AIAPGET Factors
– KRODHA, SHOKA & BHAYA are the psychological causes talked about amongst the Nidanas of RAKTAPITTA. (Su.Ut.45/3)
– Essential Purvarupas of Raktapitta are – Sadanam, SHITA KAMITVAM, KANTA DHUMAYANAM, Vami, LOHAGANDHI NISHVASA.
– Vamana – indicated in Adhah Raktapitta. Virechana – indicated in Urdhwa Raktapitta. Shamana – indicated in Ubhayatah Raktapitta.
– APATARPANA is the primary line of therapy for RAKTAPITTA. It ought to be administered when there may be Ati Pravrddha Doshas, Akshina Bala, Mamsa and Agni. (Su.Ut.45/13)
– PALASHA GHRTA – is a vital Ghee preparation prescribed in Raktapitta. This ought to be consumed chilly with honey.
– The roots and flowers of MATULUNGA ought to be macerated. It ought to be consumed together with rice-wash. (Su.Ut.45/36, Nasagata Raktapitta Chikitsa).
For Extra AIAPGET Factors from this chapter and in addition for content material and preparation, please be a part of our SARATHI Program.
The forty fifth chapter of Uttaratantra of Sushruta Samhita is known as as Raktapitta Pratiṣedha Adhyaya. This chapter offers with the Remedy of Bleeding Illness.
अथातो रक्तपित्तप्रतिषेधं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
We are going to now expound Raktapitta pratiṣedha – therapy of bleeding illness; as revealed by the venerable Dhanvantari.
Nidāna samprapti- causes and pathogenesis
क्रोधशोकभयायासविरुद्धान्नातपानलान् |
कट्वम्ललवणक्षारतीक्ष्णोष्णातिविदाहिनः ||३||
नित्यमभ्यसतो दुष्टो रसः पित्तं प्रकोपयेत् |
विदग्धं स्वगुणैः पित्तं विदहत्याशु शोणितम् ||४||
ततः प्रवर्तते रक्तमूर्ध्वं चाधो द्विधाऽपि वा |५|
Causative Elements of Raktapitta –
Extreme indulgence within the under talked about elements –
– anger, sorrow, concern or exertion,
– incompatible meals,
– extreme publicity to daylight and hearth,
– consumption of meals that are predominantly pungent, bitter, salty or alkaline in style,
– meals that are penetrating, scorching in contact and efficiency and people which trigger extra burning sensation throughout digestion
Pathogenesis – As a result of above mentioned causes, rasa – the essence of meals produced after digestion (chyme) causes pitta aggravation. The pitta turns into irregular in its personal qualities and in flip vitiates rakta – blood.
Then, the blood flows out of the physique by higher or decrease orifices or in each instructions.
आमाशयाद्व्रजेदूर्ध्वमधः पक्वाशयाद्व्रजेत् ||५||
विदग्धयोर्द्वयोश्चापि द्विधाभागं प्रवर्तते |
केचित् सयकृतः प्लीह्नः प्रवदन्त्यसृजो गतिम् ||६||
Blood current within the amasaya – abdomen comes out by the higher orifices i.e. by mouth, nostril, eyes and ears.
Blood current in Pakvasaya i.e. giant gut / colon – comes out by the decrease passages / orifices i.e. rectum (anus), urethra and vagina.
Blood comes out from each orifices (higher and decrease orifices) when each the asayas i.e. amasaya and pakvasaya are irregular. In line with the opinion of some students, blood comes from yakrit – liver and pliha – spleen.
