https://www.carakasamhitaonline.com/api.php?action=feedcontributions&feedformat=atom&user=AgniveshaCharak Samhita - User contributions [en]2026-05-25T16:54:46ZUser contributionsMediaWiki 1.43.6https://www.carakasamhitaonline.com/index.php?title=Katidhapurusha_Sharira&diff=45435Katidhapurusha Sharira2026-04-21T06:07:21Z<p>Agnivesha: /* Tattva Vimarsha (Fundamental Principles) */</p>
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|title=Katidhapurusha Sharira<br />
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|keywords=purusha, holistic human being, Mana, mind, Atma, Self, consciousness, soul, salvation, pradnyaparadha, intellectual errors, causes of miseries and comfort, Ayurveda, Indian system of medicine, charak samhita. <br />
|description=Sharira Sthana Chapter 1. Knowledge of holistic human being<br />
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<big>'''Sharira Sthana Chapter 1. Knowledge of holistic human being '''</big><br />
{{Infobox<br />
|title = Katidhapurusha Sharira<br />
|label1 = Section/Chapter<br />
|data1 = [[Sharira Sthana]] Chapter 1<br />
|label2 = Preceding Chapter<br />
|data2 = None<br />
<br />
|label3= Succeeding Chapter<br />
|data3 = [[Atulyagotriya Sharira]]<br />
|label5 = Other Sections<br />
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br />
|label6 = Translator and commentator<br />
|data6 = Dwivedi R.B., Gujarathi R.<br />
|label7 = Reviewer <br />
|data7 = Rajagopala S., Chandola H.M., Tanna I.<br />
|label8 = Editors<br />
|data8 = Bhalerao S., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br />
|label9 = Year of publication <br />
|data9 = 2020<br />
|label10 = Publisher <br />
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label11 = DOI <br />
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s04.002 10.47468/CSNE.2020.e01.s04.002]<br />
}}<br />
<big>'''Abstract'''</big><br />
<p style="text-align:justify;">A healthcare provider cannot treat an individual without comprehensive knowledge of his constitution. A study of human being can be initiated only after understanding concept of [[purusha]], that means holistic human being, the self ([[Aatma]]), consciousness, the cosmic man, etc., depending upon the context. This first chapter describes [[purusha]] in the context of samyoga purusha that means a logical body of six constituents (shad-dhatuja), of twenty-four constituents (chaturvimshati- tattvatmak), or that which is ideal for treatment (chikitsya purusha). The third meaning of [[purusha]] is in the context of ativahika purusha, a subtle body that passes on from one body to the next along with the soul. Besides these, there are several other forms or connotations described here in this text. This chapter answers all queries about the [[soul]], its origin, proof of existence, mind, its description, intellectual error and its adverse effect, types of miseries and their causes, etc. Thus this chapter describes aspects of human evolution, spirituality and psychology as well. </p> <br />
<br />
'''Keywords:''' [[purusha]], holistic human being, [[mana]], [[mind]], [[Aatma]], self, consciousness, [[soul]], salvation, [[prajnaparadha]], intellectual errors, causes of miseries and comfort. <br />
<br />
<br />
== Introduction ==<br />
<div style="text-align:justify;"><br />
An aspiring [[Ayurveda]] practitioner who has obtained thorough knowledge about diseases, and their signs and symptoms from [[Nidana Sthana]] and studied ''rasa prabhava'' and ''[[dosha]] prabhava'' in the context of [[dravya]] and [[vyadhi]] from [[Vimana Sthana]] may have built a foundation in disease management, but cannot initiate treatment until he has a thorough knowledge of the human body. Therefore, a logical continuation from the preceding sections is this section on the human physiology and anatomy especially body’s connection to the universe. As mentioned earlier, the concept of [[purusha]] is integral to understanding [[sharira]], and therefore understanding [[Sharira Sthana]]. This chapter therefore deals with various topics related to [[purusha]] such as its types, origin, constituents, details about mind and soul, the process of knowledge, the theory of evolution and destruction, types of diseases and their causative factors, treatment of the diseases of past, present and future, desire as the ultimate cause of sorrow, the method by which an individual can get the permanent relief from pain, role of ''yoga'' in achieving salvation, and the means of salvation.<br />
<br />
This chapter also deals with a philosophical approach to human body and mind (apparent, since the chapter deals with a complex concept like the [[purusha]]). All eastern philosophies consider the [[aatma]] (soul) as the entity that is responsible for all actions and therefore the recipient of the consequences of those actions. The ultimate reason for all kinds of pain and sufferings is that human beings do not realize or consider the body and the soul to be two distinct entities. The relationship between the soul and the mind is complex and subtle. One has to “rein in” the mind and also strive to stay detached from all the actions performed by him to liberate himself from this material world. A person who is detached from worldly possessions and actions is free from the karmic cycle of actions and consequences, and birth and death. Thus the chapter describes some of the basic physical and meta-physical aspects of the human entity.<br />
</div><br />
==Sanskrit text, Transliteration and English Translation==<br />
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अथातः कतिधापुरुषीयं शारीरं व्याख्यास्यामः||१|| इति ह स्माह भगवानात्रेयः||२||<br />
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athātaḥ katidhāpuruṣīyaṁ śārīraṁ vyākhyāsyāmaḥ||1|| iti ha smāha bhagavānātrēyaḥ||2|| <br />
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athAtaH katidhApuruShIyaM shArIraM vyAkhyAsyAmaH||1|| iti ha smAha bhagavAnAtreyaH||2|| <br />
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Now we shall expound the chapter "Katidhapurusheeyam Shariram" (Knowledge of holistic human being). Thus said Lord Atreya. [1-2]<br />
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===Questions by Agnivesha===<br />
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कतिधा पुरुषो धीमन्! धातुभेदेन भिद्यते| <br />
पुरुषः कारणं कस्मात्, प्रभवः पुरुषस्य कः||३|| <br />
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katidhā puruṣō dhīman! dhātubhēdēna bhidyatē| <br />
puruṣaḥ kāraṇaṁ kasmāt, prabhavaḥ puruṣasya kaḥ||3||<br />
<br />
katidhA puruSho dhIman! dhAtubhedena bhidyate| <br />
puruShaH kAraNaM kasmAt, prabhavaH puruShasya kaH||3|| <br />
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किमज्ञो ज्ञः, स नित्यः किं किमनित्यो निदर्शितः| <br />
प्रकृतिः का, विकाराः के, किं लिङ्गं पुरुषस्य च||४|| <br />
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kimajñō jñaḥ, sa nityaḥ kiṁ kimanityō nidarśitaḥ| <br />
prakr̥tiḥ kā, vikārāḥ kē, kiṁ liṅgaṁ puruṣasya ca||4|| <br />
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kimaj~jo j~jaH, sa nityaH kiM kimanityo nidarshitaH| <br />
prakRutiH kA, vikArAH ke, kiM li~ggaM puruShasya ca||4|| <br />
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निष्क्रियं च स्वतन्त्रं च वशिनं सर्वगं विभुम्| <br />
वदन्त्यात्मानमात्मज्ञाः क्षेत्रज्ञं साक्षिणं तथा||५|| <br />
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niṣkriyaṁ ca svatantraṁ ca vaśinaṁ sarvagaṁ vibhum| <br />
vadantyātmānamātmajñāḥ kṣētrajñaṁ sākṣiṇaṁ tathā||5|| <br />
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niShkriyaM ca svatantraM ca vashinaM sarvagaM vibhum| <br />
vadantyAtmAnamAtmaj~jAH kShetraj~jaM sAkShiNaM tathA||5||<br />
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निष्क्रियस्य क्रिया तस्य भगवन्! विद्यते कथम्| <br />
स्वतन्त्रश्चेदनिष्टासु कथं योनिषु जायते||६|| <br />
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niṣkriyasya kriyā tasya bhagavan! vidyatē katham| <br />
svatantraścēdaniṣṭāsu kathaṁ yōniṣu jāyatē||6|| <br />
<br />
niShkriyasya kriyA tasya bhagavan! vidyate katham| <br />
svatantrashcedaniShTAsu kathaM yoniShu jAyate||6|| <br />
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वशी यद्यसुखैः कस्माद्भावैराक्रम्यते बलात्| <br />
सर्वाः सर्वगतत्वाच्च वेदनाः किं न वेत्ति सः||७|| <br />
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vaśī yadyasukhaiḥ kasmādbhāvairākramyatē balāt| <br />
sarvāḥ sarvagatatvācca vēdanāḥ kiṁ na vētti saḥ||7|| <br />
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vashI yadyasukhaiH kasmAdbhAvairAkramyate balAt| <br />
sarvAH sarvagatatvAcca vedanAH kiM na vetti saH||7|| <br />
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न पश्यति विभुः कस्माच्छैलकुड्यतिरस्कृतम्| <br />
क्षेत्रज्ञः क्षेत्रमथवा किं पूर्वमिति संशयः||८||<br />
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na paśyati vibhuḥ kasmācchailakuḍyatiraskr̥tam| <br />
kṣētrajñaḥ kṣētramathavā kiṁ pūrvamiti saṁśayaḥ||8|| <br />
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na pashyati vibhuH kasmAcchailakuDyatiraskRutam| <br />
kShetraj~jaH kShetramathavA kiM pUrvamiti saMshayaH||8|| <br />
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ज्ञेयं क्षेत्रं विना पूर्वं क्षेत्रज्ञो हि न युज्यते| <br />
क्षेत्रं च यदि पूर्वं स्यात् क्षेत्रज्ञः स्यादशाश्वतः||९|| <br />
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jñēyaṁ kṣētraṁ vinā pūrvaṁ kṣētrajñō hi na yujyatē| <br />
kṣētraṁ ca yadi pūrvaṁ syāt kṣētrajñaḥ syādaśāśvataḥ||9|| <br />
<br />
j~jeyaM kShetraM vinA pUrvaM kShetraj~jo hi na yujyate| <br />
kShetraM ca yadi pUrvaM syAt kShetraj~jaH syAdashAshvataH||9|| <br />
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साक्षिभूतश्च कस्यायं कर्ता ह्यन्यो न विद्यते| <br />
स्यात् कथं चाविकारस्य विशेषो वेदनाकृतः||१०|| <br />
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sākṣibhūtaśca kasyāyaṁ kartā hyanyō na vidyatē| <br />
syāt kathaṁ cāvikārasya viśēṣō vēdanākr̥taḥ||10|| <br />
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sAkShibhUtashca kasyAyaM kartA hyanyo na vidyate| <br />
syAt kathaM cAvikArasya visheSho vedanAkRutaH||10|| <br />
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अथ चार्तस्य भगवंस्तिसृणां कां चिकित्सति| <br />
अतीतां वेदनां वैद्यो वर्तमानां भविष्यतीम्||११|| <br />
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atha cārtasya bhagavaṁstisr̥ṇāṁ kāṁ cikitsati| <br />
atītāṁ vēdanāṁ vaidyō vartamānāṁ bhaviṣyatīm||11|| <br />
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atha cArtasya bhagavaMstisRuNAM kAM cikitsati| <br />
atItAM vedanAM vaidyo vartamAnAM bhaviShyatIm||11|| <br />
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भविष्यन्त्या असम्प्राप्तिरतीताया अनागमः| <br />
साम्प्रतिक्या अपि स्थानं नास्त्यर्तेः संशयो ह्यतः||१२|| <br />
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bhaviṣyantyā asamprāptiratītāyā anāgamaḥ| <br />
sāmpratikyā api sthānaṁ nāstyartēḥ saṁśayō hyataḥ||12|| <br />
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bhaviShyantyA asamprAptiratItAyA anAgamaH| <br />
sAmpratikyA api sthAnaM nAstyarteH saMshayo hyataH||12|| <br />
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कारणं वेदनानां किं, किमधिष्ठानमुच्यते| <br />
क्व चैता वेदनाः सर्वा निवृत्तिं यान्त्यशेषतः||१३|| <br />
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kāraṇaṁ vēdanānāṁ kiṁ, kimadhiṣṭhānamucyatē| <br />
kva caitā vēdanāḥ sarvā nivr̥ttiṁ yāntyaśēṣataḥ||13|| <br />
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kAraNaM vedanAnAM kiM, kimadhiShThAnamucyate| <br />
kva caitA vedanAH sarvA nivRuttiM yAntyasheShataH||13|| <br />
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सर्ववित् सर्वसन्न्यासी सर्वसंयोगनिःसृतः| <br />
एकः प्रशान्तो भूतात्मा कैर्लिङ्गैरुपलभ्यते||१४|| <br />
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sarvavit sarvasannyāsī sarvasaṁyōganiḥsr̥taḥ| <br />
ēkaḥ praśāntō bhūtātmā kairliṅgairupalabhyatē||14|| <br />
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sarvavit sarvasannyAsI sarvasaMyoganiHsRutaH| <br />
ekaH prashAnto bhUtAtmA kairli~ggairupalabhyate||14|| <br />
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इत्यग्निवेशस्य [१] वचः श्रुत्वा मतिमतां वरः| <br />
सर्वं यथावत् प्रोवाच प्रशान्तात्मा पुनर्वसुः||१५|| <br />
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ityagnivēśasya [1] vacaḥ śrutvā matimatāṁ varaḥ| <br />
sarvaṁ yathāvat prōvāca praśāntātmā punarvasuḥ||15|| <br />
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ityagniveshasya [1] vacaH shrutvA matimatAM varaH| <br />
sarvaM yathAvat provAca prashAntAtmA punarvasuH||15|| <br />
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Agnivesha requested Punarvasu to explain the following: <br />
<br />
# What are the divisions of the [[purusha]] according to the division of the [[dhatu]] (elements)?<br />
# Why is this [[purusha]] considered as the ''karana'' (''karta''/doer)? Is the [[Purusha]] considered to be the cause of the body?<br />
# What is the origin of [[Purusha]]?<br />
# Is the [[Purusha]] a sentient or an insentient entity?<br />
# Is the [[Purusha]] eternal or ephemeral?<br />
# What is the primordial source of creation and what are its byproducts?<br />
# what are the characteristic features of the [[purusha]]?<br />
# Those proficient in spiritual science describe the [[Purusha]] to be devoid of action, independent, absolutely free, all pervasive, knower of the body and a witness. When is the [[Purusha]] devoid of action? How does action emanate from it?<br />
# If the [[Purusha]] is independent, how does it take birth among the undesirable species?<br />
# If the [[Purusha]] is absolutely free, how does it get overpowered by miserable ideas?<br />
# Being omnipresent, why is it not aware of all miseries in its surroundings?<br />
# If it is ubiquitous, how does it not visualize things interrupted by hills and walls?<br />
# Which comes first – the body or the knower of the body (soul)? In the absence of the body, the object that perceives, emergence of the [[Purusha]] does not appear to be appropriate. But then if the body comes first, the [[Purusha]] would not be deemed eternal.<br />
# What is it of which the [[Purusha]] is considered to be a witness?<br />
# Can the same [[Purusha]] be a creator as well as a witness at the same time?<br />
# If the [[Purusha]] is derived from any modification, how does it subject itself to specific situations arising out of miseries (diseases)?<br />
# Out of the three types of miseries of a patient, which one is treatable by the physician – the past one, the present one or the future one? <br />
## The future one is in fact not in existence; <br />
## the past one has already ceased to exist; and <br />
## even the present one is, in a sense, momentary and so in the absence of continuity, it is non manageable to any treatment. Hence the dilemma.<br />
# What are the common causative factors of all miseries (diseases)?<br />
# What are the sites of their manifestation?<br />
# Where do all these miseries completely get merged after their cure?<br />
# What are the signs that help in recognizing the [[Purusha]] which is omnipresent, all renouncing, devoid of all contacts, only one and tranquil? <br />
After listening questions by the most intelligent (disciple) Agnivesh, Punarvasu replied all of them one by one in a tranquilized state.<br />
[3-15]<br />
<br />
=== Details about [[purusha]] ===<br />
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खादयश्चेतनाषष्ठा धातवः पुरुषः स्मृतः| <br />
चेतनाधातुरप्येकः स्मृतः पुरुषसञ्ज्ञकः||१६||<br />
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khādayaścētanāṣaṣṭhā [1] dhātavaḥ puruṣaḥ smr̥taḥ| <br />
cētanādhāturapyēkaḥ smr̥taḥ puruṣasañjñakaḥ||16||<br />
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khAdayashcetanAShaShThA [1] dhAtavaH puruShaH smRutaH| <br />
cetanAdhAturapyekaH smRutaH puruShasa~jj~jakaH||16|| <br />
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[[Purusha]] comprises of six [[dhatu]] (elements), viz. five [[mahabhuta]] (in their subtle form) and consciousness. The element of consciousness alone could also be considered [[purusha]]. [16]<br />
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पुनश्च धातुभेदेन चतुर्विंशतिकः स्मृतः| <br />
मनो दशेन्द्रियाण्यर्थाः प्रकृतिश्चाष्टधातुकी||१७||<br />
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punaśca dhātubhēdēna caturviṁśatikaḥ smr̥taḥ| <br />
manō daśēndriyāṇyarthāḥ prakr̥tiścāṣṭadhātukī||17||<br />
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punashca dhAtubhedena caturviMshatikaH smRutaH| <br />
mano dashendriyANyarthAH prakRutishcAShTadhAtukI||17||<br />
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According to another classification, [[Purusha]] comprises of twenty four [[dhatu]], i.e. [[mana]] (mind), ten [[indriya]] (sensory and motor organs), five objects of sense organs and [[prakriti]] (consisting of eight [[dhatu]], viz. five [[mahabhuta]] (in their subtle form), [[ahamkara]] (ego), [[mahat]] (intellect) and ''[[Avyakta|avyakta]]'' (primordial element) [17]<br />
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=== Description of [[Manas]] (mind) ===<br />
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लक्षणं मनसो ज्ञानस्याभावो भाव एव च| <br />
सति ह्यात्मेन्द्रियार्थानां सन्निकर्षे न वर्तते||१८|| <br />
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lakṣaṇaṁ manasō jñānasyābhāvō bhāva ēva ca| <br />
sati hyātmēndriyārthānāṁ sannikarṣē na vartatē||18|| <br />
<br />
lakShaNaM manaso j~jAnasyAbhAvo bhAva eva ca| <br />
sati hyAtmendriyArthAnAM sannikarShe na vartate||18|| <br />
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वैवृत्त्यान्मनसो ज्ञानं सान्निध्यात्तच्च वर्तते| <br />
अणुत्वमथ चैकत्वं द्वौ गुणौ मनसः स्मृतौ||१९|| <br />
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vaivr̥ttyānmanasō jñānaṁ sānnidhyāttacca vartatē| <br />
aṇutvamatha caikatvaṁ dvau guṇau manasaḥ smr̥tau||19||<br />
<br />
vaivRuttyAnmanaso j~jAnaM sAnnidhyAttacca vartate| <br />
aNutvamatha caikatvaM dvau guNau manasaH smRutau||19|| <br />
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<div style="text-align:justify;"><br />
Sometimes one understands a thing and sometimes one does not. This proves the existence of the mind as a separate sense organ. That is why, when there is no contact of the mind with sense organs and their objects, no understanding of things can occur. It is only when the required mental contact is there that one can understand things. Atomicity and oneness are considered to be the two characteristic qualities of the mind. [18-19]<br />
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चिन्त्यं विचार्यमूह्यं च ध्येयं सङ्कल्प्यमेव च| <br />
यत्किञ्चिन्मनसो ज्ञेयं तत् सर्वं ह्यर्थसञ्ज्ञकम्||२०|| <br />
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cintyaṁ vicāryamūhyaṁ ca dhyēyaṁ saṅkalpyamēva ca| <br />
yatkiñcinmanasō jñēyaṁ tat sarvaṁ hyarthasañjñakam||20|| <br />
<br />
cintyaM vicAryamUhyaM ca dhyeyaM sa~gkalpyameva ca| <br />
yatki~jcinmanaso j~jeyaM tat sarvaM hyarthasa~jj~jakam||20|| <br />
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इन्द्रियाभिग्रहः कर्म मनसः स्वस्य निग्रहः| <br />
ऊहो विचारश्च, ततः परं बुद्धिः प्रवर्तते||२१|| <br />
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indriyābhigrahaḥ karma manasaḥ svasya nigrahaḥ| <br />
ūhō vicāraśca, tataḥ paraṁ buddhiḥ pravartatē||21|| <br />
<br />
indriyAbhigrahaH karma manasaH svasya nigrahaH| <br />
Uho vicArashca, tataH paraM buddhiH pravartate||21|| <br />
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<div style="text-align:justify;"><br />
Things requiring thought, consideration, hypothesis, attention, determination or whatever can be perceived by the mind, are regarded as its objects. Control of sense organs, self restraint, hypothesis and consideration represent the action of the mind. Beyond that flourishes the domain and intellect [20-21]<br />
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===Role of [[buddhi]] (intellect)===<br />
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इन्द्रियेणेन्द्रियार्थो हि समनस्केन गृह्यते| <br />
कल्प्यते मनसा तूर्ध्वं गुणतो दोषतोऽथवा||२२||<br />
<br />
जायते विषये तत्र या बुद्धिर्निश्चयात्मिका| <br />
व्यवस्यति तया वक्तुं कर्तुं वा बुद्धिपूर्वकम्||२३|| <br />
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indriyēṇēndriyārthō hi samanaskēna gr̥hyatē| <br />
kalpyatē manasā tūrdhvaṁ guṇatō dōṣatō'thavā||22||<br />
<br />
jāyatē viṣayē tatra yā buddhirniścayātmikā| <br />
vyavasyati tayā vaktuṁ kartuṁ vā buddhipūrvakam||23|| <br />
<br />
indriyeNendriyArtho hi samanaskena gRuhyate| <br />
kalpyate manasA tUrdhvaM guNato doShato~athavA||22||<br />
<br />
jAyate viShaye tatra yA buddhirnishcayAtmikA| <br />
vyavasyati tayA vaktuM kartuM vA buddhipUrvakam||23|| <br />
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<br />
<div style="text-align:justify;"><br />
Objects are perceived with the help of sense organs and the mind. This perception is purely mental in the beginning, while the practical advantages or disadvantages are ascertained thereafter. The intellect which determines the specific properties of the object impels the (same) individual to speak or act intelligently. [22-23]<br />
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एकैकाधिकयुक्तानि खादीनामिन्द्रियाणि तु| <br />
पञ्च कर्मानुमेयानि येभ्यो बुद्धिः प्रवर्तते||२४|| <br />
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ēkaikādhikayuktāni khādīnāmindriyāṇi tu| <br />
pañca karmānumēyāni yēbhyō buddhiḥ pravartatē||24|| <br />
<br />
ekaikAdhikayuktAni khAdInAmindriyANi tu| <br />
pa~jca karmAnumeyAni yebhyo buddhiH pravartate||24|| <br />
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<br />
<div style="text-align:justify;"><br />
The five sense faculties, made of the five ''[[mahabhuta]]s'' (each sense faculty has one dominant ''[[mahabhuta]]''), are inferred from their five respective actions which serve as agents for the manifestation of the intellect [24]<br />
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=== Functions of ''karmendriya'' (motor organs) ===<br />
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हस्तौ पादौ [२] गुदोपस्थं वागिन्द्रियमथापि च| <br />
कर्मेन्द्रियाणि पञ्चैव पादौ गमनकर्मणि||२५|| <br />
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hastau pādau [2] gudōpasthaṁ vāgindriyamathāpi ca| <br />
karmēndriyāṇi pañcaiva pādau gamanakarmaṇi||25|| <br />
<br />
hastau pAdau [2] gudopasthaM vAgindriyamathApi ca| <br />
karmendriyANi pa~jcaiva pAdau gamanakarmaNi||25|| <br />
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पायूपस्थं विसर्गार्थं हस्तौ ग्रहणधारणे| <br />
जिह्वा वागिन्द्रियं वाक् च सत्या ज्योतिस्तमोऽनृता||२६|| <br />
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pāyūpasthaṁ visargārthaṁ hastau grahaṇadhāraṇē| <br />
jihvā vāgindriyaṁ vāk ca satyā jyōtistamō'nr̥tā||26|| <br />
<br />
pAyUpasthaM visargArthaM hastau grahaNadhAraNe| <br />
jihvA vAgindriyaM vAk ca satyA jyotistamo~anRutA||26|| <br />
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<div style="text-align:justify;"><br />
Motor organs are of five categories, viz. hands, feet, anus, phallus and the organ of speech (tongue). Feet are useful in locomotion, anus and phallus for passing body waste while the hands are for collecting and holding. The tongue represents the organ of speech which speaks in two ways, viz. truth and false. The truth can be compared with light, that illuminates (the knowledge of worldly life and life after death). The false creates darkness (that creates confusion). [25-26]<br />
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<br />
=== [[Mahabhuta]] (five fundamental elements) ===<br />
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महाभूतानि खं वायुरग्निरापः क्षितिस्तथा| <br />
शब्दः स्पर्शश्च रूपं च रसो गन्धश्च तद्गुणाः||२७|| <br />
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mahābhūtāni khaṁ vāyuragnirāpaḥ kṣitistathā| <br />
śabdaḥ sparśaśca rūpaṁ ca rasō gandhaśca tadguṇāḥ||27|| <br />
<br />
mahAbhUtAni khaM vAyuragnirApaH kShitistathA| <br />
shabdaH sparshashca rUpaM ca raso gandhashca tadguNAH||27|| <br />
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<br />
The five [[mahabhuta]] are [[akasha]], [[vayu]], [[agni]], [[jala]] and [[prithvi]] (in this order). Their attributes are sound, touch, vision, taste and smell respectively. [27]<br />
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तेषामेकगुणः पूर्वो [२] गुणवृद्धिः परे परे| <br />
पूर्वः पूर्वगुणश्चैव [३] क्रमशो गुणिषु स्मृतः||२८|| <br />
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tēṣāmēkaguṇaḥ pūrvō [2] guṇavr̥ddhiḥ parē parē| <br />
pūrvaḥ pūrvaguṇaścaiva [3] kramaśō guṇiṣu smr̥taḥ||28|| <br />
<br />
teShAmekaguNaH pUrvo [2] guNavRuddhiH pare pare| <br />
pUrvaH pUrvaguNashcaiva [3] kramasho guNiShu smRutaH||28|| <br />
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<div style="text-align:justify;"><br />
The order of ''[[mahabhuta]]s'' mentioned above is important because, starting with ''[[akasha]]'', the number of attributes per ''[[mahabhuta]]'' increases in the above order. This increase in number of attributes is cumulative, i.e., the attribute of the preceding ''[[mahabhuta]]s'' is added to the succeeding one. This process of ''gunantara vriddhi'' in ''[[mahabhuta]]s'' is also known as ''bhutanipravesha'' [28]<br />
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खरद्रवचलोष्णत्वं भूजलानिलतेजसाम्| <br />
आकाशस्याप्रतीघातो दृष्टं लिङ्गं यथाक्रमम्||२९||<br />
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kharadravacalōṣṇatvaṁ bhūjalānilatējasām| <br />
ākāśasyāpratīghātō dr̥ṣṭaṁ liṅgaṁ yathākramam||29|| <br />
<br />
kharadravacaloShNatvaM bhUjalAnilatejasAm| <br />
AkAshasyApratIghAto dRuShTaM li~ggaM yathAkramam||29|| <br />
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लक्षणं सर्वमेवैतत् स्पर्शनेन्द्रियगोचरम्| <br />
स्पर्शनेन्द्रियविज्ञेयः स्पर्शो हि सविपर्ययः||३०|| <br />
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lakṣaṇaṁ sarvamēvaitat sparśanēndriyagōcaram| <br />
sparśanēndriyavijñēyaḥ sparśō hi saviparyayaḥ||30|| <br />
<br />
lakShaNaM sarvamevaitat sparshanendriyagocaram| <br />
sparshanendriyavij~jeyaH sparsho hi saviparyayaH||30|| <br />
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<div style="text-align:justify;"><br />
''[[Prithvi]], [[jala]], [[agni]]/tejas, [[vayu]]'' and ''[[akasha]]'' are characterized by ''kharatva'' (roughness), ''dravatva'' (liquidity), ''ushnatva'' (heat), ''chalatva'' (mobility) and ''apratighatatva'' (unobstructibility) respectively. All these attributes are perceptible by the tactile sense organ. Touch, together with its absence, is perceived by the tactile sense organ. [29-30]<br />
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गुणाः शरीरे गुणिनां निर्दिष्टाश्चिह्नमेव च| ३१| <br />
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guṇāḥ śarīrē guṇināṁ nirdiṣṭāścihnamēva ca| <br />
<br />
guNAH sharIre guNinAM nirdiShTAshcihnameva ca| <br />
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<br />
Thus the attributes and characteristics of the five physical elements are described. [31-1]<br />
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अर्थाः शब्दादयो ज्ञेया गोचरा विषया गुणाः||३१||<br />
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arthāḥ śabdādayō jñēyā gōcarā viṣayā guṇāḥ||31||<br />
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arthAH shabdAdayo j~jeyA gocarA viShayA guNAH||31||<br />
<br />
</div></div><br />
The objects of sense organs are sound, touch, vision, taste and smell, which constitute the attributes of gross [[mahabhuta]]. [31]<br />
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<br />
===Process of perception===<br />
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या यदिन्द्रियमाश्रित्य जन्तोर्बुद्धिः प्रवर्तते| <br />
याति सा तेन निर्देशं मनसा च मनोभवा||३२|| <br />
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yā yadindriyamāśritya jantōrbuddhiḥ pravartatē| <br />
yāti sā tēna nirdēśaṁ manasā ca manōbhavā||32|| <br />
<br />
yA yadindriyamAshritya jantorbuddhiH pravartate| <br />
yAti sA tena nirdeshaM manasA ca manobhavA||32|| <br />
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भेदात् कार्येन्द्रियार्थानां बह्व्यो वै बुद्धयः स्मृताः| <br />
आत्मेन्द्रियमनोर्थानामेकैका [१] सन्निकर्षजा||३३|| <br />
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bhēdāt kāryēndriyārthānāṁ bahvyō vai buddhayaḥ smr̥tāḥ| <br />
ātmēndriyamanōrthānāmēkaikā [1] sannikarṣajā||33|| <br />
<br />
bhedAt kAryendriyArthAnAM bahvyo vai buddhayaH smRutAH| <br />
AtmendriyamanorthAnAmekaikA [1] sannikarShajA||33|| <br />
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अङ्गुल्यङ्गुष्ठतलजस्तन्त्रीवीणानखोद्भवः| <br />
दृष्टः शब्दो यथा बुद्धिर्दृष्टा संयोगजा तथा||३४|| <br />
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aṅgulyaṅguṣṭhatalajastantrīvīṇānakhōdbhavaḥ| <br />
dr̥ṣṭaḥ śabdō yathā buddhirdr̥ṣṭā saṁyōgajā tathā||34|| <br />
<br />
a~ggulya~gguShThatalajastantrIvINAnakhodbhavaH| <br />
dRuShTaH shabdo yathA buddhirdRuShTA saMyogajA tathA||34||<br />
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<div style="text-align:justify;"><br />
The perceptual faculty of living beings shapes itself depending upon the contact it has with the various sense faculties. Mental perception like anxiety or sorrow is also based on the contact of perceptual faculty with the mental faculty. <br />
<br />
Perceptual faculties are of several types, depending upon the variations in action and objects of sense organs. <br />
<br />
Just as the same sound differs according to how it is produced out of friction in the finger and the thumb, and the veena (musical instrument with strings) and nail, so does the perceptual faculty differ according to its production from out of the mutual contacts with the soul, sense organs, mind and objects of sense organs. [32-34]<br />
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=== Rashi [[purusha]] (Holistic human being)===<br />
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बुद्धीन्द्रियमनोर्थानां विद्याद्योगधरं परम्| <br />
चतुर्विंशतिको ह्येष राशिः पुरुषसञ्ज्ञकः||३५|| <br />
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buddhīndriyamanōrthānāṁ vidyādyōgadharaṁ param| <br />
caturviṁśatikō hyēṣa rāśiḥ puruṣasañjñakaḥ||35|| <br />
<br />
buddhIndriyamanorthAnAM vidyAdyogadharaM param| <br />
caturviMshatiko hyeSha rAshiH puruShasa~jj~jakaH||35|| <br />
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<br />
<div style="text-align:justify;"><br />
Among the various types of [[Purusha]] described in the first few verses of this chapter, rashi[[purusha]] is one form that consists of 24 ''tattvas'' i.e. ''avyakata, mahat, ahankara,'' five ''tanmatras'' five [[mahabhuta]] and ten [indriya]] and [[manas]]. Since this specific combination is considered superior, a [[purusha]] of this type is called ''rashi[[purusha]]'' in Ayurvedic science. Of these ''tattvas, avyakta'' serves as an excellent coordinator of perceptual faculties, sense organs, mind and the objects of the senses. <br />
Thus a combination of the above mentioned (verses 17-35) twenty four elements is known as [[Purusha]]. [35]<br />
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रजस्तमोभ्यां युक्तस्य संयोगोऽयमनन्तवान्| <br />
ताभ्यां निराकृताभ्यां तु सत्त्ववृद्ध्या निवर्तते||३६|| <br />
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rajastamōbhyāṁ yuktasya saṁyōgō'yamanantavān| <br />
tābhyāṁ nirākr̥tābhyāṁ tu sattvavr̥ddhyā nivartatē||36|| <br />
<br />
rajastamobhyAM yuktasya saMyogo~ayamanantavAn| <br />
tAbhyAM nirAkRutAbhyAM tu sattvavRuddhyA nivartate||36|| <br />
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<br />
The association of [[purusha]] with the 24 tattvas continues so long as it is influenced by [[rajas]] and [[tamas]]. If it is freed from this influence (of [[rajas]] and [[tamas]]) by dominance of [[sattva]], the [[purusha]] is said to be liberated (and free from its association with the ''tattvas''). [36] <br />
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अत्र कर्म फलं चात्र ज्ञानं चात्र प्रतिष्ठितम्| <br />
अत्र मोहः सुखं दुःखं जीवितं मरणं स्वता||३७|| <br />
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atra karma phalaṁ cātra jñānaṁ cātra pratiṣṭhitam| <br />
atra mōhaḥ sukhaṁ duḥkhaṁ jīvitaṁ maraṇaṁ svatā||37|| <br />
<br />
atra karma phalaM cAtra j~jAnaM cAtra pratiShThitam| <br />
atra mohaH sukhaM duHkhaM jIvitaM maraNaM svatA||37|| <br />
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एवं [३] यो वेद तत्त्वेन स वेद प्रलयोदयौ| <br />
पारम्पर्यं चिकित्सां च ज्ञातव्यं [४] यच्च किञ्चन||३८|| <br />
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ēvaṁ [3] yō vēda tattvēna sa vēda pralayōdayau| <br />
pāramparyaṁ cikitsāṁ ca jñātavyaṁ [4] yacca kiñcana||38|| <br />
<br />
evaM [3] yo veda tattvena sa veda pralayodayau| <br />
pAramparyaM cikitsAM ca j~jAtavyaM [4] yacca ki~jcana||38|| <br />
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<br />
<div style="text-align:justify;"><br />
It is within this combination of 24 elements (known as the [[Purusha]]), that action, fruit or consequence of the action, knowledge, ignorance, happiness, misery, life, death and ownership are established. One who duely knows this, knows life, death, continuity of the body, treatment (physical and spiritual) and all other knowable objects. [37-38]<br />
<br />
[[Ayurveda]] believes that this ''rashipurusha'' is responsible for all deeds in life and has to face the consequences of these deeds. It is also responsible for the (creation/gaining of) knowledge, pleasure, sorrow, and joy. A term for the ''rashipurusha'' is ''karma purusha'' and physicians call it ''chikitsa adhikrita purusha''. The person who knows this ''rashipurusha'' in its true sense also understands the whole process of the genesis and destruction of life. Such an intellectual person becomes well aware of ''chikitsa'' and nothing else remains for him to be learnt.<br />
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भास्तमः सत्यमनृतं वेदाः कर्म शुभाशुभम्| <br />
न स्युः कर्ता [१] च बोद्धा च पुरुषो न भवेद्यदि||३९|| <br />
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bhāstamaḥ satyamanr̥taṁ vēdāḥ karma śubhāśubham| <br />
na syuḥ kartā [1] ca bōddhā ca puruṣō na bhavēdyadi||39|| <br />
<br />
bhAstamaH satyamanRutaM vedAH karma shubhAshubham| <br />
na syuH kartA [1] ca boddhA ca puruSho na bhavedyadi||39|| <br />
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नाश्रयो न सुखं नार्तिर्न गतिर्नागतिर्न वाक्| <br />
न विज्ञानं न शास्त्राणि न जन्म मरणं न च||४०|| <br />
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nāśrayō na sukhaṁ nārtirna gatirnāgatirna vāk| <br />
na vijñānaṁ na śāstrāṇi na janma maraṇaṁ na ca||40|| <br />
<br />
nAshrayo na sukhaM nArtirna gatirnAgatirna vAk| <br />
na vij~jAnaM na shAstrANi na janma maraNaM na ca||40|| <br />
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न बन्धो न च मोक्षः स्यात् पुरुषो न भवेद्यदि| <br />
कारणं पुरुषस्तस्मात् कारणज्ञैरुदाहृतः||४१|| <br />
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na bandhō na ca mōkṣaḥ syāt puruṣō na bhavēdyadi| <br />
kāraṇaṁ puruṣastasmāt kāraṇajñairudāhr̥taḥ||41|| <br />
<br />
na bandho na ca mokShaH syAt puruSho na bhavedyadi| <br />
kAraNaM puruShastasmAt kAraNaj~jairudAhRutaH||41|| <br />
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न चेत् कारणमात्मा स्याद्भादयः [२] स्युरहेतुकाः| <br />
न चैषु सम्भवेज् ज्ञानं न च तैः स्यात् प्रयोजनम्||४२|| <br />
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na cēt kāraṇamātmā syādbhādayaḥ [2] syurahētukāḥ| <br />
na caiṣu sambhavēj jñānaṁ na ca taiḥ syāt prayōjanam||42|| <br />
<br />
na cet kAraNamAtmA syAdbhAdayaH [2] syurahetukAH| <br />
na caiShu sambhavej j~jAnaM na ca taiH syAt prayojanam||42|| <br />
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<br />
<div style="text-align:justify;"><br />
While describing the reason for existence, (Charak says that) for anyone not accepting [[purusha]] as the cause or reason for existence (of life), there will be no existence of knowledge, ignorance, truth or falsehood, the ''vedas'', auspicious and non-auspicious deeds, and the agents of action and knowledge. There would be no support, happiness, misery, movement, immobility, speech, knowledge, scriptures, birth, death, bondage or salvation. Thus, the [[Purusha]] is recognized as a cause (of creation) by those well versed in the theory of causation. If [[Purusha]] is not recognized as a chief cause, then everything mentioned above will be considered as causeless. Then the theory of cause and effect which is a fundamental tenet of [[Ayurveda]] will fail and no one will put any effort in understanding the cause of any effect. [39-42]<br />
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कृतं मृद्दण्डचक्रैश्च कुम्भकारादृते घटम्| <br />
कृतं मृत्तृणकाष्ठैश्च गृहकाराद्विना गृहम्||४३|| <br />
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kr̥taṁ mr̥ddaṇḍacakraiśca kumbhakārādr̥tē ghaṭam| <br />
kr̥taṁ mr̥ttr̥ṇakāṣṭhaiśca gr̥hakārādvinā gr̥ham||43|| <br />
<br />
kRutaM mRuddaNDacakraishca kumbhakArAdRute ghaTam| <br />
kRutaM mRuttRuNakAShThaishca gRuhakArAdvinA gRuham||43|| <br />
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यो वदेत् स वदेद्देहं सम्भूय करणैः कृतम्| <br />
विना कर्तारमज्ञानाद्युक्त्यागमबहिष्कृतः||४४|| <br />
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yō vadēt sa vadēddēhaṁ sambhūya karaṇaiḥ kr̥tam| <br />
vinā kartāramajñānādyuktyāgamabahiṣkr̥taḥ||44|| <br />
<br />
yo vadet sa vadeddehaM sambhUya karaNaiH kRutam| <br />
vinA kartAramaj~jAnAdyuktyAgamabahiShkRutaH||44|| <br />
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<div style="text-align:justify;"><br />
In support of the causativity of [[Purusha]], author has given few practical examples of world where existence of ''karta'' (doer) becomes mandatory.<br />
<br />
Without a potter, can a pitcher be constructed with materials like mud, rod, and wheel alone? Can a house be constructed with mud, straw, and beams, if there is no mason? If the answer is “no” in both these cases, how can we expect the body to be created just by virtue of the combination of different sense organs, without a conscious agent? It is only an ignorant person devoid of rational outlook and scriptural knowledge who can assume otherwise. [43-44]<br />
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कारणं पुरुषः सर्वैः प्रमाणैरुपलभ्यते| <br />
येभ्यः प्रमेयं सर्वेभ्य आगमेभ्यः प्रमीयते||४५|| <br />
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kāraṇaṁ puruṣaḥ sarvaiḥ pramāṇairupalabhyatē| <br />
yēbhyaḥ pramēyaṁ sarvēbhya āgamēbhyaḥ pramīyatē||45|| <br />
<br />
kAraNaM puruShaH sarvaiH pramANairupalabhyate| <br />
yebhyaH prameyaM sarvebhya AgamebhyaH pramIyate||45|| <br />
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<br />
All the sources of knowledge, including scriptures that serve as an instrument for acquiring knowledge of various kinds, establish the causality of [[Purusha]]. [45]<br />
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न ते तत्सदृशास्त्वन्ये पारम्पर्यसमुत्थिताः| <br />
सारूप्याद्ये त एवेति निर्दिश्यन्ते नवा नवाः||४६|| <br />
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na tē tatsadr̥śāstvanyē pāramparyasamutthitāḥ| <br />
sārūpyādyē ta ēvēti nirdiśyantē navā navāḥ||46|| <br />
<br />
na te tatsadRushAstvanye pAramparyasamutthitAH| <br />
sArUpyAdye ta eveti nirdishyante navA navAH||46|| <br />
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भावास्तेषां समुदयो निरीशः सत्त्वसञ्ज्ञकः| <br />
कर्ता भोक्ता न स पुमानिति केचिद्व्यवस्थिताः||४७|| <br />
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bhāvāstēṣāṁ samudayō nirīśaḥ sattvasañjñakaḥ| <br />
kartā bhōktā na sa pumāniti kēcidvyavasthitāḥ||47|| <br />
<br />
bhAvAsteShAM samudayo nirIshaH sattvasa~jj~jakaH| <br />
kartA bhoktA na sa pumAniti kecidvyavasthitAH||47|| <br />
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<br />
<div style="text-align:justify;"><br />
Here, the author has given his opinion on other philosophies that do not accept the causality of [[Purusha]] but rather believe that there is always a new doer with every birth. They opine that there is no permanent [[Purusha]] as such. They believe that the [[Purusha]] is merely a combination of ephemeral elements devoid of any permanent controlling agent or consciousness. Certain schools of thought, including schools within Buddhism share this view. In their opinion, it is ''sattva'' and not the ''[[Aatma]]'' ([[Purusha]]) that becomes the doer and sufferer of its previous deeds. (This is also known as ''kshanabhangavada'') [46-47]<br />
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तेषामन्यैः कृतस्यान्ये भावा [१] भावैर्नवाः फलम्| <br />
भुञ्जते सदृशाः प्राप्तं यैरात्मा नोपदिश्यते||४८|| <br />
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tēṣāmanyaiḥ kr̥tasyānyē bhāvā [1] bhāvairnavāḥ phalam| <br />
bhuñjatē sadr̥śāḥ prāptaṁ yairātmā nōpadiśyatē||48|| <br />
<br />
teShAmanyaiH kRutasyAnye bhAvA [1] bhAvairnavAH phalam| <br />
bhu~jjate sadRushAH prAptaM yairAtmA nopadishyate||48|| <br />
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<br />
Those who subscribe to the above theory do not accept the soul as the cause or reason for existence. To them, the results of actions performed by one would be enjoyed by some other similar (momentary) entities. [48]<br />
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करणान्यान्यता दृष्टा कर्तुः कर्ता स एव तु| <br />
कर्ता हि करणैर्युक्तः कारणं सर्वकर्मणाम्||४९|| <br />
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karaṇānyānyatā dr̥ṣṭā kartuḥ kartā sa ēva tu| <br />
kartā hi karaṇairyuktaḥ kāraṇaṁ sarvakarmaṇām||49|| <br />
<br />
karaNAnyAnyatA dRuShTA kartuH kartA sa eva tu| <br />
kartA hi karaNairyuktaH kAraNaM sarvakarmaNAm||49|| <br />
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<br />
<div style="text-align:justify;"><br />
The bodily organs of a living being might be different but the soul i.e. the agent of action (deeds) is one and the same. The agent (doer) of action (deed) like a sculptor is an efficient cause of all actions (viz. sculpture etc.) by virtue of his possession of the various ''karana'' (equipment). [49]<br />
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निमेषकालाद्भावानां कालः शीघ्रतरोऽत्यये| <br />
भग्नानां न [१] पुनर्भावः कृतं नान्यमुपैति च||५०|| <br />
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nimēṣakālādbhāvānāṁ kālaḥ śīghratarō'tyayē| <br />
bhagnānāṁ na [1] punarbhāvaḥ kr̥taṁ nānyamupaiti ca||50|| <br />
<br />
nimeShakAlAdbhAvAnAM kAlaH shIghrataro~atyaye| <br />
bhagnAnAM na [1] punarbhAvaH kRutaM nAnyamupaiti ca||50|| <br />
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मतं तत्त्वविदामेतद्यस्मात्तस्मात् स कारणम्| <br />
क्रियोपभोगे भूतानां नित्यः पुरुषसञ्ज्ञकः||५१|| <br />
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mataṁ tattvavidāmētadyasmāttasmāt sa kāraṇam| <br />
kriyōpabhōgē bhūtānāṁ nityaḥ puruṣasañjñakaḥ||51|| <br />
<br />
mataM tattvavidAmetadyasmAttasmAt sa kAraNam| <br />
kriyopabhoge bhUtAnAM nityaH puruShasa~jj~jakaH||51|| <br />
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<div style="text-align:justify;"><br />
Physical elements can get destroyed at a rate faster than the twinkling of an eye. Those destroyed do not come back to their original form again and the results of the deeds (like ''yagna'') of one individual may not be enjoyable to another individual. The learned are, therefore, of the view that there is a permanent entity known as [[Purusha]] (soul) who is the causative factor for the action as well as for the enjoyment of the result of deeds. [50-51]<br />
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अहङ्कारः फलं कर्म देहान्तरगतिः स्मृतिः| <br />
विद्यते सति भूतानां कारणे देहमन्तरा||५२|| <br />
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ahaṅkāraḥ phalaṁ karma dēhāntaragatiḥ smr̥tiḥ| <br />
vidyatē sati bhūtānāṁ kāraṇē dēhamantarā||52|| <br />
<br />
aha~gkAraH phalaM karma dehAntaragatiH smRutiH| <br />
vidyate sati bhUtAnAM kAraNe dehamantarA||52|| <br />
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<br />
In living beings, a factor other than the body (i.e. the soul) is responsible for ego, enjoyment of the result of deeds, engagement in deeds, transmigration from one body to another body, and keeping the memory of the individual alive. [52]<br />
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प्रभवो न ह्यनादित्वाद्विद्यते परमात्मनः| <br />
पुरुषो राशिसञ्ज्ञस्तु मोहेच्छाद्वेषकर्मजः||५३|| <br />
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prabhavō na hyanāditvādvidyatē paramātmanaḥ| <br />
puruṣō rāśisañjñastu mōhēcchādvēṣakarmajaḥ||53|| <br />
<br />
prabhavo na hyanAditvAdvidyate paramAtmanaH| <br />
puruSho rAshisa~jj~jastu mohecchAdveShakarmajaH||53|| <br />
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<br />
answering the question of Agnivesha about the origin of soul, teacher said: <br />
<div style="text-align:justify;"><br />
As the supreme soul is without a beginning (i.e., is eternal), no birth can be ascribed to it. Of course, the [[Purusha]] who represents the combination of 24 elements (''rashipurusha'') certainly has its origin born out of its deeds in the previous life due to its delusion, desire and aversion. [53]<br />
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आत्मा ज्ञः करणैर्योगाज् ज्ञानं त्वस्य प्रवर्तते| <br />
करणानामवैमल्यादयोगाद्वा न वर्तते||५४|| <br />
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ātmā jñaḥ karaṇairyōgāj jñānaṁ tvasya pravartatē| <br />
karaṇānāmavaimalyādayōgādvā na vartatē||54|| <br />
<br />
AtmA j~jaH karaNairyogAj j~jAnaM tvasya pravartate| <br />
karaNAnAmavaimalyAdayogAdvA na vartate||54|| <br />
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पश्यतोऽपि यथाऽऽदर्शे सङ्क्लिष्टे नास्ति दर्शनम्| <br />
तत्त्वं [१] जले वा कलुषे चेतस्युपहते तथा||५५|| <br />
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paśyatō'pi yathā''darśē saṅkliṣṭē nāsti darśanam| <br />
tattvaṁ [1] jalē vā kaluṣē cētasyupahatē tathā||55|| <br />
<br />
pashyato~api yathA~a~adarshe sa~gkliShTe nAsti darshanam| <br />
tattvaM [1] jale vA kaluShe cetasyupahate tathA||55|| <br />
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<br />
<div style="text-align:justify;"><br />
The [[Purusha]] is endowed with the power of perception. It perceives things when it is associated with the mind, intellect and sense faculties. If these instruments of perception are either absent (i.e., detached from the [[Purusha]] or not associated with it) or impeded, then there will be no perception. One cannot get the true reflection of an image from a mirror that is covered with dirt or from dirty water. Similar is the case when the mind gets afflicted. [54-55]<br />
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करणानि मनो बुद्धिर्बुद्धिकर्मेन्द्रियाणि च| <br />
कर्तुः संयोगजं कर्म वेदना बुद्धिरेव च||५६|| <br />
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karaṇāni manō buddhirbuddhikarmēndriyāṇi ca| <br />
kartuḥ saṁyōgajaṁ karma vēdanā buddhirēva ca||56|| <br />
<br />
karaNAni mano buddhirbuddhikarmendriyANi ca| <br />
kartuH saMyogajaM karma vedanA buddhireva ca||56|| <br />
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नैकः प्रवर्तते कर्तुं भूतात्मा नाश्नुते फलम्| <br />
संयोगाद्वर्तते सर्वं तमृते नास्ति किञ्चन||५७|| <br />
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naikaḥ pravartatē kartuṁ bhūtātmā nāśnutē phalam| <br />
saṁyōgādvartatē sarvaṁ tamr̥tē nāsti kiñcana||57|| <br />
<br />
naikaH pravartate kartuM bhUtAtmA nAshnute phalam| <br />
saMyogAdvartate sarvaM tamRute nAsti ki~jcana||57|| <br />
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<br />
<div style="text-align:justify;"><br />
The instruments of knowledge are mind, intellect and cognitive and conative organs. Their association with the doer ([[Purusha]]) results in action, sensation and understanding. The [[Purusha]] alone (soul in the absence of ''[[manas]]'' and ''[[indriya]]s'') does neither initiate deeds nor enjoy the result of deeds. Combination of all these factors is responsible for the manifestation of every effect and without that nothing exists nor happens. [56-57]<br />
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न ह्येको वर्तते भावो वर्तते नाप्यहेतुकः| <br />
शीघ्रगत्वात्स्वभावात्त्वभावो [४] न व्यतिवर्तते||५८|| <br />
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na hyēkō vartatē bhāvō vartatē nāpyahētukaḥ| <br />
śīghragatvātsvabhāvāttvabhāvō [4] na vyativartatē||58|| <br />
<br />
na hyeko vartate bhAvo vartate nApyahetukaH| <br />
shIghragatvAtsvabhAvAttvabhAvo [4] na vyativartate||58|| <br />
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<br />
The [[Purusha]], not alone but accompanied with ''[[manass]]'' and ''[[indriya]]s'', is responsible for the manifestation of things. The process of decay on the other hand being too quick in succession does not need any cause as such. [58]<br />
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अनादिः पुरुषो नित्यो विपरीतस्तु हेतुजः| <br />
सदकारणवन्नित्यं दृष्टं हेतुजमन्यथा||५९|| <br />
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anādiḥ puruṣō nityō viparītastu hētujaḥ| <br />
sadakāraṇavannityaṁ dr̥ṣṭaṁ hētujamanyathā||59|| <br />
<br />
anAdiH puruSho nityo viparItastu hetujaH| <br />
sadakAraNavannityaM dRuShTaM hetujamanyathA||59|| <br />
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<br />
Thus, the absolute soul is without a beginning or an end, but the [[Purusha]] (i.e. the combination of 24 elements) being caused by something is not so i.e. it has a beginning and is ephemeral. <br />
<br />
All that exists without cause is eternal. Anything produced from a cause is ephemeral. [59]<br />
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तदेव भावादग्राह्यं नित्यत्व [१] न कुतश्चन| <br />
भावाज्ज्ञेयं तदव्यक्तमचिन्त्यं व्यक्तमन्यथा||६०|| <br />
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tadēva bhāvādagrāhyaṁ nityatva [1] na kutaścana| <br />
bhāvājjñēyaṁ tadavyaktamacintyaṁ vyaktamanyathā||60|| <br />
<br />
tadeva bhAvAdagrAhyaM nityatva [1] na kutashcana| <br />
bhAvAjj~jeyaM tadavyaktamacintyaM vyaktamanyathA||60|| <br />
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<br />
अव्यक्तमात्मा क्षेत्रज्ञः शाश्वतो विभुरव्ययः| <br />
तस्माद्यदन्यत्तद्व्यक्तं, वक्ष्यते चापरं द्वयम्||६१|| <br />
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avyaktamātmā kṣētrajñaḥ śāśvatō vibhuravyayaḥ| <br />
tasmādyadanyattadvyaktaṁ, vakṣyatē cāparaṁ dvayam||61|| <br />
<br />
avyaktamAtmA kShetraj~jaH shAshvato vibhuravyayaH| <br />
tasmAdyadanyattadvyaktaM, vakShyate cAparaM dvayam||61|| <br />
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<br />
व्यक्तमैन्द्रियकं चैव गृह्यते तद्यदिन्द्रियैः| <br />
अतोऽन्यत् पुनरव्यक्तं लिङ्गग्राह्यमतीन्द्रियम्||६२|| <br />
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vyaktamaindriyakaṁ caiva gr̥hyatē tadyadindriyaiḥ| <br />
atō'nyat punaravyaktaṁ liṅgagrāhyamatīndriyam||62|| <br />
<br />
vyaktamaindriyakaM caiva gRuhyate tadyadindriyaiH| <br />
ato~anyat punaravyaktaM li~ggagrAhyamatIndriyam||62|| <br />
</div></div><br />
<br />
<div style="text-align:justify;"><br />
The absolute soul cannot be perceived by anything, for eternity is not caused by anything. So, the absolute soul is unmanifested and imperceptible. The manifested creation is, of course, otherwise. <br />
<br />
The absolute soul is unmanifested, knower of creation, eternal, universal and indestructible. The manifested creation ([[Purusha]]) is, of course, otherwise. Another way of distinguishing manifested things from the unmanifested ones is that the former can be perceived by sense faculties. The latter is transcendental in nature and is not perceptible with the senses. It can only be inferred (rather than perceived). [60-62]<br />
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===Ashta bhuta [[prakriti]] (eight sources of creation) and ''Shodash'' vikara (sixteen elements)===<br />
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खादीनि बुद्धिरव्यक्तमहङ्कारस्तथाऽष्टमः| <br />
भूतप्रकृतिरुद्दिष्टा विकाराश्चैव षोडश||६३|| <br />
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khādīni buddhiravyaktamahaṅkārastathā'ṣṭamaḥ| <br />
bhūtaprakr̥tiruddiṣṭā vikārāścaiva ṣōḍaśa||63|| <br />
<br />
khAdIni buddhiravyaktamaha~gkArastathA~aShTamaH| <br />
bhUtaprakRutiruddiShTA vikArAshcaiva ShoDasha||63|| <br />
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बुद्धीन्द्रियाणि पञ्चैव पञ्च कर्मेन्द्रियाणि च| <br />
समनस्काश्च पञ्चार्था विकारा इति सञ्ज्ञिताः||६४|| <br />
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buddhīndriyāṇi pañcaiva pañca karmēndriyāṇi ca| <br />
samanaskāśca pañcārthā vikārā iti sañjñitāḥ||64|| <br />
<br />
buddhIndriyANi pa~jcaiva pa~jca karmendriyANi ca| <br />
samanaskAshca pa~jcArthA vikArA iti sa~jj~jitAH||64|| <br />
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<div style="text-align:justify;"><br />
The five subtle elements (viz. ''shabdatanmantra, sparshatanmantra, rupatanmantra, rasatanmatra'' and ''gandhatanmatra''), ''[[buddhi]]'' (intellect), ''avyakta'' (''[[prakriti]]'' or nature) and ''ahamkara'' (ego) are the eight sources of creation. Transformed and bio-transformed elements (''vikara'') are sixteen in number, viz. five sense faculties, five motor faculties, mind and five ''[[mahabhuta]]s''. [63-64]<br />
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इति क्षेत्रं समुद्दिष्टं सर्वमव्यक्तवर्जितम्| <br />
अव्यक्तमस्य क्षेत्रस्य क्षेत्रज्ञमृषयो विदुः||६५|| <br />
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iti kṣētraṁ samuddiṣṭaṁ sarvamavyaktavarjitam| <br />
avyaktamasya kṣētrasya kṣētrajñamr̥ṣayō viduḥ||65|| <br />
<br />
iti kShetraM samuddiShTaM sarvamavyaktavarjitam| <br />
avyaktamasya kShetrasya kShetraj~jamRuShayo viduH||65|| <br />
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<br />
As explained by wise ones, all this taken together, except the unmanifested one (''avyakta''), is known as ''kshetra'' i.e. corpus (body). The unmanifested (soul) one is known as ''kshetragna'' (knower of the corpus) which adjoins the body. [65]<br />
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जायते बुद्धिरव्यक्ताद्बुद्ध्याऽहमिति मन्यते| <br />
परं खादीन्यहङ्कारादुत्पद्यन्ते [१] यथाक्रमम्||६६|| <br />
ततः सम्पूर्णसर्वाङ्गो जातोऽभ्युदित उच्यते|<br />
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jāyatē buddhiravyaktādbuddhyā'hamiti manyatē| <br />
paraṁ khādīnyahaṅkārādutpadyantē [1] yathākramam||66|| <br />
tataḥ sampūrṇasarvāṅgō jātō'bhyudita ucyatē|<br />
jAyate buddhiravyaktAdbuddhyA~ahamiti manyate| <br />
paraM khAdInyaha~gkArAdutpadyante [1] yathAkramam||66|| <br />
tataH sampUrNasarvA~ggo jAto~abhyudita ucyate|<br />
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<div style="text-align:justify;"><br />
''[[Buddhi]]'' originates from ''avyakta'', ''ahamkara'' from ''[[buddhi]]'', and the five subtle ''[[mahabhuta]]s'' (''Tanmatras''), viz. ''akashatanmatra'' etc. from ''ahamkara''. These, along with the five gross ''[[mahabhuta]]s'' (in the right sequence) and the bio-transformed five ''[[indriya]]s'', constitute the [[Purusha]]. Thus, with this [[Purusha]] manifested in its entirety, the body (life) with its all constituents is said to be born (living life). [66-67]<br />
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पुरुषः प्रलये चेष्टैः पुनर्भावैर्वियुज्यते||६७|| <br />
अव्यक्ताद्व्यक्ततां याति व्यक्तादव्यक्ततां पुनः| <br />
रजस्तमोभ्यामाविष्टश्चक्रवत् परिवर्तते||६८|| <br />
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puruṣaḥ pralayē cēṣṭaiḥ punarbhāvairviyujyatē||67||<br />
avyaktādvyaktatāṁ yāti vyaktādavyaktatāṁ punaḥ| <br />
rajastamōbhyāmāviṣṭaścakravat parivartatē||68|| <br />
<br />
puruShaH pralaye ceShTaiH punarbhAvairviyujyate||67||<br />
avyaktAdvyaktatAM yAti vyaktAdavyaktatAM punaH| <br />
rajastamobhyAmAviShTashcakravat parivartate||68|| <br />
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येषां द्वन्द्वे परा सक्तिरहङ्कारपराश्च ये| <br />
उदयप्रलयौ तेषां न तेषां ये त्वतोऽन्यथा||६९|| <br />
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yēṣāṁ dvandvē parā saktirahaṅkāraparāśca yē| <br />
udayapralayau tēṣāṁ na tēṣāṁ yē tvatō'nyathā||69|| <br />
<br />
yeShAM dvandve parA saktiraha~gkAraparAshca ye| <br />
udayapralayau teShAM na teShAM ye tvato~anyathA||69|| <br />
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<div style="text-align:justify;"><br />
At the time of destruction of life, the [[Purusha]] (soul) again dissociates itself from all the manifestations meant for its enjoyment, viz. ''[[buddhi]]'' etc. The universe accompanied with ''[[rajas]]'' and ''[[tamas]]'' cycles between the unmanifested and the manifested stages. <br />
Those who are attached to ''[[rajas]]'' and ''[[tamas]]'' and those who are egoistic undergo the process of birth and rebirth. Others that are not, get liberation. [67-69]<br />
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प्राणापानौ निमेषाद्या जीवनं मनसो गतिः| <br />
इन्द्रियान्तरसञ्चारः प्रेरणं धारणं च यत्||७०|| <br />
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prāṇāpānau nimēṣādyā jīvanaṁ manasō gatiḥ| <br />
indriyāntarasañcāraḥ prēraṇaṁ dhāraṇaṁ ca yat||70|| <br />
<br />
prANApAnau nimeShAdyA jIvanaM manaso gatiH| <br />
indriyAntarasa~jcAraH preraNaM dhAraNaM ca yat||70|| <br />
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देशान्तरगतिः स्वप्ने पञ्चत्वग्रहणं तथा| <br />
दृष्टस्य दक्षिणेनाक्ष्णा सव्येनावगमस्तथा||७१|| <br />
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dēśāntaragatiḥ svapnē pañcatvagrahaṇaṁ tathā| <br />
dr̥ṣṭasya dakṣiṇēnākṣṇā savyēnāvagamastathā||71|| <br />
<br />
deshAntaragatiH svapne pa~jcatvagrahaNaM tathA| <br />
dRuShTasya dakShiNenAkShNA savyenAvagamastathA||71|| <br />
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इच्छा द्वेषः सुखं दुःखं प्रयत्नश्चेतना धृतिः| <br />
बुद्धिः स्मृतिरहङ्कारो लिङ्गानि परमात्मनः||७२|| <br />
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icchā dvēṣaḥ sukhaṁ duḥkhaṁ prayatnaścētanā dhr̥tiḥ| <br />
buddhiḥ smr̥tirahaṅkārō liṅgāni paramātmanaḥ||72|| <br />
<br />
cchA dveShaH sukhaM duHkhaM prayatnashcetanA dhRutiH| <br />
buddhiH smRutiraha~gkAro li~ggAni paramAtmanaH||72|| <br />
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यस्मात् समुपलभ्यन्ते लिङ्गान्येतानि जीवतः| <br />
न मृतस्यात्मलिङ्गानि तस्मादाहुर्महर्षयः||७३|| <br />
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yasmāt samupalabhyantē liṅgānyētāni jīvataḥ| <br />
na mr̥tasyātmaliṅgāni tasmādāhurmaharṣayaḥ||73|| <br />
<br />
yasmAt samupalabhyante li~ggAnyetAni jIvataH| <br />
na mRutasyAtmali~ggAni tasmAdAhurmaharShayaH||73|| <br />
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शरीरं हि गते तस्मिञ् शून्यागारमचेतनम्| <br />
पञ्चभूतावशेषत्वात् पञ्चत्वं गतमुच्यते||७४|| <br />
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śarīraṁ hi gatē tasmiñ śūnyāgāramacētanam| <br />
pañcabhūtāvaśēṣatvāt pañcatvaṁ gatamucyatē||74|| <br />
<br />
sharIraM hi gate tasmi~j shUnyAgAramacetanam| <br />
pa~jcabhUtAvasheShatvAt pa~jcatvaM gatamucyate||74|| <br />
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<div style="text-align:justify;"><br />
In response to the question on the signs and symptoms of a soul in the living body, as well as the proofs of existence of the soul in living animates, Lord Atreya mentions the following as proof:<br />
<br />
# Inspiration and expiration;<br />
# Twinkling of the eye;<br />
# Sign and symptoms of living life;<br />
# Ability to mentally teleport oneself (e.g. arriving at a distant place like Pataliputra in imagination or dream);<br />
# Shift from one object of sense organ to another (e.g. shift from visual perception to tactile perception);<br />
# Inspiration and controlling mind and ''[[indriya]]s''<br />
# Journey to another country in dreams;<br />
# Anticipation of death;<br />
# Knowledge of something visualized in right eye by the left eye;<br />
# Desire, envy, happiness, misery, effort, consciousness, stability, intellect, memory and ego.<br />
<br />
All these are signs of a living person. These signs are not available in a dead body. So, they are considered to be proof of existence of the soul till the living life. When that soul, with all its associates (''[[indriya]]s'', ''[[manas]]'' and four subtle ''[[mahabhuta]]s'') departs, the body becomes vacant and is deprived of consciousness. Only the five ''[[mahabhuta]]s'' remain. So, a dead body is said to have attained the state of five ''[[mahabhuta]]s'' (''panchtatva'') [70-74]<br />
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अचेतनं क्रियावच्च मनश्चेतयिता परः| <br />
युक्तस्य मनसा तस्य निर्दिश्यन्ते विभोः क्रियाः||७५|| <br />
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acētanaṁ kriyāvacca manaścētayitā paraḥ| <br />
yuktasya manasā tasya nirdiśyantē vibhōḥ kriyāḥ||75|| <br />
<br />
acetanaM kriyAvacca manashcetayitA paraH| <br />
yuktasya manasA tasya nirdishyante vibhoH kriyAH||75|| <br />
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चेतनावान् यतश्चात्मा ततः कर्ता निरुच्यते| <br />
अचेतनत्वाच्च मनः क्रियावदपि नोच्यते||७६|| <br />
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cētanāvān yataścātmā tataḥ kartā nirucyatē| <br />
acētanatvācca manaḥ kriyāvadapi nōcyatē||76|| <br />
<br />
cetanAvAn yatashcAtmA tataH kartA nirucyate| <br />
acetanatvAcca manaH kriyAvadapi nocyate||76|| <br />
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<br />
Mind is active, but devoid of consciousness. The omnipresent soul becomes active only when it coordinates with mind. Though the soul is not active, it is conscious and is considered a doer, or an actor, or an agent of deeds. The mind is not considered as actor, because it is devoid of Consciousness, though it is responsible for activity. [75-76] <br />
<br />
Thus, the ability to “cause” or “act” resides in the conscious and not in unconscious.<br />
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यथास्वेनात्मनाऽऽत्मानं सर्वः सर्वासु योनिषु| <br />
प्राणैस्तन्त्रयते प्राणी नह्यन्योऽस्त्यस्य तन्त्रकः||७७|| <br />
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yathāsvēnātmanā''tmānaṁ sarvaḥ sarvāsu yōniṣu| <br />
prāṇaistantrayatē prāṇī nahyanyō'styasya tantrakaḥ||77|| <br />
<br />
yathAsvenAtmanA~a~atmAnaM sarvaH sarvAsu yoniShu| <br />
prANaistantrayate prANI nahyanyo~astyasya tantrakaH||77|| <br />
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वशी तत् कुरुते कर्म यत् कृत्वा फलमश्नुते| <br />
वशी चेतः समाधत्ते वशी सर्वं निरस्यति||७८|| <br />
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vaśī tat kurutē karma yat kr̥tvā phalamaśnutē| <br />
vaśī cētaḥ samādhattē vaśī sarvaṁ nirasyati||78|| <br />
<br />
vashI tat kurute karma yat kRutvA phalamashnute| <br />
vashI cetaH samAdhatte vashI sarvaM nirasyati||78|| <br />
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<div style="text-align:justify;"><br />
The soul can independently enter any animate body. There is no other controller of soul, hence, it is considered a self controller. It is to said that the soul is free and independent to do its deeds but it is not free to get result of its deeds as per its own wish. Here it can be understood that the control of its activities and its entry into the body is governed by the result of its deeds. <br />
The soul is absolutely free to act as it pleases. It is however obliged to enjoy the results of its own deeds. It is also free to control the mind associated with it. And the free soul, when meditates, get rid of the results of good or bad acts of its own. [78]<br />
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देही सर्वगतोऽप्यात्मा [१] स्वे स्वे संस्पर्शनेन्द्रिये| <br />
सर्वाः सर्वाश्रयस्थास्तु नात्माऽतो वेत्ति वेदनाः||७९|| <br />
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dēhī sarvagatō'pyātmā [1] svē svē saṁsparśanēndriyē| <br />
sarvāḥ sarvāśrayasthāstu nātmā'tō vētti vēdanāḥ||79|| <br />
<br />
dehI sarvagato~apyAtmA [1] sve sve saMsparshanendriye| <br />
sarvAH sarvAshrayasthAstu nAtmA~ato vetti vedanAH||79|| <br />
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<div style="text-align:justify;"><br />
Even though the soul is all pervasive, it can perceive sensations in its associated physical body through the contact of sense organs with their respective objects. (Being limited by the contacts of the bodily sense organs with their objects), the soul cannot have all sensations [79]<br />
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विभुत्वमत एवास्य यस्मात् सर्वगतो महान्| <br />
मनसश्च समाधानात् पश्यत्यात्मा तिरस्कृतम्||८०|| <br />
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vibhutvamata ēvāsya yasmāt sarvagatō mahān| <br />
manasaśca samādhānāt paśyatyātmā tiraskr̥tam||80|| <br />
<br />
vibhutvamata evAsya yasmAt sarvagato mahAn| <br />
manasashca samAdhAnAt pashyatyAtmA tiraskRutam||80|| <br />
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नित्यानुबन्धं मनसा देहकर्मानुपातिना| <br />
सर्वयोनिगतं विद्यादेकयोनावपि स्थितम्||८१|| <br />
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nityānubandhaṁ manasā dēhakarmānupātinā| <br />
sarvayōnigataṁ vidyādēkayōnāvapi sthitam||81|| <br />
<br />
nityAnubandhaM manasA dehakarmAnupAtinA| <br />
sarvayonigataM vidyAdekayonAvapi sthitam||81|| <br />
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<div style="text-align:justify;"><br />
When the omnipresent, supreme soul gets combined with ''[[manas]]'' and other senses, it becomes ''kshetragya'' i.e., one that has the power to go anywhere in the universe and become a knower of that body. It can perceive objects inspite of (spatial, temporal or material) obstructions. Even though it is located in one body when associated with the mind through physical actions, it is still present in all other bodies. Conversely, in spite of it being present in all bodies, its field of action is limited to one body alone because of its contact with the mind. [80-81]<br />
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आदिर्नास्त्यात्मनः [१] क्षेत्रपारम्पर्यमनादिकम्| <br />
अतस्तयोरनादित्वात् किं पूर्वमिति नोच्यते||८२|| <br />
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ādirnāstyātmanaḥ [1] kṣētrapāramparyamanādikam| <br />
atastayōranāditvāt kiṁ pūrvamiti nōcyatē||82|| <br />
<br />
AdirnAstyAtmanaH [1] kShetrapAramparyamanAdikam| <br />
atastayoranAditvAt kiM pUrvamiti nocyate||82|| <br />
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ज्ञः साक्षीत्युच्यते नाज्ञः साक्षी त्वात्मा यतः स्मृतः| <br />
सर्वे भावा हि सर्वेषां भूतानामात्मसाक्षिकाः||८३|| <br />
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jñaḥ sākṣītyucyatē nājñaḥ sākṣī tvātmā yataḥ smr̥taḥ| <br />
sarvē bhāvā hi sarvēṣāṁ bhūtānāmātmasākṣikāḥ||83|| <br />
<br />
j~jaH sAkShItyucyate nAj~jaH sAkShI tvAtmA yataH smRutaH| <br />
sarve bhAvA hi sarveShAM bhUtAnAmAtmasAkShikAH||83|| <br />
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<br />
<div style="text-align:justify;"><br />
''[[Aatma]]'' (soul) does not have a beginning, and similarly, the corpus (combination of [[ayu]] elements) also does not have a beginning. The continuity of ''kshetra'' and ''kshetragya'' is so long that it is not possible to say which came earlier (''kshetra'' or ''kshetragya'')<br />
[82]<br />
<br />
It is only he who knows things that can stand as a witness. So, all attributes, actions etc., of [[bhuta]]s are witnessed by the [[soul]] (who alone is the knower of things). Things cannot be witnessed by unconscious objects (like stone). [83]<br />
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नैकः कदाचिद्भूतात्मा लक्षणैरुपलभ्यते| <br />
विशेषोऽनुपलभ्यस्य तस्य नैकस्य विद्यते||८४|| <br />
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naikaḥ kadācidbhūtātmā lakṣaṇairupalabhyatē| <br />
viśēṣō'nupalabhyasya tasya naikasya vidyatē||84|| <br />
<br />
naikaH kadAcidbhUtAtmA lakShaNairupalabhyate| <br />
visheSho~anupalabhyasya tasya naikasya vidyate||84|| <br />
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संयोगपुरुषस्येष्टो विशेषो वेदनाकृतः| <br />
वेदना यत्र नियता विशेषस्तत्र तत्कृतः||८५|| <br />
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saṁyōgapuruṣasyēṣṭō viśēṣō vēdanākr̥taḥ| <br />
vēdanā yatra niyatā viśēṣastatra tatkr̥taḥ||85|| <br />
<br />
saMyogapuruShasyeShTo visheSho vedanAkRutaH| <br />
vedanA yatra niyatA visheShastatra tatkRutaH||85|| <br />
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<div style="text-align:justify;"><br />
The absolute soul is unity and singular. It does not have signs or symptoms. Since it is inaccessible, it has no sensation. It is only the samyoga [[purusha]] (24 tattvatmaka purusha) that has sensations. These sensations do not constitute the attributes of the soul as such, but arise out of contact (of the sense organs with their objects). [84-85]<br />
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चिकित्सति भिषक् सर्वास्त्रिकाला वेदना इति| <br />
यया युक्त्या वदन्त्येके सा युक्तिरुपधार्यताम्||८६|| <br />
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cikitsati bhiṣak sarvāstrikālā vēdanā iti| <br />
yayā yuktyā vadantyēkē sā yuktirupadhāryatām||86|| <br />
<br />
cikitsati bhiShak sarvAstrikAlA vedanA iti| <br />
yayA yuktyA vadantyeke sA yuktirupadhAryatAm||86|| <br />
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पुनस्तच्छिरसः शूलं ज्वरः स पुनरागतः| <br />
पुनः स कासो बलवांश्छर्दिः सा पुनरागता||८७|| <br />
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punastacchirasaḥ śūlaṁ jvaraḥ sa punarāgataḥ| <br />
punaḥ sa kāsō balavāṁśchardiḥ sā punarāgatā||87||<br />
<br />
punastacchirasaH shUlaM jvaraH sa punarAgataH| <br />
punaH sa kAso balavAMshchardiH sA punarAgatA||87|| <br />
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एभिः प्रसिद्धवचनैरतीतागमनं मतम्| <br />
कालश्चायमतीतानामर्तीनां पुनरागतः||८८|| <br />
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ēbhiḥ prasiddhavacanairatītāgamanaṁ matam| <br />
kālaścāyamatītānāmartīnāṁ punarāgataḥ||88|| <br />
<br />
ebhiH prasiddhavacanairatItAgamanaM matam| <br />
kAlashcAyamatItAnAmartInAM punarAgataH||88|| <br />
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तमर्तिकालमुद्दिश्य भेषजं यत् प्रयुज्यते| <br />
अतीतानां प्रशमनं वेदनानां तदुच्यते||८९|| <br />
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tamartikālamuddiśya bhēṣajaṁ yat prayujyatē| <br />
atītānāṁ praśamanaṁ vēdanānāṁ taducyatē||89||<br />
<br />
tamartikAlamuddishya bheShajaM yat prayujyate| <br />
atItAnAM prashamanaM vedanAnAM taducyate||89||<br />
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आपस्ताः पुनरागुर्मा याभिः शस्यं पुरा हतम्| <br />
यथा प्रक्रियते सेतुः प्रतिकर्म तथाऽऽश्रये||९०|| <br />
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āpastāḥ punarāgurmā yābhiḥ śasyaṁ purā hatam| <br />
yathā prakriyatē sētuḥ pratikarma tathā''śrayē||90|| <br />
<br />
ApastAH punarAgurmA yAbhiH shasyaM purA hatam| <br />
yathA prakriyate setuH pratikarma tathA~a~ashraye||90|| <br />
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पूर्वरूपं विकाराणां दृष्ट्वा प्रादुर्भविष्यताम्| <br />
या क्रिया क्रियते सा च वेदनां हन्त्यनागताम्||९१|| <br />
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pūrvarūpaṁ vikārāṇāṁ dr̥ṣṭvā prādurbhaviṣyatām| <br />
yā kriyā kriyatē sā ca vēdanāṁ hantyanāgatām||91|| <br />
<br />
pUrvarUpaM vikArANAM dRuShTvA prAdurbhaviShyatAm| <br />
yA kriyA kriyate sA ca vedanAM hantyanAgatAm||91||<br />
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पारम्पर्यानबन्धस्तु दुःखानां विनिवर्तते| <br />
सुखहेतूपचारेण सुखं चापि प्रवर्तते||९२|| <br />
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pāramparyānabandhastu duḥkhānāṁ vinivartatē| <br />
sukhahētūpacārēṇa sukhaṁ cāpi pravartatē||92|| <br />
<br />
pAramparyAnabandhastu duHkhAnAM vinivartate| <br />
sukhahetUpacAreNa sukhaM cApi pravartate||92|| <br />
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न समा यान्ति वैषम्यं विषमाः समतां न च| <br />
हेतुभिः सदृशा नित्यं जायन्ते देहधातवः||९३|| <br />
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na samā yānti vaiṣamyaṁ viṣamāḥ samatāṁ na ca| <br />
hētubhiḥ sadr̥śā nityaṁ jāyantē dēhadhātavaḥ||93|| <br />
<br />
na samA yAnti vaiShamyaM viShamAH samatAM na ca| <br />
hetubhiH sadRushA nityaM jAyante dehadhAtavaH||93|| <br />
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युक्तिमेतां पुरस्कृत्य त्रिकालां वेदनां भिषक्| <br />
हन्तीत्युक्तं चिकित्सा तु नैष्ठिकी या विनोपधाम्||९४|| <br />
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yuktimētāṁ puraskr̥tya trikālāṁ vēdanāṁ bhiṣak| <br />
hantītyuktaṁ cikitsā tu naiṣṭhikī yā vinōpadhām||94|| <br />
<br />
yuktimetAM puraskRutya trikAlAM vedanAM bhiShak| <br />
hantItyuktaM cikitsA tu naiShThikI yA vinopadhAm||94|| <br />
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<div style="text-align:justify;"><br />
The following logic is given here while responding to the question on the management of illnesses of the past, the present and the future.<br />
Recurrence of headache, fever, cough and vomiting establishes the fact that diseases of the past do relapse. That is to say, the time of occurrence of the various diseases in the past repeats itself. The therapeutic devices meant for alleviating such recurring diseases verily take the past history (of such diseases) into consideration.<br />
<br />
In order that flood waters may not damage crops as they did in the past, a dam is constructed as a preventive measure. By observing premonitory symptoms, some therapies are prescribed to prevent certain diseases which are likely to attack living beings in future. This treatment relates to prevention of future diseases.<br />
<br />
A continuity of ailments is checked by treatments that are conducive to the continuity of happiness. <br />
The state of equilibrium of [[dhatu]] is not disturbed nor is the imbalanced state brought to normalcy without some causative factors. It is the causative factors which determine the equilibrium or imbalance of the [[dhatu]]. <br />
So a physician treats the diseases pertaining to the past, present and future. The treatment that is devoid of desires (upadha) is called as complete treatment or supreme treatment (naishthiki chikitsa). [86-94]<br />
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उपधा हि परो हेतुर्दुःखदुःखाश्रयप्रदः| <br />
त्यागः सर्वोपधानां च सर्वदुःखव्यपोहकः||९५|| <br />
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upadhā hi parō hēturduḥkhaduḥkhāśrayapradaḥ| <br />
tyāgaḥ sarvōpadhānāṁ ca sarvaduḥkhavyapōhakaḥ||95|| <br />
<br />
upadhA hi paro heturduHkhaduHkhAshrayapradaH| <br />
tyAgaH sarvopadhAnAM ca sarvaduHkhavyapohakaH||95|| <br />
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कोषकारो यथा ह्यंशूनुपादत्ते वधप्रदान् [३] | <br />
उपादत्ते तथाऽर्थेभ्यस्तृष्णामज्ञः सदाऽऽतुरः||९६|| <br />
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kōṣakārō yathā hyaṁśūnupādattē vadhapradān [3] | <br />
upādattē tathā'rthēbhyastr̥ṣṇāmajñaḥ sadā''turaḥ||96|| <br />
<br />
koShakAro yathA hyaMshUnupAdatte vadhapradAn [3] | <br />
upAdatte tathA~arthebhyastRuShNAmaj~jaH sadA~a~aturaH||96|| <br />
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यस्त्वग्निकल्पानर्थाञ् ज्ञो ज्ञात्वा तेभ्यो निवर्तते| <br />
अनारम्भादसंयोगात्तं दुःखं नोपतिष्ठते||९७|| <br />
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yastvagnikalpānarthāñ jñō jñātvā tēbhyō nivartatē| <br />
anārambhādasaṁyōgāttaṁ duḥkhaṁ nōpatiṣṭhatē||97|| <br />
<br />
yastvagnikalpAnarthA~j j~jo j~jAtvA tebhyo nivartate| <br />
anArambhAdasaMyogAttaM duHkhaM nopatiShThate||97|| <br />
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Absolute eradication of miseries is obtained by the elimination of desires. Desire is the root cause of all miseries. Elimination of desires leads to the eradication of all miseries. A silk worm provides for itself suicidal threads. So, does an ignorant person. Bound by worldly miseries, he provides for himself desires arising out of the various objects. A wise person who abstains from the objects of senses, considering them as dangerous as burning fire, does not subject himself to any wishful acts and attachments with the result that miseries never overcome him. [94-97]<br />
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=== Basic causes of miseries in life===<br />
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धीधृतिस्मृतिविभ्रंशः सम्प्राप्तिः कालकर्मणाम्| <br />
असात्म्यार्थागमश्चेति ज्ञातव्या दुःखहेतवः||९८|| <br />
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dhīdhr̥tismr̥tivibhraṁśaḥ samprāptiḥ kālakarmaṇām| <br />
asātmyārthāgamaścēti jñātavyā duḥkhahētavaḥ||98|| <br />
<br />
dhIdhRutismRutivibhraMshaH samprAptiH kAlakarmaNAm| <br />
asAtmyArthAgamashceti j~jAtavyA duHkhahetavaH||98|| <br />
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<br />
<div style="text-align:justify;"><br />
Impairment of intellect (grasping and keeping power), ''dhriti'' (controlling power) and memory (recalling power), ageing/advent of maturity, deeds and unwholesome contact with objects of senses could be counted as factors responsible for causing miseries. [98]<br />
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विषमाभिनिवेशो यो नित्यानित्ये हिताहिते| <br />
ज्ञेयः स बुद्धिविभ्रंशः समं बुद्धिर्हि पश्यति||९९|| <br />
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viṣamābhinivēśō yō nityānityē hitāhitē| <br />
jñēyaḥ sa buddhivibhraṁśaḥ samaṁ buddhirhi paśyati||99|| <br />
<br />
viShamAbhinivesho yo nityAnitye hitAhite| <br />
j~jeyaH sa buddhivibhraMshaH samaM buddhirhi pashyati||99|| <br />
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<br />
If something eternal is viewed as ephemeral and something harmful as useful, and vice versa, this is indicative of the impairment of intellect. For, the normal intellect views things as they are. [99]<br />
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विषयप्रवणं सत्त्वं धृतिभ्रंशान्न शक्यते| <br />
नियन्तुमहितादर्थाद्धृतिर्हि नियमात्मिका||१००|| <br />
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viṣayapravaṇaṁ sattvaṁ dhr̥tibhraṁśānna śakyatē| <br />
niyantumahitādarthāddhr̥tirhi niyamātmikā||100|| <br />
<br />
viShayapravaNaM sattvaM dhRutibhraMshAnna shakyate| <br />
niyantumahitAdarthAddhRutirhi niyamAtmikA||100|| <br />
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<br />
A mind indulging in worldly enjoyments cannot be restrained from harmful objects due to the impairment of ''dhriti'' (controlling power). It is ''dhriti'' that can restrain the mind (from its harmful objects). [100]<br />
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तत्त्वज्ञाने स्मृतिर्यस्य रजोमोहावृतात्मनः| <br />
भ्रश्यते स स्मृतिभ्रंशः स्मर्तव्यं हि स्मृतौ स्थितम्||१०१|| <br />
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tattvajñānē smr̥tiryasya rajōmōhāvr̥tātmanaḥ| <br />
bhraśyatē sa smr̥tibhraṁśaḥ smartavyaṁ hi smr̥tau sthitam||101|| <br />
<br />
tattvaj~jAne smRutiryasya rajomohAvRutAtmanaH| <br />
bhrashyate sa smRutibhraMshaH smartavyaM hi smRutau sthitam||101|| <br />
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<br />
If the memory is impaired due to a person being overcome by [[rajas]] and [[tamas]], the recollection of knowledge of reality or self is impaired. This is known as the impairment of [[smriti]]. Normally [[smriti]] contains everything memorable. [101]<br />
<br />
=== [[Prajnaparadha]] (intellectual defect) and its consequences ===<br />
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धीधृतिस्मृतिविभ्रष्टः कर्म यत् कुरुतेऽशुभम्| <br />
प्रज्ञापराधं तं विद्यात् सर्वदोषप्रकोपणम्||१०२|| <br />
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dhīdhr̥tismr̥tivibhraṣṭaḥ karma yat kurutē'śubham| <br />
prajñāparādhaṁ taṁ vidyāt sarvadōṣaprakōpaṇam||102|| <br />
<br />
dhIdhRutismRutivibhraShTaH karma yat kurute~ashubham| <br />
praj~jAparAdhaM taM vidyAt sarvadoShaprakopaNam||102|| <br />
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उदीरणं गतिमतामुदीर्णानां च निग्रहः| <br />
सेवनं साहसानां च नारीणां चातिसेवनम्||१०३|| <br />
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udīraṇaṁ gatimatāmudīrṇānāṁ ca nigrahaḥ| <br />
sēvanaṁ sāhasānāṁ ca nārīṇāṁ cātisēvanam||103|| <br />
<br />
udIraNaM gatimatAmudIrNAnAM ca nigrahaH| <br />
sevanaM sAhasAnAM ca nArINAM cAtisevanam||103|| <br />
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कर्मकालातिपातश्च मिथ्यारम्भश्च कर्मणाम्| <br />
विनयाचारलोपश्च पूज्यानां चाभिधर्षणम्||१०४|| <br />
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karmakālātipātaśca mithyārambhaśca karmaṇām| <br />
vinayācāralōpaśca pūjyānāṁ cābhidharṣaṇam||104|| <br />
<br />
karmakAlAtipAtashca mithyArambhashca karmaNAm| <br />
vinayAcAralopashca pUjyAnAM cAbhidharShaNam||104|| <br />
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ज्ञातानां स्वयमर्थानामहितानां निषेवणम्| <br />
परमौन्मादिकानां च प्रत्ययानां निषेवणम्||१०५|| <br />
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jñātānāṁ svayamarthānāmahitānāṁ niṣēvaṇam| <br />
paramaunmādikānāṁ ca pratyayānāṁ niṣēvaṇam||105|| <br />
<br />
j~jAtAnAM svayamarthAnAmahitAnAM niShevaNam| <br />
paramaunmAdikAnAM ca pratyayAnAM niShevaNam||105|| <br />
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अकालादेशसञ्चारौ मैत्री सङ्क्लिष्टकर्मभिः| <br />
इन्द्रियोपक्रमोक्तस्य सद्वृत्तस्य च वर्जनम्||१०६|| <br />
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akālādēśasañcārau maitrī saṅkliṣṭakarmabhiḥ| <br />
indriyōpakramōktasya sadvr̥ttasya ca varjanam||106|| <br />
<br />
akAlAdeshasa~jcArau maitrI sa~gkliShTakarmabhiH| <br />
indriyopakramoktasya sadvRuttasya ca varjanam||106|| <br />
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ईर्ष्यामानभयक्रोधलोभमोहमदभ्रमाः| <br />
तज्जं वा कर्म यत् क्लिष्टं क्लिष्टं यद्देहकर्म च||१०७|| <br />
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īrṣyāmānabhayakrōdhalōbhamōhamadabhramāḥ| <br />
tajjaṁ vā karma yat kliṣṭaṁ kliṣṭaṁ yaddēhakarma ca||107|| <br />
<br />
IrShyAmAnabhayakrodhalobhamohamadabhramAH| <br />
tajjaM vA karma yat kliShTaM kliShTaM yaddehakarma ca||107|| <br />
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यच्चान्यदीदृशं कर्म रजोमोहसमुत्थितम्| <br />
प्रज्ञापराधं तं शिष्टा ब्रुवते व्याधिकारणम् [१] ||१०८|| <br />
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yaccānyadīdr̥śaṁ karma rajōmōhasamutthitam| <br />
prajñāparādhaṁ taṁ śiṣṭā bruvatē vyādhikāraṇam [1] ||108|| <br />
<br />
yaccAnyadIdRushaM karma rajomohasamutthitam| <br />
praj~jAparAdhaM taM shiShTA bruvate vyAdhikAraNam [1] ||108|| <br />
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<div style="text-align:justify;"><br />
When a person’s ''dhi'' (ability to comprehend), ''dhriti'' (controlling power), and [[smriti]] (power to recall memories, or reminisce) get impaired, he performs inauspicious deeds that lead to aggravation of all [[dosha]]. This is called [[prajnaparadha]] (mistake of the intellect, knowingly committing crime or unwholesome/sinful acts).<br />
<br />
Forcible stimulation of natural urges and suppression of the manifested ones, exhibition of undue strength, over indulgence in sexual acts, negligence of the time and method of administering of treatment (i.e. non utilization, excessive utilization, and impaired utilization of therapies), initiation of action in improper time, loss of modesty and good conduct, disrespecting those that deserve respect, enjoyment of harmful objects, resorting to the factors that are responsible for the causation of madness, walking and travelling at improper time and places, friendship with persons of bad character, avoidance of ''sadvritta'' (noble code of conduct) described in [[Indriyopakramaniya Adhyaya]] ([[Sutra Sthana]] 8th chapter) or harboring malice, vanity, fear, anger, greed, ignorance, intoxication and bewilderment or bad actions arising out of any of them, and/or physical evil acts arising out of [[rajas]] and ''[[tamas]]'' constitute [[prajnaparadha]], the root cause of several diseases told by learned seers of [[Ayurveda]]. [102-108]<br />
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बुद्ध्या विषमविज्ञानं विषमं च प्रवर्तनम्| <br />
प्रज्ञापराधं जानीयान्मनसो गोचरं हि तत्||१०९|| <br />
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buddhyā viṣamavijñānaṁ viṣamaṁ ca pravartanam| <br />
prajñāparādhaṁ jānīyānmanasō gōcaraṁ hi tat||109|| <br />
<br />
buddhyA viShamavij~jAnaM viShamaM ca pravartanam| <br />
praj~jAparAdhaM jAnIyAnmanaso gocaraM hi tat||109|| <br />
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<br />
<div style="text-align:justify;"><br />
Understanding the subjects in improper way due to the impairment of intellect and, at the same time, executing this improper knowledge in the wrong way is also termed as [[prajnaparadha]] which makes improper cognition of [[manasa]], [[indriya]] with their objects and subjects. [109]<br />
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=== Importance of ''[[Kala]]'' (time factor)===<br />
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निर्दिष्टा कालसम्प्राप्तिर्व्याधीनां व्याधिसङ्ग्रहे| <br />
चयप्रकोपप्रशमाः पित्तादीनां यथा पुरा||११०|| <br />
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nirdiṣṭā kālasamprāptirvyādhīnāṁ vyādhisaṅgrahē| <br />
cayaprakōpapraśamāḥ pittādīnāṁ yathā purā||110|| <br />
<br />
nirdiShTA kAlasamprAptirvyAdhInAM vyAdhisa~ggrahe| <br />
cayaprakopaprashamAH pittAdInAM yathA purA||110|| <br />
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मिथ्यातिहीनलिङ्गाश्च वर्षान्ता रोगहेतवः| <br />
जीर्णभुक्तप्रजीर्णान्नकालाकालस्थितिश्च [१] या||१११|| <br />
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mithyātihīnaliṅgāśca varṣāntā rōgahētavaḥ| <br />
jīrṇabhuktaprajīrṇānnakālākālasthitiśca [1] yā||111|| <br />
<br />
mithyAtihInali~ggAshca varShAntA rogahetavaH| <br />
jIrNabhuktaprajIrNAnnakAlAkAlasthitishca [1] yA||111|| <br />
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पूर्वमध्यापराह्णाश्च रात्र्या यामास्त्रयश्च ये| <br />
एषु कालेषु नियता ये रोगास्ते च कालजाः||११२|| <br />
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pūrvamadhyāparāhṇāśca rātryā yāmāstrayaśca yē| <br />
ēṣu kālēṣu niyatā yē rōgāstē ca kālajāḥ||112|| <br />
<br />
pUrvamadhyAparAhNAshca rAtryA yAmAstrayashca ye| <br />
eShu kAleShu niyatA ye rogAste ca kAlajAH||112|| <br />
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<div style="text-align:justify;"><br />
Ailments due to the advent of the season are already described in Sutra 17:114. It has been explained there, how ''[[pitta]]'' and other ''[[dosha]]s'' get accumulated, aggravated and alleviated (depending on seasonal variation).<br />
<br />
This category includes causative factors of diseases marked by wrong manifestation, over manifestation and under manifestation of their symptoms during seasons ending with the rains; during various stages of digestion viz. time of final digestion, time of intake of food and time of initial digestion; during different times of the day, viz. forenoon, mid-day and afternoon and during different hours of the night, viz. pre-midnight, midnight and post mid night. Diseases which as a rule manifest themselves during these times are also known as ''kalaja'' diseases. [110-112]<br />
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अन्येद्युष्को द्व्यहग्राही तृतीयकचतुर्थकौ| <br />
स्वे स्वे काले प्रवर्तन्ते काले ह्येषां बलागमः||११३|| <br />
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anyēdyuṣkō dvyahagrāhī tr̥tīyakacaturthakau| <br />
svē svē kālē pravartantē kālē hyēṣāṁ balāgamaḥ||113|| <br />
<br />
anyedyuShko dvyahagrAhI tRutIyakacaturthakau| <br />
sve sve kAle pravartante kAle hyeShAM balAgamaH||113|| <br />
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<br />
<div style="text-align:justify;"><br />
Diseases like ''anyedyushka'' (quotidian fever which occurs at a fixed time every day), ''dvyahagrahi'' (reverse quotidian fever), ''tritiyaka'' (tertian fever which occurs at an interval of one day) and ''chaturthaka'' (quartan fever which occurs at an interval of two days) manifest themselves at fixed hours in as much as they get strength only at such hours. [113]<br />
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एते चान्ये [६] च ये केचित् कालजा विविधा गदाः| <br />
अनागते चिकित्स्यास्ते बलकालौ विजानता||११४|| <br />
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ētē cānyē [6] ca yē kēcit kālajā vividhā gadāḥ| <br />
anāgatē cikitsyāstē balakālau vijānatā||114|| <br />
<br />
ete cAnye [6] ca ye kecit kAlajA vividhA gadAH| <br />
anAgate cikitsyAste balakAlau vijAnatA||114|| <br />
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<br />
A physician acquainted with the knowledge of ''[[dosha]] bala'' and ''[[kala]] bala'' should treat this and other similar diseases prior to their actual manifestations. [114]<br />
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कालस्य परिणामेन जरामृत्युनिमित्तजाः| <br />
रोगाः स्वाभाविका दृष्टाः स्वभावो निष्प्रतिक्रियः||११५|| <br />
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kālasya pariṇāmēna jarāmr̥tyunimittajāḥ| <br />
rōgāḥ svābhāvikā dr̥ṣṭāḥ svabhāvō niṣpratikriyaḥ||115|| <br />
<br />
kAlasya pariNAmena jarAmRutyunimittajAH| <br />
rogAH svAbhAvikA dRuShTAH svabhAvo niShpratikriyaH||115|| <br />
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<br />
The diseases arising out of temporal factors that bring about old age and death are to be considered as natural ones, which affect everyone, and these such natural manifestations are irremediable. [115]<br />
<br />
=== ''Daiva'' (fate/destiny) ===<br />
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निर्दिष्टं दैवशब्देन कर्म यत् पौर्वदेहिकम्| <br />
हेतुस्तदपि कालेन रोगाणामुपलभ्यते||११६|| <br />
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nirdiṣṭaṁ daivaśabdēna karma yat paurvadēhikam| <br />
hētustadapi kālēna rōgāṇāmupalabhyatē||116|| <br />
<br />
nirdiShTaM daivashabdena karma yat paurvadehikam| <br />
hetustadapi kAlena rogANAmupalabhyate||116|| <br />
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<br />
<div style="text-align:justify;"><br />
The deeds performed in the previous life or past time are known as ''daiva'' (fate) also constitutes in due course causative factors for the manifestation of diseases. [116] In other words it could be also said that some causes do not produce disease at the same time because they have less strength (''karmaja roga'').<br />
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न हि कर्म महत् किञ्चित् फलं यस्य न भुज्यते| <br />
क्रियाघ्नाः कर्मजा रोगाः प्रशमं यान्ति तत्क्षयात्||११७|| <br />
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na hi karma mahat kiñcit phalaṁ yasya na bhujyatē| <br />
kriyāghnāḥ karmajā rōgāḥ praśamaṁ yānti tatkṣayāt||117|| <br />
<br />
na hi karma mahat ki~jcit phalaM yasya na bhujyate| <br />
kriyAghnAH karmajA rogAH prashamaM yAnti tatkShayAt||117|| <br />
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<div style="text-align:justify;"><br />
There is no such major action/deed (performed in the previous life/past time) which does not lead to the corresponding results. Diseases arising out of such actions/deeds are not amenable to any therapeutic measures. They are cured only after the effects of past actions/deeds are exhausted i.e. fully enjoyed. [117]<br />
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=== ''Asatmya indriyartha samyoga'' (improper use of senses) ===<br />
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अत्युग्रशब्दश्रवणाच्छ्रवणात् सर्वशो न च| <br />
शब्दानां चातिहीनानां भवन्ति श्रवणाज्जडाः||११८|| <br />
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atyugraśabdaśravaṇācchravaṇāt sarvaśō na ca| <br />
śabdānāṁ cātihīnānāṁ bhavanti śravaṇājjaḍāḥ||118|| <br />
<br />
atyugrashabdashravaNAcchravaNAt sarvasho na ca| <br />
shabdAnAM cAtihInAnAM bhavanti shravaNAjjaDAH||118|| <br />
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परुषोद्भीषणाशस्ताप्रियव्यसनसूचकैः| <br />
शब्दैः श्रवणसंयोगो मिथ्यासंयोग उच्यते||११९|| <br />
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paruṣōdbhīṣaṇāśastāpriyavyasanasūcakaiḥ| <br />
śabdaiḥ śravaṇasaṁyōgō mithyāsaṁyōga ucyatē||119|| <br />
<br />
paruShodbhIShaNAshastApriyavyasanasUcakaiH| <br />
shabdaiH shravaNasaMyogo mithyAsaMyoga ucyate||119|| <br />
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असंस्पर्शोऽतिसंस्पर्शो हीनसंस्पर्श एव च| <br />
स्पृश्यानां सङ्ग्रहेणोक्तः स्पर्शनेन्द्रियबाधकः||१२०|| <br />
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asaṁsparśō'tisaṁsparśō hīnasaṁsparśa ēva ca| <br />
spr̥śyānāṁ saṅgrahēṇōktaḥ sparśanēndriyabādhakaḥ||120|| <br />
<br />
asaMsparsho~atisaMsparsho hInasaMsparsha eva ca| <br />
spRushyAnAM sa~ggraheNoktaH sparshanendriyabAdhakaH||120||<br />
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यो भूतविषवातानामकालेनागतश्च यः| <br />
स्नेहशीतोष्णसंस्पर्शो मिथ्यायोग स उच्यते||१२१|| <br />
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yō bhūtaviṣavātānāmakālēnāgataśca yaḥ| <br />
snēhaśītōṣṇasaṁsparśō mithyāyōga sa ucyatē||121|| <br />
<br />
yo bhUtaviShavAtAnAmakAlenAgatashca yaH| <br />
snehashItoShNasaMsparsho mithyAyoga sa ucyate||121|| <br />
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रूपाणां भास्वतां दृष्टिर्विनश्यत्यतिदर्शनात्| <br />
दर्शनाच्चातिसूक्ष्माणां सर्वशश्चाप्यदर्शनात्||१२२|| <br />
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rūpāṇāṁ bhāsvatāṁ dr̥ṣṭirvinaśyatyatidarśanāt| <br />
darśanāccātisūkṣmāṇāṁ sarvaśaścāpyadarśanāt||122|| <br />
<br />
rUpANAM bhAsvatAM dRuShTirvinashyatyatidarshanAt| <br />
darshanAccAtisUkShmANAM sarvashashcApyadarshanAt||122|| <br />
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द्विष्टभैरवबीभत्सदूरातिश्लिष्टदर्शनात् [१] | <br />
तामसानां च रूपाणां मिथ्यासंयोग उच्यते||१२३|| <br />
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dviṣṭabhairavabībhatsadūrātiśliṣṭadarśanāt [1] | <br />
tāmasānāṁ ca rūpāṇāṁ mithyāsaṁyōga ucyatē||123|| <br />
<br />
dviShTabhairavabIbhatsadUrAtishliShTadarshanAt [1] | <br />
tAmasAnAM ca rUpANAM mithyAsaMyoga ucyate||123|| <br />
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अत्यादानमनादानमोकसात्म्यादिभिश्च यत्| <br />
रसानां विषमादानमल्पादानं च दूषणम्||१२४|| <br />
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atyādānamanādānamōkasātmyādibhiśca yat| <br />
rasānāṁ viṣamādānamalpādānaṁ ca dūṣaṇam||124|| <br />
<br />
atyAdAnamanAdAnamokasAtmyAdibhishca yat| <br />
rasAnAM viShamAdAnamalpAdAnaM ca dUShaNam||124|| <br />
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अतिमृद्वतितीक्ष्णानां गन्धानामुपसेवनम्| <br />
असेवनं सर्वशश्च घ्राणेन्द्रियविनाशनम्||१२५|| <br />
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atimr̥dvatitīkṣṇānāṁ gandhānāmupasēvanam| <br />
asēvanaṁ sarvaśaśca ghrāṇēndriyavināśanam||125|| <br />
<br />
atimRudvatitIkShNAnAM gandhAnAmupasevanam| <br />
asevanaM sarvashashca ghrANendriyavinAshanam||125|| <br />
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पूतिभूतविषद्विष्टा गन्धा ये चाप्यनार्तवाः| <br />
तैर्गन्धैर्घ्राणसंयोगो मिथ्यायोगः स उच्यते||१२६|| <br />
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pūtibhūtaviṣadviṣṭā gandhā yē cāpyanārtavāḥ| <br />
tairgandhairghrāṇasaṁyōgō mithyāyōgaḥ sa ucyatē||126|| <br />
<br />
pUtibhUtaviShadviShTA gandhA ye cApyanArtavAH| <br />
tairgandhairghrANasaMyogo mithyAyogaH sa ucyate||126|| <br />
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इत्यसात्म्यार्थसंयोगस्त्रिविधो दोषकोपनः|<br />
असात्म्यमिति तद्विद्याद्यन्न याति सहात्मताम्||१२७|| <br />
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ityasātmyārthasaṁyōgastrividhō dōṣakōpanaḥ|<br />
asātmyamiti tadvidyādyanna yāti sahātmatām||127|| <br />
<br />
ityasAtmyArthasaMyogastrividho doShakopanaH|<br />
asAtmyamiti tadvidyAdyanna yAti sahAtmatAm||127||<br />
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<br />
<div style="text-align:justify;"><br />
The auditory sense faculty is impaired by the hearing of excessively loud or low sound (even by not hearing excessively loud sound) or by the absolute non – utilization of this sense faculty. Auditory contact with sounds indicating roughness, terror, inauspiciousness, distate and misery constitute the wrong utilization of the auditory sense organ.<br />
<br />
The tactual sense is impaired, briefly speaking by the nonutilization, excessive utilization, and inadequate utilization of the touchable (including massage, unction etc).<br />
<br />
Untimely contact with poisonous germs, poisonous wind; unctuous, cold and hot substances constitute wrong utilization of tactual sensation.<br />
Vision gets impaired by the excessive contact with dazzling objects or by contact with extremely subtle elements or by absolute nonutilization of visual faculty.<br />
<br />
Visual contact with undesirable, terrific, despicable objects and objects placed at a distance or in close proximity constitutes the wrong utilization of visual faculty. Vision is also impaired by the contact of the visual faculty with faint objects. <br />
Excessive intake, absence of intake, intake in utter disregard to the wholesomeness of addiction and inadequate intake of ''rasas'' (tastes) vitiate the gustatory faculty. <br />
<br />
Olfactory faculty also gets impaired by the enjoyment of smells too mild and too sharp or by absolute nonutilization of this faculty. <br />
Inhalation of the smell of putrified objects, germs and poisonous as well as unseasonal smells constitutes wrong utilization of olfactory faculty. <br />
<br />
These are the three types of unwholesome contact of sense with their respective objects which aggravate the ''[[dosha]]s''. A thing which is not conducive to the body is regarded as asatmya or unwholesome and which becomes responsible to provoke all the ''[[dosha]]s''. [118-127]<br />
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मिथ्यातिहीनयोगेभ्यो यो व्याधिरुपजायते| <br />
शब्दादीनां स विज्ञेयो व्याधिरैन्द्रियको बुधैः||१२८|| <br />
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mithyātihīnayōgēbhyō yō vyādhirupajāyatē| <br />
śabdādīnāṁ sa vijñēyō vyādhiraindriyakō budhaiḥ||128|| <br />
<br />
<br />
mithyAtihInayogebhyo yo vyAdhirupajAyate| <br />
shabdAdInAM sa vij~jeyo vyAdhiraindriyako budhaiH||128|| <br />
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<br />
When a disease is caused by wrong utilization, excessive, utilization and inadequate utilization (non – utilization) of sense faculties, viz. auditory etc, it is known as ''Aindriyaka''(sensorial diseases) i.e. a disease caused by the impairment of senses. [128]<br />
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वेदनानामशान्तानामित्येते [३] हेतवः स्मृताः| <br />
सुखहेतुः समस्त्वेकः समयोगः सुदुर्लभः||१२९|| <br />
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vēdanānāmaśāntānāmityētē [3] hētavaḥ smr̥tāḥ| <br />
sukhahētuḥ samastvēkaḥ samayōgaḥ sudurlabhaḥ||129|| <br />
<br />
vedanAnAmashAntAnAmityete [3] hetavaH smRutAH| <br />
sukhahetuH samastvekaH samayogaH sudurlabhaH||129|| <br />
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<br />
<div style="text-align:justify;"><br />
These are the causative factors of the diseases which do not subside easily. But for a blissful life or a life without misery i.e. ''samayoga'' i.e. very much proper contact of the sensory organ with their objects is needed though it is very difficult to keep in practice. These are the factors responsible for miseries. Equitable utilization (of time, intellect and objects of sense faculties) brings about happiness. This equitable utilization is difficult to attain. [129]<br />
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=== Causes of happiness and miseries ===<br />
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नेन्द्रियाणि न चैवार्थाः सुखदुःखस्य हेतवः| <br />
हेतुस्तु सुखदुःखस्य योगो दृष्टश्चतुर्विधः||१३०|| <br />
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nēndriyāṇi na caivārthāḥ sukhaduḥkhasya hētavaḥ| <br />
hētustu sukhaduḥkhasya yōgō dr̥ṣṭaścaturvidhaḥ||130|| <br />
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nendriyANi na caivArthAH sukhaduHkhasya hetavaH| <br />
hetustu sukhaduHkhasya yogo dRuShTashcaturvidhaH||130|| <br />
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सन्तीन्द्रियाणि सन्त्यर्था योगो न [१] च न चास्ति रुक्| <br />
न सुखं, कारणं तस्माद्योग एव चतुर्वधः||१३१|| <br />
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santīndriyāṇi santyarthā yōgō na [1] ca na cāsti ruk| <br />
na sukhaṁ, kāraṇaṁ tasmādyōga ēva caturvadhaḥ||131|| <br />
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santIndriyANi santyarthA yogo na [1] ca na cAsti ruk| <br />
na sukhaM, kAraNaM tasmAdyoga eva caturvadhaH||131|| <br />
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Neither the sense organs nor their objects alone can bring about happiness or miseries. The latter are in fact caused by the fourfold contacts mentioned above (viz., proper utilization, wrong utilization, excessive utilization and non-utilization). Even if there are sense organs and their objects present, there would be no disease, nor any happiness unless the fourfold combination is involved. So, this contact itself constitutes a causative factor for happiness and miseries. [130-131]<br />
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नात्मेन्द्रियं मनो बुद्धिं गोचरं [१] कर्म वा विना| <br />
सुखदुःखं, यथा यच्च बोद्धव्यं तत्तथोच्यते||१३२|| <br />
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nātmēndriyaṁ manō buddhiṁ gōcaraṁ [1] karma vā vinā| <br />
sukhaduḥkhaṁ, yathā yacca bōddhavyaṁ tattathōcyatē||132|| <br />
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nAtmendriyaM mano buddhiM gocaraM [1] karma vA vinA| <br />
sukhaduHkhaM, yathA yacca boddhavyaM tattathocyate||132|| <br />
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As a matter of fact, no happiness or misery can be caused without the soul, the sense organs, mind, intellect, objects of sense organs and results of past action/deeds. But in the context of the science of medicine, it is only the fourfold contact which is relevant as a causative factor of happiness and miseries, that is to say the wholesome contact is required to be adhered to and the unwholesome one to be given up for the maintenance of good health. [132]<br />
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स्पर्शनेन्द्रियसंस्पर्शः स्पर्शो मानस एव च| <br />
द्विविधः सुखदुःखानां वेदनानां प्रवर्तकः||१३३|| <br />
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sparśanēndriyasaṁsparśaḥ sparśō mānasa ēva ca| <br />
dvividhaḥ sukhaduḥkhānāṁ vēdanānāṁ pravartakaḥ||133|| <br />
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sparshanendriyasaMsparshaH sparsho mAnasa eva ca| <br />
dvividhaH sukhaduHkhAnAM vedanAnAM pravartakaH||133|| <br />
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Tactual contact and mental contact are two types of contacts which bring about happiness and miseries. [133]<br />
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इच्छाद्वेषात्मिका तृष्णा सुखदुःखात् प्रवर्तते| <br />
तृष्णा च सुखदुःखानां कारणं पुनरुच्यते||१३४|| <br />
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icchādvēṣātmikā tr̥ṣṇā sukhaduḥkhāt pravartatē| <br />
tr̥ṣṇā ca sukhaduḥkhānāṁ kāraṇaṁ punarucyatē||134|| <br />
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icchAdveShAtmikA tRuShNA sukhaduHkhAt pravartate| <br />
tRuShNA ca sukhaduHkhAnAM kAraNaM punarucyate||134|| <br />
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उपादत्ते हि सा भावान् वेदनाश्रयसञ्ज्ञकान्| <br />
स्पृश्यते नानुपादाने नास्पृष्टो वेत्ति वेदनाः||१३५|| <br />
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upādattē hi sā bhāvān vēdanāśrayasañjñakān| <br />
spr̥śyatē nānupādānē nāspr̥ṣṭō vētti vēdanāḥ||135|| <br />
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upAdatte hi sA bhAvAn vedanAshrayasa~jj~jakAn| <br />
spRushyate nAnupAdAne nAspRuShTo vetti vedanAH||135|| <br />
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Happiness and miseries bring about desire in the form of likes and dislikes respectively. Then again this desire is responsible cause for happiness and miseries. It is desire which gathers several factors, which serve as substrata for happiness and misery. Unless such factors are gathered, there will be no contact whatsoever and there can be no happiness or miseries without such contacts (Cause for such type of contact is again [[purusha]]).[134-135]<br />
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वेदनानामधिष्ठानं मनो देहश्च सेन्द्रियः| <br />
केशलोमनखाग्रान्नमलद्रवगुणैर्विना||१३६|| <br />
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vēdanānāmadhiṣṭhānaṁ manō dēhaśca sēndriyaḥ| <br />
kēśalōmanakhāgrānnamaladravaguṇairvinā||136|| <br />
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vedanAnAmadhiShThAnaM mano dehashca sendriyaH| <br />
keshalomanakhAgrAnnamaladravaguNairvinA||136|| <br />
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The mind and the body together with the sense organs exclusive of ''kesha'' (hair), ''loma'' (body hair), tip of the nail, ingested food, excreta, excretory fluids and objects of senses are the sites of manifestation of happiness and miseries. [136]<br />
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=== Importance of ''Yoga'' (union with self) ===<br />
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योगे मोक्षे च सर्वासां वेदनानामवर्तनम्| <br />
मोक्षे निवृत्तिर्निःशेषा योगो मोक्षप्रवर्तकः||१३७|| <br />
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yōgē mōkṣē ca sarvāsāṁ vēdanānāmavartanam| <br />
mōkṣē nivr̥ttirniḥśēṣā yōgō mōkṣapravartakaḥ||137|| <br />
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yoge mokShe ca sarvAsAM vedanAnAmavartanam| <br />
mokShe nivRuttirniHsheShA yogo mokShapravartakaH||137|| <br />
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Recurrence of all sensation is checked through ''yoga'' and ''moksha''. The absolute eradication of sensation is attained through ''moksha''. The ''yoga'' is a means to attain ''moksha''. [137]<br />
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आत्मेन्द्रियमनोर्थानां सन्निकर्षात् प्रवर्तते| <br />
सुखदुःखमनारम्भादात्मस्थे मनसि स्थिरे||१३८|| <br />
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ātmēndriyamanōrthānāṁ sannikarṣāt pravartatē| <br />
sukhaduḥkhamanārambhādātmasthē manasi sthirē||138|| <br />
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AtmendriyamanorthAnAM sannikarShAt pravartate| <br />
sukhaduHkhamanArambhAdAtmasthe manasi sthire||138|| <br />
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निवर्तते तदुभयं वशित्वं चोपजायते| <br />
सशरीरस्य योगज्ञास्तं योगमृषयो विदुः||१३९|| <br />
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nivartatē tadubhayaṁ vaśitvaṁ cōpajāyatē| <br />
saśarīrasya yōgajñāstaṁ yōgamr̥ṣayō viduḥ||139|| <br />
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nivartate tadubhayaM vashitvaM copajAyate| <br />
sasharIrasya yogaj~jAstaM yogamRuShayo viduH||139|| <br />
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Happiness and miseries are felt due to the contact of the soul with the sense organs, mind and the objects of senses. Both these types of sensations disappear when the mind is concentrated and contained in the soul and the super natural powers in the mind and body are attained. This state is known as ''yoga'' according to sages well versed in this science. [138-139]<br />
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आवेशश्चेतसो ज्ञानमर्थानां छन्दतः क्रिया| <br />
दृष्टिः श्रोत्रं स्मृतिः कान्तिरिष्टतश्चाप्यदर्शनम्||१४०|| <br />
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āvēśaścētasō jñānamarthānāṁ chandataḥ kriyā| <br />
dr̥ṣṭiḥ śrōtraṁ smr̥tiḥ kāntiriṣṭataścāpyadarśanam||140|| <br />
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Aveshashcetaso j~jAnamarthAnAM chandataH kriyA| <br />
dRuShTiH shrotraM smRutiH kAntiriShTatashcApyadarshanam||140|| <br />
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इत्यष्टविधमाख्यातं योगिनां बलमैश्वरम्| <br />
शुद्धसत्त्वसमाधानात्तत् सर्वमुपजायते||१४१|| <br />
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ityaṣṭavidhamākhyātaṁ yōgināṁ balamaiśvaram| <br />
śuddhasattvasamādhānāttat sarvamupajāyatē||141|| <br />
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ityaShTavidhamAkhyAtaM yoginAM balamaishvaram| <br />
shuddhasattvasamAdhAnAttat sarvamupajAyate||141|| <br />
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(1) Entering others body, (2) thought reading (3) doing things at will, (4) Super natural vision (5) super natural audition (6) miraculous memory (7) uncommon brilliance and (8) invisibility when so desired – these are the eight supernatural powers attained by those who practice ''yoga''. All this is achieved through the purity of the mind. (free from ''[[rajas]]'' and ''[[tamas]]'') [140-141]<br />
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=== ''Moksha'' (salvation) and means for its attainment===<br />
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मोक्षो रजस्तमोऽभावात् बलवत्कर्मसङ्क्षयात्| <br />
वियोगः सर्वसंयोगैरपुनर्भव उच्यते||१४२|| <br />
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mōkṣō rajastamō'bhāvāt balavatkarmasaṅkṣayāt| <br />
viyōgaḥ sarvasaṁyōgairapunarbhava ucyatē||142|| <br />
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mokSho rajastamo~abhAvAt balavatkarmasa~gkShayAt| <br />
viyogaH sarvasaMyogairapunarbhava ucyate||142|| <br />
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This is the stage of salvation in which there is detachment of ''sharira, [[manas]], [[indriya]]'' and ''[[Aatma]]''.<br />
''Moksha'' or salvation is nothing but an absolute detachment of all contacts by virtue of absence of ''[[rajas]]'' and ''[[tamas]]'' in the mind and annihilation of effects of potent past actions/deeds. This is a state after which there is no more physical or mental contacts. Further there is no process of rebirth.[142]<br />
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सतामुपासनं सम्यगसतां परिवर्जनम्| <br />
व्रतचर्योपवासौ च नियमाश्च पृथग्विधाः||१४३|| <br />
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satāmupāsanaṁ samyagasatāṁ parivarjanam| <br />
vratacaryōpavāsau ca niyamāśca pr̥thagvidhāḥ||143|| <br />
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satAmupAsanaM samyagasatAM parivarjanam| <br />
vratacaryopavAsau ca niyamAshca pRuthagvidhAH||143|| <br />
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धारणं धर्मशास्त्राणां विज्ञानं विजने रतिः| <br />
विषयेष्वरतिर्मोक्षे व्यवसायः परा धृतिः||१४४|| <br />
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dhāraṇaṁ dharmaśāstrāṇāṁ vijñānaṁ vijanē ratiḥ| <br />
viṣayēṣvaratirmōkṣē vyavasāyaḥ parā dhr̥tiḥ||144|| <br />
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dhAraNaM dharmashAstrANAM vij~jAnaM vijane ratiH| <br />
viShayeShvaratirmokShe vyavasAyaH parA dhRutiH||144|| <br />
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कर्मणामसमारम्भः कृतानां च परिक्षयः| <br />
नैष्क्रम्यमनहङ्कारः [१] संयोगे भयदर्शनम्||१४५|| <br />
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karmaṇāmasamārambhaḥ kr̥tānāṁ ca parikṣayaḥ| <br />
naiṣkramyamanahaṅkāraḥ [1] saṁyōgē bhayadarśanam||145|| <br />
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karmaNAmasamArambhaH kRutAnAM ca parikShayaH| <br />
naiShkramyamanaha~gkAraH [1] saMyoge bhayadarshanam||145|| <br />
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मनोबुद्धिसमाधानमर्थतत्त्वपरीक्षणम्| <br />
तत्त्वस्मृतेरुपस्थानात् सर्वमेतत् प्रवर्तते||१४६|| <br />
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manōbuddhisamādhānamarthatattvaparīkṣaṇam| <br />
tattvasmr̥tērupasthānāt sarvamētat pravartatē||146|| <br />
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manobuddhisamAdhAnamarthatattvaparIkShaNam| <br />
tattvasmRuterupasthAnAt sarvametat pravartate||146|| <br />
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The following serve as means to the attainment of ''moksha''. <br />
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# Due devotion to noble person;<br />
# Shunning of the company of the wicked;<br />
# Observing sacred vows and fast;<br />
# Pursuit of the rules of good conduct;<br />
# Compliance with scriptural prescriptions;<br />
# Scriptural knowledge;<br />
# Liking for lonely living;<br />
# Detachment from the objects of senses;<br />
# Striving for ''moksha'' (salvation);<br />
# Absolute mental control;<br />
# Abstinence from performing the acts(leading to any effect);<br />
# Annihilation of the effects of past actions/deeds;<br />
# Desire to get away from the worldly trap;<br />
# Absence of egoistic disposition;<br />
# Being afraid of contacts of the soul, the mind and the body;<br />
# Concentration of the mind and intellect in the soul; and<br />
# Review of spiritual facts. <br />
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All this can be attained by virtue of the constant remembering of the fact that the soul is different from the body, mind and senses and the latter has nothing to do with the former. [143-146]<br />
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=== [[Smriti]] (memory) ===<br />
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स्मृतिः सत्सेवनाद्यैश्च धृत्यन्तैरुपजायते| <br />
स्मृत्वा स्वभावं भावानां स्मरन् दुःखात् प्रमुच्यते||१४७|| <br />
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smr̥tiḥ satsēvanādyaiśca dhr̥tyantairupajāyatē| <br />
smr̥tvā svabhāvaṁ bhāvānāṁ smaran duḥkhāt pramucyatē||147||<br />
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smRutiH satsevanAdyaishca dhRutyantairupajAyate| <br />
smRutvA svabhAvaM bhAvAnAM smaran duHkhAt pramucyate||147|| <br />
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वक्ष्यन्ते कारणान्यष्टौ स्मृतिर्यैरुपजायते| <br />
निमित्तरूपग्रहणात् सादृश्यात् सविपर्ययात्||१४८|| <br />
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vakṣyantē kāraṇānyaṣṭau smr̥tiryairupajāyatē| <br />
nimittarūpagrahaṇāt sādr̥śyāt saviparyayāt||148|| <br />
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vakShyante kAraNAnyaShTau smRutiryairupajAyate| <br />
nimittarUpagrahaNAt sAdRushyAt saviparyayAt||148|| <br />
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सत्त्वानुबन्धादभ्यासाज्ज्ञानयोगात् पुनः श्रुतात्| <br />
दृष्टश्रुतानुभूतानां स्मारणात् स्मृतिरुच्यते||१४९|| <br />
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sattvānubandhādabhyāsājjñānayōgāt punaḥ śrutāt| <br />
dr̥ṣṭaśrutānubhūtānāṁ smāraṇāt smr̥tirucyatē||149|| <br />
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sattvAnubandhAdabhyAsAjj~jAnayogAt punaH shrutAt| <br />
dRuShTashrutAnubhUtAnAM smAraNAt smRutirucyate||149|| <br />
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A memory is nothing but the remembrance of things directly perceived, heard (from scriptures) or experienced earlier. The regimen prescribed in verses above, beginning with devotion to the noble persons and ending with absolute mental control (items 1-10) serve as an aid to good memory. If one only remembers the real nature of thing he gets rid of miseries. <br />
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The following are the eight factors that bring about a good memory:<br />
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# Knowledge of cause (of a thing and event etc.);<br />
# Knowledge of form (e.g. after seeing ''gavaya'' in the forest one remembers a cow having a similar form);<br />
# Knowledge of similarity (e.g. on seeing a son one remembers his father having similar form);<br />
# Knowledge of contrast (e.g. having seen an ugly form one remembers a beautiful form);<br />
# Concentration of mind;<br />
# Practice;<br />
# Attainment of metaphysical knowledge; and <br />
# Subsequent repeated visualization and hearing (of a thing or an event). [147-149]<br />
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एतत्तदेकमयनं मुक्तैर्मोक्षस्य दर्शितम्| <br />
तत्त्वस्मृतिबलं, येन गता न पुनरागताः||१५०|| <br />
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ētattadēkamayanaṁ muktairmōkṣasya darśitam| <br />
tattvasmr̥tibalaṁ, yēna gatā na punarāgatāḥ||150|| <br />
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etattadekamayanaM muktairmokShasya darshitam| <br />
tattvasmRutibalaM, yena gatA na punarAgatAH||150|| <br />
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अयनं पुनराख्यातमेतद्योगस्य योगिभिः| <br />
सङ्ख्यातधर्मैः साङ्ख्यैश्च मुक्तैर्मोक्षस्य चायनम्||१५१|| <br />
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ayanaṁ punarākhyātamētadyōgasya yōgibhiḥ| <br />
saṅkhyātadharmaiḥ sāṅkhyaiśca muktairmōkṣasya cāyanam||151|<br />
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ayanaM punarAkhyAtametadyogasya yogibhiH| <br />
sa~gkhyAtadharmaiH sA~gkhyaishca muktairmokShasya cAyanam||151|| <br />
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The power of metaphysical memory constitutes the best way of liberation, as shown by the liberated ones. Persons following this way do not get rebirth after death. This is again the best way to the attainment of ''yoga'' (communion with God) as well as ''moksha'' (salvation). This is what the ''yogins'', the virtous ones, the followers of the ''Sankhya'' system, and the liberated ones say. [150-151]<br />
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<br />
सर्वं कारणवद्दुःखमस्वं चानित्यमेव च| <br />
न चात्मकृतकं तद्धि तत्र चोत्पद्यते स्वता||१५२|| <br />
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sarvaṁ kāraṇavadduḥkhamasvaṁ cānityamēva ca| <br />
na cātmakr̥takaṁ taddhi tatra cōtpadyatē svatā||152|| <br />
<br />
sarvaM kAraNavadduHkhamasvaM cAnityameva ca| <br />
na cAtmakRutakaM taddhi tatra cotpadyate svatA||152|| <br />
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यावन्नोत्पद्यते सत्या बुद्धिर्नैतदहं यया| <br />
नैतन्ममेति विज्ञाय ज्ञः सर्वमतिवर्तते||१५३|| <br />
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yāvannōtpadyatē satyā buddhirnaitadahaṁ yayā| <br />
naitanmamēti vijñāya jñaḥ sarvamativartatē||153|| <br />
<br />
yAvannotpadyate satyA buddhirnaitadahaM yayA| <br />
naitanmameti vij~jAya j~jaH sarvamativartate||153|| <br />
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Any thing that has a cause constitutes misery; it is not one's own and ephemeral. It is not produced by the soul (''[[Aatma]]''); but one has got a feeling of its ownership until one has got a real knowledge to the effect that this is something different from him; and is not his own. As soon as one knows it, he gets rid of all miseries. [152-153]<br />
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तस्मिंश्चरमसन्न्यासे समूलाः सर्ववेदनाः| <br />
ससञ्ज्ञाज्ञानविज्ञाना [४] निवृत्तिं यान्त्यशेषतः||१५४|| <br />
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tasmiṁścaramasannyāsē samūlāḥ sarvavēdanāḥ| <br />
sasañjñājñānavijñānā [4] nivr̥ttiṁ yāntyaśēṣataḥ||154|| <br />
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tasmiMshcaramasannyAse samUlAH sarvavedanAH| <br />
sasa~jj~jAj~jAnavij~jAnA [4] nivRuttiM yAntyasheShataH||154|| <br />
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<br />
As soon as the final renunciation in respect of all subsequent actions is attained, the very consciousness together with its final causes in the form of indeterminate, determinate or scriptural knowledge is completely eradicated. [154]<br />
<br />
=== Process of knowledge of self ===<br />
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अतः परं ब्रह्मभूतो भूतात्मा नोपलभ्यते| <br />
निःसृतः सर्वभावेभ्यश्चिह्नं यस्य न विद्यते| <br />
गतिर्ब्रह्मविदां ब्रह्म तच्चाक्षरमलक्षणम्।<br />
ज्ञानं ब्रह्मविदां चात्र नाज्ञस्तज्ज्ञातुमर्हति||१५५|| <br />
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ataḥ paraṁ brahmabhūtō bhūtātmā nōpalabhyatē| <br />
niḥsr̥taḥ sarvabhāvēbhyaścihnaṁ yasya na vidyatē| <br />
jñānaṁ brahmavidāṁ cātra nājñastajjñātumarhati||155|| <br />
<br />
ataH paraM brahmabhUto bhUtAtmA nopalabhyate| <br />
niHsRutaH sarvabhAvebhyashcihnaM yasya na vidyate| <br />
j~jAnaM brahmavidAM cAtra nAj~jastajj~jAtumarhati||155|| <br />
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Thereafter, one identifies himself with supreme soul and the [[Purusha]] ceases to exist. He is easily distinguishable form all other manifestations. He does not even leave any indication (inspiration, expiration etc.) of his existence. This is what those well versed in the ''bramajnana'' say. It is impossible for an ignorant person to know this. Later on when the soul (''jivatma'') attains the state of ''Brahma'' (supreme soul), then state of ''bhutatma'' get lost and this supreme soul gets detached by all associated factors and also gets freed from all those signs and symptoms of ''jeevatma'' (verses 70-72) . This is a state of ''bragyana'' which could be achieved by few intellectual one (''brahmgyani'') not by ignorant one. [155]<br />
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<br />
===Summary===<br />
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<br />
तत्र श्लोकः- <br />
प्रश्नाः पुरुषमाश्रित्य त्रयोविंशतिरुत्तमाः| <br />
कतिधापुरुषीयेऽस्मिन्निर्णीतास्तत्त्वदर्शिना||१५६|| <br />
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tatra ślōkaḥ- <br />
praśnāḥ puruṣamāśritya trayōviṁśatiruttamāḥ| <br />
katidhāpuruṣīyē'sminnirṇītāstattvadarśinā||156|| <br />
<br />
tatra shlokaH- <br />
prashnAH puruShamAshritya trayoviMshatiruttamAH| <br />
katidhApuruShIye~asminnirNItAstattvadarshinA||156|| <br />
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<br />
To sum up :<br />
<div style="text-align:justify;"><br />
In this chapter, the various constituents of the [[Purusha]] etc., conducive to the understanding of the human physiology, 23 important questions regarding the [[Purusha]] and the supreme soul have been answered by the enlightened Seer. [156]<br />
<br />
== Tattva Vimarsha (Fundamental Principles) ==<br />
<br />
# ''[[Purusha]]'' represents the element of consciousness, i.e. the soul, different from the body. This ''[[purusha]]'' plays an important role in formulating treatments for the eradication of miseries and attainment of salvation. <br />
# The mind analyses sense objects on the basis of merits and demerits, their acceptability or otherwise, while ''ahamkara'' causes self attachment and finally ''[[buddhi]]'' takes decision whether they are acceptable or not. Charak describes senses composed of ''bhutas'' whereas ''samkhya'' mentions them as evolved from ''ahamkara''. This is the different view of [[Ayurveda]] based on its application in management. (21-24)<br />
# Mind is an important entity involved in the process of knowledge. Knowledge of objects cannot be perceived if the mind is absent in the process. Atomicity and oneness are the two properties of mind. Mind controls itself as well as the five senses. The different objects of the mind are thought, consideration, hypothesis, attention and determination. The knowledge of the objects is perceived through the five senses in connection with mind. The advantages and disadvantages of the perceived objects are ascertained thereafter. Then the intellect decides the specific properties of the objects and individual acts accordingly. The chain of perception starts from the desire that arises with the ''[[purusha]]''. The important components of this chain are [[Aatma]], mind, five senses and objects. Any abnormality in this chain leads to nonperception or false knowledge. (18-25)<br />
# ''[[Purusha]]'' is considered as the main causative factor. Occurrence of intelligence, ignorance, support, movement etc. is not possible without existence of ''[[purusha]]''. ''[[Purusha]]'' is the supporting element for truth, falsehood, food and bad actions. ''[[Purusha]]'' i.e. conscious element provides the utility value to other things. The cause of ''purusha'' can be proved by all ''pramanas''. The organs of living beings are different but the entity responsible for their action is one and the same and that is the soul. Therefore, apart from the body which is in the constant process of decay, soul is eternal and responsible for all the actions and also experiences the results of such deeds. (49-62)<br />
# The supreme soul is without a beginning, but the ''rashipurusha'', which is a combination of 24 elements, is born due to the ignorant actions/deeds originated because of auspicious and inauspicious, and is therefore ephemeral. The twenty four elements are the combination of ''ashta [[prakriti]]'' and ''shodasha vikara''. ''Ashta [[prakriti]]'' comprises of the five subtle ''[[mahabhuta]]s, [[buddhi]], avyakta,'' and ''ahamkara''. ''Shodasha vikaras'' are five sense faculties (''jnanendriya''), five motor faculties (''karmendriya''), mind and five ''[[mahabhuta]]s''. The ''[[purusha]]'' along with the instruments of knowledge i.e. '';[[manas]], [[buddhi]], jnanendriya'' and ''karmendriya'' is responsible for the manifestation of things. (63-64)<br />
# The process of evolution incorporates the chain of events that originate from [[avyakta]], [[avyakta]] produces [[buddhi]], [[buddhi]] produces [[ahamkara]], [[ahamkara]] produces the five subtle and five gross [[mahabhuta]]s, and (in the right sequence) and the bio-transformed five [[indriya]]s, constitute the [[Purusha]]. Thus, with this [[Purusha]] manifested in its entirety, the body (life) with its all constituents is said to be born (living life). Whereas during the process of dissolution the reverse changes take place. As a result of theses reverse changes the manifested one gets converted into the unmanifested one. Those who are afflicted with ''[[rajas]], [[tamas]]'' and have ego undergo the process of birth and death and rebirth. Others who are free of ''[[rajas]]'' and ''[[tamas]]'' and does not have ego are free from the cycle of birth, death and rebirth. (65-69)<br />
# The soul is the source of consciousness and along with mind is responsible for all actions. As the mind does not have consciousness in spite of its involvement in all actions it is not held responsible for the actions. All the living beings themselves are responsible for their transmigration from one species/body to another. Though the soul is free to act, it can control the mind and get rid of the results of the actions of his own. As this soul with controlled mind pervades the entire universe it is considered Omni-prescient. But its contact with the mind makes him restricted with one body only. This soul becomes the sole witness of all actions performed. (70-85)<br />
# A physician treats the diseases of past, present and future by different methods. The causative factors are responsible for the equilibrium and imbalance of ''[[dhatu]]s''. (86)<br />
# A person indulges in various activities due to his desires. He subjects himself to good and bad effects of his actions leading to miseries. The miseries can be checked if the desires are ignored. The impairment of ''dhi, dhriti, [[smriti]],'' maturity of time and actions and unwholesome contact of senses with their objects leads to miseries. The diseases originated from temporal factors (''kalaja'') leads to geriatrics and death. These diseases are called as ''swabhavika roga'' and these diseases are irremediable. The other variety of ''roga'' is ''karmaja roga'' which are results of acts of past life. These disease, do not respond to any therapeutic measures. They are cured only after the results of past action are exhausted. One more variety of the disease is a indriyaka i.e. the diseases which are originated due to improper utilization of senses. So, proper utilization of time, intellect and senses bring about happiness, but this proper utilization is difficult to attain. (95-131)<br />
# The ultimate cause of happiness and miseries is lust. All kinds of pain can be checked with the help of ''yoga'' and ''moksha''. ''Yoga'' leads to temporary loss of pain where as moksha leads to absolute eradication of all kinds of pain. As soon as the stage of ''yoga'' is disturbed, there will be recurrence of pain. ''Yoga'' is one of the means to attain ''moksha''. Both the sensations i.e. happiness and miseries disappear when mind is concentrated and contained in the soul. This stage is known as ''yoga'' and it gives eight super natural powers to the individual who has attained this stage. Absence of ''[[rajas]]'' and ''[[tamas]]'' in mind and reduction of the potent effects of past actions leads to absolute detachment i.e ''moksha''. To achieve the salvation, one has to always remember that soul and body are two different entities. Until and unless one acquires the real knowledge, i.e., ''satya buddhi'' he can not get rid of all miseries. A Person who follows all the means to achieve salvation do not return to this world and is permantly set free from all kinds of miseries. (134-146)<br />
<br />
== Vidhi Vimarsha (Applied Inferences) ==<br />
<br />
Unlike the description of human anatomy in modern medical texts given as independent isolated structure, this chapter explains the anatomy and functioning of human mind and body in relation to the universe. Such connected relationship of humans with universe is the basis of pursuing the lifestyle to have disease free, productive and long life. The chapter directs to a lifestyle with connection to the source (consciousness), control of senses and conduciveness to the seasons by practicing ''yoga''. <br />
<br />
=== Test for existence of mind and its importance in process of knowledge ===<br />
One and the most important proof of existence of mind is materialization or otherwise of direct perception. The contact of mind with soul, sense organs with their objects consequently leads to understanding and knowledge of that particular object. The presence of mind can be inferred from presence or absence of knowledge. [Cha.Sa.[[Sharira Sthana]] 1/18-19] This is also one of the sign of functioning mind. It is most applicable test because mind plays great role in the chain of perception to knowledge and memory. The things are memorized only after proper attention and perception. Otherwise all goes in vain in absent minded people.<br />
<br />
=== Attributes of mind ===<br />
<br />
The mind is ''anu'' (subtle) and ''eka'' (unitary). [Cha.Sa.[[Sharira Sthana]] 1/19] It is subtler than the subtlest and hence cannot be perceived by ordinary senses. This subtleness is the reason for limitation of modern psychiatry to define and conclude the exact structure of mind. It appears multiple in same individual due to variation in pertaining to perception of its own objects (''svartha''), motivation and perception of objects of senses (''indriyartha'') and its deposition. Similarly it takes various forms due to its contact with qualities like intelligence (''sattva''), arrogance (''[[rajas]]'') and Ignorance (''[[tamas]]''). But it is only one because it can motivate only one sense organ resulting in activation of only one organ at a time. Mind is not multiple because it cannot motivate and establish contact with all sense organs simultaneously. [Cha.Sa.[[Sutra Sthana]] 8/5] This quality again denotes the application of power of mind concentration to perceive things. <br />
<br />
The other attribute of mind is its ''Chanchalatva'' (fickleness). It is one of the major obstacles in concentration and meditation.<br />
<br />
=== Functions of mind (''karmani'') ===<br />
<br />
Four important functions of mind (Cha.Sha.1/21)are described as:<br />
<br />
# Control of Sense faculties (''Indriyabhigraha'')<br />
# Self restraint (''Svasya Nigraha'')<br />
# Speculation (''Uha'')<br />
# Consideration and Thinking (''Vichara'')<br />
## Control of Sense faculties (''Indriyabhigraha''):Mind is considered as the master motivator and controller of all sense organs. The sensations can be perceived only in active presence of mind. Thus mind is the driving force for perception of external world through cognitive senses.<br />
## Self restraint (''Svasya nigraha''): None other can control activities of mind except mind itself. Thus mind is regulator and coordinator of its own activities. This function of self restraint has been implied widely in psychiatric treatments also. The ''Satvavajaya'' (victory over mind) [Cha.Sa.[[Sutra Sthana]] 11/54] i.e. restraining mind from harmful objects is traditional form of psychotherapy which includes training of mind to avoid dangerous things. In practicing meditation also one has to have better control over activities of mind.<br />
## Speculation (''Uha''): Guessing on the logical interpretations is speculation This is peculiar function of mind on the basis of which science stands, grows, new discoveries are made, and innovations are materialized. Speculation is applied in logical way to make a conjuncture about the possible outcome in a given situation.<br />
## Consideration and Thinking (''Vichara''):This is another important function of mind applied almost in every decision made. This is the thinking power of mind to differentiate the things between right and wrong, correct or incorrect, useful or harmful etc. This power makes the man different from other animals.<br />
<br />
=== Objects of Mind ===<br />
<br />
In addition to functions, the objects of mind are also described [Cha.Sa.[[Sharira Sthana 1/20] viz. ''Chintya'' (cogitation), ''Vicharya'' (consideration of discrimination), ''Uhya'' (speculation and logical reasoning), ''Dhyeya'' (aiming), ''Sankalpya'' (conviction and determination). <br />
<br />
[[Charak Samhita]] has described three reasons for occurrence of disease:<br />
<br />
# Mistake of the intellect (''[[prajnaparadha]]'') by losing connection to the source (consciousness).<br />
# Losing control of special senses.<br />
# Not acting conducive to seasons and place. <br />
<br />
==== ''[[Prajnaparadha]]'' (intellectual errors) ====<br />
<br />
The description of ''[[prajnaparadha]]'' seems to work for cause as well as effect in the patho-physiology of stress. ''[[Prajnaparadha]]'' has been defined as the composite consequence of ''dhi, dhriti'' and ''[[smriti]] vibramsha''. [Cha.Sa.[[Sharira Sthana]] 1/98-101] This means it can affect the conscience, self-control and memory functioning of intellect. It is the root cause of all mental disorders such as passion, anger, fear, confusion, grief [Cha.Sa.[[Sutra Sthana]] 7/52] as well as the ''karmaja'' and ''atmaja vyadhi''. [Cha.Sa.[[Nidana Sthana]] 7/21] <br />
<br />
The improper actions caused by this intellectual error leads to vitiation of physical and mental ''[[dosha]]'' as follows:<br />
<br />
# Forceful stimulation of natural urges and suppression of the manifested ones. This is applicable for both the physical ''sharira adharaniya'' ''vega'' and ''manas dharaniya vega'' (natural urges).<br />
# Excess adventure beyond one’s capacity<br />
# Excess indulgence in sexual act<br />
# Negligence to seek treatment in time<br />
# Initiation of action at improper time and improper acts<br />
# Decrease in modesty and good conduct<br />
# Disrespect to respectable persons <br />
# Indulgence in harmful sensory activities <br />
# Intake of harmful substances and addicting to the factors which can cause elation or even ''unmada''(insanity)<br />
# Traveling at improper place in improper time<br />
# Association with evil actions and persons involved in it<br />
# Not following the daily, seasonal diet and lifestyle regimen described in the classics<br />
#Indulgence in negative activities originated by envy, ego, fear, anger, intoxication, confusion.<br />
<br />
==== Disturbance of intellectual functioning by ''[[Prajnaparadha]]'' ====<br />
<br />
''Dhi'' (intellect), ''dhriti'' (self control or patience) and ''[[smriti]]'' (memory) can be considered as the three important functioning faculties, impairment of which leads to psychiatric disorders. The ''dhi''(intellect) normally views things as they really are and its impairment leads to viewing eternal things as ephemeral and something harmful as useful and vice versa. The ''dhi vibhramsha'' leads to indecisiveness of the person to discriminate between right and wrong things. <br />
<br />
Due to impairment of patience mind indulging in various worldly enjoyments cannot be restrained from harmful objects. ''Dhriti vibhramsha'' results into lack of self control over activities. Normally memory contains everything memorable and if it is impaired due to overcoming by ''[[rajas]]'' and ''[[tamas]]'', the worthy things are not memorized leading to misconduct of the person. [Cha.Sa.[[Sharira Sthana]] 1/98-101] and ''[[smriti]] vibhramsha'' leads to decrease or improper recall, retention of things in memory. <br />
<br />
The other two causative factors like ''parinama'' and ''asatmendriyartha samyoga'' are also equally important causes. <br />
<br />
The ''parinama'' or time factor means not adapting the seasonal, diurnal changes as per physiological changes of ''[[dosha]]''. The changes related to age and death are also included in ''kala''.<br />
<br />
''Asatmendriyartha samyoga'' is self explanatory term denoting improper indulgence in the unsuitable sensory activities. The activities are enlisted in detail in the chapter. In today’s era of modernization and technological dependence, the excess indulgence in use of sense organs shall be avoided. <br />
<br />
Practicing ''yogic'' lifestyle negates above three factors which cause disease and thus prevents disease and gives healthy long life.<br />
There are many disciplines of ''yoga'' described since Vedic period dating back 4000 to 5000 years. In the second century B.C. Patanjali outlined ''ashtanga yoga'' (eight limbs of ''yoga'') or ''raja yoga'' which is being recognized as the most common and practical in the current society.<br />
<br />
Origin of the word ''yoga'' is from Sanskrit word ''yuj'' meaning “union” and represents union of mind, body, soul and spirit. As mentioned in the chapter, all started from pure being or ''purusha'' which is divine and state of perfection without any suffering because there is nothing material. ''[[Purusha]]'' creates ''[[prakriti]]'' which is all around us and we start relating to it and forget that our essence is ''[[purusha]]''. This continued relationship to ''[[prakriti]]'' is the cause for desires and expectations resulting in suffering. The realization of this comes through ''chitta'' which is feeling, centered in the heart and is evolution of consciousness.<br />
<br />
In order to transcend this dichotomy, Patanjali described the following eight limbs of ''ashtanga yoga''.<br />
<br />
The first two aspects are ''yama'' and ''niyama'' to create social and personal discipline in the society. The next two, ''asana'' and ''pranayama'' are to achieve physical and mental strength and stability.<br />
<br />
''Pratyahara, dharana, dhyana'' and ''samadhi'' are to achieve ''moksha'' by detachment, focus, meditation and bliss. Each one of us has unique qualities and has different levels of existing skills provided by each of the limbs of ''yoga''. Therefore, some individuals may require a teacher or ''guru'' to give guidance in the early stages.<br />
<br />
# ''Yamas'' (social restraints for relating to society) These are:<br />
## ''Ahimsa'': We should not cause pain to others by thoughts, words and actions. Show kindness and thoughtfulness to others.<br />
## ''Satya'': Truthfulness and honesty.<br />
## ''Asteya'' or non-stealing: Tangible and intangible.<br />
## ''Bramhacharya'': Control over senses, appropriate sexual behavior. <br />
## ''Aparigraha'' or non hoarding: Taking from nature what is needed.<br />
# ''Niyama'': (Personal restraints or conduct)<br />
## ''Shaucha'': Physical and mental cleanliness or purity.<br />
## ''Santosha'': Contentment<br />
## ''Tapas'': Self discipline.<br />
## ''Swadhyaya'': Self study<br />
## ''Ishwara pranidhana'': Acceptance. Do karma and leave results to higher powers.<br />
# ''Asanas'': Means steady and comfortable posture. Improves health, strength, balance and flexibility. On a deeper level it is a tool to calm the mind and move into the inner essence of being.<br />
# ''Pranayama'': Directing the life force produces heat (''tapa'') and cleans the channels, strengthens the respiratory system, calms the mind to be able to concentrate and meditate. <br />
# ''Pratyahara'': This is a stage when withdrawal of senses occurs due to break in the link between senses and the mind. It facilitates the next three limbs of ''yoga''.<br />
# ''Dharana'': This is a stage of deep concentration of mind on one particular object, sound or thought and there is cultivation of inner awareness.<br />
# ''Dhyana'' or meditation: This is the seventh step of ''yoga'' and during this stage there is deep awareness but no focus. There may be very few thoughts or no thoughts.<br />
# ''Samadhi'': This is a stage of bliss where the subject and object merge as one. Person feels connected to all living beings and is at peace. Illusionary separation of “I” and “mine” is lost as mind does not distinguish between self and non-self.<br />
<br />
All these have positive benefits to improve body-mind strength and harmony. Integrated ''yoga'' can be taught to normal participants without any harmful effects and it may reduce the negative affect and increase the positive affect within a week.<br />
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[[#top| Back to the Top ]]</span></div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Guduchi&diff=45434Guduchi2026-04-13T10:31:19Z<p>Agnivesha: </p>
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|title=Charak Samhita<br />
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|keywords=Guduchi, Gudoochi, Tinospora cordifolia, Heart leaved moonseed, Charak Samhita, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, ancient Ayurveda text, Indian system of medicine, Ayurveda, Charak, Charaka Samhita, agnivesha, atreya, gopal basisht, yogesh deole, charak samhita wikipedia edition, charak samhita new edition, charaka samhita new edition, carak samhita new edition, caraka samhita new edition, research on charak samhita, text book charak samhita, fundamental principles of ayurveda, basic concepts of ayurveda,<br />
|description=''Guduchi'' (गुडूची), commonly known as ' Giloy', is the Sanskrit name for the medicinal plant Tinospora cordifolia (Willd.) Hook. f. & Thomson of the family.It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<br />
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br />
|image_alt=charak samhita<br />
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}}<br />
Guduchi (Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.)<br />
<br />
''Guduchi'' (गुडूची), commonly known as ' Giloy', is the Sanskrit name for the medicinal plant Tinospora cordifolia (Willd.) Hook. f. & Thomson of the family Menispermaceae.<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref> It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<ref name="AYUSHDossier"/><br />
<br />
<br />
{{Infobox<br />
|title = Guduchi<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Guduchi<br />
|label2 = Botanical name(s)<br />
|data2 = Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
|label3 = Family<br />
|data3 = Menispermaceae<br />
|label4 = Availability<br />
|data4 = Available<br />
|label5 = Contributors<br />
|data5 = Deole Y.S., Thakkar R., Tanna J.<br />
|label6 = Year of publication <br />
|data6 = 2026<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Skill Development Centre]], Symbiohealth Foundation, India<br />
|label8 = DOI <br />
|data8 = Awaited<br />
}}<br />
<br />
==English name == <br />
<br />
Heart leaved moonseed<br />
<br />
== Botanical identity ==<br />
<br />
The principal medicinal source of Guduchi is the stem of ''Tinospora cordifolia''.<ref name="AYUSHDossier"/> The plant is a deciduous, climbing shrub with simple, heart‑shaped leaves and small, greenish flowers.<ref name="AYUSHDossier"/> The genus ''Tinospora'' includes several species, and correct identification is important because some related species (e.g., ''Tinospora crispa'') have been implicated in hepatotoxicity reports.<ref name="LiverTox">Nnamani I, Tolu-Akinnawo O, Dufera RR, Akintunde A, Maliakkal B. Tinospora cordifolia (Guduchi/Giloy)-Induced Liver Injury: A Case Review. Cureus. 2023 May 31;15(5):e39793. doi: 10.7759/cureus.39793. PMID: 37273324; PMCID: PMC10238282.</ref><br />
<br />
For Ayurvedic purposes, the AYUSH technical dossier specifies that properly identified ''T. cordifolia'' stem should be used, warning against confusion with other ''Tinospora'' species that may occur in commercial supply.<ref name="AYUSHDossier"/><br />
<br />
== Other botanical names/varieties ==<br />
<br />
The following botanical names are accepted by Plants of the World Online as of January 2024.<br />
<br />
* Tinospora crispa (L.) Hook.f. & Thomson<br />
* Tinospora sinensis (Lour.) Merr<br />
* Tinospora arfakiana Becc.<br />
* Tinospora baenzigeri Forman<br />
* Tinopora bakis (A.Rich.)Miers<br />
* Tinospora celebica Diels<br />
* Tinopora dissitiflora (K.Schum. & Lauterb.) Diels<br />
* Tinopora esiangkara (F.M..Bailey) Forman<br />
* Tinospora formanii Udayan & Pradeep<br />
* Tinospora fragosa (I.Verd.) I.Verd. & Troupin<br />
* Tinospora glabra (Burm.f.)Merr.<br />
* Tinospora glandulosa Merr.<br />
* Tinospora guangxiensis H.S.Lo<br />
* Tinospora hainanensis H.S.Lo &Z.X.Li<br />
* Tinospora hirsuta (Becc.) Forman<br />
* Tinospora homosepala Diels<br />
* Tinospora macrocarpa Diels<br />
* Tinospora merriliana Diels<br />
* Tinospora neocaledonica Forman<br />
* Tinospora nudiflora (Griff.) Kurz<br />
* Tinospora orophila Troupin<br />
* Tinospora palminervis Miers<br />
* Tinospora siamensis Forman<br />
* Tinospora smilacina Benth.<br />
* Tinospora sumatrana Becc.<br />
* Tinospora teijsmannii Boerl.<br />
* Tinospora tenera Miers.<br />
* Tinospora tinosporoides (F.Muell.) Forman<br />
* Tinospora trilobata Diels.<br />
<br />
== Synonyms in Charak Samhita==<br />
<br />
Amruta, Madhuparni, Vayastha, Chhinnaruha, Vatsadini<br />
<br />
== Synonyms in Bhavaprakasha Nighantu ==<br />
Guduchi, Madhuparni, Amrita, Amritavallari, Chhinna, Chhinnaruha, Chhinnodbhava, Vatsadani, Jivanti, Tantrika, Soma, Somavalli, Kundali, Chakralakshanika, Dhira, Vishalya, Rasayani, Chandrahasa, Vayastha, Mandali, Devanirmita<br />
<br />
==Anupana according to Dosha==<br />
* '''Vata''' – Ghrita <br />
* '''Pitta''' – Sharkara (Sugar)<br />
* '''Kapha''' – Madhu (Honey)<br />
* '''Vibandha''' (Constipation)– Guda (Jaggery)<br />
* '''Vatarakta''' (Gout) – Eranda taila (Castor oil)<br />
* '''Amavaata'''(Rhumatoid arthritis) – Shunthi (Ginger)<br />
<br />
== Ayurvedic pharmacological properties ==<br />
{| class="wikitable"<br />
|+Table 1: Properties of Guduchi<br />
|-<br />
! Sr.no. !! Pharmacological criteria !! Properties<br />
|-<br />
| 1 || Taste ([[rasa]]) || Bitter (tikta), Astringent (kashaya)<br />
|-<br />
| 2 || Potency ([[veerya]]) || Hot (ushna)<br />
|-<br />
| 3 || Post digestion effect ([[vipaka]]) || Sweet (madhura)<br />
|-<br />
| 4 || Qualities ([[guna]])|| Heavy (guru), Unctuous (snigdha)<br />
|-<br />
| 5 || Actions ([[karma]]) || Pacify [[vata]], [[pitta]] and [[kapha]]<br />
|}<br />
== Reference in Charak Samhita and its actions == <br />
<br />
{| class="wikitable"<br />
|+ Herbs and their activities<br />
|-<br />
! Sr.no. !! Reference in Charak Samhita !! Activity <br />
|-<br />
| 1 ||Cha.Sa.[[Sutra Sthana]] 2/12 || Asthapana<br />
|-<br />
| 2 || Cha.Sa.[[Sutra Sthana]] 3/3 || Siddhatamachurnapradeha<br />
|-<br />
| 3 ||Cha.Sa.[[Sutra Sthana]] 4/9(11) || Truptighnamahakashay<br />
|-<br />
| 4 ||Cha.Sa.[[Sutra Sthana]] 4/9(18) || Stanyashodhanamahakashay<br />
|-<br />
| 5 ||Cha.Sa.[[Sutra Sthana]] 4/9(21) || Snehopagmahakashay<br />
|-<br />
| 6 ||Cha.Sa.[[Sutra Sthana]] 4/9(29) || Trishnanigrahanamahakashay<br />
|-<br />
| 7 ||Cha.Sa.[[Sutra Sthana]] 4/9(41) || Dahaprashamanamahakashaya<br />
|-<br />
| 8 ||Cha.Sa.[[Sutra Sthana]] 4/9(49) || Prajasthapanamahakashaya<br />
|-<br />
| 9 ||Cha.Sa.[[Sutra Sthana]] 4/9(50) || Vayasthapanmahakashaya<br />
|-<br />
| 10 ||Cha.Sa.[[Sutra Sthana]] 14/31 <br />
| Dravya for Nadi Sweda<br />
|-<br />
| 11 ||Cha.Sa.[[Sutra Sthana]] 21/22 <br />
| Management of obesity<br />
|-<br />
|12<br />
|Cha.Sa.[[Sutra Sthana]] 25/40<br />
|Agrya Sangraha<br />
|-<br />
|13<br />
|Cha.Sa.[[Sutra Sthana]]27/4<br />
|Natural qualities.<br />
|-<br />
|14<br />
|Cha.Sa.[[Sutra Sthana]] 27/106<br />
|Shaka Varga<br />
|-<br />
|15<br />
|Cha.Sa.[[Sutra Sthana]] 26/49<br />
|Veerya varnan<br />
|-<br />
|16<br />
|Cha.Sa.[[Vimana Sthana]] 8/135<br />
|Vaman dravyani<br />
|-<br />
|17<br />
|Cha.Sa.[[Vimana Sthana]] 8/139<br />
|Madhur skanda<br />
|-<br />
|18<br />
|Cha.Sa.[[Vimana Sthana]] 8/143<br />
|Tikta skandha<br />
|-<br />
|19<br />
|Cha.Sa.[[Sharira Sthana]].8/56<br />
|Kshira vishodhana dravya<br />
|-<br />
|20<br />
|Cha.Sa.[[Kalpa Sthana]] 1/22<br />
|Vamanartha<br />
|-<br />
|21<br />
|Cha.Sa.[[Kalpa Sthana]] 7/19<br />
|Preparations of Trivritta<br />
|-<br />
|22<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/198<br />
|Used as kwath or sheeta kashaya for trushna, deepana, doshapachana, jwar, aruchi and mukhavairasya.<br />
|-<br />
|23<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in trutiyaka jwara.<br />
|-<br />
|24<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in chaturthaka jwara.<br />
|-<br />
|25<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/211<br />
|As an ingredient of shatyadi varga used in kasa, svasa, tandra,parshvashoola, hrdgraha and sannipata jwara.<br />
|-<br />
|26<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/222<br />
|As an ingredient of Vasadi Ghrita.<br />
|-<br />
|27<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/247<br />
|Used in niruha basti.<br />
|-<br />
|28<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/251<br />
|Used in Patoladi niruha basti.<br />
|-<br />
|29<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/267<br />
|In formulation of Agurvadi taila.<br />
|-<br />
|30<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/299<br />
|Used as swarasa in Vishama jwara.<br />
|-<br />
|31<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/343<br />
|Used in punaravrtaka jwara(Kirat tiktadi kwath)<br />
|-<br />
|32<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/29<br />
|Used for making decoction in Kaphaj prameh<br />
|-<br />
|33<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/30<br />
|Used for making decoction in Pittaja Prameha <br />
|-<br />
|34<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/77<br />
|Ingredient in Kanakabindurishta<br />
|-<br />
|35<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/124<br />
|Bahyaprayogarth Lepa in Vata-Kaphaja Kushtha<br />
|-<br />
|36<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/146<br />
|Ingredient in Mahatikta Ghrita<br />
|-<br />
|37<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/153<br />
|Ingredient in Mahakhadira Ghrita<br />
|-<br />
|38<br />
|Cha.Sa.[[Chikitsa Sthana]] 8/72<br />
|For Parisheka purpose<br />
|-<br />
|39<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/25<br />
|In treatment of Vataja Shvayathu<br />
|-<br />
|40<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/34<br />
|Ingredient in Punarnavadyarishta<br />
|-<br />
|41<br />
|Cha.Sa.[[Chikitsa Sthana]] 5/190<br />
|Used in preparation of Panchama Kshara<br />
|-<br />
|42<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/63<br />
|In Kamala Guduchi Swarasa should be given in early in the morning <br />
|-<br />
|43<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/134 <br />
|Used in Halimak Chikitsa<br />
|-<br />
|44<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/94<br />
|Used in yusha preparation for hikka svasa<br />
|-<br />
|45<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/102<br />
|Used as yavagu in hikka svasa<br />
|-<br />
|46<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/35<br />
|As a ghrita dravya<br />
|-<br />
|47<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/161<br />
|As an ingredient of guduchyadi ghrita.<br />
|-<br />
|48<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/31 <br />
|As a pana yoga in Pittaja chhardi.<br />
|-<br />
|49<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/35<br />
|As a pathya ahara in kaphaja chhardi.<br />
|-<br />
|50<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/58<br />
|For kashaya pana.<br />
|-<br />
|51<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/130<br />
|Used in granthi visarpa.<br />
|-<br />
|52<br />
|Cha.Sa.[[Chikitsa Sthana]] 22/45<br />
|As a pana yoga.<br />
|-<br />
|53<br />
|Cha.Sa.[[Chikitsa Sthana]] 23/70<br />
|As an ingredient of Gandha hasti agada.<br />
|-<br />
|54<br />
|Cha.Sa.[[Chikitsa Sthana]] 24/145<br />
|Used as swarasa where pittaja madatyaya is associated with sarakta kasa, Parshvashoola, Stanashoola, Daaha & Hradayotkleda.<br />
|-<br />
|55<br />
|Cha.Sa.[[Chikitsa Sthana]] 25/75<br />
|Used in shoola with sneha & sarkara.<br />
|-<br />
|56<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/57<br />
|Used in Kaphaja mutrakruchhra.<br />
|-<br />
|57<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/70<br />
|As an ingredient of Karpasmooladi yoga.<br />
|-<br />
|58<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/83<br />
|As an ingredient of Haritakyadi Ghrita.<br />
|-<br />
|59<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/243<br />
|As an ingredient of Amrutadi varti.<br />
|-<br />
|60<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/283<br />
|Used in Vataja swarbheda.<br />
|-<br />
|61<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/148<br />
|As an ingredient of Bala taila. <br />
|-<br />
|62<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/157<br />
|As an ingredient of Amrutadi taila.<br />
|-<br />
|63<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/170<br />
|As an ingredient of Vrushamuladi taila.<br />
|-<br />
|64<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/172<br />
|As an ingredient of Mulaka taila.<br />
|-<br />
|65<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/71<br />
|Anupana of Drakshadi Ghrita.<br />
|-<br />
|66<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/73<br />
|As an ingredient of Jeevakadi mahasneha.<br />
|-<br />
|67<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/92<br />
|As an ingredient of Madhuparnyadi taila.<br />
|-<br />
|68<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/103<br />
|As an ingredient of Amrutadhya taila.<br />
|-<br />
|69<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/117<br />
|As an ingredient of Shatapaka Madhuparni taila.<br />
|-<br />
|70<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/53<br />
|As an ingredient of Kashmaryadi ghrita, used in the treatment of Vataja yoni.<br />
|-<br />
|71<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/58<br />
|For parishechana in yoni shula.<br />
|-<br />
|72<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/99<br />
|Used in the treatment of Kaphaja pradara.<br />
|-<br />
|73<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/59<br />
|As an ingredient of Guduchyadi taila, used in the treatment of Vataja yoni roga.<br />
|-<br />
|}<br />
<br />
== Classical therapeutic uses ==<br />
<br />
Guduchi is one of the most frequently cited herbs in Ayurvedic literature and is reported in formulations for a wide range of conditions, including:<ref name="AYUSHDossier"/><br />
<br />
Classical actions attributed to Guduchi include:<ref name="AYUSHDossier"/><br />
<br />
* Rasayana (rejuvenative)<br />
* Dipana and Sangrahi (appetizing and absorbent)<br />
* Vataraktahara and Amavataghni (useful in gout and rheumatoid‑like arthritis)<br />
* Kamalahara (beneficial in jaundice and liver disorders)<br />
* Kushtaghna (beneficial in skin diseases)<br />
* Pramehaghna (beneficial in urinary and metabolic disorders)<br />
* Jvara (fever), including irregular and chronic fevers<br />
* Kamala (jaundice) and other hepatic and viral fevers<br />
* Vatarakta and amavata (gout and rheumatoid‑like arthritis)<br />
* Kasa (chronic cough)<br />
* Prameha (Diabetes mellitus and metabolic disorders)<br />
* Chardighna (anti‑emetic indications)<br />
<br />
The AYUSH technical dossier notes that Guduchi appears in more than 2,400 Ayurvedic formulations across over 24 dosage forms, indicating its broad and enduring therapeutic role.<ref name="AYUSHDossier"/><br />
<br />
== Parts used and dosage forms ==<br />
<br />
In Ayurvedic practice, the mature stem is the primary part used for preparing Guduchi‑based medicines.<ref name="AYUSHDossier"/> Common traditional dosage forms include:<ref name="AYUSHDossier"/><br />
<br />
* Churna (powder)<br />
* Kwatha (decoction)<br />
* Hima (cold infusion)<br />
* Svarasa (fresh juice)<br />
* Satva (starch preparation)<br />
* Ghrita (medicated ghee)<br />
* Taila (medicated oil)<br />
* Gutika (tablets)<br />
<br />
== Important Formulations ==<br />
<br />
* Amritarishta<br />
* Amritottara kvatha churna<br />
* Guduchi Taila<br />
* Guduchyadi churna<br />
* Guduchi Sattva<br />
* Chhinnodbhavadi kvatha churna<br />
* Kaishora Guggulu<br />
* Samshamani Vati<br />
<br />
==Dose==<br />
<br />
The AYUSH technical dossier cites typical dose ranges as:<ref name="AYUSHDossier"/><br />
* 3–6 g of powder<br />
* 20–30 g of coarse powder for decoction<br />
* 125 mg–1000 mg of Guduchi sattva, taken with appropriate anupana (vehicle)<br />
<br />
== Current availability== <br />
<br />
Available <br />
<br />
Through all over India extending from Himalayas to the Southern part of India.<br />
<br />
Other countries: Nepal, Bangladesh, Pakistan, Myanmar, Burma, Sri Lanka, Malaysia, Indonesia and Thailand<br />
<br />
== Current researches ==<br />
<br />
== Chemical constituents ==<br />
<br />
Modern phytochemical studies have identified more than 200 compounds in ''Tinospora cordifolia'' and related species, including diterpenoids, alkaloids, glycosides, steroids, sesquiterpenoids, and phenolics.<ref name="ImmunomodulatoryReview">Yates CR, Bruno EJ, Yates MED. Tinospora Cordifolia: A review of its immunomodulatory properties. J Diet Suppl. 2022;19(2):271-285. doi: 10.1080/19390211.2021.1873214. Epub 2021 Jan 22. PMID: 33480818.</ref> Key constituents reported in the literature include:<ref name="AYUSHDossier"/>,<ref name="OnePlantManyRoles">Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012 Apr;31(4):151-9. doi: 10.4103/0257-7941.107344. PMID: 23661861; PMCID: PMC3644751</ref><br />
<br />
* Clerodane‑type diterpenoids<br />
* Cordifolioside A and tinosporaside (used as assay markers)<br />
* Alkaloids such as magnoflorine and berberine‑like compounds<br />
* Diterpenoid lactones and glycosides<br />
<br />
These constituents are thought to contribute to the herb’s bitter taste, immunomodulatory, anti‑inflammatory, and antioxidant properties.<ref name="ImmunomodulatoryReview"/><br />
<br />
== Pharmacological actions ==<br />
<br />
Experimental studies, including in vitro and animal models, support several pharmacological activities of Guduchi extracts.<ref name="ImmunomodulatoryReview"/><ref name="OnePlantManyRoles"/><br />
<br />
* Immunomodulatory effects: Modulation of immune cell function and cytokine pathways.<ref name="ImmunomodulatoryReview"/><br />
* Anti‑inflammatory effects: Reduction of pro‑inflammatory cytokines such as TNF‑α and IL‑1β.<ref name="ImmunomodulatoryReview"/><ref name="ScientificReports2019">{{Cite Ghatpande NS, Misar AV, Waghole RJ, Jadhav SH, Kulkarni PP. Tinospora cordifolia protects against inflammation associated anemia by modulating inflammatory cytokines and hepcidin expression in male Wistar rats. Sci Rep. 2019 Jul 29;9(1):10969. doi: 10.1038/s41598-019-47458-0. PMID: 31358831; PMCID: PMC6662690}}</ref><br />
* Antioxidant activity: Scavenging of free radicals and reduction of oxidative stress.<ref name="OnePlantManyRoles"/><br />
* Antipyretic and analgesic activity in fever‑like models.<ref name="ImmunomodulatoryReview"/><br />
<br />
Some studies also report hepatoprotective, hypoglycemic, and anti‑arthritic‑like effects, although the exact mechanisms and clinical relevance remain under investigation.<ref name="OnePlantManyRoles"/><ref name="ImmunomodulatoryReview"/><br />
<br />
== Metabolic and endocrine research ==<br />
<br />
Recent reviews suggest that Guduchi may have beneficial effects on diabetes, hyperlipidemia, obesity, and related features of metabolic syndrome.<ref name="MetabolicReview2025">{{Mansouri M, Imenshahidi M, Rameshrad M, Hosseinzadeh H. Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review. Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4979-5009. doi: 10.1007/s00210-024-03642-2. Epub 2024 Dec 28. PMID: 39731594.}}</ref> Anti‑diabetic and antihyperglycemic actions have been reported in animal models and some small human studies, including a randomized trial in diabetic dyslipidemia showing improvement in lipid profile, inflammatory markers, and metabolic‑syndrome prevalence with Guduchi‑stem supplementation.<ref name="DiabeticDyslipidemiaRCT">{{Cite journal |year=2024 |title=Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open‑labelled randomized controlled trial |journal=International Journal of Research and Pharmaceutical Sciences |volume=15 |issue=12 |pages=100–107 |url=https://ffhdj.com/index.php/ffhd/article/view/208}}</ref><br />
<br />
However, the overall evidence base still relies heavily on preclinical data and heterogeneous herbal preparations rather than standardized, large‑scale randomized trials.<ref name="MetabolicReview2025"/><br />
<br />
== Musculoskeletal and inflammatory conditions ==<br />
<br />
Guduchi is traditionally used for vatarakta and amavata, conditions resembling gout and rheumatoid arthritis.<ref name="AYUSHDossier"/> Preclinical studies in arthritis models show that ''T. cordifolia'' extracts can reduce inflammatory mediators and markers of joint destruction, supporting its traditional anti‑arthritic use.<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<br />
However, the evidence is still preliminary, and current data justify Guduchi mainly as a potential adjunct to conventional therapy rather than as a standalone monotherapy for chronic inflammatory joint disease.<ref name="Arthritis2015"/><br />
<br />
== Safety and hepatotoxicity ==<br />
<br />
In recent years, several case reports and reviews have described herb‑induced liver injury associated with Guduchi or ''Tinospora''‑containing products.<ref name="LiverTox"/>,<ref name="PMC2021LiverInjury">Björnsson ES, Navarro VJ, Chalasani N. Liver Injury Following Tinospora Cordifolia Consumption: Drug-Induced AIH, or de novo AIH? J Clin Exp Hepatol. 2022 Jan-Feb;12(1):6-9. doi: 10.1016/j.jceh.2021.11.014. Epub 2021 Nov 29. PMID: 35068778; PMCID: PMC8766689.</ref><br />
<br />
The NIH LiverTox resource notes that Guduchi‑associated liver injury can range from mild elevation of liver enzymes to clinically significant hepatitis and, rarely, acute liver failure, with some cases showing autoimmune‑like features.<ref name="LiverTox"/> Many cases occur in patients with pre‑existing liver disease or autoimmune predisposition and may be idiosyncratic or immune‑mediated.<ref name="LiverTox"/><br />
<br />
The AYUSH technical dossier highlights that many published liver injury reports lack detailed baseline documentation and may mix different species and preparations, underscoring the need for careful botanical identification, product quality control, and medical supervision, especially in patients with pre‑existing liver conditions.<ref name="AYUSHDossier"/><br />
<br />
== Current research trends ==<br />
<br />
PubMed‑based trend analyses indicate a substantial increase in publications on Guduchi, rising from several hundred articles in the early 2010s to over 900 indexed studies by 2024, reflecting growing scientific interest.<ref name="AYUSHDossier"/> This growth reflects heightened scientific and public interest but does not, by itself, equate to high‑quality clinical evidence.<ref name="MetabolicReview2025"/><br />
<br />
Most of the current evidence is from preclinical studies, mechanistic investigations, small trials, and narrative reviews; large, well‑designed randomized controlled trials are still limited.<ref name="MetabolicReview2025"/><br />
<br />
== Clinical position ==<br />
<br />
From an Ayurvedic perspective, Guduchi is regarded as a classical Rasayana with broad therapeutic indications, supported by long‑standing clinical experience.<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles"/> From a modern evidence‑based medicine standpoint, it is best viewed as a promising but not yet fully established botanical agent for conditions such as metabolic syndrome, certain inflammatory disorders, and liver and immune‑mediated conditions.<ref name="MetabolicReview2025"/><br />
<br />
Use in clinical practice should emphasize:<ref name="LiverTox"/><ref name="AYUSHDossier"/><br />
<br />
* Accurate botanical identification and use of standardized preparations<br />
* Caution in patients with liver disease or autoimmunity<br />
* Integration with, rather than substitution for, established medical therapies<br />
<br />
=== Indian Medicinal Plant Database, Phytochemistry And Therapeutics (IMPPAT) ===<br />
<br />
Link: https://cb.imsc.res.in/imppat/phytochemical/Tinospora%20crispa <br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development ..<br />
<br />
==References==</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Talk:Guduchi&diff=45433Talk:Guduchi2026-04-13T10:22:10Z<p>Agnivesha: </p>
<hr />
<div>Guduchi (Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.)<br />
<br />
''Guduchi'' (गुडूची), commonly known as ' Giloy', is the Sanskrit name for the medicinal plant Tinospora cordifolia (Willd.) Hook. f. & Thomson of the family [[Menispermaceae]].<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref> It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<ref name="AYUSHDossier"/><br />
<br />
<br />
{{Infobox<br />
|title = Guduchi<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Guduchi<br />
|label2 = Botanical name(s)<br />
|data2 = Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
|label3 = Family<br />
|data3 = Menispermaceae<br />
|label4 = Availability<br />
|data4 = Available<br />
|label5 = Contributors<br />
|data5 = Deole Y.S.<br />
|label6 = Year of publication <br />
|data6 = 2026<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Skill Development Centre]], Symbiohealth Foundation, India<br />
|label8 = DOI <br />
|data8 = Awaited<br />
}}<br />
<br />
==English name == <br />
<br />
Heart leaved moonseed<br />
<br />
== Botanical identity ==<br />
<br />
The principal medicinal source of Guduchi is the stem of ''Tinospora cordifolia''.<ref name="AYUSHDossier"/> The plant is a deciduous, climbing shrub with simple, heart‑shaped leaves and small, greenish flowers.<ref name="AYUSHDossier"/> The genus ''Tinospora'' includes several species, and correct identification is important because some related species (e.g., ''Tinospora crispa'') have been implicated in hepatotoxicity reports.<ref name="LiverTox">Nnamani I, Tolu-Akinnawo O, Dufera RR, Akintunde A, Maliakkal B. Tinospora cordifolia (Guduchi/Giloy)-Induced Liver Injury: A Case Review. Cureus. 2023 May 31;15(5):e39793. doi: 10.7759/cureus.39793. PMID: 37273324; PMCID: PMC10238282.</ref><br />
<br />
For Ayurvedic purposes, the AYUSH technical dossier specifies that properly identified ''T. cordifolia'' stem should be used, warning against confusion with other ''Tinospora'' species that may occur in commercial supply.<ref name="AYUSHDossier"/><br />
<br />
== Other botanical names/varieties ==<br />
<br />
The following botanical names are accepted by Plants of the World Online as of January 2024.<br />
<br />
* Tinospora crispa (L.) Hook.f. & Thomson<br />
* Tinospora sinensis (Lour.) Merr<br />
* Tinospora arfakiana Becc.<br />
* Tinospora baenzigeri Forman<br />
* Tinopora bakis (A.Rich.)Miers<br />
* Tinospora celebica Diels<br />
* Tinopora dissitiflora (K.Schum. & Lauterb.) Diels<br />
* Tinopora esiangkara (F.M..Bailey) Forman<br />
* Tinospora formanii Udayan & Pradeep<br />
* Tinospora fragosa (I.Verd.) I.Verd. & Troupin<br />
* Tinospora glabra (Burm.f.)Merr.<br />
* Tinospora glandulosa Merr.<br />
* Tinospora guangxiensis H.S.Lo<br />
* Tinospora hainanensis H.S.Lo &Z.X.Li<br />
* Tinospora hirsuta (Becc.) Forman<br />
* Tinospora homosepala Diels<br />
* Tinospora macrocarpa Diels<br />
* Tinospora merriliana Diels<br />
* Tinospora neocaledonica Forman<br />
* Tinospora nudiflora (Griff.) Kurz<br />
* Tinospora orophila Troupin<br />
* Tinospora palminervis Miers<br />
* Tinospora siamensis Forman<br />
* Tinospora smilacina Benth.<br />
* Tinospora sumatrana Becc.<br />
* Tinospora teijsmannii Boerl.<br />
* Tinospora tenera Miers.<br />
* Tinospora tinosporoides (F.Muell.) Forman<br />
* Tinospora trilobata Diels.<br />
<br />
== Synonyms in Charak Samhita==<br />
<br />
Amruta, Madhuparni, Vayastha, Chhinnaruha, Vatsadini<br />
<br />
== Synonyms in Bhavaprakasha Nighantu ==<br />
Guduchi, Madhuparni, Amrita, Amritavallari, Chhinna, Chhinnaruha, Chhinnodbhava, Vatsadani, Jivanti, Tantrika, Soma, Somavalli, Kundali, Chakralakshanika, Dhira, Vishalya, Rasayani, Chandrahasa, Vayastha, Mandali, Devanirmita<br />
<br />
==Anupana according to Dosha==<br />
* '''Vata''' – Ghrita <br />
* '''Pitta''' – Sharkara (Sugar)<br />
* '''Kapha''' – Madhu (Honey)<br />
* '''Vibandha''' (Constipation)– Guda (Jaggery)<br />
* '''Vatarakta''' (Gout) – Eranda taila (Castor oil)<br />
* '''Amavaata'''(Rhumatoid arthritis) – Shunthi (Ginger)<br />
<br />
== Ayurvedic pharmacological properties ==<br />
{| class="wikitable"<br />
|+Table 1: Properties of Guduchi<br />
|-<br />
! Sr.no. !! Pharmacological criteria !! Properties<br />
|-<br />
| 1 || Taste ([[rasa]]) || Bitter (tikta), Astringent (kashaya)<br />
|-<br />
| 2 || Potency ([[veerya]]) || Hot (ushna)<br />
|-<br />
| 3 || Post digestion effect ([[vipaka]]) || Sweet (madhura)<br />
|-<br />
| 4 || Qualities ([[guna]])|| Heavy (guru), Unctuous (snigdha)<br />
|-<br />
| 5 || Actions ([[karma]]) || Pacify [[vata]], [[pitta]] and [[kapha]]<br />
|}<br />
== Reference in Charak Samhita and its actions == <br />
<br />
{| class="wikitable"<br />
|+ Herbs and their activities<br />
|-<br />
! Sr.no. !! Reference in Charak Samhita !! Activity <br />
|-<br />
| 1 ||Cha.Sa.[[Sutra Sthana]] 2/12 || Asthapana<br />
|-<br />
| 2 || Cha.Sa.[[Sutra Sthana]] 3/3 || Siddhatamachurnapradeha<br />
|-<br />
| 3 ||Cha.Sa.[[Sutra Sthana]] 4/9(11) || Truptighnamahakashay<br />
|-<br />
| 4 ||Cha.Sa.[[Sutra Sthana]] 4/9(18) || Stanyashodhanamahakashay<br />
|-<br />
| 5 ||Cha.Sa.[[Sutra Sthana]] 4/9(21) || Snehopagmahakashay<br />
|-<br />
| 6 ||Cha.Sa.[[Sutra Sthana]] 4/9(29) || Trishnanigrahanamahakashay<br />
|-<br />
| 7 ||Cha.Sa.[[Sutra Sthana]] 4/9(41) || Dahaprashamanamahakashaya<br />
|-<br />
| 8 ||Cha.Sa.[[Sutra Sthana]] 4/9(49) || Prajasthapanamahakashaya<br />
|-<br />
| 9 ||Cha.Sa.[[Sutra Sthana]] 4/9(50) || Vayasthapanmahakashaya<br />
|-<br />
| 10 ||Cha.Sa.[[Sutra Sthana]] 14/31 <br />
| Dravya for Nadi Sweda<br />
|-<br />
| 11 ||Cha.Sa.[[Sutra Sthana]] 21/22 <br />
| Management of obesity<br />
|-<br />
|12<br />
|Cha.Sa.[[Sutra Sthana]] 25/40<br />
|Agrya Sangraha<br />
|-<br />
|13<br />
|Cha.Sa.[[Sutra Sthana]]27/4<br />
|Natural qualities.<br />
|-<br />
|14<br />
|Cha.Sa.[[Sutra Sthana]] 27/106<br />
|Shaka Varga<br />
|-<br />
|15<br />
|Cha.Sa.[[Sutra Sthana]] 26/49<br />
|Veerya varnan<br />
|-<br />
|16<br />
|Cha.Sa.[[Vimana Sthana]] 8/135<br />
|Vaman dravyani<br />
|-<br />
|17<br />
|Cha.Sa.[[Vimana Sthana]] 8/139<br />
|Madhur skanda<br />
|-<br />
|18<br />
|Cha.Sa.[[Vimana Sthana]] 8/143<br />
|Tikta skandha<br />
|-<br />
|19<br />
|Cha.Sa.[[Sharira Sthana]].8/56<br />
|Kshira vishodhana dravya<br />
|-<br />
|20<br />
|Cha.Sa.[[Kalpa Sthana]] 1/22<br />
|Vamanartha<br />
|-<br />
|21<br />
|Cha.Sa.[[Kalpa Sthana]] 7/19<br />
|Preparations of Trivritta<br />
|-<br />
|22<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/198<br />
|Used as kwath or sheeta kashaya for trushna, deepana, doshapachana, jwar, aruchi and mukhavairasya.<br />
|-<br />
|23<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in trutiyaka jwara.<br />
|-<br />
|24<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in chaturthaka jwara.<br />
|-<br />
|25<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/211<br />
|As an ingredient of shatyadi varga used in kasa, svasa, tandra,parshvashoola, hrdgraha and sannipata jwara.<br />
|-<br />
|26<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/222<br />
|As an ingredient of Vasadi Ghrita.<br />
|-<br />
|27<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/247<br />
|Used in niruha basti.<br />
|-<br />
|28<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/251<br />
|Used in Patoladi niruha basti.<br />
|-<br />
|29<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/267<br />
|In formulation of Agurvadi taila.<br />
|-<br />
|30<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/299<br />
|Used as swarasa in Vishama jwara.<br />
|-<br />
|31<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/343<br />
|Used in punaravrtaka jwara(Kirat tiktadi kwath)<br />
|-<br />
|32<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/29<br />
|Used for making decoction in Kaphaj prameh<br />
|-<br />
|33<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/30<br />
|Used for making decoction in Pittaja Prameha <br />
|-<br />
|34<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/77<br />
|Ingredient in Kanakabindurishta<br />
|-<br />
|35<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/124<br />
|Bahyaprayogarth Lepa in Vata-Kaphaja Kushtha<br />
|-<br />
|36<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/146<br />
|Ingredient in Mahatikta Ghrita<br />
|-<br />
|37<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/153<br />
|Ingredient in Mahakhadira Ghrita<br />
|-<br />
|38<br />
|Cha.Sa.[[Chikitsa Sthana]] 8/72<br />
|For Parisheka purpose<br />
|-<br />
|39<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/25<br />
|In treatment of Vataja Shvayathu<br />
|-<br />
|40<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/34<br />
|Ingredient in Punarnavadyarishta<br />
|-<br />
|41<br />
|Cha.Sa.[[Chikitsa Sthana]] 5/190<br />
|Used in preparation of Panchama Kshara<br />
|-<br />
|42<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/63<br />
|In Kamala Guduchi Swarasa should be given in early in the morning <br />
|-<br />
|43<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/134 <br />
|Used in Halimak Chikitsa<br />
|-<br />
|44<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/94<br />
|Used in yusha preparation for hikka svasa<br />
|-<br />
|45<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/102<br />
|Used as yavagu in hikka svasa<br />
|-<br />
|46<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/35<br />
|As a ghrita dravya<br />
|-<br />
|47<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/161<br />
|As an ingredient of guduchyadi ghrita.<br />
|-<br />
|48<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/31 <br />
|As a pana yoga in Pittaja chhardi.<br />
|-<br />
|49<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/35<br />
|As a pathya ahara in kaphaja chhardi.<br />
|-<br />
|50<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/58<br />
|For kashaya pana.<br />
|-<br />
|51<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/130<br />
|Used in granthi visarpa.<br />
|-<br />
|52<br />
|Cha.Sa.[[Chikitsa Sthana]] 22/45<br />
|As a pana yoga.<br />
|-<br />
|53<br />
|Cha.Sa.[[Chikitsa Sthana]] 23/70<br />
|As an ingredient of Gandha hasti agada.<br />
|-<br />
|54<br />
|Cha.Sa.[[Chikitsa Sthana]] 24/145<br />
|Used as swarasa where pittaja madatyaya is associated with sarakta kasa, Parshvashoola, Stanashoola, Daaha & Hradayotkleda.<br />
|-<br />
|55<br />
|Cha.Sa.[[Chikitsa Sthana]] 25/75<br />
|Used in shoola with sneha & sarkara.<br />
|-<br />
|56<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/57<br />
|Used in Kaphaja mutrakruchhra.<br />
|-<br />
|57<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/70<br />
|As an ingredient of Karpasmooladi yoga.<br />
|-<br />
|58<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/83<br />
|As an ingredient of Haritakyadi Ghrita.<br />
|-<br />
|59<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/243<br />
|As an ingredient of Amrutadi varti.<br />
|-<br />
|60<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/283<br />
|Used in Vataja swarbheda.<br />
|-<br />
|61<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/148<br />
|As an ingredient of Bala taila. <br />
|-<br />
|62<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/157<br />
|As an ingredient of Amrutadi taila.<br />
|-<br />
|63<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/170<br />
|As an ingredient of Vrushamuladi taila.<br />
|-<br />
|64<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/172<br />
|As an ingredient of Mulaka taila.<br />
|-<br />
|65<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/71<br />
|Anupana of Drakshadi Ghrita.<br />
|-<br />
|66<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/73<br />
|As an ingredient of Jeevakadi mahasneha.<br />
|-<br />
|67<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/92<br />
|As an ingredient of Madhuparnyadi taila.<br />
|-<br />
|68<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/103<br />
|As an ingredient of Amrutadhya taila.<br />
|-<br />
|69<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/117<br />
|As an ingredient of Shatapaka Madhuparni taila.<br />
|-<br />
|70<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/53<br />
|As an ingredient of Kashmaryadi ghrita, used in the treatment of Vataja yoni.<br />
|-<br />
|71<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/58<br />
|For parishechana in yoni shula.<br />
|-<br />
|72<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/99<br />
|Used in the treatment of Kaphaja pradara.<br />
|-<br />
|73<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/59<br />
|As an ingredient of Guduchyadi taila, used in the treatment of Vataja yoni roga.<br />
|-<br />
|}<br />
<br />
== Classical therapeutic uses ==<br />
<br />
Guduchi is one of the most frequently cited herbs in Ayurvedic literature and is reported in formulations for a wide range of conditions, including:<ref name="AYUSHDossier"/><br />
<br />
Classical actions attributed to Guduchi include:<ref name="AYUSHDossier"/><br />
<br />
* Rasayana (rejuvenative)<br />
* Dipana and Sangrahi (appetizing and absorbent)<br />
* Vataraktahara and Amavataghni (useful in gout and rheumatoid‑like arthritis)<br />
* Kamalahara (beneficial in jaundice and liver disorders)<br />
* Kushtaghna (beneficial in skin diseases)<br />
* Pramehaghna (beneficial in urinary and metabolic disorders)<br />
* Jvara (fever), including irregular and chronic fevers<br />
* Kamala (jaundice) and other hepatic and viral fevers<br />
* Vatarakta and amavata (gout and rheumatoid‑like arthritis)<br />
* Kasa (chronic cough)<br />
* Prameha (Diabetes mellitus and metabolic disorders)<br />
* Chardighna (anti‑emetic indications)<br />
<br />
The AYUSH technical dossier notes that Guduchi appears in more than 2,400 Ayurvedic formulations across over 24 dosage forms, indicating its broad and enduring therapeutic role.<ref name="AYUSHDossier"/><br />
<br />
== Parts used and dosage forms ==<br />
<br />
In Ayurvedic practice, the mature stem is the primary part used for preparing Guduchi‑based medicines.<ref name="AYUSHDossier"/> Common traditional dosage forms include:<ref name="AYUSHDossier"/><br />
<br />
* Churna (powder)<br />
* Kwatha (decoction)<br />
* Hima (cold infusion)<br />
* Svarasa (fresh juice)<br />
* Satva (starch preparation)<br />
* Ghrita (medicated ghee)<br />
* Taila (medicated oil)<br />
* Gutika (tablets)<br />
<br />
== Important Formulations ==<br />
<br />
* Amritarishta<br />
* Amritottara kvatha churna<br />
* Guduchi Taila<br />
* Guduchyadi churna<br />
* Guduchi Sattva<br />
* Chhinnodbhavadi kvatha churna<br />
* Kaishora Guggulu<br />
* Samshamani Vati<br />
<br />
==Dose==<br />
<br />
The AYUSH technical dossier cites typical dose ranges as:<ref name="AYUSHDossier"/><br />
* 3–6 g of powder<br />
* 20–30 g of coarse powder for decoction<br />
* 125 mg–1000 mg of Guduchi sattva, taken with appropriate anupana (vehicle)<br />
<br />
== Current availability== <br />
<br />
Available <br />
<br />
Through all over India extending from Himalayas to the Southern part of India.<br />
<br />
Other countries: Nepal, Bangladesh, Pakistan, Myanmar, Burma, Sri Lanka, Malaysia, Indonesia and Thailand<br />
<br />
== Current researches ==<br />
<br />
== Chemical constituents ==<br />
<br />
Modern phytochemical studies have identified more than 200 compounds in ''Tinospora cordifolia'' and related species, including diterpenoids, alkaloids, glycosides, steroids, sesquiterpenoids, and phenolics.<ref name="ImmunomodulatoryReview">Yates CR, Bruno EJ, Yates MED. Tinospora Cordifolia: A review of its immunomodulatory properties. J Diet Suppl. 2022;19(2):271-285. doi: 10.1080/19390211.2021.1873214. Epub 2021 Jan 22. PMID: 33480818.</ref> Key constituents reported in the literature include:<ref name="AYUSHDossier"/>,<ref name="OnePlantManyRoles">Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012 Apr;31(4):151-9. doi: 10.4103/0257-7941.107344. PMID: 23661861; PMCID: PMC3644751</ref><br />
<br />
* Clerodane‑type diterpenoids<br />
* Cordifolioside A and tinosporaside (used as assay markers)<br />
* Alkaloids such as magnoflorine and berberine‑like compounds<br />
* Diterpenoid lactones and glycosides<br />
<br />
These constituents are thought to contribute to the herb’s bitter taste, immunomodulatory, anti‑inflammatory, and antioxidant properties.<ref name="ImmunomodulatoryReview"/><br />
<br />
== Pharmacological actions ==<br />
<br />
Experimental studies, including in vitro and animal models, support several pharmacological activities of Guduchi extracts.<ref name="ImmunomodulatoryReview"/><ref name="OnePlantManyRoles"/><br />
<br />
* Immunomodulatory effects: Modulation of immune cell function and cytokine pathways.<ref name="ImmunomodulatoryReview"/><br />
* Anti‑inflammatory effects: Reduction of pro‑inflammatory cytokines such as TNF‑α and IL‑1β.<ref name="ImmunomodulatoryReview"/><ref name="ScientificReports2019">{{Cite Ghatpande NS, Misar AV, Waghole RJ, Jadhav SH, Kulkarni PP. Tinospora cordifolia protects against inflammation associated anemia by modulating inflammatory cytokines and hepcidin expression in male Wistar rats. Sci Rep. 2019 Jul 29;9(1):10969. doi: 10.1038/s41598-019-47458-0. PMID: 31358831; PMCID: PMC6662690}}</ref><br />
* Antioxidant activity: Scavenging of free radicals and reduction of oxidative stress.<ref name="OnePlantManyRoles"/><br />
* Antipyretic and analgesic activity in fever‑like models.<ref name="ImmunomodulatoryReview"/><br />
<br />
Some studies also report hepatoprotective, hypoglycemic, and anti‑arthritic‑like effects, although the exact mechanisms and clinical relevance remain under investigation.<ref name="OnePlantManyRoles"/><ref name="ImmunomodulatoryReview"/><br />
<br />
== Metabolic and endocrine research ==<br />
<br />
Recent reviews suggest that Guduchi may have beneficial effects on diabetes, hyperlipidemia, obesity, and related features of metabolic syndrome.<ref name="MetabolicReview2025">{{Mansouri M, Imenshahidi M, Rameshrad M, Hosseinzadeh H. Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review. Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4979-5009. doi: 10.1007/s00210-024-03642-2. Epub 2024 Dec 28. PMID: 39731594.}}</ref> Anti‑diabetic and antihyperglycemic actions have been reported in animal models and some small human studies, including a randomized trial in diabetic dyslipidemia showing improvement in lipid profile, inflammatory markers, and metabolic‑syndrome prevalence with Guduchi‑stem supplementation.<ref name="DiabeticDyslipidemiaRCT">{{Cite journal |year=2024 |title=Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open‑labelled randomized controlled trial |journal=International Journal of Research and Pharmaceutical Sciences |volume=15 |issue=12 |pages=100–107 |url=https://ffhdj.com/index.php/ffhd/article/view/208}}</ref><br />
<br />
However, the overall evidence base still relies heavily on preclinical data and heterogeneous herbal preparations rather than standardized, large‑scale randomized trials.<ref name="MetabolicReview2025"/><br />
<br />
== Musculoskeletal and inflammatory conditions ==<br />
<br />
Guduchi is traditionally used for vatarakta and amavata, conditions resembling gout and rheumatoid arthritis.<ref name="AYUSHDossier"/> Preclinical studies in arthritis models show that ''T. cordifolia'' extracts can reduce inflammatory mediators and markers of joint destruction, supporting its traditional anti‑arthritic use.<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<br />
However, the evidence is still preliminary, and current data justify Guduchi mainly as a potential adjunct to conventional therapy rather than as a standalone monotherapy for chronic inflammatory joint disease.<ref name="Arthritis2015"/><br />
<br />
== Safety and hepatotoxicity ==<br />
<br />
In recent years, several case reports and reviews have described herb‑induced liver injury associated with Guduchi or ''Tinospora''‑containing products.<ref name="LiverTox"/>,<ref name="PMC2021LiverInjury">Björnsson ES, Navarro VJ, Chalasani N. Liver Injury Following Tinospora Cordifolia Consumption: Drug-Induced AIH, or de novo AIH? J Clin Exp Hepatol. 2022 Jan-Feb;12(1):6-9. doi: 10.1016/j.jceh.2021.11.014. Epub 2021 Nov 29. PMID: 35068778; PMCID: PMC8766689.</ref><br />
<br />
The NIH LiverTox resource notes that Guduchi‑associated liver injury can range from mild elevation of liver enzymes to clinically significant hepatitis and, rarely, acute liver failure, with some cases showing autoimmune‑like features.<ref name="LiverTox"/> Many cases occur in patients with pre‑existing liver disease or autoimmune predisposition and may be idiosyncratic or immune‑mediated.<ref name="LiverTox"/><br />
<br />
The AYUSH technical dossier highlights that many published liver injury reports lack detailed baseline documentation and may mix different species and preparations, underscoring the need for careful botanical identification, product quality control, and medical supervision, especially in patients with pre‑existing liver conditions.<ref name="AYUSHDossier"/><br />
<br />
== Current research trends ==<br />
<br />
PubMed‑based trend analyses indicate a substantial increase in publications on Guduchi, rising from several hundred articles in the early 2010s to over 900 indexed studies by 2024, reflecting growing scientific interest.<ref name="AYUSHDossier"/> This growth reflects heightened scientific and public interest but does not, by itself, equate to high‑quality clinical evidence.<ref name="MetabolicReview2025"/><br />
<br />
Most of the current evidence is from preclinical studies, mechanistic investigations, small trials, and narrative reviews; large, well‑designed randomized controlled trials are still limited.<ref name="MetabolicReview2025"/><br />
<br />
== Clinical position ==<br />
<br />
From an Ayurvedic perspective, Guduchi is regarded as a classical Rasayana with broad therapeutic indications, supported by long‑standing clinical experience.<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles"/> From a modern evidence‑based medicine standpoint, it is best viewed as a promising but not yet fully established botanical agent for conditions such as metabolic syndrome, certain inflammatory disorders, and liver and immune‑mediated conditions.<ref name="MetabolicReview2025"/><br />
<br />
Use in clinical practice should emphasize:<ref name="LiverTox"/><ref name="AYUSHDossier"/><br />
<br />
* Accurate botanical identification and use of standardized preparations<br />
* Caution in patients with liver disease or autoimmunity<br />
* Integration with, rather than substitution for, established medical therapies<br />
<br />
=== Indian Medicinal Plant Database, Phytochemistry And Therapeutics (IMPPAT) ===<br />
<br />
Link: https://cb.imsc.res.in/imppat/phytochemical/Tinospora%20crispa <br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development ..<br />
<br />
==References==</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Talk:Guduchi&diff=45432Talk:Guduchi2026-04-13T10:17:30Z<p>Agnivesha: /* Current research trends */</p>
<hr />
<div>Guduchi (Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.)<br />
<br />
''Guduchi'' ({{langx|sa|गुडूची}}), commonly known as [[Giloy]], is the Sanskrit name for the medicinal plant [[Tinospora cordifolia]] (Willd.) Hook. f. & Thomson of the family [[Menispermaceae]].<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref> It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<ref name="AYUSHDossier"/><br />
<br />
<br />
{{Infobox<br />
|title = Guduchi<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Guduchi<br />
|label2 = Botanical name(s)<br />
|data2 = Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
|label3 = Family<br />
|data3 = Menispermaceae<br />
|label4 = Availability<br />
|data4 = Available<br />
|label5 = Contributors<br />
|data5 = --<br />
|label6 = Year of publication <br />
|data6 = 2026<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Skill Development Centre]], Symbiohealth Foundation, India<br />
|label8 = DOI <br />
|data8 = Awaited<br />
}}<br />
<br />
==English name == <br />
<br />
Heart leaved moonseed<br />
<br />
== Botanical identity ==<br />
<br />
The principal medicinal source of Guduchi is the stem of ''Tinospora cordifolia''.<ref name="AYUSHDossier"/> The plant is a deciduous, climbing shrub with simple, heart‑shaped leaves and small, greenish flowers.<ref name="AYUSHDossier"/> The genus ''Tinospora'' includes several species, and correct identification is important because some related species (e.g., ''Tinospora crispa'') have been implicated in hepatotoxicity reports.<ref name="LiverTox">Nnamani I, Tolu-Akinnawo O, Dufera RR, Akintunde A, Maliakkal B. Tinospora cordifolia (Guduchi/Giloy)-Induced Liver Injury: A Case Review. Cureus. 2023 May 31;15(5):e39793. doi: 10.7759/cureus.39793. PMID: 37273324; PMCID: PMC10238282.</ref><br />
<br />
For Ayurvedic purposes, the AYUSH technical dossier specifies that properly identified ''T. cordifolia'' stem should be used, warning against confusion with other ''Tinospora'' species that may occur in commercial supply.<ref name="AYUSHDossier"/><br />
<br />
== Other botanical names/varieties ==<br />
<br />
The following botanical names are accepted by Plants of the World Online as of January 2024.<br />
<br />
* Tinospora crispa (L.) Hook.f. & Thomson<br />
* Tinospora sinensis (Lour.) Merr<br />
* Tinospora arfakiana Becc.<br />
* Tinospora baenzigeri Forman<br />
* Tinopora bakis (A.Rich.)Miers<br />
* Tinospora celebica Diels<br />
* Tinopora dissitiflora (K.Schum. & Lauterb.) Diels<br />
* Tinopora esiangkara (F.M..Bailey) Forman<br />
* Tinospora formanii Udayan & Pradeep<br />
* Tinospora fragosa (I.Verd.) I.Verd. & Troupin<br />
* Tinospora glabra (Burm.f.)Merr.<br />
* Tinospora glandulosa Merr.<br />
* Tinospora guangxiensis H.S.Lo<br />
* Tinospora hainanensis H.S.Lo &Z.X.Li<br />
* Tinospora hirsuta (Becc.) Forman<br />
* Tinospora homosepala Diels<br />
* Tinospora macrocarpa Diels<br />
* Tinospora merriliana Diels<br />
* Tinospora neocaledonica Forman<br />
* Tinospora nudiflora (Griff.) Kurz<br />
* Tinospora orophila Troupin<br />
* Tinospora palminervis Miers<br />
* Tinospora siamensis Forman<br />
* Tinospora smilacina Benth.<br />
* Tinospora sumatrana Becc.<br />
* Tinospora teijsmannii Boerl.<br />
* Tinospora tenera Miers.<br />
* Tinospora tinosporoides (F.Muell.) Forman<br />
* Tinospora trilobata Diels.<br />
<br />
== Synonyms in Charak Samhita==<br />
<br />
Amruta, Madhuparni, Vayastha, Chhinnaruha, Vatsadini<br />
<br />
== Synonyms in Bhavaprakasha Nighantu ==<br />
Guduchi, Madhuparni, Amrita, Amritavallari, Chhinna, Chhinnaruha, Chhinnodbhava, Vatsadani, Jivanti, Tantrika, Soma, Somavalli, Kundali, Chakralakshanika, Dhira, Vishalya, Rasayani, Chandrahasa, Vayastha, Mandali, Devanirmita<br />
<br />
==Anupana according to Dosha==<br />
* '''Vata''' – Ghrita <br />
* '''Pitta''' – Sharkara (Sugar)<br />
* '''Kapha''' – Madhu (Honey)<br />
* '''Vibandha''' (Constipation)– Guda (Jaggery)<br />
* '''Vatarakta''' (Gout) – Eranda taila (Castor oil)<br />
* '''Amavaata'''(Rhumatoid arthritis) – Shunthi (Ginger)<br />
<br />
== Ayurvedic pharmacological properties ==<br />
{| class="wikitable"<br />
|+Table 1: Properties of Guduchi<br />
|-<br />
! Sr.no. !! Pharmacological criteria !! Properties<br />
|-<br />
| 1 || Taste ([[rasa]]) || Bitter (tikta), Astringent (kashaya)<br />
|-<br />
| 2 || Potency ([[veerya]]) || Hot (ushna)<br />
|-<br />
| 3 || Post digestion effect ([[vipaka]]) || Sweet (madhura)<br />
|-<br />
| 4 || Qualities ([[guna]])|| Heavy (guru), Unctuous (snigdha)<br />
|-<br />
| 5 || Actions ([[karma]]) || Pacify [[vata]], [[pitta]] and [[kapha]]<br />
|}<br />
== Reference in Charak Samhita and its actions == <br />
<br />
{| class="wikitable"<br />
|+ Herbs and their activities<br />
|-<br />
! Sr.no. !! Reference in Charak Samhita !! Activity <br />
|-<br />
| 1 ||Cha.Sa.[[Sutra Sthana]] 2/12 || Asthapana<br />
|-<br />
| 2 || Cha.Sa.[[Sutra Sthana]] 3/3 || Siddhatamachurnapradeha<br />
|-<br />
| 3 ||Cha.Sa.[[Sutra Sthana]] 4/9(11) || Truptighnamahakashay<br />
|-<br />
| 4 ||Cha.Sa.[[Sutra Sthana]] 4/9(18) || Stanyashodhanamahakashay<br />
|-<br />
| 5 ||Cha.Sa.[[Sutra Sthana]] 4/9(21) || Snehopagmahakashay<br />
|-<br />
| 6 ||Cha.Sa.[[Sutra Sthana]] 4/9(29) || Trishnanigrahanamahakashay<br />
|-<br />
| 7 ||Cha.Sa.[[Sutra Sthana]] 4/9(41) || Dahaprashamanamahakashaya<br />
|-<br />
| 8 ||Cha.Sa.[[Sutra Sthana]] 4/9(49) || Prajasthapanamahakashaya<br />
|-<br />
| 9 ||Cha.Sa.[[Sutra Sthana]] 4/9(50) || Vayasthapanmahakashaya<br />
|-<br />
| 10 ||Cha.Sa.[[Sutra Sthana]] 14/31 <br />
| Dravya for Nadi Sweda<br />
|-<br />
| 11 ||Cha.Sa.[[Sutra Sthana]] 21/22 <br />
| Management of obesity<br />
|-<br />
|12<br />
|Cha.Sa.[[Sutra Sthana]] 25/40<br />
|Agrya Sangraha<br />
|-<br />
|13<br />
|Cha.Sa.[[Sutra Sthana]]27/4<br />
|Natural qualities.<br />
|-<br />
|14<br />
|Cha.Sa.[[Sutra Sthana]] 27/106<br />
|Shaka Varga<br />
|-<br />
|15<br />
|Cha.Sa.[[Sutra Sthana]] 26/49<br />
|Veerya varnan<br />
|-<br />
|16<br />
|Cha.Sa.[[Vimana Sthana]] 8/135<br />
|Vaman dravyani<br />
|-<br />
|17<br />
|Cha.Sa.[[Vimana Sthana]] 8/139<br />
|Madhur skanda<br />
|-<br />
|18<br />
|Cha.Sa.[[Vimana Sthana]] 8/143<br />
|Tikta skandha<br />
|-<br />
|19<br />
|Cha.Sa.[[Sharira Sthana]].8/56<br />
|Kshira vishodhana dravya<br />
|-<br />
|20<br />
|Cha.Sa.[[Kalpa Sthana]] 1/22<br />
|Vamanartha<br />
|-<br />
|21<br />
|Cha.Sa.[[Kalpa Sthana]] 7/19<br />
|Preparations of Trivritta<br />
|-<br />
|22<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/198<br />
|Used as kwath or sheeta kashaya for trushna, deepana, doshapachana, jwar, aruchi and mukhavairasya.<br />
|-<br />
|23<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in trutiyaka jwara.<br />
|-<br />
|24<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in chaturthaka jwara.<br />
|-<br />
|25<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/211<br />
|As an ingredient of shatyadi varga used in kasa, svasa, tandra,parshvashoola, hrdgraha and sannipata jwara.<br />
|-<br />
|26<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/222<br />
|As an ingredient of Vasadi Ghrita.<br />
|-<br />
|27<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/247<br />
|Used in niruha basti.<br />
|-<br />
|28<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/251<br />
|Used in Patoladi niruha basti.<br />
|-<br />
|29<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/267<br />
|In formulation of Agurvadi taila.<br />
|-<br />
|30<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/299<br />
|Used as swarasa in Vishama jwara.<br />
|-<br />
|31<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/343<br />
|Used in punaravrtaka jwara(Kirat tiktadi kwath)<br />
|-<br />
|32<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/29<br />
|Used for making decoction in Kaphaj prameh<br />
|-<br />
|33<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/30<br />
|Used for making decoction in Pittaja Prameha <br />
|-<br />
|34<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/77<br />
|Ingredient in Kanakabindurishta<br />
|-<br />
|35<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/124<br />
|Bahyaprayogarth Lepa in Vata-Kaphaja Kushtha<br />
|-<br />
|36<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/146<br />
|Ingredient in Mahatikta Ghrita<br />
|-<br />
|37<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/153<br />
|Ingredient in Mahakhadira Ghrita<br />
|-<br />
|38<br />
|Cha.Sa.[[Chikitsa Sthana]] 8/72<br />
|For Parisheka purpose<br />
|-<br />
|39<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/25<br />
|In treatment of Vataja Shvayathu<br />
|-<br />
|40<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/34<br />
|Ingredient in Punarnavadyarishta<br />
|-<br />
|41<br />
|Cha.Sa.[[Chikitsa Sthana]] 5/190<br />
|Used in preparation of Panchama Kshara<br />
|-<br />
|42<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/63<br />
|In Kamala Guduchi Swarasa should be given in early in the morning <br />
|-<br />
|43<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/134 <br />
|Used in Halimak Chikitsa<br />
|-<br />
|44<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/94<br />
|Used in yusha preparation for hikka svasa<br />
|-<br />
|45<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/102<br />
|Used as yavagu in hikka svasa<br />
|-<br />
|46<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/35<br />
|As a ghrita dravya<br />
|-<br />
|47<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/161<br />
|As an ingredient of guduchyadi ghrita.<br />
|-<br />
|48<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/31 <br />
|As a pana yoga in Pittaja chhardi.<br />
|-<br />
|49<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/35<br />
|As a pathya ahara in kaphaja chhardi.<br />
|-<br />
|50<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/58<br />
|For kashaya pana.<br />
|-<br />
|51<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/130<br />
|Used in granthi visarpa.<br />
|-<br />
|52<br />
|Cha.Sa.[[Chikitsa Sthana]] 22/45<br />
|As a pana yoga.<br />
|-<br />
|53<br />
|Cha.Sa.[[Chikitsa Sthana]] 23/70<br />
|As an ingredient of Gandha hasti agada.<br />
|-<br />
|54<br />
|Cha.Sa.[[Chikitsa Sthana]] 24/145<br />
|Used as swarasa where pittaja madatyaya is associated with sarakta kasa, Parshvashoola, Stanashoola, Daaha & Hradayotkleda.<br />
|-<br />
|55<br />
|Cha.Sa.[[Chikitsa Sthana]] 25/75<br />
|Used in shoola with sneha & sarkara.<br />
|-<br />
|56<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/57<br />
|Used in Kaphaja mutrakruchhra.<br />
|-<br />
|57<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/70<br />
|As an ingredient of Karpasmooladi yoga.<br />
|-<br />
|58<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/83<br />
|As an ingredient of Haritakyadi Ghrita.<br />
|-<br />
|59<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/243<br />
|As an ingredient of Amrutadi varti.<br />
|-<br />
|60<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/283<br />
|Used in Vataja swarbheda.<br />
|-<br />
|61<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/148<br />
|As an ingredient of Bala taila. <br />
|-<br />
|62<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/157<br />
|As an ingredient of Amrutadi taila.<br />
|-<br />
|63<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/170<br />
|As an ingredient of Vrushamuladi taila.<br />
|-<br />
|64<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/172<br />
|As an ingredient of Mulaka taila.<br />
|-<br />
|65<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/71<br />
|Anupana of Drakshadi Ghrita.<br />
|-<br />
|66<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/73<br />
|As an ingredient of Jeevakadi mahasneha.<br />
|-<br />
|67<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/92<br />
|As an ingredient of Madhuparnyadi taila.<br />
|-<br />
|68<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/103<br />
|As an ingredient of Amrutadhya taila.<br />
|-<br />
|69<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/117<br />
|As an ingredient of Shatapaka Madhuparni taila.<br />
|-<br />
|70<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/53<br />
|As an ingredient of Kashmaryadi ghrita, used in the treatment of Vataja yoni.<br />
|-<br />
|71<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/58<br />
|For parishechana in yoni shula.<br />
|-<br />
|72<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/99<br />
|Used in the treatment of Kaphaja pradara.<br />
|-<br />
|73<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/59<br />
|As an ingredient of Guduchyadi taila, used in the treatment of Vataja yoni roga.<br />
|-<br />
|}<br />
<br />
== Classical therapeutic uses ==<br />
<br />
Guduchi is one of the most frequently cited herbs in Ayurvedic literature and is reported in formulations for a wide range of conditions, including:<ref name="AYUSHDossier"/><br />
<br />
Classical actions attributed to Guduchi include:<ref name="AYUSHDossier"/><br />
<br />
* Rasayana (rejuvenative)<br />
* Dipana and Sangrahi (appetizing and absorbent)<br />
* Vataraktahara and Amavataghni (useful in gout and rheumatoid‑like arthritis)<br />
* Kamalahara (beneficial in jaundice and liver disorders)<br />
* Kushtaghna (beneficial in skin diseases)<br />
* Pramehaghna (beneficial in urinary and metabolic disorders)<br />
* Jvara (fever), including irregular and chronic fevers<br />
* Kamala (jaundice) and other hepatic and viral fevers<br />
* Vatarakta and amavata (gout and rheumatoid‑like arthritis)<br />
* Kasa (chronic cough)<br />
* Prameha (Diabetes mellitus and metabolic disorders)<br />
* Chardighna (anti‑emetic indications)<br />
<br />
The AYUSH technical dossier notes that Guduchi appears in more than 2,400 Ayurvedic formulations across over 24 dosage forms, indicating its broad and enduring therapeutic role.<ref name="AYUSHDossier"/><br />
<br />
== Parts used and dosage forms ==<br />
<br />
In Ayurvedic practice, the mature stem is the primary part used for preparing Guduchi‑based medicines.<ref name="AYUSHDossier"/> Common traditional dosage forms include:<ref name="AYUSHDossier"/><br />
<br />
* Churna (powder)<br />
* Kwatha (decoction)<br />
* Hima (cold infusion)<br />
* Svarasa (fresh juice)<br />
* Satva (starch preparation)<br />
* Ghrita (medicated ghee)<br />
* Taila (medicated oil)<br />
* Gutika (tablets)<br />
<br />
== Important Formulations ==<br />
<br />
* Amritarishta<br />
* Amritottara kvatha churna<br />
* Guduchi Taila<br />
* Guduchyadi churna<br />
* Guduchi Sattva<br />
* Chhinnodbhavadi kvatha churna<br />
* Kaishora Guggulu<br />
* Samshamani Vati<br />
<br />
==Dose==<br />
<br />
The AYUSH technical dossier cites typical dose ranges as:<ref name="AYUSHDossier"/><br />
* 3–6 g of powder<br />
* 20–30 g of coarse powder for decoction<br />
* 125 mg–1000 mg of Guduchi sattva, taken with appropriate anupana (vehicle)<br />
<br />
== Current availability== <br />
<br />
Available <br />
<br />
Through all over India extending from Himalayas to the Southern part of India.<br />
<br />
Other countries: Nepal, Bangladesh, Pakistan, Myanmar, Burma, Sri Lanka, Malaysia, Indonesia and Thailand<br />
<br />
== Current researches ==<br />
<br />
== Chemical constituents ==<br />
<br />
Modern phytochemical studies have identified more than 200 compounds in ''Tinospora cordifolia'' and related species, including diterpenoids, alkaloids, glycosides, steroids, sesquiterpenoids, and phenolics.<ref name="ImmunomodulatoryReview">Yates CR, Bruno EJ, Yates MED. Tinospora Cordifolia: A review of its immunomodulatory properties. J Diet Suppl. 2022;19(2):271-285. doi: 10.1080/19390211.2021.1873214. Epub 2021 Jan 22. PMID: 33480818.</ref> Key constituents reported in the literature include:<ref name="AYUSHDossier"/>,<ref name="OnePlantManyRoles">Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012 Apr;31(4):151-9. doi: 10.4103/0257-7941.107344. PMID: 23661861; PMCID: PMC3644751</ref><br />
<br />
* Clerodane‑type diterpenoids<br />
* Cordifolioside A and tinosporaside (used as assay markers)<br />
* Alkaloids such as magnoflorine and berberine‑like compounds<br />
* Diterpenoid lactones and glycosides<br />
<br />
These constituents are thought to contribute to the herb’s bitter taste, immunomodulatory, anti‑inflammatory, and antioxidant properties.<ref name="ImmunomodulatoryReview"/><br />
<br />
== Pharmacological actions ==<br />
<br />
Experimental studies, including in vitro and animal models, support several pharmacological activities of Guduchi extracts.<ref name="ImmunomodulatoryReview"/><ref name="OnePlantManyRoles"/><br />
<br />
* Immunomodulatory effects: Modulation of immune cell function and cytokine pathways.<ref name="ImmunomodulatoryReview"/><br />
* Anti‑inflammatory effects: Reduction of pro‑inflammatory cytokines such as TNF‑α and IL‑1β.<ref name="ImmunomodulatoryReview"/><ref name="ScientificReports2019">{{Cite Ghatpande NS, Misar AV, Waghole RJ, Jadhav SH, Kulkarni PP. Tinospora cordifolia protects against inflammation associated anemia by modulating inflammatory cytokines and hepcidin expression in male Wistar rats. Sci Rep. 2019 Jul 29;9(1):10969. doi: 10.1038/s41598-019-47458-0. PMID: 31358831; PMCID: PMC6662690}}</ref><br />
* Antioxidant activity: Scavenging of free radicals and reduction of oxidative stress.<ref name="OnePlantManyRoles"/><br />
* Antipyretic and analgesic activity in fever‑like models.<ref name="ImmunomodulatoryReview"/><br />
<br />
Some studies also report hepatoprotective, hypoglycemic, and anti‑arthritic‑like effects, although the exact mechanisms and clinical relevance remain under investigation.<ref name="OnePlantManyRoles"/><ref name="ImmunomodulatoryReview"/><br />
<br />
== Metabolic and endocrine research ==<br />
<br />
Recent reviews suggest that Guduchi may have beneficial effects on diabetes, hyperlipidemia, obesity, and related features of metabolic syndrome.<ref name="MetabolicReview2025">{{Mansouri M, Imenshahidi M, Rameshrad M, Hosseinzadeh H. Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review. Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4979-5009. doi: 10.1007/s00210-024-03642-2. Epub 2024 Dec 28. PMID: 39731594.}}</ref> Anti‑diabetic and antihyperglycemic actions have been reported in animal models and some small human studies, including a randomized trial in diabetic dyslipidemia showing improvement in lipid profile, inflammatory markers, and metabolic‑syndrome prevalence with Guduchi‑stem supplementation.<ref name="DiabeticDyslipidemiaRCT">{{Cite journal |year=2024 |title=Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open‑labelled randomized controlled trial |journal=International Journal of Research and Pharmaceutical Sciences |volume=15 |issue=12 |pages=100–107 |url=https://ffhdj.com/index.php/ffhd/article/view/208}}</ref><br />
<br />
However, the overall evidence base still relies heavily on preclinical data and heterogeneous herbal preparations rather than standardized, large‑scale randomized trials.<ref name="MetabolicReview2025"/><br />
<br />
== Musculoskeletal and inflammatory conditions ==<br />
<br />
Guduchi is traditionally used for vatarakta and amavata, conditions resembling gout and rheumatoid arthritis.<ref name="AYUSHDossier"/> Preclinical studies in arthritis models show that ''T. cordifolia'' extracts can reduce inflammatory mediators and markers of joint destruction, supporting its traditional anti‑arthritic use.<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<br />
However, the evidence is still preliminary, and current data justify Guduchi mainly as a potential adjunct to conventional therapy rather than as a standalone monotherapy for chronic inflammatory joint disease.<ref name="Arthritis2015"/><br />
<br />
== Safety and hepatotoxicity ==<br />
<br />
In recent years, several case reports and reviews have described herb‑induced liver injury associated with Guduchi or ''Tinospora''‑containing products.<ref name="LiverTox"/>,<ref name="PMC2021LiverInjury">Björnsson ES, Navarro VJ, Chalasani N. Liver Injury Following Tinospora Cordifolia Consumption: Drug-Induced AIH, or de novo AIH? J Clin Exp Hepatol. 2022 Jan-Feb;12(1):6-9. doi: 10.1016/j.jceh.2021.11.014. Epub 2021 Nov 29. PMID: 35068778; PMCID: PMC8766689.</ref><br />
<br />
The NIH LiverTox resource notes that Guduchi‑associated liver injury can range from mild elevation of liver enzymes to clinically significant hepatitis and, rarely, acute liver failure, with some cases showing autoimmune‑like features.<ref name="LiverTox"/> Many cases occur in patients with pre‑existing liver disease or autoimmune predisposition and may be idiosyncratic or immune‑mediated.<ref name="LiverTox"/><br />
<br />
The AYUSH technical dossier highlights that many published liver injury reports lack detailed baseline documentation and may mix different species and preparations, underscoring the need for careful botanical identification, product quality control, and medical supervision, especially in patients with pre‑existing liver conditions.<ref name="AYUSHDossier"/><br />
<br />
== Current research trends ==<br />
<br />
PubMed‑based trend analyses indicate a substantial increase in publications on Guduchi, rising from several hundred articles in the early 2010s to over 900 indexed studies by 2024, reflecting growing scientific interest.<ref name="AYUSHDossier"/> This growth reflects heightened scientific and public interest but does not, by itself, equate to high‑quality clinical evidence.<ref name="MetabolicReview2025"/><br />
<br />
Most of the current evidence is from preclinical studies, mechanistic investigations, small trials, and narrative reviews; large, well‑designed randomized controlled trials are still limited.<ref name="MetabolicReview2025"/><br />
<br />
== Clinical position ==<br />
<br />
From an Ayurvedic perspective, Guduchi is regarded as a classical Rasayana with broad therapeutic indications, supported by long‑standing clinical experience.<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles"/> From a modern evidence‑based medicine standpoint, it is best viewed as a promising but not yet fully established botanical agent for conditions such as metabolic syndrome, certain inflammatory disorders, and liver and immune‑mediated conditions.<ref name="MetabolicReview2025"/><br />
<br />
Use in clinical practice should emphasize:<ref name="LiverTox"/><ref name="AYUSHDossier"/><br />
<br />
* Accurate botanical identification and use of standardized preparations<br />
* Caution in patients with liver disease or autoimmunity<br />
* Integration with, rather than substitution for, established medical therapies<br />
<br />
=== Indian Medicinal Plant Database, Phytochemistry And Therapeutics (IMPPAT) ===<br />
<br />
Link: https://cb.imsc.res.in/imppat/phytochemical/Tinospora%20crispa <br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development ..<br />
<br />
==References==</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Talk:Guduchi&diff=45431Talk:Guduchi2026-04-13T10:14:57Z<p>Agnivesha: /* Clinical position */</p>
<hr />
<div>Guduchi (Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.)<br />
<br />
''Guduchi'' ({{langx|sa|गुडूची}}), commonly known as [[Giloy]], is the Sanskrit name for the medicinal plant [[Tinospora cordifolia]] (Willd.) Hook. f. & Thomson of the family [[Menispermaceae]].<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref> It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<ref name="AYUSHDossier"/><br />
<br />
<br />
{{Infobox<br />
|title = Guduchi<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Guduchi<br />
|label2 = Botanical name(s)<br />
|data2 = Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
|label3 = Family<br />
|data3 = Menispermaceae<br />
|label4 = Availability<br />
|data4 = Available<br />
|label5 = Contributors<br />
|data5 = --<br />
|label6 = Year of publication <br />
|data6 = 2026<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Skill Development Centre]], Symbiohealth Foundation, India<br />
|label8 = DOI <br />
|data8 = Awaited<br />
}}<br />
<br />
==English name == <br />
<br />
Heart leaved moonseed<br />
<br />
== Botanical identity ==<br />
<br />
The principal medicinal source of Guduchi is the stem of ''Tinospora cordifolia''.<ref name="AYUSHDossier"/> The plant is a deciduous, climbing shrub with simple, heart‑shaped leaves and small, greenish flowers.<ref name="AYUSHDossier"/> The genus ''Tinospora'' includes several species, and correct identification is important because some related species (e.g., ''Tinospora crispa'') have been implicated in hepatotoxicity reports.<ref name="LiverTox">Nnamani I, Tolu-Akinnawo O, Dufera RR, Akintunde A, Maliakkal B. Tinospora cordifolia (Guduchi/Giloy)-Induced Liver Injury: A Case Review. Cureus. 2023 May 31;15(5):e39793. doi: 10.7759/cureus.39793. PMID: 37273324; PMCID: PMC10238282.</ref><br />
<br />
For Ayurvedic purposes, the AYUSH technical dossier specifies that properly identified ''T. cordifolia'' stem should be used, warning against confusion with other ''Tinospora'' species that may occur in commercial supply.<ref name="AYUSHDossier"/><br />
<br />
== Other botanical names/varieties ==<br />
<br />
The following botanical names are accepted by Plants of the World Online as of January 2024.<br />
<br />
* Tinospora crispa (L.) Hook.f. & Thomson<br />
* Tinospora sinensis (Lour.) Merr<br />
* Tinospora arfakiana Becc.<br />
* Tinospora baenzigeri Forman<br />
* Tinopora bakis (A.Rich.)Miers<br />
* Tinospora celebica Diels<br />
* Tinopora dissitiflora (K.Schum. & Lauterb.) Diels<br />
* Tinopora esiangkara (F.M..Bailey) Forman<br />
* Tinospora formanii Udayan & Pradeep<br />
* Tinospora fragosa (I.Verd.) I.Verd. & Troupin<br />
* Tinospora glabra (Burm.f.)Merr.<br />
* Tinospora glandulosa Merr.<br />
* Tinospora guangxiensis H.S.Lo<br />
* Tinospora hainanensis H.S.Lo &Z.X.Li<br />
* Tinospora hirsuta (Becc.) Forman<br />
* Tinospora homosepala Diels<br />
* Tinospora macrocarpa Diels<br />
* Tinospora merriliana Diels<br />
* Tinospora neocaledonica Forman<br />
* Tinospora nudiflora (Griff.) Kurz<br />
* Tinospora orophila Troupin<br />
* Tinospora palminervis Miers<br />
* Tinospora siamensis Forman<br />
* Tinospora smilacina Benth.<br />
* Tinospora sumatrana Becc.<br />
* Tinospora teijsmannii Boerl.<br />
* Tinospora tenera Miers.<br />
* Tinospora tinosporoides (F.Muell.) Forman<br />
* Tinospora trilobata Diels.<br />
<br />
== Synonyms in Charak Samhita==<br />
<br />
Amruta, Madhuparni, Vayastha, Chhinnaruha, Vatsadini<br />
<br />
== Synonyms in Bhavaprakasha Nighantu ==<br />
Guduchi, Madhuparni, Amrita, Amritavallari, Chhinna, Chhinnaruha, Chhinnodbhava, Vatsadani, Jivanti, Tantrika, Soma, Somavalli, Kundali, Chakralakshanika, Dhira, Vishalya, Rasayani, Chandrahasa, Vayastha, Mandali, Devanirmita<br />
<br />
==Anupana according to Dosha==<br />
* '''Vata''' – Ghrita <br />
* '''Pitta''' – Sharkara (Sugar)<br />
* '''Kapha''' – Madhu (Honey)<br />
* '''Vibandha''' (Constipation)– Guda (Jaggery)<br />
* '''Vatarakta''' (Gout) – Eranda taila (Castor oil)<br />
* '''Amavaata'''(Rhumatoid arthritis) – Shunthi (Ginger)<br />
<br />
== Ayurvedic pharmacological properties ==<br />
{| class="wikitable"<br />
|+Table 1: Properties of Guduchi<br />
|-<br />
! Sr.no. !! Pharmacological criteria !! Properties<br />
|-<br />
| 1 || Taste ([[rasa]]) || Bitter (tikta), Astringent (kashaya)<br />
|-<br />
| 2 || Potency ([[veerya]]) || Hot (ushna)<br />
|-<br />
| 3 || Post digestion effect ([[vipaka]]) || Sweet (madhura)<br />
|-<br />
| 4 || Qualities ([[guna]])|| Heavy (guru), Unctuous (snigdha)<br />
|-<br />
| 5 || Actions ([[karma]]) || Pacify [[vata]], [[pitta]] and [[kapha]]<br />
|}<br />
== Reference in Charak Samhita and its actions == <br />
<br />
{| class="wikitable"<br />
|+ Herbs and their activities<br />
|-<br />
! Sr.no. !! Reference in Charak Samhita !! Activity <br />
|-<br />
| 1 ||Cha.Sa.[[Sutra Sthana]] 2/12 || Asthapana<br />
|-<br />
| 2 || Cha.Sa.[[Sutra Sthana]] 3/3 || Siddhatamachurnapradeha<br />
|-<br />
| 3 ||Cha.Sa.[[Sutra Sthana]] 4/9(11) || Truptighnamahakashay<br />
|-<br />
| 4 ||Cha.Sa.[[Sutra Sthana]] 4/9(18) || Stanyashodhanamahakashay<br />
|-<br />
| 5 ||Cha.Sa.[[Sutra Sthana]] 4/9(21) || Snehopagmahakashay<br />
|-<br />
| 6 ||Cha.Sa.[[Sutra Sthana]] 4/9(29) || Trishnanigrahanamahakashay<br />
|-<br />
| 7 ||Cha.Sa.[[Sutra Sthana]] 4/9(41) || Dahaprashamanamahakashaya<br />
|-<br />
| 8 ||Cha.Sa.[[Sutra Sthana]] 4/9(49) || Prajasthapanamahakashaya<br />
|-<br />
| 9 ||Cha.Sa.[[Sutra Sthana]] 4/9(50) || Vayasthapanmahakashaya<br />
|-<br />
| 10 ||Cha.Sa.[[Sutra Sthana]] 14/31 <br />
| Dravya for Nadi Sweda<br />
|-<br />
| 11 ||Cha.Sa.[[Sutra Sthana]] 21/22 <br />
| Management of obesity<br />
|-<br />
|12<br />
|Cha.Sa.[[Sutra Sthana]] 25/40<br />
|Agrya Sangraha<br />
|-<br />
|13<br />
|Cha.Sa.[[Sutra Sthana]]27/4<br />
|Natural qualities.<br />
|-<br />
|14<br />
|Cha.Sa.[[Sutra Sthana]] 27/106<br />
|Shaka Varga<br />
|-<br />
|15<br />
|Cha.Sa.[[Sutra Sthana]] 26/49<br />
|Veerya varnan<br />
|-<br />
|16<br />
|Cha.Sa.[[Vimana Sthana]] 8/135<br />
|Vaman dravyani<br />
|-<br />
|17<br />
|Cha.Sa.[[Vimana Sthana]] 8/139<br />
|Madhur skanda<br />
|-<br />
|18<br />
|Cha.Sa.[[Vimana Sthana]] 8/143<br />
|Tikta skandha<br />
|-<br />
|19<br />
|Cha.Sa.[[Sharira Sthana]].8/56<br />
|Kshira vishodhana dravya<br />
|-<br />
|20<br />
|Cha.Sa.[[Kalpa Sthana]] 1/22<br />
|Vamanartha<br />
|-<br />
|21<br />
|Cha.Sa.[[Kalpa Sthana]] 7/19<br />
|Preparations of Trivritta<br />
|-<br />
|22<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/198<br />
|Used as kwath or sheeta kashaya for trushna, deepana, doshapachana, jwar, aruchi and mukhavairasya.<br />
|-<br />
|23<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in trutiyaka jwara.<br />
|-<br />
|24<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in chaturthaka jwara.<br />
|-<br />
|25<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/211<br />
|As an ingredient of shatyadi varga used in kasa, svasa, tandra,parshvashoola, hrdgraha and sannipata jwara.<br />
|-<br />
|26<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/222<br />
|As an ingredient of Vasadi Ghrita.<br />
|-<br />
|27<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/247<br />
|Used in niruha basti.<br />
|-<br />
|28<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/251<br />
|Used in Patoladi niruha basti.<br />
|-<br />
|29<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/267<br />
|In formulation of Agurvadi taila.<br />
|-<br />
|30<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/299<br />
|Used as swarasa in Vishama jwara.<br />
|-<br />
|31<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/343<br />
|Used in punaravrtaka jwara(Kirat tiktadi kwath)<br />
|-<br />
|32<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/29<br />
|Used for making decoction in Kaphaj prameh<br />
|-<br />
|33<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/30<br />
|Used for making decoction in Pittaja Prameha <br />
|-<br />
|34<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/77<br />
|Ingredient in Kanakabindurishta<br />
|-<br />
|35<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/124<br />
|Bahyaprayogarth Lepa in Vata-Kaphaja Kushtha<br />
|-<br />
|36<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/146<br />
|Ingredient in Mahatikta Ghrita<br />
|-<br />
|37<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/153<br />
|Ingredient in Mahakhadira Ghrita<br />
|-<br />
|38<br />
|Cha.Sa.[[Chikitsa Sthana]] 8/72<br />
|For Parisheka purpose<br />
|-<br />
|39<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/25<br />
|In treatment of Vataja Shvayathu<br />
|-<br />
|40<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/34<br />
|Ingredient in Punarnavadyarishta<br />
|-<br />
|41<br />
|Cha.Sa.[[Chikitsa Sthana]] 5/190<br />
|Used in preparation of Panchama Kshara<br />
|-<br />
|42<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/63<br />
|In Kamala Guduchi Swarasa should be given in early in the morning <br />
|-<br />
|43<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/134 <br />
|Used in Halimak Chikitsa<br />
|-<br />
|44<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/94<br />
|Used in yusha preparation for hikka svasa<br />
|-<br />
|45<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/102<br />
|Used as yavagu in hikka svasa<br />
|-<br />
|46<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/35<br />
|As a ghrita dravya<br />
|-<br />
|47<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/161<br />
|As an ingredient of guduchyadi ghrita.<br />
|-<br />
|48<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/31 <br />
|As a pana yoga in Pittaja chhardi.<br />
|-<br />
|49<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/35<br />
|As a pathya ahara in kaphaja chhardi.<br />
|-<br />
|50<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/58<br />
|For kashaya pana.<br />
|-<br />
|51<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/130<br />
|Used in granthi visarpa.<br />
|-<br />
|52<br />
|Cha.Sa.[[Chikitsa Sthana]] 22/45<br />
|As a pana yoga.<br />
|-<br />
|53<br />
|Cha.Sa.[[Chikitsa Sthana]] 23/70<br />
|As an ingredient of Gandha hasti agada.<br />
|-<br />
|54<br />
|Cha.Sa.[[Chikitsa Sthana]] 24/145<br />
|Used as swarasa where pittaja madatyaya is associated with sarakta kasa, Parshvashoola, Stanashoola, Daaha & Hradayotkleda.<br />
|-<br />
|55<br />
|Cha.Sa.[[Chikitsa Sthana]] 25/75<br />
|Used in shoola with sneha & sarkara.<br />
|-<br />
|56<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/57<br />
|Used in Kaphaja mutrakruchhra.<br />
|-<br />
|57<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/70<br />
|As an ingredient of Karpasmooladi yoga.<br />
|-<br />
|58<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/83<br />
|As an ingredient of Haritakyadi Ghrita.<br />
|-<br />
|59<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/243<br />
|As an ingredient of Amrutadi varti.<br />
|-<br />
|60<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/283<br />
|Used in Vataja swarbheda.<br />
|-<br />
|61<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/148<br />
|As an ingredient of Bala taila. <br />
|-<br />
|62<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/157<br />
|As an ingredient of Amrutadi taila.<br />
|-<br />
|63<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/170<br />
|As an ingredient of Vrushamuladi taila.<br />
|-<br />
|64<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/172<br />
|As an ingredient of Mulaka taila.<br />
|-<br />
|65<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/71<br />
|Anupana of Drakshadi Ghrita.<br />
|-<br />
|66<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/73<br />
|As an ingredient of Jeevakadi mahasneha.<br />
|-<br />
|67<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/92<br />
|As an ingredient of Madhuparnyadi taila.<br />
|-<br />
|68<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/103<br />
|As an ingredient of Amrutadhya taila.<br />
|-<br />
|69<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/117<br />
|As an ingredient of Shatapaka Madhuparni taila.<br />
|-<br />
|70<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/53<br />
|As an ingredient of Kashmaryadi ghrita, used in the treatment of Vataja yoni.<br />
|-<br />
|71<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/58<br />
|For parishechana in yoni shula.<br />
|-<br />
|72<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/99<br />
|Used in the treatment of Kaphaja pradara.<br />
|-<br />
|73<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/59<br />
|As an ingredient of Guduchyadi taila, used in the treatment of Vataja yoni roga.<br />
|-<br />
|}<br />
<br />
== Classical therapeutic uses ==<br />
<br />
Guduchi is one of the most frequently cited herbs in Ayurvedic literature and is reported in formulations for a wide range of conditions, including:<ref name="AYUSHDossier"/><br />
<br />
Classical actions attributed to Guduchi include:<ref name="AYUSHDossier"/><br />
<br />
* Rasayana (rejuvenative)<br />
* Dipana and Sangrahi (appetizing and absorbent)<br />
* Vataraktahara and Amavataghni (useful in gout and rheumatoid‑like arthritis)<br />
* Kamalahara (beneficial in jaundice and liver disorders)<br />
* Kushtaghna (beneficial in skin diseases)<br />
* Pramehaghna (beneficial in urinary and metabolic disorders)<br />
* Jvara (fever), including irregular and chronic fevers<br />
* Kamala (jaundice) and other hepatic and viral fevers<br />
* Vatarakta and amavata (gout and rheumatoid‑like arthritis)<br />
* Kasa (chronic cough)<br />
* Prameha (Diabetes mellitus and metabolic disorders)<br />
* Chardighna (anti‑emetic indications)<br />
<br />
The AYUSH technical dossier notes that Guduchi appears in more than 2,400 Ayurvedic formulations across over 24 dosage forms, indicating its broad and enduring therapeutic role.<ref name="AYUSHDossier"/><br />
<br />
== Parts used and dosage forms ==<br />
<br />
In Ayurvedic practice, the mature stem is the primary part used for preparing Guduchi‑based medicines.<ref name="AYUSHDossier"/> Common traditional dosage forms include:<ref name="AYUSHDossier"/><br />
<br />
* Churna (powder)<br />
* Kwatha (decoction)<br />
* Hima (cold infusion)<br />
* Svarasa (fresh juice)<br />
* Satva (starch preparation)<br />
* Ghrita (medicated ghee)<br />
* Taila (medicated oil)<br />
* Gutika (tablets)<br />
<br />
== Important Formulations ==<br />
<br />
* Amritarishta<br />
* Amritottara kvatha churna<br />
* Guduchi Taila<br />
* Guduchyadi churna<br />
* Guduchi Sattva<br />
* Chhinnodbhavadi kvatha churna<br />
* Kaishora Guggulu<br />
* Samshamani Vati<br />
<br />
==Dose==<br />
<br />
The AYUSH technical dossier cites typical dose ranges as:<ref name="AYUSHDossier"/><br />
* 3–6 g of powder<br />
* 20–30 g of coarse powder for decoction<br />
* 125 mg–1000 mg of Guduchi sattva, taken with appropriate anupana (vehicle)<br />
<br />
== Current availability== <br />
<br />
Available <br />
<br />
Through all over India extending from Himalayas to the Southern part of India.<br />
<br />
Other countries: Nepal, Bangladesh, Pakistan, Myanmar, Burma, Sri Lanka, Malaysia, Indonesia and Thailand<br />
<br />
== Current researches ==<br />
<br />
== Chemical constituents ==<br />
<br />
Modern phytochemical studies have identified more than 200 compounds in ''Tinospora cordifolia'' and related species, including diterpenoids, alkaloids, glycosides, steroids, sesquiterpenoids, and phenolics.<ref name="ImmunomodulatoryReview">Yates CR, Bruno EJ, Yates MED. Tinospora Cordifolia: A review of its immunomodulatory properties. J Diet Suppl. 2022;19(2):271-285. doi: 10.1080/19390211.2021.1873214. Epub 2021 Jan 22. PMID: 33480818.</ref> Key constituents reported in the literature include:<ref name="AYUSHDossier"/>,<ref name="OnePlantManyRoles">Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012 Apr;31(4):151-9. doi: 10.4103/0257-7941.107344. PMID: 23661861; PMCID: PMC3644751</ref><br />
<br />
* Clerodane‑type diterpenoids<br />
* Cordifolioside A and tinosporaside (used as assay markers)<br />
* Alkaloids such as magnoflorine and berberine‑like compounds<br />
* Diterpenoid lactones and glycosides<br />
<br />
These constituents are thought to contribute to the herb’s bitter taste, immunomodulatory, anti‑inflammatory, and antioxidant properties.<ref name="ImmunomodulatoryReview"/><br />
<br />
== Pharmacological actions ==<br />
<br />
Experimental studies, including in vitro and animal models, support several pharmacological activities of Guduchi extracts.<ref name="ImmunomodulatoryReview"/><ref name="OnePlantManyRoles"/><br />
<br />
* Immunomodulatory effects: Modulation of immune cell function and cytokine pathways.<ref name="ImmunomodulatoryReview"/><br />
* Anti‑inflammatory effects: Reduction of pro‑inflammatory cytokines such as TNF‑α and IL‑1β.<ref name="ImmunomodulatoryReview"/><ref name="ScientificReports2019">{{Cite Ghatpande NS, Misar AV, Waghole RJ, Jadhav SH, Kulkarni PP. Tinospora cordifolia protects against inflammation associated anemia by modulating inflammatory cytokines and hepcidin expression in male Wistar rats. Sci Rep. 2019 Jul 29;9(1):10969. doi: 10.1038/s41598-019-47458-0. PMID: 31358831; PMCID: PMC6662690}}</ref><br />
* Antioxidant activity: Scavenging of free radicals and reduction of oxidative stress.<ref name="OnePlantManyRoles"/><br />
* Antipyretic and analgesic activity in fever‑like models.<ref name="ImmunomodulatoryReview"/><br />
<br />
Some studies also report hepatoprotective, hypoglycemic, and anti‑arthritic‑like effects, although the exact mechanisms and clinical relevance remain under investigation.<ref name="OnePlantManyRoles"/><ref name="ImmunomodulatoryReview"/><br />
<br />
== Metabolic and endocrine research ==<br />
<br />
Recent reviews suggest that Guduchi may have beneficial effects on diabetes, hyperlipidemia, obesity, and related features of metabolic syndrome.<ref name="MetabolicReview2025">{{Mansouri M, Imenshahidi M, Rameshrad M, Hosseinzadeh H. Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review. Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4979-5009. doi: 10.1007/s00210-024-03642-2. Epub 2024 Dec 28. PMID: 39731594.}}</ref> Anti‑diabetic and antihyperglycemic actions have been reported in animal models and some small human studies, including a randomized trial in diabetic dyslipidemia showing improvement in lipid profile, inflammatory markers, and metabolic‑syndrome prevalence with Guduchi‑stem supplementation.<ref name="DiabeticDyslipidemiaRCT">{{Cite journal |year=2024 |title=Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open‑labelled randomized controlled trial |journal=International Journal of Research and Pharmaceutical Sciences |volume=15 |issue=12 |pages=100–107 |url=https://ffhdj.com/index.php/ffhd/article/view/208}}</ref><br />
<br />
However, the overall evidence base still relies heavily on preclinical data and heterogeneous herbal preparations rather than standardized, large‑scale randomized trials.<ref name="MetabolicReview2025"/><br />
<br />
== Musculoskeletal and inflammatory conditions ==<br />
<br />
Guduchi is traditionally used for vatarakta and amavata, conditions resembling gout and rheumatoid arthritis.<ref name="AYUSHDossier"/> Preclinical studies in arthritis models show that ''T. cordifolia'' extracts can reduce inflammatory mediators and markers of joint destruction, supporting its traditional anti‑arthritic use.<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<br />
However, the evidence is still preliminary, and current data justify Guduchi mainly as a potential adjunct to conventional therapy rather than as a standalone monotherapy for chronic inflammatory joint disease.<ref name="Arthritis2015"/><br />
<br />
== Safety and hepatotoxicity ==<br />
<br />
In recent years, several case reports and reviews have described herb‑induced liver injury associated with Guduchi or ''Tinospora''‑containing products.<ref name="LiverTox"/>,<ref name="PMC2021LiverInjury">Björnsson ES, Navarro VJ, Chalasani N. Liver Injury Following Tinospora Cordifolia Consumption: Drug-Induced AIH, or de novo AIH? J Clin Exp Hepatol. 2022 Jan-Feb;12(1):6-9. doi: 10.1016/j.jceh.2021.11.014. Epub 2021 Nov 29. PMID: 35068778; PMCID: PMC8766689.</ref><br />
<br />
The NIH LiverTox resource notes that Guduchi‑associated liver injury can range from mild elevation of liver enzymes to clinically significant hepatitis and, rarely, acute liver failure, with some cases showing autoimmune‑like features.<ref name="LiverTox"/> Many cases occur in patients with pre‑existing liver disease or autoimmune predisposition and may be idiosyncratic or immune‑mediated.<ref name="LiverTox"/><br />
<br />
The AYUSH technical dossier highlights that many published liver injury reports lack detailed baseline documentation and may mix different species and preparations, underscoring the need for careful botanical identification, product quality control, and medical supervision, especially in patients with pre‑existing liver conditions.<ref name="AYUSHDossier"/><br />
<br />
== Current research trends ==<br />
<br />
PubMed‑based trend analyses indicate a substantial increase in publications on Guduchi, rising from several hundred articles in the early 2010s to over 900 indexed studies by 2024, reflecting growing scientific interest.<ref name="IMRReview2020"/>,<ref name="AYUSHDossier"/> This growth reflects heightened scientific and public interest but does not, by itself, equate to high‑quality clinical evidence.<ref name="MetabolicReview2025"/><br />
<br />
Most of the current evidence is from preclinical studies, mechanistic investigations, small trials, and narrative reviews; large, well‑designed randomized controlled trials are still limited.<ref name="MetabolicReview2025"/>,<ref name="IMRReview2020"/><br />
<br />
== Clinical position ==<br />
<br />
From an Ayurvedic perspective, Guduchi is regarded as a classical Rasayana with broad therapeutic indications, supported by long‑standing clinical experience.<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles"/> From a modern evidence‑based medicine standpoint, it is best viewed as a promising but not yet fully established botanical agent for conditions such as metabolic syndrome, certain inflammatory disorders, and liver and immune‑mediated conditions.<ref name="MetabolicReview2025"/><br />
<br />
Use in clinical practice should emphasize:<ref name="LiverTox"/><ref name="AYUSHDossier"/><br />
<br />
* Accurate botanical identification and use of standardized preparations<br />
* Caution in patients with liver disease or autoimmunity<br />
* Integration with, rather than substitution for, established medical therapies<br />
<br />
=== Indian Medicinal Plant Database, Phytochemistry And Therapeutics (IMPPAT) ===<br />
<br />
Link: https://cb.imsc.res.in/imppat/phytochemical/Tinospora%20crispa <br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development ..<br />
<br />
==References==</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Talk:Guduchi&diff=45430Talk:Guduchi2026-04-13T10:10:57Z<p>Agnivesha: /* Current research trends */</p>
<hr />
<div>Guduchi (Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.)<br />
<br />
''Guduchi'' ({{langx|sa|गुडूची}}), commonly known as [[Giloy]], is the Sanskrit name for the medicinal plant [[Tinospora cordifolia]] (Willd.) Hook. f. & Thomson of the family [[Menispermaceae]].<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref> It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<ref name="AYUSHDossier"/><br />
<br />
<br />
{{Infobox<br />
|title = Guduchi<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Guduchi<br />
|label2 = Botanical name(s)<br />
|data2 = Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
|label3 = Family<br />
|data3 = Menispermaceae<br />
|label4 = Availability<br />
|data4 = Available<br />
|label5 = Contributors<br />
|data5 = --<br />
|label6 = Year of publication <br />
|data6 = 2026<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Skill Development Centre]], Symbiohealth Foundation, India<br />
|label8 = DOI <br />
|data8 = Awaited<br />
}}<br />
<br />
==English name == <br />
<br />
Heart leaved moonseed<br />
<br />
== Botanical identity ==<br />
<br />
The principal medicinal source of Guduchi is the stem of ''Tinospora cordifolia''.<ref name="AYUSHDossier"/> The plant is a deciduous, climbing shrub with simple, heart‑shaped leaves and small, greenish flowers.<ref name="AYUSHDossier"/> The genus ''Tinospora'' includes several species, and correct identification is important because some related species (e.g., ''Tinospora crispa'') have been implicated in hepatotoxicity reports.<ref name="LiverTox">Nnamani I, Tolu-Akinnawo O, Dufera RR, Akintunde A, Maliakkal B. Tinospora cordifolia (Guduchi/Giloy)-Induced Liver Injury: A Case Review. Cureus. 2023 May 31;15(5):e39793. doi: 10.7759/cureus.39793. PMID: 37273324; PMCID: PMC10238282.</ref><br />
<br />
For Ayurvedic purposes, the AYUSH technical dossier specifies that properly identified ''T. cordifolia'' stem should be used, warning against confusion with other ''Tinospora'' species that may occur in commercial supply.<ref name="AYUSHDossier"/><br />
<br />
== Other botanical names/varieties ==<br />
<br />
The following botanical names are accepted by Plants of the World Online as of January 2024.<br />
<br />
* Tinospora crispa (L.) Hook.f. & Thomson<br />
* Tinospora sinensis (Lour.) Merr<br />
* Tinospora arfakiana Becc.<br />
* Tinospora baenzigeri Forman<br />
* Tinopora bakis (A.Rich.)Miers<br />
* Tinospora celebica Diels<br />
* Tinopora dissitiflora (K.Schum. & Lauterb.) Diels<br />
* Tinopora esiangkara (F.M..Bailey) Forman<br />
* Tinospora formanii Udayan & Pradeep<br />
* Tinospora fragosa (I.Verd.) I.Verd. & Troupin<br />
* Tinospora glabra (Burm.f.)Merr.<br />
* Tinospora glandulosa Merr.<br />
* Tinospora guangxiensis H.S.Lo<br />
* Tinospora hainanensis H.S.Lo &Z.X.Li<br />
* Tinospora hirsuta (Becc.) Forman<br />
* Tinospora homosepala Diels<br />
* Tinospora macrocarpa Diels<br />
* Tinospora merriliana Diels<br />
* Tinospora neocaledonica Forman<br />
* Tinospora nudiflora (Griff.) Kurz<br />
* Tinospora orophila Troupin<br />
* Tinospora palminervis Miers<br />
* Tinospora siamensis Forman<br />
* Tinospora smilacina Benth.<br />
* Tinospora sumatrana Becc.<br />
* Tinospora teijsmannii Boerl.<br />
* Tinospora tenera Miers.<br />
* Tinospora tinosporoides (F.Muell.) Forman<br />
* Tinospora trilobata Diels.<br />
<br />
== Synonyms in Charak Samhita==<br />
<br />
Amruta, Madhuparni, Vayastha, Chhinnaruha, Vatsadini<br />
<br />
== Synonyms in Bhavaprakasha Nighantu ==<br />
Guduchi, Madhuparni, Amrita, Amritavallari, Chhinna, Chhinnaruha, Chhinnodbhava, Vatsadani, Jivanti, Tantrika, Soma, Somavalli, Kundali, Chakralakshanika, Dhira, Vishalya, Rasayani, Chandrahasa, Vayastha, Mandali, Devanirmita<br />
<br />
==Anupana according to Dosha==<br />
* '''Vata''' – Ghrita <br />
* '''Pitta''' – Sharkara (Sugar)<br />
* '''Kapha''' – Madhu (Honey)<br />
* '''Vibandha''' (Constipation)– Guda (Jaggery)<br />
* '''Vatarakta''' (Gout) – Eranda taila (Castor oil)<br />
* '''Amavaata'''(Rhumatoid arthritis) – Shunthi (Ginger)<br />
<br />
== Ayurvedic pharmacological properties ==<br />
{| class="wikitable"<br />
|+Table 1: Properties of Guduchi<br />
|-<br />
! Sr.no. !! Pharmacological criteria !! Properties<br />
|-<br />
| 1 || Taste ([[rasa]]) || Bitter (tikta), Astringent (kashaya)<br />
|-<br />
| 2 || Potency ([[veerya]]) || Hot (ushna)<br />
|-<br />
| 3 || Post digestion effect ([[vipaka]]) || Sweet (madhura)<br />
|-<br />
| 4 || Qualities ([[guna]])|| Heavy (guru), Unctuous (snigdha)<br />
|-<br />
| 5 || Actions ([[karma]]) || Pacify [[vata]], [[pitta]] and [[kapha]]<br />
|}<br />
== Reference in Charak Samhita and its actions == <br />
<br />
{| class="wikitable"<br />
|+ Herbs and their activities<br />
|-<br />
! Sr.no. !! Reference in Charak Samhita !! Activity <br />
|-<br />
| 1 ||Cha.Sa.[[Sutra Sthana]] 2/12 || Asthapana<br />
|-<br />
| 2 || Cha.Sa.[[Sutra Sthana]] 3/3 || Siddhatamachurnapradeha<br />
|-<br />
| 3 ||Cha.Sa.[[Sutra Sthana]] 4/9(11) || Truptighnamahakashay<br />
|-<br />
| 4 ||Cha.Sa.[[Sutra Sthana]] 4/9(18) || Stanyashodhanamahakashay<br />
|-<br />
| 5 ||Cha.Sa.[[Sutra Sthana]] 4/9(21) || Snehopagmahakashay<br />
|-<br />
| 6 ||Cha.Sa.[[Sutra Sthana]] 4/9(29) || Trishnanigrahanamahakashay<br />
|-<br />
| 7 ||Cha.Sa.[[Sutra Sthana]] 4/9(41) || Dahaprashamanamahakashaya<br />
|-<br />
| 8 ||Cha.Sa.[[Sutra Sthana]] 4/9(49) || Prajasthapanamahakashaya<br />
|-<br />
| 9 ||Cha.Sa.[[Sutra Sthana]] 4/9(50) || Vayasthapanmahakashaya<br />
|-<br />
| 10 ||Cha.Sa.[[Sutra Sthana]] 14/31 <br />
| Dravya for Nadi Sweda<br />
|-<br />
| 11 ||Cha.Sa.[[Sutra Sthana]] 21/22 <br />
| Management of obesity<br />
|-<br />
|12<br />
|Cha.Sa.[[Sutra Sthana]] 25/40<br />
|Agrya Sangraha<br />
|-<br />
|13<br />
|Cha.Sa.[[Sutra Sthana]]27/4<br />
|Natural qualities.<br />
|-<br />
|14<br />
|Cha.Sa.[[Sutra Sthana]] 27/106<br />
|Shaka Varga<br />
|-<br />
|15<br />
|Cha.Sa.[[Sutra Sthana]] 26/49<br />
|Veerya varnan<br />
|-<br />
|16<br />
|Cha.Sa.[[Vimana Sthana]] 8/135<br />
|Vaman dravyani<br />
|-<br />
|17<br />
|Cha.Sa.[[Vimana Sthana]] 8/139<br />
|Madhur skanda<br />
|-<br />
|18<br />
|Cha.Sa.[[Vimana Sthana]] 8/143<br />
|Tikta skandha<br />
|-<br />
|19<br />
|Cha.Sa.[[Sharira Sthana]].8/56<br />
|Kshira vishodhana dravya<br />
|-<br />
|20<br />
|Cha.Sa.[[Kalpa Sthana]] 1/22<br />
|Vamanartha<br />
|-<br />
|21<br />
|Cha.Sa.[[Kalpa Sthana]] 7/19<br />
|Preparations of Trivritta<br />
|-<br />
|22<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/198<br />
|Used as kwath or sheeta kashaya for trushna, deepana, doshapachana, jwar, aruchi and mukhavairasya.<br />
|-<br />
|23<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in trutiyaka jwara.<br />
|-<br />
|24<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in chaturthaka jwara.<br />
|-<br />
|25<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/211<br />
|As an ingredient of shatyadi varga used in kasa, svasa, tandra,parshvashoola, hrdgraha and sannipata jwara.<br />
|-<br />
|26<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/222<br />
|As an ingredient of Vasadi Ghrita.<br />
|-<br />
|27<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/247<br />
|Used in niruha basti.<br />
|-<br />
|28<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/251<br />
|Used in Patoladi niruha basti.<br />
|-<br />
|29<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/267<br />
|In formulation of Agurvadi taila.<br />
|-<br />
|30<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/299<br />
|Used as swarasa in Vishama jwara.<br />
|-<br />
|31<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/343<br />
|Used in punaravrtaka jwara(Kirat tiktadi kwath)<br />
|-<br />
|32<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/29<br />
|Used for making decoction in Kaphaj prameh<br />
|-<br />
|33<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/30<br />
|Used for making decoction in Pittaja Prameha <br />
|-<br />
|34<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/77<br />
|Ingredient in Kanakabindurishta<br />
|-<br />
|35<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/124<br />
|Bahyaprayogarth Lepa in Vata-Kaphaja Kushtha<br />
|-<br />
|36<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/146<br />
|Ingredient in Mahatikta Ghrita<br />
|-<br />
|37<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/153<br />
|Ingredient in Mahakhadira Ghrita<br />
|-<br />
|38<br />
|Cha.Sa.[[Chikitsa Sthana]] 8/72<br />
|For Parisheka purpose<br />
|-<br />
|39<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/25<br />
|In treatment of Vataja Shvayathu<br />
|-<br />
|40<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/34<br />
|Ingredient in Punarnavadyarishta<br />
|-<br />
|41<br />
|Cha.Sa.[[Chikitsa Sthana]] 5/190<br />
|Used in preparation of Panchama Kshara<br />
|-<br />
|42<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/63<br />
|In Kamala Guduchi Swarasa should be given in early in the morning <br />
|-<br />
|43<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/134 <br />
|Used in Halimak Chikitsa<br />
|-<br />
|44<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/94<br />
|Used in yusha preparation for hikka svasa<br />
|-<br />
|45<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/102<br />
|Used as yavagu in hikka svasa<br />
|-<br />
|46<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/35<br />
|As a ghrita dravya<br />
|-<br />
|47<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/161<br />
|As an ingredient of guduchyadi ghrita.<br />
|-<br />
|48<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/31 <br />
|As a pana yoga in Pittaja chhardi.<br />
|-<br />
|49<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/35<br />
|As a pathya ahara in kaphaja chhardi.<br />
|-<br />
|50<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/58<br />
|For kashaya pana.<br />
|-<br />
|51<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/130<br />
|Used in granthi visarpa.<br />
|-<br />
|52<br />
|Cha.Sa.[[Chikitsa Sthana]] 22/45<br />
|As a pana yoga.<br />
|-<br />
|53<br />
|Cha.Sa.[[Chikitsa Sthana]] 23/70<br />
|As an ingredient of Gandha hasti agada.<br />
|-<br />
|54<br />
|Cha.Sa.[[Chikitsa Sthana]] 24/145<br />
|Used as swarasa where pittaja madatyaya is associated with sarakta kasa, Parshvashoola, Stanashoola, Daaha & Hradayotkleda.<br />
|-<br />
|55<br />
|Cha.Sa.[[Chikitsa Sthana]] 25/75<br />
|Used in shoola with sneha & sarkara.<br />
|-<br />
|56<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/57<br />
|Used in Kaphaja mutrakruchhra.<br />
|-<br />
|57<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/70<br />
|As an ingredient of Karpasmooladi yoga.<br />
|-<br />
|58<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/83<br />
|As an ingredient of Haritakyadi Ghrita.<br />
|-<br />
|59<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/243<br />
|As an ingredient of Amrutadi varti.<br />
|-<br />
|60<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/283<br />
|Used in Vataja swarbheda.<br />
|-<br />
|61<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/148<br />
|As an ingredient of Bala taila. <br />
|-<br />
|62<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/157<br />
|As an ingredient of Amrutadi taila.<br />
|-<br />
|63<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/170<br />
|As an ingredient of Vrushamuladi taila.<br />
|-<br />
|64<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/172<br />
|As an ingredient of Mulaka taila.<br />
|-<br />
|65<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/71<br />
|Anupana of Drakshadi Ghrita.<br />
|-<br />
|66<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/73<br />
|As an ingredient of Jeevakadi mahasneha.<br />
|-<br />
|67<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/92<br />
|As an ingredient of Madhuparnyadi taila.<br />
|-<br />
|68<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/103<br />
|As an ingredient of Amrutadhya taila.<br />
|-<br />
|69<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/117<br />
|As an ingredient of Shatapaka Madhuparni taila.<br />
|-<br />
|70<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/53<br />
|As an ingredient of Kashmaryadi ghrita, used in the treatment of Vataja yoni.<br />
|-<br />
|71<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/58<br />
|For parishechana in yoni shula.<br />
