarān|  
 
śūlapravāhikādhmānaparikartyarucijvarān|  
 +
 
tṛṣṇōṣṇadāhamūrcchādīṁścaiṣāṁ vidyādupadravān||22||
 
tṛṣṇōṣṇadāhamūrcchādīṁścaiṣāṁ vidyādupadravān||22||
  
 
ShaNNAmeShAM dvisaMsargAt triMshadbhedA bhavanti tu|  
 
ShaNNAmeShAM dvisaMsargAt triMshadbhedA bhavanti tu|  
 +
 
kevalaiH saha ShaTtriMshadvidyAt sopadravAnapi||21||
 
kevalaiH saha ShaTtriMshadvidyAt sopadravAnapi||21||
 +
 
shUlapravAhikAdhmAnaparikartyarucijvarAn|  
 
shUlapravAhikAdhmAnaparikartyarucijvarAn|  
 +
 
tRuShNoShNadAhamUrcchAdIMshcaiShAM vidyAdupadravAn||22||
 
tRuShNoShNadAhamUrcchAdIMshcaiShAM vidyAdupadravAn||22||
 +
</div></div>
  
These six types of atisāra may have thirty variants as a result of mutual combination of two morbid factors. Together with basic six, they constitute thirtysix, which manifest along with their complications. Śūla (abdominal pain), pravāhikā (dysentery), ādhmāna (abdominal distension) parikarti (anal pain), aruchi (distaste for food), jwara (fever), tṛṣṇā (thirst), uṣṇatva (feeling of heat), dāha (burning sensation) and mūrcchā (syncope) are its complications (upadrava). (21-22)
+
These six types of ''atisara'' may have thirty variants as a result of mutual combination of two morbid factors. Together with basic six, they constitute thirty six types, which manifest along with their complications. ''Shoola'' (abdominal pain), ''pravahika'' (dysentery), ''adhmana'' (abdominal distension) ''parikarti'' (anal pain), ''aruchi'' (distaste for food), ''[[jwara]]'' (fever), ''tṛishna'' (thirst), ''ushnatva'' (feeling of heat), ''daha'' (burning sensation) and ''murccha''(syncope) are its complications (''upadrava''). [21-22]
  
 +
=== Treatment of ''ama-atisara'' ( diarrhea with improper digestion) ===
 +
<div class="mw-collapsible mw-collapsed">
  
Treatment of ama-atisara ( diarrhea with improper digestion):
 
 
तत्रामेऽन्तरपानं स्यात् व्योषाम्ललवणैर्युतम्|  
 
तत्रामेऽन्तरपानं स्यात् व्योषाम्ललवणैर्युतम्|  
 +
 
पाचनं शस्यते बस्तिरामे हि प्रतिषिध्यते||२३||
 
पाचनं शस्यते बस्तिरामे हि प्रतिषिध्यते||२३||
 +
<div class="mw-collapsible-content">
 +
 
tatrāmē'ntarapānaṁ syāt vyōṣāmlalavaṇairyutam|  
 
tatrāmē'ntarapānaṁ syāt vyōṣāmlalavaṇairyutam|  
 +
 
ṁ śasyatē bastirāmē hi pratiṣidhyatē||23||
 
ṁ śasyatē bastirāmē hi pratiṣidhyatē||23||
  
 
tatrAme~antarapAnaM  syAt vyoShAmlalavaNairyutam|  
 
tatrAme~antarapAnaM  syAt vyoShAmlalavaNairyutam|  
 +
 
pAcanaM shasyate bastirAme hi pratiShidhyate||23||
 
pAcanaM shasyate bastirAme hi pratiShidhyate||23||
 +
</div></div>
  
In case of āmātisāra, a drink having pācana action added with trikaṭu (a group of three pungent drugs viz. rhizome of Zingiber officinalis Roxb.; fruits of Piper nigrum Linn. and Piper longum Linn.), amla (sour) and lavaṇa (salty) substances is recommended. Bastis are contraindicated in āma condition. (23)
+
In case of ''amatisara'', a drink having ''[[pachana]]'' action added with ''trikatu'' (a group of three pungent drugs viz. rhizome of Zingiber officinalis Roxb.; fruits of Piper nigrum Linn. and Piper longum Linn.), ''amla'' (sour) and ''lavana'' (salty) substances is recommended. ''[[Basti]]s'' are contraindicated in ''ama'' condition. [23]
  
Treatment of shakrita-atisara and vata atisara( diarrhea with excess stools and vata):
+
=== Treatment of ''shakrita-atisara'' and ''[[vata]] atisara''( diarrhea with excess stools and ''[[vata]]'') ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
वातघ्नैर्ग्राहिवर्गीयैर्बस्तिः शकृति शस्यते |
 
वातघ्नैर्ग्राहिवर्गीयैर्बस्तिः शकृति शस्यते |
 +
 
स्वाद्वम्ललवणैः शस्तः स्नेहबस्तिः समीरणे||२४||
 
स्वाद्वम्ललवणैः शस्तः स्नेहबस्तिः समीरणे||२४||
 +
<div class="mw-collapsible-content">
  
 
vātaghnairgrāhivargīyairbastiḥ śakṛti śasyatē
 
vātaghnairgrāhivargīyairbastiḥ śakṛti śasyatē
 +
 
svādvamlalavaṇaiḥ śastaḥ snēhabastiḥ samīraṇē||24||
 
svādvamlalavaṇaiḥ śastaḥ snēhabastiḥ samīraṇē||24||
  
 
vAtaghnairgrAhivargIyairbastiH shakRuti shasyate
 
vAtaghnairgrAhivargIyairbastiH shakRuti shasyate
 +
 
svAdvamlalavaNaiH shastaH snehabastiH samIraNe||24||  
 
svAdvamlalavaNaiH shastaH snehabastiH samIraNe||24||  
In śakṛtatisāra (atisāra in which only stool is passed), basti with vātaghna and grāhī category of medicines is recommended. In vāta related atisāra, snēhabasti with svādu (sweet), amla (sour) and lavaṇa (salty) substances is acclaimed. (24)
+
</div></div>
  
Treatment of rakta atisara, pitta atisara and kapha atisara (diarrhea with blood, pitta and kapha):
+
In ''shakritatisara'' (''atisara'' in which only stool is passed), ''[[basti]]'' with ''vataghna'' and ''grahi'' category of medicines is recommended. In ''[[vata]]'' related ''atisara, sneha [[basti]]'' with ''svadu'' (sweet), ''amla'' (sour) and ''lavana'' (salty) substances is acclaimed. [24]
 +
 
 +
=== Treatment of ''[[rakta]] atisara, [[pitta]] atisara'' and ''[[kapha]] atisara'' (diarrhea with blood, ''[[pitta]]'' and ''[[kapha]]'') ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
रक्ते रक्तेन, पित्ते तु कषायस्वादुतिक्तकैः|  
 
रक्ते रक्तेन, पित्ते तु कषायस्वादुतिक्तकैः|  
 +
 
सार्यमाणे कफे बस्तिः कषायकटुतिक्तकैः||२५||
 
सार्यमाणे कफे बस्तिः कषायकटुतिक्तकैः||२५||
 +
<div class="mw-collapsible-content">
 +
 
raktē raktēna, pittē tu kaṣāyasvādutiktakaiḥ|  
 
raktē raktēna, pittē tu kaṣāyasvādutiktakaiḥ|  
 +
 
sāryamāṇē kaphē bastiḥ kaṣāyakaṭutiktakaiḥ||25||
 
sāryamāṇē kaphē bastiḥ kaṣāyakaṭutiktakaiḥ||25||
  
 
rakte raktena, pitte tu kaShAyasvAdutiktakaiH|  
 
rakte raktena, pitte tu kaShAyasvAdutiktakaiH|  
 +
 
sAryamANe kaphe bastiH kaShAyakaTutiktakaiH||25||
 
sAryamANe kaphe bastiH kaShAyakaTutiktakaiH||25||
 +
</div></div>
  
In raktātisāra (diarrhea with blood) basti with blood, in pittātisāra basti with kaṣāya (astringent), madhura (sweet) and tikta (bitter) substances and in kaphātisāra with kaṣāya (astringent), kaṭu (pungent) and tikta (bitter) substances is to be administered. (25)
+
In ''[[rakta]] atisara'' (diarrhea with blood) ''[[basti]]'' with blood, in ''[[pitta]] atisara [[basti]]'' with ''kashaya'' (astringent), ''madhura'' (sweet) and ''tikta'' (bitter) substances and in ''[[kapha]] atisara'' with ''kashaya'' (astringent), ''katu'' (pungent) and ''tikta'' (bitter) substances is to be administered. [25]
  
Treatment of atisara (diarrhea) mixed with shakrita-ama and vata:
+
=== Treatment of ''atisara'' (diarrhea) mixed with ''shakrita-ama'' and ''[[vata]]'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
शकृता वायुना वाऽऽमे तेन वर्चस्यथानिले|  
 
शकृता वायुना वाऽऽमे तेन वर्चस्यथानिले|  
 +
 
संसृष्टेऽन्तरपानं स्याद् व्योषाम्ललवणैर्युतम्||२६||  
 
संसृष्टेऽन्तरपानं स्याद् व्योषाम्ललवणैर्युतम्||२६||  
 +
<div class="mw-collapsible-content">
 +
 +
śakṛtā vāyunā vā”me tena varcasyathānilē|
  
śakṛtā vāyunā vā”me tena varcasyathānilē|
 
 
saṁsṛṣṭē'ntarapānaṁ syād vyōṣāmlalavaṇairyutam||26||  
 
saṁsṛṣṭē'ntarapānaṁ syād vyōṣāmlalavaṇairyutam||26||  
  
 
shakRutA vAyunA vA~a~ame tena varcasyathAnile|  
 
shakRutA vAyunA vA~a~ame tena varcasyathAnile|  
 +
 
saMsRuShTe~antarapAnaM syAd vyoShAmlalavaNairyutam||26||  
 
saMsRuShTe~antarapAnaM syAd vyoShAmlalavaNairyutam||26||  
 +
</div></div>
 +
 +
In the conditions where ''ama'' is associated with ''shakrita'' (stool) or ''[[vata]]'', or ''shakrita'' (stool) or ''[[vata]]'' is associated with ''ama'' a drink, prepared with ''vyosha'' (a group of three pungent drugs, commonly known as ''trikatu'', viz. rhizome of Zingiber officinalis Roxb.; fruits of Piper nigrum Linn. and Piper longum Linn.), sour and salty substances, is recommended. [26]
 +
 +
=== Treatment of ''atisara'' (diarrhea) mixed with ''[[pitta]]-[[rakta]]'' and ''ama'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
In the conditions where āma is associated with śakṛt (stool) or vāta, or śakṛt (stool) or vāta is associated with āma a drink, prepared with vyōṣa (a group of three pungent drugs, commonly known as trikaṭu, viz. rhizome of Zingiber officinalis Roxb.; fruits of Piper nigrum Linn. and Piper longum Linn.), sour and salty substances, is recommended. (26)
 
Treatment of atisara (diarrhea) mixed with pitta-rakta and ama:
 
 
पित्तेनामेऽसृजा वाऽपि तयोरामेन वा पुनः|  
 
पित्तेनामेऽसृजा वाऽपि तयोरामेन वा पुनः|  
 +
 
संसृष्टयोर्भवेत् पानं सव्योषस्वादुतिक्तकम्||२७||
 
संसृष्टयोर्भवेत् पानं सव्योषस्वादुतिक्तकम्||२७||
 +
<div class="mw-collapsible-content">
 +
 
pittēnāmē'sṛjā vā'pi tayōrāmēna vā punaḥ|  
 
pittēnāmē'sṛjā vā'pi tayōrāmēna vā punaḥ|  
saṁsṛṣṭayōrbhavēt pānaṁ savyōṣasvādutiktakam||27||  
+
 
 +
saṁsṛṣṭayōrbhavēt pānaṁ savyōṣasvādutiktakam||27||
 +
 
pittenAme~asRujA vA~api tayorAmena vA punaH|  
 
pittenAme~asRujA vA~api tayorAmena vA punaH|  
 +
 
saMsRuShTayorbhavet pAnaM savyoShasvAdutiktakam||27||
 
saMsRuShTayorbhavet pAnaM savyoShasvAdutiktakam||27||
 +
</div></div>
 +
 +
If there is association of ''ama'' with ''[[pitta]]'' or ''[[rakta]]'' or of both separately with ''ama'' then a drink with ''trikaṭu'', sweet and bitter substances is indicated. [27]
  
If there is association of āma with pitta or rakta or of both separately with āma then a drink with trikaṭu, sweet and bitter substances is indicated. (27)
+
=== Treatment of ''atisara'' (diarrhea)mixed with ''[[kapha]]-ama'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
Treatment of atisara (diarrhea)mixed with kapha-ama:
 
 
तथाऽऽमे कफसंसृष्टे  कषायव्योषतिक्तकम्|  
 
तथाऽऽमे कफसंसृष्टे  कषायव्योषतिक्तकम्|  
 +
 
आमेन तु कफे व्योषकषायलवणैर्युतम्||२८||  
 
आमेन तु कफे व्योषकषायलवणैर्युतम्||२८||  
 +
<div class="mw-collapsible-content">
  
 
tathā''mē kaphasaṁsṛṣṭē kaṣāyavyōṣatiktakam|  
 
tathā''mē kaphasaṁsṛṣṭē kaṣāyavyōṣatiktakam|  
 +
 
āmēna tu kaphē vyōṣakaṣāyalavaṇairyutam||28||  
 
āmēna tu kaphē vyōṣakaṣāyalavaṇairyutam||28||  
  
tathA~a~ame kaphasaMsRuShTe kaShAyavyoShatiktakam|  
+
tathA~a~ame kaphasaMsRuShTe kaShAyavyoShatiktakam|
 +
 
Amena tu kaphe vyoShakaShAyalavaNairyutam||28||  
 
Amena tu kaphe vyoShakaShAyalavaNairyutam||28||  
 +
</div></div>
  
If āma is associated with kapha, a basti containing kaṣāya (astringent), trikaṭu and bitter substances and when kapha is associated with āma, a basti containing trikaṭu, kaṣāya (astringent) and salty substances is recommended. (28)  
+
If ''ama'' is associated with ''[[kapha]]'', a ''[[basti]]'' containing ''kashaya'' (astringent), ''trikatu'' and bitter substances and when ''[[kapha]]'' is associated with ''ama'', a ''[[basti]]'' containing ''trikatu, kashaya'' (astringent) and salty substances is recommended. [28]
 +
 
 +
=== Treatment of ''atisara'' (diarrhea) mixed with ''[[pitta]]-[[vata]]-shakrita'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
Treatment of atisara (diarrhea) mixed with pitta-vata-shakrita:
 
 
वातेन विशि पित्ते वा विट्पित्ताभ्यां  तथाऽनिले|  
 
वातेन विशि पित्ते वा विट्पित्ताभ्यां  तथाऽनिले|  
 +
 
मधुराम्लकषायः स्यात् संसृष्टे बस्तिरुत्तमः||२९||
 
मधुराम्लकषायः स्यात् संसृष्टे बस्तिरुत्तमः||२९||
 +
<div class="mw-collapsible-content">
 +
 
vātēna viśi pittē vā viṭpittābhyāṁ  tathā'nilē|  
 
vātēna viśi pittē vā viṭpittābhyāṁ  tathā'nilē|  
 +
 
madhurāmlakaṣāyaḥ syāt saṁsṛṣṭē bastiruttamaḥ||29||
 
madhurāmlakaṣāyaḥ syāt saṁsṛṣṭē bastiruttamaḥ||29||
 +
 
vAtena vishi pitte vA viTpittAbhyAM  tathA~anile|  
 
vAtena vishi pitte vA viTpittAbhyAM  tathA~anile|  
 +
 
madhurAmlakaShAyaH syAt saMsRuShTe bastiruttamaH||29||
 
madhurAmlakaShAyaH syAt saMsRuShTe bastiruttamaH||29||
 +
</div></div>
  
When stool or pitta is associated with vāta or vāta is associated with stool and pitta, a basti with sweet, sour and astringent substances, is excellent. (29)
+
When stool or ''[[pitta]]'' is associated with ''[[vata]]'' or ''[[vata]]'' is associated with stool and ''[[pitta]]'', a ''[[basti]]'' with sweet, sour and astringent substances, is excellent. [29]
 +
 
 +
=== Treatment of ''atisara'' (diarrhea) mixed with ''[[pitta]]-[[rakta]]-shakrita'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
Treatment of atisara (diarrhea) mixed with pitta-rakta-shakrita:
 
 
शकृच्छोणितयोः पित्तशकृतो रक्तपित्तयोः|  
 
शकृच्छोणितयोः पित्तशकृतो रक्तपित्तयोः|  
 +
 
बस्तिरन्योन्यसंसर्गे कषायस्वादुतिक्तकः||३०||  
 
बस्तिरन्योन्यसंसर्गे कषायस्वादुतिक्तकः||३०||  
 +
<div class="mw-collapsible-content">
 +
 
śakṛcchōṇitayōḥ pittaśakṛtō raktapittayōḥ|  
 
śakṛcchōṇitayōḥ pittaśakṛtō raktapittayōḥ|  
 +
 
bastiranyōnyasaṁsargē kaṣāyasvādutiktakaḥ||30||
 
bastiranyōnyasaṁsargē kaṣāyasvādutiktakaḥ||30||
 +
 
shakRucchoNitayoH pittashakRuto raktapittayoH|  
 
shakRucchoNitayoH pittashakRuto raktapittayoH|  
 +
 
bastiranyonyasaMsarge kaShAyasvAdutiktakaH||30||  
 
bastiranyonyasaMsarge kaShAyasvAdutiktakaH||30||  
In case of morbid mutual associations of pitta with stool and rakta, as well as stool with rakta and pitta, basti with astringent, sweet and bitter ingredients. (30)
+
</div></div>
 +
 
 +
In case of morbid mutual associations of ''[[pitta]]'' with stool and ''[[rakta]]'', as well as stool with ''[[rakta]]'' and ''[[pitta]], [[basti]]'' with astringent, sweet and bitter ingredients. [30]
 +
 
 +
=== Treatment of ''atisara'' (diarrhea) mixed with ''[[kapa]]-[[rakta]]-[[pitta]]-shakrita'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
Treatment of atisara (diarrhea) mixed with kapa-rakta-pitta-shakrita:
 
 
कफेन विशि पित्ते वा कफे विट्पित्तशोणितैः|  
 
कफेन विशि पित्ते वा कफे विट्पित्तशोणितैः|  
 +
 
व्योषतिक्तकषायः स्यात् संसृष्टे बस्तिरुत्तमः||३१||  
 
व्योषतिक्तकषायः स्यात् संसृष्टे बस्तिरुत्तमः||३१||  
 +
<div class="mw-collapsible-content">
  
 
kaphēna viśi pittē vā kaphē viṭpittaśōṇitaiḥ|  
 
kaphēna viśi pittē vā kaphē viṭpittaśōṇitaiḥ|  
 +
 
vyōṣatiktakaṣāyaḥ syāt saṁsṛṣṭē bastiruttamaḥ||31||
 
vyōṣatiktakaṣāyaḥ syāt saṁsṛṣṭē bastiruttamaḥ||31||
 +
 
kaphena vishi pitte vA kaphe viTpittashoNitaiH|  
 
kaphena vishi pitte vA kaphe viTpittashoNitaiH|  
 +
 
vyoShatiktakaShAyaH syAt saMsRuShTe bastiruttamaH||31||
 
vyoShatiktakaShAyaH syAt saMsRuShTe bastiruttamaH||31||
 +
</div></div>
 +
 +
In case of similar associations of ''[[kapha]]'' with stool or ''[[pitta]]''; or of stool or ''[[pitta]]'' or ''[[rakta]]'' with ''[[kapha]]'', a ''[[basti]]'' with ''trikatu'', bitter and ''kashaya'' ingredients is to be recommended. [31]
  
In case of similar associations of kapha with stool or pitta; or of stool or pitta or rakta with kapha, a basti with trikaṭu, bitter and kaṣāya ingredients is to be recommended. (31)
+
=== Treatment of ''atisara'' (diarrhea) mixed with ''[[vata]]-[[kapha]]-shakrita'' and ''[[rakta]]-[[kapha]]'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
Treatment of atisara (diarrhea) mixed with vata-kapha-shakrita and rakta-kapha:
 
 
स्याद्बस्तिर्व्योषतिक्ताम्लः संसृष्टे वायुना कफे|  
 
स्याद्बस्तिर्व्योषतिक्ताम्लः संसृष्टे वायुना कफे|  
 +
 
मधुरव्योषतिक्तस्तु रक्ते कफविमूर्च्छिते||३२||  
 
मधुरव्योषतिक्तस्तु रक्ते कफविमूर्च्छिते||३२||  
 +
<div class="mw-collapsible-content">
 +
 
syādbastirvyōṣatiktāmlaḥ saṁsṛṣṭē vāyunā kaphē|  
 
syādbastirvyōṣatiktāmlaḥ saṁsṛṣṭē vāyunā kaphē|  
 +
 
madhuravyōṣatiktastu raktē kaphavimūrcchitē||32||  
 
madhuravyōṣatiktastu raktē kaphavimūrcchitē||32||  
 +
 
syAdbastirvyoShatiktAmlaH saMsRuShTe vAyunA kaphe|  
 
syAdbastirvyoShatiktAmlaH saMsRuShTe vAyunA kaphe|  
 +
 
madhuravyoShatiktastu rakte kaphavimUrcchite||32||
 
madhuravyoShatiktastu rakte kaphavimUrcchite||32||
 +
</div></div>
  
In atisāra where kapha is associated with vāta, basti with trikaṭu, bitter and sour ingredients, and if rakta is associated with kapha then with sweet, trikaṭu and bitter is recommended. (32)
+
In ''atisara'' where ''[[kapha]]'' is associated with ''[[vata]], [[basti]]'' with ''trikatu'', bitter and sour ingredients, and if ''[[rakta]]'' is associated with ''[[kapha]]'' then with sweet, ''trikatu'' and bitter is recommended. [32]
 +
 
 +
=== Treatment of ''atisara'' (diarrhea) mixed with ''[[kapha]]- [[vata]] -shakrita'' and ''[[vata]]-[[pitta]]'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
Treatment of atisara (diarrhea) mixed with kapha- vata -shakrita and vata-pitta:
 
 
मारुते कफसंसृष्टे व्योषाम्ललवणो भवेत्|  
 
मारुते कफसंसृष्टे व्योषाम्ललवणो भवेत्|  
 +
 
बस्तिर्वातेन पित्ते  तु कार्यः स्वाद्वम्लतिक्तकः||३३||
 
बस्तिर्वातेन पित्ते  तु कार्यः स्वाद्वम्लतिक्तकः||३३||
 +
<div class="mw-collapsible-content">
 +
 
mārutē kaphasaṁsṛṣṭē vyōṣāmlalavaṇō bhavēt|  
 
mārutē kaphasaṁsṛṣṭē vyōṣāmlalavaṇō bhavēt|  
 +
 
bastirvātēna pittē  tu kāryaḥ svādvamlatiktakaḥ||33||
 
bastirvātēna pittē  tu kāryaḥ svādvamlatiktakaḥ||33||
  
 +
mArute kaphasaMsRuShTe vyoShAmlalavaNo bhavet|
  
mArute kaphasaMsRuShTe vyoShAmlalavaNo bhavet|
 
 
bastirvAtena pitte [2] tu kAryaH svAdvamlatiktakaH||33||
 
bastirvAtena pitte [2] tu kAryaH svAdvamlatiktakaH||33||
 +
</div></div>
 +
 +
If ''[[vata]]'' is accompanied by ''[[kapha]]'', a ''[[basti]]'' with ''trikatu'', sour and salty ingredients; and when ''[[pitta]]'' is associated with ''[[vata]], [[basti]]'' with sweet, sour and bitter substances is to be administered. [33]
  
