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==([[Chikitsa Sthana Chapter 22. TrishnChapter on management of morbid thirst)

==([[Chikitsa Sthana]] Chapter 22, Chapter on management of morbid thirst) ==

Abstract:

 

=== Abstract ===

 

Trishna and pipasa are two commonly used words denoting desire for water, the difference between the two is, trishna is pathological and pipasa is physiological. Generally, desire for water is physiological process to maintain fluid balance but if dosha are vitiated then they can lead to excessive thirst and can produce trishna, a disease in which person constantly craves for the water. Beside independent disease, trishna or thirst is also seen as prodromal symptom, clinical feature, complication, poor prognostic sign etc. in various clinical conditions. In this chapter, etiological factors, premonitory symptoms, pathogenesis, clinical features and complications of trishna as a disease are discussed.

Trishna and pipasa are two commonly used words denoting desire for water, the difference between the two is, trishna is pathological and pipasa is physiological. Generally, desire for water is physiological process to maintain fluid balance but if dosha are vitiated then they can lead to excessive thirst and can produce trishna, a disease in which person constantly craves for the water. Beside independent disease, trishna or thirst is also seen as prodromal symptom, clinical feature, complication, poor prognostic sign etc. in various clinical conditions. In this chapter, etiological factors, premonitory symptoms, pathogenesis, clinical features and complications of trishna as a disease are discussed.

Key words: trishna, vata, pitta, mukha shosha, jala, thirst, polydipsia, water  and fluid balance, osmosis, ion balance.   

 

Introduction:

'''Keywords''': trishna, vata, pitta, mukha shosha, jala, thirst, polydipsia, water  and fluid balance, osmosis, ion balance.  

   

=== Introduction ===

‘Water is not necessary to life but rather life itself’ – This quotation describes importance of water in our life. Water is the most abundant constituent in the body, comprising approximately 50% of body weight in women and 60% in men.[ ] It is crucial for survival as it performs various functions. It transports nutrients to the tissues, removes metabolic waste products, detoxifies body elements, regulates body temperature, maintains pH, electrolyte balance etc. and homeostasis of body. In normal physiological process, certain amount of fluid is lost continuously. If this fluid balance is not maintained then, both acute and chronic fluid deficits may lead to number of adverse health outcomes. Even modest fluid deficits may precipitate adverse events, especially in young children, in the frail elderly and in those with poor health. [ ] Fluid balance in body is maintained via thirst, a feedback-controlled variable, regulated acutely by central and peripheral mechanisms. [ ] Thirst is physiological but when it exceeds its threshold it becomes pathological and is common in many diseases. Modern science accepts it as symptom only and have not given it as an entity of ‘disease’. Ayurveda is more comprehensive and broader in its approach. Fluid imbalance is a major cause of morbidity and mortality and considering this fact ‘thirst’ which is an indicator of fluid imbalance has been described as separate disease and not merely a symptom.

‘Water is not necessary to life but rather life itself’ – This quotation describes importance of water in our life. Water is the most abundant constituent in the body, comprising approximately 50% of body weight in women and 60% in men.[ ] It is crucial for survival as it performs various functions. It transports nutrients to the tissues, removes metabolic waste products, detoxifies body elements, regulates body temperature, maintains pH, electrolyte balance etc. and homeostasis of body. In normal physiological process, certain amount of fluid is lost continuously. If this fluid balance is not maintained then, both acute and chronic fluid deficits may lead to number of adverse health outcomes. Even modest fluid deficits may precipitate adverse events, especially in young children, in the frail elderly and in those with poor health. [ ] Fluid balance in body is maintained via thirst, a feedback-controlled variable, regulated acutely by central and peripheral mechanisms. [ ] Thirst is physiological but when it exceeds its threshold it becomes pathological and is common in many diseases. Modern science accepts it as symptom only and have not given it as an entity of ‘disease’. Ayurveda is more comprehensive and broader in its approach. Fluid imbalance is a major cause of morbidity and mortality and considering this fact ‘thirst’ which is an indicator of fluid imbalance has been described as separate disease and not merely a symptom.

The other meaning of trishna is greed or insatiable desire for something. It can be referred that word trishna not only denotes physical craving but includes psychological desires also. In morbid thirst both body and mind crave and there are conditions like psychogenic polydypsia in which thirst is only due to mental involvement. As mind plays an important role in thirst as a disease this chapter has been named as “trishna chikitsitam” not “pipasa chikitsitam.  

The other meaning of trishna is greed or insatiable desire for something. It can be referred that word trishna not only denotes physical craving but includes psychological desires also. In morbid thirst both body and mind crave and there are conditions like psychogenic polydypsia in which thirst is only due to mental involvement. As mind plays an important role in thirst as a disease this chapter has been named as “trishna chikitsitam” not “pipasa chikitsitam.