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Pitta gets the name lohitapitta because after mixing with blood it acquires the color and smell of blood. (5)
 
Pitta gets the name lohitapitta because after mixing with blood it acquires the color and smell of blood. (5)
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Prodromal symptoms:
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==== Prodromal symptoms ====
    
तस्येमानि पूर्वरूपाणि भवन्ति; तद्यथा- अनन्नाभिलाषः, भुक्तस्य विदाहः, शुक्ताम्लगन्धरस उद्गारः, छर्देरभीक्ष्णमागमनं, छर्दितस्य बीभत्सता, स्वरभेदो, गात्राणां सदनं, परिदाहः, मुखाद्धूमागम इव, लोहलोहितमत्स्यामगन्धित्वमिव चास्यस्य, रक्तहरितहारिद्रत्वमङ्गावयवशकृन्मूत्रस्वेदलालासिङ्घाणकास्यकर्णमलपिडकोलिकापिडकानाम्, अङ्गवेदना, लोहितनीलपीतश्यावानामर्चिष्मतां च रूपाणां स्वप्ने दर्शनमभीक्ष्णमिति (लोहितपित्तपूर्वरूपाणि  भवन्ति)||६||
 
तस्येमानि पूर्वरूपाणि भवन्ति; तद्यथा- अनन्नाभिलाषः, भुक्तस्य विदाहः, शुक्ताम्लगन्धरस उद्गारः, छर्देरभीक्ष्णमागमनं, छर्दितस्य बीभत्सता, स्वरभेदो, गात्राणां सदनं, परिदाहः, मुखाद्धूमागम इव, लोहलोहितमत्स्यामगन्धित्वमिव चास्यस्य, रक्तहरितहारिद्रत्वमङ्गावयवशकृन्मूत्रस्वेदलालासिङ्घाणकास्यकर्णमलपिडकोलिकापिडकानाम्, अङ्गवेदना, लोहितनीलपीतश्यावानामर्चिष्मतां च रूपाणां स्वप्ने दर्शनमभीक्ष्णमिति (लोहितपित्तपूर्वरूपाणि  भवन्ति)||६||
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tasyēmāni pūrvarūpāṇi bhavanti; tadyathā- anannābhilāṣaḥ, bhuktasya vidāhaḥ, śuktāmlagandharasa udgāraḥ, chardērabhīkṣṇamāgamanaṁ, charditasyabībhatsatā, svarabhēdō, gātrāṇāṁ sadanaṁ, paridāhaḥ, mukhāddhūmāgama iva, lōhalōhitamatsyāmagandhitvamiva cāsyasya,raktaharitahāridratvamaṅgāvayavaśakr̥nmūtrasvēdalālāsiṅghāṇakāsyakarṇamalapiḍakōlikāpiḍakānām [14] , aṅgavēdanā, lōhitanīlapītaśyāvānāmarciṣmatāṁ carūpāṇāṁ svapnē darśanamabhīkṣṇamiti (lōhitapittapūrvarūpāṇi [15] bhavanti)||6||
 
tasyēmāni pūrvarūpāṇi bhavanti; tadyathā- anannābhilāṣaḥ, bhuktasya vidāhaḥ, śuktāmlagandharasa udgāraḥ, chardērabhīkṣṇamāgamanaṁ, charditasyabībhatsatā, svarabhēdō, gātrāṇāṁ sadanaṁ, paridāhaḥ, mukhāddhūmāgama iva, lōhalōhitamatsyāmagandhitvamiva cāsyasya,raktaharitahāridratvamaṅgāvayavaśakr̥nmūtrasvēdalālāsiṅghāṇakāsyakarṇamalapiḍakōlikāpiḍakānām [14] , aṅgavēdanā, lōhitanīlapītaśyāvānāmarciṣmatāṁ carūpāṇāṁ svapnē darśanamabhīkṣṇamiti (lōhitapittapūrvarūpāṇi [15] bhavanti)||6||
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tasyemAni pUrvarUpANi bhavanti; tadyathA- anannAbhilAShaH, bhuktasya vidAhaH, shuktAmlagandharasa udgAraH, charderabhIkShNamAgamanaM, charditasyabIbhatsatA, svarabhedo, gAtrANAM sadanaM, paridAhaH, mukhAddhUmAgama iva, lohalohitamatsyAmagandhitvamiva cAsyasya,raktaharitahAridratvama~ggAvayavashakRunmUtrasvedalAlAsi~gghANakAsyakarNamalapiDakolikApiDakAnAm [14] , a~ggavedanA,lohitanIlapItashyAvAnAmarciShmatAM ca rUpANAM svapne darshanamabhIkShNamiti (lohitapittapUrvarUpANi [15] bhavanti)||6||  
 
