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अथातोऽतीसारचिकित्सितं व्याख्यास्यामः||१||  

अथातोऽतीसारचिकित्सितं व्याख्यास्यामः||१||  

इति ह स्माह भगवानात्रेयः||२||  

इति ह स्माह भगवानात्रेयः||२||  

athātō'tīsāracikitsitaṁ vyākhyāsyāmaḥ||1||  

athātō'tīsāracikitsitaṁ vyākhyāsyāmaḥ||1||  

iti ha smāha bhagavānātrēyaḥ||2||  

iti ha smāha bhagavānātrēyaḥ||2||  

athAto~atIsAracikitsitaM vyAkhyAsyAmaH||1||  

athAto~atIsAracikitsitaM vyAkhyAsyAmaH||1||  

iti ha smAha bhagavAnAtreyaH||2||  

iti ha smAha bhagavAnAtreyaH||2||  

We shall now illustrate the chapter on the management of atisara (diarrhoea).  Thus, said lord Atreya [1-2]

 

Query by Agnivesha:

We shall now illustrate the chapter on the management of ''atisara'' (diarrhea).  Thus, said lord Atreya [1-2]

भगवन्तंखल्वात्रेयंकृताह्निकंहुताग्निहोत्रमासीनमृषिगणपरिवृतमुत्तरेहिमवतःपार्श्वेविनयादुपेत्याभिवाद्यचाग्निवेशउवाच- भगवन्! अतीसारस्यप्रागुत्पत्तिनिमित्तलक्षणोपशमनानिप्रजानुग्रहार्थमाख्यातुमर्हसीति ||३||

 

bhagavantaṁ khalvātrēyaṁ kr̥tāhnikaṁ hutāgnihōtramāsīnamr̥ṣigaṇaparivr̥tamuttarē himavataḥ pārśvēvinayādupētyābhivādya cāgnivēśa uvācabhagavan! atīsārasya prāgutpattinimittalakṣaṇōpaśamanāniprajānugrahārthamākhyātumarhasīti||3||

==== Query by Agnivesha ====

bhagavantaM khalvAtreyaM kRutAhnikaM hutAgnihotramAsInamRuShigaNaparivRutamuttare himavataHpArshve vinayAdupetyAbhivAdya cAgnivesha uvAca- bhagavan! atIsArasyaprAgutpattinimittalakShaNopashamanAni prajAnugrahArthamAkhyAtumarhasIti||3||  

 

On one occasion, when Lord Atreya was sitting on the northern slope of the Himalayas surrounded by the sages after completing his daily worship and oblations to the fire, Agnivesha approached him, offered his humble salutations to him, and requested him to expound the origin, etiology, signs and symptoms, and treatment of atisāara (diarrhoea) for the wellbeing of humanity [3].

भगवन्तंखल्वात्रेयंकृताह्निकंहुताग्निहोत्रमासीनमृषिगणपरिवृतमुत्तरेहिमवतःपार्श्वेविनयादुपेत्याभिवाद्यचाग्निवेशउवाच-  

Hystorical origins of atisara:

भगवन्! अतीसारस्यप्रागुत्पत्तिनिमित्तलक्षणोपशमनानिप्रजानुग्रहार्थमाख्यातुमर्हसीति ||३||

 

bhagavantaṁ khalvātrēyaṁ kr̥tāhnikaṁ hutāgnihōtramāsīnamr̥ṣigaṇaparivr̥tamuttarē himavataḥ pārśvēvinayādupētyābhivādya cāgnivēśa uvāca

bhagavan! atīsārasya prāgutpattinimittalakṣaṇōpaśamanāniprajānugrahārthamākhyātumarhasīti||3||

 

bhagavantaM khalvAtreyaM kRutAhnikaM hutAgnihotramAsInamRuShigaNaparivRutamuttare himavataHpArshve vinayAdupetyAbhivAdya cAgnivesha uvAca-  

bhagavan! atIsArasyaprAgutpattinimittalakShaNopashamanAni prajAnugrahArthamAkhyAtumarhasIti||3||  

 

On one occasion, when Lord Atreya was sitting on the northern slope of the Himalayas surrounded by the sages after completing his daily worship and oblations to the fire, Agnivesha approached him, offered his humble salutations to him, and requested him to expound the origin, etiology, signs and symptoms, and treatment of ''atisara'' (diarrhea) for the well-being of humanity [3]

 

==== Historical origins of ''atisara'' ====

 