If vāta is accompanied by kapha, a basti with trikaṭu, sour and salty ingredients; and when pitta is associated with vāta, basti with sweet, sour and bitter substances is to be administered. (33)  
+
=== Treatment for conditions due to ''samsarga'' (combination of ''[[dosha]]'') ===
 +
<div class="mw-collapsible mw-collapsed">
  
Treatment for conditions due to samsarga (combination of dosha):
 
 
त्रिचतुःपञ्चसंसर्गानेवमेव विकल्पयेत्|  
 
त्रिचतुःपञ्चसंसर्गानेवमेव विकल्पयेत्|  
 +
 
युक्तिश्चैषातिसारोक्ता सर्वरोगेष्वपि स्मृता||३४||
 
युक्तिश्चैषातिसारोक्ता सर्वरोगेष्वपि स्मृता||३४||
 +
<div class="mw-collapsible-content">
 +
 
tricatuḥpañcasaṁsargānēvamēva vikalpayēt|  
 
tricatuḥpañcasaṁsargānēvamēva vikalpayēt|  
 +
 
yuktiścaiṣātisārōktā sarvarōgēṣvapi smṛtā||34||
 
yuktiścaiṣātisārōktā sarvarōgēṣvapi smṛtā||34||
 +
 
tricatuHpa~jcasaMsargAnevameva vikalpayet|  
 
tricatuHpa~jcasaMsargAnevameva vikalpayet|  
yuktishcaiShAtisAroktA sarvarogeShvapi smRutA||34||  
+
 
Similarly a plan may be designed in cases of morbid combinations of three, four or five components. This planning for atisāra is applicable in all disease conditions. (34)
+
yuktishcaiShAtisAroktA sarvarogeShvapi smRutA||34||
 +
</div></div>
 +
 +
Similarly a plan may be designed in cases of morbid combinations of three, four or five components. This planning for ''atisara'' is applicable in all disease conditions. [34]
 +
<div class="mw-collapsible mw-collapsed">
 
   
 
   
 
युगपत् षड्रसं षण्णां संसर्गे पाचनं भवेत् |  
 
युगपत् षड्रसं षण्णां संसर्गे पाचनं भवेत् |  
 +
 
निरामाणां तु पञ्चानां बस्तिः षाड्रसिको मतः||३५||
 
निरामाणां तु पञ्चानां बस्तिः षाड्रसिको मतः||३५||
 +
<div class="mw-collapsible-content">
 +
 
yugapat ṣaḍrasaṁ ṣaṇṇāṁ saṁsargē pācanaṁ bhavēt [1] |  
 
yugapat ṣaḍrasaṁ ṣaṇṇāṁ saṁsargē pācanaṁ bhavēt [1] |  
 +
 
nirāmāṇāṁ tu pañcānāṁ bastiḥ ṣāḍrasikō mataḥ||35||  
 
nirāmāṇāṁ tu pañcānāṁ bastiḥ ṣāḍrasikō mataḥ||35||  
  
 
yugapat ShaDrasaM ShaNNAM saMsarge pAcanaM bhavet [1] |  
 
yugapat ShaDrasaM ShaNNAM saMsarge pAcanaM bhavet [1] |  
 +
 
nirAmANAM tu pa~jcAnAM bastiH ShADrasiko mataH||35||
 
nirAmANAM tu pa~jcAnAM bastiH ShADrasiko mataH||35||
 +
</div></div>
  
In atisāra, if all six pathological components are simultaneously involved, a pāchana (causing or promoting digestion or transformation) medicine containing the drugs of all six tastes is useful, while in nirāma (without āma) condition, where other five are involved a basti consisting of all six rasas (tastes) is indicated. (35)
+
In ''atisara'', if all six pathological components are simultaneously involved, a ''[[pachana]]'' (causing or promoting digestion or transformation) medicine containing the drugs of all six tastes is useful, while in ''nirama'' (without ''ama'') condition, where other five are involved a ''[[basti]]'' consisting of all six ''rasas'' (tastes) is indicated. [35]
 +
 
 +
=== ''Sarvatisara nashaka ghrita'' (medicated ghee for treatment of all types of diarrhea) ===
 +
<div class="mw-collapsible mw-collapsed">
  
Sarvatisara nashaka ghrita (medicated ghee for treatment of all types of diarrhea):
 
 
उदुम्बरशलाटूनि जम्ब्वाम्रोदुम्बरत्वचः|  
 
उदुम्बरशलाटूनि जम्ब्वाम्रोदुम्बरत्वचः|  
 +
 
शङ्खं सर्जरसं लाक्षां कर्दमं च पलांशिकम्||३६||  
 
शङ्खं सर्जरसं लाक्षां कर्दमं च पलांशिकम्||३६||  
 +
 
पिष्ट्वा तैः सर्पिषः प्रस्थं क्षीरद्विगुणितं पचेत्|  
 
पिष्ट्वा तैः सर्पिषः प्रस्थं क्षीरद्विगुणितं पचेत्|  
 +
 
अतीसारेषु सर्वेषु पेयमेतद्यथाबलम्||३७||  
 
अतीसारेषु सर्वेषु पेयमेतद्यथाबलम्||३७||  
 +
<div class="mw-collapsible-content">
 +
 
udumbarani jambvāmrōdumbaratvacaḥ|  
 
udumbarani jambvāmrōdumbaratvacaḥ|  
 +
 
śaṅkhaṁ sarjarasaṁ lākṣāṁ kardamaṁ ca palāṁśikam||36||  
 
śaṅkhaṁ sarjarasaṁ lākṣāṁ kardamaṁ ca palāṁśikam||36||  
piṣṭvā taiḥ sarpiṣaḥ prasthaṁ kṣīradviguṇitaṁ pacēt|  
+
 
 +
piṣṭvā taiḥ sarpiṣaḥ prasthaṁ kṣīradviguṇitaṁ pacēt|
 +
 
atīsārēṣu sarvēṣu pēyamētadyathābalam||37||
 
atīsārēṣu sarvēṣu pēyamētadyathābalam||37||
 +
 
udumbarashalATUni jambvAmrodumbaratvacaH|  
 
udumbarashalATUni jambvAmrodumbaratvacaH|  
 +
 
sha~gkhaM sarjarasaM lAkShAM kardamaM ca palAMshikam||36||  
 
sha~gkhaM sarjarasaM lAkShAM kardamaM ca palAMshikam||36||  
 +
 
piShTvA taiH sarpiShaH prasthaM kShIradviguNitaM pacet|  
 
piShTvA taiH sarpiShaH prasthaM kShIradviguNitaM pacet|  
 +
 
atIsAreShu sarveShu peyametadyathAbalam||37||
 
atIsAreShu sarveShu peyametadyathAbalam||37||
 +
</div></div>
 
   
 
   
A freshly prepared paste of udumbaraśalāṭu (unripe fruits of Ficus glomerata Roxb.), bark of jāmbu (Syzygium cumini Skeels.), amra  (Mangifera indica Linn.) and udumbara (Ficus glomerata Roxb.); saṅkha (conch shell), sarjarasa (resin of Vateria indica Linn.), lākṣā (resinous secretion of Laccifera lacca Kerr.) and kardama (a type of rice), each one pala (about 50 grams) is to be cooked with one prastha (about 800 ml.) of ghṛta, and two prastha of milk. This (thus prepared ghṛta) is to be taken in all types of atisāras according to bala (strength of the patient as well as disease). (36-37)
+
A freshly prepared paste of ''udumbarashalaatu'' (unripe fruits of Ficus glomerata Roxb.), bark of ''jaambu'' (Syzygium cumini Skeels.), ''amra'' (Mangifera indica Linn.) and ''udumbara'' (Ficus glomerata Roxb.); ''sankha'' (conch shell), ''sarjarasa'' (resin of Vateria indica Linn.), ''laaksha'' (resinous secretion of Laccifera lacca Kerr.) and ''kardama'' (a type of rice), each one ''pala'' (about 50 grams) is to be cooked with one ''prastha'' (about 800 ml.) of ''ghrita'', and two ''prastha'' of milk. This (thus prepared ''ghrita'') is to be taken in all types of ''atisara'' according to ''bala'' (strength of the patient as well as disease). [36-37]
 +
 
 +
=== ''Sarvatisara nashaka yavagu'' (medicated gruel for treatment of all types of diarrhea) ===
 +
<div class="mw-collapsible mw-collapsed">
  
Sarvatisara nashaka yavagu (medicated gruel for treatment of all types of diarrhea):
 
 
कच्छुराधातकीबिल्वसमङ्गारक्तशालिभिः|  
 
कच्छुराधातकीबिल्वसमङ्गारक्तशालिभिः|  
 +
 
मसूराश्वत्थशुङ्गैश्च यवागूः स्याज्जले शृतैः||३८||  
 
मसूराश्वत्थशुङ्गैश्च यवागूः स्याज्जले शृतैः||३८||  
 +
 
बालोदुम्बरकट्वङ्गसमङ्गाप्लक्षपल्लवैः  |  
 
बालोदुम्बरकट्वङ्गसमङ्गाप्लक्षपल्लवैः  |  
 +
 
मसूरधातकीपुष्पबलाभिश्च तथा भवेत्||३९||  
 
मसूरधातकीपुष्पबलाभिश्च तथा भवेत्||३९||  
 +
<div class="mw-collapsible-content">
  
 
kacchurādhātakībilvasamaṅgāraktaśālibhiḥ|  
 
kacchurādhātakībilvasamaṅgāraktaśālibhiḥ|  
masūrāśvatthaśuṅgaiśca yavāgūḥ syājjalē śṛtaiḥ||38||  
+
 
 +
masūrāśvatthaśuṅgaiśca yavāgūḥ syājjalē śṛtaiḥ||38||
 +
 
bālōdumbarakaṭvaṅgasamaṅgāplakṣapallavaiḥ  |  
 
bālōdumbarakaṭvaṅgasamaṅgāplakṣapallavaiḥ  |  
 +
 
masūradhātakīpuṣpabalābhiśca tathā bhavēt||39||
 
masūradhātakīpuṣpabalābhiśca tathā bhavēt||39||
  
 
kacchurAdhAtakIbilvasama~ggAraktashAlibhiH|  
 
kacchurAdhAtakIbilvasama~ggAraktashAlibhiH|  
 +
 
masUrAshvatthashu~ggaishca yavAgUH syAjjale shRutaiH||38||  
 
masUrAshvatthashu~ggaishca yavAgUH syAjjale shRutaiH||38||  
 +
 
bAlodumbarakaTva~ggasama~ggAplakShapallavaiH  |  
 
bAlodumbarakaTva~ggasama~ggAplakShapallavaiH  |  
 +
 
masUradhAtakIpuShpabalAbhishca tathA bhavet||39||
 
masUradhAtakIpuShpabalAbhishca tathA bhavet||39||
 +
</div></div>
  
A yavāgū (gruel) prepared by cooking raktaśālī (a variety of rice brownish in color) masūra (Lens culinaris Medic.)) in a decoction of kacchurā (Mucuna pruriens Baker. ), dhātakī (Woodfordia fruticosa Kurz.), bilva (Aegle marmelos Carr.), samaṅgā (Mimosa pudica Linn.) and aśvatthaśuṅga (leaf bud of Ficus religiosa Linn.) is beneficial in atisāra.  
+
A ''yavagu'' (gruel) prepared by cooking ''raktashali'' (a variety of rice brownish in color) and ''masura'' (Lens culinaris Medic.)) in a decoction of ''kacchura'' (Mucuna pruriens Baker. ), ''dhataki'' (Woodfordia fruticosa Kurz.), ''bilva'' (Aegle marmelos Carr.), ''samanga'' (Mimosa pudica Linn.) and ''ashvatthashunga'' (leaf bud of Ficus religiosa Linn.) is beneficial in ''atisara''.
Similar preparation can be made with unripe fruit of udumbara, leaves of kaṭvaṅga (Ailanthus excelsa Roxb.) and samaṅgā as well as plakṣa (Ficus lacor Buch.), masūra (Lens culinaris Medic.) and dhātakī flowers. (38-39)
+
 +
Similar preparation can be made with unripe fruit of ''udumbara'', leaves of ''kathvanga'' (Ailanthus excelsa Roxb.) and ''samanga'' as well as ''plaksha'' (Ficus lacor Buch.), ''masura'' (Lens culinaris Medic.) and ''dhataki'' flowers. [38-39]
  
Treatment of all types of diarrhea:
+
=== Treatment of all types of diarrhea ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
स्थिरादीनां बलादीनामिक्ष्वादीनामथापि वा|  
 
स्थिरादीनां बलादीनामिक्ष्वादीनामथापि वा|  
 +
 
क्वाथेषु समसूराणां यवाग्वः स्युः पृथक् पृथक्||४०||  
 
क्वाथेषु समसूराणां यवाग्वः स्युः पृथक् पृथक्||४०||  
 +
 
कच्छुरामूलशाल्यादितण्डुलैरुपसाधिताः|  
 
कच्छुरामूलशाल्यादितण्डुलैरुपसाधिताः|  
 +
 
दधितक्रारनालाम्लक्षीरेष्विक्षुरसेऽपि वा||४१||  
 
दधितक्रारनालाम्लक्षीरेष्विक्षुरसेऽपि वा||४१||  
 +
 
शीताः सशर्कराक्षौद्राः सर्वातिसारनाशनाः|  
 
शीताः सशर्कराक्षौद्राः सर्वातिसारनाशनाः|  
 +
 
ससर्पिर्मरिचाजाज्यो मधुरा लवणाः शिवाः||४२||
 
ससर्पिर्मरिचाजाज्यो मधुरा लवणाः शिवाः||४२||
 +
<div class="mw-collapsible-content">
  
 
sthirādīnāṁ balādīnāmikṣvādīnāmathāpi vā|  
 
sthirādīnāṁ balādīnāmikṣvādīnāmathāpi vā|  
 +
 
kvāthēṣu samasūrāṇāṁ yavāgvaḥ syuḥ pṛthak pṛthak||40||  
 
kvāthēṣu samasūrāṇāṁ yavāgvaḥ syuḥ pṛthak pṛthak||40||  
 +
 
kacchurāmūlaśālyāditaṇḍulairupasādhitāḥ|  
 
kacchurāmūlaśālyāditaṇḍulairupasādhitāḥ|  
 +
 
dadhitakrāranālāmlakṣīrēṣvikṣurasē'pi vā||41||  
 
dadhitakrāranālāmlakṣīrēṣvikṣurasē'pi vā||41||  
 +
 
śītāḥ saśarkarākṣaudrāḥ sarvātisāranāśanāḥ|  
 
śītāḥ saśarkarākṣaudrāḥ sarvātisāranāśanāḥ|  
 +
 
sasarpirmaricājājyō madhurā lavaṇāḥ śivāḥ||42||  
 
sasarpirmaricājājyō madhurā lavaṇāḥ śivāḥ||42||  
 +
 
sthirAdInAM balAdInAmikShvAdInAmathApi vA|  
 
sthirAdInAM balAdInAmikShvAdInAmathApi vA|  
 +
 
kvAtheShu samasUrANAM yavAgvaH syuH pRuthak pRuthak||40||  
 
kvAtheShu samasUrANAM yavAgvaH syuH pRuthak pRuthak||40||  
 +
 
kacchurAmUlashAlyAditaNDulairupasAdhitAH|  
 
kacchurAmUlashAlyAditaNDulairupasAdhitAH|  
 +
 
dadhitakrAranAlAmlakShIreShvikShurase~api vA||41||  
 
dadhitakrAranAlAmlakShIreShvikShurase~api vA||41||  
 +
 
shItAH sasharkarAkShaudrAH sarvAtisAranAshanAH|  
 
shItAH sasharkarAkShaudrAH sarvAtisAranAshanAH|  
 +
 
sasarpirmaricAjAjyo madhurA lavaNAH shivAH||42||
 
sasarpirmaricAjAjyo madhurA lavaNAH shivAH||42||
 +
</div></div>
  
Different yavāgūs can be prepared by combining masūra (Lens culinaris Medic.) with the decoctions of sthirādi, balādi and ikṣvādi (groups of plants). (40)
+
Different ''yavagus'' can be prepared by combining ''masura'' (Lens culinaris Medic.) with the decoctions of ''sthiradi, baladi'' and ''ikshvadi'' (groups of plants). [40]
Roots of kacchurā (Mucuna pruriens Baker.) and rice of śālī and other varieties cooked with dadhi (yogurt), takra (churned yogurt) āranāla (sour fermented supernatant of cooked rice), kṣīra (milk) or ikṣurasa (sugarcane juice), and after being cooled added with sugar and honey, is able to treat all types of atisāra. The above-mentioned gruels are promising (anti-diarrhoeal) when added with ghṛta, pepper and cumin (Cuminum cyminum Linn.), sweet substances and rock salt. (41-42)
 
  
 +
Roots of ''kacchura'' (Mucuna pruriens Baker.) and rice of ''shali'' and other varieties cooked with ''dadhi'' (yogurt), ''takra'' (churned yogurt), ''aranala'' (sour fermented supernatant of cooked rice), ''ksheera'' (milk) or ''ikshurasa'' (sugarcane juice), and after being cooled added with sugar and honey, is able to treat all types of ''atisara''. The above-mentioned gruels are promising (anti-diarreal) when added with ''ghrita'', pepper and cumin (Cuminum cyminum Linn.), sweet substances and rock salt. [41-42]
  
Treatment principles:
+
=== Treatment principles ===
भवन्ति चात्र श्लोकाः-  
+
<div class="mw-collapsible mw-collapsed">
 +
 
 +
भवन्ति चात्र श्लोकाः-
 +
 
स्निग्धाम्ललवणमधुरं पानं बस्तिश्च मारुते कोष्णः|  
 
स्निग्धाम्ललवणमधुरं पानं बस्तिश्च मारुते कोष्णः|  
 +
 
शीतं तिक्तकषायं मधुरं पित्ते च रक्ते च||४३||  
 
शीतं तिक्तकषायं मधुरं पित्ते च रक्ते च||४३||  
 +
 
तिक्तोष्णकषायकटुश्लेष्मणि सङ्ग्राहि वातनुच्छकृति|  
 
तिक्तोष्णकषायकटुश्लेष्मणि सङ्ग्राहि वातनुच्छकृति|  
 +
 
पाचनमामे पानं पिच्छासृग्बस्तयो रक्ते||४४||  
 
पाचनमामे पानं पिच्छासृग्बस्तयो रक्ते||४४||  
 +
 
अतिसारं प्रत्युक्तं मिश्रं द्वन्द्वादियोगजेष्वपि च|  
 
अतिसारं प्रत्युक्तं मिश्रं द्वन्द्वादियोगजेष्वपि च|  
 +
 
तत्रोद्रेकविशेषाद्दोषेषूपक्रमः कार्यः||४५||
 
तत्रोद्रेकविशेषाद्दोषेषूपक्रमः कार्यः||४५||
 +
<div class="mw-collapsible-content">
 +
 
bhavanti cātra ślōkāḥ-  
 
bhavanti cātra ślōkāḥ-  
 +
 
snigdhāmlalavaṇamadhuraṁ pānaṁ bastiśca mārutē kōṣṇaḥ|  
 
snigdhāmlalavaṇamadhuraṁ pānaṁ bastiśca mārutē kōṣṇaḥ|  
 +
 
śītaṁ tiktakaṣāyaṁ madhuraṁ pittē ca raktē ca||43||  
 
śītaṁ tiktakaṣāyaṁ madhuraṁ pittē ca raktē ca||43||  
 +
 
tiktōṣṇakaṣāyakaṭuślēṣmaṇi saṅgrāhi vātanucchakṛti|  
 
tiktōṣṇakaṣāyakaṭuślēṣmaṇi saṅgrāhi vātanucchakṛti|  
 +
 
pācanamāmē pānaṁ picchāsṛgbastayō raktē||44||  
 
pācanamāmē pānaṁ picchāsṛgbastayō raktē||44||  
 +
 
atisāraṁ pratyuktaṁ miśraṁ dvandvādiyōgajēṣvapi [1] ca|  
 
atisāraṁ pratyuktaṁ miśraṁ dvandvādiyōgajēṣvapi [1] ca|  
 +
 
tatrōdrēkaviśēṣāddōṣēṣūpakramaḥ kāryaḥ||45||  
 
tatrōdrēkaviśēṣāddōṣēṣūpakramaḥ kāryaḥ||45||  
  
 
bhavanti cAtra shlokAH-  
 
bhavanti cAtra shlokAH-  
 +
 
snigdhAmlalavaNamadhuraM pAnaM bastishca mArute koShNaH|  
 
snigdhAmlalavaNamadhuraM pAnaM bastishca mArute koShNaH|  
 +
 
shItaM tiktakaShAyaM madhuraM pitte ca rakte ca||43||  
 
shItaM tiktakaShAyaM madhuraM pitte ca rakte ca||43||  
 +
 
tiktoShNakaShAyakaTushleShmaNi sa~ggrAhi vAtanucchakRuti|  
 
tiktoShNakaShAyakaTushleShmaNi sa~ggrAhi vAtanucchakRuti|  
 +
 
pAcanamAme pAnaM picchAsRugbastayo rakte||44||  
 
pAcanamAme pAnaM picchAsRugbastayo rakte||44||  
 +
 
atisAraM pratyuktaM mishraM dvandvAdiyogajeShvapi  ca|  
 
atisAraM pratyuktaM mishraM dvandvAdiyogajeShvapi  ca|  
 +
 
tatrodrekavisheShAddoSheShUpakramaH kAryaH||45||
 
tatrodrekavisheShAddoSheShUpakramaH kAryaH||45||
 +
</div></div>
 +
 +
Here the ''shlokas'' (verses) remain-
 +
 +
(Besides the above some more treatment-principles useful in ''atisaras'' are given below as per the factors involved)
 +
 +
#''[[Vata]]: snigdha'' (unctuous) ''amla'' (sour) ''lavana'' (salty) and ''madhura'' (sweet) liquids orally and warm ''[[basti]]s'' with same substances.
 +
#''[[Pitta]]'' and ''[[rakta]]'': cold bitter astringent and sweet substances.
 +
#''[[Kapha]]'': bitter, hot, astringent and pungent substances.
 +
#''Shakrita'' (stool): ''sangrahi'' (checks ''atisara'' through improving the digestion) and ''vataghna'' (measures)
 +
#''Ama: [[pachana]]'' (measures digesting ''ama'')
 +
#''[[Rakta]]: picchabasti'' and ''raktabasti'' 
 +
#''Atisara'' may also be in combination of two or more factors. In those conditions treatment is to be planned according to dominance of the ''[[dosha]]s'' (and the factors involved). [43-45]
  
Here the ślōkas (verses) remain-
+
=== Summary ===
(Besides the above some more treatment-principles useful in atisāras are given below as per the factors involved)
+
<div class="mw-collapsible mw-collapsed">
Vāta: snigdha (unctuous) amla (sour) lavaṇa (salty) and madhura (sweet) liquids orally and 
 
warm bastis with same substances.
 
