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Raktapitta Chikitsa (view source)

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{{#seo:

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|title=Raktapitta Chikitsa

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|titlemode=append

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|keywords=Raktapitta, Chikitsa, Mahagada, bleeding disorders, pitta aggravation, rakta vitiation

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|description=Chikitsa Sthana Chapter 4. Management of Raktapitta (Bleeding Disorders)

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}}

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<big>'''[[Chikitsa Sthana]] Chapter 4. Management of Raktapitta (Bleeding Disorders)'''</big>

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=== Sanskrit text, Transliteration and English Translation ===

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अथातो रक्तपित्तचिकित्सितं व्याख्यास्यामः ||१||

इति ह स्माह भगवानात्रेयः||२||

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athātō raktapittacikitsitaṁ vyākhyāsyāmaḥ||1||

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iti ha smAha bhagavAnAtreyaH||2||

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</div></div>

Now we shall expound the chapter on ''raktapitta'' (haemorrhagic disorders). (1)

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==== Agnivesha’s query ====

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विहरन्तं जितात्मानं पञ्चगङ्गे पुनर्वसुम्|

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भगवन् रक्तपित्तस्य हेतुरुक्तः सलक्षणः|

वक्तव्यं यत् परं तस्य वक्तुमर्हसि तद्गुरो||४||

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viharantaṁ jitātmānaṁ pañcagaṅgē punarvasum|

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bhagavan raktapittasya heturuktaH salakShaNaH|

vaktavyaM yat paraM tasya vaktumarhasi tadguro||4||

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</div></div>

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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गुरुरुवाच-

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तस्योष्णं तीक्ष्णमम्लं च कटूनि लवणानि च|

घर्मश्चान्नविदाहश्च हेतुः पूर्वं निदर्शितः||६||

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gururuvāca-

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tasyoShNaM tIkShNamamlaM ca kaTUni lavaNAni ca|

gharmashcAnnavidAhashca hetuH pUrvaM nidarshitaH||6||

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</div></div>

The teacher said-

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==== Pathogenesis ====

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तैर्हेतुभिः समुत्क्लिष्टं पित्तं रक्तं प्रपद्यते|

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तस्योष्मणा द्रवो धातुर्धातोर्धातोः प्रसिच्यते|

स्विद्यतस्तेन संवृद्धिं भूयस्तदधिगच्छति||८||

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tairhētubhiḥ samutkliṣṭaṁ pittaṁ raktaṁ prapadyatē|

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tasyoShmaNA dravo dhAturdhAtordhAtoH prasicyate|

svidyatastena saMvRuddhiM bhUyastadadhigacchati||8||

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</div></div>

''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]

==== Derivation ====

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संयोगाद्दूषणात्तत्तु सामान्याद्गन्धवर्णयोः|

रक्तस्य पित्तमाख्यातं रक्तपित्तं मनीषिभिः||९||

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saṁyōgāddūṣaṇāttattu sāmānyādgandhavarṇayōḥ|

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saMyogAddUShaNAttattu sAmAnyAdgandhavarNayoH|

raktasya pittamAkhyAtaM raktapittaM manIShibhiH||9||

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</div></div>

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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प्लीहानं च यकृच्चैव तदधिष्ठाय वर्तते|

स्रोतांसि रक्तवाहीनि तन्मूलानि हि देहिनाम्||१०||

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plīhānaṁ ca yakr̥ccaiva tadadhiṣṭhāya vartatē|

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plIhAnaM ca yakRuccaiva tadadhiShThAya vartate|

srotAMsi raktavAhIni tanmUlAni hi dehinAm||10||

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</div></div>

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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सान्द्रं सपाण्डु सस्नेहं पिच्छिलं च कफान्वितम्|

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संसृष्टलिङ्गं संसर्गात्त्रिलिङ्गं सान्निपातिकम्|१३|

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sāndraṁ sapāṇḍu sasnēhaṁ picchilaṁ ca kaphānvitam|