ऊर्ध्वं साध्यमधोयाप्यमसाध्यं युगपद्गतम् |७|
The prognosis of Raktapitta is as talked about under –
– blood coming from higher orifices – is curable,
– blood coming from decrease orifices – is controllable and persists for very long time and
– blood coming from each orifices – is incurable
Purvarüpa- premonitory signs
Rupa and vidha-
सदनं शीतकामित्वं कण्ठधूमायनं वमिः ||७||
लोहगन्धिश्च निःश्वासो भवत्यस्मिन् भविष्यति |८|
Beneath talked about are the premonitory signs of raktapitta (signs of the illness which is but to be manifested) –
– debility,
– want for chilly issues,
– feeling of scorching fumes popping out of the throat,
– vomiting and
– scent of iron in expiration
बाह्यासृग्लक्षणैस्तस्य सङ्ख्यादोषोच्छ्रितीर्विदुः ||८||
The signs of the illness (raktapitta) are the identical as these of blood vitiated by the doshas (as defined in sutra sthana part, chapter 14). Forms of the illness are additionally the identical because the aggravated doshas.
Upadravās – issues / secondary ailments
दौर्बल्यश्वासकासज्वरवमथुमदास्तन्द्रितादाहमूर्च्छा
भुक्ते चान्ने विदाहस्त्वधृतिरपि सदा हृद्यतुल्या च पीडा |
तृष्णा कण्ठस्य भेदः शिरसि च दवनं पूतिनिष्ठीवनं च
द्वेषो भक्तेऽविपाको विरतिरपि रते रक्तपित्तोपसर्गाः ||९||
Beneath talked about are the issues of Raktapitta –
– Debility,
– Dyspnoea,
– Cough,
– Fever,
– Vomiting,
– Toxaemia,
– Stupor,
– Feeling of burning sensation,
– Fainting,
– Burning sensation contained in the physique when the meals is consumed,
– Feeling of Anxiousness,
– Fixed ache within the area of coronary heart / coronary heart,
– Thirst,
– Probability of voice,
– Intense ache within the head,
– Dangerous scent within the sputum,
– Improper digestion and
– Lack of sexual want
मांसप्रक्षालनाभं क्वथितमिव च यत् कर्दमाम्भोनिभं वा
मेदःपूयास्रकल्पं यकृदिव यदि वा पक्वजम्बूफलाभम् |
यत् कृष्णं यच्च नीलं भृशमतिकुणपं यत्र चोक्ता विकारास्तद्वर्ज्यं रक्तपित्तं सुरपतिधनुषा यच्च तुल्यं विभाति ||१०||
Sufferers of Raktapitta ought to be rejected (shouldn’t be handled) if the blood popping out of the orifices of the physique has under talked about traits –
– resembles mutton wash,
– resembles decoction or muddy water,
– is combined with fats or pus or blood,
– resembles liver or ripe fruit of Jambu in color,
– is black or blue,
– enormously emits cadaveric scent,
– shines like a rainbow, with many colors and
– accompanied with issues talked about earlier
Cikitsa – therapy
नादौ सङ्ग्राह्यमुद्रिक्तं यदसृग्बलिनोऽश्नतः |
तत् पाण्डुग्रहणीकुष्ठप्लीहगुल्मज्वरावहम् ||११||
In individuals who’re robust and are consuming meals, bleeding, despite being extreme, shouldn’t be stopped in Raktapitta.
if bleeding is stopped it should give rise to the under talked about issues –
– anaemia,
– duodenal illness,
– pores and skin ailments,
– spleen ailments,
– stomach tumours and
– fever
अधःप्रवृत्तं वमनैरूर्ध्वगं च विरेचनैः |
जयेदन्यतरद्वाऽपि क्षीणस्य शमनैरसृक् ||१२||
Emesis – ought to be administered to regulate bleeding from the decrease routes / orifices.
Purgation – ought to be administered to regulate bleeding from higher routes / orifices.
Palliatives – ought to be administered to regulate bleeding occurring from each routes i.e. upward and downward orifices.