Pitta and rakta: cold bitter astringent and sweet subsances.
 
Kapha: bitter, hot, astringent and pungent subsances.
 
Śakṛt (stool): saṅgrāhi (checks atisāra through improving the digestion) and vātaghna
 
(measures)
 
Āma: pāchana (measures digesting āma)
 
Rakta:  picchābasti and raktabasti 
 
Atisāra may also be in combination of two or more factors. In those conditions treatment is to be planned according to dominance of the doṣhas (and the factors involved). (43-45)
 
  
Summary:
 
 
तत्र श्लोकः-  
 
तत्र श्लोकः-  
 +
 
प्रासृतिकाः सव्यापत्क्रिया निरूहास्तथाऽतिसारहिताः|  
 
प्रासृतिकाः सव्यापत्क्रिया निरूहास्तथाऽतिसारहिताः|  
 +
 
रसकल्पघृतयवाग्वश्चोक्ता  गुरुणा प्रसृतसिद्धौ||४६||
 
रसकल्पघृतयवाग्वश्चोक्ता  गुरुणा प्रसृतसिद्धौ||४६||
 +
<div class="mw-collapsible-content">
 +
 
tatra ślōkaḥ-  
 
tatra ślōkaḥ-  
 +
 
prāsṛtikāḥ savyāpatkriyā nirūhāstathā'tisārahitāḥ|  
 
prāsṛtikāḥ savyāpatkriyā nirūhāstathā'tisārahitāḥ|  
 +
 
rasakalpaghṛtayavāgvaścōktā [1] guruṇā prasṛtasiddhau||46||  
 
rasakalpaghṛtayavāgvaścōktā [1] guruṇā prasṛtasiddhau||46||  
  
 
tatra shlokaH-  
 
tatra shlokaH-  
 +
 
prAsRutikAH savyApatkriyA nirUhAstathA~atisArahitAH|  
 
prAsRutikAH savyApatkriyA nirUhAstathA~atisArahitAH|  
 +
 
rasakalpaghRutayavAgvashcoktA [1] guruNA prasRutasiddhau||46||
 
rasakalpaghRutayavAgvashcoktA [1] guruNA prasRutasiddhau||46||
 +
</div></div>
 +
 +
In this chapter of [[Prasrita Yogiyam Siddhi]] management of the complications, ''prasritika niruhas'', and the ''[[basti]]s,'' decoctions, ''ghrita'', gruels useful in the management of ''atisaras'' are presented by the teacher. [46]
 +
<div class="mw-collapsible mw-collapsed">
  
In this chapter of prāsṛtayōgīyā siddhi, management of the complications, prāsṛtika nirūhas, and the bastis, decoctions, ghṛta, gruels useful in the management of atisāras are presented by the teacher. (46)
+
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते
  
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते
 
 
दृढबलसम्पूरिते सिद्धिस्थाने प्रासृतयोगीयसिद्धिर्नामाष्टमोऽध्यायः ||८||
 
दृढबलसम्पूरिते सिद्धिस्थाने प्रासृतयोगीयसिद्धिर्नामाष्टमोऽध्यायः ||८||
 +
<div class="mw-collapsible-content">
 +
 
ityagnivēśakṛtē tantrē carakapratisaṁskṛtē'prāptē  
 
ityagnivēśakṛtē tantrē carakapratisaṁskṛtē'prāptē  
 +
 
dṛḍhabalasampūritē siddhisthānē prāsṛtayōgīyasiddhirnāmāṣṭamō'dhyāyaḥ [1] ||8||  
 
dṛḍhabalasampūritē siddhisthānē prāsṛtayōgīyasiddhirnāmāṣṭamō'dhyāyaḥ [1] ||8||  
  
 
ityagniveshakRute tantre carakapratisaMskRute~aprApte  
 
ityagniveshakRute tantre carakapratisaMskRute~aprApte  
 +
 
dRuDhabalasampUrite siddhisthAne prAsRutayogIyasiddhirnAmAShTamo~adhyAyaH [1] ||8||
 
dRuDhabalasampUrite siddhisthAne prAsRutayogIyasiddhirnAmAShTamo~adhyAyaH [1] ||8||
 +
</div></div>
 +
 +
Thus in the treatise (originally) prepared by Agnivesha, edited by Charak and supplemented the lost parts by Dridhabala, in [[Siddhi Sthana]], the eighth chapter entitled [[Prasrita Yogiyam Siddhi]] is concluded.
 +
 +
== Tattva Vimarsha (Fundamental Principles) ==
 +
 +
*A milder form of ''[[basti]]'' can get stagnated inside leading to complications of not eliminating ''[[dosha]]s''. This may result into ''ayoga'' or ''heenayoga'' (insufficient action). On the contrary if a ''[[basti]]'' is stronger it may cause an ''atiyoga'' (action in excess) causing excessive evacuation of ''[[dosha]]'' along with body constituents.
 +
*Faulty application of ''[[basti]]s'' may cause a complication in the form of ''atisara'' (diarrhea).
 +
*''Atisara'' (diarrhea) may be either acute with undigested material associated with ''ama'' or chronic without much undigested material/ ''pakwa''.
 +
*''Pakwa'' type of ''atisara'' is again of five types as with ''shakrita'' (fecal matter), with ''[[vata]]'' (flatus), with ''asrika'' (blood), with ''[[pitta]]'' and with ''[[kapha]]''.
 +
*Basic principle of treatment of every condition associated with ''ama'' is ''amapachana''. Decoction / powder of ''musta, ativisha, kushtha, nata, daru'' and ''vacha'' are ideal for ''amapachana''. This recipe is useful in ''amatisara''.
 +
*To manage ''pakvatisara'', medicines of two categories viz. ''vataghna'' (anti-''vata'') and ''grahi'' (anti-diarrheal by promoting digestion and absorption) are used.
 +
*''Picchabasti'' and ''raktabasti'' are treatments for diarrhea with blood.These can be considered as ''[[stambhana]]'' (stop bleeding) and ''vishesha [[brimhana]]'' (enhance internal strength).
 +
*The treatment principles of various types of ''atisara'' due to complications of ''[[basti]]'' therapy:
 +
**''[[Vata]]'': ''snigdha'' (unctuous), ''amla'' (sour), ''lavana'' (salty) and ''madhura'' (sweet) liquids orally and warm ''[[basti]]s'' with same substances.
 +
**''[[Pitta]]'' and ''[[rakta]]'': cold bitter astringent and sweet substances.
 +
**''[[Kapha]]'': bitter, hot, astringent and pungent substances.
 +
**''Shakrita'' (stool): ''sangrahi'' (checks ''atisara'' through improving the digestion) and ''vataghna'' (measures)
 +
**''Ama: [[pachana]]'' (measures digesting ''ama'')
 +
**''[[Rakta]]: picchabasti'' and ''raktabasti''.
 +
 +
== Vidhi Vimarsha (Applied Inferences ) ==
 +
 +
The unit ''prasrita'', according to [[Charak Samhita]] is an amount of two ''palas'' which is approximately equal to 100 milliliter (1''pala''=50ml).<ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.4. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.</ref>,<ref>Agnihotri Avadhabihari; Bhaiṣajyakalpanā Vijñāna; Chaukhamba orientalia publication, 6th edition, 2006, P 7-20.</ref> (verse 1-2)[[Charak Samhita]] is written in the form of dialogue between the teacher (Atreya) and his disciples (mainly Agnivesha). Mild form of ''[[shodhana]]'' measures are for those subjects who are not suitable for strong measures and for the patients who suffered with the complications of the measures described in previous chapters. ''[[Vamana]]'' and ''[[virechana]]'' are major procedures for ''[[shodhana]]''. However, these are contraindicated for the tender persons. Tender persons may not tolerate even ''[[basti]]''. Therefore, mild forms of ''[[basti]]s'' are described for them. Similarly, the measures to treat the complications developed due to the faulty application of the procedures especially the ''[[basti]]''.
 +
 +
Some translators interpreted the phrase ''karmana viplutanama'' as ‘exhausted of hard work’.<ref> Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.3. In: Dash Bhagavan & Sharma R K, Editor. Charak Samhita.2nd ed. Varanasi: Chowkhamba Sanskrit Series, 2005; P 310</ref>
 +
However, the meaning of this phrase can be taken as ‘complicated by the consequences of the therapies’, which seems to be more appropriate in this context. The complications may be natural consequences of the therapies or may be due to faulty application. (verse 3)
 +
 +
The recipe in verse 4 is composed of total five ''prasritas'' (2 ''prasritas'' of milk, 1 ''prasrita'' each of honey, sesame oil and ''ghrita''), therefore this ''[[basti]]'' is named by Gangadhara as ''panchaprasrtika basti''.<ref>Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya . In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3735.</ref> This ''[[basti]]'' is useful for eliminating ''[[vata]]'' as well as promoting the strength and the complexion.
  
Thus in the treatise (originally) prepared by Agnivēśa, edited by Charaka  and supplemented the lost parts by Dṛḍhabala, in its siddhisthāna section, the eighth chapter entitled prāsṛtayōgīyā siddhi is concluded.
+
''[[Vata]]'' eliminating measures usually promotes quality of ''[[dhatu]]s'' and ''upadhatus'' (structural components of the body). This eventually results in promotion of the body strength and the complexion. Word ''bala'' also denotes the immune function; hence this may also be interpreted as promoting immune activity. In ancient time to mix a ''[[basti]]'' material, churning stick was used. In modern time an electric blender is an ideal alternative. With a blender the mixture is better homogenized than a manual churning stick.
  
Tattva Vimarsha:
+
Chakrapani considered ''bilvadi'' group in his [[Ayurveda]] ''deepika'' commentary as ''dashamula''.<ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.5. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.</ref> This group consists of roots of ten plants viz. ''bilva'' (Aegle marmelos Carr.), ''shyonaka'' (Oroxylum indicumVent.),''gambhari'' (Gmelina arborea Roxb.), ''patala'' (Stereospermum suaveolensDC.),''agnimantha'' (Premna integrifolia Roxb.), ''shalaparni'' (Desmodium gangeticumDC.), ''prishniparni'' (Uraria picta Desr.) ''brihati'' (Solanum indicum Linn.), ''kantakari'' (Solanum suranttense Burm.) and ''gokshura'' (Tribulus terrestris Linn.).  
• A milder form of basti can get stagnated inside leading to complications of not eliminating doshas. This may result into ayoga or hīnayoga (insufficient action). On the contrary if a basti is stronger it may cause an atiyoga (action in excess) causing excessive evacuation of dosha along with body constituents.
 
• Faulty application of bastis may cause a complication in the form of atisāra (diarrhea).
 
• Atisāra (diarrhea) may be either acute with undigested material associated with āma  or chronic without much undigested material/ pakwa.
 
• Pakwa type of Atisara is again of 5 types as with shakrit (fecal matter), with vata (flatus), with asrik (blood), with pitta  and with kapha.  
 
• Basic principle of treatment of every condition associated with āma is āmapāchana. Decoction / powder of mustā, ativiṣā, kuṣṭha, nata, dāru and vacā are ideal for amapachana. This recipe is useful in āmātisāra.
 
• To manage pakvātisāra, medicines of two categories viz. vātaghna (anti-vāta) and grāhī (antidiarrheal by promoting digestion and absorption) are used.
 
• Picchabasti and raktabasti are treatments for diarrhea with blood.These can be considered as stambhana (stop bleeding) and vishesha brimhana (enhance internal strength).  
 
• The treatment principles of various types of atisara due to complications of basti therapy:
 
o Vāta: snigdha (unctuous) amla (sour) lavaṇa (salty) and madhura (sweet) liquids orally and warm bastis with same substances.
 
o Pitta and rakta: cold bitter astringent and sweet subsances.
 
o Kapha: bitter, hot, astringent and pungent subsances.
 
o Śakṛt (stool): saṅgrāhi (checks atisāra through improving the digestion) and vātaghna  (measures)
 
o Āma: pāchana (measures digesting āma)
 
o Rakta: picchābasti and raktabasti.
 
  
 +
While Gangadhara in his ''Jalpakalpataru'' commentary mentions this as ''panchamula'' –the roots of a group of five plants viz. ''bilva,shyonaka, gambhari, patala'' and ''agnimantha.''<ref>Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya.Verse 5 In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3735.</ref>Since next verse (5th) describes a recipe with ''panchamula'', in this verse considering ''bilvadi'' as ''dashamula'' is more logical and practical. This ''[[basti]]'' consists a total of eight ''prasritas'' (one ''prasrita'' each of ''taila, prasanna, madhu'' and ''ghrita'' and two ''prasritas'' each of ''bilvadi'' decoction and ''kulattha'' decoction). Therefore, Gangadhara names this as ''ashtaprasritika [[basti]]''.<ref>Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya . In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3735.</ref>
  
Vidhi vimarsha:
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The ''[[basti]]'' in verse six, consists of total nine ''prasritas'' i.e. ''panchamula'' decoction- five ''prasritas'', sesame oil - two ''prasritas'', honey- one ''prasrita, ghrita''- one ''prasrita''. Therefore, Gangadhara names this as ''navaprasritika [[basti]]''.<ref>Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya . In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3736.</ref> (verses 4-6)
The unit prasṛta, according to caraka saṁhitā is an amount of two palas which is approximately equal to 100 milliliter (1pala=50ml).[ ] ,[ ] (verse 1-2)Carakasamhitā is written in the form of dialogue between the teacher (Ātreya) and his disciples (mainly Agniveśa). Mild form of shodhana measures are for those subjects who are not suitable for strong measures and for the patients who suffered with the complications of the measures described in previous chapters. Vamana and virechana are major procedures for shodhana. However, these are contraindicated for the tender persons. Tender persons may not tolerate even basti. Therefore, mild forms of bastis are described for them. Similarly, the measures to treat the complications developed due to the faulty application of the procedures especially the basti.  
 
Some translators interpreted the phrase ‘karmaṇā viplutānāṁ’ as ‘exhausted of hard work’.[ ] However, the meaning of this phrase can be taken as ‘complicated by the consequences of the therapies’, which seems to be more appropriate in this context. The complications may be natural consequences of the therapies or may be due to faulty application. (verse 3)
 
  
The recipe in verse 4 is composed of total five prasṛtas (2 prasṛtas of milk, 1 prasṛta each of honey, sesame oil and ghṛta), therefore this basti is named by Gaṅgādhara as pāñcaprāsṛtika basti.[ ] This basti is useful for eliminating vāta as well as promoting the strength and the complexion.
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''Aksha'' and ''karsha'' are the units of same amount, which is equal to about twelve grams. Hence the amount of rock salt in this [[basti]] would be about 6 grams. ''[[Shukra]]'' is one of the seven ''[[dhatu]]s'' (structural components). ''[[Shukra]]'' is not a single entity. It comprises male reproductive cells and substances including the androgenic hormones responsible for manhood in a man. This ''[[basti]]'' promotes quality and quantity of all these entities in the body.
Vāta eliminating mesures usually promotes quality of dhātus and upadhātus (structural components of the body). This eventually results in promotion of the body strength and the complexion. Word ‘bala’ also denotes the immune function; hence this may also be interpreted as promoting immune activity. In ancient time to mix a basti material, churning stick was used. In modern time an electric blender is an ideal alternative. With a blender the mixture is better homogenized than a manual churning stick.
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Cakrapāṇi considered bilvādi group in his Āyurveda dīpikā commentary as daśamula.[ ]This group consists of roots of ten plants viz. bilva (Aegle marmelos Carr.), śyonāka (Oroxylum indicumVent.),gambhārī (Gmelina arborea Roxb.), pāṭalā (Stereospermum suaveolensDC.),agnimantha (Premna integrifolia Roxb.), śālaparṇī (Desmodium gangeticumDC.), pṛśniparṇī (Uraria picta Desr.) bṛhatī (Solanum indicum Linn.) kaṇṭakārī (Solanum suranttense Burm.) and gokṣura (Tribulus terrestris Linn.).  While Gaṅgādhara in his Jalpakalpataru commentary mentions this as pañchamūla –the roots of a group of five plants viz. bilva,śyonāka, gambhārī, pāṭalā and agnimantha.[ ]Since next verse (5th) describes a recipe with pañchamūla, in this verse considering bilvādi as daśamula is more logical and practical. This basti consists a total of eight prasṛtas (one prasṛta each of taila, prasannā, madhu and ghṛta and two prasṛtaseachof bilvādi decoction and kulattha decoction). Therefore, Gaṅgādhara names this as aṣṭaprāsṛtika basti.[ ]
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The usual contents of a ''niruha [[basti]]'' are salt, honey, oil'', kalka'' and decoction (or a liquid). These are to be mixed by churning in the sequence as mentioned above. Here the mixing may be in this sequence- ''saindhava'', honey, oil, ''ghrita, hapusha'' (fruits of Juniperus communis Linn.)and milk.(verse 7)
The basti in verse six, consists of total nine prasṛtas i.e. pañchamūla decoction- five prasṛtas, sesame oil - two prasṛtas, honey- one prasṛta, ghṛta- one prasṛta. Therefore, Gaṅgādhara names this as navaprāsṛtika basti.[ ] (verses 4-6)
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Akṣa and karṣa are the units of same amount, which is equal to about twelve grams. Hence the amount of rock salt in this basti would be about 6 grams. Śukra is one of the seven dhātus (structural components). Śukra is not a single entity. It comprises male reprodudtive cells and substances including the androgenic hormones responsible for manhood in a man. This basti promotes quality and quantity of all these entities in the body.
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''[[Basti]]'' is usually contraindicated in ''kushtha''<ref>Charak. Sidhi Sthana, Cha.2 Panchakamiya Siddhi ver.14. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 688.</ref>. However, Sushruta Samhita recommends ''niruhabastis'' in this condition.<ref>Sushruta. Chikitsa Sthana, Cha.35 Netrabastipramana pravibhaga Chikitsitam Adhyaya verse 22. In: Jadavaji Trikamji Aacharya and Narayana Ram Acharya, Editors. Sushruta Samhita. 4th ed. Varanasi: Chaukhambha Orientalia;1980, P 527.</ref> Practically ''niruha [[basti]]'', with bitter substances e.g. ''panchatikta niruha'', is useful in ''kushtha''.
The usual contents of a nirūha basti are salt, honey, oil, kalka and decoction (or a liquid). These are to be mixed by churning in the sequence as mentioned above. Here the mixing may be in this sequence- saindhava, honey, oil, ghṛta, hapuṣā (fruits of Juniperus communis Linn.)and milk.
+
 
(verse 7)
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The quantity of ''kalka'' of ''sarshapa'' is not mentioned in the above recipe. According to commentary of Chakrapani on this verse, it may be decided. <ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.8-9. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.</ref> In the ''niruha bastis'' with an amount of twelve ''prasritas'', the amount of ''kalka'' is usually two ''palas'' (about 100gms). In present recipe, the amount is five ''prasritas'' and therefore the amount of ''kalka'' of ''sarshapa'' would be about 40 gms. This principle is applicable in latter recipes also where the amount of ''kalka'' is not mentioned.
Basti is usually contraindicated in kuṣṭha [Ca. Si. 2/14][ ]. However, Suśrutasaṁhitā recommends nirūhabastis in this condition [Su.Ci.35/22].[ ] Practically nirūha basti, with bitter substances e.g. pañchatikta nirūha, is useful in kuṣṭha.
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The quantity of kalka of sarṣapa is not mentioned in the above recipe. According to commentary of Cakrapāṇi on this verse, it may be decided. [ ] In the nirūha bastis with an amount of twelve prasṛtas, the amount of kalka is usually two palas (about100gms). In present recipe, the amount is five prasṛtas and therefore the amount of kalka of sarṣapa would be about 40 gms. This principle is applicable in latter recipes also where the amount of kalka is not mentioned.  
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This ''[[basti]]'' contains ''vidanga'' (Embelia ribes Burm.) which is the best among ''krimighna''(anti-parasitic) [Cha. Sa. [[Sutra Sthana]] 25/40] substances. Therefore, it has a ''kriminashana'' effect. (verse 9-10)
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 +
Gangadhara in his ''Jalpakalpataru'' commentary considers ''payasyas ksheerakakoli'', which is Fritillaria roylei Hook. Some scholars consider ''payasyaas vidari'', but at present, ''vidari'' recipies already include one ingredient therefore to consider it ''ksheerakakoli'' is appropriate.
  
This basti contains viḍaṅga (Embelia ribes Burm.) which is the best among krimighna(anti-parasitic) [Ca.Su. 25/40] substances. Therefore, it has a krimināśana effect. (verse 9-10)
 
Gaṅgādhara in his Jalpakalpataru commentary considers payasyāas kṣīrakākolī, which is Fritillaria roylei Hook. Some scholars consider payasyāas vidārī, but in present recipe vidārīis already one ingredient therefore to consider it kṣīrakākolīis appropriate.
 
 
In the recipes of verse 11-12, the amount of paste is not mentioned. This may be calculated as stated in earlier verse 8th -9th. (verse 11-12)
 
In the recipes of verse 11-12, the amount of paste is not mentioned. This may be calculated as stated in earlier verse 8th -9th. (verse 11-12)
In above verses from 4 to 14, nine recipes of prasṛtabastis are described. Here a special and practical instruction is given that even if salt is not mentioned in any of the recipes, rock salt is to be added and these bastis are always given with a moderate warm temperature.
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While preparing the bastis, rock salt is to be added. The amount is to be calculated according to the principle described in the 7th verse i.e. about 6 gms. After preparing the basti, to keep it warm until it is administered, a hot water bath may be used. (verse 13-14)
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In above verses from 4 to 14, nine recipes of ''prasrita bastis'' are described. Here a special and practical instruction is given that even if salt is not mentioned in any of the recipes, rock salt is to be added and these ''[[basti]]s'' are always given with a moderate warm temperature.
In the verse 15-16, two opposite possibilities are described.  It may be milder than normal or it may be stronger than a normal. A mild basti is unable not only to eliminate doṣas, but it itself is not ableto come out. This is ayoga or hīnayoga (insufficient action). In such a case a basti is to be repeated with a stronger recipe. Contrary to this, if a basti is stronger it may cause an atiyoga (action in excess) causing evacuation of colonic contents more than required and eventually loss of essential substances.
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A soft acting basti is not able to eliminate the doṣhas and may get stagnated and cause disturbance. To eliminate it, a strong and sharp acting basti is recommended. If strong bastis have caused emaciation, dehydration or weakness, the bastis with madhura (sweet) substances are useful because madhura substances are nourishing in action. (verses 15-16)
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While preparing the ''[[basti]]s'', rock salt is to be added. The amount is to be calculated according to the principle described in the 7th verse i.e. about 6 gms. After preparing the ''[[basti]]'', to keep it warm until it is administered, a hot water bath may be used. (verse 13-14)
In vāta-related disorders, basti material with physically and pharmacologically hot property is preferred. It may cause pitta aggravation resulting in burning sensation and other such pitta-related symptoms. In such a condition, grape juice or decoction of raisins added with a kalka (paste) of trivṛt (Operculina turpethum Linn.) is given. In case of unavailability of kalka, its powder can be used. This cures the burning sensation and other pitta-related symptoms with its anti-pitta action and expulsion of stool, pitta and vāta. Yavāgu with sugar is given for nourishing purpose after this laxation. (verses 16-17)
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In the verse 15-16, two opposite possibilities are described.  It may be milder than normal or it may be stronger than a normal. A mild ''[[basti]]'' is unable not only to eliminate ''[[dosha]]s'', but it itself is not ableto come out. This is ''ayoga'' or ''heenayoga'' (insufficient action). In such a case a ''[[basti]]'' is to be repeated with a stronger recipe. Contrary to this, if a ''[[basti]]'' is stronger it may cause an ''atiyoga'' (action in excess) causing evacuation of colonic contents more than required and eventually loss of essential substances.
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 +
A soft acting ''[[basti]]'' is not able to eliminate the ''[[dosha]]s'' and may get stagnated and cause disturbance. To eliminate it, a strong and sharp acting ''[[basti]]'' is recommended. If strong ''[[basti]]s'' have caused emaciation, dehydration or weakness, the ''[[basti]]s'' with ''madhura'' (sweet) substances are useful because ''madhura'' substances are nourishing in action. (verses 15-16)
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 +
In ''[[vata]]''-related disorders, ''[[basti]]'' material with physically and pharmacologically hot property is preferred. It may cause ''[[pitta]]'' aggravation resulting in burning sensation and other such ''[[pitta]]''-related symptoms. In such a condition, grape juice or decoction of raisins added with a ''kalka'' (paste) of ''trivrita'' (Operculina turpethum Linn.) is given. In case of unavailability of ''kalka'', its powder can be used. This cures the burning sensation and other ''[[pitta]]''-related symptoms with its anti-''[[pitta]]'' action and expulsion of stool, ''[[pitta]]'' and ''[[vata]]''. ''Yavagu'' with sugar is given for nourishing purpose after this laxation. (verses 16-17)
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If the purgation is in excess, it may cause significant loss of stool along with essential substances (e.g.water and electrolytes). This requires immediate attention to prevent the harm due to depletion of essential body components.
 
