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Line 2: − + − + + + + − − <big>'''Abstract '''</big> − − ''Raktapitta'' is a treatable bleeding disorder, if recognized and managed in early stage. If diagnosis is missed and disease is not managed properly, it becomes life threatening (''mahagada'').It occurs because of excessive aggravation of ''pitta'' and its affliction with ''rakta''. Before initiation of treatment, it is important to assess strength of the patient because the treatment regimen is personified for well nourished and emaciated persons. Etiology, classification, prognosis and treatment of ''raktapitta'' have been described in detail. A good number of herbal and animal preparations are given. Further, this chapter enumerates aspects that are favorable or unfavorable to ''raktapitta''. To improve the efficacy of treatment, external beneficial measures, such as ''pradeha, parisheka, sheetasnana'' and habitat are described at the end of chapter.This bleeding disorder is not described in modern medicine writings and appears to be unknown to allopathic medicine. − − '''Keywords''': ''Raktapitta, Chikitsa, Mahagada,'' bleeding disorders, ''pitta'' aggravation, ''rakta'' vitiation. − Line 25:
Line 21: + + + + + + + + + + + + + + + + + − |header3 = + − }} + + − ''Raktapitta'' is a serious disease caused due to vitiation of ''rakta'' by aggravated ''pitta''. This chapter is placed after ''jwara'', because ''raktapitta'' can occur due to the increased heat in the body produced after ''jwara''. Prompt management is necessary for this dreadful disease. This disease develops due to ''pitta'' aggravation as a result of consumption of ''ushna, teekshna, agneya dravya'' and excessive exposure to sunlight.+ − − − − It originates in the spleen and liver which play pivotal roles in the blood physiology, including clotting. Manifestations of ''raktapitta'' depend upon vitiation and predominance of a particular ''dosha''. There may be a combination of one, two or all the three ''dosha''. Based on ''dosha'' specific features, the blood of the patient of ''raktapitta'' may appear pale, unctuous and slimy in ''kapha'', frothy, blackish red in ''vata'' and cane sugar like cow urine, shiny black, smoky and coarse-like collerium in ''pitta''. ''Raktapitta'' associated with one ''dosha'' is curable, with two ''dosha'' is difficult to cure and incurable if all three ''dosha'' are involved. − Movement of ''raktapitta'' may be upward or downward meaning bleeding from upper and/or lower external orifices. This manifestation depends on etiological factors, unctuous hot factors associated with ''kapha'' has upward ''raktapitta'' however rough hot associated with ''vata'' has downward ''raktapitta''.+ − Upward ''raktapitta'', associated with ''kapha dosha'' is treated with ''tarpana'' (nourishment therapy) and downwards ''raktapitta'' is associated with ''vata'' and ''peya'' (liquid gruel) should be used.+ − Their drugs mainly have ''madhura, tikta'' and ''sheeta guna'' which pacify ''pitta'' and ''rakta''. One herb which is very important in ''raktapitta'' is ''vasa'', which alone can check the bleeding quickly.+ − === Sanskrit text, Transliteration and English Translation ===+ + + Line 61:
Line 73: − + − As propounded by Lord Atreya. [1-2]+ − − ==== Agnivesha’s query ==== Line 87:
Line 97: − + − ==== Atreya Punarvasu’s reply ====+ Line 123:
Line 133: − ==== Pathogenesis ====+ Line 146:
Line 156: − + − ==== Derivation ====+ Line 164:
Line 174: − ==== Origin of disease ====+ Line 178:
Line 188: − + − ==== Characteristics of ''dosha'' vitiation ====+ Line 209:
Line 219: − + − ==== Prognosis ====+ Line 231:
Line 241: − + − ==== ''Gati'' (direction of flow) and prognosis ====+ Line 303:
Line 313: − + − + − ==== Characteristics of curable ''raktapitta'' ====+ Line 344:
Line 354: − + − ==== Consequneces of styptic therapy in ''rakta-pitta'' ====+ Line 387:
Line 397: − + Line 412:
Line 422: − + − ==== Nourishment regimen ====+ Line 468:
Line 478: − ==== Diet advised in ''raktapitta'' ====+ Line 547:
Line 557: − + − ==== Medicated gruels in ''raktapitta'' ====+ Line 640:
Line 650: − + Line 659:
Line 669: − + Line 681:
Line 691: − ==== Indication of purification therapy ====+ Line 755:
Line 765: − + − + Line 766:
Line 776: − + − ==== Pacification therapy ====+ Line 1,020:
Line 1,030: − + Line 1,031:
Line 1,041: − ==== Treatment of hematuria and per rectal bleeding ====+ Line 1,047:
Line 1,057: − ==== Treatment of per rectal bleeding ====+ Line 1,070:
Line 1,080: − + − ==== ''Vasa'' ghee ====+ Line 1,126:
Line 1,136: − ==== External applications ====+ Line 1,151:
Line 1,161: − ==== Treatment of ''raktapitta'' with associated ''kapha'' ====+ Line 1,174:
Line 1,184: − + − ==== ''Shatavaryadi'' ghee ====+ Line 1,209:
Line 1,219: − ==== Treatment of nasal bleeding ====+ Line 1,259:
Line 1,269: − + Line 1,356:
Line 1,366: − ==== Summary ====+ Line 1,404:
Line 1,414: − + − + − + − + − + − + − + − + − + − + − + − + Line 1,426:
Line 1,436: − ==== Types of Bleeding Disorders ====+ Line 1,436:
Line 1,446: − ==== Identification of Bleeding Disorders/Symptoms ====+ Line 1,455:
Line 1,465: − + Line 1,478:
Line 1,488: − + − ==== Commonly used medicines in ''raktapitta'' ====+ − ===== Important medicines =====+ Line 1,488:
Line 1,498: − ===== Treatment of ''urdhvaga raktapitta'' =====+ − ===== Treatment of ''adhoga raktapitta'' =====+ Line 1,500:
Line 1,510: − ===== Treatment of chronic stage =====+ − === Related Chapters ===+ + + + + + + + + +
Raktapitta Chikitsa (view source)
Revision as of 22:19, 23 September 2021
, 22:19, 23 September 2021→Related Chapters
|title=Raktapitta Chikitsa
|title=Raktapitta Chikitsa
|titlemode=append
|titlemode=append
|keywords=Raktapitta, Chikitsa, Mahagada, bleeding disorders, pitta aggravation, rakta vitiation
|keywords=Raktapitta, Chikitsa, Mahagada, bleeding disorders, pitta aggravation, rakta vitiation, Ayurveda, charak samhita, Indian system of medicine.