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saMsRuShTali~ggaM saMsargAttrili~ggaM sAnnipAtikam|13|

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</div></div>

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]

==== Prognosis ====

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एकदोषानुगं साध्यं द्विदोषं याप्यमुच्यते||१३||

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यत्त्रिदोषमसाध्यं तन्मन्दाग्नेरतिवेगवत्|व्याधिभिः

क्षीणदेहस्य वृद्धस्यानश्नतश्च यत्||१४||

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ēkadōṣānugaṁ sādhyaṁ dvidōṣaṁ yāpyamucyatē||13||

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yattridoShamasAdhyaM tanmandAgnerativegavat|

vyAdhibhiH kShINadehasya vRuddhasyAnashnatashca yat||14||

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</div></div>

''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]

==== ''Gati'' (direction of flow) and prognosis ====

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गतिरूर्ध्वमधश्चैव रक्तपित्तस्य दर्शिता|

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यद्विदोषानुगं यद्वा शान्तं शान्तं प्रकुप्यति|

मार्गान्मार्गं चरेद्यद्वा याप्यं पित्तमसृक् चतत्||२१||

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gatirūrdhvamadhaścaiva raktapittasya |

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yadvidoShAnugaM yadvA shAntaM shAntaM [5] prakupyati|

mArgAnmArgaM caredyadvA yApyaM pittamasRuk ca tat||21||

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</div></div>

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.

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==== Characteristics of curable ''raktapitta'' ====

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एकमार्गं बलवतो नातिवेगं नवोत्थितम्|

रक्तपित्तं काले साध्यं स्यान्निरुपद्रवम्||२२||

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ēkamārgaṁ balavatō nātivēgaṁ avōtthitam|

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ekamArgaM balavato nAtivegaM navotthitam|

raktapittaM sukhe kAle sAdhyaM syAnnirupadravam||22||

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</div></div>

''Raktapitta'' which has only one passage, is in the strong person, not very forceful, with recent onset, in favorable season (early winter and winter) and without complication is curable. [22]

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स्निग्धोष्णमुष्णरूक्षं च रक्तपित्तस्य कारणम्|

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ऊर्ध्वगं कफसंसृष्टमधोगं मारुतानुगम्|

द्विमार्गं कफवाताभ्यामुभाभ्यामनुबध्यते||२४||

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snigdhōṣṇamuṣṇarūkṣaṁ ca raktapittasya kāraṇam|

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UrdhvagaM kaphasaMsRuShTamadhogaM mArutAnugam|

dvimArgaM kaphavAtAbhyAmubhAbhyAmanubadhyate||24||

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</div></div>

''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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अक्षीणबलमांसस्य रक्तपित्तं यदश्नतः|

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तस्मादुपेक्ष्यं बलिनो बलदोषविचारिणा |

रक्तपित्तं प्रथमतप्रवृद्धंसिद्धिमिच्छता||२८||

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akṣīṇabalamāṁsasya raktapittaṁ yadaśnataḥ|

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tasmAdupekShyaM balino baladoShavicAriNA [6] |

raktapittaM prathamataH pravRuddhaM [7] siddhimicchatA||28||

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</div></div>

''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.

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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प्रायेण हि समुत्क्लिष्टमामदोषाच्छरीरिणाम्|

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मार्गौ दोषानुबन्धं च निदानं प्रसमीक्ष्य च|

लङ्घनं रक्तपित्तादौ तर्पणं वा प्रयोजयेत्||३०||

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prāyēṇa hi mutkliṣṭamāmadōṣāccharīriṇām|

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mArgau doShAnubandhaM ca nidAnaM prasamIkShya ca|

la~gghanaM raktapittAdau tarpaNaM vA prayojayet||30||

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</div></div>

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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ह्रीबेरचन्दनोशीरमुस्तपर्पटकैः शृतम्|

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मन्दाग्नेरम्लसात्म्याय तत् साम्लमपि कल्पयेत्|

दाडिमामलकैर्विद्वानम्लार्थंचानुदापयेत्||३५||

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hrībēracandanōśīramustaparpaṭakaiḥ

