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मारुतोभयशोकाभ्यांशीघ्रंहिपरिकुप्यति |  

मारुतोभयशोकाभ्यांशीघ्रंहिपरिकुप्यति |  

तयोःक्रियावातहरीहर्षणाश्वासनानिच ||१२||  

तयोःक्रियावातहरीहर्षणाश्वासनानिच ||१२||  

इत्युक्ताःषडतीसाराः, साध्यानांसाधनंत्वतः |  

इत्युक्ताःषडतीसाराः, साध्यानांसाधनंत्वतः |  

प्रवक्ष्याम्यनुपूर्वेणयथावत्तन्निबोधत ||१३||

प्रवक्ष्याम्यनुपूर्वेणयथावत्तन्निबोधत ||१३||

mārutō bhayaśōkābhyāṁ śīghraṁ hi parikupyati|  

mārutō bhayaśōkābhyāṁ śīghraṁ hi parikupyati|  

tayōḥ kriyā vātaharī harṣaṇāśvāsanāni ca||12||  

tayōḥ kriyā vātaharī harṣaṇāśvāsanāni ca||12||  

ityuktāḥ ṣaḍatīsārāḥ, sādhyānāṁ sādhanaṁ tvataḥ|  

ityuktāḥ ṣaḍatīsārāḥ, sādhyānāṁ sādhanaṁ tvataḥ|  

pravakṣyāmyanupūrvēṇa yathāvattannibōdhata||13||

pravakṣyāmyanupūrvēṇa yathāvattannibōdhata||13||

mAruto bhayashokAbhyAM shIghraM hi parikupyati|  

mAruto bhayashokAbhyAM shIghraM hi parikupyati|  

tayoH kriyA vAtaharI harShaNAshvAsanAni ca||12||  

tayoH kriyA vAtaharI harShaNAshvAsanAni ca||12||  

ityuktAH ShaDatIsArAH, sAdhyAnAM sAdhanaM tvataH|  

ityuktAH ShaDatIsArAH, sAdhyAnAM sAdhanaM tvataH|  

pravakShyAmyanupUrveNa yathAvattannibodhata||13||  

pravakShyAmyanupUrveNa yathAvattannibodhata||13||  

The following therapies help to cure agantuja/mānasa or exogenous:

 

Both fear and grief causes aggravation of vata instantaneously. Vata alleviating drugs and therapies should be administered for the treatment of exogenous atisara. The patient suffering from diarrhoea caused by fear (bhayaja) should be exhilarated.  The patient suffering from diarrhoea caused by shoka (grief) should be consoled [12-13]  

The following therapies help to cure ''agantuja/manasa'' or exogenous:

Principles of treatment:

 

Both fear and grief causes aggravation of ''vata'' instantaneously. ''Vata'' alleviating drugs and therapies should be administered for the treatment of exogenous ''atisara''. The patient suffering from diarrhea caused by fear (''bhayaja'') should be exhilarated.  The patient suffering from diarrhea caused by ''shoka'' (grief) should be consoled [12-13]  

 

==== Principles of treatment ====

 