If the purgation is in excess, it may cause significant loss of stool along with essential substances (e.g.water and electrolytes). This requires immediate attention to prevent the harm due to depletion of essential body components.
In such a condition it is to be corrected by eating māṣayūṣa (soup of black beans) and kulmāṣa (half cooked grains); and by taking honey or surā. Kulmāṣa is also interpreted as a sour gruel (prepared by the spontaneous fermentation of fruit-juices or boiled rice). However, according to Cakrapāṇi this is half cooked grain (barley etc.), which is popularly known as ghughunī.[ ],[ ]This is known as ghughari in Gujarat and western Madhyapradesh. This is more suitable interpretation. This is considered to be well nourishing food article. (verse 18)
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Faulty application of bastis may cause a complication in the form of atisāra. Atisāra is a clinical condition of colon characterized by excessive and frequent defecation with altered consistency of stool. In short it may be interpreted as diarrhea. In next verse different forms of atisāra and their management are described. In this verse the condition is characterized by sāma stool (stool containing āma- undigested material), which smells like a decomposing body (putrid smell) and is associated with abdominal pain. Āma is a substance produced due to weak agni resulting in incomplete transformation of substance. In the present context, due to weak jatharāgni the transformation of food in to digested absorbable substances is incomplete resulting in to production of some intermediate substances.[ ],[ ] These substances are known as āma. Because of its adherent quality it is supposed to be a pathogenic substance.In this condition a decoction of mustā, ativiṣā, kuṣṭha, nata, dāru and vacā is recommended. These medicines help in pāchana (termination) of āma.
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In such a condition it is to be corrected by eating ''mashayusha'' (soup of black beans) and ''kulmasha'' (half cooked grains); and by taking honey or ''sura''. ''Kulmasha'' is also interpreted as a sour gruel (prepared by the spontaneous fermentation of fruit-juices or boiled rice). However, according to Chakrapani this is half cooked grain (barley etc.), which is popularly known as ''ghughuni''.<ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.18. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.</ref>,<ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya. Verse 13-14.In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3738.</ref>. This is known as ''ghughari'' in Gujarat and western Madhya Pradesh. This is more suitable interpretation. This is considered to be well nourishing food article. (verse 18)
This chapter describes six types of atisāra based on the pathogens being excreted in excess. This verse explains the remedy for one of them in which patient passes stool with significant undigested material. This undigested material causes putrid smell after decomposition. Decomposition also produces some toxic substances, which cause abdominal pain and loss of appetite. The recipe described here is not useful in atisāra produced as complication of basti but also in āmātisāra of any origin. (verse 19)
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Faulty application of ''[[basti]]s'' may cause a complication in the form of atisāra. ''Atisāra'' is a clinical condition of colon characterized by excessive and frequent defecation with altered consistency of stool. In short it may be interpreted as diarrhea. In next verse different forms of atisāra and their management are described. In this verse the condition is characterized by sāma stool (stool containing āma- undigested material), which smells like a decomposing body (putrid smell) and is associated with abdominal pain. Āma is a substance produced due to weak agni resulting in incomplete transformation of substance. In the present context, due to weak jatharāgni the transformation of food in to digested absorbable substances is incomplete resulting in to production of some intermediate substances.<ref>Vagbhata. Sutra Sthana, Cha.13 Doshopakramaniya Adhyaya verse 25. In: Bhiṣagācārya Hariśāstrī Parādakara Vaidya, Editors. Ashtanga Hridayam. 1oth ed. Varanasi: Chaukhambha Orientalia;2000.p.4.2014; P 216.</ref> ,<ref>Vijayarakshita and Srikanthadata, Madavakara chapter 25,Amavata nidana  Verse 5, In: Brakmanand Tripathi Editor, Madhava Nidana ? ed. Varanasi: Chaukhamba Surabharati Prakashan,2012; P 573-574.</ref>These substances are known as āma. Because of its adherent quality it is supposed to be a pathogenic substance.In this condition a decoction of ''mustā, ativiṣā, kuṣṭha, nata, dāru'' and ''vacā'' is recommended. These medicines help in ''[[pachana]]'' (termination) of āma.
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This chapter describes six types of ''atisāra'' based on the pathogens being excreted in excess. This verse explains the remedy for one of them in which patient passes stool with significant undigested material. This undigested material causes putrid smell after decomposition. Decomposition also produces some toxic substances, which cause abdominal pain and loss of appetite. The recipe described here is not useful in atisāra produced as complication of [[basti]] but also in āmātisāra of any origin. (verse 19)
  
 
This verse number 20 describes other five types of atisāra. In this way, six types of atisāras those are depicted in above verses are as follow.
 
This verse number 20 describes other five types of atisāra. In this way, six types of atisāras those are depicted in above verses are as follow.
1.Atisāra (diarrhea) in which stool contains āma (undigested material) 
 
2. Atisāra (diarrhea) in which stool is pakva i.e.free from āma (undigested material)
 
3. Atisāra (diarrhea) in which stool is pakva and containing vāta i.e. significant flatulence.
 
4. Atisāra (diarrhea) in which stool is pakva and containing asṛk (blood).
 
5. Atisāra (diarrhea) in which stool is pakva and containing pitta.
 
6. Atisāra (diarrhea) in which stool is pakva and containing kapha.
 
  
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#''Atisara'' (diarrhea) in which stool contains ''ama'' (undigested material) 
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#Atisāra (diarrhea) in which stool is pakva i.e.free from āma (undigested material)
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#Atisāra (diarrhea) in which stool is pakva and containing [[vata]] i.e. significant flatulence.
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#Atisāra (diarrhea) in which stool is pakva and containing asṛk (blood).
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#Atisāra (diarrhea) in which stool is pakva and containing [[pitta]].
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#Atisāra (diarrhea) in which stool is pakva and containing [[kapha]].
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For the management of these conditions [[basti]]s prepared with the svavargīya medicines (group of medicines acting against particular pathologies) are given.<ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.20. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714.</ref> For example the vargas (classified groups) described in Ṣaḍvirecanaśatāśrīya chapter (chapter 4th) of sūtrasthāna of Carakasaṁhitā. So, the recommended group of medicines for last five conditions of pathology is  purīṣasaṁgrahaṇīya [Cha.Sa.[[Sutra Sthana]] 4/8/31], vātaghna, śoṇitasthāpana [Cha.Sa.[[Sutra Sthana]] 4/8/46], pittaghna  and kaphaghna vargas  respectively.<ref>Chakrapani, Charak. Sidhi Sthana, Cha.4 Snehavyapat Siddhi ver.8. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714. P 33 & 34.</ref>.Purīṣasaṁgrahaṇīya group consists of priyaṅgu (Callicarpa macrophylla R.Br.), ananta (Hemidesmus indicusR.Br.), Seed of  mango, kaṭvaṅga (Ailanthus excelsa Roxb.), lodhra (Symplocos racemosa Roxb.), mocharasa (secretion of Salmalia malabarica Scott&Endl.), samṅgā (Mimosa pudica Linn.), dhātakī (Woodfordia fruticosa Kurz.), padmā (Clerodendrum serratum Linn.) and padmakesara (Stamen of Nelumbo nucifera Gaertn.). shoṇitasthāpana group consists of honey, madhuka (Glycyrrhiza glabra Linn.), saffron, mocarasa (secretion of Salmalia malabarica Scott &Endl.), broken earthen vessel, lodhra (Symplocos racemosa Roxb.), gairika (red ochre), priyaṅgu (Callicarpa macrophylla  R.Br.), sharkarā(sugar) and lājā (puffed rice).<ref>Chakrapani, Charak. Sidhi Sthana, Cha.4 Snehavyapat Siddhi ver.8. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714. P 33 & 34.</ref>The form of [[basti]] is not described here. However, this may be decided according to disease condition and patient’s tolerance. (verse 20)
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In this version of [[Charak Samhita]] thirty six variants are cited, but another version ‘kēvalaiḥ saha ceṭ triṁśadvidyāt sōpadravānapi’ mentions only thirty.<ref>Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya . In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3739.</ref> Gaṅgādhara also explains thirty forms in the following manner.<ref>Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya.Verse 17 In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3739.</ref>
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The six basic forms of atisāra are:
 +
#āmātisāra (diarrhea with undigested material)
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#śakṛdatisāra (frequent stool only)
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#vātātisāra (that with significant flatulence)
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#asṛkātisāra (that with blood)
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#pittātisāra (that with [[pitta]]) and
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#kaphātisāra (that with [[kapha]]).
 +
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Due to saṁsarga (mutual combinations of two) a total of fifteen variants occur, viz.
 +
#āma-śakṛd, āma-[[vata]], āma-asṛk, āma-[[pitta]], āma-[[kapha]],
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#śakṛd-[[vata]], śakṛd-asṛk, śakṛd-[[pitta]], śakṛd-[[kapha]],
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#vāta-asṛk, [[vata]]-[[pitta]], [[vata]]-[[kapha]],
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#asṛk-[[pitta]], asṛk-[[kapha]], and
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#[[pitta]]-[[kapha]].
  
For the management of these conditions bastis prepared with the svavargīya medicines (group of medicines acting against particular pathologies) are given.[ ] For example the vargas (classified groups) described in Ṣaḍvirecanaśatāśrīya chapter (chapter 4th) of sūtrasthāna of Carakasaṁhitā.  So, the recommended group of medicines for last five conditions of pathology is  purīṣasaṁgrahaṇīya [Ca.Sū.4/8/31], vātaghna, śoṇitasthāpana [Ca.Sū.4/8/46], pittaghna  and kaphaghna vargas  respectively.[ ]Purīṣasaṁgrahaṇīya group consists of priyaṅgu (Callicarpa macrophylla  R.Br.), ananta (Hemidesmus indicusR.Br.), Seed of  mango, kaṭvaṅga (Ailanthus excelsa Roxb.), lodhra (Symplocos racemosa Roxb.), mocharasa (secretion of Salmalia malabarica Scott&Endl.), samṅgā (Mimosa pudica Linn.), dhātakī (Woodfordia fruticosa Kurz.), padmā (Clerodendrum serratum Linn.) and padmakesara (Stamen of Nelumbo nucifera Gaertn.). shoṇitasthāpana group consists of honey, madhuka (Glycyrrhiza glabra Linn.), saffron, mocarasa (secretion of Salmalia malabarica Scott &Endl.), broken earthen vessel, lodhra (Symplocos racemosa Roxb.), gairika (red ochre), priyaṅgu (Callicarpa macrophylla  R.Br.), sharkarā(sugar) and lājā (puffed rice).[ ]The form of basti is not described here. However, this may be decided according to disease condition and patient’s tolerance. (verse 20)
+
Nine ''upadrava'' as cited above.
In this version of Charaka samhitā thirty six variants are cited, but another version ‘kēvalaiḥ saha ceṭ triṁśadvidyāt sōpadravānapi’ mentions only thirty.[ ]Gaṅgādhara also explains thirty forms in the following manner.[ ]
 
 The six basic forms of atisāra are:
 
o āmātisāra (diarrhea with undigested material)
 
o śakṛdatisāra (frequent stool only)
 
o vātātisāra (that with significant flatulence)
 
o asṛkātisāra (that with blood)
 
o pittātisāra (that with pitta) and
 
o kaphātisāra (that with kapha).
 
 Due to saṁsarga (mutual combinations of two) a total of fifteen variants occur, viz.
 
o āma-śakṛd, āma-vāta, āma-asṛk, āma-pitta, āma-kapha,
 
o śakṛd-vāta, śakṛd-asṛk, śakṛd-pitta, śakṛd-kapha,
 
o vāta-asṛk, vāta-pitta, vāta-kapha,
 
o asṛk-pitta, asṛk-kapha, and
 
o pitta-kapha.
 
Nine upadrava as cited above.
 
The upadravas in present version of chapter are ten. Gaṅgādhara has taken description of nine upadravas from another version.[ ]But upadravas cannot be counted among types of a disease. Hence the thirtysix variants would be in following manner.
 
  
The six basic forms of atisāra are as mentioned above.
+
The upadravas in present version of chapter are ten. Gaṅgādhara has taken description of nine upadravas from another version.<ref>Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya. In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3739.</ref> But upadravas cannot be counted among types of a disease. Hence the thirtysix variants would be in following manner.
 Due to saṁsarga (mutual combinations of two) atotal of thirtyvariants occur, viz. fifteen samsargas as mentioned above and other fifteen are as below:
 
o śakṛd- āma, vāta-āma, asṛk-āma, pitta-āma, kapha-āma,
 
o vāta-śakṛd, asṛk-śakṛd, pitta-śakṛd, kapha-śakṛd,
 
o asṛk-vāta, pitta-vāta, kapha-vāta,
 
o pitta-asṛk, kapha-asṛk, and
 
o kapha-pitta.
 
  
Moreover Caraka saṁhitā describes types of atisāra in its chapter 19th of Sūtrasthāna and 19th chapter of Cikitsāsthāna differently. [ ],[ ] The context of the topic atisāra in present chapter is absolutely different. Here it is described first as a complication of basti, which eloborted further in the chapter. In earlier sections atisāra was described as a primary disease manifested because of its own physical and mental etiological factors. (verse 21-22)
+
The six basic forms of atisāra are as mentioned above.
 +
 
 +
Due to saṁsarga (mutual combinations of two) a total of thirty variants occur, viz. fifteen samsargas as mentioned above and other fifteen are as below:
 +
#śakṛd- āma, [[vata]]-āma, asṛk-āma, [[pitta]]-āma, [[kapha]]-āma,
 +
#[[vata]]-śakṛd, asṛk-śakṛd, [[pitta]]-śakṛd, [[kapha]]-śakṛd,
 +
#asṛk-[[vata]], [[pitta]]-[[vata]], [[kapha]]-[[vata]],
 +
#[[pitta]]-asṛk, [[kapha]]-asṛk, and
 +
#[[kapha]]-[[pitta]].
 +
 
 +
Moreover [[Charak Samhita]] describes types of atisāra in its chapter 19th of [[Sutra Sthana]] and 19th chapter of [[Chikitsa Sthana]] differently. <ref> Charak. Sutra Sthana, Cha.19 Ashtodariya Adhyaya ver.4/3. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 110.</ref>,<ref> Charak. Chiktsa Sthana, Cha.19 Atisara Chikitsitam Adhyaya. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 547-549.</ref> The context of the topic atisāra in present chapter is absolutely different. Here it is described first as a complication of [[basti]], which eloborted further in the chapter. In earlier sections atisāra was described as a primary disease manifested because of its own physical and mental etiological factors. (verse 21-22)
  
 
Basic principle of treatment of every condition associated with āma is āmapāchana (termination of āma by promoting function of agni). For this purpose mustā, ativiṣā, kuṣṭha, nata, dāru and vacā (which are mentioned in 19th verse) are to be given. This combination may be given in form of powder or as decoction. This recipe is useful in āmātisāra every origin. (verse 23)
 
Basic principle of treatment of every condition associated with āma is āmapāchana (termination of āma by promoting function of agni). For this purpose mustā, ativiṣā, kuṣṭha, nata, dāru and vacā (which are mentioned in 19th verse) are to be given. This combination may be given in form of powder or as decoction. This recipe is useful in āmātisāra every origin. (verse 23)
  
For vātaghna medicines to be used in vata associated atisara, Cakrapāṇi recommends daśhamula, while Gaṅgādhara considers bṛhat pañchamūla (see the commentary on 5th verse). For grāhī purpose the medicines of purīṣasaṁgrahaṇīya varga [Ca..4/8/31] are to be used.[ ]
+
For vātaghna medicines to be used in [[vata]] associated atisara, Cakrapāṇi recommends daśhamula, while Gaṅgādhara considers bṛhat pañchamūla (see the commentary on 5th verse). For grāhī purpose the medicines of purīṣasaṁgrahaṇīya varga [Cha.Sa.[[Sutra Sthana]].4/8/31] are to be used.<ref>Charak. Chiktsa Sthana, Cha.19 Atisara Chikitsitam Adhyaya. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 33 & 34.</ref>
Next condition in which atisāra is associated with dominance of vāta, snēhabasti supplemented with sweet, sourand salty substances is recommended. Being opposite to the properties of vāta, the substances in this basti antagonizes the vāta principle. (verse 24)
 
  
Now the management of other conditions - raktātisāra, pittātisāra and kaphātisāra is explained.  In raktātisāra, a basti with blood of animals e.g. goat, is given. This not only stops the bleeding but also supplements the substances to produce blood, which is lost due to colonic bleeding. Pitta pacifying remedies also helpful in this condition and therefore the remedies useful in pittātisāra can also be given in raktātisāra. Substances with astringent, sweetandbitter tastes have pitta-antagonizing action and hence the basti consists of such substances are helpful in management of pittātisāra. Substances with astringent, pungent and bitter tastes have kapha-antagonizing action; therefore, a basti with such medicines is beneficial in kaphātisāra.
+
Next condition in which atisāra is associated with dominance of [[vata]], snēha [[basti]] supplemented with sweet, sour and salty substances is recommended. Being opposite to the properties of [[vata]], the substances in this [[basti]] antagonizes the [[vata]] principle. (verse 24)
 +
 
 +
Now the management of other conditions - raktātisāra, pittātisāra and kaphātisāra is explained.  In raktātisāra, a [[basti]] with blood of animals e.g. goat, is given. This not only stops the bleeding but also supplements the substances to produce blood, which is lost due to colonic bleeding. [[Pitta]] pacifying remedies also helpful in this condition and therefore the remedies useful in pittātisāra can also be given in raktātisāra. Substances with astringent, sweet and bitter tastes have [[pitta]]-antagonizing action and hence the [[basti]] consists of such substances are helpful in management of pittātisāra. Substances with astringent, pungent and bitter tastes have [[kapha]]-antagonizing action; therefore, a [[basti]] with such medicines is beneficial in kaphātisāra.
 +
 
 +
The [[basti]] used in pittātisāra is useful in raktātisāra also. Applying this principle, this type of [[basti]] may be used in a disease entity known as ulcerative colitis. (verse 25)
 +
 
 +
These verses number 26-27 describe management plan for the saṁsargaja atisāras (in which two morbid components are associated and have mutual vitiation). Cakrapāṇi in his commentary decides the main and secondary role of the involved components on the basis of vibhakti (noun case) of the words. 7th vibhakti signifies the main role while 3rd expresses secondary role of the factors.<ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.26-31. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714.</ref>
  
The basti used in pittātisārais useful in raktātisāra also. Applying this principle, this type of basti may be used in a disease entity known as ulcerative colitis. (verse 25)
 
These verses number 26-27 describe management plan for the saṁsargaja atisāras (in which two morbid components are associated and have mutual vitiation). Cakrapāṇi in his commentary decides the main and secondary role of the involved components on the basis of vibhakti (noun case) of the words. 7thvibhakti signifies the main role while 3rd expresses secondary role of the factors.[ ]
 
 
In the 26th verse the possible combination are-
 
In the 26th verse the possible combination are-
1.āma is associated with śakṛt i.e.stool (āma is primary and stool is secondary)
+
#āma is associated with śakṛt i.e.stool (āma is primary and stool is secondary)
2.āma is associated with vāta (āma is primary and vāta is secondary)
+
#āma is associated with [[vata]] (āma is primary and [[vata]] is secondary)
3. śakṛt (stool) is associated with āma (stool is primary āma is secondary)
+
#śakṛt (stool) is associated with āma (stool is primary āma is secondary)
4.vāta is associated with āma  (vāta is primary and āma is secondary)
+
#[[vata]] is associated with āma  ([[vata]] is primary and āma is secondary)
 +
 
 
In the 27th verse the possible combination are-
 
In the 27th verse the possible combination are-
1.āma is associated with pitta  (āma is primary and pitta is secondary)
+
#āma is associated with [[pitta]] (āma is primary and [[pitta]] is secondary)
2.āma is associated with rakta (āma is primary and rakta is secondary)
+
#āma is associated with [[rakta]] (āma is primary and [[rakta]] is secondary)
3. pitta is associated with āma  (pitta is primary and āma is secondary)
+
#[[pitta]] is associated with āma  ([[pitta]] is primary and āma is secondary)
4.rakta is associated with āma (rakta is primary and āma is secondary)
+
#[[rakta]] is associated with āma ([[rakta]] is primary and āma is secondary)
In these conditions in mentioned in 26th verse, a drink prepared with trikaṭu, sour and salty substances is recommended. While the conditions mentioned in 27th verse, are manageable with adrink, prepared with trikaṭu, sweetand bitter substances is useful. (verse 26-27)
+
 
 +
In these conditions in mentioned in 26th verse, a drink prepared with trikaṭu, sour and salty substances is recommended. While the conditions mentioned in 27th verse, are manageable with adrink, prepared with trikaṭu, sweet and bitter substances are useful. (verse 26-27)
 +
 
 
The description of saṁsargaja atisāras continues in these verses 28-29. In the 28th verse, the possible combination are-
 
The description of saṁsargaja atisāras continues in these verses 28-29. In the 28th verse, the possible combination are-
1.āma is associated with kapha (āma is primary and kapha is secondary)
+
 
