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{{#seo:

|title=Trimarmiya Chikitsa

|titlemode=append

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|keywords=trimarma (three vital organs), prana (life force), uttarabasti,varti prayoga, udavarta, mutra kruchchra, hridroga, nasya karma, pratishyaya (rhinitis), dushta pratishyaya (persistent rhinitis), apinasa (chronic rhinitis), puya rakta (purulent and sanguinous rhinitis), nasa paka (suppurative rhinitis), nasa shotha (edematous rhinitis), kshavathu (sneezing), nasa shosha (dryness of nasal mucosal membrane), pratinaha (nasal obstruction), pratisrava (nasal discharge), puti nasya (ozena), nasa arbuda (nasal tumor), arumshi (furunculosis), nasa dipta (burnt nose), anaha (constipation), arochaka (anorexia),Ayurveda, Indian system of medicine, charak samhita.

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|keywords=trimarma (three vital organs), prana (life force), uttarabasti,varti prayoga, udavarta, mutra kruchchra, hridroga, nasya karma, pratishyaya (rhinitis), dushta pratishyaya (persistent rhinitis), apinasa (chronic rhinitis), puya rakta (purulent and sanguinous rhinitis), nasa paka (suppurative rhinitis), nasa shotha (edematous rhinitis), kshavathu (sneezing), nasa shosha (dryness of nasal mucosal membrane), pratinaha (nasal obstruction), pratisrava (nasal discharge), puti nasya (ozena), nasa arbuda (nasal tumor), arumshi (furunculosis), nasa dipta (burnt nose), anaha (constipation), arochaka (anorexia),Ayurveda, Indian system of medicine, charak samhita,Ojha S.N., Samant A.,Deole Y.S., Basisht G.

|description=Chikitsa Sthana Chapter 26. Management of Tri marma (diseases of three vital organs)

|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg

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|type=article

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<big>'''[[Chikitsa Sthana]] Chapter 26. Management of Trimarma (diseases of three vital organs)</big>'''

{{Infobox

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|data7 = Dixit U.

|label8 = Editors

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|data8 = Ojha S.N.,Deole Y.S., Basisht G.

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|data8 = Ojha S.N., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]

|label9 = Year of publication

|data9 = 2020

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}}

<big>'''Abstract </big>'''

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<~~div~~ style="text-align:justify;">

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<p style="text-align:justify;">This chapter highlights the importance of ''trimarma'' (three vital organs, viz, cardiovascular system, cerebrovascular system and renal system) and treatment of their diseases. There are one hundred seven vital points (''marma'') on the body which when injured cause disease, disability or death. Three of these ''marma'' are located in ''hridaya'' (heart), ''shira'' (head) and ''basti'' (urinary bladder). Impairment of these three ''marma'' can cause life threatening conditions in cardio-vascular system, cerebrovascular system and urinary system respectively. An internal relationship exists between these ''marma'' and respective body systems. Disease of one system affects the functioning of the other. The disease conditions caused by impairment of these three ''marma'' account for higher mortality and morbidity in society. The present chapter deals with etiology, signs and symptoms, classification, principles of treatment for the diseases pertaining to these three ''marma''. The chapter also includes description of various categories of diseases like diseases of ear, nose, throat, eyes under the heading of diseases of head; diseases like urinary calculi under diseases of renal system. <br/>

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This chapter highlights the importance of ''trimarma'' (three vital organs, viz, cardiovascular system, cerebrovascular system and renal system) and treatment of their diseases. There are one hundred seven vital points (''marma'') on the body which when injured cause disease, disability or death. Three of these ''marma'' are located in ''hridaya'' (heart), ''shira'' (head) and ''basti'' (urinary bladder). Impairment of these three ''marma'' can cause life threatening conditions in cardio-vascular system, cerebrovascular system and urinary system respectively. An internal relationship exists between these ''marma'' and respective body systems. Disease of one system affects the functioning of the other. The disease conditions caused by impairment of these three ''marma'' account for higher mortality and morbidity in society. The present chapter deals with etiology, signs and symptoms, classification, principles of treatment for the diseases pertaining to these three ''marma''. The chapter also includes description of various categories of diseases like diseases of ear, nose, throat, eyes under the heading of diseases of head; diseases like urinary calculi under diseases of renal system.