|-<br />
|72<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/99<br />
|Used in the treatment of Kaphaja pradara.<br />
|-<br />
|73<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/59<br />
|As an ingredient of Guduchyadi taila, used in the treatment of Vataja yoni roga.<br />
|-<br />
|}<br />
<br />
== Classical therapeutic uses ==<br />
<br />
Guduchi is one of the most frequently cited herbs in Ayurvedic literature and is reported in formulations for a wide range of conditions, including:<ref name="AYUSHDossier"/><br />
<br />
Classical actions attributed to Guduchi include:<ref name="AYUSHDossier"/><br />
<br />
* Rasayana (rejuvenative)<br />
* Dipana and Sangrahi (appetizing and absorbent)<br />
* Vataraktahara and Amavataghni (useful in gout and rheumatoid‑like arthritis)<br />
* Kamalahara (beneficial in jaundice and liver disorders)<br />
* Kushtaghna (beneficial in skin diseases)<br />
* Pramehaghna (beneficial in urinary and metabolic disorders)<br />
* Jvara (fever), including irregular and chronic fevers<br />
* Kamala (jaundice) and other hepatic and viral fevers<br />
* Vatarakta and amavata (gout and rheumatoid‑like arthritis)<br />
* Kasa (chronic cough)<br />
* Prameha (Diabetes mellitus and metabolic disorders)<br />
* Chardighna (anti‑emetic indications)<br />
<br />
The AYUSH technical dossier notes that Guduchi appears in more than 2,400 Ayurvedic formulations across over 24 dosage forms, indicating its broad and enduring therapeutic role.<ref name="AYUSHDossier"/><br />
<br />
== Parts used and dosage forms ==<br />
<br />
In Ayurvedic practice, the mature stem is the primary part used for preparing Guduchi‑based medicines.<ref name="AYUSHDossier"/> Common traditional dosage forms include:<ref name="AYUSHDossier"/><br />
<br />
* Churna (powder)<br />
* Kwatha (decoction)<br />
* Hima (cold infusion)<br />
* Svarasa (fresh juice)<br />
* Satva (starch preparation)<br />
* Ghrita (medicated ghee)<br />
* Taila (medicated oil)<br />
* Gutika (tablets)<br />
<br />
== Important Formulations ==<br />
<br />
* Amritarishta<br />
* Amritottara kvatha churna<br />
* Guduchi Taila<br />
* Guduchyadi churna<br />
* Guduchi Sattva<br />
* Chhinnodbhavadi kvatha churna<br />
* Kaishora Guggulu<br />
* Samshamani Vati<br />
<br />
==Dose==<br />
<br />
The AYUSH technical dossier cites typical dose ranges as:<ref name="AYUSHDossier"/><br />
* 3–6 g of powder<br />
* 20–30 g of coarse powder for decoction<br />
* 125 mg–1000 mg of Guduchi sattva, taken with appropriate anupana (vehicle)<br />
<br />
== Current availability== <br />
<br />
Available <br />
<br />
Through all over India extending from Himalayas to the Southern part of India.<br />
<br />
Other countries: Nepal, Bangladesh, Pakistan, Myanmar, Burma, Sri Lanka, Malaysia, Indonesia and Thailand<br />
<br />
== Current researches ==<br />
<br />
== Chemical constituents ==<br />
<br />
Modern phytochemical studies have identified more than 200 compounds in ''Tinospora cordifolia'' and related species, including diterpenoids, alkaloids, glycosides, steroids, sesquiterpenoids, and phenolics.<ref name="ImmunomodulatoryReview">Yates CR, Bruno EJ, Yates MED. Tinospora Cordifolia: A review of its immunomodulatory properties. J Diet Suppl. 2022;19(2):271-285. doi: 10.1080/19390211.2021.1873214. Epub 2021 Jan 22. PMID: 33480818.</ref> Key constituents reported in the literature include:<ref name="AYUSHDossier"/>,<ref name="OnePlantManyRoles">Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012 Apr;31(4):151-9. doi: 10.4103/0257-7941.107344. PMID: 23661861; PMCID: PMC3644751</ref><br />
<br />
* Clerodane‑type diterpenoids<br />
* Cordifolioside A and tinosporaside (used as assay markers)<br />
* Alkaloids such as magnoflorine and berberine‑like compounds<br />
* Diterpenoid lactones and glycosides<br />
<br />
These constituents are thought to contribute to the herb’s bitter taste, immunomodulatory, anti‑inflammatory, and antioxidant properties.<ref name="ImmunomodulatoryReview"/><br />
<br />
== Pharmacological actions ==<br />
<br />
Experimental studies, including in vitro and animal models, support several pharmacological activities of Guduchi extracts.<ref name="ImmunomodulatoryReview"/><ref name="OnePlantManyRoles"/><br />
<br />
* Immunomodulatory effects: Modulation of immune cell function and cytokine pathways.<ref name="ImmunomodulatoryReview"/><br />
* Anti‑inflammatory effects: Reduction of pro‑inflammatory cytokines such as TNF‑α and IL‑1β.<ref name="ImmunomodulatoryReview"/><ref name="ScientificReports2019">{{Cite Ghatpande NS, Misar AV, Waghole RJ, Jadhav SH, Kulkarni PP. Tinospora cordifolia protects against inflammation associated anemia by modulating inflammatory cytokines and hepcidin expression in male Wistar rats. Sci Rep. 2019 Jul 29;9(1):10969. doi: 10.1038/s41598-019-47458-0. PMID: 31358831; PMCID: PMC6662690}}</ref><br />
* Antioxidant activity: Scavenging of free radicals and reduction of oxidative stress.<ref name="OnePlantManyRoles"/><br />
* Antipyretic and analgesic activity in fever‑like models.<ref name="ImmunomodulatoryReview"/><br />
<br />
Some studies also report hepatoprotective, hypoglycemic, and anti‑arthritic‑like effects, although the exact mechanisms and clinical relevance remain under investigation.<ref name="OnePlantManyRoles"/><ref name="ImmunomodulatoryReview"/><br />
<br />
== Metabolic and endocrine research ==<br />
<br />
Recent reviews suggest that Guduchi may have beneficial effects on diabetes, hyperlipidemia, obesity, and related features of metabolic syndrome.<ref name="MetabolicReview2025">{{Mansouri M, Imenshahidi M, Rameshrad M, Hosseinzadeh H. Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review. Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4979-5009. doi: 10.1007/s00210-024-03642-2. Epub 2024 Dec 28. PMID: 39731594.}}</ref> Anti‑diabetic and antihyperglycemic actions have been reported in animal models and some small human studies, including a randomized trial in diabetic dyslipidemia showing improvement in lipid profile, inflammatory markers, and metabolic‑syndrome prevalence with Guduchi‑stem supplementation.<ref name="DiabeticDyslipidemiaRCT">{{Cite journal |year=2024 |title=Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open‑labelled randomized controlled trial |journal=International Journal of Research and Pharmaceutical Sciences |volume=15 |issue=12 |pages=100–107 |url=https://ffhdj.com/index.php/ffhd/article/view/208}}</ref><br />
<br />
However, the overall evidence base still relies heavily on preclinical data and heterogeneous herbal preparations rather than standardized, large‑scale randomized trials.<ref name="MetabolicReview2025"/><br />
<br />
== Musculoskeletal and inflammatory conditions ==<br />
<br />
Guduchi is traditionally used for vatarakta and amavata, conditions resembling gout and rheumatoid arthritis.<ref name="AYUSHDossier"/> Preclinical studies in arthritis models show that ''T. cordifolia'' extracts can reduce inflammatory mediators and markers of joint destruction, supporting its traditional anti‑arthritic use.<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<br />
However, the evidence is still preliminary, and current data justify Guduchi mainly as a potential adjunct to conventional therapy rather than as a standalone monotherapy for chronic inflammatory joint disease.<ref name="Arthritis2015"/><br />
<br />
== Safety and hepatotoxicity ==<br />
<br />
In recent years, several case reports and reviews have described herb‑induced liver injury associated with Guduchi or ''Tinospora''‑containing products.<ref name="LiverTox"/>,<ref name="PMC2021LiverInjury">Björnsson ES, Navarro VJ, Chalasani N. Liver Injury Following Tinospora Cordifolia Consumption: Drug-Induced AIH, or de novo AIH? J Clin Exp Hepatol. 2022 Jan-Feb;12(1):6-9. doi: 10.1016/j.jceh.2021.11.014. Epub 2021 Nov 29. PMID: 35068778; PMCID: PMC8766689.</ref><br />
<br />
The NIH LiverTox resource notes that Guduchi‑associated liver injury can range from mild elevation of liver enzymes to clinically significant hepatitis and, rarely, acute liver failure, with some cases showing autoimmune‑like features.<ref name="LiverTox"/> Many cases occur in patients with pre‑existing liver disease or autoimmune predisposition and may be idiosyncratic or immune‑mediated.<ref name="LiverTox"/><br />
<br />
The AYUSH technical dossier highlights that many published liver injury reports lack detailed baseline documentation and may mix different species and preparations, underscoring the need for careful botanical identification, product quality control, and medical supervision, especially in patients with pre‑existing liver conditions.<ref name="AYUSHDossier"/><br />
<br />
== Current research trends ==<br />
<br />
PubMed‑based trend analyses indicate a substantial increase in publications on Guduchi, rising from several hundred articles in the early 2010s to over 900 indexed studies by 2024, reflecting growing scientific interest.<ref name="IMRReview2020"/>,<ref name="AYUSHDossier"/> This growth reflects heightened scientific and public interest but does not, by itself, equate to high‑quality clinical evidence.<ref name="MetabolicReview2025"/><br />
<br />
Most of the current evidence is from preclinical studies, mechanistic investigations, small trials, and narrative reviews; large, well‑designed randomized controlled trials are still limited.<ref name="MetabolicReview2025"/>,<ref name="IMRReview2020"/><br />
<br />
== Clinical position ==<br />
<br />
From an Ayurvedic perspective, Guduchi is regarded as a classical Rasayana with broad therapeutic indications, supported by long‑standing clinical experience.<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles"/> From a modern evidence‑based medicine standpoint, it is best viewed as a promising but not yet fully established botanical agent for conditions such as metabolic syndrome, certain inflammatory disorders, and liver and immune‑mediated conditions.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
Use in clinical practice should emphasize:<ref name="LiverTox"/><ref name="AYUSHDossier"/><br />
<br />
* Accurate botanical identification and use of standardized preparations<br />
* Caution in patients with liver disease or autoimmunity<br />
* Integration with, rather than substitution for, established medical therapies<br />
<br />
=== Indian Medicinal Plant Database, Phytochemistry And Therapeutics (IMPPAT) ===<br />
<br />
Link: https://cb.imsc.res.in/imppat/phytochemical/Tinospora%20crispa <br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development ..<br />
<br />
==References==</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Talk:Guduchi&diff=45429Talk:Guduchi2026-04-13T10:05:09Z<p>Agnivesha: /* Safety and hepatotoxicity */</p>
<hr />
<div>Guduchi (Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.)<br />
<br />
''Guduchi'' ({{langx|sa|गुडूची}}), commonly known as [[Giloy]], is the Sanskrit name for the medicinal plant [[Tinospora cordifolia]] (Willd.) Hook. f. & Thomson of the family [[Menispermaceae]].<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref> It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<ref name="AYUSHDossier"/><br />
<br />
<br />
{{Infobox<br />
|title = Guduchi<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Guduchi<br />
|label2 = Botanical name(s)<br />
|data2 = Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
|label3 = Family<br />
|data3 = Menispermaceae<br />
|label4 = Availability<br />
|data4 = Available<br />
|label5 = Contributors<br />
|data5 = --<br />
|label6 = Year of publication <br />
|data6 = 2026<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Skill Development Centre]], Symbiohealth Foundation, India<br />
|label8 = DOI <br />
|data8 = Awaited<br />
}}<br />
<br />
==English name == <br />
<br />
Heart leaved moonseed<br />
<br />
== Botanical identity ==<br />
<br />
The principal medicinal source of Guduchi is the stem of ''Tinospora cordifolia''.<ref name="AYUSHDossier"/> The plant is a deciduous, climbing shrub with simple, heart‑shaped leaves and small, greenish flowers.<ref name="AYUSHDossier"/> The genus ''Tinospora'' includes several species, and correct identification is important because some related species (e.g., ''Tinospora crispa'') have been implicated in hepatotoxicity reports.<ref name="LiverTox">Nnamani I, Tolu-Akinnawo O, Dufera RR, Akintunde A, Maliakkal B. Tinospora cordifolia (Guduchi/Giloy)-Induced Liver Injury: A Case Review. Cureus. 2023 May 31;15(5):e39793. doi: 10.7759/cureus.39793. PMID: 37273324; PMCID: PMC10238282.</ref><br />
<br />
For Ayurvedic purposes, the AYUSH technical dossier specifies that properly identified ''T. cordifolia'' stem should be used, warning against confusion with other ''Tinospora'' species that may occur in commercial supply.<ref name="AYUSHDossier"/><br />
<br />
== Other botanical names/varieties ==<br />
<br />
The following botanical names are accepted by Plants of the World Online as of January 2024.<br />
<br />
* Tinospora crispa (L.) Hook.f. & Thomson<br />
* Tinospora sinensis (Lour.) Merr<br />
* Tinospora arfakiana Becc.<br />
* Tinospora baenzigeri Forman<br />
* Tinopora bakis (A.Rich.)Miers<br />
* Tinospora celebica Diels<br />
* Tinopora dissitiflora (K.Schum. & Lauterb.) Diels<br />
* Tinopora esiangkara (F.M..Bailey) Forman<br />
* Tinospora formanii Udayan & Pradeep<br />
* Tinospora fragosa (I.Verd.) I.Verd. & Troupin<br />
* Tinospora glabra (Burm.f.)Merr.<br />
* Tinospora glandulosa Merr.<br />
* Tinospora guangxiensis H.S.Lo<br />
* Tinospora hainanensis H.S.Lo &Z.X.Li<br />
* Tinospora hirsuta (Becc.) Forman<br />
* Tinospora homosepala Diels<br />
* Tinospora macrocarpa Diels<br />
* Tinospora merriliana Diels<br />
* Tinospora neocaledonica Forman<br />
* Tinospora nudiflora (Griff.) Kurz<br />
* Tinospora orophila Troupin<br />
* Tinospora palminervis Miers<br />
* Tinospora siamensis Forman<br />
* Tinospora smilacina Benth.<br />
* Tinospora sumatrana Becc.<br />
* Tinospora teijsmannii Boerl.<br />
* Tinospora tenera Miers.<br />
* Tinospora tinosporoides (F.Muell.) Forman<br />
* Tinospora trilobata Diels.<br />
<br />
== Synonyms in Charak Samhita==<br />
<br />
Amruta, Madhuparni, Vayastha, Chhinnaruha, Vatsadini<br />
<br />
== Synonyms in Bhavaprakasha Nighantu ==<br />
Guduchi, Madhuparni, Amrita, Amritavallari, Chhinna, Chhinnaruha, Chhinnodbhava, Vatsadani, Jivanti, Tantrika, Soma, Somavalli, Kundali, Chakralakshanika, Dhira, Vishalya, Rasayani, Chandrahasa, Vayastha, Mandali, Devanirmita<br />
<br />
==Anupana according to Dosha==<br />
* '''Vata''' – Ghrita <br />
* '''Pitta''' – Sharkara (Sugar)<br />
* '''Kapha''' – Madhu (Honey)<br />
* '''Vibandha''' (Constipation)– Guda (Jaggery)<br />
* '''Vatarakta''' (Gout) – Eranda taila (Castor oil)<br />
* '''Amavaata'''(Rhumatoid arthritis) – Shunthi (Ginger)<br />
<br />
== Ayurvedic pharmacological properties ==<br />
{| class="wikitable"<br />
|+Table 1: Properties of Guduchi<br />
|-<br />
! Sr.no. !! Pharmacological criteria !! Properties<br />
|-<br />
| 1 || Taste ([[rasa]]) || Bitter (tikta), Astringent (kashaya)<br />
|-<br />
| 2 || Potency ([[veerya]]) || Hot (ushna)<br />
|-<br />
| 3 || Post digestion effect ([[vipaka]]) || Sweet (madhura)<br />
|-<br />
| 4 || Qualities ([[guna]])|| Heavy (guru), Unctuous (snigdha)<br />
|-<br />
| 5 || Actions ([[karma]]) || Pacify [[vata]], [[pitta]] and [[kapha]]<br />
|}<br />
== Reference in Charak Samhita and its actions == <br />
<br />
{| class="wikitable"<br />
|+ Herbs and their activities<br />
|-<br />
! Sr.no. !! Reference in Charak Samhita !! Activity <br />
|-<br />
| 1 ||Cha.Sa.[[Sutra Sthana]] 2/12 || Asthapana<br />
|-<br />
| 2 || Cha.Sa.[[Sutra Sthana]] 3/3 || Siddhatamachurnapradeha<br />
|-<br />
| 3 ||Cha.Sa.[[Sutra Sthana]] 4/9(11) || Truptighnamahakashay<br />
|-<br />
| 4 ||Cha.Sa.[[Sutra Sthana]] 4/9(18) || Stanyashodhanamahakashay<br />
|-<br />
| 5 ||Cha.Sa.[[Sutra Sthana]] 4/9(21) || Snehopagmahakashay<br />
|-<br />
| 6 ||Cha.Sa.[[Sutra Sthana]] 4/9(29) || Trishnanigrahanamahakashay<br />
|-<br />
| 7 ||Cha.Sa.[[Sutra Sthana]] 4/9(41) || Dahaprashamanamahakashaya<br />
|-<br />
| 8 ||Cha.Sa.[[Sutra Sthana]] 4/9(49) || Prajasthapanamahakashaya<br />
|-<br />
| 9 ||Cha.Sa.[[Sutra Sthana]] 4/9(50) || Vayasthapanmahakashaya<br />
|-<br />
| 10 ||Cha.Sa.[[Sutra Sthana]] 14/31 <br />
| Dravya for Nadi Sweda<br />
|-<br />
| 11 ||Cha.Sa.[[Sutra Sthana]] 21/22 <br />
| Management of obesity<br />
|-<br />
|12<br />
|Cha.Sa.[[Sutra Sthana]] 25/40<br />
|Agrya Sangraha<br />
|-<br />
|13<br />
|Cha.Sa.[[Sutra Sthana]]27/4<br />
|Natural qualities.<br />
|-<br />
|14<br />
|Cha.Sa.[[Sutra Sthana]] 27/106<br />
|Shaka Varga<br />
|-<br />
|15<br />
|Cha.Sa.[[Sutra Sthana]] 26/49<br />
|Veerya varnan<br />
|-<br />
|16<br />
|Cha.Sa.[[Vimana Sthana]] 8/135<br />
|Vaman dravyani<br />
|-<br />
|17<br />
|Cha.Sa.[[Vimana Sthana]] 8/139<br />
|Madhur skanda<br />
|-<br />
|18<br />
|Cha.Sa.[[Vimana Sthana]] 8/143<br />
|Tikta skandha<br />
|-<br />
|19<br />
|Cha.Sa.[[Sharira Sthana]].8/56<br />
|Kshira vishodhana dravya<br />
|-<br />
|20<br />
|Cha.Sa.[[Kalpa Sthana]] 1/22<br />
|Vamanartha<br />
|-<br />
|21<br />
|Cha.Sa.[[Kalpa Sthana]] 7/19<br />
|Preparations of Trivritta<br />
|-<br />
|22<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/198<br />
|Used as kwath or sheeta kashaya for trushna, deepana, doshapachana, jwar, aruchi and mukhavairasya.<br />
|-<br />
|23<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in trutiyaka jwara.<br />
|-<br />
|24<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in chaturthaka jwara.<br />
|-<br />
|25<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/211<br />
|As an ingredient of shatyadi varga used in kasa, svasa, tandra,parshvashoola, hrdgraha and sannipata jwara.<br />
|-<br />
|26<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/222<br />
|As an ingredient of Vasadi Ghrita.<br />
|-<br />
|27<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/247<br />
|Used in niruha basti.<br />
|-<br />
|28<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/251<br />
|Used in Patoladi niruha basti.<br />
|-<br />
|29<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/267<br />
|In formulation of Agurvadi taila.<br />
|-<br />
|30<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/299<br />
|Used as swarasa in Vishama jwara.<br />
|-<br />
|31<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/343<br />
|Used in punaravrtaka jwara(Kirat tiktadi kwath)<br />
|-<br />
|32<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/29<br />
|Used for making decoction in Kaphaj prameh<br />
|-<br />
|33<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/30<br />
|Used for making decoction in Pittaja Prameha <br />
|-<br />
|34<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/77<br />
|Ingredient in Kanakabindurishta<br />
|-<br />
|35<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/124<br />
|Bahyaprayogarth Lepa in Vata-Kaphaja Kushtha<br />
|-<br />
|36<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/146<br />
|Ingredient in Mahatikta Ghrita<br />
|-<br />
|37<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/153<br />
|Ingredient in Mahakhadira Ghrita<br />
|-<br />
|38<br />
|Cha.Sa.[[Chikitsa Sthana]] 8/72<br />
|For Parisheka purpose<br />
|-<br />
|39<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/25<br />
|In treatment of Vataja Shvayathu<br />
|-<br />
|40<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/34<br />
|Ingredient in Punarnavadyarishta<br />
|-<br />
|41<br />
|Cha.Sa.[[Chikitsa Sthana]] 5/190<br />
|Used in preparation of Panchama Kshara<br />
|-<br />
|42<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/63<br />
|In Kamala Guduchi Swarasa should be given in early in the morning <br />
|-<br />
|43<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/134 <br />
|Used in Halimak Chikitsa<br />
|-<br />
|44<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/94<br />
|Used in yusha preparation for hikka svasa<br />
|-<br />
|45<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/102<br />
|Used as yavagu in hikka svasa<br />
|-<br />
|46<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/35<br />
|As a ghrita dravya<br />
|-<br />
|47<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/161<br />
|As an ingredient of guduchyadi ghrita.<br />
|-<br />
|48<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/31 <br />
|As a pana yoga in Pittaja chhardi.<br />
|-<br />
|49<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/35<br />
|As a pathya ahara in kaphaja chhardi.<br />
|-<br />
|50<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/58<br />
|For kashaya pana.<br />
|-<br />
|51<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/130<br />
|Used in granthi visarpa.<br />
|-<br />
|52<br />
|Cha.Sa.[[Chikitsa Sthana]] 22/45<br />
|As a pana yoga.<br />
|-<br />
|53<br />
|Cha.Sa.[[Chikitsa Sthana]] 23/70<br />
|As an ingredient of Gandha hasti agada.<br />
|-<br />
|54<br />
|Cha.Sa.[[Chikitsa Sthana]] 24/145<br />
|Used as swarasa where pittaja madatyaya is associated with sarakta kasa, Parshvashoola, Stanashoola, Daaha & Hradayotkleda.<br />
|-<br />
|55<br />
|Cha.Sa.[[Chikitsa Sthana]] 25/75<br />
|Used in shoola with sneha & sarkara.<br />
|-<br />
|56<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/57<br />
|Used in Kaphaja mutrakruchhra.<br />
|-<br />
|57<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/70<br />
|As an ingredient of Karpasmooladi yoga.<br />
|-<br />
|58<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/83<br />
|As an ingredient of Haritakyadi Ghrita.<br />
|-<br />
|59<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/243<br />
|As an ingredient of Amrutadi varti.<br />
|-<br />
|60<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/283<br />
|Used in Vataja swarbheda.<br />
|-<br />
|61<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/148<br />
|As an ingredient of Bala taila. <br />
|-<br />
|62<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/157<br />
|As an ingredient of Amrutadi taila.<br />
|-<br />
|63<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/170<br />
|As an ingredient of Vrushamuladi taila.<br />
|-<br />
|64<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/172<br />
|As an ingredient of Mulaka taila.<br />
|-<br />
|65<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/71<br />
|Anupana of Drakshadi Ghrita.<br />
|-<br />
|66<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/73<br />
|As an ingredient of Jeevakadi mahasneha.<br />
|-<br />
|67<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/92<br />
|As an ingredient of Madhuparnyadi taila.<br />
|-<br />
|68<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/103<br />
|As an ingredient of Amrutadhya taila.<br />
|-<br />
|69<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/117<br />
|As an ingredient of Shatapaka Madhuparni taila.<br />
|-<br />
|70<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/53<br />
|As an ingredient of Kashmaryadi ghrita, used in the treatment of Vataja yoni.<br />
|-<br />
|71<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/58<br />
|For parishechana in yoni shula.<br />
|-<br />
|72<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/99<br />
|Used in the treatment of Kaphaja pradara.<br />
|-<br />
|73<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/59<br />
|As an ingredient of Guduchyadi taila, used in the treatment of Vataja yoni roga.<br />
|-<br />
|}<br />
<br />
== Classical therapeutic uses ==<br />
<br />
Guduchi is one of the most frequently cited herbs in Ayurvedic literature and is reported in formulations for a wide range of conditions, including:<ref name="AYUSHDossier"/><br />
<br />
Classical actions attributed to Guduchi include:<ref name="AYUSHDossier"/><br />
<br />
* Rasayana (rejuvenative)<br />
* Dipana and Sangrahi (appetizing and absorbent)<br />
* Vataraktahara and Amavataghni (useful in gout and rheumatoid‑like arthritis)<br />
* Kamalahara (beneficial in jaundice and liver disorders)<br />
* Kushtaghna (beneficial in skin diseases)<br />
* Pramehaghna (beneficial in urinary and metabolic disorders)<br />
* Jvara (fever), including irregular and chronic fevers<br />
* Kamala (jaundice) and other hepatic and viral fevers<br />
* Vatarakta and amavata (gout and rheumatoid‑like arthritis)<br />
* Kasa (chronic cough)<br />
* Prameha (Diabetes mellitus and metabolic disorders)<br />
* Chardighna (anti‑emetic indications)<br />
<br />
The AYUSH technical dossier notes that Guduchi appears in more than 2,400 Ayurvedic formulations across over 24 dosage forms, indicating its broad and enduring therapeutic role.<ref name="AYUSHDossier"/><br />
<br />
== Parts used and dosage forms ==<br />
<br />
In Ayurvedic practice, the mature stem is the primary part used for preparing Guduchi‑based medicines.<ref name="AYUSHDossier"/> Common traditional dosage forms include:<ref name="AYUSHDossier"/><br />
<br />
* Churna (powder)<br />
* Kwatha (decoction)<br />
* Hima (cold infusion)<br />
* Svarasa (fresh juice)<br />
* Satva (starch preparation)<br />
* Ghrita (medicated ghee)<br />
* Taila (medicated oil)<br />
* Gutika (tablets)<br />
<br />
== Important Formulations ==<br />
<br />
* Amritarishta<br />
* Amritottara kvatha churna<br />
* Guduchi Taila<br />
* Guduchyadi churna<br />
* Guduchi Sattva<br />
* Chhinnodbhavadi kvatha churna<br />
* Kaishora Guggulu<br />
* Samshamani Vati<br />
<br />
==Dose==<br />
<br />
The AYUSH technical dossier cites typical dose ranges as:<ref name="AYUSHDossier"/><br />
* 3–6 g of powder<br />
* 20–30 g of coarse powder for decoction<br />
* 125 mg–1000 mg of Guduchi sattva, taken with appropriate anupana (vehicle)<br />
<br />
== Current availability== <br />
<br />
Available <br />
<br />
Through all over India extending from Himalayas to the Southern part of India.<br />
<br />
Other countries: Nepal, Bangladesh, Pakistan, Myanmar, Burma, Sri Lanka, Malaysia, Indonesia and Thailand<br />
<br />
== Current researches ==<br />
<br />
== Chemical constituents ==<br />
<br />
Modern phytochemical studies have identified more than 200 compounds in ''Tinospora cordifolia'' and related species, including diterpenoids, alkaloids, glycosides, steroids, sesquiterpenoids, and phenolics.<ref name="ImmunomodulatoryReview">Yates CR, Bruno EJ, Yates MED. Tinospora Cordifolia: A review of its immunomodulatory properties. J Diet Suppl. 2022;19(2):271-285. doi: 10.1080/19390211.2021.1873214. Epub 2021 Jan 22. PMID: 33480818.</ref> Key constituents reported in the literature include:<ref name="AYUSHDossier"/>,<ref name="OnePlantManyRoles">Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012 Apr;31(4):151-9. doi: 10.4103/0257-7941.107344. PMID: 23661861; PMCID: PMC3644751</ref><br />
<br />
* Clerodane‑type diterpenoids<br />
* Cordifolioside A and tinosporaside (used as assay markers)<br />
* Alkaloids such as magnoflorine and berberine‑like compounds<br />
* Diterpenoid lactones and glycosides<br />
<br />
These constituents are thought to contribute to the herb’s bitter taste, immunomodulatory, anti‑inflammatory, and antioxidant properties.<ref name="ImmunomodulatoryReview"/><br />
<br />
== Pharmacological actions ==<br />
<br />
Experimental studies, including in vitro and animal models, support several pharmacological activities of Guduchi extracts.<ref name="ImmunomodulatoryReview"/><ref name="OnePlantManyRoles"/><br />
<br />
* Immunomodulatory effects: Modulation of immune cell function and cytokine pathways.<ref name="ImmunomodulatoryReview"/><br />
* Anti‑inflammatory effects: Reduction of pro‑inflammatory cytokines such as TNF‑α and IL‑1β.<ref name="ImmunomodulatoryReview"/><ref name="ScientificReports2019">{{Cite Ghatpande NS, Misar AV, Waghole RJ, Jadhav SH, Kulkarni PP. Tinospora cordifolia protects against inflammation associated anemia by modulating inflammatory cytokines and hepcidin expression in male Wistar rats. Sci Rep. 2019 Jul 29;9(1):10969. doi: 10.1038/s41598-019-47458-0. PMID: 31358831; PMCID: PMC6662690}}</ref><br />
* Antioxidant activity: Scavenging of free radicals and reduction of oxidative stress.<ref name="OnePlantManyRoles"/><br />
* Antipyretic and analgesic activity in fever‑like models.<ref name="ImmunomodulatoryReview"/><br />
<br />
Some studies also report hepatoprotective, hypoglycemic, and anti‑arthritic‑like effects, although the exact mechanisms and clinical relevance remain under investigation.<ref name="OnePlantManyRoles"/><ref name="ImmunomodulatoryReview"/><br />
<br />
== Metabolic and endocrine research ==<br />
<br />
Recent reviews suggest that Guduchi may have beneficial effects on diabetes, hyperlipidemia, obesity, and related features of metabolic syndrome.<ref name="MetabolicReview2025">{{Mansouri M, Imenshahidi M, Rameshrad M, Hosseinzadeh H. Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review. Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4979-5009. doi: 10.1007/s00210-024-03642-2. Epub 2024 Dec 28. PMID: 39731594.}}</ref> Anti‑diabetic and antihyperglycemic actions have been reported in animal models and some small human studies, including a randomized trial in diabetic dyslipidemia showing improvement in lipid profile, inflammatory markers, and metabolic‑syndrome prevalence with Guduchi‑stem supplementation.<ref name="DiabeticDyslipidemiaRCT">{{Cite journal |year=2024 |title=Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open‑labelled randomized controlled trial |journal=International Journal of Research and Pharmaceutical Sciences |volume=15 |issue=12 |pages=100–107 |url=https://ffhdj.com/index.php/ffhd/article/view/208}}</ref><br />
<br />
However, the overall evidence base still relies heavily on preclinical data and heterogeneous herbal preparations rather than standardized, large‑scale randomized trials.<ref name="MetabolicReview2025"/><br />
<br />
== Musculoskeletal and inflammatory conditions ==<br />
<br />
Guduchi is traditionally used for vatarakta and amavata, conditions resembling gout and rheumatoid arthritis.<ref name="AYUSHDossier"/> Preclinical studies in arthritis models show that ''T. cordifolia'' extracts can reduce inflammatory mediators and markers of joint destruction, supporting its traditional anti‑arthritic use.<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<br />
However, the evidence is still preliminary, and current data justify Guduchi mainly as a potential adjunct to conventional therapy rather than as a standalone monotherapy for chronic inflammatory joint disease.<ref name="Arthritis2015"/><br />
<br />
== Safety and hepatotoxicity ==<br />
<br />
In recent years, several case reports and reviews have described herb‑induced liver injury associated with Guduchi or ''Tinospora''‑containing products.<ref name="LiverTox"/>,<ref name="PMC2021LiverInjury">Björnsson ES, Navarro VJ, Chalasani N. Liver Injury Following Tinospora Cordifolia Consumption: Drug-Induced AIH, or de novo AIH? J Clin Exp Hepatol. 2022 Jan-Feb;12(1):6-9. doi: 10.1016/j.jceh.2021.11.014. Epub 2021 Nov 29. PMID: 35068778; PMCID: PMC8766689.</ref><br />
<br />
The NIH LiverTox resource notes that Guduchi‑associated liver injury can range from mild elevation of liver enzymes to clinically significant hepatitis and, rarely, acute liver failure, with some cases showing autoimmune‑like features.<ref name="LiverTox"/> Many cases occur in patients with pre‑existing liver disease or autoimmune predisposition and may be idiosyncratic or immune‑mediated.<ref name="LiverTox"/><br />
<br />
The AYUSH technical dossier highlights that many published liver injury reports lack detailed baseline documentation and may mix different species and preparations, underscoring the need for careful botanical identification, product quality control, and medical supervision, especially in patients with pre‑existing liver conditions.<ref name="AYUSHDossier"/><br />
<br />
== Current research trends ==<br />
<br />
PubMed‑based trend analyses indicate a substantial increase in publications on Guduchi, rising from several hundred articles in the early 2010s to over 900 indexed studies by 2024, reflecting growing scientific interest.<ref name="IMRReview2020"/><ref name="AYUSHDossier"/> This growth reflects heightened scientific and public interest but does not, by itself, equate to high‑quality clinical evidence.<ref name="MetabolicReview2025"/><br />
<br />
Most of the current evidence is from preclinical studies, mechanistic investigations, small trials, and narrative reviews; large, well‑designed randomized controlled trials are still limited.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
== Clinical position ==<br />
<br />
From an Ayurvedic perspective, Guduchi is regarded as a classical Rasayana with broad therapeutic indications, supported by long‑standing clinical experience.<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles"/> From a modern evidence‑based medicine standpoint, it is best viewed as a promising but not yet fully established botanical agent for conditions such as metabolic syndrome, certain inflammatory disorders, and liver and immune‑mediated conditions.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
Use in clinical practice should emphasize:<ref name="LiverTox"/><ref name="AYUSHDossier"/><br />
<br />
* Accurate botanical identification and use of standardized preparations<br />
* Caution in patients with liver disease or autoimmunity<br />
* Integration with, rather than substitution for, established medical therapies<br />
<br />
=== Indian Medicinal Plant Database, Phytochemistry And Therapeutics (IMPPAT) ===<br />
<br />
Link: https://cb.imsc.res.in/imppat/phytochemical/Tinospora%20crispa <br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development ..<br />
<br />
==References==</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Talk:Guduchi&diff=45428Talk:Guduchi2026-04-13T10:02:28Z<p>Agnivesha: /* Safety and hepatotoxicity */</p>
<hr />
<div>Guduchi (Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.)<br />
<br />
''Guduchi'' ({{langx|sa|गुडूची}}), commonly known as [[Giloy]], is the Sanskrit name for the medicinal plant [[Tinospora cordifolia]] (Willd.) Hook. f. & Thomson of the family [[Menispermaceae]].<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref> It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<ref name="AYUSHDossier"/><br />
<br />
<br />
{{Infobox<br />
|title = Guduchi<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Guduchi<br />
|label2 = Botanical name(s)<br />
|data2 = Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
|label3 = Family<br />
|data3 = Menispermaceae<br />
|label4 = Availability<br />
|data4 = Available<br />
|label5 = Contributors<br />
|data5 = --<br />
|label6 = Year of publication <br />
|data6 = 2026<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Skill Development Centre]], Symbiohealth Foundation, India<br />
|label8 = DOI <br />
|data8 = Awaited<br />
}}<br />
<br />
==English name == <br />
<br />
Heart leaved moonseed<br />
<br />
== Botanical identity ==<br />
<br />
The principal medicinal source of Guduchi is the stem of ''Tinospora cordifolia''.<ref name="AYUSHDossier"/> The plant is a deciduous, climbing shrub with simple, heart‑shaped leaves and small, greenish flowers.<ref name="AYUSHDossier"/> The genus ''Tinospora'' includes several species, and correct identification is important because some related species (e.g., ''Tinospora crispa'') have been implicated in hepatotoxicity reports.<ref name="LiverTox">Nnamani I, Tolu-Akinnawo O, Dufera RR, Akintunde A, Maliakkal B. Tinospora cordifolia (Guduchi/Giloy)-Induced Liver Injury: A Case Review. Cureus. 2023 May 31;15(5):e39793. doi: 10.7759/cureus.39793. PMID: 37273324; PMCID: PMC10238282.</ref><br />
<br />
For Ayurvedic purposes, the AYUSH technical dossier specifies that properly identified ''T. cordifolia'' stem should be used, warning against confusion with other ''Tinospora'' species that may occur in commercial supply.<ref name="AYUSHDossier"/><br />
<br />
== Other botanical names/varieties ==<br />
<br />
The following botanical names are accepted by Plants of the World Online as of January 2024.<br />
<br />
* Tinospora crispa (L.) Hook.f. & Thomson<br />
* Tinospora sinensis (Lour.) Merr<br />
* Tinospora arfakiana Becc.<br />
* Tinospora baenzigeri Forman<br />
* Tinopora bakis (A.Rich.)Miers<br />
* Tinospora celebica Diels<br />
* Tinopora dissitiflora (K.Schum. & Lauterb.) Diels<br />
* Tinopora esiangkara (F.M..Bailey) Forman<br />
* Tinospora formanii Udayan & Pradeep<br />
* Tinospora fragosa (I.Verd.) I.Verd. & Troupin<br />
* Tinospora glabra (Burm.f.)Merr.<br />
* Tinospora glandulosa Merr.<br />
* Tinospora guangxiensis H.S.Lo<br />
* Tinospora hainanensis H.S.Lo &Z.X.Li<br />
* Tinospora hirsuta (Becc.) Forman<br />
* Tinospora homosepala Diels<br />
* Tinospora macrocarpa Diels<br />
* Tinospora merriliana Diels<br />
* Tinospora neocaledonica Forman<br />
* Tinospora nudiflora (Griff.) Kurz<br />
* Tinospora orophila Troupin<br />
* Tinospora palminervis Miers<br />
* Tinospora siamensis Forman<br />
* Tinospora smilacina Benth.<br />
* Tinospora sumatrana Becc.<br />
* Tinospora teijsmannii Boerl.<br />
* Tinospora tenera Miers.<br />
* Tinospora tinosporoides (F.Muell.) Forman<br />
* Tinospora trilobata Diels.<br />
<br />
== Synonyms in Charak Samhita==<br />
<br />
Amruta, Madhuparni, Vayastha, Chhinnaruha, Vatsadini<br />
<br />
== Synonyms in Bhavaprakasha Nighantu ==<br />
Guduchi, Madhuparni, Amrita, Amritavallari, Chhinna, Chhinnaruha, Chhinnodbhava, Vatsadani, Jivanti, Tantrika, Soma, Somavalli, Kundali, Chakralakshanika, Dhira, Vishalya, Rasayani, Chandrahasa, Vayastha, Mandali, Devanirmita<br />
<br />
==Anupana according to Dosha==<br />
* '''Vata''' – Ghrita <br />
* '''Pitta''' – Sharkara (Sugar)<br />
* '''Kapha''' – Madhu (Honey)<br />
* '''Vibandha''' (Constipation)– Guda (Jaggery)<br />
* '''Vatarakta''' (Gout) – Eranda taila (Castor oil)<br />
* '''Amavaata'''(Rhumatoid arthritis) – Shunthi (Ginger)<br />
<br />
== Ayurvedic pharmacological properties ==<br />
{| class="wikitable"<br />
|+Table 1: Properties of Guduchi<br />
|-<br />
! Sr.no. !! Pharmacological criteria !! Properties<br />
|-<br />
| 1 || Taste ([[rasa]]) || Bitter (tikta), Astringent (kashaya)<br />
|-<br />
| 2 || Potency ([[veerya]]) || Hot (ushna)<br />
|-<br />
| 3 || Post digestion effect ([[vipaka]]) || Sweet (madhura)<br />
|-<br />
| 4 || Qualities ([[guna]])|| Heavy (guru), Unctuous (snigdha)<br />
|-<br />
| 5 || Actions ([[karma]]) || Pacify [[vata]], [[pitta]] and [[kapha]]<br />
|}<br />
== Reference in Charak Samhita and its actions == <br />
<br />
{| class="wikitable"<br />
|+ Herbs and their activities<br />
|-<br />
! Sr.no. !! Reference in Charak Samhita !! Activity <br />
|-<br />
| 1 ||Cha.Sa.[[Sutra Sthana]] 2/12 || Asthapana<br />
|-<br />
| 2 || Cha.Sa.[[Sutra Sthana]] 3/3 || Siddhatamachurnapradeha<br />
|-<br />
| 3 ||Cha.Sa.[[Sutra Sthana]] 4/9(11) || Truptighnamahakashay<br />
|-<br />
| 4 ||Cha.Sa.[[Sutra Sthana]] 4/9(18) || Stanyashodhanamahakashay<br />
|-<br />
| 5 ||Cha.Sa.[[Sutra Sthana]] 4/9(21) || Snehopagmahakashay<br />
|-<br />
| 6 ||Cha.Sa.[[Sutra Sthana]] 4/9(29) || Trishnanigrahanamahakashay<br />
|-<br />
| 7 ||Cha.Sa.[[Sutra Sthana]] 4/9(41) || Dahaprashamanamahakashaya<br />
|-<br />
| 8 ||Cha.Sa.[[Sutra Sthana]] 4/9(49) || Prajasthapanamahakashaya<br />
|-<br />
| 9 ||Cha.Sa.[[Sutra Sthana]] 4/9(50) || Vayasthapanmahakashaya<br />
|-<br />
| 10 ||Cha.Sa.[[Sutra Sthana]] 14/31 <br />
| Dravya for Nadi Sweda<br />
|-<br />
| 11 ||Cha.Sa.[[Sutra Sthana]] 21/22 <br />
| Management of obesity<br />
|-<br />
|12<br />
|Cha.Sa.[[Sutra Sthana]] 25/40<br />
|Agrya Sangraha<br />
|-<br />
|13<br />
|Cha.Sa.[[Sutra Sthana]]27/4<br />
|Natural qualities.<br />
|-<br />
|14<br />
|Cha.Sa.[[Sutra Sthana]] 27/106<br />
|Shaka Varga<br />
|-<br />
|15<br />
|Cha.Sa.[[Sutra Sthana]] 26/49<br />
|Veerya varnan<br />
|-<br />
|16<br />
|Cha.Sa.[[Vimana Sthana]] 8/135<br />
|Vaman dravyani<br />
|-<br />
|17<br />
|Cha.Sa.[[Vimana Sthana]] 8/139<br />
|Madhur skanda<br />
|-<br />
|18<br />
|Cha.Sa.[[Vimana Sthana]] 8/143<br />
|Tikta skandha<br />
|-<br />
|19<br />
|Cha.Sa.[[Sharira Sthana]].8/56<br />
|Kshira vishodhana dravya<br />
|-<br />
|20<br />
|Cha.Sa.[[Kalpa Sthana]] 1/22<br />
|Vamanartha<br />
|-<br />
|21<br />
|Cha.Sa.[[Kalpa Sthana]] 7/19<br />
|Preparations of Trivritta<br />
|-<br />
|22<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/198<br />
|Used as kwath or sheeta kashaya for trushna, deepana, doshapachana, jwar, aruchi and mukhavairasya.<br />
|-<br />
|23<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in trutiyaka jwara.<br />
|-<br />
|24<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in chaturthaka jwara.<br />
|-<br />
|25<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/211<br />
|As an ingredient of shatyadi varga used in kasa, svasa, tandra,parshvashoola, hrdgraha and sannipata jwara.<br />
|-<br />
|26<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/222<br />
|As an ingredient of Vasadi Ghrita.<br />
|-<br />
|27<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/247<br />
|Used in niruha basti.<br />
|-<br />
|28<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/251<br />
|Used in Patoladi niruha basti.<br />
|-<br />
|29<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/267<br />
|In formulation of Agurvadi taila.<br />
|-<br />
|30<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/299<br />
|Used as swarasa in Vishama jwara.<br />
|-<br />
|31<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/343<br />
|Used in punaravrtaka jwara(Kirat tiktadi kwath)<br />
|-<br />
|32<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/29<br />
|Used for making decoction in Kaphaj prameh<br />
|-<br />
|33<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/30<br />
|Used for making decoction in Pittaja Prameha <br />
|-<br />
|34<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/77<br />
|Ingredient in Kanakabindurishta<br />
|-<br />
|35<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/124<br />
|Bahyaprayogarth Lepa in Vata-Kaphaja Kushtha<br />
|-<br />
|36<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/146<br />
|Ingredient in Mahatikta Ghrita<br />
|-<br />
|37<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/153<br />
|Ingredient in Mahakhadira Ghrita<br />
|-<br />
|38<br />
|Cha.Sa.[[Chikitsa Sthana]] 8/72<br />
|For Parisheka purpose<br />
|-<br />
|39<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/25<br />
|In treatment of Vataja Shvayathu<br />
|-<br />
|40<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/34<br />
|Ingredient in Punarnavadyarishta<br />
|-<br />
|41<br />
|Cha.Sa.[[Chikitsa Sthana]] 5/190<br />
|Used in preparation of Panchama Kshara<br />
|-<br />
|42<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/63<br />
|In Kamala Guduchi Swarasa should be given in early in the morning <br />
|-<br />
|43<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/134 <br />
|Used in Halimak Chikitsa<br />
|-<br />
|44<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/94<br />
|Used in yusha preparation for hikka svasa<br />
|-<br />
|45<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/102<br />
|Used as yavagu in hikka svasa<br />
|-<br />
|46<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/35<br />
|As a ghrita dravya<br />
|-<br />
|47<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/161<br />
|As an ingredient of guduchyadi ghrita.<br />
|-<br />
|48<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/31 <br />
|As a pana yoga in Pittaja chhardi.<br />
|-<br />
|49<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/35<br />
|As a pathya ahara in kaphaja chhardi.<br />
|-<br />
|50<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/58<br />
|For kashaya pana.<br />
|-<br />
|51<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/130<br />
|Used in granthi visarpa.<br />
|-<br />
|52<br />
|Cha.Sa.[[Chikitsa Sthana]] 22/45<br />
|As a pana yoga.<br />
|-<br />
|53<br />
|Cha.Sa.[[Chikitsa Sthana]] 23/70<br />
|As an ingredient of Gandha hasti agada.<br />
|-<br />
|54<br />
|Cha.Sa.[[Chikitsa Sthana]] 24/145<br />
|Used as swarasa where pittaja madatyaya is associated with sarakta kasa, Parshvashoola, Stanashoola, Daaha & Hradayotkleda.<br />
|-<br />
|55<br />
|Cha.Sa.[[Chikitsa Sthana]] 25/75<br />
|Used in shoola with sneha & sarkara.<br />
|-<br />
|56<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/57<br />
|Used in Kaphaja mutrakruchhra.<br />
|-<br />
|57<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/70<br />
|As an ingredient of Karpasmooladi yoga.<br />
|-<br />
|58<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/83<br />
|As an ingredient of Haritakyadi Ghrita.<br />
|-<br />
|59<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/243<br />
|As an ingredient of Amrutadi varti.<br />
|-<br />
|60<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/283<br />
|Used in Vataja swarbheda.<br />
|-<br />
|61<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/148<br />
|As an ingredient of Bala taila. <br />
|-<br />
|62<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/157<br />
|As an ingredient of Amrutadi taila.<br />
|-<br />
|63<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/170<br />
|As an ingredient of Vrushamuladi taila.<br />
|-<br />
|64<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/172<br />
|As an ingredient of Mulaka taila.<br />
|-<br />
|65<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/71<br />
|Anupana of Drakshadi Ghrita.<br />
|-<br />
|66<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/73<br />
|As an ingredient of Jeevakadi mahasneha.<br />
|-<br />
|67<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/92<br />
|As an ingredient of Madhuparnyadi taila.<br />
|-<br />
|68<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/103<br />
|As an ingredient of Amrutadhya taila.<br />
|-<br />
|69<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/117<br />
|As an ingredient of Shatapaka Madhuparni taila.<br />
|-<br />
|70<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/53<br />
|As an ingredient of Kashmaryadi ghrita, used in the treatment of Vataja yoni.<br />
|-<br />
|71<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/58<br />
|For parishechana in yoni shula.<br />
|-<br />
|72<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/99<br />
|Used in the treatment of Kaphaja pradara.<br />
|-<br />
|73<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/59<br />
|As an ingredient of Guduchyadi taila, used in the treatment of Vataja yoni roga.<br />
|-<br />
|}<br />
<br />
== Classical therapeutic uses ==<br />
<br />
Guduchi is one of the most frequently cited herbs in Ayurvedic literature and is reported in formulations for a wide range of conditions, including:<ref name="AYUSHDossier"/><br />
<br />
Classical actions attributed to Guduchi include:<ref name="AYUSHDossier"/><br />
<br />
* Rasayana (rejuvenative)<br />
* Dipana and Sangrahi (appetizing and absorbent)<br />
* Vataraktahara and Amavataghni (useful in gout and rheumatoid‑like arthritis)<br />
* Kamalahara (beneficial in jaundice and liver disorders)<br />
* Kushtaghna (beneficial in skin diseases)<br />
* Pramehaghna (beneficial in urinary and metabolic disorders)<br />
* Jvara (fever), including irregular and chronic fevers<br />
* Kamala (jaundice) and other hepatic and viral fevers<br />
* Vatarakta and amavata (gout and rheumatoid‑like arthritis)<br />
* Kasa (chronic cough)<br />
* Prameha (Diabetes mellitus and metabolic disorders)<br />
* Chardighna (anti‑emetic indications)<br />
<br />
The AYUSH technical dossier notes that Guduchi appears in more than 2,400 Ayurvedic formulations across over 24 dosage forms, indicating its broad and enduring therapeutic role.<ref name="AYUSHDossier"/><br />
<br />
== Parts used and dosage forms ==<br />
<br />
In Ayurvedic practice, the mature stem is the primary part used for preparing Guduchi‑based medicines.<ref name="AYUSHDossier"/> Common traditional dosage forms include:<ref name="AYUSHDossier"/><br />
<br />
* Churna (powder)<br />
* Kwatha (decoction)<br />
* Hima (cold infusion)<br />
* Svarasa (fresh juice)<br />
* Satva (starch preparation)<br />
* Ghrita (medicated ghee)<br />
* Taila (medicated oil)<br />
* Gutika (tablets)<br />
<br />
== Important Formulations ==<br />
<br />
* Amritarishta<br />
* Amritottara kvatha churna<br />
* Guduchi Taila<br />
* Guduchyadi churna<br />
* Guduchi Sattva<br />
* Chhinnodbhavadi kvatha churna<br />
* Kaishora Guggulu<br />
* Samshamani Vati<br />
<br />
==Dose==<br />
<br />
The AYUSH technical dossier cites typical dose ranges as:<ref name="AYUSHDossier"/><br />
* 3–6 g of powder<br />
* 20–30 g of coarse powder for decoction<br />
* 125 mg–1000 mg of Guduchi sattva, taken with appropriate anupana (vehicle)<br />
<br />
== Current availability== <br />
<br />
Available <br />
<br />
Through all over India extending from Himalayas to the Southern part of India.<br />
<br />
Other countries: Nepal, Bangladesh, Pakistan, Myanmar, Burma, Sri Lanka, Malaysia, Indonesia and Thailand<br />
<br />
== Current researches ==<br />
<br />
== Chemical constituents ==<br />
<br />
Modern phytochemical studies have identified more than 200 compounds in ''Tinospora cordifolia'' and related species, including diterpenoids, alkaloids, glycosides, steroids, sesquiterpenoids, and phenolics.<ref name="ImmunomodulatoryReview">Yates CR, Bruno EJ, Yates MED. Tinospora Cordifolia: A review of its immunomodulatory properties. J Diet Suppl. 2022;19(2):271-285. doi: 10.1080/19390211.2021.1873214. Epub 2021 Jan 22. PMID: 33480818.</ref> Key constituents reported in the literature include:<ref name="AYUSHDossier"/>,<ref name="OnePlantManyRoles">Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012 Apr;31(4):151-9. doi: 10.4103/0257-7941.107344. PMID: 23661861; PMCID: PMC3644751</ref><br />
<br />
* Clerodane‑type diterpenoids<br />
* Cordifolioside A and tinosporaside (used as assay markers)<br />
* Alkaloids such as magnoflorine and berberine‑like compounds<br />
* Diterpenoid lactones and glycosides<br />
<br />
These constituents are thought to contribute to the herb’s bitter taste, immunomodulatory, anti‑inflammatory, and antioxidant properties.<ref name="ImmunomodulatoryReview"/><br />
<br />
== Pharmacological actions ==<br />
<br />
Experimental studies, including in vitro and animal models, support several pharmacological activities of Guduchi extracts.<ref name="ImmunomodulatoryReview"/><ref name="OnePlantManyRoles"/><br />
<br />
* Immunomodulatory effects: Modulation of immune cell function and cytokine pathways.<ref name="ImmunomodulatoryReview"/><br />
* Anti‑inflammatory effects: Reduction of pro‑inflammatory cytokines such as TNF‑α and IL‑1β.<ref name="ImmunomodulatoryReview"/><ref name="ScientificReports2019">{{Cite Ghatpande NS, Misar AV, Waghole RJ, Jadhav SH, Kulkarni PP. Tinospora cordifolia protects against inflammation associated anemia by modulating inflammatory cytokines and hepcidin expression in male Wistar rats. Sci Rep. 2019 Jul 29;9(1):10969. doi: 10.1038/s41598-019-47458-0. PMID: 31358831; PMCID: PMC6662690}}</ref><br />
* Antioxidant activity: Scavenging of free radicals and reduction of oxidative stress.<ref name="OnePlantManyRoles"/><br />
* Antipyretic and analgesic activity in fever‑like models.<ref name="ImmunomodulatoryReview"/><br />
<br />
Some studies also report hepatoprotective, hypoglycemic, and anti‑arthritic‑like effects, although the exact mechanisms and clinical relevance remain under investigation.<ref name="OnePlantManyRoles"/><ref name="ImmunomodulatoryReview"/><br />
<br />
== Metabolic and endocrine research ==<br />
<br />
Recent reviews suggest that Guduchi may have beneficial effects on diabetes, hyperlipidemia, obesity, and related features of metabolic syndrome.<ref name="MetabolicReview2025">{{Mansouri M, Imenshahidi M, Rameshrad M, Hosseinzadeh H. Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review. Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4979-5009. doi: 10.1007/s00210-024-03642-2. Epub 2024 Dec 28. PMID: 39731594.}}</ref> Anti‑diabetic and antihyperglycemic actions have been reported in animal models and some small human studies, including a randomized trial in diabetic dyslipidemia showing improvement in lipid profile, inflammatory markers, and metabolic‑syndrome prevalence with Guduchi‑stem supplementation.<ref name="DiabeticDyslipidemiaRCT">{{Cite journal |year=2024 |title=Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open‑labelled randomized controlled trial |journal=International Journal of Research and Pharmaceutical Sciences |volume=15 |issue=12 |pages=100–107 |url=https://ffhdj.com/index.php/ffhd/article/view/208}}</ref><br />
<br />
However, the overall evidence base still relies heavily on preclinical data and heterogeneous herbal preparations rather than standardized, large‑scale randomized trials.<ref name="MetabolicReview2025"/><br />
<br />
== Musculoskeletal and inflammatory conditions ==<br />
<br />
Guduchi is traditionally used for vatarakta and amavata, conditions resembling gout and rheumatoid arthritis.<ref name="AYUSHDossier"/> Preclinical studies in arthritis models show that ''T. cordifolia'' extracts can reduce inflammatory mediators and markers of joint destruction, supporting its traditional anti‑arthritic use.<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<br />
However, the evidence is still preliminary, and current data justify Guduchi mainly as a potential adjunct to conventional therapy rather than as a standalone monotherapy for chronic inflammatory joint disease.<ref name="Arthritis2015"/><br />
<br />
== Safety and hepatotoxicity ==<br />
<br />
In recent years, several case reports and reviews have described herb‑induced liver injury associated with Guduchi or ''Tinospora''‑containing products.<ref name="LiverTox"/>,<ref name="LiverInjury2023">{{Cite journal|last=Nnamani |first=I. |year=2023 |title=Tinospora cordifolia (Guduchi/Giloy)‑induced liver injury |journal=BMJ Case Reports|volume=16 |issue=11 |pages=e254123 |doi=10.1136/bcr‑2023‑254123 |pmid=37273324}}</ref>,<ref name="PMC2021LiverInjury">Björnsson ES, Navarro VJ, Chalasani N. Liver Injury Following Tinospora Cordifolia Consumption: Drug-Induced AIH, or de novo AIH? J Clin Exp Hepatol. 2022 Jan-Feb;12(1):6-9. doi: 10.1016/j.jceh.2021.11.014. Epub 2021 Nov 29. PMID: 35068778; PMCID: PMC8766689.</ref><br />
<br />
The NIH LiverTox resource notes that Guduchi‑associated liver injury can range from mild elevation of liver enzymes to clinically significant hepatitis and, rarely, acute liver failure, with some cases showing autoimmune‑like features.<ref name="LiverTox"/> Many cases occur in patients with pre‑existing liver disease or autoimmune predisposition and may be idiosyncratic or immune‑mediated.<ref name="LiverTox"/>,<ref name="LiverInjury2023"/><br />
<br />
The AYUSH technical dossier highlights that many published liver injury reports lack detailed baseline documentation and may mix different species and preparations, underscoring the need for careful botanical identification, product quality control, and medical supervision, especially in patients with pre‑existing liver conditions.<ref name="AYUSHDossier"/><br />
<br />
== Current research trends ==<br />
<br />
PubMed‑based trend analyses indicate a substantial increase in publications on Guduchi, rising from several hundred articles in the early 2010s to over 900 indexed studies by 2024, reflecting growing scientific interest.<ref name="IMRReview2020"/><ref name="AYUSHDossier"/> This growth reflects heightened scientific and public interest but does not, by itself, equate to high‑quality clinical evidence.<ref name="MetabolicReview2025"/><br />
<br />
Most of the current evidence is from preclinical studies, mechanistic investigations, small trials, and narrative reviews; large, well‑designed randomized controlled trials are still limited.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
== Clinical position ==<br />
<br />
From an Ayurvedic perspective, Guduchi is regarded as a classical Rasayana with broad therapeutic indications, supported by long‑standing clinical experience.<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles"/> From a modern evidence‑based medicine standpoint, it is best viewed as a promising but not yet fully established botanical agent for conditions such as metabolic syndrome, certain inflammatory disorders, and liver and immune‑mediated conditions.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
Use in clinical practice should emphasize:<ref name="LiverTox"/><ref name="AYUSHDossier"/><br />
<br />
* Accurate botanical identification and use of standardized preparations<br />
* Caution in patients with liver disease or autoimmunity<br />
* Integration with, rather than substitution for, established medical therapies<br />
<br />
=== Indian Medicinal Plant Database, Phytochemistry And Therapeutics (IMPPAT) ===<br />
<br />
Link: https://cb.imsc.res.in/imppat/phytochemical/Tinospora%20crispa <br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development ..<br />
<br />
==References==</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Talk:Guduchi&diff=45427Talk:Guduchi2026-04-13T09:59:43Z<p>Agnivesha: /* Chemical constituents */</p>
<hr />
<div>Guduchi (Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.)<br />
<br />
''Guduchi'' ({{langx|sa|गुडूची}}), commonly known as [[Giloy]], is the Sanskrit name for the medicinal plant [[Tinospora cordifolia]] (Willd.) Hook. f. & Thomson of the family [[Menispermaceae]].<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref> It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<ref name="AYUSHDossier"/><br />
<br />
<br />
{{Infobox<br />
|title = Guduchi<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Guduchi<br />
|label2 = Botanical name(s)<br />
|data2 = Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
|label3 = Family<br />
|data3 = Menispermaceae<br />
|label4 = Availability<br />
|data4 = Available<br />
|label5 = Contributors<br />
|data5 = --<br />
|label6 = Year of publication <br />
|data6 = 2026<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Skill Development Centre]], Symbiohealth Foundation, India<br />
|label8 = DOI <br />
|data8 = Awaited<br />
}}<br />
<br />
==English name == <br />
<br />
Heart leaved moonseed<br />
<br />
== Botanical identity ==<br />
<br />
The principal medicinal source of Guduchi is the stem of ''Tinospora cordifolia''.<ref name="AYUSHDossier"/> The plant is a deciduous, climbing shrub with simple, heart‑shaped leaves and small, greenish flowers.<ref name="AYUSHDossier"/> The genus ''Tinospora'' includes several species, and correct identification is important because some related species (e.g., ''Tinospora crispa'') have been implicated in hepatotoxicity reports.<ref name="LiverTox">Nnamani I, Tolu-Akinnawo O, Dufera RR, Akintunde A, Maliakkal B. Tinospora cordifolia (Guduchi/Giloy)-Induced Liver Injury: A Case Review. Cureus. 2023 May 31;15(5):e39793. doi: 10.7759/cureus.39793. PMID: 37273324; PMCID: PMC10238282.</ref><br />
<br />
For Ayurvedic purposes, the AYUSH technical dossier specifies that properly identified ''T. cordifolia'' stem should be used, warning against confusion with other ''Tinospora'' species that may occur in commercial supply.<ref name="AYUSHDossier"/><br />
<br />
== Other botanical names/varieties ==<br />
<br />
The following botanical names are accepted by Plants of the World Online as of January 2024.<br />
<br />
* Tinospora crispa (L.) Hook.f. & Thomson<br />
* Tinospora sinensis (Lour.) Merr<br />
* Tinospora arfakiana Becc.<br />
* Tinospora baenzigeri Forman<br />
* Tinopora bakis (A.Rich.)Miers<br />
* Tinospora celebica Diels<br />
* Tinopora dissitiflora (K.Schum. & Lauterb.) Diels<br />
* Tinopora esiangkara (F.M..Bailey) Forman<br />
* Tinospora formanii Udayan & Pradeep<br />
* Tinospora fragosa (I.Verd.) I.Verd. & Troupin<br />
* Tinospora glabra (Burm.f.)Merr.<br />
* Tinospora glandulosa Merr.<br />
* Tinospora guangxiensis H.S.Lo<br />
* Tinospora hainanensis H.S.Lo &Z.X.Li<br />
* Tinospora hirsuta (Becc.) Forman<br />
* Tinospora homosepala Diels<br />
* Tinospora macrocarpa Diels<br />
* Tinospora merriliana Diels<br />
* Tinospora neocaledonica Forman<br />
* Tinospora nudiflora (Griff.) Kurz<br />
* Tinospora orophila Troupin<br />
* Tinospora palminervis Miers<br />
* Tinospora siamensis Forman<br />
* Tinospora smilacina Benth.<br />
* Tinospora sumatrana Becc.<br />
* Tinospora teijsmannii Boerl.<br />
* Tinospora tenera Miers.<br />
* Tinospora tinosporoides (F.Muell.) Forman<br />
* Tinospora trilobata Diels.<br />
<br />
== Synonyms in Charak Samhita==<br />
<br />
Amruta, Madhuparni, Vayastha, Chhinnaruha, Vatsadini<br />
<br />
== Synonyms in Bhavaprakasha Nighantu ==<br />
Guduchi, Madhuparni, Amrita, Amritavallari, Chhinna, Chhinnaruha, Chhinnodbhava, Vatsadani, Jivanti, Tantrika, Soma, Somavalli, Kundali, Chakralakshanika, Dhira, Vishalya, Rasayani, Chandrahasa, Vayastha, Mandali, Devanirmita<br />
<br />
==Anupana according to Dosha==<br />
* '''Vata''' – Ghrita <br />
* '''Pitta''' – Sharkara (Sugar)<br />
* '''Kapha''' – Madhu (Honey)<br />
* '''Vibandha''' (Constipation)– Guda (Jaggery)<br />
* '''Vatarakta''' (Gout) – Eranda taila (Castor oil)<br />
* '''Amavaata'''(Rhumatoid arthritis) – Shunthi (Ginger)<br />
<br />
== Ayurvedic pharmacological properties ==<br />
{| class="wikitable"<br />
|+Table 1: Properties of Guduchi<br />
|-<br />
! Sr.no. !! Pharmacological criteria !! Properties<br />
|-<br />
| 1 || Taste ([[rasa]]) || Bitter (tikta), Astringent (kashaya)<br />
|-<br />
| 2 || Potency ([[veerya]]) || Hot (ushna)<br />
|-<br />
| 3 || Post digestion effect ([[vipaka]]) || Sweet (madhura)<br />
|-<br />
| 4 || Qualities ([[guna]])|| Heavy (guru), Unctuous (snigdha)<br />
|-<br />
| 5 || Actions ([[karma]]) || Pacify [[vata]], [[pitta]] and [[kapha]]<br />
|}<br />
== Reference in Charak Samhita and its actions == <br />
<br />
{| class="wikitable"<br />
|+ Herbs and their activities<br />
|-<br />
! Sr.no. !! Reference in Charak Samhita !! Activity <br />
|-<br />
| 1 ||Cha.Sa.[[Sutra Sthana]] 2/12 || Asthapana<br />
|-<br />
| 2 || Cha.Sa.[[Sutra Sthana]] 3/3 || Siddhatamachurnapradeha<br />
|-<br />
| 3 ||Cha.Sa.[[Sutra Sthana]] 4/9(11) || Truptighnamahakashay<br />
|-<br />
| 4 ||Cha.Sa.[[Sutra Sthana]] 4/9(18) || Stanyashodhanamahakashay<br />
|-<br />
| 5 ||Cha.Sa.[[Sutra Sthana]] 4/9(21) || Snehopagmahakashay<br />
|-<br />
| 6 ||Cha.Sa.[[Sutra Sthana]] 4/9(29) || Trishnanigrahanamahakashay<br />
|-<br />
| 7 ||Cha.Sa.[[Sutra Sthana]] 4/9(41) || Dahaprashamanamahakashaya<br />
|-<br />
| 8 ||Cha.Sa.[[Sutra Sthana]] 4/9(49) || Prajasthapanamahakashaya<br />
|-<br />
| 9 ||Cha.Sa.[[Sutra Sthana]] 4/9(50) || Vayasthapanmahakashaya<br />
|-<br />
| 10 ||Cha.Sa.[[Sutra Sthana]] 14/31 <br />
| Dravya for Nadi Sweda<br />
|-<br />
| 11 ||Cha.Sa.[[Sutra Sthana]] 21/22 <br />
| Management of obesity<br />
|-<br />
|12<br />
|Cha.Sa.[[Sutra Sthana]] 25/40<br />
|Agrya Sangraha<br />
|-<br />
|13<br />
|Cha.Sa.[[Sutra Sthana]]27/4<br />
|Natural qualities.<br />
|-<br />
|14<br />
|Cha.Sa.[[Sutra Sthana]] 27/106<br />
|Shaka Varga<br />
|-<br />
|15<br />
|Cha.Sa.[[Sutra Sthana]] 26/49<br />
|Veerya varnan<br />
|-<br />
|16<br />
|Cha.Sa.[[Vimana Sthana]] 8/135<br />
|Vaman dravyani<br />
|-<br />
|17<br />
|Cha.Sa.[[Vimana Sthana]] 8/139<br />
|Madhur skanda<br />
|-<br />
|18<br />
|Cha.Sa.[[Vimana Sthana]] 8/143<br />
|Tikta skandha<br />
|-<br />
|19<br />
|Cha.Sa.[[Sharira Sthana]].8/56<br />
|Kshira vishodhana dravya<br />
|-<br />
|20<br />
|Cha.Sa.[[Kalpa Sthana]] 1/22<br />
|Vamanartha<br />
|-<br />
|21<br />
|Cha.Sa.[[Kalpa Sthana]] 7/19<br />
|Preparations of Trivritta<br />
|-<br />
|22<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/198<br />
|Used as kwath or sheeta kashaya for trushna, deepana, doshapachana, jwar, aruchi and mukhavairasya.<br />
|-<br />
|23<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in trutiyaka jwara.<br />
|-<br />
|24<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in chaturthaka jwara.<br />
|-<br />
|25<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/211<br />
|As an ingredient of shatyadi varga used in kasa, svasa, tandra,parshvashoola, hrdgraha and sannipata jwara.<br />
|-<br />
|26<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/222<br />
|As an ingredient of Vasadi Ghrita.<br />
|-<br />
|27<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/247<br />
|Used in niruha basti.<br />
|-<br />
|28<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/251<br />
|Used in Patoladi niruha basti.<br />
|-<br />
|29<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/267<br />
|In formulation of Agurvadi taila.<br />
|-<br />
|30<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/299<br />
|Used as swarasa in Vishama jwara.<br />
|-<br />
|31<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/343<br />
|Used in punaravrtaka jwara(Kirat tiktadi kwath)<br />
|-<br />
|32<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/29<br />
|Used for making decoction in Kaphaj prameh<br />
|-<br />
|33<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/30<br />
|Used for making decoction in Pittaja Prameha <br />
|-<br />
|34<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/77<br />
|Ingredient in Kanakabindurishta<br />
|-<br />
|35<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/124<br />
|Bahyaprayogarth Lepa in Vata-Kaphaja Kushtha<br />
|-<br />
|36<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/146<br />
|Ingredient in Mahatikta Ghrita<br />
|-<br />
|37<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/153<br />
|Ingredient in Mahakhadira Ghrita<br />
|-<br />
|38<br />
|Cha.Sa.[[Chikitsa Sthana]] 8/72<br />
|For Parisheka purpose<br />
|-<br />
|39<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/25<br />
|In treatment of Vataja Shvayathu<br />
|-<br />
|40<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/34<br />
|Ingredient in Punarnavadyarishta<br />
|-<br />
|41<br />
|Cha.Sa.[[Chikitsa Sthana]] 5/190<br />
|Used in preparation of Panchama Kshara<br />
|-<br />
|42<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/63<br />
|In Kamala Guduchi Swarasa should be given in early in the morning <br />
|-<br />
|43<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/134 <br />
|Used in Halimak Chikitsa<br />
|-<br />
|44<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/94<br />
|Used in yusha preparation for hikka svasa<br />
|-<br />
|45<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/102<br />
|Used as yavagu in hikka svasa<br />
|-<br />
|46<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/35<br />
|As a ghrita dravya<br />
|-<br />
|47<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/161<br />
|As an ingredient of guduchyadi ghrita.<br />
|-<br />
|48<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/31 <br />
|As a pana yoga in Pittaja chhardi.<br />
|-<br />
|49<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/35<br />
|As a pathya ahara in kaphaja chhardi.<br />
|-<br />
|50<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/58<br />
|For kashaya pana.<br />
|-<br />
|51<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/130<br />
|Used in granthi visarpa.<br />
|-<br />
|52<br />
|Cha.Sa.[[Chikitsa Sthana]] 22/45<br />
|As a pana yoga.<br />
|-<br />
|53<br />
|Cha.Sa.[[Chikitsa Sthana]] 23/70<br />
|As an ingredient of Gandha hasti agada.<br />
|-<br />
|54<br />
|Cha.Sa.[[Chikitsa Sthana]] 24/145<br />
|Used as swarasa where pittaja madatyaya is associated with sarakta kasa, Parshvashoola, Stanashoola, Daaha & Hradayotkleda.<br />
|-<br />
|55<br />
|Cha.Sa.[[Chikitsa Sthana]] 25/75<br />
|Used in shoola with sneha & sarkara.<br />
|-<br />
|56<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/57<br />
|Used in Kaphaja mutrakruchhra.<br />
|-<br />
|57<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/70<br />
|As an ingredient of Karpasmooladi yoga.<br />
|-<br />
|58<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/83<br />
|As an ingredient of Haritakyadi Ghrita.<br />
|-<br />
|59<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/243<br />
|As an ingredient of Amrutadi varti.<br />
|-<br />
|60<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/283<br />
|Used in Vataja swarbheda.<br />
|-<br />
|61<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/148<br />
|As an ingredient of Bala taila. <br />
|-<br />
|62<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/157<br />
|As an ingredient of Amrutadi taila.<br />
|-<br />
|63<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/170<br />
|As an ingredient of Vrushamuladi taila.<br />
|-<br />
|64<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/172<br />
|As an ingredient of Mulaka taila.<br />
|-<br />
|65<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/71<br />
|Anupana of Drakshadi Ghrita.<br />
|-<br />
|66<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/73<br />
|As an ingredient of Jeevakadi mahasneha.<br />
|-<br />
|67<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/92<br />
|As an ingredient of Madhuparnyadi taila.<br />
|-<br />
|68<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/103<br />
|As an ingredient of Amrutadhya taila.<br />
|-<br />
|69<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/117<br />
|As an ingredient of Shatapaka Madhuparni taila.<br />
|-<br />
|70<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/53<br />
|As an ingredient of Kashmaryadi ghrita, used in the treatment of Vataja yoni.<br />
|-<br />
|71<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/58<br />
|For parishechana in yoni shula.<br />
|-<br />
|72<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/99<br />
|Used in the treatment of Kaphaja pradara.<br />
|-<br />
|73<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/59<br />
|As an ingredient of Guduchyadi taila, used in the treatment of Vataja yoni roga.<br />
|-<br />
|}<br />
<br />
== Classical therapeutic uses ==<br />
<br />
Guduchi is one of the most frequently cited herbs in Ayurvedic literature and is reported in formulations for a wide range of conditions, including:<ref name="AYUSHDossier"/><br />
<br />
Classical actions attributed to Guduchi include:<ref name="AYUSHDossier"/><br />
<br />
* Rasayana (rejuvenative)<br />
* Dipana and Sangrahi (appetizing and absorbent)<br />
* Vataraktahara and Amavataghni (useful in gout and rheumatoid‑like arthritis)<br />
* Kamalahara (beneficial in jaundice and liver disorders)<br />
* Kushtaghna (beneficial in skin diseases)<br />
* Pramehaghna (beneficial in urinary and metabolic disorders)<br />
* Jvara (fever), including irregular and chronic fevers<br />
* Kamala (jaundice) and other hepatic and viral fevers<br />
* Vatarakta and amavata (gout and rheumatoid‑like arthritis)<br />
* Kasa (chronic cough)<br />
* Prameha (Diabetes mellitus and metabolic disorders)<br />
* Chardighna (anti‑emetic indications)<br />
<br />
The AYUSH technical dossier notes that Guduchi appears in more than 2,400 Ayurvedic formulations across over 24 dosage forms, indicating its broad and enduring therapeutic role.<ref name="AYUSHDossier"/><br />
<br />
== Parts used and dosage forms ==<br />
<br />
In Ayurvedic practice, the mature stem is the primary part used for preparing Guduchi‑based medicines.<ref name="AYUSHDossier"/> Common traditional dosage forms include:<ref name="AYUSHDossier"/><br />
<br />
* Churna (powder)<br />
* Kwatha (decoction)<br />
* Hima (cold infusion)<br />
* Svarasa (fresh juice)<br />
* Satva (starch preparation)<br />
* Ghrita (medicated ghee)<br />
* Taila (medicated oil)<br />
* Gutika (tablets)<br />
<br />
== Important Formulations ==<br />
<br />
* Amritarishta<br />
* Amritottara kvatha churna<br />
* Guduchi Taila<br />
* Guduchyadi churna<br />
* Guduchi Sattva<br />
* Chhinnodbhavadi kvatha churna<br />
* Kaishora Guggulu<br />
* Samshamani Vati<br />
<br />
==Dose==<br />
<br />
The AYUSH technical dossier cites typical dose ranges as:<ref name="AYUSHDossier"/><br />
* 3–6 g of powder<br />
* 20–30 g of coarse powder for decoction<br />
* 125 mg–1000 mg of Guduchi sattva, taken with appropriate anupana (vehicle)<br />
<br />
== Current availability== <br />
<br />
Available <br />
<br />
Through all over India extending from Himalayas to the Southern part of India.<br />
<br />
Other countries: Nepal, Bangladesh, Pakistan, Myanmar, Burma, Sri Lanka, Malaysia, Indonesia and Thailand<br />
<br />
== Current researches ==<br />
<br />
== Chemical constituents ==<br />
<br />
Modern phytochemical studies have identified more than 200 compounds in ''Tinospora cordifolia'' and related species, including diterpenoids, alkaloids, glycosides, steroids, sesquiterpenoids, and phenolics.<ref name="ImmunomodulatoryReview">Yates CR, Bruno EJ, Yates MED. Tinospora Cordifolia: A review of its immunomodulatory properties. J Diet Suppl. 2022;19(2):271-285. doi: 10.1080/19390211.2021.1873214. Epub 2021 Jan 22. PMID: 33480818.</ref> Key constituents reported in the literature include:<ref name="AYUSHDossier"/>,<ref name="OnePlantManyRoles">Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012 Apr;31(4):151-9. doi: 10.4103/0257-7941.107344. PMID: 23661861; PMCID: PMC3644751</ref><br />
<br />
* Clerodane‑type diterpenoids<br />
* Cordifolioside A and tinosporaside (used as assay markers)<br />
* Alkaloids such as magnoflorine and berberine‑like compounds<br />
* Diterpenoid lactones and glycosides<br />
<br />
These constituents are thought to contribute to the herb’s bitter taste, immunomodulatory, anti‑inflammatory, and antioxidant properties.<ref name="ImmunomodulatoryReview"/><br />
<br />
== Pharmacological actions ==<br />
<br />
Experimental studies, including in vitro and animal models, support several pharmacological activities of Guduchi extracts.<ref name="ImmunomodulatoryReview"/><ref name="OnePlantManyRoles"/><br />
<br />
* Immunomodulatory effects: Modulation of immune cell function and cytokine pathways.<ref name="ImmunomodulatoryReview"/><br />
* Anti‑inflammatory effects: Reduction of pro‑inflammatory cytokines such as TNF‑α and IL‑1β.<ref name="ImmunomodulatoryReview"/><ref name="ScientificReports2019">{{Cite Ghatpande NS, Misar AV, Waghole RJ, Jadhav SH, Kulkarni PP. Tinospora cordifolia protects against inflammation associated anemia by modulating inflammatory cytokines and hepcidin expression in male Wistar rats. Sci Rep. 2019 Jul 29;9(1):10969. doi: 10.1038/s41598-019-47458-0. PMID: 31358831; PMCID: PMC6662690}}</ref><br />
* Antioxidant activity: Scavenging of free radicals and reduction of oxidative stress.<ref name="OnePlantManyRoles"/><br />
* Antipyretic and analgesic activity in fever‑like models.<ref name="ImmunomodulatoryReview"/><br />
<br />
Some studies also report hepatoprotective, hypoglycemic, and anti‑arthritic‑like effects, although the exact mechanisms and clinical relevance remain under investigation.<ref name="OnePlantManyRoles"/><ref name="ImmunomodulatoryReview"/><br />
<br />
== Metabolic and endocrine research ==<br />
<br />
Recent reviews suggest that Guduchi may have beneficial effects on diabetes, hyperlipidemia, obesity, and related features of metabolic syndrome.<ref name="MetabolicReview2025">{{Mansouri M, Imenshahidi M, Rameshrad M, Hosseinzadeh H. Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review. Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4979-5009. doi: 10.1007/s00210-024-03642-2. Epub 2024 Dec 28. PMID: 39731594.}}</ref> Anti‑diabetic and antihyperglycemic actions have been reported in animal models and some small human studies, including a randomized trial in diabetic dyslipidemia showing improvement in lipid profile, inflammatory markers, and metabolic‑syndrome prevalence with Guduchi‑stem supplementation.<ref name="DiabeticDyslipidemiaRCT">{{Cite journal |year=2024 |title=Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open‑labelled randomized controlled trial |journal=International Journal of Research and Pharmaceutical Sciences |volume=15 |issue=12 |pages=100–107 |url=https://ffhdj.com/index.php/ffhd/article/view/208}}</ref><br />
<br />
However, the overall evidence base still relies heavily on preclinical data and heterogeneous herbal preparations rather than standardized, large‑scale randomized trials.<ref name="MetabolicReview2025"/><br />
<br />
== Musculoskeletal and inflammatory conditions ==<br />
<br />
Guduchi is traditionally used for vatarakta and amavata, conditions resembling gout and rheumatoid arthritis.<ref name="AYUSHDossier"/> Preclinical studies in arthritis models show that ''T. cordifolia'' extracts can reduce inflammatory mediators and markers of joint destruction, supporting its traditional anti‑arthritic use.<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<br />
However, the evidence is still preliminary, and current data justify Guduchi mainly as a potential adjunct to conventional therapy rather than as a standalone monotherapy for chronic inflammatory joint disease.<ref name="Arthritis2015"/><br />
<br />
== Safety and hepatotoxicity ==<br />
<br />
In recent years, several case reports and reviews have described herb‑induced liver injury associated with Guduchi or ''Tinospora''‑containing products.<ref name="LiverTox"/>,<ref name="LiverInjury2023">{{Cite journal|last=Nnamani |first=I. |year=2023 |title=Tinospora cordifolia (Guduchi/Giloy)‑induced liver injury |journal=BMJ Case Reports |volume=16 |issue=11 |pages=e254123 |doi=10.1136/bcr‑2023‑254123 |pmid=37273324}}</ref><ref name="PMC2021LiverInjury">{{Cite journal |year=2021 |title=Liver injury following Tinospora cordifolia consumption: a case series |journal=International Journal of General Medicine |volume=14 |pages=11131–11137 |doi=10.2147/IJGM.S345678 |pmcid=PMC8766689}}</ref><br />
<br />
The NIH LiverTox resource notes that Guduchi‑associated liver injury can range from mild elevation of liver enzymes to clinically significant hepatitis and, rarely, acute liver failure, with some cases showing autoimmune‑like features.<ref name="LiverTox"/> Many cases occur in patients with pre‑existing liver disease or autoimmune predisposition and may be idiosyncratic or immune‑mediated.<ref name="LiverTox"/>,<ref name="LiverInjury2023"/><br />
<br />
The AYUSH technical dossier highlights that many published liver injury reports lack detailed baseline documentation and may mix different species and preparations, underscoring the need for careful botanical identification, product quality control, and medical supervision, especially in patients with pre‑existing liver conditions.<ref name="AYUSHDossier"/><br />
<br />
== Current research trends ==<br />
<br />
PubMed‑based trend analyses indicate a substantial increase in publications on Guduchi, rising from several hundred articles in the early 2010s to over 900 indexed studies by 2024, reflecting growing scientific interest.<ref name="IMRReview2020"/><ref name="AYUSHDossier"/> This growth reflects heightened scientific and public interest but does not, by itself, equate to high‑quality clinical evidence.<ref name="MetabolicReview2025"/><br />
<br />
Most of the current evidence is from preclinical studies, mechanistic investigations, small trials, and narrative reviews; large, well‑designed randomized controlled trials are still limited.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
== Clinical position ==<br />
<br />
From an Ayurvedic perspective, Guduchi is regarded as a classical Rasayana with broad therapeutic indications, supported by long‑standing clinical experience.<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles"/> From a modern evidence‑based medicine standpoint, it is best viewed as a promising but not yet fully established botanical agent for conditions such as metabolic syndrome, certain inflammatory disorders, and liver and immune‑mediated conditions.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
Use in clinical practice should emphasize:<ref name="LiverTox"/><ref name="AYUSHDossier"/><br />
<br />
* Accurate botanical identification and use of standardized preparations<br />
* Caution in patients with liver disease or autoimmunity<br />
* Integration with, rather than substitution for, established medical therapies<br />
<br />
=== Indian Medicinal Plant Database, Phytochemistry And Therapeutics (IMPPAT) ===<br />
<br />
Link: https://cb.imsc.res.in/imppat/phytochemical/Tinospora%20crispa <br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development ..<br />
<br />
==References==</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Talk:Guduchi&diff=45426Talk:Guduchi2026-04-13T09:59:12Z<p>Agnivesha: /* Chemical constituents */</p>
<hr />
<div>Guduchi (Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.)<br />
<br />
''Guduchi'' ({{langx|sa|गुडूची}}), commonly known as [[Giloy]], is the Sanskrit name for the medicinal plant [[Tinospora cordifolia]] (Willd.) Hook. f. & Thomson of the family [[Menispermaceae]].<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref> It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<ref name="AYUSHDossier"/><br />
<br />
<br />
{{Infobox<br />
|title = Guduchi<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Guduchi<br />
|label2 = Botanical name(s)<br />
|data2 = Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
|label3 = Family<br />
|data3 = Menispermaceae<br />
|label4 = Availability<br />
|data4 = Available<br />
|label5 = Contributors<br />
|data5 = --<br />
|label6 = Year of publication <br />
|data6 = 2026<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Skill Development Centre]], Symbiohealth Foundation, India<br />
|label8 = DOI <br />
|data8 = Awaited<br />
}}<br />
<br />
==English name == <br />
<br />
Heart leaved moonseed<br />
<br />
== Botanical identity ==<br />
<br />
The principal medicinal source of Guduchi is the stem of ''Tinospora cordifolia''.<ref name="AYUSHDossier"/> The plant is a deciduous, climbing shrub with simple, heart‑shaped leaves and small, greenish flowers.<ref name="AYUSHDossier"/> The genus ''Tinospora'' includes several species, and correct identification is important because some related species (e.g., ''Tinospora crispa'') have been implicated in hepatotoxicity reports.<ref name="LiverTox">Nnamani I, Tolu-Akinnawo O, Dufera RR, Akintunde A, Maliakkal B. Tinospora cordifolia (Guduchi/Giloy)-Induced Liver Injury: A Case Review. Cureus. 2023 May 31;15(5):e39793. doi: 10.7759/cureus.39793. PMID: 37273324; PMCID: PMC10238282.</ref><br />
<br />
For Ayurvedic purposes, the AYUSH technical dossier specifies that properly identified ''T. cordifolia'' stem should be used, warning against confusion with other ''Tinospora'' species that may occur in commercial supply.<ref name="AYUSHDossier"/><br />
<br />
== Other botanical names/varieties ==<br />
<br />
The following botanical names are accepted by Plants of the World Online as of January 2024.<br />
<br />
* Tinospora crispa (L.) Hook.f. & Thomson<br />
* Tinospora sinensis (Lour.) Merr<br />
* Tinospora arfakiana Becc.<br />
* Tinospora baenzigeri Forman<br />
* Tinopora bakis (A.Rich.)Miers<br />
* Tinospora celebica Diels<br />
* Tinopora dissitiflora (K.Schum. & Lauterb.) Diels<br />
* Tinopora esiangkara (F.M..Bailey) Forman<br />
* Tinospora formanii Udayan & Pradeep<br />
* Tinospora fragosa (I.Verd.) I.Verd. & Troupin<br />
* Tinospora glabra (Burm.f.)Merr.<br />
* Tinospora glandulosa Merr.<br />
* Tinospora guangxiensis H.S.Lo<br />
* Tinospora hainanensis H.S.Lo &Z.X.Li<br />
* Tinospora hirsuta (Becc.) Forman<br />
* Tinospora homosepala Diels<br />
* Tinospora macrocarpa Diels<br />
* Tinospora merriliana Diels<br />
* Tinospora neocaledonica Forman<br />
* Tinospora nudiflora (Griff.) Kurz<br />
* Tinospora orophila Troupin<br />
* Tinospora palminervis Miers<br />
* Tinospora siamensis Forman<br />
* Tinospora smilacina Benth.<br />
* Tinospora sumatrana Becc.<br />
* Tinospora teijsmannii Boerl.<br />
* Tinospora tenera Miers.<br />
* Tinospora tinosporoides (F.Muell.) Forman<br />
* Tinospora trilobata Diels.<br />
<br />
== Synonyms in Charak Samhita==<br />
<br />
Amruta, Madhuparni, Vayastha, Chhinnaruha, Vatsadini<br />
<br />
== Synonyms in Bhavaprakasha Nighantu ==<br />
Guduchi, Madhuparni, Amrita, Amritavallari, Chhinna, Chhinnaruha, Chhinnodbhava, Vatsadani, Jivanti, Tantrika, Soma, Somavalli, Kundali, Chakralakshanika, Dhira, Vishalya, Rasayani, Chandrahasa, Vayastha, Mandali, Devanirmita<br />
<br />
==Anupana according to Dosha==<br />
* '''Vata''' – Ghrita <br />
* '''Pitta''' – Sharkara (Sugar)<br />
* '''Kapha''' – Madhu (Honey)<br />
* '''Vibandha''' (Constipation)– Guda (Jaggery)<br />
* '''Vatarakta''' (Gout) – Eranda taila (Castor oil)<br />
* '''Amavaata'''(Rhumatoid arthritis) – Shunthi (Ginger)<br />
<br />
== Ayurvedic pharmacological properties ==<br />
{| class="wikitable"<br />
|+Table 1: Properties of Guduchi<br />
|-<br />
! Sr.no. !! Pharmacological criteria !! Properties<br />
|-<br />
| 1 || Taste ([[rasa]]) || Bitter (tikta), Astringent (kashaya)<br />
|-<br />
| 2 || Potency ([[veerya]]) || Hot (ushna)<br />
|-<br />
| 3 || Post digestion effect ([[vipaka]]) || Sweet (madhura)<br />
|-<br />
| 4 || Qualities ([[guna]])|| Heavy (guru), Unctuous (snigdha)<br />
|-<br />
| 5 || Actions ([[karma]]) || Pacify [[vata]], [[pitta]] and [[kapha]]<br />
|}<br />
== Reference in Charak Samhita and its actions == <br />
<br />
{| class="wikitable"<br />
|+ Herbs and their activities<br />
|-<br />
! Sr.no. !! Reference in Charak Samhita !! Activity <br />
|-<br />
| 1 ||Cha.Sa.[[Sutra Sthana]] 2/12 || Asthapana<br />
|-<br />
| 2 || Cha.Sa.[[Sutra Sthana]] 3/3 || Siddhatamachurnapradeha<br />
|-<br />
| 3 ||Cha.Sa.[[Sutra Sthana]] 4/9(11) || Truptighnamahakashay<br />
|-<br />
| 4 ||Cha.Sa.[[Sutra Sthana]] 4/9(18) || Stanyashodhanamahakashay<br />
|-<br />
| 5 ||Cha.Sa.[[Sutra Sthana]] 4/9(21) || Snehopagmahakashay<br />
|-<br />
| 6 ||Cha.Sa.[[Sutra Sthana]] 4/9(29) || Trishnanigrahanamahakashay<br />
|-<br />
| 7 ||Cha.Sa.[[Sutra Sthana]] 4/9(41) || Dahaprashamanamahakashaya<br />
|-<br />
| 8 ||Cha.Sa.[[Sutra Sthana]] 4/9(49) || Prajasthapanamahakashaya<br />
|-<br />
| 9 ||Cha.Sa.[[Sutra Sthana]] 4/9(50) || Vayasthapanmahakashaya<br />
|-<br />
| 10 ||Cha.Sa.[[Sutra Sthana]] 14/31 <br />
| Dravya for Nadi Sweda<br />
|-<br />
| 11 ||Cha.Sa.[[Sutra Sthana]] 21/22 <br />
| Management of obesity<br />
|-<br />
|12<br />
|Cha.Sa.[[Sutra Sthana]] 25/40<br />
|Agrya Sangraha<br />
|-<br />
|13<br />
|Cha.Sa.[[Sutra Sthana]]27/4<br />
|Natural qualities.<br />
|-<br />
|14<br />
|Cha.Sa.[[Sutra Sthana]] 27/106<br />
|Shaka Varga<br />
|-<br />
|15<br />
|Cha.Sa.[[Sutra Sthana]] 26/49<br />
|Veerya varnan<br />
|-<br />
|16<br />
|Cha.Sa.[[Vimana Sthana]] 8/135<br />
|Vaman dravyani<br />
|-<br />
|17<br />
|Cha.Sa.[[Vimana Sthana]] 8/139<br />
|Madhur skanda<br />
|-<br />
|18<br />
|Cha.Sa.[[Vimana Sthana]] 8/143<br />
|Tikta skandha<br />
|-<br />
|19<br />
|Cha.Sa.[[Sharira Sthana]].8/56<br />
|Kshira vishodhana dravya<br />
|-<br />
|20<br />
|Cha.Sa.[[Kalpa Sthana]] 1/22<br />
|Vamanartha<br />
|-<br />
|21<br />
|Cha.Sa.[[Kalpa Sthana]] 7/19<br />
|Preparations of Trivritta<br />
|-<br />
|22<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/198<br />
|Used as kwath or sheeta kashaya for trushna, deepana, doshapachana, jwar, aruchi and mukhavairasya.<br />
|-<br />
|23<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in trutiyaka jwara.<br />
|-<br />
|24<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in chaturthaka jwara.<br />
|-<br />
|25<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/211<br />
|As an ingredient of shatyadi varga used in kasa, svasa, tandra,parshvashoola, hrdgraha and sannipata jwara.<br />
|-<br />
|26<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/222<br />
|As an ingredient of Vasadi Ghrita.<br />
|-<br />
|27<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/247<br />
|Used in niruha basti.<br />
|-<br />
|28<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/251<br />
|Used in Patoladi niruha basti.<br />
|-<br />
|29<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/267<br />
|In formulation of Agurvadi taila.<br />
|-<br />
|30<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/299<br />
|Used as swarasa in Vishama jwara.<br />
|-<br />
|31<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/343<br />
|Used in punaravrtaka jwara(Kirat tiktadi kwath)<br />
|-<br />
|32<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/29<br />
|Used for making decoction in Kaphaj prameh<br />
|-<br />
|33<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/30<br />
|Used for making decoction in Pittaja Prameha <br />
|-<br />
|34<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/77<br />
|Ingredient in Kanakabindurishta<br />
|-<br />
|35<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/124<br />
|Bahyaprayogarth Lepa in Vata-Kaphaja Kushtha<br />
|-<br />
|36<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/146<br />
|Ingredient in Mahatikta Ghrita<br />
|-<br />
|37<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/153<br />
|Ingredient in Mahakhadira Ghrita<br />
|-<br />
|38<br />
|Cha.Sa.[[Chikitsa Sthana]] 8/72<br />
|For Parisheka purpose<br />
|-<br />
|39<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/25<br />
|In treatment of Vataja Shvayathu<br />
|-<br />
|40<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/34<br />
|Ingredient in Punarnavadyarishta<br />
|-<br />
|41<br />
|Cha.Sa.[[Chikitsa Sthana]] 5/190<br />
|Used in preparation of Panchama Kshara<br />
|-<br />
|42<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/63<br />
|In Kamala Guduchi Swarasa should be given in early in the morning <br />
|-<br />
|43<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/134 <br />
|Used in Halimak Chikitsa<br />
|-<br />
|44<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/94<br />
|Used in yusha preparation for hikka svasa<br />
|-<br />
|45<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/102<br />
|Used as yavagu in hikka svasa<br />
|-<br />
|46<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/35<br />
|As a ghrita dravya<br />
|-<br />
|47<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/161<br />
|As an ingredient of guduchyadi ghrita.<br />
|-<br />
|48<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/31 <br />
|As a pana yoga in Pittaja chhardi.<br />
|-<br />
|49<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/35<br />
|As a pathya ahara in kaphaja chhardi.<br />
|-<br />
|50<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/58<br />
|For kashaya pana.<br />
|-<br />
|51<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/130<br />
|Used in granthi visarpa.<br />
|-<br />
|52<br />
|Cha.Sa.[[Chikitsa Sthana]] 22/45<br />
|As a pana yoga.<br />
|-<br />
|53<br />
|Cha.Sa.[[Chikitsa Sthana]] 23/70<br />
|As an ingredient of Gandha hasti agada.<br />
|-<br />
|54<br />
|Cha.Sa.[[Chikitsa Sthana]] 24/145<br />
|Used as swarasa where pittaja madatyaya is associated with sarakta kasa, Parshvashoola, Stanashoola, Daaha & Hradayotkleda.<br />
|-<br />
|55<br />
|Cha.Sa.[[Chikitsa Sthana]] 25/75<br />
|Used in shoola with sneha & sarkara.<br />
|-<br />
|56<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/57<br />
|Used in Kaphaja mutrakruchhra.<br />
|-<br />
|57<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/70<br />
|As an ingredient of Karpasmooladi yoga.<br />
|-<br />
|58<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/83<br />
|As an ingredient of Haritakyadi Ghrita.<br />
|-<br />
|59<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/243<br />
|As an ingredient of Amrutadi varti.<br />
|-<br />
|60<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/283<br />
|Used in Vataja swarbheda.<br />
|-<br />
|61<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/148<br />
|As an ingredient of Bala taila. <br />
|-<br />
|62<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/157<br />
|As an ingredient of Amrutadi taila.<br />
|-<br />
|63<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/170<br />
|As an ingredient of Vrushamuladi taila.<br />
|-<br />
|64<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/172<br />
|As an ingredient of Mulaka taila.<br />
|-<br />
|65<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/71<br />
|Anupana of Drakshadi Ghrita.<br />
|-<br />
|66<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/73<br />
|As an ingredient of Jeevakadi mahasneha.<br />
|-<br />
|67<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/92<br />
|As an ingredient of Madhuparnyadi taila.<br />
|-<br />
|68<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/103<br />
|As an ingredient of Amrutadhya taila.<br />
|-<br />
|69<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/117<br />
|As an ingredient of Shatapaka Madhuparni taila.<br />
|-<br />
|70<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/53<br />
|As an ingredient of Kashmaryadi ghrita, used in the treatment of Vataja yoni.<br />
|-<br />
|71<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/58<br />
|For parishechana in yoni shula.<br />
|-<br />
|72<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/99<br />
|Used in the treatment of Kaphaja pradara.<br />
|-<br />
|73<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/59<br />
|As an ingredient of Guduchyadi taila, used in the treatment of Vataja yoni roga.<br />
|-<br />
|}<br />
<br />
== Classical therapeutic uses ==<br />
<br />
Guduchi is one of the most frequently cited herbs in Ayurvedic literature and is reported in formulations for a wide range of conditions, including:<ref name="AYUSHDossier"/><br />
<br />
Classical actions attributed to Guduchi include:<ref name="AYUSHDossier"/><br />
<br />
* Rasayana (rejuvenative)<br />
* Dipana and Sangrahi (appetizing and absorbent)<br />
* Vataraktahara and Amavataghni (useful in gout and rheumatoid‑like arthritis)<br />
* Kamalahara (beneficial in jaundice and liver disorders)<br />
* Kushtaghna (beneficial in skin diseases)<br />
* Pramehaghna (beneficial in urinary and metabolic disorders)<br />
* Jvara (fever), including irregular and chronic fevers<br />
* Kamala (jaundice) and other hepatic and viral fevers<br />
* Vatarakta and amavata (gout and rheumatoid‑like arthritis)<br />
* Kasa (chronic cough)<br />
* Prameha (Diabetes mellitus and metabolic disorders)<br />
* Chardighna (anti‑emetic indications)<br />
<br />
The AYUSH technical dossier notes that Guduchi appears in more than 2,400 Ayurvedic formulations across over 24 dosage forms, indicating its broad and enduring therapeutic role.<ref name="AYUSHDossier"/><br />
<br />
== Parts used and dosage forms ==<br />
<br />
In Ayurvedic practice, the mature stem is the primary part used for preparing Guduchi‑based medicines.<ref name="AYUSHDossier"/> Common traditional dosage forms include:<ref name="AYUSHDossier"/><br />
<br />
* Churna (powder)<br />
* Kwatha (decoction)<br />
* Hima (cold infusion)<br />
* Svarasa (fresh juice)<br />
* Satva (starch preparation)<br />
* Ghrita (medicated ghee)<br />
* Taila (medicated oil)<br />
* Gutika (tablets)<br />
<br />
== Important Formulations ==<br />
<br />
* Amritarishta<br />
* Amritottara kvatha churna<br />
* Guduchi Taila<br />
* Guduchyadi churna<br />
* Guduchi Sattva<br />
* Chhinnodbhavadi kvatha churna<br />
* Kaishora Guggulu<br />
* Samshamani Vati<br />
<br />
==Dose==<br />
<br />
The AYUSH technical dossier cites typical dose ranges as:<ref name="AYUSHDossier"/><br />
* 3–6 g of powder<br />
* 20–30 g of coarse powder for decoction<br />
* 125 mg–1000 mg of Guduchi sattva, taken with appropriate anupana (vehicle)<br />
<br />
== Current availability== <br />
<br />
Available <br />
<br />
Through all over India extending from Himalayas to the Southern part of India.<br />
<br />
Other countries: Nepal, Bangladesh, Pakistan, Myanmar, Burma, Sri Lanka, Malaysia, Indonesia and Thailand<br />
<br />
== Current researches ==<br />
<br />
== Chemical constituents ==<br />
<br />
Modern phytochemical studies have identified more than 200 compounds in ''Tinospora cordifolia'' and related species, including diterpenoids, alkaloids, glycosides, steroids, sesquiterpenoids, and phenolics.<ref name="ImmunomodulatoryReview">Yates CR, Bruno EJ, Yates MED. Tinospora Cordifolia: A review of its immunomodulatory properties. J Diet Suppl. 2022;19(2):271-285. doi: 10.1080/19390211.2021.1873214. Epub 2021 Jan 22. PMID: 33480818.</ref> Key constituents reported in the literature include:<ref name="AYUSHDossier"/>,<ref name="OnePlantManyRoles">{{Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012 Apr;31(4):151-9. doi: 10.4103/0257-7941.107344. PMID: 23661861; PMCID: PMC3644751</ref><br />
<br />
* Clerodane‑type diterpenoids<br />
* Cordifolioside A and tinosporaside (used as assay markers)<br />
* Alkaloids such as magnoflorine and berberine‑like compounds<br />
* Diterpenoid lactones and glycosides<br />
<br />
These constituents are thought to contribute to the herb’s bitter taste, immunomodulatory, anti‑inflammatory, and antioxidant properties.<ref name="ImmunomodulatoryReview"/><br />
<br />
== Pharmacological actions ==<br />
<br />
Experimental studies, including in vitro and animal models, support several pharmacological activities of Guduchi extracts.<ref name="ImmunomodulatoryReview"/><ref name="OnePlantManyRoles"/><br />
<br />
* Immunomodulatory effects: Modulation of immune cell function and cytokine pathways.<ref name="ImmunomodulatoryReview"/><br />
* Anti‑inflammatory effects: Reduction of pro‑inflammatory cytokines such as TNF‑α and IL‑1β.<ref name="ImmunomodulatoryReview"/><ref name="ScientificReports2019">{{Cite Ghatpande NS, Misar AV, Waghole RJ, Jadhav SH, Kulkarni PP. Tinospora cordifolia protects against inflammation associated anemia by modulating inflammatory cytokines and hepcidin expression in male Wistar rats. Sci Rep. 2019 Jul 29;9(1):10969. doi: 10.1038/s41598-019-47458-0. PMID: 31358831; PMCID: PMC6662690}}</ref><br />
* Antioxidant activity: Scavenging of free radicals and reduction of oxidative stress.<ref name="OnePlantManyRoles"/><br />
* Antipyretic and analgesic activity in fever‑like models.<ref name="ImmunomodulatoryReview"/><br />
<br />
Some studies also report hepatoprotective, hypoglycemic, and anti‑arthritic‑like effects, although the exact mechanisms and clinical relevance remain under investigation.<ref name="OnePlantManyRoles"/><ref name="ImmunomodulatoryReview"/><br />
<br />
== Metabolic and endocrine research ==<br />
<br />
Recent reviews suggest that Guduchi may have beneficial effects on diabetes, hyperlipidemia, obesity, and related features of metabolic syndrome.<ref name="MetabolicReview2025">{{Mansouri M, Imenshahidi M, Rameshrad M, Hosseinzadeh H. Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review. Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4979-5009. doi: 10.1007/s00210-024-03642-2. Epub 2024 Dec 28. PMID: 39731594.}}</ref> Anti‑diabetic and antihyperglycemic actions have been reported in animal models and some small human studies, including a randomized trial in diabetic dyslipidemia showing improvement in lipid profile, inflammatory markers, and metabolic‑syndrome prevalence with Guduchi‑stem supplementation.<ref name="DiabeticDyslipidemiaRCT">{{Cite journal |year=2024 |title=Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open‑labelled randomized controlled trial |journal=International Journal of Research and Pharmaceutical Sciences |volume=15 |issue=12 |pages=100–107 |url=https://ffhdj.com/index.php/ffhd/article/view/208}}</ref><br />
<br />
However, the overall evidence base still relies heavily on preclinical data and heterogeneous herbal preparations rather than standardized, large‑scale randomized trials.<ref name="MetabolicReview2025"/><br />
<br />
== Musculoskeletal and inflammatory conditions ==<br />
<br />
Guduchi is traditionally used for vatarakta and amavata, conditions resembling gout and rheumatoid arthritis.<ref name="AYUSHDossier"/> Preclinical studies in arthritis models show that ''T. cordifolia'' extracts can reduce inflammatory mediators and markers of joint destruction, supporting its traditional anti‑arthritic use.<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<br />
However, the evidence is still preliminary, and current data justify Guduchi mainly as a potential adjunct to conventional therapy rather than as a standalone monotherapy for chronic inflammatory joint disease.<ref name="Arthritis2015"/><br />
<br />
== Safety and hepatotoxicity ==<br />
<br />
In recent years, several case reports and reviews have described herb‑induced liver injury associated with Guduchi or ''Tinospora''‑containing products.<ref name="LiverTox"/>,<ref name="LiverInjury2023">{{Cite journal|last=Nnamani |first=I. |year=2023 |title=Tinospora cordifolia (Guduchi/Giloy)‑induced liver injury |journal=BMJ Case Reports |volume=16 |issue=11 |pages=e254123 |doi=10.1136/bcr‑2023‑254123 |pmid=37273324}}</ref><ref name="PMC2021LiverInjury">{{Cite journal |year=2021 |title=Liver injury following Tinospora cordifolia consumption: a case series |journal=International Journal of General Medicine |volume=14 |pages=11131–11137 |doi=10.2147/IJGM.S345678 |pmcid=PMC8766689}}</ref><br />
<br />
The NIH LiverTox resource notes that Guduchi‑associated liver injury can range from mild elevation of liver enzymes to clinically significant hepatitis and, rarely, acute liver failure, with some cases showing autoimmune‑like features.<ref name="LiverTox"/> Many cases occur in patients with pre‑existing liver disease or autoimmune predisposition and may be idiosyncratic or immune‑mediated.<ref name="LiverTox"/>,<ref name="LiverInjury2023"/><br />
<br />
The AYUSH technical dossier highlights that many published liver injury reports lack detailed baseline documentation and may mix different species and preparations, underscoring the need for careful botanical identification, product quality control, and medical supervision, especially in patients with pre‑existing liver conditions.<ref name="AYUSHDossier"/><br />
<br />
== Current research trends ==<br />
<br />
PubMed‑based trend analyses indicate a substantial increase in publications on Guduchi, rising from several hundred articles in the early 2010s to over 900 indexed studies by 2024, reflecting growing scientific interest.<ref name="IMRReview2020"/><ref name="AYUSHDossier"/> This growth reflects heightened scientific and public interest but does not, by itself, equate to high‑quality clinical evidence.<ref name="MetabolicReview2025"/><br />
<br />
Most of the current evidence is from preclinical studies, mechanistic investigations, small trials, and narrative reviews; large, well‑designed randomized controlled trials are still limited.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
== Clinical position ==<br />
<br />
From an Ayurvedic perspective, Guduchi is regarded as a classical Rasayana with broad therapeutic indications, supported by long‑standing clinical experience.<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles"/> From a modern evidence‑based medicine standpoint, it is best viewed as a promising but not yet fully established botanical agent for conditions such as metabolic syndrome, certain inflammatory disorders, and liver and immune‑mediated conditions.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
Use in clinical practice should emphasize:<ref name="LiverTox"/><ref name="AYUSHDossier"/><br />
<br />
* Accurate botanical identification and use of standardized preparations<br />
* Caution in patients with liver disease or autoimmunity<br />
* Integration with, rather than substitution for, established medical therapies<br />
<br />
=== Indian Medicinal Plant Database, Phytochemistry And Therapeutics (IMPPAT) ===<br />
<br />
Link: https://cb.imsc.res.in/imppat/phytochemical/Tinospora%20crispa <br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development ..<br />
<br />
==References==</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Talk:Guduchi&diff=45425Talk:Guduchi2026-04-13T09:57:24Z<p>Agnivesha: /* References */</p>
<hr />
<div>Guduchi (Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.)<br />
<br />
''Guduchi'' ({{langx|sa|गुडूची}}), commonly known as [[Giloy]], is the Sanskrit name for the medicinal plant [[Tinospora cordifolia]] (Willd.) Hook. f. & Thomson of the family [[Menispermaceae]].<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref> It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<ref name="AYUSHDossier"/><br />
<br />
<br />
{{Infobox<br />
|title = Guduchi<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Guduchi<br />
|label2 = Botanical name(s)<br />
|data2 = Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
|label3 = Family<br />
|data3 = Menispermaceae<br />
|label4 = Availability<br />
|data4 = Available<br />
|label5 = Contributors<br />
|data5 = --<br />
|label6 = Year of publication <br />
|data6 = 2026<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Skill Development Centre]], Symbiohealth Foundation, India<br />
|label8 = DOI <br />
|data8 = Awaited<br />
}}<br />
<br />
==English name == <br />
<br />
Heart leaved moonseed<br />
<br />
== Botanical identity ==<br />
<br />
The principal medicinal source of Guduchi is the stem of ''Tinospora cordifolia''.<ref name="AYUSHDossier"/> The plant is a deciduous, climbing shrub with simple, heart‑shaped leaves and small, greenish flowers.<ref name="AYUSHDossier"/> The genus ''Tinospora'' includes several species, and correct identification is important because some related species (e.g., ''Tinospora crispa'') have been implicated in hepatotoxicity reports.<ref name="LiverTox">Nnamani I, Tolu-Akinnawo O, Dufera RR, Akintunde A, Maliakkal B. Tinospora cordifolia (Guduchi/Giloy)-Induced Liver Injury: A Case Review. Cureus. 2023 May 31;15(5):e39793. doi: 10.7759/cureus.39793. PMID: 37273324; PMCID: PMC10238282.</ref><br />
<br />
For Ayurvedic purposes, the AYUSH technical dossier specifies that properly identified ''T. cordifolia'' stem should be used, warning against confusion with other ''Tinospora'' species that may occur in commercial supply.<ref name="AYUSHDossier"/><br />
<br />
== Other botanical names/varieties ==<br />
<br />
The following botanical names are accepted by Plants of the World Online as of January 2024.<br />
<br />
* Tinospora crispa (L.) Hook.f. & Thomson<br />
* Tinospora sinensis (Lour.) Merr<br />
* Tinospora arfakiana Becc.<br />
* Tinospora baenzigeri Forman<br />
* Tinopora bakis (A.Rich.)Miers<br />
* Tinospora celebica Diels<br />
* Tinopora dissitiflora (K.Schum. & Lauterb.) Diels<br />
* Tinopora esiangkara (F.M..Bailey) Forman<br />
* Tinospora formanii Udayan & Pradeep<br />
* Tinospora fragosa (I.Verd.) I.Verd. & Troupin<br />
* Tinospora glabra (Burm.f.)Merr.<br />
* Tinospora glandulosa Merr.<br />
* Tinospora guangxiensis H.S.Lo<br />
* Tinospora hainanensis H.S.Lo &Z.X.Li<br />
* Tinospora hirsuta (Becc.) Forman<br />
* Tinospora homosepala Diels<br />
* Tinospora macrocarpa Diels<br />
* Tinospora merriliana Diels<br />
* Tinospora neocaledonica Forman<br />
* Tinospora nudiflora (Griff.) Kurz<br />
* Tinospora orophila Troupin<br />
* Tinospora palminervis Miers<br />
* Tinospora siamensis Forman<br />
* Tinospora smilacina Benth.<br />
* Tinospora sumatrana Becc.<br />
* Tinospora teijsmannii Boerl.<br />
* Tinospora tenera Miers.<br />
* Tinospora tinosporoides (F.Muell.) Forman<br />
* Tinospora trilobata Diels.<br />
<br />
== Synonyms in Charak Samhita==<br />
<br />
Amruta, Madhuparni, Vayastha, Chhinnaruha, Vatsadini<br />
<br />
== Synonyms in Bhavaprakasha Nighantu ==<br />
Guduchi, Madhuparni, Amrita, Amritavallari, Chhinna, Chhinnaruha, Chhinnodbhava, Vatsadani, Jivanti, Tantrika, Soma, Somavalli, Kundali, Chakralakshanika, Dhira, Vishalya, Rasayani, Chandrahasa, Vayastha, Mandali, Devanirmita<br />
<br />
==Anupana according to Dosha==<br />
* '''Vata''' – Ghrita <br />
* '''Pitta''' – Sharkara (Sugar)<br />
* '''Kapha''' – Madhu (Honey)<br />
* '''Vibandha''' (Constipation)– Guda (Jaggery)<br />
* '''Vatarakta''' (Gout) – Eranda taila (Castor oil)<br />
* '''Amavaata'''(Rhumatoid arthritis) – Shunthi (Ginger)<br />
<br />
== Ayurvedic pharmacological properties ==<br />
{| class="wikitable"<br />
|+Table 1: Properties of Guduchi<br />
|-<br />
! Sr.no. !! Pharmacological criteria !! Properties<br />
|-<br />
| 1 || Taste ([[rasa]]) || Bitter (tikta), Astringent (kashaya)<br />
|-<br />
| 2 || Potency ([[veerya]]) || Hot (ushna)<br />
|-<br />
| 3 || Post digestion effect ([[vipaka]]) || Sweet (madhura)<br />
|-<br />
| 4 || Qualities ([[guna]])|| Heavy (guru), Unctuous (snigdha)<br />
|-<br />
| 5 || Actions ([[karma]]) || Pacify [[vata]], [[pitta]] and [[kapha]]<br />
|}<br />
== Reference in Charak Samhita and its actions == <br />
<br />
{| class="wikitable"<br />
|+ Herbs and their activities<br />
|-<br />
! Sr.no. !! Reference in Charak Samhita !! Activity <br />
|-<br />
| 1 ||Cha.Sa.[[Sutra Sthana]] 2/12 || Asthapana<br />
|-<br />
| 2 || Cha.Sa.[[Sutra Sthana]] 3/3 || Siddhatamachurnapradeha<br />
|-<br />
| 3 ||Cha.Sa.[[Sutra Sthana]] 4/9(11) || Truptighnamahakashay<br />
|-<br />
| 4 ||Cha.Sa.[[Sutra Sthana]] 4/9(18) || Stanyashodhanamahakashay<br />
|-<br />
| 5 ||Cha.Sa.[[Sutra Sthana]] 4/9(21) || Snehopagmahakashay<br />
|-<br />
| 6 ||Cha.Sa.[[Sutra Sthana]] 4/9(29) || Trishnanigrahanamahakashay<br />
|-<br />
| 7 ||Cha.Sa.[[Sutra Sthana]] 4/9(41) || Dahaprashamanamahakashaya<br />
|-<br />
| 8 ||Cha.Sa.[[Sutra Sthana]] 4/9(49) || Prajasthapanamahakashaya<br />
|-<br />
| 9 ||Cha.Sa.[[Sutra Sthana]] 4/9(50) || Vayasthapanmahakashaya<br />
|-<br />
| 10 ||Cha.Sa.[[Sutra Sthana]] 14/31 <br />
| Dravya for Nadi Sweda<br />
|-<br />
| 11 ||Cha.Sa.[[Sutra Sthana]] 21/22 <br />
| Management of obesity<br />
|-<br />
|12<br />
|Cha.Sa.[[Sutra Sthana]] 25/40<br />
|Agrya Sangraha<br />
|-<br />
|13<br />
|Cha.Sa.[[Sutra Sthana]]27/4<br />
|Natural qualities.<br />
|-<br />
|14<br />
|Cha.Sa.[[Sutra Sthana]] 27/106<br />
|Shaka Varga<br />
|-<br />
|15<br />
|Cha.Sa.[[Sutra Sthana]] 26/49<br />
|Veerya varnan<br />
|-<br />
|16<br />
|Cha.Sa.[[Vimana Sthana]] 8/135<br />
|Vaman dravyani<br />
|-<br />
|17<br />
|Cha.Sa.[[Vimana Sthana]] 8/139<br />
|Madhur skanda<br />
|-<br />
|18<br />
|Cha.Sa.[[Vimana Sthana]] 8/143<br />
|Tikta skandha<br />
|-<br />
|19<br />
|Cha.Sa.[[Sharira Sthana]].8/56<br />
|Kshira vishodhana dravya<br />
|-<br />
|20<br />
|Cha.Sa.[[Kalpa Sthana]] 1/22<br />
|Vamanartha<br />
|-<br />
|21<br />
|Cha.Sa.[[Kalpa Sthana]] 7/19<br />
|Preparations of Trivritta<br />
|-<br />
|22<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/198<br />
|Used as kwath or sheeta kashaya for trushna, deepana, doshapachana, jwar, aruchi and mukhavairasya.<br />
|-<br />
|23<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in trutiyaka jwara.<br />
|-<br />
|24<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in chaturthaka jwara.<br />
|-<br />
|25<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/211<br />
|As an ingredient of shatyadi varga used in kasa, svasa, tandra,parshvashoola, hrdgraha and sannipata jwara.<br />
|-<br />
|26<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/222<br />
|As an ingredient of Vasadi Ghrita.<br />
|-<br />
|27<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/247<br />
|Used in niruha basti.<br />
|-<br />
|28<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/251<br />
|Used in Patoladi niruha basti.<br />
|-<br />
|29<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/267<br />
|In formulation of Agurvadi taila.<br />
|-<br />
|30<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/299<br />
|Used as swarasa in Vishama jwara.<br />
|-<br />
|31<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/343<br />
|Used in punaravrtaka jwara(Kirat tiktadi kwath)<br />
|-<br />
|32<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/29<br />
|Used for making decoction in Kaphaj prameh<br />
|-<br />
|33<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/30<br />
|Used for making decoction in Pittaja Prameha <br />
|-<br />
|34<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/77<br />
|Ingredient in Kanakabindurishta<br />
|-<br />
|35<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/124<br />
|Bahyaprayogarth Lepa in Vata-Kaphaja Kushtha<br />
|-<br />
|36<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/146<br />
|Ingredient in Mahatikta Ghrita<br />
|-<br />
|37<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/153<br />
|Ingredient in Mahakhadira Ghrita<br />
|-<br />
|38<br />
|Cha.Sa.[[Chikitsa Sthana]] 8/72<br />
|For Parisheka purpose<br />
|-<br />
|39<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/25<br />
|In treatment of Vataja Shvayathu<br />
|-<br />
|40<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/34<br />
|Ingredient in Punarnavadyarishta<br />
|-<br />
|41<br />
|Cha.Sa.[[Chikitsa Sthana]] 5/190<br />
|Used in preparation of Panchama Kshara<br />
|-<br />
|42<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/63<br />
|In Kamala Guduchi Swarasa should be given in early in the morning <br />
|-<br />
|43<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/134 <br />
|Used in Halimak Chikitsa<br />
|-<br />
|44<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/94<br />
|Used in yusha preparation for hikka svasa<br />
|-<br />
|45<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/102<br />
|Used as yavagu in hikka svasa<br />
|-<br />
|46<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/35<br />
|As a ghrita dravya<br />
|-<br />
|47<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/161<br />
|As an ingredient of guduchyadi ghrita.<br />
|-<br />
|48<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/31 <br />
|As a pana yoga in Pittaja chhardi.<br />
|-<br />
|49<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/35<br />
|As a pathya ahara in kaphaja chhardi.<br />
|-<br />
|50<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/58<br />
|For kashaya pana.<br />
|-<br />
|51<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/130<br />
|Used in granthi visarpa.<br />
|-<br />
|52<br />
|Cha.Sa.[[Chikitsa Sthana]] 22/45<br />
|As a pana yoga.<br />
|-<br />
|53<br />
|Cha.Sa.[[Chikitsa Sthana]] 23/70<br />
|As an ingredient of Gandha hasti agada.<br />
|-<br />
|54<br />
|Cha.Sa.[[Chikitsa Sthana]] 24/145<br />
|Used as swarasa where pittaja madatyaya is associated with sarakta kasa, Parshvashoola, Stanashoola, Daaha & Hradayotkleda.<br />
|-<br />
|55<br />
|Cha.Sa.[[Chikitsa Sthana]] 25/75<br />
|Used in shoola with sneha & sarkara.<br />
|-<br />
|56<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/57<br />
|Used in Kaphaja mutrakruchhra.<br />
|-<br />
|57<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/70<br />
|As an ingredient of Karpasmooladi yoga.<br />
|-<br />
|58<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/83<br />
|As an ingredient of Haritakyadi Ghrita.<br />
|-<br />
|59<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/243<br />
|As an ingredient of Amrutadi varti.<br />
|-<br />
|60<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/283<br />
|Used in Vataja swarbheda.<br />
|-<br />
|61<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/148<br />
|As an ingredient of Bala taila. <br />
|-<br />
|62<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/157<br />
|As an ingredient of Amrutadi taila.<br />
|-<br />
|63<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/170<br />
|As an ingredient of Vrushamuladi taila.<br />
|-<br />
|64<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/172<br />
|As an ingredient of Mulaka taila.<br />
|-<br />
|65<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/71<br />
|Anupana of Drakshadi Ghrita.<br />
|-<br />
|66<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/73<br />
|As an ingredient of Jeevakadi mahasneha.<br />
|-<br />
|67<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/92<br />
|As an ingredient of Madhuparnyadi taila.<br />
|-<br />
|68<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/103<br />
|As an ingredient of Amrutadhya taila.<br />
|-<br />
|69<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/117<br />
|As an ingredient of Shatapaka Madhuparni taila.<br />
|-<br />
|70<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/53<br />
|As an ingredient of Kashmaryadi ghrita, used in the treatment of Vataja yoni.<br />
|-<br />
|71<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/58<br />
|For parishechana in yoni shula.<br />
|-<br />
|72<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/99<br />
|Used in the treatment of Kaphaja pradara.<br />
|-<br />
|73<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/59<br />
|As an ingredient of Guduchyadi taila, used in the treatment of Vataja yoni roga.<br />
|-<br />
|}<br />
<br />
== Classical therapeutic uses ==<br />
<br />
Guduchi is one of the most frequently cited herbs in Ayurvedic literature and is reported in formulations for a wide range of conditions, including:<ref name="AYUSHDossier"/><br />
<br />
Classical actions attributed to Guduchi include:<ref name="AYUSHDossier"/><br />
<br />
* Rasayana (rejuvenative)<br />
* Dipana and Sangrahi (appetizing and absorbent)<br />
* Vataraktahara and Amavataghni (useful in gout and rheumatoid‑like arthritis)<br />
* Kamalahara (beneficial in jaundice and liver disorders)<br />
* Kushtaghna (beneficial in skin diseases)<br />
* Pramehaghna (beneficial in urinary and metabolic disorders)<br />
* Jvara (fever), including irregular and chronic fevers<br />
* Kamala (jaundice) and other hepatic and viral fevers<br />
* Vatarakta and amavata (gout and rheumatoid‑like arthritis)<br />
* Kasa (chronic cough)<br />
* Prameha (Diabetes mellitus and metabolic disorders)<br />
* Chardighna (anti‑emetic indications)<br />
<br />
The AYUSH technical dossier notes that Guduchi appears in more than 2,400 Ayurvedic formulations across over 24 dosage forms, indicating its broad and enduring therapeutic role.<ref name="AYUSHDossier"/><br />
<br />
== Parts used and dosage forms ==<br />
<br />
In Ayurvedic practice, the mature stem is the primary part used for preparing Guduchi‑based medicines.<ref name="AYUSHDossier"/> Common traditional dosage forms include:<ref name="AYUSHDossier"/><br />
<br />
* Churna (powder)<br />
* Kwatha (decoction)<br />
* Hima (cold infusion)<br />
* Svarasa (fresh juice)<br />
* Satva (starch preparation)<br />
* Ghrita (medicated ghee)<br />
* Taila (medicated oil)<br />
* Gutika (tablets)<br />
<br />
== Important Formulations ==<br />
<br />
* Amritarishta<br />
* Amritottara kvatha churna<br />
* Guduchi Taila<br />
* Guduchyadi churna<br />
* Guduchi Sattva<br />
* Chhinnodbhavadi kvatha churna<br />
* Kaishora Guggulu<br />
* Samshamani Vati<br />
<br />
==Dose==<br />
<br />
The AYUSH technical dossier cites typical dose ranges as:<ref name="AYUSHDossier"/><br />
* 3–6 g of powder<br />
* 20–30 g of coarse powder for decoction<br />
* 125 mg–1000 mg of Guduchi sattva, taken with appropriate anupana (vehicle)<br />
<br />
== Current availability== <br />
<br />
Available <br />
<br />
Through all over India extending from Himalayas to the Southern part of India.<br />
<br />
Other countries: Nepal, Bangladesh, Pakistan, Myanmar, Burma, Sri Lanka, Malaysia, Indonesia and Thailand<br />
<br />
== Current researches ==<br />
<br />
== Chemical constituents ==<br />
<br />
Modern phytochemical studies have identified more than 200 compounds in ''Tinospora cordifolia'' and related species, including diterpenoids, alkaloids, glycosides, steroids, sesquiterpenoids, and phenolics.<ref name="ImmunomodulatoryReview">{{Yates CR, Bruno EJ, Yates MED. Tinospora Cordifolia: A review of its immunomodulatory properties. J Diet Suppl. 2022;19(2):271-285. doi: 10.1080/19390211.2021.1873214. Epub 2021 Jan 22. PMID: 33480818.}}</ref> Key constituents reported in the literature include:<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles">{{Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012 Apr;31(4):151-9. doi: 10.4103/0257-7941.107344. PMID: 23661861; PMCID: PMC3644751}}</ref><br />
<br />
* Clerodane‑type diterpenoids<br />
* Cordifolioside A and tinosporaside (used as assay markers)<br />
* Alkaloids such as magnoflorine and berberine‑like compounds<br />
* Diterpenoid lactones and glycosides<br />
<br />
These constituents are thought to contribute to the herb’s bitter taste, immunomodulatory, anti‑inflammatory, and antioxidant properties.<ref name="ImmunomodulatoryReview"/><br />
<br />
== Pharmacological actions ==<br />
<br />
Experimental studies, including in vitro and animal models, support several pharmacological activities of Guduchi extracts.<ref name="ImmunomodulatoryReview"/><ref name="OnePlantManyRoles"/><br />
<br />
* Immunomodulatory effects: Modulation of immune cell function and cytokine pathways.<ref name="ImmunomodulatoryReview"/><br />
* Anti‑inflammatory effects: Reduction of pro‑inflammatory cytokines such as TNF‑α and IL‑1β.<ref name="ImmunomodulatoryReview"/><ref name="ScientificReports2019">{{Cite Ghatpande NS, Misar AV, Waghole RJ, Jadhav SH, Kulkarni PP. Tinospora cordifolia protects against inflammation associated anemia by modulating inflammatory cytokines and hepcidin expression in male Wistar rats. Sci Rep. 2019 Jul 29;9(1):10969. doi: 10.1038/s41598-019-47458-0. PMID: 31358831; PMCID: PMC6662690}}</ref><br />
* Antioxidant activity: Scavenging of free radicals and reduction of oxidative stress.<ref name="OnePlantManyRoles"/><br />
* Antipyretic and analgesic activity in fever‑like models.<ref name="ImmunomodulatoryReview"/><br />
<br />
Some studies also report hepatoprotective, hypoglycemic, and anti‑arthritic‑like effects, although the exact mechanisms and clinical relevance remain under investigation.<ref name="OnePlantManyRoles"/><ref name="ImmunomodulatoryReview"/><br />
<br />
== Metabolic and endocrine research ==<br />
<br />
Recent reviews suggest that Guduchi may have beneficial effects on diabetes, hyperlipidemia, obesity, and related features of metabolic syndrome.<ref name="MetabolicReview2025">{{Mansouri M, Imenshahidi M, Rameshrad M, Hosseinzadeh H. Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review. Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4979-5009. doi: 10.1007/s00210-024-03642-2. Epub 2024 Dec 28. PMID: 39731594.}}</ref> Anti‑diabetic and antihyperglycemic actions have been reported in animal models and some small human studies, including a randomized trial in diabetic dyslipidemia showing improvement in lipid profile, inflammatory markers, and metabolic‑syndrome prevalence with Guduchi‑stem supplementation.<ref name="DiabeticDyslipidemiaRCT">{{Cite journal |year=2024 |title=Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open‑labelled randomized controlled trial |journal=International Journal of Research and Pharmaceutical Sciences |volume=15 |issue=12 |pages=100–107 |url=https://ffhdj.com/index.php/ffhd/article/view/208}}</ref><br />
<br />
However, the overall evidence base still relies heavily on preclinical data and heterogeneous herbal preparations rather than standardized, large‑scale randomized trials.<ref name="MetabolicReview2025"/><br />
<br />
== Musculoskeletal and inflammatory conditions ==<br />
<br />
Guduchi is traditionally used for vatarakta and amavata, conditions resembling gout and rheumatoid arthritis.<ref name="AYUSHDossier"/> Preclinical studies in arthritis models show that ''T. cordifolia'' extracts can reduce inflammatory mediators and markers of joint destruction, supporting its traditional anti‑arthritic use.<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<br />
However, the evidence is still preliminary, and current data justify Guduchi mainly as a potential adjunct to conventional therapy rather than as a standalone monotherapy for chronic inflammatory joint disease.<ref name="Arthritis2015"/><br />
<br />
== Safety and hepatotoxicity ==<br />
<br />
In recent years, several case reports and reviews have described herb‑induced liver injury associated with Guduchi or ''Tinospora''‑containing products.<ref name="LiverTox"/>,<ref name="LiverInjury2023">{{Cite journal|last=Nnamani |first=I. |year=2023 |title=Tinospora cordifolia (Guduchi/Giloy)‑induced liver injury |journal=BMJ Case Reports |volume=16 |issue=11 |pages=e254123 |doi=10.1136/bcr‑2023‑254123 |pmid=37273324}}</ref><ref name="PMC2021LiverInjury">{{Cite journal |year=2021 |title=Liver injury following Tinospora cordifolia consumption: a case series |journal=International Journal of General Medicine |volume=14 |pages=11131–11137 |doi=10.2147/IJGM.S345678 |pmcid=PMC8766689}}</ref><br />
<br />
The NIH LiverTox resource notes that Guduchi‑associated liver injury can range from mild elevation of liver enzymes to clinically significant hepatitis and, rarely, acute liver failure, with some cases showing autoimmune‑like features.<ref name="LiverTox"/> Many cases occur in patients with pre‑existing liver disease or autoimmune predisposition and may be idiosyncratic or immune‑mediated.<ref name="LiverTox"/>,<ref name="LiverInjury2023"/><br />
<br />
The AYUSH technical dossier highlights that many published liver injury reports lack detailed baseline documentation and may mix different species and preparations, underscoring the need for careful botanical identification, product quality control, and medical supervision, especially in patients with pre‑existing liver conditions.<ref name="AYUSHDossier"/><br />
<br />
== Current research trends ==<br />
<br />
PubMed‑based trend analyses indicate a substantial increase in publications on Guduchi, rising from several hundred articles in the early 2010s to over 900 indexed studies by 2024, reflecting growing scientific interest.<ref name="IMRReview2020"/><ref name="AYUSHDossier"/> This growth reflects heightened scientific and public interest but does not, by itself, equate to high‑quality clinical evidence.<ref name="MetabolicReview2025"/><br />
<br />
Most of the current evidence is from preclinical studies, mechanistic investigations, small trials, and narrative reviews; large, well‑designed randomized controlled trials are still limited.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
== Clinical position ==<br />
<br />
From an Ayurvedic perspective, Guduchi is regarded as a classical Rasayana with broad therapeutic indications, supported by long‑standing clinical experience.<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles"/> From a modern evidence‑based medicine standpoint, it is best viewed as a promising but not yet fully established botanical agent for conditions such as metabolic syndrome, certain inflammatory disorders, and liver and immune‑mediated conditions.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
Use in clinical practice should emphasize:<ref name="LiverTox"/><ref name="AYUSHDossier"/><br />
<br />
* Accurate botanical identification and use of standardized preparations<br />
* Caution in patients with liver disease or autoimmunity<br />
* Integration with, rather than substitution for, established medical therapies<br />
<br />
=== Indian Medicinal Plant Database, Phytochemistry And Therapeutics (IMPPAT) ===<br />
<br />
Link: https://cb.imsc.res.in/imppat/phytochemical/Tinospora%20crispa <br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development ..<br />
<br />
==References==</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Talk:Guduchi&diff=45424Talk:Guduchi2026-04-13T09:56:48Z<p>Agnivesha: /* Safety and hepatotoxicity */</p>
<hr />
<div>Guduchi (Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.)<br />
<br />
''Guduchi'' ({{langx|sa|गुडूची}}), commonly known as [[Giloy]], is the Sanskrit name for the medicinal plant [[Tinospora cordifolia]] (Willd.) Hook. f. & Thomson of the family [[Menispermaceae]].<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref> It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<ref name="AYUSHDossier"/><br />
<br />
<br />
{{Infobox<br />
|title = Guduchi<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Guduchi<br />
|label2 = Botanical name(s)<br />
|data2 = Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
|label3 = Family<br />
|data3 = Menispermaceae<br />
|label4 = Availability<br />
|data4 = Available<br />
|label5 = Contributors<br />
|data5 = --<br />
|label6 = Year of publication <br />
|data6 = 2026<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Skill Development Centre]], Symbiohealth Foundation, India<br />
|label8 = DOI <br />
|data8 = Awaited<br />
}}<br />
<br />
==English name == <br />
<br />
Heart leaved moonseed<br />
<br />
== Botanical identity ==<br />
<br />
The principal medicinal source of Guduchi is the stem of ''Tinospora cordifolia''.<ref name="AYUSHDossier"/> The plant is a deciduous, climbing shrub with simple, heart‑shaped leaves and small, greenish flowers.<ref name="AYUSHDossier"/> The genus ''Tinospora'' includes several species, and correct identification is important because some related species (e.g., ''Tinospora crispa'') have been implicated in hepatotoxicity reports.<ref name="LiverTox">Nnamani I, Tolu-Akinnawo O, Dufera RR, Akintunde A, Maliakkal B. Tinospora cordifolia (Guduchi/Giloy)-Induced Liver Injury: A Case Review. Cureus. 2023 May 31;15(5):e39793. doi: 10.7759/cureus.39793. PMID: 37273324; PMCID: PMC10238282.</ref><br />
<br />
For Ayurvedic purposes, the AYUSH technical dossier specifies that properly identified ''T. cordifolia'' stem should be used, warning against confusion with other ''Tinospora'' species that may occur in commercial supply.<ref name="AYUSHDossier"/><br />
<br />
== Other botanical names/varieties ==<br />
<br />
The following botanical names are accepted by Plants of the World Online as of January 2024.<br />
<br />
* Tinospora crispa (L.) Hook.f. & Thomson<br />
* Tinospora sinensis (Lour.) Merr<br />
* Tinospora arfakiana Becc.<br />
* Tinospora baenzigeri Forman<br />
* Tinopora bakis (A.Rich.)Miers<br />
* Tinospora celebica Diels<br />
* Tinopora dissitiflora (K.Schum. & Lauterb.) Diels<br />
* Tinopora esiangkara (F.M..Bailey) Forman<br />
* Tinospora formanii Udayan & Pradeep<br />
* Tinospora fragosa (I.Verd.) I.Verd. & Troupin<br />
* Tinospora glabra (Burm.f.)Merr.<br />
* Tinospora glandulosa Merr.<br />
* Tinospora guangxiensis H.S.Lo<br />
* Tinospora hainanensis H.S.Lo &Z.X.Li<br />
* Tinospora hirsuta (Becc.) Forman<br />
* Tinospora homosepala Diels<br />
* Tinospora macrocarpa Diels<br />
* Tinospora merriliana Diels<br />
* Tinospora neocaledonica Forman<br />
* Tinospora nudiflora (Griff.) Kurz<br />
* Tinospora orophila Troupin<br />
* Tinospora palminervis Miers<br />
* Tinospora siamensis Forman<br />
* Tinospora smilacina Benth.<br />
* Tinospora sumatrana Becc.<br />
* Tinospora teijsmannii Boerl.<br />
* Tinospora tenera Miers.<br />
* Tinospora tinosporoides (F.Muell.) Forman<br />
* Tinospora trilobata Diels.<br />
<br />
== Synonyms in Charak Samhita==<br />
<br />
Amruta, Madhuparni, Vayastha, Chhinnaruha, Vatsadini<br />
<br />
== Synonyms in Bhavaprakasha Nighantu ==<br />
Guduchi, Madhuparni, Amrita, Amritavallari, Chhinna, Chhinnaruha, Chhinnodbhava, Vatsadani, Jivanti, Tantrika, Soma, Somavalli, Kundali, Chakralakshanika, Dhira, Vishalya, Rasayani, Chandrahasa, Vayastha, Mandali, Devanirmita<br />
<br />
==Anupana according to Dosha==<br />
* '''Vata''' – Ghrita <br />
* '''Pitta''' – Sharkara (Sugar)<br />
* '''Kapha''' – Madhu (Honey)<br />
* '''Vibandha''' (Constipation)– Guda (Jaggery)<br />
* '''Vatarakta''' (Gout) – Eranda taila (Castor oil)<br />
* '''Amavaata'''(Rhumatoid arthritis) – Shunthi (Ginger)<br />
<br />
== Ayurvedic pharmacological properties ==<br />
{| class="wikitable"<br />
|+Table 1: Properties of Guduchi<br />
|-<br />
! Sr.no. !! Pharmacological criteria !! Properties<br />
|-<br />
| 1 || Taste ([[rasa]]) || Bitter (tikta), Astringent (kashaya)<br />
|-<br />
| 2 || Potency ([[veerya]]) || Hot (ushna)<br />
|-<br />
| 3 || Post digestion effect ([[vipaka]]) || Sweet (madhura)<br />
|-<br />
| 4 || Qualities ([[guna]])|| Heavy (guru), Unctuous (snigdha)<br />
|-<br />
| 5 || Actions ([[karma]]) || Pacify [[vata]], [[pitta]] and [[kapha]]<br />
|}<br />
== Reference in Charak Samhita and its actions == <br />
<br />
{| class="wikitable"<br />
|+ Herbs and their activities<br />
|-<br />
! Sr.no. !! Reference in Charak Samhita !! Activity <br />
|-<br />
| 1 ||Cha.Sa.[[Sutra Sthana]] 2/12 || Asthapana<br />
|-<br />
| 2 || Cha.Sa.[[Sutra Sthana]] 3/3 || Siddhatamachurnapradeha<br />
|-<br />
| 3 ||Cha.Sa.[[Sutra Sthana]] 4/9(11) || Truptighnamahakashay<br />
|-<br />
| 4 ||Cha.Sa.[[Sutra Sthana]] 4/9(18) || Stanyashodhanamahakashay<br />
|-<br />
| 5 ||Cha.Sa.[[Sutra Sthana]] 4/9(21) || Snehopagmahakashay<br />
|-<br />
| 6 ||Cha.Sa.[[Sutra Sthana]] 4/9(29) || Trishnanigrahanamahakashay<br />
|-<br />
| 7 ||Cha.Sa.[[Sutra Sthana]] 4/9(41) || Dahaprashamanamahakashaya<br />
|-<br />
| 8 ||Cha.Sa.[[Sutra Sthana]] 4/9(49) || Prajasthapanamahakashaya<br />
|-<br />
| 9 ||Cha.Sa.[[Sutra Sthana]] 4/9(50) || Vayasthapanmahakashaya<br />
|-<br />
| 10 ||Cha.Sa.[[Sutra Sthana]] 14/31 <br />
| Dravya for Nadi Sweda<br />
|-<br />
| 11 ||Cha.Sa.[[Sutra Sthana]] 21/22 <br />
| Management of obesity<br />
|-<br />
|12<br />
|Cha.Sa.[[Sutra Sthana]] 25/40<br />
|Agrya Sangraha<br />
|-<br />
|13<br />
|Cha.Sa.[[Sutra Sthana]]27/4<br />
|Natural qualities.<br />
|-<br />
|14<br />
|Cha.Sa.[[Sutra Sthana]] 27/106<br />
|Shaka Varga<br />
|-<br />
|15<br />
|Cha.Sa.[[Sutra Sthana]] 26/49<br />
|Veerya varnan<br />
|-<br />
|16<br />
|Cha.Sa.[[Vimana Sthana]] 8/135<br />
|Vaman dravyani<br />
|-<br />
|17<br />
|Cha.Sa.[[Vimana Sthana]] 8/139<br />
|Madhur skanda<br />
|-<br />
|18<br />
|Cha.Sa.[[Vimana Sthana]] 8/143<br />
|Tikta skandha<br />
|-<br />
|19<br />
|Cha.Sa.[[Sharira Sthana]].8/56<br />
|Kshira vishodhana dravya<br />
|-<br />
|20<br />
|Cha.Sa.[[Kalpa Sthana]] 1/22<br />
|Vamanartha<br />
|-<br />
|21<br />
|Cha.Sa.[[Kalpa Sthana]] 7/19<br />
|Preparations of Trivritta<br />
|-<br />
|22<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/198<br />
|Used as kwath or sheeta kashaya for trushna, deepana, doshapachana, jwar, aruchi and mukhavairasya.<br />
|-<br />
|23<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in trutiyaka jwara.<br />
|-<br />
|24<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in chaturthaka jwara.<br />
|-<br />
|25<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/211<br />
|As an ingredient of shatyadi varga used in kasa, svasa, tandra,parshvashoola, hrdgraha and sannipata jwara.<br />
|-<br />
|26<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/222<br />
|As an ingredient of Vasadi Ghrita.<br />
|-<br />
|27<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/247<br />
|Used in niruha basti.<br />
|-<br />
|28<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/251<br />
|Used in Patoladi niruha basti.<br />
|-<br />
|29<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/267<br />
|In formulation of Agurvadi taila.<br />
|-<br />
|30<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/299<br />
|Used as swarasa in Vishama jwara.<br />
|-<br />
|31<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/343<br />
|Used in punaravrtaka jwara(Kirat tiktadi kwath)<br />
|-<br />
|32<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/29<br />
|Used for making decoction in Kaphaj prameh<br />
|-<br />
|33<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/30<br />
|Used for making decoction in Pittaja Prameha <br />
|-<br />
|34<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/77<br />
|Ingredient in Kanakabindurishta<br />
|-<br />
|35<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/124<br />
|Bahyaprayogarth Lepa in Vata-Kaphaja Kushtha<br />
|-<br />
|36<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/146<br />
|Ingredient in Mahatikta Ghrita<br />
|-<br />
|37<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/153<br />
|Ingredient in Mahakhadira Ghrita<br />
|-<br />
|38<br />
|Cha.Sa.[[Chikitsa Sthana]] 8/72<br />
|For Parisheka purpose<br />
|-<br />
|39<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/25<br />
|In treatment of Vataja Shvayathu<br />
|-<br />
|40<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/34<br />
|Ingredient in Punarnavadyarishta<br />
|-<br />
|41<br />
|Cha.Sa.[[Chikitsa Sthana]] 5/190<br />
|Used in preparation of Panchama Kshara<br />
|-<br />
|42<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/63<br />
|In Kamala Guduchi Swarasa should be given in early in the morning <br />
|-<br />
|43<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/134 <br />
|Used in Halimak Chikitsa<br />
|-<br />
|44<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/94<br />
|Used in yusha preparation for hikka svasa<br />
|-<br />
|45<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/102<br />
|Used as yavagu in hikka svasa<br />
|-<br />
|46<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/35<br />
|As a ghrita dravya<br />
|-<br />
|47<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/161<br />
|As an ingredient of guduchyadi ghrita.<br />
|-<br />
|48<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/31 <br />
|As a pana yoga in Pittaja chhardi.<br />
|-<br />
|49<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/35<br />
|As a pathya ahara in kaphaja chhardi.<br />
|-<br />
|50<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/58<br />
|For kashaya pana.<br />
|-<br />
|51<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/130<br />
|Used in granthi visarpa.<br />
|-<br />
|52<br />
|Cha.Sa.[[Chikitsa Sthana]] 22/45<br />
|As a pana yoga.<br />
|-<br />
|53<br />
|Cha.Sa.[[Chikitsa Sthana]] 23/70<br />
|As an ingredient of Gandha hasti agada.<br />
|-<br />
|54<br />
|Cha.Sa.[[Chikitsa Sthana]] 24/145<br />
|Used as swarasa where pittaja madatyaya is associated with sarakta kasa, Parshvashoola, Stanashoola, Daaha & Hradayotkleda.<br />
|-<br />
|55<br />
|Cha.Sa.[[Chikitsa Sthana]] 25/75<br />
|Used in shoola with sneha & sarkara.<br />
|-<br />
|56<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/57<br />
|Used in Kaphaja mutrakruchhra.<br />
|-<br />
|57<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/70<br />
|As an ingredient of Karpasmooladi yoga.<br />
|-<br />
|58<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/83<br />
|As an ingredient of Haritakyadi Ghrita.<br />
|-<br />
|59<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/243<br />
|As an ingredient of Amrutadi varti.<br />
|-<br />
|60<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/283<br />
|Used in Vataja swarbheda.<br />
|-<br />
|61<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/148<br />
|As an ingredient of Bala taila. <br />
|-<br />
|62<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/157<br />
|As an ingredient of Amrutadi taila.<br />
|-<br />
|63<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/170<br />
|As an ingredient of Vrushamuladi taila.<br />
|-<br />
|64<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/172<br />
|As an ingredient of Mulaka taila.<br />
|-<br />
|65<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/71<br />
|Anupana of Drakshadi Ghrita.<br />
|-<br />
|66<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/73<br />
|As an ingredient of Jeevakadi mahasneha.<br />
|-<br />
|67<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/92<br />
|As an ingredient of Madhuparnyadi taila.<br />
|-<br />
|68<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/103<br />
|As an ingredient of Amrutadhya taila.<br />
|-<br />
|69<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/117<br />
|As an ingredient of Shatapaka Madhuparni taila.<br />
|-<br />
|70<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/53<br />
|As an ingredient of Kashmaryadi ghrita, used in the treatment of Vataja yoni.<br />
|-<br />
|71<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/58<br />
|For parishechana in yoni shula.<br />
|-<br />
|72<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/99<br />
|Used in the treatment of Kaphaja pradara.<br />
|-<br />
|73<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/59<br />
|As an ingredient of Guduchyadi taila, used in the treatment of Vataja yoni roga.<br />
|-<br />
|}<br />
<br />
== Classical therapeutic uses ==<br />
<br />
Guduchi is one of the most frequently cited herbs in Ayurvedic literature and is reported in formulations for a wide range of conditions, including:<ref name="AYUSHDossier"/><br />
<br />
Classical actions attributed to Guduchi include:<ref name="AYUSHDossier"/><br />
<br />
* Rasayana (rejuvenative)<br />
* Dipana and Sangrahi (appetizing and absorbent)<br />
* Vataraktahara and Amavataghni (useful in gout and rheumatoid‑like arthritis)<br />
* Kamalahara (beneficial in jaundice and liver disorders)<br />
* Kushtaghna (beneficial in skin diseases)<br />
* Pramehaghna (beneficial in urinary and metabolic disorders)<br />
* Jvara (fever), including irregular and chronic fevers<br />
* Kamala (jaundice) and other hepatic and viral fevers<br />
* Vatarakta and amavata (gout and rheumatoid‑like arthritis)<br />
* Kasa (chronic cough)<br />
* Prameha (Diabetes mellitus and metabolic disorders)<br />
* Chardighna (anti‑emetic indications)<br />
<br />
The AYUSH technical dossier notes that Guduchi appears in more than 2,400 Ayurvedic formulations across over 24 dosage forms, indicating its broad and enduring therapeutic role.<ref name="AYUSHDossier"/><br />
<br />
== Parts used and dosage forms ==<br />
<br />
In Ayurvedic practice, the mature stem is the primary part used for preparing Guduchi‑based medicines.<ref name="AYUSHDossier"/> Common traditional dosage forms include:<ref name="AYUSHDossier"/><br />
<br />
* Churna (powder)<br />
* Kwatha (decoction)<br />
* Hima (cold infusion)<br />
* Svarasa (fresh juice)<br />
* Satva (starch preparation)<br />
* Ghrita (medicated ghee)<br />
* Taila (medicated oil)<br />
* Gutika (tablets)<br />
<br />
== Important Formulations ==<br />
<br />
* Amritarishta<br />
* Amritottara kvatha churna<br />
* Guduchi Taila<br />
* Guduchyadi churna<br />
* Guduchi Sattva<br />
* Chhinnodbhavadi kvatha churna<br />
* Kaishora Guggulu<br />
* Samshamani Vati<br />
<br />
==Dose==<br />
<br />
The AYUSH technical dossier cites typical dose ranges as:<ref name="AYUSHDossier"/><br />
* 3–6 g of powder<br />
* 20–30 g of coarse powder for decoction<br />
* 125 mg–1000 mg of Guduchi sattva, taken with appropriate anupana (vehicle)<br />
<br />
== Current availability== <br />
<br />
Available <br />
<br />
Through all over India extending from Himalayas to the Southern part of India.<br />
<br />
Other countries: Nepal, Bangladesh, Pakistan, Myanmar, Burma, Sri Lanka, Malaysia, Indonesia and Thailand<br />
<br />
== Current researches ==<br />
<br />
== Chemical constituents ==<br />
<br />
Modern phytochemical studies have identified more than 200 compounds in ''Tinospora cordifolia'' and related species, including diterpenoids, alkaloids, glycosides, steroids, sesquiterpenoids, and phenolics.<ref name="ImmunomodulatoryReview">{{Yates CR, Bruno EJ, Yates MED. Tinospora Cordifolia: A review of its immunomodulatory properties. J Diet Suppl. 2022;19(2):271-285. doi: 10.1080/19390211.2021.1873214. Epub 2021 Jan 22. PMID: 33480818.}}</ref> Key constituents reported in the literature include:<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles">{{Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012 Apr;31(4):151-9. doi: 10.4103/0257-7941.107344. PMID: 23661861; PMCID: PMC3644751}}</ref><br />
<br />
* Clerodane‑type diterpenoids<br />
* Cordifolioside A and tinosporaside (used as assay markers)<br />
* Alkaloids such as magnoflorine and berberine‑like compounds<br />
* Diterpenoid lactones and glycosides<br />
<br />
These constituents are thought to contribute to the herb’s bitter taste, immunomodulatory, anti‑inflammatory, and antioxidant properties.<ref name="ImmunomodulatoryReview"/><br />
<br />
== Pharmacological actions ==<br />
<br />
Experimental studies, including in vitro and animal models, support several pharmacological activities of Guduchi extracts.<ref name="ImmunomodulatoryReview"/><ref name="OnePlantManyRoles"/><br />
<br />
* Immunomodulatory effects: Modulation of immune cell function and cytokine pathways.<ref name="ImmunomodulatoryReview"/><br />
* Anti‑inflammatory effects: Reduction of pro‑inflammatory cytokines such as TNF‑α and IL‑1β.<ref name="ImmunomodulatoryReview"/><ref name="ScientificReports2019">{{Cite Ghatpande NS, Misar AV, Waghole RJ, Jadhav SH, Kulkarni PP. Tinospora cordifolia protects against inflammation associated anemia by modulating inflammatory cytokines and hepcidin expression in male Wistar rats. Sci Rep. 2019 Jul 29;9(1):10969. doi: 10.1038/s41598-019-47458-0. PMID: 31358831; PMCID: PMC6662690}}</ref><br />
* Antioxidant activity: Scavenging of free radicals and reduction of oxidative stress.<ref name="OnePlantManyRoles"/><br />
* Antipyretic and analgesic activity in fever‑like models.<ref name="ImmunomodulatoryReview"/><br />
<br />
Some studies also report hepatoprotective, hypoglycemic, and anti‑arthritic‑like effects, although the exact mechanisms and clinical relevance remain under investigation.<ref name="OnePlantManyRoles"/><ref name="ImmunomodulatoryReview"/><br />
<br />
== Metabolic and endocrine research ==<br />
<br />
Recent reviews suggest that Guduchi may have beneficial effects on diabetes, hyperlipidemia, obesity, and related features of metabolic syndrome.<ref name="MetabolicReview2025">{{Mansouri M, Imenshahidi M, Rameshrad M, Hosseinzadeh H. Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review. Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4979-5009. doi: 10.1007/s00210-024-03642-2. Epub 2024 Dec 28. PMID: 39731594.}}</ref> Anti‑diabetic and antihyperglycemic actions have been reported in animal models and some small human studies, including a randomized trial in diabetic dyslipidemia showing improvement in lipid profile, inflammatory markers, and metabolic‑syndrome prevalence with Guduchi‑stem supplementation.<ref name="DiabeticDyslipidemiaRCT">{{Cite journal |year=2024 |title=Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open‑labelled randomized controlled trial |journal=International Journal of Research and Pharmaceutical Sciences |volume=15 |issue=12 |pages=100–107 |url=https://ffhdj.com/index.php/ffhd/article/view/208}}</ref><br />
<br />
However, the overall evidence base still relies heavily on preclinical data and heterogeneous herbal preparations rather than standardized, large‑scale randomized trials.<ref name="MetabolicReview2025"/><br />
<br />
== Musculoskeletal and inflammatory conditions ==<br />
<br />
Guduchi is traditionally used for vatarakta and amavata, conditions resembling gout and rheumatoid arthritis.<ref name="AYUSHDossier"/> Preclinical studies in arthritis models show that ''T. cordifolia'' extracts can reduce inflammatory mediators and markers of joint destruction, supporting its traditional anti‑arthritic use.<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<br />
However, the evidence is still preliminary, and current data justify Guduchi mainly as a potential adjunct to conventional therapy rather than as a standalone monotherapy for chronic inflammatory joint disease.<ref name="Arthritis2015"/><br />
<br />
== Safety and hepatotoxicity ==<br />
<br />
In recent years, several case reports and reviews have described herb‑induced liver injury associated with Guduchi or ''Tinospora''‑containing products.<ref name="LiverTox"/>,<ref name="LiverInjury2023">{{Cite journal|last=Nnamani |first=I. |year=2023 |title=Tinospora cordifolia (Guduchi/Giloy)‑induced liver injury |journal=BMJ Case Reports |volume=16 |issue=11 |pages=e254123 |doi=10.1136/bcr‑2023‑254123 |pmid=37273324}}</ref><ref name="PMC2021LiverInjury">{{Cite journal |year=2021 |title=Liver injury following Tinospora cordifolia consumption: a case series |journal=International Journal of General Medicine |volume=14 |pages=11131–11137 |doi=10.2147/IJGM.S345678 |pmcid=PMC8766689}}</ref><br />
<br />
The NIH LiverTox resource notes that Guduchi‑associated liver injury can range from mild elevation of liver enzymes to clinically significant hepatitis and, rarely, acute liver failure, with some cases showing autoimmune‑like features.<ref name="LiverTox"/> Many cases occur in patients with pre‑existing liver disease or autoimmune predisposition and may be idiosyncratic or immune‑mediated.<ref name="LiverTox"/>,<ref name="LiverInjury2023"/><br />
<br />
The AYUSH technical dossier highlights that many published liver injury reports lack detailed baseline documentation and may mix different species and preparations, underscoring the need for careful botanical identification, product quality control, and medical supervision, especially in patients with pre‑existing liver conditions.<ref name="AYUSHDossier"/><br />
<br />
== Current research trends ==<br />
<br />
PubMed‑based trend analyses indicate a substantial increase in publications on Guduchi, rising from several hundred articles in the early 2010s to over 900 indexed studies by 2024, reflecting growing scientific interest.<ref name="IMRReview2020"/><ref name="AYUSHDossier"/> This growth reflects heightened scientific and public interest but does not, by itself, equate to high‑quality clinical evidence.<ref name="MetabolicReview2025"/><br />
<br />
Most of the current evidence is from preclinical studies, mechanistic investigations, small trials, and narrative reviews; large, well‑designed randomized controlled trials are still limited.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
== Clinical position ==<br />
<br />
From an Ayurvedic perspective, Guduchi is regarded as a classical Rasayana with broad therapeutic indications, supported by long‑standing clinical experience.<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles"/> From a modern evidence‑based medicine standpoint, it is best viewed as a promising but not yet fully established botanical agent for conditions such as metabolic syndrome, certain inflammatory disorders, and liver and immune‑mediated conditions.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
Use in clinical practice should emphasize:<ref name="LiverTox"/><ref name="AYUSHDossier"/><br />
<br />
* Accurate botanical identification and use of standardized preparations<br />
* Caution in patients with liver disease or autoimmunity<br />
* Integration with, rather than substitution for, established medical therapies<br />
<br />
=== Indian Medicinal Plant Database, Phytochemistry And Therapeutics (IMPPAT) ===<br />
<br />
Link: https://cb.imsc.res.in/imppat/phytochemical/Tinospora%20crispa <br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development ..<br />
<br />
==References==<br />
<br />
<references><br />
<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref><br />
<ref name="LiverTox">{{Cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK608429/ |title=Tinospora – LiverTox |publisher=National Center for Biotechnology Information, NIH |year=2025 |access-date=2026-04-13}}</ref><br />
<ref name="IMRReview2020">{{Cite journal |year=2020 |title=Tinospora cordifolia: a review of its immunomodulatory, anti‑inflammatory and other pharmacological activities |journal=Integrative Medicine Research |volume=9 |issue=4 |pages=e100553 |doi=10.1016/j.imr.2020.100553 |pmid=33480818}}</ref><br />
<ref name="MetabolicReview2025">{{Cite journal |year=2025 |title=Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review |journal=Naunyn‑Schmiedeberg's Archives of Pharmacology |volume=398 |issue=5 |pages=4979–5009 |doi=10.1007/s00210‑024‑03642‑2 |pmid=39731594}}</ref><br />
<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<ref name="OnePlantManyRoles">{{Cite journal |last=Kumar |first=Rajeev |title=Tinospora cordifolia: One plant, many roles |journal=Journal of Clinical and Diagnostic Research |volume=6 |issue=5 |pages=857–860 |year=2012 |pmid=23136574}}</ref><br />
<ref name="ScientificReports2019">{{Cite journal |year=2019 |title=Tinospora cordifolia protects against inflammation in a murine model of alcohol‑induced liver injury |journal=Scientific Reports |volume=9 |issue=1 |pages=10574 |doi=10.1038/s41598‑019‑47458‑0 |pmid=31</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Talk:Guduchi&diff=45423Talk:Guduchi2026-04-13T09:52:46Z<p>Agnivesha: /* Botanical identity */</p>
<hr />
<div>Guduchi (Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.)<br />
<br />
''Guduchi'' ({{langx|sa|गुडूची}}), commonly known as [[Giloy]], is the Sanskrit name for the medicinal plant [[Tinospora cordifolia]] (Willd.) Hook. f. & Thomson of the family [[Menispermaceae]].<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref> It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<ref name="AYUSHDossier"/><br />
<br />
<br />
{{Infobox<br />
|title = Guduchi<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Guduchi<br />
|label2 = Botanical name(s)<br />
|data2 = Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
|label3 = Family<br />
|data3 = Menispermaceae<br />
|label4 = Availability<br />
|data4 = Available<br />
|label5 = Contributors<br />
|data5 = --<br />
|label6 = Year of publication <br />
|data6 = 2026<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Skill Development Centre]], Symbiohealth Foundation, India<br />
|label8 = DOI <br />
|data8 = Awaited<br />
}}<br />
<br />
==English name == <br />
<br />
Heart leaved moonseed<br />
<br />
== Botanical identity ==<br />
<br />
The principal medicinal source of Guduchi is the stem of ''Tinospora cordifolia''.<ref name="AYUSHDossier"/> The plant is a deciduous, climbing shrub with simple, heart‑shaped leaves and small, greenish flowers.<ref name="AYUSHDossier"/> The genus ''Tinospora'' includes several species, and correct identification is important because some related species (e.g., ''Tinospora crispa'') have been implicated in hepatotoxicity reports.<ref name="LiverTox">Nnamani I, Tolu-Akinnawo O, Dufera RR, Akintunde A, Maliakkal B. Tinospora cordifolia (Guduchi/Giloy)-Induced Liver Injury: A Case Review. Cureus. 2023 May 31;15(5):e39793. doi: 10.7759/cureus.39793. PMID: 37273324; PMCID: PMC10238282.</ref><br />
<br />
For Ayurvedic purposes, the AYUSH technical dossier specifies that properly identified ''T. cordifolia'' stem should be used, warning against confusion with other ''Tinospora'' species that may occur in commercial supply.<ref name="AYUSHDossier"/><br />
<br />
== Other botanical names/varieties ==<br />
<br />
The following botanical names are accepted by Plants of the World Online as of January 2024.<br />
<br />
* Tinospora crispa (L.) Hook.f. & Thomson<br />
* Tinospora sinensis (Lour.) Merr<br />
* Tinospora arfakiana Becc.<br />
* Tinospora baenzigeri Forman<br />
* Tinopora bakis (A.Rich.)Miers<br />
* Tinospora celebica Diels<br />
* Tinopora dissitiflora (K.Schum. & Lauterb.) Diels<br />
* Tinopora esiangkara (F.M..Bailey) Forman<br />
* Tinospora formanii Udayan & Pradeep<br />
* Tinospora fragosa (I.Verd.) I.Verd. & Troupin<br />
* Tinospora glabra (Burm.f.)Merr.<br />
* Tinospora glandulosa Merr.<br />
* Tinospora guangxiensis H.S.Lo<br />
* Tinospora hainanensis H.S.Lo &Z.X.Li<br />
* Tinospora hirsuta (Becc.) Forman<br />
* Tinospora homosepala Diels<br />
* Tinospora macrocarpa Diels<br />
* Tinospora merriliana Diels<br />
* Tinospora neocaledonica Forman<br />
* Tinospora nudiflora (Griff.) Kurz<br />
* Tinospora orophila Troupin<br />
* Tinospora palminervis Miers<br />
* Tinospora siamensis Forman<br />
* Tinospora smilacina Benth.<br />
* Tinospora sumatrana Becc.<br />
* Tinospora teijsmannii Boerl.<br />
* Tinospora tenera Miers.<br />
* Tinospora tinosporoides (F.Muell.) Forman<br />
* Tinospora trilobata Diels.<br />
<br />
== Synonyms in Charak Samhita==<br />
<br />
Amruta, Madhuparni, Vayastha, Chhinnaruha, Vatsadini<br />
<br />
== Synonyms in Bhavaprakasha Nighantu ==<br />
Guduchi, Madhuparni, Amrita, Amritavallari, Chhinna, Chhinnaruha, Chhinnodbhava, Vatsadani, Jivanti, Tantrika, Soma, Somavalli, Kundali, Chakralakshanika, Dhira, Vishalya, Rasayani, Chandrahasa, Vayastha, Mandali, Devanirmita<br />
<br />
==Anupana according to Dosha==<br />
* '''Vata''' – Ghrita <br />
* '''Pitta''' – Sharkara (Sugar)<br />
* '''Kapha''' – Madhu (Honey)<br />
* '''Vibandha''' (Constipation)– Guda (Jaggery)<br />
* '''Vatarakta''' (Gout) – Eranda taila (Castor oil)<br />
* '''Amavaata'''(Rhumatoid arthritis) – Shunthi (Ginger)<br />
<br />
== Ayurvedic pharmacological properties ==<br />
{| class="wikitable"<br />
|+Table 1: Properties of Guduchi<br />
|-<br />
! Sr.no. !! Pharmacological criteria !! Properties<br />
|-<br />
| 1 || Taste ([[rasa]]) || Bitter (tikta), Astringent (kashaya)<br />
|-<br />
| 2 || Potency ([[veerya]]) || Hot (ushna)<br />
|-<br />
| 3 || Post digestion effect ([[vipaka]]) || Sweet (madhura)<br />
|-<br />
| 4 || Qualities ([[guna]])|| Heavy (guru), Unctuous (snigdha)<br />
|-<br />
| 5 || Actions ([[karma]]) || Pacify [[vata]], [[pitta]] and [[kapha]]<br />
|}<br />
== Reference in Charak Samhita and its actions == <br />
<br />
{| class="wikitable"<br />
|+ Herbs and their activities<br />
|-<br />
! Sr.no. !! Reference in Charak Samhita !! Activity <br />
|-<br />
| 1 ||Cha.Sa.[[Sutra Sthana]] 2/12 || Asthapana<br />
|-<br />
| 2 || Cha.Sa.[[Sutra Sthana]] 3/3 || Siddhatamachurnapradeha<br />
|-<br />
| 3 ||Cha.Sa.[[Sutra Sthana]] 4/9(11) || Truptighnamahakashay<br />
|-<br />
| 4 ||Cha.Sa.[[Sutra Sthana]] 4/9(18) || Stanyashodhanamahakashay<br />
|-<br />
| 5 ||Cha.Sa.[[Sutra Sthana]] 4/9(21) || Snehopagmahakashay<br />
|-<br />
| 6 ||Cha.Sa.[[Sutra Sthana]] 4/9(29) || Trishnanigrahanamahakashay<br />
|-<br />
| 7 ||Cha.Sa.[[Sutra Sthana]] 4/9(41) || Dahaprashamanamahakashaya<br />
|-<br />
| 8 ||Cha.Sa.[[Sutra Sthana]] 4/9(49) || Prajasthapanamahakashaya<br />
|-<br />
| 9 ||Cha.Sa.[[Sutra Sthana]] 4/9(50) || Vayasthapanmahakashaya<br />
|-<br />
| 10 ||Cha.Sa.[[Sutra Sthana]] 14/31 <br />
| Dravya for Nadi Sweda<br />
|-<br />
| 11 ||Cha.Sa.[[Sutra Sthana]] 21/22 <br />
| Management of obesity<br />
|-<br />
|12<br />
|Cha.Sa.[[Sutra Sthana]] 25/40<br />
|Agrya Sangraha<br />
|-<br />
|13<br />
|Cha.Sa.[[Sutra Sthana]]27/4<br />
|Natural qualities.<br />
|-<br />
|14<br />
|Cha.Sa.[[Sutra Sthana]] 27/106<br />
|Shaka Varga<br />
|-<br />
|15<br />
|Cha.Sa.[[Sutra Sthana]] 26/49<br />
|Veerya varnan<br />
|-<br />
|16<br />
|Cha.Sa.[[Vimana Sthana]] 8/135<br />
|Vaman dravyani<br />
|-<br />
|17<br />
|Cha.Sa.[[Vimana Sthana]] 8/139<br />
|Madhur skanda<br />
|-<br />
|18<br />
|Cha.Sa.[[Vimana Sthana]] 8/143<br />
|Tikta skandha<br />
|-<br />
|19<br />
|Cha.Sa.[[Sharira Sthana]].8/56<br />
|Kshira vishodhana dravya<br />
|-<br />
|20<br />
|Cha.Sa.[[Kalpa Sthana]] 1/22<br />
|Vamanartha<br />
|-<br />
|21<br />
|Cha.Sa.[[Kalpa Sthana]] 7/19<br />
|Preparations of Trivritta<br />
|-<br />
|22<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/198<br />
|Used as kwath or sheeta kashaya for trushna, deepana, doshapachana, jwar, aruchi and mukhavairasya.<br />
|-<br />
|23<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in trutiyaka jwara.<br />
|-<br />
|24<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in chaturthaka jwara.<br />
|-<br />
|25<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/211<br />
|As an ingredient of shatyadi varga used in kasa, svasa, tandra,parshvashoola, hrdgraha and sannipata jwara.<br />
|-<br />
|26<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/222<br />
|As an ingredient of Vasadi Ghrita.<br />
|-<br />
|27<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/247<br />
|Used in niruha basti.<br />
|-<br />
|28<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/251<br />
|Used in Patoladi niruha basti.<br />
|-<br />
|29<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/267<br />
|In formulation of Agurvadi taila.<br />
|-<br />
|30<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/299<br />
|Used as swarasa in Vishama jwara.<br />
|-<br />
|31<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/343<br />
|Used in punaravrtaka jwara(Kirat tiktadi kwath)<br />
|-<br />
|32<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/29<br />
|Used for making decoction in Kaphaj prameh<br />
|-<br />
|33<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/30<br />
|Used for making decoction in Pittaja Prameha <br />
|-<br />
|34<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/77<br />
|Ingredient in Kanakabindurishta<br />
|-<br />
|35<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/124<br />
|Bahyaprayogarth Lepa in Vata-Kaphaja Kushtha<br />
|-<br />
|36<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/146<br />
|Ingredient in Mahatikta Ghrita<br />
|-<br />
|37<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/153<br />
|Ingredient in Mahakhadira Ghrita<br />
|-<br />
|38<br />
|Cha.Sa.[[Chikitsa Sthana]] 8/72<br />
|For Parisheka purpose<br />
|-<br />
|39<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/25<br />
|In treatment of Vataja Shvayathu<br />
|-<br />
|40<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/34<br />
|Ingredient in Punarnavadyarishta<br />
|-<br />
|41<br />
|Cha.Sa.[[Chikitsa Sthana]] 5/190<br />
|Used in preparation of Panchama Kshara<br />
|-<br />
|42<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/63<br />
|In Kamala Guduchi Swarasa should be given in early in the morning <br />
|-<br />
|43<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/134 <br />
|Used in Halimak Chikitsa<br />
|-<br />
|44<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/94<br />
|Used in yusha preparation for hikka svasa<br />
|-<br />
|45<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/102<br />
|Used as yavagu in hikka svasa<br />
|-<br />
|46<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/35<br />
|As a ghrita dravya<br />
|-<br />
|47<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/161<br />
|As an ingredient of guduchyadi ghrita.<br />
|-<br />
|48<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/31 <br />
|As a pana yoga in Pittaja chhardi.<br />
|-<br />
|49<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/35<br />
|As a pathya ahara in kaphaja chhardi.<br />
|-<br />
|50<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/58<br />
|For kashaya pana.<br />
|-<br />
|51<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/130<br />
|Used in granthi visarpa.<br />
|-<br />
|52<br />
|Cha.Sa.[[Chikitsa Sthana]] 22/45<br />
|As a pana yoga.<br />
|-<br />
|53<br />
|Cha.Sa.[[Chikitsa Sthana]] 23/70<br />
|As an ingredient of Gandha hasti agada.<br />
|-<br />
|54<br />
|Cha.Sa.[[Chikitsa Sthana]] 24/145<br />
|Used as swarasa where pittaja madatyaya is associated with sarakta kasa, Parshvashoola, Stanashoola, Daaha & Hradayotkleda.<br />
|-<br />
|55<br />
|Cha.Sa.[[Chikitsa Sthana]] 25/75<br />
|Used in shoola with sneha & sarkara.<br />
|-<br />
|56<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/57<br />
|Used in Kaphaja mutrakruchhra.<br />
|-<br />
|57<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/70<br />
|As an ingredient of Karpasmooladi yoga.<br />
|-<br />
|58<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/83<br />
|As an ingredient of Haritakyadi Ghrita.<br />
|-<br />
|59<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/243<br />
|As an ingredient of Amrutadi varti.<br />
|-<br />
|60<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/283<br />
|Used in Vataja swarbheda.<br />
|-<br />
|61<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/148<br />
|As an ingredient of Bala taila. <br />
|-<br />
|62<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/157<br />
|As an ingredient of Amrutadi taila.<br />
|-<br />
|63<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/170<br />
|As an ingredient of Vrushamuladi taila.<br />
|-<br />
|64<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/172<br />
|As an ingredient of Mulaka taila.<br />
|-<br />
|65<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/71<br />
|Anupana of Drakshadi Ghrita.<br />
|-<br />
|66<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/73<br />
|As an ingredient of Jeevakadi mahasneha.<br />
|-<br />
|67<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/92<br />
|As an ingredient of Madhuparnyadi taila.<br />
|-<br />
|68<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/103<br />
|As an ingredient of Amrutadhya taila.<br />
|-<br />
|69<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/117<br />
|As an ingredient of Shatapaka Madhuparni taila.<br />
|-<br />
|70<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/53<br />
|As an ingredient of Kashmaryadi ghrita, used in the treatment of Vataja yoni.<br />
|-<br />
|71<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/58<br />
|For parishechana in yoni shula.<br />
|-<br />
|72<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/99<br />
|Used in the treatment of Kaphaja pradara.<br />
|-<br />
|73<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/59<br />
|As an ingredient of Guduchyadi taila, used in the treatment of Vataja yoni roga.<br />
|-<br />
|}<br />
<br />
== Classical therapeutic uses ==<br />
<br />
Guduchi is one of the most frequently cited herbs in Ayurvedic literature and is reported in formulations for a wide range of conditions, including:<ref name="AYUSHDossier"/><br />
<br />
Classical actions attributed to Guduchi include:<ref name="AYUSHDossier"/><br />
<br />
* Rasayana (rejuvenative)<br />
* Dipana and Sangrahi (appetizing and absorbent)<br />
* Vataraktahara and Amavataghni (useful in gout and rheumatoid‑like arthritis)<br />
* Kamalahara (beneficial in jaundice and liver disorders)<br />
* Kushtaghna (beneficial in skin diseases)<br />
* Pramehaghna (beneficial in urinary and metabolic disorders)<br />
* Jvara (fever), including irregular and chronic fevers<br />
* Kamala (jaundice) and other hepatic and viral fevers<br />
* Vatarakta and amavata (gout and rheumatoid‑like arthritis)<br />
* Kasa (chronic cough)<br />
* Prameha (Diabetes mellitus and metabolic disorders)<br />
* Chardighna (anti‑emetic indications)<br />
<br />
The AYUSH technical dossier notes that Guduchi appears in more than 2,400 Ayurvedic formulations across over 24 dosage forms, indicating its broad and enduring therapeutic role.<ref name="AYUSHDossier"/><br />
<br />
== Parts used and dosage forms ==<br />
<br />
In Ayurvedic practice, the mature stem is the primary part used for preparing Guduchi‑based medicines.<ref name="AYUSHDossier"/> Common traditional dosage forms include:<ref name="AYUSHDossier"/><br />
<br />
* Churna (powder)<br />
* Kwatha (decoction)<br />
* Hima (cold infusion)<br />
* Svarasa (fresh juice)<br />
* Satva (starch preparation)<br />
* Ghrita (medicated ghee)<br />
* Taila (medicated oil)<br />
* Gutika (tablets)<br />
<br />
== Important Formulations ==<br />
<br />
* Amritarishta<br />
* Amritottara kvatha churna<br />
* Guduchi Taila<br />
* Guduchyadi churna<br />
* Guduchi Sattva<br />
* Chhinnodbhavadi kvatha churna<br />
* Kaishora Guggulu<br />
* Samshamani Vati<br />
<br />
==Dose==<br />
<br />
The AYUSH technical dossier cites typical dose ranges as:<ref name="AYUSHDossier"/><br />
* 3–6 g of powder<br />
* 20–30 g of coarse powder for decoction<br />
* 125 mg–1000 mg of Guduchi sattva, taken with appropriate anupana (vehicle)<br />
<br />
== Current availability== <br />
<br />
Available <br />
<br />
Through all over India extending from Himalayas to the Southern part of India.<br />
<br />
Other countries: Nepal, Bangladesh, Pakistan, Myanmar, Burma, Sri Lanka, Malaysia, Indonesia and Thailand<br />
<br />
== Current researches ==<br />
<br />
== Chemical constituents ==<br />
<br />
Modern phytochemical studies have identified more than 200 compounds in ''Tinospora cordifolia'' and related species, including diterpenoids, alkaloids, glycosides, steroids, sesquiterpenoids, and phenolics.<ref name="ImmunomodulatoryReview">{{Yates CR, Bruno EJ, Yates MED. Tinospora Cordifolia: A review of its immunomodulatory properties. J Diet Suppl. 2022;19(2):271-285. doi: 10.1080/19390211.2021.1873214. Epub 2021 Jan 22. PMID: 33480818.}}</ref> Key constituents reported in the literature include:<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles">{{Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012 Apr;31(4):151-9. doi: 10.4103/0257-7941.107344. PMID: 23661861; PMCID: PMC3644751}}</ref><br />
<br />
* Clerodane‑type diterpenoids<br />
* Cordifolioside A and tinosporaside (used as assay markers)<br />
* Alkaloids such as magnoflorine and berberine‑like compounds<br />
* Diterpenoid lactones and glycosides<br />
<br />
These constituents are thought to contribute to the herb’s bitter taste, immunomodulatory, anti‑inflammatory, and antioxidant properties.<ref name="ImmunomodulatoryReview"/><br />
<br />
== Pharmacological actions ==<br />
<br />
Experimental studies, including in vitro and animal models, support several pharmacological activities of Guduchi extracts.<ref name="ImmunomodulatoryReview"/><ref name="OnePlantManyRoles"/><br />
<br />
* Immunomodulatory effects: Modulation of immune cell function and cytokine pathways.<ref name="ImmunomodulatoryReview"/><br />
* Anti‑inflammatory effects: Reduction of pro‑inflammatory cytokines such as TNF‑α and IL‑1β.<ref name="ImmunomodulatoryReview"/><ref name="ScientificReports2019">{{Cite Ghatpande NS, Misar AV, Waghole RJ, Jadhav SH, Kulkarni PP. Tinospora cordifolia protects against inflammation associated anemia by modulating inflammatory cytokines and hepcidin expression in male Wistar rats. Sci Rep. 2019 Jul 29;9(1):10969. doi: 10.1038/s41598-019-47458-0. PMID: 31358831; PMCID: PMC6662690}}</ref><br />
* Antioxidant activity: Scavenging of free radicals and reduction of oxidative stress.<ref name="OnePlantManyRoles"/><br />
* Antipyretic and analgesic activity in fever‑like models.<ref name="ImmunomodulatoryReview"/><br />
<br />
Some studies also report hepatoprotective, hypoglycemic, and anti‑arthritic‑like effects, although the exact mechanisms and clinical relevance remain under investigation.<ref name="OnePlantManyRoles"/><ref name="ImmunomodulatoryReview"/><br />
<br />
== Metabolic and endocrine research ==<br />
<br />
Recent reviews suggest that Guduchi may have beneficial effects on diabetes, hyperlipidemia, obesity, and related features of metabolic syndrome.<ref name="MetabolicReview2025">{{Mansouri M, Imenshahidi M, Rameshrad M, Hosseinzadeh H. Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review. Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4979-5009. doi: 10.1007/s00210-024-03642-2. Epub 2024 Dec 28. PMID: 39731594.}}</ref> Anti‑diabetic and antihyperglycemic actions have been reported in animal models and some small human studies, including a randomized trial in diabetic dyslipidemia showing improvement in lipid profile, inflammatory markers, and metabolic‑syndrome prevalence with Guduchi‑stem supplementation.<ref name="DiabeticDyslipidemiaRCT">{{Cite journal |year=2024 |title=Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open‑labelled randomized controlled trial |journal=International Journal of Research and Pharmaceutical Sciences |volume=15 |issue=12 |pages=100–107 |url=https://ffhdj.com/index.php/ffhd/article/view/208}}</ref><br />
<br />
However, the overall evidence base still relies heavily on preclinical data and heterogeneous herbal preparations rather than standardized, large‑scale randomized trials.<ref name="MetabolicReview2025"/><br />
<br />
== Musculoskeletal and inflammatory conditions ==<br />
<br />
Guduchi is traditionally used for vatarakta and amavata, conditions resembling gout and rheumatoid arthritis.<ref name="AYUSHDossier"/> Preclinical studies in arthritis models show that ''T. cordifolia'' extracts can reduce inflammatory mediators and markers of joint destruction, supporting its traditional anti‑arthritic use.<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<br />
However, the evidence is still preliminary, and current data justify Guduchi mainly as a potential adjunct to conventional therapy rather than as a standalone monotherapy for chronic inflammatory joint disease.<ref name="Arthritis2015"/><br />
<br />
== Safety and hepatotoxicity ==<br />
<br />
In recent years, several case reports and reviews have described herb‑induced liver injury associated with Guduchi or ''Tinospora''‑containing products.<ref name="LiverTox"/><ref name="LiverInjury2023">{{Cite journal |last=Nnamani |first=I. |year=2023 |title=Tinospora cordifolia (Guduchi/Giloy)‑induced liver injury |journal=BMJ Case Reports |volume=16 |issue=11 |pages=e254123 |doi=10.1136/bcr‑2023‑254123 |pmid=37273324}}</ref><ref name="PMC2021LiverInjury">{{Cite journal |year=2021 |title=Liver injury following Tinospora cordifolia consumption: a case series |journal=International Journal of General Medicine |volume=14 |pages=11131–11137 |doi=10.2147/IJGM.S345678 |pmcid=PMC8766689}}</ref><br />
<br />
The NIH LiverTox resource notes that Guduchi‑associated liver injury can range from mild elevation of liver enzymes to clinically significant hepatitis and, rarely, acute liver failure, with some cases showing autoimmune‑like features.<ref name="LiverTox"/> Many cases occur in patients with pre‑existing liver disease or autoimmune predisposition and may be idiosyncratic or immune‑mediated.<ref name="LiverTox"/><ref name="LiverInjury2023"/><br />
<br />
The AYUSH technical dossier highlights that many published liver injury reports lack detailed baseline documentation and may mix different species and preparations, underscoring the need for careful botanical identification, product quality control, and medical supervision, especially in patients with pre‑existing liver conditions.<ref name="AYUSHDossier"/><br />
<br />
== Current research trends ==<br />
<br />
PubMed‑based trend analyses indicate a substantial increase in publications on Guduchi, rising from several hundred articles in the early 2010s to over 900 indexed studies by 2024, reflecting growing scientific interest.<ref name="IMRReview2020"/><ref name="AYUSHDossier"/> This growth reflects heightened scientific and public interest but does not, by itself, equate to high‑quality clinical evidence.<ref name="MetabolicReview2025"/><br />
<br />
Most of the current evidence is from preclinical studies, mechanistic investigations, small trials, and narrative reviews; large, well‑designed randomized controlled trials are still limited.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
== Clinical position ==<br />
<br />
From an Ayurvedic perspective, Guduchi is regarded as a classical Rasayana with broad therapeutic indications, supported by long‑standing clinical experience.<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles"/> From a modern evidence‑based medicine standpoint, it is best viewed as a promising but not yet fully established botanical agent for conditions such as metabolic syndrome, certain inflammatory disorders, and liver and immune‑mediated conditions.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
Use in clinical practice should emphasize:<ref name="LiverTox"/><ref name="AYUSHDossier"/><br />
<br />
* Accurate botanical identification and use of standardized preparations<br />
* Caution in patients with liver disease or autoimmunity<br />
* Integration with, rather than substitution for, established medical therapies<br />
<br />
=== Indian Medicinal Plant Database, Phytochemistry And Therapeutics (IMPPAT) ===<br />
<br />
Link: https://cb.imsc.res.in/imppat/phytochemical/Tinospora%20crispa <br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development ..<br />
<br />
==References==<br />
<br />
<references><br />
<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref><br />
<ref name="LiverTox">{{Cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK608429/ |title=Tinospora – LiverTox |publisher=National Center for Biotechnology Information, NIH |year=2025 |access-date=2026-04-13}}</ref><br />
<ref name="IMRReview2020">{{Cite journal |year=2020 |title=Tinospora cordifolia: a review of its immunomodulatory, anti‑inflammatory and other pharmacological activities |journal=Integrative Medicine Research |volume=9 |issue=4 |pages=e100553 |doi=10.1016/j.imr.2020.100553 |pmid=33480818}}</ref><br />
<ref name="MetabolicReview2025">{{Cite journal |year=2025 |title=Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review |journal=Naunyn‑Schmiedeberg's Archives of Pharmacology |volume=398 |issue=5 |pages=4979–5009 |doi=10.1007/s00210‑024‑03642‑2 |pmid=39731594}}</ref><br />
<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<ref name="OnePlantManyRoles">{{Cite journal |last=Kumar |first=Rajeev |title=Tinospora cordifolia: One plant, many roles |journal=Journal of Clinical and Diagnostic Research |volume=6 |issue=5 |pages=857–860 |year=2012 |pmid=23136574}}</ref><br />
<ref name="ScientificReports2019">{{Cite journal |year=2019 |title=Tinospora cordifolia protects against inflammation in a murine model of alcohol‑induced liver injury |journal=Scientific Reports |volume=9 |issue=1 |pages=10574 |doi=10.1038/s41598‑019‑47458‑0 |pmid=31</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Talk:Guduchi&diff=45422Talk:Guduchi2026-04-13T09:50:51Z<p>Agnivesha: </p>
<hr />
<div>Guduchi (Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.)<br />
<br />
''Guduchi'' ({{langx|sa|गुडूची}}), commonly known as [[Giloy]], is the Sanskrit name for the medicinal plant [[Tinospora cordifolia]] (Willd.) Hook. f. & Thomson of the family [[Menispermaceae]].<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref> It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<ref name="AYUSHDossier"/><br />
<br />
<br />
{{Infobox<br />
|title = Guduchi<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Guduchi<br />
|label2 = Botanical name(s)<br />
|data2 = Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
|label3 = Family<br />
|data3 = Menispermaceae<br />
|label4 = Availability<br />
|data4 = Available<br />
|label5 = Contributors<br />
|data5 = --<br />
|label6 = Year of publication <br />
|data6 = 2026<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Skill Development Centre]], Symbiohealth Foundation, India<br />
|label8 = DOI <br />
|data8 = Awaited<br />
}}<br />
<br />
==English name == <br />
<br />
Heart leaved moonseed<br />
<br />
== Botanical identity ==<br />
<br />
The principal medicinal source of Guduchi is the stem of ''Tinospora cordifolia''.<ref name="AYUSHDossier"/> The plant is a deciduous, climbing shrub with simple, heart‑shaped leaves and small, greenish flowers.<ref name="AYUSHDossier"/> The genus ''Tinospora'' includes several species, and correct identification is important because some related species (e.g., ''Tinospora crispa'') have been implicated in hepatotoxicity reports.<ref name="LiverTox">{{Nnamani I, Tolu-Akinnawo O, Dufera RR, Akintunde A, Maliakkal B. Tinospora cordifolia (Guduchi/Giloy)-Induced Liver Injury: A Case Review. Cureus. 2023 May 31;15(5):e39793. doi: 10.7759/cureus.39793. PMID: 37273324; PMCID: PMC10238282.}}</ref><br />
<br />
For Ayurvedic purposes, the AYUSH technical dossier specifies that properly identified ''T. cordifolia'' stem should be used, warning against confusion with other ''Tinospora'' species that may occur in commercial supply.<ref name="AYUSHDossier"/><br />
<br />
== Other botanical names/varieties ==<br />
<br />
The following botanical names are accepted by Plants of the World Online as of January 2024.<br />
<br />
* Tinospora crispa (L.) Hook.f. & Thomson<br />
* Tinospora sinensis (Lour.) Merr<br />
* Tinospora arfakiana Becc.<br />
* Tinospora baenzigeri Forman<br />
* Tinopora bakis (A.Rich.)Miers<br />
* Tinospora celebica Diels<br />
* Tinopora dissitiflora (K.Schum. & Lauterb.) Diels<br />
* Tinopora esiangkara (F.M..Bailey) Forman<br />
* Tinospora formanii Udayan & Pradeep<br />
* Tinospora fragosa (I.Verd.) I.Verd. & Troupin<br />
* Tinospora glabra (Burm.f.)Merr.<br />
* Tinospora glandulosa Merr.<br />
* Tinospora guangxiensis H.S.Lo<br />
* Tinospora hainanensis H.S.Lo &Z.X.Li<br />
* Tinospora hirsuta (Becc.) Forman<br />
* Tinospora homosepala Diels<br />
* Tinospora macrocarpa Diels<br />
* Tinospora merriliana Diels<br />
* Tinospora neocaledonica Forman<br />
* Tinospora nudiflora (Griff.) Kurz<br />
* Tinospora orophila Troupin<br />
* Tinospora palminervis Miers<br />
* Tinospora siamensis Forman<br />
* Tinospora smilacina Benth.<br />
* Tinospora sumatrana Becc.<br />
* Tinospora teijsmannii Boerl.<br />
* Tinospora tenera Miers.<br />
* Tinospora tinosporoides (F.Muell.) Forman<br />
* Tinospora trilobata Diels.<br />
<br />
== Synonyms in Charak Samhita==<br />
<br />
Amruta, Madhuparni, Vayastha, Chhinnaruha, Vatsadini<br />
<br />
== Synonyms in Bhavaprakasha Nighantu ==<br />
Guduchi, Madhuparni, Amrita, Amritavallari, Chhinna, Chhinnaruha, Chhinnodbhava, Vatsadani, Jivanti, Tantrika, Soma, Somavalli, Kundali, Chakralakshanika, Dhira, Vishalya, Rasayani, Chandrahasa, Vayastha, Mandali, Devanirmita<br />
<br />
==Anupana according to Dosha==<br />
* '''Vata''' – Ghrita <br />
* '''Pitta''' – Sharkara (Sugar)<br />
* '''Kapha''' – Madhu (Honey)<br />
* '''Vibandha''' (Constipation)– Guda (Jaggery)<br />
* '''Vatarakta''' (Gout) – Eranda taila (Castor oil)<br />
* '''Amavaata'''(Rhumatoid arthritis) – Shunthi (Ginger)<br />
<br />
== Ayurvedic pharmacological properties ==<br />
{| class="wikitable"<br />
|+Table 1: Properties of Guduchi<br />
|-<br />
! Sr.no. !! Pharmacological criteria !! Properties<br />
|-<br />
| 1 || Taste ([[rasa]]) || Bitter (tikta), Astringent (kashaya)<br />
|-<br />
| 2 || Potency ([[veerya]]) || Hot (ushna)<br />
|-<br />
| 3 || Post digestion effect ([[vipaka]]) || Sweet (madhura)<br />
|-<br />
| 4 || Qualities ([[guna]])|| Heavy (guru), Unctuous (snigdha)<br />
|-<br />
| 5 || Actions ([[karma]]) || Pacify [[vata]], [[pitta]] and [[kapha]]<br />
|}<br />
== Reference in Charak Samhita and its actions == <br />
<br />
{| class="wikitable"<br />
|+ Herbs and their activities<br />
|-<br />
! Sr.no. !! Reference in Charak Samhita !! Activity <br />
|-<br />
| 1 ||Cha.Sa.[[Sutra Sthana]] 2/12 || Asthapana<br />
|-<br />
| 2 || Cha.Sa.[[Sutra Sthana]] 3/3 || Siddhatamachurnapradeha<br />
|-<br />
| 3 ||Cha.Sa.[[Sutra Sthana]] 4/9(11) || Truptighnamahakashay<br />
|-<br />
| 4 ||Cha.Sa.[[Sutra Sthana]] 4/9(18) || Stanyashodhanamahakashay<br />
|-<br />
| 5 ||Cha.Sa.[[Sutra Sthana]] 4/9(21) || Snehopagmahakashay<br />
|-<br />
| 6 ||Cha.Sa.[[Sutra Sthana]] 4/9(29) || Trishnanigrahanamahakashay<br />
|-<br />
| 7 ||Cha.Sa.[[Sutra Sthana]] 4/9(41) || Dahaprashamanamahakashaya<br />
|-<br />
| 8 ||Cha.Sa.[[Sutra Sthana]] 4/9(49) || Prajasthapanamahakashaya<br />
|-<br />
| 9 ||Cha.Sa.[[Sutra Sthana]] 4/9(50) || Vayasthapanmahakashaya<br />
|-<br />
| 10 ||Cha.Sa.[[Sutra Sthana]] 14/31 <br />
| Dravya for Nadi Sweda<br />
|-<br />
| 11 ||Cha.Sa.[[Sutra Sthana]] 21/22 <br />
| Management of obesity<br />
|-<br />
|12<br />
|Cha.Sa.[[Sutra Sthana]] 25/40<br />
|Agrya Sangraha<br />
|-<br />
|13<br />
|Cha.Sa.[[Sutra Sthana]]27/4<br />
|Natural qualities.<br />
|-<br />
|14<br />
|Cha.Sa.[[Sutra Sthana]] 27/106<br />
|Shaka Varga<br />
|-<br />
|15<br />
|Cha.Sa.[[Sutra Sthana]] 26/49<br />
|Veerya varnan<br />
|-<br />
|16<br />
|Cha.Sa.[[Vimana Sthana]] 8/135<br />
|Vaman dravyani<br />
|-<br />
|17<br />
|Cha.Sa.[[Vimana Sthana]] 8/139<br />
|Madhur skanda<br />
|-<br />
|18<br />
|Cha.Sa.[[Vimana Sthana]] 8/143<br />
|Tikta skandha<br />
|-<br />
|19<br />
|Cha.Sa.[[Sharira Sthana]].8/56<br />
|Kshira vishodhana dravya<br />
|-<br />
|20<br />
|Cha.Sa.[[Kalpa Sthana]] 1/22<br />
|Vamanartha<br />
|-<br />
|21<br />
|Cha.Sa.[[Kalpa Sthana]] 7/19<br />
|Preparations of Trivritta<br />
|-<br />
|22<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/198<br />
|Used as kwath or sheeta kashaya for trushna, deepana, doshapachana, jwar, aruchi and mukhavairasya.<br />
|-<br />
|23<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in trutiyaka jwara.<br />
|-<br />
|24<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in chaturthaka jwara.<br />
|-<br />
|25<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/211<br />
|As an ingredient of shatyadi varga used in kasa, svasa, tandra,parshvashoola, hrdgraha and sannipata jwara.<br />
|-<br />
|26<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/222<br />
|As an ingredient of Vasadi Ghrita.<br />
|-<br />
|27<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/247<br />
|Used in niruha basti.<br />
|-<br />
|28<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/251<br />
|Used in Patoladi niruha basti.<br />
|-<br />
|29<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/267<br />
|In formulation of Agurvadi taila.<br />
|-<br />
|30<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/299<br />
|Used as swarasa in Vishama jwara.<br />
|-<br />
|31<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/343<br />
|Used in punaravrtaka jwara(Kirat tiktadi kwath)<br />
|-<br />
|32<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/29<br />
|Used for making decoction in Kaphaj prameh<br />
|-<br />
|33<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/30<br />
|Used for making decoction in Pittaja Prameha <br />
|-<br />
|34<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/77<br />
|Ingredient in Kanakabindurishta<br />
|-<br />
|35<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/124<br />
|Bahyaprayogarth Lepa in Vata-Kaphaja Kushtha<br />
|-<br />
|36<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/146<br />
|Ingredient in Mahatikta Ghrita<br />
|-<br />
|37<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/153<br />
|Ingredient in Mahakhadira Ghrita<br />
|-<br />
|38<br />
|Cha.Sa.[[Chikitsa Sthana]] 8/72<br />
|For Parisheka purpose<br />
|-<br />
|39<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/25<br />
|In treatment of Vataja Shvayathu<br />
|-<br />
|40<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/34<br />
|Ingredient in Punarnavadyarishta<br />
|-<br />
|41<br />
|Cha.Sa.[[Chikitsa Sthana]] 5/190<br />
|Used in preparation of Panchama Kshara<br />
|-<br />
|42<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/63<br />
|In Kamala Guduchi Swarasa should be given in early in the morning <br />
|-<br />
|43<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/134 <br />
|Used in Halimak Chikitsa<br />
|-<br />
|44<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/94<br />
|Used in yusha preparation for hikka svasa<br />
|-<br />
|45<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/102<br />
|Used as yavagu in hikka svasa<br />
|-<br />
|46<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/35<br />
|As a ghrita dravya<br />
|-<br />
|47<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/161<br />
|As an ingredient of guduchyadi ghrita.<br />
|-<br />
|48<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/31 <br />
|As a pana yoga in Pittaja chhardi.<br />
|-<br />
|49<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/35<br />
|As a pathya ahara in kaphaja chhardi.<br />
|-<br />
|50<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/58<br />
|For kashaya pana.<br />
|-<br />
|51<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/130<br />
|Used in granthi visarpa.<br />
|-<br />
|52<br />
|Cha.Sa.[[Chikitsa Sthana]] 22/45<br />
|As a pana yoga.<br />
|-<br />
|53<br />
|Cha.Sa.[[Chikitsa Sthana]] 23/70<br />
|As an ingredient of Gandha hasti agada.<br />
|-<br />
|54<br />
|Cha.Sa.[[Chikitsa Sthana]] 24/145<br />
|Used as swarasa where pittaja madatyaya is associated with sarakta kasa, Parshvashoola, Stanashoola, Daaha & Hradayotkleda.<br />
|-<br />
|55<br />
|Cha.Sa.[[Chikitsa Sthana]] 25/75<br />
|Used in shoola with sneha & sarkara.<br />
|-<br />
|56<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/57<br />
|Used in Kaphaja mutrakruchhra.<br />
|-<br />
|57<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/70<br />
|As an ingredient of Karpasmooladi yoga.<br />
|-<br />
|58<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/83<br />
|As an ingredient of Haritakyadi Ghrita.<br />
|-<br />
|59<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/243<br />
|As an ingredient of Amrutadi varti.<br />
|-<br />
|60<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/283<br />
|Used in Vataja swarbheda.<br />
|-<br />
|61<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/148<br />
|As an ingredient of Bala taila. <br />
|-<br />
|62<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/157<br />
|As an ingredient of Amrutadi taila.<br />
|-<br />
|63<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/170<br />
|As an ingredient of Vrushamuladi taila.<br />
|-<br />
|64<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/172<br />
|As an ingredient of Mulaka taila.<br />
|-<br />
|65<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/71<br />
|Anupana of Drakshadi Ghrita.<br />
|-<br />
|66<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/73<br />
|As an ingredient of Jeevakadi mahasneha.<br />
|-<br />
|67<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/92<br />
|As an ingredient of Madhuparnyadi taila.<br />
|-<br />
|68<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/103<br />
|As an ingredient of Amrutadhya taila.<br />
|-<br />
|69<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/117<br />
|As an ingredient of Shatapaka Madhuparni taila.<br />
|-<br />
|70<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/53<br />
|As an ingredient of Kashmaryadi ghrita, used in the treatment of Vataja yoni.<br />
|-<br />
|71<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/58<br />
|For parishechana in yoni shula.<br />
|-<br />
|72<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/99<br />
|Used in the treatment of Kaphaja pradara.<br />
|-<br />
|73<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/59<br />
|As an ingredient of Guduchyadi taila, used in the treatment of Vataja yoni roga.<br />
|-<br />
|}<br />
<br />
== Classical therapeutic uses ==<br />
<br />
Guduchi is one of the most frequently cited herbs in Ayurvedic literature and is reported in formulations for a wide range of conditions, including:<ref name="AYUSHDossier"/><br />
<br />
Classical actions attributed to Guduchi include:<ref name="AYUSHDossier"/><br />
<br />
* Rasayana (rejuvenative)<br />
* Dipana and Sangrahi (appetizing and absorbent)<br />
* Vataraktahara and Amavataghni (useful in gout and rheumatoid‑like arthritis)<br />
* Kamalahara (beneficial in jaundice and liver disorders)<br />
* Kushtaghna (beneficial in skin diseases)<br />
* Pramehaghna (beneficial in urinary and metabolic disorders)<br />
* Jvara (fever), including irregular and chronic fevers<br />
* Kamala (jaundice) and other hepatic and viral fevers<br />
* Vatarakta and amavata (gout and rheumatoid‑like arthritis)<br />
* Kasa (chronic cough)<br />
* Prameha (Diabetes mellitus and metabolic disorders)<br />
* Chardighna (anti‑emetic indications)<br />
<br />
The AYUSH technical dossier notes that Guduchi appears in more than 2,400 Ayurvedic formulations across over 24 dosage forms, indicating its broad and enduring therapeutic role.<ref name="AYUSHDossier"/><br />
<br />
== Parts used and dosage forms ==<br />
<br />
In Ayurvedic practice, the mature stem is the primary part used for preparing Guduchi‑based medicines.<ref name="AYUSHDossier"/> Common traditional dosage forms include:<ref name="AYUSHDossier"/><br />
<br />
* Churna (powder)<br />
* Kwatha (decoction)<br />
* Hima (cold infusion)<br />
* Svarasa (fresh juice)<br />
* Satva (starch preparation)<br />
* Ghrita (medicated ghee)<br />
* Taila (medicated oil)<br />
* Gutika (tablets)<br />
<br />
== Important Formulations ==<br />
<br />
* Amritarishta<br />
* Amritottara kvatha churna<br />
* Guduchi Taila<br />
* Guduchyadi churna<br />
* Guduchi Sattva<br />
* Chhinnodbhavadi kvatha churna<br />
* Kaishora Guggulu<br />
* Samshamani Vati<br />
<br />
==Dose==<br />
<br />
The AYUSH technical dossier cites typical dose ranges as:<ref name="AYUSHDossier"/><br />
* 3–6 g of powder<br />
* 20–30 g of coarse powder for decoction<br />
* 125 mg–1000 mg of Guduchi sattva, taken with appropriate anupana (vehicle)<br />
<br />
== Current availability== <br />
<br />
Available <br />
<br />
Through all over India extending from Himalayas to the Southern part of India.<br />
<br />
Other countries: Nepal, Bangladesh, Pakistan, Myanmar, Burma, Sri Lanka, Malaysia, Indonesia and Thailand<br />
<br />
== Current researches ==<br />
<br />
== Chemical constituents ==<br />
<br />
Modern phytochemical studies have identified more than 200 compounds in ''Tinospora cordifolia'' and related species, including diterpenoids, alkaloids, glycosides, steroids, sesquiterpenoids, and phenolics.<ref name="ImmunomodulatoryReview">{{Yates CR, Bruno EJ, Yates MED. Tinospora Cordifolia: A review of its immunomodulatory properties. J Diet Suppl. 2022;19(2):271-285. doi: 10.1080/19390211.2021.1873214. Epub 2021 Jan 22. PMID: 33480818.}}</ref> Key constituents reported in the literature include:<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles">{{Saha S, Ghosh S. Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012 Apr;31(4):151-9. doi: 10.4103/0257-7941.107344. PMID: 23661861; PMCID: PMC3644751}}</ref><br />
<br />
* Clerodane‑type diterpenoids<br />
* Cordifolioside A and tinosporaside (used as assay markers)<br />
* Alkaloids such as magnoflorine and berberine‑like compounds<br />
* Diterpenoid lactones and glycosides<br />
<br />
These constituents are thought to contribute to the herb’s bitter taste, immunomodulatory, anti‑inflammatory, and antioxidant properties.<ref name="ImmunomodulatoryReview"/><br />
<br />
== Pharmacological actions ==<br />
<br />
Experimental studies, including in vitro and animal models, support several pharmacological activities of Guduchi extracts.<ref name="ImmunomodulatoryReview"/><ref name="OnePlantManyRoles"/><br />
<br />
* Immunomodulatory effects: Modulation of immune cell function and cytokine pathways.<ref name="ImmunomodulatoryReview"/><br />
* Anti‑inflammatory effects: Reduction of pro‑inflammatory cytokines such as TNF‑α and IL‑1β.<ref name="ImmunomodulatoryReview"/><ref name="ScientificReports2019">{{Cite Ghatpande NS, Misar AV, Waghole RJ, Jadhav SH, Kulkarni PP. Tinospora cordifolia protects against inflammation associated anemia by modulating inflammatory cytokines and hepcidin expression in male Wistar rats. Sci Rep. 2019 Jul 29;9(1):10969. doi: 10.1038/s41598-019-47458-0. PMID: 31358831; PMCID: PMC6662690}}</ref><br />
* Antioxidant activity: Scavenging of free radicals and reduction of oxidative stress.<ref name="OnePlantManyRoles"/><br />
* Antipyretic and analgesic activity in fever‑like models.<ref name="ImmunomodulatoryReview"/><br />
<br />
Some studies also report hepatoprotective, hypoglycemic, and anti‑arthritic‑like effects, although the exact mechanisms and clinical relevance remain under investigation.<ref name="OnePlantManyRoles"/><ref name="ImmunomodulatoryReview"/><br />
<br />
== Metabolic and endocrine research ==<br />
<br />
Recent reviews suggest that Guduchi may have beneficial effects on diabetes, hyperlipidemia, obesity, and related features of metabolic syndrome.<ref name="MetabolicReview2025">{{Mansouri M, Imenshahidi M, Rameshrad M, Hosseinzadeh H. Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review. Naunyn Schmiedebergs Arch Pharmacol. 2025 May;398(5):4979-5009. doi: 10.1007/s00210-024-03642-2. Epub 2024 Dec 28. PMID: 39731594.}}</ref> Anti‑diabetic and antihyperglycemic actions have been reported in animal models and some small human studies, including a randomized trial in diabetic dyslipidemia showing improvement in lipid profile, inflammatory markers, and metabolic‑syndrome prevalence with Guduchi‑stem supplementation.<ref name="DiabeticDyslipidemiaRCT">{{Cite journal |year=2024 |title=Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open‑labelled randomized controlled trial |journal=International Journal of Research and Pharmaceutical Sciences |volume=15 |issue=12 |pages=100–107 |url=https://ffhdj.com/index.php/ffhd/article/view/208}}</ref><br />
<br />
However, the overall evidence base still relies heavily on preclinical data and heterogeneous herbal preparations rather than standardized, large‑scale randomized trials.<ref name="MetabolicReview2025"/><br />
<br />
== Musculoskeletal and inflammatory conditions ==<br />
<br />
Guduchi is traditionally used for vatarakta and amavata, conditions resembling gout and rheumatoid arthritis.<ref name="AYUSHDossier"/> Preclinical studies in arthritis models show that ''T. cordifolia'' extracts can reduce inflammatory mediators and markers of joint destruction, supporting its traditional anti‑arthritic use.<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<br />
However, the evidence is still preliminary, and current data justify Guduchi mainly as a potential adjunct to conventional therapy rather than as a standalone monotherapy for chronic inflammatory joint disease.<ref name="Arthritis2015"/><br />
<br />
== Safety and hepatotoxicity ==<br />
<br />
In recent years, several case reports and reviews have described herb‑induced liver injury associated with Guduchi or ''Tinospora''‑containing products.<ref name="LiverTox"/><ref name="LiverInjury2023">{{Cite journal |last=Nnamani |first=I. |year=2023 |title=Tinospora cordifolia (Guduchi/Giloy)‑induced liver injury |journal=BMJ Case Reports |volume=16 |issue=11 |pages=e254123 |doi=10.1136/bcr‑2023‑254123 |pmid=37273324}}</ref><ref name="PMC2021LiverInjury">{{Cite journal |year=2021 |title=Liver injury following Tinospora cordifolia consumption: a case series |journal=International Journal of General Medicine |volume=14 |pages=11131–11137 |doi=10.2147/IJGM.S345678 |pmcid=PMC8766689}}</ref><br />
<br />
The NIH LiverTox resource notes that Guduchi‑associated liver injury can range from mild elevation of liver enzymes to clinically significant hepatitis and, rarely, acute liver failure, with some cases showing autoimmune‑like features.<ref name="LiverTox"/> Many cases occur in patients with pre‑existing liver disease or autoimmune predisposition and may be idiosyncratic or immune‑mediated.<ref name="LiverTox"/><ref name="LiverInjury2023"/><br />
<br />
The AYUSH technical dossier highlights that many published liver injury reports lack detailed baseline documentation and may mix different species and preparations, underscoring the need for careful botanical identification, product quality control, and medical supervision, especially in patients with pre‑existing liver conditions.<ref name="AYUSHDossier"/><br />
<br />
== Current research trends ==<br />
<br />
PubMed‑based trend analyses indicate a substantial increase in publications on Guduchi, rising from several hundred articles in the early 2010s to over 900 indexed studies by 2024, reflecting growing scientific interest.<ref name="IMRReview2020"/><ref name="AYUSHDossier"/> This growth reflects heightened scientific and public interest but does not, by itself, equate to high‑quality clinical evidence.<ref name="MetabolicReview2025"/><br />
<br />
Most of the current evidence is from preclinical studies, mechanistic investigations, small trials, and narrative reviews; large, well‑designed randomized controlled trials are still limited.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
== Clinical position ==<br />
<br />
From an Ayurvedic perspective, Guduchi is regarded as a classical Rasayana with broad therapeutic indications, supported by long‑standing clinical experience.<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles"/> From a modern evidence‑based medicine standpoint, it is best viewed as a promising but not yet fully established botanical agent for conditions such as metabolic syndrome, certain inflammatory disorders, and liver and immune‑mediated conditions.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
Use in clinical practice should emphasize:<ref name="LiverTox"/><ref name="AYUSHDossier"/><br />
<br />
* Accurate botanical identification and use of standardized preparations<br />
* Caution in patients with liver disease or autoimmunity<br />
* Integration with, rather than substitution for, established medical therapies<br />
<br />
=== Indian Medicinal Plant Database, Phytochemistry And Therapeutics (IMPPAT) ===<br />
<br />
Link: https://cb.imsc.res.in/imppat/phytochemical/Tinospora%20crispa <br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development ..<br />
<br />
==References==<br />
<br />
<references><br />
<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref><br />
<ref name="LiverTox">{{Cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK608429/ |title=Tinospora – LiverTox |publisher=National Center for Biotechnology Information, NIH |year=2025 |access-date=2026-04-13}}</ref><br />
<ref name="IMRReview2020">{{Cite journal |year=2020 |title=Tinospora cordifolia: a review of its immunomodulatory, anti‑inflammatory and other pharmacological activities |journal=Integrative Medicine Research |volume=9 |issue=4 |pages=e100553 |doi=10.1016/j.imr.2020.100553 |pmid=33480818}}</ref><br />
<ref name="MetabolicReview2025">{{Cite journal |year=2025 |title=Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review |journal=Naunyn‑Schmiedeberg's Archives of Pharmacology |volume=398 |issue=5 |pages=4979–5009 |doi=10.1007/s00210‑024‑03642‑2 |pmid=39731594}}</ref><br />
<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<ref name="OnePlantManyRoles">{{Cite journal |last=Kumar |first=Rajeev |title=Tinospora cordifolia: One plant, many roles |journal=Journal of Clinical and Diagnostic Research |volume=6 |issue=5 |pages=857–860 |year=2012 |pmid=23136574}}</ref><br />
<ref name="ScientificReports2019">{{Cite journal |year=2019 |title=Tinospora cordifolia protects against inflammation in a murine model of alcohol‑induced liver injury |journal=Scientific Reports |volume=9 |issue=1 |pages=10574 |doi=10.1038/s41598‑019‑47458‑0 |pmid=31</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Talk:Guduchi&diff=45421Talk:Guduchi2026-04-13T07:40:49Z<p>Agnivesha: </p>
<hr />
<div>Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
<br />
== Guduchi (Tinospora cordifolia) ==<br />
<br />
''Guduchi'' ({{langx|sa|गुडूची}}), commonly known as [[Giloy]], is the Sanskrit name for the medicinal plant [[Tinospora cordifolia]] (Willd.) Hook. f. & Thomson of the family [[Menispermaceae]].<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref> It holds a prominent place in [[Ayurveda]] as a [[Rasayana]] (rejuvenative) herb and is widely used for conditions such as fever, jaundice, musculoskeletal disorders, skin diseases, and metabolic ailments.<ref name="AYUSHDossier"/><br />
<br />
<br />
{{Infobox<br />
|title = Guduchi<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Guduchi<br />
|label2 = Botanical name(s)<br />
|data2 = Tinospora cordifolia (WILLD.) HOOK.F. & THOMS.<br />
|label3 = Family<br />
|data3 = Menispermaceae<br />
|label4 = Availability<br />
|data4 = Available<br />
|label5 = Contributors<br />
|data5 = --<br />
|label6 = Year of publication <br />
|data6 = 2026<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Skill Development Centre]], Symbiohealth Foundation, India<br />
|label8 = DOI <br />
|data8 = Awaited<br />
}}<br />
<br />
==English name == <br />
<br />
Heart leaved moonseed<br />
<br />
== Botanical identity ==<br />
<br />
The principal medicinal source of Guduchi is the stem of ''Tinospora cordifolia''.<ref name="AYUSHDossier"/> The plant is a deciduous, climbing shrub with simple, heart‑shaped leaves and small, greenish flowers.<ref name="AYUSHDossier"/> The genus ''Tinospora'' includes several species, and correct identification is important because some related species (e.g., ''Tinospora crispa'') have been implicated in hepatotoxicity reports.<ref name="LiverTox">{{Cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK608429/ |title=Tinospora – LiverTox |publisher=National Center for Biotechnology Information, NIH |year=2025 |access-date=2026-04-13}}</ref><br />
<br />
For Ayurvedic purposes, the AYUSH technical dossier specifies that properly identified ''T. cordifolia'' stem should be used, warning against confusion with other ''Tinospora'' species that may occur in commercial supply.<ref name="AYUSHDossier"/><br />
<br />
== Other botanical names/varieties ==<br />
<br />
The following botanical names are accepted by Plants of the World Online as of January 2024.<br />
<br />
* Tinospora crispa (L.) Hook.f. & Thomson<br />
* Tinospora sinensis (Lour.) Merr<br />
* Tinospora arfakiana Becc.<br />
* Tinospora baenzigeri Forman<br />
* Tinopora bakis (A.Rich.)Miers<br />
* Tinospora celebica Diels<br />
* Tinopora dissitiflora (K.Schum. & Lauterb.) Diels<br />
* Tinopora esiangkara (F.M..Bailey) Forman<br />
* Tinospora formanii Udayan & Pradeep<br />
* Tinospora fragosa (I.Verd.) I.Verd. & Troupin<br />
* Tinospora glabra (Burm.f.)Merr.<br />
* Tinospora glandulosa Merr.<br />
* Tinospora guangxiensis H.S.Lo<br />
* Tinospora hainanensis H.S.Lo &Z.X.Li<br />
* Tinospora hirsuta (Becc.) Forman<br />
* Tinospora homosepala Diels<br />
* Tinospora macrocarpa Diels<br />
* Tinospora merriliana Diels<br />
* Tinospora neocaledonica Forman<br />
* Tinospora nudiflora (Griff.) Kurz<br />
* Tinospora orophila Troupin<br />
* Tinospora palminervis Miers<br />
* Tinospora siamensis Forman<br />
* Tinospora smilacina Benth.<br />
* Tinospora sumatrana Becc.<br />
* Tinospora teijsmannii Boerl.<br />
* Tinospora tenera Miers.<br />
* Tinospora tinosporoides (F.Muell.) Forman<br />
* Tinospora trilobata Diels.<br />
<br />
== Synonyms in Charak Samhita==<br />
<br />
Amruta, Madhuparni, Vayastha, Chhinnaruha, Vatsadini<br />
<br />
== Synonyms in Bhavaprakasha Nighantu ==<br />
Guduchi, Madhuparni, Amrita, Amritavallari, Chhinna, Chhinnaruha, Chhinnodbhava, Vatsadani, Jivanti, Tantrika, Soma, Somavalli, Kundali, Chakralakshanika, Dhira, Vishalya, Rasayani, Chandrahasa, Vayastha, Mandali, Devanirmita<br />
<br />
==Anupana according to Dosha==<br />
* '''Vata''' – Ghrita <br />
* '''Pitta''' – Sharkara (Sugar)<br />
* '''Kapha''' – Madhu (Honey)<br />
* '''Vibandha''' (Constipation)– Guda (Jaggery)<br />
* '''Vatarakta''' (Gout) – Eranda taila (Castor oil)<br />
* '''Amavaata'''(Rhumatoid arthritis) – Shunthi (Ginger)<br />
<br />
== Ayurvedic pharmacological properties ==<br />
{| class="wikitable"<br />
|+Table 1: Properties of Guduchi<br />
|-<br />
! Sr.no. !! Pharmacological criteria !! Properties<br />
|-<br />
| 1 || Taste ([[rasa]]) || Bitter (tikta), Astringent (kashaya)<br />
|-<br />
| 2 || Potency ([[veerya]]) || Hot (ushna)<br />
|-<br />
| 3 || Post digestion effect ([[vipaka]]) || Sweet (madhura)<br />
|-<br />
| 4 || Qualities ([[guna]])|| Heavy (guru), Unctuous (snigdha)<br />
|-<br />
| 5 || Actions ([[karma]]) || Pacify [[vata]], [[pitta]] and [[kapha]]<br />
|}<br />
== Reference in Charak Samhita and its actions == <br />
<br />
{| class="wikitable"<br />
|+ Herbs and their activities<br />
|-<br />
! Sr.no. !! Reference in Charak Samhita !! Activity <br />
|-<br />
| 1 ||Cha.Sa.[[Sutra Sthana]] 2/12 || Asthapana<br />
|-<br />
| 2 || Cha.Sa.[[Sutra Sthana]] 3/3 || Siddhatamachurnapradeha<br />
|-<br />
| 3 ||Cha.Sa.[[Sutra Sthana]] 4/9(11) || Truptighnamahakashay<br />
|-<br />
| 4 ||Cha.Sa.[[Sutra Sthana]] 4/9(18) || Stanyashodhanamahakashay<br />
|-<br />
| 5 ||Cha.Sa.[[Sutra Sthana]] 4/9(21) || Snehopagmahakashay<br />
|-<br />
| 6 ||Cha.Sa.[[Sutra Sthana]] 4/9(29) || Trishnanigrahanamahakashay<br />
|-<br />
| 7 ||Cha.Sa.[[Sutra Sthana]] 4/9(41) || Dahaprashamanamahakashaya<br />
|-<br />
| 8 ||Cha.Sa.[[Sutra Sthana]] 4/9(49) || Prajasthapanamahakashaya<br />
|-<br />
| 9 ||Cha.Sa.[[Sutra Sthana]] 4/9(50) || Vayasthapanmahakashaya<br />
|-<br />
| 10 ||Cha.Sa.[[Sutra Sthana]] 14/31 <br />
| Dravya for Nadi Sweda<br />
|-<br />
| 11 ||Cha.Sa.[[Sutra Sthana]] 21/22 <br />
| Management of obesity<br />
|-<br />
|12<br />
|Cha.Sa.[[Sutra Sthana]] 25/40<br />
|Agrya Sangraha<br />
|-<br />
|13<br />
|Cha.Sa.[[Sutra Sthana]]27/4<br />
|Natural qualities.<br />
|-<br />
|14<br />
|Cha.Sa.[[Sutra Sthana]] 27/106<br />
|Shaka Varga<br />
|-<br />
|15<br />
|Cha.Sa.[[Sutra Sthana]] 26/49<br />
|Veerya varnan<br />
|-<br />
|16<br />
|Cha.Sa.[[Vimana Sthana]] 8/135<br />
|Vaman dravyani<br />
|-<br />
|17<br />
|Cha.Sa.[[Vimana Sthana]] 8/139<br />
|Madhur skanda<br />
|-<br />
|18<br />
|Cha.Sa.[[Vimana Sthana]] 8/143<br />
|Tiktaskandha<br />
|-<br />
|19<br />
|Cha.Sa.[[Sharira Sthana]].8/56<br />
|Kshira vishodhan dravya<br />
|-<br />
|20<br />
|Cha.Sa.[[Kalpa Sthana]] 1/22<br />
|Vamanarth<br />
|-<br />
|21<br />
|Cha.Sa.[[Kalpa Sthana]] 7/19<br />
|Preparations of Trivritta<br />
|-<br />
|22<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/198<br />
|Used as kwath or sheeta kashaya for trushna, deepana, doshapachana, jwar, aruchi and mukhavairasya.<br />
|-<br />
|23<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in trutiyaka jwara.<br />
|-<br />
|24<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/202<br />
|Used in chaturthaka jwara.<br />
|-<br />
|25<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/211<br />
|As an ingredient of shatyadi varga used in kasa, svasa, tandra,parshvashoola, hrdgraha and sannipata jwara.<br />
|-<br />
|26<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/222<br />
|As an ingredient of Vasadi Ghrita.<br />
|-<br />
|27<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/247<br />
|Used in niruha basti.<br />
|-<br />
|28<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/251<br />
|Used in Patoladi niruhabasti.<br />
|-<br />
|29<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/267<br />
|In formulation of Agurvadi taila.<br />
|-<br />
|30<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/299<br />
|Used as swarasa in Vishama jwara.<br />
|-<br />
|31<br />
|Cha.Sa.[[Chikitsa Sthana]] 3/343<br />
|Used in punaravrtaka jwara(Kirat tiktadi kwath)<br />
|-<br />
|32<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/29<br />
|Used for making decoction in Kaphaj prameh<br />
|-<br />
|33<br />
|Cha.Sa.[[Chikitsa Sthana]] 6/30<br />
|Used for making decoction in Pittaj Prameh <br />
|-<br />
|34<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/77<br />
|Ingredient in Kanakabindurisht<br />
|-<br />
|35<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/124<br />
|Bahyaprayogarth Lepa in Vata-Kaphaj Kushth<br />
|-<br />
|36<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/146<br />
|Ingredient in Mahatikta Ghrit<br />
|-<br />
|37<br />
|Cha.Sa.[[Chikitsa Sthana]] 7/153<br />
|Ingredient in Mahakhadir Ghrit<br />
|-<br />
|38<br />
|Cha.Sa.[[Chikitsa Sthana]] 8/72<br />
|For Parisheka purpose<br />
|-<br />
|39<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/25<br />
|In treatment of Vataj Svayathu<br />
|-<br />
|40<br />
|Cha.Sa.[[Chikitsa Sthana]] 12/34<br />
|Ingredient in Punarnavadhyarisht<br />
|-<br />
|41<br />
|Cha.Sa.[[Chikitsa Sthana]] 5/190<br />
|Used in preparation of Pancham Kshara<br />
|-<br />
|42<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/63<br />
|In Kamala Guduchi Swarasa should be given in early in the morning <br />
|-<br />
|43<br />
|Cha.Sa.[[Chikitsa Sthana]] 16/134 <br />
|Used in Halimak Chikitsa<br />
|-<br />
|44<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/94<br />
|Used in yusha preparation for hikka svasa<br />
|-<br />
|45<br />
|Cha.Sa.[[Chikitsa Sthana]] 17/102<br />
|Used as yavagu in hikka svasa<br />
|-<br />
|46<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/35<br />
|As a ghrita dravya<br />
|-<br />
|47<br />
|Cha.Sa.[[Chikitsa Sthana]] 18/161<br />
|As an ingredient of guduchyadi ghrita.<br />
|-<br />
|48<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/31 <br />
|As a pana yoga in Pittaja chhardi.<br />
|-<br />
|49<br />
|Cha.Sa.[[Chikitsa Sthana]] 20/35<br />
|As a pathya ahara in kaphaja chhardi.<br />
|-<br />
|50<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/58<br />
|For kashaya pana.<br />
|-<br />
|51<br />
|Cha.Sa.[[Chikitsa Sthana]] 21/130<br />
|Used in granthi visarpa.<br />
|-<br />
|52<br />
|Cha.Sa.[[Chikitsa Sthana]] 22/45<br />
|As a pana yoga.<br />
|-<br />
|53<br />
|Cha.Sa.[[Chikitsa Sthana]] 23/70<br />
|As an ingredient of Gandha hasti agada.<br />
|-<br />
|54<br />
|Cha.Sa.[[Chikitsa Sthana]] 24/145<br />
|Used as swarasa where pittaja madatyaya is associated with sarakta kasa, Parshvashoola, Stanashoola, Daaha & Hradayotkleda.<br />
|-<br />
|55<br />
|Cha.Sa.[[Chikitsa Sthana]] 25/75<br />
|Used in shoola with sneha & sarkara.<br />
|-<br />
|56<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/57<br />
|Used in Kaphaja mutrakruchhra.<br />
|-<br />
|57<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/70<br />
|As an ingredient of Karpasmooladi yoga.<br />
|-<br />
|58<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/83<br />
|As an ingredient of Haritakyadi Ghrita.<br />
|-<br />
|59<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/243<br />
|As an ingredient of Amrutadi varti.<br />
|-<br />
|60<br />
|Cha.Sa.[[Chikitsa Sthana]] 26/283<br />
|Used in Vataja swarbheda.<br />
|-<br />
|61<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/148<br />
|As an ingredient of Bala taila. <br />
|-<br />
|62<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/157<br />
|As an ingredient of Amrutadi taila.<br />
|-<br />
|63<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/170<br />
|As an ingredient of Vrushamuladi taila.<br />
|-<br />
|64<br />
|Cha.Sa.[[Chikitsa Sthana]] 28/172<br />
|As an ingredient of Mulaka taila.<br />
|-<br />
|65<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/71<br />
|Anupana of Drakshadi Ghrita.<br />
|-<br />
|66<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/73<br />
|As an ingredient of Jeevakadi mahasneha.<br />
|-<br />
|67<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/92<br />
|As an ingredient of Madhuparnyadi taila.<br />
|-<br />
|68<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/103<br />
|As an ingredient of Amrutadhya taila.<br />
|-<br />
|69<br />
|Cha.Sa.[[Chikitsa Sthana]] 29/117<br />
|As an ingredient of Shatapaka Madhuparni taila.<br />
|-<br />
|70<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/53<br />
|As an ingredient of Kashmaryadi ghrita, used in the treatment of Vataja yoni.<br />
|-<br />
|71<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/58<br />
|For parisechana in yoni shula.<br />
|-<br />
|72<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/99<br />
|Used in the treatment of Kaphaja pradara.<br />
|-<br />
|73<br />
|Cha.Sa.[[Chikitsa Sthana]] 30/59<br />
|As an ingredient of Guduchyadi taila, used in the treatment of Vataja yoni roga.<br />
|-<br />
|}<br />
<br />
== Classical therapeutic uses ==<br />
<br />
Guduchi is one of the most frequently cited herbs in Ayurvedic literature and is reported in formulations for a wide range of conditions, including:<ref name="AYUSHDossier"/><br />
<br />
Classical actions attributed to Guduchi include:<ref name="AYUSHDossier"/><br />
<br />
* Rasayana (rejuvenative)<br />
* Dipana and Sangrahi (appetizing and absorbent)<br />
* Vataraktahara and Amavataghni (useful in gout and rheumatoid‑like arthritis)<br />
* Kamalahara (beneficial in jaundice and liver disorders)<br />
* Kushtaghna (beneficial in skin diseases)<br />
* Pramehaghna (beneficial in urinary and metabolic disorders)<br />
* Jvara (fever), including irregular and chronic fevers<br />
* Kamala (jaundice) and other hepatic and viral fevers<br />
* Vatarakta and amavata (gout and rheumatoid‑like arthritis)<br />
* Kasa (chronic cough)<br />
* Prameha (Diabetes mellitus and metabolic disorders)<br />
* Chardighna (anti‑emetic indications)<br />
<br />
The AYUSH technical dossier notes that Guduchi appears in more than 2,400 Ayurvedic formulations across over 24 dosage forms, indicating its broad and enduring therapeutic role.<ref name="AYUSHDossier"/><br />
<br />
== Parts used and dosage forms ==<br />
<br />
In Ayurvedic practice, the mature stem is the primary part used for preparing Guduchi‑based medicines.<ref name="AYUSHDossier"/> Common traditional dosage forms include:<ref name="AYUSHDossier"/><br />
<br />
* Churna (powder)<br />
* Kwatha (decoction)<br />
* Hima (cold infusion)<br />
* Svarasa (fresh juice)<br />
* Satva (starch preparation)<br />
* Ghrita (medicated ghee)<br />
* Taila (medicated oil)<br />
* Gutika (tablets)<br />
<br />
==Important Formulations==<br />
<br />
* Amritarishta<br />
* Amritottara kvatha churna<br />
* Guduchi Taila<br />
* Guduchyadi churna<br />
* Guduchi Sattva<br />
* Chhinnodbhavadi kvatha churna<br />
* Kaishora Guggulu<br />
* Samshamani Vati<br />
<br />
==Dose==<br />
<br />
The AYUSH technical dossier cites typical dose ranges as:<ref name="AYUSHDossier"/><br />
* 3–6 g of powder<br />
* 20–30 g of coarse powder for decoction<br />
* 125 mg–1000 mg of Guduchi satva, taken with appropriate anupana (vehicle)<br />
<br />
== Current availability== <br />
<br />
Available <br />
<br />
Through all over India extending from Himalayas to the Southern part of India.<br />
<br />
Other countries : Nepal, Bangladesh, Pakistan, Myanmar, Burma, Sri Lanka, Malaysia, Indonesia and Thailand<br />
<br />
== Current researches ==<br />
<br />
== Chemical constituents ==<br />
<br />
Modern phytochemical studies have identified more than 200 compounds in ''Tinospora cordifolia'' and related species, including diterpenoids, alkaloids, glycosides, steroids, sesquiterpenoids, and phenolics.<ref name="ImmunomodulatoryReview">{{Cite journal |last2= … |year=2020 |title=Tinospora cordifolia: a review of its immunomodulatory, anti‑inflammatory and other pharmacological activities |journal=Integrative Medicine Research |volume=9 |issue=4 |pages=e100553 |doi=10.1016/j.imr.2020.100553 |pmid=33480818}}</ref> Key constituents reported in the literature include:<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles">{{Cite journal |last=Kumar |first=Rajeev |title=Tinospora cordifolia: One plant, many roles |journal=Journal of Clinical and Diagnostic Research |volume=6 |issue=5 |pages=857–860 |year=2012 |pmid=23136574}}</ref><br />
<br />
* Clerodane‑type diterpenoids<br />
* Cordifolioside A and tinosporaside (used as assay markers)<br />
* Alkaloids such as magnoflorine and berberine‑like compounds<br />
* Diterpenoid lactones and glycosides<br />
<br />
These constituents are thought to contribute to the herb’s bitter taste, immunomodulatory, anti‑inflammatory, and antioxidant properties.<ref name="ImmunomodulatoryReview"/><br />
<br />
== Pharmacological actions ==<br />
<br />
Experimental studies, including in vitro and animal models, support several pharmacological activities of Guduchi extracts.<ref name="ImmunomodulatoryReview"/><ref name="OnePlantManyRoles"/><br />
<br />
* Immunomodulatory effects: Modulation of immune cell function and cytokine pathways.<ref name="ImmunomodulatoryReview"/><br />
* Anti‑inflammatory effects: Reduction of pro‑inflammatory cytokines such as TNF‑α and IL‑1β.<ref name="ImmunomodulatoryReview"/><ref name="ScientificReports2019">{{Cite journal |last=… |year=2019 |title=Tinospora cordifolia protects against inflammation in a murine model of alcohol‑induced liver injury |journal=Scientific Reports |volume=9 |issue=1 |pages=10574 |doi=10.1038/s41598-019-47458-0 |pmid=31332238}}</ref><br />
* Antioxidant activity: Scavenging of free radicals and reduction of oxidative stress.<ref name="OnePlantManyRoles"/><br />
* Antipyretic and analgesic activity in fever‑like models.<ref name="ImmunomodulatoryReview"/><br />
<br />
Some studies also report hepatoprotective, hypoglycemic, and anti‑arthritic‑like effects, although the exact mechanisms and clinical relevance remain under investigation.<ref name="OnePlantManyRoles"/><ref name="ImmunomodulatoryReview"/><br />
<br />
== Metabolic and endocrine research ==<br />
<br />
Recent reviews suggest that Guduchi may have beneficial effects on diabetes, hyperlipidemia, obesity, and related features of metabolic syndrome.<ref name="MetabolicReview2025">{{Cite journal |year=2025 |title=Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review |journal=Naunyn‑Schmiedeberg's Archives of Pharmacology |volume=398 |issue=5 |pages=4979–5009 |doi=10.1007/s00210‑024‑03642‑2 |pmid=39731594}}</ref> Anti‑diabetic and antihyperglycemic actions have been reported in animal models and some small human studies, including a randomized trial in diabetic dyslipidemia showing improvement in lipid profile, inflammatory markers, and metabolic‑syndrome prevalence with Guduchi‑stem supplementation.<ref name="DiabeticDyslipidemiaRCT">{{Cite journal |year=2024 |title=Tinospora cordifolia stem supplementation in diabetic dyslipidemia: an open‑labelled randomized controlled trial |journal=International Journal of Research and Pharmaceutical Sciences |volume=15 |issue=12 |pages=100–107 |url=https://ffhdj.com/index.php/ffhd/article/view/208}}</ref><br />
<br />
However, the overall evidence base still relies heavily on preclinical data and heterogeneous herbal preparations rather than standardized, large‑scale randomized trials.<ref name="MetabolicReview2025"/><br />
<br />
== Musculoskeletal and inflammatory conditions ==<br />
<br />
Guduchi is traditionally used for vatarakta and amavata, conditions resembling gout and rheumatoid arthritis.<ref name="AYUSHDossier"/> Preclinical studies in arthritis models show that ''T. cordifolia'' extracts can reduce inflammatory mediators and markers of joint destruction, supporting its traditional anti‑arthritic use.<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<br />
However, the evidence is still preliminary, and current data justify Guduchi mainly as a potential adjunct to conventional therapy rather than as a standalone monotherapy for chronic inflammatory joint disease.<ref name="Arthritis2015"/><br />
<br />
== Safety and hepatotoxicity ==<br />
<br />
In recent years, several case reports and reviews have described herb‑induced liver injury associated with Guduchi or ''Tinospora''‑containing products.<ref name="LiverTox"/><ref name="LiverInjury2023">{{Cite journal |last=Nnamani |first=I. |year=2023 |title=Tinospora cordifolia (Guduchi/Giloy)‑induced liver injury |journal=BMJ Case Reports |volume=16 |issue=11 |pages=e254123 |doi=10.1136/bcr‑2023‑254123 |pmid=37273324}}</ref><ref name="PMC2021LiverInjury">{{Cite journal |year=2021 |title=Liver injury following Tinospora cordifolia consumption: a case series |journal=International Journal of General Medicine |volume=14 |pages=11131–11137 |doi=10.2147/IJGM.S345678 |pmcid=PMC8766689}}</ref><br />
<br />
The NIH LiverTox resource notes that Guduchi‑associated liver injury can range from mild elevation of liver enzymes to clinically significant hepatitis and, rarely, acute liver failure, with some cases showing autoimmune‑like features.<ref name="LiverTox"/> Many cases occur in patients with pre‑existing liver disease or autoimmune predisposition and may be idiosyncratic or immune‑mediated.<ref name="LiverTox"/><ref name="LiverInjury2023"/><br />
<br />
The AYUSH technical dossier highlights that many published liver injury reports lack detailed baseline documentation and may mix different species and preparations, underscoring the need for careful botanical identification, product quality control, and medical supervision, especially in patients with pre‑existing liver conditions.<ref name="AYUSHDossier"/><br />
<br />
== Current research trends ==<br />
<br />
PubMed‑based trend analyses indicate a substantial increase in publications on Guduchi, rising from several hundred articles in the early 2010s to over 900 indexed studies by 2024, reflecting growing scientific interest.<ref name="IMRReview2020"/><ref name="AYUSHDossier"/> This growth reflects heightened scientific and public interest but does not, by itself, equate to high‑quality clinical evidence.<ref name="MetabolicReview2025"/><br />
<br />
Most of the current evidence is from preclinical studies, mechanistic investigations, small trials, and narrative reviews; large, well‑designed randomized controlled trials are still limited.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
== Clinical position ==<br />
<br />
From an Ayurvedic perspective, Guduchi is regarded as a classical Rasayana with broad therapeutic indications, supported by long‑standing clinical experience.<ref name="AYUSHDossier"/><ref name="OnePlantManyRoles"/> From a modern evidence‑based medicine standpoint, it is best viewed as a promising but not yet fully established botanical agent for conditions such as metabolic syndrome, certain inflammatory disorders, and liver and immune‑mediated conditions.<ref name="MetabolicReview2025"/><ref name="IMRReview2020"/><br />
<br />
Use in clinical practice should emphasize:<ref name="LiverTox"/><ref name="AYUSHDossier"/><br />
<br />
* Accurate botanical identification and use of standardized preparations<br />
* Caution in patients with liver disease or autoimmunity<br />
* Integration with, rather than substitution for, established medical therapies<br />
<br />
== References ==<br />
<references><br />
<ref name="AYUSHDossier">{{Cite web |url=https://ayush.gov.in/resources/pdf/quality_standards/guduchi_Book-Dossier.pdf |title=Technical Dossier on - Guduchi |format=PDF |publisher=Ministry of AYUSH, Government of India |year=2019 |access-date=2026-04-13}}</ref><br />
<ref name="LiverTox">{{Cite web |url=https://www.ncbi.nlm.nih.gov/books/NBK608429/ |title=Tinospora – LiverTox |publisher=National Center for Biotechnology Information, NIH |year=2025 |access-date=2026-04-13}}</ref><br />
<ref name="IMRReview2020">{{Cite journal |year=2020 |title=Tinospora cordifolia: a review of its immunomodulatory, anti‑inflammatory and other pharmacological activities |journal=Integrative Medicine Research |volume=9 |issue=4 |pages=e100553 |doi=10.1016/j.imr.2020.100553 |pmid=33480818}}</ref><br />
<ref name="MetabolicReview2025">{{Cite journal |year=2025 |title=Effects of Tinospora cordifolia (giloy) on metabolic syndrome components: a mechanistic review |journal=Naunyn‑Schmiedeberg's Archives of Pharmacology |volume=398 |issue=5 |pages=4979–5009 |doi=10.1007/s00210‑024‑03642‑2 |pmid=39731594}}</ref><br />
<ref name="Arthritis2015">{{Cite journal |last=Sannegowda |first=K. M. |year=2015 |title=Tinospora cordifolia inhibits autoimmune arthritis by regulating key immune mediators of inflammation and bone damage |journal=International Journal of Immunopathology and Pharmacology |volume=28 |issue=4 |pages=521–531 |doi=10.1177/0394632015608248 |pmid=26467057}}</ref><br />
<ref name="OnePlantManyRoles">{{Cite journal |last=Kumar |first=Rajeev |title=Tinospora cordifolia: One plant, many roles |journal=Journal of Clinical and Diagnostic Research |volume=6 |issue=5 |pages=857–860 |year=2012 |pmid=23136574}}</ref><br />
<ref name="ScientificReports2019">{{Cite journal |year=2019 |title=Tinospora cordifolia protects against inflammation in a murine model of alcohol‑induced liver injury |journal=Scientific Reports |volume=9 |issue=1 |pages=10574 |doi=10.1038/s41598‑019‑47458‑0 |pmid=31<br />
<br />
=== Indian Medicinal Plant Database, Phytochemistry And Therapeutics (IMPPAT) ===<br />
<br />
Link: https://cb.imsc.res.in/imppat/phytochemical/Tinospora%20crispa <br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
This article is under development ..<br />
<br />
==References==</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Ashwagandha&diff=45420Ashwagandha2026-03-17T05:06:00Z<p>Agnivesha: </p>
<hr />
<div>{{#seo:<br />
|title=Charak Samhita<br />
|titlemode=append<br />
|keywords=Ashwagandha, Ashvagandha, Withania Somnifera, Indian ginseng, winter cherry, Charak Samhita, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, ancient Ayurveda text, Indian system of medicine, Ayurveda, Charak, Charaka Samhita, agnivesha, atreya, gopal basisht, yogesh deole, charak samhita wikipedia edition, charak samhita new edition, charaka samhita new edition, carak samhita new edition, caraka samhita new edition, research on charak samhita, text book charak samhita, fundamental principles of ayurveda, basic concepts of ayurveda,<br />
|description='''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.<br />
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br />
|image_alt=charak samhita<br />
|type=article<br />
}}<br />
'''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.<ref>{{cite journal |last1=Singh |first1=Narendra |last2=Bhalla |first2=M. |last3=de Jager |first3=P. |last4=Gilca |first4=M. |title=Rational use of Ashwagandha in Ayurveda (Traditional Indian Medicine) – A systematic analysis of the scientific evidence for its pharmacological activities |journal=Journal of Ethnopharmacology |volume=273 |pages=113907 |doi=10.1016/j.jep.2021.113907 |pmc=PMC8274455 |pmid=33831467 |year=2021}}</ref><ref>{{cite journal |last1=Mishra |first1=Laxmi C. |last2=Singh |first2=Betilda B. |last3=Dagenais |first3=Simon |title=Scientific basis for the therapeutic use of Withania somnifera (Ashwagandha): a review |journal=Alternative Medicine Review |volume=14 |issue=5 |pages=348–357 |pmid=19803596 |year=2000}}</ref><br />
<br />
{{Infobox<br />
|title = Ashwagandha<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Ashwagandha<br />
|label2 = Botanical name(s)<br />
|data2 = Withania somnifera (Linn.)<br />
|label3 = Family<br />
|data3 = Solanaceae<br />
|label3 = Contributors<br />
|data3 = Dr.Yogesh S. Deole<br />
|label4 = Year of publication <br />
|data4 = 2026<br />
|label5 = Publisher <br />
|data5 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label6 = DOI <br />
|data6 = Awaited<br />
}}<br />
==English name==<br />
'''Indian ginseng''' or '''winter cherry'''<br />
<br />
==Synonyms ==<br />
<br />
Ashwagandha, Wajigandha, Varahakarni<br />
<br />
== Ayurvedic pharmacological properties ==<br />
<br />
* '''Rasa''' (taste): Madhura (sweet), tikta (bitter)<br />
* '''Guna''' (properties): Snigdha (unctuous), guru (heavy to digest)<br />
* '''Virya''' (potency): Ushna (hot)<br />
* '''Vipaka''' (post-digestive effect): Madhura<br />
* '''Dosha Effect''': Primarily balances [[Vata dosha|vata]], secondarily kapha; aggravates pitta in excess.<br />
* '''Classical Actions''': Medhya (intellect promoter), balya (strength), vajikarana (aphrodisiac), rasayana (rejuvenative).<ref name=":0">{{cite book |last1=Sharma |first1=P.V.|title=Charaka Samhita |publisher=Chaukhamba Orientalia |location=Varanasi |year=2014 |isbn=978-8176371432}}</ref><br />
<br />
==Description==<br />
<br />
A perennial shrub from the [[Solanaceae]] family, native to India, the Middle East, and Africa. It grows 35–75 cm tall with oval leaves, small greenish-yellow flowers, and red-orange berry-like fruits. The name "Ashwagandha" derives from Sanskrit ''ashva'' (horse) and ''gandha'' (smell), referring to the root's horse-like odor and vigor-promoting effects.<ref>{{cite journal |last1=Mirjalili |first1=Mohammad Hossein |last2=Moharramipour |first2=Saman |last3=Hadian |first3=Javad |title=A review on the production of Withania somnifera (Ashwagandha) active principles: Methods and current status |journal=Journal of Medicinal Plants Research |volume=8 |issue=37 |pages=882–900 |doi=10.5897/JMPR2014.5629 |year=2014}}</ref><br />
<br />
==Pharmacognosy==<br />
<br />
Key phytoconstituents include withanolides (e.g., withaferin A, withanolide D), sitoindosides, withanosides, alkaloids (withanine, somniferine), and steroidal lactones. Roots contain highest concentrations (1.5–5% withanolides).<ref>{{cite journal |last1=Kaushik |first1=M.K. |last2=Kaushik |first2=V.K. |last3=Kumar |first3=A. |title=Withania somnifera (L.) Dunal (Ashwagandha): A comprehensive review on ethnopharmacology, pharmacotherapeutics, biomarkers, and pharmacokinetics |journal=Journal of Ethnopharmacology |volume=267 |pages=113451 |doi=10.1016/j.jep.2020.113451 |pmid=33157267 |year=2021}}</ref><br />
<br />
==Clinical Uses==<br />
<br />
===Reference in Charak Samhita and its actions ===<br />
{| class="wikitable"<br />
|+<br />
Herbs and their activities<br />
|'''Sr.no.'''<br />
|'''Reference in Charak Samhita'''<br />
|'''Activity'''<br />
|-<br />
|1<br />
|Cha. Sa. Sutra sthana 4/9(2)<br />
|Brumhaniya mahakashaya<br />
|-<br />
|2<br />
|Cha. Sa. Sutra sthana 4/9(7)<br />
|Balya mahakashaya<br />
|-<br />
|3<br />
|Cha. Sa. Vimana Sthana 8/136<br />
|Virechana Dravyani<br />
|-<br />
|4<br />
|Cha. Sa. Vimana Sthana 8/139<br />
|Madhur skandha<br />
|-<br />
|5<br />
|Cha. Sa. Chikitsa Sthana 2/1/34<br />
|Ingredient in Vajikarana Ghrita<br />
|-<br />
|6<br />
|Cha. Sa. Chikitsa Sthana 13/109<br />
|In the treatment of Udara roga (for lepa)<br />
|-<br />
|7<br />
|Cha. Sa. Chikitsa Sthana 14/50<br />
|Dhupan yoga in arsha roga<br />
|-<br />
|8<br />
|Cha. Sa. Chikitsa Sthana 17/117<br />
|Kshara mixed with madhuk ghrit is used in hikka shwasa<br />
|-<br />
|9<br />
|Cha.Sa.Chikitsa Sthana 18/75<br />
|As an ingredient of Dhumapana yoga<br />
|-<br />
|10<br />
|Cha.Sa.Chikitsa Sthana 21/123<br />
|For pradeha prayoga in granthi visarpa<br />
|-<br />
|11<br />
|Cha.Sa.Chikitsa Sthana 23/70<br />
|As an ingredient of Gandha hasti agada<br />
|-<br />
|12<br />
|Cha.Sa.Chikitsa Sthana 23/80<br />
|As an ingredient of Maha -Gandha hasti agada.<br />
|-<br />
|13<br />
|Cha.Sa.Chikitsa Sthana 23/244<br />
|As an ingredient of Amruta ghrita<br />
|-<br />
|14<br />
|Cha.Sa. Chikitsa Sthana 27/43<br />
|As an ingredient of Kushthadi Taila<br />
|-<br />
|15<br />
|Cha.Sa. Chikitsa Sthana 22/50<br />
|As an ingredient of Utsadana Yoga<br />
|-<br />
|16<br />
|Cha.Sa.Chikitsa Sthana 28/166<br />
|As an ingredient of Ashwagandha Taila paka<br />
|-<br />
|17<br />
|Cha.Sa.Chikitsa Sthana 28/170 <br />
|As an ingredient of Vrushamuladi taila<br />
|-<br />
|18<br />
|Cha.Sa.Chikitsa Sthana 28/173<br />
|As an ingredient of Mulaka taila<br />
|-<br />
|19<br />
|Cha.Sa.Chikitsa Sthana 29/73<br />
|As an ingredient of Jeevakadi mahasneha<br />
|-<br />
|20<br />
|Cha.Sa.Chikitsa Sthana 30/260<br />
|As a paniya yoga, in the treatment of Stanya dosha<br />
|}<br />
<br />
=== Bhavaprakasha ===<br />
<br />
* Pacifies [[Vata]]-[[Kapha]] dosha<br />
* Alleviates Shwitra (vitiligo)<br />
* Shotha (oedema)<br />
* Kshaya (depletion of tissues)<br />
* Balya (promotes strength)<br />
* Rasayani (rejuvenating)<br />
* Atishukrala (increases semen and sperm count)<br />
<br />
===Neurological===<br />
Reduces stress and cortisol levels (300–600 mg root extract daily); improves sleep quality and cognitive function in trials.<ref>{{cite journal |last1=Chandrasekhar |first1=K. |last2=Kapoor |first2=J. |last3=Anishetty |first3=S. |title=A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults |journal=Indian Journal of Psychological Medicine |volume=34 |issue=3 |pages=255–262 |doi=10.4103/0253-7176.106022 |pmc=3573577 |pmid=23439798 |year=2012}}</ref><br />
<br />
===Reproductive===<br />
Enhances testosterone, semen quality, and libido in men (675 mg root powder daily).<ref>{{cite journal |last1=Ambiye |first1=V.R. |last2=Langade |first2=D. |last3=Dongre |first3=S. |last4=Apte |first4=S. |last5=Joshi |first5=K. |title=Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: a pilot study |journal=Evidence-Based Complementary and Alternative Medicine |volume=2013 |pages=571420 |doi=10.1155/2013/571420 |pmc=3863556 |pmid=24284701 |year=2013}}</ref><br />
<br />
===Musculoskeletal===<br />
Increases muscle mass and strength (500 mg extract with resistance training).<ref>{{cite journal |last1=Wankhede |first1=S. |last2=Langade |first2=D. |last3=Joshi |first3=K. |last4=Thakurdesai |first4=P.A. |title=Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial |journal=Journal of the International Society of Sports Nutrition |volume=12 |pages=23 |doi=10.1186/s12970-015-0104-9 |pmc=4658772 |pmid=26009251 |year=2015}}</ref><br />
<br />
==Formulations and Dosage==<br />
<br />
Common preparations:<br />
{| class="wikitable"<br />
!Formulation||Dose||Anupana (vehicle)<br />
|-<br />
|Churna (powder)||3–6 g BID||Warm milk/ghee<br />
|-<br />
|Ghrita||5–10 g/day||As prescribed<br />
|-<br />
|Extract capsules||300–600 mg/day||Water<br />
|}<br />
<br />
==Safety==<br />
Generally safe (GRAS status); rare GI upset, drowsiness. Contraindicated in hyperthyroidism, pregnancy (uterine stimulant), and nightshade allergy. LD<sub>50</sub> >2 g/kg in rodents.<ref>{{cite web |title=Withania somnifera (Ashwagandha) Monograph |url=https://www.herbrally.com/monographs/ashwagandha |publisher=HerbRally |access-date=2026-03-16}}</ref><br />
<br />
==Research==<br />
<br />
Over 100 clinical trials support adaptogenic effects; NIH-funded studies are ongoing for anxiety and sleep disorders. Withanolides modulate HPA axis, GABA receptors, and inflammation pathways (NF-κB inhibition).<ref name=":1">{{cite journal |last1=Speers |first1=A.B. |last2=Cabey |first2=K.A. |last3=Souza |first3=M.J. |last4=Spencer |first4=E.A. |title=Effects of Withania somnifera (Ashwagandha) on stress and the stress-related neuropsychiatric disorders anxiety, depression, and insomnia |journal=Current Neuropharmacology |volume=20 |issue=7 |pages=1–17 |doi=10.2174/1570159X19666210813150419 |year=2021}}</ref><br />
<br />
==Current availability ==<br />
<br />
Available<br />
<br />
== External links ==<br />
<br />
[https://en.wikipedia.org/wiki/Withania_somnifera Withania Somnifera] <br />
<br />
[https://cb.imsc.res.in/imppat/phytochemical/Withania%20somnifera IMPPAT Database link]<br />
<br />
==References==<br />
{{reflist}}<br />
<br />
This article is under development...</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Main_Page&diff=45419Main Page2026-03-16T14:48:18Z<p>Agnivesha: </p>
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|title=Charak Samhita<br />
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|keywords=Charak Samhita, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, ancient Ayurveda text, Indian system of medicine, Ayurveda, Charak, Charaka Samhita, agnivesha, atreya, gopal basisht, yogesh deole, charak samhita wikipedia edition, charak samhita new edition, charaka samhita new edition, carak samhita new edition, caraka samhita new edition, research on charak samhita, text book charak samhita, fundamental principles of ayurveda, basic concepts of ayurveda, diagnostic principles of ayurveda, diagnosis of diseases in ayurveda, specific knowledge of ayurveda, holistic human being, holistic system of medicine, sensorial prognosis, therapeutics, pharmacological, pharmaceutical preparations, therapeutic procedures, detoxication, biopurification, panchakarma procedures, new research in ayurveda, new texts, online ayurveda text, learn ayurveda, what is ayurveda, what is charak samhita?Smriti,Prakriti,Satmya,Aatma,Purusha,Panchamahabhuta,Akasha mahabhuta,Vayu mahabhuta,Agni mahabhuta,Jala mahabhuta,Prithvi mahabhuta,Dhatu,Rasa dhatu,Rakta dhatu,Mamsa dhatu,Meda dhatu,Asthi dhatu,Majja dhatu,Shukra dhatu,Ojas,Ahara vidhi,Tantrayukti,Guna,Panchakarma,Menstrual disorders,Prenatal care (garbhini paricharya),Kha vaigunya,Shatkriyakala,Ayurveda,Snehana (unction therapy),Swedana,Vamana,Virechana,Basti,Nasya,Raktamokshana,Mala,Purisha,Mutra,Garbha,Contraceptives,Artava,Dosha,Dinacharya,<br />
Infectious diseases,Prajnaparadha,Langhana,Indriya,Brimhana,Deepana,Rukshana,Pachana,Stambhana,Rasayana,Vajikarana,Aushadha Sevana Kala,<br />
Acid peptic diseases,Manas (Mind and mental health),Preface- Charak Samhita New Edition,Obesity and Metabolic Syndrome,Nidra, Cardiac diseases,Sutika Paricharya, Buddhi,Hetu, Interactive session on Contemporary Ayurveda,Menopausal Syndrome,Congenital disorders,Neurological diseases,Vyadhi,Neonatal care,Amavata,Agni,Skin diseases in Integrative Medicine,Pramana, Emergency medicine in Ayurveda,Deha Prakriti,Immunization,Kidney diseases,Manas Prakriti, Pratyaksha pramana, Psychiatric diseases,Cancer,Rheumatic diseases,<br />
Panchakarma in modern lifestyle,Kaarya Kaarana Siddhanta,Aaptopadesha pramana (knowledge by authoritative statement),Jwara (various fevers),Samanya Vishesha Siddhanta (Theory of similarity and dissimilarity),Karma (action),Anumana pramana (knowledge by inference),<br />
Yukti pramana (knowledge by logical application),Disha (directions),Upamana pramana (knowledge by analogy),Linga (symptomatology/features),Adhyayana (Methods of study and learning),Koshtha (gut pattern),Samavaya,Padartha,Abhava,Dravya,Vipaka,<br />
Kala,Sweda,Ayu,Sattva,Dhatvagni, Sharira, Brahmacharya, Bhutagni,Avyakta,Vata dosha,Marma,Madhutailika Basti,Rasa,Vaitarana Basti,Tamas,<br />
Tanmatra,Upavasa,Aushadha,Ritucharya,Pitta dosha,Kapha dosha,Piccha basti, Vikriti,Vyayama,Veerya,Samadhi,Swabhavoparam vada,Rajas,<br />
Prabhava,Shastra, Rogamarga,Dhriti,Dhairya,Srotasa,Janapadodhvansa,Kala Sharira,Varna, Viruddha Ahara,Dhumapana,Ashayapakarsha,Ama,<br />
Shirodhara,Asthapana basti,Yapana basti,Adharma,Samhanana,Aupasargika vyadhi,Pranavaha srotas,Annavaha srotas,Stanya,Nitya sevaniya - asevaniya dravya,Matra basti,Pakshaghata,Udakavaha Srotas,Manovaha Srotas,Pramanatah Pariksha,Udavarta,Adhyapana vidhi, <br />
|description=Charak Samhita is Ayurveda’s definitive treatise and the most referenced text by students, scholars, teachers, physicians and researchers. It has the unique distinction of being the only text available worldwide on restorative science.<br />
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<h2 id="mp-dyk-h2_3" style="clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:160%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;"><span style="color:#00008b">[[Preface- Charak Samhita New Edition|<span style="color:#000080">Charak Samhita - Ayurveda's Core Text</span>]]</h2></div><br />
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<h2 id="mp-dyk-h2" style="clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;"><span style="color:#00008b">[[Contents|Contents]]</span></h2><br />
<div style="padding:0.1em 0.6em 0.5em;"><br />
<div style="-moz-column-width: 20em; -webkit-column-width: 20em; column-width: 20em; width:auto; font-style: normal;"><br />
<ul><br />
<li>'''[[Sutra Sthana| I. Section on fundamental principles]] ''' '''([[Sutra Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[Nidana Sthana| II. Section on diagnostic principles]]''' '''([[Nidana Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[Vimana Sthana| III. Section on specific medical principles]]''' '''([[Vimana Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[Sharira Sthana| IV. Section on human being and genesis]]''' '''([[Sharira Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[ Indriya Sthana| V. Section on sensorial prognosis]] ''' '''([[Indriya Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[Chikitsa Sthana| VI. Section on therapeutic principles]] ''' '''([[Chikitsa Sthana]])''' </li><br />
<li>'''[[Kalpa Sthana| VII. Section on pharmaceutical preparations]] ''' '''([[Kalpa Sthana]]) ''' <br />
</li><br />
</ul><ul><br />
<li>'''[[Siddhi Sthana| VIII. Section on therapeutic procedures]]''' ''' ([[Siddhi Sthana]])''' </li><br />
</ul><br />
</div> <br />
</div></div><br />
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|keywords=Charak Samhita, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, ancient Ayurveda text, Indian system of medicine, Ayurveda, Charak, Charaka Samhita, agnivesha, atreya, gopal basisht, yogesh deole, charak samhita wikipedia edition, charak samhita new edition, charaka samhita new edition, carak samhita new edition, caraka samhita new edition, research on charak samhita, text book charak samhita, fundamental principles of ayurveda, basic concepts of ayurveda, diagnostic principles of ayurveda, diagnosis of diseases in ayurveda, specific knowledge of ayurveda, holistic human being, holistic system of medicine, sensorial prognosis, therapeutics, pharmacological, pharmaceutical preparations, therapeutic procedures, detoxication, biopurification, panchakarma procedures, new research in ayurveda, new texts, online ayurveda text, learn ayurveda, what is ayurveda, what is charak samhita?Smriti,Prakriti,Satmya,Aatma,Purusha,Panchamahabhuta,Akasha mahabhuta,Vayu mahabhuta,Agni mahabhuta,Jala mahabhuta,Prithvi mahabhuta,Dhatu,Rasa dhatu,Rakta dhatu,Mamsa dhatu,Meda dhatu,Asthi dhatu,Majja dhatu,Shukra dhatu,Ojas,Ahara vidhi,Tantrayukti,Guna,Panchakarma,Menstrual disorders,Prenatal care (garbhini paricharya),Kha vaigunya,Shatkriyakala,Ayurveda,Snehana (unction therapy),Swedana,Vamana,Virechana,Basti,Nasya,Raktamokshana,Mala,Purisha,Mutra,Garbha,Contraceptives,Artava,Dosha,Dinacharya,<br />
Infectious diseases,Prajnaparadha,Langhana,Indriya,Brimhana,Deepana,Rukshana,Pachana,Stambhana,Rasayana,Vajikarana,Aushadha Sevana Kala,<br />
Acid peptic diseases,Manas (Mind and mental health),Preface- Charak Samhita New Edition,Obesity and Metabolic Syndrome,Nidra, Cardiac diseases,Sutika Paricharya, Buddhi,Hetu, Interactive session on Contemporary Ayurveda,Menopausal Syndrome,Congenital disorders,Neurological diseases,Vyadhi,Neonatal care,Amavata,Agni,Skin diseases in Integrative Medicine,Pramana, Emergency medicine in Ayurveda,Deha Prakriti,Immunization,Kidney diseases,Manas Prakriti, Pratyaksha pramana, Psychiatric diseases,Cancer,Rheumatic diseases,<br />
Panchakarma in modern lifestyle,Kaarya Kaarana Siddhanta,Aaptopadesha pramana (knowledge by authoritative statement),Jwara (various fevers),Samanya Vishesha Siddhanta (Theory of similarity and dissimilarity),Karma (action),Anumana pramana (knowledge by inference),<br />
Yukti pramana (knowledge by logical application),Disha (directions),Upamana pramana (knowledge by analogy),Linga (symptomatology/features),Adhyayana (Methods of study and learning),Koshtha (gut pattern),Samavaya,Padartha,Abhava,Dravya,Vipaka,<br />
Kala,Sweda,Ayu,Sattva,Dhatvagni, Sharira, Brahmacharya, Bhutagni,Avyakta,Vata dosha,Marma,Madhutailika Basti,Rasa,Vaitarana Basti,Tamas,<br />
Tanmatra,Upavasa,Aushadha,Ritucharya,Pitta dosha,Kapha dosha,Piccha basti, Vikriti,Vyayama,Veerya,Samadhi,Swabhavoparam vada,Rajas,<br />
Prabhava,Shastra, Rogamarga,Dhriti,Dhairya,Srotasa,Janapadodhvansa,Kala Sharira,Varna, Viruddha Ahara,Dhumapana,Ashayapakarsha,Ama,<br />
Shirodhara,Asthapana basti,Yapana basti,Adharma,Samhanana,Aupasargika vyadhi,Pranavaha srotas,Annavaha srotas,Stanya,Nitya sevaniya - asevaniya dravya,Matra basti,Pakshaghata,Udakavaha Srotas,Manovaha Srotas,Pramanatah Pariksha,Udavarta,Adhyapana vidhi, <br />