अथभगवान्पुनर्वसुरात्रेयस्तदग्निवेशवचनमनुनिशम्योवाच- श्रूयतामग्निवेश! सर्वमेतदखिलेनव्याख्यायमानम् |  

अथभगवान्पुनर्वसुरात्रेयस्तदग्निवेशवचनमनुनिशम्योवाच- श्रूयतामग्निवेश! सर्वमेतदखिलेनव्याख्यायमानम् |  

आदिकालेखलुयज्ञेषुपशवःसमालभनीयाबभूवुर्नालम्भायप्रक्रियन्तेस्म |  

आदिकालेखलुयज्ञेषुपशवःसमालभनीयाबभूवुर्नालम्भायप्रक्रियन्तेस्म |  

अतश्चप्रत्यवरकालंपृषध्रेणदीर्घसत्रेणयजतापशूनामलाभाद्गवामालम्भःप्रवर्तितः |  

अतश्चप्रत्यवरकालंपृषध्रेणदीर्घसत्रेणयजतापशूनामलाभाद्गवामालम्भःप्रवर्तितः |  

तंदृष्ट्वाप्रव्यथिताभूतगणाः, तेषांचोपयोगादुपाकृतानांगवांगौरवादौष्ण्यादसात्म्यत्वादशस्तोपयोगाच्चोपहताग्नीनामुपहतमनसां[१]चातीसारःपूर्वमुत्पन्नःपृषध्रयज्ञे ||४||

तंदृष्ट्वाप्रव्यथिताभूतगणाः, तेषांचोपयोगादुपाकृतानांगवांगौरवादौष्ण्यादसात्म्यत्वादशस्तोपयोगाच्चोपहताग्नीनामुपहतमनसां[१]चातीसारःपूर्वमुत्पन्नःपृषध्रयज्ञे ||४||

atha bhagavān punarvasurātrēyastadagnivēśavacanamanuniśamyōvāca- śrūyatāmagnivēśa!sarvamētadakhilēna vyākhyāyamānam|  

atha bhagavān punarvasurātrēyastadagnivēśavacanamanuniśamyōvāca- śrūyatāmagnivēśa!sarvamētadakhilēna vyākhyāyamānam|  

ādikālē khalu yajñēṣu paśavaḥ samālabhanīyā babhūvurnālambhāya prakriyantē sma|  

ādikālē khalu yajñēṣu paśavaḥ samālabhanīyā babhūvurnālambhāya prakriyantē sma|  

ataśca pratyavarakālaṁ pr̥ṣadhrēṇa dīrghasatrēṇa yajatā paśūnāmalābhādgavāmālambhaḥ pravartitaḥ|  

ataśca pratyavarakālaṁ pr̥ṣadhrēṇa dīrghasatrēṇa yajatā paśūnāmalābhādgavāmālambhaḥ pravartitaḥ|  

taṁ dr̥ṣṭvā pravyathitā bhūtagaṇāḥ, tēṣāṁ cōpayōgādupākr̥tānāṁ gavāṁgauravādauṣṇyādasātmyatvādaśastōpayōgāccōpahatāgnīnāmupahatamanasāṁ [1] cātīsāraḥpūrvamutpannaḥ pr̥ṣadhrayajñē||4||  

taṁ dr̥ṣṭvā pravyathitā bhūtagaṇāḥ, tēṣāṁ cōpayōgādupākr̥tānāṁ gavāṁgauravādauṣṇyādasātmyatvādaśastōpayōgāccōpahatāgnīnāmupahatamanasāṁ [1] cātīsāraḥpūrvamutpannaḥ pr̥ṣadhrayajñē||4||  

atha bhagavAn punarvasurAtreyastadagniveshavacanamanunishamyovAca- shrUyatAmagnivesha!sarvametadakhilena vyAkhyAyamAnam|  

atha bhagavAn punarvasurAtreyastadagniveshavacanamanunishamyovAca- shrUyatAmagnivesha!sarvametadakhilena vyAkhyAyamAnam|  

AdikAle khalu yaj~jeShu pashavaH samAlabhanIyA babhUvurnAlambhAya prakriyante sma|  

