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Now we shall expound the chapter "Rogabhishagjitiya Vimana" (Methods of conquering debate and disease). Thus said Lord Atreya. [1-2]
 
Now we shall expound the chapter "Rogabhishagjitiya Vimana" (Methods of conquering debate and disease). Thus said Lord Atreya. [1-2]
 +
 +
=== Aspects of medical education ===
    
==== Selection of medical treatise ====
 
==== Selection of medical treatise ====
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The teacher holding such qualities quickly inculcates physician’s qualities in his disciple as the seasonal cloud furnishes good crop in a suitable land. [4]
 
The teacher holding such qualities quickly inculcates physician’s qualities in his disciple as the seasonal cloud furnishes good crop in a suitable land. [4]
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=== Means of learning in medical science ===
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==== Means of learning in medical science ====
 
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The means for enhancing depth of knowledge  are- study, teaching and discussion with authorities. [6]
 
The means for enhancing depth of knowledge  are- study, teaching and discussion with authorities. [6]
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=== Method of study ===
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==== Method of study ====
 
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=== Characteristics of ideal student and method of teaching ===
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==== Characteristics of ideal student and method of teaching ====
 
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*following  all the instructions of the teacher and being attached to his teacher.[8]
 
*following  all the instructions of the teacher and being attached to his teacher.[8]
   −
=== Commencement of academic session/teaching ===
+
==== Commencement of academic session/teaching ====
 
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The disciple should follow him. After offering oblations he should go round the fire keeping it to the right side, than ''brahmanas'' should recite ''svasti''. At the end, he should pay regards to the physicians in the society.  [12]
 
The disciple should follow him. After offering oblations he should go round the fire keeping it to the right side, than ''brahmanas'' should recite ''svasti''. At the end, he should pay regards to the physicians in the society.  [12]
   −
=== Code of conduct for medical student and professional ===
+
==== Code of conduct for medical student and professional ====
 
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If the disciple follows these instructions then he should be taught, otherwise not. The teacher when teaches such a worthy disciple obtains the aforesaid fruits of teaching and enjoins the disciple and himself with other not mentioned beneficial qualities. Thus, the method of teaching is said. [14]
 
If the disciple follows these instructions then he should be taught, otherwise not. The teacher when teaches such a worthy disciple obtains the aforesaid fruits of teaching and enjoins the disciple and himself with other not mentioned beneficial qualities. Thus, the method of teaching is said. [14]
 
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=== Organization of discussion meetings ===
   −
=== Method of conducting discussion in seminars and symposia of experts ===  
+
==== Method of conducting discussion in seminars and symposia of experts ====  
 
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=== Two types of discussions ===
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==== Two types of discussions ====
 
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Discussion with experts is of two types- friendly discussion and hostile discussion. [16]  
 
Discussion with experts is of two types- friendly discussion and hostile discussion. [16]  
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=== Friendly discussion ===
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==== Friendly discussion ====
 
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=== Hostile discussion ===
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==== Hostile discussion ====
 
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=== Three categories of opponent ===
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==== Three categories of opponent ====
 
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The opponent may be of three types – superior, inferior or equal, according to the above mentioned qualities for discussion and not all aspects .[19]
 
The opponent may be of three types – superior, inferior or equal, according to the above mentioned qualities for discussion and not all aspects .[19]
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=== Types of assembly ===
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==== Types of assembly ====
 
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=== Summary of discussion technique ===
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==== Summary of discussion technique ====
 
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In a hostile discussion, one should speak reasonably and should not withdraw the words once spoken. A hostile speech gives rise to strong agitation in some persons. The agitated person, may do some unfavourable things or may speak some unwanted words. Hence the wise do not recommend quarrel in the assembly of noble persons. Thus one should perform in discussion initiated. [22-24]  
 
In a hostile discussion, one should speak reasonably and should not withdraw the words once spoken. A hostile speech gives rise to strong agitation in some persons. The agitated person, may do some unfavourable things or may speak some unwanted words. Hence the wise do not recommend quarrel in the assembly of noble persons. Thus one should perform in discussion initiated. [22-24]  
 
   
 
   
=== Guidelines for preparation before initiation and recording the debate ===
+
==== Guidelines for preparation before initiation and recording the debate ====
 
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These ten entities should be examined first and thereafter one should proceed for action. Hence the physician desirous of taking up action should beforehand examine the entire situation by proper methods and then initiate the action(treatment). [79]
 