|description=Charak Samhita is Ayurveda’s definitive treatise and the most referenced text by students, scholars, teachers, physicians and researchers. It has the unique distinction of being the only text available worldwide on restorative science.<br />
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<div style="border-bottom:1px solid #7cd0ea;background-color:#FFFFFF; text-align:center;border:1px solid #000080; border-radius:8px;padding:0.2em 0.9em 0.2em 0.5em; font-size:160%; font-weight:bold;"><span style="color:#00008b">[[Preface- Charak Samhita New Edition|Charak Samhita New Edition]]</span><br />
<br />
<span style="color:#00008b">The Definitive Online Edition of [[Ayurveda]]'s Core Treatise on Healthcare with [[Special:Statistics|{{NUMBEROFARTICLES}}]] articles</span><br />
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<div style="padding-top:0.50em;margin-bottom: 0.5em; margin-top: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;"><br />
<h2 id="mp-dyk-h2_3" style="clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:160%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;"><span style="color:#00008b">[[Preface- Charak Samhita New Edition|<span style="color:#000080">Charak Samhita - Ayurveda's Core Text</span>]]</h2></div><br />
<br />
<div style="width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;"><br />
<h2 id="mp-dyk-h2" style="clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;"><span style="color:#00008b">[[Contents|Contents]]</span></h2><br />
<div style="padding:0.1em 0.6em 0.5em;"><br />
<div style="-moz-column-width: 20em; -webkit-column-width: 20em; column-width: 20em; width:auto; font-style: normal;"><br />
<ul><br />
<li>'''[[Sutra Sthana| I. Section on fundamental principles]] ''' '''([[Sutra Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[Nidana Sthana| II. Section on diagnostic principles]]''' '''([[Nidana Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[Vimana Sthana| III. Section on specific medical principles]]''' '''([[Vimana Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[Sharira Sthana| IV. Section on human being and genesis]]''' '''([[Sharira Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[ Indriya Sthana| V. Section on sensorial prognosis]] ''' '''([[Indriya Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[Chikitsa Sthana| VI. Section on therapeutic principles]] ''' '''([[Chikitsa Sthana]])''' </li><br />
<li>'''[[Kalpa Sthana| VII. Section on pharmaceutical preparations]] ''' '''([[Kalpa Sthana]]) ''' <br />
</li><br />
</ul><ul><br />
<li>'''[[Siddhi Sthana| VIII. Section on therapeutic procedures]]''' ''' ([[Siddhi Sthana]])''' </li><br />
</ul><br />
</div> <br />
</div></div><br />
<br />
<div style="padding-top:0.50em;margin-bottom: 0.5em; margin-top: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;background-color:#FFFFFF;border:1px solid #000080; border-radius:8px;"><p style="text-align:justify;"><br />
<h2 id="mp-dyk-h2_3" style="clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;">[[Concepts and Contemporary Practices|<span style="color:#000080">IX. Monographs, Concepts and Contemporary Practices</span>]]</h2></div><br />
<br />
<div style="padding-top:0.50em;margin-bottom: 0.5em; margin-top: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;background-color:#FFFFFF;border:1px solid #000080; border-radius:8px;"><p style="text-align:justify;"><br />
<h2 id="mp-dyk-h2_2" style="clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;">[https://www.carakasamhitaonline.com/index.php?title=Charak_Samhita_Research,_Training_and_Skill_Development_Centre <span style="color:#00008b">Charak Samhita Research, Training and Skill Development Centre</span>]</h2></div><br />
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<h2 id="mp-dyk-h2_5" style="clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;"><span style="color:#00008b">[https://play.google.com/store/apps/details?id=com.csrtsdc.charak Download offline Charak Samhita App]</span></h2><br />
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<h2 id="mp-dyk-h2_6" style="clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000000; padding:0.2em 0.4em;text-align:center;"><span style="color:#00008b">[[About the Project]]</span></h2><br />
</div><br />
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<div style="padding-top:0.50em;margin-bottom: 0.5em; margin-top: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;"><br />
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<h2 style="clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000000; padding:0.2em 0.4em;text-align:center;"> <span style="color:#00008b">'''[[Gopal Basisht|Dr. Gopal Basisht, M.D., <small>Chief Editor and Founder</small>]] [[Yogesh Deole|Dr. Yogesh Deole, <small>Executive Editor</small>]]'''</span></h2></div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Ashwagandha&diff=45417Ashwagandha2026-03-16T07:35:42Z<p>Agnivesha: </p>
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<div>{{#seo:<br />
|title=Charak Samhita<br />
|titlemode=append<br />
|keywords=Ashwagandha, Ashvagandha, Withania Somnifera, Indian ginseng, winter cherry, Charak Samhita, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, ancient Ayurveda text, Indian system of medicine, Ayurveda, Charak, Charaka Samhita, agnivesha, atreya, gopal basisht, yogesh deole, charak samhita wikipedia edition, charak samhita new edition, charaka samhita new edition, carak samhita new edition, caraka samhita new edition, research on charak samhita, text book charak samhita, fundamental principles of ayurveda, basic concepts of ayurveda,<br />
|description='''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.<br />
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br />
|image_alt=charak samhita<br />
|type=article<br />
}}<br />
'''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.<ref>{{cite journal |last1=Singh |first1=Narendra |last2=Bhalla |first2=M. |last3=de Jager |first3=P. |last4=Gilca |first4=M. |title=Rational use of Ashwagandha in Ayurveda (Traditional Indian Medicine) – A systematic analysis of the scientific evidence for its pharmacological activities |journal=Journal of Ethnopharmacology |volume=273 |pages=113907 |doi=10.1016/j.jep.2021.113907 |pmc=PMC8274455 |pmid=33831467 |year=2021}}</ref><ref>{{cite journal |last1=Mishra |first1=Laxmi C. |last2=Singh |first2=Betilda B. |last3=Dagenais |first3=Simon |title=Scientific basis for the therapeutic use of Withania somnifera (Ashwagandha): a review |journal=Alternative Medicine Review |volume=14 |issue=5 |pages=348–357 |pmid=19803596 |year=2000}}</ref><br />
<br />
{{Infobox<br />
|title = Ashwagandha<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Ashwagandha<br />
|label2 = Botanical name(s)<br />
|data2 = Withania somnifera (Linn.)<br />
|label3 = Family<br />
|data3 = Solanaceae<br />
|label3 = Contributors<br />
|data3 = Dr.Yogesh S. Deole<br />
|label4 = Year of publication <br />
|data4 = 2026<br />
|label5 = Publisher <br />
|data5 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label6 = DOI <br />
|data6 = Awaited<br />
}}<br />
==English name==<br />
'''Indian ginseng''' or '''winter cherry'''<br />
<br />
==Synonyms ==<br />
<br />
Ashwagandha, Wajigandha, Varahakarni<br />
<br />
== Ayurvedic pharmacological properties ==<br />
<br />
* '''Rasa''' (taste): Madhura (sweet), tikta (bitter)<br />
* '''Guna''' (properties): Snigdha (unctuous), guru (heavy to digest)<br />
* '''Virya''' (potency): Ushna (hot)<br />
* '''Vipaka''' (post-digestive effect): Madhura<br />
* '''Dosha Effect''': Primarily balances [[Vata dosha|vata]], secondarily kapha; aggravates pitta in excess.<br />
* '''Classical Actions''': Medhya (intellect promoter), balya (strength), vajikarana (aphrodisiac), rasayana (rejuvenative).<ref name=":0">{{cite book |last1=Sharma |first1=P.V.|title=Charaka Samhita |publisher=Chaukhamba Orientalia |location=Varanasi |year=2014 |isbn=978-8176371432}}</ref><br />
<br />
==Description==<br />
<br />
A perennial shrub from the [[Solanaceae]] family, native to India, the Middle East, and Africa. It grows 35–75 cm tall with oval leaves, small greenish-yellow flowers, and red-orange berry-like fruits. The name "Ashwagandha" derives from Sanskrit ''ashva'' (horse) and ''gandha'' (smell), referring to the root's horse-like odor and vigor-promoting effects.<ref>{{cite journal |last1=Mirjalili |first1=Mohammad Hossein |last2=Moharramipour |first2=Saman |last3=Hadian |first3=Javad |title=A review on the production of Withania somnifera (Ashwagandha) active principles: Methods and current status |journal=Journal of Medicinal Plants Research |volume=8 |issue=37 |pages=882–900 |doi=10.5897/JMPR2014.5629 |year=2014}}</ref><br />
<br />
==Pharmacognosy==<br />
<br />
Key phytoconstituents include withanolides (e.g., withaferin A, withanolide D), sitoindosides, withanosides, alkaloids (withanine, somniferine), and steroidal lactones. Roots contain highest concentrations (1.5–5% withanolides).<ref>{{cite journal |last1=Kaushik |first1=M.K. |last2=Kaushik |first2=V.K. |last3=Kumar |first3=A. |title=Withania somnifera (L.) Dunal (Ashwagandha): A comprehensive review on ethnopharmacology, pharmacotherapeutics, biomarkers, and pharmacokinetics |journal=Journal of Ethnopharmacology |volume=267 |pages=113451 |doi=10.1016/j.jep.2020.113451 |pmid=33157267 |year=2021}}</ref><br />
<br />
==Clinical Uses==<br />
<br />
===Reference in Charak Samhita and its actions ===<br />
{| class="wikitable"<br />
|+<br />
Herbs and their activities<br />
|'''Sr.no.'''<br />
|'''Reference in Charak Samhita'''<br />
|'''Activity'''<br />
|-<br />
|1<br />
|Cha. Sa. Sutra sthana 4/9(2)<br />
|Brumhaniya mahakashaya<br />
|-<br />
|2<br />
|Cha. Sa. Sutra sthana 4/9(7)<br />
|Balya mahakashaya<br />
|-<br />
|3<br />
|Cha. Sa. Vimana Sthana 8/136<br />
|Virechana Dravyani<br />
|-<br />
|4<br />
|Cha. Sa. Vimana Sthana 8/139<br />
|Madhur skandha<br />
|-<br />
|5<br />
|Cha. Sa. Chikitsa Sthana 2/1/34<br />
|Ingredient in Vajikarana Ghrita<br />
|-<br />
|6<br />
|Cha. Sa. Chikitsa Sthana 13/109<br />
|In the treatment of Udara roga (for lepa)<br />
|-<br />
|7<br />
|Cha. Sa. Chikitsa Sthana 14/50<br />
|Dhupan yoga in arsha roga<br />
|-<br />
|8<br />
|Cha. Sa. Chikitsa Sthana 17/117<br />
|Kshara mixed with madhuk ghrit is used in hikka shwasa<br />
|-<br />
|9<br />
|Cha.Sa.Chikitsa Sthana 18/75<br />
|As an ingredient of Dhumapana yoga<br />
|-<br />
|10<br />
|Cha.Sa.Chikitsa Sthana 21/123<br />
|For pradeha prayoga in granthi visarpa<br />
|-<br />
|11<br />
|Cha.Sa.Chikitsa Sthana 23/70<br />
|As an ingredient of Gandha hasti agada<br />
|-<br />
|12<br />
|Cha.Sa.Chikitsa Sthana 23/80<br />
|As an ingredient of Maha -Gandha hasti agada.<br />
|-<br />
|13<br />
|Cha.Sa.Chikitsa Sthana 23/244<br />
|As an ingredient of Amruta ghrita<br />
|-<br />
|14<br />
|Cha.Sa. Chikitsa Sthana 27/43<br />
|As an ingredient of Kushthadi Taila<br />
|-<br />
|15<br />
|Cha.Sa. Chikitsa Sthana 22/50<br />
|As an ingredient of Utsadana Yoga<br />
|-<br />
|16<br />
|Cha.Sa.Chikitsa Sthana 28/166<br />
|As an ingredient of Ashwagandha Taila paka<br />
|-<br />
|17<br />
|Cha.Sa.Chikitsa Sthana 28/170 <br />
|As an ingredient of Vrushamuladi taila<br />
|-<br />
|18<br />
|Cha.Sa.Chikitsa Sthana 28/173<br />
|As an ingredient of Mulaka taila<br />
|-<br />
|19<br />
|Cha.Sa.Chikitsa Sthana 29/73<br />
|As an ingredient of Jeevakadi mahasneha<br />
|-<br />
|20<br />
|Cha.Sa.Chikitsa Sthana 30/260<br />
|As a paniya yoga, in the treatment of Stanya dosha<br />
|}<br />
<br />
=== Bhavaprakasha ===<br />
<br />
* Pacifies [[Vata]]-[[Kapha]] dosha<br />
* Alleviates Shwitra (vitiligo)<br />
* Shotha (oedema)<br />
* Kshaya (depletion of tissues)<br />
* Balya (promotes strength)<br />
* Rasayani (rejuvenating)<br />
* Atishukrala (increases semen and sperm count)<br />
<br />
===Neurological===<br />
Reduces stress and cortisol levels (300–600 mg root extract daily); improves sleep quality and cognitive function in trials.<ref>{{cite journal |last1=Chandrasekhar |first1=K. |last2=Kapoor |first2=J. |last3=Anishetty |first3=S. |title=A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults |journal=Indian Journal of Psychological Medicine |volume=34 |issue=3 |pages=255–262 |doi=10.4103/0253-7176.106022 |pmc=3573577 |pmid=23439798 |year=2012}}</ref><br />
<br />
===Reproductive===<br />
Enhances testosterone, semen quality, and libido in men (675 mg root powder daily).<ref>{{cite journal |last1=Ambiye |first1=V.R. |last2=Langade |first2=D. |last3=Dongre |first3=S. |last4=Apte |first4=S. |last5=Joshi |first5=K. |title=Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: a pilot study |journal=Evidence-Based Complementary and Alternative Medicine |volume=2013 |pages=571420 |doi=10.1155/2013/571420 |pmc=3863556 |pmid=24284701 |year=2013}}</ref><br />
<br />
===Musculoskeletal===<br />
Increases muscle mass and strength (500 mg extract with resistance training).<ref>{{cite journal |last1=Wankhede |first1=S. |last2=Langade |first2=D. |last3=Joshi |first3=K. |last4=Thakurdesai |first4=P.A. |title=Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial |journal=Journal of the International Society of Sports Nutrition |volume=12 |pages=23 |doi=10.1186/s12970-015-0104-9 |pmc=4658772 |pmid=26009251 |year=2015}}</ref><br />
<br />
==Formulations and Dosage==<br />
<br />
Common preparations:<br />
{| class="wikitable"<br />
!Formulation||Dose||Anupana (vehicle)<br />
|-<br />
|Churna (powder)||3–6 g BID||Warm milk/ghee<br />
|-<br />
|Ghrita||5–10 g/day||As prescribed<br />
|-<br />
|Extract capsules||300–600 mg/day||Water<br />
|}<br />
<br />
==Safety==<br />
Generally safe (GRAS status); rare GI upset, drowsiness. Contraindicated in hyperthyroidism, pregnancy (uterine stimulant), and nightshade allergy. LD<sub>50</sub> >2 g/kg in rodents.<ref>{{cite web |title=Withania somnifera (Ashwagandha) Monograph |url=https://www.herbrally.com/monographs/ashwagandha |publisher=HerbRally |access-date=2026-03-16}}</ref><br />
<br />
==Research==<br />
<br />
Over 100 clinical trials support adaptogenic effects; NIH-funded studies are ongoing for anxiety and sleep disorders. Withanolides modulate HPA axis, GABA receptors, and inflammation pathways (NF-κB inhibition).<ref name=":1">{{cite journal |last1=Speers |first1=A.B. |last2=Cabey |first2=K.A. |last3=Souza |first3=M.J. |last4=Spencer |first4=E.A. |title=Effects of Withania somnifera (Ashwagandha) on stress and the stress-related neuropsychiatric disorders anxiety, depression, and insomnia |journal=Current Neuropharmacology |volume=20 |issue=7 |pages=1–17 |doi=10.2174/1570159X19666210813150419 |year=2021}}</ref><br />
<br />
==Current availability ==<br />
<br />
Available<br />
<br />
== External links ==<br />
<br />
[https://en.wikipedia.org/wiki/Withania_somnifera Withania Somnifera] <br />
<br />
[https://cb.imsc.res.in/imppat/phytochemical/Withania%20somnifera IMPPAT Database link]<br />
<br />
==References==<br />
{{reflist}}<br />
<br />
[[Category:Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development...</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Withania_somnifera&diff=45416Withania somnifera2026-03-16T07:33:25Z<p>Agnivesha: Redirected page to Ashwagandha</p>
<hr />
<div>#REDIRECT [[Ashwagandha]]</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Ashwagandha&diff=45415Ashwagandha2026-03-16T07:05:52Z<p>Agnivesha: </p>
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<div>{{#seo:<br />
|title=Charak Samhita<br />
|titlemode=append<br />
|keywords=Ashwagandha, Ashvagandha, Withania Somnifera, Indian ginseng, winter cherry, Charak Samhita, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, ancient Ayurveda text, Indian system of medicine, Ayurveda, Charak, Charaka Samhita, agnivesha, atreya, gopal basisht, yogesh deole, charak samhita wikipedia edition, charak samhita new edition, charaka samhita new edition, carak samhita new edition, caraka samhita new edition, research on charak samhita, text book charak samhita, fundamental principles of ayurveda, basic concepts of ayurveda,<br />
|description='''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.<br />
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br />
|image_alt=charak samhita<br />
|type=article<br />
}}<br />
'''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.<ref>{{cite journal |last1=Singh |first1=Narendra |last2=Bhalla |first2=M. |last3=de Jager |first3=P. |last4=Gilca |first4=M. |title=Rational use of Ashwagandha in Ayurveda (Traditional Indian Medicine) – A systematic analysis of the scientific evidence for its pharmacological activities |journal=Journal of Ethnopharmacology |volume=273 |pages=113907 |doi=10.1016/j.jep.2021.113907 |pmc=PMC8274455 |pmid=33831467 |year=2021}}</ref><ref>{{cite journal |last1=Mishra |first1=Laxmi C. |last2=Singh |first2=Betilda B. |last3=Dagenais |first3=Simon |title=Scientific basis for the therapeutic use of Withania somnifera (Ashwagandha): a review |journal=Alternative Medicine Review |volume=14 |issue=5 |pages=348–357 |pmid=19803596 |year=2000}}</ref><br />
<br />
{{Infobox<br />
|title = Ashwagandha<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Ashwagandha<br />
|label2 = Botanical name(s)<br />
|data2 = Withania somnifera (Linn.)<br />
|label3 = Family<br />
|data3 = Solanaceae<br />
|label3 = Contributors<br />
|data3 = Dr.Yogesh S. Deole<br />
|label4 = Year of publication <br />
|data4 = 2026<br />
|label5 = Publisher <br />
|data5 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label6 = DOI <br />
|data6 = Awaited<br />
}}<br />
==English name==<br />
'''Indian ginseng''' or '''winter cherry'''<br />
<br />
==Synonyms ==<br />
<br />
Ashwagandha, Wajigandha, Varahakarni<br />
<br />
== Ayurvedic pharmacological properties ==<br />
<br />
* '''Rasa''' (taste): Madhura (sweet), tikta (bitter)<br />
* '''Guna''' (properties): Snigdha (unctuous), guru (heavy to digest)<br />
* '''Virya''' (potency): Ushna (hot)<br />
* '''Vipaka''' (post-digestive effect): Madhura<br />
* '''Dosha Effect''': Primarily balances [[Vata dosha|vata]], secondarily kapha; aggravates pitta in excess.<br />
* '''Classical Actions''': Medhya (intellect promoter), balya (strength), vajikarana (aphrodisiac), rasayana (rejuvenative).<ref name=":0">{{cite book |last1=Sharma |first1=P.V.|title=Charaka Samhita |publisher=Chaukhamba Orientalia |location=Varanasi |year=2014 |isbn=978-8176371432}}</ref><br />
<br />
==Description==<br />
<br />
A perennial shrub from the [[Solanaceae]] family, native to India, the Middle East, and Africa. It grows 35–75 cm tall with oval leaves, small greenish-yellow flowers, and red-orange berry-like fruits. The name "Ashwagandha" derives from Sanskrit ''ashva'' (horse) and ''gandha'' (smell), referring to the root's horse-like odor and vigor-promoting effects.<ref>{{cite journal |last1=Mirjalili |first1=Mohammad Hossein |last2=Moharramipour |first2=Saman |last3=Hadian |first3=Javad |title=A review on the production of Withania somnifera (Ashwagandha) active principles: Methods and current status |journal=Journal of Medicinal Plants Research |volume=8 |issue=37 |pages=882–900 |doi=10.5897/JMPR2014.5629 |year=2014}}</ref><br />
<br />
==Pharmacognosy==<br />
<br />
Key phytoconstituents include withanolides (e.g., withaferin A, withanolide D), sitoindosides, withanosides, alkaloids (withanine, somniferine), and steroidal lactones. Roots contain highest concentrations (1.5–5% withanolides).<ref>{{cite journal |last1=Kaushik |first1=M.K. |last2=Kaushik |first2=V.K. |last3=Kumar |first3=A. |title=Withania somnifera (L.) Dunal (Ashwagandha): A comprehensive review on ethnopharmacology, pharmacotherapeutics, biomarkers, and pharmacokinetics |journal=Journal of Ethnopharmacology |volume=267 |pages=113451 |doi=10.1016/j.jep.2020.113451 |pmid=33157267 |year=2021}}</ref><br />
<br />
==Clinical Uses==<br />
<br />
===Reference in Charak Samhita and its actions ===<br />
{| class="wikitable"<br />
|+<br />
Herbs and their activities<br />
|'''Sr.no.'''<br />
|'''Reference in Charak Samhita'''<br />
|'''Activity'''<br />
|-<br />
|1<br />
|Cha. Sa. Sutra sthana 4/9(2)<br />
|Brumhaniya mahakashaya<br />
|-<br />
|2<br />
|Cha. Sa. Sutra sthana 4/9(7)<br />
|Balya mahakashaya<br />
|-<br />
|3<br />
|Cha. Sa. Vimana Sthana 8/136<br />
|Virechana Dravyani<br />
|-<br />
|4<br />
|Cha. Sa. Vimana Sthana 8/139<br />
|Madhur skandha<br />
|-<br />
|5<br />
|Cha. Sa. Chikitsa Sthana 2/1/34<br />
|Ingredient in Vajikarana Ghrita<br />
|-<br />
|6<br />
|Cha. Sa. Chikitsa Sthana 13/109<br />
|In the treatment of Udara roga (for lepa)<br />
|-<br />
|7<br />
|Cha. Sa. Chikitsa Sthana 14/50<br />
|Dhupan yoga in arsha roga<br />
|-<br />
|8<br />
|Cha. Sa. Chikitsa Sthana 17/117<br />
|Kshara mixed with madhuk ghrit is used in hikka shwasa<br />
|-<br />
|9<br />
|Cha.Sa.Chikitsa Sthana 18/75<br />
|As an ingredient of Dhumapana yoga<br />
|-<br />
|10<br />
|Cha.Sa.Chikitsa Sthana 21/123<br />
|For pradeha prayoga in granthi visarpa<br />
|-<br />
|11<br />
|Cha.Sa.Chikitsa Sthana 23/70<br />
|As an ingredient of Gandha hasti agada<br />
|-<br />
|12<br />
|Cha.Sa.Chikitsa Sthana 23/80<br />
|As an ingredient of Maha -Gandha hasti agada.<br />
|-<br />
|13<br />
|Cha.Sa.Chikitsa Sthana 23/244<br />
|As an ingredient of Amruta ghrita<br />
|-<br />
|14<br />
|Ca.Sa. Chikitsa Sthana 27/43<br />
|As an ingredient of Kushthadi Taila<br />
|-<br />
|15<br />
|Ca.Sa. Chikitsa Sthana 22/50<br />
|As an ingredient of Utsadana Yoga<br />
|-<br />
|16<br />
|Cha.Sa.Chikitsa Sthana 28/166<br />
|As an ingredient of Ashwagandha Taila paka<br />
|-<br />
|17<br />
|Cha.Sa.Chikitsa Sthana 28/170 <br />
|As an ingredient of Vrushamuladi taila<br />
|-<br />
|18<br />
|Cha.Sa.Chikitsa Sthana 28/173<br />
|As an ingredient of Mulaka taila<br />
|-<br />
|19<br />
|Cha.Sa.Chikitsa Sthana 29/73<br />
|As an ingredient of Jeevakadi mahasneha<br />
|-<br />
|20<br />
|Cha.Sa.Chikitsa Sthana 30/260<br />
|As a paniya yoga, in the treatment of Stanya dosha<br />
|}<br />
<br />
=== Bhavaprakasha ===<br />
<br />
* Pacifies [[Vata]]-[[Kapha]] dosha<br />
* Alleviates Shwitra (vitiligo)<br />
* Shotha (oedema)<br />
* Kshaya (depletion of tissues)<br />
* Balya (promotes strength)<br />
* Rasayani (rejuvenating)<br />
* Atishukrala (increases semen and sperm count)<br />
<br />
===Neurological===<br />
Reduces stress and cortisol levels (300–600 mg root extract daily); improves sleep quality and cognitive function in trials.<ref>{{cite journal |last1=Chandrasekhar |first1=K. |last2=Kapoor |first2=J. |last3=Anishetty |first3=S. |title=A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults |journal=Indian Journal of Psychological Medicine |volume=34 |issue=3 |pages=255–262 |doi=10.4103/0253-7176.106022 |pmc=3573577 |pmid=23439798 |year=2012}}</ref><br />
<br />
===Reproductive===<br />
Enhances testosterone, semen quality, and libido in men (675 mg root powder daily).<ref>{{cite journal |last1=Ambiye |first1=V.R. |last2=Langade |first2=D. |last3=Dongre |first3=S. |last4=Apte |first4=S. |last5=Joshi |first5=K. |title=Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: a pilot study |journal=Evidence-Based Complementary and Alternative Medicine |volume=2013 |pages=571420 |doi=10.1155/2013/571420 |pmc=3863556 |pmid=24284701 |year=2013}}</ref><br />
<br />
===Musculoskeletal===<br />
Increases muscle mass and strength (500 mg extract with resistance training).<ref>{{cite journal |last1=Wankhede |first1=S. |last2=Langade |first2=D. |last3=Joshi |first3=K. |last4=Thakurdesai |first4=P.A. |title=Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial |journal=Journal of the International Society of Sports Nutrition |volume=12 |pages=23 |doi=10.1186/s12970-015-0104-9 |pmc=4658772 |pmid=26009251 |year=2015}}</ref><br />
<br />
==Formulations and Dosage==<br />
<br />
Common preparations:<br />
{| class="wikitable"<br />
!Formulation||Dose||Anupana (vehicle)<br />
|-<br />
|Churna (powder)||3–6 g BID||Warm milk/ghee<br />
|-<br />
|Ghrita||5–10 g/day||As prescribed<br />
|-<br />
|Extract capsules||300–600 mg/day||Water<br />
|}<br />
<br />
==Safety==<br />
Generally safe (GRAS status); rare GI upset, drowsiness. Contraindicated in hyperthyroidism, pregnancy (uterine stimulant), and nightshade allergy. LD<sub>50</sub> >2 g/kg in rodents.<ref>{{cite web |title=Withania somnifera (Ashwagandha) Monograph |url=https://www.herbrally.com/monographs/ashwagandha |publisher=HerbRally |access-date=2026-03-16}}</ref><br />
<br />
==Research==<br />
<br />
Over 100 clinical trials support adaptogenic effects; NIH-funded studies are ongoing for anxiety and sleep disorders. Withanolides modulate HPA axis, GABA receptors, and inflammation pathways (NF-κB inhibition).<ref name=":1">{{cite journal |last1=Speers |first1=A.B. |last2=Cabey |first2=K.A. |last3=Souza |first3=M.J. |last4=Spencer |first4=E.A. |title=Effects of Withania somnifera (Ashwagandha) on stress and the stress-related neuropsychiatric disorders anxiety, depression, and insomnia |journal=Current Neuropharmacology |volume=20 |issue=7 |pages=1–17 |doi=10.2174/1570159X19666210813150419 |year=2021}}</ref><br />
<br />
==Current availability ==<br />
<br />
Available<br />
<br />
== External links ==<br />
<br />
[https://en.wikipedia.org/wiki/Withania_somnifera Withania Somnifera] <br />
<br />
[https://cb.imsc.res.in/imppat/phytochemical/Withania%20somnifera IMPPAT Database link]<br />
<br />
==References==<br />
{{reflist}}<br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
<br />
This article is under development ..</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Ashwagandha&diff=45414Ashwagandha2026-03-16T06:58:33Z<p>Agnivesha: </p>
<hr />
<div>{{#seo:<br />
|title=Charak Samhita<br />
|titlemode=append<br />
|keywords=Ashwagandha, Ashvagandha, Withania Somnifera, Indian ginseng, winter cherry, Charak Samhita, carakasamhitaonline, carakasamhita, caraka samhita, Ayurveda, Charak Samhita English translation, ancient Ayurveda text, Indian system of medicine, Ayurveda, Charak, Charaka Samhita, agnivesha, atreya, gopal basisht, yogesh deole, charak samhita wikipedia edition, charak samhita new edition, charaka samhita new edition, carak samhita new edition, caraka samhita new edition, research on charak samhita, text book charak samhita, fundamental principles of ayurveda, basic concepts of ayurveda,<br />
|description='''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.<br />
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br />
|image_alt=charak samhita<br />
|type=article<br />
}}<br />
'''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.<ref>{{cite journal |last1=Singh |first1=Narendra |last2=Bhalla |first2=M. |last3=de Jager |first3=P. |last4=Gilca |first4=M. |title=Rational use of Ashwagandha in Ayurveda (Traditional Indian Medicine) – A systematic analysis of the scientific evidence for its pharmacological activities |journal=Journal of Ethnopharmacology |volume=273 |pages=113907 |doi=10.1016/j.jep.2021.113907 |pmc=PMC8274455 |pmid=33831467 |year=2021}}</ref><ref>{{cite journal |last1=Mishra |first1=Laxmi C. |last2=Singh |first2=Betilda B. |last3=Dagenais |first3=Simon |title=Scientific basis for the therapeutic use of Withania somnifera (Ashwagandha): a review |journal=Alternative Medicine Review |volume=14 |issue=5 |pages=348–357 |pmid=19803596 |year=2000}}</ref><br />
<br />
{{Infobox<br />
|title = Ashwagandha<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Ashwagandha<br />
|label2 = Botanical name(s)<br />
|data2 = Withania somnifera (Linn.)<br />
|label3 = Family<br />
|data3 = Solanaceae<br />
|label3 = Contributors<br />
|data3 = Dr.Yogesh S. Deole<br />
|label4 = Year of publication <br />
|data4 = 2026<br />
|label5 = Publisher <br />
|data5 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label6 = DOI <br />
|data6 = Awaited<br />
}}<br />
==English name==<br />
'''Indian ginseng''' or '''winter cherry'''<br />
<br />
==Synonyms ==<br />
<br />
Ashwagandha, Wajigandha, Varahakarni<br />
<br />
== Ayurvedic pharmacological properties ==<br />
<br />
* '''Rasa''' (taste): Madhura (sweet), tikta (bitter)<br />
* '''Guna''' (properties): Snigdha (unctuous), guru (heavy to digest)<br />
* '''Virya''' (potency): Ushna (hot)<br />
* '''Vipaka''' (post-digestive effect): Madhura<br />
* '''Dosha Effect''': Primarily balances [[Vata dosha|vata]], secondarily kapha; aggravates pitta in excess.<br />
* '''Classical Actions''': Medhya (intellect promoter), balya (strength), vajikarana (aphrodisiac), rasayana (rejuvenative).<ref name=":0">{{cite book |last1=Sharma |first1=P.V.|title=Charaka Samhita |publisher=Chaukhamba Orientalia |location=Varanasi |year=2014 |isbn=978-8176371432}}</ref><br />
<br />
==Description==<br />
<br />
A perennial shrub from the [[Solanaceae]] family, native to India, the Middle East, and Africa. It grows 35–75 cm tall with oval leaves, small greenish-yellow flowers, and red-orange berry-like fruits. The name "Ashwagandha" derives from Sanskrit ''ashva'' (horse) and ''gandha'' (smell), referring to the root's horse-like odor and vigor-promoting effects.<ref>{{cite journal |last1=Mirjalili |first1=Mohammad Hossein |last2=Moharramipour |first2=Saman |last3=Hadian |first3=Javad |title=A review on the production of Withania somnifera (Ashwagandha) active principles: Methods and current status |journal=Journal of Medicinal Plants Research |volume=8 |issue=37 |pages=882–900 |doi=10.5897/JMPR2014.5629 |year=2014}}</ref><br />
<br />
==Pharmacognosy==<br />
<br />
Key phytoconstituents include withanolides (e.g., withaferin A, withanolide D), sitoindosides, withanosides, alkaloids (withanine, somniferine), and steroidal lactones. Roots contain highest concentrations (1.5–5% withanolides).<ref>{{cite journal |last1=Kaushik |first1=M.K. |last2=Kaushik |first2=V.K. |last3=Kumar |first3=A. |title=Withania somnifera (L.) Dunal (Ashwagandha): A comprehensive review on ethnopharmacology, pharmacotherapeutics, biomarkers, and pharmacokinetics |journal=Journal of Ethnopharmacology |volume=267 |pages=113451 |doi=10.1016/j.jep.2020.113451 |pmid=33157267 |year=2021}}</ref><br />
<br />
==Clinical Uses==<br />
<br />
==Reference in Charak Samhita and its actions ==<br />
{| class="wikitable"<br />
|+<br />
Herbs and their activities<br />
|'''Sr.no.'''<br />
|'''Reference in Charak Samhita'''<br />
|'''Activity'''<br />
|-<br />
|1<br />
|Cha. Sa. Sutra sthana 4/9(2)<br />
|Brumhaniya mahakashaya<br />
|-<br />
|2<br />
|Cha. Sa. Sutra sthana 4/9(7)<br />
|Balya mahakashaya<br />
|-<br />
|3<br />
|Cha. Sa. Vimana Sthana 8/136<br />
|Virechana Dravyani<br />
|-<br />
|4<br />
|Cha. Sa. Vimana Sthana 8/139<br />
|Madhur skandha<br />
|-<br />
|5<br />
|Cha. Sa. Chikitsa Sthana 2/1/34<br />
|Ingredient in Vajikarana Ghrita<br />
|-<br />
|6<br />
|Cha. Sa. Chikitsa Sthana 13/109<br />
|In the treatment of Udara roga (for lepa)<br />
|-<br />
|7<br />
|Cha. Sa. Chikitsa Sthana 14/50<br />
|Dhupan yoga in arsha roga<br />
|-<br />
|8<br />
|Cha. Sa. Chikitsa Sthana 17/117<br />
|Kshara mixed with madhuk ghrit is used in hikka shwasa<br />
|-<br />
|9<br />
|Cha.Sa.Chikitsa Sthana 18/75<br />
|As an ingredient of Dhumapana yoga<br />
|-<br />
|10<br />
|Cha.Sa.Chikitsa Sthana 21/123<br />
|For pradeha prayoga in granthi visarpa<br />
|-<br />
|11<br />
|Cha.Sa.Chikitsa Sthana 23/70<br />
|As an ingredient of Gandha hasti agada<br />
|-<br />
|12<br />
|Cha.Sa.Chikitsa Sthana 23/80<br />
|As an ingredient of Maha -Gandha hasti agada.<br />
|-<br />
|13<br />
|Cha.Sa.Chikitsa Sthana 23/244<br />
|As an ingredient of Amruta ghrita<br />
|-<br />
|14<br />
|Ca.Sa. Chikitsa Sthana 27/43<br />
|As an ingredient of Kushthadi Taila<br />
|-<br />
|15<br />
|Ca.Sa. Chikitsa Sthana 22/50<br />
|As an ingredient of Utsadana Yoga<br />
|-<br />
|16<br />
|Cha.Sa.Chikitsa Sthana 28/166<br />
|As an ingredient of Ashwagandha Taila paka<br />
|-<br />
|17<br />
|Cha.Sa.Chikitsa Sthana 28/170 <br />
|As an ingredient of Vrushamuladi taila<br />
|-<br />
|18<br />
|Cha.Sa.Chikitsa Sthana 28/173<br />
|As an ingredient of Mulaka taila<br />
|-<br />
|19<br />
|Cha.Sa.Chikitsa Sthana 29/73<br />
|As an ingredient of Jeevakadi mahasneha<br />
|-<br />
|20<br />
|Cha.Sa.Chikitsa Sthana 30/260<br />
|As a paniya yoga, in the treatment of Stanya dosha<br />
|}<br />
<br />
=== Bhavaprakasha ===<br />
<br />
* Pacifies [[Vata]]-[[Kapha]] dosha<br />
* Alleviates Shwitra (vitiligo)<br />
* Shotha (oedema)<br />
* Kshaya (depletion of tissues)<br />
* Balya (promotes strength)<br />
* Rasayani (rejuvenating)<br />
* Atishukrala (increases semen and sperm count)<br />
<br />
===Neurological===<br />
Reduces stress and cortisol levels (300–600 mg root extract daily); improves sleep quality and cognitive function in trials.<ref>{{cite journal |last1=Chandrasekhar |first1=K. |last2=Kapoor |first2=J. |last3=Anishetty |first3=S. |title=A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults |journal=Indian Journal of Psychological Medicine |volume=34 |issue=3 |pages=255–262 |doi=10.4103/0253-7176.106022 |pmc=3573577 |pmid=23439798 |year=2012}}</ref><br />
<br />
===Reproductive===<br />
Enhances testosterone, semen quality, and libido in men (675 mg root powder daily).<ref>{{cite journal |last1=Ambiye |first1=V.R. |last2=Langade |first2=D. |last3=Dongre |first3=S. |last4=Apte |first4=S. |last5=Joshi |first5=K. |title=Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: a pilot study |journal=Evidence-Based Complementary and Alternative Medicine |volume=2013 |pages=571420 |doi=10.1155/2013/571420 |pmc=3863556 |pmid=24284701 |year=2013}}</ref><br />
<br />
===Musculoskeletal===<br />
Increases muscle mass and strength (500 mg extract with resistance training).<ref>{{cite journal |last1=Wankhede |first1=S. |last2=Langade |first2=D. |last3=Joshi |first3=K. |last4=Thakurdesai |first4=P.A. |title=Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial |journal=Journal of the International Society of Sports Nutrition |volume=12 |pages=23 |doi=10.1186/s12970-015-0104-9 |pmc=4658772 |pmid=26009251 |year=2015}}</ref><br />
<br />
==Formulations and Dosage==<br />
<br />
Common preparations:<br />
{| class="wikitable"<br />
!Formulation||Dose||Anupana (vehicle)<br />
|-<br />
|Churna (powder)||3–6 g BID||Warm milk/ghee<br />
|-<br />
|Ghrita||5–10 g/day||As prescribed<br />
|-<br />
|Extract capsules||300–600 mg/day||Water<br />
|}<br />
<br />
==Safety==<br />
Generally safe (GRAS status); rare GI upset, drowsiness. Contraindicated in hyperthyroidism, pregnancy (uterine stimulant), and nightshade allergy. LD<sub>50</sub> >2 g/kg in rodents.<ref>{{cite web |title=Withania somnifera (Ashwagandha) Monograph |url=https://www.herbrally.com/monographs/ashwagandha |publisher=HerbRally |access-date=2026-03-16}}</ref><br />
<br />
==Research==<br />
<br />
Over 100 clinical trials support adaptogenic effects; NIH-funded studies are ongoing for anxiety and sleep disorders. Withanolides modulate HPA axis, GABA receptors, and inflammation pathways (NF-κB inhibition).<ref name=":1">{{cite journal |last1=Speers |first1=A.B. |last2=Cabey |first2=K.A. |last3=Souza |first3=M.J. |last4=Spencer |first4=E.A. |title=Effects of Withania somnifera (Ashwagandha) on stress and the stress-related neuropsychiatric disorders anxiety, depression, and insomnia |journal=Current Neuropharmacology |volume=20 |issue=7 |pages=1–17 |doi=10.2174/1570159X19666210813150419 |year=2021}}</ref><br />
<br />
==Current availability ==<br />
<br />
Available<br />
<br />
== Exzternal links ==<br />
<br />
[https://en.wikipedia.org/wiki/Withania_somnifera Withania Somnifera] <br />
<br />
[https://cb.imsc.res.in/imppat/phytochemical/Withania%20somnifera IMPPAT Database link]<br />
<br />
==References==<br />
{{reflist}}<br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
[[Category:Ayurvedic medicines]]<br />
[[Category:Adaptogens]]<br />
[[Category:Withania]]<br />
[[Category:Medicinal plants of Asia]]<br />
<br />
This article is under development ..</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Ashwagandha&diff=45413Ashwagandha2026-03-16T06:47:56Z<p>Agnivesha: </p>
<hr />
<div>'''Ashwagandha''' (अश्वगंधा) or ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.<ref>{{cite journal |last1=Singh |first1=Narendra |last2=Bhalla |first2=M. |last3=de Jager |first3=P. |last4=Gilca |first4=M. |title=Rational use of Ashwagandha in Ayurveda (Traditional Indian Medicine) – A systematic analysis of the scientific evidence for its pharmacological activities |journal=Journal of Ethnopharmacology |volume=273 |pages=113907 |doi=10.1016/j.jep.2021.113907 |pmc=PMC8274455 |pmid=33831467 |year=2021}}</ref><ref>{{cite journal |last1=Mishra |first1=Laxmi C. |last2=Singh |first2=Betilda B. |last3=Dagenais |first3=Simon |title=Scientific basis for the therapeutic use of Withania somnifera (Ashwagandha): a review |journal=Alternative Medicine Review |volume=14 |issue=5 |pages=348–357 |pmid=19803596 |year=2000}}</ref><br />
<br />
{{Infobox<br />
|title = Ashwagandha<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Ashwagandha<br />
|label2 = Botanical name(s)<br />
|data2 = Withania somnifera (Linn.)<br />
|label3 = Family<br />
|data3 = Solanaceae<br />
|label3 = Contributors<br />
|data3 = Dr.Yogesh S. Deole<br />
|label4 = Year of publication <br />
|data4 = 2026<br />
|label5 = Publisher <br />
|data5 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label6 = DOI <br />
|data6 = Awaited<br />
}}<br />
==English name==<br />
'''Indian ginseng''' or '''winter cherry'''<br />
<br />
==Synonyms ==<br />
<br />
Ashwagandha, Wajigandha, Varahakarni<br />
<br />
== Ayurvedic pharmacological properties ==<br />
<br />
* '''Rasa''' (taste): Madhura (sweet), tikta (bitter)<br />
* '''Guna''' (properties): Snigdha (unctuous), guru (heavy to digest)<br />
* '''Virya''' (potency): Ushna (hot)<br />
* '''Vipaka''' (post-digestive effect): Madhura<br />
* '''Dosha Effect''': Primarily balances [[Vata dosha|vata]], secondarily kapha; aggravates pitta in excess.<br />
* '''Classical Actions''': Medhya (intellect promoter), balya (strength), vajikarana (aphrodisiac), rasayana (rejuvenative).<ref name=":0">{{cite book |last1=Sharma |first1=P.V.|title=Charaka Samhita |publisher=Chaukhamba Orientalia |location=Varanasi |year=2014 |isbn=978-8176371432}}</ref><br />
<br />
==Description==<br />
<br />
A perennial shrub from the [[Solanaceae]] family, native to India, the Middle East, and Africa. It grows 35–75 cm tall with oval leaves, small greenish-yellow flowers, and red-orange berry-like fruits. The name "Ashwagandha" derives from Sanskrit ''ashva'' (horse) and ''gandha'' (smell), referring to the root's horse-like odor and vigor-promoting effects.<ref>{{cite journal |last1=Mirjalili |first1=Mohammad Hossein |last2=Moharramipour |first2=Saman |last3=Hadian |first3=Javad |title=A review on the production of Withania somnifera (Ashwagandha) active principles: Methods and current status |journal=Journal of Medicinal Plants Research |volume=8 |issue=37 |pages=882–900 |doi=10.5897/JMPR2014.5629 |year=2014}}</ref><br />
<br />
==Pharmacognosy==<br />
<br />
Key phytoconstituents include withanolides (e.g., withaferin A, withanolide D), sitoindosides, withanosides, alkaloids (withanine, somniferine), and steroidal lactones. Roots contain highest concentrations (1.5–5% withanolides).<ref>{{cite journal |last1=Kaushik |first1=M.K. |last2=Kaushik |first2=V.K. |last3=Kumar |first3=A. |title=Withania somnifera (L.) Dunal (Ashwagandha): A comprehensive review on ethnopharmacology, pharmacotherapeutics, biomarkers, and pharmacokinetics |journal=Journal of Ethnopharmacology |volume=267 |pages=113451 |doi=10.1016/j.jep.2020.113451 |pmid=33157267 |year=2021}}</ref><br />
<br />
==Clinical Uses==<br />
<br />
==Reference in Charak Samhita and its actions ==<br />
{| class="wikitable"<br />
|+<br />
Herbs and their activities<br />
|'''Sr.no.'''<br />
|'''Reference in Charak Samhita'''<br />
|'''Activity'''<br />
|-<br />
|1<br />
|Cha. Sa. Sutra sthana 4/9(2)<br />
|Brumhaniya mahakashaya<br />
|-<br />
|2<br />
|Cha. Sa. Sutra sthana 4/9(7)<br />
|Balya mahakashaya<br />
|-<br />
|3<br />
|Cha. Sa. Vimana Sthana 8/136<br />
|Virechana Dravyani<br />
|-<br />
|4<br />
|Cha. Sa. Vimana Sthana 8/139<br />
|Madhur skandha<br />
|-<br />
|5<br />
|Cha. Sa. Chikitsa Sthana 2/1/34<br />
|Ingredient in Vajikarana Ghrita<br />
|-<br />
|6<br />
|Cha. Sa. Chikitsa Sthana 13/109<br />
|In the treatment of Udara roga (for lepa)<br />
|-<br />
|7<br />
|Cha. Sa. Chikitsa Sthana 14/50<br />
|Dhupan yoga in arsha roga<br />
|-<br />
|8<br />
|Cha. Sa. Chikitsa Sthana 17/117<br />
|Kshara mixed with madhuk ghrit is used in hikka shwasa<br />
|-<br />
|9<br />
|Cha.Sa.Chikitsa Sthana 18/75<br />
|As an ingredient of Dhumapana yoga<br />
|-<br />
|10<br />
|Cha.Sa.Chikitsa Sthana 21/123<br />
|For pradeha prayoga in granthi visarpa<br />
|-<br />
|11<br />
|Cha.Sa.Chikitsa Sthana 23/70<br />
|As an ingredient of Gandha hasti agada<br />
|-<br />
|12<br />
|Cha.Sa.Chikitsa Sthana 23/80<br />
|As an ingredient of Maha -Gandha hasti agada.<br />
|-<br />
|13<br />
|Cha.Sa.Chikitsa Sthana 23/244<br />
|As an ingredient of Amruta ghrita<br />
|-<br />
|14<br />
|Ca.Sa. Chikitsa Sthana 27/43<br />
|As an ingredient of Kushthadi Taila<br />
|-<br />
|15<br />
|Ca.Sa. Chikitsa Sthana 22/50<br />
|As an ingredient of Utsadana Yoga<br />
|-<br />
|16<br />
|Cha.Sa.Chikitsa Sthana 28/166<br />
|As an ingredient of Ashwagandha Taila paka<br />
|-<br />
|17<br />
|Cha.Sa.Chikitsa Sthana 28/170 <br />
|As an ingredient of Vrushamuladi taila<br />
|-<br />
|18<br />
|Cha.Sa.Chikitsa Sthana 28/173<br />
|As an ingredient of Mulaka taila<br />
|-<br />
|19<br />
|Cha.Sa.Chikitsa Sthana 29/73<br />
|As an ingredient of Jeevakadi mahasneha<br />
|-<br />
|20<br />
|Cha.Sa.Chikitsa Sthana 30/260<br />
|As a paniya yoga, in the treatment of Stanya dosha<br />
|}<br />
<br />
===Neurological===<br />
Reduces stress and cortisol levels (300–600 mg root extract daily); improves sleep quality and cognitive function in trials.<ref>{{cite journal |last1=Chandrasekhar |first1=K. |last2=Kapoor |first2=J. |last3=Anishetty |first3=S. |title=A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults |journal=Indian Journal of Psychological Medicine |volume=34 |issue=3 |pages=255–262 |doi=10.4103/0253-7176.106022 |pmc=3573577 |pmid=23439798 |year=2012}}</ref><br />
<br />
===Reproductive===<br />
Enhances testosterone, semen quality, and libido in men (675 mg root powder daily).<ref>{{cite journal |last1=Ambiye |first1=V.R. |last2=Langade |first2=D. |last3=Dongre |first3=S. |last4=Apte |first4=S. |last5=Joshi |first5=K. |title=Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: a pilot study |journal=Evidence-Based Complementary and Alternative Medicine |volume=2013 |pages=571420 |doi=10.1155/2013/571420 |pmc=3863556 |pmid=24284701 |year=2013}}</ref><br />
<br />
===Musculoskeletal===<br />
Increases muscle mass and strength (500 mg extract with resistance training).<ref>{{cite journal |last1=Wankhede |first1=S. |last2=Langade |first2=D. |last3=Joshi |first3=K. |last4=Thakurdesai |first4=P.A. |title=Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial |journal=Journal of the International Society of Sports Nutrition |volume=12 |pages=23 |doi=10.1186/s12970-015-0104-9 |pmc=4658772 |pmid=26009251 |year=2015}}</ref><br />
<br />
==Formulations and Dosage==<br />
<br />
Common preparations:<br />
{| class="wikitable"<br />
!Formulation||Dose||Anupana (vehicle)<br />
|-<br />
|Churna (powder)||3–6 g BID||Warm milk/ghee<br />
|-<br />
|Ghrita||5–10 g/day||As prescribed<br />
|-<br />
|Extract capsules||300–600 mg/day||Water<br />
|}<br />
<br />
==Safety==<br />
Generally safe (GRAS status); rare GI upset, drowsiness. Contraindicated in hyperthyroidism, pregnancy (uterine stimulant), and nightshade allergy. LD<sub>50</sub> >2 g/kg in rodents.<ref>{{cite web |title=Withania somnifera (Ashwagandha) Monograph |url=https://www.herbrally.com/monographs/ashwagandha |publisher=HerbRally |access-date=2026-03-16}}</ref><br />
<br />
==Research==<br />
<br />
Over 100 clinical trials support adaptogenic effects; NIH-funded studies are ongoing for anxiety and sleep disorders. Withanolides modulate HPA axis, GABA receptors, and inflammation pathways (NF-κB inhibition).<ref name=":1">{{cite journal |last1=Speers |first1=A.B. |last2=Cabey |first2=K.A. |last3=Souza |first3=M.J. |last4=Spencer |first4=E.A. |title=Effects of Withania somnifera (Ashwagandha) on stress and the stress-related neuropsychiatric disorders anxiety, depression, and insomnia |journal=Current Neuropharmacology |volume=20 |issue=7 |pages=1–17 |doi=10.2174/1570159X19666210813150419 |year=2021}}</ref><br />
<br />
==Current availability ==<br />
<br />
Available<br />
<br />
== Exzternal links ==<br />
<br />
[https://en.wikipedia.org/wiki/Withania_somnifera Withania Somnifera] <br />
<br />
==References==<br />
{{reflist}}<br />
<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
[[Category:Ayurvedic medicines]]<br />
[[Category:Adaptogens]]<br />
[[Category:Withania]]<br />
[[Category:Medicinal plants of Asia]]<br />
<br />
This article is under development ..</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Ashwagandha&diff=45412Ashwagandha2026-03-16T06:15:03Z<p>Agnivesha: </p>
<hr />
<div>'''Ashwagandha''' ({{lang-sa|अश्वगंधा}} ''Ashvagandha''; [[Withania somnifera]]), also known as '''Indian ginseng''' or '''winter cherry''', is a [[Rasayana|rasayana]] (rejuvenator) herb in [[Ayurveda]], valued for its adaptogenic, balya (strength-promoting), and nervine properties. Primarily, the root is used for stress management, vitality, immunity, and musculoskeletal health as documented in classical texts like ''[[Charaka Samhita]]'' and modern clinical studies.<ref>{{cite journal |last1=Singh |first1=Narendra |last2=Bhalla |first2=M. |last3=de Jager |first3=P. |last4=Gilca |first4=M. |title=Rational use of Ashwagandha in Ayurveda (Traditional Indian Medicine) – A systematic analysis of the scientific evidence for its pharmacological activities |journal=Journal of Ethnopharmacology |volume=273 |pages=113907 |doi=10.1016/j.jep.2021.113907 |pmc=PMC8274455 |pmid=33831467 |year=2021}}</ref><ref>{{cite journal |last1=Mishra |first1=Laxmi C. |last2=Singh |first2=Betilda B. |last3=Dagenais |first3=Simon |title=Scientific basis for the therapeutic use of Withania somnifera (Ashwagandha): a review |journal=Alternative Medicine Review |volume=14 |issue=5 |pages=348–357 |pmid=19803596 |year=2000}}</ref><br />
<br />
{{Infobox<br />
|title = Ashwagandha<br />
|label1 = Section/Chapter<br />
|data1 = Herb database/Ashwagandha<br />
|label2 = Botanical name(s)<br />
|data2 = Withania somnifera<br />
|label3 = Contributors<br />
|data3 = --<br />
|label4 = Year of publication <br />
|data4 = 2023<br />
|label5 = Publisher <br />
|data5 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label6 = DOI <br />
|data6 = Awaited<br />
}}<br />
==English name==<br />
--<br />
<br />
==Synonyms in Charak Samhita==<br />
Ashwagandha<br />
<br />
<br />
== Ayurvedic pharmacological properties ==<br />
<br />
* '''Rasa''' (taste): Madhura (sweet), tikta (bitter)<br />
* '''Guna''' (properties): Snigdha (unctuous), guru (heavy)<br />
* '''Virya''' (potency): Ushna (hot)<br />
* '''Vipaka''' (post-digestive effect): Madhura<br />
* '''Dosha Effect''': Primarily balances [[Vata dosha|vata]], secondarily kapha; aggravates pitta in excess.<br />
* '''Classical Actions''': Medhya (intellect promoter), balya (strength), vajikarana (aphrodisiac), rasayana (rejuvenative).<ref name=":0">{{cite book |last1=Sharma |first1=P.V. |title=Charaka Samhita |publisher=Chaukhamba Orientalia |location=Varanasi |year=2014 |isbn=978-8176371432}}</ref><br />
<br />
==Description==<br />
<br />
A perennial shrub from the [[Solanaceae]] family, native to India, the Middle East, and Africa. It grows 35–75 cm tall with oval leaves, small greenish-yellow flowers, and red-orange berry-like fruits. The name "Ashwagandha" derives from Sanskrit ''ashva'' (horse) and ''gandha'' (smell), referring to the root's horse-like odor and vigor-promoting effects.<ref>{{cite journal |last1=Mirjalili |first1=Mohammad Hossein |last2=Moharramipour |first2=Saman |last3=Hadian |first3=Javad |title=A review on the production of Withania somnifera (Ashwagandha) active principles: Methods and current status |journal=Journal of Medicinal Plants Research |volume=8 |issue=37 |pages=882–900 |doi=10.5897/JMPR2014.5629 |year=2014}}</ref><br />
<br />
==Pharmacognosy==<br />
<br />
Key phytoconstituents include withanolides (e.g., withaferin A, withanolide D), sitoindosides, withanosides, alkaloids (withanine, somniferine), and steroidal lactones. Roots contain highest concentrations (1.5–5% withanolides).<ref>{{cite journal |last1=Kaushik |first1=M.K. |last2=Kaushik |first2=V.K. |last3=Kumar |first3=A. |title=Withania somnifera (L.) Dunal (Ashwagandha): A comprehensive review on ethnopharmacology, pharmacotherapeutics, biomarkers, and pharmacokinetics |journal=Journal of Ethnopharmacology |volume=267 |pages=113451 |doi=10.1016/j.jep.2020.113451 |pmid=33157267 |year=2021}}</ref><br />
<br />
==Clinical Uses==<br />
<br />
==Reference in Charak Samhita and its actions ==<br />
{| class="wikitable"<br />
|+<br />
Herbs and their activities<br />
|'''Sr.no.'''<br />
|'''Reference in Charak Samhita'''<br />
|'''Activity'''<br />
|-<br />
|1<br />
|Cha. Sa. Sutra sthana 4/9(2)<br />
|Brumhaniya mahakashaya<br />
|-<br />
|2<br />
|Cha. Sa. Sutra sthana 4/9(7)<br />
|Balya mahakashaya<br />
|-<br />
|3<br />
|Cha. Sa. Vimana Sthana 8/136<br />
|Virechana Dravyani<br />
|-<br />
|4<br />
|Cha. Sa. Vimana Sthana 8/139<br />
|Madhur skandha<br />
|-<br />
|5<br />
|Cha. Sa. Chikitsa Sthana 2/1/34<br />
|Ingredient in Vajikarana Ghrita<br />
|-<br />
|6<br />
|Cha. Sa. Chikitsa Sthana 13/109<br />
|In the treatment of Udara roga (for lepa)<br />
|-<br />
|7<br />
|Cha. Sa. Chikitsa Sthana 14/50<br />
|Dhupan yoga in arsha roga<br />
|-<br />
|8<br />
|Cha. Sa. Chikitsa Sthana 17/117<br />
|Kshara mixed with madhuk ghrit is used in hikka shwasa<br />
|-<br />
|9<br />
|Cha.Sa.Chikitsa Sthana 18/75<br />
|As an ingredient of Dhumapana yoga<br />
|-<br />
|10<br />
|Cha.Sa.Chikitsa Sthana 21/123<br />
|For pradeha prayoga in granthi visarpa<br />
|-<br />
|11<br />
|Cha.Sa.Chikitsa Sthana 23/70<br />
|As an ingredient of Gandha hasti agada<br />
|-<br />
|12<br />
|Cha.Sa.Chikitsa Sthana 23/80<br />
|As an ingredient of Maha -Gandha hasti agada.<br />
|-<br />
|13<br />
|Cha.Sa.Chikitsa Sthana 23/244<br />
|As an ingredient of Amruta ghrita<br />
|-<br />
|14<br />
|Ca.Sa. Chikitsa Sthana 27/43<br />
|As an ingredient of Kushthadi Taila<br />
|-<br />
|15<br />
|Ca.Sa. Chikitsa Sthana 22/50<br />
|As an ingredient of Utsadana Yoga<br />
|-<br />
|16<br />
|Cha.Sa.Chikitsa Sthana 28/166<br />
|As an ingredient of Ashwagandha Taila paka<br />
|-<br />
|17<br />
|Cha.Sa.Chikitsa Sthana 28/170 <br />
|As an ingredient of Vrushamuladi taila<br />
|-<br />
|18<br />
|Cha.Sa.Chikitsa Sthana 28/173<br />
|As an ingredient of Mulaka taila<br />
|-<br />
|19<br />
|Cha.Sa.Chikitsa Sthana 29/73<br />
|As an ingredient of Jeevakadi mahasneha<br />
|-<br />
|20<br />
|Cha.Sa.Chikitsa Sthana 30/260<br />
|As a paniya yoga, in the treatment of Stanya dosha<br />
|}<br />
<br />
===Neurological===<br />
Reduces stress and cortisol levels (300–600 mg root extract daily); improves sleep quality and cognitive function in trials.<ref>{{cite journal |last1=Chandrasekhar |first1=K. |last2=Kapoor |first2=J. |last3=Anishetty |first3=S. |title=A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of Ashwagandha root in reducing stress and anxiety in adults |journal=Indian Journal of Psychological Medicine |volume=34 |issue=3 |pages=255–262 |doi=10.4103/0253-7176.106022 |pmc=3573577 |pmid=23439798 |year=2012}}</ref><br />
<br />
===Reproductive===<br />
Enhances testosterone, semen quality, and libido in men (675 mg root powder daily).<ref>{{cite journal |last1=Ambiye |first1=V.R. |last2=Langade |first2=D. |last3=Dongre |first3=S. |last4=Apte |first4=S. |last5=Joshi |first5=K. |title=Clinical evaluation of the spermatogenic activity of the root extract of Ashwagandha (Withania somnifera) in oligospermic males: a pilot study |journal=Evidence-Based Complementary and Alternative Medicine |volume=2013 |pages=571420 |doi=10.1155/2013/571420 |pmc=3863556 |pmid=24284701 |year=2013}}</ref><br />
<br />
===Musculoskeletal===<br />
Increases muscle mass and strength (500 mg extract with resistance training).<ref>{{cite journal |last1=Wankhede |first1=S. |last2=Langade |first2=D. |last3=Joshi |first3=K. |last4=Thakurdesai |first4=P.A. |title=Examining the effect of Withania somnifera supplementation on muscle strength and recovery: a randomized controlled trial |journal=Journal of the International Society of Sports Nutrition |volume=12 |pages=23 |doi=10.1186/s12970-015-0104-9 |pmc=4658772 |pmid=26009251 |year=2015}}</ref><br />
<br />
==Formulations and Dosage==<br />
<br />
Common preparations:<br />
{| class="wikitable"<br />
!Formulation||Dose||Anupana (vehicle)<br />
|-<br />
|Churna (powder)||3–6 g BID||Warm milk/ghee<br />
|-<br />
|Ghrita||5–10 g/day||As prescribed<br />
|-<br />
|Extract capsules||300–600 mg/day||Water<br />
|}<br />
<br />
==Safety==<br />
Generally safe (GRAS status); rare GI upset, drowsiness. Contraindicated in hyperthyroidism, pregnancy (uterine stimulant), nightshade allergy. LD<sub>50</sub> >2 g/kg in rodents.<ref>{{cite web |title=Withania somnifera (Ashwagandha) Monograph |url=https://www.herbrally.com/monographs/ashwagandha |publisher=HerbRally |access-date=2026-03-16}}</ref><br />
<br />
==Research==<br />
<br />
Over 100 clinical trials support adaptogenic effects; NIH-funded studies ongoing for anxiety and sleep disorders. Withanolides modulate HPA axis, GABA receptors, and inflammation pathways (NF-κB inhibition).<ref name=":1">{{cite journal |last1=Speers |first1=A.B. |last2=Cabey |first2=K.A. |last3=Souza |first3=M.J. |last4=Spencer |first4=E.A. |title=Effects of Withania somnifera (Ashwagandha) on stress and the stress-related neuropsychiatric disorders anxiety, depression, and insomnia |journal=Current Neuropharmacology |volume=20 |issue=7 |pages=1–17 |doi=10.2174/1570159X19666210813150419 |year=2021}}</ref><br />
<br />
<br />
==References==<br />
{{reflist}}<br />
<br />
[[Category:Ayurvedic medicines]]<br />
[[Category:Adaptogens]]<br />
[[Category:Withania]]<br />
[[Category:Medicinal plants of Asia]]<br />
<br />
==Current availability ==<br />
<br />
Available<br />
<br />
==Current researches ==<br />
[[Category: Database of herbs and minerals | Herbs]]<br />
This article is under development ..</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Vatavyadhi_Chikitsa&diff=45411Vatavyadhi Chikitsa2026-02-25T04:20:53Z<p>Agnivesha: </p>
<hr />
<div>{{CiteButton}}<br />
{{#seo:<br />
|title=Vatavyadhi Chikitsa<br />
|titlemode=append<br />
|keywords=Akshepaka, Anyonyavarana, Apana, Ardita, Avabahuka, Avarana, Ayurveda, Convulsive disorders, Dhatukshaya, Facial palsy, Gatavata, General Line of treatment of Vatavyadhi, Gridhrasi, Neurological disorders, Pakshaghata, Prana, Samana, Sciatica, Specific treatments of Vatavyadhi, Stroke, Udana, Vishwachi, Vyana,Ayurveda, Indian system of medicine, charak samhita. <br />
|description=Chikitsa Sthana Chapter 28.Management of disorders caused by vata dosha<br />
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br />
|image_alt=charak samhita<br />
|type=article<br />
}}<br />
<big>'''[[Chikitsa Sthana]] Chapter 28.Management of diseases caused by [[vata]] [[dosha]] '''</big><br />
{{Infobox<br />
|title = Vatavyadhi Chikitsa<br />
|label1 = Section/Chapter<br />
|data1 = [[Chikitsa Sthana]] Chapter 28<br />
|label2 = Preceding Chapter<br />
|data2 = [[Urustambha Chikitsa]]<br />
<br />
|label3= Succeeding Chapter<br />
|data3 = [[Vatarakta Chikitsa ]]<br />
|label5 = Other Sections<br />
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br />
|label6 = Translator and commentator<br />
|data6 = Mangalasseri P.<br />
|label7 = Reviewer <br />
|data7 = Ojha S.N.<br />
|label8 = Editors <br />
|data8 = Ojha S.N., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br />
|label9 = Year of publication <br />
|data9 = 2020<br />
|label10 = Publisher <br />
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label11 = DOI <br />
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.029 10.47468/CSNE.2020.e01.s06.029]<br />
<br />
}}<br />
<big>'''Abstract </big>'''<br />
<p style="text-align:justify;">[[Vatavyadhi Chikitsa]] deals with diseases particularly caused by [[vata]] [[dosha]]. It is an important chapter as it encompasses a large spectrum of disorders especially concerned with neurological system, musculoskeletal system, reticulo-endothelial system and further pervades to all other systems in the body. The chapter highlights the five sub classifications of [[vata]], their habitat and functions. The etiological factors of [[vata]]vyadhi are enlisted and two major pathology viz, [[dhatu]]kshaya and ''avarana'' are detailed. In [[dhatu]]kshaya, vitiated [[vata]] assumes the status of gatavata (increased movement of [[vata]]) and occupies various sites leading to [[dhatu]]gata (affecting tissues) [[vata]], ashayagata (affecting various sites) [[vata]] and ''avayava'' (organs) gata[[vata]]. ''Avarana'' (obstruction by covering) is a distinct pathology of [[vata]] in which the free mobility of [[vata]] is hampered. Accordingly, ''avarana'' may happen either due to two other [[dosha]], [[dhatu]] ([[rakta]], etc.) or [[mala]] (waste). ''Avarana'' may also happen in between two subtypes of [[vata]] as the direction of movement of various types of [[vata]] differ. This is called ''anyonyavarana''. The symptomatology, pathology and management strategies of ''avarana'' as well as gata[[vata]] are detailed in the chapter. The most common neurological disorders like ''pakshaghata'' (stroke), ''ardita'' (facial palsy), ''gridhrasi'' (sciatica), ''avabahuka'' (frozen shoulder), ''viswachi'' (cervico brachial neuralgia) etc. are described. Various formulations including medicated oils and ghee etc. are also included in the chapter. The chapter confirms the difficulty in curability of chronic ''vatavyadhi'' affecting debilitated individuals. <br />
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'''Keywords''': Akshepaka, Anyonyavarana, Apana, Ardita, Avabahuka, Avarana, [[Ayurveda]], Convulsive disorders, [[Dhatu]]kshaya, Facial palsy, Gata[[vata]], General Line of treatment of ''Vatavyadhi, Gridhrasi,'' Neurological disorders, ''Pakshaghata, Prana, Samana,'' Sciatica, Specific treatments of ''Vatavyadhi'', Stroke, ''Udana, Vishwachi, Vyana.''<br />
</p><br />
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<br />
== Introduction ==<br />
<div style="text-align:justify;"><br />
[[Vatavyadhi Chikitsa]] exclusively deals with certain common disorders where the specific vitiation of [[vata]] takes place. Before entering the chapter, let us consider the etymological derivations of the term [[vata]]. The technical term [[vata]] is derived from Sanskrit root verb ''va'' which means ''gati gandhanayoh'' (movement and continued efforts/enthusiasm.) or by the application of ''kta'' to the root verb ''va'' which again means the same as above, ''vatiti vata'', the term [[vata]] is derived. As all ancient Indian scientific treatise observe strict rules regarding formation of a word, for the brevity and secrecy of expressions, it should be analyzed in detail for better understanding. The meaning of ''gati'' is to acquire; and ''jnana'' is to get aware or to sense. The term ''gandhana'' means to enthuse, to excite or to stimulate. Considering the different meanings of ''gati'', and ''gandhana'' it is understood that the term [[vata]] itself conveys its role as a receptor as well as stimulator. Hence it can be said that [[vata]] is the biological force which recognizes and stimulates all the activities in the body.<br />
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[[Vata]] is the prime [[dosha]]. Owing to its incorporeal nature and instability it is inaccessible in comparison to other two [[dosha]]. The inaccessibility is characterized in regard to its functional and physical attributes but is more relevant regarding the therapeutic aspect. [[Vata]] is also explained as ''achintyaveerya'' (inconceivable prowess) and ''doshaanaam netah'' (propeller of all functional elements in the body).<ref>Dalhana, Sushruta. Nidana Sthana, Cha.1 Vatavyadhi Nidana Adhyaya verse 8. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1. </ref><br />
<br />
Before discussing the importance and implications of [[vata]], the references on [[vata]] and neurological elements in vedic literature is to be highlighted. In vedic science two terminologies namely ''prana'' and ''pranaja'' were used to denote nerve impulses. ''Prana'' is ''kriyashakti'' (power for action) and may be compared with motor impulse. ''Pranaja'' is also same as ''prana'' but conveys sensation of taste, smell, vision, sound, coitus, reproduction, pleasure and pain. It can be compared with sensory afferent impulse. Both ''prana'' and ''pranaja'' leave body at death. The entire neural axis is explained as ''sushumna'' (spinal cord) and it extends from the mid-perineum to inside of cranium runing through the middle of the spine to reach the cerebrum, twelve fingers breadth from nose. The shape of ''sushumna'' is compared with flower of ''datura alba'' with two dilatations at thoracic and lumbar areas. The cross section of spinal column is compared with the letter ''Aum'' in which grey matter and white matter is identified as ''chitrini'' (name for grey matter) and ''vajra'' (name for white matter). The neural networks are compared with ''luta tantu'' (spider web).<ref>B C Joshy, Neurology in Ancient India – some evidences, Indian journal of History of science, 19(4):366-396(1984)</ref> Ten subtypes of ''vata'' are explained and ''dhananjaya'' (the tenth and last subtype) does not leave the body even after death. This is responsible for tissue transplantation after death. The description of ''shadchakra'' (six ''chakras'') is also very striking with latest functional modern neurology. The difference between vedic and ayurvedic neurology is that vedic science used it to attain higher level of consciousness through control of one’s nerve impulses. Ayurvedic science is meant for academic advancement or therapeutics. In [[Ayurveda]] it can be seen that practical utilization of vedic knowledge for therapeutic purpose by modification through experiments and experiences is done. Detailed descriptions of features of [[vata]] are available in various chapters of [[Charak Samhita]] including [[Deerghanjiviteeya Adhyaya]], [[Vatakalakaliya Adhyaya]] and [[Rogabhishagjitiya Vimana]], etc. The pathology and therapeutic aspects of [[vata]] is explained in this chapter. There is no separate chapter for diseases of [[pitta]] and [[kapha dosha]]. [[Vatavyadhi Chikitsa]] is an exclusive chapter dealing with [[vata]] janita vishesha vyadhi (diseases caused by [[vata]] vitiation). It is because of the supremacy of [[vata]]. The chapter is kept just after [[Urustambha Chikitsa]] since in that particular disease ama, [[kapha]], meda, etc. are associated to cause [[vata]]prakopa and ''urustambha''. On application of strenuous [[rukshana]] chikitsa in urustambha, [[vata]]prakopa alone may also happen. Even though in ''nanatmaja'' (single [[dosha]]) [[vata]]vyadhi the presence of other [[dosha]] can be traced, the disease cannot manifest without the vitiation of [[vata]]. <br />
<br />
[[Vata]] as explained earlier is the biological force present in the body which recognizes and stimulates all the activities. Instability of [[vata]] makes it inaccessible. It is characterized by an increase in the ''chala'' (motion) property, which is favored and contributed by other properties also. The ''chala guna'' is directional in nature and termed as ''gati''. ''Gati'' is the distinct quality of [[vata]], very important on physiological and pathological aspects. The ''gati'' of individual components of [[vata]] is to be analyzed according to the intensity, direction and area; depending upon the particular function it is carrying out. When the ''gati'' is aggravated (''gatatva'') or obstructed (''avarana'') the functional normality’s of [[vata]] are impaired. The ''gati'' or ''gatatva'' have two implications, one subjected to activity (to move, carry out or reach-gata) and the second subjected to abode of activity (pathway). ''Gatatva'' is an essential part of any [[vata]]ja samprapti'' (pathogenesis). ''Gatatva'' of [[vata]] is possible in [[dhatu]], upadhatu, asaya'' (sites or hollow cavities of organs), ''avayava'' (part or organ), etc. Consumption of ''ahara'' of relatively higher ''kittansha'' (waste products) leads to diminution of [[dhatu]] and aggravation of [[vata]] [ Cha. Sa. [[Sutra Sthana]] 28/4]. It leads to ''riktata'' (emptiness) and more ''avakasha'' (space) in [[Dhatu|dhatu,]] makes the engorgement and hyper movement of aggravated [[vata]] in the site. [[Dhatu]]gatavata and [[dhatu]]avrita [[vata]] are also distinct pathologies as in ''avarana'' the vitiation of [[vata]] is passive and the ''gati'' is obstructed.<br />
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The chapter begins with praising of powerful [[vata]] followed with five subtypes of [[vata]]. After these descriptions, the etiopathological and therapeutic aspects of [[vata]] are explained. In the present chapter the two distinct pathology of [[vata]] is explained with possible causative factors. In the context of ''gatavata'', the pathology is related to the various [[dhatu]], ashaya or ''avayava'' involved in ''gatatva''. The same way different ''avarana'' of [[vata]] by other two [[dosha]], [[dhatu]], [[mala]], anna, etc. are explained. Since different subtypes of [[vata]] possess different ''gati'' mutual ''avarana'' among subtypes are also possible. The chapter also explains various disorders like ''pakshaghata, ardita, akshepaka, avabahuka'' etc. The general line of treatment of absolute [[vata]] vitiation is detailed in the chapter by giving importance to [[snehana]], [[swedana]], [[samshodhana]], etc. An ample amount of medications including various ''taila yoga, ghr̥ita yoga,'' etc. are also given in the chapter. The specific treatment approaches in exclusive conditions are also explained.<br />
<br />
[[Vata]] vyadhi are group of disorders which are very commonly encountered by ayurvedic physicians. In many diseases like ''pakshaghata, ardita, gridhrasi, kateegraha,'' etc. ayurvedic physicians are claiming better results and it is widely accepted also. Critical understandings of pathology, types, prognostic factors etc. are very important for academic and clinical success. Thus, thorough understanding of [[vata]] roga is essential for every treating physician.<br />
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== Sanskrit Text, Transliteration and English Translation ==<br />
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अथातो वातव्याधिचिकित्सितं व्याख्यास्यामः ||१|| <br />
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इति ह स्माह भगवानात्रेयः ||२|| <br />
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athAto VātavyādhicikitśītāM vyAkhyAsyAmaH ||1|| <br />
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iti ha smAha bhagavAnAtreyaH ||2|| <br />
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athātō vātavyādhicikitśītāṁ vyākhyāsyāmaḥ||1|| <br />
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iti ha smāha bhagavānātrēyaḥ||2|| <br />
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Now we shall expound the chapter [[Vata]] vyadhi chikitsa (Management of diseases caused by [[vata]] [[dosha]]). Thus said Lord Atreya.[1-2]<br />
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=== Significance of [[vayu]] ===<br />
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वायुरायुर्बलं वायुर्वायुर्धाता शरीरिणाम् | <br /><br />
वायुर्विश्वमिदं सर्वं प्रभुर्वायुश्च कीर्तितः ||३|| <br /><br />
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Vāyur AyurbalaM Vāyur VāyurdhAtA sharIriNAm | <br /><br />
Vāyur vishvamidaM sarvaM prabhurVāyushcakIrtitaH ||3|| <br /><br />
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Vāyurāyurbalaṁ vāyurvāyurdhātā śarīriṇām| <br /><br />
vāyurviśvamidaṁ sarvaṁ prabhurvāyuśca kīrtitaḥ||3|| <br /><br />
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[[Vayu]] is life, [[vayu]] is strength, [[vayu]] mainstays living organism, the same [[vayu]] is verily the universe, and hence the Lord [[Vayu]] is praised. [3]<br />
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=== Important role of [[vayu]] in health ===<br />
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अव्याहतगतिर्यस्य स्थानस्थः प्रकृतौ स्थितः | <br /><br />
वायुः स्यात्सोऽधिकं जीवेद्वीतरोगः समाः शतम् ||४|| <br /><br />
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avyAhatagatiryasya sthānasthaH prakRutau sthitaH | <br /><br />
VāyuHsyAtso~adhikaM jIvedvItarōgaH samAH shatam ||4||<br /><br />
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avyāhatagatiryasya sthānasthaḥ prakr̥tau sthitaḥ| <br /><br />
vāyuḥ syātsō'dhikaṁ jīvēdvītarōgaḥ samāḥ śatam||4|| <br /><br />
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When normal (non vitiated) [[vayu]] is at its abode with unobstructed (free) movement, is responsible for long lifespan of hundred years devoid of diseases.[4]<br />
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=== Types of [[vayu]] and their functions ===<br />
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प्राणोदानसमानाख्यव्यानापानैः स पञ्चधा | <br /><br />
देहं तन्त्रयते सम्यक् स्थानेष्वव्याहतश्चरन् ||५|| <br /><br />
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स्थानं प्राणस्य मूर्धोरःकण्ठजिह्वास्यनासिकाः [१] | <br /><br />
ष्ठीवनक्षवथूद्गारश्वासाहारादि कर्म च ||६|| <br /><br />
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उदानस्य पुनः स्थानं नाभ्युरः कण्ठ एव च | <br /><br />
वाक्प्रवृत्तिः प्रयत्नौर्जोबलवर्णादि कर्म च ||७|| <br /><br />
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स्वेददोषाम्बुवाहीनि स्रोतांसि समधिष्ठितः | <br /><br />
अन्तरग्नेश्च पार्श्वस्थः समानोऽग्निबलप्रदः ||८|| <br /><br />
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देहं व्याप्नोति सर्वं तु व्यानः शीघ्रगतिर्नृणाम् | <br /><br />
गतिप्रसारणाक्षेपनिमेषादिक्रियः सदा ||९|| <br /><br />
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वृषणौ बस्तिमेढ्रं च नाम्भूरू वङ्क्षणौ गुदम् | <br /><br />
अपानस्थानमन्त्रस्थः शुक्रमूत्रशकृन्ति [२] च ||१०||<br /><br />
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सृजत्यार्तवगर्भौ च युक्ताः स्थानस्थिताश्च ते | <br /><br />
स्वकर्म कुर्वते देहो धार्यते तैरनामयः ||११||<br /><br />
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prānaodAnasamānakhya vyānapānaiH sa pa~jcadhA | <br /><br />
dehaM tantrayate samyak sthAneShvavyAhatashcaran ||5|| <br /><br />
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sthānaM prānasya mUrdhoraHkaNThajihvAsyanAsikAH [1] | <br /><br />
ShThIvanakṣavathūdgArashvAsAhArAdi karma ca ||6|| <br /><br />
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udānasya punaH sthānaM nAbhyuraH kaNTha eva ca | <br /><br />
vAkpravRuttiH prayatnaurjobalavarNAdi karma ca ||7|| <br /><br />
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sveda dōṣambuvAhIni srotAMsi samadhiShThitaH | <br /><br />
antaragneshca pArshvasthaH Samānao~agnibalapradaH ||8|| <br /><br />
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dehaM vyApnoti sarvaM tu vyānaH shIghragatirnRuNAm | <br /><br />
gatiprasAraNAkShepanimeShAdikriyaH sadA ||9|| <br /><br />
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vRuShaNau bastimeDhraM ca nAmbhUrU va~gkShaNau gudam | <br /><br />
apāna sthānamantrasthaH śukramūtrashakRunti [2] ca ||10|| <br /><br />
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sRujatyArtavagarbhau ca yuktAH sthānasthitAshca te | <br /><br />
svakarma kurvate deho dhAryate tairanAmayaH ||11|| <br /><br />
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prāṇōdānasamānākhyavyānapāna iḥ sa pañcadhā| <br /><br />
dēhaṁ tantrayatē samyak sthānēṣvavyāhataścaran||5|| <br /><br />
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sthānaṁ prāṇasya mūrdhōraḥkaṇṭhajihvāsyanāsikāḥ [1] | <br /><br />
ṣṭhīvanakṣavathūdgāraśvāsāhārādi karma ca||6|| <br /><br />
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udānasya punaḥ sthānaṁ nābhyuraḥ kaṇṭha ēva ca| <br /><br />
vākpravr̥ttiḥ prayatnaurjōbalavarṇādi karma ca||7|| <br /><br />
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svēdadōṣāmbuvāhīni srōtāṁsi samadhiṣṭhitaḥ| <br /><br />
antaragnēśca pārśvasthaḥ samānō'gnibalapradaḥ||8|| <br /><br />
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dēhaṁ vyāpnōti sarvaṁ tu vyānaḥ śīghragatirnr̥ṇām| <br /><br />
gatiprasāraṇākṣēpanimēṣādikriyaḥ sadā||9|| <br /><br />
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vr̥ṣaṇau bastimēḍhraṁ ca nābhyūrū vaṅkṣaṇau gudam|<br /> <br />
apānasthānamantrasthaḥ śukramūtraśakr̥nti [2] ca||10|| <br /><br />
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sr̥jatyārtavagarbhau ca yuktāḥ sthānasthitāśca tē| <br /><br />
svakarma kurvatē dēhō dhāryatē tairanāmayaḥ||11|| <br /><br />
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[[Vayu]] is of five types namely prana, udana, samana, vyana and apana and they mechanize the body optimally occupying their sites without any irregular movement. <br />
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The location of ''prana'' is vertex, thorax, trachea, tongue, mouth and nose and it performs functions of spitting, sneezing, eructation, respiration, deglutition etc. <br />
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The site of ''udana'' is umbilicus, thorax and trachea and is responsible for vocalization, drive, energy, strength, complexion etc. <br />
''Samana'' is located in channels of sweat, humors and water and lateral to the seat of [[agni]] (digestive enzymes ([[agni]]) and yield strength to the digestive fire. <br />
<br />
''Vyana'' has swift movement and spreads all over the body and is responsible for gait, flexion, extension, twinkling etc. <br />
''Apana'' is told to be located in testicles, urinary bladder, penis, umbilicus, thighs, inguinal region and anus and performs ejaculation, micturition, defecation, expulsion of menstrual blood and fetus. <br />
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When these five are located in respective sites optimally, perform their functions, supports life without any morbidity. [5-11]<br />
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=== Role of [[vata]]/[[vayu]] in causing diseases ===<br />
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विमार्गस्था ह्ययुक्ता वा रोगैः स्वस्थानकर्मजैः | <br /><br />
शरीरं पीडयन्त्येते प्राणानाशु हरन्ति च ||१२|| <br /><br />
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सङ्ख्यामप्यतिवृत्तानां तज्जानां हि प्रधानतः | <br /><br />
अशीतिर्नखभेदाद्या रोगाः सूत्रे निदर्शिताः ||१३|| <br /><br />
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तानुच्यमानान् पर्यायैः सहेतूपक्रमाञ्छृणु | <br /><br />
केवलं वायुमुद्दिश्य स्थानभेदात्तथाऽऽवृतम् ||१४|| <br /><br />
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vimArgasthA hyayuktA vA rōgaiH svasthānakarmajaiH |<br /> <br />
sharIraM pIDayantyete prānanAshu haranti ca ||12|| <br /><br />
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sa~gkhyAmapyativRuttAnAM tajjAnAM hi pradhAnataH | <br /><br />
ashItirnakhabhedAdyA rōgaH sUtre nidarshitAH ||13|| <br /><br />
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tAnucyamAnAn paryAyaiH sahetUpakramA~jchRuNu | <br /><br />
kevalaM Vāyu muddishya sthānabhedAttathA~a~avRutam ||14|| <br /><br />
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vimārgasthā hyayuktā vā rōgaiḥ svasthānakarmajaiḥ| <br /><br />
śarīraṁ pīḍayantyētē prāṇānāśu haranti ca||12|| <br /><br />
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saṅkhyāmapyativr̥ttānāṁ tajjānāṁ hi pradhānataḥ| <br /><br />
aśītirnakhabhēdādyā rōgāḥ sūtrē nidarśitāḥ||13|| <br /><br />
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tānucyamānān paryāyaiḥ sahētūpakramāñchr̥ṇu| <br /><br />
kēvalaṁ vāyumuddiśya sthānabhēdāttathā''vr̥tam||14|| <br /><br />
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When dislodged or impaired, [[dosha]] harm the body by diseases according to their respective site and function, and may even lead to instantaneous death.<br />
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Even though the diseases caused by them are innumerable, starting from ''nakhabheda'' (nail splitting), the major eighty diseases enlisted in [[Sutra Sthana]] are important.<br />
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Now the aforesaid synonymous diseases with etiology and therapeutics are about to explain here, the absolute [[vata]] as per different locations as well as that got obstructed. [12-14]<br />
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=== Etiopathology ===<br />
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रूक्षशीताल्पलघ्वन्नव्यवायातिप्रजागरैः | <br /><br />
विषमादुपचाराच्च दोषासृक्स्रवणादति ||१५|| <br /><br />
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लङ्घनप्लवनात्यध्वव्यायामातिविचेष्टितैः | <br /><br />
धातूनां सङ्क्षयाच्चिन्ताशोकरोगातिकर्षणात् ||१६|| <br /><br />
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दुःखशय्यासनात् क्रोधाद्दिवास्वप्नाद्भयादपि | <br /><br />
वेगसन्धारणादामादभिघातादभोजनात् ||१७|| <br /><br />
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मर्माघाताद्गजोष्ट्राश्वशीघ्रयानापतंसनात् | <br /><br />
देहे स्रोतांसि रिक्तानि पूरयित्वाऽनिलो बली ||१८|| <br /><br />
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करोति विविधान् व्याधीन् सर्वाङ्गैकाङ्गसंश्रितान् |१९|<br /><br />
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rūkṣashItAlpalaghvannavyavAyAtiprajAgaraiH | <br /><br />
viShamAdupacArAcca dōṣasRuksravaNAdati ||15|| <br /><br />
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la~gghanaplavanAtyadhvavyAyAmAtiviceShTitaiH | <br /><br />
dhātunAM sa~gkṣayaccintAshokarōgatikarShaNAt ||16|| <br /><br />
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duHkhashayyAsanAt krodhAddivAsvapnAdbhayAdapi | <br /><br />
vegasandhAraNAdAmAdabhighAtAdabhojanAt ||17|| <br /><br />
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marmAghAtAdgajoShTrAshvashIghrayAnApataMsanAt | <br /><br />
dehe srotAMsi riktAni pUrayitvA~anilo balI ||18|| <br /><br />
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karoti vividhAn vyAdhIn sarvA~ggaikA~ggasaMshritAn |19| <br /><br />
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rūkṣaśītālpalaghvannavyavāyātiprajāgaraiḥ| <br /><br />
viṣamādupacārācca dōṣāsr̥ksravaṇādati||15|| <br /><br />
<br />
laṅghanaplavanātyadhvavyāyāmātivicēṣṭitaiḥ| <br /><br />
dhātūnāṁ saṅkṣayāccintāśōkarōgātikarṣaṇāt||16|| <br /><br />
<br />
duḥkhaśayyāsanāt krōdhāddivāsvapnādbhayādapi| <br /><br />
vēgasandhāraṇādāmādabhighātādabhōjanāt||17|| <br /><br />
<br />
marmāghātādgajōṣṭrāśvaśīghrayānāpataṁsanāt| <br /><br />
dēhē srōtāṁsi riktāni pūrayitvā'nilō balī||18|| <br /><br />
<br />
karōti vividhān vyādhīn sarvāṅgaikāṅgasaṁśritān|19| <br /><br />
</div></div><br />
<br />
Due to intake of dry, cold, deficient and light food; excessive sex and sleeplessness; improper treatments; expelling of [[dosha]] or blood letting; by excessive fasting, swimming, walking, exercising, and physical activity; depletion of tissue elements; worrying, grief, debilitating diseases; usage of uncomfortable beds or seats; anger, day sleep or even with fright; suppression of natural urges, indigestion, trauma, abstaining from food; injury to vital areas, falling from swift moving elephant, camel or horse etc. [[vata]] is aggravated. This gets filled in the vacuous channels in the body and leads to various generalized or localized disorders. [15-19]<br />
<br />
=== Premonitory symptoms ===<br />
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<br />
अव्यक्तं लक्षणं तेषां पूर्वरूपमिति स्मृतम् ||१९|| <br />
<br />
आत्मरूपं तु तद्व्यक्तमपायो लघुता पुनः |२०|<br />
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<br />
avyaktaM lakShaNaM teShAM pUrvarUpamiti smRutam ||19|| <br />
<br />
AtmarUpaM tu tadvyaktamapAyo laghutA punaH |20| <br />
<br />
avyaktaṁ lakṣaṇaṁ tēṣāṁ pūrvarūpamiti smr̥tam||19|| <br />
<br />
ātmarūpaṁ tu tadvyaktamapāyō laghutā punaḥ|20| <br />
</div></div><br />
<br />
Indistinct manifestation of the diseases are considered as prodromal symptoms.When the cardinal feature is clearly manifested, it is called as symptom, while the lessening of features are indicative of cure. [19-20]<br />
<br />
=== General signs and symptoms of [[vata]] vitiation ===<br />
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<br />
सङ्कोचः पर्वणां स्तम्भो भेदोऽस्थ्नां पर्वणामपि ||२०|| <br />
<br />
लोमहर्षः प्रलापश्च पाणिपृष्ठशिरोग्रहः | <br /><br />
खाञ्ज्यपाङ्गुल्यकुब्जत्वं शोषोऽङ्गानामनिद्रता ||२१|| <br /><br />
<br />
गर्भशुक्ररजोनाशः स्पन्दनं गात्रसुप्तता | <br /><br />
शिरोनासाक्षिजत्रूणां ग्रीवायाश्चापि हुण्डनम् ||२२|| <br /><br />
<br />
भेदस्तोदार्तिराक्षेपो मोहश्चायास एव च | <br /><br />
एवंविधानि रूपाणि करोति कुपितोऽनिलः ||२३|| <br /><br />
<br />
हेतुस्थानविशेषाच्च भवेद्रोगविशेषकृत् |२४| <br /><br />
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<br />
sa~gkocaH parvaNAM stambho bhedo~asthnAM parvaNAmapi ||20|| <br /><br />
<br />
lomaharShaH pralApashca pANipRuShThashirograhaH | <br /><br />
khA~jjyapA~ggulyakubjatvaM shoSho~a~ggAnAmanidratA ||21|| <br /><br />
<br />
garbhaśukrarajonāśaH spandanaM gAtrasuptatA | <br /><br />
shironAsAkShijatrUNAM grIvAyAshcApi huNDanam ||22|| <br /><br />
<br />
bhedastodArtirAkShepo mohashcAyAsa eva ca | <br /><br />
evaMvidhAni rUpANi karoti kupito~anilaH ||23|| <br /><br />
<br />
hetusthānavisheShAcca bhavedrōgavisheShakRut |24| <br /><br />
<br />
Saṅkōcaḥ parvaṇāṁ stambhō bhēdō'sthnāṁ parvaṇāmapi||20||<br /><br />
<br />
lōmaharṣaḥ pralāpaśca pāṇipr̥ṣṭhaśirōgrahaḥ| <br /><br />
khāñjyapāṅgulyakubjatvaṁ śōṣō'ṅgānāmanidratā||21|| <br /><br />
<br />
garbhaśukrarajōnāśaḥ spandanaṁ gātrasuptatā| <br /><br />
śirōnāsākṣijatrūṇāṁ grīvāyāścāpi huṇḍanam||22|| <br /><br />
<br />
bhēdastōdārtirākṣēpō mōhaścāyāsa ēva ca| <br /><br />
ēvaṁvidhāni rūpāṇi karōti kupitō'nilaḥ||23|| <br /><br />
<br />
hētusthānaviśēṣācca bhavēdrōgaviśēṣakr̥t|24| <br /><br />
</div></div><br />
<br />
Vitiated [[vata]] causes various symptoms like contractures, joint stiffness, splitting of bones and joints, horripilation, delirium, spasticity of hands, back and neck; limping, paraplegia, hunch back; organ atrophy, insomnia, intrauterine death of embryo and fetus, diminishing sperms and menstruation fasciculation, generalized numbness, benumbing or paralysis of muscles of head, nose, eyes, supraclavicular part and neck; splitting, pricking or aching type of pains; convulsions, loss of consciousness, fatigue etc. Different specific diseases of [[vata]] are caused by specificity in etiological factors and site of affliction. [20-24]<br />
<br />
=== Clinical features of vitiation of [[vata]] at different sites ===<br />
==== Koshthashrita [[vata]] (vitiation at gastrointestinal tract) ====<br />
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<br />
तत्र कोष्ठाश्रिते दुष्टे निग्रहो मूत्रवर्चसोः ||२४|| <br />
<br />
ब्रध्नहृद्रोगगुल्मार्शःपार्श्वशूलं च मारुते |<br />
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<br />
tatra kōṣṭhashrite duShTe nigraho mūtravarcasoH ||24|| <br />
<br />
bradhnahRudrōgagulmArshaHpArshvashUlaM ca mArute | <br />
<br />
tatra kōṣṭhāśritē duṣṭē nigrahō mūtravarcasōḥ||24|| <br />
<br />
bradhnahr̥drōgagulmārśaḥpārśvaśūlaṁ ca mārutē| <br />
</div></div><br />
<br />
When vitiated [[vata]] is located in gastrointestinal tract or in abdomen it leads to urinary retention and constipation, intestinal and epigastric discomforts, gulma, piles and pain in flanks.[24]<br />
<br />
==== Sarvanga kupita [[vata]] (vitiation all over body) ====<br />
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<br />
सर्वाङ्गुकुपिते वाते गात्रस्फुरणभञ्जने ||२५|| <br />
<br />
वेदनाभिः परीतश्च स्फुटन्तीवास्य सन्धयः | <br />
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<br />
sarvA~ggukupite vAte gAtrasphuraNabha~jjane ||25|| <br />
<br />
vedanAbhiH parItashca sphuTantIvAsya sandhayaH | <br />
<br />
sarvāṅgakupitē vātē gātrasphuraṇabhañjanē||25|| <br />
<br />
vēdanābhiḥ parītaśca sphuṭantīvāsya sandhayaḥ| <br />
</div></div><br />
<br />
When vitiated [[vata]] is located all over the body, it produces generalized fasciculation and breaking pain; different types of pain and the generalized joint crepitus. [25]<br />
<br />
==== Guda sthita [[vata]] (vitiation at anus) ====<br />
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<br />
ग्रहो विण्मूत्रवातानां शूलाध्मानाश्मशर्कराः ||२६|| <br />
<br />
जङ्घोरुत्रिकपात्पृष्ठरोगशोषौ गुदस्थिते | <br />
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<br />
graho viNmūtravātanAM shUlAdhmAnAshmasharkarAH ||26|| <br />
<br />
ja~gghorutrikapAtpRuShTharōgashoShau [1] gudasthite | <br />
grahō viṇmūtravātānāṁ śūlādhmānāśmaśarkarāḥ||26|| <br />
<br />
jaṅghōrutrikapātpr̥ṣṭharōgaśōṣau [1] gudasthitē| <br />
</div></div><br />
<br />
When vitiated [[vata]] is located in anus, it leads to retention of feces, urine and flatus; colicky pain, flatulence, renal calculi, micro-calculi; diseases with atrophy in calf, thigh, pelvis, and the back.[26]<br />
<br />
==== Amashaya sthita [[vata]] (vitiation at stomach) ====<br />
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<br />
हृन्नाभिपार्श्वोदररुक्तृष्णोद्गारविसूचिकाः ||२७|| <br />
<br />
कासः कण्ठास्यशोषश्च श्वासश्चामाशयस्थिते | <br />
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<br />
hRunnAbhipArshvodararuktRuShNodgAravisUcikAH ||27|| <br />
<br />
kAsaH kaNThAsyashoShashca shvAsashcĀmashayasthite | <br />
<br />
hr̥nnābhipārśvōdararuktr̥ṣṇōdgāravisūcikāḥ||27|| <br />
<br />
kāsaḥ kaṇṭhāsyaśōṣaśca śvāsaścāmāśayasthitē| <br />
</div></div><br />
<br />
When vitiated [[vata]] is located in stomach, symptoms manifest as pain in epigastrium, umbilicus, flanks and abdomen; morbid thirst, eructation, acute gastroenteritis, cough, dryness of throat and mouth and breathing difficulty.[27]<br />
<br />
=== Pakwashaya sthita [[vata]] (vitiation at colon) ===<br />
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<br />
पक्वाशयस्थोऽन्त्रकूजं शूलाटोपौ करोति च ||२८|| <br />
<br />
कृच्छ्रमूत्रपुरीषत्वमानाहं त्रिकवेदनाम् | <br />
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<br />
pakvAshayastho~antrakUjaM shUlATopau karoti ca ||28|| <br />
<br />
kRucchramūtrapurIShatvamAnAhaM trikavedanAm | <br />
<br />
pakvāśayasthō'ntrakūjaṁ śūlāṭōpau karōti ca||28|| <br />
<br />
kr̥cchramūtrapurīṣatvamānāhaṁ trikavēdanām| <br />
</div></div><br />
<br />
When vitiated [[vata]] is located in colon it causes gurgling, colicky pain, tympanites, difficulty in defecation and urination, flatulence and lumbar/ sacroiliac pain. [28]<br />
<br />
=== Indriya gata [[vata]] (vitiation in sense organs) ===<br />
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<br />
श्रोत्रादिष्विन्द्रियवधं कुर्याद्दुष्टसमीरणः ||२९|| <br />
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<br />
shrotrAdiShvindriyavadhaM kuryAdduShTasamIraNaH ||29|| <br />
<br />
śrōtrādiṣvindriyavadhaṁ kuryādduṣṭasamīraṇaḥ||29|| <br />
</div></div><br />
<br />
When vitiated [[vata]] is located in ear like sense organs leads to sensorial loss in the respective organs. [29]<br />
<br />
=== Twaksthita [[vata]] (vitiation at skin) ===<br />
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<br />
त्वग्रूक्षा स्फुटिता सुप्ता कृशा कृष्णा च तुद्यते | <br /><br />
आतन्यते सरागा च पर्वरुक् त्वक्स्थितेऽनिले ||३०|| <br /><br />
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<br />
tvagrūkṣa sphuTitA suptA kRushA kRuShNA ca tudyate |<br /> <br />
Atanyate sarAgA ca parvaruk tvaksthite~anile ||30|| <br /><br />
<br />
tvagrūkṣā sphuṭitā suptā kr̥śā kr̥ṣṇā ca tudyatē| <br /><br />
ātanyatē sarāgā ca parvaruk tvaksthitē'nilē||30|| <br /><br />
</div></div><br />
<br />
When vitiated [[vata]] is located in skin it becomes dry, fissured, numb, thin, blackish. It causes pain along with erythema and strain and leads to pain in distal end of bones.[30]<br />
<br />
=== [[Rakta]]gata [[vata]](vitiation at blood) ===<br />
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<br />
रुजस्तीव्राः ससन्तापा वैवर्ण्यं कृशताऽरुचिः | <br /><br />
गात्रे चारूंषि भुक्तस्य स्तम्भश्चासृग्गतेऽनिले ||३१|| <br /><br />
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<br />
rujastIvrAH sasantApA vaivarNyaM kRushatA~aruciH | <br /><br />
gAtre cArUMShi bhuktasya stambhashcAsRuggate~anile ||31|| <br /><br />
<br />
rujastīvrāḥ sasantāpā vaivarṇyaṁ kr̥śatā'ruciḥ| <br /><br />
gātrē cārūṁṣi bhuktasya stambhaścāsr̥ggatē'nilē||31|| <br /><br />
</div></div><br />
<br />
When vitiated [[vata]] is located in blood it manifests as severe pain with warmth and discoloration; weight loss, anorexia, specific raised rashes in body and esophageal spasm.[31]<br />
<br />
=== Mamsa medogata [[vata]] (vitiation in muscles and fats) ===<br />
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<br />
गुर्वङ्गं तुद्यतेऽत्यर्थं दण्डमुष्टिहतं तथा | <br /><br />
सरुक् श्रमितमत्यर्थं [२] मांसमेदोगतेऽनिले ||३२|| <br /><br />
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<br />
gurva~ggaM tudyate~atyarthaM daNDamuShTihataM tathA | <br /><br />
saruk shramitamatyarthaM [2] māṁsamedogate~anile ||32||<br /><br />
<br />
gurvaṅgaṁ tudyatē'tyarthaṁ daṇḍamuṣṭihataṁ tathā| <br /><br />
saruk śramitamatyarthaṁ [2] māṁsamēdōgatē'nilē||32|| <br /><br />
</div></div><br />
<br />
When vitiated [[vata]] is located in muscles and fat, it manifest as heaviness of body, pricking pain and as if beaten by a strong rod or fist cuff and painful severe fatigue.[32]<br />
<br />
=== Majja-asthigata [[vata]] (vitiation in bones and marrow) ===<br />
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<br />
भेदोऽस्थिपर्वणां सन्धिशूलं मांसबलक्षयः | <br /><br />
अस्वप्नः सन्तता रुक् च मज्जास्थिकुपितेऽनिले ||३३|| <br /><br />
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<br />
bhedo~asthiparvaNAM sandhishUlaM māṁsabalakṣayaH | <br /><br />
asvapnaH santatA ruk ca majjAsthikupite~anile ||33|| <br /><br />
<br />
bhēdō'sthiparvaṇāṁ sandhiśūlaṁ māṁsabalakṣayaḥ| <br /><br />
asvapnaḥ santatā ruk ca majjāsthikupitē'nilē||33|| <br /><br />
</div></div><br />
<br />
When vitiated [[vata]] is located in bones and marrow it leads to splitting pain of bones and joints, arthralgia, loss of muscle strength, insomnia and continuous pain.[33]<br />
<br />
=== Shukra gata [[vata]] (vitiation in semen) ===<br />
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<br />
क्षिप्रं मुञ्चति बध्नाति शुक्रं गर्भमथापि वा | <br /><br />
विकृतिं जनयेच्चापि शुक्रस्थः कुपितोऽनिलः ||३४|| <br /><br />
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<br />
kShipraM mu~jcati badhnAti śukraM garbhamathApi vA | <br /><br />
vikRutiM janayeccApi śukrasthaH kupito~anilaH ||34|| <br /><br />
<br />
kṣipraṁ muñcati badhnāti śukraṁ garbhamathāpi vā| <br /><br />
vikr̥tiṁ janayēccāpi śukrasthaḥ kupitō'nilaḥ||34|| <br /><br />
</div></div><br />
<br />
When vitiated [[vata]] is located in semen, it causes premature ejaculation or anejaculation. It may also lead to preterm or delayed labor. It may also cause deformity in fetus. [34]<br />
<br />
=== Snayugata [[vata]] (vitiation in tendons) ===<br />
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<br />
बाह्याभ्यन्तरमायामं खल्लिं कुब्जत्वमेव च | <br /><br />
सर्वाङ्गैकाङ्गरोगांश्च कुर्यात् स्नायुगतोऽनिलः ||३५|| <br /><br />
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<br />
bAhyAbhyantaramAyAmaM khalliM kubjatvameva ca | <br /><br />
sarvA~ggaikA~ggarōgaMshca kuryAt snAyugato~anilaH ||35|| <br /><br />
<br />
bāhyābhyantaramāyāmaṁ khalliṁ kubjatvamēva ca| <br /><br />
sarvāṅgaikāṅgarōgāṁśca kuryāt snāyugatō'nilaḥ||35|| <br /><br />
</div></div><br />
<br />
When vitiated [[vata]] is located in neural tissue or tendons, it leads to ophisthotonus or emprosthotonus, radiculopathy, kyphosis, quadriplegia or hemiplegia. [35]<br />
<br />
=== Siragata [[vata]] (vitiation in vascular tissue) ===<br />
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<br />
शरीरं मन्दरुक्शोफं शुष्यति स्पन्दते तथा | <br /><br />
सुप्तास्तन्व्यो महत्यो वा सिरा वाते सिरागते ||३६|| <br /><br />
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<br />
sharIraM mandarukśōphaM shuShyati spandate tathA |<br /> <br />
suptAstanvyo mahatyo vA sirā vAte sirāgate ||36|| <br /><br />
<br />
śarīraṁ mandarukśōphaṁ śuṣyati spandatē tathā| <br /><br />
suptāstanvyō mahatyō vā sirā vātē sirāgatē||36|| <br /><br />
</div></div><br />
<br />
When vitiated [[vata]] is located in vascular tissue it leads to mildly painful edema in the body, emaciation, twitching, loss of pulsation along with dilation or coarctation of vessels. [36]<br />
<br />
===Sandhigata [[vata]] (vitiation in joints) ===<br />
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<br />
वातपूर्णदृतिस्पर्शः शोथः सन्धिगतेऽनिले | <br /><br />
प्रसारणाकुञ्चनयोः प्रवृत्तिश्च [३] सवेदना ||३७|| <br /><br />
<br />
(इत्युक्तं [४] स्थानभेदेन वायोर्लक्षणमेव च) |३८| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
vātapUrNadRutisparshaH śōthaH sandhigate~anile | <br /><br />
prasAraNAku~jcanayoH pravRuttishca [3] savedanA ||37|| <br /><br />
<br />
(ityuktaM [4] sthānabhedena vAyorlakShaNameva ca) |38| <br /><br />
<br />
vātapūrṇadr̥tisparśaḥ śōthaḥ sandhigatē'nilē| <br /><br />
prasāraṇākuñcanayōḥ pravr̥ttiśca [3] savēdanā||37|| <br /><br />
<br />
(ityuktaṁ [4] sthānabhēdēna vāyōrlakṣaṇamēva ca)|38| <br /><br />
</div></div><br />
<br />
When vitiated [[vata]] is located in joints, it leads to palpatory feeling of air in joints(crepitus), swelling along with painful flexion and extension.[38]<br />
<br />
Thus the symptomatology of [[vata]] according to various site are explained. [38]<br />
<br />
=== ''Ardita'' (facial paralysis) ===<br />
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<br />
अतिवृद्धः शरीरार्धमेकं वायुः प्रपद्यते | <br /><br />
यदा तदोपशोष्यासृग्बाहुं पादं च जानु च ||३८|| <br /><br />
<br />
तस्मिन् सङ्कोचयत्यर्धे मुखं जिह्मं करोति च | <br /><br />
वक्रीकरोति नासाभूललाटाक्षिहनूस्तथा ||३९|| <br /><br />
<br />
ततो वक्रं व्रजत्यास्ये भोजनं वक्रनासिकम् [१] | <br /><br />
स्तब्धं नेत्रं कथयतः क्षवथुश्च निगृह्यते ||४०|| <br /><br />
<br />
दीना जिह्मा समुत्क्षिप्ता कला [२] सज्जति चास्य वाक् | <br /><br />
दन्ताश्चलन्ति बाध्येते श्रवणौ भिद्यते स्वरः ||४१|| <br /><br />
<br />
पादहस्ताक्षिजङ्घोरुशङ्खश्रवणगण्डरुक् [३] | <br /><br />
अर्धे तस्मिन्मुखार्धे वा केवले स्यात्तदर्दितम् ||४२|| <br /><br />
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<br />
ativRuddhaH sharIrArdhamekaM Vāyu H prapadyate | <br /><br />
yadA tadopashoShyAsRugbAhuM pAdaM ca jAnu ca ||38|| <br /><br />
<br />
tasmin sa~gkocayatyardhe mukhaM jihmaM karoti ca | <br /><br />
vakrIkaroti nAsAbhUlalATAkShihanUstathA ||39|| <br /><br />
<br />
tato vakraM vrajatyAsye bhojanaM vakranAsikam [1] | <br /><br />
stabdhaM netraM kathayataH kṣavathūshca nigRuhyate ||40|| <br /><br />
<br />
dInA jihmA samutkShiptA kalA [2] sajjati cAsya vAk | <br /><br />
dantAshcalanti bAdhyete shravaNau bhidyate svaraH ||41|| <br /><br />
<br />
pAdahastAkShija~gghorusha~gkhashravaNagaNDaruk [3] | <br /><br />
ardhe tasminmukhArdhe vA kevale syAttadarditam ||42||<br /><br />
<br />
ativr̥ddhaḥ śarīrārdhamēkaṁ vāyuḥ prapadyatē| <br /><br />
yadā tadōpaśōṣyāsr̥gbāhuṁ pādaṁ ca jānu ca||38|| <br /><br />
<br />
tasmin saṅkōcayatyardhē mukhaṁ jihmaṁ karōti ca| <br /><br />
vakrīkarōti nāsābhrūlalāṭākṣihanūstathā||39|| <br /><br />
<br />
tatō vakraṁ vrajatyāsyē bhōjanaṁ vakranāsikam [1] | <br /><br />
stabdhaṁ nētraṁ kathayataḥ kṣavathuśca nigr̥hyatē||40|| <br /><br />
<br />
dīnā jihmā samutkṣiptā kalā [2] sajjati cāsya vāk| <br /><br />
dantāścalanti bādhyētē śravaṇau bhidyatē svaraḥ||41|| <br /><br />
<br />
pādahastākṣijaṅghōruśaṅkhaśravaṇagaṇḍaruk [3] | <br /><br />
ardhē tasminmukhārdhē vā kēvalē syāttadarditam||42|| <br /><br />
</div></div><br />
<br />
If the excessively increased [[vata]] affects one half of the body, as it diminishes the blood there, leads to contracture of arm, leg and knee of the affected half, and causes distortion of one side of the face and produces asymmetry of the nose, eye brow, fore head, eye and jaw.<br />
<br />
The food goes into one side of the mouth; while speaking the nose gets curved, the eye remains rigid and without blink; the sneeze gets suppressed. His speech is feeble, distorted, strenuous and indistinct. His teeth get rickety, hearing affected and voice is hoarse. There is pain in his feet, hand, eyes, calves, thighs, temples, ears and cheek. This condition, may affect half the body or half of the face only, is called ''ardita'' (facial paralysis). [38-42]<br />
<br />
=== ''Antarayama'' (Emprosthotonous) ===<br />
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<br />
मन्ये संश्रित्य वातोऽन्तर्यदा नाडीः प्रपद्यते | <br /><br />
मन्यास्तम्भं तदा कुर्यादन्तरायामसञ्ज्ञितम् ||४३|| <br /><br />
<br />
अन्तरायम्यते ग्रीवा मन्या च स्तभ्यते भृशम् | <br /><br />
दन्तानां दंशनं लाला पृष्ठायामः [१] शिरोग्रहः ||४४|| <br /><br />
<br />
जृम्भा वदनसङ्गश्चाप्यन्तरायामलक्षणम् | <br /><br />
(इत्युक्तस्त्वन्तरायामो [२] ... |४५|<br /><br />
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<br />
manye saMshritya vAto~antaryadA nADIH prapadyate | <br /><br />
manyAstambhaM tadA kuryAdantarAyAmasa~jj~jitam ||43|| <br /><br />
<br />
antarAyamyate grIvA manyA ca stabhyate bhRusham | <br /><br />
dantAnAM daMshanaM lAlA pRuShThAyAmaH [1] shirograhaH ||44|| <br /><br />
<br />
jRumbhA vadanasa~ggashcApyantarAyAmalakShaNam | <br /><br />
(ityuktastvantarAyAmo [2] ... |45| <br /><br />
<br />
manyē saṁśritya vātō'ntaryadā nāḍīḥ prapadyatē| <br /><br />
manyāstambhaṁ tadā kuryādantarāyāmasañjñitam||43|| <br /><br />
<br />
antarāyamyatē grīvā manyā ca stabhyatē bhr̥śam| <br /><br />
dantānāṁ daṁśanaṁ lālā pr̥ṣṭhāyāmaḥ [1] śirōgrahaḥ||44|| <br /><br />
<br />
jr̥mbhā vadanasaṅgaścāpyantarāyāmalakṣaṇam| <br /><br />
(ityuktastvantarāyāmō [2] ...|45|<br /><br />
</div></div><br />
<br />
When [[vata]] get localised in the ''manya'' (neck), lateral aspect of the neck and gets spread into the internal vessels, it causes ''manyastambha'' otherwise named as ''antarayam'' (Emprosthotonus). So the neck becomes convulsed inward and the lateral aspect becomes very stiff, the teeth get clenched with salivation, contraction of the back muscles and the head is stiff; yawning and lock jaw; these are the symptoms of ''antarayam''. Thus ''antarayam'' is explained. [43-45]<br />
<br />
=== ''Bahirayama''(ophisthotonous) ===<br />
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<br />
...बहिरायाम उच्यते) ||४५|| <br /><br />
<br />
पृष्ठमन्याश्रिता बाह्याः शोषयित्वा सिरा बली | <br /><br />
वायुः कुर्याद्धनुस्तम्भं बहिरायामसञ्ज्ञकम् ||४६|| <br /><br />
<br />
चापवन्नाम्यमानस्य पृष्ठतो नीयते शिरः | <br /><br />
उर उत्क्षिप्यते मन्या स्तब्धा ग्रीवाऽवमृद्यते ||४७|| <br /><br />
<br />
दन्तानां दशनं जृम्भा लालास्रावश्च वाग्ग्रहः | <br /><br />
जातवेगो निहन्त्येष वैकल्यं वा प्रयच्छति ||४८||<br /><br />
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<br />
...bahirAyAma ucyate) ||45|| <br /><br />
<br />
pRuShThamanyAshritA bAhyAH shoShayitvA sirā balI | <br /><br />
Vāyu H kuryAddhanustambhaM bahirAyAmasa~jj~jakam ||46|| <br /><br />
<br />
cApavannAmyamAnasya pRuShThato nIyate shiraH | <br /><br />
ura utkShipyate manyA stabdhA grIvA~avamRudyate ||47|| <br /><br />
<br />
dantAnAM dashanaM jRumbhA lAlAsrAvashca vAggrahaH | <br /><br />
jAtavego nihantyeSha vaikalyaM vA prayacchati ||48||<br /><br />
<br />
...bahirāyāma ucyatē)||45||<br /><br />
<br />
pr̥ṣṭhamanyāśritā bāhyāḥ śōṣayitvā sirā balī| <br /><br />
vāyuḥ kuryāddhanustambhaṁ bahirāyāmasañjñakam||46|| <br /><br />
<br />
cāpavannāmyamānasya pr̥ṣṭhatō nīyatē śiraḥ| <br /><br />
ura utkṣipyatē manyā stabdhā grīvā'vamr̥dyatē||47|| <br /><br />
<br />
dantānāṁ daśanaṁ jr̥mbhā lālāsrāvaśca vāggrahaḥ| <br /><br />
jātavēgō nihantyēṣa vaikalyaṁ vā prayacchati||48|| <br /><br />
</div></div><br />
<br />
''Bahirayama'', will now be described. The potently provoked [[vata]], on getting localized in the posterior and lateral of the neck and constricting external vessels, causes bow leg like rigidity of the body which is called as ''bahirayama'' (ophisthotonous).<br />
<br />
As the body being bent like a bow, the head gets retracted almost touching his back and his chest is thrown forward, the sides of the neck become rigid and the neck in total get compressed along with clenching of teeth, salivation and aphasia. The attack may lead to death of the patient or deformity.[46-48]<br />
<br />
=== ''Hanugraha'' (lock jaw) ===<br />
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<br />
हनुमूले स्थितो बन्धात् संस्रयत्यनिलो हनू | <br /><br />
विवृतास्यत्वमथवा कुर्यात् [१] स्तब्धमवेदनम् ||४९||<br /><br />
<br />
हनुग्रहं च संस्तभ्य हनुं(नू)संवृतवक्रताम् |५०|<br /><br />
<div class="mw-collapsible-content"><br />
<br />
hanumUle sthito bandhAt saMsrayatyanilo hanU | <br /><br />
vivRutAsyatvamathavA kuryAt [1] stabdhamavedanam ||49|| <br /><br />
<br />
hanugrahaM ca saMstabhya hanuM(nU)saMvRutavakratAm |50| <br /><br />
<br />
hanumūlē sthitō bandhāt saṁsrayatyanilō hanū| <br /><br />
vivr̥tāsyatvamathavā kuryāt [1] stabdhamavēdanam||49|| <br /><br />
<br />
hanugrahaṁ ca saṁstabhya hanuṁ(nū)saṁvr̥tavakratām|50| <br /><br />
</div></div><br />
<br />
When the [[vata]] gets localized at the root of the jaws causes dislocation of the jaws and produces either a condition of stiff gaping of mouth without any pain; or by causing spasticity of the jaw, the mouth becomes fixed and cannot be opened. This is called as ''hanugraha'' (lock jaw)<br />
<br />
=== ''Aakshepaka'' (episodic contractions) ===<br />
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<br />
मुहुराक्षिपति क्रुद्धो गात्राण्याक्षेपकोऽनिलः ||५०|| <br />
<br />
पाणिपादं च संशोष्य सिराः सस्नायुकण्डराः |५१|<br />
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<br />
muhurAkShipati kruddho gAtrANyAkShepako~anilaH ||50|| <br />
<br />
pANipAdaM ca saMshoShya sirāH sasnAyukaNDarAH |51| <br />
<br />
muhurākṣipati kruddhō gātrāṇyākṣēpakō'nilaḥ||50|| <br />
<br />
pāṇipādaṁ ca saṁśōṣya sirāḥ sasnāyukaṇḍarāḥ|51| <br />
</div></div><br />
<br />
In ''akshepaka'' (..), the provoked [[vata]] contracts vessels, tendons and ligaments of the hands and feet cause episodic contraction in different parts of the body. [50-51]<br />
<br />
=== ''Dandaka'' (stiffness of body) ===<br />
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<br />
पाणिपादशिरःपृष्ठश्रोणीः स्तभ्नाति मारुतः ||५१|| <br />
<br />
दण्डवत्स्तब्धगात्रस्य दण्डकः सोऽनुपक्रमः |५२|<br />
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<br />
pANipAdashiraHpRuShThashroNIH stabhnAti mArutaH ||51|| <br />
<br />
daNDavatstabdhagAtrasya daNDakaH so~anupakramaH |52|<br />
<br />
pāṇipādaśiraḥpr̥ṣṭhaśrōṇīḥ stabhnāti mārutaḥ||51|| <br />
<br />
daṇḍavatstabdhagātrasya daṇḍakaḥ sō'nupakramaḥ|52| <br />
</div></div><br />
<br />
When [[vata]] causes rigidity of muscles of the hands, feet, head, back and hips, so that the body becomes stiff as a stick, is called as ''dandaka'', the condition is irremediable. [51-52]<br />
<br />
=== Episodic nature of [[vata]] disorders ===<br />
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<br />
स्वस्थः स्यादर्दितादीनां मुहुर्वेगे [१] गतेऽगते ||५२|| <br />
<br />
पीड्यते पीडनैस्तैस्तैर्भिषगेतान् विवर्जयेत् |५३|<br />
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<br />
svasthaH syAdarditAdInAM muhurvege [1] gate~agate ||52|| <br />
<br />
pIDyate pIDanaistaistairbhiShagetAn vivarjayet |53| <br />
<br />
svasthaḥ syādarditādīnāṁ muhurvēgē [1] gatē'gatē||52|| <br />
<br />
pīḍyatē pīḍanaistaistairbhiṣagētān vivarjayēt|53| <br />
</div></div><br />
<br />
In diseases like ''ardita'' etc. when the episodic convulsions are gone, the patient returns to normal. Later as the episodes return the patient gets severely afflicted with characteristic features; the physicians should regard this condition as incurable. [52-53]<br />
<br />
=== ''Pakshaghata'' (paralysis) ===<br />
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<br />
हत्वैकं मारुतः पक्षं दक्षिणं वाममेव वा ||५३|| <br /><br />
<br />
कुर्याच्चेष्टानिवृत्तिं हि रुजं वाक्स्तमभमेव [१] च | <br /><br />
गृहीत्वाऽर्धं शरीरस्य सिराः स्नायूर्विशोष्य च ||५४|| <br /><br />
<br />
पादं सङ्कोचयत्येकं हस्तं वा तोदशूलकृत् | <br /><br />
एकाङ्गरोगं तं विद्यात् सर्वाङ्गं [२] सर्वदेहजम् ||५५||<br /><br />
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<br />
hatvaikaM mArutaH pakShaM dakShiNaM vAmameva vA ||53|| <br /><br />
<br />
kuryAcceShTAnivRuttiM hi rujaM vAkstamabhameva [1] ca | <br /><br />
gRuhItvA~ardhaM sharIrasya sirāH snAyUrvishoShya ca ||54|| <br /><br />
<br />
pAdaM sa~gkocayatyekaM hastaM vA todashUlakRut | <br /><br />
ekA~ggarōgaM taM vidyAt sarvA~ggaM [2] sarvadehajam ||55||<br /><br />
<br />
hatvaikaṁ mārutaḥ pakṣaṁ dakṣiṇaṁ vāmamēva vā||53|| <br /><br />
<br />
kuryāccēṣṭānivr̥ttiṁ hi rujaṁ vākstambhamēva [1] ca| <br /><br />
gr̥hītvā'rdhaṁ śarīrasya sirāḥ snāyūrviśōṣya ca||54|| <br /><br />
<br />
pādaṁ saṅkōcayatyēkaṁ hastaṁ vā tōdaśūlakr̥t| <br /><br />
ēkāṅgarōgaṁ taṁ vidyāt sarvāṅgaṁ [2] sarvadēhajam||55||<br /><br />
</div></div><br />
<br />
When [[vata]] paralyze one side of the body either right or left, leads to motor deficit, pain and aphasia on the affected side. [This is called as ''pakshaghata'' (hemiplegia)]. By afflicting one side of the body,[[vata]] causes diminution of the vessels and nerves lead to contraction of either one leg or one arm with aching and piercing pain. That condition is to be known ''ekangaroga'' (monoplegia). If it affects whole body it is called ''sarvangaroga'' (quadriplegia).[53-55]<br />
<br />
=== ''Gridhrasi'' (sciatica) and ''khalli'' (radiculopathy) ===<br />
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<br />
स्फिक्पूर्वा कटिपृष्ठोरुजानुजङ्घापदं क्रमात् | <br /><br />
गृध्रसी स्तम्भरुक्तोदैर्गृह्णाति स्पन्दते मुहुः ||५६|| <br /><br />
<br />
वाताद्वातकफात्तन्द्रागौरवारोचकान्विता | <br /><br />
खल्ली तु पादजङ्घोरुकरमूलावमोटनी ||५७||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
sphikpUrvA kaTipRuShThorujAnuja~gghApadaM kramAt | <br /><br />
gRudhrasI stambharuktodairgRuhNAti spandate muhuH ||56|| <br /><br />
<br />
vātadvātakaphAttandrAgauravArocakAnvitA | <br /><br />
khallI tu pAdaja~gghorukaramUlAvamoTanI ||57|| <br /><br />
<br />
sphikpūrvā kaṭi pr̥ṣṭh ōrujānujaṅghāpadaṁ kramāt| <br /><br />
gr̥dhrasī stambharuktōdairgr̥hṇāti spandatē muhuḥ||56|| <br /><br />
<br />
vātādvātakaphāttandrāgauravārōcakānvitā| <br /><br />
khallī tu pādajaṅghōrukaramūlāvamōṭanī||57|| <br /><br />
</div></div><br />
<br />
''Gridhrasi'' due to [[vata]] is manifested as; stiffness, ache and pricking pain in the course of gluteal region, hip and posterior aspect of thigh, knee, calf and soles and twitching infrequently. If it is due to combined [[vata]] and [[kapha]], there will be additional symptoms of listlessness, heaviness and anorexia. The condition is known as ''khalli'' where there is kneading pain referable to feet, calf, thigh and shoulder. [56-57]<br />
<br />
=== Other local disorders ===<br />
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<br />
स्थानानामनुरूपैश्च लिङ्गैः शेषान् विनिर्दिशेत् |५८|<br />
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<br />
sthānanAmanurUpaishca li~ggaiH sheShAn vinirdishet |58| <br />
<br />
sthānānāmanurūpaiśca liṅgaiḥ śēṣān vinirdiśēt|58| <br />
</div></div><br />
<br />
The rest of the disorders should be diagnosed according to the symptoms characteristic of the seat of affection. [58]<br />
<br />
=== Pathological factors ===<br />
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<br />
सर्वेष्वेतेषु संसर्गं पित्ताद्यैरुपलक्षयेत् ||५८|| <br /><br />
<br />
वायोर्धातुक्षयात् कोपो मार्गस्यावरणेन च (वा) | <br /><br />
वातपित्तकफा देहे सर्वस्रोतोऽनुसारिणः ||५९|| <br /><br />
<br />
वायुरेव हि सूक्ष्मत्वाद्द्वयोस्तत्राप्युदीरणः [१] | <br /><br />
कुपितस्तौ समुद्धूय तत्र तत्र क्षिपन् गदान् ||६०|| <br /><br />
<br />
करोत्यावृतमार्गत्वाद्रसादींश्चोपशोषयेत् |६१| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
sarveShveteShu saMsargaM pittAdyairupalakṣayaet ||58|| <br /><br />
<br />
vAyordhātukṣayat kopo mArgasyĀvaranaena ca (vA) | <br /><br />
vātapittakaphA dehe sarvasroto~anusAriNaH ||59|| <br /><br />
<br />
Vāyu reva hi sUkShmatvAddvayostatrApyudIraNaH [1] | <br /><br />
kupitastau samuddhUya tatra tatra kShipan gadAn ||60|| <br /><br />
<br />
karotyAvRutamArgatvAdrasAdIMshcopashoShayet |61|<br /><br />
<br />
sarvēṣvētēṣu saṁsargaṁ pittādyairupalakṣayēt||58|| <br /><br />
<br />
vāyōrdhātukṣayāt kōpō mārgasyāvaraṇēna ca (vā)| <br /><br />
vātapittakaphā dēhē sarvasrōtō'nusāriṇaḥ||59|| <br /><br />
<br />
vāyurēva hi sūkṣmatvāddvayōstatrāpyudīraṇaḥ [1] | <br /><br />
kupitastau samuddhūya tatra tatra kṣipan gadān||60|| <br /><br />
<br />
karōtyāvr̥tamārgatvādrasādīṁścōpaśōṣayēt|61| <br /><br />
</div></div><br />
<br />
In all these disorders, the association of other [[dosha]] like [[pitta]] etc. is to be considered. <br />
<br />
The provocation of [[vata]] is either due to [[dhatu]]kshaya, means diminution of tissue elements and/ or due to ''avarana'' means obstruction to its pathway. The [[vata]], [[pitta]] and [[kapha]], always circulate through all the body channels. The [[vata]], owing to its subtle characteristics is really the impeller of the other two. When the [[vata]] is provoked, it propels the other two [[dosha]] and dislodges them about here and there, causing various diseases. Due to ''avarana'' (obstruction in its path), it further causes diminution of the body nutrient fluid and other body elements. [59-61]<br />
<br />
=== Avrita [[vata]] (conditions due to obstructed [[vata]]) ===<br />
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लिङ्गं पित्तावृते दाहस्तृष्णा शूलं भ्रमस्तमः [१] ||६१|| <br />
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कट्वम्ललवणोष्णैश्च विदाहः शीतकामिता | <br /><br />
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शैत्यगौरवशूलानि कट्वाद्युपशयोऽधिकम् ||६२||<br />
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लङ्घनायासरूक्षोष्णकामिता च कफावृते | <br /><br />
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रक्तावृते सदाहार्तिस्त्वङ्मांसान्तरजो भृशम् ||६३|| <br />
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भवेत् सरागः श्वयथुर्जायन्ते मण्डलानि च | <br /><br />
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कठिनाश्च विवर्णाश्च पिडकाः श्वयथुस्तथा ||६४||<br />
हर्षः पिपीलिकानां च सञ्चार इव मांसगे | <br /><br />
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चलः स्निग्धो मृदुः शीतः शोफोऽङ्गेष्वरुचिस्तथा ||६५|| <br />
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आढ्यवात इति ज्ञेयः स कृच्छ्रो मेदसाऽऽवृतः | <br /><br />
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स्पर्शमस्थ्नाऽऽवृते तूष्णं पीडनं चाभिनन्दति ||६६||<br />
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सम्भज्यते सीदति च सूचीभिरिव तुद्यते | <br /><br />
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मज्जावृते विनामः [२] स्याज्जृम्भणं परिवेष्टनम् ||६७||<br />
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शूलं तु पीड्यमाने च पाणिभ्यां लभते सुखम् | <br /><br />
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शुक्रावेगोऽतिवेगो वा निष्फलत्वं च शुक्रगे ||६८||<br /><br />
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भुक्ते कुक्षौ च रुग्जीर्णे शाम्यत्यन्नावृतेऽनिले | <br /><br />
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मूत्राप्रवृत्तिराध्मानं बस्तौ मूत्रावृतेऽनिले ||६९|| <br /><br />
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वर्चसोऽतिविबन्धोऽधः स्वे स्थाने परिकृन्तति | <br />
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व्रजत्याशु जरां स्नेहो भुक्ते चानह्यते नरः ||७०||<br />
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चिरात् पीडितमन्नेन दुःखं शुष्कं शकृत् सृजेत् |<br />
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श्रोणीवङ्क्षणपृष्ठेषु रुग्विलोमश्च मारुतः ||७१||<br />
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अस्वस्थं हृदयं चैव वर्चसा त्वावृतेऽनिले |७२|<br /><br />
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li~ggaM pittAvRute dAhastRuShNA shUlaM bhramastamaH [1] ||61|| <br /><br />
kaTvamlalavaNoShNaishca vidAhaH shItakAmitA | <br /><br />
<br />
shaityagauravashUlAni kaTvAdyupashayo~adhikam ||62|| <br /><br />
la~gghanAyAsarUkShoShNakAmitA ca kaphAvRute | <br /><br />
<br />
raktAvRute sadAhArtistva~gmāṁsantarajo bhRusham ||63|| <br /><br />
bhavet sarAgaH shvayathurjAyante maNDalAni ca | <br /><br />
<br />
kaThinAshca vivarNAshca piDakAH shvayathustathA ||64|| <br /><br />
harShaH pipIlikAnAM ca sa~jcAra iva māṁsage | <br /><br />
<br />
calaH snigdho mRuduH shItaH shopho~a~ggeShvarucistathA ||65|| <br /><br />
ADhyavāta iti j~jeyaH sa kRucchro medasA~a~avRutaH | <br /><br />
<br />
sparshamasthnA~a~avRute tUShNaM pIDanaM cAbhinandati ||66|| <br /><br />
sambhajyate sIdati ca sUcIbhiriva tudyate | <br /><br />
<br />
majjAvRute vinAmaH [2] syAjjRumbhaNaM pariveShTanam ||67|| <br /><br />
shUlaM tu pIDyamAne ca pANibhyAM labhate sukham | <br /><br />
<br />
śukravego~ativego vA niShphalatvaM ca śukrage ||68|| <br /><br />
bhukte kukShau ca rugjIrNe shAmyatyannAvRute~anile | <br /><br />
<br />
mūtrapravRuttirAdhmAnaM bastau mūtravRute~anile ||69|| <br /><br />
<br />
varcaso~ativibandho~adhaH sve sthAne parikRuntati | <br /><br />
vrajatyAshu jarAM sneho bhukte cAnahyate naraH ||70|| <br /><br />
cirAt pIDitamannena duHkhaM shuShkaM shakRut sRujet | <br /><br />
shroNIva~gkShaNapRuShTheShu rugvilomashca mArutaH ||71|| <br /><br />
asvasthaM hRudayaM caiva varcasA tvAvRute~anile |72| <br /><br />
<br />
liṅgaṁ pittāvr̥tē dāhastr̥ṣṇā śūlaṁ bhramastamaḥ [1] ||61|| <br /><br />
kaṭvamlalavaṇōṣṇaiśca vidāhaḥ śītakāmitā| <br /><br />
<br />
śaityagauravaśūlāni kaṭvādyupaśayō'dhikam||62|| <br /><br />
laṅghanāyāsarūkṣōṣṇakāmitā ca kaphāvr̥tē| <br /><br />
<br />
raktāvr̥tē sadāhārtistvaṅmāṁsāntarajō bhr̥śam||63|| <br /><br />
bhavēt sarāgaḥ śvayathurjāyantē maṇḍalāni ca| <br /><br />
<br />
kaṭhināśca vivarṇāśca piḍakāḥ śvayathustathā||64|| <br /><br />
harṣaḥ pipīlikānāṁ ca sañcāra iva māṁsagē| <br /><br />
<br />
calaḥ snigdhō mr̥duḥ śītaḥ śōphō'ṅgēṣvarucistathā||65|| <br /><br />
āḍhyavāta iti jñēyaḥ sa kr̥cchrō mēdasā''vr̥taḥ| <br /><br />
<br />
sparśamasthnā''vr̥tē tūṣṇaṁ pīḍanaṁ cābhinandati||66|| <br /><br />
sambhajyatē sīdati ca sūcībhiriva tudyatē| <br /><br />
<br />
majjāvr̥tē vināmaḥ [2] syājjr̥mbhaṇaṁ parivēṣṭanam||67|| <br /><br />
śūlaṁ tu pīḍyamānē ca pāṇibhyāṁ labhatē sukham| <br /><br />
<br />
śukrāvēgō'tivēgō vā niṣphalatvaṁ ca śukragē||68|| <br /><br />
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bhuktē kukṣau ca rugjīrṇē śāmyatyannāvr̥tē'nilē| <br /><br />
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mūtrāpravr̥ttirādhmānaṁ bastau mūtrāvr̥tē'nilē||69|| <br /><br />
varcasō'tivibandhō'dhaḥ svē sthānē parikr̥ntati| <br /><br />
vrajatyāśu jarāṁ snēhō bhuktē cānahyatē naraḥ||70|| <br /><br />
cirāt pīḍitamannēna duḥkhaṁ śuṣkaṁ śakr̥t sr̥jēt| <br /><br />
śrōṇīvaṅkṣaṇapr̥ṣṭhēṣu rugvilōmaśca mārutaḥ||71|| <br /><br />
asvasthaṁ hr̥dayaṁ caiva varcasā tvāvr̥tē'nilē|72| <br /><br />
</div></div><br />
<br />
==== [[Vata]] occluded by [[pitta]] ====<br />
<br />
The symptoms of [[vata]] occluded by [[pitta]] are burning sensation, morbid thirst, colic, giddiness, darkness of vision; heart burn on eating pungent, sour, salt and hot things and craving for cold things.[61]<br />
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==== [[Vata]] occluded by [[kapha]] ==== <br />
<br />
If the [[vata]] is occluded by [[kapha]], there will be excess feeling of cold, heaviness, pain, pacification by pungent and similar other articles, craving for fasting, exertion, dry and hot things.[62]<br />
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==== [[Vata]] occluded by blood ====<br />
<br />
When it is occluded by the blood, there will be severe burning pain in the area between the skin and the flesh, along with edema and reddish tinge and round patches.[63]<br />
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==== [[Vata]] occluded by [[mamsa dhatu]] ==== <br />
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In the flesh, it causes hard, discolored boils, and swellings, horripilation and tingling.[64]<br />
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==== [[Vata]] occluded by [[meda dhatu]] ====<br />
<br />
When the [[vata]] is occluded in the adipose tissue, it causes movable, smooth, soft and cold swellings in the body, as well as anorexia. This condition is known as ''adhyavata'' and is difficult to cure. [65]<br />
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==== [[Vata]] occluded by [[asthi dhatu]] ====<br />
<br />
When the [[vata]] is occluded in the osseous tissue, the patient likes hot touch (local sudation) and pressing . He has splitting pain and feels as though his body is being pricked with needles.[66]<br />
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==== [[Vata]] occluded by [[majja dhatu]] ====<br />
<br />
When the [[vata]] is occluded in the marrow, there will be flexure/bending/curving of the body, /pandiculation (stretching and stiffening of the trunk and extremities), excess yawning, twisting and colicky pain. The patient gets relief on pressing with the hand (gentle massage). [67]<br />
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==== [[Vata]] occluded by [[shukra dhatu]] ====<br />
<br />
If the [[vata]] is occluded in semen, it results in ejaculation or premature ejaculation or sterility.[68]<br />
<br />
==== [[Vata]] occluded by food ====<br />
<br />
If the [[vata]] is occluded by food, there will be pain in the stomach on ingestion of food and disappearance of pain after digestion.[68]<br />
<br />
====[[Vata]] occluded by urine ====<br />
<br />
If the [[vata]] is occluded by urine leads to urinary retention and distension of bladder.[69]<br />
<br />
==== [[Vata]] occluded by feces ==== <br />
<br />
If the [[vata]] is occluded by the fecal matter; it leads to obstinate constipation, scissoring type pain in anal region, all unctuous matter ingested is immediately digested (due to excess dryness in colon), after food intake the person suffers from increased distension of abdomen and owing to the pressure of the food ingested the patient passes dry feces with difficulty and after long delay. He is afflicted with pain in the hips, groins and back; as the [[vata]] moves in a reverse direction causes epigastric discomfort. [70-71]<br />
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=== Prognosis ===<br />
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सन्धिच्युतिर्हनुस्तम्भः [१] कुञ्चनं कुब्जताऽर्दितः ||७२|| <br /><br />
<br />
पक्षाघातोऽङ्गसंशोषः [२] पङ्गुत्वं खुडवातता | <br /><br />
स्तम्भनं चाढ्यवातश्च रोगा मज्जास्थिगाश्च ये ||७३|| <br /><br />
<br />
एते स्थानस्य गाम्भीर्याद्यत्नात् सिध्यन्ति वा न वा | <br /><br />
नवान् बलवतस्त्वेतान् साधयेन्निरुपद्रवान् ||७४||<br /><br />
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sandhicyutirhanustambhaH [1] ku~jcanaM kubjatA~arditaH ||72|| <br /><br />
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pakShAghAto~a~ggasaMshoShaH [2] pa~ggutvaM khuDavātatA | <br /><br />
stambhanaM cADhyavātashca rōga majjAsthigAshca ye ||73|| <br /><br />
<br />
ete sthānasya gAmbhIryAdyatnAt sidhyanti vA na vA | <br /><br />
navAn balavātastvetAn sAdhayennirupadravAn ||74|| <br /><br />
<br />
sandhicyutirhanustambhaḥ [1] kuñcanaṁ kubjatā'rditaḥ||72|| <br /><br />
<br />
pakṣāghātō'ṅgasaṁśōṣaḥ [2] paṅgutvaṁ khuḍavātatā| <br /><br />
stambhanaṁ cāḍhyavātaśca rōgā majjāsthigāśca yē||73|| <br /><br />
<br />
ētē sthānasya gāmbhīryādyatnāt sidhyanti vā na vā| <br /><br />
navān balavātastvētān sādhayēnnirupadravān||74|| <br /><br />
</div></div><br />
<br />
Joint dislocation, lock jaw, contracture, hunch back(kyphosis), facial paralysis, hemiplegia, atrophy of a part, paraplegia, arthritis, stiffness, rheumatic conditions and disorders due to affliction of vāta in the marrow; all these on account of their seriousness of the seat affected , may or may not be cured even after deliberate treatment. These can be cured when they are of recent origin in strong patient and without any complications. [72-74]<br />
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=== General management of [[vata]] disorders ===<br />
==== Importance of [[snehana]] (oleation therapy) and [[swedana]](sudation therapy) ====<br />
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क्रियामतः परं सिद्धां वातरोगापहां शृणु | <br /><br />
केवलं निरुपस्तम्भमादौ स्नेहैरुपाचरेत् ||७५||<br /><br />
<br />
वायुं सर्पिर्वसातैलमज्जपानैर्नरं ततः | <br /><br />
स्नेहक्लान्तं समाश्वास्य पयोभिः स्नेहयेत् पुनः ||७६|| <br /><br />
<br />
यूषैर्ग्राम्याम्बुजानूपरसैर्वा स्नेहसंयुतैः | <br /><br />
पायसैः कृशरैः साम्ललवणैरनुवासनैः ||७७|| <br /><br />
<br />
नावनैस्तर्पणैश्चान्नैः [१] सुस्निग्धं स्वेदयेत्ततः | <br /><br />
स्वभ्यक्तं स्नेहसंयुक्तैर्नाडीप्रस्तरसङ्करैः ||७८|| <br /><br />
<br />
तथाऽन्यैर्विविधैः स्वेदैर्यथायोगमुपाचरेत् | <br /><br />
स्नेहाक्तं [२] स्विन्नमङ्गं तु वक्रं स्तब्धमथापि वा ||७९|| <br /><br />
<br />
शनैर्नामयितुं शक्यं यथेष्टं शुष्कदारुवत् | <br /><br />
हर्षतोदरुगायामशोथस्तम्भग्रहादयः ||८०|| <br /><br />
<br />
स्विन्नस्याशु प्रशाम्यन्ति मार्दवं चोपजायते | <br /><br />
स्नेहश्च धातून्संशुष्कान् पुष्णात्याशु प्रयोजितः ||८१|| <br /><br />
<br />
बलमग्निबलं पुष्टिं प्राणांश्चाप्यभिवर्धयेत् | <br /><br />
असकृत्तं पुनः स्नेहैः स्वेदैश्चाप्युपपादयेत् ||८२|| <br /><br />
<br />
तथा स्नेहमृदौ कोष्ठे न तिष्ठन्त्यनिलामयाः |८३|<br /><br />
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<br />
kriyAmataH paraM siddhAM vātarōgapahAM shRuNu | <br /><br />
kevalaM nirupastambhamAdau SnēhairupAcaret ||75|| <br /><br />
<br />
Vāyu M sarpirvasAtailamajjapāna irnaraM tataH | <br /><br />
SnēhaklAntaM samAshvAsya payobhiH Snēhayet punaH ||76|| <br /><br />
<br />
yUShairgrAmyAmbujAnUparasairvA SnēhasaMyutaiH | <br /><br />
pAyasaiH kRusharaiH sAmlalavaNairanuvAsanaiH ||77|| <br /><br />
<br />
nAvanaistarpaNaishcAnnaiH [1] susnigdhaM svedayettataH | <br /><br />
svabhyaktaM SnēhasaMyuktairnADIprastarasa~gkaraiH ||78|| <br /><br />
<br />
tathA~anyairvividhaiH svedairyathAyogamupAcaret | <br /><br />
SnēhaktaM [2] svinnama~ggaM tu vakraM stabdhamathApi vA ||79|| <br /><br />
<br />
shanairnAmayituM shakyaM yatheShTaM shuShkadAruvat | <br /><br />
harShatodarugAyAmaśōthastambhagrahAdayaH ||80|| <br /><br />
<br />
svinnasyAshu prashAmyanti mArdavaM copajAyate | <br /><br />
Snēhashca dhātunsaMshuShkAn puShNAtyAshu prayojitaH ||81|| <br /><br />
<br />
balamagnibalaM puShTiM prānaMshcApyabhivardhayet | <br /><br />
asakRuttaM punaH SnēhaiH svedaishcApyupapAdayet ||82|| <br /><br />
<br />
tathA SnēhamRudau koShThe na tiShThantyanilAmayAH |83| <br /><br />
<br />
kriyāmataḥ paraṁ siddhāṁ vātarōgāpahāṁ śr̥ṇu| <br /><br />
kēvalaṁ nirupastambhamādau snēhairupācarēt||75|| <br /><br />
<br />
vāyuṁ sarpirvasātailamajjapānairnaraṁ tataḥ| <br /><br />
snēhaklāntaṁ samāśvāsya payōbhiḥ snēhayēt punaḥ||76|| <br /><br />
<br />
yūṣairgrāmyāmbujānūparasairvā snēhasaṁyutaiḥ| <br /><br />
pāyasaiḥ kr̥śaraiḥ sāmlalavaṇairanuvāsanaiḥ||77|| <br /><br />
<br />
nāvanaistarpaṇaiścānnaiḥ [1] susnigdhaṁ svēdayēttataḥ| <br /><br />
svabhyaktaṁ snēhasaṁyuktairnāḍīprastarasaṅkaraiḥ||78|| <br /><br />
<br />
tathā'nyairvividhaiḥ svēdairyathāyōgamupācarēt| <br /><br />
snēhāktaṁ [2] svinnamaṅgaṁ tu vakraṁ stabdhamathāpi vā||79|| <br /><br />
<br />
śanairnāmayituṁ śakyaṁ yathēṣṭaṁ śuṣkadāruvat| <br /><br />
harṣatōdarugāyāmaśōthastambhagrahādayaḥ||80|| <br /><br />
<br />
svinnasyāśu praśāmyanti mārdavaṁ cōpajāyatē| <br /><br />
snēhaśca dhātūnsaṁśuṣkān puṣṇātyāśu prayōjitaḥ||81|| <br /><br />
<br />
balamagnibalaṁ puṣṭiṁ prāṇāṁścāpyabhivardhayēt| <br /><br />
asakr̥ttaṁ punaḥ snēhaiḥ svēdaiścāpyupapādayēt||82|| <br /><br />
<br />
tathā snēhamr̥dau kōṣṭhē na tiṣṭhantyanilāmayāḥ|83| <br /><br />
</div></div><br />
<br />
Now listen to the effective line of treatment for the cure of diseases due to [[vata]]. If there is absolute vitiation of [[vata]] without any kind of association(obstruction), it should be treated at first with oleation therapy, such as internal administration of ghee, fat, oil and marrow. Then as the person, when saturated by the oleation, should be eased by consolation and should again be oleated with unctuous articles added milk; thin gruel of cereals and pulses or meat juice of domestic, wet-land and aquatic animals, milk or meat without bones mixed with sour and salt articles; followed with unctuous enema, nasal medications and nutritive food. [75-77]<br />
<br />
When he is well oleated, he should be subjected to sudation therapy, for which oil is applied externally, and then fomentation is done through tubular, mattress or bolus method or different other types suitable to the situation. [78]<br />
<br />
By application of oleation and sudation, even a deformed stiffened limb can be slowly brought back to normality, just as it possible to bend as desired even a dried piece of wood by such measures. [79]<br />
<br />
Tingling numbness, pricking pain, aches, convulsions, swelling, stiffness and spasticity and similar other conditions can be quickly cured and the softness of the part restored by means of sudation. [80]<br />
<br />
The oleation therapy when applied quickly replenishes the diminished body elements and increases the strength, power of the digestive mechanism, robustness and the vitality. [81]<br />
<br />
The oleation and sudation procedures should be repeatedly administered so that the disorders of [[vata]] may not stay in the viscera softened by oleation procedure. [82]<br />
<br />
==== ''Mridu samshodhana'' (Mild purgation) ====<br />
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<br />
यद्यनेन सदोषत्वात् कर्मणा न प्रशाम्यति ||८३|| <br /><br />
<br />
मृदुभिः स्नेहसंयुक्तैरौषधैस्तं विशोधयेत् | <br /><br />
घृतं तिल्वकसिद्धं वा सातलासिद्धमेव वा ||८४|| <br /><br />
<br />
पयसैरण्डतैलं वा पिबेद्दोषहरं शिवम् | <br /><br />
स्निग्धाम्ललवणोष्णाद्यैराहारैर्हि मलश्चितः ||८५|| <br /><br />
<br />
स्रोतो बद्ध्वाऽनिलं रुन्ध्यात्तस्मात्तमनुलोमयेत् [१] | <br /><br />
दुर्बलो योऽविरेच्यः स्यात्तं निरूहैरुपाचरेत् ||८६|| <br /><br />
<br />
पाचनैर्दीपनीयैर्वा भोजनैस्तद्युतैर्नरम् | <br /><br />
संशुद्धस्योत्थिते चाग्नौ स्नेहस्वेदौ पुनर्हितौ ||८७|| <br /><br />
<br />
स्वाद्वम्ललवणस्निग्धैराहारैः सततं पुनः | <br /><br />
नावनैर्धूमपानैश्च सर्वानेवोपपादयेत् ||८८|| <br /><br />
<br />
इति सामान्यतः प्रोक्तं वातरोगचिकित्सितम् |८९| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
yadyanena sa dōṣatvAt karmaNA na prashAmyati ||83|| <br /><br />
<br />
mRudubhiH SnēhasaMyuktairauShadhaistaM vishodhayet | <br /><br />
ghRutaM tilvakasiddhaM vA sAtalAsiddhameva vA ||84|| <br /><br />
<br />
payasairaNDatailaM vA pibed dōṣaharaM shivam | <br /><br />
snigdhAmlalavaNoShNAdyairAhArairhi malashcitaH ||85|| <br /><br />
<br />
sroto baddhvA~anilaM rundhyAttasmAttamanulomayet [1] | <br /><br />
durbalo yo~avirecyaH syAttaM nirUhairupAcaret ||86|| <br /><br />
<br />
pācanairdIpanIyairvA bhojanaistadyutairnaram | <br /><br />
saMshuddhasyotthite cAgnau Snēhasvedau punarhitau ||87|| <br /><br />
<br />
svAdvamlalavaNasnigdhairAhAraiH satataM punaH | <br /><br />
nAvanairdhUmapāna ishca sarvAnevopapAdayet ||88|| <br /><br />
<br />
iti SamānayataH proktaM vātarōgacikitśītām |89| <br /><br />
<br />
yadyanēna sadōṣatvāt karmaṇā na praśāmyati||83|| <br /><br />
<br />
mr̥dubhiḥ snēhasaṁyuktairauṣadhaistaṁ viśōdhayēt| <br /><br />
ghr̥taṁ tilvakasiddhaṁ vā sātalāsiddhamēva vā||84|| <br /><br />
<br />
payasairaṇḍatailaṁ vā pibēddōṣaharaṁ śivam| <br /><br />
snigdhāmlalavaṇōṣṇādyairāhārairhi malaścitaḥ||85|| <br /><br />
<br />
srōtō baddhvā'nilaṁ rundhyāttasmāttamanulōmayēt [1] | <br /><br />
durbalō yō'virēcyaḥ syāttaṁ nirūhairupācarēt||86|| <br /><br />
<br />
pācanairdīpanīyairvā bhōjanaistadyutairnaram| <br /><br />
saṁśuddhasyōtthitē cāgnau snēhasvēdau punarhitau||87|| <br /><br />
<br />
svādvamlalavaṇasnigdhairāhāraiḥ satataṁ punaḥ| <br /><br />
nāvanairdhūmapānaiśca sarvānēvōpapādayēt||88|| <br /><br />
<br />
iti sāmānyataḥ prōktaṁ vātarōgacikitśītām|89| <br /><br />
</div></div><br />
<br />
If due to residual morbidity, the symptoms did not subside with the above procedures, then the patient should be cleansed by means of mild drugs mixed with unctuous articles. [83]<br />
<br />
For this purpose the patient may take the medicated ghee prepared with ''tilvaka'' or ''satala'', or castor oil with milk; all of these are auspicious and expel the morbid humors. [84]<br />
<br />
By excessive use of unctuous, sour, salty and hot articles of diet, the excretory matter gets accumulated and occluding the alimentary passage, obstructs the [[vata]], hence ''anulomana'' of [[vata]] should be done. [85]<br />
<br />
Debilitated patients, in whom purgation is contraindicated, should be given evacuative enema followed by a diet consisting of, or mixed with, the drugs of the digestive and appetizer groups. [86]<br />
<br />
Sudation and oleation procedures, repeated again, are beneficial for those whose digestive mechanism has been stimulated as a result of the purificatory procedure. [87]<br />
<br />
All diseases due to [[vata]] vitiation are always to be continually treated with sweet, sour, salty and unctuous articles of diet and nasal medication and inhalations. Thus the treatment of diseases due to [[vata]] provocation has been expounded in general. [88]<br />
<br />
==== Specific treatment of various conditions ====<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
विशेषतस्तु कोष्ठस्थे वाते क्षारं [१] पिबेन्नरः ||८९|| <br /><br />
<br />
पाचनैर्दीपनैर्युक्तैरम्लैर्वा [२] पाचयेन्मलान् | <br /><br />
गुदपक्वाशयस्थे तु कर्मोदावर्तनुद्धितम् ||९०|| <br /><br />
<br />
आमाशयस्थे शुद्धस्य यथादोषहरीः क्रियाः | <br /><br />
सर्वाङ्गकुपितेऽभ्यङ्गो बस्तयः सानुवासनाः ||९१|| <br /><br />
<br />
स्वेदाभ्यङ्गावगाहाश्च हृद्यं चान्नं त्वगाश्रिते | <br /><br />
शीताः प्रदेहा रक्तस्थे विरेको रक्तमोक्षणम् ||९२|| <br /><br />
<br />
विरेको मांसमेदःस्थे निरूहाः शमनानि च | <br /><br />
बाह्याभ्यन्तरतः स्नेहैरस्थिमज्जगतं जयेत् ||९३|| <br /><br />
<br />
हर्षोऽन्नपानं शुक्रस्थे बलशुक्रकरं हितम् | <br /><br />
विबद्धमार्गं दृष्ट्वा वा शुक्रं दद्याद्विरेचनम् ||९४|| <br /><br />
<br />
विरिक्तप्रतिभुक्तस्य पूर्वोक्तां कारयेत् क्रियाम् | <br /><br />
गर्भे शुष्के तु वातेन बालानां चापि शुष्यताम् ||९५|| <br /><br />
<br />
सिताकाश्मर्यमधुकैर्हितमुत्थापने पयः | <br /><br />
हृदि प्रकुपिते सिद्धमंशुमत्या पयो हितम् ||९६|| <br /><br />
<br />
मत्स्यान्नाभिप्रदेशस्थे सिद्धान् बिल्वशलाटुभिः | <br /><br />
वायुना वेष्ट्यमाने तु गात्रे स्यादुपनाहनम् ||९७|| <br /><br />
<br />
तैलं सङ्कुचितेऽभ्यङ्गो माषसैन्धवसाधितम् | <br /><br />
बाहुशीर्षगते नस्यं पानं चौत्तरभक्तिकम् ||९८|| <br /><br />
<br />
बस्तिकर्म त्वधो नाभेः शस्यते चावपीडकः |९९| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
visheShatastu kōṣṭhasthe vAte kShAraM [1] pibennaraH ||89|| <br /><br />
<br />
pācanairdIpanairyuktairamlairvA [2] pAcayenmalAn | <br /><br />
gudapakvAshayasthe tu karmodAvartanuddhitam ||90|| <br /><br />
<br />
Āmashayasthe shuddhasya yathA dōṣaharIH kriyAH | <br /><br />
sarvA~ggakupite~abhya~ggo bastayaH sAnuvAsanAH ||91|| <br /><br />
<br />
svedAbhya~ggAvagAhAshca hRudyaM cAnnaM tvagAshrite | <br /><br />
shItAH pradehA raktasthe vireko raktamokShaNam ||92|| <br /><br />
<br />
vireko māṁsamedaHsthe nirUhAH shamanAni ca | <br /><br />
bAhyAbhyantarataH SnēhairasthimajjagataM jayet ||93|| <br /><br />
<br />
harSho~annapāna M śukrasthe balaśukrakaraM hitam | <br /><br />
vibaddhamArgaM dRuShTvA vA śukraM dadyAdvirēcanam ||94|| <br /><br />
<br />
viriktapratibhuktasya pUrvoktAM kArayet kriyAm | <br /><br />
garbhe shuShke tu vAtena bAlAnAM cApi shuShyatAm ||95|| <br /><br />
<br />
śītākAshmaryamadhukairhitamutthApānae payaH | <br /><br />
hRudi prakupite siddhamaMshumatyA payo hitam ||96||<br /><br />
<br />
matsyAnnAbhipradeshasthe siddhAn bilvashalATubhiH | <br /><br />
Vāyu nA veShTyamAne tu gAtre syAdupanAhanam ||97|| <br /><br />
<br />
tailaM sa~gkucite~abhya~ggo mAShasaindhavasAdhitam | <br /><br />
bAhushIrShagate nasyaM pAnaM cauttarabhaktikam ||98|| <br /><br />
<br />
bastikarma tvadho nAbheH shasyate cAvapIDakaH |99| <br /><br />
<br />
viśēṣatastu kōṣṭhasthē vātē kṣāraṁ [1] pibēnnaraḥ||89|| <br /><br />
<br />
pācanairdīpanairyuktairamlairvā [2] pācayēnmalān| <br /><br />
gudapakvāśayasthē tu karmōdāvartanuddhitam||90|| <br /><br />
<br />
āmāśayasthē śuddhasya yathādōṣaharīḥ kriyāḥ| <br /><br />
sarvāṅgakupitē'bhyaṅgō bastayaḥ sānuvāsanāḥ||91|| <br /><br />
<br />
svēdābhyaṅgāvagāhāśca hr̥dyaṁ cānnaṁ tvagāśritē| <br /><br />
śītāḥ pradēhā raktasthē virēkō raktamōkṣaṇam||92|| <br /><br />
<br />
virēkō māṁsamēdaḥsthē nirūhāḥ śamanāni ca| <br /><br />
bāhyābhyantarataḥ snēhairasthimajjagataṁ jayēt||93|| <br /><br />
<br />
harṣō'nnapānaṁ śukrasthē balaśukrakaraṁ hitam| <br /><br />
vibaddhamārgaṁ dr̥ṣṭvā vā śukraṁ dadyādvirēcanam||94|| <br /><br />
<br />
viriktapratibhuktasya pūrvōktāṁ kārayēt kriyām| <br /><br />
garbhē śuṣkē tu vātēna bālānāṁ cāpi śuṣyatām||95|| <br /><br />
<br />
sitākāśmaryamadhukairhitamutthāpanē payaḥ| <br /><br />
hr̥di prakupitē siddhamaṁśumatyā payō hitam||96|| <br /><br />
<br />
matsyānnābhipradēśasthē siddhān bilvaśalāṭubhiḥ| <br /><br />
vāyunā vēṣṭyamānē tu gātrē syādupanāhanam||97|| <br /><br />
<br />
tailaṁ saṅkucitē'bhyaṅgō māṣasaindhavasādhitam| <br /><br />
bāhuśīrṣagatē nasyaṁ pānaṁ cauttarabhaktikam||98|| <br /><br />
<br />
bastikarma tvadhō nābhēḥ śasyatē cāvapīḍakaḥ|99| <br /><br />
</div></div><br />
<br />
==== Treatment of [[vata]] located in alimentary tract ====<br />
<br />
Now to be specific; in the condition of morbid [[vata]] lodged in the alimentary tract, the patient should drink alkaline drugs or digestion of humors is to be done with digestive and appetizer groups of drugs.[89]<br />
<br />
==== Treatment of [[vata]] located in colon ==== <br />
<br />
In condition of morbid [[vata]] lodged in the rectum or the colon, the treatment of ''udavarta'' should be given. [90]<br />
<br />
==== Treatment of [[vata]] located in stomach ====<br />
<br />
If it is lodged in the stomach, after the purificatory process, specific treatment as per the [[dosha]] should be given.<br />
<br />
==== Treatment of [[vata]] located in entire body ====<br />
<br />
When the [[vata]] is provoked in the entire body, oil massage, evacuative enema and unctuous enema should be given. [91]<br />
<br />
==== Treatment of [[vata]] located in skin ====<br />
<br />
When the skin is affected, sudation, oil application, hot immersion bath and cordial food should be given.<br />
<br />
==== Treatment of [[vata]] located in blood ====<br />
<br />
When the blood is affected, thick and cold external applications, purgation and blood letting are to be done. [92]<br />
<br />
==== Treatment of [[vata]] located in muscle flesh and fat ====<br />
<br />
As the flesh and fat is affected purgation, evacuative enema and palliative measures should be administered.<br />
<br />
==== Treatment of [[vata]] located in osseous tissue and bone marrow ====<br />
<br />
The osseous tissues and bone-marrow affliction should be corrected with internal and external oleation therapy.[93]<br />
<br />
==== Treatment of [[vata]] located in semen and intrauterine growth retardation ==== <br />
<br />
If the semen is affected, virility enhancing food and drinks which promote strength and semen are beneficial. If the passage of semen is found to be occluded, purgation should be administered. Only after purgation and consumption of diet, the previously mentioned line of treatment should be carried out.[94]<br />
<br />
When [[vata]] causes intrauterine growth retardation or new born is emaciated, then milk prepared with sugar, ''kashmarya'' and ''madhuka'' is beneficial for restoration.[95]<br />
<br />
==== Treatment of [[vata]] located in cardiac region ==== <br />
<br />
If the provoked [[vata]] is located in the cardiac region, the milk prepared of aṁśumati is beneficial. <br />
<br />
==== Treatment of [[vata]] located in umbilicus ====<br />
<br />
If it is located in the umbilicus, fish processed with unripe ''bilva'' fruits should be given.[97]<br />
<br />
==== Treatment of [[vata]] located in parts of body ==== <br />
<br />
If there are cramps in any part of the body, poultice should be applied.<br />
<br />
In contractures of body parts, external massage with the medicated oil prepared with black gram and rock salt should be prescribed.<br />
<br />
If there is [[vata]] provocation in the shoulders nasal medication and ghee should be administered after food. <br />
<br />
When the morbid [[vata]] is localized below the umbilical region, enema and ''avapidhaka sneha'' are recommended.[98]<br />
<br />
=== Treatment of [[vata]] disorders affecting tendon, ligaments and vessels ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
अर्दिते नावनं मूर्ध्नि तैलं तर्पणमेव च ||९९|| <br /><br />
<br />
नाडीस्वेदोपनाहाश्चाप्यानूपपिशितैर्हिताः | <br /><br />
स्वेदनं स्नेहसंयुक्तं पक्षाघाते विरेचनम् ||१००|| <br /><br />
<br />
अन्तराकण्डरागुल्फं सिरा बस्त्यग्निकर्म च | <br /><br />
गृध्रसीषु प्रयुञ्जीत खल्ल्यां तूष्णोपनाहनम् ||१०१|| <br /><br />
<br />
पायसैः कृशरैर्मांसैः शस्तं तैलघृतान्वितैः | <br /><br />
व्यात्तानने हनुं स्विन्नामङ्गुष्ठाभ्यां प्रपीड्य च ||१०२|| <br /><br />
<br />
प्रदेशिनीभ्यां चोन्नाभ्य चिबुकोन्नामनं हितम् | <br /><br />
स्रस्तं स्वं गमयेत्स्थानं स्तब्धं स्विन्नं विनामयेत् ||१०३||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
ardite nAvanaM mUrdhni tailaM tarpaNameva ca ||99|| <br /><br />
<br />
nADIsvedopanAhAshcApyAnUpapishitairhitAH | <br /><br />
svedanaM SnēhasaMyuktaM pakShAghAte virēcanam ||100|| <br /><br />
<br />
antarAkaNDarAgulphaM [1] sirā bastyagnikarma ca | <br /><br />
gRudhrasIShu prayu~jjIta khallyAM tUShNopanAhanam ||101|| <br /><br />
<br />
pAyasaiH kRusharairmāṁsaiH shastaM tailaghRutAnvitaiH | <br /><br />
vyAttAnane [2] hanuM svinnAma~gguShThAbhyAM prapIDya ca ||102|| <br /><br />
<br />
pradeshinIbhyAM connAbhya cibukonnAmanaM hitam | <br /><br />
srastaM svaM gamayetsthānaM stabdhaM svinnaM vinAmayet ||103|| <br /><br />
<br />
arditē nāvanaṁ mūrdhni tailaṁ tarpaṇamēva ca||99|| <br /><br />
<br />
nāḍīsvēdōpanāhāścāpyānūpapiśitairhitāḥ| <br /><br />
svēdanaṁ snēhasaṁyuktaṁ pakṣāghātē virēcanam||100|| <br /><br />
<br />
antarākaṇḍarāgulphaṁ [1] sirā bastyagnikarma ca| <br /><br />
gr̥dhrasīṣu prayuñjīta khallyāṁ tūṣṇōpanāhanam||101|| <br /><br />
<br />
pāyasaiḥ kr̥śarairmāṁsaiḥ śastaṁ tailaghr̥tānvitaiḥ| <br /><br />
vyāttānanē [2] hanuṁ svinnāmaṅguṣṭhābhyāṁ prapīḍya ca||102|| <br /><br />
<br />
pradēśinībhyāṁ cōnnābhya cibukōnnāmanaṁ hitam| <br /><br />
srastaṁ svaṁ gamayētsthānaṁ stabdhaṁ svinnaṁ vināmayēt||103|| <br /><br />
</div></div><br />
<br />
In facial paralysis, nasal medication, overhead application of oil, ''tarpaṇa'', tubular fomentation and poultices prepared of the flesh of aquatic animals are beneficial.[99]<br />
<br />
In hemiplegia, sudation with unctuous preparations and purgation are beneficial. <br />
<br />
In sciatica, venesection of the vein situated between medially situated tendon (''kandhara'') and ''gulpha'', enema and cauterization should be resorted.[100]<br />
<br />
In ''khalli'', hot poultices prepared with milk pudding or ''krishara'' or flesh mixed with oil and ghee are beneficial.[101]<br />
<br />
In lock jaw; in case of opened fixed mouth, the jaw should be subjected to sudation procedure first and then it should be pressed downwards by the thumbs (inserting in the mouth and pressing on the molar teeth) and pushed upwards by fingers (which are placed externally below the chin) is beneficial. So the subluxated part will reach its proper position. In stiffness it should be subjected to sudation procedure and flexed. [102-103]<br />
<br />
=== Specific treatment as per site and ''dushya'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
प्रत्येकं स्थानदूष्यादिक्रियावैशेष्यमाचरेत् [१] |१०४|<br />
<div class="mw-collapsible-content"><br />
<br />
pratyekaM sthānadUShyAdikriyAvaisheShyamAcaret [1] |104| <br />
<br />
pratyēkaṁ sthānadūṣyādikriyāvaiśēṣyamācarēt [1] |104| <br />
</div></div><br />
<br />
Specific line of treatment should be adopted in specific condition depending on site of affliction and the vitiated tissue involved.[104]<br />
<br />
==== [[Brimhana]] (nourishment) treatment ====<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
सर्पिस्तैलवसामज्जसेकाभ्यञ्जनबस्तयः [१] ||१०४|| <br /><br />
<br />
स्निग्धाः स्वेदा निवातं च स्थानं प्रावरणानि च | <br /><br />
रसाः पयांसि भोज्यानि स्वाद्वम्ललवणानि च ||१०५|| <br /><br />
<br />
बृंहणं यच्च तत् सर्वं प्रशस्तं वातरोगिणाम् |१०६|<br /><br />
<div class="mw-collapsible-content"><br />
<br />
sarpistailavasAmajjasekAbhya~jjanabastayaH [1] ||104|| <br /><br />
<br />
snigdhAH svedA nivātaM ca sthānaM prĀvaranani ca | <br /><br />
rasAH payAMsi bhojyAni svAdvamlalavaNAni ca ||105|| <br /><br />
<br />
bRuMhaNaM yacca tat sarvaM prashastaM vātarogiNAm |106| <br /><br />
<br />
sarpistailavasāmajjasēkābhyañjanabastayaḥ [1] ||104||<br /><br />
<br />
snigdhāḥ svēdā nivātaṁ ca sthānaṁ prāvaraṇāni ca| <br /><br />
rasāḥ payāṁsi bhōjyāni svādvamlalavaṇāni ca||105|| <br /><br />
<br />
br̥ṁhaṇaṁ yacca tat sarvaṁ praśastaṁ vātarōgiṇām|106| <br /><br />
</div></div><br />
<br />
Ghee, oil, fat, marrow, affusion, massage, enema, unctuous sudation, staying at calm places (without strong wind), covering with blankets, meat soups, various milks, articles of diet of sweet, sour and salt tastes and whatever is nourishing are beneficial for disorders due to [[vata]].[104-106]<br />
<br />
=== Various formulations ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
बलायाः पञ्चमूलस्य दशमूलस्य वा रसे ||१०६|| <br /><br />
<br />
अजशीर्षाम्बुजानूपमांसादपिशितैः पृथक् | <br /><br />
साधयित्वा रसान् स्निग्धान्दध्यम्लव्योषसंस्कृतान् ||१०७|| <br /><br />
<br />
भोजयेद्वातरोगार्तं तैर्व्यक्तलवणैर्नरम् | <br /><br />
एतैरेवोपनाहांश्च पिशितैः सम्प्रकल्पयेत् ||१०८|| <br /> <br />
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balAyAH pa~jcamUlasya dashamUlasya vA rase ||106|| <br /><br />
<br />
ajashIrShAmbujAnUpamāṁsadapishitaiH pRuthak | <br /><br />
sAdhayitvA rasAn snigdhAndadhyamlavyoShasaMskRutAn ||107|| <br /><br />
<br />
bhojayedvātarōgartaM tairvyaktalavaNairnaram | <br /><br />
etairevopanAhAMshca pishitaiH samprakalpayet ||108|| <br /><br />
<br />
balāyāḥ pañcamūlasya daśamūlasya vā rasē||106|| <br /><br />
<br />
ajaśīrṣāmbujānūpamāṁsādapiśitaiḥ pr̥thak| <br /><br />
sādhayitvā rasān snigdhāndadhyamlavyōṣasaṁskr̥tān||107|| <br /><br />
<br />
bhōjayēdvātarōgārtaṁ tairvyaktalavaṇairnaram| <br /><br />
ētairēvōpanāhāṁśca piśitaiḥ samprakalpayēt||108|| <br /><br />
</div></div><br />
<br />
The patient afflicted with [[vata]] disorders should be given meat soup of the flesh of the head of the goat, or of the aquatic, wet land or carnivorous animals prepared separately in the decoction of ''sida'' species, ''panchamoola'' and ''dashamoola'' seasoned with unctuous articles, sour curds and ''trikatu'' which is salted liberally.[106-107]<br />
<br />
Poultices should be prepared from the same flesh as mixed with ghee, oil and sour articles, with the boneless flesh well crushed and steamed. [108]<br />
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घृततैलयुतैः साम्लैः क्षुण्णस्विन्नैरनस्थिभिः | <br /><br />
पत्रोत्क्वाथपयस्तैलद्रोण्यः स्युरवगाहने ||१०९|| <br /><br />
<br />
स्वभ्यक्तानां प्रशस्यन्ते सेकाश्चानिलरोगिणाम् | <br /><br />
आनूपौदकमांसानि दशमूलं शतावरीम् ||११०|| <br /><br />
<br />
कुलत्थान् बदरान्माषांस्तिलान्रास्नां यवान् बलाम् | <br /><br />
वसादध्यारनालाम्लैः सह कुम्भ्यां विपाचयेत् ||१११|| <br /><br />
<br />
नाडीस्वेदं प्रयुञ्जीत पिष्टैश्चाप्युपनाहनम् | <br /><br />
तैश्च सिद्धं घृतं तैलमभ्यङ्गं पानमेव च ||११२|| <br /><br />
<br />
मुस्तं किण्वं तिलाः कुष्ठं सुराह्वं लवणं नतम् | <br /><br />
दधिक्षीरचतुःस्नेहैः सिद्धं स्यादुपनाहनम् ||११३|| <br /><br />
<br />
उत्कारिकावेसवारक्षीरमाषतिलौदनैः | <br /><br />
एरण्डबीजगोधूमयवकोलस्थिरादिभिः ||११४|| <br /><br />
<br />
सस्नेहैः सरुजं गात्रमालिप्य बहलं भिषक् | <br /><br />
एरण्डपत्रैर्बध्नीयाद्रात्रौ कल्यं विमोक्षयेत् ||११५|| <br /><br />
<br />
क्षीराम्बुना ततः सिक्तं पुनश्चैवोपनाहितम् | <br /><br />
मुञ्चेद्रात्रौ दिवाबद्धं चर्मभिश्च सलोमभिः ||११६|| <br /><br />
<br />
फलानां तैलयोनीनामम्लपिष्टान् सुशीतलान् | <br /><br />
प्रदेहानुपनाहांश्च गन्धैर्वातहरैरपि ||११७|| <br /><br />
<br />
पायसैः कृशरैश्चैव कारयेत् स्नेहसंयुतैः |११८|<br /><br />
<br />
रूक्षशुद्धानिलार्तानामतः स्नेहान् प्रचक्ष्महे||११८|| <br /><br />
विविधान् विविधव्याधिप्रशमायामृतोपमान्| <br /><br />
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ghRutatailayutaiH sAmlaiH kShuNNasvinnairanasthibhiH | <br /><br />
patrotkvAthapayastailadroNyaH syuravagAhane ||109|| <br /><br />
<br />
svabhyaktAnAM prashasyante sekAshcAnilarogiNAm | <br /><br />
AnUpaudakamāṁsani dashamUlaM shatAvarIm ||110|| <br /><br />
<br />
kulatthAn badarAnmAShAMstilAnrāsnāM yavAn balAm | <br /><br />
vasAdadhyAranAlAmlaiH saha kumbhyAM vipAcayet ||111|| <br /><br />
<br />
nADIsvedaM prayu~jjIta piShTaishcApyupanAhanam | <br /><br />
taishca siddhaM ghRutaM tailamabhya~ggaM pAnameva ca ||112|| <br /><br />
<br />
mustaM kiNvaM tilAH kuṣṭhaM surAhvaM lavaNaM natam | <br /><br />
dadhikShIracatuHSnēhaiH siddhaM syAdupanAhanam ||113|| <br /><br />
<br />
utkArikAvesavArakShIramAŚaṭīlaudānaiH | <br /><br />
eraṇḍabIjagodhUmayavakōlasthirAdibhiH ||114|| <br /><br />
<br />
saSnēhaiH sarujaM gAtramAlipya bahalaM bhiShak | <br /><br />
eraṇḍapatrairbadhnIyAdrAtrau kalyaM vimokṣayaet ||115|| <br /><br />
<br />
kShIrAmbunA tataH siktaM punashcaivopanAhitam | <br /><br />
mu~jcedrAtrau divAbaddhaM carmabhishca salomabhiH ||116|| <br /><br />
<br />
phalAnAM tailayonInAmamlapiShTAn sushItalAn | <br /><br />
pradehAnupanAhAMshca gandhairvātaharairapi ||117|| <br /><br />
<br />
pAyasaiH kRusharaishcaiva kArayet SnēhasaMyutaiH |118| <br /><br />
<br />
rūkṣashuddhAnilArtAnAmataH Snēhan pracakShmahe ||118|| <br /><br />
vividhAn vividhavyAdhiprashamAyAmRutopamAn | <br /><br />
<br />
ghr̥tatailayutaiḥ sāmlaiḥ kṣuṇṇasvinnairanasthibhiḥ|<br /> <br />
patrōtkvāthapayastailadrōṇyaḥ syuravagāhanē||109|| <br /><br />
<br />
svabhyaktānāṁ praśasyantē sēkāścānilarōgiṇām| <br /><br />
ānūpaudakamāṁsāni daśamūlaṁ śatāvarīm||110|| <br /><br />
<br />
kulatthān badarānmāṣāṁstilānrāsnāṁ yavān balām| <br /><br />
vasādadhyāranālāmlaiḥ saha kumbhyāṁ vipācayēt||111|| <br /><br />
<br />
nāḍīsvēdaṁ prayuñjīta piṣṭaiścāpyupanāhanam| <br /><br />
taiśca siddhaṁ ghr̥taṁ tailamabhyaṅgaṁ pānamēva ca||112|| <br /><br />
<br />
mustaṁ kiṇvaṁ tilāḥ kuṣṭhaṁ surāhvaṁ lavaṇaṁ natam| <br /><br />
dadhikṣīracatuḥsnēhaiḥ siddhaṁ syādupanāhanam||113|| <br /><br />
<br />
utkārikāvēsavārakṣīramāṣatilaudānaiḥ| <br /><br />
ēraṇḍabījagōdhūmayavakōlasthirādibhiḥ||114|| <br /><br />
<br />
sasnēhaiḥ sarujaṁ gātramālipya bahalaṁ bhiṣak| <br /><br />
ēraṇḍapatrairbadhnīyādrātrau kalyaṁ vimōkṣayēt||115|| <br /><br />
<br />
kṣīrāmbunā tataḥ siktaṁ punaścaivōpanāhitam| <br /><br />
muñcēdrātrau divābaddhaṁ carmabhiśca salōmabhiḥ||116|| <br /><br />
<br />
phalānāṁ tailayōnīnāmamlapiṣṭān suśītalān| <br /><br />
pradēhānupanāhāṁśca gandhairvātaharairapi||117|| <br /><br />
<br />
pāyasaiḥ kr̥śaraiścaiva kārayēt snēhasaṁyutaiḥ|118| <br /><br />
<br />
rūkṣaśuddhānilārtānāmataḥ snēhān pracakṣmahē||118|| <br /><br />
vividhān vividhavyādhipraśamāyāmr̥tōpamān| <br /><br />
</div></div><br />
<br />
For immersion bath, vessel should be filled with the decoction of the leaves curative of [[vata]] or with medicated milk or oil. <br />
<br />
Affusion is recommended after a good oil massage to the patient suffering from [[vata]] disorder. [109]<br />
<br />
Cook in a pot the flesh of wetland and aquatic creatures, ''dashamoola'', asparagus, horse-gram, jujube, black gram, sesame, ''rasna'', barley and ''sida'' along with fat, curds, acetic acid and sour articles and administer this in the form of kettle sudation. This in the form of paste may also be used as poultice. And medicated ghee and oil prepared with this may be used for external massage as well as internal administration. [110-112]<br />
<br />
The preparations made of ''musta'', yeast, sesame, ''kushtha, devadaru,'' rock salt and ''nata'', along with curds milk and the four varieties of unctuous articles should be used as poultice. [113]<br />
<br />
The physician should give on the painful part, a thick application prepared of pancakes, ''vesavara'' preparation, milk, black gram, sesame, boiled rice, castor seeds, wheat, barley, ''badara,'' and ''sthira'' etc mixed with unctuous articles. This application should be at night and bandaged with caster leaves, and the bandage should be removed the next morning. Then the part should be poured with milk added with water and again poultice. The bandage which is applied during the day must be of leather with fur, and it should be removed at night. [114-116]<br />
<br />
Thick applications can be made of oleiferous fruits well pasted with sour articles and be applied after it gets cool. And poultices can be made of the fragrant group of drugs curative of [[vata]], milk pudding or ''krishara'' mixed with unctuous articles be used. [117]<br />
<br />
We shall describe the various unctuous preparations which are comparable to nectar and are curative of disorders in those who are afflicted with dryness after purification and [[vata]] provocation. [118]<br />
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द्रोणेऽम्भसः पचेद्भागान् दशमूलाच्चतुष्पलान्||११९|| <br /><br />
<br />
यवकोलकुलत्थानां भागैः प्रस्थोन्मितैः सह| <br /><br />
पादशेषे रसे पिष्टैर्जीवनीयैः सशर्करैः||१२०|| <br /><br />
<br />
तथा खर्जूरकाश्मर्यद्राक्षाबदरफल्गुभिः| <br /><br />
सक्षीरैः सर्पिषः प्रस्थः सिद्धः केवलवातनुत्||१२१||<br /><br />
<br />
निरत्ययः प्रयोक्तव्यः पानाभ्यञ्जनबस्तिषु| <br /><br />
चित्रकं नागरं रास्नां पौष्करं पिप्पलीं शटीम्||१२२|| <br /><br />
<br />
पिष्ट्वा विपाचयेत् सर्पिर्वातरोगहरं परम्| <br /><br />
बलाबिल्वशृते क्षीरे घृतमण्डं विपाचयेत्||१२३|| <br /><br />
<br />
तस्य शुक्तिः प्रकुञ्चो वा नस्यं मूर्धगतेऽनिले| <br /><br />
ग्राम्यानूपौदकानां तु भित्वाऽस्थीनि पचेज्जले||१२४|| <br /><br />
<br />
तं स्नेहं दशमूलस्य कषायेण पुनः पचेत्| <br /><br />
जीवकर्षभकास्फोताविदारीकपिकच्छुभिः||१२५|| <br /><br />
<br />
वातघ्नैर्जीवनीयैश्च कल्कैर्द्विक्षीरभागिकम्| <br /><br />
तत्सिद्धं नावनाभ्यङ्गात्तथा पानानुवासनात्||१२६|| <br /><br />
<br />
सिरापर्वास्थिकोष्ठस्थं प्रणुदत्याशु मारुतम्| <br /><br />
ये स्युः प्रक्षीणमज्जानः क्षीणशुक्रौजसश्च ये||१२७|| <br /><br />
<br />
बलपुष्टिकरं तेषामेतत् स्यादमृतोपमम्| <br /><br />
तद्वत्सिद्धा वसा नक्रमत्स्यकूर्मचुलूकजा||१२८|| <br /><br />
<br />
प्रत्यग्रा विधिनाऽनेन नस्यपानेषु शस्यते| <br /><br />
प्रस्थः स्यात्त्रिफलायास्तु कुलत्थकुडवद्वयम्||१२९|| <br /><br />
<br />
कृष्णगन्धात्वगाढक्योः पृथक् पञ्चपलं भवेत्| <br /><br />
रास्नाचित्रकयोर्द्वे द्वे दशमूलं पलोन्मितम्||१३०|| <br /><br />
<br />
जलद्रोणे पचेत् पादशेषे प्रस्थोन्मितं पृथक्| <br /><br />
सुरारनालदध्यम्लसौवीरकतुषोदकम्||१३१|| <br /><br />
<br />
कोलदाडिमवृक्षाम्लरसं तैलं वसां घृतम्| <br /><br />
मज्जानं च पयश्चैव जीवनीयपलानि षट्||१३२|| <br /><br />
<br />
कल्कं दत्त्वा महास्नेहं सम्यगेनं विपाचयेत्| <br /><br />
सिरामज्जास्थिगे वाते सर्वाङ्गैकाङ्गरोगिषु||१३३|| <br /><br />
<br />
वेपनाक्षेपशूलेषु तदभ्यङ्गे प्रयोजयेत्| <br /><br />
निर्गुण्ड्या मूलपत्राभ्यां गृहीत्वा स्वरसं ततः||१३४|| <br /><br />
<br />
तेन सिद्धं समं तैलं नाडीकुष्ठानिलार्तिषु| <br /><br />
हितं पामापचीनां च पानाभ्यञ्जनपूरणम्||१३५|| <br /><br />
<br />
कार्पासास्थिकुलत्थानां रसे सिद्धं च वातनुत्|१३६| <br /><br />
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<br />
droNe~ambhasaH pacedbhAgAn dashamUlAccatuShpalAn ||119|| <br /><br />
<br />
yavakōlakulatthAnAM bhAgaiH prasthonmitaiH saha | <br /><br />
pAdasheShe rase piShTairjIvanIyaiH sasharkaraiH ||120|| <br /><br />
<br />
tathA kharjUrakAshmaryadrAkShAbadaraphalgubhiH | <br /><br />
sakShIraiH sarpiShaH prasthaH siddhaH kevalavātanut ||121|| <br /><br />
<br />
niratyayaH prayoktavyaH pAnAbhya~jjanabastiShu | <br /><br />
citrakaM nAgaraM rāsnāM pauShkaraM pippalIM śaṭīm ||122|| <br /><br />
<br />
piShTvA vipAcayet sarpirvātarōgaharaM param | <br /><br />
balAbilvashRute kShIre ghRutamaNDaM vipAcayet ||123|| <br /><br />
<br />
tasya shuktiH praku~jco vA nasyaM mUrdhagate~anile | <br /><br />
grAmyAnUpaudakAnAM tu bhitvA~asthIni pacejjale ||124|| <br /><br />
<br />
taM SnēhaM dashamUlasya kaShAyeNa punaH pacet | <br /><br />
jIvakarShabhakAsphotAvidArIkapikacchubhiH ||125|| <br /><br />
<br />
vātaghnairjIvanIyaishca kalkairdvikShIrabhAgikam | <br /><br />
tatsiddhaM nAvanAbhya~ggAttathA pAnAnuvAsanAt ||126|| <br /><br />
<br />
sirāparvAsthikōṣṭhasthaM prānaudatyAshu mArutam | <br /><br />
ye syuH prakShINamajjAnaH kShINaśukraujasashca ye ||127|| <br /><br />
<br />
balapuShTikaraM teShAmetat syAdamRutopamam | <br /><br />
tadvatsiddhA vasA nakramatsyakUrmaculUkajA ||128|| <br /><br />
<br />
pratyagrA vidhinA~anena nasYāpanaeShu shasyate | <br /><br />
prasthaH syAttriphalAyAstu kulatthakuDavadvayam ||129|| <br /><br />
<br />
kRuShNagandhAtvagADhakyoH pRuthak pa~jcapalaM bhavet | <br /><br />
rāsnācitrakayordve dve dashamUlaM palonmitam ||130|| <br /><br />
<br />
jaladroNe pacet pAdasheShe prasthonmitaM pRuthak | <br /><br />
surAranAladadhyamlasauvIrakatuShodakam ||131|| <br /><br />
<br />
kōladADimavRūkṣamlarasaM tailaM vasAM ghRutam | <br /><br />
majjAnaM ca payashcaiva jIvanIyapalAni ShaT ||132|| <br /><br />
<br />
kalkaM dattvA mahASnēhaM samyagenaM vipAcayet | <br /><br />
sirāmajjAsthige vAte sarvA~ggaikA~ggarogiShu ||133|| <br /><br />
<br />
vepanAkShepashUleShu tadabhya~gge prayojayet | <br /><br />
nirguNDyA mUlapatrAbhyAM gRuhItvA svarasaM tataH ||134|| <br /><br />
<br />
tena siddhaM samaM tailaM nADIkuṣṭhanilArtiShu | <br /><br />
hitaM pAmApacInAM ca pAnAbhya~jjanapUraNam ||135|| <br /><br />
<br />
kArpAsAsthikulatthAnAM rase siddhaM ca vātanut |136| <br /><br />
<br />
drōṇē'mbhasaḥ pacēdbhāgān daśamūlāccatuṣpalān||119|| <br /><br />
<br />
yavakōlakulatthānāṁ bhāgaiḥ prasthōnmitaiḥ saha| <br /><br />
pādaśēṣē rasē piṣṭairjīvanīyaiḥ saśarkaraiḥ||120|| <br /><br />
<br />
tathā kharjūrakāśmaryadrākṣābadaraphalgubhiḥ| <br /><br />
sakṣīraiḥ sarpiṣaḥ prasthaḥ siddhaḥ kēvalavātanut||121|| <br /><br />
<br />
niratyayaḥ prayōktavyaḥ pānābhyañjanabastiṣu| <br /><br />
citrakaṁ nāgaraṁ rāsnāṁ pauṣkaraṁ pippalīṁ śaṭīm||122|| <br /><br />
<br />
piṣṭvā vipācayēt sarpirvātarōgaharaṁ param| <br /><br />
balābilvaśr̥tē kṣīrē ghr̥tamaṇḍaṁ vipācayēt||123|| <br /><br />
<br />
tasya śuktiḥ prakuñcō vā nasyaṁ mūrdhagatē'nilē| <br /><br />
grāmyānūpaudakānāṁ tu bhitvā'sthīni pacējjalē||124|| <br /><br />
<br />
taṁ snēhaṁ daśamūlasya kaṣāyēṇa punaḥ pacēt| <br /><br />
jīvakarṣabhakāsphōtāvidārīkapikacchubhiḥ||125|| <br /><br />
<br />
vātaghnairjīvanīyaiśca kalkairdvikṣīrabhāgikam| <br /><br />
tatsiddhaṁ nāvanābhyaṅgāttathā pānānuvāsanāt||126|| <br /><br />
<br />
sirāparvāsthikōṣṭhasthaṁ praṇudatyāśu mārutam| <br /><br />
yē syuḥ prakṣīṇamajjānaḥ kṣīṇaśukraujasaśca yē||127|| <br /><br />
<br />
balapuṣṭikaraṁ tēṣāmētat syādamr̥tōpamam| <br /><br />
tadvatsiddhā vasā nakramatsyakūrmaculūkajā||128|| <br /><br />
<br />
pratyagrā vidhinā'nēna nasyapānēṣu śasyatē| <br /><br />
prasthaḥ syāttriphalāyāstu kulatthakuḍavadvayam||129|| <br /><br />
<br />
kr̥ṣṇagandhātvagāḍhakyōḥ pr̥thak pañcapalaṁ bhavēt| <br /><br />
rāsnācitrakayōrdvē dvē daśamūlaṁ palōnmitam||130|| <br /><br />
<br />
jaladrōṇē pacēt pādaśēṣē prasthōnmitaṁ pr̥thak| <br /><br />
surāranāladadhyamlasauvīrakatuṣōdakam||131|| <br /><br />
<br />
kōladāḍimavr̥kṣāmlarasaṁ tailaṁ vasāṁ ghr̥tam| <br /><br />
majjānaṁ ca payaścaiva jīvanīyapalāni ṣaṭ||132|| <br /><br />
<br />
kalkaṁ dattvā mahāsnēhaṁ samyagēnaṁ vipācayēt| <br /><br />
sirāmajjāsthigē vātē sarvāṅgaikāṅgarōgiṣu||133|| <br /><br />
<br />
vēpanākṣēpaśūlēṣu tadabhyaṅgē prayōjayēt| <br /><br />
nirguṇḍyā mūlapatrābhyāṁ gr̥hītvā svarasaṁ tataḥ||134|| <br /><br />
<br />
tēna siddhaṁ samaṁ tailaṁ nāḍīkuṣṭhānilārtiṣu| <br /><br />
hitaṁ pāmāpacīnāṁ ca pānābhyañjanapūraṇam||135|| <br /><br />
<br />
kārpāsāsthikulatthānāṁ rasē siddhaṁ ca vātanut|136| <br /><br />
</div></div><br />
<br />
Four ''pala'' (192 gm) of ''dashamoola'' should be decocted in one ''drone'' of water adding 64 ''tolas'' (768 gm) of barley, ''badara'' and horse gram. When it is reduced to one fourth quantity, prepare a medicated ghee in this decoction by taking 16 ''pala'' (768 gm) of ghee and adding milk, the paste of the ''jeevaniya'' drugs, sugar, dates, white teak, grape, ''badara'' and fig. This ghee is curative of disorders due to absolute ''vata''. This preparation is harmless and should be used for internal administration, external massage and enema. [119-121] <br />
<br />
Medicated ghee, prepared with the paste of ''chitraka'', dry-ginger, ''rasna, pushkara,'' long pepper and ''shathi'' is excellent to cure [[vata]]-disorders. [122]<br />
<br />
The supernatant part of ghee should be prepared with the milk boiled with ''sida'' and ''bilva''. Two or four ''tolas'' (48 gm) of this should be used as nasal medication in condition of morbid [[vata]] affecting the head. [123]<br />
<br />
The bones of the domestic, wet-land and aquatic animals should be broken into bits and cooked in water. The unctuous fluid obtained should again be cooked in the decoction of the ''dashamoola'', adding the paste of ''rishabhaka, sphota, vidari'' and ''kapikachchu'' and of [[vata]]-curative drugs or ''jeevaniya'' group of drugs and double the quantity of milk. By the use of this preparation as nasal medication, massage, internal administration and unctuous enema, the morbid [[vata]] affecting the vessels, joints, bones and in ''kushtha'' gets quickly cured. For those suffering from loss of marrow as well as those who suffer from loss of semen and vital essence, this imparts strength and robustness and acts like nectar. [124-127]<br />
<br />
The fresh fat of the alligator, fish, tortoise or the porpoise prepared similarly as described above is recommended as nasal medication and for internal administration. [128]<br />
<br />
Take 64 ''tolas'' (768 gm) of the ''triphala'', 32 ''tolas'' (384 gm) of horse gram, 20 ''tolas'' (240 gm) each of the bark of the ''krishnagandha'' and ''adhaki'', 8 ''tolas'' (96 gm) each of ''rasna, chitraka'' and four ''tolas'' (48 gm) of each of the ''dashamoola'' and decoct them in 1 ''drone'' (12.288 l) of water, reduced to one fourth of its quantity. Than add 64 ''tolas'' (768 gm) each of ''sura, aranala,'' sour curds, ''sauveeraka, tushodakam,'' the decoction of small ''badara,'' pomegranate, tamarind, butter, oil, fat, ghee, marrow, milk and 24 ''tolas'' (288gm) of the paste of the ''jeevaniya'' group of drugs, and prepare the ''mahasneha'' preparation in the due manner. [129-132]<br />
<br />
This should be used as inunction in morbid [[vata]] affecting the vessels. Marrow and bones as well as is conditions of tremors contractions and colic, and [[vata]] disorder affecting the entire body or only a part of the body. [133]<br />
<br />
The expressed juice of the root and leaves of ''nirgundi'' should be cooked with an equal quantity of oil. This oil can be used for internal administration, external massage and ear-fill; it is beneficial in sinuses or fistula -in -ano, dermatosis and other [[vata]] disorders as well as in scabies and scrofula. The oil prepared with the decoction of cotton seeds and horse gram is also curative of [[vata]]. [134-135]<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
मूलकस्वरसे क्षीरसमे स्थाप्यं त्र्यहं दधि||१३६||<br /><br />
<br />
तस्याम्लस्य त्रिभिः प्रस्थैस्तैलप्रस्थं विपाचयेत् | <br /><br />
यष्ट्याह्वशर्करारास्नालवणार्द्रकनागरैः ||१३७|| <br /><br />
<br />
सुपिष्टैः पलिकैः पानात्तदभ्यङ्गाच्च वातनुत् |१३८|<br /><br />
<div class="mw-collapsible-content"><br />
<br />
mUlakasvarase kShIrasame sthApyaM tryahaM dadhi ||136|| <br /><br />
<br />
tasyAmlasya tribhiH prasthaistailaprasthaM vipAcayet | <br /><br />
yaShTyAhvasharkarArāsnālavaNArdrakanAgaraiH ||137|| <br /><br />
<br />
supiShTaiH palikaiH pAnAttadabhya~ggAcca vātanut |138| <br /><br />
<br />
mūlakasvarasē kṣīrasamē sthāpyaṁ tryahaṁ dadhi||136|| <br /><br />
<br />
tasyāmlasya tribhiḥ prasthaistailaprasthaṁ vipācayēt| <br /><br />
yaṣṭyāhvaśarkarārāsnālavaṇārdrakanāgaraiḥ||137|| <br /><br />
<br />
supiṣṭaiḥ palikaiḥ pānāttadabhyaṅgācca vātanut|138| <br /><br />
</div></div><br />
<br />
Curds should be kept for three days in a mixture of equal measures of the expressed juice of radish and milk. Prepare medicated oil by taking 64 ''tolas'' (768 gm) of oil and triple the quantity of this sour preparation adding the paste of 4 ''tolas'' (48 gm) each of liquorice, sugar, ''rasna,'' rock salt and green ginger. This oil can be used for internal administration and external application as curative of [[vata]]. [136-137]<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
पञ्चमूलकषायेण पिण्याकं बहुवार्षिकम् ||१३८||<br /><br />
<br />
पक्त्वा तस्य रसं पूत्वा तैलप्रस्थं विपाचयेत् | <br /><br />
पयसाऽष्टगुणेनैतत् सर्ववातविकारनुत् ||१३९|| <br /><br />
<br />
संसृष्टे श्लेष्मणा चैतद्वाते शस्तं विशेषतः | <br /><br />
यवकोलकुलत्थानां श्रेयस्याः शुष्कमूलकात् ||१४०|| <br /><br />
<br />
बिल्वाच्चाञ्जलिमेकैकं द्रवैरम्लैर्विपाचयेत् | <br /><br />
तेन तैलं कषायेण फलाम्लैः कटुभिस्तथा ||१४१|| <br /><br />
<br />
पिष्टैः सिद्धं महावातैरार्तः शीते प्रयोजयेत् |१४२|<br /><br />
<div class="mw-collapsible-content"><br />
<br />
pa~jcamUlakaShAyeNa piNyAkaM bahuvArShikam ||138|| <br /><br />
<br />
paktvA tasya rasaM pUtvA [1] tailaprasthaM vipAcayet | <br /><br />
payasA~aShTaguNenaitat sarvavātavikAranut ||139|| <br /><br />
<br />
saMsRuShTe shleShmaNA caitadvAte shastaM visheShataH | <br /><br />
yavakōlakulatthAnAM shreyasyAH shuShkamUlakAt ||140|| <br /><br />
<br />
bilvAccA~jjalimekaikaM dravairamlairvipAcayet | <br /><br />
tena tailaM kaShAyeNa phalAmlaiH kaTubhistathA ||141|| <br /><br />
<br />
piShTaiH siddhaM mahAvātairArtaH shIte prayojayet |142| <br /><br />
<br />
pañcamūlakaṣāyēṇa piṇyākaṁ bahuvārṣikam||138|| <br /><br />
<br />
paktvā tasya rasaṁ pūtvā [1] tailaprasthaṁ vipācayēt| <br /><br />
payasā'ṣṭaguṇēnaitat sarvavātavikāranut||139|| <br /><br />
<br />
saṁsr̥ṣṭē ślēṣmaṇā caitadvātē śastaṁ viśēṣataḥ| <br /><br />
yavakōlakulatthānāṁ śrēyasyāḥ śuṣkamūlakāt||140|| <br /><br />
<br />
bilvāccāñjalimēkaikaṁ dravairamlairvipācayēt| <br /><br />
tēna tailaṁ kaṣāyēṇa phalāmlaiḥ kaṭubhistathā||141|| <br /><br />
<br />
piṣṭaiḥ siddhaṁ mahāvātairārtaḥ śītē prayōjayēt|142| <br /><br />
<br />
pañcamūlakaṣāyēṇa piṇyākaṁ bahuvārṣikam||138|| <br /><br />
<br />
paktvā tasya rasaṁ pūtvā [1] tailaprasthaṁ vipācayēt| <br /><br />
payasā'ṣṭaguṇēnaitat sarvavātavikāranut||139|| <br /><br />
<br />
saṁsr̥ṣṭē ślēṣmaṇā caitadvātē śastaṁ viśēṣataḥ| <br /><br />
yavakōlakulatthānāṁ śrēyasyāḥ śuṣkamūlakāt||140|| <br /><br />
<br />
bilvāccāñjalimēkaikaṁ dravairamlairvipācayēt| <br /><br />
tēna tailaṁ kaṣāyēṇa phalāmlaiḥ kaṭubhistathā||141|| <br /><br />
<br />
piṣṭaiḥ siddhaṁ mahāvātairārtaḥ śītē prayōjayēt|142| <br /><br />
</div></div><br />
<br />
Cook very old oil-cake in the decoction of dashamūla; strain the solution and prepare a medicated oil in this solution by taking 64 ''tolas'' (768 gm) of oil and eight times the quantity of milk. This oil is curative of all disorders of [[vata]]. This is specially recommended in conditions of [[vata]] associated with [[kapha]].[138-139]<br />
<br />
Take 16 ''tolas'' (192 gm) each of barley, ''kola'', horse gram, ''shreyasi,'' dry radish and ''bilva'' and cook them in a sour solution. The medicated oil prepared with this decoction along with sour fruit and the paste of pungent spices, should be used by the patient suffering from severe disorders of [[vata]], in the cold season. [140-141]<br />
<br />
==== ''Sahachara taila'' and ''baladi taila'' ====<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
सर्ववातविकाराणां तैलान्यन्यान्यतः शृणु ||१४२|| <br /><br />
<br />
चतुष्प्रयोगाण्यायुष्यबलवर्णकराणि च | <br /><br />
रजःशुक्रप्रदोषघ्नान्यपत्यजननानि च ||१४३|| <br /><br />
<br />
निरत्ययानि सिद्धानि सर्वदोषहराणि च | <br /><br />
सहाचरतुलायाश्च रसे तैलाढकं पचेत् ||१४४|| <br /><br />
<br />
मूलकल्काद्दशपलं पयो दत्त्वा चतुर्गुणम् | <br /><br />
सिद्धेऽस्मिञ्छर्कराचूर्णादष्टादशपलं भिषक् ||१४५|| <br /><br />
<br />
विनीय दारुणेष्वेतद्वातव्याधिषु योजयेत् | <br /><br />
श्वदंष्ट्रास्वरसप्रस्थौ द्वौ समौ पयसा सह ||१४६|| <br /><br />
<br />
षट्पलं शृङ्गवेरस्य गुडस्याष्टपलं तथा | <br /><br />
तैलप्रस्थं विपक्वं तैर्दद्यात् सर्वानिलार्तिषु ||१४७|| <br /><br />
<br />
जीर्णे तैले च दुग्धेन पेयाकल्पः प्रशस्यते | <br /><br />
बलाशतं गुडूच्याश्च पादं रास्नाष्टभागिकम् ||१४८|| <br /><br />
<br />
जलाढकशते पक्त्वा दशभागस्थिते रसे | <br /><br />
दधिमस्त्विक्षुनिर्यासशुक्तैस्तैलाढकं समैः ||१४९|| <br /><br />
<br />
पचेत् साजपयोऽर्धांशैः कल्कैरेभिः पलोन्मितैः | <br /><br />
शटीसरलदार्वेलामञ्जिष्ठागुरुचन्दनैः ||१५०|| <br /><br />
<br />
पद्मकातिविषामुस्तसूर्पपर्णीहरेणुभिः | <br /><br />
यष्ट्याह्वसुरसव्याघ्रनखर्षभकजीवकैः ||१५१|| <br /><br />
<br />
पलाशरसकस्तूरीनलिकाजातिकोषकैः | <br /><br />
स्पृक्काकुङ्कुमशैलेयजातीकटुफलाम्बुभिः ||१५२|| <br /><br />
<br />
त्वचाकुन्दुरुकर्पूरतुरुष्कश्रीनिवासकैः [१] | <br /><br />
लवङ्गनखकक्कोलकुष्ठमांसीप्रियङ्गुभिः ||१५३|| <br /><br />
<br />
स्थौणेयतगरध्यामवचामदनपल्लवैः | <br /><br />
सनागकेशरैः सिद्धे क्षिपेच्चात्रावतारिते ||१५४|| <br /><br />
<br />
पत्रकल्कं ततः पूतं विधिना तत् प्रयोजयेत् | <br /><br />
श्वासं कासं ज्वरं हिक्कां [२] छर्दिं गुल्मान् क्षतं क्षयम् ||१५५|| <br /><br />
<br />
प्लीहशोषावपस्मारमलक्ष्मीं च प्रणाशयेत् | <br /><br />
बलातैलमिदं श्रेष्ठं वातव्याधिविनाशनम् ||१५६|| <br /><br />
<br />
(अग्निवेशाय गुरुणा कृष्णात्रेयेण भाषितम्) | <br /><br />
इति बलातैलम् |<br /><br />
<div class="mw-collapsible-content"><br />
<br />
sarvavātavikArANAM tailAnyanyAnyataH shRuNu ||142|| <br /><br />
<br />
catuShprayogANyAyuShyabalavarNakarANi ca | <br /><br />
rajaHśukrapra dōṣaghnAnyapatyajananAni ca ||143|| <br /><br />
<br />
niratyayAni siddhAni sarva dōṣaharANi ca | <br /><br />
sahAcaratulAyAshca rase tailADhakaM pacet ||144|| <br /><br />
<br />
mUlakalkAddashapalaM payo dattvA caturguNam | <br /><br />
siddhe~asmi~jcharkarAcUrNAdaShTAdashapalaM bhiShak ||145|| <br /><br />
<br />
vinIya dAruNeShvetadVātavyādhiShu yojayet | <br /><br />
shvadaMShTrAsvarasaprasthau dvau samau payasA saha ||146|| <br /><br />
<br />
ShaTpalaM shRu~ggaverasya guDasyAShTapalaM tathA | <br /><br />
tailaprasthaM vipakvaM tairdadyAt sarvAnilArtiShu ||147|| <br /><br />
<br />
jIrNe taile ca dugdhena peyAkalpaH prashasyate | <br /><br />
balAshataM guDUcyAshca pAdaM rāsnāShTabhAgikam ||148|| <br /><br />
<br />
jalADhakashate paktvA dashabhAgasthite rase | <br /><br />
dadhimastvikShuniryAsashuktaistailADhakaM samaiH ||149|| <br /><br />
<br />
pacet sAjapayo~ardhAMshaiH kalkairebhiH palonmitaiH | <br /><br />
śaṭīsaraladArvelAma~jjiShThAgurucandanaiH ||150|| <br /><br />
<br />
padmakAtiviṣāmustasUrpaparNIhareNubhiH | <br /><br />
yaShTyAhvasurasavyAghranakharShabhakajIvakaiH ||151|| <br /><br />
<br />
palAsharasakastUrInalikAjAtikoShakaiH | <br /><br />
spRukkAku~gkumashaileyajAtIkaTuphalAmbubhiH ||152|| <br /><br />
<br />
tvacAkundurukarpUraturuShkashrInivAsakaiH [1] | <br /><br />
lava~gganakhakakkōlakuṣṭhamAMsIpriya~ggubhiH ||153|| <br /><br />
<br />
sthauNeyatagaradhyAmavacAmadanapallavaiH | <br /><br />
sanAgakesharaiH siddhe kShipeccAtrAvātarite ||154|| <br /><br />
<br />
patrakalkaM tataH pUtaM vidhinA tat prayojayet | <br /><br />
shvAsaM kAsaM jvaraM hikkAM [2] chardiM gulmAn kShataM kṣayam ||155|| <br /><br />
<br />
plIhashoShAvapasmAramalakShmIM ca prānāśayet | <br /><br />
balAtailamidaM shreShThaM Vātavyādhivināśanam ||156|| <br /><br />
<br />
(agniveshAya guruNA kRuShNAtreyeNa bhAShitam) | <br /><br />
iti balAtailam |<br /><br />
<br />
sarvavātavikārāṇāṁ tailānyanyānyataḥ śr̥ṇu||142|| <br /><br />
<br />
catuṣprayōgāṇyāyuṣyabalavarṇakarāṇi ca| <br /><br />
rajaḥśukrapradōṣaghnānyapatyajananāni ca||143|| <br /><br />
<br />
niratyayāni siddhāni sarvadōṣaharāṇi ca| <br /><br />
sahācaratulāyāśca rasē tailāḍhakaṁ pacēt||144|| <br /><br />
<br />
mūlakalkāddaśapalaṁ payō dattvā caturguṇam| <br /><br />
siddhē'smiñcharkarācūrṇādaṣṭādaśapalaṁ bhiṣak||145|| <br /><br />
<br />
vinīya dāruṇēṣvētadvātavyādhiṣu yōjayēt| <br /><br />
śvadaṁṣṭrāsvarasaprasthau dvau samau payasā saha||146|| <br /><br />
<br />
ṣaṭpalaṁ śr̥ṅgavērasya guḍasyāṣṭapalaṁ tathā| <br /><br />
tailaprasthaṁ vipakvaṁ tairdadyāt sarvānilārtiṣu||147|| <br /><br />
<br />
jīrṇē tailē ca dugdhēna pēyākalpaḥ praśasyatē| <br /><br />
balāśataṁ guḍūcyāśca pādaṁ rāsnāṣṭabhāgikam||148|| <br /><br />
<br />
jalāḍhakaśatē paktvā daśabhāgasthitē rasē| <br /><br />
dadhimastvikṣuniryāsaśuktaistailāḍhakaṁ samaiḥ||149|| <br /><br />
<br />
pacēt sājapayō'rdhāṁśaiḥ kalkairēbhiḥ palōnmitaiḥ| <br /><br />
śaṭīsaraladārvēlāmañjiṣṭhāgurucandanaiḥ||150|| <br /><br />
<br />
padmakātiviṣāmustasūrpaparṇīharēṇubhiḥ| <br /><br />
yaṣṭyāhvasurasavyāghranakharṣabhakajīvakaiḥ||151|| <br /><br />
<br />
palāśarasakastūrīnalikājātikōṣakaiḥ| <br /><br />
spr̥kkākuṅkumaśailēyajātīkaṭuphalāmbubhiḥ||152|| <br /><br />
<br />
tvacākundurukarpūraturuṣkaśrīnivāsakaiḥ [1] | <br /><br />
lavaṅganakhakakkōlakuṣṭhamāṁsīpriyaṅgubhiḥ||153|| <br /><br />
<br />
sthauṇēyatagaradhyāmavacāmadanapallavaiḥ| <br /><br />
sanāgakēśaraiḥ siddhē kṣipēccātrāvatāritē||154|| <br /><br />
<br />
patrakalkaṁ tataḥ pūtaṁ vidhinā tat prayōjayēt| <br /><br />
śvāsaṁ kāsaṁ jvaraṁ hikkāṁ [2] chardiṁ gulmān kṣataṁ kṣayam||155|| <br /><br />
<br />
plīhaśōṣāvapasmāramalakṣmīṁ ca praṇāśayēt| <br /><br />
balātailamidaṁ śrēṣṭhaṁ vātavyādhivināśanam||156|| <br /><br />
<br />
(agnivēśāya guruṇā kr̥ṣṇātrēyēṇa bhāṣitam)| <br /><br />
iti balātailam| <br /><br />
</div></div><br />
<br />
Listen now to the description of other preparations of oils for all types of diseases of [[vata]] that can be used in all the four therapeutic modes; that are promotive of longevity, strength and complexion; that are curative of menstrual and seminal disorders; which are inductive of progeny; and which are free from harmful effects and are generally curative of all kinds of morbidity. [142-143]<br />
<br />
Prepare medicated oil in 400 ''tolas'' (4.8 l) of the decoction of ''sahachara'', by using 256 ''tolas'' (3.072 liters) of oil and adding 40 ''tolas'' (480 gm) of the paste of radish and four times the quantity milk is added.The physician should use this oil mixed with 72 ''tolas'' (864 gm) of powdered sugar, in severe types of [[vata]] disorder. [144-145]<br />
<br />
Prepare medicated oil by taking 64 ''tolas'' (768 ml) of oil along with 128 ''tolas'' (1.536 liters) of the expressed juice of ''shvadamshthra'', equal quantity of milk, 24 ''tolas'' (288 gm) of dry ginger and 32 ''tolas'' (384 gm) of jaggery. This should be administered in all kinds of disorders of ''vata''. After the dose of oil has been digested the regimen of thin gruel along with milk is recommended. [146-147]<br />
<br />
Take 400 ''tolas'' (4.8 kg) of ''bala'', fourth part of ''guduchi'' and one eighth quantity of ''rasna'' and cook in 1 ''adhaka'' (307.2 l) of water till it is reduced to one tenth of the quantity. Prepare 256 ''tolas'' (3.072 l) of oil with this decoction adding equal quantities of whey, sugarcane juice and vinegar along with half the quantity of goat’s milk and the paste of four ''tolas'' (48 gm) of the leaves of each of the following drugs:- ''shathi, sarala, darvi, ela, manjishtha, agaru, chandana, padmaka, ativisha, musta, surpaparni, harenu, yashthimadhu, surasa, vyaghranakha, rshabhaka, jeevakaih,'' juice of ''palasha, kastūrī, nalika,'' buds of jasmine, ''sprrikka, kunkuma, shaileya, jati phala, kathuphala, ambu, tvak, kunduru, karpura, aturushka, shrinivasa, lavanga, nakha, kakkoli, kushtha, mamsi, priyangu, sthauneya, tagara, dhyama, vacha,'' leaves of ''madana'' and ''nagakesar''. This should then be strained and the paste of fragrant drugs are added to it and administered duly. This excellent ''bala'' oil is curative of [[vata]] disorders in general. It can be used in dyspnea, cough, fever, hiccup, vomiting, ''gulma'', pectoral lesions, cachexia, splenic disorders, emaciation, epilepsy and lack of lustre. [148-154]<br />
<br />
==== ''Amritadi tailam'' ====<br />
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<br />
अमृतायास्तुलाः पञ्च द्रोणेष्वष्टस्वपां पचेत् ||१५७|| <br /><br />
<br />
पादशेषे समक्षीरं तैलस्य द्व्याढकं पचेत् | <br /><br />
एलामांसीनतोशीरसारिवाकुष्ठचन्दनैः ||१५८|| <br /><br />
<br />
बलातामलकीमेदाशतपुष्पर्धिजीवकैः [१] | <br /><br />
काकोलीक्षीरकाकोलीश्रावण्यतिबलानखैः ||१५९|| <br /><br />
<br />
महाश्रावणिजीवन्तीविदारीकपिकच्छुभिः | <br /><br />
शतावरीमहामेदाकर्कटाख्याहरेणुभिः ||१६०|| <br /><br />
<br />
वचागोक्षुरकैरण्डरास्नाकालासहाचरैः | <br /><br />
वीराशल्लकिमुस्तत्वक्पत्रर्षभकबालकैः ||१६१|| <br /><br />
<br />
सहैलाकुङ्कुमस्पृक्कात्रिदशाह्वैश्च कार्षिकैः | <br /><br />
मञ्जिष्ठायास्त्रिकर्षेण मधुकाष्टपलेन च ||१६२|| <br /><br />
<br />
कल्कैस्तत् क्षीणवीर्याग्निबलसम्मूढचेतसः | <br /><br />
उन्मादारत्यपस्मारैरार्तांश्च प्रकृतिं नयेत् ||१६३|| <br /><br />
<br />
वातव्याधिहरं श्रेष्ठं तैलाग्र्यममृताह्वयम् | <br /><br />
(कृष्णात्रेयेण [२] गुरुणा भाषितं वैद्यपूजितम्) ||१६४|| <br /><br />
<br />
इत्यमृताद्यं तैलम् |<br /><br />
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<br />
amRutAyAstulAH pa~jca droNeShvaShTasvapAM pacet ||157|| <br /><br />
<br />
pAdasheShe samakShIraM tailasya dvyADhakaM pacet | <br /><br />
elAmAMsInatoshIrasArivAkuṣṭhacandanaiH ||158|| <br /><br />
<br />
balAtAmalakImedAshatapuShpardhijIvakaiH [1] | <br /><br />
kAkolIkShIrakAkolIshrAvaNyatibalAnakhaiH ||159|| <br /><br />
<br />
mahAshrAvaNijIvantIvidArIkapikacchubhiH | <br /><br />
shatAvarImahAmedAkarkaTAkhyAhareNubhiH ||160|| <br /><br />
<br />
vacAgokShurakairaNDarāsnākAlAsahAcaraiH | <br /><br />
vIrAshallakimustatvakpatrarShabhakabAlakaiH ||161|| <br /><br />
<br />
sahailAku~gkumaspRukkAtridashAhvaishca kArShikaiH | <br /><br />
ma~jjiShThAyAstrikarSheNa madhukAShTapalena ca ||162|| <br /><br />
<br />
kalkaistat kShINavIryAgnibalasammUDhacetasaH | <br /><br />
unmAdAratyapasmArairArtAMshca prakRutiM nayet ||163|| <br /><br />
<br />
VātavyādhiharaM shreShThaM tailAgryamamRutAhvayam | <br /><br />
(kRuShNAtreyeNa [2] guruNA bhAShitaM vaidyapUjitam) ||164|| <br /><br />
<br />
ityamRutAdyaM tailam | <br /><br />
<br />
amr̥tāyāstulāḥ pañca drōṇēṣvaṣṭasvapāṁ pacēt||157|| <br /><br />
<br />
pādaśēṣē samakṣīraṁ tailasya dvyāḍhakaṁ pacēt| <br /><br />
ēlāmāṁsīnatōśīrasārivākuṣṭhacandanaiḥ||158|| <br /><br />
<br />
balātāmalakīmēdāśatapuṣpardhijīvakaiḥ [1] | <br /><br />
kākōlīkṣīrakākōlīśrāvaṇyatibalānakhaiḥ||159|| <br /><br />
<br />
mahāśrāvaṇijīvantīvidārīkapikacchubhiḥ| <br /><br />
śatāvarīmahāmēdākarkaṭākhyāharēṇubhiḥ||160|| <br /><br />
<br />
vacāgōkṣurakairaṇḍarāsnākālāsahācaraiḥ| <br /><br />
vīrāśallakimustatvakpatrarṣabhakabālakaiḥ||161|| <br /><br />
<br />
sahailākuṅkumaspr̥kkātridaśāhvaiśca kārṣikaiḥ| <br /><br />
mañjiṣṭhāyāstrikarṣēṇa madhukāṣṭapalēna ca||162|| <br /><br />
<br />
kalkaistat kṣīṇavīryāgnibalasammūḍhacētasaḥ| <br /><br />
unmādāratyapasmārairārtāṁśca prakr̥tiṁ nayēt||163|| <br /><br />
<br />
vātavyādhiharaṁ śrēṣṭhaṁ tailāgryamamr̥tāhvayam| <br /><br />
(kr̥ṣṇātrēyēṇa [2] guruṇā bhāṣitaṁ vaidyapūjitam)||164|| <br /><br />
<br />
ityamr̥tādyaṁ tailam <br /><br />
</div></div><br />
<br />
Prepare decoction of 2000 ''tolas'' (24 kg) of ''guduchi'' in 5 ''drone'' (98.304 l) of water by reducing to ¼th its quantity. Later add 512 ''tolas'' (60144 l) of sesame oil and equal quantity of milk in this decoction, along with paste of 1 ''tola'' (12 gm) each of cardamom, ''ela, mamsi, nata, ushira, sariva, kushtha, chandana, bala, tamalaki, meda, shatapushpa, riddhi, jeevaka, kakoli, ksheerakakoli, shravani, atibala, nakha, mahashravani, jeevanti,vidari, kapikacchu, shatavari, mahameda, karkata, harenu, vacha, gokshura, eranda, rasna, kala, sahachara, bala, veera, shallaki, musta, tvak, patra, rishabhaka, balaka, ela, kunkuma, sprikka'' and three ''tolas'' (36 gm) of manjishtha and 32 ''tolas'' (384 gm) of ''yashtimadhu''. It restores the health of those affected with reduced semen, digestive power and vitality. Normalizes individuals with insanity and epilepsy and is excellent to cure [[vata]] disorder. This is the ''amritadya taila'' propounded by preceptor ''krishnatreya'' who was respected by reverent physicians. [157- 164]<br />
<br />
==== ''Rasna taila'' ====<br />
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<br />
रास्नासहस्रनिर्यूहे तैलद्रोणं विपाचयेत् | <br /><br />
गन्धैर्हैमवतैः पिष्टैरेलाद्यैश्चानिलार्तिनुत् ||१६५|| <br /><br />
<br />
कल्पोऽयमश्वगन्धायां प्रसारण्यां बलाद्वये | <br /><br />
क्वाथकल्कपयोभिर्वा बलादीनां पचेत् पृथक् ||१६६|| <br /><br />
<br />
इति रास्नातैलम् | <br /><br />
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<br />
rāsnāsahasraniryUhe tailadroNaM vipAcayet | <br /><br />
gandhairhaimavātaiH piShTairelAdyaishcAnilArtinut ||165|| <br /><br />
<br />
kalpo~ayamashvagandhAyAM prasAraNyAM balAdvaye | <br /><br />
kvAthakalkapayobhirvA balAdInAM pacet pRuthak ||166|| <br /><br />
<br />
iti rāsnātailam | <br /><br />
<br />
rāsnāsahasraniryūhē tailadrōṇaṁ vipācayēt| <br /><br />
gandhairhaimavātaiḥ piṣṭairēlādyaiścānilārtinut||165|| <br /><br />
<br />
kalpō'yamaśvagandhāyāṁ prasāraṇyāṁ balādvayē| <br /><br />
kvāthakalkapayōbhirvā balādīnāṁ pacēt pr̥thak||166|| <br /><br />
<br />
iti rāsnātailam <br /><br />
</div></div><br />
<br />
The medicated oil is prepared by taking 1024 ''tolas'' (12.288 l) of oil and cooking it in 4000 ''tolas'' (48 l) of the decoction of ''rasna'' along with the paste of the fragrant groups of drugs grown in the Himalayas, as well as the cardamom group of drugs. This oil is curative of [[vata]]. A similar preparation of ''ashvagandha'' and ''prasarani'' and the two varieties of ''sida'' or the medicated oil of ''sida'' and other drugs may be prepared using these drugs individually in the form of decoction, paste or milk.<br />
<br />
Thus, ''rasna taila'' has been explained. [165–166]<br />
<br />
==== ''Mulakadya taila'' and ''vrishmuladi taila'' ====<br />
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<br />
मूलकस्वरसं क्षीरं तैलं दध्यम्लकाञ्जिकम् | <br /><br />
तुल्यं विपाचयेत् कल्कैर्बलाचित्रकसैन्धवैः ||१६७|| <br /><br />
<br />
पिप्पल्यतिविषारास्नाचविकागुरुशिग्रुकैः | <br /><br />
भल्लातकवचाकुष्ठश्वदंष्ट्राविश्वभेषजैः ||१६८|| <br /><br />
<br />
पुष्कराह्वशटीबिल्वशताह्वानतदारुभिः | <br /><br />
तत्सिद्धं पीतमत्युग्रान् हन्ति वातात्मकान् गदान् ||१६९|| <br /><br />
<br />
इति मूलकाद्यं तैलम् | <br /><br />
<br />
वृषमूलगुडूच्योश्च द्विशतस्य शतस्य च | <br /><br />
चित्रकात् साश्वगन्धाच्च क्वाथे तैलाढकं पचेत् ||१७०|| <br /><br />
<br />
सक्षीरं वायुना भग्ने दद्याज्जर्जरिते तथा | <br /><br />
प्राक्तैलावापसिद्धं च भवेदेतद्गुणोत्तरम् ||१७१|| <br /><br />
<br />
इति वृषमूलादितैलम् |<br /><br />
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<br />
mUlakasvarasaM kShIraM tailaM dadhyamlakA~jjikam | <br /><br />
tulyaM vipAcayet kalkairbalAcitrakasaindhavaiH ||167|| <br /><br />
<br />
pippalyativiṣārāsnācavikAgurushigrukaiH | <br /><br />
bhallAtakavacAkuṣṭhashvadaMShTrAvishvabheShajaiH ||168|| <br /><br />
<br />
puShkarAhvaśaṭībilvashatAhvAnatadArubhiH | <br /><br />
tatsiddhaM pItamatyugrAn hanti vātatmakAn gadAn ||169|| <br /><br />
<br />
iti mUlakAdyaM tailam | <br /><br />
<br />
vRuShamUlaguDUcyoshca dvishatasya shatasya ca | <br /><br />
citrakAt sAshvagandhAcca kvAthe tailADhakaM pacet ||170|| <br /><br />
<br />
sakShIraM Vāyu nA bhagne dadyAjjarjarite tathA | <br /><br />
prAktailAvApasiddhaM ca bhavedetadguNottaram ||171|| <br /><br />
<br />
iti vRuShamUlAditailam | <br /><br />
<br />
mūlakasvarasaṁ kṣīraṁ tailaṁ dadhyamlakāñjikam| <br /><br />
tulyaṁ vipācayēt kalkairbalācitrakasaindhavaiḥ||167|| <br /><br />
<br />
pippalyativiṣārāsnācavikāguruśigrukaiḥ| <br /><br />
bhallātakavacākuṣṭhaśvadaṁṣṭrāviśvabhēṣajaiḥ||168|| <br /><br />
<br />
puṣkarāhvaśaṭībilvaśatāhvānatadārubhiḥ| <br /><br />
tatsiddhaṁ pītamatyugrān hanti vātātmakān gadān||169|| <br /><br />
<br />
iti mūlakādyaṁ tailam| <br /><br />
<br />
vr̥ṣamūlaguḍūcyōśca dviśatasya śatasya ca| <br /><br />
citrakāt sāśvagandhācca kvāthē tailāḍhakaṁ pacēt||170|| <br /><br />
<br />
sakṣīraṁ vāyunā bhagnē dadyājjarjaritē tathā| <br /><br />
prāktailāvāpasiddhaṁ ca bhavēdētadguṇōttaram||171|| <br /><br />
<br />
iti vr̥ṣamūlāditailam| <br /><br />
</div></div><br />
<br />
Medicated oil is prepared by taking 64 ''tolas'' (768 gm) of oil and cooking it in equal quantities of radish juice, milk, sour curds, and sour ''kanji'', the paste of ''sida, chitraka,'' rock salt, ''pippali, ativisha, rasna, chavika, agaru, shigru, bhallataka, vacha, kushtha, shvadamishtra, vishvabheshaja, pushkara, shati, bilwa, shatahva, nata,'' and ''devadaru''. This ''mulakadya taila'', when taken internally, cures even very severe types of ''vata'' disorders. [167-169]<br />
<br />
256 ''tolas'' (3.072 l) of sesame oil are cooked in 800 ''tolas'' (9.6 l) of the decoction of ''vrisha'' roots and guduchi, and 400 ''tolas'' (4.8 l) of the decoction of ''chitraka, ashvagandha'' and milk. This medicated oil should be prescribed in fractured or serious conditions of bone due to ''vata''. It becomes exceedingly effective if prepared with the paste mentioned in earlier oils. [170-171]<br />
<br />
==== ''Mulaka taila'' ====<br />
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<br />
रास्नाशिरीषयष्ट्याह्वशुण्ठीसहचरामृताः ||१७२|| <br /><br />
<br />
स्योनाकदारुशम्पाकहयगन्धात्रिकण्टकाः | <br /><br />
एषां दशपलान् भागान् कषायमुपकल्पयेत् ||१७३||<br /><br />
<br />
ततस्तेन कषायेण सर्वगन्धैश्च कार्षिकैः | <br /><br />
दध्यारनालमाषाम्बुमूलकेक्षुरसैः [१] शुभैः ||१७४||<br /><br />
<br />
पृथक् प्रस्थोन्मितैः सार्धं तैलप्रस्थं विपाचयेत् | <br /><br />
प्लीहमूत्रग्रहश्वासकासमारुतरोगनुत् [२] ||१७५|| <br /><br />
<br />
एतन्मूलकतैलाख्यं [३] वर्णायुर्बलवर्धनम् | <br /><br />
इति मूलकतैलम् | <br /><br />
<br />
यवकोलकुलत्थानां मत्स्यानां शिग्रुबिल्वयोः | <br /><br />
रसेन मूलकानां च तैलं दधिपयोन्वितम् ||१७६|| <br /><br />
<br />
साधयित्वा भिषग्दद्यात् सर्ववातामयापहम् | <br /><br />
लशुनस्वरसे सिद्धं तैलमेभिश्च वातनुत् ||१७७|| <br /><br />
<br />
तैलान्येतान्यृतुस्नातामङ्गनां पाययेत च | <br /><br />
पीत्वाऽन्यतममेषां हि वन्ध्याऽपि जनयेत् सुतम् ||१७८|| <br /><br />
<br />
यच्च शीतज्वरे तैलमगुर्वाद्यमुदाहृतम् | <br /><br />
अनेकशतशस्तच्च सिद्धं स्याद्वातरोगनुत् ||१७९|| <br /><br />
<br />
वक्ष्यन्ते यानि तैलानि वातशोणितकेऽपि च | <br /><br />
तानि चानिलशान्त्यर्थं सिद्धिकामः प्रयोजयेत् ||१८०|| <br /><br />
<br />
नास्ति तैलात् परं किञ्चिदौषधं मारुतापहम् | <br /><br />
व्यवाय्युष्णगुरुस्नेहात् संस्काराद्वलवत्तरम् ||१८१||<br /><br />
<br />
गणैर्वातहरैस्तस्माच्छतशोऽथं सहस्रशः | <br /><br />
सिद्धं क्षिप्रतरं हन्ति सूक्ष्ममार्गस्थितान् गदान् ||१८२||<br /><br />
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<br />
rāsnāshirIShayaShTyAhvashuNThIsahacarAmRutAH ||172|| <br /><br />
<br />
syonAkadArushampAkahayagandhAtrikaNTakAH | <br /><br />
eShAM dashapalAn bhAgAn kaShAyamupakalpayet ||173|| <br /><br />
<br />
tatastena kaShAyeNa sarvagandhaishca kArShikaiH | <br /><br />
dadhyAranAlamAShAmbumUlakekShurasaiH [1] shubhaiH ||174|| <br /><br />
<br />
pRuthak prasthonmitaiH sArdhaM tailaprasthaM vipAcayet | <br /><br />
plIhamūtragrahashvAsakAsamArutarōganut [2] ||175|| <br /><br />
<br />
etanmUlakatailAkhyaM [3] varNAyurbalavardhanam | <br /><br />
iti mUlakatailam | <br /><br />
<br />
yavakōlakulatthAnAM matsyAnAM shigrubilvayoH | <br /><br />
rasena mUlakAnAM ca tailaM dadhipayonvitam ||176|| <br /><br />
<br />
sAdhayitvA bhiShagdadyAt sarvavātamayApaham | <br /><br />
lashunasvarase siddhaM tailamebhishca vātanut ||177|| <br /><br />
<br />
tailAnyetAnyRutuṣṇā tAma~gganAM pAyayeta ca | <br /><br />
pItvA~anyatamameShAM hi vandhyA~api janayet sutam ||178|| <br /><br />
<br />
yacca shItajvare tailamagurvAdyamudAhRutam | <br /><br />
anekashatashastacca siddhaM syAdvātarōganut ||179|| <br /><br />
<br />
vakShyante yAni tailAni vātashoNitake~api ca | <br /><br />
tAni cAnilashAntyarthaM siddhikAmaH prayojayet ||180|| <br /><br />
<br />
nAsti tailAt paraM ki~jcidauShadhaM mArutApaham | <br /><br />
vyavAyyuShNaguruSnēhat saMskArAdvalavattaram ||181|| <br /><br />
<br />
gaNairvātaharaistasmAcchatasho~athaM sahasrashaH | <br /><br />
siddhaM kShiprataraM hanti sUkShmamArgasthitAn gadAn ||182|| <br /><br />
<br />
rāsnāśirīṣayaṣṭyāhvaśuṇṭhīsahacarāmr̥tāḥ||172|| <br /><br />
<br />
syōnākadāruśampākahayagandhātrikaṇṭakāḥ| <br /><br />
ēṣāṁ daśapalān bhāgān kaṣāyamupakalpayēt||173|| <br /><br />
<br />
tatastēna kaṣāyēṇa sarvagandhaiśca kārṣikaiḥ| <br /><br />
dadhyāranālamāṣāmbumūlakēkṣurasaiḥ [1] śubhaiḥ||174|| <br /><br />
<br />
pr̥thak prasthōnmitaiḥ sārdhaṁ tailaprasthaṁ vipācayēt| <br /><br />
plīhamūtragrahaśvāsakāsamārutarōganut [2] ||175|| <br /><br />
<br />
ētanmūlakatailākhyaṁ [3] varṇāyurbalavardhanamiti <br />
mūlakatailamyavakōlakulatthānāṁ matsyānāṁśigrubilvayōḥ| <br /><br />
rasēna mūlakānāṁ ca tailaṁ dadhipayōnvitam||176|| <br /><br />
<br />
sādhayitvā bhiṣagdadyāt sarvavātāmayāpaham| <br /><br />
laśunasvarasē siddhaṁ tailamēbhiśca vātanut||177|| <br /><br />
<br />
tailānyētānyr̥tusnātāmaṅganāṁ pāyayēta ca| <br /><br />
pītvā'nyatamamēṣāṁ hi vandhyā'pi janayēt sutam||178|| <br /><br />
<br />
yacca śītajvarē tailamagurvādyamudāhr̥tam| <br /><br />
anēkaśataśastacca siddhaṁ syādvātarōganut||179|| <br /><br />
<br />
vakṣyantē yāni tailāni vātaśōṇitakē'pi ca| <br /><br />
tāni cānilaśāntyarthaṁ siddhikāmaḥ prayōjayēt||180|| <br /><br />
<br />
nāsti tailāt paraṁ kiñcidauṣadhaṁ mārutāpaham| <br /><br />
vyavāyyuṣṇagurusnēhāt saṁskārādvalavattaram||181|| <br /><br />
<br />
gaṇairvātaharaistasmācchataśō'tha sahasraśaḥ| <br /><br />
siddhaṁ kṣiprataraṁ hanti sūkṣmamārgasthitān gadān||182|| <br /><br />
</div></div><br />
<br />
Prepare a decoction by taking 40 ''tolas'' (48 gm) of each of ''rasna, shirisha,'' liquorice, dry ginger, ''sahachara, guduchi, syonaka, devadaru, shampaka, ashvagandha'' and ''gokshura''. Then oil is prepared by taking 64 ''tolas'' (768 ml) of sesame oil and cooking it in the above said decoction along with 64 ''tolas'' (768 ml) each of curds, ''aranala'', decoction of black gram, juices of good quality of radish, and sugar cane, adding one ''tola'' (12 gm) of the paste of each of the ''gandhavarga'' drugs. <br />
This ''mūlaka'' oil is curative of splenic disorders, retention of urine, dyspnoea, cough and other [[vata]] disorders. It is also promotive of complexion, life and vitality. Thus ''mūlaka taila'' is explained. [172-173]<br />
<br />
Medicated oil is prepared by taking sesame oil and cooking it in the decoction of barley, ''kola'', horse gram, fish, drumstick, ''bael'', radish, curds and milk. This is curative of all [[vata]] disorders. The medicated oil prepared in the expressed juice of garlic and the drugs mentioned above, is curative of [[vata roga]]. These different oils may be given as potion to a woman who has just taken her purificatory bath on the cessation of menses. By taking any of this medicated oil as ''pana'', even a sterile woman will become fertile. <br />
<br />
The ''agurvadya'' oil, which has been described in the treatment of ''shita jwara'', if processed again many hundred times, becomes curative of [[vata]] disorders. And the medicated oils, which will be described in the therapeutics of rheumatic conditions, may be prescribed for the alleviation of vāta disorders, by the physician desirous of success in treatment. [176-180]<br />
<br />
There exists no medication superior to oil as a remedy for [[vata]], due to its quality of extreme spreadability, hot in potency, heaviness, unctuousness and by virtue of becoming more powerful on being medicated with the [[vata]] curative group of drugs. <br />
<br />
Being also capable of further intensification of potency, by being processed again for hundreds or thousands of times, ''taila'' very quickly cures the diseases which are located into even the minutest part of the body. [181-182]<br />
<br />
=== Management of avrita [[vata]] conditions ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
क्रिया साधारणी सर्वा संसृष्टे चापि शस्यते | <br /><br />
वाते पित्तादिभिः स्रोतःस्वावृतेषु विशेषतः ||१८३|| <br /><br />
<br />
पित्तावृते विशेषेण शीतामुष्णां तथा क्रियाम् | <br /><br />
व्यत्यासात् कारयेत् सर्पिर्जीवनीयं च शस्यते ||१८४|| <br /><br />
<br />
धन्वमांसं यवाः शालिर्यापनाः क्षीरबस्तयः | <br /><br />
विरेकः क्षीरपानं च पञ्चमूलीबलाशृतम् ||१८५|| <br /><br />
<br />
मधुयष्टिबलातैलघृतक्षीरैश्च सेचनम् | <br /><br />
पञ्चमूलकषायेण कुर्याद्वा शीतवारिणा ||१८६|| <br /><br />
<br />
कफावृते यवान्नानि जाङ्गला मृगपक्षिणः | <br /><br />
स्वेदास्तीक्ष्णा निरूहाश्च वमनं सविरेचनम् ||१८७|| <br /><br />
<br />
जीर्णं सर्पिस्तथा तैलं तिलसर्षपजं हितम् | <br /><br />
संसृष्टे कफपित्ताभ्यां पित्तमादौ विनिर्जयेत् ||१८८||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
kriyA sAdhAraNI sarvA saMsRuShTe cApi shasyate | <br /><br />
vAte pittAdibhiH srotaHsvAvRuteShu visheShataH ||183|| <br /><br />
<br />
pittAvRute visheSheNa shItAmuShNAM tathA kriyAm | <br /><br />
vyatyAsAt kArayet sarpirjIvanIyaM ca shasyate ||184|| <br /><br />
<br />
dhanvamāṁsaM yavAH shAlirYāpana H kShIrabastayaH | <br /><br />
virekaH kShIrapāna M ca pa~jcamUlIbalAshRutam ||185|| <br /><br />
<br />
madhuyaShTibalAtailaghRutakShIraishca secanam | <br /><br />
pa~jcamUlakaShAyeNa kuryAdvA shItavAriNA ||186|| <br /><br />
<br />
kaphAvRute yavAnnAni jA~ggalA mRugapakShiNaH | <br /><br />
svedAstIkShNA nirUhAshca vamanaM savirēcanam ||187|| <br /><br />
<br />
jIrNaM sarpistathA tailaM tilasarShapajaM hitam | <br /><br />
saMsRuShTe kaphapittAbhyAM pittamAdau vinirjayet ||188|| <br /><br />
<br />
kriyā sādhāraṇī sarvā saṁsr̥ṣṭē cāpi śasyatē|<br /><br />
vātē pittādibhiḥ srōtaḥsvāvr̥tēṣu viśēṣataḥ||183|| <br /><br />
<br />
pittāvr̥tē viśēṣēṇa śītāmuṣṇāṁ tathā kriyām| <br /><br />
vyatyāsāt kārayēt sarpirjīvanīyaṁ ca śasyatē||184|| <br /><br />
<br />
dhanvamāṁsaṁ yavāḥ śāliryāpanāḥ kṣīrabastayaḥ| <br /><br />
virēkaḥ kṣīrapānaṁ ca pañcamūlībalāśr̥tam||185|| <br /><br />
<br />
madhuyaṣṭibalātailaghr̥takṣīraiśca sēcanam| <br /><br />
pañcamūlakaṣāyēṇa kuryādvā śītavāriṇā||186|| <br /><br />
<br />
kaphāvr̥tē yavānnāni jāṅgalā mr̥gapakṣiṇaḥ| <br /><br />
svēdāstīkṣṇā nirūhāśca vamanaṁ savirēcanam||187|| <br /><br />
<br />
jīrṇaṁ sarpistathā tailaṁ tilasarṣapajaṁ hitam| <br /><br />
saṁsr̥ṣṭē kaphapittābhyāṁ pittamādau vinirjayēt||188|| <br /><br />
</div></div><br />
<br />
This general line of treatment is also recommended in conditions of association with morbidity of other humors, but especially when the body channels have been occluded by [[pitta]] and [[kapha]] in [[vata]] disorders. [183]<br />
<br />
==== Management of [[pitta]]vrita [[vata]] ====<br />
<br />
In condition of occlusion of [[pitta]], the physician should administer cold and hot lins of treatment in alternation. Here, ghee prepared of ''jeevaniya gana'' is recommended.<br />
<br />
Diet which contains flesh of ''jaṇgala'' animals, barley and ''shali'' rice, ''yapana'' enema, milk enema, purgation, drinking of milk, decoction of ''panchamula'' and ''sida'' is also beneficial.[184-185]<br />
<br />
The patient should be given ''dharā'' with medicated oil or ghee or milk prepared with liquorice and ''sida'', or with the decoction of ''panchamūla'' or with cold water. [186]<br />
<br />
In conditions of occlusion by [[kapha]] articles made of barley, the flesh of animals and birds of ''jangala'' area as diet is effective along with strong sudation, evacuative enema and emesis and purgation. Old ghee, sesame oil and mustard oil are also beneficial. [187-187 ½]<br />
<br />
In the condition of occlusion by both [[kapha]] and [[pitta]], [[pitta]] must be subdued first. [188]<br />
<br />
=== Management of various condition of [[vata]] located in other sites ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
आमाशयगतं मत्वा कफं वमनमाचरेत् ||१८९|| <br /><br />
<br />
पक्वाशये विरेकं तु पित्ते सर्वत्रगे तथा | <br /><br />
स्वेदैर्विष्यन्दितः श्लेष्मा यदा पक्वाशये स्थितः ||१९०|| <br /><br />
<br />
पित्तं वा दर्शयेल्लिङ्गं बस्तिभिस्तौ विनिर्हरेत् | <br /><br />
श्लेष्मणाऽनुगतं वातमुष्णैर्गोमूत्रसंयुतैः ||१९१|| <br /><br />
<br />
निरूहैः पित्तसंसृष्टं निर्हरेत् क्षीरसंयुतैः | <br /><br />
मधुरौषधसिद्धैश्च तैलैस्तमनुवासयेत् ||१९२|| <br /><br />
<br />
शिरोगते तु सकफे धूमनस्यादि कारयेत् | <br /><br />
हृते पित्ते कफे यः स्यादुरःस्रोतोऽनुगोऽनिलः ||१९३|| <br /><br />
<br />
सशेषः स्यात् क्रिया तत्र कार्या केवलवातिकी | <br /><br />
शोणितेनावृते कुर्याद्वातशोणितकीं क्रियाम् ||१९४|| <br /><br />
<br />
प्रमेहवातमेदोघ्नीमामवाते [३] प्रयोजयेत् | <br /><br />
स्वेदाभ्यङ्गरसक्षीरस्नेहा मांसावृते हिताः ||१९५|| <br /><br />
<br />
महास्नेहोऽस्थिमज्जस्थे पूर्ववद्रेतसाऽऽवृते | <br /><br />
अन्नावृते तदुल्लेखः [४] पाचनं दीपनं लघु ||१९६|| <br /><br />
<br />
मूत्रलानि तु मूत्रेण स्वेदाः सोत्तरबस्तयः | <br /><br />
शकृता तैलमैरण्डं स्निग्धोदावर्तवत्क्रिया [५] ||१९७|| <br /><br />
<br />
स्वस्थानस्थो बली दोषः प्राक् तं स्वैरौषधैर्जयेत् | <br /><br />
वमनैर्वा विरेकैर्वा बस्तिभिः शमनेन वा ||१९८|| <br /><br />
<br />
(इत्युक्तमावृते वाते पित्तादिभिर्यथायथम् [६] ) |१९९|<br /><br />
<div class="mw-collapsible-content"><br />
<br />
ĀmashayagataM matvA [1] kaphaM vamanamAcaret ||189|| <br /><br />
<br />
pakvAshaye virekaM tu pitte sarvatrage tathA | <br /><br />
svedairviShyanditaH shleShmA yadA pakvAshaye sthitaH ||190|| <br /><br />
<br />
pittaM vA darshayelli~ggaM bastibhistau vinirharet | <br /><br />
shleShmaNA~anugataM vātamuShNairgomūtrasaMyutaiH ||191|| <br /><br />
<br />
nirUhaiH pittasaMsRuShTaM nirharet kShIrasaMyutaiH | <br /><br />
madhurauShadhasiddhaishca tailaistamanuvAsayet ||192|| <br /><br />
<br />
shirōgate tu sakaphe dhUmanasyAdi kArayet | <br /><br />
hRute pitte kaphe yaH syAduraHsroto~anugo~anilaH ||193|| <br /><br />
<br />
sasheShaH [2] syAt kriyA tatra kAryA kevalavAtikI | <br /><br />
shoNitenAvRute kuryAdvātashoNitakIM kriyAm ||194|| <br /><br />
<br />
pramehavātamedoghnImAmavAte [3] prayojayet | <br /><br />
svedAbhya~ggarasakShIraSnēha māṁsavRute hitAH ||195|| <br /><br />
<br />
mahAsneho~asthimajjasthe pUrvavadretasA~a~avRute | <br /><br />
annAvRute tadullekhaH [4] pācanaM dIpanaM laghu ||196|| <br /><br />
<br />
mūtralAni tu mUtreNa svedAH sottarabastayaH | <br /><br />
shakRutA tailamairaNDaM snigdhodAvartavatkriyA [5] ||197|| <br /><br />
<br />
svasthānastho balI dōṣaH prAk taM svairauShadhairjayet | <br /><br />
vamanairvA virekairvA bastibhiH shamanena vA ||198|| <br /><br />
<br />
(ityuktamAvRute vAte pittAdibhiryathAyatham [6] ) |199| <br /><br />
<br />
āmāśayagataṁ matvā [1] kaphaṁ vamanamācarēt||189|| <br /><br />
<br />
pakvāśayē virēkaṁ tu pittē sarvatragē tathā| <br /><br />
svēdairviṣyanditaḥ ślēṣmā yadā pakvāśayē sthitaḥ||190|| <br /><br />
<br />
pittaṁ vā darśayēlliṅgaṁ bastibhistau vinirharēt| <br /><br />
ślēṣmaṇā'nugataṁ vātamuṣṇairgōmūtrasaṁyutaiḥ||191|| <br /><br />
<br />
nirūhaiḥ pittasaṁsr̥ṣṭaṁ nirharēt kṣīrasaṁyutaiḥ| <br /><br />
madhurauṣadhasiddhaiśca tailaistamanuvāsayēt||192|| <br /><br />
<br />
śirōgatē tu sakaphē dhūmanasyādi kārayēt| <br /><br />
hr̥tē pittē kaphē yaḥ syāduraḥsrōtō'nugō'nilaḥ||193|| <br /><br />
<br />
saśēṣaḥ [2] syāt kriyā tatra kāryā kēvalavātikī| <br /><br />
śōṇitēnāvr̥tē kuryādvātaśōṇitakīṁ kriyām||194|| <br /><br />
<br />
pramēhavātamēdōghnīmāmavātē [3] prayōjayēt| <br /><br />
svēdābhyaṅgarasakṣīrasnēhā māṁsāvr̥tē hitāḥ||195|| <br /><br />
<br />
mahāsnēhō'sthimajjasthē pūrvavadrētasā''vr̥tē| <br /><br />
annāvr̥tē tadullēkhaḥ [4] pācanaṁ dīpanaṁ laghu||196|| <br /><br />
<br />
mūtralāni tu mūtrēṇa svēdāḥ sōttarabastayaḥ| <br /><br />
śakr̥tā tailamairaṇḍaṁ snigdhōdāvartavatkriyā [5] ||197|| <br /><br />
<br />
svasthānasthō balī dōṣaḥ prāk taṁ svairauṣadhairjayēt| <br /><br />
vamanairvā virēkairvā bastibhiḥ śamanēna vā||198|| <br /><br />
<br />
(ityuktamāvr̥tē vātē pittādibhiryathāyatham [6] )|199| <br /><br />
</div></div><br />
<br />
On finding that [[kapha]] is located in the stomach (''amashaya''), emesis should be given and if it is located in the colon (''pakvashaya''), the treatment of choice is purgation. If [[pitta]] has pervaded all over the body, again the same (purgation) should be given. [189-189 ½]<br />
<br />
As [[kapha]] or [[pitta]] gets liquefied by sudation, and gets accumulated in the colon and the symptoms of ''pitta'' manifest, both of these should be eliminated by the use of enema. [190-190 ½]<br />
<br />
If [[vata]] is associated with [[kapha]], it should be eliminated by warm evacuative enema mixed with cow’s urine. If [[vata]] is associated with [[pitta]], it should be eliminated by evacuative enema mixed with milk. Then the patient should be given unctuous enema prepared with the ''madhura rasa'' group of drugs. [191-192]<br />
<br />
In condition of [[vata]] located in the head and associated with [[kapha]], inhalation and nasal medication should be given. [192 ½]<br />
<br />
If after the elimination of [[pitta]] and [[kapha]], there remains a residual morbidity of [[vata]] in the channels of the chest region, the treatment indicated in absolute [[vata]] should be given. [193- 193 ½]<br />
<br />
If [[vata]] is occluded by blood, the line of treatment should be the same as indicated in ''vatashonita''.[194]<br />
<br />
In ama [[vata]], treatment curative of ''prameha, [[vata]] and ''meda'', should be given. [194 ½]<br />
<br />
If [[vata]] is occluded by the flesh, than sudation, massage, meat juices, milk and unctuous medications are recommended. [195]<br />
<br />
If [[vata]] is occluded by the osseous tissue or the marrow, ''mahasneha'' should be given. If occluded in the semen, the treatment has already been described. [195 ½]<br />
<br />
If [[vata]] is occluded by food, then emesis, digestives, carminatives and light diet are recommended. [196]<br />
<br />
If occluded by urine, diuretics, sudation and trans-urethral enema are recommended. If [[vata]] is occluded by fecal matter, the remedies are castor oil and unctuous therapy as indicated in ''udavarta''. [197]<br />
<br />
A morbid humor, while in its natural habitat, and when more powerful; it should be first subdued by its own suitable medications such as emesis, purgation, enema or sudation. [198]<br />
<br />
Thus has been described the treatment of conditions of occlusion of [[vata]] by [[pitta]], etc. [198 ½]<br />
<br />
=== Mutual occlusions by types of [[vata]] and their management ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
मारुतानां हि पञ्चानामन्योन्यावरणे शृणु ||१९९|| <br /><br />
<br />
लिङ्गं व्याससमासाभ्यामुच्यमानं मयाऽनघ! | <br /><br />
प्राणो वृणोत्युदानादीन् प्राणं वृण्वन्ति तेऽपि च ||२००|| <br /><br />
<br />
उदानाद्यास्तथाऽन्योन्यं सर्व एव यथाक्रमम् | <br /><br />
विंशतिर्वरणान्येतान्युल्बणानां [१] परस्परम् ||२०१|| <br /><br />
<br />
मारुतानां हि पञ्चानां तानि सम्यक् प्रतर्कयेत् | <br /><br />
सर्वेन्द्रियाणां शून्यत्वं ज्ञात्वा स्मृतिबलक्षयम् ||२०२|| <br /><br />
<br />
व्याने प्राणावृते लिङ्गं कर्म तत्रोर्ध्वजत्रुकम् | <br /><br />
स्वेदोऽत्यर्थं लोमहर्षस्त्वग्दोषः सुप्तगात्रता ||२०३|| <br /><br />
<br />
प्राणे व्यानावृते तत्र स्नेहयुक्तं विरेचनम् | <br /><br />
प्राणावृते समाने स्युर्जडगद्गदमूकताः ||२०४|| <br /><br />
<br />
चतुष्प्रयोगाः शस्यन्ते स्नेहास्तत्र सयापनाः | <br /><br />
समानेनावृतेऽपाने [२] ग्रहणीपार्श्वहृद्गदाः ||२०५||<br /><br />
<br />
शूलं चामाशये तत्र दीपनं सर्पिरिष्यते |२०६|<br /><br />
<div class="mw-collapsible-content"><br />
<br />
mArutAnAM hi pa~jcAnAmanyonyĀvaranae shRuNu ||199|| <br /><br />
<br />
li~ggaM vyAsasamAsAbhyAmucyamAnaM mayA~anagha! | <br /><br />
prānao vRuNotyudānadIn prānaM vRuNvanti te~api ca ||200|| <br /><br />
<br />
udānadyAstathA~anyonyaM sarva eva yathAkramam | <br /><br />
viMśaṭīrvaraNAnyetAnyulbaNAnAM [1] parasparam ||201|| <br /><br />
<br />
mArutAnAM hi pa~jcAnAM tAni samyak pratarkayet | <br /><br />
sarvendriyANAM shUnyatvaM j~jAtvA smRutibalakṣayam ||202|| <br /><br />
<br />
vyānae prānavRute li~ggaM karma tatrordhvajatrukam | <br /><br />
svedo~atyarthaM lomaharShastvag dōṣaH suptagAtratA ||203|| <br /><br />
<br />
prānae vyānavRute tatra SnēhayuktaM virēcanam | <br /><br />
prānavRute Samānae syurjaDagadgadamUkatAH ||204|| <br /><br />
<br />
catuShprayogAH shasyante Snēhastatra saYāpana H | <br /><br />
SamānaenAvRute~apānae [2] grahaNIpArshvahRudgadAH ||205|| <br /><br />
<br />
shUlaM cAmAshaye tatra dIpanaM sarpiriShyate |206| <br /><br />
<br />
mārutānāṁ hi pañcānāmanyōnyāvaraṇē śr̥ṇu||199|| <br /><br />
<br />
liṅgaṁ vyāsasamāsābhyāmucyamānaṁ mayā'nagha!| <br /><br />
prāṇō vr̥ṇōtyudānādīn prāṇaṁ vr̥ṇvanti tē'pi ca||200|| <br /><br />
<br />
udānādyāstathā'nyōnyaṁ sarva ēva yathākramam| <br /><br />
viṁśatirvaraṇānyētānyulbaṇānāṁ [7] parasparam||201|| <br /><br />
<br />
mārutānāṁ hi pañcānāṁ tāni samyak pratarkayēt| <br /><br />
sarvēndriyāṇāṁ śūnyatvaṁ jñātvā smr̥tibalakṣayam||202|| <br /><br />
<br />
vyānē prāṇāvr̥tē liṅgaṁ karma tatrōrdhvajatrukam| <br /><br />
svēdō'tyarthaṁ lōmaharṣastvagdōṣaḥ suptagātratā||203|| <br /><br />
<br />
prāṇē vyānāvr̥tē tatra snēhayuktaṁ virēcanam| <br /><br />
prāṇāvr̥tē samānē syurjaḍagadgadamūkatāḥ||204|| <br /><br />
<br />
catuṣprayōgāḥ śasyantē snēhāstatra sayāpanāḥ| <br /><br />
samānēnāvr̥tē'pānē [8] grahaṇīpārśvahr̥dgadāḥ||205|| <br /><br />
<br />
śūlaṁ cāmāśayē tatra dīpanaṁ sarpiriṣyatē|206|<br /><br />
</div></div><br />
<br />
Oh Sinless Dear! I shall next describe the mutual obstruction between the five types of [[vata]] in detailed and concised manner. [199-199 ½]<br />
<br />
The prana [[vata]] occludes the ''udana'' and other types of [[vata]] while they too may occlude the ''prana.'' [200]<br />
<br />
''Udana'' and all other types of vāta may occlude one another in the same manner. There occur twenty conditions of occlusion caused by mutual obstruction of these five types of provoked [[vata]]. These should be properly debated. [201-201½]<br />
<br />
On observing the loss of function of all the sense organs, and loss of memory and strength, it should be diagnosed as the condition of the occlusion of ''vyana'' by ''prana''.<br />
<br />
Here the therapeutic approaches above the supra-clavicular region of the body are to be done. [202-202½]<br />
<br />
When ''prana'' gets occluded by ''vyana'' excessive perspiration, horripilation, skin diseases, and numbness of limbs is manifested. The treatment is purgation combined with unctuous articles. [203-203½]<br />
<br />
In condition of occlusion of ''samana'' by ''prana'', the speech will be scanty, slurred or even muteness can occur. All the four modes of unctuous therapy along with ''yapana'' enema are recommended as treatment. [204-204½]<br />
<br />
In condition of occlusion of ''apana'' by ''samana, grahani,'' pain in ''parshva'', heart diseases and colicky pain of the stomach manifest where treatment indicated is the ghee medicated with digestive stimulants. [205-205½]<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
शिरोग्रहः प्रतिश्यायो निःश्वासोच्छ्वाससङ्ग्रहः ||२०६|| <br /><br />
<br />
हृद्रोगो मुखशोषश्चाप्युदाने प्राणसंवृते | <br /><br />
तत्रोर्ध्वभागिकं कर्म कार्यमाश्वासनं तथा ||२०७|| <br /><br />
<br />
कर्मौजोबलवर्णानां नाशो मृत्युरथापि वा | <br /><br />
उदानेनावृते प्राणे तं शनैः शीतवारिणा ||२०८|| <br /><br />
<br />
सिञ्चेदाश्वासयेच्चैनं सुखं चैवोपपादयेत् | <br /><br />
उर्ध्वगेनावृतेऽपाने छर्दिश्वासादयो गदाः ||२०९|| <br /><br />
<br />
स्युर्वाते तत्र बस्त्यादि भोज्यं चैवानुलोमनम् | <br /><br />
मोहोऽल्पोऽग्निरतीसार ऊर्ध्वगेऽपानसंवृते ||२१०|| <br /><br />
<br />
वाते स्याद्वमनं तत्र दीपनं ग्राहि चाशनम् | <br /><br />
वम्याध्मानमुदावर्तगुल्मार्तिपरिकर्तिकाः ||२११|| <br /><br />
<br />
लिङ्गं व्यानावृतेऽपाने तं स्निग्धैरनुलोमयेत् | <br /><br />
अपानेनावृते व्याने भवेद्विण्मूत्ररेतसाम् ||२१२|| <br /><br />
<br />
अतिप्रवृत्तिस्तत्रापि सर्वं सङ्ग्रहणं मतम् | <br /><br />
मूर्च्छा तन्द्रा प्रलापोऽङ्गसादोऽग्न्योजोबलक्षयः ||२१३|| <br /><br />
<br />
समानेनावृते व्याने व्यायामो लघुभोजनम् | <br /><br />
स्तब्धताऽल्पाग्निताऽस्वेदश्चेष्टाहानिर्निमीलनम् ||२१४|| <br /><br />
<br />
उदानेनावृते व्याने तत्र पथ्यं मितं लघु | <br /><br />
पञ्चान्योन्यावृतानेवं वातान् बुध्येत लक्षणैः ||२१५|| <br /><br />
<br />
एषां स्वकर्मणां हानिर्वृद्धिर्वाऽऽवरणे मता | <br /><br />
यथास्थूलं समुद्दिष्टमेतदावरणेऽष्टकम् ||२१६|| <br /><br />
<br />
सलिङ्गभेषजं सम्यग्बुधानां बुद्धिवृद्धये |२१७|<br /><br />
<div class="mw-collapsible-content"><br />
<br />
shirograhaH pratishyAyo niHshvAsocchvAsasa~ggrahaH ||206|| <br /><br />
<br />
hRudrogo mukhashoShashcApyudānae prānasaMvRute | <br /><br />
tatrordhvabhAgikaM karma kAryamAshvAsanaM tathA ||207|| <br /><br />
<br />
karmaujobalavarNAnAM nAsho mRutyurathApi vA | <br /><br />
udānaenAvRute prānae taM shanaiH shItavAriNA ||208|| <br /><br />
<br />
si~jcedAshvAsayeccainaM sukhaM caivopapAdayet | <br /><br />
urdhvagenAvRute~apānae chardishvAsAdayo gadAH ||209|| <br /><br />
<br />
syurvAte tatra bastyAdi bhojyaM caivAnulomanam | <br /><br />
moho~alpo~agnira’tīsāra Urdhvage~apāna saMvRute ||210|| <br /><br />
<br />
vAte syAdvamanaM tatra dIpanaM grAhi cAshanam | <br /><br />
vamyAdhmAnamudAvartagulmArtiparikartikAH ||211|| <br /><br />
<br />
li~ggaM vyānavRute~apānae taM snigdhairanulomayet | <br /><br />
apānaenAvRute vyānae bhavedviNmūtraretasAm ||212|| <br /><br />
<br />
atipravRuttistatrApi sarvaM sa~ggrahaNaM matam | <br /><br />
mUrcchA tandrA pralApo~a~ggasAdo~agnyojobalakṣayaH ||213|| <br /><br />
<br />
SamānaenAvRute vyānae vyAyAmo laghubhojanam | <br /><br />
stabdhatA~alpAgnitA~asvedashceShTAhAnirnimIlanam ||214|| <br /><br />
<br />
udānaenAvRute vyānae tatra pathyaM mitaM laghu | <br /><br />
pa~jcAnyonyAvRutAnevaM vātan budhyeta lakShaNaiH ||215|| <br /><br />
<br />
eShAM svakarmaNAM hAnirvRuddhirvA~a~āvaranae matA | <br /><br />
yathAsthUlaM samuddiShTametadĀvaranae~aShTakam ||216|| <br /><br />
<br />
sali~ggabheShajaM samyagbudhAnAM buddhivRuddhaye |217| <br /><br />
<br />
śirōgrahaḥ pratiśyāyō niḥśvāsōcchvāsasaṅgrahaḥ||206|| <br /><br />
<br />
hr̥drōgō mukhaśōṣaścāpyudānē prāṇasaṁvr̥tē| <br /><br />
tatrōrdhvabhāgikaṁ karma kāryamāśvāsanaṁ tathā||207|| <br /><br />
<br />
karmaujōbalavarṇānāṁ nāśō mr̥tyurathāpi vā| <br /><br />
udānēnāvr̥tē prāṇē taṁ śanaiḥ śītavāriṇā||208|| <br /><br />
<br />
siñcēdāśvāsayēccainaṁ sukhaṁ caivōpapādayēt| <br /><br />
urdhvagēnāvr̥tē'pānē chardiśvāsādayō gadāḥ||209|| <br /><br />
<br />
syurvātē tatra bastyādi bhōjyaṁ caivānulōmanam| <br /><br />
mōhō'lpō'gniratīsāra ūrdhvagē'pānasaṁvr̥tē||210|| <br /><br />
<br />
vātē syādvamanaṁ tatra dīpanaṁ grāhi cāśanam| <br /><br />
vamyādhmānamudāvartagulmārtiparikartikāḥ||211|| <br /><br />
<br />
liṅgaṁ vyānāvr̥tē'pānē taṁ snigdhairanulōmayēt| <br /><br />
apānēnāvr̥tē vyānē bhavēdviṇmūtrarētasām||212|| <br /><br />
<br />
atipravr̥ttistatrāpi sarvaṁ saṅgrahaṇaṁ matam| <br /><br />
mūrcchā tandrā pralāpō'ṅgasādō'gnyōjōbalakṣayaḥ||213|| <br /><br />
<br />
samānēnāvr̥tē vyānē vyāyāmō laghubhōjanam| <br /><br />
stabdhatā'lpāgnitā'svēdaścēṣṭāhānirnimīlanam||214|| <br /><br />
<br />
udānēnāvr̥tē vyānē tatra pathyaṁ mitaṁ laghu| <br /><br />
pañcānyōnyāvr̥tānēvaṁ vātān budhyēta lakṣaṇaiḥ||215|| <br /><br />
<br />
ēṣāṁ svakarmaṇāṁ hānirvr̥ddhirvā''varaṇē matā| <br /><br />
yathāsthūlaṁ samuddiṣṭamētadāvaraṇē'ṣṭakam||216|| <br /><br />
<br />
saliṅgabhēṣajaṁ samyagbudhānāṁ buddhivr̥ddhayē|217| <br /><br />
</div></div><br />
<br />
In conditions of occlusion of ''udana'' by ''prana'', there is neck rigidity, coryza, impediment to inspiration and expiration, cardiac disorders and dryness of the mouth.<br />
<br />
Here the treatment is as indicated in diseases of the parts above the supra-clavicular region and consolation. [206-207]<br />
<br />
In condition of occlusion of ''prana'' by ''udana'', there will be loss of function, vital essence, strength and complexion or it may even lead to death.<br />
<br />
This condition should be treated by gradual pouring with cold water and comforting measures in such a way that the patient may be restored to health. [208-208½]<br />
<br />
In condition of the occlusion of ''apana'' by ''udana'', there will be vomiting, dyspnea, and similar other disorders. The treatment is enema and similar measures, and diet inducing ''vata anulomana''. [209-209½]<br />
<br />
In condition of the occlusion of ''udana'' by ''apana'', there occur stupor, reduced digestive mechanism and diarrhea. The treatment measures are emesis and diet that is digestive, stimulant and ''grahi''. [210-210½]<br />
<br />
In condition of occlusion of ''apana'' by ''vyana'', there occur the symptoms of vomiting, distension of abdomen, ''udavarta, gulma,'' colic and griping pain. This condition should be treated by ''anulomana'' by means of unctuous medications. [211-211½]<br />
<br />
In condition of occlusion of ''vyana'' by ''apana'', there occurs excessive discharge of feces, urine and semen. Here the treatment indicated is ''sangrahana'' therapy. [212-212½]<br />
<br />
In condition of occlusion of ''vyana'' by ''samana'', there occurs fainting, stupor, garrulousness, asthenia of the limbs, reduced digestive mechanism, vital essence and strength. Exercise and light diet are indicated as treatment for this condition. [213-213½]<br />
<br />
In condition of occlusion of ''vyana'' by ''udana'', there occurs rigidity, decreased gastro-intestinal enzymes activity, anhidrosis, and loss of movement and absence of winking. The treatment is wholesome, measured and light diet. [214-214½]<br />
<br />
By the symptoms one should diagnose the condition of mutual occlusion of these five types of [[vata]], and it has been laid down that there will occurs either the increase or decrease of its functions as the particular type of [[vata]] is affected. [215-215½]<br />
<br />
Thus have been described in general this eight conditions of mutual occlusion along with their symptoms and treatment, in order to aid the understanding of intelligent physicians. [216-216½]<br />
<br />
=== General guidelines for management ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
स्थानान्यवेक्ष्य वातानां वृद्धिं हानिं च कर्मणाम् ||२१७|| <br /><br />
<br />
द्वादशावरणान्यन्यान्यभिलक्ष्य भिषग्जितम् | <br /><br />
कुर्यादभ्यञ्जनस्नेहपानबस्त्यादि [१] सर्वशः ||२१८|| <br /><br />
<br />
क्रममुष्णमनुष्णं वा व्यत्यासादवचारयेत् |२१९|<br /><br />
<div class="mw-collapsible-content"><br />
<br />
sthānanyavekShya vātanAM vRuddhiM hAniM ca karmaNAm ||217|| <br /><br />
<br />
dvAdashĀvarananyanyAnyabhilakShya bhiShagjitam | <br /><br />
kuryAdabhya~jjanaSnēhapāna bastyAdi [1] sarvashaH ||218|| <br /><br />
<br />
kramamuShNamanuShNaM vA vyatyAsAdavacArayet |219| <br /><br />
<br />
sthānānyavēkṣya vātānāṁ vr̥ddhiṁ hāniṁ ca karmaṇām||217||<br /><br />
<br />
dvādaśāvaraṇānyanyānyabhilakṣya bhiṣagjitam| <br /><br />
kuryādabhyañjanasnēhapānabastyādi [1] sarvaśaḥ||218|| <br /><br />
<br />
kramamuṣṇamanuṣṇaṁ vā vyatyāsādavacārayēt|219| <br /><br />
</div></div><br />
<br />
On investigating the habitat of each type of [[vata]], as well as the signs of increase or decrease of its functions, the physician should diagnose the remaining twelve conditions of mutual occlusions and should treat them by means of external application, unctuous internal administration, enema and all other procedures, or he may be alternatively given cold and hot measures. [217-218½]<br />
<br />
=== Specific principles of management ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
उदानं योजयेदूर्ध्वमपानं चानुलोमयेत् ||२१९|| <br /><br />
<br />
समानं शमयेच्चैव त्रिधा व्यानं तु योजयेत् | <br /><br />
प्राणो रक्ष्यश्चतुर्भ्योऽपि स्थाने ह्यस्य स्थितिर्ध्रुवा ||२२०||<br /> <br />
<br />
स्वं स्थानं गमयेदेवं वृतानेतान् विमार्गगान् |२२१|<br /><br />
<div class="mw-collapsible-content"><br />
<br />
udānaM yojayedUrdhvamapāna M cAnulomayet ||219|| <br /><br />
<br />
samānaM shamayeccaiva tridhA vyānaM tu yojayet | <br /><br />
prānao rakShyashcaturbhyo~api sthAne hyasya sthitirdhruvA ||220|| <br /><br />
<br />
svaM sthānaM gamayedevaM vRutAnetAn vimArgagAn |221| <br /><br />
<br />
udānaṁ yōjayēdūrdhvamapānaṁ cānulōmayēt||219|| <br /><br />
<br />
samānaṁ śamayēccaiva tridhā vyānaṁ tu yōjayēt| <br /><br />
prāṇō rakṣyaścaturbhyō'pi sthānē hyasya sthitirdhruvā||220|| <br /><br />
<br />
svaṁ sthānaṁ gamayēdēvaṁ vr̥tānētān vimārgagān|221| <br /><br />
</div></div><br />
<br />
The ''udana'' should be regulated upwards and the ''apana'' downwards. The ''samana'' should be alleviated and the ''vyana'' should be treated by all the three methods. Even more carefully than the other four types of [[vata]], the ''prana'' should be maintained, because life depends on the proper maintenance of it in its habitat.<br />
<br />
Thus the physician should regulate and establish types of [[vata]] in their normal habitats, which have been occluded and misdirected. [219-220½]<br />
<br />
=== Types of [[vata]] occluded by [[dosha]] ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
मूर्च्छा दाहो भ्रमः शूलं विदाहः शीतकामिता ||२२१|| <br /><br />
<br />
छर्दनं च विदग्धस्य प्राणे पित्तसमावृते | <br /><br />
ष्ठीवनं क्षवथूद्गारनिःश्वासोच्छ्वाससङ्ग्रहः ||२२२|| <br /><br />
<br />
प्राणे कफावृते रूपाण्यरुचिश्छर्दिरेव च | <br /><br />
मूर्च्छाद्यानि च रूपाणि दाहो नाभ्युरसः क्लमः ||२२३|| <br /><br />
<br />
ओजोभ्रंशश्च सादश्चाप्युदाने पित्तसंवृते | <br /><br />
आवृते श्लेष्मणोदाने वैवर्ण्यं वाक्स्वरग्रहः ||२२४|| <br /><br />
<br />
दौर्बल्यं गुरुगात्रत्वमरुचिश्चोपजायते | <br /><br />
अतिस्वेदस्तृषा दाहो मूर्च्छा चारुचिरेव [१] च ||२२५|| <br /><br />
<br />
पित्तावृते समाने स्यादुपघातस्तथोष्मणः | <br /><br />
अस्वेदो वह्निमान्द्यं च लोमहर्षस्तथैव च ||२२६|| <br /><br />
<br />
कफावृते समाने स्याद्गात्राणां चातिशीतता | <br /><br />
व्याने पित्तावृते तु स्याद्दाहः सर्वाङ्गगः क्लमः ||२२७|| <br /><br />
<br />
गात्रविक्षेपसङ्गश्च ससन्तापः सवेदनः | <br /><br />
गुरुता सर्वगात्राणां सर्वसन्ध्यस्थिजा रुजः ||२२८|| <br /><br />
<br />
व्याने कफावृते लिङ्गं गतिसङ्गस्तथाऽधिकः [२] | <br /><br />
हारिद्रमूत्रवर्चस्त्वं तापश्च गुदमेढ्रयोः ||२२९|| <br /><br />
<br />
लिङ्गं पित्तावृतेऽपाने रजसश्चातिवर्तनम् | <br /><br />
भिन्नामश्लेष्मसंसृष्टगुरुवर्चःप्रवर्तनम् ||२३०|| <br /><br />
<br />
श्लेष्मणा संवृतेऽपाने कफमेहस्य चागमः |२३१|<br /><br />
<div class="mw-collapsible-content"><br />
<br />
mUrcchA dAho bhramaH shUlaM vidAhaH shItakAmitA ||221|| <br /><br />
<br />
chardanaM ca vidagdhasya prānae pittasamAvRute | <br /><br />
ShThIvanaM kṣavathūdgAraniHshvAsocchvAsasa~ggrahaH ||222|| <br /><br />
<br />
prānae kaphAvRute rUpANyarucishchardireva ca | <br /><br />
mUrcchAdyAni ca rUpANi dAho nAbhyurasaH klamaH ||223|| <br /><br />
<br />
ojobhraMshashca sAdashcApyudānae pittasaMvRute | <br /><br />
AvRute shleShmaNodAne vaivarNyaM vAksvaragrahaH ||224|| <br /><br />
<br />
daurbalyaM gurugAtratvamarucishcopajAyate | <br /><br />
atisvedastRuShA dAho mUrcchA cArucireva [1] ca ||225|| <br /><br />
<br />
pittAvRute Samānae syAdupaghAtastathoShmaNaH | <br /><br />
asvedo vahnimAndyaM ca lomaharShastathaiva ca ||226|| <br /><br />
<br />
kaphAvRute Samānae syAdgAtrANAM cAtishItatA | <br /><br />
vyānae pittAvRute tu syAddAhaH sarvA~ggagaH klamaH ||227|| <br /><br />
<br />
gAtravikShepasa~ggashca sasantApaH savedanaH | <br /><br />
gurutA sarvagAtrANAM sarvasandhyasthijA rujaH ||228|| <br /><br />
<br />
vyānae kaphAvRute li~ggaM gatisa~ggastathA~adhikaH [2] | <br /><br />
hAridramūtravarcastvaM tApashca gudameDhrayoH ||229|| <br /><br />
<br />
li~ggaM pittAvRute~apānae rajasashcAtivartanam | <br /><br />
bhinnAmashleShmasaMsRuShTaguruvarcaHpravartanam ||230|| <br /><br />
<br />
shleShmaNA saMvRute~apānae kaphamehasya cAgamaH |231| <br /><br />
<br />
mūrcchā dāhō bhramaḥ śūlaṁ vidāhaḥ śītakāmitā||221|| <br /><br />
<br />
chardanaṁ ca vidagdhasya prāṇē pittasamāvr̥tē| <br /><br />
ṣṭhīvanaṁ kṣavathūdgāraniḥśvāsōcchvāsasaṅgrahaḥ||222|| <br /><br />
<br />
prāṇē kaphāvr̥tē rūpāṇyaruciśchardirēva ca| <br /><br />
mūrcchādyāni ca rūpāṇi dāhō nābhyurasaḥ klamaḥ||223|| <br /><br />
<br />
ōjōbhraṁśaśca sādaścāpyudānē pittasaṁvr̥tē| <br /><br />
āvr̥tē ślēṣmaṇōdānē vaivarṇyaṁ vāksvaragrahaḥ||224|| <br /><br />
<br />
daurbalyaṁ gurugātratvamaruciścōpajāyatē| <br /><br />
atisvēdastr̥ṣā dāhō mūrcchā cārucirēva [11] ca||225|| <br /><br />
<br />
pittāvr̥tē samānē syādupaghātastathōṣmaṇaḥ| <br /><br />
asvēdō vahnimāndyaṁ ca lōmaharṣastathaiva ca||226|| <br /><br />
<br />
kaphāvr̥tē samānē syādgātrāṇāṁ cātiśītatā| <br /><br />
vyānē pittāvr̥tē tu syāddāhaḥ sarvāṅgagaḥ klamaḥ||227|| <br /><br />
<br />
gātravikṣēpasaṅgaśca sasantāpaḥ savēdanaḥ| <br /><br />
gurutā sarvagātrāṇāṁ sarvasandhyasthijā rujaḥ||228|| <br /><br />
<br />
vyānē kaphāvr̥tē liṅgaṁ gatisaṅgastathā'dhikaḥ [12] | <br /><br />
hāridramūtravarcastvaṁ tāpaśca gudamēḍhrayōḥ||229|| <br /><br />
<br />
liṅgaṁ pittāvr̥tē'pānē rajasaścātivartanam| <br /><br />
bhinnāmaślēṣmasaṁsr̥ṣṭaguruvarcaḥpravartanam||230|| <br /><br />
<br />
ślēṣmaṇā saṁvr̥tē'pānē kaphamēhasya cāgamaḥ|231| <br /><br />
</div></div><br />
<br />
In occlusion of ''prana'' by [[pitta]] fainting, giddiness, colic, burning sensation, craving for cold things and vomiting of acidic gastric material are seen as symptoms. [221-221½]<br />
<br />
In occlusion of ''prana'' by [[kapha]], there occur symptoms such as frequent spitting, sneezing, eructation, impediment to the inspiration and expiration, anorexia and vomiting. [222-222½]<br />
<br />
In condition of occlusion of ''udana'' by [[pitta]], there occur symptoms such as fainting etc and burning in the umbilical region and chest, exhaustion, loss of vital essence and asthenia. [223-223½]<br />
<br />
In occlusion of ''udana'' by [[kapha]], there occur discolorations, aphasia and dysarthria, debility, heaviness of the body and anorexia. [224-224½]<br />
<br />
In condition of occlusion of ''samana'' by [[pitta]], there occur hyperhidrosis, thirst, burning, fainting, anorexia, derangement of appetite and decreased gastro-intestinal enzyme activity. [225-225½]<br />
<br />
In condition of occlusion of the ''samana'' by [[kapha]], there occur anhidrosis, reduced gastro-intestinal enzyme activity, horripilation and excessive coldness of the limbs. [226-226½]<br />
<br />
In condition of occlusion of ''vyana'' by [[pitta]], there occur burning all over the body, exhaustion, chorea or poverty of movements accompanied with temperature and pain. [227-227½]<br />
<br />
In condition of occlusion of ''vyana'' by [[kapha]], there occur symptoms such as heaviness of the limbs, pain in all the bones and joints, and impaired gait. [228-228½]<br />
<br />
In condition of occlusion of ''apana'' by [[pitta]], there occur symptoms such as yellowish discoloration of urine and feces, sensation of heat in the rectum and penis and excessive flow of the menses. [229-229½]<br />
<br />
In condition of occlusion of ''apana'' by [[kapha]], there occur stools that are loose, heavy and mixed with undigested matter and mucus and [[kapha]] dominated ''prameha''. [230-230½]<br />
<br />
=== Guidelines for diagnosis of conditions ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
लक्षणानां तु मिश्रत्वं पित्तस्य च कफस्य च ||२३१|| <br /><br />
<br />
उपलक्ष्य भिषग्विद्वान् मिश्रमावरणं वदेत् | <br /><br />
यद्यस्य वायोर्निर्दिष्टं स्थानं तत्रेतरौ स्थितौ ||२३२|| <br /><br />
<br />
दोषौ बहुविधान् व्याधीन् दर्शयेतां यथानिजान् | <br /><br />
आवृतं श्लेष्मपित्ताभ्यां प्राणं चोदानमेव च ||२३३|| <br /><br />
<br />
गरीयस्त्वेन पश्यन्ति भिषजः शास्त्रचक्षुषः | <br /><br />
विशेषाज्जीवितं प्राणे उदाने संश्रितं बलम् ||२३४|| <br /><br />
<br />
स्यात्तयोः पीडनाद्धानिरायुषश्च बलस्य च | <br /><br />
सर्वेऽप्येतेऽपरिज्ञाताः परिसंवत्सरास्तथा ||२३५|| <br /><br />
<br />
उपेक्षणादसाध्याः स्युरथवा दुरुपक्रमाः [१] |२३६|<br /><br />
<div class="mw-collapsible-content"><br />
<br />
lakShaNAnAM tu mishratvaM pittasya ca kaphasya ca ||231|| <br /><br />
<br />
upalakShya bhiShagvidvAn mishramĀvaranaM vadet | <br /><br />
yadyasya vAyornirdiShTaM sthānaM tatretarau sthitau ||232|| <br /><br />
<br />
dōṣau bahuvidhAn vyAdhIn darshayetAM yathAnijAn | <br /><br />
AvRutaM shleShmapittAbhyAM prānaM codAnameva ca ||233|| <br /><br />
<br />
garIyastvena pashyanti bhiShajaH shAstracakShuShaH | <br /><br />
visheShAjjIvitaM prānae udānae saMshritaM balam ||234|| <br /><br />
<br />
syAttayoH pIDanAddhAnirAyuShashca balasya ca | <br /><br />
sarve~apyete~aparij~jAtAH parisaMvatsarAstathA ||235|| <br /><br />
<br />
upekShaNAdasAdhyAH syurathavA durupakramAH [1] |236| <br /><br />
<br />
lakṣaṇānāṁ tu miśratvaṁ pittasya ca kaphasya ca||231|| <br /><br />
<br />
upalakṣya bhiṣagvidvān miśramāvaraṇaṁ vadēt| <br /><br />
yadyasya vāyōrnirdiṣṭaṁ sthānaṁ tatrētarau sthitau||232|| <br /><br />
<br />
dōṣau bahuvidhān vyādhīn darśayētāṁ yathānijān| <br /><br />
āvr̥taṁ ślēṣmapittābhyāṁ prāṇaṁ cōdānamēva ca||233|| <br /><br />
<br />
garīyastvēna paśyanti bhiṣajaḥ śāstracakṣuṣaḥ| <br /><br />
viśēṣājjīvitaṁ prāṇē udānē saṁśritaṁ balam||234|| <br /><br />
<br />
syāttayōḥ pīḍanāddhānirāyuṣaśca balasya ca| <br /><br />
sarvē'pyētē'parijñātāḥ parisaṁvatsarāstathā||235|| <br /><br />
<br />
upēkṣaṇādasādhyāḥ syurathavā durupakramāḥ [13] |236| <br /><br />
<br />
lakṣaṇānāṁ tu miśratvaṁ pittasya ca kaphasya ca||231|| <br /><br />
<br />
upalakṣya bhiṣagvidvān miśramāvaraṇaṁ vadēt| <br /><br />
yadyasya vāyōrnirdiṣṭaṁ sthānaṁ tatrētarau sthitau||232|| <br /><br />
<br />
dōṣau bahuvidhān vyādhīn darśayētāṁ yathānijān| <br /><br />
āvr̥taṁ ślēṣmapittābhyāṁ prāṇaṁ cōdānamēva ca||233|| <br /><br />
<br />
garīyastvēna paśyanti bhiṣajaḥ śāstracakṣuṣaḥ| <br /><br />
viśēṣājjīvitaṁ prāṇē udānē saṁśritaṁ balam||234|| <br /><br />
<br />
syāttayōḥ pīḍanāddhānirāyuṣaśca balasya ca| <br /><br />
sarvē'pyētē'parijñātāḥ parisaṁvatsarāstathā||235|| <br /><br />
<br />
upēkṣaṇādasādhyāḥ syurathavā durupakramāḥ [1] |236| <br /><br />
</div></div><br />
<br />
On observing the mixed symptoms of [[pitta]] and [[kapha]], the learned physician should diagnose it as a condition of combined occlusion. [231-231½]<br />
<br />
If the two other [[dosha]] get located in the places described as the habitat of [[vata]], they manifest various symptoms of disorders characteristic to each of them. [232-232½]<br />
<br />
Medical authorities regard, as most serious, the condition of occlusion of ''prana'' or ''udana'' by [[kapha]] and [[pitta]] combined, because life is particularly dependent on ''prana'', and strength on ''udana;'' and occlusion of them, will result in loss of life and vitality. [233-234½]<br />
<br />
If all these conditions are either undiagnosed or neglected for longer than a year, they become either incurable or extreme difficult to cure. [235-235½]<br />
<br />
=== Complications and management ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
हृद्रोगो विद्रधिः प्लीहा गुल्मोऽतीसार एव च ||२३६|| <br /><br />
<br />
भवन्त्युपद्रवास्तेषामावृतानामुपेक्षणात् | <br /><br />
तस्मादावरणं वैद्यः पवनस्योपलक्षयेत् ||२३७|| <br /><br />
<br />
पञ्चात्मकस्य वातेन पित्तेन श्लेष्मणाऽपि वा | <br /><br />
भिषग्जितमतः सम्यगुपलक्ष्य समाचरेत् ||२३८|| <br /><br />
<br />
अनभिष्यन्दिभिः स्निग्धैः स्रोतसां शुद्धिकारकैः | <br /><br />
कफपित्ताविरुद्धं यद्यच्च वातानुलोमनम् ||२३९|| <br /><br />
<br />
सर्वस्थानावृतेऽप्याशु तत् कार्यं मारुते हितम् | <br /><br />
यापना बस्तयः प्रायो मधुराः सानुवासनाः ||२४०|| <br /><br />
<br />
प्रसमीक्ष्य बलाधिक्यं मृदु वा स्रंसनं हितम् | <br /><br />
रसायनानां सर्वेषामुपयोगः प्रशस्यते ||२४१|| <br /><br />
<br />
शैलस्य जतुनोऽत्यर्थं पयसा गुग्गुलोस्तथा | <br /><br />
लेहं वा भार्गवप्रोक्तमभ्यसेत् क्षीरभुङ्नरः ||२४२|| <br /><br />
<br />
अभयामलकीयोक्तमेकादशसिताशतम् [१] | <br /><br />
अपानेनावृते सर्वं दीपनं ग्राहि भेषजम् ||२४३|| <br /><br />
<br />
वातानुलोमनं यच्च पक्वाशयविशोधनम् | <br /><br />
इति सङ्क्षेपतः प्रोक्तमावृतानां चिकित्सितम् ||२४४|| <br /><br />
<br />
प्राणादीनां भिषक् कुर्याद्वितर्क्य स्वयमेव तत् | <br /><br />
<br />
पित्तावृते तु पित्तघ्नैर्मारुतस्याविरोधिभिः | <br /><br />
कफावृते कफघ्नैस्तु मारुतस्यानुलोमनैः ||२४५||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
hRudrogo vidradhiH plIhA gulmo~a’tīsāra eva ca ||236|| <br /><br />
<br />
bhavantyupadravAsteShAmAvRutAnAmupekShaNAt | <br /><br />
tasmAdĀvaranaM vaidyaH pavanasyopalakṣayaet ||237|| <br /><br />
<br />
pa~jcAtmakasya vAtena pittena shleShmaNA~api vA | <br /><br />
bhiShagjitamataH samyagupalakShya samAcaret ||238|| <br /><br />
<br />
anabhiShyandibhiH snigdhaiH srotasAM shuddhikArakaiH | <br /><br />
kaphapittAviruddhaM yadyacca vātanulomanam ||239|| <br /><br />
<br />
sarvasthānavRute~apyAshu tat kAryaM mArute hitam | <br /><br />
Yāpana bastayaH prAyo madhurAH sAnuvAsanAH ||240|| <br /><br />
<br />
prasamIkShya balAdhikyaM mRudu vA sraMsanaM hitam | <br /><br />
rasāyananAM sarveShAmupayogaH prashasyate ||241|| <br /><br />
<br />
shailasya jatuno~atyarthaM payasA guggulostathA | <br /><br />
lehaM vA bhArgavaproktamabhyaset kShIrabhu~gnaraH ||242|| <br /><br />
<br />
abhayAmalakIyoktamekAdashaśītāshatam [1] | <br /><br />
apānaenAvRute sarvaM dIpanaM grAhi bheShajam ||243|| <br /><br />
<br />
vātanulomanaM yacca pakvAshayavishodhanam | <br /><br />
iti sa~gkShepataH proktamAvRutAnAM cikitśītām ||244|| <br /><br />
<br />
prānadInAM bhiShak kuryAdvitarkya svayameva tat | <br /><br />
<br />
pittAvRute tu pittaghnairmArutasyAvirodhibhiH | <br /><br />
kaphAvRute kaphaghnaistu mArutasyAnulomanaiH ||245|| <br /><br />
<br />
hr̥drōgō vidradhiḥ plīhā gulmō'tīsāra ēva ca||236|| <br /><br />
<br />
bhavantyupadravāstēṣāmāvr̥tānāmupēkṣaṇāt| <br /><br />
tasmādāvaraṇaṁ vaidyaḥ pavanasyōpalakṣayēt||237|| <br /><br />
<br />
pañcātmakasya vātēna pittēna ślēṣmaṇā'pi vā| <br /><br />
bhiṣagjitamataḥ samyagupalakṣya samācarēt||238|| <br /><br />
<br />
anabhiṣyandibhiḥ snigdhaiḥ srōtasāṁ śuddhikārakaiḥ| <br /><br />
kaphapittāviruddhaṁ yadyacca vātānulōmanam||239|| <br /><br />
<br />
sarvasthānāvr̥tē'pyāśu tat kāryaṁ mārutē hitam| <br /><br />
yāpanā bastayaḥ prāyō madhurāḥ sānuvāsanāḥ||240|| <br /><br />
<br />
prasamīkṣya balādhikyaṁ mr̥du vā sraṁsanaṁ hitam| <br /><br />
rasāyanānāṁ sarvēṣāmupayōgaḥ praśasyatē||241|| <br /><br />
<br />
śailasya jatunō'tyarthaṁ payasā guggulōstathā| <br /><br />
lēhaṁ vā bhārgavaprōktamabhyasēt kṣīrabhuṅnaraḥ||242|| <br /><br />
<br />
abhayāmalakīyōktamēkādaśasitāśatam [14] | <br /><br />
apānēnāvr̥tē sarvaṁ dīpanaṁ grāhi bhēṣajam||243|| <br /><br />
<br />
vātānulōmanaṁ yacca pakvāśayaviśōdhanam| <br /><br />
iti saṅkṣēpataḥ prōktamāvr̥tānāṁ cikitśītām||244|| <br /><br />
<br />
prāṇādīnāṁ bhiṣak kuryādvitarkya svayamēva tat| <br /><br />
<br />
pittāvr̥tē tu pittaghnairmārutasyāvirōdhibhiḥ| <br /><br />
kaphāvr̥tē kaphaghnaistu mārutasyānulōmanaiḥ||245|| <br /><br />
</div></div><br />
<br />
As a result of neglecting these conditions of occlusions, there occur complications such as cardiac disorders, abscesses, splenic disorders, ''gulma'' and diarrhea. [236-236½]<br />
<br />
Therefore, the physician should diagnose the condition of occlusion of the five types of [[vata]], by [[vata]], [[pitta]], or [[kapha]]. [237-237½]<br />
<br />
After having well thought about the proper medications, the physician should treat the patient by measures which are non-''abhishyandi'', unctuous and depurative of body channels. [238-238½]<br />
<br />
In condition of occlusion of [[vata]] in all its habitats, taking prompt measures which are [[vata]] anulomana and at the same time not antagonistic to [[kapha]] and [[pitta]] is beneficial. [239-239½]<br />
<br />
The ''yapana'' enema as well as the sweet unctuous enema is generally beneficial, and if the patient found to be sufficiently strong mild laxatives may be used. [240-240½]<br />
<br />
The use of all kinds of [[rasayana]] is highly recommended. A course of ''shilajatu'' and a course of ''guggulu'' with milk are especially beneficial. [241-241½]<br />
<br />
The patient living on milk diet, may take a course of [[rasayana]] (told by Bhargava explained in ''Abhayamalaki Pada'') containing 4400 ''tolas'' (52.8 kg) of sugar. (242-242½)<br />
<br />
In condition of occlusion by ''apana'', all measures that are [[deepana]], grahi, [[vata]] anulomana and which cleanse ''pakvashaya'' constitute the treatment. [243-243½]<br />
<br />
Thus has been described in brief the line of treatment in conditions of occlusion of ''prana'' and other types of [[vata]]; the physician should use his own discretion and give the proper treatment. [244-244½]<br />
<br />
In a condition of occlusion of [[vata]] by [[pitta]], the physician should administer medications curative of [[pitta]] and not antagonistic to [[vata]]. <br />
<br />
In a condition of occlusion of [[vata]] by [[kapha]], medications curative of [[kapha]] and [[vata]] anulomana should be given. [245]<br />
<br />
=== Similarity in macrocosm and microcosm ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
लोके वाय्वर्कसोमानां दुर्विज्ञेया यथा गतिः | <br /><br />
तथा शरीरे वातस्य पित्तस्य च कफस्य च ||२४६||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
loke vAyvarkasomAnAM durvij~jeyA yathA gatiH | <br /><br />
tathA sharIre vātasya pittasya ca kaphasya ca ||246||<br /><br />
<br />
lōkē vāyvarkasōmānāṁ durvijñēyā yathā gatiḥ| <br /><br />
tathā śarīrē vātasya pittasya ca kaphasya ca||246|| <br /><br />
</div></div><br />
<br />
Just as in the universe the courses of the air, the sun and the moon are difficult to comprehend, even so are the forces of [[vata]], [[pitta]] and [[kapha]] in the body.[246]<br />
<br />
=== Four states of [[dosha]] ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
क्षयं वृद्धिं समत्वं च तथैवावरणं भिषक् | <br /><br />
विज्ञाय पवनादीनां न प्रमुह्यति कर्मसु ||२४७||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
kṣayaM vRuddhiM samatvaM ca tathaivĀvaranaM bhiShak | <br /><br />
vij~jAya pavanAdInAM na pramuhyati karmasu ||247|| <br /><br />
<br />
kṣayaṁ vr̥ddhiṁ samatvaṁ ca tathaivāvaraṇaṁ bhiṣak| <br /><br />
vijñāya pavanādīnāṁ na pramuhyati karmasu||247|| <br /><br />
</div></div><br />
<br />
The physician who understand the condition of decrease, increase, normality and occlusion of [[vata]] and other [[dosha]], is not deluded with regard to treatment.[247]<br />
<br />
=== Summary ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
तत्र श्लोकौ- <br />
<br />
पञ्चात्मनः स्थानवशाच्छरीरे स्थानानि कर्माणि च देहधातोः | <br /><br />
प्रकोपहेतुः कुपितश्च रोगान् स्थानेषु चान्येषु वृतोऽवृतश्च ||२४८||<br /><br />
<br />
प्राणेश्वरः प्राणभृतां करोति क्रिया च तेषामखिला निरुक्ता | <br /><br />
तां देशसात्म्यर्तुबलान्यवेक्ष्य प्रयोजयेच्छास्त्रमतानुसारी ||२४९||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
tatra shlokau- <br />
<br />
pa~jcAtmanaH sthānavashAccharIre sthānani karmANi ca dehadhAtoH | <br /><br />
prakopahetuH kupitashca rōgan sthAneShu cAnyeShu vRuto~avRutashca ||248||<br /><br />
<br />
prānaeshvaraH prānabhRutAM karoti kriyA ca teShAmakhilA niruktA | <br /><br />
tAM deshasAtmyartubalAnyavekShya prayojayecchAstramatAnusArI ||249||<br /><br />
<br />
tatra ślōkau- <br />
<br />
pañcātmanaḥ sthānavaśāccharīrē sthānāni karmāṇi ca dēhadhātōḥ| <br /><br />
prakōpahētuḥ kupitaśca rōgān sthānēṣu cānyēṣu vr̥tō'vr̥taśca||248|| <br /><br />
<br />
prāṇēśvaraḥ prāṇabhr̥tāṁ karōti kriyā ca tēṣāmakhilā niruktā| <br /><br />
tāṁ dēśasātmyartubalānyavēkṣya prayōjayēcchāstramatānusārī||249|| <br /><br />
</div></div><br />
<br />
The [[vata]] being the subject of this chapter, the habitats and functions of the five-fold body sustaining element [[vata]], have been dealt with here. The causes of provocation, the diseases which this life controlling principle of [[vata]] gives rise to in the persons, when provoked, both in its own habitat and in other places, both in conditions of occlusion and in no occlusion, and the treatment of all those disease have been fully expounded here. The physician guided by the directions of the science, should administer the treatment, giving full consideration to factors of place, similarity, season and strength. [248-249]<br />
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<br />
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने वातव्याधिचिकित्सितं नामाष्टाविंशोऽध्यायः ||२८||<br />
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<br />
Ity agniveshakRute tantre carakapratisaMskRute~aprApte dRuDhabalasampUrite cikitsāsthAne VātavyādhicikitśītāM nAmAShTAviMsho~adhyAyaH ||28||<br />
<br />
ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē vātavyādhicikitśītāṁnāmāṣṭāviṁśō'dhyāyaḥ||28|| <br />
</div></div><br />
<br />
Thus, in the section on ‘Therapeutics’, in the treatise compiled by Agnivesha and revised by Charak, the twenty-eighth chapter entitled [[Vatavyadhi Chikitsa]] not being available, the same as restored by Dridhabala, is completed.[28]<br />
<br />
== Tattva Vimarsha (Fundamental Principles) ==<br />
<br />
#[[Vayu]]/[[vata]] is responsible for life, strength and functioning of living organisms. <br />
#Normal (non vitiated) [[vayu]]/[[vata]] with unobstructed (free) movement and location at its natural site, is responsible for long healthy lifespan. <br />
#[[Vayu]]/[[vata]] is of five types namely ''prana, udāna, samana, vyana'' and ''apana'' and they mechanize the body optimally occupying their sites without any irregular movement. <br />
#The location of ''prana'' is vertex, thorax, trachea, tongue, mouth and nose and it performs functions of spitting, sneezing, eructation, respiration, deglutition etc. <br />
#The site of ''udana'' is umbilicus, thorax and trachea and is responsible for vocalization, drive, energy, strength, complexion etc. <br />
#''Samana'' is located in channels of sweat, humors and water and lateral to the seat of [[agni]] (digestive enzymes ([[agni]]) and yield strength to the digestive fire. <br />
#''Vyana'' has swift movement and spreads all over the body and is responsible for gait, flexion, extension, twinkling etc. <br />
#''Apana'' is located in testicles, urinary bladder, penis, umbilicus, thighs, inguinal region and anus and performs ejaculation, micturition, defecation, expulsion of menstrual blood and fetus. <br />
#When these five are located in respective sites optimally, they perform their functions and support life without any morbidity. <br />
#Due to various [[vata]] provoking factors, [[vata]] is vitiated and it fills the empty channels and leads to various disorders at that particular site. <br />
#The onset of [[vata]] disorders is generally sudden without any premonitory signs. <br />
#The diagnosis of [[vata]] disorders is based upon the symptoms characteristic of the seat of affliction.<br />
#In all [[vata]] disorders, the association of other [[dosha]] like [[pitta]] etc. is to be considered. <br />
#The provocation of [[vata]] is either due to [[dhatu]]kshaya, means diminution of tissue elements and/ or due to ''avarana'' means obstruction to its pathway. The [[vata]], [[pitta]] and [[kapha]] always circulate through all the body channels. <br />
#The [[vata]], owing to its quality of subtleness is really the impeller of the other two [[dosha]]. <br />
#When the [[vata]] is provoked, it propels the other two [[dosha]] and dislodges them about here and there, causing various diseases. Due to ''avarana'' (obstruction in its path), it further causes diminution of the body nutrient fluid and other body elements.<br />
#In case of ''avarana'' (occlusion of [[vata]]), the clinical presentation includes the increased signs of [[dosha]] which is occluding [[vata]]. <br />
#In pure vitiation of [[vata]], without any association or obstruction by other [[dosha]], [[snehana]] and [[swedana]] therapy are first principles of treatment. <br />
#Mild cleansing with unctuous drugs shall be given to remove the residual morbidity. <br />
#By excessive use of unctuous, sour, salty and hot articles of diet, the excretory matter gets accumulated, occluding the alimentary passage, obstructs the [[vata]], hence ''anulomana'' of [[vata]] should be done.<br />
#Specific line of treatment should be adopted in specific condition depending on site of affliction and the vitiated tissue involved.<br />
#Ghee, oil, fat, marrow, affusion, massage, enema, unctuous sudation, staying at calm places (without strong wind), covering with blankets, meat soups, various milks, articles of diet of sweet, sour and salty taste and whatever is nourishing are beneficial for disorders due to [[vata]].<br />
#[[Pitta]] and [[kapha]] [[dosha]] occlude [[vata]] [[dosha]] at their sites and result in disorders. The clinical features are dominated by the vitiated [[dosha]]. The functions of obstructed [[dosha]] are decreased in these conditions. <br />
#The various types of [[vata]] [[dosha]] can mutually occlude each other’s pathways and result in disorders. There are increased signs of obstructing types of [[vata]] and decreased functions of obstructed type of [[vata]] [[dosha]]. <br />
#The ''udana'' should be regulated with therapies leading to its upward movement. The ''apana'' should be regulated with therapies leading to its downwards movement. The ''samana'' should be alleviated and the ''vyana'' should be treated by all the three methods. ''Prana'' should be maintained even more carefully than the other four types of [[vata]], because life depends on the proper maintenance of it in its habitat. Thus, the treatment is intended to regulate and establish types of vāta in their normal habitats, which have been occluded and misdirected.<br />
#Life and vitality is particularly dependent on ''prana'', and strength on ''udana;'' and occlusion of them, will result in loss of life and vitality.<br />
#In a condition of occlusion of [[vata]] by [[pitta]], the treatment is done with medications curative of [[pitta]] and not antagonistic to [[vata]]. <br />
#In a condition of occlusion of [[vata]] by [[kapha]], medications curative of [[kapha]] and [[vata]] anulomana should be given.<br />
#Just as in the universe the courses of the air, the sun and the moon are difficult to comprehend, even so are the forces of [[vata]], [[pitta]] and [[kapha]] in the body. The first three are responsible for all functions in macrocosm, whereas the latter three are for functions in microcosm. <br />
#There are four conditions viz. decrease, increase, normality and occlusion of [[vata]] and other [[dosha]].<br />
<br />
== Vidhi Vimarsha (Applied Inferences ) ==<br />
<br />
=== Importance of [[vata]] [[dosha]] in overall health and disease ===<br />
<br />
This text highlights the grandness of [[vata dosha]]. [[Vata]] is equated to [[ayu]]. Life is sustained by [[vayu]] only. Even though [[ayu]] is previously defined as conglomeration of [[sharira]] (physical body), [[indriya]] (sensorium), [[sattva]] (mind) and [[atma]] (soul). [Cha. Sa. [[Sutra Sthana]] 1/42] Here it is mentioned equivalent to [[vayu]]. The sense organs, mind and soul in physical body are manifested through the functions of [[vayu]] only. The strength of the individual is also provided by [[vayu]]. These two usages of [[ayu]] and bala are later explained as, ''prana'' is life and ''udana'' is strength. [verse 3]<br />
<br />
[[Vata]] performs all its activity for a healthy long life subject to status of its three functions. They are ''akupita''(not increased, decreased or vitiated), ''sthanastha'' (located in its own place) and ''avyahatagati''(nothing is interfering with its movement or ''gati'').<br />
<br />
=== Nature of [[vata]] ===<br />
<br />
[[Pitta]] and [[kapha]] are relatively compact and in corporeal form. On the contrary [[vata]] is incorporeal (''avayavasamghatarahita''). It can be termed as rarified in nature. The [[vata]] is ''anavasthita'' (unstable) too. These two properties are due to its composition formed by [[akasha]] and [[vayu]] predominantly<ref> Indu, Vagbhata, Sutra sthana Chap 20 Doshabhediya Verse 2, In: Sreekumari Amma (eds.) 1st ed. Trivandrum: Publication Division; Ayurveda College, 2000.</ref> which are incorporeal (''amurta''). ''Chalatva'' (mobility) and ''apratighata'' (unobstructability) are characteristics of [[vayu]] and [[akasha]] perceptible by the tactile sense organ. [Cha. Sa. [[Sharira Sthana]] 1/29-30] The biological [[vata]] (which is present in the living being) is self originated (''svayambhu''), subtle (''sukshma'') and all pervasive (''sarvagata''). It is invisible (''[[avyakta]]'') but its activities are patent or manifest (''vyaktakarma'').<ref>Dalhana, Sushruta. Nidana Sthana, Cha.1 Vatavyadhi Nidana Adhyaya verse 5. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref><br />
<br />
Anavasthita (unstable) is due to chala property of [[vata]]. This continuous moving nature of [[vata]] is explained with other terminologies also like ''sheeghravata''(swift movement)[Cha. Sa. [[Vimana Sthana]] 8/98], ''ashukari'' (instantaneous action), ''muhushchari'' (rhythmic movement).<ref>Dalhana, Sushruta. Nidana Sthana, Cha.1 Vatavyadhi Nidana Adhyaya verse 9. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>. It abounds in the fundamental quality of ''raja'' (the principle of cohesion and action). The predominance of ''raja'' is responsible for the instability of [[vata]]. The quality of ''chalatva'' is directional in nature, which is explained by the term ''gati''. [[Vata]] convenes all bodily activities by this important feature.<br />
<br />
Owing to its incorporeal nature and instability [[vata]] is ''anasadhya'' (inaccessible) also. The inaccessibility is characterized in regard to its functional and physical attributes but more relevant regarding the therapeutic aspect. Above explained cardinal features make [[vata]] achintya veerya (inconceivable prowess) and [[dosha]]nam neta (propeller of all functional elements in the body).[Cha. Sa. [[Sutra Sthana]] 1/8]<br />
<br />
=== Properties of [[vata]] ===<br />
<br />
In [[Vatakalakaliya Adhyaya]], questions have been raised about exciting and alleviating factors regarding qualities of [[vata]]. ''Ruksha''(dry), ''laghu''(light), ''sheeta''(cool), ''daruna'' (dreadful), ''khara'' (rough) and ''vishada'' (clean) have been explained as qualities of [[vata]]. Repeated use of substances with these qualities and actions of such similar qualities causes aggravation and excitation of [[vata]] and is alleviated by use of substances possessing contrary qualities. This brings out the phenomenon of two mutually interrelated and inseparable of sharira [[vayu]] viz. <br />
#that, the sharira [[vayu]] is a biophysical force and <br />
#that it is closely associated with material substances which form part of the structure of the body for example, functions of nervous system. It is a chemical reaction sequence which occurs during the course of life. This chemical reaction –sequence, can be accelerated (excited) or inhibited by substances with similar properties (''dravya samanya''), qualities (''guna samanya'') and actions (''karma samanya'') and inhibited by substances with opposite properties. In other words, it may be concluded that the bio – physical force – the ''sharira vayu'' – is closely linked with some material structural factors. These can be influenced by diet and medicine on the basis of similar increase and opposite decrease.<br />
<br />
Sodium, potassium, calcium, and chloride ions are continuously moving around (brownian movement) which is the result of their ionic state (''swabhava / swayambhu guna''). The ionic inflow and outflow within the cell causes depolarization and repolarization or in other words impulse is generated. Hyper or hypo state of these ions is the cause for disease condition which may present in the form of seizures, palpitations, muscle cramps, lethargy, altered sensorium, coma and death.<br />
<br />
Therefore, the biological energy produced by this ionic movement is the cause for ''sharira vayu'' and as per modern science too their concentration depends on ''ahara'' and ''vihara''.<br />
<br />
The continuous, controlled movement of the ions is responsible for cell activity which together at the level of cells contributes to tissue activity which together contributes to the organ, system and in turn whole body. [verse 4]<br />
<br />
==== Types of [[vata]] [[dosha]] ====<br />
<br />
In Vedic literature, as a medical system, the important five types of [[vata]] are explained with their locations and functions. The word ''tantrayate'' is used to explain the functional quality of [[vata]] and ''sharira'' (physical body) is ''yantra'' for functioning of ''tantra''. The [[vata]] [[dosha]] on basis of its functions is classified into five types. They reside in the ''sharira'' at the level of ''sharira paramanu'' (cell) and also at gross level. Five types of [[vata]] work together in a synchronized manner for the normal functioning of the sharira ([[vayu]] tantrayantra dhara). [verse 5-11]<br />
<br />
=== General etiological factors and basic pathogenesis of ''vata'' disorders ===<br />
<br />
The etiological factors can be divided into two:<br />
<br />
#which cause direct [[vata]] vitiation and <br />
#which cause indirect [[vata]] vitiation. <br />
<br />
Day sleep (''divaswapna'') do not directly lead to vitiation of [[vata]]. However, it leads to formation of ''ama'' and cause [[vata]] vitiation indirectly by obstructing [[vata]]. ''Vegasandharana'' (suppression of natural urges) and ''marmabhighata'' (trauma to vital organs) etc. are examples of direct vitiation. The pathogenesis is also bi-fold. The initial pathology is aggravation of [[vata]] and diminution of [[dhatu]] and vice versa. One augments the other. This ultimately causes emptiness in channels and rarity in tissues which gives more space for movements of [[vata]]. The second pathology is by increase in [[dhatu]] leading to excessive filling in channels to cause their clogging and blocking [[vata]]. [verse 15-19]<br />
<br />
==== Premonitory signs and symptoms ====<br />
<br />
Clinical manifestations may not be apparent because of vague manifestation of symptoms (''Avyaktam lakshanam''). This occurs in two situations, either the pathogenesis is extremely slow or it is abrupt. In the initial case, it is unable to appreciate the prodromal symptoms and presenting complaints separately. If it is an abrupt pathology the clinical presentation immediately follows the prodromal symptoms without appreciable gap. [verse 19-20]<br />
<br />
==== Clinical features ====<br />
<br />
The clinical presentations vary according to the specificity of [[hetu]] (cause) and ''sthana'' (location). The treatment options also vary accordingly. For example if [[vata]] prakopa takes place due to ''ruksha vriddhi'' in ''pakvashaya'' it may lead to habitual constipation in which ''snigdha, ushna'' and ''tikshna aushadha'' like ''mishraka sneha'' may be a good treatment option. <br />
<br />
If the same [[vata]] gets vitiated in ''amashaya'' due to ''snigdha vriddhi'', it leads to gastro-esophageal reflux disease (GERD), ''ruksha ushna'' and ''tikshna'' like ''gomutra bhavita shaddharana'' is the ideal treatment option. ''Anuvasana'' is the ideal therapy in [[vata]] vitiated in ''pakwashaya'', whereas [[vamana]] is the best therapy in [[vata]] vitiated in ''amashaya''. [verse 20-24]<br />
<br />
==== Three modes of pathogenesis of [[vata]] diseases ====<br />
<br />