अतिप्रवृद्धदोषस्य पूर्वं लोहितपित्तिनः |
अक्षीणबलमांसाग्नेः कर्तव्यमपतर्पणम् ||१३||
लङ्घितस्य ततः पेयां विदध्यात् स्वल्पतण्डुलाम् |
रसयूषौ प्रदातव्यौ सुराभिस्नेहसंस्कृतौ |
तर्पणं पाचनं लेहान् सर्पींषि विविधानि च ||१४||
The particular person ought to be suggested to do fasting within the under talked about circumstances –
– when there may be nice aggravation of doshas and
– affected person doesn’t have lower of energy, muscle mass and digestive hearth
The affected person ought to be given peya – skinny gruel having much less grains of rice in it for consuming, after he has fasted.
Following this, meat soup or soup of pulses processed with herbs smelling candy and fat ought to be administered.
After this, nourishing and digestive confections ought to be given and so additionally completely different sorts of medicated ghee.
द्रक्षामधुककाश्मर्यसितायुक्तं विरेचनम् |
यष्टीमधुकयुक्तं च सक्षौद्रं वमनं हितम् ||१५||
Powder of the under talked about substances ought to be given added with sugar to induce purgation –
– Draksa,
– Madhuka,
– Kasmarya
Decoction of Yastimadhuka added with honey ought to be used to induce vomiting.
पयांसि शीतानि रसाश्च जाङ्गलाः सतीनयूषाश्च सशालिषष्टिकाः |
पटोलशेलूसुनिषण्णयूथिकावटातिमुक्ताङ्कुरसिन्दुवारजम् ||१६||
हितं च शाकं घृतसंस्कृतं सदा तथैव धात्रीफलदाडिमान्वितम् |
रसाश्च पारावतशङ्खकूर्मजास्तथा यवाग्वो विहिता घृतोत्तराः ||१७||
सन्तानिकाश्चोत्पलवर्गसाधिते क्षीरे प्रशस्ता मधुशर्करोत्तराः |
हिमाः प्रदेहा मधुरा गणाश्च ये घृतानि पथ्यानि रक्तपित्तिनाम् ||१८||
The affected person ought to devour the under talked about meals –
– milk and soup of meat of animals dwelling in arid lands, made chilly,
– soup of satina,
– meals ready with sali and swastika,
– patola, selu, sunisanna, yuthika, tender leaves of vata, atimukta and sinduvara processed with ghee and
– dhatriphala and dadima fruits
Beneath talked about meals are additionally helpful –
– soup of meat of pigeon, worm of conch and of tortoise or
– yavagu – thick gruel with extra amount of ghee,
– cream of milk,
– milk boiled with herbs belonging to Utpaladi Gana group, added with extra amount of honey and sugar
For the sufferers of bleeding ailments, chilly poultice and ghee ready with herbs of candy style (Kakolyadi Gana group) are perfect.
मधूकशोभाञ्जनकोविदारजैः प्रियङ्गुकायाः कुसुमैश्च चूर्णितैः |
भिषग्विदध्याच्चतुरः समाक्षिकान् हिताय लेहानसृजः प्रशान्तये ||१९||
लिह्याच्च दूर्वावटजांश्च पल्लवान् मधुद्वितीयान् सितकर्णिकस्य च |
हितं च खर्जूरफलं समाक्षिकं फलानि चान्यान्यपि तद्गुणान्यथ ||२०||
Powder of Madhuka, Sobhanjana, Kovidara and Priyangu kusuma ought to be administered with honey by the clever doctor for mitigating bleeding.
Beneath talked about ought to be combined collectively and given for licking –
– one a part of – tender leaves of durva, vata and sveta karnikara collectively and
– two elements of honey
Kharjura phala or different fruits having related properties as these of Kharjura phala ought to be given for consumption, combined with honey.
रक्तातिसारप्रोक्तांश्च योगानत्रापि योजयेत् |२१|
Medicines and formulations prescribed for treating bleeding diarrhoea (rakta atisara) may additionally be administered on this illness.