2.kapha is associated with āma (kapha is primary and āma is secondary)
+
#āma is associated with [[kapha]] (āma is primary and [[kapha]] is secondary)
In 1st condition the recommended basti is with trikaṭu, astringent and bitter substances while in 2nd condition with trikaṭu, astringent and salty medicines.
+
#[[kapha]] is associated with āma ([[kapha]] is primary and āma is secondary)
In a pāthabheda (another version) of 29th verse[ ], rakta is also included. With this inclusion the the possible combination are-
+
 
1. śakṛt (stool) is associated with vāta  (stool is primary and vāta is secondary)
+
In 1st condition the recommended [[basti]] is with trikaṭu, astringent and bitter substances while in 2nd condition with trikaṭu, astringent and salty medicines.
2. pitta is associated with vāta  (pitta is primary and vāta is secondary)
+
 
3. rakta is associated with vāta  (pitta is primary and āma is  secondary)  
+
In a pāthabheda (another version) of 29th verse<ref>Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya.Verse 23 In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3741.</ref>, [[rakta]]is also included. With this inclusion the possible combination are-
4. vāta is associated withstool(vāta is primary and stool is secondary)
+
 
5. vāta is associated with pitta (vāta is primary and pitta is secondary)
+
#śakṛt (stool) is associated with [[vāta]] (stool is primary and [[vata]] is secondary)
6. vāta is associated with rakta (vāta is primary and rakta is secondary)
+
#[[pitta]] is associated with [[vāta]] ([[pitta]] is primary and [[vata]] is secondary)
In these pathological conditions a basti with sweet, sour and astringent materials is acclaimed. (verse 28-29)
+
#[[rakta]] is associated with [[vāta]] ([[pitta]] is primary and āma is  secondary)  
 +
#[[vata]] is associated withstool([[vata]] is primary and stool is secondary)
 +
#[[vata]] is associated with [[pitta]] ([[vata]] is primary and [[pitta]] is secondary)
 +
#[[vata]] is associated with [[rakta]] ([[vata]] is primary and [[rakta]] is secondary)
 +
 
 +
In these pathological conditions a [[basti]] with sweet, sour and astringent materials is acclaimed. (verse 28-29)
  
 
The management of saṁsargaja atisāras further continues in these verses. In the 30th verse the possible combination are-
 
The management of saṁsargaja atisāras further continues in these verses. In the 30th verse the possible combination are-
1. rakta is associated with śakṛt i.e. stool(rakta is primary andstool is secondary)
+
#[[rakta]] is associated with śakṛt i.e. stool([[rakta]] is primary and stool is secondary)
2. rakta is associated with pitta (rakta is primary and pitta is secondary)
+
#[[rakta]] is associated with [[pitta]] ([[rakta]] is primary and [[pitta]] is secondary)
3. śakṛt (stool) is associated with pitta (stool is primary and pitta is secondary)  
+
#śakṛt (stool) is associated with [[pitta]] (stool is primary and [[pitta]] is secondary)  
4. śakṛt stoolis associated with rakta (stool is primary and rakta is secondary)
+
#śakṛt stool is associated with [[rakta]] (stool is primary and [[rakta]] is secondary)
5. pitta is associated with rakta (pitta is primary and rakta is secondary)
+
#[[pitta]] is associated with [[rakta]] ([[pitta]] is primary and [[rakta]] is secondary)
6. pitta  is associated with śakṛt stool (pitta is primary and stool is secondary)
+
#[[pitta]] is associated with śakṛt stool ([[pitta]] is primary and stool is secondary)
 +
 
 
In the 31st verse the possible combination are-
 
In the 31st verse the possible combination are-
            1. stool is associated with kapha (stoolis primary and kapha is secondary)
+
#stool is associated with [[kapha]] (stool is primary and [[kapha]] is secondary)
2. pitta is associated with kapha (pitta is primary and kapha is secondary)
+
#[[pitta]] is associated with [[kapha]] ([[pitta]] is primary and [[kapha]] is secondary)
3. kapha is associated with stool (kapha is primary andstool is secondary)  
+
#[[kapha]] is associated with stool ([[kapha]] is primary andstool is secondary)  
4. kapha is associated with pitta (kapha is primary and pitta is secondary)
+
#[[kapha]] is associated with [[pitta]] ([[kapha]] is primary and [[pitta]] is secondary)
5. kapha is associated with rakta (kapha is primary and rakta issecondary)
+
#[[kapha]] is associated with [[rakta]] ([[kapha]] is primary and [[rakta]] issecondary)
The conditions mentioned in 30th verse are managed by administration of basti prepared with astringent, sweet and bitter ingredients. While the pathologies in 31stverse, are manageable by a basti with trikaṭu, bitter and astringent ingredients. (verse 30-31)
+
 
 +
The conditions mentioned in 30th verse are managed by administration of [[basti]] prepared with astringent, sweet and bitter ingredients. While the pathologies in 31stverse, are manageable by a [[basti]] with trikaṭu, bitter and astringent ingredients. (verse 30-31)
 +
 
 +
In these verses 32-33, four more combinations of pathology are described with their management. In 32nd verse the [[kapha]] is main factor with [[vata]] as secondary and [[rakta]] as main with [[kapha]] as secondary while in 33rd verse [[vata]] is main factor with [[kapha]] as secondary and [[pitta]] as main with [[vata]] as secondary.
  
In these verses 32-33, four more combinations of pathology are described with their management. In 32nd verse the kapha is main factor with vāta as secondary and rakta as main with kapha as secondary while in 33rd verse vāta is main factor with kapha as secondary and pitta as main with vāta as secondary.
+
Type of atisāra according to involvement of factors. Reccommended material for [[basti]]
 +
[[Kapha]] is main factor with [[vata]] as secondary trikaṭu, bitter and sour ingredients
 +
[[Rakta]] as main with [[kapha]] as secondary sweet,trikaṭu and bitter
 +
[[Vata]] is main factor with [[kapha]] as secondary trikaṭu,sour and salty
 +
[[Pitta]] is main with [[vata]] as secondary. sweet, sour and bitter(verse 32-33)
 +
 
 +
There are six components involved in the pathogenesis of atisāra. In earlier verses the combinations of two components are described. The combinations of three, four or five are also possible. Gaṅgādhara in his Jalpakalpataru commentary mentions the possibility of combination of all six also.<ref>Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya. In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3742-43.</ref> This appears logical, as when five may combine six together may also be possible.  
  
Type of atisāra according to involvement of factors. Reccommended material for basti
 
Kapha is main factor with vāta as secondary trikaṭu, bitter and sour ingredients
 
Rakta as main with kapha as secondary sweet,trikaṭu and bitter
 
Vāta is main factor with kapha as secondary trikaṭu,sour and salty
 
Pitta is main with vāta as secondary. sweet, sour and bitter
 
(verse 32-33)
 
There are six components involved in the pathogenesis of atisāra. In earlier verses the combinations of two components are described. The combinations of three, four or five are also possible. Gaṅgādhara in his Jalpakalpataru commentary mentions the possibility of combination of all six also.[ ] This appears logical, as when five may combine six together may also be possible.
 
 
According to Gaṅgādhara, the following combinations may happen viz. ten clinical forms due to combinations of three, six forms due to combinations of four, three forms due to combinations of five and one form with all six. In this way twenty forms are possible. These combinations are as below.
 
According to Gaṅgādhara, the following combinations may happen viz. ten clinical forms due to combinations of three, six forms due to combinations of four, three forms due to combinations of five and one form with all six. In this way twenty forms are possible. These combinations are as below.
 +
 
Combinations of three Combinations of four Combinations of five Combination of six
 
Combinations of three Combinations of four Combinations of five Combination of six
 
āmaviḍvātaja
 
āmaviḍvātaja
Line 675: Line 1,069:
 
vātāsṛkpittaja
 
vātāsṛkpittaja
 
vātāsṛkkaphaja
 
vātāsṛkkaphaja
asṛkpittakaphaja āmaviḍvātāsṛja
+
asṛkpittakaphaja
 +
āmaviḍvātāsṛja
 
āmaviḍvātapittaja
 
āmaviḍvātapittaja
 
āmaviḍvātakaphaja
 
āmaviḍvātakaphaja
 
viḍvātāsṛkpittaja
 
viḍvātāsṛkpittaja
 
viḍvātāsṛkkaphaja
 
viḍvātāsṛkkaphaja
vātāsṛkpittakaphaja āmaviḍvātāsṛkpittaja
+
vātāsṛkpittakaphaja
 +
āmaviḍvātāsṛkpittaja
 
āmaviḍvātāsṛkkaphaja
 
āmaviḍvātāsṛkkaphaja
 
viḍvātāsṛkpitta kaphaja
 
viḍvātāsṛkpitta kaphaja
āmaviḍvātāsṛkpittakaphaja
+
āmaviḍvātāsṛkpittakaphaja(verse 34)
 +
 
 +
If case of association of āma, [[basti]]s are contraindicated. This is a general rule. In such condition the āmapācana (preparation to terminate āma)is given. However, in nirāma condition (without association of āma), [[basti]]s are recommended. (verse 35)
  
+
In these verses 36-37, two new units of measurement are described i.e. pala and prastha. After calculating these amounts in modern units of metric system, pala is around 50 gms or 50 ml while prastha around 800 ml. Though, in previous verses the management of different types of atisāras, has been described. In coherence of the topic, more remedies for atisāra are described in present verses.
(verse 34)
 
If case of association of āma, bastis are contraindicated. This is a general rule. In such condition the āmapācana (preparation to terminate āma)is given. However, in nirāma condition (without association of āma), bastis are recommended. (verse 35)
 
  
 +
This medicated ghṛta is processed with plants having [[stambhana]] action. Therefore, it is useful in all types of atisāra. Being a nourishing preparation, it is useful in compensating the loss of the essential body substances. A [[basti]] may also be given with this preparation and should be retained as much as possible. This type of [[basti]] may be useful in inflammatory bowel diseases. (verse 36-37)
  
In these verses 36-37, two new units of measurement are described i.e. pala and prastha. After calculating these amounts in modern units of metric system, pala is around 50 gms or 50 ml while prastha around 800 ml. Though, in previous verses the management of different types of atisāras, has been described. In coherence of the topic, more remedies for atisāra are described in present verses.
+
The remedies for atisāra continue in these verses 38-39. These verses describe recipe of medicated gruels useful in management of this disease. First the decoction is prepared according to the recipe of ṣaḍaṅgapānīya.<ref>Chakrapani, Charak. Chikitsa Sthana, Cha.3 Jwara Chikitsitam ver.145 In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714.P 410.</ref>,<ref>Agnihotri Avadhabihari; Bhaiṣajyakalpanā Vijñāna; Chaukhamba orientalia publication, 6th edition, 2006, P 146-147.</ref>
  
This medicated ghṛta is processed with plants having staṁbhana action. Therefore, it is useful in all types of atisāra. Being a nourishing preparation, it is useful in compensating the loss of the essential body substances. A basti may also be given with this preparation and should be retained as much as possible. This type of basti may be useful in inflammatory bowel diseases. (verse 36-37)
 
The remedies for atisāra continue in these verses 38-39. These verses describe recipe of medicated gruels useful in management of this disease. First the decoction is prepared according to the recipe of ṣaḍaṅgapānīya.[ ],[ ]
 
 
For this purpose one part of the course powder of all plants is boiled with 64 parts of water. When water is reduced to half, this is to be taken to cook yavāgū. There are three varieties of yavāgū-maṇḍa, peyā and vilepī. These three are gradually thicker in consistency and may be chosen according to strength of a patient and his agni. (verse 38-39)
 
For this purpose one part of the course powder of all plants is boiled with 64 parts of water. When water is reduced to half, this is to be taken to cook yavāgū. There are three varieties of yavāgū-maṇḍa, peyā and vilepī. These three are gradually thicker in consistency and may be chosen according to strength of a patient and his agni. (verse 38-39)
Gaṅgādhara considers Sthirādi group of plantsas Svalpapañcamūlaconsists of śālaparṇī (Desmodium gangeticum DC.), pṛśniparṇī (Uraria picta Desr.) bṛhatī (Solanum indicum Linn.) kaṇṭakārī (Solanum suranttense Burm.) and gokṣura (Tribulus terrestris Linn.). About balādi group there is no clarification by any commentator however the plants Sida cordifolia Linn., abutilon indicum Linn., Sida rhombifolia Linn. and Grewia hirsute Vahl. may be taken for this purpose. Ikṣvādi is considered by Cakrapāṇi as roots of Saccharum officinarum Linn., Desmostachya bipinnata Stapf., Saccharum spontaneum Linn. and roots of rice.
+
 
 +
Gaṅgādhara considers Sthirādi group of plants as Svalpapañcamūla consists of śālaparṇī (Desmodium gangeticum DC.), pṛśniparṇī (Uraria picta Desr.) bṛhatī (Solanum indicum Linn.) kaṇṭakārī (Solanum suranttense Burm.) and gokṣura (Tribulus terrestris Linn.). About balādi group there is no clarification by any commentator however the plants Sida cordifolia Linn., abutilon indicum Linn., Sida rhombifolia Linn. and Grewia hirsute Vahl. may be taken for this purpose. Ikṣvādi is considered by Cakrapāṇi as roots of Saccharum officinarum Linn., Desmostachya bipinnata Stapf., Saccharum spontaneum Linn. and roots of rice.
 
There is another version of verse 42, which mentions last line as ‘sasarpirlavaṇā yojyā madhurā lavaṇāpi vā’ which means that this preparation can be used with ghṛta and rock salt in sweet or salty form.
 
There is another version of verse 42, which mentions last line as ‘sasarpirlavaṇā yojyā madhurā lavaṇāpi vā’ which means that this preparation can be used with ghṛta and rock salt in sweet or salty form.
 +
 
Above verses give some more recipes for medicated yavāgūs those are helpful in management of atisāra. (verse 40-42)
 
Above verses give some more recipes for medicated yavāgūs those are helpful in management of atisāra. (verse 40-42)
In these verses some additional and useful remedies for management of various types of atisāra are given. It is to be recalled that in this chapter, authors have considered six factors responsible in pathogenesis and manifestation of atisāra viz. āma vāta, pitta, kapha, rakta and sakṛt (stool). The treatments are to be considered as per the factors involved. (verse 43-45)
+
In these verses some additional and useful remedies for management of various types of atisāra are given. It is to be recalled that in this chapter, authors have considered six factors responsible in pathogenesis and manifestation of atisāra viz. āma [[vata]], [[pitta]], [[kapha]], [[rakta]] and sakṛt (stool). The treatments are to be considered as per the factors involved. (verse 43-45)
The chapter describes various clinical forms of atisara according to the components involved in the pathogenesis. The therapeutics for these various forms of atisāra is described in a planned manner. Ayurvedic management is not merely medicaments but it recommends the food preparations those are helpful in restoring the normalcy of the body components of the patient. Thus the chapter is significantly useful for clinical practice of basti therapies and the treatment of disease atisāra, which includes several modern diseases such as ulcerative colitis, Crohn’s dieases and irritable bowel syndrome. (verse 46)
+
The chapter describes various clinical forms of atisara according to the components involved in the pathogenesis. The therapeutics for these various forms of atisāra is described in a planned manner. Ayurvedic management is not merely medicaments but it recommends the food preparations those are helpful in restoring the normalcy of the body components of the patient. Thus the chapter is significantly useful for clinical practice of [[basti]] therapies and the treatment of disease atisāra, which includes several modern diseases such as ulcerative colitis, Crohn’s dieases and irritable bowel syndrome. (verse 46)
The basti formulations mentioned in this chapter are used widely in today’s clinical practice. However, though atisara (diarrhea) is explained in detail as complication of improperly administered basti, in todays clinical practice, this complication is observed rarely.  
+
The [[basti]] formulations mentioned in this chapter are used widely in today’s clinical practice. However, though atisara (diarrhea) is explained in detail as complication of improperly administered [[basti]], in todays clinical practice, this complication is observed rarely.
Glossary
+
</div>
Abhiṣyanda (abhiShyanda; अभिष्यन्द): Oozing; The term signifies excessive oozing of body fluids.
 
Ādhmāna (AdhmAna; आध्मान): Distention: The term signifies distention of a bodypart caused due to stagnation of the substances inside it; but generally, is taken for distention of the abdomen associated with pain due to various reasons like obstruction to the urine and feces, accumulation of blood in abdomen etc.
 
Akṣa (akSha; अक्ष): A measurement equivalent to approximately 12gms.
 
Āmātisāra (AmAtisAra; आमातिसार): a clinical condition in which frequency of defecation is associated with āma (undigested substance)
 
Ānāha (AnAha; आनाह): Obstruction, constipation; Obstruction of the feces in the intestine is to be termed as constipation. The term also signifies obstruction to the flow or normal movements of any substance in nay part of the body
 
Āranāla (AranAala; आरनाल): a fermented sour gruel.
 
Arōchaka (arochaka; अरोचक):  lack of interest; anorexia, A disease where in the person has dislikes towards all kinds of food and drink
 
Aruchi (aruchi; अरुचि): The term signifies the complete or partial loss of the taste. Disapproval of food even after it has been taken in the mouth due to lack of perception of the taste in the mouth
 
Asṛk (asruk; असृक्): blood, rakta dhātu
 
Atisāra (atisAra; अतिसार): Diarrhoea; A disease of large intestine having cardinal feature as excessive and frequent defecation of atisāras
 
Balavarṇakṛt (balavarNakRut; बलवर्णकृत्): Promoting bala (strength and immunity) and varṇa (complexion)
 
Basti (basti; बस्ति): Urinary bladder, enema.
 
Bhēdana (bhedana; भेदन): Breaking pain, breaking- reduction of the hard substances into small pieces.
 
Dadhimaṇḍa (dadhimaNDa; दधिमण्ड): Whey, supernatant fluid in yogurt.
 
Dāha (dAha; दाह): Burning sensation
 
Dōshānulōmana (doShAnulomana; दोषानुलोमन): Bringing the movement of the dōsha(s) in right direction.
 
Ghṛt: (ghRut; घृत्), ghee, clarified butter.
 
khaja (khaja; खज): Churner.
 
Aṣṭaprāsṛtika basti (aShTaprAsrRutika basti; अष्टप्रासृतिक बस्ति): A basti consisting of total amount of eight prāsṛtas
 
Grāhī (grAhI; ग्राही): Substances which increase appetite, digestive power and absorb liquid from stool; e.g. dry ginger and piper longum
 
Gudadāha (gudadAha; गुददाह): Burning in anal region.
 
Tṛṣṇā (tRuShNA; तृष्णा): Polydipsia; the condition resembles to morbid thirst in which the person even after continuous water intake fails to quench his thirst.
 
Kāñjī (kA~jI; काञ्जी): Prepared by using cereals (rice and horse gram) and pulses and fermented till it attains acidity
 
Kapha (kapha; कफ): A synonym for śleṣhmā. One of the three body doṣhas responsible for stability, unctousness, lubrication, immunity, and cohesion. This is predominant of pṛthvī and jalamahābhūtas. The attributes of kapha are: guru (heavy), manda (dull), hima (cold), snigdha (unctuous), ślakṣṇa (smooth), mṛtsna (soft) and sthira (stable). Major seats of kapha are: thorax, throat, head, kloma, joints, stomach, rasa, meda, nose and tongue. This is of five types: avalaṃbaka, kledaka, bodhaka, sleṣhaka, and tarpaka.
 
Kardama (kardama; कर्दम): a type of rice.
 
Karṣa (karSha; कर्ष): A unit of measurement; Two kolas  make one karṣa= 12 g of metric units
 
Kaṣāya (kashAya; कषाय): Astringent; One among the six rasas; Boiled and filtered decoction of herbs, used for the therapeutics & pharmaceutical manufacturing
 
Kōṣṇa (koShna; कोष्ण):  moderately warm
 
Kṛmi (kRmi; कृमि):Parasitic  infestation; Diseases caused due to worm infestation.
 
Kṣaudra (kShaudra; क्षौद्र): Honey
 
Kṣīra (kShira; क्षीर):Milk; Synonym of Dugdha;Latex of plants; milky exudation
 
Kulmāṣa (kulmASha; कुल्माष): Half cooked grains.
 
Kuṇapa (kuNapa; कुणप): Deadbody
 
Kuṣṭha(kuShTha; कुष्ठ): Multiple dermatological manifestations; Chronic Dermatological diseases characterized by disfiguring and discoloration chronic skin disorders
 
Kvātha(kvAtha; क्वाथ): synonym of kaṣāya - boiled & filtered liquid of herbs for specific time used for the therapeutics & pharmaceutical manufacturing
 
Mēha (meha; मेह):  also known as prameha, a condition of polyuria with altered consistency and composition of urine.
 
Mṛdu (mRudu; मृदु): Softness/mildness; One of the 20 gurvādiguṇas. Caused due activated akāśa &jala; denotes physiological & pharmacological softness & mildness; causes relaxation; relieves burning sensation
 
Karmaṇā viplutānāṁ(karmaNAviplutAnAm; कर्मणाविप्लुतानाम्): suffered from complications by the consequences of the therapies.
 
Mūrcchā (mUrcchA; मूर्च्छा): Syncope; A condition characterized by loss of consciousness and postural tone due to vitiation of blood.
 
Mūtrakṛcchra (mUtrakRucchra; मूत्रकृच्छ्र): Dysuria; A disease characterized by difficult and painful micturation without any structural abnormality in the genitourinary system
 
Lavaṇa (lavaNa; लवण): Salty; one of the six rasa; Salt; e.g. Common table salt, rock salt
 
Pācana (pAchana; पाचन): 1. Digestives; substances having capacity to digest but not necessarily increases the apetite; 2. Wound Suppuration
 
Pala (pala; पल): A unit of Measurement; Four karṣas will make one pala i.e. 48 g of metric units
 
Pallava (pallava; पल्लव): Tender leaves; Synonym of leaf
 
Pañcakarma (panchakarma; पञ्चकर्म): A group of five therapies viz. Vamana(therapeutic emesis),virecana(therapeutic purgation), anuvāsana(oily enema), āsthāpana(enema with decoctions) and nasya( nasal administration).
 
Pitta (pitta; पित्त): One of the three bodily doṣas that is responsible for digestion and metabolism in the body. It is situated in umbilicus, stomach, sweat, lymph, blood, watery fluids of the body, eye and skin. It is predominant of Agni mahābhūta. Its attributes are: sasneha (slightly unctuous), tīkṣṇa (sharp), uṣṇa (hot), laghu (light), visra (of pungent odour), sara (flowing) and drava (liquid). pitta is of five types: pāchaka, ālochaka, raṅjaka, bhrājaka and sādhaka.
 
Prasannā (prasannA; प्रसन्ना): supernatant part of surā (an alcoholic preparation)
 
Prasṛta (prasRuta; प्रसृत): An amount equal to about 100 milliliter.
 
Prastha (prastha; प्रस्थ): An amount equal to about 800 milliliter.
 
Pravāhik (pravAhik; प्रवाहिक्): dysentery, a condition characterized by frequency of defecation withtenesmus.
 
Rakta (rakta; रक्त): The second dhātu among seven dhātus whose function is jīvana(to give life). It is formed in Yakṛt (liver) and Plīhā (spleen) with the help of Raṅjaka pitta and rakta dhātvagni. This is dominant in agni mahābhūta. Is named so because of its rakta i.e. red color.
 