|description=Chikitsa Sthana Chapter 4. Management of Raktapitta (Bleeding Disorders)
|description=Chikitsa Sthana Chapter 4. Management of Bleeding Disorders
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
|image_alt=charak samhita
|type=article
}}
}}
<big>'''[[Chikitsa Sthana]] Chapter 4. Management of Raktapitta (Bleeding Disorders)'''</big>
<big>'''[[Chikitsa Sthana]] Chapter 4. Management of Raktapitta (Bleeding Disorders)'''</big>
{{Infobox
{{Infobox
|title = Raktapitta Chikitsa
|title = Raktapitta Chikitsa
|label5 = Other Sections
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|label6 = Translator and commentator
|data6 = Joshi V.K.,Ghildiyal S.
|label7 = Reviewer
|data7 = Chandola H.M.
|label8 = Editors
|data8 = Baghel M.S., Deole Y.S., Basisht G.
|label9 = Year of publication
|data9 = 2020
|label10 = Publisher
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]
|label11 = DOI
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.005 10.47468/CSNE.2020.e01.s06.005]
}}
<big>'''Abstract '''</big>
<div style="text-align:justify;">
''Raktapitta'' is a treatable bleeding disorder, if recognized and managed in early stage. If diagnosis is missed and disease is not managed properly, it becomes life threatening (''mahagada'').It occurs because of excessive aggravation of ''[[pitta]]'' and its affliction with ''[[rakta]]''. Before initiation of treatment, it is important to assess strength of the patient because the treatment regimen is personified for well nourished and emaciated persons. Etiology, classification, prognosis and treatment of ''raktapitta'' have been described in detail. A good number of herbal and animal preparations are given. Further, this chapter enumerates aspects that are favorable or unfavorable to ''raktapitta''. To improve the efficacy of treatment, external beneficial measures, such as ''pradeha, parisheka, sheetasnana'' and habitat are described at the end of chapter. This bleeding disorder is not described in modern medicine writings and appears to be unknown to allopathic medicine.</div>
'''Keywords''': ''Raktapitta, Chikitsa, Mahagada,'' bleeding disorders, ''[[pitta]]'' aggravation, ''[[rakta]]'' vitiation.
== Introduction ==
== Introduction ==
<div style="text-align:justify;">
''Raktapitta'' is a serious disease caused due to vitiation of ''[[rakta]]'' by aggravated ''[[pitta]]''. This chapter is placed after ''jwara'', because ''raktapitta'' can occur due to the increased heat in the body produced after ''jwara''. Prompt management is necessary for this dreadful disease. This disease develops due to ''[[pitta]]'' aggravation as a result of consumption of ''ushna, teekshna, agneya dravya'' and excessive exposure to sunlight.
Because of similarity in constitution of ''[[pitta]]'' with ''[[rakta]], [[rakta dhatu]]'' is also vitiated by the etiological factors and has similarity in its smell and color, and is therefore called ''raktapitta''.
Because of similarity in constitution of ''pitta'' with ''rakta, rakta dhatu'' is also vitiated by the etiological factors and has similarity in its smell and color, and is therefore called ''raktapitta''.
It originates in the spleen and liver which play pivotal roles in the blood physiology, including clotting. Manifestations of ''raktapitta'' depend upon vitiation and predominance of a particular ''[[dosha]]''. There may be a combination of one, two or all the three ''[[dosha]]''. Based on ''[[dosha]]'' specific features, the blood of the patient of ''raktapitta'' may appear pale, unctuous and slimy in ''[[kapha]]'', frothy, blackish red in ''[[vata]]'' and cane sugar like cow urine, shiny black, smoky and coarse-like collerium in ''[[pitta]]''. ''Raktapitta'' associated with one ''[[dosha]]'' is curable, with two ''[[dosha]]'' is difficult to cure and incurable if all three ''[[dosha]]'' are involved.
Movement of ''raktapitta'' may be upward or downward meaning bleeding from upper and/or lower external orifices. This manifestation depends on etiological factors, unctuous hot factors associated with ''[[kapha]]'' has upward ''raktapitta'' however rough hot associated with ''[[vata]]'' has downward ''raktapitta''.