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mandAgneramlasAtmyAya tat sAmlamapi kalpayet|

dADimAmalakairvidvAnamlArthaM [8] cAnudApayet||35||

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</div></div>

The patient who feels thirsty should be given water boiled with ''hribera, chandana, ushira, musta'' and ''parpataka'' or only cooled boiled water. One having knowledge of constitution and preparation should prescribe saturating drink in upward movement of ''raktapitta'' and liquid gruel in the downward one considering time, suitability and association of ''doshas''. For saturation, water boiled with ''kharjura'' (date), ''mridvika'' (fruit), ''madhuka'' (dry flowers) and ''parushaka'' (fruit) and cooled along with sugar.

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==== Diet advised in ''raktapitta'' ====

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शालिषष्टिकनीवारकोरदूषप्रशान्तिकाः|

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कफानुगे यूषशाकं दद्याद्वातानुगे रसम्|

रक्तपित्ते यवागूनामतः कल्पः प्रवक्ष्यते||४३||

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śāliṣaṣṭikanīvārakōradūṣapraśāntikāḥ|

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kaphAnuge yUShashAkaM dadyAdvAtAnuge rasam|

raktapitte yavAgUnAmataH kalpaH pravakShyate||43||

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</div></div>

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.

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==== Medicated gruels in ''raktapitta'' ====

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पद्मोत्पलानां किञ्जल्कः पृश्निपर्णी यङ्गुकाः|

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इत्युक्ता रक्तपित्तघ्न्यः शीताः समधुशर्कराः|

यवाग्वः कल्पना चैषा कार्या मांसरसेष्वपि||४८||

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padmōtpalānāṁ kiñjalkaḥ pr̥śniparṇī priyaṅgukāḥ|

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ityuktA raktapittaghnyaH shItAH samadhusharkarAH|

yavAgvaH kalpanA caiShA kAryA mAMsaraseShvapi||48||

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</div></div>

The stamens of lotus and water lily, ''prashniparni'' and ''priyangu'' grains should be boiled in water. In the same decoction liquid gruel should be prepared for the patients of ''raktapitta''. Gruel may also be prepared in the decoction of

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These are the gruels useful in ''raktapitta'' and should be taken cooled and added with honey and sugar. Such preparations may also be made in meat-soups. [44-48]

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शशः सवास्तुकः शस्तो विबन्धे रक्तपित्तिनाम्|

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तृष्यते तिक्तकैः सिद्धं तृष्णाघ्नं वा फलोदकम्|

सिद्धं विदारिगन्धाद्यैरथवाशृतशीतलम्||५१||

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śaśaḥ savāstukaḥ śastō vibandhē raktapittinām|

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tRuShyate tiktakaiH siddhaM tRuShNAghnaM vA phalodakam|

siddhaM vidArigandhAdyairathavA [11] shRutashItalam||51||

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</div></div>

In the patient of ''raktapitta'' if there is constipation due to aggravated ''vata'', the following preparations are useful:

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#fowl cooked in decoction of ''nygrodha'',

#''vartaka'' and ''krakara'' cooked in decoction of ''bilwa, utpala'' etc. In the condition of thirst, water boiled with bitter or thirst-alleviating fruit-juice, or water boiled with the drugs of the ''vidarigandhadi'' group or simply water boiled and cooled is prescribed. [49-51]

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ज्ञात्वा दोषावनुबलौ बलमाहारमेव च|

जलं पिपासवे दद्याद्विसर्गादल्पशोऽपि वा||५२||

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jñātvā dōṣāvanubalau balamāhāramēva ca|

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j~jAtvA doShAvanubalau balamAhArameva ca|

jalaM pipAsave dadyAdvisargAdalpasho~api [12] vA||52||

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</div></div>

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]

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निदानं रक्तपित्तस्य यत्किञ्चित् सम्प्रकाशितम्|