'''Keywords''': ''trimarma'' (three vital organs), ''prana'' (life force), ''uttarabasti,varti prayoga, udavarta, mutra kruchchra, hridroga, nasya karma, pratishyaya'' (rhinitis), ''dushta pratishyaya'' (persistent rhinitis), ''apinasa'' (chronic rhinitis), ''puya rakta'' (purulent and sanguinous rhinitis), ''nasa paka'' (suppurative rhinitis), ''nasa shotha'' (edematous rhinitis), ''kshavathu'' (sneezing), ''nasa shosha'' (dryness of nasal mucosal membrane), ''pratinaha'' (nasal obstruction), ''pratisrava'' (nasal discharge), ''puti nasya'' (ozena), ''nasa arbuda'' (nasal tumor), ''arumshi'' (furunculosis), ''nasa dipta'' (burnt nose), ''anaha'' (constipation), ''arochaka'' (anorexia)

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</p>

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== Introduction ==

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''Dosha'' aggravated separately or all together when being provoked by their vitiating factors which get located in kidney or urinary bladder and distress the urinary passage, leads to ''mutrakricchra''(dysuria).[33]

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====== Signs of [[vata]]ja dysuria ======

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====== Signs of [[vata]]ja dysuria ======

Severe pain in groins, urinary bladder and genitals and the patient frequently passes urine in small quantity.

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====== Signs of [[pitta]]ja dysuria ======

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====== Signs of [[pitta]]ja dysuria ======

The patient passes yellow or bloody urine with pain and burning sensation frequently and with difficulty. [34]

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====== Signs of [[kapha]]ja dysuria ======

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====== Signs of [[kapha]]ja dysuria ======

Heaviness and oedema in urinary bladder and phallus and the urine is associated with slimy materials.

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If the vitiated blood due to ''kshata'' (trauma) or ''kshaya'' (emaciation caused by excessive discharge of semen) when accumulated in urinary bladder, it causes obstruction and severe pain in the bladder. Vitiated blood when associate with urine forms the calculus, which causes the distention of abdomen and heaviness in the region of urinary bladder however the patient feels lightness when the calculus passes out. Thus, ends the diagnosis of dysuria (''mootra krucchrara''). [43-44]

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==== Treatment of [[vata]]ja dsyuria ====

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==== Treatment of [[vata]]ja dsyuria ====

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Intake of oil seeds along with sour things in lukewarm form is also useful. [48]

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==== Treatment of [[pitta]]ja dysuria ====

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==== Treatment of [[pitta]]ja dysuria ====

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The decoction of ''kamala'' and ''utpala'' (water lily) or ''shringhataka'' or ''vidari'' or the root of ''danairaka'' with honey and sugar is useful in [[pitta]]ja type of dysuria. Simple cold water mixed with water, honey, and sugar is also helpful in ''paittika'' type of dysuria. [51]

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==== Remedies for [[pitta]]ja dysuria ====

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==== Remedies for [[pitta]]ja dysuria ====

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#Drink prepared out of ''daruharidra''-Berberis vulgaris L, juice of ''amalaki''-Emblica officinalis Gaertn mixed with honey is helpful in [[pitta]]ja mutra krucchra''.[53]

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==== Treatment of [[kapha]]ja type of dysuria ====

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==== Treatment of [[kapha]]ja type of dysuria ====

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===== Specific features of different types of ''hridrogas'' =====

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====== In predominance of [[vata]] ([[vata]]ja heart disease) ======

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====== In predominance of [[vata]] ([[vata]]ja heart disease) ======

Feeling of emptiness in the cardiac region, palpitation/ tachycardia, dryness of cardiac muscles (wasting/ atrophy), pricking pain, obstructed movement and mental confusion (unconsciousness) are the specific features of ''vatika'' type of heart disease. [79]

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====== In predominance of [[pitta]] ([[pitta]]ja heart disease) ======

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====== In predominance of [[pitta]] ([[pitta]]ja heart disease) ======

Darkness of vision/ blackout, giddiness, distress, burning sensation, confusion/unconsciousness, heat sensation, pyrexia and yellowishness are the specific features of ''paittika hridroga'' [80]

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====== In predominance of [[kapha]] ([[kapha]]ja heart disease) ======

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====== In predominance of [[kapha]] ([[kapha]]ja heart disease) ======

Bradycardia, heaviness, timidity of heart/ dullness associated with salivation, fever, cough and drowsiness are the specific features of [[kapha]]ja hridroga.