Upward ''raktapitta'', associated with ''[[kapha dosha]]'' is treated with ''tarpana'' (nourishment therapy) and downwards ''raktapitta'' is associated with ''[[vata]]'' and ''peya'' (liquid gruel) should be used.
Their drugs mainly have ''madhura, tikta'' and ''sheeta guna'' which pacify ''[[pitta]]'' and ''[[rakta]]''. One herb which is very important in ''raktapitta'' is ''vasa'', which alone can check the bleeding quickly.
</div>
== Sanskrit text, Transliteration and English Translation ==
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Now we shall expound the chapter on ''raktapitta'' (haemorrhagic disorders). (1)
Now we shall expound the chapter "Raktapitta Chikitsa"(Management of bleeding disorders). Thus said Lord Atreya. [1-2]
=== Agnivesha’s query ===
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vaktavyaM yat paraM tasya vaktumarhasi tadguro||4||<br />
vaktavyaM yat paraM tasya vaktumarhasi tadguro||4||<br />
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<div style="text-align:justify;">
Agnivesha bowed to Punarvasu Atreya who is devoid of confusion, having fire-like brilliance(sharp intellect) and self-control while he was making stroll in the ''panchaganga'' region, and said, “O Lord! the etiology along with symptoms of haemorrhagic disorders has already been said, now you may tell me the further points, O my teacher! [3-4]
Agnivesha bowed to Punarvasu Atreya who is devoid of confusion, having fire-like brilliance(sharp intellect) and self-control while he was making stroll in the ''panchaganga'' region, and said, “O Lord! the etiology along with symptoms of haemorrhagic disorders has already been said, now you may tell me the further points, O my teacher! [3-4]
=== Atreya Punarvasu’s reply ===
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The physician knowing causes and symptoms should quickly manage the case of haemorrhagic disorders which is an acute dreadful disease, having more severity and quick-acting like fire. The etiology of the same has already been said earlier such as intake of hot, sharp, sour, pungent and salty substances in excess, exposure to the sun and foods that cause burning sensations. [5-6]
The physician knowing causes and symptoms should quickly manage the case of haemorrhagic disorders which is an acute dreadful disease, having more severity and quick-acting like fire. The etiology of the same has already been said earlier such as intake of hot, sharp, sour, pungent and salty substances in excess, exposure to the sun and foods that cause burning sensations. [5-6]
=== Pathogenesis ===
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''Pitta'' aggravated by these causes vitiates ''rakta''. Due to similarity in constitution (of ''rakta'' and ''pitta''), the pathogenesis develops furthermore to vitiate ''rakta''. Due to heat of ''pitta'', the fluid portion from all the fomented ''dhatus'' oozes out, which additionally leads to aggravation of ''rakta'' and ''pitta''. [7-8]
''[[Pitta]]'' aggravated by these causes vitiates ''[[rakta]]''. Due to similarity in constitution (of ''[[rakta]]'' and ''[[pitta]]''), the pathogenesis develops furthermore to vitiate ''[[rakta]]''. Due to heat of ''[[pitta]]'', the fluid portion from all the fomented ''[[dhatu]]s'' oozes out, which additionally leads to aggravation of ''[[rakta]]'' and ''[[pitta]]''. [7-8]
=== Derivation ===
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Because of conjunction with, similarity in causes of vitiation, odor, color and origin, the disease is called ''rakta-pitta''. [9]
Because of conjunction with, similarity in causes of vitiation, odor, color and origin, the disease is called ''rakta-pitta''. [9]
=== Origin of disease ===
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The ''pitta'' (''raktapitta'') stays located in spleen and liver, because in persons the blood vessels originate from them. [10]
The ''[[pitta]]'' (''raktapitta'') stays located in spleen and liver, because in persons the blood vessels originate from them. [10]
=== Characteristics of ''[[dosha]]'' vitiation ===
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Viscous, pale, unctuous and slimy (in blood coming out) indicates affliction by ''kapha''. Blackish, reddish, frothy, thin and roughness in blood indicates affliction by ''vata''. That having ochre-like, black, cow-urine-like, shining black, smoky and collerium-like color indicates ''pitta'' affliction. Due to combination of two ''doshas'' the symptoms of the concerned ones are combined. ''Raktapitta'' caused by ''sannipata'' has symptoms of all the three ''doshas''. [11-12]
Viscous, pale, unctuous and slimy (in blood coming out) indicates affliction by ''[[kapha]]''. Blackish, reddish, frothy, thin and roughness in blood indicates affliction by ''[[vata]]''. That having ochre-like, black, cow-urine-like, shining black, smoky and collerium-like color indicates ''[[pitta]]'' affliction. Due to combination of two ''[[dosha]]s'' the symptoms of the concerned ones are combined. ''Raktapitta'' caused by ''sannipata'' has symptoms of all the three ''[[dosha]]s''. [11-12]
=== Prognosis ===
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''Raktapitta'' associated with one ''dosha'' is curable; that with two ''doshas'' is palliable while that caused by three ''doshas'' is incurable. It is also incurable if it is severely forceful and invading the person who has poor digestion, is emaciated due to diseases, old and under-nourished. [13-14]
''Raktapitta'' associated with one ''[[dosha]]'' is curable; that with two ''[[dosha]]s'' is palliable while that caused by three ''[[dosha]]s'' is incurable. It is also incurable if it is severely forceful and invading the person who has poor digestion, is emaciated due to diseases, old and under-nourished. [13-14]
=== ''Gati'' (direction of flow) and prognosis ===
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Movement of ''raktapitta'' is directed upwards and downwards, the former through seven orifices and the latter through two orifices. There are seven orifices in head and two below. That coming from upper passages is curable, the one coming downwards is palliable and that which comes both ways is incurable. When it flows out from all the orifices including the hair follicles it is known as with innumerable movements which is fatal.