दोषाःसन्निचितायस्यविदग्धाहारमूर्च्छिताः |  

दोषाःसन्निचितायस्यविदग्धाहारमूर्च्छिताः |  

अतीसारायकल्पन्तेभूयस्तान्सम्प्रवर्तयेत् ||१४||  

अतीसारायकल्पन्तेभूयस्तान्सम्प्रवर्तयेत् ||१४||  

नतुसङ्ग्रहणंदेयंपूर्वमामातिसारिणे |  

नतुसङ्ग्रहणंदेयंपूर्वमामातिसारिणे |  

विबध्यमानाःप्राग्दोषाजनयन्त्यामयान्बहून् ||१५||  

विबध्यमानाःप्राग्दोषाजनयन्त्यामयान्बहून् ||१५||  

दण्डकालसकाध्मानग्रहण्यर्शोगदांस्तथा |  

दण्डकालसकाध्मानग्रहण्यर्शोगदांस्तथा |  

शोथपाण्ड्वामयप्लीहकुष्ठगुल्मोदरज्वरान् ||१६||  

शोथपाण्ड्वामयप्लीहकुष्ठगुल्मोदरज्वरान् ||१६||  

तस्मादुपेक्षेतोत्क्लिष्टान्वर्तमानान्स्वयंमलान् |  

तस्मादुपेक्षेतोत्क्लिष्टान्वर्तमानान्स्वयंमलान् |  

कृच्छ्रंवावहतांदद्यादभयांसम्प्रवर्तिनीम् ||१७||  

कृच्छ्रंवावहतांदद्यादभयांसम्प्रवर्तिनीम् ||१७||  

तयाप्रवाहितेदोषेप्रशाम्यत्युदरामयः |  

तयाप्रवाहितेदोषेप्रशाम्यत्युदरामयः |  

जायतेदेहलघुताजठराग्निश्चवर्धते ||१८||  

जायतेदेहलघुताजठराग्निश्चवर्धते ||१८||  

प्रमथ्यांमध्यदोषाणांदद्याद्दीपनपाचनीम् |  

प्रमथ्यांमध्यदोषाणांदद्याद्दीपनपाचनीम् |  

लङ्घनंचाल्पदोषाणांप्रशस्तमतिसारिणाम् ||१९||

लङ्घनंचाल्पदोषाणांप्रशस्तमतिसारिणाम् ||१९||

dōṣāḥ sannicitā yasya vidagdhāhāramūrcchitāḥ|  

dōṣāḥ sannicitā yasya vidagdhāhāramūrcchitāḥ|  

atīsārāya kalpantē bhūyastān sampravartayēt||14||  

atīsārāya kalpantē bhūyastān sampravartayēt||14||

na tu saṅgrahaṇaṁ dēyaṁ pūrvamāmātisāriṇē|  

na tu saṅgrahaṇaṁ dēyaṁ pūrvamāmātisāriṇē|  

vibadhyamānāḥ prāgdōṣā janayantyāmayān bahūn||15||  

vibadhyamānāḥ prāgdōṣā janayantyāmayān bahūn||15||  

daṇḍakālasakādhmānagrahaṇyarśōgadāṁstathā|  

daṇḍakālasakādhmānagrahaṇyarśōgadāṁstathā|  

śōthapāṇḍvāmayaplīhakuṣṭhagulmōdarajvarān||16||  

śōthapāṇḍvāmayaplīhakuṣṭhagulmōdarajvarān||16||  

tasmādupēkṣētōtkliṣṭān vartamānān svayaṁ malān|  

tasmādupēkṣētōtkliṣṭān vartamānān svayaṁ malān|  

kr̥cchraṁ vā vahatāṁ dadyādabhayāṁ sampravartinīm||17||  

kr̥cchraṁ vā vahatāṁ dadyādabhayāṁ sampravartinīm||17||  

tayā pravāhitē dōṣē praśāmyatyudarāmayaḥ|  

tayā pravāhitē dōṣē praśāmyatyudarāmayaḥ|  

jāyatē dēhalaghutā jaṭharāgniśca vardhatē||18||  

jāyatē dēhalaghutā jaṭharāgniśca vardhatē||18||  

pramathyāṁ madhyadōṣāṇāṁ dadyāddīpanapācanīm|  

pramathyāṁ madhyadōṣāṇāṁ dadyāddīpanapācanīm|  

laṅghanaṁ cālpadōṣāṇāṁ praśastamatisāriṇām||19||  

laṅghanaṁ cālpadōṣāṇāṁ praśastamatisāriṇām||19||  

doShAH sannicitA yasya vidagdhAhAramUrcchitAH|  

doShAH sannicitA yasya vidagdhAhAramUrcchitAH|  

atIsArAya kalpante bhUyastAn sampravartayet||14||  

atIsArAya kalpante bhUyastAn sampravartayet||14||  

na tu sa~ggrahaNaM deyaM pUrvamAmAtisAriNe|  

na tu sa~ggrahaNaM deyaM pUrvamAmAtisAriNe|  

vibadhyamAnAH prAgdoShA janayantyAmayAn bahUn||15||  

vibadhyamAnAH prAgdoShA janayantyAmayAn bahUn||15||  

daNDakAlasakAdhmAnagrahaNyarshogadAMstathA|  

daNDakAlasakAdhmAnagrahaNyarshogadAMstathA|  

shothapANDvAmayaplIhakuShThagulmodarajvarAn||16||  

shothapANDvAmayaplIhakuShThagulmodarajvarAn||16||  

tasmAdupekShetotkliShTAn vartamAnAn svayaM malAn|  

tasmAdupekShetotkliShTAn vartamAnAn svayaM malAn|  

kRucchraM vA vahatAM dadyAdabhayAM sampravartinIm||17||  

kRucchraM vA vahatAM dadyAdabhayAM sampravartinIm||17||  

tayA pravAhite doShe prashAmyatyudarAmayaH|  

tayA pravAhite doShe prashAmyatyudarAmayaH|  

jAyate dehalaghutA jaTharAgnishca vardhate||18||  

jAyate dehalaghutA jaTharAgnishca vardhate||18||  

pramathyAM madhyadoShANAM dadyAddIpanapAcanIm|  

pramathyAM madhyadoShANAM dadyAddIpanapAcanIm|  

la~gghanaM cAlpadoShANAM prashastamatisAriNAm||19||  

la~gghanaM cAlpadoShANAM prashastamatisAriNAm||19||  

The following principles of treatment are used in management of atisara:

 