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There is intense discomfort/acute pain and piercing pain with itching. [80]

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===== Treatment of [[vata]]ja hridroga =====

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===== Treatment of [[vata]]ja hridroga =====

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One ''prasta'' of ghee and buffalo’s curd to be added and cook all the above together and taken in dose of one ''pala'', mixed with half ''pala'' of honey. It useful in dyspnea, cough, anemia, ''halimaka'' (type of jaundice), heart disease and disorders of ''grahani'' (malabsorption syndrome) [86-89]

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===== Treatment of [[pitta]]ja hridroga =====

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===== Treatment of [[pitta]]ja hridroga =====

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#Cold juice of sweet fruits or sugar cane is useful in ''paittika hridroga''.[95]

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===== Treatment of [[kapha]]ja hridroga =====

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===== Treatment of [[kapha]]ja hridroga =====

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#Decoction (three part) of ''udumbara, asvattha, vata, arjuna, palasa, rohitaka, khadira'' and powder of ''trivrita, trikatu''(''shunti ,maricha, pippali'') and made into a linctus (''lehya'').Taken with warm water cures [[kapha]]ja hridroga''. [98]

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====== ''Rasayanas'' for [[kapha]]ja hridroga ======

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====== ''Rasayanas'' for [[kapha]]ja hridroga ======

An expert physician may also administer ''silajatu'' according to the method prescribed in [[rasayana]] section to get its rejuvenating effect. ''Chyavanaprasha, agastyaharitaki, brahma rasayana'' or ''amalaki rasayana'' may also be used for the patient suffering from [[kapha]]ja type of ''hridroga''. [99]

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===== Treatment of tri[[dosha]]ja/sannipatika hridroga =====

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===== Treatment of tri[[dosha]]ja/sannipatika hridroga =====

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===== Treatment of supra-clavicular diseases (''urdhva jatrugata roga'') =====

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===== Treatment of [[vata]]ja pinasa =====

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===== Treatment of [[vata]]ja pinasa =====

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Patient should live in wind-free warm room and avoid anxiety, exertion, excessive speech and sexual intercourse considering once own well being. [143]

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===== Treatment of [[pitta]]ja pinasa =====

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===== Treatment of [[pitta]]ja pinasa =====

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</div></div>

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====== Treatment of [[kapha]]ja pinasa ======

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====== Treatment of [[kapha]]ja pinasa ======

#In [[kapha]]ja pinasa, associated with heaviness and anorexia, fasting therapy should be advised. For digestion (of impurity) head should be smeared with ghee and then, fomentation and affusion therapies should be administered. [149]

#Garlic mixed with powder of green gram, ''trikatu, yavakshara'' and ghee should be given to reduce the alleviated [[kapha]]. When [[kapha]] is in excess alleviated condition then emetic therapy should be given with [[kapha]] alleviating medicines. [150]

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#Treatment for diminished/ milder [[kapha]]ja pinasa: The patient should be given oleation therapy followed by emetic therapy. Gruel prepared out of ''tila'' and black gram by adding milk boiled with emetic drugs should be used in this emetic therapy. [155]

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====== Diet for [[kapha]]ja pinasa ======

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====== Diet for [[kapha]]ja pinasa ======

Soups of ''vartaka, patola, trikatu, kulattha, adhaki, mudga'' and [[kapha]] alleviating cereals and affusion of hot water is to be advised. [156]

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</div></div>

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===== Treatment of [[vata]]ja head diseases =====

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===== Treatment of [[vata]]ja head diseases =====

#General treatment of [[vata]]ja head diseases: oleation, fomentation and snuffing/ inhalation therapy, [[vata]] alleviating diet and poultices are used. [158]

#Hot poultices/''upanaha'': One should use the paste of drugs of the ''agaru'' etc group, ''jivaniya'' group, ''sumanas'' (flowers of ''jati'') or of fish or meat fried in oil and used for lukewarm poultices. [159]