These ten entities should be examined first and thereafter one should proceed for action. Hence the physician desirous of taking up action should beforehand examine the entire situation by proper methods and then initiate the action(treatment). [79]
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=== Questions for discussion ===
+
==== Questions for discussion ====
 
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=== Types of examinations ===
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==== Types of examinations ====
 
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So, these entities should be specifically examined with great emphasis.[85]
 
So, these entities should be specifically examined with great emphasis.[85]
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=== Assessment of physician and qualities of good physician ===
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==== Assessment of physician and qualities of good physician ====
 
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=== Assessment of medicine and categories ===
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==== Assessment of medicine and categories ====
 
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=== Assessment of disequilibrium of ''dhatu'' ===
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==== Assessment of disequilibrium of ''dhatu'' ====
 
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=== Assessment of equilibrium of ''dhatu'' ===
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==== Assessment of equilibrium of ''dhatu'' ====
 
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=== Outcome of therapeutic management ===
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==== Outcome of therapeutic management ====
 
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The result of the act (''karyaphala'') is attainment of happiness. It is featured as satisfaction of mind, intellect, sense organs and the body pleasure.[90]
 
The result of the act (''karyaphala'') is attainment of happiness. It is featured as satisfaction of mind, intellect, sense organs and the body pleasure.[90]
   −
=== Consequence of therapeutic management ===
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==== Consequence of therapeutic management ====
 
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After effect (''anubandha'') is life and it is characterized by union with ''prana''(vitality).[91]
 
After effect (''anubandha'') is life and it is characterized by union with ''prana''(vitality).[91]
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=== Field of action and its assessment ===
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==== Field of action and its assessment ====
 
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=== Examination of patient ===
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==== Examination of patient ====
 
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=== ''Prakriti pariksha'' (Assessment of basic constitution of patient) ===
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==== ''[[Prakriti]] pariksha'' (Assessment of basic constitution of patient) ====
 
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=== Characteristics of ''kapha prakriti'' ===
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===== Characteristics of ''kapha prakriti'' =====
 
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=== Characteristics of ''pitta prakriti'' ===
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===== Characteristics of ''pitta prakriti'' =====
 
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=== Characteristics of ''vata prakriti'' ===
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===== Characteristics of ''vata prakriti'' =====
 
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In persons having equilibrium of all ''dhatus'', the characters of all of the three are found. Thus one should examine the constitution.[100]
 
In persons having equilibrium of all ''dhatus'', the characters of all of the three are found. Thus one should examine the constitution.[100]
   −
=== Assessment of ''vikriti'' (disorder) ===
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==== Assessment of ''vikriti'' (disorder) ====
 
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=== Assessment of ''sara'' (best qualities of body tissues) ===
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==== Assessment of ''sara'' (best qualities of body tissues) ====
 
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Moreover a patient should be examined in respect of ''sara'' i.e. (best qualities of body tissues). There are eight types of ''sara'' in human beings which are described here for the knowledge of degree of strength such as –''tvak, rakta, mamsa, meda, asthi, majja, shukra'' and ''sattva''.[102]
 
Moreover a patient should be examined in respect of ''sara'' i.e. (best qualities of body tissues). There are eight types of ''sara'' in human beings which are described here for the knowledge of degree of strength such as –''tvak, rakta, mamsa, meda, asthi, majja, shukra'' and ''sattva''.[102]
   −
==== Characteristics of ''twak sara'' (best quality of skin) ====
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===== Characteristics of ''twak sara'' (best quality of skin) =====
 
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==== Characteristics of ''rakta sara'' (best quality of blood tissue) ====
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===== Characteristics of ''rakta sara'' (best quality of blood tissue) =====
 
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In persons with essence of ''rakta'' have there ear, eye, face, tongue, nose, lips, palms, soles, nails, forehead and genitals to be unctuous, red, beautiful and shining. This essence indicates happiness, sharp intellect, magnanimity, tenderness, moderate strength, lack for endurance and intolerance to heat.[104]
 
In persons with essence of ''rakta'' have there ear, eye, face, tongue, nose, lips, palms, soles, nails, forehead and genitals to be unctuous, red, beautiful and shining. This essence indicates happiness, sharp intellect, magnanimity, tenderness, moderate strength, lack for endurance and intolerance to heat.[104]
   −
==== Characteristics of ''mamsa sara'' (best quality of muscular tissue) ====
+
===== Characteristics of ''mamsa sara'' (best quality of muscular tissue) =====
 