The three characteristics of [[vata]] vitiation viz. ''svatantra dushti'' (vitiation due to independent specific causes), gata [[vata]] (increased movement of [[vata]]) and ''avarana'' (obstruction to movement of [[vata]]). imply three possible modes of pathogenesis in [[vata]] diseases. These can be further analyzed as follows; due to the following three important properties of [[vata]], it is regarded entirely different from other [[dosha]][Cha. Sa. [[Sutra Sthana]] 12/3]<br />
<br />
#''Asamghata'' (Incorporeal)<br />
#''Anavasthita'' (Unstable)<br />
#''Anasadhya'' (Inaccessible)<br />
<br />
=== Pathogenesis of various conditions ===<br />
<br />
All the verses explain a specific type of ''samprapti'' (pathogenesis) like koshthagata [[vata]] ([[vata]] affecting alimentary tract), amashayagata [[vata]] ([[vata]] affecting stomach.) etc. They are not to be considered as a single disease. These specific diseases may lead to many disease presentations in which the treatment strategies can be generalized. Any [[dosha]] may occupy any particular site or area and lead to diseases. This type of pathology of vitiated [[vata]] is called as gata[[vata]]. Normally in all gata[[vata]], the affected dushya(vitiated body components) will be ''kshina'' (depleted) and affected ''srotas'' will be ''rikta'' (empty). The concept of gata[[vata]] can be further explored physiologically.[[Dhatu]] are classified into two types’ ''asthayi'' (temporary) [[dhatu]] and sthayi(permanent) [[dhatu]]. Asthayi [[dhatu]] are the ones which are ''dravaswarupa'' (liquid state) and undergoing conversion (''parinam apadyamananam'') and they are being ''vikshepita'' (circulated) from their ''mulasthana'' (origin) throughout the ''sharira'' (''abhivahana'') for the purpose of ''poshana'' (nourishment) of the sthayi [[dhatu]]. This ''parinamana'' (conversion) and ''abhivahana prakriya''(transportation) takes place in ''marga'' (channel) which are known as ''srotas''; hence ''marga'' is one of the synonym used for ''srotas'' along with ''sira'' (vein), ''dhamani'' (artery), ''rasayani'' (capillary), ''rasavahini'' (channels carrying nutrient fluid), ''nadi'' (nerve), ''panthana'' (pathway), ''sharira chhidra'' (perforated channel), ''samvrita-asamvritani'' (covered or uncovered), ''sthana'' (site), ''ashaya'' (organ), ''niketa'' (habitat), ''shariradhatu avakasha'' (hollow space in body tissues).<br />
<br />
''Prakupita''(vitiated) [[dosha]] have the capacity to further vitiate both ''sthanastha dhatu'' (fixed tissue element) as well as ''margagata'' (circulating tissue elements) sharira [[dhatu]]. When prakupita [[vata]] vitiates the [[dhatu]], it is called as gata[[vata]]. In this condition, vitiated [[vata]] affects the specific site due to specific etiological factors. While designing treatment protocol, in this context specific etiological factors for each and every gata[[vata]] related diseases must be observed to clarify why vitiated [[vata]] goes to specific part of the body or to specific [[dhatu]] to develop kosthagata [[vata]], raktagata [[vata]] etc. In this condition, [[dhatu]] is ''dushya'' (getting vitiated).<br />
<br />
'''Koshthagata [[vata]]:''' <br />
<br />
[[Vata]] getting vitiated in the koshtha(alimentary tract) is explained as koshthagata [[vata]]. <br />
<br />
'''Gudagata [[vata]]:''' <br />
<br />
It can also be explained that gudagata [[vata]] and pakvashayagata [[vata]] are different clinical entities. In gudagata [[vata]], obstruction of stool, urine and flatus is observed, whereas in pakvashayagata [[vata]] there is painful defecation, micturition with ''antrakujana'' (gurgling sound), ''atopa'' (distension) and ''anaha'' (constipation). ''Ashma sarkara'' (urolith) is exclusively present in gudagata [[vata]] with pain and atrophy in calf muscles, thighs, sacram, feet and back. This can be compared with lumbo-sacral plexopathy. It may be understood as in case of ''pakvashaya gatavata'', proximal part of large intestine along with ascending, transverse and descending colon is involved; whereas in gudagata [[vata]], involvement of sigmoid colon, rectum, anus and their nerve supply.<br />
<br />
'''Amashayagata [[vata]]''': <br />
<br />
This is a typical presentation of [[vata]] leaving its own site and vitiating other site. Here the local [[dosha]] is considered important because it is more virulent than the external [[dosha]] coming from other sites. The clinical entities originating from ''amashaya'' (stomach) are caused due to vitiated [[vata]] entering into ''amashaya''. It increases emptiness of stomach leading to indigestion or ''ama pradoshaja vikara'' like ''visuchika'' (diarrhea) etc.<br />
<br />
'''Indriyagata [[vata]]''': <br />
<br />
Indriyagata [[vata]] is applicable to any sense organ. ''Indriya vadha'' may be interpreted as complete, partial or minimal loss of sensation. ''Shrotra''(ears) has specific importance among other ''indriya'', in which inherent [[dosha]] of ''shrotra'' is [[vata]] itself. So [[vata]] prakopa in ''shrotra'' is more impacting. It is worthy to remember the notion in vatakalakaleeya that [[vata]] is ''sarvendriyanam udyojaka'' (motivating factors for all sense organs).<br />
<br />
'''Twakgata [[vata]]''': <br />
<br />
''Tvak'' (skin) is referred as somatic organ even though it is a sensory organ. ''Supti'' (numbness) and ''toda'' (pricking sensation) are not symptoms specific to ''tvakindriya.'' Here ''tvak'' represents [[rasa dhatu]]. Rasa does not have cellular pattern and hence not included in ''shakha''. The ''tvak'' is derivative of ''rasa'' and is included in ''shakha''. ''Tvakindriya gatavata'' should be understood under indriyagata[[vata]].<br />
<br />
'''Siragata [[vata]]''': <br />
<br />
When [[vata]] afflicts ''sira'' (blood vessel) it may broaden or narrow the sirā. Widening may lead to ''shopha'' and narrowing may lead to ''shosha'' or vice versa as per the site of affliction. Two different conditions of vascular diseases i.e. aneurysym (''mahat'') and atherosclerosis / venous thrombosis (''tanu'') are examples.<br />
<br />
'''Sandhigata [[vata]] (osteoarthritis)''': <br />
<br />
There is depletion of periarticular and articular tissue by vitiated [[vata]] in sandhigata [[vata]]/osteoarthritis, empty spaces are occupied by [[vata]] which is felt as crepitus on palpation. [[Vata]] also causes hypertrophic tissue in the form of osteophytes and causes painful flexion and extension movements. This is the characteristic feature of swelling in sandhigata [[vata]]. <br />
<br />
'''Ardita''': <br />
<br />
''Ardita'' is a disease of episodic origin. It may lead to facial paralysis or hemiplegia or both. In other classics ''ardita'' is explained as facial paralysis only. [verse 38-42]<br />
<br />
'''Antarayama (emprosthotonous) and bahirayama(ophisthotonous):''' <br />
<br />
These diseases are tetany like conditions in which the body is sharply bent forward and backward respectively. [verse 43-48]<br />
<br />
'''Hanugraha''': <br />
<br />
It is a lockjaw like condition that may be persistent or intermittent or recurrent due to vitiation of [[vata]] affecting the mandibular joint. [verse 49]<br />
<br />
'''Dandaka''':<br />
<br />
''Dandaka'' is a condition in which the muscles are hypertonic but without convulsions. When it further manifests as tonic clonic convulsions it is referred as ''danda akshepaka''. This condition is caused due to vitiation of [[vata]] simultaneously in muscle groups. [verse 51]<br />
<br />
'''Episodic nature of various [[vata]] disorders''' <br />
<br />
The disorders mentioned from ''ardita'' onwards are ''vegavana'' (episodic). All ''vegavana'' disorders have two phases, ''vega'' and ''vegantara''. ''Vegantara'' is the symptom free period and is considered as right time for medication. [verse 52]<br />
<br />
'''Pakshaghata''': <br />
<br />
Three diseases namely ''pakshaghata''(hemiplegia), ''ekangaroga'' (monoplegia) and ''sarvangaroga'' (quadriplegia) are explained. In ''pakshaghata'' no painful symptoms are explained. ''Sira'' and ''snayu'' are considered as ''dushya'' in ''ekangaroga'' and ''sarvangaroga''. ''Sira'' is the ''upadhatu'' of [[rakta]] and ''snayu'' is the ''upadhatu'' of meda, therefore ''meda'' and ''rakta'' have vital role in pathogenesis of these diseases. [verse 53-55]<br />
<br />
'''Gridhrasi''': <br />
<br />
''Gridhrasi'' is a ''snayugata'' (affecting tendon) ''roga''. The word ''gridhrasi'' is derived from ''ghridhra'', which means vulture, the typical gait of the disease is highlighted by the name. The patient’s gait is changed like a vulture due to affected tendons by vitiated [[vata]]. <br />
<br />
''Khalli'' is the term given to severe painful twisting conditions of tendons. [verse 56-57]<br />
<br />
'''Nomenclature of diseases:''' <br />
<br />
All the [[vata]] disorders cannot be named or explained. They should be understood on the basis of site of affliction as well as nomenclature. [verse 58]<br />
<br />
'''Diagnosis of [[dhatu]]kshaya (degenerative pathology) and avarana (obstructive pathology) induced vitiation of [[vata]]:''' <br />
<br />
[[Vata]] can be vitiated due to [[dhatu]]kshaya and ''margavarana'' types of pathogenesis. [[Dhatu]]kshaya leads to depletion of tissues and more space for [[vata]] to move. This leads to gata[[vata]] phenomenon. ''Avarana'' of [[vata]] can be caused by other [[dosha]] or [[dhatu]]. So the differences between ''avarana'' and gata[[vata]] should be understood.<br />
<br />
The word, ''avarana'' means obstruction or resistance or friction to the normal ''gati'' of [[vata]]. Hence when its normal movement is hampered or vitiated, it becomes ''avrita'' and leads to different disorders. The gatatva and avritatva are entirely different phenomenon. Here an attempt is being made to differentiate the both physio-pathologies. [16]<br />
<br />
#In ''avarana'', generally the vitiation of [[vata]] is passive. When vitiated [[dosha]] or any other thing obstructs the pathway of [[vata]], avarana happens. Normal state of [[vata]] gets vitiated as ''avarana'' progresses. The substance which obstructs the pathway of [[vata]] is called as ''avaraka'' and the [[dosha]] ([[vata]] in general or its components) affected by ''avarana'' is called as ''avariya'' or ''avrita''. Normally the ''avarana'' is caused by the etiological factors for the vitiation of ''avaraka''. Etiological factors for the vitiation of [[vata]] (''sva nidana'') will be absent. In case of gata[[vata]] the vitiation of [[vata]] will be active. Here its own etiological factors are operating in the vitiation of [[vata]] in the pathogenesis and the vitiated [[vata]] adopts specific pathway and abnormally localizes at particular sites.<br />
#In the process of ''avarana chala'' property of [[vata]] is diminished due to obstruction. Other properties are not involved in the process of obstruction. But in case of ''gatatva'' the vitiation of [[vata]] takes place by involvement of other properties like ''ruksha, laghu, khara, vishada'' etc along with ''chala''.<br />
#In ''avarana'' the ''gati'' of [[vata]] is obstructed partially or fully. Once gets obstructed the [[vata]] may simply get lodged there (''baddha marga, margarodha''), try to nullify the obstruction, may get covered by the obstructing substance (''avrita''), adopt an opposite direction (''pratiloma'') or alter the direction (''viloma''). The different terminologies have been used to denote ''avarana'' in different contexts according to the nature of ''avarana'' and the state of [[vata]] and ''marga'' (passage). In case of ''gatatva'' the ''gati'' of vitiated [[vata]] aggravated and starts moving abnormally leading to localization at particular sites.''Avarana'' is caused by ''purnata'' (filling) of other [[dosha]] in the ''srotas/marga'' (passage) of [[vata]]. In ''gatatva'' the ''srotas'' or sites of occupation of [[vata]] are ''rikta'' (unfilled or spacious) and the aggravated [[vata]] fills the ''srotas''/site.<br />
#In ''avarana'' of [[vata]], swakarma vriddhi (exaggerated activities) of ''avaraka'' (covering [[dosha]]) is manifested. The ''avrita'' (i.e. [[vata]]) will show ''swakarma hani'' (diminished activity). This is the general feature of ''avarana''. Here the excessively increased strong ''avaraka'' suppresses the normal action of ''avrita'' (i.e.[[vata]]). Therefore, when the obstruction is complete it may lead to the ''prakopa'' of [[vata]] resulting in the presentation of [[vata]] vitiated symptoms as well as its disorders[ Cha. Sa. [[Chikitsa Sthana]] 28/215, Chakrapani]. In case of ''gatatva'' the symptomatology will be predominantly of [[vata]] vitiation and pain is a common and chief complaint in all the conditions of ''gatatva''.<br />
#Obstruction or covering of [[vata]] is possible by body components like [[dosha]] ([[pitta]] and [[kapha]]),tissues,food, excretory products or mutual affliction of [[vata]] types. Gatatva of [[vata]] (affection) is happening in empty spaces or hollow cavities of tissues, their elements, organs and other body parts. In ''avarana'', the body component is in increased state causing fullness in respected channels, while in ''gatatva'' pathology, the body components are in depleted state casusing emptiness in the respected channels. Dhatugata [[vata]] will be presented with decreased quality of tissues associated with signs of vitiated [[vata]]. Obviously, exceptions are possible according to the complexities of process of ''avarana'' or ''gatatva''.<br />
#In case of ''avarana'' of [[vata]], the ''avaraka'' is important for treatment since vitiation of [[vata]] is passive. When ''avarana'' is removed vitiated [[vata]] gets pacified. But in cases of ''gatatva'', the vitiated [[vata]] has to be treated first along with correction of ''adhisthana''.<br />
#Diagnosis of ''avarana'' is made with the help of ''upashaya–anupashaya'' (pacifying and aggravating factors) method. Diagnosis of ''gatatva'' is made according to the ''rupa'' (symptomatology). <br />
#Complications of ''avarana'' are explained in case of improper diagnosis and delayed treatment like ''hridroga, vidradhi, kamala'' etc. No known complication occur in ''gatatva''.<br />
#''Avarana'' of [[vata]] may cause depletion of nutrition to [[dhatu]] ([[dhatu]]gata sama) leading to successive diminition of rasadi [[dhatu]](''rasadimscha upasosayet'').[Cha. sa. [[Sutra Sthana]] 28/61] No such reference is available in case of ''gatatva''. <br />
<br />
The discussed points are briefly enlisted in the table below:<br />
{| class="wikitable"<br />
|-<br />
! scope="col"| ''Avrita''(obstructed) [[vata]]<br />
! scope="col"| ''Gata'' (excess movement) [[vata]]<br />
|-<br />
| Vitiation of [[vata]] is passive<br />
| Vitiation of [[vata]] is active<br />
|-<br />
| Normally ''svanidana''(specific causes for vitiation) of [[vata]] are not responsible<br />
| Vitiation of [[vata]] by ''svanidana''<br />
|-<br />
| Only ''chala'' property of [[vata]] is involved and it is diminished in the phenomenon<br />
| Other properties of [[vata]] are also involved and the ''chala'' property aggravated in the phenomenon<br />
|-<br />
| ''Gati'' of [[vata]] is obstructed<br />
| ''Gati'' of [[vata]] is aggravated<br />
|-<br />
| ''Purnata''(fullness) in ''srotas/marga''<br />
| ''Riktaka''(emptiness) in ''srotas''<br />
|-<br />
| [[Vata]] shows ''svakarma hani'' (decreased function)<br />
| [[Vata]] shows ''svakarma vriddhi'' (increased function)<br />
|-<br />
| [[Dhatu]] are in ''vriddhi'' (increase) or ''saama''<br />
| [[Dhatu]] daurbalya (decrease) present<br />
|-<br />
| ''Avarana'' possible with other [[dosha]]/anna/[[mala]]/individual components of [[vata]]<br />
| Not possible<br />
|-<br />
| ''Avarana'' by ''avayava''(body part) or ''ashaya''(organ) not possible<br />
| ''Gatatva'' in ''ashaya'' and ''avayava'' explained<br />
|-<br />
| ''Avaraka'' gets importance in treatment<br />
| [[Vata]] gets importance in treatment<br />
|-<br />
| Diagnosis made with ''upashaya anupashaya'' (hit and trial)<br />
| Diagnosis with ''rupa''<br />
|-<br />
| Complications of ''avarana'' possible<br />
| None<br />
|-<br />
| Successive diminution of rasadi [[dhatu]] possible<br />
| None<br />
|}<br />
<br />
As ''avarana'' proceeds it may end up in [[dhatu]]kshaya as the ''avrita'' will block [[rasa dhatu]] which give nourishment. This is commonly observed. This is possible in many other disorders also. The best example is rajayakshma. <br />
<br />
'''Prognosis''': <br />
<br />
Exclusive [[vata]] disorders are serious and have poor prognosis. The symptoms / diseases explained manifest when vitiated [[vata]] affects vital parts. The therapeutic approaches should be cautious and extra efforts are essential for a better recovery. As the disease becomes chronic the curability rate drastically declines. The physical strength of the patient is also very important in determining prognosis. [verse 72-74]<br />
<br />
'''General principles of management''': <br />
<br />
The general line of management of ''vatavyadhi'' applies to absolute [[vata]] vitiation only. If there is any association or obstruction of other dosha in ''vatavyadhi'', the treatment will be different. ''Kevalam'' term indicates pathology of vitiation of exclusive [[vata]]. ''Nirupastambha'' is condition without any association of other [[dosha]]. This pathology shall be primarily treated with oleation therapy.<br />
<br />
As in exclusive [[vata]]ja disease the major ''gunavriddhi'' is ''ruksha'' which leads to ''riktata'' in ''srotas'' and [[dhatu]] and more ''avakasha'' (space) for [[vata]]; [[snehana]] is essential and ideal. Various methods for [[snehana]] are employed depending on ''avastha'' (stage), ''sthana'' (site) and ''bala'' (strength) of the diseases and as well as patient.<br />
<br />
Following [[snehana]], [[swedana]] is also mandatory. Here the ''ushna guna'' (hot property) operates to control ''sheeta'' (cold). Repeated [[snehana]] and [[swedana]] imparts high grade of flexibility. <br />
<br />
''Sneha'' is a good medium to control [[vata]] as well as [[vata]]-[[pitta]]. Generally, this line of treatment can be counted as a part of [[brimhana]]. [verse 75-83]<br />
<br />
Repeated [[snehana]] and [[swedana]] therapies can control [[vata]] well. However, ''samshodhana'' (purification) therapies are executed to remove the residual [[dosha]]. As ''shodhana'' has a definite chance for causation of [[vata]] prakopa, the approach should be cautious, so ''mridu samshodana'' (mild purification) is done. Sneha [[virechana]] is done by ''tilwaka ghrita'' or ''eranda taila'', etc. ''Eranda taila'' is very effective in treating [[vata]] prakopa due to ''udavarta''. If [[virechana]] is not possible, ''anulomana'' diet should be adviced. If the patient is extremely weak niruha is better option. Even after ''shodhana''; recurrent application of [[snehana]] and [[swedana]] are essential.[verse 83-88] <br />
<br />
==== Management of [[vata]] at different sites ====<br />
<br />
Treatment of disorders of [[vata]], when located in different sites, habitat (''sthana'') is more important in comparison to the invaded (''agantu'') [[dosha]] e.g in koshthagata [[vata]], koshtha is given preference in treatment, and so ''kshara'' is used which helps in digestion ([[pachana]]). But when [[vata]] is located in ''pakvashaya'' or ''guda'' which is [[vata]]sthana, udavartahara treatment is selected, which includes [[vata]] anulomana, [[basti]], varti'' etc. In amashayagata [[vata]], shodhana in the form of [[vamana]] is done. ''<br />
<br />
''Hridaya anna'' (favourite food) is typically indicated in tvakgata [[vata]] because, rūkṣatā in tvak is a result of rasakṣaya caused by overworrying.[Cha. Sa. [[Vimana Sthana]] 5/13]<br />
<br />
Bahya [[snehana]] in the form of ''abhyanga'' or ''dhara'', etc are very effective in [[asthi dhatu]]gata and [[majja dhatu]]gata [[vata]]. Abhyantara [[snehana]] replenishes [[meda dhatu]] and subsequently [[asthi dhatu]] and [[majja dhatu]]. It is worthy to note the utility of ''tikta ghrita'' in [[asthi dhatu]] kshaya. <br />
<br />
In ''shukrakshaya'' (depletion of ''shukra''), ''harshana'' (pleasure) and ''vrishya annapana'' (aphorodisiac diet) is very useful. <ref>Vagbhata, Sharira Sthana Chap 5 , Angavibhaga Adhyaya, Verse 67. In: Bhishagacharya Harisastri Paradikara Vaidya (eds.) 9th ed. Varanasi: Chaukhambha Orientalia; 2005. P798</ref><br />
<br />
=== Management of ''ardita'' (facial palsy) ===<br />
<br />
The line of treatment of ''ardita'' aims at ''mastishkya'' (brain), therefore, [[nasya]] is indicated. [[Nasya]] is explained to be the direct entrance to the cranial vault. [[Nasya]] may be ''shodhana, shamana'' or [[brimhana]] as the case may be. But there is an opinion that since the word ''navana'' is used, it means snaihika [[nasya]]. ''Murdhni taila'' is absolutely meant for treatment in head region and is of four types viz. ''abhyanga'' ( head massage), ''seka'' (pouring liquid on head), ''pichu'' ( therapeutic unctuous swab on head) and ''shirobasti''. ''Tarpana'' (nourishment therapy) is ''akshitarpana'' (nourishing eyes) and ''shrotratarpana'' (nourishing ears). ''Nadisweda'' is very specific in ''ardita'' and ''ksheeradhooma'' (medicated fumes of milk).<br />
<br />
Poultice prepared from flesh of marshy animals is used for [[brimhana]] in atrophy of muscles. [[Vamana]] is indicated in ''ardita'', when it is associated with ''shopha'' and ''raktamokshana'' is indicated when associated with ''daha'' (burning) and ''raga'' (redness).<br />
<br />
In ''pakshaghata, [[swedana]], fomentation mixed with unctuous material and [[virechana]] or purgation therapy with unctuous substance is indicated. [[Virechana]] is the line of treatment in ''pakshaghata'' and outweighs [[basti]] which is said to be ideal for [[vata]]kopa. ''Pakshaghata'' may be understood as a concealed ''urdhwaga raktapitta'' (bleeding from upper orifices of body) in which the only and effective choice is ''adho-shodhana'' (purgation). ''Gridhrasi'' is a tendon and ligament disorder and ''shastra, kshara,'' and ''agnikarma'' are the main line of treatment. Therefore ''siravyadha'' (blood letting) and ''dahakarma'' (cauterization) is advised. [[Basti]] is also a good choice since pakvashayagata [[vata]] leads to ''kateegraha'' and ''gridhrasi''. <br />
<br />
''Agnikarma'' and ''siravyadha'' are the two line of treatment which are useful in acute phase to relieve the pain in ''gridhrasi'' and also in ''khalli''. ''Agnikarma'' relieves muscle spasm thereby reducing pain whereas ''siravyadha'' may be helpful by reducing the blood stasis. Improved circulation removes cytokines and other inflammatory factors thereby reducing pain. (99-103)<br />
<br />
''Agnikarma'' is a para surgical procedure in which a metallic thin pointed rod called ''shalaka'' is heated and applied to specific points of pain for relief. It is commonly used as efficient pain reducing therapy in musculoskeletal disorders.<br />
<br />
=== Importance of site of affliction in treatment ===<br />
<br />
The specificity of treatment depends on the site of affliction and the associated morbid tissues. For example masthishkya is very specific for ardita, pakshaghata, indriyagatavata etc. Even though [[vamana]] is [[kapha]]hara, it is exclusively indicated in āmashayagata vāta taking into account of site of affliction. [verse 104]<br />
<br />
[[Brimhana]] treatment of [[vata]] vitiation: The treatment of exclusive [[vata]] vitiation (without involvement of other [[dosha]]) is [[brimhana]]. If associated [[dosha]] is present, they shall be treated first. [verse 105]<br />
<br />
Bala is excellent for lone vitiated [[vata]]. The head of goat is indicated on the basis of the principle ‘samanyam vridhikaranam’(like increases like). These also explain the awareness of utilization of brain of goat in degenerative brain lesions. Lavana relieves stambha (stiffness) and samghata (conglomeration). Upanaha is also prepared with such well fomented flesh and added with different oils, salts etc. Such upanāha are brimhana. [verse 106-108]<br />
<br />
=== Avagaha (immersion) sweda ===<br />
<br />
Avagaha is typically indicated in apana vaigunya (defects due to apana [[vata]] vitiation), it is a type of drava sweda (liquid fomentation). Nadisweda is also an excellent option for all types of vataroga. Poultices (upanaha) of different types provide self generated heat to cause swedana. It is by virtue of various dhanya (cereals) and kinwa (yeast) available in it. [verse 109-118]<br />
<br />
=== Different formulations===<br />
<br />
Different medicated ghrita, taila, vasa, majja and maha sneha (combination of all four sneha) are indicated for various conditions in the form of oral ingestion, inhalation, enema and external application etc. Maha sneha is guru (heavy to digest) and ultimately indicated in disorders like convulsions, tremor etc. [verse 119-136]<br />
<br />
Pinyaka taila is a preparation in which ruksha [[guna]] is imparted to taila and is highly useful in [[kapha]] associated [[Vata]] vyadhi. [verse 136-137]<br />
<br />
=== Importance of oil in treatment of [[vata]]=== <br />
<br />
By virtue of vyavayi [[guna]] (pervading/diffusive), it reaches the different interior parts of the body without any metabolic changes. By processing taila can adopt any type of qualitative changes. The drugs are potentiated by repeated processing in its own media. Drugs like ksheerbala (101 avartita), dhanwatharam (21 avartita) etc. are worth mentioning here. This approach of samskara makes sneha as sukshma sneha (with better bio-availability and penetration). [verse 181-182]<br />
<br />
<br />
=== Management of avrita [[vata]] ===<br />
<br />
In [[pitta]]vritta [[vata]], hot and cold should be applied alternately. Jivaniya sarpi is also very [[brimhana]]. [[Brimhana]] is the ideal pacifying line of treatment for [[vata]] and [[vata]]-[[pitta]]. <br />
<br />
In [[kapha]]vritta [[vata]], ruksha is given importance. In association of [[kapha]] along with [[pitta]] in [[vata]]roga, [[pitta]] should be given importance in management. It is because of the fact that [[pitta]] makes the disease process as ‘ashukari’(instantaneous). <br />
<br />
In [[Kapha]]vritta [[vata]]; tikshna sweda, niruha and [[vamana]] which reduces [[kapha]] is indicated followed by [[virechana]] intended for [[vata]] anulomana and also useful for [[kapha]].<br />
<br />
Jirna/purana sarpi (old ghee) which has [[kapha]]ghna quality has to be used; tila and sarshapa which are [[kapha]] [[vata]]ghna are to be used. Warm drinks of yava, jangala mamsa rasa which gives strength to the patient without increasing kapha are to be administered. [verse 183-188]<br />
<br />
Kshara [[basti]] (gomutrayukta [[basti]]) in case of [[kapha]]-[[vata]] and ksheera [[basti]] in [[pitta]]-[[vata]] is recommended. [[Rakta]]vruta [[vata]] is similar to uttana-vatarakta and treatment is accordingly same. [[Rakta]] avruta [[vata]] is one of the phases of vatarakta. Thus [[raktamokshana]] and [[basti]] chikitsa which is useful in vatarakta is also helpful in rakta avruta [[vata]]. <br />
<br />
Prameha samprapti mentioned in Sutra sthana 17th chapter explains [[kapha]], [[pitta]], [[meda dhatu]] and [[mamsa dhatu]] which when increased causes avarana of [[vata]]. Therefore, pramehagna cikitsa is helpful in meda avruta [[vata]] and also in mamsavrutta [[vata]]. Hence in mamsavrutta [[vata]] the pipilika iva sanchara (tingling sensation) reduces, if prameha is treated. Similarly, in obesity, medasavruta [[vata]] ([[vata]] obstructed by excess meda) [Cha.Sa.[[Sutra Sthana]] 21/5] and meda and mamsa ativridhi [Cha.Sa.[[Sutra Sthana]] 21/9] is observed. These conditions are best treated on the principles of management of prameha, sthaulya associated with vitiated [[vata]]. Therapeutic emesis to expel out the intoxicated food in stomach is advised in condition of annavrita [[vata]] ( [[vata]] obstructed by food). [[Pachana]] and [[deepana]] helps in digestion and also pacifies [[vata]].<br />
<br />
Hot fomentation reduces urethral pressure. A study done by Shafik A. showed that sitting in warm water helps in micturition which seems to be initiated by reflex internal urethral sphincter relaxation. A thermo sphincter reflex is likely to be involved.<br />
<br />
Uttara basti effect is similar to catheterization. Further depending on the medicines used for uttara basti, tri[[dosha]] shamana can be done.<br />
<br />
The lines of treatment of [[rakta]]gata [[vata]] and raktvrita [[vata]] as well as [[shukra]]gata [[vata]] and shukrāavruta [[vata]] are one and the same irrespective difference in samprapti as gata [[vata]] or avruta [[vata]]. It is because of the fact that [[rakta]] and [[shukra]] are mobile and comparatively pervaded all over the body like [[vata]] so gata[[vata]] and avruta [[vata]] are mutually complimentary here. <br />
Finally, the treatment strategies of anyasthanagata(in other sites) [[vata]] are explained. The importance is given to sthanastha [[dosha]] (in own sites).[Verse 189-199]<br />
<br />
Movements of [[vata]] and concept of anyonyavarana:As discussed earlier avyahatagati (free movement) is a cardinal feature of [[vata]] to perform normally. In [[avarana]] certain obstacles like [[dosha]], [[dhatu]] or anna etc which are immobile, occupy the pathway of mobile [[vata]. It is not mandatory that such immobile articles only cause obstruction to [[vata]]. If the individual sub types of [[vata]] are considered prana, udana, vyana, samana and apana are mobile and has some specific direction for their gati. For example, prana has movement from murdha (head) to downwards. Udana has movement from uras(chest) to upwards. Vyana moves upward downward and sidewards like rasa. Samana moves around jatharagni. Apana move downwards from pakvashaya. This can be further analysed as follows. Udana possess upward movement. Likewise ‘apana’ has downward direction. Vyana [[vayu]] moves in horizontal direction (vyāpanat vyāna uccyate) along with upward and downward directions as rasa samvahana (circulation) is concerned.[19]Samana is also having such qualities to equally distribute the nutrients through out the body. Prana has multi directional gati. So, the movements of individual subtypes of vāta are directional in nature. When these meet in opposite direction it makes anyonyavarana. For example prāna and udāna meet opposite and interfere with mutual normal movements leads to difficulty in inspiration as well as expiration which is comparatively irreversible. This concept is called anyonyāvarana. It is of 20 types taking into account of 5 different types making 4 particular combinations. Anyonyāvarana are comparatively difficult situations. [verses 199-206]<br />
<br />
Anyonya avarana is characterized by Svakarma hani or vriddhi (either increase or decrease in functions) which depends on the nature and site of anyonyāvarana (mutual covering). For example prana avruta udana may lead to difficulty in respiration, followed with cardiac symptoms, aphasia or dysarthria and some times upper respiratory symptoms. This presentation is comparatively acute in onset and. Here the functions of udāna are masked by prana. But in udana avruta prana the symptoms are loss of motor power, immunity and complexion leading to death. Here the functions of prana are seriously hampered. This symptom may be acute or chronic in nature. When apana got avarana by udana the normal peristalsis is hampared and anulomana is the line of treatment. In apana avarana to udana increased bowel motility can be seen grāhi is the line of treatment which should be adopted here.<br />
<br />
=== Rehabilitation of [[vata]]=== <br />
<br />
Prakrutisthapanam means re-establishment in its own pathway (sva margaga)/ or in its own place (sva sthana gamayed enam). Therefore for udana [[vayu]], [[vamana]] etc. treatment should be administered to regulate the normal functional status of udana [[vayu]]. Apana has adhogati, therefore anulomana chikitsā should be done, thereby regularizing the urdhva apana bhava of Apana [[vayu]]. Shamana should be line of treatment for samana [[vayu]]. Empowering digestive power should be done. Samana being sited near [[agni]], proper digestion and absorption of essential elements will be observed. Proper electrolyte balance will be maintained, thereby maintaining the pH of body fluids. As discussed previously vyāna has all the three gati i.e. urdhva, adho and madhya gati. Here the general line of treatment of anyonyavarana is discussed. [verse 219-221]<br />
<br />
===Importance of udana and prana vata===<br />
<br />
Among various avarana, the involvement of udana and prana are very important. As explained in the introductory comments, prana is life and udana is strength. These are very vital issues as far as avarana is concerned. Improper management or avoidance of treatments may lead to permanant disabilities in avarana. [verse 231-236]<br />
<br />
=== Complications of Avarana===<br />
<br />
This includes hrudroga, vidradhi, plīhā, gulma, atisara. Hrudroga is a common complication of ill treated avarana of prana and udana. Vidradhi and pliha are caused by wrongly managed avarana of vyana. Gulma and atisara are common complications of avarana of samana and apana. <br />
<br />
Srotoshodhana is an important line of management in Avarana. It ensures unobstructed movement of [[vata]]. All abhishyandi(increasing discharges in body) food causes srotorodha (obstruction of channels). Yapana [[Basti]] is ideal for all age group and safe to severe clinical presentations. It protects all marma points. As it is neither lekhana (reducing body components), nor [[brimhana]], it is useful for managing [[vata]] as well as avaraka [[kapha]] or [[pitta]]. Guggulu rasāyana and shilajatu rasāyana is ideal for many clinical conditions of avarana.<br />
<br />
=== Related chapters ===<br />
<br />
[[Vatakalakaliya Adhyaya]], [[Basti]], [[Snehana]], [[Panchakarma]]<br />
<br />
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<big>'''[[Siddhi Sthana]] Chapter 9. Management of diseases of three vital organs'''</big><br />
{{Infobox<br />
|title = Trimarmiya Siddhi<br />
|label1 = Section/Chapter<br />
|data1 = [[Siddhi Sthana]] Chapter 9<br />
|label2 = Preceding Chapter<br />
|data2 = [[Prasrita Yogiyam Siddhi]]<br />
|label4 = Succeeding Chapter<br />
|data4 = [[Basti Siddhi]]<br />
|label5 = Other Sections<br />
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]<br />
|label6 = Translator and commentator<br />
|data6 = Shenoy R.<br />
|label7 = Reviewer <br />
|data7 = Panse A.<br />
|label8 = Editors<br />
|data8 = Thakar A. B., Mangalasseri P., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br />
|label9 = Year of publication <br />
|data9 = 2020<br />
|label10 = Publisher <br />
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label11 = DOI <br />
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s08.010 10.47468/CSNE.2020.e01.s08.010]<br />
}}<br />
<big>''' Abstract </big>'''<br />
<p style="text-align:justify;">This chapter describes importance of three vital organs viz. ''hridaya'' (heart), ''shiras'' (head) and ''basti'' (urinary bladder) during purification procedures. The etio-pathogenesis of ''marma'' disorders are elaborated in detail with their management. The diseases include ''apatantraka'' (Opisthotomus), ''tandra'' (drowsiness) related to ''hridaya'' involvement, thirteen types of ''mutra dosha'' (diseases caused due to vitiation of urine), and diseases related to head viz. ''shankhaka'' (acute temporal headache ), ''ardhavabhedaka'' (one sided headache or migraine), ''suryavarta'' (headache that increases with sun rise) and ''anantavata'' (headache that starts from an area and then gradually involves the entire head and face). ''Uttara basti'' (per urethral and per vaginal drug delivery) as a treatment modality, its procedure of administration and dimensions of ''netra'' (nozzle) are discussed in detail for the management of urinary and reproductive systemic disorders. ''[[Nasya]]'' therapy (nasal errhines) is described for the management of disorders of head. The chapter emphasizes on importance of sustaining health of ''marma'' by following preventive measures and timely treatment. <br />
<br/><br />
'''Keywords''': ''Marma'' (vital points), Diseases of head and nervous system, Heart and cardiovascular system, bladder, kidney and urinary system, ''Apatantraka, Ardhavabhedaka, Basti, Hridaya, Mutradosha, [[Nasya]], Shiromarma, Suravarta, Tandra, Trimarma, Udavarta,Uttara basti,'' per vaginal drug delivery, per urethral drug delivery.<br />
</p><br />
<br />
== Introduction ==<br />
<div style="text-align:justify;"><br />
[[Panchakarma]] and ''[[basti]]'' in particular can cause complications pertaining to ''marmas'' especially to the three vital points (''trimarma-hridaya, shiras'' and ''basti'') and successful treatment entails the proper administration of ''[[basti]]''. All marmas fall under the ''madhyama rogamarga'' (disease pathways including internal systems) [ Cha.Sa.[[Sutra Sthana]] 11/48], and their diseases are difficult to manage. ''[[Vata dosha]]'' is important in etio-pathology of any disease, because the it is responsible for movement of vitiated ''[[dosha]]s'' to other sites of disease (''roga marga''). ''[[Basti]]'' is the best treatment to alleviate ''[[vata]]'' and manage these diseases [Cha.Sa [[Siddhi Sthana]] 1/38-39]. Some diseases described in this chapter are not mentioned in the [[Trimarmiya Chikitsa]] chapter [Cha. Sa.[[Chikitsa Sthana]] 26] described earlier.<br />
<br />
''Uttara basti'' (per urethral and per vaginal drug delivery) is the third type of ''[[basti]]'' in the management of ''shukravaha srotas'' (reproductive system) and ''mutravaha srotas'' (urinary systems). This treatment modality to deliver drug in bladder in case of urinary system disorders and in uterus in case of uterine and reproductive system disorders is explained in detail. ''[[Nasya]]'' therapy (nasal errhines), its types and its importance in management of disorders of head is described further. Thus, the present chapter encompasses etio-pathology and medical management of all disorders related to heart, head and urinary system.<br />
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== Sanskrit text, Transliteration and English Translation == <br />
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अथातस्त्रिमर्मीयां सिद्धिं व्याख्यास्यामः||१|| <br />
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इति ह स्माह भगवानात्रेयः||२||<br />
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athātastrimarmīyāṁ siddhiṁ vyākhyāsyāmaḥ||1||<br />
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iti ha smāha bhagavānātrēyaḥ||2||<br />
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athAtastrimarmIyAM siddhiM vyAkhyAsyAmaH||1|| <br />
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iti ha smAha bhagavAnAtreyaH||2|| <br />
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Now we shall expound the chapter "Trimarmiya Siddhi" (Management of diseases of three vital organs). Thus said Lord Atreya [1-2]<br />
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=== Description of ''marma'' (vital points and organs) ===<br />
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सप्तोत्तरं मर्मशतमस्मिञ्छरीरे स्कन्धशाखासमाश्रितमग्निवेश!| <br />
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तेषामन्यतमपीडायां समधिका पीडा भवति, चेतनानिबन्धवैशेष्यात्| <br />
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तत्र शाखाश्रितेभ्यो मर्मभ्यः स्कन्धाश्रितानि गरीयांसि, शाखानां तदाश्रितत्वात्; स्कन्धाश्रितेभ्योऽपि हृद्वस्तिशिरांसि, तन्मूलत्वाच्छरीरस्य||३||<br />
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saptōttaraṁ marmaśatamasmiñcharīrē skandhaśākhāsamāśritamagnivēśa!| <br />
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tēṣāmanyatamapīḍāyāṁ samadhikā pīḍā bhavati, cētanānibandhavaiśēṣyāt| <br />
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tatra śākhāśritēbhyō marmabhyaḥ skandhāśritāni garīyāṁsi, śākhānāṁ tadāśritatvāt; skandhāśritēbhyō'pi hr̥dvastiśirāṁsi, tanmūlatvāccharīrasya||3||<br />
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saptottaraM marmashatamasmi~jcharIre skandhashAkhAsamAshritamagnivesha!| <br />
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teShAmanyatamapIDAyAM samadhikA pIDA bhavati, cetanAnibandhavaisheShyAt| <br />
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tatra shAkhAshritebhyo marmabhyaH skandhAshritAni garIyAMsi, shAkhAnAM tadAshritatvAt; skandhAshritebhyo~api hRudvastishirAMsi, tanmUlatvAccharIrasya||3||<br />
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<div style="text-align:justify;"><br />
Hey Agnivesha! There are 107 ''marmas'' in this ''sharira'' situated in the ''skandha'' (trunk) and ''shakha'' (extremities or limbs). Trauma or pain occurring in these areas is much more intense as compared to other parts because of ''chetana'' (life) is bound to these sites.<br />
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The ''marmas'' related to ''skandha'' are more important than those situated in the ''shakha'' because the ''shakha'' is attached to the ''skandha'' and more so among the ''skandha'' situated ''marmas, hrid, basti'' and ''shiras'' are important owing to the fact that they are the root cause of body (on them depends the existence or otherwise of the body).[3]<br />
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=== Description of three vital organs ===<br />
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तत्र हृदये दश धमन्यः प्राणापानौ मनो बुद्धिश्चेतना महाभूतानि च नाभ्यामरा इव प्रतिष्ठितानि, शिरसि इन्द्रियाणि इन्द्रियप्राणवहानि च स्रोतांसि सूर्यमिव गभस्तयः संश्रितानि, बस्तिस्तु स्थूलगुदमुष्कसेवनीशुक्रमूत्रवाहिनीनां नाडी(ली)नां मध्ये मूत्रधारोऽम्बुवहानां सर्वस्रोतसामुदधिरिवापगानां प्रतिष्ठा, बहुभिश्च तन्मूलैर्मर्मसञ्ज्ञकैः स्रोतोभिर्गगनमिव दिनकरकरैर्व्याप्तमिदं शरीरम्||४||<br />
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तेषां त्रयाणामन्यतमस्यापि भेदादाश्वेव शरीरभेदः स्यात्, आश्रयनाशादाश्रितस्यापि विनाशः; तदुपघातात्तु घोरतरव्याधिप्रादुर्भावः; तस्मादेतानि विशेषेण रक्ष्याणि बाह्याभिघाद्वातादिभ्यश्च||५||<br />
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tatra hr̥dayē daśa dhamanyaḥ prāṇāpānau manō buddhiścētanā mahābhūtāni ca nābhyāmarā iva pratiṣṭhitāni, śirasi indriyāṇi indriyaprāṇavahāni ca srōtāṁsi sūryamiva gabhastayaḥ saṁśritāni, bastistu sthūlagudamuṣkasēvanīśukramūtravāhinīnāṁ nāḍī(lī)nāṁ m adhyē mūtradhārō'mbuvahānāṁ sarvasrōtasāmudadhirivāpagānāṁ pratiṣṭhā, bahubhiśca tanmūlairmarmasañjñakaiḥ srōtōbhirgaganamiva dinakarakarairvyāptamidaṁ śarīram||4|| <br />
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tēṣāṁ trayāṇāmanyatamasyāpi bhēdādāśvēva śarīrabhēdaḥ syāt, āśrayanāśādāśritasyāpi vināśaḥ; tadupaghātāttu ghōrataravyādhiprādurbhāvaḥ; tasmādētāni viśēṣēṇa rakṣyāṇi bāhyābhighādvātādibhyaśca||5||<br />
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tatra hRudaye dasha dhamanyaH prANApAnau mano buddhishcetanA mahAbhUtAni ca nAbhyAmarA iva pratiShThitAni, shirasi indriyANi indriyaprANavahAni casrotAMsi sUryamiva gabhastayaH saMshritAni, bastistu sthUlagudamuShkasevanIshukramUtravAhinInAM nADI(lI)nAM madhye mUtradhAro~ambuvahAnAMsarvasrotasAmudadhirivApagAnAM pratiShThA , bahubhishca tanmUlairmarmasa~jj~jakaiH srotobhirgaganamiva dinakarakarairvyAptamidaM sharIram||4|| <br />
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teShAM trayANAmanyatamasyApi bhedAdAshveva sharIrabhedaH syAt, AshrayanAshAdAshritasyApi vinAshaH; tadupaghAtAttu ghorataravyAdhiprAdurbhAvaH;tasmAdetAni visheSheNa rakShyANi bAhyAbhighAdvAtAdibhyashca||5|| <br />
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<div style="text-align:justify;"><br />
In the ''hridaya'' (heart), are situated the ten ''dhamani'' (ten great vessels arising from the heart), ''prana, apana, manas'' (mind), ''buddhi'' (intellect), ''chetana'' (life), ''[[mahabhuta]]s'' (5 fundamental elements) just like spokes to the axle in the center of a wheel. <br />
<br />
In the ''shiras'' (head) are situated the ''[[indriya]]s'' (the seat of special senses), the ''srotas'' (channels) pertaining to the conduction of ''[[indriya]]'' and ''prana'' like the radiating spicules of the rays of sunlight. <br />
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The ''basti'' (bladder) situated in the midst of ''sthula guda'' (rectum), ''mushka'' (scrotum), ''sevani'' (perineal raphe), ''nadis'' carrying ''[[mutra]]'' (urine) and ''[[shukra]]'' (semen) is the ''mutradhara'' (reservoir of urine) in to which drain all the ''ambuvaha srotas'', similar to the ''udadhi'' (sea/ ocean) into which drain all the rivers. Hence, the body may be described to be pervaded by innumerable ''srotas'' nourishing ''marmas'' similar to the sky which is pervaded by the rays of sunlight. <br />
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Among all the ''marmas, bheda'' (injury) to these 3 ''marmas'' (''hridaya, shiras'' and ''basti'') leads to sudden loss to the body. The destruction of substance (''ashraya'') leads to the destruction of the substrate. Its injury leads to severe disease manifestation. Hence, these should be especially protected against external injury and ''vatadi [[dosha]]s''.[5]<br />
</div><br />
=== Clinical signs of injury to three ''marmas'' ===<br />
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तत्र हृद्यभिहते कासश्वासबलक्षयकण्ठशोषक्लोमाकर्षणजिह्वानिर्गममुखतालुशोषापस्मारोन्मादप्रलापचित्तनाशादयः स्युः; शिरस्यभिहते मन्यास्तम्भार्दितचक्षुर्विभ्रममोहोद्वेष्टनचेष्टानाशकासश्वासहनुग्रहमूकगद्गदत्वाक्षिनिमीलन- गण्डस्पन्दनजृम्भणलालास्रावस्वरहानिवदनजिह्मत्वादीनि, बस्तौ तु वातमूत्रवर्चोनिग्रहवङ्क्षणमेहनबस्तिशूलकुण्डलोदावर्तगुल्मानिलाष्ठीलोपस्तम्भनाभिकुक्षिगुदश्रोणिग्रहादयः; वाताद्युपसृष्टानां त्वेषां लिङ्गानि चिकित्सिते सक्रियाविधीन्युक्तानि||६||<br />
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tatra hr̥dyabhihatē kāsaśvāsabalakṣayakaṇṭhaśōṣaklōmākarṣaṇajihvānirgamamukhatāluśōṣāpasmārōnmādapralāpacittanāśādayaḥ syuḥ; śirasyabhihatē manyāstambhārditacakṣurvibhramamōhōdvēṣṭanacēṣṭānāśakāsaśvāsahanugrahamūkagadgadatvākṣinimīlana- gaṇḍaspandanajr̥mbhaṇalālāsrāvasvarahānivadanajihmatvādīni, bastau tu vātamūtravarcōnigrahavaṅkṣaṇamēhanabastiśūlakuṇḍalōdāvartagulmānilāṣṭhīlōpastambhanābhikukṣigudaśrōṇigrahādayaḥ ; vātādyupasr̥ṣṭānāṁ tvēṣāṁ liṅgāni cikitsitē sakriyāvidhīnyuktāni||6||<br />
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tatra hRudyabhihate kAsashvAsabalakShayakaNThashoShaklomAkarShaNajihvAnirgamamukhatAlushoShApasmAronmAdapralApacittanAshAdayaH syuH; shirasyabhihate manyAstambhArditacakShurvibhramamohodveShTanaceShTAnAshakAsashvAsahanugrahamUkagadgadatvAkShinimIlana- gaNDaspandanajRumbhaNalAlAsrAvasvarahAnivadanajihmatvAdIni, bastau tu vAtamUtravarconigrahava~gkShaNamehanabastishUlakuNDalodAvartagulmAnilAShThIlopastambhanAbhikukShigudashroNigrahAdayaH; vAtAdyupasRuShTAnAM tveShAM li~ggAni cikitsite sakriyAvidhInyuktAni||6||<br />
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<div style="text-align:justify;"><br />
Injury to the ''hridaya'' leads to ''kasa'' (cough), ''shwasa'' (breathlessness), ''balakshaya'' (weakness), ''kantashosha'' (dryness of throat), ''klomakarshana'' (a form of severe chest pain), ''jihvanirgama'' (prolapse of tongue), ''mukhashosha'' (dryness of mouth), ''talushosha'' (dryness of palate), ''apasmara'' (epilepsy), ''unmada'' (psychosis), ''pralapa'' (irrelevant speech), ''chittanahsa'' (loss of mental integrity) etc.<br />
<br />
Injury to the ''shiras'' leads to ''manyastambha'' (stiffness of neck), ''ardita'' (hemiplegia with facial palsy), ''chakshuvibhrama'' (improper movements of eyeball/lesions in sight), ''moha'' (a state of confusion), ''udveshtana'' (twisting pain in the head), ''cheshtanasha'' (loss of body functions), ''kasa'' (cough), ''shwasa'' (breathlessness), ''hanugraha'' (stiffness of jaw), ''muka'' (dumbness), ''gadgada'' (hoarseness of voice), ''akshinimilana'' (ptosis), ''gandaspandana'' (twitching in cheek), ''jrambhana'' (excessive yawning), ''lalasrava'' (dribbling of saliva), ''svarahani'' (aphonia), ''vadana jihmatva'' (deviation of face) etc.<br />
<br />
Affliction of ''basti'' causes ''[[vata]]- [[mutra]]- varcha nigraha'' (retention of flatus, urine and stools), ''vankshana- mehana- basti shula'' (pain in groin, genitals and bladder region), ''kundala'' (retrogressive movement of ''[[vata]]'' or ''[[mutra]]''), ''udavarta'' (reflux of ''[[vata]]'' or ''[[mutra]]''), ''gulma'' (abdominal lumps ), ''anila asthila'' (a solid mass due to aggravated ''[[vata]]''), ''upastambha'' (obstruction or retention of urine), ''nabhi- kukshi- guda- shroni graha'' (stiffness in umbilicus, epigastrium, rectum and pelvis) etc. <br />
<br />
These mentioned symptoms due to affliction by ''vatadi [[dosha]]s'' have been explained in [[Chikitsa Sthana]] with their management. [6]<br />
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=== Importance of ''[[vata dosha]]'' and ''[[basti]]'' therapy ===<br />
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किन्त्वेतानि विशेषतोऽनिलाद्रक्ष्याणि, अनिलो हि पित्तकफसमुदीरणे हेतुः प्राणमूलं च, स बस्तिकर्मसाध्यतमः, तस्मान्न बस्तिसमं किञ्चित् कर्म मर्मपरिपालनमस्ति| <br />
तत्र षडास्थापनस्कन्धान् विमाने द्वौ चानुवासनस्कन्धाविह च विहितान् बस्तीन् बुद्ध्या विचार्य महामर्मपरिपालनार्थं प्रयोजयेद्वातव्याधिचिकित्सां च||७||<br />
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kintvētāni viśēṣatō'nilādrakṣyāṇi, anilō hi pittakaphasamudīraṇē hētuḥ prāṇamūlaṁ ca, sa bastikarmasādhyatamaḥ, tasmānna bastisamaṁ kiñcit karma marmaparipālanamasti| <br />
tatra ṣaḍāsthāpanaskandhān vimānē dvau cānuvāsanaskandhāviha ca vihitān bastīn buddhyā vicārya mahāmarmaparipālanārthaṁ prayōjayēdvātavyādhicikitsāṁ ca||7||<br />
<br />
kintvetAni visheShato~anilAdrakShyANi, anilo hi pittakaphasamudIraNe hetuH prANamUlaM ca, sa bastikarmasAdhyatamaH, tasmAnna bastisamaM ki~jcit karma marmaparipAlanamasti| <br />
tatra ShaDAsthApanaskandhAn vimAne dvau cAnuvAsanaskandhAviha ca vihitAn bastIn buddhyA vicArya mahAmarmaparipAlanArthaM prayojayedvAtavyAdhicikitsAM ca||7||<br />
</div></div><br />
<div style="text-align:justify;"><br />
However, these ''marmas'' have to be protected especially from ''anila'' (''[[vata]]''), as ''[[vata]]'' is the prime factor or cause for the aggravation of ''[[pitta]]'' and ''[[kapha]]'' and also it is the cause of ''prana'' (life) and is best palliable by ''[[basti]]''. Hence, there is no treatment better than ''[[basti]]'' to maintain the ''marma''. Hereby, the six ''asthapana skandhas'' (decoction enemas) and also the two ''anuvasana skandhas'' described in [[Vimana Sthana]], as well as the ''[[basti]]s'' described in [[Siddhi Sthana]] with the treatment of ''vatavyadhi chikitsa'' may be rationally employed in the protection and restoration of the ''maha marmas'' (three great ''marmas'').[7]<br />
</div><br />
=== Management of ''marma'' disorders ===<br />
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भूयश्च हृद्युपसृष्टे हिङ्गुचूर्णं लवणानामन्यतमचूर्णसंयुक्तं मातुलुङ्गस्य रसेनान्येन वाऽम्लेन हृद्येन वा पाययेत्, स्थिरादिपञ्चमूलीरसः सशर्करः पानार्थं, बिल्वादिपञ्चमूलरससिद्धा च यवागूः, हृद्रोगविहितं च कर्म; मूर्ध्नि तु वातोपसृष्टेऽभ्यङ्गस्वेदनोपनाहस्नेहपाननस्तःकर्मावपीडनधूमादीनि; बस्तौ तु कुम्भीस्वेदः, वर्तयः, श्यामादिभिर्गोमूत्रसिद्धो निरूहः, बिल्वादिभिश्च सुरासिद्धः, शरकाशेक्षुदर्भगोक्षुरकमूलशृतक्षीरैश्च त्रपुसैर्वारुखराश्वाबीजयवर्षभकवृद्धिकल्कितो निरूहः, पीतदारुसिद्धतैलेनानुवासनं, तैल्वकं च सर्पिर्विरेकार्थं, शतावरीगोक्षुरकबृहतीकण्टकारिकागुडूचीपुनर्नवोशीरमधुकद्विसारिवालोध्रश्रेयसीकुशकाशमूलकषायक्षीरचतुर्गुणं बलावृषर्षभकखराश्वोपकुञ्चिकावत्सकत्रपुसैर्वारुबीजशितिवारकमधुकवचाशतपुष्पाश्मभेदकवर्षाभूमदनफलकल्कसिद्धं तैलमुत्तरबस्तिर्निरूहो वा शुद्धस्निग्धस्विन्नस्य बस्तिशूलमूत्रविकारहर इति||८||<br />
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bhūyaśca hr̥dyupasr̥ṣṭē hiṅgucūrṇaṁ lavaṇānāmanyatamacūrṇasaṁyuktaṁ mātuluṅgasya rasēnānyēna vā'mlēna hr̥dyēna vā pāyayēt, sthirādipañcamūlīrasaḥ saśarkaraḥ pānārthaṁ, bilvādipañcamūlarasasiddhā ca yavāgūḥ, hr̥drōgavihitaṁ ca karma; mūrdhni tu vātōpasr̥ṣṭē'bhyaṅgasvēdanōpanāhasnēhapānanastaḥkarmāvapīḍanadhūmādīni; bastau tu kumbhīsvēdaḥ, vartayaḥ, śyāmādibhirgōmūtrasiddhō nirūhaḥ, bilvādibhiśca surāsiddhaḥ, śarakāśēkṣudarbhagōkṣurakamūlaśr̥takṣīraiśca trapusairvārukharāśvābījayavarṣabhakavr̥ddhikalkitō nirūhaḥ, pītadārusiddhatailēnānuvāsanaṁ, tailvakaṁ ca sarpirvirēkārthaṁ, śatāvarīgōkṣurakabr̥hatīkaṇṭakārikāguḍūcīpunarnavōśīramadhukadvisārivālōdhraśrēyasīkuśakāśamūlakaṣāyakṣīracaturguṇaṁ balāvr̥ṣarṣabhakakharāśvōpakuñcikāvatsakatrapusairvārubījaśitivārakamadhukavacāśatapuṣpāśmabhēdakavarṣābhūmadanaphalakalkasiddhaṁ tailamuttarabastirnirūhō vā śuddhasnigdhasvinnasya bastiśūlamūtravikārahara iti||8|| <br />
<br />
bhUyashca hRudyupasRuShTe hi~ggucUrNaM lavaNAnAmanyatamacUrNasaMyuktaM mAtulu~ggasya rasenAnyena vA~amlena hRudyena vA pAyayet, sthirAdipa~jcamUlIrasaH sasharkaraH pAnArthaM, bilvAdipa~jcamUlarasasiddhA ca yavAgUH, hRudrogavihitaM ca karma; mUrdhni tu vAtopasRuShTe~abhya~ggasvedanopanAhasnehapAnanastaHkarmAvapIDanadhUmAdIni; bastau tu kumbhIsvedaH, vartayaH, shyAmAdibhirgomUtrasiddho nirUhaH, bilvAdibhishca surAsiddhaH, sharakAshekShudarbhagokShurakamUlashRutakShIraishca trapusairvArukharAshvAbIjayavarShabhakavRuddhikalkito nirUhaH, pItadArusiddhatailenAnuvAsanaM, tailvakaM ca sarpirvirekArthaM, shatAvarIgokShurakabRuhatIkaNTakArikAguDUcIpunarnavoshIramadhukadvisArivAlodhrashreyasIkushakAshamUlakaShAyakShIracaturguNaM balAvRuSharShabhakakharAshvopaku~jcikAvatsakatrapusairvArubIjashitivArakamadhukavacAshatapuShpAshmabhedakavarShAbhUmadanaphalakalkasiddhaM tailamuttarabastirnirUho vA shuddhasnigdhasvinnasya bastishUlamUtravikArahara iti||8||<br />
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When the ''hridaya'' is predominantly affected, one should consume powdered ''hingu'' (asafetida) with ''lavana'' (rock salt) (primary base, in a powdered form) admixed with juice of ''matulunga'' (Citrus indica) or any other juice which is predominantly sour in taste and liked by the individual. ''Sthiradi panchamula'' (Five roots comprising ''sthira/ salaparni''- Desmodium gangeticum, ''Prishniparni''- Uraria picta, ''brihati''- Solanum indicum, ''kantakari''- Solanum surattense/ xanthocarpum, ''gokshura''- Tribulus terrestris) ''rasa'' with sugar for drinking, ''yavagu'' (porridge) prepared out of ''bilvadi panchamula'' (five great roots comprising ''bilva''- Aegle marmelos, ''agnimantha''- Clerodendrum phlomides, ''syonaka''- Oroxylum indicum , ''patala''- Stereospermum tetragonum , ''Gambhari''- Gmelina arborea) ''rasa'', treatment modalities described under ''hridroga''.<br />
<br />
When ''murdhni'' (shiras ) is afflicted by ''[[vata]], abhyanga'' (oil massage), ''sweda'' (fomentation), ''upanaha'' (poultice), ''snehapana'' (internal oleation), ''nastah'' ( nasal drug aministration errhines) such as ''avapidana'' (with ''churnas''), ''dhuma'' (smoke) should be employed.<br />
<br />
In disorders of ''basti, kumbhisweda'' ( a type of ''mahasweda'' described in [Cha.Sa.[[Sutra Sthana]] 14/56-58], ''varti prayoga'' (urethral suppository), ''niruha [[basti]]'' (decoction enema) prepared of ''shyamadi'' (Operculina turpethum etc) drugs with ''gomutra'' (Cows Urine) or ''bilvadi'' (Aegle marmelos etc) drugs with ''sura'' (fermented liquid), or with ''sara'' (Saccharum munja), ''kasa'' (Saccharum spontaneum), ''ikshu'' (Saccharum officinarum), ''darbha'' (Eragrostis cynosuroides/ Desmostachya bipinnata), ''gokshura'' (Tribulus terrestris), ''mulaka'' (Raphanus sativus) ''kvatha'' mixed with milk and paste of ''trapusa'' ( Cucumis sativus), ''ervaruka'' (Cucumis sativus- bitter), ''kharasvabija'' (Ajamoda- Apium graveolens), ''yava'' (Hordeum vulgare), ''rishabhaka'' (Microstylis muscifera Ridley ), ''vriddhi'' ((Habenaria intermedia D.Don syn. Habenaria arietina H.f.) ); ''anuvasana'' (Oil enema) with ''taila'' prepared from ''pitadaru'' (Berberis aristata), ghee prepared out of ''tilvaka'' (Symplocos racemosa or Viburnum sp.) for ''virechana'' (purgation); oil prepared out of ''kashaya'' (decoction) of ''shatavari'' (Asparagus racemosus), ''gokshura'' (Tribulus terrestris), ''brahati'' (Solanum indicum), ''kantakari'' (Solanum xanthocarpum), ''guduchi'' (Tinospora cordifolia), ''punarnava'' (Boerhavia diffusa), ''usira'' (Vetiveria zizanoides), ''madhuka'' (Glycyrrhiza glabra), 2 ''sariva''(''sveta sariva''- Hemidesmus indicus and ''krishna sariva''- Cryptolepis buchanana), ''lodhra'' (Symplocos racemosa), ''shreyasi'' (Cavya-Piper chaba), ''kusha'' (Desmostachys bipinnata), ''kasha'' (Saccharum spontaneum) roots, with 4 times ''kshira'' (milk), ''kalka''(paste) made of ''bala'' (Sida cordifolia), ''vrisha'' (Adhatoda vasica), ''rishabhaka'' (Microstylis muscifera Ridley ), ''kharashva'' (Ajamoda- Apium graveolens), ''upakunchika'' (Elatteria cardomum), ''vatsaka'' (Holarrhena antidysenterica), ''trapusha'' (Cucumis sativus), ''ervarubija'' (Cucumis sativus seeds), ''shitivaraka'' (Sunishannaka- Marsilea quadrifida), ''madhuka'' (Glycyrrhiza glabra), ''vacha'' (Acorus calamus), ''shatapushpa'' (Peucedanum graveolens/ Anethum graveolens), ''asmabhedaka'' (Bergenia ligulata), ''varshabhu'' (Trianthema monogyna/ crystallina), ''madanaphala'' (Randia spinosa) should be used for ''uttara basti'' (enema into urethral route), and ''niruha'' (decoction enema) after ''[[shodhana]]'' (purification) , in an individual who is ''snigdha svinna'' (who is properly oleated and fomented) alleviates ''basti shula'' (pain in ''basti'') and ''mutra vikara'' (urinary disorders). [8] <br />
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<br />
भवन्ति चात्र श्लोकाः- <br /><br />
<br />
हृदये मूर्ध्नि बस्तौ च नृणां प्राणाः प्रतिष्ठिताः| <br /><br />
तस्मात्तेषां सदा यत्नं कुर्वीत परिपालने||९|| <br /><br />
<br />
आबाधवर्जनं नित्यं स्वस्थवृत्तानुवर्तनम्| <br /><br />
उत्पन्नार्तिविघातश्च मर्मणां परिपालनम्||१०||<br /><br />
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bhavanti cātra ślōkāḥ- <br /><br />
<br />
hr̥dayē mūrdhni bastau ca nr̥ṇāṁ prāṇāḥ pratiṣṭhitāḥ| <br /><br />
tasmāttēṣāṁ sadā yatnaṁ kurvīta paripālanē||9|| <br /><br />
<br />
ābādhavarjanaṁ nityaṁ svasthavr̥ttānuvartanam| <br /><br />
utpannārtivighātaśca marmaṇāṁ paripālanam||10||<br /><br />
<br />
bhavanti cAtra shlokAH- <br /><br />
<br />
hRudaye mUrdhni bastau ca nRuNAM prANAH pratiShThitAH| <br /><br />
tasmAtteShAM sadA yatnaM kurvIta paripAlane||9|| <br /><br />
<br />
AbAdhavarjanaM nityaM svasthavRuttAnuvartanam| <br /><br />
utpannArtivighAtashca marmaNAM paripAlanam||10||<br /><br />
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Thereby concluding the ''Slokha''-<br />
<br />
In the ''hridaya, murdhna'' (head) and ''basti'' of individuals is situated the ''prana'' (life element) and hence attempts should be made to maintain ''paripalana'' (maintain normalcy) them. ''Abadhavarjana'' (avoidance of factors that cause affliction to ''marmas''), ''svasthavrittanuvartana'' (following the healthy regimen), ''utpannarti vighata'' (management of the existing conditions) ensures maintenance of ''marmas'' (''marma paripalana'').[9-10]<br />
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अत उर्ध्वं विकारा ये त्रिमर्मीये चिकित्सिते| <br /><br />
न प्रोक्ता मर्मजास्तेषां कांश्चिद्वक्ष्यामि सौषधान्||११||<br /><br />
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ata urdhvaṁ vikārā yē trimarmīyē cikitsitē|<br /> <br />
na prōktā marmajāstēṣāṁ kāṁścidvakṣyāmi sauṣadhān||11||<br /><br />
<br />
ata urdhvaM vikArA ye trimarmIye cikitsite| <br /><br />
na proktA marmajAsteShAM kAMshcidvakShyAmi sauShadhAn||11||<br /><br />
</div></div><br />
<br />
Hence forward, will be described some of the diseases related to ''marma'' that have not been described in the chapter [[Trimarmiya Chikitsa]], alongwith their treatment.[11]<br />
<br />
=== Etiopathology of ''apatantraka'' (Opisthtomus) ===<br />
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<br />
क्रुद्धः स्वैः कोपनैर्वायुः स्थानादूर्ध्वं प्रपद्यते| <br /><br />
पीडयन् हृदयं गत्वा शिरः शङ्खौ च पीडयन्||१२|| <br /><br />
<br />
धनुर्वन्नमयेद्गात्राण्याक्षिपेन्मोहयेत्तथा| <br /><br />
(नमयेच्चाक्षिपेच्चाङ्गान्युच्छ्वासं निरुणद्धि च)| <br /><br />
कृच्छ्रेण चाप्युच्छ्वसिति स्तब्धाक्षोऽथ निमीलकः ||१३|| <br /><br />
<br />
कपोत इव कूजेच्च निःसञ्ज्ञः सोऽपतन्त्रकः| <br /><br />
दृष्टिं संस्तम्भ्य सञ्ज्ञां च हत्वा कण्ठेन कूजति||१४|| <br /><br />
<br />
हृदि मुक्ते नरः स्वास्थ्यं याति मोहं वृते पुनः| <br /><br />
वायुना दारुणं प्राहुरेके तमपतानकम्||१५||<br /><br />
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kruddhaḥ svaiḥ kōpanairvāyuḥ sthānādūrdhvaṁ prapadyatē| <br /><br />
pīḍayan hr̥dayaṁ gatvā śiraḥ śaṅkhau ca pīḍayan||12|| <br /><br />
<br />
dhanurvannamayēdgātrāṇyākṣipēnmōhayēttathā| <br /><br />
(namayēccākṣipēccāṅgānyucchvāsaṁ niruṇaddhi ca)| <br /><br />
kr̥cchrēṇa cāpyucchvasiti stabdhākṣō'tha nimīlakaḥ ||13|| <br /><br />
<br />
kapōta iva kūjēcca niḥsañjñaḥ sō'patantrakaḥ| <br /><br />
dr̥ṣṭiṁ saṁstambhya sañjñāṁ ca hatvā kaṇṭhēna kūjati||14|| <br /><br />
<br />
hr̥di muktē naraḥ svāsthyaṁ yāti mōhaṁ vr̥tē punaḥ| <br /><br />
vāyunā dāruṇaṁ prāhurēkē tamapatānakam||15||<br /><br />
<br />
kruddhaH svaiH kopanairvAyuH sthAnAdUrdhvaM prapadyate| <br /><br />
pIDayan hRudayaM gatvA shiraH sha~gkhau ca pIDayan||12|| <br /><br />
<br />
dhanurvannamayedgAtrANyAkShipenmohayettathA| <br /><br />
(namayeccAkShipeccA~ggAnyucchvAsaM niruNaddhi ca)| <br /><br />
kRucchreNa cApyucchvasiti stabdhAkSho~atha nimIlakaH ||13|| <br /><br />
<br />
kapota iva kUjecca niHsa~jj~jaH so~apatantrakaH| <br /><br />
dRuShTiM saMstambhya sa~jj~jAM ca hatvA kaNThena kUjati||14|| <br /><br />
<br />
hRudi mukte naraH svAsthyaM yAti mohaM vRute punaH| <br /><br />
vAyunA dAruNaM prAhureke tamapatAnakam||15||<br /><br />
</div></div><br />
<br />
''[[Vata]]'' aggaravated by its own causative factors moves upwards from its ''sthana'' (site), reaching the ''hridaya'' produces pain or discomfort in ''hridaya'' (heart) and also in ''shira'' (head) and ''shankha'' (temporal area). It causes a bow-like bending of the body, ''akshipet'' (involuntary jerks) and ''mohayet'' (altered consciousness). (It causes involuntary bending or contractures and jerky movements and also obstruction to breathing). The person breathes out with difficulty, has spasm of eye movements or drooping, makes cooing sounds like a dove, becomes unconscious. The condition is called ''apatantraka''. Some authors call a variant of this condition as ''apatanaka'', in which there is fixity of eyes (gaze fixed) and grunting sounds from throat. When ''hridaya'' is free of ''[[dosha]]s'' the person becomes healthy and becomes unconscious again when gets afflicted with ''[[dosha]]s'' and is due to severe aggravation of ''[[vata]]''. [12-15]<br />
<br />
=== Management of ''apatantraka'' (opisthotomus) ===<br />
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<br />
श्वसनं कफवाताभ्यां रुद्धं तस्य विमोक्षयेत्| <br /><br />
तीक्ष्णैः प्रधमनैः सञ्ज्ञां तासु मुक्तासु विन्दति||१६|| <br /><br />
<br />
मरिचं शिग्रुबीजानि विडङ्गं च फणिज्झकम्| <br /><br />
एतानि सूक्ष्मचूर्णानि दद्याच्छीर्षविरेचनम्||१७|| <br /><br />
<br />
तुम्बुरूण्यभया हिङ्गु पौष्करं लवणत्रयम्| <br /><br />
यवक्वाथाम्बुना पेयं हृद्ग्रहे चापतन्त्रके ||१८|| <br /><br />
<br />
हिङ्ग्वम्लवेतसं शुण्ठीं ससौवर्चलदाडिमम्| <br /><br />
पिबेद्वातकफघ्नं च कर्म हृद्रोगनुद्धितम्||१९|| <br /><br />
<br />
शोधना बस्तयस्तीक्ष्णा न हितास्तस्य कृत्स्नशः| <br /><br />
सौवर्चलाभयाव्योषैः सिद्धं तस्मै घृतं हितम्||२०||<br /><br />
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śvasanaṁ kaphavātābhyāṁ ruddhaṁ tasya vimōkṣayēt| <br /><br />
tīkṣṇaiḥ pradhamanaiḥ sañjñāṁ tāsu muktāsu vindati||16|| <br /><br />
<br />
maricaṁ śigrubījāni viḍaṅgaṁ ca phaṇijjhakam| <br /><br />
ētāni sūkṣmacūrṇāni dadyācchīrṣavirēcanam||17|| <br /><br />
<br />
tumburūṇyabhayā hiṅgu pauṣkaraṁ lavaṇatrayam| <br /><br />
yavakvāthāmbunā pēyaṁ hr̥dgrahē cāpatantrakē ||18||<br /><br />
<br />
hiṅgvamlavētasaṁ śuṇṭhīṁ sasauvarcaladāḍimam| <br /><br />
pibēdvātakaphaghnaṁ ca karma hr̥drōganuddhitam||19|| <br /><br />
<br />
śōdhanā bastayastīkṣṇā na hitāstasya kr̥tsnaśaḥ| <br /><br />
sauvarcalābhayāvyōṣaiḥ siddhaṁ tasmai ghr̥taṁ hitam||20||<br /><br />
<br />
shvasanaM kaphavAtAbhyAM ruddhaM tasya vimokShayet| <br /><br />
tIkShNaiH pradhamanaiH sa~jj~jAM tAsu muktAsu vindati||16|| <br /><br />
<br />
maricaM shigrubIjAni viDa~ggaM ca phaNijjhakam| <br /><br />
etAni sUkShmacUrNAni dadyAcchIrShavirecanam||17|| <br /><br />
<br />
tumburUNyabhayA hi~ggu pauShkaraM lavaNatrayam| <br /><br />
yavakvAthAmbunA peyaM hRudgrahe cApatantrake ||18|| <br /><br />
<br />
hi~ggvamlavetasaM shuNThIM sasauvarcaladADimam| <br /><br />
pibedvAtakaphaghnaM ca karma hRudroganuddhitam||19|| <br /><br />
<br />
shodhanA bastayastIkShNA na hitAstasya kRutsnashaH| <br /><br />
sauvarcalAbhayAvyoShaiH siddhaM tasmai ghRutaM hitam||20||<br /><br />
</div></div><br />
<br />
The aggravated ''[[kapha]] [[vata]] [[dosha]]s'' cause obstruction to ''shvasana'' (breathing) which should be cleared by ''tikshna pradhamana [[nasya]]'' (powder blowing into nostrils). This restores the ''sanjna'' (consciousness). ''Sirsha virechana'' (purification of head) should be given using very fine powder of ''maricha'' (black peper/Piper indicum), ''shigrubija'' (seeds of Moringa olifera), ''vidanga'' (Embelia ribes) and ''phaninjjaka'' (Marubaka- Origanum majorana). In ''hridgraha'' (stiffness or tightness in Heart) and ''apatantraka'' one should consume ''tumburu'' (Zanthoxylum alatum), ''abhaya'' (Terminalia chebula fruit), ''hingu'' (Asafoetida), ''pushkara'' (Inula racemosa), three types of ''lavana'' (''saindhava, sauvarcala'' and ''bida lavana'') with decoction of ''yava'' (Hordeum vulgare). Consume ''hingu'' (Asafoetida), a''mlavetasa'' (Garcinia pedunculata), ''sunthi'' (Zingiber officinale), with ''sauvarchala'' (sorchal salt) and ''dadima'' (juice of pomergranate/ Punica granatum) and employ treatment that alleviates ''[[vata]] [[kapha]] [[dosha]]s'' and which cures ''hridroga'' (cardiac disorders). ''Tikshna shodhana [[basti]]'' (strong purificatory enemas) is totally unsuitable. ''Ghrita'' prepared by ''sauvarchala'' salt, ''abhaya'' (Terminalia chebula), ''vyosha'' (''pippali, maricha, sunthi'' i.e., Piper longum, Piper indicum and Zingiber officinale) is suitable. [16-20]<br />
<br />
=== Etiopathology and treatment of ''tandra'' (drowsiness) ===<br />
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<br />
मधुरस्निग्धगुर्वन्नसेवनाच्चिन्तनाच्छ्रमात् | <br /><br />
शोकाद्व्याध्यनुषङ्गाच्च वायुनोदीरितः कफः||२१|| <br /><br />
<br />
यदाऽसौ समवस्कन्द्य हृदयं हृदयाश्रयान्| <br /><br />
समावृणोति ज्ञानादींस्तदा तन्द्रोपजायते||२२|| <br /><br />
<br />
हृदये व्याकुलीभावो वाक्चेष्टेन्द्रियगौरवम्| <br /><br />
मनोबुद्ध्यप्रसादश्च तन्द्राया लक्षणं मतम्||२३|| <br /><br />
<br />
कफघ्नं तत्र कर्तव्यं शोधनं शमनानि च| <br /><br />
व्यायामो रक्तमोक्षश्च भोज्यं च कटुतिक्तकम्||२४||<br /><br />
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madhurasnigdhagurvannasēvanāccintanācchramāt | <br /><br />
śōkādvyādhyanuṣaṅgācca vāyunōdīritaḥ kaphaḥ||21|| <br /><br />
<br />
yadā'sau samavaskandya hr̥dayaṁ hr̥dayāśrayān| <br /><br />
samāvr̥ṇōti jñānādīṁstadā tandrōpajāyatē||22|| <br /><br />
<br />
hr̥dayē vyākulībhāvō vākcēṣṭēndriyagauravam| <br /><br />
manōbuddhyaprasādaśca tandrāyā lakṣaṇaṁ matam||23|| <br /><br />
<br />
kaphaghnaṁ tatra kartavyaṁ śōdhanaṁ śamanāni ca| <br /><br />
vyāyāmō raktamōkṣaśca bhōjyaṁ ca kaṭutiktakam||24||<br /><br />
<br />
madhurasnigdhagurvannasevanAccintanAcchramAt | <br /><br />
shokAdvyAdhyanuSha~ggAcca vAyunodIritaH kaphaH||21|| <br /><br />
<br />
yadA~asau samavaskandya hRudayaM hRudayAshrayAn| <br /><br />
samAvRuNoti j~jAnAdIMstadA tandropajAyate||22|| <br /><br />
<br />
hRudaye vyAkulIbhAvo vAkceShTendriyagauravam| <br /><br />
manobuddhyaprasAdashca tandrAyA lakShaNaM matam||23|| <br /><br />
<br />
kaphaghnaM tatra kartavyaM shodhanaM shamanAni ca| <br /><br />
vyAyAmo raktamokShashca bhojyaM ca kaTutiktakam||24||<br /><br />
</div></div><br />
<br />
Due to consumption of ''anna'' (foods) that are ''madhura'' (sweet), ''snigdha'' (unctuous), ''guru'' (heavy to digest), ''chintana'' (excessive thinking), ''shrama'' (exertion), ''shoka'' (grief), ''vyadhyanushanga'' (chronicity of diseases), ''[[kapha]]'' aggravated by ''[[vata]]'' in association when gets lodged in ''hridaya'', obscures the process of ''jnana, tandra'' (drowsiness) occurs. The symptoms of ''tandra'' are ''hridaye vyakulibhava'' (uneasiness or discomfort in the region of heart), sluggishness of speech and physical activity, decreased acuity of the sense organs, clouding of mind and intellect. This condition should be managed by ''[[shodhana]]'' and ''shamana'' measures that are ''kaphahara, vyayama'' (exercise), ''[[raktamokshana]]'' (blood letting) and intake of foods that are predominantly ''katu'' (pungent) and ''tikta'' (bitter).[21-24]<br />
<br />
=== Thirteen types of urinary disorders ===<br />
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<br />
मूत्रौकसादो जठरं कृच्छ्रमुत्सङ्गसङ्क्षयौ| <br /><br />
मूत्रातीतोऽनिलाष्ठीला वातबस्त्युष्णमारुतौ||२५|| <br /><br />
<br />
वातकुण्डलिका ग्रन्थिर्विड्घातो बस्तिकुण्डलम्| <br /><br />
त्रयोदशैते मूत्रस्य दोषास्ताँल्लिङ्गतः शृणु||२६||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
mūtraukasādō jaṭharaṁ kr̥cchramutsaṅgasaṅkṣayau| <br /><br />
mūtrātītō'nilāṣṭhīlā vātabastyuṣṇamārutau||25|| <br /><br />
<br />
vātakuṇḍalikā granthirviḍghātō bastikuṇḍalam| <br /><br />
trayōdaśaitē mūtrasya dōṣāstāmँlliṅgataḥ śr̥ṇu||26||<br /><br />
<br />
mUtraukasAdo jaTharaM kRucchramutsa~ggasa~gkShayau| <br /><br />
mUtrAtIto~anilAShThIlA vAtabastyuShNamArutau||25|| <br /><br />
<br />
vAtakuNDalikA granthirviDghAto bastikuNDalam| <br /><br />
trayodashaite mUtrasya doShAstA@mlli~ggataH shRuNu||26||<br /><br />
</div></div><br />
<br />
''Mutraukasada''(dense urine), ''mutrajathara'' (accumulation of urine in abdominal cavity), ''mutrakrichchra'' (dysuria), ''mutrotsanga'' (residual urination), ''mutrasamkshaya'' (suppression of urine formation), ''mutratita'' (delayed micturition), ''vatashthila'' (hard globular swelling like tumor), ''vatabasti'' (vata affection of bladder), ''ushnavata'' (vata-pitta vitiation of urine/burning micturition), ''vatakundalika'' (scanty and painful flow of urine), ''granthi'' (cyst at the neck of bladder), ''vidghata'' (feces coming through urine) and ''bastikundala'' (circular distension of bladder) are the thirteen varieties of ''mutra dosha'' (urinary disorders) and listen to them with their symptoms.[25-26]<br />
<br />
=== ''Mutraukasada'' (dense urine) ===<br />
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<br />
पित्तं कफो द्वावपि वा बस्तौ संहन्यते यदा| <br /><br />
मारुतेन तदा मूत्रं रक्तं पीतं घनं सृजेत्||२७|| <br /><br />
<br />
सदाहं श्वेतसान्द्रं वा सर्वैर्वा लक्षणैर्युतम्| <br /><br />
मूत्रौकसादं तं विद्यात् पित्तश्लेष्महरैर्जयेत्||२८||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
pittaṁ kaphō dvāvapi vā bastau saṁhanyatē yadā| <br /><br />
mārutēna tadā mūtraṁ raktaṁ pītaṁ ghanaṁ sr̥jēt||27|| <br /><br />
<br />
sadāhaṁ śvētasāndraṁ vā sarvairvā lakṣaṇairyutam| <br /><br />
mūtraukasādaṁ taṁ vidyāt pittaślēṣmaharairjayēt||28||<br /><br />
<br />
pittaM kapho dvAvapi vA bastau saMhanyate yadA| <br /><br />
mArutena tadA mUtraM raktaM pItaM ghanaM sRujet||27|| <br /><br />
<br />
sadAhaM shvetasAndraM vA sarvairvA lakShaNairyutam| <br /><br />
mUtraukasAdaM taM vidyAt pittashleShmaharairjayet||28||<br /><br />
</div></div><br />
<br />
''[[Pitta]], [[kapha]]'' both or singly getting aggravated with ''[[vata]]'', when reach into the ''basti'' cause reddish, yellowish, thick urine to flow, with burning, or whitish, thick or with all the symptoms. The condition is called ''mutraukasada'' and should be treated with ''[[pitta]] [[kapha]]hara'' measures.[27-28]<br />
<br />
=== ''Mutra jathara'' (accumulation of urine in abdominal cavity) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
विधारणात् प्रतिहतं वातोदावर्तितं यदा| <br /><br />
पूरयत्युदरं मूत्रं तदा तदनिमित्तरुक्||२९||<br /><br />
<br />
अपक्तिमूत्रविट्सङ्गैस्तन्मूत्रजठरं वदेत्| <br /><br />
मूत्रवैरेचनीं तत्र चिकित्सां सम्प्रयोजयेत्||३०|| <br /><br />
<br />
हिङ्गुद्विरुत्तरं चूर्णं त्रिमर्मीये प्रकीर्तितम्| <br /><br />
हन्यान्मूत्रोदरानाहमाध्मानं गुदमेढ्रयोः||३१||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
vidhāraṇāt pratihataṁ vātōdāvartitaṁ yadā| <br /><br />
pūrayatyudaraṁ mūtraṁ tadā tadanimittaruk||29|| <br /><br />
<br />
apaktimūtraviṭsaṅgaistanmūtrajaṭharaṁ vadēt| <br /><br />
mūtravairēcanīṁ tatra cikitsāṁ samprayōjayēt||30||<br /><br />
<br />
hiṅgudviruttaraṁ cūrṇaṁ trimarmīyē prakīrtitam| <br /><br />
hanyānmūtrōdarānāhamādhmānaṁ gudamēḍhrayōḥ||31||<br /><br />
<br />
vidhAraNAt pratihataM vAtodAvartitaM yadA| <br /><br />
pUrayatyudaraM mUtraM tadA tadanimittaruk||29|| <br /><br />
<br />
apaktimUtraviTsa~ggaistanmUtrajaTharaM vadet| <br /><br />
mUtravairecanIM tatra cikitsAM samprayojayet||30|| <br /><br />
<br />
hi~ggudviruttaraM cUrNaM trimarmIye prakIrtitam| <br /><br />
hanyAnmUtrodarAnAhamAdhmAnaM gudameDhrayoH||31||<br /><br />
</div></div><br />
<br />
Withholding the urge to urinate, causes ''[[vata]]'' to get obstructed in its normal pathway which causes ''udavarta'' (reversal of movements) and thereby the ''mutra'' fills up in the ''udara'' producing inconsistent pain, sense of indigestion, obstruction to the flow of ''[[mutra]]'' and ''vid''. This is called ''mutra jathara''. ''Mutra virechana chikitsa'' (diuresis) should be employed in this condition. ''Hingu dvirittara churna'' clears ''mutrodara'' (distension of abdomen due to urinary retention), ''anaha'' (simple distension due to indigestion or constipation), ''adhmana'' (distension with pain) of ''guda'' (anus) and ''medhra'' (phallum). [29-31]<br />
<br />
=== ''Mutra krichchra'' (dysuria) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
मूत्रितस्य व्यवायात्तु रेतो वातोद्धतं च्युतम्| <br /><br />
पूर्वं मूत्रस्य पश्चाद्वा स्रवेत् कृच्छ्रं तदुच्यते||३२|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
mūtritasya vyavāyāttu rētō vātōddhataṁ cyutam| <br /><br />
pūrvaṁ mūtrasya paścādvā sravēt kr̥cchraṁ taducyatē||32|| <br /><br />
<br />
mUtritasya vyavAyAttu reto vAtoddhataM cyutam| <br /><br />
pUrvaM mUtrasya pashcAdvA sravet kRucchraM taducyate||32||<br /><br />
</div></div><br />
<br />
Indulgence in sexual intercourse by a person with active urge to micturate causes affliction of the dislodged ''[[shukra]]'' (seminal secretions) which flows either before or after the urine stream and this is called ''mutra krichchra''.[32]<br />
<br />
=== ''Mutrotsanga'' (residual urination) ===<br />
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<br />
खवैगुण्यानिलाक्षेपैः किञ्चिन्मूत्रं च तिष्ठति| <br /><br />
मणिसन्धौ स्रवेत् पश्चात्तदरुग्वाऽथ चातिरुक्||३३|| <br /><br />
<br />
मूत्रोत्सङ्गः स विच्छिन्नमुच्छेषगुरुशेफसः | <br /><br />
<div class="mw-collapsible-content"><br />
<br />
khavaiguṇyānilākṣēpaiḥ kiñcinmūtraṁ ca tiṣṭhati| <br /><br />
maṇisandhau sravēt paścāttadarugvā'tha cātiruk||33|| <br /><br />
<br />
mūtrōtsaṅgaḥ sa vicchinnamucchēṣaguruśēphasaḥ| <br /><br />
<br />
khavaiguNyAnilAkShepaiH ki~jcinmUtraM ca tiShThati| <br /><br />
maNisandhau sravet pashcAttadarugvA~atha cAtiruk||33|| <br /><br />
<br />
mUtrotsa~ggaH sa vicchinnamuccheShagurushephasaH | <br /><br />
</div></div><br />
<br />
Due to ''khavaigunya'' (structural deformity) in the ''mutravaha srotas'', severe ''[[vata]]'' aggravation, some urine remains in the ''manisandhi'' (base of penis) and discharges sometime later either without pain or with severe pain. ''[[Mutra]]'' passes in ''vichchinna'' (split form) and ''uchchesha'' (with some residual urine in the enlarged or engorged penis) from the ''guru shepha'' (enlarged penis due to accumulation of excess urine in the penis). This is ''mutrotsanga''. [33-33½]<br />
<br />
=== ''Mutra samkshaya'' (suppression of urine formation) ===<br />
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<br />
वाताकृतिर्भवेद्वातान्मूत्रे शुष्यति सङ्क्षयः||३४|| <br />
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<br />
vātākr̥tirbhavēdvātānmūtrē śuṣyati saṅkṣayaḥ||34||<br />
<br />
vAtAkRutirbhavedvAtAnmUtre shuShyati sa~gkShayaH||34|| <br />
</div></div><br />
<br />
Due to aggravation of ''[[vata]]'', the urine gets decreased with manifestation of ''vatakriti'' (symptoms of aggravated ''[[vata]]''). The condition is ''mutra kshaya''. [34]<br />
<br />
=== ''Mutratita'' (delayed micturition) ===<br />
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<br />
चिरं धारयतो मूत्रं त्वरया न प्रवर्तते| <br /><br />
मेहमानस्य मन्दं वा मूत्रातीतः स उच्यते||३५|| <br /><br />
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<br />
ciraṁ dhārayatō mūtraṁ tvarayā na pravartatē| <br /><br />
mēhamānasya mandaṁ vā mūtrātītaḥ sa ucyatē||35||<br /><br />
<br />
ciraM dhArayato mUtraM tvarayA na pravartate| <br /><br />
mehamAnasya mandaM vA mUtrAtItaH sa ucyate||35|| <br /><br />
</div></div><br />
<br />
In a person withholding for long, the urge to urinate, the urine does not flow instantly or flows with mild stream. This is called ''mutratita''.[35]<br />
<br />
=== ''Ashthila'' (hard globular swelling like tumor) ===<br />
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<br />
आध्मापयन् बस्तिगुदं रुद्ध्वा वायुश्चलोन्नताम्| <br /><br />
कुर्यात्तीव्रार्तिमष्ठीलां मूत्रविण्मार्गरोधिनीम्||३६|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
ādhmāpayan bastigudaṁ ruddhvā vāyuścalōnnatām| <br /><br />
kuryāttīvrārtimaṣṭhīlāṁ mūtraviṇmārgarōdhinīm||36|| <br /><br />
<br />
AdhmApayan bastigudaM ruddhvA vAyushcalonnatAm| <br /><br />
kuryAttIvrArtimaShThIlAM mUtraviNmArgarodhinIm||36|| <br /><br />
</div></div><br />
<br />
When ''[[vata]]'' obstructs the path of ''[[mutra]]'', it causes ''adhmana'' (distension) of ''basti'' (bladder area) and ''guda'' (rectal area) producing ''ashthila'' (stone like hard mass or swelling) which is ''chala'' (freely mobile), ''unnata'' (elevated) which causes ''tivra arti'' (severe pain) and ''vinmutrarodhini'' (obstruction to stools and urine). [36]<br />
<br />
=== ''Vatabasti'' (''[[vata]]'' affliction of bladder) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
मूत्रं धारयतो बस्तौ वायुः क्रुद्धो विधारणात्| <br /><br />
मूत्ररोधार्तिकण्डूभिर्वातबस्तिः स उच्यते||३७|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
mūtraṁ dhārayatō bastau vāyuḥ kruddhō vidhāraṇāt| <br /><br />
mūtrarōdhārtikaṇḍūbhirvātabastiḥ sa ucyatē||37||<br /><br />
<br />
mUtraM dhArayato bastau vAyuH kruddho vidhAraNAt| <br /><br />
mUtrarodhArtikaNDUbhirvAtabastiH sa ucyate||37|| <br /><br />
</div></div><br />
<br />
Withholding the urine in the ''basti'' causes ''[[vata]]'' to aggravate which causes ''mutrarodha'' (urinary obstruction), ''arti'' (pain), ''kandu'' (itching) and this is called ''vatabasti''. [37]<br />
<br />
=== ''Ushnavata'' ((''vata-pitta'' affliction of urine/burning micturition) ===<br />
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<br />
उष्मणा सोष्मकं मूत्रं शोषयन् रक्तपीतकम्| <br /><br />
उष्णवातः सृजेत् कृच्छ्राद्बस्त्युपस्थार्तिदाहवान्||३८|| <br /><br />
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<br />
uṣmaṇā sōṣmakaṁ mūtraṁ śōṣayan raktapītakam| <br /><br />
uṣṇavātaḥ sr̥jēt kr̥cchrādbastyupasthārtidāhavān||38|| <br /><br />
<br />
uShmaNA soShmakaM mUtraM shoShayan raktapItakam| <br /><br />
uShNavAtaH sRujet kRucchrAdbastyupasthArtidAhavAn||38|| <br /><br />
</div></div><br />
<br />
Due to indulgence in ''ushma'' (factors that increase the heat in the body), there will be ''mutra shosha'' (decrease in ''[[mutra]]''), ''raktapita mutra'' (reddish or yellowish urine), passed with difficulty (''krichchrat''), causing ''arti'' (pain) and ''daha'' (burning) in ''basti'' (urinary bladder) and ''upastha'' (genitalia). This is ''ushnavata''. [38]<br />
<br />
=== ''Vatakundalika'' (scanty and painful flow of urine) ===<br />
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<br />
गतिसङ्गादुदावृत्तः स मूत्रस्थानमार्गयोः| <br /><br />
मूत्रस्य विगुणो वायुर्भग्नव्याविद्धकुण्डली||३९|| <br /><br />
<br />
मूत्रं विहन्ति संस्तम्भभङ्गगौरववेष्टनैः| <br /><br />
तीव्ररुङ्मूत्रविट्सङ्गैर्वातकुण्डलिकेति सा||४०|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
gatisaṅgādudāvr̥ttaḥ sa mūtrasthānamārgayōḥ| <br /><br />
mūtrasya viguṇō vāyurbhagnavyāviddhakuṇḍalī||39|| <br /><br />
<br />
mūtraṁ vihanti saṁstambhabhaṅgagauravavēṣṭanaiḥ| <br /><br />
tīvraruṅmūtraviṭsaṅgairvātakuṇḍalikēti sā||40||<br /><br />
<br />
gatisa~ggAdudAvRuttaH sa mUtrasthAnamArgayoH| <br /><br />
mUtrasya viguNo vAyurbhagnavyAviddhakuNDalI||39|| <br /><br />
<br />
mUtraM vihanti saMstambhabha~ggagauravaveShTanaiH| <br /><br />
tIvraru~gmUtraviTsa~ggairvAtakuNDaliketi sA||40|| <br /><br />
</div></div><br />
<br />
Due to ''gatisanga'' (obstruction in the pathway) of ''[[mutra]]'' in the ''mutrasthana'' (''mutrasaya'') and ''mutramarga'' (''mutravaha srotas''), the ''viguna vayu'' (aggravated ''[[vata]]'') becomes ''udavratta'' (reflux or moves in opposite direction) and thereby ''bhagna'' (broken), ''vyaviddha'' (zigzag) or ''kundali'' (rotatory) in its pathway. It then affects the ''[[mutra]]'' with ''samstambha'' (stiffness or rigidity), ''bhanga'' (breaking pain), ''gaurava'' (heaviness), ''veshtana'' (twisting pain), ''tivraruk'' (severe pain) and ''mutravitsanga'' (retention of urine and feces). The condition is called ''vata kundalika''. [39-40]<br />
<br />
=== ''Raktagranthi'' (nodular swelling in bladder) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
रक्तं वातकफाद्दुष्टं बस्तिद्वारे सुदारुणम्| <br /><br />
ग्रन्थिं कुर्यात् स कृच्छ्रेण सृजेन्मूत्रं तदावृतम्||४१|| <br /><br />
<br />
अश्मरीसमशूलं तं रक्तग्रन्थिं प्रचक्षते| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
raktaṁ vātakaphādduṣṭaṁ bastidvārē sudāruṇam| <br /><br />
granthiṁ kuryāt sa kr̥cchrēṇa sr̥jēnmūtraṁ tadāvr̥tam||41|| <br /><br />
<br />
aśmarīsamaśūlaṁ taṁ raktagranthiṁ pracakṣatē|<br /><br />
<br />
raktaM vAtakaphAdduShTaM bastidvAre sudAruNam| <br /><br />
granthiM kuryAt sa kRucchreNa sRujenmUtraM tadAvRutam||41|| <br /><br />
<br />
ashmarIsamashUlaM taM raktagranthiM pracakShate| <br /><br />
</div></div><br />
<br />
''[[Rakta]]'' getting vitiated by ''[[vata]]'' and ''[[kapha]]'', produces a grievous nodular swelling (''granthi'') which obstructs the ''[[mutra]]'' and as a result the ''[[mutra]]'' is eliminated with difficulty and pain similar to urinary calculus. The condition is called ''raktagranthi''. [41-41½]<br />
<br />
=== ''Vid vighata'' (feces coming through urine) ===<br />
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<br />
रूक्षदुर्बलयोर्वातेनोदावृत्तं शकृद्यदा||४२|| <br /><br />
<br />
मूत्रस्रोतः प्रपद्येत विट्संसृष्टं तदा नरः| <br /><br />
विड्गन्धं मूत्रयेत् कृच्छ्राद्विड्विघातं विनिर्दिशेत्||४३|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
rūkṣadurbalayōrvātēnōdāvr̥ttaṁ śakr̥dyadā||42|| <br /><br />
<br />
mūtrasrōtaḥ prapadyēta viṭsaṁsr̥ṣṭaṁ tadā naraḥ| <br /><br />
viḍgandhaṁ mūtrayēt kr̥cchrādviḍvighātaṁ vinirdiśēt||43|| <br /><br />
<br />
rUkShadurbalayorvAtenodAvRuttaM shakRudyadA||42|| <br /><br />
<br />
mUtrasrotaH prapadyeta viTsaMsRuShTaM tadA naraH| <br /><br />
viDgandhaM mUtrayet kRucchrAdviDvighAtaM vinirdishet||43||<br /><br />
</div></div><br />
<br />
In a ''ruksha'' (emaciated) and ''durbala'' (weak) person, due to aggravated ''[[vata]]'' when ''shakrita'' (stool matter) becomes ''udavarta'' (moves into other pathway) and enters the channels of ''[[mutra]]'', the person passes ''[[mutra]]'' admixed with stool matter bearing a fecal odor with difficulty. The condition is called ''vidvighata''.[42-43]<br />
<br />
=== ''Basti kundala'' (circular distension of bladder) ===<br />
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<br />
द्रुताध्वलङ्घनायासादभिघातात् प्रपीडनात्| <br /><br />
स्वस्थानाद्वस्तिरुद्वृत्तः स्थूलस्तिष्ठति गर्भवत्||४४|| <br /><br />
<br />
शूलस्पन्दनदाहार्तो बिन्दुं बिन्दुं स्रवत्यपि| <br /><br />
पीडितस्तु सृजेद्धारां संस्तम्भोद्वेष्टनार्तिमान्||४५|| <br /><br />
<br />
बस्तिकुण्डलमाहुस्तं घोरं शस्त्रविषोपमम्| <br /><br />
पवनप्रबलं प्रायो दुर्निवारमबुद्धिभिः||४६|| <br /><br />
<br />
तस्मिन् पित्तान्विते दाहः शूलं मूत्रविवर्णता| <br /><br />
श्लेष्मणा गौरवं शोफः स्निग्धं मूत्रं घनं सितम्||४७|| <br /><br />
<br />
श्लेष्मरुद्धबिलो बस्तिः पित्तोदीर्णो न सिध्यति| <br /><br />
अविभ्रान्तबिलः साध्यो न तु यः कुण्डलीकृतः||४८|| <br /><br />
<br />
स्याद्वस्तौ कुण्डलीभूते हृन्मोहः श्वास एव च|४९|<br /><br />
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<br />
drutādhvalaṅghanāyāsādabhighātāt prapīḍanāt| <br /><br />
svasthānādvastirudvr̥ttaḥ sthūlastiṣṭhati garbhavat||44|| <br /><br />
<br />
śūlaspandanadāhārtō binduṁ binduṁ sravatyapi| <br /><br />
pīḍitastu sr̥jēddhārāṁ saṁstambhōdvēṣṭanārtimān||45||<br /> <br />
<br />
bastikuṇḍalamāhustaṁ ghōraṁ śastraviṣōpamam| <br /><br />
pavanaprabalaṁ prāyō durnivāramabuddhibhiḥ||46|| <br />
<br />
tasmin pittānvitē dāhaḥ śūlaṁ mūtravivarṇatā| <br /><br />
ślēṣmaṇā gauravaṁ śōphaḥ snigdhaṁ mūtraṁ ghanaṁ sitam||47|| <br /><br />
<br />
ślēṣmaruddhabilō bastiḥ pittōdīrṇō na sidhyati| <br /><br />
avibhrāntabilaḥ sādhyō na tu yaḥ kuṇḍalīkr̥taḥ||48|| <br /><br />
<br />
syādvastau kuṇḍalībhūtē hr̥nmōhaḥ śvāsa ēva ca|49|| <br /><br />
<br />
drutAdhvala~gghanAyAsAdabhighAtAt prapIDanAt| <br /><br />
svasthAnAdvastirudvRuttaH sthUlastiShThati garbhavat||44|| <br /><br />
<br />
shUlaspandanadAhArto binduM binduM sravatyapi| <br /><br />
pIDitastu sRujeddhArAM saMstambhodveShTanArtimAn||45|| <br /><br />
<br />
bastikuNDalamAhustaM ghoraM shastraviShopamam| <br /><br />
pavanaprabalaM prAyo durnivAramabuddhibhiH||46|| <br /><br />
<br />
tasmin pittAnvite dAhaH shUlaM mUtravivarNatA| <br /><br />
shleShmaNA gauravaM shophaH snigdhaM mUtraM ghanaM sitam||47|| <br /><br />
<br />
shleShmaruddhabilo bastiH pittodIrNo na sidhyati| <br /><br />
avibhrAntabilaH sAdhyo na tu yaH kuNDalIkRutaH||48|| <br /><br />
<br />
syAdvastau kuNDalIbhUte hRunmohaH shvAsa eva ca|49|<br /><br />
</div></div><br />
<br />
Due to factors such as fast walking, fasting, exhaustion, injury and compression, the ''basti'' is displaced upwards giving the appearance of distended gravid uterus. The patient manifests with ''shula'' (severe pain), ''spandana'' (involuntary contractions or spasms) and ''daha'' (burning) and passes urine drop by drop. On straining there is streamed urine with ''samstambha'' (griping pain), ''udvestana'' (twisting pain) or ''arti'' (simple pain). The condition is called ''basti kundala'' and is similar to ''shastra'' (sharp weapon), ''visha'' (poison) in its action. The condition is dominant of ''[[vata]]'' and is incurable by the unintelligent.<br />
<br />
When ''[[vata]]'' is associated with ''[[pitta]]'', there occurs ''daha'' (burning), ''shula'' (colicky pain) and discoloration of urine.<br />
<br />
Association with ''[[kapha]]'' causes ''gaurava'' (heaviness), ''shopha'' (swelling), and the ''[[mutra]]'' is ''snigdha'' (unctuous), ''ghana'' (thick) and ''sita'' (whitish).<br />
<br />
When ''[[kapha]]'' obstructs the bladder neck or when ''[[pitta]]'' is severely aggravated it is incurable. If bladder neck is unobstructed, it is curable but not when there is circumgyration. When there is circumgyration in bladder it causes ''hrid moha'' (altered consciousness) and breathlessness. [44-48½]<br />
<br />
=== Management of urinary disorders ===<br />
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<br />
दोषाधिक्यमवेक्ष्यैतान् मूत्रकृच्छ्रहरैर्जयेत्॥४९॥<br />
<br />
बस्तिमुत्तरबस्तिं च सर्वेषामेव दापयेत् |<br />
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<br />
dōṣādhikyamavēkṣyaitān mūtrakr̥cchraharairjayēt||49|| <br />
<br />
bastimuttarabastiṁ ca sarvēṣāmēva dāpayēt|50|<br />
<br />
doShAdhikyamavekShyaitAn mUtrakRucchraharairjayet||49|| <br />
<br />
bastimuttarabastiM ca sarveShAmeva dApayet|50|<br />
</div></div><br />
<br />
These conditions should be examined in terms of dominance of ''[[dosha]]'' and treated by measures that relieve ''mutrakrichchra'' (dysuria). ''[[Basti]]'' (rectal enemas) and ''uttara basti'' (Bladder enemas) should be administered in all these conditions. [49-49½]<br />
<br />
=== Description of ''uttara basti'' (urethral/per vaginal drug administration) ===<br />
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<br />
पुष्पनेत्रं तु हैमं स्याच्छ्लक्ष्णमौत्तरबस्तिकम्||५०|| <br /><br />
<br />
जात्यश्वहनवृन्तेन समं गोपुच्छसंस्थितम्| <br /><br />
रौप्यं वा सर्षपच्छिद्रं द्विकर्णं द्वादशाङ्गुलम्||५१|| <br /><br />
<br />
तेनाजबस्तियुक्तेन स्नेहस्यार्धपलं नयेत्| <br /><br />
यथावयोविशेषेण स्नेहमात्रां विकल्प्य वा||५२|| <br /><br />
<br />
स्नातस्य भुक्तभक्तस्य रसेन पयसाऽपि वा| <br /><br />
सृष्टविण्मूत्रवेगस्य पीठे जानुसमे मृदौ||५३|| <br /><br />
<br />
ऋजोः सुखोपविष्टस्य हृष्टे मेढ्रे घृताक्तया| <br /><br />
शलाकयाऽन्विष्य गतिं यद्यप्रतिहता व्रजेत्||५४|| <br /><br />
<br />
ततः शेफःप्रमाणेन पुष्पनेत्रं प्रवेशयेत्| <br /><br />
गुदवन्मूत्रमार्गेण प्रणयेदनु सेवनीम्||५५|| <br /><br />
<br />
हिंस्यादतिगतं बस्तिमूने स्नेहो न गच्छति| <br /><br />
सुखं प्रपीड्य निष्कम्पं निष्कर्षेन्नेत्रमेव च||५६|| <br /><br />
<br />
प्रत्यागते द्वितीयं च तृतीयं च प्रदापयेत्| <br /><br />
अनागच्छन्नुपेक्ष्यस्तु रजनीव्युषितस्य च||५७||<br /><br />
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<br />
puṣpanētraṁ tu haimaṁ syācchlakṣṇamauttarabastikam||50|| <br /><br />
<br />
jātyaśvahanavr̥ntēna samaṁ gōpucchasaṁsthitam| <br /><br />
raupyaṁ vā sarṣapacchidraṁ dvikarṇaṁ dvādaśāṅgulam||51|| <br /><br />
<br />
tēnājabastiyuktēna snēhasyārdhapalaṁ nayēt| <br /><br />
yathāvayōviśēṣēṇa snēhamātrāṁ vikalpya vā||52|| <br /><br />
<br />
snātasya bhuktabhaktasya rasēna payasā'pi vā| <br /><br />
sr̥ṣṭaviṇmūtravēgasya pīṭhē jānusamē mr̥dau||53|| <br /><br />
<br />
r̥jōḥ sukhōpaviṣṭasya hr̥ṣṭē mēḍhrē ghr̥tāktayā| <br /><br />
śalākayā'nviṣya gatiṁ yadyapratihatā vrajēt||54|| <br /><br />
<br />
tataḥ śēphaḥpramāṇēna puṣpanētraṁ pravēśayēt| <br /><br />
gudavanmūtramārgēṇa praṇayēdanu sēvanīm||55|| <br /><br />
<br />
hiṁsyādatigataṁ bastimūnē snēhō na gacchati| <br /><br />
sukhaṁ prapīḍya niṣkampaṁ niṣkarṣēnnētramēva ca||56|| <br /><br />
<br />
pratyāgatē dvitīyaṁ ca tr̥tīyaṁ ca pradāpayēt| <br /><br />
anāgacchannupēkṣyastu rajanīvyuṣitasya ca||57||<br /><br />
<br />
puShpanetraM tu haimaM syAcchlakShNamauttarabastikam||50|| <br /><br />
<br />
jAtyashvahanavRuntena samaM gopucchasaMsthitam| <br /><br />
raupyaM vA sarShapacchidraM dvikarNaM dvAdashA~ggulam||51|| <br /><br />
<br />
tenAjabastiyuktena snehasyArdhapalaM nayet| <br /><br />
yathAvayovisheSheNa snehamAtrAM vikalpya vA||52|| <br /><br />
<br />
snAtasya bhuktabhaktasya rasena payasA~api vA| <br /><br />
sRuShTaviNmUtravegasya pIThe jAnusame mRudau||53|| <br /><br />
<br />
RujoH sukhopaviShTasya hRuShTe meDhre ghRutAktayA| <br /><br />
shalAkayA~anviShya gatiM yadyapratihatA vrajet||54|| <br /><br />
<br />
tataH shephaHpramANena puShpanetraM praveshayet| <br /><br />
gudavanmUtramArgeNa praNayedanu sevanIm||55|| <br /><br />
<br />
hiMsyAdatigataM bastimUne sneho na gacchati| <br /><br />
sukhaM prapIDya niShkampaM niShkarShennetrameva ca||56|| <br /><br />
<br />
pratyAgate dvitIyaM ca tRutIyaM ca pradApayet| <br /><br />
rajanIvyuShitasya ca||57||<br /><br />
</div></div><br />
<br />
''Pushpanetra'' (''uttara basti'' nozzle) used for ''uttara basti'' should be made of gold or silver, smooth, be similar to stalk of ''jati'' (Jasminum officinale), or ''asvahana'' (''Karavira''- Nerium odorum/ indicum) and like cow’s tail (tapering). It should be 12 ''angulas'' long, have two ridges (''dvikarna'') and ''sarshapachidra'' (permitting the passage of mustard seed). It fitted on to goats bladder, half ''pala'' (25ml) of ''sneha'' should be taken or the quantity of ''sneha'' should be judiciously calculated in consideration of the patient’s age. <br />
<br />
The patient having bathed, taken food with ''mamsarasa'' or milk, after clearing the urges of urine and feces, seated erect comfortably on a soft seat of knee height, the erect penis probed with a ''shalaka'' (metallic probe) duly lubricated with ghee and if found to be unobstructed, then in accordance with the size of penis the enema nozzle should be introduced as per the procedure of ''guda[[basti]]'' i.e., along the direction of perineal raphe. If it is excessively introduced it causes pain and if insufficiently introduced the ''[[snehana]]'' does not occur. After compressing the ''basti yantra'' (douche bag) without shaking and comfortably (without causing discomfort to the patient) the ''basti netra'' should be removed. In case, the ''[[basti]]'' medicine comes out, a second and even a third enema may be given. If it does not come out then it can be ignored for a night. [50-57]<br />
<br />
=== ''Pippalyadi varti'' (medicated wick/suppository)===<br />
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<br />
पिप्पलीलवणागारधूमापामार्गसर्षपैः| <br /><br />
वार्ताकुरसनिर्गुण्डीशम्पाकैः ससहाचरैः||५८||<br /><br />
<br />
मूत्राम्लपिष्टैः सगुडैर्वर्तिं कृत्वा प्रवेशयेत्| <br /><br />
अग्रे तु सर्षपाकारां पश्चार्धे माषसम्मिताम्||५९|| <br /><br />
<br />
नेत्रदीर्घां घृताभ्यक्तां सुकुमारामभङ्गुराम्| <br /><br />
नेत्रवन्मूत्रनाड्यां तु पायौ चाङ्गुष्ठसम्मिताम्||६०||<br /><br />
<br />
स्नेहे प्रत्यागते ताभ्यामानुवासनिको विधिः| <br /><br />
परिहारश्च सव्यापत् ससम्यग्दत्तलक्षणः||६१||<br /><br />
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<br />
pippalīlavaṇāgāradhūmāpāmārgasarṣapaiḥ| <br /><br />
vārtākurasanirguṇḍīśampākaiḥ sasahācaraiḥ||58|| <br /><br />
<br />
mūtrāmlapiṣṭaiḥ saguḍairvartiṁ kr̥tvā pravēśayēt| <br /><br />
agrē tu sarṣapākārāṁ paścārdhē māṣasammitām||59|| <br /><br />
<br />
nētradīrghāṁ ghr̥tābhyaktāṁ sukumārāmabhaṅgurām| <br /><br />
nētravanmūtranāḍyāṁ tu pāyau cāṅguṣṭhasammitām||60||<br /><br />
<br />
snēhē pratyāgatē tābhyāmānuvāsanikō vidhiḥ| <br /><br />
parihāraśca savyāpat sasamyagdattalakṣaṇaḥ||61||<br /><br />
<br />
pippalIlavaNAgAradhUmApAmArgasarShapaiH| <br /><br />
vArtAkurasanirguNDIshampAkaiH sasahAcaraiH||58|| <br /><br />
<br />
mUtrAmlapiShTaiH saguDairvartiM kRutvA praveshayet| <br /><br />
agre tu sarShapAkArAM pashcArdhe mAShasammitAm||59|| <br /><br />
<br />
netradIrghAM ghRutAbhyaktAM sukumArAmabha~ggurAm| <br /><br />
netravanmUtranADyAM tu pAyau cA~gguShThasammitAm||60|| <br /><br />
<br />
snehe pratyAgate tAbhyAmAnuvAsaniko vidhiH| <br /><br />
parihArashca savyApat sasamyagdattalakShaNaH||61|| <br /><br />
</div></div><br />
<br />
''Varti'' (suppository) prepared out of ''pippali'' (Piper longum), ''lavana'' (rock salt), ''agaradhuma'' (house soot), ''apamarga'' (Achyranthus aspera), ''sarshapa'' (Brassica campestris), ''vartaku'' (Solanum melongena), ''nirgundi'' juice (juice of Vitex negundo), ''shampaka'' (Cassia fistula), ''sahachara'' (Barleria prionitis), ''mutra'' (Urine of cattle etc. 8 animals), ''amla'' (''amlavarga dravyas'' like ''nimbuka'' etc) with ''gud'' (jaggery) all pounded together and ''varti'' prepared which is introduced into the urinary passage. The tip of ''varti'' should be of the size of ''sarshapa'' (seed of Brassica campestris) and the other end resembling ''masha'' (Phaseolus radiatus). In the ''mutranadi'' (urinary passage), it should be introduced like the ''bastinetra'' and in the ''payu'' (anal orifice) it should be of thickness upto 1 ''angushta''. When the ''sneha'' comes out, it should be followed by ''anuvasana basti vidhi'' (procedures mentioned in the after care of ''anuvasana basti''). The ''vyapat'' (complications), their management and symptoms of proper administration are also similar to ''anuvasana basti'' procedure.[58-61]<br />
<br />
=== Time of administration of ''uttara basti'' ===<br />
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<br />
स्त्रीणामार्तवकाले तु प्रतिकर्म तदाचरेत्| <br /><br />
गर्भासना सुखं स्नेहं तदाऽऽदत्ते ह्यपावृता||६२|| <br /><br />
<br />
गर्भं योनिस्तदा शीघ्रं जिते गृह्णाति मारुते| <br /><br />
बस्तिजेषु विकारेषु योनिविभ्रंशजेषु च||६३|| <br /><br />
<br />
योनिशूलेषु तीव्रेषु योनिव्यापत्स्वसृग्दरे| <br /><br />
अप्रस्रवति मूत्रे च बिन्दुं बिन्दुं स्रवत्यपि||६४||<br /><br />
<br />
विदध्यादुत्तरं बस्तिं यथास्वौषधसंस्कृतम् |६५|<br /><br />
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<br />
strīṇāmārtavakālē tu pratikarma tadācarēt| <br /><br />
garbhāsanā sukhaṁ snēhaṁ tadā''dattē hyapāvr̥tā||62|| <br /><br />
<br />
garbhaṁ [1] yōnistadā śīghraṁ jitē gr̥hṇāti mārutē| <br /><br />
bastijēṣu vikārēṣu yōnivibhraṁśajēṣu ca||63|| <br /><br />
<br />
yōniśūlēṣu tīvrēṣu yōnivyāpatsvasr̥gdarē| <br /><br />
aprasravati mūtrē ca binduṁ binduṁ sravatyapi||64|| <br /><br />
<br />
vidadhyāduttaraṁ bastiṁ yathāsvauṣadhasaṁskr̥tam [2] |65| <br /><br />
<br />
strINAmArtavakAle tu pratikarma tadAcaret| <br /><br />
garbhAsanA sukhaM snehaM tadA~a~adatte hyapAvRutA||62|| <br /><br />
<br />
garbhaM [1] yonistadA shIghraM jite gRuhNAti mArute| <br /><br />
bastijeShu vikAreShu yonivibhraMshajeShu ca||63|| <br /><br />
<br />
yonishUleShu tIvreShu yonivyApatsvasRugdare| <br /><br />
aprasravati mUtre ca binduM binduM sravatyapi||64|| <br /><br />
<br />
vidadhyAduttaraM bastiM yathAsvauShadhasaMskRutam [2] |65|<br /><br />
</div></div><br />
<br />
In women, ''uttara basti'' should be administered immediately after the menses as the vagina is then open and easily receives the ''sneha'' administered, thereby the ''[[vata]]'' being subdued, it easily becomes impregnable. ''Uttara basti'' with appropriate medicines should be administered in disorders of ''basti'' (Urinary bladder), prolapse of uterus, severe pain related to uterus, 20 diseases of uterus and vagina (described in [Cha.Sa.[[Chikitsa Sthana]] 30th chapter], menorrhagia-metrorrhagia conditions, retention of urine and dribbling incontinence.[62-64½]<br />
<br />
=== Dimensions of nozzle for ''uttara basti'' and its procedure ===<br />
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<br />
पुष्पनेत्रप्रमाणं तु प्रमदानां दशाङ्गुलम्||६५|| <br /><br />
<br />
मूत्रस्रोतःपरीणाहं मुद्गस्रोतोऽनुवाहि च| <br /><br />
अपत्यमार्गे नारीणां विधेयं चतुरङ्गुलम्||६६|| <br /><br />
<br />
द्व्यङ्गुलं मूत्रमार्गे तु बालायास्त्वेकमङ्गुलम्| <br /><br />
उत्तानायाः शयानायाः सम्यक् सङ्कोच्य सक्थिनी||६७|| <br /><br />
<br />
अथास्याः प्रणयेन्नेत्रमनुवंशगतं सुखम्| <br /><br />
द्विस्त्रिश्चतुरिति स्नेहानहोरात्रेण योजयेत्||६८|| <br /><br />
<br />
बस्तौ, बस्तौ प्रणीते च वर्तिः पीनतरा भवेत्| <br /><br />
त्रिरात्रं कर्म कुर्वीत स्नेहमात्रां विवर्धयेत्||६९|| <br /><br />
<br />
अनेनैव विधानेन कर्म कुर्यात् पुनस्त्र्यहात्|७०|<br /><br />
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<br />
puṣpanētrapramāṇaṁ tu pramadānāṁ daśāṅgulam||65|| <br /><br />
<br />
mūtrasrōtaḥparīṇāhaṁ mudgasrōtō'nuvāhi ca| <br /><br />
apatyamārgē nārīṇāṁ vidhēyaṁ caturaṅgulam||66||<br /><br />
<br />
dvyaṅgulaṁ mūtramārgē tu bālāyāstvēkamaṅgulam| <br /><br />
uttānāyāḥ śayānāyāḥ samyak saṅkōcya sakthinī||67|| <br /><br />
<br />
athāsyāḥ praṇayēnnētramanuvaṁśagataṁ sukham| <br /><br />
dvistriścaturiti snēhānahōrātrēṇa yōjayēt||68|| <br /><br />
<br />
bastau, bastau praṇītē ca vartiḥ pīnatarā bhavēt| <br /><br />
trirātraṁ karma kurvīta snēhamātrāṁ vivardhayēt||69|| <br /><br />
<br />
anēnaiva vidhānēna karma kuryāt punastryahāt|70|<br /><br />
<br />
puShpanetrapramANaM tu pramadAnAM dashA~ggulam||65|| <br /><br />
<br />
mUtrasrotaHparINAhaM mudgasroto~anuvAhi ca| <br /><br />
apatyamArge nArINAM vidheyaM catura~ggulam||66|| <br /><br />
<br />
dvya~ggulaM mUtramArge tu bAlAyAstvekama~ggulam| <br /><br />
uttAnAyAH shayAnAyAH samyak sa~gkocya sakthinI||67|| <br /><br />
<br />
athAsyAH praNayennetramanuvaMshagataM sukham| <br /><br />
dvistrishcaturiti snehAnahorAtreNa yojayet||68|| <br /><br />
<br />
bastau, bastau praNIte ca vartiH pInatarA bhavet| <br /><br />
trirAtraM karma kurvIta snehamAtrAM vivardhayet||69||<br /><br />
<br />
anenaiva vidhAnena karma kuryAt punastryahAt|70|<br /><br />
</div></div><br />
<br />
The ''uttarabasti'' nozzle for females should be 10 ''angulas'' in length, circumference as equal to that of urethra and its inner lumen permitting a seed of ''mudga'' (whole green gram/ phaseolus mungo). It should be introduced to a length of 4 ''angulas'' in the genital tract and 2 ''angulas'' into urinary tract for adult females and 1 ''angula'' for ''bala'' (unmarried below 16 years of age). The lady lying down supine with thighs folded upon itself, should be introduced the nozzle comfortably in the direction parallel to the spine. Two, three or four unctuous enemas may be administered in a span of 24 hours. The ''varti'' (suppository) to be administered for elimination of ''[[basti]]'' medicament should be thicker than the enema nozzle. This ''uttarabasti'' should be done for three consecutive nights with gradual increase in the dose of unctuous medicament. The procedure should be likewise repeated after 3 days.[65-69½]<br />
<br />
=== Etiopathology and management of diseases of Head ===<br />
<br />
==== ''Shankhaka'' (temporal headache) ====<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
अतः शिरोविकाराणां कश्चिद्भेदः प्रवक्ष्यते||७०|| <br /><br />
<br />
रक्तपित्तानिला दुष्टाः शङ्खदेशे विमूर्च्छिताः| <br /><br />
तीव्ररुग्दाहरागं हि शोफं कुर्वन्ति दारुणम्||७१|| <br /><br />
<br />
स शिरो विषवद्वेगी निरुध्याशु गलं तथा| <br /><br />
त्रिरात्राज्जीवितं हन्ति शङ्खको नाम नामतः||७२|| <br /><br />
<br />
परं त्र्यहाज्जीवति चेत् प्रत्याख्यायाचरेत् क्रियाम्| <br /><br />
शिरोविरेकसेकादि सर्वं वीसर्पनुच्च यत्||७३||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
ataḥ śirōvikārāṇāṁ kaścidbhēdaḥ pravakṣyatē||70|| <br /><br />
<br />
raktapittānilā duṣṭāḥ śaṅkhadēśē vimūrcchitāḥ| <br /><br />
tīvrarugdāharāgaṁ hi śōphaṁ kurvanti dāruṇam||71|| <br /><br />
<br />
sa śirō viṣavadvēgī nirudhyāśu galaṁ tathā| <br /><br />
trirātrājjīvitaṁ hanti śaṅkhakō nāma nāmataḥ||72|| <br /><br />
<br />
paraṁ tryahājjīvati cēt pratyākhyāyācarēt kriyām| <br /><br />
śirōvirēkasēkādi sarvaṁ vīsarpanucca yat||73||<br /><br />
<br />
ataH shirovikArANAM kashcidbhedaH pravakShyate||70|| <br /><br />
<br />
raktapittAnilA duShTAH sha~gkhadeshe vimUrcchitAH| <br /><br />
tIvrarugdAharAgaM hi shophaM kurvanti dAruNam||71|| <br /><br />
<br />
sa shiro viShavadvegI nirudhyAshu galaM tathA| <br /><br />
trirAtrAjjIvitaM hanti sha~gkhako nAma nAmataH||72|| <br /><br />
<br />
paraM tryahAjjIvati cet pratyAkhyAyAcaret kriyAm| <br /><br />
shirovirekasekAdi sarvaM vIsarpanucca yat||73||<br /><br />
</div></div><br />
<br />
Here after shall be elaborated certain diseases of the head. The aggravated ''[[rakta]], [[pitta]]'' and ''[[vata]]'' getting lodged in the ''shankhadesha'' (temporal area) produce a severe painful swelling with redness. It is acute in manifestation like poison and obstructs the channels of the head and neck, killing the patient in 3 nights. If the patient survives beyond these 3 days, then considering the condition as ''pratyakhyeya'' (incurable but manageable) one should administer treatment modalities such as ''shirovirecha'' (errhines), ''seka'' (affusions) etc., which are curative of ''visarpa'' (erysipelas like lesions).[70-73]<br />
<br />
==== ''Ardhavabhedaka'' (migraine affecting one side of head) ====<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
रूक्षात्यध्यशनात् पूर्ववातावश्यायमैथुनैः| <br /><br />
वेगसन्धारणायासव्यायामैः कुपितोऽनिलः||७४|| <br /><br />
<br />
केवलः सकफो वाऽर्धं गृहीत्वा शिरसस्ततः| <br /><br />
मन्याभ्रूशङ्खकर्णाक्षिललाटार्धेऽतिवेदनाम्||७५|| <br /><br />
<br />
शस्त्रारणिनिभां कुर्यात्तीव्रां सोऽर्धावभेदकः| <br /><br />
नयनं वाऽथवा श्रोत्रमतिवृद्धो विनाशयेत्||७६|| <br /><br />
<br />
चतुःस्नेहोत्तमा मात्रा शिरःकायविरेचनम्| <br /><br />
नाडीस्वेदो घृतं जीर्णं बस्तिकर्मानुवासनम्||७७||<br /> <br />
<br />
उपनाहः शिरोबस्तिर्दहनं चात्र शस्यते| <br /><br />
प्रतिश्याये शिरोरोगे यच्चोद्दिष्टं चिकित्सितम्||७८||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
rūkṣātyadhyaśanāt pūrvavātāvaśyāyamaithunaiḥ| <br /><br />
vēgasandhāraṇāyāsavyāyāmaiḥ kupitō'nilaḥ||74|| <br /><br />
<br />
kēvalaḥ sakaphō vā'rdhaṁ gr̥hītvā śirasastataḥ| <br /><br />
manyābhrūśaṅkhakarṇākṣilalāṭārdhē'tivēdanām||75|| <br /><br />
<br />
śastrāraṇinibhāṁ kuryāttīvrāṁ sō'rdhāvabhēdakaḥ| <br /><br />
nayanaṁ vā'thavā śrōtramativr̥ddhō vināśayēt||76|| <br /><br />
<br />
catuḥsnēhōttamā mātrā śiraḥkāyavirēcanam| <br /><br />
nāḍīsvēdō ghr̥taṁ jīrṇaṁ bastikarmānuvāsanam||77|| <br /><br />
<br />
upanāhaḥ śirōbastirdahanaṁ cātra śasyatē| <br /><br />
pratiśyāyē śirōrōgē yaccōddiṣṭaṁ cikitsitam||78||<br /><br />
<br />
rUkShAtyadhyashanAt pUrvavAtAvashyAyamaithunaiH| <br /><br />
vegasandhAraNAyAsavyAyAmaiH kupito~anilaH||74|| <br /><br />
<br />
kevalaH sakapho vA~ardhaM gRuhItvA shirasastataH| <br /><br />
manyAbhrUsha~gkhakarNAkShilalATArdhe~ativedanAm||75|| <br /><br />
<br />
shastrAraNinibhAM kuryAttIvrAM so~ardhAvabhedakaH| <br /><br />
nayanaM vA~athavA shrotramativRuddho vinAshayet||76|| <br /><br />
<br />
catuHsnehottamA mAtrA shiraHkAyavirecanam| <br /><br />
nADIsvedo ghRutaM jIrNaM bastikarmAnuvAsanam||77|| <br /><br />
<br />
upanAhaH shirobastirdahanaM cAtra shasyate| <br /><br />
pratishyAye shiroroge yaccoddiShTaM cikitsitam||78||<br /><br />
</div></div><br />
<br />
''[[Vata]]'' aggravated due to consumption of ''ruksha'' (dry/ ununctuous) substances, excessive quantity or frequent intake (''adhyashana''), easterly breeze, dew/snow, sexual intercourse, withholding of urges, exhaustion and exercise, either singly or along with ''[[kapha]]'', affecting either half of the head produces severe pain in neck, eyebrow, temples, ear, eye, forehead of one side. The condition is acutely severe like a sharp weapon or fire-log and is called ''ardhavabhedaka''. The condition when severe may impair the functions of an eye or an ear. The 4 ''snehas'' (''taila, ghrita, vasa'' and ''majja'') in the maximum dose, ''kayavirechana'' (purgation), ''sirovirechana'' (purificatory errhines), ''nadisweda'', 10 year old ghee, oil enemas, poultices, ''shirobasti'', cautery are advocated here. The management told for ''pratishyaya'' (rhinitis) and headaches as mentioned should also be employed appropriately. [74-78]<br />
<br />
==== ''Suryavarta'' (headache increasing after sun-rise and in noon) ====<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
सन्धारणादजीर्णाद्यैर्मस्तिष्कं रक्तमारुतौ| <br /><br />
दुष्टौ दूषयतस्तच्च दुष्टं ताभ्यां विमूर्च्छितम्||७९||<br /><br />
<br />
सूर्योदयेंऽशुसन्तापाद्द्रवं विष्यन्दते शनैः| <br /><br />
ततो दिने शिरःशूलं दिनवृद्ध्या विवर्धते||८०|| <br /><br />
<br />
दिनक्षये ततः स्त्याने मस्तिष्के सम्प्रशाम्यति| <br /><br />
सूर्यावर्तः स तत्र स्यात् सर्पिरौत्तरभक्तिकम्||८१|| <br /><br />
<br />
शिरःकायविरेकौ च मूर्ध्ना त्रिस्नेहधारणम् | <br /><br />
जाङ्गलैरुपनाहश्च घृतक्षीरैश्च सेचनम् ||८२|| <br /><br />
<br />
बर्हितित्तिरिलावादिशृतक्षीरोत्थितं घृतम्| <br /><br />
स्यान्नावनं जीवनीयक्षीराष्टगुणसाधितम्||८३||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
sandhāraṇādajīrṇādyairmastiṣkaṁ raktamārutau| <br /><br />
duṣṭau dūṣayatastacca duṣṭaṁ tābhyāṁ vimūrcchitam||79|| <br /><br />
<br />
sūryōdayēṁ'śusantāpāddravaṁ viṣyandatē śanaiḥ| <br /><br />
tatō dinē śiraḥśūlaṁ dinavr̥ddhyā vivardhatē||80|| <br /><br />
<br />
dinakṣayē tataḥ styānē mastiṣkē sampraśāmyati| <br /><br />
sūryāvartaḥ sa tatra syāt sarpirauttarabhaktikam||81|| <br /><br />
<br />
śiraḥkāyavirēkau ca mūrdhnā trisnēhadhāraṇam | <br /><br />
jāṅgalairupanāhaśca ghr̥takṣīraiśca sēcanam ||82|| <br /><br />
<br />
barhitittirilāvādiśr̥takṣīrōtthitaṁ ghr̥tam| <br /><br />
syānnāvanaṁ jīvanīyakṣīrāṣṭaguṇasādhitam||83||<br /><br />
<br />
sandhAraNAdajIrNAdyairmastiShkaM raktamArutau| <br /><br />
duShTau dUShayatastacca duShTaM tAbhyAM vimUrcchitam||79|| <br /><br />
<br />
sUryodayeM~ashusantApAddravaM viShyandate shanaiH| <br /><br />
tato dine shiraHshUlaM dinavRuddhyA vivardhate||80|| <br /><br />
<br />
dinakShaye tataH styAne mastiShke samprashAmyati| <br /><br />
sUryAvartaH sa tatra syAt sarpirauttarabhaktikam||81|| <br /><br />
<br />
shiraHkAyavirekau ca mUrdhnA trisnehadhAraNam | <br /><br />
jA~ggalairupanAhashca ghRutakShIraishca secanam ||82|| <br /><br />
<br />
barhitittirilAvAdishRutakShIrotthitaM ghRutam| <br /><br />
syAnnAvanaM jIvanIyakShIrAShTaguNasAdhitam||83|| <br /><br />
</div></div><br />
<br />
Witholding the urges, indigestion etc. leads to the vitiation of ''[[rakta]]'' and ''[[vata]]'' which in turn vitiate the ''mastishka'' (brain). Thus, affected by the vitiated ''[[rakta]]'' and ''[[vata]]'', at sunrise due to the heat of sunrays these slowly liquefy and thereby during the day there is headache which increases with the day. At the end of the day as they solidify, the headache subsides. The condition is called ''suryavarta'' and is managed by post-prandial ghee consumption, ''shirovireka'' (purificatory errhines), ''kayavireka'' (purgation), ''shiropichu'' (holding a gauze or piece of cotton soaked in medicated oil over the vertex) or ''shirobasti'' (holding medicated oil in a circular tank like formation over the head) with ''trisnehas'', poultices prepared with ''jangala mamsa'' (meat of animals living in dry lands), affusions with ghee and milk, ghee (''[[nasya]]'') errhines prepared out of ''ksheerapaka'' of ''barhi, tittiri, lava'' (birds that live on land) etc. and ''navana'' (unctuous errhines) with ghee processed with 8 parts milk and ''jeevaniya'' drugs (''jeevaka, jeevanti''- Leptadenia reticulata, ''rishabhaka, kakoli, kshirakakoli'' etc.).[79-83]<br />
<br />
=== ''Anantavata'' (pulsating headache involving all areas of head) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
(उपवासातिशोकातिरूक्षशीताल्पभोजनैः)| <br /><br />
दुष्टा दोषास्त्रयो मन्यापश्चाद्घाटासु वेदनाम्||८४|| <br /><br />
<br />
तीव्रां कुर्वन्ति सा चाक्षिभ्रूशङ्खेष्ववतिष्ठते| <br /><br />
स्पन्दनं गण्डपार्श्वस्य नेत्ररोगं हनुग्रहम्||८५|| <br /><br />
<br />
सोऽनन्तवातस्तं हन्यात् सिरार्कावर्तनाशनैः| <br /><br />
वातो रूक्षादिभिः क्रुद्धः शिरःकम्पमुदीरयेत्||८६|| <br /><br />
<br />
तत्रामृताबलारास्नामहाश्वेताश्वगन्धकैः| <br /><br />
स्नेहस्वेदादि वातघ्नं शस्तं नस्यं च तर्पणम्||८७||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
(upavāsātiśōkātirūkṣaśītālpabhōjanaiḥ)| <br /><br />
duṣṭā dōṣāstrayō manyāpaścādghāṭāsu vēdanām||84|| <br /><br />
<br />
tīvrāṁ kurvanti sā cākṣibhrūśaṅkhēṣvavatiṣṭhatē| <br /><br />
spandanaṁ gaṇḍapārśvasya nētrarōgaṁ hanugraham||85|| <br /><br />
<br />
sō'nantavātastaṁ hanyāt sirārkāvartanāśanaiḥ| <br /><br />
vātō rūkṣādibhiḥ kruddhaḥ śiraḥkampamudīrayēt||86|| <br /><br />
<br />
tatrāmr̥tābalārāsnāmahāśvētāśvagandhakaiḥ| <br /><br />
snēhasvēdādi vātaghnaṁ śastaṁ nasyaṁ ca tarpaṇam||87||<br /><br />
<br />
(upavAsAtishokAtirUkShashItAlpabhojanaiH)| <br /><br />
duShTA doShAstrayo manyApashcAdghATAsu vedanAm||84|| <br /><br />
<br />
tIvrAM kurvanti sA cAkShibhrUsha~gkheShvavatiShThate| <br /><br />
spandanaM gaNDapArshvasya netrarogaM hanugraham||85|| <br /><br />
<br />
so~anantavAtastaM hanyAt sirArkAvartanAshanaiH| <br /><br />
vAto rUkShAdibhiH kruddhaH shiraHkampamudIrayet||86|| <br /><br />
<br />
tatrAmRutAbalArAsnAmahAshvetAshvagandhakaiH| <br /><br />
snehasvedAdi vAtaghnaM shastaM nasyaM ca tarpaNam||87||<br /><br />
</div></div><br />
<br />
The three ''[[dosha]]s'' aggravated due to fasting, severe grief, consumption of food which is ununctuous, cold and less in quantity, producing severe pain in ''manya'' (antero lateral part of neck) and then ''ghata'' (posterior part of neck). Later the pain localizes to the eye, eyebrow and temples, causes twitching in the cheek, diseases of the eye and stiffness of the jaw. The condition is called ''anantavata''. <br />
It is treated by ''siravyadha'' (venesection) and medicines that cure ''suryavarta''. The ''[[vata]]'' aggravated by ''ruksha'' etc factors produces tremors of the head. In this condition ''amrita'' (Tinospora cordifolia), ''bala'' (Sida cordifolia), ''rasna'' (Pluchea lanceolata), ''mahashveta'' (Clitoria ternatea Linn.), ''ashvagandha'' (Withania sommifera) which are alleviators of ''[[vata]]'' should be used for oleation, fomentation and ''tarpana [[nasya]]'' (nourishing errhines) should be employed.[84-87]<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
नस्तःकर्म च कुर्वीत शिरोरोगेषु शास्त्रविद्| <br /><br />
द्वारं हि शिरसो नासा तेन तद् व्याप्य हन्ति तान्||८८|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
nastaḥkarma ca kurvīta śirōrōgēṣu śāstravid| <br /><br />
dvāraṁ hi śirasō nāsā tēna tad vyāpya hanti tān||88|| <br /><br />
<br />
nastaHkarma ca kurvIta shirorogeShu shAstravid| <br /><br />
dvAraM hi shiraso nAsA tena tad vyApya hanti tAn||88||<br /><br />
</div></div><br />
<br />
A physician proficient in the [[Ayurveda]] scriptures should employ ''[[nasya]] karma'' (errhines) in diseases of the head as the nose being the gateway of head, the medicines administered thereby pervades into the head and cures diseases pertaining to the head.[88]<br />
<br />
=== Types of ''[[nasya]]'' (nasal drug delivery therapy) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
नावनं चावपीडश्च ध्मापनं धूम एव च| <br /><br />
प्रतिमर्शश्च विज्ञेयं नस्तःकर्म तु पञ्चधा||८९|| <br /><br />
<br />
स्नेहनं शोधनं चैव द्विविधं नावनं स्मृतम्| <br /><br />
शोधनः स्तम्भनश्च स्यादवपीडो द्विधा मतः ||९०|| <br /><br />
<br />
चूर्णस्याध्मापनं तद्धि देहस्रोतोविशोधनम् | <br /><br />
विज्ञेयस्त्रिविधो धूमः प्रागुक्तः शमनादिकः||९१||<br /><br />
<br />
प्रतिमर्शो भवेत् स्नेहो निर्दोष उभयार्थकृत्| <br /><br />
एवं तद्रेचनं कर्म तर्पणं शमनं त्रिधा||९२||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
nāvanaṁ cāvapīḍaśca dhmāpanaṁ dhūma ēva ca| <br /><br />
pratimarśaśca vijñēyaṁ nastaḥkarma tu pañcadhā||89|| <br /><br />
<br />
snēhanaṁ śōdhanaṁ caiva dvividhaṁ nāvanaṁ smr̥tam| <br /><br />
śōdhanaḥ stambhanaśca syādavapīḍō dvidhā mataḥ ||90|| <br /><br />
<br />
cūrṇasyādhmāpanaṁ taddhi dēhasrōtōviśōdhanam | <br /><br />
vijñēyastrividhō dhūmaḥ prāguktaḥ śamanādikaḥ||91|| <br /><br />
<br />
pratimarśō bhavēt snēhō nirdōṣa ubhayārthakr̥t| <br /><br />
ēvaṁ tadrēcanaṁ karma tarpaṇaṁ śamanaṁ tridhā||92||<br /><br />
<br />
nAvanaM cAvapIDashca dhmApanaM dhUma eva ca| <br /><br />
pratimarshashca vij~jeyaM nastaHkarma tu pa~jcadhA||89|| <br /><br />
<br />
snehanaM shodhanaM caiva dvividhaM nAvanaM smRutam| <br /><br />
shodhanaH stambhanashca syAdavapIDo dvidhA mataH ||90|| <br /><br />
<br />
cUrNasyAdhmApanaM taddhi dehasrotovishodhanam | <br /><br />
vij~jeyastrividho dhUmaH prAguktaH shamanAdikaH||91|| <br /><br />
<br />
pratimarsho bhavet sneho nirdoSha ubhayArthakRut| <br /><br />
evaM tadrecanaM karma tarpaNaM shamanaM tridhA||92||<br /><br />
</div></div><br />
<br />
''[[Nasya]] karma'' is said to be of 5 types- ''navana'' (unctuous errhines), ''avapida'' (expressed errhines), ''dhmapana'' (powder errhines), ''dhuma'' (smoke inhalation) and ''pratimarsha'' (low dose unctuous errhines). ''Navana'' (unctuous errhines) is of two types viz, ''snehana'' (oleating) and ''shodhana'' (purificatory). ''Avapida'' (Expressed errhine) is of two types-''shodhana'' (purificatory) and ''stambhana'' (astringent). Blowing of ''churna'' (powder errhine) is said to cleanse the body passages. ''Dhuma'' (smoke inhalation) is said to be of three types ie, ''shamana'' etc (palliative, oleating and purificatory) as mentioned before. ''Pratimarsha'' is an oleative type of errhine without any adverse effects whatsoever and serves both (oleation and purification). Hence, the above mentioned 5 types of errhines fall into 3 categories – ''rechana'' (purificatory), ''tarpana'' (nourishing) and ''samana'' (palliative). [89-92]<br />
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<br />
स्तम्भसुप्तिगुरुत्वाद्याः श्लैष्मिका ये शिरोगदाः| <br /><br />
शिरोविरेचनं तेषु नस्तःकर्म प्रशस्यते||९३|| <br /><br />
<br />
ये च वातात्मका रोगाः शिरःकम्पार्दितादयः| <br /><br />
शिरसस्तर्पणं तेषु नस्तःकर्म प्रशस्यते ||९४|| <br /><br />
<br />
रक्तपित्तादिरोगेषु शमनं नस्यमिष्यते| <br /><br />
ध्मापनं धूमपानं च तथा योग्येषु शस्यते ||९५|| <br /><br />
<br />
(दोषादिकं समीक्ष्यैव भिषक् सम्यक् च कारयेत्)|९६|<br /><br />
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<br />
stambhasuptigurutvādyāḥ ślaiṣmikā yē śirōgadāḥ| <br /><br />
śirōvirēcanaṁ tēṣu nastaḥkarma praśasyatē||93|| <br /><br />
<br />
yē ca vātātmakā rōgāḥ śiraḥkampārditādayaḥ| <br /><br />
śirasastarpaṇaṁ tēṣu nastaḥkarma praśasyatē ||94|| <br /><br />
<br />
raktapittādirōgēṣu śamanaṁ nasyamiṣyatē| <br /><br />
dhmāpanaṁ dhūmapānaṁ ca tathā yōgyēṣu śasyatē ||95||<br /><br />
<br />
(dōṣādikaṁ samīkṣyaiva bhiṣak samyak ca kārayēt)|96|<br /><br />
<br />
stambhasuptigurutvAdyAH shlaiShmikA ye shirogadAH| <br /><br />
shirovirecanaM teShu nastaHkarma prashasyate||93|| <br /><br />
<br />
ye ca vAtAtmakA rogAH shiraHkampArditAdayaH| <br /><br />
shirasastarpaNaM teShu nastaHkarma prashasyate ||94|| <br /><br />
<br />
raktapittAdirogeShu shamanaM nasyamiShyate| <br /><br />
dhmApanaM dhUmapAnaM ca tathA yogyeShu shasyate ||95|| <br /><br />
<br />
(doShAdikaM samIkShyaiva bhiShak samyak ca kArayet)|96|<br /><br />
</div></div><br />
<br />
In ''kaphaja shirorogas'' characterized by stiffness, numbness, heaviness etc. ''Nasta karma''(nasal errhines) especially purificatory type is beneficial. Those diseases of head which are due to [[vata]] such as tremors of the head, facial palsy etc in them ''nastakarma'' in the form of ''tarpana'' is most suited. In diseases like ''raktapitta'' (bleeding dyscrasias) palliative errhines are indicated. Powder errhines and smoke inhalation are indicated for appropriate ones (treatment should be carried out by the physician after duly considering the ''[[dosha]]'' etc factors).[93-95½]<br />
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<br />
फलादिभेषजं प्रोक्तं शिरसो यद्विरेचनम्||९६|| <br /><br />
<br />
तच्चूर्णं कल्पयेत्तेन पचेत् स्नेहं विरेचनम्| <br /><br />
यदुक्तं मधुरस्कन्धे भेषजं तेन तर्पणम्||९७|| <br /><br />
<br />
साधयित्वा भिषक् स्नेहं नस्तः कुर्याद्विधानवित्|९८|<br /><br />
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<br />
phalādibhēṣajaṁ prōktaṁ śirasō yadvirēcanam||96|| <br /><br />
<br />
taccūrṇaṁ kalpayēttēna pacēt snēhaṁ virēcanam| <br /><br />
yaduktaṁ madhuraskandhē bhēṣajaṁ tēna tarpaṇam||97|| <br /><br />
<br />
sādhayitvā bhiṣak snēhaṁ nastaḥ kuryādvidhānavit|98| <br /><br />
<br />
phalAdibheShajaM proktaM shiraso yadvirecanam||96|| <br /><br />
<br />
taccUrNaM kalpayettena pacet snehaM virecanam| <br /><br />
yaduktaM madhuraskandhe bheShajaM tena tarpaNam||97|| <br /><br />
<br />
sAdhayitvA bhiShak snehaM nastaH kuryAdvidhAnavit|98|<br /><br />
</div></div><br />
<br />
The fruit etc. seven categories of medications suitable as errhines for purification of head mentioned in [[Rogabhishagjitiya Vimana]] may be used as powder and in oil base for purification. The drugs of sweet category mentioned in the that chapter may be used for ''tarpana'' (nourishing). With these mentioned drugs the ''sneha'' should be prepared and used by the physician who is skillful in the errhine therapy.[96-97½]<br />
<br />
=== Procedure of [[nasya]] therapy ===<br />
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<br />
प्राक्सूर्ये मध्यसूर्ये वा प्राक्कृतावश्यकस्य च||९८|| <br /><br />
<br />
उत्तानस्य शयानस्य शयने स्वास्तृते सुखम्| <br /><br />
प्रलम्बशिरसः किञ्चित् किञ्चित् पादोन्नतस्य च||९९|| <br /><br />
<br />
दद्यान्नासापुटे स्नेहं तर्पणं बुद्धिमान् भिषक्| <br /><br />
अनवाक्शिरसो नस्यं न शिरः प्रतिपद्यते||१००|| <br /><br />
<br />
अत्यवाक्शिरसो नस्यं मस्तुलुङ्गेऽवतिष्ठति| <br /><br />
अत एवंशयानस्य शुद्ध्यर्थं स्वेदयेच्छिरः||१०१|| <br /><br />
<br />
संस्वेद्य नासामुन्नम्य वामेनाङ्गुष्ठपर्वणा| <br /><br />
हस्तेन दक्षिणेनाथ कुर्यादुभयतः समम्||१०२|| <br /><br />
<br />
प्रणाड्या पिचुना वाऽपि नस्तःस्नेहं यथाविधि| <br /><br />
कृते च स्वेदयेद्भूय आकर्षेच्च पुनः पुनः||१०३||<br /><br />
<br />
तं स्नेहं श्लेष्मणा साकं तथा स्नेहो न तिष्ठति| <br /><br />
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<br />
prāksūryē madhyasūryē vā prākkr̥tāvaśyakasya ca||98|| <br /><br />
<br />
uttānasya śayānasya śayanē svāstr̥tē sukham| <br /><br />
pralambaśirasaḥ kiñcit kiñcit pādōnnatasya ca||99|| <br /><br />
<br />
dadyānnāsāpuṭē snēhaṁ tarpaṇaṁ buddhimān bhiṣak| <br /><br />
anavākśirasō nasyaṁ na śiraḥ pratipadyatē||100|| <br /><br />
<br />
atyavākśirasō nasyaṁ mastuluṅgē'vatiṣṭhati| <br /><br />
ata ēvaṁśayānasya śuddhyarthaṁ svēdayēcchiraḥ||101|| <br /><br />
<br />
saṁsvēdya nāsāmunnamya vāmēnāṅguṣṭhaparvaṇā| <br /><br />
hastēna dakṣiṇēnātha kuryādubhayataḥ samam||102|| <br /><br />
<br />
praṇāḍyā picunā vā'pi nastaḥsnēhaṁ yathāvidhi| <br /><br />
kr̥tē ca svēdayēdbhūya ākarṣēcca punaḥ punaḥ||103|| <br /><br />
<br />
taṁ snēhaṁ ślēṣmaṇā sākaṁ tathā snēhō na tiṣṭhati|<br /><br />
prAksUrye madhyasUrye vA prAkkRutAvashyakasya ca||98|| <br /><br />
<br />
uttAnasya shayAnasya shayane svAstRute sukham| <br /><br />
pralambashirasaH ki~jcit ki~jcit pAdonnatasya ca||99|| <br /><br />
<br />
dadyAnnAsApuTe snehaM tarpaNaM buddhimAn bhiShak| <br /><br />
anavAkshiraso nasyaM na shiraH pratipadyate||100|| <br /><br />
<br />
atyavAkshiraso nasyaM mastulu~gge~avatiShThati| <br /><br />
ata evaMshayAnasya shuddhyarthaM svedayecchiraH||101|| <br /><br />
<br />
saMsvedya nAsAmunnamya vAmenA~gguShThaparvaNA| <br /><br />
hastena dakShiNenAtha kuryAdubhayataH samam||102|| <br /><br />
<br />
praNADyA picunA vA~api nastaHsnehaM yathAvidhi| <br /><br />
kRute ca svedayedbhUya AkarShecca punaH punaH||103|| <br /><br />
<br />
taM snehaM shleShmaNA sAkaM [1] tathA sneho na tiShThati|<br /><br />
</div></div><br />
<br />
''Tarpana sneha [[nasya]]'' should be administered into the nostrils of a patient in the early morning or mid noon, who has attended to his ablutions lying down supine comfortably on a well spread couch, with head extended and the foot slightly raised. If the head is not lowered at all, the medication does not reach the head. If the head is excessively lowered the [[nasya]] medication may reach into the brain. Hence, a reclining patient for proper purification should be administered fomentation to the head. After proper fomentation, the tip of nose elevated with the thumb of left hand and with the right hand the unctuous errhine should be dropped into the nostril through a tube or gauze, equally into both the nostrils. After having done this, the head should be duly fomented and the instilled medicine should be repeatedly extracted along with the phlegmmatous discharge so that no medicine remains. (98-103½)<br />
<br />
=== ''Dhumapana'' (medicated smoking) and post ''[[nasya]]'' therapy ===<br />
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<br />
स्वेदेनोत्क्लेशितः श्लेष्मा नस्तःकर्मण्युपस्थितः ||१०४||<br /><br />
<br />
भूयः स्नेहस्य शैत्येन शिरसि स्त्यायते ततः| <br /><br />
श्रोत्रमन्यागलाद्येषु विकाराय स कल्पते||१०५|| <br /><br />
<br />
ततो नस्तःकृते धूमं पिबेत् कफविनाशनम् | <br /><br />
हितान्नभुङ्निवातोष्णसेवी स्यान्नियतेन्द्रियः||१०६|| <br /><br />
<br />
विधिरेषोऽवपीडस्य कार्यः प्रध्मापनस्य तु| <br /><br />
तत् षडङ्गुलया नाड्या धमेच्चूर्णं मुखेन तु||१०७|| <br /><br />
<br />
विरिक्तशिरसं तूष्णं पाययित्वाऽम्बु भोजयेत्| <br /><br />
लघु त्रिष्वविरुद्धं च निवातस्थमतन्द्रितः||१०८|| <br /><br />
<br />
विरेकशुद्धो दोषस्य कोपनं यस्य सेवते| <br /><br />
स दोषो विचरंस्तत्र करोति स्वान् गदान् बहून्||१०९||<br /><br />
<br />
यथास्वं विहितां तेषु क्रियां कुर्याद्विचक्षणः| <br /><br />
अकालकृतजातानां रोगाणामनुरूपतः||११०||<br /><br />
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<br />
svēdēnōtklēśitaḥ ślēṣmā nastaḥkarmaṇyupasthitaḥ ||104|| <br /><br />
<br />
bhūyaḥ snēhasya śaityēna śirasi styāyatē tataḥ| <br /><br />
śrōtramanyāgalādyēṣu vikārāya sa kalpatē||105|| <br /><br />
<br />
tatō nastaḥkr̥tē dhūmaṁ pibēt kaphavināśanam | <br /><br />
hitānnabhuṅnivātōṣṇasēvī syānniyatēndriyaḥ||106|| <br /><br />
<br />
vidhirēṣō'vapīḍasya kāryaḥ pradhmāpanasya tu| <br /><br />
tat ṣaḍaṅgulayā nāḍyā dhamēccūrṇaṁ mukhēna tu||107|| <br /><br />
<br />
viriktaśirasaṁ tūṣṇaṁ pāyayitvā'mbu bhōjayēt| <br /><br />
laghu triṣvaviruddhaṁ ca nivātasthamatandritaḥ||108|| <br /><br />
<br />
virēkaśuddhō dōṣasya kōpanaṁ yasya sēvatē| <br /><br />
sa dōṣō vicaraṁstatra karōti svān gadān bahūn||109|| <br /><br />
<br />
yathāsvaṁ vihitāṁ tēṣu kriyāṁ kuryādvicakṣaṇaḥ| <br /><br />
akālakr̥tajātānāṁ rōgāṇāmanurūpataḥ||110|| <br /><br />
<br />
svedenotkleshitaH shleShmA nastaHkarmaNyupasthitaH ||104|| <br /><br />
<br />
bhUyaH snehasya shaityena shirasi styAyate tataH| <br /><br />
shrotramanyAgalAdyeShu vikArAya sa kalpate||105|| <br /><br />
<br />
tato nastaHkRute dhUmaM pibet kaphavinAshanam | <br /><br />
hitAnnabhu~gnivAtoShNasevI syAnniyatendriyaH||106|| <br /><br />
<br />
vidhireSho~avapIDasya kAryaH pradhmApanasya tu| <br /><br />
tat ShaDa~ggulayA nADyA dhameccUrNaM mukhena tu||107|| <br /><br />
<br />
viriktashirasaM tUShNaM pAyayitvA~ambu bhojayet| <br /><br />
laghu triShvaviruddhaM ca nivAtasthamatandritaH||108|| <br /><br />
<br />
virekashuddho doShasya kopanaM yasya sevate| <br /><br />
sa doSho vicaraMstatra karoti svAn gadAn bahUn||109|| <br /><br />
<br />
yathAsvaM vihitAM teShu kriyAM kuryAdvicakShaNaH| <br /><br />
akAlakRutajAtAnAM rogANAmanurUpataH||110|| <br /><br />
</div></div><br />
<br />
The mucus liquefied by the sudation, accumulated by the administration of errhine will get condensed back in the head due to the inherent coldness of the unctuous errhine which leads to diseases of ears, neck and throat. Hence, after the errhine therapy, one should take smoking which eliminates ''[[kapha]]'', consume wholesome diet, resort to breezeless, warm residence and observe self restraint. <br />
<br />
The same procedure should be employed for administration of ''avapida [[nasya]]'' (expressed errhine). As regards ''pradhmapana'' (powder inhalation), the medicinal powder should be blown by mouth through a 6 ''Angula'' long tube. After purification of the head he should be made to drink hot water followed by predominant fluid diet which is light and not against the three ''[[dosha]]s'', and then made to reside in a breezeless place by vigilant physician. One who is purified off the ''[[dosha]]s'' if indulges in factors which cause ''[[dosha]]'' aggravation, the ''[[dosha]]s'' getting provoked move about in the body producing many diseases due to them. In these the wise physician should carry out treatments as mentioned and as appropriate for diseases arising due to untimely administration of errhine therapy. [104-110]<br />
<br />
=== The treatment of vitiated ''[[dosha]]s'' after ''[[nasya]]'' ===<br />
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<br />
अजीर्णे भोजने भुक्ते तोये पीतेऽथ दुर्दिने| <br /><br />
प्रतिश्याये नवे स्नाते स्नेहपानेऽनुवासने||१११|| <br /><br />
<br />
नावनं स्नेहनं रोगान् करोति श्लैष्मिकान् बहून्| <br /><br />
तत्र श्लेष्महरः सर्वस्तीक्ष्णोष्णादिर्विधिर्हितः||११२|| <br /><br />
<br />
क्षामे विरेचिते गर्भे व्यायामाभिहते तृषि| <br /><br />
वातो रूक्षेण नस्येन क्रुद्धः स्वाञ्जनयेद्गदान्||११३|| <br /><br />
<br />
तत्र वातहरः सर्वो विधिः स्नेहनबृंहणः| <br /><br />
स्वेदादिः, स्याद्घृतं क्षीरं गर्भिण्यास्तु विशेषतः||११४|| <br /><br />
<br />
ज्वरशोकातितप्तानां तिमिरं मद्यपस्य तु| <br /><br />
रूक्षैः शीताञ्जनैर्लेपैः पुटपाकैश्च साधयेत् ||११५||<br /><br />
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<br />
ajīrṇē bhōjanē bhuktē tōyē pītē'tha durdinē| <br /><br />
pratiśyāyē navē snātē snēhapānē'nuvāsanē||111|| <br /><br />
<br />
nāvanaṁ snēhanaṁ rōgān karōti ślaiṣmikān bahūn| <br /><br />
tatra ślēṣmaharaḥ sarvastīkṣṇōṣṇādirvidhirhitaḥ||112|| <br /><br />
<br />
kṣāmē virēcitē garbhē vyāyāmābhihatē tr̥ṣi| <br /><br />
vātō rūkṣēṇa nasyēna kruddhaḥ svāñjanayēdgadān||113|| <br /><br />
<br />
tatra vātaharaḥ sarvō vidhiḥ snēhanabr̥ṁhaṇaḥ| <br /><br />
svēdādiḥ, syādghr̥taṁ kṣīraṁ garbhiṇyāstu viśēṣataḥ||114|| <br /><br />
<br />
jvaraśōkātitaptānāṁ timiraṁ madyapasya tu| <br /><br />
rūkṣaiḥ śītāñjanairlēpaiḥ puṭapākaiśca sādhayēt ||115||<br /><br />
<br />
ajIrNe bhojane bhukte toye pIte~atha durdine| <br /><br />
pratishyAye nave snAte snehapAne~anuvAsane||111|| <br /><br />
<br />
nAvanaM snehanaM rogAn karoti shlaiShmikAn bahUn| <br /><br />
tatra shleShmaharaH sarvastIkShNoShNAdirvidhirhitaH||112|| <br /><br />
<br />
kShAme virecite garbhe vyAyAmAbhihate tRuShi| <br /><br />
vAto rUkSheNa nasyena kruddhaH svA~jjanayedgadAn||113|| <br /><br />
<br />
tatra vAtaharaH sarvo vidhiH snehanabRuMhaNaH| <br /><br />
svedAdiH, syAdghRutaM kShIraM garbhiNyAstu visheShataH||114|| <br /><br />
<br />
jvarashokAtitaptAnAM timiraM madyapasya tu| <br /><br />
rUkShaiH shItA~jjanairlepaiH puTapAkaishca sAdhayet ||115||<br /><br />
</div></div><br />
<br />
Unctuous errhine administered in patients of indigestion, soon after major food, water consumption, on an unsuitable (cloudy) day, in case of acute rhinitis, after bath, internal oleation, oil enema gives rise to many diseases of ''[[kapha]]''. In these conditions all measures that alleviate ''[[kapha]]'' such as penetrating, hot etc are beneficial. <br />
<br />
Ununctuous or dry errhines in persons who are emaciated, after purgation, pregnant, exhausted due to severe exercise, thirsty, leads to aggravation of ''[[vata]]'' and produce diseases due to it. In such conditions all ''[[vata]]'' alleviating measures such as oleation, nourishing therapy, sudation etc should be done. In case of pregnant especially, ghee and milk should be administered. <br />
Unctuous errhine administered in those afflicted by severe fever, grief and alcoholics causes dimness of vision. It should be managed by collyrium and applications to the eye and instillation of medicine prepared by ''putapaka'' method which are un-unctuous and cold. [111-115]<br />
<br />
=== Types of ''navana'' (unctuous errhines) ===<br />
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स्नेहनं शोधनं चैव द्विविधं नावनं मतम्| <br /><br />
प्रतिमर्शस्तु नस्यार्थं करोति न च दोषावान्||११६|| <br /><br />
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नस्तः स्नेहाङ्गुलिं दद्यात् प्रातर्निशि च सर्वदा| <br /><br />
न चोच्छिङ्घेदरोगाणां प्रतिमर्शः स दार्ढ्यकृत्||११७||<br /><br />
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snēhanaṁ śōdhanaṁ caiva dvividhaṁ nāvanaṁ matam| <br /><br />
pratimarśastu nasyārthaṁ karōti na ca dōṣāvān||116||<br /><br />
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nastaḥ snēhāṅguliṁ dadyāt prātarniśi ca sarvadā| <br /><br />
na cōcchiṅghēdarōgāṇāṁ pratimarśaḥ sa dārḍhyakr̥t||117||<br /><br />
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snehanaM shodhanaM caiva dvividhaM nAvanaM matam| <br /><br />
pratimarshastu nasyArthaM karoti na ca doShAvAn||116|| <br /><br />
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nastaH snehA~gguliM dadyAt prAtarnishi ca sarvadA| <br /><br />
na cocchi~gghedarogANAM pratimarshaH sa dArDhyakRut||117||<br /><br />
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Unctuous errhine (all errhines for that matter) is of two types- oleating and purificatory. ''Pratimarsha'' (low dose unctuous errhine) serves both the purpose and does not produce any ill effects. In the morning, night and at all times, one should use an oleated finger for ''pratimarsha''. It should not be inhaled deeply. It is suitable for healthy and serves to strengthen the head.[116-117]<br />
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=== Summary ===<br />
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तत्र श्लोकौ <br /><br />
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त्रीणि यस्मात् प्रधानानि मर्माण्यभिहतेषु च| <br /><br />
तेषु लिङ्गं चिकित्सां च रोगभेदाश्च सौषधाः||११८|| <br /><br />
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विधिरुत्तरबस्तेश्च नस्तःकर्मविधिस्तथा| <br /><br />
सव्यापद्भेषजं सिद्धौ मर्माख्यायां प्रकीर्तितम्||११९||<br /><br />
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tatra ślōkau <br /><br />
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trīṇi yasmāt pradhānāni marmāṇyabhihatēṣu ca| <br /><br />
tēṣu liṅgaṁ cikitsāṁ ca rōgabhēdāśca sauṣadhāḥ||118|| <br /><br />
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vidhiruttarabastēśca nastaḥkarmavidhistathā| <br /><br />
savyāpadbhēṣajaṁ siddhau marmākhyāyāṁ prakīrtitam||119||<br /><br />
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tatra shlokau <br /><br />
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trINi yasmAt pradhAnAni marmANyabhihateShu ca| <br /><br />
teShu li~ggaM cikitsAM ca rogabhedAshca sauShadhAH||118|| <br /><br />
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vidhiruttarabasteshca nastaHkarmavidhistathA| <br /><br />
savyApadbheShajaM siddhau marmAkhyAyAM prakIrtitam||119||<br /><br />
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To conclude the verses- <br />
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The 3 most important among the ''marmas'', signs and symptoms due to their injury, their treatment, diseases affecting these ''marmas'' with their management, ''uttarabasti'' procedure, procedure of ''[[nasya]]karma'', their complications with management have all been described in the chapter on ''siddhi'' related to three ''marmas''.[118-119]<br />
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इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते <br />
सिद्धिस्थाने त्रिमर्मीयसिद्धिर्नाम नवमोऽध्यायः||९||<br />
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ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē'prāptē dr̥ḍhabalasampūritē <br />
siddhisthānē trimarmīyasiddhirnāma navamō'dhyāyaḥ||9|| <br />
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ityagniveshakRute tantre carakapratisaMskRute~aprApte dRuDhabalasampUrite <br />
siddhisthAne trimarmIyasiddhirnAma navamo~adhyAyaH||9||<br />
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Hence, the 9th chapter of [[Siddhi Sthana]] named [[Trimarmiya Siddhi]], which was unavailable and hence, completed by Dridhabala in Agnivesha’s compendium redacted by Charaka.<br />
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== Tattva Vimarsha (Fundamental Principles) ==<br />
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*''Marmas'' are the vital junctions and organs in the body. <br />
*''Marmas'' are the site of ''chetana'' (vital power of life). Therefore, their diseases/injuries are more severe and need immediate attention in treatment. <br />
*The vital organs in trunk and abdomen are more important that those in extremities or at superficial level.<br />
*''Hridaya'' (heart including cardio-vascular system), ''basti'' (Urinary bladder including urinary system and kidneys) and ''shiras'' (head including sensory-motor nervous system) are important owing to the fact that they are the roots of body and the existence of life depends on them. <br />
*''Hridaya'' (heart) is the center for receiving the ten ''dhamani'' (ten great vessels arising from the heart), ''prana, apana, [[manas]]'' (mind), ''[[buddhi]]'' (intellect), ''chetana'' (life), ''[[mahabhuta]]s'' (5 fundamental elements) just like spokes to the axle in the center of a wheel.<br />
*''Shiras'' (head) is the centre for the ''[[indriya]]s'' (the seat of special senses), the ''srotas'' (channels) pertaining to the conduction of ''[[indriya]]'' and ''prana'' like the radiating spicules of the rays of sunlight.<br />
*The ''basti'' (bladder) is center that is related with the functions of ''sthula guda'' (rectum), ''mushka'' (scrotum), ''sevani'' (perineal raphe), urinary channels and ''[[shukra]]'' (semen). It is also the ''mutradhara'' (reservoir of urine) in to all the water carrying channels in the body drain, similar to all the rivers drain into the ''udadhi'' (sea/ ocean). <br />
*Injury to these three ''marmas'' (''hridaya, shiras'' and basti) leads to sudden loss to the life. Therefore these should be especially protected against external injury and ''vatadi [[dosha]]s''.<br />
*''[[Vata]]'' is the prime factor or cause for the aggravation of ''[[pitta]]'' and ''[[kapha]]'' and also it is the cause of ''prana'' (life) and is best managed by ''[[basti]]''.<br />
*''Prana'' (life) is situated at ''hridaya'' (heart), ''murdhna'' (head) and ''[[basti]]'' (bladder and urinary system). Hence attempts should be made to maintain ''paripalana'' (maintain normalcy) them. ''Abadhavarjana'' (avoidance of factors that cause affliction to ''marmas''), ''svasthavrittanuvartana'' (following the healthy regimen), ''utpannarti vighata'' (management of the existing conditions) ensures maintenance of ''marmas'' (''marma paripalana'').<br />
*''Apatantraka'' (opisthotomus) disease is caused by ''[[kapha]]-[[vata]]'' dominance and it shall be managed by ''[[kapha]]-[[vata]]'' pacifying measures including ''tikshna pradhamana [[nasya]]'' (powder blowing into nostrils). Strong purification enemas are contraindicated in the treatment of ''apatantraka''. <br />
*''Tandra'' (drowsiness) is caused due to vitiation of ''[[vata]]'' and ''[[kapha dosha]]''. This condition should be managed by ''[[shodhana]]'' and ''shamana'' measures that are ''kaphahara, [[vyayama]]'' (exercise), ''[[raktamokshana]]'' (bloodletting) and intake of foods that are predominantly ''katu'' (pungent) and ''tikta'' (bitter).<br />
*The urinary disorder occur mainly due to suppression of urine urge, vitiation of ''[[dosha]]s'' in urine. These conditions should be treated based on dominance of ''[[dosha]]'' and by measures that relieve ''mutrakrichchra'' (dysuria), ''[[basti]]'' ( per rectal enemas) and ''uttara basti'' (per urethral enemas).<br />
*Improper diet and lifestyle habits are causative factors for various types of headaches. The ''[[dosha]]s'' with ''[[rakta]]'' are involved in the etio-pathology of head diseases.<br />
*Administration of four ''snehas'' (''taila, ghrita, vasa'' and ''majja'') in the maximum dose, ''Kaya[[virechana]]'' (purgation), ''shirovirechana'' (purificatory errhines), ''nadisweda'' ( fomentation), 10 year old ghee, oil enemas, poultices, ''shirobasti'', cautery are advocated in the management of head diseases. <br />
*The disorders of head and organs in the supra-clavicular region can be managed by ''[[nasya]] karma'' (errhines). Nasal drug administration is the gateway of head, the medicines administered thereby pervade into the head and cures diseases pertaining to the head.<br />
*In ''[[kapha]]'' dominant diseases of head with obstructive pathology, ''[[nasya]]'' (nasal errhines) of purificatory type are advised. <br />
*In ''[[vata]]'' dominant diseases of head with degenerative pathology, ''[[nasya]]'' (nasal errhines) of nourishing type are advised. <br />
*In ''[[pitta]]'' dominant diseases of head with hemorrhagic pathology, ''[[nasya]]'' (nasal errhines) of palliative type are advised.<br />
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== Vidhi Vimarsha (Applied Inferences ) ==<br />
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The concept of ''marma'' described in [[Ayurveda]] texts differs with those described in ''Keraliya Marma Chikitsa'' (''Kalari Marma'') and the Tamilian ''marma'' concept. The numbers and positions also vary greatly. The Keraliyan ''marma'' concept seems to be more related to warfare medicine and the management of trauma while the tamilian ''marma'' concept is more so as described in [[Ayurveda]] related to ''kshata'' as well well as ''doshaja aghata''. [[Ayurveda]] believes that suppression of urges, over enthusiastic activities, strainful activities, faulty treatment practices can actually cause ''doshaja marmaghata''.<br />
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Clinical conditions like paralysis, paresis, paraplegia, quadriplegia, haemorrhage can be understood on Ayurvedic lines by taking clue from here. When it takes place at ''shirasthana'' above mentioned conditions can manifest. They need to be treated on the lines of treatment of ''marmaghata'' rather than only treating them as ''vatavyadhi''. <br />
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The clinical presentations described to occur under the affection of three ''marmas'' are almost practically found in relation to ''[[dosha]]'' aggravations affecting the ''marmas'' and also in case of their injury. Some symptoms are due to direct organ damage and others due to reflex neurological or hormonal disturbances.<br />
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''[[Vata]]'' is considered to be cause of provocation of ''[[pitta]]'' and ''[[kapha]]''. In the process of disease formation direct reference of involvement of ''[[vata]]'' as early as in the stage of ''prasara'' (third out of six stages of disease formation) ''[[vata]]'' is also said to be cause of life to underline its importance as well as the need to address it urgently. Amongst all the treatments of ''[[vata]], [[basti]]'' is the best purely on its merits to take care of ''[[vata]]'' disorders of all the systems throughout the body. <br />
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''Hridaya'' when gets affected, is managed by juices which are ''amla'' (sour) in taste ,as it is best among ''hridya dravyas''.<br />
The drug ''hingu'' (asafoetida) has been found to be effective as a ''vatanulomaka, [[pachana]], amahara,'' and ''sulaghna''. It is also widely used in ''udavarta'' conditions, to relieve functional spasms of smooth muscles as in intestinal colic. ''Hingu vachadi churna'' is specifically used for such conditions. Clinical conditions related to ''Trimarma'' are alarmingly high today. By effecting subtle changes in life style in accordance with classical guidelines will help to reduce life risk to great extent. Preventing the injury to vital organs and timely appropriate management in case of diseases is the key to prevention of diseases and promotion of health. <br />
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''Apatantraka''(opisthotomus) is due to obstruction of ''[[kapha]]'' to ''[[vata]]'', ''apatanaka''(status epilepticus) is only due to ''[[vata]]''.<br />
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Based on the descriptions of the condition involving the heart which is the ''[[manas]]a sthana'' and the involvement of head as well, with clinical manifestations like unconsciousness with flexion spasms or bending of the body, which is temporary, this condition may be considered as a form of syncope.<br />
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Treatment schedule for ''apatantraka'' starts with ''tikshna pradhamana'' as ''prana vilomatva'' has to be corrected to maintain the life of the patient. Second in line is ''shirovirechana'', as vitiated ''[[vata]]'' creates pain in ''sirah'' and ''shankha'' by taking upward course. Then treatment for pacification of ''[[vata]] [[kapha]]'' in ''hridroga'' is applied to take care of ''hridaya'', as ''[[vata]]'' also occupies ''hridaya'' when does upward direction. Further ''[[basti]]'' would have been an ideal option to take ''[[vata]]'' into its own site and pacify it, but it should not be strong, it is to be given in lesser quantity. Involvement of ''hridaya'' in pathogenesis might have prompted this thought, as strong ''basti'' might cause dehydration due to excess elimination leading to fatal condition of ''hridaya''.<br />
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Fine powders of ''shirovirechana'' medicines can clear obstructive pathology faster and hence are preferred. ''Maricha'' which is ''pramathi'' i.e., with its potency drags the ''[[dosha]]s'' out of ''srotasas'' (channels) and removes them from the system. Other medicines ''shigrubija, vidanga'' are known for their ''shirovirechana'' activity.<br />
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''[[Vata]]'' and ''[[kapha]]'' are both considered as causative factors for the onset of ''tandra''. ''[[Vata]]'' agitates ''[[kapha]]'', which in turn occupies ''hridaya''. The knowledge process gets blocked leading to ''tandra''. Treatment aims at eliminating and pacifying ''[[kapha]]''. ''[[Vyayama]]'' and diet of pungent and bitter tastes which acts against ''[[kapha]]'' are suitable. The unusual reference of blood letting can be attributed to involvement of ''hridaya'', which is an organ made up of purest form of ''[[rakta]]''.<br />
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The factors that bring about physical and mental exertion with foods that prolong the digestion or are heavy for digestion bring about an aggravation of ''[[kapha]]'' with ''[[vata]]'' and ''tamo [[guna]]'' thereby producing ''tandra'' (drowsiness). Hence, all medicines that help to clear the ''avarana'' of ''[[manas]]'' by these ''[[doshas]]]'' may be employed, especially so ''teekshna pradhamana nasya''.<br />
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The ''mutravaha srotovikaras'' have been broadly classified into ''mutra atipravrittija'' (excess urination) and ''mutra apravrittija'' (less urination) ''vikaras'' by Vagbhata (A.H.Ni.9/40). The former includes twenty varieties of ''prameha'' and the latter includes two categories of disorders – 8 types of ''mutrakrichchra'' (dysuria) and 12 types ''mutraghata'' (urinary disorders), though both the set of disorders are described under the title ''mutraghata''. Under ''mutraghata, bastikundala'' (circular distension of bladder) is not described. <br />
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In general terms though we find that ''mutraghata'' is described as condition with suppression or less production of urine and ''mutrakrichchra'' as dysuria, not all conditions described under ''mutraghata'' are characterized by oliguria or reduced output.<br />
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Most of the conditions seem to occur predominantly by retention of urine or bladder distension. ''Mutrasaada, mutraukasaada'' and ''ushnavata'' may be considered as scanty urination or oliguria; ''Mutrakshaya'' may be equated to oliguria or anuria.<br />
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''Mutrakrichchra'' is a condition of dysuria due to spermorrhoea. Others like ''vatabasti, mutratita, mutrajathara'' seem to occur due to voluntary withholding of the urge of micturition resulting in physiological bladder atony as in mutratita or retention with pain as in ''vatabasti'' and atonied distended bladder in ''mutrajathara'' all progressive conditions of the same pathological process. <br />
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''Bastikundala'' also seems to be a condition of bladder atony but with superadded cystitis due to severe physical stress and states of dehydration. In ''vatashthila'' and ''mutragranthi'' there seems to be an obvious anatomical growth which causes obstruction to the urine pathway which may be considered as prostatomegaly and vesicle tumors respectively. The condition of ''vatakundalika'', though from the ''Nidana'' seems to be similar to the conditions of withholding the urge of urination, due to the symptoms seems more or less like urethral stricture. ''Mutrotsanga'' seems to be a condition of acute urethritis or cystitis where there is stranguary, dysuria, hesitancy and sometimes blood in urine. ''Mutrakshaya'' more or less seems like anuria or oliguria due to dehydration. ''Vidvighata'' clearly seems a case of recto vesicle or rectourethral fistula. <br />
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Susruta describes ''pittaja'' and ''kaphaja'' types of ''mutraukasada'' (dense urine) as two different conditions. In ''pittaja mutraukasada'' he describes that on drying, the urine resembles ''gorochana churna'' (powder of a stone or 'bezoar' found in cattle) and in case of ''kaphaja'' variety, on drying the urine becomes like ''shankha churna'' (powder of conch shell). <br />
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Due to holding of natural urges, obstruction to the downward movement of ''[[vata]]'' makes ''vata gati'' in to upward and circular, manifesting in to severe condition called ''mutrajathara'' (accumulation of urine in abdominal cavity). Along with symptoms like retention of urine and stool, indigestion is also one of the symptoms.<br />
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Based on the descriptions, the condition seems to be a neurological disturbance of bladder function due to repeated withholding the urge of micturition.<br />
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All the above mentioned ''[[mutra]]doshas'' are in accordance with the ''nidanas'' described under Ca.Vi.5/20 ie, drinking water, consuming food, indulging in sexual intercourse when one feels the urge to micturate and withholding the urge of micturition especially in an emaciated or traumatized individual. <br />
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The condition ''mutratita'' seems to be a physiological atony of bladder owing to prolonged withholding the urge to micturate, thereby the bladder contractions wean away and paves the way for atony. Recurrent withholding the urge may result in pathological atony as well as neurological disturbances in bladder function due to disturbances in the balance between sympathetic and parasympathetic functions. This concept may be practically found in patients of diabetes mellitus with recurrent urinary tract infections (cystitis), wherein USG reveals significant residual urine in bladder due to bladder atony. Such patients are immensely benefited by toilet training ie, developing a habit of regular micturition at timely intervals which in due course reduces the incidence of recurrent urinary tract infections and in due course significantly reduces the residual urine, possibly improving the bladder tone and nervous integrity.<br />
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The role of ''[[basti]] chikitsa'' and specifically ''uttarabasti'' in the management of ''apana vata vikriti'' and also ''sthana dushti'' (local vitiation) has been highlighted in the classical texts.<br />
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The drugs having ''mutrala'' (mutravirecaneeya and mutravirajaneeya) actions are all useful in the above mentioned ''mutradoshas''. The ''mutravirajaneeya, mutravirechaneeya gana dravyas''[Cha.Sa.[[Sutra Sthana]] 4/15] are very helpful. <br />
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The descriptions of the procedure with materials or equipment used thereby are clearly stated in the texts. Gold and silver are metals considered to be soft and malleable. The ''uttarabasti'' nozzle prepared out of these are specially suited for introducing into urethra as it is extremely vulnerable to trauma during the procedure which can be minimized by these metals. Primarily the chance of injury is due to the fact that male urethra is curved (‘S’ shaped) and straightened slightly when the penis is erect. Nevertheless, when fully straight there is a increased chance of trauma. Further these metals have a protective effect on the body.<br />
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In clinical practice, simple rubber catheters no. 6 or 7 may be used for the procedure after sterilization by autoclaving and so should be the medicine used for ''uttarabasti''. With due aseptic precautions, the procedure should be carried out in a fumigated room preferably like an O.T. procedure which reduces the likely chances of U.T.I. Nevertheless, in the outcome the chances of asymptomatic pyuria or abacteriuric pyuria are always there. These possibly can be minimized with the use of filtered medicament (so as to ensure no particles), pre-autoclaved and administered with nozzle of gold or silver. Though the classical position of the patient is seating, lying down position is equally easy and the patient may be made to feel more comfortable. An hour after the procedure, the patient should be instructed to consume plenty of oral fluids to maintain a high urine output. The patients comfortably retain the medicament for 2-4 hours. The procedure may be done daily for 8 days after an initial ''gudagata asthapana basti''. The procedure is done after asking the patient to evacuate the bladder and bowel. <br />
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The drugs described are mostly ''ushna veerya, vatanulomana'' and hence are highly beneficial in clearing the ''avarodha''(obstruction) of ''aushadha''.<br />
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The indication of administration of ''varti'' into ''gudamarga'' as well, probably indicates that some reflex mechanisms are involved in the evacuation of bladder in case of retained medicament. This in the classical description may be explained as causing ''apanavatanulomana''.<br />
<br />
The modern gynecological texts describe per vaginal investigative procedures to be carried out soon after the menses after the stoppage of bleeding. In practice, it’s the ideal time for the ''uttarabasti'' as it’s the time wherein this is naturally open to shed the endometrium which almost closes by the period of ovulation. Further, not only do the medicament enter the uterus with ease but also it acts at a time ideal for it to receive the sperms as well as provides a conducive environment for implantation of fertilized ovum maximizing the chances to conceive.<br />
<br />
Vitiated ''[[rakta]], [[pitta]]'' and ''[[vata]]'' takes course of ''shirah''(head), especially ''shankha'' (temporal region), a ''marma'' of the type ''sadyahpranahara'' (acute life threatening), making the condition incurable. Involvement of ''[[rakta dhatu]]'' in diseases of ''shirah'' is appreciated by Charaka in [Cha.Sa.[[Sutra Sthana]] 17/11] ''[[Pitta]]'' dominating symptoms like ''daha'' (burning sensation), ''raga'' (redness) and vitiation of ''[[rakta dhatu]]'' brings in treatment of ''visarpa'' in to picture, as it also has both these entities vitiated.<br />
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The consideration of ''shankhaka'' as ''pratyakhyeya vyadhi'' and the initiation of treatment in case of survival probably indicates the fact that there could be residual symptoms needing effective management and also that there is a likely chance of recurrence.<br />
<br />
Pathogenesis of the disease indicates two different ways of vitiation of ''[[dosha]], [[vata]]'' and ''[[vata]][[kapha]]''. Further treatment can also be understood on this basis. Use of ''Chatusneha'' (all four ''snehas ghrita, taila, vasa, majja''), procedures like ''shirobasti, anuvasanabasti,'' aimed at pacifying ''[[vata]]'' while more aggresive treatments like ''shirovirechana, [[virechana]],'' use of 10 year old ghee, ''upanaha'' (poultice), ''dahana'' (cautery) are useful in ''[[vata]][[kapha]]'' dominating condition.<br />
<br />
From the descriptions, it appears that this condition could possibly be migraine. The possible triggering factors such as sleep deprivation, physical exhaustion, mental factors such as anxiety, stress etc, may all be understood under the ''nidanas'' described in the classics. The location of pain is also similar. The severity of pain and the disturbances of vision and audition are all classical being found in the stage of aura and may even associate with the proper stage. <br />
<br />
Treatment is aimed at elimination of ''[[dosha]]'' initially followed by pacification of them by various means. Three ''sneha'' viz, ''taila, ghrita, vasa'' to be used in ''murdha taila'' form (holding these materials on head). Here ''majja'' is excluded as it is ''gurutara'' (most heavy amongst ''snehas''). ''Seka''(effusion) in the form of ''ghrita'', milk will help in pacifying ''[[vata]]'' by acting as ''[[brimhana]]'' (nourishment), at the same time ''[[rakta]]prasadana'' (pacifying the impurities in blood) is achieved. ''[[Nasya]]'' with ''jeevaniya ghrita'' is also to pacify ''[[vata]]'' and to account for ''[[rakta]]prasadana''. <br />
<br />
In Bhavaprakasa Nighantu, due to non availability, ''pratinidhi'' (substitutes) have been described for ''ashtha varga'' (group of eight vitalizer herbs) drugs like ''vidarikanda'' (Pueraria tuberosa) for ''jeevaka'' and ''rshabhaka, ashvagandha'' (Withania somnifera) for ''kakoli'' and ''kshirakakoli, varahikanda'' (Dioscorea bulbifera) for ''riddhi'' and ''vriddhi, shatavari'' (Asparagus racemosus) for ''meda'' and ''mahameda''.<br />
<br />
The description of the incidence and timing of the symptoms point to the condition of frontal sinusitis which usually starts as a dull headache in the morning that increases in severity as the day progresses. Occasionally it may be relieved by sleep or sometimes not which depends on the relative dominance of ''[[rakta]]'' and ''[[vata]]''. <br />
<br />
As the condition is purely ''[[vata]]'' dominant, all the treatments described for ''suryavarta'' such as ''ghritapana, ghrita [[nasya]], siropichu, sirobasti'' are all beneficial. If the condition is associated with ''[[rakta]]vrita [[vata]], siravyadha'' is utmost beneficial. This condition may be possibly correlated with Trigeminal neuralgia, based on the location of pain. ''Siravyadha'' at the temporal area is of utmost benefit in neuralgic headaches. <br />
<br />
It is uncontroversial that nose is the gateway of head as all the authors of ''brihattrayis'' and ''laghutrayis'' have shared the importance of ''[[nasya]]karma'' in ''shirorogas''.<br />
<br />
Though the exact mode of action of ''[[nasya]]'' is not studied some hypotheses have been put forward by the scholars of [[Ayurveda]]. One of them is that the medicament directly penetrates into the brain, as fat soluble substances can easily diffuse through the cribriform plate of ethmoid bone (which forms the roof of the nasal cavity) which is porous and owing to the location of olfactory bulbs the medicament can percolate along the fibers of olfactory nerve. The second most agreeable hypothesis is the receptor theory, which believes stimulation of certain brain centers through specific receptors situated in the nasal cavity. The administration of posterior pituitary extract into nostrils by means of sprays, practically and successfully followed in diabetes insipidus is a proof sufficient that through suitable formulation, medicament may be made to act on the brain.<br />
<br />
It is clearly described that ''sneha [[nasya]]'' should be done in ''[[vata]]'' aggravation and ''ruksha [[nasya]]'' should be done in ''kaphaja'' diseases. If this indication is ignored the complications that may follow and the measures to tackle them is described in the above verses.<br />
<br />
In Ashtanga Hridaya, ten specific timings suitable for administration of ''pratimarsha'' have been described.<br />
<br />
In practice, especially in conditions of migraine, allergic rhinitis and atopic rhinitis we advise patients to smear medicated oil or ghee into the nostrils using an oleated finger. This may be considered a form of ''pratimarsha'' itself.<br />
<br />
=== Related Chapters ===<br />
* [[Kiyanta Shiraseeya Adhyaya]] <br />
* [[Trimarmiya Chikitsa]]<br />
<br />
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[[#top| Back to the Top ]]</span></div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Prasrita_Yogiyam_Siddhi&diff=45409Prasrita Yogiyam Siddhi2026-02-11T09:17:41Z<p>Agnivesha: /* Treatment of atisara (diarrhea) mixed with kapa-rakta-pitta-shakrita */</p>
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|title=Prasrita Yogiyam Siddhi<br />
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|keywords=atisara, basti, doshanulomana, grahi, karsha, karmanaviplutanam, niruha, pachana, Panchakarma, prasrita, prastha, snehabasti, vyapat, enema in delicate persons, complication of Panchakarma,Ayurveda, Indian system of medicine, charak samhita. <br />
|description=Siddhi Sthana Chapter 8. Standardized therapeutic enema formulations in a dose of ''Prasrita'' Unit<br />
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<big>'''[[Siddhi Sthana]] Chapter 8. Standardized therapeutic enema formulations in a dose of ''Prasrita'' Unit'''</big><br />
{{Infobox<br />
|title = Prasrita Yogiyam Siddhi<br />
|label1 = Section/Chapter<br />
|data1 = [[Siddhi Sthana]] Chapter 8<br />
|label2 = Preceding Chapter<br />
|data2 = [[Bastivyapat Siddhi]]<br />
|label4 = Succeeding Chapter<br />
|data4 = [[Trimarmiya Siddhi]]<br />
|label5 = Other Sections<br />
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]<br />
|label6 = Translator and commentator<br />
|data6 = Gupta S.N.<br />
|label7 = Reviewer <br />
|data7 = Panse A.<br />
|label8 = Editors<br />
|data8 = Thakar A. B., Mangalasseri P., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br />
|label9 = Year of publication <br />
|data9 = 2020<br />
|label10 = Publisher <br />
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label11 = DOI <br />
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s08.009 10.47468/CSNE.2020.e01.s08.009]<br />
}}<br />
<big>''' Abstract </big>'''<br />
<p style="text-align:justify;">This chapter describes recipes of ''prasritayogiya bastis'' (enema formulation in which ingredients are measured in unit of ''prasrita''). ''Prasrita'' is a measurement, which is approximately equal to 100 millilitre. Nine types of ''[[basti]]'' therapies for various clinical conditions including ''prameha'' (urinary disorders including diabetes), ''abhishyanda'' (oozing), ''kushtha'' (skin diseases), ''krimi'' (worm infestation), ''mutrakrichchra'' (dysuria) and alike are described. ''Atisara'', a clinical condition characterized by frequent defecation with altered composition and consistency of stool is described in detail. ''Atisara'' has various forms depending upon involvement of six morbid components in the pathogenesis viz. ''ama'' (stool with undigested material), ''shakrita'' (stool only), ''[[vata]]'' (with dominant flatulence), ''asrik'' (stool with blood), ''[[pitta]]'' and ''[[kapha]]''. Different recipes of ''[[basti]]'', oral medicaments and food preparations are described to treat these ''atisara'' conditions. These remedies are practically quite useful in several modern diseases like ulcerative colitis and irritable bowel syndrome.<br />
<br/><br />
'''Keywords''': ''atisara, [[basti]], doshanulomana, grahi, karsha, karmanaviplutanam, niruha, [[pachana]],'' [[Panchakarma]], ''prasrita, prastha, snehabasti, vyapat,'' enema in delicate persons, complication of [[Panchakarma]].<br />
</p><br />
<br />
<br />
== Introduction ==<br />
<div style="text-align:justify;"><br />
There are two main types of ''[[basti]]'' according to the composition and the action. ''Anuvasana basti'' is composed of unctuous substance and it is to be retained for minimum nine hours. ''Asthapana basti'' contains mainly decoction with least oil and is evacuated after few minutes. ''[[Basti]]'' is administered through ano-rectal route and acting through the ''pakvashaya'' (colon). It is useful in several diseases particularly [[vata]] disorders having roots in ''pakvashaya''. It is claimed to be half a treatment or even a complete treatment by ancient practitioners<ref>Charak. Siddhi Sthana, Cha.1 Kalpana Siddhi Adhyaya verse 38-40. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi:Munshiram Manoharlal publishers pvt. Ltd; 1981; P 683-684.</ref>. It is not only a procedure of ''[[shodhana]]'' but also providing a recto-colonic route of drug administration. <br />
<br />
Previous chapter ([[Bastivyapat Siddhi]]) deals with the ''vyapat'' (complications) arising due to faulty application of ''[[basti]]s''. Present chapter begins with the treatment of those patients who developed complications as a result of faulty application of therapies (''karmana viplutanam'') and for the tender persons who are not able to tolerate strong measures. For this purpose, chapter describes mild form of ''niruha bastis''. The ingredients of these ''[[basti]]s'' are measured in the unit of ''prasrita''. Therefore the name of the chapter is [[Prasrita Yogiyam Siddhi]]. The unit ''prasrita'' is equal to two ''palas'', which is approximately equal to 100 milliliter (1 ''pala''= approx. 50 ml).<ref>Chakrapani, Charak. Siddhi Sthana, Cha.8 Bastivyapad Siddhi ver.04. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed.New Delhi:Munshiram Manoharlal publishers pvt. Ltd; 1981; P 713</ref><ref>Agnihotri Avadhabihari; Bhaiṣajyakalpanā Vijñāna; Chaukhamba orientalia publication, 6th edition, 2006, P 7-20</ref><br />
<br />
== Sanskrit text, Transliteration and English Translation ==<br />
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<br />
अथातः प्रासृतयोगीयां सिद्धिं व्याख्यास्यामः||१|| <br />
<br />
इति ह स्माह भगवानात्रेयः||२||<br />
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Athātaḥ prāsṛtayōgīyāṁ siddhiṁ vyākhyāsyāmaḥ ||1|| <br />
<br />
iti ha smāha bhagavānātrēyaḥ ||2||<br />
<br />
athAtaH prAsRutayogIyAM siddhiM vyAkhyAsyAmaH||1|| <br />
<br />
iti ha smAha bhagavAnAtreyaH||2||<br />
</div></div><br />
<br />
Now we shall expound the chapter "Prasrita Yogiyam Siddhi" (Standardized therapeutic enema formulations in a dose of ''Prasrita'' Unit). Thus said Lord Atreya. [1-2]<br />
<br />
Note: The chapter describes the formulations having ingredients measured in the unit ''prasrita''(approximately equal to 100 millilitre).<br />
<br />
=== Objective of ''prasrita basti'' ===<br />
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<br />
अथेमान् सुकुमाराणां निरूहान् स्नेहनान् मृदून्| <br />
<br />
कर्मणा विप्लुतानां च वक्ष्यामि प्रसृतैः पृथक्||३|| <br />
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<br />
athēmān sukumārāṇāṁ nirūhān snēhanān mṛdūn| <br />
<br />
karmaṇā viplutānāṁ ca vakṣyāmi prasṛtaiḥ pṛthak||3||<br />
<br />
athemAn sukumArANAM nirUhAn snehanAn mRudUn| <br />
<br />
karmaNA viplutAnAM ca vakShyAmi prasRutaiH pRuthak||3||<br />
</div></div><br />
<br />
Now, I (Atreya) shall explain oleaginous and mild form of ''niruha [[basti]]s'', for the tender persons and the patients suffered from complications as a result of therapies. Composition of those will be in the unit of ''prasrita''. [3]<br />
<br />
=== ''Pancha prasritiki Basti''-I ===<br />
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<br />
क्षीराद्द्वौ प्रसृतौ कार्यौ मधुतैलघृतात्त्रयः| <br />
<br />
खजेन मथितो बस्तिर्वातघ्नो बलवर्णकृत्||४|| <br />
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<br />
kṣīrāddvau prasṛtau kāryau madhutailaghṛtāttrayaḥ| <br />
<br />
khajēna mathitō bastirvātaghno balavarṇakṛt||4|| <br />
<br />
kShIrAddvau prasRutau kAryau madhutailaghRutAttrayaH| <br />
<br />
khajena mathito bastirvAtaghno balavarNakRut||4|| <br />
</div></div><br />
<br />
Two ''prasritas'' of milk and three ''prasritas'' of ''madhu'' (honey), ''taila'' (sesame oil) and ''ghrita'' (clarified butter) are taken together and churned with a churning stick. This ''[[basti]]'' eliminates ''[[vata]]'', and promotes strength as well as complexion. [4]<br />
<br />
=== ''Ashta-prasritiki basti'' ===<br />
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<br />
एकैकः प्रसृतस्तैलप्रसन्नाक्षौद्रसर्पिषाम्| <br />
<br />
बिल्वादिमूलक्वाथाद्द्वौ कौलत्थाद्द्वौ स वातनुत्||५|| <br />
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ēkaikaḥ prasṛtastailaprasannākṣaudrasarpiṣām| <br />
<br />
bilvādimūlakvāthāddvau kaulatthāddvau sa vātanut||5|| <br />
<br />
ekaikaH prasRutastailaprasannAkShaudrasarpiShAm| <br />
<br />
bilvAdimUlakvAthAddvau kaulatthAddvau sa vAtanut||5|| <br />
</div></div><br />
<br />
''[[Basti]]'', composed of one ''prasrita'' each of ''taila'' (sesame oil), ''prasanna''(supernatant part of ''sura''- a type of alcoholic preparation), ''kshaudra'' (honey) and ''ghrita'' (clarified butter) and two ''prasritas'' each of the decoctions of roots of ''bilvadi'' (a group of plants that begins with ''bilva''-Aegle marmelos Carr.) as well as two ''prasritas'' of ''kulattha'' (Phaseolus biflorus Linn.), antagonizes ''[[vata]]''. [5]<br />
<br />
=== ''Nava--prasritiki basti'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
पञ्चमूलरसात् पञ्च द्वौ तैलात् क्षौद्रसर्पिषोः| <br />
<br />
एकैकः प्रसृतो बस्तिः स्नेहनीयोऽनिलापहः||६||<br />
<div class="mw-collapsible-content"><br />
<br />
pañcamūlarasāt pañca dvau tailāt kṣaudrasarpiṣoḥ|<br />
<br />
ēkaikaḥ prasṛto bastiḥ snēhanīyō'nilāpahaḥ||6||<br />
<br />
pa~jcamUlarasAt pa~jca dvau tailAt kShaudrasarpiShoH| <br />
<br />
ekaikaH prasRuto bastiH snehanIyo~anilApahaH||6||<br />
</div></div><br />
<br />
''[[Basti]]'' prepared with five ''prasritas'' of the decoction of ''panchamula'' (''bilva, shyonaka, gambhari, patala'' and ''agnimantha''), two ''prasritas'' of ''taila'' (sesame oil) and one ''prasrita'' each of ''kshaudra'' (honey) as well as ''sarpi'' (''ghrita''), oleates (the body) and expels ''[[vata]]''. [6]<br />
<br />
=== ''Chatu-prasritiki basti''-I ===<br />
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<br />
सैन्धवार्धाक्ष एकैकः क्षौद्रतैलपयोघृतात्| <br />
<br />
प्रसृतो हपुषाकर्षो निरूहः शुक्रकृत् परम्||७||<br />
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<br />
saindhavārdhākṣa ēkaikaḥ kṣaudratailapayōghṛtāt| <br />
<br />
prasṛtō hapuṣākarṣō nirūhaḥ śukrakṛt param||7||<br />
<br />
saindhavArdhAkSha ekaikaH kShaudratailapayoghRutAt| <br />
<br />
prasRuto hapuShAkarSho nirUhaH shukrakRut param||7||<br />
</div></div><br />
<br />
''Niruha basti'', prepared with half ''aksha'' (about 6 grams) of ''saindhava'' (rock salt) one ''prasrita'' each of honey, sesame oil, milk, and ''ghrita'', and one ''karsha'' (about 12 grams) of ''hapusha'' (Juniperus communis Linn.), is an excellent promoter of ''shukra''. [7]<br />
<br />
=== ''Panchatikta niruha basti'' ===<br />
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<br />
पटोलनिम्बभूनिम्बरास्नासप्तच्छदाम्भसः| <br />
<br />
चत्वारः प्रसृता एको घृतात् सर्षपकल्कितः||८|| <br />
<br />
निरूहः पञ्चतिक्तोऽयं मेहाभिष्यन्दकुष्ठनुत् |९|<br />
<div class="mw-collapsible-content"><br />
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paṭōlanimbabhūnimbarāsnāsaptacchadāmbhasaḥ| <br />
<br />
catvāraḥ prasṛtā ēkō ghṛtāt sarṣapakalkitaḥ||8|| <br />
<br />
nirūhaḥ pañcatiktō'yaṁ mēhābhiṣyandakuṣṭhanut |9|<br />
<br />
paTolanimbabhUnimbarAsnAsaptacchadAmbhasaH| <br />
<br />
catvAraH prasRutA eko ghRutAt sarShapakalkitaH||8|| <br />
<br />
nirUhaH pa~jcatikto~ayaM mehAbhiShyandakuShThanut |9|<br />
</div></div><br />
<br />
A ''[[basti]]'' prepared by mixing four ''prasritas'' of decoction of ''patola'' (Trichosanthes dioica Roxb.), ''nimba'' (Azadirachta indica A.Juss.), ''bhunimba'' (Andrographis paniculata Nees.), ''rasna'' (Pluchea lanceolata Oliver &Hiern.), ''saptacchada'' (Alstonia scholaris R.Br.); one ''prasrita'' of ''ghrita'', mixed with a ''kalka'' (paste) of ''sarshapa'' (Brassica campestris Linn.) is known as ''panchatikta niruha'' and is acting against ''prameha, abhishyanda'' and ''kushtha''. [8-8½]<br />
<br />
'''Note''': The quantity of ''kalka'' of ''sarshapa'' is not mentioned in the above recipe. According to commentary of Chakrapani on this verse, it may be decided.<ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.8-9. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.</ref><br />
In the ''niruha basti'' with an amount of twelve ''prasritas'', the amount of ''kalka'' is usually two ''palas'' (about 100 gms). In present recipe, the amount is five ''prasritas'' and therefore the amount of ''kalka'' of ''sarshapa'' would be about 40 gms. This principle is applicable in latter recipes also where the amount of ''kalka'' is not mentioned.<br />
<br />
=== ''Shat-prasritika basti'' ===<br />
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<br />
विडङ्गत्रिफलाशिग्रुफलमुस्ताखुपर्णिजात्||९|| <br />
<br />
कषायात् प्रसृताः पञ्च तैलादेको विमथ्य तान्| <br />
<br />
विडङ्गपिप्पलीकल्को निरूहः क्रिमिनाशनः||१०||<br />
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viḍaṅgatriphalāśigruphalamustākhuparṇijāt||9||<br />
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kaṣāyāt prasṛtāḥ pañca tailādēkō vimathya tān| <br />
<br />
viḍaṅgapippalīkalkō nirūhaḥ krimināśanaḥ||10||<br />
<br />
viDa~ggatriphalAshigruphalamustAkhuparNijAt||9|| <br />
<br />
kaShAyAt prasRutAH pa~jca tailAdeko vimathya tAn|<br />
<br />
viDa~ggapippalIkalko nirUhaH kriminAshanaH||10||<br />
</div></div><br />
<br />
Five ''prasritas'' of decoction of ''vidanga'' (Embelia ribes Burm.), ''triphala'' (a combination of three fruits viz. Emblica officinalis Gaertn, terminalia chebula Retz. and terminalia belerica Roxb.), ''shigru'' (Moringa oleifera Linn.), ''madanaphala'' (Randia dumetorum Lam.), ''musta'' (Cyperus rotundus Linn.) and ''akhuparni'' (Merremia emarginata Burm.) and one ''prasrita'' of ''tila taila'' (sesame oil) churned together with a paste of ''vidanga'' (Embelia ribes Burm.) and ''pippali'' (Piper longum Linn.) is ''kriminashana niruha'' (''niruha'' acting against parasites) [9-10]<br />
<br />
=== ''Sapta-prasritika basti'' ===<br />
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<br />
पयस्येक्षुस्थिरारास्नाविदारीक्षौद्रसर्पिषाम्| <br />
<br />
एकैकः प्रसृतो बस्तिः कृष्णाकल्को वृषत्वकृत्||११|| <br />
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<br />
payasyēkṣusthirārāsnāvidārīkṣaudrasarpiṣām| <br />
<br />
ēkaikaḥ prasṛtō bastiḥ kṛṣṇākalkō vṛṣatvakṛt||11|| <br />
<br />
payasyekShusthirArAsnAvidArIkShaudrasarpiShAm| <br />
<br />
ekaikaH prasRuto bastiH kRuShNAkalko vRuShatvakRut||11|| <br />
</div></div><br />
<br />
''[[Basti]]'' prepared with decoction of one ''prasrita'' of each of ''payasya'' (Fritillaria roylei Hook.), ''ikshu'' (Saccharum officinarum Linn.), ''sthira'' (Desmodium gangeticum DC.), ''rasna'' (Pluchea lanceolata Oliver & Hiern.) and ''vidari'' (Pueraria tuberosa DC.); one ''prasrita'' each of honey and ''ghrita'', and paste of ''pippali'' (Piper longum Linn.) is ''vrishya'' (enhancing libido and sexual vigour). [11]<br />
<br />
=== ''Chatu-prasritika basti''-II ===<br />
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<br />
चत्वारस्तैलगोमूत्रदधिमण्डाम्लकाञ्जिकात्| <br />
<br />
प्रसृताः सर्षपैः कल्कैर्विट्सङ्गानाहभेदनः ||१२||<br />
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<br />
catvārastailagōmūtradadhimaṇḍāmlakāñjikāt <br />
<br />
prasṛtāḥ sarṣapaiḥ kalkairviṭsaṅgānāhabhēdanaḥ ||12||<br />
<br />
catvArastailagomUtradadhimaNDAmlakA~jjikAt| <br />
<br />
prasRutAH sarShapaiH kalkairviTsa~ggAnAhabhedanaH ||12||<br />
</div></div><br />
<br />
''[[Basti]]'' prepared with a total of four ''prasritas'' of ''tila taila'' (sesame oil), cow’s urine, ''dadhimanda'' (whey) and ''amlakanji'' (fermented sour gruel) mixed with a paste of ''sarshapa'' (Brassica campestris Linn.) relieves the stagnation of stool and constipation. [12]<br />
<br />
=== ''Pancha-prasritika basti''-II ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
श्वदंष्ट्राश्मभिदेरण्डरसात्तैलात् सुरासवात्| <br />
<br />
प्रसृताः पञ्च यष्ट्याह्वकौन्तीमागधिकासिताः||१३|| <br />
<br />
कल्कः स्यान्मूत्रकृच्छ्रे तु सानाहे बस्तिरुत्तमः| <br />
<br />
एते सलवणाः कोष्णा निरूहाः प्रसृतैर्नव||१४||<br />
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śvadaṁṣṭrāśmabhidēraṇḍarasāttailāt surāsavāt| <br />
<br />
prasṛtāḥ pañca yaṣṭyāhvakauntīmāgadhikāsitāḥ||13||<br />
<br />
kalkaḥ syānmūtrakṛcchrē tu sānāhē bastiruttamaḥ| <br />
<br />
ētē salavaṇāḥ kōṣṇā nirūhāḥ prasṛtairnava||14||<br />
<br />
shvadaMShTrAshmabhideraNDarasAttailAt surAsavAt| <br />
<br />
prasRutAH pa~jca yaShTyAhvakauntImAgadhikAsitAH||13|| <br />
<br />
kalkaH syAnmUtrakRucchre tu sAnAhe bastiruttamaH| <br />
<br />
ete salavaNAH koShNA nirUhAH prasRutairnava||14||<br />
</div></div><br />
<br />
''[[Basti]]'' prepared with five ''prasritas'' decoction of ''shvadamshtra'' (Tribulus terrestris Linn.), ''ashmabhida'' (Bergenia ligulata Wall.), ''eranda'' (Ricinus communis Linn.) together, ''taila'' and ''surasava'' (an alcoholic preparation) added with paste of ''yashti'' (Glycyrrhiza glabra Linn.), ''kaunti'' (Piper aurantiacum Wall.), ''magadhika'' (Piper longum Linn.) and ''sitah'' (sugar candy) is useful in ''mutrakricchra'' (a condition characterized by difficult and painful micturition) and ''anaha'' (constipation). These nine ''prasrita bastis'' are given with salt and moderately warm. [13-14]<br />
<br />
=== Treatment of stagnated ''[[basti]]'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
मृदुबस्तिजडीभूते तीक्ष्णोऽन्यो बस्तिरिष्यते| <br />
<br />
तीक्ष्णैर्विकर्षिते स्वादु प्रत्यास्थापनमिष्यते ||१५||<br />
<div class="mw-collapsible-content"><br />
<br />
mṛdubastijaḍībhūtē tīkṣṇō'nyō bastiriṣyatē| <br />
<br />
tīkṣṇairvikarṣitē svādu pratyāsthāpanamiṣyatē [1] ||15||<br />
<br />
mRudubastijaDIbhUte tIkShNo~anyo bastiriShyate| <br />
<br />
tIkShNairvikarShite svAdu pratyAsthApanamiShyate ||15||<br />
</div></div><br />
<br />
If a ''mridubasti'' (mild acting ''[[basti]]'') gets stagnated, that needs another ''teekshna basti'' (strong and sharp acting ''[[basti]]''). One, who is emaciated because of strong ''[[basti]]s'', requires ''asthapana [[basti]]'' prepared with ''madhura'' (sweet) substances. [15]<br />
<br />
=== Treatment of ''guda-daha'' (burning sensation in anus) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
वातोपसृष्टस्योष्णैः स्युर्गुददाहादयो यदि| <br />
<br />
द्राक्षाम्बुना त्रिवृत्कल्कं दद्याद्दोषानुलोमनम्||१६|| <br />
<br />
तद्धि पित्तशकृद्वातान् हृत्वा दाहादिकाञ्जयेत्| <br />
<br />
शुद्धश्चापि पिबेच्छीतां यवागूं शर्करायुताम्||१७||<br />
<div class="mw-collapsible-content"><br />
<br />
vātōpasṛṣṭasyōṣṇaiḥ syurgudadāhādayō yadi| <br />
<br />
drākṣāmbunā trivṛtkalkaṁ dadyāddōṣānulōmanam||16|| <br />
<br />
taddhi pittaśakṛdvātān hṛtvā dāhādikāñjayēt| <br />
<br />
śuddhaścāpi pibēcchītāṁ yavāgūṁ śarkarāyutām||17||<br />
<br />
vAtopasRuShTasyoShNaiH syurgudadAhAdayoyadi| <br />
<br />
drAkShAmbunA trivRutkalkaM dadyAddoShAnulomanam||16|| <br />
<br />
taddhi pittashakRudvAtAn hRutvA dAhAdikA~jjayet| <br />
<br />
shuddhashcApi pibecchItAM yavAgUM sharkarAyutAm||17||<br />
</div></div><br />
<br />
If a patient with ''[[vata]]'' disorder suffers from anorectal burning (and other similar ''[[pitta]]''-related symptoms) due to (administration of) hot ''[[basti]]s'', a mixture of ''drakshambu'' (grape juice or decoction of raisins) and ''trivritkalka'' (paste of Operculina turpethum Linn.), which is ''doshanulshmana'' (bringing the movement of ''[[dosha]]'' in right direction) is given. This relieves burning sensation and similar conditions by expelling the ''[[pitta]]'', stool and ''[[vata]]''. After the body is cleansed, the patient has to take cold ''yavagu'' added with sugar. [16-17]<br />
<br />
=== Treatment of ''mala kshaya'' (depletion of stool) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
अथवाऽतिविरिक्तः स्यात् क्षीणविट्कः स भक्षयेत्|<br />
<br />
माषयूषेण कुल्माषान् पिबेन्मध्वथवा सुराम्||१८||<br />
<div class="mw-collapsible-content"><br />
<br />
athavā'tiviriktaḥ syāt kṣīṇaviṭkaḥ sa bhakṣayēt <br />
<br />
māṣayūṣēṇa kulmāṣān pibēnmadhvathavā surām||18||<br />
<br />
athavA~ativiriktaH syAt kShINaviTkaH sa bhakShayet| <br />
<br />
mAShayUSheNa kulmAShAn pibenmadhvathavA surAm||18||<br />
</div></div><br />
<br />
On the other hand, if a patient has excessive purgation and suffers from depletion of stool (and other essential body components e.g. fluids), he or she has to take ''kulmasha'' (half cooked grains) with ''mashayoosha'' (soup of Phaseolus mungo Linn.), or ''sura'' (an alcoholic preparation) or honey. [18]<br />
<br />
=== Treatment of ''amaja shula'' (abdominal pain due to improper digestion) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
सामं चेत् कुणपं शूलैरुपविशेदरोचकी| <br />
<br />
स घनातिविषाकुष्ठनतदारुवचाः पिबेत्||१९||<br />
<div class="mw-collapsible-content"><br />
<br />
sāmaṁ cēt kuṇapaṁ śūlairupaviśēdarōcakī| <br />
<br />
sa ghanātiviṣākuṣṭhanatadāruvacāḥ pibēt||19||<br />
<br />
sAmaM cet kuNapaM shUlairupavishedarocakI| <br />
<br />
sa ghanAtiviShAkuShThanatadAruvacAH pibet||19|| <br />
</div></div><br />
<br />
(A decoction of) ''musta'' (Cyperus rotundus Linn.), ''ativisha'' (Aconitum heterophyllum wall.), ''kushtha'' (Saussurea lappa C.B.Clarke.), ''nata'' (Valeriana wallichii DC.), ''daru'' (Cedrus deodara Roxb.) and ''vacha'' (Acorus calamus Linn.) is recommended to a patient with loss of appetite, passing ''sama'' stool (i.e., stool containing ''ama'') smelling like a dead (decomposing) body and with abdominal pain. [19]<br />
<br />
=== Treatment of ''atisara'' (diarrhea) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
शकृद्वातमसृक् पित्तं कफं वा योऽतिसार्यते| <br />
<br />
पक्वं , तत्र स्ववर्गीयैर्बस्तिः श्रेष्ठं भिषग्जितम्||२०||<br />
<div class="mw-collapsible-content"><br />
<br />
śakṛdvātamasṛk pittaṁ kaphaṁ vā yō'tisāryatē| <br />
<br />
pakvaṁ , tatra svavargīyairbastiḥ śrēṣṭhaṁ bhiṣagjitam||20||<br />
<br />
shakRudvAtamasRuk pittaM kaphaM vA yo~atisAryate| <br />
<br />
pakvaM , tatra svavargIyairbastiH shreShThaM bhiShagjitam||20||<br />
</div></div><br />
<br />
When a patient has ''pakva atisara'' (without undigested material) passing ''shakrita'' (stool), ''[[vata]], asrika'' (blood), ''[[pitta]]'' or ''[[kapha]]'', then ''[[basti]]'' prepared with a specific group of medicines acting against each of these pathologies is best measure. [20]<br />
<br />
=== Six types of ''atisara'' and its common complications ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
षण्णामेषां द्विसंसर्गात् त्रिंशद्भेदा भवन्ति तु| <br />
<br />
केवलैः सह षट्त्रिंशद्विद्यात् सोपद्रवानपि||२१||<br />
<br />
शूलप्रवाहिकाध्मानपरिकर्त्यरुचिज्वरान्| <br />
<br />
तृष्णोष्णदाहमूर्च्छादींश्चैषां विद्यादुपद्रवान्||२२||<br />
<div class="mw-collapsible-content"><br />
<br />
ṣaṇṇāmēṣāṁ dvisaṁsargāt triṁśadbhēdā bhavanti tu| <br />
<br />
kēvalaiḥ saha ṣaṭtriṁśadvidyāt sōpadravānapi||21||<br />
<br />
śūlapravāhikādhmānaparikartyarucijvarān| <br />
<br />
tṛṣṇōṣṇadāhamūrcchādīṁścaiṣāṁ vidyādupadravān||22||<br />
<br />
ShaNNAmeShAM dvisaMsargAt triMshadbhedA bhavanti tu| <br />
<br />
kevalaiH saha ShaTtriMshadvidyAt sopadravAnapi||21||<br />
<br />
shUlapravAhikAdhmAnaparikartyarucijvarAn| <br />
<br />
tRuShNoShNadAhamUrcchAdIMshcaiShAM vidyAdupadravAn||22||<br />
</div></div><br />
<br />
These six types of ''atisara'' may have thirty variants as a result of mutual combination of two morbid factors. Together with basic six, they constitute thirty six types, which manifest along with their complications. ''Shoola'' (abdominal pain), ''pravahika'' (dysentery), ''adhmana'' (abdominal distension) ''parikarti'' (anal pain), ''aruchi'' (distaste for food), ''[[jwara]]'' (fever), ''tṛishna'' (thirst), ''ushnatva'' (feeling of heat), ''daha'' (burning sensation) and ''murccha''(syncope) are its complications (''upadrava''). [21-22]<br />
<br />
=== Treatment of ''ama-atisara'' ( diarrhea with improper digestion) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
तत्रामेऽन्तरपानं स्यात् व्योषाम्ललवणैर्युतम्| <br />
<br />
पाचनं शस्यते बस्तिरामे हि प्रतिषिध्यते||२३||<br />
<div class="mw-collapsible-content"><br />
<br />
tatrāmē'ntarapānaṁ syāt vyōṣāmlalavaṇairyutam| <br />
<br />
ṁ śasyatē bastirāmē hi pratiṣidhyatē||23||<br />
<br />
tatrAme~antarapAnaM syAt vyoShAmlalavaNairyutam| <br />
<br />
pAcanaM shasyate bastirAme hi pratiShidhyate||23||<br />
</div></div><br />
<br />
In case of ''amatisara'', a drink having ''[[pachana]]'' action added with ''trikatu'' (a group of three pungent drugs viz. rhizome of Zingiber officinalis Roxb.; fruits of Piper nigrum Linn. and Piper longum Linn.), ''amla'' (sour) and ''lavana'' (salty) substances is recommended. ''[[Basti]]s'' are contraindicated in ''ama'' condition. [23]<br />
<br />
=== Treatment of ''shakrita-atisara'' and ''[[vata]] atisara''( diarrhea with excess stools and ''[[vata]]'') ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
वातघ्नैर्ग्राहिवर्गीयैर्बस्तिः शकृति शस्यते |<br />
<br />
स्वाद्वम्ललवणैः शस्तः स्नेहबस्तिः समीरणे||२४||<br />
<div class="mw-collapsible-content"><br />
<br />
vātaghnairgrāhivargīyairbastiḥ śakṛti śasyatē<br />
<br />
svādvamlalavaṇaiḥ śastaḥ snēhabastiḥ samīraṇē||24||<br />
<br />
vAtaghnairgrAhivargIyairbastiH shakRuti shasyate<br />
<br />
svAdvamlalavaNaiH shastaH snehabastiH samIraNe||24|| <br />
</div></div><br />
<br />
In ''shakritatisara'' (''atisara'' in which only stool is passed), ''[[basti]]'' with ''vataghna'' and ''grahi'' category of medicines is recommended. In ''[[vata]]'' related ''atisara, sneha [[basti]]'' with ''svadu'' (sweet), ''amla'' (sour) and ''lavana'' (salty) substances is acclaimed. [24]<br />
<br />
=== Treatment of ''[[rakta]] atisara, [[pitta]] atisara'' and ''[[kapha]] atisara'' (diarrhea with blood, ''[[pitta]]'' and ''[[kapha]]'') ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
रक्ते रक्तेन, पित्ते तु कषायस्वादुतिक्तकैः| <br />
<br />
सार्यमाणे कफे बस्तिः कषायकटुतिक्तकैः||२५||<br />
<div class="mw-collapsible-content"><br />
<br />
raktē raktēna, pittē tu kaṣāyasvādutiktakaiḥ| <br />
<br />
sāryamāṇē kaphē bastiḥ kaṣāyakaṭutiktakaiḥ||25||<br />
<br />
rakte raktena, pitte tu kaShAyasvAdutiktakaiH| <br />
<br />
sAryamANe kaphe bastiH kaShAyakaTutiktakaiH||25||<br />
</div></div><br />
<br />
In ''[[rakta]] atisara'' (diarrhea with blood) ''[[basti]]'' with blood, in ''[[pitta]] atisara [[basti]]'' with ''kashaya'' (astringent), ''madhura'' (sweet) and ''tikta'' (bitter) substances and in ''[[kapha]] atisara'' with ''kashaya'' (astringent), ''katu'' (pungent) and ''tikta'' (bitter) substances is to be administered. [25]<br />
<br />
=== Treatment of ''atisara'' (diarrhea) mixed with ''shakrita-ama'' and ''[[vata]]'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
शकृता वायुना वाऽऽमे तेन वर्चस्यथानिले| <br />
<br />
संसृष्टेऽन्तरपानं स्याद् व्योषाम्ललवणैर्युतम्||२६|| <br />
<div class="mw-collapsible-content"><br />
<br />
śakṛtā vāyunā vā”me tena varcasyathānilē| <br />
<br />
saṁsṛṣṭē'ntarapānaṁ syād vyōṣāmlalavaṇairyutam||26|| <br />
<br />
shakRutA vAyunA vA~a~ame tena varcasyathAnile| <br />
<br />
saMsRuShTe~antarapAnaM syAd vyoShAmlalavaNairyutam||26|| <br />
</div></div><br />
<br />
In the conditions where ''ama'' is associated with ''shakrita'' (stool) or ''[[vata]]'', or ''shakrita'' (stool) or ''[[vata]]'' is associated with ''ama'' a drink, prepared with ''vyosha'' (a group of three pungent drugs, commonly known as ''trikatu'', viz. rhizome of Zingiber officinalis Roxb.; fruits of Piper nigrum Linn. and Piper longum Linn.), sour and salty substances, is recommended. [26]<br />
<br />
=== Treatment of ''atisara'' (diarrhea) mixed with ''[[pitta]]-[[rakta]]'' and ''ama'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
पित्तेनामेऽसृजा वाऽपि तयोरामेन वा पुनः| <br />
<br />
संसृष्टयोर्भवेत् पानं सव्योषस्वादुतिक्तकम्||२७||<br />
<div class="mw-collapsible-content"><br />
<br />
pittēnāmē'sṛjā vā'pi tayōrāmēna vā punaḥ| <br />
<br />
saṁsṛṣṭayōrbhavēt pānaṁ savyōṣasvādutiktakam||27||<br />
<br />
pittenAme~asRujA vA~api tayorAmena vA punaH| <br />
<br />
saMsRuShTayorbhavet pAnaM savyoShasvAdutiktakam||27||<br />
</div></div><br />
<br />
If there is association of ''ama'' with ''[[pitta]]'' or ''[[rakta]]'' or of both separately with ''ama'' then a drink with ''trikaṭu'', sweet and bitter substances is indicated. [27]<br />
<br />
=== Treatment of ''atisara'' (diarrhea)mixed with ''[[kapha]]-ama'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
तथाऽऽमे कफसंसृष्टे कषायव्योषतिक्तकम्| <br />
<br />
आमेन तु कफे व्योषकषायलवणैर्युतम्||२८|| <br />
<div class="mw-collapsible-content"><br />
<br />
tathā''mē kaphasaṁsṛṣṭē kaṣāyavyōṣatiktakam| <br />
<br />
āmēna tu kaphē vyōṣakaṣāyalavaṇairyutam||28|| <br />
<br />
tathA~a~ame kaphasaMsRuShTe kaShAyavyoShatiktakam|<br />
<br />
Amena tu kaphe vyoShakaShAyalavaNairyutam||28|| <br />
</div></div><br />
<br />
If ''ama'' is associated with ''[[kapha]]'', a ''[[basti]]'' containing ''kashaya'' (astringent), ''trikatu'' and bitter substances and when ''[[kapha]]'' is associated with ''ama'', a ''[[basti]]'' containing ''trikatu, kashaya'' (astringent) and salty substances is recommended. [28]<br />
<br />
=== Treatment of ''atisara'' (diarrhea) mixed with ''[[pitta]]-[[vata]]-shakrita'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
वातेन विशि पित्ते वा विट्पित्ताभ्यां तथाऽनिले| <br />
<br />
मधुराम्लकषायः स्यात् संसृष्टे बस्तिरुत्तमः||२९||<br />
<div class="mw-collapsible-content"><br />
<br />
vātēna viśi pittē vā viṭpittābhyāṁ tathā'nilē| <br />
<br />
madhurāmlakaṣāyaḥ syāt saṁsṛṣṭē bastiruttamaḥ||29||<br />
<br />
vAtena vishi pitte vA viTpittAbhyAM tathA~anile| <br />
<br />
madhurAmlakaShAyaH syAt saMsRuShTe bastiruttamaH||29||<br />
</div></div><br />
<br />
When stool or ''[[pitta]]'' is associated with ''[[vata]]'' or ''[[vata]]'' is associated with stool and ''[[pitta]]'', a ''[[basti]]'' with sweet, sour and astringent substances, is excellent. [29]<br />
<br />
=== Treatment of ''atisara'' (diarrhea) mixed with ''[[pitta]]-[[rakta]]-shakrita'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
शकृच्छोणितयोः पित्तशकृतो रक्तपित्तयोः| <br />
<br />
बस्तिरन्योन्यसंसर्गे कषायस्वादुतिक्तकः||३०|| <br />
<div class="mw-collapsible-content"><br />
<br />
śakṛcchōṇitayōḥ pittaśakṛtō raktapittayōḥ| <br />
<br />
bastiranyōnyasaṁsargē kaṣāyasvādutiktakaḥ||30||<br />
<br />
shakRucchoNitayoH pittashakRuto raktapittayoH| <br />
<br />
bastiranyonyasaMsarge kaShAyasvAdutiktakaH||30|| <br />
</div></div><br />
<br />
In case of morbid mutual associations of ''[[pitta]]'' with stool and ''[[rakta]]'', as well as stool with ''[[rakta]]'' and ''[[pitta]], [[basti]]'' with astringent, sweet and bitter ingredients. [30]<br />
<br />
=== Treatment of ''atisara'' (diarrhea) mixed with ''[[kapha]]-[[rakta]]-[[pitta]]-shakrita'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
कफेन विशि पित्ते वा कफे विट्पित्तशोणितैः| <br />
<br />
व्योषतिक्तकषायः स्यात् संसृष्टे बस्तिरुत्तमः||३१|| <br />
<div class="mw-collapsible-content"><br />
<br />
kaphēna viśi pittē vā kaphē viṭpittaśōṇitaiḥ| <br />
<br />
vyōṣatiktakaṣāyaḥ syāt saṁsṛṣṭē bastiruttamaḥ||31||<br />
<br />
kaphena vishi pitte vA kaphe viTpittashoNitaiH| <br />
<br />
vyoShatiktakaShAyaH syAt saMsRuShTe bastiruttamaH||31||<br />
</div></div><br />
<br />
In case of similar associations of ''[[kapha]]'' with stool or ''[[pitta]]''; or of stool or ''[[pitta]]'' or ''[[rakta]]'' with ''[[kapha]]'', a ''[[basti]]'' with ''trikatu'', bitter and ''kashaya'' ingredients is to be recommended. [31]<br />
<br />
=== Treatment of ''atisara'' (diarrhea) mixed with ''[[vata]]-[[kapha]]-shakrita'' and ''[[rakta]]-[[kapha]]'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
स्याद्बस्तिर्व्योषतिक्ताम्लः संसृष्टे वायुना कफे| <br />
<br />
मधुरव्योषतिक्तस्तु रक्ते कफविमूर्च्छिते||३२|| <br />
<div class="mw-collapsible-content"><br />
<br />
syādbastirvyōṣatiktāmlaḥ saṁsṛṣṭē vāyunā kaphē| <br />
<br />
madhuravyōṣatiktastu raktē kaphavimūrcchitē||32|| <br />
<br />
syAdbastirvyoShatiktAmlaH saMsRuShTe vAyunA kaphe| <br />
<br />
madhuravyoShatiktastu rakte kaphavimUrcchite||32||<br />
</div></div><br />
<br />
In ''atisara'' where ''[[kapha]]'' is associated with ''[[vata]], [[basti]]'' with ''trikatu'', bitter and sour ingredients, and if ''[[rakta]]'' is associated with ''[[kapha]]'' then with sweet, ''trikatu'' and bitter is recommended. [32]<br />
<br />
=== Treatment of ''atisara'' (diarrhea) mixed with ''[[kapha]]- [[vata]] -shakrita'' and ''[[vata]]-[[pitta]]'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
मारुते कफसंसृष्टे व्योषाम्ललवणो भवेत्| <br />
<br />
बस्तिर्वातेन पित्ते तु कार्यः स्वाद्वम्लतिक्तकः||३३||<br />
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<br />
mārutē kaphasaṁsṛṣṭē vyōṣāmlalavaṇō bhavēt| <br />
<br />
bastirvātēna pittē tu kāryaḥ svādvamlatiktakaḥ||33||<br />
<br />
mArute kaphasaMsRuShTe vyoShAmlalavaNo bhavet| <br />
<br />
bastirvAtena pitte [2] tu kAryaH svAdvamlatiktakaH||33||<br />
</div></div><br />
<br />
If ''[[vata]]'' is accompanied by ''[[kapha]]'', a ''[[basti]]'' with ''trikatu'', sour and salty ingredients; and when ''[[pitta]]'' is associated with ''[[vata]], [[basti]]'' with sweet, sour and bitter substances is to be administered. [33]<br />
<br />
=== Treatment for conditions due to ''samsarga'' (combination of ''[[dosha]]'') ===<br />
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<br />
त्रिचतुःपञ्चसंसर्गानेवमेव विकल्पयेत्| <br />
<br />
युक्तिश्चैषातिसारोक्ता सर्वरोगेष्वपि स्मृता||३४||<br />
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<br />
tricatuḥpañcasaṁsargānēvamēva vikalpayēt| <br />
<br />
yuktiścaiṣātisārōktā sarvarōgēṣvapi smṛtā||34||<br />
<br />
tricatuHpa~jcasaMsargAnevameva vikalpayet| <br />
<br />
yuktishcaiShAtisAroktA sarvarogeShvapi smRutA||34||<br />
</div></div><br />
<br />
Similarly a plan may be designed in cases of morbid combinations of three, four or five components. This planning for ''atisara'' is applicable in all disease conditions. [34]<br />
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<br />
युगपत् षड्रसं षण्णां संसर्गे पाचनं भवेत् | <br />
<br />
निरामाणां तु पञ्चानां बस्तिः षाड्रसिको मतः||३५||<br />
<div class="mw-collapsible-content"><br />
<br />
yugapat ṣaḍrasaṁ ṣaṇṇāṁ saṁsargē pācanaṁ bhavēt [1] | <br />
<br />
nirāmāṇāṁ tu pañcānāṁ bastiḥ ṣāḍrasikō mataḥ||35|| <br />
<br />
yugapat ShaDrasaM ShaNNAM saMsarge pAcanaM bhavet [1] | <br />
<br />
nirAmANAM tu pa~jcAnAM bastiH ShADrasiko mataH||35||<br />
</div></div><br />
<br />
In ''atisara'', if all six pathological components are simultaneously involved, a ''[[pachana]]'' (causing or promoting digestion or transformation) medicine containing the drugs of all six tastes is useful, while in ''nirama'' (without ''ama'') condition, where other five are involved a ''[[basti]]'' consisting of all six ''rasas'' (tastes) is indicated. [35]<br />
<br />
=== ''Sarvatisara nashaka ghrita'' (medicated ghee for treatment of all types of diarrhea) ===<br />
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<br />
उदुम्बरशलाटूनि जम्ब्वाम्रोदुम्बरत्वचः| <br />
<br />
शङ्खं सर्जरसं लाक्षां कर्दमं च पलांशिकम्||३६|| <br />
<br />
पिष्ट्वा तैः सर्पिषः प्रस्थं क्षीरद्विगुणितं पचेत्| <br />
<br />
अतीसारेषु सर्वेषु पेयमेतद्यथाबलम्||३७|| <br />
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<br />
udumbarani jambvāmrōdumbaratvacaḥ| <br />
<br />
śaṅkhaṁ sarjarasaṁ lākṣāṁ kardamaṁ ca palāṁśikam||36|| <br />
<br />
piṣṭvā taiḥ sarpiṣaḥ prasthaṁ kṣīradviguṇitaṁ pacēt|<br />
<br />
atīsārēṣu sarvēṣu pēyamētadyathābalam||37||<br />
<br />
udumbarashalATUni jambvAmrodumbaratvacaH| <br />
<br />
sha~gkhaM sarjarasaM lAkShAM kardamaM ca palAMshikam||36|| <br />
<br />
piShTvA taiH sarpiShaH prasthaM kShIradviguNitaM pacet| <br />
<br />
atIsAreShu sarveShu peyametadyathAbalam||37||<br />
</div></div><br />
<br />
A freshly prepared paste of ''udumbarashalaatu'' (unripe fruits of Ficus glomerata Roxb.), bark of ''jaambu'' (Syzygium cumini Skeels.), ''amra'' (Mangifera indica Linn.) and ''udumbara'' (Ficus glomerata Roxb.); ''sankha'' (conch shell), ''sarjarasa'' (resin of Vateria indica Linn.), ''laaksha'' (resinous secretion of Laccifera lacca Kerr.) and ''kardama'' (a type of rice), each one ''pala'' (about 50 grams) is to be cooked with one ''prastha'' (about 800 ml.) of ''ghrita'', and two ''prastha'' of milk. This (thus prepared ''ghrita'') is to be taken in all types of ''atisara'' according to ''bala'' (strength of the patient as well as disease). [36-37]<br />
<br />
=== ''Sarvatisara nashaka yavagu'' (medicated gruel for treatment of all types of diarrhea) ===<br />
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<br />
कच्छुराधातकीबिल्वसमङ्गारक्तशालिभिः| <br />
<br />
मसूराश्वत्थशुङ्गैश्च यवागूः स्याज्जले शृतैः||३८|| <br />
<br />
बालोदुम्बरकट्वङ्गसमङ्गाप्लक्षपल्लवैः | <br />
<br />
मसूरधातकीपुष्पबलाभिश्च तथा भवेत्||३९|| <br />
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<br />
kacchurādhātakībilvasamaṅgāraktaśālibhiḥ| <br />
<br />
masūrāśvatthaśuṅgaiśca yavāgūḥ syājjalē śṛtaiḥ||38||<br />
<br />
bālōdumbarakaṭvaṅgasamaṅgāplakṣapallavaiḥ | <br />
<br />
masūradhātakīpuṣpabalābhiśca tathā bhavēt||39||<br />
<br />
kacchurAdhAtakIbilvasama~ggAraktashAlibhiH| <br />
<br />
masUrAshvatthashu~ggaishca yavAgUH syAjjale shRutaiH||38|| <br />
<br />
bAlodumbarakaTva~ggasama~ggAplakShapallavaiH | <br />
<br />
masUradhAtakIpuShpabalAbhishca tathA bhavet||39||<br />
</div></div><br />
<br />
A ''yavagu'' (gruel) prepared by cooking ''raktashali'' (a variety of rice brownish in color) and ''masura'' (Lens culinaris Medic.)) in a decoction of ''kacchura'' (Mucuna pruriens Baker. ), ''dhataki'' (Woodfordia fruticosa Kurz.), ''bilva'' (Aegle marmelos Carr.), ''samanga'' (Mimosa pudica Linn.) and ''ashvatthashunga'' (leaf bud of Ficus religiosa Linn.) is beneficial in ''atisara''.<br />
<br />
Similar preparation can be made with unripe fruit of ''udumbara'', leaves of ''kathvanga'' (Ailanthus excelsa Roxb.) and ''samanga'' as well as ''plaksha'' (Ficus lacor Buch.), ''masura'' (Lens culinaris Medic.) and ''dhataki'' flowers. [38-39]<br />
<br />
=== Treatment of all types of diarrhea ===<br />
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<br />
स्थिरादीनां बलादीनामिक्ष्वादीनामथापि वा| <br />
<br />
क्वाथेषु समसूराणां यवाग्वः स्युः पृथक् पृथक्||४०|| <br />
<br />
कच्छुरामूलशाल्यादितण्डुलैरुपसाधिताः| <br />
<br />
दधितक्रारनालाम्लक्षीरेष्विक्षुरसेऽपि वा||४१|| <br />
<br />
शीताः सशर्कराक्षौद्राः सर्वातिसारनाशनाः| <br />
<br />
ससर्पिर्मरिचाजाज्यो मधुरा लवणाः शिवाः||४२||<br />
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<br />
sthirādīnāṁ balādīnāmikṣvādīnāmathāpi vā| <br />
<br />
kvāthēṣu samasūrāṇāṁ yavāgvaḥ syuḥ pṛthak pṛthak||40|| <br />
<br />
kacchurāmūlaśālyāditaṇḍulairupasādhitāḥ| <br />
<br />
dadhitakrāranālāmlakṣīrēṣvikṣurasē'pi vā||41|| <br />
<br />
śītāḥ saśarkarākṣaudrāḥ sarvātisāranāśanāḥ| <br />
<br />
sasarpirmaricājājyō madhurā lavaṇāḥ śivāḥ||42|| <br />
<br />
sthirAdInAM balAdInAmikShvAdInAmathApi vA| <br />
<br />
kvAtheShu samasUrANAM yavAgvaH syuH pRuthak pRuthak||40|| <br />
<br />
kacchurAmUlashAlyAditaNDulairupasAdhitAH| <br />
<br />
dadhitakrAranAlAmlakShIreShvikShurase~api vA||41|| <br />
<br />
shItAH sasharkarAkShaudrAH sarvAtisAranAshanAH| <br />
<br />
sasarpirmaricAjAjyo madhurA lavaNAH shivAH||42||<br />
</div></div><br />
<br />
Different ''yavagus'' can be prepared by combining ''masura'' (Lens culinaris Medic.) with the decoctions of ''sthiradi, baladi'' and ''ikshvadi'' (groups of plants). [40]<br />
<br />
Roots of ''kacchura'' (Mucuna pruriens Baker.) and rice of ''shali'' and other varieties cooked with ''dadhi'' (yogurt), ''takra'' (churned yogurt), ''aranala'' (sour fermented supernatant of cooked rice), ''ksheera'' (milk) or ''ikshurasa'' (sugarcane juice), and after being cooled added with sugar and honey, is able to treat all types of ''atisara''. The above-mentioned gruels are promising (anti-diarreal) when added with ''ghrita'', pepper and cumin (Cuminum cyminum Linn.), sweet substances and rock salt. [41-42]<br />
<br />
=== Treatment principles ===<br />
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<br />
भवन्ति चात्र श्लोकाः-<br />
<br />
स्निग्धाम्ललवणमधुरं पानं बस्तिश्च मारुते कोष्णः| <br />
<br />
शीतं तिक्तकषायं मधुरं पित्ते च रक्ते च||४३|| <br />
<br />
तिक्तोष्णकषायकटुश्लेष्मणि सङ्ग्राहि वातनुच्छकृति| <br />
<br />
पाचनमामे पानं पिच्छासृग्बस्तयो रक्ते||४४|| <br />
<br />
अतिसारं प्रत्युक्तं मिश्रं द्वन्द्वादियोगजेष्वपि च| <br />
<br />
तत्रोद्रेकविशेषाद्दोषेषूपक्रमः कार्यः||४५||<br />
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<br />
bhavanti cātra ślōkāḥ- <br />
<br />
snigdhāmlalavaṇamadhuraṁ pānaṁ bastiśca mārutē kōṣṇaḥ| <br />
<br />
śītaṁ tiktakaṣāyaṁ madhuraṁ pittē ca raktē ca||43|| <br />
<br />
tiktōṣṇakaṣāyakaṭuślēṣmaṇi saṅgrāhi vātanucchakṛti| <br />
<br />
pācanamāmē pānaṁ picchāsṛgbastayō raktē||44|| <br />
<br />
atisāraṁ pratyuktaṁ miśraṁ dvandvādiyōgajēṣvapi [1] ca| <br />
<br />
tatrōdrēkaviśēṣāddōṣēṣūpakramaḥ kāryaḥ||45|| <br />
<br />
bhavanti cAtra shlokAH- <br />
<br />
snigdhAmlalavaNamadhuraM pAnaM bastishca mArute koShNaH| <br />
<br />
shItaM tiktakaShAyaM madhuraM pitte ca rakte ca||43|| <br />
<br />
tiktoShNakaShAyakaTushleShmaNi sa~ggrAhi vAtanucchakRuti| <br />
<br />
pAcanamAme pAnaM picchAsRugbastayo rakte||44|| <br />
<br />
atisAraM pratyuktaM mishraM dvandvAdiyogajeShvapi ca| <br />
<br />
tatrodrekavisheShAddoSheShUpakramaH kAryaH||45||<br />
</div></div><br />
<br />
Here the ''shlokas'' (verses) remain-<br />
<br />
(Besides the above some more treatment-principles useful in ''atisaras'' are given below as per the factors involved)<br />
<br />
#''[[Vata]]: snigdha'' (unctuous) ''amla'' (sour) ''lavana'' (salty) and ''madhura'' (sweet) liquids orally and warm ''[[basti]]s'' with same substances. <br />
#''[[Pitta]]'' and ''[[rakta]]'': cold bitter astringent and sweet substances.<br />
#''[[Kapha]]'': bitter, hot, astringent and pungent substances.<br />
#''Shakrita'' (stool): ''sangrahi'' (checks ''atisara'' through improving the digestion) and ''vataghna'' (measures)<br />
#''Ama: [[pachana]]'' (measures digesting ''ama'')<br />
#''[[Rakta]]: picchabasti'' and ''raktabasti'' <br />
#''Atisara'' may also be in combination of two or more factors. In those conditions treatment is to be planned according to dominance of the ''[[dosha]]s'' (and the factors involved). [43-45]<br />
<br />
=== Summary ===<br />
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<br />
तत्र श्लोकः- <br />
<br />
प्रासृतिकाः सव्यापत्क्रिया निरूहास्तथाऽतिसारहिताः| <br />
<br />
रसकल्पघृतयवाग्वश्चोक्ता गुरुणा प्रसृतसिद्धौ||४६||<br />
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<br />
tatra ślōkaḥ- <br />
<br />
prāsṛtikāḥ savyāpatkriyā nirūhāstathā'tisārahitāḥ| <br />
<br />
rasakalpaghṛtayavāgvaścōktā [1] guruṇā prasṛtasiddhau||46|| <br />
<br />
tatra shlokaH- <br />
<br />
prAsRutikAH savyApatkriyA nirUhAstathA~atisArahitAH| <br />
<br />
rasakalpaghRutayavAgvashcoktA [1] guruNA prasRutasiddhau||46||<br />
</div></div><br />
<br />
In this chapter of [[Prasrita Yogiyam Siddhi]] management of the complications, ''prasritika niruhas'', and the ''[[basti]]s,'' decoctions, ''ghrita'', gruels useful in the management of ''atisaras'' are presented by the teacher. [46]<br />
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<br />
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते <br />
<br />
दृढबलसम्पूरिते सिद्धिस्थाने प्रासृतयोगीयसिद्धिर्नामाष्टमोऽध्यायः ||८||<br />
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<br />
ityagnivēśakṛtē tantrē carakapratisaṁskṛtē'prāptē <br />
<br />
dṛḍhabalasampūritē siddhisthānē prāsṛtayōgīyasiddhirnāmāṣṭamō'dhyāyaḥ [1] ||8|| <br />
<br />
ityagniveshakRute tantre carakapratisaMskRute~aprApte <br />
<br />
dRuDhabalasampUrite siddhisthAne prAsRutayogIyasiddhirnAmAShTamo~adhyAyaH [1] ||8||<br />
</div></div><br />
<br />
Thus in the treatise (originally) prepared by Agnivesha, edited by Charak and supplemented the lost parts by Dridhabala, in [[Siddhi Sthana]], the eighth chapter entitled [[Prasrita Yogiyam Siddhi]] is concluded.<br />
<br />
== Tattva Vimarsha (Fundamental Principles) ==<br />
<br />
*A milder form of ''[[basti]]'' can get stagnated inside leading to complications of not eliminating ''[[dosha]]s''. This may result into ''ayoga'' or ''heenayoga'' (insufficient action). On the contrary if a ''[[basti]]'' is stronger it may cause an ''atiyoga'' (action in excess) causing excessive evacuation of ''[[dosha]]'' along with body constituents.<br />
*Faulty application of ''[[basti]]s'' may cause a complication in the form of ''atisara'' (diarrhea).<br />
*''Atisara'' (diarrhea) may be either acute with undigested material associated with ''ama'' or chronic without much undigested material/ ''pakwa''.<br />
*''Pakwa'' type of ''atisara'' is again of five types as with ''shakrita'' (fecal matter), with ''[[vata]]'' (flatus), with ''asrika'' (blood), with ''[[pitta]]'' and with ''[[kapha]]''. <br />
*Basic principle of treatment of every condition associated with ''ama'' is ''amapachana''. Decoction / powder of ''musta, ativisha, kushtha, nata, daru'' and ''vacha'' are ideal for ''amapachana''. This recipe is useful in ''amatisara''. <br />
*To manage ''pakvatisara'', medicines of two categories viz. ''vataghna'' (anti-''vata'') and ''grahi'' (anti-diarrheal by promoting digestion and absorption) are used. <br />
*''Picchabasti'' and ''raktabasti'' are treatments for diarrhea with blood.These can be considered as ''[[stambhana]]'' (stop bleeding) and ''vishesha [[brimhana]]'' (enhance internal strength). <br />
*The treatment principles of various types of ''atisara'' due to complications of ''[[basti]]'' therapy:<br />
**''[[Vata]]'': ''snigdha'' (unctuous), ''amla'' (sour), ''lavana'' (salty) and ''madhura'' (sweet) liquids orally and warm ''[[basti]]s'' with same substances. <br />
**''[[Pitta]]'' and ''[[rakta]]'': cold bitter astringent and sweet substances.<br />
**''[[Kapha]]'': bitter, hot, astringent and pungent substances.<br />
**''Shakrita'' (stool): ''sangrahi'' (checks ''atisara'' through improving the digestion) and ''vataghna'' (measures)<br />
**''Ama: [[pachana]]'' (measures digesting ''ama'')<br />
**''[[Rakta]]: picchabasti'' and ''raktabasti''.<br />
<br />
== Vidhi Vimarsha (Applied Inferences ) ==<br />
<br />
The unit ''prasrita'', according to [[Charak Samhita]] is an amount of two ''palas'' which is approximately equal to 100 milliliter (1''pala''=50ml).<ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.4. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.</ref>,<ref>Agnihotri Avadhabihari; Bhaiṣajyakalpanā Vijñāna; Chaukhamba orientalia publication, 6th edition, 2006, P 7-20.</ref> (verse 1-2)[[Charak Samhita]] is written in the form of dialogue between the teacher (Atreya) and his disciples (mainly Agnivesha). Mild form of ''[[shodhana]]'' measures are for those subjects who are not suitable for strong measures and for the patients who suffered with the complications of the measures described in previous chapters. ''[[Vamana]]'' and ''[[virechana]]'' are major procedures for ''[[shodhana]]''. However, these are contraindicated for the tender persons. Tender persons may not tolerate even ''[[basti]]''. Therefore, mild forms of ''[[basti]]s'' are described for them. Similarly, the measures to treat the complications developed due to the faulty application of the procedures especially the ''[[basti]]''. <br />
<br />
Some translators interpreted the phrase ''karmana viplutanama'' as ‘exhausted of hard work’.<ref> Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.3. In: Dash Bhagavan & Sharma R K, Editor. Charak Samhita.2nd ed. Varanasi: Chowkhamba Sanskrit Series, 2005; P 310</ref><br />
However, the meaning of this phrase can be taken as ‘complicated by the consequences of the therapies’, which seems to be more appropriate in this context. The complications may be natural consequences of the therapies or may be due to faulty application. (verse 3)<br />
<br />
The recipe in verse 4 is composed of total five ''prasritas'' (2 ''prasritas'' of milk, 1 ''prasrita'' each of honey, sesame oil and ''ghrita''), therefore this ''[[basti]]'' is named by Gangadhara as ''panchaprasrtika basti''.<ref>Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya . In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3735.</ref> This ''[[basti]]'' is useful for eliminating ''[[vata]]'' as well as promoting the strength and the complexion. <br />
<br />
''[[Vata]]'' eliminating measures usually promotes quality of ''[[dhatu]]s'' and ''upadhatus'' (structural components of the body). This eventually results in promotion of the body strength and the complexion. Word ''bala'' also denotes the immune function; hence this may also be interpreted as promoting immune activity. In ancient time to mix a ''[[basti]]'' material, churning stick was used. In modern time an electric blender is an ideal alternative. With a blender the mixture is better homogenized than a manual churning stick.<br />
<br />
Chakrapani considered ''bilvadi'' group in his [[Ayurveda]] ''deepika'' commentary as ''dashamula''.<ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.5. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.</ref> This group consists of roots of ten plants viz. ''bilva'' (Aegle marmelos Carr.), ''shyonaka'' (Oroxylum indicumVent.),''gambhari'' (Gmelina arborea Roxb.), ''patala'' (Stereospermum suaveolensDC.),''agnimantha'' (Premna integrifolia Roxb.), ''shalaparni'' (Desmodium gangeticumDC.), ''prishniparni'' (Uraria picta Desr.) ''brihati'' (Solanum indicum Linn.), ''kantakari'' (Solanum suranttense Burm.) and ''gokshura'' (Tribulus terrestris Linn.). <br />
<br />
While Gangadhara in his ''Jalpakalpataru'' commentary mentions this as ''panchamula'' –the roots of a group of five plants viz. ''bilva,shyonaka, gambhari, patala'' and ''agnimantha.''<ref>Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya.Verse 5 In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3735.</ref>Since next verse (5th) describes a recipe with ''panchamula'', in this verse considering ''bilvadi'' as ''dashamula'' is more logical and practical. This ''[[basti]]'' consists a total of eight ''prasritas'' (one ''prasrita'' each of ''taila, prasanna, madhu'' and ''ghrita'' and two ''prasritas'' each of ''bilvadi'' decoction and ''kulattha'' decoction). Therefore, Gangadhara names this as ''ashtaprasritika [[basti]]''.<ref>Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya . In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3735.</ref><br />
<br />
The ''[[basti]]'' in verse six, consists of total nine ''prasritas'' i.e. ''panchamula'' decoction- five ''prasritas'', sesame oil - two ''prasritas'', honey- one ''prasrita, ghrita''- one ''prasrita''. Therefore, Gangadhara names this as ''navaprasritika [[basti]]''.<ref>Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya . In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3736.</ref> (verses 4-6)<br />
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''Aksha'' and ''karsha'' are the units of same amount, which is equal to about twelve grams. Hence the amount of rock salt in this [[basti]] would be about 6 grams. ''[[Shukra]]'' is one of the seven ''[[dhatu]]s'' (structural components). ''[[Shukra]]'' is not a single entity. It comprises male reproductive cells and substances including the androgenic hormones responsible for manhood in a man. This ''[[basti]]'' promotes quality and quantity of all these entities in the body.<br />
<br />
The usual contents of a ''niruha [[basti]]'' are salt, honey, oil'', kalka'' and decoction (or a liquid). These are to be mixed by churning in the sequence as mentioned above. Here the mixing may be in this sequence- ''saindhava'', honey, oil, ''ghrita, hapusha'' (fruits of Juniperus communis Linn.)and milk.(verse 7)<br />
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''[[Basti]]'' is usually contraindicated in ''kushtha''<ref>Charak. Sidhi Sthana, Cha.2 Panchakamiya Siddhi ver.14. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 688.</ref>. However, Sushruta Samhita recommends ''niruhabastis'' in this condition.<ref>Sushruta. Chikitsa Sthana, Cha.35 Netrabastipramana pravibhaga Chikitsitam Adhyaya verse 22. In: Jadavaji Trikamji Aacharya and Narayana Ram Acharya, Editors. Sushruta Samhita. 4th ed. Varanasi: Chaukhambha Orientalia;1980, P 527.</ref> Practically ''niruha [[basti]]'', with bitter substances e.g. ''panchatikta niruha'', is useful in ''kushtha''.<br />
<br />
The quantity of ''kalka'' of ''sarshapa'' is not mentioned in the above recipe. According to commentary of Chakrapani on this verse, it may be decided. <ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.8-9. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.</ref> In the ''niruha bastis'' with an amount of twelve ''prasritas'', the amount of ''kalka'' is usually two ''palas'' (about 100gms). In present recipe, the amount is five ''prasritas'' and therefore the amount of ''kalka'' of ''sarshapa'' would be about 40 gms. This principle is applicable in latter recipes also where the amount of ''kalka'' is not mentioned. <br />
<br />
This ''[[basti]]'' contains ''vidanga'' (Embelia ribes Burm.) which is the best among ''krimighna''(anti-parasitic) [Cha. Sa. [[Sutra Sthana]] 25/40] substances. Therefore, it has a ''kriminashana'' effect. (verse 9-10)<br />
<br />
Gangadhara in his ''Jalpakalpataru'' commentary considers ''payasyas ksheerakakoli'', which is Fritillaria roylei Hook. Some scholars consider ''payasyaas vidari'', but at present, ''vidari'' recipies already include one ingredient therefore to consider it ''ksheerakakoli'' is appropriate.<br />
<br />
In the recipes of verse 11-12, the amount of paste is not mentioned. This may be calculated as stated in earlier verse 8th -9th. (verse 11-12)<br />
<br />
In above verses from 4 to 14, nine recipes of ''prasrita bastis'' are described. Here a special and practical instruction is given that even if salt is not mentioned in any of the recipes, rock salt is to be added and these ''[[basti]]s'' are always given with a moderate warm temperature.<br />
<br />
While preparing the ''[[basti]]s'', rock salt is to be added. The amount is to be calculated according to the principle described in the 7th verse i.e. about 6 gms. After preparing the ''[[basti]]'', to keep it warm until it is administered, a hot water bath may be used. (verse 13-14)<br />
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In the verse 15-16, two opposite possibilities are described. It may be milder than normal or it may be stronger than a normal. A mild ''[[basti]]'' is unable not only to eliminate ''[[dosha]]s'', but it itself is not ableto come out. This is ''ayoga'' or ''heenayoga'' (insufficient action). In such a case a ''[[basti]]'' is to be repeated with a stronger recipe. Contrary to this, if a ''[[basti]]'' is stronger it may cause an ''atiyoga'' (action in excess) causing evacuation of colonic contents more than required and eventually loss of essential substances.<br />
<br />
A soft acting ''[[basti]]'' is not able to eliminate the ''[[dosha]]s'' and may get stagnated and cause disturbance. To eliminate it, a strong and sharp acting ''[[basti]]'' is recommended. If strong ''[[basti]]s'' have caused emaciation, dehydration or weakness, the ''[[basti]]s'' with ''madhura'' (sweet) substances are useful because ''madhura'' substances are nourishing in action. (verses 15-16)<br />
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In ''[[vata]]''-related disorders, ''[[basti]]'' material with physically and pharmacologically hot property is preferred. It may cause ''[[pitta]]'' aggravation resulting in burning sensation and other such ''[[pitta]]''-related symptoms. In such a condition, grape juice or decoction of raisins added with a ''kalka'' (paste) of ''trivrita'' (Operculina turpethum Linn.) is given. In case of unavailability of ''kalka'', its powder can be used. This cures the burning sensation and other ''[[pitta]]''-related symptoms with its anti-''[[pitta]]'' action and expulsion of stool, ''[[pitta]]'' and ''[[vata]]''. ''Yavagu'' with sugar is given for nourishing purpose after this laxation. (verses 16-17)<br />
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If the purgation is in excess, it may cause significant loss of stool along with essential substances (e.g.water and electrolytes). This requires immediate attention to prevent the harm due to depletion of essential body components.<br />
<br />
In such a condition it is to be corrected by eating ''mashayusha'' (soup of black beans) and ''kulmasha'' (half cooked grains); and by taking honey or ''sura''. ''Kulmasha'' is also interpreted as a sour gruel (prepared by the spontaneous fermentation of fruit-juices or boiled rice). However, according to Chakrapani this is half cooked grain (barley etc.), which is popularly known as ''ghughuni''.<ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.18. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 713.</ref>,<ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya. Verse 13-14.In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3738.</ref>. This is known as ''ghughari'' in Gujarat and western Madhya Pradesh. This is more suitable interpretation. This is considered to be well nourishing food article. (verse 18)<br />
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Faulty application of ''[[basti]]s'' may cause a complication in the form of atisāra. ''Atisāra'' is a clinical condition of colon characterized by excessive and frequent defecation with altered consistency of stool. In short it may be interpreted as diarrhea. In next verse different forms of atisāra and their management are described. In this verse the condition is characterized by sāma stool (stool containing āma- undigested material), which smells like a decomposing body (putrid smell) and is associated with abdominal pain. Āma is a substance produced due to weak agni resulting in incomplete transformation of substance. In the present context, due to weak jatharāgni the transformation of food in to digested absorbable substances is incomplete resulting in to production of some intermediate substances.<ref>Vagbhata. Sutra Sthana, Cha.13 Doshopakramaniya Adhyaya verse 25. In: Bhiṣagācārya Hariśāstrī Parādakara Vaidya, Editors. Ashtanga Hridayam. 1oth ed. Varanasi: Chaukhambha Orientalia;2000.p.4.2014; P 216.</ref> ,<ref>Vijayarakshita and Srikanthadata, Madavakara chapter 25,Amavata nidana Verse 5, In: Brakmanand Tripathi Editor, Madhava Nidana ? ed. Varanasi: Chaukhamba Surabharati Prakashan,2012; P 573-574.</ref>These substances are known as āma. Because of its adherent quality it is supposed to be a pathogenic substance.In this condition a decoction of ''mustā, ativiṣā, kuṣṭha, nata, dāru'' and ''vacā'' is recommended. These medicines help in ''[[pachana]]'' (termination) of āma.<br />
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This chapter describes six types of ''atisāra'' based on the pathogens being excreted in excess. This verse explains the remedy for one of them in which patient passes stool with significant undigested material. This undigested material causes putrid smell after decomposition. Decomposition also produces some toxic substances, which cause abdominal pain and loss of appetite. The recipe described here is not useful in atisāra produced as complication of [[basti]] but also in āmātisāra of any origin. (verse 19)<br />
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This verse number 20 describes other five types of atisāra. In this way, six types of atisāras those are depicted in above verses are as follow.<br />
<br />
#''Atisara'' (diarrhea) in which stool contains ''ama'' (undigested material) <br />
#Atisāra (diarrhea) in which stool is pakva i.e.free from āma (undigested material) <br />
#Atisāra (diarrhea) in which stool is pakva and containing [[vata]] i.e. significant flatulence.<br />
#Atisāra (diarrhea) in which stool is pakva and containing asṛk (blood).<br />
#Atisāra (diarrhea) in which stool is pakva and containing [[pitta]].<br />
#Atisāra (diarrhea) in which stool is pakva and containing [[kapha]].<br />
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For the management of these conditions [[basti]]s prepared with the svavargīya medicines (group of medicines acting against particular pathologies) are given.<ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.20. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714.</ref> For example the vargas (classified groups) described in Ṣaḍvirecanaśatāśrīya chapter (chapter 4th) of sūtrasthāna of Carakasaṁhitā. So, the recommended group of medicines for last five conditions of pathology is purīṣasaṁgrahaṇīya [Cha.Sa.[[Sutra Sthana]] 4/8/31], vātaghna, śoṇitasthāpana [Cha.Sa.[[Sutra Sthana]] 4/8/46], pittaghna and kaphaghna vargas respectively.<ref>Chakrapani, Charak. Sidhi Sthana, Cha.4 Snehavyapat Siddhi ver.8. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714. P 33 & 34.</ref>.Purīṣasaṁgrahaṇīya group consists of priyaṅgu (Callicarpa macrophylla R.Br.), ananta (Hemidesmus indicusR.Br.), Seed of mango, kaṭvaṅga (Ailanthus excelsa Roxb.), lodhra (Symplocos racemosa Roxb.), mocharasa (secretion of Salmalia malabarica Scott&Endl.), samṅgā (Mimosa pudica Linn.), dhātakī (Woodfordia fruticosa Kurz.), padmā (Clerodendrum serratum Linn.) and padmakesara (Stamen of Nelumbo nucifera Gaertn.). shoṇitasthāpana group consists of honey, madhuka (Glycyrrhiza glabra Linn.), saffron, mocarasa (secretion of Salmalia malabarica Scott &Endl.), broken earthen vessel, lodhra (Symplocos racemosa Roxb.), gairika (red ochre), priyaṅgu (Callicarpa macrophylla R.Br.), sharkarā(sugar) and lājā (puffed rice).<ref>Chakrapani, Charak. Sidhi Sthana, Cha.4 Snehavyapat Siddhi ver.8. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714. P 33 & 34.</ref>The form of [[basti]] is not described here. However, this may be decided according to disease condition and patient’s tolerance. (verse 20)<br />
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In this version of [[Charak Samhita]] thirty six variants are cited, but another version ‘kēvalaiḥ saha ceṭ triṁśadvidyāt sōpadravānapi’ mentions only thirty.<ref>Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya . In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3739.</ref> Gaṅgādhara also explains thirty forms in the following manner.<ref>Gangadhara, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya.Verse 17 In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3739.</ref><br />
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The six basic forms of atisāra are: <br />
#āmātisāra (diarrhea with undigested material) <br />
#śakṛdatisāra (frequent stool only) <br />
#vātātisāra (that with significant flatulence) <br />
#asṛkātisāra (that with blood)<br />
#pittātisāra (that with [[pitta]]) and <br />
#kaphātisāra (that with [[kapha]]).<br />
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Due to saṁsarga (mutual combinations of two) a total of fifteen variants occur, viz.<br />
#āma-śakṛd, āma-[[vata]], āma-asṛk, āma-[[pitta]], āma-[[kapha]],<br />
#śakṛd-[[vata]], śakṛd-asṛk, śakṛd-[[pitta]], śakṛd-[[kapha]],<br />
#vāta-asṛk, [[vata]]-[[pitta]], [[vata]]-[[kapha]],<br />
#asṛk-[[pitta]], asṛk-[[kapha]], and<br />
#[[pitta]]-[[kapha]].<br />
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Nine ''upadrava'' as cited above.<br />
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The upadravas in present version of chapter are ten. Gaṅgādhara has taken description of nine upadravas from another version.<ref>Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya. In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3739.</ref> But upadravas cannot be counted among types of a disease. Hence the thirtysix variants would be in following manner.<br />
<br />
The six basic forms of atisāra are as mentioned above.<br />
<br />
Due to saṁsarga (mutual combinations of two) a total of thirty variants occur, viz. fifteen samsargas as mentioned above and other fifteen are as below:<br />
#śakṛd- āma, [[vata]]-āma, asṛk-āma, [[pitta]]-āma, [[kapha]]-āma,<br />
#[[vata]]-śakṛd, asṛk-śakṛd, [[pitta]]-śakṛd, [[kapha]]-śakṛd,<br />
#asṛk-[[vata]], [[pitta]]-[[vata]], [[kapha]]-[[vata]],<br />
#[[pitta]]-asṛk, [[kapha]]-asṛk, and<br />
#[[kapha]]-[[pitta]].<br />
<br />
Moreover [[Charak Samhita]] describes types of atisāra in its chapter 19th of [[Sutra Sthana]] and 19th chapter of [[Chikitsa Sthana]] differently. <ref> Charak. Sutra Sthana, Cha.19 Ashtodariya Adhyaya ver.4/3. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 110.</ref>,<ref> Charak. Chiktsa Sthana, Cha.19 Atisara Chikitsitam Adhyaya. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 547-549.</ref> The context of the topic atisāra in present chapter is absolutely different. Here it is described first as a complication of [[basti]], which eloborted further in the chapter. In earlier sections atisāra was described as a primary disease manifested because of its own physical and mental etiological factors. (verse 21-22)<br />
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Basic principle of treatment of every condition associated with āma is āmapāchana (termination of āma by promoting function of agni). For this purpose mustā, ativiṣā, kuṣṭha, nata, dāru and vacā (which are mentioned in 19th verse) are to be given. This combination may be given in form of powder or as decoction. This recipe is useful in āmātisāra every origin. (verse 23)<br />
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For vātaghna medicines to be used in [[vata]] associated atisara, Cakrapāṇi recommends daśhamula, while Gaṅgādhara considers bṛhat pañchamūla (see the commentary on 5th verse). For grāhī purpose the medicines of purīṣasaṁgrahaṇīya varga [Cha.Sa.[[Sutra Sthana]].4/8/31] are to be used.<ref>Charak. Chiktsa Sthana, Cha.19 Atisara Chikitsitam Adhyaya. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 33 & 34.</ref><br />
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Next condition in which atisāra is associated with dominance of [[vata]], snēha [[basti]] supplemented with sweet, sour and salty substances is recommended. Being opposite to the properties of [[vata]], the substances in this [[basti]] antagonizes the [[vata]] principle. (verse 24)<br />
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Now the management of other conditions - raktātisāra, pittātisāra and kaphātisāra is explained. In raktātisāra, a [[basti]] with blood of animals e.g. goat, is given. This not only stops the bleeding but also supplements the substances to produce blood, which is lost due to colonic bleeding. [[Pitta]] pacifying remedies also helpful in this condition and therefore the remedies useful in pittātisāra can also be given in raktātisāra. Substances with astringent, sweet and bitter tastes have [[pitta]]-antagonizing action and hence the [[basti]] consists of such substances are helpful in management of pittātisāra. Substances with astringent, pungent and bitter tastes have [[kapha]]-antagonizing action; therefore, a [[basti]] with such medicines is beneficial in kaphātisāra.<br />
<br />
The [[basti]] used in pittātisāra is useful in raktātisāra also. Applying this principle, this type of [[basti]] may be used in a disease entity known as ulcerative colitis. (verse 25)<br />
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These verses number 26-27 describe management plan for the saṁsargaja atisāras (in which two morbid components are associated and have mutual vitiation). Cakrapāṇi in his commentary decides the main and secondary role of the involved components on the basis of vibhakti (noun case) of the words. 7th vibhakti signifies the main role while 3rd expresses secondary role of the factors.<ref>Chakrapani, Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Siddhi ver.26-31. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714.</ref><br />
<br />
In the 26th verse the possible combination are-<br />
#āma is associated with śakṛt i.e.stool (āma is primary and stool is secondary)<br />
#āma is associated with [[vata]] (āma is primary and [[vata]] is secondary)<br />
#śakṛt (stool) is associated with āma (stool is primary āma is secondary)<br />
#[[vata]] is associated with āma ([[vata]] is primary and āma is secondary)<br />
<br />
In the 27th verse the possible combination are-<br />
#āma is associated with [[pitta]] (āma is primary and [[pitta]] is secondary)<br />
#āma is associated with [[rakta]] (āma is primary and [[rakta]] is secondary)<br />
#[[pitta]] is associated with āma ([[pitta]] is primary and āma is secondary)<br />
#[[rakta]] is associated with āma ([[rakta]] is primary and āma is secondary)<br />
<br />
In these conditions in mentioned in 26th verse, a drink prepared with trikaṭu, sour and salty substances is recommended. While the conditions mentioned in 27th verse, are manageable with adrink, prepared with trikaṭu, sweet and bitter substances are useful. (verse 26-27)<br />
<br />
The description of saṁsargaja atisāras continues in these verses 28-29. In the 28th verse, the possible combination are-<br />
<br />
#āma is associated with [[kapha]] (āma is primary and [[kapha]] is secondary)<br />
#[[kapha]] is associated with āma ([[kapha]] is primary and āma is secondary)<br />
<br />
In 1st condition the recommended [[basti]] is with trikaṭu, astringent and bitter substances while in 2nd condition with trikaṭu, astringent and salty medicines.<br />
<br />
In a pāthabheda (another version) of 29th verse<ref>Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya.Verse 23 In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3741.</ref>, [[rakta]]is also included. With this inclusion the possible combination are-<br />
<br />
#śakṛt (stool) is associated with [[vāta]] (stool is primary and [[vata]] is secondary)<br />
#[[pitta]] is associated with [[vāta]] ([[pitta]] is primary and [[vata]] is secondary)<br />
#[[rakta]] is associated with [[vāta]] ([[pitta]] is primary and āma is secondary) <br />
#[[vata]] is associated withstool([[vata]] is primary and stool is secondary)<br />
#[[vata]] is associated with [[pitta]] ([[vata]] is primary and [[pitta]] is secondary)<br />
#[[vata]] is associated with [[rakta]] ([[vata]] is primary and [[rakta]] is secondary)<br />
<br />
In these pathological conditions a [[basti]] with sweet, sour and astringent materials is acclaimed. (verse 28-29)<br />
<br />
The management of saṁsargaja atisāras further continues in these verses. In the 30th verse the possible combination are-<br />
#[[rakta]] is associated with śakṛt i.e. stool([[rakta]] is primary and stool is secondary)<br />
#[[rakta]] is associated with [[pitta]] ([[rakta]] is primary and [[pitta]] is secondary)<br />
#śakṛt (stool) is associated with [[pitta]] (stool is primary and [[pitta]] is secondary) <br />
#śakṛt stool is associated with [[rakta]] (stool is primary and [[rakta]] is secondary)<br />
#[[pitta]] is associated with [[rakta]] ([[pitta]] is primary and [[rakta]] is secondary)<br />
#[[pitta]] is associated with śakṛt stool ([[pitta]] is primary and stool is secondary)<br />
<br />
In the 31st verse the possible combination are-<br />
#stool is associated with [[kapha]] (stool is primary and [[kapha]] is secondary)<br />
#[[pitta]] is associated with [[kapha]] ([[pitta]] is primary and [[kapha]] is secondary)<br />
#[[kapha]] is associated with stool ([[kapha]] is primary andstool is secondary) <br />
#[[kapha]] is associated with [[pitta]] ([[kapha]] is primary and [[pitta]] is secondary)<br />
#[[kapha]] is associated with [[rakta]] ([[kapha]] is primary and [[rakta]] issecondary)<br />
<br />
The conditions mentioned in 30th verse are managed by administration of [[basti]] prepared with astringent, sweet and bitter ingredients. While the pathologies in 31stverse, are manageable by a [[basti]] with trikaṭu, bitter and astringent ingredients. (verse 30-31)<br />
<br />
In these verses 32-33, four more combinations of pathology are described with their management. In 32nd verse the [[kapha]] is main factor with [[vata]] as secondary and [[rakta]] as main with [[kapha]] as secondary while in 33rd verse [[vata]] is main factor with [[kapha]] as secondary and [[pitta]] as main with [[vata]] as secondary.<br />
<br />
Type of atisāra according to involvement of factors. Reccommended material for [[basti]]<br />
[[Kapha]] is main factor with [[vata]] as secondary trikaṭu, bitter and sour ingredients<br />
[[Rakta]] as main with [[kapha]] as secondary sweet,trikaṭu and bitter <br />
[[Vata]] is main factor with [[kapha]] as secondary trikaṭu,sour and salty<br />
[[Pitta]] is main with [[vata]] as secondary. sweet, sour and bitter(verse 32-33)<br />
<br />
There are six components involved in the pathogenesis of atisāra. In earlier verses the combinations of two components are described. The combinations of three, four or five are also possible. Gaṅgādhara in his Jalpakalpataru commentary mentions the possibility of combination of all six also.<ref>Charak. Sidhi Sthana, Cha.8 Prasrita Yogiyam Sidhi Adhyaya. In: Kaviraj shree Narendranath sen Gupta, and kaviraj shree Balaichandra sen Gupta, Editors. Charak Samhita.? ed. New Delhi;Rastriya Samskrita Samsthana, 2002; P 3742-43.</ref> This appears logical, as when five may combine six together may also be possible. <br />
<br />
According to Gaṅgādhara, the following combinations may happen viz. ten clinical forms due to combinations of three, six forms due to combinations of four, three forms due to combinations of five and one form with all six. In this way twenty forms are possible. These combinations are as below.<br />
<br />
Combinations of three Combinations of four Combinations of five Combination of six<br />
āmaviḍvātaja<br />
āmaviḍasṛja<br />
āmaviḍpittaja<br />
āmaviḍkaphaja<br />
viḍvātāsṛja<br />
viḍvātapittaja<br />
viḍvātakaphaja<br />
vātāsṛkpittaja<br />
vātāsṛkkaphaja<br />
asṛkpittakaphaja <br />
āmaviḍvātāsṛja<br />
āmaviḍvātapittaja<br />
āmaviḍvātakaphaja<br />
viḍvātāsṛkpittaja<br />
viḍvātāsṛkkaphaja<br />
vātāsṛkpittakaphaja <br />
āmaviḍvātāsṛkpittaja<br />
āmaviḍvātāsṛkkaphaja<br />
viḍvātāsṛkpitta kaphaja<br />
āmaviḍvātāsṛkpittakaphaja(verse 34) <br />
<br />
If case of association of āma, [[basti]]s are contraindicated. This is a general rule. In such condition the āmapācana (preparation to terminate āma)is given. However, in nirāma condition (without association of āma), [[basti]]s are recommended. (verse 35)<br />
<br />
In these verses 36-37, two new units of measurement are described i.e. pala and prastha. After calculating these amounts in modern units of metric system, pala is around 50 gms or 50 ml while prastha around 800 ml. Though, in previous verses the management of different types of atisāras, has been described. In coherence of the topic, more remedies for atisāra are described in present verses.<br />
<br />
This medicated ghṛta is processed with plants having [[stambhana]] action. Therefore, it is useful in all types of atisāra. Being a nourishing preparation, it is useful in compensating the loss of the essential body substances. A [[basti]] may also be given with this preparation and should be retained as much as possible. This type of [[basti]] may be useful in inflammatory bowel diseases. (verse 36-37)<br />
<br />
The remedies for atisāra continue in these verses 38-39. These verses describe recipe of medicated gruels useful in management of this disease. First the decoction is prepared according to the recipe of ṣaḍaṅgapānīya.<ref>Chakrapani, Charak. Chikitsa Sthana, Cha.3 Jwara Chikitsitam ver.145 In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.4th ed. New Delhi: Munshiram Manoharlal publishers pvt. Ltd; 4th edition 1981; P 714.P 410.</ref>,<ref>Agnihotri Avadhabihari; Bhaiṣajyakalpanā Vijñāna; Chaukhamba orientalia publication, 6th edition, 2006, P 146-147.</ref><br />
<br />
For this purpose one part of the course powder of all plants is boiled with 64 parts of water. When water is reduced to half, this is to be taken to cook yavāgū. There are three varieties of yavāgū-maṇḍa, peyā and vilepī. These three are gradually thicker in consistency and may be chosen according to strength of a patient and his agni. (verse 38-39)<br />
<br />
Gaṅgādhara considers Sthirādi group of plants as Svalpapañcamūla consists of śālaparṇī (Desmodium gangeticum DC.), pṛśniparṇī (Uraria picta Desr.) bṛhatī (Solanum indicum Linn.) kaṇṭakārī (Solanum suranttense Burm.) and gokṣura (Tribulus terrestris Linn.). About balādi group there is no clarification by any commentator however the plants Sida cordifolia Linn., abutilon indicum Linn., Sida rhombifolia Linn. and Grewia hirsute Vahl. may be taken for this purpose. Ikṣvādi is considered by Cakrapāṇi as roots of Saccharum officinarum Linn., Desmostachya bipinnata Stapf., Saccharum spontaneum Linn. and roots of rice.<br />
There is another version of verse 42, which mentions last line as ‘sasarpirlavaṇā yojyā madhurā lavaṇāpi vā’ which means that this preparation can be used with ghṛta and rock salt in sweet or salty form.<br />
<br />
Above verses give some more recipes for medicated yavāgūs those are helpful in management of atisāra. (verse 40-42)<br />
In these verses some additional and useful remedies for management of various types of atisāra are given. It is to be recalled that in this chapter, authors have considered six factors responsible in pathogenesis and manifestation of atisāra viz. āma [[vata]], [[pitta]], [[kapha]], [[rakta]] and sakṛt (stool). The treatments are to be considered as per the factors involved. (verse 43-45)<br />
The chapter describes various clinical forms of atisara according to the components involved in the pathogenesis. The therapeutics for these various forms of atisāra is described in a planned manner. Ayurvedic management is not merely medicaments but it recommends the food preparations those are helpful in restoring the normalcy of the body components of the patient. Thus the chapter is significantly useful for clinical practice of [[basti]] therapies and the treatment of disease atisāra, which includes several modern diseases such as ulcerative colitis, Crohn’s dieases and irritable bowel syndrome. (verse 46)<br />
The [[basti]] formulations mentioned in this chapter are used widely in today’s clinical practice. However, though atisara (diarrhea) is explained in detail as complication of improperly administered [[basti]], in todays clinical practice, this complication is observed rarely.<br />
</div><br />
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[[#top| Back to the Top ]]</span></div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Kasa_Chikitsa&diff=45408Kasa Chikitsa2026-01-30T08:37:20Z<p>Agnivesha: /* Management of kshataja kasa (due to injury) */</p>
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<big>'''[[Chikitsa Sthana]] Chapter 18. Management of Kasa (Cough of various origins) </big>''' <br />
{{Infobox<br />
|title = Kasa Chikitsa<br />
|label1 = Section/Chapter<br />
|data1 = [[Chikitsa Sthana]] Chapter 18<br />
|label2 = Preceding Chapter<br />
|data2 = [[Hikka Shwasa Chikitsa]]<br />
<br />
|label3= Succeeding Chapter<br />
|data3 = [[Atisara Chikitsa]]<br />
|label5 = Other Sections<br />
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br />
|label6 = Translator and commentator<br />
|data6 = Nesari T., Mallya S., [[Yogesh Deole|Deole Y. S.]]<br />
|label7 = Reviewer <br />
|data7 = Prasad B.S., Mali P.<br />
|label8 = Editors<br />
|data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br />
|label9 = Year of publication <br />
|data9 = 2020<br />
|label10 = Publisher <br />
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label11 = DOI <br />
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.019 10.47468/CSNE.2020.e01.s06.019]<br />
}}<br />
<big>'''Abstract </big>'''<br />
<p style="text-align:justify;">''Hikka, shwasa'' and ''kasa'' (hiccups, dyspnea and cough) are the three main diseases of ''pranavaha srotas'' (respiratory system). There are similarities in clinical presentation and management of these three. Therefore, these are described in sequence. ''Kasa'' is categorized in to five types based on its dominance of dosha and etiology. The vata dominant, pitta dominant and kapha dominant kasa are curable with proper medication. The other two types originating due to kshata (injury) and depletion of body constituents (kshaya) are palliable (yapya). Avoiding etiological factors (Nidana parivarjana), purification therapy ([[shodhana]]), pacification therapy ([[shamana]]), disease specific treatment (vyadhiahara [[rasayana]]) are principles of management for all types of ''kasa''. Administration of [[shodhana]] therapy is important. The reduction in persistent nature of illness with episodic exacerbation and the severity is possible if all modalities are followed in sequence. <br />
<br/><br/><br />
'''Keywords''': ''kasa'', cough, treatment of cough, respiratory diseases, kshataja, kshayaja, snehapana, [[vamana]], [[virechana]], vairechanika [[nasya]] (nasal catarrhal), [[dhumapana]] (medicated cigarettes).<br />
</p><br />
<br />
== Introduction ==<br />
<div style="text-align:justify;"><br />
''Pranavaha srotas'' is a vital system of the body and although this ''srotas'' is more susceptible to abuse from little amount of smoke, allergens, adulterants, petrochemicals and many pollutants in atmosphere, there are a variety of disorders and diseases that are temporary and harmless, while others can be life threatening. In literature, ''pranavaha srotas'' disorders are elaborated under the heading of ''shwasa, kasa, hikka, rajayakshma'' and ''urakshata'' (''kshata-kshina''). Cough, expectoration, breathlessness, sore throat, chest pain are common clinical features of respiratory diseases. ''Kasa'' is one such disease, which is identified by the hoarse phonetic sound, produced due to the pathological process of [[dosha]] dushti'' (vitiation of [[dosha]]), ''vimarga gamana'' (diverted movement) of ''pranavata'' and ''avarana'' (occlusions) of [[vayu]] by the [[kapha]]. The main pathology is in chest region with reduced functioning of the respiratory system. <br />
<br />
Smoke, dust, and over exertion (''dhumopaghata, raja, vyayama'') are largely considered as causative factors (''samanya nidana''). These may cause direct damage to the harmony of the ''pranavaha srotas'' which occurs in all respiratory disorders. Apart from above said causative factors some in particular like ''guru'' (heavy), ''snigdha'' (unctuous), ''madhura'' (sweet), ''asatmya'' (unhabituated), ''paryushita ahara'' (rotten food) will cause vitiation of [[dosha]], more specifically [[vata]] and [[kapha]] which will in turn have its impact on ''pranavaha srotas'' to cause structural and functional impairments (''kha vaigunya''). Improper diet will result in the improper digestion and absorption of ''ahara rasa'' which will in turn produce ''kasa''. These can be considered as intrinsic factors for the pathogenesis. <br />
<br />
Prodromal symptoms (''purvarupa'') are irritation of throat with pricking sensation, itching (''kantha kandu'')and inability to swallow (''bhojyanam avarodha''). These are very much similar with upper respiratory tract infection leading to condition of pharyngitis or pharyngotonsillitis and persistence of such upper respiratory tract infection will further spread to lower respiratory tract.<br />
<br />
There are five types of ''kasa'' namely,[[vata]]ja, [[pitta]]ja, [[kapha]]ja, kshataja and kshayaja. ''Vatika kasa'' is more related to upper respiratory tract with ''swarabheda'' (hoarseness of voice) as its diagnostic feature and is unproductive. It resembles more to allergic rhinobronchitis, which may be self-limiting and curable. ''Paittika'' and [[kapha]]ja kasa'' involve lower respiratory tract and are productive in nature. While ''paittika kasa'' seems to be the result of inflammation, [[kapha]]ja kasa is due to mucosal hypertrophy of bronchial lining or chronic bronchitis. ''Kshyaja kasa'' is a state of chronic cough associated with emaciation. Charak has mentioned that the disturbance in the action of ''jatharagni'' all the three [[dosha]] get vitiated, which causes emaciation of [[dhatu]] of the body either due to ''anulomana kshaya'' or ''pratiloma kshaya'' [Cha.Sa. [[Chikitsa Sthana]] 18/24]. That makes it different from ''shosha'', which is a tri[[dosha]]ja disease manifests as a group of several diseases. ''Kshataja kasa'' is associated with break in integrity of lung parenchyma with ''shonita darshana'' (blood tinged mucous) as a symptom. There may or may not be ''shosha'' (emaciation).<br />
<br />
Snehapana, [[vamana]], [[virechana]], vairechanika [[nasya]] (nasal catarrhal), [[dhumapana]] (medicated cigaretes) are indicated as treatment modalities in different types of ''kasa''.<br />
</div><br />
<br />
== Sanskrit Text, Transliteration and English Translation ==<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
अथातः कासचिकित्सितं व्याख्यास्यामः ||१|| <br />
<br />
इति ह स्माह भगवानात्रेयः ||२|| <br />
<div class="mw-collapsible-content"><br />
<br />
athātaḥ kāsacikitsitaṁ vyākhyāsyāmaḥ||1|| <br />
<br />
iti ha smāha bhagavānātrēyaḥ||2|<br />
<br />
athAtaH kAsacikitsitaM vyAkhyAsyAmaH||1|| <br />
<br />
iti ha smAha bhagavAnAtreyaH||2|| <br />
</div></div><br />
<div style="text-align:justify;"><br />
Now we shall expound the chapter "Kasa chikitsa"(Management of cough of various origins). Thus said Lord Atreya.[1-2]<br />
<br />
=== Types ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
तपसा यशसा धृत्या धिया च परयाऽन्वितः | <br />
आत्रेयः कासशान्त्यर्थं प्राह सिद्धं चिकित्सितम् ||३||<br />
<br />
वातादिजास्त्रयो ये च क्षतजः क्षयजस्तथा | <br />
पञ्चैते स्युर्नृणां कासा वर्धमानाः क्षयप्रदाः ||४|| <br />
<div class="mw-collapsible-content"><br />
<br />
tapasā yaśasā dhr̥tyā dhiyā ca parayā'nvitaḥ| <br />
ātrēyaḥ kāsaśāntyarthaṁ prāha siddhaṁ cikitsitam||3|| <br />
<br />
vātādijāstrayō yē ca kṣatajaḥ kṣayajastathā| <br />
pañcaitē syurnr̥ṇāṁ kāsā vardhamānāḥ kṣayapradāḥ||4|| <br />
<br />
tapasA yashasA dhRutyA dhiyA ca parayA~anvitaH| <br />
AtreyaH kAsashAntyarthaM prAha siddhaM cikitsitam||3|| <br />
<br />
vAtAdijAstrayo ye ca kShatajaH kShayajastathA| <br />
pa~jcaite syurnRuNAM kAsA vardhamAnAH kShayapradAH||4|| <br />
</div></div><br />
<br />
Atreya, endowed with power of penance, fame and perseverance and super-intellect expounded the infallible therapies for the treatment of ''kasa''. There are five types of ''kasa''. If exacerbated they may cause kshaya. These five types are [[vata]]ja, [[pitta]]ja, [[kapha]]ja, kshataja and kshayaja. [3-4]<br />
<br />
=== Premonitory signs ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
पूर्वरूपं भवेत्तेषां शूकपूर्णगलास्यता | <br />
कण्ठे कण्डूश्च भोज्यानामवरोधश्च जायते ||५|| <br />
<div class="mw-collapsible-content"><br />
<br />
pūrvarūpaṁ bhavēttēṣāṁ śūkapūrṇagalāsyatā| <br />
kaṇṭhē kaṇḍūśca bhōjyānāmavarōdhaśca jāyatē||5|| <br />
<br />
pUrvarUpaM bhavetteShAM shUkapUrNagalAsyatA| <br />
kaNThe kaNDUshca bhojyAnAmavarodhashca jAyate||5|| <br />
</div></div><br />
<br />
Following are the premonitory signs and symptoms of ''kasa'': <br />
<br />
#Sensation as if throat and mouth are filled with ''shooka'' (thorns).<br />
#Itching sensation in the throat.<br />
#Inability to swallow food.[3-4]<br />
<br />
=== Pathophysiology ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
अधःप्रतिहतो वायुरूर्ध्वस्रोतःसमाश्रितः | <br />
उदानभावमापन्नः कण्ठे सक्तस्तथोरसि ||६|| <br />
<br />
आविश्य शिरसः खानि सर्वाणि प्रतिपूरयन् | <br />
आभञ्जन्नाक्षिपन् देहं हनुमन्ये तथाऽक्षिणी ||७|| <br />
<br />
नेत्रे पृष्ठमुरःपार्श्वे निर्भुज्य स्तम्भयंस्ततः | <br />
शुष्को वा सकफो वाऽपि कसनात्कास उच्यते ||८|| <br />
<div class="mw-collapsible-content"><br />
<br />
adhaḥpratihatō vāyurūrdhvasrōtaḥsamāśritaḥ| <br />
udānabhāvamāpannaḥ kaṇṭhē saktastathōrasi||6|| <br />
<br />
āviśya śirasaḥ khāni sarvāṇi pratipūrayan| <br />
ābhañjannākṣipan dēhaṁ hanumanyē tathā'kṣiṇī||7|| <br />
<br />
nētrē pr̥ṣṭhamuraḥpārśvē nirbhujya stambhayaṁstataḥ| <br />
śuṣkō vā sakaphō vā'pi kasanātkāsa ucyatē||8|| <br />
<br />
adhaHpratihato vAyurUrdhvasrotaHsamAshritaH| <br />
udAnabhAvamApannaH kaNThe saktastathorasi||6|| <br />
<br />
Avishya shirasaH khAni sarvANi pratipUrayan| <br />
Abha~jjannAkShipan dehaM hanumanye tathA~akShiNI||7|| <br />
<br />
netre pRuShThamuraHpArshve nirbhujya stambhayaMstataH| <br />
shuShko vA sakapho vA~api kasanAtkAsa ucyate||8|| <br />
</div></div><br />
<br />
[[Vata]] being obstructed in the lower region of the body, moves upwards, afflicts the channels of circulation in the upper part of the body, takes over the function of udana vayu and gets localized in the throat and chest. Then entering all the cavities in the head, fills them up and causes hunching and convulsive movements of the body, jaws, sides of the neck and eyes. Thereafter this obstructed [[vata]] causes contraction and stiffness of the eyes, back, chest and sides of the chest, gives rise to ''kasa'' which may be dry or with phlegm because of which it is known as ''kasa''.[6-8]<br />