शुद्धेक्षुकाण्डमापोथ्य नवे कुम्भे हिमाम्भसा ||२१||
योजायित्वा क्षिपेद्रात्रावाकाशे सोत्पलं तु तत् |
प्रातः स्रुतं क्षौद्रयुतं पिबेच्छोणितपित्तवान् ||२२||
पिबेच्छीतकषायं वा जम्ब्वाम्रार्जुनसम्भवम् |
उदुम्बरफलं पिष्ट्वा पिबेत्तद्रसमेव वा ||२३||
Sugarcane items ought to be taken. At evening, they need to be put into a brand new pot containing chilly water. This pot ought to be stored in open area. The water ought to be filtered the following morning. Powder of Utpala and honey are added to it. This recipe will probably be helpful whether it is consumed by the affected person affected by bleeding ailments. Alternatively, the affected person must drink chilly infusions ready from Jambu, Amra, Arjuna or juice of Udumbara fruits.
त्रपुषीमूलकल्कं वा सक्षौद्रं तण्डुलाम्बुना |
पिबेदक्षसमं कल्कं यष्टीमधुकमेव वा ||२४||
चन्दनं मधुकं रोध्रमेवमेव समं पिबेत् |
करञ्जबीजमेवं वा सिताक्षौद्रयुतं पिबेत् ||२५||
मज्जानमिङ्गुदयस्यैवं पिबेन्मधुकसंयुतम् |
सुखोष्णं लवणं बीजं कारञ्जं दधिमस्तुना ||२६||
पिबेद्वाऽपि त्र्यहं मर्त्यो रक्तपित्ताभिपीडितः |
रक्तपित्तहराः शस्ताः षडेते योगसत्तमाः ||२७||
पथ्याश्चैवावपीडेषु घ्राणतः प्रस्रुतेऽसृजि |२८|
Roots of Trapusa are taken and made into paste. It’s added with honey and consumed. Following this, the affected person ought to drink rice-wash.
Alternatively, paste of Yastimadhu ought to be taken in a single aksa (10gm) amount.
Equally, the under talked about recipes could also be consumed –
– pastes of candana, madhuka and rodhra,
– paste of karanja added with sugar and honey or
– marrow of ingudi fruit combined with honey or
– paste of karanja seeds combined with water, curd and salt
All these ought to be consumed heat.
Thus, six formulae have been described right here. These recipes ought to be consumed for 3 days. They’re mentioned to be one of the best ones for the affected person affected by bleeding issues. The identical formulations are additionally helpful for treating nostril bleeding.
अतिनिस्रुतरक्तो वा क्षौद्रयुक्तं पिबेदसृक् |
यकृद्वा भक्षयेदाजमामं पित्तसमायुतम् ||२८||
The affected person could also be given blood of animals combined with honey for consuming if there may be profuse bleeding. Alternatively he could also be requested to devour raw liver of a goat together with its bile.
पलाशवृक्षस्वरसे विपक्वं सर्पिः पिबेत् क्षौद्रयुतं सुशीतम् |
वनस्पतीनां स्वरसैः कृतं वा सशर्करं क्षीरघृतं पिबेद्वा ||२९||
Ghee ought to be cooked and ready with contemporary juice from the Palasa. This ghee ought to be added with honey and consumed chilly.
Alternatively, ghee ought to be cooked with juice of different vanaspatis (pancavalkala timber and many others.). It ought to be consumed with sugar.
द्राक्षामुशीराण्यथ पद्मकं सिता पृथक्पलांशान्युदके समावपेत् |
स्थितं निशां तद्रुधिरामयं जयेत् पीतं पयो वाऽम्बुसमं हिताशिनः ||३०||
One pala (40 gm) every of Draksa, Usira, Padmaka and Sita (sugar) are put into water. The substances are allowed to remain for one evening within the water. This ought to be consumed by the affected person who’s taking appropriate meals, within the morning, added with milk. This recipe cures bleeding ailments.