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“A wise physician may prepare ''ghrita'', with the above mentioned ingredients and the procedure, with rats, chickens, swans and rabbits (substituted for the peacock (''mayura'')) which also cure supraclavicular disorders” [175]

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===== Treatment of [[pitta]]ja diseases of head =====

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===== Treatment of [[pitta]]ja diseases of head =====

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#The [[nasya]] in diseases of head: Ghee fortified with ingredients such as ''madhuyashti, chandana, ananta'' and milk is used for [[nasya]]. Similarly medicated ghee prepared from ''sharkara, draksha, madhuka'' is useful in [[pitta]]ja head disease. [179]

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===== Treatment of [[kapha]]ja, sannipatika and krimija head diseases =====

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===== Treatment of [[kapha]]ja, sannipatika and krimija head diseases =====

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</div></div>

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====== General treatment of [[kapha]]ja head diseases ======

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====== General treatment of [[kapha]]ja head diseases ======

Fomentation therapy, smoking, snuffing and insufflation of powders in to nostrils and then managed with [[kapha]]-alleviating paste and diet along with intake of old ghee and teekshna [[basti]] (medicated enema having strong cleansing property). [180-181]

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==== Researches done on [[Trimarmiya Chikitsa]] ====

#Mohanlal P.K. (1976): A study on Tri-marma W.S.R. to Hridaya, , Trivandrum

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#Thakare S.S. (1992): Charakokta Trimarmo mein Basti marma ka rachanatmaka ~~Visihesh Adhayana.~~ , Nagpur

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#Thakare S.S. (1992): Charakokta Trimarmo mein Basti marma ka rachanatmaka Vishesh Adhyayana , Nagpur

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#Waghmare S.S. (2003): Charak samhita varnita trimarmi paiki Hridaya Marma cha itar samhitatil sthana va tya babat vivechanatkaka rugna adhyanana, R K T. [[Ayurveda]] ~~Maha-vidhyalaya~~, Akola

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#Waghmare S.S. (2003): Charak samhita varnita trimarmi paiki Hridaya Marma cha itar samhitatil sthana va tya babat vivechanatkaka rugna adhyanana, R K T. [[Ayurveda]] Mahavidyalaya, Akola

#Chirag Goradiya, (2006): An applied aspect of Trimarmiya Adhyaya (Charak Chikitsa 26 and Siddhi 9) wsr to Mutraukasada, Jamnagar.

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#Chaudhari R. C. (1997): “Mootraashmari Par Aayurvedeeya Aushadhiyon Kaa Prab-haavaatmaka Adhyayana”.

===== Puri =====

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#Sunita Mahapatra (2003): “Management of Mootraashmari (Urinary Calculus) with ~~In-digenous~~ Drugs”.

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#Sunita Mahapatra (2003): “Management of Mootraashmari (Urinary Calculus) with Indigenous Drugs”.

==== Causes, prevalence, clinical features and management of diseases of heart ====

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====== Preventive aspect ======

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Prevention of cardiac diseases can be done by following dietary regulations, lifestyle modifications, [[Panchakarma]] (body purification therapies), psychotherapies as per ''dosha'' dominance in ''prakriti''.

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Prevention of cardiac diseases can be done by following dietary regulations, lifestyle modifications, [[Panchakarma]] (body purification therapies), psychotherapies as per [[dosha]] dominance in [[prakriti]].

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The management emphasizes upon prevention of any obstruction to flow of ''vata dosha''. Facilitating the movement of ''vata'' in its proper direction is the key factor in management of heart diseases. The flow of ''vata'' with respect to cardiac functions is observed in respiration, digestive processes, nervous conduction, and blood circulation. If there is any obstruction in any of these functions, then cardiac function is affected. Hence the preventive and curative aspect focuses on proper unobstructed functioning of ''vata'' in body.

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The management emphasizes upon prevention of any obstruction to flow of [[vata dosha]]. Facilitating the movement of [[vata]] in its proper direction is the key factor in management of heart diseases. The flow of [[vata]] with respect to cardiac functions is observed in respiration, digestive processes, nervous conduction, and blood circulation. If there is any obstruction in any of these functions, then cardiac function is affected. Hence the preventive and curative aspect focuses on proper unobstructed functioning of [[vata]] in body.

====== Management of disease ======

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