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इत्यन्नपानं निर्दिष्टं क्रमशो रक्तपित्तनुत्|५४|

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nidānaṁ raktapittasya yatkiñcit samprakāśitam|

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ityannapAnaM nirdiShTaM kramasho raktapittanut|54|

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</div></div>

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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वक्ष्यते बहुदोषाणां कार्यं बलवतां च यत्||५४||

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ऊर्ध्वगे शुद्धकोष्ठस्य तर्पणादिः क्रमो हितः|

अधोगते यवाग्वादिर्न चेत्स्यान्मारुतोबली||६१||

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vakṣyatē bahudōṣāṇāṁ kāryaṁ balavatāṁ ca yat||54||

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Urdhvage shuddhakoShThasya tarpaNAdiH kramo hitaH|

adhogate yavAgvAdirna cetsyAnmAruto balI||61||

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</div></div>

Now the management of strong patients having plenty of ''doshas'' will be explained further:

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==== Pacification therapy ====

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बलमांसपरिक्षीणं शोकभाराध्वकर्शितम्|

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धन्वजानामसृग्लिह्यान्मधुना मृगपक्षिणाम्|

सक्षौद्रं ग्रथिते रक्ते लिह्यात् पारावतं शकृत्||७२||

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balamāṁsaparikṣīṇaṁ śōkabhārādhvakarśitam

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dhanvajAnAmasRuglihyAnmadhunA mRugapakShiNAm|

sakShaudraM grathite rakte lihyAt pArAvataM shakRut||72||

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</div></div>

The patient of ''raktapitta'' who is not fit for emesis or purgation such as one debilitated, emaciated by excess grief, weight lifting or walking, exposed to heat of the fire or the sun, or emaciated by other diseases, pregnant, old, child, taking rough, little and measured diet or associated with phthisis should be treated with pacificatory treatment which is mentioned hereafter.

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Blood of the wild animals and birds should be taken with honey. If the blood is clotted, one should take excrement of pigeon with honey. [62-72]

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उशीरकालीयकलोध्रपद्मकप्रियङ्गुकाकट्फलशङ्खगैरिकाः|

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निशिस्थिता वा स्वरसीकृता वा कल्कीकृतावा मृदिताः शृता वा|

एते समस्ता गणशः पृथग्वा रक्तं सपित्तं शमयन्ति योगाः||७७||

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uśīrakālīyakalōdhrapadmakapriyaṅgukākaṭphalaśaṅkhagairikāḥ|

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nishi sthitA vA svarasIkRutA vA kalkIkRutA [16] vA mRuditAH shRutA vA|

ete samastA gaNashaH pRuthagvA raktaM sapittaM shamayanti [17] yogAH||77||

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</div></div>

''Ushira, kaliyaka, lodhra, padmaka, priyangu, katphala,'' conch and ochre-each taken separately with equal part of sandal along with sugar and dissolved in rice water alleviate quickly internal haemorhage, fainting, thirst and burning sensation.

''Kiratatikta, kramuka, musta, prapaundarika, kamala, utpala, hribera'' (root), ''patola'' (leaves), ''duralabha, parpataka,'' lotus stalk, bark of ''arjuna, udumbara, vetasa, nyagrodha, shaileya'' and ''yavashaka; tuga, lata'' (''durva''), vetasa ''tanduliya, sariva, mocharasa'' and ''lajjalu'' – each separately mixed with sandal may be administered as above. They collectively as group or separately used in the form of cold infusion, juice, paste, hot infusion or decoction check the hemorrhagic disorder. [72-77]

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मुद्गाः सलाजाःसयवाः कृष्णाः सोशीरमुस्ताःसह चन्दनेन|

बलाजले पर्युषिताः कषाया रक्तं सपित्तं शमयन्त्युदीर्णम्||७८||

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mudgāḥ salājāḥ sayavāḥ sakr̥ṣṇāḥ sōśīramustāḥ