<br />
=== Specific features of ''kasa'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
प्रतिघातविशेषेण तस्य वायोः सरंहसः | <br />
वेदनाशब्दवैशिष्ट्यं कासानामुपजायते ||९|| <br />
<div class="mw-collapsible-content"><br />
<br />
pratighātaviśēṣēṇa tasya vāyōḥ saraṁhasaḥ| <br />
vēdanāśabdavaiśiṣṭyaṁ kāsānāmupajāyatē||9|| <br />
<br />
pratighAtavisheSheNa tasya vAyoH saraMhasaH| <br />
vedanAshabdavaishiShTyaM kAsAnAmupajAyate||9|| <br />
</div></div><br />
<br />
Specific variations in the pain and sound associated with different types of ''kasa'' are caused by the specific nature of the obstruction (by [[kapha]], etc.) to the force fully moving [[vayu]].[9]<br />
<br />
==== Etiological factors, clinical features of [[Vata]]ja kasa ====<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
रूक्षशीतकषायाल्पप्रमितानशनं स्त्रियः | <br />
वेगधारणमायासो वातकासप्रवर्तकाः ||१०|| <br />
<br />
हृत्पार्श्वोरःशिरःशूलस्वरभेदकरो भृशम् | <br />
शुष्कोरःकण्ठवक्रस्य हृष्टलोम्नः प्रताम्यतः ||११|| <br />
<br />
निर्घोषदैन्यस्तननदौर्बल्यक्षोभमोहकृत् | <br />
शुष्ककासः कफं शुष्कं कृच्छ्रान्मुक्त्वाऽल्पतां व्रजेत् ||१२|| <br />
<br />
स्निग्धाम्ललवणोष्णैश्च भुक्तपीतैः प्रशाम्यति | <br />
ऊर्ध्ववातस्य जीर्णेऽन्ने वेगवान्मारुतो भवेत् ||१३|| <br />
<div class="mw-collapsible-content"><br />
<br />
rūkṣaśītakaṣāyālpapramitānaśanaṁ striyaḥ| <br />
vēgadhāraṇamāyāsō vātakāsapravartakāḥ||10|| <br />
<br />
hr̥tpārśvōraḥśiraḥśūlasvarabhēdakarō bhr̥śam| <br />
śuṣkōraḥkaṇṭhavakrasya hr̥ṣṭalōmnaḥ pratāmyataḥ||11|| <br />
<br />
nirghōṣadainyastananadaurbalyakṣōbhamōhakr̥t| <br />
śuṣkakāsaḥ kaphaṁ śuṣkaṁ kr̥cchrānmuktvā'lpatāṁ vrajēt||12|| <br />
<br />
snigdhāmlalavaṇōṣṇaiśca bhuktapītaiḥ praśāmyati| <br />
ūrdhvavātasya jīrṇē'nnē vēgavānmārutō bhavēt||13|| <br />
<br />
rUkShashItakaShAyAlpapramitAnashanaM striyaH| <br />
vegadhAraNamAyAso vAtakAsapravartakAH||10|| <br />
<br />
hRutpArshvoraHshiraHshUlasvarabhedakaro bhRusham| <br />
shuShkoraHkaNThavakrasya hRuShTalomnaH pratAmyataH||11|| <br />
<br />
nirghoShadainyastananadaurbalyakShobhamohakRut| <br />
shuShkakAsaH kaphaM shuShkaM kRucchrAnmuktvA~alpatAM vrajet||12|| <br />
<br />
snigdhAmlalavaNoShNaishca bhuktapItaiH prashAmyati| <br />
UrdhvavAtasya jIrNe~anne vegavAnmAruto bhavet||13|| <br />
</div></div><br />
<br />
Following are the causative factors of ''vatika'' type of ''kasa'':<br />
<br />
#Intake of ''ruksha'' (dry), ''sheeta''(cold), ''kashaya'' (astringent) type of food.<br />
#Intake of food in less quantity or much less quantity or not taking food at all.<br />
#Excess indulgence in ''vyavaya''.<br />
#Suppression of ''vega''.<br />
#Excessive physical strain.<br />
<br />
Its signs and symptoms are as follows:<br />
<br />
#Excruciating pain in the epigastric region, flanks, chest, and head.<br />
#Excessive hoarseness of the voice.<br />
#Dryness in the chest, throat and mouth.<br />
#Horripilation and fainting.<br />
#Resonant sound during coughing, looks hopeless, hollow sound during coughing.<br />
#weakness, agitated, illusive perceptions.<br />
#Dry cough<br />
#Expectorate scanty phlegm with pain.<br />
#The ''kasa'' gets alleviated by the food and drinks that are ''snigdha, amla, lavana'' and ''ushna''.<br />
#The upward movements increases [[vata]] after digestion of food.[10-13]<br />
<br />
==== Etiological factors, clinical features of [[Pitta]]ja kasa ====<br />
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<br />
कटुकोष्णविदाह्यम्लक्षाराणामतिसेवनम् | <br />
पित्तकासकरं क्रोधः सन्तापश्चाग्निसूर्यजः ||१४|| <br />
<br />
पीतनिष्ठीवनाक्षित्वं तिक्तास्यत्वं स्वरामयः | <br />
उरोधूमायनं तृष्णा दाहो मोहोऽरुचिर्भ्रमः ||१५|| <br />
<br />
प्रततं कासमानश्च ज्योतींषीव च पश्यति | <br />
श्लेष्माणं पित्तसंसृष्टं निष्ठीवति च पैत्तिके ||१६|| <br />
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<br />
kaṭukōṣṇavidāhyamlakṣārāṇāmatisēvanam| <br />
pittakāsakaraṁ krōdhaḥ santāpaścāgnisūryajaḥ||14|| <br />
<br />
pītaniṣṭhīvanākṣitvaṁ tiktāsyatvaṁ svarāmayaḥ| <br />
urōdhūmāyanaṁ tr̥ṣṇā dāhō mōhō'rucirbhramaḥ||15|| <br />
<br />
pratataṁ kāsamānaśca jyōtīṁṣīva ca paśyati| <br />
ślēṣmāṇaṁ pittasaṁsr̥ṣṭaṁ niṣṭhīvati ca paittikē||16|| <br />
<br />
kaTukoShNavidAhyamlakShArANAmatisevanam| <br />
pittakAsakaraM krodhaH santApashcAgnisUryajaH||14|| <br />
<br />
pItaniShThIvanAkShitvaM tiktAsyatvaM svarAmayaH| <br />
urodhUmAyanaM tRuShNA dAho moho~arucirbhramaH||15||<br />
<br />
pratataM kAsamAnashca jyotIMShIva ca pashyati| <br />
shleShmANaM pittasaMsRuShTaM niShThIvati ca paittike||16||<br />
</div></div><br />
<br />
Excessive intake of ''ushna, katu, vidahi, amla'' and ''kshara'' type of ''ahara; krodha, santapa'' , exposure to the heat of the fire and sun are the causative factors of [[pitta]]ja kasa''.<br />
<br />
Signs and symptoms of [[pitta]]ja kasa'' are as follows:<br />
#Yellowish sputum and eyes<br />
#Bitter taste in mouth<br />
#Voice disorders <br />
#Feeling of smoke is being vomited out of the chest<br />
#Morbid thirst, burning, illusive, anorexia and giddiness<br />
#Appearance of twinkling stars in front of the eyes while coughing continuously<br />
#Expectoration of sputum mixed with [[pitta]]. [14-16]<br />
<br />
==== Etiological factors, clinical features of [[Kapha]]ja kasa ====<br />
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<br />
गुर्वभिष्यन्दिमधुरस्निग्धस्वप्नाविचेष्टनैः | <br />
वृद्धः श्लेष्माऽनिलं रुद्ध्वा कफकासं करोति हि ||१७|| <br />
<br />
मन्दाग्नित्वारुचिच्छर्दिपीनसोत्क्लेशगौरवैः | <br />
लोमहर्षास्यमाधुर्यक्लेदसंसदनैर्युतम् ||१८|| <br />
<br />
बहुलं मधुरं स्निग्धं निष्ठीवति घनं कफम् | <br />
कासमानो ह्यरुग् वक्षः सम्पूर्णमिव मन्यते ||१९|| <br />
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<br />
gurvabhiṣyandimadhurasnigdhasvapnāvicēṣṭanaiḥ| <br />
vr̥ddhaḥ ślēṣmā'nilaṁ ruddhvā kaphakāsaṁ [1] karōti hi||17|| <br />
<br />
mandāgnitvārucicchardipīnasōtklēśagauravaiḥ| <br />
lōmaharṣāsyamādhuryaklēdasaṁsadanairyutam||18|| <br />
<br />
bahulaṁ madhuraṁ snigdhaṁ niṣṭhīvati ghanaṁ kapham| <br />
kāsamānō hyarug vakṣaḥ sampūrṇamiva manyatē||19|| <br />
<br />
gurvabhiShyandimadhurasnigdhasvapnAviceShTanaiH| <br />
vRuddhaH shleShmA~anilaM ruddhvA kaphakAsaM [1] karoti hi||17|| <br />
<br />
mandAgnitvArucicchardipInasotkleshagauravaiH| <br />
lomaharShAsyamAdhuryakledasaMsadanairyutam||18|| <br />
<br />
bahulaM madhuraM snigdhaM niShThIvati ghanaM kapham| <br />
kAsamAno hyarug vakShaH sampUrNamiva manyate||19|| <br />
</div></div><br />
<br />
Intake of heavy to digest, slimy, excessive sweets and oily foods ; excessive sleep and habitual inertia leads to aggravation of [[kapha]] and thereby obstructs the movement of [[vata]] which gives rise to [[kapha]]ja type of ''kasa''.<br />
<br />
The signs and symptoms of [[kapha]]ja type of ''kasa'' are as follows:<br />
#Lowered digestion process, anorexia, vomitng, nasal discharge, nausea and heaviness<br />
#Horripilation, stickiness and sweetness of the mouth<br />
#Expectoration of thick, sweet, slimy, phlegm in large quantity<br />
#Not feeling of pain in the chest while coughing<br />
#Feeling of fullness in the chest [17-19]<br />
<br />
==== Etiological factors, clinical features of ''Kshataja kasa'' ====<br />
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<br />
अतिव्यवायभाराध्वयुद्धाश्वगजविग्रहैः | <br />
रूक्षस्योरः क्षतं वायुर्गृहीत्वा कासमावहेत् ||२०|| <br />
<br />
स पूर्वं कासते शुष्कं ततः ष्ठीवेत् सशोणितम् | <br />
कण्ठेन रुजताऽत्यर्थं विरुग्णेनेव चोरसा ||२१|| <br />
<br />
सूचीभिरिव तीक्ष्णाभिस्तुद्यमानेन शूलिना | <br />
दुःखस्पर्शेन शूलेन भेदपीडाभितापिना ||२२|| <br />
<br />
पर्वभेदज्वरश्वासतृष्णावैस्वर्यपीडितः | <br />
पारावत इवाकूजन् कासवेगात्क्षतोद्भवात् ||२३|| <br />
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<br />
ativyavāyabhārādhvayuddhāśvagajavigrahaiḥ| <br />
rūkṣasyōraḥ kṣataṁ vāyurgr̥hītvā kāsamāvahēt||20|| <br />
<br />
sa pūrvaṁ kāsatē śuṣkaṁ tataḥ ṣṭhīvēt saśōṇitam| <br />
kaṇṭhēna rujatā'tyarthaṁ virugṇēnēva cōrasā||21|| <br />
<br />
sūcībhiriva tīkṣṇābhistudyamānēna śūlinā| <br />
duḥkhasparśēna śūlēna bhēdapīḍābhitāpinā||22|| <br />
<br />
parvabhēdajvaraśvāsatr̥ṣṇāvaisvaryapīḍitaḥ| <br />
pārāvata ivākūjan kāsavēgātkṣatōdbhavāt||23|| <br />
<br />
ativyavAyabhArAdhvayuddhAshvagajavigrahaiH| <br />
rUkShasyoraH kShataM vAyurgRuhItvA kAsamAvahet||20|| <br />
<br />
sa pUrvaM kAsate shuShkaM tataH ShThIvet sashoNitam| <br />
kaNThena rujatA~atyarthaM virugNeneva corasA||21|| <br />
<br />
sUcIbhiriva tIkShNAbhistudyamAnena shUlinA| <br />
duHkhasparshena shUlena bhedapIDAbhitApinA||22|| <br />
<br />
parvabhedajvarashvAsatRuShNAvaisvaryapIDitaH| <br />
pArAvata ivAkUjan kAsavegAtkShatodbhavAt||23|| <br />
</div></div><br />
<br />
Excessive indulgence in ''vyavaya'', carrying excessive heavy load, walking excessively long distance, indulgence in fighting, excessive indulgence in restraining the movement of horses and elephants etc. factors cause injury to the chest and bring about ''rukshata'' in the body and in turn causes aggravation of [[vata]] there by results in the manifestation of ''kshataja kasa''.<br />
<br />
Signs and symptoms of ''kshataja kasa'' are as follows:<br />
<br />
#The cough will be dry in the beginning followed by blood tinged sputum<br />
#Excessive pain in the throat and feeling of cracking pain in the chest<br />
#Pricking type of pain as if pricked by sharp needles<br />
#Excruciating pain and discomfort by touch on chest, miserable appearance.<br />
#Pain in joints and fingers, fever, labored breath, thirst and altered voice<br />
#While coughing, sounds humming like pigeon. [20-23]<br />
<br />
==== Etiological factors, clinical features of ''Kshayaja kasa'' ====<br />
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<br />
विषमासात्म्यभोज्यातिव्यवायाद्वेगनिग्रहात् | <br />
घृणिनां शोचतां नॄणां व्यापन्नेऽग्नौ त्रयो मलाः ||२४|| <br />
<br />
कुपिताः क्षयजं कासं कुर्युर्देहक्षयप्रदम् | <br />
दुर्गन्धं हरितं रक्तं ष्ठीवेत् पूयोपमं कफम् ||२५|| <br />
<br />
स्थानादुत्कासमानश्च हृदयं मन्यते च्युतम् | <br />
अकस्मादुष्णशीतार्तो बह्वाशी दुर्बलः कृशः ||२६|| <br />
<br />
स्निग्धाच्छमुखवर्णत्वक् श्रीमद्दर्शनलोचनः | <br />
पाणिपादतलैः श्लक्ष्णैः सततासूयको घृणी ||२७|| <br />
<br />
ज्वरो मिश्राकृतिस्तस्य पार्श्वरुक् पीनसोऽरुचिः | <br />
भिन्नसंहतवर्चस्त्वं स्वरभेदोऽनिमित्ततः ||२८|| <br />
<br />
इत्येष क्षयजः कासः क्षीणानां देहनाशनः | <br />
साध्यो बलवतां वा स्याद्याप्यस्त्वेवं क्षतोत्थितः ||२९|| <br />
<br />
नवौ कदाचित् सिध्येतामेतौ पादगुणान्वितौ | <br />
स्थविराणां जराकासः सर्वो याप्यः प्रकीर्तितः ||३०|| <br />
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<br />
viṣamāsātmyabhōjyātivyavāyādvēganigrahāt| <br />
ghr̥ṇināṁ śōcatāṁ nr̥̄ṇāṁ vyāpannē'gnau trayō malāḥ||24|| <br />
<br />
kupitāḥ kṣayajaṁ kāsaṁ kuryurdēhakṣayapradam| <br />
durgandhaṁ haritaṁ raktaṁ ṣṭhīvēt pūyōpamaṁ kapham||25|| <br />
<br />
sthānādutkāsamānaśca hr̥dayaṁ manyatē cyutam [1] | <br />
akasmāduṣṇaśītārtō bahvāśī durbalaḥ kr̥śaḥ||26|| <br />
<br />
snigdhācchamukhavarṇatvak śrīmaddarśanalōcanaḥ [2] | <br />
pāṇipādatalaiḥ ślakṣṇaiḥ satatāsūyakō [3] ghr̥ṇī||27|| <br />
<br />
jvarō miśrākr̥tistasya pārśvaruk pīnasō'ruciḥ| <br />
bhinnasaṁhatavarcastvaṁ [4] svarabhēdō'nimittataḥ||28|| <br />
<br />
ityēṣa kṣayajaḥ kāsaḥ kṣīṇānāṁ dēhanāśanaḥ| <br />
sādhyō balavatāṁ vā syādyāpyastvēvaṁ kṣatōtthitaḥ||29|| <br />
<br />
navau kadācit sidhyētāmētau pādaguṇānvitau| <br />
sthavirāṇāṁ jarākāsaḥ sarvō yāpyaḥ prakīrtitaḥ||30|| <br />
<br />
viShamAsAtmyabhojyAtivyavAyAdveganigrahAt| <br />
ghRuNinAM shocatAM nRUNAM vyApanne~agnau trayo malAH||24|| <br />
<br />
kupitAH kShayajaM kAsaM kuryurdehakShayapradam| <br />
durgandhaM haritaM raktaM ShThIvet pUyopamaM kapham||25|| <br />
<br />
sthAnAdutkAsamAnashca hRudayaM manyate cyutam [1] | <br />
akasmAduShNashItArto bahvAshI durbalaH kRushaH||26|| <br />
<br />
snigdhAcchamukhavarNatvak shrImaddarshanalocanaH [2] | <br />
pANipAdatalaiH shlakShNaiH satatAsUyako [3] ghRuNI||27|| <br />
<br />
jvaro mishrAkRutistasya pArshvaruk pInaso~aruciH| <br />
bhinnasaMhatavarcastvaM [4] svarabhedo~animittataH||28||<br />
<br />
ityeSha kShayajaH kAsaH kShINAnAM dehanAshanaH| <br />
sAdhyo balavatAM vA syAdyApyastvevaM kShatotthitaH||29|| <br />
<br />
navau kadAcit sidhyetAmetau pAdaguNAnvitau| <br />
</div></div><br />
<br />
Intake of ''vishamashana'' and ''asatmya ahara'', indulgence in ''vyavaya'', suppression of ''vega, ghrina'' and ''shoka'' etc factors leads to vitiation of [[agni]] thereby aggravation of tri[[dosha]] giving rise to ''kshayaja kasa''.<br />
<br />
Signs and symptoms of ''kshayaja kasa'' are as follows:<br />
#Expectoration of the [[kapha]], which is greenish, red in colour, associated with pus and bad odor.<br />
#While coughing person feels as if the heart is displaced.<br />
#Feels suddenly afflicted with both hot and cold sensations.<br />
#Consumption of food in excessive quantity<br />
#Feeling of very weak, and emaciation<br />
#Clean and unctuous complexion of face, associated with gracious appearance of face and eyes.<br />
#Soft silky touch of hands and foot.<br />
#Person always finds fault with others and develops immensely hateful disposition.<br />
#Person suffers from diseases like ''jwara'' (having signs and symptoms of all [[dosha]]), nasal congestion, anorexia, painful flanks, altered voice.<br />
#Feces hard or loose frequently without apparent cause stool.<br />
<br />
This is called ''kshayaja kasa'' which leads to the death of the patient if he is already very weak. If the patient is strong, then the disease can be cured.<br />
<br />
''Kshataja kasa'' is palliable if the patient is strong. If these two diseases(''kshataja'' and ''kshayaja'') are in their initial stage and if all four ''chikitsa chatushpada'' are endowed with efficiency, then both of these are curable. All types of ''kasa'' are however palliable if the patient is old. [24-30]<br />
<br />
=== Prognosis ===<br />
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<br />
त्रीन्साध्यान्साधयेत्पूर्वान् पथ्यैर्याप्यांश्च यापयेत् | <br />
चिकित्सामत ऊर्ध्वं तु शृणु कासनिबर्हिणीम् ||३१|| <br />
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<br />
trīnsādhyānsādhayētpūrvān pathyairyāpyāṁśca yāpayēt| <br />
cikitsāmata ūrdhvaṁ tu śr̥ṇu kāsanibarhiṇīm||31|| <br />
<br />
trInsAdhyAnsAdhayetpUrvAn pathyairyApyAMshca yApayet| <br />
cikitsAmata UrdhvaM tu shRuNu kAsanibarhiNIm||31|| <br />
</div></div><br />
<br />
The first three types of ''kasa'' ([[vata]]ja, [[pitta]]ja, [[kapha]]ja) should be treated as these are ''sadhya vyadhi''. Whereas other two types (''khataja'' and ''kshayaja'') should be palliated with appropriate drugs and diet.<br />
<br />
Treatment of different types of ''kasa'' has been described here after.[31]<br />
<br />
=== Management ===<br />
=== Management of [[vata]] [[dosha]] dominant kasa ===<br />
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<br />
रूक्षस्यानिलजं कासमादौ स्नेहैरुपाचरेत् | <br />
सर्पिर्भिर्बस्तिभिः पेयायूषक्षीररसादिभिः ||३२|| <br />
<br />
वातघ्नसिद्धैः स्नेहाद्यैर्धूमैर्लेहैश्च युक्तितः | <br />
अभ्यङ्गैः परिषेकैश्च स्निग्धैः स्वेदैश्च बुद्धिमान् ||३३|| <br />
<br />
बस्तिभिर्बद्धविड्वातं शुष्कोर्ध्वं चोर्ध्वभक्तिकैः | <br />
घृतैः सपित्तं सकफं जयेत् स्नेहविरेचनैः ||३४|| <br />
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<br />
rūkṣasyānilajaṁ kāsamādau snēhairupācarēt| <br />
sarpirbhirbastibhiḥ pēyāyūṣakṣīrarasādibhiḥ||32|| <br />
<br />
vātaghnasiddhaiḥ snēhādyairdhūmairlēhaiśca yuktitaḥ| <br />
abhyaṅgaiḥ pariṣēkaiśca snigdhaiḥ svēdaiśca buddhimān||33|| <br />
<br />
bastibhirbaddhaviḍvātaṁ śuṣkōrdhvaṁ cōrdhvabhaktikaiḥ| <br />
ghr̥taiḥ sapittaṁ sakaphaṁ jayēt snēhavirēcanaiḥ||34|| <br />
<br />
rUkShasyAnilajaM kAsamAdau snehairupAcaret| <br />
sarpirbhirbastibhiH peyAyUShakShIrarasAdibhiH||32|| <br />
<br />
vAtaghnasiddhaiH snehAdyairdhUmairlehaishca yuktitaH| <br />
abhya~ggaiH pariShekaishca snigdhaiH svedaishca buddhimAn||33|| <br />
<br />
bastibhirbaddhaviDvAtaM shuShkordhvaM cordhvabhaktikaiH| <br />
ghRutaiH sapittaM sakaphaM jayet snehavirecanaiH||34|| <br />
</div></div><br />
<br />
As dryness (rukshata) will be more prominent in [[vata]]ja type of ''kasa'', it should be treated with unctuous therapies (snehika upacharas). Ghrita pana,[[basti]], peya, yusha, ksheera, mamsa rasa etc. should be prepared with [[vata]]ghna dravya and is to be administered properly. <br />
<br />
[[Abhyanga]], [[parisheka]] (sprinkling or pouring), snigdha sweda etc. should be followed appropriately. <br />
<br />
If it is associated with constipation and flatulence should be treated with [[basti]]. If the person has dryness in the upper part of the body, and is associated with aggravated [[pitta]], then he should be given medicated [[ghrita]] after intake of food. <br />
<br />
If the person has dryness of the upper part of the body associated with [[kapha]] aggravation, then he should be treated with snigdha [[virechana]].[32-34]<br />
<br />
==== Kantakari ghrita ====<br />
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<br />
कण्टकारीगुडूचीभ्यां पृथक् त्रिंशत्पलाद्रसे | <br />
प्रस्थः सिद्धो घृताद्वातकासनुद्वह्निदीपनः ||३५|| <br />
<br />
इति कण्टकारीघृतम् | <br />
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<br />
kaṇṭakārīguḍūcībhyāṁ pr̥thak triṁśatpalādrasē| <br />
prasthaḥ siddhō ghr̥tādvātakāsanudvahnidīpanaḥ||35|| <br />
<br />
iti kaṇṭakārīghr̥tam| kaNTakArIguDUcIbhyAM pRuthak triMshatpalAdrase| <br />
prasthaH siddho ghRutAdvAtakAsanudvahnidIpanaH||35|| <br />
<br />
iti kaNTakArIghRutam| <br />
</div></div><br />
<br />
Thirty ''pala'' of ''kantakari'' and ''guduchi kashaya'' each is to be boiled with ''ghrita'' to prepare 1 ''Prastha'' of ''ghrita''. This particular ''ghrita'' is beneficial in ''vatika kasa''. It promotes the power of digestion. Thus ends the description of ''kantakari ghrita''.[35]<br />
<br />
==== Pippalyadi ghrita ====<br />
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पिप्पलीपिप्पलीमूलचव्यचित्रकनागरैः | <br />
धान्यपाठावचारास्नायष्ट्याह्वक्षारहिङ्गुभिः ||३६|| <br />
<br />
कोलमात्रैर्घृतप्रस्थाद्दशमूलीरसाढके | <br />
सिद्धाच्चतुर्थिकां पीत्वा पेयामण्डं पिबेदनु ||३७|| <br />
<br />
तच्छ्वासकासहृत्पार्श्वग्रहणीदोषगुल्मनुत् | <br />
पिप्पल्याद्यं घृतं चैतदात्रेयेण प्रकीर्तितम् ||३८|| <br />
<br />
इति पिप्पल्यादिघृतम् | <br />
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pippalīpippalīmūlacavyacitrakanāgaraiḥ| <br />
dhānyapāṭhāvacārāsnāyaṣṭyāhvakṣārahiṅgubhiḥ||36|| <br />
<br />
kōlamātrairghr̥taprasthāddaśamūlīrasāḍhakē| <br />
siddhāccaturthikāṁ pītvā pēyāmaṇḍaṁ pibēdanu||37|| <br />
<br />
tacchvāsakāsahr̥tpārśvagrahaṇīdōṣagulmanut| <br />
pippalyādyaṁ ghr̥taṁ caitadātrēyēṇa prakīrtitam||38|| <br />
<br />
iti pippalyādighr̥tam| pippalIpippalImUlacavyacitrakanAgaraiH| <br />
dhAnyapAThAvacArAsnAyaShTyAhvakShArahi~ggubhiH||36|| <br />
<br />
kolamAtrairghRutaprasthAddashamUlIrasADhake| <br />
siddhAccaturthikAM pItvA peyAmaNDaM pibedanu||37|| <br />
<br />
tacchvAsakAsahRutpArshvagrahaNIdoShagulmanut| <br />
pippalyAdyaM ghRutaM caitadAtreyeNa prakIrtitam||38|| <br />
<br />
iti pippalyAdighRutam| <br />
</div></div><br />
<br />
One ''prastha'' of ''ghrita'' is to be cooked by adding one ''adhaka'' of the decoction of ''dashamoola'' and the paste of one ''kola'' of each ''pippali, pippali-moola, chavya, chitraka, nagara, dhanyaka, patha, vacha, rasna, yashtimadhu, kshara'', and ''hingu''. Intake of one ''chaturthika'' (''pala'') of this ''ghrita'' along with ''peya, manda'' is beneficial in ''shwasa, kasa, hridroga, parshwashoola, grahani'' and ''gulma''. This particular formulation is known as ''pipplyaadi ghrita'' and is propounded by Atreya. <br />
<br />
Thus ends the description of ''pipplyadi-ghrita''.[36-38]<br />
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==== Tryushanadi ghrita ====<br />
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त्र्यूषणं त्रिफलां द्राक्षां काश्मर्याणि परूषकम् | <br />
द्वे पाठे देवदार्वृद्धिं स्वगुप्तां चित्रकं शटीम् ||३९|| <br />
<br />
ब्राह्मीं तामलकीं मेदां काकनासां शतावरीम् | <br />
त्रिकण्टकं विदारीं च पिष्ट्वा कर्षसमं घृतात् ||४०|| <br />
<br />
प्रस्थं चतुर्गुणे क्षीरे सिद्धं कासहरं पिबेत् | <br />
ज्वरगुल्मारुचिप्लीहशिरोहृत्पार्श्वशूलनुत् ||४१|| <br />
<br />
कामलार्शोऽनिलाष्ठीलाक्षतशोषक्षयापहम् | <br />
त्र्यूषणं नाम विख्यातमेतद्धृतमनुत्तमम् ||४२|| <br />
<br />
इति त्र्यूषणाद्यं घृतम् |<br />
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tryūṣaṇaṁ triphalāṁ drākṣāṁ kāśmaryāṇi parūṣakam| <br />
dvē pāṭhē dēvadārvr̥ddhiṁ svaguptāṁ citrakaṁ śaṭīm||39|| <br />
<br />
brāhmīṁ [1] tāmalakīṁ mēdāṁ kākanāsāṁ śatāvarīm| <br />
trikaṇṭakaṁ vidārīṁ ca piṣṭvā karṣasamaṁ ghr̥tāt||40|| <br />
<br />
prasthaṁ caturguṇē kṣīrē siddhaṁ kāsaharaṁ pibēt| <br />
jvaragulmāruciplīhaśirōhr̥tpārśvaśūlanut||41|| <br />
<br />
kāmalārśō'nilāṣṭhīlākṣataśōṣakṣayāpaham| <br />
tryūṣaṇaṁ nāma vikhyātamētaddhr̥tamanuttamam||42|| <br />
<br />
iti tryūṣaṇādyaṁ ghr̥tam| tryUShaNaM triphalAM drAkShAM kAshmaryANi parUShakam| <br />
dve pAThe devadArvRuddhiM svaguptAM citrakaM shaTIm||39|| <br />
<br />
brAhmIM [1] tAmalakIM medAM kAkanAsAM shatAvarIm| <br />
trikaNTakaM vidArIM ca piShTvA karShasamaM ghRutAt||40|| <br />
<br />
prasthaM caturguNe kShIre siddhaM kAsaharaM pibet| <br />
jvaragulmAruciplIhashirohRutpArshvashUlanut||41|| <br />
<br />
kAmalArsho~anilAShThIlAkShatashoShakShayApaham| <br />
tryUShaNaM nAma vikhyAtametaddhRutamanuttamam||42|| <br />
<br />
iti tryUShaNAdyaM ghRutam| <br />
</div></div><br />
<br />
One ''prastha'' of ''ghrita'' should be cooked by adding four ''prasthas'' of milk and the paste of one ''karsha'' each of ''tryushana, triphala, draksha, kashmari, parushaka, dve patha'' (''patha, raja patha''), ''devadaru, rddhi, swagupta, chitraka, shati, brahmi, tamalaki, meda, kakanasa, shatavari, trikantaka, vidari''. This is an effective ''kasahara'' formulation. It also cures ''jwara, gulma, aruchi, pleeha, shirah shoola, hrit shoola, parshwa shoola, kamala, arshas, ashtheela, kshata, shosha, kshaya''. This well known formulation is named as ''tryushanadi ghrita''.<br />
<br />
Thus ends the description of ''tryushanadi ghrita''. [39-42]<br />
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==== Rasna ghritam ====<br />
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द्रोणेऽपां साधयेद्रास्नां दशमूलीं शतावरीम् | <br />
पलिकां माणिकांशांस्तु कुलत्थान्बदरान्यवान् ||४३|| <br />
<br />
तुलार्धं चाजमांसस्य पादशेषेण तेन च | <br />
घृताढकं समक्षीरं जीवनीयैः पलोन्मितैः ||४४|| <br />
<br />
सिद्धं तद्दशभिः कल्कैर्नस्यपानानुवासनैः | <br />
समीक्ष्य वातरोगेषु यथावस्थं प्रयोजयेत् ||४५|| <br />
<br />
पञ्चकासान् शिरःकम्पं शूलं वङ्क्षणयोनिजम् | <br />
सर्वाङ्गैकाङ्गरोगांश्च सप्लीहोर्ध्वानिलाञ्जयेत् ||४६|| <br />
<br />
इति रास्नाघृतम् | <br />
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drōṇē'pāṁ sādhayēdrāsnāṁ daśamūlīṁ śatāvarīm| <br />
palikāṁ māṇikāṁśāṁstu kulatthānbadarānyavān||43|| <br />
<br />
tulārdhaṁ cājamāṁsasya pādaśēṣēṇa tēna ca| <br />
ghr̥tāḍhakaṁ samakṣīraṁ jīvanīyaiḥ palōnmitaiḥ||44|| <br />
<br />
siddhaṁ taddaśabhiḥ kalkairnasyapānānuvāsanaiḥ| <br />
samīkṣya vātarōgēṣu yathāvasthaṁ prayōjayēt||45|| <br />
<br />
pañcakāsān śiraḥkampaṁ śūlaṁ vaṅkṣaṇayōnijam| <br />
sarvāṅgaikāṅgarōgāṁśca saplīhōrdhvānilāñjayēt||46|| <br />
<br />
iti rāsnāghr̥tam| droNe~apAM sAdhayedrAsnAM dashamUlIM shatAvarIm| <br />
palikAM mANikAMshAMstu kulatthAnbadarAnyavAn||43|| <br />
<br />
tulArdhaM cAjamAMsasya pAdasheSheNa tena ca| <br />
ghRutADhakaM samakShIraM jIvanIyaiH palonmitaiH||44|| <br />
<br />
siddhaM taddashabhiH kalkairnasyapAnAnuvAsanaiH| <br />
samIkShya vAtarogeShu yathAvasthaM prayojayet||45|| <br />
<br />
pa~jcakAsAn shiraHkampaM shUlaM va~gkShaNayonijam| <br />
sarvA~ggaikA~ggarogAMshca saplIhordhvAnilA~jjayet||46|| <br />
<br />
iti rAsnAghRutam| <br />
</div></div><br />
<br />
In one ''drona'' of water, one ''pala'' of each of ''rasna, dashamoolas,'' one ''manika'' of each of ''kulattha, badara, yava'' and half ''tula'' of ''ajamamsa'' should be added and boiled till one fourth of water remains. To this decoction, one ''adhaka'' of each of ''ghrita, ksheera'' and one ''pala'' of each of ten drugs belonging to ''jivaneeya'' (''dashemani'') should be added and cooked. This prepared ''ghrita'' should be used in the form of [[nasya]], pana and ''anuvasana'', after proper assessment of the stages of [[vata]]roga. This cures five types of ''kasa, shirahshoola, kamparoga, vankshna'' and ''yoni roga'', diseases afflicting whole body or only one limb of the body, pleeha roga, urdhwa [[vata]].<br />
<br />
Thus ends the description of ''rasna- ghrita''.[43-46]<br />
==== Various formulations ====<br />
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विडङ्गं नागरं रास्ना पिप्पली हिङ्गु सैन्धवम् | <br />
भार्गी क्षारश्च तच्चूर्णं पिबेद्वा घृतमात्रया ||४७|| <br />
<br />
सकफेऽनिलजे कासे श्वासहिक्काहताग्निषु | <br />
द्वौ क्षारौ पञ्चकोलानि पञ्चैव लवणानि च ||४८|| <br />
<br />
शटीनागरकोदीच्यकल्कं वा वस्त्रगालितम् | <br />
पाययेत घृतोन्मिश्रं वातकासनिबर्हणम् ||४९|| <br />
<br />
दुरालभां शटीं द्राक्षां शृङ्गवेरं सितोपलाम् | <br />
लिह्यात् कर्कटशृङ्गीं च कासे तैलेन वातजे ||५०|| <br />
<br />
दुःस्पर्शां पिप्पलीं मुस्तं भार्गीं कर्कटकीं शटीम् | <br />
पुराणगुडतैलाभ्यां चूर्णितं वाऽपि लेहयेत् ||५१|| <br />
<br />
विडङ्गं सैन्धवं कुष्ठं व्योषं हिङ्गु मनःशिलाम् | <br />
मधुसर्पिर्युतं कासहिक्काश्वासं जयेल्लिहन् ||५२||<br />
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viḍaṅgaṁ nāgaraṁ rāsnā pippalī hiṅgu saindhavam| <br />
bhārgī kṣāraśca taccūrṇaṁ pibēdvā ghr̥tamātrayā||47|| <br />
<br />
sakaphē'nilajē kāsē śvāsahikkāhatāgniṣu| <br />
dvau kṣārau pañcakōlāni pañcaiva lavaṇāni ca||48|| <br />
<br />
śaṭīnāgarakōdīcyakalkaṁ vā vastragālitam| <br />
pāyayēta ghr̥tōnmiśraṁ vātakāsanibarhaṇam||49|| <br />
<br />
durālabhāṁ śaṭīṁ drākṣāṁ śr̥ṅgavēraṁ sitōpalām| <br />
lihyāt karkaṭaśr̥ṅgīṁ ca kāsē tailēna vātajē||50|| <br />
<br />
duḥsparśāṁ pippalīṁ mustaṁ bhārgīṁ karkaṭakīṁ śaṭīm| <br />
purāṇaguḍatailābhyāṁ cūrṇitaṁ vā'pi lēhayēt||51|| <br />
<br />
viḍaṅgaṁ saindhavaṁ kuṣṭhaṁ vyōṣaṁ hiṅgu manaḥśilām| <br />
madhusarpiryutaṁ [1] kāsahikkāśvāsaṁ jayēllihan||52|| <br />
<br />
viDa~ggaM nAgaraM rAsnA pippalI hi~ggu saindhavam| <br />
bhArgI kShArashca taccUrNaM pibedvA ghRutamAtrayA||47|| <br />
<br />
sakaphe~anilaje kAse shvAsahikkAhatAgniShu| <br />
dvau kShArau pa~jcakolAni pa~jcaiva lavaNAni ca||48|| <br />
<br />
shaTInAgarakodIcyakalkaM vA vastragAlitam| <br />
pAyayeta ghRutonmishraM vAtakAsanibarhaNam||49|| <br />
<br />
durAlabhAM shaTIM drAkShAM shRu~ggaveraM sitopalAm| <br />
lihyAt karkaTashRu~ggIM ca kAse tailena vAtaje||50|| <br />
<br />
duHsparshAM pippalIM mustaM bhArgIM karkaTakIM shaTIm| <br />
purANaguDatailAbhyAM cUrNitaM vA~api lehayet||51|| <br />
<br />
viDa~ggaM saindhavaM kuShThaM vyoShaM hi~ggu manaHshilAm| <br />
madhusarpiryutaM [1] kAsahikkAshvAsaM jayellihan||52||<br />
</div></div><br />
<br />
Intake of the powder prepared out of ''vidanga, nagara, rasna, pippali, hingu, saindhava lavana, bharangi'' and ''kshara'' along with appropriate quantity of ''ghrita'' is beneficial in [[vata]]ja kasa, [[kapha]]ja kasa, shwasa, hikka and suppression of digestion power.<br />
<br />
Fine ''vastragalita'' powder prepared out of ''dwou kshara''(''yava kshara'' & ''sarja kshara''), ''pancha kola, pancha lavana, shati, nagara'' and ''udichya'' , taken along with appropriate quantity of ''ghrita'' cures ''vatika'' type of ''kasa''.<br />
<br />
Intake of the powder prepared out of ''duralabha, shati, draksha, shringavera, sitopala, karkata shringi'' along with mixed with ''taila'' and its licking will cure [[vata]]ja kasa.<br />
<br />
The powder of ''dusparsha, pippali, musta, bharangi, karkataki,'' and ''shati'' should be mixed with ''purana guda'' and ''taila''.<br />
<br />
Taken this powder in the form of ''leha'' is beneficial in ''vatika'' type of ''kasa''.<br />
<br />
Powder prepared out of ''vidanga, saindhava lavana, kushtha, vyosha, hingu, manahshila'' taken along with ''madhua'' and ''sarpi'' in the form of ''leha'' eradicates ''kasa, hikka'' and ''shwasa''.[47-52]<br />
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==== ''Chitrakadi leha'' ====<br />
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चित्रकं पिप्पलीमूलं व्योषं हिङ्गु दुरालभाम् | <br />
शटीं पुष्करमूलं च श्रेयसीं सुरसां वचाम् ||५३|| <br />
<br />
भार्गीं छिन्नरुहां रास्नां शृङ्गीं द्राक्षां च कार्षिकान् | <br />
कल्कानर्धतुलाक्वाथे निदिग्ध्याः पलविंशतिम् ||५४|| <br />
<br />
दत्त्वा मत्स्यण्डिकायाश्च घृताच्च कुडवं पचेत् | <br />
सिद्धं शीतं पृथक् क्षौद्रपिप्पलीकुडवान्वितम् ||५५|| <br />
<br />
चतुष्पलं तुगाक्षीर्याश्चूर्णितं तत्र दापयेत् | <br />
लेहयेत् कासहृद्रोगश्वासगुल्मनिवारणम् ||५६|| <br />
<br />
इति चित्रकादिलेहः |<br />
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citrakaṁ pippalīmūlaṁ vyōṣaṁ hiṅgu durālabhām| <br />
śaṭīṁ puṣkaramūlaṁ ca śrēyasīṁ surasāṁ vacām||53|| <br />
<br />
bhārgīṁ chinnaruhāṁ rāsnāṁ śr̥ṅgīṁ drākṣāṁ ca kārṣikān| <br />
kalkānardhatulākvāthē nidigdhyāḥ palaviṁśatim [1] ||54|| <br />
<br />
dattvā matsyaṇḍikāyāśca ghr̥tācca kuḍavaṁ pacēt| <br />
siddhaṁ śītaṁ pr̥thak kṣaudrapippalīkuḍavānvitam||55|| <br />
<br />
catuṣpalaṁ tugākṣīryāścūrṇitaṁ tatra dāpayēt| <br />
lēhayēt kāsahr̥drōgaśvāsagulmanivāraṇam||56|| <br />
<br />
iti citrakādilēhaḥ|<br />
<br />
citrakaM pippalImUlaM vyoShaM hi~ggu durAlabhAm| <br />
shaTIM puShkaramUlaM ca shreyasIM surasAM vacAm||53|| <br />
<br />
bhArgIM chinnaruhAM rAsnAM shRu~ggIM drAkShAM ca kArShikAn| <br />
kalkAnardhatulAkvAthe nidigdhyAH palaviMshatim [1] ||54|| <br />
<br />
dattvA matsyaNDikAyAshca ghRutAcca kuDavaM pacet| <br />
siddhaM shItaM pRuthak kShaudrapippalIkuDavAnvitam||55|| <br />
<br />
catuShpalaM tugAkShIryAshcUrNitaM tatra dApayet| <br />
lehayet kAsahRudrogashvAsagulmanivAraNam||56|| <br />
<br />
iti citrakAdilehaH| <br />
</div></div><br />
<br />
In half ''tula'' of the decoction of ''nidigdhika''(Solanum xanthocarpum), the powder or paste of one ''karsha'' of each of ''chitraka, pippalimula, vyosha, hingu, duralabha, shati, pushkaramoola, shreyasi, surasa, vacha, bharangi, chinnaruha, rasna, shringi, draksha'' should be added. To this twenty ''palas'' of ''matsyandika'' and one ''kudava'' of ''ghrita'' should be added and cooked, There after when it becomes cool, one ''kudava'' of each of ''madhu, pippali'' powder, four ''palas'' of the powder of ''tugakshiri'' should be added. This ''leha'' will cure ''kasa, hridroga, shwasa, gulma''.<br />
<br />
Thus ends the description of ''chitrakadi leha''.[53-56]<br />
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==== Agastya haritaki ====<br />
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दशमूलीं स्वयङ्गुप्तां शङ्खपुष्पीं शटीं बलाम् | <br />
हस्तिपिप्पल्यपामार्गपिप्पलीमूलचित्रकान् ||५७|| <br />
<br />
भार्गीं पुष्करमूलं च द्विपलांशं यवाढकम् | <br />
हरीतकीशतं चैकं जले पञ्चाढके पचेत् ||५८|| <br />
<br />
यवैः स्विन्नैः कषायं तं पूतं तच्चाभयाशतम् | <br />
पचेद्गुडतुलां दत्त्वा कुडवं च पृथग्घृतात् ||५९|| <br />
<br />
तैलात् सपिप्पलीचूर्णात् सिद्धशीते च माक्षिकात् | <br />
लिह्याद्द्वे चाभये नित्यमतः खादेद्रसायनात् ||६०|| <br />
<br />
तद्वलीपलितं हन्ति वर्णायुर्बलवर्धनम् | <br />
पञ्चकासान् क्षयं श्वासं हिक्कां च विषमज्वरम् ||६१||<br />
<br />
हन्यात्तथाऽर्शोग्रहणीहृद्रोगारुचिपीनसान् | <br />
अगस्त्यविहितं श्रेष्ठं रसायनमिदं शुभम् ||६२|| <br />
<br />
इत्यगस्त्यहरीतकी | <br />
<div class="mw-collapsible-content"><br />
<br />
daśamūlīṁ svayaṅguptāṁ śaṅkhapuṣpīṁ śaṭīṁ balām| <br />
hastipippalyapāmārgapippalīmūlacitrakān||57|| <br />
<br />
bhārgīṁ puṣkaramūlaṁ ca dvipalāṁśaṁ yavāḍhakam| <br />
harītakīśataṁ caikaṁ jalē pañcāḍhakē pacēt||58||<br />
<br />
yavaiḥ svinnaiḥ kaṣāyaṁ taṁ pūtaṁ taccābhayāśatam| <br />
pacēdguḍatulāṁ dattvā kuḍavaṁ ca pr̥thagghr̥tāt||59|| <br />
<br />
tailāt sapippalīcūrṇāt siddhaśītē ca mākṣikāt| <br />
lihyāddvē cābhayē nityamataḥ khādēdrasāyanāt||60|| <br />
<br />
tadvalīpalitaṁ hanti varṇāyurbalavardhanam| <br />
pañcakāsān kṣayaṁ śvāsaṁ hikkāṁ ca viṣamajvaram||61|| <br />
<br />
hanyāttathā'rśōgrahaṇīhr̥drōgārucipīnasān| <br />
agastyavihitaṁ śrēṣṭhaṁ rasāyanamidaṁ śubham||62|| <br />
<br />
ityagastyaharītakī| <br />
dashamUlIM svaya~gguptAM sha~gkhapuShpIM shaTIM balAm| <br />
hastipippalyapAmArgapippalImUlacitrakAn||57|| <br />
<br />
bhArgIM puShkaramUlaM ca dvipalAMshaM yavADhakam| <br />
harItakIshataM caikaM jale pa~jcADhake pacet||58|| <br />
<br />
yavaiH svinnaiH kaShAyaM taM pUtaM taccAbhayAshatam| <br />
pacedguDatulAM dattvA kuDavaM ca pRuthagghRutAt||59|| <br />
<br />
tailAt sapippalIcUrNAt siddhashIte ca mAkShikAt| <br />
lihyAddve cAbhaye nityamataH khAdedrasAyanAt||60|| <br />
<br />
tadvalIpalitaM hanti varNAyurbalavardhanam| <br />
pa~jcakAsAn kShayaM shvAsaM hikkAM ca viShamajvaram||61|| <br />
<br />
hanyAttathA~arshograhaNIhRudrogArucipInasAn| <br />
agastyavihitaM shreShThaM rasAyanamidaM shubham||62|| <br />
ityagastyaharItakI| <br />
</div></div><br />
<br />
Two palas of each among ''dashamoola, swayamgupta, shankahpushpi, shati, bala, hasti pippali, apamarga, pippalimoola, chitraka, bharangi, pushkaramoola'' should be added with one ''adhaka'' of water, these drugs should be cooked till the grains of ''yava'' becomes soft. And then decoction should be strained out. These hundred fruits of ''abhaya'' should be added with above mentioned decoction, one ''tula'' of ''guda'', one ''kudava'' of ''ghrita, taila'' and powder of ''pippali''. This is to be cooked and after attaining coldness one ''kudava'' of ''makshika'' is to be added. <br />
<br />
Intake of two fruits of ''haritaki'' along with ''leha'' daily is considered as [[rasayana]]. It removes ''vali, palita''; increases [[varna]], [[ayu]] and [[bala]]. Beneficial in ''panchakasa, kshaya, shwaasa, hikka, vishamajwara, arshas, grahani, hridroga, aruchi, pinasa''. This excellent formulation is propounded by Agastya and is auspicious.<br />
<br />
Thus, ends the description of ''Agastya-haritaki''.[57-62]<br />
<br />
==== Other formulations ====<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
सैन्धवं पिप्पलीं भार्गीं शृङ्गवेरं दुरालभाम् | <br />
दाडिमाम्लेन कोष्णेन भार्गीनागरमम्बुना ||६३|| <br />
<br />
पिबेत् खदिरसारं वा मदिरादधिमस्तुभिः | <br />
अथवा पिप्पलीकल्कं घृतभृष्टं ससैन्धवम् ||६४|| <br />
<div class="mw-collapsible-content"><br />
<br />
saindhavaṁ pippalīṁ bhārgīṁ śr̥ṅgavēraṁ durālabhām| <br />
dāḍimāmlēna kōṣṇēna bhārgīnāgaramambunā||63||<br />
<br />
pibēt khadirasāraṁ [1] vā madirādadhimastubhiḥ| <br />
athavā pippalīkalkaṁ ghr̥tabhr̥ṣṭaṁ sasaindhavam||64||<br />
<br />
saindhavaM pippalIM bhArgIM shRu~ggaveraM durAlabhAm| <br />
dADimAmlena koShNena bhArgInAgaramambunA||63||<br />
<br />
pibet khadirasAraM [1] vA madirAdadhimastubhiH| <br />
athavA pippalIkalkaM ghRutabhRuShTaM sasaindhavam||64|| <br />
</div></div><br />
<br />
Intake of the powder of ''saindhava, pippali, bharangi, shringavera'' and ''duralabha'' along with lukewarm juice of sour ''dadima'' or the decoction of ''nagara'' cures [[vata]]ja kasa. <br />
<br />
Intake of ''khadira saara'' along with ''madira'' or ''takra''; intake of ''pippali'' fried with ''ghrita'' mixed with ''saindhava'' is beneficial in [[vata]]ja kasa. [63-64]<br />
<br />
==== [[Dhumapana]] (medicated smoke inhalation) formulations ====<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
शिरसः पीडने स्रावे नासाया हृदि ताम्यति | <br />
कासप्रतिश्यायवतां धूमं वैद्यः प्रयोजयेत् ||६५|| <br />
<br />
दशाङ्गुलोन्मितां नाडीमथवाऽष्टाङ्गुलोन्मिताम् | <br />
शरावसम्पुटच्छिद्रे कृत्वा जिह्मां विचक्षणः ||६६|| <br />
<br />
वैरेचनं मुखेनैव कासवान् धूममापिबेत् | <br />
तमुरः केवलं प्राप्तं मुखेनैवोद्वमेत् पुनः ||६७|| <br />
<br />
स ह्यस्य तैक्ष्ण्याद्विच्छिद्य श्लेष्माणमुरसि स्थितम् | <br />
निष्कृष्य शमयेत् कासं वातश्लेष्मसमुद्भवम् ||६८|| <br />
<div class="mw-collapsible-content"><br />
<br />
śirasaḥ pīḍanē srāvē nāsāyā hr̥di tāmyati| <br />
kāsapratiśyāyavatāṁ dhūmaṁ vaidyaḥ prayōjayēt||65|| <br />
<br />
daśāṅgulōnmitāṁ nāḍīmathavā'ṣṭāṅgulōnmitām| <br />
śarāvasampuṭacchidrē kr̥tvā jihmāṁ vicakṣaṇaḥ||66|| <br />
<br />
vairēcanaṁ mukhēnaiva kāsavān dhūmamāpibēt| <br />
tamuraḥ kēvalaṁ prāptaṁ mukhēnaivōdvamēt punaḥ||67|| <br />
<br />
sa hyasya taikṣṇyādvicchidya ślēṣmāṇamurasi sthitam| <br />
niṣkr̥ṣya śamayēt kāsaṁ vātaślēṣmasamudbhavam||68||<br />
<br />
shirasaH pIDane srAve nAsAyA hRudi tAmyati| <br />
kAsapratishyAyavatAM dhUmaM vaidyaH prayojayet||65|| <br />
<br />
dashA~ggulonmitAM nADImathavA~aShTA~ggulonmitAm| <br />
sharAvasampuTacchidre kRutvA jihmAM vicakShaNaH||66|| <br />
<br />
vairecanaM mukhenaiva kAsavAn dhUmamApibet| <br />
tamuraH kevalaM prAptaM mukhenaivodvamet punaH||67|| <br />
<br />
sa hyasya taikShNyAdvicchidya shleShmANamurasi sthitam| <br />
niShkRuShya shamayet kAsaM vAtashleShmasamudbhavam||68|| <br />
</div></div><br />
<br />
If there is pain in the ''shiras, nasa srava, arrhythmia'' of ''hridaya'' and ''pratishyaya'' in ''kasa'' then the physician should administer ''dhuma''. A wise physician should keep the ingredients of the recipe which cause elimination of [[dosha]] from the head inside two earthen plates with their brims sealed with mud-smeared cloth. In the upper plate there should be a hole to which a tube, ten or eight ''angulas'' in length, should be inserted in slightly curved form. The patient suffering from ''kasa'' should smoke the fume emanating from this tube through his mouth. After the smoke pervades the entire chest, it should be smoked out through the mouth. Because of the sharpness of the ingredients used in this recipe, the phlegm located in the chest gets detached and forcibly thrown out as a result of which ''kasa'' caused by [[vayu]] and [[kapha]] gets alleviated. [65-68]<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
मनःशिलालमधुकमांसीमुस्तेङ्गुदैः पिबेत् | <br />
धूमं तस्यानु च क्षीरं सुखोष्णं सगुडं पिबेत् ||६९|| <br />
<br />
एष कासान् पृथग्दोषसन्निपातसमुद्भवान् | <br />
धूमो हन्यादसंसिद्धानन्यैर्योगशतैरपि ||७०|| <br />
<br />
प्रपौण्डरीकं मधुकं शार्ङ्गेष्टां समनःशिलाम् | <br />
मरिचं पिप्पलीं द्राक्षामेलां सुरसमञ्जरीम् ||७१|| <br />
<br />
कृत्वा वर्तिं पिबेद्धूमं क्षौमचेलानुवर्तिताम् | <br />
घृताक्तामनु च क्षीरं गुडोदकमथापि वा ||७२|| <br />
<br />
मनःशिलैलामरिचक्षाराञ्जनकुटन्नटैः | <br />
वंशलेखनसेव्यालक्षौमलक्तकरोहिषैः ||७३|| <br />
<br />
पूर्वकल्पेन धूमोऽयं सानुपानो विधीयते | <br />
मनःशिलाले तद्वच्च पिप्पलीनागरैः सह ||७४|| <br />
<br />
त्वगैङ्गुदी बृहत्यौ द्वे तालमूली मनःशिला | <br />
कार्पासास्थ्यश्वगन्धा च धूमः कासविनाशनः ||७५||<br />
<div class="mw-collapsible-content"><br />
<br />
manaḥśilālamadhukamāṁsīmustēṅgudaiḥ pibēt| <br />
dhūmaṁ tasyānu ca kṣīraṁ sukhōṣṇaṁ saguḍaṁ pibēt||69|| <br />
<br />
ēṣa kāsān pr̥thagdōṣasannipātasamudbhavān| <br />
dhūmō hanyādasaṁsiddhānanyairyōgaśatairapi||70|| <br />
<br />
prapauṇḍarīkaṁ madhukaṁ śārṅgēṣṭāṁ samanaḥśilām| <br />
maricaṁ pippalīṁ drākṣāmēlāṁ surasamañjarīm||71|| <br />
<br />
kr̥tvā vartiṁ pibēddhūmaṁ kṣaumacēlānuvartitām| <br />
ghr̥tāktāmanu ca kṣīraṁ guḍōdakamathāpi vā||72|| <br />
<br />
manaḥśilailāmaricakṣārāñjanakuṭannaṭaiḥ| <br />
vaṁśalēkhanasēvyālakṣaumalaktakarōhiṣaiḥ [1] ||73|| <br />
<br />
pūrvakalpēna dhūmō'yaṁ sānupānō vidhīyatē| <br />
manaḥśilālē tadvacca pippalīnāgaraiḥ saha||74|| <br />
<br />
tvagaiṅgudī br̥hatyau dvē tālamūlī manaḥśilā| <br />
kārpāsāsthyaśvagandhā ca dhūmaḥ kāsavināśanaḥ||75||<br />
<br />
manaHshilAlamadhukamAMsImuste~ggudaiH pibet| <br />
dhUmaM tasyAnu ca kShIraM sukhoShNaM saguDaM pibet||69||<br />
<br />
eSha kAsAn pRuthagdoShasannipAtasamudbhavAn| <br />
dhUmo hanyAdasaMsiddhAnanyairyogashatairapi||70|| <br />
<br />
prapauNDarIkaM madhukaM shAr~ggeShTAM samanaHshilAm| <br />
maricaM pippalIM drAkShAmelAM surasama~jjarIm||71|| <br />
<br />
kRutvA vartiM pibeddhUmaM kShaumacelAnuvartitAm| <br />
ghRutAktAmanu ca kShIraM guDodakamathApi vA||72|| <br />
<br />
manaHshilailAmaricakShArA~jjanakuTannaTaiH| <br />
vaMshalekhanasevyAlakShaumalaktakarohiShaiH [1] ||73|| <br />
<br />
pUrvakalpena dhUmo~ayaM sAnupAno vidhIyate| <br />
manaHshilAle tadvacca pippalInAgaraiH saha||74|| <br />
<br />
tvagai~ggudI bRuhatyau dve tAlamUlI manaHshilA| <br />
kArpAsAsthyashvagandhA ca dhUmaH kAsavinAshanaH||75|| <br />
</div></div><br />
<br />
Intake of lukewarm milk along with guda after the ''dhumapana'' using ''manahshila, ala''(''haritala''), ''madhuka, jatamansi, ingudi'' cures ''kasa'' of ''prthakdosha'' (three [[dosha]] individually) or ''sannipatika''. This can cure such ailments which were not cured even after the treatment with hundred other recipes.<br />
<br />
The paste prepared out of ''prapoundarika, madhuka, sharangeshta, manhashila, maricha, pippali, draksha, ela'' and ''surasa manjari''(inflorescence of Ocimum sanctum), should be smeared on silk cloth and a ''varti'' should be prepared. This ''varti'' smeared with ''ghrita'' should be used for ''dhumapana'', followed by intake of milk or jaggery mixed with water cures both ''ekadoshaja'' and ''sannipatika kasa''.<br />
<br />
''Dhuma varti'' prepared out of ''manahshila, ela, maricha, kshara, anjana, kutannata, vamshalekhana, sevya, ala, kshouma, alakthaka, rohisha'' as per earlier mentioned procedure and should be administered along with prior said ''anupana'', in ''kasa''. <br />
<br />
Similarly ''dhumavarti'' can be prepared out of ''manahshila, ala, pippali'' and ''nagara''.<br />
<br />
''Dhuma'' therapy using bark of ''ingudi, brihati, kantakari, talamuli, manahshila, karpasasthi'' (Seeds of ''karpasa''), ''ashwagandha'' cures ''kasa''. [69-75]<br />
<br />
=== Diet recipes ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
ग्राम्यानूपौदकैः शालियवगोधूमषष्टिकान् | <br />
रसैर्माषात्मगुप्तानां यूषैर्वा भोजयेद्धितान् ||७६|| <br />
<br />
यवानीपिप्पलीबिल्वमध्यनागरचित्रकैः | <br />
रास्नाजाजीपृथक्पर्णीपलाशशटिपौष्करैः ||७७|| <br />
<br />
स्निग्धाम्ललवणां सिद्धां पेयामनिलजे पिबेत् | <br />
कटीहृत्पार्श्वकोष्ठार्तिश्वासहिक्काप्रणाशिनीम् ||७८|| <br />
<br />
दशमूलरसे तद्वत्पञ्चकोलगुडान्विताम् | <br />
सिद्धां समतिलां दद्यात्क्षीरे वाऽपि ससैन्धवाम् ||७९||<br />
<br />
मात्स्यकौक्कुटवाराहैरामिषैर्वा घृतान्विताम् | <br />
सिद्धां ससैन्धवां पेयां वातकासी पिबेन्नरः ||८०|| <br />
<br />
वास्तुको वायसीशाकं मूलकं सुनिषण्णकम् | <br />
स्नेहास्तैलादयो भक्ष्याः क्षीरेक्षुरसगौडिकाः ||८१|| <br />
<br />
दध्यारनालाम्लफलप्रसन्नापानमेव च | <br />
शस्यते वातकासे तु स्वाद्वम्ललवणानि च ||८२|| <br />
<br />
इति वातकासचिकित्सा | <br />
<div class="mw-collapsible-content"><br />
<br />
grāmyānūpaudakaiḥ śāliyavagōdhūmaṣaṣṭikān| <br />
rasairmāṣātmaguptānāṁ yūṣairvā bhōjayēddhitān||76|| <br />
<br />
yavānīpippalībilvamadhyanāgaracitrakaiḥ| <br />
rāsnājājīpr̥thakparṇīpalāśaśaṭipauṣkaraiḥ||77|| <br />
<br />
snigdhāmlalavaṇāṁ siddhāṁ pēyāmanilajē pibēt| <br />
kaṭīhr̥tpārśvakōṣṭhārtiśvāsahikkāpraṇāśinīm||78|| <br />
<br />
daśamūlarasē tadvatpañcakōlaguḍānvitām| <br />
siddhāṁ samatilāṁ dadyātkṣīrē vā'pi sasaindhavām||79|| <br />
<br />
mātsyakaukkuṭavārāhairāmiṣairvā ghr̥tānvitām| <br />
siddhāṁ [1] sasaindhavāṁ pēyāṁ vātakāsī pibēnnaraḥ||80|| <br />
<br />
vāstukō vāyasīśākaṁ mūlakaṁ suniṣaṇṇakam| <br />
snēhāstailādayō bhakṣyāḥ kṣīrēkṣurasagauḍikāḥ||81|| <br />
<br />
dadhyāranālāmlaphalaprasannāpānamēva ca| <br />
śasyatē vātakāsē tu svādvamlalavaṇāni ca||82|| <br />
<br />
iti vātakāsacikitsā| <br />
<br />
grAmyAnUpaudakaiH shAliyavagodhUmaShaShTikAn| <br />
rasairmAShAtmaguptAnAM yUShairvA bhojayeddhitAn||76|| <br />
<br />
yavAnIpippalIbilvamadhyanAgaracitrakaiH| <br />
rAsnAjAjIpRuthakparNIpalAshashaTipauShkaraiH||77|| <br />
<br />
snigdhAmlalavaNAM siddhAM peyAmanilaje pibet| <br />
kaTIhRutpArshvakoShThArtishvAsahikkApraNAshinIm||78|| <br />
<br />
dashamUlarase tadvatpa~jcakolaguDAnvitAm| <br />
siddhAM samatilAM dadyAtkShIre vA~api sasaindhavAm||79|| <br />
<br />
mAtsyakaukkuTavArAhairAmiShairvA ghRutAnvitAm| <br />
siddhAM [1] sasaindhavAM peyAM vAtakAsI pibennaraH||80|| <br />
<br />
vAstuko vAyasIshAkaM mUlakaM suniShaNNakam| <br />
snehAstailAdayo bhakShyAH kShIrekShurasagauDikAH||81|| <br />
<br />
dadhyAranAlAmlaphalaprasannApAnameva ca| <br />
shasyate vAtakAse tu svAdvamlalavaNAni ca||82|| <br />
<br />
iti vAtakAsacikitsA| <br />
</div></div><br />
<br />
Intake of ''shashtikashali, shali, yava, godhuma'' along with the ''mamsa rasa'' or ''yusha'' prepared out of ''masha'' or ''Atmagupta'' is beneficial in ''vataja kasa. Peya'' prepared out of ''yavani, pippali, bilwa, nagara, chitraka, rasna, ajaji, prithakparni, palasha, shati'' and ''pushkaramoola'' by adding ''snigdha, amla'' and ''lavana dravyas'' is beneficial in ''vataja kasa''. This particular ''peya'' is helpful in curing ''vataja kasa'' associated with ''shoola'' in ''kati, parshwa, koshta, hikka'' and ''shwasa''.<br />
<br />
Intake of ''peya'' prepared with ''dashamoola kashaya'' by adding the powder of ''panchakola'' and ''gud'' is specifically useful in [[vata]]ja kasa. Similarly the ''peya'' prepared by adding equal quantity of ''tila'' and boiled by adding ''ksheera'' is also useful in this ''kasa''. <br />
<br />
''Peya'' prepared out of ''matsya, kukkuta, varaha mamsa'' by adding ''ghrita'' and ''saindhava lavana'' should be taken by a person suffering from ''vataja kasa''. Vegetables like ''vastuka, vayasi, mulaka, sunishannaka'' should be used in ''vataja kasa'' along with adequate quantity of ''sneha, kshera, ikshurasa'' and ''gud''. ''Aranala, amla phala, prasanna'' etc foods and drinks which are ''madhura, amla, lavana'' in nature are useful in ''vataja kasa''.[76-82]<br />
<br />
=== Management of [[pitta]] [[dosha]] dominant kasa ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
पैत्तिके सकफे कासे वमनं सर्पिषा हितम् | <br />
तथा मदनकाश्मर्यमधुकक्वथितैर्जलैः ||८३|| <br />
<br />
यष्ट्याह्वफलकल्कैर्वा विदारीक्षुरसायुतैः | <br />
हृतदोषस्ततः शीतं मधुरं च क्रमं भजेत् ||८४|| <br />
<br />
पैत्ते तनुकफे कासे त्रिवृतां मधुरैर्युताम् | <br />
दद्याद्घनकफे तिक्तैर्विरेकार्थे युतां भिषक् ||८५|| <br />
<br />
स्निग्धशीतस्तनुकफे रूक्षशीतः कफे घने | <br />
क्रमः कार्यः परं भोज्यैः स्नेहैर्लेहैश्च शस्यते ||८६|| <br />
<br />
शृङ्गाटकं पद्मबीजं नीलीसाराणि पिप्पली | <br />
पिप्पलीमुस्तयष्ट्याह्वद्राक्षामूर्वामहौषधम् ||८७||<br />
<br />
लाजाऽमृतफला द्राक्षा त्वक्क्षीरी पिप्पली सिता | <br />
पिप्पलीपद्मकद्राक्षा बृहत्याश्च फलाद्रसः ||८८|| <br />
<br />
खर्जूरं पिप्पली वांशी श्वदंष्ट्रा चेति पञ्च ते | <br />
घृतक्षौद्रयुता लेहाः श्लोकार्धैः पित्तकासिनाम् ||८९|| <br />
<br />
शर्कराचन्दनद्राक्षामधुधात्रीफलोत्पलैः | <br />
पैत्ते, समुस्तमरिचः सकफे, सघृतोऽनिले ||९०|| <br />
<br />
मृद्वीकार्धशतं त्रिंशत्पिप्पलीः शर्करापलम् | <br />
लेहयेन्मधुना गोर्वा क्षीरपं च शकृद्रसम् ||९१|| <br />
<br />
त्वगेलाव्योषमृद्वीकापिप्पलीमूलपौष्करैः | <br />
लाजामुस्तशटीरास्नाधात्रीफलबिभीतकैः ||९२|| <br />
<br />
शर्कराक्षौद्रसर्पिर्भिर्लेहः कासविनाशनः | <br />
श्वासं हिक्कां क्षयं चैव हृद्रोगं च प्रणाशयेत् ||९३|| <br />
<br />
पिप्पल्यामलकं द्राक्षां लाक्षां लाजां सितोपलाम् | <br />
क्षीरे पक्त्वा घनं शीतं लिह्यात् क्षौद्राष्टभागिकम् ||९४|| <br />
<br />
विदारीक्षुमृणालानां रसान् क्षीरं सितोपलाम् | <br />
पिबेद्वा मधुसंयुक्तं पित्तकासहरं परम् ||९५|| <br />
<br />
मधुरैर्जाङ्गलरसैः श्यामाकयवकोद्रवाः | <br />
मुद्गादियूषैः शाकैश्च तिक्तकैर्मात्रया हिताः ||९६|| <br />
<br />
घनश्लेष्मणि लेहास्तु तिक्तका मधुसंयुताः | <br />
शालयः स्युस्तनुकफे षष्टिकाश्च रसादिभिः ||९७|| <br />
<br />
शर्कराम्भोऽनुपानार्थं द्राक्षेक्षूणां रसाः पयः | <br />
सर्वं च मधुरं शीतमविदाहि प्रशस्यते ||९८|| <br />
<br />
काकोलीबृहतीमेदायुग्मैः सवृषनागरैः | <br />
पित्तकासे रसान् क्षीरं यूषांश्चाप्युपकल्पयेत् ||९९|| <br />
<br />
शरादिपञ्चमूलस्य पिप्पलीद्राक्षयोस्तथा | <br />
कषायेण शृतं क्षीरं पिबेत् समधुशर्करम् ||१००|| <br />
<br />
स्थिरासितापृश्निपर्णीश्रावणीबृहतीयुगैः | <br />
जीवकर्षभकाकोलीतामलक्यृद्धिजीवकैः ||१०१|| <br />
<br />
शृतं पयः पिबेत् कासी ज्वरी दाही क्षतक्षयी | <br />
तज्जं वा साधयेत् सर्पिः सक्षीरेक्षुरसं भिषक् ||१०२|| <br />
<br />
जीवकाद्यैर्मधुरकैः फलैश्चाभिषुकादिभिः | <br />
कल्कैस्त्रिकार्षिकैः सिद्धे पूतशीते प्रदापयेत् ||१०३|| <br />
<br />
शर्करापिप्पलीचूर्णं त्वक्क्षीर्या मरिचस्य च | <br />
शृङ्गाटकस्य चावाप्य क्षौद्रगर्भान्पलोन्मितान् ||१०४|| <br />
<br />
गुडान् गोधूमचूर्णेन कृत्वा खादेद्धिताशनः | <br />
शुक्रासृग्दोषशोषेषु कासे क्षीणक्षतेषु च ||१०५|| <br />
<br />
शर्करानागरोदीच्यं कण्टकारीं शटीं समम् | <br />
पिष्ट्वा रसं पिबेत्पूतं वस्त्रेण घृतमूर्च्छितम् ||१०६|| <br />
<br />
महिष्यजाविगोक्षीरधात्रीफलरसैः समैः | <br />
सर्पिः सिद्धं पिबेद्युक्त्या पित्तकासनिबर्हणम् ||१०७|| <br />
<br />
इति पित्तकासचिकित्सा | <br />
<div class="mw-collapsible-content"><br />
<br />
paittikē sakaphē kāsē vamanaṁ sarpiṣā hitam| <br />
tathā madanakāśmaryamadhukakvathitairjalaiḥ||83|| <br />
<br />
yaṣṭyāhvaphalakalkairvā vidārīkṣurasāyutaiḥ| <br />
hr̥tadōṣastataḥ śītaṁ madhuraṁ ca kramaṁ bhajēt||84|| <br />
<br />
paittē tanukaphē kāsē trivr̥tāṁ madhurairyutām| <br />
dadyādghanakaphē tiktairvirēkārthē yutāṁ bhiṣak||85|| <br />
<br />
snigdhaśītastanukaphē rūkṣaśītaḥ kaphē ghanē| <br />
kramaḥ kāryaḥ paraṁ bhōjyaiḥ snēhairlēhaiśca śasyatē||86|| <br />
<br />
śr̥ṅgāṭakaṁ padmabījaṁ nīlīsārāṇi pippalī| <br />
pippalīmustayaṣṭyāhvadrākṣāmūrvāmahauṣadham||87|| <br />
<br />
lājā'mr̥taphalā drākṣā tvakkṣīrī pippalī sitā| <br />
pippalīpadmakadrākṣā br̥hatyāśca phalādrasaḥ||88|| <br />
<br />
kharjūraṁ pippalī vāṁśī śvadaṁṣṭrā cēti pañca tē| <br />
ghr̥takṣaudrayutā lēhāḥ ślōkārdhaiḥ pittakāsinām||89|| <br />
<br />
śarkarācandanadrākṣāmadhudhātrīphalōtpalaiḥ| <br />
paittē, samustamaricaḥ sakaphē, saghr̥tō'nilē||90|| <br />
<br />
mr̥dvīkārdhaśataṁ triṁśatpippalīḥ śarkarāpalam| <br />
lēhayēnmadhunā gōrvā kṣīrapaṁ [1] ca śakr̥drasam||91|| <br />
<br />
tvagēlāvyōṣamr̥dvīkāpippalīmūlapauṣkaraiḥ| <br />
lājāmustaśaṭīrāsnādhātrīphalabibhītakaiḥ||92|| <br />
<br />
śarkarākṣaudrasarpirbhirlēhaḥ kāsavināśanaḥ| <br />
śvāsaṁ hikkāṁ kṣayaṁ caiva hr̥drōgaṁ ca praṇāśayēt||93|| <br />
<br />
pippalyāmalakaṁ drākṣāṁ lākṣāṁ lājāṁ sitōpalām| <br />
kṣīrē paktvā ghanaṁ śītaṁ lihyāt kṣaudrāṣṭabhāgikam||94|| <br />
<br />
vidārīkṣumr̥ṇālānāṁ rasān kṣīraṁ sitōpalām| <br />
pibēdvā madhusaṁyuktaṁ pittakāsaharaṁ param||95|| <br />
<br />
madhurairjāṅgalarasaiḥ śyāmākayavakōdravāḥ| <br />
mudgādiyūṣaiḥ śākaiśca tiktakairmātrayā hitāḥ||96|| <br />
<br />
ghanaślēṣmaṇi lēhāstu tiktakā madhusaṁyutāḥ| <br />
śālayaḥ syustanukaphē ṣaṣṭikāśca rasādibhiḥ||97|| <br />
<br />
śarkarāmbhō'nupānārthaṁ drākṣēkṣūṇāṁ rasāḥ payaḥ| <br />
sarvaṁ ca madhuraṁ śītamavidāhi praśasyatē||98|| <br />
<br />
kākōlībr̥hatīmēdāyugmaiḥ savr̥ṣanāgaraiḥ| <br />
pittakāsē rasān kṣīraṁ yūṣāṁścāpyupakalpayēt||99|| <br />
<br />
śarādipañcamūlasya pippalīdrākṣayōstathā| <br />
kaṣāyēṇa śr̥taṁ kṣīraṁ pibēt samadhuśarkaram||100|| <br />
<br />
sthirāsitāpr̥śniparṇīśrāvaṇībr̥hatīyugaiḥ| <br />
jīvakarṣabhakākōlītāmalakyr̥ddhijīvakaiḥ||101|| <br />
<br />
śr̥taṁ payaḥ pibēt kāsī jvarī dāhī kṣatakṣayī| <br />
tajjaṁ vā sādhayēt sarpiḥ sakṣīrēkṣurasaṁ bhiṣak||102|| <br />
<br />
jīvakādyairmadhurakaiḥ phalaiścābhiṣukādibhiḥ| <br />
kalkaistrikārṣikaiḥ siddhē pūtaśītē pradāpayēt||103|| <br />
<br />
śarkarāpippalīcūrṇaṁ tvakkṣīryā maricasya ca| <br />
śr̥ṅgāṭakasya cāvāpya kṣaudragarbhānpalōnmitān||104|| <br />
<br />
guḍān gōdhūmacūrṇēna kr̥tvā khādēddhitāśanaḥ| <br />
śukrāsr̥gdōṣaśōṣēṣu kāsē kṣīṇakṣatēṣu ca||105|| <br />
<br />
śarkarānāgarōdīcyaṁ kaṇṭakārīṁ śaṭīṁ samam| <br />
piṣṭvā rasaṁ pibētpūtaṁ vastrēṇa ghr̥tamūrcchitam||106|| <br />
<br />
mahiṣyajāvigōkṣīradhātrīphalarasaiḥ samaiḥ| <br />
sarpiḥ siddhaṁ pibēdyuktyā pittakāsanibarhaṇam||107|| <br />
<br />
iti pittakāsacikitsā| <br />
<br />
paittike sakaphe kAse vamanaM sarpiShA hitam| <br />
tathA madanakAshmaryamadhukakvathitairjalaiH||83|| <br />
<br />
yaShTyAhvaphalakalkairvA vidArIkShurasAyutaiH| <br />
hRutadoShastataH shItaM madhuraM ca kramaM bhajet||84|| <br />
<br />
paitte tanukaphe kAse trivRutAM madhurairyutAm| <br />
dadyAdghanakaphe tiktairvirekArthe yutAM bhiShak||85|| <br />
<br />
snigdhashItastanukaphe rUkShashItaH kaphe ghane| <br />
kramaH kAryaH paraM bhojyaiH snehairlehaishca shasyate||86|| <br />
<br />
shRu~ggATakaM padmabIjaM nIlIsArANi pippalI| <br />
pippalImustayaShTyAhvadrAkShAmUrvAmahauShadham||87|| <br />
<br />
lAjA~amRutaphalA drAkShA tvakkShIrI pippalI sitA| <br />
pippalIpadmakadrAkShA bRuhatyAshca phalAdrasaH||88|| <br />
<br />
kharjUraM pippalI vAMshI shvadaMShTrA ceti pa~jca te| <br />
ghRutakShaudrayutA lehAH shlokArdhaiH pittakAsinAm||89|| <br />
<br />
sharkarAcandanadrAkShAmadhudhAtrIphalotpalaiH| <br />
paitte, samustamaricaH sakaphe, saghRuto~anile||90|| <br />
<br />
mRudvIkArdhashataM triMshatpippalIH sharkarApalam| <br />
lehayenmadhunA gorvA kShIrapaM [1] ca shakRudrasam||91|| <br />
<br />
tvagelAvyoShamRudvIkApippalImUlapauShkaraiH| <br />
lAjAmustashaTIrAsnAdhAtrIphalabibhItakaiH||92|| <br />
<br />
sharkarAkShaudrasarpirbhirlehaH kAsavinAshanaH| <br />
shvAsaM hikkAM kShayaM caiva hRudrogaM ca praNAshayet||93|| <br />
<br />
pippalyAmalakaM drAkShAM lAkShAM lAjAM sitopalAm| <br />
kShIre paktvA ghanaM shItaM lihyAt kShaudrAShTabhAgikam||94|| <br />
<br />
vidArIkShumRuNAlAnAM rasAn kShIraM sitopalAm| <br />
pibedvA madhusaMyuktaM pittakAsaharaM param||95|| <br />
<br />
madhurairjA~ggalarasaiH shyAmAkayavakodravAH| <br />
mudgAdiyUShaiH shAkaishca tiktakairmAtrayA hitAH||96|| <br />
<br />
ghanashleShmaNi lehAstu tiktakA madhusaMyutAH| <br />
shAlayaH syustanukaphe ShaShTikAshca rasAdibhiH||97|| <br />
<br />
sharkarAmbho~anupAnArthaM drAkShekShUNAM rasAH payaH| <br />
sarvaM ca madhuraM shItamavidAhi prashasyate||98|| <br />
<br />
kAkolIbRuhatImedAyugmaiH savRuShanAgaraiH| <br />
pittakAse rasAn kShIraM yUShAMshcApyupakalpayet||99|| <br />
<br />
sharAdipa~jcamUlasya pippalIdrAkShayostathA| <br />
kaShAyeNa shRutaM kShIraM pibet samadhusharkaram||100|| <br />
<br />
sthirAsitApRushniparNIshrAvaNIbRuhatIyugaiH| <br />
jIvakarShabhakAkolItAmalakyRuddhijIvakaiH||101|| <br />
<br />
shRutaM payaH pibet kAsI jvarI dAhI kShatakShayI| <br />
tajjaM vA sAdhayet sarpiH sakShIrekShurasaM bhiShak||102|| <br />
<br />
jIvakAdyairmadhurakaiH phalaishcAbhiShukAdibhiH| <br />
kalkaistrikArShikaiH siddhe pUtashIte pradApayet||103|| <br />
<br />
sharkarApippalIcUrNaM tvakkShIryA maricasya ca| <br />
shRu~ggATakasya cAvApya kShaudragarbhAnpalonmitAn||104|| <br />
<br />
guDAn godhUmacUrNena kRutvA khAdeddhitAshanaH| <br />
shukrAsRugdoShashoSheShu kAse kShINakShateShu ca||105|| <br />
<br />
sharkarAnAgarodIcyaM kaNTakArIM shaTIM samam| <br />
piShTvA rasaM pibetpUtaM vastreNa ghRutamUrcchitam||106|| <br />
<br />
mahiShyajAvigokShIradhAtrIphalarasaiH samaiH| <br />
sarpiH siddhaM pibedyuktyA pittakAsanibarhaNam||107|| <br />
iti pittakAsacikitsA| <br />
</div></div><br />
<br />
If [[pitta]]ja kasa is associated with the aggravation of [[kapha]], then [[vamana]] karma is to be advised with ''ghrita'' or using the ''kashaya'' prepared out of ''madana, kashmari, madhuka''. [[Vamana]] can also be induced by using the ''klaka'' of ''madanaphal'' and ''madhuyashti'' along with ''vidari'' and ''ikshurasa''. Once after the elimination of aggravated ''doshas'' he should be treated with ''sheeta'' and ''madhura aharas''.<br />
<br />
If in [[pitta]]ja kasa the phlegm is thin then [[virechana]] is to be advised using ''trivrita'' mixed with ''madhura dravyas'', followed by ''snigdha'' and ''sheeta ahara''. Whereas if the phlegm is thick then ''trivrita'' is to be mixed with ''tiktha dravyas'', followed by ''ruksha'' and ''sheeta dravyas''.<br />
<br />
After proper ''shodhana'' therapy person should be treated with ''snigdha leha kalpanas''.<br />
<br />
Following five formulations have been advised for [[pitta]]ja kasa along with ''ghrita'' and ''kshoudra'' and made into the form of ''leha'':<br />
#''Shringataka, padma beeja, sara'' of ''nili,'' and ''pippali''<br />
#''Pippali, musta, yashtimadhu, draksha, murva, mahoushadha''<br />
#''Laja, amritapahala, draksha, tavaksheeri, pippali, sita''<br />
#''Pippali, padmaka, draksha, brihati phalarasa''<br />
#''Kharjuara, pippali, vamshalochana, shwadamshtra''<br />
<br />
If ''kasa'' is exclusively of ''pitta'', then the patient should be given the combination of ''sharkara, chanadana, draksha, madhu, dhatriphala'' and ''utpala''. If there is association of [[kapha]], then he should administer this along with ''musta'' and ''maricha.'' If however, it is associated with [[vata]], then it should be used with ''ghrita''.<br />
<br />
Fifty fruits of ''mridvika,'' thirty fruits of ''pippali'' and one ''pala'' of sugar should be added with ''madhu'', and given to the patient suffering from ''pittaja kasa''.<br />
<br />
Administration of ''madhu'' either with cows milk or urine is beneficial in [[pitta]]ja kasa. But during this therapy patient should drink only milk. The ''leha'' prepared out of ''twak, ela, shunthi, pippali, maricha, mridvika, pippalimula, pushkaramula, laja, musta, shati, rasna, dhatriphala'' and ''bibhitaka'' along with ''sharkara, madhu'' and ''ghrita'' cures ''kasa, shwasa, hikka, kshaya, hridroga. Pippali, amalaki, draksha, lakshai, laja'' and ''sitopala'' should be cooked by adding milk. When it becomes cool , one eighth part of ''madhu'' should be added. This is indicated in ''kasa''. Intake of the liquid prepared out ''vidari, ikshu, mrinala, ksheera'' and ''sitopala'' mixed with ''madhu'' cures [[pitta]]ja kasa effectively. Intake of ''yusha'' prepared out of ''shyamaka, yavaka, kodrava, mudga'' along with sweet ''jangal mamsa rasa'' along with ''tiktha shaka'' is beneficial in ''pittaja kasa''. If the phlegm is thick then the patient should be administered with ''lehas'' prepared out of ''tiktha rasa dravyas'' along with ''madhu''. If the phlegm is thin, then the patient should be given with ''shali'' and ''shashtika shali'' along with ''mamsa rasa''.<br />
<br />
In this [[pitta]]ja kasa drink prepared out of ''sharkara, draksha, ikshurasa'' and milk are beneficial. All things which are ''madhura, sheeta'' and ''avidahi'' should be used.<br />
<br />
Dishes like ''mamsa rasa, ksheera, yusha'' etc prepared out of ''kakoli, brihati, meda, mahameda, vasa'' and ''nagara'' are to be used in [[pitta]]ja kasa. Similarly milk boiled with ''sharadi panchamoola''(Trinapanchamoola), ''pippali, draksha'' along with ''madhu'' and ''sharkara'' should be taken in [[pitta]]ja kasa. <br />
<br />
Milk boiled with ''sthira, sita, prashniparni, sharavani, brihati, kantakari, jivaka, rshabhaka, kakoli, tamalaki, rddhi'' and ''jivaka'' is useful in the treatment of ''kasa, jwara, daha, kshata'' and ''kshaya''. <br />
<br />
The ''ghrita'' collected from the above mentioned should be added with milk, ''ikshu rasa'' and the paste of three ''karsas'' of each of the ''madhura dravya'' belonging to ''jivaneeya'' group, fruits of ''abhishuka'' etc and cooked. The ''ghrita'' should then be filtered out and made to cool. To this the powder of ''sharkara, pippali, tvak-kshiri, maricha , shringatak'' and ''madhu'' should be added. This paste should be added with wheat-flour and ''gud'' (''sarpi gud'') should be prepared out of it. Intake of this cures ''shukra'' and ''asrig dosha, shosha, kasa , kshataksheena'' etc. <br />
<br />
Fine paste of ''sharkara, nagara, udeechya, kantakari, shati'' should be prepared and is to be filtered through a cloth. This liquid is to be used for the ''ghrita murchana''. This ''murchita ghrita'' cures [[pitta]]ja kasa.<br />
<br />
''Ghrita'' should be cooked with ''mahisha, aja'' and cows milk, along with ''dhatri phala rasa'', all taken in equal quantity. Intake of this ''ghrita'' in appropriate quantity cures [[pitta]]ja kasa.<br />
<br />
Thus ends the description of [[pitta]]ja kasa. [83-107]<br />
<br />
=== Management of [[kapha]] [[dosha]] dominant kasa ===<br />
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<br />
बलिनं वमनैरादौ शोधितं कफकासिनम् | <br />
यवान्नैः कटूरूक्षोष्णैः कफघ्नैश्चाप्युपाचरेत् ||१०८|| <br />
<br />
पिप्पलीक्षारिकैर्युषैः कौलत्थैर्मूलकस्य च | <br />
लघून्यन्नानि भुञ्जीत रसैर्वा कटुकान्वितैः ||१०९|| <br />
<br />
धान्वबैलरसैः स्नेहैस्तिलसर्षपबिल्वजैः | <br />
मध्वम्लोष्णाम्बुतक्रं वा मद्यं वा निगदं पिबेत् ||११०|| <br />
<br />
पौष्करारग्वधं मूलं पटोलं तैर्निशास्थितम् | <br />
जलं मधुयुतं पेयं कालेष्वन्नस्य वा त्रिषु ||१११||<br />
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<br />
balinaṁ vamanairādau śōdhitaṁ kaphakāsinam| <br />
yavānnaiḥ kaṭurūkṣōṣṇaiḥ kaphaghnaiścāpyupācarēt||108|| <br />
<br />
pippalīkṣārikairyūṣaiḥ kaulatthairmūlakasya ca| <br />
laghūnyannāni bhuñjīta rasairvā kaṭukānvitaiḥ||109|| <br />
<br />
dhānvabailarasaiḥ snēhaistilasarṣapabilvajaiḥ| <br />
madhvamlōṣṇāmbutakraṁ vā madyaṁ vā nigadaṁ pibēt||110|| <br />
<br />
pauṣkarāragvadhaṁ mūlaṁ paṭōlaṁ tairniśāsthitam| <br />
jalaṁ madhuyutaṁ pēyaṁ kālēṣvannasya vā triṣu||111|| <br />
<br />
balinaM vamanairAdau shodhitaM kaphakAsinam| <br />
yavAnnaiH kaTurUkShoShNaiH kaphaghnaishcApyupAcaret||108|| <br />
<br />
pippalIkShArikairyUShaiH kaulatthairmUlakasya ca| <br />
laghUnyannAni bhu~jjIta rasairvA kaTukAnvitaiH||109|| <br />
<br />
dhAnvabailarasaiH snehaistilasarShapabilvajaiH| <br />
madhvamloShNAmbutakraM vA madyaM vA nigadaM pibet||110|| <br />
<br />
pauShkarAragvadhaM mUlaM paTolaM tairnishAsthitam| <br />
jalaM madhuyutaM peyaM kAleShvannasya vA triShu||111|| <br />
</div></div><br />
<br />
If the person suffering from [[kapha]]ja kasa is strong, then he should follow ''shodhana'' procedure by means of [[vamana]]. There after he should be given with ''yava'' and such other [[kapha]]ghna food which are ''katu, ruksha'' and ''ushna'' in nature.<br />
<br />
The person should take ''laghu ahara'' with the ''yusha'' prepared out of ''kulattha, pippali, kshara, mulaka'' or with the ''mamsa rasa'' of animals of arid zone/ ''bilehsya'' etc. mixed with ''katu rasadravya, srashapataila'' and ''bilva''.<br />
<br />
Drinks such as ''madhu, amala rasa,'' warm water, butter milk or harmless ''madya'' are preferred in [[kapha]]ja kasa. Roots of ''pushkaramoola, argwadha, patola, tinisha'' should be kept in water for whole night. Next morning water should be strained out and added with ''madhu''. This should be taken before, during and after food. [108-111]<br />
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<br />
कट्फलं कत्तृणं भार्गीं मुस्तं धान्यं वचाभये | <br />
शुण्ठीं पर्पटकं शृङ्गीं सुराह्वं च शृतं जले ||११२|| <br />
<br />
मधुहिङ्गुयुतं पेयं कासे वातकफात्मके | <br />
कण्ठरोगे मुखे शूने श्वासहिक्काज्वरेषु च ||११३|| <br />
<br />
पाठां शुण्ठीं शटीं मूर्वां गवाक्षीं मुस्तपिप्पलीम् | <br />
पिष्ट्वा घर्माम्बुना हिङ्गुसैन्धवाभ्यां युतां पिबेत् ||११४|| <br />
<br />
नागरातिविषे मुस्तं शृङ्गीं कर्कटकस्य च | <br />
हरीतकीं शटीं चैव तेनैव विधिना पिबेत् ||११५|| <br />
<br />
तैलभृष्टं च पिप्पल्याः कल्काक्षं ससितोपलम् | <br />
पिबेद्वा श्लेष्मकासघ्नं कुलत्थरससंयुतम् ||११६|| <br />
<br />
कासमर्दाश्वविट्भृङ्गराजवार्ताकजो रसः | <br />
सक्षौद्रः कफकासघ्नः सुरसस्यासितस्य च ||११७|| <br />
<br />
देवदारु शटी रास्ना कर्कटाख्या दुरालभा | <br />
पिप्पली नागरं मुस्तं पथ्याधात्रीसितोपलाः ||११८|| <br />
<br />
मधुतैलयुतावेतौ लेहौ वातानुगे कफे | <br />
पिप्पली पिप्पलीमूलं चित्रको हस्तिपिप्पली ||११९|| <br />
<br />
पथ्या तामलकी धात्री भद्रमुस्ता च पिप्पली | <br />
देवदार्वभया मुस्तं पिप्पली विश्वभेषजम् ||१२०|| <br />
<br />
विशाला पिप्पली मुस्तं त्रिवृता चेति लेहयेत् | <br />
चतुरो मधुना लेहान् कफकासहरान् भिषक् ||१२१|| <br />
<br />
सौवर्चलाभयाधात्रीपिप्पलीक्षारनागरम् | <br />
चूर्णितं सर्पिषा वातकफकासहरं पिबेत् ||१२२||<br />
<br />
दशमूलाढके प्रस्थं घृतस्याक्षसमैः पचेत् | <br />
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<br />
kaṭphalaṁ kattr̥ṇaṁ bhārgīṁ mustaṁ dhānyaṁ vacābhayē| <br />
śuṇṭhīṁ parpaṭakaṁ śr̥ṅgīṁ surāhvaṁ ca śr̥taṁ jalē||112||<br />
<br />
madhuhiṅguyutaṁ pēyaṁ kāsē vātakaphātmakē| <br />
kaṇṭharōgē mukhē śūnē śvāsahikkājvarēṣu ca||113||<br />
<br />
pāṭhāṁ śuṇṭhīṁ śaṭīṁ mūrvāṁ gavākṣīṁ mustapippalīm| <br />
piṣṭvā gharmāmbunā hiṅgusaindhavābhyāṁ yutāṁ pibēt||114|| <br />
<br />
nāgarātiviṣē mustaṁ śr̥ṅgīṁ karkaṭakasya ca| <br />
harītakīṁ śaṭīṁ caiva tēnaiva vidhinā pibēt||115|| <br />
<br />
tailabhr̥ṣṭaṁ ca pippalyāḥ kalkākṣaṁ sasitōpalam| <br />
pibēdvā ślēṣmakāsaghnaṁ kulattharasasaṁyutam||116|| <br />
<br />
kāsamardāśvaviṭbhr̥ṅgarājavārtākajō rasaḥ| <br />
sakṣaudraḥ kaphakāsaghnaḥ surasasyāsitasya ca||117|| <br />
<br />
dēvadāru śaṭī rāsnā karkaṭākhyā durālabhā| <br />
pippalī nāgaraṁ mustaṁ pathyādhātrīsitōpalāḥ||118|| <br />
<br />
madhutailayutāvētau lēhau vātānugē kaphē| <br />
pippalī pippalīmūlaṁ citrakō hastipippalī||119|| <br />
<br />
pathyā tāmalakī dhātrī bhadramustā ca pippalī| <br />
dēvadārvabhayā mustaṁ pippalī viśvabhēṣajam||120|| <br />
<br />
viśālā pippalī mustaṁ trivr̥tā cēti lēhayēt| <br />
caturō madhunā lēhān kaphakāsaharān bhiṣak||121|| <br />
<br />
sauvarcalābhayādhātrīpippalīkṣāranāgaram| <br />
cūrṇitaṁ sarpiṣā vātakaphakāsaharaṁ pibēt||122|| <br />
<br />
kaTphalaM kattRuNaM bhArgIM mustaM dhAnyaM vacAbhaye| <br />
shuNThIM parpaTakaM shRu~ggIM surAhvaM ca shRutaM jale||112|| <br />
<br />
madhuhi~gguyutaM peyaM kAse vAtakaphAtmake| <br />
kaNTharoge mukhe shUne shvAsahikkAjvareShu ca||113|| <br />
<br />
pAThAM shuNThIM shaTIM mUrvAM gavAkShIM mustapippalIm| <br />
piShTvA gharmAmbunA hi~ggusaindhavAbhyAM yutAM pibet||114|| <br />
<br />
nAgarAtiviShe mustaM shRu~ggIM karkaTakasya ca| <br />
harItakIM shaTIM caiva tenaiva vidhinA pibet||115|| <br />
<br />
tailabhRuShTaM ca pippalyAH kalkAkShaM sasitopalam| <br />
pibedvA shleShmakAsaghnaM kulattharasasaMyutam||116|| <br />
<br />
kAsamardAshvaviTbhRu~ggarAjavArtAkajo rasaH| <br />
sakShaudraH kaphakAsaghnaH surasasyAsitasya ca||117|| <br />
<br />
devadAru shaTI rAsnA karkaTAkhyA durAlabhA| <br />
pippalI nAgaraM mustaM pathyAdhAtrIsitopalAH||118|| <br />
<br />
madhutailayutAvetau lehau vAtAnuge kaphe| <br />
pippalI pippalImUlaM citrako hastipippalI||119|| <br />
<br />
pathyA tAmalakI dhAtrI bhadramustA ca pippalI| <br />
devadArvabhayA mustaM pippalI vishvabheShajam||120|| <br />
<br />
vishAlA pippalI mustaM trivRutA ceti lehayet| <br />
caturo madhunA lehAn kaphakAsaharAn bhiShak||121|| <br />
<br />
sauvarcalAbhayAdhAtrIpippalIkShAranAgaram| <br />
cUrNitaM sarpiShA vAtakaphakAsaharaM pibet||122|| <br />
</div></div><br />
<br />
Decoction prepared by boiling drugs such as ''katphala, kuttrana, bharangi, musta, dhanyaka, vacha, abhaya, shunthi, parpata, shrungi'' and ''surahva'' is to be used in ''kasa'' associated with [[vata]] and [[kapha]] along with ''madhu'' and ''hingu''. This is also beneficial in ''kantharoga, mukha roga, shoola, shwasa, hikka'' and ''jwara''.<br />
<br />
''Patha, shunthi, shati, murva, gavakshi, musta'' and ''pippali'' paste taken along with hot water by adding ''hingu'' and ''saindhava'' cures ''kasa''. Similarly administration of ''nagara, ativisha, musta, karkatashringi, haritaki'' and ''shati'' is also beneficial.<br />
<br />
One ''aksha'' of the paste of ''pippali'', fried with oil should be added with ''sitopala''. Intake of this recipe along with ''kulattha yusha'' cures [[kapha]]ja kasa. The ''swarasa'' extracted out of ''kasamarda'', stool of horse, ''bhringaraja, vartaka'' and black variety of ''surasa'' along with honey cures [[kapha]]ja kasa.<br />
<br />
Powder prepared out of ''devadaru, shati, rasna, karkatashringi, duralabha'' taken along with ''madhu'' and ''taila'' is effective in [[vata]]nuga [[kapha]]ja kasa.<br />
<br />
''Pippali, nagara, musta, haritaki, amalaki'' and ''sitopala'' is to be taken along with ''madhu'' and ''taila'' is effective in [[vata]]nuga [[kapha]]ja kasa.<br />
<br />
''Pippali, pippalimula, chitraka'' and ''gaja pippali'' should be made into ''leha'' form by adding ''madhu''. Intake of this cures [[kapha]]ja kasa.<br />
<br />
Similarly ''pathya, tamalaki, dhatri, bhadra-musta'' and ''pippali'' combination taken along with ''madhu'' cures ''kaphajakasa''.<br />
''Vishala, pippali, musta, trivrit'' should be taken along with honey in [[kapha]]ja kasa.<br />
<br />
Intake of the powder prepared out of ''souvarchala, abhaya, dhatri, pipplai, kshara'' and ''nagara'' taken along with ''ghrita'' cures ''kasa'' caused by [[vata]] and [[kapha]]. [112-122]<br />
<br />
==== Dashamuladi ghritam ====<br />
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<br />
पुष्कराह्वशटीबिल्वसुरसव्योषहिङ्गुभिः ||१२३|| <br />
<br />
पेयानुपानं तत् पेयं कासे वातकफात्मके | <br />
श्वासरोगेषु सर्वेषु कफवातात्मकेषु च ||१२४|| <br />
<br />
इति दशमूलादिघृतम् | <br />
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<br />
daśamūlāḍhakē prasthaṁ ghr̥tasyākṣasamaiḥ pacēt| <br />
puṣkarāhvaśaṭībilvasurasavyōṣahiṅgubhiḥ||123|| <br />
<br />
pēyānupānaṁ tat pēyaṁ kāsē vātakaphātmakē| <br />
śvāsarōgēṣu sarvēṣu kaphavātātmakēṣu ca||124|| <br />
<br />
iti daśamūlādighr̥tam|<br />
<br />
dashamUlADhake prasthaM ghRutasyAkShasamaiH pacet| <br />
puShkarAhvashaTIbilvasurasavyoShahi~ggubhiH||123|| <br />
<br />
peyAnupAnaM tat peyaM kAse vAtakaphAtmake| <br />
shvAsarogeShu sarveShu kaphavAtAtmakeShu ca||124|| <br />
<br />
iti dashamUlAdighRutam| <br />
</div></div><br />
<br />
One ''prastha'' of ''dashamoola'' should be cooked by adding one ''adhaka'' of the decoction of ''dashamoola'' and the paste of one ''aksha'' each of ''pushkar-moola, shati, bilva, surasa, shunthi, pippali, maricha'' and ''hingu''. Administration of this ghee followed by ''peya'' as ''anupana'' cure [[vata]] [[kapha]]ja kasa, shwasa roga.<br />
<br />
Thus ends the description of ''dashamooladi ghrita''. [123-124]<br />
<br />
==== Kantakari ghritam ====<br />
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<br />
समूलफलपत्रायाः कण्टकार्या रसाढके | <br />
घृतप्रस्थं बलाव्योषविडङ्गशटिचित्रकैः ||१२५|| <br />
<br />
सौवर्चलयवक्षारपिप्पलीमूलपौष्करैः | <br />
वृश्चीरबृहतीपथ्यायवानीदाडिमर्धिभिः ||१२६|| <br />
<br />
द्राक्षापुनर्नवाचव्यदुरालम्भाम्लवेतसैः | <br />
शृङ्गीतामलकीभार्गीरास्नागोक्षुरकैः पचेत् ||१२७|| <br />
<br />
कल्कैस्तत् सर्वकासेषु हिक्काश्वासेषु शस्यते | <br />
कण्टकारीघृतं ह्येतत् कफव्याधिनिसूदनम् ||१२८|| <br />
<br />
इति कण्टकारीघृतम् |<br />
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<br />
samūlaphalapatrāyāḥ kaṇṭakāryā rasāḍhakē| <br />
ghr̥taprasthaṁ balāvyōṣaviḍaṅgaśaṭicitrakaiḥ||125|| <br />
<br />
sauvarcalayavakṣārapippalīmūlapauṣkaraiḥ| <br />
vr̥ścīrabr̥hatīpathyāyavānīdāḍimardhibhiḥ||126|| <br />
<br />
drākṣāpunarnavācavyadurālambhāmlavētasaiḥ| <br />
śr̥ṅgītāmalakībhārgīrāsnāgōkṣurakaiḥ pacēt||127|| <br />
<br />
kalkaistat sarvakāsēṣu hikkāśvāsēṣu śasyatē| <br />
kaṇṭakārīghr̥taṁ hyētat kaphavyādhinisūdanam||128|| <br />
<br />
iti kaṇṭakārīghr̥tam| <br />
<br />
samUlaphalapatrAyAH kaNTakAryA rasADhake| <br />
ghRutaprasthaM balAvyoShaviDa~ggashaTicitrakaiH||125|| <br />
<br />
sauvarcalayavakShArapippalImUlapauShkaraiH| <br />
vRushcIrabRuhatIpathyAyavAnIdADimardhibhiH||126|| <br />
<br />
drAkShApunarnavAcavyadurAlambhAmlavetasaiH| <br />
shRu~ggItAmalakIbhArgIrAsnAgokShurakaiH pacet||127|| <br />
<br />
kalkaistat sarvakAseShu hikkAshvAseShu shasyate| <br />
kaNTakArIghRutaM hyetat kaphavyAdhinisUdanam||128|| <br />
<br />
iti kaNTakArIghRutam| <br />
</div></div><br />
<br />
One ''adhaka'' of ''kantakari kashaya'' should be prepared using its root, fruit and leaves. This is to be processed with one ''prastha'' of ''ghrita'' by adding the paste of ''bala, shunthi, pippali, maricha, vidanga, shati, chitraka, sauvarchala, yavakshara, pippalimula, pushkarmoola, vrischira, brihati, pathya, yavani, dadima, riddhi, draksha, punaranava, chavya, duralabha, amlavetasa, shringi, tamalaki, bharangi, rasna'' and ''gokshuara''. This is beneficial in all types of ''kasa, hikka'' and ''shwasa''. This is known as ''kantakari ghrita'' and it cures all types of [[kapha]]ja diseases.<br />
<br />
Thus ends the description of ''kantakari-ghrita''.<br />
<br />
==== Kulatthadi ghritam ====<br />
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<br />
कुलत्थरसयुक्तं वा पञ्चकोलशृतं घृतम् | <br />
पाययेत् कफजे कासे हिक्काश्वासे च शस्यते ||१२९|| <br />
<br />
इति कुलत्थादिघृतम् | <br />
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<br />
kulattharasayuktaṁ vā pañcakōlaśr̥taṁ ghr̥tam| <br />
pāyayēt kaphajē kāsē hikkāśvāsē ca śasyatē||129|| <br />
<br />
iti kulatthādighr̥tam|<br />
<br />
kulattharasayuktaM vA pa~jcakolashRutaM ghRutam| <br />
pAyayet kaphaje kAse hikkAshvAse ca shasyate||129|| <br />
<br />
iti kulatthAdighRutam|<br />
</div></div><br />
<br />
''Ghrita'' cooked with the decoction of ''kulattha'' or with that of ''panchakola'' is useful in [[kapha]]ja kasa, hikka and ''shwasa''. <br />
<br />
Thus ends the description of ''kulatthadi- ghrita''. [125-129]<br />
<br />
==== [[Dhuma]] (medicated smmoke) formulations ====<br />
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<br />
धूमांस्तानेव दद्याच्च ये प्रोक्ता वातकासिनाम् | <br />
कोशातकीफलान्मध्यं पिबेद्वा समनःशिलम् ||१३०|| <br />
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<br />
dhūmāṁstānēva dadyācca yē prōktā vātakāsinām| <br />
kōśātakīphalānmadhyaṁ pibēdvā samanaḥśilam||130|| <br />
<br />
dhUmAMstAneva dadyAcca ye proktA vAtakAsinAm| <br />
koshAtakIphalAnmadhyaM pibedvA samanaHshilam||130|| <br />
</div></div><br />
<br />
''Dhuma yogas'' which have been mentioned at the context of [[vata]]ja kasa can also be administered in [[pitta]]ja kasa. Specifically ''manshilla'' kept inside the ''koshataki phala majja'' is useful in the form of ''dhupana'' in [[kapha]]ja-kasa. [130]<br />
<br />
=== Principles of treatment in various states of [[dosha]] ===<br />
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<br />
तमकः कफकासे तु स्याच्चेत् पित्तानुबन्धजः | <br />
पित्तकासक्रियां तत्र यथावस्थं प्रयोजयेत् ||१३१|| <br />
<br />
वाते कफानुबन्धे तु कुर्यात् कफहरीं क्रियाम् | <br />
पित्तानुबन्धयोर्वातकफयोः पित्तनाशिनीम् ||१३२|| <br />
<br />
आर्द्रे विरूक्षणं, शुष्के स्निग्धं, वातकफात्मके | <br />
कासेऽन्नपानं कफजे सपित्ते तिक्तसंयुतम् ||१३३|| <br />
<br />
इति कफजकासचिकित्सा | <br />
<div class="mw-collapsible-content"><br />
<br />
tamakaḥ kaphakāsē tu syāccēt pittānubandhajaḥ| <br />
pittakāsakriyāṁ tatra yathāvasthaṁ prayōjayēt||131|| <br />
<br />
vātē kaphānubandhē tu kuryāt kaphaharīṁ kriyām| <br />
pittānubandhayōrvātakaphayōḥ pittanāśinīm||132|| <br />
<br />
ārdrē virūkṣaṇaṁ, śuṣkē snigdhaṁ, vātakaphātmakē| <br />
kāsē'nnapānaṁ kaphajē sapittē tiktasaṁyutam||133|| <br />
<br />
iti kaphajakāsacikitsā| <br />
<br />
tamakaH kaphakAse tu syAccet pittAnubandhajaH| <br />
pittakAsakriyAM tatra yathAvasthaM prayojayet||131|| <br />
<br />
vAte kaphAnubandhe tu kuryAt kaphaharIM kriyAm| <br />
pittAnubandhayorvAtakaphayoH pittanAshinIm||132|| <br />
<br />
Ardre virUkShaNaM, shuShke snigdhaM, vAtakaphAtmake| <br />
kAse~annapAnaM kaphaje sapitte tiktasaMyutam||133|| <br />
<br />
iti kaphajakAsacikitsA| <br />
</div></div><br />
<br />
If [[kapha]]ja kasa is associated with ''tamaka''(a type of ''shwasa'') then at this stage of ''kasa'', therapies prescribed for [[pitta]]ja kasa should be administered. <br />
<br />
If there is association [[kapha]] in [[vata]]ja kasa the [[kapha]]hara measures should be administered.<br />
<br />
If [[pitta]] is associated with [[vata]]ja and [[kapha]]ja kasa then [[pitta]]hara measures should be followed.<br />
<br />
If [[vata]]ja and [[kapha]]ja kasa are associated with expectoration of phlegm, then ''rukshana'' therapy should be followed, whereas if not associated with phlegm then ''snigdha'' therapy should be administered.<br />
<br />
If [[kapha]]ja kasa is associated with [[pitta]], then the patient should be given food and drinks mixed with ''tikta dravyas''.<br />
<br />
Thus ends the description of [[kapha]]ja kasa.[131-134]<br />
<br />
=== Management of kshataja kasa (due to injury) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
कासमात्ययिकं मत्वा क्षतजं त्वरया जयेत् | <br />
मधुरैर्जीवनीयैश्च बलमांसविवर्धनैः ||१३४|| <br />
<br />
पिप्पली मधुकं पिष्टं कार्षिकं ससितोपलम् | <br />
प्रास्थिकं गव्यमाजं च क्षीरमिक्षुरसस्तथा ||१३५|| <br />
<br />
यवगोधूममृद्वीकाचूर्णमामलकाद्रसः | <br />
तैलं च प्रसृतांशानि तत् सर्वं मृदुनाऽग्निना ||१३६|| <br />
<br />
पचेल्लेहं घृतक्षौद्रयुक्तः स क्षतकासहा | <br />
श्वासहृद्रोगकार्श्येषु हितो वृद्धेऽल्परेतसि ||१३७||<br />
<div class="mw-collapsible-content"><br />
<br />
kāsamātyayikaṁ matvā kṣatajaṁ tvarayā jayēt| <br />
madhurairjīvanīyaiśca balamāṁsavivardhanaiḥ||134|| <br />
<br />
pippalī madhukaṁ piṣṭaṁ kārṣikaṁ sasitōpalam| <br />
prāsthikaṁ gavyamājaṁ ca kṣīramikṣurasastathā||135|| <br />
<br />
yavagōdhūmamr̥dvīkācūrṇamāmalakādrasaḥ| <br />
tailaṁ ca prasr̥tāṁśāni tat sarvaṁ mr̥dunā'gninā||136|| <br />
<br />
pacēllēhaṁ ghr̥takṣaudrayuktaḥ sa kṣatakāsahā| <br />
śvāsahr̥drōgakārśyēṣu hitō vr̥ddhē'lparētasi||137|| <br />
<br />
kAsamAtyayikaM matvA kShatajaM tvarayA jayet| <br />
madhurairjIvanIyaishca balamAMsavivardhanaiH||134|| <br />
<br />
pippalI madhukaM piShTaM kArShikaM sasitopalam| <br />
prAsthikaM gavyamAjaM ca kShIramikShurasastathA||135|| <br />
<br />
yavagodhUmamRudvIkAcUrNamAmalakAdrasaH| <br />
tailaM ca prasRutAMshAni tat sarvaM mRudunA~agninA||136|| <br />
<br />
pacellehaM ghRutakShaudrayuktaH sa kShatakAsahA| <br />
shvAsahRudrogakArshyeShu hito vRuddhe~alparetasi||137|| <br />
</div></div><br />
<br />
''Kshataja kasa'' is a serious ailment. Keeping this in view the treatment of the patient should be initiated instantaneously with ''madhura'' and ''jivaniya dravyas'', which are promoters of ''bala'' and ''mamsa''. <br />
<br />
The paste of one ''karsha'' of each of ''pippali, madhuka,'' one ''karsha'' of ''sitopala'', one ''prastha'' of each of cows milk, goats milk and ''ikshurasa'', one ''prastha'' of the powder of ''yava, godhuma, draksha'' and one ''prastha'' of each of the juice of ''amalaka'' and ''tilataila'' should be cooked over mridu [[agni]]. Intake of this ''leha'' along with ''ghrita'' and ''madhu'' cures ''kshataja kasa, shwasa, hridroga'' and ''kshata''. It is also useful for old persons and those who have less semen.[134-137]<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
क्षतकासाभिभूतानां वृत्तिः स्यात् पित्तकासिकी | <br />
क्षीरसर्पिर्मधुप्राया संसर्गे तु विशेषणम् ||१३८|| <br />
<br />
वातपित्तार्दितेऽभ्यङ्गो गात्रभेदे घृतैर्हितः | <br />
तैलैर्मारुतरोगघ्नैः पीड्यमाने च वायुना ||१३९|| <br />
<br />
हृत्पार्श्वार्तिषु पानं स्याज्जीवनीयस्य सर्पिषः | <br />
सदाहं कासिनो रक्तं ष्ठीवतः सबलेऽनले ||१४०|| <br />
<br />
मांसोचितेभ्यः क्षामेभ्यो लावादीनां रसा हिताः | <br />
तृष्णार्तानां पयश्छागं शरमूलादिभिः शृतम् ||१४१|| <br />
<br />
रक्ते स्रोतोभ्य आस्याद्वाऽप्यागते क्षीरजं घृतम् | <br />
नस्यं पानं यवागूर्वा श्रान्ते क्षामे हतानले ||१४२|| <br />
<br />
स्तम्भायामेषु महतीं मात्रां वा सर्पिषः पिबेत् | <br />
कुर्याद्वा वातरोगघ्नं पित्तरक्ताविरोधि यत् ||१४३|| <br />
<br />
निवृत्ते क्षतदोषे तु कफे वृद्ध उरः क्षते | <br />
दाल्यते कासिनो यस्य स धूमान्ना पिबेदिमान् ||१४४|| <br />
<br />
द्वे मेदे मधुकं द्वे च बले तैः क्षौमलक्तकैः | <br />
वर्तितैर्धूममापीय जीवनीयघृतं पिबेत् ||१४५|| <br />
<br />
मनःशिलापलाशाजगन्धात्वक्क्षीरिनागरैः | <br />
भावयित्वा पिबेत् क्षौममनु चेक्षुगुडोदकम् ||१४६|| <br />
<br />
पिष्ट्वा मनःशिलां तुल्यामार्द्रया वटशुङ्गया | <br />
ससर्पिष्कं पिबेद्धूमं तित्तिरिप्रतिभोजनम् ||१४७|| <br />
<br />
भावितं जीवनीयैर्वा कुलिङ्गाण्डरसायुतैः | <br />
क्षौमं धूमं पिबेत् क्षीरं शृतं चायोगुडैरनु ||१४८|| <br />
<br />
इति क्षतजकासचिकित्सा |<br />
<div class="mw-collapsible-content"><br />
<br />
kṣatakāsābhibhūtānāṁ vr̥ttiḥ syāt pittakāsikī| <br />
kṣīrasarpirmadhuprāyā saṁsargē tu viśēṣaṇam||138|| <br />
<br />
vātapittārditē'bhyaṅgō gātrabhēdē ghr̥tairhitaḥ| <br />
tailairmārutarōgaghnaiḥ pīḍyamānē ca vāyunā||139|| <br />
<br />
hr̥tpārśvārtiṣu pānaṁ syājjīvanīyasya sarpiṣaḥ| <br />
sadāhaṁ kāsinō raktaṁ ṣṭhīvataḥ sabalē'nalē||140|| <br />
<br />
māṁsōcitēbhyaḥ kṣāmēbhyō lāvādīnāṁ rasā hitāḥ| <br />
tr̥ṣṇārtānāṁ payaśchāgaṁ śaramūlādibhiḥ śr̥tam||141|| <br />
<br />
raktē srōtōbhya āsyādvā'pyāgatē kṣīrajaṁ ghr̥tam| <br />
nasyaṁ pānaṁ yavāgūrvā śrāntē kṣāmē hatānalē||142|| <br />
<br />
stambhāyāmēṣu mahatīṁ mātrāṁ vā sarpiṣaḥ pibēt| <br />
kuryādvā vātarōgaghnaṁ pittaraktāvirōdhi yat||143|| <br />
<br />
nivr̥ttē kṣatadōṣē tu kaphē vr̥ddha uraḥ [1] kṣatē| <br />
dālyatē kāsinō yasya sa dhūmānnā pibēdimān||144|| <br />
<br />
dvē mēdē madhukaṁ dvē ca balē taiḥ kṣaumalaktakaiḥ| <br />
vartitairdhūmamāpīya jīvanīyaghr̥taṁ pibēt||145|| <br />
<br />
manaḥśilāpalāśājagandhātvakkṣīrināgaraiḥ| <br />
bhāvayitvā pibēt kṣaumamanu cēkṣuguḍōdakam||146|| <br />
<br />
piṣṭvā manaḥśilāṁ tulyāmārdrayā vaṭaśuṅgayā| <br />
sasarpiṣkaṁ pibēddhūmaṁ tittiripratibhōjanam||147|| <br />
<br />
bhāvitaṁ jīvanīyairvā kuliṅgāṇḍarasāyutaiḥ| <br />
kṣaumaṁ dhūmaṁ pibēt kṣīraṁ śr̥taṁ cāyōguḍairanu||148|| <br />
<br />
iti kṣatajakāsacikitsā| <br />
kShatakAsAbhibhUtAnAM vRuttiH syAt pittakAsikI| <br />
kShIrasarpirmadhuprAyA saMsarge tu visheShaNam||138|| <br />
<br />
vAtapittArdite~abhya~ggo gAtrabhede ghRutairhitaH| <br />
tailairmArutarogaghnaiH pIDyamAne ca vAyunA||139|| <br />
<br />
hRutpArshvArtiShu pAnaM syAjjIvanIyasya sarpiShaH| <br />
sadAhaM kAsino raktaM ShThIvataH sabale~anale||140|| <br />
<br />
mAMsocitebhyaH kShAmebhyo lAvAdInAM rasA hitAH| <br />
tRuShNArtAnAM payashchAgaM sharamUlAdibhiH shRutam||141|| <br />
<br />
rakte srotobhya AsyAdvA~apyAgate kShIrajaM ghRutam| <br />
nasyaM pAnaM yavAgUrvA shrAnte kShAme hatAnale||142|| <br />
<br />
stambhAyAmeShu mahatIM mAtrAM vA sarpiShaH pibet| <br />
kuryAdvA vAtarogaghnaM pittaraktAvirodhi yat||143|| <br />
<br />
nivRutte kShatadoShe tu kaphe vRuddha uraH [1] kShate| <br />
dAlyate kAsino yasya sa dhUmAnnA pibedimAn||144|| <br />
<br />
dve mede madhukaM dve ca bale taiH kShaumalaktakaiH| <br />
vartitairdhUmamApIya jIvanIyaghRutaM pibet||145|| <br />
<br />
manaHshilApalAshAjagandhAtvakkShIrinAgaraiH| <br />
bhAvayitvA pibet kShaumamanu cekShuguDodakam||146|| <br />
<br />
piShTvA manaHshilAM tulyAmArdrayA vaTashu~ggayA| <br />
sasarpiShkaM pibeddhUmaM tittiripratibhojanam||147|| <br />
<br />
bhAvitaM jIvanIyairvA kuli~ggANDarasAyutaiH| <br />
kShaumaM dhUmaM pibet kShIraM shRutaM cAyoguDairanu||148|| <br />
<br />
iti kShatajakAsacikitsA| <br />
</div></div><br />
<br />
The medicaments prescribed for the [[pitta]]ja kasa are also useful for ''kshataja kasa''. Generally milk, ghee and honey should be given to such patients. If two [[dosha]] are involved in the pathogenesis of this ailment then special therapies are required.<br />
<br />
If this ailment is associated with [[vata]] and [[pitta]] and the person has pain all over the body then ''abhyanga'' should be given with ghee. If there is excessive [[vata]] aggravation, causing pain, then ''abhyanga'' should be given with ''taila'' prepared out of [[vata]]hara dravya. <br />
<br />
The person suffering from ''kasa'' along with pain in ''hridaya'' and ''parshwa'' associated with burning sensation, hemoptysis, and aggravation of [[agni]] should take jivaniya siddha ghrita.<br />
<br />
If the person weak and habituated to take mamsa then the ''mamsarasa'' prepared out of lava is beneficial for him. <br />
<br />
If he is suffering from ''trishna'' then he can take goats milk processed with ''trinapanchamoola''.<br />
<br />
If there is bleeding then he should take the ghee extracted out of this milk. Or this ghee can be administered in the form of [[nasya]] or as a drink.<br />
<br />
If the patient of ''kshata'' is fatigued and weak, and if he has low power of digestion, then he should be given ''yavagu'' to eat.<br />
<br />
If there is ''stambha'' and ''ayama'' then the patient should be given ghee in large quantities.<br />
<br />
Thus all therapies which alleviate the [[vata]], simultaneously which do not aggravate [[pitta]] and [[rakta]] should be followed in such persons.<br />
<br />
After ''khsataja kasa'' treatment, after complete relief, still person is complaining of pain at the place of injury due to aggravation of [[kapha]], should be given ''dhumapana chikitsa'' with following combination.<br />
<br />
''Meda, mahameda, madhuka, bala'' and ''mahabala'' should be made into paste and smeared over silk-cloth and ''varti'' is to be prepared. After the ''pana'' of this ''dhumavarti'' should be prepared by smearing a piece of silk cloth with the paste of ''manahshila'', ''palasha, ajagandha, tavksheeri,'' and ''nagara''. After ''dhumapana'' the person should drink ''ikshurasa'' and water mixed with jaggery.<br />
<br />
''Manhashila'' should be made into a paste by tritrating it with the vatashrunga. To this ghee should be added. After ''dhuma'' the person should be given ''tittiri pakshi mamsa rasa''.<br />
<br />
The silk cloth should be soaked with ''jivaniya gana dravyas'' or with egg yolk of ''kulinga''. With this ''varti'' should be prepared and after ''dhumapana'', the person should take the milk soaked with hot iron balls. This is beneficial in ''kshataja kasa''.[138-148]<br />
<br />
=== Management of kshayaja kasa (due to depletion)=== <br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
सम्पूर्णरूपं क्षयजं दुर्बलस्य विवर्जयेत् | <br />
नवोत्थितं बलवतः प्रत्याख्यायाचरेत् क्रियाम् ||१४९|| <br />
<br />
तस्मै बृंहणमेवादौ कुर्यादग्नेश्च दीपनम् | <br />
बहुदोषाय सस्नेहं मृदु दद्याद्विरेचनम् ||१५०|| <br />
<br />
शम्पाकेन त्रिवृतया मृद्वीकारसयुक्तया | <br />
तिल्वकस्य कषायेण विदारीस्वरसेन च ||१५१|| <br />
<br />
सर्पिः सिद्धं पिबेद्युक्त्या क्षीणदेहो विशोधनम् | <br />
(हितं तद्देहबलयोरस्य संरक्षणं मतम् ) ||१५२|| <br />
<br />
पित्ते कफे च सङ्क्षीणे परिक्षीणेषु धातुषु | <br />
घृतं कर्कटकीक्षीरद्विबलासाधितं पिबेत् ||१५३|| <br />
<br />
विदारीभिः कदम्बैर्वा तालसस्यैस्तथा शृतम् | <br />
घृतं पयश्च मूत्रस्य वैवर्ण्ये कृच्छ्रनिर्गमे ||१५४|| <br />
<br />
शूने सवेदने मेढ्रे पायौ सश्रोणिवङ्क्षणे | <br />
घृतमण्डेन मधुनाऽनुवास्यो मिश्रकेण वा ||१५५|| <br />
<br />
जाङ्गलैः प्रतिभुक्तस्य वर्तकाद्या बिलेशयाः | <br />
क्रमशः प्रसहाश्चैव प्रयोज्याः पिशिताशिनः ||१५६|| <br />
<br />
औष्ण्यात् प्रमाथिभावाच्च स्रोतोभ्यश्च्यावयन्ति ते | <br />
कफं, शुद्धैश्च तैः पुष्टिं कुर्यात्सम्यग्वहन्रसः ||१५७|| <br />
<div class="mw-collapsible-content"><br />
<br />
sampūrṇarūpaṁ kṣayajaṁ durbalasya vivarjayēt| <br />
navōtthitaṁ balavataḥ pratyākhyāyācarēt kriyām||149|| <br />
<br />
tasmai br̥ṁhaṇamēvādau kuryādagnēśca dīpanam| <br />
bahudōṣāya sasnēhaṁ mr̥du dadyādvirēcanam||150|| <br />
<br />
śampākēna trivr̥tayā mr̥dvīkārasayuktayā| <br />
tilvakasya kaṣāyēṇa vidārīsvarasēna ca||151|| <br />
<br />
sarpiḥ siddhaṁ pibēdyuktyā kṣīṇadēhō viśōdhanam| <br />
(hitaṁ taddēhabalayōrasya saṁrakṣaṇaṁ matam [1] )||152|| <br />
<br />
pittē kaphē ca saṅkṣīṇē parikṣīṇēṣu dhātuṣu| <br />
ghr̥taṁ karkaṭakīkṣīradvibalāsādhitaṁ pibēt||153|| <br />
<br />
vidārībhiḥ kadambairvā tālasasyaistathā śr̥tam| <br />
ghr̥taṁ payaśca mūtrasya vaivarṇyē kr̥cchranirgamē||154|| <br />
<br />
śūnē savēdanē mēḍhrē pāyau saśrōṇivaṅkṣaṇē| <br />
ghr̥tamaṇḍēna madhunā'nuvāsyō [2] miśrakēṇa vā||155|| <br />
<br />
jāṅgalaiḥ pratibhuktasya vartakādyā bilēśayāḥ| <br />
kramaśaḥ prasahāścaiva prayōjyāḥ piśitāśinaḥ||156|| <br />
<br />
auṣṇyāt pramāthibhāvācca srōtōbhyaścyāvayanti tē| <br />
kaphaṁ, śuddhaiśca taiḥ puṣṭiṁ kuryātsamyagvahanrasaḥ||1<br />
57|| <br />
<br />
sampUrNarUpaM kShayajaM durbalasya vivarjayet| <br />
navotthitaM balavataH pratyAkhyAyAcaret kriyAm||149|| <br />
<br />
tasmai bRuMhaNamevAdau kuryAdagneshca dIpanam| <br />
bahudoShAya sasnehaM mRudu dadyAdvirecanam||150|| <br />
<br />
shampAkena trivRutayA mRudvIkArasayuktayA| <br />
tilvakasya kaShAyeNa vidArIsvarasena ca||151|| <br />
<br />
sarpiH siddhaM pibedyuktyA kShINadeho vishodhanam| <br />
(hitaM taddehabalayorasya saMrakShaNaM matam [1] )||152|| <br />
<br />
pitte kaphe ca sa~gkShINe parikShINeShu dhAtuShu| <br />
ghRutaM karkaTakIkShIradvibalAsAdhitaM pibet||153|| <br />
<br />
vidArIbhiH kadambairvA tAlasasyaistathA shRutam| <br />
ghRutaM payashca mUtrasya vaivarNye kRucchranirgame||154|| <br />
<br />
shUne savedane meDhre pAyau sashroNiva~gkShaNe| <br />
ghRutamaNDena madhunA~anuvAsyo [2] mishrakeNa vA||155|| <br />
<br />
jA~ggalaiH pratibhuktasya vartakAdyA bileshayAH| <br />
kramashaH prasahAshcaiva prayojyAH pishitAshinaH||156|| <br />
<br />
auShNyAt pramAthibhAvAcca srotobhyashcyAvayanti te| <br />
kaphaM, shuddhaishca taiH puShTiM kuryAtsamyagvahanrasaH||157|| <br />
</div></div><br />
<br />
If ''kshayaja kasa'' is manifested with all the signs and symptoms, and if the patient is weak, then he should not be treated. However if the disease has recently occurred and if the patient is strong enough, then he may be treated even though the disease is incurable. In the beginning the person should be given [[brihmana]] therapy along with [[agni]] [[deepana]]. If [[dosha]] aggravation is more, then he can be given mild purgation therapy along with ''snigdha dravyas''.<br />
<br />
Ghee cooked with the decoction of ''shamapaka''(fruit pulp of ''aragwadha''), ''trivrit, mridvika rasa, tilvaka kashaya'' and ''vidari swarasa'' should be given in appropriate dosage for the ''shodhana'' of ''ksheena'' person. It protects the body as well as gives strength for the ''uras''. <br />
<br />
When [[pitta]] and [[kapha]] are reduced in quantity, along emaciation of [[dhatu]], then the person should take the ''ghrita'' prepared out of ''karkatashringi'', milk, ''bala'' and ''atibala''.<br />
<br />
If there is association of ''mutra vaivarnyata'' or ''krichchchrata'', then he should be given the milk boiled with ''vidari, kadamba'' or with tender fruits of ''tala''.<br />
<br />
If there is swelling and pain in the ''medhra, payu, shroni'' and ''vankshana'', then the person should be given the ''anuvasana'' prepared out of ''ghritamanda, madhu'' or with ''mishraka sneha''.<br />
<br />
After ''anuvasana'' the person should be fed with ''mamsa rasa'' prepared out of ''jangala, prasaha, bileshaya,'' and ''vartakas''. Because of their ''ushnata, pramathi bhava'' these move properly in all ''srotas'' and cause dryness of [[kapha]] and simultaneously they nourish the ''srotas''.[149-157]<br />
<br />
==== Dvi-panchamuladi ghritam ====<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
द्विपञ्चमूलीत्रिफलाचविकाभार्गिचित्रकैः | <br />
कुलत्थपिप्पलीमूलपाठाकोलयवैर्जले ||१५८|| <br />
<br />
शृतैर्नागरदुःस्पर्शापिप्पलीशटिपौष्करैः | <br />
कल्कैः कर्कटशृङ्ग्या च समैः सर्पिर्विपाचयेत् ||१५९||<br />
<br />
सिद्धैऽस्मिंश्चूर्णितौ क्षारौ द्वौ पञ्च लवणानि च | <br />
दत्त्वा युक्त्या पिबेन्मात्रां क्षयकासनिपीडितः ||१६०|| <br />
<br />
इति द्विपञ्चमूलादिघृतम् | <br />
<div class="mw-collapsible-content"><br />
<br />
dvipañcamūlītriphalācavikābhārgicitrakaiḥ| <br />
kulatthapippalīmūlapāṭhākōlayavairjalē||158|| <br />
<br />
śr̥tairnāgaraduḥsparśāpippalīśaṭipauṣkaraiḥ| <br />
kalkaiḥ karkaṭaśr̥ṅgyā ca samaiḥ sarpirvipācayēt||159|| <br />
<br />
siddhē'smiṁścūrṇitau kṣārau dvau pañca lavaṇāni ca| <br />
dattvā yuktyā pibēnmātrāṁ kṣayakāsanipīḍitaḥ||160|| <br />
<br />
iti dvipañcamūlādighr̥tam| <br />
<br />
dvipa~jcamUlItriphalAcavikAbhArgicitrakaiH| <br />
kulatthapippalImUlapAThAkolayavairjale||158|| <br />
<br />
shRutairnAgaraduHsparshApippalIshaTipauShkaraiH| <br />
kalkaiH karkaTashRu~ggyA ca samaiH sarpirvipAcayet||159|| <br />
<br />
siddhe~asmiMshcUrNitau kShArau dvau pa~jca lavaNAni ca| <br />
dattvA yuktyA pibenmAtrAM kShayakAsanipIDitaH||160|| <br />
<br />
iti dvipa~jcamUlAdighRutam| <br />
</div></div><br />
<br />
Decoction should be prepared out of ''bilva, shyonaka, gambhari, patala, ganikarika, shalaparni, prashanaparni, brihati, kantakari, gokshuara, haritaki, bibhitaka, amalaki, chavika, bharangi, chitraka, kulattha, pippali moola, patha, kola'' and ''yava''. To this decoction ghee and the paste prepared out of ''nagara, dusparsha, pippali, shati, karkatashringi'' and ''pushkara'' should be added and ''ghritapachana'' should be done. After proper ''paka'' powder prepared out of ''yavakshara, sarjakshara, saindhava-lavana, samudra-lavana, sauvarchala-lavana, vida-lavana'' and ''audbhida-lavana'' is to be added. Intake of this cures ''kshayajakasa''.<br />
<br />
Thus ends the description of ''dwi-pancha-mooladi-ghrita''.[158-160]<br />
<br />
==== Guduchyadi ghritam ====<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
गुडूचीं पिप्पलीं मूर्वां हरिद्रां श्रेयसीं वचाम् | <br />
निदिग्धिकां कासमर्दं पाठां चित्रकनागरम् ||१६१|| <br />
<br />
जले चतुर्गुणे पक्त्वा पादशेषेण तत्समम् | <br />
सिद्धं सर्पिः पिबेद्गुल्मश्वासार्तिक्षयकासनुत् ||१६२|| <br />
<br />
इति गुडूच्यादिघृतम् | <br />
<div class="mw-collapsible-content"><br />
<br />
guḍūcīṁ pippalīṁ mūrvāṁ haridrāṁ śrēyasīṁ vacām| <br />
nidigdhikāṁ kāsamardaṁ pāṭhāṁ citrakanāgaram||161|| <br />
<br />
jalē caturguṇē paktvā pādaśēṣēṇa tatsamam| <br />
siddhaṁ sarpiḥ pibēdgulmaśvāsārtikṣayakāsanut||162|| <br />
<br />
iti guḍūcyādighr̥tam|<br />
<br />
guDUcIM pippalIM mUrvAM haridrAM shreyasIM vacAm| <br />
nidigdhikAM kAsamardaM pAThAM citrakanAgaram||161|| <br />
<br />
jale caturguNe paktvA pAdasheSheNa tatsamam| <br />
siddhaM sarpiH pibedgulmashvAsArtikShayakAsanut||162|| <br />
<br />
iti guDUcyAdighRutam| <br />
</div></div><br />
<br />
''Guduchi, pippali, murva, haridra, shreyasi, vacha, nidigdhika, kasmarda, patha, chitraka'' and ''nagara'' are to be boiled with four times of water, till the quantity of water reduces to one-fourth. To this decoction equal quantity of ''ghrita'' should be added and cooked. Intake of this cures ''gulma, shwasa'' and ''kshayajakasa''.<br />
<br />
Thus ends the description of ''guduchyaadi-ghrita''.[161-162]<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
कासमर्दाभयामुस्तपाठाकट्फलनागरैः | <br />
पिप्पलीकटुकाद्राक्षाकाश्मर्यसुरसैस्तथा ||१६३|| <br />
<br />
अक्षमात्रैर्घृतप्रस्थं क्षीरद्राक्षारसाढके | <br />
पचेच्छोषज्वरप्लीहसर्वकासहरं शिवम् ||१६४|| <br />
<br />
धात्रीफलैः क्षीरसिद्धैः सर्पिर्वाऽप्यवचूर्णितम् | <br />
द्विगुणे दाडिमरसे विपक्वं व्योषसंयुतम् ||१६५|| <br />
<br />
पिबेदुपरि भक्तस्य यवक्षारघृतं नरः | <br />
पिप्पलीगुडसिद्धं वा च्छागक्षीरयुतं घृतम् ||१६६|| <br />
<br />
एतान्यग्निविवृद्ध्यर्थं सर्पींषि क्षयकासिनाम् | <br />
स्युर्दोषबद्धकोष्ठोरःस्रोतसां च विशुद्धये ||१६७|| <br />
<div class="mw-collapsible-content"><br />
<br />
kāsamardābhayāmustapāṭhākaṭphalanāgaraiḥ| <br />
pippalīkaṭukādrākṣākāśmaryasurasaistathā||163|| <br />
<br />
akṣamātrairghr̥taprasthaṁ kṣīradrākṣārasāḍhakē| <br />
pacēcchōṣajvaraplīhasarvakāsaharaṁ śivam||164|| <br />
<br />
dhātrīphalaiḥ kṣīrasiddhaiḥ sarpirvā'pyavacūrṇitam| <br />
dviguṇē dāḍimarasē vipakvaṁ vyōṣasaṁyutam||165|| <br />
<br />
pibēdupari bhaktasya yavakṣāraghr̥taṁ naraḥ| <br />
pippalīguḍasiddhaṁ vā cchāgakṣīrayutaṁ ghr̥tam||166|| <br />
<br />
ētānyagnivivr̥ddhyarthaṁ sarpīṁṣi kṣayakāsinām| <br />
syurdōṣabaddhakōṣṭhōraḥsrōtasāṁ ca viśuddhayē||167|| <br />
<br />
kAsamardAbhayAmustapAThAkaTphalanAgaraiH| <br />
pippalIkaTukAdrAkShAkAshmaryasurasaistathA||163|| <br />
<br />
akShamAtrairghRutaprasthaM kShIradrAkShArasADhake| <br />
pacecchoShajvaraplIhasarvakAsaharaM shivam||164|| <br />
<br />
dhAtrIphalaiH kShIrasiddhaiH sarpirvA~apyavacUrNitam| <br />
dviguNe dADimarase vipakvaM vyoShasaMyutam||165|| <br />
<br />
pibedupari bhaktasya yavakShAraghRutaM naraH| <br />
pippalIguDasiddhaM vA cchAgakShIrayutaM ghRutam||166|| <br />
<br />
etAnyagnivivRuddhyarthaM sarpIMShi kShayakAsinAm| <br />
syurdoShabaddhakoShThoraHsrotasAM ca vishuddhaye||167|| <br />
</div></div><br />
<br />
One ''prastha'' of ''ghrita'' should be cooked by adding the paste of one ''aksha'' of each of ''kasamarda, abhaya, musta, patha, katphala, nagara, pippali, katuka, draksha, kashmarya'' and ''surasa''; one ''adhaka'' of milk and one ''adhaka'' of grape juice. Thus prepared ''ghrita'' is considered as auspicious, and cures ''shosha, jwara, pleeha'' and ''kasa''. <br />
<br />
''Dhatri phala'' or ''dhatriphala'' powder should be cooked with ''ksheera'' and ''ghrita'' for ''ghritapaka, yava-kshara-ghrita'' prepared by adding double the quantity of ''dadima-rasa'' and the powder of ''vyosha'', and which should be taken at the end of a meal; ''ghrita'' cooked with the paste of ''pippali, gud'' and ''chaga dugdha'';<br />
<br />
All the above mentioned ''ghrita'' will promote agni of the patient suffering from ''kshayajakasa''. These also cleanse the adhered ''doshas'' from the ''srotas'' of ''koshtha'' and ''uras''.[163-167]<br />
<br />
==== Haritaki leha ====<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
हरीतकीर्यवक्वाथद्व्याढके विंशतिं पचेत् | <br />
स्विन्ना मृदित्वा तास्तस्मिन् पुराणं गुडषट्पलम् ||१६८|| <br />
<br />
दद्यान्मनःशिलाकर्षं कर्षार्धं च रसाञ्जनात् | <br />
कुडवार्धं च पिप्पल्याः स लेहः श्वासकासनुत् ||१६९|| <br />
<br />
इति हरीतकीलेहः |<br />
<div class="mw-collapsible-content"><br />
<br />
harītakīryavakvāthadvyāḍhakē viṁśatiṁ pacēt| <br />
svinnā mr̥ditvā tāstasmin purāṇaṁ guḍaṣaṭpalam||168|| <br />
<br />
dadyānmanaḥśilākarṣaṁ karṣārdhaṁ ca rasāñjanāt| <br />
kuḍavārdhaṁ ca pippalyāḥ sa lēhaḥ śvāsakāsanut||169|| <br />
<br />
iti harītakīlēhaḥ| <br />
<br />
harItakIryavakvAthadvyADhake viMshatiM pacet| <br />
svinnA mRuditvA tAstasmin purANaM guDaShaTpalam||168|| <br />
<br />
dadyAnmanaHshilAkarShaM karShArdhaM ca rasA~jjanAt| <br />
kuDavArdhaM ca pippalyAH sa lehaH shvAsakAsanut||169|| <br />
<br />
iti harItakIlehaH| <br />
</div></div><br />
<br />
Twenty fruits of ''haritaki'' should be boiled with one ''adhaka'' of ''yava kashaya''. These boiled and soft fruits of ''haritaki'' are to be smashed. To this paste, six ''palas'' of ''purana gud'', one ''karsha'' of ''rasanjana'', half ''kudava'' of ''pippali'' should be added and cooked. This particular ''leha'' cures ''shwasa'' and ''kasa''.<br />
<br />
Thus ends the description of ''haritaki-leha''. [168-169]<br />
<br />
==== Padmakadi leha ====<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
श्वाविधः सूचयो दग्धाः सघृतक्षौद्रशर्कराः | <br />
श्वासकासहरा बर्हिपादौ वा क्षौद्रसर्पिषा ||१७०|| <br />
<br />
एरण्डपत्रक्षारं वा व्योषतैलगुडान्वितम् | <br />
लिह्यादेतेन विधिना सुरसैरण्डपत्रजम् ||१७१|| <br />
<br />
द्राक्षापद्मकवार्ताकपिप्पलीः क्षौद्रसर्पिषा | <br />
लिह्यात्त्र्यूषणचूर्णं वा पुराणगुडसर्पिषा ||१७२|| <br />
<br />
चित्रकं त्रिफलाजाजी कर्कटाख्या कटुत्रिकम् | <br />
द्राक्षां च क्षौद्रसर्पिर्भ्यां लिह्यादद्याद्गुडेन वा ||१७३|| <br />
<br />
पद्मकं त्रिफलां व्योषं विडङ्गं सुरदारु च | <br />
बलां रास्नां च तुल्यानि सूक्ष्मचूर्णानि कारयेत् ||१७४|| <br />
<br />
सर्वैरेभिः समं चूर्णैः पृथक् क्षौद्रं घृतं सिताम् | <br />
विमथ्य लेहयेल्लेहं सर्वकासहरं शिवम् ||१७५|| <br />
<br />
जीवन्तीं मधुकं पाठां त्वक्क्षीरीं त्रिफलां शटीम् | <br />
मुस्तैले पद्मकं द्राक्षां द्वे बृहत्यौ वितुन्नकम् ||१७६||<br />
<br />
सारिवां पौष्करं मूलं कर्कटाख्यां रसाञ्जनम् | <br />
पुनर्नवां लोहरजस्त्रायमाणां यवानिकाम् ||१७७|| <br />
<br />
भार्गीं तामलकीमृद्धिं विडङ्गं धन्वयासकम् | <br />
क्षारचित्रकचव्याम्लवेतसव्योषदारु च ||१७८|| <br />
<br />
चूर्णीकृत्य समांशानि लेहयेत् क्षौद्रसर्पिषा | <br />
चूर्णात्पाणितलं पञ्च कासानेतद् व्यपोहति ||१७९|| <br />
<br />
इति पद्मकादिलेहः |<br />
<div class="mw-collapsible-content"><br />
<br />
śvāvidhaḥ sūcayō dagdhāḥ saghr̥takṣaudraśarkarāḥ| <br />
śvāsakāsaharā barhipādau vā kṣaudrasarpiṣā||170|| <br />
<br />
ēraṇḍapatrakṣāraṁ vā vyōṣatailaguḍānvitam| <br />
lihyādētēna vidhinā surasairaṇḍapatrajam||171|| <br />
<br />
drākṣāpadmakavārtākapippalīḥ kṣaudrasarpiṣā| <br />
lihyāttryūṣaṇacūrṇaṁ vā purāṇaguḍasarpiṣā||172|| <br />
<br />
citrakaṁ triphalājājī karkaṭākhyā kaṭutrikam| <br />
drākṣāṁ ca kṣaudrasarpirbhyāṁ lihyādadyādguḍēna vā||173|| <br />
<br />
padmakaṁ triphalāṁ vyōṣaṁ viḍaṅgaṁ suradāru ca| <br />
balāṁ rāsnāṁ ca tulyāni sūkṣmacūrṇāni kārayēt||174|| <br />
<br />
sarvairēbhiḥ samaṁ cūrṇaiḥ pr̥thak kṣaudraṁ ghr̥taṁ sitām| <br />
vimathya lēhayēllēhaṁ sarvakāsaharaṁ śivam||175|| <br />
<br />
jīvantīṁ madhukaṁ pāṭhāṁ tvakkṣīrīṁ triphalāṁ śaṭīm| <br />
mustailē padmakaṁ drākṣāṁ dvē br̥hatyau vitunnakam||176|| <br />
<br />
sārivāṁ pauṣkaraṁ mūlaṁ karkaṭākhyāṁ rasāñjanam| <br />
punarnavāṁ lōharajastrāyamāṇāṁ yavānikām||177|| <br />
<br />
bhārgīṁ tāmalakīmr̥ddhiṁ viḍaṅgaṁ dhanvayāsakam| <br />
kṣāracitrakacavyāmlavētasavyōṣadāru ca||178|| <br />
<br />
cūrṇīkr̥tya samāṁśāni lēhayēt kṣaudrasarpiṣā| <br />
cūrṇātpāṇitalaṁ pañca kāsānētad vyapōhati||179|| <br />
<br />
iti padmakādilēhaḥ| <br />
<br />
shvAvidhaH sUcayo dagdhAH saghRutakShaudrasharkarAH| <br />
shvAsakAsaharA barhipAdau vA kShaudrasarpiShA||170|| <br />
<br />
eraNDapatrakShAraM vA vyoShatailaguDAnvitam| <br />
lihyAdetena vidhinA surasairaNDapatrajam||171|| <br />
<br />
drAkShApadmakavArtAkapippalIH kShaudrasarpiShA| <br />
lihyAttryUShaNacUrNaM vA purANaguDasarpiShA||172|| <br />
<br />
citrakaM triphalAjAjI karkaTAkhyA kaTutrikam| <br />
drAkShAM ca kShaudrasarpirbhyAM lihyAdadyAdguDena vA||173|| <br />
<br />
padmakaM triphalAM vyoShaM viDa~ggaM suradAru ca| <br />
balAM rAsnAM ca tulyAni sUkShmacUrNAni kArayet||174|| <br />
<br />
sarvairebhiH samaM cUrNaiH pRuthak kShaudraM ghRutaM sitAm| <br />
vimathya lehayellehaM sarvakAsaharaM shivam||175|| <br />
<br />
jIvantIM madhukaM pAThAM tvakkShIrIM triphalAM shaTIm| <br />
mustaile padmakaM drAkShAM dve bRuhatyau vitunnakam||176|| <br />
<br />
sArivAM pauShkaraM mUlaM karkaTAkhyAM rasA~jjanam| <br />
punarnavAM loharajastrAyamANAM yavAnikAm||177|| <br />
<br />
bhArgIM tAmalakImRuddhiM viDa~ggaM dhanvayAsakam| <br />
kShAracitrakacavyAmlavetasavyoShadAru ca||178|| <br />
<br />
cUrNIkRutya samAMshAni lehayet kShaudrasarpiShA| <br />
cUrNAtpANitalaM pa~jca kAsAnetad vyapohati||179|| <br />
<br />
iti padmakAdilehaH| <br />
</div></div><br />
<br />
Quills of ''svavit'' should be burnt. Intake of these ashes along with ghee, honey and ''ikshurasa'' cure ''kasa'' and ''shwasa''.<br />
Intake of the ash prepared by burning the peacock leg, along with ''madhu'' and ''ghrita'' cures ''kasa'' and ''shwasa''.<br />
<br />
The ''kshara'' should be prepared out of ''eranda'' leaves. Intake of this along with ''shunthi, maricha, taila'' and ''gud'' cures ''kasa'' and ''shwasa''.<br />
<br />
Similarly ''kshara'' prepared out of ''eranda'' leaves and ''surasa'' can be used in above said manner.<br />
<br />
The powder of ''draksha, padmaka, vartaka'' and ''pippali'' should be added with ''madhu'' and ''ghrita''. Intake of this cures ''shwasa'' and ''kasa''.<br />
<br />
Intake of ''tryushana'' powder along with ''purana gud'' and ''srapi'' is also effective in ''kasa'' and ''shwasa''.<br />
<br />
The powder of ''chitraka, haritaki, bibhitaka, amalaka, ajaji, karkatashringi, shunthi, pippali, maricha'' and ''draksha'' should be mixed with ''madhu, ghrita'' and ''purana gud''. Intake of these two cures ''kasa'' and ''shwasa''.<br />
<br />
''Padmaka, triphala, vyosha, vidanga, suradaru, bala'' and ''rasna'' taken in equal quantity should be made into fine powder. To this powder equal quantity of ''madhu, ghrita'' and sugar should be added and mixed well. This cures all types of ''kasa''.<br />
<br />
''Jivanti, madhuka, patha, tavaksheeri, triphala, shati, musta, ela, padmaka, draksha, brihati, kantakari, vitunnaka, sariva, pushkara, karkatashringi, rasanjana, punaranava, loha, rajatha, trayamana, yavanika, bharangi, tamalaki, riddhi, vidanga, dhanvayaasa, kshara, chitraka, chavya, amlavetasa, vyosha'', and ''devadaru'' should be taken in equal quantity and a fine powder should be prepared. Intake of this powder in one ''panitala matra'' along with ''madhu'' and ''ghrita'' cures all five types of ''kasa''.[170-179]<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
लिह्यान्मरिचचूर्णं वा सघृतक्षौद्रशर्करम् | <br />
बदरीपत्रकल्कं वा घृतभृष्टं ससैन्धवम् ||१८०|| <br />
<br />
स्वरभेदे च कासे च लेहमेतं प्रयोजयेत् | <br />
पत्रकल्कं घृतैर्भृष्टं तिल्वकस्य सशर्करम् ||१८१|| <br />
<br />
पेया चोत्कारिका च्छर्दितृट्कासामातिसारनुत् | <br />
गौरसर्षपगण्डीरविडङ्गव्योषचित्रकान् | <br />
साभयान् साधयेत्तोये यवागूं तेन चाम्भसा ||१८२|| <br />
<br />
ससर्पिर्लवणां कासे हिक्काश्वासे सपीनसे | <br />
पाण्ड्वामये क्षये शोथे कर्णशूले च दापयेत् ||१८३|| <br />
<br />
कण्टकारीरसे सिद्धो मुद्गयूषः सुसंस्कृतः | <br />
सगौरामलकः साम्लः सर्वकासभिषग्जितम् ||१८४|| <br />
<br />
वातघ्नौषधनिष्क्वाथं क्षीरं यूषान् रसानपि | <br />
वैष्किरप्रतुदान् बैलान् दापयेत् क्षयकासिने ||१८५|| <br />
<br />
क्षतकासे च ये धूमाः सानुपाना निदर्शिताः | <br />
क्षयकासेऽपि तानेव यथावस्थं प्रयोजयेत् ||१८६|| <br />
<div class="mw-collapsible-content"><br />
<br />
lihyānmaricacūrṇaṁ vā saghr̥takṣaudraśarkaram| <br />
badarīpatrakalkaṁ vā ghr̥tabhr̥ṣṭaṁ sasaindhavam||180|| <br />
<br />
svarabhēdē ca [1] kāsē ca lēhamētaṁ prayōjayēt| <br />
patrakalkaṁ ghr̥tairbhr̥ṣṭaṁ tilvakasya saśarkaram||181|| <br />
<br />
pēyā cōtkārikā ccharditr̥ṭkāsāmātisāranut| <br />
gaurasarṣapagaṇḍīraviḍaṅgavyōṣacitrakān| <br />
sābhayān sādhayēttōyē yavāgūṁ tēna cāmbhasā||182|| <br />
<br />
sasarpirlavaṇāṁ kāsē hikkāśvāsē sapīnasē| <br />
pāṇḍvāmayē kṣayē śōthē [2] karṇaśūlē ca dāpayēt||183|| <br />
<br />
kaṇṭakārīrasē siddhō mudgayūṣaḥ susaṁskr̥taḥ| <br />
sagaurāmalakaḥ sāmlaḥ sarvakāsabhiṣagjitam||184|| <br />
<br />
vātaghnauṣadhaniṣkvāthaṁ kṣīraṁ yūṣān rasānapi| <br />
vaiṣkirapratudān bailān dāpayēt kṣayakāsinē||185|| <br />
<br />
kṣatakāsē ca yē dhūmāḥ sānupānā nidarśitāḥ| <br />
kṣayakāsē'pi tānēva yathāvasthaṁ prayōjayēt||186|| <br />
<br />
lihyAnmaricacUrNaM vA saghRutakShaudrasharkaram| <br />
badarIpatrakalkaM vA ghRutabhRuShTaM sasaindhavam||180|| <br />
<br />
svarabhede ca [1] kAse ca lehametaM prayojayet| <br />
patrakalkaM ghRutairbhRuShTaM tilvakasya sasharkaram||181|| <br />
<br />
peyA cotkArikA ccharditRuTkAsAmAtisAranut| <br />
gaurasarShapagaNDIraviDa~ggavyoShacitrakAn| <br />
sAbhayAn sAdhayettoye yavAgUM tena cAmbhasA||182|| <br />
<br />
sasarpirlavaNAM kAse hikkAshvAse sapInase| <br />
pANDvAmaye kShaye shothe [2] karNashUle ca dApayet||183|| <br />
<br />
kaNTakArIrase siddho mudgayUShaH susaMskRutaH| <br />
sagaurAmalakaH sAmlaH sarvakAsabhiShagjitam||184|| <br />
<br />
vAtaghnauShadhaniShkvAthaM kShIraM yUShAn rasAnapi| <br />
vaiShkirapratudAn bailAn dApayet kShayakAsine||185|| <br />
<br />
kShatakAse ca ye dhUmAH sAnupAnA nidarshitAH| <br />
kShayakAse~api tAneva yathAvasthaM prayojayet||186|| <br />
</div></div><br />
<br />
The powder of ''maricha'' should be given with ''ghrita, madhu'' and ''sharkara''. ''Badara'' leaves should be fried with ghee and this given with ''saindhava lavana''. Both these formulations are beneficial in ''kasa'' and ''swarabheda''.<br />
<br />
The paste of the leaves of ''tilvaka'' should be sizzled with ''ghrita'' and made in to ''utkarika'' by adding sugar. Intake of this cures ''chhardi, trishna, kasa,''and ''amatisaara''.<br />
<br />
White variety of ''sarshapa, gandira, vidanga, vyosha, chitraka'' and ''abhaya'' should be boiled with water and the decoction is to be prepared. With this decoction ''yavagu'' should be prepared. This ''yavagu'' administered along with ''ghrita'' and ''lavana'' is beneficial in ''kasa, hikka, shwasa, pinasa, pandu, kshaya, shotha'' and ''karnashoola''.<br />
<br />
''Mudga yusha'' should be prepared by using ''kantakari'' decoction. Intake of this ''yusha'' along with ''goura amalaka'' and other ''amla dravyas'' cure all types of ''kasa''.<br />
<br />
''Ksheera, yusha, mamsa rasa'' are preferred in ''kshayajakasa'' persons. For the preparation of ''mamasarasa vishkira, pratuda'' and ''bileshaya mamsa'' should be added. Always these food preparations should be prepared by [[vata]]ghna drugs.<br />
<br />
''Dhumapana'' formulations mentioned in reference to ''kshatajakasa'' can also be administered to the patients suffering from ''kshayajakasa''.[180-186]<br />
<br />
==== Principles of management ====<br />
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<br />
दीपनं बृंहणं चैव स्रोतसां च विशोधनम् | <br />
व्यत्यासात्क्षयकासिभ्यो बल्यं सर्वं हितं भवेत् ||१८७|| <br />
<br />
सन्निपातभवोऽप्येष क्षयकासः सुदारुणः | <br />
सन्निपातहितं तस्मात् सदा कार्यं भिषग्जितम् ||१८८|| <br />
<br />
दोषानुबलयोगाच्च हरेद्रोगबलाबलम् | <br />
कासेष्वेषु गरीयांसं जानीयादुत्तरोत्तरम् ||१८९||<br />
<br />
भोज्यं पानानि सर्पींषि लेहाश्च सह पानकैः | <br />
क्षीरं सर्पिर्गुडा धूमाः कासभैषज्यसङ्ग्रहः ||१९०|| <br />
<div class="mw-collapsible-content"><br />
<br />
dīpanaṁ br̥ṁhaṇaṁ caiva srōtasāṁ ca viśōdhanam| <br />
vyatyāsātkṣayakāsibhyō balyaṁ sarvaṁ hitaṁ bhavēt||187|| <br />
<br />
sannipātabhavō'pyēṣa kṣayakāsaḥ sudāruṇaḥ| <br />
sannipātahitaṁ tasmāt sadā kāryaṁ bhiṣagjitam||188|| <br />
<br />
dōṣānubalayōgācca harēdrōgabalābalam| <br />
kāsēṣvēṣu garīyāṁsaṁ jānīyāduttarōttaram||189|| <br />
<br />
bhōjyaṁ pānāni sarpīṁṣi lēhāśca [1] saha pānakaiḥ| <br />
kṣīraṁ sarpirguḍā dhūmāḥ kāsabhaiṣajyasaṅgrahaḥ||190|| <br />
<br />
dIpanaM bRuMhaNaM caiva srotasAM ca vishodhanam| <br />
vyatyAsAtkShayakAsibhyo balyaM sarvaM hitaM bhavet||187|| <br />
<br />
sannipAtabhavo~apyeSha kShayakAsaH sudAruNaH| <br />
sannipAtahitaM tasmAt sadA kAryaM bhiShagjitam||188|| <br />
<br />
doShAnubalayogAcca haredrogabalAbalam| <br />
kAseShveShu garIyAMsaM jAnIyAduttarottaram||189|| <br />
<br />
bhojyaM pAnAni sarpIMShi lehAshca [1] saha pAnakaiH| <br />
kShIraM sarpirguDA dhUmAH kAsabhaiShajyasa~ggrahaH||190|| <br />
</div></div><br />
<br />
[[Dipana]], [[brihmana]] and ''srotoshodhana'' therapies should be followed alternatively in the patient suffering from ''kshyajakaasa''. All such therapies which are ''balya'' are preferred in this condition. <br />
<br />
''Kshayajakasa'' is caused by ''sannipata''. Therefore therapies which alleviate tri[[dosha]] are to be administered for the treatment.<br />
<br />
But still ''bala'' (strength) and ''abalata'' (weakness) of the disease is determined by the nature of aggravation of associated [[dosha]]. Keeping this in view, treatment should be administered.<br />
<br />
The physician should know that among these five kasa, the succeeding ones are more serious than the preceding. <br />
Different formulations mentioned under [[Kasa Chikitsa]] ''adhyaya'' are as follows:<br />
<br />
''Bhojya, pana, sarpi, leha, panaka, ksheera, sarpiguda'' and ''dhuma''.[187-190]<br />
<br />
=== Summary ===<br />
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<br />
तत्र श्लोकः- <br />
<br />
सङ्ख्या निमित्तं रूपाणि साध्यासाध्यत्वमेव च | <br />
कासानां भेषजं प्रोक्तं गरीयस्त्वं च कासिनः ||१९१|| <br />
<div class="mw-collapsible-content"><br />
<br />
tatra ślōkaḥ- <br />
<br />
saṅkhyā nimittaṁ rūpāṇi sādhyāsādhyatvamēva ca| <br />
kāsānāṁ bhēṣajaṁ prōktaṁ garīyastvaṁ ca kāsinaḥ||191|| <br />
<br />
tatra shlokaH- <br />
<br />
sa~gkhyA nimittaM rUpANi sAdhyAsAdhyatvameva ca| <br />
kAsAnAM bheShajaM proktaM garIyastvaM ca kAsinaH||191|| <br />
</div></div><br />
<br />
''Sankhya'' (types of ''kasa''), ''nimitta'' (etiological factors), ''rupa'' (signs and symptoms), ''sadhya-asadhyata'' (curability and incurability), ''kasa bheshaja'' (medicinal formulations), ''gariyastva'' (comparative seriousness of the disease) – have been discussed under this chapter. [191]<br />
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<br />
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते <br />
चिकित्सास्थाने कासचिकित्सितं नामाष्टादशोऽध्यायः ||१८||<br />
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<br />
ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē'prāptē dr̥ḍhabalasampūritē <br />
cikitsāsthānē kāsacikitsitaṁ nāmāṣṭādaśō'dhyāyaḥ||18|| <br />
<br />
cikitsAsthAne kAsacikitsitaM nAmAShTAdasho~adhyAyaH||18|| <br />
</div></div><br />
<br />
Thus ends the eighteenth chapter in [[Chikitsa Sthana]] dealing with treatment of ''kasa'' in the work of Agnivesha which was redacted by Charak and because of non-availability supplemented by Dridhabala.<br />
<br />
== Tattva Vimarsha (Fundamental Principles) ==<br />
<br />
*[[Vata]] being obstructed in the lower region of the body, moves upwards, afflicts the channels of circulation in the upper part of the body, takes over the function of udana [[vayu]] and gets localized in the throat and chest, then enters and fills up all the cavities in the head. <br />
*Udana[[vata]] plays key role in ''kasa''. It is located in sinuses, throat and upper respiratory tract. Its main function is to exude out secretions from head and upper respiratory tract, effortlessly. <br />
*Due to one group of etiological factors, sinuses and bronchial tree gets filled with secretions. Another group of factors like over exertion, weaken the functions of udana[[vata]] by over consuming it.<br />
*Since udana[[vata]] is not available, the physiological mechanism of ''kasa'' (cough reflex) starts to work causing forceful, frictionful expectoration with sound.<br />
*In order to prevent damage to delicate mucosa and avoid friction, treatment with good amount of ghee after meal is best.<br />
*In contrast to ''hikka'' and shwasa, [[pitta]] is not involved ''kasa'' except ''paittic kasa''. </div><br />
<br />
== Vidhi Vimarsha (Applied Inferences) ==<br />
<br />
=== Diagnostic codes===<br />
<br />
National Ayurveda Morbidity Code: EA-3<ref>Avaialable from http://namstp.ayush.gov.in/#/Ayurveda accessed on 10/06/2021</ref><br />
<br />
ICD code: R05<br />
<br />
=== Causes of kasa ===<br />
<br />
'''Dietary:'''<br />
<br />
*Excessive intake of dry, cold and astringent food <br />
*Excess fasting <br />
*Taking food in less quantity [Cha.Sa.[[Chikitsa Sthana]] 18/10]<br />
*Excessive intake of hot, spicy, sour foods [Cha.Sa.[[Chikitsa Sthana]] 18/14]<br />
*Intake of heavy to digest, slimy, sweet and oily foods [Cha.Sa.[[Chikitsa Sthana]] 18/17]<br />
<br />
'''Lifestyle:'''<br />
<br />
*Excessive indulgence in sex <br />
*Excessive physical strain <br />
*Suppression of natural urges [Cha.Sa.[[Chikitsa Sthana]] 18/10]<br />
*Excessive exposure to heat [Cha.Sa.[[Chikitsa Sthana]] 18/14]<br />
*Excessive sleep and inactivity [Cha.Sa.[[Chikitsa Sthana]] 18/17]<br />
*Carrying a hefty load<br />
*Walking excessively long distance<br />
*Chest injury <br />
*Indirect trauma due to excessive heavy exertional work like in bullfight, controlling mighty animals like horses and elephants as in occupational fieldworks [Cha.Sa.[[Chikitsa Sthana]] 18/20]<br />
<br />
'''Psychological:'''<br />
<br />
*Anger and grief [Cha.Sa.[[Chikitsa Sthana]] 18/14]<br />
<br />
'''Acute exacerbating causes:'''<br />
<br />
*Exposure to smoke and dust <br />
*Entry of food into respiratory tract [Su.Sa.Uttara Sthana 52/4]<ref name= Susruta> Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref><br />
<br />
===Classification===<br />
<br />
#[[Vata]] [[dosha]] predominance<br />
#[[Pitta]] [[dosha]] predominance<br />
#[[Kapha]] [[dosha]] predominance<br />
#Traumatic injury (kshataja)<br />
#Depletion of body tissues (kshayaja) [Cha.Sa.[[Chikitsa Sthana]] 18/3-4]<br />
<br />
===Premonitory features===<br />
<br />
*Thorny feeling in mouth and throat <br />
*Itching in throat <br />
*Obstruction in deglutition [Cha.Sa.[[Chikitsa Sthana]] 18/4]<br />
*Coating of mucous or sticky secretions in throat and palate<br />
*Low raspy voice<br />
*Anorexia <br />
*Low digestive capacity [Su.Sa.Uttara Sthana 52/7]<ref name=Susruta/><br />
<br />
===Clinical features===<br />
<br />
====General clinical features====<br />
<br />
The voice of patient resembles the sound that comes out of a broken bronze vessel. [Su.Sa.Uttara Sthana 52/5]<ref name=Susruta/><br />
<br />
====[[Dosha]] specific clinical features====<br />
<br />
======[[Vata]] dominant kasa======<br />
<br />
*Excruciating pain in the epigastric region, flanks, chest, and head<br />
*Excessive hoarseness of the voice<br />
*Dryness in the chest, throat and mouth<br />
*Horripilation and fainting<br />
*Resonant sound during coughing, looks hopeless, hollow sound during coughing<br />
*Weakness, agitated, illusive perceptions<br />
*Dry cough<br />
*Painful coughing with scanty expectoration <br />
*Cough gets alleviated by the food and drinks that are unctuous, hot, salty and sour<br />
*Increases after digestion of food [Cha.Sa.[[Chikitsa Sthana]] 18/10-13]<br />
<br />
======[[Pitta]] dominant kasa======<br />
<br />
*Yellowish sputum and eyes<br />
*Bitter taste in mouth<br />
*Abnormal voice or inflammation of vocal apparatus as in pharyngitis, laryngitis <br />
*A feeling of smoke is being vomited out of the chest<br />
*Morbid thirst, burning, illusive, anorexia and giddiness<br />
*Appearance of twinkling stars in front of the eyes while coughing continuously<br />
*Expectoration of sputum mixed with [[pitta]] [Cha.Sa.[[Chikitsa Sthana]] 15-16]<br />
<br />
======[[Kapha]] dominant kasa======<br />
<br />
*Poor digestion<br />
*Anorexia, vomiting, nausea <br />
*Nasal discharge<br />
*Heaviness<br />
*Horripilation, stickiness, and sweetness of the mouth<br />
*Expectoration of thick, sweet, slimy phlegm in large quantity<br />
*Painless coughing and smooth release of sputum is differentiating feature of [[kapha]] dominance <br />
*Feeling of fullness in the chest [Cha.Sa.[[Chikitsa Sthana]] 18/18-19]<br />
<br />
In a study, [[kapha]]kasa is compared with chronic bronchitis.<ref name=shilpals>Shilpa L.S., Prashanth A.S. A Critical Review on the Etiopathogenesis and Treatment of Kaphaja Kasa (Chronic Bronchitis). J Ayurveda Integr Med Sci 2016;4:118-122. http://dx.doi.org/10.21760/jaims.v1i4.6928</ref><br />
<br />
====== Kasa as a result of trauma (kshataja)======<br />
<br />
*Initial dry cough followed by blood-tinged sputum<br />
*Excessive pain in the throat <br />
*Cracking pain in the chest<br />
*Sharp pricking pain <br />
*Excruciating pain and discomfort on touching the chest <br />
*Miserable appearance.<br />
*Pain in joints and fingers, fever, labored breath, thirst, and altered voice<br />
*While coughing, sounds humming like a pigeon. [Cha.Sa.[[Chikitsa Sthana]] 18/20-23]<br />
<br />
======Kasa due to depletion of body tissues (kshayaja)======<br />
<br />
*Expectoration of greenish, reddish sputum, associated with pus and bad odor.<br />
*While coughing, the person feels as if the heart is displaced.<br />
*Feels suddenly afflicted with both hot and cold sensations<br />
*Weakness and emaciation even after taking food in excessive quantity<br />
*The clean and unctuous complexion of the face, associated with the gracious appearance of face and eyes.<br />
*The soft silky touch of hands and foot<br />
*The person always finds fault with others and develops an immensely hateful disposition<br />
*The person suffers from diseases like [[jwara]] (having signs and symptoms of all [[dosha]]), nasal congestion, anorexia, painful flanks, and altered voice<br />
*Frequent hard or loose stools without apparent cause [Cha.Sa.[[Chikitsa Sthana]] 18/25-28]<br />
<br />
===Pathogenesis===<br />
<br />
[[File:Kasa_Samprapti.JPG|500px|'''Image 1: Samprapti of Kasa'''|thumb]]<br />
<br />
*[[Dosha]]: [[Vata]], [[Kapha]]<br />
*[[Dushya]]: [[Rasa]]<br />
*Srotasa: pranavaha, rasavaha<br />
*Site of origin: amashaya (stomach) <br />
*Site of manifestation/clinical presentation: Throat (kantha) and chest (uras)<br />
*Type of pathogenesis: Obstruction (sanga), Movement of [[dosha]] in the wrong direction (vimargagamana)[Cha.Sa.[[Chikitsa Sthana]] 18/6-8]<br />
<br />
===Clinical examination===<br />
<br />
*Respiratory rate <br />
*Pulse examination <br />
*Chest examination by auscultation, palpation and percussion<br />
<br />
===Investigations===<br />
<br />
'''Radiological examinations:'''<br />
<br />
*Chest X-Ray<br />
*C.T.Scan of chest and thoracic region<br />
<br />
'''Laboratory investigations:'''<br />
<br />
*Sputum examination <br />
*Absolute Eosinophil count <br />
<br />
===Prognosis===<br />
<br />
*[[Vata]], [[pitta]] and [[kapha]] dominant kasa are curable. <br />
*Cough due to trauma (kshataja) and cough due to depletion of body tissues (kshayaja) are curable initially and in strong individuals. In the chronic stage, they can be controlled and palliated with appropriate drugs and diet. [Cha.Sa.[[Chikitsa Sthana]] 18/29-31]<br />
<br />
'''Poor prognostic features:''' <br />
<br />
If the patient is weak, cough due to depletion of body tissues (kshayaja kasa) may cause death. All types are palliable in old patients.[Cha.Sa.[[Chikitsa Sthana]] 18/29-30]<br />
<br />
===Management===<br />
<br />
====Principles of management====<br />
<br />
*Avoidance of etiological factors <br />
*Purification therapy (shodhana) as per dominance of [[dosha]]<br />
*Pacification therapy (shamana) as per dominance of [[dosha]]<br />
*Disease-specific rejuvenation treatment (vyadhiahara [[rasayana]])<br />
<br />
====[[Dosha]] specific treatment principles====<br />
<br />
======[[Vata]] predominance======<br />
<br />
*Unctuous therapies ([[snehana]]) <br />
*Dietary supplements like gruels, milk, meat etc. processed with [[vata]] alleviating medicines can be used. [Cha.Sa.[[Chikitsa Sthana]] 18/32-33] <br />
*Therapeutic enema ([[basti]]) [Cha.Sa.[[Chikitsa Sthana]] 18/32]<br />
*In association [[kapha]] or [[pitta]], [[dosha]]-specific measures shall be used. [Cha.Sa.[[Chikitsa Sthana]] 18/132] When [[vata]] dominant kasa is associated with [[pitta]], medicated ghee and milk after food is indicated. [A.Hr.Chikitsa Sthana 3/2]<ref name= Hridaya > Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref><br />
<br />
======[[Pitta]] predominance======<br />
<br />
*Therapeutic purgation ([[virechana]]) [Cha.Sa.[[Chikitsa Sthana]] 18/85]<br />
*Other purification therapies as per quantity of [[dosha]]<br />
*Unctuous electuaries [Cha.Sa.[[Chikitsa Sthana]] 18/86]<br />
<br />
======[[Kapha]] predominance======<br />
<br />
*Therapeutic emesis ([[vamana]]) [Cha.Sa.[[Chikitsa Sthana]] 18/108] <br />
*Dry and light to digest foods <br />
*The oil exuding out from burning log of Cedrus deodara (devadaru) is used in treatment. It is mixed with powders of Piper longum, Piper nigrum and Zingiber officinale (trikatu), and ash of Hordeum vulgare (yavakshara) as a first line of treatment. [A.Hr.Chikitsa Sthana 3/41]<ref name=Hridaya/><br />
<br />
====Disease-specific treatment principles====<br />
<br />
=====Cough due to traumatic injury =====<br />
<br />
*This acute condition should be treated immediately with drugs promoting strength and improving muscle tissues ([[mamsa dhatu]]). Sweet and life-promoting (jivaniya) drugs shall be used. [Cha.Sa.[[Chikitsa Sthana]] 18/134] <br />
*Kerria lacca (laksha) mixed with honey with milk is advised. [A.Hr.Chikitsa Sthana 3/73]<ref name=Hridaya/> <br />
*Medicines used for [[pitta]] dominant kasa are indicated.<br />
*Milk, ghee, and honey are given in such patients. [Cha.Sa.[[Chikitsa Sthana]] 18/138] <br />
*All therapies which alleviate [[vata]][[dosha]], and do not aggravate [[pitta]] and [[rakta]] should be followed in such persons.<br />
*Ghee prepared with life-promoting (jivaniya) medicines. <br />
*Meat, meat soup prepared out of common quail (lava)<br />
*Goat’s milk processed with trinapanchamoola (combination of Desmostachyabipinnata, Saccharum spontaneum, Phragmites karka, Imperata cylindrical, Saccharum officinarum etc.) in case of morbid thirst (trushna)<br />
*Ghee in the form of nasal administration ([[nasya]]) or as a drink in case of bleeding.<br />
*In case of stiffness of body, ghee in larger quantity should be given.[Cha.Sa.[[Chikitsa Sthana]] 18/139-143]<br />
<br />
===== Cough due to depletion of body tissues or degenerative conditions ===== <br />
<br />
In the initial stage, nourishing therapy ([[brimhana]]) with [[deepana]] (therapies that increase digestive capacity) should be given. [Cha.Sa.[[Chikitsa Sthana]] 18/150] These therapies and purification therapies (srotoshodana) shall be done alternatively. As all three [[dosha]]s are vitiated in this type of kasa, the therapies aim to pacify and balance all three [[dosha]]s. [Cha.Sa.[[Chikitsa Sthana]] 18/187-88]<br />
<br />
If the amount of [[pitta]] and [[kapha]] are less, and associated with emaciation, then ghee processed with Pistacia chinensis (karkatakasringi), Sida cordifolia (bala), Sidarhombifolia (atibala) and milk should be given.<br />
<br />
If kasa is associated with discoloration or difficulty in urination, then milk processed with Pueraria tuberose (vidari), Neolamarckia cadamba (kadamba) or with tender fruits of Flacourita jangomas (tall) should be given. [Cha.Sa.[[Chikitsa Sthana]] 18/153-54] <br />
<br />
==== [[Panchakarma]] procedures with safety precautions ====<br />
<br />
*Internal administration of unctuous substances (snehapana): In [[vata]]kasa [Cha.Sa.[[Chikitsa Sthana]] 18/32-33] <br />
*Oil massage (abhyanga): It is indicated in [[vata]] dominant kasa [Cha.Sa.[[Chikitsa Sthana]] 18/32-33] and cough due to chest injury associated with [[vata]] and [[pitta]]. [Cha.Sa.[[Chikitsa Sthana]] 18/139] <br />
*Fomentation: Unctuous fomentation is indicated in [[vata]] dominant kasa [Cha.Sa.[[Chikitsa Sthana]] 18/32-33] <br />
*Therapeutic enema ([[basti]]): It is indicated in [[vata]] dominant kasa associated with constipation and flatulence [Cha.Sa.[[Chikitsa Sthana]] 18/32-33] <br />
*Therapeutic purgation ([[virechana]]): Purgation with unctuous substance (like castor oil) shall be given in case of dryness and aggravation of [[kapha]]. [ [Cha.Sa.[[Chikitsa Sthana]] 18/34] In case of thin phlegm, then Operculina turpethum (trivrit) mixed with sweet substances is advised for purgation. In case of thick phlegm, Operculina turpethum (trivrit) mixed with bitter substances is advised for purgation. [Cha.Sa.[[Chikitsa Sthana]] 18/85] Mild purgation is advised to reduce aggravated [[dosha]] in kasa due to depletion of body tissues. [Cha.Sa.[[Chikitsa Sthana]] 18/150] <br />
*Medicated smoke/fumigation (dhuma): It is indicated in case of headache and coryza associated with [[vata]] and [[kapha]][[dosha]]. [Cha.Sa.[[Chikitsa Sthana]] 18/65-68] <br />
*Therapeutic emesis ([[vamana]]): In [[pitta]] dominant kasa associated with [[kapha]][[dosha]], therapeutic emesis ([[vamana]]) is advised with decoction (kashaya) prepared out of Catunaregam spinosa (madana), Gmelina arborea (kashmari), Glycyrrhiza glabra (madhuka) etc. [Cha.Sa.[[Chikitsa Sthana]] 18/83] In [[kapha]] dominant kasa and strong person, therapeutic emesis shall be done first. [Cha.Sa.[[Chikitsa Sthana]] 18/108] <br />
*Intra nasal drug administration ([[nasya]]): If bleeding is present in kasa (as a result of trauma), trinapanchamula ghee is used for [[nasya]]. It is prepared from milk processed with herbs of trinapanchamoola (combination of Desmostachyabi pinnata, Saccharum spontaneum, Phragmites karka, Imperata cylindrical, Saccharum officinarum etc.). [Cha.Sa.[[Chikitsa Sthana]] 18/142] In [[kapha]] dominant kasa, nasal instillation with medicines having purificatory properties (shirovirechana nasya) is advised. [Su.Sa.Uttara Sthana 52/28]<ref name=Susruta/><br />
*Decoction enema (niruha [[basti]]): Therapeutic enema with decoction is indicated [Su.Sa.Uttara Sthana 52/27]<ref name=Susruta/> in [[vata]] dominant kasa with constipation and flatulence. [A.Hr. Chikitsa Sthana 3/2]<ref name=Hridaya/><br />
*Medicated unctuous enema (anuvasana [[basti]]): Medicated unctuous enema (anuvasana) is advised if pain and swelling in loin, groin, anus or penile region are present in kasa (due to depletion of body tissue) patient. [Cha.Sa.[[Chikitsa Sthana]] 18/155]. It is indicated in [[vata]] dominant kasa. [Su.Sa.Uttara Sthana 52/27]<ref name=Susruta/><br />
<br />
====Medicines used in current practice====<br />
<br />
=====Herbs=====<br />
<br />
Piper longam (pippali), Piper nigrum (maricha), Flacourtia jangomas (talisapatra), Solanum virginianum (kantakari), Inula racemosa (pushkaramula).<ref name=Ranades>Ranade S. Pranavaha srotas (Respiratory sysytem). In: Kayachikitsa Vol 2. Delhi: Chaukhamba Sanskrit pratishthan; 2014: 212-24</ref><br />
<br />
=====Herbal formulations=====<br />
<br />
Agastya Haritaki [Cha.Sa.[[Chikitsa Sthana]] 18/ 57-62], Kushmandarasayana [A.Hr.Chikitsa Sthana 3/114-117]<ref name=Hridaya/>, Vyaghriharitaki [B.R.15/169-172]<ref name=Ratnavali> Govindadas. Bhaishajyaratnavali. Translated from Sanskrit by Kanjiv Lochan. Reprint. Varanasi: Chaukhambha Sanskrit sansthan;2008.</ref>, Talisadichurna [B.R 15/36-40]<ref name=Ratnavali/>, Vasa arishta<ref name=shilpals/>, Vasa avaleha [B.R.15/179-181]<ref name=Ratnavali/>, Sitopaladi churna<ref name=shilpals/>, Lavangadivati [B.R.15/35]<ref name=Ratnavali/>, Khadiradi vati<ref name=Ranades/>, Kanakasava.<ref name=Ranades/><br />
<br />
=====Herbo-mineral formulations=====<br />
<br />
Laxmivilasa rasa [B.R 15/130-37]<ref name=Ratnavali/>, Kasakuthara rasa, Svachandabhairava rasa<ref name=shilpals/>, Hema garbha potalirasa<ref name=shilpals/>, Rudraparpati, Bhutankusha rasa<ref name=Ranades/>, Amritarnava rasa[B.R 15/60-61]<ref name=Ratnavali/><br />
<br />
====Wholesome diet====<br />
<br />
Meat soup along with wheat, barley, rice etc. and sweet, sour and salty foods are wholesome in kasa with [[vata]] predominance.[Cha.Sa.[[Chikitsa Sthana]] 18/76-82]<br />
<br />
Dysphania ambrosioides (vastuka), Solanum americanum (vayasi), Senna occidentalis (kasaghna), fruits and leaves of Solanum virginianum (kantakari), dried tender Raphanus raphanistrum (mulaka), Sesamum indicum (tila) oil, edibles prepared from milk, sugarcane juice and jaggery, whey of curds, juice prepared from sour fruits and fermented beverages are wholesome in [[vata]]kasa. [A.Hr.Chikitsa Sthana 3/23-24]<ref name=Hridaya/><br />
<br />
In kasa with [[pitta]] predominance, sweet and cold things are advised. Shyamaka, Hordeum vulgare (yava), Paspalum scrobiculatum (kodrava), bitter vegetables etc. are wholesome. [B.R 15/8]<ref name=Ratnavali/> [Cha.Sa.[[Chikitsa Sthana]] 18/98]<br />
<br />
Hot and spicy food materials are wholesome in kasa with [[kapha]] predominance. [Cha.Sa.[[Chikitsa Sthana]] 18/108] <br />
<br />
Drinks such as honey (madhu), warm water, buttermilk etc. are preferred in kasa with [[kapha]] predominance. [Cha.Sa.[[Chikitsa Sthana]] 18/110] <br />
<br />
Piper longum, Piper nigrum and Zingiber officinale (trikatu)[Su.Sa.Uttara Sthana 52/29]<ref name=Susruta/>, barley, green gram, horse gram etc. are wholesome in [[kapha]]kasa.[A.Hr.Chikitsa Sthana 3/43]<ref name=Hridaya/><br />
<br />
Goat’s milk is good in all types of kasa.<ref name=shilpals/><br />
<br />
===Complications===<br />
<br />
If kasa is not appropriately treated, it leads to consumption (rajayakshma) due to aggravation of all three [[dosha]] and depletion of body tissues.[Su.Sa.Uttara Sthana 52/6]<ref name=Susruta/><br />
<br />
===Contemporary views===<br />
<br />
====Case reports====<br />
<br />
=====Solanum xanthocarpum=====<br />
<br />
The whole plant (panchanga) of Solanum xanthocarpum showed significant anti-tussive activity when compared to its roots. Administration of 10 gms of powder of drug for 10 days in 30 patients reported better action over [[kapha]] dominant kasa. The drug might be suppressing the central cough center by stimulating opioid receptors in the brain. It may be acting through protective ciliary activity in the respiratory tract. The action as demulcent can relieve cough.<ref name=mansukh>Mansukh S Parmar (2012): A comparative pharmacognostical, physicochemical and pharmacological study of moola and panchanga of Kantakari (Solanum xanthocarpum Schrad. & Wendl.) w.s.r. to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamnagar</ref><br />
<br />
=====Tribulus terrestris=====<br />
<br />
An experimental study reported anti-tussive activity of root powder of Tribulus terrestris (laghu gokshura) in sulphur dioxide induced cough models. The number of cough episodes was significantly less in Tribulus terrestris (laghu gokshura) root administered group. While root of Pedalium murex (brihat gokshura) showed insignificant decrease in number of cough episodes. In a clinical study, administration of powder of Tribulus terrestris (laghu gokshura) root and root of Pedalium murex (brihat gokshura), 3gm twice a day in 28 patients of kasa is observed. It reported better effect in group administered with Tribulus terrestris. The effect was better in reducing [[vata]]kasa. This study also suggested effect of drug on central nervous system and its anti-inflammatory activity.<ref name=chandrika>Chandrika N Methekar (2012): A comparative pharmacognostical and phyto pharmacological assessment of moola, panchanga of laghu gokshura (Tribulus terrestris Linn.) and Brihat gokshura (Pedalium murex Linn.) w.s.r to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamanagar</ref> <br />
<br />
=====Combination of terminalia chebula and rock salt===== <br />
<br />
In a study conducted on 19 patients, Terminalia chebula (haritaki) with Rock salt (saindava lavana) was found effective in reducing the symptoms of [[kapha]]kasa. There was 92.3% relief in cough with sputum and itching in throat. The action of haritaki on [[vata]] and [[kapha]][[dosha]] due to its hot potency is observed as reason behind efficacy.<ref name=rout>Rout AK, Dwivedi RR. A clinical study of Haritaki and Saindhava Lavana in Kaphaja Kasa with special reference to Samyoga Guna. Ayu. 2011 Jul;32(3):357-60. doi: 10.4103/0974-8520.93914. PMID: 22736910; PMCID: PMC3326882.</ref> <br />
<br />
=====Kantakari-maricha leha=====<br />
<br />
In a study, kantakari-marichaleha (ayurvedic formulation) was administered for 7 days in 30 children with symptoms of [[kapha]]kasa. It was found effective in reducing the signs and symptoms.<ref name=sawant>Sawant S, Nandgaonkar J A, Gujarathi R H. Efficacy of kantakari maricha leha on kaphaja kasa in children of age group 1 to 5 years. WJPR. 2018 Mar;7(7):1250-55. doi: 10.20959/wjpr20187-11693</ref> <br />
<br />
=====Samasharkara powder formulation=====<br />
<br />
In another study on 60 patients with [[kapha]]kasa, 10gms of Samasarkarachurna for 15 days is found effective in reducing the signs and symptoms.<ref name=dighe>Dighe P M. Efficacy of Samsharkara Churna in Kaphaj Kasa. Ijam. 2013, 4(1), 36-42</ref> <br />
<br />
=====Bhrigarajasava as adjunct to anti tubercular treatment=====<br />
<br />
In another study conducted on 60 patients with pulmonary tuberculosis (TB), administration of Bhrigarajasava along with the standard treatment was found effective in reducing the cough. The cough progressively diminished and became occasional and non-productive within 15 days of treatment.<ref>Dornala SN, Dornala SS. Clinical efficacy of Bhringarajasava as Naimittika Rasayana in Rajayakshma with special reference to pulmonary tuberculosis. Ayu. 2012 Oct;33(4):523-9. doi: 10.4103/0974-8520.110536. PMID: 23723670; PMCID: PMC3665204.</ref><br />
<br />
=====Vyaghri-haritaki avaleha in chronic bronchitis=====<br />
<br />
A study on 66 patients with chronic bronchitis reported that Vyaghri-haritaki avaleha effectively reduced the productive cough, which is the cardinal feature of chronic bronchitis.<ref>Ram J, Baghel MS. Clinical efficacy of Vyaghriharitaki Avaleha in the management of chronic bronchitis. Ayu. 2015 Jan-Mar;36(1):50-5. doi: 10.4103/0974-8520.169009. PMID: 26730139; PMCID: PMC4687240.</ref><br />
<br />
In another study conducted on 25 patients of kasa, administration of vyaghri-haritaki avaleha for four weeks showed highly significant results signs and symptoms.<ref>Suhas A. Chaudhary, Patel KS, Kori VK , Rajagopala S. Management of doshika kasa in subacute and chronic stage with Vyaghri haritaki avaleha in children. Ayurpharm Int J Ayur Alli Sci. 2014;3(4):97-111.</ref> <br />
<br />
=====Unctuous enema in pertussis=====<br />
<br />
Administration of unctuous enema (sneha[[basti]]) in pertussis patients of pediatric age group ( n=2) was studied. It was found very effective in reducing dry cough. Sesame oil in a dose of 10 - 20ml is used in [[basti]] for 14 days along with antimicrobial therapy. Initially, the intensity of cough was reduced, followed by a reduction in the frequency of cough episodes. Unctuous enema acts directly over the colon to restore normal functions of [[vata]][[dosha]].<ref>Gujarathi RH, Gokhale VM, Tongaonkar JN. Effect of Basti (oil enema) therapy for the management of cough in pertussis. Ayu. 2013 Oct;34(4):397-400. doi: 10.4103/0974-8520.127722. PMID: 24696577; PMCID: PMC3968703.</ref><br />
<br />
=====Kasahara dashemani tablets=====<br />
<br />
In 40 children with kasa, administration of Kasahara Dashemani vati for 60 days showed relief in all symptoms of kasa. Reduction in acute eosinophil count (AEC) and erythrocyte sedimentation rate (ESR) levels are noted. The decrease in IgE levels indicates the drug’s action against allergy. It is found effective in [[vata]] and [[pitta]] predominant kasa.<ref>Subrahmanya NK, Patel KS, Kori VK, Shrikrishna R. Role of Kasahara Dashemani Vati in Kasa and Vyadhikshamatva in children with special reference to recurrent respiratory tract infections. Ayu. 2013 Jul;34(3):281-7. doi: 10.4103/0974-8520.123124. PMID: 24501524; PMCID: PMC3902595.</ref><br />
<br />
=== List of research works done ===<br />
<br />
#Mansukh S Parmar (2012): A comparative pharmacognostical, physicochemical and pharmacological study of moola and panchanga of Kantakari (Solanum xanthocarpum Schrad. & Wendl.) w.s.r. to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamnagar<br />
#Chandrika N Methekar (2012): A comparative pharmacognostical and phyto pharmacological assessment of moola, panchanga of laghugokshura (Tribulus terrestris Linn.) and Brihatgokshura (Pedalium murex Linn.) w.s.r to its kasahara karma, Department of Dravyaguna Vigyan, IPGT&RA, Jamanagar<br />
<br />
=== Abbreviations ===<br />
<br />
Cha. = Charak, Su. = Sushruta, A. = Ashtanga, Hr. = Hridayam, Sa. = Samhita, B.R = Bhaishajya ratnavali<br />
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<h1 style="color: #2c5aa0; margin-bottom: 10px; font-size: 2.5em;">Charak Samhita - 120 Chapters (Adhyaya)</h1><br />
<p style="color: #666; font-size: 1.1em; font-style: italic;">Complete Index of Chapters Organized by Eight Sections (Sthana)</p><br />
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[[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]<br><br />
[[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br />
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<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">I</div><br />
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<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Sutra Sthana|Section on Fundamental Principles (Sutra Sthana)]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Basic principles of Ayurveda, daily regimen, seasonal regimen, and fundamental therapies</p><br />
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<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Deerghanjiviteeya Adhyaya|Longevity (Deerghanjiviteeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Apamarga Tanduliya Adhyaya|Dehusked Seeds of Apamarga (Apamarga Tanduliya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Aragvadhiya Adhyaya|Aragvadha (Cassia) and Other Medicines (Aragvadhiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Shadvirechanashatashritiya Adhyaya|Resources of Six Hundred Evacuatives (Shadvirechanashatashritiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Matrashiteeya Adhyaya|Proper Quantity of Food (Matrashiteeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Tasyashiteeya Adhyaya|Seasonal Regimen (Tasyashiteeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Naveganadharaniya Adhyaya|Natural Urges (Naveganadharaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Indriyopakramaniya Adhyaya|Disciplinary Protocol for Sense Organs (Indriyopakramaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Khuddakachatushpada Adhyaya|Four Fundamental Components of Healthcare (Khuddakachatushpada Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Mahachatushpada Adhyaya|Four Important Components of Therapeutics (Mahachatushpada Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Tistraishaniya Adhyaya|Three Desires of Life (Tistraishaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vatakalakaliya Adhyaya|Merits and Demerits of Vata (Vatakalakaliya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sneha Adhyaya|Oleation Therapies (Sneha Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sweda Adhyaya|Sudation Therapies (Sweda Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Upakalpaniya Adhyaya|Hospital Management Guidelines (Upakalpaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Chikitsaprabhritiya Adhyaya|Assessment in Panchakarma (Chikitsaprabhritiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kiyanta Shiraseeya Adhyaya|Diseases of Vital Organs (Kiyanta Shiraseeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trishothiya Adhyaya|Three Types of Swellings (Trishothiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Ashtodariya Adhyaya|Numerical Classification of Diseases (Ashtodariya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Maharoga Adhyaya|Dosha Specific Classification (Maharoga Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Ashtauninditiya Adhyaya|Eight Undesirable Constitutions (Ashtauninditiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Langhanabrimhaniya Adhyaya|Reduction and Nourishing Therapies (Langhanabrimhaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Santarpaniya Adhyaya|Over-nutrition and Under-nutrition (Santarpaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vidhishonitiya Adhyaya|Characteristics of Shonita (Blood) (Vidhishonitiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Yajjah Purushiya Adhyaya|Origin of Human Beings (Yajjah Purushiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Atreyabhadrakapyiya Adhyaya|Pharmacological Principles (Atreyabhadrakapyiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Annapanavidhi Adhyaya|Classification of Food and Beverages (Annapanavidhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vividhashitapitiya Adhyaya|Sequential Effects of Food (Vividhashitapitiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Dashapranayataneeya Adhyaya|Ten Seats of Life Forces (Dashapranayataneeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Arthedashmahamooliya Adhyaya|Ten Great Vessels from Heart (Arthedashmahamooliya Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Nidana Sthana --><br />
<div id="Nidana" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">II</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Nidana Sthana|Section on Diagnostic Principles (Nidana Sthana)]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Etiology, pathogenesis, and diagnosis of major diseases</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Jwara Nidana Adhyaya|Diagnosis of Jwara (Fever) (Jwara Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Raktapitta Nidana Adhyaya|Diagnosis of Bleeding Disorders (Raktapitta Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Gulma Nidana Adhyaya|Diagnosis of Abdominal Lumps (Gulma Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Prameha Nidana Adhyaya|Diagnosis of Urinary Disorders (Prameha Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kushtha Nidana Adhyaya|Diagnosis of Skin Diseases (Kushtha Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Shosha Nidana Adhyaya|Diagnosis of Wasting Disease (Shosha Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Unmada Nidana Adhyaya|Diagnosis of Psychosis (Unmada Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Apasmara Nidana Adhyaya|Diagnosis of Seizure Disorders (Apasmara Nidana Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Vimana Sthana --><br />
<div id="Vimana" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">III</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Vimana Sthana|Section on Specific Medical Principles (Vimana Sthana)]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Detailed knowledge of diseases, channels, and examination methods</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Rasa Vimana Adhyaya|Taste-based Factors (Rasa Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trividhakukshiya Vimana Adhyaya|Three Parts of Abdomen (Trividhakukshiya Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Janapadodhvansaniya Vimana Adhyaya|Destruction of Communities (Janapadodhvansaniya Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trividha Roga Vishesha Vijnaniya Vimana Adhyaya|Three Methods of Disease Knowledge (Trividha Roga Vishesha Vijnaniya Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sroto Vimana Adhyaya|Channels of Transport (Sroto Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Roganika Vimana Adhyaya|Classification of Diseases (Roganika Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vyadhita Rupiya Vimana Adhyaya|Types of Patients (Vyadhita Rupiya Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Rogabhishagjitiya Vimana Adhyaya|Conquering Debate and Disease (Rogabhishagjitiya Vimana Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Sharira Sthana --><br />
<div id="Sharira" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">IV</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Sharira Sthana|Section on Human Being and Genesis (Sharira Sthana)]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Embryology, anatomy, and physiology of human beings</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Katidhapurusha Sharira Adhyaya|Holistic Human Being (Katidhapurusha Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Atulyagotriya Sharira Adhyaya|Different Clans (Atulyagotriya Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Khuddika Garbhavakranti Sharira Adhyaya|Factors for Embryogenesis (Khuddika Garbhavakranti Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Mahatigarbhavakranti Sharira Adhyaya|Embryonic Development (Mahatigarbhavakranti Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Purusha Vichaya Sharira Adhyaya|Detailed Study of Human Being (Purusha Vichaya Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sharira Vichaya Sharira Adhyaya|Analytical Study of Body (Sharira Vichaya Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sharira Sankhya Sharira Adhyaya|Numerological Account (Sharira Sankhya Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Jatisutriya Sharira Adhyaya|Obstetrics and Neonatal Care (Jatisutriya Sharira Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Indriya Sthana --><br />
<div id="Indriya" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">V</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Indriya Sthana|Section on Sensorial Prognosis (Indriya Sthana)]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Prognosis based on signs and symptoms from sense organs</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Varnasvariyam Indriyam Adhyaya|Fatal Signs in Complexion and Voice (Varnasvariyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Pushpitakam Indriyam Adhyaya|Fatal Signs of Tactile and Olfactory Perception (Pushpitakam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Parimarshaneeyam Indriyam Adhyaya|Palpable Signs of Death (Parimarshaneeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Indriyaneekam Indriyam Adhyaya|Fatal Signs in Sense Organs (Indriyaneekam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Purvarupeeyam Indriyam Adhyaya|Prognosis by Prodromal Symptoms (Purvarupeeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Katamanisharireeyam Indriyam Adhyaya|Specific Fatal Clinical Features (Katamanisharireeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Pannarupiyam Indriyam Adhyaya|Changes in Shadows and Complexion (Pannarupiyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Avakshiraseeyam Indriyam Adhyaya|Inverted Shadow of Dying Person (Avakshiraseeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Yasyashyavanimittiyam Indriyam Adhyaya|Palliative Care Signs (Yasyashyavanimittiyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sadyomaraneeyam Indriyam Adhyaya|Signs of Instant Death (Sadyomaraneeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Anujyotiyam Indriyam Adhyaya|Diminution of Agni (Anujyotiyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Gomayachurniyam Indriyam Adhyaya|Characteristics of Messenger (Gomayachurniyam Indriyam Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Chikitsa Sthana --><br />
<div id="Chikitsa" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">VI</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Chikitsa Sthana|Section on Therapeutic Principles (Chikitsa Sthana)]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Management and treatment of various diseases</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Rasayana Adhyaya|Rejuvenation Therapy (Rasayana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vajikarana Adhyaya|Aphrodisiac Therapy (Vajikarana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Jwara Chikitsa Adhyaya|Management of Jwara (Fever) (Jwara Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Raktapitta Chikitsa Adhyaya|Management of Bleeding Disorders (Raktapitta Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Gulma Chikitsa Adhyaya|Management of Gulma (Gulma Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Prameha Chikitsa Adhyaya|Management of Urinary Disorders (Prameha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kushtha Chikitsa Adhyaya|Management of Skin Diseases (Kushtha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Rajayakshma Chikitsa Adhyaya|Management of Wasting Diseases (Rajayakshma Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Unmada Chikitsa Adhyaya|Management of Psychosis (Unmada Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Apasmara Chikitsa Adhyaya|Management of Seizure Disorders (Apasmara Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kshatakshina Chikitsa Adhyaya|Management of Emaciation due to Trauma (Kshatakshina Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Shvayathu Chikitsa Adhyaya|Management of Swellings (Shvayathu Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Udara Chikitsa Adhyaya|Management of Abdominal Enlargement (Udara Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Arsha Chikitsa Adhyaya|Management of Hemorrhoids (Arsha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Grahani Chikitsa Adhyaya|Management of Digestive Diseases (Grahani Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Pandu Chikitsa Adhyaya|Management of Anemia (Pandu Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Hikka Shwasa Chikitsa Adhyaya|Management of Hiccups and Dyspnea (Hikka Shwasa Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kasa Chikitsa Adhyaya|Management of Cough (Kasa Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Atisara Chikitsa Adhyaya|Management of Diarrhea (Atisara Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Chhardi Chikitsa Adhyaya|Management of Vomiting (Chhardi Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Visarpa Chikitsa Adhyaya|Management of Acute Spreading Erysipelas (Visarpa Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trishna Chikitsa Adhyaya|Management of Morbid Thirst (Trishna Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Visha Chikitsa Adhyaya|Management of Poisoning (Visha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Madatyaya Chikitsa Adhyaya|Management of Intoxication (Madatyaya Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Dwivraniya Chikitsa Adhyaya|Management of Ulcers (Dwivraniya Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trimarmiya Chikitsa Adhyaya|Management of Three Vital Organs (Trimarmiya Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Urustambha Chikitsa Adhyaya|Management of Thigh and Hip Diseases (Urustambha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vatavyadhi Chikitsa Adhyaya|Management of Vata Diseases (Vatavyadhi Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vatarakta Chikitsa Adhyaya|Management of Vata and Rakta Diseases (Vatarakta Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Yonivyapat Chikitsa Adhyaya|Management of Genital Tract Disorders (Yonivyapat Chikitsa Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Kalpa Sthana --><br />
<div id="Kalpa" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">VII</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Kalpa Sthana|Section on Pharmaceutical Preparations (Kalpa Sthana)]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Formulation and preparation of medicinal compounds</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Madana Kalpa Adhyaya|Preparations of Madanaphala (Madana Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Jimutaka Kalpa Adhyaya|Preparations of Jimutaka (Jimutaka Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Ikshvaku Kalpa Adhyaya|Preparations of Ikshvaku (Ikshvaku Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Dhamargava Kalpa Adhyaya|Preparations of Dhamargava (Dhamargava Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vatsaka Kalpa Adhyaya|Preparations of Vatsaka (Vatsaka Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kritavedhana Kalpa Adhyaya|Preparations of Kritavedhana (Kritavedhana Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Shyamatrivrita Kalpa Adhyaya|Preparations of Shyama Trivrita (Shyamatrivrita Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Chaturangula Kalpa Adhyaya|Preparations of Chaturangula (Chaturangula Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Tilvaka Kalpa Adhyaya|Preparations of Tilvaka (Tilvaka Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sudha Kalpa Adhyaya|Preparations of Sudha (Sudha Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Saptalashankhini Kalpa Adhyaya|Preparations of Saptala and Shankhini (Saptalashankhini Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Dantidravanti Kalpa Adhyaya|Preparations of Danti and Dravanti (Dantidravanti Kalpa Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Siddhi Sthana --><br />
<div id="Siddhi" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">VIII</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Siddhi Sthana|Section on Therapeutic Procedures (Siddhi Sthana)]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Administration of purification therapies and Panchakarma</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle (Netrabastivyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation (Vamana Virechana Vyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema (Bastivyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations (Prasrita Yogiyam Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs (Trimarmiya Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Basti Siddhi Adhyaya|Successful Enema Administration (Basti Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits (Phalamatra Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema (Uttar Basti Siddhi Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
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<div style="margin-top: 50px; padding: 25px; background: #f0f7ff; border-radius: 10px; text-align: center; border: 1px solid #cce0ff;"><br />
<div style="font-size: 1.2em; margin-bottom: 15px; color: #2c5aa0;"><br />
<strong>Total Chapters: 120</strong> | <strong>Sections: 8</strong><br />
</div><br />
<p style="color: #666; font-size: 0.95em; max-width: 800px; margin: 0 auto; line-height: 1.6;">This index provides links to all chapters of Charak Samhita, the foundational text of Ayurveda. Each section (Sthana) covers specific aspects of Ayurvedic knowledge and practice.</p><br />
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</div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Sandip_Bhagyoday&diff=45405Sandip Bhagyoday2026-01-20T14:07:14Z<p>Agnivesha: </p>
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|description=Complete list and links to all one hundred twenty chapters of Charak Samhita organized by sections (Sthana)<br />
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<div style="max-width: 1200px; margin: 0 auto; padding: 20px; font-family: 'Segoe UI', Tahoma, Geneva, Verdana, sans-serif;"><br />
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<div style="text-align: center; margin-bottom: 40px; padding-bottom: 20px; border-bottom: 3px solid #2c5aa0;"><br />
<h1 style="color: #2c5aa0; margin-bottom: 10px; font-size: 2.5em;">Charak Samhita - 120 Chapters (Adhyaya)</h1><br />
<p style="color: #666; font-size: 1.1em; font-style: italic;">Complete Index of Chapters Organized by Eight Sections (Sthana)</p><br />
</div><br />
<br />
<div style="margin-bottom: 30px;"><br />
<div style="background: #f0f7ff; border: 2px solid #2c5aa0; border-radius: 10px; padding: 15px; text-align: center;"><br />
<h3 style="margin-top: 0; color: #2c5aa0;">Quick Navigation</h3><br />
<div style="font-size: 1.1em; line-height: 1.6;"><br />
[[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]<br><br />
[[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br />
</div><br />
</div><br />
</div><br />
<br />
<!-- Sutra Sthana --><br />
<div id="Sutra" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">I</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Sutra Sthana|Section on Fundamental Principles]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Basic principles of Ayurveda, daily regimen, seasonal regimen, and fundamental therapies</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Deerghanjiviteeya Adhyaya|Longevity (Deerghanjiviteeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Apamarga Tanduliya Adhyaya|Dehusked Seeds of Apamarga (Apamarga Tanduliya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Aragvadhiya Adhyaya|Aragvadha (Cassia) and Other Medicines (Aragvadhiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Shadvirechanashatashritiya Adhyaya|Resources of Six Hundred Evacuatives (Shadvirechanashatashritiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Matrashiteeya Adhyaya|Proper Quantity of Food (Matrashiteeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Tasyashiteeya Adhyaya|Seasonal Regimen (Tasyashiteeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Naveganadharaniya Adhyaya|Natural Urges (Naveganadharaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Indriyopakramaniya Adhyaya|Disciplinary Protocol for Sense Organs (Indriyopakramaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Khuddakachatushpada Adhyaya|Four Fundamental Components of Healthcare (Khuddakachatushpada Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Mahachatushpada Adhyaya|Four Important Components of Therapeutics (Mahachatushpada Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Tistraishaniya Adhyaya|Three Desires of Life (Tistraishaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vatakalakaliya Adhyaya|Merits and Demerits of Vata (Vatakalakaliya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sneha Adhyaya|Oleation Therapies (Sneha Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sweda Adhyaya|Sudation Therapies (Sweda Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Upakalpaniya Adhyaya|Hospital Management Guidelines (Upakalpaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Chikitsaprabhritiya Adhyaya|Assessment in Panchakarma (Chikitsaprabhritiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kiyanta Shiraseeya Adhyaya|Diseases of Vital Organs (Kiyanta Shiraseeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trishothiya Adhyaya|Three Types of Swellings (Trishothiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Ashtodariya Adhyaya|Numerical Classification of Diseases (Ashtodariya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Maharoga Adhyaya|Dosha Specific Classification (Maharoga Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Ashtauninditiya Adhyaya|Eight Undesirable Constitutions (Ashtauninditiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Langhanabrimhaniya Adhyaya|Reduction and Nourishing Therapies (Langhanabrimhaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Santarpaniya Adhyaya|Over-nutrition and Under-nutrition (Santarpaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vidhishonitiya Adhyaya|Characteristics of Shonita (Blood) (Vidhishonitiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Yajjah Purushiya Adhyaya|Origin of Human Beings (Yajjah Purushiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Atreyabhadrakapyiya Adhyaya|Pharmacological Principles (Atreyabhadrakapyiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Annapanavidhi Adhyaya|Classification of Food and Beverages (Annapanavidhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vividhashitapitiya Adhyaya|Sequential Effects of Food (Vividhashitapitiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Dashapranayataneeya Adhyaya|Ten Seats of Life Forces (Dashapranayataneeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Arthedashmahamooliya Adhyaya|Ten Great Vessels from Heart (Arthedashmahamooliya Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Nidana Sthana --><br />
<div id="Nidana" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">II</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Nidana Sthana|Section on Diagnostic Principles]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Etiology, pathogenesis, and diagnosis of major diseases</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Jwara Nidana Adhyaya|Diagnosis of Jwara (Fever) (Jwara Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Raktapitta Nidana Adhyaya|Diagnosis of Bleeding Disorders (Raktapitta Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Gulma Nidana Adhyaya|Diagnosis of Abdominal Lumps (Gulma Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Prameha Nidana Adhyaya|Diagnosis of Urinary Disorders (Prameha Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kushtha Nidana Adhyaya|Diagnosis of Skin Diseases (Kushtha Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Shosha Nidana Adhyaya|Diagnosis of Wasting Disease (Shosha Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Unmada Nidana Adhyaya|Diagnosis of Psychosis (Unmada Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Apasmara Nidana Adhyaya|Diagnosis of Seizure Disorders (Apasmara Nidana Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Vimana Sthana --><br />
<div id="Vimana" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">III</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Vimana Sthana|Section on Specific Medical Principles]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Detailed knowledge of diseases, channels, and examination methods</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Rasa Vimana Adhyaya|Taste-based Factors (Rasa Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trividhakukshiya Vimana Adhyaya|Three Parts of Abdomen (Trividhakukshiya Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Janapadodhvansaniya Vimana Adhyaya|Destruction of Communities (Janapadodhvansaniya Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trividha Roga Vishesha Vijnaniya Vimana Adhyaya|Three Methods of Disease Knowledge (Trividha Roga Vishesha Vijnaniya Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sroto Vimana Adhyaya|Channels of Transport (Sroto Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Roganika Vimana Adhyaya|Classification of Diseases (Roganika Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vyadhita Rupiya Vimana Adhyaya|Types of Patients (Vyadhita Rupiya Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Rogabhishagjitiya Vimana Adhyaya|Conquering Debate and Disease (Rogabhishagjitiya Vimana Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Sharira Sthana --><br />
<div id="Sharira" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">IV</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Sharira Sthana|Section on Human Being and Genesis]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Embryology, anatomy, and physiology of human beings</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Katidhapurusha Sharira Adhyaya|Holistic Human Being (Katidhapurusha Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Atulyagotriya Sharira Adhyaya|Different Clans (Atulyagotriya Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Khuddika Garbhavakranti Sharira Adhyaya|Factors for Embryogenesis (Khuddika Garbhavakranti Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Mahatigarbhavakranti Sharira Adhyaya|Embryonic Development (Mahatigarbhavakranti Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Purusha Vichaya Sharira Adhyaya|Detailed Study of Human Being (Purusha Vichaya Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sharira Vichaya Sharira Adhyaya|Analytical Study of Body (Sharira Vichaya Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sharira Sankhya Sharira Adhyaya|Numerological Account (Sharira Sankhya Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Jatisutriya Sharira Adhyaya|Obstetrics and Neonatal Care (Jatisutriya Sharira Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Indriya Sthana --><br />
<div id="Indriya" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">V</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Indriya Sthana|Section on Sensorial Prognosis]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Prognosis based on signs and symptoms from sense organs</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Varnasvariyam Indriyam Adhyaya|Fatal Signs in Complexion and Voice (Varnasvariyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Pushpitakam Indriyam Adhyaya|Fatal Signs of Tactile and Olfactory Perception (Pushpitakam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Parimarshaneeyam Indriyam Adhyaya|Palpable Signs of Death (Parimarshaneeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Indriyaneekam Indriyam Adhyaya|Fatal Signs in Sense Organs (Indriyaneekam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Purvarupeeyam Indriyam Adhyaya|Prognosis by Prodromal Symptoms (Purvarupeeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Katamanisharireeyam Indriyam Adhyaya|Specific Fatal Clinical Features (Katamanisharireeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Pannarupiyam Indriyam Adhyaya|Changes in Shadows and Complexion (Pannarupiyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Avakshiraseeyam Indriyam Adhyaya|Inverted Shadow of Dying Person (Avakshiraseeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Yasyashyavanimittiyam Indriyam Adhyaya|Palliative Care Signs (Yasyashyavanimittiyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sadyomaraneeyam Indriyam Adhyaya|Signs of Instant Death (Sadyomaraneeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Anujyotiyam Indriyam Adhyaya|Diminution of Agni (Anujyotiyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Gomayachurniyam Indriyam Adhyaya|Characteristics of Messenger (Gomayachurniyam Indriyam Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Chikitsa Sthana --><br />
<div id="Chikitsa" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">VI</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Chikitsa Sthana|Section on Therapeutic Principles]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Management and treatment of various diseases</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Rasayana Adhyaya|Rejuvenation Therapy (Rasayana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vajikarana Adhyaya|Aphrodisiac Therapy (Vajikarana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Jwara Chikitsa Adhyaya|Management of Jwara (Fever) (Jwara Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Raktapitta Chikitsa Adhyaya|Management of Bleeding Disorders (Raktapitta Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Gulma Chikitsa Adhyaya|Management of Gulma (Gulma Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Prameha Chikitsa Adhyaya|Management of Urinary Disorders (Prameha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kushtha Chikitsa Adhyaya|Management of Skin Diseases (Kushtha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Rajayakshma Chikitsa Adhyaya|Management of Wasting Diseases (Rajayakshma Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Unmada Chikitsa Adhyaya|Management of Psychosis (Unmada Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Apasmara Chikitsa Adhyaya|Management of Seizure Disorders (Apasmara Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kshatakshina Chikitsa Adhyaya|Management of Emaciation due to Trauma (Kshatakshina Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Shvayathu Chikitsa Adhyaya|Management of Swellings (Shvayathu Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Udara Chikitsa Adhyaya|Management of Abdominal Enlargement (Udara Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Arsha Chikitsa Adhyaya|Management of Hemorrhoids (Arsha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Grahani Chikitsa Adhyaya|Management of Digestive Diseases (Grahani Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Pandu Chikitsa Adhyaya|Management of Anemia (Pandu Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Hikka Shwasa Chikitsa Adhyaya|Management of Hiccups and Dyspnea (Hikka Shwasa Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kasa Chikitsa Adhyaya|Management of Cough (Kasa Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Atisara Chikitsa Adhyaya|Management of Diarrhea (Atisara Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Chhardi Chikitsa Adhyaya|Management of Vomiting (Chhardi Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Visarpa Chikitsa Adhyaya|Management of Acute Spreading Erysipelas (Visarpa Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trishna Chikitsa Adhyaya|Management of Morbid Thirst (Trishna Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Visha Chikitsa Adhyaya|Management of Poisoning (Visha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Madatyaya Chikitsa Adhyaya|Management of Intoxication (Madatyaya Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Dwivraniya Chikitsa Adhyaya|Management of Ulcers (Dwivraniya Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trimarmiya Chikitsa Adhyaya|Management of Three Vital Organs (Trimarmiya Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Urustambha Chikitsa Adhyaya|Management of Thigh and Hip Diseases (Urustambha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vatavyadhi Chikitsa Adhyaya|Management of Vata Diseases (Vatavyadhi Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vatarakta Chikitsa Adhyaya|Management of Vata and Rakta Diseases (Vatarakta Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Yonivyapat Chikitsa Adhyaya|Management of Genital Tract Disorders (Yonivyapat Chikitsa Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Kalpa Sthana --><br />
<div id="Kalpa" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">VII</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Kalpa Sthana|Section on Pharmaceutical Preparations]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Formulation and preparation of medicinal compounds</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Madana Kalpa Adhyaya|Preparations of Madanaphala (Madana Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Jimutaka Kalpa Adhyaya|Preparations of Jimutaka (Jimutaka Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Ikshvaku Kalpa Adhyaya|Preparations of Ikshvaku (Ikshvaku Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Dhamargava Kalpa Adhyaya|Preparations of Dhamargava (Dhamargava Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vatsaka Kalpa Adhyaya|Preparations of Vatsaka (Vatsaka Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kritavedhana Kalpa Adhyaya|Preparations of Kritavedhana (Kritavedhana Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Shyamatrivrita Kalpa Adhyaya|Preparations of Shyama Trivrita (Shyamatrivrita Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Chaturangula Kalpa Adhyaya|Preparations of Chaturangula (Chaturangula Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Tilvaka Kalpa Adhyaya|Preparations of Tilvaka (Tilvaka Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sudha Kalpa Adhyaya|Preparations of Sudha (Sudha Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Saptalashankhini Kalpa Adhyaya|Preparations of Saptala and Shankhini (Saptalashankhini Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Dantidravanti Kalpa Adhyaya|Preparations of Danti and Dravanti (Dantidravanti Kalpa Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Siddhi Sthana --><br />
<div id="Siddhi" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">VIII</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Siddhi Sthana|Section on Therapeutic Procedures]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Administration of purification therapies and Panchakarma</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle (Netrabastivyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation (Vamana Virechana Vyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema (Bastivyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations (Prasrita Yogiyam Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs (Trimarmiya Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Basti Siddhi Adhyaya|Successful Enema Administration (Basti Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits (Phalamatra Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema (Uttar Basti Siddhi Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div style="margin-top: 50px; padding: 25px; background: #f0f7ff; border-radius: 10px; text-align: center; border: 1px solid #cce0ff;"><br />
<div style="font-size: 1.2em; margin-bottom: 15px; color: #2c5aa0;"><br />
<strong>Total Chapters: 120</strong> | <strong>Sections: 8</strong><br />
</div><br />
<p style="color: #666; font-size: 0.95em; max-width: 800px; margin: 0 auto; line-height: 1.6;">This index provides links to all chapters of Charak Samhita, the foundational text of Ayurveda. Each section (Sthana) covers specific aspects of Ayurvedic knowledge and practice.</p><br />
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</div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Sandip_Bhagyoday&diff=45404Sandip Bhagyoday2026-01-20T14:04:33Z<p>Agnivesha: </p>
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<h1 style="color: #2c5aa0; margin-bottom: 10px; font-size: 2.5em;">Charak Samhita - 120 Chapters (Adhyaya)</h1><br />
<p style="color: #666; font-size: 1.1em; font-style: italic;">Complete Index of Chapters Organized by Eight Sections (Sthana)</p><br />
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<div style="background: #f0f7ff; border: 2px solid #2c5aa0; border-radius: 10px; padding: 15px; text-align: center;"><br />
<h3 style="margin-top: 0; color: #2c5aa0;">Quick Navigation</h3><br />
<div style="font-size: 1.1em; line-height: 1.6;"><br />
[[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]<br><br />
[[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br />
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<!-- Sutra Sthana --><br />
<div id="Sutra" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">I</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Sutra Sthana|Section on Fundamental Principles]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Basic principles of Ayurveda, daily regimen, seasonal regimen, and fundamental therapies</p><br />
</div><br />
</div><br />
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<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Deerghanjiviteeya Adhyaya|Longevity (Deerghanjiviteeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Apamarga Tanduliya Adhyaya|Dehusked Seeds of Apamarga (Apamarga Tanduliya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Aragvadhiya Adhyaya|Aragvadha (Cassia) and Other Medicines (Aragvadhiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Shadvirechanashatashritiya Adhyaya|Resources of Six Hundred Evacuatives (Shadvirechanashatashritiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Matrashiteeya Adhyaya|Proper Quantity of Food (Matrashiteeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Tasyashiteeya Adhyaya|Seasonal Regimen (Tasyashiteeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Naveganadharaniya Adhyaya|Natural Urges (Naveganadharaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Indriyopakramaniya Adhyaya|Disciplinary Protocol for Sense Organs (Indriyopakramaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Khuddakachatushpada Adhyaya|Four Fundamental Components of Healthcare (Khuddakachatushpada Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Mahachatushpada Adhyaya|Four Important Components of Therapeutics (Mahachatushpada Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Tistraishaniya Adhyaya|Three Desires of Life (Tistraishaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vatakalakaliya Adhyaya|Merits and Demerits of Vata (Vatakalakaliya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sneha Adhyaya|Oleation Therapies (Sneha Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sweda Adhyaya|Sudation Therapies (Sweda Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Upakalpaniya Adhyaya|Hospital Management Guidelines (Upakalpaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Chikitsaprabhritiya Adhyaya|Assessment in Panchakarma (Chikitsaprabhritiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kiyanta Shiraseeya Adhyaya|Diseases of Vital Organs (Kiyanta Shiraseeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trishothiya Adhyaya|Three Types of Swellings (Trishothiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Ashtodariya Adhyaya|Numerical Classification of Diseases (Ashtodariya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Maharoga Adhyaya|Dosha Specific Classification (Maharoga Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Ashtauninditiya Adhyaya|Eight Undesirable Constitutions (Ashtauninditiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Langhanabrimhaniya Adhyaya|Reduction and Nourishing Therapies (Langhanabrimhaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Santarpaniya Adhyaya|Over-nutrition and Under-nutrition (Santarpaniya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vidhishonitiya Adhyaya|Characteristics of Shonita (Blood) (Vidhishonitiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Yajjah Purushiya Adhyaya|Origin of Human Beings (Yajjah Purushiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Atreyabhadrakapyiya Adhyaya|Pharmacological Principles (Atreyabhadrakapyiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Annapanavidhi Adhyaya|Classification of Food and Beverages (Annapanavidhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vividhashitapitiya Adhyaya|Sequential Effects of Food (Vividhashitapitiya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Dashapranayataneeya Adhyaya|Ten Seats of Life Forces (Dashapranayataneeya Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Arthedashmahamooliya Adhyaya|Ten Great Vessels from Heart (Arthedashmahamooliya Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
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<!-- Nidana Sthana --><br />
<div id="Nidana" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">II</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Nidana Sthana|Section on Diagnostic Principles]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Etiology, pathogenesis, and diagnosis of major diseases</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Jwara Nidana Adhyaya|Diagnosis of Jwara (Fever) (Jwara Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Raktapitta Nidana Adhyaya|Diagnosis of Bleeding Disorders (Raktapitta Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Gulma Nidana Adhyaya|Diagnosis of Abdominal Lumps (Gulma Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Prameha Nidana Adhyaya|Diagnosis of Urinary Disorders (Prameha Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kushtha Nidana Adhyaya|Diagnosis of Skin Diseases (Kushtha Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Shosha Nidana Adhyaya|Diagnosis of Wasting Disease (Shosha Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Unmada Nidana Adhyaya|Diagnosis of Psychosis (Unmada Nidana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Apasmara Nidana Adhyaya|Diagnosis of Seizure Disorders (Apasmara Nidana Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Vimana Sthana --><br />
<div id="Vimana" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">III</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Vimana Sthana|Section on Specific Medical Principles]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Detailed knowledge of diseases, channels, and examination methods</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Rasa Vimana Adhyaya|Taste-based Factors (Rasa Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trividhakukshiya Vimana Adhyaya|Three Parts of Abdomen (Trividhakukshiya Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Janapadodhvansaniya Vimana Adhyaya|Destruction of Communities (Janapadodhvansaniya Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trividha Roga Vishesha Vijnaniya Vimana Adhyaya|Three Methods of Disease Knowledge (Trividha Roga Vishesha Vijnaniya Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sroto Vimana Adhyaya|Channels of Transport (Sroto Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Roganika Vimana Adhyaya|Classification of Diseases (Roganika Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vyadhita Rupiya Vimana Adhyaya|Types of Patients (Vyadhita Rupiya Vimana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Rogabhishagjitiya Vimana Adhyaya|Conquering Debate and Disease (Rogabhishagjitiya Vimana Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Sharira Sthana --><br />
<div id="Sharira" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">IV</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Sharira Sthana|Section on Human Being and Genesis]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Embryology, anatomy, and physiology of human beings</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Katidhapurusha Sharira Adhyaya|Holistic Human Being (Katidhapurusha Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Atulyagotriya Sharira Adhyaya|Different Clans (Atulyagotriya Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Khuddika Garbhavakranti Sharira Adhyaya|Factors for Embryogenesis (Khuddika Garbhavakranti Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Mahatigarbhavakranti Sharira Adhyaya|Embryonic Development (Mahatigarbhavakranti Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Purusha Vichaya Sharira Adhyaya|Detailed Study of Human Being (Purusha Vichaya Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sharira Vichaya Sharira Adhyaya|Analytical Study of Body (Sharira Vichaya Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sharira Sankhya Sharira Adhyaya|Numerological Account (Sharira Sankhya Sharira Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Jatisutriya Sharira Adhyaya|Obstetrics and Neonatal Care (Jatisutriya Sharira Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Indriya Sthana --><br />
<div id="Indriya" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">V</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Indriya Sthana|Section on Sensorial Prognosis]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Prognosis based on signs and symptoms from sense organs</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Varnasvariyam Indriyam Adhyaya|Fatal Signs in Complexion and Voice (Varnasvariyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Pushpitakam Indriyam Adhyaya|Fatal Signs of Tactile and Olfactory Perception (Pushpitakam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Parimarshaneeyam Indriyam Adhyaya|Palpable Signs of Death (Parimarshaneeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Indriyaneekam Indriyam Adhyaya|Fatal Signs in Sense Organs (Indriyaneekam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Purvarupeeyam Indriyam Adhyaya|Prognosis by Prodromal Symptoms (Purvarupeeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Katamanisharireeyam Indriyam Adhyaya|Specific Fatal Clinical Features (Katamanisharireeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Pannarupiyam Indriyam Adhyaya|Changes in Shadows and Complexion (Pannarupiyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Avakshiraseeyam Indriyam Adhyaya|Inverted Shadow of Dying Person (Avakshiraseeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Yasyashyavanimittiyam Indriyam Adhyaya|Palliative Care Signs (Yasyashyavanimittiyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sadyomaraneeyam Indriyam Adhyaya|Signs of Instant Death (Sadyomaraneeyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Anujyotiyam Indriyam Adhyaya|Diminution of Agni (Anujyotiyam Indriyam Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Gomayachurniyam Indriyam Adhyaya|Characteristics of Messenger (Gomayachurniyam Indriyam Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Chikitsa Sthana --><br />
<div id="Chikitsa" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">VI</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Chikitsa Sthana|Section on Therapeutic Principles]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Management and treatment of various diseases</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 2; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Rasayana Adhyaya|Rejuvenation Therapy (Rasayana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vajikarana Adhyaya|Aphrodisiac Therapy (Vajikarana Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Jwara Chikitsa Adhyaya|Management of Jwara (Fever) (Jwara Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Raktapitta Chikitsa Adhyaya|Management of Bleeding Disorders (Raktapitta Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Gulma Chikitsa Adhyaya|Management of Gulma (Gulma Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Prameha Chikitsa Adhyaya|Management of Urinary Disorders (Prameha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kushtha Chikitsa Adhyaya|Management of Skin Diseases (Kushtha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Rajayakshma Chikitsa Adhyaya|Management of Wasting Diseases (Rajayakshma Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Unmada Chikitsa Adhyaya|Management of Psychosis (Unmada Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Apasmara Chikitsa Adhyaya|Management of Seizure Disorders (Apasmara Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kshatakshina Chikitsa Adhyaya|Management of Emaciation due to Trauma (Kshatakshina Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Shvayathu Chikitsa Adhyaya|Management of Swellings (Shvayathu Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Udara Chikitsa Adhyaya|Management of Abdominal Enlargement (Udara Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Arsha Chikitsa Adhyaya|Management of Hemorrhoids (Arsha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Grahani Chikitsa Adhyaya|Management of Digestive Diseases (Grahani Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Pandu Chikitsa Adhyaya|Management of Anemia (Pandu Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Hikka Shwasa Chikitsa Adhyaya|Management of Hiccups and Dyspnea (Hikka Shwasa Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kasa Chikitsa Adhyaya|Management of Cough (Kasa Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Atisara Chikitsa Adhyaya|Management of Diarrhea (Atisara Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Chhardi Chikitsa Adhyaya|Management of Vomiting (Chhardi Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Visarpa Chikitsa Adhyaya|Management of Acute Spreading Erysipelas (Visarpa Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trishna Chikitsa Adhyaya|Management of Morbid Thirst (Trishna Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Visha Chikitsa Adhyaya|Management of Poisoning (Visha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Madatyaya Chikitsa Adhyaya|Management of Intoxication (Madatyaya Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Dwivraniya Chikitsa Adhyaya|Management of Ulcers (Dwivraniya Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trimarmiya Chikitsa Adhyaya|Management of Three Vital Organs (Trimarmiya Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Urustambha Chikitsa Adhyaya|Management of Thigh and Hip Diseases (Urustambha Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vatavyadhi Chikitsa Adhyaya|Management of Vata Diseases (Vatavyadhi Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vatarakta Chikitsa Adhyaya|Management of Vata and Rakta Diseases (Vatarakta Chikitsa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Yonivyapat Chikitsa Adhyaya|Management of Genital Tract Disorders (Yonivyapat Chikitsa Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Kalpa Sthana --><br />
<div id="Kalpa" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">VII</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Kalpa Sthana|Section on Pharmaceutical Preparations]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Formulation and preparation of medicinal compounds</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Madana Kalpa Adhyaya|Preparations of Madanaphala (Madana Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Jimutaka Kalpa Adhyaya|Preparations of Jimutaka (Jimutaka Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Ikshvaku Kalpa Adhyaya|Preparations of Ikshvaku (Ikshvaku Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Dhamargava Kalpa Adhyaya|Preparations of Dhamargava (Dhamargava Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vatsaka Kalpa Adhyaya|Preparations of Vatsaka (Vatsaka Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Kritavedhana Kalpa Adhyaya|Preparations of Kritavedhana (Kritavedhana Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Shyamatrivrita Kalpa Adhyaya|Preparations of Shyama Trivrita (Shyamatrivrita Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Chaturangula Kalpa Adhyaya|Preparations of Chaturangula (Chaturangula Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Tilvaka Kalpa Adhyaya|Preparations of Tilvaka (Tilvaka Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Sudha Kalpa Adhyaya|Preparations of Sudha (Sudha Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Saptalashankhini Kalpa Adhyaya|Preparations of Saptala and Shankhini (Saptalashankhini Kalpa Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Dantidravanti Kalpa Adhyaya|Preparations of Danti and Dravanti (Dantidravanti Kalpa Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<!-- Siddhi Sthana --><br />
<div id="Siddhi" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">VIII</div><br />
<div><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Siddhi Sthana|Section on Therapeutic Procedures]]</h2><br />
<p style="margin: 0; opacity: 0.9; font-size: 1em;">Administration of purification therapies and Panchakarma</p><br />
</div><br />
</div><br />
<br />
<div style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle (Netrabastivyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation (Vamana Virechana Vyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema (Bastivyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations (Prasrita Yogiyam Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs (Trimarmiya Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Basti Siddhi Adhyaya|Successful Enema Administration (Basti Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits (Phalamatra Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema (Uttar Basti Siddhi Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div style="margin-top: 50px; padding: 25px; background: #f0f7ff; border-radius: 10px; text-align: center; border: 1px solid #cce0ff;"><br />
<div style="font-size: 1.2em; margin-bottom: 15px; color: #2c5aa0;"><br />
<strong>Total Chapters: 120</strong> | <strong>Sections: 8</strong><br />
</div><br />
<p style="color: #666; font-size: 0.95em; max-width: 800px; margin: 0 auto; line-height: 1.6;">This index provides links to all chapters of Charak Samhita, the foundational text of Ayurveda. Each section (Sthana) covers specific aspects of Ayurvedic knowledge and practice.</p><br />
</div><br />
<br />
</div><br />
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</div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Sandip_Bhagyoday&diff=45403Sandip Bhagyoday2026-01-20T13:57:30Z<p>Agnivesha: </p>
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<div><div class="charak-index-container" style="max-width: 1200px; margin: 0 auto; padding: 20px; font-family: 'Segoe UI', Tahoma, Geneva, Verdana, sans-serif;"><br />
<br />
<div class="charak-header" style="text-align: center; margin-bottom: 40px; padding-bottom: 20px; border-bottom: 3px solid #2c5aa0;"><br />
<h1 style="color: #2c5aa0; margin-bottom: 10px; font-size: 2.5em;">Charak Samhita - 120 Chapters (Adhyaya)</h1><br />
<p class="subtitle" style="color: #666; font-size: 1.1em; font-style: italic;">Complete Index of Chapters Organized by Eight Sections (Sthana)</p><br />
</div><br />
<br />
<div class="charak-navigation" style="margin-bottom: 30px;"><br />
<div class="nav-box" style="background: #f0f7ff; border: 2px solid #2c5aa0; border-radius: 10px; padding: 15px; text-align: center;"><br />
<h3 style="margin-top: 0; color: #2c5aa0;">Quick Navigation</h3><br />
<div class="nav-links" style="font-size: 1.1em; line-height: 1.6;"><br />
[[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]<br><br />
[[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br />
</div><br />
</div><br />
</div><br />
<br />
<!-- Repeat this pattern for all sections --><br />
<div class="sthna-section" id="Siddhi" style="margin-bottom: 50px; background: white; border-radius: 12px; box-shadow: 0 4px 15px rgba(0,0,0,0.08); overflow: hidden; border: 1px solid #e0e0e0;"><br />
<div class="sthna-header" style="background: linear-gradient(135deg, #2c5aa0 0%, #3a7bd5 100%); color: white; padding: 25px; display: flex; align-items: center; gap: 25px;"><br />
<div class="sthna-number" style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">VIII</div><br />
<div class="sthna-title"><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Siddhi Sthana|Section on Therapeutic Procedures]]</h2><br />
<p class="sthna-desc" style="margin: 0; opacity: 0.9; font-size: 1em;">Administration of purification therapies and Panchakarma</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid" style="padding: 30px;"><br />
<ol start="1" style="margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle (Netrabastivyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation (Vamana Virechana Vyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema (Bastivyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations (Prasrita Yogiyam Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs (Trimarmiya Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Basti Siddhi Adhyaya|Successful Enema Administration (Basti Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits (Phalamatra Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema (Uttar Basti Siddhi Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="charak-footer" style="margin-top: 50px; padding: 25px; background: #f0f7ff; border-radius: 10px; text-align: center; border: 1px solid #cce0ff;"><br />
<div class="total-chapters" style="font-size: 1.2em; margin-bottom: 15px; color: #2c5aa0;"><br />
<strong>Total Chapters: 120</strong> | <strong>Sections: 8</strong><br />
</div><br />
<p class="footer-note" style="color: #666; font-size: 0.95em; max-width: 800px; margin: 0 auto; line-height: 1.6;">This index provides links to all chapters of Charak Samhita, the foundational text of Ayurveda. Each section (Sthana) covers specific aspects of Ayurvedic knowledge and practice.</p><br />
</div><br />
<br />
</div><br />
<br />
<!-- Back to top button --><br />
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<span style="color:white; font-size:0.9em; font-family:verdana,sans-serif; font-weight:bold;"><br />
[[#top|↑ Back to Top]]<br />
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</div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Sandip_Bhagyoday&diff=45402Sandip Bhagyoday2026-01-20T13:57:07Z<p>Agnivesha: </p>
<hr />
<div><div style="max-width: 1200px; margin: 0 auto; padding: 20px; font-family: Arial, sans-serif;"><br />
<br />
<div style="text-align: center; margin-bottom: 40px; padding-bottom: 20px; border-bottom: 3px solid #2c5aa0;"><br />
<h1 style="color: #2c5aa0; margin-bottom: 10px;">Charak Samhita - 120 Chapters</h1><br />
<p style="color: #666;">Complete Index of Chapters</p><br />
</div><br />
<br />
<div style="background: #f0f7ff; border: 2px solid #2c5aa0; border-radius: 10px; padding: 15px; text-align: center; margin-bottom: 30px;"><br />
<h3 style="color: #2c5aa0; margin-top: 0;">Quick Navigation</h3><br />
<div><br />
[[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]<br><br />
[[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br />
</div><br />
</div><br />
<br />
<!-- Sections with minimal styling --><br />
<div style="margin-bottom: 30px; background: white; border: 1px solid #ddd; border-radius: 5px;"><br />
<div style="background: #2c5aa0; color: white; padding: 15px;"><br />
<h2 style="margin: 0;">[[Siddhi Sthana|Section on Therapeutic Procedures]]</h2><br />
<p style="margin: 5px 0 0 0; opacity: 0.9;">Administration of purification therapies</p><br />
</div><br />
<div style="padding: 20px;"><br />
<ol><br />
<li>'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle]]'''</li><br />
<li>'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation]]'''</li><br />
<li>'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema]]'''</li><br />
<li>'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations]]'''</li><br />
<li>'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs]]'''</li><br />
<li>'''[[Basti Siddhi Adhyaya|Successful Enema Administration]]'''</li><br />
<li>'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits]]'''</li><br />
<li>'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
</div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Sandip_Bhagyoday&diff=45401Sandip Bhagyoday2026-01-20T13:55:32Z<p>Agnivesha: </p>
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<h1 style="color: #2c5aa0; margin-bottom: 10px; font-size: 2.5em;">Charak Samhita - 120 Chapters (Adhyaya)</h1><br />
<p class="subtitle" style="color: #666; font-size: 1.1em; font-style: italic;">Complete Index of Chapters Organized by Eight Sections (Sthana)</p><br />
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<h3 style="margin-top: 0; color: #2c5aa0;">Quick Navigation</h3><br />
<div class="nav-links" style="font-size: 1.1em; line-height: 1.6;"><br />
[[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]<br><br />
[[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br />
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<div class="sthna-number" style="font-size: 3em; font-weight: bold; opacity: 0.9; min-width: 60px;">VIII</div><br />
<div class="sthna-title"><br />
<h2 style="margin: 0 0 10px 0; font-size: 1.8em;">[[Siddhi Sthana|Section on Therapeutic Procedures]]</h2><br />
<p class="sthna-desc" style="margin: 0; opacity: 0.9; font-size: 1em;">Administration of purification therapies and Panchakarma</p><br />
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<ol start="1" style="margin: 0; padding-left: 20px; column-count: 3; column-gap: 40px;"><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle (Netrabastivyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation (Vamana Virechana Vyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema (Bastivyapat Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations (Prasrita Yogiyam Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs (Trimarmiya Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Basti Siddhi Adhyaya|Successful Enema Administration (Basti Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits (Phalamatra Siddhi Adhyaya)]]'''</li><br />
<li style="margin-bottom: 12px; line-height: 1.5; padding: 8px 0; border-bottom: 1px dashed #eee;">'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema (Uttar Basti Siddhi Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
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<div class="total-chapters" style="font-size: 1.2em; margin-bottom: 15px; color: #2c5aa0;"><br />
<strong>Total Chapters: 120</strong> | <strong>Sections: 8</strong><br />
</div><br />
<p class="footer-note" style="color: #666; font-size: 0.95em; max-width: 800px; margin: 0 auto; line-height: 1.6;">This index provides links to all chapters of Charak Samhita, the foundational text of Ayurveda. Each section (Sthana) covers specific aspects of Ayurvedic knowledge and practice.</p><br />
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</div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Sandip_Bhagyoday&diff=45400Sandip Bhagyoday2026-01-20T13:50:54Z<p>Agnivesha: </p>
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<div class="charak-index-container"><br />
<br />
<div class="charak-header"><br />
<h1>Charak Samhita - 120 Chapters (Adhyaya)</h1><br />
<p class="subtitle">Complete Index of Chapters Organized by Eight Sections (Sthana)</p><br />
</div><br />
<br />
<div class="charak-navigation"><br />
<div class="nav-box"><br />
<h3>Quick Navigation</h3><br />
<div class="nav-links"><br />
[[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]<br><br />
[[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br />
</div><br />
</div><br />
</div><br />
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<div class="sthna-section" id="Sutra"><br />
<div class="sthna-header"><br />
<div class="sthna-number">I</div><br />
<div class="sthna-title"><br />
<h2>[[Sutra Sthana|Section on Fundamental Principles]]</h2><br />
<p class="sthna-desc">Basic principles of Ayurveda, daily regimen, seasonal regimen, and fundamental therapies</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid"><br />
<ol start="1"><br />
<li>'''[[Deerghanjiviteeya Adhyaya|Longevity (Deerghanjiviteeya Adhyaya)]]'''</li><br />
<li>'''[[Apamarga Tanduliya Adhyaya|Dehusked Seeds of Apamarga (Apamarga Tanduliya Adhyaya)]]'''</li><br />
<li>'''[[Aragvadhiya Adhyaya|Aragvadha (Cassia) and Other Medicines (Aragvadhiya Adhyaya)]]'''</li><br />
<li>'''[[Shadvirechanashatashritiya Adhyaya|Resources of Six Hundred Evacuatives (Shadvirechanashatashritiya Adhyaya)]]'''</li><br />
<li>'''[[Matrashiteeya Adhyaya|Proper Quantity of Food (Matrashiteeya Adhyaya)]]'''</li><br />
<li>'''[[Tasyashiteeya Adhyaya|Seasonal Regimen (Tasyashiteeya Adhyaya)]]'''</li><br />
<li>'''[[Naveganadharaniya Adhyaya|Natural Urges (Naveganadharaniya Adhyaya)]]'''</li><br />
<li>'''[[Indriyopakramaniya Adhyaya|Disciplinary Protocol for Sense Organs (Indriyopakramaniya Adhyaya)]]'''</li><br />
<li>'''[[Khuddakachatushpada Adhyaya|Four Fundamental Components of Healthcare (Khuddakachatushpada Adhyaya)]]'''</li><br />
<li>'''[[Mahachatushpada Adhyaya|Four Important Components of Therapeutics (Mahachatushpada Adhyaya)]]'''</li><br />
<li>'''[[Tistraishaniya Adhyaya|Three Desires of Life (Tistraishaniya Adhyaya)]]'''</li><br />
<li>'''[[Vatakalakaliya Adhyaya|Merits and Demerits of Vata (Vatakalakaliya Adhyaya)]]'''</li><br />
<li>'''[[Sneha Adhyaya|Oleation Therapies (Sneha Adhyaya)]]'''</li><br />
<li>'''[[Sweda Adhyaya|Sudation Therapies (Sweda Adhyaya)]]'''</li><br />
<li>'''[[Upakalpaniya Adhyaya|Hospital Management Guidelines (Upakalpaniya Adhyaya)]]'''</li><br />
<li>'''[[Chikitsaprabhritiya Adhyaya|Assessment in Panchakarma (Chikitsaprabhritiya Adhyaya)]]'''</li><br />
<li>'''[[Kiyanta Shiraseeya Adhyaya|Diseases of Vital Organs (Kiyanta Shiraseeya Adhyaya)]]'''</li><br />
<li>'''[[Trishothiya Adhyaya|Three Types of Swellings (Trishothiya Adhyaya)]]'''</li><br />
<li>'''[[Ashtodariya Adhyaya|Numerical Classification of Diseases (Ashtodariya Adhyaya)]]'''</li><br />
<li>'''[[Maharoga Adhyaya|Dosha Specific Classification (Maharoga Adhyaya)]]'''</li><br />
<li>'''[[Ashtauninditiya Adhyaya|Eight Undesirable Constitutions (Ashtauninditiya Adhyaya)]]'''</li><br />
<li>'''[[Langhanabrimhaniya Adhyaya|Reduction and Nourishing Therapies (Langhanabrimhaniya Adhyaya)]]'''</li><br />
<li>'''[[Santarpaniya Adhyaya|Over-nutrition and Under-nutrition (Santarpaniya Adhyaya)]]'''</li><br />
<li>'''[[Vidhishonitiya Adhyaya|Characteristics of Shonita (Blood) (Vidhishonitiya Adhyaya)]]'''</li><br />
<li>'''[[Yajjah Purushiya Adhyaya|Origin of Human Beings (Yajjah Purushiya Adhyaya)]]'''</li><br />
<li>'''[[Atreyabhadrakapyiya Adhyaya|Pharmacological Principles (Atreyabhadrakapyiya Adhyaya)]]'''</li><br />
<li>'''[[Annapanavidhi Adhyaya|Classification of Food and Beverages (Annapanavidhi Adhyaya)]]'''</li><br />
<li>'''[[Vividhashitapitiya Adhyaya|Sequential Effects of Food (Vividhashitapitiya Adhyaya)]]'''</li><br />
<li>'''[[Dashapranayataneeya Adhyaya|Ten Seats of Life Forces (Dashapranayataneeya Adhyaya)]]'''</li><br />
<li>'''[[Arthedashmahamooliya Adhyaya|Ten Great Vessels from Heart (Arthedashmahamooliya Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Nidana"><br />
<div class="sthna-header"><br />
<div class="sthna-number">II</div><br />
<div class="sthna-title"><br />
<h2>[[Nidana Sthana|Section on Diagnostic Principles]]</h2><br />
<p class="sthna-desc">Etiology, pathogenesis, and diagnosis of major diseases</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid columns-2"><br />
<ol start="1"><br />
<li>'''[[Jwara Nidana Adhyaya|Diagnosis of Jwara (Fever) (Jwara Nidana Adhyaya)]]'''</li><br />
<li>'''[[Raktapitta Nidana Adhyaya|Diagnosis of Bleeding Disorders (Raktapitta Nidana Adhyaya)]]'''</li><br />
<li>'''[[Gulma Nidana Adhyaya|Diagnosis of Abdominal Lumps (Gulma Nidana Adhyaya)]]'''</li><br />
<li>'''[[Prameha Nidana Adhyaya|Diagnosis of Urinary Disorders (Prameha Nidana Adhyaya)]]'''</li><br />
<li>'''[[Kushtha Nidana Adhyaya|Diagnosis of Skin Diseases (Kushtha Nidana Adhyaya)]]'''</li><br />
<li>'''[[Shosha Nidana Adhyaya|Diagnosis of Wasting Disease (Shosha Nidana Adhyaya)]]'''</li><br />
<li>'''[[Unmada Nidana Adhyaya|Diagnosis of Psychosis (Unmada Nidana Adhyaya)]]'''</li><br />
<li>'''[[Apasmara Nidana Adhyaya|Diagnosis of Seizure Disorders (Apasmara Nidana Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Vimana"><br />
<div class="sthna-header"><br />
<div class="sthna-number">III</div><br />
<div class="sthna-title"><br />
<h2>[[Vimana Sthana|Section on Specific Medical Principles]]</h2><br />
<p class="sthna-desc">Detailed knowledge of diseases, channels, and examination methods</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid columns-2"><br />
<ol start="1"><br />
<li>'''[[Rasa Vimana Adhyaya|Taste-based Factors (Rasa Vimana Adhyaya)]]'''</li><br />
<li>'''[[Trividhakukshiya Vimana Adhyaya|Three Parts of Abdomen (Trividhakukshiya Vimana Adhyaya)]]'''</li><br />
<li>'''[[Janapadodhvansaniya Vimana Adhyaya|Destruction of Communities (Janapadodhvansaniya Vimana Adhyaya)]]'''</li><br />
<li>'''[[Trividha Roga Vishesha Vijnaniya Vimana Adhyaya|Three Methods of Disease Knowledge (Trividha Roga Vishesha Vijnaniya Vimana Adhyaya)]]'''</li><br />
<li>'''[[Sroto Vimana Adhyaya|Channels of Transport (Sroto Vimana Adhyaya)]]'''</li><br />
<li>'''[[Roganika Vimana Adhyaya|Classification of Diseases (Roganika Vimana Adhyaya)]]'''</li><br />
<li>'''[[Vyadhita Rupiya Vimana Adhyaya|Types of Patients (Vyadhita Rupiya Vimana Adhyaya)]]'''</li><br />
<li>'''[[Rogabhishagjitiya Vimana Adhyaya|Conquering Debate and Disease (Rogabhishagjitiya Vimana Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Sharira"><br />
<div class="sthna-header"><br />
<div class="sthna-number">IV</div><br />
<div class="sthna-title"><br />
<h2>[[Sharira Sthana|Section on Human Being and Genesis]]</h2><br />
<p class="sthna-desc">Embryology, anatomy, and physiology of human beings</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid columns-2"><br />
<ol start="1"><br />
<li>'''[[Katidhapurusha Sharira Adhyaya|Holistic Human Being (Katidhapurusha Sharira Adhyaya)]]'''</li><br />
<li>'''[[Atulyagotriya Sharira Adhyaya|Different Clans (Atulyagotriya Sharira Adhyaya)]]'''</li><br />
<li>'''[[Khuddika Garbhavakranti Sharira Adhyaya|Factors for Embryogenesis (Khuddika Garbhavakranti Sharira Adhyaya)]]'''</li><br />
<li>'''[[Mahatigarbhavakranti Sharira Adhyaya|Embryonic Development (Mahatigarbhavakranti Sharira Adhyaya)]]'''</li><br />
<li>'''[[Purusha Vichaya Sharira Adhyaya|Detailed Study of Human Being (Purusha Vichaya Sharira Adhyaya)]]'''</li><br />
<li>'''[[Sharira Vichaya Sharira Adhyaya|Analytical Study of Body (Sharira Vichaya Sharira Adhyaya)]]'''</li><br />
<li>'''[[Sharira Sankhya Sharira Adhyaya|Numerological Account (Sharira Sankhya Sharira Adhyaya)]]'''</li><br />
<li>'''[[Jatisutriya Sharira Adhyaya|Obstetrics and Neonatal Care (Jatisutriya Sharira Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Indriya"><br />
<div class="sthna-header"><br />
<div class="sthna-number">V</div><br />
<div class="sthna-title"><br />
<h2>[[Indriya Sthana|Section on Sensorial Prognosis]]</h2><br />
<p class="sthna-desc">Prognosis based on signs and symptoms from sense organs</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid columns-3"><br />
<ol start="1"><br />
<li>'''[[Varnasvariyam Indriyam Adhyaya|Fatal Signs in Complexion and Voice (Varnasvariyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Pushpitakam Indriyam Adhyaya|Fatal Signs of Tactile and Olfactory Perception (Pushpitakam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Parimarshaneeyam Indriyam Adhyaya|Palpable Signs of Death (Parimarshaneeyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Indriyaneekam Indriyam Adhyaya|Fatal Signs in Sense Organs (Indriyaneekam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Purvarupeeyam Indriyam Adhyaya|Prognosis by Prodromal Symptoms (Purvarupeeyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Katamanisharireeyam Indriyam Adhyaya|Specific Fatal Clinical Features (Katamanisharireeyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Pannarupiyam Indriyam Adhyaya|Changes in Shadows and Complexion (Pannarupiyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Avakshiraseeyam Indriyam Adhyaya|Inverted Shadow of Dying Person (Avakshiraseeyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Yasyashyavanimittiyam Indriyam Adhyaya|Palliative Care Signs (Yasyashyavanimittiyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Sadyomaraneeyam Indriyam Adhyaya|Signs of Instant Death (Sadyomaraneeyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Anujyotiyam Indriyam Adhyaya|Diminution of Agni (Anujyotiyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Gomayachurniyam Indriyam Adhyaya|Characteristics of Messenger (Gomayachurniyam Indriyam Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Chikitsa"><br />
<div class="sthna-header"><br />
<div class="sthna-number">VI</div><br />
<div class="sthna-title"><br />
<h2>[[Chikitsa Sthana|Section on Therapeutic Principles]]</h2><br />
<p class="sthna-desc">Management and treatment of various diseases</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid columns-2"><br />
<ol start="1"><br />
<li>'''[[Rasayana Adhyaya|Rejuvenation Therapy (Rasayana Adhyaya)]]'''</li><br />
<li>'''[[Vajikarana Adhyaya|Aphrodisiac Therapy (Vajikarana Adhyaya)]]'''</li><br />
<li>'''[[Jwara Chikitsa Adhyaya|Management of Jwara (Fever) (Jwara Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Raktapitta Chikitsa Adhyaya|Management of Bleeding Disorders (Raktapitta Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Gulma Chikitsa Adhyaya|Management of Gulma (Gulma Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Prameha Chikitsa Adhyaya|Management of Urinary Disorders (Prameha Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Kushtha Chikitsa Adhyaya|Management of Skin Diseases (Kushtha Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Rajayakshma Chikitsa Adhyaya|Management of Wasting Diseases (Rajayakshma Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Unmada Chikitsa Adhyaya|Management of Psychosis (Unmada Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Apasmara Chikitsa Adhyaya|Management of Seizure Disorders (Apasmara Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Kshatakshina Chikitsa Adhyaya|Management of Emaciation due to Trauma (Kshatakshina Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Shvayathu Chikitsa Adhyaya|Management of Swellings (Shvayathu Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Udara Chikitsa Adhyaya|Management of Abdominal Enlargement (Udara Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Arsha Chikitsa Adhyaya|Management of Hemorrhoids (Arsha Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Grahani Chikitsa Adhyaya|Management of Digestive Diseases (Grahani Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Pandu Chikitsa Adhyaya|Management of Anemia (Pandu Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Hikka Shwasa Chikitsa Adhyaya|Management of Hiccups and Dyspnea (Hikka Shwasa Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Kasa Chikitsa Adhyaya|Management of Cough (Kasa Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Atisara Chikitsa Adhyaya|Management of Diarrhea (Atisara Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Chhardi Chikitsa Adhyaya|Management of Vomiting (Chhardi Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Visarpa Chikitsa Adhyaya|Management of Acute Spreading Erysipelas (Visarpa Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Trishna Chikitsa Adhyaya|Management of Morbid Thirst (Trishna Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Visha Chikitsa Adhyaya|Management of Poisoning (Visha Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Madatyaya Chikitsa Adhyaya|Management of Intoxication (Madatyaya Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Dwivraniya Chikitsa Adhyaya|Management of Ulcers (Dwivraniya Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Trimarmiya Chikitsa Adhyaya|Management of Three Vital Organs (Trimarmiya Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Urustambha Chikitsa Adhyaya|Management of Thigh and Hip Diseases (Urustambha Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Vatavyadhi Chikitsa Adhyaya|Management of Vata Diseases (Vatavyadhi Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Vatarakta Chikitsa Adhyaya|Management of Vata and Rakta Diseases (Vatarakta Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Yonivyapat Chikitsa Adhyaya|Management of Genital Tract Disorders (Yonivyapat Chikitsa Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Kalpa"><br />
<div class="sthna-header"><br />
<div class="sthna-number">VII</div><br />
<div class="sthna-title"><br />
<h2>[[Kalpa Sthana|Section on Pharmaceutical Preparations]]</h2><br />
<p class="sthna-desc">Formulation and preparation of medicinal compounds</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid columns-3"><br />
<ol start="1"><br />
<li>'''[[Madana Kalpa Adhyaya|Preparations of Madanaphala (Madana Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Jimutaka Kalpa Adhyaya|Preparations of Jimutaka (Jimutaka Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Ikshvaku Kalpa Adhyaya|Preparations of Ikshvaku (Ikshvaku Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Dhamargava Kalpa Adhyaya|Preparations of Dhamargava (Dhamargava Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Vatsaka Kalpa Adhyaya|Preparations of Vatsaka (Vatsaka Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Kritavedhana Kalpa Adhyaya|Preparations of Kritavedhana (Kritavedhana Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Shyamatrivrita Kalpa Adhyaya|Preparations of Shyama Trivrita (Shyamatrivrita Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Chaturangula Kalpa Adhyaya|Preparations of Chaturangula (Chaturangula Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Tilvaka Kalpa Adhyaya|Preparations of Tilvaka (Tilvaka Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Sudha Kalpa Adhyaya|Preparations of Sudha (Sudha Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Saptalashankhini Kalpa Adhyaya|Preparations of Saptala and Shankhini (Saptalashankhini Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Dantidravanti Kalpa Adhyaya|Preparations of Danti and Dravanti (Dantidravanti Kalpa Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Siddhi"><br />
<div class="sthna-header"><br />
<div class="sthna-number">VIII</div><br />
<div class="sthna-title"><br />
<h2>[[Siddhi Sthana|Section on Therapeutic Procedures]]</h2><br />
<p class="sthna-desc">Administration of purification therapies and Panchakarma</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid columns-3"><br />
<ol start="1"><br />
<li>'''[[Kalpana Siddhi Adhyaya|Standard Administration of Purification (Kalpana Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Panchakarmiya Siddhi Adhyaya|Successful Panchakarma Administration (Panchakarmiya Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Bastisutriyam Siddhi Adhyaya|Standard Practices of Basti (Bastisutriyam Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Snehavyapat Siddhi Adhyaya|Complications of Unctuous Enema (Snehavyapat Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle (Netrabastivyapat Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation (Vamana Virechana Vyapat Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema (Bastivyapat Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations (Prasrita Yogiyam Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs (Trimarmiya Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Basti Siddhi Adhyaya|Successful Enema Administration (Basti Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits (Phalamatra Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema (Uttar Basti Siddhi Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<div class="charak-footer"><br />
<div class="total-chapters"><br />
<strong>Total Chapters: 120</strong> | <strong>Sections: 8</strong><br />
</div><br />
<p class="footer-note">This index provides links to all chapters of Charak Samhita, the foundational text of Ayurveda. Each section (Sthana) covers specific aspects of Ayurvedic knowledge and practice.</p><br />
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</div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Sandip_Bhagyoday&diff=45399Sandip Bhagyoday2026-01-20T13:47:54Z<p>Agnivesha: </p>
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<br />
<div class="charak-index-container"><br />
<br />
<div class="charak-header"><br />
<h1>Charak Samhita - 120 Chapters (Adhyaya)</h1><br />
<p class="subtitle">Complete Index of Chapters Organized by Eight Sections (Sthana)</p><br />
</div><br />
<br />
<div class="charak-navigation"><br />
<div class="nav-box"><br />
<h3>Quick Navigation</h3><br />
<div class="nav-links"><br />
[[#Sutra|Sutra Sthana]] • [[#Nidana|Nidana Sthana]] • [[#Vimana|Vimana Sthana]] • [[#Sharira|Sharira Sthana]]<br><br />
[[#Indriya|Indriya Sthana]] • [[#Chikitsa|Chikitsa Sthana]] • [[#Kalpa|Kalpa Sthana]] • [[#Siddhi|Siddhi Sthana]]<br />
</div><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Sutra"><br />
<div class="sthna-header"><br />
<div class="sthna-number">I</div><br />
<div class="sthna-title"><br />
<h2>[[Sutra Sthana|Section on Fundamental Principles]]</h2><br />
<p class="sthna-desc">Basic principles of Ayurveda, daily regimen, seasonal regimen, and fundamental therapies</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid"><br />
<ol start="1"><br />
<li>'''[[Deerghanjiviteeya Adhyaya|Longevity (Deerghanjiviteeya Adhyaya)]]'''</li><br />
<li>'''[[Apamarga Tanduliya Adhyaya|Dehusked Seeds of Apamarga (Apamarga Tanduliya Adhyaya)]]'''</li><br />
<li>'''[[Aragvadhiya Adhyaya|Aragvadha (Cassia) and Other Medicines (Aragvadhiya Adhyaya)]]'''</li><br />
<li>'''[[Shadvirechanashatashritiya Adhyaya|Resources of Six Hundred Evacuatives (Shadvirechanashatashritiya Adhyaya)]]'''</li><br />
<li>'''[[Matrashiteeya Adhyaya|Proper Quantity of Food (Matrashiteeya Adhyaya)]]'''</li><br />
<li>'''[[Tasyashiteeya Adhyaya|Seasonal Regimen (Tasyashiteeya Adhyaya)]]'''</li><br />
<li>'''[[Naveganadharaniya Adhyaya|Natural Urges (Naveganadharaniya Adhyaya)]]'''</li><br />
<li>'''[[Indriyopakramaniya Adhyaya|Disciplinary Protocol for Sense Organs (Indriyopakramaniya Adhyaya)]]'''</li><br />
<li>'''[[Khuddakachatushpada Adhyaya|Four Fundamental Components of Healthcare (Khuddakachatushpada Adhyaya)]]'''</li><br />
<li>'''[[Mahachatushpada Adhyaya|Four Important Components of Therapeutics (Mahachatushpada Adhyaya)]]'''</li><br />
<li>'''[[Tistraishaniya Adhyaya|Three Desires of Life (Tistraishaniya Adhyaya)]]'''</li><br />
<li>'''[[Vatakalakaliya Adhyaya|Merits and Demerits of Vata (Vatakalakaliya Adhyaya)]]'''</li><br />
<li>'''[[Sneha Adhyaya|Oleation Therapies (Sneha Adhyaya)]]'''</li><br />
<li>'''[[Sweda Adhyaya|Sudation Therapies (Sweda Adhyaya)]]'''</li><br />
<li>'''[[Upakalpaniya Adhyaya|Hospital Management Guidelines (Upakalpaniya Adhyaya)]]'''</li><br />
<li>'''[[Chikitsaprabhritiya Adhyaya|Assessment in Panchakarma (Chikitsaprabhritiya Adhyaya)]]'''</li><br />
<li>'''[[Kiyanta Shiraseeya Adhyaya|Diseases of Vital Organs (Kiyanta Shiraseeya Adhyaya)]]'''</li><br />
<li>'''[[Trishothiya Adhyaya|Three Types of Swellings (Trishothiya Adhyaya)]]'''</li><br />
<li>'''[[Ashtodariya Adhyaya|Numerical Classification of Diseases (Ashtodariya Adhyaya)]]'''</li><br />
<li>'''[[Maharoga Adhyaya|Dosha Specific Classification (Maharoga Adhyaya)]]'''</li><br />
<li>'''[[Ashtauninditiya Adhyaya|Eight Undesirable Constitutions (Ashtauninditiya Adhyaya)]]'''</li><br />
<li>'''[[Langhanabrimhaniya Adhyaya|Reduction and Nourishing Therapies (Langhanabrimhaniya Adhyaya)]]'''</li><br />
<li>'''[[Santarpaniya Adhyaya|Over-nutrition and Under-nutrition (Santarpaniya Adhyaya)]]'''</li><br />
<li>'''[[Vidhishonitiya Adhyaya|Characteristics of Shonita (Blood) (Vidhishonitiya Adhyaya)]]'''</li><br />
<li>'''[[Yajjah Purushiya Adhyaya|Origin of Human Beings (Yajjah Purushiya Adhyaya)]]'''</li><br />
<li>'''[[Atreyabhadrakapyiya Adhyaya|Pharmacological Principles (Atreyabhadrakapyiya Adhyaya)]]'''</li><br />
<li>'''[[Annapanavidhi Adhyaya|Classification of Food and Beverages (Annapanavidhi Adhyaya)]]'''</li><br />
<li>'''[[Vividhashitapitiya Adhyaya|Sequential Effects of Food (Vividhashitapitiya Adhyaya)]]'''</li><br />
<li>'''[[Dashapranayataneeya Adhyaya|Ten Seats of Life Forces (Dashapranayataneeya Adhyaya)]]'''</li><br />
<li>'''[[Arthedashmahamooliya Adhyaya|Ten Great Vessels from Heart (Arthedashmahamooliya Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Nidana"><br />
<div class="sthna-header"><br />
<div class="sthna-number">II</div><br />
<div class="sthna-title"><br />
<h2>[[Nidana Sthana|Section on Diagnostic Principles]]</h2><br />
<p class="sthna-desc">Etiology, pathogenesis, and diagnosis of major diseases</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid columns-2"><br />
<ol start="1"><br />
<li>'''[[Jwara Nidana Adhyaya|Diagnosis of Jwara (Fever) (Jwara Nidana Adhyaya)]]'''</li><br />
<li>'''[[Raktapitta Nidana Adhyaya|Diagnosis of Bleeding Disorders (Raktapitta Nidana Adhyaya)]]'''</li><br />
<li>'''[[Gulma Nidana Adhyaya|Diagnosis of Abdominal Lumps (Gulma Nidana Adhyaya)]]'''</li><br />
<li>'''[[Prameha Nidana Adhyaya|Diagnosis of Urinary Disorders (Prameha Nidana Adhyaya)]]'''</li><br />
<li>'''[[Kushtha Nidana Adhyaya|Diagnosis of Skin Diseases (Kushtha Nidana Adhyaya)]]'''</li><br />
<li>'''[[Shosha Nidana Adhyaya|Diagnosis of Wasting Disease (Shosha Nidana Adhyaya)]]'''</li><br />
<li>'''[[Unmada Nidana Adhyaya|Diagnosis of Psychosis (Unmada Nidana Adhyaya)]]'''</li><br />
<li>'''[[Apasmara Nidana Adhyaya|Diagnosis of Seizure Disorders (Apasmara Nidana Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Vimana"><br />
<div class="sthna-header"><br />
<div class="sthna-number">III</div><br />
<div class="sthna-title"><br />
<h2>[[Vimana Sthana|Section on Specific Medical Principles]]</h2><br />
<p class="sthna-desc">Detailed knowledge of diseases, channels, and examination methods</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid columns-2"><br />
<ol start="1"><br />
<li>'''[[Rasa Vimana Adhyaya|Taste-based Factors (Rasa Vimana Adhyaya)]]'''</li><br />
<li>'''[[Trividhakukshiya Vimana Adhyaya|Three Parts of Abdomen (Trividhakukshiya Vimana Adhyaya)]]'''</li><br />
<li>'''[[Janapadodhvansaniya Vimana Adhyaya|Destruction of Communities (Janapadodhvansaniya Vimana Adhyaya)]]'''</li><br />
<li>'''[[Trividha Roga Vishesha Vijnaniya Vimana Adhyaya|Three Methods of Disease Knowledge (Trividha Roga Vishesha Vijnaniya Vimana Adhyaya)]]'''</li><br />
<li>'''[[Sroto Vimana Adhyaya|Channels of Transport (Sroto Vimana Adhyaya)]]'''</li><br />
<li>'''[[Roganika Vimana Adhyaya|Classification of Diseases (Roganika Vimana Adhyaya)]]'''</li><br />
<li>'''[[Vyadhita Rupiya Vimana Adhyaya|Types of Patients (Vyadhita Rupiya Vimana Adhyaya)]]'''</li><br />
<li>'''[[Rogabhishagjitiya Vimana Adhyaya|Conquering Debate and Disease (Rogabhishagjitiya Vimana Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Sharira"><br />
<div class="sthna-header"><br />
<div class="sthna-number">IV</div><br />
<div class="sthna-title"><br />
<h2>[[Sharira Sthana|Section on Human Being and Genesis]]</h2><br />
<p class="sthna-desc">Embryology, anatomy, and physiology of human beings</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid columns-2"><br />
<ol start="1"><br />
<li>'''[[Katidhapurusha Sharira Adhyaya|Holistic Human Being (Katidhapurusha Sharira Adhyaya)]]'''</li><br />
<li>'''[[Atulyagotriya Sharira Adhyaya|Different Clans (Atulyagotriya Sharira Adhyaya)]]'''</li><br />
<li>'''[[Khuddika Garbhavakranti Sharira Adhyaya|Factors for Embryogenesis (Khuddika Garbhavakranti Sharira Adhyaya)]]'''</li><br />
<li>'''[[Mahatigarbhavakranti Sharira Adhyaya|Embryonic Development (Mahatigarbhavakranti Sharira Adhyaya)]]'''</li><br />
<li>'''[[Purusha Vichaya Sharira Adhyaya|Detailed Study of Human Being (Purusha Vichaya Sharira Adhyaya)]]'''</li><br />
<li>'''[[Sharira Vichaya Sharira Adhyaya|Analytical Study of Body (Sharira Vichaya Sharira Adhyaya)]]'''</li><br />
<li>'''[[Sharira Sankhya Sharira Adhyaya|Numerological Account (Sharira Sankhya Sharira Adhyaya)]]'''</li><br />
<li>'''[[Jatisutriya Sharira Adhyaya|Obstetrics and Neonatal Care (Jatisutriya Sharira Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Indriya"><br />
<div class="sthna-header"><br />
<div class="sthna-number">V</div><br />
<div class="sthna-title"><br />
<h2>[[Indriya Sthana|Section on Sensorial Prognosis]]</h2><br />
<p class="sthna-desc">Prognosis based on signs and symptoms from sense organs</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid columns-3"><br />
<ol start="1"><br />
<li>'''[[Varnasvariyam Indriyam Adhyaya|Fatal Signs in Complexion and Voice (Varnasvariyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Pushpitakam Indriyam Adhyaya|Fatal Signs of Tactile and Olfactory Perception (Pushpitakam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Parimarshaneeyam Indriyam Adhyaya|Palpable Signs of Death (Parimarshaneeyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Indriyaneekam Indriyam Adhyaya|Fatal Signs in Sense Organs (Indriyaneekam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Purvarupeeyam Indriyam Adhyaya|Prognosis by Prodromal Symptoms (Purvarupeeyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Katamanisharireeyam Indriyam Adhyaya|Specific Fatal Clinical Features (Katamanisharireeyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Pannarupiyam Indriyam Adhyaya|Changes in Shadows and Complexion (Pannarupiyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Avakshiraseeyam Indriyam Adhyaya|Inverted Shadow of Dying Person (Avakshiraseeyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Yasyashyavanimittiyam Indriyam Adhyaya|Palliative Care Signs (Yasyashyavanimittiyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Sadyomaraneeyam Indriyam Adhyaya|Signs of Instant Death (Sadyomaraneeyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Anujyotiyam Indriyam Adhyaya|Diminution of Agni (Anujyotiyam Indriyam Adhyaya)]]'''</li><br />
<li>'''[[Gomayachurniyam Indriyam Adhyaya|Characteristics of Messenger (Gomayachurniyam Indriyam Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Chikitsa"><br />
<div class="sthna-header"><br />
<div class="sthna-number">VI</div><br />
<div class="sthna-title"><br />
<h2>[[Chikitsa Sthana|Section on Therapeutic Principles]]</h2><br />
<p class="sthna-desc">Management and treatment of various diseases</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid columns-2"><br />
<ol start="1"><br />
<li>'''[[Rasayana Adhyaya|Rejuvenation Therapy (Rasayana Adhyaya)]]'''</li><br />
<li>'''[[Vajikarana Adhyaya|Aphrodisiac Therapy (Vajikarana Adhyaya)]]'''</li><br />
<li>'''[[Jwara Chikitsa Adhyaya|Management of Jwara (Fever) (Jwara Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Raktapitta Chikitsa Adhyaya|Management of Bleeding Disorders (Raktapitta Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Gulma Chikitsa Adhyaya|Management of Gulma (Gulma Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Prameha Chikitsa Adhyaya|Management of Urinary Disorders (Prameha Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Kushtha Chikitsa Adhyaya|Management of Skin Diseases (Kushtha Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Rajayakshma Chikitsa Adhyaya|Management of Wasting Diseases (Rajayakshma Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Unmada Chikitsa Adhyaya|Management of Psychosis (Unmada Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Apasmara Chikitsa Adhyaya|Management of Seizure Disorders (Apasmara Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Kshatakshina Chikitsa Adhyaya|Management of Emaciation due to Trauma (Kshatakshina Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Shvayathu Chikitsa Adhyaya|Management of Swellings (Shvayathu Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Udara Chikitsa Adhyaya|Management of Abdominal Enlargement (Udara Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Arsha Chikitsa Adhyaya|Management of Hemorrhoids (Arsha Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Grahani Chikitsa Adhyaya|Management of Digestive Diseases (Grahani Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Pandu Chikitsa Adhyaya|Management of Anemia (Pandu Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Hikka Shwasa Chikitsa Adhyaya|Management of Hiccups and Dyspnea (Hikka Shwasa Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Kasa Chikitsa Adhyaya|Management of Cough (Kasa Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Atisara Chikitsa Adhyaya|Management of Diarrhea (Atisara Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Chhardi Chikitsa Adhyaya|Management of Vomiting (Chhardi Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Visarpa Chikitsa Adhyaya|Management of Acute Spreading Erysipelas (Visarpa Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Trishna Chikitsa Adhyaya|Management of Morbid Thirst (Trishna Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Visha Chikitsa Adhyaya|Management of Poisoning (Visha Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Madatyaya Chikitsa Adhyaya|Management of Intoxication (Madatyaya Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Dwivraniya Chikitsa Adhyaya|Management of Ulcers (Dwivraniya Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Trimarmiya Chikitsa Adhyaya|Management of Three Vital Organs (Trimarmiya Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Urustambha Chikitsa Adhyaya|Management of Thigh and Hip Diseases (Urustambha Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Vatavyadhi Chikitsa Adhyaya|Management of Vata Diseases (Vatavyadhi Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Vatarakta Chikitsa Adhyaya|Management of Vata and Rakta Diseases (Vatarakta Chikitsa Adhyaya)]]'''</li><br />
<li>'''[[Yonivyapat Chikitsa Adhyaya|Management of Genital Tract Disorders (Yonivyapat Chikitsa Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Kalpa"><br />
<div class="sthna-header"><br />
<div class="sthna-number">VII</div><br />
<div class="sthna-title"><br />
<h2>[[Kalpa Sthana|Section on Pharmaceutical Preparations]]</h2><br />
<p class="sthna-desc">Formulation and preparation of medicinal compounds</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid columns-3"><br />
<ol start="1"><br />
<li>'''[[Madana Kalpa Adhyaya|Preparations of Madanaphala (Madana Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Jimutaka Kalpa Adhyaya|Preparations of Jimutaka (Jimutaka Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Ikshvaku Kalpa Adhyaya|Preparations of Ikshvaku (Ikshvaku Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Dhamargava Kalpa Adhyaya|Preparations of Dhamargava (Dhamargava Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Vatsaka Kalpa Adhyaya|Preparations of Vatsaka (Vatsaka Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Kritavedhana Kalpa Adhyaya|Preparations of Kritavedhana (Kritavedhana Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Shyamatrivrita Kalpa Adhyaya|Preparations of Shyama Trivrita (Shyamatrivrita Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Chaturangula Kalpa Adhyaya|Preparations of Chaturangula (Chaturangula Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Tilvaka Kalpa Adhyaya|Preparations of Tilvaka (Tilvaka Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Sudha Kalpa Adhyaya|Preparations of Sudha (Sudha Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Saptalashankhini Kalpa Adhyaya|Preparations of Saptala and Shankhini (Saptalashankhini Kalpa Adhyaya)]]'''</li><br />
<li>'''[[Dantidravanti Kalpa Adhyaya|Preparations of Danti and Dravanti (Dantidravanti Kalpa Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="sthna-section" id="Siddhi"><br />
<div class="sthna-header"><br />
<div class="sthna-number">VIII</div><br />
<div class="sthna-title"><br />
<h2>[[Siddhi Sthana|Section on Therapeutic Procedures]]</h2><br />
<p class="sthna-desc">Administration of purification therapies and Panchakarma</p><br />
</div><br />
</div><br />
<br />
<div class="chapters-grid columns-3"><br />
<ol start="1"><br />
<li>'''[[Kalpana Siddhi Adhyaya|Standard Administration of Purification (Kalpana Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Panchakarmiya Siddhi Adhyaya|Successful Panchakarma Administration (Panchakarmiya Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Bastisutriyam Siddhi Adhyaya|Standard Practices of Basti (Bastisutriyam Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Snehavyapat Siddhi Adhyaya|Complications of Unctuous Enema (Snehavyapat Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Netrabastivyapat Siddhi Adhyaya|Complications of Enema Nozzle (Netrabastivyapat Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Vamana Virechana Vyapat Siddhi Adhyaya|Complications of Emesis and Purgation (Vamana Virechana Vyapat Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Bastivyapat Siddhi Adhyaya|Complications of Therapeutic Enema (Bastivyapat Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Prasrita Yogiyam Siddhi Adhyaya|Standardized Enema Formulations (Prasrita Yogiyam Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Trimarmiya Siddhi Adhyaya|Management of Three Vital Organs (Trimarmiya Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Basti Siddhi Adhyaya|Successful Enema Administration (Basti Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Phalamatra Siddhi Adhyaya|Utility of Medicinal Fruits (Phalamatra Siddhi Adhyaya)]]'''</li><br />
<li>'''[[Uttar Basti Siddhi Adhyaya|Best Effective Therapeutic Enema (Uttar Basti Siddhi Adhyaya)]]'''</li><br />
</ol><br />
</div><br />
</div><br />
<br />
<div class="charak-footer"><br />
<div class="total-chapters"><br />
<strong>Total Chapters: 120</strong> | <strong>Sections: 8</strong><br />
</div><br />
<p class="footer-note">This index provides links to all chapters of Charak Samhita, the foundational text of Ayurveda. Each section (Sthana) covers specific aspects of Ayurvedic knowledge and practice.</p><br />
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<div style="border-bottom:1px solid #7cd0ea;background-color:#FFFFFF; text-align:center;border:1px solid #000080; border-radius:8px;padding:0.2em 0.9em 0.2em 0.5em; font-size:160%; font-weight:bold;"><span style="color:#00008b">[[Preface- Charak Samhita New Edition|Charak Samhita New Edition]]</span><br />
<br />
<span style="color:#00008b">The Definitive Online Edition of [[Ayurveda]]'s Core Treatise on Healthcare with [[Special:Statistics|{{NUMBEROFARTICLES}}]] articles</span><br />
</div><br />
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<div style="padding-top:0.50em;margin-bottom: 0.5em; margin-top: 0.5em; padding-bottom:0.50em; padding-left:0.50em; padding-right:0.50em;width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;"><br />
<h2 id="mp-dyk-h2_3" style="clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:160%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;"><span style="color:#00008b">[[Preface- Charak Samhita New Edition|<span style="color:#000080">Charak Samhita - Ayurveda's Core Text</span>]]</h2></div><br />
<br />
<div style="width:100%; min-width:200px; border:1px solid #000080; border:1px solid #000080; border-radius:8px; padding:0; background-color:#FFFFFF; vertical-align:top; color:#000080;"><br />
<h2 id="mp-dyk-h2" style="clear:both; margin:0.5em; background:#FFFFFF;font-family:inherit; font-size:130%; font-weight:bold; border-radius:8px; color:#000080; padding:0.2em 0.4em;text-align:center;"><span style="color:#00008b">[[Contents|Contents]]</span></h2><br />
<div style="padding:0.1em 0.6em 0.5em;"><br />
<div style="-moz-column-width: 20em; -webkit-column-width: 20em; column-width: 20em; width:auto; font-style: normal;"><br />
<ul><br />
<li>'''[[Sutra Sthana| I. Section on fundamental principles]] ''' '''([[Sutra Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[Nidana Sthana| II. Section on diagnostic principles]]''' '''([[Nidana Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[Vimana Sthana| III. Section on specific medical principles]]''' '''([[Vimana Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[Sharira Sthana| IV. Section on human being and genesis]]''' '''([[Sharira Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[ Indriya Sthana| V. Section on sensorial prognosis]] ''' '''([[Indriya Sthana]])''' </li><br />
</ul><ul><br />
<li>'''[[Chikitsa Sthana| VI. Section on therapeutic principles]] ''' '''([[Chikitsa Sthana]])''' </li><br />
<li>'''[[Kalpa Sthana| VII. Section on pharmaceutical preparations]] ''' '''([[Kalpa Sthana]]) ''' <br />
</li><br />
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<li>'''[[Siddhi Sthana| VIII. Section on therapeutic procedures]]''' ''' ([[Siddhi Sthana]])''' </li><br />
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<div>{{CiteButton}}<br />
{{#seo:<br />
|title=Shyamatrivrita Kalpa Adhyaya<br />
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|keywords=Shyama, Trivrita, Virechana, Operculana turpenthum Linn., purgation, Ayurveda, Indian system of medicine, charak samhita.<br />
|description=Kalpa Sthana Chapter 7. Pharmaceutical preparations of Shyama Trivrita<br />
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<big>'''[[Kalpa Sthana]] Chapter 7. Pharmaceutical preparations of Shyama Trivrita '''</big><br />
{{Infobox<br />
|title = Shyamatrivrita Kalpa Adhyaya<br />
|label1 = Section/Chapter<br />
|data1 = [[Kalpa Sthana]] Chapter 7<br />
|label2 = Preceding Chapter<br />
|data2 = [[Kritavedhana Kalpa Adhyaya]]<br />
<br />
|label3= Succeeding Chapter<br />
|data3 = [[Chaturangula Kalpa Adhyaya]]<br />
|label5 = Other Sections<br />
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Siddhi Sthana]]<br />
|label6 = Translator and commentator<br />
|data6 = Sitaram B., Sawant B.<br />
|label7 = Reviewer <br />
|data7 = Sawant B., Nishteswar K.<br />
|label8 = Editors<br />
|data8 = Nishteswar K., Sawant B., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br />
|label9 = Year of publication <br />
|data9 = 2020<br />
|label10 = Publisher <br />
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label11 = DOI <br />
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s07.008 10.47468/CSNE.2020.e01.s07.008]<br />
}}<br />
<big>'''Abstract'''</big><br />
<p style="text-align:justify;">The seventh Chapter of [[Kalpa Sthana]] deals with the pharmaceutical preparations for ''virechana karma'' (purgative therapy) using ''Shyama'' and ''Trivrita''. ''Trivrita'', is considered best purgative because of its effectiveness and minimal side effects. The chapter describes synonyms of the plant, its morphology, pharmacological properties, the varieties of plant with their different indications and untoward effects, the method of collection of the plant part used i.e. the root and its storage are also described. Then, one hundred and ten preparations using ''Trivrita'' or ''Shyama'' or combination of these two drugs are enlisted. Proportions of different drugs that are to be used along with the main drug are discussed and the dosage to different individuals is also presented. Recipes made of ''Trivrita'' or ''Shyama'' are formulated in such a way to suit any individual depending upon the seasons and climatic conditions.<br/><br />
<br />
'''Keywords''': Shyama, Trivrita, [[Virechana]], Operculana turpenthum Linn., purgation.<br />
</p><br />
<br />
<br />
== Introduction ==<br />
<div style="text-align:justify;"><br />
The first six chapters of this section dealt with preparations used for [[Vamana]] Karma (therapeutic emesis). The preparations aimed at [[Virechana]] Karma (therapeutic purgation) begin with this chapter and are extended in five more chapters. ''Trivrita'' is considered the best as it causes very little side effects and less spasmodic pain during the process of purgation, that is the reason many recipes of this drug are being described.<br />
<br />
The action of [[Virechana]] drugs known as laxatives or purgatives or cathartics varies depending upon the drug used. The different varieties of drugs used in modern medicine act according to their structure and chemical composition. The latency and effect of all laxatives vary with dosage. In sufficiently high dosage, many laxatives promote catharsis, which implies purgation with more fluid evacuation. Generally many of the drugs used in [[Ayurveda]] for catharsis or laxative action are stimulant laxatives. These drugs stimulate accumulation of water and electrolytes in the colonic lumen and they also enhance intestinal motility. Anthraquinones that are present in many of the Ayurvedic drugs like ''Haritaki, Aragvadha'' or ''Trivrita'' exert their action similarly. They reduce net absorption of electrolytes and water and also increase the permeability of the mucosa, possibly by making tight junctions leaky. This persistent action allows fats to secrete through the intestinal mucosa there by reducing the overall levels of triglycerides in the body. Many of the laxatives of this type increase the synthesis of prostaglandins and this action may contribute to increased secretion of water and electrolytes and is a factor for the spasmodic pain during the process of catharsis. In the present chapter, purgative preparations of ''Trivrita'' are described.<br />
<br />
== Sanskrit Text, Transliteration with English Translation ==<br />
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<br />
अथातः श्यामात्रिवृत्कल्पं व्याख्यास्यामः ||१||<br />
<br />
इति ह स्माह भगवानात्रेयः ||२|| <br />
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athatah shyamatrivrutkalpam vyakhyasyamah ||1|| <br />
<br />
iti ha smaha bhagavanatreyah ||2|| <br />
<br />
athatah shyamatrivrutkalpam vyakhyasyamah||1|| <br />
<br />
iti ha smaha bhagavanatreyah||2|| <br />
</div></div><br />
<br />
Now we shall expound the chapter "Shyamatrivrita Kalpa" (Pharmaceutical preparations of Shyama Trivrita). Thus said Lord Atreya.[1-2]<br />
<br />
=== Importance of ''Trivrita'' as a Purgative ===<br />
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<br />
विरेचने त्रिवृन्मूलं श्रेष्ठमाहुर्मनीषिणः |<br />
<br />
तस्याः सञ्ज्ञा गुणाः कर्म भेदः कल्पश्च वक्ष्यते ||३|| <br />
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<br />
virechane trivrunmulam shreshthamahurmanishinah | <br />
<br />
tasyah saungya gunah karma bhedah kalpashcha vakshyate ||3|| <br />
<br />
virechane trivrunmulam shreshthamahurmanishinah | <br />
<br />
tasyah saungya gunah karma bhedah kalpashcha vakshyate||3|| <br />
</div></div><br />
<br />
According to physicians who are knowledgeable and wise, the root of ''Trivrita'' is considered the best among the purgative drugs. Now, its identity in the form of Synonyms, Pharmacological properties, Therapeutic actions, varieties or types and recipes will be described (in the following verses). [3]<br />
<br />
=== Identity and Synonyms ===<br />
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<br />
त्रिभण्डी त्रिवृता चैव श्यामा कूटरणा तथा | <br />
<br />
सर्वानुभूतिः सुवहा शब्दैः पर्यायवाचकैः ||४|| <br />
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tribhandi trivruta chaiva shyama kutarana tatha | <br />
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sarvanubhutih suvaha shabdaih paryayavachakaihi ||4|| <br />
<br />
tribhandi trivruta chaiva shyama kutarana tatha| <br />
<br />
sarvanubhutih suvaha shabdaih paryayavachakaihi ||4|| <br />
</div></div><br />
<br />
''Tribhandi, Trivrita, Shyama, Kutarana, Sarvanubhuti'' and ''Suvaha'' are the synonyms of the drug ''Trivrita''. [4]<br />
<br />
=== Properties ===<br />
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<br />
कषाया मधुरा रूक्षा विपाके कटुका च सा | <br /><br />
कफपित्तप्रशमनी रौक्ष्याच्चानिलकोपनी ||५|| <br /><br />
<br />
सेदानीमौषधैर्युक्ता वातपित्तकफापहैः | <br /><br />
कल्पवैशेष्यमासाद्य सर्वरोगहरा भवेत् ||६|| <br /><br />
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kashaya madhura ruksha vipake katuka cha sa | <br /><br />
kaphapittaprashamani raukshyacchaanilakopani ||5|| <br /><br />
<br />
sedanimaushadhairyukta vatapittakaphapahaih | <br /><br />
kalpavaisheshyamasadya sarvarogahara bhavet ||6|| <br /><br />
<br />
kashaya madhura ruksha vipake katuka cha sa| <br /><br />
kaphapittaprashamani raukshyacchaanilakopani||5|| <br /><br />
<br />
sedanimaushadhairyukta vatapittakaphapahaih| <br /><br />
kalpavaisheshyamasadya [1] sarvarogahara bhavet||6|| <br /><br />
</div></div><br />
<br />
''Trivrita'' is astringent and sweet in taste, dry (not oily or creamy) and pungent in ''vipaka'' (post digestive effect). Due to its dry property it pacifies [[kapha]] and [[pitta]] and aggravates [[vata]]. Even then, when utilized along with drugs which pacify [[vata]], [[pitta]] and [[kapha]] and also depending upon the combinations used in various pharmaceutical preparations, this drug attains the capacity of curing all types of diseases. [5-6]<br />
<br />
=== Types of ''Trivrita'' ===<br />
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मूलं तु द्विविधं तस्याः श्यामं चारुणमेव च |<br />
<br />
तयोर्मुख्यतरं विद्धि मूलं यदरुणप्रभम् ||७|| <br />
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<br />
mulam tu dvividham tasyah shyamam charunameva cha | <br />
<br />
tayormukhyataram viddhi mulam yadarunaprabham ||7|| <br />
<br />
mulam tu dvividham tasyah shyamam charunameva cha| <br />
<br />
tayormukhyataram viddhi mulam yadarunaprabham||7|| <br />
</div></div><br />
<br />
Roots of the plant ''Trivrita'' are of two types. The one that is black (''shyama'') is more beneficial than the other blackish red one. [7]<br />
<br />
=== Utility of Pink Variety ===<br />
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सुकुमारे शिशौ वृद्धे मृदुकोष्ठे च तच्छुभम् | <br />
