Sushruta Samhita Uttaratantra Chapter 40 Atisära Pratiṣedha (Therapy of Diarrhoea) ⋆ Straightforward Ayurveda Hospital

The above talked about 5 sorts of formulations must be consumed with comfy heat water.

निवृत्तेष्वामशूलेषु यस्य न प्रगुणोऽनिलः |
स्तोकं स्तोकं रुजामच्च सशूलं योऽतिसार्यते ||५४||
सक्षारलवणैर्युक्तं मन्दाग्निः स पिबेद्घृतम् |
क्षीरनागरचाङ्गेरीकोलदध्यम्लसाधितम् ||५५||
सर्पिरच्छं पिबेद्वापि शूलातीसारशान्तये |
दध्ना तैलघृतं पक्वं सव्योषाजातिचित्रकैः ||५६||
सबिल्वपिप्पलीमूलदाडिमैर्वा रुगन्वितैः |
निखिलो विधिरुक्तोऽयं वातश्लेष्मोपशान्तये ||५७||

Ghee must be boiled and ready with the under talked about components –

–        milk,

–        nagara,

–        cangeri,

–        kola and

–        dadhyamla

This ghee must be administered within the under talked about circumstances –

–        after the stomach ache has subsided,

–        in individuals in whom vata shouldn’t be aggravated,

–        when faeces is expelled in small portions and sometimes, and

–        in presence of ache and poor digestive fireplace / energy

Alternatively, plain ghee must be given for consuming.

These ghee would mitigate ache and diarrhoea.

Oil or ghee must be cooked with curd. It must be added with Vyosa, Ajaji, Citraka, Bilva, Pippalimula and Dadima. This must be administered to the affected person affected by ache.

The above stated are the remedies useful for mitigating diarrhoea produced by vata-kapha i.e. mixed aggravation of vata and kapha.

Pittätisära cikitsä

तीक्ष्णोष्णवर्ज्यमेनं तु विदध्यात्पित्तजे भिषक् |
यथोक्तमुपवासान्ते यवागूश्च प्रशस्यते ||५८||
बलयोरंशुमत्यां च श्वदंष्ट्रबृहतीषु च |
शतावर्यां च संसिद्धाः सुशीता मधुसंयुताः ||५९||
मुद्गादिषु च यूषाः स्युर्द्रव्यैरेतैः सुसंस्कृताः |६०|

Herbs having scorching efficiency and penetrating qualities shouldn’t be prescribed by the doctor whereas treating the diarrhoea produced by pitta. He ought to in reality advise the affected person to do fasting and use of yavagu – thick gruels on the finish.

The affected person shall devour ghee boiled with the under talked about herbs in a chilly state, combined with honey –

–        bala and amsumati,

–        svadamstra and brhati or

–        satavari

Alternatively, yusa – soup of mudga and so forth. processed with the identical herbs talked about above shall be consumed.

मृदुभिर्दीपनैस्तिक्तैर्द्रव्यैः स्यादामपाचनम् ||६०||
हरिद्रातिविषापाठावत्सबीजरसाञ्जनम् |
रसाञ्जनं हरिद्रे द्वे बीजानि कुटजस्य च ||६१||
पाठा गुडूची भूनिम्बस्तथैव कटुरोहिणी |
एतैः श्लोकार्धनिर्दिष्टैः क्वाथाः स्युः पित्तपाचनाः ||६२||

Ama would get digested when the herbs which increase starvation mildly and predominantly have a bitter style are administered.

To digest ama related to pitta, the decoctions of herbs talked about within the under talked about half verses could also be used –

1.   Haridra, Ativisa, Patha, Vatsabija and Rasanjana,
2.   Rasanjana, two sorts of Haridra and Kutaja Bija,
3.   Patha, Guduci, Bhunimba and Katurohini

मुस्तं कुटजबीजानि भूनिम्बं सरसाञ्जनम् |
दार्वी दुरालभा बिल्वं वालकं रक्तचन्दनम् ||६३||
चन्दनं वालकं मुस्तं भूनिम्बं सदुरालभम् |
मृणालं चन्दनं रोध्रं नागरं नीलमुत्पलम् ||६४||
पाठा मुस्तं हरिद्रे द्वे पिप्पली कौटजं फलम् |
फलत्वचं वत्सकस्य शृङ्गवेरं घनं [१] वचा ||६५||
षडेतेऽभिहिता योगाः पित्तातीसारनाशनाः |६६|
Under talked about six formulations in decoction kind is helpful in curing pittatisara – diarrhoea brought on by aggravated pitta –

1. Mustā, kutajabija, bhūnimba and rasañjana
2. Dārvī, durālabhā, bilva, valaka and raktacandana
3. Cañidana, vālaka, mustā, bhūnimba and durālabhā
4. Mrnāla, candana, rodhra, nāgara and nilotpala
5. Pathā, mustā, the 2 haridra, pippali and kutajaphala
6. Bark of fruit of vatsaka, Sringavera, ghana and vacã

बिल्वशक्रयवाम्भोदबालकातिविषाकृतः |
कषायो हन्त्यतीसारं सामं पित्तसमुद्भवम् ||६६||
मधुकोत्पलबिल्वाब्दह्रीबेरोशीरनागरैः |
कृतः क्वाथो मधुयुतः पित्तातीसारनाशनः ||६७||

Decoction of the under talked about herbs cures diarrhoea brought on by pitta –

–        Bilva,

–        Sakrayava – Indrayava,

–        Amboda – Musta,

–        Valaka and

–        Ativisa

Decoction must be ready with under talked about herbs –

–        Madhuka,

–        Utpala,

–        Bilva,

–        Abda,

–        Hribera,

–        Usira and

–        Nagara

Honey must be added to this decoction. When consumed, it cures diarrhoea brought on by pitta.

यदा पक्वोऽप्यतीसारः सरत्येव मुहुर्मुहुः |
ग्रहण्या मार्दवाज्जन्तोस्तत्र संस्तम्भनं हितम् ||६८||

Controlling the diarrhoea is helpful when –

–        it has change into ripe (pakva) after lapse of some days however,

–        the faeces typically strikes out as a result of weak point of grahani (duodenum)

समङ्गा धातकीपुष्पं मञ्जिष्ठा लोध्रमुस्तकम् |
शाल्मलीवेष्टको रोध्रं वृक्षदाडिमयोस्त्वचौ ||६९||
आम्रास्थिमध्यं लोध्रं च बिल्वमध्यं प्रियङ्गवः |
मधुकं शृङ्गवेरं च दीर्घवृन्तत्वगेव च ||७०||
चत्वार एते योगाः स्युः पक्वातीसारनाशनाः |
उक्ता य उपयोज्यास्ते सक्षौद्रास्तण्डुलाम्बुना ||७१||

Powder of the herbs talked about under within the half verses remedy pakva atisara – ripe diarrhoea brought on by pitta –

1. Samañgā, dhätakīpuṣpa, mañjistha, lodhra and mustaka.
2. Śālmalivestaka (gum of Śālmali tree), rodhra and bark of vrksa (kutaja) and dadima.
3. Kernel of seed of āmra, lodhra, pulp of bilva fruit and priyañgu
4. Madhuka, Srngavera and bark of dirghavrita (aralu),

These powders must be administered combined with honey and rice wash.

