Changes

|keywords=atisara, diarrhea, ama, nirama, sangrahi treatment, pichcha basti,Ayurveda, Indian system of medicine, charak samhita.  

|keywords=atisara, diarrhea, ama, nirama, sangrahi treatment, pichcha basti,Ayurveda, Indian system of medicine, charak samhita.  

|description=Chikitsa Sthana Chapter 20. Management of Chhardi (vomiting)

|description=Chikitsa Sthana Chapter 20. Management of Chhardi (vomiting)

|image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg

|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg

|image_alt=charak samhita

|image_alt=charak samhita

|type=article

|type=article

|label7 = Reviewer  

|label7 = Reviewer  

|data7  = Prasad B.S.

|data7  = Prasad B.S.

|label8 = Editor

|label8 = Editors

|data8  = Singh G., Goyal M.

|data8  = Singh G., Goyal M., Deole Y.S., Basisht G.

|label9 = Date of publication  

|label9 = Year of publication  

|data9 = December 17, 2018

|data9 = 2020

|label10 = DOI

|label10 = Publisher

|data10  =  

|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]

|header3 =  

|label11 = DOI

 

|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.021 10.47468/CSNE.2020.e01.s06.021]

}}

}}

=== Types of ''chhardi'' ===

=== Types of ''chhardi'' ===

Diseases are classified according to the dominance of ''doshas''-involved and their mutual amalgamation, which are of four types. The 5th type of ''chhardi'' (''dwishtarthayoga'') is due to aversive food related to the involvement of ''panchagyanendriyas'' (five sense organs) and their ''vishaya upalabdhi'' (Cha su 1/54) (perceivance of senses). The contact through ''rupa'' (visible) or ''rasa'' (taste) or ''gandha'' (smell) or ''sparsha'' (touch) or ''shabda'' (hear) or in combination with each other, stimulates body mechanism which results in ''dwistarthayoga chhardi'' (vomiting due to aversion). One cannot exclude the role of ''manah'' (mind) as predisposing factor in causing ''dwistarthayoga chhardi''.  

Diseases are classified according to the dominance of ''doshas''-involved and their mutual amalgamation, which are of four types. The 5th type of ''chhardi'' (''dwishtarthayoga'') is due to aversive food related to the involvement of ''panchagyanendriyas'' (five sense organs) and their ''vishaya upalabdhi'' [Cha. Sa. [[Sutra Sthana]] 1/54] (perceivance of senses). The contact through ''rupa'' (visible) or ''rasa'' (taste) or ''gandha'' (smell) or ''sparsha'' (touch) or ''shabda'' (hear) or in combination with each other, stimulates body mechanism which results in ''dwistarthayoga chhardi'' (vomiting due to aversion). One cannot exclude the role of ''manah'' (mind) as predisposing factor in causing ''dwistarthayoga chhardi''.  

''Douhruda janita'' (pregnancy induced vomitting), ''satmya prakopaja'' (vomiting due to inadequacy of substances) and ''krimija'' (vomiting due to microbial infection) type of ''chhardi'' are other causes of ''chhardi''.<ref>Shastri Ambika Dutt, Sushruta Samhita, Hindi commentary by Kaviraj 5th Edition, 1982, Chaukhamba Sanskrit Series, Varanasi</ref>  

''Douhruda janita'' (pregnancy induced vomitting), ''satmya prakopaja'' (vomiting due to inadequacy of substances) and ''krimija'' (vomiting due to microbial infection) type of ''chhardi'' are other causes of ''chhardi''.<ref>Sushruta. Sushruta Samhita . In: Kaviraj Shastri Ambika Dutt, Editors. 5th ed. Varanasi: Chaukhambha Sanskrit Series;1982. p.?.</ref>  

==== ''Vataja chhardi'' ====   

==== ''Vataja chhardi'' ====   

*''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).   

*''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 possesses many more qualities [Cha. Sa. [[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 [ Cha. Sa.[[Sutra Sthana]] 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 [Cha. Sa. [[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.Sa. [[Sutra Sthana]] 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. Sa.[[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. Sa.[[Chikitsa Sthana]] 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. Sa.[[Chikitsa Sthana]] 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 ''vata'' pacifying 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. Sa.[[Sutra Sthana]] 27/231-32] and [ Cha. Sa. [[Sutra Sthana]] 13/13] can be beneficial in ''vataja hridroga''.  

*In ''vataja chhardi'', ''laghu susanskrita mamsarasa'' (processed meat soup) is helpful in easy digestion and gives strength due to ''vata'' pacifying 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. Sa.[[Sutra Sthana]] 27/231-32] and [ Cha. Sa. [[Sutra Sthana]] 13/13] can be beneficial in ''vataja hridroga''.