Raktaśālī (raktashAlI;रक्तशाली): A variety of rice having brown or reddish color.
 
 
 
Raktātisāra (raktAtisAra; रक्तातिसार): Blood containing diarrhea
 
Saindhava (saindhava; सैन्धव): Rock salt
 
Śakṛd (shakRud; शकृद्): Feces, synonym of purīṣa
 
Śālūta (shAlUta; शालूत): Unripe fruit.
 
Sāma (sAma; साम):  Associated with āma (an intermediate product during digestion and metabolism)
 
Saṁsarga (saMsarga; संसर्ग): Association, Mixture, Adjoining; The term literally means association of two.    Generally the term is used to signify association of two vitiated humors in the pathogenesis
 
Śaṅkha (shaMkha; शंख): 1. Temples 2. Conch
 
Siddhiḥ (siddhiH; सिध्धिः): Achievement, success.
 
Snēhabasti (snehabasti; स्नेहबस्ति): A form of unctousenema; Medicated unctous enema having quantity four times less to that of decocotion enema.
 
Śōṇita (shoNita; शोणित): 1. Synonym of rakta2. Synonym of ārtava
 
pala (pala; पल): an amount equal to approximately 50gms.
 
Sōpadrava (sopadrava; सोपद्रव): Associated with upadrava(complications)
 
Śṛta (shruta; शृत): A form of decoction.
 
Śukrakṛt (shukrakrut; शुक्रकृत्):  Promoting śukra.
 
Śūla (shUla; शूल): -The term indicates continuous pinning like pain arising in different parts of the body
 
Śuṅga (shuMga; शुंग):  Leaf bud of a tree.
 
Surā (surA; सुरा): Indigenous beerbeverage prepared from fermented cereals. The cereals that are either cooked or ground are mixed with jaggery and other spices and are subjected to naturalfermentation. Beneficial for emaciated, suffering from obstruction in urine, piles, alleviates vāta and useful in anaemia
 
Svādu (svAdu; स्वादु):  Synonym of madhura, sweet.
 
Tīkṣṇa (tIkShNa; तीक्ष्ण): The property of the substance which causes sharpness and quick penetration;sharpness/fast; one of the 20 gurvādi guṇas; caused due activated agni; denotes physiological & pharmacological quickening ofprocesses; instrumental for eliminative therapy; pacifies kapha &vāta , increases pitta; causes irritation, burning & excretion. An attribute of pitta.
 
Uṣṇa (uShNa; उष्ण): Heat/hotness; one of the 20 gurvādi guṇas; caused due to activated agnimahābhūta; denotes physiological & pharmacological hotness; manifested by increasedagni, improved appetite & digestion, increased motion in channels, pacifies vāta, kapha, increases pitta. An attribute of Pitta
 
Vāta (vAta; वात):    A synonym of vāyu, one of the three bodily doṣas, that ispredominant of vāyu and ākāśa mahābhūtas. This is a vital biological force that performs the fuctions like all sensory perceptions, all motor activities, and higher mental activities. This is of five subtypes: prāṇa,vyāna, udāna, samāna and apāna. The major sites of distribution are: large intestine, pelvis, extremities, ears, bones and skin. The attributes of vāyu are: rūkṣa (dry), laghu (light), śīta (cold), khara(rough), sūkṣma(minute), cala (mobile).
 
Vātaghna (vAtaghna; वातघ्न): Antagonizing vāta.
 
Vātanut (vAtanut; वातनुत्): Synonym of vātaghna
 
Viṭsaṅga (viTsaMga; विट्संग): Stagnation of stool.
 
Vṛṣatva (vRuShatva; वृषत्व): Virility, manliness.
 
Vyāpat (vyApat; व्यापत्): Complications; Complications caused in therapeutic procedures.
 
Yavāgū (yavAgU; यवागू): Gruel; it is type of congenial preparation of cereals, like rice, wheat, barley etc. Is of three types: maṇḍa (is only the liquid portion of the prepared gruel), peyā and vilepī.
 
  
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Latest revision as of 10:54, 23 February 2024

Cite.png

Siddhi Sthana Chapter 8. Standardized therapeutic enema formulations in a dose of Prasrita Unit

Prasrita Yogiyam Siddhi
Section/Chapter Siddhi Sthana Chapter 8
Preceding Chapter Bastivyapat Siddhi
Succeeding Chapter Trimarmiya Siddhi
Other Sections Sutra Sthana, Nidana Sthana, Vimana Sthana, Sharira Sthana, Indriya Sthana, Chikitsa Sthana, Kalpa Sthana
Translator and commentator Gupta S.N.
Reviewer Panse A.
Editors Thakar A. B., Mangalasseri P., Deole Y.S., Basisht G.
Year of publication 2020
Publisher Charak Samhita Research, Training and Skill Development Centre
DOI 10.47468/CSNE.2020.e01.s08.009

Abstract

This chapter describes recipes of prasritayogiya bastis (enema formulation in which ingredients are measured in unit of prasrita). Prasrita is a measurement, which is approximately equal to 100 millilitre. Nine types of basti therapies for various clinical conditions including prameha (urinary disorders including diabetes), abhishyanda (oozing), kushtha (skin diseases), krimi (worm infestation), mutrakrichchra (dysuria) and alike are described. Atisara, a clinical condition characterized by frequent defecation with altered composition and consistency of stool is described in detail. Atisara has various forms depending upon involvement of six morbid components in the pathogenesis viz. ama (stool with undigested material), shakrita (stool only), vata (with dominant flatulence), asrik (stool with blood), pitta and kapha. Different recipes of basti, oral medicaments and food preparations are described to treat these atisara conditions. These remedies are practically quite useful in several modern diseases like ulcerative colitis and irritable bowel syndrome.
Keywords: atisara, basti, doshanulomana, grahi, karsha, karmanaviplutanam, niruha, pachana, Panchakarma, prasrita, prastha, snehabasti, vyapat, enema in delicate persons, complication of Panchakarma.


Introduction

There are two main types of basti according to the composition and the action. Anuvasana basti is composed of unctuous substance and it is to be retained for minimum nine hours. Asthapana basti contains mainly decoction with least oil and is evacuated after few minutes. Basti is administered through ano-rectal route and acting through the pakvashaya (colon). It is useful in several diseases particularly vata disorders having roots in pakvashaya. It is claimed to be half a treatment or even a complete treatment by ancient practitioners[1]. It is not only a procedure of shodhana but also providing a recto-colonic route of drug administration.

Previous chapter (Bastivyapat Siddhi) deals with the vyapat (complications) arising due to faulty application of bastis. Present chapter begins with the treatment of those patients who developed complications as a result of faulty application of therapies (karmana viplutanam) and for the tender persons who are not able to tolerate strong measures. For this purpose, chapter describes mild form of niruha bastis. The ingredients of these bastis are measured in the unit of prasrita. Therefore the name of the chapter is Prasrita Yogiyam Siddhi. The unit prasrita is equal to two palas, which is approximately equal to 100 milliliter (1 pala= approx. 50 ml).[2][3]

Sanskrit text, Transliteration and English Translation

अथातः प्रासृतयोगीयां सिद्धिं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

Athātaḥ prāsṛtayōgīyāṁ siddhiṁ vyākhyāsyāmaḥ ||1||

iti ha smāha bhagavānātrēyaḥ ||2||

athAtaH prAsRutayogIyAM siddhiM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall expound the chapter "Prasrita Yogiyam Siddhi" (Standardized therapeutic enema formulations in a dose of Prasrita Unit). Thus said Lord Atreya. [1-2]

Note: The chapter describes the formulations having ingredients measured in the unit prasrita(approximately equal to 100 millilitre).

Objective of prasrita basti

अथेमान् सुकुमाराणां निरूहान् स्नेहनान् मृदून्|

कर्मणा विप्लुतानां च वक्ष्यामि प्रसृतैः पृथक्||३||

athēmān sukumārāṇāṁ nirūhān snēhanān mṛdūn|

karmaṇā viplutānāṁ ca vakṣyāmi prasṛtaiḥ pṛthak||3||

athemAn sukumArANAM nirUhAn snehanAn mRudUn|

karmaNA viplutAnAM ca vakShyAmi prasRutaiH pRuthak||3||

Now, I (Atreya) shall explain oleaginous and mild form of niruha bastis, for the tender persons and the patients suffered from complications as a result of therapies. Composition of those will be in the unit of prasrita. [3]

Pancha prasritiki Basti-I

क्षीराद्द्वौ प्रसृतौ कार्यौ मधुतैलघृतात्त्रयः|

खजेन मथितो बस्तिर्वातघ्नो बलवर्णकृत्||४||

kṣīrāddvau prasṛtau kāryau madhutailaghṛtāttrayaḥ|

khajēna mathitō bastirvātaghno balavarṇakṛt||4||

kShIrAddvau prasRutau kAryau madhutailaghRutAttrayaH|

khajena mathito bastirvAtaghno balavarNakRut||4||

Two prasritas of milk and three prasritas of madhu (honey), taila (sesame oil) and ghrita (clarified butter) are taken together and churned with a churning stick. This basti eliminates vata, and promotes strength as well as complexion. [4]

Ashta-prasritiki basti

एकैकः प्रसृतस्तैलप्रसन्नाक्षौद्रसर्पिषाम्|

बिल्वादिमूलक्वाथाद्द्वौ कौलत्थाद्द्वौ स वातनुत्||५||

ēkaikaḥ prasṛtastailaprasannākṣaudrasarpiṣām|

bilvādimūlakvāthāddvau kaulatthāddvau sa vātanut||5||

ekaikaH prasRutastailaprasannAkShaudrasarpiShAm|

bilvAdimUlakvAthAddvau kaulatthAddvau sa vAtanut||5||

Basti, composed of one prasrita each of taila (sesame oil), prasanna(supernatant part of sura- a type of alcoholic preparation), kshaudra (honey) and ghrita (clarified butter) and two prasritas each of the decoctions of roots of bilvadi (a group of plants that begins with bilva-Aegle marmelos Carr.) as well as two prasritas of kulattha (Phaseolus biflorus Linn.), antagonizes vata. [5]

Nava--prasritiki basti

पञ्चमूलरसात् पञ्च द्वौ तैलात् क्षौद्रसर्पिषोः|

एकैकः प्रसृतो बस्तिः स्नेहनीयोऽनिलापहः||६||

pañcamūlarasāt pañca dvau tailāt kṣaudrasarpiṣoḥ|

ēkaikaḥ prasṛto bastiḥ snēhanīyō'nilāpahaḥ||6||

pa~jcamUlarasAt pa~jca dvau tailAt kShaudrasarpiShoH|

ekaikaH prasRuto bastiH snehanIyo~anilApahaH||6||

Basti prepared with five prasritas of the decoction of panchamula (bilva, shyonaka, gambhari, patala and agnimantha), two prasritas of taila (sesame oil) and one prasrita each of kshaudra (honey) as well as sarpi (ghrita), oleates (the body) and expels vata. [6]

Chatu-prasritiki basti-I

सैन्धवार्धाक्ष एकैकः क्षौद्रतैलपयोघृतात्|

प्रसृतो हपुषाकर्षो निरूहः शुक्रकृत् परम्||७||

saindhavārdhākṣa ēkaikaḥ kṣaudratailapayōghṛtāt|

prasṛtō hapuṣākarṣō nirūhaḥ śukrakṛt param||7||

saindhavArdhAkSha ekaikaH kShaudratailapayoghRutAt|

prasRuto hapuShAkarSho nirUhaH shukrakRut param||7||

Niruha basti, prepared with half aksha (about 6 grams) of saindhava (rock salt) one prasrita each of honey, sesame oil, milk, and ghrita, and one karsha (about 12 grams) of hapusha (Juniperus communis Linn.), is an excellent promoter of shukra. [7]

Panchatikta niruha basti

पटोलनिम्बभूनिम्बरास्नासप्तच्छदाम्भसः|

चत्वारः प्रसृता एको घृतात् सर्षपकल्कितः||८||

निरूहः पञ्चतिक्तोऽयं मेहाभिष्यन्दकुष्ठनुत् |९|

paṭōlanimbabhūnimbarāsnāsaptacchadāmbhasaḥ|

catvāraḥ prasṛtā ēkō ghṛtāt sarṣapakalkitaḥ||8||

nirūhaḥ pañcatiktō'yaṁ mēhābhiṣyandakuṣṭhanut |9|

paTolanimbabhUnimbarAsnAsaptacchadAmbhasaH|

catvAraH prasRutA eko ghRutAt sarShapakalkitaH||8||

nirUhaH pa~jcatikto~ayaM mehAbhiShyandakuShThanut |9|

A basti prepared by mixing four prasritas of decoction of patola (Trichosanthes dioica Roxb.), nimba (Azadirachta indica A.Juss.), bhunimba (Andrographis paniculata Nees.), rasna (Pluchea lanceolata Oliver &Hiern.), saptacchada (Alstonia scholaris R.Br.); one prasrita of ghrita, mixed with a kalka (paste) of sarshapa (Brassica campestris Linn.) is known as panchatikta niruha and is acting against prameha, abhishyanda and kushtha. [8-8½]

Note: The quantity of kalka of sarshapa is not mentioned in the above recipe. According to commentary of Chakrapani on this verse, it may be decided.[4] In the niruha basti with an amount of twelve prasritas, the amount of kalka is usually two palas (about 100 gms). In present recipe, the amount is five prasritas and therefore the amount of kalka of sarshapa would be about 40 gms. This principle is applicable in latter recipes also where the amount of kalka is not mentioned.

Shat-prasritika basti

विडङ्गत्रिफलाशिग्रुफलमुस्ताखुपर्णिजात्||९||

कषायात् प्रसृताः पञ्च तैलादेको विमथ्य तान्|

विडङ्गपिप्पलीकल्को निरूहः क्रिमिनाशनः||१०||

viḍaṅgatriphalāśigruphalamustākhuparṇijāt||9||

kaṣāyāt prasṛtāḥ pañca tailādēkō vimathya tān|

viḍaṅgapippalīkalkō nirūhaḥ krimināśanaḥ||10||

viDa~ggatriphalAshigruphalamustAkhuparNijAt||9||

kaShAyAt prasRutAH pa~jca tailAdeko vimathya tAn|

viDa~ggapippalIkalko nirUhaH kriminAshanaH||10||

Five prasritas of decoction of vidanga (Embelia ribes Burm.), triphala (a combination of three fruits viz. Emblica officinalis Gaertn, terminalia chebula Retz. and terminalia belerica Roxb.), shigru (Moringa oleifera Linn.), madanaphala (Randia dumetorum Lam.), musta (Cyperus rotundus Linn.) and akhuparni (Merremia emarginata Burm.) and one prasrita of tila taila (sesame oil) churned together with a paste of vidanga (Embelia ribes Burm.) and pippali (Piper longum Linn.) is kriminashana niruha (niruha acting against parasites) [9-10]

Sapta-prasritika basti

पयस्येक्षुस्थिरारास्नाविदारीक्षौद्रसर्पिषाम्|

एकैकः प्रसृतो बस्तिः कृष्णाकल्को वृषत्वकृत्||११||

payasyēkṣusthirārāsnāvidārīkṣaudrasarpiṣām|

ēkaikaḥ prasṛtō bastiḥ kṛṣṇākalkō vṛṣatvakṛt||11||

payasyekShusthirArAsnAvidArIkShaudrasarpiShAm|

ekaikaH prasRuto bastiH kRuShNAkalko vRuShatvakRut||11||

Basti prepared with decoction of one prasrita of each of payasya (Fritillaria roylei Hook.), ikshu (Saccharum officinarum Linn.), sthira (Desmodium gangeticum DC.), rasna (Pluchea lanceolata Oliver & Hiern.) and vidari (Pueraria tuberosa DC.); one prasrita each of honey and ghrita, and paste of pippali (Piper longum Linn.) is vrishya (enhancing libido and sexual vigour). [11]

Chatu-prasritika basti-II

चत्वारस्तैलगोमूत्रदधिमण्डाम्लकाञ्जिकात्|

प्रसृताः सर्षपैः कल्कैर्विट्सङ्गानाहभेदनः ||१२||

catvārastailagōmūtradadhimaṇḍāmlakāñjikāt

prasṛtāḥ sarṣapaiḥ kalkairviṭsaṅgānāhabhēdanaḥ ||12||

catvArastailagomUtradadhimaNDAmlakA~jjikAt|

prasRutAH sarShapaiH kalkairviTsa~ggAnAhabhedanaH ||12||

Basti prepared with a total of four prasritas of tila taila (sesame oil), cow’s urine, dadhimanda (whey) and amlakanji (fermented sour gruel) mixed with a paste of sarshapa (Brassica campestris Linn.) relieves the stagnation of stool and constipation. [12]

Pancha-prasritika basti-II

श्वदंष्ट्राश्मभिदेरण्डरसात्तैलात् सुरासवात्|

प्रसृताः पञ्च यष्ट्याह्वकौन्तीमागधिकासिताः||१३||

कल्कः स्यान्मूत्रकृच्छ्रे तु सानाहे बस्तिरुत्तमः|

एते सलवणाः कोष्णा निरूहाः प्रसृतैर्नव||१४||

śvadaṁṣṭrāśmabhidēraṇḍarasāttailāt surāsavāt|

prasṛtāḥ pañca yaṣṭyāhvakauntīmāgadhikāsitāḥ||13||

kalkaḥ syānmūtrakṛcchrē tu sānāhē bastiruttamaḥ|

ētē salavaṇāḥ kōṣṇā nirūhāḥ prasṛtairnava||14||

shvadaMShTrAshmabhideraNDarasAttailAt surAsavAt|

prasRutAH pa~jca yaShTyAhvakauntImAgadhikAsitAH||13||

kalkaH syAnmUtrakRucchre tu sAnAhe bastiruttamaH|

ete salavaNAH koShNA nirUhAH prasRutairnava||14||

Basti prepared with five prasritas decoction of shvadamshtra (Tribulus terrestris Linn.), ashmabhida (Bergenia ligulata Wall.), eranda (Ricinus communis Linn.) together, taila and surasava (an alcoholic preparation) added with paste of yashti (Glycyrrhiza glabra Linn.), kaunti (Piper aurantiacum Wall.), magadhika (Piper longum Linn.) and sitah (sugar candy) is useful in mutrakricchra (a condition characterized by difficult and painful micturition) and anaha (constipation). These nine prasrita bastis are given with salt and moderately warm. [13-14]

Treatment of stagnated basti

मृदुबस्तिजडीभूते तीक्ष्णोऽन्यो बस्तिरिष्यते|

तीक्ष्णैर्विकर्षिते स्वादु प्रत्यास्थापनमिष्यते ||१५||

mṛdubastijaḍībhūtē tīkṣṇō'nyō bastiriṣyatē|

tīkṣṇairvikarṣitē svādu pratyāsthāpanamiṣyatē [1] ||15||

mRudubastijaDIbhUte tIkShNo~anyo bastiriShyate|

tIkShNairvikarShite svAdu pratyAsthApanamiShyate ||15||

If a mridubasti (mild acting basti) gets stagnated, that needs another teekshna basti (strong and sharp acting basti). One, who is emaciated because of strong bastis, requires asthapana basti prepared with madhura (sweet) substances. [15]

Treatment of guda-daha (burning sensation in anus)

वातोपसृष्टस्योष्णैः स्युर्गुददाहादयो यदि|

द्राक्षाम्बुना त्रिवृत्कल्कं दद्याद्दोषानुलोमनम्||१६||

तद्धि पित्तशकृद्वातान् हृत्वा दाहादिकाञ्जयेत्|

शुद्धश्चापि पिबेच्छीतां यवागूं शर्करायुताम्||१७||

vātōpasṛṣṭasyōṣṇaiḥ syurgudadāhādayō yadi|

drākṣāmbunā trivṛtkalkaṁ dadyāddōṣānulōmanam||16||

taddhi pittaśakṛdvātān hṛtvā dāhādikāñjayēt|

śuddhaścāpi pibēcchītāṁ yavāgūṁ śarkarāyutām||17||

vAtopasRuShTasyoShNaiH syurgudadAhAdayoyadi|

drAkShAmbunA trivRutkalkaM dadyAddoShAnulomanam||16||

taddhi pittashakRudvAtAn hRutvA dAhAdikA~jjayet|

shuddhashcApi pibecchItAM yavAgUM sharkarAyutAm||17||

If a patient with vata disorder suffers from anorectal burning (and other similar pitta-related symptoms) due to (administration of) hot bastis, a mixture of drakshambu (grape juice or decoction of raisins) and trivritkalka (paste of Operculina turpethum Linn.), which is doshanulshmana (bringing the movement of dosha in right direction) is given. This relieves burning sensation and similar conditions by expelling the pitta, stool and vata. After the body is cleansed, the patient has to take cold yavagu added with sugar. [16-17]

Treatment of mala kshaya (depletion of stool)

अथवाऽतिविरिक्तः स्यात् क्षीणविट्कः स भक्षयेत्|

माषयूषेण कुल्माषान् पिबेन्मध्वथवा सुराम्||१८||

athavā'tiviriktaḥ syāt kṣīṇaviṭkaḥ sa bhakṣayēt

māṣayūṣēṇa kulmāṣān pibēnmadhvathavā surām||18||

athavA~ativiriktaH syAt kShINaviTkaH sa bhakShayet|

mAShayUSheNa kulmAShAn pibenmadhvathavA surAm||18||

On the other hand, if a patient has excessive purgation and suffers from depletion of stool (and other essential body components e.g. fluids), he or she has to take kulmasha (half cooked grains) with mashayoosha (soup of Phaseolus mungo Linn.), or sura (an alcoholic preparation) or honey. [18]

Treatment of amaja shula (abdominal pain due to improper digestion)

सामं चेत् कुणपं शूलैरुपविशेदरोचकी|

स घनातिविषाकुष्ठनतदारुवचाः पिबेत्||१९||

sāmaṁ cēt kuṇapaṁ śūlairupaviśēdarōcakī|

sa ghanātiviṣākuṣṭhanatadāruvacāḥ pibēt||19||

sAmaM cet kuNapaM shUlairupavishedarocakI|

sa ghanAtiviShAkuShThanatadAruvacAH pibet||19||

(A decoction of) musta (Cyperus rotundus Linn.), ativisha (Aconitum heterophyllum wall.), kushtha (Saussurea lappa C.B.Clarke.), nata (Valeriana wallichii DC.), daru (Cedrus deodara Roxb.) and vacha (Acorus calamus Linn.) is recommended to a patient with loss of appetite, passing sama stool (i.e., stool containing ama) smelling like a dead (decomposing) body and with abdominal pain. [19]

Treatment of atisara (diarrhea)

शकृद्वातमसृक् पित्तं कफं वा योऽतिसार्यते|

पक्वं , तत्र स्ववर्गीयैर्बस्तिः श्रेष्ठं भिषग्जितम्||२०||

śakṛdvātamasṛk pittaṁ kaphaṁ vā yō'tisāryatē|

pakvaṁ , tatra svavargīyairbastiḥ śrēṣṭhaṁ bhiṣagjitam||20||

shakRudvAtamasRuk pittaM kaphaM vA yo~atisAryate|

pakvaM , tatra svavargIyairbastiH shreShThaM bhiShagjitam||20||

When a patient has pakva atisara (without undigested material) passing shakrita (stool), vata, asrika (blood), pitta or kapha, then basti prepared with a specific group of medicines acting against each of these pathologies is best measure. [20]