tasyemAni pUrvarUpANi bhavanti; tadyathA- anannAbhilAShaH, bhuktasya vidAhaH, shuktAmlagandharasa udgAraH, charderabhIkShNamAgamanaM, charditasyabIbhatsatA, svarabhedo, gAtrANAM sadanaM, paridAhaH, mukhAddhUmAgama iva, lohalohitamatsyAmagandhitvamiva cAsyasya,raktaharitahAridratvama~ggAvayavashakRunmUtrasvedalAlAsi~gghANakAsyakarNamalapiDakolikApiDakAnAm [14] , a~ggavedanA,lohitanIlapItashyAvAnAmarciShmatAM ca rUpANAM svapne darshanamabhIkShNamiti (lohitapittapUrvarUpANi [15] bhavanti)||6||  
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The prodromal symptoms of raktapitta include aversion to food, hot eructation just after meal, belches with smell and aftertaste of sour gruel, frequent vomiting, ugliness of vomitus, hoarseness of voice, malaise, radiating burning sensation, emittance of smoke from the mouth, smell of metal, blood, or fish , mucus in the mouth, appearance of red, green or yellow spots in body parts, feces, urine, sweat, saliva, nose-secretion, excreta from mouth and ear and boils, bodyache, and frequent vision of red, blue, yellow, blackish and brilliant objects in dreams. (6)   
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The prodromal symptoms of raktapitta include aversion to food, hot eructation just after meal, belches with smell and aftertaste of sour gruel, frequent vomiting, ugliness of vomitus, hoarseness of voice, malaise, radiating burning sensation, emittance of smoke from the mouth, smell of metal, blood, or fish , mucus in the mouth, appearance of red, green or yellow spots in body parts, feces, urine, sweat, saliva, nose-secretion, excreta from mouth and ear and boils, bodyache, and frequent vision of red, blue, yellow, blackish and brilliant objects in dreams. [6]
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Complications:
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==== Complications ====
    
उपद्रवास्तु खलु दौर्बल्यारोचकाविपाकश्वासकासज्वरातीसारशोफशोषपाण्डुरोगाः स्वरभेदश्च||७||
 
उपद्रवास्तु खलु दौर्बल्यारोचकाविपाकश्वासकासज्वरातीसारशोफशोषपाण्डुरोगाः स्वरभेदश्च||७||
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upadravāstu khalu daurbalyārōcakāvipākaśvāsakāsajvarātīsāraśōphaśōṣapāṇḍurōgāḥ svarabhēdaśca||7||  
 
upadravāstu khalu daurbalyārōcakāvipākaśvāsakāsajvarātīsāraśōphaśōṣapāṇḍurōgāḥ svarabhēdaśca||7||  
 
upadravAstu khalu daurbalyArocakAvipAkashvAsakAsajvarAtIsArashophashoShapANDurogAH svarabhedashca||7||
 
upadravAstu khalu daurbalyArocakAvipAkashvAsakAsajvarAtIsArashophashoShapANDurogAH svarabhedashca||7||
Complications (of raktapitta) include debility, anorexia, indigestion, dyspnea, cough, fever, diarrhea, edema, emaciation, anemia and hoarseness of voice. (7)
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Complications (of raktapitta) include debility, anorexia, indigestion, dyspnea, cough, fever, diarrhea, edema, emaciation, anemia and hoarseness of voice. [7]
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==== Disease pathways ====
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Disease pathways:
   