Movement of ''raktapitta'' is directed upwards and downwards, the former through seven orifices and the latter through two orifices. There are seven orifices in head and two below. That coming from upper passages is curable, the one coming downwards is palliable and that which comes both ways is incurable. When it flows out from all the orifices including the hair follicles it is known as with innumerable movements which is fatal.
''Raktapitta'' passing out excessively through both the passages, having corpselike smell, exceedingly red or black, associated with ''kapha'' and ''vata'', adhering in throat, having all the complications mentioned earlier, possessing deep yellow, blue, green or coppery color and is in emaciated and coughing patient is incurable.
''Raktapitta'' passing out excessively through both the passages, having corpselike smell, exceedingly red or black, associated with ''[[kapha]]'' and ''[[vata]]'', adhering in throat, having all the complications mentioned earlier, possessing deep yellow, blue, green or coppery color and is in emaciated and coughing patient is incurable.
That ''raktapitta'' is palliable which is associated with two ''doshas'', which aggravates again and again after subsiding and shifts from one passage to another. [15-21]
That ''raktapitta'' is palliable which is associated with two ''[[dosha]]s'', which aggravates again and again after subsiding and shifts from one passage to another. [15-21]
=== Characteristics of curable ''raktapitta'' ===
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''Raktapitta'' is caused by food having predominantly unctuous-hot and rough-hot properties. The former often gives rise to the upward movement and the latter to the downward movement of ''raktapitta''. The upward movement in ''raktapitta'' is associated with ''kapha'', the downward one with ''vata'' and that from both the passages is associated with both ''kapha'' and ''vata''. [23-24]
''Raktapitta'' is caused by food having predominantly unctuous-hot and rough-hot properties. The former often gives rise to the upward movement and the latter to the downward movement of ''raktapitta''. The upward movement in ''raktapitta'' is associated with ''[[kapha]]'', the downward one with ''[[vata]]'' and that from both the passages is associated with both ''[[kapha]]'' and ''[[vata]]''. [23-24]
=== Consequneces of styptic therapy in ''rakta-pitta'' ===
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''Stambhana'' (styptic therapy) should not be given at first in hemorrhagic disorders having excessive impurities, aggravated ''doshas'' and in a person who is not emaciated and weak and originated from excess nourishment. If checked at the very start, it produces throat congestion, fetid smell from the nose, fainting, anorexia, fever, ''gulma'', spleen enlargement, hardness of bowels, leucoderma, dysuria, skin disorders, piles, erysipelas, loss of complexion, fistula-in-ano, obstruction to intellect and senses.
''[[Stambhana]]'' (styptic therapy) should not be given at first in hemorrhagic disorders having excessive impurities, aggravated ''[[dosha]]s'' and in a person who is not emaciated and weak and originated from excess nourishment. If checked at the very start, it produces throat congestion, fetid smell from the nose, fainting, anorexia, fever, ''gulma'', spleen enlargement, hardness of bowels, leucoderma, dysuria, skin disorders, piles, erysipelas, loss of complexion, fistula-in-ano, obstruction to intellect and senses.
Hence for successful management, one should at first ignore (should not give styptic therapy) the hemorrhagic disorder after assessing the strength and condition or morbidity in a strong patient. [25-28]
Hence for successful management, one should at first ignore (should not give styptic therapy) the hemorrhagic disorder after assessing the strength and condition or morbidity in a strong patient. [25-28]
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Mostly the ''raktapitta'' is aggravated by ''amadosha'', hence patient should be managed with lightening measures. The physician should apply in the beginning of ''raktapitta'', lightening or nourishing measure according to passage, association of ''dosha'' and etiology. [29-30]
Mostly the ''raktapitta'' is aggravated by ''amadosha'', hence patient should be managed with lightening measures. The physician should apply in the beginning of ''raktapitta'', lightening or nourishing measure according to passage, association of ''[[dosha]]'' and etiology. [29-30]
=== Nourishment regimen ===
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Powder of parched paddy mixed with ghee and honey makes a good saturating preparation which, if taken timely, alleviates the upward movement of ''raktapitta''. The saturating preparation may be soured with pomegranates and ''amalaka'' fruits in persons having poor digestion and suited to sour things.[31-35]
Powder of parched paddy mixed with ghee and honey makes a good saturating preparation which, if taken timely, alleviates the upward movement of ''raktapitta''. The saturating preparation may be soured with pomegranates and ''amalaka'' fruits in persons having poor digestion and suited to sour things.[31-35]
=== Diet advised in ''raktapitta'' ===
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The patients of ''raktapitta'' should take meal consisting of the cereals of ''shali, shashtika, nivara, koradusha, prashantika, shyamaka'' and ''priyangu''. For them gram, lentils, green grams, ''makustha'' (kidney beans), and ''adhaki'' are recommended for the pulse-soup. The vegetables useful in ''raktapitta'' are ''patola, nimba,'' tip of ''vetra'', tender leaves of ''plaksha'' and ''vetasa'', ''kiratatikta, gandira'' and ''kathillaka''. The flowers of ''kovidara, kashmarya'' and ''shalmali'' are also used and vegetable should be prepared by boiling or frying with ghee or like soup and given to the vegetarian patients.