• When the diarrhoea is caused by the accumulated (aggravated) doshas impelled by vidagdha (fermentation of undigested) food, the patient should be given laxative to eliminate the dosha.  

The following principles of treatment are used in management of ''atisara'':

• In the initial state i.e. ama (primary or immature) of diarrhoea, stopping or binding therapies are never indicated.

 

• Administration of such bowel-binding therapies in the initial stage obstructs the movement and elimination of the already aggravated dosha leading to complications like dandakālasaka (obstruction to intestinal peristalsis), adhmāna (flatulence), grahani roga (digestive disorders like sprue syndrome), piles, fistula-in-ano, edema, anemia, splenic disorders, kushtha (obstinate skin diseases including leprosy), gulma (abdominal lumps), udara roga (obstinate abdominal diseases including ascites) and fever.  

*When the diarrhea is caused by the accumulated (aggravated) ''doshas'' impelled by ''vidagdha'' (fermentation of undigested) food, the patient should be given laxative to eliminate the ''dosha''.  

• Hence, the physician should ignore the downward movement of the detached (utklishta) morbid matter, which is moving downwards on its own.  

*In the initial state i.e. ''ama'' (primary or immature) of diarrhea, stopping or binding therapies are never indicated.

• Diarrhoea should be allowed to continue and should not be stopped by constipating medicines.  

*Administration of such bowel-binding therapies in the initial stage obstructs the movement and elimination of the already aggravated ''dosha'' leading to complications like ''dandakalasaka'' (obstruction to intestinal peristalsis), ''adhmana'' (flatulence), ''grahani roga'' (digestive disorders like sprue syndrome), piles, fistula-in-ano, edema, anemia, splenic disorders, ''kushtha'' (obstinate skin diseases including leprosy), ''gulma'' (abdominal lumps), ''udara roga'' (obstinate abdominal diseases including ascites) and fever.  

• If the diarrhoea is associated with griping pain (difficulty in evacuating), then haritaki should be given as a mild laxative.  

*Hence, the physician should ignore the downward movement of the detached (''utklishta'') morbid matter, which is moving downwards on its own.  

• Once the morbid matter is eliminated through downward movement then this abdominal disease (diarrhoea) gets cured, the body becomes light and the power of agni becomes strong.

*Diarrhea should be allowed to continue and should not be stopped by constipating medicines.  

• Moderately aggravated dosha should be managed by pramathya (a type of decoction of drugs) which stimulates the power of digestion (dipana) and which is carminative (pachana) should be administered. Slightly aggravated dosha should be managed by langhana (fasting therapy)- [14-19].

*If the diarrhea is associated with griping pain (difficulty in evacuating), then ''haritaki'' should be given as a mild laxative.  

Recipes of pramathya:

*Once the morbid matter is eliminated through downward movement then this abdominal disease (diarrhea) gets cured, the body becomes light and the power of ''agni'' becomes strong.

*Moderately aggravated ''dosha'' should be managed by ''pramathya'' (a type of decoction of drugs) which stimulates the power of digestion (''dipana'') and which is carminative (''pachana'') should be administered. Slightly aggravated ''dosha'' should be managed by ''langhana'' (fasting therapy) [14-19].

 

==== Recipes of ''pramathya'' ====

 

पिप्पलीनागरंधान्यंभूतीकमभयावचा |  

पिप्पलीनागरंधान्यंभूतीकमभयावचा |  

ह्रीवेरंभद्रमुस्तानिबिल्वंनागरधान्यकम् ||२०||  

ह्रीवेरंभद्रमुस्तानिबिल्वंनागरधान्यकम् ||२०||