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sukumare shishau vruddhe mrudukoshthe cha tacchubham ||7½ |||<br />
<br />
sukumare shishau vruddhe mrudukoshthe cha tacchubham | <br />
</div></div><br />
<br />
The root of the Trivruta having blackish red color can be used as a purgative drug, for persons having delicate health, for children, for aged and for persons having laxed bowel (''Mridu koshtha'') [7½]<br />
<br />
=== Utility of Black variety ===<br />
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<br />
मोहयेदाशुकारित्वाच्छ्यामा क्षिण्वीत मूर्च्छयेत् ||८||<br />
<br />
तैक्ष्ण्यात् कर्षति हृत्कण्ठमाशु दोषं हरत्यपि | <br />
<br />
शस्यते बहुदोषाणां क्रूरकोष्ठाश्च ये नराः ||९|| <br />
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mohayedashukaritvacchyama kshinvita murcchayet ||8|| <br />
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taikshnyat karshati hrutkanthamashu dosham haratyapi | <br />
<br />
shasyate bahudoshanam krurakoshthashcha ye narah ||9|| <br />
<br />
mohayedashukaritvacchyama kshinvita murcchayet ||8|| <br />
<br />
taikshnyat karshati hrutkanthamashu dosham haratyapi| <br />
<br />
shasyate bahudoshanam krurakoshthashcha ye narah||9||<br />
</div></div><br />
<br />
The root of the ''Trivrita'' having black colour, when used for purgative action, due to its instantaneous action, leads to unconsciousness, loss (of tissue elements or in another sense, electrolytes) and fainting. Due to its rapid action, it causes spasmodic pain (torment) in the cardiac region and throat. It eliminates the morbid (accumulated) material instantaneously. Hence, this variety is highly useful in persons having excessively aggravated [[dosha]] and highly constipated bowel (''Krura koshtha'') [7 ½ -9]<br />
<br />
=== Method of collection ===<br />
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गुणवत्यां तयोर्भूमौ जातं मूलं समुद्धरेत् |<br />
<br />
उपोष्य प्रयतः शुक्ले शुक्लवासाः समाहितः ||१०|| <br />
<br />
गम्भीरानुगतं श्लक्ष्णमतिर्यग्विसृतं च यत् | <br />
<br />
तद्विपाट्योद्धरेद्गर्भं त्वचं शुष्कां निधापयेत् ||११|| <br />
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gunavatyam tayorbhumau jatam mulam samuddharet | <br />
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uposhya prayatah shukle shuklavasah samahitah ||10|| <br />
<br />
gambhiranugatam shlakshnamatiryagvisrutam cha yat | <br />
<br />
tadvipatyoddharedgarbham tvacham shushkam nidhapayet ||11|| <br />
<br />
gunavatyam tayorbhumau jatam mulam samuddharet| <br />
<br />
uposhya prayatah shukle shuklavasah samahitah||10|| <br />
<br />
gambhiranugatam shlakshnamatiryagvisrutam cha yat| <br />
<br />
tadvipatyoddharedgarbham [1] tvacham shushkam nidhapayet||11||<br />
</div></div><br />
<br />
Both the varieties of the ''Trivrita'' root, growing in good soil, should be uprooted from the ground by a person who has observed fast, in ''Shukla Paksha'', who is wearing white colored formal clothing and who has got concentration of mind. The roots should have deeply penetrated, smooth (without nodes or side roots), and not spreading sideways. Then, these roots are to be split and the pith is to be removed. Then, the root bark is to be separated. When the bark of the root is completely dried, it is to be appropriately preserved. [10-11]<br />
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=== Preparatory measures ===<br />
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स्निग्धस्विन्नो विरेच्यस्तु पेयामात्रोषितः सुखम् |१२|<br />
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snigdhasvinno virechyastu peyamatroshitah sukham |12| <br />
<br />
snigdhasvinno virechyastu peyamatroshitah sukham|12| <br />
</div></div><br />
<br />
The person who has undergone oleation and fomentation therapies (who is ready to be given purgative drug the next day, is to be given ''peya'' (gruel made of cereals, which is thin) as food in the previous night so that, he purges with ease (in the next morning, after administration of the purgative drug). [11 ½]<br />
<br />
=== Preparations of ''Trivrita'' along with sour liquid etc. ===<br />
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अक्षमात्रं तयोः पिण्डं विनीयाम्लेन ना पिबेत् ||१२|| <br />
<br />
गोऽव्यजामहिषीमूत्रसौवीरकतुषोदकैः | <br />
<br />
प्रसन्नया त्रिफलया शृतया च पृथक् पिबेत् ||१३|| <br />
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akshamatram tayoh pindam viniyamlena na pibet ||12|| <br />
<br />
goavyajamahishimutrasauvirakatushodakaih | <br />
<br />
prasannaya triphalaya shrutaya cha pruthak pibet ||13|| <br />
<br />
akshamatram tayoh pindam viniyamlena na pibet||12|| <br />
<br />
goavyajamahishimutrasauvirakatushodakaih| <br />
<br />
prasannaya triphalaya shrutaya cha pruthak pibet||13|| <br />
</div></div><br />
<br />
Grinded paste of, either of the roots of ''Trivrita'' or in combination, in a round bolus form (''pinda''), in a dose of around 12 Gms. (one ''aksha'') should be mixed with sour drinks (''kanjika''), and can be taken in by a person (who is to be purgated).<br />
<br />
Similarly, urine of cow, sheep, goat or she-buffalo, vinegar (''sauviraka''), a sour drink prepared of raw barley (''tushodaka''), a type of diluted wine (''Prasanna'') or the decoction of ''Triphala'' should be used separately to take this paste of ''Trivrita''. [11 ½ - 13]<br />
<br />
=== Preparations of ''Trivrita'' in powder form ===<br />
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एकैकं सैन्धवादीनां द्वादशानां सनागरम् | <br /><br />
त्रिवृद्द्विगुणसंयुक्तं चूर्णमुष्णाम्बुना पिबेत् ||१४|| <br /><br />
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ekaikam saindhavadinam dvadashanam sanagaram | <br /><br />
trivrddvigunasamyuktam churnamushnambuna pibet ||14|| <br /><br />
<br />
ekaikam saindhavadinam dvadashanam sanagaram| <br /><br />
trivruddvigunasamyuktam churnamushnambuna pibet||14|| <br /><br />
</div></div><br />
<br />
Two parts of ''Trivrita'' root powder may be mixed with one part of salt out of its twelve types (''Saindhava, Sauvarchala, Kala, Bida, Pakya, Anupa, Kupya, Valukaja, Maulaka, Samudra, Romaka,'' and ''Audbhida''). These preparations should be taken in along with ''Nagara'' (dry ginger powder) and hot water. [14]<br />
<br />
=== Preparations of ''Trivrita'' to be taken along with Cow Urine ===<br />
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पिप्पली पिप्पलीमूलं मरिचं गजपिप्पली | <br /><br />
सरलः किलिमं हिङ्गु भार्गी तेजोवती तथा ||१५|| <br /><br />
<br />
मुस्तं हैमवती पथ्या चित्रको रजनी वचा | <br /><br />
स्वर्णक्षीर्यजमोदा च शृङ्गवेरं च तैः पृथक् ||१६|| <br /><br />
<br />
एकैकार्धांशसंयुक्तं पिबेद्गोमूत्रसंयुतम् |१७| <br /><br />
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<br />
pippali pippalimulam maricham gajapippali | <br /><br />
saralah kilimam hingu bhargi tejovati tatha ||15|| <br /><br />
<br />
mustam haimavati pathya chitrako rajani vacha | <br /><br />
svarnakshiryajamoda cha shrungaveram cha taih pruthak ||16|| <br /><br />
<br />
ekaikardhamshasamyuktam pibedgomutrasamyutam |17| <br /><br />
<br />
pippali pippalimulam maricham gajapippali| <br /><br />
saralah kilimam hingu bhargi tejovati tatha||15|| <br /><br />
<br />
mustam haimavati pathya chitrako rajani vacha| <br /><br />
svarnakshiryajamoda cha shrungaveram cha taih pruthak||16|| <br /><br />
<br />
ekaikardhamshasamyuktam pibedgomutrasamyutam|17|<br /><br />
</div></div><br />
<br />
One part of ''Trivrita'' root powdered should be added with half part of the powder of either ''Pippali, Pippalimula, Maricha, Gajapippali, Sarala, Kilima, Hingu, Bharngi, Tejovati, Musta, Haimavati, Pathya, Chitraka, Rajani (Haridra), Vacha, Svarna Kshiri, Ajamoda,'' or ''Shringavera''. Any one of these may be taken in, along with cow urine for purgation. [15-16- 16 ½]<br />
<br />
=== Preparation of ''Trivrita'' along with ''Madhuka'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
मधुकार्धांशसंयुक्तं शर्कराम्बुयुतं पिबेत् ||१७||<br />
<div class="mw-collapsible-content"><br />
<br />
madhukardhamshasamyuktam sharkarambuyutam pibet ||17|| <br />
<br />
madhukardhamshasamyuktam sharkarambuyutam pibet||17|| <br />
</div></div><br />
<br />
Half part of ''Madhuka'' (''Yashtimadhu'') powder may be added with one part of ''Trivrita'' powder this mixture can be taken in along with sugar water for purgation. [17]<br />
<br />
=== Preparations of ''Trivrita'' along with ''Jivaka'', etc. ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
जीवकर्षभकौ मेदां श्रावणीं कर्काटाह्वयाम् | <br /><br />
मुद्गमाषाख्यपर्ण्यौ च महतीं श्रावणीं तथा ||१८|| <br /><br />
<br />
काकोलीं क्षीरकाकोलीमिन्द्रां छिन्नरुहां तथा | <br /><br />
क्षीरशुक्लां पयस्यां च यष्ट्याह्वं विधिना पिबेत् ||१९|| <br /><br />
<br />
वातपित्तहितान्येतान्यन्यानि तु कफानिले |२०| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
jivakarhushabhakau medam shravanim karkatahvayam | <br /><br />
mudgamashakhyaparnyau cha mahatim shravanim tatha ||18|| <br /><br />
<br />
kakolim kshirakakolimindram chinnaruham tatha | <br /><br />
kshirashuklam payasyam cha yashtyahvam vidhina pibet ||19|| <br /><br />
<br />
vatapittahitanyetanyanyani tu kaphanile |20| <br /><br />
<br />
jivakarhushabhakau medam shravanim karkatahvayam| <br /><br />
mudgamashakhyaparnyau cha mahatim shravanim tatha||18|| <br /><br />
<br />
kakolim kshirakakolimindram [1] chinnaruham tatha| <br /><br />
kshirashuklam payasyam cha yashtyahvam vidhina pibet||19|| <br /><br />
<br />
vatapittahitanyetanyanyani tu kaphanile|20| <br /><br />
</div></div><br />
<br />
The powder of ''Trivrita'' can be taken along with the powder of either, ''Jivaka, Rhushbhaka, Meda, Shravani (Mundi), Karkatashringi, Mudgaparni, Mashaparni, Maha-shravani, Kakoli, Kshirakakoli, Indra (Indravaruni), Chinna riha (Guduchi), Kshirashukla (Kshiravidari)'' or ''Payasya (Arka-puspha)'' for purgation. Similarly, the powder of ''Trivrita'' root can be taken along with ''Yashtimadhu (Madhuka)'' for purgation. The above-mentioned preparations are useful for diseases caused by[[vata]] and [[pitta]]. The preparations that will be useful for the diseases caused by [[kapha]] and [[vata]] will be described later. [18 –19½]<br />
<br />
=== Preparations of Trivrita, to be taken along with liquids ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
क्षीरमांसेक्षुकाश्मर्यद्राक्षापीलुरसैः पृथक् ||२०|| <br />
<br />
सर्पिषा वा तयोश्चूर्णमभयार्धांशिकं पिबेत् |२१| <br />
<div class="mw-collapsible-content"><br />
<br />
kshiramamsekshukashmaryadrakshapilurasaih pruthak ||20|| <br />
<br />
sarpisha va tayoshchurnamabhayardhamshikam pibet |21| <br />
<br />
kshiramamsekshukashmaryadrakshapilurasaih pruthak||20|| <br />
<br />
sarpisha va tayoshchurnamabhayardhamshikam pibet|21|<br />
</div></div><br />
<br />
One part of the ''Trivrita'' root powdered mixed with half part of powdered ''haritaki'' may be taken in along with either, Milk, Meat-soup, Sugar cane juice, Fruit juice of ''Kashmarya (Gambhari)'', Fruit juice of ''Draksha'' (grapes), Fruit Juice of ''Pilu'', or Ghee, for purgation. [19 ½ - 20½]<br />
<br />
=== Preparation of ''Trivrita'' in the form of Linctus (No. 1) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
लिह्याद्वा मधुसर्पिर्भ्यां संयुक्तं ससितोपलम् ||२१|| <br />
<div class="mw-collapsible-content"><br />
<br />
lihyadva madhusarpirbhyam samyuktam sasitopalam ||21|| <br />
<br />
lihyadva madhusarpirbhyam samyuktam sasitopalam||21|| <br />
</div></div><br />
<br />
(Powered root of ''Trivrita'' may be) added with honey and ghee (to form a linctus). Then, crudely powdered sugar candy is added to it (and taken in for purgation) [21]<br />
<br />
=== Preparation of ''Trivrita'' in the form of linctus (No. 2) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
अजगन्धा तुगाक्षीरी विदारी शर्करा त्रिवृत् | <br /><br />
चूर्णितं क्षौद्रसर्पिर्भ्यां लीढ्वा साधु विरिच्यते ||२२|| <br /><br />
<br />
सन्निपातज्वरस्तम्भदाहतृष्णार्दितो नरः | <br /><br />
<div class="mw-collapsible-content"><br />
<br />
ajagandha tugakshiri vidari sharkara trivrut | <br /><br />
churnitam kshaudrasarpirbhyam lidhva sadhu virichyate ||22|| <br /><br />
<br />
sannipatajvarastambhadahatrushnardito narah |<br /><br />
<br />
ajagandha tugakshiri vidari sharkara trivrut| <br /><br />
churnitam kshaudrasarpirbhyam lidhva sadhu virichyate||22|| <br /><br />
<br />
sannipatajvarastambhadahatrushnardito narah| <br /><br />
</div></div><br />
<br />
The powders of ''Ajagandha, Tugakshiri, Vidari, Sarkara'' (sugar) and ''Trivrita'' may be mixed with honey and ghee. This linctus taken in, is useful as a mild purgative, for the patient suffering from ''Sannipata Jwara'' (fevers caused by aggravation of all the three ''doshas''), ''Stambha'' (either retention of urine and faeces or generalized stiffness of the body), ''Daha'' (burning sensation in some parts or throughout the body) and ''Trishna'' (Thirst due to some underlying pathology). [22- 22 ½]<br />
<br />
=== Preparation of ''Trivrita'' in the form of linctus (No. 3) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
श्यामात्रिवृत्कषायेण कल्केन च सशर्करम् ||२३|| <br />
<br />
साधयेद्विधिवल्लेहं लिह्यात् पाणितलं ततः | <br />
<div class="mw-collapsible-content"><br />
<br />
shyamatrivrutkashayena kalkena cha sasharkaram ||23|| <br />
<br />
sadhayedvidhivalleham lihyat panitalam tatah | <br />
<br />
shyamatrivrutkashayena kalkena cha sasharkaram||23|| <br />
<br />
sadhayedvidhivalleham lihyat panitalam tatah| <br />
</div></div><br />
<br />
With the decoction and paste (either dried powder or wet paste) of the black variety of Trivruta root, a linctus is to be prepared following the prescribed procedure) using sugar (as a solvent). In a dose of one ''panitala'' this linctus can be taken in (for purgation). [22 ½ - 23½]<br />
<br />
=== Preparation of ''Trivrita'' in the form of linctus (No. 4) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
सक्षौद्रां शर्करां पक्त्वा कुर्यान्मृद्भाजने नवे ||२४|| <br />
<br />
क्षिपेच्छीते त्रिवृच्चूर्णं त्वक्पत्रमरिचैः सह | <br />
<br />
मात्रया लेहयेदेतदीश्वराणां विरेचनम् ||२५|| <br />
<div class="mw-collapsible-content"><br />
<br />
sakshaudram sharkaram paktva kuryanmrudbhajane nave ||24|| <br />
<br />
kshipecchite trivrucchurnam tvakpatramarichaih saha | <br />
<br />
matraya lehayedetadishvaranam virechanam ||25|| <br />
<br />
sakshaudram sharkaram paktva kuryanmrudbhajane nave||24|| <br />
<br />
kshipecchite [1] trivruccurnam tvakpatramarichaih saha| <br />
<br />
matraya [2] lehayedetadishvaranam virechanam||25|| <br />
</div></div><br />
<br />
Sugar and honey are mixed well and boiled (till the sugar is completely dissolved) in a new earthen vessel. When it is properly cooked and cooled, powdered ''Trivrita'' may be added to it, along with powders of ''Tvak'' (Cinnamon bark), ''Patra'' (Cinnamon leaves) and ''Maricha'' (black pepper) are added to it. This linctus can be taken in, in the prescribed and suitable dose. This is a useful purgative for persons belonging to the upper class. [2 ½ - 25]<br />
<br />
=== Preparation of ''Trivrita'' in the form of Linctus (No. 5) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
कुडवांशान् रसानिक्षुद्राक्षापीलुपरुषकात् | <br /><br />
सितोपलापलं क्षौद्रात् कुडवार्धं च साधयेत् ||२६|| <br /><br />
<br />
तं लेहं योजयेच्छीतं त्रिवृच्चूर्णेन शास्त्रवित् | <br /><br />
एतदुत्सन्नपित्तानामीश्वराणां विरेचनम् ||२७|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
kudavamshan rasanikshudrakshapiluparushakat | <br /><br />
sitopalapalam kshaudrat kudavardham cha sadhayet ||26|| <br /><br />
<br />
tam leham yojayecchitam trivrucchurnena shastravit | <br /><br />
etadutsannapittanamishvaranam virechanam ||27|| <br /><br />
<br />
kudavamshan [3] rasanikshudrakshapiluparushakat| <br /><br />
sitopalapalam kshaudrat kudavardham cha sadhayet||26|| <br /><br />
<br />
tam leham yojayecchitam trivrucchurnena shastravit| <br /><br />
etadutsannapittanamishvaranam [4] virechanam||27|| <br /><br />
</div></div><br />
<br />
Each one ''kudava'' (approx 200 ml) of the juices of ''Ikshu, Draksha, Pilu'' and ''Parushaka,'' one ''pala'' (approx.48g) of ''Sitopala'' (sugar candy) and half a ''kudava'' (approx 100 ml) of honey are to be boiled together. When it is cooled, powdered ''Trivrita'' is to be added to it by experts (in the field of such preparations) and made into linctus. This preparation is highly useful as a purgative for those persons, who are having excessively aggravated ''pitta dosha'' and who are from the upper classes of the society. [26-27]<br />
<br />
=== Preparations of ''Trivrita'' with Sugar ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
शर्करामोदकान् वर्तीर्गुलिकामांसपूपकान् | <br /><br />
अनेन विधिना कुर्यात् पैत्तिकानां विरेचनम् ||२८|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
sharkaramodakan vartirgulikamamsapupakan | <br /><br />
anena vidhina kuryat paittikanam virechanam ||28|| <br /><br />
<br />
sharkaramodakan vartirgulikamamsapupakan| <br /><br />
anena vidhina kuryat paittikanam virechanam||28|| <br /><br />
</div></div><br />
<br />
Following the same method (as mentioned in the above verses) preparations may be done in the form of ''Sharkara modaka'' (round, ball like sweets made of sugar), ''Sharkara varti'' (rolls made of sugar), ''Sharkaragulika'' (Pills made with sugar) and ''Sharkara mamsapupaka'' (Cake prepared with sugar and meat). These preparations are useful as purgatives for those persons, suffering from diseases caused by [[pitta]] [[dosha]] [28]<br />
<br />
=== Preparations of ''Trivrita'' in the form of linctus (No. 6) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
पिप्पलीं नागरं क्षारं श्यामां त्रिवृतया सह | <br /><br />
लेहयेन्मधुना सार्धं श्लेष्मलानां विरेचनम् ||२९||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
pippalim nagaram ksharam shyamam trivrutaya saha | <br /><br />
lehayenmadhuna sardham shleshmalanam virechanam ||29|| <br /><br />
<br />
pippalim nagaram ksharam shyamam trivrutaya saha| <br /><br />
lehayenmadhuna sardham shleshmalanam virechanam||29|| <br /><br />
</div></div><br />
<br />
The powder of ''Trivrita'' (having pink roots) may be added with powders of ''Pippali, Nagara, Kshara'' (an alkali preparation) and ''Shyama'' (the variety having black roots).<br />
<br />
To this mixed powder, honey may be added and can be taken in, in the form of linctus for purgation for those having [[kapha]] type of constitution or for those persons suffering from disease due to the aggravation of [[kapha]].<br />
<br />
=== Preparation of ''Trivrita'' in the form of linctus (No. 7) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
मातुलुङ्गाभयाधात्रीश्रीपर्णीकोलदाडिमात् |<br /><br />
सुभृष्टान् स्वरसांस्तैले साधयेत्तत्र चावपेत् ||३०|| <br /><br />
<br />
सहकारात् कपित्थाच्च मध्यमम्लं च यत् फलम् |<br /><br />
पूर्ववद्बहलीभूते त्रिवृच्चूर्णं समावपेत् ||३१|| <br /><br />
<br />
त्वक्पत्रकेशरैलानां चूर्णं मधु च मात्रया |<br /><br />
लेहोऽयं कफपूर्णानामीश्वराणां विरेचनम् ||३२|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
matulungabhayadhatrishriparnikoladadimat | <br /><br />
subhrushtan svarasamstaile sadhayettatra chavapet ||30||<br /><br />
<br />
sahakarat kapitthaccha madhyamamlam cha yat phalam | <br /><br />
purvavadbahalibhute trivrucchurnam samavapet ||31|| <br /><br />
<br />
tvakpatrakesharailanam curnam madhu cha matraya | <br /><br />
lehoayam kaphapurnanamishvaranam virechanam ||32|| <br /><br />
<br />
matulungabhayadhatrishriparnikoladadimat| <br /><br />
subhrushtan svarasamstaile sadhayettatra chavapet||30|| <br /><br />
<br />
sahakarat kapitthaccha madhyamamlam cha yat phalam| <br /><br />
purvavadbahalibhute trivruccurnam samavapet||31|| <br /><br />
<br />
tvakpatrakesharailanam curnam madhu cha matraya| <br /><br />
lehoayam kaphapurnanamishvaranam virechanam||32|| <br /><br />
</div></div><br />
<br />
The juice of ''Matulunga, Abhaya, Dhatri, Shriparni, Kola'' and ''Dadima'' are to be properly sizzled (fried till a hissing sound comes out) and cooked in oil by adding the pulp of ''Sahakara'' (mango), ''Kapittha'' (wood apple) and ''Matulunga'' (Sour fruit). When the preparation starts concentrating, the powder of ''Trivrita'', root along with the powders of ''Tvak, Patra, Keshara'' and ''Ela'' are to be added. Finally honey is to be added to make linctus. Intake of this linctus in appropriate dose is useful as a purgative for those persons from upper classes.[30-32]<br />
<br />
=== Preparations of ''Trivrita'' in the form of Syrup etc. ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
पानकानि रसान् यूषान्मोदकान् रागषाडवान् |<br /><br />
अनेन विधिना कुर्याद्विरेकार्थं कफाधिके ||३३|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
panakani rasan yushanmodakan ragashadavan | <br /><br />
anena vidhina kuryadvirekartham kaphadhike ||33|| <br /><br />
<br />
panakani rasan yushanmodakan ragashadavan| <br /><br />
anena vidhina kuryadvirekartham kaphadhike||33|| <br /><br />
</div></div><br />
<br />
Similar to the above mentioned procedure, the preparations (of ''Trivrita'') are to be made in the forms of ''Panak'' (syrup), ''Rasa'' (meat soup), ''Yusha'' (pulse-soup), ''Modaka'' (sweet-meat), and ''Raga'' – ''shadava'' (sour drinks with and pungent taste). These preparations can be administered for purgation to persons having aggravated [[kapha]]. [33]<br />
<br />
=== Preparations of ''Trivrita'' in the form of ''Tarpana'' (soothing drink) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
भृङ्गैलाभ्यां समा नीली तैस्त्रिवृत्तैश्च शर्करा |<br /><br />
चूर्णं फलरसक्षौद्रशक्तुभिस्तर्पणं पिबेत् ||३४|| <br /><br />
<br />
वातपित्तकफोत्थेषु रोगेष्वल्पानलेषु च | <br /><br />
नरेषु सुकुमारेषु निरपायं विरेचनम् ||३५|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
bhrngailabhyam sama nili taistrivruttaishcha sharkara | <br /><br />
churnam phalarasakshaudrashaktubhistarpanam pibet ||34|| <br /><br />
<br />
vatapittakaphottheshu rogeshvalpanaleshu cha | <br /><br />
nareshu sukumareshu nirapayam virechanam ||35|| <br /><br />
<br />
bhrungailabhyam sama nili taistrivruttaishcha sharkara| <br /><br />
churnam phalarasakshaudrashaktubhistarpanam pibet||34|| <br /><br />
<br />
vatapittakaphottheshu rogeshvalpanaleshu cha| <br /><br />
nareshu sukumareshu nirapayam virechanam||35|| <br /><br />
</div></div><br />
<br />
A ''Tarpana'' or soothing drink should be prepared by adding the powder of one part of ''Bhringa'', one part of ''Ela'' (Cinnamon bark), two parts of ''Nili'', three parts of ''Trivrita'' and seven parts of sugar to the juice of ''Dadima'', honey and powder of pop-rice or barley. This is a very safe purgative preparation for the patients suffering from diseases due to [[vata]], [[pitta]] and [[kapha]], for persons having low digestive fire and for persons who are very much tender or delicate. [34-35]<br />
<br />
=== Preparation of ''Trivrita'' in the form of ''Modaka'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
शर्करात्रिफलाश्यामात्रिवृत्पिप्पलिमाक्षिकैः |<br /><br />
मोदकः सन्निपातोर्ध्वरक्तपित्तज्वरापहः ||३६|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
sharkaratriphalashyamatrivrutpippalimakshikaihi | <br /><br />
modakah sannipatordhvaraktapittajvarapahah ||36|| <br /><br />
<br />
sharkaratriphalashyamatrivrutpippalimakshikaihi | <br /><br />
modakah sannipatordhvaraktapittajvarapahah||36|| <br /><br />
</div></div><br />
<br />
A ''Modaka'' (large sized round sweet-meat) may be prepared using sugar, ''Haritaki, Vibhitaki, and Amalaki'', black variety of ''Trivrita'' roots, ''Pippali'' and honey. Intake of this preparation cures ''Sannipata'' (simultaneous aggravation of all the three [[dosha]] and diseases caused there upon), ''Urdhva Raktapitta'' (bleeding from the opening of the upper parts of the body like mouth or nose) and fever. [36]<br />
<br />
=== Preparation of ''Trivrita'' in the form of linctus (No. 8) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
त्रिवृच्छाणा मतास्तिस्रस्तिस्रश्च त्रिफलात्वचः |<br /><br />
विडङ्गपिप्पलीक्षारशाणास्तिस्रश्च चूर्णिताः ||३७|| <br /><br />
<br />
लिह्यात् सर्पिर्मधुभ्यां च मोदकं वा गुडेन तु | <br /><br />
भक्षयेन्निष्परीहारमेतच्छोधनमुत्तमम् ||३८|| <br /><br />
<br />
गुल्मं प्लीहोदरं श्वासं हलीमकमरोचकम् | <br /><br />
कफवातकृतांश्चान्यान् व्याधीनेतह्यपोहति ||३९|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
trivrcchana matastisrastisrashcha triphalatvachah | <br /><br />
vidangapippaliksharashanastisrashcha churnitah ||37|| <br /><br />
<br />
lihyat sarpirmadhubhyam cha modakam va gudena tu | <br /><br />
bhakshayennishpariharametacchodhanamuttamam ||38|| <br /><br />
<br />
gulmam plihodaram shvasam halimakamarochakam | <br /><br />
kaphavatakrutamshchanyan vyadhinetahyapohati ||39|| <br /><br />
<br />
trivrucchana matastisrastisrashcha triphalatvachah| <br /><br />
vidangapippaliksharashanastisrashcha churnitah||37||<br /><br />
<br />
lihyAt sarpirmadhubhyam cha modakam va gudena tu| <br /><br />
bhakshayennishpariharametacchodhanamuttamam ||38|| <br /><br />
<br />
gulmam plihodaram shvasam halimakamarochakam| <br /><br />
kaphavatakrutamshchanyan vyadhinetahyapohati||39||<br /><br />
</div></div><br />
<br />
Three ''shanas'' of ''Trivrita'' powder is to be added with one ''shana'' rind powders of ''Haritaki, Vibhitaki, Amalaki,'' ''Vidanga'', ''Pippali'' and ''Kshara'' (an alkali preparation). This compounded powder may be mixed with ghee and honey and made to linctus or to an ''Modaka'' (round large sized sweet meat) using jaggery. This is considered as a good purgative and a person using it need not follow any dietary or any other restrictions. If this preparation is taken in, it can cure ''gulma'' (benign tumors of intestines), ''Plihodara'' (splenomegaly), ''Shvasa'' (broncho-spasm), ''Halimaka'' (chronic hepatitis), ''Arochaka'' (anorexia) and other such diseases caused by the aggravation of [[kapha]] and [[vata]] [37-39]<br />
<br />
=== Preparation of ''Trivrita'' in the form of ''Modaka'' (No. 2) ===<br />
==== ''Kalyanaka guda'' ====<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
विडङ्गपिप्पलीमूलत्रिफलाधान्यचित्रकान् |<br /><br />
मरिचेन्द्रयवाजाजीपिप्पलीहस्तिपिप्पलीः ||४०||<br /><br />
<br />
लवणान्यजमोदां च चूर्णितं कार्षिकं पृथक् | <br /><br />
तिलतैलत्रिवृच्चूर्णभागौ चाष्टपलोन्मितौ ||४१|| <br /><br />
<br />
धात्रीफलरसप्रस्थांस्त्रीन् गुडार्धतुलां तथा | <br /><br />
पक्त्वा मृद्वग्निना खादेद्बदरोदुम्बरोपमान् ||४२||<br /><br />
<br />
गुडान् कृत्वा न चात्र स्याद्विहाराहारयन्त्रणा | <br /><br />
मन्दाग्नित्वं ज्वरं मूर्च्छां मूत्रकृच्छ्रमरोचकम् ||४३|| <br /><br />
<br />
अस्वप्नं गात्रशूलं च कासं श्वासं भ्रमं क्षयम् | <br /><br />
कुष्ठार्शःकामलामेहगुल्मोदरभगन्दरान् ||४४|| <br /><br />
<br />
ग्रहणीपाण्डुरोगांश्च हन्युः पुंसवनाश्च ते | <br /><br />
कल्याणका इति ख्याताः सर्वेष्वृतुषु यौगिकाः ||४५|| <br /><br />
<br />
इति कल्याणकगुडः |४६| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
vidangapippalimulatriphaladhanyacitrakan | <br /><br />
marichendrayavajajipippalihastipippalih ||40|| <br /><br />
<br />
lavananyajamodam cha churnitam karshikam pruthak | <br /><br />
tilatailatrivrcchurnabhagau chashtapalonmitau ||41|| <br /><br />
<br />
dhatriphalarasaprasthamstrin gudardhatulam tatha | <br /><br />
paktva mrudvagnina khadedbadarodumbaropaman ||42|| <br /><br />
<br />
gudan krutva na chatra syadviharaharayantrana | <br /><br />
mandagnitvam jvaram murccham mutrakrucchramarochakam ||43|| <br /><br />
<br />
asvapnam gatrashulam cha kasam shvasam bhramam kshayam | <br /><br />
kushtharshahkamalamehagulmodarabhagandaran ||44|| <br /><br />
<br />
grahanipandurogamshcha hanyuh pumsavanashcha te | <br /><br />
kalyanaka iti khyatah sarveshvrtushu yaugikah ||45|| <br /><br />
<br />
iti kalyanakagudah |46| <br /><br />
<br />
vidangapippalimulatriphaladhanyacitrakan| <br /><br />
marichendrayavajajipippalihastipippalih||40|| <br /><br />
<br />
lavananyajamodam cha churnitam karshikam pruthak| <br /><br />
tilatailatrivrucchurnabhagau chashtapalonmitau||41|| <br /><br />
<br />
dhatriphalarasaprasthamstrin gudardhatulam tatha| <br /><br />
paktva mrudvagnina khadedbadarodumbaropaman||42|| <br /><br />
<br />
gudan krutva na chatra syadviharaharayantrana| <br /><br />
mandagnitvam jvaram murccham mutrakrucchramarochakam||43|| <br /><br />
<br />
asvapnam gatrashulam cha kasam shvasam bhramam kshayam| <br /><br />
kushtharshahkamalamehagulmodarabhagandaran||44|| <br /><br />
<br />
grahanipandurogamshcha hanyuh pumsavanashcha te| <br /><br />
kalyanaka iti khyatah sarveshvrutushu yaugikah||45|| <br /><br />
<br />
iti kalyanakagudah|46| <br /><br />
</div></div><br />
<br />
Each one ''karsha'' (around 12 grams) of ''Vidanga, Pippalimula, Triphala, Dhanyaka, Chitraka, Maricha, Indrayava, Ajaji Hasti pippali, Saindhava lavana, Samudra lavana, Vida lavana, Sauvarchala lavana, Audbhida lavana'' and ''Ajamoda'' are to be powdered separately and mixed together. Then, each eight ''pala'' (around 320 grams) of sesame oil and powdered root of ''Trivrita'' are added. Then, three ''prasthas'' (around 2.20 litres) juice of ''Amalaki'' and half a ''tula'' of jaggery are added to the entire material and cooked over mild fire. (When, it is completely cooked), round pills (''Guda'') of the size of ''Badara'' or ''Udumbara'' are made from the compound. While taking in these pills, there is no need of restrictions of food or any other regimen. Utilization of this purgative drug relieves loss of digestive power (''Mandagni''), fever (''Jwara''), fainting (''Murchcha''), dysuria (''Mutrakrichchra''), anorexia (''Arochaka''), insomnia (''Asvapna''), body pains (''Gatrashula''), cough (''Kasa''), bronchitis (''Shvasa''), vertigo (''Bhrama''), loss of tissues (''Kshaya''), skin diseases (''Kushtha''), haemorrhoids (''Arshas''), jaundice (''Kamala''), urinary tract diseases including diabetes (''Meha''), benign tumors of the intestines (''Gulma''), diseases of the visceral organs (''Udara''), fistula-in-ano (''Bhagandara''), dysentery (''Grahani''), and anaemia (''Panduroga''). This medicinal preparation also helps in conceiving a male progeny (''pumsavana''). The preparation, thus made and used is known as ''Kalyanaka guda'' and can be used in all seasons [40-45 ½]<br />
<br />
=== Preparation of ''Trivrita'' in the form of ''Modaka'' ( bolus)(No. 3) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
व्योषत्वक्पत्रमुस्तैलाविडङ्गामलकाभयाः |<br /><br />
समभागा भिषग्दद्याद्द्विगुणं च मुकूलकम् ||४६|| <br /><br />
<br />
त्रिवृतोऽष्टगुणं भागं शर्करायाश्च षड्गुणम् | <br /><br />
चूर्णितं गुडिकाः कृत्वा क्षौद्रेण पलसम्मिताः ||४७|| <br /><br />
<br />
भक्षयेत् कल्यमुत्थाय शीतं चानु पिबेज्जलम् | <br /><br />
मूत्रकृच्छ्रे ज्वरे वम्यां कासे श्वासे भ्रमे क्षये ||४८|| <br /><br />
<br />
तापे पाण्ड्वामयेऽल्पेऽग्नौ शस्ता निर्यन्त्रणाशिनः | <br /><br />
योगः सर्वविषाणां च मतः श्रेष्ठो विरेचने ||४९|| <br /><br />
<br />
मूत्रजानां च रोगाणां विधिज्ञेनावचारितः |५०| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
vyoshatvakpatramustailavidangamalakabhayah | <br /><br />
samabhaga bhishagdadyaddvigunam cha mukulakam ||46|| <br /><br />
<br />
trivrutoashtagunam bhagam sharkarayashcha shadgunam | <br /><br />
churnitam gudikah krutva kshaudrena palasammitah ||47|| <br /><br />
<br />
bhakshayet kalyamutthaya shitam chanu pibejjalam | <br /><br />
mutrakrucchre jvare vamyam kase shvase bhrame kshaye ||48|| <br /><br />
<br />
tape pandvamayealpeagnau shasta niryantranashinah | <br /><br />
yogah sarvavishanam cha matah shreshtho virechane ||49|| <br /><br />
<br />
mutrajanam cha roganam vidhinyenavacharitah |50| <br /><br />
<br />
vyoshatvakpatramustailavidangamalakabhayah | <br /><br />
samabhaga bhishagdadyaddvigunam cha mukulakam||46|| <br /><br />
<br />
trivrutoashtagunam bhagam sharkarayashcha shadgunam| <br /><br />
churnitam gudikah krutva kshaudrena palasammitah||47|| <br /><br />
<br />
bhakshayet kalyamutthaya shitam chanu pibejjalam| <br /><br />
mutrakrucchre jvare vamyam kase shvase bhrame kshaye||48|| <br /><br />
<br />
tape pandvamayealpeagnau shasta niryantranashinah| <br /><br />
yogah sarvavishanam cha matah shreshtho virechane||49|| <br /><br />
<br />
mutrajanam cha roganam vidhinyenavacharitah|50| <br /><br />
</div></div><br />
<br />
Each one part of ''Shunthi, Pippali, Maricha, Tvak, Patra, Musta, Ela, Vidanga, Amalaki'' and ''Haritaki,'' two parts of ''Mukulaka'' (''Danti''), eight parts of ''Trivrita'' and six parts of sugar are to be made into powder. To this compound, honey is added and ''Gudika'' (round large pills), each weighing one ''pala'' (around 40 grams) are to be made. One such pill is to be consumed early in the morning after rising from the bed. Cool water can be taken in along with the pill. This is very much useful in dysuria (''Mutrakrchchra''), fever (''Jwara''), vomiting (''Vami''), cough (''Kasa''), bronchial spasm (''Shwasa''), vertigo (''Bhrama''), tissue loss (''Kshaya'') burning sensation (''Tapa''), anemia (''Pandu'') and loss of digestive fire (''Alpagni''). It can be used without following any restrictions regarding food or regimen. It can be used as an excellent purgative drug in all cases of poisoning and also in cases of diseases of urinary tract. [45 ½ - 49½]<br />
<br />
=== Preparation of ''Trivrita'' in the form of ''Modaka'' (bolus) (No. 4) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
पथ्याधात्र्युरुबूकाणां प्रसृतौ द्वौ त्रिवृत्पलम् ||५०||<br />
<br />
दश तान्मोदकान् कुर्यादीश्वराणां विरेचनम् |५१| <br />
<div class="mw-collapsible-content"><br />
<br />
pathyadhatryurubukanam prasrutau dvau trivrutpalam ||50|| <br />
<br />
dasha tanmodakan kuryadishvaranam virechanam |51| <br />
<br />
pathyadhatryurubukanam prasrutau dvau trivrutpalam||50|| <br />
<br />
dasha tanmodakan kuryadishvaranam virechanam|51|<br />
</div></div><br />
<br />
One ''pala'' (around 50 grams) of ''Trivrita'' powder may be added with two ''prasrita'' (around 180 grams) powder of ''Pathya, Dhatri'' and ''Urubuka'' (root bark powder of Castor plant). (After adding sufficient quantity of honey), ten large sized bolus like pills may be prepared. This is ideal for upper class persons and delicate persons for purgation. [49½ - 50½]<br />
<br />
=== Preparation of ''Trivrita'' in the form of ''Modaka'' (bolus) (no.5) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
त्रिवृद्धैमवती श्यामा नीलिनी हस्तिपिप्पली ||५१||<br /><br />
<br />
समूला पिप्पली मुस्तमजमोदा दुरालभा | <br /><br />
कार्षिकं नागरपलं गुडस्य पलविंशतिम् ||५२|| <br /><br />
<br />
चूर्णितं मोदकान् कुर्यादुदुम्बरफलोपमान् | <br /><br />
हिङ्गुसौवर्चलव्योषयवानीबिडजीरकैः ||५३|| <br /><br />
<br />
वचाजगन्धात्रिफलाचव्यचित्रकधान्यकैः | <br /><br />
मोदकान् वेष्टयेच्चूर्णैस्तान् सतुम्बुरुदाडिमैः ||५४|| <br /><br />
<br />
त्रिकवङ्क्षणहृद्बस्तिकोष्ठार्शःप्लीहशूलिनाम् | <br /><br />
हिक्काकासारुचिश्वासकफोदावर्तिनां शुभाः ||५५|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
trivruddhaimavati shyama nilini hastipippali ||51|| <br /><br />
<br />
samula pippali mustamajamoda duralabha | <br /><br />
karshikam nagarapalam gudasya palavimshatim ||52|| <br /><br />
<br />
churnitam modakan kuryadudumbaraphalopaman | <br /><br />
hingusauvarchalavyoshayavanibidajirakaih ||53|| <br /><br />
<br />
vachajagandhatriphalachavyacitrakadhanyakaih | <br /><br />
modakan veshtayecchurnaistan satumburudadimaihi ||54|| <br /><br />
<br />
trikavankshanahrudbastikoshtharshahplihashulinam | <br /><br />
hikkakasarucishvasakaphodavartinam shubhah ||55|| <br /><br />
<br />
trivruddhaimavati shyama nilini hastipippali||51|| <br /><br />
<br />
samula pippali mustamajamoda duralabha| <br /><br />
karshikam nagarapalam gudasya palavimshatim||52|| <br /><br />
<br />
churnitam modakan kuryadudumbaraphalopaman| <br /><br />
hingusauvarchalavyoshayavanibidajirakaih||53|| <br /><br />
<br />
vachajagandhatriphalachavyacitrakadhanyakaih| <br /><br />
modakan veshtayecchurnaistan satumburudadimaihi ||54|| <br /><br />
<br />
trikavakshanahrudbastikoshtharshahplihashulinam| <br /><br />
hikkakasarucishvasakaphodavartinam shubhah ||55|| <br /><br />
</div></div><br />
<br />
Each one ''karsha'' (around 12 grams) of the ''Trivrita'' powder (the variety having pink roots), ''Haimavati'' (rind of ''Haritaki''). ''Shyama'' (the variety having black roots) ''Nilini, Hastipippali, Pippalimula, Musta, Ajamoda'' and ''Duralabha'', one ''pala'' of ''Nagara'' and twenty ''pala'' of jaggery are mixed together. ''Modakas'' (large pills of the size of ''Udumbara'' fruit may be preferred using the above said paste like mixture. These ''modakas'' are to be rolled well in a compounded powder of ''Hingu, Sauvarchala lavana, Vyosha (Trikatu), Yavani, Bidalavana, Jiraka, Vacha, Ajagandha, Triphala, Chavya, Chitraka, Dhanyaka, Tumburu'' and ''Dadima'' (bark powder), till the ''modakas'' (bolus) are covered completely. These ''modakas'' are positively indicated in pain in the Lumbo-Sacral area (''Trika''), inguinal area (''Vamkshana''), Cardiac or epigastric region (''Hridaya''), pelvic area (''Vasti'') and umbilical area (''Koshtha''), hemorrhoids (''Arshas''), Splenic disorders (''Plihashula''), hiccup (''Hikka''), Cough (''Kasa''), anorexia (''Aruchi''), bronchial spasm (''Shwasa'') and reversed peristalsis due to the obstruction in the stomach due to aggravated ''kapha'' (''kaphaja udavarta''). [50½ -55]<br />
<br />
=== Purgative preparation of ''Trivrita'' useful in Rainy season ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
त्रिवृतां कौटजं बीजं पिप्पलीं विश्वभेषजम् |<br /><br />
क्षौद्रद्राक्षारसोपेतं वर्षास्वेतद्विरेचनम् ||५६|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
trivrutam kautajam bijam pippalim vishvabheshajam | <br /><br />
kshaudradraksharasopetam varshasvetadvirechanam ||56|| <br /><br />
<br />
trivrutam kautajam bijam pippalim vishvabheshajam| <br /><br />
kshaudradraksharasopetam varshasvetadvirechanam||56|| <br /><br />
</div></div><br />
<br />
The powder of ''Trivrita, Kutajabija, Pippali'' and ''Vishvabheshaja'' (''Shunthi'') are to be mixed with honey and grape juice. This preparation is useful as a purgative in rainy reason. [56]<br />
<br />
=== Preparation of ''Trivrita'' useful in post-rainy season ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
त्रिवृद्दुरालभामुस्तशर्करोदीच्यचन्दनम् |<br /><br />
द्राक्षाम्बुना सयष्ट्याह्वसातलं जलदात्यये ||५७|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
trivrdduralabhamustasharkarodicyachandanam | <br /><br />
drakshambuna sayashtyahvasatalam jaladatyaye ||57|| <br /><br />
<br />
trivrudduralabhamustasharkarodicyachandanam| <br /><br />
drakshambuna sayashtyahvasatalam jaladatyaye||57|| <br /><br />
</div></div><br />
<br />
The powder of ''Trivrita, Duralabha, Musta, Sugar, Udichya'' (''Balaka''), ''Chandana, Yashti'' and ''Satala'' (''charmakasa'') may be token in along with ''Drakshambu'' (grape water) for purgation. This preparation is useful in post-rainy season.[57]<br />
<br />
=== Preparation of ''Trivrita'' useful in winter ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
त्रिवृतां चित्रकं पाठामजाजीं सरलं वचाम् |<br /><br />
स्वर्णक्षीरीं च हेमन्ते पिष्ट्वा तूष्णाम्बुना पिबेत् ||५८|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
trivrutam citrakam pathamajajim saralam vacham | <br /><br />
svarnakshirim cha hemante pishtva tushnambuna pibet ||58|| <br /><br />
<br />
trivrutam citrakam pathamajajim saralam vacham| <br /><br />
svarnakshirim cha hemante pishtva tushnambuna pibet||58|| <br /><br />
</div></div><br />
<br />
The powder or paste of ''Trivrita, Chitraka, Patha, Ajaji, Sarala, Vacha'' and ''Svarnakshiri'' may be taken in, along with hot water. This preparation causes purgation in ''Hemanta'' i.e. winter season.[58]<br />
<br />
=== Preparation of ''Trivrita'' useful in summer ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
शर्करा त्रिवृता तुल्या ग्रीष्मकाले विरेचनम् |<br />
<div class="mw-collapsible-content"><br />
<br />
sharkara trivruta tulya grishmakale virechanam | 58 ½ |<br />
<br />
sharkara trivruta tulya grishmakale virechanam| <br />
</div></div><br />
<br />
The powder of ''Trivrita'', mixed with equal quantity of sugar, can be taken in during summer, for purgation.[58½]<br />
<br />
=== Preparation of ''Trivrita'' suitable during any season ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
त्रिवृत्त्रायन्तिहपुषाः सातलां कटुरोहिणीम् ||५९|| <br /><br />
<br />
स्वर्णक्षीरीं च सञ्चूर्ण्य गोमूत्रे भावयेत्त्र्यहम् | <br /><br />
एष सर्वर्तुको योगः स्निग्धानां मलदोषहृत् ||६०|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
trivruttrayantihapushah satalam katurohinim ||59|| <br /><br />
<br />
svarnakshirim cha sancurnya gomutre bhavayettryaham | <br /><br />
esha sarvartuko yogah snigdhanam maladoshahrt ||60|| <br /><br />
<br />
trivruttrayantihapushah satalam katurohinim ||59|| <br /><br />
<br />
svarnakshirim cha sanchurnya gomutre bhavayettryaham| <br /><br />
esha sarvartuko yogah snigdhanam maladoshahrut||60|| <br /><br />
</div></div><br />
<br />
''Trivrita, Trayanti, Hapusha, Satala, Katurohini'' and ''Svaranakshiri'' are to be powdered well and soaked in cows urine continuously for a period of three days. This preparation is ideal for purgation during all seasons. It can easily expel out the stagnated morbid material from the bodies of persons, who are ''Snigdha'' (persons who underwent oleation therapy or persons who are naturally having sufficient quantity of fatty tissues in their body stores).[58½ - 60]<br />
<br />
=== Preparation of ''Trivrita'' suitable during any season ===<br />
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<br />
त्रिवृच्छ्यामा दुरालम्भा वत्सकं हस्तिपिप्पली |<br /><br />
नीलिनी त्रिफला मुस्तं कटुका च सुचूर्णितम् ||६१|| <br /><br />
<br />
सर्पिर्मांसरसोष्णाम्बुयुक्तं पाणितलं ततः | <br /><br />
पिबेत् सुखतमं ह्येतद्रूक्षाणामपि शस्यते ||६२|| <br /><br />
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<br />
trivrcchyama duralambha vatsakam hastipippali | <br /><br />
nilini triphala mustam katuka cha suchurnitam ||61|| <br /><br />
<br />
sarpirmamsarasoshnambuyuktam panitalam tatah | <br /><br />
pibet sukhatamam hyetadrukshanamapi shasyate ||62|| <br /><br />
<br />
trivrucchyama duralambha vatsakam hastipippali| <br /><br />
nilini triphala mustam katuka cha suchurnitam||61|| <br /><br />
<br />
sarpirmamsarasoshnambuyuktam panitalam tatah| <br /><br />
pibet sukhatamam hyetadrukshanamapi shasyate||62|| <br /><br />
</div></div><br />
<br />
''Trivrita'' (root having pink color), ''Shyama'' (root having black color), ''Duralambha, Vatsaka, Hastipippali, Nilini, Triphala, Musta'' and ''Katuka'' are to be finely powdered. This powder is to be taken in, along with ghee, meat-sour and hot water, in a dose of one ''Panitala'' (around 12 grams). This preparation causes purgation with ease and is indicated even to persons who are ''Ruksha'' (who didn’t undergo oleation therapy or who are ''Ruksha'' (who didn’t undergo oleation therapy or who do not possess sufficient quantity of fat stores in their body). [61-62]<br />
<br />
=== Preparation of ''Trivrita'' in the form of powder ===<br />
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<br />
त्र्यूषणं त्रिफला हिङ्गु कार्षिकं त्रिवृतापलम् |<br /><br />
सौवर्चलार्धकर्षं च पलार्धं चाम्लवेतसात् ||६३|| <br /><br />
<br />
तच्चूर्णं शर्करातुल्यं मद्येनाम्लेन वा पिबेत् | <br /><br />
गुल्मपार्श्वार्तिनुत्सिद्धं जीर्णे चाद्याद्रसौदनम् ||६४|| <br /><br />
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<br />
tryushanam triphala hingu karshikam trivrutapalam | <br /><br />
sauvarchalardhakarsham cha palardham chamlavetasat ||63|| <br /><br />
<br />
tacchurnam sharkaratulyam madyenamlena va pibet | <br /><br />
gulmaparshvartinutsiddham jirne chadyadrasaudanam ||64|| <br /><br />
<br />
tryushanam triphala hingu karshikam trivrutapalam| <br /><br />
sauvarchalardhakarsham cha palardham chamlavetasat||63|| <br /><br />
<br />
tacchurnam sharkaratulyam madyenamlena va pibet| <br /><br />
gulmaparshvartinutsiddham jirne chadyadrasaudanam||64||<br /><br />
</div></div><br />
<br />
Each one ''karsha'' (around 12 grams) of ''Tryushana, Triphala'' and ''Hingu,'' one ''pala'' (around 48 grams) of ''Trivrita,'' half a ''karsha'' (around 6 grams) of ''sauvarchala'' salt and half a ''pala'' (around 24 grams) of ''Amlavetasa'' are to be powdered well and mixed with equal quantity of powdered sugar. This preparation, in the form of powder can be taken in along with alcohol or sour juices (of fruits). This preparation surely relieves pain originating from ''Gulma'' (a benign intestinal tumor) and ''Parshva'' (both the sides of the chest cavity). When the medicinal preparation is completely digested, the patient can be given a diet comprising of meat soup. [63-64]<br />
<br />
=== Preparation of ''Trivrita'' in the form of ''Tarpana'' (With nourishing drink) ===<br />
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<br />
त्रिवृतां त्रिफलां दन्तीं सप्तलां व्योषसैन्धवम् |<br /><br />
कृत्वा चूर्णं तु सप्ताहं भाव्यमामलकीरसे ||६५|| <br /><br />
<br />
तद्योज्यं तर्पणे यूषे पिशिते रागयुक्तिषु |६६| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
trivrutam triphalam dantim saptalam vyoshasaindhavam | <br /><br />
krutva churnam tu saptaham bhavyamamalakirase ||65|| <br /><br />
<br />
tadyojyam tarpane yushe pishite ragayuktishu |66| <br /><br />
<br />
trivrutam triphalam dantim saptalam vyoshasaindhavam| <br /><br />
krutva churnam tu saptaham bhavyamamalakirase||65|| <br /><br />
<br />
tadyojyam tarpane yushe pishite ragayuktishu|66| <br /><br />
</div></div><br />
<br />
''Trivrita, Haritaki, Vibhitaki, Amalaki, Danti, Saptala, Shunthi, Pippali, Maricha'' and ''Saindhava'' are powdered well. This powder is to be soaked in the juice of ''Amalaki'' for seven days. This preparation can be used along with either ''Tarpana'' (nourishing) soothing drink or ''Yusha'' (pulse-soup) or ''pishita'' (meat or meat-soup) or any other drinks like ''raga'' (a drink mixed with sweet, sour and pungent tastes).[65- 65½]<br />
<br />
=== Preparations of ''Trivrita'' in the form of medicated ghee and milk ===<br />
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<br />
तुल्याम्लं त्रिवृताकल्कसिद्धं गुल्महरं घृतम् ||६६||<br /><br />
<br />
श्यामात्रिवृतयोर्मूलं पचेदामलकैः सह | <br /><br />
जले तेन कषायेण पक्त्वा सर्पिः पिबेन्नरः ||६७|| <br /><br />
<br />
श्यामात्रिवृत्कषायेण सिद्धं सर्पिः पिबेत्तथा | <br /><br />
साधितं वा पयस्ताभ्यां सुखं तेन विरिच्यते ||६८|| <br /><br />
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<br />
tulyamlam trivrutakalkasiddham gulmaharam ghrutam ||66|| <br /><br />
<br />
shyamatrivrutayormulam pachedamalakaih saha | <br /><br />
jale tena kashayena paktva sarpih pibennarah ||67|| <br /><br />
<br />
shyamatrivrutkashayena siddham sarpih pibettatha | <br /><br />
sadhitam va payastabhyam sukham tena virichyate ||68|| <br /><br />
<br />
tulyamlam trivrutakalkasiddham gulmaharam ghrutam||66||<br /><br />
<br />
shyamatrivrutayormulam pachedamalakaih saha| <br /><br />
jale tena kashayena paktva sarpih pibennarah||67|| <br /><br />
<br />
shyamatrivrutkashayena siddham sarpih pibettatha| <br /><br />
sadhitam va payastabhyam sukham tena virichyate||68|| <br /><br />
</div></div><br />
<br />
Equal quantity of sour juice and ghee are to be boiled along with the paste of ''Trivrita''. This medicated ghee relieves ''Gulma'' (abdominal lumps).<br />
<br />
The root of ''Shyama'' (the variety of ''Trivrita'' having black root) and ''Trivrita'' (the variety having pinkish root) are to be boiled in water along with the paste of ''Amalaki''. Using this decoction, medicated ghee is prepared and taken in (for purgation).<br />
<br />
Using the decoctions of ''Shyama'' (the variety of ''Trivrita'' having black root) and ''Trivrita'' (the variety having pinkish root), medicated ghee can be prepared and taken in (for purgation).<br />
<br />
Using both of the varieties of ''Trivrita'' milk is boiled, filtered and used for purgation with ease. [65½ - 68]<br />
<br />
=== Preparations of ''Trivrita'' in the form of alcoholic beverages ===<br />
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<br />
त्रिवृन्मुष्टींस्तु सनखानष्टौ द्रोणेऽम्भसः पचेत् |<br /><br />
पादशेषं कषायं तं पूतं गुडतुलायुतम् ||६९||<br /><br />
<br />
स्निग्धे स्थाप्यं घटे क्षौद्रपिप्पलीफलचित्रकैः | <br /><br />
प्रलिप्ते मधुना मासं जातं तन्मात्रया पिबेत् ||७०|| <br /><br />
<br />
ग्रहणीपाण्डुरोगघ्नं गुल्मश्वयथुनाशनम् | <br /><br />
सुरां वा त्रिवृतायोगकिण्वां तत्क्वाथसंयुताम् ||७१|| <br /><br />
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<br />
trivrnmushtimstu sanakhanashtau droneambhasah pachet | <br /><br />
padashesham kashayam tam putam gudatulayutam ||69|| <br /><br />
<br />
snigdhe sthapyam ghate kshaudrapippaliphalacitrakaihi | <br /><br />
pralipte madhuna masam jatam tanmatraya pibet ||70|| <br /><br />
<br />
grahanipandurogaghnam gulmashvayathunashanam | <br /><br />
suram va trivrutayogakinvam tatkvathasamyutam ||71|| <br /><br />
<br />
trivrunmushtimstu sanakhanashtau droneambhasah pachet | <br /><br />
padashesham kashayam tam putam gudatulayutam ||69|| <br /><br />
<br />
snigdhe sthapyam ghate kshaudrapippaliphalacitrakaihi | <br /><br />
pralipte madhuna masam jatam tanmatraya pibet ||70|| <br /><br />
<br />
grahanipandurogaghnam gulmashvayathunashanam | <br /><br />
suram va trivrutayogakinvam tatkvathasamyutam ||71|| <br /><br />
</div></div><br />
<br />
Eight fist-full of ''Trivrita'' root is to be boiled in one ''drona'' of water till one fourth of the water remains. Then the decoction is filtered out and mixed with one ''tula'' of jaggery, honey and powders of ''Pippali'' seeds of / ''Madana phala'' and ''Chitraka''. Then the entire liquid is poured into an earthen vessel, whose inner side is thoroughly coated with ghee initially followed by a second coat with the powders of ''Pippali, Madana bija'' and ''Chitraka'', grinded with honey. The vessel is to be covered and left over for one month. When fermented well, this can be taken in, in appropriate dosage, which cures dysentery (''Grahani''), anaemia (''Pandu''), abdominal lumps (''Gulma''), and edema (''Shvayathu'').<br />
<br />
Similarly, the fermented liquid prepared using the decoction of ''Trivrita'' and ''Kinva'' (sediment left behind after the fermentation process is over) of the above preparation may also be used (for purgation).[69-71]<br />
<br />
=== Preparations of ''Trivrita'' in the form of ''Kanjika'' (fermented gruels) ===<br />
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<br />
यवैः श्यामात्रिवृत्क्वाथस्विन्नैः कुल्माषमम्भसा |<br /><br />
आसुतं षडहं पल्ले जातं सौवीरकं पिबेत् ||७२|| <br /><br />
<br />
भृष्टान् वा सतुषाञ्छुद्धान् यवांस्तच्चूर्णसंयुतान् | <br /><br />
आसुतानम्भसा तद्वत् पिबेज्जातं तुषोदकम् ||७३|| <br /><br />
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<br />
yavaihi shyamatrivrutkvathasvinnaihi kulmashamambhasa | <br /><br />
asutam shadaham palle jatam sauvirakam pibet ||72|| <br /><br />
<br />
bhrushtan va satushanchuddhan yavamstacchurnasamyutan | <br /><br />
asutanambhasa tadvat pibejjatam tushodakam ||73|| <br /><br />
<br />
yavaihi shyamatrivrutkvathasvinnaihi kulmashamambhasa| <br /><br />
Asutam shadaham palle jatam sauvirakam pibet||72|| <br /><br />
<br />
bhrushtan va satushaachuddhan yavamstacchurnasamyutan| <br /><br />
asutanambhasa tadvat pibejjatam tushodakam||73|| <br /><br />
</div></div><br />
<br />
Dehusked barley is to be steam boiled with the decoction of ''Shyama'' (the variety of ''Trivrita'' having black roots) and ''Trivrita'' (the variety of ''Trivrita'' having pink roots). This steam boiled barley (''Kulmasha'') is to be mixed with water, (kept in a pot) and allowed to ferment for six days covered by a heap of grains (''Palla''). The ''Sauviraka'' (fermented liquid) prepared can be taken in (for the purpose of purgation).<br />
<br />
Alternatively, unhusked barley is to be fried well and powdered. This powder, along with the powdered root of ''Trivrita'' can be mixed with water and stored for six days till fermentation, following the procedure of the previous preparation. This ''Tushodaka'' (Fermented liquid) can be utilized for the purpose of purgation. [72-73]<br />
<br />
=== Preparations of ''Trivrita'' in the form of ''Badara'' etc. ===<br />
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<br />
तथा मदनकल्पोक्तान् षाडवादीन् पृथग्दश |<br /><br />
त्रिवृच्चूर्णेन संयोज्य विरेकार्थं प्रयोजयेत् ||७४|| <br /><br />
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<br />
tatha madanakalpoktan shadavadin prthagdasha | <br /><br />
trivrcchurnena samyojya virekartham prayojayet ||74|| <br /><br />
<br />
tatha madanakalpoktan shadavadin pruthagdasha| <br /><br />
trivrucchurnena samyojya virekartham prayojayet||74|| <br /><br />
</div></div><br />
<br />
As described in [[Madanakalpa Adhyaya]] verse 26, ten such preparations in different forms like ''Shadava'' etc. using the powder of ''Trivrita'' can be made and used for purgation.[74]<br />
<br />
=== Methods of making the drug more palatable ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
भवतश्चात्र-<br /><br />
<br />
त्वक्केशराम्रातकदाडिमैलासितोपलामाक्षिकमातुलुङ्गैः | <br /><br />
मद्यैस्तथाऽम्लैश्च मनोनुकूलैर्युक्तानि देयानि विरेचनानि ||७५||<br /> <br />
<br />
शीताम्बुना पीतवतश्च तस्य सिञ्चेन्मुखं छर्दिविघातहेतोः | <br /><br />
हृद्यांश्च मृत्पुष्पफलप्रवालानम्लं च दद्यादुपजिघ्रणार्थम् ||७६|| <br /><br />
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<br />
bhavatashchatra- <br /><br />
<br />
tvakkesharamratakadadimailasitopalamakshikamatulungaihi | <br /><br />
madyaistathaamlaishcha manonukulairyuktani deyani virechanani ||75|| <br /><br />
<br />
shitambuna pitavatashcha tasya sinchenmukham chardivighatahetoh | <br /><br />
hrudyamshcha mrutpushpaphalapravalanamlam cha dadyadupajighranartham ||76|| <br /><br />
<br />
bhavatashchatra- <br /><br />
<br />
tvakkesharamratakadadimailasitopalamakshikamatulungaihi | <br /><br />
madyaistathaamlaishcha manonukulairyuktani deyani virechanani ||75|| <br /><br />
<br />
shitambuna pitavatashcha tasya sinchenmukham chardivighatahetoh | <br /><br />
hrudyamshcha mrutpushpaphalapravalanamlam cha dadyadupajighranartham ||76|| <br /><br />
</div></div><br />
<br />
Thus, it is said,<br />
<br />
A purgative drug may be administered along with, ''Twak'' (cinnamon bark), ''Kesara'' (saffron), ''Amrataka, Dadima, Ela, Sitopala'' (sugar candy), honey, ''Matulunga'', alcohol or fermented liquid and sour drinks, to make them more palatable or cordial.<br />
<br />
If a person develops vomiting sensation after consuming a purgative drug, cool water may be sprinkled over his face. He can be advised to inhale pleasing aromas or fragrances originating from earth, flowers, fruits, tender leaves and sour substances, which control the same.[75-76]<br />
<br />
=== Summary of the chapter ===<br />
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<br />
तत्र श्लोकाः- <br /><br />
<br />
एकोऽम्लादिभिरष्टौ च दश द्वौ सैन्धवादिभिः | <br /><br />
मूत्रेऽष्टादश यष्ट्यां द्वौ जीवकादौ चतुर्दश ||७७|| <br /><br />
<br />
क्षीरादौ सप्त लेहेऽष्टौ चत्वारः सितयाऽपि च | <br /><br />
पानकादिषु पञ्चैव षडृतौ पञ्च मोदकाः ||७८|| <br /><br />
<br />
चत्वारश्च घृते क्षीरे द्वौ चूर्णे तर्पणे तथा |<br /><br />
द्वौ मद्ये काञ्जिके द्वौ च दशान्ये षाडवादिषु ||७९|| <br /><br />
<br />
श्यामायास्त्रिवृतायाश्च कल्पेऽस्मिन् समुदाहृतम् | <br /><br />
शतं दशोत्तरं सिद्धं योगानां परमर्षिणा ||८०|| <br /><br />
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<br />
tatra shlokah- <br /><br />
<br />
ekoamladibhirashtau cha dasha dvau saindhavadibhih | <br /><br />
mutreashtadasha yashtyam dvau jivakadau chaturdasha ||77|| <br /><br />
<br />
kshiradau sapta leheashtau chatvarah sitayaapi cha | <br /><br />
panakadishu panchaiva shadrutau pancha modakah ||78|| <br /><br />
<br />
chatvarashcha ghrte kshire dvau curne tarpane tatha | <br /><br />
dvau madye kanjike dvau cha dashanye shadavadishu ||79|| <br /><br />
<br />
shyamayastrivrutayashcha kalpeasmin samudahrutam | <br /><br />
shatam dashottaram siddham yoganam paramarshina ||80|| <br /><br />
<br />
tatra shlokah- <br /><br />
<br />
ekoamladibhirashtau cha dasha dvau saindhavadibhih| <br /><br />
mutreashtadasha yashtyam dvau jivakadau chaturdasha||77|| <br /><br />
<br />
kshiradau sapta leheashtau chatvarah sitayaapi cha| <br /><br />
panakadishu panchaiva shadrutau panjcha modakah||78|| <br /><br />
<br />
chatvarashcha ghrute kshire dvau curne tarpane tatha| <br /><br />
dvau madye kanjike dvau cha dashanye shadavadishu||79||<br /><br />
<br />
shyamayastrivrutayashcha kalpeasmin samudahrutam| <br /><br />
shatam dashottaram siddham yoganam paramarshina||80|| <br /><br />
</div></div><br />
<br />
To sum up,<br />
<br />
The chapter on the pharmaceutical preparations of ''Shyama Trivrita'', the great seer (Charaka) has prescribed one hundred and ten formulations to be used as purgatives. They are summarized here, as follows:<br />
#Nine preparations with sour juice etc.;<br />
#Twelve preparations with rock salt etc.;<br />
#Eighteen preparations with cow’s urine<br />
#Two preparations with ''Yashtimadhu''<br />
#Fourteen preparations with ''Jivaka'', etc;<br />
#Seven preparations with milk etc.<br />
#Eight preparations in the form of linctus. <br />
#Four preparations with sugar<br />
#Five preparations in the form of syrup etc.<br />
#Six preparations for different seasons.<br />
#Five preparations in the form of ''Modaka'' (large pills).<br />
#Four preparations in the form of medicated ghee or medicated milk.<br />
#Two preparations, one, in the form of powder and another in the form of soothing drink.<br />
#Two preparations in the form of medicated alcohol<br />
#Two preparations in the form of ''Kanji'' (fermented beverage)<br />
#Ten preparations in the form of ''Shadava, Badara'', etc.; [77-80]<br />
<br />
Colophon:<br />
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<br />
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते <br />
दृढबलसम्पूरिते कल्पस्थाने श्यामात्रिवृत्कल्पो नाम सप्तमोऽध्यायः ||७||<br />
<div class="mw-collapsible-content"><br />
<br />
ityagniveshakrte tantre charakapratisamskruteaprapte <br />
drudhabalasampurite kalpasthane shyamatrivrutkalpo nama saptamoadhyayah ||7||<br />
</div></div><br />
<br />
Thus ends the seventh chapter titled “The pharmaceutical preparations of ''Shyama Trivrita''” in the section named [[Kalpa Sthana]] of the work of Agnivesha, as redacted by Charaka and supplemented by Dridhabala.<br />
<br />
== Tattva Vimarsha (Fundamental Principles) ==<br />
<br />
*''Trivrita'' is ''kashaya''(astringent), ''madhura''(sweet) ''rasa, katu''(pungent), ''vipaka''(product after digestion), and ''ruksha''(dry) properties. These properties do not support the purgative action, in spite of this ''Trivrita'' is best among purgative drug. <br />
*It pacifies [[kapha]] and [[pitta]] and aggravates [[vata]] due to its ''ruksha''(dry) property. <br />
*Roots of ''Trivrita'' are used in pharmaceutical processing. These are of two types: black (''Shyama'') and the other having Blackish red. The latter are more useful between them.<br />
*The blackish red root of ''Trivrita'' can be safely used as mild purgative in tender persons, children, old aged people and those with laxed bowel. The blackish variety is strong purgative and can cause untoward effects. It is used in more aggravation of [[dosha]] and hard bowel persons. <br />
*After combining with respective [[dosha]] pacifying drugs, ''Trivrita'' can be used in treatment of all diseases due to any [[dosha]] vitiation. It can also be used in all seasons in combination with various drugs.<br />
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== Vidhi Vimarsha (Applied Inferences ) ==<br />
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=== Synonyms ===<br />
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The first two synonyms ''Tribhandi'' and Trivrita are indicative of the nature of its stem. It is a stout, twining and three winged stem. ''Tribhandi'' specifically denotes its wavy looking stem in three angles. Trivrita points at its nature of growth of the stem in three directions.<br />
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''Shyama'' is indicative of the color of its root. The fourth word ''Kutarana'' is probably a misspelt synonym. It will be very much ideal, if we read it as ''Kotarana'' which directs us towards its flower. Flowers are generally white in colour, funnel shaped and arranged in few flowered cymes. The meaning of ''Kotara'' is hollow and the petals of the flower form a hollow and funnel like tubular structure and are an identification point to many of the flowers of the Ipomoea genera. When a ''Pratyaya'' (suffix) is added to the word ''Kotara'', the final word ''Kotarana'' is formed. The last two synonyms, ''Sarvanubhuti'' and ''Suvaha'' open us a clue regarding its wide acceptability and suitability to all individuals, causing no spasmodic pain and any other such type of undesired actions. ''Sarvanubhuti'' means suitability to all and ''Suvaha'' means tolerated by all. (Verse 4)<br />
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=== Properties ===<br />
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Some drugs have got inborn tendency to act in some pathological conditions. Similarly, ''Trivrita'' has the natural property to aggravate [[vata]] and pacify [[pitta]] and [[kapha]]. But when prepared with [[vata]] pacifying drugs, it cures diseases caused by [[vata]]. Similarly, when prepared with [[pitta]] and [[kapha]] pacifying drugs, it can be capable of curing diseases caused by [[pitta]], and [[kapha]] respectively. This property of modulating the pharmacological action depending upon the preparation is known as ''Samskarabhivartana; Ghuta'' or clarified butter is also said to possess the similar property.<br />
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Pharmacological Properties of a drug are described in any context to gain full length knowledge about its therapeutic actions. But at times, there may not be exact concordance between these two. The Ayurvedic parameters like ''rasa, guna'', etc.; generally show or exhibit the same therapeutic actions, attributed to them. But some drugs that are strong emetics, purgatives and antitoxic, do not imbibe themselves to the theoretical parameters and exert their individualized action. So, ''Trivrita'' also can be considered as a drug with individualized action. (Verse 5-6)<br />
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=== Types ===<br />
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The commentators like Chakrapani opined that Charaka preferred the blackish red variety because of its good or sustained purgative action along with less or little undesired actions, causing no ''vyapatti'' (complications). <br />
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Actually, there is no confusion regarding the source of ''Trivrita'', which is the root of Operculum turpethum (Linn) Silva Manso, Syn. Ipomoea turpethum R. Br. (Fam. Convolvulaceae). Then, how it happens to procure two types of roots having different colors and different pharmacological actions with difference in the intensity of the action of purgation. Either they should be from different genera or different species or should be from an entirely different plant. The confusion originated at this juncture, complicated by commentators, traders and less knowledgeable physicians. Adding to the existing confusion, we can find two more words in Sushruta Samhita and they are ''Maha Trivrita'' (or major ''trivrita'') and ''Maha Shyama'' (major''shyama''). They probably are the roots of a fully grown/mature plant, where the roots tend to grow large because of the perennial nature of the twining plant. At the same time, traders, who market the drug started selling some different roots or stem pieces with the name of ''trivrita'' or ''shyama'', knowingly or unknowingly for hundreds of years. But in the market, stem pieces or rarely root pieces of Marsdenia tenacissima W. & A are sold under the name of ''trivrita'' or ''shyama'' which are neither black nor white, but when sold as they are, they look black and when decorticated, they appear white or pinkish white. In the markets of Kanpur in India, the roots of Operculina turpethnum are sold with the name of ''vidhara'' or ''vriddhadaru'', which is not mentioned by either Charaka or Sushruta. Recently, as reported by Dr K. Nishteswar, roots of ''Ipomoea triloba'' are also sold with the name of ''trivrita'' in the markets of Gujarat.<br />
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It is well reported and also observed by the author personally that, the root bark of ''Operculina turpethum (Linn)'' Silva Manso, when dried under the sun becomes white and when shade dried, turns black. This point is to be observed very carefully because, in the original text, Charaka nowhere mentioned two plant species but mentioned two varieties of roots, which is supported by the word ''Tasyah Mulam Dvividham'' i.e., its root is of two types using singular form for the plant. Hence, the concept of sun-dried and shade-dried roots, stands good and it is a known fact that factors like storage, preservation, exposure to heat or sunlight bring many changes in the chemical constituents of plant parts but, till date no research work has been conducted in differentiating the constituents of differently dried root parts, which may bring some light into the subject.<br />
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But, with lapse of time, by the time of lexicographers like Sodhala, Dhanvantari and Bhavamishra, the other variety of ''Shyama'' intruded the market or trade and new plant species having better or equivalent laxative or purgative action attracted the authors. Some new synonyms like ''Palindi, Kali, Masuravidala'' and ''Kalameshika'' are attributed to the black variety of ''Trivrita'' i.e. ''Shyama'' and this variety is distinctly separated as a new variety, while disregarding the opinion of Charaka or Sushruta who never considered two plant species but explored only two varieties of roots. Then, some species of Ipomoea which resembles the morphological synonyms is to be searched for. In this prolonged process, many modern authors suggested different species, depending upon the traditional utility and morphological similarities. One of such plants Ipomoea petaloidea can be equated with ''Shyama'', basing on the synonyms. The word ''Palindi'' indicates the flowers; The upper part of the sepals is divided and resembles ''pali'', i.e., ear lobe. ''Kali'' and ''Kalameshika'' denote the color of the flowers as bluish black where as that of ''Shveta Trivrita'' (Operculina sp) appear pure white. ''Masuravidala'' means the two separated parts of the lens shaped lentil seed and the leaves of Ipomoea pes-caprae (Linn.) Sweet, exactly resemble them. Hence, some authors considered this species also as ''Shyama''.<br />
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Then, coming to the opinions of different modern day authors, Bapalal has suggested using ''jalapa'' i.e. Exogoneum purge, Benth. As the white variety of ''Trivrita'', well developed ''Trivrita'' as ''Maha Shyama'' and O. turpethum as ''Shyama''. Sharma, P.V accepted O. Turpethum as ''Trivrita'' and Ipomoea petaloidea Chois as Shyama. Regarding Maha Shyama, he has suggested two possibilities. It is either some Ipomoea or Euphorbia species.<br />
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But according to the opinion of the author, if, we wish to follow the instructions of Charaka as they are, ''Trivrita'' is only one plant i.e. Operculina turpethum (Linn.) Silva Manso and we have to use the roots of the same plant. If we need to procure pinkish roots, we have to dry them in sunlight and for black roots they may be dried in shade. This practice can be continued till a final conclusion, basing on the phyto-chemical, pharmacological and therapeutic works and till that time, it is better not to confuse with the names and traditional practice of using different plant species for purgation can be continued. (Verse 7)<br />
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=== Indications ===<br />
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According to the indications, persons having delicate health and children are not advised purgative therapy. Even then, it may be necessary sometimes to utilize purgatives for such persons also. Then, ''Trivrita'', having blackish red root can be administered safely.<br />
Generally, there will be exceptions for any prescribed rule and the same thing is applicable in case of purgatives also. Though, they are not indicated for all, in case of emergency situations, because of the high safety margin, ''Trivrita'' roots of blackish red variety may be used.<br />
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The first blackish red variety acts as a mild purgative but black variety acts as a cathartic. It can cause many undesired actions also due to its potent activity. It mainly creates spasm in the alimentary tract. So, the person experiences pain in the throat and cardiac regions immediately after consuming the drug. When, excessive purgation occurs naturally, there is tissue loss, electrolyte imbalance and dehydration and as a result, the patient may undergo stupor and unconsciousness. Even then, it is highly praised for its prompt action and potent evacuative capacity of bowels.<br />
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=== Method of collection ===<br />
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The method of collecting emetic and purgative drugs is well described in [[Madanakalpa Adhyaya]]. The same method may be followed in case of ''trivrita'' also. Additionally, some specific measures that are to be followed while collecting ''trivrita'' roots are mentioned here. The root of ''trivrita'' that is penetrated deep into the earth is to be collected. A Synonym, ''Sarala'' which denotes the deeply and straightly penetrating nature of the root is mentioned in Dhanvantari Nighantu and Bhavaprakasha. The roots that spread sideways are not stout and are not supplied with sufficient nutrition. Hence, they may not contain the needed chemical constituents and are to be avoided. Usually, the pith inside a root acts for stability and never contains any type of active principles. Without removing the pith, the bark cannot be dried quickly. Anyhow, the methods of storage, as suggested in the first chapter can be followed.<br />
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=== Various preparations ===<br />
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Administration of thin gruel, in the previous night is an exception to the general rule to the purgation process, as stated in Sutra 13:18. There, it is said that the person who is to be purgated is to be given a liquid diet along with meat-soup which is unctuous (''Snehavat'') and hot, continuously for three days. But when, purgation with ''trivrita'' is being done, this rule need not be followed and a single semi liquid diet in the previous night is sufficient. Anyhow, it is to be given when hot and is prepared with meat soup, adding ghee. The reason for this exception is that, ''trivrita'' is such a drug which can cause purgation with ease, causing less or little complications.<br />
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In total, 110 preparations of ''trivrita'' are described in this chapter, utilizing different vehicles and different forms that are suitable for each individual. Out of them nine preparations are counted here. Fermented liquids or urine of different animals are used. Though, the secondary purpose of liquid is to swallow the drug easily, the main purpose is to facilitate the action of the drug.i.e ''trivrita''. In general, the fermented liquids can expel out the hard ''feces'' (''bhedi''), palatable and control reversed peristalsis there by reducing the spasm generated during the administration of purgatives. The person suffers from less colicky pain by using them. The use of urine of different animals helps to pacify [[kapha]] and alleviate colicky pain. Thus, the use of vehicles, enhance the desired action of the main drug and reduce the undesired actions.<br />
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=== Twelve preparations ===<br />
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Another twelve preparations of ''trivrita'', along with twelve different types of salts are described. Anyone of them should be mixed with the powdered root of ''trivrita'' and powdered ginger and taken in with hot water. The list of the salts is not mentioned here but as per the suggestion of Chakrapani, the commentator, they are enlisted here from the eighth chapter of [[Vimana Sthana]] of [[Charaka Samhita]]. There, total number of fifteen salts is mentioned and Charaka advised here, to consider the first twelve salts. The other three types of salts that are left over are ''ushara, pateyaka'' and ''pamshya''. The main purpose of mixing any of the salts in the process of purgation is to prevent dehydration and electrolyte loss. Addition of dry ginger (''shunthi'') also serves the purpose of breaking the hard feces and reducing spasmodic pain.<br />
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=== Eighteen formulations ===<br />
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Eighteen formulations, using eighteen drugs along with the powdered root of ''trivrita'' which can be used along with cow’s urine as a liquid vehicle are mentioned. All the plant drugs that are used here are appetizers, stimulants and they relieve spasm as well. The role of cow’s urine in this context is quite reasonable in the sense that, it acts as a stimulant and is capable of modulating the action of any drug taken along with it positively. That itself is capable of doing mild laxation and acts as an anti-toxic drug.<br />
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=== Yashtimadhu combination ===<br />
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One preparation, along with ''yashtimadhu'' is described. In the index at the end of this chapter, two preparations, using the same drug are enlisted. The other one is narrated in the verse no. 19. This preparation is very much palatable and is specifically useful for those persons having [[pitta]] type of constitution who are suffering from symptoms like throat burn.<br />
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=== Fourteen preparations ===<br />
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Fourteen preparations using ''trivrita'' along with fourteen different drugs like ''jivaka'' are narrated. Additionally, one more preparation, using ''yashtimadhu'' is also described. These preparations are very much palatable as most of the drugs are sweet in taste. Though, some of them are bitter, their ''vipaka'' or post digestive effect is sweet. So, apart from causing purgation, they relieve many diseases caused by [[vata]] and [[pitta]] and act as rejuvenatives ([[rasayana]]) as well.<br />
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=== Seven preparations ===<br />
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Total number of seven preparations, of ''trivrita'' are prescribed, using seven different ingredients. Many of them are having sweet taste and are able to control [[vata]] potentially. Milk and meat soup are highly palatable and can be given to individuals with their choice. The third one is sugar cane juice, accepted by all and is an addition to the laxative action. The next three recipes are fruit juices and have got pure sweet taste with mild laxative action. The seventh one is ghee which alleviates [[vata]] and reduces the drastic action of any purgative drug. ''Haritaki'' is added half the quantity to the main drug to enhance the purgative action of ''trivrita'' very safely and in a sustained manner.<br />
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=== Avaleha (linctus) ===<br />
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This is the first one of the eight preparations in the form of linctus. ''Avaleha'' or linctus is such a preparation which provides additional palatability to any of the drug mixed with it. Persons, who feel aversion to medicinal preparations that too emetics or purgatives due to their bitter taste or disagreeable aroma, can easily consume such preparations.<br />
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=== Powder combinations ===<br />
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The powders of three more drugs along with powdered sugar are advised to be taken along with ''trivrita'' in the powder form. They are thoroughly mixed with honey and ghee to make it linctus. But, nowhere, the proportion of the drugs used is mentioned either by Charaka or the commentators. Ashtanga Hridaya also followed the same verse but didn’t mention either the proportion or the dosage. Because, this preparation is used in conditions like fever and thirst, it will be better to use the ingredients in equal proportions and limit the dose for laxation but not for purgation.<br />
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=== Proportion of trivrita ===<br />
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In this preparation, the proportions of individual ingredients are mentioned by Chakrapani. One part of the powder or paste of ''trivrita'', One part of sugar and one-fourth part of the decoction of ''trivrita'' may be used to make an agreeable form of preparation. This is highly palatable as this contains only the black variety of ''trivrita'' as its ingredient, it can be used with caution but more precisely.<br />
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As a principle, honey is not heated or boiled, which makes it poisonous, according to the Ayurvedic texts. But in this preparation, exceptionally, it is advised by Charaka himself to boil honey and melt sugar. It is true that, honey bees collect honey from many poisonous flowers also. This toxicity may enhance, when the honey is heated or boiled. But, when given along with as a purgative drug, there is less chance of honey being absorbed into the system. Apart from this, it enhances the palatability of the preparation and intestinal motility is increased due to the ''ushna viryata''. The proportions of ingredients in this preparation are, powdered ''trivrita'' in one-fourth quantity to the syrup and the other drugs like cinnamon bark in the required quantity. Their purpose is to enhance the flavor of the preparation, to make it acceptable.<br />
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This preparation (Verse 23 ½ - 25) is intended for rich people and whose physique is tender. As they usually consume high fat diet regularly, they need not undergo oleation therapy as a prerequisite to purgation. This linctus can cause purgation even in them, with ease. <br />
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Though, the quantity of ''trivrita'' to be added is not mentioned here, as a common rule, one-fourth quantity to the liquids may be added. The fruit juices in general and juices of grapes and ''pilu'' specifically cause mild laxation and expel out the stagnated [[pitta]] [[dosha]] from the body effectively. The honey that is heated also can act as a [[pitta]] aggravating factor to mobilize it from the existing place and move it out. Similar preparation is found also in Sushruta Samhita and Ashtanga Hridaya. (Verse 26-27)<br />
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These preparations (Verse 28) are made in the similar process as that of linctus. For making these preparations, sugarcane juice etc; as described in the verses 26-27 are to be utilized accordingly.<br />
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In this preparation (Verse 29), both the varieties of ''trivrita'' roots are used for their synergistic action. Though, the propositions are not mentioned, they can be taken in equal quantity. The other drugs are also able to check the status of [[kapha]] and help to expel out the stagnated [[kapha]] from the body. ''Kshara'' mentioned here is an alkali preparation that is prepared synthetically, using grasses and herbs.<br />
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This preparation (Verse 30-32) can be made as per the method mentioned in verses 26-27. Quantity of the ingredients individually is not mentioned here. But for all practical purposes, the juice of ''Matulunga'', etc; are to be taken in the quantity of one ''kudava'' each. This is as per the suggestions made by Chakrapani.<br />
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In Verse 33, five types of preparations are mentioned for better palatability. These preparations also help in averting any type of undesired action. Moreover, these due to their liquid nature, pass on to the large intestines very easily so that the drug action starts early.<br />
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This type of smoothening drink (Verse 34-35) is one of the two, prescribed in the same chapter. This is very much pleasing, tasty, aromatic and strength giving while causing purgation. The recipient never feels tired even after purgation as the complications are little.<br />
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This (Verse 36) is one of the five preparations of ''trivrita'' in the form of ''modaka''. The taste of this is good and causes less hazardous effects on the body while curing the disease proper.<br />
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This (Verse 37-39) is the eighth and the last one of the preparations in the form of linctus. Measurement of ''modaka'' used here is one ''shana'' which measures approximately 3.0 grams. Because this contains many drugs which pacify [[kapha]], the preparation is indicated in upper abdominal diseases including bronchitis. Though it is said that no restrictions of any type are required here, they are to be followed cautiously and judiciously so that unexpected complications do not arise.<br />
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=== Kalyanaka guda ===<br />
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This preparation, known as ''kalyanaka guda'' is the second one in the form of ''modaka''. The quantity of ''trivrita'' in this multi drug preparation is proportionately low; so, even though, this is consumed in different seasons without following any restrictions, there may not be any undesired effects. Moreover, an additional advantage of this preparation, which usual purgative does not possess is that it can help in promoting male progeny.<br />
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This is the third preparation (Verse 45 ½ - 49½) in the form of ''modaka''. This is also known as ''abhayadi modaka'', according to Chakrapani. The quantity of honey is not prescribed here and can be used as per the need to prepare the ''modaka''. He further says that ''danti'' and ''trivrita'' are to be used two times and eight times to the total ingredients of ''shunthi'' etc; or can be used two parts and eight parts respectively. He did not clarify the proportions but put forth the opinions of others. This is a special preparation in the sense that, he added one more purgative drug i.e. ''danti''. There seems to be similar preparation mentioned in the Ashtanga Hridaya, known by the name of ''Avipattiyoga''. In that formulation, ''danti'' is not added and the proportion of ''trivrita'' is suggested as nine parts, as the other ingredients are nine in number and each one part of them are taken for the preparation. This opinion is further supported by both of the commentators Hemadri and Arunadatta and we can follow the same opinion for all practical purposes.<br />
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This (Verse 49½ - 50½) is the fourth formulation of ''trivrita'' in the form of ''modaka''. Here, Charaka has used the word ''urubuka'' (castor plant) but did not mention the part of the plant to be used. Ancient commentators on any of the verse too did not give their opinion. Some modern commentators advised to take powdered seed which does not appear to be correct since the powder is highly toxic and can kill a person in that dose. Hence, it is ideal to use the root bark of castor plant which is not toxic but causes purgation without causing intestinal spasm.<br />
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The fifth type of trivrita formulation (Verse 50½ -55) in the form of modaka is prepared by dividing it into two parts - while the first one is preparation of large sized pills, the second part consists of application of medicated powders over it to make it more effective and palatable. There is a debate regarding the part of ''dadima'' to be used for preparations. In the similar compound, as mentioned in Ashtanga Hridaya, the preparation of ''modaka'' and its ingredients are to certain extent similar but the rolling (''veshtana'') process is not present. The seed powder of ''dadima'' is not effective therapeutically when dried and hence, the powder of the stem bark, which has got many potent actions against the diseases of colon that, can be used. Due to the addition of drugs like ''vacha, chitraka'' and ''tumburu'', diseases due to [[kapha]] are definitely alleviated.<br />
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=== Importance of Trivrita ===<br />
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''Trivrita'' is undoubtedly considered the best of all the drugs used for purgation due to its potent activity with very little undesired actions. Even then, the climatic conditions and impact of different seasons on our bodily functions cannot be neglected.<br />
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To make this drug more safe and more effective surpassing these climatic changes, Charaka has given four different preparations, useful for four seasons - summer, rainy/monsoon, autumn and winter. Apart from these four, he has also formulated two preparations that are useful for all seasons. Though it is stated that, for a healthy person, purgation therapy is to be employed in post rainy season, it has to be administered as and when an emergency state occurs in any season. There, this preparation helps a physician and the patient to cope up with the situation safely. In rainy season, there is a dominance of ''vata'' and the addition of ''shunthi'', honey and grape juice help to overcome this problem.<br />
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In this purgative preparation (Verse 57) that is useful in post rainy season, two drugs of plant origin appear to be confusing. They are ''duralabha'' and ''udichya''. ''Duralabha'' can be better equated with Fagonia cretica Linn. As some sweet resionous substance is prepared from this plant and marketed which pacifies [[Pitta]]. So the other plant ''udichya'' can be equated with some Valeriana sp. which acts against [[pitta]].<br />
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The word ''drakshambu'' is different from the juice of grapes. Grape juice is a direct extraction of the fruits through compression. But for grape water, dry grapes are to be soaked in water over night, thoroughly squeezed and filtered. The difference between them is that the first one is more concentrated and the latter is more diluted.<br />
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=== Contraindication of purgation therapy and seasons affecting its efficacy ===<br />
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Purgation therapy is not indicated during winter season due to the likely development of intestinal spasm because of the cold wave. Even then, in case of emergency or in a particular disease where [[kapha]] is causing problem or obstructing the lower parts of the colon, this purgation therapy is indicated. The powders mixed together can be ground well with hot water, so that the actual compound acts upon the system with ease.<br />
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During hot summer, purgation therapy is not at all advised due to the fear of developing dehydration or electrolyte imbalance. Even during that season, if need arises, ''trivrita'' can be utilized without any complication. To avoid any unexpected problem Charaka suggested using it with sugar which can prevent gastritis due to [[pitta]].<br />
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This formula (Verse 58½ - 60 )contains good number of purgative drugs apart from ''trivrita'', such as ''satala'' and ''svaranakshiri''. ''Katurohini'' is famous for its action of breaking and expelling out hard fecal matter. Moreover, all the drugs are allowed to soak in cow’s urine for three days. This entire process makes the compound more sharp and potent. So, this drug is said to cause proper purgation in patients who are overweight or who have undergone comprehensive oleation therapy. This can be used in all seasons irrespective of the climatic conditions because all the ingredients used are safe and never cause drastic purgation. This also means that, it should never be used in patients who have not undergone oleation.<br />
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This preparation (Verse 61-62) contains both of the Trivruta roots (Pink and black) along with Nilini, a purgative drug. Even then, as it is advised to consume this preparation along with ghee and meat soup, it can be given even to persons who have less storage of fats in their body and who didn’t undergo oleation therapy. Thus, a total number of six preparations are prescribed in concordance with the seasons of varying climatic conditions.<br />
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Verse 63-64: Though Chakrapani confused a little bit in numbering this preparation as the first one in the powder form, the preparation vide verse Nos. 34-35, in the form of Tarpana can be taken as the first one and the preparations of verse nos. 63-64 and 65 – ½ 66 can be considered as the second preparation. Then, the total number of one hundred and ten comes to a factual conclusion.<br />
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In Verse 65- 65½, is the second one of the two preparations with ''trivrita'' used in the form of nourishing drink. This is highly palatable, nutritious and purgative and never causes any type of complications.<br />
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Total four preparations (Verse 65½-68 )are described using ghee or milk as base. Both of the varieties of ''trivrita'' are utilized here as the main drugs of the compound. As milk or ghee are used along with, the harmful side effects of ''shyama'' never crop up.<br />
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Two preparations (Verse 69-71) in the form of fermented beverages are mentioned. The main purpose is to store the preparation for a longer period of time. Additionally, the palatability becomes an advantage. This can also be used in persons habituated to alcohol for a longer period.<br />
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These two preparations (Verse 72-73) are also fermented liquids like the preparations mentioned in verses 69-71. They are easily absorbable, palatable, fast acting and can be stored for a longer period of time. The first one is ''sauviraka'' which is prepared with dehusked barley and boiled. The second one is prepared with unhusked barley in the powder form and not boiled. These two preparations are equally effective and are suggested for those patients who are habituated to alcoholic beverages.<br />
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=== Enhancing palatability of formulation ===<br />
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Here, ten preparations, utilizing the powdered root of ''trivrita'' are suggested. Their names and method of preparations are described in Charak Samhita [ Cha. Sa.[[Kalpa Sthana]] 1/26 ].<br />
#Badara – badava – Sour liquid made of jujube fruit<br />
#Raga – A liquid with, sour and pungent tastes.<br />
#Leha – A linctus<br />
#Modaka – A type of Indian sweet<br />
#Utkarika – A cake like preparation<br />
#Tarpana – Soothening drink<br />
#Panaka – Syrup<br />
#Mamsarasa – meat soup<br />
#Yusha – Pulse Soup and (or)<br />
#Madya – Alcoholic beverages.<br />
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These preparations using ''Trivrita'' as the base drug enhance the pharmacological activity, palatability and acceptability.<br />
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A common phenomenon that occurs after administration of purgative drugs is that, quite often, the patient develops nausea or vomiting sensation. If he vomits, the drug consumed becomes useless and can’t be given once again the same day. The reason is that many of such drugs are either bitter or aversive. So, the palatability of the preparation is to be maintained inspite of all the precautions, if he develops nausea, it is to be averted following certain methods which are pleasing to the mind.<br />
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=== Further reading ===<br />
<br />
#Kohli KR, Nipanukar SU, Kadbahane KP. A comprehensive review on Trivruta (Operculina turpethum) International journal of Pharma and biosciences, 2010: 1(4) 443-52<br />
#Bhande RM, Lakshmayya, Kumar P. Pharmacological Screening of root of Operculina turpethum and its formulations. Acta Pharmaceutica Sciencia, 2006: 48 11-7.<br />
#Sharma V. Singh M Operculina turpethum as a panoramic herbal medicine: a review, International journal of Pharmaceutical sciences and research 2012. 3(1) : 21-5<br />
#Kumar SV, sujatha C. Syamala J, Nayasudha B, Misra SH, Protective effect of root extract of Operculima turpethum Linn. Against paracetamol induced hepatotoxicity in rats. Indian J. of pharm Sci – 2006: 28 (1) 32-5.<br />
#Nitin Mahurkar A, Arati Malpani, S.Girish Kumar, RGUHS J. Pharm Sci. Vol 2, 4, 2012. 73-79.<br />
#Md. Harumal Rashid, MA Gafur, Antibacterial and Cytotoxic activities of extracts and isolated compounds of ipomolaturpethum, Pakistan Journal of Biological sciences 5(5) 597-599, (2002).<br />
#C. Anbuselvam, K. Vijayavel, Operculina turpethum against 7, 12 dimethylbenzanthracine induced oxidative stress with ref. to breast cancer in rats. Chemico Biological interactions, 168: 229-236 (2007).<br />
#Chunnekar, KC, Hota SP. Plants of Bhavaprakasha, Pub. National academy of [[Ayurveda]], New Delhi, 1999.<br />
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[[#top| Back to the Top ]]</span></div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Emergency_medicine_in_Ayurveda&diff=45396Emergency medicine in Ayurveda2026-01-03T08:59:34Z<p>Agnivesha: /* References of emergency conditions in Ayurveda texts */</p>
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{{#seo:Emergency medicine in Ayurveda<br />
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|keywords= Principles, diagnosis, management, medical emergencies, life-threatening condition, medical system healthcare, symbiohealth, charak samhita, caraka samhita, Indian system of medicine, alternative medicine, complementary medicine, Upendra Dixit, atyayika chikitsa, <br />
|description= Principles of diagnosis and management of medical emergencies in Ayurveda are described. <br />
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'''Principles of Diagnosis and Management of medical emergencies in Ayurveda'''<br />
<p style="text-align:justify;"><br />
(This article is based on a lecture delivered by Dr. Upendra Dixit, Chief consultant, Dixit Ayurveda, Goa, India., in Prof.M.S.Baghel Memorial Lecture Series on October 09, 2021.) </p><br />
<br />
{{Infobox<br />
|title = Contributors<br />
<br />
|label1 = Section/Chapter/topic<br />
|data1 = [[Concepts and Contemporary Practices]] -[[Nidana]] [[Chikitsa]] /Emergency medicine <br />
<br />
|label2 = Author<br />
|data2 = Dixit U.<sup>1</sup><br />
<br />
|label3 = Reviewers <br />
|data3 = [[Gopal Basisht|Basisht G.]]<sup>2</sup> <br />
<br />
|label4 = Editors<br />
|data4 = [[Yogesh Deole|Deole Y.S.]]<sup>2</sup>, [[Gopal Basisht|Basisht G.]]<sup>2</sup> <br />
<br />
|label5 = Affiliations<br />
|data5 = <sup>1</sup>Chief consultant, Dixit Ayurveda, Goa, India.<br />
<br />
<sup>2</sup>[[Charak Samhita Research, Training and Development Centre]], I.T.& R.A., Jamnagar, Gujarat, India <br />
<br />
<br />
|label6 = Correspondence email:<br />
|data6 = carakasamhita@gmail.com<br />
<br />
|label7 = Publisher <br />
|data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br />
<br />
|label8 = Date of first publication:<br />
|data8 = December 10, 2021<br />
<br />
|label9 = DOI<br />
|data9 = 10.47468/CSNE.2021.e01.s09.076<br />
}}<br />
<br />
<div style='text-align:justify;'><br />
The Atharvaveda quotes assurance statements by the sages to the person on the death bed. <br />
<br />
“Do not fear. You won’t die. We will save your life. “[Atharva veda 5.30.8] <br />
<br />
Ashtanga Hridaya quotes, [[Ayurveda]] can save the life of a person from the noose of death by using various measures. [A.Hr.Uttara tantra 44/74]<ref name=AH>Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref> <br />
<br />
It shows that medical emergency measures were handled successfully in ancient times to save human lives. Though no science can completely assure to prevent death, the physician has to try to save a life until the last breath. The physician is required to study the management of medical emergencies to find better, safe, and cost-effective healthcare solutions to save lives. <br />
</div><br />
==References of emergency conditions in Ayurveda texts==<br />
<div style='text-align:justify;'><br />
The word ‘atyaya’ denotes destruction or death. [Chakrapani, Cha.Sa. [[Sharira Sthana]] 1/50] [Dalhana, Su.Sa. Sharira Sthana 10/19-20].<ref name=SU>Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref> The word ‘atyayika’ denotes the quickest possible treatment done to protect life without any delay. [Dallhana, Su.Sa. Sharira Sthana. 8/5]<ref name=SU /> [Hemadri A.Hr.Sutra Sthana 2/33]<ref name=AH /> Therefore, the medicines to be used in medical emergencies shall be ready with the physician for first aid emergency treatment, even if the patient is to be referred to higher critical care centers. <br />
<br />
The word niratyaya explains how diet, various activities, and treatments can be performed in such a safe way that complications leading to severe consequences and emergencies can be prevented. <br />
</div><br />
<br />
==Medical emergencies== <br />
<div style='text-align:justify;'><br />
American college of emergency physicians has listed 1733 emergency conditions.<ref>Available from http://emedicine.medscape.com/emergency_medicine accessed on 03/12/2021 </ref> It shows the scope of emergencies occurring in various medical fields. From this, we can understand that emergency medicine is a vast field. [[Ayurveda]] has a lot of potential to contribute to medical emergencies. However, it is not much explored in the current practices of [[Ayurveda]]. Although a few [[Ayurveda]] consultants are working in this field. Recently AVP research foundation, Coimbatore has undertaken a project on Ayurvedic emergency medicine. Not much literature is available to study the subject of management of emergency conditions through [[Ayurveda]]. A series of articles entitled ‘Basic principles of emergency treatment of [[Ayurveda]]’, published in AYU Journal written by Vaidya Mhaiskar V.B.<ref>Mhaiskar V.B. Basic principles of emergency medicine in Ayurveda (Gujarathi). Gujarat Ayurved University. Jamanagar</ref> is one of the best sources to learn this topic. <br />
[[Ayurveda]] especially Brihat Trayi (texts termed as a great triad) provides lot of references regarding emergency conditions and their treatment. Here are a few examples:<br />
<br />
The condition of [[Vata]] dominant prameha (obstinate urinary disorders including diabetes) is incurable and has potential of causing emergency conditions. [Cha.Sa. [[Nidana Sthana]] 4/38]<br />
<br />
The [[pitta]] dominant gulma should be treated as an emergency condition. [Cha.Sa.[[Chikitsa Sthana]] 5/114]<br />
<br />
The cough (kasa) due to chest injury shall be treated as an emergency condition. [Cha.Sa. [[Chikitsa Sthana]] 8/134]<br />
<br />
The erysipelas (visarpa) due to vitiation of all [[dosha]] is considered as an emergency condition. [Cha.Sa.[[Chikitsa Sthana]] 21/41]<br />
<br />
The physician shall treat weak patients with utmost care to prevent complications. [Cha.Sa. [[Vimana Sthana]] 8/94]<br />
<br />
In an emergency condition, one should administer the purification therapies (shodhana) with great care. [Cha.Sa.[[Vimana Sthana]] 8/127]<br />
<br />
For understanding emergency treatment , all such references need to be compiled and thoroughly studied. The author has made efforts in this regard. <br />
</div><br />
<br />
==Causative factors of emergency or life-threatening condition==<br />
<div style='text-align:justify;'><br />
From all textual references, it can be understood that certain factors cause most emergencies. They are as below:<br />
<br />
*[[Marma|Marma (vital organs)]]<br />
<br />
*[[Rakta]] (blood)<br />
<br />
*[[Oja]] (immunity and essence of body tissues)<br />
<br />
*Udaka (fluid) <br />
<br />
*Prana vayu (a type of [[vata dosha]])<br />
<br />
*Pranavaha Srotasa (respiratory system transporting vital air) <br />
<br />
*[[Agni]] (digestion and metabolism)<br />
<br />
*Udana vayu (a type of [[vata dosha]])<br />
<br />
*[[Dhatu]] gata avastha (state of the affliction of tissues)<br />
<br />
*Shulopahatava ( Pain threshold or severity)<br />
<br />
*Upadrava jushtata (comorbid conditions or complications of various diseases)<br />
<br />
*Janapadodhwasa (epidemics and pandemic conditions)<br />
</div><br />
<br />
==Concept of prana in [[Ayurveda]]==<br />
<div style='text-align:justify;'><br />
The term prana is used for the vitality of life or life force. It is essential to understand the concept of prana and its importance in life-threatening emergency conditions.There are twelve sites of vitality (prana). Ayurvedic texts use the word ‘Prana’ as a synonym for certain body constituents. Prana is also used as a prefix to the names of certain body constituents.This indicates these body constituents are most vital, for saving a life. [[Agni]], Soma, Vayu, Sattva, Rajas, Tamas, [[Atma]] and [[Pancha mahabhuta]].[Su.Sa.Sharira Sthana 4/3]<ref name=SU /> <br />
<br />
The two temples, the three vital organs, the throat, rakta dhatu (blood), shukra dhatu (reproductive tissue), oja (the vital essence), and the anus are ten sites of life forces (prana).[Cha.Sa.[[Sutra Sthana]] 29/3]<br />
<br />
Prana vayu is one of the five types of [[Vata dosha]][Cha.Sa. [[Chikitsa Sthana]] 28/234].Food (anna)[Cha.Sa.[[Chikitsa Sthana]]24/60], water (udaka)[A.S.Sutra Sthana.6.11]<ref name=AS>Vridha Vagbhata, Ashtanga Sangraha. Edited by Shivaprasad Sharma. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012.</REF> and strength or immunity (balam) are factors influencing vitality[Dalhana, on Su.Sa.Sutra Sthana 17/13].<ref name=SU /> <br />
<br />
The vitality from external sources or nature (bahya prana) and internal vitality (abhyantara prana) sustain human life. The vitality from external sources or nature is converted into internal vitality through channels of transportation and transformation of vitality (pranavaha srotasa) [Su.Sa.Sutra Sthana 17/13].<ref name=SU/> The vitality especially depends on blood tissue (rakta)[Cha.Sa.[[Sutra Sthana]] 24/4], essence ([[oja]]) (Chakrapani on Cha.Sa.[[Sutra Sthana]]28/4], digestion, and metabolism ([[agni]])[Cha.Sa.[[Chikitsa Sthana]]15/3,4]. It is presented through sensory and motor organs (indriya)[Cha.Sa.[[Sutra Sthana]]1/48]. <br />
<br />
Injury to the umbilicus (nabhi)[Su. Sa.Sharira Sthana 7/5]<ref name=SU /> , channels carrying nutrient fluid (rasavaha srotasa)[Su. Sa.Sharira Sthana 9/12]<ref name=SU/>, blood vessels (sira) can lead to sudden death(Dalhana on Su.Sa.Sharira Sthana 7/5].<ref name=SU/> <br />
<br />
Commonly observed clinical features in an emergency: <br />
<br />
* Acute and severe pain in vital organs like cardiac pain or abdominal pain etc. as observed in trimarmiya chikitsa chapter of charak Samhita. It is mentioned as sahasa daruna marmaruja. <br />
<br />
* Acute hemorrhage or excessive bleeding (sahasa atyartha raktasrava)<br />
<br />
* Dyspnoea (shvasakashta) <br />
<br />
* Sudden loss of sensation (sahasa indriyanasha)<br />
<br />
* Unconsciousness (sanjna nasha) <br />
<br />
* Syncope (moorchha)<br />
<br />
* Acute organ failure <br />
<br />
* Clinical features of the affliction of vital organs can cause death within seven days (sadya pranahara marma) like loss of perception, sudden vomiting, excess perspiration, a sudden feeling of heaviness [A.Sa.Sharira Sthana 7/47]<ref name=AS/><br />
<br />
The clinical features of near-death patients are described in chapters of [[Indriya Sthana]].<br />
<br />
==Diagnostic tools ==<br />
<br />
* In addition to the above clinical features, arishta or fatal signs observed in the patients are tools to diagnose emergency conditions. These appear suddenly, without any known cause, with the constantly deteriorating condition of the patient. <br />
<br />
* Changes in breathing patterns or respiration can indicate emergency conditions. Guidelines about this can be referred from the clinical features of affection of channels of transportation and transformation of prana (pranavaha srotasa). [Cha.Sa. [[Vimana Sthana]] 5/8]The patterns of respiration are described under types of shwasa like maha (a type of shwasa disease), urdhva (a type of shwasa disease) and chhinna (a type of shwasa disease) shwasa [Cha.Sa.[[Chikitsa Sthana]] 17] can be studied to understand emergency conditions resulting into death.<br />
<br />
* Dehydration status – can be understood from the clinical features of affection of channels of transportation and transformation of udaka (udakavaha srotasa). [Cha.Sa.[[Vimana Sthana]] 5/8]<br />
<br />
* Consequences of excessive emesis and purgation (atiyoga of vamana and virechana) are described showing emergency conditions. Effects ranging from mild degrees like dryness in the throat to severe effects like dilatation of pupil as precursor to death are described. [A.Sa.Sutra Sthana 27/20]<ref name=AS /><br />
<br />
* Status of consciousness and orientation<br />
<br />
==Consequences of the affliction of [[Marma|marma]] == <br />
Injury to different vital structures ([[Marma|marma]]) can have various consequences. Certain [[Marma|marma]] called 'sadyopranahara marma’ can lead to death instantaneously or within a week. General signs and symptoms can guide about injury to [[Marma|marma]], and accordingly the patient can be cared for. The clinical features are numbness of the body (deha supti), heaviness, confusional state, desire of cold things, excess perspiration, syncope, vomiting, dyspnoea, [A. Sa. Sharira sthana 7/47]<ref name=AS/><br />
<br />
Injury to [[Marma|marma]] causes vasodilatation and profuse bleeding. This may lead to death. [A.Hr.Sharira Sthana 4/65]<ref name= AH/><br />
<br />
==Clinical assessment - Nadi (pulse examination)==<br />
Texts like Yogaratnakar etc. describe pulse examination. Here certain readings about pulse can indicate emergency conditions and imminent death of the patient. E.g. the pulse is irregular and unstable in case of emergency conditions. [Yoga Ratnakar] The other clinical parameters can be implied to assess critical conditions.<br />
<br />
==Life-threatening conditions ==<br />
Certain diseases are specifically mentioned as resulting in death. In this regard, the following chapters shall be studied in depth to understand critical conditions in [[Ayurveda]]. <br />
<br />
*Jwara specifically sannipatika jwara (due to combination of all dosha) [Cha.Sa.[[Chikitsa Sthana]] 3] <br />
<br />
* Shwasa and Hikka (respiratory failure) [Cha.Sa.[[Chikitsa Sthana]] 17]<br />
<br />
* Sanyasa (coma) [Cha.Sa.[[Sutra Sthana]] 24]<br />
<br />
* Visarpa (eryspelas) [Cha.Sa.[[Chikitsa Sthana]] 21]<br />
<br />
==Medical ethics in critical conditions==<br />
<br />
The patient on the death bed may not survive due to his predestined life span. However, the physician shall treat the patient till the last breath with a hope of life. Proper consent shall be taken from the close relatives of the patient after informing them of details about the critical condition. [A.Sa.Sharira Sthana 7/75] <ref name=AS /><br />
<br />
==Management of emergency conditions==<br />
<br />
The principles of management of emergency conditions include: <br />
<br />
* Protecting prana and [[Marma|marma]] (vital organs and structures) especially heart, brain, and urinary system <br />
<br />
* Use of antidotes or medicines used in poisoning (agada)<br />
<br />
* Protection and enhancement of oja (essence) and strength or immunity (bala)<br />
<br />
* Protection and maintenance of digestion and metabolism (agni)<br />
<br />
* Protection of sensory and motor organs (indriya) that are sites of consciousness (chetana)<br />
<br />
== Emergency medicine kit ==<br />
<br />
A kit of potent Ayurveda medicines shall always be ready with the physicians. It consists of the following:<br />
<br />
* Honey <br />
<br />
* Ardraka sattva or ginger juice <br />
<br />
* Levigating stone<br />
<br />
* Suvarna sutashekhara pottali <br />
<br />
* Hemagarbha pottali <br />
<br />
* Trailokya Chintamani rasa pottali<br />
<br />
* Other life-saving medicines and instruments<br />
<br />
To make proper use of these medicines to save the life of the patients, it is necessary to understand the exact mode of action of these medicines. With such knowledge, the physician can select appropriate medicine in the appropriate conditions. Here is a summary of the mode of action of these three most important medicines-<br />
<br />
===1. Hemagarbha===<br />
<br />
* The veiling of tamas (inertia) on intellect ([[buddhi]]) and mind ([[mana]]) is removed and consciousness is regained and maintained.<br />
<br />
* [[Indriya]] (sense organs) are activated.<br />
<br />
* Chhedana (pertusion) of [[kapha dosha]] removes obstruction in the movement of [[vata dosha]]<br />
<br />
* Restore normal movement of [[vata]], by correcting avasada (slackening) – especially of prana, udana, and samana.<br />
<br />
* Maintains and increases heart rate, pulse rate, and heart rate in case of avasada (slackening)<br />
<br />
* Activates and promotes [[agni]] (deepana)<br />
<br />
* Specially used in Shlaishmika ([[kapha]] dominant), Antrika (intestinal affliction), and shvasanaka sannipata (respiratory affliction), tamaka-maha and urdhva shvasa, sanyasa etc.<br />
<br />
===2. Trailokyachintamani rasa===<br />
<br />
* Removes the veiling of abnormal [[kapha dosha]]<br />
<br />
* Restores normal movements of [[vata dosha]], by correcting avasada(slackening)<br />
<br />
* [[Agni]]- dhatvagni deepana ( activates- ignites [[agni]])<br />
<br />
* Instantaneously increases [[oja]]<br />
<br />
* Destroys visha(~ poisons/toxins)<br />
<br />
* Protects heart and senses<br />
<br />
* Specially used in shlaishmika and shvasanaka sannipata.<br />
<br />
* Hridroga caused by obstruction of channels (srotas) by [[kapha]], ama, etc., Also in Hridroga caused by sudden depletion of [[oja]] or psychological factors like grief etc.<br />
<br />
* By controlling actions of prana, activities of senses([[indriya]]) are maintained, Avasada(slackening) is removed, which controls and maintains normal functions of the heart and lungs.<br />
<br />
* Provides immediate relief in hritshoola(angina)<br />
<br />
* Controls actions of vyana, thereby the actions of muscles<br />
<br />
* Vishanashaka (destroys toxins)<br />
<br />
* Specially used in critical conditions of hemiplegia (pakhaghata) and other [[vata]] dominant [[vyadhi]], in patients with severe debility<br />
<br />
===3. Suvarna Sootashekhara===<br />
<br />
* Best medicine for restoring the normalcy of all three [[dosha]].<br />
<br />
* Maintains and regulates normal functions of all five types of [[vata dosha]].<br />
<br />
* By regulating actions of prana, regulates functions of senses([[indriya]]), mind([[mana]]), and intelligence([[buddhi]])<br />
<br />
* By regulating the actions of prana, regulates heart and respiration rate.<br />
<br />
* By regulating actions of samana, causes [[agni]] deepti(activates- ignites [[agni]]), regulates secretions of [[pitta dosha]], regulates gastrointestinal motility, regulates assimilation, separation, and absorption process (sarakitta vibhajana)<br />
<br />
* Samana, regulates sweating and maintenance of body temperature and energy levels.<br />
<br />
* Vyana, regulates circulation, sweating and bleeding process, movements of muscles, and other physical activities.<br />
<br />
* Apana, regulates defecation, micturition, etc. processes.<br />
<br />
* Performs pachana of sama [[pitta]], especially with amla, drava, and visra [[guna]]. <br />
<br />
* Controls [[kapha]]<br />
<br />
* Destroys visha(~ poisons/toxins)<br />
<br />
These pharmacological activities are observed in clinical experiences. More research on experimental models can be done on these medicines. <br />
Usually, these medicines are levigated on a specific levigating stone and applied on the gums of unconscious patients. For levigation, a small drop of honey and in specific conditions, 2-3 drops of ginger juice are used. The medicine is in minute quantity, so chances of entering into the respiratory tract are minimum. The medicine starts showing its actions within a few seconds. Many of such patients are in the intensive care unit (I.C.U.), on monitors. In such patients, the changes in heart rate, blood pressure, respiratory rate, etc. are observed instantaneously. Eg. The hemagarbha pottali was observed to instantaneously increase heart rate and improve the rate of respiration after application on gums in intensive care patients. Further research is needed to study the exact mode of action of these medicines. <br />
<br />
[[Ayurveda]] has described the criteria for prognosis of patients. Charaka Samhita presents a separate section on the prognosis of the patients and specific signs and symptoms observed in the critical patients (arishta), indicating certain death in the near future. In such patients, a complete cure is not possible. But even in these patients, it is observed that the life span can be extended for some time with Ayurvedic emergency medicines. If such signs and symptoms(Arishta), are not observed, the patient can survive for a longer period.<br />
<br />
==Importance of food== <br />
Food plays an essential role in maintaining vitality in critical conditions. If the food is not given as per the digestive capacity ([[agni]]) of the patient, then it leads to the formation of toxic metabolites ([[ama]]). This further blocks the channels of transportation of nutrients ([[srotas]]) and worsens the condition. Therefore, easy-to-digest food like green gram soup (mudga yusha) is advisable to be given in critical cases. The wholesome food that is suitable to the patient and helpful in treating underlying disease conditions is advised.<br />
<br />
==Experience-based evidence == <br />
It is difficult to maintain documentation of all cases while managing emergency medical conditions because the priority of the physician at that time is to save the life of the patient. There are further limitations to access case records of the patients from hospitals. The author has tried to maintain the records, as far as possible. The author has treated more than 170 critical patients in intensive care units of various hospitals in Goa and outside. In many of these patients, when the ongoing modern medical treatment was not showing the desired effects, Ayurvedic treatment was given as an adjuvant. Some patients were treated with Ayurvedic treatment only. Even during the pandemic of SARS COVID 19, around 40 patients showed better improvement when Ayurvedic treatment was given as an adjuvant to the modern medicines <br />
<br />
==Acute conditions==<br />
[[Ayurveda]] has the potential to treat various acute conditions. For this, various methods of management and quick-acting medicines are available. The author has experienced various such conditions like high fevers, acute asthmatic exacerbation, hiccups, hypertension and hypotension, diarrhea including cholera, and gastroenteritis. In such acute conditions, it is experienced that [[Ayurveda]] has quick-acting medicines by which improvements can be observed right from the first dose, and within a few minutes changes are noted.<br />
<br />
==Case reports of critical cases==<br />
Following case reports are available with necessary investigation reports, discharge summaries and videos wherever necessary.<br />
<br />
===Case 1===<br />
<br />
A 68-year-old male patient with a history of hypertension for 10 years, alcoholic liver disease, cirrhosis, and adenocarcinoma of stomach was treated with ayurvedic treatments. He was in a comatosed state after suffering from seizures, cerebrovascular stroke due to intracranial hemorrhage, and hemiplegia. He was not responding to modern treatment in the hospital ICU, therefore was taken for home care treatment. Then onwards he was only on Ayurvedic treatment. The patient was treated with medicines like sutendra rasayana with honey, Arpisa rasayana, a combination of dhatri, raktapachaka and dhamasa . tapyadi loha, swarna raja vangeshwara rasa, haridra ghana, kukkuta nakhi, rasa sindura with honey. The patient regained consciousness in three to four days and was relieved of major symptoms. He survived for more than one and a half years. <br />
<br />
===Case 2===<br />
<br />
A thirty-year old male patient suffered from a road traffic accident. He was in a coma due to traumatic brain injury. The injury included 10x,2x deep lacerated wound on right side forehead, brain contusion at the frontal lobe, and intraventricular bleeding on the right side. Since he was not responding to ongoing treatment in the ICU, in addition to the conventional treatment, the patient was treated with Ayurvedic medicines like swarna sindoora (30 mg) mixed with haridra ghana and honey applied on the gums of the patient. The patient became semiconscious in two days and improved in orientation, too. The patient was further treated with Yogendra rasa (60 mg). He regained consciousness and recovered completely. <br />
<br />
===Case 3===<br />
<br />
A 43-year-old male patient suffered from skull and facial bones fractures due to a road traffic accident 10 years ago. He suffered from epilepsy and was taking treatment. The patient-reported history of excess mental stress, excess fasting (paryushana upavasa in the Jain tradition), anorexia, and anger. He suffered from convulsions and became unconscious due to intracerebral hemorrhage of 7.9 x 5.6 cm size in right temporoparietal region. Fever and sepsis-like conditions were observed. Since he was not responding to the ongoing ICU treatment, he was treated with Ayurvedic medicines like sindura bhushana mixed with haridra ghana every four hours applied on gums. Medicated water processed with gold (Suvarna siddha jala) and green gram soup was given to the patient through Ryle’s tube. Jaymangal rasa and guduchi ghana was added to treat fever. The fever subsided in one day and subsequently, the patient started maintaining oxygen levels. The life support system was taken off. The orientation and consciousness improved significantly in a week of treatment. Arpisa rasayana, Jaymangal rasa, vara, and raktapachaka medicines were continued for the next two weeks, till the complete recovery of the patient. Significant clinical improvement in neurological functions was observed in this patient. The patient recovered completely and he is well to date.<br />
<br />
===Case 4 ===<br />
<br />
During May and June 2021, the author treated more than 30 ICU patients of COVID 19. Here, Ayurvedic treatment was given as adjuvant treatment, along with the ongoing ICU treatment. It was observed that with adjuvant Ayurvedic treatment, the patients had better and quicker improvement and better survival chances.<br />
<br />
A 72 years male patient with h/o DM, HTN, IHD, PTCA was COVID +_ve, admitted in the hospital with HRCT score 17/25, CORAD scores 6, and SPO2 84. He was suffering from high fever, breathing difficulty, and severe debility. Since expected improvement was not observed even after 9 days of conventional treatment, Ayurvedic treatment was started as an adjuvant. Sootashekhara with Vasa, Haridra, Kantakari, Saptaparnadi thrice a day was prescribed. Triphala with Arogyavardhini and Rasapachaka were given in between meals. Jayamangal Rasa with Rasaka was given two times in the morning and evening. Fever subsided within 2 days. After which, mahalakshmivilasa was added. He started maintaining O2 levels and the mask was removed within 6 days. He recovered completely.<br />
<br />
There is a wide scope of research on the role of Ayurveda medicines in the treatment of critical and medical emergency conditions. It can be helpful to provide a safe, cost-effective, and better solution to extend life with a higher survival chance.<br />
<br />
== Related chapters == <br />
<br />
[[Trimarmiya Chikitsa Adhyaya]], [[Vatavyadhi Chikitsa Adhyaya]], [[Trimarmiya Siddhi Adhyaya]]<br />
<br />
<big>'''Link to video lecture: https://fb.watch/8l9mKsmLtT/'''</big> <br />
<br />
<big>'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''</big><br />
<br />
==References==<br />
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[[#top| Back to the Top ]]</span></div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=MediaWiki:Common.css&diff=45395MediaWiki:Common.css2025-12-30T16:12:33Z<p>Agnivesha: </p>
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/* Cell sizes for ambox/tmbox/imbox/cmbox/ombox/fmbox/dmbox message boxes */<br />
th.mbox-text, td.mbox-text { /* The message body cell(s) */<br />
border: none;<br />
/* @noflip */<br />
padding: 0.25em 0.9em; /* 0.9em left/right */<br />
width: 100%; /* Make all mboxes the same width regardless of text length */<br />
}<br />
td.mbox-image { /* The left image cell */<br />
border: none;<br />
/* @noflip */<br />
padding: 2px 0 2px 0.9em; /* 0.9em left, 0px right */<br />
text-align: center;<br />
}<br />
td.mbox-imageright { /* The right image cell */<br />
border: none;<br />
/* @noflip */<br />
padding: 2px 0.9em 2px 0; /* 0px left, 0.9em right */<br />
text-align: center;<br />
}<br />
td.mbox-empty-cell { /* An empty narrow cell */<br />
border: none;<br />
padding: 0;<br />
width: 1px;<br />
}<br />
<br />
/* Article message box styles */<br />
table.ambox {<br />
margin: 0 10%; /* 10% = Will not overlap with other elements */<br />
border: 1px solid #a2a9b1;<br />
/* @noflip */<br />
border-left: 10px solid #36c; /* Default "notice" blue */<br />
background: #fbfbfb;<br />
}<br />
table.ambox + table.ambox { /* Single border between stacked boxes. */<br />
margin-top: -1px;<br />
}<br />
.ambox th.mbox-text,<br />
.ambox td.mbox-text { /* The message body cell(s) */<br />
padding: 0.25em 0.5em; /* 0.5em left/right */<br />
}<br />
.ambox td.mbox-image { /* The left image cell */<br />
/* @noflip */<br />
padding: 2px 0 2px 0.5em; /* 0.5em left, 0px right */<br />
}<br />
.ambox td.mbox-imageright { /* The right image cell */<br />
/* @noflip */<br />
padding: 2px 0.5em 2px 0; /* 0px left, 0.5em right */<br />
}<br />
<br />
table.ambox-notice {<br />
/* @noflip */<br />
border-left: 10px solid #36c; /* Blue */<br />
}<br />
table.ambox-speedy {<br />
/* @noflip */<br />
border-left: 10px solid #b32424; /* Red */<br />
background: #fee7e6; /* Pink */<br />
}<br />
table.ambox-delete {<br />
/* @noflip */<br />
border-left: 10px solid #b32424; /* Red */<br />
}<br />
table.ambox-content {<br />
/* @noflip */<br />
border-left: 10px solid #f28500; /* Orange */<br />
}<br />
table.ambox-style {<br />
/* @noflip */<br />
border-left: 10px solid #fc3; /* Yellow */<br />
}<br />
table.ambox-move {<br />
/* @noflip */<br />
border-left: 10px solid #9932cc; /* Purple */<br />
}<br />
table.ambox-protection {<br />
/* @noflip */<br />
border-left: 10px solid #a2a9b1; /* Gray-gold */<br />
}<br />
<br />
/* Image message box styles */<br />
table.imbox {<br />
margin: 4px 10%;<br />
border-collapse: collapse;<br />
border: 3px solid #36c; /* Default "notice" blue */<br />
background: #fbfbfb;<br />
}<br />
.imbox .mbox-text .imbox { /* For imboxes inside imbox-text cells. */<br />
margin: 0 -0.5em; /* 0.9 - 0.5 = 0.4em left/right. */<br />
display: block; /* Fix for webkit to force 100% width. */<br />
}<br />
.mbox-inside .imbox { /* For imboxes inside other templates. */<br />
margin: 4px;<br />
}<br />
<br />
table.imbox-notice {<br />
border: 3px solid #36c; /* Blue */<br />
}<br />
table.imbox-speedy {<br />
border: 3px solid #b32424; /* Red */<br />
background: #fee7e6; /* Pink */<br />
}<br />
table.imbox-delete {<br />
border: 3px solid #b32424; /* Red */<br />
}<br />
table.imbox-content {<br />
border: 3px solid #f28500; /* Orange */<br />
}<br />
table.imbox-style {<br />
border: 3px solid #fc3; /* Yellow */<br />
}<br />
table.imbox-move {<br />
border: 3px solid #9932cc; /* Purple */<br />
}<br />
table.imbox-protection {<br />
border: 3px solid #a2a9b1; /* Gray-gold */<br />
}<br />
table.imbox-license {<br />
border: 3px solid #88a; /* Dark gray */<br />
background: #f7f8ff; /* Light gray */<br />
}<br />
table.imbox-featured {<br />
border: 3px solid #cba135; /* Brown-gold */<br />
}<br />
<br />
/* Category message box styles */<br />
table.cmbox {<br />
margin: 3px 10%;<br />
border-collapse: collapse;<br />
border: 1px solid #a2a9b1;<br />
background: #DFE8FF; /* Default "notice" blue */<br />
}<br />
<br />
table.cmbox-notice {<br />
background: #D8E8FF; /* Blue */<br />
}<br />
table.cmbox-speedy {<br />
margin-top: 4px;<br />
margin-bottom: 4px;<br />
border: 4px solid #b32424; /* Red */<br />
background: #FFDBDB; /* Pink */<br />
}<br />
table.cmbox-delete {<br />
background: #FFDBDB; /* Red */<br />
}<br />
table.cmbox-content {<br />
background: #FFE7CE; /* Orange */<br />
}<br />
table.cmbox-style {<br />
background: #FFF9DB; /* Yellow */<br />
}<br />
table.cmbox-move {<br />
background: #E4D8FF; /* Purple */<br />
}<br />
table.cmbox-protection {<br />
background: #EFEFE1; /* Gray-gold */<br />
}<br />
<br />
/* Other pages message box styles */<br />
table.ombox {<br />
margin: 4px 10%;<br />
border-collapse: collapse;<br />
border: 1px solid #a2a9b1; /* Default "notice" gray */<br />
background: #f8f9fa;<br />
}<br />
<br />
table.ombox-notice {<br />
border: 1px solid #a2a9b1; /* Gray */<br />
}<br />
table.ombox-speedy {<br />
border: 2px solid #b32424; /* Red */<br />
background: #fee7e6; /* Pink */<br />
}<br />
table.ombox-delete {<br />
border: 2px solid #b32424; /* Red */<br />
}<br />
table.ombox-content {<br />
border: 1px solid #f28500; /* Orange */<br />
}<br />
table.ombox-style {<br />
border: 1px solid #fc3; /* Yellow */<br />
}<br />
table.ombox-move {<br />
border: 1px solid #9932cc; /* Purple */<br />
}<br />
table.ombox-protection {<br />
border: 2px solid #a2a9b1; /* Gray-gold */<br />
}<br />
<br />
/* Talk page message box styles */<br />
table.tmbox {<br />
margin: 4px 10%;<br />
border-collapse: collapse;<br />
border: 1px solid #c0c090; /* Default "notice" gray-brown */<br />
background: #f8eaba;<br />
}<br />
.mediawiki .mbox-inside .tmbox { /* For tmboxes inside other templates. The "mediawiki" class ensures that */<br />
margin: 2px 0; /* this declaration overrides other styles (including mbox-small above) */<br />
width: 100%; /* For Safari and Opera */<br />
}<br />
.mbox-inside .tmbox.mbox-small { /* "small" tmboxes should not be small when */<br />
line-height: 1.5em; /* also "nested", so reset styles that are */<br />
font-size: 100%; /* set in "mbox-small" above. */<br />
}<br />
<br />
table.tmbox-speedy {<br />
border: 2px solid #b32424; /* Red */<br />
background: #fee7e6; /* Pink */<br />
}<br />
table.tmbox-delete {<br />
border: 2px solid #b32424; /* Red */<br />
}<br />
table.tmbox-content {<br />
border: 2px solid #f28500; /* Orange */<br />
}<br />
table.tmbox-style {<br />
border: 2px solid #fc3; /* Yellow */<br />
}<br />
table.tmbox-move {<br />
border: 2px solid #9932cc; /* Purple */<br />
}<br />
table.tmbox-protection,<br />
table.tmbox-notice {<br />
border: 1px solid #c0c090; /* Gray-brown */<br />
}<br />
<br />
/* Disambig and set index box styles */<br />
table.dmbox {<br />
clear: both;<br />
margin: 0.9em 1em;<br />
border-top: 1px solid #ccc;<br />
border-bottom: 1px solid #ccc;<br />
background: transparent;<br />
}<br />
<br />
/* Footer and header message box styles */<br />
table.fmbox {<br />
clear: both;<br />
margin: 0.2em 0;<br />
width: 100%;<br />
border: 1px solid #a2a9b1;<br />
background: #f8f9fa; /* Default "system" gray */<br />
}<br />
table.fmbox-system {<br />
background: #f8f9fa;<br />
}<br />
table.fmbox-warning {<br />
border: 1px solid #bb7070; /* Dark pink */<br />
background: #ffdbdb; /* Pink */<br />
}<br />
table.fmbox-editnotice {<br />
background: transparent;<br />
}<br />
/* Div based "warning" style fmbox messages. */<br />
div.mw-warning-with-logexcerpt,<br />
div.mw-lag-warn-high,<br />
div.mw-cascadeprotectedwarning,<br />
div#mw-protect-cascadeon,<br />
div.titleblacklist-warning,<br />
div.locked-warning {<br />
clear: both;<br />
margin: 0.2em 0;<br />
border: 1px solid #bb7070;<br />
background: #ffdbdb;<br />
padding: 0.25em 0.9em;<br />
}<br />
/* Div based "system" style fmbox messages.<br />
Used in [[MediaWiki:Readonly lag]]. */<br />
div.mw-lag-warn-normal,<br />
div.fmbox-system {<br />
clear: both;<br />
margin: 0.2em 0;<br />
border: 1px solid #a2a9b1;<br />
background: #f8f9fa;<br />
padding: 0.25em 0.9em;<br />
}<br />
<br />
/* These mbox-small classes must be placed after all other<br />
ambox/tmbox/ombox etc classes. "html body.mediawiki" is so<br />
they override "table.ambox + table.ambox" above. */<br />
html body.mediawiki .mbox-small { /* For the "small=yes" option. */<br />
/* @noflip */<br />
clear: right;<br />
/* @noflip */<br />
float: right;<br />
/* @noflip */<br />
margin: 4px 0 4px 1em;<br />
box-sizing: border-box;<br />
width: 238px;<br />
font-size: 88%;<br />
line-height: 1.25em;<br />
}<br />
html body.mediawiki .mbox-small-left { /* For the "small=left" option. */<br />
/* @noflip */<br />
margin: 4px 1em 4px 0;<br />
box-sizing: border-box;<br />
overflow: hidden;<br />
width: 238px;<br />
border-collapse: collapse;<br />
font-size: 88%;<br />
line-height: 1.25em;<br />
}<br />
<br />
/* Style for compact ambox */<br />
/* Hide the images */<br />
.compact-ambox table .mbox-image,<br />
.compact-ambox table .mbox-imageright,<br />
.compact-ambox table .mbox-empty-cell {<br />
display: none;<br />
}<br />
/* Remove borders, backgrounds, padding, etc. */<br />
.compact-ambox table.ambox {<br />
border: none;<br />
border-collapse: collapse;<br />
background: transparent;<br />
margin: 0 0 0 1.6em !important;<br />
padding: 0 !important;<br />
width: auto;<br />
display: block;<br />
}<br />
body.mediawiki .compact-ambox table.mbox-small-left {<br />
font-size: 100%;<br />
width: auto;<br />
margin: 0;<br />
}<br />
/* Style the text cell as a list item and remove its padding */<br />
.compact-ambox table .mbox-text {<br />
padding: 0 !important;<br />
margin: 0 !important;<br />
}<br />
.compact-ambox table .mbox-text-span {<br />
display: list-item;<br />
line-height: 1.5em;<br />
list-style-type: square;<br />
list-style-image: url(/w/skins/MonoBook/bullet.gif);<br />
}<br />
.skin-vector .compact-ambox table .mbox-text-span {<br />
list-style-type: disc;<br />
list-style-image: url(/w/skins/Vector/images/bullet-icon.svg);<br />
list-style-image: url(/w/skins/Vector/images/bullet-icon.png)\9;<br />
}<br />
/* Allow for hiding text in compact form */<br />
.compact-ambox .hide-when-compact {<br />
display: none;<br />
}<br />
<br />
/* Remove default styles for [[MediaWiki:Noarticletext]]. */<br />
div.noarticletext {<br />
border: none;<br />
background: transparent;<br />
padding: 0;<br />
}<br />
<br />
/* Hide (formatting) elements from screen, but not from screenreaders */<br />
.visualhide {<br />
position: absolute;<br />
left: -10000px;<br />
top: auto;<br />
width: 1px;<br />
height: 1px;<br />
overflow: hidden;<br />
}<br />
<br />
/* Bold save button */<br />
#wpSave {<br />
font-weight: bold;<br />
}<br />
<br />
/* class hiddenStructure is defunct. See [[Wikipedia:hiddenStructure]] */<br />
.hiddenStructure {<br />
display: inline !important;<br />
color: #f00;<br />
background-color: #0f0;<br />
}<br />
<br />
/* suppress missing interwiki image links where #ifexist cannot<br />
be used due to high number of requests see .hidden-redlink on<br />
[[m:MediaWiki:Common.css]] */<br />
.check-icon a.new {<br />
display: none;<br />
speak: none;<br />
}<br />
<br />
/* Removes underlines from certain links */<br />
.nounderlines a,<br />
.IPA a:link, .IPA a:visited {<br />
text-decoration: none !important;<br />
}<br />
<br />
/* Standard Navigationsleisten, aka box hiding thingy<br />
from .de. Documentation at [[Wikipedia:NavFrame]]. */<br />
div.NavFrame {<br />
margin: 0;<br />
padding: 4px;<br />
border: 1px solid #a2a9b1;<br />
text-align: center;<br />
border-collapse: collapse;<br />
font-size: 95%;<br />
}<br />
div.NavFrame + div.NavFrame {<br />
border-top-style: none;<br />
border-top-style: hidden;<br />
}<br />
div.NavPic {<br />
background-color: #fff;<br />
margin: 0;<br />
padding: 2px;<br />
/* @noflip */<br />
float: left;<br />
}<br />
div.NavFrame div.NavHead {<br />
line-height: 1.6em;<br />
font-weight: bold;<br />
background-color: #ccf;<br />
position: relative;<br />
}<br />
div.NavFrame p,<br />
div.NavFrame div.NavContent,<br />
div.NavFrame div.NavContent p {<br />
font-size: 100%;<br />
}<br />
div.NavEnd {<br />
margin: 0;<br />
padding: 0;<br />
line-height: 1px;<br />
clear: both;<br />
}<br />
a.NavToggle {<br />
position: absolute;<br />
top: 0;<br />
/* @noflip */<br />
right: 3px;<br />
font-weight: normal;<br />
font-size: 90%;<br />
}<br />
<br />
/* Hatnotes and disambiguation notices */<br />
.hatnote {<br />
font-style: italic;<br />
}<br />
.hatnote i {<br />
font-style: normal;<br />
}<br />
div.hatnote {<br />
/* @noflip */<br />
padding-left: 1.6em;<br />
margin-bottom: 0.5em;<br />
}<br />
div.hatnote + div.hatnote {<br />
margin-top: -0.5em;<br />
}<br />
<br />
/* Allow transcluded pages to display in lists rather than a table. */<br />
.listify td { display: list-item; }<br />
.listify tr { display: block; }<br />
.listify table { display: block; }<br />
<br />
/* Geographical coordinates defaults. See [[Template:Coord/link]]<br />
for how these are used. The classes "geo", "longitude", and<br />
"latitude" are used by the [[Geo microformat]]. */<br />
.geo-default, .geo-dms, .geo-dec { display: inline; }<br />
.geo-nondefault, .geo-multi-punct { display: none; }<br />
.longitude, .latitude { white-space: nowrap; }<br />
<br />
/* Temporary(!) fix for horizontal TOC in Blink (Chrone/Opera) */<br />
.hlist .tocnumber,<br />
.hlist .toctext {<br />
display: inline;<br />
}<br />
/* When <div class="nonumtoc"> is used on the table of contents,<br />
the ToC will display without numbers */<br />
.nonumtoc .tocnumber {<br />
display: none;<br />
}<br />
.nonumtoc #toc ul,<br />
.nonumtoc .toc ul {<br />
line-height: 1.5em;<br />
list-style: none none;<br />
margin: .3em 0 0;<br />
padding: 0;<br />
}<br />
.hlist.nonumtoc #toc ul ul,<br />
.hlist.nonumtoc .toc ul ul {<br />
/* @noflip */<br />
margin: 0;<br />
}<br />
<br />
/* Allow limiting of which header levels are shown in a TOC;<br />
<div class="toclimit-3">, for instance, will limit to<br />
showing ==headings== and ===headings=== but no further<br />
(as long as there are no =headings= on the page, which<br />
there shouldn't be according to the MoS). */<br />
.toclimit-2 .toclevel-1 ul,<br />
.toclimit-3 .toclevel-2 ul,<br />
.toclimit-4 .toclevel-3 ul,<br />
.toclimit-5 .toclevel-4 ul,<br />
.toclimit-6 .toclevel-5 ul,<br />
.toclimit-7 .toclevel-6 ul {<br />
display: none;<br />
}<br />
<br />
/* Styling for Template:Quote */<br />
blockquote.templatequote div.templatequotecite {<br />
line-height: 1.5em;<br />
/* @noflip */<br />
text-align: left;<br />
/* @noflip */<br />
padding-left: 1.6em;<br />
margin-top: 0;<br />
}<br />
<br />
/* User block messages */<br />
div.user-block {<br />
padding: 5px;<br />
margin-bottom: 0.5em;<br />
border: 1px solid #A9A9A9;<br />
background-color: #FFEFD5;<br />
}<br />
<br />
/* Prevent line breaks in silly places:<br />
1) Where desired<br />
2) Links when we don't want them to<br />
3) Bold "links" to the page itself<br />
4) Ref tags with group names <ref group="Note"> --> "[Note 1]" */<br />
.nowrap,<br />
.nowraplinks a,<br />
.nowraplinks .selflink,<br />
sup.reference a {<br />
white-space: nowrap;<br />
}<br />
.nowrap pre {<br />
white-space: pre;<br />
}<br />
/* But allow wrapping where desired: */<br />
.wrap,<br />
.wraplinks a {<br />
white-space: normal;<br />
}<br />
<br />
/* For template documentation */<br />
.template-documentation {<br />
clear: both;<br />
margin: 1em 0 0 0;<br />
border: 1px solid #a2a9b1;<br />
background-color: #ecfcf4;<br />
padding: 1em;<br />
}<br />
<br />
/* Increase the height of the image upload box */<br />
#wpUploadDescription {<br />
height: 13em;<br />
}<br />
<br />
/* Minimum thumb width */<br />
.thumbinner {<br />
min-width: 100px;<br />
}<br />
<br />
/* The backgrounds for galleries. */<br />
div#content .gallerybox div.thumb {<br />
/* Light gray padding */<br />
background-color: #f8f9fa;<br />
}<br />
/* Put a chequered background behind images, only visible if they have transparency.<br />
'.filehistory a img' and '#file img:hover' are handled by MediaWiki core (as of 1.19) */<br />
.gallerybox .thumb img {<br />
background: #fff url(//upload.wikimedia.org/wikipedia/commons/5/5d/Checker-16x16.png) repeat;<br />
}<br />
/* But not on articles, user pages, portals or with opt-out. */<br />
.ns-0 .gallerybox .thumb img,<br />
.ns-2 .gallerybox .thumb img,<br />
.ns-100 .gallerybox .thumb img,<br />
.nochecker .gallerybox .thumb img {<br />
background: #fff;<br />
}<br />
<br />
/* Prevent floating boxes from overlapping any category listings,<br />
file histories, edit previews, and edit [Show changes] views. */<br />
#mw-subcategories, #mw-pages, #mw-category-media,<br />
#filehistory, #wikiPreview, #wikiDiff {<br />
clear: both;<br />
}<br />
<br />
body.rtl #mw-articlefeedbackv5, body.rtl #mw-articlefeedback {<br />
display: block; /* Override inline block mode */<br />
margin-bottom: 1em;<br />
/* @noflip */<br />
clear: right; /* Clear any info boxes that stick out */<br />
/* @noflip */<br />
float: right; /* Prevents margin collapsing */<br />
}<br />
<br />
/* Selectively hide headers in WikiProject banners */<br />
.wpb .wpb-header { display: none; }<br />
.wpbs-inner .wpb .wpb-header { display: block; } /* for IE */<br />
.wpbs-inner .wpb .wpb-header { display: table-row; } /* for real browsers */<br />
.wpbs-inner .wpb-outside { display: none; } /* hide things that should only display outside shells */<br />
<br />
/* Styling for Abuse Filter tags */<br />
.mw-tag-markers {<br />
font-style:italic;<br />
font-size:90%;<br />
}<br />
<br />
/* Hide stuff meant for accounts with special permissions. Made visible again in<br />
[[MediaWiki:Group-sysop.css]], [[MediaWiki:Group-accountcreator.css]],<br />
[[MediaWiki:Group-templateeditor.css]], [[MediaWiki:Group-extendedmover.css]] and [[Mediawiki:Group-autoconfirmed.css]]. */<br />
.sysop-show,<br />
.accountcreator-show,<br />
.templateeditor-show,<br />
.extendedmover-show,<br />
.autoconfirmed-show,<br />
.user-show {<br />
display: none;<br />
}<br />
<br />
/**<br />
* Hide the redlink generated by {{Editnotice}},<br />
* this overrides the ".sysop-show { display: none; }" above that applies<br />
* to the same link as well. See [[phab:T45013]]<br />
*<br />
* Hide the images in editnotices to keep them readable in VE view.<br />
* Long term, editnotices should become a core feature so that they can be designed responsive.<br />
*/<br />
.ve-ui-mwNoticesPopupTool-item .editnotice-redlink,<br />
.ve-ui-mwNoticesPopupTool-item .mbox-image,<br />
.ve-ui-mwNoticesPopupTool-item .mbox-imageright {<br />
display: none !important;<br />
}<br />
<br />
/* Remove bullets when there are multiple edit page warnings */<br />
ul.permissions-errors > li {<br />
list-style: none none;<br />
}<br />
ul.permissions-errors {<br />
margin: 0;<br />
}<br />
<br />
/* No linewrap on the labels of the login/signup page */<br />
body.page-Special_UserLogin .mw-label label,<br />
body.page-Special_UserLogin_signup .mw-label label {<br />
white-space: nowrap;<br />
}<br />
<br />
/* Pie chart: transparent borders */<br />
.transborder {<br />
border: solid transparent;<br />
}<br />
<br />
/* Generic class for Times-based serif, texhtml class for inline math */<br />
.times-serif,<br />
span.texhtml {<br />
font-family: "Nimbus Roman No9 L", "Times New Roman", Times, serif;<br />
font-size: 118%;<br />
line-height: 1;<br />
}<br />
span.texhtml {<br />
white-space: nowrap;<br />
}<br />
span.texhtml span.texhtml {<br />
font-size: 100%;<br />
}<br />
span.mwe-math-mathml-inline {<br />
font-size: 118%;<br />
}<br />
<br />
/* Force tabular and lining display for digits and texhtml */<br />
.digits,<br />
.texhtml {<br />
-moz-font-feature-settings: "lnum", "tnum", "kern" 0;<br />
-webkit-font-feature-settings: "lnum", "tnum", "kern" 0;<br />
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width: 98%;<br />
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On wide screens, show these as two columns<br />
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/* Decouple the columns on narrow screens */<br />
.portal-column-left,<br />
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.portal-column-left-extra-wide,<br />
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float: inherit;<br />
width: inherit;<br />
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}<br />
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background-image:url('//upload.wikimedia.org/wikipedia/commons/e/e0/Tan-page-corner.png');<br />
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padding: 2em;<br />
background-color: #faf9f2;<br />
}<br />
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padding: 0;<br />
margin: 0;<br />
}<br />
.treeview li {<br />
padding: 0;<br />
margin: 0;<br />
list-style-type: none;<br />
list-style-image: none;<br />
}<br />
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background: url("//upload.wikimedia.org/wikipedia/commons/f/f2/Treeview-grey-line.png") no-repeat 0 -2981px;<br />
/* @noflip */<br />
padding-left: 20px;<br />
text-indent: 0.3em;<br />
}<br />
.treeview li li.lastline {<br />
background-position: 0 -5971px<br />
}<br />
.treeview li.emptyline > ul {<br />
/* @noflip */<br />
margin-left: -1px;<br />
}<br />
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background-position: 0 9px<br />
}<br />
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th .sortkey {<br />
display: none;<br />
speak: none;<br />
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.inputbox-hidecheckboxes form .inputbox-element,<br />
.inputbox-hidecheckboxes .mw-ui-checkbox {<br />
display: none !important;<br />
}<br />
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/* Work-around for [[Phabricator:25965]] (Kaltura advertisement) */<br />
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visibility: hidden;<br />
}<br />
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/* Move 'play' button of video player to bottom left corner */<br />
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margin: 0;<br />
top: auto;<br />
right: auto;<br />
bottom: 0;<br />
left: 0;<br />
}<br />
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/* Hide FlaggedRevs notice UI when there are no pending changes */<br />
.flaggedrevs_draft_synced,<br />
.flaggedrevs_stable_synced {<br />
display: none;<br />
}<br />
/* Social Links styling */<br />
.social-links-portlet {<br />
margin-top: 20px;<br />
border-top: 1px solid #eee;<br />
padding-top: 10px;<br />
}<br />
<br />
.social-links-portlet h3 {<br />
font-size: 14px;<br />
color: #333;<br />
margin-bottom: 10px;<br />
text-align: center;<br />
}<br />
<br />
.social-links-portlet .body {<br />
padding: 5px;<br />
text-align: center;<br />
}<br />
<br />
.social-links-portlet .fb-like,<br />
.social-links-portlet .g-ytsubscribe,<br />
.social-links-portlet .twitter-follow-button {<br />
margin: 10px auto;<br />
display: inline-block;<br />
}</div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=MediaWiki:Citethispage-content&diff=45394MediaWiki:Citethispage-content2025-11-27T14:00:52Z<p>Agnivesha: </p>
<hr />
<div>__NOTOC__<br />
<div class="mw-specialCiteThisPage-bibliographic"><br />
<br />
== Bibliographic details for {{FULLPAGENAME}} ==<br />
*{{#switch: {{FULLPAGENAME}}<br />
| Charak Samhita New Edition = Names of the authors of the chapter<br />
| Sutra Sthana = Names of the authors of the chapter<br />
| Nidana Sthana = Names of the authors of the chapter<br />
| Vimana Sthana = Names of the authors of the chapter<br />
| Sharira Sthana = Names of the authors of the chapter<br />
| Indriya Sthana = Names of the authors of the chapter<br />
| Chikitsa Sthana = Names of the authors of the chapter<br />
| Kalpa Sthana = Names of the authors of the chapter<br />
| Siddhi Sthana = Names of the authors of the chapter<br />
| Names of the authors of the chapter (Translator and commentator)<br />
}} : {{TranslatorSurnameFirst}}<br />
<br />
* Name of Adhyaya (Chapter) : {{AdhyayaName}}<br />
* Name of Samhita (Treatise) : Charak Samhita New Edition<br />
* Name of the Editor : {{EditorSurnameFirst}}<br />
* Sthana (Section) : {{SthanaName}}<br />
<br />
* Link to the chapter: {{canonicalurl:{{FULLPAGENAME}}}}<br />
* Publisher name : Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)<br />
* City of publication : Jamnagar, India<br />
* Year of publication : 2020<br />
* Edition no. : 01<br />
* Date of last revision: {{CURRENTDAY}} {{CURRENTMONTHNAME}} {{CURRENTYEAR}} {{CURRENTTIME}} UTC<br />
* Date retrieved: <citation>{{CURRENTDAY}} {{CURRENTMONTHNAME}} {{CURRENTYEAR}} {{CURRENTTIME}} UTC</citation><br />
* Page Version ID: {{PAGEID}}<br />
* DOI : {{DoiWithLink}}<br />
<br />
</div><br />
<div class="plainlinks mw-specialCiteThisPage-styles"><br />
<br />
== Citation styles for {{FULLPAGENAME}} ==<br />
<br />
=== [[AMA|AMA style]] ===<br />
{{TranslatorSurnameFirst}}. {{AdhyayaName}}. In: {{EditorSurnameFirst}}, eds. Charak Samhita New Edition. 1<sup>st</sup> ed. Jamnagar, Ind: CSRTSDC; 2020. {{canonicalurl:{{FULLPAGENAME}}}}. Accessed <citation>{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}</citation>.<br />
<br />
=== [[APA style]] ===<br />
{{TranslatorSurnameFirst}}. ({{DateOfPublication}}). {{AdhyayaName}}. In: {{EditorSurnameFirst}}, (Eds.), Charak Samhita New Edition (1<sup>st</sup> ed. pp.{{PageNo}}). CSRTSDC. {{DoiLink}}<br />
<br />
=== [[The MLA style manual|MLA style]] ===<br />
{{TranslatorSurnameFirst}}. "{{AdhyayaName}}". Charak Samhita New Edition, edited by {{EditorSurnameFirst}}, eds., 1<sup>st</sup> edition, CSRTSDC, {{DateOfPublication}}, pp. {{PageNo}}, Doi:{{DoiWithLink}}<br />
<br />
=== [[MHRA Style Guide|MHRA style]] ===<br />
{{TranslatorSurnameFirst}}, {{AdhyayaName}}, In Charak Samhita New Edition, ed.by {{EditorSurnameFirst}}, 1<sup>st</sup> edition (Ind:Jamnagar,2020), pp.{{PageNo}}. CSRTSDC ebook Doi:{{DoiWithLink}}<br />
<br />
=== [[The Chicago Manual of Style|Chicago style]] ===<br />
{{TranslatorNameFirst}}, "{{AdhyayaName}}" in Charak Samhita New Edition, ed.by {{EditorNameFirst}}, page {{PageNo}}, (Jamnagar:CSRTSDC,2020), {{canonicalurl:{{FULLPAGENAME}}}} (accessed <citation>{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}</citation>).<br />
<br />
=== [[Council of Science Editors|CBE/CSE style]] ===<br />
{{TranslatorSurnameFirst}}. ({{DateOfPublication}}) {{AdhyayaName}}. In: {{EditorSurnameFirst}}, editor(s). Charak Samhita New Edition.Jamnagar:CSRTSDC; [accessed <citation>{{CURRENTYEAR}} {{CURRENTMONTHNAME}} {{CURRENTDAY}}</citation>]. Doi:{{DoiWithLink}}<br />
<br />
=== [[Bluebook|Bluebook style]] ===<br />
{{AdhyayaName}}, in Charak Samhita New Edition ({{TranslatorSurnameFirst}}, 2020), {{canonicalurl:{{FULLPAGENAME}}}} (last visited <citation>{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}</citation>).<br />
<br />
=== [[BibTeX]] entry ===<br />
<br />
@book{{{#explode:{{TranslatorSurnameFirst}}| |0}}{{PAGEID}},<br />
title = <nowiki>{</nowiki>{{FULLPAGENAME}}<nowiki>}</nowiki> --- {Charak Samhita New Edition},<br />
author = <nowiki>{</nowiki>{{TranslatorSurnameFirst}}<nowiki>}</nowiki>,<br />
editor = <nowiki>{</nowiki>{{EditorSurnameFirst}}<nowiki>}</nowiki>,<br />
year = <nowiki>{</nowiki>{{DateOfPublication}}<nowiki>}</nowiki>,<br />
pages = <nowiki>{</nowiki>{{PageNo}}-{{PageNo}}<nowiki>}</nowiki>,<br />
publisher = {Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)},<br />
url = "{{canonicalurl:{{FULLPAGENAME}}}}",<br />
doi = <nowiki>{</nowiki>{{DoiWithLink}}<nowiki>}</nowiki>,<br />
note = "[Online; accessed <citation>{{CURRENTDAY}}-{{CURRENTMONTHNAME}}-{{CURRENTYEAR}}</citation>]"<br />
}<br />
<br />
When using the [[LaTeX]] package url (<code>\usepackage{url}</code> somewhere in the preamble) which tends to give much more nicely formatted web addresses, the following may be preferred:<br />
<br />
@book{{{#explode:{{TranslatorSurnameFirst}}| |0}}{{PAGEID}},<br />
title = <nowiki>{</nowiki>{{FULLPAGENAME}}<nowiki>}</nowiki> --- {Charak Samhita New Edition},<br />
author = <nowiki>{</nowiki>{{TranslatorSurnameFirst}}<nowiki>}</nowiki>,<br />
editor = <nowiki>{</nowiki>{{EditorSurnameFirst}}<nowiki>}</nowiki>,<br />
year = <nowiki>{</nowiki>{{DateOfPublication}}<nowiki>}</nowiki>,<br />
pages = <nowiki>{</nowiki>{{PageNo}}-{{PageNo}}<nowiki>}</nowiki>,<br />
publisher = {Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)},<br />
url = "{{canonicalurl:{{FULLPAGENAME}}}}",<br />
doi = <nowiki>{</nowiki>{{DoiWithLink}}<nowiki>}</nowiki>,<br />
note = "[Online; accessed <citation>{{CURRENTDAY}}-{{CURRENTMONTHNAME}}-{{CURRENTYEAR}}</citation>]"<br />
}<br />
<br />
<br />
</div> <!--closing div for "plainlinks"--></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=MediaWiki:Citethispage-content&diff=45393MediaWiki:Citethispage-content2025-11-27T13:43:04Z<p>Agnivesha: </p>
<hr />
<div>__NOTOC__<br />
<div class="mw-specialCiteThisPage-bibliographic"><br />
<br />
== Bibliographic details for {{FULLPAGENAME}} ==<br />
*{{#switch: {{FULLPAGENAME}}<br />
| Charak Samhita New Edition = Names of the authors of the chapter<br />
| Sutra Sthana = Names of the authors of the chapter<br />
| Nidana Sthana = Names of the authors of the chapter<br />
| Vimana Sthana = Names of the authors of the chapter<br />
| Sharira Sthana = Names of the authors of the chapter<br />
| Indriya Sthana = Names of the authors of the chapter<br />
| Chikitsa Sthana = Names of the authors of the chapter<br />
| Kalpa Sthana = Names of the authors of the chapter<br />
| Siddhi Sthana = Names of the authors of the chapter<br />
| Names of the authors of the chapter (Translator and commentator)<br />
}} : {{TranslatorSurnameFirst}}<br />
<br />
* Name of Adhyaya (Chapter) : {{AdhyayaName}}<br />
* Name of Samhita (Treatise) : Charak Samhita New Edition<br />
* Name of the Editor : {{EditorSurnameFirst}}<br />
* Sthana (Section) : {{SthanaName}}<br />
<br />
* Link to the chapter: {{canonicalurl:{{FULLPAGENAME}}}}<br />
* Publisher name : Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)<br />
* City of publication : Jamnagar, India<br />
* Year of publication : 2020<br />
* Edition no. : 01<br />
* Date of last revision: {{CURRENTDAY}} {{CURRENTMONTHNAME}} {{CURRENTYEAR}} {{CURRENTTIME}} UTC<br />
* Date retrieved: <citation>{{CURRENTDAY}} {{CURRENTMONTHNAME}} {{CURRENTYEAR}} {{CURRENTTIME}} UTC</citation><br />
* Page Version ID: {{PAGEID}}<br />
* DOI : {{DoiWithLink}}<br />
<br />
</div><br />
<div class="plainlinks mw-specialCiteThisPage-styles"><br />
<br />
== Citation styles for {{FULLPAGENAME}} ==<br />
<br />
=== [[AMA|AMA style]] ===<br />
{{TranslatorSurnameFirst}}. {{AdhyayaName}}. In: {{EditorSurnameFirst}}, eds. Charak Samhita New Edition. 1<sup>st</sup> ed. Jamnagar, Ind: CSRTSDC; 2020. {{canonicalurl:{{FULLPAGENAME}}}}. Accessed <citation>{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}</citation>.<br />
<br />
=== [[APA style]] ===<br />
{{TranslatorSurnameFirst}}. ({{DateOfPublication}}). {{AdhyayaName}}. In: {{EditorSurnameFirst}}, (Eds.), Charak Samhita New Edition (1<sup>st</sup> ed. pp.{{PageNo}}). CSRTSDC. {{DoiLink}}<br />
<br />
=== [[The MLA style manual|MLA style]] ===<br />
{{TranslatorSurnameFirst}}. "{{AdhyayaName}}". Charak Samhita New Edition, edited by {{EditorSurnameFirst}}, eds., 1<sup>st</sup> edition, CSRTSDC, {{DateOfPublication}}, pp. {{PageNo}}, Doi:{{DoiWithLink}}<br />
<br />
=== [[MHRA Style Guide|MHRA style]] ===<br />
{{TranslatorSurnameFirst}}, {{AdhyayaName}}, In Charak Samhita New Edition, ed.by {{EditorSurnameFirst}}, 1<sup>st</sup> edition (Ind:Jamnagar,2020), pp.{{PageNo}}. CSRTSDC ebook Doi:{{DoiWithLink}}<br />
<br />
=== [[The Chicago Manual of Style|Chicago style]] ===<br />
{{TranslatorNameFirst}}, "{{AdhyayaName}}" in Charak Samhita New Edition, ed.by {{EditorNameFirst}}, page {{PageNo}}, (Jamnagar:CSRTSDC,2020), {{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}} (accessed <citation>{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}</citation>).<br />
<br />
=== [[Council of Science Editors|CBE/CSE style]] ===<br />
{{TranslatorSurnameFirst}}. ({{DateOfPublication}}) {{AdhyayaName}}. In: {{EditorSurnameFirst}}, editor(s). Charak Samhita New Edition.Jamnagar:CSRTSDC; [accessed <citation>{{CURRENTYEAR}} {{CURRENTMONTHNAME}} {{CURRENTDAY}}</citation>]. Doi:{{DoiWithLink}}<br />
<br />
=== [[Bluebook|Bluebook style]] ===<br />
{{AdhyayaName}}, in Charak Samhita New Edition ({{TranslatorSurnameFirst}}, 2020), {{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}} (last visited <citation>{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}</citation>).<br />
<br />
=== [[BibTeX]] entry ===<br />
<br />
@book{{{#explode:{{TranslatorSurnameFirst}}| |0}}{{PAGEID}},<br />
title = <nowiki>{</nowiki>{{FULLPAGENAME}}<nowiki>}</nowiki> --- {Charak Samhita New Edition},<br />
author = <nowiki>{</nowiki>{{TranslatorSurnameFirst}}<nowiki>}</nowiki>,<br />
editor = <nowiki>{</nowiki>{{EditorSurnameFirst}}<nowiki>}</nowiki>,<br />
year = <nowiki>{</nowiki>{{DateOfPublication}}<nowiki>}</nowiki>,<br />
pages = <nowiki>{</nowiki>{{PageNo}}-{{PageNo}}<nowiki>}</nowiki>,<br />
publisher = {Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)},<br />
url = "{{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}}",<br />
doi = <nowiki>{</nowiki>{{DoiWithLink}}<nowiki>}</nowiki>,<br />
note = "[Online; accessed <citation>{{CURRENTDAY}}-{{CURRENTMONTHNAME}}-{{CURRENTYEAR}}</citation>]"<br />
}<br />
<br />
When using the [[LaTeX]] package url (<code>\usepackage{url}</code> somewhere in the preamble) which tends to give much more nicely formatted web addresses, the following may be preferred:<br />
<br />
@book{{{#explode:{{TranslatorSurnameFirst}}| |0}}{{PAGEID}},<br />
title = <nowiki>{</nowiki>{{FULLPAGENAME}}<nowiki>}</nowiki> --- {Charak Samhita New Edition},<br />
author = <nowiki>{</nowiki>{{TranslatorSurnameFirst}}<nowiki>}</nowiki>,<br />
editor = <nowiki>{</nowiki>{{EditorSurnameFirst}}<nowiki>}</nowiki>,<br />
year = <nowiki>{</nowiki>{{DateOfPublication}}<nowiki>}</nowiki>,<br />
pages = <nowiki>{</nowiki>{{PageNo}}-{{PageNo}}<nowiki>}</nowiki>,<br />
publisher = {Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)},<br />
url = "{{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}}",<br />
doi = <nowiki>{</nowiki>{{DoiWithLink}}<nowiki>}</nowiki>,<br />
note = "[Online; accessed <citation>{{CURRENTDAY}}-{{CURRENTMONTHNAME}}-{{CURRENTYEAR}}</citation>]"<br />
}<br />
<br />
<br />
</div> <!--closing div for "plainlinks"--></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=MediaWiki:Citethispage-content&diff=45392MediaWiki:Citethispage-content2025-11-27T13:41:17Z<p>Agnivesha: </p>
<hr />
<div>__NOTOC__<br />
<div class="mw-specialCiteThisPage-bibliographic"><br />
<br />
== Bibliographic details for {{FULLPAGENAME}} ==<br />
*{{#switch: {{FULLPAGENAME}}<br />
| Charak Samhita New Edition = Names of the authors of the chapter<br />
| Sutra Sthana = Names of the authors of the chapter<br />
| Nidana Sthana = Names of the authors of the chapter<br />
| Vimana Sthana = Names of the authors of the chapter<br />
| Sharira Sthana = Names of the authors of the chapter<br />
| Indriya Sthana = Names of the authors of the chapter<br />
| Chikitsa Sthana = Names of the authors of the chapter<br />
| Kalpa Sthana = Names of the authors of the chapter<br />
| Siddhi Sthana = Names of the authors of the chapter<br />
| Names of the authors of the chapter (Translator and commentator)<br />
}} : {{TranslatorSurnameFirst}}<br />
<br />
* Name of Adhyaya (Chapter) : {{AdhyayaName}}<br />
* Name of Samhita (Treatise) : Charak Samhita New Edition<br />
* Name of the Editor : {{EditorSurnameFirst}}<br />
* Sthana (Section) : {{SthanaName}}<br />
<br />
* Link to the chapter: {{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}}<br />
* Publisher name : Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)<br />
* City of publication : Jamnagar, India<br />
* Year of publication : 2020<br />
* Edition no. : 01<br />
* Date of last revision: {{CURRENTDAY}} {{CURRENTMONTHNAME}} {{CURRENTYEAR}} {{CURRENTTIME}} UTC<br />
* Date retrieved: <citation>{{CURRENTDAY}} {{CURRENTMONTHNAME}} {{CURRENTYEAR}} {{CURRENTTIME}} UTC</citation><br />
* Page Version ID: {{PAGEID}}<br />
* DOI : {{DoiWithLink}}<br />
<br />
</div><br />
<div class="plainlinks mw-specialCiteThisPage-styles"><br />
<br />
== Citation styles for {{FULLPAGENAME}} ==<br />
<br />
=== [[AMA|AMA style]] ===<br />
{{TranslatorSurnameFirst}}. {{AdhyayaName}}. In: {{EditorSurnameFirst}}, eds. Charak Samhita New Edition. 1<sup>st</sup> ed. Jamnagar, Ind: CSRTSDC; 2020. {{canonicalurl:{{FULLPAGENAME}}}}. Accessed <citation>{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}</citation>.<br />
<br />
=== [[APA style]] ===<br />
{{TranslatorSurnameFirst}}. ({{DateOfPublication}}). {{AdhyayaName}}. In: {{EditorSurnameFirst}}, (Eds.), Charak Samhita New Edition (1<sup>st</sup> ed. pp.{{PageNo}}). CSRTSDC. {{DoiLink}}<br />
<br />
=== [[The MLA style manual|MLA style]] ===<br />
{{TranslatorSurnameFirst}}. "{{AdhyayaName}}". Charak Samhita New Edition, edited by {{EditorSurnameFirst}}, eds., 1<sup>st</sup> edition, CSRTSDC, {{DateOfPublication}}, pp. {{PageNo}}, Doi:{{DoiWithLink}}<br />
<br />
=== [[MHRA Style Guide|MHRA style]] ===<br />
{{TranslatorSurnameFirst}}, {{AdhyayaName}}, In Charak Samhita New Edition, ed.by {{EditorSurnameFirst}}, 1<sup>st</sup> edition (Ind:Jamnagar,2020), pp.{{PageNo}}. CSRTSDC ebook Doi:{{DoiWithLink}}<br />
<br />
=== [[The Chicago Manual of Style|Chicago style]] ===<br />
{{TranslatorNameFirst}}, "{{AdhyayaName}}" in Charak Samhita New Edition, ed.by {{EditorNameFirst}}, page {{PageNo}}, (Jamnagar:CSRTSDC,2020), {{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}} (accessed <citation>{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}</citation>).<br />
<br />
=== [[Council of Science Editors|CBE/CSE style]] ===<br />
{{TranslatorSurnameFirst}}. ({{DateOfPublication}}) {{AdhyayaName}}. In: {{EditorSurnameFirst}}, editor(s). Charak Samhita New Edition.Jamnagar:CSRTSDC; [accessed <citation>{{CURRENTYEAR}} {{CURRENTMONTHNAME}} {{CURRENTDAY}}</citation>]. Doi:{{DoiWithLink}}<br />
<br />
=== [[Bluebook|Bluebook style]] ===<br />
{{AdhyayaName}}, in Charak Samhita New Edition ({{TranslatorSurnameFirst}}, 2020), {{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}} (last visited <citation>{{CURRENTMONTHNAME}} {{CURRENTDAY}}, {{CURRENTYEAR}}</citation>).<br />
<br />
=== [[BibTeX]] entry ===<br />
<br />
@book{{{#explode:{{TranslatorSurnameFirst}}| |0}}{{PAGEID}},<br />
title = <nowiki>{</nowiki>{{FULLPAGENAME}}<nowiki>}</nowiki> --- {Charak Samhita New Edition},<br />
author = <nowiki>{</nowiki>{{TranslatorSurnameFirst}}<nowiki>}</nowiki>,<br />
editor = <nowiki>{</nowiki>{{EditorSurnameFirst}}<nowiki>}</nowiki>,<br />
year = <nowiki>{</nowiki>{{DateOfPublication}}<nowiki>}</nowiki>,<br />
pages = <nowiki>{</nowiki>{{PageNo}}-{{PageNo}}<nowiki>}</nowiki>,<br />
publisher = {Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)},<br />
url = "{{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}}",<br />
doi = <nowiki>{</nowiki>{{DoiWithLink}}<nowiki>}</nowiki>,<br />
note = "[Online; accessed <citation>{{CURRENTDAY}}-{{CURRENTMONTHNAME}}-{{CURRENTYEAR}}</citation>]"<br />
}<br />
<br />
When using the [[LaTeX]] package url (<code>\usepackage{url}</code> somewhere in the preamble) which tends to give much more nicely formatted web addresses, the following may be preferred:<br />
<br />
@book{{{#explode:{{TranslatorSurnameFirst}}| |0}}{{PAGEID}},<br />
title = <nowiki>{</nowiki>{{FULLPAGENAME}}<nowiki>}</nowiki> --- {Charak Samhita New Edition},<br />
author = <nowiki>{</nowiki>{{TranslatorSurnameFirst}}<nowiki>}</nowiki>,<br />
editor = <nowiki>{</nowiki>{{EditorSurnameFirst}}<nowiki>}</nowiki>,<br />
year = <nowiki>{</nowiki>{{DateOfPublication}}<nowiki>}</nowiki>,<br />
pages = <nowiki>{</nowiki>{{PageNo}}-{{PageNo}}<nowiki>}</nowiki>,<br />
publisher = {Charak Samhita Research, Training and Skill Development Centre (CSRTSDC)},<br />
url = "{{canonicalurl:{{FULLPAGENAME}}|oldid={{REVISIONID}}}}",<br />
doi = <nowiki>{</nowiki>{{DoiWithLink}}<nowiki>}</nowiki>,<br />
note = "[Online; accessed <citation>{{CURRENTDAY}}-{{CURRENTMONTHNAME}}-{{CURRENTYEAR}}</citation>]"<br />
}<br />
<br />
<br />
</div> <!--closing div for "plainlinks"--></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Trishna_Chikitsa&diff=45391Trishna Chikitsa2025-11-24T05:24:07Z<p>Agnivesha: </p>
<hr />
<div>{{CiteButton}}<br />
{{#seo:<br />
|title=Trishna Chikitsa<br />
|titlemode=append<br />
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|description=Chikitsa Sthana Chapter 22. Management of Trishna (Morbid thirst)<br />
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br />
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}}<br />
<big>''' [[Chikitsa Sthana]] Chapter 22. Management of Trishna (Morbid thirst) </big>''' <br />
{{Infobox<br />
|title = Trishna Chikitsa<br />
|label1 = Section/Chapter<br />
|data1 = [[Chikitsa Sthana]] Chapter 22<br />
|label2 = Preceding Chapter<br />
|data2 = [[Visarpa Chikitsa]]<br />
<br />
|label3= Succeeding Chapter<br />
|data3 = [[Visha Chikitsa]]<br />
|label5 = Other Sections<br />
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br />
|label6 = Translator and commentator<br />
|data6 = Sharma R.<br />
|label7 = Reviewer <br />
|data7 = Pande A.<br />
|label8 = Editors <br />
|data8 = Ojha S.N., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br />
|label9 = Year of publication <br />
|data9 = 2020<br />
|label10 = Publisher <br />
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label11 = DOI <br />
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.023 10.47468/CSNE.2020.e01.s06.023]<br />
<br />
|header3 = <br />
<br />
}}<br />
<br />
<big>''' Abstract </big>''' <br />
<p style="text-align:justify;">''Trishna'' and ''pipasa'' are two commonly used words denoting desire for water, the difference between the two is, ''trishna'' is pathological and ''pipasa'' is physiological. Generally, desire for water is physiological process to maintain fluid balance but if ''dosha'' are vitiated then they can lead to excessive thirst and can produce ''trishna'', a disease in which person constantly craves for the water. Beside independent disease, ''trishna'' or thirst is also seen as prodromal symptom, clinical feature, complication, poor prognostic sign etc. in various clinical conditions. In this chapter, etiological factors, premonitory symptoms, pathogenesis, clinical features and complications of trishna as a disease are discussed.<br />
</br><br />
'''Keywords''': trishna, [[vata]], [[pitta]], mukha shosha, jala, thirst, polydipsia, water and fluid balance, osmosis, ion balance.<br />
</p><br />
<br />
== Introduction ==<br />
<div style="text-align:justify;"><br />
‘Water is not necessary to life but rather life itself’ – This quotation describes importance of water in our life. Water is the most abundant constituent in the body, comprising approximately 50% of body weight in women and 60% in men.<ref> Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., editors. Harrison’s principles of internal medicine., Chapter 46, Fluid and Electrolyte Disturbances, Sodium and Water, 16th ed. New York: McGraw Hill; 2005.</ref> It is crucial for survival as it performs various functions. It transports nutrients to the tissues, removes metabolic waste products, detoxifies body elements, regulates body temperature, maintains pH, electrolyte balance etc. and homeostasis of body. In normal physiological process, certain amount of fluid is lost continuously. If this fluid balance is not maintained then, both acute and chronic fluid deficits may lead to number of adverse health outcomes. Even modest fluid deficits may precipitate adverse events, especially in young children, in the frail elderly and in those with poor health.<ref>Maughan RJ., Hydration, morbidity, and mortality in vulnerable populations, Nutr Rev. 2012 Nov;70 Suppl 2:S152-5.</ref> Fluid balance in body is maintained via thirst, a feedback-controlled variable, regulated acutely by central and peripheral mechanisms.<ref>Millard-Stafford M, Wendland DM, O'Dea NK, Norman TL, Thirst and hydration status in everyday life. Nutr Rev. 2012 Nov;70 Suppl 2:S147-51</ref> Thirst is physiological but when it exceeds its threshold it becomes pathological and is common in many diseases. Modern science accepts it as symptom only and have not given it as an entity of ‘disease’. [[Ayurveda]] is more comprehensive and broader in its approach. Fluid imbalance is a major cause of morbidity and mortality and considering this fact ‘thirst’ which is an indicator of fluid imbalance has been described as separate disease and not merely a symptom.<br />
<br />
The other meaning of ''trishna'' is greed or insatiable desire for something. It can be referred that word ''trishna'' not only denotes physical craving but includes psychological desires also. In morbid thirst both body and mind crave and there are conditions like psychogenic polydypsia in which thirst is only due to mental involvement. As mind plays an important role in thirst as a disease this chapter has been named as ''trishna chikitsitam'' (or [[Trishna Chikitsa]]) not ''pipasa chikitsitam''. <br />
<br />
''Trishna'' word in [[Ayurveda]] is interchangeably used for physiological as well as pathological thirst. Normally, [[vata]] and [[pitta]] are the two [[dosha]] inseparably involved in causing ''trishna'' as they have ''shoshana guna'' (property to absorb the water element) but the difference is [[vata]] absorbs the moisture by its dry property, whereas [[pitta]] does it by its hot property. Thirst is function of unvitiated [[pitta]] and clinically presents as ''mukha shosha'' (dry mouth) which occurs due to [[vata]]. So, it can be said that both [[dosha]] are inseparably involved in thirst production. When they are ‘unvitiated’, physiological thirst is produced and when ‘vitiated’ they can cause ''trishna''. Based on etiological factor and pathogenesis involved, ''trishna'' is classified into five types – [[vata]]ja, [[pitta]]ja, amaja, kshayaja and ''upasargaja''. These [[dosha]] absorb water from the saumya [[dhatu]] like [[rasa dhatu]], udaka and [[kapha]] (tissues in which water content is more). Three more types – [[kapha]]ja, bhaktodhabhavaja'' (after excess eating) and ''kshataja'' (thirst produced due to external injury). <br />
<br />
Presently we rely only on fluid and electrolyte supplementation to treat thirst. Treatment of ''trishna'' by ayurvedic principles may open newer vistas in the cases where thirst is difficult to treat. Increased mortality due to dehydration, especially in vulnerable populations, it is commonly observed during periods of abnormally warm weather.<ref> Maughan RJ.,Nutr Rev. 2012 Nov;70 Suppl 2:S152-5, Hydration, morbidity, and mortality in vulnerable populations.</ref> Mortality rate is high in remote areas where health care facilities are not good enough. Ayurvedic preparations mentioned in this chapter are easy to make, can be life saving where sophisticated medical care is not available. Based on Ayurvedic principles, rules regarding use of water in various diseases have been also given in this chapter.<br />
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== Sanskrit Text, Transliteration and English Translation ==<br />
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अथातस्तृष्णाचिकित्सितं व्याख्यास्यामः ||१|| <br />
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इति ह स्माह भगवानात्रेयः ||२||<br />
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athātastrishnacikitsitaṁ vyākhyāsyāmaḥ||1|| <br />
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iti ha smāha bhagavānātrēyaḥ||2||<br />
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athAtastRuṣṇacikitsitaM vyAkhyAsyAmaH ||1|| <br />
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iti ha smAha bhagavAnAtreyaH ||2||<br />
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Now we shall expound the chapter "Trishna Chikitsa" (Management of morbid thirst).Thus said the Lord atreya. [1-2]<br />
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ज्ञानप्रशमतपोभिः ख्यातोऽत्रिसुतो जगद्धितेऽभिरतः | <br />
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तृष्णानां प्रशमार्थं चिकित्सितं प्राह पञ्चानाम् ||३||<br />
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jñānapraśamatapōbhiḥ khyātō'trisutō jagaddhitē'bhirataḥ| <br />
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trishnanāṁ praśamārthaṁ cikitsitaṁ prāha pañcānām||3||<br />
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j~jAnaprashamatapobhiH khyAto~atrisuto jagaddhite~abhirataH | <br />
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tRuṣṇanAM prashamArthaM cikitsitaM prAha pa~jcAnAm ||3||<br />
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The son of Atri, famed for his sagaciousness, tranquility, austerity and devoted to the wellness of the world, expounded the chapter therapeutics of morbid thirst. [3]<br />
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=== Etio-pathogenesis ===<br />
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क्षोभाद्भयाच्छ्रमादपि शोकात्क्रोधाद्विलङ्घनान्मद्यात् | <br />
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क्षाराम्ललवणकटुकोष्णरूक्षशुष्कान्नसेवाभिः ||४|| <br />
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धातुक्षयगदकर्षणवमनाद्यतियोगसूर्यसन्तापैः | <br />
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पित्तानिलौ प्रवृद्धौ सौम्यान्धातूंश्च शोषयतः ||५|| <br />
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रसवाहिनीश्च नालीर्जिह्वामूलगलतालुकक्लोम्नः | <br />
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संशोष्य नृणां देहे कुरुतस्तृष्णां महाबलावेतौ ||६|| <br />
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पीतं पीतं हि जलं शोषयतस्तावतो न याति शमम् | <br />
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घोरव्याधिकृशानां प्रभवत्युपसर्गभूता सा ||७||<br />
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kṣōbhādbhayācchramādapi śōkātkrōdhādvilaṅghanānmadyāt| <br />
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kṣārāmlalavaṇakaṭukōṣṇarūkṣaśuṣkānnasēvābhiḥ||4|| <br />
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dhātukṣayagadakarṣaṇavamanādyatiyōgasūryasantāpaiḥ| <br />
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pittānilau pravr̥ddhau saumyāndhātūṁśca śōṣayataḥ||5|| <br />
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rasavāhinīśca nālīrjihvāmūlagalatālukaklōmnaḥ [1] | <br />
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saṁśōṣya nr̥ṇāṁ dēhē kurutastrishnaṁ mahābalāvētau||6|| <br />
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pītaṁ pītaṁ hi jalaṁ śōṣayatastāvatō na yāti śamam| <br />
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ghōravyādhikr̥śānāṁ prabhavatyupasargabhūtā [2] sā||7||<br />
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kShobhAdbhayAcchramAdapi shokAtkrodhAdvila~gghanAnmadyAt | <br />
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kShArAmlalavaNakaTukoShNarūkṣashuShkAnnasevAbhiH ||4|| <br />
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dhātukShayagadakarShaNavamanAdyatiyogasUryasantApaiH | <br />
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pittAnilau pravRuddhau saumyAndhātuMshca śōṣayataH ||5|| <br />
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rasavAhinIshca nAlIrjihvAmUlagalatAlukaklomnaH | <br />
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saMshoShya nRuNAM dehe kurutastRuṣṇaM mahAbalAvetau ||6|| <br />
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pItaM pItaM hi jalaM śōṣayatastAvato na yAti shamam | <br />
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ghoravyAdhikRushAnAM prabhavatyupasargabhUtA sA ||7||<br />
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As a result of shock/excess distress, fear, fatigue, grief, anger, extreme starvation, alcoholism, regular use of alkaline and sour substances, use of excessive salt, pungent, salty, dry and dehydrated food, emaciation due to excessive loss of basic body forming elements and emaciation due to disease, excessive use of purifactory procedures, excessive exposure to sunlight, [[pitta]] and [[vata]] get severely vitiated and dry up the watery contents of the body. These two [[dosha]] vigorously dehydrate the fluid carrying ducts and channels situated at the base of the tongue, throat, palate and ''kloma'' which causes morbid thirst in a man. Though the patient perpetually drinks water yet his thirst is not quenched. Such morbid thirst arises as a complication in the persons suffering from emaciation due to grave diseases. [4-8]<br />
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=== Premonitory and cardinal symptoms and signs ===<br />
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प्राग्रूपं मुखशोषः, स्वलक्षणं सर्वदाऽम्बुकामित्वम् | <br />
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तृष्णानां सर्वासां लिङ्गानां लाघवमपायः ||८||<br />
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prāgrūpaṁ mukhaśōṣaḥ, svalakṣaṇaṁ sarvadā'mbukāmitvam| <br />
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trishnanāṁ sarvāsāṁ liṅgānāṁ lāghavamapāyaḥ||8|| <br />
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prAgrUpaM mukhaśōṣaH, svalakShaNaM sarvadA~ambukAmitvam | <br />
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tRuṣṇanAM sarvAsAM li~ggAnAM lAghavamapAyaH ||8||<br />
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The premonitory symptoms of morbid thirst are dryness of mouth along with constant craving for water as a cardinal symptom. All the clinical features of morbid thirst may occur in mild form or some of the features may be seen in premonitory stage of morbid thirst. [8]<br />
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=== General clinical signs and symptoms ===<br />
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मुखशोषस्वरभेदभ्रमसन्तापप्रलापसंस्तम्भान् | <br />
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ताल्वोष्ठकण्ठजिह्वाकर्कशतां चित्तनाशं च ||९|| <br />
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जिह्वानिर्गममरुचिं बाधिर्यं मर्मदूयनं सादम् | <br />
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तृष्णोद्भूता कुरुते, पञ्चविधां लिङ्गतः शृणु ताम् ||१०||<br />
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mukhaśōṣasvarabhēdabhramasantāpapralāpasaṁstambhān| <br />
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tālvōṣṭhakaṇṭhajihvākarkaśatāṁ cittanāśaṁ ca||9|| <br />
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jihvānirgamamaruciṁ bādhiryaṁ marmadūyanaṁ sādam| <br />
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tr̥ṣṇōdbhūtā kurutē, pañcavidhāṁ liṅgataḥ śr̥ṇu tām||10|| <br />
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mukhaśōṣasvarabhedabhramasantApapralApasaMstambhAn | <br />
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tAlvoShThakaNThajihvAkarkashatAM cittanAshaM ca ||9|| <br />
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jihvAnirgamamaruciM bAdhiryaM marmadUyanaM sAdam | <br />
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tRuShNodbhUtA kurute, pa~jcavidhAM li~ggataH shRuNu tAm ||10||<br />
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Dryness of mouth, hoarseness of voice, giddiness, burning sensation all over body, delirium, rigidity, dryness and roughness of palate, lip, throat and tongue, stupefaction, loss of concentration, protrusion of the tongue, anorexia, auditory impairment, burning sensation in vital organs and exhaustion are the symptoms of morbid thirst. Now listen carefully the symptoms of each of the five varieties of morbid thirst separately.[9-10]<br />
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=== [[Vata]] dominant ''trishna'' ===<br />
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अब्धातुं देहस्थं कुपितः पवनो यदा विशोषयति | <br />
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तस्मिञ्शुष्के शुष्यत्यबलस्तृष्यत्यथ विशुष्यन् ||११||<br />
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abdhātuṁ dēhasthaṁ kupitaḥ pavanō yadā viśōṣayati| <br />
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tasmiñśuṣkē śuṣyatyabalastr̥ṣyatyatha viśuṣyan||11|| <br />
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abdhātuM dehasthaM kupitaH pavano yadA viśōṣayati | <br />
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tasmi~jshuShke shuShyatyabalastRuShyatyatha vishuShyan ||11||<br />
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Vitiated [[vata]] absorbs the watery elements in the body. As a result of absorption of these fluids, the weak person gets dehydrated and consequently suffers from morbid thirst. [11]<br />
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निद्रानाशः शिरसो भ्रमस्तथा शुष्कविरसमुखता च स्रोतोऽवरोध इति च स्याल्लिङ्गं वाततृष्णायाः ||१२||<br />
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nidrānāśaḥ śirasō bhramastathā śuṣkavirasamukhatā ca <br />
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srōtō'varōdha iti ca syālliṅgaṁ vātatrishnayāḥ||12||<br />
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nidrAnAshaH shiraso bhramastathA shuShkavirasamukhatA ca sroto~avarodha iti ca syAlli~ggaM VātatRuṣṇayAH ||12||<br />
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Lack of sleep, giddiness, dry mouth, distaste, and occlusion of the channels are the symptoms of the [[vata]]ja morbid thirst. [12]<br />
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=== [[Pitta]] dominant ''trishna'' ===<br />
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पित्तं मतमाग्नेयं कुपितं चेत्तापयत्यपां धातुम् | <br />
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सन्तप्तः स हि जनयेत्तृष्णां दाहोल्बणां नॄणाम् ||१३|| <br />
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तिक्तास्यत्वं शिरसो दाहः शीताभिनन्दता मूर्च्छा | <br />
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पीताक्षिमूत्रवर्चस्त्वमाकृतिः पित्ततृष्णायाः ||१४||<br />
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pittaṁ matamāgnēyaṁ kupitaṁ cēttāpayatyapāṁ dhātum| <br />
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santaptaḥ sa hi janayēttrishnaṁ dāhōlbaṇāṁ nr̥̄ṇām||13|| <br />
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tiktāsyatvaṁ śirasō dāhaḥ śītābhinandatā mūrcchā| <br />
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pītākṣimūtravarcastvamākr̥tiḥ pittatrishnayāḥ||14|| <br />
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pittaM matamAgneyaM kupitaM cettApayatyapAM dhātum | <br />
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santaptaH sa hi janayettRuṣṇaM dAholbaNAM nRUNAm ||13|| <br />
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tiktAsyatvaM shiraso dAhaH shItAbhinandatA mUrcchA |<br />
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pItAkShimUtravarcastvamAkRutiH pittatRuṣṇayAH ||14||<br />
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The [[pitta]] is regarded as the thermal elements in the body which on vitiation, heats the watery elements to cause morbid thirst and person suffers from excessive burning sensation.<br />
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Bitter taste in the mouth, burning sensation in the head, cravings for cold things, fainting and yellowish discoloration of eyes, urine and feces, are the clinical features of [[pitta]]ja morbid thirst.[13-14]<br />
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=== ''Trishna'' due to ''ama'' vitiation ===<br />
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तृष्णा याऽऽमप्रभवा साऽप्याग्नेयाऽऽमपित्तजनितत्वात् | <br />
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लिङ्गं तस्याश्चारुचिराध्मानकफप्रसेकौ च ||१५||<br />
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trishna yā''maprabhavā sā'pyāgnēyā''mapittajanitatvāt [1] | <br />
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liṅgaṁ tasyāścārucirādhmānakaphaprasēkau ca||15|| <br />
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tRuṣṇa yA~a~amaprabhavA sA~apyAgneyA~a~amapittajanitatvAt | <br />
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li~ggaM tasyAshcArucirAdhmAnakaphaprasekau ca ||15||<br />
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Morbid thirst, which originates from incomplete transformation or metabolism of food, is also a [[pitta]]ja type as it originates from ''ama'' and [[pitta]] ([[pitta]] obstructed due to vitiated ''ama''). Its clinical features are anorexia, flatulence and excessive salivation. [15]<br />
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=== ''Trishna'' due to depletion of body elements ===<br />
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देहो रसजोऽम्बुभवो रसश्च तस्य क्षयाच्च तृष्येद्धि | <br />
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दीनस्वरः प्रताम्यन् संशुष्कहृदयगलतालुः ||१६||<br />
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dēhō rasajō'mbubhavō rasaśca tasya kṣayācca tr̥ṣyēddhi| <br />
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dīnasvaraḥ pratāmyan saṁśuṣkahr̥dayagalatāluḥ [1] ||16|| <br />
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deho rasajo~ambubhavo rasashca tasya kShayAcca tRuShyeddhi | <br />
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dInasvaraH pratAmyan saMshuShkahRudayagalatAluH ||16||<br />
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The body is composed of watery elements and the colloidal fluids of the body are in turn composed of the aqueous elements. The loss of these watery elements induces thirst, low voice (altered voice), fainting, dryness of throat and palate. [16]<br />
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=== ''Trishna'' due to complications of other diseases ===<br />
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भवति खलु योपसर्गात्तृष्णा सा शोषिणी कष्टा | <br />
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ज्वरमेहक्षयशोषश्वासाद्युपसृष्टदेहानाम् ||१७||<br />
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bhavati khalu yōpasargāttrishna sā śōṣiṇī kaṣṭā| <br />
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jvaramēhakṣayaśōṣaśvāsādyupasr̥ṣṭadēhānām [1] ||17||<br />
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bhavati khalu yopasargAttRuṣṇa sA shoShiNI kaShTA | <br />
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jvaramehakShayaśōṣashvAsAdyupasRuShTadehAnAm ||17||<br />
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Morbid thirst which occurs in a person as a complication of fever, urinary disorders in which abnormal and increased quantity of urine is passed, emaciation, consumption, dyspnea and similar other disorders, cause severe dehydration and such type of ''trishna'' is very difficult to treat.[17]<br />
<br />
=== Serious consequence of ''trishna'' ===<br />
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<br />
सर्वास्त्वतिप्रसक्ता रोगकृशानां वमिप्रसक्तानाम् | <br />
<br />
घोरोपद्रवयुक्तास्तृणा मरणाय विज्ञेयाः ||१८||<br />
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<br />
sarvāstvatiprasaktā rōgakr̥śānāṁ vamiprasaktānām| <br />
<br />
ghōrōpadravayuktāstr̥ṇā maraṇāya vijñēyāḥ||18|| <br />
<br />
sarvAstvatiprasaktA rogakRushAnAM vamiprasaktAnAm | <br />
<br />
ghoropadravayuktAstRuNA maraNAya vij~jeyAH ||18||<br />
</div></div><br />
<br />
All varieties of diseases which are chronic in nature, which occur in the patients emaciated by diseases and afflicted with perpetual vomiting which occurs along with grave complications to be known as being indicative of approaching death. [18]<br />
<br />
=== Role of [[vata]] and [[pitta]] in ''trishna'' ===<br />
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<br />
नाग्निं विना हि तर्षः पवनाद्वा तौ हि शोषणे हेतू | <br />
<br />
अब्धातोरतिवृद्धावपां क्षये तृष्यते नरो हि ||१९|| <br />
<br />
गुर्वन्नपयःस्नेहैः सम्मूर्च्छद्भिर्विदाहकाले च | <br />
<br />
यस्तृष्येद्वृतमार्गे तत्राप्यनिलानलौ हेतू ||२०|| <br />
<br />
तीक्ष्णोष्णरूक्षभावान्मद्यं पित्तानिलौ प्रकोपयति | <br />
<br />
शोषयतोऽपां धातुं तावेव हि मद्यशीलानाम् ||२१|| <br />
<br />
तप्तास्विव सिकतासु हि तोयमाशु शुष्यति क्षिप्तम् | <br />
<br />
तेषां सन्तप्तानां हिमजलपानाद्भवति शर्म ||२२||<br />
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<br />
nāgniṁ vinā hi tarṣaḥ pavanādvā tau hi śōṣaṇē hētū| <br />
<br />
abdhātōrativr̥ddhāvapāṁ kṣayē tr̥ṣyatē narō hi||19|| <br />
<br />
gurvannapayaḥsnēhaiḥ sammūrcchadbhirvidāhakālē ca| <br />
<br />
yastr̥ṣyēdvr̥tamārgē tatrāpyanilānalau hētū||20|| <br />
<br />
tīkṣṇōṣṇarūkṣabhāvānmadyaṁ pittānilau prakōpayati| <br />
<br />
śōṣayatō'pāṁ dhātuṁ tāvēva hi madyaśīlānām||21|| <br />
<br />
taptāsviva sikatāsu hi tōyamāśu śuṣyati kṣiptam| <br />
<br />
tēṣāṁ santaptānāṁ himajalapānādbhavati śarma||22|| <br />
<br />
nAgniM vinA hi tarShaH pavanAdvA tau hi śōṣane hetU | <br />
<br />
abdhAtorativRuddhAvapAM kShaye tRuShyate naro hi ||19|| <br />
<br />
gurvannapayaHsnehaiH sammUrcchadbhirvidAhakAle ca | <br />
<br />
yastRuShyedvRutamArge tatrApyanilAnalau hetU ||20|| <br />
<br />
tIkShNoShNarūkṣabhAvAnmadyaM pittAnilau prakopayati | <br />
<br />
śōṣayato~apAM dhātuM tAveva hi madyashIlAnAm ||21|| <br />
<br />
taptAsviva sikatAsu hi toyamAshu shuShyati kShiptam | <br />
<br />
teShAM santaptAnAM himajalapAnAdbhavati sharma ||22||<br />
</div></div><br />
<br />
Thirst can‘t occur without [[pitta]] (heat) and [[vata]]; the excessive increase in these two elements results in absorption of the watery element, and loss of water in body leads to thirst.<br />
<br />
In a condition where person after indulging in heavy food, milk and unctuous articles, which during the digestive process cause thirst by obstructing the channels, in such condition [[vata]] and the thermal elements act as the causative factors.<br />
<br />
Alcohol by its quality being ''tikshna'' (the property which causes sharp action and quick penetration), salty, sultry and dry, provokes [[pitta]] and [[vata]]. These two factors ([[pitta]] and [[vata]]) dry up the watery elements of the body in alcohol addicts. Just as hot sand absorbs and dries up the water poured on it, similarly relief is obtained by pouring of the cold water.[19-22]<br />
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<br />
शिशिरस्नातस्योष्मा रुद्धः कोष्ठं प्रपद्य तर्षयति | <br />
<br />
तस्मान्नोष्णक्लान्तो भजेत सहसा जलं शीतम् ||२३||<br />
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<br />
śiśirasnātasyōṣmā ruddhaḥ kōṣṭhaṁ prapadya tarṣayati| <br />
<br />
tasmānnōṣṇaklāntō bhajēta sahasā jalaṁ śītam [1] ||23|| <br />
<br />
shishirasnAtasyoShmA ruddhaH koShThaM prapadya tarShayati | <br />
<br />
tasmAnnoShNaklAnto bhajeta sahasA jalaM shItam ||23||<br />
</div></div><br />
<br />
The body heat of the person is obstructed in the peripheral region by a cold bath and it passes to the internal organs and produces thirst. Therefore, the person who is fatigued by excessive heat should not take cold water immediately. [23]<br />
<br />
=== Management of ''trishna'' ===<br />
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<br />
लिङ्गं सर्वास्वेतास्वनिलक्षयपित्तजं भवत्यथ तु | <br />
<br />
पृथगागमाच्चिकित्सितमतः प्रवक्ष्यामि तृष्णानाम् ||२४||<br />
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<br />
liṅgaṁ sarvāsvētāsvanilakṣayapittajaṁ bhavatyatha tu| <br />
<br />
pr̥thagāgamāccikitsitamataḥ pravakṣyāmi trishnanām||24|| <br />
<br />
li~ggaM sarvAsvetAsvanilakShayapittajaM bhavatyatha tu | <br />
<br />
pRuthagAgamAccikitsitamataH pravakShyAmi tRuṣṇanAm ||24||<br />
</div></div><br />
<br />
In all these types of the morbid thirst, symptoms arising from the vitiation of [[vata]], [[pitta]] and loss of watery elements of the body are manifested. Now, I shall describe the treatment of morbid thirst of various types one by one according to the authoritative tradition. [24]<br />
<br />
=== Properties of pure rain water and its benefits ===<br />
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<br />
अपां क्षयाद्धि तृष्णा संशोष्य नरं प्रणाशयेदाशु | <br />
<br />
तस्मादैन्द्रं तोयं समधु पिबेत्तद्गुणं वाऽन्यत् ||२५|| <br />
<br />
किञ्चित्तुवरानुरसं तनु लघु शीतलं सुगन्धि सुरसं च | <br />
<br />
अनभिष्यन्दि च यत्तत्क्षितिगतमप्यैन्द्रवज्ज्ञेयम् ||२६||<br />
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<br />
apāṁ kṣayāddhi trishna saṁśōṣya naraṁ praṇāśayēdāśu| <br />
<br />
tasmādaindraṁ tōyaṁ samadhu pibēttadguṇaṁ vā'nyat||25|| <br />
<br />
kiñcittuvarānurasaṁ tanu laghu śītalaṁ sugandhi surasaṁ ca| <br />
<br />
anabhiṣyandi ca yattatkṣitigatamapyaindravajjñēyam||26||<br />
<br />
apAM kShayAddhi tRuṣṇa saMshoShya naraM praNAshayedAshu | <br />
<br />
tasmAdaindraM toyaM samadhu pibettadguNaM vA~anyat ||25|| <br />
<br />
ki~jcittuvarAnurasaM tanu laghu shItalaM sugandhi surasaM ca | <br />
<br />
anabhiShyandi ca yattatkShitigatamapyaindravajj~jeyam ||26||<br />
</div></div><br />
<br />
Due to the loss of watery elements, man becomes dehydrated and dies soon due to thirst; the patients should therefore drink pure rain water mixed with honey, or any other water having similar properties that of rain water.<br />
<br />
The water, that has slight astringent, secondary taste, which is light to digest, cool, possess good smell and taste and devoid of channel blocking quality, should be considered equal to rain water in effect though it may be terrestrial.[25-26]<br />
<br />
=== Various diet recipes in management of ''trishna'' ===<br />
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<br />
शृतशीतं ससितोपलमथवा शरपूर्वपञ्चमूलेन | <br />
<br />
लाजासक्तुसिताह्वामधुयुतमैन्द्रेण वा मन्थम् ||२७|| <br />
<br />
वाट्यं वाऽऽमयवानां शीतं मधुशर्करायुतं दद्यात् | <br />
<br />
पेयां वा शालीनां दद्याद्वा कोरदूषाणाम् ||२८|| <br />
<br />
पयसा शृतेन भोजनमथवा मधुशर्करायुतं योज्यम् | <br />
<br />
पारावतादिकरसैर्घृतभृष्टैर्वाऽप्यलवणाम्लैः ||२९|| <br />
<br />
तृणपञ्चमूलमुञ्जातकैः प्रियालैश्च जाङ्गलाः सुकृताः | <br />
<br />
शस्ता रसाः पयो वा तैः सिद्धं शर्करामधुमत् ||३०||<br />
<br />
शतधौतघृतेनाक्तः पयः पिबेच्छीततोयमवगाह्य | <br />
<br />
मुद्गमसूरचणकजा रसास्तु भृष्टा घृते देयाः ||३१|| <br />
<br />
मधुरैः सजीवनीयैः शीतैश्च सतिक्तकैः शृतं क्षीरम् | <br />
<br />
पानाभ्यञ्जनसेकेष्विष्टं मधुशर्करायुक्तम् ||३२|| <br />
<br />
तज्जं वा घृतमिष्टं पानाभ्यङ्गेषु नस्यमपि च स्यात् | <br />
<br />
नारीपयः सशर्करमुष्ट्र्या अपि नस्यमिक्षुरसः ||३३||<br />
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<br />
śr̥taśītaṁ sasitōpalamathavā śarapūrvapañcamūlēna| <br />
<br />
lājāsaktusitāhvāmadhuyutamaindrēṇa [4] vā mantham||27|| <br />
<br />
vāṭyaṁ vā''mayavānāṁ śītaṁ madhuśarkarāyutaṁ dadyāt| <br />
<br />
pēyāṁ vā śālīnāṁ dadyādvā kōradūṣāṇām||28|| <br />
<br />
payasā śr̥tēna bhōjanamathavā madhuśarkarāyutaṁ yōjyam| <br />
<br />
pārāvatādikarasairghr̥tabhr̥ṣṭairvā'pyalavaṇāmlaiḥ||29|| <br />
<br />
tr̥ṇapañcamūlamuñjātakaiḥ priyālaiśca jāṅgalāḥ sukr̥tāḥ| <br />
<br />
śastā rasāḥ payō vā taiḥ siddhaṁ śarkarāmadhumat||30|| <br />
<br />
śatadhautaghr̥tēnāktaḥ payaḥ pibēcchītatōyamavagāhya| <br />
<br />
mudgamasūracaṇakajā rasāstu bhr̥ṣṭā ghr̥tē [5] dēyāḥ||31|| <br />
<br />
madhuraiḥ sajīvanīyaiḥ śītaiśca satiktakaiḥ śr̥taṁ kṣīram| <br />
<br />
pānābhyañjanasēkēṣviṣṭaṁ madhuśarkarāyuktam||32|| <br />
<br />
tajjaṁ vā ghr̥tamiṣṭaṁ pānābhyaṅgēṣu nasyamapi ca syāt| <br />
<br />
nārīpayaḥ saśarkaramuṣṭryā api nasyamikṣurasaḥ||33|| <br />
<br />
shRutashItaM sasitopalamathavA sharapUrvapa~jcamUlena | <br />
<br />
lAjAsaktusitAhvAmadhuyutamaindreNa vA mantham ||27|| <br />
<br />
vATyaM vA~a~amayavAnAM shItaM madhusharkarAyutaM dadyAt | <br />
<br />
pēyāM vA shAlInAM dadyAdvA koradUShANAm ||28|| <br />
<br />
payasA shRutena bhojanamathavA madhusharkarAyutaM yojyam | <br />
<br />
pArAVātadikarasairghRutabhRuShTairvA~apyalavaNAmlaiH ||29|| <br />
<br />
tRuNapa~jcamUlamu~jjAtakaiH priyAlaishca jA~ggalAH sukRutAH | <br />
<br />
shastA rasAH payo vA taiH siddhaM sharkarAmadhumat ||30|| <br />
<br />
shatadhautaghRutenAktaH payaH pibecchItatoyamavagAhya | <br />
<br />
mudgamasUracaNakajA rasAstu bhRuShTA ghRute deyAH ||31|| <br />
<br />
madhuraiH sajIvanIyaiH shItaishca satiktakaiH shRutaM kShIram | <br />
<br />
pAnAbhya~jjanasekeShviShTaM madhusharkarAyuktam ||32|| <br />
<br />
tajjaM vA ghRutamiShTaM pAnAbhya~ggeShu nasyamapi ca syAt | <br />
<br />
nArIpayaH sasharkaramuShTryA api nasyamikShurasaH ||33||<br />
</div></div><br />
<br />
The physician may give the decoction of roots of the ''shara panchamula'' after cooling and mixing with sugar or the demulcent drink prepared of roasted paddy powder, sugar, honey and rain water; or he may give the top part of half cooked barley gruels cooled and mixed with sugar or he may give the thin gruel of ''shali'' rice or of common millets.<br />
<br />
Food mixed with boiled milk or with honey and sugar, or with meat juice of the pigeon and other similar birds of its group may be given after seasoning it with ghee. Sour or salty substances should not be added as mentioned in classical procedure.<br />
<br />
The meat of ''jangala'' animals well prepared with the roots of the ''trina panchamula, munjataka'' and ''priyala'' must be recommended; or the milk prepared with the above drugs mixed with sugar and honey should be given.<br />
<br />
The patients anointing himself with the ''shatadhauta'' ghee (ghee processed for hundred times) and taking cold bath, should drink milk or soups of green gram, lentils and chicken peas, seasoned with ghee.<br />
<br />
The milk boiled with drugs of sweet groups of medicine, or life promoter group of medicine, cool and bitter group of medicine mixed with honey and sugar may be utilized as potion for inunction and affusion.<br />
<br />
Or, the ghee prepared out of this medicated milk is propitious as potion and inunction as well as nasal medication. Breast milk or camel’s milk with sugar or sugarcane juice is good as nasal medication. [27-33]<br />
<br />
=== Various therapeutics modalities ===<br />
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<br />
क्षीरेक्षुरसगुडोदकसितोपलाक्षौद्रसीधुमार्द्वीकैः | <br />
<br />
वृक्षाम्लमातुलुङ्गैर्गण्डूषास्तालुशोषघ्नाः ||३४|| <br />
<br />
जम्ब्वाम्रातकबदरीवेतसपञ्चवल्कपञ्चाम्लैः | <br />
<br />
हृन्मुखशिरःप्रदेहाःसघृता मूर्च्छाभ्रमतृष्णाघ्नाः स्युः ||३५|| <br />
<br />
दाडिमदधित्थलोध्रैः सविदारीबीजपूरकैः शिरसः | <br />
<br />
लेपो गौरामलकैर्घृतारनालायुतैश्च हितः ||३६|| <br />
<br />
शैवलपङ्काम्बुरुहैः साम्लैः सघृतैश्च शक्तुभिर्लेपः | <br />
<br />
मस्त्वारनालार्द्रवसनकमलमणिहारसंस्पर्शाः ||३७|| <br />
<br />
शिशिराम्बुचन्दनार्द्रस्तनतटपाणितलगात्रसंस्पर्शाः | <br />
<br />
क्षौमार्द्रनिवसनानां वराङ्गनानां प्रियाणां च ||३८|| <br />
<br />
हिमवद्दरीवनसरित्सरोऽम्बुजपवनेन्दुपादशिशिराणाम् | <br />
<br />
रम्यशिशिरोदकानां स्मरणं कथाश्च तृष्णाघ्नाः ||३९||<br />
<div class="mw-collapsible-content"><br />
<br />
kShIrekShurasaguDodakasitopalAkShaudrasIdhumArdvIkaiH |<br />
<br />
vRūkṣamlamAtulu~ggairgaNDUShAstAlushoShaghnAH ||34|| <br />
<br />
jambvAmrAtakabadarIvetasapa~jcavalkapa~jcAmlaiH | <br />
<br />
hRunmukhashiraHpradehAHsaghRutA mUrcchAbhramatRuṣṇaghnAH syuH ||35|| <br />
<br />
dADimadadhitthalodhraiH savidArIbIjapUrakaiH shirasaH | <br />
<br />
lepo gaurAmalakairghRutAranAlAyutaishca hitaH ||36|| <br />
<br />
shaivalapa~gkAmburuhaiH sAmlaiH saghRutaishca shaktubhirlepaH | <br />
<br />
mastvAranAlArdravasanakamalamaNihArasaMsparshAH ||37|| <br />
<br />
shishirAmbucandanArdrastanataTapANitalagAtrasaMsparshAH | <br />
<br />
kShaumArdranivasanAnAM varA~gganAnAM priyANAM ca ||38|| <br />
<br />
himavaddarIvanasaritsaro~ambujapavanendupAdashishirANAm | <br />
<br />
ramyashishirodakAnAM smaraNaM kathAshca tRuṣṇaghnAH ||39||<br />
<br />
kShIrekShurasaguDodakasitopalAkShaudrasIdhumArdvIkaiH | <br />
<br />
vRūkṣamlamAtulu~ggairgaNDUShAstAluśōṣaghnAH ||34|| <br />
<br />
jambvAmrAtakabadarIvetasapa~jcavalkapa~jcAmlaiH | <br />
<br />
hRunmukhashiraHpradehAHsaghRutA mUrcchAbhramatRuṣṇaghnAH syuH ||35|| <br />
<br />
dADimadadhitthalodhraiH savidArIbIjapUrakaiH shirasaH | <br />
<br />
lepo gaurAmalakairghRutAranAlAyutaishca hitaH ||36|| <br />
<br />
shaivalapa~gkAmburuhaiH sAmlaiH saghRutaishca ŚaktubhirlepaH | <br />
<br />
mastvAranAlArdravasanakamalamaNihArasaMsparshAH ||37|| <br />
<br />
shishirAmbucandanArdrastanataTapANitalagAtrasaMsparshAH | <br />
<br />
kShaumArdranivasanAnAM varA~gganAnAM priyANAM ca ||38|| <br />
<br />
himavaddarIvanasaritsaro~ambujapavanendupAdashishirANAm | <br />
<br />
ramyashishirodakAnAM smaraNaM kathAshca tRuṣṇaghnAH ||39||<br />
</div></div><br />
<br />
The gargles of milk, sugarcane juice, jaggery water, sugar, honey, and wine prepared from sugarcane, grape wine, ''kokam'' (Garcinia cambogia) and citron fruit are beneficial in curing dryness of the palate.<br />
<br />
The application of ''jambu'' (Syzgium cumini), Indian hog plum jujube, country willow, barks of five herbs (''panchavalkal'') and the herbs of ''panchamla'' group mixed with ghee over pericardial region, face are curative of fainting, giddiness and thirst.<br />
<br />
When external application of paste prepared from pomegranate, wood apple, ''lodhra'' (Symplocos racemosa), white yam and citron or of whitish emblica myrobalans mixed with ghee and sour wheat porridge is done over head area it proves useful.<br />
<br />
Paste prepared from moss, mud, and lotuses or with roasted paddy powder mixed with sour articles and ghee or application of wet cloth soaked in whey or sour wheat ''conjee'' or application of lotuses or of garlands of precious stones should be done. The contact of the breast and hands of resplendent and beloved women clad in wet silken garments and besmeared with cool and fragrant waters or sandal paste, proves beneficial.<br />
<br />
The thinking of or listening to the description of Himalayan caves, woods, streams, lakes, lotuses, breezes, moonlight, and other cool things as well as of lovely cool waters- these have an allaying effect on morbid thirst.[34-39]<br />
<br />
=== Guidelines for management of [[vata]] dominant ''trishna'' ===<br />
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<br />
वातघ्नमन्नपानं मृदु लघु शीतं च वाततृष्णायाम् | <br />
<br />
क्षयकासनुच्छृतं क्षीरघृतमूर्ध्ववाततृष्णाघ्नम् ||४०|| <br />
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<br />
vātaghnamannapānaṁ mr̥du laghu śītaṁ ca vātatrishnayām| <br />
<br />
kṣayakāsanucchr̥taṁ kṣīraghr̥tamūrdhvavātatrishnaghnam ||40|| <br />
<br />
VātaghnamannapAnaM mRudu laghu shItaM ca VātatRuṣṇayAm | <br />
<br />
kShayakAsanucchRutaM kShIraghRutamUrdhvaVātatRuṣṇaghnam ||40||<br />
</div></div><br />
<br />
If the morbid thirst is due to[[vata]] dominance, then soft, light to digest food and drink with cooling property, curative of [[vata]] are recommended. Also ghee which is churned directly from milk is indicated which has been mentioned for the treatment of ''kshayaja kasa'' (cough due to wasting) and is curative of thirst and dyspnea. [40]<br />
<br />
=== Guidelines for management of [[pitta]] dominant ''trishna'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
स्याज्जीवनीयसिद्धं क्षीरघृतं वातपित्तजे तर्ष |४१|<br />
<br />
पैत्ते द्राक्षाचन्दनखर्जूरोशीरमधुयुतं तोयम् ||४१|| <br />
<br />
लोहितशालितण्डुलखर्जूरपरूषकोत्पलद्राक्षाः | <br />
<br />
मधु पक्वलोष्टमेव च जले स्थितं शीतलं पेयम् ||४२|| <br />
<br />
लोहितशालिप्रस्थः सलोध्रमधुकाञ्जनोत्पलः क्षुण्णः | <br />
<br />
पक्वामलोष्टजलमधुसमायुतो मृन्मये पेयः ||४३|| <br />
<br />
वटमातुलुङ्गवेतसपल्लवकुशकाशमूलयष्ट्याह्वैः | <br />
<br />
सिद्धेऽम्भस्यग्निनिभां कृष्णमृदं कृष्णसिकतां वा ||४४|| <br />
<br />
तत्पानि नवकपालान्यथवा निर्वाप्य पाययेताच्छम् | <br />
<br />
आपाकशर्करं वाऽमृतवल्ल्युदकं तृषां हन्ति ||४५|| <br />
<br />
क्षीरवतां मधुराणां शीतानां शर्करामधुविमिश्राः | <br />
<br />
शीतकषाया मृद्भृष्टसंयुताः पित्ततृष्णाघ्नाः ||४६||<br />
<div class="mw-collapsible-content"><br />
<br />
syājjīvanīyasiddhaṁ kṣīraghr̥taṁ vātapittajē tarṣa|41| <br />
<br />
paittē drākṣācandanakharjūrōśīramadhuyutaṁ tōyam||41|| <br />
<br />
lōhitaśālitaṇḍulakharjūraparūṣakōtpaladrākṣāḥ| <br />
<br />
madhu pakvalōṣṭamēva ca jalē sthitaṁ śītalaṁ pēyam||42|| <br />
<br />
lōhitaśāliprasthaḥ salōdhramadhukāñjanōtpalaḥ kṣuṇṇaḥ| <br />
<br />
pakvāmalōṣṭajalamadhusamāyutō [9] mr̥nmayē pēyaḥ||43|| <br />
<br />
vaṭamātuluṅgavētasapallavakuśakāśamūlayaṣṭyāhvaiḥ| <br />
<br />
siddhē'mbhasyagninibhāṁ kr̥ṣṇamr̥daṁ kr̥ṣṇasikatāṁ vā||44|| <br />
<br />
taptāni navakapālānyathavā nirvāpya pāyayētāccham| <br />
<br />
āpākaśarkaraṁ vā'mr̥tavallyudakaṁ tr̥ṣāṁ hanti||45|| <br />
<br />
kṣīravatāṁ madhurāṇāṁ śītānāṁ śarkarāmadhuvimiśrāḥ| <br />
<br />
śītakaṣāyā mr̥dbhr̥ṣṭasaṁyutāḥ pittatrishnaghnāḥ||46|| <br />
<br />
syAjjIvanIyasiddhaM kShIraghRutaM Vātapittaje tarSha |41|<br />
<br />
paitte drAkShAcandanakharjUroshIramadhuyutaM toyam ||41|| <br />
<br />
lohitashAlitaNDulakharjUraparUShakotpaladrAkShAH | <br />
<br />
madhu pakvaloShTameva ca jale sthitaM shItalaM pēyām ||42|| <br />
<br />
lohitashAliprasthaH salodhramadhukA~jjanotpalaH kShuNNaH | <br />
<br />
pakvAmaloShTajalamadhusamAyuto mRunmaye pēyāH ||43|| <br />
<br />
VātamAtulu~ggavetasapallavakushakAshamUlayaShTyAhvaiH | <br />
<br />
siddhe~ambhasyagninibhAM kRuṣṇamRudaM kRuṣṇasikatAM vA ||44|| <br />
<br />
tatpAni navakapAlAnyathavA nirvApya pAyayetAccham | <br />
<br />
ApAkasharkaraM vA~amRutavallyudakaM tRuShAM hanti ||45|| <br />
<br />
kShIraVātaM madhurANAM shItAnAM sharkarAmadhuvimishrAH | <br />
<br />
shItakaShAyA mRudbhRuShTasaMyutAH pittatRuṣṇaghnAH ||46||<br />
</div></div><br />
<br />
In morbid thirst due to [[vata]] and [[pitta]], the ghee taken out of milk prepared with drugs of life promoter group, is recommended.<br />
<br />
In [[pitta]]ja morbid thirst, water mixed with grapes, sandalwood, dates, vetiveria zizanioidis, honey and cold water in which red ''shali'' rice, dates, ''parushaka'', blue water lily, grapes, honey and a baked lump of earth have been kept, may be given or water kept in earthen pot in which 64 tola of red ''shali'' rice, pounded with ''lodhra'', liquorice, antimony and blue water lily are put and in which a baked clod of clay, water and honey have been integrated. This is a curative drink in morbid thirst.<br />
<br />
In the water prepared with sprouts of banyan, citrus medica, country willow, roots of sacrificial and thatch grass and liquorice and quench black earthen or black sand or pieces of new earthen vessel which have been heated up to red hot. Use supernatant part of this mixture and give it to the patient.<br />
<br />
Quench red hot stones in decoction of ''guduchi'' and use it after cooling it.<br />
<br />
The cold infusions prepared from ''kshiri'' and ''madhur, shita'' group of plants should be given after adding sugar and honey quenching of baked clay should be done as described earlier. It is useful in [[pitta]]ja trishna. [41-46]<br />
<br />
=== Guidelines for management of ''amaja trishna'' ===<br />
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<br />
व्योषवचाभल्लातकतिक्तकषायास्तथाऽऽमतृष्णाघ्नाः | <br />
<br />
यच्चोक्तं कफजायां वम्यां तच्चैव कार्यं स्यात् ||४७|| <br />
<br />
स्तम्भारुच्यविपाकालस्यच्छर्दिषु कफानुगां तृष्णाम् | <br />
<br />
ज्ञात्वा दधिमधुतर्पणलवणोष्णजलैर्वमनमिष्टम् ||४८|| <br />
<br />
दाडिममम्लफलं वाऽप्यन्यत् सकषायमथ लेहम् | <br />
<br />
पेयमथवा प्रदद्याद्रजनीशर्करायुक्तम् ||४९|| <br />
<div class="mw-collapsible-content"><br />
<br />
vyōṣavacābhallātakatiktakaṣāyāstathā''matrishnaghnāḥ| <br />
<br />
yaccōktaṁ kaphajāyāṁ vamyāṁ taccaiva kāryaṁ syāt||47|| <br />
<br />
stambhārucyavipākālasyacchardiṣu kaphānugāṁ trishnam| <br />
<br />
jñātvā dadhimadhutarpaṇalavaṇōṣṇajalairvamanamiṣṭam||48|| <br />
<br />
dāḍimamamlaphalaṁ vā'pyanyat sakaṣāyamatha lēham| <br />
<br />
pēyamathavā pradadyādrajanīśarkarāyuktam [12] ||49|| <br />
<br />
vyoShavacAbhallAtakatiktakaShAyAstathA~a~amatRuṣṇaghnAH | <br />
<br />
yaccoktaM kaphajAyAM vamyAM taccaiva kAryaM syAt ||47|| <br />
<br />
stambhArucyavipAkAlasyacchardiShu kaphAnugAM tRuṣṇam | <br />
<br />
j~jAtvA dadhimadhutarpaNalavaNoShNajalairvamanamiShTam ||48|| <br />
<br />
dADimamamlaphalaM vA~apyanyat sakaShAyamatha leham | <br />
<br />
pēyāmathavA pradadyAdrajanIsharkarAyuktam ||49|| <br />
</div></div><br />
<br />
In ''amaja trishna'', decoctions prepared form ''trikatu'', sweet flag, marking nut and drugs of bitter groups are useful; or treatment principles of [[kapha]]ja chhardi can be used.<br />
<br />
Rigidity, anorexia, indigestion, lethargy and regurgitation are suggestive of [[kapha]]ja type of thirst. In such condition, a dose of prepared curds, honey demulcent drink, salt and warm water should be used to induce vomiting.<br />
<br />
The physician may also give pomegranate or other sour fruits or the linctus mixed with astringent substances or he may give a potion containing turmeric and sugar.[47-49]<br />
<br />
=== Guidelines for management of ''kshayaja trishna'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
क्षयकासेन तु तुल्या क्षयतृष्णा सा गरीयसी नॄणाम् | <br />
<br />
क्षीणक्षतशोषहितैस्तस्मात्तां भेषजैः शमयेत् ||५०|| <br />
<br />
पानतृषार्तः पानं त्वर्धोदकमम्ललवणगन्धाढ्यम् | <br />
<br />
शिशिरस्नातः पानं मद्याम्बु गुडाम्बु वा तृषितः ||५१|| <br />
<br />
भक्तोपरोधतृषितः स्नेहतृषार्तोऽथवा तनुयवागूम् | <br />
<br />
प्रपिबेद्गुरुणा तृषितो भुक्तेन तदुद्धरेद्भुक्तम् ||५२|| <br />
<br />
मद्याम्बु वाऽम्बु कोष्णं बलवांस्तृषितः समुल्लिखेत् पीत्वा | <br />
<br />
मागधिकाविशदमुखः सशर्करं वा पिबेन्मन्थम् ||५३|| <br />
<br />
बलवांस्तु तालुशोषे पिबेद्धृतं तृष्यमद्याच्च | <br />
<br />
सर्पिर्भृष्टं क्षीरं मांसरसांश्चाबलः स्निग्धान् ||५४|| <br />
<br />
अतिरूक्षदुर्बलानां तर्षं शमयेन्नृणामिहाशु पयः | <br />
<br />
छागो वा घृतभृष्टः शीतो मधुरो रसो हृद्यः ||५५|| <br />
<br />
स्निग्धेऽन्ने भुक्ते या तृष्णा स्यात्तां गुडाम्बुना शमयेत् | <br />
<br />
तर्षं मूर्च्छाभिहतस्य रक्तपित्तापहैर्हन्यात् ||५६||<br />
<div class="mw-collapsible-content"><br />
<br />
kṣayakāsēna tu tulyā kṣayatrishna sā garīyasī nr̥̄ṇām| <br />
<br />
kṣīṇakṣataśōṣahitaistasmāttāṁ bhēṣajaiḥ śamayēt||50|| <br />
<br />
pānatr̥ṣārtaḥ pānaṁ tvardhōdakamamlalavaṇagandhāḍhyam| <br />
<br />
śiśirasnātaḥ pānaṁ madyāmbu guḍāmbu vā tr̥ṣitaḥ||51|| <br />
<br />
bhaktōparōdhatr̥ṣitaḥ snēhatr̥ṣārtō'thavā tanuyavāgūm| <br />
<br />
prapibēdguruṇā tr̥ṣitō bhuktēna taduddharēdbhuktam||52|| <br />
<br />
madyāmbu vā'mbu kōṣṇaṁ balavāṁstr̥ṣitaḥ samullikhēt pītvā| <br />
<br />
māgadhikāviśadamukhaḥ saśarkaraṁ vā pibēnmantham||53|| <br />
<br />
balavāṁstu tāluśōṣē pibēddhr̥taṁ tr̥ṣyamadyācca| <br />
<br />
sarpirbhr̥ṣṭaṁ kṣīraṁ māṁsarasāṁścābalaḥ snigdhān||54|| <br />
<br />
atirūkṣadurbalānāṁ tarṣaṁ śamayēnnr̥ṇāmihāśu payaḥ| <br />
<br />
chāgō vā ghr̥tabhr̥ṣṭaḥ śītō madhurō rasō hr̥dyaḥ||55|| <br />
<br />
snigdhē'nnē bhuktē yā trishna syāttāṁ guḍāmbunā śamayēt| <br />
<br />
tarṣaṁ mūrcchābhihatasya raktapittāpahairhanyāt||56|| <br />
<br />
kShayakAsena tu tulyA kShayatRuṣṇa sA garIyasI nRUNAm | <br />
<br />
kShINakShataśōṣahitaistasmAttAM bheShajaiH shamayet ||50|| <br />
<br />
pAnatRuShArtaH pAnaM tvardhodakamamlalavaNagandhADhyam | <br />
<br />
shishirasnAtaH pAnaM madyAmbu guDAmbu vA tRuShitaH ||51|| <br />
<br />
bhaktoparodhatRuShitaH snehatRuShArto~athavA tanuyavAgUm |<br />
<br />
prapibedguruNA tRuShito bhuktena taduddharedbhuktam ||52|| <br />
<br />
madyAmbu vA~ambu koShNaM balavAMstRuShitaH samullikhet pItvA | <br />
<br />
mAgadhikAvishadamukhaH sasharkaraM vA pibenmantham ||53|| <br />
<br />
balavAMstu tAlushoShe pibeddhRutaM tRuShyamadyAcca | <br />
<br />
sarpirbhRuShTaM kShIraM māṁsarasAMshcAbalaH snigdhAn ||54|| <br />
<br />
atirūkṣadurbalAnAM tarShaM shamayennRuNAmihAshu payaH | <br />
<br />
chAgo vA ghRutabhRuShTaH shIto madhuro raso hRudyaH ||55|| <br />
<br />
snigdhe~anne bhukte yA tRuṣṇa syAttAM guDAmbunA shamayet | <br />
<br />
tarShaM mUrcchAbhihatasya raktapittApahairhanyAt ||56||<br />
</div></div><br />
<br />
''Kshayaja trishna'' is serious in nature as like ''kshayaja kasa'' (cough due to wasting), therefore this type of thirst should be treated with medications mentioned in cough due to wasting. Medications mentioned in ''kshatakshina'' and ''shosha'' are helpful.<br />
<br />
In polydipsia due to alcoholism, a potion of wine diluted with equal amount of water mixed with sour, salt and liberal quantity of fragrant substances are advised. In thirst immediately after a cold bath, a drink of diluted wine or jaggery water is recommended. If thirst is due to abstinence from food or due to indigestion of unctuous diet, the patient may take thin medicated gruel; if the thirst is due to ingestion of heavy meal, the patient should vomit out the food.<br />
<br />
If patient is strong enough, he may drink a dose of wine and water or warm water before vomiting and after cleaning mouth with long pepper, he may take a demulcent drink with sugar.<br />
<br />
If the thirsty patient has good strength and he suffers from dry palate, he may drink ghee or use it in his food; if the patient is weak, he may take milk seasoned with ghee or unctuous meat juice.<br />
<br />
The people who are extremely dehydrated and are weak can pacify their thirst immediately by milk or the cool and sweet meat juice of goat seasoned with ghee.<br />
<br />
The thirst resulting from eating unctuous food should be quenched with jaggery water; and the thirst in a person who has fainted should be remedied by medication mentioned in ''murchha'' (fainting).[50-56]<br />
<br />
=== Indications of cold and hot water ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
तृट्दाहमूर्च्छाभ्रमक्लममदात्ययास्रविषपित्ते |<br />
<br />
शस्तं स्वभावशीतं, शृतशीतं सन्निपातेऽम्भः ||५७|| <br />
<br />
हिक्काश्वासनवज्वरपीनसघृतपीतपार्श्वगलरोगे | <br />
<br />
कफवातकृते स्त्याने सद्यःशुद्धे च हितमुष्णम् ||५८|| <br />
<br />
पाण्डूदरपीनसमेहगुल्ममन्दानलातिसारेषु | <br />
<br />
प्लीह्नि च तोयं न हितं काममसह्ये पिबेदल्पम् ||५९|| <br />
<br />
पूर्वामयातुरः सन् दीनस्तृष्णार्दितो जलं काङ्क्षन् | <br />
<br />
न लभेत स चेन्मरणमाश्वेवाप्नुयाद्दीर्घरोगं वा ||६०|| <br />
<br />
तस्माद्धान्याम्बु पिबेत्तृष्यन् रोगी सशर्कराक्षौद्रम् | <br />
<br />
यद्वा तस्यान्यत्स्यात् सात्म्यं रोगस्य तच्चेष्टम् ||६१|| <br />
<br />
तस्यां विनिवृत्तायां तज्जन्य उपद्रवः सुखं जेतुम् | <br />
<br />
तस्मात्तृष्णां पूर्वं जयेद्बहुभ्योऽपि रोगेभ्यः ||६२||<br />
<div class="mw-collapsible-content"><br />
<br />
tr̥ṭdāhamūrcchābhramaklamamadātyayāsraviṣapittē | <br />
<br />
śastaṁ svabhāvaśītaṁ, śr̥taśītaṁ sannipātē'mbhaḥ||57|| <br />
<br />
hikkāśvāsanavajvarapīnasaghr̥tapītapārśvagalarōgē| <br />
<br />
kaphavātakr̥tē styānē sadyaḥśuddhē ca hitamuṣṇam||58|| <br />
<br />
pāṇḍūdarapīnasamēhagulmamandānalātisārēṣu| <br />
<br />
plīhni ca tōyaṁ na hitaṁ kāmamasahyē pibēdalpam||59|| <br />
<br />
pūrvāmayāturaḥ san dīnastrishnarditō jalaṁ kāṅkṣan| <br />
<br />
na labhēta sa cēnmaraṇamāśvēvāpnuyāddīrgharōgaṁ vā||60|| <br />
<br />
tasmāddhānyāmbu pibēttr̥ṣyan rōgī saśarkarākṣaudram| <br />
<br />
yadvā tasyānyatsyāt sātmyaṁ rōgasya taccēṣṭam||61|| <br />
<br />
tasyāṁ vinivr̥ttāyāṁ tajjanya upadravaḥ sukhaṁ jētum| <br />
<br />
tasmāttrishnaṁ pūrvaṁ jayēdbahubhyō'pi rōgēbhyaḥ||62|| <br />
<br />
tRuTdAhamUrcchAbhramaklamamadAtyayAsraviShapitte | <br />
<br />
shastaM svabhAvashItaM, shRutashItaM sannipAte~ambhaH ||57|| <br />
<br />
hikkAshvAsanavajvarapInasaghRutapItapArshvagalaroge | <br />
<br />
kaphaVātakRute styAne sadyaHshuddhe ca hitamuṣṇam ||58|| <br />
<br />
pANDUdarapInasamehagulmamandAnalAtisAreShu | <br />
<br />
plIhni ca toyaM na hitaM kAmamasahye pibedalpam ||59|| <br />
<br />
pUrvAmayAturaH san dInastRuṣṇardito jalaM kA~gkShan | <br />
<br />
na labheta sa cenmaraNamAshvevApnuyAddIrgharogaM vA ||60|| <br />
<br />
tasmAddhAnyAmbu pibettRuShyan rogI sasharkarAkShaudram | <br />
<br />
yadvA tasyAnyatsyAt sAtmyaM rogasya tacceShTam ||61|| <br />
<br />
tasyAM vinivRuttAyAM tajjanya upadravaH sukhaM jetum | <br />
<br />
tasmAttRuṣṇaM pUrvaM jayedbahubhyo~api rogebhyaH ||62||<br />
</div></div><br />
<br />
Fresh cold water is beneficial in thirst associated with fainting, giddiness, exhaustion, alcoholism, poisoning and disorder of [[rakta]] and [[pitta]]. <br />
<br />
In thirst caused by ''sannipata'' (vitiation of all [[dosha]]) ''tridoshaja'', water cooled after boiling is beneficial.<br />
<br />
Warm water is useful in condition like hiccough, dyspnea, acute fever, coryza, after consumption of ghee, disorders of flanks and throat, diseases caused by [[kapha]] and [[vata]], or when the [[dosha]] are still not moving properly in the body and just after the purificatory treatment.<br />
<br />
In anemia, abdominal disease, ''gulma, meha,'' depleted digestive power, diarrhea and splenic disorders water intake is not beneficial; but if the thirst is unbearable, the patient may drink water in less quantity.<br />
<br />
If the patient is suffering from the above mentioned diseases and has become miserably afflicted with thirst and craving for water and if he does not get water, he may soon die or be afflicted with chronic illness then such thirsty patient may drink coriander water mixed with honey and sugar, or other medicated water which is wholesome in this condition.<br />
<br />
If the thirst is remedied, it is facile to subdue the complication arising from it; therefore thirst should be treated first in all diseases. [57-62]<br />
<br />
=== Summary ===<br />
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<br />
तत्र श्लोकः- <br />
<br />
हेतू यथाऽग्निपवनौ कुरुतः सोपद्रवां च पञ्चानाम् | <br />
<br />
तृष्णानां पृथगाकृतिरसाध्यता साधनं चोक्तम् ||६३||<br />
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<br />
tatra ślōkaḥ- <br />
<br />
hētū yathā'gnipavanau kurutaḥ sōpadravāṁ ca pañcānām| <br />
<br />
trishnanāṁ pr̥thagākr̥tirasādhyatā sādhanaṁ cōktam||63|| <br />
<br />
tatra shlokaH- <br />
<br />
hetU yathA~agnipavanau kurutaH sopadravAM ca pa~jcAnAm | <br />
<br />
tRuṣṇanAM pRuthagAkRutirasAdhyatA sAdhanaM coktam ||63||<br />
</div></div><br />
<br />
Here is the recapitulatory verse-<br />
<br />
How the thermal factors and [[vata]] are the two causative factors for five kinds of ''trishna'', their separate characteristics, the incurable condition and the method of remedy have all been described.[63]<br />
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<br />
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने तृष्णारोगचिकित्सितं नाम द्वाविंशोऽध्यायः ||२२||<br />
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<br />
ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē trishnarōgacikitsitaṁnāma dvāviṁśō'dhyāyaḥ||22|| <br />
<br />
ityagniveshakRute tantre carakapratisaMskRute~aprApte dRuDhabalasampUrite cikitsāsthAne tRuṣṇarogacikitsitaM nAma dvAviMsho~adhyAyaH ||22||<br />
</div></div><br />
<br />
Thus, in the section of therapeutics in the treatise complied by Agnivesha and revised by Charak, the twenty second chapter entitled [[Trishna Chikitsa]] not being available, annotated by Charak and redacted by Dridhabala, is completed.[22]<br />
<br />
== Tattva Vimarsha (Fundamental Principles) ==<br />
<br />
*Morbid thirst is caused by severe vitiation of [[pitta]] and [[vata]] [[dosha]]. <br />
*Etiological factors for ''trishna'' are vitiated [[vata]] and [[pitta]] as both [[dosha]] have absorbent (''shoshaka'') property which damage the ''rasavaha'' and ''udakavaha srotas'' and manifest the symptom of constant craving for water.<br />
*Severely vitiated [[dosha]] vigorously dehydrate the fluid carrying ducts and channels situated at the base of the tongue, throat, palate and ''kloma'' leading to morbid thirst in a person.<br />
*Constant craving for water is the cardinal symptom of pathological thirst. <br />
*The morbid thirst is classified into [[vata]] dominant, [[pitta]] dominant, that due to vitiation of ''ama'', due to excess depletion of body elements and as a complication of other diseases. <br />
*Rain water is the best remedy to pacify thirst. The water, that has slight astringent taste, light to digest, cool properties, possess good smell and taste and is devoid of channel blocking quality, should be considered equal to rain water in effect though it may be terrestrial. Various recipes having same properties are used in management of thirst.<br />
*The management principle of ''trishna'' includes rehydration with pure rain water, medicated water, external application of medicinal pastes.<br />
*The temperature of water plays key role in the management of ''trishna''. Hot water, normal water and cold water shall be used after proper assessment of [[dosha]] dominant condition. <br />
*Nourishment of all body elements ([[dhatu]]) depends on ''ahara rasa''. ''Rasa'' is predominantly ''apya'' (dominated by water element) in nature. So, diminution of [[rasa dhatu]] ultimately leads to loss of water content in body and production of ''trishna''.<br />
<br />
== Vidhi Vimarsha (Applied Inferences ) ==<br />
<br />
=== Differentiation between ''trishna'' and ''pipasa'' ===<br />
<br />
''Trishna'' and ''pipasa'' are two commonly used terms. ''Trishna'' is pathological thirst while ''pipasa'' is physiological. Physiological thirst is relieved after adequate water intake, whereas, pathological thirst is not relieved even after repeated water intake. Both of them are due to [[vata]] and [[pitta]] [[dosha]]. In ''pipasa'' they are in balanced state while in ''trishna'' they are vitiated. ''Trishna'' is manifestation of decrease in saumya [[dhatu]] (body elements composed of predominantly water) in body [[rasa dhatu]], [[rakta dhatu]], lasika, kleda, [[meda dhatu]], and urine. One common channel, ''udakavaha srotas'' regulates all the water content of the body. It is situated between palate, tongue and throat.<br />
<br />
==== ''Udakavaha srotasa'' ====<br />
<br />
The root of transport channels of water are ''talu'' and ''kloma'' which have more than anatomical importance. They include the area of brain where thirst center is located and also throughout the body where the osmo-regulators are situated. They signal to higher integrative centers, where ultimately the conscious craving arises. As described in context of ''udara chikitsa, kloma'' should be understood as a physiological entity and may be compared with interstitial fluid which has definite role in pathogenesis of thirst as described in the chapter.<br />
<br />
=== Fluid balance, normal quantity of water and other elements ===<br />
<br />
The regulation of the volume and composition of body fluids (''udaka''), their distribution throughout the body, and balancing the pH of body fluids is crucial to maintaining overall homeostasis and health. The water and dissolved solutes throughout the body constitute the body fluids. Regulatory mechanisms involving the kidneys and other organs normally maintain homeostasis of the body fluids. Malfunction in any or all of them may seriously endanger the functioning of organs throughout the body. <br />
<br />
Body fluids are present in two main “compartments”—inside cells and outside cells. About two-thirds of body fluid is intracellular fluid (ICF) or cytosol, the fluid within cells. The other third, called extracellular fluid (ECF) includes all other body fluids.<br />
<br />
About 80% of the ECF is interstitial fluid, which occupies the microscopic spaces between tissue cells, and 20% of the ECF is plasma, the liquid portion of the blood. Other extracellular fluids that are grouped with interstitial fluid include lymph in lymphatic vessels; cerebrospinal fluid in the nervous system; synovial fluid in joints; aqueous humor and vitreous body in the eyes; endolymph and perilymph in the ears; and pleural, pericardial, and peritoneal fluids between serous membranes. The body is in fluid balance when the required amounts of water and solutes are present and are correctly proportioned among the various compartments. Water is by far the largest single component of the body, making up 45–75% of total body mass, depending on age and gender.<br />
<br />
It may be noted that ''udaka'' has been mentioned to be present in quantity of ten ''anjali'' and this quantity is irrespective of ''rasa'' which is nine ''anjali'' in quantity and ''rakta'' is eight ''anjali'' in quantity. But this ''udaka'' acts as a replacement for [[rakta]] and [[rasa dhatu]] as and when necessary. ''Sweda, lasika, [[kapha]], etc. are also ''jaliya'' (watery) entity which are closely related with ''udaka''.<br />
<br />
=== Mechanisms of fluid balance ===<br />
<br />
*Osmosis is the primary means of water movement between intracellular fluid and interstitial fluid, the concentration of solutes in these fluids determines the direction of water movement. Because most solutes in body fluids are electrolytes, inorganic compounds that dissociate into ions, fluid balance is closely related to electrolyte balance. Because intake of water and electrolytes rarely occurs in exactly the same proportions as their presence in body fluids, the ability of the kidneys to excrete excess water by producing dilute urine, or to excrete excess electrolytes by producing concentrated urine, is of utmost importance in the maintenance of homeostasis. ''Sama anayati iti samanam'' is the definition of samana [[vayu]]. ''Samana'' has a seat in ''sweda, [[dosha]] and ''ambhuvaha srotas''. As discussed above maintaining the pH (''sami karoti'') is brought about by specific ionic movement and this particular force is provided by samana [[vayu]]. It maintains the pH by maintaining a specific ratio of solutes and solvents and if this specific ratio is disturbed it leads to various diseases for e.g. a decrease in blood volume causes blood pressure to fall. This change stimulates the kidneys to release renin, which promotes the formation of angiotensin II. Increased nerve impulses from osmo-receptors in the hypothalamus, triggered by increased blood osmolarity, and increased angiotensin II in the blood both stimulate the thirst center in the hypothalamus. Other signals that stimulate thirst come from (1) neurons in the mouth that detect dryness due to a decreased flow of saliva and (2) baroreceptors that detect lowered blood pressure in the heart and blood vessels. As a result, the sensation of thirst increases, which usually leads to increased fluid intake (if fluids are available) and restoration of normal fluid volume. Overall, fluid gain balances fluid loss. Sometimes, however, the sensation of thirst does not occur quickly enough or access to fluids is restricted, and significant dehydration ensues. This happens most often in elderly people, in infants, and in those who are in a confused mental state. Even though the loss of water and solutes through sweating and exhalation increases during exercise, elimination of excess body water or solutes occurs mainly by control of their loss in urine.<br />
*The extent of urinary salt (NaCl) loss is the main factor that determines body fluid volume. The reason for this is that “water follows solutes” in osmosis, and the two main solutes in extracellular fluid (and in urine) are sodium ions (Na) and chloride ions (Cl). In a similar way, the main factor that determines body fluid osmolarity is the extent of urinary water loss. Because our daily diet contains a highly variable amount of NaCl, urinary excretion of Na and Cl must also vary to maintain homeostasis. Hormonal changes regulate the urinary loss of these ions, which in turn affects blood volume. The increased intake of NaCl produces an increase in plasma levels of Na and Cl (the major contributors to osmolarity of extracellular fluid). As a result, the osmolarity of interstitial fluid increases, which causes movement of water from intracellular fluid into interstitial fluid and then into plasma. Such water movement increases blood volume. <br />
*Water balance and electrolyte balance are closely linked. The body works to keep the total amount of water and the levels of electrolytes in the blood constant. For example, when the sodium level becomes too high, thirst develops, leading to an increased intake of fluids. In addition, vasopressin (also called antidiuretic hormone), a hormone secreted by the brain in response to dehydration, causes the kidneys to excrete less water. The combined effect is an increased amount of water in the blood. As a result, sodium is diluted and the balance of sodium and water is restored. When the sodium level becomes too low, the kidneys excrete more water, which decreases the amount of water in the blood, again restoring the balance. Water flows passively (by osmosis) from one area or compartment of the body to another. This passive flow allows the larger volumes of fluid in the cells and the area around the cells to act as reservoirs to protect the more critical but smaller volume of fluid in the blood vessels from dehydration.<br />
*Function of samana [[vayu]] needs to be understood. Sweda [[dosha]] ambuvaha srotas is the seat for ''samana vayu''. Maintaining the balance is the function of samana [[vayu]] and it is brought about by ''grahanati'' (to retain food until digested), ''pachati'' (to digest) , ''vivechayati'' (differentiating between waste and useful product) and ''munchati'' (to release waste to ''apana'') action. Samana [[vayu]] is vital for organisms to be able to maintain their fluid levels in very narrow ranges. One set of receptors responsible for thirst detects the concentration of interstitial fluid. The other set of receptors detects blood volume. Arterial baroreceptors sense a decreased arterial pressure, and signal to the central nervous system in the area postrema and nucleus tractus solitarii. Cardiopulmonary receptors sense a decreased blood volume, and signal to area postrema and nucleus tractus solitarii as well. This explains the function of ''srotas sthita maruta'' (vyana [[vayu]]) and [[manas]] due to its ''satva guna'' helps in getting knowledge about the surrounding.<br />
*Osmometric thirst occurs when the solute concentration of the interstitial fluid increases. This increase draws water out of the cells, and they shrink in volume. The solute concentration of the interstitial fluid increases by high intake of sodium in diet or by the drop in volume of extracellular fluids (such as blood plasma and cerebrospinal fluid) due to loss of water through perspiration, respiration, urination and defecation. The increase in interstitial fluid solute concentration causes water to migrate from the cells of the body, through their membranes, to the extracellular compartment, by osmosis, thus causing cellular dehydration.<br />
<br />
The above mechanisms are disturbed in ''trishna''.<br />
<br />
=== Etiopathogenesis of ''trishna'' ===<br />
<br />
In morbid thirst, [[vata]] and [[pitta]] [[dosha]] are predominately involved. Etiological factors aggravate either [[vata]], [[pitta]] or both and manifest ''trishna''. Both [[dosha]] have absorbent (''soshaka'') property, [[vata]] [[dosha]] by its drying property and [[pitta]] by its heating property. Therefore excess exposure to various factors in diet and lifestyles leading to dryness and heat inside the body are considered as causative factors for ''trishna''. Some of the commonly observed factors are enlisted below: <br />
*'''Dietary causes''': Regular use of alkaline & sour substances, use of excessive salt, pungent, salty, dry and dehydrated food, extreme starvation, alcoholism<br />
*'''Lifestyle causes''': Excess exercise [Cha.Sa. [[Sutra Sthana]] 7/33], excess distress, excessive exposure to sunlight, fatigue.<br />
*'''Psychological causes''': Fear, grief, anger<br />
*'''Iatrogenic causes''': Excessive use of purification procedures, improper ''snehapana'' (administration of therapeutic medicated ghee or similar unctuous substance) [Cha. Sa.[[Sutra Sthana]] 13/71]<br />
*Due to chronic diseases leading to emaciation and excessive loss of basic body forming elements <br />
*Associated symptom of diseases like ''shotha'' [Cha. Sa. [[Sutra Sthana]] 18/18], [[pitta]] dominant ''gulma'' [Cha.Sa. [[Chikitsa Sthana]] 5/36], ''vrana'' [Cha. Sa. [[Chikitsa Sthana]] 25/30], ''udavarta'' [Cha.Sa. [[Chikitsa Sthana]] 26/9], ''prameha'' [Cha.Sa. [[Nidana Sthana]] 4/48], ''kushtha'' [Cha. Sa.[[Nidana Sthana]] 5/11], ''antarvega jwara'' [Cha.Sa.[[Chikitsa Sthana]] 3/39], ''bahirvegi jwara'' [Cha. Sa. [[Chikitsa Sthana]] 3/41],[[rakta dhatu]]gata jwara[Cha. Sa. [[Chikitsa Sthana]] 3/77] , [[vata]] [[pitta]] jwara[ Cha.Sa.[[Chikitsa Sthana]] 3/85], ''shleshma-paittika jwara'' [Cha.Sa. [[Chikitsa Sthana]] 3/88], [[pitta]] kapholvana hina [[vata]] sannipata jwara''[Cha.Sa.[[Chikitsa Sthana]] 3/93] , ''vatolvana [[kapha]] [[pitta]] hina sannipata jwara'' [Cha.Sa.[[Chikitsa Sthana]] 3/94], ''pittolvana madhya [[kapha]] hina [[vata]] jwara'' [Cha.Sa. [[Chikitsa Sthana]] 3/98], ''sama sannipata jwara''[Cha.Sa.[[Chikitsa Sthana]] 3/102], ''pittolvana [[vata]] madhya [[kapha]] hina jwara''[Cha.Sa. [[Chikitsa Sthana]] 3/106], ''pachyamana jwara'' [Cha.Sa.[[Chikitsa Sthana]] 3/136], ''romantika'' [Cha.Sa.[[Chikitsa Sthana]] 12/92], ''pittodara'' [Cha.Sa.[[Chikitsa Sthana]] 13/28], ''badhagudodara'' [Cha.Sa.[[Chikitsa Sthana]] 13/41],''chhidrodara'' [Cha. Sa. [[Chikitsa Sthana]] 13/44], ''sahaja arsha''[Cha. Sa. [[Chikitsa Sthana]] 14/8 ], ''paittika ajirna'' [Cha. Sa.[[Chikitsa Sthana]] 15/46], ''grahani'' [Cha. Sa. [[Chikitsa Sthana]] 15/53] ,[[vata]]ja grahani [Cha.Sa.[[Chikitsa Sthana]] 15/61],''paittika pandu'' [Cha. Sa. [[Chikitsa Sthana ]] 16 /20], ''halimaka'' [Cha.Sa. [[Chikitsa Sthana]] 16/133],''vyapeta hikka'' [Cha.Sa. [[Chikitsa Sthana]] 17/32], ''paittika kasa'' [Cha.Sa.[[Chikitsa Sthana]] 18/15], ''kshataja kasa'' [Cha.Sa.[[Chikitsa Sthana]] 18/23], ''paittika atisara'' [Cha. Sa.[[Chikitsa Sthana]] 19/6],''raktatisara'' [Cha.Sa. [[Chikitsa Sthana]] 19/70], ''sannitpatika chhardi'' [Cha. Sa. [[Chikitsa Sthana]] 20/15], ''abhyantara visarpa'' [Cha. Sa. [[Chikitsa Sthana]] 21/16], ''paittika visarpa'' [Cha.Sa. [[Chikitsa Sthana]] 21/32],''vata-paittika visarpa'' [Cha.Sa.[[Chikitsa Sthana]] 21/36],''paittika madatyaya'' [Cha.Sa.[[Chikitsa Sthana]] 24/94], ''madatyaya'' general symptom [Cha.Sa.[[Chikitsa Sthana]] 24/101], ''tikshna madatyaya'' [Cha.Sa.[[Chikitsa Sthana]] 24/113],''vikshaya'' [Cha.Sa. [[Chikitsa Sthana]] 24/ 102],''paittika vrana'' [Cha.Sa.[[Chikitsa Sthana]] 25/13], ''paittika mukharoga'' [Cha.Sa.[[Chikitsa Sthana]] 26/120],''pittavrita vayu'' [Cha.Sa.[[Chikitsa Sthana]] 28 /61], ''paittika vatarakta'' [Cha.Sa. [[Chikitsa Sthana]] 29/ 28], ''dhvaja bhanga'' [Cha. Sa.[[Chikitsa Sthana]] 30/171], ''paittika shiroroga'' [Cha.Sa.[[Sutra Sthana]] 17/23], ''paittika hridroga'' [Cha.Sa.[[Sutra Sthana]] 17 /33], [[vata]]-[[kapha]] kshaya [[pitta]] vriddhi[Cha.Sa.[[Sutra Sthana]] 17 /60], ''alaji'' [Cha.Sa.[[Sutra Sthana]].17/88],[[vata]]-[[pitta]]janya vidradhi [Cha.Sa.[[Sutra Sthana]] 17/ 96], [[pitta]] nanatmaja vikara'' [Cha.Sa.[[Sutra Sthana]] 20 /14 ], ''ambuvaha sroto dushti'' [Cha.Sa.[[ Vimana Sthana]] 5 /11],''paittika jwara'' [Cha.Sa. [[Nidana Sthana]] 1/24]. <br />
*Complication (''upasarga'') of diseases like ''jwara, meha, kshaya, shosha, shwasa'' [Cha.Sa. [[Chikitsa Sthana]] 22/17]<br />
<br />
=== General pathogenesis ===<br />
<br />
Due to above mentioned factors, [[vata]] and [[pitta]] [[dosha]] are vitiated and further affect channels carrying fluids like ''rasavaha'' and ''udakavaha srotasa''.<br />
<br />
=== Etio-pathological factors in thirst ===<br />
<br />
Acute fall in blood pressure and/or blood volume will also stimulate thirst. 15% or more reduction in circulating blood volume is required for this effect. However, the effects are short-lived and the effect of osmolality changes on thirst is more significant. <br />
<br />
Thus classification may be done as follows:<br />
==== A. Causes of excessive thirst without excessive urination ====<br />
==== 1. Dehydration due to: ====<br />
*Excessive sweating (diaphoresis)<br />
*Diarrhea<br />
*Large loose stools after eating foods high in fiber<br />
*Hyperventilation due to anxiousness, certain diseases, such as pneumonia, or at high altitudes.<br />
<br />
==== 2. Other causes of dry mouth ====<br />
<br />
'''Acute (sudden) causes of dry mouth''':<br />
*Eating dry or spicy or salty foods<br />
*Breathing dry air, breathing through the mouth, snoring, smoking, chewing tobacco<br />
*Anxiety, depression, stress <br />
*Hangover<br />
*Disorder of salivary glands (mumps, side effect of irradiation) <br />
*Stroke <br />
*Shock (hypovolemic, septic, anaphylactic)<br />
<br />
'''Chronic causes of dry mouth (xerostomia)''':<br />
*Anemia<br />
*Hypertension<br />
*Oral thrush caused by fungal [candida] infection<br />
*Disorders of salivary glands (sialadenitis, stones)<br />
*Autoimmune diseases: Sjögren’s syndrome, systemic lupus erythematosus (SLE), systemic sclerosis, sarcoidosis (neurosarcoidosis), rheumatoid arthritis <br />
*Parkinson’s disease<br />
*HIV/AIDS<br />
*Alzheimer’s disease<br />
*Mouth or throat cancer<br />
*Cystic fibrosis<br />
<br />
'''Dry mouth as a side effect of medications or supplements''':<br />
*Anti-acne drugs: tretinoin <br />
*Anticholinergics (spasmolytics): atropine <br />
*Antidepressants: fluoxetine <br />
*Antidiarrheals: bismuth subsalicylate, loperamide<br />
*Antiemetics (drugs to treat nausea/vomiting): chlorpromazine, metoclopramide, ondansetron, promethazine, scopolamine <br />
*Antihistamines <br />
*Antiepileptics: valproate, topiramate<br />
*Antiparkinsonians <br />
*Antipsoriatics: acitretin<br />
*Antipsychotics: modafinil, phenothiazines, risperidone, indapamide<br />
*Antivirals: ritonavir, indinavir; antiretrovirals (to treat AIDS) <br />
*Aspirin overdose <br />
*Beta-blockers (for heart disease, hypertension): atenolol, propranolol<br />
*Bronchodilators (to treat asthma): theophylline, salbutamol <br />
*Chemotherapeutics: bortezomib, cisplatin <br />
*Muscle relaxants <br />
*Nasal decongestants (sprays)<br />
*Non-steroidal anti-inflammatory drugs (NSAIDs): aspirin, diclofenac, ibuprofen, naproxen<br />
*Opiates: morphine <br />
*Sedatives (sleeping pills: diazepam)<br />
*Steroids <br />
*Stimulants: armodafinil <br />
<br />
'''Illegal Drugs''':<br />
*Marijuana (cannabis) <br />
*Ecstasy (MDMA) <br />
*Cocaine <br />
*Heroin <br />
*Amphetamine<br />
<br />
==== B. Causes of excessive thirst with excessive urination ====<br />
<br />
==== Psychogenic Polydipsia ====<br />
<br />
In most cases of polydipsia, people drink water to replace water they have lost due to excessive urination caused by certain organic disorders. Individuals with primary or psychogenic polydipsia (often associated with schizophrenia) have no organic disorder, but they believe or feel they should drink a lot of fluid. This can lead to water intoxication (hyponatremia), which can be life threatening.<br />
<br />
==== Brain Disorders Resulting in Central Diabetes Insipidus ====<br />
<br />
*Head injury, tumor, stroke <br />
<br />
==== Impaired Kidney Function Resulting in Nephrogenic Diabetes Insipidus ====<br />
<br />
*Salt-wasting nephropathy (in a polycystic kidney disease) , post-obstructive diuresis (after resolution of urinary tract blockage), medullary kidney cystic disease, proximal renal tubular acidosis<br />
<br />
==== Heart Disorders ====<br />
*Supraventricular tachycardia (a type of heart arrhythmia), postural hypotension, systemic capillary leak syndrome<br />
<br />
==== Hormonal Disorders ====<br />
*Gestational diabetes insipidus; in the 3rd trimester of pregnancy<br />
*Adrenal hyperactivity<br />
*Epinephrine (adrenaline)-secreting tumor (pheochromocytoma) in the adrenal medulla <br />
*Pituitary disorders: <br />
**Cushing’s syndrome <br />
**Sheehan’s syndrome (pituitary infarct)<br />
**Hyperthyroidism, especially acute severe thyrotoxicosis (thyroid storm) (hyperglycemia, excessive sweating and diarrhea lead to polydipsia)<br />
**Hyperparathyroidism <br />
<br />
==== Metabolic Disorders ====<br />
*Hypokalemia <br />
*Hypercalcemia<br />
*Hypernatremia<br />
<br />
==== Genetic and Congenital Disorders ====<br />
*Aceruloplasminemia<br />
*Alsing syndrome<br />
*Bartter’s syndrome <br />
*Boichis syndrome <br />
*Cystinosis <br />
*DEND syndrome <br />
*EAST syndrome <br />
*Fanconi syndrome<br />
*Froelich’s syndrome<br />
*Gitelman syndrome <br />
*Liddle’s syndrome <br />
*Nephronophthisis <br />
*Schroeder syndrome<br />
*Sickle cell anemia <br />
*Wolfram (DIDMOAD) syndrome<br />
*Apparent Mineralocorticoid Excess Syndrome<br />
<br />
==== Other Disorders ====<br />
*Adiposogenital dystrophy <br />
*Langerhans cell histiocytosis<br />
*Omega-3 FFA deficiency syndrome<br />
*Sarcoidosis (neurosarcoidosis) <br />
*Tumors/cancers: <br />
**Adrenal adenoma <br />
**Ganglioblastoma <br />
**Glucagonoma — glucagon secreting tumor (gluconeogenesis > hyperglycemia > polydipsia) <br />
**Multiple myeloma <br />
**Pheochromocytoma<br />
<br />
==== Drugs ====<br />
*Amphotericin B <br />
*Antiobesity drugs: lorcaserin, orlistat, phentermine, sibutramine<br />
*Caffeine intoxication (excessive coffee or tea drinking) <br />
*Demeclocycline <br />
*Diuretics<br />
*Lithium <br />
*Vitamin D overdose (hypervitaminosis D)<br />
<br />
==== Poisons ====<br />
*Acid ingestion <br />
*Amanita muscaria (fly agaric) and other toxic mushrooms <br />
*Arsine gas <br />
*Belladonna-like plant<br />
*Bloodroot <br />
*Death camas <br />
*Horse nettle intake<br />
*Jimsonweed/Jamestown weed ingestion<br />
*Meadow Saffron plant<br />
*Mercury poisoning in children (acrodynia, pink disease)<br />
*Yellow jessamine (jasmine poisoning) <br />
*Snake bites <br />
<br />
==== Table 1: Condition with morbid thirst and diagnostic tests ====<br />
<br />
{|class="wikitable"<br />
|-<br />
!scope = "col"| CONDITION<br />
!scope = "col"| SYMPTOMS AND SIGNS (besides excessive urination and thirst)<br />
!scope = "col"| LAB TESTS<br />
|-<br />
!scope = "row"| Dehydration<br />
|Sudden weight loss, dark urine (decreased, not increased urination)<br />
|Decreased 24-hour urine; in mild and moderate dehydration: normal blood sodium; in severe dehydration: increased blood sodium<br />
|-<br />
!scope = "row"| Heat exhaustion or heat stroke<br />
|Exhaustion, cool, clammy skin, increased body temperature (in heat stroke: warm skin, body T > 105.8 °F or 41 °C)<br />
|Decreased 24-hour urine<br />
|-<br />
!scope = "row"| Diabetes mellitus<br />
|Hunger or poor appetite, weight loss, extreme fatigue, blurred vision, jock itch, diabetes in family<br />
|Increased glucose levels in the blood and urine<br />
|-<br />
!scope = "row"| Diabetes insipidus (central and nephrogenic)<br />
|History of brain trauma, surgery or tumor, or a kidney disease<br />
|Decreased urine specific gravity and osmolality, increased blood sodium<br />
|-<br />
!scope = "row"| Diuretics<br />
|Dry mouth<br />
|Decreased urine specific gravity<br />
|-<br />
!scope = "row"| Psychogenic polydipsia<br />
|Usually in individuals with schizophrenia treated with antipsychotics<br />
|Increased 24-hour urine, decreased urine specific gravity and osmolality, sometimes: decreased blood sodium<br />
|-<br />
!scope = "row"| Adrenal hyperactivity (hyperaldosteronism)<br />
|Increased blood pressure<br />
|Decreased blood potassium, increased urine potassium, increased blood aldosterone after sodium challenge<br />
|-<br />
!scope = "row"| Anorexia nervosa<br />
|Severely decreased body weight<br />
|Mineral and vitamin deficiencies (hypokalemia, low iron, etc.)<br />
|-<br />
!scope = "row"| Postural (orthostatic) hypotension <br />
|Dizziness after raising up, Drop of blood pressure > 30 mm Hg upon standing<br />
|Nothing typical<br />
|-<br />
!scope = "row"| Hypertension<br />
|Increased blood pressure<br />
|Possible increase of blood aldosterone, renin<br />
|-<br />
!scope = "row"| Anemia<br />
|Paleness, fatigue, hyperventilation<br />
|Decreased RBC or abnormal erythrocytes<br />
|-<br />
!scope = "row"| Congestive heart failure <br />
|Chest pain, swollen legs<br />
|ECG abnormalities<br />
|-<br />
!scope = "row"| Liver cirrhosis <br />
|History of alcoholism, poor appetite, loss of weight, spider nevuses<br />
|Decreased serum proteins (albumin), increased liver enzymes and bilirubin<br />
|-<br />
!scope = "row"| Chronic dry mouth (xerostomia) in Sjögren’s syndrome and SLE<br />
|Rash, joint pain<br />
|Specific antibodies in the blood<br />
|-<br />
!scope = "row"| Shock (hypovolemic, septic, anaphylactic)<br />
|Cool, clammy skin, increased heart rate; in late shock: lethargy, low blood pressure<br />
|Septic shock: increased or decreased white blood cells (WBC), increased blood glucose<br />
|-<br />
!scope = "row"| Ecstasy (MDMA), cocaine, marijuana <br />
|Euphoria<br />
|Positive urine drug test<br />
|-<br />
!scope = "row"| Opiates (morphine, heroin)<br />
|Sleepiness<br />
|Positive urine drug test<br />
|}<br />
<br />
=== Laboratory Tests ===<br />
==== Blood Tests ====<br />
==== Glucose Elevated ====<br />
<br />
*Diabetes mellitus<br />
*Cushing’s syndrome<br />
*Early phase of hypovolemic shock (bleeding)<br />
*Pheochromocytoma <br />
<br />
==== Sodium ====<br />
<br />
*Normal levels (135-145 meq/L):<br />
**In most cases of dehydration (diarrhea, vomiting, excessive sweating)<br />
**Within 8 hours of onset of acute bleeding<br />
*Hyponatremia (<135 meq/L): <br />
**>8 hours after onset of bleeding, when interstitial fluid moves into the intravascular space<br />
**Sometimes after repeated vomiting or severe diarrhea<br />
**Water intoxication<br />
**Diabetic ketoacidosis (usually) <br />
**Cerebral salt wasting (head injury, tumor) <br />
**Hypernatremia (>145 meq/L) <br />
**Dehydration (sometimes) <br />
**Diabetes insipidus <br />
<br />
==== Potassium ==== <br />
*Hypokalemia: <br />
**Hyperaldosteronism<br />
**Anorexia nervosa<br />
**Hyperthyroidism<br />
*Hyperkalemia: <br />
**Diabetic ketoacidosis (usually) <br />
<br />
==== Calcium ====<br />
*Hypercalcemia: <br />
**Hyperparathyroidism<br />
**Hypervitaminosis D <br />
*Hypocalcemia: <br />
**Diabetic ketoacidosis (usually) <br />
<br />
==== CBC ====<br />
*White blood cells increased or decreased in sepsis<br />
<br />
==== Hematocrit (HCT) ====<br />
*Decreased in water intoxication<br />
<br />
==== Blood Urea Nitrogen (BUN) ====<br />
*Increased in kidney failure<br />
*Decreased in water intoxication<br />
<br />
==== pH ====<br />
*<7.3 (diabetic ketoacidosis) <br />
<br />
==== Proteins ====<br />
*Hypoalbuminemia in liver cirrhosis, nephrotic syndrome, severe malnutrition<br />
<br />
==== Hormone levels ====<br />
*ADH <br />
*Decreased in central diabetes insipidus<br />
*Increased in nephrogenic diabetes insipidus <br />
*ACTH may be increased in pituitary adenoma or adrenal hyperplasia<br />
*Cortisol may be increased in adrenal adenoma<br />
*Aldosterone may be increased in adrenal adenoma or primary hyperaldosteronism<br />
<br />
==== Urine Tests ====<br />
*Osmolality <br />
*<200 mOsm/kg in psychogenic polydipsia, diabetes insipidus <br />
*Specific gravity <br />
*<1.005 in diabetes insipidus<br />
*Glucose <br />
*Untreated diabetes mellitus 1 or 2 <br />
*Pheochromocytoma; rare <br />
*Proteins <br />
*In nephrotic syndrome<br />
*Sodium >20 meq/L: cerebral salt wasting<br />
<br />
==== Principles of management ====<br />
<br />
The treatment modalities intended to pacify [[vata]] and [[pitta]] [[dosha]] are applied for management of ''trishna''. Specifically rain water, water processed with drugs having ''manda'' (mild) and ''sheeta'' (cool) properties, various medicated ghee mentioned in the text are used to manage ''trishna''.<br />
<br />
==== Various preparations used in management ====<br />
==== Food and beverages ====<br />
*''Trina panchamula'' medicated water<br />
''Trina Panchamula'' contains five drugs namely ''kusha, kasha, nala, darbha'' and ''kandekshu''. It pacifies [[pitta]] and it is indicated in ''trishna''<ref> Sushruta. Sutra Sthana, Cha.38 Dravyasangrahaneeya Adhyaya verse 77. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>. In ''Bhaisajya Ratnavali, Shara'' is given in place of ''Nala''. (''Bhaisajya Ratnavali, Mutrakricharogadhikar'' 10)<br />
<br />
''Kusha – Desmostachya bipinnata''<br />
<br />
''Kasha – Saccharum spontaneum''<br />
<br />
''Shara – Saccharum munja''<br />
<br />
''Darbha'' –Imperata cylindrical<br />
<br />
''Ikshu'' – Sugarcane – Saccharum officinarum<br />
<br />
The above drugs should be taken along with water in ratio of 1:64 and then it should be reduced to half by boiling and later on filtered and used after cooling similar to Shadangapaniya vidhi as explained in [[Jwara Chikitsa]].<br />
*''Laja sattu'': ''Laja sattu'' is a thin gruel prepared from ''laja'' (parched rice) or roasted rice. It should be prepared with rain water and should be given to patient after mixing honey and sugar to it [Cha. Sa. [[Sutra Sthana]] 27/256].<br />
*''Yava'' medicated gruel: ''Yava'' (barley) is used in ''yava vatya'' (a gruel prepared out of one part of coarse powder of roasted ''yava'' (barley) and 14 parts of water).<br />
*''Peya'' is thin gruel of rice along with its solid portion (''sikta''). To prepare ''peya'', 14 parts of water and one part of broken rice are taken and boiled well till all the rice particles become soft. ''Peya'' prepared with ''shali'' and ''koradusha'' (type of cereal) pacifies thirst.<br />
*Food boiled with milk and ''mamsa rasa'' mixed with honey and ''sita'' (kind of sugar) should be given. ''Sita'' pacifies [[vata]] and [[pitta]] [[dosha]] so it is useful in patient of thirst <ref>Bhavamishra. Bhavaprakasha -Volume II. Chapter 23, Verse 31, Translated from Sanskrit by K.R. Srikantha Murthy. Reprint ed. Varanasi: Krishnadas academy;2004.pp.-</ref>.<br />
*''Trina panchamula, munjataka, priyala'' drugs should be mixed with ''mamsa rasa'' or ''kshira paka'' prepared from these should be given after mixing honey and sugar to it. All above drugs pacify [[pitta]] hence quench the thirst.<br />
