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==([[Chikitsa Sthana]] Chapter 19, )

==([[Chikitsa Sthana]] Chapter 19, )==

Atisara Chikitsitam

Atisara Chikitsitam

(Management of diarrhea and associated disorders)

(Management of diarrhea and associated disorders)

Abstract:  The chapter on Atisara chikitsa (management of diarrhoea) - traces the hystorical origin of the disorder since the Vedic period and attributes it to eating of heavy and hot foods specially meat products. There are six types of diarrhoea, three of which are caused by single dosha (vataja, pittaja and kaphaja) while a fourth is caused by the combination of all the three doshas. The fifth and sixth types are caused due to psychological factors such as fear and grief. Some of these variants could be further classified based on their constituents, e.g., vataja atisara (diarrhea caused due to vata dosha) is further divided into amaja and nirāmaja atisara (with or without mucoid substances diarrhoea) and it has been emphasized not to stop the lose motions in initial or ama stage.  

 

=== Abstract ===

 

The chapter on Atisara chikitsa (management of diarrhoea) - traces the hystorical origin of the disorder since the Vedic period and attributes it to eating of heavy and hot foods specially meat products. There are six types of diarrhoea, three of which are caused by single dosha (vataja, pittaja and kaphaja) while a fourth is caused by the combination of all the three doshas. The fifth and sixth types are caused due to psychological factors such as fear and grief. Some of these variants could be further classified based on their constituents, e.g., vataja atisara (diarrhea caused due to vata dosha) is further divided into amaja and nirāmaja atisara (with or without mucoid substances diarrhoea) and it has been emphasized not to stop the lose motions in initial or ama stage.  

The etiology, pathology, signs and symptoms of each of these six types of diarrhoea, along with their prognosis have been detailed here.The principles of treatment and complications associated with diarrhoea, such as bleeding, suppuration, ulceration and  prolapsed anus are also described along with various measures to tackle the problems effectively.  

The etiology, pathology, signs and symptoms of each of these six types of diarrhoea, along with their prognosis have been detailed here.The principles of treatment and complications associated with diarrhoea, such as bleeding, suppuration, ulceration and  prolapsed anus are also described along with various measures to tackle the problems effectively.  

Sangrahi (astringent or anti-diarrheals) therapies are not advisable in the initial stage of the disease beacuase of presence of ama inside the body. Instead, mild laxative should be given to eliminate the accumulated doshas. Diarrhoea should be allowed to continue and should not be stopped by constipating or bowel binding drugs. The patients shall be managed with light to digest, nutritive and liquid diet regimen which enhances power of agni as well as it helps to stop diarrhoea.  

Sangrahi (astringent or anti-diarrheals) therapies are not advisable in the initial stage of the disease beacuase of presence of ama inside the body. Instead, mild laxative should be given to eliminate the accumulated doshas. Diarrhoea should be allowed to continue and should not be stopped by constipating or bowel binding drugs. The patients shall be managed with light to digest, nutritive and liquid diet regimen which enhances power of agni as well as it helps to stop diarrhoea.  

Keywords: atisara, diarrhoea, amaja, niramaja, sangrahi treatment, pichcha basti.  

Keywords: atisara, diarrhoea, amaja, niramaja, sangrahi treatment, pichcha basti.  

Introduction:

 

=== Introduction ===

 

Grahani and atisara - both manifest due to the vitiation of agni and share common features of impairment of digestion resulting in indigestion and loose motions. Therefore, this chapter should logically precede or succeed the chapter on grahani. But it is described three chapters after that on grahani. The reason for this unusual sequencing of these topics is that since pandu is a common symptom and sequelae of the malabsorption syndrome (grahani), the chapter on pandu follows grahani. Now, dyspnea (shvāsa) is a major symptom of pāndu, and thus, follows the chapter on pandu. Similarly, chapter on kāsa (cough) follows  shvāsa because of their relationship. That explains the sequencing of grahani and atisara in Charaka Samhita.

Grahani and atisara - both manifest due to the vitiation of agni and share common features of impairment of digestion resulting in indigestion and loose motions. Therefore, this chapter should logically precede or succeed the chapter on grahani. But it is described three chapters after that on grahani. The reason for this unusual sequencing of these topics is that since pandu is a common symptom and sequelae of the malabsorption syndrome (grahani), the chapter on pandu follows grahani. Now, dyspnea (shvāsa) is a major symptom of pāndu, and thus, follows the chapter on pandu. Similarly, chapter on kāsa (cough) follows  shvāsa because of their relationship. That explains the sequencing of grahani and atisara in Charaka Samhita.

Ayurveda considers atisara as a defence mechanism of the body to eject out any toxic material from it. Therefore, it is recommended that in amaja (or initial) state loose motions should not be checked. After evacuation of toxins from the body, fasting and digestive drugs are prescribed as a cure for milder forms of diarrhoea. However, for other types of diarrhoea, various preparations, diet and basti are advised. Picchabasti (mucilegue type of medicated enema) is prescribed particularly if blood accompanies the stool. Appropriate treatments for ulcer, suppuration of anus and prolapse of anus are dealt with, since these accompany the more complex forms of diarrhoea.  

Ayurveda considers atisara as a defence mechanism of the body to eject out any toxic material from it. Therefore, it is recommended that in amaja (or initial) state loose motions should not be checked. After evacuation of toxins from the body, fasting and digestive drugs are prescribed as a cure for milder forms of diarrhoea. However, for other types of diarrhoea, various preparations, diet and basti are advised. Picchabasti (mucilegue type of medicated enema) is prescribed particularly if blood accompanies the stool. Appropriate treatments for ulcer, suppuration of anus and prolapse of anus are dealt with, since these accompany the more complex forms of diarrhoea.