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Line 1,588: − • 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).+ − • Interaction of prakruti (basic constitution) and the diet and lifestyle of similar properties (as that of dosha prakriti) makes the person susceptible for atisara. + − • The exogenous factors like consumption of intoxicating beverages, exposure to krimi (bacteria and parasites), other diseases like shosha, jwara, arsha influence all the above factors and three dosha to cause sannipatic atisara (diarrhea) which includes bloody diahrrea.+ − • If spicy, hot, dry food in large quantity is ingested when agni is low, undigested food becomes waste product and samana vata sends it to excretory channels where apana vayu increases the motility of purishvaha srotus to excretes these large waste products, frequently. + − • To fill this vaccum created by expulsion of wastes, the body fluids shift to the gut and get expelled out as atisara/diarrhea causing dehydration.Thus after involvement of purishavaha srotasa ( lower GIT), udakavaha srotasa (body fluids) is also predominantly involved in pathogenesis of atisara. + − • Fear and grief are two important mental factors leading to atisara. The presentation and treatment of this atisara is similar to vata dominant atisara. The fear shall be treated with harshana(exhilaration) treatment and grief shall be treated with ashwasana (consolation) therapy. + − • The endogenous atisara shall be treated after proper assessment of dominant dosha, causative factors and pacifying factors, + − • At the initial stage of atisara when undigested food is being expelled, stambhan (anti diarrheal treatment) is strictly contraindicated. If stambhana is given, it leads to various complications. Mild laxatives like haritaki shall be administered for evacuating the mala (accumulated undigested wastes). Deepana and pachana (stimulation of agni for digestion and metabolism) should be given with light nutritive liquid foods. After restoration of agni, stambhan is given and care should taken to keep vata balanced.+ + + + + + + + + + + + − • In case of prolapse of rectum, medicated ghee processed with sour herbs or anuvasana (unctuous enema) is prescribed. − • Various states of atisara like that mixed with mucous, blood, associated with colic pain shall be treated with pichcha basti (mucilaginous enema). − • When kapha gets reduced because of the above mentioned therapeutic measures, the vata is aggravated in its own location (colon). This aggravated vata must be immediately treated as it may cause instantaneous death. − • 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. −
→Tattva Vimarsha
=== ''Tattva Vimarsha'' ===
=== ''Tattva Vimarsha'' ===
*''Atisara'' is caused by intake of heavy to digest, excessively hot and food that is incompatible to the body, impairment of ''agni'' and mind. The body reacts to expel out the incompatible material out of gut in the form of ''atisara''.
*There are five categories of etiological factors for ''atisara'':
#Reduced ''agni'',
#Vitiated ''vata'' and its sub types ''samana'' and ''apana''.
#Vitiated body fluids.
#Vitiated ''purishvaha srotas'' and organs of excretion.
#Fear and grief (metal).
*Interaction of ''prakriti'' (basic constitution) and the diet and lifestyle of similar properties (as that of ''dosha prakriti'') makes the person susceptible for ''atisara''.
*The exogenous factors like consumption of intoxicating beverages, exposure to '''krimi''' (bacteria and parasites), other diseases like ''shosha, jwara, arsha'' influence all the above factors and three ''dosha'' to cause ''sannipatik atisara'' (diarrhea) which includes bloody diarrhea.
*If spicy, hot, dry food in large quantity is ingested when ''agni'' is low, undigested food becomes waste product and ''samana vata'' sends it to excretory channels where ''apana vayu'' increases the motility of ''purishvaha srotas'' to excretes these large waste products, frequently.
*To fill this vacuum created by expulsion of wastes, the body fluids shift to the gut and get expelled out as ''atisara''/diarrhea causing dehydration.Thus after involvement of ''purishavaha srotasa'' ( lower GIT), ''udakavaha srotasa'' (body fluids) is also predominantly involved in pathogenesis of ''atisara''.
*Fear and grief are two important mental factors leading to ''atisara''. The presentation and treatment of this ''atisara'' is similar to ''vata'' dominant ''atisara''. The fear shall be treated with ''harshana''(exhilaration) treatment and grief shall be treated with ''ashwasana'' (consolation) therapy.
*The endogenous ''atisara'' shall be treated after proper assessment of dominant ''dosha'', causative factors and pacifying factors,
*At the initial stage of ''atisara'' when undigested food is being expelled, ''stambhan'' (anti diarrheal treatment) is strictly contraindicated. If ''stambhana'' is given, it leads to various complications. Mild laxatives like ''haritaki'' shall be administered for evacuating the ''mala'' (accumulated undigested wastes). ''Deepana'' and ''pachana'' (stimulation of ''agni'' for digestion and metabolism) should be given with light nutritive liquid foods. After restoration of ''agni, stambhan'' is given and care should taken to keep ''vata'' balanced.
*In case of prolapse of rectum, medicated ghee processed with sour herbs or ''anuvasana'' (unctuous enema) is prescribed.
*Various states of ''atisara'' like that mixed with mucous, blood, associated with colic pain shall be treated with ''pichcha basti'' (mucilaginous enema).
*When ''kapha'' gets reduced because of the above mentioned therapeutic measures, the ''vata'' is aggravated in its own location (colon). This aggravated ''vata'' must be immediately treated as it may cause instantaneous death.
*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'' ===