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==== Characteristics of ''meda sara'' (best quality of lipid tissues) ====
+
===== Characteristics of ''meda sara'' (best quality of lipid tissues) =====
 
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The person endowed with essence of ''meda'' have significant unctuousness specifically in complexion, voice, eyes, hair, skin hairs, nails, teeth, lips, urine and feces. This indicates wealth, power, happiness, enjoyment, charity, simplicity and delicacy in dealings.[106]
 
The person endowed with essence of ''meda'' have significant unctuousness specifically in complexion, voice, eyes, hair, skin hairs, nails, teeth, lips, urine and feces. This indicates wealth, power, happiness, enjoyment, charity, simplicity and delicacy in dealings.[106]
   −
==== Characteristics of ''asthi sara'' (best quality of bone) ====
+
===== Characteristics of ''asthi sara'' (best quality of bone) =====
 
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Person with ''asthi sara'' has prominent heels (''parshni''), ankles (''gulpha''), knee joint (''janu''), elbows (''aratni''), collarbones (''jatru''), chin (''chibuka''), head (''shira''), flanks (''parshva'') and joints and also bones and teeth. Such persons are excess enthusiastic, very active, enduring, having strong and firm body as well as longevity.[107]
 
Person with ''asthi sara'' has prominent heels (''parshni''), ankles (''gulpha''), knee joint (''janu''), elbows (''aratni''), collarbones (''jatru''), chin (''chibuka''), head (''shira''), flanks (''parshva'') and joints and also bones and teeth. Such persons are excess enthusiastic, very active, enduring, having strong and firm body as well as longevity.[107]
   −
==== Characteristics of ''majja sara''(best quality of bone marrow tissue) ====
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===== Characteristics of ''majja sara''(best quality of bone marrow tissue) =====
 
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The persons with soft body parts, strong, unctuous complexion and sweet voice, prominent (''sthula''), long (''dirgha'') and rounded joints should be known as ''majjasara'' (or the essence of''majja''). They are long-lived, strong and endowed with learning ability, wealth, understanding, progeny and respectful image.[108]
 
The persons with soft body parts, strong, unctuous complexion and sweet voice, prominent (''sthula''), long (''dirgha'') and rounded joints should be known as ''majjasara'' (or the essence of''majja''). They are long-lived, strong and endowed with learning ability, wealth, understanding, progeny and respectful image.[108]
   −
==== Characteristics of ''shukra sara''(best quality of reproductive tissues) ====
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===== Characteristics of ''shukra sara''(best quality of reproductive tissues) =====
 
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==== Characteristics of ''sattva sara'' (best quality of mind) ====
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===== Characteristics of ''sattva sara'' (best quality of mind) =====
 
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=== Characteristics of ''sarva sara'' (best quality of all tissues) ===
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==== Characteristics of ''sarva sara'' (best quality of all tissues) ====
 
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=== Characteristics of ''Asara'' (no/low quality of tissues) ===
+
==== Characteristics of ''Asara'' (no/low quality of tissues) ====
 
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And those persons having no or less essence of tissues are contrary to these individual.[112]
 
And those persons having no or less essence of tissues are contrary to these individual.[112]
   −
=== Characteristics of ''madhya sara''(moderate quality of tissues) ===
+
==== Characteristics of ''madhya sara''(moderate quality of tissues) ====
 
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=== Assessment of ''samhanana'' (compactness) ===
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==== Assessment of ''samhanana'' (compactness) ====
 
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=== Assessment of ''pramana'' (proportion and measurements) ===
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==== Assessment of ''pramana'' (proportion and measurements) ====
 
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=== Assessment of ''satmya'' (suitability) ===
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==== Assessment of [[satmya]] (suitability) ====
 
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=== Assessment of ''Sattva'' (psyche/mental strength) ===
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==== Assessment of ''Sattva'' (psyche/mental strength) ====
 
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=== Assessment of ''aharashakti'' (power of assimilation) ===
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==== Assessment of ''aharashakti'' (power of assimilation) ====
 
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Examination regarding power for assimilation (''aharashakti'') is to be done in respect of power of ingestion as well as digestion. Strength and life depends on diet.[120]
 