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mudgAH salAjAH sayavAH sakRuShNAH soshIramustAH saha candanena|

balAjale paryuShitAH kaShAyA raktaM sapittaM shamayantyudIrNam||78||

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</div></div>

Green gram, parched paddy, ''pippali, ushira, musta'' and ''chandana'' are kept for the whole night in water boiled with ''bala''. This pacifies even the aggravated ''raktapitta''. [78]

+

वैदूर्यमुक्तामणिगैरिकाणां मृच्छङ्खहेमामलकोदकानाम्|

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प्रियङ्गुकाचन्दनलोध्रसारिवामधूकमुस्ताभयधातकीजलम्|

समृत्प्रसादं सह यष्टिकाम्बुना सशर्करं रक्तनिबर्हणं परम्||८१||

+

vaidūryamuktāmaṇigairikāṇāṁ mr̥cchaṅkhahēmāmalakōdakānām|

Line 905: Line 983:

priya~ggukAcandanalodhrasArivAmadhUkamustAbhayadhAtakIjalam|

samRutprasAdaM saha yaShTikAmbunA [20] sasharkaraM raktanibarhaNaM param||81||

+

</div></div>

Hemorrhagic disorder gets alleviated by the use of water in contact with ''vaidurya'' (cat's eye), pearls, gems, ochre, earth, conch, ''nagakeshara'' and ''amalaka''; honey-water and sugar cane juice.

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Water kept with ''priyangu, chandana, lodhra, sariva, madhuka, musta, ushira'' and ''dhataki,'' or water kept with brick, or ''shashtika'' rice water added with sugar is an excellent haemostatic. [79-81]

+

कषाययोगैर्विविधैर्यथोक्तैर्दीप्तेऽनले श्लेष्मणि निर्जिते च|

Line 920: Line 1,000:

द्राक्षाशृतं नागरकैःशृतं वा बलाशृतं गोक्षुरकैः शृतं वा|

सजीवकं सर्षभकं ससर्पिः पयः प्रयोज्यं सितया शृतं वा||८४||

+

kaṣāyayōgairvividhairyathōktairdīptē'nalē ślēṣmaṇi nirjitē ca|

Line 938: Line 1,019:

drAkShAshRutaM nAgarakaiH shRutaM vA balAshRutaM gokShurakaiH shRutaM vA|

sajIvakaM sarShabhakaM sasarpiH payaH prayojyaM sitayA shRutaM vA||84||

+

</div></div>

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.

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==== Treatment of hematuria and per rectal bleeding ====

+

शतावरीगोक्षुरकैः शृतं वा शृतं पयो वाऽप्यथ पर्णिनीभिः|

रक्तं निहन्त्याशु विशेषतस्तु यन्मूत्रमार्गात् सरुजं याति||८५||

+

śatāvarīgōkṣurakaiḥ śr̥taṁ vā śr̥taṁ payō vā'pyatha parṇinībhiḥ|

Line 960: Line 1,044:

shatAvarIgokShurakaiH shRutaM vA shRutaM payo vA~apyatha parNinIbhiH|

raktaM nihantyAshu visheShatastu yanmUtramArgAt sarujaM prayAti||85||

+

</div></div>

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 ====

+

विशेषतो विट्पथसम्प्रवृत्ते पयो मतं मोचरसेन सिद्धम्|

Line 970: Line 1,056:

कषाययोगान् पयसा पुरा वा पीत्वाऽनु चाद्यात् पयसैव शालीन्|

कषाययोगैरथवा विपक्वमेतैः पिबेत् सर्पिरतिस्रवे च||८७||

+

viśēṣatō viṭpathasampravr̥ttē payō mataṁ mōcarasēnasiddham|

Line 982: Line 1,069:

kaShAyayogAn payasA purA vA pItvA~anu cAdyAt payasaiva shAlIn|

kaShAyayogairathavA vipakvametaiH pibet sarpiratisrave ca||87||

+

</div></div>

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 ====

+

वासां सशाखां सपलाशमूलां कृत्वा कषायं कुसुमानि चास्याः|

Line 991: Line 1,080:

इति वासाघृतम्|

+

vāsāṁ saśākhāṁ sapalāśamūlāṁ kr̥tvā kaṣāyaṁ kusumāni cāsyāḥ|

Line 1,001: Line 1,091:

iti vAsAghRutam

+

</div></div>

''Vasa'' along with branches, leaves and root should be boiled and made into decoction. Ghee should be cooked with this decoction putting ''vasa'' flowers as paste. This (''vasa'') ''ghrita'' taken with honey checks the hemorrhage quickly (thus the name, ''vasa ghrita''). [88]

+

पलाशवृन्तस्वरसेन सिद्धं तस्यैव कल्केन मधुद्रवेण|

Line 1,010: Line 1,102:

स्यात्त्रायमाणाविधिरेष एव सोदुम्बरे चैव पटोलपत्रे |

सर्पींषि पित्तज्वरनाशनानि सर्वाणि शस्तानि च रक्तपित्ते||९०||

+

palāśavr̥ntasvarasēna siddhaṁ

Line 1,024: Line 1,117:

syAttrAyamANAvidhireSha eva sodumbare caiva paTolapatre|

sarpIMShi pittajvaranAshanAni sarvANi shastAni ca raktapitte||90||

+

</div></div>

''Ghrita'' cooked with:

Line 1,034: Line 1,128:

==== External applications ====

+

अभ्यङ्गयोगाः परिषेचनानि सेकावगाहाः शयनानि वेश्म|

Line 1,040: Line 1,135:

तद्रक्तपित्ते निखिलेन कार्यं कालं च मात्रां च पुरा समीक्ष्य|

सर्पिर्गुडा ये च हिताः क्षतेभ्यस्ते रक्तपित्तं शमयन्ति सद्यः||९२||

+

abhyaṅgayōgāḥ pariṣēcanāni sēkāvagāhāḥ śayanāni vēśma|

Line 1,052: Line 1,148:

tadraktapitte nikhilena kAryaM kAlaM ca mAtrAM ca purA samIkShya|

sarpirguDA ye ca hitAH kShatebhyaste raktapittaM shamayanti sadyaH||92||

+

</div></div>

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'' ====

+

कफानुबन्धे रुधिरे सपित्ते कण्ठागते स्याद्ग्रथिते प्रयोगः|

Line 1,062: Line 1,160:

मृणालपद्मोत्पलकेशराणां तथा पलाशस्य तथा प्रियङ्गोः|

तथा मधूकस्य तथाऽसनस्य क्षाराः प्रयोज्या विधिनैव तेन||९४||

+

kaphānubandhē rudhirē sapittē kaṇṭhāgatē syādgrathitē prayōgaḥ|

Line 1,074: Line 1,173:

mRuNAlapadmotpalakesharANAM tathA palAshasya tathA priya~ggoH|

tathA madhUkasya tathA~asanasya kShArAH prayojyA vidhinaiva tena||94||

+

</div></div>

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 ====

+

शतावरीदाडिमतिन्तिडीकं काकोलिमेदे मधुकं विदारीम्|

Line 1,086: Line 1,187:

इति शतावर्यादिघृतम्|

+

śatāvarīdāḍimatintiḍīkaṁ kākōlimēdē madhukaṁvidārīm| piṣṭvā ca mūlaṁ phalapūrakasya ghr̥taṁ pacēt kṣīracaturguṇaṁ jñaḥ||95||

Line 1,101: Line 1,203:

iti shatAvaryAdighRutam

+

</div></div>

Ghee should be cooked with ''shatavari, dadima, tintidika, kakoli, meda, madhuka'' and ''vidari'' along with the paste of the root of ''bijapura'' adding four times milk. This ghrita alleviates cough, fever, hardness of bowels, constipation, pain and hemorrhagic disorder.