मार्गौ पुनरस्य द्वौ ऊर्ध्वं, चाधश्च तद्बहुश्लेष्मणि शरीरे  श्लेष्मसंसर्गादूर्ध्वं प्रतिपद्यमानं कर्णनासिकानेत्रास्येभ्यः प्रच्यवते, बहुवाते तु शरीरे वातसंसर्गादधः प्रतिपद्यमानं मूत्रपुरीषमार्गाभ्यां प्रच्यवते, बहुश्लेष्मवाते तु शरीरे श्लेष्मवातसंसर्गाद्द्वावपि मार्गौ प्रतिपद्यते, तौ मार्गौ प्रतिपद्यमानं सर्वेभ्य एव यथोक्तेभ्यः खेभ्यः प्रच्यवते शरीरस्य||८||  
 
मार्गौ पुनरस्य द्वौ ऊर्ध्वं, चाधश्च तद्बहुश्लेष्मणि शरीरे  श्लेष्मसंसर्गादूर्ध्वं प्रतिपद्यमानं कर्णनासिकानेत्रास्येभ्यः प्रच्यवते, बहुवाते तु शरीरे वातसंसर्गादधः प्रतिपद्यमानं मूत्रपुरीषमार्गाभ्यां प्रच्यवते, बहुश्लेष्मवाते तु शरीरे श्लेष्मवातसंसर्गाद्द्वावपि मार्गौ प्रतिपद्यते, तौ मार्गौ प्रतिपद्यमानं सर्वेभ्य एव यथोक्तेभ्यः खेभ्यः प्रच्यवते शरीरस्य||८||  
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mārgau punarasya dvau ūrdhvaṁ, cādhaśca|  
 
mārgau punarasya dvau ūrdhvaṁ, cādhaśca|  
 
tadbahuślēṣmaṇi śarīrē ślēṣmasaṁsargādūrdhvaṁ pratipadyamānaṁ karṇanāsikānētrāsyēbhyaḥ pracyavatē, bahuvātē tu śarīrē vātasaṁsargādadhaḥpratipadyamānaṁ mūtrapurīṣamārgābhyāṁ pracyavatē, bahuślēṣmavātē tu śarīrē ślēṣmavātasaṁsargāddvāvapi mārgau pratipadyatē, tau mārgaupratipadyamānaṁ sarvēbhya ēva yathōktēbhyaḥ khēbhyaḥ pracyavatē śarīrasya||8||  
 
tadbahuślēṣmaṇi śarīrē ślēṣmasaṁsargādūrdhvaṁ pratipadyamānaṁ karṇanāsikānētrāsyēbhyaḥ pracyavatē, bahuvātē tu śarīrē vātasaṁsargādadhaḥpratipadyamānaṁ mūtrapurīṣamārgābhyāṁ pracyavatē, bahuślēṣmavātē tu śarīrē ślēṣmavātasaṁsargāddvāvapi mārgau pratipadyatē, tau mārgaupratipadyamānaṁ sarvēbhya ēva yathōktēbhyaḥ khēbhyaḥ pracyavatē śarīrasya||8||  
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mArgau punarasya dvau UrdhvaM, cAdhashca|  
 
mArgau punarasya dvau UrdhvaM, cAdhashca|  
 
tadbahushleShmaNi sharIre shleShmasaMsargAdUrdhvaM pratipadyamAnaM karNanAsikAnetrAsyebhyaH pracyavate, bahuvAte tu sharIre vAtasaMsargAdadhaHpratipadyamAnaM mUtrapurIShamArgAbhyAM pracyavate, bahushleShmavAte tu sharIre shleShmavAtasaMsargAddvAvapi mArgau pratipadyate, tau mArgaupratipadyamAnaM sarvebhya eva yathoktebhyaH khebhyaH pracyavate sharIrasya||8||  
 