Examination regarding power for assimilation (''aharashakti'') is to be done in respect of power of ingestion as well as digestion. Strength and life depends on diet.[120]
   −
=== Assessment of ''vyayamashakti'' (exercise capacity) ===
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==== Assessment of ''vyayamashakti'' (exercise capacity) ====
 
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In respect of capacity of exercise (''vyayamashakti'') examination should be done by the capactiy for work. In accordance with capacity for work strength is inferred as of three types (poor, moderate and good). [121]
 
In respect of capacity of exercise (''vyayamashakti'') examination should be done by the capactiy for work. In accordance with capacity for work strength is inferred as of three types (poor, moderate and good). [121]
   −
=== Assessment of ''vaya'' (age) ===
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==== Assessment of ''vaya'' (age) ====
 
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   −
=== Knowledge of lifespan ===
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===== Knowledge of lifespan =====
 
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In regard to knowledge of measure of life span, there is description of symptoms in Indriya sthana and Jatisutriya adhyaya (eighth chapter of sharira sthana).[124]
 
In regard to knowledge of measure of life span, there is description of symptoms in Indriya sthana and Jatisutriya adhyaya (eighth chapter of sharira sthana).[124]
   −
=== Assessment of ''Kala'' (time or stage or season) ===
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==== Assessment of ''Kala'' (time or stage or season) ====
 
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''Kala'' (time) has been considered of two types viz. year aspect and status of the patient. The year has been divided into two, three, six, twelve or even more parts according to nature of action (to be taken). Now, dividing into six, the action will be said. ''Hemanta'' (early winter), ''grishma'' (summer) and ''varsha'' (rainy season) these are the three seasons characterised by cold, heat and rains. In between them, there are other three seasons having common characters as ''pravrit'' (early rain), ''sharada'' (autumn) and ''vasanta'' (spring). ''Pravrit'' denotes the early rain; ''varsha'' is the continuation of the same. Thus, these six divisions of the seasons have been made for the purpose of evacuative therapy.[125]
 
''Kala'' (time) has been considered of two types viz. year aspect and status of the patient. The year has been divided into two, three, six, twelve or even more parts according to nature of action (to be taken). Now, dividing into six, the action will be said. ''Hemanta'' (early winter), ''grishma'' (summer) and ''varsha'' (rainy season) these are the three seasons characterised by cold, heat and rains. In between them, there are other three seasons having common characters as ''pravrit'' (early rain), ''sharada'' (autumn) and ''vasanta'' (spring). ''Pravrit'' denotes the early rain; ''varsha'' is the continuation of the same. Thus, these six divisions of the seasons have been made for the purpose of evacuative therapy.[125]
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=== Appropriate season for purification therapies ===
+
==== Appropriate season for purification therapies ====
 
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Therefore, the measures like emesis etc. are stopped in the seasons ending with the rains (early winter, summer and rainy seasons) except in case of emergency. In emergency too, one should administer the therapy with great care after modifying the seasonal effects sufficiently by artificial means producing qualities contrary to the seasons and by making the measure appropriate in standard potency with variation in combination, processing and quantity. [127]
 
Therefore, the measures like emesis etc. are stopped in the seasons ending with the rains (early winter, summer and rainy seasons) except in case of emergency. In emergency too, one should administer the therapy with great care after modifying the seasonal effects sufficiently by artificial means producing qualities contrary to the seasons and by making the measure appropriate in standard potency with variation in combination, processing and quantity. [127]
   −
=== Stage of disease ===
+
==== Stage of disease ====
 
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The status of the patient is also called as timely or untimely in relation the act being performed or not. Such as, in a certain condition one drug is untimely, and the other one is timely. This is also due to specific condition, hence the nomenclature of ''kala'' (timely) and ''akala'' (untimely) is given to the conditions of the patients. This is examined like this- the physician should observe all the conditions of the patient again and again in order to administer the correct therapy. The therapy administered after or before the (opportune) time is not effective because time determines the sufficiency to the administration of therapy.[128]
 
The status of the patient is also called as timely or untimely in relation the act being performed or not. Such as, in a certain condition one drug is untimely, and the other one is timely. This is also due to specific condition, hence the nomenclature of ''kala'' (timely) and ''akala'' (untimely) is given to the conditions of the patients. This is examined like this- the physician should observe all the conditions of the patient again and again in order to administer the correct therapy. The therapy administered after or before the (opportune) time is not effective because time determines the sufficiency to the administration of therapy.[128]
   −
=== ''Pravritti'' (inclination or action) ===
+
==== ''Pravritti'' (inclination or action) ====
 