Line 1,107: Line 1,210:

==== Treatment of nasal bleeding ====

+

कषाययोगा य इहोपदिष्टास्ते चावपीडे भिषजा प्रयोज्याः|

Line 1,122: Line 1,226:

प्रियालतैलं मधुकं पयश्च सिद्धं घृतं माहिषमाजिकं वा|

आम्रास्थिपूर्वैः पयसा च नस्यं ससारिवैः स्यात् कमलोत्पलैश्च||१०१||

+

kaṣāyayōgā ya ihōpadiṣṭāstē cāvapīḍē bhiṣajā prayōjyāḥ|

Line 1,152: Line 1,257:

priyAlatailaM madhukaM payashca siddhaM ghRutaM mAhiShamAjikaM vA|

AmrAsthipUrvaiH payasA ca nasyaM sasArivaiH syAt kamalotpalaishca||101||

+

</div></div>

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.

Line 1,168: Line 1,274:

#mango seed, ''lajjatu, dhataki, mocarasa'' and ''lodhra'' along with milk,

#''sariva, kamala'' and ''utpala'' with milk. [97-101]

+

भद्रश्रियं लोहितचन्दनं च प्रपौण्डरीकं कमलोत्पले च|

Line 1,192: Line 1,299:

सरिद्ध्रदानां हिमवद्दरीणां चन्द्रोदयानां कमलाकराणाम्|

मनोऽनुकूलाः शिशिराश्च सर्वाः कथाः सरक्तं शमयन्ति पित्तम्||१०९||

+

bhadraśriyaṁ lōhitacandanaṁ ca prapauṇḍarīkaṁ kamalōtpalē ca|

Line 1,241: Line 1,349:

sariddhradAnAM himavaddarINAM candrodayAnAM kamalAkarANAm|

mano~anukUlAH shishirAshca sarvAH kathAH saraktaM shamayanti pittam||109||

+

</div></div>

''Bhadrashriya'', red sandal, ''prapaundarika, kamala, utpala, ushira, vanira, hribera, mrinala,'' bigger ''shatavari, madhuka, payasya,'' roots of ''shali, ikshu, yavasa, gundra, nala, kusha, kuchandana, shaivala, ananta,'' seasonal grass roots (of cold season), ''riddhi'', roots and flowers of aquatic plants, local application of mud from pond, ''udumbara, ashwattha, madhuka, lodhra'' and other astringent and cold plants – the physician desiring allevation of ''raktapitta'' should use the drugs of the (above) ''bhadrashriyadi'' group in anointing, sprinkling, bath and preparation of ghee and oil.

Line 1,248: Line 1,357:

==== Summary ====

+

तत्र श्लोकौ-

Line 1,256: Line 1,366:

पानान्नमिष्टमेव च वर्ज्यं संशोधनं च शमनं च|

गुरुरुक्तवान्यथावच्चिकित्सिते रक्तपित्तस्य||१११||

+

tatra ślōkau-

Line 1,272: Line 1,383:

pAnAnnamiShTameva ca varjyaM saMshodhanaM ca shamanaM ca|

gururuktavAnyathAvaccikitsite raktapittasya||111||

+

</div></div>

Now the summing up verse –

Etiology, aggravation, definition, location, symptoms, passages, curability, incurability and maintainability principle of treatment, diet indicated and contraindicated, purification and pacification measures, all this described by the teacher shall be applied for treatment of ''raktapitta'' (hemorrhagic disorder). [110]

+

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेचिकित्सितस्थाने रक्तपित्तचिकित्सितं नाम चतुर्थोऽध्यायः||४||

+

ityagnivēśakr̥tētantrē carakapratisaṁskr̥tē cikitsitasthānēraktapittacikitsitaṁ nāma caturthō'dhyāyaḥ||4||

Line 1,283: Line 1,397:

ityagniveshakRute tantre carakapratisaMskRute cikitsitasthAne

raktapittacikitsitaM nAma caturtho~adhyAyaH||4||

+

</div></div>

Thus ends the fourth chapter on the treatment of hemorrhagic disorder in [[Chikitsa Sthana]] in the treatise composed by Agnivesha and redacted by Charak. (4)

Agnivesha

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