The patients of ''raktapitta'' should take meal consisting of the cereals of ''shali, shashtika, nivara, koradusha, prashantika, shyamaka'' and ''priyangu''. For them gram, lentils, green grams, ''makustha'' (kidney beans), and ''adhaki'' are recommended for the pulse-soup. The vegetables useful in ''raktapitta'' are ''patola, nimba,'' tip of ''vetra'', tender leaves of ''plaksha'' and ''vetasa'', ''kiratatikta, gandira'' and ''kathillaka''. The flowers of ''kovidara, kashmarya'' and ''shalmali'' are also used and vegetable should be prepared by boiling or frying with ghee or like soup and given to the vegetarian patients.
The flesh of dove, pigeon, common quail, ''raktaksha'' (crane), ''vartaka'' (a quail), grey partridge, ''ena, harina'' and ''kalapucchaka'' (species of deer) are wholesome in ''raktapitta''. Their soup is used in sour or in-soured form, fried with ghee and added sugar. In (''raktapitta'') associated with ''kapha'' vegetable soup and in that with ''vata'' meat-soup is prescribed. Now for ''raktapitta'', preparations of gruel will be described. [36-43]
The flesh of dove, pigeon, common quail, ''raktaksha'' (crane), ''vartaka'' (a quail), grey partridge, ''ena, harina'' and ''kalapucchaka'' (species of deer) are wholesome in ''raktapitta''. Their soup is used in sour or in-soured form, fried with ghee and added sugar. In (''raktapitta'') associated with ''[[kapha]]'' vegetable soup and in that with ''[[vata]]'' meat-soup is prescribed. Now for ''raktapitta'', preparations of gruel will be described. [36-43]
=== Medicated gruels in ''raktapitta'' ===
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In the patient of ''raktapitta'' if there is constipation due to aggravated ''vata'', the following preparations are useful:
In the patient of ''raktapitta'' if there is constipation due to aggravated ''[[vata]]'', the following preparations are useful:
#rabbit cooked with ''vastuka'',
#rabbit cooked with ''vastuka'',
#partridge cooked in decoction of ''udumbara'',
#partridge cooked in decoction of ''udumbara'',
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Water should be given to the thirsty patient up to complete satisfaction of thirst or in small quantity considering the associated ''doshas'', strength as well as diet (of the patient). [52]
Water should be given to the thirsty patient up to complete satisfaction of thirst or in small quantity considering the associated ''[[dosha]]s'', strength as well as diet (of the patient). [52]
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Whatever etiological factors of ''raktapitta'' are mentioned should be avoided by those patients, if they want to survive and to be free from the disease. Thus, the diet allevating ''raktapitta'' has been described in order. [53]
Whatever etiological factors of ''raktapitta'' are mentioned should be avoided by those patients, if they want to survive and to be free from the disease. Thus, the diet allevating ''raktapitta'' has been described in order. [53]
=== Indication of purification therapy ===
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Now the management of strong patients having plenty of ''doshas'' will be explained further:
Now the management of strong patients having plenty of ''[[dosha]]s'' will be explained further:
''Raktapitta'', due to excess nutrition in a strong patient with aggravated ''doshas'', who do not have emaciation, debility and complications, should be treated with purification therapy by purgation in upward type and emesis in lower movement of ''raktapitta''.
''Raktapitta'', due to excess nutrition in a strong patient with aggravated ''[[dosha]]s'', who do not have emaciation, debility and complications, should be treated with purification therapy by purgation in upward type and emesis in lower movement of ''raktapitta''.
Purgation should be administered with (the decoction) of ''trivrita, haritaki,'' fruit of ''aragavadha, trayamana, indrayana'' (roots) or ''amalaka'' (fruits) mixed with plenty of honey and sugar. Their decoction is efficacious particularly in ''raktapitta''.
Purgation should be administered with (the decoction) of ''trivrita, haritaki,'' fruit of ''aragavadha, trayamana, indrayana'' (roots) or ''amalaka'' (fruits) mixed with plenty of honey and sugar. Their decoction is efficacious particularly in ''raktapitta''.
#sugarcane juice, or ''indrayava, musta, madana, madhuka'' and honey – all mixed together make an excellent emetic.
#sugarcane juice, or ''indrayava, musta, madana, madhuka'' and honey – all mixed together make an excellent emetic.
After purification, in the case of upward type, the dietetic regimen starts with saturating drink while in that of downward type, it starts with gruel subjected to the condition that ''vata'' is not dominant. [54-61]
After purification, in the case of upward type, the dietetic regimen starts with saturating drink while in that of downward type, it starts with gruel subjected to the condition that ''[[vata]]'' is not dominant. [54-61]
=== Pacification therapy ===
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The hemorrhagic disorder which does not get pacified by the said various extracts after digestive fire being kindled and ''kapha'' being overcome, there may be association of ''vayu'' which should be treated thereafter.
