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तस्याशुकारिणो दावाग्नेरिवापतितस्यात्ययिकस्याशु प्रशान्त्यै प्रयतितव्यं मात्रां देशं कालं चाभिसमीक्ष्य  सन्तर्पणेनापतर्पणेन  वा मृदुमधुरशिशिरतिक्तकषायैरभ्यवहार्यैः प्रदेहपरिषेकावगाहसंस्पर्शनैर्वमनाद्यैर्वा  तत्रावहितेनेति||११||

तस्याशुकारिणो दावाग्नेरिवापतितस्यात्ययिकस्याशु प्रशान्त्यै प्रयतितव्यं मात्रां देशं कालं चाभिसमीक्ष्य  सन्तर्पणेनापतर्पणेन  वा मृदुमधुरशिशिरतिक्तकषायैरभ्यवहार्यैः प्रदेहपरिषेकावगाहसंस्पर्शनैर्वमनाद्यैर्वा  तत्रावहितेनेति||११||

tasyāśukāriṇō dāvāgnērivāpatitasyātyayikasyāśu praśāntyai prayatitavyaṁ mātrāṁ dēśaṁ kālaṁ cābhisamīkṣya santarpaṇēnāpatarpaṇēna vāmr̥dumadhuraśiśiratiktakaṣāyairabhyavahāryaiḥ pradēhapariṣēkāvagāhasaṁsparśanairvamanādyairvā tatrāvahitēnēti||11||  

tasyāśukāriṇō dāvāgnērivāpatitasyātyayikasyāśu praśāntyai prayatitavyaṁ mātrāṁ dēśaṁ kālaṁ cābhisamīkṣya santarpaṇēnāpatarpaṇēna vāmr̥dumadhuraśiśiratiktakaṣāyairabhyavahāryaiḥ pradēhapariṣēkāvagāhasaṁsparśanairvamanādyairvā tatrāvahitēnēti||11||  

tasyAshukAriNo dAvAgnerivApatitasyAtyayikasyAshu prashAntyai prayatitavyaM mAtrAM deshaM kAlaM cAbhisamIkShya santarpaNenApatarpaNena vAmRudumadhurashishiratiktakaShAyairabhyavahAryaiH pradehapariShekAvagAhasaMsparshanairvamanAdyairvA tatrAvahiteneti||11||  

tasyAshukAriNo dAvAgnerivApatitasyAtyayikasyAshu prashAntyai prayatitavyaM mAtrAM deshaM kAlaM cAbhisamIkShya santarpaNenApatarpaNena vAmRudumadhurashishiratiktakaShAyairabhyavahAryaiH pradehapariShekAvagAhasaMsparshanairvamanAdyairvA tatrAvahiteneti||11||  

The disease is acute in nature and becomes critical very quickly, spreading like bush fire. Hence its treatment should be done immediately with saturating or de-saturating soft, sweet, cold, bitter and astringent diet and pastes, baths, emesis etc. after due consideration of dose, place and time. (11) 

The disease is acute in nature and becomes critical very quickly, spreading like bush fire. Hence its treatment should be done immediately with saturating or de-saturating soft, sweet, cold, bitter and astringent diet and pastes, baths, emesis etc. after due consideration of dose, place and time. [11]