मौस्तं कषायमेकं वा पेयं मधुसमायुतम् |
लोध्राम्बष्ठाप्रियङ्ग्वादीन् गणानेवं प्रयोजयेत् ||७२||

Alternatively, decoction of musta alone must be consumed by the affected person, including honey to the decoction.

Equally, decoction of herbs belonging to the under talked about teams could also be used –

–        Lodhradi Gana,

–        Ambasthadi Gana and

–        Priyangvadi Gana

पद्मां समङ्गां मधुकं बिल्वजम्बूशलाटु च |
पिबेत्तण्डुलतोयेन सक्षौद्रमगदङ्करम् ||७३||

Powder of the under talked about components must be consumed together with rice-wash and honey –

–        Padma,

–        Samanga,

–        Madhuka,

–        Tender fruits of Bilva and

–        Jambu

This recipe cures Pittaja Atisara.

कच्छुरामूलकल्कं वाऽप्युदुम्बरफलोपमम् |
पयस्या चन्दनं पद्मा सितामुस्ताब्जकेशरम् ||७४||
पक्वातिसारं योगोऽयं जयेत्पीतः सशोणितम् |७५|

Alternatively, the under talked about recipes must be used to remedy Pakvatisara with bleeding –

1. Paste of root of Kaccura (Kankatika), equal to the scale of Udumbara fruit – must be consumed with rice-wash added with honey,
2. Paste of the under talked about components must be consumed with rice-wash added with honey

–        Payasya,

–        Candana,

–        Padma,

–        Sita,

–        Musta,

–        Abja and

–        Kesara (Padma Kesara)

निरामरूपं शूलार्तं लङ्घनाद्यैश्च कर्षितम् ||७५||
नरं रूक्षमवेक्ष्याग्निं सक्षारं पाययेद्घृतम् |७६|

Ghee added with Yava Ksara must be administered after contemplating the digestive fireplace / energy, to the individual –

–        who has signs of absence of ama,

–        has stomach ache,

–        is emaciated by fasting and so forth. therapies and

–        is dry (physique is dry)

बलाबृहत्यंशुमतीकच्छुरामूलसाधितम् ||७६||
मधूक्षितं समधुकं पिबेच्छूलैरभिद्रुतः |७७|

Decoction of the under talked about components cures stomach ache if the affected person drinks it combined with honey –

–        Bala,

–        Brhati,

–        Amsumati,

–        Kaccuramula and

–        Madhuka

Sannipata atisara cikitsä

दार्वीबिल्वकणाद्राक्षाकटुकेन्द्रयवैर्घृतम् ||७७||
साधितं हन्त्यतीसारं वातपित्तकफात्मकम् |
दध्ना चाम्लेन सम्पक्वं सव्योषाजाजिचित्रकम् ||७८||
सचव्यपिप्पलीमूलं दाडिमैर्वा रुगर्दितः |
पयो घृतं च मधु च पिबेच्छूलैरभिद्रुतः ||७९||
सिताजमोदकट्वङ्गमधुकैरवचूर्णितम् |८०|

Ghee boiled and ready with the under talked about herbs cures diarrhoea produced by all three doshas i.e. vata, pitta and kapha collectively –

–        Darvi,

–        Bilva,

–        Kana,

–        Draksa,

–        Katuka and

–        Indrayava

Alternatively, ghee boiled and ready with bitter curds together with Vyosa, Rajani, Citraka, Cavya, Pippalimula and Dadima could also be consumed by the affected person. This is able to remedy the ache.

Additionally, combination of the under talked about must be consumed –

–        milk,

–        ghee,

–        honey or

–        sugar

Powder of Ajamoda, Katvanga and Madhuka must be added to this recipe whereas consuming. This recipe cures ache.

अवेदनं सुसम्पक्वं दीप्ताग्नेः सुचिरोत्थितम् ||८०||
नानावर्णमतीसारं पुटपाकैरुपाचरेत् |८१|

Putapaka (juice of medicinal herbs cooked inside burning coal) is good for use in treating atisara within the under talked about circumstances –

–        diarrhoea not related to ache,

–        is ripe i.e. has change into outdated,

–        persisting for very long time,

–        faeces of various colors eradicated, for very long time and

–        the affected person having keenness of digestive fireplace

त्वक्पिण्डं दीर्घवृन्तस्य पद्मकेसरसंयुतम् ||८१||
काश्मरीपद्मपत्रैश्चावेष्ट्य सूत्रेण सन्दृढम् |
मृदाऽवलिप्तं सुकृतमङ्गारेष्ववकूलयेत् ||८२||
स्विन्नमुद्धृत्य निष्पीड्य रसमादाय तं ततः |
शीतं मधुयुतं कृत्वा पाययेतोदरामये ||८३||
जीवन्तीमेषशृङ्ग्यादिष्वेवं द्रव्येषु साधयेत् |८४|

Balls are ready from paste of Dirghavrita (Syonaka) bark added with filaments of lotus flower (Padmakesara). These balls are enveloped with leaves of Kasmari or Padma and fixed nicely with thread. Later, a coating of mud is given on this and the balls are dried barely. The dried balls are put right into a heap of burning coal and correctly cooked. The balls are taken out as soon as they’re correctly cooked. The layers are eliminated and the balls of medicinal herbs are squeezed in order to extract its juice. As soon as this juice is cooled, honey is added to it. The affected person having stomach ailments (diarrhoea right here) ought to drink this juice.

Equally, the juice obtained from Jivanti, Mesasrngi and so forth. extracted in the identical (defined) technique can also be used.

तित्तिरिं लुञ्चितं सम्यक् निष्कृष्टान्त्रं तु पूरयेत् ||८४||
न्यग्रोधादित्वचां कल्कैः पूर्ववच्चावकूलयेत् |
रसमादाय तस्याथ सुस्विन्नस्य समाक्षिकम् ||८५||
शर्करोपहितं शीतं पाययेतोदरामये |८६|

Feathers and intestines (beak and legs additionally) of a Tittiri chook are eliminated and the chook is stuffed with paste of bark of Nyagrodha and so forth. i.e. barks of Pancavalkala timber. This mass is enveloped with leaves and dust plaster as defined above. That is cooked inside a heap of burning coal following the putapaka technique as defined earlier (above context). It’s taken out as soon as it’s nicely cooked and its juice is extracted. This juice is combined with honey and sugar. The affected person affected by stomach ailments (diarrhoea right here) ought to devour this juice. This recipe will remedy the illness.