तुरङ्गवर्चःस्वरसं समाक्षिकं पिबेत् सिताक्षौद्रयुतं वृषस्य वा |
लिहेत्तथा वास्तुकबीजचूर्णं क्षौद्रान्वितं तण्डुलसाह्वयं वा ||३१||
लिह्याच्च लाजाञ्जनचूर्णमेकमेवं सिताक्षौद्रयुतां तुगाख्याम् |
द्राक्षां सितां तिक्तकरोहिणीं च हिमाम्बुना वा मधुकेन युक्ताम् ||३२||
पथ्यामहिंस्रां रजनीं घृतं च लिह्यात्तथा शोणितपित्तरोगी |३३|
Juice of contemporary dung of horse or bull ought to be taken. To this, sugar and honey ought to be added and consumed.
Alternatively, the powder of seeds of Vastuka ought to be taken with honey or rice wash.
Beneath talked about recipes can be utilized by affected person of bleeding ailments –
– Powder of Anjana (Srotonjana)
– Powder of Tugaksiri added with sugar and honey
– Paste of Draksa, Sita and Tiktarohini added with honey and
– Powder of Madhuka with chilly water or
– Paste of Pathya,
– Ahimsa and Rajani added with ghee
वासाकषायोत्पलमृत्प्रियङ्गुरोध्राञ्जनाम्भोरुहकेशराणि ||३३||
पीत्वा सिताक्षौद्रयुतानि जह्यात् पित्तासृजो वेगमुदीर्णमाशु |३४|
Decoction of Vasa ought to be ready. It ought to be added with the under talked about substances and consumed –
– utpala,
– mrt (black mud),
– priyangu,
– rodhra,
– anjana,
– filaments of ambhoruha,
– sugar and
– honey
This recipe shortly stops bouts of bleeding when consumed.
गायत्रिजम्ब्वर्जुनकोविदारशिरीषरोध्राशनशाल्मलीनाम् ||३४||
पुष्पाणि शिग्रोश्च विचूर्ण्य लेहो मध्वन्वितः शोणितपित्तरोगे |३५|
Flowers of the under talked about are collected –
– Gayatri,
– Jambu,
– Arjuna,
– Kovidara,
– Sirisa,
– Rodhra,
– Asana (Bijaka),
– Salmali and
– Sigru
The powder of those flowers is ready. The powder ought to be combined in honey and licked. It cures bleeding issues.
सक्षौद्रमिन्दीवरभस्मवारि करञ्जबीजं मधुसर्पिषी च ||३५||
जम्ब्वर्जुनाम्रक्वथितं च तोयं घ्नन्ति त्रयः पित्तमसृक् च योगाः |३६|
Beneath talked about three formulations treatment bleeding ailments –
– answer of ash of indivara combined with honey and ghee or
– paste of seeds of karanja combined with honey and ghee and
– decoction of jambu, arjuna and amra
Nāsāraktapitta – therapy of epistaxis
मूलानि पुष्पाणि च मातुलुङ्ग्याः पिष्ट्वा पिबेत्तण्डुलधावनेन ||३६||
घ्राणप्रवृत्ते जलमाशु देयं सशर्करं नासिकया पयो वा |
द्राक्षारसं क्षीरघृतं पिबेद्वा सशर्करं चेक्षुरसं हिमं वा ||३७||
The roots and flowers of Matulunga ought to be macerated. It ought to be consumed together with rice-wash. Drops of sugar water ought to be instilled into the nostril. This might cease bleeding from the nostril.