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''Pravritti'' (inclination or action) is the initiation of the therapy which is characterized by the combination of physician, drug, patient and attendant in treatment. [129]
 
''Pravritti'' (inclination or action) is the initiation of the therapy which is characterized by the combination of physician, drug, patient and attendant in treatment. [129]
   −
=== ''Upaya'' (management) ===
+
==== ''Upaya'' (management) ====
 
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Thus these mentioned ten entities should be examined separately and sincerely.[131]
 
Thus these mentioned ten entities should be examined separately and sincerely.[131]
   −
=== Objective of examination ===
+
==== Objective of examination ====
 
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In situation where symptoms of both indication and contraindication conjoined, one should decide (the treatment protocol) after proper examination of dominant or recessive condition of ''dosha''. The diseases mentioned in treatises are in respect of their treatment as general rule or exception. Hence it is said that one should take action after considering the dominant or recessive condition of ''dosha''. [134]
 
In situation where symptoms of both indication and contraindication conjoined, one should decide (the treatment protocol) after proper examination of dominant or recessive condition of ''dosha''. The diseases mentioned in treatises are in respect of their treatment as general rule or exception. Hence it is said that one should take action after considering the dominant or recessive condition of ''dosha''. [134]
   −
=== List of medicines used in therapeutic emesis ===
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==== List of medicines used in therapeutic emesis ====
 
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*Decoction of ''shalmali, shalmalika, bhadraparni, elaparni, upodika, uddalaka, dhanvana, rajadana, upachitra, gopi (sariva), shringataka; pippali, pippalimula, chavya, chitraka, shringavera, sarshapa, phanita, kshira, kshara,'' salt with water and made into bolus and other eatables added with ''vartti kriya'' (suppository), powder, linctus, processed in lipids, extract, meat soup, gruel, (vegetable) soup, ''kambalika'' and milk should be administered to the patient requiring emesis according to prescribed procedure. These are, in brief, the pharmaceutical forms of emetic drugs, which are described in detail latter on in [[Kalpa Sthana]].[135]
 
*Decoction of ''shalmali, shalmalika, bhadraparni, elaparni, upodika, uddalaka, dhanvana, rajadana, upachitra, gopi (sariva), shringataka; pippali, pippalimula, chavya, chitraka, shringavera, sarshapa, phanita, kshira, kshara,'' salt with water and made into bolus and other eatables added with ''vartti kriya'' (suppository), powder, linctus, processed in lipids, extract, meat soup, gruel, (vegetable) soup, ''kambalika'' and milk should be administered to the patient requiring emesis according to prescribed procedure. These are, in brief, the pharmaceutical forms of emetic drugs, which are described in detail latter on in [[Kalpa Sthana]].[135]
   −
=== List of medicines used in therapeutic purgation ===
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==== List of medicines used in therapeutic purgation ====
 
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*made into bolus and other eatables added with ''vartikriya'' (suppository), ''churna'' (powder), ''asava, leha'' (linctus), ''sneha'' (medicated fatty preparation), ''kashaya'' (decoction), ''mamsarasa'' (meat-soup), ''yusha'' (vegetable soup), ''kambalika'' (a kind of soup prepared from whey and green gram), ''yavagu'' (gruel), ''kshiropadheyan'' (milk administered), ''modaka'' (comparatively big tablet for high dose), and other forms of food preparation are to be used in patient requiring purgation. These are in brief the pharmaceutical preparation of purgative drugs, which will be further described in detail.[136]
 
*made into bolus and other eatables added with ''vartikriya'' (suppository), ''churna'' (powder), ''asava, leha'' (linctus), ''sneha'' (medicated fatty preparation), ''kashaya'' (decoction), ''mamsarasa'' (meat-soup), ''yusha'' (vegetable soup), ''kambalika'' (a kind of soup prepared from whey and green gram), ''yavagu'' (gruel), ''kshiropadheyan'' (milk administered), ''modaka'' (comparatively big tablet for high dose), and other forms of food preparation are to be used in patient requiring purgation. These are in brief the pharmaceutical preparation of purgative drugs, which will be further described in detail.[136]
   −
=== List of medicines used in therapeutic non-unctuous enema ===
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==== List of medicines used in therapeutic non-unctuous enema ====
 