लोध्रचन्दनयष्ट्याह्वदार्वीपाठासितोत्पलान् ||८६||
तण्डुलोदकसम्पिष्टान् दीर्घवृन्तत्वगन्वितान् |
पूर्ववत् कूलितात्तस्माद्रसमादाय शीतलम् ||८७||
मध्वाक्तं पाययेच्चैतत् कफपित्तोदरामये |८८|

Ball is ready by macerating Lodhra, Candana, Yastyahva, Darvipatha and Sitotpala in rice-wash. This ball is roofed with bark of Dirghavrnta and cooked as described above. After the ball is cooked, it’s eliminated, its layers are separated and the juice is extracted from the ball of herbs. This juice is combined with honey. When administered, this recipe cures diarrhoea brought on by mixed vitiation of kapha and pitta.

एवं प्ररोहैः कुर्वीत वटादीनां विधानवत् ||८८||
पुटपाकान् यथायोगं जाङ्गलोपहितान् शुभान् |८९|

Equally, juice of leaf buds of Vata and so forth. timber could also be obtained and used and so additionally the juice of meat of birds dwelling in arid areas.

बहुश्लेष्म सरक्तं च मन्दवातं चिरोत्थितम् ||८९||
कौटजं फाणितं वाऽपि हन्त्यतीसारमोजसा |
अम्बष्ठादिमधुयुतं पिप्पल्यादिसमन्वितम् ||९०||

Kutaja Phanita would remedy atisara with its energy (motion) within the under talked about circumstances –

–        if there may be extra mucus within the faeces in atisara,

–        if faeces is combined with blood,

–        if the operate of vata is delicate and

–        if the illness is persisting for a very long time

Alternatively, Phanita of herbs belonging to Pippalyadi Gana group combined with honey and administered may also remedy that illness.

पृश्निपर्णीबलाबिल्ववालकोत्पलधान्यकैः |
सनागरैः पिबेत् पेयां साधितामुदरामयी ||९१||

Peya – skinny gruel ready with the under talked about herbs could also be consumed by the affected person of atisara –

–        Prsniparni,

–        Bala,

–        Bilva,

–        Valaka,

–        Utpala,

–        Dhanyaka and

–        Nagara

अरलुत्वक् प्रियङ्गुं च मधुकं दाडिमाङ्कुरान् |
आवाप्य पिष्ट्वा दधनि यवागूं साधयेद्द्रवाम् ||९२||
एषा सर्वानतीसारान् हन्ति पक्वानसंशयम् |९३|

Under talked about components are macerated with curd –

–        Bark of Aralu,

–        Priyangu,

–        Madhuka and

–        Tender leaves of Dadima

From this, Yavagu – thick gruel is ready.

When consumed, it cures all types of outdated (persistent / ripe) diarrhoeas with none doubt.

रसाञ्जनं सातिविषं त्वग्बीजं कौटजं तथा ||९३||
धातकी नागरं चैव पाययेत्तण्डुलाम्बुना |
सशूलं रक्तजं घ्नन्ति एते मधुसमायुताः ||९४||

Powder of the under talked about components must be ready –

–        Rasanjana,

–        Ativisa,

–        Bark and seeds of Kutaja,

–        Dhataki and

–        Nagara

This must be consumed together with rice wash added with honey. It cures diarrhoea accompanied with ache and bleeding.

मधुकं बिल्वपेशी च शर्करामधुसंयुता |
अतीसारं निहन्युश्च शालिषष्टिकयोः कणाः ||९५||
तद्वल्लीढं मधुयुतं बदरीमूलमेव तु |९६|

For remedy of diarrhoea, Madhuka and younger fruit of Bilva must be given to the affected person added with sugar and honey.

Equally, flour of Sali and Sastika rice must be administered with sugar and honey.

Alternatively, paste of root of Badari must be consumed added with sugar and honey. This recipe too will remedy diarrhoea.

बदर्यर्जुनजम्ब्वाम्रशल्लकीवेतसत्वचः ||९६||
शर्कराक्षौद्रसंयुक्ताः पीता घ्नन्त्युदरामयम् |९७|
एतैरेव यवागूंश्च षडान् यूषांश्च कारयेत् ||९७||
पानीयानि च तृष्णासु द्रव्येष्वेतेषु बुद्धिमान् |९८|
Paste of the under talked about herbs must be combined with sugar and honey –

–        Bark of Badari,

–        Arjuna,

–        Jambu,

–        Amra,

–        Sallaki and

–        Vetasa

When consumed, this recipe cures diarrhoea.

The identical herbs can be utilized by an clever doctor to organize the under mentionend recipes –

–        Yavagu – thick gruel,

–        Sadava – bitter fruit salad and

–        Yusa – soup and

–        Paniya – consuming water

These recipes additionally remedy diarrhoea.

कृतं शाल्मलिवृन्तेषु कषायं हिमसञ्ज्ञितम् ||९८||
निशापर्युषितं पेयं सक्षौद्रं मधुकान्वितम् |९९|

Chilly infusion (hima kashaya) of Salmali Vrnta must be ready and stored in a single day. This must be used subsequent morning added with honey.

विबद्धवातविट् शूलपरीतः सप्रवाहिकः ||९९||
सरक्तपित्तश्च पयः पिबेत्तृष्णासमन्वितः |
यथाऽमृतं तथा क्षीरमतीसारेषु पूजितम् ||१००||
चिरोत्थितेषु तत् पेयमपां भागैस्त्रिभिः शृतम् |
दोषशेषं हरेत्तद्धि तस्मात्पथ्यतमं स्मृतम् ||१०१||

Milk must be consumed by the affected person within the under talked about circumstances –

–        he who has obstruction of flatus and faeces,

–        stomach ache,

–        straining whereas defecating,

–        raktapitta – bleedingn problems and

–        thirst

Milk is just like nectar in diarrhoeas.

Milk must be consumed with three elements of water in persistent diarrhoeas. Because the milk removes residue of doshas, it’s thought-about as most fitted in atisara.

हितः स्नेहविरेको वा बस्तयः पिच्छिलाश्च ये |
पिच्छिलस्वरसे सिद्धं हितं च घृतमुच्यते ||१०२||

Under talked about recipes are additionally useful –

–        Sneha Virechana – unctuous purgatives,

–        Picchila Basti – enema ready with slimy substances, ready from recent juice of slimy substances and

–        Ghrta – Use of medicated ghee

शकृता यस्तु संसृष्टमतिसार्येत शोणितम् |
प्राक् पश्चाद्वा पुरीषस्य सरुक् सपरिकर्तिकः ||१०३||
क्षीरिशुङ्गाशृतं सर्पिः पिबेत् सक्षौद्रशर्करम् |१०४|

Ghee must be ready with decoction of leaf buds of ksiri vrksa i.e. timber yielding milky sap. This ghee is combined with honey and sugar and could also be consumed when –

–        the blood is being eradicated both combined with faeces or earlier than or after elimination of faeces, accompanied with

–        ache in stomach and

–        reducing ache within the anus / rectum

दार्वीत्वक्पिप्पलीशुण्ठीलाक्षाशक्रयवैर्घृतम् ||१०४||
संयुक्तं भद्ररोहिण्या पक्वं पेयादिमिश्रितम् |
त्रिदोषमप्यतीसारं पीतं हन्ति सुदारुणम् ||१०५||

Decoction must be ready with –

–        Bark of Darvi,

–        Pippali,

–        Sunthi,

–        Laksa,

–        Sakrayava – Indrayava and

–        Bhadrarohini – Katukarohini

Ghee must be ready with this decoction. When consumed together with peya (skinny gruel) and so forth., this recipe cures even dreadful diarrhoea brought on by all three doshas collectively.

