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→Treatment of vataja atisara
• Shālaparni, prashniparni, brhati, kantakarika, balā, svadamstrā, bilva, pāthā, nāgara, dhānyaka, shati, palāsha, hapushā, vacha, jiraka, pippali, yavani, pippali-mula, chitraka, hastipippali, vrikshāmla, sour pomegranate, hingu, vida and saindhava-these ingredients should be appropriately used in processing food preparations. Drugs belonging to the vata and kapha alleviative group and those drugs which are dipana (digestive stimulant), pachana (carminative), grahi (constipating), balya (promoter of strength) and rochana (appetiser) should be prescribed. [26-29]
• Shālaparni, prashniparni, brhati, kantakarika, balā, svadamstrā, bilva, pāthā, nāgara, dhānyaka, shati, palāsha, hapushā, vacha, jiraka, pippali, yavani, pippali-mula, chitraka, hastipippali, vrikshāmla, sour pomegranate, hingu, vida and saindhava-these ingredients should be appropriately used in processing food preparations. Drugs belonging to the vata and kapha alleviative group and those drugs which are dipana (digestive stimulant), pachana (carminative), grahi (constipating), balya (promoter of strength) and rochana (appetiser) should be prescribed. [26-29]
Management of diarrhea associated with pain:
==== Management of diarrhea associated with pain ====
आमेपरिणतेयस्तुविबद्धमतिसार्यते |
आमेपरिणतेयस्तुविबद्धमतिसार्यते |
After the maturity of ama (product of indigestion), if the patient experiences loose motions along with scybalous faeces associated with colic pain and mucus very frequently in small quantities, and if there is griping pain, then he should be given food along with the soup of mulaka, badara, upodikā, kshirini, yavāni, vāstuka, suvarchala, chanchu (nadika), leaves of avalguja, shati, karkaruka, jivanti, chirbhata (karkati), lonika, pāthā or shushka-shāka (kāsamarda according to Chakrapani). These soups should be cooked along with curd (yoghurt) and dadima, and added with ghee in copious quantities [30-33]
After the maturity of ama (product of indigestion), if the patient experiences loose motions along with scybalous faeces associated with colic pain and mucus very frequently in small quantities, and if there is griping pain, then he should be given food along with the soup of mulaka, badara, upodikā, kshirini, yavāni, vāstuka, suvarchala, chanchu (nadika), leaves of avalguja, shati, karkaruka, jivanti, chirbhata (karkati), lonika, pāthā or shushka-shāka (kāsamarda according to Chakrapani). These soups should be cooked along with curd (yoghurt) and dadima, and added with ghee in copious quantities [30-33]
Treatment of pravāhikā (dysentery):
==== Treatment of pravāhikā (dysentery) ====
कल्कःस्याद्बालबिल्वानांतिलकल्कश्चतत्समः |
कल्कःस्याद्बालबिल्वानांतिलकल्कश्चतत्समः |
दध्नःसरोऽम्लस्नेहाद्यःखडोहन्यात्प्रवाहिकाम् ||३४||
दध्नःसरोऽम्लस्नेहाद्यःखडोहन्यात्प्रवाहिकाम् ||३४||
• It is prepared by adding the paste of tender fruits of bilva, equal quantities of the paste of sesame, cream of sour curd and copious quantities of ghee [34].
• It is prepared by adding the paste of tender fruits of bilva, equal quantities of the paste of sesame, cream of sour curd and copious quantities of ghee [34].
Treatment of varcha-kshaya (scanty formation of stool):
==== Treatment of varcha-kshaya (scanty formation of stool) ====
यवानांमुद्गमाषाणांशालीनांचतिलस्यच |
यवानांमुद्गमाषाणांशालीनांचतिलस्यच |
• Cream of curd sizzled with ghee and oil, and mixed with jaggery and shunthi, alcohol sizzled with ghee and oil, sour fruits sizzled with ghee and oil, soup of granjanaka, meat soup of lopaka added with sour ingredients, meat soup of kacchapa added with ghee and sour ingredients, or the soup of the meat of barhi, tittiri, daksha or vartaka. These soups should be used as vyanjana (side-dish).
• Cream of curd sizzled with ghee and oil, and mixed with jaggery and shunthi, alcohol sizzled with ghee and oil, sour fruits sizzled with ghee and oil, soup of granjanaka, meat soup of lopaka added with sour ingredients, meat soup of kacchapa added with ghee and sour ingredients, or the soup of the meat of barhi, tittiri, daksha or vartaka. These soups should be used as vyanjana (side-dish).
• The red variety of shāli rice boiled by adding ghee and sour ingredients.
• The red variety of shāli rice boiled by adding ghee and sour ingredients.