Six types of atisara and its common complications

षण्णामेषां द्विसंसर्गात् त्रिंशद्भेदा भवन्ति तु|

केवलैः सह षट्त्रिंशद्विद्यात् सोपद्रवानपि||२१||

शूलप्रवाहिकाध्मानपरिकर्त्यरुचिज्वरान्|

तृष्णोष्णदाहमूर्च्छादींश्चैषां विद्यादुपद्रवान्||२२||

ṣaṇṇāmēṣāṁ dvisaṁsargāt triṁśadbhēdā bhavanti tu|

kēvalaiḥ saha ṣaṭtriṁśadvidyāt sōpadravānapi||21||

śūlapravāhikādhmānaparikartyarucijvarān|

tṛṣṇōṣṇadāhamūrcchādīṁścaiṣāṁ vidyādupadravān||22||

ShaNNAmeShAM dvisaMsargAt triMshadbhedA bhavanti tu|

kevalaiH saha ShaTtriMshadvidyAt sopadravAnapi||21||

shUlapravAhikAdhmAnaparikartyarucijvarAn|

tRuShNoShNadAhamUrcchAdIMshcaiShAM vidyAdupadravAn||22||

These six types of atisara may have thirty variants as a result of mutual combination of two morbid factors. Together with basic six, they constitute thirty six types, which manifest along with their complications. Shoola (abdominal pain), pravahika (dysentery), adhmana (abdominal distension) parikarti (anal pain), aruchi (distaste for food), jwara (fever), tṛishna (thirst), ushnatva (feeling of heat), daha (burning sensation) and murccha(syncope) are its complications (upadrava). [21-22]

Treatment of ama-atisara ( diarrhea with improper digestion)

तत्रामेऽन्तरपानं स्यात् व्योषाम्ललवणैर्युतम्|

पाचनं शस्यते बस्तिरामे हि प्रतिषिध्यते||२३||

tatrāmē'ntarapānaṁ syāt vyōṣāmlalavaṇairyutam|

ṁ śasyatē bastirāmē hi pratiṣidhyatē||23||

tatrAme~antarapAnaM syAt vyoShAmlalavaNairyutam|

pAcanaM shasyate bastirAme hi pratiShidhyate||23||

In case of amatisara, a drink having pachana action added with trikatu (a group of three pungent drugs viz. rhizome of Zingiber officinalis Roxb.; fruits of Piper nigrum Linn. and Piper longum Linn.), amla (sour) and lavana (salty) substances is recommended. Bastis are contraindicated in ama condition. [23]

Treatment of shakrita-atisara and vata atisara( diarrhea with excess stools and vata)

वातघ्नैर्ग्राहिवर्गीयैर्बस्तिः शकृति शस्यते |

स्वाद्वम्ललवणैः शस्तः स्नेहबस्तिः समीरणे||२४||

vātaghnairgrāhivargīyairbastiḥ śakṛti śasyatē

svādvamlalavaṇaiḥ śastaḥ snēhabastiḥ samīraṇē||24||

vAtaghnairgrAhivargIyairbastiH shakRuti shasyate

svAdvamlalavaNaiH shastaH snehabastiH samIraNe||24||

In shakritatisara (atisara in which only stool is passed), basti with vataghna and grahi category of medicines is recommended. In vata related atisara, sneha basti with svadu (sweet), amla (sour) and lavana (salty) substances is acclaimed. [24]

Treatment of rakta atisara, pitta atisara and kapha atisara (diarrhea with blood, pitta and kapha)

रक्ते रक्तेन, पित्ते तु कषायस्वादुतिक्तकैः|

सार्यमाणे कफे बस्तिः कषायकटुतिक्तकैः||२५||

raktē raktēna, pittē tu kaṣāyasvādutiktakaiḥ|

sāryamāṇē kaphē bastiḥ kaṣāyakaṭutiktakaiḥ||25||

rakte raktena, pitte tu kaShAyasvAdutiktakaiH|

sAryamANe kaphe bastiH kaShAyakaTutiktakaiH||25||

In rakta atisara (diarrhea with blood) basti with blood, in pitta atisara basti with kashaya (astringent), madhura (sweet) and tikta (bitter) substances and in kapha atisara with kashaya (astringent), katu (pungent) and tikta (bitter) substances is to be administered. [25]

Treatment of atisara (diarrhea) mixed with shakrita-ama and vata

शकृता वायुना वाऽऽमे तेन वर्चस्यथानिले|

संसृष्टेऽन्तरपानं स्याद् व्योषाम्ललवणैर्युतम्||२६||

śakṛtā vāyunā vā”me tena varcasyathānilē|

saṁsṛṣṭē'ntarapānaṁ syād vyōṣāmlalavaṇairyutam||26||

shakRutA vAyunA vA~a~ame tena varcasyathAnile|

saMsRuShTe~antarapAnaM syAd vyoShAmlalavaNairyutam||26||

In the conditions where ama is associated with shakrita (stool) or vata, or shakrita (stool) or vata is associated with ama a drink, prepared with vyosha (a group of three pungent drugs, commonly known as trikatu, viz. rhizome of Zingiber officinalis Roxb.; fruits of Piper nigrum Linn. and Piper longum Linn.), sour and salty substances, is recommended. [26]

Treatment of atisara (diarrhea) mixed with pitta-rakta and ama

पित्तेनामेऽसृजा वाऽपि तयोरामेन वा पुनः|

संसृष्टयोर्भवेत् पानं सव्योषस्वादुतिक्तकम्||२७||

pittēnāmē'sṛjā vā'pi tayōrāmēna vā punaḥ|

saṁsṛṣṭayōrbhavēt pānaṁ savyōṣasvādutiktakam||27||

pittenAme~asRujA vA~api tayorAmena vA punaH|

saMsRuShTayorbhavet pAnaM savyoShasvAdutiktakam||27||

If there is association of ama with pitta or rakta or of both separately with ama then a drink with trikaṭu, sweet and bitter substances is indicated. [27]

Treatment of atisara (diarrhea)mixed with kapha-ama

तथाऽऽमे कफसंसृष्टे कषायव्योषतिक्तकम्|

आमेन तु कफे व्योषकषायलवणैर्युतम्||२८||

tathāmē kaphasaṁsṛṣṭē kaṣāyavyōṣatiktakam|

āmēna tu kaphē vyōṣakaṣāyalavaṇairyutam||28||

tathA~a~ame kaphasaMsRuShTe kaShAyavyoShatiktakam|

Amena tu kaphe vyoShakaShAyalavaNairyutam||28||

If ama is associated with kapha, a basti containing kashaya (astringent), trikatu and bitter substances and when kapha is associated with ama, a basti containing trikatu, kashaya (astringent) and salty substances is recommended. [28]

Treatment of atisara (diarrhea) mixed with pitta-vata-shakrita

वातेन विशि पित्ते वा विट्पित्ताभ्यां तथाऽनिले|

मधुराम्लकषायः स्यात् संसृष्टे बस्तिरुत्तमः||२९||

vātēna viśi pittē vā viṭpittābhyāṁ tathā'nilē|

madhurāmlakaṣāyaḥ syāt saṁsṛṣṭē bastiruttamaḥ||29||

vAtena vishi pitte vA viTpittAbhyAM tathA~anile|

madhurAmlakaShAyaH syAt saMsRuShTe bastiruttamaH||29||

When stool or pitta is associated with vata or vata is associated with stool and pitta, a basti with sweet, sour and astringent substances, is excellent. [29]

Treatment of atisara (diarrhea) mixed with pitta-rakta-shakrita

शकृच्छोणितयोः पित्तशकृतो रक्तपित्तयोः|

बस्तिरन्योन्यसंसर्गे कषायस्वादुतिक्तकः||३०||

śakṛcchōṇitayōḥ pittaśakṛtō raktapittayōḥ|

bastiranyōnyasaṁsargē kaṣāyasvādutiktakaḥ||30||

shakRucchoNitayoH pittashakRuto raktapittayoH|

bastiranyonyasaMsarge kaShAyasvAdutiktakaH||30||

In case of morbid mutual associations of pitta with stool and rakta, as well as stool with rakta and pitta, basti with astringent, sweet and bitter ingredients. [30]

Treatment of atisara (diarrhea) mixed with kapa-rakta-pitta-shakrita

कफेन विशि पित्ते वा कफे विट्पित्तशोणितैः|

व्योषतिक्तकषायः स्यात् संसृष्टे बस्तिरुत्तमः||३१||

kaphēna viśi pittē vā kaphē viṭpittaśōṇitaiḥ|

vyōṣatiktakaṣāyaḥ syāt saṁsṛṣṭē bastiruttamaḥ||31||

kaphena vishi pitte vA kaphe viTpittashoNitaiH|

vyoShatiktakaShAyaH syAt saMsRuShTe bastiruttamaH||31||

In case of similar associations of kapha with stool or pitta; or of stool or pitta or rakta with kapha, a basti with trikatu, bitter and kashaya ingredients is to be recommended. [31]

Treatment of atisara (diarrhea) mixed with vata-kapha-shakrita and rakta-kapha

स्याद्बस्तिर्व्योषतिक्ताम्लः संसृष्टे वायुना कफे|

मधुरव्योषतिक्तस्तु रक्ते कफविमूर्च्छिते||३२||

syādbastirvyōṣatiktāmlaḥ saṁsṛṣṭē vāyunā kaphē|

madhuravyōṣatiktastu raktē kaphavimūrcchitē||32||

syAdbastirvyoShatiktAmlaH saMsRuShTe vAyunA kaphe|

madhuravyoShatiktastu rakte kaphavimUrcchite||32||

In atisara where kapha is associated with vata, basti with trikatu, bitter and sour ingredients, and if rakta is associated with kapha then with sweet, trikatu and bitter is recommended. [32]

Treatment of atisara (diarrhea) mixed with kapha- vata -shakrita and vata-pitta

मारुते कफसंसृष्टे व्योषाम्ललवणो भवेत्|

बस्तिर्वातेन पित्ते तु कार्यः स्वाद्वम्लतिक्तकः||३३||

mārutē kaphasaṁsṛṣṭē vyōṣāmlalavaṇō bhavēt|

bastirvātēna pittē tu kāryaḥ svādvamlatiktakaḥ||33||

mArute kaphasaMsRuShTe vyoShAmlalavaNo bhavet|

bastirvAtena pitte [2] tu kAryaH svAdvamlatiktakaH||33||

If vata is accompanied by kapha, a basti with trikatu, sour and salty ingredients; and when pitta is associated with vata, basti with sweet, sour and bitter substances is to be administered. [33]

Treatment for conditions due to samsarga (combination of dosha)

त्रिचतुःपञ्चसंसर्गानेवमेव विकल्पयेत्|

युक्तिश्चैषातिसारोक्ता सर्वरोगेष्वपि स्मृता||३४||

tricatuḥpañcasaṁsargānēvamēva vikalpayēt|

yuktiścaiṣātisārōktā sarvarōgēṣvapi smṛtā||34||

tricatuHpa~jcasaMsargAnevameva vikalpayet|

yuktishcaiShAtisAroktA sarvarogeShvapi smRutA||34||

Similarly a plan may be designed in cases of morbid combinations of three, four or five components. This planning for atisara is applicable in all disease conditions. [34]

युगपत् षड्रसं षण्णां संसर्गे पाचनं भवेत् |

निरामाणां तु पञ्चानां बस्तिः षाड्रसिको मतः||३५||

yugapat ṣaḍrasaṁ ṣaṇṇāṁ saṁsargē pācanaṁ bhavēt [1] |

nirāmāṇāṁ tu pañcānāṁ bastiḥ ṣāḍrasikō mataḥ||35||

yugapat ShaDrasaM ShaNNAM saMsarge pAcanaM bhavet [1] |

nirAmANAM tu pa~jcAnAM bastiH ShADrasiko mataH||35||

In atisara, if all six pathological components are simultaneously involved, a pachana (causing or promoting digestion or transformation) medicine containing the drugs of all six tastes is useful, while in nirama (without ama) condition, where other five are involved a basti consisting of all six rasas (tastes) is indicated. [35]

Sarvatisara nashaka ghrita (medicated ghee for treatment of all types of diarrhea)

उदुम्बरशलाटूनि जम्ब्वाम्रोदुम्बरत्वचः|

शङ्खं सर्जरसं लाक्षां कर्दमं च पलांशिकम्||३६||

पिष्ट्वा तैः सर्पिषः प्रस्थं क्षीरद्विगुणितं पचेत्|

अतीसारेषु सर्वेषु पेयमेतद्यथाबलम्||३७||

udumbarani jambvāmrōdumbaratvacaḥ|

śaṅkhaṁ sarjarasaṁ lākṣāṁ kardamaṁ ca palāṁśikam||36||

piṣṭvā taiḥ sarpiṣaḥ prasthaṁ kṣīradviguṇitaṁ pacēt|

atīsārēṣu sarvēṣu pēyamētadyathābalam||37||

udumbarashalATUni jambvAmrodumbaratvacaH|

sha~gkhaM sarjarasaM lAkShAM kardamaM ca palAMshikam||36||

piShTvA taiH sarpiShaH prasthaM kShIradviguNitaM pacet|

atIsAreShu sarveShu peyametadyathAbalam||37||

A freshly prepared paste of udumbarashalaatu (unripe fruits of Ficus glomerata Roxb.), bark of jaambu (Syzygium cumini Skeels.), amra (Mangifera indica Linn.) and udumbara (Ficus glomerata Roxb.); sankha (conch shell), sarjarasa (resin of Vateria indica Linn.), laaksha (resinous secretion of Laccifera lacca Kerr.) and kardama (a type of rice), each one pala (about 50 grams) is to be cooked with one prastha (about 800 ml.) of ghrita, and two prastha of milk. This (thus prepared ghrita) is to be taken in all types of atisara according to bala (strength of the patient as well as disease). [36-37]

Sarvatisara nashaka yavagu (medicated gruel for treatment of all types of diarrhea)

कच्छुराधातकीबिल्वसमङ्गारक्तशालिभिः|

मसूराश्वत्थशुङ्गैश्च यवागूः स्याज्जले शृतैः||३८||

बालोदुम्बरकट्वङ्गसमङ्गाप्लक्षपल्लवैः |

मसूरधातकीपुष्पबलाभिश्च तथा भवेत्||३९||

kacchurādhātakībilvasamaṅgāraktaśālibhiḥ|

masūrāśvatthaśuṅgaiśca yavāgūḥ syājjalē śṛtaiḥ||38||

bālōdumbarakaṭvaṅgasamaṅgāplakṣapallavaiḥ |

masūradhātakīpuṣpabalābhiśca tathā bhavēt||39||

kacchurAdhAtakIbilvasama~ggAraktashAlibhiH|

masUrAshvatthashu~ggaishca yavAgUH syAjjale shRutaiH||38||

bAlodumbarakaTva~ggasama~ggAplakShapallavaiH |

masUradhAtakIpuShpabalAbhishca tathA bhavet||39||

A yavagu (gruel) prepared by cooking raktashali (a variety of rice brownish in color) and masura (Lens culinaris Medic.)) in a decoction of kacchura (Mucuna pruriens Baker. ), dhataki (Woodfordia fruticosa Kurz.), bilva (Aegle marmelos Carr.), samanga (Mimosa pudica Linn.) and ashvatthashunga (leaf bud of Ficus religiosa Linn.) is beneficial in atisara.

Similar preparation can be made with unripe fruit of udumbara, leaves of kathvanga (Ailanthus excelsa Roxb.) and samanga as well as plaksha (Ficus lacor Buch.), masura (Lens culinaris Medic.) and dhataki flowers. [38-39]

Treatment of all types of diarrhea

स्थिरादीनां बलादीनामिक्ष्वादीनामथापि वा|

क्वाथेषु समसूराणां यवाग्वः स्युः पृथक् पृथक्||४०||

कच्छुरामूलशाल्यादितण्डुलैरुपसाधिताः|

दधितक्रारनालाम्लक्षीरेष्विक्षुरसेऽपि वा||४१||

शीताः सशर्कराक्षौद्राः सर्वातिसारनाशनाः|

ससर्पिर्मरिचाजाज्यो मधुरा लवणाः शिवाः||४२||

sthirādīnāṁ balādīnāmikṣvādīnāmathāpi vā|

kvāthēṣu samasūrāṇāṁ yavāgvaḥ syuḥ pṛthak pṛthak||40||

kacchurāmūlaśālyāditaṇḍulairupasādhitāḥ|

dadhitakrāranālāmlakṣīrēṣvikṣurasē'pi vā||41||

śītāḥ saśarkarākṣaudrāḥ sarvātisāranāśanāḥ|

sasarpirmaricājājyō madhurā lavaṇāḥ śivāḥ||42||

sthirAdInAM balAdInAmikShvAdInAmathApi vA|

kvAtheShu samasUrANAM yavAgvaH syuH pRuthak pRuthak||40||

kacchurAmUlashAlyAditaNDulairupasAdhitAH|

dadhitakrAranAlAmlakShIreShvikShurase~api vA||41||

shItAH sasharkarAkShaudrAH sarvAtisAranAshanAH|

sasarpirmaricAjAjyo madhurA lavaNAH shivAH||42||

Different yavagus can be prepared by combining masura (Lens culinaris Medic.) with the decoctions of sthiradi, baladi and ikshvadi (groups of plants). [40]

Roots of kacchura (Mucuna pruriens Baker.) and rice of shali and other varieties cooked with dadhi (yogurt), takra (churned yogurt), aranala (sour fermented supernatant of cooked rice), ksheera (milk) or ikshurasa (sugarcane juice), and after being cooled added with sugar and honey, is able to treat all types of atisara. The above-mentioned gruels are promising (anti-diarreal) when added with ghrita, pepper and cumin (Cuminum cyminum Linn.), sweet substances and rock salt. [41-42]

Treatment principles

भवन्ति चात्र श्लोकाः-

स्निग्धाम्ललवणमधुरं पानं बस्तिश्च मारुते कोष्णः|

शीतं तिक्तकषायं मधुरं पित्ते च रक्ते च||४३||

तिक्तोष्णकषायकटुश्लेष्मणि सङ्ग्राहि वातनुच्छकृति|

पाचनमामे पानं पिच्छासृग्बस्तयो रक्ते||४४||

अतिसारं प्रत्युक्तं मिश्रं द्वन्द्वादियोगजेष्वपि च|

तत्रोद्रेकविशेषाद्दोषेषूपक्रमः कार्यः||४५||

bhavanti cātra ślōkāḥ-

snigdhāmlalavaṇamadhuraṁ pānaṁ bastiśca mārutē kōṣṇaḥ|

śītaṁ tiktakaṣāyaṁ madhuraṁ pittē ca raktē ca||43||

tiktōṣṇakaṣāyakaṭuślēṣmaṇi saṅgrāhi vātanucchakṛti|

pācanamāmē pānaṁ picchāsṛgbastayō raktē||44||

atisāraṁ pratyuktaṁ miśraṁ dvandvādiyōgajēṣvapi [1] ca|

tatrōdrēkaviśēṣāddōṣēṣūpakramaḥ kāryaḥ||45||

bhavanti cAtra shlokAH-

snigdhAmlalavaNamadhuraM pAnaM bastishca mArute koShNaH|

shItaM tiktakaShAyaM madhuraM pitte ca rakte ca||43||

tiktoShNakaShAyakaTushleShmaNi sa~ggrAhi vAtanucchakRuti|

pAcanamAme pAnaM picchAsRugbastayo rakte||44||

atisAraM pratyuktaM mishraM dvandvAdiyogajeShvapi ca|

tatrodrekavisheShAddoSheShUpakramaH kAryaH||45||

Here the shlokas (verses) remain-

(Besides the above some more treatment-principles useful in atisaras are given below as per the factors involved)

  1. Vata: snigdha (unctuous) amla (sour) lavana (salty) and madhura (sweet) liquids orally and warm bastis with same substances.
  2. Pitta and rakta: cold bitter astringent and sweet substances.
  3. Kapha: bitter, hot, astringent and pungent substances.
  4. Shakrita (stool): sangrahi (checks atisara through improving the digestion) and vataghna (measures)
  5. Ama: pachana (measures digesting ama)
  6. Rakta: picchabasti and raktabasti
  7. Atisara may also be in combination of two or more factors. In those conditions treatment is to be planned according to dominance of the doshas (and the factors involved). [43-45]

Summary

तत्र श्लोकः-

प्रासृतिकाः सव्यापत्क्रिया निरूहास्तथाऽतिसारहिताः|

रसकल्पघृतयवाग्वश्चोक्ता गुरुणा प्रसृतसिद्धौ||४६||

tatra ślōkaḥ-

prāsṛtikāḥ savyāpatkriyā nirūhāstathā'tisārahitāḥ|

rasakalpaghṛtayavāgvaścōktā [1] guruṇā prasṛtasiddhau||46||

tatra shlokaH-

prAsRutikAH savyApatkriyA nirUhAstathA~atisArahitAH|

rasakalpaghRutayavAgvashcoktA [1] guruNA prasRutasiddhau||46||

In this chapter of Prasrita Yogiyam Siddhi management of the complications, prasritika niruhas, and the bastis, decoctions, ghrita, gruels useful in the management of atisaras are presented by the teacher. [46]

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते

दृढबलसम्पूरिते सिद्धिस्थाने प्रासृतयोगीयसिद्धिर्नामाष्टमोऽध्यायः ||८||

ityagnivēśakṛtē tantrē carakapratisaṁskṛtē'prāptē

dṛḍhabalasampūritē siddhisthānē prāsṛtayōgīyasiddhirnāmāṣṭamō'dhyāyaḥ [1] ||8||

ityagniveshakRute tantre carakapratisaMskRute~aprApte

dRuDhabalasampUrite siddhisthAne prAsRutayogIyasiddhirnAmAShTamo~adhyAyaH [1] ||8||

Thus in the treatise (originally) prepared by Agnivesha, edited by Charak and supplemented the lost parts by Dridhabala, in Siddhi Sthana, the eighth chapter entitled Prasrita Yogiyam Siddhi is concluded.

Tattva Vimarsha (Fundamental Principles)

  • A milder form of basti can get stagnated inside leading to complications of not eliminating doshas. This may result into ayoga or heenayoga (insufficient action). On the contrary if a basti is stronger it may cause an atiyoga (action in excess) causing excessive evacuation of dosha along with body constituents.
  • Faulty application of bastis may cause a complication in the form of atisara (diarrhea).
  • Atisara (diarrhea) may be either acute with undigested material associated with ama or chronic without much undigested material/ pakwa.
  • Pakwa type of atisara is again of five types as with shakrita (fecal matter), with vata (flatus), with asrika (blood), with pitta and with kapha.
  • Basic principle of treatment of every condition associated with ama is amapachana. Decoction / powder of musta, ativisha, kushtha, nata, daru and vacha are ideal for amapachana. This recipe is useful in amatisara.
  • To manage pakvatisara, medicines of two categories viz. vataghna (anti-vata) and grahi (anti-diarrheal by promoting digestion and absorption) are used.
  • Picchabasti and raktabasti are treatments for diarrhea with blood.These can be considered as stambhana (stop bleeding) and vishesha brimhana (enhance internal strength).
  • The treatment principles of various types of atisara due to complications of basti therapy:
    • Vata: snigdha (unctuous), amla (sour), lavana (salty) and madhura (sweet) liquids orally and warm bastis with same substances.
    • Pitta and rakta: cold bitter astringent and sweet substances.
    • Kapha: bitter, hot, astringent and pungent substances.
    • Shakrita (stool): sangrahi (checks atisara through improving the digestion) and vataghna (measures)
    • Ama: pachana (measures digesting ama)
    • Rakta: picchabasti and raktabasti.