The hemorrhagic disorder which does not get pacified by the said various extracts after digestive fire being kindled and ''[[kapha]]'' being overcome, there may be association of ''vayu'' which should be treated thereafter.
Goat milk is the excellent remedy for that. Cow milk boiled with:
Goat milk is the excellent remedy for that. Cow milk boiled with:
#''jivaka'' and ''rishabhaka'' added with ghee and sugar. [82-84]
#''jivaka'' and ''rishabhaka'' added with ghee and sugar. [82-84]
=== Treatment of hematuria ===
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Milk boiled with ''shatavari'' and ''gokshura'', or the four leaved herbs (''mudgaparni, mashaparni, shalaparni'' and ''prashniparni''), check the hemorrhage quickly particularly that from urinary passage and with pain.[85]
Milk boiled with ''shatavari'' and ''gokshura'', or the four leaved herbs (''mudgaparni, mashaparni, shalaparni'' and ''prashniparni''), check the hemorrhage quickly particularly that from urinary passage and with pain.[85]
=== Treatment of per rectal bleeding ===
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Particularly in haemorrhage from rectum milk boiled with ''mocharasa'', or hanging roots or leaf-buds of ''vata'' or ''hribera, nilotpala'' and ''nagara'' (''musta'') should be taken. After taking the medicinal extracts with milk the patient should take ghee cooked with these extracts. [85-87]
Particularly in haemorrhage from rectum milk boiled with ''mocharasa'', or hanging roots or leaf-buds of ''[[vata]]'' or ''hribera, nilotpala'' and ''nagara'' (''musta'') should be taken. After taking the medicinal extracts with milk the patient should take ghee cooked with these extracts. [85-87]
=== ''Vasa'' ghee ===
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#''patola'' leaves are efficacious in ''paittika'' fever and all are commended for use in hemorrhagic disorder. [89-90]
#''patola'' leaves are efficacious in ''paittika'' fever and all are commended for use in hemorrhagic disorder. [89-90]
=== External applications ===
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All measures which are prescribed for the treatment of ''pattika'' fever such as massage, sprinkling, baths, beds, room/coverings, cooling methods or enema should be applied in hemorrhagic disorder considering the season and dose. ''Sarpirguda'' (the formulation of jaggery and ghee) prescribed for the patients of ''kshata'' (chest injury) control the hemorrhagic disorder quickly. [91-92]
All measures which are prescribed for the treatment of ''pattika'' fever such as massage, sprinkling, baths, beds, room/coverings, cooling methods or enema should be applied in hemorrhagic disorder considering the season and dose. ''Sarpirguda'' (the formulation of jaggery and ghee) prescribed for the patients of ''kshata'' (chest injury) control the hemorrhagic disorder quickly. [91-92]
=== Treatment of ''raktapitta'' with associated ''[[kapha]]'' ===
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In case of ''raktapitta'' if there is association of ''kapha'' and blood reaching the throat is adherent, alkali of the stalk of water lily mixed with honey and ghee should be used. In the same way, alkali of lotus stalk, lotus, water lily, ''nagakeshara, palasha, priyangu, madhuka'' and asana should be used. [93-94]
In case of ''raktapitta'' if there is association of ''[[kapha]]'' and blood reaching the throat is adherent, alkali of the stalk of water lily mixed with honey and ghee should be used. In the same way, alkali of lotus stalk, lotus, water lily, ''nagakeshara, palasha, priyangu, madhuka'' and asana should be used. [93-94]
=== ''Shatavaryadi'' ghee ===
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Ghee cooked with drugs of five groups of five roots each( described in [[Rasayana]] chapter) has the same effect. (This is ''shatavaryadi ghrita''). [95-96]
Ghee cooked with drugs of five groups of five roots each( described in [[Rasayana]] chapter) has the same effect. (This is ''shatavaryadi ghrita''). [95-96]
=== Treatment of nasal bleeding ===
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The hemorrhagic disorder coming out of the nose should be treated with the above decoctive drugs in the form of ''avapida'' (nasal errhines with juice) when the vitiated ''doshas'' are eliminated, otherwise if the affected ''rakta'' is checked by juice-snuffing it produces obstinate coryza, head diseases, blood with pus and corpse-like smell, loss of smell sensation and maggots.
The hemorrhagic disorder coming out of the nose should be treated with the above decoctive drugs in the form of ''avapida'' (nasal errhines with juice) when the vitiated ''[[dosha]]s'' are eliminated, otherwise if the affected ''[[rakta]]'' is checked by juice-snuffing it produces obstinate coryza, head diseases, blood with pus and corpse-like smell, loss of smell sensation and maggots.
In this condition snuffing with:
In this condition snuffing with:
Visit of rivers and lakes, glaciers, ponds having water lily and lotus flowers, ''shishira'' (winter) season, favorite and soothing narratives pacify ''raktapitta''. [101-109]
Visit of rivers and lakes, glaciers, ponds having water lily and lotus flowers, ''shishira'' (winter) season, favorite and soothing narratives pacify ''raktapitta''. [101-109]
=== Summary ===
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*The causes of ''raktapitta'' include excess consumption of food with hot potency and ingredients with sharp, sour, pungent and salty taste, exposure to the sun and foods that cause burning sensations.