<br />
==== External applications ====<br />
<br />
External application of ''shatadhauta ghrita'' is [[pitta]] shamaka so it should be used. ''Yusha'' is a soup prepared from pulses. Drugs which are ''madhura, tikta, sheeta'' and having ''jeevaniya'' properties, pacify [[pitta]]. They should be given to the patient for drinking as well as for external application.<br />
<br />
==== Medicated ghee ====<br />
<br />
''Ghrita'' processed with drugs of ''madhuradi gana'' mentioned in [[Vimana Sthana]] 8th chapter should be used for drinking, massage and sprinkling purpose. ''Ghrita'' is best for pacifying [[pitta]] and [[vata]].[Cha.Sa. [[Sutra Sthana]] 25/40] When processed with ''madhura gana'' drugs its property increases as it is ''yogavahi'' in nature (the one that accelerates the properties of others).<br />
<br />
==== Nasal administration ====<br />
<br />
Various milk or juice of sugarcane when administered through nasal route decreases thirst. [Cha.Sa.[[ Sutra Sthana ]] 27/224]<br />
Following table enlists various diet recipes and medicinal formulations used in the management of ''trishna'' referred at various places.<br />
<br />
==== Table 2: Diet and formulations for management of ''trishna'' ====<br />
<br />
{| class = "wikitable"<br />
|-<br />
!scope = "col"| Name of Formulations<br />
!scope = "col"| References<br />
|-<br />
| ''Peya''<br />
| [Cha. Sa. [[Chikitsa Sthana]] 3/187]<br />
|-<br />
| General property of milk pacifying ''trishna''<br />
| [Cha. Sa. [[Sutra Sthana]] 1/109]<br />
|-<br />
| Use of ''panchatikta kwatha''<br />
| [Cha. Sa. [[Chikitsa Sthana]] 3/200 ]<br />
|-<br />
| Use of ''Vidarigandhadi, Bilva, Utpala'' etc.<br />
| [Cha. Sa. [[Chikitsa Sthana]] 4/51]<br />
|-<br />
| ''Rohityada Ghrita''<br />
| [Cha. Sa. [[Chikitsa Sthana]] 5/117]<br />
|-<br />
| ''Duralabhadya Ghrita''<br />
| [Cha. Sa. [[Chikitsa Sthana]] 8/110]<br />
|-<br />
| ''Eladi Gutika''<br />
| [Cha. Sa. [[Chikitsa Sthana]] 11/23 ]<br />
|-<br />
| ''Amritaprasha Ghrita''<br />
| [Cha.Sa. [[Chikitsa Sthana]] 11 /43]<br />
|-<br />
| ''Tritiya Sarpi Guda''<br />
| [Cha. Sa. [[Chikitsa Sthana]] 11/65 ]<br />
|-<br />
| ''Patolamuladi Kwatha''<br />
| [Cha. Sa. [[Chikitsa Sthana]] 12/54]<br />
|-<br />
| ''Water Siddha'' with ''Trina panchamula Kwatha''<br />
| [Cha. Sa. [[Chikitsa Sthana]] 18/141]<br />
|-<br />
| ''Chandana'',sugar, honey with ''Tandulodaka''<br />
| [Cha. Sa. [[Chikitsa Sthana]] 19/86]<br />
|-<br />
| Use of ''Gairika, Sugandhabala'' with ''Tandulodaka''<br />
| [Cha. Sa. [[Chikitsa Sthana]] 20/32]<br />
|-<br />
| ''Drakshadi sita Kwatha/ Prapoundarika Kwatha''<br />
| [Cha. Sa. [[Chikitsa Sthana]] 21/58 ]<br />
|-<br />
|''Water processed with ''Parushaka'' and ''Pilu; Chatuparni; Musta, Dadima, Laja''<br />
| [Cha. Sa. [[Chikitsa Sthana]] 24/149] <br />
|-<br />
|Cold water<br />
|[Cha. Sa. [[Chikitsa Sthana]] 24/163]<br />
|-<br />
|''Madhura rasa''<br />
|[Cha. Sa. [[Chikitsa Sthana]] 26/43]<br />
|-<br />
|''Tikta rasa''<br />
|[Cha. Sa. [[Chikitsa Sthana]] 26/43 ]<br />
|-<br />
|''Rakta Shali''<br />
|[Cha. Sa. [[Chikitsa Sthana]] 27/11]<br />
|-<br />
|''Ervaruka''<br />
|[Cha. Sa. [[Chikitsa Sthana]] 27/111]<br />
|-<br />
|''Mridvika''<br />
|[Cha. Sa. [[Chikitsa Sthana]] 27/125 ]<br />
|-<br />
|''Sarkara''<br />
|[Cha. Sa. [[Chikitsa Sthana]] 27/242 ]<br />
|-<br />
|''Laja peya''<br />
|[Cha. Sa. [[Chikitsa Sthana]] 27/250 ]<br />
|-<br />
|''Saktu''<br />
|[Cha. Sa. [[Chikitsa Sthana]] 27/264 ]<br />
|}<br />
<br />
*''Gandusha'':<br />
''Gandusha'' (filling the mouth to its full capacity with liquid without allowing its movement in oral cavity) with various sweet and sour drugs is useful in thirst. ''Madhura rasa'' pacify ''pitta'' whereas ''amla rasa'' is cold on external application and increases salivation so both have soothing effect in dry mouth.<ref>Sushruta. Sutra Sthana, Cha.42 Rasavishesha Vijnaniya Adhyaya verse 10. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref> Use of ''amla'' drugs in the form of external application has also been advocated as they have cooling effect on touch. Thinking about cold things and environment is a part of psychotherapy which helps patient to combat desire of water.<br />
<br />
==== Management of [[vata]] dominant ''trishna'' ====<br />
All dietary formulations and drugs used in [[vata]]ja trishna must have property to pacify [[vata]]. Milk and ''ghrita'' mentioned in ''kshayaja kasa'' (like ''dwipanchamuladi ghrita, guduchyadi ghrita, kasmardadi ghrita'' etc.) pacify [[vata]] [[dosha]] effectively and thus these preparations can also be used in [[vata]]ja trishna.<br />
<br />
==== Management of [[pitta]] dominant ''trishna'' ====<br />
<br />
Various [[pitta]] pacifying drugs mixed with water are mentioned in treatment of [[pitta]]ja trishna''. These drugs pacify [[pitta]] as well as they are useful in maintaining water homeostasis.<br />
<br />
Water obtained after quenching of baked earth is said to be best for pacifying excessive thirst in ''agrya prakarana''. This simple method can be clinically evaluated in patients of morbid thirst. [Cha. Sa. [[Sutra Sthana]] 25/40].<br />
<br />
==== Management of ''amaja trishna'' ====<br />
<br />
To treat ''amaja trishna'', it is necessary that first ''ama'' is removed. For ''ama pachana'' drugs which increase [[agni]] can be used as well. Treatment of [[kapha]]ja chhardi can be followed as [[kapha]] nasaka'' treatment helps to remove ''ama''. If symptoms pertaining to ''ama'' are seen than ''ama'' should be removed by inducing emesis and warm water should be used to increase [[agni]] to remove ''ama''. As discussed earlier ''kshaya'' refers to emaciation of tissues. So, treatment which helps in revitalizing the tissue can be used as mentioned in ''kshatakshina, shosha'' can also be used.<br />
<br />
==== Management of ''trishna'' due to ''madatyaya'' ====<br />
<br />
Use of alcohol for treating thirst induced due to alcohol is example of ''Hetu Vipritarthakari'' (treatment with a substance similar to the cause).<br />
<br />
==== Effect of cold water and hot water on body fluid balance ====<br />
<br />
In conditions of dehydration and where [[pitta]] is dominant (''Dhaha, bhrama, madatyaya'' etc) cold water should be given as it restores water content in body as well as pacify [[pitta]] by its sheeta [[guna]]. After boiling, water becomes free from various micro-organisms. Boiled water should be used in ''sannipatika'' diseases after cooling, such diseases are difficult to treat. In a study it was found that temperature range from 55 to 65 degree C is critical for effective elimination of enteric/pathogenic bacterial components.<ref> Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., editors. Harrison’s principles of internal medicine, Chapter 11. Palliative and End-of-Life Care,16th ed. New York: McGraw Hill; 2005</ref> As all three [[dosha]] are involved we can’t use hot or cold water as they will aggravate at least one of the [[dosha]] (hot will increase [[pitta]], cold water will increase [[vata]]/[[kapha]]) so normal water should be used.<br />
<br />
In conditions with [[vata]]/[[kapha]]/[[vata]]-[[kapha]] dominance like ''hikka-shwasa'' ([[kapha]] [[vata]] tamako''), fever of recent origin (''nutana jwara'' in ''samavastha'') etc. Warm water should be given. After ''ghrita'' consumption, warm water should be used as it increases absorption of ''ghrita''. Warm water increases [[agni]] in ''nutan jwara''.[ Cha. Sa. [[Chikitsa Sthana]] 3/144], [ Cha. Sa. [[Vimana Sthana]] 3/40]<br />
<br />
In a study it was concluded that drinking hot fluids transiently increases nasal mucus velocity and so hot liquid is superior to cold liquids in the management of fluids in upper respiratory tract infections.<ref>Saketkhoo K, Januszkiewicz A, Sackner MA., Effects of drinking hot water, cold water, and chicken soup on nasal mucus velocity and nasal airflow resistance, Chest. 1978 Oct;74 (4):408-10.</ref><br />
<br />
Water is major constituent and is needed for normal physiological process of the body. Any disturbance in its homeostasis will lead to production of many diseases. Some diseases occur due to water deficit whereas in many diseases water retention in the body is their main cause. According to Ayurvedic principles in such conditions water use should be minimal. Due to same reason it is contraindicated in ''udara''. In ''jalodara'' (ascites) excessive intake of water is one of the causes.[ Cha. Sa. [[Chikitsa Sthana]] 13/45]<br />
<br />
In ''pandu'' there is presence of hemodilution and edema so water intake should be restricted to minimal. In ''gulma, mandagni'' is main causative factor. [Cha. Sa.[[Chikitsa Sthana]] 5/112]<br />
<br />
Excessive intake of water causes ''mandagni'' and if, water is taken in ''mandagni'' stage excessively, strength of [[agni]] decreases further <ref>Madhavakara. Madhava Nidanam (Roga vinischaya) Chap 6 Verse 7. Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--</ref>. So, water is contraindicated in ''mandagni'' stage. If needed, water can be given in less quantity.<br />
Nowadays we are using bottled water frequently. So, it is necessary that we analyze properties of bottled water also. Studies have shown that chemicals called phthalates, which are known to disrupt testosterone and other hormones, can leach into bottled water over time. One study found that water that had been stored for 10 weeks in plastic and in glass bottles contained phthalates, suggesting that the chemicals could be coming from the plastic cap or liner.<ref>Available from: http://www.nrdc.org/about </ref> The bacterial count in bottled water increased dramatically, from less than 1 colony per milliliter (col/mL) to 38,000 col/mL over 48 hours of storage at 37 degrees C. Bacterial growth was markedly reduced at cold temperatures (refrigeration) compared with room temperature, with 50% fewer bacterial colonies in 24 hours and 84% fewer colonies in 48 hours. Interestingly, tap water resulted in only minimal growth, especially at cold temperatures (< 100 col/mL at 48 hours). These findings may be useful to increase public awareness and development of guidelines on storage temperature and expiration time for bottled water once it is opened and used.<ref>Raj SD., Bottled water: how safe is it? Water Environ Res. 2005 Nov-Dec;77(7):3013-8.</ref> In a study it was suggested that various types of unfinished beverages have microorganism growth and can include food borne pathogens and bacterial toxins.<ref>Watanabe M, Ohnishi T, Araki E, Kanda T, Tomita A, Ozawa K, Goto K, Sugiyama K, Konuma H, Hara-Kudo Y., Characteristics of bacterial and fungal growth in plastic bottled beverages under a consuming condition model, J Environ Sci Health A Tox Hazard Subst Environ Eng. 2014;49(7):819-26.</ref> This suggests that proper and judicious use of water should be done in healthy as well as diseases condition.<br />
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[[#top| Back to the Top ]]</span></div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Visarpa_Chikitsa&diff=45390Visarpa Chikitsa2025-11-18T04:32:24Z<p>Agnivesha: /* Introduction */</p>
<hr />
<div>{{CiteButton}}<br />
{{#seo:<br />
|title=Visarpa Chikitsa<br />
|titlemode=append<br />
|keywords=Visarpa, Parisarpa, Erysepalas, Gangrene, Septicaemia, Sepsis, Fulminant spreading skin infections,Ayurveda, Indian system of medicine, charak samhita. <br />
|description=Chikitsa Sthana Chapter 21. Management of Visarpa (acute spreading erysepalas)<br />
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br />
|image_alt=charak samhita<br />
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<big>'''[[Chikitsa Sthana]] Chapter 21. Management of Visarpa (acute spreading erysepalas)</big>'''<br />
{{Infobox<br />
|title = Visarpa Chikitsa<br />
|label1 = Section/Chapter<br />
|data1 = [[Chikitsa Sthana]] Chapter 21<br />
|label2 = Preceding Chapter<br />
|data2 = [[Chhardi Chikitsa]]<br />
<br />
|label3= Succeeding Chapter<br />
|data3 = [[Trishna Chikitsa]]<br />
|label5 = Other Sections<br />
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br />
|label6 = Translator and commentator<br />
|data6 = Kendre M.<br />
|label7 = Reviewer <br />
|data7 = Ojha S.N.<br />
|label8 = Editors <br />
|data8 = Ojha S.N., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br />
|label9 = Year of publication <br />
|data9 = 2020<br />
|label10 = Publisher <br />
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label11 = DOI <br />
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.022 10.47468/CSNE.2020.e01.s06.022]<br />
}}<br />
<big>'''Abstract </big>'''<br />
<p style="text-align:justify;">This chapter deals with detailed description of etiopathogenesis, classification and management principles of ''visarpa''. This is acute disease with a quick spread involving mainly skin, blood, lymph and muscle tissue due to vitiation of all three [[dosha]]. Disease is clinically presented in three pathways viz. external, internal and both. Based on the involvement of dominant [[dosha]], it is classified into seven types. Prognosis and treatment duration of disease is proportionate to degree of involvement of [[dosha]] and affected internal organs. As the basic nature of disease is [[rakta]] and [[pitta]] dominant, management is focused on body purification treatments especially therapeutic purgation, blood letting, fasting therapy, medicated ghee, use of bitter drugs and various external applications having soothing and cooling effect. Guidelines for external application in the form of ''pralepa, pradeha'' and ''alepa'' are enlisted in the chapter. Blood letting is emphasized as most important treatment in ''visarpa''. <br />
<br/><br />
'''Keywords''': ''Visarpa, Parisarpa,'' Erysepalas, Gangrene, Septicaemia, Sepsis, Fulminant spreading skin infections.<br />
</p><br />
<br />
== Introduction ==<br />
<div style="text-align:justify;"><br />
The twenty first chapter is named [[Visarpa Chikitsa]]. The term ''visarpa'' has two parts viz., ''vi'' and ''sarpa''- ''vi'' stands for ''vividha'' meaning ‘various’ (ways) and ''sarpa'' stands for ''sarpan'' means ‘spreading’. Erythematous, pustular, glandular etc. lesions which spread rapidly in localized or generalized pattern are known as ''visarpa'' [ Cha.Sa. [[Chikitsa Sthana]] 21/11, Chakrapani]. This aliment is also called ''parisarpa''. The prefix ''pari'' stands for ''paritah'' or ''sarvatah'' meaning all over. The disease which spreads all over the body is called ''visarpa''. [Cha. Sa.[[ Chikitsa Sthana]] 21/11, Chakrapani]. This indicates that ''visarpa'' is an umbrella term used for acute spreading disorders caused due to vitiation of [[rakta]]. <br />
<br />
In this chapter Atreya answers the queries about ''visarpa'' derivation, synonyms, classification, [[dosha]], dushya,etiology, habitat, gradation, symptoms, complications, prognosis and treatment of curable ones. The chapter follows that of [Cha. Sa. [[Chhardi Chikitsa|Chhardi]] Chikitsa ] because suppression of chhardi (vomiting) causes [[Rakta dhatu|rakta]] dushti(vitiation of blood) leading to visarpa indicating that [[Rakta dhatu|rakta]] (blood) vitiating factors and vitiation of rakta is an important basic underlying phenomenon prior to the visarpa.<br />
<br />
''Visarpa'' is acute, spreading and fatal in nature leading to death if not treated promptly. On location basis this is classified into ''bahih-shrita'' (externally situated), ''antah-shrita'' (internally situated) and ''ubhayasam shrita'' (all over situated). ''Bahih-shrita visarpa'' is fulminant, spreading skin and flesh infection with symptoms and signs of inflammatory edema, blisters, ulcers, fever, pain etc. and is curable. ''Antah-shrita visarpa'' involves internal vital organs with mild septicaemia and is curable before complications. ''Ubhayasamshrita visarpa'' has advanced manifestations of both types spreading all over body with severe septicaemia and is fatal.<br />
<br />
''Visarpa'' never occurs without association of [[rakta]] and [[pitta]], hence general treatment of ''visarpa'' is described by considering [[rakta]] and [[pitta]] vitiation. Specific treatments are described by considering particular [[dosha]] involvement. <br />
Various etiological factors of ''visarpa'' are diet, life style, injury, poison, toxin, burn etc. vitiates [[rakta]] as well as [[dosha]] ([[vata]], [[pitta]] and [[kapha]]) and other [[dhatu]] (body elements) leading to fulminant disease requiring urgent medical care.<br />
<br />
Seven components are involved in the pathogenesis of ''visarpa'' viz., [[rakta]] (blood), ''lasika'' (lymph), ''tvak'' (skin), [[mamsa dhatu]] (flesh), [[vata]], [[pitta]]<nowiki/>and [[Kapha dosha|kapha]]. Same components are associated with [[Kushtha Chikitsa|kushtha]] (various skin disorders) but clinical presentation of both the diseases is different because etiological factors act different. As kushtha is chronic in nature and visarpa is acute in nature[Cha. Sa. Chikitsa Sthana 21/15,Chakrapani] therefore spreading kushtha should not be interpreted as visarpa. <br />
<br />
It is also classified into ''vatika, paittika, slaishmika, agni visarpa, kardam visarpa, granthi visarpa'' and ''sannipatik'' on [[dosha]] basis. ''Bahih-shrita visarpa'' involves exterior part i.e. Skin, flesh, etc. of the body having symptoms like inflammatory oedema, blisters, ulcers, fever, pain etc. and is curable. ''Agni visarpa'' and ''kardam visarpa'' may be cured with appropriate timely management otherwise negligence leads to death of the patient. ''Granthi visarpa'' should be treated before complications otherwise it becomes incurable. ''Sannipatika visarpa'' is a severe manifestation of the disease leading to death.[Cha. Sa. [[Chikitsa Sthana]] 21/42] <br />
<br />
In ''visarpa, shodhana'' therapy has given prime importance because ''rakta kleda'' (putrificatory ingredient) and [[dosha]] vitiation is at higher level hence ''samana'' (pacification) therapy is not very effective. ''Visarpa'' never occurs without association of [[rakta]] and [[pitta]]. Hence general treatment of ''visarpa'' is described by considering [[rakta]] and [[pitta]] vitiation. Specific treatments are described as per the involvement of [[dosha]]. Single ''raktamokshana'' (blood letting) treatment is equal to all of other treatments described for ''visarpa''. [Cha. Sa. [[Chikitsa Sthana]] 21/141-143]. <br />
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''Kshataja visarpa'' is another variety mentioned additionally in Sushruta Samhita. The later texts followed the same description with addition of some medications.<br />
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== Sanskrit Text, Transliteration and English Translation ==<br />
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अथातो विसर्पचिकित्सितं व्याख्यास्यामः ||१||<br />
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इति ह स्माह भगवानात्रेयः ||२||<br />
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athātō visarpacikitsitaṁ vyākhyāsyāmaḥ||1|| <br />
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iti ha smāha bhagavānātrēyaḥ||2|| <br />
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athAto visarpacikitsitaM vyAkhyAsyAmaH||1|| <br />
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iti ha smAha bhagavAnAtreyaH||2|| <br />
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<div style="text-align:justify;"><br />
Now we shall expound the chapter "Visarpa Chikitsa" (Management of acute spreading erysepalas). Thus said Lord Atreya. [1-2] <br />
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=== Agnivesha’s queries on ''visarpa'' ===<br />
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कैलासे किन्नराकीर्णे बहुप्रस्रवणौषधे | <br />
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पादपैर्विविधैः स्निग्धैर्नित्यं कुसुमसम्पदा ||३|| <br />
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वमद्भिर्मधुरान् गन्धान् सर्वतः स्वभ्यलङ्कृते | <br />
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विहरन्तं जितात्मानमात्रेयमृषिवन्दितम् ||४|| <br />
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महर्षिभिः परिवृतं सर्वभूतहिते रतम् | <br />
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अग्निवेशो गुरुं काले विनयादिदमुक्तवान् ||५|| <br />
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भगवन्! दारुणं रोगमाशीविषविषोपमम् | <br />
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विसर्पन्तं शरीरेषु देहिनामुपलक्षये ||६|| <br />
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सहसैव नरास्तेन परीताः शीघ्रकारिणा | <br />
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विनश्यन्त्यनुपक्रान्तास्तत्र नः संशयो महान् ||७|| <br />
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स नाम्ना केन विज्ञेयः सञ्ज्ञितः केन हेतुना | <br />
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कतिभेदः कियद्धातुः किन्निदानः किमाश्रयः ||८|| <br />
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सुखसाध्यः कृच्छ्रसाध्यो ज्ञेयो यश्चानुपक्रमः | <br />
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कथं कैर्लक्षणैः किं च भगवन्! तस्य भेषजम् ||९|| <br />
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तदग्निवेशस्य वचः श्रुत्वाऽऽत्रेयः पुनर्वसुः | <br />
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यथावदखिलं सर्वं प्रोवाच मुनिसत्तमः ||१०||<br />
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kailāsē kinnarākīrṇē bahuprasravaṇauṣadhē| <br />
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pādapairvividhaiḥ snigdhairnityaṁ kusumasampadā||3|| <br />
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vamadbhirmadhurān gandhān sarvātaḥ svabhyalaṅkr̥tē| <br />
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viharantaṁ jitātmānamātrēyamr̥ṣivanditam||4|| <br />
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maharṣibhiḥ parivr̥taṁ sarvabhūtahitē ratam| <br />
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agnivēśō guruṁ kālē vinayādidamuktavān||5|| <br />
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bhagavan! dāruṇaṁ rōgamāśīviṣaviṣōpamam| <br />
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visarpantaṁ śarīrēṣu dēhināmupalakṣayē||6|| <br />
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sahasaiva narāstēna parītāḥ śīghrakāriṇā| <br />
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vinaśyantyanupakrāntāstatra naḥ saṁśayō mahān||7|| <br />
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sa nāmnā kēna vijñēyaḥ sañjñitaḥ kēna hētunā| <br />
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katibhēdaḥ kiyaddhātuḥ kinnidānaḥ kimāśrayaḥ||8|| <br />
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sukhasādhyaḥ kr̥cchrasādhyō jñēyō yaścānupakramaḥ| <br />
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kathaṁ kairlakṣaṇaiḥ kiṁ ca bhagavan! tasya bhēṣajam||9|| <br />
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tadagnivēśasya vacaḥ śrutvā''trēyaḥ punarvasuḥ| <br />
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yathāvadakhilaṁ sarvaṁ prōvāca munisattamaḥ||10||<br />
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kailAse kinnarAkIrNe bahuprasravaNauShadhe| <br />
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pAdapairvividhaiH snigdhairnityaM kusumasampadA||3||<br />
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vamadbhirmadhurAn gandhAn sarvātaH svabhyala~gkRute| <br />
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viharantaM jitAtmAnamAtreyamRuShivanditam||4|| <br />
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maharShibhiH parivRutaM sarvabhUtahite ratam| <br />
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agnivesho guruM kAle vinayAdidamuktavAn||5|| <br />
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bhagavan! dAruNaM rōgamAshIviShaviShopamam| <br />
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visarpantaM sharIreShu dehinAmupalakShaye||6|| <br />
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sahasaiva narAstena parItAH shIghrakAriNA| <br />
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vinashyantyanupakrAntAstatra naH saMshayo mahAn||7|| <br />
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sa nAmnA kena vij~jeyaH sa~jj~jitaH kena hetunA| <br />
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katibhedaH kiyaddhātuH kinnidAnaH kimAshrayaH||8|| <br />
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sukhasAdhyaH kRucchrasAdhyo j~jeyo yashcAnupakramaH| <br />
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kathaM kairlakShaNaiH kiM ca bhagavan! tasya bheShajam||9|| <br />
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tadagniveshasya vacaH shrutvA~a~atreyaH punarvasuH| <br />
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yathAvadakhilaM sarvaM provAca munisattamaH||10|| <br />
</div></div><br />
<br />
In the Kailas region inhabited by ''kinnaras'', having numerous water streams and medicinal plants with ever emitting sweet pleasant (''ishat gandha'') aroma by their wealth of flowers, Atreya who had great self-control, was surrounded by great sages and engaged in welfare of all creatures. Then Agnivesha choosing the appropriate time asked politely to his enlightened teacher, <br />
“Oh Lord, I observe the acute emergency disease in the body of human being which spreads with the virulence of snake-venom. Those human who are afflicted by this acute fulminating disease succumb to death quickly, unless treated promptly. We are in great need of enlightenment concerning this disease. <br />
<br />
By which name should it be known? Why does it derive its name? What are its varieties? Which body elements are involved in its pathogenesis? What is its etiology? Where is its location? How to understand its prognosis i.e. easy curable, difficult to cure and incurable? What are the signs and symptoms of this disease? And O worshipful one! What is the method of its treatment?”<br />
Having heard the queries of Agnivesha, Atreya Punarvasu, the foremost among the sages, explained all the relevant details of the disease ''visarpa''. [3-10]<br />
<br />
=== Definition of ''visarpa'' ===<br />
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विविधं सर्पति यतो विसर्पस्तेन स स्मृतः | <br />
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परिसर्पोऽथवा नाम्ना सर्वतः परिसर्पणात् ||११||<br />
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vividhaṁ sarpati yatō visarpastēna sa smr̥taḥ| <br />
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parisarpō'thavā nāmnā sarvātaḥ parisarpaṇāt||11|| <br />
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vividhaM sarpati yato visarpastena sa smRutaH| <br />
<br />
parisarpo~athavA nAmnA sarvātaH parisarpaNAt||11|| <br />
</div></div><br />
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It spreads in various ways hence known as ''visarpa''. It is also called ''parisarpa'' due to its extensive spreading.[11]<br />
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=== Classification ===<br />
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स च सप्तविधो दोषैर्विज्ञेयः सप्तधातुकः | <br />
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पृथक् त्रयस्त्रिभिश्चैको विसर्पो द्वन्द्वजास्त्रयः ||१२|| <br />
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वातिकः पैत्तिकश्चैव कफजः सान्निपातिकः | <br />
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चत्वार एते विसर्पा वक्ष्यन्ते द्वन्द्वजास्त्रयः ||१३|| <br />
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आग्नेयो वातपित्ताभ्यां ग्रन्थ्याख्यः कफवातजः | <br />
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यस्तु कर्दमको घोरः स पित्तकफसम्भवः ||१४|| <br />
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sa ca saptavidhō dōṣairvijñēyaḥ saptadhātukaḥ| <br />
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pr̥thak trayastribhiścaikō visarpō dvandvajāstrayaḥ||12|| <br />
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vātikaḥ paittikaścaiva kaphajaḥ sānnipātikaḥ| <br />
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catvāra ētē visarpā vakṣyantē dvandvajāstrayaḥ||13|| <br />
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āgnēyō vātapittābhyāṁ granthyākhyaḥ kaphavātajaḥ| <br />
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yastu kardamakō ghōraḥ sa pittakaphasambhavaḥ||14|| <br />
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sa ca saptavidho dōṣairvij~jeyaH saptadhātukaH| <br />
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pRuthak trayastribhishcaiko visarpo dvandvajAstrayaH||12|| <br />
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vAtikaH paittikashcaiva kaphajaH sAnnipAtikaH| <br />
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catvAra ete visarpA vakShyante dvandvajAstrayaH||13|| <br />
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Agneyo vātapittAbhyAM granthyAkhyaH kaphavātajaH| <br />
<br />
yastu kardamako ghoraH sa pittakaphasambhavaH||14|| <br />
</div></div><br />
<br />
''Visarpa'' is of seven types as per [[dosha]] basis and it involves seven body elements.<br />
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Three types of ''visarpa'' are due to the morbidity of individual [[dosha]]; one variety is due to the morbidity of all the three [[dosha]] and three varieties are due to the morbidity of any of the two [[dosha]]. <br />
<br />
''Vatika, paittika, kaphaja'' and ''sannipatik'' these are the four varieties of ''visarpa'' and the remaining three varieties viz., [[vata]]-[[pitta]]ja, [[kapha]]-[[vata]]ja and [[pitta]]-[[kapha]]ja type will now be described.<br />
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The variety due to morbid [[vata]]-[[pitta]] is agnivisarpa, [[kapha]]-[[vata]] cause ''granthi visarpa'' and [[pitta]]-[[kapha]] leads to serious condition known as ''kardamaka visarpa''. [12-14]<br />
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=== Vitiated factors ===<br />
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रक्तं लसीकात्वङ्मांसं दूष्यं दोषास्त्रयो मलाः | <br />
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विसर्पाणां समुत्पत्तौ विज्ञेयाः सप्त धातवः ||१५||<br />
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raktaṁ lasīkā tvaṅmāṁsaṁ dūṣyaṁ dōṣāstrayō malāḥ| <br />
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visarpāṇāṁ samutpattau vijñēyāḥ sapta dhātavaḥ||15||<br />
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raktaM lasIkA tva~gmAMsaM dUShyaM dōṣastrayo malAH| <br />
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visarpANAM samutpattau vij~jeyAH sapta dhAtavaH||15|| <br />
</div></div><br />
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Blood, lymph, skin, flesh and three [[dosha]], these seven elements are involved in the pathogenesis of ''visarpa'' of all kinds. [15]<br />
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=== Etiology ===<br />
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लवणाम्लकटष्णानां रसानामतिसेवनात् | <br />
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दध्यम्लमस्तुशुक्तानां सुरासौवीरकस्य च ||१६|| <br />
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व्यापन्नबहुमद्योष्णरागषाडवसेवनात् | <br />
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शाकानां हरितानां च सेवनाच्च विदाहिनाम् ||१७|| <br />
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कूर्चिकानां किलाटानां सेवनान्मन्दकस्य च | <br />
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दध्नः शाण्डाकिपूर्वाणामासुतानां च सेवनात् ||१८||<br />
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तिलमाषकुलत्थानां तैलानां पैष्टिकस्य च | <br />
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ग्राम्यानूपौदकानां च मांसानां लशुनस्य च ||१९|| <br />
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प्रक्लिन्नानामसात्म्यानां विरुद्धानां च सेवनात् |<br />
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अत्यादानाद्दिवास्वप्नादजीर्णाध्यशनात् क्षतात् ||२०||<br />
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क्षतबन्धप्रपतनाद्धर्मकर्मातिसेवनात् [१] | <br />
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विषवाताग्निदोषाच्च विसर्पाणां समुद्भवः ||२१|| <br />
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एतैर्निदानैर्व्यामिश्रैः कुपिता मारुतादयः | <br />
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दूष्यान् सन्दूष्य रक्तादीन् विसर्पन्त्यहिताशिनाम् ||२२||<br />
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lavaṇāmlakaṭūṣṇānāṁ rasānāmatisēvanāt| <br />
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dadhyamlamastuśuktānāṁ surāsauvīrakasya ca||16|| <br />
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vyāpannabahumadyōṣṇarāgaṣāḍavasēvanāt| <br />
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śākānāṁ haritānāṁ ca sēvanācca vidāhinām||17|| <br />
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kūrcikānāṁ kilāṭānāṁ sēvanānmandakasya ca| <br />
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dadhnaḥ śāṇḍākipūrvāṇāmāsutānāṁ ca sēvanāt||18|| <br />
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tilamāṣakulatthānāṁ tailānāṁ paiṣṭikasya ca| <br />
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grāmyānūpaudakānāṁ ca māṁsānāṁ laśunasya ca||19|| <br />
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praklinnānāmasātmyānāṁ viruddhānāṁ ca sēvanāt| <br />
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atyādānāddivāsvapnādajīrṇādhyaśanāt kṣatāt||20|| <br />
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kṣatabandhaprapatanāddharmakarmātisēvanāt [1] | <br />
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viṣavātāgnidōṣācca visarpāṇāṁ samudbhavaḥ||21|| <br />
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ētairnidānairvyāmiśraiḥ kupitā mārutādayaḥ| <br />
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dūṣyān sandūṣya raktādīn visarpantyahitāśinām||22|| <br />
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lavaNAmlakaTUShNAnAM rasAnAmatisevanAt| <br />
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dadhyamlamastushuktAnAM surAsauvIrakasya ca||16|| <br />
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vyApannabahumadyoShNarAgaShADavasevanAt| <br />
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shAkAnAM haritAnAM ca sevanAcca vidAhinAm||17|| <br />
<br />
kUrcikAnAM kilATAnAM sevanAnmandakasya ca| <br />
<br />
dadhnaH shANDAkipUrvANAmAsutAnAM ca sevanAt||18|| <br />
<br />
tilamAShakulatthAnAM tailAnAM paiShTikasya ca| <br />
<br />
grAmyAnUpaudakAnAM ca mAMsAnAM lashunasya ca||19|| <br />
<br />
praklinnAnAmasAtmyAnAM viruddhAnAM ca sevanAt| <br />
<br />
atyAdAnAddivAsvapnAdajIrNAdhyashanAt kShatAt||20||<br />
<br />
kShatabandhaprapatanAddharmakarmAtisevanAt [1] | <br />
<br />
viShavātagnidōṣacca visarpANAM samudbhavaH||21|| <br />
<br />
etairnidAnairvyAmishraiH kupitA mArutAdayaH| <br />
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dUShyAn sandUShya raktAdIn visarpantyahitAshinAm||22|| <br />
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<br />
The following are the causative factors of the ''visarpa'':<br />
<br />
Excessive indulgence in ''lavana'' (salt), ''amla'' (sour), ''katu'' (pungent) and ''ushna'' (hot ingredients); as also in ''amla dadhi'' (sour curd), ''dadhi mastu'' (whey), ''shukta'' (vinegars), ''sura'' (type of liquor) and ''sauviraka'' (type of wine); the use of ''vyapanna madya'' (contaminated wine) or excessive liquor or heat inducing ''raga'' (condiments) and ''sadava'' (confectionery), the use of ''vidahi'' (causes burning), ''shaka'' (vegetables) and ''harita'' (''lashunadi harita'' group ''dravya''), ''kilata'' (cheese), ''kurchika'' (inspissated milk) and ''mandaka'' (immature curd), the use of ''sandaki'' (fermented wine), as also of ''paistika'' (one made up of ''pistamai padarth'' or pastries) and oils made of sesame, black gram and horse gram, the use of flesh of domesticated, wet land and aquatic animals and garlic, the use of the ''praklinna'' (putrified food), ''asatmya'' (unwholesome) and ''viruddha'' (mutually contradictory ingredients), over eating, sleeping during day time, ''ajirnashana'' (eating during indigestion), ''adhyashana'' (eating food immediately after the meal); ''kshatat'' (traumatic injury), ''kshata'' (wounds), ''bandha'' (ligatures), ''prapatana'' (trauma due to falls) over exposure to sun, strainful work, poisons, poisonous air,burns etc.<br />
<br />
By combination of above mentioned etiological factors, the provoked [[vata]]di [[dosha]] affect the susceptible body elements such as [[rakta]], lasika etc. and spread in the body in those indulged in unwholesome diet. [16-22]<br />
<br />
=== Pathways of spreading the disease ===<br />
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बहिःश्रितः श्रितश्चान्तस्तथा चोभयसंश्रितः | <br />
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विसर्पो बलमेतेषां ज्ञेयं गुरु यथोत्तरम् ||२३|| <br />
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बहिर्मार्गाश्रितं साध्यमसाध्यमुभयाश्रितम् | <br />
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विसर्पं दारुणं विद्यात् सुकृच्छ्रं त्वन्तराश्रयम् ||२४|| <br />
<br />
अन्तःप्रकुपिता दोषा विसर्पन्त्यन्तराश्रये | <br />
<br />
बहिर्बहिःप्रकुपिताः सर्वत्रोभयसंश्रिताः ||२५||<br />
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bahiḥśritaḥ śritaścāntastathā cōbhayasaṁśritaḥ| <br />
<br />
visarpō balamētēṣāṁ jñēyaṁ guru yathōttaram||23|| <br />
<br />
bahirmārgāśritaṁ sādhyamasādhyamubhayāśritam| <br />
<br />
visarpaṁ dāruṇaṁ vidyāt sukr̥cchraṁ tvantarāśrayam||24|| <br />
<br />
antaḥprakupitā dōṣā visarpantyantarāśrayē| <br />
<br />
bahirbahiḥprakupitāḥ sarvatrōbhayasaṁśritāḥ||25||<br />
<br />
bahiHshritaH shritashcAntastathA cobhayasaMshritaH| <br />
<br />
visarpo balameteShAM j~jeyaM guru yathottaram||23|| <br />
<br />
bahirmArgAshritaM sAdhyamasAdhyamubhayAshritam| <br />
<br />
visarpaM dAruNaM vidyAt sukRucchraM tvantarAshrayam||24|| <br />
<br />
antaHprakupitA dōṣa visarpantyantarAshraye| <br />
<br />
bahirbahiHprakupitAH sarvatrobhayasaMshritAH||25||<br />
</div></div><br />
<br />
Externally situated (pathogenesis in shakha, [[rasa dhatu]]and [[rakta dhatu]]), internally situated (pathogenesis in internal organs and other [[dhatu]]) and situated in both (externally as well as internally) pathways ''visarpa'' is to be known more and more serious consecutively. <br />
<br />
Externally situated ''visarpa'' is curable, internally situated ''visarpa'' is very serious and difficult to cure whereas externally as well as internally situated type is incurable.<br />
<br />
The humors provoked in internal regions spreads internally, if provoked in external regions spreads externally and if provoked in both regions spreads all over the body.[23-25]<br />
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=== Causes and features of internal and external ''visarpa'' ===<br />
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मर्मोपघातात् सम्मोहादयनानां विघट्टनात् | <br />
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तृष्णातियोगाद्वेगानां विषमाणां प्रवर्तनात् ||२६|| <br />
<br />
विद्याद्विसर्पमन्तर्जमाशु चाग्निबलक्षयात् | <br />
<br />
अतो विपर्ययाद्बाह्यमन्यैर्विद्यात् स्वलक्षणैः ||२७|| <br />
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marmōpaghātāt sammōhādayanānāṁ vighaṭṭanāt| <br />
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tr̥ṣṇātiyōgādvēgānāṁ viṣamāṇāṁ pravartanāt||26|| <br />
<br />
vidyādvisarpamantarjamāśu cāgnibalakṣayāt| <br />
<br />
atō viparyayādbāhyamanyairvidyāt svalakṣaṇaiḥ||27||<br />
<br />
marmopaghAtAt sammohAdayanAnAM vighaTTanAt| <br />
<br />
tRuShNAtiyōgadvegAnAM viShamANAM pravartanAt||26|| <br />
<br />
vidyAdvisarpamantarjamAshu cAgnibalakShayAt| <br />
<br />
ato viparyayAdbAhyamanyairvidyAt svalakShaNaiH||27||<br />
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<br />
Affliction of vital organs, impaired consciousness, impaired circulation, morbid thirst and impaired natural urges and sudden reduction in digestive as well as immune power of body is known as ''antah-visarpa''. ''Bahih-visarpa'' should be understood by the external manifestations appearing on skin flesh etc. and by their own specific symptoms. [26-27]<br />
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=== Bad prognostic features ===<br />
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यस्य सर्वाणि लिङ्गानि बलवद्यस्यकारणम् | <br />
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यस्य चोपद्रवाः कष्टा मर्मगो यश्च हन्ति सः ||२८||<br />
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yasya sarvāṇi liṅgāni balavadyasya kāraṇam| <br />
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yasya cōpadravāḥ kaṣṭā marmagō yaśca hanti saḥ||28|| <br />
<br />
yasya sarvANi li~ggAni balavadyasya kAraNam| <br />
<br />
yasya copadravAH kaShTA marmago yashca hanti saH||28|| <br />
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<br />
''Visarpa'' manifesting with all signs and symptoms, having strong etiological factors, which is associated with formidable complications and that situates as well as affects vital parts, proves fatal.[28]<br />
</div><br />
=== Etio-pathogeneis and clinical features of [[vata]] dominant ''visarpa'' ===<br />
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रूक्षोष्णैः केवलो वायुः पूरणैर्वा समावृतः |<br />
<br />
प्रदुष्टो दूषयन् दूष्यान् विसर्पति यथाबलम् ||२९||<br />
<br />
तस्य रूपाणि- भ्रमदवथुपिपासानिस्तोदशूलाङ्गमर्दोद्वेष्टनकम्पज्वरतमककासास्थिसन्धिभेदविश्लेषणवेपनारोचकाविपाकाश्चक्षुषोराकुलत्वमस्रागमनं पिपीलिकासञ्चार इव चाङ्गेषु, यस्मिंश्चावकाशे विसर्पो विसर्पति [१] सोऽवकाशः श्यावारुणाभासः श्वयथुमान् निस्तोदभेदशूलायामसङ्कोचहर्षस्फुरणैरतिमात्रं प्रपीड्यते, अनुपक्रान्तश्चोपचीयते शीघ्रभेदैः स्फोटकैस्तनुभिररुणाभैः श्यावैर्वा तनुविशदारुणाल्पास्रावैः, विबद्धवातमूत्रपुरीषश्च भवति, निदानोक्तानि चास्य नोपशेरते विपरीतानि चोपशेरत इति वातविसर्पः ||३०||<br />
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rūkṣōṣṇaiḥ kēvalō vāyuḥ pūraṇairvā samāvr̥taḥ| <br />
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praduṣṭō dūṣayan dūṣyān visarpati yathābalam||29|| <br />
<br />
tasya rūpāṇi- bhramadavathupipāsānistōdaśūlāṅgamardōdvēṣṭanakampajvaratamaka-kāsāsthisandhibhēdaviślēṣaṇavēpanārōcakāvipākāścakṣuṣōrākulatvamasrāgamanaṁ pipīlikāsañcāra ivacāṅgēṣu, yasmiṁścāvakāśē visarpō visarpati [1] sō'vakāśaḥ śyāvāruṇābhāsaḥ śvayathumānnistōdabhēdaśūlāyāmasaṅkōcaharṣasphuraṇairatimātraṁ prapīḍyatē, anupakrāntaścōpacīyatēśīghrabhēdaiḥ sphōṭakaistanubhiraruṇābhaiḥ śyāvairvā tanuviśadāruṇālpāsrāvaiḥ,vibaddhavātamūtrapurīṣaśca bhavati, nidānōktāni cāsya nōpaśēratē viparītāni cōpaśērata itivātavisarpaḥ||30||<br />
<br />
rUkShoShNaiH kevalo vAyuH pUraNairvA samAvRutaH| <br />
<br />
praduShTo dUShayan dUShyAn visarpati yathAbalam||29|| <br />
<br />
tasya rUpANi- bhramadavathupipAsAnistodashUlA~ggamardodveShTanakampajvaratamaka-kAsAsthisandhibhedavishleShaNavepanArocakAvipAkAshcakShuShorAkulatvamasrAgamanaMpipIlikAsa~jcAra iva cA~ggeShu, yasmiMshcAvakAshe visarpo visarpati [1] so~avakAshaHshyAvAruNAbhAsaH shvayathumAn nistodabhedashUlAyAmasa~gkocaharShasphuraNairatimAtraMprapIDyate, anupakrAntashcopacIyate shIghrabhedaiH sphoTakaistanubhiraruNAbhaiH shyAvairvātanuvishadAruNAlpAsrAvaiH, vibaddhavātamUtrapurIShashca bhavati, nidAnoktAni cAsya nopasherateviparItAni copasherata iti vātavisarpaH||30||<br />
</div></div><br />
<div style="text-align:justify;"><br />
[[Vayu]] aggravated by ununctuous and hot ingredients or by the obstruction due to vitiated [[dosha]], impairs the body elements and spreads in proportion to its strength. <br />
<br />
Its signs and symptoms are giddiness, burning sensation, excessive thirst, pricking sensation, severe pain, body ache, cramps, shivering, fever, feeling of entering in darkness, cough, breaking and splitting pains in the bones and joints, looseness in joints, trembling, anorexia, indigestion, congestion of the eyes, lacrimation and paresthesia; the region where the inflammation is spreading becomes blackish and reddish in color and edematous. The patient suffers from severe pricking, splitting or aching pain in the part affected as also extension and contractions of the parts, horripilation and quivering. If not treated it gives rise to quick bursting small blackish or reddish blisters with thin clear reddish and scanty discharge. The patient also suffers from the retention of flatus, urine and feces. Etiological factors do not suit and the contrary ones suit the patient, this is [[vata]] dominant ''visarpa''. [29-30]<br />
</div><br />
=== Etio-pathogeneis and clinical features of [[pitta]] dominant ''visarpa'' ===<br />
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पित्तमुष्णोपचारेण विदाह्यम्लाशनैश्चितम् | <br />
<br />
दूष्यान् सन्दूष्य धमनीः [१] पूरयन् वै विसर्पति ||३१||<br />
<br />
तस्य रूपाणि- ज्वरस्तृष्णा मूर्च्छा मोहश्छर्दिररोचकोऽङ्गभेदः स्वेदोऽतिमात्रमन्तर्दाहः प्रलापः शिरोरुक् चक्षुषोराकुलत्वमस्वप्नमरतिर्भ्रमः शीतवातवारितर्षोऽतिमात्रं हरितहारिद्रनेत्रमूत्रवर्चस्त्वं हरितहारिद्ररूपदर्शनं च, यस्मिंश्चावकाशे विसर्पोऽनुसर्पति सोऽवकाशस्ताम्रहरितहारिद्रनीलकृष्णरक्तानां वर्णानामन्यतमं पुष्यति, सोत्सेधैश्चातिमात्रं दाहसम्भेदनपरीतैः स्फोटकैरुपचीयते तुल्यवर्णास्रावैश्चिरपाकैश्च, निदानोक्तानि चास्य नोपशेरते विपरीतानि चोपशेरत इति पित्तविसर्पः ||३२||<br />
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pittamuṣṇōpacārēṇa vidāhyamlāśanaiścitam| <br />
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dūṣyān sandūṣya dhamanīḥ [1] pūrayan vai visarpati||31|| <br />
<br />
tasya rūpāṇi- jvarastr̥ṣṇā mūrcchā mōhaśchardirarōcakō'ṅgabhēdaḥ svēdō'timātramantardāhaḥ pralāpaḥśirōruk cakṣuṣōrākulatvamasvapnamaratirbhramaḥ śītavātavāritarṣō'timātraṁharitahāridranētramūtravarcastvaṁ haritahāridrarūpadarśanaṁ ca, yasmiṁścāvakāśē visarpō'nusarpatisō'vakāśastāmraharitahāridranīlakr̥ṣṇaraktānāṁ varṇānāmanyatamaṁ puṣyati, sōtsēdhaiścātimātraṁdāhasambhēdanaparītaiḥ sphōṭakairupacīyatē tulyavarṇāsrāvaiścirapākaiśca, nidānōktāni cāsyanōpaśēratē viparītāni cōpaśērata iti pittavisarpaḥ||32|| <br />
<br />
pittamuShNopacAreNa vidAhyamlAshanaishcitam| <br />
<br />
dUShyAn sandUShya dhamanIH [1] pUrayan vai visarpati||31|| <br />
<br />
tasya rUpANi- jvarastRuShNA mUrcchA mohashchardirarocako~a~ggabhedaHsvedo~atimAtramantardAhaH pralApaH shiroruk cakShuShorAkulatvamasvapnamaratirbhramaHshItavātavAritarSho~atimAtraM haritahAridranetramUtravarcastvaM haritahAridrarUpadarshanaM ca,yasmiMshcAvakAshe visarpo~anusarpati so~avakAshastAmraharitahAridranIlakRuShNaraktAnAMvarNAnAmanyatamaM puShyati, sotsedhaishcAtimAtraM dAhasambhedanaparItaiH sphoTakairupacIyatetulyavarNAsrAvaishcirapAkaishca, nidAnoktAni cAsya nopasherate viparItAni copasherata itipittavisarpaH||32|| <br />
</div></div><br />
<div style="text-align:justify;"><br />
The [[pitta]] aggravated by the use of hot regimen, by eating irritant and sour foods vitiates the susceptible body elements and by feeling the vessels, begins to spread.<br />
<br />
Its signs and symptoms are fever, morbid thirst, fainting, disturbed consciousness, vomiting, anorexia, breaking body ache, excessive perspiration, burning, delirium, headache, congestion of the eyes, insomnia, restlessness, giddiness, excessive desire for cold air and water. Greenish or yellowish coloration of eyes, urine and feces, objects visualizes green and yellow. In the region where the ''visarpa'' spreads, becomes coppery, greenish, yellowish, bluish, blackish, reddish color. Affected part becomes excessively edematous and full of pustules, having intense burning and tearing pain, suppurating quickly and discharging fluid of similar color.<br />
<br />
The etiological factors do no suit and the contrary ones suit the patient. This is [[pitta]] dominant ''visarpa''. [31-32]<br />
</div><br />
=== Etio-pathogeneis and clinical features of [[kapha]] dominant ''visarpa'' ===<br />
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स्वाद्वम्ललवणस्निग्धगुर्वन्नस्वप्नसञ्चितः | <br />
<br />
कफः सन्दूषयन् दूष्यान् कृच्छ्रमङ्गे विसर्पति ||३३|| <br />
<br />
तस्य रूपाणि- शीतकः शीतज्वरो गौरवं निद्रा तन्द्राऽरोचको मधुरास्यत्वमास्योपलेपो निष्ठीविका छर्दिरालस्यं स्तैमित्यमग्निनाशो दौर्बल्यं च, यस्मिंश्चावकाशे विसर्पोऽनुसर्पति सोऽवकाशः श्वयथुमान् पाण्डुर्नातिरक्तः स्नेहसुप्तिस्तम्भगौरवैरन्वितोऽल्पवेदनः कृच्छ्रपाकैश्चिरकारिभिर्बहुलत्वगुपलेपैः स्फोटः श्वेतपाण्डुभिरनुबध्यते, प्रभिन्नस्तु श्वेतं पिच्छिलं तन्तुमद्धनमनुबद्धं स्निग्धमास्रावं स्रवति, ऊर्ध्वं च गुरुभिः स्थिरैर्जालावततैः स्निग्धैर्बहुलत्वगुपलेपैर्व्रणैरनुबध्यतेऽनुषङ्गी च भवति, श्वेतनखनयनवदनत्वङ्मूत्रवर्चस्त्वं, निदानोक्तानि चास्य नोपशेरते विपरीतानि चोपशेरत इति श्लेष्मविसर्पः ||३४||<br />
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svādvamlalavaṇasnigdhagurvannasvapnasañcitaḥ| <br />
<br />
kaphaḥ sandūṣayan dūṣyān kr̥cchramaṅgē visarpati||33|| <br />
<br />
tasya rūpāṇi- śītakaḥ śītajvarō gauravaṁ nidrā tandrā'rōcakō madhurāsyatvamāsyōpalēpō niṣṭhīvikāchardirālasyaṁ staimityamagnināśō daurbalyaṁ ca, yasmiṁścāvakāśē visarpō'nusarpati sō'vakāśaḥśvayathumān pāṇḍurnātiraktaḥ snēhasuptistambhagauravairanvitō'lpavēdanaḥkr̥cchrapākaiścirakāribhirbahulatvagupalēpaiḥ sphōṭaḥ śvētapāṇḍubhiranubadhyatē, prabhinnastu śvētaṁpicchilaṁ tantumaddhanamanubaddhaṁ snigdhamāsrāvaṁ sravati, ūrdhvaṁ ca gurubhiḥsthirairjālāvātataiḥ snigdhairbahulatvagupalēpairvraṇairanubadhyatē'nuṣaṅgī ca bhavati,śvētanakhanayanavadanatvaṅmūtravarcastvaṁ, nidānōktāni cāsya nōpaśēratē viparītāni cōpaśērata itiślēṣmavisarpaḥ||34|| <br />
</div></div><br />
<div style="text-align:justify;"><br />
[[Kapha]] excessively accumulated due to intake of sweet, sour, salt, unctuous and heavy foods, and also by excessive sleep, vitiates the susceptible body elements and spreads with slow speed in the body. <br />
<br />
Its signs and symptoms are chills, fever with chills, heaviness, excess sleep, drowsiness, adherence of sticky material in the mouth, excess spitting, vomiting, lassitude, timidity, loss of appetite and prostration. The region where the disease spreads becomes edematous, pallor or slight red, unctuous, numbness, rigidness, heaviness and slight pain. It suppurates hardly and chronic in nature. It is studded with eruptions which are covered with a thick skin and having white pale color. When burst, they discharge white, slimy, fibrinous, dense, sticky and viscid discharge from it. Thereafter it is followed by the ulcers which are heavy, deep seated, surrounded by capillary network, unctuous and covered with many skin scabs. These ulcers are chronic in nature. The nails, eyes, face, skin, urine and faces of the patient appear pale. The etiological factors do no suit and the contrary ones suit the patient. This is [[kapha]]ja visarpa''. [33-34]<br />
</div><br />
=== Etio-pathogenesis and clinical features of [[vata]]-[[pitta]] dominant ''agni visarpa'' ===<br />
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वातपित्तं प्रकुपितमतिमात्रं स्वहेतुभिः | <br />
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परस्परं लब्धबलं दहद्गात्रं विसर्पति ||३५|| <br />
<br />
तदुपतापादातुरः सर्वशरीरमङ्गारैरिवाकीर्यमाणं मन्यते, छर्द्यतीसारमूर्च्छादाहमोहज्वरतमकारोचकास्थिसन्धिभेदतृष्णाविपाकाङ्गभेदादिभिश्चाभिभूयते, यं यं चावकाशं विसर्पोऽनुसर्पति सोऽवकाशः शान्ताङ्गारप्रकाशोऽतिरक्तो वा भवति, अग्निदग्धप्रकारैश्च स्फोटैरुपचीयते, स शीघ्रगत्वादाश्वेव मर्मानुसारी भवति, मर्मणि चोपतप्ते पवनोऽतिबलो भिनत्त्यङ्गान्यतिमात्रं प्रमोहयति सञ्ज्ञां, हिक्काश्वासौ जनयति, नाशयति निद्रां, स नष्टनिद्रः प्रमूढसञ्ज्ञो व्यथितचेता न क्वचन सुखमुपलभते, अरतिपरीतः स्थानादासनाच्छय्यां क्रान्तुमिच्छति, क्लिष्टभूयिष्ठश्चाशु निद्रां भजति, दुर्बलो दुःखप्रबोधश्च भवति; तमेवंविधमग्निविसर्पपरीतमचिकित्स्यं विद्यात् ||३६||<br />
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vātapittaṁ prakupitamatimātraṁ svahētubhiḥ| <br />
<br />
parasparaṁ labdhabalaṁ dahadgātraṁ visarpati||35||<br />
<br />
tadupatāpādāturaḥ sarvaśarīramaṅgārairivākīryamāṇaṁ manyatē,chardyatīsāramūrcchādāhamōhajvaratamakārōcakāsthisandhibhēdatr̥ṣṇāvipākāṅgabhēdādibhiścābhibhūyatē,yaṁ yaṁ cāvakāśaṁ visarpō'nusarpati sō'vakāśaḥ śāntāṅgāraprakāśō'tiraktō vā bhavati,agnidagdhaprakāraiśca sphōṭairupacīyatē, sa śīghragatvādāśvēva marmānusārī bhavati, marmaṇi cōpataptēpavanō'tibalō bhinattyaṅgānyatimātraṁ pramōhayati sañjñāṁ, hikkāśvāsau janayati, nāśayati nidrāṁ, sanaṣṭanidraḥ pramūḍhasañjñō vyathitacētā na kvacana sukhamupalabhatē, aratiparītaḥsthānādāsanācchayyāṁ krāntumicchati, kliṣṭabhūyiṣṭhaścāśu nidrāṁ bhajati, durbalō duḥkhaprabōdhaścabhavati; tamēvaṁvidhamagnivisarpaparītamacikitsyaṁ vidyāt||36||<br />
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vātapittaM prakupitamatimAtraM svahetubhiH| <br />
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parasparaM labdhabalaM dahadgAtraM visarpati||35|| <br />
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tadupatApAdAturaH sarvasharIrama~ggArairivAkIryamANaM manyate,chardyatIsAramUrcchAdAhamohajvaratamakArocakAsthisandhibhedatRuShNAvipAkA~ggabhedAdibhishcAbhibhUyate,yaM yaM cAvakAshaM visarpo~anusarpati so~avakAshaH shAntA~ggAraprakAsho~atirakto vA bhavati,agnidagdhaprakAraishca sphoTairupacIyate, sa shIghragatvAdAshveva marmAnusArI bhavati, marmaNi copataptepavano~atibalo bhinattya~ggAnyatimAtraM pramohayati sa~jj~jAM, hikkAshvAsau janayati, nAshayati nidrAM, sanaShTanidraH pramUDhasa~jj~jo vyathitacetA na kvacana sukhamupalabhate, aratiparItaH sthAnAdAsanAcchayyAMkrAntumicchati, kliShTabhUyiShThashcAshu nidrAM bhajati, durbalo duHkhaprabodhashca bhavati;tamevaMvidhamagnivisarpaparItamacikitsyaM vidyAt||36|| <br />
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When ''vata-pitta'' vitiated severely due to their respective etiological factors and strengthened mutually, spreads producing severe burning pain in the body. <br />
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The patient affected with this type of ''visarpa'' feels as if his body is sprinkled with flaming coals. He suffers from vomiting, diarrhea, fainting, burning sensation, disturbed consciousness, fever, feeling of darkness, anorexia, breaking pain in bones and joints, morbid thirst, indigestion, breaking body pain etc. The part where the disease spreads looks like extinguished charcoal or blood like red, affected region gets covered with blisters like those caused by burns. Due to its rapid progress, it soon spreads to vital regions. When the vital parts gets affected, the [[vata]] which is excessively aggravated causes extensive disintegration of the tissues and leads to disturbed consciousness, produces hiccup, dyspnea and insomnia. That sleepless patient with disturbed consciousness and miserable mind does not get relief anywhere. He becomes restless in standing, seating and desires to lie on bed, thus exceedingly exhausted due to pain soon falls into deep sleep. Being debilitated, he is aroused from this state with difficulty. One suffering from ''agni-visarpa'' is to be regarded as incurable.[35-36]<br />
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=== Etio-pathogenesis and clinical features of [[kapha]]-[[pitta]] dominant ''kardam visarpa'' ===<br />
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कफपित्तं प्रकुपित्तं बलवत् स्वेन हेतुना | <br />
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विसर्पत्येकदेशे तु प्रक्लेदयति देहिनम् ||३७||<br />
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तद्विकाराः- शीतज्वरः शिरोगुरुत्वं दाहः स्तैमित्यमङ्गावसदनं निद्रा तन्द्रा मोहोऽन्नद्वेषः प्रलापोऽग्निनाशो दौर्बल्यमस्थिभेदो मूर्च्छा पिपासा स्रोतसां प्रलेपो जाड्यमिन्द्रियाणां प्रायोपवेशनमङ्गविक्षेपोऽङ्गमर्दोऽरतिरौत्सुक्यं चोपजायते, प्रायश्चामाशये विसर्पत्यलसक एकदेशग्राही च, यस्मिंश्चावकाशे विसर्पो विसर्पति सोऽवकाशो रक्तपीतपाण्डुपिडकावकीर्ण इव मेचकाभः कालो मलिनः स्निग्धो बहूष्मा गुरुः स्तिमितवेदनः श्वयथुमान् गम्भीरपाको निरास्रावः शीघ्रक्लेदः स्विन्नक्लिन्नपूतिमांसत्वक् क्रमेणाल्परुक् परामृष्टोऽवदीर्यते कर्दम इवावपीडितोऽन्तरं प्रयच्छत्युपक्लिन्नपूतिमांसत्यागी सिरास्नायुसन्दर्शी कुणपगन्धी च भवति सञ्ज्ञास्मृतिहन्ता च; तं कर्दमविसर्पपरीतमचिकित्स्यं विद्यात् ||३८||<br />
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kaphapittaṁ prakupittaṁ balavat svēna hētunā| <br />
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visarpatyēkadēśē tu praklēdayati dēhinam||37|| <br />
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tadvikārāḥ- śītajvaraḥ śirōgurutvaṁ dāhaḥ staimityamaṅgāvasadanaṁ nidrā tandrā mōhō'nnadvēṣaḥpralāpō'gnināśō daurbalyamasthibhēdō mūrcchā pipāsā srōtasāṁ pralēpō jāḍyamindriyāṇāṁprāyōpavēśanamaṅgavikṣēpō'ṅgamardō'ratirautsukyaṁ cōpajāyatē, prāyaścāmāśayē visarpatyalasakaēkadēśagrāhī ca, yasmiṁścāvakāśē visarpō visarpati sō'vakāśō raktapītapāṇḍupiḍakāvakīrṇa ivamēcakābhaḥ kālō malinaḥ snigdhō bahūṣmā guruḥ stimitavēdanaḥ śvayathumān gambhīrapākō nirāsrāvaḥśīghraklēdaḥ svinnaklinnapūtimāṁsatvak kramēṇālparuk parāmr̥ṣṭō'vadīryatē kardama ivāvapīḍitō'ntaraṁprayacchatyupaklinnapūtimāṁsatyāgī sirāsnāyusandarśī kuṇapagandhī ca bhavati sañjñāsmr̥tihantā ca;taṁ kardamavisarpaparītamacikitsyaṁ vidyāt||38||<br />
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kaphapittaM prakupittaM balavat svena hetunA| <br />
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visarpatyekadeshe tu prakledayati dehinam||37|| <br />
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tadvikArAH- shItajvaraH shirogurutvaM dAhaH staimityama~ggAvasadanaM nidrA tandrAmoho~annadveShaH pralApo~agninAsho daurbalyamasthibhedo mUrcchA pipAsA srotasAM pralepojADyamindriyANAM prAyopaveshanama~ggavikShepo~a~ggamardo~aratirautsukyaM copajAyate,prAyashcAmAshaye visarpatyalasaka ekadeshagrAhI ca, yasmiMshcAvakAshe visarpo visarpatiso~avakAsho raktapItapANDupiDakAvakIrNa iva mecakAbhaH kAlo malinaH snigdho bahUShmA guruHstimitavedanaH shvayathumAn gambhIrapAko nirAsrAvaH shIghrakledaH svinnaklinnapUtimAMsatvakkrameNAlparuk parAmRuShTo~avadIryate kardama ivAvapIDito~antaraMprayacchatyupaklinnapUtimAMsatyAgI sirAsnAyusandarshI kuNapagandhI ca bhavati sa~jj~jAsmRutihantAca; taM kardamavisarpaparItamacikitsyaM vidyAt||38|| <br />
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Excessively aggravated [[kapha]] [[pitta]] due to their respective etiological factors, spreads in the body causing suppuration of the tissues in particular part. <br />
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Its signs and symptoms are fever with chills, heaviness of the head, burning sensation, timidity, prostration, excessive sleep, drowsiness, disturbed consciousness, food dislike, delirium, loss of appetite, weakness, breaking pain in bones, fainting, morbid thirst, adhesions of sticky material in channels, dullness of the senses, mostly seating, abnormal movements of limbs, body pain, restlessness, anxiety, often it spreads to ''amashaya''. It is localized and spreads with slow speed.<br />
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The part where the disease spreads looks as if filled with reddish, yellowish, pale eruptions. The affected part becomes muddy, black, dirty, unctuous, excess hot, heavy, dull aching, edematous, with deep seated suppuration, having no discharge, rapidly become sloughy, sweated suppurated, having putrid flesh and skin, gradual little pain, when touched bursts and gives space on pressing, throws out decomposed and putrefied flesh, shows blood vessels, ligaments and has cadaverous smell and causes disturbed consciousness as well as memory. This is called ''kardam visarpa'' and is incurable. [37-38]<br />
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=== Etio-pathogenesis and clinical features of [[kapha]] [[vata]] dominant ''granthi visarpa'' ===<br />
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स्थिरगुरुकठिनमधुरशीतस्निग्धान्नपानाभिष्यन्दिसेविनामव्यायामादिसेविनामप्रतिक <br />
र्मशीलानां श्लेष्मा वायुश्च प्रकोपमापद्यते, तावुभौ दुष्टप्रवृद्धावतिबलौ प्रदूष्य दूष्यान् विसर्पाय कल्पेते; तत्र वायुः श्लेष्मणा विबद्धमार्गस्तमेव श्लेष्माणमनेकधा भिन्दन् क्रमेण ग्रन्थिमालां कृच्छ्रपाकसाध्यां कफाशये सञ्जनयति, उत्सन्नरक्तस्य वा प्रदूष्य रक्तं सिरास्नायुमांसत्वगाश्रितं ग्रन्थीनां मालां कुरुते तीव्ररुजानां स्थूलानामणूनां वा दीर्घवृत्तरक्तानां, तदुपतापाज्ज्वरातिसारकासहिक्काश्वासशोषप्रमोहवैवर्ण्यारोचकाविपाकप्रसेकच्छ <br />
र्दिर्मूर्च्छाङ्गभङ्गनिद्रारतिसदनाद्याः प्रादुर्भवन्त्युपद्रवाः; स एतैरुपद्रुतः सर्वकर्मणां विषयमतिपतितो विवर्जनीयो भवतीति ग्रन्थिविसर्पः ||३९||<br />
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sthiragurukaṭhinamadhuraśītasnigdhānnapānābhiṣyandisēvināmavyāyāmādisēvināmapratikarmaśīlānāṁślēṣmā vāyuśca prakōpamāpadyatē, tāvubhau duṣṭapravr̥ddhāvatibalau pradūṣya dūṣyān visarpāyakalpētē; tatra vāyuḥ ślēṣmaṇā vibaddhamārgastamēva ślēṣmāṇamanēkadhā bhindan kramēṇagranthimālāṁ kr̥cchrapākasādhyāṁ kaphāśayē sañjanayati, utsannaraktasya vā pradūṣya raktaṁsirāsnāyumāṁsatvagāśritaṁ granthīnāṁ mālāṁ kurutē tīvrarujānāṁ sthūlānāmaṇūnāṁ vādīrghavr̥ttaraktānāṁ, tadupatāpājjvarātisārakāsahikkāśvāsaśōṣapramōhavaivarṇyārōcakāvipākaprasēkacchardirmūrcchāṅgabhaṅganidrāratisadanādyāḥprādurbhavantyupadravāḥ; sa ētairupadrutaḥ sarvakarmaṇāṁ viṣayamatipatitō vivarjanīyō bhavatītigranthivisarpaḥ||39|| <br />
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sthiragurukaThinamadhurashItasnigdhAnnapAnAbhiShyandisevinAmavyAyAmAdisevinAmapratikarmashIlAnAMshleShmA vAyushca prakopamApadyate, tAvubhau duShTapravRuddhAvatibalau pradUShya dUShyAnvisarpAya kalpete; tatra vAyuH shleShmaNA vibaddhamArgastameva shleShmANamanekadhA bhindankrameNa granthimAlAM kRucchrapAkasAdhyAMkaphAshaye sa~jjanayati, utsannaraktasya vA pradUShyaraktaM sirAsnAyumAMsatvagAshritaM granthInAM mAlAM kurute tIvrarujAnAM sthUlAnAmaNUnAM vAdIrghavRuttaraktAnAM, tadupatApAjjvarAtisArakAsahikkAshvAsashoSha-pramohavaivarNyArocakAvipAkaprasekacchardirmUrcchA~ggabha~gganidrAratisadanAdyAHprAdurbhavantyupadravAH; sa etairupadrutaH sarvakarmaNAM viShayamatipatito vivarjanIyo bhavatItigranthivisarpaH||39|| <br />
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[[Kapha]] and [[vata]] gets vitiated due to the use of firm, heavy, hard, sweet, cold, unctuous, and ''abhishyandi'' (which increase discharges and cause obstruction) ingredients of diet, lack of physical exercise etc. not following preventive seasonal [[Panchakarma]] purification. Deranged excessively, aggravated, powerful both [[kapha]] and [[vata]] vitiates the susceptible body elements giving rise to ''granthi visarpa''. Thereafter the [[vata]] being occluded by [[kapha]] in its progress and disintegrates [[kapha]] in many ways and gradually giving rise to chain of glands, hardly suppurating and difficult to cure, in the habitats of [[kapha]].<br />
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In a person having aggravated blood, vitiated [[kapha]]-[[pitta]] provoke blood giving rise to a series of glandular enlargements which are exceedingly painful, large or small or elongated or round and of red color, located in blood vessels, ligaments, flesh and skin. Being afflicted, complications arise like fever, diarrhea, cough, hiccup, dyspnea, emaciation disturbed consciousness, abnormal complexion, anorexia, indigestion, excess salivation, vomiting, fainting, breaking pain in body , excessive sleep, restlessness, malaise, the patient associated with these complications goes beyond the reach of all remedial measures and as such is rejectable. This is ''granthi visarpa''.[39]<br />
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=== ''Upadrava'' (complications) ===<br />
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उपद्रवस्तु खलु रोगोत्तरकालजो रोगाश्रयो रोग एव स्थूलोऽणुर्वा, रोगात् पश्चाज्जायत इत्युपद्रवसञ्ज्ञः| <br />
तत्र प्रधानो व्याधिः, व्याधेर्गुणभूत [१] उपद्रवः, तस्य प्रायः प्रधानप्रशमे प्रशमो भवति | <br />
स तु पीडाकरतरो भवति पश्चादुत्पद्यमानो व्याधिपरिक्लिष्टशरीरत्वात्; तस्मादुपद्रवं त्वरमाणोऽभिबाधेत ||४०||<br />
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upadravastu khalu rōgōttarakālajō rōgāśrayō rōga ēva sthūlō'ṇurvā, rōgāt paścājjāyataityupadravasañjñaḥ| <br />
tatra pradhānō vyādhiḥ, vyādhērguṇabhūta [1] upadravaḥ, tasya prāyaḥ pradhānapraśamē praśamōbhavati| <br />
sa tu pīḍākaratarō bhavati paścādutpadyamānō vyādhiparikliṣṭaśarīratvāt; tasmādupadravaṁtvaramāṇō'bhibādhēta||40|| <br />
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upadravastu khalu rogottarakAlajo rōgashrayo rōga eva sthUlo~aNurvA, rōgat pashcAjjAyataityupadravasa~jj~jaH| <br />
tatra pradhAno vyAdhiH, vyAdherguNabhUta [1] upadravaH, tasya prAyaH pradhAnaprashame prashamobhavati| <br />
sa tu pIDAkarataro bhavati pashcAdutpadyamAno vyAdhiparikliShTasharIratvAt; tasmAdupadravaMtvaramANo~abhibAdheta||40|| <br />
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''Upadrava'' (complication) is disorder itself, outsized or undersized manifesting in the later period of a disease and rooted in the same (disease). ''Upadrava'' is so named because it manifests after the disease. Hence the main disease is primary and complication is secondary, it is generally pacified when the main disease gets pacified. It is more troublesome than the main disease itself, because it appears in the later stages of disease when the body is already weakened. Hence, one should treat the complications very promptly.[40]<br />
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=== Severity of ''visarpa'' ===<br />
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सर्वायतनसमुत्थं सर्वलिङ्गव्यापिनं सर्वधात्वनुसारिणमाशुकारिणं महात्ययिकमिति सन्निपातविसर्पमचिकित्स्यं विद्यात् ||४१||<br />
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sarvāyatanasamutthaṁ sarvaliṅgavyāpinaṁ sarvadhātvanusāriṇamāśukāriṇaṁ mahātyayikamitisannipātavisarpamacikitsyaṁ vidyāt||41|| <br />
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sarvAyatanasamutthaM sarvali~ggavyApinaM sarvadhAtvanusAriNamAshukAriNaM mahAtyayikamitisannipAtavisarpamacikitsyaM vidyAt||41||<br />
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The ''visarpa'' which is caused by all etiological factors, manifesting with all signs and symptoms, spreads in all body elements very rapidly and great disastrous is known as ''sannipataja visarpa'' and is not treatable. [41]<br />
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=== Prognosis of ''visarpa'' ===<br />
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तत्र वातपित्तश्लेष्मनिमित्ता विसर्पास्त्रयः साध्या भवन्ति; अग्निकर्दमाख्यौ पुनरनुपसृष्टे मर्मणि अनुपगते वा सिरास्नायुमांसक्लेदे साधारणक्रियाभिरुभावेवाभ्यस्यमानौ प्रशान्तिमापद्येयाताम्, अनादरोपक्रान्तः पुनस्तयोरन्यतरो हन्याद्देहमाश्वेवाशीविषवत्; तथा ग्रन्थिविसर्पमजातोपद्रवमारभेत चिकित्सितुम्, उपद्रवोपद्रुतं त्वेनं परिहरेत्; सन्निपातजं तु सर्वधात्वनुसारित्वादाशुकारित्वाद्विरुद्धोपक्रमत्वाच्चासाध्यं विद्यात् ||४२||<br />
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tatra vātapittaślēṣmanimittā visarpāstrayaḥ sādhyā bhavanti; agnikardamākhyau punaranupasr̥ṣṭēmarmaṇi anupagatē vā sirāsnāyumāṁsaklēdē sādhāraṇakriyābhirubhāvēvābhyasyamānaupraśāntimāpadyēyātām, anādarōpakrāntaḥ punastayōranyatarō hanyāddēhamāśvēvāśīviṣavat; tathāgranthivisarpamajātōpadravamārabhēta cikitsitum, upadravōpadrutaṁ tvēnaṁ pariharēt; sannipātajaṁ tusarvadhātvanusāritvādāśukāritvādviruddhōpakramatvāccāsādhyaṁ vidyāt||42|| <br />
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tatra vātapittashleShmanimittA visarpAstrayaH sAdhyA bhavanti; agnikardamAkhyau punaranupasRuShTemarmaNi anupagate vA sirAsnAyumAMsaklede sAdhAraNakriyAbhirubhAvevAbhyasyamAnauprashAntimApadyeyAtAm, anAdaropakrAntaH punastayoranyataro hanyAddehamAshvevAshIviShavat;tathA granthivisarpamajAtopadravamArabheta cikitsitum, upadravopadrutaM tvenaM pariharet;sannipAtajaM tu sarvadhAtvanusAritvAdAshukAritvAdviruddhopakramatvAccAsAdhyaM vidyAt||42|| <br />
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Among all types of ''visarpa vatik'', ''paittik'' and [[kapha]]ja these three are curable. ''Agni'' and ''kardam visarpa'' not spreading to vital organs and causing no suppuration of the vessels, ligaments and muscles can be pacified by the general treatment of ''visarpa''. When managed with negligence both may cause death of patients like snake venom. ''Granthi visarpa'' should be treated before complications has arisen, otherwise should be rejected. ''Sannipataja visarpa'' should be taken as incurable because of it is spreading to all [[dhatu]], very fulminant and refractory to treatment.[42]<br />
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=== Principles of treatment ===<br />
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तत्र साध्यानां साधनमनुव्याख्यास्यामः ||४३|| <br />
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लङ्घनोल्लेखने शस्ते तिक्तकानां च सेवनम् | <br />
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कफस्थानगते सामे रूक्षशीतैः प्रलेपयेत् ||४४||<br />
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पित्तस्थानगतेऽप्येतत् सामे कुर्याच्चिकित्सितम् | <br />
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शोणितस्यावसेकं च विरेकं च विशेषतः ||४५|| <br />
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मारुताशयसम्भूतेऽप्यादितः स्याद्विरूक्षणम् | <br />
<br />
रक्तपित्तान्वयेऽप्यादौ स्नेहनं न हितं मतम् ||४६|| <br />
<br />
वातोल्बणे तिक्तघृतं पैत्तिके च प्रशस्यते | <br />
<br />
लघुदोषे, महादोषे पैत्तिके स्याद्विरेचनम् ||४७|| <br />
<br />
न घृतं बहुदोषाय देयं यन्न [१] विरेचयेत् | <br />
<br />
तेन दोषो ह्युपष्टब्धस्त्वङ्मांसरुधिरं पचेत् ||४८|| <br />
<br />
तस्माद्विरेकमेवादौ शस्तं विद्याद्विसर्पिणः | <br />
<br />
रुधिरस्यावसेकं च तद्ध्यस्याश्रयसञ्ज्ञितम् ||४९||<br />
<div class="mw-collapsible-content"><br />
<br />
tatra sādhyānāṁ sādhanamanuvyākhyāsyāmaḥ||43|| <br />
<br />
laṅghanōllēkhanē śastē tiktakānāṁ ca sēvanam| <br />
<br />
kaphasthānagatē sāmē rūkṣaśītaiḥ pralēpayēt||44|| <br />
<br />
pittasthānagatē'pyētat sāmē kuryāccikitsitam| <br />
<br />
śōṇitasyāvasēkaṁ ca virēkaṁ ca viśēṣataḥ||45||<br />
<br />
mārutāśayasambhūtē'pyāditaḥ syādvirūkṣaṇam| <br />
<br />
raktapittānvayē'pyādau snēhanaṁ na hitaṁ matam||46|| <br />
<br />
vātōlbaṇē tiktaghr̥taṁ paittikē ca praśasyatē| <br />
<br />
laghudōṣē, mahādōṣē paittikē syādvirēcanam||47|| <br />
<br />
na ghr̥taṁ bahudōṣāya dēyaṁ yanna [1] virēcayēt| <br />
<br />
tēna dōṣō hyupaṣṭabdhastvaṅmāṁsarudhiraṁ pacēt||48|| <br />
<br />
tasmādvirēkamēvādau śastaṁ vidyādvisarpiṇaḥ| <br />
<br />
rudhirasyāvasēkaṁ ca taddhyasyāśrayasañjñitam||49|| <br />
<br />
tatra sAdhyAnAM sAdhanamanuvyAkhyAsyAmaH||43|| <br />
<br />
la~gghanollekhane shaste tiktakAnAM ca sevanam| <br />
<br />
kaphasthAnagate sAme rūkṣashItaiH pralepayet||44|| <br />
<br />
pittasthAnagate~apyetat sAme kuryAccikitsitam| <br />
<br />
shoNitasyAvasekaM ca virekaM ca visheShataH||45|| <br />
<br />
mArutAshayasambhUte~apyAditaH syAdvirūkṣaNam| <br />
<br />
raktapittAnvaye~apyAdau snehanaM na hitaM matam||46||<br />
<br />
vAtolbaNe tiktaghRutaM paittike ca prashasyate| <br />
<br />
laghudoShe, mahAdoShe paittike syAdvirecanam||47||<br />
<br />
na ghRutaM bahudōṣaya deyaM yanna [1] virecayet| <br />
<br />
tena doSho hyupaShTabdhastva~gmAMsarudhiraM pacet||48|| <br />
<br />
tasmAdvirekamevAdau shastaM vidyAdvisarpiNaH| <br />
<br />
rudhirasyAvasekaM ca taddhyasyAshrayasa~jj~jitam||49|| <br />
</div></div><br />
<br />
Now the treatment of the curable varieties of ''visarpa'' will be described. <br />
<br />
If the ''visarpa'' is caused with ama [[dosha]]([[dosha]] in the state of incomplete transformation) and is located in [[kapha]]sthana (in thorax and upper body parts), then [[langhana]] (fasting therapy), [[vamana]] (emesis) therapy, ''tikta'' (bitter) drugs internally and application of paste of drugs with dry and cold properties externally is beneficial. <br />
<br />
The same treatment should be adopted in case of association of ''ama'' and location in [[pitta]] sthana (abdomen and middle parts of body). <br />
<br />
In addition, [[rakta]]mokshana (blood letting) and [[virechana]] (purgation therapy) are specially indicated. <br />
<br />
If ''sama'' (with ama [[dosha]]) ''visarpa'' is arouse from ''vatashaya'' (pelvis and lower part of body) ununctuous measures are indicated in the beginning. Even in association with [[rakta]]-[[pitta]] uncting measure is not regarded as beneficial in the beginning. <br />
<br />
In [[vata]]ja visarpa and paittika visarpa of mild aggravated [[dosha]] tiktaka ghritam is beneficial. But if the [[pitta]] [[dosha]] is excessively aggravated then [[virechana]] should be given. <br />
<br />
In the condition of excessively aggravated [[dosha]], ghee should not be given at first which does not cause [[virechana]]. Because non purgating ghee occlude the [[dosha]] resulting in decomposed skin, flesh and blood. Hence in visarpa, [[virechana]] followed by [[rakta]]mokshana is recommended because the disorder is located in blood.[43-49]<br />
<br />
=== Formulations used in ''visarpa'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
इति वीसर्पनुत् प्रोक्तं समासेन चिकित्सितम् | <br />
<br />
एतदेव पुनः सर्वं व्यासतः सम्प्रवक्ष्यते ||५०|| <br />
<br />
मदनं मधुकं निम्बं वत्सकस्य फलानि च | <br />
<br />
वमनं सम्प्रदातव्यं विसर्पे कफपित्तजे ||५१|| <br />
<br />
पटोलपिचुमर्दाभ्यां पिप्पल्या मदनेन च | <br />
<br />
विसर्पे वमनं शस्तं तथा चेन्द्रयवैः सह ||५२|| <br />
<br />
यांश्च योगान् प्रवक्ष्याभि कल्पेषु कफपित्तिनाम् | <br />
<br />
विसर्पिणां प्रयोज्यास्ते दोषनिर्हरणाः शिवाः ||५३||<br />
<div class="mw-collapsible-content"><br />
<br />
iti vīsarpanut prōktaṁ samāsēna cikitsitam| <br />
<br />
ētadēva punaḥ sarvaṁ vyāsataḥ sampravakṣyatē||50|| <br />
<br />
madanaṁ madhukaṁ nimbaṁ vatsakasya phalāni ca| <br />
<br />
vamanaṁ sampradātavyaṁ visarpē kaphapittajē||51|| <br />
<br />
paṭōlapicumardābhyāṁ pippalyā madanēna ca| <br />
<br />
visarpē vamanaṁ śastaṁ tathā cēndrayavaiḥ saha||52|| <br />
<br />
yāṁśca yōgān pravakṣyābhi kalpēṣu kaphapittinām| <br />
<br />
visarpiṇāṁ prayōjyāstē dōṣanirharaṇāḥ śivāḥ||53|| <br />
<br />
iti vIsarpanut proktaM samAsena cikitsitam| <br />
<br />
etadeva punaH sarvaM vyAsataH sampravakShyate||50|| <br />
<br />
madanaM madhukaM nimbaM vatsakasya phalAni ca| <br />
<br />
vamanaM sampradAtavyaM visarpe kaphapittaje||51|| <br />
<br />
patōlapicumardAbhyAM pippalyA madanena ca| <br />
<br />
visarpe vamanaM shastaM tathA cendrayavaiH saha||52|| <br />
<br />
yAMshca yōgan pravakShyAbhi kalpeShu kaphapittinAm| <br />
<br />
visarpiNAM prayojyAste dōṣanirharaNAH shivAH||53||<br />
</div></div><br />
<br />
Thus the treatment principles of ''visarpa'' have been described in brief. The same is being detailed further. <br />
<br />
In [[kapha]] [[pitta]]ja visarpa, [[vamana]] should be given with the ''madana'' (Randia spinosa), ''madhuka'' (Glycyrrhiza glabra Linn), ''nimba'' (Azadirachta indica), and fruits of ''vatsaka'' (Holarrhena antidysenterica Linn). <br />
<br />
In visarpa [[vamana]] is beneficial with ''patola'' (Trichosanthes dioica Roxb), ''pichumarda'' (Azadirachta indica), ''pippali'' (Piper longum linn), ''madana'' (Randia spinosa) and ''indrayava'' (Holarrhena antidysenterica Linn). <br />
<br />
Further, all those formulations which will be described in ''kalpasthana'' in connection with the disorders of [[kapha]] [[pitta]] should be used for the patients of ''visarpa'' as well because they are eliminative of morbid [[dosha]] and are beneficial.[50-53]<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
मुस्तनिम्बपटोलानां चन्दनोत्पलयोरपि | <br />
<br />
सारिवामलकोशीरमुस्तानां वा विचक्षणः ||५४|| <br />
<br />
कषायान् पाययेद्वैद्यः सिद्धान् वीसर्पनाशनान् | <br />
<br />
किराततिक्तकं लोध्रं चन्दनं सदुरालभम् ||५५|| <br />
<br />
नागरं पद्मकिञ्जल्कमुत्पलं सबिभीतकम् | <br />
<br />
मधुकं नागपुष्पं च दद्याद्वीसर्पशान्तये ||५६|| <br />
<br />
प्रपौण्डरीकं मधुकं पद्मकिञ्जल्कमुत्पलम् | <br />
<br />
नागपुष्पं च लोध्रं च तेनैव विधिना पिबेत् ||५७|| <br />
<br />
द्राक्षां पर्पटकं शुण्ठीं गुडूचीं धन्वयासकम् | <br />
<br />
निशापर्युषितं दद्यात्तृष्णावीसर्पशान्तये ||५८|| <br />
<br />
पटोलं पिचुमर्दं च दार्वीं कटुकरोहिणीम् | <br />
<br />
यष्ट्याह्वां त्रायमाणां च दद्याद्वीसर्पशान्तये ||५९|| <br />
<br />
पटोलादिकषायं वा पिबेत्त्रिफलया सह | <br />
<br />
मसूरविदलैर्युक्तं घृतमिश्रं प्रदापयेत् ||६०|| <br />
<br />
पटोलपत्रमुद्गानां रसमामलकस्य च | <br />
<br />
पाययेत घृतोन्मिश्रं नरं वीसर्पपीडितम् ||६१||<br />
<div class="mw-collapsible-content"><br />
<br />
mustānimbapaṭōlānāṁ candanōtpalayōrapi| <br />
<br />
sārivāmalakōśīramustānāṁ vā vicakṣaṇaḥ||54|| <br />
<br />
kaṣāyān pāyayēdvaidyaḥ siddhān vīsarpanāśanān| <br />
<br />
kirātatiktakaṁ lōdhraṁ candanaṁ sadurālabham||55|| <br />
<br />
nāgaraṁ padmakiñjalkamutpalaṁ sabibhītakam| <br />
<br />
madhukaṁ nāgapuṣpaṁ ca dadyādvīsarpaśāntayē||56|| <br />
<br />
prapauṇḍarīkaṁ madhukaṁ padmakiñjalkamutpalam| <br />
<br />
nāgapuṣpaṁ ca lōdhraṁ ca tēnaiva vidhinā pibēt||57|| <br />
<br />
drākṣāṁ parpaṭakaṁ śuṇṭhīṁ guḍūcīṁ dhanvayāsakam| <br />
<br />
niśāparyuṣitaṁ dadyāttr̥ṣṇāvīsarpaśāntayē||58|| <br />
<br />
paṭōlaṁ picumardaṁ ca dārvīṁ kaṭukarōhiṇīm| <br />
<br />
yaṣṭyāhvāṁ trāyamāṇāṁ ca dadyādvīsarpaśāntayē||59|| <br />
<br />
paṭōlādikaṣāyaṁ vā pibēttriphalayā saha| <br />
<br />
masūravidalairyuktaṁ ghr̥tamiśraṁ pradāpayēt||60|| <br />
<br />
paṭōlapatramudgānāṁ rasamāmalakasya ca| <br />
<br />
pāyayēta ghr̥tōnmiśraṁ naraṁ vīsarpapīḍitam||61|| <br />
<br />
mustānimbapatōlanAM candanotpalayorapi| <br />
<br />
sArivAmalakoshIramustānAM vA vicakShaNaH||54|| <br />
<br />
kaShAyAn pAyayedvaidyaH siddhAn vIsarpanAshanAn| <br />
<br />
kirAtatiktakaM lōdhraM candanaM sadurAlabham||55|| <br />
<br />
nAgaraM padmaki~jjalkamutpalaM sabibhItakam| <br />
<br />
madhukaM nAgapuShpaM ca dadyAdvIsarpashAntaye||56|| <br />
<br />
prapauNDarIkaM madhukaM padmaki~jjalkamutpalam| <br />
<br />
nAgapuShpaM ca lōdhraM ca tenaiva vidhinA pibet||57|| <br />
<br />
drAkShAM parpaTakaM shuNThIM guDUcIM dhanvayAsakam| <br />
<br />
nishAparyuShitaM dadyAttRuShNAvIsarpashAntaye||58|| <br />
<br />
patōlaM picumardaM ca dArvIM kaTukarōhinim| <br />
<br />
yaShTyAhvAM trAyamANAM ca dadyAdvIsarpashAntaye||59|| <br />
<br />
patōladikaShAyaM vA pibettriphalayA saha|<br />
<br />
masUravidalairyuktaM ghRutamishraM pradApayet||60|| <br />
<br />
patōlapatramudgAnAM rasamAmalakasya ca| <br />
<br />
pAyayeta ghRutonmishraM naraM vIsarpapIDitam||61||<br />
</div></div><br />
<br />
The skillful physician should administer the decoctions of tested efficacy for the cure of ''visarpa'' made up of ''musta'' (Cyperus rotundus linn), ''nimba'' (Azadirachta indica) and ''patola'' (Trichosanthes dioica Roxb) or ''chandana'' (Santalum album linn) and utpal (Nymphaea nouchali) or ''sariva'' (Hemidesmus indicus), ''amalaki'' (Emblica officinalis), ''ushira'' (Vetiveria zizanioidis Linn) and ''musta'' (Cyperus rotundus linn). <br />
<br />
''Kiratatikta'' (Swertia chirayita), ''lodhra'' (Symplocos racemosa), ''chandana'' (Santalum album linn), ''duralabha'' (Fagonia cretica), ''shunthi'' (Zingiber officinale), ''padmakinjalka'' (Prunus cerasoides), ''utpala'' (Nymphaea nouchali), ''bibhitaka'' (Terminalia bellirica), ''madhuka'' (Glycyrrhiza glabra Linn) and ''nagapushpa'' (Mesua ferrea Linn), this formulation physician may administer for the alleviation of ''visarpa''. <br />
<br />
''Prapaundrika'' (Nelumbo nucifera), ''madhuka'' (Glycyrrhiza glabra Linn), ''padmakinjalka'' (Prunus cerasoides), ''utpala'' (Nymphaea nouchali), ''nagapuspa'' (Mesua ferrea Linn), and ''lodhra'' (Symplocos racemosa), should be taken by the above method. <br />
<br />
''Draksha'' (Vitis vinifera Linn), ''parpataka'' (Carthmus tinctorius), ''shunthi'' (Zingiber officinale), ''guduchi'' (Tinospora cordifolia) and ''dhanvayasa'' (fagonia cretica) kept for the whole night in the water (''shitakashaya''), should be administered to alleviate morbid thirst and ''visarpa''. <br />
<br />
''Patola'' (Trichosanthes dioica Roxb.), ''pichumarda'' (Azadirachta indica), ''darvi'' (Berberis aristata), ''katuki'' (Picrorhiza kurroa), ''rohini'' (Terminalia chebula), ''yasti'' (Glycyrrhiza glabra Linn.), and ''trayamana'' (Gentiana kurroo) should be administered to alleviate ''visarpa''. <br />
<br />
Physician should administer ''patoladi kashaya'' with ''triphala'' (''Haritaki'' -Terminalia chebula, ''Bibhitaki''-Terminalia bellirica, and ''amalaki''- Emblica officinalis) and ''masur'' (lentil pulse) mixed with ghee. <br />
<br />
Physician should administer ''patola patra'' (Trichosanthes dioica Roxb.), ''mudga'' (green gram) and ''amalaki'' juice (Emblica officinalis) mixed with ghee. [54-61]<br />
<br />
=== Formulations for [[dosha]] situated in koshtha, [[pitta]] dominant ''visarpa'' and [[virechana]] ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
यच्च सर्पिर्महातिक्तं पित्तकुष्ठनिबर्हणम् | <br />
<br />
निर्दिष्टं तदपि प्राज्ञो दद्याद्वीसर्पशान्तये ||६२|| <br />
<br />
त्रायमाणाघृतं सिद्धं गौल्मिके यदुदाहृतम् | <br />
<br />
विसर्पाणां प्रशान्त्यर्थं दद्यात्तदपि बुद्धिमान् ||६३|| <br />
<br />
त्रिवृच्चूर्णं समालोड्य सर्पिषा पयसाऽपि वा |<br />
<br />
घर्माम्बुना वा संयोज्य मृद्वीकानां रसेन वा ||६४|| <br />
<br />
विरेकार्थं प्रयोक्तव्यं सिद्धं वीसर्पनाशनम् | <br />
<br />
त्रायमाणाशृतं वाऽपि पयो दद्याद्विरेचनम् ||६५|| <br />
<br />
त्रिफलारससंयुक्तं सर्पिस्त्रिवृतया सह | <br />
<br />
प्रयोक्तव्यं विरेकार्थं विसर्पज्वरनाशनम् ||६६|| <br />
<br />
रसमामलकानां वा घृतमिश्रं प्रदापयेत् | <br />
<br />
स एव गुरुकोष्ठाय त्रिवृच्चूर्णयुतो हितः ||६७||<br />
<br />
दोषे कोष्ठगते भूय एतत् कुर्याच्चिकित्सितम् |68|<br />
<div class="mw-collapsible-content"><br />
<br />
yacca sarpirmahātiktaṁ pittakuṣṭhanibarhaṇam| <br />
<br />
nirdiṣṭaṁ tadapi prājñō dadyādvīsarpaśāntayē||62|| <br />
<br />
trāyamāṇāghr̥taṁ siddhaṁ gaulmikē yadudāhr̥tam| <br />
<br />
visarpāṇāṁ praśāntyarthaṁ dadyāttadapi buddhimān||63|| <br />
<br />
trivr̥ccūrṇaṁ samālōḍya sarpiṣā payasā'pi vā| <br />
<br />
gharmāmbunā vā saṁyōjya mr̥dvīkānāṁ rasēna vā||64|| <br />
<br />
virēkārthaṁ prayōktavyaṁ siddhaṁ vīsarpanāśanam| <br />
<br />
trāyamāṇāśr̥taṁ vā'pi payō dadyādvirēcanam||65|| <br />
<br />
triphalārasasaṁyuktaṁ sarpistrivr̥tayā saha| <br />
<br />
prayōktavyaṁ virēkārthaṁ visarpajvaranāśanam||66|| <br />
<br />
rasamāmalakānāṁ vā ghr̥tamiśraṁ pradāpayēt| <br />
<br />
sa ēva gurukōṣṭhāya trivr̥ccūrṇayutō hitaḥ||67|| <br />
<br />
dōṣē kōṣṭhagatē bhūya ētat kuryāccikitsitam|68| <br />
<br />
yacca sarpirmahAtiktaM pittakuShThanibarhaNam| <br />
<br />
nirdiShTaM tadapi prAj~jo dadyAdvIsarpashAntaye||62|| <br />
<br />
trAyamANAghRutaM siddhaM gaulmike yadudAhRutam| <br />
<br />
visarpANAM prashAntyarthaM dadyAttadapi buddhimAn||63|| <br />
<br />
trivRuccUrNaM samAloDya sarpiShA payasA~api vA| <br />
<br />
gharmAmbunA vA saMyojya mRudvIkAnAM rasena vA||64|| <br />
<br />
virekArthaM prayoktavyaM siddhaM vIsarpanAshanam| <br />
<br />
trAyamANAshRutaM vA~api payo dadyAdvirecanam||65|| <br />
<br />
triphalArasasaMyuktaM sarpistrivRutayA saha| <br />
<br />
prayoktavyaM virekArthaM visarpajvaranAshanam||66|| <br />
<br />
rasamAmalakAnAM vA ghRutamishraM pradApayet| <br />
<br />
sa eva gurukoShThAya trivRuccUrNayuto hitaH||67|| <br />
<br />
doShe koShThagate bhUya etat kuryAccikitsitam|68| <br />
</div></div><br />
<br />
The ''mahatikta ghritam'' indicated in ''paittika kustha'' should also be given by the intelligent physician for the alleviation of ''visarpa''. <br />
<br />
''Trayamana ghritam'' of tested efficacy mentioned in the treatment of ''gulma'' should be administered by the brilliant physician to alleviate ''visarpa''. <br />
<br />
The powder of ''trivritta'' (Operculina turpethum Linn) mixed with ghee or milk or hot water or ''mridvika'' (Vitis vinifera Linn) juice should be administered for [[virechana]] and is tested to alleviate ''visarpa'' or ''trayamana'' (Gentiana kurroo) decocted with milk should be given for [[virechana]]. <br />
<br />
The decoction of ''triphala'' (''Haritaki, Bibhitaki'' and ''Amalaki'') mixed with ghee and ''trivritta'' (Operculina turpethum Linn) and used for [[virechana]] to alleviate ''visarpa'' and ''jwara''.<br />
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The juice of ''amalaki'' (Emblica officinalis) mixed with ghee should be administered in ''visarpa'' patient of heavy bowel the same preparation mixed with ''trivritta'' (Operculina turpethum Linn) powder is beneficial. <br />
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When the morbid [[dosha]] are situated in ''kostha'' (internally), these measures should be administered.[62-67]<br />
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=== Formulations for [[dosha]] situated in ''shakha'' and modes of blood letting ===<br />
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शाखादुष्टे तु रुधिरे रक्तमेवादितो हरेत् ||६८|| <br />
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भिषग्वातान्वितं रक्तं विषाणेन विनिर्हरेत् | <br />
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पित्तान्वितं जलौकोभिः, कफान्वितमलाबुभिः ||६९|| <br />
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यथासन्नं विकारस्य व्यधयेदाशु वा सिराम् | <br />
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त्वङ्मांसस्नायुसङ्क्लेदो रक्तक्लेदाद्धि जायते ||७०||<br />
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śākhāduṣṭē tu rudhirē raktamēvāditō harēt||68|| <br />
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bhiṣagvātānvitaṁ raktaṁ viṣāṇēna vinirharēt| <br />
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pittānvitaṁ jalaukōbhiḥ, kaphānvitamalābubhiḥ||69|| <br />
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yathāsannaṁ vikārasya vyadhayēdāśu vā sirām| <br />
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tvaṅmāṁsasnāyusaṅklēdō raktaklēdāddhi jāyatē||70|| <br />
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shAkhAduShTe tu rudhire raktamevAdito haret||68|| <br />
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bhiShagvātanvitaM raktaM viShANena vinirharet| <br />
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pittAnvitaM jalaukobhiH, kaphAnvitamalAbubhiH||69|| <br />
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yathAsannaM vikArasya vyadhayedAshu vA sirAm| <br />
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tva~gmAMsasnAyusa~gkledo raktakledAddhi jAyate||70||<br />
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If [[dosha]] in ''shakha'' (body elements) vitiate the blood then ''raktamokshana'' should be administered at first. The physician should use ''vishana'' (deer horn) in [[vata]] dominance, ''jalauka'' (Hirudinea medicinalis) in [[pitta]] dominance and ''alabu'' (lagenaria siceraria) in [[kapha]] dominance for blood letting or physician should perform ''siravyadha'' (blood letting through vein) promptly from the adjacent vein to the affected part, without which ''rakta kleda'' (putrifying blood content) gives rise to decomposed skin, flesh and ligaments. [68-70]<br />
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=== External applications ===<br />
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अन्तःशरीरे [१] संशुद्धे दोषे त्वङ्मांससंश्रिते | <br />
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आदितो वाऽल्पदोषाणां क्रिया बाह्या प्रवक्ष्यते ||७१||<br />
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उदुम्बरत्वङ्मधुकं पद्मकिञ्जल्कमुत्पलम् | <br />
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नागपुष्पं प्रियङ्गुश्च प्रदेहः सघृतो हितः ||७२||<br />
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न्यग्रोधपादास्तरुणाः कदलीगर्भसंयुताः | <br />
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बिसग्रन्थिश्च लेपः स्याच्छतधौतघृताप्लुतः ||७३||<br />
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कालीयं मधुकं हेम वन्यं चन्दनपद्मकौ | <br />
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एला मृणालं फलिनी प्रलेपः स्याद्धृताप्लुतः ||७४|| <br />
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शाद्वलं च मृणालं च शङ्खं चन्दनमुत्पलम् |<br />
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वेतसस्य च मूलानि प्रदेहः स्यात् सतण्डुलः ||७५||<br />
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सारिवा पद्मकिञ्जल्कमुशीरं नीलमुत्पलम् | <br />
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मञ्जिष्ठा चन्दनं लोध्रमभया च प्रलेपनम् ||७६|| <br />
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नलदं च हरेणुश्च लोध्रं मधुकपद्मकौ [२] |<br />
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दूर्वा सर्जरसश्चैव सघृतं स्यात् प्रलेपनम् ||७७||<br />
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यावकाः सक्तवश्चैव सर्पिषा सह योजिताः | <br />
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प्रदेहो मधुकं वीरा सघृता यवसक्तवः ||७८|| <br />
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बलामुत्पलशालूकं वीरामगुरुचन्दनम् | <br />
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कुर्यादालेपनं वैद्यो मृणालं च बिसान्वितम् ||७९||<br />
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यवचूर्णं समधुकं सघृतं च प्रलेपनम् | <br />
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हरेणवो मसुराश्च समुद्गाः श्वेतशालयः ||८०|| <br />
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पृथक् पृथक् प्रदेहाः स्युः सर्वे वा सर्पिषा सह | <br />
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पद्मिनीकर्दमः शीतो मौक्तिकं पिष्टमेव वा ||८१|| <br />
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शङ्खः प्रवालः शुक्तिर्वा गैरिकं वा घृताप्लुतम् | <br />
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(पृथगेते प्रदेहाश्च हिता ज्ञेया विसर्पिणाम् [३] ) | <br />
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प्रपौण्डरीकं मधुकं बला शालूकमुत्पलम् ||८२|| <br />
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न्यग्रोधपत्रदुग्धीके सघृतं स्यात् प्रलेपनम् | <br />
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बिसानि च मृणालं च सघृताश्च कशेरुकाः ||८३|| <br />
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शतावरीविदार्योश्च कन्दौ धौतघृताप्लुतौ | <br />
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शैवालं नलमूलानि गोजिह्वा वृषकर्णिका ||८४|| <br />
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इन्द्राणिशाकं सघृतं शिरीषत्वग्बलाघृतम् [४] | <br />
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न्यग्रोधोदुम्बरप्लक्षवेतसाश्वत्थपल्लवैः ||८५|| <br />
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त्वक्कल्कैर्बहुसर्पिर्भिः शीतैरालेपनं हितम् | <br />
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प्रदेहाः सर्व एवैते वातपित्तोल्बणे [५] शुभाः ||८६||<br />
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सकफे [६] तु प्रवक्ष्यामि प्रदेहानपरान् हितान् | <br />
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त्रिफलां पद्मकोशीरं समङ्गां करवीरकम् ||८७|| <br />
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नलमूलान्यनन्तां च प्रदेहमुपकल्पयेत् | <br />
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खदिरं सप्तपर्णं च मुस्तमारग्वधं धवम् ||८८|| <br />
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कुरण्टकं देवदारु दद्यादालेपनं भिषक् | <br />
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आरग्वधस्य पत्राणि त्वचं श्लेष्मातकस्य च ||८९|| <br />
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इन्द्राणिशाकं काकाह्वां शिरीषकुसुमानि च | <br />
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शैवालं नलमूलानि वीरां गन्धप्रियङ्गुकाम् ||९०|| <br />
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त्रिफलां मधुकं वीरां शिरीषकुसुमानि च | <br />
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प्रपौण्डरीकं ह्रीबेरं दार्वीत्वङ्मधुकं बलाम् ||९१|| <br />
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पृथगालेपनं कुर्याद्द्वन्द्वशः सर्वशोऽपि वा | <br />
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प्रदेहाः सर्व एवैते देयाः स्वल्पघृताप्लुताः ||९२|| <br />
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वातपित्तोल्बणे ये तु प्रदेहास्ते घृताधिकाः | <br />
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घृतेन शतधौतेन प्रदिह्यात् केवलेन वा ||९३|| <br />
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घृतमण्डेन शीतेन पयसा मधुकाम्बुना | <br />
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पञ्चवल्ककषायेण सेचयेच्छीतलेन वा ||९४|| <br />
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वातासृक्पित्तबहुलं विसर्पं बहुशो भिषक् | <br />
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सेचनास्ते प्रदेहा ये त एव घृतसाधनाः ||९५|| <br />
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ते चूर्णयोगा वीसर्पव्रणानामवचूर्णनाः | <br />
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दूर्वास्वरससिद्धं च घृतं स्याद्व्रणरोपणम् ||९६|| <br />
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दार्वीत्वङूमधुकं लोध्रं केशरं चावचूर्णनम् | <br />
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पटोलः पिचुमर्दश्च त्रिफला मधुकोत्पले ||९७|| <br />
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एतत् प्रक्षालनं सर्पिर्व्रणचूर्णं प्रलेपनम् |<br />
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प्रदेहाः सर्व एवैते कर्तव्याः सम्प्रसादनाः [१] ||९८|| <br />
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antaḥśarīrē [1] saṁśuddhē dōṣē tvaṅmāṁsasaṁśritē| <br />
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āditō vā'lpadōṣāṇāṁ kriyā bāhyā pravakṣyatē||71||<br />
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udumbaratvaṅmadhukaṁ padmakiñjalkamutpalam| <br />
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nāgapuṣpaṁ priyaṅguśca pradēhaḥ saghr̥tō hitaḥ||72|| <br />
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nyagrōdhapādāstaruṇāḥ kadalīgarbhasaṁyutāḥ| <br />
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bisagranthiśca lēpaḥ syācchatadhautaghr̥tāplutaḥ||73|| <br />
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kālīyaṁ madhukaṁ hēma vanyaṁ candanapadmakau| <br />
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ēlā mr̥ṇālaṁ phalinī pralēpaḥ syāddhr̥tāplutaḥ||74|| <br />
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śādvalaṁ ca mr̥ṇālaṁ ca śaṅkhaṁ candanamutpalam| <br />
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vētasasya ca mūlāni pradēhaḥ syāt sataṇḍulaḥ||75|| <br />
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sārivā padmakiñjalkamuśīraṁ nīlamutpalam| <br />
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mañjiṣṭhā candanaṁ lōdhramabhayā ca pralēpanam||76|| <br />
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naladaṁ ca harēṇuśca lōdhraṁ madhukapadmakau [2] |<br />
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dūrvā sarjarasaścaiva saghr̥taṁ syāt pralēpanam||77|| <br />
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yāvakāḥ saktavaścaiva sarpiṣā saha yōjitāḥ| <br />
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pradēhō madhukaṁ vīrā saghr̥tā yavasaktavaḥ||78|| <br />
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balāmutpalaśālūkaṁ vīrāmagurucandanam| <br />
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kuryādālēpanaṁ vaidyō mr̥ṇālaṁ ca bisānvitam||79|| <br />
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yavacūrṇaṁ samadhukaṁ saghr̥taṁ ca pralēpanam| <br />
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harēṇavō masurāśca samudgāḥ śvētaśālayaḥ||80|| <br />
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pr̥thak pr̥thak pradēhāḥ syuḥ sarvē vā sarpiṣā saha| <br />
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padminīkardamaḥ śītō mauktikaṁ piṣṭamēva vā||81|| <br />
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śaṅkhaḥ pravālaḥ śuktirvā gairikaṁ vā ghr̥tāplutam| <br />
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(pr̥thagētē pradēhāśca hitā jñēyā visarpiṇām [3] )| <br />
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prapauṇḍarīkaṁ madhukaṁ balā śālūkamutpalam||82|| <br />
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nyagrōdhapatradugdhīkē saghr̥taṁ syāt pralēpanam| <br />
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bisāni ca mr̥ṇālaṁ ca saghr̥tāśca kaśērukāḥ||83|| <br />
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śatāvarīvidāryōśca kandau dhautaghr̥tāplutau| <br />
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śaivālaṁ nalamūlāni gōjihvā vr̥ṣakarṇikā||84|| <br />
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indrāṇiśākaṁ saghr̥taṁ śirīṣatvagbalāghr̥tam [4] | <br />
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nyagrōdhōdumbaraplakṣavētasāśvatthapallavaiḥ||85|| <br />
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tvakkalkairbahusarpirbhiḥ śītairālēpanaṁ hitam| <br />
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pradēhāḥ sarva ēvaitē vātapittōlbaṇē [5] śubhāḥ||86|| <br />
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sakaphē [6] tu pravakṣyāmi pradēhānaparān hitān| <br />
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triphalāṁ padmakōśīraṁ samaṅgāṁ karavīrakam||87|| <br />
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nalamūlānyanantāṁ ca pradēhamupakalpayēt| <br />
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khadiraṁ saptaparṇaṁ ca mustāmāragvadhaṁ dhavam||88|| <br />
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kuraṇṭakaṁ dēvadāru dadyādālēpanaṁ bhiṣak| <br />
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āragvadhasya patrāṇi tvacaṁ ślēṣmātakasya ca||89|| <br />
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indrāṇiśākaṁ kākāhvāṁ śirīṣakusumāni ca| <br />
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śaivālaṁ nalamūlāni vīrāṁ gandhapriyaṅgukām||90|| <br />
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triphalāṁ madhukaṁ vīrāṁ śirīṣakusumāni ca| <br />
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prapauṇḍarīkaṁ hrībēraṁ dārvītvaṅmadhukaṁ balām||91|| <br />
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pr̥thagālēpanaṁ kuryāddvandvaśaḥ sarvaśō'pi vā| <br />
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pradēhāḥ sarva ēvaitē dēyāḥ svalpaghr̥tāplutāḥ||92|| <br />
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vātapittōlbaṇē yē tu pradēhāstē ghr̥tādhikāḥ| <br />
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ghr̥tēna śatadhautēna pradihyāt kēvalēna vā||93|| <br />
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ghr̥tamaṇḍēna śītēna payasā madhukāmbunā| <br />
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pañcavalkakaṣāyēṇa sēcayēcchītalēna vā||94|| <br />
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vātāsr̥kpittabahulaṁ visarpaṁ bahuśō bhiṣak| <br />
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sēcanāstē pradēhā yē ta ēva ghr̥tasādhanāḥ||95|| <br />
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tē cūrṇayōgā vīsarpavraṇānāmavacūrṇanāḥ| <br />
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dūrvāsvarasasiddhaṁ ca ghr̥taṁ syādvraṇarōpaṇam||96|| <br />
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dārvītvaṅmadhukaṁ lōdhraṁ kēśaraṁ cāvacūrṇanam| <br />
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paṭōlaḥ picumardaśca triphalā madhukōtpalē||97|| <br />
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ētat prakṣālanaṁ sarpirvraṇacūrṇaṁ pralēpanam|98|<br />
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antaHsharIre [1] saMshuddhe doShe tva~gmAMsasaMshrite| <br />
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Adito vA~alpadōṣaNAM kriyA bAhyA pravakShyate||71|| <br />
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udumbaratva~gmadhukaM padmaki~jjalkamutpalam| <br />
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nAgapuShpaM priya~ggushca pradehaH saghRuto hitaH||72|| <br />
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nyagrodhapAdAstaruNAH kadalIgarbhasaMyutAH| <br />
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bisagranthishca lepaH syAcchatadhautaghRutAplutaH||73|| <br />
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kAlIyaM madhukaM hema vanyaM candanapadmakau| <br />
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elA mRuNAlaM phalinI pralepaH syAddhRutAplutaH||74|| <br />
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shAdvalaM ca mRuNAlaM ca sha~gkhaM candanamutpalam| <br />
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vetasasya ca mUlAni pradehaH syAt sataNDulaH||75|| <br />
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sArivA padmaki~jjalkamushIraM nIlamutpalam| <br />
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ma~jjiShThA candanaM lōdhramabhayA ca pralepanam||76|| <br />
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naladaM ca hareNushca lōdhraM madhukapadmakau [2] | <br />
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dUrvA sarjarasashcaiva saghRutaM syAt pralepanam||77|| <br />
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yAvakAH saktavashcaiva sarpiShA saha yojitAH| <br />
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pradeho madhukaM vIrA saghRutA yavasaktavaH||78|| <br />
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balAmutpalashAlUkaM vIrAmagurucandanam| <br />
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kuryAdAlepanaM vaidyo mRuNAlaM ca bisAnvitam||79|| <br />
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yavacUrNaM samadhukaM saghRutaM ca pralepanam| <br />
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hareNavo masurAshca samudgAH shvetashAlayaH||80|| <br />
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pRuthak pRuthak pradehAH syuH sarve vA sarpiShA saha| <br />
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padminIkardamaH shIto mauktikaM piShTameva vA||81|| <br />
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sha~gkhaH pravAlaH shuktirvA gairikaM vA ghRutAplutam| <br />
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(pRuthagete pradehAshca hitA j~jeyA visarpiNAm [3] )| <br />
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prapauNDarIkaM madhukaM balA shAlUkamutpalam||82|| <br />
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nyagrodhapatradugdhIke saghRutaM syAt pralepanam| <br />
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bisAni ca mRuNAlaM ca saghRutAshca kasherukAH||83|| <br />
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shatAvarIvidAryoshca kandau dhautaghRutAplutau| <br />
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shaivAlaM nalamUlAni gojihvA vRuShakarNikA||84|| <br />
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indrANishAkaM saghRutaM shirIShatvagbalAghRutam [4] | <br />
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nyagrodhodumbaraplakShavetasAshvatthapallavaiH||85|| <br />
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tvakkalkairbahusarpirbhiH shItairAlepanaM hitam| <br />
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pradehAH sarva evaite vātapittolbaNe [5] shubhAH||86|| <br />
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sakaphe [6] tu pravakShyAmi pradehAnaparAn hitAn| <br />
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triphalAM padmakoshIraM sama~ggAM karavIrakam||87|| <br />
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nalamUlAnyanantAM ca pradehamupakalpayet| <br />
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khadiraM saptaparNaM ca mustāmAragvadhaM dhavam||88|| <br />
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kuraNTakaM devadAru dadyAdAlepanaM bhiShak| <br />
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Aragvadhasya patrANi tvacaM shleShmAtakasya ca||89|| <br />
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indrANishAkaM kAkAhvAM shirIShakusumAni ca| <br />
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shaivAlaM nalamUlAni vIrAM gandhapriya~ggukAm||90|| <br />
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triphalAM madhukaM vIrAM shirIShakusumAni ca| <br />
<br />
prapauNDarIkaM hrIberaM dArvItva~gmadhukaM balAm||91|| <br />
<br />
pRuthagAlepanaM kuryAddvandvashaH sarvasho~api vA| <br />
<br />
pradehAH sarva evaite deyAH svalpaghRutAplutAH||92|| <br />
<br />
vātapittolbaNe ye tu pradehAste ghRutAdhikAH| <br />
<br />
ghRutena shatadhautena pradihyAt kevalena vA||93|| <br />
<br />
ghRutamaNDena shItena payasA madhukAmbunA| <br />
<br />
pa~jcavalkakaShAyeNa secayecchItalena vA||94|| <br />
<br />
vātasRukpittabahulaM visarpaM bahusho bhiShak| <br />
<br />
secanAste pradehA ye ta eva ghRutasAdhanAH||95|| <br />
<br />
te cUrNayōga vIsarpavraNAnAmavacUrNanAH| <br />
<br />
dUrvAsvarasasiddhaM ca ghRutaM syAdvraNaropaNam||96|| <br />
<br />
dArvItva~gmadhukaM lōdhraM kesharaM cAvacUrNanam| <br />
<br />
patōlaH picumardashca triphalA madhukotpale||97|| <br />
<br />
etat prakShAlanaM sarpirvraNacUrNaM pralepanam|98| <br />
</div></div><br />
<br />
After the body is cleansed internally (systemic) and morbid [[dosha]] remains in the skin and flesh (external tissues), or [[dosha]] morbidity is little, the external treatment to be carried out will now be described. <br />
<br />
The bark of ''udumbara'' (Ficus glomerata), ''madhuka'' (Glycyrrhiza glabra Linn), ''padmakinjalka'' (Prunas cerasoides), ''utpala'' (Nymphaea nouchali), ''nagapuspa'' (Mesua ferrea Linn) and ''priyangu'' (Callicarpa macrophylla) mixed with ghee and applied externally as ''pradeha'' and is beneficial. <br />
<br />
The tender adventitious roots of ''nyagrodha'' (Ficus bengalensis Linn), pith of ''kadali'' (Musa paradisiaca Linn.) and rhizome of lotus should be mixed with ghee washed hundred times and is applied externally as a ''lepa''.<br />
<br />
The ''kaliyaka'' (Santalum album Linn), ''madhuka'' (Glycyrrhiza glabra Linn), ''hema'' (calophyllum inophyllum), ''vanya'' (cyperus esculentus), ''chandana'' (Santalum album Linn), ''padmaka'' (Prunas cerasoides), ''ela'' (Elettaria cardamomum), ''mrnala'' (Nelumbo nucifera) and ''phalini'' (Callicarpa macrophylla) should be mixed with ghee and is applied externally as a ''pralepa''. <br />
<br />
The roots ''shadvala'' (Elymus repens), ''mrnala'' (Nelumbo nucifera), ''shankha'' (conch shells), ''chandana'' (Santalum album Linn), ''utpala'' (Nymphaea nouchali), ''vetas'' (Salix caprea Linn) and ''tandula'' (rice) should be applied externally as a ''pradeha''. <br />
''Sariva'' (Hemidesmus indicus), ''padmakinjalka'' (Prunas cerasoides), ''ushira'' (Vetiveria zizanioidis), ''nila utpala'' (Nymphaea caerulea), ''manjistha'' (Rubia cordifolia), ''chandana'' (Santalum album Linn), ''lodhra'' (symplocos racemosa) and ''abhaya'' (Terminalia chebula) should be applied externally as ''pralepa''. <br />
<br />
''Nalada'' (Vetiveria zizanioidis), ''harenu'' (Vitex negundo Linn), ''lodhra'' (Symplocos racemosa), ''madhuka'' (Glycyrrhiza glabra Linn), ''padmaka'' (Prunas cerasoides), ''durva'' (Cynodon dactylon) and ''sarjarasa'' (Shorea robusta) should be mixed with ghee and used externally as a ''pralepa''.<br />
<br />
The gruel prepared of barley or roasted flour of cereals should be mixed with ghee and also ''madhuka'' (Glycyrrhiza glabra Linn), ''vira'' (Pueraria tuberose) and ''yavasaktu'' mixed with ghee should be used externally as a ''pradeha''. <br />
<br />
The physician should use mixture of ''bala'' (Sida cordifolia Linn), ''utpala'' (Nymphaea nouchali), ''shaluka'' (Asparagus racemosus), ''vira'' (Pueraria tuberose), ''aguru'' (Aquilaria agallocha), ''chandana'' (Santalum album Linn), ''mrnala'' (stalk) and ''bisa'' (tubers of Nelumbo nucifera) externally as ''alepan'' (local application as a smear or thick paste or coating). <br />
<br />
The powder of barley mixed with honey and ghee should be used externally as a ''pralepa'' (application as thin paste). <br />
<br />
''Harenu'' (Pisum sativum), ''masura'' (Lens culinaris), ''mudga'' (Vigna radiata) and white ''shali'' rice should be mixed with ghee individually or in combination and used externally as a ''pradeha'' (application as a poultice).<br />
<br />
The cooling mud at the root of lotus, pearls or rice flour or conch shells, coral, oyster shell and ochre should be mixed with ghee separately and beneficial externally as a ''pradeha'' in ''visarpa''.<br />
<br />
''Prapaundarika'' (Nelumbo nucifera), ''madhuka'' (Glycyrrhiza glabra Linn), ''bala'' (Sida cordifolia), ''shaluka'' (Asparagus racemosus), ''utpala'' (Nymphaea nouchali), ''nyagrodha'' (Ficus bengalensis Linn) and ''dugdhika'' (Euphorbia hirta Linn.) mixed with ghee should be used externally as a ''pralepan''. <br />
<br />
The ''bisa'' (lotus fibres), ''mrnala'' (lotus stalks) and ''kasheruka'' (Cyperus esculentus) mixed with ghee. The ''shatavari'' (Asparagus racemosus) and ''vidarikand'' (Pueraria tuberose) mixed with washed ghee.<br />
<br />
The ''shaival'' (moss), root of ''nala'' (phragmites australis), ''gojihva'' (Amorphophallus paeoniifolius), ''vrsa karnika'' (Calystegia soldanella) and ''indranishaka'' (Vitex agnus-castus) mixed with ghee.<br />
<br />
The bark of ''sirisa'' (Albizzia lebbeck) and ''bala'' (Sida cordifolia Linn) mixed with ghee. ''Nyagrodha'' (Ficus bengalensis Linn), ''udumbar'' (Ficus glomerata), ''plaksha'' (Ficus sycomorus), ''vetas'' (Salix caprea Linn), ''asvattha'' (Ficus religiosa) leaves and bark mixed with ample ghee used as a cold ''alepan'' is beneficial. <br />
<br />
All these external applications are beneficial in [[vata]] [[pitta]] predominant ''visarpa''. <br />
<br />
Other external applications useful in [[kapha]] predominant ''visarpa'' will be described here after. ''Triphala'' (''haritaki, bibhitaki'' and ''amalaki''), ''padmaka'' (Prunas cerasoides), ''usir'' (Vetiveria zizanioidis Linn), ''samanga'' (Mimosa pudica), ''karviraka'' (Nerium indicum), root of ''nala'' (Phragmites australis) and ''ananta'' (hemidesmus indicus) should be used externally as a ''pradeha''. <br />
<br />
''Khadira'' (Acacia catechu), ''saptaparna'' (Alstonia scholaris), ''musta'' (Cyperus rotundus linn), ''aragvadha'' (Cassia fistula Linn), ''dhava'' (Anogeissus latifolia, Wall). ''Kurantaka'' (Lawsonia inermis) and ''devdaru'' (Cedrus deodar) should be applied externally as a ''pradeha''.<br />
<br />
''Aragvadha'' leaves (Cassia fistula Linn.) and ''sleshmantak'' bark (Cordia dichotoma), ''indrani shak'' (Vitex negundo Linn), ''kakahva'' (Canvalia gladiata) and ''sirisa'' flowers (Albizia lebbeck Linn.), ''saivala'' (Spirogyra maxima) root of ''nala'' (Phragmites australis), ''veera'' (Pueraria tuberose) and ''gandpriyangu'' (Callicarpa macrophylla), ''triphala'' (''Haritaki, Bibhitaki'' and ''Amalaki''), ''madhuka'' (Glycyrrhiza glabra Linn), ''prapaundrika'' (nelumbo nucifera), ''hribera'' (Pavonia odorata), bark of ''darvi'' (Berberis aristata), and ''bala'' (Sida cordifolia Linn.) - these should be applied singly, dually or collectively as a ''pradeha''. All these external applications should be mixed with small quantity of ghee. In [[vata]] [[pitta]] predominant condition these preparations should be mixed with profuse quantity of ghee.<br />
<br />
The applications of ''shatdhaut ghrita'' as ''pradeha'' or effuse with cold ghee scum, or cold milk or cold decoction of ''madhuka'' (Glycyrrhiza glabra Linn), or ''panchavalka'' (bark of ''nygrodha, udumbara, asvattha, plaksa'' and ''vetasa''), the physician should use frequently in [[vata]], [[rakta]] and [[pitta]] predominant ''visarpa''.<br />
<br />
The external application mentioned as ''pradeha'' may also be used for sprinkling or for preparation ''ghrita yoga'' or ''churna yoga'' used for dusting in wounds of ''visarpa'', ghee cooked with ''durva'' juice promotes wound healing.<br />
<br />
Bark of ''daruharidra'' (Berberis aristata), ''madhuka'' (Glycyrrhiza glabra Linn), ''lodhra'' (Symplocos racemosa) and ''keshara'' (Crocus sativus Linn), powder may be used for dusting the ulcers. ''Patola'' (Trichosanthes dioica Roxb), ''pichumarda'' (Azadirachta indica), ''triphala'' (''haritaki, bibhitaki'' and ''amalaki''), ''madhuka'' (Glycyrrhiza glabra Linn) and ''utpala'' (Nymphaea nouchali), these ingredients may be used to prepare decoction for cleansing the ulcers or to prepare ''ghrita'' or to prepare powder for dusting the ulcers or to prepare ''pralepa''.<br />
<br />
All these external applications as ''pradeha'' should be used for ''samprasadana'' (cleansing and pacifying the blood). [71-98]<br />
<br />
=== Guidelines for local application and its types ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
क्षणे क्षणे प्रयोक्तव्याः पूर्वमुद्धृत्य लेपनम् | <br />
<br />
अधावनोद्धृते पूर्वे प्रदेहा बहुशोऽघनाः ||९९|| <br />
<br />
देयाः प्रदेहाः कफजे पर्याधानोद्धृते घनाः | <br />
<br />
त्रिभागाङ्गुष्ठमात्रः स्यात् प्रलेपः कल्कपेषितः ||१००|| <br />
<br />
नातिस्निग्धो न रूक्षश्च न पिण्डो न द्रवः समः |<br />
<br />
न च पर्युषितं लेपं कदाचिदवचारयेत् ||१०१|| <br />
<br />
न च तेनैव लेपेन पुनर्जातु प्रलेपयेत् | <br />
<br />
क्लेदवीसर्पशूलानि सोष्णाभावात् प्रवर्तयेत् ||१०२|| <br />
<br />
लेपो ह्युपरि पट्टस्य कृतः स्वेदयति व्रणम् | <br />
<br />
स्वेदजाः पिडकास्तस्य कण्डूश्चैवोपजायते ||१०३|| <br />
<br />
उपर्युपरि लेपस्य लेपो यद्यवचार्यते | <br />
<br />
तानेव दोषाञ्जनयेत् पट्टस्योपरि यान् कृतः ||१०४|| <br />
<br />
अतिस्निग्धोऽतिद्रवश्च लेपो यद्यवचार्यते | <br />
<br />
त्वचि न श्लिष्यते सम्यङ्न दोषं शमयत्यपि ||१०५|| <br />
<br />
तन्वालिप्तं न कुर्वीत संशुष्को ह्यापुटायते | <br />
<br />
न चौषधिरसो व्याधिं प्राप्नोत्यपि च शुष्यति ||१०६|| <br />
<br />
तन्वालिप्तेन ये दोषास्तानेव जनयेद्भृशम् | <br />
<br />
संशुष्कः पीडयेद्व्याधिं निःस्नेहो ह्यवचारितः ||१०७|| <br />
<div class="mw-collapsible-content"><br />
<br />
pradēhāḥ sarva ēvaitē kartavyāḥ samprasādanāḥ [1] ||98|| <br />
<br />
kṣaṇē kṣaṇē prayōktavyāḥ pūrvamuddhr̥tya lēpanam| <br />
<br />
adhāvanōddhr̥tē pūrvē pradēhā bahuśō'ghanāḥ||99|| <br />
<br />
dēyāḥ pradēhāḥ kaphajē paryādhānōddhr̥tē ghanāḥ| <br />
<br />
tribhāgāṅguṣṭhamātraḥ syāt pralēpaḥ kalkapēṣitaḥ||100|| <br />
<br />
nātisnigdhō na rūkṣaśca na piṇḍō na dravaḥ samaḥ| <br />
<br />
na ca paryuṣitaṁ lēpaṁ kadācidavacārayēt||101|| <br />
<br />
na ca tēnaiva lēpēna punarjātu pralēpayēt| <br />
<br />
klēdavīsarpaśūlāni sōṣṇābhāvāt pravartayēt||102|| <br />
<br />
lēpō hyupari paṭṭasya kr̥taḥ svēdayati vraṇam| <br />
<br />
svēdajāḥ piḍakāstasya kaṇḍūścaivōpajāyatē||103|| <br />
<br />
uparyupari lēpasya lēpō yadyavacāryatē| <br />
<br />
tānēva dōṣāñjanayēt paṭṭasyōpari yān kr̥taḥ||104|| <br />
<br />
atisnigdhō'tidravaśca lēpō yadyavacāryatē| <br />
<br />
tvaci na śliṣyatē samyaṅna dōṣaṁ śamayatyapi||105|| <br />
<br />
tanvāliptaṁ na kurvīta saṁśuṣkō hyāpuṭāyatē| <br />
<br />
na cauṣadhirasō vyādhiṁ prāpnōtyapi ca śuṣyati||106|| <br />
<br />
tanvāliptēna yē dōṣāstānēva janayēdbhr̥śam| <br />
<br />
saṁśuṣkaḥ pīḍayēdvyādhiṁ niḥsnēhō hyavacāritaḥ||107|| <br />
<br />
pradehAH sarva evaite kartavyAH samprasAdanAH [1] ||98|| <br />
<br />
kShaNe kShaNe prayoktavyAH pUrvamuddhRutya lepanam| <br />
<br />
adhAvanoddhRute pUrve pradehA bahusho~aghanAH||99|| <br />
<br />
deyAH pradehAH kaphaje paryAdhAnoddhRute ghanAH| <br />
<br />
tribhAgA~gguShThamAtraH syAt pralepaH kalkapeShitaH||100|| <br />
<br />
nAtisnigdho na rūkṣashca na piNDo na dravaH samaH| <br />
<br />
na ca paryuShitaM lepaM kadAcidavacArayet||101|| <br />
<br />
na ca tenaiva lepena punarjAtu pralepayet| <br />
<br />
kledavIsarpashUlAni soShNAbhAvAt pravartayet||102|| <br />
<br />
lepo hyupari paTTasya kRutaH svedayati vraNam| <br />
<br />
svedajAH piDakAstasya kaNDUshcaivopajAyate||103|| <br />
<br />
uparyupari lepasya lepo yadyavacAryate| <br />
<br />
tAneva dōṣa~jjanayet paTTasyopari yAn kRutaH||104|| <br />
<br />
atisnigdho~atidravashca lepo yadyavacAryate| <br />
<br />
tvaci na shliShyate samya~gna dōṣaM shamayatyapi||105|| <br />
<br />
tanvAliptaM na kurvIta saMshuShko hyApuTAyate| <br />
<br />
na cauShadhiraso vyAdhiM prApnotyapi ca shuShyati||106|| <br />
<br />
tanvAliptena ye dōṣastAneva janayedbhRusham| <br />
<br />
saMshuShkaH pIDayedvyAdhiM niHsneho hyavacAritaH||107|| <br />
</div></div><br />
<br />
These ''lepa'' (local applications of pastes) are to be used repeatedly after removing the previous applied ''lepa''.<br />
<br />
Thin ''predeha'' should be applied as thick paste repeatedly after removing the previous one, but without washing it. <br />
<br />
In [[kapha]]ja visarpa, pradeha should be repeatedly applied as thick paste after removing the previous dried paste.<br />
<br />
The ''pralepa'' should be prepared as ''kalka'' (micronized paste) and applied of thickness equal to one third of the thumb. <br />
<br />
A ''pralepa'' should be neither too unctuous nor too dry, neither too solid nor too liquid, but of the right consistency. <br />
<br />
The stale ''lepa'' should never be used for application; the previously used ''lepa'' should not be used again for application, because it causes accumulation of heat leading to ''kleda'' (putrification), ''visarpa'' (spread of disease) and pain.<br />
<br />
The ''pralepa'' smeared over a piece of cloth, and that cloth is used for application on wound, it sudates the wound and consequently ''swedaja pidaka'' (boils) and itching are induced. <br />
<br />
If the ''pralepa'' is applied without removing the previous ''pralepa'', it produces same adverse effects as those mentioned above in the case of applications over the bandage. <br />
<br />
The ''pralepa'' applied externally that is either too unctuous or too fluid does not adhere properly and therefore cannot alleviate the diseased condition. <br />
<br />
Thin ''lepa'' should not be applied because while drying develops cracks and medicinal property of ''lepa'' does not penetrates properly in the affected part as it dries up quickly.<br />
<br />
If the ''pralepa'' is applied without mixing ghee, it produces same but in excess adverse effects as described for thin ''pralepa''. While getting dried up this ''pralepa'' leads to aggravation of disease manifestation. [99-107]<br />
<br />
=== Diet recipes for treatment of ''visarpa'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
अन्नपानानि वक्ष्यामि विसर्पाणां निवृत्तये | <br />
<br />
लङ्घितेभ्यो हितो मन्थो रूक्षः सक्षौद्रशर्करः ||१०८|| <br />
<br />
मधुरः किञ्चिदम्लो वा दाडिमामलकान्वितः | <br />
<br />
सपरूषकमृद्वीकः सखर्जूरः शृताम्बुना ||१०९|| <br />
<br />
तर्पणैर्यवशालीनां सस्नेहा चावलेहिका | <br />
<br />
जीर्णे पुराणशालीनां यूषैर्भुञ्जीत भोजनम् ||११०|| <br />
<br />
मुद्गान्मसूरांश्चणकान् यूषार्थमुपकल्पयेत् | <br />
<br />
अनम्लान् दाडिमाम्लान् वा पटोलामलकैः सह ||१११|| <br />
<br />
जाङ्गलानां च मांसानां रसांस्तस्योपकल्पयेत् | <br />
<br />
रूक्षान् परूषकद्राक्षादाडिमामलकान्वितान् ||११२|| <br />
<br />
रक्ताः श्वेता महाह्वाश्च शालयः षष्टिकैः सह | <br />
<br />
भोजनार्थे प्रशस्यन्ते पुराणाः सुपरिस्रुताः ||११३|| <br />
<br />
यवगोधूमशालीनां सात्म्यान्येव प्रदापयेत् | <br />
<br />
येषां नात्युचितः शालिर्नरा ये च कफाधिकाः ||११४||<br />
<div class="mw-collapsible-content"><br />
<br />
annapānāni vakṣyāmi visarpāṇāṁ nivr̥ttayē| <br />
<br />
laṅghitēbhyō hitō manthō rūkṣaḥ sakṣaudraśarkaraḥ||108|| <br />
<br />
madhuraḥ kiñcidamlō vā dāḍimāmalakānvitaḥ| <br />
<br />
saparūṣakamr̥dvīkaḥ sakharjūraḥ śr̥tāmbunā||109|| <br />
<br />
tarpaṇairyavaśālīnāṁ sasnēhā cāvalēhikā| <br />
<br />
jīrṇē purāṇaśālīnāṁ yūṣairbhuñjīta bhōjanam||110|| <br />
<br />
mudgānmasūrāṁścaṇakān yūṣārthamupakalpayēt| <br />
<br />
anamlān dāḍimāmlān vā paṭōlāmalakaiḥ saha||111|| <br />
<br />
jāṅgalānāṁ ca māṁsānāṁ rasāṁstasyōpakalpayēt| <br />
<br />
rūkṣān parūṣakadrākṣādāḍimāmalakānvitān||112|| <br />
<br />
raktāḥ śvētā mahāhvāśca śālayaḥ ṣaṣṭikaiḥ saha| <br />
<br />
bhōjanārthē praśasyantē purāṇāḥ suparisrutāḥ||113|| <br />
<br />
yavagōdhūmaśālīnāṁ sātmyānyēva pradāpayēt| <br />
<br />
yēṣāṁ nātyucitaḥ śālirnarā yē ca kaphādhikāḥ||114|| <br />
<br />
annapAnAni vakShyAmi visarpANAM nivRuttaye| <br />
<br />
la~gghitebhyo hito mantho rūkṣaH sakShaudrasharkaraH||108|| <br />
<br />
madhuraH ki~jcidamlo vA dADimAmalakAnvitaH| <br />
<br />
saparUShakamRudvIkaH sakharjUraH shRutAmbunA||109|| <br />
<br />
tarpaNairyavashAlInAM sasnehA cAvalehikA| <br />
<br />
jIrNe purANashAlInAM yUShairbhu~jjIta bhojanam||110|| <br />
<br />
mudgAnmasUrAMshcaNakAn yUShArthamupakalpayet| <br />
<br />
anamlAn dADimAmlAn vA patōlamalakaiH saha||111|| <br />
<br />
jA~ggalAnAM ca mAMsAnAM rasAMstasyopakalpayet| <br />
<br />
rūkṣan parUShakadrAkShAdADimAmalakAnvitAn||112|| <br />
<br />
raktAH shvetA mahAhvAshca shAlayaH ShaShTikaiH saha| <br />
<br />
bhojanArthe prashasyante purANAH suparisrutAH||113|| <br />
<br />
yavagodhUmashAlInAM sAtmyAnyeva pradApayet| <br />
<br />
yeShAM nAtyucitaH shAlirnarA ye ca kaphAdhikAH||114|| <br />
</div></div><br />
<br />
The diet regimen helps to alleviate ''visarpa'' is described here after.<br />
<br />
In the beginning [[langhana]] (fasting therapy) should be given. There after use of ''mantha'' (roasted flour mixed with water in specific proportion and kept for specific time) is beneficial. The ''mantha'' should be without unctus ingredients and added with honey and sugar. It becomes sweet sour in taste due to mixing of ''dadima'' (Punica granatum Linn.) or ''amalaki'' (Emblica officinalis) and ''parushaka'' or ''mrdvika'' (Vitis vinifera Linn) or ''kharjura'' (Phoenix sylvestris) and boiled water should be used to prepare ''mantha''. <br />
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Thereafter linctus made of the flour of roasted barley and ''shali'' rice and mixed with ghee should be given in the form of ''avalehika''. After digestion of ''avalehika'', one should take old ''shali'' rice with soup of green gram or lentils or Bengal gram, soured or not soured with pomegranates and added with ''patola'' (Trichosanthes dioica Roxb) and ''amalaki''. He may also take meat soup of wild animals without ghee and added with ''parushaka'' or ''draksha'' or ''dadima'' or ''amalaki''. Red or white or extra long variety of ''shastika'' rice, which are old, well boiled and residual water should be completely drained, it is beneficial food. <br />
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The persons who have predominance of [[kapha]] and not suited to rice should be given the preparation of barley or wheat or ''purana shali'' which is suitable.[108-114]<br />
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=== Contra-indications in ''visarpa'' ===<br />
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विदाहीन्यन्नपानानि विरुद्धं स्वपनं दिवा | <br />
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क्रोधव्यायामसूर्याग्निप्रवातांश्च विवर्जयेत् ||११५||<br />
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vidāhīnyannapānāni viruddhaṁ svapanaṁ divā| <br />
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krōdhavyāyāmasūryāgnipravātāṁśca vivarjayēt||115|| <br />
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vidAhInyannapAnAni viruddhaM svapanaM divA| <br />
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krodhavyAyAmasUryAgnipravātaMshca vivarjayet||115|| <br />
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The patient should avoid the ''vidahi'' (that causes burning) and ''viruddha'' (mutually contradictory or incompatible) diet, day sleep, anger, exercise, exposure to sun heat, fire and fast winds.[115]<br />
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=== General guidelines of treatment ===<br />
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कुर्याच्चिकित्सितादस्माच्छीतप्रायाणि पैत्तिके | <br />
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रूक्षप्रायाणि कफजे स्नैहिकान्यनिलात्मके ||११६||<br />
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वातपित्तप्रशमनमग्निवीसर्पणे हितम् | <br />
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कफपित्तप्रशमनं प्रायः कर्दमसञ्ज्ञिते ||११७||<br />
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kuryāccikitsitādasmācchītaprāyāṇi paittikē| <br />
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rūkṣaprāyāṇi kaphajē snaihikānyanilātmakē||116|| <br />
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vātapittapraśamanamagnivīsarpaṇē hitam| <br />
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kaphapittapraśamanaṁ prāyaḥ kardamasañjñitē||117||<br />
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kuryAccikitsitAdasmAcchItaprAyANi paittike| <br />
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rūkṣaprAyANi kaphaje snaihikAnyanilAtmake||116|| <br />
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vātapittaprashamanamagnivIsarpaNe hitam| <br />
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kaphapittaprashamanaM prAyaH kardamasa~jj~jite||117||<br />
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Of these measures, predominantly ''sheeta'' (cool) measures are prescribed in [[pitta]] dominant condition, ''ruksha'' in [[kapha]] dominant condition and ''snigdha'' in [[vata]] dominant condition of ''visarpa''.<br />
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In agni visarpa, [[vata]]-[[pitta]] pacifying measures are beneficial and in ''kardama visarpa'' mostly [[kapha]] [[pitta]] alleviating measures should be administered.[116-117]<br />
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=== Treatment of ''granthi visarpa'' ===<br />
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रक्तपित्तोत्तरं दृष्ट्वा ग्रन्थिवीसर्पमादितः | <br />
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रूक्षणैर्लङ्घनैः सेकैः प्रदेहैः पाञ्चवल्कलैः ||११८|| <br />
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सिरामोक्षैर्जलौकोभिर्वमनैः सविरेचनैः | <br />
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घृतैः कषायतिक्तैश्च कालज्ञः समुपाचरेत् ||११९||<br />
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ऊर्ध्वं चाधश्च शुद्धाय रक्ते चाप्यवसेचिते | <br />
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वातश्लेष्महरं कर्म ग्रन्थिवीसर्पिणे हितम् ||१२०||<br />
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उत्कारिकाभिरुष्णाभिरुपनाहःप्रशस्यते| <br />
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स्निग्धाभिर्वेशवारैर्वा ग्रन्थिवीसर्पशूलिनाम् ||१२१|| <br />
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दशमूलोपसिद्धेन तैलेनोष्णेन सेचयेत् |<br />
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कुष्ठतैलेन चोष्णेन पाक्यक्षारयुतेन च ||१२२||<br />
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गोमूत्रैः पत्रनिर्यूहैरुष्णैर्वा परिषेचयेत् | <br />
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सुखोष्णया प्रदिह्याद्वा पिष्टया चाश्वगन्धया ||१२३|| <br />
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शुष्कमूलककल्केन नक्तमालत्वचाऽपि वा | <br />
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बिभीतकत्वचां वाऽपि कल्केनोष्णेन लेपयेत् ||१२४|| <br />
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बलां नागबलां पथ्यां भूर्जग्रन्थिं बिभीतकम् | <br />
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वंशपत्राण्यग्निमन्थं कुर्याद्ग्रन्थिप्रलेपनम् ||१२५|| <br />
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दन्ती चित्रकमूलत्वक् सुधार्कपयसी गुडः | <br />
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भल्लातकास्थि कासीसं लेपो भिन्द्याच्छिलामपि ||१२६|| <br />
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बहिर्मार्गास्थितं ग्रन्थिं किं पुनः कफसम्भवम् | <br />
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दीर्घकालस्थितं ग्रन्थिं भिन्द्याद्वा भेषजैरिमैः ||१२७|| <br />
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मूलकानां कुलत्थानां यूषैः सक्षारदाडिमैः | <br />
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गोधूमान्नैर्यवान्नैर्वा ससीधुमधुशर्करैः ||१२८|| <br />
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सक्षौद्रेर्वारुणीमण्डैर्मातुलुङ्गरसान्वितैः | <br />
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त्रिफलायाः प्रयोगैश्च पिप्पलीक्षौद्रसंयुतैः ||१२९|| <br />
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मुस्तभल्लातशक्तूनां प्रयोगैर्माक्षिकस्य च | <br />
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देवदारुगुडूच्योश्च प्रयोगैर्गिरिजस्य च ||१३०|| <br />
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धूमैर्विरेकैः शिरसः पूर्वोक्तैर्गुल्मभेदनैः | <br />
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अयोलवणपाषाणहेमताम्रप्रपीडनैः ||१३१||<br />
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आभिः क्रियाभिः सिद्धाभिर्विविधाभिर्बली स्थिरः | <br />
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ग्रन्थिः पाषाणकठिनो यदा नैवोपशाम्यति ||१३२|| <br />
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अथास्य दाहः क्षारेण शरैर्हेम्नाऽथ वा हितः | <br />
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पाकिभिः पाचयित्वा वा पाटयित्वा समुद्धरेत् ||१३३|| <br />
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मोक्षयेद्बहुशश्चास्य रक्तमुत्क्लेशमागतम् | <br />
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पुनश्चापहृते रक्ते वातश्लेष्मजिदौषधम् ||१३४|| <br />
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धूमो विरेकः शिरसः स्वेदनं परिमर्दनम् | <br />
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अप्रशाम्यति दोषे च पाचनं वा प्रशस्यते ||१३५|| <br />
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प्रक्लिन्नं दाहपाकाभ्यां भिषक् शोधनरोपणैः | <br />
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बाह्यैश्चाभ्यन्तरैश्चैव व्रणवत् समुपाचरेत् ||१३६||<br />
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कम्पिल्लकं विडङ्गानि दार्वीं कारञ्जकं फलम् | <br />
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पिष्ट्वा तैलं विपक्तव्यं ग्रन्थिव्रणचिकित्सितम् ||१३७|| <br />
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द्विव्रणीयोपदिष्टेन कर्मणा चाप्युपाचरेत् | <br />
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देशकालविभागज्ञो व्रणान् वीसर्पजान् बुधः ||१३८|| <br />
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इति ग्रन्थिविसर्पचिकित्सा | <br />
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raktapittōttaraṁ dr̥ṣṭvā granthivīsarpamāditaḥ| <br />
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rūkṣaṇairlaṅghanaiḥ sēkaiḥ pradēhaiḥ pāñcavalkalaiḥ||118|| <br />
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sirāmōkṣairjalaukōbhirvamanaiḥ savirēcanaiḥ| <br />
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ghr̥taiḥ [1] kaṣāyatiktaiśca kālajñaḥ samupācarēt||119|| <br />
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ūrdhvaṁ cādhaśca śuddhāya raktē cāpyavasēcitē| <br />
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vātaślēṣmaharaṁ karma granthivīsarpiṇē hitam||120|| <br />
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utkārikābhiruṣṇābhirupanāhaḥ praśasyatē| <br />
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snigdhābhirvēśavārairvā granthivīsarpaśūlinām||121|| <br />
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daśamūlōpasiddhēna tailēnōṣṇēna sēcayēt| <br />
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kuṣṭhatailēna cōṣṇēna pākyakṣārayutēna ca||122|| <br />
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gōmūtraiḥ patraniryūhairuṣṇairvā pariṣēcayēt| <br />
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sukhōṣṇayā pradihyādvā piṣṭayā cāśvagandhayā||123|| <br />
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śuṣkamūlakakalkēna naktamālatvacā'pi vā| <br />
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bibhītakatvacāṁ vā'pi [2] kalkēnōṣṇēna lēpayēt||124|| <br />
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balāṁ nāgabalāṁ pathyāṁ bhūrjagranthiṁ bibhītakam| <br />
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vaṁśapatrāṇyagnimanthaṁ kuryādgranthipralēpanam||125|| <br />
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dantī citrakamūlatvak sudhārkapayasī guḍaḥ| <br />
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bhallātakāsthi kāsīsaṁ lēpō bhindyācchilāmapi||126|| <br />
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bahirmārgāsthitaṁ granthiṁ kiṁ punaḥ kaphasambhavam| <br />
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dīrghakālasthitaṁ granthiṁ bhindyādvā bhēṣajairimaiḥ||127|| <br />
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mūlakānāṁ kulatthānāṁ yūṣaiḥ sakṣāradāḍimaiḥ| <br />
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gōdhūmānnairyavānnairvā sasīdhumadhuśarkaraiḥ||128|| <br />
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sakṣaudrairvāruṇīmaṇḍairmātuluṅgarasānvitaiḥ| <br />
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triphalāyāḥ prayōgaiśca pippalīkṣaudrasaṁyutaiḥ||129|| <br />
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mustābhallātaśaktūnāṁ prayōgairmākṣikasya ca| <br />
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dēvadāruguḍūcyōśca prayōgairgirijasya ca||130|| <br />
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dhūmairvirēkaiḥ śirasaḥ pūrvōktairgulmabhēdanaiḥ|<br />
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ayōlavaṇapāṣāṇahēmatāmraprapīḍanaiḥ||131|| <br />
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ābhiḥ kriyābhiḥ siddhābhirvividhābhirbalī sthiraḥ| <br />
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granthiḥ pāṣāṇakaṭhinō yadā naivōpaśāmyati||132|| <br />
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athāsya dāhaḥ kṣārēṇa śarairhēmnā'tha [3] vā hitaḥ| <br />
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pākibhiḥ pācayitvā vā pāṭayitvā samuddharēt||133|| <br />
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mōkṣayēdbahuśaścāsya raktamutklēśamāgatam| <br />
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punaścāpahr̥tē [4] raktē vātaślēṣmajidauṣadham||134|| <br />
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dhūmō virēkaḥ śirasaḥ svēdanaṁ parimardanam| <br />
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apraśāmyati dōṣē ca pācanaṁ [5] vā praśasyatē||135|| <br />
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praklinnaṁ dāhapākābhyāṁ bhiṣak śōdhanarōpaṇaiḥ| <br />
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bāhyaiścābhyantaraiścaiva vraṇavat samupācarēt||136|| <br />
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kampillakaṁ viḍaṅgāni dārvīṁ kārañjakaṁ phalam| <br />
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piṣṭvā tailaṁ vipaktavyaṁ granthivraṇacikitsitam||137|| <br />
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dvivraṇīyōpadiṣṭēna karmaṇā cāpyupācarēt| <br />
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dēśakālavibhāgajñō vraṇān vīsarpajān budhaḥ||138|| <br />
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iti granthivisarpacikitsā| <br />
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raktapittottaraM dRuShTvA granthivIsarpamAditaH| <br />
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rūkṣaNairla~gghanaiH sekaiH pradehaiH pA~jcavalkalaiH||118||<br />
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sirAmokShairjalaukobhirvamanaiH savirecanaiH| <br />
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ghRutaiH [1] kaShAyatiktaishca kAlaj~jaH samupAcaret||119|| <br />
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UrdhvaM cAdhashca shuddhAya rakte cApyavasecite| <br />
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vātashleShmaharaM karma granthivIsarpiNe hitam||120|| <br />
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utkArikAbhiruShNAbhirupanAhaH prashasyate| <br />
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snigdhAbhirveshavArairvA granthivIsarpashUlinAm||121|| <br />
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dashamUlopasiddhena tailenoShNena secayet| <br />
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kuShThatailena coShNena pAkyakShArayutena ca||122|| <br />
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gomUtraiH patraniryUhairuShNairvA pariShecayet| <br />
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sukhoShNayA pradihyAdvA piShTayA cAshvagandhayA||123|| <br />
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shuShkamUlakakalkena naktamAlatvacA~api vA| <br />
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bibhItakatvacAM vA~api [2] kalkenoShNena lepayet||124|| <br />
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balAM nAgabalAM pathyAM bhUrjagranthiM bibhItakam| <br />
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vaMshapatrANyagnimanthaM kuryAdgranthipralepanam||125|| <br />
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dantI citrakamUlatvak sudhArkapayasI guDaH| <br />
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bhallAtakAsthi kAsIsaM lepo bhindyAcchilAmapi||126|| <br />
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bahirmArgAsthitaM granthiM kiM punaH kaphasambhavam| <br />
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dIrghakAlasthitaM granthiM bhindyAdvA bheShajairimaiH||127|| <br />
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mUlakAnAM kulatthAnAM yUShaiH sakShAradADimaiH| <br />
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godhUmAnnairyavAnnairvA sasIdhumadhusharkaraiH||128|| <br />
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sakShaudrairvAruNImaNDairmAtulu~ggarasAnvitaiH| <br />
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triphalAyAH prayōgaishca pippalIkShaudrasaMyutaiH||129|| <br />
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mustābhallAtashaktUnAM prayōgairmAkShikasya ca| <br />
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devadAruguDUcyoshca prayōgairgirijasya ca||130|| <br />
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dhUmairvirekaiH shirasaH pUrvoktairgulmabhedanaiH| <br />
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ayolavaNapAShANahematAmraprapIDanaiH||131|| <br />
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AbhiH kriyAbhiH siddhAbhirvividhAbhirbalI sthiraH| <br />
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granthiH pAShANakaThino yadA naivopashAmyati||132|| <br />
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athAsya dAhaH kShAreNa sharairhemnA~atha [3] vA hitaH| <br />
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pAkibhiH pAcayitvA vA pATayitvA samuddharet||133|| <br />
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mokShayedbahushashcAsya raktamutkleshamAgatam| <br />
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punashcApahRute [4] rakte vātashleShmajidauShadham||134|| <br />
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dhUmo virekaH shirasaH svedanaM parimardanam| <br />
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aprashAmyati doShe ca pAcanaM [5] vA prashasyate||135|| <br />
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praklinnaM dAhapAkAbhyAM bhiShak sōdhanaropaNaiH| <br />
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bAhyaishcAbhyantaraishcaiva vraNavat samupAcaret||136|| <br />
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kampillakaM viDa~ggAni dArvIM kAra~jjakaM phalam| <br />
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piShTvA tailaM vipaktavyaM granthivraNacikitsitam||137|| <br />
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dvivraNIyopadiShTena karmaNA cApyupAcaret| <br />
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deshakAlavibhAgaj~jo vraNAn vIsarpajAn budhaH||138|| <br />
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iti granthivisarpacikitsA| <br />
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The ''granthi visarpa'', on inspection is predominant in [[rakta]] [[pitta]]; the physician experienced in timely management should treat the case with [[rukshana]] (de-oleation), [[langhana]] (lightening therapy), ''seka'' (affusion), and ''pradeha'' (external application) of ''panchavalka, siramoksha'' (blood letting), ''jalauka'' (leech therapy), [[vamana]] (emesis therapy), [[virechana]] (purgation therapy) and ''kashaya- tikta'' (astringent and bitter) ghee preparations. <br />
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After cleansing of body by [[vamana]] and [[virechana]], [[rakta]] mokshana should be administered and the measures alleviating [[vata]]-[[kapha]] are beneficial.<br />
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When there is pain in ''granthi visarpa, upanaha'' (hot poultice) of warm and unctuous ''utkarika'' (medicinal pancake) or ''vesavara'' (medicated meat) application on the affected part is beneficial.<br />
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The warm oil prepared from ''dashamoola'' (roots of ten plants) should be sprinkled on the affected part. Warm ''kustha'' (costus) oil added with ''pakya kshara'' (prepared medicinal alkali) or warm cow’s urine or decoction of [[vata]] [[kapha]]hara leaves should be used as affusion on the affected part.<br />
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The warm paste of ''ashvagandha'' (Withania somnifera) should be applied as ''pradeha'' on the affected part. <br />
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The warm paste of dried ''mulaka'' (Raphanus sativus) or bark of ''naktamala'' (Pongamia pinnata) or bark of ''bibhitaka'' (Terminalia bellirica) should be applied externally as a ''lepa'' on the affected part. ''Bala'' (Sida cordifolia Linn), ''nagabala'' (Grewia hirsuta), ''pathya'' (Terminalia chebula), ''bhurjagranthi'' (betula bhojpatra), ''bibhitaka'' (Terminalia bellirica), ''vamsha'' leaves (bambusa vulgaris) and ''agnimantha'' (Premna mucronata) should be applied as ''pralepa'' on ''granthi''.<br />
<br />
''Danti'' (Baliospermum montanum), bark of ''chitraka'' root (Plumbago zeylanica Linn), latex of ''snuhi'' (Euphoria nerrifolia) and ''arka'' (Calatropis gigantean), jaggery, seed of ''bhallataka'' (Semecarpus anacardium linn) and ''kasisa'' (green vitriol) application as a ''lepa'' breaks even a stone, then what to speak of the nodules caused by [[kapha]] and situated in external regions of body. Long standing ''granthi'' should be broken by the use of the internal medications such as ''Yusha'' of ''mulaka'' (Raphanus sativus) and ''kullatha'' (Macrotyloma uniflorum.) added with ''kshara'' (prepared alkali) and ''dadima'' (Punica granatum), food prepared from ''godhum'' and ''yava'' with ''sidhu'', honey and sugar, ''varuni'' scum with honey and ''matulung'' juice (Citrus medica), use of ''triphala'' with ''pippali'' (Piper longum linn) and honey, ''musta'' (Cyperus rotundus linn) or ''bhallataka saktu'' (Semecarpus anacardium linn) and honey, ''devadaru'' (Cedrus deodara), ''guduchi'' (Tinospora cordifolia) and ''girija'' (Asphaltum punjabianum).<br />
<br />
''Dhuma, shirovirechana,'' measures described to break the ''gulma'' in [[Gulma Chikitsa]] chapter, as well as iron, salt, stone, gold and copper should be used for ''prapidana'' (compression) of ''granthi''.<br />
<br />
If ''granthi'' is strong, firm and stony hard and not responding to all these proven methods of treatment then it is better to be cauterized with ''kshara'' (medicinal alkali) or hot metal arrow or hot gold or after making it suppurate by applying suitable suppurative medications one should open and extract. <br />
<br />
Besides, vitiated blood should be eliminated, frequently followed administration of [[vata]] and [[kapha]] pacifying medicines, ''dhuma'' (fumigation therapy), ''shirovechana'' (errhine therapy), [[swedana]](sudation) and ''parimardana'' (pressure method). If [[dosha]] do not pacify, [[pachana]] (suppuration) treatment is beneficial. When the ''granthi'' is decomposed with ''agni'' and suppuration then physician should treat it with external and internal ''shodhana'' (cleansing) and ''ropana'' (healing) as described in ''Vrana Chikitsa''.<br />
<br />
''Kampillaka'' (Mallotus philippinensis), ''vidanga'' (Embelia ribes Burm), ''daruharidra'' (Berberis aristata) and ''karanja'' fruit (Pongamia pinnata), the paste of all these drugs should be used to prepare oil which is indicated in the treatment of ''granthi vrina''.<br />
<br />
The intelligent physician may also treat the ''visarpa'' as per the guidelines described in [[Dwivraniya Chikitsa]] chapter.<br />
<br />
Thus ends the description of the treatment of ''granthi visarpa''.[118-138]<br />
<br />
=== Treatment of ''galaganda'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
य एव विधिरुद्दिष्टो ग्रन्थीनां विनिवृत्तये | <br />
<br />
स एव गलगण्डानां कफजानां निवृत्तये ||१३९|| <br />
<br />
गलगण्डास्तु वातोत्था ये कफानुगता नृणाम् | <br />
<br />
घृतक्षीरकषायाणामभ्यासान्न भवन्ति ते ||१४०|| <br />
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<br />
ya ēva vidhiruddiṣṭō granthīnāṁ vinivr̥ttayē| <br />
<br />
sa ēva galagaṇḍānāṁ kaphajānāṁ nivr̥ttayē||139|| <br />
<br />
galagaṇḍāstu vātōtthā yē kaphānugatā [1] nr̥ṇām| <br />
<br />
ghr̥takṣīrakaṣāyāṇāmabhyāsānna bhavanti tē||140|| <br />
<br />
ya eva vidhiruddiShTo granthInAM vinivRuttaye| <br />
<br />
sa eva galagaNDAnAM kaphajAnAM nivRuttaye||139|| <br />
<br />
galagaNDAstu vAtotthA ye kaphAnugatA [1] nRuNAm| <br />
<br />
ghRutakShIrakaShAyANAmabhyAsAnna bhavanti te||140|| <br />
</div></div><br />
<br />
The line of treatment of ''granthi'' should be applied for the treatment of [[kapha]]ja galganda''. <br />
<br />
The ''vatika galaganda'' associated with [[kapha]] may be cured by regular use of ghee, milk and decoction preparations.[139-140]<br />
<br />
=== Importance of ''raktamokshana'' in ''visarpa'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
यानीहोक्तानि कर्माणि विसर्पाणां निवृत्तये | <br />
<br />
एकतस्तानि सर्वाणि रक्तमोक्षणमेकतः ||१४१|| <br />
<br />
विसर्पो न ह्यसंसृष्टो रक्तपित्तेन जायते | <br />
<br />
तस्मात् साधारणं सर्वमुक्तमेतच्चिकित्सितम् ||१४२|| <br />
<br />
विशेषो दोषवैषम्यान्न च नोक्तः समासतः | <br />
<br />
समासव्यासनिर्दिष्टां क्रियां विद्वानुपाचरेत् ||१४३||<br />
<div class="mw-collapsible-content"><br />
<br />
yānīhōktāni karmāṇi visarpāṇāṁ nivr̥ttayē| <br />
<br />
ēkatastāni sarvāṇi raktamōkṣaṇamēkataḥ||141|| <br />
<br />
visarpō na hyasaṁsr̥ṣṭō raktapittēna jāyatē| <br />
<br />
tasmāt sādhāraṇaṁ sarvamuktamētaccikitsitam||142|| <br />
<br />
viśēṣō dōṣavaiṣamyānna ca nōktaḥ samāsataḥ| <br />
<br />
samāsavyāsanirdiṣṭāṁ [1] kriyāṁ vidvānupācarēt||143|| <br />
<br />
yAnIhoktAni karmANi visarpANAM nivRuttaye| <br />
<br />
ekatastAni sarvANi raktamokShaNamekataH||141|| <br />
<br />
visarpo na hyasaMsRuShTo raktapittena jAyate| <br />
<br />
tasmAt sAdhAraNaM sarvamuktametaccikitsitam||142||<br />
<br />
visheSho dōṣavaiShamyAnna ca noktaH samAsataH| <br />
<br />
samAsavyAsanirdiShTAM [1] kriyAM vidvAnupAcaret||143|| <br />
</div></div><br />
<br />
If all the therapeutic measures described here as curative of ''visarpa'' be put on one side and ''raktamokshana'' on other, they will be found equal. <br />
<br />
''Visarpa'' never occurs without the association of the [[rakta]] and [[pitta]] hence entirely general treatment has been described. It does not mean that line of treatment as per other [[dosha]] predominance is not explained here. Thus, the therapeutic measures both in general and specific cases are described both in brief and in detail. The expert physician should administer these therapies appropriately.[141-143]<br />
<br />
=== Summary ===<br />
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<br />
तत्र श्लोकाः- <br />
<br />
निरुक्तं नामभेदाश्च दोषा दूष्याणि हेतवः | <br />
<br />
आश्रयो मार्गतश्चैव विसर्पगुरुलाघवम् ||१४४|| <br />
<br />
लिङ्गान्युपद्रवा ये च यल्लक्षण उपद्रवः | <br />
<br />
साध्यत्वं, न च, साध्यानां साधनं च यथाक्रमम् ||१४५|| <br />
<br />
इति पिप्रक्षवे सिद्धिमग्निवेशाय धीमते | <br />
<br />
पुनर्वसुरुवाचेदं विसर्पाणां चिकित्सितम् ||१४६||<br />
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<br />
tatra ślōkāḥ- <br />
<br />
niruktaṁ nāmabhēdāśca dōṣā dūṣyāṇi hētavaḥ| <br />
<br />
āśrayō mārgataścaiva visarpagurulāghavam||144|| <br />
<br />
liṅgānyupadravā yē ca yallakṣaṇa upadravaḥ| <br />
<br />
sādhyatvaṁ, na ca, sādhyānāṁ sādhanaṁ ca yathākramam||145|| <br />
<br />
iti piprakṣavē siddhimagnivēśāya dhīmatē| <br />
<br />
punarvasuruvācēdaṁ visarpāṇāṁ cikitsitam||146|| <br />
<br />
tatra shlokAH- <br />
<br />
niruktaM nAmabhedAshca dōṣa dUShyANi hetavaH| <br />
<br />
Ashrayo mArgatashcaiva visarpagurulAghavam||144|| <br />
<br />
li~ggAnyupadravA ye ca yallakShaNa upadravaH| <br />
<br />
sAdhyatvaM, na ca, sAdhyAnAM sAdhanaM ca yathAkramam||145|| <br />
<br />
iti piprakShave siddhimagniveshAya dhImate| <br />
<br />
punarvasuruvAcedaM visarpANAM cikitsitam||146||<br />
</div></div><br />
<br />
Now the summing up verses –<br />
<br />
Derivation,synonyms, classification, [[dosha]], dushya, etiology, the habitat, the severe and mild gradation, symptoms and signs, complications, the nature of complications, prognosis and treatment of curable ones. All these aspects has been explained by Punarvasu Atreya for the inquisitive and intelligent Agnivesha under the treatment of ''visarpa''. [144-146]<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते चिकित्सास्थाने <br />
<br />
विसर्पचिकित्सितं नामैकविंशोऽध्यायः ||२१||<br />
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<br />
ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē cikitsāsthānē <br />
<br />
visarpacikitsitaṁ nāmaikaviṁśō'dhyāyaḥ||21|| <br />
<br />
ityagniveshakRute tantre carakapratisaMskRute cikitsAsthAne <br />
<br />
visarpacikitsitaM nAmaikaviMsho~adhyAyaH||21|| <br />
</div></div><br />
<br />
Thus ends the twenty first chapter on treatment of ''visarpa'' in [[Chikitsa Sthana]] in the treatise composed by Agnivesha and redacted by Charak.[21]<br />
<br />
== Tattva Vimarsha (Fundamental Principles) == <br />
<br />
*Seven elements are involved in the pathogenesis of ''visarpa'' viz., [[rakta]], lasika, tvak, [[mamsa dhatu]], [[vata]], [[pitta]] and [[kapha]]. <br />
*''Visarpa'' is acute spreading disease and fatal in nature. General etiological factors of ''visarpa'' are diet and life style related, injury, poisons, toxins, burns etc., some of these cause vitiation of [[dosha]] and ''khavaigunya'' (disease prone condition) in [[dhatu]] and some cause direct vitiation of [[dosha]] and [[dhatu]] leading to ''visarpa''. Hence favorable condition for infection or disease phenomenon occurs at first therefore, diet and lifestyle related factors are important preventive measures.<br />
*Excess intake of salt, sour, pungent, hot articles lead to vitiation of [[rakta]] first and then lead to ''visarpa''. <br />
*''Visarpa'' is manifested externally, internally or in both pathways. Severity of disease increases respectively in these cases. <br />
*Classification and pathogenesis of ''visarpa'' is based upon involvement of [[dosha]] as per their severity. Treatment protocol is designed for primarily involved predominant [[dosha]]. If the ''visarpa'' is caused with ama dosha (the state of incomplete transformation) and is located in ''kaphasthana'' (in thorax and upper body parts), then [[langhana]] (fasting therapy), [[vamana]] (emesis) therapy, ''tikta'' (bitter) drugs internally and application of paste of drugs with dry and cold properties externally is beneficial. <br />
*The same treatment should be adopted in case of association of ''ama'' and location in [[pitta]] sthana (abdomen and middle parts of body). In addition, ''raktamokshana'' (blood letting) and [[virechana]] (therapeutic purgation therapy) are specially indicated. <br />
*If ''sama'' (with ''ama dosha'') ''visarpa'' occurs from ''vatashaya'' (pelvis and lower part of body) dry measures are indicated in the beginning. Even in association with [[rakta]]-[[pitta]], unction measure is not regarded as beneficial in the beginning. <br />
*In [[vata]]ja visarpa and ''paittika visarpa'' of mild aggravated [[dosha]], tiktaka ghritam'' is beneficial. But if the [[pitta]] [[dosha]] is excessively aggravated then [[virechana]] should be given. <br />
*In the condition of excessively aggravated [[dosha]], ghee should not be given at first, which does not cause [[virechana]]. Because non purgating ghee occlude the [[dosha]] resulting in decomposed skin, flesh and blood. Hence in ''visarpa, virechana'' followed by ''raktamokshana'' is recommended because the disorder is located in blood.<br />
*If [[dosha]] in ''shakha'' (body elements) vitiate the blood, then [[rakta]]mokshana should be administered first. The physician should use ''vishana'' (deer horn) in [[vata]] dominance, ''jalauka'' (Hirudinea medicinalis) in [[pitta]] dominance and ''alabu'' (lagenaria siceraria) in [[kapha]] dominance for blood letting or physician should perform ''siravyadha'' (blood letting through vein) promptly from the adjacent vein to the affected part, without which ''rakta kleda'' (putrifying blood content) gives rise to decomposed skin, flesh and ligaments.<br />
*External application in the form of ''pralepa, pradeha'' and ''alepana'' (local applications of pastes) are to be used repeatedly for treatment of external lesions in ''visarpa''. The guidelines shall be followed for local applications. <br />
*Diet articles with sweet, bitter, cooling and blood pacifying properties is prescribed in the treatment of ''visarpa''.<br />
*''Vidahi'' (that causes burning) and ''viruddha'' (mutually contradictory or incompatible) diet, day sleep, anger, exercise, exposure to sun heat, fire and fast winds are contraindicated in ''visarpa''.<br />
*Predominantly ''shita'' (cool) measures are prescribed in [[pitta]] dominant condition, ''ruksha'' in [[kapha]] dominant condition and ''snigdha'' in [[vata]] dominant condition of ''visarpa''. In ''agni visarpa, [[vata]]-[[pitta]] pacifying measures are beneficial and in ''kardama visarpa'' mostly [[kapha]] [[pitta]] alleviating measures should be administered.<br />
*The ''granthi visarpa'', on inspection is predominant in [[rakta]] [[pitta]], the physician experienced in timely management should treat the case with [[rukshana]] (de-oleation), [[langhana]] (lightening therapy), ''seka'' (affusion), and ''pradeha'' (external application) of ''panchavalka, siramoksha'' (blood letting), ''jalauka'' (leech therapy), [[vamana]] (emesis therapy), [[virechana]] (purgation therapy) and ''kashaya- tikta'' (astringent and bitter) ghee preparations. After cleansing of body by [[vamana]] and [[virechana]], [[rakta]] mokshana should be administered and the measures alleviating [[vata]]-[[kapha]] are beneficial.<br />
*The same line of treatment of ''granthi'' should be applied for the treatment of [[kapha]]ja galganda''. The ''vatika galaganda'' associated with [[kapha]] may be cured by regular use of ghee, milk and decoction preparations.<br />
<br />
== Vidhi Vimarsha (Applied Inferences ) ==<br />
<br />
=== Causative factors of ''visarpa'' in contemporary era ===<br />
<br />
Modern point of view ''visarpa'' is generally caused by a variety of infections. As per Punarvasu Atreya, the general etiological factors of ''visarpa'' are diet and lifestyle, injury, poisons, toxins, burns etc; some of these cause vitiation of [[dosha]] and ''khavaigunya'' (disease prone condition) in [[dhatu]] and some cause direct vitiation of [[dosha]] and [[dhatu]] leading to ''visarpa''. This is confusing to the new scholars. Atreya's understanding of etiology is more specific because favorable condition for infection occurs at first then infection therefore diet and lifestyle related factors are described in detail and in the beginning. In treatment plan this concept of favorable environment should be considered. Change in internal body environment is possible by ''shodhana'' therapy and ''aushadha'' along with treatment of infection. <br />
<br />
=== Pathophysiology of ''Visarpa'' [flow chart] ===<br />
<br />
[[File:Visarpa1.png]]<br />
<br />
<br />
=== Common clinical conditions considered under ''visarpa'' ===<br />
<br />
''Visarpa'' is acute and extensive spreading in nature. As ''kushtha'' is chronic in nature and ''visarpa'' is acute therefore spreading ''kushtha'' should not be interpreted as visarpa. It is observed that ''visarpa'' interpretation to allopath disorders is very confusing to the scholars. It is difficult to label ''visarpa'' as a single entity. For proper interpretation, experienced intelligent expert in emergency treatments is required and diagnostic research in this direction is challenge to the researchers.<br />
<br />
Clinical manifestation of ''vatika visarpa'' suggests ''bahih-srita visarpa'' and generally observed in acute skin infections (erysipelas etc.) and is curable with prompt management. <br />
<br />
''Paittika visarpa'' symptoms are suggestive of severe skin disease (erysipelas, extensive herpes, burns etc.) and are curable with appropriate management. <br />
<br />
[[Kapha]]ja visarpa appears as progressively but gradually spreading ailment, suggestive of acute skin infection (erysipelas etc.) and is curable. <br />
<br />
''Agni visarpa'' is a serious infection of skin and lead to septicemia like condition. ''Agnivisarpa'' with the signs and symptoms described here is a serious ailment and is incurable. This ailment may be cured if vitals are not involved. <br />
<br />
The name ''kardam visarpa'' is because the affected part appears like ''kardam'' (mud). The clinical picture of ''kardam'' described here is serious skin infection, necrotizing the adjacent structures (Necrotizing Fasciitis, gangrene etc.) and is incurable. The curable variant should be considered ''agnivisarpa''. <br />
<br />
''Granthi visarpa'' is a serious ailment (B cell lymphoma etc.) and associated with complications is incurable. <br />
<br />
''Sannipatik visarpa'' is a very serious manifestation of ''visarpa'' and is ''ubhaya-samsrita''. This is like a very serious manifestation of sepsis and is not treatable. <br />
<br />
=== Current clinical practices in management of ''visarpa'' ===<br />
<br />
==== Experience based ====<br />
<br />
Prognostic assessment of disease is very important while treating acute disorders. Majority of ''visarpa'' cases are having bad prognosis as per experience of Punarvasu Atreya. Even though some cases of curable ''bahihsrita visarpa'' may become incurable and fatal if not treated early and promptly. Quick diagnosis of life threatening conditions and prompt life saving management in intensive care unit is required in ''visarpa'' disorder.<br />
<br />
It is already stated that there are serious diseases which are curable but they cause death if not treated. ''Agni'' and kardam ''visarpa'' are curable only by the most effective therapeutic measures. ''Antahsrita'' and ''ubhaysamsrita visarpa'' are incurable or sometimes may be cured by most experienced, intelligent physician with most appropriate timely approach in intensive care unit. ''Bahihsrita'' curable ''visarpa'' may convert into ''ubhayasamsrita'' if not treated appropriately. <br />
<br />
''Shodhana'' and ''shamana'' therapy is described for curable ''visarpa'' and maximum ''visarpa'' cases are incurable. This is challenge to the researchers to apply ''shodhana'' and ''shamana'' therapy in incurable emergency cases along with life saving management to cure the incurable ones.<br />
<br />
==== Evidence based studies ====<br />
<br />
''Visarpa'' is acute and fatal in nature and maximum [[Ayurveda]] hospitals have limited facilities for emergency managements. Some of clinicians are treating self limiting minor cases of herpes as a ''visarpa'' following the treatment of [[pitta]]ja visarpa. A case study on effect of Ayurvedic management in oro-facial herpes was conducted. The diagnosed case of oro-facial herpes in 72-year-old male patient was treated with medicines of bitter taste (tikta rasa) internally, diet regimen, anulomana variety of therapeutic purgation (virechana) and topical application of cold (sheeta)-dry(ruksha) medicines(lepa). The case is observed symptom free after a total period of 164 days.<ref>Mutnali K, Roopa BJ, Shivaprasad T, Yadav R. Ayurveda management of oro-facial herpes: a case report. J Ayurveda Integr Med. 2020 Jul-Sep;11(3):357-359. doi: 10.1016/j.jaim.2020.06.003. Epub 2020 Aug 4. PMID: 32768346; PMCID: PMC7527852.</ref><br />
<br />
=== Researches done on ''visarpa'' ===<br />
<br />
Considerable research work is not carried out on ''visarpa'' by [[Ayurveda]] researchers. This is due to acute and fatal nature of this disease and [[Ayurveda]] research centers are not well equipped for emergency managements. Hence it is necessary to work in the direction to treat such incurable fatal condition. Initially research work on this disease may be carried out in collaboration with well equipped intensive care unit and experts in emergency managements. Researchers may work by combining algorithmic [[Ayurveda]] treatment with allopath. Incurable and fatal cases of ''visarpa'' experienced by Punarvasu Atreya may be cured with early appropriate management in intensive care unit due to advances in drug research and technology. <br />
<br />
=== Further reading ===<br />
<br />
#Charak, Chikitsa Sthana, chap 21 Visarpa Chikitsa Adhyaya. In:Vaidya Yadavaji Trikamji Aacharya, Editor, Charak samhita, 2nd edition, Varanasi;Chaukhamba Sanskrit Sansthan,1990;228.<br />
#Chakrapani,Charak,Chikitsa Sthana, Chap 21 Visarpa Chikitsa Adhyaya, 2nd edition,Varanasi; Chaukhamba Sanskrit Sansthan, 1990; 225.<br />
#Charak,Cikitsa Sthana,Chap 21 Visarpa Cikitsitam. In: Pt. Dutta R, editor. Charak Samhita, 2nd ed., 2003 reprint, Varanasi: Chaukhambha Bharti Academy; 2003. p. 231. <br />
#Charak,Chikitsa Sthana, Chap 21 Visarpa Chikitsa Adhyaya,In:Kashiram Shastri and Gorakhnath Chaturvedi, editors. Charak Samhita,(Hindi traslation) Part II. Varanasi: Chaukhambha Bharati Academy; Reprint 2005. p. 235. <br />
#Charak, Chikitsa Sthana, Visarpa Cikitsitam,21, In: Vd. Khushvaha HS,editors,Charak Samhita Ayushi hindi commentary, 1 st edition, Chaukhambha Orientalia Publisher, Varanasi, 2009;224. <br />
#Chakrapani, Charak, Cikitsa Sthana, Chap 21 Visarpa Cikitsitam. In: Vd. Yadavaji T. A.,Editor, Charak Samhita, 1 st edition, Varanasi;Chaukhambha Orientalia Publications, 2001;227. <br />
#Sushruta. Cikitsa Sthana, 17. Visarpanadisthanaroga Chikitsitam Adhyaya In: Vaidya Yadavji Trikamji Acharaya, Narayan Ram Acharaya, editors. Sushruta Samhita,?ed, Varanasi: Chaukhambha Orientalia; 2007. p. 321. <br />
#Susruta, Nidana sthana,cha 10, Visarpanadisthanaroga Nidana In:Kaviraj Ambikadutt Shastri,editor, Sushruta Samhita, 11 th ed. Varanasi: Chaukhambha Sanskrit Sansthan; 1998. p. 129. <br />
#Vagbhata, Ashtanga Sangraha, Cikitsa Sthana, 20,Visarpa chikitsitam Adhyaya. translated to English by Prof. Murthy KR, 9 th edition,Varanasi; Chaukhambha Orientalia Publisher,2005;229. <br />
#Vagbhata, Ashtanga Sangraha, Nidana Sthana, 13, Pandurogakamalasophavisarpa Nidanam Adhyaya. translated to English by Prof. Murthy KR, 9 th edition, Varanasi,Chaukhambha Orientalia Publisher, 2005; 229. <br />
#Vagbhata, Ashtanga Hridyam ,Cikitsa Sthana,18. Visarpa chikitsitam Adhyaya .Translated to English by Prof. K.R. Shrikanth Murthy, 7 th ed., Vol. 1. Varanasi: Chaukhambha Krishnadas Academy; 2010. p. 221. <br />
#Vagbhata,Ashtanga Hridyam , Nidana Sthana, Chap 13 Pandurogasophavisarpa Nidana.Translated by Prof. K.R. Shrikanth Murthy, 7 th ed., Vol. 1. Varanasi: Chaukhambha Krishnadas Academy; 2010. p. 221. </div><br />
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[[#top| Back to the Top ]]</span></div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Visarpa_Chikitsa&diff=45389Visarpa Chikitsa2025-11-18T04:28:54Z<p>Agnivesha: /* Introduction */</p>
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|title=Visarpa Chikitsa<br />
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|keywords=Visarpa, Parisarpa, Erysepalas, Gangrene, Septicaemia, Sepsis, Fulminant spreading skin infections,Ayurveda, Indian system of medicine, charak samhita. <br />
|description=Chikitsa Sthana Chapter 21. Management of Visarpa (acute spreading erysepalas)<br />
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<big>'''[[Chikitsa Sthana]] Chapter 21. Management of Visarpa (acute spreading erysepalas)</big>'''<br />
{{Infobox<br />
|title = Visarpa Chikitsa<br />
|label1 = Section/Chapter<br />
|data1 = [[Chikitsa Sthana]] Chapter 21<br />
|label2 = Preceding Chapter<br />
|data2 = [[Chhardi Chikitsa]]<br />
<br />
|label3= Succeeding Chapter<br />
|data3 = [[Trishna Chikitsa]]<br />
|label5 = Other Sections<br />
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br />
|label6 = Translator and commentator<br />
|data6 = Kendre M.<br />
|label7 = Reviewer <br />
|data7 = Ojha S.N.<br />
|label8 = Editors <br />
|data8 = Ojha S.N., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br />
|label9 = Year of publication <br />
|data9 = 2020<br />
|label10 = Publisher <br />
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label11 = DOI <br />
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.022 10.47468/CSNE.2020.e01.s06.022]<br />
}}<br />
<big>'''Abstract </big>'''<br />
<p style="text-align:justify;">This chapter deals with detailed description of etiopathogenesis, classification and management principles of ''visarpa''. This is acute disease with a quick spread involving mainly skin, blood, lymph and muscle tissue due to vitiation of all three [[dosha]]. Disease is clinically presented in three pathways viz. external, internal and both. Based on the involvement of dominant [[dosha]], it is classified into seven types. Prognosis and treatment duration of disease is proportionate to degree of involvement of [[dosha]] and affected internal organs. As the basic nature of disease is [[rakta]] and [[pitta]] dominant, management is focused on body purification treatments especially therapeutic purgation, blood letting, fasting therapy, medicated ghee, use of bitter drugs and various external applications having soothing and cooling effect. Guidelines for external application in the form of ''pralepa, pradeha'' and ''alepa'' are enlisted in the chapter. Blood letting is emphasized as most important treatment in ''visarpa''. <br />
<br/><br />
'''Keywords''': ''Visarpa, Parisarpa,'' Erysepalas, Gangrene, Septicaemia, Sepsis, Fulminant spreading skin infections.<br />
</p><br />
<br />
== Introduction ==<br />
<div style="text-align:justify;"><br />
The twenty first chapter is named [[Visarpa Chikitsa]]. The term ''visarpa'' has two parts viz., ''vi'' and ''sarpa''- ''vi'' stands for ''vividha'' meaning ‘various’ (ways) and ''sarpa'' stands for ''sarpan'' means ‘spreading’. Erythematous, pustular, glandular etc. lesions which spread rapidly in localized or generalized pattern are known as ''visarpa'' [ Cha.Sa. [[Chikitsa Sthana]] 21/11, Chakrapani]. This aliment is also called ''parisarpa''. The prefix ''pari'' stands for ''paritah'' or ''sarvatah'' meaning all over. The disease which spreads all over the body is called ''visarpa''. [Cha. Sa.[[ Chikitsa Sthana]] 21/11, Chakrapani]. This indicates that ''visarpa'' is an umbrella term used for acute spreading disorders caused due to vitiation of [[rakta]]. <br />
<br />
In this chapter Atreya answers the queries about ''visarpa'' derivation, synonyms, classification, [[dosha]], dushya,etiology, habitat, gradation, symptoms, complications, prognosis and treatment of curable ones. The chapter follows that of [Cha. Sa. [[Chhardi Chikitsa|Chhardi]] Chikitsa ] because suppression of chhardi (vomiting) causes [[Rakta dhatu|rakta]] dushti(vitiation of blood) leading to visarpa indicating that [[Rakta dhatu|rakta]] (blood) vitiating factors and vitiation of rakta is an important basic underlying phenomenon prior to the visarpa.<br />
<br />
''Visarpa'' is acute, spreading and fatal in nature leading to death if not treated promptly. On location basis this is classified into ''bahih-shrita'' (externally situated), ''antah-shrita'' (internally situated) and ''ubhayasam shrita'' (all over situated). ''Bahih-shrita visarpa'' is fulminant, spreading skin and flesh infection with symptoms and signs of inflammatory edema, blisters, ulcers, fever, pain etc. and is curable. ''Antah-shrita visarpa'' involves internal vital organs with mild septicaemia and is curable before complications. ''Ubhayasamshrita visarpa'' has advanced manifestations of both types spreading all over body with severe septicaemia and is fatal.<br />
<br />
''Visarpa'' never occurs without association of [[rakta]] and [[pitta]], hence general treatment of ''visarpa'' is described by considering [[rakta]] and [[pitta]] vitiation. Specific treatments are described by considering particular [[dosha]] involvement. <br />
Various etiological factors of ''visarpa'' are diet, life style, injury, poison, toxin, burn etc. vitiates [[rakta]] as well as [[dosha]] ([[vata]], [[pitta]] and [[kapha]]) and other [[dhatu]] (body elements) leading to fulminant disease requiring urgent medical care.<br />
<br />
Seven components are involved in the pathogenesis of ''visarpa'' viz., [[rakta]] (blood), ''lasika'' (lymph), ''tvak'' (skin), [[mamsa dhatu]] (flesh), [[vata]], [[pitta'' and ''kapha''. Same components are associated with ''kushtha'' (various skin disorders) but clinical presentation of both the diseases is different because etiological factors act different. As ''kushtha'' is chronic in nature and ''visarpa'' is acute in nature[Cha. Sa. [[Chikitsa Sthana]] 21/15,Chakrapani] therefore spreading ''kushtha'' should not be interpreted as ''visarpa''. <br />
<br />
It is also classified into ''vatika, paittika, slaishmika, agni visarpa, kardam visarpa, granthi visarpa'' and ''sannipatik'' on [[dosha]] basis. ''Bahih-shrita visarpa'' involves exterior part i.e. Skin, flesh, etc. of the body having symptoms like inflammatory oedema, blisters, ulcers, fever, pain etc. and is curable. ''Agni visarpa'' and ''kardam visarpa'' may be cured with appropriate timely management otherwise negligence leads to death of the patient. ''Granthi visarpa'' should be treated before complications otherwise it becomes incurable. ''Sannipatika visarpa'' is a severe manifestation of the disease leading to death.[Cha. Sa. [[Chikitsa Sthana]] 21/42] <br />
<br />
In ''visarpa, shodhana'' therapy has given prime importance because ''rakta kleda'' (putrificatory ingredient) and [[dosha]] vitiation is at higher level hence ''samana'' (pacification) therapy is not very effective. ''Visarpa'' never occurs without association of [[rakta]] and [[pitta]]. Hence general treatment of ''visarpa'' is described by considering [[rakta]] and [[pitta]] vitiation. Specific treatments are described as per the involvement of [[dosha]]. Single ''raktamokshana'' (blood letting) treatment is equal to all of other treatments described for ''visarpa''. [Cha. Sa. [[Chikitsa Sthana]] 21/141-143]. <br />
<br />
''Kshataja visarpa'' is another variety mentioned additionally in Sushruta Samhita. The later texts followed the same description with addition of some medications.<br />
</div><br />
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== Sanskrit Text, Transliteration and English Translation ==<br />
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अथातो विसर्पचिकित्सितं व्याख्यास्यामः ||१||<br />
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इति ह स्माह भगवानात्रेयः ||२||<br />
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athātō visarpacikitsitaṁ vyākhyāsyāmaḥ||1|| <br />
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iti ha smāha bhagavānātrēyaḥ||2|| <br />
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athAto visarpacikitsitaM vyAkhyAsyAmaH||1|| <br />
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iti ha smAha bhagavAnAtreyaH||2|| <br />
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<div style="text-align:justify;"><br />
Now we shall expound the chapter "Visarpa Chikitsa" (Management of acute spreading erysepalas). Thus said Lord Atreya. [1-2] <br />
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=== Agnivesha’s queries on ''visarpa'' ===<br />
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कैलासे किन्नराकीर्णे बहुप्रस्रवणौषधे | <br />
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पादपैर्विविधैः स्निग्धैर्नित्यं कुसुमसम्पदा ||३|| <br />
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वमद्भिर्मधुरान् गन्धान् सर्वतः स्वभ्यलङ्कृते | <br />
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विहरन्तं जितात्मानमात्रेयमृषिवन्दितम् ||४|| <br />
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महर्षिभिः परिवृतं सर्वभूतहिते रतम् | <br />
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अग्निवेशो गुरुं काले विनयादिदमुक्तवान् ||५|| <br />
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भगवन्! दारुणं रोगमाशीविषविषोपमम् | <br />
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विसर्पन्तं शरीरेषु देहिनामुपलक्षये ||६|| <br />
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सहसैव नरास्तेन परीताः शीघ्रकारिणा | <br />
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विनश्यन्त्यनुपक्रान्तास्तत्र नः संशयो महान् ||७|| <br />
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स नाम्ना केन विज्ञेयः सञ्ज्ञितः केन हेतुना | <br />
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कतिभेदः कियद्धातुः किन्निदानः किमाश्रयः ||८|| <br />
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सुखसाध्यः कृच्छ्रसाध्यो ज्ञेयो यश्चानुपक्रमः | <br />
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कथं कैर्लक्षणैः किं च भगवन्! तस्य भेषजम् ||९|| <br />
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तदग्निवेशस्य वचः श्रुत्वाऽऽत्रेयः पुनर्वसुः | <br />
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यथावदखिलं सर्वं प्रोवाच मुनिसत्तमः ||१०||<br />
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kailāsē kinnarākīrṇē bahuprasravaṇauṣadhē| <br />
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pādapairvividhaiḥ snigdhairnityaṁ kusumasampadā||3|| <br />
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vamadbhirmadhurān gandhān sarvātaḥ svabhyalaṅkr̥tē| <br />
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viharantaṁ jitātmānamātrēyamr̥ṣivanditam||4|| <br />
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maharṣibhiḥ parivr̥taṁ sarvabhūtahitē ratam| <br />
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agnivēśō guruṁ kālē vinayādidamuktavān||5|| <br />
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bhagavan! dāruṇaṁ rōgamāśīviṣaviṣōpamam| <br />
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visarpantaṁ śarīrēṣu dēhināmupalakṣayē||6|| <br />
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sahasaiva narāstēna parītāḥ śīghrakāriṇā| <br />
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vinaśyantyanupakrāntāstatra naḥ saṁśayō mahān||7|| <br />
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sa nāmnā kēna vijñēyaḥ sañjñitaḥ kēna hētunā| <br />
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katibhēdaḥ kiyaddhātuḥ kinnidānaḥ kimāśrayaḥ||8|| <br />
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sukhasādhyaḥ kr̥cchrasādhyō jñēyō yaścānupakramaḥ| <br />
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kathaṁ kairlakṣaṇaiḥ kiṁ ca bhagavan! tasya bhēṣajam||9|| <br />
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tadagnivēśasya vacaḥ śrutvā''trēyaḥ punarvasuḥ| <br />
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yathāvadakhilaṁ sarvaṁ prōvāca munisattamaḥ||10||<br />
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kailAse kinnarAkIrNe bahuprasravaNauShadhe| <br />
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pAdapairvividhaiH snigdhairnityaM kusumasampadA||3||<br />
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vamadbhirmadhurAn gandhAn sarvātaH svabhyala~gkRute| <br />
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viharantaM jitAtmAnamAtreyamRuShivanditam||4|| <br />
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maharShibhiH parivRutaM sarvabhUtahite ratam| <br />
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agnivesho guruM kAle vinayAdidamuktavAn||5|| <br />
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bhagavan! dAruNaM rōgamAshIviShaviShopamam| <br />
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visarpantaM sharIreShu dehinAmupalakShaye||6|| <br />
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sahasaiva narAstena parItAH shIghrakAriNA| <br />
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vinashyantyanupakrAntAstatra naH saMshayo mahAn||7|| <br />
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sa nAmnA kena vij~jeyaH sa~jj~jitaH kena hetunA| <br />
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katibhedaH kiyaddhātuH kinnidAnaH kimAshrayaH||8|| <br />
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sukhasAdhyaH kRucchrasAdhyo j~jeyo yashcAnupakramaH| <br />
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kathaM kairlakShaNaiH kiM ca bhagavan! tasya bheShajam||9|| <br />
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tadagniveshasya vacaH shrutvA~a~atreyaH punarvasuH| <br />
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yathAvadakhilaM sarvaM provAca munisattamaH||10|| <br />
</div></div><br />
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In the Kailas region inhabited by ''kinnaras'', having numerous water streams and medicinal plants with ever emitting sweet pleasant (''ishat gandha'') aroma by their wealth of flowers, Atreya who had great self-control, was surrounded by great sages and engaged in welfare of all creatures. Then Agnivesha choosing the appropriate time asked politely to his enlightened teacher, <br />
“Oh Lord, I observe the acute emergency disease in the body of human being which spreads with the virulence of snake-venom. Those human who are afflicted by this acute fulminating disease succumb to death quickly, unless treated promptly. We are in great need of enlightenment concerning this disease. <br />
<br />
By which name should it be known? Why does it derive its name? What are its varieties? Which body elements are involved in its pathogenesis? What is its etiology? Where is its location? How to understand its prognosis i.e. easy curable, difficult to cure and incurable? What are the signs and symptoms of this disease? And O worshipful one! What is the method of its treatment?”<br />
Having heard the queries of Agnivesha, Atreya Punarvasu, the foremost among the sages, explained all the relevant details of the disease ''visarpa''. [3-10]<br />
<br />
=== Definition of ''visarpa'' ===<br />
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विविधं सर्पति यतो विसर्पस्तेन स स्मृतः | <br />
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परिसर्पोऽथवा नाम्ना सर्वतः परिसर्पणात् ||११||<br />
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vividhaṁ sarpati yatō visarpastēna sa smr̥taḥ| <br />
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parisarpō'thavā nāmnā sarvātaḥ parisarpaṇāt||11|| <br />
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vividhaM sarpati yato visarpastena sa smRutaH| <br />
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parisarpo~athavA nAmnA sarvātaH parisarpaNAt||11|| <br />
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It spreads in various ways hence known as ''visarpa''. It is also called ''parisarpa'' due to its extensive spreading.[11]<br />
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=== Classification ===<br />
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स च सप्तविधो दोषैर्विज्ञेयः सप्तधातुकः | <br />
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पृथक् त्रयस्त्रिभिश्चैको विसर्पो द्वन्द्वजास्त्रयः ||१२|| <br />
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वातिकः पैत्तिकश्चैव कफजः सान्निपातिकः | <br />
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चत्वार एते विसर्पा वक्ष्यन्ते द्वन्द्वजास्त्रयः ||१३|| <br />
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आग्नेयो वातपित्ताभ्यां ग्रन्थ्याख्यः कफवातजः | <br />
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यस्तु कर्दमको घोरः स पित्तकफसम्भवः ||१४|| <br />
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sa ca saptavidhō dōṣairvijñēyaḥ saptadhātukaḥ| <br />
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pr̥thak trayastribhiścaikō visarpō dvandvajāstrayaḥ||12|| <br />
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vātikaḥ paittikaścaiva kaphajaḥ sānnipātikaḥ| <br />
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catvāra ētē visarpā vakṣyantē dvandvajāstrayaḥ||13|| <br />
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āgnēyō vātapittābhyāṁ granthyākhyaḥ kaphavātajaḥ| <br />
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yastu kardamakō ghōraḥ sa pittakaphasambhavaḥ||14|| <br />
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sa ca saptavidho dōṣairvij~jeyaH saptadhātukaH| <br />
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pRuthak trayastribhishcaiko visarpo dvandvajAstrayaH||12|| <br />
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vAtikaH paittikashcaiva kaphajaH sAnnipAtikaH| <br />
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catvAra ete visarpA vakShyante dvandvajAstrayaH||13|| <br />
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Agneyo vātapittAbhyAM granthyAkhyaH kaphavātajaH| <br />
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yastu kardamako ghoraH sa pittakaphasambhavaH||14|| <br />
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''Visarpa'' is of seven types as per [[dosha]] basis and it involves seven body elements.<br />
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Three types of ''visarpa'' are due to the morbidity of individual [[dosha]]; one variety is due to the morbidity of all the three [[dosha]] and three varieties are due to the morbidity of any of the two [[dosha]]. <br />
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''Vatika, paittika, kaphaja'' and ''sannipatik'' these are the four varieties of ''visarpa'' and the remaining three varieties viz., [[vata]]-[[pitta]]ja, [[kapha]]-[[vata]]ja and [[pitta]]-[[kapha]]ja type will now be described.<br />
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The variety due to morbid [[vata]]-[[pitta]] is agnivisarpa, [[kapha]]-[[vata]] cause ''granthi visarpa'' and [[pitta]]-[[kapha]] leads to serious condition known as ''kardamaka visarpa''. [12-14]<br />
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=== Vitiated factors ===<br />
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रक्तं लसीकात्वङ्मांसं दूष्यं दोषास्त्रयो मलाः | <br />
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विसर्पाणां समुत्पत्तौ विज्ञेयाः सप्त धातवः ||१५||<br />
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raktaṁ lasīkā tvaṅmāṁsaṁ dūṣyaṁ dōṣāstrayō malāḥ| <br />
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visarpāṇāṁ samutpattau vijñēyāḥ sapta dhātavaḥ||15||<br />
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raktaM lasIkA tva~gmAMsaM dUShyaM dōṣastrayo malAH| <br />
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visarpANAM samutpattau vij~jeyAH sapta dhAtavaH||15|| <br />
</div></div><br />
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Blood, lymph, skin, flesh and three [[dosha]], these seven elements are involved in the pathogenesis of ''visarpa'' of all kinds. [15]<br />
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=== Etiology ===<br />
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लवणाम्लकटष्णानां रसानामतिसेवनात् | <br />
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दध्यम्लमस्तुशुक्तानां सुरासौवीरकस्य च ||१६|| <br />
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व्यापन्नबहुमद्योष्णरागषाडवसेवनात् | <br />
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शाकानां हरितानां च सेवनाच्च विदाहिनाम् ||१७|| <br />
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कूर्चिकानां किलाटानां सेवनान्मन्दकस्य च | <br />
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दध्नः शाण्डाकिपूर्वाणामासुतानां च सेवनात् ||१८||<br />
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तिलमाषकुलत्थानां तैलानां पैष्टिकस्य च | <br />
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ग्राम्यानूपौदकानां च मांसानां लशुनस्य च ||१९|| <br />
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प्रक्लिन्नानामसात्म्यानां विरुद्धानां च सेवनात् |<br />
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अत्यादानाद्दिवास्वप्नादजीर्णाध्यशनात् क्षतात् ||२०||<br />
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क्षतबन्धप्रपतनाद्धर्मकर्मातिसेवनात् [१] | <br />
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विषवाताग्निदोषाच्च विसर्पाणां समुद्भवः ||२१|| <br />
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एतैर्निदानैर्व्यामिश्रैः कुपिता मारुतादयः | <br />
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दूष्यान् सन्दूष्य रक्तादीन् विसर्पन्त्यहिताशिनाम् ||२२||<br />
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lavaṇāmlakaṭūṣṇānāṁ rasānāmatisēvanāt| <br />
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dadhyamlamastuśuktānāṁ surāsauvīrakasya ca||16|| <br />
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vyāpannabahumadyōṣṇarāgaṣāḍavasēvanāt| <br />
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śākānāṁ haritānāṁ ca sēvanācca vidāhinām||17|| <br />
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kūrcikānāṁ kilāṭānāṁ sēvanānmandakasya ca| <br />
<br />
dadhnaḥ śāṇḍākipūrvāṇāmāsutānāṁ ca sēvanāt||18|| <br />
<br />
tilamāṣakulatthānāṁ tailānāṁ paiṣṭikasya ca| <br />
<br />
grāmyānūpaudakānāṁ ca māṁsānāṁ laśunasya ca||19|| <br />
<br />
praklinnānāmasātmyānāṁ viruddhānāṁ ca sēvanāt| <br />
<br />
atyādānāddivāsvapnādajīrṇādhyaśanāt kṣatāt||20|| <br />
<br />
kṣatabandhaprapatanāddharmakarmātisēvanāt [1] | <br />
<br />
viṣavātāgnidōṣācca visarpāṇāṁ samudbhavaḥ||21|| <br />
<br />
ētairnidānairvyāmiśraiḥ kupitā mārutādayaḥ| <br />
<br />
dūṣyān sandūṣya raktādīn visarpantyahitāśinām||22|| <br />
<br />
lavaNAmlakaTUShNAnAM rasAnAmatisevanAt| <br />
<br />
dadhyamlamastushuktAnAM surAsauvIrakasya ca||16|| <br />
<br />
vyApannabahumadyoShNarAgaShADavasevanAt| <br />
<br />
shAkAnAM haritAnAM ca sevanAcca vidAhinAm||17|| <br />
<br />
kUrcikAnAM kilATAnAM sevanAnmandakasya ca| <br />
<br />
dadhnaH shANDAkipUrvANAmAsutAnAM ca sevanAt||18|| <br />
<br />
tilamAShakulatthAnAM tailAnAM paiShTikasya ca| <br />
<br />
grAmyAnUpaudakAnAM ca mAMsAnAM lashunasya ca||19|| <br />
<br />
praklinnAnAmasAtmyAnAM viruddhAnAM ca sevanAt| <br />
<br />
atyAdAnAddivAsvapnAdajIrNAdhyashanAt kShatAt||20||<br />
<br />
kShatabandhaprapatanAddharmakarmAtisevanAt [1] | <br />
<br />
viShavātagnidōṣacca visarpANAM samudbhavaH||21|| <br />
<br />
etairnidAnairvyAmishraiH kupitA mArutAdayaH| <br />
<br />
dUShyAn sandUShya raktAdIn visarpantyahitAshinAm||22|| <br />
</div></div><br />
<br />
The following are the causative factors of the ''visarpa'':<br />
<br />
Excessive indulgence in ''lavana'' (salt), ''amla'' (sour), ''katu'' (pungent) and ''ushna'' (hot ingredients); as also in ''amla dadhi'' (sour curd), ''dadhi mastu'' (whey), ''shukta'' (vinegars), ''sura'' (type of liquor) and ''sauviraka'' (type of wine); the use of ''vyapanna madya'' (contaminated wine) or excessive liquor or heat inducing ''raga'' (condiments) and ''sadava'' (confectionery), the use of ''vidahi'' (causes burning), ''shaka'' (vegetables) and ''harita'' (''lashunadi harita'' group ''dravya''), ''kilata'' (cheese), ''kurchika'' (inspissated milk) and ''mandaka'' (immature curd), the use of ''sandaki'' (fermented wine), as also of ''paistika'' (one made up of ''pistamai padarth'' or pastries) and oils made of sesame, black gram and horse gram, the use of flesh of domesticated, wet land and aquatic animals and garlic, the use of the ''praklinna'' (putrified food), ''asatmya'' (unwholesome) and ''viruddha'' (mutually contradictory ingredients), over eating, sleeping during day time, ''ajirnashana'' (eating during indigestion), ''adhyashana'' (eating food immediately after the meal); ''kshatat'' (traumatic injury), ''kshata'' (wounds), ''bandha'' (ligatures), ''prapatana'' (trauma due to falls) over exposure to sun, strainful work, poisons, poisonous air,burns etc.<br />
<br />
By combination of above mentioned etiological factors, the provoked [[vata]]di [[dosha]] affect the susceptible body elements such as [[rakta]], lasika etc. and spread in the body in those indulged in unwholesome diet. [16-22]<br />
<br />
=== Pathways of spreading the disease ===<br />
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<br />
बहिःश्रितः श्रितश्चान्तस्तथा चोभयसंश्रितः | <br />
<br />
विसर्पो बलमेतेषां ज्ञेयं गुरु यथोत्तरम् ||२३|| <br />
<br />
बहिर्मार्गाश्रितं साध्यमसाध्यमुभयाश्रितम् | <br />
<br />
विसर्पं दारुणं विद्यात् सुकृच्छ्रं त्वन्तराश्रयम् ||२४|| <br />
<br />
अन्तःप्रकुपिता दोषा विसर्पन्त्यन्तराश्रये | <br />
<br />
बहिर्बहिःप्रकुपिताः सर्वत्रोभयसंश्रिताः ||२५||<br />
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bahiḥśritaḥ śritaścāntastathā cōbhayasaṁśritaḥ| <br />
<br />
visarpō balamētēṣāṁ jñēyaṁ guru yathōttaram||23|| <br />
<br />
bahirmārgāśritaṁ sādhyamasādhyamubhayāśritam| <br />
<br />
visarpaṁ dāruṇaṁ vidyāt sukr̥cchraṁ tvantarāśrayam||24|| <br />
<br />
antaḥprakupitā dōṣā visarpantyantarāśrayē| <br />
<br />
bahirbahiḥprakupitāḥ sarvatrōbhayasaṁśritāḥ||25||<br />
<br />
bahiHshritaH shritashcAntastathA cobhayasaMshritaH| <br />
<br />
visarpo balameteShAM j~jeyaM guru yathottaram||23|| <br />
<br />
bahirmArgAshritaM sAdhyamasAdhyamubhayAshritam| <br />
<br />
visarpaM dAruNaM vidyAt sukRucchraM tvantarAshrayam||24|| <br />
<br />
antaHprakupitA dōṣa visarpantyantarAshraye| <br />
<br />
bahirbahiHprakupitAH sarvatrobhayasaMshritAH||25||<br />
</div></div><br />
<br />
Externally situated (pathogenesis in shakha, [[rasa dhatu]]and [[rakta dhatu]]), internally situated (pathogenesis in internal organs and other [[dhatu]]) and situated in both (externally as well as internally) pathways ''visarpa'' is to be known more and more serious consecutively. <br />
<br />
Externally situated ''visarpa'' is curable, internally situated ''visarpa'' is very serious and difficult to cure whereas externally as well as internally situated type is incurable.<br />
<br />
The humors provoked in internal regions spreads internally, if provoked in external regions spreads externally and if provoked in both regions spreads all over the body.[23-25]<br />
<br />
=== Causes and features of internal and external ''visarpa'' ===<br />
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<br />
मर्मोपघातात् सम्मोहादयनानां विघट्टनात् | <br />
<br />
तृष्णातियोगाद्वेगानां विषमाणां प्रवर्तनात् ||२६|| <br />
<br />
विद्याद्विसर्पमन्तर्जमाशु चाग्निबलक्षयात् | <br />
<br />
अतो विपर्ययाद्बाह्यमन्यैर्विद्यात् स्वलक्षणैः ||२७|| <br />
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<br />
marmōpaghātāt sammōhādayanānāṁ vighaṭṭanāt| <br />
<br />
tr̥ṣṇātiyōgādvēgānāṁ viṣamāṇāṁ pravartanāt||26|| <br />
<br />
vidyādvisarpamantarjamāśu cāgnibalakṣayāt| <br />
<br />
atō viparyayādbāhyamanyairvidyāt svalakṣaṇaiḥ||27||<br />
<br />
marmopaghAtAt sammohAdayanAnAM vighaTTanAt| <br />
<br />
tRuShNAtiyōgadvegAnAM viShamANAM pravartanAt||26|| <br />
<br />
vidyAdvisarpamantarjamAshu cAgnibalakShayAt| <br />
<br />
ato viparyayAdbAhyamanyairvidyAt svalakShaNaiH||27||<br />
</div></div><br />
<br />
Affliction of vital organs, impaired consciousness, impaired circulation, morbid thirst and impaired natural urges and sudden reduction in digestive as well as immune power of body is known as ''antah-visarpa''. ''Bahih-visarpa'' should be understood by the external manifestations appearing on skin flesh etc. and by their own specific symptoms. [26-27]<br />
<br />
=== Bad prognostic features ===<br />
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<br />
यस्य सर्वाणि लिङ्गानि बलवद्यस्यकारणम् | <br />
<br />
यस्य चोपद्रवाः कष्टा मर्मगो यश्च हन्ति सः ||२८||<br />
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yasya sarvāṇi liṅgāni balavadyasya kāraṇam| <br />
<br />
yasya cōpadravāḥ kaṣṭā marmagō yaśca hanti saḥ||28|| <br />
<br />
yasya sarvANi li~ggAni balavadyasya kAraNam| <br />
<br />
yasya copadravAH kaShTA marmago yashca hanti saH||28|| <br />
</div></div><br />
<br />
''Visarpa'' manifesting with all signs and symptoms, having strong etiological factors, which is associated with formidable complications and that situates as well as affects vital parts, proves fatal.[28]<br />
</div><br />
=== Etio-pathogeneis and clinical features of [[vata]] dominant ''visarpa'' ===<br />
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<br />
रूक्षोष्णैः केवलो वायुः पूरणैर्वा समावृतः |<br />
<br />
प्रदुष्टो दूषयन् दूष्यान् विसर्पति यथाबलम् ||२९||<br />
<br />
तस्य रूपाणि- भ्रमदवथुपिपासानिस्तोदशूलाङ्गमर्दोद्वेष्टनकम्पज्वरतमककासास्थिसन्धिभेदविश्लेषणवेपनारोचकाविपाकाश्चक्षुषोराकुलत्वमस्रागमनं पिपीलिकासञ्चार इव चाङ्गेषु, यस्मिंश्चावकाशे विसर्पो विसर्पति [१] सोऽवकाशः श्यावारुणाभासः श्वयथुमान् निस्तोदभेदशूलायामसङ्कोचहर्षस्फुरणैरतिमात्रं प्रपीड्यते, अनुपक्रान्तश्चोपचीयते शीघ्रभेदैः स्फोटकैस्तनुभिररुणाभैः श्यावैर्वा तनुविशदारुणाल्पास्रावैः, विबद्धवातमूत्रपुरीषश्च भवति, निदानोक्तानि चास्य नोपशेरते विपरीतानि चोपशेरत इति वातविसर्पः ||३०||<br />
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rūkṣōṣṇaiḥ kēvalō vāyuḥ pūraṇairvā samāvr̥taḥ| <br />
<br />
praduṣṭō dūṣayan dūṣyān visarpati yathābalam||29|| <br />
<br />
tasya rūpāṇi- bhramadavathupipāsānistōdaśūlāṅgamardōdvēṣṭanakampajvaratamaka-kāsāsthisandhibhēdaviślēṣaṇavēpanārōcakāvipākāścakṣuṣōrākulatvamasrāgamanaṁ pipīlikāsañcāra ivacāṅgēṣu, yasmiṁścāvakāśē visarpō visarpati [1] sō'vakāśaḥ śyāvāruṇābhāsaḥ śvayathumānnistōdabhēdaśūlāyāmasaṅkōcaharṣasphuraṇairatimātraṁ prapīḍyatē, anupakrāntaścōpacīyatēśīghrabhēdaiḥ sphōṭakaistanubhiraruṇābhaiḥ śyāvairvā tanuviśadāruṇālpāsrāvaiḥ,vibaddhavātamūtrapurīṣaśca bhavati, nidānōktāni cāsya nōpaśēratē viparītāni cōpaśērata itivātavisarpaḥ||30||<br />
<br />
rUkShoShNaiH kevalo vAyuH pUraNairvA samAvRutaH| <br />
<br />
praduShTo dUShayan dUShyAn visarpati yathAbalam||29|| <br />
<br />
tasya rUpANi- bhramadavathupipAsAnistodashUlA~ggamardodveShTanakampajvaratamaka-kAsAsthisandhibhedavishleShaNavepanArocakAvipAkAshcakShuShorAkulatvamasrAgamanaMpipIlikAsa~jcAra iva cA~ggeShu, yasmiMshcAvakAshe visarpo visarpati [1] so~avakAshaHshyAvAruNAbhAsaH shvayathumAn nistodabhedashUlAyAmasa~gkocaharShasphuraNairatimAtraMprapIDyate, anupakrAntashcopacIyate shIghrabhedaiH sphoTakaistanubhiraruNAbhaiH shyAvairvātanuvishadAruNAlpAsrAvaiH, vibaddhavātamUtrapurIShashca bhavati, nidAnoktAni cAsya nopasherateviparItAni copasherata iti vātavisarpaH||30||<br />
</div></div><br />
<div style="text-align:justify;"><br />
[[Vayu]] aggravated by ununctuous and hot ingredients or by the obstruction due to vitiated [[dosha]], impairs the body elements and spreads in proportion to its strength. <br />
<br />
Its signs and symptoms are giddiness, burning sensation, excessive thirst, pricking sensation, severe pain, body ache, cramps, shivering, fever, feeling of entering in darkness, cough, breaking and splitting pains in the bones and joints, looseness in joints, trembling, anorexia, indigestion, congestion of the eyes, lacrimation and paresthesia; the region where the inflammation is spreading becomes blackish and reddish in color and edematous. The patient suffers from severe pricking, splitting or aching pain in the part affected as also extension and contractions of the parts, horripilation and quivering. If not treated it gives rise to quick bursting small blackish or reddish blisters with thin clear reddish and scanty discharge. The patient also suffers from the retention of flatus, urine and feces. Etiological factors do not suit and the contrary ones suit the patient, this is [[vata]] dominant ''visarpa''. [29-30]<br />
</div><br />
=== Etio-pathogeneis and clinical features of [[pitta]] dominant ''visarpa'' ===<br />
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<br />
पित्तमुष्णोपचारेण विदाह्यम्लाशनैश्चितम् | <br />
<br />
दूष्यान् सन्दूष्य धमनीः [१] पूरयन् वै विसर्पति ||३१||<br />
<br />
तस्य रूपाणि- ज्वरस्तृष्णा मूर्च्छा मोहश्छर्दिररोचकोऽङ्गभेदः स्वेदोऽतिमात्रमन्तर्दाहः प्रलापः शिरोरुक् चक्षुषोराकुलत्वमस्वप्नमरतिर्भ्रमः शीतवातवारितर्षोऽतिमात्रं हरितहारिद्रनेत्रमूत्रवर्चस्त्वं हरितहारिद्ररूपदर्शनं च, यस्मिंश्चावकाशे विसर्पोऽनुसर्पति सोऽवकाशस्ताम्रहरितहारिद्रनीलकृष्णरक्तानां वर्णानामन्यतमं पुष्यति, सोत्सेधैश्चातिमात्रं दाहसम्भेदनपरीतैः स्फोटकैरुपचीयते तुल्यवर्णास्रावैश्चिरपाकैश्च, निदानोक्तानि चास्य नोपशेरते विपरीतानि चोपशेरत इति पित्तविसर्पः ||३२||<br />
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pittamuṣṇōpacārēṇa vidāhyamlāśanaiścitam| <br />
<br />
dūṣyān sandūṣya dhamanīḥ [1] pūrayan vai visarpati||31|| <br />
<br />
tasya rūpāṇi- jvarastr̥ṣṇā mūrcchā mōhaśchardirarōcakō'ṅgabhēdaḥ svēdō'timātramantardāhaḥ pralāpaḥśirōruk cakṣuṣōrākulatvamasvapnamaratirbhramaḥ śītavātavāritarṣō'timātraṁharitahāridranētramūtravarcastvaṁ haritahāridrarūpadarśanaṁ ca, yasmiṁścāvakāśē visarpō'nusarpatisō'vakāśastāmraharitahāridranīlakr̥ṣṇaraktānāṁ varṇānāmanyatamaṁ puṣyati, sōtsēdhaiścātimātraṁdāhasambhēdanaparītaiḥ sphōṭakairupacīyatē tulyavarṇāsrāvaiścirapākaiśca, nidānōktāni cāsyanōpaśēratē viparītāni cōpaśērata iti pittavisarpaḥ||32|| <br />
<br />
pittamuShNopacAreNa vidAhyamlAshanaishcitam| <br />
<br />
dUShyAn sandUShya dhamanIH [1] pUrayan vai visarpati||31|| <br />
<br />
tasya rUpANi- jvarastRuShNA mUrcchA mohashchardirarocako~a~ggabhedaHsvedo~atimAtramantardAhaH pralApaH shiroruk cakShuShorAkulatvamasvapnamaratirbhramaHshItavātavAritarSho~atimAtraM haritahAridranetramUtravarcastvaM haritahAridrarUpadarshanaM ca,yasmiMshcAvakAshe visarpo~anusarpati so~avakAshastAmraharitahAridranIlakRuShNaraktAnAMvarNAnAmanyatamaM puShyati, sotsedhaishcAtimAtraM dAhasambhedanaparItaiH sphoTakairupacIyatetulyavarNAsrAvaishcirapAkaishca, nidAnoktAni cAsya nopasherate viparItAni copasherata itipittavisarpaH||32|| <br />
</div></div><br />
<div style="text-align:justify;"><br />
The [[pitta]] aggravated by the use of hot regimen, by eating irritant and sour foods vitiates the susceptible body elements and by feeling the vessels, begins to spread.<br />
<br />
Its signs and symptoms are fever, morbid thirst, fainting, disturbed consciousness, vomiting, anorexia, breaking body ache, excessive perspiration, burning, delirium, headache, congestion of the eyes, insomnia, restlessness, giddiness, excessive desire for cold air and water. Greenish or yellowish coloration of eyes, urine and feces, objects visualizes green and yellow. In the region where the ''visarpa'' spreads, becomes coppery, greenish, yellowish, bluish, blackish, reddish color. Affected part becomes excessively edematous and full of pustules, having intense burning and tearing pain, suppurating quickly and discharging fluid of similar color.<br />
<br />
The etiological factors do no suit and the contrary ones suit the patient. This is [[pitta]] dominant ''visarpa''. [31-32]<br />
</div><br />
=== Etio-pathogeneis and clinical features of [[kapha]] dominant ''visarpa'' ===<br />
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<br />
स्वाद्वम्ललवणस्निग्धगुर्वन्नस्वप्नसञ्चितः | <br />
<br />
कफः सन्दूषयन् दूष्यान् कृच्छ्रमङ्गे विसर्पति ||३३|| <br />
<br />
तस्य रूपाणि- शीतकः शीतज्वरो गौरवं निद्रा तन्द्राऽरोचको मधुरास्यत्वमास्योपलेपो निष्ठीविका छर्दिरालस्यं स्तैमित्यमग्निनाशो दौर्बल्यं च, यस्मिंश्चावकाशे विसर्पोऽनुसर्पति सोऽवकाशः श्वयथुमान् पाण्डुर्नातिरक्तः स्नेहसुप्तिस्तम्भगौरवैरन्वितोऽल्पवेदनः कृच्छ्रपाकैश्चिरकारिभिर्बहुलत्वगुपलेपैः स्फोटः श्वेतपाण्डुभिरनुबध्यते, प्रभिन्नस्तु श्वेतं पिच्छिलं तन्तुमद्धनमनुबद्धं स्निग्धमास्रावं स्रवति, ऊर्ध्वं च गुरुभिः स्थिरैर्जालावततैः स्निग्धैर्बहुलत्वगुपलेपैर्व्रणैरनुबध्यतेऽनुषङ्गी च भवति, श्वेतनखनयनवदनत्वङ्मूत्रवर्चस्त्वं, निदानोक्तानि चास्य नोपशेरते विपरीतानि चोपशेरत इति श्लेष्मविसर्पः ||३४||<br />
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svādvamlalavaṇasnigdhagurvannasvapnasañcitaḥ| <br />
<br />
kaphaḥ sandūṣayan dūṣyān kr̥cchramaṅgē visarpati||33|| <br />
<br />
tasya rūpāṇi- śītakaḥ śītajvarō gauravaṁ nidrā tandrā'rōcakō madhurāsyatvamāsyōpalēpō niṣṭhīvikāchardirālasyaṁ staimityamagnināśō daurbalyaṁ ca, yasmiṁścāvakāśē visarpō'nusarpati sō'vakāśaḥśvayathumān pāṇḍurnātiraktaḥ snēhasuptistambhagauravairanvitō'lpavēdanaḥkr̥cchrapākaiścirakāribhirbahulatvagupalēpaiḥ sphōṭaḥ śvētapāṇḍubhiranubadhyatē, prabhinnastu śvētaṁpicchilaṁ tantumaddhanamanubaddhaṁ snigdhamāsrāvaṁ sravati, ūrdhvaṁ ca gurubhiḥsthirairjālāvātataiḥ snigdhairbahulatvagupalēpairvraṇairanubadhyatē'nuṣaṅgī ca bhavati,śvētanakhanayanavadanatvaṅmūtravarcastvaṁ, nidānōktāni cāsya nōpaśēratē viparītāni cōpaśērata itiślēṣmavisarpaḥ||34|| <br />
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[[Kapha]] excessively accumulated due to intake of sweet, sour, salt, unctuous and heavy foods, and also by excessive sleep, vitiates the susceptible body elements and spreads with slow speed in the body. <br />
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Its signs and symptoms are chills, fever with chills, heaviness, excess sleep, drowsiness, adherence of sticky material in the mouth, excess spitting, vomiting, lassitude, timidity, loss of appetite and prostration. The region where the disease spreads becomes edematous, pallor or slight red, unctuous, numbness, rigidness, heaviness and slight pain. It suppurates hardly and chronic in nature. It is studded with eruptions which are covered with a thick skin and having white pale color. When burst, they discharge white, slimy, fibrinous, dense, sticky and viscid discharge from it. Thereafter it is followed by the ulcers which are heavy, deep seated, surrounded by capillary network, unctuous and covered with many skin scabs. These ulcers are chronic in nature. The nails, eyes, face, skin, urine and faces of the patient appear pale. The etiological factors do no suit and the contrary ones suit the patient. This is [[kapha]]ja visarpa''. [33-34]<br />
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=== Etio-pathogenesis and clinical features of [[vata]]-[[pitta]] dominant ''agni visarpa'' ===<br />
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वातपित्तं प्रकुपितमतिमात्रं स्वहेतुभिः | <br />
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परस्परं लब्धबलं दहद्गात्रं विसर्पति ||३५|| <br />
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तदुपतापादातुरः सर्वशरीरमङ्गारैरिवाकीर्यमाणं मन्यते, छर्द्यतीसारमूर्च्छादाहमोहज्वरतमकारोचकास्थिसन्धिभेदतृष्णाविपाकाङ्गभेदादिभिश्चाभिभूयते, यं यं चावकाशं विसर्पोऽनुसर्पति सोऽवकाशः शान्ताङ्गारप्रकाशोऽतिरक्तो वा भवति, अग्निदग्धप्रकारैश्च स्फोटैरुपचीयते, स शीघ्रगत्वादाश्वेव मर्मानुसारी भवति, मर्मणि चोपतप्ते पवनोऽतिबलो भिनत्त्यङ्गान्यतिमात्रं प्रमोहयति सञ्ज्ञां, हिक्काश्वासौ जनयति, नाशयति निद्रां, स नष्टनिद्रः प्रमूढसञ्ज्ञो व्यथितचेता न क्वचन सुखमुपलभते, अरतिपरीतः स्थानादासनाच्छय्यां क्रान्तुमिच्छति, क्लिष्टभूयिष्ठश्चाशु निद्रां भजति, दुर्बलो दुःखप्रबोधश्च भवति; तमेवंविधमग्निविसर्पपरीतमचिकित्स्यं विद्यात् ||३६||<br />
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vātapittaṁ prakupitamatimātraṁ svahētubhiḥ| <br />
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parasparaṁ labdhabalaṁ dahadgātraṁ visarpati||35||<br />
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tadupatāpādāturaḥ sarvaśarīramaṅgārairivākīryamāṇaṁ manyatē,chardyatīsāramūrcchādāhamōhajvaratamakārōcakāsthisandhibhēdatr̥ṣṇāvipākāṅgabhēdādibhiścābhibhūyatē,yaṁ yaṁ cāvakāśaṁ visarpō'nusarpati sō'vakāśaḥ śāntāṅgāraprakāśō'tiraktō vā bhavati,agnidagdhaprakāraiśca sphōṭairupacīyatē, sa śīghragatvādāśvēva marmānusārī bhavati, marmaṇi cōpataptēpavanō'tibalō bhinattyaṅgānyatimātraṁ pramōhayati sañjñāṁ, hikkāśvāsau janayati, nāśayati nidrāṁ, sanaṣṭanidraḥ pramūḍhasañjñō vyathitacētā na kvacana sukhamupalabhatē, aratiparītaḥsthānādāsanācchayyāṁ krāntumicchati, kliṣṭabhūyiṣṭhaścāśu nidrāṁ bhajati, durbalō duḥkhaprabōdhaścabhavati; tamēvaṁvidhamagnivisarpaparītamacikitsyaṁ vidyāt||36||<br />
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vātapittaM prakupitamatimAtraM svahetubhiH| <br />
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parasparaM labdhabalaM dahadgAtraM visarpati||35|| <br />
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tadupatApAdAturaH sarvasharIrama~ggArairivAkIryamANaM manyate,chardyatIsAramUrcchAdAhamohajvaratamakArocakAsthisandhibhedatRuShNAvipAkA~ggabhedAdibhishcAbhibhUyate,yaM yaM cAvakAshaM visarpo~anusarpati so~avakAshaH shAntA~ggAraprakAsho~atirakto vA bhavati,agnidagdhaprakAraishca sphoTairupacIyate, sa shIghragatvAdAshveva marmAnusArI bhavati, marmaNi copataptepavano~atibalo bhinattya~ggAnyatimAtraM pramohayati sa~jj~jAM, hikkAshvAsau janayati, nAshayati nidrAM, sanaShTanidraH pramUDhasa~jj~jo vyathitacetA na kvacana sukhamupalabhate, aratiparItaH sthAnAdAsanAcchayyAMkrAntumicchati, kliShTabhUyiShThashcAshu nidrAM bhajati, durbalo duHkhaprabodhashca bhavati;tamevaMvidhamagnivisarpaparItamacikitsyaM vidyAt||36|| <br />
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When ''vata-pitta'' vitiated severely due to their respective etiological factors and strengthened mutually, spreads producing severe burning pain in the body. <br />
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The patient affected with this type of ''visarpa'' feels as if his body is sprinkled with flaming coals. He suffers from vomiting, diarrhea, fainting, burning sensation, disturbed consciousness, fever, feeling of darkness, anorexia, breaking pain in bones and joints, morbid thirst, indigestion, breaking body pain etc. The part where the disease spreads looks like extinguished charcoal or blood like red, affected region gets covered with blisters like those caused by burns. Due to its rapid progress, it soon spreads to vital regions. When the vital parts gets affected, the [[vata]] which is excessively aggravated causes extensive disintegration of the tissues and leads to disturbed consciousness, produces hiccup, dyspnea and insomnia. That sleepless patient with disturbed consciousness and miserable mind does not get relief anywhere. He becomes restless in standing, seating and desires to lie on bed, thus exceedingly exhausted due to pain soon falls into deep sleep. Being debilitated, he is aroused from this state with difficulty. One suffering from ''agni-visarpa'' is to be regarded as incurable.[35-36]<br />
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=== Etio-pathogenesis and clinical features of [[kapha]]-[[pitta]] dominant ''kardam visarpa'' ===<br />
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कफपित्तं प्रकुपित्तं बलवत् स्वेन हेतुना | <br />
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विसर्पत्येकदेशे तु प्रक्लेदयति देहिनम् ||३७||<br />
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तद्विकाराः- शीतज्वरः शिरोगुरुत्वं दाहः स्तैमित्यमङ्गावसदनं निद्रा तन्द्रा मोहोऽन्नद्वेषः प्रलापोऽग्निनाशो दौर्बल्यमस्थिभेदो मूर्च्छा पिपासा स्रोतसां प्रलेपो जाड्यमिन्द्रियाणां प्रायोपवेशनमङ्गविक्षेपोऽङ्गमर्दोऽरतिरौत्सुक्यं चोपजायते, प्रायश्चामाशये विसर्पत्यलसक एकदेशग्राही च, यस्मिंश्चावकाशे विसर्पो विसर्पति सोऽवकाशो रक्तपीतपाण्डुपिडकावकीर्ण इव मेचकाभः कालो मलिनः स्निग्धो बहूष्मा गुरुः स्तिमितवेदनः श्वयथुमान् गम्भीरपाको निरास्रावः शीघ्रक्लेदः स्विन्नक्लिन्नपूतिमांसत्वक् क्रमेणाल्परुक् परामृष्टोऽवदीर्यते कर्दम इवावपीडितोऽन्तरं प्रयच्छत्युपक्लिन्नपूतिमांसत्यागी सिरास्नायुसन्दर्शी कुणपगन्धी च भवति सञ्ज्ञास्मृतिहन्ता च; तं कर्दमविसर्पपरीतमचिकित्स्यं विद्यात् ||३८||<br />
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kaphapittaṁ prakupittaṁ balavat svēna hētunā| <br />
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visarpatyēkadēśē tu praklēdayati dēhinam||37|| <br />
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tadvikārāḥ- śītajvaraḥ śirōgurutvaṁ dāhaḥ staimityamaṅgāvasadanaṁ nidrā tandrā mōhō'nnadvēṣaḥpralāpō'gnināśō daurbalyamasthibhēdō mūrcchā pipāsā srōtasāṁ pralēpō jāḍyamindriyāṇāṁprāyōpavēśanamaṅgavikṣēpō'ṅgamardō'ratirautsukyaṁ cōpajāyatē, prāyaścāmāśayē visarpatyalasakaēkadēśagrāhī ca, yasmiṁścāvakāśē visarpō visarpati sō'vakāśō raktapītapāṇḍupiḍakāvakīrṇa ivamēcakābhaḥ kālō malinaḥ snigdhō bahūṣmā guruḥ stimitavēdanaḥ śvayathumān gambhīrapākō nirāsrāvaḥśīghraklēdaḥ svinnaklinnapūtimāṁsatvak kramēṇālparuk parāmr̥ṣṭō'vadīryatē kardama ivāvapīḍitō'ntaraṁprayacchatyupaklinnapūtimāṁsatyāgī sirāsnāyusandarśī kuṇapagandhī ca bhavati sañjñāsmr̥tihantā ca;taṁ kardamavisarpaparītamacikitsyaṁ vidyāt||38||<br />
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kaphapittaM prakupittaM balavat svena hetunA| <br />
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visarpatyekadeshe tu prakledayati dehinam||37|| <br />
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tadvikArAH- shItajvaraH shirogurutvaM dAhaH staimityama~ggAvasadanaM nidrA tandrAmoho~annadveShaH pralApo~agninAsho daurbalyamasthibhedo mUrcchA pipAsA srotasAM pralepojADyamindriyANAM prAyopaveshanama~ggavikShepo~a~ggamardo~aratirautsukyaM copajAyate,prAyashcAmAshaye visarpatyalasaka ekadeshagrAhI ca, yasmiMshcAvakAshe visarpo visarpatiso~avakAsho raktapItapANDupiDakAvakIrNa iva mecakAbhaH kAlo malinaH snigdho bahUShmA guruHstimitavedanaH shvayathumAn gambhIrapAko nirAsrAvaH shIghrakledaH svinnaklinnapUtimAMsatvakkrameNAlparuk parAmRuShTo~avadIryate kardama ivAvapIDito~antaraMprayacchatyupaklinnapUtimAMsatyAgI sirAsnAyusandarshI kuNapagandhI ca bhavati sa~jj~jAsmRutihantAca; taM kardamavisarpaparItamacikitsyaM vidyAt||38|| <br />
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Excessively aggravated [[kapha]] [[pitta]] due to their respective etiological factors, spreads in the body causing suppuration of the tissues in particular part. <br />
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Its signs and symptoms are fever with chills, heaviness of the head, burning sensation, timidity, prostration, excessive sleep, drowsiness, disturbed consciousness, food dislike, delirium, loss of appetite, weakness, breaking pain in bones, fainting, morbid thirst, adhesions of sticky material in channels, dullness of the senses, mostly seating, abnormal movements of limbs, body pain, restlessness, anxiety, often it spreads to ''amashaya''. It is localized and spreads with slow speed.<br />
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The part where the disease spreads looks as if filled with reddish, yellowish, pale eruptions. The affected part becomes muddy, black, dirty, unctuous, excess hot, heavy, dull aching, edematous, with deep seated suppuration, having no discharge, rapidly become sloughy, sweated suppurated, having putrid flesh and skin, gradual little pain, when touched bursts and gives space on pressing, throws out decomposed and putrefied flesh, shows blood vessels, ligaments and has cadaverous smell and causes disturbed consciousness as well as memory. This is called ''kardam visarpa'' and is incurable. [37-38]<br />
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=== Etio-pathogenesis and clinical features of [[kapha]] [[vata]] dominant ''granthi visarpa'' ===<br />
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स्थिरगुरुकठिनमधुरशीतस्निग्धान्नपानाभिष्यन्दिसेविनामव्यायामादिसेविनामप्रतिक <br />
र्मशीलानां श्लेष्मा वायुश्च प्रकोपमापद्यते, तावुभौ दुष्टप्रवृद्धावतिबलौ प्रदूष्य दूष्यान् विसर्पाय कल्पेते; तत्र वायुः श्लेष्मणा विबद्धमार्गस्तमेव श्लेष्माणमनेकधा भिन्दन् क्रमेण ग्रन्थिमालां कृच्छ्रपाकसाध्यां कफाशये सञ्जनयति, उत्सन्नरक्तस्य वा प्रदूष्य रक्तं सिरास्नायुमांसत्वगाश्रितं ग्रन्थीनां मालां कुरुते तीव्ररुजानां स्थूलानामणूनां वा दीर्घवृत्तरक्तानां, तदुपतापाज्ज्वरातिसारकासहिक्काश्वासशोषप्रमोहवैवर्ण्यारोचकाविपाकप्रसेकच्छ <br />
र्दिर्मूर्च्छाङ्गभङ्गनिद्रारतिसदनाद्याः प्रादुर्भवन्त्युपद्रवाः; स एतैरुपद्रुतः सर्वकर्मणां विषयमतिपतितो विवर्जनीयो भवतीति ग्रन्थिविसर्पः ||३९||<br />
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sthiragurukaṭhinamadhuraśītasnigdhānnapānābhiṣyandisēvināmavyāyāmādisēvināmapratikarmaśīlānāṁślēṣmā vāyuśca prakōpamāpadyatē, tāvubhau duṣṭapravr̥ddhāvatibalau pradūṣya dūṣyān visarpāyakalpētē; tatra vāyuḥ ślēṣmaṇā vibaddhamārgastamēva ślēṣmāṇamanēkadhā bhindan kramēṇagranthimālāṁ kr̥cchrapākasādhyāṁ kaphāśayē sañjanayati, utsannaraktasya vā pradūṣya raktaṁsirāsnāyumāṁsatvagāśritaṁ granthīnāṁ mālāṁ kurutē tīvrarujānāṁ sthūlānāmaṇūnāṁ vādīrghavr̥ttaraktānāṁ, tadupatāpājjvarātisārakāsahikkāśvāsaśōṣapramōhavaivarṇyārōcakāvipākaprasēkacchardirmūrcchāṅgabhaṅganidrāratisadanādyāḥprādurbhavantyupadravāḥ; sa ētairupadrutaḥ sarvakarmaṇāṁ viṣayamatipatitō vivarjanīyō bhavatītigranthivisarpaḥ||39|| <br />
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sthiragurukaThinamadhurashItasnigdhAnnapAnAbhiShyandisevinAmavyAyAmAdisevinAmapratikarmashIlAnAMshleShmA vAyushca prakopamApadyate, tAvubhau duShTapravRuddhAvatibalau pradUShya dUShyAnvisarpAya kalpete; tatra vAyuH shleShmaNA vibaddhamArgastameva shleShmANamanekadhA bhindankrameNa granthimAlAM kRucchrapAkasAdhyAMkaphAshaye sa~jjanayati, utsannaraktasya vA pradUShyaraktaM sirAsnAyumAMsatvagAshritaM granthInAM mAlAM kurute tIvrarujAnAM sthUlAnAmaNUnAM vAdIrghavRuttaraktAnAM, tadupatApAjjvarAtisArakAsahikkAshvAsashoSha-pramohavaivarNyArocakAvipAkaprasekacchardirmUrcchA~ggabha~gganidrAratisadanAdyAHprAdurbhavantyupadravAH; sa etairupadrutaH sarvakarmaNAM viShayamatipatito vivarjanIyo bhavatItigranthivisarpaH||39|| <br />
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[[Kapha]] and [[vata]] gets vitiated due to the use of firm, heavy, hard, sweet, cold, unctuous, and ''abhishyandi'' (which increase discharges and cause obstruction) ingredients of diet, lack of physical exercise etc. not following preventive seasonal [[Panchakarma]] purification. Deranged excessively, aggravated, powerful both [[kapha]] and [[vata]] vitiates the susceptible body elements giving rise to ''granthi visarpa''. Thereafter the [[vata]] being occluded by [[kapha]] in its progress and disintegrates [[kapha]] in many ways and gradually giving rise to chain of glands, hardly suppurating and difficult to cure, in the habitats of [[kapha]].<br />
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In a person having aggravated blood, vitiated [[kapha]]-[[pitta]] provoke blood giving rise to a series of glandular enlargements which are exceedingly painful, large or small or elongated or round and of red color, located in blood vessels, ligaments, flesh and skin. Being afflicted, complications arise like fever, diarrhea, cough, hiccup, dyspnea, emaciation disturbed consciousness, abnormal complexion, anorexia, indigestion, excess salivation, vomiting, fainting, breaking pain in body , excessive sleep, restlessness, malaise, the patient associated with these complications goes beyond the reach of all remedial measures and as such is rejectable. This is ''granthi visarpa''.[39]<br />
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=== ''Upadrava'' (complications) ===<br />
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उपद्रवस्तु खलु रोगोत्तरकालजो रोगाश्रयो रोग एव स्थूलोऽणुर्वा, रोगात् पश्चाज्जायत इत्युपद्रवसञ्ज्ञः| <br />
तत्र प्रधानो व्याधिः, व्याधेर्गुणभूत [१] उपद्रवः, तस्य प्रायः प्रधानप्रशमे प्रशमो भवति | <br />
स तु पीडाकरतरो भवति पश्चादुत्पद्यमानो व्याधिपरिक्लिष्टशरीरत्वात्; तस्मादुपद्रवं त्वरमाणोऽभिबाधेत ||४०||<br />
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upadravastu khalu rōgōttarakālajō rōgāśrayō rōga ēva sthūlō'ṇurvā, rōgāt paścājjāyataityupadravasañjñaḥ| <br />
tatra pradhānō vyādhiḥ, vyādhērguṇabhūta [1] upadravaḥ, tasya prāyaḥ pradhānapraśamē praśamōbhavati| <br />
sa tu pīḍākaratarō bhavati paścādutpadyamānō vyādhiparikliṣṭaśarīratvāt; tasmādupadravaṁtvaramāṇō'bhibādhēta||40|| <br />
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upadravastu khalu rogottarakAlajo rōgashrayo rōga eva sthUlo~aNurvA, rōgat pashcAjjAyataityupadravasa~jj~jaH| <br />
tatra pradhAno vyAdhiH, vyAdherguNabhUta [1] upadravaH, tasya prAyaH pradhAnaprashame prashamobhavati| <br />
sa tu pIDAkarataro bhavati pashcAdutpadyamAno vyAdhiparikliShTasharIratvAt; tasmAdupadravaMtvaramANo~abhibAdheta||40|| <br />
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''Upadrava'' (complication) is disorder itself, outsized or undersized manifesting in the later period of a disease and rooted in the same (disease). ''Upadrava'' is so named because it manifests after the disease. Hence the main disease is primary and complication is secondary, it is generally pacified when the main disease gets pacified. It is more troublesome than the main disease itself, because it appears in the later stages of disease when the body is already weakened. Hence, one should treat the complications very promptly.[40]<br />
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=== Severity of ''visarpa'' ===<br />
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सर्वायतनसमुत्थं सर्वलिङ्गव्यापिनं सर्वधात्वनुसारिणमाशुकारिणं महात्ययिकमिति सन्निपातविसर्पमचिकित्स्यं विद्यात् ||४१||<br />
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sarvāyatanasamutthaṁ sarvaliṅgavyāpinaṁ sarvadhātvanusāriṇamāśukāriṇaṁ mahātyayikamitisannipātavisarpamacikitsyaṁ vidyāt||41|| <br />
<br />
sarvAyatanasamutthaM sarvali~ggavyApinaM sarvadhAtvanusAriNamAshukAriNaM mahAtyayikamitisannipAtavisarpamacikitsyaM vidyAt||41||<br />
</div></div><br />
<br />
The ''visarpa'' which is caused by all etiological factors, manifesting with all signs and symptoms, spreads in all body elements very rapidly and great disastrous is known as ''sannipataja visarpa'' and is not treatable. [41]<br />
</div><br />
=== Prognosis of ''visarpa'' ===<br />
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<br />
तत्र वातपित्तश्लेष्मनिमित्ता विसर्पास्त्रयः साध्या भवन्ति; अग्निकर्दमाख्यौ पुनरनुपसृष्टे मर्मणि अनुपगते वा सिरास्नायुमांसक्लेदे साधारणक्रियाभिरुभावेवाभ्यस्यमानौ प्रशान्तिमापद्येयाताम्, अनादरोपक्रान्तः पुनस्तयोरन्यतरो हन्याद्देहमाश्वेवाशीविषवत्; तथा ग्रन्थिविसर्पमजातोपद्रवमारभेत चिकित्सितुम्, उपद्रवोपद्रुतं त्वेनं परिहरेत्; सन्निपातजं तु सर्वधात्वनुसारित्वादाशुकारित्वाद्विरुद्धोपक्रमत्वाच्चासाध्यं विद्यात् ||४२||<br />
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<br />
tatra vātapittaślēṣmanimittā visarpāstrayaḥ sādhyā bhavanti; agnikardamākhyau punaranupasr̥ṣṭēmarmaṇi anupagatē vā sirāsnāyumāṁsaklēdē sādhāraṇakriyābhirubhāvēvābhyasyamānaupraśāntimāpadyēyātām, anādarōpakrāntaḥ punastayōranyatarō hanyāddēhamāśvēvāśīviṣavat; tathāgranthivisarpamajātōpadravamārabhēta cikitsitum, upadravōpadrutaṁ tvēnaṁ pariharēt; sannipātajaṁ tusarvadhātvanusāritvādāśukāritvādviruddhōpakramatvāccāsādhyaṁ vidyāt||42|| <br />
<br />
tatra vātapittashleShmanimittA visarpAstrayaH sAdhyA bhavanti; agnikardamAkhyau punaranupasRuShTemarmaNi anupagate vA sirAsnAyumAMsaklede sAdhAraNakriyAbhirubhAvevAbhyasyamAnauprashAntimApadyeyAtAm, anAdaropakrAntaH punastayoranyataro hanyAddehamAshvevAshIviShavat;tathA granthivisarpamajAtopadravamArabheta cikitsitum, upadravopadrutaM tvenaM pariharet;sannipAtajaM tu sarvadhAtvanusAritvAdAshukAritvAdviruddhopakramatvAccAsAdhyaM vidyAt||42|| <br />
</div></div><br />
<div style="text-align:justify;"><br />
Among all types of ''visarpa vatik'', ''paittik'' and [[kapha]]ja these three are curable. ''Agni'' and ''kardam visarpa'' not spreading to vital organs and causing no suppuration of the vessels, ligaments and muscles can be pacified by the general treatment of ''visarpa''. When managed with negligence both may cause death of patients like snake venom. ''Granthi visarpa'' should be treated before complications has arisen, otherwise should be rejected. ''Sannipataja visarpa'' should be taken as incurable because of it is spreading to all [[dhatu]], very fulminant and refractory to treatment.[42]<br />
<br />
=== Principles of treatment ===<br />
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<br />
तत्र साध्यानां साधनमनुव्याख्यास्यामः ||४३|| <br />
<br />
लङ्घनोल्लेखने शस्ते तिक्तकानां च सेवनम् | <br />
<br />
कफस्थानगते सामे रूक्षशीतैः प्रलेपयेत् ||४४||<br />
<br />
पित्तस्थानगतेऽप्येतत् सामे कुर्याच्चिकित्सितम् | <br />
<br />
शोणितस्यावसेकं च विरेकं च विशेषतः ||४५|| <br />
<br />
मारुताशयसम्भूतेऽप्यादितः स्याद्विरूक्षणम् | <br />
<br />
रक्तपित्तान्वयेऽप्यादौ स्नेहनं न हितं मतम् ||४६|| <br />
<br />
वातोल्बणे तिक्तघृतं पैत्तिके च प्रशस्यते | <br />
<br />
लघुदोषे, महादोषे पैत्तिके स्याद्विरेचनम् ||४७|| <br />
<br />
न घृतं बहुदोषाय देयं यन्न [१] विरेचयेत् | <br />
<br />
तेन दोषो ह्युपष्टब्धस्त्वङ्मांसरुधिरं पचेत् ||४८|| <br />
<br />
तस्माद्विरेकमेवादौ शस्तं विद्याद्विसर्पिणः | <br />
<br />
रुधिरस्यावसेकं च तद्ध्यस्याश्रयसञ्ज्ञितम् ||४९||<br />
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tatra sādhyānāṁ sādhanamanuvyākhyāsyāmaḥ||43|| <br />
<br />
laṅghanōllēkhanē śastē tiktakānāṁ ca sēvanam| <br />
<br />
kaphasthānagatē sāmē rūkṣaśītaiḥ pralēpayēt||44|| <br />
<br />
pittasthānagatē'pyētat sāmē kuryāccikitsitam| <br />
<br />
śōṇitasyāvasēkaṁ ca virēkaṁ ca viśēṣataḥ||45||<br />
<br />
mārutāśayasambhūtē'pyāditaḥ syādvirūkṣaṇam| <br />
<br />
raktapittānvayē'pyādau snēhanaṁ na hitaṁ matam||46|| <br />
<br />
vātōlbaṇē tiktaghr̥taṁ paittikē ca praśasyatē| <br />
<br />
laghudōṣē, mahādōṣē paittikē syādvirēcanam||47|| <br />
<br />
na ghr̥taṁ bahudōṣāya dēyaṁ yanna [1] virēcayēt| <br />
<br />
tēna dōṣō hyupaṣṭabdhastvaṅmāṁsarudhiraṁ pacēt||48|| <br />
<br />
tasmādvirēkamēvādau śastaṁ vidyādvisarpiṇaḥ| <br />
<br />
rudhirasyāvasēkaṁ ca taddhyasyāśrayasañjñitam||49|| <br />
<br />
tatra sAdhyAnAM sAdhanamanuvyAkhyAsyAmaH||43|| <br />
<br />
la~gghanollekhane shaste tiktakAnAM ca sevanam| <br />
<br />
kaphasthAnagate sAme rūkṣashItaiH pralepayet||44|| <br />
<br />
pittasthAnagate~apyetat sAme kuryAccikitsitam| <br />
<br />
shoNitasyAvasekaM ca virekaM ca visheShataH||45|| <br />
<br />
mArutAshayasambhUte~apyAditaH syAdvirūkṣaNam| <br />
<br />
raktapittAnvaye~apyAdau snehanaM na hitaM matam||46||<br />
<br />
vAtolbaNe tiktaghRutaM paittike ca prashasyate| <br />
<br />
laghudoShe, mahAdoShe paittike syAdvirecanam||47||<br />
<br />
na ghRutaM bahudōṣaya deyaM yanna [1] virecayet| <br />
<br />
tena doSho hyupaShTabdhastva~gmAMsarudhiraM pacet||48|| <br />
<br />
tasmAdvirekamevAdau shastaM vidyAdvisarpiNaH| <br />
<br />
rudhirasyAvasekaM ca taddhyasyAshrayasa~jj~jitam||49|| <br />
</div></div><br />
<br />
Now the treatment of the curable varieties of ''visarpa'' will be described. <br />
<br />
If the ''visarpa'' is caused with ama [[dosha]]([[dosha]] in the state of incomplete transformation) and is located in [[kapha]]sthana (in thorax and upper body parts), then [[langhana]] (fasting therapy), [[vamana]] (emesis) therapy, ''tikta'' (bitter) drugs internally and application of paste of drugs with dry and cold properties externally is beneficial. <br />
<br />
The same treatment should be adopted in case of association of ''ama'' and location in [[pitta]] sthana (abdomen and middle parts of body). <br />
<br />
In addition, [[rakta]]mokshana (blood letting) and [[virechana]] (purgation therapy) are specially indicated. <br />
<br />
If ''sama'' (with ama [[dosha]]) ''visarpa'' is arouse from ''vatashaya'' (pelvis and lower part of body) ununctuous measures are indicated in the beginning. Even in association with [[rakta]]-[[pitta]] uncting measure is not regarded as beneficial in the beginning. <br />
<br />
In [[vata]]ja visarpa and paittika visarpa of mild aggravated [[dosha]] tiktaka ghritam is beneficial. But if the [[pitta]] [[dosha]] is excessively aggravated then [[virechana]] should be given. <br />
<br />
In the condition of excessively aggravated [[dosha]], ghee should not be given at first which does not cause [[virechana]]. Because non purgating ghee occlude the [[dosha]] resulting in decomposed skin, flesh and blood. Hence in visarpa, [[virechana]] followed by [[rakta]]mokshana is recommended because the disorder is located in blood.[43-49]<br />
<br />
=== Formulations used in ''visarpa'' ===<br />
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<br />
इति वीसर्पनुत् प्रोक्तं समासेन चिकित्सितम् | <br />
<br />
एतदेव पुनः सर्वं व्यासतः सम्प्रवक्ष्यते ||५०|| <br />
<br />
मदनं मधुकं निम्बं वत्सकस्य फलानि च | <br />
<br />
वमनं सम्प्रदातव्यं विसर्पे कफपित्तजे ||५१|| <br />
<br />
पटोलपिचुमर्दाभ्यां पिप्पल्या मदनेन च | <br />
<br />
विसर्पे वमनं शस्तं तथा चेन्द्रयवैः सह ||५२|| <br />
<br />
यांश्च योगान् प्रवक्ष्याभि कल्पेषु कफपित्तिनाम् | <br />
<br />
विसर्पिणां प्रयोज्यास्ते दोषनिर्हरणाः शिवाः ||५३||<br />
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<br />
iti vīsarpanut prōktaṁ samāsēna cikitsitam| <br />
<br />
ētadēva punaḥ sarvaṁ vyāsataḥ sampravakṣyatē||50|| <br />
<br />
madanaṁ madhukaṁ nimbaṁ vatsakasya phalāni ca| <br />
<br />
vamanaṁ sampradātavyaṁ visarpē kaphapittajē||51|| <br />
<br />
paṭōlapicumardābhyāṁ pippalyā madanēna ca| <br />
<br />
visarpē vamanaṁ śastaṁ tathā cēndrayavaiḥ saha||52|| <br />
<br />
yāṁśca yōgān pravakṣyābhi kalpēṣu kaphapittinām| <br />
<br />
visarpiṇāṁ prayōjyāstē dōṣanirharaṇāḥ śivāḥ||53|| <br />
<br />
iti vIsarpanut proktaM samAsena cikitsitam| <br />
<br />
etadeva punaH sarvaM vyAsataH sampravakShyate||50|| <br />
<br />
madanaM madhukaM nimbaM vatsakasya phalAni ca| <br />
<br />
vamanaM sampradAtavyaM visarpe kaphapittaje||51|| <br />
<br />
patōlapicumardAbhyAM pippalyA madanena ca| <br />
<br />
visarpe vamanaM shastaM tathA cendrayavaiH saha||52|| <br />
<br />
yAMshca yōgan pravakShyAbhi kalpeShu kaphapittinAm| <br />
<br />
visarpiNAM prayojyAste dōṣanirharaNAH shivAH||53||<br />
</div></div><br />
<br />
Thus the treatment principles of ''visarpa'' have been described in brief. The same is being detailed further. <br />
<br />
In [[kapha]] [[pitta]]ja visarpa, [[vamana]] should be given with the ''madana'' (Randia spinosa), ''madhuka'' (Glycyrrhiza glabra Linn), ''nimba'' (Azadirachta indica), and fruits of ''vatsaka'' (Holarrhena antidysenterica Linn). <br />
<br />
In visarpa [[vamana]] is beneficial with ''patola'' (Trichosanthes dioica Roxb), ''pichumarda'' (Azadirachta indica), ''pippali'' (Piper longum linn), ''madana'' (Randia spinosa) and ''indrayava'' (Holarrhena antidysenterica Linn). <br />
<br />
Further, all those formulations which will be described in ''kalpasthana'' in connection with the disorders of [[kapha]] [[pitta]] should be used for the patients of ''visarpa'' as well because they are eliminative of morbid [[dosha]] and are beneficial.[50-53]<br />
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<br />
मुस्तनिम्बपटोलानां चन्दनोत्पलयोरपि | <br />
<br />
सारिवामलकोशीरमुस्तानां वा विचक्षणः ||५४|| <br />
<br />
कषायान् पाययेद्वैद्यः सिद्धान् वीसर्पनाशनान् | <br />
<br />
किराततिक्तकं लोध्रं चन्दनं सदुरालभम् ||५५|| <br />
<br />
नागरं पद्मकिञ्जल्कमुत्पलं सबिभीतकम् | <br />
<br />
मधुकं नागपुष्पं च दद्याद्वीसर्पशान्तये ||५६|| <br />
<br />
प्रपौण्डरीकं मधुकं पद्मकिञ्जल्कमुत्पलम् | <br />
<br />
नागपुष्पं च लोध्रं च तेनैव विधिना पिबेत् ||५७|| <br />
<br />
द्राक्षां पर्पटकं शुण्ठीं गुडूचीं धन्वयासकम् | <br />
<br />
निशापर्युषितं दद्यात्तृष्णावीसर्पशान्तये ||५८|| <br />
<br />
पटोलं पिचुमर्दं च दार्वीं कटुकरोहिणीम् | <br />
<br />
यष्ट्याह्वां त्रायमाणां च दद्याद्वीसर्पशान्तये ||५९|| <br />
<br />
पटोलादिकषायं वा पिबेत्त्रिफलया सह | <br />
<br />
मसूरविदलैर्युक्तं घृतमिश्रं प्रदापयेत् ||६०|| <br />
<br />
पटोलपत्रमुद्गानां रसमामलकस्य च | <br />
<br />
पाययेत घृतोन्मिश्रं नरं वीसर्पपीडितम् ||६१||<br />
<div class="mw-collapsible-content"><br />
<br />
mustānimbapaṭōlānāṁ candanōtpalayōrapi| <br />
<br />
sārivāmalakōśīramustānāṁ vā vicakṣaṇaḥ||54|| <br />
<br />
kaṣāyān pāyayēdvaidyaḥ siddhān vīsarpanāśanān| <br />
<br />
kirātatiktakaṁ lōdhraṁ candanaṁ sadurālabham||55|| <br />
<br />
nāgaraṁ padmakiñjalkamutpalaṁ sabibhītakam| <br />
<br />
madhukaṁ nāgapuṣpaṁ ca dadyādvīsarpaśāntayē||56|| <br />
<br />
prapauṇḍarīkaṁ madhukaṁ padmakiñjalkamutpalam| <br />
<br />
nāgapuṣpaṁ ca lōdhraṁ ca tēnaiva vidhinā pibēt||57|| <br />
<br />
drākṣāṁ parpaṭakaṁ śuṇṭhīṁ guḍūcīṁ dhanvayāsakam| <br />
<br />
niśāparyuṣitaṁ dadyāttr̥ṣṇāvīsarpaśāntayē||58|| <br />
<br />
paṭōlaṁ picumardaṁ ca dārvīṁ kaṭukarōhiṇīm| <br />
<br />
yaṣṭyāhvāṁ trāyamāṇāṁ ca dadyādvīsarpaśāntayē||59|| <br />
<br />
paṭōlādikaṣāyaṁ vā pibēttriphalayā saha| <br />
<br />
masūravidalairyuktaṁ ghr̥tamiśraṁ pradāpayēt||60|| <br />
<br />
paṭōlapatramudgānāṁ rasamāmalakasya ca| <br />
<br />
pāyayēta ghr̥tōnmiśraṁ naraṁ vīsarpapīḍitam||61|| <br />
<br />
mustānimbapatōlanAM candanotpalayorapi| <br />
<br />
sArivAmalakoshIramustānAM vA vicakShaNaH||54|| <br />
<br />
kaShAyAn pAyayedvaidyaH siddhAn vIsarpanAshanAn| <br />
<br />
kirAtatiktakaM lōdhraM candanaM sadurAlabham||55|| <br />
<br />
nAgaraM padmaki~jjalkamutpalaM sabibhItakam| <br />
<br />
madhukaM nAgapuShpaM ca dadyAdvIsarpashAntaye||56|| <br />
<br />
prapauNDarIkaM madhukaM padmaki~jjalkamutpalam| <br />
<br />
nAgapuShpaM ca lōdhraM ca tenaiva vidhinA pibet||57|| <br />
<br />
drAkShAM parpaTakaM shuNThIM guDUcIM dhanvayAsakam| <br />
<br />
nishAparyuShitaM dadyAttRuShNAvIsarpashAntaye||58|| <br />
<br />
patōlaM picumardaM ca dArvIM kaTukarōhinim| <br />
<br />
yaShTyAhvAM trAyamANAM ca dadyAdvIsarpashAntaye||59|| <br />
<br />
patōladikaShAyaM vA pibettriphalayA saha|<br />
<br />
masUravidalairyuktaM ghRutamishraM pradApayet||60|| <br />
<br />
patōlapatramudgAnAM rasamAmalakasya ca| <br />
<br />
pAyayeta ghRutonmishraM naraM vIsarpapIDitam||61||<br />
</div></div><br />
<br />
The skillful physician should administer the decoctions of tested efficacy for the cure of ''visarpa'' made up of ''musta'' (Cyperus rotundus linn), ''nimba'' (Azadirachta indica) and ''patola'' (Trichosanthes dioica Roxb) or ''chandana'' (Santalum album linn) and utpal (Nymphaea nouchali) or ''sariva'' (Hemidesmus indicus), ''amalaki'' (Emblica officinalis), ''ushira'' (Vetiveria zizanioidis Linn) and ''musta'' (Cyperus rotundus linn). <br />
<br />
''Kiratatikta'' (Swertia chirayita), ''lodhra'' (Symplocos racemosa), ''chandana'' (Santalum album linn), ''duralabha'' (Fagonia cretica), ''shunthi'' (Zingiber officinale), ''padmakinjalka'' (Prunus cerasoides), ''utpala'' (Nymphaea nouchali), ''bibhitaka'' (Terminalia bellirica), ''madhuka'' (Glycyrrhiza glabra Linn) and ''nagapushpa'' (Mesua ferrea Linn), this formulation physician may administer for the alleviation of ''visarpa''. <br />
<br />
''Prapaundrika'' (Nelumbo nucifera), ''madhuka'' (Glycyrrhiza glabra Linn), ''padmakinjalka'' (Prunus cerasoides), ''utpala'' (Nymphaea nouchali), ''nagapuspa'' (Mesua ferrea Linn), and ''lodhra'' (Symplocos racemosa), should be taken by the above method. <br />
<br />
''Draksha'' (Vitis vinifera Linn), ''parpataka'' (Carthmus tinctorius), ''shunthi'' (Zingiber officinale), ''guduchi'' (Tinospora cordifolia) and ''dhanvayasa'' (fagonia cretica) kept for the whole night in the water (''shitakashaya''), should be administered to alleviate morbid thirst and ''visarpa''. <br />
<br />
''Patola'' (Trichosanthes dioica Roxb.), ''pichumarda'' (Azadirachta indica), ''darvi'' (Berberis aristata), ''katuki'' (Picrorhiza kurroa), ''rohini'' (Terminalia chebula), ''yasti'' (Glycyrrhiza glabra Linn.), and ''trayamana'' (Gentiana kurroo) should be administered to alleviate ''visarpa''. <br />
<br />
Physician should administer ''patoladi kashaya'' with ''triphala'' (''Haritaki'' -Terminalia chebula, ''Bibhitaki''-Terminalia bellirica, and ''amalaki''- Emblica officinalis) and ''masur'' (lentil pulse) mixed with ghee. <br />
<br />
Physician should administer ''patola patra'' (Trichosanthes dioica Roxb.), ''mudga'' (green gram) and ''amalaki'' juice (Emblica officinalis) mixed with ghee. [54-61]<br />
<br />
=== Formulations for [[dosha]] situated in koshtha, [[pitta]] dominant ''visarpa'' and [[virechana]] ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
यच्च सर्पिर्महातिक्तं पित्तकुष्ठनिबर्हणम् | <br />
<br />
निर्दिष्टं तदपि प्राज्ञो दद्याद्वीसर्पशान्तये ||६२|| <br />
<br />
त्रायमाणाघृतं सिद्धं गौल्मिके यदुदाहृतम् | <br />
<br />
विसर्पाणां प्रशान्त्यर्थं दद्यात्तदपि बुद्धिमान् ||६३|| <br />
<br />
त्रिवृच्चूर्णं समालोड्य सर्पिषा पयसाऽपि वा |<br />
<br />
घर्माम्बुना वा संयोज्य मृद्वीकानां रसेन वा ||६४|| <br />
<br />
विरेकार्थं प्रयोक्तव्यं सिद्धं वीसर्पनाशनम् | <br />
<br />
त्रायमाणाशृतं वाऽपि पयो दद्याद्विरेचनम् ||६५|| <br />
<br />
त्रिफलारससंयुक्तं सर्पिस्त्रिवृतया सह | <br />
<br />
प्रयोक्तव्यं विरेकार्थं विसर्पज्वरनाशनम् ||६६|| <br />
<br />
रसमामलकानां वा घृतमिश्रं प्रदापयेत् | <br />
<br />
स एव गुरुकोष्ठाय त्रिवृच्चूर्णयुतो हितः ||६७||<br />
<br />
दोषे कोष्ठगते भूय एतत् कुर्याच्चिकित्सितम् |68|<br />
<div class="mw-collapsible-content"><br />
<br />
yacca sarpirmahātiktaṁ pittakuṣṭhanibarhaṇam| <br />
<br />
nirdiṣṭaṁ tadapi prājñō dadyādvīsarpaśāntayē||62|| <br />
<br />
trāyamāṇāghr̥taṁ siddhaṁ gaulmikē yadudāhr̥tam| <br />
<br />
visarpāṇāṁ praśāntyarthaṁ dadyāttadapi buddhimān||63|| <br />
<br />
trivr̥ccūrṇaṁ samālōḍya sarpiṣā payasā'pi vā| <br />
<br />
gharmāmbunā vā saṁyōjya mr̥dvīkānāṁ rasēna vā||64|| <br />
<br />
virēkārthaṁ prayōktavyaṁ siddhaṁ vīsarpanāśanam| <br />
<br />
trāyamāṇāśr̥taṁ vā'pi payō dadyādvirēcanam||65|| <br />
<br />
triphalārasasaṁyuktaṁ sarpistrivr̥tayā saha| <br />
<br />
prayōktavyaṁ virēkārthaṁ visarpajvaranāśanam||66|| <br />
<br />
rasamāmalakānāṁ vā ghr̥tamiśraṁ pradāpayēt| <br />
<br />
sa ēva gurukōṣṭhāya trivr̥ccūrṇayutō hitaḥ||67|| <br />
<br />
dōṣē kōṣṭhagatē bhūya ētat kuryāccikitsitam|68| <br />
<br />
yacca sarpirmahAtiktaM pittakuShThanibarhaNam| <br />
<br />
nirdiShTaM tadapi prAj~jo dadyAdvIsarpashAntaye||62|| <br />
<br />
trAyamANAghRutaM siddhaM gaulmike yadudAhRutam| <br />
<br />
visarpANAM prashAntyarthaM dadyAttadapi buddhimAn||63|| <br />
<br />
trivRuccUrNaM samAloDya sarpiShA payasA~api vA| <br />
<br />
gharmAmbunA vA saMyojya mRudvIkAnAM rasena vA||64|| <br />
<br />
virekArthaM prayoktavyaM siddhaM vIsarpanAshanam| <br />
<br />
trAyamANAshRutaM vA~api payo dadyAdvirecanam||65|| <br />
<br />
triphalArasasaMyuktaM sarpistrivRutayA saha| <br />
<br />
prayoktavyaM virekArthaM visarpajvaranAshanam||66|| <br />
<br />
rasamAmalakAnAM vA ghRutamishraM pradApayet| <br />
<br />
sa eva gurukoShThAya trivRuccUrNayuto hitaH||67|| <br />
<br />
doShe koShThagate bhUya etat kuryAccikitsitam|68| <br />
</div></div><br />
<br />
The ''mahatikta ghritam'' indicated in ''paittika kustha'' should also be given by the intelligent physician for the alleviation of ''visarpa''. <br />
<br />
''Trayamana ghritam'' of tested efficacy mentioned in the treatment of ''gulma'' should be administered by the brilliant physician to alleviate ''visarpa''. <br />
<br />
The powder of ''trivritta'' (Operculina turpethum Linn) mixed with ghee or milk or hot water or ''mridvika'' (Vitis vinifera Linn) juice should be administered for [[virechana]] and is tested to alleviate ''visarpa'' or ''trayamana'' (Gentiana kurroo) decocted with milk should be given for [[virechana]]. <br />
<br />
The decoction of ''triphala'' (''Haritaki, Bibhitaki'' and ''Amalaki'') mixed with ghee and ''trivritta'' (Operculina turpethum Linn) and used for [[virechana]] to alleviate ''visarpa'' and ''jwara''.<br />
<br />
The juice of ''amalaki'' (Emblica officinalis) mixed with ghee should be administered in ''visarpa'' patient of heavy bowel the same preparation mixed with ''trivritta'' (Operculina turpethum Linn) powder is beneficial. <br />
<br />
When the morbid [[dosha]] are situated in ''kostha'' (internally), these measures should be administered.[62-67]<br />
<br />
=== Formulations for [[dosha]] situated in ''shakha'' and modes of blood letting ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
शाखादुष्टे तु रुधिरे रक्तमेवादितो हरेत् ||६८|| <br />
<br />
भिषग्वातान्वितं रक्तं विषाणेन विनिर्हरेत् | <br />
<br />
पित्तान्वितं जलौकोभिः, कफान्वितमलाबुभिः ||६९|| <br />
<br />
यथासन्नं विकारस्य व्यधयेदाशु वा सिराम् | <br />
<br />
त्वङ्मांसस्नायुसङ्क्लेदो रक्तक्लेदाद्धि जायते ||७०||<br />
<div class="mw-collapsible-content"><br />
<br />
śākhāduṣṭē tu rudhirē raktamēvāditō harēt||68|| <br />
<br />
bhiṣagvātānvitaṁ raktaṁ viṣāṇēna vinirharēt| <br />
<br />
pittānvitaṁ jalaukōbhiḥ, kaphānvitamalābubhiḥ||69|| <br />
<br />
yathāsannaṁ vikārasya vyadhayēdāśu vā sirām| <br />
<br />
tvaṅmāṁsasnāyusaṅklēdō raktaklēdāddhi jāyatē||70|| <br />
<br />
shAkhAduShTe tu rudhire raktamevAdito haret||68|| <br />
<br />
bhiShagvātanvitaM raktaM viShANena vinirharet| <br />
<br />
pittAnvitaM jalaukobhiH, kaphAnvitamalAbubhiH||69|| <br />
<br />
yathAsannaM vikArasya vyadhayedAshu vA sirAm| <br />
<br />
tva~gmAMsasnAyusa~gkledo raktakledAddhi jAyate||70||<br />
</div></div><br />
<br />
If [[dosha]] in ''shakha'' (body elements) vitiate the blood then ''raktamokshana'' should be administered at first. The physician should use ''vishana'' (deer horn) in [[vata]] dominance, ''jalauka'' (Hirudinea medicinalis) in [[pitta]] dominance and ''alabu'' (lagenaria siceraria) in [[kapha]] dominance for blood letting or physician should perform ''siravyadha'' (blood letting through vein) promptly from the adjacent vein to the affected part, without which ''rakta kleda'' (putrifying blood content) gives rise to decomposed skin, flesh and ligaments. [68-70]<br />
<br />
=== External applications ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
अन्तःशरीरे [१] संशुद्धे दोषे त्वङ्मांससंश्रिते | <br />
<br />
आदितो वाऽल्पदोषाणां क्रिया बाह्या प्रवक्ष्यते ||७१||<br />
<br />
उदुम्बरत्वङ्मधुकं पद्मकिञ्जल्कमुत्पलम् | <br />
<br />
नागपुष्पं प्रियङ्गुश्च प्रदेहः सघृतो हितः ||७२||<br />
<br />
न्यग्रोधपादास्तरुणाः कदलीगर्भसंयुताः | <br />
<br />
बिसग्रन्थिश्च लेपः स्याच्छतधौतघृताप्लुतः ||७३||<br />
<br />
कालीयं मधुकं हेम वन्यं चन्दनपद्मकौ | <br />
<br />
एला मृणालं फलिनी प्रलेपः स्याद्धृताप्लुतः ||७४|| <br />
<br />
शाद्वलं च मृणालं च शङ्खं चन्दनमुत्पलम् |<br />
<br />
वेतसस्य च मूलानि प्रदेहः स्यात् सतण्डुलः ||७५||<br />
<br />
सारिवा पद्मकिञ्जल्कमुशीरं नीलमुत्पलम् | <br />
<br />
मञ्जिष्ठा चन्दनं लोध्रमभया च प्रलेपनम् ||७६|| <br />
<br />
नलदं च हरेणुश्च लोध्रं मधुकपद्मकौ [२] |<br />
<br />
दूर्वा सर्जरसश्चैव सघृतं स्यात् प्रलेपनम् ||७७||<br />
<br />
यावकाः सक्तवश्चैव सर्पिषा सह योजिताः | <br />
<br />
प्रदेहो मधुकं वीरा सघृता यवसक्तवः ||७८|| <br />
<br />
बलामुत्पलशालूकं वीरामगुरुचन्दनम् | <br />
<br />
कुर्यादालेपनं वैद्यो मृणालं च बिसान्वितम् ||७९||<br />
<br />
यवचूर्णं समधुकं सघृतं च प्रलेपनम् | <br />
<br />
हरेणवो मसुराश्च समुद्गाः श्वेतशालयः ||८०|| <br />
<br />
पृथक् पृथक् प्रदेहाः स्युः सर्वे वा सर्पिषा सह | <br />
<br />
पद्मिनीकर्दमः शीतो मौक्तिकं पिष्टमेव वा ||८१|| <br />
<br />
शङ्खः प्रवालः शुक्तिर्वा गैरिकं वा घृताप्लुतम् | <br />
<br />
(पृथगेते प्रदेहाश्च हिता ज्ञेया विसर्पिणाम् [३] ) | <br />
<br />
प्रपौण्डरीकं मधुकं बला शालूकमुत्पलम् ||८२|| <br />
<br />
न्यग्रोधपत्रदुग्धीके सघृतं स्यात् प्रलेपनम् | <br />
<br />
बिसानि च मृणालं च सघृताश्च कशेरुकाः ||८३|| <br />
<br />
शतावरीविदार्योश्च कन्दौ धौतघृताप्लुतौ | <br />
<br />
शैवालं नलमूलानि गोजिह्वा वृषकर्णिका ||८४|| <br />
<br />
इन्द्राणिशाकं सघृतं शिरीषत्वग्बलाघृतम् [४] | <br />
<br />
न्यग्रोधोदुम्बरप्लक्षवेतसाश्वत्थपल्लवैः ||८५|| <br />
<br />
त्वक्कल्कैर्बहुसर्पिर्भिः शीतैरालेपनं हितम् | <br />
<br />
प्रदेहाः सर्व एवैते वातपित्तोल्बणे [५] शुभाः ||८६||<br />
<br />
सकफे [६] तु प्रवक्ष्यामि प्रदेहानपरान् हितान् | <br />
<br />
त्रिफलां पद्मकोशीरं समङ्गां करवीरकम् ||८७|| <br />
<br />
नलमूलान्यनन्तां च प्रदेहमुपकल्पयेत् | <br />
<br />
खदिरं सप्तपर्णं च मुस्तमारग्वधं धवम् ||८८|| <br />
<br />
कुरण्टकं देवदारु दद्यादालेपनं भिषक् | <br />
<br />
आरग्वधस्य पत्राणि त्वचं श्लेष्मातकस्य च ||८९|| <br />
<br />
इन्द्राणिशाकं काकाह्वां शिरीषकुसुमानि च | <br />
<br />
शैवालं नलमूलानि वीरां गन्धप्रियङ्गुकाम् ||९०|| <br />
<br />
त्रिफलां मधुकं वीरां शिरीषकुसुमानि च | <br />
<br />
प्रपौण्डरीकं ह्रीबेरं दार्वीत्वङ्मधुकं बलाम् ||९१|| <br />
<br />
पृथगालेपनं कुर्याद्द्वन्द्वशः सर्वशोऽपि वा | <br />
<br />
प्रदेहाः सर्व एवैते देयाः स्वल्पघृताप्लुताः ||९२|| <br />
<br />
वातपित्तोल्बणे ये तु प्रदेहास्ते घृताधिकाः | <br />
<br />
घृतेन शतधौतेन प्रदिह्यात् केवलेन वा ||९३|| <br />
<br />
घृतमण्डेन शीतेन पयसा मधुकाम्बुना | <br />
<br />
पञ्चवल्ककषायेण सेचयेच्छीतलेन वा ||९४|| <br />
<br />
वातासृक्पित्तबहुलं विसर्पं बहुशो भिषक् | <br />
<br />
सेचनास्ते प्रदेहा ये त एव घृतसाधनाः ||९५|| <br />
<br />
ते चूर्णयोगा वीसर्पव्रणानामवचूर्णनाः | <br />
<br />
दूर्वास्वरससिद्धं च घृतं स्याद्व्रणरोपणम् ||९६|| <br />
<br />
दार्वीत्वङूमधुकं लोध्रं केशरं चावचूर्णनम् | <br />
<br />
पटोलः पिचुमर्दश्च त्रिफला मधुकोत्पले ||९७|| <br />
<br />
एतत् प्रक्षालनं सर्पिर्व्रणचूर्णं प्रलेपनम् |<br />
<br />
प्रदेहाः सर्व एवैते कर्तव्याः सम्प्रसादनाः [१] ||९८|| <br />
<div class="mw-collapsible-content"><br />
<br />
antaḥśarīrē [1] saṁśuddhē dōṣē tvaṅmāṁsasaṁśritē| <br />
<br />
āditō vā'lpadōṣāṇāṁ kriyā bāhyā pravakṣyatē||71||<br />
<br />
udumbaratvaṅmadhukaṁ padmakiñjalkamutpalam| <br />
<br />
nāgapuṣpaṁ priyaṅguśca pradēhaḥ saghr̥tō hitaḥ||72|| <br />
<br />
nyagrōdhapādāstaruṇāḥ kadalīgarbhasaṁyutāḥ| <br />
<br />
bisagranthiśca lēpaḥ syācchatadhautaghr̥tāplutaḥ||73|| <br />
<br />
kālīyaṁ madhukaṁ hēma vanyaṁ candanapadmakau| <br />
<br />
ēlā mr̥ṇālaṁ phalinī pralēpaḥ syāddhr̥tāplutaḥ||74|| <br />
<br />
śādvalaṁ ca mr̥ṇālaṁ ca śaṅkhaṁ candanamutpalam| <br />
<br />
vētasasya ca mūlāni pradēhaḥ syāt sataṇḍulaḥ||75|| <br />
<br />
sārivā padmakiñjalkamuśīraṁ nīlamutpalam| <br />
<br />
mañjiṣṭhā candanaṁ lōdhramabhayā ca pralēpanam||76|| <br />
<br />
naladaṁ ca harēṇuśca lōdhraṁ madhukapadmakau [2] |<br />
<br />
dūrvā sarjarasaścaiva saghr̥taṁ syāt pralēpanam||77|| <br />
<br />
yāvakāḥ saktavaścaiva sarpiṣā saha yōjitāḥ| <br />
<br />
pradēhō madhukaṁ vīrā saghr̥tā yavasaktavaḥ||78|| <br />
<br />
balāmutpalaśālūkaṁ vīrāmagurucandanam| <br />
<br />
kuryādālēpanaṁ vaidyō mr̥ṇālaṁ ca bisānvitam||79|| <br />
<br />
yavacūrṇaṁ samadhukaṁ saghr̥taṁ ca pralēpanam| <br />
<br />
harēṇavō masurāśca samudgāḥ śvētaśālayaḥ||80|| <br />
<br />
pr̥thak pr̥thak pradēhāḥ syuḥ sarvē vā sarpiṣā saha| <br />
<br />
padminīkardamaḥ śītō mauktikaṁ piṣṭamēva vā||81|| <br />
<br />
śaṅkhaḥ pravālaḥ śuktirvā gairikaṁ vā ghr̥tāplutam| <br />
<br />
(pr̥thagētē pradēhāśca hitā jñēyā visarpiṇām [3] )| <br />
<br />
prapauṇḍarīkaṁ madhukaṁ balā śālūkamutpalam||82|| <br />
<br />
nyagrōdhapatradugdhīkē saghr̥taṁ syāt pralēpanam| <br />
<br />
bisāni ca mr̥ṇālaṁ ca saghr̥tāśca kaśērukāḥ||83|| <br />
<br />
śatāvarīvidāryōśca kandau dhautaghr̥tāplutau| <br />
<br />
śaivālaṁ nalamūlāni gōjihvā vr̥ṣakarṇikā||84|| <br />
<br />
indrāṇiśākaṁ saghr̥taṁ śirīṣatvagbalāghr̥tam [4] | <br />
<br />
nyagrōdhōdumbaraplakṣavētasāśvatthapallavaiḥ||85|| <br />
<br />
tvakkalkairbahusarpirbhiḥ śītairālēpanaṁ hitam| <br />
<br />
pradēhāḥ sarva ēvaitē vātapittōlbaṇē [5] śubhāḥ||86|| <br />
<br />
sakaphē [6] tu pravakṣyāmi pradēhānaparān hitān| <br />
<br />
triphalāṁ padmakōśīraṁ samaṅgāṁ karavīrakam||87|| <br />
<br />
nalamūlānyanantāṁ ca pradēhamupakalpayēt| <br />
<br />
khadiraṁ saptaparṇaṁ ca mustāmāragvadhaṁ dhavam||88|| <br />
<br />
kuraṇṭakaṁ dēvadāru dadyādālēpanaṁ bhiṣak| <br />
<br />
āragvadhasya patrāṇi tvacaṁ ślēṣmātakasya ca||89|| <br />
<br />
indrāṇiśākaṁ kākāhvāṁ śirīṣakusumāni ca| <br />
<br />
śaivālaṁ nalamūlāni vīrāṁ gandhapriyaṅgukām||90|| <br />
<br />
triphalāṁ madhukaṁ vīrāṁ śirīṣakusumāni ca| <br />
<br />
prapauṇḍarīkaṁ hrībēraṁ dārvītvaṅmadhukaṁ balām||91|| <br />
<br />
pr̥thagālēpanaṁ kuryāddvandvaśaḥ sarvaśō'pi vā| <br />
<br />
pradēhāḥ sarva ēvaitē dēyāḥ svalpaghr̥tāplutāḥ||92|| <br />
<br />
vātapittōlbaṇē yē tu pradēhāstē ghr̥tādhikāḥ| <br />
<br />
ghr̥tēna śatadhautēna pradihyāt kēvalēna vā||93|| <br />
<br />
ghr̥tamaṇḍēna śītēna payasā madhukāmbunā| <br />
<br />
pañcavalkakaṣāyēṇa sēcayēcchītalēna vā||94|| <br />
<br />
vātāsr̥kpittabahulaṁ visarpaṁ bahuśō bhiṣak| <br />
<br />
sēcanāstē pradēhā yē ta ēva ghr̥tasādhanāḥ||95|| <br />
<br />
tē cūrṇayōgā vīsarpavraṇānāmavacūrṇanāḥ| <br />
<br />
dūrvāsvarasasiddhaṁ ca ghr̥taṁ syādvraṇarōpaṇam||96|| <br />
<br />
dārvītvaṅmadhukaṁ lōdhraṁ kēśaraṁ cāvacūrṇanam| <br />
<br />
paṭōlaḥ picumardaśca triphalā madhukōtpalē||97|| <br />
<br />
ētat prakṣālanaṁ sarpirvraṇacūrṇaṁ pralēpanam|98|<br />
<br />
antaHsharIre [1] saMshuddhe doShe tva~gmAMsasaMshrite| <br />
<br />
Adito vA~alpadōṣaNAM kriyA bAhyA pravakShyate||71|| <br />
<br />
udumbaratva~gmadhukaM padmaki~jjalkamutpalam| <br />
<br />
nAgapuShpaM priya~ggushca pradehaH saghRuto hitaH||72|| <br />
<br />
nyagrodhapAdAstaruNAH kadalIgarbhasaMyutAH| <br />
<br />
bisagranthishca lepaH syAcchatadhautaghRutAplutaH||73|| <br />
<br />
kAlIyaM madhukaM hema vanyaM candanapadmakau| <br />
<br />
elA mRuNAlaM phalinI pralepaH syAddhRutAplutaH||74|| <br />
<br />
shAdvalaM ca mRuNAlaM ca sha~gkhaM candanamutpalam| <br />
<br />
vetasasya ca mUlAni pradehaH syAt sataNDulaH||75|| <br />
<br />
sArivA padmaki~jjalkamushIraM nIlamutpalam| <br />
<br />
ma~jjiShThA candanaM lōdhramabhayA ca pralepanam||76|| <br />
<br />
naladaM ca hareNushca lōdhraM madhukapadmakau [2] | <br />
<br />
dUrvA sarjarasashcaiva saghRutaM syAt pralepanam||77|| <br />
<br />
yAvakAH saktavashcaiva sarpiShA saha yojitAH| <br />
<br />
pradeho madhukaM vIrA saghRutA yavasaktavaH||78|| <br />
<br />
balAmutpalashAlUkaM vIrAmagurucandanam| <br />
<br />
kuryAdAlepanaM vaidyo mRuNAlaM ca bisAnvitam||79|| <br />
<br />
yavacUrNaM samadhukaM saghRutaM ca pralepanam| <br />
<br />
hareNavo masurAshca samudgAH shvetashAlayaH||80|| <br />
<br />
pRuthak pRuthak pradehAH syuH sarve vA sarpiShA saha| <br />
<br />
padminIkardamaH shIto mauktikaM piShTameva vA||81|| <br />
<br />
sha~gkhaH pravAlaH shuktirvA gairikaM vA ghRutAplutam| <br />
<br />
(pRuthagete pradehAshca hitA j~jeyA visarpiNAm [3] )| <br />
<br />
prapauNDarIkaM madhukaM balA shAlUkamutpalam||82|| <br />
<br />
nyagrodhapatradugdhIke saghRutaM syAt pralepanam| <br />
<br />
bisAni ca mRuNAlaM ca saghRutAshca kasherukAH||83|| <br />
<br />
shatAvarIvidAryoshca kandau dhautaghRutAplutau| <br />
<br />
shaivAlaM nalamUlAni gojihvA vRuShakarNikA||84|| <br />
<br />
indrANishAkaM saghRutaM shirIShatvagbalAghRutam [4] | <br />
<br />
nyagrodhodumbaraplakShavetasAshvatthapallavaiH||85|| <br />
<br />
tvakkalkairbahusarpirbhiH shItairAlepanaM hitam| <br />
<br />
pradehAH sarva evaite vātapittolbaNe [5] shubhAH||86|| <br />
<br />
sakaphe [6] tu pravakShyAmi pradehAnaparAn hitAn| <br />
<br />
triphalAM padmakoshIraM sama~ggAM karavIrakam||87|| <br />
<br />
nalamUlAnyanantAM ca pradehamupakalpayet| <br />
<br />
khadiraM saptaparNaM ca mustāmAragvadhaM dhavam||88|| <br />
<br />
kuraNTakaM devadAru dadyAdAlepanaM bhiShak| <br />
<br />
Aragvadhasya patrANi tvacaM shleShmAtakasya ca||89|| <br />
<br />
indrANishAkaM kAkAhvAM shirIShakusumAni ca| <br />
<br />
shaivAlaM nalamUlAni vIrAM gandhapriya~ggukAm||90|| <br />
<br />
triphalAM madhukaM vIrAM shirIShakusumAni ca| <br />
<br />
prapauNDarIkaM hrIberaM dArvItva~gmadhukaM balAm||91|| <br />
<br />
pRuthagAlepanaM kuryAddvandvashaH sarvasho~api vA| <br />
<br />
pradehAH sarva evaite deyAH svalpaghRutAplutAH||92|| <br />
<br />
vātapittolbaNe ye tu pradehAste ghRutAdhikAH| <br />
<br />
ghRutena shatadhautena pradihyAt kevalena vA||93|| <br />
<br />
ghRutamaNDena shItena payasA madhukAmbunA| <br />
<br />
pa~jcavalkakaShAyeNa secayecchItalena vA||94|| <br />
<br />
vātasRukpittabahulaM visarpaM bahusho bhiShak| <br />
<br />
secanAste pradehA ye ta eva ghRutasAdhanAH||95|| <br />
<br />
te cUrNayōga vIsarpavraNAnAmavacUrNanAH| <br />
<br />
dUrvAsvarasasiddhaM ca ghRutaM syAdvraNaropaNam||96|| <br />
<br />
dArvItva~gmadhukaM lōdhraM kesharaM cAvacUrNanam| <br />
<br />
patōlaH picumardashca triphalA madhukotpale||97|| <br />
<br />
etat prakShAlanaM sarpirvraNacUrNaM pralepanam|98| <br />
</div></div><br />
<br />
After the body is cleansed internally (systemic) and morbid [[dosha]] remains in the skin and flesh (external tissues), or [[dosha]] morbidity is little, the external treatment to be carried out will now be described. <br />
<br />
The bark of ''udumbara'' (Ficus glomerata), ''madhuka'' (Glycyrrhiza glabra Linn), ''padmakinjalka'' (Prunas cerasoides), ''utpala'' (Nymphaea nouchali), ''nagapuspa'' (Mesua ferrea Linn) and ''priyangu'' (Callicarpa macrophylla) mixed with ghee and applied externally as ''pradeha'' and is beneficial. <br />
<br />
The tender adventitious roots of ''nyagrodha'' (Ficus bengalensis Linn), pith of ''kadali'' (Musa paradisiaca Linn.) and rhizome of lotus should be mixed with ghee washed hundred times and is applied externally as a ''lepa''.<br />
<br />
The ''kaliyaka'' (Santalum album Linn), ''madhuka'' (Glycyrrhiza glabra Linn), ''hema'' (calophyllum inophyllum), ''vanya'' (cyperus esculentus), ''chandana'' (Santalum album Linn), ''padmaka'' (Prunas cerasoides), ''ela'' (Elettaria cardamomum), ''mrnala'' (Nelumbo nucifera) and ''phalini'' (Callicarpa macrophylla) should be mixed with ghee and is applied externally as a ''pralepa''. <br />
<br />
The roots ''shadvala'' (Elymus repens), ''mrnala'' (Nelumbo nucifera), ''shankha'' (conch shells), ''chandana'' (Santalum album Linn), ''utpala'' (Nymphaea nouchali), ''vetas'' (Salix caprea Linn) and ''tandula'' (rice) should be applied externally as a ''pradeha''. <br />
''Sariva'' (Hemidesmus indicus), ''padmakinjalka'' (Prunas cerasoides), ''ushira'' (Vetiveria zizanioidis), ''nila utpala'' (Nymphaea caerulea), ''manjistha'' (Rubia cordifolia), ''chandana'' (Santalum album Linn), ''lodhra'' (symplocos racemosa) and ''abhaya'' (Terminalia chebula) should be applied externally as ''pralepa''. <br />
<br />