Vidhi Vimarsha (Applied Inferences )

The unit prasrita, according to Charak Samhita is an amount of two palas which is approximately equal to 100 milliliter (1pala=50ml).[5],[6] (verse 1-2)Charak Samhita is written in the form of dialogue between the teacher (Atreya) and his disciples (mainly Agnivesha). Mild form of shodhana measures are for those subjects who are not suitable for strong measures and for the patients who suffered with the complications of the measures described in previous chapters. Vamana and virechana are major procedures for shodhana. However, these are contraindicated for the tender persons. Tender persons may not tolerate even basti. Therefore, mild forms of bastis are described for them. Similarly, the measures to treat the complications developed due to the faulty application of the procedures especially the basti.

Some translators interpreted the phrase karmana viplutanama as ‘exhausted of hard work’.[7] However, the meaning of this phrase can be taken as ‘complicated by the consequences of the therapies’, which seems to be more appropriate in this context. The complications may be natural consequences of the therapies or may be due to faulty application. (verse 3)

The recipe in verse 4 is composed of total five prasritas (2 prasritas of milk, 1 prasrita each of honey, sesame oil and ghrita), therefore this basti is named by Gangadhara as panchaprasrtika basti.[8] This basti is useful for eliminating vata as well as promoting the strength and the complexion.

Vata eliminating measures usually promotes quality of dhatus and upadhatus (structural components of the body). This eventually results in promotion of the body strength and the complexion. Word bala also denotes the immune function; hence this may also be interpreted as promoting immune activity. In ancient time to mix a basti material, churning stick was used. In modern time an electric blender is an ideal alternative. With a blender the mixture is better homogenized than a manual churning stick.

Chakrapani considered bilvadi group in his Ayurveda deepika commentary as dashamula.[9] This group consists of roots of ten plants viz. bilva (Aegle marmelos Carr.), shyonaka (Oroxylum indicumVent.),gambhari (Gmelina arborea Roxb.), patala (Stereospermum suaveolensDC.),agnimantha (Premna integrifolia Roxb.), shalaparni (Desmodium gangeticumDC.), prishniparni (Uraria picta Desr.) brihati (Solanum indicum Linn.), kantakari (Solanum suranttense Burm.) and gokshura (Tribulus terrestris Linn.).

While Gangadhara in his Jalpakalpataru commentary mentions this as panchamula –the roots of a group of five plants viz. bilva,shyonaka, gambhari, patala and agnimantha.[10]Since next verse (5th) describes a recipe with panchamula, in this verse considering bilvadi as dashamula is more logical and practical. This basti consists a total of eight prasritas (one prasrita each of taila, prasanna, madhu and ghrita and two prasritas each of bilvadi decoction and kulattha decoction). Therefore, Gangadhara names this as ashtaprasritika basti.[11]

The basti in verse six, consists of total nine prasritas i.e. panchamula decoction- five prasritas, sesame oil - two prasritas, honey- one prasrita, ghrita- one prasrita. Therefore, Gangadhara names this as navaprasritika basti.[12] (verses 4-6)

Aksha and karsha are the units of same amount, which is equal to about twelve grams. Hence the amount of rock salt in this basti would be about 6 grams. Shukra is one of the seven dhatus (structural components). Shukra is not a single entity. It comprises male reproductive cells and substances including the androgenic hormones responsible for manhood in a man. This basti promotes quality and quantity of all these entities in the body.

The usual contents of a niruha basti are salt, honey, oil, kalka and decoction (or a liquid). These are to be mixed by churning in the sequence as mentioned above. Here the mixing may be in this sequence- saindhava, honey, oil, ghrita, hapusha (fruits of Juniperus communis Linn.)and milk.(verse 7)

Basti is usually contraindicated in kushtha[13]. However, Sushruta Samhita recommends niruhabastis in this condition.[14] Practically niruha basti, with bitter substances e.g. panchatikta niruha, is useful in kushtha.

The quantity of kalka of sarshapa is not mentioned in the above recipe. According to commentary of Chakrapani on this verse, it may be decided. [15] In the niruha bastis with an amount of twelve prasritas, the amount of kalka is usually two palas (about 100gms). In present recipe, the amount is five prasritas and therefore the amount of kalka of sarshapa would be about 40 gms. This principle is applicable in latter recipes also where the amount of kalka is not mentioned.

This basti contains vidanga (Embelia ribes Burm.) which is the best among krimighna(anti-parasitic) [Cha. Sa. Sutra Sthana 25/40] substances. Therefore, it has a kriminashana effect. (verse 9-10)

Gangadhara in his Jalpakalpataru commentary considers payasyas ksheerakakoli, which is Fritillaria roylei Hook. Some scholars consider payasyaas vidari, but at present, vidari recipies already include one ingredient therefore to consider it ksheerakakoli is appropriate.

In the recipes of verse 11-12, the amount of paste is not mentioned. This may be calculated as stated in earlier verse 8th -9th. (verse 11-12)

In above verses from 4 to 14, nine recipes of prasrita bastis are described. Here a special and practical instruction is given that even if salt is not mentioned in any of the recipes, rock salt is to be added and these bastis are always given with a moderate warm temperature.

While preparing the bastis, rock salt is to be added. The amount is to be calculated according to the principle described in the 7th verse i.e. about 6 gms. After preparing the basti, to keep it warm until it is administered, a hot water bath may be used. (verse 13-14)

In the verse 15-16, two opposite possibilities are described. It may be milder than normal or it may be stronger than a normal. A mild basti is unable not only to eliminate doshas, but it itself is not ableto come out. This is ayoga or heenayoga (insufficient action). In such a case a basti is to be repeated with a stronger recipe. Contrary to this, if a basti is stronger it may cause an atiyoga (action in excess) causing evacuation of colonic contents more than required and eventually loss of essential substances.

A soft acting basti is not able to eliminate the doshas and may get stagnated and cause disturbance. To eliminate it, a strong and sharp acting basti is recommended. If strong bastis have caused emaciation, dehydration or weakness, the bastis with madhura (sweet) substances are useful because madhura substances are nourishing in action. (verses 15-16)

In vata-related disorders, basti material with physically and pharmacologically hot property is preferred. It may cause pitta aggravation resulting in burning sensation and other such pitta-related symptoms. In such a condition, grape juice or decoction of raisins added with a kalka (paste) of trivrita (Operculina turpethum Linn.) is given. In case of unavailability of kalka, its powder can be used. This cures the burning sensation and other pitta-related symptoms with its anti-pitta action and expulsion of stool, pitta and vata. Yavagu with sugar is given for nourishing purpose after this laxation. (verses 16-17)

If the purgation is in excess, it may cause significant loss of stool along with essential substances (e.g.water and electrolytes). This requires immediate attention to prevent the harm due to depletion of essential body components.

In such a condition it is to be corrected by eating mashayusha (soup of black beans) and kulmasha (half cooked grains); and by taking honey or sura. Kulmasha is also interpreted as a sour gruel (prepared by the spontaneous fermentation of fruit-juices or boiled rice). However, according to Chakrapani this is half cooked grain (barley etc.), which is popularly known as ghughuni.[16],[17]. This is known as ghughari in Gujarat and western Madhya Pradesh. This is more suitable interpretation. This is considered to be well nourishing food article. (verse 18)

Faulty application of bastis may cause a complication in the form of atisāra. Atisāra is a clinical condition of colon characterized by excessive and frequent defecation with altered consistency of stool. In short it may be interpreted as diarrhea. In next verse different forms of atisāra and their management are described. In this verse the condition is characterized by sāma stool (stool containing āma- undigested material), which smells like a decomposing body (putrid smell) and is associated with abdominal pain. Āma is a substance produced due to weak agni resulting in incomplete transformation of substance. In the present context, due to weak jatharāgni the transformation of food in to digested absorbable substances is incomplete resulting in to production of some intermediate substances.[18] ,[19]These substances are known as āma. Because of its adherent quality it is supposed to be a pathogenic substance.In this condition a decoction of mustā, ativiṣā, kuṣṭha, nata, dāru and vacā is recommended. These medicines help in pachana (termination) of āma.

This chapter describes six types of atisāra based on the pathogens being excreted in excess. This verse explains the remedy for one of them in which patient passes stool with significant undigested material. This undigested material causes putrid smell after decomposition. Decomposition also produces some toxic substances, which cause abdominal pain and loss of appetite. The recipe described here is not useful in atisāra produced as complication of basti but also in āmātisāra of any origin. (verse 19)

This verse number 20 describes other five types of atisāra. In this way, six types of atisāras those are depicted in above verses are as follow.

  1. Atisara (diarrhea) in which stool contains ama (undigested material)
  2. Atisāra (diarrhea) in which stool is pakva i.e.free from āma (undigested material)
  3. Atisāra (diarrhea) in which stool is pakva and containing vata i.e. significant flatulence.
  4. Atisāra (diarrhea) in which stool is pakva and containing asṛk (blood).
  5. Atisāra (diarrhea) in which stool is pakva and containing pitta.
  6. Atisāra (diarrhea) in which stool is pakva and containing kapha.

For the management of these conditions bastis prepared with the svavargīya medicines (group of medicines acting against particular pathologies) are given.[20] For example the vargas (classified groups) described in Ṣaḍvirecanaśatāśrīya chapter (chapter 4th) of sūtrasthāna of Carakasaṁhitā. So, the recommended group of medicines for last five conditions of pathology is purīṣasaṁgrahaṇīya [Cha.Sa.Sutra Sthana 4/8/31], vātaghna, śoṇitasthāpana [Cha.Sa.Sutra Sthana 4/8/46], pittaghna and kaphaghna vargas respectively.[21].Purīṣasaṁgrahaṇīya group consists of priyaṅgu (Callicarpa macrophylla R.Br.), ananta (Hemidesmus indicusR.Br.), Seed of mango, kaṭvaṅga (Ailanthus excelsa Roxb.), lodhra (Symplocos racemosa Roxb.), mocharasa (secretion of Salmalia malabarica Scott&Endl.), samṅgā (Mimosa pudica Linn.), dhātakī (Woodfordia fruticosa Kurz.), padmā (Clerodendrum serratum Linn.) and padmakesara (Stamen of Nelumbo nucifera Gaertn.). shoṇitasthāpana group consists of honey, madhuka (Glycyrrhiza glabra Linn.), saffron, mocarasa (secretion of Salmalia malabarica Scott &Endl.), broken earthen vessel, lodhra (Symplocos racemosa Roxb.), gairika (red ochre), priyaṅgu (Callicarpa macrophylla R.Br.), sharkarā(sugar) and lājā (puffed rice).[22]The form of basti is not described here. However, this may be decided according to disease condition and patient’s tolerance. (verse 20)

In this version of Charak Samhita thirty six variants are cited, but another version ‘kēvalaiḥ saha ceṭ triṁśadvidyāt sōpadravānapi’ mentions only thirty.[23] Gaṅgādhara also explains thirty forms in the following manner.[24]

The six basic forms of atisāra are:

  1. āmātisāra (diarrhea with undigested material)
  2. śakṛdatisāra (frequent stool only)
  3. vātātisāra (that with significant flatulence)
  4. asṛkātisāra (that with blood)
  5. pittātisāra (that with pitta) and
  6. kaphātisāra (that with kapha).

Due to saṁsarga (mutual combinations of two) a total of fifteen variants occur, viz.

  1. āma-śakṛd, āma-vata, āma-asṛk, āma-pitta, āma-kapha,
  2. śakṛd-vata, śakṛd-asṛk, śakṛd-pitta, śakṛd-kapha,
  3. vāta-asṛk, vata-pitta, vata-kapha,
  4. asṛk-pitta, asṛk-kapha, and
  5. pitta-kapha.

Nine upadrava as cited above.

The upadravas in present version of chapter are ten. Gaṅgādhara has taken description of nine upadravas from another version.[25] But upadravas cannot be counted among types of a disease. Hence the thirtysix variants would be in following manner.

The six basic forms of atisāra are as mentioned above.

Due to saṁsarga (mutual combinations of two) a total of thirty variants occur, viz. fifteen samsargas as mentioned above and other fifteen are as below:

  1. śakṛd- āma, vata-āma, asṛk-āma, pitta-āma, kapha-āma,
  2. vata-śakṛd, asṛk-śakṛd, pitta-śakṛd, kapha-śakṛd,
  3. asṛk-vata, pitta-vata, kapha-vata,
  4. pitta-asṛk, kapha-asṛk, and
  5. kapha-pitta.

Moreover Charak Samhita describes types of atisāra in its chapter 19th of Sutra Sthana and 19th chapter of Chikitsa Sthana differently. [26],[27] The context of the topic atisāra in present chapter is absolutely different. Here it is described first as a complication of basti, which eloborted further in the chapter. In earlier sections atisāra was described as a primary disease manifested because of its own physical and mental etiological factors. (verse 21-22)

Basic principle of treatment of every condition associated with āma is āmapāchana (termination of āma by promoting function of agni). For this purpose mustā, ativiṣā, kuṣṭha, nata, dāru and vacā (which are mentioned in 19th verse) are to be given. This combination may be given in form of powder or as decoction. This recipe is useful in āmātisāra every origin. (verse 23)

For vātaghna medicines to be used in vata associated atisara, Cakrapāṇi recommends daśhamula, while Gaṅgādhara considers bṛhat pañchamūla (see the commentary on 5th verse). For grāhī purpose the medicines of purīṣasaṁgrahaṇīya varga [Cha.Sa.Sutra Sthana.4/8/31] are to be used.[28]

Next condition in which atisāra is associated with dominance of vata, snēha basti supplemented with sweet, sour and salty substances is recommended. Being opposite to the properties of vata, the substances in this basti antagonizes the vata principle. (verse 24)

Now the management of other conditions - raktātisāra, pittātisāra and kaphātisāra is explained. In raktātisāra, a basti with blood of animals e.g. goat, is given. This not only stops the bleeding but also supplements the substances to produce blood, which is lost due to colonic bleeding. Pitta pacifying remedies also helpful in this condition and therefore the remedies useful in pittātisāra can also be given in raktātisāra. Substances with astringent, sweet and bitter tastes have pitta-antagonizing action and hence the basti consists of such substances are helpful in management of pittātisāra. Substances with astringent, pungent and bitter tastes have kapha-antagonizing action; therefore, a basti with such medicines is beneficial in kaphātisāra.

The basti used in pittātisāra is useful in raktātisāra also. Applying this principle, this type of basti may be used in a disease entity known as ulcerative colitis. (verse 25)

These verses number 26-27 describe management plan for the saṁsargaja atisāras (in which two morbid components are associated and have mutual vitiation). Cakrapāṇi in his commentary decides the main and secondary role of the involved components on the basis of vibhakti (noun case) of the words. 7th vibhakti signifies the main role while 3rd expresses secondary role of the factors.[29]

In the 26th verse the possible combination are-

  1. āma is associated with śakṛt i.e.stool (āma is primary and stool is secondary)
  2. āma is associated with vata (āma is primary and vata is secondary)
  3. śakṛt (stool) is associated with āma (stool is primary āma is secondary)
  4. vata is associated with āma (vata is primary and āma is secondary)

In the 27th verse the possible combination are-

  1. āma is associated with pitta (āma is primary and pitta is secondary)
  2. āma is associated with rakta (āma is primary and rakta is secondary)
  3. pitta is associated with āma (pitta is primary and āma is secondary)
  4. rakta is associated with āma (rakta is primary and āma is secondary)

In these conditions in mentioned in 26th verse, a drink prepared with trikaṭu, sour and salty substances is recommended. While the conditions mentioned in 27th verse, are manageable with adrink, prepared with trikaṭu, sweet and bitter substances are useful. (verse 26-27)

The description of saṁsargaja atisāras continues in these verses 28-29. In the 28th verse, the possible combination are-

  1. āma is associated with kapha (āma is primary and kapha is secondary)
  2. kapha is associated with āma (kapha is primary and āma is secondary)

In 1st condition the recommended basti is with trikaṭu, astringent and bitter substances while in 2nd condition with trikaṭu, astringent and salty medicines.

In a pāthabheda (another version) of 29th verse[30], raktais also included. With this inclusion the possible combination are-

  1. śakṛt (stool) is associated with vāta (stool is primary and vata is secondary)
  2. pitta is associated with vāta (pitta is primary and vata is secondary)
  3. rakta is associated with vāta (pitta is primary and āma is secondary)
  4. vata is associated withstool(vata is primary and stool is secondary)
  5. vata is associated with pitta (vata is primary and pitta is secondary)
  6. vata is associated with rakta (vata is primary and rakta is secondary)

In these pathological conditions a basti with sweet, sour and astringent materials is acclaimed. (verse 28-29)

The management of saṁsargaja atisāras further continues in these verses. In the 30th verse the possible combination are-

  1. rakta is associated with śakṛt i.e. stool(rakta is primary and stool is secondary)
  2. rakta is associated with pitta (rakta is primary and pitta is secondary)
  3. śakṛt (stool) is associated with pitta (stool is primary and pitta is secondary)
  4. śakṛt stool is associated with rakta (stool is primary and rakta is secondary)
  5. pitta is associated with rakta (pitta is primary and rakta is secondary)
  6. pitta is associated with śakṛt stool (pitta is primary and stool is secondary)

In the 31st verse the possible combination are-

  1. stool is associated with kapha (stool is primary and kapha is secondary)
  2. pitta is associated with kapha (pitta is primary and kapha is secondary)
  3. kapha is associated with stool (kapha is primary andstool is secondary)
  4. kapha is associated with pitta (kapha is primary and pitta is secondary)
  5. kapha is associated with rakta (kapha is primary and rakta issecondary)

The conditions mentioned in 30th verse are managed by administration of basti prepared with astringent, sweet and bitter ingredients. While the pathologies in 31stverse, are manageable by a basti with trikaṭu, bitter and astringent ingredients. (verse 30-31)

In these verses 32-33, four more combinations of pathology are described with their management. In 32nd verse the kapha is main factor with vata as secondary and rakta as main with kapha as secondary while in 33rd verse vata is main factor with kapha as secondary and pitta as main with vata as secondary.

Type of atisāra according to involvement of factors. Reccommended material for basti Kapha is main factor with vata as secondary trikaṭu, bitter and sour ingredients Rakta as main with kapha as secondary sweet,trikaṭu and bitter Vata is main factor with kapha as secondary trikaṭu,sour and salty Pitta is main with vata as secondary. sweet, sour and bitter(verse 32-33)

There are six components involved in the pathogenesis of atisāra. In earlier verses the combinations of two components are described. The combinations of three, four or five are also possible. Gaṅgādhara in his Jalpakalpataru commentary mentions the possibility of combination of all six also.[31] This appears logical, as when five may combine six together may also be possible.

According to Gaṅgādhara, the following combinations may happen viz. ten clinical forms due to combinations of three, six forms due to combinations of four, three forms due to combinations of five and one form with all six. In this way twenty forms are possible. These combinations are as below.

Combinations of three Combinations of four Combinations of five Combination of six āmaviḍvātaja āmaviḍasṛja āmaviḍpittaja āmaviḍkaphaja viḍvātāsṛja viḍvātapittaja viḍvātakaphaja vātāsṛkpittaja vātāsṛkkaphaja asṛkpittakaphaja āmaviḍvātāsṛja āmaviḍvātapittaja āmaviḍvātakaphaja viḍvātāsṛkpittaja viḍvātāsṛkkaphaja vātāsṛkpittakaphaja āmaviḍvātāsṛkpittaja āmaviḍvātāsṛkkaphaja viḍvātāsṛkpitta kaphaja āmaviḍvātāsṛkpittakaphaja(verse 34)

If case of association of āma, bastis are contraindicated. This is a general rule. In such condition the āmapācana (preparation to terminate āma)is given. However, in nirāma condition (without association of āma), bastis are recommended. (verse 35)

In these verses 36-37, two new units of measurement are described i.e. pala and prastha. After calculating these amounts in modern units of metric system, pala is around 50 gms or 50 ml while prastha around 800 ml. Though, in previous verses the management of different types of atisāras, has been described. In coherence of the topic, more remedies for atisāra are described in present verses.

This medicated ghṛta is processed with plants having stambhana action. Therefore, it is useful in all types of atisāra. Being a nourishing preparation, it is useful in compensating the loss of the essential body substances. A basti may also be given with this preparation and should be retained as much as possible. This type of basti may be useful in inflammatory bowel diseases. (verse 36-37)

The remedies for atisāra continue in these verses 38-39. These verses describe recipe of medicated gruels useful in management of this disease. First the decoction is prepared according to the recipe of ṣaḍaṅgapānīya.[32],[33]

For this purpose one part of the course powder of all plants is boiled with 64 parts of water. When water is reduced to half, this is to be taken to cook yavāgū. There are three varieties of yavāgū-maṇḍa, peyā and vilepī. These three are gradually thicker in consistency and may be chosen according to strength of a patient and his agni. (verse 38-39)

Gaṅgādhara considers Sthirādi group of plants as Svalpapañcamūla consists of śālaparṇī (Desmodium gangeticum DC.), pṛśniparṇī (Uraria picta Desr.) bṛhatī (Solanum indicum Linn.) kaṇṭakārī (Solanum suranttense Burm.) and gokṣura (Tribulus terrestris Linn.). About balādi group there is no clarification by any commentator however the plants Sida cordifolia Linn., abutilon indicum Linn., Sida rhombifolia Linn. and Grewia hirsute Vahl. may be taken for this purpose. Ikṣvādi is considered by Cakrapāṇi as roots of Saccharum officinarum Linn., Desmostachya bipinnata Stapf., Saccharum spontaneum Linn. and roots of rice. There is another version of verse 42, which mentions last line as ‘sasarpirlavaṇā yojyā madhurā lavaṇāpi vā’ which means that this preparation can be used with ghṛta and rock salt in sweet or salty form.

Above verses give some more recipes for medicated yavāgūs those are helpful in management of atisāra. (verse 40-42) In these verses some additional and useful remedies for management of various types of atisāra are given. It is to be recalled that in this chapter, authors have considered six factors responsible in pathogenesis and manifestation of atisāra viz. āma vata, pitta, kapha, rakta and sakṛt (stool). The treatments are to be considered as per the factors involved. (verse 43-45) The chapter describes various clinical forms of atisara according to the components involved in the pathogenesis. The therapeutics for these various forms of atisāra is described in a planned manner. Ayurvedic management is not merely medicaments but it recommends the food preparations those are helpful in restoring the normalcy of the body components of the patient. Thus the chapter is significantly useful for clinical practice of basti therapies and the treatment of disease atisāra, which includes several modern diseases such as ulcerative colitis, Crohn’s dieases and irritable bowel syndrome. (verse 46) The basti formulations mentioned in this chapter are used widely in today’s clinical practice. However, though atisara (diarrhea) is explained in detail as complication of improperly administered basti, in todays clinical practice, this complication is observed rarely.

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References

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