AdikAle khalu yaj~jeShu pashavaH samAlabhanIyA babhUvurnAlambhAya prakriyante sma|  

atashca pratyavarakAlaM pRuShadhreNa dIrghasatreNa yajatA pashUnAmalAbhAdgavAmAlambhaHpravartitaH|  

atashca pratyavarakAlaM pRuShadhreNa dIrghasatreNa yajatA pashUnAmalAbhAdgavAmAlambhaHpravartitaH|  

taM dRuShTvA pravyathitA bhUtagaNAH, teShAM copayogAdupAkRutAnAM gavAMgauravAdauShNyAdasAtmyatvAdashastopayogAccopahatAgnInAmupahatamanasAM [1] cAtIsAraHpUrvamutpannaH pRuShadhrayaj~je||4||  

taM dRuShTvA pravyathitA bhUtagaNAH, teShAM copayogAdupAkRutAnAM gavAMgauravAdauShNyAdasAtmyatvAdashastopayogAccopahatAgnInAmupahatamanasAM [1] cAtIsAraHpUrvamutpannaH pRuShadhrayaj~je||4||  

After consideration of the above submission of Agnivesha, Lord Punarvasu said, “O Agnivesha, listen to me. I shall give a detailed response to your question.   

After consideration of the above submission of Agnivesha, Lord Punarvasu said, “O Agnivesha, listen to me. I shall give a detailed response to your question.   

In the Vedic age/ancient times, sacrificial animals used to get released in the wild soon after the recitation of the sacrificial mantras, and these animals were not killed during the course of the sacrifice (yajna). However, in the subsequent periods following the reign of Daksha Prajapati, the sons of Manu named Narishyana, Nabhag, Ikshvaku, Nriga, and Sharyati, sacrifice of these animals became a part of the yajna (sacrificial ritual) at their instinctive acquiescence. After that, during the sacrifice over a long course of time performed by the prushadra (name of a king), as goats were not obtainable, even the sacred cows were also offered up for sacrifice. This deviation bewildered (or disturbed) all of humanity leading to grief. When the flesh of these sanctified cows were eaten, by the heavy, hot and incompatible to human nature properties of their flesh, as well as the use of what was not prescribed by the scriptures, the people started suffering from the loss of their ability to digest and losing their mental equilibrium, resulting in  atisara (diarrhoea). Thus, diarrhoea originated from the yajna performed by Prushadhra [4]  

 

Vataja atisara:

In the Vedic age/ancient times, sacrificial animals used to get released in the wild soon after the recitation of the sacrificial mantras, and these animals were not killed during the course of the sacrifice (''yajna''). However, in the subsequent periods following the reign of Daksha Prajapati, the sons of Manu named Narishyana, Nabhag, Ikshvaku, Nriga, and Sharyati, sacrifice of these animals became a part of the ''yajna'' (sacrificial ritual) at their instinctive acquiescence. After that, during the sacrifice over a long course of time performed by Prushadra (name of a king), as goats were not obtainable, even the sacred cows were also offered up for sacrifice. This deviation bewildered (or disturbed) all of humanity leading to grief. When the flesh of these sanctified cows were eaten, by the heavy, hot and incompatible to human nature properties of their flesh, as well as the use of what was not prescribed by the scriptures, the people started suffering from the loss of their ability to digest and losing their mental equilibrium, resulting in  ''atisara'' (diarrhea). Thus, diarrhea originated from the ''yajna'' performed by Prushadhra [4]  

 

==== ''Vataja atisara'' ====

 

अथावरकालंवातलस्यवातातपव्यायामात्रनिषेविणोरूक्षाल्पप्रमिताशिनस्तीक्ष्णमद्यव्यवायनित्यस्योदावर्तयतश्चवेगान्वायुःप्रकोपमापद्यते, पक्ताचोपहन्यते; सवायुःकुपितोऽग्नावुपहतेमूत्रस्वेदौपुरीषाशयमुपहृत्य, ताभ्यांपुरीषंद्रवीकृत्य, अतीसारायप्रकल्पते |  

अथावरकालंवातलस्यवातातपव्यायामात्रनिषेविणोरूक्षाल्पप्रमिताशिनस्तीक्ष्णमद्यव्यवायनित्यस्योदावर्तयतश्चवेगान्वायुःप्रकोपमापद्यते, पक्ताचोपहन्यते; सवायुःकुपितोऽग्नावुपहतेमूत्रस्वेदौपुरीषाशयमुपहृत्य, ताभ्यांपुरीषंद्रवीकृत्य, अतीसारायप्रकल्पते |  