भवन्ति  चात्र- साध्यं लोहितपित्तं तद्यदूर्ध्वं प्रतिपद्यते|  

भवन्ति  चात्र- साध्यं लोहितपित्तं तद्यदूर्ध्वं प्रतिपद्यते|  

विरेचनस्य योगित्वाद्बहुत्वाद्भेषजस्य  च||१२||

विरेचनस्य योगित्वाद्बहुत्वाद्भेषजस्य  च||१२||

विरेचनं  तु  पित्तस्य  जयार्थे  परमौषधम्|  

विरेचनं  तु  पित्तस्य  जयार्थे  परमौषधम्|  

यश्च  तत्रान्वयः श्लेष्मा तस्य चानधमं स्मृतम्||१३||

यश्च  तत्रान्वयः श्लेष्मा तस्य चानधमं स्मृतम्||१३||

भवेद्योगावहं तत्र मधुरं चैव भेषजम्|  

भवेद्योगावहं तत्र मधुरं चैव भेषजम्|  

तस्मात् साध्यं मतं रक्तं  यदूर्ध्वं प्रतिपद्यते||१४||

तस्मात् साध्यं मतं रक्तं  यदूर्ध्वं प्रतिपद्यते||१४||

bhavanti cātra- sādhyaṁ lōhitapittaṁ tadyadūrdhvaṁ pratipadyatē|  

bhavanti cātra- sādhyaṁ lōhitapittaṁ tadyadūrdhvaṁ pratipadyatē|  

virēcanasya yōgitvādbahutvādbhēṣajasya ca||12||  

virēcanasya yōgitvādbahutvādbhēṣajasya ca||12||  

virēcanaṁ tu pittasya jayārthē paramauṣadham|  

virēcanaṁ tu pittasya jayārthē paramauṣadham|  

yaśca tatrānvayaḥ [17] ślēṣmā tasya cānadhamaṁ smr̥tam||13||  

yaśca tatrānvayaḥ [17] ślēṣmā tasya cānadhamaṁ smr̥tam||13||  

bhavēdyōgāvahaṁ tatra madhuraṁ [18] caiva bhēṣajam|  

bhavēdyōgāvahaṁ tatra madhuraṁ [18] caiva bhēṣajam|  

tasmāt sādhyaṁ mataṁ raktaṁ yadūrdhvaṁ pratipadyatē||14||

tasmāt sādhyaṁ mataṁ raktaṁ yadūrdhvaṁ pratipadyatē||14||

bhavanti cAtra- sAdhyaM lohitapittaM tadyadUrdhvaM pratipadyate|  

bhavanti cAtra- sAdhyaM lohitapittaM tadyadUrdhvaM pratipadyate|  

virecanasya yogitvAdbahutvAdbheShajasya ca||12||  

virecanasya yogitvAdbahutvAdbheShajasya ca||12||  

virecanaM tu pittasya jayArthe paramauShadham|  

virecanaM tu pittasya jayArthe paramauShadham|  

yashca tatrAnvayaH [17] shleShmA tasya cAnadhamaM smRutam||13||  

yashca tatrAnvayaH [17] shleShmA tasya cAnadhamaM smRutam||13||  

bhavedyogAvahaM tatra madhuraM [18] caiva bheShajam|  

bhavedyogAvahaM tatra madhuraM [18] caiva bheShajam|  

tasmAt sAdhyaM mataM raktaM yadUrdhvaM pratipadyate||14||

tasmAt sAdhyaM mataM raktaM yadUrdhvaM pratipadyate||14||

 

The “upward” variety of ''raktapitta'' is curable because of applicability of purgation and abundance of useful drugs. Purgation is the best remedy for alleviation of ''pitta'' and ambivalence to ''kapha''. Sweet drugs are also applicable in this case. Hence, bleeding from the upper part is curable. [12-14]

The “upward” variety of raktapitta is curable because of applicability of purgation and abundance of useful drugs. Purgation is the best remedy for alleviation of pitta and ambivalence to kapha. Sweet drugs are also applicable in this case. Hence, bleeding from the upper part is curable. (12-14) 