• The meat soup of the trunk of sheep should be added with its blood and sizzled by adding the extract of dādima, dhānya, ghee and nāgara. This soup should be used for boiling red variety of shāli rice. Intake of this cooked rice and drinking this soup make the patient free from the ailments caused by varchā-kshaya (scanty stool)-[35-41]
• The meat soup of the trunk of sheep should be added with its blood and sizzled by adding the extract of dādima, dhānya, ghee and nāgara. This soup should be used for boiling red variety of shāli rice. Intake of this cooked rice and drinking this soup make the patient free from the ailments caused by varchā-kshaya (scanty stool) [35-41]
Treatment of prolapse of rectum:
==== Treatment of prolapse of rectum ====
गुदनिःसरणेशूलेपानमम्लस्यसर्पिषः |
गुदनिःसरणेशूलेपानमम्लस्यसर्पिषः |
प्रशस्यतेनिरामाणामथवाऽप्यनुवासनम् ||४२||
प्रशस्यतेनिरामाणामथवाऽप्यनुवासनम् ||४२||
If there is prolapse of rectum and colic pain, and if the diarrhoea is free from ama, then the patient should be given medicated ghee prepared with sour drugs or anuvasana (unctuous enema). [42]
If there is prolapse of rectum and colic pain, and if the diarrhoea is free from ama, then the patient should be given medicated ghee prepared with sour drugs or anuvasana (unctuous enema). [42]
Chāṅgērīghr̥tam:
==== Chāṅgērīghr̥tam ====
चाङ्गेरीकोलदध्यम्लनागरक्षारसंयुतम् |
चाङ्गेरीकोलदध्यम्लनागरक्षारसंयुतम् |
घृतमुत्क्वथितंपेयंगुदभ्रंशरुजापहम् ||४३||
घृतमुत्क्वथितंपेयंगुदभ्रंशरुजापहम् ||४३||
Ghee should be cooked with the juice of changeri, decoction of kola and sour curd, and the paste of nāgara and kshāra (alkali preparation). Intake of this medicated ghee cures ailments caused by prolapse of rectum. Thus, ends the description of changeri-ghrta [43].
Ghee should be cooked with the juice of changeri, decoction of kola and sour curd, and the paste of nāgara and kshāra (alkali preparation). Intake of this medicated ghee cures ailments caused by prolapse of rectum. Thus, ends the description of changeri-ghrta [43].
Chavyādighr̥tam:
==== Chavyādighr̥tam ====
सचव्यपिप्पलीमूलंसव्योषविडदाडिमम् |
सचव्यपिप्पलीमूलंसव्योषविडदाडिमम् |
पेयमम्लंघृतंयुक्त्यासधान्याजाजिचित्रकम् ||४४||
पेयमम्लंघृतंयुक्त्यासधान्याजाजिचित्रकम् ||४४||
Ghee should be cooked with the sour ingredients (juice of changeri, decoction of kola and sour curd), and the pastes of chavya, pippali-mula, shunthi, pippali, marica, vida and dādima. Intake of this medicated ghee should be done along with dhānya, ajāji and chitraka in appropriate quantities (for curing prolapse of rectum)
Ghee should be cooked with the sour ingredients (juice of changeri, decoction of kola and sour curd), and the pastes of chavya, pippali-mula, shunthi, pippali, marica, vida and dādima. Intake of this medicated ghee should be done along with dhānya, ajāji and chitraka in appropriate quantities (for curing prolapse of rectum)
Thus, ends the description of chavyadi -ghrita for prolapsed rectum [44].
Thus, ends the description of chavyadi -ghrita for prolapsed rectum [44].
Anuvasana basti in prolapse of rectum:
==== Anuvasana basti in prolapse of rectum ====
दशमूलोपसिद्धंवासबिल्वमनुवासनम् |
दशमूलोपसिद्धंवासबिल्वमनुवासनम् |
शटीशताह्वाबिल्वैर्वावचयाचित्रकेणवा ||४५||
शटीशताह्वाबिल्वैर्वावचयाचित्रकेणवा ||४५||
• Chitraka cooked with fat [45].
• Chitraka cooked with fat [45].
Management of strangulated prolapsed rectum:
==== Management of strangulated prolapsed rectum ====
स्तब्धभ्रष्टगुदेपूर्वंस्नेहस्वेदौप्रयोजयेत् |
स्तब्धभ्रष्टगुदेपूर्वंस्नेहस्वेदौप्रयोजयेत् |
सुस्विन्नंतंमृदूभूतंपिचुनासम्प्रवेशयेत् ||४६||
सुस्विन्नंतंमृदूभूतंपिचुनासम्प्रवेशयेत् ||४६||
If the prolapsed rectum becomes stiff or strangulated, and does not go inside of its own, then oil should be applied over it and fomentation should be given. Thereafter, when the prolapsed rectum is well fomented and has become soft, then with the help of a cotton pad (or pad made of thick cloth) it should be pushed inside and restored to its original place [46].
If the prolapsed rectum becomes stiff or strangulated, and does not go inside of its own, then oil should be applied over it and fomentation should be given. Thereafter, when the prolapsed rectum is well fomented and has become soft, then with the help of a cotton pad (or pad made of thick cloth) it should be pushed inside and restored to its original place [46].
