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''Gandusha'' (filling the mouth to its full capacity with liquid without allowing its movement in oral cavity) with various sweet and sour drugs is useful in thirst. ''Madhura rasa'' pacify ''pitta'' whereas ''amla rasa'' is cold on external application and increases salivation so both have soothing effect in dry mouth.(Su.Su.42/10) Use of ''amla'' drugs in the form of external application has also been advocated as they have cooling effect on touch. Thinking about cold things and environment is a part of psychotherapy which helps patient to combat desire of water.
 
''Gandusha'' (filling the mouth to its full capacity with liquid without allowing its movement in oral cavity) with various sweet and sour drugs is useful in thirst. ''Madhura rasa'' pacify ''pitta'' whereas ''amla rasa'' is cold on external application and increases salivation so both have soothing effect in dry mouth.(Su.Su.42/10) Use of ''amla'' drugs in the form of external application has also been advocated as they have cooling effect on touch. Thinking about cold things and environment is a part of psychotherapy which helps patient to combat desire of water.
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===== Management of ''vata'' dominant ''trishna'': =====
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===== Management of ''vata'' dominant ''trishna'' =====
All dietary formulations and drugs used in vataja trishna must have property to pacify vata. Milk and ghrita mentioned in kshayaja kasa (like dvipancamuladi ghrita, guduchyadi ghrita, kasmardadi ghrita etc.) pacify vata dosha effectively and thus these preparations can also be used in vataja trishna.
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All dietary formulations and drugs used in ''vataja trishna'' must have property to pacify ''vata''. Milk and ''ghrita'' mentioned in ''kshayaja kasa'' (like ''dwipanchamuladi ghrita, guduchyadi ghrita, kasmardadi ghrita'' etc.) pacify ''vata dosha'' effectively and thus these preparations can also be used in ''vataja trishna''.
Management of pitta dominant trishna:
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Various pitta pacifying drugs mixed with water are mentioned in treatment of pittaja trishna. These drugs pacify pitta as well as they are useful in maintaining water homeostasis.
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===== Management of ''pitta'' dominant ''trishna'' =====
Water obtained after quenching of baked earth is said to be best for pacifying excessive thirst in agrya prakarana. This simple method can be clinically evaluated in patients of morbid thirst. (Cha.Su.25/40).
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Management of amaja trishna:
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Various ''pitta'' pacifying drugs mixed with water are mentioned in treatment of ''pittaja trishna''. These drugs pacify ''pitta'' as well as they are useful in maintaining water homeostasis.
To treat amaja trishna, it is necessary that first ama is removed. For ama pachana drugs which increase agni can be used as well. Treatment of kaphaja chhardi can be followed as kapha nasaka treatment helps to remove ama. If symptoms pertaining to ama are seen than ama should be removed by inducing emesis and warm water should be used to increase agni to remove ama. As discussed earlier ‘kshaya’ refers to emaciation of tissues. So, treatment which helps in revitalizing the tissue can be used as mentioned in kshatakshina, shosha can also be used.
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Management of trishna due to madatyaya:
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Water obtained after quenching of baked earth is said to be best for pacifying excessive thirst in ''agrya prakarana''. This simple method can be clinically evaluated in patients of morbid thirst. (Cha.Su.25/40).
Use of alcohol for treating thirst induced due to alcohol is example of ‘Hetu Vipritarthakari’ (treatment with a substance similar to the cause).
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===== Management of ''amaja trishna'' =====
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To treat ''amaja trishna'', it is necessary that first ''ama'' is removed. For ''ama pachana'' drugs which increase ''agni'' can be used as well. Treatment of ''kaphaja chhardi'' can be followed as ''kapha nasaka'' treatment helps to remove ''ama''. If symptoms pertaining to ''ama'' are seen than ''ama'' should be removed by inducing emesis and warm water should be used to increase ''agni'' to remove ''ama''. As discussed earlier ''kshaya'' refers to emaciation of tissues. So, treatment which helps in revitalizing the tissue can be used as mentioned in ''kshatakshina, shosha'' can also be used.
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===== Management of ''trishna'' due to ''madatyaya'' =====
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Use of alcohol for treating thirst induced due to alcohol is example of ''Hetu Vipritarthakari'' (treatment with a substance similar to the cause).
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===== Effect of cold water and hot water on body fluid balance =====
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Effect of cold water and hot water on body fluid balance:
   
In conditions of dehydration and where pitta is dominant (Ddaha, bhrama, madatyaya etc) cold water should be given as it restores water content in body as well as pacify pitta by its shita guna. After boiling, water becomes free from various micro-organisms. Boiled water should be used in sanipattika diseases after cooling, such diseases are difficult to treat. In a study it was found that temperature range from 55 to 65 degree C is critical for effective elimination of enteric/pathogenic bacterial components [ ] As all three dosha are involved we can’t use hot or cold water as they will aggravate atleast one of the dosha (hot will increase pitta, cold water will increase vata/kapha) so normal water should be used.
 
In conditions of dehydration and where pitta is dominant (Ddaha, bhrama, madatyaya etc) cold water should be given as it restores water content in body as well as pacify pitta by its shita guna. After boiling, water becomes free from various micro-organisms. Boiled water should be used in sanipattika diseases after cooling, such diseases are difficult to treat. In a study it was found that temperature range from 55 to 65 degree C is critical for effective elimination of enteric/pathogenic bacterial components [ ] As all three dosha are involved we can’t use hot or cold water as they will aggravate atleast one of the dosha (hot will increase pitta, cold water will increase vata/kapha) so normal water should be used.
 
In conditions with vata/kapha /vata-kapha dominance like hikka-shwasa (kapha vata tamako), fever of recent origin (nutana jwara in samavastha) etc. Warm water should be given. After ghrita consumption, warm water should be used as it increases absorption of ghrita. Warm water increases agni in nutan jwara.( Ca. Ci. 3/144;  Ca.Vi.3/40)
 
In conditions with vata/kapha /vata-kapha dominance like hikka-shwasa (kapha vata tamako), fever of recent origin (nutana jwara in samavastha) etc. Warm water should be given. After ghrita consumption, warm water should be used as it increases absorption of ghrita. Warm water increases agni in nutan jwara.( Ca. Ci. 3/144;  Ca.Vi.3/40)