रक्तं  तु यदधोभागं तद्याप्यमिति  निश्चितम्|  

रक्तं  तु यदधोभागं तद्याप्यमिति  निश्चितम्|  

वमनस्याल्पयोगित्वादल्पत्वाद्भेषजस्य च||१५||

वमनस्याल्पयोगित्वादल्पत्वाद्भेषजस्य च||१५||

वमनं हि  न पित्तस्य  हरणे श्रेष्ठमुच्यते|  

वमनं हि  न पित्तस्य  हरणे श्रेष्ठमुच्यते|  

यश्च तत्रान्वयो वायुस्तच्छान्तौ चावरं स्मृतम्||१६||

यश्च तत्रान्वयो वायुस्तच्छान्तौ चावरं स्मृतम्||१६||

तच्चायोगावहं तत्र कषायं तिक्तकानि च|  

तच्चायोगावहं तत्र कषायं तिक्तकानि च|  

तस्माद्याप्यं समाख्यातं यदुक्तमनुलोमगम्||१७||

तस्माद्याप्यं समाख्यातं यदुक्तमनुलोमगम्||१७||

raktaṁ tu yadadhōbhāgaṁ tadyāpyamiti niścitam|  

raktaṁ tu yadadhōbhāgaṁ tadyāpyamiti niścitam|  

vamanasyālpayōgitvādalpatvādbhēṣajasya ca||15||  

vamanasyālpayōgitvādalpatvādbhēṣajasya ca||15||  

vamanaṁ hi na pittasya haraṇē [20] śrēṣṭhamucyatē|  

vamanaṁ hi na pittasya haraṇē [20] śrēṣṭhamucyatē|  

yaśca tatrānvayō [21] vāyustacchāntau cāvaraṁ smr̥tam||16||  

yaśca tatrānvayō [21] vāyustacchāntau cāvaraṁ smr̥tam||16||  

taccāyōgāvahaṁ [22] tatra kaṣāyaṁ tiktakāni ca|  

taccāyōgāvahaṁ [22] tatra kaṣāyaṁ tiktakāni ca|  

tasmādyāpyaṁ samākhyātaṁ yaduktamanulōmagam [23] ||17||

tasmādyāpyaṁ samākhyātaṁ yaduktamanulōmagam [23] ||17||

raktaM tu yadadhobhAgaM tadyApyamiti nishcitam|  

raktaM tu yadadhobhAgaM tadyApyamiti nishcitam|  

vamanasyAlpayogitvAdalpatvAdbheShajasya ca||15||  

vamanasyAlpayogitvAdalpatvAdbheShajasya ca||15||  

vamanaM hi na pittasya haraNe [20] shreShThamucyate|  

vamanaM hi na pittasya haraNe [20] shreShThamucyate|  

yashca tatrAnvayo [21] vAyustacchAntau cAvaraM smRutam||16||  

yashca tatrAnvayo [21] vAyustacchAntau cAvaraM smRutam||16||  

taccAyogAvahaM [22] tatra kaShAyaM tiktakAni ca|  

taccAyogAvahaM [22] tatra kaShAyaM tiktakAni ca|  

tasmAdyApyaM samAkhyAtaM yaduktamanulomagam [23] ||17||

tasmAdyApyaM samAkhyAtaM yaduktamanulomagam [23] ||17||

Hemorrhage from the lower parts is decidedly palliable because emesis has limited efficacy here and effective drugs are also a few. Emesis is not so efficacious for elimination of pitta and it is also ineffective in alleviation of vata responsible for the downward flow. Moreover, astringents and bitter drugs are not applicable there. Hence hemorrhage from the lower parts is considered palliable. (15-17)   

Hemorrhage from the lower parts is decidedly palliable because emesis has limited efficacy here and effective drugs are also a few. Emesis is not so efficacious for elimination of pitta and it is also ineffective in alleviation of ''vata'' responsible for the downward flow. Moreover, astringents and bitter drugs are not applicable there. Hence hemorrhage from the lower parts is considered palliable. (15-17)   

रक्तपित्तं तु यन्मार्गौ द्वावपि  प्रतिपद्यते|  

रक्तपित्तं तु यन्मार्गौ द्वावपि  प्रतिपद्यते|  

असाध्यमिति तज्ज्ञेयं पूर्वोक्तादेव कारणात्||१८||

असाध्यमिति तज्ज्ञेयं पूर्वोक्तादेव कारणात्||१८||

नहि  संशोधनं  किञ्चिदस्त्यस्य प्रतिमार्गगम्|  

नहि  संशोधनं  किञ्चिदस्त्यस्य प्रतिमार्गगम्|  

प्रतिमार्गं  च  हरणं रक्तपित्ते  विधीयते||१९||

प्रतिमार्गं  च  हरणं रक्तपित्ते  विधीयते||१९||

एवमेवोपशमनं सर्वशो नास्य  विद्यते|  

एवमेवोपशमनं सर्वशो नास्य  विद्यते|  

संसृष्टेषु  च  दोषेषु  सर्वजिच्छमनं  मतम् ||२०||

संसृष्टेषु  च  दोषेषु  सर्वजिच्छमनं  मतम् ||२०||

इत्युक्तं त्रिविधोदर्कं  रक्तं मार्गविशेषतः|

 