Use of medicated milk:
==== Use of medicated milk ====
विबद्धवातवर्चास्तुबहुशूलप्रवाहिकः |
विबद्धवातवर्चास्तुबहुशूलप्रवाहिकः |
सरक्तपिच्छस्तृष्णार्तःक्षीरसौहित्यमर्हति ||४७||
सरक्तपिच्छस्तृष्णार्तःक्षीरसौहित्यमर्हति ||४७||
Milk boiled with the root of castor or tender fruit of bilva may also be given in the above mentioned condition. By the intake of the recipes of medicated ghee mentioned above, bleeding and mucus discharge from the anus stops. These recipes also cure colic pain, dysentery and constipation [47-49]
Milk boiled with the root of castor or tender fruit of bilva may also be given in the above mentioned condition. By the intake of the recipes of medicated ghee mentioned above, bleeding and mucus discharge from the anus stops. These recipes also cure colic pain, dysentery and constipation [47-49]
Treatment of pittaja atisara:
==== Treatment of pittaja atisara ====
पित्तातिसारंपुनर्निदानोपशयाकृतिभिरामान्वयमुपलभ्ययथाबलंलङ्घनपाचनाभ्यामुपाचरेत् |
पित्तातिसारंपुनर्निदानोपशयाकृतिभिरामान्वयमुपलभ्ययथाबलंलङ्घनपाचनाभ्यामुपाचरेत् |
तृष्यतस्तुमुस्तपर्पटकोशीरसारिवाचन्दनकिराततिक्तकोदीच्यवारिभिरुपचारः |
तृष्यतस्तुमुस्तपर्पटकोशीरसारिवाचन्दनकिराततिक्तकोदीच्यवारिभिरुपचारः |
• Agni (power of digestion) should be stimulated gradually with the vegetable soup of mudga, masura, harenu, makustha and adhaki or with the soup of the meat of lāvā, kapinjala, shash, harina, ena and kalapuccha. These vegetable soups and meat soups may or may not be sour.
• Agni (power of digestion) should be stimulated gradually with the vegetable soup of mudga, masura, harenu, makustha and adhaki or with the soup of the meat of lāvā, kapinjala, shash, harina, ena and kalapuccha. These vegetable soups and meat soups may or may not be sour.
• If the pittaja atisara persists even after the administration of the above mentioned measures, then the patient should be treated with recipes which are dipaniya (digestive stimulant), pāchaniya (carminative), upashamaniya (dosha-alleviator) and sangrahaniya (constipating). [50]
• If the pittaja atisara persists even after the administration of the above mentioned measures, then the patient should be treated with recipes which are dipaniya (digestive stimulant), pāchaniya (carminative), upashamaniya (dosha-alleviator) and sangrahaniya (constipating). [50]
Recipes for pittaja atisara:
==== Recipes for pittaja atisara ====
सक्षौद्रातिविषंपिष्ट्वावत्सकस्यफलत्वचम् |
सक्षौद्रातिविषंपिष्ट्वावत्सकस्यफलत्वचम् |
पिबेत्पित्तातिसारघ्नंतण्डुलोदकसंयुतम् ||५१||
पिबेत्पित्तातिसारघ्नंतण्डुलोदकसंयुतम् ||५१||
• Powder of utpala, dhātaki(flower), dādima,tvak and mahaushadha
• Powder of utpala, dhātaki(flower), dādima,tvak and mahaushadha
• Katphala, nāgara, pāthā, seed-pulp of jambu and amra, and duralabhā. Once the above mentioned recipes are digested, the patient should be given to eat red variety of rice harvested in earlier seasons, along with appropriately cooked meat-soup added with constipating drugs [51-56]
• Katphala, nāgara, pāthā, seed-pulp of jambu and amra, and duralabhā. Once the above mentioned recipes are digested, the patient should be given to eat red variety of rice harvested in earlier seasons, along with appropriately cooked meat-soup added with constipating drugs [51-56]
Administration of milk:
==== Administration of milk ====
पित्तातिसारोदीपाग्नेःक्षिप्रंसमुपशाम्यति |
पित्तातिसारोदीपाग्नेःक्षिप्रंसमुपशाम्यति |
अजाक्षीरप्रयोगेणबलंवर्णश्चवर्धते ||५७||
अजाक्षीरप्रयोगेणबलंवर्णश्चवर्धते ||५७||
• During the course of sansarjana-krama (gradual administration of light food) after purification therapy if the colic pain persists, then anuvāsana basti therapy should be administered immediately because morbid matter is already eliminated. Satapushpādi ghee is advised for anuvāsana basti [57-62].
• During the course of sansarjana-krama (gradual administration of light food) after purification therapy if the colic pain persists, then anuvāsana basti therapy should be administered immediately because morbid matter is already eliminated. Satapushpādi ghee is advised for anuvāsana basti [57-62].
Picchā basti (slimy medicated enema)
==== Picchā basti (slimy medicated enema) ====
कृतानुवासनस्यास्यकृतसंसर्जनस्यच |
कृतानुवासनस्यास्यकृतसंसर्जनस्यच |
वर्ततेयद्यतीसारःपिच्छाबस्तिरतःपरम् ||६३||
वर्ततेयद्यतीसारःपिच्छाबस्तिरतःपरम् ||६३||
If diarrhoea persists inspite of the administration of anuvāsana basti and observing the samsarjana-krama (gradual administration of lighter to heavier food) then picchā basti (mucilaginous type of medicated enema) should be given.
If diarrhoea persists inspite of the administration of anuvāsana basti and observing the samsarjana-krama (gradual administration of lighter to heavier food) then picchā basti (mucilaginous type of medicated enema) should be given.