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That non-unctuous enema is of six types having single rasa as said by physician. Drugs possess mostly the combined ''rasa'' therefore grouping them in single group is not possible, hence the drugs included in ''madhura'' group mean those which are sweet, predominantly sweet, and sweet in ''vipaka'' or having effects similar to sweet drugs. This is same for other drugs also.[138]
 
That non-unctuous enema is of six types having single rasa as said by physician. Drugs possess mostly the combined ''rasa'' therefore grouping them in single group is not possible, hence the drugs included in ''madhura'' group mean those which are sweet, predominantly sweet, and sweet in ''vipaka'' or having effects similar to sweet drugs. This is same for other drugs also.[138]
   −
=== ''Madhura skandha'' (group of sweet drugs) ===
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==== ''Madhura skandha'' (group of sweet drugs) ====
 
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The drugs mentioned in sweet group (''madhura skandha'') are ''jivaka, rushabhaka, jivanti, vira, amalaki, kakoli, kshirakakoli, mudgaparni, mashaparṇi, shalaparni, prushniparni, mashaparni, shalaparni, meda, mahameda, karkatashringi, shringataka, chinnaruha, cchatra, aticchatra, shravani, mahashravavani, sahadeva, vishvadeva, shukla, kshirashukla, bala, atibala, vidari, kshiravidari, kshudrasaha, mahasaha, rishyagandha, ashvagandha, vrishchira, punarnava, brihati, kantakari, korubuka, moraṭa, shwadamshtra, samharsha, shatavari, shaatapushpa, madhukapushpi, yashtimadhu, madhulika, mrudvika, kharjura, parushaka, atmagupta, pushkarabija, kasheruka, rajakasheruka, rajadana, kataka, kashmarya, shita, pakya, danapaki tala, kharjura, mastakam, ikshu, ikshuvalika, darbha, kusha, kasha, shali, gundrrtkataka, shaaramula, rajakshavaka, rushyaprokta, dvarada, bharadvaj, vanatrapushya, bhirupatri hamsapadi, kakanasa, kulinga, kshiravalli, kapolavalli, kapotavalli, somavalli'' and ''gopavalli''. These and such other drugs of sweet group should be taken. After cutting and breaking them into small pieces and washing with water properly, should be kept in a vessel. Adding to it milk diluted with half water should be cooked stirring till its major portion of water is absorbed, drugs are extracted and milk is not charred. The vessel should be brought down and the milk should be taken out of it and filtered well. This lukewarm milk added with ghee, oil, fat, marrow, salt and ''phanita'' should be used properly for enema by expert in ''vatika'' disorders. In ''paittika'' disorders, the same should be given cold and combined with honey and ghee. Thus, ends the sweet group of drugs. [139]
 
The drugs mentioned in sweet group (''madhura skandha'') are ''jivaka, rushabhaka, jivanti, vira, amalaki, kakoli, kshirakakoli, mudgaparni, mashaparṇi, shalaparni, prushniparni, mashaparni, shalaparni, meda, mahameda, karkatashringi, shringataka, chinnaruha, cchatra, aticchatra, shravani, mahashravavani, sahadeva, vishvadeva, shukla, kshirashukla, bala, atibala, vidari, kshiravidari, kshudrasaha, mahasaha, rishyagandha, ashvagandha, vrishchira, punarnava, brihati, kantakari, korubuka, moraṭa, shwadamshtra, samharsha, shatavari, shaatapushpa, madhukapushpi, yashtimadhu, madhulika, mrudvika, kharjura, parushaka, atmagupta, pushkarabija, kasheruka, rajakasheruka, rajadana, kataka, kashmarya, shita, pakya, danapaki tala, kharjura, mastakam, ikshu, ikshuvalika, darbha, kusha, kasha, shali, gundrrtkataka, shaaramula, rajakshavaka, rushyaprokta, dvarada, bharadvaj, vanatrapushya, bhirupatri hamsapadi, kakanasa, kulinga, kshiravalli, kapolavalli, kapotavalli, somavalli'' and ''gopavalli''. These and such other drugs of sweet group should be taken. After cutting and breaking them into small pieces and washing with water properly, should be kept in a vessel. Adding to it milk diluted with half water should be cooked stirring till its major portion of water is absorbed, drugs are extracted and milk is not charred. The vessel should be brought down and the milk should be taken out of it and filtered well. This lukewarm milk added with ghee, oil, fat, marrow, salt and ''phanita'' should be used properly for enema by expert in ''vatika'' disorders. In ''paittika'' disorders, the same should be given cold and combined with honey and ghee. Thus, ends the sweet group of drugs. [139]
   −
=== ''Amla skandha'' (group of sour drugs) ===
+
==== ''Amla skandha'' (group of sour drugs) ====
 