इत्युक्तं त्रिविधोदर्कं  रक्तं मार्गविशेषतः||२१||

 

raktapittaṁ tu yanmārgau dvāvapi pratipadyatē|  

raktapittaṁ tu yanmārgau dvāvapi pratipadyatē|  

asādhyamiti tajjñēyaṁ pūrvōktādēva kāraṇāt||18||  

asādhyamiti tajjñēyaṁ pūrvōktādēva kāraṇāt||18||  

nahi saṁśōdhanaṁ kiñcidastyasya pratimārgagam|  

nahi saṁśōdhanaṁ kiñcidastyasya pratimārgagam|  

pratimārgaṁ ca haraṇaṁ raktapittē vidhīyatē||19||  

pratimārgaṁ ca haraṇaṁ raktapittē vidhīyatē||19||  

ēvamēvōpaśamanaṁ sarvaśō nāsya vidyatē|  

ēvamēvōpaśamanaṁ sarvaśō nāsya vidyatē|  

saṁsr̥ṣṭēṣu ca dōṣēṣu sarvajicchamanaṁ matam [25] ||20||  

saṁsr̥ṣṭēṣu ca dōṣēṣu sarvajicchamanaṁ matam [25] ||20||  

ityuktaṁ trividhōdarkaṁ raktaṁ mārgaviśēṣataḥ|21|  

ityuktaṁ trividhōdarkaṁ raktaṁ mārgaviśēṣataḥ|21|  

raktapittaM tu yanmArgau dvAvapi pratipadyate|  

raktapittaM tu yanmArgau dvAvapi pratipadyate|  

asAdhyamiti tajj~jeyaM pUrvoktAdeva kAraNAt||18||  

asAdhyamiti tajj~jeyaM pUrvoktAdeva kAraNAt||18||  

nahi saMshodhanaM ki~jcidastyasya pratimArgagam|  

nahi saMshodhanaM ki~jcidastyasya pratimArgagam|  

pratimArgaM ca haraNaM raktapitte vidhIyate||19||  

pratimArgaM ca haraNaM raktapitte vidhIyate||19||  

evamevopashamanaM sarvasho nAsya vidyate|  

evamevopashamanaM sarvasho nAsya vidyate|  

saMsRuShTeShu ca doSheShu sarvajicchamanaM matam [25] ||20||  

saMsRuShTeShu ca doSheShu sarvajicchamanaM matam [25] ||20||  

ityuktaM trividhodarkaM raktaM mArgavisheShataH|21|  

ityuktaM trividhodarkaM raktaM mArgavisheShataH|21|  

In cases where blood comes out from both the routes, raktapitta is incurable because no effective evacuative measure is applicable. In raktapitta, elimination of dosha from the opposite route is recommended. Thus, the three types (on the basis of the routes taken by rakta) of raktapitta progression (udarka) have been described. (18-20) 

In cases where blood comes out from both the routes, ''raktapitta'' is incurable because no effective evacuative measure is applicable. In ''raktapitta'', elimination of ''dosha'' from the opposite route is recommended. Thus, the three types (on the basis of the routes taken by ''rakta'') of ''raktapitta'' progression (''udarka'') have been described. [18-20]

एभ्यस्तु खलु हेतुभ्यः किञ्चित्साध्यं न सिध्यति||२१||

एभ्यस्तु खलु हेतुभ्यः किञ्चित्साध्यं न सिध्यति||२१||

प्रेष्योपकरणाभावाद्दौरात्म्याद्वैद्यदोषतः|  

प्रेष्योपकरणाभावाद्दौरात्म्याद्वैद्यदोषतः|  

अकर्मतश्च साध्यत्वं  कश्चिद्रोगोऽतिवर्तते||२२||

अकर्मतश्च साध्यत्वं  कश्चिद्रोगोऽतिवर्तते||२२||