Green stalks of shālmali should be covered with green kusha and tied. This bundle is then smeared with the mud of black soil and placed over cow-dung fire. After the mud is dried up, the stalks of shālmali is removed. These stalks are then triturated in a pestle and mortar. One mushti (pala or handful) of this paste should be mixed with one prastha of boiled milk and filtered. In this milk, oil, ghee and paste of madhuka is added in adequate quantity. This recipe is used for medicated enema to be given to the patient after massaging the body with oil. When the nasty material comes out, the patient should take bath and thereafter take food along with either milk or the meat soup of the wild animals. This picchā-basti (mucilaginous enema) cures paittika type of diarrhoea, fever, edema, gulma (abdominal lumps), chronic diarrhoea, grahani (digestive disorders) and the acute complications of purgation as well as of asthāpana basti [63-68]
Green stalks of shālmali should be covered with green kusha and tied. This bundle is then smeared with the mud of black soil and placed over cow-dung fire. After the mud is dried up, the stalks of shālmali is removed. These stalks are then triturated in a pestle and mortar. One mushti (pala or handful) of this paste should be mixed with one prastha of boiled milk and filtered. In this milk, oil, ghee and paste of madhuka is added in adequate quantity. This recipe is used for medicated enema to be given to the patient after massaging the body with oil. When the nasty material comes out, the patient should take bath and thereafter take food along with either milk or the meat soup of the wild animals. This picchā-basti (mucilaginous enema) cures paittika type of diarrhoea, fever, edema, gulma (abdominal lumps), chronic diarrhoea, grahani (digestive disorders) and the acute complications of purgation as well as of asthāpana basti [63-68]
Raktatisara (bloody diarrhoea):
==== Raktatisara (bloody diarrhoea) ====
पित्तातिसारीयस्त्वेतांक्रियांमुक्त्वानिषेवते |
पित्तातिसारीयस्त्वेतांक्रियांमुक्त्वानिषेवते |
पित्तलान्यन्नपानानितस्यपित्तंमहाबलम् ||६९||
पित्तलान्यन्नपानानितस्यपित्तंमहाबलम् ||६९||
If a pittaja atisara patient does not follow the therapeutic measures and resorts to such foods and drinks which cause aggravation of pitta, then the excessively provoked pitta causes raktatisara and instantaneous vitiation of rakta (blood). This leads to serious complications like morbid thirst, colic pain, burning sensation and suppuration of the anus. It can also manifest itself directly on account of excessive aggravation of pitta and vitiation of blood [69-70]
If a pittaja atisara patient does not follow the therapeutic measures and resorts to such foods and drinks which cause aggravation of pitta, then the excessively provoked pitta causes raktatisara and instantaneous vitiation of rakta (blood). This leads to serious complications like morbid thirst, colic pain, burning sensation and suppuration of the anus. It can also manifest itself directly on account of excessive aggravation of pitta and vitiation of blood [69-70]
Treatment of raktatisara:
==== Treatment of raktatisara ====
तत्रच्छागंपयःशस्तंशीतंसमधुशर्करम् |
तत्रच्छागंपयःशस्तंशीतंसमधुशर्करम् |
पानार्थंभोजनार्थंचगुदप्रक्षालनेतथा ||७१||
पानार्थंभोजनार्थंचगुदप्रक्षालनेतथा ||७१||
• The powder of nilotpala, mocharasa, samangā and padmakeshara should be administered along with the goat’s milk. After the digestion of this potion, the patient should be given rice with milk. If the patient is weak, then food can be given to him even before the above mentioned potion is digested.
• The powder of nilotpala, mocharasa, samangā and padmakeshara should be administered along with the goat’s milk. After the digestion of this potion, the patient should be given rice with milk. If the patient is weak, then food can be given to him even before the above mentioned potion is digested.
• Butter along with honey and sugar may be given before meals [71-76].
• Butter along with honey and sugar may be given before meals [71-76].
Measures to alleviate bleeding in raktatisara:
==== Measures to alleviate bleeding in raktatisara ====
प्राश्यक्षीरोत्थितंसर्पिःकपिञ्जलरसाशनः |
प्राश्यक्षीरोत्थितंसर्पिःकपिञ्जलरसाशनः |
त्र्यहादारोग्यमाप्नोतिपयसाक्षीरभुक्तथा ||७७||
त्र्यहादारोग्यमाप्नोतिपयसाक्षीरभुक्तथा ||७७||
• While consuming milk as food (drink), the patient should take the paste of shatāvari mixed with milk. He may also take ghee boiled with the paste of shatāvari.
• While consuming milk as food (drink), the patient should take the paste of shatāvari mixed with milk. He may also take ghee boiled with the paste of shatāvari.
• Consumption of ghee cooked by adding the paste of fruits of kutaja, along with the scum (upper part) of yavagu, and followed by intake of peya (thin gruel) is advised [77-79].
• Consumption of ghee cooked by adding the paste of fruits of kutaja, along with the scum (upper part) of yavagu, and followed by intake of peya (thin gruel) is advised [77-79].