तस्यरूपाणि- विज्जलमामंविप्लुतमवसादिरूक्षंद्रवंसशूलमामगन्धमीषच्छब्दमशब्दंवाविबद्धमूत्रवातमतिसार्यतेपुरीषं, वायुश्चान्तःकोष्ठेसशब्दशूलस्तिर्यक्चरतिविबद्धइत्यामातिसारोवातात् |  

तस्यरूपाणि- विज्जलमामंविप्लुतमवसादिरूक्षंद्रवंसशूलमामगन्धमीषच्छब्दमशब्दंवाविबद्धमूत्रवातमतिसार्यतेपुरीषं, वायुश्चान्तःकोष्ठेसशब्दशूलस्तिर्यक्चरतिविबद्धइत्यामातिसारोवातात् |  

पक्वंवाविबद्धमल्पाल्पंसशब्दंसशूलफेनपिच्छापरिकर्तिकंहृष्टरोमाविनिःश्वसञ्शुष्कमुखःकट्यूरुत्रिकजानुपृष्ठपार्श्वशूलीभ्रष्टगुदोमुहुर्मुहुर्विग्रथितमुपवेश्यतेपुरीषंवातात्; तमाहुरनुग्रथितमित्येके, वातानुग्रथितवर्चस्त्वात् ||५||

पक्वंवाविबद्धमल्पाल्पंसशब्दंसशूलफेनपिच्छापरिकर्तिकंहृष्टरोमाविनिःश्वसञ्शुष्कमुखःकट्यूरुत्रिकजानुपृष्ठपार्श्वशूलीभ्रष्टगुदोमुहुर्मुहुर्विग्रथितमुपवेश्यतेपुरीषंवातात्; तमाहुरनुग्रथितमित्येके, वातानुग्रथितवर्चस्त्वात् ||५||

athāvarakālaṁ vātalasya vātātapavyāyāmātimātraniṣēviṇōrūkṣālpapramitāśinastīkṣṇamadyavyavāyanityasyōdāvartayataśca vēgān vāyuḥ prakōpamāpadyatē, paktācōpahanyatē; sa vāyuḥ kupitō'gnāvupahatē mūtrasvēdau purīṣāśayamupahr̥tya, tābhyāṁ purīṣaṁdravīkr̥tya, atīsārāya prakalpatē|  

athāvarakālaṁ vātalasya vātātapavyāyāmātimātraniṣēviṇōrūkṣālpapramitāśinastīkṣṇamadyavyavāyanityasyōdāvartayataśca vēgān vāyuḥ prakōpamāpadyatē, paktācōpahanyatē; sa vāyuḥ kupitō'gnāvupahatē mūtrasvēdau purīṣāśayamupahr̥tya, tābhyāṁ purīṣaṁdravīkr̥tya, atīsārāya prakalpatē|  

tasya rūpāṇivijjalamāmaṁ viplutamavasādi rūkṣaṁ dravaṁ saśūlamāmagandhamīṣacchabdamaśabdaṁvā vibaddhamūtravātamatisāryatē purīṣaṁ, vāyuścāntaḥkōṣṭhē saśabdaśūlastiryak carati vibaddhaityāmātisārō vātāt|  

tasya rūpāṇivijjalamāmaṁ viplutamavasādi rūkṣaṁ dravaṁ saśūlamāmagandhamīṣacchabdamaśabdaṁvā vibaddhamūtravātamatisāryatē purīṣaṁ, vāyuścāntaḥkōṣṭhē saśabdaśūlastiryak carati vibaddhaityāmātisārō vātāt|  

pakvaṁ vā vibaddhamalpālpaṁ saśabdaṁ saśūlaphēnapicchāparikartikaṁ hr̥ṣṭarōmā viniḥśvasañśuṣkamukhaḥ kaṭyūrutrikajānupr̥ṣṭhapārśvaśūlī bhraṣṭagudō muhurmuhurvigrathitamupavēśyatē purīṣaṁvātāt; tamāhuranugrathitamityēkē, vātānugrathitavarcastvāt||5||

pakvaṁ vā vibaddhamalpālpaṁ saśabdaṁ saśūlaphēnapicchāparikartikaṁ hr̥ṣṭarōmā viniḥśvasañśuṣkamukhaḥ kaṭyūrutrikajānupr̥ṣṭhapārśvaśūlī bhraṣṭagudō muhurmuhurvigrathitamupavēśyatē purīṣaṁvātāt; tamāhuranugrathitamityēkē, vātānugrathitavarcastvāt||5||

athAvarakAlaM vAtalasya vAtAtapavyAyAmAtimAtraniSheviNorUkShAlpapramitAshinastIkShNamadyavyavAyanityasyodAvartayatashca vegAn vAyuHprakopamApadyate, paktA copahanyate; sa vAyuH kupito~agnAvupahate mUtrasvedaupurIShAshayamupahRutya, tAbhyAM purIShaM dravIkRutya, atIsArAya prakalpate|  