tadbahushleShmaNi sharIre shleShmasaMsargAdUrdhvaM pratipadyamAnaM karNanAsikAnetrAsyebhyaH pracyavate, bahuvAte tu sharIre vAtasaMsargAdadhaHpratipadyamAnaM mUtrapurIShamArgAbhyAM pracyavate, bahushleShmavAte tu sharIre shleShmavAtasaMsargAddvAvapi mArgau pratipadyate, tau mArgaupratipadyamAnaM sarvebhya eva yathoktebhyaH khebhyaH pracyavate sharIrasya||8||  
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There are two routes of the manifestation of raktapitta -  upwards and downwards. In persons having an abundance of kapha, vitiated rakta goes up and bleeding occurs from ear, nose, eyes and mouth. In those having an excess of vata, rakta flows downwards along with vata and patients bleed through the urinary tract and rectum. Finally, in those having abundance of both kapha and vata, rakta comes out from the body with both the routes and thus bleeds through all the aforesaid orifices. (8
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There are two routes of the manifestation of raktapitta -  upwards and downwards. In persons having an abundance of kapha, vitiated rakta goes up and bleeding occurs from ear, nose, eyes and mouth. In those having an excess of vata, rakta flows downwards along with vata and patients bleed through the urinary tract and rectum. Finally, in those having abundance of both kapha and vata, rakta comes out from the body with both the routes and thus bleeds through all the aforesaid orifices. [8]
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Prognosis:
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==== Prognosis ====
    
तत्र यदूर्ध्वभागं तत् साध्यं, विरेचनोपक्रमणीयत्वाद्बह्वौषधत्वाच्च; यदधोभागं तद्याप्यं, वमनोपक्रमणीयत्वादल्पौषधत्वाच्च; यदुभयभागं तदसाध्यं, वमनविरेचनायोगित्वादनौषधत्वाच्चेति||९||
 
तत्र यदूर्ध्वभागं तत् साध्यं, विरेचनोपक्रमणीयत्वाद्बह्वौषधत्वाच्च; यदधोभागं तद्याप्यं, वमनोपक्रमणीयत्वादल्पौषधत्वाच्च; यदुभयभागं तदसाध्यं, वमनविरेचनायोगित्वादनौषधत्वाच्चेति||९||
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Amongst these, that which comes out of the upper orifices is curable and is treatable by purgation due to availability of plenty of drugs for the purpose. That coming out from the lower orifices is palliable because of being amenable to emesis and availability of lesser number of drugs for the purpose. That coming out from both the routes is incurable because of non-applicability of both emesis and purgation and in want of suitable drugs. (9)
 
Amongst these, that which comes out of the upper orifices is curable and is treatable by purgation due to availability of plenty of drugs for the purpose. That coming out from the lower orifices is palliable because of being amenable to emesis and availability of lesser number of drugs for the purpose. That coming out from both the routes is incurable because of non-applicability of both emesis and purgation and in want of suitable drugs. (9)
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Origin of raktapitta:
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==== Origin of raktapitta ====
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रक्तपित्तप्रकोपस्तु खलु पुरा दक्षयज्ञोद्ध्वंसे रुद्रकोपामर्षाग्निना प्राणिनां  परिगतशरीरप्राणानामभवज्ज्वरमनु||१०||  
 
रक्तपित्तप्रकोपस्तु खलु पुरा दक्षयज्ञोद्ध्वंसे रुद्रकोपामर्षाग्निना प्राणिनां  परिगतशरीरप्राणानामभवज्ज्वरमनु||१०||  
 
raktapittaprakōpastu khalu purā dakṣayajñōddhvaṁsē rudrakōpāmarṣāgninā [16] prāṇināṁ parigataśarīraprāṇānāmabhavajjvaramanu||10||
 
raktapittaprakōpastu khalu purā dakṣayajñōddhvaṁsē rudrakōpāmarṣāgninā [16] prāṇināṁ parigataśarīraprāṇānāmabhavajjvaramanu||10||
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Hystorically, raktapitta occured after jwara because of Rudra’s anger pervaded the human being  at the time of destruction of Daksha's sacrifice. (10)
 
Hystorically, raktapitta occured after jwara because of Rudra’s anger pervaded the human being  at the time of destruction of Daksha's sacrifice. (10)
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General principles of management:
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==== General principles of management ====
    
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||

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