Treatment of sannipātaja atisara:
==== Treatment of sannipātaja atisara ====
त्वक्चदारुहरिद्रायाःकुटजस्यफलानिच |
त्वक्चदारुहरिद्रायाःकुटजस्यफलानिच |
पिप्पलीशृङ्गवेरंचद्राक्षाकटुकरोहिणी ||८०||
पिप्पलीशृङ्गवेरंचद्राक्षाकटुकरोहिणी ||८०||
atIsAraM jayecchIghraM tridoShamapi dAruNam||81||
atIsAraM jayecchIghraM tridoShamapi dAruNam||81||
Ghee should be cooked by adding the six drugs, viz., the bark of daru-haridra, fruits of kutaja, pippali, shringavera, drāksā and katukarohini. Intake of peya (thin gruel) and manda (very thin gruel) along with this medicated ghee cures a serious type of diarrhoea even if caused by sannipata (simultaneous aggravationof all the three doshas).[80-81]
Ghee should be cooked by adding the six drugs, viz., the bark of daru-haridra, fruits of kutaja, pippali, shringavera, drāksā and katukarohini. Intake of peya (thin gruel) and manda (very thin gruel) along with this medicated ghee cures a serious type of diarrhoea even if caused by sannipata (simultaneous aggravationof all the three doshas).[80-81]
Hemostatic recipes:
==== Hemostatic recipes ====
कृष्णमृन्मधुकंशङ्खंरुधिरंतण्डुलोदकम् |
कृष्णमृन्मधुकंशङ्खंरुधिरंतण्डुलोदकम् |
पीतमेकत्रसक्षौद्रंरक्तसङ्ग्रहणंपरम् ||८२||
पीतमेकत्रसक्षौद्रंरक्तसङ्ग्रहणंपरम् ||८२||
• Intake of the decoction of the seeds of vatsaka, while taking meat-soup as food, cures pittaja disorders of abdomen (jathara).
• Intake of the decoction of the seeds of vatsaka, while taking meat-soup as food, cures pittaja disorders of abdomen (jathara).
• Intake of chandana along with rice-water, mixed with sugar and honey cures burning sensation, morbid thirst, prameha and bleeding [82-86].
• Intake of chandana along with rice-water, mixed with sugar and honey cures burning sensation, morbid thirst, prameha and bleeding [82-86].
Treatment of anal suppuration:
==== Treatment of anal suppuration ====
गुदोबहुभिरुत्थानैर्यस्यपित्तेनपच्यते |
गुदोबहुभिरुत्थानैर्यस्यपित्तेनपच्यते |
सेचयेत्तंसुशीतेनपटोलमधुकाम्बुना ||८७||
सेचयेत्तंसुशीतेनपटोलमधुकाम्बुना ||८७||
sēcayēttaṁ suśītēna paṭōlamadhukāmbunā||87||
sēcayēttaṁ suśītēna paṭōlamadhukāmbunā||87||
pañcavalkamadhūkānāṁ rasairikṣurasairghr̥taiḥ|
pañcavalkamadhūkānāṁ rasairikṣurasairghr̥taiḥ|
chāgairgavyaiḥ payōbhirvā śarkarākṣaudrasaṁyutaiḥ||88|| prakṣālanānāṁ kalkairvā sasarpiṣkaiḥ pralēpayēt|
chāgairgavyaiḥ payōbhirvā śarkarākṣaudrasaṁyutaiḥ||88||
prakṣālanānāṁ kalkairvā sasarpiṣkaiḥ pralēpayēt|
ēṣāṁ vā sukr̥taiścūrṇaistaṁ gudaṁ prAtisārayēt||89||
ēṣāṁ vā sukr̥taiścūrṇaistaṁ gudaṁ prAtisārayēt||89||
dhātakīlōdhracūrṇairvā samāṁśaiḥ prAtisārayēt|
dhātakīlōdhracūrṇairvā samāṁśaiḥ prAtisārayēt|
• If there is excessive bleeding (from the anus), the cold decoction of the above mentioned drugs should be impregnated with ghee, and sprinkled over the anal region, pelvic region, lumbar region and thighs.
• If there is excessive bleeding (from the anus), the cold decoction of the above mentioned drugs should be impregnated with ghee, and sprinkled over the anal region, pelvic region, lumbar region and thighs.
• Excessive bleeding should be controlled with a cotton pad soaked with chandanadya-taila (C.S Ci 3-258) or satadhauta-ghrita (ghee washed with cold water for one hundred times), and the oil or ghee; squeeze this pad over the anal and pelvic regions [87-92 ½]
• Excessive bleeding should be controlled with a cotton pad soaked with chandanadya-taila (C.S Ci 3-258) or satadhauta-ghrita (ghee washed with cold water for one hundred times), and the oil or ghee; squeeze this pad over the anal and pelvic regions [87-92 ½]
Piccha-basti (mucilaginous enema) for dysentery:
==== Piccha-basti (mucilaginous enema) for dysentery ====
अल्पाल्पंबहुशोरक्तंसशूलमुपवेश्यते ||९३||
अल्पाल्पंबहुशोरक्तंसशूलमुपवेश्यते ||९३||
यदावायुर्विबद्धश्चकृच्छ्रंचरतिवानवा |
यदावायुर्विबद्धश्चकृच्छ्रंचरतिवानवा |
tasmAdabhIkShNashasteShAM gude snehaM prayojayet|96|
tasmAdabhIkShNashasteShAM gude snehaM prayojayet|96|
When the movement of the aggravated vata (flatus) gets obstructed or moves with difficulty or seizing of vata inside the abdomen, then the patient voids blood frequently in small quantities which is associated with pain. Piccha-basti should be administered to such patients. This type of patient may also be managed by anuvasana basti given with medicated ghee prepared with prapaundarika. Because of chronic diarrhoea, the anus of the patient generally becomes weak. Therefore cotton soaked in medicated ghee should be inserted into the anus frequently or anuvasana basti with medicated ghee is given [93-95½ ].