 

athAvarakAlaM vAtalasya vAtAtapavyAyAmAtimAtraniSheviNorUkShAlpapramitAshinastIkShNamadyavyavAyanityasyodAvartayatashca vegAn vAyuHprakopamApadyate, paktA copahanyate; sa vAyuH kupito~agnAvupahate mUtrasvedaupurIShAshayamupahRutya, tAbhyAM purIShaM dravIkRutya, atIsArAya prakalpate|  

tasya rUpANi- vijjalamAmaM viplutamavasAdi rUkShaM dravaMsashUlamAmagandhamIShacchabdamashabdaM vA vibaddhamUtravAtamatisAryate purIShaM,vAyushcAntaHkoShThe sashabdashUlastiryak carati vibaddha ityAmAtisAro vAtAt|  

tasya rUpANi- vijjalamAmaM viplutamavasAdi rUkShaM dravaMsashUlamAmagandhamIShacchabdamashabdaM vA vibaddhamUtravAtamatisAryate purIShaM,vAyushcAntaHkoShThe sashabdashUlastiryak carati vibaddha ityAmAtisAro vAtAt|  

pakvaM vA vibaddhamalpAlpaM sashabdaM sashUlaphenapicchAparikartikaM hRuShTaromA viniHshvasa~jshuShkamukhaH kaTyUrutrikajAnupRuShThapArshvashUlI bhraShTagudomuhurmuhurvigrathitamupaveshyate purIShaM vAtAt; tamAhuranugrathitamityeke,vAtAnugrathitavarcastvAt||5||  

pakvaM vA vibaddhamalpAlpaM sashabdaM sashUlaphenapicchAparikartikaM hRuShTaromA viniHshvasa~jshuShkamukhaH kaTyUrutrikajAnupRuShThapArshvashUlI bhraShTagudomuhurmuhurvigrathitamupaveshyate purIShaM vAtAt; tamAhuranugrathitamityeke,vAtAnugrathitavarcastvAt||5||  

• Vata dominant atisara occurs if a person with vata dominant constitution indulges in following: Exposure to strong wind, excess sunlight, and physical exercise;

 

• Indulgence in dry and rough or less quantities of food (pramitashana) or irregular meals  or strong alcoholic drinks or excessive sexual intercourse; and

*''Vata'' dominant ''atisara'' occurs if a person with ''vata'' dominant constitution indulges in following: Exposure to strong wind, excess sunlight, and physical exercise;

• Suppression of natural urges.

*Indulgence in dry and rough or less quantities of food (''pramitashana'') or irregular meals  or strong alcoholic drinks or excessive sexual intercourse; and

The above factors aggravate vata, afflicting the power of digestion (or, reducing the agni). With the depletion of agni, the aggravated vata forces urine and sweat to the colon (purishashaya), liquefying the stool and manifesting vataja atisara.

*Suppression of natural urges.

Vataja amaja atisara (early stages of vataja atisara):

 

The early signs and symptoms of vataja amaja atisara are as follows:

The above factors aggravate ''vata'', afflicting the power of digestion (or, reducing the ''agni''). With the depletion of ''agni'', the aggravated ''vata'' forces urine and sweat to the colon (''purishashaya''), liquefying the stool and manifesting ''vataja atisara''.

• The stool is slimy and has mucus (ama);

 

• The stool floats on water;

''Vataja amaja atisara'' (early stages of ''vataja atisara''):

• The stool, when placed over the earth, gets soaked;

 

• The stool is rough (i.e., not oily) and liquid;

The early signs and symptoms of ''vataja amaja atisara'' are as follows:

• Evacuation of stool is accompanied with colic pain;

*The stool is slimy and has mucus (''ama'');

• The stool smells like undigested food;

*The stool floats on water;

• Evacuation of stool is associated with little or no sound;

*The stool, when placed over the earth, gets soaked;

• Evacuation of the stool is not accompanied with flatus and urine; and

*The stool is rough (i.e., not oily) and liquid;

• The aggravated vata (flatus) moves in the kostha (gastrointestinal tract) obliquely along with gurgling sound, causing colic pain.