Alternatively the under talked about recipes additionally can be utilized in chilly state to cease bleeding from the nostril –
– juice of draksa for consuming
– ghee ready (extracted) from milk or combined with milk for consuming,
– sugarcane juice combined with sugar shall be put into the nostril in chilly state
शीतोपचारं मधुरं च कुर्याद्विशेषतः शोणितपित्तरोगे |३८|
In bleeding ailments, under talked about ought to at all times be administered –
– all types of chilly remedies and
– medicines and meals predominantly of candy style
Gudaraktasrāva – rectal haemorrhage
द्राक्षाघृतक्षौद्रसितायुतेन विदारिगन्धादिविपाचितेन ||३८||
क्षीरेण चास्थापनमग्र्यमुक्तं हितं घृतं चाप्यनुवासनार्थम् |३९|
Decoction ought to be ready from the herbs belonging to Vidarigandhadi Gana group. This decoction ought to be administered as decoction enema after including paste of draksa, ghee and honey.
Milk ought to be boiled and processed with the identical herbs including ghee to it. This ghee is useful for use as Anuvasana Basti – unctuous enema.
प्रियङ्गुरोध्राञ्जनगैरिकोत्पलैः सुवर्णकालीयकरक्तचन्दनैः ||३९||
सिताश्वगन्धाम्बुदयष्टिकाह्वयैर्मृणालसौगन्धिकतुल्यपेषितैः |
निरूह्य चैनं पयसा समाक्षिकैर्घृतप्लुतैः शीतजलावसेचितम् ||४०||
क्षीरौदनं भुक्तमथानुवासयेद्घृतेन यष्टीमधुसाधितेन च |
अधोवहं शोणितमेष नाशयेत्तथाऽतिसारं रुधिरस्य दुस्तरम् ||४१||
विरेकयोगे त्वति चैव शस्यते… |४२|
Paste of equal elements of the under talked about is ready –
– Priyangu,
– Rodhra,
– Anjana,
– Gairika,
– Utpala,
– Suvarna Gairika,
– Kalingaka,
– Rakta Candana,
– Sita,
– Asvagandha,
– Ambuda,
– Yastikahvaya,
– Mrnala,
– Saugandhika (a wide range of Kumuda)
This paste is combined with ghee and chilly water and is run as decoction enema.
The affected person is given meals with milk.
Lubricating enema is run after meals. For this, ghee boiled and processed with Yastimadhu ought to be used.
This might treatment circumstances of bleeding by decrease orifices. Additionally it is helpful in treating even extreme circumstances of bleeding diarrhoea.
The identical recipe can be utilized in extra bouts of purgation remedy.
… वाम्यश्च रक्ते विजिते बलान्वितः ||४२||
The affected person ought to be administered emesis remedy after the bleeding stops and the affected person has gained energy.
एवंविधा उत्तरबस्तयश्च मूत्राशयस्थे रुधिरे विधेयाः |
प्रवृत्तरक्तेषु च पायुजेषु कुर्याद्विधानं खलु रक्तपैत्तम् ||४३||
Uttara Basti – urethral enema (doouche) ought to be administered in the identical method when the bleeding happens by the urinary bladder (urinary passages).
Remedies prescribed for bleeding ailments may additionally be adopted when the bleeding happens from piles.
विधिश्चासृग्दरेऽप्येष स्त्रीणां कार्यो विजानता |
शस्त्रकर्मणि रक्तं च यस्यातीव प्रवर्तते ||४४||
The identical remedies as carried out in bleeding ailments ought to be adopted in Asrgdhara – menorrhagia occurring in girls.
The identical remedies (of bleeding ailments) can be administered when profuse bleeding takes place throughout surgical operations (procedures).
त्रयाणामपि दोषाणां शोणितेऽपि च सर्वशः |
लिङ्गान्यालोक्य कर्तव्यं चिकित्सितमनन्तरम् ||४५||
Remedies ought to be determined after noting the signs produced by the three doshas and blood in case of therapy of Raktapitta and in addition in different circumstances involving bleeding.
इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे रक्तपित्तप्रतिषेधो नाम (सप्तमोऽध्यायः, आदितः) पञ्चचत्वारिंशत्तमोऽध्यायः ||४५||
Thus ends the forty-fifth chapter by identify Raktapitta Pratiședha in Uttara Sthana of Suśruta Samhita.
