Changes

==== Treatment ====

==== Treatment ====

*Langhana becomes the first line of treatment in chhardi as shamana chikitsa (pacificatory treatment). Samshodha can be preferred where doshas are in utklisht stage and ready to be expelled out. Vamana is recommended when doshas are accumulated in amashya or amashayottha (originating from stomach or upper gastro-intestinal tract). Whereas virechana is recommended in case of post-amashayottha (in lower gastro intestinal tract) accumulated doshas, considering nearest route of samshodhana. The choice of drugs should be done as per the doshanashakatva (capacity to subside the vitiated doshas) ( verse 20).   

*''Langhana'' becomes the first line of treatment in ''chhardi'' as ''shamana chikitsa'' (pacificatory treatment). ''Samshodha'' can be preferred where ''doshas'' are in ''utklishtha'' stage and ready to be expelled out. ''Vamana'' is recommended when ''doshas'' are accumulated in '''amashaya''' or ''amashayottha'' (originating from stomach or upper gastro-intestinal tract). Whereas ''virechana'' is recommended in case of post-''amashayottha'' (in lower gastro-intestinal tract) accumulated ''doshas'', considering nearest route of ''samshodhana''. The choice of drugs should be done as per the ''doshanashakatva'' (capacity to subside the vitiated doshas) ( verse 20).   

*Haritaki is known for its laxative action (anulomaneeya). It not only tridoshahara but also posseses many more qualities (Charaka Chikitsa 1/1/29-34) which can be helpful for samprapti vighanatana (breaking pathogenesis) in chhardi.  The choice of hridya dravya (liking to mind) is recommended in chhardi which should be given with madya (alcohol) and dugdha (cow milk) as an anupana. Madya due to its specific guna (Cha. Su. 27/ 193-195) results in quick absorption of the dravya and hastens the mode of action. Dugdha (cow milk) along with many other qualities (Cha su 27/217-18) is naturally saraka (purgative) in nature which makes anulomana gati (natural movements) of vayu.  

*''Haritaki'' is known for its laxative action (''anulomaneeya''). It not only ''tridoshahara'' but also possesses many more qualities ([[Chikitsa Sthana]] 1/1/29-34) which can be helpful for ''samprapti vighanatana'' (breaking pathogenesis) in ''chhardi''.  The choice of ''hridaya dravya'' (liking to mind) is recommended in ''chhardi'' which should be given with ''madya'' (alcohol) and ''dugdha'' (cow milk) as an ''anupana''. ''Madya'' due to its specific ''guna'' (Cha. Su. 27/ 193-195) results in quick absorption of the ''dravya'' and hastens the mode of action. ''Dugdha'' (cow milk) along with many other qualities ([[Sutra Sthana]] 27/217-18) is naturally ''saraka'' (purgative) in nature which makes ''anulomana gati'' (natural movements) of ''vayu''.  

*As the doshas are already in utklishta avastha(stage of aggravation or ready to come out), the choice of valliphala for vamana is considered as a mridu (mild). On the other hand if the patient is weak and cannot tolerate the vamana effort, shamana chikitsa should be considered. The treatment planning should be done keeping manah as center point. The diet or pathya should be a manah prasannakara (mind pleasing) (Cha. Chi. 20/ 41-42) . It should be preferably mamsarasa, dry food or liquid diet which is easily digestible ( verses 21-22).   

*As the ''doshas'' are already in ''utklishta avastha''(stage of aggravation or ready to come out), the choice of valliphala for vamana is considered as a mridu (mild). On the other hand if the patient is weak and cannot tolerate the vamana effort, shamana chikitsa should be considered. The treatment planning should be done keeping manah as center point. The diet or pathya should be a manah prasannakara (mind pleasing) (Cha. Chi. 20/ 41-42) . It should be preferably mamsarasa, dry food or liquid diet which is easily digestible ( verses 21-22).   

*In vataja chhardi, laghu susanskrita mamsarasa (processed meat soup) is helpful in easy digestion and gives strength due to vatapacifying property. The yusha prepared from amlarasatmaka (sour taste) is not only vata pacifying but also stimulates the heart and leads to Anulomana gati of vayu. Ghrita as sanskaranuvartana (synergistically increases the properties of associated drugs) (Cha. Su. 27/231-32, Cha. Su. 13/13) can be benifitial in vātaja hridroga.  

*In vataja chhardi, laghu susanskrita mamsarasa (processed meat soup) is helpful in easy digestion and gives strength due to vatapacifying property. The yusha prepared from amlarasatmaka (sour taste) is not only vata pacifying but also stimulates the heart and leads to Anulomana gati of vayu. Ghrita as sanskaranuvartana (synergistically increases the properties of associated drugs) (Cha. Su. 27/231-32, Cha. Su. 13/13) can be benifitial in vātaja hridroga.  

*If the aggravated doshas are in distal part of amāshaya (post- amāshaya) the nearest route to remove pitta is through virechana procedure. If the aggravated pitta is in amāshaya then the nearest route to remove pitta is through vamana. Both these procedures should be adopted in balavan rogi (physically strong) judiciously clubbing with proper samsarjana krama (protocol after purification procedure) to prevent aggravation of vata dosha.  

*If the aggravated doshas are in distal part of amāshaya (post- amāshaya) the nearest route to remove pitta is through virechana procedure. If the aggravated pitta is in amāshaya then the nearest route to remove pitta is through vamana. Both these procedures should be adopted in balavan rogi (physically strong) judiciously clubbing with proper samsarjana krama (protocol after purification procedure) to prevent aggravation of vata dosha.