When the movement of the aggravated vata (flatus) gets obstructed or moves with difficulty or seizing of vata inside the abdomen, then the patient voids blood frequently in small quantities which is associated with pain. Piccha-basti should be administered to such patients. This type of patient may also be managed by anuvasana basti given with medicated ghee prepared with prapaundarika. Because of chronic diarrhoea, the anus of the patient generally becomes weak. Therefore cotton soaked in medicated ghee should be inserted into the anus frequently or anuvasana basti with medicated ghee is given [93-95½ ].
Medicated enema and recipes of linctus:
==== Medicated enema and recipes of linctus ====
पवनोऽतिप्रवृत्तोहिस्वेस्थानेलभतेऽधिकम् ||९६||
पवनोऽतिप्रवृत्तोहिस्वेस्थानेलभतेऽधिकम् ||९६||
बलंतस्यसपित्तस्यजयार्थेबस्तिरुत्तमः |
बलंतस्यसपित्तस्यजयार्थेबस्तिरुत्तमः |
• If bleeding takes place before evacuating the stool or after evacuation of stool (i.e., a case of raktatisara), then shatavari-ghrita (C.S Ci 30: 64-69) in the form of linctus should be given.
• If bleeding takes place before evacuating the stool or after evacuation of stool (i.e., a case of raktatisara), then shatavari-ghrita (C.S Ci 30: 64-69) in the form of linctus should be given.
• Intake of freshly collected butter along with half the quantity of sugar and one fourth quantity of honey cures the above mentioned ailments. While taking this potion, the patient should take wholesome food. Adventitious roots of nyagrodha, udumbara and ashvattha should be crushed and kept soaked in hot water for twenty four hours. Ghee should be cooked along with this water. This medicated ghee should be added with half the quantity of sugar and one fourth in quantity of honey, and taken in the form of linctus. It cures raktatisara, associated with bleeding either before or after the passing of stool [96-100½]
• Intake of freshly collected butter along with half the quantity of sugar and one fourth quantity of honey cures the above mentioned ailments. While taking this potion, the patient should take wholesome food. Adventitious roots of nyagrodha, udumbara and ashvattha should be crushed and kept soaked in hot water for twenty four hours. Ghee should be cooked along with this water. This medicated ghee should be added with half the quantity of sugar and one fourth in quantity of honey, and taken in the form of linctus. It cures raktatisara, associated with bleeding either before or after the passing of stool [96-100½]
Suppuration of anal sphincters:
==== Suppuration of anal sphincters ====
यस्त्वेवंदुर्बलोमोहात्पित्तलान्येवसेवते ||१०१||
यस्त्वेवंदुर्बलोमोहात्पित्तलान्येवसेवते ||१०१||
दारुणंसवलीपाकंप्राप्यशीघ्रंविपद्यते |१०२|
दारुणंसवलीपाकंप्राप्यशीघ्रंविपद्यते |१०२|
yastvēvaṁ durbalō mōhāt pittalānyēva sēvatē||101||
yastvēvaṁ durbalō mōhāt pittalānyēva sēvatē||101||
dāruṇaṁ sa valīpākaṁ prāpya śīghraṁ vipadyatē|102|
dāruṇaṁ sa valīpākaṁ prāpya śīghraṁ vipadyatē|102|
yastvevaM durbalo mohAt pittalAnyeva sevate||101||
dAruNaM sa valIpAkaM prApya shIghraM vipadyate|102|
dAruNaM sa valIpAkaM prApya shIghraM vipadyate|102|
A patient who has become weak because of raktatisara, if indulges in pitta-aggravating ingredients out of ignorance, then the anal sphincters gets suppurated. This is a serious condition leading to instantaneous death [101½].
A patient who has become weak because of raktatisara, if indulges in pitta-aggravating ingredients out of ignorance, then the anal sphincters gets suppurated. This is a serious condition leading to instantaneous death [101½].