गौरवे वमनं पथ्यं यस्य स्यात् प्रबलः कफः |
ज्वरे दाहे सविड्बन्धे मारुताद्रक्तपित्तवत् ||१०६||

Therapeutic emesis is good when the affected person has a sense of heaviness within the physique attributable to predominance of kapha.

Atisara shall be handled on the strains of treating adhoga raktapitta i.e. bleeding from downward path, when there may be fever, burning sensation and constipation attributable to predominance of vata.

सम्पक्वे बहुदोषे च विबन्धे मूत्रशोधनैः |
कार्यमास्थापनं क्षिप्रं तथा [१] चैवानुवासनम् ||१०७||

Decoction enema ready with herbs which purify urine must be shortly administered adopted by oil enema, when the doshas are ripe and when the individual has constipation.

प्रवाहणे गुदभ्रंशे मूत्राघाते कटिग्रहे |
मधुराम्लैः शृतं तैलं सर्पिर्वाऽप्यनुवासनम् ||१०८||

Oil or ghee boiled and ready with herbs predominantly having candy and bitter tastes is one of the best one for anuvasana basti (unctuous enema) when –

–        there may be straining,

–        prolapse of rectum,

–        retention of urine and

–        catching ache within the waist

गुदपाकस्तु पित्तेन यस्य स्यादहिताशिनः |
तस्य पित्तहराः सेकास्तत्सिद्धाश्चानुवासनाः ||१०९||
दधिमण्डसुराबिल्वसिद्धं तैलं समारुते |
भोजने च हितं क्षीरं कच्छुरामूलसाधितम् ||११०||

In individuals who’re indulged in unsuitable meals, pitta aggravation takes place and would trigger gudapaka (suppuration of anus / rectum). In such circumstances, under talked about remedies are useful –

–        pouring liquids which mitigate pitta and

–        unctuous enema with oils ready from pitta mitigating herbs,

When vata is predominant, oil ready with whey (scum of curds), beer (sura) and bilva is good for use. Likewise, milk boiled and ready with roots of Kacchura used together with meals is appropriate.

अल्पाल्पं बहुशो रक्तं सरुग्य उपवेश्यते |
यदा वायुर्विबद्धश्च पिच्छाबस्तिस्तदा हितः ||१११||

Pichcha Basti i.e. slimy enemas are useful and therefore administered when the individual is eliminating small portions of faeces and extra blood accompanied with ache and retention of flatus.

प्रायेण गुददौर्बल्यं दीर्घकालातिसारिणाम् |
भवेत्तस्माद्धितं तेषां गुदे तैलावचारणम् ||११२||

Often, when diarrhoea persists for a very long time, weak point of the rectum / anus develops. Subsequently it’s useful to use medicated oil into the anus.

कपित्थशाल्मलीफञ्जीवटकार्पासदाडिमाः |
यूथिका कच्छुरा शेलुः शणश्चुच्चूश्च दाधिकाः ||११३||
शालपर्णी पृश्निपर्णी बृहती कण्टकारिका |
बलाश्वदंष्ट्राबिल्वानि पाठानागरधान्यकम् ||११४||
एष आहारसंयोगे हितः सर्वातिसारिणाम् |
तिलकल्को हितश्चात्र मौद्गो मुद्गरसस्तथा ||११५|| 

Under talked about herbs boiled and combined with curds must be used together with meals –

–        Kapittha,

–        Salmali,

–        Vata,

–        Karpasa,

–        Dadima,

–        Yuthika,

–        Kacchura,

–        Selu,

–        Sana and

–        Cunccu

Under talked about herbs are useful for utilization as adjuncts to meals and to remedy all types of diarrhoea –

–        Saliparni,

–        Prsniparni,

–        Brhati,

–        Kantakari,

–        Bala,

–        Svadamstra,

–        Bilva,

–        Patha,

–        Nagara and

–        Dhanyaka

Equally, paste of tila – sesame or mudga – inexperienced gram taken with mudgarasa – soup of inexperienced gram is helpful.

Raktātisāra – haemorrhagic diarrhoea

पित्तातिसारी यो मर्त्यः पित्तलान्यतिषेवते |
पित्तं प्रदुष्टं तस्याशु रक्तातीसारमावहेत् ||११६||
ज्वरं शूलं तृषां दाहं गुदपाकं च दारुणम् |११७|

Raktatisara (Rakta Atisara) means diarrhoea whereby blood is eradicated with free stools i.e. diarrhoea with haemorrhage from rectum (anus). That is prompted when a affected person affected by pitta kind of diarrhoea will get indulged in meals which irritate pitta. Resulting from this, the pitta will get excessively elevated and causes bloody diarrhoea.

Raktatisara is related to

–        fever,

–        ache within the stomach,

–        thirst,

–        burning sensation and

–        extreme suppuration of rectum / anus

यो रक्तं शकृतः पूर्वं पश्चाद्वा प्रतिसार्यते ||११७||
स पल्लवैर्वटादीनां ससर्पिः साधितं पयः |
पिबेत् सशर्कराक्षौद्रमथवाऽप्यभिमथ्य तत् ||११८||
नवनीतमथो लिह्यात्तक्रं चानुपिबेत्ततः |११९|

Under talked about recipes must be consumed by the affected person who eliminates blood both earlier than or after defecation –

–        milk boiled with leaf buds of vata and so forth. herbs i.e. pancavalkala added with ghee,

–        lick butter ready from milk which has been added with the above stated (vata and so forth) leaf buds and churned with sugar and honey, this must be adopted by consuming buttermilk

प्रियालशाल्मलीप्लक्षशल्लकीतिनिशत्वचः ||११९||
क्षीरे विमृदिताः पीताः सक्षौद्रा रक्तनाशनाः |१२०|

Under talked about herbs must be combined milk, churned nicely and consumed after including honey to it –

–        Bark of Priyangu,

–        Salmali,

–        Plaksa,

–        Sallaki and

–        Tinisa

This recipe cures bleeding.

मधुकं शर्करां लोध्रं पयस्यामथ सारिवाम् ||१२०||
पिबेच्छागेन पयसा सक्षौद्रं रक्तनाशनम् |१२१|

Under talked about must be boiled in goat’s milk –

–        Madhuka,

–        Sarkara,

–        Lodhra,

–        Payasa and

–        Sariva

Honey is added to this milk and combined correctly. When consumed, this recipe cures haemorrhage.