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These and such other drugs of the sour group should be taken and after cutting and breaking into small pieces should be placed in a vessel along with liquids and be cooked. The lukewarm product added properly with oil, fat, ''majja'', salt and ''phanita'' should be used for enema in ''vatika'' disorders according to procedure by the expert physician. Thus, ends the sour group. [140]
 
These and such other drugs of the sour group should be taken and after cutting and breaking into small pieces should be placed in a vessel along with liquids and be cooked. The lukewarm product added properly with oil, fat, ''majja'', salt and ''phanita'' should be used for enema in ''vatika'' disorders according to procedure by the expert physician. Thus, ends the sour group. [140]
   −
=== ''Lavana skandha'' (group of salty drugs) ===
+
==== ''Lavana skandha'' (group of salty drugs) ====
 
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In the salty group (''lavana skandha''), the drugs mentioned are – ''saindhava, sauvarchala, kala, vida, pakya, anupa, valukaila, maulaka, samudra, romaka, audbhida, aushara, pateyaka, pamshuja'' and others. These drugs added with sour or warm water along with fatty substance in lukewarm condition should be used for enema in ''vatika'' disorders according to procedure by the expert. This concludes the salty group of drugs. [141]
 
In the salty group (''lavana skandha''), the drugs mentioned are – ''saindhava, sauvarchala, kala, vida, pakya, anupa, valukaila, maulaka, samudra, romaka, audbhida, aushara, pateyaka, pamshuja'' and others. These drugs added with sour or warm water along with fatty substance in lukewarm condition should be used for enema in ''vatika'' disorders according to procedure by the expert. This concludes the salty group of drugs. [141]
   −
=== ''Katu skandha'' (group of pungent drugs) ===
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==== ''Katu skandha'' (group of pungent drugs) ====
 
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In pungent group (''katuka skandha'') the drugs included are – ''pippali, pippalimula, gajapippali, chavya, chitraka, shunţhi, maricha, ajamoda, ardraka, vidanga, dhanyaka, pilu, tejavati, ela, kushtha, bhallatakasthi, hinguniryasa, devadaru, mulaka, sarshapa, lashuna, karanja, shigru, madhu shigru, kharapushpa, bhustruna sumukha, surasa, kutheraka, arjaka, gandira, kalamalaka, parnasa, kshavaka, phanijjhaka,'' alkali, urines, and biles. These along with other similar drugs of group (pungent) should be taken and after cutting and breaking into pieces should be cooked with cow’s urine. This while lukewarm added with honey oil and salt should be used for enema in ''shlaishmika'' disorders according to procedure by experts. Thus ends the pungent group.[142]
 
In pungent group (''katuka skandha'') the drugs included are – ''pippali, pippalimula, gajapippali, chavya, chitraka, shunţhi, maricha, ajamoda, ardraka, vidanga, dhanyaka, pilu, tejavati, ela, kushtha, bhallatakasthi, hinguniryasa, devadaru, mulaka, sarshapa, lashuna, karanja, shigru, madhu shigru, kharapushpa, bhustruna sumukha, surasa, kutheraka, arjaka, gandira, kalamalaka, parnasa, kshavaka, phanijjhaka,'' alkali, urines, and biles. These along with other similar drugs of group (pungent) should be taken and after cutting and breaking into pieces should be cooked with cow’s urine. This while lukewarm added with honey oil and salt should be used for enema in ''shlaishmika'' disorders according to procedure by experts. Thus ends the pungent group.[142]
   −
=== ''Tikta skandha'' (group of bitter drugs) ===
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==== ''Tikta skandha'' (group of bitter drugs) ====
 