*The causes of ''raktapitta'' include excess consumption of food with hot potency and ingredients with sharp, sour, pungent and salty taste, exposure to the sun and foods that cause burning sensations.
*''Pitta dosha'' and ''rakta'' have similar properties in terms of vitiation, odor, color and origin. Therefore, anything affecting ''pitta'' will affect ''rakta'' and vice versa.
*''[[Pitta dosha]]'' and ''[[rakta]]'' have similar properties in terms of vitiation, odor, color and origin. Therefore, anything affecting ''[[pitta]]'' will affect ''[[rakta]]'' and vice versa.
*The ''pitta'' and ''rakta'' (blood) including blood vessels originate from spleen and liver.
*The ''[[pitta]]'' and ''[[rakta]]'' (blood) including blood vessels originate from spleen and liver.
*Affliction by ''kapha'' in ''rakta'' can be observed by appearance of viscous, pale, unctuous and slimy blood (in blood coming out).
*Affliction by ''[[kapha]]'' in ''[[rakta]]'' can be observed by appearance of viscous, pale, unctuous and slimy blood (in blood coming out).
*Blackish, reddish, frothy, thin and roughness in blood indicates affliction by ''vata''.
*Blackish, reddish, frothy, thin and roughness in blood indicates affliction by ''[[vata]]''.
*Blood having ochre-like, black, cow-urine-like, shining black, smoky and collyrium-like color indicates ''pitta'' affliction. Due to combination of two ''doshas'' the symptoms of both manifest. ''Raktapitta'' caused by ''sannipata'' has symptoms of all the three ''doshas''.
*Blood having ochre-like, black, cow-urine-like, shining black, smoky and collyrium-like color indicates ''[[pitta]]'' affliction. Due to combination of two ''[[dosha]]s'' the symptoms of both manifest. ''Raktapitta'' caused by ''sannipata'' has symptoms of all the three ''[[dosha]]s''.
*The prognosis and treatment of ''raktapitta'' depend upon movement of vitiated ''rakta'', direction of its flow, origin, severity of disease, strength of patient.
*The prognosis and treatment of ''raktapitta'' depend upon movement of vitiated ''[[rakta]]'', direction of its flow, origin, severity of disease, strength of patient.
*''Raktapitta'' is caused by food having predominantly unctuous-hot and rough-hot properties. The former often gives rise to the upward movement and the latter to the downward movement of ''raktapitta''.
*''Raktapitta'' is caused by food having predominantly unctuous-hot and rough-hot properties. The former often gives rise to the upward movement and the latter to the downward movement of ''raktapitta''.
*The upward movement in ''raktapitta'' is associated with ''kapha'', the downward one with ''vata'' and that from both the passages is associated with both ''kapha'' and ''vata''.
*The upward movement in ''raktapitta'' is associated with ''[[kapha]]'', the downward one with ''[[vata]]'' and that from both the passages is associated with both ''[[kapha]]'' and ''[[vata]]''.
*''Stambhana'' (styptic therapy) should not be given at first in hemorrhagic disorders having excessive impurities, aggravated ''doshas'', over-nourished and in a person who is not emaciated and weak.
*''[[Stambhana]]'' (styptic therapy) should not be given at first in hemorrhagic disorders having excessive impurities, aggravated ''[[dosha]]s'', over-nourished and in a person who is not emaciated and weak.
*Mostly the ''raktapitta'' is aggravated by ''amadosha'', hence patient should be managed with ''langhana'' (lightening measures). In the beginning stage of ''raktapitta'', lightening or nourishing measure according to passage, association of ''dosha'' and etiology shall be applied.
*Mostly the ''raktapitta'' is aggravated by ''amadosha'', hence patient should be managed with ''[[langhana]]'' (lightening measures). In the beginning stage of ''raktapitta'', lightening or nourishing measure according to passage, association of ''[[dosha]]'' and etiology shall be applied.
*''Raktapitta'', due to excess nutrition in a strong patient with aggravated ''doshas'', who don’t have emaciation, debility and complications, should be treated with purification therapy by purgation in upward type and emesis in lower movement of ''raktapitta''.
*''Raktapitta'', due to excess nutrition in a strong patient with aggravated ''[[[dosha]]s'', who don’t have emaciation, debility and complications, should be treated with purification therapy by purgation in upward type and emesis in lower movement of ''raktapitta''.
*After purification, in the case of upward type, the dietetic regimen starts with saturating drinks. In that of downward type, it starts with gruel subjected to the condition that ''vata'' is not dominant.
*After purification, in the case of upward type, the dietetic regimen starts with saturating drinks. In that of downward type, it starts with gruel subjected to the condition that ''[[vata]]'' is not dominant.
*All types of sweet, bitter, astringent medicines with cold potency are indicated in diet and medicinal management. In lifestyle management, the cold measures and avoiding exposure to excess heat are applied in treatment of hemorrhagic disorders.
*All types of sweet, bitter, astringent medicines with cold potency are indicated in diet and medicinal management. In lifestyle management, the cold measures and avoiding exposure to excess heat are applied in treatment of hemorrhagic disorders.