मञ्जिष्ठां सारिवां लोध्रं पद्मकं कुमुदोत्पलम् ||१२१||
पिबेत् पद्मां च दुग्धेन छागेनासृक्प्रशान्तये |१२२|

Under talked about components are boiled and processed in goat’s milk –

–        Manjistha,

–        Sariva,

–        Lodhra,

–        Padmaka,

–        Kumuda,

–        Utpala and

–        Padma

When this medicated milk is consumed, it stops bleeding.

शर्करोत्पललोध्राणि समङ्गा मधुकं तिलाः ||१२२||
तिलाः कृष्णाः सयष्ट्याह्वाः समङ्गा चोत्पलानि च |
तिला मोचरसो लोध्रं तथैव मधुकोत्पलम् ||१२३||
कच्छुरा तिलकल्कश्च योगाश्चत्वार एव च |
आजेन पयसा पेयाः सरक्ते मधुसंयुताः ||१२४||

The under talked about 4 teams of herbs must be boiled in goat’s milk and consumed added with honey –

1.   Sarkara, urpala. lodhra, samanga, madhuka and tila.
2.   Krsnatila, yastyāhva, samanga and utpala
3.   Tila, mocarasa, lodhra, madhuka and utpala
4.   Kacchura and tila paste

These recipes remedy bleeding.

द्रवे सरक्ते स्रवति बालबिल्वं सफाणितम् |
सक्षौद्रतैलं प्रागेव लिह्यादाशु हितं हि तत् ||१२५||

Phanita i.e. molasses must be consumed together with tender fruit of Bilva, honey and sesame oil. That is useful when liquid faeces is eradicated with blood and must be administered proper initially itself.

कोशकारं घृते भृष्टं लाजचूर्णं सिता मधु |
सशूलं रक्तपित्तोत्थं लीढं हन्त्युदरामयम् ||१२६||
बिल्वमध्यं समधुकं शर्कराक्षौद्रसंयुतम् |
तण्डुलाम्बुयुतो योगः पित्तरक्तोत्थितं जयेत् ||१२७||
योगान् साङ्ग्राहिकांश्चान्यान् पिबेत्सक्षौद्रशर्करान् |
न्यग्रोधादिषु कुर्याच्च पुटपाकान् यथेरितान् ||१२८||

Kosakara is quite a lot of sugarcane. It must be fried in ghee and added with powder of Laja, sugar and honey. When consumed, this recipe cures diarrhoea produced by rakta and pitta, related to stomach ache.

Pulp of Bilva fruit and Madhuka are combined with sugar and honey. This combination must be consumed with rice washed water. It cures diarrhoea brought on by aggravation of pitta and rakta (blood).

Additionally, every other recipe (formulation) which binds the stools and causes constipation (of the fluids getting expelled) must be combined with honey and sugar and consumed.

Nyagrodha and so forth. herbs must be cooked by Putapaka technique. The juice extracted after cooking them must be consumed as beforehand described.

गुदपाके च ये उक्तास्तेऽत्रापि विधयः स्मृताः |
रुजायां चाप्रशाम्यन्त्यां पिच्छाबस्तिर्हितो भवेत् ||१२९||

In raktatisara i.e. haemorrhagic diarrhoea additionally, the remedies indicated for ulcers of the rectum / anus are useful. Pichcha Basti i.e. slimy enema shall be administered when the ache shouldn’t be subsiding.

सक्तविड् दोषबहुलं दीप्ताग्निर्योऽतिसार्यते |
विडङ्गत्रिफलाकृष्णाकषायैस्तं विरेचयेत् ||१३०||
अथवैरण्डसिद्धेन पयसा केवलेन वा |
यवागूर्वितरेच्चास्य वातघ्नैर्दीपनैः कृताः ||१३१||

Purgation remedy must be administered within the under talked about circumstances –

–        if there may be obstruction of faeces,

–        if there nice enhance of doshas,

–        if the digestive fireplace is eager and

–        if there may be frequent elimination of faeces

For the aim of purgation, decoction of Vidanga, Triphala and Krsna must be used. Alternatively, milk added and combined with Eranda Taila must be used.

After this, the affected person must be given Yavagu (thick gruel) ready with herbs which mitigate vata and in addition these which kindle starvation.

दीप्ताग्निर्निष्पुरीषो यः सार्यते फेनिलं शकृत् |
स पिबेत् फाणितं शुण्ठीदधितैलपयोघृतम् ||१३२||
स्विन्नानि गुडतैलाभ्यां भक्षयेद्बदराणि च |
स्विन्नानि पिष्टवद्वाऽपि समं बिल्वशलाटुभिः ||१३३||
दध्नोपयुज्य कुल्माषान् श्वेतामनुपिबेत् सुराम् |१३४|

Phanita – molasses combined with ginger, curds, oil and ghee must be consumed by individuals having eager digestive fireplace and eliminates frothy stools that are devoid of faecal matter.

Boiled badara fruits must be consumed combined with jaggery and sesame oil.

Alternatively, cooked tender bilva fruit (bilva salatu) can also be consumed.

One ought to devour Kulmasa i.e. boiled pulses with curds so long as attainable. After this, he ought to drink Sveta Sura i.e. white beer.

शशमांसं सरुधिरं समङ्गां सघृतं दधि ||१३४||
खादेद्विपाच्य सेवेत मृद्वन्नं शकृतः क्षये |
संस्कृतो यमके माषयवकोलरसः शुभः ||१३५||
भोजनार्थं प्रदातव्यो दधिदाडिमसाधितः |१३६|
The affected person ought to eat rabbit’s meat together with cooked blood after including Samanga, ghee, curd and soft-boiled rice to it when he has decreased faeces.

Soup of Masa, Yava and Kola must be ready. This soup must be processed with any two fat mixed collectively (yamaka – ghee and oil). This must be used as meals after including curds and pomegranate.

विडं बिल्वशलाटूनि नागरं चाम्लपेषितम् ||१३६||
दध्नः सरश्च यमके भृष्टो वर्चःक्षये हितः |
सशूलं क्षीणवर्चा यो दीप्ताग्निरतिसार्यते |
स पिबेद्दीपनैर्युक्तं सर्पिः सङ्ग्राहकैः सह ||१३७||

Under talked about components are macerated with bitter juice –

–        Bida Lavana,

–        Tender fruits of Bilva and

–        Nagara

This must be added with whey (dadhi sara – scum of curds) and later fried in a combination of oil and ghee. This recipe is claimed to be useful for treating circumstances of decreased faeces.