*Evacuation of stool is accompanied with colic pain;

The above mentioned signs and symptoms pertain to the ama stage (primary or immature stage) of the vataja atisara.

*The stool smells like undigested food;

Vataja niramaja atisara (advanced stage of vataja atisara):

*Evacuation of stool is associated with little or no sound;

In the pakva stage (advanced or mature stage) of vataja atisara, the signs and symptoms manifested are as follows:  

*Evacuation of the stool is not accompanied with flatus and urine; and

• The patient evacuates hard stool in small quantities;

*The aggravated ''vata'' (flatus) moves in the ''koshtha'' (gastrointestinal tract) obliquely along with gurgling sound, causing colic pain.

• The evacuation of stool is associated with sound and colic pain;

 

• The stool is frothy and slimy;  

The above mentioned signs and symptoms pertain to the ''ama'' stage (primary or immature stage) of the ''vataja atisara''.

• The patient suffers from griping pain, horripilation, groaning, dryness of the mouth, pain in the lumbar region, thighs, sacral region, knees, back and sides of the chest, and prolapse of the rectum; and

 

• Evacuates scybalous stool frequently.

''Vataja niramaja atisara'' (advanced stage of ''vataja atisara''):

According to some physicians, this type of diarrhoea is also called anugrathita-atisara because of evacuation the scybalous stool. [5]  

 

Pittaja atisara:

In the ''pakva'' stage (advanced or mature stage) of ''vataja atisara'', the signs and symptoms manifested are as follows:  

*The patient evacuates hard stool in small quantities;

*The evacuation of stool is associated with sound and colic pain;

*The stool is frothy and slimy;  

*The patient suffers from griping pain, horripilation, groaning, dryness of the mouth, pain in the lumbar region, thighs, sacral region, knees, back and sides of the chest, and prolapse of the rectum; and

*Evacuates scybalous stool frequently.

 

According to some physicians, this type of diarrhea is also called ''anugrathita-atisara'' because of evacuation the scybalous stool. [5]  

 

==== ''Pittaja atisara'' ====

 

पित्तलस्यपुनरम्ललवणकटुकक्षारोष्णतीक्ष्णातिमात्रनिषेविणःप्रतताग्निसूर्यसन्तापोष्णमारुतोपहतगात्रस्यक्रोधेर्ष्याबहुलस्यपित्तंप्रकोपमापद्यते |  

पित्तलस्यपुनरम्ललवणकटुकक्षारोष्णतीक्ष्णातिमात्रनिषेविणःप्रतताग्निसूर्यसन्तापोष्णमारुतोपहतगात्रस्यक्रोधेर्ष्याबहुलस्यपित्तंप्रकोपमापद्यते |  

तत्प्रकुपितंद्रवत्वादूष्माणमुपहत्यपुरीषाशयविसृतमौष्ण्याद्द्रवत्वात्सरत्वाच्चभित्त्वापुरीषमतिसारायप्रकल्पते | तस्यरूपाणि- हारिद्रंहरितंनीलंकृष्णंरक्तपित्तोपहितमतिदुर्गन्धमतिसार्यते[१]पुरीषं, तृष्णादाह स्वेद मूर्च्छाशूलब्रध्नसन्तापपाकपरीतइतिपित्तातिसारः ||६|| pittalasya punaramlalavaṇakaṭukakṣārōṣṇatīkṣṇātimātraniṣēviṇaḥpratatāgnisūryasantāpōṣṇamārutōpahatagātrasya krōdhērṣyābahulasya pittaṁ prakōpamāpadyatē|  

तत्प्रकुपितंद्रवत्वादूष्माणमुपहत्यपुरीषाशयविसृतमौष्ण्याद्द्रवत्वात्सरत्वाच्चभित्त्वापुरीषमतिसारायप्रकल्पते | तस्यरूपाणि- हारिद्रंहरितंनीलंकृष्णंरक्तपित्तोपहितमतिदुर्गन्धमतिसार्यते[१]पुरीषं, तृष्णादाह स्वेद मूर्च्छाशूलब्रध्नसन्तापपाकपरीतइतिपित्तातिसारः ||६|| pittalasya punaramlalavaṇakaṭukakṣārōṣṇatīkṣṇātimātraniṣēviṇaḥpratatāgnisūryasantāpōṣṇamārutōpahatagātrasya krōdhērṣyābahulasya pittaṁ prakōpamāpadyatē|