=== ''Vidhi Vimarsha'' / Applied Inferences===
== Vidhi Vimarsha (Applied Inferences ) ==
Bleeding disorders are often caused by a failure of the blood to clot. Several conditions can affect the way the blood clots. Many causes are related to protein defects in the plasma (the liquid component of blood). These proteins are directly responsible for how the blood coagulates (clots). In some diseases, these proteins might be missing completely or they may be low in count. The majority of these defects are hereditary (passed from parent to child through genes). However, some may develop due to other medical conditions. Other conditions that can cause bleeding disorders are:
Bleeding disorders are often caused by a failure of the blood to clot. Several conditions can affect the way the blood clots. Many causes are related to protein defects in the plasma (the liquid component of blood). These proteins are directly responsible for how the blood coagulates (clots). In some diseases, these proteins might be missing completely or they may be low in count. The majority of these defects are hereditary (passed from parent to child through genes). However, some may develop due to other medical conditions. Other conditions that can cause bleeding disorders are:
*medication side-effects
*medication side-effects
=== Types of Bleeding Disorders ===
There are several bleeding disorders that can be inherited (passed down through genetics) or acquired. Some cause bleeding spontaneously, whereas others cause bleeding following an accident.
There are several bleeding disorders that can be inherited (passed down through genetics) or acquired. Some cause bleeding spontaneously, whereas others cause bleeding following an accident.
Certain diseases or medical conditions can also cause a deficiency of one or more blood clotting factors. The most common causes of acquired bleeding disorders are end-stage liver disease or vitamin K deficiency. According to the American Association of Clinical Chemistry (AACC), this is because most blood clotting factors are produced in the liver, and certain clotting factors are vitamin k dependent (AACC, 2011).
Certain diseases or medical conditions can also cause a deficiency of one or more blood clotting factors. The most common causes of acquired bleeding disorders are end-stage liver disease or vitamin K deficiency. According to the American Association of Clinical Chemistry (AACC), this is because most blood clotting factors are produced in the liver, and certain clotting factors are vitamin k dependent (AACC, 2011).
=== Identification of Bleeding Disorders/Symptoms ===
The main sign of a bleeding disorder is prolonged or excessive bleeding. The bleeding is normally heavier than normal and unprovoked.
The main sign of a bleeding disorder is prolonged or excessive bleeding. The bleeding is normally heavier than normal and unprovoked.
| rowspan="3"|''Urdhvaga''
| rowspan="3"|''Urdhvaga''
| ''Nasa''
| ''Nasa''
| Epitaxis
| Epistaxis
|-
|-
| ''Mukha''
| ''Mukha''
|}
|}
There are various bleeding disorders, some of which can be correlated with ''raktapitta''. Bleeding disorders can occur either due to decrease in coagulation factor in blood or due to increase in bleeding factor. When patient has bleeding from anus (''guda'') or vagina(''yoni''), then it is difficult to differentiate whether the disease is ''adhoga raktapitta'' or ''raktarsha'' or ''raktatisara'' or ''pradara''. There are major similarities in causes, signs, ''doshas'' involved but also minor differences. And that minor differences need to be studied to capture the right link of disease, which can be done only when one has, the deep knowledge of Ayurvedic diagnostic tool i.e. ''nidanpanchaka''. The profound cognizance of ''nidanapanchaka'' as a diagnostic tool can enhance the treatment modalities of Ayurvedic management of diseases in coming years.
There are various bleeding disorders, some of which can be correlated with ''raktapitta''. Bleeding disorders can occur either due to decrease in coagulation factor in blood or due to increase in bleeding factor. When patient has bleeding from anus (''guda'') or vagina(''yoni''), then it is difficult to differentiate whether the disease is ''adhoga raktapitta'' or ''raktarsha'' or ''raktatisara'' or ''pradara''. There are major similarities in causes, signs, ''[[dosha]]s'' involved but also minor differences. And that minor differences need to be studied to capture the right link of disease, which can be done only when one has, the deep knowledge of Ayurvedic diagnostic tool i.e. ''nidanpanchaka''. The profound cognizance of ''nidanapanchaka'' as a diagnostic tool can enhance the treatment modalities of Ayurvedic management of diseases in coming years.
=== Commonly used medicines in ''raktapitta'' ===
==== Important medicines ====
#''Vasa''
#''Vasa''
#''Praval bhasma''
#''Praval bhasma''
==== Treatment of ''urdhvaga raktapitta'' ====
#''Lakshadi'' mixture 3-5 grams frequently with ''vasavaleha''
#''Lakshadi'' mixture 3-5 grams frequently with ''vasavaleha''
#''Padmakadi tailam'' 10-20 drops empty stomach three times in a day with milk
#''Padmakadi tailam'' 10-20 drops empty stomach three times in a day with milk
==== Treatment of ''adhoga raktapitta'' ====
#''Shatavaryadi kwatha'' 25 to 40 ml empty stomach three times with sugar
#''Shatavaryadi kwatha'' 25 to 40 ml empty stomach three times with sugar
#''Bol-parpati'' mixture 250 to 500 mg after meals with ''vasavaleha''
#''Bol-parpati'' mixture 250 to 500 mg after meals with ''vasavaleha''
==== Treatment of chronic stage ====
#''Vasa'' ghee 10 to 40 ml after meals with milk
#''Vasa'' ghee 10 to 40 ml after meals with milk
== Related Chapters ==
*[[Vidhishonitiya Adhyaya]]
*[[Vidhishonitiya Adhyaya]]
*[[Raktapitta Nidana]]
*[[Raktapitta Nidana]]
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