Ghee boiled and processed with carminative (dipana) and constipating (grahi) herbs must be consumed by –

–        the individual having diarrhoea related to ache and

–        decreased faeces and having

–        good digestive fireplace / energy

Pravāhikā – dysentery

वायुः प्रवृद्धो निचितं बलासं नुदत्यधस्तादहिताशनस्य |
प्रवाहमाणस्य मुहुर्मलाक्तं प्रवाहिकां तां प्रवदन्ति तज्ज्ञाः ||१३८||

Vata will get aggravated in individuals indulged in common consumption of unhealthy meals. This aggravated vata pushes kapha collected within the colon downwards repeatedly, after straining and combined with faeces. The realized physicians name this situation as Pravahika.

प्रवाहिका वातकृता सशूला पित्तात् सदाहा सकफा कफाच्च |
सशोणिता शोणितसम्भवा तु ताः स्नेहरूक्षप्रभवा मतास्तु ||१३९||
तासामतीसारवदादिशेच्च लिङ्गं क्रमं चामविपक्वतां च |१४०|

Under talked about are the principle signs in Pravahika produced by particular doshas –

–        In vata kind of pravahika – ache is predominantly current,

–        In pitta kind of pravahika – there may be burning sensation,

–        In kapha kind of pravahika – faeces is eradicated combined with kapha,

–        In rakta kind of pravahika – faeces is combined with blood

These kind of Pravahika are produced by extra unctuousness and dryness within the colon.

The indicators and signs, strategies of remedy and options of ama – unripe and pakva – ripe phases are just like these of atisara – diarrhoea.

Pravahikā cikitsā – remedy of dysentery

न शान्तिमायाति विलङ्घनैर्या योगैरुदीर्णा यदि पाचनैर्वा ||१४०||
तां क्षीरमेवाशु शृतं निहन्ति तैलं तिलाः पिच्छिलबस्तयश्च |१४१|

Use of boiled milk, sesame oil and slimy enemas (piccha basti) would subside pravahika which –

–        doesn’t subside by administration of therapies like vilanghana and so forth. i.e. fasting and different strategies which trigger lightness / thinness of the physique or

–        will get elevated by use of pacana – digestive medicines (which digest ama)

आर्द्रैः कुशैः सम्परिवेष्टितानि वृन्तान्यथार्द्राणि हि शाल्मलीनाम् ||१४१||
पक्वानि सम्यक् पुटपाकयोगेनापोथ्य तेभ्यो रसमाददीत |
क्षीरं शृतं तैलहविर्विमिश्रं कल्केन यष्टीमधुकस्य वाऽपि ||१४२||
बस्तिं विदध्याद्भिषगप्रमत्तः प्रवाहिकामूत्रपुरीषसङ्गे |१४३|

Moist stalks of Salmali fruits are chosen. They’re enveloped with moist blades of kusa grass. They’re cooked by the putapaka technique. As soon as they’re cooked correctly, their juice is extracted. This juice is combined with cooked milk, oil, ghee and yastimadhu paste. All these are stirred nicely and administered by physicians as enema, slowly. It’s administered in pravahika and obstruction of faeces and urine. 

द्विपञ्चमूलीक्वथितेन शूले प्रवाहमाणस्य समाक्षिकेण ||१४३||
क्षीरेण चास्थापनमग्र्यमुक्तं तैलेन युञ्ज्यादनुवासनं च |१४४|

Decoction enema ready with decoction of mahat and laghu pancamula group of herbs, added with honey and milk is claimed to be one of the best enema recipe to be administered when ache is predominantly current in sufferers affected by pravahika. Anuvasana Basti – oil enema ready with the identical herbs can be useful in the identical situation.

वातघ्नवर्गे लवणेषु चैव तैलं च सिद्धं हितमन्नपाने ||१४४||
लोध्रं विडं बिल्वशलाटु चैव लिह्याच्च तैलेन कटुत्रिकाढ्यम् |१४५|

Together with meals and drinks, oil boiled and processed with herbs belonging to the vata mitigating group and all salts must be used.

Paste of Lodhra, Bida Lavana and tender fruit of Bilva must be ready. This paste must be added with extra Trikatu and must be licked.

दध्ना ससारेण समाक्षिकेण भुञ्जीत निश्चा(स्सा)रकपीडितस्तु ||१४५||
सुतप्तकुप्यक्वथितेन वाऽपि क्षीरेण शीतेन मधुप्लुतेन |
शूलार्दितो व्योषविदारिगन्धासिद्धेन दुग्धेन हिताय भोज्यः ||१४६||
वातघ्नसाङ्ग्राहिकदीपनीयैः कृतान् षडांश्चाप्युपभोजयेच्च [२] |
खादेच्च मत्स्यान् रसमाप्नुयाच्च वातघ्नसिद्धं सघृतं सतैलम् ||१४७||
एणाव्यजानां तु वटप्रवालैः सिद्धानि सार्धं पिशितानि खादेत् |
मेध्य(द्य)स्य सिद्धं त्वथ वाऽपि रक्तं बस्तस्य दध्ना घृततैलयुक्तम् ||१४८||
खादेत् प्रदेहैः शिखिलावजैर्वा भुञ्जीत यूषैर्दधिभिश्च मुख्यैः |
माषान् सुसिद्धान् घृतमण्डयुक्तान् खादेच्च दध्ना मरिचोपदंशान् ||१४९||

Meals must be consumed together with one of many under talked about by the individual affected by pravahika –

–        with scum of curds (whey) added with honey or

–        with milk boiled in a metallic vessel, cooled and added with honey

If there may be ache, the individual ought to take meals in under talked about methods –

–        meals must be taken with milk boiled with vyosa and herbs belonging to vidarigandhadi gana group, rasa (mamsarasa – meat soup) ready with vata mitigating herbs and herbs inflicting constipation and rising starvation

–        fish may be consumed or

–        meat soup boiled and ready with vata mitigating herbs, added with ghee or oil must be taken or

–        meat of ena (deer), avi (sheep) or aja (goat) cooked with tender leaves of vata must be consumed or

–        meat of medhya (fats goat) or its blood cooked and added with ghee and oil could also be consumed or

–        meat of peacock or lava birds and their soup could also be consumed together with soup of pulses and curds or

–        masa – black gram cooked nicely, added with scum of ghee and marica must be consumed

महारुजे मूत्रकृच्छ्रे भिषग् बस्तिं प्रदापयेत् |
पयोमधुघृतोन्मिश्रं मधुकोत्पलसाधितम् ||१५०||
स बस्तिः शमयेत्तस्य रक्तं दाहमथो ज्वरम् |१५१|

The doctor ought to administer decoction enema ready with madhuka and utpala combined with milk, honey and ghee when there may be extreme ache and dysuria. This enema mitigates bleeding, burning sensation and fever.