योज्यश्चामातिसारघ्नोयथोक्तोदीपनोगणः |
योज्यश्चामातिसारघ्नोयथोक्तोदीपनोगणः |
लङ्घितस्यानुपूर्व्यांचकृतायांननिवर्तते ||१०३||
लङ्घितस्यानुपूर्व्यांचकृतायांननिवर्तते ||१०३||
कफजोयद्यतीसारःकफघ्नैस्तमुपाचरेत् | बिल्वंकर्कटिकामुस्तमभयाविश्वभेषजम् ||१०४||
कफजोयद्यतीसारःकफघ्नैस्तमुपाचरेत् |
बिल्वंकर्कटिकामुस्तमभयाविश्वभेषजम् ||१०४||
वचाविडङ्गंभूतीकंधान्यकंदेवदारुच |
वचाविडङ्गंभूतीकंधान्यकंदेवदारुच |
कुष्ठंसातिविषापाठाचव्यंकटुकरोहिणी ||१०५||
कुष्ठंसातिविषापाठाचव्यंकटुकरोहिणी ||१०५||
yōjyaścāmātisāraghnō yathōktō dīpanō gaṇaḥ|
yōjyaścāmātisāraghnō yathōktō dīpanō gaṇaḥ|
laṅghitasyānupūrvyāṁ ca kr̥tāyāṁ na nivartatē||103||
laṅghitasyānupūrvyāṁ ca kr̥tāyāṁ na nivartatē||103||
kaphajō yadyatīsāraḥ kaphaghnaistamupācarēt bilvaṁ karkaṭikā mustamabhayā viśvabhēṣajam||104||
kaphajō yadyatīsāraḥ kaphaghnaistamupācarēt
bilvaṁ karkaṭikā mustamabhayā viśvabhēṣajam||104||
vacā viḍaṅgaṁ bhūtīkaṁ dhānyakaṁ dēvadāru ca|
vacā viḍaṅgaṁ bhūtīkaṁ dhānyakaṁ dēvadāru ca|
kuṣṭhaṁ sātiviṣā pāṭhā cavyaṁ kaṭukarōhiṇī||105||
kuṣṭhaṁ sātiviṣā pāṭhā cavyaṁ kaṭukarōhiṇī||105||
• Intake of the pulp of kapittha along with shunthi, pippali, maricha, honey and sugar, or katphala along with honey cures diseases of digestive system (jathara).
• Intake of the pulp of kapittha along with shunthi, pippali, maricha, honey and sugar, or katphala along with honey cures diseases of digestive system (jathara).
• Intake of pippali along with honey, or butter-milk added with the powder of chitraka or the powder of the tender fruits of bilva cures diseases of digestive system [102-112½].
• Intake of pippali along with honey, or butter-milk added with the powder of chitraka or the powder of the tender fruits of bilva cures diseases of digestive system [102-112½].
Management of complications of atisara:
==== Management of complications of atisara ====
कणांमधुयुतांपीत्वातक्रंपीत्वासचित्रकम् ||११३||
कणांमधुयुतांपीत्वातक्रंपीत्वासचित्रकम् ||११३||
जग्ध्वावाबालबिल्वानिमुच्यतेजठरामयात् |
जग्ध्वावाबालबिल्वानिमुच्यतेजठरामयात् |
• Diet prepared with vata alleviating ingredients along with the vegetable soup, meat soup and khada (a type of sour drink) described under vataj atisara should be given.
• Diet prepared with vata alleviating ingredients along with the vegetable soup, meat soup and khada (a type of sour drink) described under vataj atisara should be given.
• Sour medicated ghee like changeri ghrita or shatpala ghrita (C.S. Chi. 5: 147-148 or (ten years) old ghee mixed with yavagu (thick gruel) and manda (thin gruel) should be given [113-116].
• Sour medicated ghee like changeri ghrita or shatpala ghrita (C.S. Chi. 5: 147-148 or (ten years) old ghee mixed with yavagu (thick gruel) and manda (thin gruel) should be given [113-116].
Picchā-basti and anuvāsana-basti:
==== Picchā-basti and anuvāsana-basti ====
वातश्लेष्मविबन्धेवाकफेवाऽतिस्रवत्यपि |
वातश्लेष्मविबन्धेवाकफेवाऽतिस्रवत्यपि |
शूलेप्रवाहिकायांवापिच्छाबस्तिंप्रयोजयेत् ||११७||
शूलेप्रवाहिकायांवापिच्छाबस्तिंप्रयोजयेत् ||११७||
• Picchā-basti should be prepared of the paste of pippali, bilva, kustha, shatahvā and vachā by adding salt.
• Picchā-basti should be prepared of the paste of pippali, bilva, kustha, shatahvā and vachā by adding salt.
• Patient feels comfortable after the ingredients of piccha-basti come out of the rectum and then patient should be advised to take bath followed by intake of food. Anuvāsana basti with lukewarm oil of bilva (C.S.Si 4: 4-7) should be given in the afternoon.The anuvāsana basti can also be given frequently with the oil cooked with the paste of pippali, bilva, kushtha, shatahvā and vachā [117-120].
• Patient feels comfortable after the ingredients of piccha-basti come out of the rectum and then patient should be advised to take bath followed by intake of food. Anuvāsana basti with lukewarm oil of bilva (C.S.Si 4: 4-7) should be given in the afternoon.The anuvāsana basti can also be given frequently with the oil cooked with the paste of pippali, bilva, kushtha, shatahvā and vachā [117-120].
Need for immediate control of vata:
==== Need for immediate control of vata ====
स्वेस्थानेमारुतोऽवश्यंवर्धतेकफसङ्क्षये |
स्वेस्थानेमारुतोऽवश्यंवर्धतेकफसङ्क्षये |
सवृद्धःसहसाहन्यात्तस्मात्तंत्वरयाजयेत् ||१२१||
सवृद्धःसहसाहन्यात्तस्मात्तंत्वरयाजयेत् ||१२१||
When kapha gets reduced because of the above mentioned therapeutic measures, the vata undoubtedly gets aggravated in its own location (colon). This aggravated vata may cause instantaneous death and hence should be controlled without delay (121).