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The drugs mentioned in bitter group (''tikta skandha'') are – ''Chandana, nalada, aragvadha, naktamala, nimba, tumburu, kutaja, haridra, daruharidra, musta, murva, kiratatikta, katurohini, trayamana, karvellika, karira, karavira, kebuka, kathillaka, vrusha, mandukaparni, karkotaka, vartaku, karkasha, kakamachi, kakodumbarika, sushavi, ativisha, patola, kulaka, patha, guduchi, tip of vetra, vetasa, vikankata, bakula, somavalka, saptaparna, sumana, arka, avalguja, vacha, tagara, agaru, balaka'' and ''ushira'', along with other similar drugs of the bitter group should be taken and after cutting  and breaking them into pieces and washing properly be cooked with water. The product when lukewarm should be added with honey, oil and salt to be used in enema for ''kaphaja'' disorders according to procedure by the expert. In ''paittika'' disorders the same should be used while cold and added with honey and ghee. This ends the bitter group.[143]
 
The drugs mentioned in bitter group (''tikta skandha'') are – ''Chandana, nalada, aragvadha, naktamala, nimba, tumburu, kutaja, haridra, daruharidra, musta, murva, kiratatikta, katurohini, trayamana, karvellika, karira, karavira, kebuka, kathillaka, vrusha, mandukaparni, karkotaka, vartaku, karkasha, kakamachi, kakodumbarika, sushavi, ativisha, patola, kulaka, patha, guduchi, tip of vetra, vetasa, vikankata, bakula, somavalka, saptaparna, sumana, arka, avalguja, vacha, tagara, agaru, balaka'' and ''ushira'', along with other similar drugs of the bitter group should be taken and after cutting  and breaking them into pieces and washing properly be cooked with water. The product when lukewarm should be added with honey, oil and salt to be used in enema for ''kaphaja'' disorders according to procedure by the expert. In ''paittika'' disorders the same should be used while cold and added with honey and ghee. This ends the bitter group.[143]
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=== ''Kashaya skandha'' (group of astringent drugs) ===
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==== ''Kashaya skandha'' (group of astringent drugs) ====
 
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And the groups of drugs which are not advocated in certain disorders should be considered as those aggravating the same. Thus, these six groups of non-unctuous enema are described dividing them according to ''rasa''. [147-148]
 
And the groups of drugs which are not advocated in certain disorders should be considered as those aggravating the same. Thus, these six groups of non-unctuous enema are described dividing them according to ''rasa''. [147-148]
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===Guidelines for inclusion or exclusion of drugs===
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==== Guidelines for inclusion or exclusion of drugs ====
 
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The wise physician should eliminate or exclude the drugs if it is not appropriate even if enumerated under the group and should add the appropriate one even if un-enumerated. In situation needed a group of drugs may be combined with other or several other groups based on the reasoning. The aphorism, though small, is able to provide wide knowledge to the wise like alms of a mendicant or seed of a farmer. The aphorism for the wise, gives rise to critical analysis and reasoning while on the other hand for the dull, it is better to follow the saying exactly. The physician following the said course succeeds in his endeavor or causes little risk because of the illustration being not too brief.[149]
 
The wise physician should eliminate or exclude the drugs if it is not appropriate even if enumerated under the group and should add the appropriate one even if un-enumerated. In situation needed a group of drugs may be combined with other or several other groups based on the reasoning. The aphorism, though small, is able to provide wide knowledge to the wise like alms of a mendicant or seed of a farmer. The aphorism for the wise, gives rise to critical analysis and reasoning while on the other hand for the dull, it is better to follow the saying exactly. The physician following the said course succeeds in his endeavor or causes little risk because of the illustration being not too brief.[149]
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=== List of drugs for unctuous enema ===
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==== List of drugs for unctuous enema ====
 
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Animal products are fat, marrow and ghee. Out of the oil, fat, marrow and ghee, excellence of applicability as unctuous enema in disorders of ''vata'' and ''kapha'', is determined in regressive order and progressive order in ''paittika'' disorders, so all are applicable in all disorders according to particular procedure and processing. [150]
 
Animal products are fat, marrow and ghee. Out of the oil, fat, marrow and ghee, excellence of applicability as unctuous enema in disorders of ''vata'' and ''kapha'', is determined in regressive order and progressive order in ''paittika'' disorders, so all are applicable in all disorders according to particular procedure and processing. [150]
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=== List of drugs for nasal errhines ===
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==== List of drugs for nasal errhines ====
 
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