मधुरौषधसिद्धं च हितं तस्यानुवासनम् ||१५१||
रात्रावहनि वा नित्यं रुजार्तो यो भवेन्नरः |
यथा यथा सतैलः स्याद्वातशान्तिस्तथा तथा ||१५२||
प्रशान्ते मारुते चापि शान्तिं याति प्रवाहिका |
तस्मात् प्रवाहिकारोगे मारुतं शमयेद्भिषक् ||१५३||

When the individual is affected by ache, anuvasana basti i.e. oil enema ready with herbs predominantly having candy style must be administered both throughout day or evening time. Vata will get mitigated as and when oil enema is run. When vata will get mitigated pravahika too will subside. Therefore, the doctor ought to at all times attempt to mitigate vata first whereas treating pravahika.

पाठाजमोदाकुटजोत्पलं [७] च शुण्ठी समा मागधिकाश्च पिष्टाः |
सुखाम्बुपीताः शमयन्ति रोगं मेध्याण्डसिद्धं सघृतं पयो वा ||१५४||

Paste of the under talked about herbs is ready –

–        Patha,

–        Ajamoda,

–        Kutaja,

–        Utpala,

–        Sunthi and

–        Magadhika

This paste is consumed with heat water. This recipe mitigates the ailments. Alternatively, testicles of goat cooked with ghee or milk additionally mitigates the illness.

शुण्ठीं घृतं सक्षवकं सतैलं विपाच्य लीढ्वाऽऽमयमाशु हन्यात् |
गजाशनाकुम्भिकदाडिमानां रसैः कृता तैलघृते सदध्नि ||१५५||
बिल्वान्विता पथ्यतमा यवागू र्धारोष्णदुग्धस्य तथा च पानम् |१५६|
लघूनि पथ्यान्यथ दीपनानि स्निग्धानि भोज्यान्युदरामयेषु ||१५६||

This illness is shortly cured when sunthi and ksavaka cooked in ghee and oil collectively is consumed.

Yavagu – thick gruel must be ready with juice of Sallaki, Kumbhika, and Dadima. It must be added with oil, ghee, curds and bilva and consumed. Alternatively, milk recent from the udder of the cow must be consumed.

हितायनित्यंवितरेद्विभज्ययोगांश्चतांस्तान्भिषगप्रमत्तः।।१५७।।

In remedy of pravahika – dysentery, meals which have the under talked about properties must be used –

–        simply digestible,

–        wholesome,

–        these rising starvation and

–        unctuous

The doctor ought to permit the affected person to devour such meals every single day in accordance to the elements like season, time of consumption of meals and so forth. with none hesitation.

तृष्णापनयनी लघ्वी दीपनी बस्तिशोधनी |
ज्वरे चैवातिसारे च यवागूः सर्वदा हिता ||१५८||

Yavagu is helpful in each jvara – fevers and atisara – diarrhoea as a result of under talked about properties –

–        it mitigates thirst,

–        will get simply digested,

–        kindles starvation / digestive fireplace and

–        cleanses the urinary bladder (helps in straightforward urination)

रूक्षाज्जाते क्रिया स्निग्धा रूक्षा स्नेहनिमित्तजे |
भयजे सान्त्वनापूर्वा शोकजे शोकनाशिनी ||१५९||
विषार्शःकृमिसम्भूते हिता चोभयशर्मदा |
छर्दिमूर्च्छातृडाद्यांश्च साधयेदविरोधतः ||१६०||

Unctuous therapies must be administered in diarrhoea produced by extreme dryness. However, diarrhoea produced attributable to extreme unctuousness (unctuous therapies) must be handled with dry therapies.

In atisara brought on by fevers, remedy ought to start with pacifying phrases.

In diarrhoea brought on by grief, remedies to beat back grief must be finished.

In diarrhoea produced by poisons, piles and worms, remedy for each trigger and impact (ailments brought on by poisons and so forth) must be finished.

Therapy for vomiting, fainting, thirst and so forth. must be finished with out interfering with the principle ailments (remedies shouldn’t be contradictory).

समवाये तु दोषाणां पूर्वं पित्तमुपाचरेत् |
ज्वरे चैवातिसारे च सर्वत्रान्यत्र मारुतम् ||१६१||

When the doshas are intimately mixed collectively in fevers and diarrhoea, pitta must be handled first. In different ailments, vata must be handled first.

Atisara nivṛtti lakṣaṇa- indicators of remedy of diarrhoea-

यस्योच्चारं विना मूत्रं सम्यग्वायुश्च गच्छति |
दीप्ताग्नेर्लघुकोष्ठस्य स्थितस्तस्योदरामयः ||१६२||

Illness of the stomach i.e. diarrhoea must be thought-about as cured within the presence of the under talked about indicators (and signs) –

–        when urine is eradicated unbiased of faeces,

–        when there may be correct elimination of flatus, with none bother,

–        when the digestive fireplace is eager and

–        when the alimentary canal is mild

Vyādhibheda – sorts of ailments

कर्मजा व्याधयः केचिद्दोषजाः सन्ति चापरे |
कर्मदोषोद्भवाश्चान्ये कर्मजास्तेष्वहेतुकाः ||१६३||
नश्यन्ति त्वक्रियाभिस्ते क्रियाभिः कर्मसङ्क्षये |
शाम्यन्ति दोषसम्भूता दोषसङ्क्षयहेतुभिः ||१६४||

Some ailments are Karmaja, some are Dosaja and a few others are Karma-dosaja.

Karmaja vyadhi are these ailments that are produced by the consequences of actions dedicated in earlier lives. These ailments don’t have any causes that may be apparently seen. These ailments disappear both with none remedy or with remedy solely after the expiry of the consequences of actions of earlier lives.

Doshaja vyadhi are these ailments that are produced by aggravation of doshas on this life. These ailments subside (cured) by the causes (remedies) which mitigate the doshas.

Karma-Doshaja vyadhi are these ailments that are produced by mixture of results of earlier lives in addition to aggravation of doshas on this life.

तेषामल्पनिदाना ये प्रतिकष्टा भवन्ति च |
मृदवो बहुदोषा वा कर्मदोषोद्भवास्तु ते ||१६५||
कर्मदोषक्षयकृता तेषां सिद्धिर्विधीयते |१६६|

Amongst all of the kinds of ailments, karmaja vyadhis – these ailments which have delicate and fewer causes or no identified causes are tough to remedy.

Equally, the ailments that are delicate and produced by highly effective doshas are additionally tough to remedy.

Therapies are advocated for these ailments that are born from a mix of each karma and dosha. The ailments brought on by karma and dosha collectively get cured solely after the lower of results of karma and doshas.

Grahani roga – ailments of the duodenum-

दुष्यति ग्रहणी जन्तोरग्निसादनहेतुभिः ||१६६||
अतिसारे निवृत्तेऽपि मन्दाग्नेरहिताशिनः |
भूयः सन्दूषितो वह्निर्ग्रहणीमभिदूषयेत् ||१६७||
तस्मात्कार्यः परीहारस्त्वतीसारे विरिक्तवत् |
यावन्न प्रकृतिस्थः स्याद्दोषतः प्राणतस्तथा ||१६८||

Because of the causes which weaken the digestive fireplace (energy), the organ grahani (duodenum) turns into disordered in dwelling beings.