When kapha gets reduced because of the above mentioned therapeutic measures, the vata undoubtedly gets aggravated in its own location (colon). This aggravated vata may cause instantaneous death and hence should be controlled without delay (121).
Principle of treatment of sannipātaja atisara:
==== Principle of treatment of sannipātaja atisara ====
वातस्यानुजयेत्पित्तं, पित्तस्यानुजयेत्कफम् |
वातस्यानुजयेत्पित्तं, पित्तस्यानुजयेत्कफम् |
त्रयाणांवाजयेत्पूर्वंयोभवेद्बलवत्तमः ||१२२||
त्रयाणांवाजयेत्पूर्वंयोभवेद्बलवत्तमः ||१२२||
• The aggravated vata should be pacified first followed by the alleviation of the aggravated pitta followed by alleviation of kapha.
• The aggravated vata should be pacified first followed by the alleviation of the aggravated pitta followed by alleviation of kapha.
• Alternatively, the most aggravated one should be controlled first followed by the treatment of the remaining two dosha [122].
• Alternatively, the most aggravated one should be controlled first followed by the treatment of the remaining two dosha [122].
Summary:
==== Summary ====
तत्रश्लोकः-
तत्रश्लोकः-
प्रागुत्पत्तिनिमित्तानिलक्षणंसाध्यतानच |
प्रागुत्पत्तिनिमित्तानिलक्षणंसाध्यतानच |
Thus, ends the nineteenth chapter of Cikitsa-sthana (section on the treatment of diseases) dealing with the treatment of atisara (diarrhoea) in the work of Agnivesha as redacted by Charaka (19).
Thus, ends the nineteenth chapter of Cikitsa-sthana (section on the treatment of diseases) dealing with the treatment of atisara (diarrhoea) in the work of Agnivesha as redacted by Charaka (19).
Tattva vimarsha:
=== ''Tattva Vimarsha'' ===
• Atisara is caused by intake of heavy to digest, excessively hot and food that is incompatible to the body, impairement of agni and mind. The body reacts to expel out the incompatible material out of gut in the form of atisara.
• Atisara is caused by intake of heavy to digest, excessively hot and food that is incompatible to the body, impairement of agni and mind. The body reacts to expel out the incompatible material out of gut in the form of atisara.
• There are five catgoroies of etiological factors for atisara, 1. reduced agni, 2. vitiated vata and its sub types samana and apana. 3.vitiated body fluids. 4. vitiated purishvaha srotus and organs of excretion. 5. fear and grief (metal).
• There are five catgoroies of etiological factors for atisara, 1. reduced agni, 2. vitiated vata and its sub types samana and apana. 3.vitiated body fluids. 4. vitiated purishvaha srotus and organs of excretion. 5. fear and grief (metal).
• In case of sannipataja atisara, at first the aggravated vata shall be pacified followed by pitta and kapha. Alternatively, the most aggravated one should be controlled first followed by the treatment of the remaining two dosha.
• In case of sannipataja atisara, at first the aggravated vata shall be pacified followed by pitta and kapha. Alternatively, the most aggravated one should be controlled first followed by the treatment of the remaining two dosha.
Vidhi Vimarsha:
=== ''Vidhi Vimarsha'' ===
Importance of agni in context of atisara:
Importance of agni in context of atisara:
Milk is an emulsion or colloid of butter fat globules within a water-based fluid that contains dissolved carbohydrates and protein aggregates with minerals. Because it is produced as a food source for the young, all of its contents provide benefits for its growth. The principal requirements are energy (lipids, lactose, and protein), biosynthesis of non-essential amino acids supplied by proteins (essential amino acids and amino groups), essential fatty acids, vitamins and inorganic elements, and water.
Milk is an emulsion or colloid of butter fat globules within a water-based fluid that contains dissolved carbohydrates and protein aggregates with minerals. Because it is produced as a food source for the young, all of its contents provide benefits for its growth. The principal requirements are energy (lipids, lactose, and protein), biosynthesis of non-essential amino acids supplied by proteins (essential amino acids and amino groups), essential fatty acids, vitamins and inorganic elements, and water.
Milk composition analysis, per 100 grams
Milk composition analysis, per 100 grams
Constituents Unit Cow
Constituents Unit Cow
Energy kcal 66 60 95 110
Energy kcal 66 60 95 110
kJ 275 253 396 463
kJ 275 253 396 463
The disease atisara may be correlated to diarrhoea.
The disease atisara may be correlated to diarrhoea.
6. Clinical presentation, examination of the stool, routine blood tests and imaging reveal diagnosis in many cases.
6. Clinical presentation, examination of the stool, routine blood tests and imaging reveal diagnosis in many cases.
7. A series of negative investigations usually implies irritable bowel syndrome but some patients clearly have organic disease and need more extensive investigations.
7. A series of negative investigations usually implies irritable bowel syndrome but some patients clearly have organic disease and need more extensive investigations.
Differential diagnosis:
Colonic Malabsorption Small bowel
Colonic Malabsorption Small bowel
Clinical features Blood and mucus Steatorrhoea Large-volume,watery stool
Clinical features Blood and mucus Steatorrhoea Large-volume,watery stool