If the individual indulges in improper meals, even after the remedy of diarrhoea or in individuals having poor digestive fireplace / energy, the doshas drastically vitiate the digestive fireplace. On the identical time, the doshas would additionally vitiate the grahani (duodenum). That is the rationale that remedies in atisara must be finished as advocated for the one who has had purgation, till the individual turns into regular in respect of dosha and in addition power.

Grahani – duodenum

षष्ठी पित्तधरा नाम या कला परिकीर्तिता |
पक्वामाशयमध्यस्था ग्रहणी सा प्रकीर्तिता ||१६९||
ग्रहण्या बलमग्निर्हि स चापि ग्रहणीं श्रितः |
तस्मात् सन्दूषिते वह्नौ ग्रहणी सम्प्रदुष्यति ||१७०||

Pittadhara Kala has been described because the sixth kala in sarira sthana part, chapter 4. This kala is located between pakvasaya – intestines and amasaya – abdomen. The identical kala is named Grahani – duodenum.

Agni – digestive fireplace is the power of grahani and that agni resides within the grahani. Therefore, when agni will get vitiated, grahani additionally turns into vitiated.

एकशः सर्वशश्चैव दोषैरत्यर्थमुच्छ्रितैः |
सा दुष्टा बहुशो भुक्तमाममेव विमुञ्चति ||१७१||
पक्वं वा सरुजं पूति मुहुर्बद्धं मुहुर्द्रवम् |
ग्रहणीरोगमाहुस्तमायुर्वेदविदो जनाः ||१७२||

Grahani turns into disordered by drastically aggravated doshas, both by particular person doshas individually or by all doshas collectively. When grahani turns into drastically disordered, it releases the ingested meals both in raw or cooked states. It’s accompanied with ache within the stomach. The grahani eliminates unhealthy smelling faeces, typically constipated (faeces is difficult, stable) and typically liquid and frequent (happens extra variety of instances). This illness is known as Grahani Roga – duodenal ailments by individuals who’re realized and nicely versed in Ayurveda.

Pürvarüpa – premonitary signs

तस्योत्पत्तौ विदाहोऽन्ने सदनालस्यतृट्क्लमाः |
बलक्षयोऽरुचिः कासः कर्णक्ष्वेडोऽन्त्रकूजनम् ||१७३||

Under talked about are the premonitory signs of Grahani Roga –

–        burning sensation as a result of presence of meals within the abdomen,

–        common debility,

–        lassitude,

–        thirst,

–        exhaustion,

–        lower of power,

–        lack of style,

–        cough,

–        ringing within the ears and

–        gurgling noise within the intestines

Rupa- scientific options

अथ जाते भवेज्जन्तुः शूनपादकरः कृशः |
पर्वरुग्लौल्यतृट्छर्दिज्वरारोचकदाहवान् ||१७४||
उद्गिरेच्छुक्ततिक्ताम्ललोहधूमामगन्धिकम् |
प्रसेकमुखवैरस्यतमकारुचिपीडितः ||१७५||

Under talked about are the signs of manifested illness –

–        swelling within the legs and arms,

–        emaciation,

–        ache within the joints,

–        greediness – liking in direction of all tastes,

–        thirst,

–        vomiting,

–        fever,

–        lack of style,

–        burning sensation contained in the physique,

–        vomiting materials seems like vinegar, is bitter and bitter, smells like iron and smoke,

–        extreme salivation,

–        unhealthy style within the mouth,

–        bronchial asthma – dyspnoea and

–        anorexia

वाताच्छूलाधिकैः पायुहृत्पार्श्वोदरमस्तकैः |
पित्तात् सदाहैर्गुरुभिः कफात्त्रिभ्यस्त्रिलक्षणैः ||१७६||
दोषवर्णैर्नखैस्तद्वद्विण्मूत्रनयनाननैः |
हृत्पाण्डूदरगुल्मार्शःप्लीहाशङ्खी च मानवः ||१७७||

Under talked about are the signs of various doshas within the illness –

The color of nails, faeces, urine, eyes and face will likely be in accordance with the predominant dosha concerned within the pathogenesis (causative dosha). The individual is more likely to be suspected as affected by coronary heart illness, anaemia, enlargement of the stomach, stomach tumour, piles and ailments of the spleen.

Cikitsā – remedy

यथादोषोच्छ्रयं तस्य विशुद्धस्य यथाक्रमम् |
पेयादिं वितरेत् सम्यग्दीपनीयोपसम्भृतम् ||१७८||
ततः पाचनसङ्ग्राहिदीपनीयगणत्रयम् |
पिबेत् प्रातः सुरारिष्टस्नेहमूत्रसुखाम्बुभिः ||१७९||
तक्रेण वाऽथ तक्रं वा केवलं हितमुच्यते |
कृमिगुल्मोदरार्शोघ्नीः क्रियाश्चात्रावचारयेत् ||१८०||
चूर्णं हिङ्ग्वादिकं चात्र घृतं वा प्लीहनाशनम् |१८१|

Shodhana i.e. purificatory therapies must be administered in accordance with the aggravation of doshas. Peya and different liquid meals that are processed with herbs rising starvation must be given. After this, powder ready from pacana (digestive), grahi (constipating) and dipana (digestive) group of herbs must be administered together with sura (beer), arista (fermented decoctions), sneha (fat), mutra (urines), sukhambu (lukewarm water) or takra (buttermilk). Buttermilk can be useful to be consumed.

Therapies defined for the under talked about circumstances also needs to be adopted –

–        ailments brought on by intestinal worms,

–        stomach tumour,

–        enlargement of stomach and

–        piles

Hingvadi Curna and medicated ghee which is indicated for enlargement of spleen also needs to be used on this context.

कल्केन मगधादेश्च चाङ्गेरीस्वरसेन च ||१८१||
चतुर्गुणेन दध्ना च घृतं सिद्धं हितं भवेत् |१८२|
सर्वथा दीपनं सर्वं ग्रहणीरोगिणां हितम् ||१८२||
ज्वरादीन विरोधाच्च साधयेत्स्वैश्चिकित्सितैः।।१८२।।

Medicated ghee must be ready with the under talked about components and used –

–        paste of magadha – pippali,

–        recent juice of cangeri,

–        dadhi – curds – 4 elements and

–        ghee – one half

Medicines which increase digestive fireplace (energy) ought to at all times be used for sufferers affected by grahani roga.

When issues like fever and so forth. come up, the remedy must be deliberate in such a means that they don’t seem to be in opposition to the first illness (grahani).

इति श्री सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गत कायचिकित्सातन्त्रेऽतिसारप्रतिषेधो नाम (द्वितीयोऽध्यायः, आदित) चत्वारिंशोऽध्यायः।।४०।।

Thus ends the fortieth chapter by title Atisara Cikitsa – in Uttara

Sthana of Suśruta Samhita.