''Nalada'' (Vetiveria zizanioidis), ''harenu'' (Vitex negundo Linn), ''lodhra'' (Symplocos racemosa), ''madhuka'' (Glycyrrhiza glabra Linn), ''padmaka'' (Prunas cerasoides), ''durva'' (Cynodon dactylon) and ''sarjarasa'' (Shorea robusta) should be mixed with ghee and used externally as a ''pralepa''.<br />
<br />
The gruel prepared of barley or roasted flour of cereals should be mixed with ghee and also ''madhuka'' (Glycyrrhiza glabra Linn), ''vira'' (Pueraria tuberose) and ''yavasaktu'' mixed with ghee should be used externally as a ''pradeha''. <br />
<br />
The physician should use mixture of ''bala'' (Sida cordifolia Linn), ''utpala'' (Nymphaea nouchali), ''shaluka'' (Asparagus racemosus), ''vira'' (Pueraria tuberose), ''aguru'' (Aquilaria agallocha), ''chandana'' (Santalum album Linn), ''mrnala'' (stalk) and ''bisa'' (tubers of Nelumbo nucifera) externally as ''alepan'' (local application as a smear or thick paste or coating). <br />
<br />
The powder of barley mixed with honey and ghee should be used externally as a ''pralepa'' (application as thin paste). <br />
<br />
''Harenu'' (Pisum sativum), ''masura'' (Lens culinaris), ''mudga'' (Vigna radiata) and white ''shali'' rice should be mixed with ghee individually or in combination and used externally as a ''pradeha'' (application as a poultice).<br />
<br />
The cooling mud at the root of lotus, pearls or rice flour or conch shells, coral, oyster shell and ochre should be mixed with ghee separately and beneficial externally as a ''pradeha'' in ''visarpa''.<br />
<br />
''Prapaundarika'' (Nelumbo nucifera), ''madhuka'' (Glycyrrhiza glabra Linn), ''bala'' (Sida cordifolia), ''shaluka'' (Asparagus racemosus), ''utpala'' (Nymphaea nouchali), ''nyagrodha'' (Ficus bengalensis Linn) and ''dugdhika'' (Euphorbia hirta Linn.) mixed with ghee should be used externally as a ''pralepan''. <br />
<br />
The ''bisa'' (lotus fibres), ''mrnala'' (lotus stalks) and ''kasheruka'' (Cyperus esculentus) mixed with ghee. The ''shatavari'' (Asparagus racemosus) and ''vidarikand'' (Pueraria tuberose) mixed with washed ghee.<br />
<br />
The ''shaival'' (moss), root of ''nala'' (phragmites australis), ''gojihva'' (Amorphophallus paeoniifolius), ''vrsa karnika'' (Calystegia soldanella) and ''indranishaka'' (Vitex agnus-castus) mixed with ghee.<br />
<br />
The bark of ''sirisa'' (Albizzia lebbeck) and ''bala'' (Sida cordifolia Linn) mixed with ghee. ''Nyagrodha'' (Ficus bengalensis Linn), ''udumbar'' (Ficus glomerata), ''plaksha'' (Ficus sycomorus), ''vetas'' (Salix caprea Linn), ''asvattha'' (Ficus religiosa) leaves and bark mixed with ample ghee used as a cold ''alepan'' is beneficial. <br />
<br />
All these external applications are beneficial in [[vata]] [[pitta]] predominant ''visarpa''. <br />
<br />
Other external applications useful in [[kapha]] predominant ''visarpa'' will be described here after. ''Triphala'' (''haritaki, bibhitaki'' and ''amalaki''), ''padmaka'' (Prunas cerasoides), ''usir'' (Vetiveria zizanioidis Linn), ''samanga'' (Mimosa pudica), ''karviraka'' (Nerium indicum), root of ''nala'' (Phragmites australis) and ''ananta'' (hemidesmus indicus) should be used externally as a ''pradeha''. <br />
<br />
''Khadira'' (Acacia catechu), ''saptaparna'' (Alstonia scholaris), ''musta'' (Cyperus rotundus linn), ''aragvadha'' (Cassia fistula Linn), ''dhava'' (Anogeissus latifolia, Wall). ''Kurantaka'' (Lawsonia inermis) and ''devdaru'' (Cedrus deodar) should be applied externally as a ''pradeha''.<br />
<br />
''Aragvadha'' leaves (Cassia fistula Linn.) and ''sleshmantak'' bark (Cordia dichotoma), ''indrani shak'' (Vitex negundo Linn), ''kakahva'' (Canvalia gladiata) and ''sirisa'' flowers (Albizia lebbeck Linn.), ''saivala'' (Spirogyra maxima) root of ''nala'' (Phragmites australis), ''veera'' (Pueraria tuberose) and ''gandpriyangu'' (Callicarpa macrophylla), ''triphala'' (''Haritaki, Bibhitaki'' and ''Amalaki''), ''madhuka'' (Glycyrrhiza glabra Linn), ''prapaundrika'' (nelumbo nucifera), ''hribera'' (Pavonia odorata), bark of ''darvi'' (Berberis aristata), and ''bala'' (Sida cordifolia Linn.) - these should be applied singly, dually or collectively as a ''pradeha''. All these external applications should be mixed with small quantity of ghee. In [[vata]] [[pitta]] predominant condition these preparations should be mixed with profuse quantity of ghee.<br />
<br />
The applications of ''shatdhaut ghrita'' as ''pradeha'' or effuse with cold ghee scum, or cold milk or cold decoction of ''madhuka'' (Glycyrrhiza glabra Linn), or ''panchavalka'' (bark of ''nygrodha, udumbara, asvattha, plaksa'' and ''vetasa''), the physician should use frequently in [[vata]], [[rakta]] and [[pitta]] predominant ''visarpa''.<br />
<br />
The external application mentioned as ''pradeha'' may also be used for sprinkling or for preparation ''ghrita yoga'' or ''churna yoga'' used for dusting in wounds of ''visarpa'', ghee cooked with ''durva'' juice promotes wound healing.<br />
<br />
Bark of ''daruharidra'' (Berberis aristata), ''madhuka'' (Glycyrrhiza glabra Linn), ''lodhra'' (Symplocos racemosa) and ''keshara'' (Crocus sativus Linn), powder may be used for dusting the ulcers. ''Patola'' (Trichosanthes dioica Roxb), ''pichumarda'' (Azadirachta indica), ''triphala'' (''haritaki, bibhitaki'' and ''amalaki''), ''madhuka'' (Glycyrrhiza glabra Linn) and ''utpala'' (Nymphaea nouchali), these ingredients may be used to prepare decoction for cleansing the ulcers or to prepare ''ghrita'' or to prepare powder for dusting the ulcers or to prepare ''pralepa''.<br />
<br />
All these external applications as ''pradeha'' should be used for ''samprasadana'' (cleansing and pacifying the blood). [71-98]<br />
<br />
=== Guidelines for local application and its types ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
क्षणे क्षणे प्रयोक्तव्याः पूर्वमुद्धृत्य लेपनम् | <br />
<br />
अधावनोद्धृते पूर्वे प्रदेहा बहुशोऽघनाः ||९९|| <br />
<br />
देयाः प्रदेहाः कफजे पर्याधानोद्धृते घनाः | <br />
<br />
त्रिभागाङ्गुष्ठमात्रः स्यात् प्रलेपः कल्कपेषितः ||१००|| <br />
<br />
नातिस्निग्धो न रूक्षश्च न पिण्डो न द्रवः समः |<br />
<br />
न च पर्युषितं लेपं कदाचिदवचारयेत् ||१०१|| <br />
<br />
न च तेनैव लेपेन पुनर्जातु प्रलेपयेत् | <br />
<br />
क्लेदवीसर्पशूलानि सोष्णाभावात् प्रवर्तयेत् ||१०२|| <br />
<br />
लेपो ह्युपरि पट्टस्य कृतः स्वेदयति व्रणम् | <br />
<br />
स्वेदजाः पिडकास्तस्य कण्डूश्चैवोपजायते ||१०३|| <br />
<br />
उपर्युपरि लेपस्य लेपो यद्यवचार्यते | <br />
<br />
तानेव दोषाञ्जनयेत् पट्टस्योपरि यान् कृतः ||१०४|| <br />
<br />
अतिस्निग्धोऽतिद्रवश्च लेपो यद्यवचार्यते | <br />
<br />
त्वचि न श्लिष्यते सम्यङ्न दोषं शमयत्यपि ||१०५|| <br />
<br />
तन्वालिप्तं न कुर्वीत संशुष्को ह्यापुटायते | <br />
<br />
न चौषधिरसो व्याधिं प्राप्नोत्यपि च शुष्यति ||१०६|| <br />
<br />
तन्वालिप्तेन ये दोषास्तानेव जनयेद्भृशम् | <br />
<br />
संशुष्कः पीडयेद्व्याधिं निःस्नेहो ह्यवचारितः ||१०७|| <br />
<div class="mw-collapsible-content"><br />
<br />
pradēhāḥ sarva ēvaitē kartavyāḥ samprasādanāḥ [1] ||98|| <br />
<br />
kṣaṇē kṣaṇē prayōktavyāḥ pūrvamuddhr̥tya lēpanam| <br />
<br />
adhāvanōddhr̥tē pūrvē pradēhā bahuśō'ghanāḥ||99|| <br />
<br />
dēyāḥ pradēhāḥ kaphajē paryādhānōddhr̥tē ghanāḥ| <br />
<br />
tribhāgāṅguṣṭhamātraḥ syāt pralēpaḥ kalkapēṣitaḥ||100|| <br />
<br />
nātisnigdhō na rūkṣaśca na piṇḍō na dravaḥ samaḥ| <br />
<br />
na ca paryuṣitaṁ lēpaṁ kadācidavacārayēt||101|| <br />
<br />
na ca tēnaiva lēpēna punarjātu pralēpayēt| <br />
<br />
klēdavīsarpaśūlāni sōṣṇābhāvāt pravartayēt||102|| <br />
<br />
lēpō hyupari paṭṭasya kr̥taḥ svēdayati vraṇam| <br />
<br />
svēdajāḥ piḍakāstasya kaṇḍūścaivōpajāyatē||103|| <br />
<br />
uparyupari lēpasya lēpō yadyavacāryatē| <br />
<br />
tānēva dōṣāñjanayēt paṭṭasyōpari yān kr̥taḥ||104|| <br />
<br />
atisnigdhō'tidravaśca lēpō yadyavacāryatē| <br />
<br />
tvaci na śliṣyatē samyaṅna dōṣaṁ śamayatyapi||105|| <br />
<br />
tanvāliptaṁ na kurvīta saṁśuṣkō hyāpuṭāyatē| <br />
<br />
na cauṣadhirasō vyādhiṁ prāpnōtyapi ca śuṣyati||106|| <br />
<br />
tanvāliptēna yē dōṣāstānēva janayēdbhr̥śam| <br />
<br />
saṁśuṣkaḥ pīḍayēdvyādhiṁ niḥsnēhō hyavacāritaḥ||107|| <br />
<br />
pradehAH sarva evaite kartavyAH samprasAdanAH [1] ||98|| <br />
<br />
kShaNe kShaNe prayoktavyAH pUrvamuddhRutya lepanam| <br />
<br />
adhAvanoddhRute pUrve pradehA bahusho~aghanAH||99|| <br />
<br />
deyAH pradehAH kaphaje paryAdhAnoddhRute ghanAH| <br />
<br />
tribhAgA~gguShThamAtraH syAt pralepaH kalkapeShitaH||100|| <br />
<br />
nAtisnigdho na rūkṣashca na piNDo na dravaH samaH| <br />
<br />
na ca paryuShitaM lepaM kadAcidavacArayet||101|| <br />
<br />
na ca tenaiva lepena punarjAtu pralepayet| <br />
<br />
kledavIsarpashUlAni soShNAbhAvAt pravartayet||102|| <br />
<br />
lepo hyupari paTTasya kRutaH svedayati vraNam| <br />
<br />
svedajAH piDakAstasya kaNDUshcaivopajAyate||103|| <br />
<br />
uparyupari lepasya lepo yadyavacAryate| <br />
<br />
tAneva dōṣa~jjanayet paTTasyopari yAn kRutaH||104|| <br />
<br />
atisnigdho~atidravashca lepo yadyavacAryate| <br />
<br />
tvaci na shliShyate samya~gna dōṣaM shamayatyapi||105|| <br />
<br />
tanvAliptaM na kurvIta saMshuShko hyApuTAyate| <br />
<br />
na cauShadhiraso vyAdhiM prApnotyapi ca shuShyati||106|| <br />
<br />
tanvAliptena ye dōṣastAneva janayedbhRusham| <br />
<br />
saMshuShkaH pIDayedvyAdhiM niHsneho hyavacAritaH||107|| <br />
</div></div><br />
<br />
These ''lepa'' (local applications of pastes) are to be used repeatedly after removing the previous applied ''lepa''.<br />
<br />
Thin ''predeha'' should be applied as thick paste repeatedly after removing the previous one, but without washing it. <br />
<br />
In [[kapha]]ja visarpa, pradeha should be repeatedly applied as thick paste after removing the previous dried paste.<br />
<br />
The ''pralepa'' should be prepared as ''kalka'' (micronized paste) and applied of thickness equal to one third of the thumb. <br />
<br />
A ''pralepa'' should be neither too unctuous nor too dry, neither too solid nor too liquid, but of the right consistency. <br />
<br />
The stale ''lepa'' should never be used for application; the previously used ''lepa'' should not be used again for application, because it causes accumulation of heat leading to ''kleda'' (putrification), ''visarpa'' (spread of disease) and pain.<br />
<br />
The ''pralepa'' smeared over a piece of cloth, and that cloth is used for application on wound, it sudates the wound and consequently ''swedaja pidaka'' (boils) and itching are induced. <br />
<br />
If the ''pralepa'' is applied without removing the previous ''pralepa'', it produces same adverse effects as those mentioned above in the case of applications over the bandage. <br />
<br />
The ''pralepa'' applied externally that is either too unctuous or too fluid does not adhere properly and therefore cannot alleviate the diseased condition. <br />
<br />
Thin ''lepa'' should not be applied because while drying develops cracks and medicinal property of ''lepa'' does not penetrates properly in the affected part as it dries up quickly.<br />
<br />
If the ''pralepa'' is applied without mixing ghee, it produces same but in excess adverse effects as described for thin ''pralepa''. While getting dried up this ''pralepa'' leads to aggravation of disease manifestation. [99-107]<br />
<br />
=== Diet recipes for treatment of ''visarpa'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
अन्नपानानि वक्ष्यामि विसर्पाणां निवृत्तये | <br />
<br />
लङ्घितेभ्यो हितो मन्थो रूक्षः सक्षौद्रशर्करः ||१०८|| <br />
<br />
मधुरः किञ्चिदम्लो वा दाडिमामलकान्वितः | <br />
<br />
सपरूषकमृद्वीकः सखर्जूरः शृताम्बुना ||१०९|| <br />
<br />
तर्पणैर्यवशालीनां सस्नेहा चावलेहिका | <br />
<br />
जीर्णे पुराणशालीनां यूषैर्भुञ्जीत भोजनम् ||११०|| <br />
<br />
मुद्गान्मसूरांश्चणकान् यूषार्थमुपकल्पयेत् | <br />
<br />
अनम्लान् दाडिमाम्लान् वा पटोलामलकैः सह ||१११|| <br />
<br />
जाङ्गलानां च मांसानां रसांस्तस्योपकल्पयेत् | <br />
<br />
रूक्षान् परूषकद्राक्षादाडिमामलकान्वितान् ||११२|| <br />
<br />
रक्ताः श्वेता महाह्वाश्च शालयः षष्टिकैः सह | <br />
<br />
भोजनार्थे प्रशस्यन्ते पुराणाः सुपरिस्रुताः ||११३|| <br />
<br />
यवगोधूमशालीनां सात्म्यान्येव प्रदापयेत् | <br />
<br />
येषां नात्युचितः शालिर्नरा ये च कफाधिकाः ||११४||<br />
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<br />
annapānāni vakṣyāmi visarpāṇāṁ nivr̥ttayē| <br />
<br />
laṅghitēbhyō hitō manthō rūkṣaḥ sakṣaudraśarkaraḥ||108|| <br />
<br />
madhuraḥ kiñcidamlō vā dāḍimāmalakānvitaḥ| <br />
<br />
saparūṣakamr̥dvīkaḥ sakharjūraḥ śr̥tāmbunā||109|| <br />
<br />
tarpaṇairyavaśālīnāṁ sasnēhā cāvalēhikā| <br />
<br />
jīrṇē purāṇaśālīnāṁ yūṣairbhuñjīta bhōjanam||110|| <br />
<br />
mudgānmasūrāṁścaṇakān yūṣārthamupakalpayēt| <br />
<br />
anamlān dāḍimāmlān vā paṭōlāmalakaiḥ saha||111|| <br />
<br />
jāṅgalānāṁ ca māṁsānāṁ rasāṁstasyōpakalpayēt| <br />
<br />
rūkṣān parūṣakadrākṣādāḍimāmalakānvitān||112|| <br />
<br />
raktāḥ śvētā mahāhvāśca śālayaḥ ṣaṣṭikaiḥ saha| <br />
<br />
bhōjanārthē praśasyantē purāṇāḥ suparisrutāḥ||113|| <br />
<br />
yavagōdhūmaśālīnāṁ sātmyānyēva pradāpayēt| <br />
<br />
yēṣāṁ nātyucitaḥ śālirnarā yē ca kaphādhikāḥ||114|| <br />
<br />
annapAnAni vakShyAmi visarpANAM nivRuttaye| <br />
<br />
la~gghitebhyo hito mantho rūkṣaH sakShaudrasharkaraH||108|| <br />
<br />
madhuraH ki~jcidamlo vA dADimAmalakAnvitaH| <br />
<br />
saparUShakamRudvIkaH sakharjUraH shRutAmbunA||109|| <br />
<br />
tarpaNairyavashAlInAM sasnehA cAvalehikA| <br />
<br />
jIrNe purANashAlInAM yUShairbhu~jjIta bhojanam||110|| <br />
<br />
mudgAnmasUrAMshcaNakAn yUShArthamupakalpayet| <br />
<br />
anamlAn dADimAmlAn vA patōlamalakaiH saha||111|| <br />
<br />
jA~ggalAnAM ca mAMsAnAM rasAMstasyopakalpayet| <br />
<br />
rūkṣan parUShakadrAkShAdADimAmalakAnvitAn||112|| <br />
<br />
raktAH shvetA mahAhvAshca shAlayaH ShaShTikaiH saha| <br />
<br />
bhojanArthe prashasyante purANAH suparisrutAH||113|| <br />
<br />
yavagodhUmashAlInAM sAtmyAnyeva pradApayet| <br />
<br />
yeShAM nAtyucitaH shAlirnarA ye ca kaphAdhikAH||114|| <br />
</div></div><br />
<br />
The diet regimen helps to alleviate ''visarpa'' is described here after.<br />
<br />
In the beginning [[langhana]] (fasting therapy) should be given. There after use of ''mantha'' (roasted flour mixed with water in specific proportion and kept for specific time) is beneficial. The ''mantha'' should be without unctus ingredients and added with honey and sugar. It becomes sweet sour in taste due to mixing of ''dadima'' (Punica granatum Linn.) or ''amalaki'' (Emblica officinalis) and ''parushaka'' or ''mrdvika'' (Vitis vinifera Linn) or ''kharjura'' (Phoenix sylvestris) and boiled water should be used to prepare ''mantha''. <br />
<br />
Thereafter linctus made of the flour of roasted barley and ''shali'' rice and mixed with ghee should be given in the form of ''avalehika''. After digestion of ''avalehika'', one should take old ''shali'' rice with soup of green gram or lentils or Bengal gram, soured or not soured with pomegranates and added with ''patola'' (Trichosanthes dioica Roxb) and ''amalaki''. He may also take meat soup of wild animals without ghee and added with ''parushaka'' or ''draksha'' or ''dadima'' or ''amalaki''. Red or white or extra long variety of ''shastika'' rice, which are old, well boiled and residual water should be completely drained, it is beneficial food. <br />
<br />
The persons who have predominance of [[kapha]] and not suited to rice should be given the preparation of barley or wheat or ''purana shali'' which is suitable.[108-114]<br />
<br />
=== Contra-indications in ''visarpa'' ===<br />
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<br />
विदाहीन्यन्नपानानि विरुद्धं स्वपनं दिवा | <br />
<br />
क्रोधव्यायामसूर्याग्निप्रवातांश्च विवर्जयेत् ||११५||<br />
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<br />
vidāhīnyannapānāni viruddhaṁ svapanaṁ divā| <br />
<br />
krōdhavyāyāmasūryāgnipravātāṁśca vivarjayēt||115|| <br />
<br />
vidAhInyannapAnAni viruddhaM svapanaM divA| <br />
<br />
krodhavyAyAmasUryAgnipravātaMshca vivarjayet||115|| <br />
</div></div><br />
<br />
The patient should avoid the ''vidahi'' (that causes burning) and ''viruddha'' (mutually contradictory or incompatible) diet, day sleep, anger, exercise, exposure to sun heat, fire and fast winds.[115]<br />
<br />
=== General guidelines of treatment ===<br />
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<br />
कुर्याच्चिकित्सितादस्माच्छीतप्रायाणि पैत्तिके | <br />
<br />
रूक्षप्रायाणि कफजे स्नैहिकान्यनिलात्मके ||११६||<br />
<br />
वातपित्तप्रशमनमग्निवीसर्पणे हितम् | <br />
<br />
कफपित्तप्रशमनं प्रायः कर्दमसञ्ज्ञिते ||११७||<br />
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<br />
kuryāccikitsitādasmācchītaprāyāṇi paittikē| <br />
<br />
rūkṣaprāyāṇi kaphajē snaihikānyanilātmakē||116|| <br />
<br />
vātapittapraśamanamagnivīsarpaṇē hitam| <br />
<br />
kaphapittapraśamanaṁ prāyaḥ kardamasañjñitē||117||<br />
<br />
kuryAccikitsitAdasmAcchItaprAyANi paittike| <br />
<br />
rūkṣaprAyANi kaphaje snaihikAnyanilAtmake||116|| <br />
<br />
vātapittaprashamanamagnivIsarpaNe hitam| <br />
<br />
kaphapittaprashamanaM prAyaH kardamasa~jj~jite||117||<br />
</div></div><br />
<br />
Of these measures, predominantly ''sheeta'' (cool) measures are prescribed in [[pitta]] dominant condition, ''ruksha'' in [[kapha]] dominant condition and ''snigdha'' in [[vata]] dominant condition of ''visarpa''.<br />
<br />
In agni visarpa, [[vata]]-[[pitta]] pacifying measures are beneficial and in ''kardama visarpa'' mostly [[kapha]] [[pitta]] alleviating measures should be administered.[116-117]<br />
<br />
=== Treatment of ''granthi visarpa'' ===<br />
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<br />
रक्तपित्तोत्तरं दृष्ट्वा ग्रन्थिवीसर्पमादितः | <br />
<br />
रूक्षणैर्लङ्घनैः सेकैः प्रदेहैः पाञ्चवल्कलैः ||११८|| <br />
<br />
सिरामोक्षैर्जलौकोभिर्वमनैः सविरेचनैः | <br />
<br />
घृतैः कषायतिक्तैश्च कालज्ञः समुपाचरेत् ||११९||<br />
<br />
ऊर्ध्वं चाधश्च शुद्धाय रक्ते चाप्यवसेचिते | <br />
<br />
वातश्लेष्महरं कर्म ग्रन्थिवीसर्पिणे हितम् ||१२०||<br />
<br />
उत्कारिकाभिरुष्णाभिरुपनाहःप्रशस्यते| <br />
<br />
स्निग्धाभिर्वेशवारैर्वा ग्रन्थिवीसर्पशूलिनाम् ||१२१|| <br />
<br />
दशमूलोपसिद्धेन तैलेनोष्णेन सेचयेत् |<br />
<br />
कुष्ठतैलेन चोष्णेन पाक्यक्षारयुतेन च ||१२२||<br />
<br />
गोमूत्रैः पत्रनिर्यूहैरुष्णैर्वा परिषेचयेत् | <br />
<br />
सुखोष्णया प्रदिह्याद्वा पिष्टया चाश्वगन्धया ||१२३|| <br />
<br />
शुष्कमूलककल्केन नक्तमालत्वचाऽपि वा | <br />
<br />
बिभीतकत्वचां वाऽपि कल्केनोष्णेन लेपयेत् ||१२४|| <br />
<br />
बलां नागबलां पथ्यां भूर्जग्रन्थिं बिभीतकम् | <br />
<br />
वंशपत्राण्यग्निमन्थं कुर्याद्ग्रन्थिप्रलेपनम् ||१२५|| <br />
<br />
दन्ती चित्रकमूलत्वक् सुधार्कपयसी गुडः | <br />
<br />
भल्लातकास्थि कासीसं लेपो भिन्द्याच्छिलामपि ||१२६|| <br />
<br />
बहिर्मार्गास्थितं ग्रन्थिं किं पुनः कफसम्भवम् | <br />
<br />
दीर्घकालस्थितं ग्रन्थिं भिन्द्याद्वा भेषजैरिमैः ||१२७|| <br />
<br />
मूलकानां कुलत्थानां यूषैः सक्षारदाडिमैः | <br />
<br />
गोधूमान्नैर्यवान्नैर्वा ससीधुमधुशर्करैः ||१२८|| <br />
<br />
सक्षौद्रेर्वारुणीमण्डैर्मातुलुङ्गरसान्वितैः | <br />
<br />
त्रिफलायाः प्रयोगैश्च पिप्पलीक्षौद्रसंयुतैः ||१२९|| <br />
<br />
मुस्तभल्लातशक्तूनां प्रयोगैर्माक्षिकस्य च | <br />
<br />
देवदारुगुडूच्योश्च प्रयोगैर्गिरिजस्य च ||१३०|| <br />
<br />
धूमैर्विरेकैः शिरसः पूर्वोक्तैर्गुल्मभेदनैः | <br />
<br />
अयोलवणपाषाणहेमताम्रप्रपीडनैः ||१३१||<br />
<br />
आभिः क्रियाभिः सिद्धाभिर्विविधाभिर्बली स्थिरः | <br />
<br />
ग्रन्थिः पाषाणकठिनो यदा नैवोपशाम्यति ||१३२|| <br />
<br />
अथास्य दाहः क्षारेण शरैर्हेम्नाऽथ वा हितः | <br />
<br />
पाकिभिः पाचयित्वा वा पाटयित्वा समुद्धरेत् ||१३३|| <br />
<br />
मोक्षयेद्बहुशश्चास्य रक्तमुत्क्लेशमागतम् | <br />
<br />
पुनश्चापहृते रक्ते वातश्लेष्मजिदौषधम् ||१३४|| <br />
<br />
धूमो विरेकः शिरसः स्वेदनं परिमर्दनम् | <br />
<br />
अप्रशाम्यति दोषे च पाचनं वा प्रशस्यते ||१३५|| <br />
<br />
प्रक्लिन्नं दाहपाकाभ्यां भिषक् शोधनरोपणैः | <br />
<br />
बाह्यैश्चाभ्यन्तरैश्चैव व्रणवत् समुपाचरेत् ||१३६||<br />
<br />
कम्पिल्लकं विडङ्गानि दार्वीं कारञ्जकं फलम् | <br />
<br />
पिष्ट्वा तैलं विपक्तव्यं ग्रन्थिव्रणचिकित्सितम् ||१३७|| <br />
<br />
द्विव्रणीयोपदिष्टेन कर्मणा चाप्युपाचरेत् | <br />
<br />
देशकालविभागज्ञो व्रणान् वीसर्पजान् बुधः ||१३८|| <br />
<br />
इति ग्रन्थिविसर्पचिकित्सा | <br />
<div class="mw-collapsible-content"><br />
<br />
raktapittōttaraṁ dr̥ṣṭvā granthivīsarpamāditaḥ| <br />
<br />
rūkṣaṇairlaṅghanaiḥ sēkaiḥ pradēhaiḥ pāñcavalkalaiḥ||118|| <br />
<br />
sirāmōkṣairjalaukōbhirvamanaiḥ savirēcanaiḥ| <br />
<br />
ghr̥taiḥ [1] kaṣāyatiktaiśca kālajñaḥ samupācarēt||119|| <br />
<br />
ūrdhvaṁ cādhaśca śuddhāya raktē cāpyavasēcitē| <br />
<br />
vātaślēṣmaharaṁ karma granthivīsarpiṇē hitam||120|| <br />
<br />
utkārikābhiruṣṇābhirupanāhaḥ praśasyatē| <br />
<br />
snigdhābhirvēśavārairvā granthivīsarpaśūlinām||121|| <br />
<br />
daśamūlōpasiddhēna tailēnōṣṇēna sēcayēt| <br />
<br />
kuṣṭhatailēna cōṣṇēna pākyakṣārayutēna ca||122|| <br />
<br />
gōmūtraiḥ patraniryūhairuṣṇairvā pariṣēcayēt| <br />
<br />
sukhōṣṇayā pradihyādvā piṣṭayā cāśvagandhayā||123|| <br />
<br />
śuṣkamūlakakalkēna naktamālatvacā'pi vā| <br />
<br />
bibhītakatvacāṁ vā'pi [2] kalkēnōṣṇēna lēpayēt||124|| <br />
<br />
balāṁ nāgabalāṁ pathyāṁ bhūrjagranthiṁ bibhītakam| <br />
<br />
vaṁśapatrāṇyagnimanthaṁ kuryādgranthipralēpanam||125|| <br />
<br />
dantī citrakamūlatvak sudhārkapayasī guḍaḥ| <br />
<br />
bhallātakāsthi kāsīsaṁ lēpō bhindyācchilāmapi||126|| <br />
<br />
bahirmārgāsthitaṁ granthiṁ kiṁ punaḥ kaphasambhavam| <br />
<br />
dīrghakālasthitaṁ granthiṁ bhindyādvā bhēṣajairimaiḥ||127|| <br />
<br />
mūlakānāṁ kulatthānāṁ yūṣaiḥ sakṣāradāḍimaiḥ| <br />
<br />
gōdhūmānnairyavānnairvā sasīdhumadhuśarkaraiḥ||128|| <br />
<br />
sakṣaudrairvāruṇīmaṇḍairmātuluṅgarasānvitaiḥ| <br />
<br />
triphalāyāḥ prayōgaiśca pippalīkṣaudrasaṁyutaiḥ||129|| <br />
<br />
mustābhallātaśaktūnāṁ prayōgairmākṣikasya ca| <br />
<br />
dēvadāruguḍūcyōśca prayōgairgirijasya ca||130|| <br />
<br />
dhūmairvirēkaiḥ śirasaḥ pūrvōktairgulmabhēdanaiḥ|<br />
<br />
ayōlavaṇapāṣāṇahēmatāmraprapīḍanaiḥ||131|| <br />
<br />
ābhiḥ kriyābhiḥ siddhābhirvividhābhirbalī sthiraḥ| <br />
<br />
granthiḥ pāṣāṇakaṭhinō yadā naivōpaśāmyati||132|| <br />
<br />
athāsya dāhaḥ kṣārēṇa śarairhēmnā'tha [3] vā hitaḥ| <br />
<br />
pākibhiḥ pācayitvā vā pāṭayitvā samuddharēt||133|| <br />
<br />
mōkṣayēdbahuśaścāsya raktamutklēśamāgatam| <br />
<br />
punaścāpahr̥tē [4] raktē vātaślēṣmajidauṣadham||134|| <br />
<br />
dhūmō virēkaḥ śirasaḥ svēdanaṁ parimardanam| <br />
<br />
apraśāmyati dōṣē ca pācanaṁ [5] vā praśasyatē||135|| <br />
<br />
praklinnaṁ dāhapākābhyāṁ bhiṣak śōdhanarōpaṇaiḥ| <br />
<br />
bāhyaiścābhyantaraiścaiva vraṇavat samupācarēt||136|| <br />
<br />
kampillakaṁ viḍaṅgāni dārvīṁ kārañjakaṁ phalam| <br />
<br />
piṣṭvā tailaṁ vipaktavyaṁ granthivraṇacikitsitam||137|| <br />
<br />
dvivraṇīyōpadiṣṭēna karmaṇā cāpyupācarēt| <br />
<br />
dēśakālavibhāgajñō vraṇān vīsarpajān budhaḥ||138|| <br />
<br />
iti granthivisarpacikitsā| <br />
<br />
raktapittottaraM dRuShTvA granthivIsarpamAditaH| <br />
<br />
rūkṣaNairla~gghanaiH sekaiH pradehaiH pA~jcavalkalaiH||118||<br />
<br />
sirAmokShairjalaukobhirvamanaiH savirecanaiH| <br />
<br />
ghRutaiH [1] kaShAyatiktaishca kAlaj~jaH samupAcaret||119|| <br />
<br />
UrdhvaM cAdhashca shuddhAya rakte cApyavasecite| <br />
<br />
vātashleShmaharaM karma granthivIsarpiNe hitam||120|| <br />
<br />
utkArikAbhiruShNAbhirupanAhaH prashasyate| <br />
<br />
snigdhAbhirveshavArairvA granthivIsarpashUlinAm||121|| <br />
<br />
dashamUlopasiddhena tailenoShNena secayet| <br />
<br />
kuShThatailena coShNena pAkyakShArayutena ca||122|| <br />
<br />
gomUtraiH patraniryUhairuShNairvA pariShecayet| <br />
<br />
sukhoShNayA pradihyAdvA piShTayA cAshvagandhayA||123|| <br />
<br />
shuShkamUlakakalkena naktamAlatvacA~api vA| <br />
<br />
bibhItakatvacAM vA~api [2] kalkenoShNena lepayet||124|| <br />
<br />
balAM nAgabalAM pathyAM bhUrjagranthiM bibhItakam| <br />
<br />
vaMshapatrANyagnimanthaM kuryAdgranthipralepanam||125|| <br />
<br />
dantI citrakamUlatvak sudhArkapayasI guDaH| <br />
<br />
bhallAtakAsthi kAsIsaM lepo bhindyAcchilAmapi||126|| <br />
<br />
bahirmArgAsthitaM granthiM kiM punaH kaphasambhavam| <br />
<br />
dIrghakAlasthitaM granthiM bhindyAdvA bheShajairimaiH||127|| <br />
<br />
mUlakAnAM kulatthAnAM yUShaiH sakShAradADimaiH| <br />
<br />
godhUmAnnairyavAnnairvA sasIdhumadhusharkaraiH||128|| <br />
<br />
sakShaudrairvAruNImaNDairmAtulu~ggarasAnvitaiH| <br />
<br />
triphalAyAH prayōgaishca pippalIkShaudrasaMyutaiH||129|| <br />
<br />
mustābhallAtashaktUnAM prayōgairmAkShikasya ca| <br />
<br />
devadAruguDUcyoshca prayōgairgirijasya ca||130|| <br />
<br />
dhUmairvirekaiH shirasaH pUrvoktairgulmabhedanaiH| <br />
<br />
ayolavaNapAShANahematAmraprapIDanaiH||131|| <br />
<br />
AbhiH kriyAbhiH siddhAbhirvividhAbhirbalI sthiraH| <br />
<br />
granthiH pAShANakaThino yadA naivopashAmyati||132|| <br />
<br />
athAsya dAhaH kShAreNa sharairhemnA~atha [3] vA hitaH| <br />
<br />
pAkibhiH pAcayitvA vA pATayitvA samuddharet||133|| <br />
<br />
mokShayedbahushashcAsya raktamutkleshamAgatam| <br />
<br />
punashcApahRute [4] rakte vātashleShmajidauShadham||134|| <br />
<br />
dhUmo virekaH shirasaH svedanaM parimardanam| <br />
<br />
aprashAmyati doShe ca pAcanaM [5] vA prashasyate||135|| <br />
<br />
praklinnaM dAhapAkAbhyAM bhiShak sōdhanaropaNaiH| <br />
<br />
bAhyaishcAbhyantaraishcaiva vraNavat samupAcaret||136|| <br />
<br />
kampillakaM viDa~ggAni dArvIM kAra~jjakaM phalam| <br />
<br />
piShTvA tailaM vipaktavyaM granthivraNacikitsitam||137|| <br />
<br />
dvivraNIyopadiShTena karmaNA cApyupAcaret| <br />
<br />
deshakAlavibhAgaj~jo vraNAn vIsarpajAn budhaH||138|| <br />
<br />
iti granthivisarpacikitsA| <br />
</div></div><br />
<br />
The ''granthi visarpa'', on inspection is predominant in [[rakta]] [[pitta]]; the physician experienced in timely management should treat the case with [[rukshana]] (de-oleation), [[langhana]] (lightening therapy), ''seka'' (affusion), and ''pradeha'' (external application) of ''panchavalka, siramoksha'' (blood letting), ''jalauka'' (leech therapy), [[vamana]] (emesis therapy), [[virechana]] (purgation therapy) and ''kashaya- tikta'' (astringent and bitter) ghee preparations. <br />
<br />
After cleansing of body by [[vamana]] and [[virechana]], [[rakta]] mokshana should be administered and the measures alleviating [[vata]]-[[kapha]] are beneficial.<br />
<br />
When there is pain in ''granthi visarpa, upanaha'' (hot poultice) of warm and unctuous ''utkarika'' (medicinal pancake) or ''vesavara'' (medicated meat) application on the affected part is beneficial.<br />
<br />
The warm oil prepared from ''dashamoola'' (roots of ten plants) should be sprinkled on the affected part. Warm ''kustha'' (costus) oil added with ''pakya kshara'' (prepared medicinal alkali) or warm cow’s urine or decoction of [[vata]] [[kapha]]hara leaves should be used as affusion on the affected part.<br />
<br />
The warm paste of ''ashvagandha'' (Withania somnifera) should be applied as ''pradeha'' on the affected part. <br />
<br />
The warm paste of dried ''mulaka'' (Raphanus sativus) or bark of ''naktamala'' (Pongamia pinnata) or bark of ''bibhitaka'' (Terminalia bellirica) should be applied externally as a ''lepa'' on the affected part. ''Bala'' (Sida cordifolia Linn), ''nagabala'' (Grewia hirsuta), ''pathya'' (Terminalia chebula), ''bhurjagranthi'' (betula bhojpatra), ''bibhitaka'' (Terminalia bellirica), ''vamsha'' leaves (bambusa vulgaris) and ''agnimantha'' (Premna mucronata) should be applied as ''pralepa'' on ''granthi''.<br />
<br />
''Danti'' (Baliospermum montanum), bark of ''chitraka'' root (Plumbago zeylanica Linn), latex of ''snuhi'' (Euphoria nerrifolia) and ''arka'' (Calatropis gigantean), jaggery, seed of ''bhallataka'' (Semecarpus anacardium linn) and ''kasisa'' (green vitriol) application as a ''lepa'' breaks even a stone, then what to speak of the nodules caused by [[kapha]] and situated in external regions of body. Long standing ''granthi'' should be broken by the use of the internal medications such as ''Yusha'' of ''mulaka'' (Raphanus sativus) and ''kullatha'' (Macrotyloma uniflorum.) added with ''kshara'' (prepared alkali) and ''dadima'' (Punica granatum), food prepared from ''godhum'' and ''yava'' with ''sidhu'', honey and sugar, ''varuni'' scum with honey and ''matulung'' juice (Citrus medica), use of ''triphala'' with ''pippali'' (Piper longum linn) and honey, ''musta'' (Cyperus rotundus linn) or ''bhallataka saktu'' (Semecarpus anacardium linn) and honey, ''devadaru'' (Cedrus deodara), ''guduchi'' (Tinospora cordifolia) and ''girija'' (Asphaltum punjabianum).<br />
<br />
''Dhuma, shirovirechana,'' measures described to break the ''gulma'' in [[Gulma Chikitsa]] chapter, as well as iron, salt, stone, gold and copper should be used for ''prapidana'' (compression) of ''granthi''.<br />
<br />
If ''granthi'' is strong, firm and stony hard and not responding to all these proven methods of treatment then it is better to be cauterized with ''kshara'' (medicinal alkali) or hot metal arrow or hot gold or after making it suppurate by applying suitable suppurative medications one should open and extract. <br />
<br />
Besides, vitiated blood should be eliminated, frequently followed administration of [[vata]] and [[kapha]] pacifying medicines, ''dhuma'' (fumigation therapy), ''shirovechana'' (errhine therapy), [[swedana]](sudation) and ''parimardana'' (pressure method). If [[dosha]] do not pacify, [[pachana]] (suppuration) treatment is beneficial. When the ''granthi'' is decomposed with ''agni'' and suppuration then physician should treat it with external and internal ''shodhana'' (cleansing) and ''ropana'' (healing) as described in ''Vrana Chikitsa''.<br />
<br />
''Kampillaka'' (Mallotus philippinensis), ''vidanga'' (Embelia ribes Burm), ''daruharidra'' (Berberis aristata) and ''karanja'' fruit (Pongamia pinnata), the paste of all these drugs should be used to prepare oil which is indicated in the treatment of ''granthi vrina''.<br />
<br />
The intelligent physician may also treat the ''visarpa'' as per the guidelines described in [[Dwivraniya Chikitsa]] chapter.<br />
<br />
Thus ends the description of the treatment of ''granthi visarpa''.[118-138]<br />
<br />
=== Treatment of ''galaganda'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
य एव विधिरुद्दिष्टो ग्रन्थीनां विनिवृत्तये | <br />
<br />
स एव गलगण्डानां कफजानां निवृत्तये ||१३९|| <br />
<br />
गलगण्डास्तु वातोत्था ये कफानुगता नृणाम् | <br />
<br />
घृतक्षीरकषायाणामभ्यासान्न भवन्ति ते ||१४०|| <br />
<div class="mw-collapsible-content"><br />
<br />
ya ēva vidhiruddiṣṭō granthīnāṁ vinivr̥ttayē| <br />
<br />
sa ēva galagaṇḍānāṁ kaphajānāṁ nivr̥ttayē||139|| <br />
<br />
galagaṇḍāstu vātōtthā yē kaphānugatā [1] nr̥ṇām| <br />
<br />
ghr̥takṣīrakaṣāyāṇāmabhyāsānna bhavanti tē||140|| <br />
<br />
ya eva vidhiruddiShTo granthInAM vinivRuttaye| <br />
<br />
sa eva galagaNDAnAM kaphajAnAM nivRuttaye||139|| <br />
<br />
galagaNDAstu vAtotthA ye kaphAnugatA [1] nRuNAm| <br />
<br />
ghRutakShIrakaShAyANAmabhyAsAnna bhavanti te||140|| <br />
</div></div><br />
<br />
The line of treatment of ''granthi'' should be applied for the treatment of [[kapha]]ja galganda''. <br />
<br />
The ''vatika galaganda'' associated with [[kapha]] may be cured by regular use of ghee, milk and decoction preparations.[139-140]<br />
<br />
=== Importance of ''raktamokshana'' in ''visarpa'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
यानीहोक्तानि कर्माणि विसर्पाणां निवृत्तये | <br />
<br />
एकतस्तानि सर्वाणि रक्तमोक्षणमेकतः ||१४१|| <br />
<br />
विसर्पो न ह्यसंसृष्टो रक्तपित्तेन जायते | <br />
<br />
तस्मात् साधारणं सर्वमुक्तमेतच्चिकित्सितम् ||१४२|| <br />
<br />
विशेषो दोषवैषम्यान्न च नोक्तः समासतः | <br />
<br />
समासव्यासनिर्दिष्टां क्रियां विद्वानुपाचरेत् ||१४३||<br />
<div class="mw-collapsible-content"><br />
<br />
yānīhōktāni karmāṇi visarpāṇāṁ nivr̥ttayē| <br />
<br />
ēkatastāni sarvāṇi raktamōkṣaṇamēkataḥ||141|| <br />
<br />
visarpō na hyasaṁsr̥ṣṭō raktapittēna jāyatē| <br />
<br />
tasmāt sādhāraṇaṁ sarvamuktamētaccikitsitam||142|| <br />
<br />
viśēṣō dōṣavaiṣamyānna ca nōktaḥ samāsataḥ| <br />
<br />
samāsavyāsanirdiṣṭāṁ [1] kriyāṁ vidvānupācarēt||143|| <br />
<br />
yAnIhoktAni karmANi visarpANAM nivRuttaye| <br />
<br />
ekatastAni sarvANi raktamokShaNamekataH||141|| <br />
<br />
visarpo na hyasaMsRuShTo raktapittena jAyate| <br />
<br />
tasmAt sAdhAraNaM sarvamuktametaccikitsitam||142||<br />
<br />
visheSho dōṣavaiShamyAnna ca noktaH samAsataH| <br />
<br />
samAsavyAsanirdiShTAM [1] kriyAM vidvAnupAcaret||143|| <br />
</div></div><br />
<br />
If all the therapeutic measures described here as curative of ''visarpa'' be put on one side and ''raktamokshana'' on other, they will be found equal. <br />
<br />
''Visarpa'' never occurs without the association of the [[rakta]] and [[pitta]] hence entirely general treatment has been described. It does not mean that line of treatment as per other [[dosha]] predominance is not explained here. Thus, the therapeutic measures both in general and specific cases are described both in brief and in detail. The expert physician should administer these therapies appropriately.[141-143]<br />
<br />
=== Summary ===<br />
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<br />
तत्र श्लोकाः- <br />
<br />
निरुक्तं नामभेदाश्च दोषा दूष्याणि हेतवः | <br />
<br />
आश्रयो मार्गतश्चैव विसर्पगुरुलाघवम् ||१४४|| <br />
<br />
लिङ्गान्युपद्रवा ये च यल्लक्षण उपद्रवः | <br />
<br />
साध्यत्वं, न च, साध्यानां साधनं च यथाक्रमम् ||१४५|| <br />
<br />
इति पिप्रक्षवे सिद्धिमग्निवेशाय धीमते | <br />
<br />
पुनर्वसुरुवाचेदं विसर्पाणां चिकित्सितम् ||१४६||<br />
<div class="mw-collapsible-content"><br />
<br />
tatra ślōkāḥ- <br />
<br />
niruktaṁ nāmabhēdāśca dōṣā dūṣyāṇi hētavaḥ| <br />
<br />
āśrayō mārgataścaiva visarpagurulāghavam||144|| <br />
<br />
liṅgānyupadravā yē ca yallakṣaṇa upadravaḥ| <br />
<br />
sādhyatvaṁ, na ca, sādhyānāṁ sādhanaṁ ca yathākramam||145|| <br />
<br />
iti piprakṣavē siddhimagnivēśāya dhīmatē| <br />
<br />
punarvasuruvācēdaṁ visarpāṇāṁ cikitsitam||146|| <br />
<br />
tatra shlokAH- <br />
<br />
niruktaM nAmabhedAshca dōṣa dUShyANi hetavaH| <br />
<br />
Ashrayo mArgatashcaiva visarpagurulAghavam||144|| <br />
<br />
li~ggAnyupadravA ye ca yallakShaNa upadravaH| <br />
<br />
sAdhyatvaM, na ca, sAdhyAnAM sAdhanaM ca yathAkramam||145|| <br />
<br />
iti piprakShave siddhimagniveshAya dhImate| <br />
<br />
punarvasuruvAcedaM visarpANAM cikitsitam||146||<br />
</div></div><br />
<br />
Now the summing up verses –<br />
<br />
Derivation,synonyms, classification, [[dosha]], dushya, etiology, the habitat, the severe and mild gradation, symptoms and signs, complications, the nature of complications, prognosis and treatment of curable ones. All these aspects has been explained by Punarvasu Atreya for the inquisitive and intelligent Agnivesha under the treatment of ''visarpa''. [144-146]<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते चिकित्सास्थाने <br />
<br />
विसर्पचिकित्सितं नामैकविंशोऽध्यायः ||२१||<br />
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<br />
ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē cikitsāsthānē <br />
<br />
visarpacikitsitaṁ nāmaikaviṁśō'dhyāyaḥ||21|| <br />
<br />
ityagniveshakRute tantre carakapratisaMskRute cikitsAsthAne <br />
<br />
visarpacikitsitaM nAmaikaviMsho~adhyAyaH||21|| <br />
</div></div><br />
<br />
Thus ends the twenty first chapter on treatment of ''visarpa'' in [[Chikitsa Sthana]] in the treatise composed by Agnivesha and redacted by Charak.[21]<br />
<br />
== Tattva Vimarsha (Fundamental Principles) == <br />
<br />
*Seven elements are involved in the pathogenesis of ''visarpa'' viz., [[rakta]], lasika, tvak, [[mamsa dhatu]], [[vata]], [[pitta]] and [[kapha]]. <br />
*''Visarpa'' is acute spreading disease and fatal in nature. General etiological factors of ''visarpa'' are diet and life style related, injury, poisons, toxins, burns etc., some of these cause vitiation of [[dosha]] and ''khavaigunya'' (disease prone condition) in [[dhatu]] and some cause direct vitiation of [[dosha]] and [[dhatu]] leading to ''visarpa''. Hence favorable condition for infection or disease phenomenon occurs at first therefore, diet and lifestyle related factors are important preventive measures.<br />
*Excess intake of salt, sour, pungent, hot articles lead to vitiation of [[rakta]] first and then lead to ''visarpa''. <br />
*''Visarpa'' is manifested externally, internally or in both pathways. Severity of disease increases respectively in these cases. <br />
*Classification and pathogenesis of ''visarpa'' is based upon involvement of [[dosha]] as per their severity. Treatment protocol is designed for primarily involved predominant [[dosha]]. If the ''visarpa'' is caused with ama dosha (the state of incomplete transformation) and is located in ''kaphasthana'' (in thorax and upper body parts), then [[langhana]] (fasting therapy), [[vamana]] (emesis) therapy, ''tikta'' (bitter) drugs internally and application of paste of drugs with dry and cold properties externally is beneficial. <br />
*The same treatment should be adopted in case of association of ''ama'' and location in [[pitta]] sthana (abdomen and middle parts of body). In addition, ''raktamokshana'' (blood letting) and [[virechana]] (therapeutic purgation therapy) are specially indicated. <br />
*If ''sama'' (with ''ama dosha'') ''visarpa'' occurs from ''vatashaya'' (pelvis and lower part of body) dry measures are indicated in the beginning. Even in association with [[rakta]]-[[pitta]], unction measure is not regarded as beneficial in the beginning. <br />
*In [[vata]]ja visarpa and ''paittika visarpa'' of mild aggravated [[dosha]], tiktaka ghritam'' is beneficial. But if the [[pitta]] [[dosha]] is excessively aggravated then [[virechana]] should be given. <br />
*In the condition of excessively aggravated [[dosha]], ghee should not be given at first, which does not cause [[virechana]]. Because non purgating ghee occlude the [[dosha]] resulting in decomposed skin, flesh and blood. Hence in ''visarpa, virechana'' followed by ''raktamokshana'' is recommended because the disorder is located in blood.<br />
*If [[dosha]] in ''shakha'' (body elements) vitiate the blood, then [[rakta]]mokshana should be administered first. The physician should use ''vishana'' (deer horn) in [[vata]] dominance, ''jalauka'' (Hirudinea medicinalis) in [[pitta]] dominance and ''alabu'' (lagenaria siceraria) in [[kapha]] dominance for blood letting or physician should perform ''siravyadha'' (blood letting through vein) promptly from the adjacent vein to the affected part, without which ''rakta kleda'' (putrifying blood content) gives rise to decomposed skin, flesh and ligaments.<br />
*External application in the form of ''pralepa, pradeha'' and ''alepana'' (local applications of pastes) are to be used repeatedly for treatment of external lesions in ''visarpa''. The guidelines shall be followed for local applications. <br />
*Diet articles with sweet, bitter, cooling and blood pacifying properties is prescribed in the treatment of ''visarpa''.<br />
*''Vidahi'' (that causes burning) and ''viruddha'' (mutually contradictory or incompatible) diet, day sleep, anger, exercise, exposure to sun heat, fire and fast winds are contraindicated in ''visarpa''.<br />
*Predominantly ''shita'' (cool) measures are prescribed in [[pitta]] dominant condition, ''ruksha'' in [[kapha]] dominant condition and ''snigdha'' in [[vata]] dominant condition of ''visarpa''. In ''agni visarpa, [[vata]]-[[pitta]] pacifying measures are beneficial and in ''kardama visarpa'' mostly [[kapha]] [[pitta]] alleviating measures should be administered.<br />
*The ''granthi visarpa'', on inspection is predominant in [[rakta]] [[pitta]], the physician experienced in timely management should treat the case with [[rukshana]] (de-oleation), [[langhana]] (lightening therapy), ''seka'' (affusion), and ''pradeha'' (external application) of ''panchavalka, siramoksha'' (blood letting), ''jalauka'' (leech therapy), [[vamana]] (emesis therapy), [[virechana]] (purgation therapy) and ''kashaya- tikta'' (astringent and bitter) ghee preparations. After cleansing of body by [[vamana]] and [[virechana]], [[rakta]] mokshana should be administered and the measures alleviating [[vata]]-[[kapha]] are beneficial.<br />
*The same line of treatment of ''granthi'' should be applied for the treatment of [[kapha]]ja galganda''. The ''vatika galaganda'' associated with [[kapha]] may be cured by regular use of ghee, milk and decoction preparations.<br />
<br />
== Vidhi Vimarsha (Applied Inferences ) ==<br />
<br />
=== Causative factors of ''visarpa'' in contemporary era ===<br />
<br />
Modern point of view ''visarpa'' is generally caused by a variety of infections. As per Punarvasu Atreya, the general etiological factors of ''visarpa'' are diet and lifestyle, injury, poisons, toxins, burns etc; some of these cause vitiation of [[dosha]] and ''khavaigunya'' (disease prone condition) in [[dhatu]] and some cause direct vitiation of [[dosha]] and [[dhatu]] leading to ''visarpa''. This is confusing to the new scholars. Atreya's understanding of etiology is more specific because favorable condition for infection occurs at first then infection therefore diet and lifestyle related factors are described in detail and in the beginning. In treatment plan this concept of favorable environment should be considered. Change in internal body environment is possible by ''shodhana'' therapy and ''aushadha'' along with treatment of infection. <br />
<br />
=== Pathophysiology of ''Visarpa'' [flow chart] ===<br />
<br />
[[File:Visarpa1.png]]<br />
<br />
<br />
=== Common clinical conditions considered under ''visarpa'' ===<br />
<br />
''Visarpa'' is acute and extensive spreading in nature. As ''kushtha'' is chronic in nature and ''visarpa'' is acute therefore spreading ''kushtha'' should not be interpreted as visarpa. It is observed that ''visarpa'' interpretation to allopath disorders is very confusing to the scholars. It is difficult to label ''visarpa'' as a single entity. For proper interpretation, experienced intelligent expert in emergency treatments is required and diagnostic research in this direction is challenge to the researchers.<br />
<br />
Clinical manifestation of ''vatika visarpa'' suggests ''bahih-srita visarpa'' and generally observed in acute skin infections (erysipelas etc.) and is curable with prompt management. <br />
<br />
''Paittika visarpa'' symptoms are suggestive of severe skin disease (erysipelas, extensive herpes, burns etc.) and are curable with appropriate management. <br />
<br />
[[Kapha]]ja visarpa appears as progressively but gradually spreading ailment, suggestive of acute skin infection (erysipelas etc.) and is curable. <br />
<br />
''Agni visarpa'' is a serious infection of skin and lead to septicemia like condition. ''Agnivisarpa'' with the signs and symptoms described here is a serious ailment and is incurable. This ailment may be cured if vitals are not involved. <br />
<br />
The name ''kardam visarpa'' is because the affected part appears like ''kardam'' (mud). The clinical picture of ''kardam'' described here is serious skin infection, necrotizing the adjacent structures (Necrotizing Fasciitis, gangrene etc.) and is incurable. The curable variant should be considered ''agnivisarpa''. <br />
<br />
''Granthi visarpa'' is a serious ailment (B cell lymphoma etc.) and associated with complications is incurable. <br />
<br />
''Sannipatik visarpa'' is a very serious manifestation of ''visarpa'' and is ''ubhaya-samsrita''. This is like a very serious manifestation of sepsis and is not treatable. <br />
<br />
=== Current clinical practices in management of ''visarpa'' ===<br />
<br />
==== Experience based ====<br />
<br />
Prognostic assessment of disease is very important while treating acute disorders. Majority of ''visarpa'' cases are having bad prognosis as per experience of Punarvasu Atreya. Even though some cases of curable ''bahihsrita visarpa'' may become incurable and fatal if not treated early and promptly. Quick diagnosis of life threatening conditions and prompt life saving management in intensive care unit is required in ''visarpa'' disorder.<br />
<br />
It is already stated that there are serious diseases which are curable but they cause death if not treated. ''Agni'' and kardam ''visarpa'' are curable only by the most effective therapeutic measures. ''Antahsrita'' and ''ubhaysamsrita visarpa'' are incurable or sometimes may be cured by most experienced, intelligent physician with most appropriate timely approach in intensive care unit. ''Bahihsrita'' curable ''visarpa'' may convert into ''ubhayasamsrita'' if not treated appropriately. <br />
<br />
''Shodhana'' and ''shamana'' therapy is described for curable ''visarpa'' and maximum ''visarpa'' cases are incurable. This is challenge to the researchers to apply ''shodhana'' and ''shamana'' therapy in incurable emergency cases along with life saving management to cure the incurable ones.<br />
<br />
==== Evidence based studies ====<br />
<br />
''Visarpa'' is acute and fatal in nature and maximum [[Ayurveda]] hospitals have limited facilities for emergency managements. Some of clinicians are treating self limiting minor cases of herpes as a ''visarpa'' following the treatment of [[pitta]]ja visarpa. A case study on effect of Ayurvedic management in oro-facial herpes was conducted. The diagnosed case of oro-facial herpes in 72-year-old male patient was treated with medicines of bitter taste (tikta rasa) internally, diet regimen, anulomana variety of therapeutic purgation (virechana) and topical application of cold (sheeta)-dry(ruksha) medicines(lepa). The case is observed symptom free after a total period of 164 days.<ref>Mutnali K, Roopa BJ, Shivaprasad T, Yadav R. Ayurveda management of oro-facial herpes: a case report. J Ayurveda Integr Med. 2020 Jul-Sep;11(3):357-359. doi: 10.1016/j.jaim.2020.06.003. Epub 2020 Aug 4. PMID: 32768346; PMCID: PMC7527852.</ref><br />
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=== Researches done on ''visarpa'' ===<br />
<br />
Considerable research work is not carried out on ''visarpa'' by [[Ayurveda]] researchers. This is due to acute and fatal nature of this disease and [[Ayurveda]] research centers are not well equipped for emergency managements. Hence it is necessary to work in the direction to treat such incurable fatal condition. Initially research work on this disease may be carried out in collaboration with well equipped intensive care unit and experts in emergency managements. Researchers may work by combining algorithmic [[Ayurveda]] treatment with allopath. Incurable and fatal cases of ''visarpa'' experienced by Punarvasu Atreya may be cured with early appropriate management in intensive care unit due to advances in drug research and technology. <br />
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=== Further reading ===<br />
<br />
#Charak, Chikitsa Sthana, chap 21 Visarpa Chikitsa Adhyaya. In:Vaidya Yadavaji Trikamji Aacharya, Editor, Charak samhita, 2nd edition, Varanasi;Chaukhamba Sanskrit Sansthan,1990;228.<br />
#Chakrapani,Charak,Chikitsa Sthana, Chap 21 Visarpa Chikitsa Adhyaya, 2nd edition,Varanasi; Chaukhamba Sanskrit Sansthan, 1990; 225.<br />
#Charak,Cikitsa Sthana,Chap 21 Visarpa Cikitsitam. In: Pt. Dutta R, editor. Charak Samhita, 2nd ed., 2003 reprint, Varanasi: Chaukhambha Bharti Academy; 2003. p. 231. <br />
#Charak,Chikitsa Sthana, Chap 21 Visarpa Chikitsa Adhyaya,In:Kashiram Shastri and Gorakhnath Chaturvedi, editors. Charak Samhita,(Hindi traslation) Part II. Varanasi: Chaukhambha Bharati Academy; Reprint 2005. p. 235. <br />
#Charak, Chikitsa Sthana, Visarpa Cikitsitam,21, In: Vd. Khushvaha HS,editors,Charak Samhita Ayushi hindi commentary, 1 st edition, Chaukhambha Orientalia Publisher, Varanasi, 2009;224. <br />
#Chakrapani, Charak, Cikitsa Sthana, Chap 21 Visarpa Cikitsitam. In: Vd. Yadavaji T. A.,Editor, Charak Samhita, 1 st edition, Varanasi;Chaukhambha Orientalia Publications, 2001;227. <br />
#Sushruta. Cikitsa Sthana, 17. Visarpanadisthanaroga Chikitsitam Adhyaya In: Vaidya Yadavji Trikamji Acharaya, Narayan Ram Acharaya, editors. Sushruta Samhita,?ed, Varanasi: Chaukhambha Orientalia; 2007. p. 321. <br />
#Susruta, Nidana sthana,cha 10, Visarpanadisthanaroga Nidana In:Kaviraj Ambikadutt Shastri,editor, Sushruta Samhita, 11 th ed. Varanasi: Chaukhambha Sanskrit Sansthan; 1998. p. 129. <br />
#Vagbhata, Ashtanga Sangraha, Cikitsa Sthana, 20,Visarpa chikitsitam Adhyaya. translated to English by Prof. Murthy KR, 9 th edition,Varanasi; Chaukhambha Orientalia Publisher,2005;229. <br />
#Vagbhata, Ashtanga Sangraha, Nidana Sthana, 13, Pandurogakamalasophavisarpa Nidanam Adhyaya. translated to English by Prof. Murthy KR, 9 th edition, Varanasi,Chaukhambha Orientalia Publisher, 2005; 229. <br />
#Vagbhata, Ashtanga Hridyam ,Cikitsa Sthana,18. Visarpa chikitsitam Adhyaya .Translated to English by Prof. K.R. Shrikanth Murthy, 7 th ed., Vol. 1. Varanasi: Chaukhambha Krishnadas Academy; 2010. p. 221. <br />
#Vagbhata,Ashtanga Hridyam , Nidana Sthana, Chap 13 Pandurogasophavisarpa Nidana.Translated by Prof. K.R. Shrikanth Murthy, 7 th ed., Vol. 1. Varanasi: Chaukhambha Krishnadas Academy; 2010. p. 221. </div><br />
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[[#top| Back to the Top ]]</span></div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Chhardi_Chikitsa&diff=45388Chhardi Chikitsa2025-11-17T07:02:25Z<p>Agnivesha: /* Bad prognostic symptoms */</p>
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{{#seo:<br />
|title=Chhardi Chikitsa<br />
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|keywords=atisara, diarrhea, ama, nirama, sangrahi treatment, pichcha basti,Ayurveda, Indian system of medicine, charak samhita. <br />
|description=Chikitsa Sthana Chapter 20. Management of Chhardi (vomiting)<br />
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg<br />
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<big>'''[[Chikitsa Sthana]] Chapter 20. Management of Chhardi (vomiting) </big>'''<br />
{{Infobox<br />
|title = Chhardi Chikitsa<br />
|label1 = Section/Chapter<br />
|data1 = [[Chikitsa Sthana]] Chapter 20<br />
|label2 = Preceding Chapter<br />
|data2 = [[Atisara Chikitsa]]<br />
<br />
|label3= Succeeding Chapter<br />
|data3 = [[Visarpa Chikitsa]]<br />
|label5 = Other Sections<br />
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br />
|label6 = Translator and commentator<br />
|data6 = Murthy A.R.V., Jani D.<br />
|label7 = Reviewer <br />
|data7 = Prasad B.S.<br />
|label8 = Editors<br />
|data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br />
|label9 = Year of publication <br />
|data9 = 2020<br />
|label10 = Publisher <br />
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label11 = DOI <br />
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.021 10.47468/CSNE.2020.e01.s06.021]<br />
}}<br />
<br />
<big>'''Abstract </big>'''<br />
<p style='text-align:justify;'>''Chhardi'' (vomiting), is a common gastrointestinal disorder characterized by bouts of vomiting, nausea, pain and black outs. The causative factors of ''chhardi'' can be categorized under dietary, lifestyle and psychological factors. Dietary factors include excessive ''upavasa'' (starvation), over intake of ''vidahi'' or ''snigdha-guru dravya'' (drugs which are very acrid, unctuous and heavy to digest), etc. Lifestyle aspects include excessive exercise, ''divasvapna'' (day sleep), etc. whereas the psychological stressors like excess worries, grief, anger, fear can precipitate it. ''Amashaya'' (stomach) and ''rasayani'' (channels) are the sites of origin of ''chhardi''. Vitiated [[dosha]] accumulate in ''amashaya'' and ''rasayani'' and are thrown out forcefully from the upper part of body causing ''pida'' (pain) to ''urdhva avayavas'' (organs situated above supraclavicular region). Comprehensive management includes avoidance of etiological factors with pharmacological treatment through medicament as well as non-pharmacological methods. <br />
</p><br />
'''Keywords''': ''Chhardi chikitsa, chhardi,'' vomiting, emesis<br />
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== Introduction ==<br />
<div style="text-align:justify;"><br />
After explaining the [[Atisara Chikitsa]] (treatment of diarrhea), there is a description of [[Chhardi Chikitsa]]. The word ''chhardi'' is derived from the root ''chhard vamane''. The word ''chhad'' means gripping (''avritta'' or ''achhadana'') and ''ard'' means pain (''peedha'')<ref>Madhavakara. Chardi praarana verse 15, In:Shastri Suderashan,editor, Madhava Nidanam (Roga vinischaya). 4th ed. Varanasi: Chaukhamba Sanskrit Series,1975.pp--</ref>. The other words like ''chhardah, chhardana, chhardi, chhardika,'' etc. are considered as the synonyms of ''chhardi''.<ref>Charak. Chikitsa Sthana, Cha.20 Chhardi Chikitsa Adhyaya. In: Bramhanand Tripathi Editor. Charak Samhita.,? ed. Varanasi: Chaukhamba Sanskrit Pratisthan,2015. p.?.</ref> The words ''chhardi'' and [[vamana]], both are used in the sense of vomiting but have basic differences. ''Chhardi'' is a pathological condition where the sufferer is exposed to particular predisposing factors for vomiting and as a result, suffers from the particular condition called ''chhardi''. On the other hand [[vamana]] is one of the purification therapies of [[Panchakarma]] (five purification procedures in [[Ayurveda]]) where the physician intends to induce vomiting to expel out vitiated [[kapha]] and [[pitta]]. In general, the vitiated [[dosha]] accumulate in stomach and are thrown out from the body through various channels. There are two major channels from which the body generally does such excretory mechanism.<ref>Sushruta. Sharira Sthana, Cha.5 Shareerasankhyavyakarana Sharira Adhyaya verse 10. In: Kaviraj Shastri Ambika Dutt, Editors. Sushruta Samhita. 5th ed. Varanasi: Chaukhamba Sanskrit Series,1982. p.?.</ref> The one is adhomārga (excretion through downward channel) for which the description of ''atisara'' is given in previous chapter and the other one is ''urdhvabhaga'' (excretion through the upward channel) where the description of ''chhardi'' is discussed here. ''Chhardi'' comes under the category of ''koshtha rasayani shrita vyadhi'' (diseases of GI tract) whose roots are in ''mahasrotas'' (GI tract) and ''manovaha'' (mind) ''srotasa''. The ''amashaya'' and ''rasayani'' are the involved ''avayavas'' (organs) in this disease.<ref>Chakrapani, Charak. Vimana Sthana, Cha.5 Srotovimna Adhyaya ver.7-3. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.1st ed. Varanasi: Krishnadas Academy;2000.p.4</ref> The management of this disease is by the pharmacological treatment through various herbs/combinations, dietary modifications and psychological counseling. The preventive aspect includes avoidance of causative factors and enhancement in psychological strength to specific items/factors.<ref>Chakrapani, Charak. Vimana Sthana, Cha.5 Srotovimna Adhyaya ver.25. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.1st ed. Varanasi: Krishnadas Academy;2000.p.4</ref> The curative treatment focuses on pharmacotherapy depending upon [[dosha]] dominance and mild ''samshodhana'' (expelling out the vitiated [[dosha]]).<br />
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== Sanskrit Text, Transliteration and English Translation ==<br />
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अथातश्छर्दिचिकित्सितं व्याख्यास्यामः||१|| <br />
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इति ह स्माह भगवानात्रेयः||२||<br />
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athātaśchardicikitsitaṁ vyākhyāsyāmaḥ||1|| <br />
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iti ha smāha bhagavānātrēyaḥ||2|| <br />
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athAtashchardicikitsitaM vyAkhyAsyAmaH||1|| <br />
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iti ha smAha bhagavAnAtreyaH||2||<br />
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Now we shall expound the chapter "Chhardi chikitsa" (Management of vomiting). Thus said Lord Atreya. [1-2]<br />
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यशस्विनं ब्रह्मतपोद्युतिभ्यां ज्वलन्तमग्न्यर्कसमप्रभावम्| <br />
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पुनर्वसुं भूतहिते निविष्टं पप्रच्छ शिष्योऽत्रिजमग्निवेशः||३|| <br />
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yaśasvinaṁ brahmatapōdyutibhyāṁ jvalantamagnyarkasamaprabhāvam| <br />
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punarvasuṁ bhūtahitē niviṣṭaṁ papraccha śiṣyō'trijamagnivēśaḥ||3||<br />
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yashasvinaM brahmatapodyutibhyAM jvalantamagnyarkasamaprabhAvam| <br />
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punarvasuM bhUtahite niviShTaM papraccha shiShyo~atrijamagniveshaH||3||<br />
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Agnivesha the disciple asked Punarvasu, the illustratious son of Atri, who was engrossed in the thinking of the well-being of humanity and who was dazzling with luster of divine knowledge and penance, who was endowed with the brilliance like that of fire and the sun, and who was dedicated to the well-being of all living beings [3]<br />
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=== Queries by Agnivesha ===<br />
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याश्छर्दयः पञ्च पुरा त्वयोक्ता रोगाधिकारे भिषजां वरिष्ठ!| <br />
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तासां चिकित्सां सनिदानलिङ्गां यथावदाचक्ष्व नृणां हितार्थम्||४|| <br />
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तदग्निवेशस्य वचो निशम्य प्रीतो भिषक्श्रेष्ठ इदं जगाद| <br />
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याश्छर्दयः पञ्च पुरा मयोक्तास्ता विस्तरेण ब्रुवतो निबोध||५||<br />
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yāśchardayaḥ pañca purā tvayōktā rōgādhikārē bhiṣajāṁ variṣṭha!|<br />
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tāsāṁ cikitsāṁ sanidānaliṅgāṁ yathāvadācakṣva nr̥ṇāṁ hitārtham||4|| <br />
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tadagnivēśasya vacō niśamya prītō bhiṣakśrēṣṭha idaṁ jagāda| <br />
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yāśchardayaḥ pañca purā mayōktāstā vistarēṇa bruvatō nibōdha||5||<br />
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yAshchardayaH pa~jca purA tvayoktA rogAdhikAre bhiShajAM variShTha!| <br />
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tAsAM cikitsAM sanidAnali~ggAM yathAvadAcakShva nRuNAM hitArtham||4||<br />
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tadagniveshasya vaco nishamya prIto bhiShakshreShTha idaM jagAda| <br />
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yAshchardayaH pa~jca purA mayoktAstA vistareNa bruvato nibodha||5|| <br />
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Oh! Revered Physician, please describe the treatment of the five types of ''chhardi'' (vomiting) mentioned by you earlier in the context of the enumeration of diseases (in Sutra 19:3-4) along with their etiology, signs and symptoms comprehensively, for the sake of well-being of humanity.<br />
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Having heard Agnivesha and being pleased the best among physicians Punarvasu Atreya said “I shall now expound all the five types of vomiting (briefly) stated earlier, in greater details. Listen to me." [4-5]<br />
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=== Classification and premonitory symptoms ===<br />
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दोषैः पृथक्त्रिप्रभवाश्चतस्रो [१] द्बिष्टार्थयोगादपि पञ्चमी स्यात्| <br />
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तासां हृदुत्क्लेशकफप्रसेकौ द्वेषोऽशने चैव हि पूर्वरूपम्||६| <br />
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dōṣaiḥ pr̥thaktriprabhavāścatasrō dbiṣṭārthayōgādapi pañcamī syāt|<br />
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tāsāṁ hr̥dutklēśakaphaprasēkau dvēṣō'śanē caiva hi pūrvarūpam||6||<br />
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doShaiH pRuthaktriprabhavAshcatasro [1] dbiShTArthayogAdapi pa~jcamI syAt|6| <br />
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tAsAM hRudutkleshakaphaprasekau dveSho~ashane caiva hi pUrvarUpam||6|| <br />
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''Chhardi'' (vomiting) is of five types; three types of vomiting caused by a [[dosha]] each i.e. vatika, paittika, [[kapha]]ja, fourth is ''sannipatika'' and fifth is ''dvistartha-yogaja-chhardi'' (that results from contact with unpleasant sense objects).<br />
The premonitory signs and symptoms of ''chhardi'' (vomiting) are nausea, excessive salivation and aversion to food [6]<br />
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=== [[Vata]]ja chhardi ===<br />
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व्यायामतीक्ष्णौषधशोकरोगभयोपवासाद्यतिकर्शितस्य| <br />
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वायुर्महास्रोतसि सम्प्रवृद्ध उत्क्लेश्य दोषांस्तत ऊर्ध्वमस्यन्||७|| <br />
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आमाशयोत्क्लेशकृतां च मर्म प्रपीडयंश्छर्दिमुदीरयेत्तु| <br />
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हृत्पार्श्वपीडामुखशोषमूर्धनाभ्यर्तिकासस्वरभेदतोदैः||८|| <br />
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उद्गारशब्दप्रबलं सफेनं विच्छिन्नकृष्णं तनुकं कषायम्| <br />
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कृच्छ्रेण चाल्पं महता च वेगेनार्तोऽनिलाच्छर्दयतीह दुःखम्||९||<br />
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vyāyāmatīkṣṇauṣadhaśōkarōgabhayōpavāsādyatikarśitasya| <br />
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vāyurmahāsrōtasi sampravr̥ddha utklēśya dōṣāṁstata ūrdhvamasyan||7|| <br />
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āmāśayōtklēśakr̥tāṁ ca marma prapīḍayaṁśchardimudīrayēttu| <br />
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hr̥tpārśvapīḍāmukhaśōṣamūrdhanābhyartikāsasvarabhēdatōdaiḥ||8|| <br />
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udgāraśabdaprabalaṁ saphēnaṁ vicchinnakr̥ṣṇaṁ tanukaṁ kaṣāyam| <br />
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kr̥cchrēṇa cālpaṁ mahatā ca vēgēnārtō'nilācchardayatīha duḥkham||9||<br />
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vyAyAmatIkShNauShadhashokarogabhayopavAsAdyatikarshitasya| <br />
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vAyurmahAsrotasi [1] sampravRuddha utkleshya doShAMstata Urdhvamasyan||7|| <br />
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AmAshayotkleshakRutAM ca marma prapIDayaMshchardimudIrayettu| <br />
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hRutpArshvapIDAmukhashoShamUrdhanAbhyartikAsasvarabhedatodaiH||8|| <br />
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udgArashabdaprabalaM saphenaM vicchinnakRuShNaM tanukaM kaShAyam| <br />
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kRucchreNa cAlpaM mahatA ca vegenArto~anilAcchardayatIha duHkham||9||<br />
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In a person extremely emaciated because of excess exercise, chronic disease, excessive intake of ''tikshna'' (sharply acting) medicines (of high potency), and indulging in grief, fear, excess fasting, etc. [[vata]] gets excessively aggravated in the ''maha-srotas'' (gastrointestinal tract), vitiates the local [[dosha]] and pushes them upwards. These [[dosha]] cause agitation in the ''amashaya'' (stomach), and after afflicting the ''marma'' (vital organs-heart) gives rise to ''chhardi'' (vomiting). This [[vata]]ja type of vomiting is characterized by the following signs and symptoms: <br />
#Pain in the cardiac region and flanks; <br />
#Dryness of the mouth; <br />
#Pain in the head and umbilical region; <br />
#Cough, hoarseness of voice and pricking pain; <br />
#Eructation with loud noise; <br />
#Vomiting of material which is frothy, scattered, black in color, thin and astringent; <br />
#The urge for vomiting is forceful, but patient vomits only in small quantities with pain; <br />
#The patient feels miserable [7-9]<br />
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=== [[Pitta]]ja chhardi ===<br />
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अजीर्णकट्वम्लविदाह्यशीतैरामाशये पित्तमुदीर्णवेगम्| <br />
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रसायनीभिर्विसृतं प्रपीड्य मर्मोर्ध्वमागम्य वमिं करोति||१०|| <br />
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मूर्च्छापिपासामुखशोषमूर्धताल्वक्षिसन्तापतमोभ्रमार्तः| <br />
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पीतं भृशोष्णं हरितं सतिक्तं धूम्रं च पित्तेन वमेत् सदाहम्||११||<br />
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ajīrṇakaṭvamlavidāhyaśītairāmāśayē pittamudīrṇavēgam| <br />
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rasāyanībhirvisr̥taṁ prapīḍya marmōrdhvamāgamya vamiṁ karōti||10|| <br />
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mūrcchāpipāsāmukhaśōṣamūrdhatālvakṣisantāpatamōbhramārtaḥ| <br />
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pītaṁ bhr̥śōṣṇaṁ haritaṁ satiktaṁ dhūmraṁ ca pittēna vamēt sadāham||11|| <br />
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ajIrNakaTvamlavidAhyashItairAmAshaye pittamudIrNavegam| <br />
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rasAyanIbhirvisRutaM prapIDya marmordhvamAgamya vamiM karoti||10|| <br />
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mUrcchApipAsAmukhashoShamUrdhatAlvakShisantApatamobhramArtaH| <br />
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pItaM bhRushoShNaM haritaM satiktaM dhUmraM ca pittena vamet sadAham||11|| <br />
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As a result of indigestion, taking pungent, sour, ''vidahi'' (which cause burning sensation) and hot potency food, the [[pitta]] in the stomach gets aggravated. This aggravated [[pitta]] spreads through the ''rasayani'' (channels) and stresses the vital organs located in the upper part of the body which results in vomiting: <br />
<br />
The signs and symptoms of this [[pitta]]ja type of ''chhardi'' (vomiting) are: <br />
#Fainting, morbid thirst and parching of mouth; <br />
#Burning (or heating) sensation in the head, palate and eyes; <br />
#A feeling as if the patient is entering into darkness: <br />
#Giddiness; <br />
#Vomitus is yellow, excessively hot, green, bitter and smoky in appearance with burning sensation [10-11]<br />
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=== [[Kapha]]ja chhardi ===<br />
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स्निग्धातिगुर्वामविदाहिभोज्यैः स्वप्नादिभिश्चैव कफोऽतिवृद्धः| <br />
<br />
उरः शिरो मर्म रसायनीश्च सर्वाः समावृत्य वमिं करोति||१२|| <br />
<br />
तन्द्रास्यमाधुर्यकफप्रसेकसन्तोषनिद्रारुचिगौरवार्तः| <br />
<br />
स्निग्धं घनं स्वादु कफाद्विशुद्धं सलोमहर्षोऽल्परुजं वमेत्तु||१३||<br />
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snigdhātigurvāmavidāhibhōjyaiḥ svapnādibhiścaiva kaphō'tivr̥ddhaḥ| <br />
<br />
uraḥ śirō marma rasāyanīśca sarvāḥ samāvr̥tya vamiṁ karōti||12|| <br />
<br />
tandrāsyamādhuryakaphaprasēkasantōṣanidrārucigauravārtaḥ| <br />
<br />
snigdhaṁ ghanaṁ svādu kaphādviśuddhaṁ salōmaharṣō'lparujaṁ vamēttu||13|| <br />
<br />
snigdhAtigurvAmavidAhibhojyaiH svapnAdibhishcaiva kapho~ativRuddhaH| <br />
<br />
uraH shiro marma rasAyanIshca sarvAH samAvRutya vamiM karoti||12|| <br />
<br />
tandrAsyamAdhuryakaphaprasekasantoShanidrArucigauravArtaH| <br />
<br />
snigdhaM ghanaM svAdu kaphAdvishuddhaM salomaharSho~alparujaM vamettu||13||<br />
</div></div><br />
<br />
As a result of the intake of unctuous, excessively heavy to digest, ''ama'' (raw/uncooked) and ''vidahi'' (causing burning sensation) food and because of excessive sleep and similar other factors, [[kapha]] gets excessively aggravated. This [[kapha]] occludes the chest, head, vital organs and all the (concerned) channels to cause ''chhardi'' (vomiting). The signs and symptoms of this [[kapha]]ja type of ''chhardi'' are as follows:<br />
#Drowsiness, sweetness in the mouth and salivation; <br />
#Sense of satiety, sleep, anorexia and heaviness; <br />
#Vomitus is unctuous, dense, sweet and devoid of any undesirable smell; and is associated with horripilation and slight pain [12-13]<br />
<br />
=== Tri[[dosha]]ja chhardi ===<br />
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<br />
समश्नतः सर्वरसान् प्रसक्तमामप्रदोषर्तुविपर्ययैश्च| <br />
<br />
सर्वे प्रकोपं युगपत् प्रपन्नाश्छर्दिं त्रिदोषां जनयन्ति दोषाः||१४|| <br />
<br />
शूलाविपाकारुचिदाहतृष्णाश्वासप्रमोहप्रबला प्रसक्तम्| <br />
<br />
छर्दिस्त्रिदोषाल्लवणाम्लनीलसान्द्रोष्णरक्तं वमतां नृणां स्यात्||१५|| <br />
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samaśnataḥ sarvarasān prasaktamāmapradōṣartuviparyayaiśca|<br />
<br />
sarvē prakōpaṁ yugapat prapannāśchardiṁ tridōṣāṁ janayanti dōṣāḥ||14|| <br />
<br />
śūlāvipākārucidāhatr̥ṣṇāśvāsapramōhaprabalā prasaktam| <br />
<br />
chardistridōṣāllavaṇāmlanīlasāndrōṣṇaraktaṁ vamatāṁ nr̥ṇāṁ syāt||15|| <br />
<br />
samashnataH sarvarasAn prasaktamAmapradoShartuviparyayaishca| <br />
<br />
sarve prakopaM yugapat prapannAshchardiM tridoShAM janayanti doShAH||14|| <br />
<br />
shUlAvipAkArucidAhatRuShNAshvAsapramohaprabalA prasaktam| <br />
<br />
chardistridoShAllavaNAmlanIlasAndroShNaraktaM vamatAM nRuNAM syAt||15||<br />
</div></div><br />
<br />
Because of constant indulgence in diet consisting of wholesome and unwholesome diet together, having all categories of taste together because of ''ama-dosha'' (ailments caused by improper digestion) and because of seasonal perversions, all the three [[dosha]] get simultaneously aggravated and cause ''sannipatika chhardi''.<br />
<br />
The signs and symptoms of this type of vomiting are as follows: <br />
#Colic pain, indigestion, anorexia, burning sensation, morbid thirst, dyspnea and fainting spells that are severe and persistent; <br />
#Vomitus is salty, sour, blue, dense, hot and reddish [14-15]<br />
<br />
=== Bad prognostic symptoms ===<br />
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<br />
विट्स्वेदमूत्राम्बुवहानि वायुः स्रोतांसि संरुध्य यदोर्ध्वमेति| <br />
<br />
उत्सन्नदोषस्य समाचितं तं दोषं समुद्धूय नरस्य कोष्ठात्||१६|| <br />
<br />
विण्मूत्रयोस्तत् समवर्णगन्धं तृट्श्वासहिक्कार्तियुतं प्रसक्तम्| <br />
<br />
प्रच्छर्दयेद्दुष्टमिहातिवेगात्तयाऽर्दितश्चाशु विनाशमेति||१७|| <br />
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viṭsvēdamūtrāmbuvahāni vāyuḥ srōtāṁsi saṁrudhya yadōrdhvamēti| <br />
<br />
utsannadōṣasya samācitaṁ taṁ dōṣaṁ samuddhūya narasya kōṣṭhāt||16|| <br />
<br />
viṇmūtrayōstat samavarṇagandhaṁ tr̥ṭśvāsahikkārtiyutaṁ prasaktam| <br />
<br />
pracchardayēdduṣṭamihātivēgāttayā'rditaścāśu vināśamēti||17|| <br />
<br />
viTsvedamUtrAmbuvahAni vAyuH srotAMsi saMrudhya yadordhvameti| <br />
<br />
utsannadoShasya samAcitaM taM doShaM samuddhUya narasya koShThAt||16|| <br />
<br />
viNmUtrayostat samavarNagandhaM tRuTshvAsahikkArtiyutaM prasaktam| <br />
<br />
pracchardayedduShTamihAtivegAttayA~arditashcAshu vinAshameti||17|| <br />
</div></div><br />
<br />
When the morbid [[vata]] occludes the channels carrying feces, sweat, urine and body fluids and moves upwards, then the morbid matter from the [[koshtha]] (gastrointestinal tract), gets incited to cause vomiting, that has the following characteristics:<br />
#Vomitus having color and odor of the feces and urine; <br />
#Persistent thirst, dyspnea hiccup and pain <br />
#Vomiting of foul smelling or ''dusta'' (putrid material); and <br />
#Bouts of vomiting ejected with great force. <br />
<br />
Such a patient succumbs to death quickly [16-17]<br />
<br />
=== ''Dvishtharthasamyogaja chhardi'' ===<br />
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द्विष्टप्रतीपाशुचिपूत्यमेध्यबीभत्सगन्धाशनदर्शनैश्च| <br />
<br />
यच्छर्दयेत्तप्तमना मनोध्नैर्द्विष्टार्थसंयोगभवा मता सा||१८|| <br />
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dviṣṭapratīpāśucipūtyamēdhyabībhatsagandhāśanadarśanaiśca| <br />
<br />
yacchardayēttaptamanā manōdhnairdviṣṭārthasaṁyōgabhavā matā sā||18||<br />
<br />
dviShTapratIpAshucipUtyamedhyabIbhatsagandhAshanadarshanaishca| <br />
<br />
yacchardayettaptamanA manodhnairdviShTArthasaMyogabhavA matA sA||18||<br />
</div></div><br />
<br />
As a result of mental disgust occasioned by senses contact with despicable, antagonistic, unclean, putrid, unholy and loathsome odors, diet or sights, the ''chhardi''(vomiting) is known as vomiting induced by contact with hateful things [18]<br />
<br />
=== Symptoms of incurable ''chhardi'' ===<br />
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क्षीणस्य या छर्दिरतिप्रवृद्धा सोपद्रवा शोणितपूययुक्ता| <br />
<br />
सचन्द्रिकां तां प्रवदन्त्यसाध्यां साध्यां चिकित्सेदनुपद्रवां च||१९||<br />
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kṣīṇasya yā chardiratipravr̥ddhā sōpadravā śōṇitapūyayuktā| <br />
<br />
sacandrikāṁ tāṁ pravadantyasādhyāṁ sādhyāṁ cikitsēdanupadravāṁ ca||19|| <br />
<br />
kShINasya yA chardiratipravRuddhA sopadravA shoNitapUyayuktA| <br />
<br />
sacandrikAM tAM pravadantyasAdhyAM sAdhyAM cikitsedanupadravAM ca||19|| <br />
</div></div><br />
<br />
Vomiting that occurs in an emaciated person, that continues incessantly, that is associated with complications, and vomitus that contains blood, pus and ''chandrika'' (circular shiny patches with variegated color) is incurable. The physician should treat only curable types that are not associated with complications [19]<br />
<br />
=== Principles of treatment ===<br />
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आमाशयोत्क्लेशभवा हि सर्वाश्छर्द्यो मता लङ्घनमेव तस्मात्| <br />
<br />
प्राक्कारयेन्मारुतजां विमुच्य संशोधनं वा कफपित्तहारि||२०|| <br />
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āmāśayōtklēśabhavā hi sarvāśchardyō matā laṅghanamēva tasmāt| <br />
<br />
prākkārayēnmārutajāṁ vimucya saṁśōdhanaṁ vā kaphapittahāri||20|| <br />
<br />
AmAshayotkleshabhavA hi sarvAshchardyo matA la~gghanameva tasmAt| <br />
<br />
prAkkArayenmArutajAM vimucya saMshodhanaM vA kaphapittahAri||20|| <br />
</div></div><br />
<br />
As all the types of vomiting are considered originating from the agitations of the [[dosha]] in the stomach, fasting therapy should first be prescribed or purificatory procedure curative of [[kapha]] and [[pitta]] should be administered except in cases of [[vata]] dominance. [20]<br />
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चूर्णानि लिह्यान्मधुनाऽभयानां हृद्यानि वा यानि विरेचनानि| <br />
<br />
मद्यैः पयोभिश्च युतानि युक्त्या नयन्त्यधो दोषमुदीर्णमूर्ध्वम्||२१|| <br />
<br />
वल्लीफलाद्यैर्वमनं पिबेद्वा यो दुर्बलस्तं शमनैश्चिकित्सेत्| <br />
<br />
रसैर्मनोज्ञैर्लघुभिर्विशुष्कैर्भक्ष्यैः सभोज्यैर्विविधैश्च पानैः||२२|| <br />
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cūrṇāni lihyānmadhunā'bhayānāṁ hr̥dyāni vā yāni virēcanāni| <br />
<br />
madyaiḥ payōbhiśca yutāni yuktyā nayantyadhō dōṣamudīrṇamūrdhvam||21|| <br />
<br />
vallīphalādyairvamanaṁ pibēdvā yō durbalastaṁ śamanaiścikitsēt| <br />
<br />
rasairmanōjñairlaghubhirviśuṣkairbhakṣyaiḥ sabhōjyairvividhaiśca pānaiḥ||22||<br />
<br />
cUrNAni lihyAnmadhunA~abhayAnAM hRudyAni vA yAni virecanAni| <br />
<br />
madyaiH payobhishca yutAni yuktyA nayantyadho doShamudIrNamUrdhvam||21|| <br />
<br />
vallIphalAdyairvamanaM pibedvA yo durbalastaM shamanaishcikitset| <br />
<br />
rasairmanoj~jairlaghubhirvishuShkairbhakShyaiH sabhojyairvividhaishca pAnaiH||22||<br />
</div></div><br />
<br />
The patient shall take powder of ''abhaya'' (chebulic myrobalans) with honey or such other palatable purgatives skillfully combined with ''madya'' (alcohol) or ''dugdha'' (milk). These recipes cause downward movement of the aggravated ''doshas'' that are impelled to move upwards. <br />
<br />
Patient may also be given emetic therapy prepared of the drugs of the ''valliphala'' (group of cucurbitaceous fruits), etc. or if the patient is weak, then he should be treated with pacification therapy through delicious soups and light as well as dry food articles for diet along with various kinds of drinks [21-22]<br />
<br />
=== Treatment of [[vata]]ja chhardi ===<br />
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<br />
सुसंस्कृतास्तित्तिरिबर्हिलावरसा व्यपोहन्त्यनिलप्रवृत्ताम्|<br />
<br />
छर्दिं तथा कोलकुलत्थधान्यबिल्वादिमूलाम्लयवैश्च यूषः||२३||<br />
<br />
वातात्मिकायां हृदयद्रवार्तो नरः पिबेत् सैन्धववद्धृतं तु|<br />
<br />
सिद्धं तथा धान्यकनागराभ्यां दध्ना च तोयेन च दाडिमस्य||२४||<br />
<br />
व्योषेण युक्तां लवणैस्त्रिभिश्च घृतस्य मात्रामथवा विदध्यात्|<br />
<br />
स्निग्धानि हृद्यानि च भोजनानि रसैः सयूषैर्दधिदाडिमाम्लैः||२५||<br />
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susaṁskr̥tāstittiribarhilāvarasā vyapōhantyanilapravr̥ttām| <br />
<br />
chardiṁ tathā kōlakulatthadhānyabilvādimūlāmlayavaiśca yūṣaḥ||23|| <br />
<br />
vātātmikāyāṁ [1] hr̥dayadravārtō naraḥ pibēt saindhavavaddhr̥taṁ tu| <br />
<br />
siddhaṁ tathā dhānyakanāgarābhyāṁ dadhnā ca tōyēna ca dāḍimasya||24|| <br />
<br />
vyōṣēṇa yuktāṁ lavaṇaistribhiśca ghr̥tasya mātrāmathavā vidadhyāt| <br />
<br />
snigdhāni hr̥dyāni ca bhōjanāni rasaiḥ sayūṣairdadhidāḍimāmlaiḥ||25|| <br />
<br />
SusamskrutAstittiribrhilAvrasA vyapohantyanilapravRuttAm| <br />
<br />
chardiM tathA kolakulatthadhAnyabilvAdimUlAmlayavaishca yUShaH||23||<br />
<br />
vAtAtmikAyAM hRudayadravArto naraH pibet saindhavavaddhRutaM tu|<br />
<br />
siddhaM tathA dhAnyakanAgarAbhyAM dadhnA ca toyena ca dADimasya||24||<br />
<br />
vyoSheNa yuktAM lavaNaistribhishca ghRutasya mAtrAmathavA vidadhyAt|<br />
<br />
snigdhAni hRudyAni ca bhojanAni rasaiH sayUShairdadhidADimAmlaiH||25||<br />
</div></div><br />
<br />
The following recipes are useful in [[vata]]ja type of vomiting (''chhardi''): <br />
#The meat juice of ''tittiri'' (partridge), ''barhi'' and ''lava'' (common quail); <br />
#Vegetable soup prepared out of ''kola'' (Zyziphus jujuba), ''kulattha'' (horse gram/Dolichos biflorus), ''dhanya'' (coriander fruit/coriandrum sativum ), group of roots of ''bilva'' (Bilva-Bengal quince/''bael'' fruit/Aegle marmelos), etc. (''syonaka'' (Oroxylem indicum) , ''gambhari'' (Gmelina arborea), ''patala'' (Trumpet/Stereospermum chelonoides), ''ganikarika'' (Premna integrifolia)), ''amla'' (sour substances) and ''yava'' (barley/Hordeum vulgare); <br />
#If the patient is suffering from vomiting of ''vata'' type of ''chhardi'' that is associated with ''hriddrava'' (palpitation), then may take ghee with rock salt. <br />
#Ghee cooked with ''dhanyaka'' (coriander), ''nagara'' (dry zingiber/ginger/Zingiber officinale), ''dadhi''(curd) and the juice of ''dadima'' (pomegranate/Punica granatum); <br />
#Ghee mixed with the powder of ''trikatu'' (''shunthi, pippali'' and ''maricha'') and three salts viz. ''saindhava'' (rock salt), ''sauvarchala'' (black salt) and ''vida'' (''pakyam'')); <br />
#The diet consisting of unctuous and palatable food, meat soups, vegetable-soup, curd sour ''dadima'' (pomegranate/Punica granatum) [23-25]<br />
<br />
=== Treatment of [[pitta]]ja chhardi ===<br />
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<br />
पित्तात्मिकायामनुलोमनार्थं द्राक्षाविदारीक्षुरसैस्त्रिवृत् स्यात्| <br />
<br />
कफाशयस्थं त्वतिमात्रवृद्धं पित्तं हरेत् स्वादुभिरूर्ध्वमेव||२६|| <br />
<br />
शुद्धाय काले मधुशर्कराभ्यां लाजैश्च मन्थं यदि वाऽपि पेयाम्| <br />
<br />
प्रदापयेन्मुद्गरसेन वाऽपि शाल्योदनं जाङ्गलजै रसैर्वा||२७|| <br />
<br />
सितोपलामाक्षिकपिप्पलीभिः कुल्माषलाजायवसक्तुगृञ्जान्| <br />
<br />
खर्जूरमांसान्यथ नारिकेलं द्राक्षामथो वा बदराणि लिह्यात्||२८|| <br />
<br />
स्रोतोजलाजोत्पलकोलमज्जचूर्णानि लिह्यान्मधुनाऽभयां च| <br />
<br />
कोलास्थिमज्जाञ्जनमक्षिकाविड्लाजासितामागधिकाकणान् वा||२९|| <br />
<br />
द्राक्षारसं वाऽपि पिबेत् सुशीतं मृद्भृष्टलोष्टप्रभवं जलं वा| <br />
<br />
जम्ब्वाम्रयोः पल्लवजं कषायं पिबेत् सुशीतं मधुसंयुतं वा||३०|| <br />
<br />
निशि स्थितं वारि समुद्गकृष्णं सोशीरधान्यं चणकोदकं वा| <br />
<br />
गवेधुकामूलजलं गुडूच्या जलं पिबेदिक्षुरसं पयो वा||३१|| <br />
<br />
सेव्यं पिबेत् काञ्चनगैरिकं वा सबालकं तण्डुलधावनेन| <br />
<br />
धात्रीरसेनोत्तमचन्दनं वा तृष्णावमिघ्नानि समाक्षिकाणि||३२|| <br />
<br />
कल्कं तथा चन्दनचव्यमांसीद्राक्षोत्तमाबालकगैरिकाणाम्| <br />
<br />
शीताम्बुना गैरिकशालिचूर्णं मूर्वां तथा तण्डुलधावनेन||३३|| <br />
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<br />
pittātmikāyāmanulōmanārthaṁ drākṣāvidārīkṣurasaistrivr̥t syāt| <br />
<br />
kaphāśayasthaṁ tvatimātravr̥ddhaṁ pittaṁ harēt svādubhirūrdhvamēva||26|| <br />
<br />
śuddhāya kālē madhuśarkarābhyāṁ lājaiśca manthaṁ yadi vā'pi pēyām| <br />
<br />
pradāpayēnmudgarasēna vā'pi śālyōdanaṁ jāṅgalajai rasairvā||27|| <br />
<br />
sitōpalāmākṣikapippalībhiḥ kulmāṣalājāyavasaktugr̥ñjān| <br />
<br />
kharjūramāṁsānyatha nārikēlaṁ drākṣāmathō vā badarāṇi lihyāt||28|| <br />
<br />
srōtōjalājōtpalakōlamajjacūrṇāni lihyānmadhunā'bhayāṁ ca| <br />
<br />
kōlāsthimajjāñjanamakṣikāviḍlājāsitāmāgadhikākaṇān vā||29|| <br />
<br />
drākṣārasaṁ vā'pi pibēt suśītaṁ mr̥dbhr̥ṣṭalōṣṭaprabhavaṁ jalaṁ vā| <br />
<br />
jambvāmrayōḥ pallavajaṁ kaṣāyaṁ pibēt suśītaṁ madhusaṁyutaṁ vā||30|| <br />
<br />
niśi sthitaṁ vāri samudgakr̥ṣṇaṁ sōśīradhānyaṁ caṇakōdakaṁ vā| <br />
<br />
gavēdhukāmūlajalaṁ guḍūcyā jalaṁ pibēdikṣurasaṁ payō vā||31|| <br />
<br />
sēvyaṁ pibēt kāñcanagairikaṁ vā sabālakaṁ taṇḍuladhāvanēna| <br />
<br />
dhātrīrasēnōttamacandanaṁ vā tr̥ṣṇāvamighnāni samākṣikāṇi||32|| <br />
<br />
kalkaṁ tathā candanacavyamāṁsīdrākṣōttamābālakagairikāṇām| <br />
<br />
śītāmbunā gairikaśālicūrṇaṁ mūrvāṁ tathā taṇḍuladhāvanēna||33|| <br />
<br />
pittAtmikAyAmanulomanArthaM drAkShAvidArIkShurasaistrivRut syAt| <br />
<br />
kaphAshayasthaM tvatimAtravRuddhaM pittaM haret svAdubhirUrdhvameva||26|| <br />
<br />
shuddhAya kAle madhusharkarAbhyAM lAjaishca manthaM yadi vA~api peyAm| <br />
<br />
pradApayenmudgarasena vA~api shAlyodanaM jA~ggalajai rasairvA||27|| <br />
<br />
sitopalAmAkShikapippalIbhiH kulmAShalAjAyavasaktugRu~jjAn| <br />
<br />
kharjUramAMsAnyatha nArikelaM drAkShAmatho vA badarANi lihyAt||28|| <br />
<br />
srotojalAjotpalakolamajjacUrNAni lihyAnmadhunA~abhayAM ca| <br />
<br />
kolAsthimajjA~jjanamakShikAviDlAjAsitAmAgadhikAkaNAn vA||29|| <br />
<br />
drAkShArasaM vA~api pibet sushItaM mRudbhRuShTaloShTaprabhavaM jalaM vA| <br />
<br />
jambvAmrayoH pallavajaM kaShAyaM pibet sushItaM madhusaMyutaM vA||30|| <br />
<br />
nishi sthitaM vAri samudgakRuShNaM soshIradhAnyaM caNakodakaM vA| <br />
<br />
gavedhukAmUlajalaM guDUcyA jalaM pibedikShurasaM payo vA||31|| <br />
<br />
sevyaM pibet kA~jcanagairikaM vA sabAlakaM taNDuladhAvanena| <br />
<br />
dhAtrIrasenottamacandanaM vA tRuShNAvamighnAni samAkShikANi||32|| <br />
<br />
kalkaM tathA candanacavyamAMsIdrAkShottamAbAlakagairikANAm| <br />
<br />
shItAmbunA gairikashAlicUrNaM mUrvAM tathA taNDuladhAvanena||33||<br />
</div></div><br />
<br />
The patient of [[pitta]]ja type of ''chhardi'' should be given ''trivrit'' (Operculina turpethum) along with the juice of ''draksha'' (grapes/Vitis vinifera), ''vidari'' (Purera tuberosa) and ''ikshu'' (sugar-cane/Saccharaum officinarum) for causing downward movement of the morbid matter (laxation). When aggravated pitta is located in site of [[kapha]] (chest/stomach), then drugs having sweet taste should be administered for elimination of [[pitta]] (through emetic therapy). <br />
<br />
After this purificatory therapy patient should be given at proper time ''laja-mantha'' (flour of popped-rice diluted in water) or ''laja-peya'' (thin gruel made of popped-rice) along with honey and sugar. The patient may also be given boiled shāli type of rice along with the soup of ''mudga'' (green gram/Phaseolus aureus) or the meat juice of ''jangala'' creatures (animals inhabiting in arid zone). <br />
<br />
The following recipes are also advocated in this context:<br />
#''Kulmasha'', the paste of boiled ''mudga'' (green gram/Phaseolus aureus), ''masura'' (lentil/ Ervum lens), etc., ''laja'' (popped paddy), ''yava-saktu'' (flour of roasted barley), ''grunja'' (boiled barley along with its supernatant segment), or the pulp of ''kharjura'' (date/Phoenix sylvestris), ''narikela'' (coconut/Cocos nucifera), ''draksha'' (grapes/Vitis vinifera) or ''badara'' (Zyziphus jujuba) should be made to a linctus by adding ''sitopala'' (sugar having big crystals), honey and ''pippali'' (long pepper/Piper longum).<br />
#The water of fountain, ''laja'' (popped paddy), ''utpala'' (Nymphaea stellata) and the pulp of ''kola'' (Zyziphus jujuba) be made into linctus by adding honey, and given.<br />
#''Abhaya'' (chebulic myrobalan) with honey may also be taken. <br />
#The seed-pulp of ''kola'' (Zyziphus jujuba), ''anjana'' (''srotonjana''), ''makshika vit'' (excreta of house- fly), ''laja'' (popped paddy), sugar and grains of ''pippali'' mixed with honey. <br />
#The patient may drink cooled grape juice or cooled water prepared with baked clay or earth. <br />
#The patient may be given the cooled decoction of the tender leaves of ''jambu'' (Syzygium cumini) and ''amra'' (mango/Mangifera indica) by adding honey. <br />
#The following things kept overnight should be taken: <br />
##Water with ''mudga'' (green gram/Phaseolus aureus) and ''pippali'' (long pepper/ Piper longum),<br />
##Water with ''usheera'' (cuscus grass/Viteveria zizanioides) and ''dhanyaka'' (coriander/Coriandrum sativum), <br />
##Water with ''chanaka'' (bengal gram/gram/chick pea/Cicer arietinum), <br />
##Water with root of ''gavedhuka'' (Adlay/Jobs tears/Coix lachryma),<br />
##Water with ''guduchi'' (Tinospora cordifolia),<br />
###The patient may be given sugar-cane-juice or milk to drink.<br />
#The following recipes are useful in morbid thirst and vomiting: <br />
##The powder of ''sevya'' (Cuscus grass/Viteveria zizanioides) and ''kanchana-gairika'' (Hematite, Fe2O3) along with ''tandulodaka'' (rice-water); <br />
##The powder of ''sevya'' and ''balaka'' (Coleus vettiveroides) along with ''tandulodaka'' (rice-water); <br />
##The paste of white variety of ''chandana'' (sandal wood) mixed with the juice of ''amalaki'' (emblic myrobalan/Emblica officinale) along with honey. <br />
#The following recipes also useful in ''paittika'' type of vomiting: <br />
##The paste of ''chandana'' (sandal wood/Santalum album), ''chavya'' (Piper chaba/Piper officinarum), ''mamsi'' (Indian nard/nardus root/Nardostachys jatamansi), ''draksha'' (grapes/Vitis vinifera) of good quality, ''balaka'' (Coleus vettiveroides) and ''gairika'' (Hematite, Fe2O3); <br />
##Powder of ''gairika'' (Hematite, Fe2O3) and ''shali'' rice along with cold water; <br />
##Powder of ''murva'' (Marsdenia tenacissima / sansevieria roxburghiana) along with ''tandulodaka'' (rice-water)[26-33]<br />
<br />
=== Treatment of [[kapha]]ja chhardi ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
कफात्मिकायां वमनं प्रशस्तं सपिप्पलीसर्षपनिम्बतोयैः| <br />
<br />
पिण्डीतकैः सैन्धवसम्प्रयुक्तैर्वम्यां कफामाशयशोधनार्थम्||३४|| <br />
<br />
गोधूमशालीन् सयवान् पुराणान् यूषैः पटोलामृतचित्रकाणाम्| <br />
<br />
व्योषस्य निम्बस्य च तक्रसिद्धैर्यूषैः फलाम्लैः कटुभिस्तथाऽद्यात्||३५|| <br />
<br />
रसांश्च शूल्यानि च जाङ्गलानां मांसानि जीर्णान्मधुसीध्वरिष्टान्| <br />
<br />
रागांस्तथा षाडवपानकानि द्राक्षाकपित्थैः फलपूरकैश्च||३६|| <br />
<br />
मुद्गान्मसूरांश्चणकान् कलायान् भृष्टान् युतान्नागरमाक्षिकाभ्याम्| <br />
<br />
लिह्यात्तथैव त्रिफलाविडङ्गचूर्णं विडङ्गप्लवयोरथो [१] वा||३७|| <br />
<br />
सजाम्बवं वा बदराम्लचूर्णं [२] मुस्तायुतां कर्कटकस्य शृङ्गीम्| <br />
<br />
दुरालभां वा मधुसम्प्रयुक्तां लिह्यात् कफच्छर्दिविनिग्रहार्थम्||३८|| <br />
<br />
मनःशिलायाः फलपूरकस्य रसैः कपित्थस्य च पिप्पलीनाम्| <br />
<br />
क्षौद्रेण चूर्णं मरिचैश्च युक्तं लिहञ्जयेच्छर्दिमुदीर्णवेगाम्||३९||<br />
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<br />
kaphātmikāyāṁ vamanaṁ praśastaṁ sapippalīsarṣapanimbatōyaiḥ| <br />
<br />
piṇḍītakaiḥ saindhavasamprayuktairvamyāṁ kaphāmāśayaśōdhanārtham||34|| <br />
<br />
gōdhūmaśālīn sayavān purāṇān yūṣaiḥ paṭōlāmr̥tacitrakāṇām| <br />
<br />
vyōṣasya nimbasya ca takrasiddhairyūṣaiḥ phalāmlaiḥ kaṭubhistathā'dyāt||35|| <br />
<br />
rasāṁśca śūlyāni ca jāṅgalānāṁ māṁsāni jīrṇānmadhusīdhvariṣṭān| <br />
<br />
rāgāṁstathā ṣāḍavapānakāni drākṣākapitthaiḥ phalapūrakaiśca||36|| <br />
<br />
mudgānmasūrāṁścaṇakān kalāyān bhr̥ṣṭān yutānnāgaramākṣikābhyām| <br />
<br />
lihyāttathaiva triphalāviḍaṅgacūrṇaṁ viḍaṅgaplavayōrathō vā||37|| <br />
<br />
sajāmbavaṁ vā badarāmlacūrṇaṁ mustāyutāṁ karkaṭakasya śr̥ṅgīm| <br />
<br />
durālabhāṁ vā madhusamprayuktāṁ lihyāt kaphacchardivinigrahārtham||38|| <br />
<br />
manaḥśilāyāḥ phalapūrakasya rasaiḥ kapitthasya ca pippalīnām| <br />
<br />
kṣaudrēṇa cūrṇaṁ maricaiśca yuktaṁ lihañjayēcchardimudīrṇavēgām||39||<br />
<br />
kaphAtmikAyAM vamanaM prashastaM sapippalIsarShapanimbatoyaiH| <br />
<br />
piNDItakaiH saindhavasamprayuktairvamyAM kaphAmAshayashodhanArtham||34|| <br />
<br />
godhUmashAlIn sayavAn purANAn yUShaiH paTolAmRutacitrakANAm| <br />
<br />
vyoShasya nimbasya ca takrasiddhairyUShaiH phalAmlaiH kaTubhistathA~adyAt||35|| <br />
<br />
rasAMshca shUlyAni ca jA~ggalAnAM mAMsAni jIrNAnmadhusIdhvariShTAn| <br />
<br />
rAgAMstathA ShADavapAnakAni drAkShAkapitthaiH phalapUrakaishca||36|| <br />
<br />
mudgAnmasUrAMshcaNakAn kalAyAn bhRuShTAn yutAnnAgaramAkShikAbhyAm| <br />
<br />
lihyAttathaiva triphalAviDa~ggacUrNaM viDa~ggaplavayoratho [1] vA||37|| <br />
<br />
sajAmbavaM vA badarAmlacUrNaM [2] mustAyutAM karkaTakasya shRu~ggIm| <br />
<br />
durAlabhAM vA madhusamprayuktAM lihyAt kaphacchardivinigrahArtham||38|| <br />
<br />
manaHshilAyAH phalapUrakasya rasaiH kapitthasya ca pippalInAm| <br />
<br />
kShaudreNa cUrNaM maricaishca yuktaM liha~jjayecchardimudIrNavegAm||39||<br />
</div></div><br />
<br />
''Vamana'' (therapeutic emesis) is supposed to be the most suitable therapy in [[kapha]]ja type of ''chhardi'' (vomiting). In order to clean the seat of [[kapha]] and ''amashaya'', the patient should be given the decoction of ''pippali, sarsapa'' (yellow sarson/Indian colza/Brassica campestris) and ''nimba'' (neem tree/Margosa/Indian lilac/Azadirachta indica) added with powder of ''pinditaka'' (madanaphala/emetic nut/bushy gardenia/Randia dumetorum) and ''saindhava'' (rock-salt). <br />
<br />
The patient should be given old wheat, rice and barley along with <br />
#Vegetable soup of ''patola'' (Trichosanthes dioica), <br />
#''Amrita'' (Tinospora cordifolia) and <br />
#''Chitraka'' (Ceylon leadwort/ white leadwort/Plumbago zeylanica) or <br />
#with the soup of ''trikatu'' (three spices) and neem prepared with butter milk, or <br />
#Soup of sour fruits along with pungent drugs. <br />
<br />
The patient should also take the meat juices and roasted flesh of ''jangala'' creature (animals inhabiting arid zone), old honey, ''sidhu'' (alcohol prepared of sugar-cane-juice) and ''arishta'' (a type of alcoholic drink); and ''raga'' (condiments), shādava (pickles) and ''panaka'' (syrup) prepared of ''draksha'' (grapes) and ''phala-puraka'' (citrion/Citrus medica). <br />
<br />
The patient should take following three recipes mixed with ''shunthi'' (dry zingiber) and honey: <br />
#Roasted ''mudga'' (green gram), ''masura'' (lentil/Ervum lens), ''chanaka'' (bengal gram/Gram/ chick pea/Cicer arietinum) and ''kalaya'' (peas/Pisum sativum) <br />
#''Triphala'' (''haritaki, bibhitaka'' and ''amalaka''), and ''vidanga'' (babreng fruits/embelia ribes)<br />
#''Vidanga'' (babreng fruits/embelia ribes) and ''plava'' (nut grass/Cyperys rotundus) <br />
<br />
The following recipes should be taken mixed with the honey <br />
#''Jambu'' (Syzygium cumini) and sour fruits of ''badara'' (Zizyphus jujuba) <br />
#''Musta'' (nut grass/Cyperus rotundus)and ''karkata-shringi'' (Pistacia integerrima)<br />
#''Duralabha'' (Fegonia cretica). <br />
<br />
The forcefully generated urge of vomiting can be controlled with the following regims <br />
#Purified ''manahsila'' (red arsenic) with the juice of ''bijapuraka'' (citrion/Citrus medica), <br />
#''Pippali'' (long piper/Piper longum) mixed with the juice of ''kapittha'' (Feronia limonia)<br />
#''Maricha'' (black pepper/Piper nigrum) with honey [34-39]<br />
<br />
=== Treatment of ''sannipatika chhardi'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
यैषा पृथक्त्वेन मया क्रियोक्ता तां सन्निपातेऽपि समस्य [१] बुद्ध्या| <br />
<br />
दोषर्तुरोगाग्निबलान्यवेक्ष्य प्रयोजयेच्छास्त्रविदप्रमत्तः||४०||<br />
<div class="mw-collapsible-content"><br />
<br />
yaiṣā pr̥thaktvēna mayā kriyōktā tāṁ sannipātē'pi samasya buddhyā| <br />
<br />
dōṣarturōgāgnibalānyavēkṣya prayōjayēcchāstravidapramattaḥ||40||<br />
<br />
yaiShA pRuthaktvena mayA kriyoktA tAM sannipAte~api samasya [1] buddhyA| <br />
<br />
doSharturogAgnibalAnyavekShya prayojayecchAstravidapramattaH||40||<br />
</div></div><br />
<br />
Judicious synthesis of the separate lines of treatment indicated by me for the derangement of individual humors should be employed by the learned physician for the patient suffering from ''sannipatika chhardi'' after carefully examining the relative preponderance of the [[dosha]] involved, the season when the disease has occurred, the stage of the disease and the power of digestion of the patient [40]<br />
<br />
=== Treatment of ''dvishtarathasamyogaja (manobhighataja) chhardi'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
मनोभिघाते तु मनोनुकूला वाचः समाश्वासनहर्षणानि| <br />
<br />
लोकप्रसिद्धाः श्रुतयो वयस्याः शृङ्गारिकाश्चैव हिता विहाराः||४१|| <br />
<br />
गन्धा विचित्रा मनसोऽनुकूला मृत्पुष्पशुक्ताम्लफलादिकानाम्| <br />
<br />
शाकानि भोज्यान्यथ पानकानि सुसंस्कृताः षाडवरागलेहाः||४२|| <br />
<br />
यूषा रसाः काम्बलिका खडाश्च मांसानि धाना विविधाश्च भक्ष्याः|<br />
<br />
फलानि मूलानि च गन्धवर्णरसैरुपेतानि वमिं जयन्ति||४३|| <br />
<br />
गन्धं रसं स्पर्शमथापि शब्दं रूपं च यद्यत् प्रियमप्यसात्म्यम्| <br />
<br />
तदेव दद्यात् प्रशमाय तस्यास्तज्जो हि रोगः सुख एव जेतुम्||४४|| <br />
<div class="mw-collapsible-content"><br />
<br />
manōbhighātē tu manōnukūlā vācaḥ samāśvāsanaharṣaṇāni| <br />
<br />
lōkaprasiddhāḥ śrutayō vayasyāḥ śr̥ṅgārikāścaiva hitā vihārāḥ||41|| <br />
<br />
gandhā vicitrā manasō'nukūlā mr̥tpuṣpaśuktāmlaphalādikānām| <br />
<br />
śākāni bhōjyānyatha pānakāni susaṁskr̥tāḥ ṣāḍavarāgalēhāḥ||42|| <br />
<br />
yūṣā rasāḥ kāmbalikā khaḍāśca māṁsāni dhānā vividhāśca bhakṣyāḥ| <br />
<br />
phalāni mūlāni ca gandhavarṇarasairupētāni vamiṁ jayanti||43|| <br />
<br />
gandhaṁ rasaṁ sparśamathāpi śabdaṁ rūpaṁ ca yadyat priyamapyasātmyam| <br />
<br />
tadēva dadyāt praśamāya tasyāstajjō hi rōgaḥ sukha ēva jētum||44||<br />
<br />
manobhighAte tu manonukUlA vAcaH samAshvAsanaharShaNAni| <br />
<br />
lokaprasiddhAH shrutayo vayasyAH shRu~ggArikAshcaiva hitA vihArAH||41|| <br />
<br />
gandhA vicitrA manaso~anukUlA mRutpuShpashuktAmlaphalAdikAnAm| <br />
<br />
shAkAni bhojyAnyatha pAnakAni susaMskRutAH ShADavarAgalehAH||42|| <br />
<br />
yUShA rasAH kAmbalikA khaDAshca mAMsAni dhAnA vividhAshca bhakShyAH| <br />
<br />
phalAni mUlAni ca gandhavarNarasairupetAni vamiM jayanti||43|| <br />
<br />
gandhaM rasaM sparshamathApi shabdaM rUpaM ca yadyat priyamapyasAtmyam| <br />
<br />
tadeva dadyAt prashamAya tasyAstajjo hi rogaH sukha eva jetum||44||<br />
</div></div><br />
<br />
In case of vomiting caused by mental disgust the following measures should be resorted to: <br />
#Words which are pleasing and comforting, counseling and encouraging <br />
#Popular legends and stories, congenial companions and pleasant wholesome diversions, amorous and wholesome regimens (games); <br />
#Odor of various types of pleasing perfumes emanating from the earth, flowers, vinegar (''sukta'') and sour fruits<br />
#Well prepared vegetables, articles of food drinks, ''sadavas'' (pickles), ''raga'' (condiments) and ''lehas'' (preparations in the form of linctus or jam), ''yusha'' (Vegetable-soups), ''rasa'' (meat-soups), ''kambalika'' (sour curry of fish and meat), ''khada'' (sour drinks prepared of fruits), ''mamsa dhana'' (meat preparations), ''bhakshya'' (popped cereals), different eatables, fruits and roots having pleasant odor, color and taste will win over the vomiting caused by mental disgust. <br />
#In general, whatever odor, taste, contact, sound or sights those are pleasing to such patients should be given though otherwise unsuitable and unwholesome because in this way disease can be treated easily [41-44]<br />
<br />
=== Treatment of complications ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
छर्द्युत्थितानां च चिकित्सितात् स्वाच्चिकित्सितं कार्यमुपद्रवाणाम्| <br />
<br />
अतिप्रवृत्तासु विरेचनस्य कर्मातियोगे विहितं विधेयम्||४५|| <br />
<div class="mw-collapsible-content"><br />
<br />
chardyutthitānāṁ ca cikitsitāt svāccikitsitaṁ kāryamupadravāṇām| <br />
<br />
atipravr̥ttāsu virēcanasya karmātiyōgē vihitaṁ vidhēyam||45||<br />
<br />
chardyutthitAnAM ca cikitsitAt svAccikitsitaM kAryamupadravANAm| <br />
<br />
atipravRuttAsu virecanasya karmAtiyoge vihitaM vidheyam||45|| <br />
</div></div><br />
<br />
The treatment of complications arising from vomiting should be done according to the lines suggested in respect of each of those ailments. In case of excessive vomiting; treatment that is suggested in [Cha. Sa.[[Siddhi Sthana]] 6/52-56] for excessive purgation should be carried out [45]<br />
<br />
=== Treatment of chronic ''chhardi'' ===<br />
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<br />
वमिप्रसङ्गात् पवनोऽप्यवश्यं धातुक्षयाद्धृद्धिमुपैति तस्मात्| <br />
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चिरप्रवृत्तास्वनिलापहानि कार्याण्युपस्तम्भनबृंहणानि||४६|| <br />
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सर्पिर्गुडाः क्षीरविधिर्घृतानि कल्याणकत्र्यूषणजीवनानि| <br />
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वृष्यास्तथा मांसरसाः सलेहाश्चिरप्रसक्तां च वमिं जयन्ति||४७|| <br />
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vamiprasaṅgāt pavanō'pyavaśyaṁ dhātukṣayāddhr̥ddhimupaiti tasmāt|<br />
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cirapravr̥ttāsvanilāpahāni kāryāṇyupastambhanabr̥ṁhaṇāni||46|| <br />
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sarpirguḍāḥ kṣīravidhirghr̥tāni kalyāṇakatryūṣaṇajīvanāni| <br />
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vr̥ṣyāstathā māṁsarasāḥ salēhāściraprasaktāṁ ca vamiṁ jayanti||47|| <br />
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vamiprasa~ggAt pavano~apyavashyaM dhAtukShayAddhRuddhimupaiti tasmAt| <br />
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cirapravRuttAsvanilApahAni kAryANyupastambhanabRuMhaNAni||46|| <br />
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sarpirguDAH kShIravidhirghRutAni kalyANakatryUShaNajIvanAni| <br />
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vRuShyAstathA mAMsarasAH salehAshciraprasaktAM ca vamiM jayanti||47|| <br />
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In persistent vomiting vāta invariably gets aggravated because of loss of tissue elements. Therefore, in case of chronic vomiting medications that are bulk promoting, [[vata]] pacifying, ''upastambhana'' (astringents) and [[brimhana]] (nutritive) should be administered.<br />
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The following recipes are useful in chronic type of vomiting.<br />
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''Sarpirguda'' [Cha. Sa. [[Chikitsa Sthana]] 11/50-77], ''kshira-vidhi'' (milk boiled by adding [[vata]]-alleviating drugs), ''kalyanaka-ghrita'' [Cha. Sa. [[Chikitsa Sthana]] 9/33-42], ''tryushana-ghrita'' [ Cha. Sa. [[Chikitsa Sthana]] 18/39-42], ''jivaniya-ghrita'' [Cha. Sa. [[Chikitsa Sthana]] 29/55-57], ''vrishya'' (virilific) recipes, ''mamsarasa'' (meat soup) and ''lehya'' like ''chyavanprasha'' (linctuses) [46-47]<br />
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=== Summary ===<br />
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तत्र श्लोकः- <br />
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हेतुं सङ्ख्यां लक्षणमुपद्रवान् साध्यतां न योगांश्च| <br />
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छर्दीनां प्रशमार्थं प्राह चिकित्सितं मुनिवर्यः||४८||<br />
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tatra ślōkaḥ- <br />
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hētuṁ saṅkhyāṁ lakṣaṇamupadravān sādhyatāṁ na yōgāṁśca| <br />
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chardīnāṁ praśamārthaṁ prāha cikitsitaṁ munivaryaḥ||48|| <br />
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tatra shlokaH- <br />
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hetuM sa~gkhyAM lakShaNamupadravAn sAdhyatAM na yogAMshca| <br />
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chardInAM prashamArthaM prAha cikitsitaM munivaryaH||48|| <br />
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To sum up, in this chapter the predisposing factors, numerals of the vomiting, symptoms, complications, prognosis, formulations and other measures of management for the relief of vomiting are described by the foremost of the sages [48]<br />
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Thus the section on therapeutics in the treatise compiled by Agnivesha redacted by Charaka and reconstructed by Dridhabala as it was not available.<br />
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== Tattva Vimarsha (Fundamental Principles) ==<br />
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*''Chhardi'' (vomiting) can be either caused by vitiation of endogenous [[dosha]] or by exogenous factors like in ''dvistartha-yogaja-chhardi'' (that results from contact with unpleasant sense objects).<br />
*The [[dosha]] vitiation due to their own specific causative factors lead to irritation of stomach, spread through ''rasayani'' (channels carrying rasa) resulting in ''chhardi''. Different types of ''chhardi'' shall be diagnosed based on the specific etio-pathogenesis and clinical presentation. <br />
*Mind and sense objects play significant role in pathogenesis of ''chhardi'' due to exposure to unwholesome objects. <br />
*The prognosis of ''chhardi'' depends upon strength of patient, bouts, presence of associated disorders and complications, contents of vomitus. <br />
*All the types of vomiting are considered originating from the agitations of the [[dosha]] in the stomach. Therefore, fasting therapy is first principle of treatment. Purification therapies of [[kapha]] and [[pitta]] are administered to expel out vitiated [[dosha]]. These therapies are contraindicated in cases of [[vata]] dominance. The choice of therapy depends upon strength of patient and type of vitiated [[dosha]]. <br />
*The drugs having nutritive properties, carminative, [[dosha]] pacifying actions are prescribed in the treatment of ''chhardi''. <br />
*Sublingual, pleasant tasting linctus, mild purgative to open the channel to lower G I tract.<br />
*During initial stage of ''chhardi'', because of irritated stomach, anti-emetic treatment is not advised. Soothing, taste enhancing and nutritive liquid substances should be given. Mind diverting and entertaining activities are also advised.<br />
*The treatment of complications arising from vomiting should be done according to the lines suggested in respect of each of those ailments.<br />
*In persistent vomiting [[vata]] invariably gets aggravated because of loss of tissue elements. Therefore, in case of chronic vomiting medications that are bulk promoting, [[vata]] pacifying, ''upastambhana'' (astringents) and [[brimhana]] (nutritive) should be administered.<br />
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== Vidhi Vimarsha (Applied Inferences ) ==<br />
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=== Pathogenesis ===<br />
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''Mahasrotus'' (gastrointestinal tract) has two parts, upper part is ''annavaha srotus'' and lower part is [[purisha]]vaha srotus. ''Atisara'' is related to [[purisha]]vaha srotus and ''chhardi'' is to ''annavaha srotus''. Etiological factors of ''chhardi'' are irritating food and practices to ''amashaya'' (stomach). They are [[vata]] vitiating, impairing ''annavaha srotus''. Even before the digestion process starts the food comes out because of action of ''urdhvavata'' or ''udanavata'', therefore, there is no involvement of [[agni]]. ''Chhardi'' is a defense mechanism to expel the toxins out of the stomach. There is vacuum created by repeated expulsion of stomach contents and ''rasayinis''(villi) instead of their normal function of absorption, they start secreting body fluids into to the stomach. <br />
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=== Types of ''chhardi'' ===<br />
<br />
Diseases are classified according to the dominance of [[dosha]]-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''. <br />
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''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> <br />
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==== [[Vata]]ja chhardi ==== <br />
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There are many factors that increase [[vata]] in the ''sharira'' .<ref> Sushruta. Sutra sthana cha 21 Vranaprashna Adhyaya verse 19. In: Kaviraj Shastri Ambika Dutt, editors, 5th Edition, Varanasi : Chaukhamba Sanskrit Series,1982.</ref> Particular ''ahara'' (food), ''vihara'' (lifestyle) and mental factors increase [[vata]] and its ''gunas'' (properties). This aggravation of [[vata]] gunas like ''rukshata'' (dryness), ''laghuta'' (lightness), etc. plays a role in causing [[vata]]ja chhardi. [ Cha. Sa. [[Sutra Sthana]] 1/59] [[dosha]] conjugate (''sammurchhana'' [ Cha. Sa.[[Sutra Sthana]] 18/46] with a particular organ (''mahasrotas, amashaya, marma'' (vital organ), ''urdhwabhaga'' (upper trunk, etc) as ''dushyas'' (affected [[dhatu]]) to cause [[vata]]ja chhardi (as ''utkshepana'' (upward movement), ''adhahkshepana'' (downward movement), etc are the ''karmas'' (actions) of [[vayu]])-(7-9).<br />
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==== [[Pitta]]ja chhardi ====<br />
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''Nidanas'' of [[pitta]]prakopaka increase [[pitta]] in nature <ref> Sushruta, Sutra sthana c21/21 Hindi commentary by Kaviraj, Shastri Ambika Dutt, 5th Edition, 1982, Chaukhamba Sanskrit Series, Varanasi </ref>and cause provocation of ''gunas'' like ''ushna'' (hot), ''tikshna'' (sharp), ''snigdha'' (unctous), etc. [ Cha. Sa. [[Sutra Sthana]] 1/60] in the body. This aggravated ''pitta'' joins (''sammurchhana'') with a particular organ (''rasayani, amashaya, marma, urdhwabhaga,'' etc) as ''dushyas''. The conjugation of [[dosha]] and ''dushya'' has affinity towards ''urdhwabhaga'' which results in [[pitta]]ja chhardi (10-11).<br />
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==== [[Kapha]]ja chhardi ====<br />
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''Nidanas'' of [[kapha]]prakopaka increase [[kapha]] in nature which causes provocation of [[guna]] like ''guru'' (heavyness), ''sheeta'' (coldness), ''manda'' (slowness), etc. [ Cha. Sa.[[Sutra Sthana]] 1/60] in the body. This aggravated [[kapha]] joins (''sammurchhana'') with a particular organ (''urah'' (chest), ''shirah'' (head), ''rasayani marma, urdhwabhaga,'' etc.) as ''dushyas''. This amalgamation of [[dosha]] and ''dushya'' has affinity towards ''urdhwabhaga'' which results in [[kapha]]ja chhardi(12-13).<br />
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==== ''Sannipataja chhardi'' ====<br />
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Intake of diet containing all ''rasas'' or tastes ideal but the intake of food with imbalances in ''rasas'' leads to the vitiation of ''tridoshas''[Cha.Sa.Sutra Sthana 26/90-101]and causes ''sannipataja chhardi'' which has varied manifestations covering broad signs of ''tridosha'' involvement ( verses 14-15). <br />
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The ''sama-varna-gandha'' (color & smell similar to) of vomitus is due to conjugation with [[purisha]] (stool) and [[mutra]] (urine). This conjugation indicates involvement of multiple ''srotasas'' and have tendency towards ''asadhyata'' (incurable)[Cha. Sa. [[Vimana Sthana]] 5/3] ( verses 16-17).<br />
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Excessive loss of any [[dhatu]] ([[rasa dhatu]]-[[rakta]]-vasa, etc) due to physical exercise or [[vamana]] vega'' (bouts) or arising out of any complications in the form of diseases like ''kasa'' (cough), ''shwasa'' (asthama), ''jwara'' (fever)<ref>Madhavakara. Madhava Nidanam (Roga vinischaya) cha 15. Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--</ref>, etc. are considered to be life threatening.<br />
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=== Treatment ===<br />
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*[[Langhana]] becomes the first line of treatment in ''chhardi'' as ''shamana chikitsa'' (pacificatory treatment). ''Samshodha'' can be preferred where [[dosha]] are in ''utklishtha'' stage and ready to be expelled out. [[Vamana]] is recommended when [[dosha]] 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 [[dosha]], considering nearest route of ''samshodhana''. The choice of drugs should be done as per the [[dosha]]nashakatva(capacity to subside the vitiated [[dosha]]) ( verse 20).<br />
*''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]]. <br />
*As the [[dosha]] 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). <br />
*In [[vata]]ja 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 [[vata]]ja hridroga.<br />
*If the aggravated [[dosha]] are in distal part of ''amashaya'' (post- ''amashaya'') the nearest route to remove [[pitta]] is through [[virechana]] procedure. If the aggravated [[pitta]] is in ''amashaya'' then the nearest route to remove [[pitta]] is through [[vamana]]. Both these procedures should be adopted in ''balavana rogi'' (physically strong patient) judiciously clubbing with proper ''samsarjana krama'' (protocol after purification procedure) to prevent aggravation of [[vata]] [[dosha]]. <br />
*For ''shamana'' treatment the selection of drugs should be [[pitta]] pacifying, ''manapralhadakara'' (mind pleasing) and ''balya'' (strength of patient) criteria. The mechanism of action of these drugs can be through ''hetu viparita'' (anti-etiology), ''vyadhi viparita'' (anti-disease) or ''hetu-vyadhi veeparita chikitsa'' (anti-cause & disease treatment). <br />
*For [[kapha]]ja chhardi chikitsa, as the [[dosha]] are situated in ''kaphashaya'' (''amashaya / ura'') the nearest and ideal route is [[vamana]]. The choice of ''dravyas'' for [[vamana]] should be [[kapha]]hara'' like ''pippali, sarshapa, nimbatoya, madanaphala,'' etc. The choice of treatment is based on aggravated ''dosha, sanchayasthana'' (place of accumulation), ''sannikrishtha marga'' (nearest route), ''dosha-shamaka guna'' of ''dravyas'', etc. <br />
*Various types of ''yusha, ragashadava, panaka'' [ Cha. Sa. [[Sutra Sthana]] 27/279-281] are ''kaphahara, madhura-amlarasatmaka'' (sweet & sour), ''deepaneeya-pachaneeya'' (appetizer & digestant) in nature. <br />
*For ''chhardinigrahana'' (anti-emetic group), the drugs should be ''kashaya rasatmaka'' (astringent taste), ''sheetaveerya'' (cool potency) and [[kapha]]ghna ([[kapha]] alleviators) in nature. The ''manahshiladi yoga'' (a formulation) is considered to be ''vyadhiviparitarthakari'' (anti-disease) measures.<br />
*In case of ''dwistarthayoga chhardi'' (vomiting due to hate/ aversion), the treatment includes ''ashvasana'' (assurance), ''vartalapa'' (conversation), ''mitramandali'' (friend circle), ''mananusarena ahara-vihara'' (preferable food & lifestyle). By doing so one can easily overcome the disease for the time being and once the ''vegavastha'' (vomiting bouts) is overcome, actual conceptual treatment can be adopted. <br />
*The ''vegakalina'' or chronic ''chhardi'', whether mild or severe, involves constant irritation of involved body parts/systems which leads to poor nourishment of [[dhatu]] resulting in [[dhatu]]ksheenata. Such a long term [[dhatu]]kshaya (loss of [[dhatu]]) increases [[vata]] in the body. The management should be purely [[vata]]shamaka treatment especially [[stambhana]] (which restricts the [[vamana]] vega) in combination with [[brimhana]] (nourishment to [[dhatu]]).<br />
<br />
The selection of drugs plays very important role here. Most of the dravyas mentioned here are ''vichitrapratyarabhadha'' (extraordinary) in nature which achieve [[stambhana]] but would not increase [[vata]]. The description about ''sarpiguda'' (a formulation), ''kalyanaka ghrita'' (a formulation), ''vrishya yoga'' (a formulation), ''avalehas'' (a formulation) etc. are the desired formulations for the management may have synergistic action.<br />
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=== Current clinical practice for management of chhardi (referred from Chikitsa Pradeep page 25) ===<br />
{|class="wikitable"<br />
!scope = "col"| Type<br />
!scope = "col"| Medicine<br />
!scope = "col"| Dosage<br />
!scope = "col"| Time<br />
!scope = "col"| ''Anupana''<br />
|-<br />
| [[Vata]] dominant and [[vata]]-[[pitta]] dominant<br />
| ''Shankha bhasma''<br />
| 60-120 mg<br />
| Frequently<br />
| ''Nimbu Panaka'' (lemon water)<br />
|-<br />
|[[Pitta]] dominant<br />
| ''Sutashekhara kalpa''<br />
| 500-1000 mg<br />
| Frequently<br />
| ''Dadimavaleha''<br />
|-<br />
| [[Kapha]] dominant<br />
| ''Mayu piccha mashi''<br />
| 1 - 3 gms<br />
| Frequently<br />
| ''Ardrakavaleha''<br />
|-<br />
| Tri[[dosha]]ja<br />
| ''Brihad vata chintamani''<br />
| 50 - 100 mg<br />
| Frequently<br />
| ''Ardraka swarasa'' + sugar + honey<br />
|-<br />
| ''Dauhridaja'' (in pregnancy)<br />
| ''Swarnashekhara'' mixture<br />
| 250-500 mg<br />
| After meals<br />
| ''Ardraka swarasa'' + ''Nimbu swarasa'' + rock salt<br />
|-<br />
| ''Krimija''<br />
| ''Vidanga-yavani phanta''<br />
| 20-40 ml<br />
| Empty stomach, two times<br />
| ''-''<br />
|}<br />
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=== Further researches ===<br />
Many parenteral and oral medicines are available in conventional medical systems for management of dehydration and emergency conditions. The ayurveada drugs listed in this chaper need to be researched further for evaluating their efficacy specifically in conditions where the parenteral administration is contra-indicated and in case of drug intorerance.<br />
</div><br />
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[[#top| Back to the Top ]]</span></div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Chhardi_Chikitsa&diff=45387Chhardi Chikitsa2025-11-17T06:33:46Z<p>Agnivesha: /* Vataja chhardi */</p>
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<div>{{CiteButton}}<br />
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|description=Chikitsa Sthana Chapter 20. Management of Chhardi (vomiting)<br />
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<big>'''[[Chikitsa Sthana]] Chapter 20. Management of Chhardi (vomiting) </big>'''<br />
{{Infobox<br />
|title = Chhardi Chikitsa<br />
|label1 = Section/Chapter<br />
|data1 = [[Chikitsa Sthana]] Chapter 20<br />
|label2 = Preceding Chapter<br />
|data2 = [[Atisara Chikitsa]]<br />
<br />
|label3= Succeeding Chapter<br />
|data3 = [[Visarpa Chikitsa]]<br />
|label5 = Other Sections<br />
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br />
|label6 = Translator and commentator<br />
|data6 = Murthy A.R.V., Jani D.<br />
|label7 = Reviewer <br />
|data7 = Prasad B.S.<br />
|label8 = Editors<br />
|data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br />
|label9 = Year of publication <br />
|data9 = 2020<br />
|label10 = Publisher <br />
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label11 = DOI <br />
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.021 10.47468/CSNE.2020.e01.s06.021]<br />
}}<br />
<br />
<big>'''Abstract </big>'''<br />
<p style='text-align:justify;'>''Chhardi'' (vomiting), is a common gastrointestinal disorder characterized by bouts of vomiting, nausea, pain and black outs. The causative factors of ''chhardi'' can be categorized under dietary, lifestyle and psychological factors. Dietary factors include excessive ''upavasa'' (starvation), over intake of ''vidahi'' or ''snigdha-guru dravya'' (drugs which are very acrid, unctuous and heavy to digest), etc. Lifestyle aspects include excessive exercise, ''divasvapna'' (day sleep), etc. whereas the psychological stressors like excess worries, grief, anger, fear can precipitate it. ''Amashaya'' (stomach) and ''rasayani'' (channels) are the sites of origin of ''chhardi''. Vitiated [[dosha]] accumulate in ''amashaya'' and ''rasayani'' and are thrown out forcefully from the upper part of body causing ''pida'' (pain) to ''urdhva avayavas'' (organs situated above supraclavicular region). Comprehensive management includes avoidance of etiological factors with pharmacological treatment through medicament as well as non-pharmacological methods. <br />
</p><br />
'''Keywords''': ''Chhardi chikitsa, chhardi,'' vomiting, emesis<br />
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<br />
== Introduction ==<br />
<div style="text-align:justify;"><br />
After explaining the [[Atisara Chikitsa]] (treatment of diarrhea), there is a description of [[Chhardi Chikitsa]]. The word ''chhardi'' is derived from the root ''chhard vamane''. The word ''chhad'' means gripping (''avritta'' or ''achhadana'') and ''ard'' means pain (''peedha'')<ref>Madhavakara. Chardi praarana verse 15, In:Shastri Suderashan,editor, Madhava Nidanam (Roga vinischaya). 4th ed. Varanasi: Chaukhamba Sanskrit Series,1975.pp--</ref>. The other words like ''chhardah, chhardana, chhardi, chhardika,'' etc. are considered as the synonyms of ''chhardi''.<ref>Charak. Chikitsa Sthana, Cha.20 Chhardi Chikitsa Adhyaya. In: Bramhanand Tripathi Editor. Charak Samhita.,? ed. Varanasi: Chaukhamba Sanskrit Pratisthan,2015. p.?.</ref> The words ''chhardi'' and [[vamana]], both are used in the sense of vomiting but have basic differences. ''Chhardi'' is a pathological condition where the sufferer is exposed to particular predisposing factors for vomiting and as a result, suffers from the particular condition called ''chhardi''. On the other hand [[vamana]] is one of the purification therapies of [[Panchakarma]] (five purification procedures in [[Ayurveda]]) where the physician intends to induce vomiting to expel out vitiated [[kapha]] and [[pitta]]. In general, the vitiated [[dosha]] accumulate in stomach and are thrown out from the body through various channels. There are two major channels from which the body generally does such excretory mechanism.<ref>Sushruta. Sharira Sthana, Cha.5 Shareerasankhyavyakarana Sharira Adhyaya verse 10. In: Kaviraj Shastri Ambika Dutt, Editors. Sushruta Samhita. 5th ed. Varanasi: Chaukhamba Sanskrit Series,1982. p.?.</ref> The one is adhomārga (excretion through downward channel) for which the description of ''atisara'' is given in previous chapter and the other one is ''urdhvabhaga'' (excretion through the upward channel) where the description of ''chhardi'' is discussed here. ''Chhardi'' comes under the category of ''koshtha rasayani shrita vyadhi'' (diseases of GI tract) whose roots are in ''mahasrotas'' (GI tract) and ''manovaha'' (mind) ''srotasa''. The ''amashaya'' and ''rasayani'' are the involved ''avayavas'' (organs) in this disease.<ref>Chakrapani, Charak. Vimana Sthana, Cha.5 Srotovimna Adhyaya ver.7-3. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.1st ed. Varanasi: Krishnadas Academy;2000.p.4</ref> The management of this disease is by the pharmacological treatment through various herbs/combinations, dietary modifications and psychological counseling. The preventive aspect includes avoidance of causative factors and enhancement in psychological strength to specific items/factors.<ref>Chakrapani, Charak. Vimana Sthana, Cha.5 Srotovimna Adhyaya ver.25. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.1st ed. Varanasi: Krishnadas Academy;2000.p.4</ref> The curative treatment focuses on pharmacotherapy depending upon [[dosha]] dominance and mild ''samshodhana'' (expelling out the vitiated [[dosha]]).<br />
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== Sanskrit Text, Transliteration and English Translation ==<br />
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अथातश्छर्दिचिकित्सितं व्याख्यास्यामः||१|| <br />
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इति ह स्माह भगवानात्रेयः||२||<br />
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athātaśchardicikitsitaṁ vyākhyāsyāmaḥ||1|| <br />
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iti ha smāha bhagavānātrēyaḥ||2|| <br />
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athAtashchardicikitsitaM vyAkhyAsyAmaH||1|| <br />
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iti ha smAha bhagavAnAtreyaH||2||<br />
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Now we shall expound the chapter "Chhardi chikitsa" (Management of vomiting). Thus said Lord Atreya. [1-2]<br />
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यशस्विनं ब्रह्मतपोद्युतिभ्यां ज्वलन्तमग्न्यर्कसमप्रभावम्| <br />
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पुनर्वसुं भूतहिते निविष्टं पप्रच्छ शिष्योऽत्रिजमग्निवेशः||३|| <br />
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yaśasvinaṁ brahmatapōdyutibhyāṁ jvalantamagnyarkasamaprabhāvam| <br />
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punarvasuṁ bhūtahitē niviṣṭaṁ papraccha śiṣyō'trijamagnivēśaḥ||3||<br />
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yashasvinaM brahmatapodyutibhyAM jvalantamagnyarkasamaprabhAvam| <br />
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punarvasuM bhUtahite niviShTaM papraccha shiShyo~atrijamagniveshaH||3||<br />
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Agnivesha the disciple asked Punarvasu, the illustratious son of Atri, who was engrossed in the thinking of the well-being of humanity and who was dazzling with luster of divine knowledge and penance, who was endowed with the brilliance like that of fire and the sun, and who was dedicated to the well-being of all living beings [3]<br />
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=== Queries by Agnivesha ===<br />
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याश्छर्दयः पञ्च पुरा त्वयोक्ता रोगाधिकारे भिषजां वरिष्ठ!| <br />
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तासां चिकित्सां सनिदानलिङ्गां यथावदाचक्ष्व नृणां हितार्थम्||४|| <br />
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तदग्निवेशस्य वचो निशम्य प्रीतो भिषक्श्रेष्ठ इदं जगाद| <br />
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याश्छर्दयः पञ्च पुरा मयोक्तास्ता विस्तरेण ब्रुवतो निबोध||५||<br />
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yāśchardayaḥ pañca purā tvayōktā rōgādhikārē bhiṣajāṁ variṣṭha!|<br />
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tāsāṁ cikitsāṁ sanidānaliṅgāṁ yathāvadācakṣva nr̥ṇāṁ hitārtham||4|| <br />
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tadagnivēśasya vacō niśamya prītō bhiṣakśrēṣṭha idaṁ jagāda| <br />
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yāśchardayaḥ pañca purā mayōktāstā vistarēṇa bruvatō nibōdha||5||<br />
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yAshchardayaH pa~jca purA tvayoktA rogAdhikAre bhiShajAM variShTha!| <br />
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tAsAM cikitsAM sanidAnali~ggAM yathAvadAcakShva nRuNAM hitArtham||4||<br />
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tadagniveshasya vaco nishamya prIto bhiShakshreShTha idaM jagAda| <br />
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yAshchardayaH pa~jca purA mayoktAstA vistareNa bruvato nibodha||5|| <br />
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Oh! Revered Physician, please describe the treatment of the five types of ''chhardi'' (vomiting) mentioned by you earlier in the context of the enumeration of diseases (in Sutra 19:3-4) along with their etiology, signs and symptoms comprehensively, for the sake of well-being of humanity.<br />
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Having heard Agnivesha and being pleased the best among physicians Punarvasu Atreya said “I shall now expound all the five types of vomiting (briefly) stated earlier, in greater details. Listen to me." [4-5]<br />
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=== Classification and premonitory symptoms ===<br />
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दोषैः पृथक्त्रिप्रभवाश्चतस्रो [१] द्बिष्टार्थयोगादपि पञ्चमी स्यात्| <br />
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तासां हृदुत्क्लेशकफप्रसेकौ द्वेषोऽशने चैव हि पूर्वरूपम्||६| <br />
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dōṣaiḥ pr̥thaktriprabhavāścatasrō dbiṣṭārthayōgādapi pañcamī syāt|<br />
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tāsāṁ hr̥dutklēśakaphaprasēkau dvēṣō'śanē caiva hi pūrvarūpam||6||<br />
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doShaiH pRuthaktriprabhavAshcatasro [1] dbiShTArthayogAdapi pa~jcamI syAt|6| <br />
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tAsAM hRudutkleshakaphaprasekau dveSho~ashane caiva hi pUrvarUpam||6|| <br />
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''Chhardi'' (vomiting) is of five types; three types of vomiting caused by a [[dosha]] each i.e. vatika, paittika, [[kapha]]ja, fourth is ''sannipatika'' and fifth is ''dvistartha-yogaja-chhardi'' (that results from contact with unpleasant sense objects).<br />
The premonitory signs and symptoms of ''chhardi'' (vomiting) are nausea, excessive salivation and aversion to food [6]<br />
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=== [[Vata]]ja chhardi ===<br />
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व्यायामतीक्ष्णौषधशोकरोगभयोपवासाद्यतिकर्शितस्य| <br />
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वायुर्महास्रोतसि सम्प्रवृद्ध उत्क्लेश्य दोषांस्तत ऊर्ध्वमस्यन्||७|| <br />
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आमाशयोत्क्लेशकृतां च मर्म प्रपीडयंश्छर्दिमुदीरयेत्तु| <br />
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हृत्पार्श्वपीडामुखशोषमूर्धनाभ्यर्तिकासस्वरभेदतोदैः||८|| <br />
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उद्गारशब्दप्रबलं सफेनं विच्छिन्नकृष्णं तनुकं कषायम्| <br />
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कृच्छ्रेण चाल्पं महता च वेगेनार्तोऽनिलाच्छर्दयतीह दुःखम्||९||<br />
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vyāyāmatīkṣṇauṣadhaśōkarōgabhayōpavāsādyatikarśitasya| <br />
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vāyurmahāsrōtasi sampravr̥ddha utklēśya dōṣāṁstata ūrdhvamasyan||7|| <br />
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āmāśayōtklēśakr̥tāṁ ca marma prapīḍayaṁśchardimudīrayēttu| <br />
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hr̥tpārśvapīḍāmukhaśōṣamūrdhanābhyartikāsasvarabhēdatōdaiḥ||8|| <br />
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udgāraśabdaprabalaṁ saphēnaṁ vicchinnakr̥ṣṇaṁ tanukaṁ kaṣāyam| <br />
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kr̥cchrēṇa cālpaṁ mahatā ca vēgēnārtō'nilācchardayatīha duḥkham||9||<br />
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vyAyAmatIkShNauShadhashokarogabhayopavAsAdyatikarshitasya| <br />
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vAyurmahAsrotasi [1] sampravRuddha utkleshya doShAMstata Urdhvamasyan||7|| <br />
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AmAshayotkleshakRutAM ca marma prapIDayaMshchardimudIrayettu| <br />
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hRutpArshvapIDAmukhashoShamUrdhanAbhyartikAsasvarabhedatodaiH||8|| <br />
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udgArashabdaprabalaM saphenaM vicchinnakRuShNaM tanukaM kaShAyam| <br />
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kRucchreNa cAlpaM mahatA ca vegenArto~anilAcchardayatIha duHkham||9||<br />
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In a person extremely emaciated because of excess exercise, chronic disease, excessive intake of ''tikshna'' (sharply acting) medicines (of high potency), and indulging in grief, fear, excess fasting, etc. [[vata]] gets excessively aggravated in the ''maha-srotas'' (gastrointestinal tract), vitiates the local [[dosha]] and pushes them upwards. These [[dosha]] cause agitation in the ''amashaya'' (stomach), and after afflicting the ''marma'' (vital organs-heart) gives rise to ''chhardi'' (vomiting). This [[vata]]ja type of vomiting is characterized by the following signs and symptoms: <br />
#Pain in the cardiac region and flanks; <br />
#Dryness of the mouth; <br />
#Pain in the head and umbilical region; <br />
#Cough, hoarseness of voice and pricking pain; <br />
#Eructation with loud noise; <br />
#Vomiting of material which is frothy, scattered, black in color, thin and astringent; <br />
#The urge for vomiting is forceful, but patient vomits only in small quantities with pain; <br />
#The patient feels miserable [7-9]<br />
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=== [[Pitta]]ja chhardi ===<br />
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अजीर्णकट्वम्लविदाह्यशीतैरामाशये पित्तमुदीर्णवेगम्| <br />
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रसायनीभिर्विसृतं प्रपीड्य मर्मोर्ध्वमागम्य वमिं करोति||१०|| <br />
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मूर्च्छापिपासामुखशोषमूर्धताल्वक्षिसन्तापतमोभ्रमार्तः| <br />
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पीतं भृशोष्णं हरितं सतिक्तं धूम्रं च पित्तेन वमेत् सदाहम्||११||<br />
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ajīrṇakaṭvamlavidāhyaśītairāmāśayē pittamudīrṇavēgam| <br />
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rasāyanībhirvisr̥taṁ prapīḍya marmōrdhvamāgamya vamiṁ karōti||10|| <br />
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mūrcchāpipāsāmukhaśōṣamūrdhatālvakṣisantāpatamōbhramārtaḥ| <br />
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pītaṁ bhr̥śōṣṇaṁ haritaṁ satiktaṁ dhūmraṁ ca pittēna vamēt sadāham||11|| <br />
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ajIrNakaTvamlavidAhyashItairAmAshaye pittamudIrNavegam| <br />
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rasAyanIbhirvisRutaM prapIDya marmordhvamAgamya vamiM karoti||10|| <br />
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mUrcchApipAsAmukhashoShamUrdhatAlvakShisantApatamobhramArtaH| <br />
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pItaM bhRushoShNaM haritaM satiktaM dhUmraM ca pittena vamet sadAham||11|| <br />
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As a result of indigestion, taking pungent, sour, ''vidahi'' (which cause burning sensation) and hot potency food, the [[pitta]] in the stomach gets aggravated. This aggravated [[pitta]] spreads through the ''rasayani'' (channels) and stresses the vital organs located in the upper part of the body which results in vomiting: <br />
<br />
The signs and symptoms of this [[pitta]]ja type of ''chhardi'' (vomiting) are: <br />
#Fainting, morbid thirst and parching of mouth; <br />
#Burning (or heating) sensation in the head, palate and eyes; <br />
#A feeling as if the patient is entering into darkness: <br />
#Giddiness; <br />
#Vomitus is yellow, excessively hot, green, bitter and smoky in appearance with burning sensation [10-11]<br />
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=== [[Kapha]]ja chhardi ===<br />
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स्निग्धातिगुर्वामविदाहिभोज्यैः स्वप्नादिभिश्चैव कफोऽतिवृद्धः| <br />
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उरः शिरो मर्म रसायनीश्च सर्वाः समावृत्य वमिं करोति||१२|| <br />
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तन्द्रास्यमाधुर्यकफप्रसेकसन्तोषनिद्रारुचिगौरवार्तः| <br />
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स्निग्धं घनं स्वादु कफाद्विशुद्धं सलोमहर्षोऽल्परुजं वमेत्तु||१३||<br />
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snigdhātigurvāmavidāhibhōjyaiḥ svapnādibhiścaiva kaphō'tivr̥ddhaḥ| <br />
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uraḥ śirō marma rasāyanīśca sarvāḥ samāvr̥tya vamiṁ karōti||12|| <br />
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tandrāsyamādhuryakaphaprasēkasantōṣanidrārucigauravārtaḥ| <br />
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snigdhaṁ ghanaṁ svādu kaphādviśuddhaṁ salōmaharṣō'lparujaṁ vamēttu||13|| <br />
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snigdhAtigurvAmavidAhibhojyaiH svapnAdibhishcaiva kapho~ativRuddhaH| <br />
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uraH shiro marma rasAyanIshca sarvAH samAvRutya vamiM karoti||12|| <br />
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tandrAsyamAdhuryakaphaprasekasantoShanidrArucigauravArtaH| <br />
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snigdhaM ghanaM svAdu kaphAdvishuddhaM salomaharSho~alparujaM vamettu||13||<br />
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As a result of the intake of unctuous, excessively heavy to digest, ''ama'' (raw/uncooked) and ''vidahi'' (causing burning sensation) food and because of excessive sleep and similar other factors, [[kapha]] gets excessively aggravated. This [[kapha]] occludes the chest, head, vital organs and all the (concerned) channels to cause ''chhardi'' (vomiting). The signs and symptoms of this [[kapha]]ja type of ''chhardi'' are as follows:<br />
#Drowsiness, sweetness in the mouth and salivation; <br />
#Sense of satiety, sleep, anorexia and heaviness; <br />
#Vomitus is unctuous, dense, sweet and devoid of any undesirable smell; and is associated with horripilation and slight pain [12-13]<br />
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=== Tri[[dosha]]ja chhardi ===<br />
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समश्नतः सर्वरसान् प्रसक्तमामप्रदोषर्तुविपर्ययैश्च| <br />
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सर्वे प्रकोपं युगपत् प्रपन्नाश्छर्दिं त्रिदोषां जनयन्ति दोषाः||१४|| <br />
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शूलाविपाकारुचिदाहतृष्णाश्वासप्रमोहप्रबला प्रसक्तम्| <br />
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छर्दिस्त्रिदोषाल्लवणाम्लनीलसान्द्रोष्णरक्तं वमतां नृणां स्यात्||१५|| <br />
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samaśnataḥ sarvarasān prasaktamāmapradōṣartuviparyayaiśca|<br />
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sarvē prakōpaṁ yugapat prapannāśchardiṁ tridōṣāṁ janayanti dōṣāḥ||14|| <br />
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śūlāvipākārucidāhatr̥ṣṇāśvāsapramōhaprabalā prasaktam| <br />
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chardistridōṣāllavaṇāmlanīlasāndrōṣṇaraktaṁ vamatāṁ nr̥ṇāṁ syāt||15|| <br />
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samashnataH sarvarasAn prasaktamAmapradoShartuviparyayaishca| <br />
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sarve prakopaM yugapat prapannAshchardiM tridoShAM janayanti doShAH||14|| <br />
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shUlAvipAkArucidAhatRuShNAshvAsapramohaprabalA prasaktam| <br />
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chardistridoShAllavaNAmlanIlasAndroShNaraktaM vamatAM nRuNAM syAt||15||<br />
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Because of constant indulgence in diet consisting of wholesome and unwholesome diet together, having all categories of taste together because of ''ama-dosha'' (ailments caused by improper digestion) and because of seasonal perversions, all the three [[dosha]] get simultaneously aggravated and cause ''sannipatika chhardi''.<br />
<br />
The signs and symptoms of this type of vomiting are as follows: <br />
#Colic pain, indigestion, anorexia, burning sensation, morbid thirst, dyspnea and fainting spells that are severe and persistent; <br />
#Vomitus is salty, sour, blue, dense, hot and reddish [14-15]<br />
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=== Bad prognostic symptoms ===<br />
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विट्स्वेदमूत्राम्बुवहानि वायुः स्रोतांसि संरुध्य यदोर्ध्वमेति| <br />
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उत्सन्नदोषस्य समाचितं तं दोषं समुद्धूय नरस्य कोष्ठात्||१६|| <br />
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विण्मूत्रयोस्तत् समवर्णगन्धं तृट्श्वासहिक्कार्तियुतं प्रसक्तम्| <br />
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प्रच्छर्दयेद्दुष्टमिहातिवेगात्तयाऽर्दितश्चाशु विनाशमेति||१७|| <br />
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viṭsvēdamūtrāmbuvahāni vāyuḥ srōtāṁsi saṁrudhya yadōrdhvamēti| <br />
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utsannadōṣasya samācitaṁ taṁ dōṣaṁ samuddhūya narasya kōṣṭhāt||16|| <br />
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viṇmūtrayōstat samavarṇagandhaṁ tr̥ṭśvāsahikkārtiyutaṁ prasaktam| <br />
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pracchardayēdduṣṭamihātivēgāttayā'rditaścāśu vināśamēti||17|| <br />
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viTsvedamUtrAmbuvahAni vAyuH srotAMsi saMrudhya yadordhvameti| <br />
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utsannadoShasya samAcitaM taM doShaM samuddhUya narasya koShThAt||16|| <br />
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viNmUtrayostat samavarNagandhaM tRuTshvAsahikkArtiyutaM prasaktam| <br />
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pracchardayedduShTamihAtivegAttayA~arditashcAshu vinAshameti||17|| <br />
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When the morbid [[vata]] occludes the channels carrying faeces, sweat, urine and body fluids and moves upwards, then the morbid matter from the ''koshtha'' (gastrointestinal tract), gets incited to cause vomiting, that has the following characteristics:<br />
#Vomitus having color and odor of the feces and urine; <br />
#Persistent thirst, dyspnea hiccup and pain <br />
#Vomiting of foul smelling or ''dusta'' (putrid material); and <br />
#Bouts of vomiting ejected with great force. <br />
<br />
Such a patient succumbs to death quickly [16-17]<br />
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=== ''Dvishtharthasamyogaja chhardi'' ===<br />
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<br />
द्विष्टप्रतीपाशुचिपूत्यमेध्यबीभत्सगन्धाशनदर्शनैश्च| <br />
<br />
यच्छर्दयेत्तप्तमना मनोध्नैर्द्विष्टार्थसंयोगभवा मता सा||१८|| <br />
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<br />
dviṣṭapratīpāśucipūtyamēdhyabībhatsagandhāśanadarśanaiśca| <br />
<br />
yacchardayēttaptamanā manōdhnairdviṣṭārthasaṁyōgabhavā matā sā||18||<br />
<br />
dviShTapratIpAshucipUtyamedhyabIbhatsagandhAshanadarshanaishca| <br />
<br />
yacchardayettaptamanA manodhnairdviShTArthasaMyogabhavA matA sA||18||<br />
</div></div><br />
<br />
As a result of mental disgust occasioned by senses contact with despicable, antagonistic, unclean, putrid, unholy and loathsome odors, diet or sights, the ''chhardi''(vomiting) is known as vomiting induced by contact with hateful things [18]<br />
<br />
=== Symptoms of incurable ''chhardi'' ===<br />
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<br />
क्षीणस्य या छर्दिरतिप्रवृद्धा सोपद्रवा शोणितपूययुक्ता| <br />
<br />
सचन्द्रिकां तां प्रवदन्त्यसाध्यां साध्यां चिकित्सेदनुपद्रवां च||१९||<br />
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<br />
kṣīṇasya yā chardiratipravr̥ddhā sōpadravā śōṇitapūyayuktā| <br />
<br />
sacandrikāṁ tāṁ pravadantyasādhyāṁ sādhyāṁ cikitsēdanupadravāṁ ca||19|| <br />
<br />
kShINasya yA chardiratipravRuddhA sopadravA shoNitapUyayuktA| <br />
<br />
sacandrikAM tAM pravadantyasAdhyAM sAdhyAM cikitsedanupadravAM ca||19|| <br />
</div></div><br />
<br />
Vomiting that occurs in an emaciated person, that continues incessantly, that is associated with complications, and vomitus that contains blood, pus and ''chandrika'' (circular shiny patches with variegated color) is incurable. The physician should treat only curable types that are not associated with complications [19]<br />
<br />
=== Principles of treatment ===<br />
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<br />
आमाशयोत्क्लेशभवा हि सर्वाश्छर्द्यो मता लङ्घनमेव तस्मात्| <br />
<br />
प्राक्कारयेन्मारुतजां विमुच्य संशोधनं वा कफपित्तहारि||२०|| <br />
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<br />
āmāśayōtklēśabhavā hi sarvāśchardyō matā laṅghanamēva tasmāt| <br />
<br />
prākkārayēnmārutajāṁ vimucya saṁśōdhanaṁ vā kaphapittahāri||20|| <br />
<br />
AmAshayotkleshabhavA hi sarvAshchardyo matA la~gghanameva tasmAt| <br />
<br />
prAkkArayenmArutajAM vimucya saMshodhanaM vA kaphapittahAri||20|| <br />
</div></div><br />
<br />
As all the types of vomiting are considered originating from the agitations of the [[dosha]] in the stomach, fasting therapy should first be prescribed or purificatory procedure curative of [[kapha]] and [[pitta]] should be administered except in cases of [[vata]] dominance. [20]<br />
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<br />
चूर्णानि लिह्यान्मधुनाऽभयानां हृद्यानि वा यानि विरेचनानि| <br />
<br />
मद्यैः पयोभिश्च युतानि युक्त्या नयन्त्यधो दोषमुदीर्णमूर्ध्वम्||२१|| <br />
<br />
वल्लीफलाद्यैर्वमनं पिबेद्वा यो दुर्बलस्तं शमनैश्चिकित्सेत्| <br />
<br />
रसैर्मनोज्ञैर्लघुभिर्विशुष्कैर्भक्ष्यैः सभोज्यैर्विविधैश्च पानैः||२२|| <br />
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<br />
cūrṇāni lihyānmadhunā'bhayānāṁ hr̥dyāni vā yāni virēcanāni| <br />
<br />
madyaiḥ payōbhiśca yutāni yuktyā nayantyadhō dōṣamudīrṇamūrdhvam||21|| <br />
<br />
vallīphalādyairvamanaṁ pibēdvā yō durbalastaṁ śamanaiścikitsēt| <br />
<br />
rasairmanōjñairlaghubhirviśuṣkairbhakṣyaiḥ sabhōjyairvividhaiśca pānaiḥ||22||<br />
<br />
cUrNAni lihyAnmadhunA~abhayAnAM hRudyAni vA yAni virecanAni| <br />
<br />
madyaiH payobhishca yutAni yuktyA nayantyadho doShamudIrNamUrdhvam||21|| <br />
<br />
vallIphalAdyairvamanaM pibedvA yo durbalastaM shamanaishcikitset| <br />
<br />
rasairmanoj~jairlaghubhirvishuShkairbhakShyaiH sabhojyairvividhaishca pAnaiH||22||<br />
</div></div><br />
<br />
The patient shall take powder of ''abhaya'' (chebulic myrobalans) with honey or such other palatable purgatives skillfully combined with ''madya'' (alcohol) or ''dugdha'' (milk). These recipes cause downward movement of the aggravated ''doshas'' that are impelled to move upwards. <br />
<br />
Patient may also be given emetic therapy prepared of the drugs of the ''valliphala'' (group of cucurbitaceous fruits), etc. or if the patient is weak, then he should be treated with pacification therapy through delicious soups and light as well as dry food articles for diet along with various kinds of drinks [21-22]<br />
<br />
=== Treatment of [[vata]]ja chhardi ===<br />
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<br />
सुसंस्कृतास्तित्तिरिबर्हिलावरसा व्यपोहन्त्यनिलप्रवृत्ताम्|<br />
<br />
छर्दिं तथा कोलकुलत्थधान्यबिल्वादिमूलाम्लयवैश्च यूषः||२३||<br />
<br />
वातात्मिकायां हृदयद्रवार्तो नरः पिबेत् सैन्धववद्धृतं तु|<br />
<br />
सिद्धं तथा धान्यकनागराभ्यां दध्ना च तोयेन च दाडिमस्य||२४||<br />
<br />
व्योषेण युक्तां लवणैस्त्रिभिश्च घृतस्य मात्रामथवा विदध्यात्|<br />
<br />
स्निग्धानि हृद्यानि च भोजनानि रसैः सयूषैर्दधिदाडिमाम्लैः||२५||<br />
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<br />
susaṁskr̥tāstittiribarhilāvarasā vyapōhantyanilapravr̥ttām| <br />
<br />
chardiṁ tathā kōlakulatthadhānyabilvādimūlāmlayavaiśca yūṣaḥ||23|| <br />
<br />
vātātmikāyāṁ [1] hr̥dayadravārtō naraḥ pibēt saindhavavaddhr̥taṁ tu| <br />
<br />
siddhaṁ tathā dhānyakanāgarābhyāṁ dadhnā ca tōyēna ca dāḍimasya||24|| <br />
<br />
vyōṣēṇa yuktāṁ lavaṇaistribhiśca ghr̥tasya mātrāmathavā vidadhyāt| <br />
<br />
snigdhāni hr̥dyāni ca bhōjanāni rasaiḥ sayūṣairdadhidāḍimāmlaiḥ||25|| <br />
<br />
SusamskrutAstittiribrhilAvrasA vyapohantyanilapravRuttAm| <br />
<br />
chardiM tathA kolakulatthadhAnyabilvAdimUlAmlayavaishca yUShaH||23||<br />
<br />
vAtAtmikAyAM hRudayadravArto naraH pibet saindhavavaddhRutaM tu|<br />
<br />
siddhaM tathA dhAnyakanAgarAbhyAM dadhnA ca toyena ca dADimasya||24||<br />
<br />
vyoSheNa yuktAM lavaNaistribhishca ghRutasya mAtrAmathavA vidadhyAt|<br />
<br />
snigdhAni hRudyAni ca bhojanAni rasaiH sayUShairdadhidADimAmlaiH||25||<br />
</div></div><br />
<br />
The following recipes are useful in [[vata]]ja type of vomiting (''chhardi''): <br />
#The meat juice of ''tittiri'' (partridge), ''barhi'' and ''lava'' (common quail); <br />
#Vegetable soup prepared out of ''kola'' (Zyziphus jujuba), ''kulattha'' (horse gram/Dolichos biflorus), ''dhanya'' (coriander fruit/coriandrum sativum ), group of roots of ''bilva'' (Bilva-Bengal quince/''bael'' fruit/Aegle marmelos), etc. (''syonaka'' (Oroxylem indicum) , ''gambhari'' (Gmelina arborea), ''patala'' (Trumpet/Stereospermum chelonoides), ''ganikarika'' (Premna integrifolia)), ''amla'' (sour substances) and ''yava'' (barley/Hordeum vulgare); <br />
#If the patient is suffering from vomiting of ''vata'' type of ''chhardi'' that is associated with ''hriddrava'' (palpitation), then may take ghee with rock salt. <br />
#Ghee cooked with ''dhanyaka'' (coriander), ''nagara'' (dry zingiber/ginger/Zingiber officinale), ''dadhi''(curd) and the juice of ''dadima'' (pomegranate/Punica granatum); <br />
#Ghee mixed with the powder of ''trikatu'' (''shunthi, pippali'' and ''maricha'') and three salts viz. ''saindhava'' (rock salt), ''sauvarchala'' (black salt) and ''vida'' (''pakyam'')); <br />
#The diet consisting of unctuous and palatable food, meat soups, vegetable-soup, curd sour ''dadima'' (pomegranate/Punica granatum) [23-25]<br />
<br />
=== Treatment of [[pitta]]ja chhardi ===<br />
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<br />
पित्तात्मिकायामनुलोमनार्थं द्राक्षाविदारीक्षुरसैस्त्रिवृत् स्यात्| <br />
<br />
कफाशयस्थं त्वतिमात्रवृद्धं पित्तं हरेत् स्वादुभिरूर्ध्वमेव||२६|| <br />
<br />
शुद्धाय काले मधुशर्कराभ्यां लाजैश्च मन्थं यदि वाऽपि पेयाम्| <br />
<br />
प्रदापयेन्मुद्गरसेन वाऽपि शाल्योदनं जाङ्गलजै रसैर्वा||२७|| <br />
<br />
सितोपलामाक्षिकपिप्पलीभिः कुल्माषलाजायवसक्तुगृञ्जान्| <br />
<br />
खर्जूरमांसान्यथ नारिकेलं द्राक्षामथो वा बदराणि लिह्यात्||२८|| <br />
<br />
स्रोतोजलाजोत्पलकोलमज्जचूर्णानि लिह्यान्मधुनाऽभयां च| <br />
<br />
कोलास्थिमज्जाञ्जनमक्षिकाविड्लाजासितामागधिकाकणान् वा||२९|| <br />
<br />
द्राक्षारसं वाऽपि पिबेत् सुशीतं मृद्भृष्टलोष्टप्रभवं जलं वा| <br />
<br />
जम्ब्वाम्रयोः पल्लवजं कषायं पिबेत् सुशीतं मधुसंयुतं वा||३०|| <br />
<br />
निशि स्थितं वारि समुद्गकृष्णं सोशीरधान्यं चणकोदकं वा| <br />
<br />
गवेधुकामूलजलं गुडूच्या जलं पिबेदिक्षुरसं पयो वा||३१|| <br />
<br />
सेव्यं पिबेत् काञ्चनगैरिकं वा सबालकं तण्डुलधावनेन| <br />
<br />
धात्रीरसेनोत्तमचन्दनं वा तृष्णावमिघ्नानि समाक्षिकाणि||३२|| <br />
<br />
कल्कं तथा चन्दनचव्यमांसीद्राक्षोत्तमाबालकगैरिकाणाम्| <br />
<br />
शीताम्बुना गैरिकशालिचूर्णं मूर्वां तथा तण्डुलधावनेन||३३|| <br />
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<br />
pittātmikāyāmanulōmanārthaṁ drākṣāvidārīkṣurasaistrivr̥t syāt| <br />
<br />
kaphāśayasthaṁ tvatimātravr̥ddhaṁ pittaṁ harēt svādubhirūrdhvamēva||26|| <br />
<br />
śuddhāya kālē madhuśarkarābhyāṁ lājaiśca manthaṁ yadi vā'pi pēyām| <br />
<br />
pradāpayēnmudgarasēna vā'pi śālyōdanaṁ jāṅgalajai rasairvā||27|| <br />
<br />
sitōpalāmākṣikapippalībhiḥ kulmāṣalājāyavasaktugr̥ñjān| <br />
<br />
kharjūramāṁsānyatha nārikēlaṁ drākṣāmathō vā badarāṇi lihyāt||28|| <br />
<br />
srōtōjalājōtpalakōlamajjacūrṇāni lihyānmadhunā'bhayāṁ ca| <br />
<br />
kōlāsthimajjāñjanamakṣikāviḍlājāsitāmāgadhikākaṇān vā||29|| <br />
<br />
drākṣārasaṁ vā'pi pibēt suśītaṁ mr̥dbhr̥ṣṭalōṣṭaprabhavaṁ jalaṁ vā| <br />
<br />
jambvāmrayōḥ pallavajaṁ kaṣāyaṁ pibēt suśītaṁ madhusaṁyutaṁ vā||30|| <br />
<br />
niśi sthitaṁ vāri samudgakr̥ṣṇaṁ sōśīradhānyaṁ caṇakōdakaṁ vā| <br />
<br />
gavēdhukāmūlajalaṁ guḍūcyā jalaṁ pibēdikṣurasaṁ payō vā||31|| <br />
<br />
sēvyaṁ pibēt kāñcanagairikaṁ vā sabālakaṁ taṇḍuladhāvanēna| <br />
<br />
dhātrīrasēnōttamacandanaṁ vā tr̥ṣṇāvamighnāni samākṣikāṇi||32|| <br />
<br />
kalkaṁ tathā candanacavyamāṁsīdrākṣōttamābālakagairikāṇām| <br />
<br />
śītāmbunā gairikaśālicūrṇaṁ mūrvāṁ tathā taṇḍuladhāvanēna||33|| <br />
<br />
pittAtmikAyAmanulomanArthaM drAkShAvidArIkShurasaistrivRut syAt| <br />
<br />
kaphAshayasthaM tvatimAtravRuddhaM pittaM haret svAdubhirUrdhvameva||26|| <br />
<br />
shuddhAya kAle madhusharkarAbhyAM lAjaishca manthaM yadi vA~api peyAm| <br />
<br />
pradApayenmudgarasena vA~api shAlyodanaM jA~ggalajai rasairvA||27|| <br />
<br />
sitopalAmAkShikapippalIbhiH kulmAShalAjAyavasaktugRu~jjAn| <br />
<br />
kharjUramAMsAnyatha nArikelaM drAkShAmatho vA badarANi lihyAt||28|| <br />
<br />
srotojalAjotpalakolamajjacUrNAni lihyAnmadhunA~abhayAM ca| <br />
<br />
kolAsthimajjA~jjanamakShikAviDlAjAsitAmAgadhikAkaNAn vA||29|| <br />
<br />
drAkShArasaM vA~api pibet sushItaM mRudbhRuShTaloShTaprabhavaM jalaM vA| <br />
<br />
jambvAmrayoH pallavajaM kaShAyaM pibet sushItaM madhusaMyutaM vA||30|| <br />
<br />
nishi sthitaM vAri samudgakRuShNaM soshIradhAnyaM caNakodakaM vA| <br />
<br />
gavedhukAmUlajalaM guDUcyA jalaM pibedikShurasaM payo vA||31|| <br />
<br />
sevyaM pibet kA~jcanagairikaM vA sabAlakaM taNDuladhAvanena| <br />
<br />
dhAtrIrasenottamacandanaM vA tRuShNAvamighnAni samAkShikANi||32|| <br />
<br />
kalkaM tathA candanacavyamAMsIdrAkShottamAbAlakagairikANAm| <br />
<br />
shItAmbunA gairikashAlicUrNaM mUrvAM tathA taNDuladhAvanena||33||<br />
</div></div><br />
<br />
The patient of [[pitta]]ja type of ''chhardi'' should be given ''trivrit'' (Operculina turpethum) along with the juice of ''draksha'' (grapes/Vitis vinifera), ''vidari'' (Purera tuberosa) and ''ikshu'' (sugar-cane/Saccharaum officinarum) for causing downward movement of the morbid matter (laxation). When aggravated pitta is located in site of [[kapha]] (chest/stomach), then drugs having sweet taste should be administered for elimination of [[pitta]] (through emetic therapy). <br />
<br />
After this purificatory therapy patient should be given at proper time ''laja-mantha'' (flour of popped-rice diluted in water) or ''laja-peya'' (thin gruel made of popped-rice) along with honey and sugar. The patient may also be given boiled shāli type of rice along with the soup of ''mudga'' (green gram/Phaseolus aureus) or the meat juice of ''jangala'' creatures (animals inhabiting in arid zone). <br />
<br />
The following recipes are also advocated in this context:<br />
#''Kulmasha'', the paste of boiled ''mudga'' (green gram/Phaseolus aureus), ''masura'' (lentil/ Ervum lens), etc., ''laja'' (popped paddy), ''yava-saktu'' (flour of roasted barley), ''grunja'' (boiled barley along with its supernatant segment), or the pulp of ''kharjura'' (date/Phoenix sylvestris), ''narikela'' (coconut/Cocos nucifera), ''draksha'' (grapes/Vitis vinifera) or ''badara'' (Zyziphus jujuba) should be made to a linctus by adding ''sitopala'' (sugar having big crystals), honey and ''pippali'' (long pepper/Piper longum).<br />
#The water of fountain, ''laja'' (popped paddy), ''utpala'' (Nymphaea stellata) and the pulp of ''kola'' (Zyziphus jujuba) be made into linctus by adding honey, and given.<br />
#''Abhaya'' (chebulic myrobalan) with honey may also be taken. <br />
#The seed-pulp of ''kola'' (Zyziphus jujuba), ''anjana'' (''srotonjana''), ''makshika vit'' (excreta of house- fly), ''laja'' (popped paddy), sugar and grains of ''pippali'' mixed with honey. <br />
#The patient may drink cooled grape juice or cooled water prepared with baked clay or earth. <br />
#The patient may be given the cooled decoction of the tender leaves of ''jambu'' (Syzygium cumini) and ''amra'' (mango/Mangifera indica) by adding honey. <br />
#The following things kept overnight should be taken: <br />
##Water with ''mudga'' (green gram/Phaseolus aureus) and ''pippali'' (long pepper/ Piper longum),<br />
##Water with ''usheera'' (cuscus grass/Viteveria zizanioides) and ''dhanyaka'' (coriander/Coriandrum sativum), <br />
##Water with ''chanaka'' (bengal gram/gram/chick pea/Cicer arietinum), <br />
##Water with root of ''gavedhuka'' (Adlay/Jobs tears/Coix lachryma),<br />
##Water with ''guduchi'' (Tinospora cordifolia),<br />
###The patient may be given sugar-cane-juice or milk to drink.<br />
#The following recipes are useful in morbid thirst and vomiting: <br />
##The powder of ''sevya'' (Cuscus grass/Viteveria zizanioides) and ''kanchana-gairika'' (Hematite, Fe2O3) along with ''tandulodaka'' (rice-water); <br />
##The powder of ''sevya'' and ''balaka'' (Coleus vettiveroides) along with ''tandulodaka'' (rice-water); <br />
##The paste of white variety of ''chandana'' (sandal wood) mixed with the juice of ''amalaki'' (emblic myrobalan/Emblica officinale) along with honey. <br />
#The following recipes also useful in ''paittika'' type of vomiting: <br />
##The paste of ''chandana'' (sandal wood/Santalum album), ''chavya'' (Piper chaba/Piper officinarum), ''mamsi'' (Indian nard/nardus root/Nardostachys jatamansi), ''draksha'' (grapes/Vitis vinifera) of good quality, ''balaka'' (Coleus vettiveroides) and ''gairika'' (Hematite, Fe2O3); <br />
##Powder of ''gairika'' (Hematite, Fe2O3) and ''shali'' rice along with cold water; <br />
##Powder of ''murva'' (Marsdenia tenacissima / sansevieria roxburghiana) along with ''tandulodaka'' (rice-water)[26-33]<br />
<br />
=== Treatment of [[kapha]]ja chhardi ===<br />
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<br />
कफात्मिकायां वमनं प्रशस्तं सपिप्पलीसर्षपनिम्बतोयैः| <br />
<br />
पिण्डीतकैः सैन्धवसम्प्रयुक्तैर्वम्यां कफामाशयशोधनार्थम्||३४|| <br />
<br />
गोधूमशालीन् सयवान् पुराणान् यूषैः पटोलामृतचित्रकाणाम्| <br />
<br />
व्योषस्य निम्बस्य च तक्रसिद्धैर्यूषैः फलाम्लैः कटुभिस्तथाऽद्यात्||३५|| <br />
<br />
रसांश्च शूल्यानि च जाङ्गलानां मांसानि जीर्णान्मधुसीध्वरिष्टान्| <br />
<br />
रागांस्तथा षाडवपानकानि द्राक्षाकपित्थैः फलपूरकैश्च||३६|| <br />
<br />
मुद्गान्मसूरांश्चणकान् कलायान् भृष्टान् युतान्नागरमाक्षिकाभ्याम्| <br />
<br />
लिह्यात्तथैव त्रिफलाविडङ्गचूर्णं विडङ्गप्लवयोरथो [१] वा||३७|| <br />
<br />
सजाम्बवं वा बदराम्लचूर्णं [२] मुस्तायुतां कर्कटकस्य शृङ्गीम्| <br />
<br />
दुरालभां वा मधुसम्प्रयुक्तां लिह्यात् कफच्छर्दिविनिग्रहार्थम्||३८|| <br />
<br />
मनःशिलायाः फलपूरकस्य रसैः कपित्थस्य च पिप्पलीनाम्| <br />
<br />
क्षौद्रेण चूर्णं मरिचैश्च युक्तं लिहञ्जयेच्छर्दिमुदीर्णवेगाम्||३९||<br />
<div class="mw-collapsible-content"><br />
<br />
kaphātmikāyāṁ vamanaṁ praśastaṁ sapippalīsarṣapanimbatōyaiḥ| <br />
<br />
piṇḍītakaiḥ saindhavasamprayuktairvamyāṁ kaphāmāśayaśōdhanārtham||34|| <br />
<br />
gōdhūmaśālīn sayavān purāṇān yūṣaiḥ paṭōlāmr̥tacitrakāṇām| <br />
<br />
vyōṣasya nimbasya ca takrasiddhairyūṣaiḥ phalāmlaiḥ kaṭubhistathā'dyāt||35|| <br />
<br />
rasāṁśca śūlyāni ca jāṅgalānāṁ māṁsāni jīrṇānmadhusīdhvariṣṭān| <br />
<br />
rāgāṁstathā ṣāḍavapānakāni drākṣākapitthaiḥ phalapūrakaiśca||36|| <br />
<br />
mudgānmasūrāṁścaṇakān kalāyān bhr̥ṣṭān yutānnāgaramākṣikābhyām| <br />
<br />
lihyāttathaiva triphalāviḍaṅgacūrṇaṁ viḍaṅgaplavayōrathō vā||37|| <br />
<br />
sajāmbavaṁ vā badarāmlacūrṇaṁ mustāyutāṁ karkaṭakasya śr̥ṅgīm| <br />
<br />
durālabhāṁ vā madhusamprayuktāṁ lihyāt kaphacchardivinigrahārtham||38|| <br />
<br />
manaḥśilāyāḥ phalapūrakasya rasaiḥ kapitthasya ca pippalīnām| <br />
<br />
kṣaudrēṇa cūrṇaṁ maricaiśca yuktaṁ lihañjayēcchardimudīrṇavēgām||39||<br />
<br />
kaphAtmikAyAM vamanaM prashastaM sapippalIsarShapanimbatoyaiH| <br />
<br />
piNDItakaiH saindhavasamprayuktairvamyAM kaphAmAshayashodhanArtham||34|| <br />
<br />
godhUmashAlIn sayavAn purANAn yUShaiH paTolAmRutacitrakANAm| <br />
<br />
vyoShasya nimbasya ca takrasiddhairyUShaiH phalAmlaiH kaTubhistathA~adyAt||35|| <br />
<br />
rasAMshca shUlyAni ca jA~ggalAnAM mAMsAni jIrNAnmadhusIdhvariShTAn| <br />
<br />
rAgAMstathA ShADavapAnakAni drAkShAkapitthaiH phalapUrakaishca||36|| <br />
<br />
mudgAnmasUrAMshcaNakAn kalAyAn bhRuShTAn yutAnnAgaramAkShikAbhyAm| <br />
<br />
lihyAttathaiva triphalAviDa~ggacUrNaM viDa~ggaplavayoratho [1] vA||37|| <br />
<br />
sajAmbavaM vA badarAmlacUrNaM [2] mustAyutAM karkaTakasya shRu~ggIm| <br />
<br />
durAlabhAM vA madhusamprayuktAM lihyAt kaphacchardivinigrahArtham||38|| <br />
<br />
manaHshilAyAH phalapUrakasya rasaiH kapitthasya ca pippalInAm| <br />
<br />
kShaudreNa cUrNaM maricaishca yuktaM liha~jjayecchardimudIrNavegAm||39||<br />
</div></div><br />
<br />
''Vamana'' (therapeutic emesis) is supposed to be the most suitable therapy in [[kapha]]ja type of ''chhardi'' (vomiting). In order to clean the seat of [[kapha]] and ''amashaya'', the patient should be given the decoction of ''pippali, sarsapa'' (yellow sarson/Indian colza/Brassica campestris) and ''nimba'' (neem tree/Margosa/Indian lilac/Azadirachta indica) added with powder of ''pinditaka'' (madanaphala/emetic nut/bushy gardenia/Randia dumetorum) and ''saindhava'' (rock-salt). <br />
<br />
The patient should be given old wheat, rice and barley along with <br />
#Vegetable soup of ''patola'' (Trichosanthes dioica), <br />
#''Amrita'' (Tinospora cordifolia) and <br />
#''Chitraka'' (Ceylon leadwort/ white leadwort/Plumbago zeylanica) or <br />
#with the soup of ''trikatu'' (three spices) and neem prepared with butter milk, or <br />
#Soup of sour fruits along with pungent drugs. <br />
<br />
The patient should also take the meat juices and roasted flesh of ''jangala'' creature (animals inhabiting arid zone), old honey, ''sidhu'' (alcohol prepared of sugar-cane-juice) and ''arishta'' (a type of alcoholic drink); and ''raga'' (condiments), shādava (pickles) and ''panaka'' (syrup) prepared of ''draksha'' (grapes) and ''phala-puraka'' (citrion/Citrus medica). <br />
<br />
The patient should take following three recipes mixed with ''shunthi'' (dry zingiber) and honey: <br />
#Roasted ''mudga'' (green gram), ''masura'' (lentil/Ervum lens), ''chanaka'' (bengal gram/Gram/ chick pea/Cicer arietinum) and ''kalaya'' (peas/Pisum sativum) <br />
#''Triphala'' (''haritaki, bibhitaka'' and ''amalaka''), and ''vidanga'' (babreng fruits/embelia ribes)<br />
#''Vidanga'' (babreng fruits/embelia ribes) and ''plava'' (nut grass/Cyperys rotundus) <br />
<br />
The following recipes should be taken mixed with the honey <br />
#''Jambu'' (Syzygium cumini) and sour fruits of ''badara'' (Zizyphus jujuba) <br />
#''Musta'' (nut grass/Cyperus rotundus)and ''karkata-shringi'' (Pistacia integerrima)<br />
#''Duralabha'' (Fegonia cretica). <br />
<br />
The forcefully generated urge of vomiting can be controlled with the following regims <br />
#Purified ''manahsila'' (red arsenic) with the juice of ''bijapuraka'' (citrion/Citrus medica), <br />
#''Pippali'' (long piper/Piper longum) mixed with the juice of ''kapittha'' (Feronia limonia)<br />
#''Maricha'' (black pepper/Piper nigrum) with honey [34-39]<br />
<br />
=== Treatment of ''sannipatika chhardi'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
यैषा पृथक्त्वेन मया क्रियोक्ता तां सन्निपातेऽपि समस्य [१] बुद्ध्या| <br />
<br />
दोषर्तुरोगाग्निबलान्यवेक्ष्य प्रयोजयेच्छास्त्रविदप्रमत्तः||४०||<br />
<div class="mw-collapsible-content"><br />
<br />
yaiṣā pr̥thaktvēna mayā kriyōktā tāṁ sannipātē'pi samasya buddhyā| <br />
<br />
dōṣarturōgāgnibalānyavēkṣya prayōjayēcchāstravidapramattaḥ||40||<br />
<br />
yaiShA pRuthaktvena mayA kriyoktA tAM sannipAte~api samasya [1] buddhyA| <br />
<br />
doSharturogAgnibalAnyavekShya prayojayecchAstravidapramattaH||40||<br />
</div></div><br />
<br />
Judicious synthesis of the separate lines of treatment indicated by me for the derangement of individual humors should be employed by the learned physician for the patient suffering from ''sannipatika chhardi'' after carefully examining the relative preponderance of the [[dosha]] involved, the season when the disease has occurred, the stage of the disease and the power of digestion of the patient [40]<br />
<br />
=== Treatment of ''dvishtarathasamyogaja (manobhighataja) chhardi'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
मनोभिघाते तु मनोनुकूला वाचः समाश्वासनहर्षणानि| <br />
<br />
लोकप्रसिद्धाः श्रुतयो वयस्याः शृङ्गारिकाश्चैव हिता विहाराः||४१|| <br />
<br />
गन्धा विचित्रा मनसोऽनुकूला मृत्पुष्पशुक्ताम्लफलादिकानाम्| <br />
<br />
शाकानि भोज्यान्यथ पानकानि सुसंस्कृताः षाडवरागलेहाः||४२|| <br />
<br />
यूषा रसाः काम्बलिका खडाश्च मांसानि धाना विविधाश्च भक्ष्याः|<br />
<br />
फलानि मूलानि च गन्धवर्णरसैरुपेतानि वमिं जयन्ति||४३|| <br />
<br />
गन्धं रसं स्पर्शमथापि शब्दं रूपं च यद्यत् प्रियमप्यसात्म्यम्| <br />
<br />
तदेव दद्यात् प्रशमाय तस्यास्तज्जो हि रोगः सुख एव जेतुम्||४४|| <br />
<div class="mw-collapsible-content"><br />
<br />
manōbhighātē tu manōnukūlā vācaḥ samāśvāsanaharṣaṇāni| <br />
<br />
lōkaprasiddhāḥ śrutayō vayasyāḥ śr̥ṅgārikāścaiva hitā vihārāḥ||41|| <br />
<br />
gandhā vicitrā manasō'nukūlā mr̥tpuṣpaśuktāmlaphalādikānām| <br />
<br />
śākāni bhōjyānyatha pānakāni susaṁskr̥tāḥ ṣāḍavarāgalēhāḥ||42|| <br />
<br />
yūṣā rasāḥ kāmbalikā khaḍāśca māṁsāni dhānā vividhāśca bhakṣyāḥ| <br />
<br />
phalāni mūlāni ca gandhavarṇarasairupētāni vamiṁ jayanti||43|| <br />
<br />
gandhaṁ rasaṁ sparśamathāpi śabdaṁ rūpaṁ ca yadyat priyamapyasātmyam| <br />
<br />
tadēva dadyāt praśamāya tasyāstajjō hi rōgaḥ sukha ēva jētum||44||<br />
<br />
manobhighAte tu manonukUlA vAcaH samAshvAsanaharShaNAni| <br />
<br />
lokaprasiddhAH shrutayo vayasyAH shRu~ggArikAshcaiva hitA vihArAH||41|| <br />
<br />
gandhA vicitrA manaso~anukUlA mRutpuShpashuktAmlaphalAdikAnAm| <br />
<br />
shAkAni bhojyAnyatha pAnakAni susaMskRutAH ShADavarAgalehAH||42|| <br />
<br />
yUShA rasAH kAmbalikA khaDAshca mAMsAni dhAnA vividhAshca bhakShyAH| <br />
<br />
phalAni mUlAni ca gandhavarNarasairupetAni vamiM jayanti||43|| <br />
<br />
gandhaM rasaM sparshamathApi shabdaM rUpaM ca yadyat priyamapyasAtmyam| <br />
<br />
tadeva dadyAt prashamAya tasyAstajjo hi rogaH sukha eva jetum||44||<br />
</div></div><br />
<br />
In case of vomiting caused by mental disgust the following measures should be resorted to: <br />
#Words which are pleasing and comforting, counseling and encouraging <br />
#Popular legends and stories, congenial companions and pleasant wholesome diversions, amorous and wholesome regimens (games); <br />
#Odor of various types of pleasing perfumes emanating from the earth, flowers, vinegar (''sukta'') and sour fruits<br />
#Well prepared vegetables, articles of food drinks, ''sadavas'' (pickles), ''raga'' (condiments) and ''lehas'' (preparations in the form of linctus or jam), ''yusha'' (Vegetable-soups), ''rasa'' (meat-soups), ''kambalika'' (sour curry of fish and meat), ''khada'' (sour drinks prepared of fruits), ''mamsa dhana'' (meat preparations), ''bhakshya'' (popped cereals), different eatables, fruits and roots having pleasant odor, color and taste will win over the vomiting caused by mental disgust. <br />
#In general, whatever odor, taste, contact, sound or sights those are pleasing to such patients should be given though otherwise unsuitable and unwholesome because in this way disease can be treated easily [41-44]<br />
<br />
=== Treatment of complications ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
छर्द्युत्थितानां च चिकित्सितात् स्वाच्चिकित्सितं कार्यमुपद्रवाणाम्| <br />
<br />
अतिप्रवृत्तासु विरेचनस्य कर्मातियोगे विहितं विधेयम्||४५|| <br />
<div class="mw-collapsible-content"><br />
<br />
chardyutthitānāṁ ca cikitsitāt svāccikitsitaṁ kāryamupadravāṇām| <br />
<br />
atipravr̥ttāsu virēcanasya karmātiyōgē vihitaṁ vidhēyam||45||<br />
<br />
chardyutthitAnAM ca cikitsitAt svAccikitsitaM kAryamupadravANAm| <br />
<br />
atipravRuttAsu virecanasya karmAtiyoge vihitaM vidheyam||45|| <br />
</div></div><br />
<br />
The treatment of complications arising from vomiting should be done according to the lines suggested in respect of each of those ailments. In case of excessive vomiting; treatment that is suggested in [Cha. Sa.[[Siddhi Sthana]] 6/52-56] for excessive purgation should be carried out [45]<br />
<br />
=== Treatment of chronic ''chhardi'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
वमिप्रसङ्गात् पवनोऽप्यवश्यं धातुक्षयाद्धृद्धिमुपैति तस्मात्| <br />
<br />
चिरप्रवृत्तास्वनिलापहानि कार्याण्युपस्तम्भनबृंहणानि||४६|| <br />
<br />
सर्पिर्गुडाः क्षीरविधिर्घृतानि कल्याणकत्र्यूषणजीवनानि| <br />
<br />
वृष्यास्तथा मांसरसाः सलेहाश्चिरप्रसक्तां च वमिं जयन्ति||४७|| <br />
<div class="mw-collapsible-content"><br />
<br />
vamiprasaṅgāt pavanō'pyavaśyaṁ dhātukṣayāddhr̥ddhimupaiti tasmāt|<br />
<br />
cirapravr̥ttāsvanilāpahāni kāryāṇyupastambhanabr̥ṁhaṇāni||46|| <br />
<br />
sarpirguḍāḥ kṣīravidhirghr̥tāni kalyāṇakatryūṣaṇajīvanāni| <br />
<br />
vr̥ṣyāstathā māṁsarasāḥ salēhāściraprasaktāṁ ca vamiṁ jayanti||47|| <br />
<br />
vamiprasa~ggAt pavano~apyavashyaM dhAtukShayAddhRuddhimupaiti tasmAt| <br />
<br />
cirapravRuttAsvanilApahAni kAryANyupastambhanabRuMhaNAni||46|| <br />
<br />
sarpirguDAH kShIravidhirghRutAni kalyANakatryUShaNajIvanAni| <br />
<br />
vRuShyAstathA mAMsarasAH salehAshciraprasaktAM ca vamiM jayanti||47|| <br />
</div></div><br />
<br />
In persistent vomiting vāta invariably gets aggravated because of loss of tissue elements. Therefore, in case of chronic vomiting medications that are bulk promoting, [[vata]] pacifying, ''upastambhana'' (astringents) and [[brimhana]] (nutritive) should be administered.<br />
<br />
The following recipes are useful in chronic type of vomiting.<br />
<br />
''Sarpirguda'' [Cha. Sa. [[Chikitsa Sthana]] 11/50-77], ''kshira-vidhi'' (milk boiled by adding [[vata]]-alleviating drugs), ''kalyanaka-ghrita'' [Cha. Sa. [[Chikitsa Sthana]] 9/33-42], ''tryushana-ghrita'' [ Cha. Sa. [[Chikitsa Sthana]] 18/39-42], ''jivaniya-ghrita'' [Cha. Sa. [[Chikitsa Sthana]] 29/55-57], ''vrishya'' (virilific) recipes, ''mamsarasa'' (meat soup) and ''lehya'' like ''chyavanprasha'' (linctuses) [46-47]<br />
<br />
=== Summary ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
तत्र श्लोकः- <br />
<br />
हेतुं सङ्ख्यां लक्षणमुपद्रवान् साध्यतां न योगांश्च| <br />
<br />
छर्दीनां प्रशमार्थं प्राह चिकित्सितं मुनिवर्यः||४८||<br />
<div class="mw-collapsible-content"><br />
<br />
tatra ślōkaḥ- <br />
<br />
hētuṁ saṅkhyāṁ lakṣaṇamupadravān sādhyatāṁ na yōgāṁśca| <br />
<br />
chardīnāṁ praśamārthaṁ prāha cikitsitaṁ munivaryaḥ||48|| <br />
<br />
tatra shlokaH- <br />
<br />
hetuM sa~gkhyAM lakShaNamupadravAn sAdhyatAM na yogAMshca| <br />
<br />
chardInAM prashamArthaM prAha cikitsitaM munivaryaH||48|| <br />
</div></div><br />
<br />
To sum up, in this chapter the predisposing factors, numerals of the vomiting, symptoms, complications, prognosis, formulations and other measures of management for the relief of vomiting are described by the foremost of the sages [48]<br />
<br />
Thus the section on therapeutics in the treatise compiled by Agnivesha redacted by Charaka and reconstructed by Dridhabala as it was not available.<br />
<br />
== Tattva Vimarsha (Fundamental Principles) ==<br />
<br />
*''Chhardi'' (vomiting) can be either caused by vitiation of endogenous [[dosha]] or by exogenous factors like in ''dvistartha-yogaja-chhardi'' (that results from contact with unpleasant sense objects).<br />
*The [[dosha]] vitiation due to their own specific causative factors lead to irritation of stomach, spread through ''rasayani'' (channels carrying rasa) resulting in ''chhardi''. Different types of ''chhardi'' shall be diagnosed based on the specific etio-pathogenesis and clinical presentation. <br />
*Mind and sense objects play significant role in pathogenesis of ''chhardi'' due to exposure to unwholesome objects. <br />
*The prognosis of ''chhardi'' depends upon strength of patient, bouts, presence of associated disorders and complications, contents of vomitus. <br />
*All the types of vomiting are considered originating from the agitations of the [[dosha]] in the stomach. Therefore, fasting therapy is first principle of treatment. Purification therapies of [[kapha]] and [[pitta]] are administered to expel out vitiated [[dosha]]. These therapies are contraindicated in cases of [[vata]] dominance. The choice of therapy depends upon strength of patient and type of vitiated [[dosha]]. <br />
*The drugs having nutritive properties, carminative, [[dosha]] pacifying actions are prescribed in the treatment of ''chhardi''. <br />
*Sublingual, pleasant tasting linctus, mild purgative to open the channel to lower G I tract.<br />
*During initial stage of ''chhardi'', because of irritated stomach, anti-emetic treatment is not advised. Soothing, taste enhancing and nutritive liquid substances should be given. Mind diverting and entertaining activities are also advised.<br />
*The treatment of complications arising from vomiting should be done according to the lines suggested in respect of each of those ailments.<br />
*In persistent vomiting [[vata]] invariably gets aggravated because of loss of tissue elements. Therefore, in case of chronic vomiting medications that are bulk promoting, [[vata]] pacifying, ''upastambhana'' (astringents) and [[brimhana]] (nutritive) should be administered.<br />
<br />
== Vidhi Vimarsha (Applied Inferences ) ==<br />
<br />
=== Pathogenesis ===<br />
<br />
''Mahasrotus'' (gastrointestinal tract) has two parts, upper part is ''annavaha srotus'' and lower part is [[purisha]]vaha srotus. ''Atisara'' is related to [[purisha]]vaha srotus and ''chhardi'' is to ''annavaha srotus''. Etiological factors of ''chhardi'' are irritating food and practices to ''amashaya'' (stomach). They are [[vata]] vitiating, impairing ''annavaha srotus''. Even before the digestion process starts the food comes out because of action of ''urdhvavata'' or ''udanavata'', therefore, there is no involvement of [[agni]]. ''Chhardi'' is a defense mechanism to expel the toxins out of the stomach. There is vacuum created by repeated expulsion of stomach contents and ''rasayinis''(villi) instead of their normal function of absorption, they start secreting body fluids into to the stomach. <br />
<br />
=== Types of ''chhardi'' ===<br />
<br />
Diseases are classified according to the dominance of [[dosha]]-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''. <br />
<br />
''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> <br />
<br />
==== [[Vata]]ja chhardi ==== <br />
<br />
There are many factors that increase [[vata]] in the ''sharira'' .<ref> Sushruta. Sutra sthana cha 21 Vranaprashna Adhyaya verse 19. In: Kaviraj Shastri Ambika Dutt, editors, 5th Edition, Varanasi : Chaukhamba Sanskrit Series,1982.</ref> Particular ''ahara'' (food), ''vihara'' (lifestyle) and mental factors increase [[vata]] and its ''gunas'' (properties). This aggravation of [[vata]] gunas like ''rukshata'' (dryness), ''laghuta'' (lightness), etc. plays a role in causing [[vata]]ja chhardi. [ Cha. Sa. [[Sutra Sthana]] 1/59] [[dosha]] conjugate (''sammurchhana'' [ Cha. Sa.[[Sutra Sthana]] 18/46] with a particular organ (''mahasrotas, amashaya, marma'' (vital organ), ''urdhwabhaga'' (upper trunk, etc) as ''dushyas'' (affected [[dhatu]]) to cause [[vata]]ja chhardi (as ''utkshepana'' (upward movement), ''adhahkshepana'' (downward movement), etc are the ''karmas'' (actions) of [[vayu]])-(7-9).<br />
<br />
==== [[Pitta]]ja chhardi ====<br />
<br />
''Nidanas'' of [[pitta]]prakopaka increase [[pitta]] in nature <ref> Sushruta, Sutra sthana c21/21 Hindi commentary by Kaviraj, Shastri Ambika Dutt, 5th Edition, 1982, Chaukhamba Sanskrit Series, Varanasi </ref>and cause provocation of ''gunas'' like ''ushna'' (hot), ''tikshna'' (sharp), ''snigdha'' (unctous), etc. [ Cha. Sa. [[Sutra Sthana]] 1/60] in the body. This aggravated ''pitta'' joins (''sammurchhana'') with a particular organ (''rasayani, amashaya, marma, urdhwabhaga,'' etc) as ''dushyas''. The conjugation of [[dosha]] and ''dushya'' has affinity towards ''urdhwabhaga'' which results in [[pitta]]ja chhardi (10-11).<br />
<br />
==== [[Kapha]]ja chhardi ====<br />
<br />
''Nidanas'' of [[kapha]]prakopaka increase [[kapha]] in nature which causes provocation of [[guna]] like ''guru'' (heavyness), ''sheeta'' (coldness), ''manda'' (slowness), etc. [ Cha. Sa.[[Sutra Sthana]] 1/60] in the body. This aggravated [[kapha]] joins (''sammurchhana'') with a particular organ (''urah'' (chest), ''shirah'' (head), ''rasayani marma, urdhwabhaga,'' etc.) as ''dushyas''. This amalgamation of [[dosha]] and ''dushya'' has affinity towards ''urdhwabhaga'' which results in [[kapha]]ja chhardi(12-13).<br />
<br />
==== ''Sannipataja chhardi'' ====<br />
<br />
Intake of diet containing all ''rasas'' or tastes ideal but the intake of food with imbalances in ''rasas'' leads to the vitiation of ''tridoshas''[Cha.Sa.Sutra Sthana 26/90-101]and causes ''sannipataja chhardi'' which has varied manifestations covering broad signs of ''tridosha'' involvement ( verses 14-15). <br />
<br />
The ''sama-varna-gandha'' (color & smell similar to) of vomitus is due to conjugation with [[purisha]] (stool) and [[mutra]] (urine). This conjugation indicates involvement of multiple ''srotasas'' and have tendency towards ''asadhyata'' (incurable)[Cha. Sa. [[Vimana Sthana]] 5/3] ( verses 16-17).<br />
<br />
Excessive loss of any [[dhatu]] ([[rasa dhatu]]-[[rakta]]-vasa, etc) due to physical exercise or [[vamana]] vega'' (bouts) or arising out of any complications in the form of diseases like ''kasa'' (cough), ''shwasa'' (asthama), ''jwara'' (fever)<ref>Madhavakara. Madhava Nidanam (Roga vinischaya) cha 15. Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--</ref>, etc. are considered to be life threatening.<br />
<br />
=== Treatment ===<br />
<br />
*[[Langhana]] becomes the first line of treatment in ''chhardi'' as ''shamana chikitsa'' (pacificatory treatment). ''Samshodha'' can be preferred where [[dosha]] are in ''utklishtha'' stage and ready to be expelled out. [[Vamana]] is recommended when [[dosha]] 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 [[dosha]], considering nearest route of ''samshodhana''. The choice of drugs should be done as per the [[dosha]]nashakatva(capacity to subside the vitiated [[dosha]]) ( verse 20).<br />
*''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]]. <br />
*As the [[dosha]] 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). <br />
*In [[vata]]ja 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 [[vata]]ja hridroga.<br />
*If the aggravated [[dosha]] are in distal part of ''amashaya'' (post- ''amashaya'') the nearest route to remove [[pitta]] is through [[virechana]] procedure. If the aggravated [[pitta]] is in ''amashaya'' then the nearest route to remove [[pitta]] is through [[vamana]]. Both these procedures should be adopted in ''balavana rogi'' (physically strong patient) judiciously clubbing with proper ''samsarjana krama'' (protocol after purification procedure) to prevent aggravation of [[vata]] [[dosha]]. <br />
*For ''shamana'' treatment the selection of drugs should be [[pitta]] pacifying, ''manapralhadakara'' (mind pleasing) and ''balya'' (strength of patient) criteria. The mechanism of action of these drugs can be through ''hetu viparita'' (anti-etiology), ''vyadhi viparita'' (anti-disease) or ''hetu-vyadhi veeparita chikitsa'' (anti-cause & disease treatment). <br />
*For [[kapha]]ja chhardi chikitsa, as the [[dosha]] are situated in ''kaphashaya'' (''amashaya / ura'') the nearest and ideal route is [[vamana]]. The choice of ''dravyas'' for [[vamana]] should be [[kapha]]hara'' like ''pippali, sarshapa, nimbatoya, madanaphala,'' etc. The choice of treatment is based on aggravated ''dosha, sanchayasthana'' (place of accumulation), ''sannikrishtha marga'' (nearest route), ''dosha-shamaka guna'' of ''dravyas'', etc. <br />
*Various types of ''yusha, ragashadava, panaka'' [ Cha. Sa. [[Sutra Sthana]] 27/279-281] are ''kaphahara, madhura-amlarasatmaka'' (sweet & sour), ''deepaneeya-pachaneeya'' (appetizer & digestant) in nature. <br />
*For ''chhardinigrahana'' (anti-emetic group), the drugs should be ''kashaya rasatmaka'' (astringent taste), ''sheetaveerya'' (cool potency) and [[kapha]]ghna ([[kapha]] alleviators) in nature. The ''manahshiladi yoga'' (a formulation) is considered to be ''vyadhiviparitarthakari'' (anti-disease) measures.<br />
*In case of ''dwistarthayoga chhardi'' (vomiting due to hate/ aversion), the treatment includes ''ashvasana'' (assurance), ''vartalapa'' (conversation), ''mitramandali'' (friend circle), ''mananusarena ahara-vihara'' (preferable food & lifestyle). By doing so one can easily overcome the disease for the time being and once the ''vegavastha'' (vomiting bouts) is overcome, actual conceptual treatment can be adopted. <br />
*The ''vegakalina'' or chronic ''chhardi'', whether mild or severe, involves constant irritation of involved body parts/systems which leads to poor nourishment of [[dhatu]] resulting in [[dhatu]]ksheenata. Such a long term [[dhatu]]kshaya (loss of [[dhatu]]) increases [[vata]] in the body. The management should be purely [[vata]]shamaka treatment especially [[stambhana]] (which restricts the [[vamana]] vega) in combination with [[brimhana]] (nourishment to [[dhatu]]).<br />
<br />
The selection of drugs plays very important role here. Most of the dravyas mentioned here are ''vichitrapratyarabhadha'' (extraordinary) in nature which achieve [[stambhana]] but would not increase [[vata]]. The description about ''sarpiguda'' (a formulation), ''kalyanaka ghrita'' (a formulation), ''vrishya yoga'' (a formulation), ''avalehas'' (a formulation) etc. are the desired formulations for the management may have synergistic action.<br />
<br />
=== Current clinical practice for management of chhardi (referred from Chikitsa Pradeep page 25) ===<br />
{|class="wikitable"<br />
!scope = "col"| Type<br />
!scope = "col"| Medicine<br />
!scope = "col"| Dosage<br />
!scope = "col"| Time<br />
!scope = "col"| ''Anupana''<br />
|-<br />
| [[Vata]] dominant and [[vata]]-[[pitta]] dominant<br />
| ''Shankha bhasma''<br />
| 60-120 mg<br />
| Frequently<br />
| ''Nimbu Panaka'' (lemon water)<br />
|-<br />
|[[Pitta]] dominant<br />
| ''Sutashekhara kalpa''<br />
| 500-1000 mg<br />
| Frequently<br />
| ''Dadimavaleha''<br />
|-<br />
| [[Kapha]] dominant<br />
| ''Mayu piccha mashi''<br />
| 1 - 3 gms<br />
| Frequently<br />
| ''Ardrakavaleha''<br />
|-<br />
| Tri[[dosha]]ja<br />
| ''Brihad vata chintamani''<br />
| 50 - 100 mg<br />
| Frequently<br />
| ''Ardraka swarasa'' + sugar + honey<br />
|-<br />
| ''Dauhridaja'' (in pregnancy)<br />
| ''Swarnashekhara'' mixture<br />
| 250-500 mg<br />
| After meals<br />
| ''Ardraka swarasa'' + ''Nimbu swarasa'' + rock salt<br />
|-<br />
| ''Krimija''<br />
| ''Vidanga-yavani phanta''<br />
| 20-40 ml<br />
| Empty stomach, two times<br />
| ''-''<br />
|}<br />
<br />
=== Further researches ===<br />
Many parenteral and oral medicines are available in conventional medical systems for management of dehydration and emergency conditions. The ayurveada drugs listed in this chaper need to be researched further for evaluating their efficacy specifically in conditions where the parenteral administration is contra-indicated and in case of drug intorerance.<br />
</div><br />
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[[#top| Back to the Top ]]</span></div></div>Agniveshahttps://www.carakasamhitaonline.com/index.php?title=Atisara_Chikitsa&diff=45386Atisara Chikitsa2025-11-12T06:06:14Z<p>Agnivesha: /* Sannipataja atisara */</p>
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<div>{{CiteButton}}<br />
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|description=Chikitsa Sthana Chapter 19. Management of Atisara (diarrhea and associated disorders)<br />
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<br />
<big>'''[[Chikitsa Sthana]] Chapter 19. Management of Atisara (diarrhea and associated disorders)</big>'''<br />
{{Infobox<br />
|title = Atisara Chikitsa<br />
|label1 = Section/Chapter<br />
|data1 = [[Chikitsa Sthana]] Chapter 19<br />
|label2 = Preceding Chapter<br />
|data2 = [[Kasa Chikitsa]]<br />
<br />
|label3= Succeeding Chapter<br />
|data3 = [[Chhardi Chikitsa]]<br />
|label5 = Other Sections<br />
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]<br />
|label6 = Translator and commentator<br />
|data6 = Byadgi P.S., Dube N.<br />
|label7 = Reviewer <br />
|data7 = Prasad B.S.<br />
|label8 = Editors<br />
|data8 = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]<br />
|label9 = Year of publication <br />
|data9 = 2020<br />
|label10 = Publisher <br />
|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]<br />
|label11 = DOI <br />
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.020 10.47468/CSNE.2020.e01.s06.020]<br />
}}<br />
<br />
<big>''' Abstract </big>'''<br />
<p style='text-align:justify;'>The chapter on [[Atisara Chikitsa]] (management of diarrhea) traces the historical origin of the disorder since the Vedic period and attributes it to eating of heavy and hot foods specially meat products. There are six types of diarrhea, three of which are caused by single [[dosha]] ([[vata]]ja, [[pitta]]ja and [[kapha]]ja) while a fourth is caused by the combination of all the three [[dosha]]. The fifth and sixth types are caused due to psychological factors such as fear and grief. Some of these variants could be further classified based on their constituents, e.g., [[vata]]ja atisara (diarrhea caused due to [[vata]] [[dosha]]) is further divided into ''ama'' and ''nirama atisara'' (with or without mucoid substances diarrhea) and it has been emphasized not to stop the lose motions in initial or ''ama'' stage. <br />
<br/><br />
The etiology, pathology, signs and symptoms of each of these six types of diarrhea, along with their prognosis have been detailed here.The principles of treatment and complications associated with diarrhea, such as bleeding, suppuration, ulceration and prolapsed anus are also described along with various measures to tackle the problems effectively. <br />
<br/><br />
''Sangrahi'' (astringent or anti-diarrheals) therapies are not advisable in the initial stage of the disease because of presence of ''ama'' inside the body. Instead, mild laxative should be given to eliminate the accumulated [[dosha]]. Diarrhea should be allowed to continue and should not be stopped by constipating or bowel binding drugs. The patients shall be managed with light to digest, nutritive and liquid diet regimen which enhances the power of [[agni]] as well as it helps to stop diarrhea. </p><br />
<br />
'''Keywords''': atisara, diarrhea, ama, nirama, sangrahi treatment, pichcha [[basti]].<br />
<br />
<br />
== Introduction ==<br />
<div style="text-align:justify;"><br />
''Grahani'' and ''atisara'' - both manifest due to the vitiation of [[agni]] and share common features of impairment of digestion resulting in indigestion and loose motions. Therefore, this chapter should logically precede or succeed the chapter on ''grahani''. But it is described three chapters after that on ''grahani''. The reason for this unusual sequencing of these topics is that since ''pandu'' is a common symptom and sequelae of the malabsorption syndrome (''grahani''), the chapter on ''pandu'' follows ''grahani''. Now, dyspnea (''shwasa'') is a major symptom of ''pandu,'' and thus, follows the chapter on ''pandu''. Similarly, chapter on ''kasa'' (cough) follows ''shwasa'' because of their relationship. That explains the sequencing of ''grahani'' and ''atisara'' in [[Charak Samhita]].<br />
<br />
[[Ayurveda]] considers ''atisara'' as a defense mechanism of the body to eject out any toxic material from it. Therefore, it is recommended that in ''amaja'' (or initial) state loose motions should not be checked. After evacuation of toxins from the body, fasting and digestive drugs are prescribed as a cure for milder forms of diarrhea. However, for other types of diarrhea, various preparations, diet and [[basti]] are advised. Piccha[[basti]] (mucilegue type of medicated enema) is prescribed particularly if blood accompanies the stool. Appropriate treatments for ulcer, suppuration of anus and prolapse of anus are dealt with, since these accompany the more complex forms of diarrhea. <br />
<br />
''Atisara'' leads to the depletion of water and beneficial salts, causing dehydration in the body. This provokes [[vata]], and therefore requires taking special care of [[vata]], particularly if, the ''atisara'' is caused by all the three [[dosha]]. Hydration of the body by means of oral administration of milk, buttermilk and various liquid preparations is advised. Goat’s milk is very useful in bloody diarrhea.The treatment of cholera and other dehydrating diarrheal diseases was revolutionized by the promotion of oral rehydration solution (ORS), the efficacy of which depends on the fact that glucose-facilitated absorption of sodium and water in the small intestine remains intact in the presence of cholera toxin. Where indicated, appropriate antimicrobial agents can shorten the duration of illness from 3–4 days to 24–36 h, hence it should be started depending on the course of illness. Adequate prophylaxis measures should be taken to prevent the infectious diarrhoea.<br />
</div><br />
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== Sanskrit Text, Transliteration and English Translation ==<br />
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<br />
अथातोऽतीसारचिकित्सितं व्याख्यास्यामः||१|| <br />
<br />
इति ह स्माह भगवानात्रेयः||२|| <br />
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athātō'tīsāracikitsitaṁ vyākhyāsyāmaḥ||1|| <br />
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iti ha smāha bhagavānātrēyaḥ||2|| <br />
<br />
athAto~atIsAracikitsitaM vyAkhyAsyAmaH||1|| <br />
<br />
iti ha smAha bhagavAnAtreyaH||2|| <br />
</div></div><br />
<div style="text-align:justify;"><br />
Now we shall expound the chapter "Atisara chikitsa" (Management of diarrhea and associated disorders). Thus said Lord Atreya. [1-2]<br />
</div><br />
=== Query by Agnivesha ===<br />
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<br />
भगवन्तंखल्वात्रेयंकृताह्निकंहुताग्निहोत्रमासीनमृषिगणपरिवृतमुत्तरेहिमवतःपार्श्वेविनयादुपेत्याभिवाद्यचाग्निवेशउवाच- <br />
भगवन्! अतीसारस्यप्रागुत्पत्तिनिमित्तलक्षणोपशमनानिप्रजानुग्रहार्थमाख्यातुमर्हसीति ||३||<br />
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<br />
bhagavantaṁ khalvātrēyaṁ kr̥tāhnikaṁ hutāgnihōtramāsīnamr̥ṣigaṇaparivr̥tamuttarē himavataḥ pārśvēvinayādupētyābhivādya cāgnivēśa uvāca<br />
bhagavan! atīsārasya prāgutpattinimittalakṣaṇōpaśamanāniprajānugrahārthamākhyātumarhasīti||3||<br />
<br />
bhagavantaM khalvAtreyaM kRutAhnikaM hutAgnihotramAsInamRuShigaNaparivRutamuttare himavataHpArshve vinayAdupetyAbhivAdya cAgnivesha uvAca- <br />
bhagavan! atIsArasyaprAgutpattinimittalakShaNopashamanAni prajAnugrahArthamAkhyAtumarhasIti||3|| <br />
</div></div><br />
<div style="text-align:justify;"><br />
On one occasion, when Lord Atreya was sitting on the northern slope of the Himalayas surrounded by the sages after completing his daily worship and oblations to the fire, Agnivesha approached him, offered his humble salutations to him, and requested him to expound the origin, etiology, signs and symptoms, and treatment of ''atisara'' (diarrhea) for the well-being of humanity [3]<br />
</div><br />
=== Historical origins of ''atisara'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
अथभगवान्पुनर्वसुरात्रेयस्तदग्निवेशवचनमनुनिशम्योवाच- श्रूयतामग्निवेश! सर्वमेतदखिलेनव्याख्यायमानम् | <br /><br />
आदिकालेखलुयज्ञेषुपशवःसमालभनीयाबभूवुर्नालम्भायप्रक्रियन्तेस्म | <br /><br />
ततोदक्षयज्ञंप्रत्यवरकालंमनोःपुत्राणांनरिष्यन्नाभागेक्ष्वाकुनृगशर्यात्यादीनांक्रतुषुपशूनामेवाभ्यनुज्ञानात्पशवःप्रोक्षणमवापुः | <br /><br />
अतश्चप्रत्यवरकालंपृषध्रेणदीर्घसत्रेणयजतापशूनामलाभाद्गवामालम्भःप्रवर्तितः | <br /><br />
तंदृष्ट्वाप्रव्यथिताभूतगणाः, तेषांचोपयोगादुपाकृतानांगवांगौरवादौष्ण्यादसात्म्यत्वादशस्तोपयोगाच्चोपहताग्नीनामुपहतमनसां[१]चातीसारःपूर्वमुत्पन्नःपृषध्रयज्ञे ||४|| <br /><br />
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<br />
atha bhagavān punarvasurātrēyastadagnivēśavacanamanuniśamyōvāca- śrūyatāmagnivēśa!sarvamētadakhilēna vyākhyāyamānam| <br /><br />
ādikālē khalu yajñēṣu paśavaḥ samālabhanīyā babhūvurnālambhāya prakriyantē sma| <br /><br />
tatō dakṣayajñaṁ pratyavarakālaṁ manōḥ putrāṇāṁ nariṣyannābhāgēkṣvākunr̥gaśaryātyādīnāṁ kratuṣupaśūnāmēvābhyanujñānāt paśavaḥ prōkṣaṇamavāpuḥ| <br /><br />
ataśca pratyavarakālaṁ pr̥ṣadhrēṇa dīrghasatrēṇa yajatā paśūnāmalābhādgavāmālambhaḥ pravartitaḥ| <br /><br />
taṁ dr̥ṣṭvā pravyathitā bhūtagaṇāḥ, tēṣāṁ cōpayōgādupākr̥tānāṁ gavāṁgauravādauṣṇyādasātmyatvādaśastōpayōgāccōpahatāgnīnāmupahatamanasāṁ [1] cātīsāraḥpūrvamutpannaḥ pr̥ṣadhrayajñē||4|| <br /><br />
<br />
atha bhagavAn punarvasurAtreyastadagniveshavacanamanunishamyovAca- shrUyatAmagnivesha!sarvametadakhilena vyAkhyAyamAnam| <br /><br />
AdikAle khalu yaj~jeShu pashavaH samAlabhanIyA babhUvurnAlambhAya prakriyante sma| <br /><br />
tato dakShayaj~jaM pratyavarakAlaM manoH putrANAMnariShyannAbhAgekShvAkunRugasharyAtyAdInAM kratuShu pashUnAmevAbhyanuj~jAnAt pashavaHprokShaNamavApuH| <br /><br />
atashca pratyavarakAlaM pRuShadhreNa dIrghasatreNa yajatA pashUnAmalAbhAdgavAmAlambhaHpravartitaH| <br /><br />
taM dRuShTvA pravyathitA bhUtagaNAH, teShAM copayogAdupAkRutAnAM gavAMgauravAdauShNyAdasAtmyatvAdashastopayogAccopahatAgnInAmupahatamanasAM [1] cAtIsAraHpUrvamutpannaH pRuShadhrayaj~je||4|| <br /><br />
</div></div><br />
<div style="text-align:justify;"><br />
After consideration of the above submission of Agnivesha, Lord Punarvasu said, “O Agnivesha, listen to me. I shall give a detailed response to your question. <br />
<br />
In the Vedic age/ancient times, sacrificial animals used to get released in the wild soon after the recitation of the sacrificial mantras, and these animals were not killed during the course of the sacrifice (''yajna''). However, in the subsequent periods following the reign of Daksha Prajapati, the sons of Manu named Narishyana, Nabhag, Ikshvaku, Nriga, and Sharyati, sacrifice of these animals became a part of the ''yajna'' (sacrificial ritual) at their instinctive acquiescence. After that, during the sacrifice over a long course of time performed by Prushadra (name of a king), as goats were not obtainable, even the sacred cows were also offered up for sacrifice. This deviation bewildered (or disturbed) all of humanity leading to grief. When the flesh of these sanctified cows were eaten, by the heavy, hot and incompatible to human nature properties of their flesh, as well as the use of what was not prescribed by the scriptures, the people started suffering from the loss of their ability to digest and losing their mental equilibrium, resulting in ''atisara'' (diarrhea). Thus, diarrhea originated from the ''yajna'' performed by Prushadhra [4] <br />
</div><br />
=== [[Vata]]ja atisara===<br />
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<br />
अथावरकालंवातलस्यवातातपव्यायामात्रनिषेविणोरूक्षाल्पप्रमिताशिनस्तीक्ष्णमद्यव्यवायनित्यस्योदावर्तयतश्चवेगान्वायुःप्रकोपमापद्यते, पक्ताचोपहन्यते; सवायुःकुपितोऽग्नावुपहतेमूत्रस्वेदौपुरीषाशयमुपहृत्य, ताभ्यांपुरीषंद्रवीकृत्य, अतीसारायप्रकल्पते | <br /><br />
तस्यरूपाणि- विज्जलमामंविप्लुतमवसादिरूक्षंद्रवंसशूलमामगन्धमीषच्छब्दमशब्दंवाविबद्धमूत्रवातमतिसार्यतेपुरीषं, वायुश्चान्तःकोष्ठेसशब्दशूलस्तिर्यक्चरतिविबद्धइत्यामातिसारोवातात् | <br /><br />
पक्वंवाविबद्धमल्पाल्पंसशब्दंसशूलफेनपिच्छापरिकर्तिकंहृष्टरोमाविनिःश्वसञ्शुष्कमुखःकट्यूरुत्रिकजानुपृष्ठपार्श्वशूलीभ्रष्टगुदोमुहुर्मुहुर्विग्रथितमुपवेश्यतेपुरीषंवातात्; तमाहुरनुग्रथितमित्येके, वातानुग्रथितवर्चस्त्वात् ||५||<br /><br />
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<br />
athāvarakālaṁ vātalasya vātātapavyāyāmātimātraniṣēviṇōrūkṣālpapramitāśinastīkṣṇamadyavyavāyanityasyōdāvartayataśca vēgān vāyuḥ prakōpamāpadyatē, paktācōpahanyatē; sa vāyuḥ kupitō'gnāvupahatē mūtrasvēdau purīṣāśayamupahr̥tya, tābhyāṁ purīṣaṁdravīkr̥tya, atīsārāya prakalpatē| <br /><br />
tasya rūpāṇivijjalamāmaṁ viplutamavasādi rūkṣaṁ dravaṁ saśūlamāmagandhamīṣacchabdamaśabdaṁvā vibaddhamūtravātamatisāryatē purīṣaṁ, vāyuścāntaḥkōṣṭhē saśabdaśūlastiryak carati vibaddhaityāmātisārō vātāt| <br /><br />
pakvaṁ vā vibaddhamalpālpaṁ saśabdaṁ saśūlaphēnapicchāparikartikaṁ hr̥ṣṭarōmā viniḥśvasañśuṣkamukhaḥ kaṭyūrutrikajānupr̥ṣṭhapārśvaśūlī bhraṣṭagudō muhurmuhurvigrathitamupavēśyatē purīṣaṁvātāt; tamāhuranugrathitamityēkē, vātānugrathitavarcastvāt||5|| <br /><br />
<br />
athAvarakAlaM vAtalasya vAtAtapavyAyAmAtimAtraniSheviNorUkShAlpapramitAshinastIkShNamadyavyavAyanityasyodAvartayatashca vegAn vAyuHprakopamApadyate, paktA copahanyate; sa vAyuH kupito~agnAvupahate mUtrasvedaupurIShAshayamupahRutya, tAbhyAM purIShaM dravIkRutya, atIsArAya prakalpate| <br /><br />
tasya rUpANi- vijjalamAmaM viplutamavasAdi rUkShaM dravaMsashUlamAmagandhamIShacchabdamashabdaM vA vibaddhamUtravAtamatisAryate purIShaM,vAyushcAntaHkoShThe sashabdashUlastiryak carati vibaddha ityAmAtisAro vAtAt| <br /><br />
pakvaM vA vibaddhamalpAlpaM sashabdaM sashUlaphenapicchAparikartikaM hRuShTaromA viniHshvasa~jshuShkamukhaH kaTyUrutrikajAnupRuShThapArshvashUlI bhraShTagudomuhurmuhurvigrathitamupaveshyate purIShaM vAtAt; tamAhuranugrathitamityeke,vAtAnugrathitavarcastvAt||5|| <br /><br />
</div></div><br />
<div style="text-align:justify;"><br />
*[[Vata]] dominant ''atisara'' occurs if a person with [[vata]] dominant constitution indulges in following: Exposure to strong wind, excess sunlight, and physical exercise;<br />
*Indulgence in dry and rough or less quantities of food (''pramitashana'') or irregular meals or strong alcoholic drinks or excessive sexual intercourse; and<br />
*Suppression of natural urges.<br />
<br />
The above factors aggravate [[vata]], afflicting the power of digestion (or, reducing the [[agni]]). With the depletion of [[agni]], the aggravated [[vata]] forces urine and sweat to the colon (''purishashaya''), liquefying the stool and manifesting [[vata]]ja atisara.<br />
<br />
[[Vata]]ja amaja atisara (early stages of [[vata]]ja atisara):<br />
<br />
The early signs and symptoms of [[vata]]ja amaja atisara are as follows:<br />
*The stool is slimy and has mucus (''ama'');<br />
*The stool floats on water;<br />
*The stool, when placed over the earth, gets soaked;<br />
*The stool is rough (i.e., not oily) and liquid;<br />
*Evacuation of stool is accompanied with colic pain;<br />
*The stool smells like undigested food;<br />
*Evacuation of stool is associated with little or no sound;<br />
*Evacuation of the stool is not accompanied with flatus and urine; and<br />
*The aggravated ''vata'' (flatus) moves in the ''koshtha'' (gastrointestinal tract) obliquely along with gurgling sound, causing colic pain.<br />
<br />
The above mentioned signs and symptoms pertain to the ''ama'' stage (primary or immature stage) of the [[vata]]ja atisara.<br />
<br />
[[Vata]]ja niramaja atisara (advanced stage of [[vata]]ja atisara):<br />
<br />
In the ''pakva'' stage (advanced or mature stage) of [[vata]]ja atisara, the signs and symptoms manifested are as follows: <br />
*The patient evacuates hard stool in small quantities;<br />
*The evacuation of stool is associated with sound and colic pain;<br />
*The stool is frothy and slimy; <br />
*The patient suffers from griping pain, horripilation, groaning, dryness of the mouth, pain in the lumbar region, thighs, sacral region, knees, back and sides of the chest, and prolapse of the rectum; and<br />
*Evacuates scybalous stool frequently.<br />
<br />
According to some physicians, this type of diarrhea is also called ''anugrathita-atisara'' because of evacuation the scybalous stool. [5] <br />
</div><br />
<br />
===[[Pitta]]ja atisara===<br />
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<br />
पित्तलस्यपुनरम्ललवणकटुकक्षारोष्णतीक्ष्णातिमात्रनिषेविणःप्रतताग्निसूर्यसन्तापोष्णमारुतोपहतगात्रस्यक्रोधेर्ष्याबहुलस्यपित्तंप्रकोपमापद्यते | <br /><br />
तत्प्रकुपितंद्रवत्वादूष्माणमुपहत्यपुरीषाशयविसृतमौष्ण्याद्द्रवत्वात्सरत्वाच्चभित्त्वापुरीषमतिसारायप्रकल्पते | <br /><br />
तस्यरूपाणि- हारिद्रंहरितंनीलंकृष्णंरक्तपित्तोपहितमतिदुर्गन्धमतिसार्यते[१]पुरीषं, तृष्णादाह स्वेद मूर्च्छाशूलब्रध्नसन्तापपाकपरीतइतिपित्तातिसारः ||६|| <br /><br />
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<br />
pittalasya punaramlalavaṇakaṭukakṣārōṣṇatīkṣṇātimātraniṣēviṇaḥpratatāgnisūryasantāpōṣṇamārutōpahatagātrasya krōdhērṣyābahulasya pittaṁ prakōpamāpadyatē| <br /><br />
tat prakupitaṁ dravatvādūṣmāṇamupahatya purīṣāśayavisr̥tamauṣṇyād dravatvāt saratvācca bhittvāpurīṣamatisārāya prakalpatē| <br /><br />
tasya rūpāṇi- hāridraṁ haritaṁ nīlaṁ <br />
kr̥ṣṇaṁ raktapittōpahitamatidurgandhamatisāryatē [1] purīṣaṁ,tr̥ṣṇādāhasvēdamūrcchāśūlabradhnasantāpapākaparīta iti pittātisāraḥ||6|| <br /><br />
<br />
pittalasya punaramlalavaNakaTukakShAroShNatIkShNAtimAtraniSheviNaHpratatAgnisUryasantApoShNamArutopahatagAtrasya krodherShyAbahulasya pittaM prakopamApadyate| <br /><br />
tat prakupitaM dravatvAdUShmANamupahatya purIShAshayavisRutamauShNyAd dravatvAt saratvAccabhittvA purIShamatisArAya prakalpate| <br /><br />
tasya rUpANi- hAridraM haritaM nIlaM <br />
kRuShNaM raktapittopahitamatidurgandhamatisAryate [1] purIShaM,tRuShNAdAhasvedamUrcchAshUlabradhnasantApapAkaparIta iti pittAtisAraH||6|| <br /><br />
</div></div><br />
<div style="text-align:justify;"><br />
A person of [[pitta]]ja constitution, by indulging in the following etiological factors, gets afflicted by [[pitta]]ja atisara:<br />
*Excessive intake of sour, saline, pungent, alkaline (''kshara''), hot and sharp (''teekshna'') ingredients;<br />
*Affliction of the body by excessive exposure to the heat of strong fire, hot rays of the sun and hot wind; and<br />
*Excessive disposition to negative emotions such as anger, jealousy, etc.<br />
<br />
Due to the above mentioned factors, [[pitta]] gets aggravated, in turn suppressing the power of [[agni]] (digestion) on account of its liquidity and reaches the colon, disintegrates the stool because of its heat, liquidity and mobility leading to the manifestation of [[pitta]]ja atisara.<br />
<br />
The signs and symptoms of [[pitta]]ja atisara are as follows:<br />
*The patient experiences frequent loose motions which are either yellow, green, blue or black in color;<br />
*The stool is mixed with blood and bile, and is excessively foul smelling; <br />
*The patient suffers from morbid thirst, burning sensation, excessive sweating, fainting, colic pain and hot sensation; and<br />
*There is suppuration of the anus [6]<br />
</div><br />
<br />
=== [[Kapha]]ja atisara===<br />
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<br />
श्लेष्मलस्यतुगुरुमधुरशीतस्निग्धोपसेविनःसम्पूरकस्याचिन्तयतोदिवास्वप्नपरस्यालसस्यश्लेष्माप्रकोपमापद्यते | <br /><br />
सस्वभावाद्गुरुमधुरशीतस्निग्धःस्रस्तोऽग्निमुपहत्य सौम्यस्वभावात्पुरीषाशयमुपहत्यो पक्लेद्यपुरीषमतिसारायकल्पते | <br /><br />
तस्यरूपाणि- स्निग्धंश्वेतंपिच्छिलंतन्तुमदामंगुरुदुर्गन्धंश्लेष्मोपहितमनुबद्धशूलमल्पाल्पमभीक्ष्णमतिसार्यतेसप्रवाहिकं, गुरूदरगुदबस्तिवङ्क्षणदेशःकृतेऽप्यकृतसञ्ज्ञःसलोमहर्षःसोत्क्लेशोनिद्रालस्यपरीतःसदनोऽन्नद्वेषीचेतिश्लेष्मातिसारः ||७|| <br />
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<br />
ślēṣmalasya tu gurumadhuraśītasnigdhōpasēvinaḥ sampūrakasyācintayatō divāsvapnaparasyālasasyaślēṣmā prakōpamāpadyatē| <br /><br />
sa svabhāvād gurumadhuraśītasnigdhaḥ srastō'gnimupahatya saumyasvabhāvātpurīṣāśayamupahatyōpaklēdya purīṣamatisārāya kalpatē| <br /><br />
tasya rūpāṇi- snigdhaṁ śvētaṁ picchilaṁ tantumadāmaṁ guru durgandhaṁślēṣmōpahitamanubaddhaśūlamalpālpamabhīkṣṇamatisāryatē sapravāhikaṁ,gurūdaragudabastivaṅkṣaṇadēśaḥ kr̥tē'pyakr̥tasañjñaḥ salōmaharṣaḥ sōtklēśō nidrālasyaparītaḥsadanō'nnadvēṣī cēti ślēṣmātisāraḥ||7|| <br /><br />
<br />
shleShmalasya tu gurumadhurashItasnigdhopasevinaH sampUrakasyAcintayatodivAsvapnaparasyAlasasya shleShmA prakopamApadyate| <br /><br />
sa svabhAvAd gurumadhurashItasnigdhaH srasto~agnimupahatya saumyasvabhAvAtpurIShAshayamupahatyopakledya purIShamatisArAya kalpate| <br /><br />
tasya rUpANi- snigdhaM shvetaM picchilaM tantumadAmaM guru durgandhaMshleShmopahitamanubaddhashUlamalpAlpamabhIkShNamatisAryate sapravAhikaM,gurUdaragudabastiva~gkShaNadeshaH kRute~apyakRutasa~jj~jaH salomaharShaH sotkleshonidrAlasyaparItaH sadano~annadveShI ceti shleShmAtisAraH||7|| <br /><br />
</div></div><br />
<div style="text-align:justify;"><br />
A person of [[kapha]]ja type of constitution indulging in the following factors experiences the manifestation of [[kapha]]ja atisara:<br />
*Consumption of heavy, sweet, cold and unctuous ingredients in excess;<br />
*Inactivity of the mind and indolence; and<br />
*Habitually sleeping during the day time.<br />
<br />
Because of the above mentioned factors, [[kapha]] gets aggravated. It moves downwards due to its nature (i.e heavy, sweet, cold and unctuous) and afflicts the [[agni]] (power of digestion) on account of its natural cooling property (which is contradictory to the heating effect of [[agni]]). Thereafter, having arrived at the colon, it liquefies the stool to cause [[kapha]]ja atisara.<br />
<br />
The signs and symptoms of [[kapha]]ja atisara (diarrhea) are as follows:<br />
*The stool is unctuous, white, slimy, fibrous, mixed with mucus as well as undigested food particles, heavy, foul-smelling and mixed with phlegm;<br />
*The patient suffers from continuous, griping, colic pain<br />
*The patient evacuates stool frequently in small quantities;<br />
*The patient suffers from heaviness in the abdomen, in the region of urinary bladder and in the pelvic region;<br />
*The patient feels the urge for passing stool even after having evacuated; and<br />
*Suffers from horripilation, nausea, excessive sleep, indolence, prostration and dislike for food.<br />
<br />
These are the specific features of [[kapha]]ja atisara. [7]<br />
</div><br />
<br />
=== Sannipataja atisara ===<br />
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अतिशीतस्निग्धरूक्षोष्णगुरुखरकठिनविषमविरुद्धासात्म्यभोजनादभोजनात्कालातीतभोजनाद्यत्किञ्चिदभ्यवहरणात्प्रदुष्टमद्यपानीयपानादतिमद्यपानादसंशोधनात्प्रतिकर्मणां<br />
विषमगमनादनुपचाराज्ज्वलनादित्यपवनसलिलातिसेवनादस्वप्ना-दतिस्वप्नाद्वेगविधारणादृतुविपर्ययादयथाबलमारम्भाद्भयशोकचित्तोद्वेगातियोगात्कृमि<br />
शोषज्वरार्शोविकारातिकर्षणाद्वाव्यापन्नाग्नेस्त्रयोदोषाः<br />
प्रकुपिताभूयएवाग्निमुपहत्यपक्वाशयमनुप्रविश्यातीसारंसर्वदोषलिङ्गंजनयन्ति ||८|| <br />
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<br />
atiśītasnigdharūkṣōṣṇagurukharakaṭhinaviṣamaviruddhāsātmyabhōjanādabhōjanāt kālātītabhōjanādyatkiñcidabhyavaharaṇāt praduṣṭamadyapānīyapānādatimadyapānādasaṁśōdhanāt pratikarmaṇāṁviṣamagamanādanupacārājjvalanādityapavanasalilātisēvanādasvapnā-datisvapnādvēgavidhāraṇādr̥tuviparyayādayathābalamārambhādbhayaśōkacittōdvēgātiyōgātkr̥miśōṣajvarārśōvikārātikarṣaṇādvā vyāpannāgnēstrayō dōṣāḥ prakupitā bhūya ēvāgnimupahatyapakvāśayamanupraviśyātīsāraṁ sarvadōṣaliṅgaṁ janayanti||8|| <br />
<br />
atishItasnigdharUkShoShNagurukharakaThinaviShamaviruddhAsAtmyabhojanAdabhojanAtkAlAtItabhojanAd yatki~jcidabhyavaharaNAtpraduShTamadyapAnIyapAnAdatimadyapAnAdasaMshodhanAt pratikarmaNAMviShamagamanAdanupacArAjjvalanAdityapavanasalilAtisevanAdasvapnA-datisvapnAdvegavidhAraNAdRutuviparyayAdayathAbalamArambhAdbhayashokacittodvegAtiyogAtkRumishoShajvarArshovikArAtikarShaNAdvA vyApannAgnestrayo doShAH prakupitA bhUyaevAgnimupahatya pakvAshayamanupravishyAtIsAraM sarvadoShali~ggaM janayanti||8|| <br />
</div></div><br />
<div style="text-align:justify;"><br />
The causative factors of ''sannipataja atisara'' (diarrhea caused by the simultaneous vitiation of all the three [[dosha]]) are as follows: <br />
*Intake of excessively cold, unctuous, ununctuous, hot, heavy, coarse and hard ingredients;<br />
*Intake of irregular meals, ingredients of food having mutually contradictory properties and unwholesome food;<br />
*Intake of food long after the scheduled time;<br />
*Intake of food without caring for its wholesomeness or otherwise;<br />
*Drinking alcohol and other drinks which are “polluted”, toxic or harmful;<br />
*Drinking alcohol in excess; <br />
*Not resorting to elimination therapies (in appropriate seasons);<br />
*Inappropriate administration or non-administration of therapeutics; <br />
*Excessive exposure to fire, hot rays of the sun, strong wind and bath etc., in strong current of water;<br />
*Not sleeping or sleeping in excess;<br />
*Suppression of natural urges; <br />
*Not resorting to appropriate regimens during different seasons,<br />
*Over-courageous attitude;<br />
*Excessive exposure to fear, grief and anxiety; and <br />
*Excessive emaciation due to worm-infection, consumption, fever and piles (bleeding).<br />
<br />
Because of the above mentioned causative factors, [[agni]] (power of digestion) gets vitiated as a result of which all the three [[dosha]] get aggravated. These aggravated [[dosha]] in turn further afflict the [[agni]], and having entered into ''pakvashaya'' (colon) cause ''sannipataja atisara''. [8]<br />
</div><br />
<br />
=== Signs and symptoms of ''sannipataja atisara'' ===<br />
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अपिचशोणितादीन्धातूनतिप्रकृष्टं[१]दूषयन्तोधातुदोषस्वभावकृतानतीसारवर्णानुपदर्शयन्ति | <br /><br />
तत्रशोणितादिषुधातुष्वतिप्रदुष्टेषुहारिद्रहरितनीलमाञ्जिष्ठमांसधावनसन्निकाशंरक्तंकृष्णंश्वेतंवराहभेदःसदृशमनुबद्धवेदनमवेदनंवासमासव्यत्यासादुपवेश्यतेशकृद्ग्रथितमामंसकृत्, सकृदपिपक्वमनतिक्षीणमांसशोणितबलोमन्दाग्निर्विहतमुखरसश्च; तादृशमातुरंकृच्छ्रसाध्यंविद्यात् | <br /><br />
एभिर्वर्णैरतिसार्यमाणंसोपद्रवमातुरमसाध्योऽयमितिप्रत्याचक्षीत; तद्यथा- पक्वशोणिताभं[२]यकृत्खण्डोपमंमेदोमांसोदकसन्निकाशंदधिघृतमज्जतैलवसाक्षीरवेसवाराभमतिनीलमतिरक्तमतिकृष्णमुदकमिवाच्छंपुनर्मेचकाभमतिस्निग्धं<br />
हरितनीलकषायवर्णंकर्बुरमाविलंपिच्छिलंतन्तुमदामंचन्द्रकोपगतमतिकुणपपूतिपूयगन्ध्यामाममत्स्यगन्धिमक्षिकाकान्तं[३]कुथितबहुधातुस्रावमल्पपुरीषमपुरीषंवाऽतिसार्यमाणं<br />
तृष्णादाहज्वरभ्रमतमकहिक्काश्वासानुबन्धमतिवेदनमवेदनंवास्रस्तपक्वगुदंपतितगुदवलिंमुक्तनालमतिक्षीणबलमांसशोणितं<br />
सर्वपर्वास्थिशूलिनमरोचकारतिप्रलापसम्मोहपरीतंसहसोपरतविकारमतिसारिणमचिकित्स्यंविद्यात्; इतिसन्निपातातिसारः ||९|| <br />
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api ca śōṇitādīn dhātūnatiprakr̥ṣṭaṁ [1] dūṣayantō dhātudōṣasvabhāvakr̥tānatīsāravarṇānupadarśayanti| <br /><br />
tatra śōṇitādiṣu dhātuṣvatipraduṣṭēṣu hāridraharitanīlamāñjiṣṭhamāṁsadhāvanasannikāśaṁ raktaṁkr̥ṣṇaṁ śvētaṁ varāhabhēdaḥsadr̥śamanubaddhavēdanamavēdanaṁ vā samāsavyatyāsādupavēśyatēśakr̥d grathitamāmaṁ sakr̥t, sakr̥dapi <br />
pakvamanatikṣīṇamāṁsaśōṇitabalō mandāgnirvihatamukharasaśca;tādr̥śamāturaṁ kr̥cchrasādhyaṁ vidyāt| <br /><br />
ēbhirvarṇairatisāryamāṇaṁ sōpadravamāturamasādhyō'yamiti pratyācakṣīta; tadyathā- pakvaśōṇitābhaṁ[2] yakr̥tkhaṇḍōpamaṁ mēdōmāṁsōdakasannikāśaṁdadhighr̥tamajjatailavasākṣīravēsavārābhamatinīlamatiraktamatikr̥ṣṇamudakamivācchaṁpunarmēcakābhamatisnigdhaṁ haritanīlakaṣāyavarṇaṁ karburamāvilaṁ picchilaṁ tantumadāmaṁcandrakōpagatamatikuṇapapūtipūyagandhyāmāmamatsyagandhi makṣikākāntaṁ [3]kuthitabahudhātusrāvamalpapurīṣamapurīṣaṁ vā'tisāryamāṇaṁtr̥ṣṇādāhajvarabhramatamakahikkāśvāsānubandhamativēdanamavēdanaṁ vā srastapakvagudaṁpatitagudavaliṁ muktanālamatikṣīṇabalamāṁsaśōṇitaṁsarvaparvāsthiśūlinamarōcakāratipralāpasammōhaparītaṁ sahasōparatavikāramatisāriṇamacikitsyaṁvidyāt; iti sannipātātisāraḥ||9||<br />
<br />
api ca shoNitAdIn dhAtUnatiprakRuShTaM [1] dUShayantodhAtudoShasvabhAvakRutAnatIsAravarNAnupadarshayanti| <br /><br />
tatra shoNitAdiShu dhAtuShvatipraduShTeShu hAridraharitanIlamA~jjiShThamAMsadhAvanasannikAshaMraktaM kRuShNaM shvetaM varAhabhedaHsadRushamanubaddhavedanamavedanaM vAsamAsavyatyAsAdupaveshyate shakRud grathitamAmaM sakRut, sakRudapipakvamanatikShINamAMsashoNitabalo mandAgnirvihatamukharasashca; tAdRushamAturaMkRucchrasAdhyaM vidyAt| <br /><br />
ebhirvarNairatisAryamANaM sopadravamAturamasAdhyo~ayamiti pratyAcakShIta; tadyathA-pakvashoNitAbhaM [2] yakRutkhaNDopamaM medomAMsodakasannikAshaMdadhighRutamajjatailavasAkShIravesavArAbhamatinIlamatiraktamatikRuShNamudakamivAcchaMpunarmecakAbhamatisnigdhaM haritanIlakaShAyavarNaM karburamAvilaM picchilaM tantumadAmaMcandrakopagatamatikuNapapUtipUyagandhyAmAmamatsyagandhi makShikAkAntaM [3]kuthitabahudhAtusrAvamalpapurIShamapurIShaM vA~atisAryamANaMtRuShNAdAhajvarabhramatamakahikkAshvAsAnubandhamativedanamavedanaM vA srastapakvagudaMpatitagudavaliM muktanAlamatikShINabalamAMsashoNitaMsarvaparvAsthishUlinamarocakAratipralApasammohaparItaM sahasoparatavikAramatisAriNamacikitsyaMvidyAt; iti sannipAtAtisAraH||9|| <br />
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The three aggravated [[dosha]] cause excessive vitiation of [[dhatu]] (tissue elements, e.g., [[rakta]] (blood)), resulting in the appearance of different colors (in the stool). The nature of these colors depends upon the nature of the vitiated [[dhatu]] and [[dosha]]. <br />
<br />
If the [[dhatu]] like [[rakta]]] are excessively vitiated then the following signs and symptoms are manifested:<br />
*The patient passes stool having yellow (like the color of turmeric), green, blue, reddish (like the color of ''manjistha''), pink (like the color of water in which meat is washed), red, black, white and yellowish (like the color of pig-fat) in color;<br />
*The patient suffers from continuous pain or may be free from any pain (in the abdomen). The above mentioned signs and symptoms may be manifested in their entirety or only some of these may be manifested. <br />
*Sometimes, the patient may pass scybalous stool, sometimes it may be mixed with mucus (''ama'') and sometimes, the stool may be free from mucus (''pakva'');<br />
*There is depletion of the muscle tissue, blood and strength;<br />
*The power of digestion ([[agni]]) of the patient is suppressed; and<br />
*There is impairment of the taste in the mouth of the patient.<br />
<br />
Such a patient is difficult to cure (''krichchra-sadhya''). <br />
<br />
The patient becomes incurable (''asadhya''), if the diarrhea is associated with the colors and complications as follows: <br />
*The color of stool is like dark blood (melena), piece of liver, appearance like washing of fat or flesh, curd,ghee, marrow, fat, milk and ''vesavara''(minced meat); or dark blue, dark red, dark black, or clear like water.<br />
*The stool is exceedingly greasy; or green, blue, saffron color; <br />
*Certain patients passes the stool with turbidity, slimy, fibrous, mixed with mucus and spotted with ''chandraka'' (colored patches circular in shape and shining like moon); <br />
*The stool has exceedingly bad smell like that of a dead body or it is exceedingly putrid in smell or the stool bears the smell of undigested products or it is like (raw) fish; <br />
*The stool attracts flies in excess; <br />
*The stool contains slough and tissue elements in excess; <br />
*The stool contains less or no fecal matter; <br />
*The patient continuously suffers from morbid thirst, burning sensation, fever, giddiness, fainting, hiccup, asthma, excessive pain or no pain; <br />
*There is prolapse and inflammation of the anal canal or the anal sphincters come out of their sites or the whole of the rectum comes out (''mukta-nala''); <br />
*There is excessive loss of strength, muscle tissue and blood; <br />
*There is pain in all the joints and bones; and <br />
*There is sudden cessation of the signs and symptoms of the disease.<br />
<br />
Such a patient should be rejected for the treatment (as it is incurable). [9]<br />
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=== Guidelines for starting treatment ===<br />
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तमसाध्यतामसम्प्राप्तंचिकित्सेद्यथाप्रधानोपक्रमेणहेतूपशयदोषविशेषपरीक्षयाचेति ||१०||<br />
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tamasādhyatāmasamprāptaṁ cikitsēd yathāpradhānōpakramēṇa hētūpaśayadōṣaviśēṣaparīkṣayācēti||10||<br />
<br />
tamasAdhyatAmasamprAptaM cikitsed yathApradhAnopakrameNa hetUpashayadoShavisheShaparIkShayAceti||10|| <br />
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The patient who has not yet reached the stage of absolute incurability should be properly treated after the examination of causative factors, ''upashaya'' (pacifying factors) and nature of the aggravation of specific [[dosha]]. In this condition, the most aggravated [[dosha]] should be treated in the beginning followed by the treatment of the other less aggravated [[dosha]]. [10]<br />
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=== Exogenous (psychological) diarrhea ===<br />
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आगन्तूद्वावतीसारौमानसौभयशोकजौ | <br /><br />
तत्तयोर्लक्षणंवायोर्यदतीसारलक्षणम् ||११||<br /><br />
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āgantū dvāvatīsārau mānasau bhayaśōkajau| <br /><br />
tattayōrlakṣaṇaṁ vāyōryadatīsāralakṣaṇam||11|| <br /><br />
<br />
AgantU dvAvatIsArau mAnasau bhayashokajau| <br /><br />
tattayorlakShaNaM vAyoryadatIsAralakShaNam||11||<br /><br />
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The exogenous type of ''atisara'' (diarrhea) is of mental origin and is of two types. One of these is caused by fear and the other is caused by grief. Their signs and symptoms are similar to those of the ''vatika'' type of ''atisara''. Thus ''atisara'' or diarrhea is of two types, viz., ''nija'' or endogenous (like [[vata]]ja, [[pitta]]ja, [[kapha]]ja and ''sannipataja atisara'' and ''agantuja/manasa'' or exogenous [11]<br />
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=== Management of exogenous (psychological) diarrhea ===<br />
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मारुतोभयशोकाभ्यांशीघ्रंहिपरिकुप्यति | <br /><br />
तयोःक्रियावातहरीहर्षणाश्वासनानिच ||१२|| <br /><br />
<br />
इत्युक्ताःषडतीसाराः, साध्यानांसाधनंत्वतः | <br /><br />
प्रवक्ष्याम्यनुपूर्वेणयथावत्तन्निबोधत ||१३||<br /><br />
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mārutō bhayaśōkābhyāṁ śīghraṁ hi parikupyati| <br /><br />
tayōḥ kriyā vātaharī harṣaṇāśvāsanāni ca||12|| <br /><br />
<br />
ityuktāḥ ṣaḍatīsārāḥ, sādhyānāṁ sādhanaṁ tvataḥ| <br /><br />
pravakṣyāmyanupūrvēṇa yathāvattannibōdhata||13||<br /><br />
<br />
mAruto bhayashokAbhyAM shIghraM hi parikupyati| <br /><br />
tayoH kriyA vAtaharI harShaNAshvAsanAni ca||12|| <br /><br />
<br />
ityuktAH ShaDatIsArAH, sAdhyAnAM sAdhanaM tvataH| <br /><br />
pravakShyAmyanupUrveNa yathAvattannibodhata||13|| <br /><br />
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The following therapies help to cure ''agantuja/manasa'' or exogenous:<br />
<br />
Both fear and grief causes aggravation of [[vata]] instantaneously. [[Vata]] alleviating drugs and therapies should be administered for the treatment of exogenous ''atisara''. The patient suffering from diarrhea caused by fear (''bhayaja'') should be exhilarated. The patient suffering from diarrhea caused by ''shoka'' (grief) should be consoled [12-13] <br />
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=== Principles of treatment ===<br />
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दोषाःसन्निचितायस्यविदग्धाहारमूर्च्छिताः | <br /><br />
अतीसारायकल्पन्तेभूयस्तान्सम्प्रवर्तयेत् ||१४|| <br /><br />
<br />
नतुसङ्ग्रहणंदेयंपूर्वमामातिसारिणे | <br /><br />
विबध्यमानाःप्राग्दोषाजनयन्त्यामयान्बहून् ||१५|| <br /><br />
<br />
दण्डकालसकाध्मानग्रहण्यर्शोगदांस्तथा | <br /><br />
शोथपाण्ड्वामयप्लीहकुष्ठगुल्मोदरज्वरान् ||१६|| <br /><br />
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तस्मादुपेक्षेतोत्क्लिष्टान्वर्तमानान्स्वयंमलान् | <br /><br />
कृच्छ्रंवावहतांदद्यादभयांसम्प्रवर्तिनीम् ||१७|| <br /><br />
<br />
तयाप्रवाहितेदोषेप्रशाम्यत्युदरामयः | <br /><br />
जायतेदेहलघुताजठराग्निश्चवर्धते ||१८|| <br /><br />
<br />
प्रमथ्यांमध्यदोषाणांदद्याद्दीपनपाचनीम् | <br /><br />
लङ्घनंचाल्पदोषाणांप्रशस्तमतिसारिणाम् ||१९||<br /><br />
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dōṣāḥ sannicitā yasya vidagdhāhāramūrcchitāḥ| <br /><br />
atīsārāya kalpantē bhūyastān sampravartayēt||14||<br /><br />
<br />
na tu saṅgrahaṇaṁ dēyaṁ pūrvamāmātisāriṇē| <br /><br />
vibadhyamānāḥ prāgdōṣā janayantyāmayān bahūn||15|| <br /><br />
<br />
daṇḍakālasakādhmānagrahaṇyarśōgadāṁstathā| <br /><br />
śōthapāṇḍvāmayaplīhakuṣṭhagulmōdarajvarān||16|| <br /><br />
<br />
tasmādupēkṣētōtkliṣṭān vartamānān svayaṁ malān| <br /><br />
kr̥cchraṁ vā vahatāṁ dadyādabhayāṁ sampravartinīm||17||<br /> <br />
<br />
tayā pravāhitē dōṣē praśāmyatyudarāmayaḥ| <br /><br />
jāyatē dēhalaghutā jaṭharāgniśca vardhatē||18|| <br /><br />
<br />
pramathyāṁ madhyadōṣāṇāṁ dadyāddīpanapācanīm| <br /><br />
laṅghanaṁ cālpadōṣāṇāṁ praśastamatisāriṇām||19|| <br /><br />
<br />
doShAH sannicitA yasya vidagdhAhAramUrcchitAH| <br /><br />
atIsArAya kalpante bhUyastAn sampravartayet||14|| <br /><br />
<br />
na tu sa~ggrahaNaM deyaM pUrvamAmAtisAriNe| <br /><br />
vibadhyamAnAH prAgdoShA janayantyAmayAn bahUn||15|| <br /><br />
<br />
daNDakAlasakAdhmAnagrahaNyarshogadAMstathA| <br /><br />
shothapANDvAmayaplIhakuShThagulmodarajvarAn||16|| <br /><br />
<br />
tasmAdupekShetotkliShTAn vartamAnAn svayaM malAn| <br /><br />
kRucchraM vA vahatAM dadyAdabhayAM sampravartinIm||17|| <br /><br />
<br />
tayA pravAhite doShe prashAmyatyudarAmayaH| <br /><br />
jAyate dehalaghutA jaTharAgnishca vardhate||18|| <br /><br />
<br />
pramathyAM madhyadoShANAM dadyAddIpanapAcanIm| <br /><br />
la~gghanaM cAlpadoShANAM prashastamatisAriNAm||19|| <br /><br />
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The following principles of treatment are used in management of ''atisara'':<br />
<br />
*When the diarrhea is caused by the accumulated (aggravated) [[dosha]] impelled by ''vidagdha'' (fermentation of undigested) food, the patient should be given laxative to eliminate the [[dosha]]. <br />
*In the initial state i.e. ''ama'' (primary or immature) of diarrhea, stopping or binding therapies are never indicated.<br />
*Administration of such bowel-binding therapies in the initial stage obstructs the movement and elimination of the already aggravated [[dosha]] leading to complications like ''dandakalasaka'' (obstruction to intestinal peristalsis), ''adhmana'' (flatulence), ''grahani roga'' (digestive disorders like sprue syndrome), piles, fistula-in-ano, edema, anemia, splenic disorders, ''kushtha'' (obstinate skin diseases including leprosy), ''gulma'' (abdominal lumps), ''udara roga'' (obstinate abdominal diseases including ascites) and fever. <br />
*Hence, the physician should ignore the downward movement of the detached (''utklishta'') morbid matter, which is moving downwards on its own. <br />
*Diarrhea should be allowed to continue and should not be stopped by constipating medicines. <br />
*If the diarrhea is associated with griping pain (difficulty in evacuating), then ''haritaki'' should be given as a mild laxative. <br />
*Once the morbid matter is eliminated through downward movement then this abdominal disease (diarrhea) gets cured, the body becomes light and the power of [[agni]] becomes strong.<br />
*Moderately aggravated [[dosha]] should be managed by ''pramathya'' (a type of decoction of drugs) which stimulates the power of digestion ([[dipana]]) and which is carminative ([[pachana]]) should be administered. Slightly aggravated [[dosha]] should be managed by [[langhana]] (fasting therapy) [14-19].<br />
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=== Recipes of ''pramathya'' ===<br />
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पिप्पलीनागरंधान्यंभूतीकमभयावचा | <br /><br />
ह्रीवेरंभद्रमुस्तानिबिल्वंनागरधान्यकम् ||२०|| <br /><br />
<br />
पृश्निपर्णीश्वदंष्ट्राचसमङ्गाकण्टकारिका | <br /><br />
तिस्रःप्रमथ्याविहिताःश्लोकार्धैरतिसारिणाम् ||२१|| <br /><br />
<br />
वचाप्रतिविषाभ्यांवामुस्तपर्पटकेनवा | <br /><br />
ह्रीवेरशृङ्गवेराभ्यांपक्वंवापाययेज्जलम् ||२२||<br /><br />
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pippalī nāgaraṁ dhānyaṁ bhūtīkamabhayā vacā| <br /><br />
hrīvēraṁ bhadramustāni bilvaṁ nāgaradhānyakam||20||<br /> <br />
<br />
pr̥śniparṇī śvadaṁṣṭrā ca samaṅgā kaṇṭakārikā| <br /><br />
tisraḥ pramathyā vihitāḥ ślōkārdhairatisāriṇām||21|| <br /><br />
<br />
vacāprativiṣābhyāṁ vā mustaparpaṭakēna vā| <br /><br />
hrīvēraśr̥ṅgavērābhyāṁ pakvaṁ vā pāyayējjalam||22|| <br /><br />
<br />
pippalI nAgaraM dhAnyaM bhUtIkamabhayA vacA| <br /><br />
hrIveraM bhadramustAni bilvaM nAgaradhAnyakam||20|| <br /><br />
<br />
pRushniparNI shvadaMShTrA ca sama~ggA kaNTakArikA| <br /><br />
tisraH pramathyA vihitAH shlokArdhairatisAriNAm||21|| <br /><br />
<br />
vacAprativiShAbhyAM vA mustaparpaTakena vA| <br /><br />
hrIverashRu~ggaverAbhyAM pakvaM vA pAyayejjalam||22||<br /><br />
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<br />
Three recipes of ''pramathya'' which are useful in the treatment of diarrhea are as follow:<br />
<br />
*Decoction of ''pippali, nagara, dhanyaka, bhutika, abhaya'' and ''vacha'' for [[vata]]ja atisara''<br />
*Decoction of ''hrivera, bhadra-musta, bilva, nagara'' and ''dhanyaka'' for [[pitta]]ja atisara'')<br />
*Decoction of ''prashniparni, svadamstra, samanga'' and ''kantakarika'' for [[kapha]]ja atisara''<br />
*Decoction of ''vacha'' and ''prativisha'' for [[vata]]ja atisara''<br />
*Decoction of ''musta'' and ''parpataka'' for [[pitta]]ja atisara''<br />
*Decoction of ''hrivera'' and ''sringavera'' for [[kapha]]ja atisara'' <br />
<br />
[Note: Decoction should be prepared as per the procedure described for ''sandanga-paniya'' in C.S.Ci.3-145.] [20-22]<br />
<br />
=== Diet and drinks for ''atisara'' patient ===<br />
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<br />
युक्तेऽन्नकालेक्षुत्क्षामंलघून्यन्नानिभोजयेत् | <br /><br />
तथासशीघ्रमाप्नोतिरुचिमग्निबलंबलम् ||२३|| <br /><br />
<br />
तक्रेणावन्तिसोमेनयवाग्वातर्पणेनवा | <br /><br />
सुरयामधुनाचादौयथासात्म्यमुपाचरेत् ||२४|| <br /><br />
<br />
यवागूभिर्विलेपीभिःखडैर्यूषैरसौदनैः | <br /><br />
दीपनग्राहिसंयुक्तैःक्रमश्चस्यादतःपरम् ||२५||<br /><br />
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<br />
yuktē'nnakālē kṣutkṣāmaṁ laghūnyannāni bhōjayēt| <br /><br />
tathā sa śīghramāpnōti rucimagnibalaṁ balam||23|| <br /><br />
<br />
takrēṇāvantisōmēna yavāgvā tarpaṇēna vā| <br /><br />
surayā madhunā cādau yathāsātmyamupācarēt||24||<br /> <br />
<br />
yavāgūbhirvilēpībhiḥ khaḍairyūṣai rasaudanaiḥ| <br /><br />
dīpanagrāhisaṁyuktaiḥ kramaśca syādataḥ param||25||<br /><br />
<br />
yukte~annakAle kShutkShAmaM laghUnyannAni bhojayet| <br /><br />
tathA sa shIghramApnoti rucimagnibalaM balam||23|| <br /><br />
<br />
takreNAvantisomena yavAgvA tarpaNena vA| <br /><br />
surayA madhunA cAdau yathAsAtmyamupAcaret||24||<br /> <br />
<br />
yavAgUbhirvilepIbhiH khaDairyUShai rasaudanaiH| <br /><br />
dIpanagrAhisaMyuktaiH kramashca syAdataH param||25|| <br /><br />
</div></div><br />
<br />
*At appropriate meal time, if the patient feels hungry, light food should be given to eat. It enhances the appetite and stimulates agni and as a result the strength is promoted immediately.<br />
*Depending upon the wholesomeness ([[satmya]]) of the patient, light food along with buttermilk or ''kanji'' (a sour drink), ''yavagu'' (thick gruel), ''tarpana'' (roasted flour of serials mixed with water), or alcoholic drink or honey should be given. Then gradually ''yavagu'' (thick gruel), ''vilepi'' (a sticky gruel), ''khanda'' (a sour appetiser), ''yusha'' (vegetable soup) and boiled rice mixed with meat soup which are prepared by adding digestive, stimulants and astringent (constipative) drugs should be given. <br />
<br />
Ingredients which are [[dipana]] (digestive stimulant) and ''grahi'' (constipating) are described in [Cha. Sa. [[Sutra Sthana]] 4/9 ] should be administered [23-25]<br />
<br />
=== Treatment of [[vata]]ja atisara ===<br />
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<br />
शालपर्णींपृश्निपर्णींबृहतींकण्टकारिकाम् | <br /><br />
बलांश्वदंष्ट्रांबिल्वानिपाठांनागरधान्यकम् ||२६|| <br /><br />
<br />
शटींपलाशंहपुषांवचांजीरकपिप्पलीम् | <br /><br />
यवानींपिप्पलीमूलंचित्रकंहस्तिपिप्पलीम् ||२७||<br /> <br />
<br />
वृक्षाम्लंदाडिमाम्लंचसहिङ्गुबिडसैन्धवम् | <br /><br />
प्रयोजयेदन्नपानेविधिनासूपकल्पितम् ||२८|| <br /><br />
<br />
वातश्लेष्महरोह्येषगणोदीपनपाचनः | <br /><br />
ग्राहीबल्योरोचनश्चतस्माच्छस्तोऽतिसारिणाम् ||२९||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
śālaparṇīṁ pr̥śniparṇīṁ br̥hatīṁ kaṇṭakārikām| <br /><br />
balāṁ śvadaṁṣṭrāṁ bilvāni pāṭhāṁ nāgaradhānyakam||26|| <br /><br />
<br />
śaṭīṁ palāśaṁ hapuṣāṁ vacāṁ jīrakapippalīm| <br /><br />
yavānīṁ pippalīmūlaṁ citrakaṁ hastipippalīm||27|| <br /><br />
<br />
vr̥kṣāmlaṁ dāḍimāmlaṁ ca sahiṅgu biḍasaindhavam| <br /><br />
prayōjayēdannapānē vidhinā sūpakalpitam||28|| <br /><br />
<br />
vātaślēṣmaharō hyēṣa gaṇō dīpanapācanaḥ| <br /><br />
grāhī balyō rōcanaśca tasmācchastō'tisāriṇām||29|| <br /><br />
<br />
shAlaparNIM pRushniparNIM bRuhatIM kaNTakArikAm| <br /><br />
balAM shvadaMShTrAM bilvAni pAThAM nAgaradhAnyakam||26|| <br /><br />
<br />
shaTIM palAshaM hapuShAM vacAM jIrakapippalIm| <br /><br />
yavAnIM pippalImUlaM citrakaM hastipippalIm||27|| <br /><br />
<br />
vRukShAmlaM dADimAmlaM ca sahi~ggu biDasaindhavam| <br /><br />
prayojayedannapAne vidhinA sUpakalpitam||28|| <br /><br />
<br />
vAtashleShmaharo hyeSha gaNo dIpanapAcanaH| <br /><br />
grAhI balyo rocanashca tasmAcchasto~atisAriNAm||29|| <br /><br />
</div></div><br />
<br />
The following drugs are useful for the cure of [[vata]]ja atisara(diarrhea):<br />
*''Shalaparni, prashniparni, brhati, kantakarika, bala, svadamstra, bilva, patha, nagara, dhanyaka, shati, palasha, hapusha, vacha, jiraka, pippali, yavani, pippali-mula, chitraka, hastipippali, vrikshamla, sour pomegranate, hingu, vida'' and ''saindhava''-these ingredients should be appropriately used in processing food preparations. <br />
*Drugs belonging to the [[vata]] and [[kapha]]' alleviative group and those drugs which are [[dipana]] (digestive stimulant), [[pachana]] (carminative), ''grahi'' (constipating), ''balya'' (promoter of strength) and ''rochana'' (appetizer) should be prescribed. [26-29]<br />
<br />
=== Management of diarrhea associated with pain ===<br />
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<br />
आमेपरिणतेयस्तुविबद्धमतिसार्यते | <br /> <br />
सशूलपिच्छमल्पाल्पंबहुशःसप्रवाहिकम् ||३०|| <br /><br />
<br />
यूषेणमूलकानांतंबदराणामथापिवा | <br /><br />
उपोदिकायाःक्षीरिण्यायवान्यावास्तुकस्यवा ||३१|| <br /><br />
<br />
सुवर्चलायाश्चञ्चोर्वाशाकेनावल्गुजस्यवा | <br /><br />
शट्याःकर्कारुकाणांवाजीवन्त्याश्चिर्भटस्यवा ||३२|| <br /><br />
<br />
लोणिकायाःसपाठायाःशुष्कशाकेनवापुनः | <br /><br />
दधिदाडिमसिद्धेनबहुस्नेहेनभोजयेत् ||३३||<br /><br />
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<br />
āmē pariṇatē yastu vibaddhamatisāryatē| <br /><br />
saśūlapicchamalpālpaṁ bahuśaḥ sapravāhikam||30||<br /><br />
<br />
yūṣēṇa mūlakānāṁ taṁ badarāṇāmathāpi vā| <br /><br />
upōdikāyāḥ kṣīriṇyā yavānyā vāstukasya vā||31|| <br /><br />
<br />
suvarcalāyāścañcōrvā śākēnāvalgujasya vā| <br /><br />
śaṭyāḥ karkārukāṇāṁ vā jīvantyāścirbhaṭasya vā||32|| <br /><br />
<br />
lōṇikāyāḥ sapāṭhāyāḥ śuṣkaśākēna vā punaḥ| <br /><br />
dadhidāḍimasiddhēna bahusnēhēna bhōjayēt||33|| <br /><br />
<br />
Ame pariNate yastu vibaddhamatisAryate| <br /><br />
sashUlapicchamalpAlpaM bahushaH sapravAhikam||30|| <br /><br />
<br />
yUSheNa mUlakAnAM taM badarANAmathApi vA| <br /><br />
upodikAyAH kShIriNyA yavAnyA vAstukasya vA||31||<br /> <br />
<br />
suvarcalAyAshca~jcorvA shAkenAvalgujasya vA| <br /><br />
shaTyAH karkArukANAM vA jIvantyAshcirbhaTasya vA||32|| <br /><br />
<br />
loNikAyAH sapAThAyAH shuShkashAkena vA punaH| <br /><br />
dadhidADimasiddhena bahusnehena bhojayet||33|| <br /><br />
</div></div><br />
<br />
After the maturity of ''ama'' (product of indigestion), if the patient experiences loose motions along with scybalous feces associated with colic pain and mucus very frequently in small quantities, and if there is griping pain, then he should be given food along with the soup of ''mulaka, badara, upodikā, kshirini, yavāni, vāstuka, suvarchala, chanchu'' (''nadika''), leaves of ''avalguja, shati, karkaruka, jivanti, chirbhata'' (karkati), ''lonika, patha'' or ''shushka-shaka'' (''kasamarda'' according to Chakrapani). These soups should be cooked along with curd (yogurt) and ''dadima'', and added with ghee in copious quantities [30-33]<br />
<br />
=== Treatment of ''pravahika'' (dysentery) ===<br />
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<br />
कल्कःस्याद्बालबिल्वानांतिलकल्कश्चतत्समः | <br /><br />
दध्नःसरोऽम्लस्नेहाद्यःखडोहन्यात्प्रवाहिकाम् ||३४|| <br /><br />
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<br />
kalkaḥ syādbālabilvānāṁ tilakalkaśca tatsamaḥ| <br /><br />
dadhnaḥ sarō'mlasnēhādyaḥ khaḍō hanyāt pravāhikām||34|| <br /><br />
<br />
kalkaH syAdbAlabilvAnAM tilakalkashca tatsamaH| <br /><br />
dadhnaH saro~amlasnehAdyaH khaDo hanyAt pravAhikAm||34|| <br /><br />
</div></div><br />
<br />
The following ''khada'' (a sour appetizer) cures ''pravahika'' (dysentery):<br />
<br />
*It is prepared by adding the paste of tender fruits of ''bilva'', equal quantities of the paste of sesame, cream of sour curd and copious quantities of ghee [34].<br />
<br />
=== Treatment of ''varcha-kshaya'' (scanty formation of stool) ===<br />
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<br />
यवानांमुद्गमाषाणांशालीनांचतिलस्यच | <br /><br />
कोलानांबालबिल्वानांधान्ययूषंप्रकल्पयेत् ||३५|| <br /><br />
<br />
ऐकध्यंयमकेभृष्टंदधिदाडिमसारिकम् | <br /><br />
वर्चःक्षयेशुष्कमुखंशाल्यन्नंतेनभोजयेत् ||३६|| <br /><br />
<br />
दध्नःसरंवायमकेभृष्टंसगुडनागरम् | <br /><br />
सुरांवायमकेभृष्टांव्यञ्जनार्थेप्रदापयेत् ||३७|| <br /><br />
<br />
फलाम्लंयमकेभृष्टंयूषंगृञ्जनकस्यवा | <br /><br />
लोपाकरसमम्लंवास्निग्धाम्लंकच्छपस्यवा ||३८|| <br /><br />
<br />
बर्हितित्तिरिदक्षाणांवर्तकानांतथारसाः | <br /><br />
स्निग्धाम्लाःशालयश्चाग्र्यावर्चःक्षयरुजापहाः ||३९|| <br /><br />
<br />
अन्तराधिरसंपूत्वारक्तंमेषस्यचोभयम् | <br /><br />
पचेद्दाडिमसाराम्लंसधान्यस्नेहनागरम् ||४०|| <br /><br />
<br />
ओदनं[१]रक्तशालीनांतेनाद्यात्प्रपिबेच्चतत् | <br /><br />
तथावर्चःक्षयकृतैर्व्याधिभिर्विप्रमुच्यते ||४१||<br /><br />
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<br />
yavānāṁ mudgamāṣāṇāṁ śālīnāṁ ca tilasya ca| <br /><br />
kōlānāṁ bālabilvānāṁ dhānyayūṣaṁ prakalpayēt||35|| <br /><br />
<br />
aikadhyaṁ yamakē bhr̥ṣṭaṁ dadhidāḍimasārikam| <br /><br />
varcaḥkṣayē śuṣkamukhaṁ śālyannaṁ tēna bhōjayēt||36|| <br /><br />
<br />
dadhnaḥ saraṁ vā yamakē bhr̥ṣṭaṁ saguḍanāgaram| <br /><br />
surāṁ vā yamakē bhr̥ṣṭāṁ vyañjanārthē pradāpayēt||37|| <br /><br />
<br />
phalāmlaṁ yamakē bhr̥ṣṭaṁ yūṣaṁ gr̥ñjanakasya vā| <br /><br />
lōpākarasamamlaṁ vā snigdhāmlaṁ kacchapasya vā||38|| <br /><br />
<br />
barhitittiridakṣāṇāṁ vartakānāṁ tathā rasāḥ| <br /><br />
snigdhāmlāḥ śālayaścāgryā varcaḥkṣayarujāpahāḥ||39|| <br /><br />
<br />
antarādhirasaṁ pūtvā raktaṁ mēṣasya cōbhayam| <br /><br />
pacēddāḍimasārāmlaṁ sadhānyasnēhanāgaram||40|| <br /><br />
<br />
ōdanaṁ [1] raktaśālīnāṁ tēnādyāt prapibēcca tat| <br /><br />
tathā varcaḥkṣayakr̥tairvyādhibhirvipramucyatē||41|| <br /><br />
<br />
yavAnAM mudgamAShANAM shAlInAM ca tilasya ca| <br /><br />
kolAnAM bAlabilvAnAM dhAnyayUShaM prakalpayet||35|| <br /><br />
<br />
aikadhyaM yamake bhRuShTaM dadhidADimasArikam| <br /><br />
varcaHkShaye shuShkamukhaM shAlyannaM tena bhojayet||36|| <br /><br />
<br />
dadhnaH saraM vA yamake bhRuShTaM saguDanAgaram| <br /><br />
surAM vA yamake bhRuShTAM vya~jjanArthe pradApayet||37|| <br /><br />
<br />
phalAmlaM yamake bhRuShTaM yUShaM gRu~jjanakasya vA| <br /><br />
lopAkarasamamlaM vA snigdhAmlaM kacchapasya vA||38|| <br /><br />
<br />
barhitittiridakShANAM vartakAnAM tathA rasAH| <br /><br />
snigdhAmlAH shAlayashcAgryA varcaHkShayarujApahAH||39|| <br /><br />
<br />
antarAdhirasaM pUtvA raktaM meShasya cobhayam| <br /><br />
paceddADimasArAmlaM sadhAnyasnehanAgaram||40|| <br /><br />
<br />
odanaM [1] raktashAlInAM tenAdyAt prapibecca tat| <br /><br />
tathA varcaHkShayakRutairvyAdhibhirvipramucyate||41||<br /><br />
</div></div><br />
<br />
If there is ''varcha-kshaya'' (scanty stool), then the patient should be given the following recipes:<br />
*If there is ''varcha-kshaya'' (scanty stool) and dryness of the mouth, then the patient should be given ''dhanya-yusha'' (a type of soup prepared of cereals and pulses) made of ''yava, mudga, masha'', and ''shali'' type of rice, sesame seeds, ''kola'' and tender fruits of ''bilva'', sizzled with ''yamaka'' (ghee and oil) taken together with curd and the extract of ''dadima''. One should take boiled shāli rice along with this soup.<br />
*Cream of curd sizzled with ghee and oil, and mixed with jaggery and ''shunthi'', alcohol sizzled with ghee and oil, sour fruits sizzled with ghee and oil, soup of ''granjanaka'', meat soup of ''lopaka'' added with sour ingredients, meat soup of ''kachchapa'' added with ghee and sour ingredients, or the soup of the meat of ''barhi, tittiri, daksha'' or ''vartaka''. These soups should be used as ''vyanjana'' (side-dish).<br />
*The red variety of ''shali'' rice boiled by adding ghee and sour ingredients. <br />
*The meat soup of the trunk of sheep should be added with its blood and sizzled by adding the extract of ''dadima, dhanya'', ghee and ''nagara''. This soup should be used for boiling red variety of ''shali'' rice. Intake of this cooked rice and drinking this soup make the patient free from the ailments caused by ''varcha-kshaya'' (scanty stool) [35-41]<br />
<br />
=== Treatment of prolapse of rectum ===<br />
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<br />
गुदनिःसरणेशूलेपानमम्लस्यसर्पिषः | <br /><br />
प्रशस्यतेनिरामाणामथवाऽप्यनुवासनम् ||४२|| <br /><br />
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<br />
gudaniḥsaraṇē śūlē pānamamlasya sarpiṣaḥ| <br /><br />
praśasyatē nirāmāṇāmathavā'pyanuvāsanam||42|| <br /><br />
<br />
gudaniHsaraNe shUle pAnamamlasya sarpiShaH| <br /><br />
prashasyate nirAmANAmathavA~apyanuvAsanam||42|| <br /><br />
</div></div><br />
<br />
If there is prolapse of rectum and colic pain, and if the diarrhea is free from ''ama'', then the patient should be given medicated ghee prepared with sour drugs or ''anuvasana'' (unctuous enema). [42]<br />
<br />
=== ''Changeri ghritam'' ===<br />
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<br />
चाङ्गेरीकोलदध्यम्लनागरक्षारसंयुतम् | <br /><br />
घृतमुत्क्वथितंपेयंगुदभ्रंशरुजापहम् ||४३|| <br /><br />
इतिचाङ्गेरीघृतम् | <br /><br />
<div class="mw-collapsible-content"><br />
<br />
cāṅgērīkōladadhyamlanāgarakṣārasaṁyutam| <br /><br />
ghr̥tamutkvathitaṁ pēyaṁ gudabhraṁśarujāpaham||43|| <br /><br />
iti cāṅgērīghr̥tam| <br /><br />
<br />
cA~ggerIkoladadhyamlanAgarakShArasaMyutam| <br /><br />
ghRutamutkvathitaM peyaM gudabhraMsharujApaham||43|| <br /><br />
iti cA~ggerIghRutam| <br /><br />
</div></div><br />
<br />
Ghee should be cooked with the juice of ''changeri'', decoction of ''kola'' and sour curd, and the paste of ''nagara'' and ''kshara'' (alkali preparation). Intake of this medicated ghee cures ailments caused by prolapse of rectum. Thus, ends the description of ''changeri-ghrita'' [43].<br />
<br />
=== ''Chavyadi ghritam'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
सचव्यपिप्पलीमूलंसव्योषविडदाडिमम् |<br /> <br />
पेयमम्लंघृतंयुक्त्यासधान्याजाजिचित्रकम् ||४४||<br /> <br />
<br />
इतिगुदभ्रंशेचव्यादिघृतम् | <br /><br />
<div class="mw-collapsible-content"><br />
<br />
sacavyapippalīmūlaṁ savyōṣaviḍadāḍimam| <br /><br />
pēyamamlaṁ ghr̥taṁ yuktyā sadhānyājājicitrakam||44|| <br /><br />
<br />
iti gudabhraṁśē cavyādighr̥tam| <br /><br />
<br />
sacavyapippalImUlaM savyoShaviDadADimam| <br /><br />
peyamamlaM ghRutaM yuktyA sadhAnyAjAjicitrakam||44|| <br /><br />
<br />
iti gudabhraMshe cavyAdighRutam| <br /><br />
</div></div><br />
<br />
Ghee should be cooked with the sour ingredients (juice of ''changeri'', decoction of ''kola'' and sour curd), and the pastes of ''chavya'', ''pippali-mula, shunthi, pippali, maricha, vida'' and ''dadima''. Intake of this medicated ghee should be done along with ''dhanya, ajaji'' and ''chitraka'' in appropriate quantities (for curing prolapse of rectum)<br />
<br />
Thus, ends the description of ''chavyadi -ghrita'' for prolapsed rectum [44].<br />
<br />
=== ''Anuvasana basti'' in prolapse of rectum ===<br />
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<br />
दशमूलोपसिद्धंवासबिल्वमनुवासनम् | <br /><br />
शटीशताह्वाबिल्वैर्वावचयाचित्रकेणवा ||४५|| <br /><br />
<br />
इतिगुदभ्रंशेऽनुवासनम् <br /><br />
<div class="mw-collapsible-content"><br />
<br />
daśamūlōpasiddhaṁ vā sabilvamanuvāsanam| <br /><br />
śaṭīśatāhvābilvairvā vacayā citrakēṇa vā||45|| <br /><br />
<br />
iti gudabhraṁśē'nuvāsanam| <br /><br />
<br />
dashamUlopasiddhaM vA sabilvamanuvAsanam| <br /><br />
shaTIshatAhvAbilvairvA vacayA citrakeNa vA||45||<br /><br />
<br />
iti gudabhraMshe~anuvAsanam| <br /><br />
</div></div><br />
<br />
For the cure of prolapse rectum, anuvasana [[basti]] (oil-based enema therapy) should be administered with the following recipes:<br />
*''Dashamoola'' cooked with fat; <br />
*''Bilva'' cooked with fat:<br />
*''Shati, shatahva'' or ''bilva'' cooked in fat; <br />
*Vacha cooked with fat; and<br />
*Chitraka cooked with fat [45].<br />
<br />
=== Management of strangulated prolapsed rectum ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
स्तब्धभ्रष्टगुदेपूर्वंस्नेहस्वेदौप्रयोजयेत् | <br /><br />
सुस्विन्नंतंमृदूभूतंपिचुनासम्प्रवेशयेत् ||४६||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
stabdhabhraṣṭagudē pūrvaṁ snēhasvēdau prayōjayēt| <br /><br />
susvinnaṁ taṁ mr̥dūbhūtaṁ picunā sampravēśayēt||46||<br /><br />
<br />
stabdhabhraShTagude pUrvaM snehasvedau prayojayet| <br /><br />
susvinnaM taM mRudUbhUtaM picunA sampraveshayet||46|| <br /><br />
</div></div><br />
<br />
If the prolapsed rectum becomes stiff or strangulated, and does not go inside of its own, then oil should be applied over it and fomentation should be given. Thereafter, when the prolapsed rectum is well fomented and has become soft, then with the help of a cotton pad (or pad made of thick cloth) it should be pushed inside and restored to its original place [46].<br />
<br />
=== Use of medicated milk ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
विबद्धवातवर्चास्तुबहुशूलप्रवाहिकः | <br /><br />
सरक्तपिच्छस्तृष्णार्तःक्षीरसौहित्यमर्हति ||४७|| <br /><br />
<br />
यमकस्योपरिक्षीरंधारोष्णंवापिबेन्नरः | <br /><br />
शृतमेरण्डमूलेनबालबिल्वेनवापयः[१] ||४८|| <br /><br />
<br />
एवंक्षीरप्रयोगेणरक्तंपिच्छाचशाम्यति | <br /><br />
शूलंप्रवाहिकाचैवविबन्धश्चोपशाम्यति ||४९||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
vibaddhavātavarcāstu bahuśūlapravāhikaḥ| <br /><br />
saraktapicchastr̥ṣṇārtaḥ kṣīrasauhityamarhati||47|| <br /><br />
<br />
yamakasyōpari kṣīraṁ dhārōṣṇaṁ vā pibēnnaraḥ| <br /><br />
śr̥tamēraṇḍamūlēna bālabilvēna vā payaḥ [1] ||48|| <br /><br />
<br />
ēvaṁ kṣīraprayōgēṇa raktaṁ picchā ca śāmyati| <br /><br />
śūlaṁ pravāhikā caiva vibandhaścōpaśāmyati||49|| <br /><br />
<br />
vibaddhavAtavarcAstu bahushUlapravAhikaH| <br /><br />
saraktapicchastRuShNArtaH kShIrasauhityamarhati||47|| <br /><br />
<br />
yamakasyopari kShIraM dhAroShNaM vA pibennaraH| <br /><br />
shRutameraNDamUlena bAlabilvena vA payaH [1] ||48|| <br /><br />
<br />
evaM kShIraprayogeNa raktaM picchA ca shAmyati| <br /><br />
shUlaM pravAhikA caiva vibandhashcopashAmyati||49|| <br /><br />
</div></div><br />
<br />
If the movement of flatus and stool is blocked(constipated), if the patient suffers from various kinds of pain, if the patient passes blood and mucus, and if the patient is thirsty, then adequate quantity of milk should be administered. Such a patient should be given ''yamaka'' (ghee and oil mixed together), and thereafter, lukewarm milk collected directly from the udder (''dharoshna'').<br />
<br />
Milk boiled with the root of castor or tender fruit of ''bilva'' may also be given in the above mentioned condition. By the intake of the recipes of medicated ghee mentioned above, bleeding and mucus discharge from the anus stops. These recipes also cure colic pain, dysentery and constipation [47-49]<br />
<br />
=== Treatment of [[pitta]]ja atisara ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
पित्तातिसारंपुनर्निदानोपशयाकृतिभिरामान्वयमुपलभ्ययथाबलंलङ्घनपाचनाभ्यामुपाचरेत् | <br /><br />
तृष्यतस्तुमुस्तपर्पटकोशीरसारिवाचन्दनकिराततिक्तकोदीच्यवारिभिरुपचारः | <br /><br />
लङ्घितस्यचाहारकालेबलातिबलासूर्पपर्णीशालपर्णीपृश्निपर्णीबृहतीकण्टकारिकाशतावरीश्वदंष्ट्रानिर्यूहसंयुक्तेनयथासात्म्यंयवागूमण्डादिनातर्पणादिनावाक्रमेणोपचारः | <br /><br />
मुद्गमसूरहरेणुमकुष्ठकाढकीयूषैर्वालावकपिञ्जलशशहरिणैणकालपुच्छकरसैरीषदम्लैरनम्लैर्वाक्रमशोऽग्निंसन्धुक्षयेत् | <br /><br />
अनुबन्धेत्वस्यदीपनीयपाचनीयोपशमनीयसङ्ग्रहणीयान्योगान्सम्प्रयोजयेदिति ||५०|| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
pittātisāraṁ punarnidānōpaśayākr̥tibhirāmānvayamupalabhya yathābalaṁlaṅghanapācanābhyāmupācarēt| <br /><br />
tr̥ṣyatastu mustaparpaṭakōśīrasārivācandanakirātatiktakōdīcyavāribhirupacāraḥ| <br /><br />
laṅghitasya cāhārakālēbalātibalāsūrpaparṇīśālaparṇīpr̥śniparṇībr̥hatīkaṇṭakārikāśatāvarīśvadaṁṣṭrāniryūhasaṁyuktēnayathāsātmyaṁ yavāgūmaṇḍādinā tarpaṇādinā vā kramēṇōpacāraḥ| <br /><br />
mudgamasūraharēṇumakuṣṭhakāḍhakīyūṣairvālāvakapiñjalaśaśahariṇaiṇakālapucchakarasairīṣadamlairanamlairvā kramaśō'gniṁ sandhukṣayēt| <br /><br />
anubandhē tvasya dīpanīyapācanīyōpaśamanīyasaṅgrahaṇīyān yōgān samprayōjayēditi||50||<br /><br />
<br />
pittAtisAraM punarnidAnopashayAkRutibhirAmAnvayamupalabhya yathAbalaMla~gghanapAcanAbhyAmupAcaret| <br /><br />
tRuShyatastu mustaparpaTakoshIrasArivAcandanakirAtatiktakodIcyavAribhirupacAraH| <br /><br />
la~gghitasya cAhArakAlebalAtibalAsUrpaparNIshAlaparNIpRushniparNIbRuhatIkaNTakArikAshatAvarIshvadaMShTrAniryUhasaMyuktenayathAsAtmyaM yavAgUmaNDAdinA tarpaNAdinA vA krameNopacAraH| <br /><br />
mudgamasUrahareNumakuShThakADhakIyUShairvAlAvakapi~jjalashashahariNaiNakAlapucchakarasairIShadamlairanamlairvA kramasho~agniM sandhukShayet|<br /> <br />
anubandhe tvasya dIpanIyapAcanIyopashamanIyasa~ggrahaNIyAn yogAn samprayojayediti||50|| <br /><br />
</div></div><br />
<br />
For the cure of [[pitta]]ja atisara, the following therapy should be administered: <br />
*If [[pitta]]ja atisara (diarrhea) patient is also afflicted with ''ama'' which can be determined by causative factors, ''upachaya'' (habituation), and signs and symptoms, then the patient should be given [[langhana]] (fasting therapy) and [[pachana]] (carminative therapy) appropriate to the strength of the patient.<br />
*If the patient is thirsty, then the decoction of ''musta, parpataka, ushira, sariva, chandana, kiratatiktaka'' and ''udichya'' should be given to drink. <br />
*After the proper fasting therapy, during meal time, the patient should be gradually given ''yavagu'' (thick gruel), ''manda'' (a type of thin gruel) and ''tarpana'' (roasted flour of cereals added with water) or decoction prepared (according to the procedure suggested for ''shadanga-paniya''[Cha.Sa. [[Chikitsa Sthana]] 3/ 145-146] of ''bala, atibala, surpa-parni'' (''mudga-parni'' and ''mansa-parni''), ''shala-parni, prashni-parni, brahati, kantakari, shatavari'' and ''shvadanshtra''.<br />
<br />
*[[Agni]] (power of digestion) should be stimulated gradually with the vegetable soup of ''mudga, masura, harenu, makustha'' and ''adhaki'' or with the soup of the meat of ''lava, kapinjala, shasha, harina, ena'' and ''kalapuchcha''. These vegetable soups and meat soups may or may not be sour. <br />
<br />
*If the [[pitta]]ja atisara persists even after the administration of the above mentioned measures, then the patient should be treated with recipes which are ''dipaniya'' (digestive stimulant), ''pachaniya'' (carminative), ''upashamaniya'' ([[dosha]]-alleviator) and ''sangrahaniya'' (constipating). [50]<br />
<br />
=== Recipes for [[pitta]]ja atisara ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
सक्षौद्रातिविषंपिष्ट्वावत्सकस्यफलत्वचम् | <br /><br />
पिबेत्पित्तातिसारघ्नंतण्डुलोदकसंयुतम् ||५१|| <br /><br />
<br />
किराततिक्तकोमुस्तंवत्सकःसरसाञ्जनः | <br /><br />
बिल्वंदारुहरिद्रात्वक्ह्रीबेरंसदुरालभम् ||५२|| <br /><br />
<br />
चन्दनंचमृणालंचनागरंलोध्रमुत्पलम् | <br /><br />
तिलामोचरसोलोध्रंसमङ्गाकमलोत्पलम् ||५३|| <br /><br />
<br />
उत्पलंधातकीपुष्पंदाडिमत्वङ्महौषधम् | <br /><br />
कट्फलंनागरंपाठाजम्ब्वाम्रास्थिदुरालभाः ||५४|| <br /><br />
<br />
योगाःषडेतेसक्षौद्रास्तण्डुलोदकसंयुताः | <br /><br />
पेयाःपित्तातिसारघ्नाःश्लोकार्धेननिदर्शिताः ||५५|| <br /><br />
<br />
जीर्णोषधानांशस्यन्तेयथायोगंप्रकल्पितैः | <br /><br />
रसैःसाङ्ग्राहिकैर्युक्ताःपुराणारक्तशालयः ||५६||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
sakṣaudrātiviṣaṁ piṣṭvā vatsakasya phalatvacam| <br /><br />
pibēt pittātisāraghnaṁ taṇḍulōdakasaṁyutam||51|| <br /><br />
<br />
kirātatiktakō mustaṁ vatsakaḥ sarasāñjanaḥ| <br /><br />
bilvaṁ dāruharidrā tvak hrībēraṁ sadurālabham||52|| <br /><br />
<br />
candanaṁ ca mr̥ṇālaṁ ca nāgaraṁ lōdhramutpalam| <br /><br />
tilā mōcarasō lōdhraṁ samaṅgā kamalōtpalam||53|| <br /><br />
<br />
utpalaṁ dhātakīpuṣpaṁ dāḍimatvaṅmahauṣadham| <br /><br />
kaṭphalaṁ nāgaraṁ pāṭhā jambvāmrāsthidurālabhāḥ||54|| <br /><br />
<br />
yōgāḥ ṣaḍētē sakṣaudrāstaṇḍulōdakasaṁyutāḥ| <br /><br />
pēyāḥ pittātisāraghnāḥ ślōkārdhēna nidarśitāḥ||55|| <br /><br />
<br />
jīrṇōṣadhānāṁ śasyantē yathāyōgaṁ prakalpitaiḥ| <br /><br />
rasaiḥ sāṅgrāhikairyuktāḥ purāṇā raktaśālayaḥ||56|| <br /><br />
<br />
sakShaudrAtiviShaM piShTvA vatsakasya phalatvacam| <br /><br />
pibet pittAtisAraghnaM taNDulodakasaMyutam||51|| <br /><br />
<br />
kirAtatiktako mustaM vatsakaH sarasA~jjanaH| <br /><br />
bilvaM dAruharidrA tvak hrIberaM sadurAlabham||52|| <br /><br />
<br />
candanaM ca mRuNAlaM ca nAgaraM lodhramutpalam| <br /><br />
tilA mocaraso lodhraM sama~ggA kamalotpalam||53|| <br /><br />
<br />
utpalaM dhAtakIpuShpaM dADimatva~gmahauShadham| <br /><br />
kaTphalaM nAgaraM pAThA jambvAmrAsthidurAlabhAH||54|| <br /><br />
<br />
yogAH ShaDete sakShaudrAstaNDulodakasaMyutAH| <br /><br />
peyAH pittAtisAraghnAH shlokArdhena nidarshitAH||55|| <br /><br />
<br />
jIrNoShadhAnAM shasyante yathAyogaM prakalpitaiH| <br /><br />
rasaiH sA~ggrAhikairyuktAH purANA raktashAlayaH||56|| <br /><br />
</div></div><br />
<br />
The following recipes are useful in curing [[pitta]]ja atisara:<br />
*The fruit and bark of ''vatsaka'' should be added with ''ativisha'' and honey. It should be taken along with rice-water (''tandulodaka''). <br />
The following recipes should be taken along with honey and rice-water (''tandulodaka'').<br />
*Powder of ''kiratatiktaka, musta, vatsaka'' and ''rasanjana''.<br />
*Powder of ''bilva, dāruharidra, tvak, hribera'' and ''duralabha''<br />
*Powder of ''chandana, mranāla, nagara, lodhra'' and ''utpala''<br />
*Powder of ''tila, mocha-rasa, lodhra, samanga, kamala'' and ''utpala''<br />
*Powder of ''utpala, dhataki''(flower), ''dadima,tvak'' and ''mahaushadha''<br />
*''Katphala, nagara, patha,'' seed-pulp of ''jambu'' and ''amra'', and ''duralabha''. Once the above mentioned recipes are digested, the patient should be given to eat red variety of rice harvested in earlier seasons, along with appropriately cooked meat-soup added with constipating drugs [51-56]<br />
<br />
=== Administration of milk ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
पित्तातिसारोदीपाग्नेःक्षिप्रंसमुपशाम्यति | <br /><br />
अजाक्षीरप्रयोगेणबलंवर्णश्चवर्धते ||५७|| <br /><br />
<br />
बहुदोषस्यदीप्ताग्नेःसप्राणस्यनतिष्ठति | <br /><br />
पैत्तिकोयद्यतीसारःपयसातंविरेचयेत् ||५८|| <br /><br />
<br />
पलाशफलनिर्यूहंपयसासहपाययेत् | <br /><br />
ततोऽनुपाययेत्कोष्णंक्षीरमेवयथाबलम् ||५९|| <br /><br />
<br />
प्रवाहितेतेनमलेप्रशाम्यत्युदरामयः | <br /><br />
पलाशवत्प्रयोज्यावात्रायमाणाविशोधिनी ||६०|| <br /><br />
<br />
सांसर्ग्यांक्रियमाणायांशूलंयद्यनुवर्तते | <br /><br />
स्रुतदोषस्यतंशीघ्रंयथावदनुवासयेत् ||६१|| <br /><br />
<br />
शतपुष्पावरीभ्यांचपयसामधुकेनच | <br /><br />
तैलपादंघृतंसिद्धंसबिल्वमनुवासनम् ||६२||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
pittātisārō dīpāgnēḥ kṣipraṁ samupaśāmyati| <br /><br />
ajākṣīraprayōgēṇa balaṁ varṇaśca vardhatē||57|| <br /><br />
<br />
bahudōṣasya dīptāgnēḥ saprāṇasya na tiṣṭhati| <br /><br />
paittikō yadyatīsāraḥ payasā taṁ virēcayēt||58|| <br /><br />
<br />
palāśaphalaniryūhaṁ payasā saha pāyayēt| <br /><br />
tatō'nupāyayēt kōṣṇaṁ kṣīramēva yathābalam||59|| <br /><br />
<br />
pravāhitē tēna malē praśāmyatyudarāmayaḥ| <br /><br />
palāśavat prayōjyā vā trāyamāṇā viśōdhinī||60|| <br /><br />
<br />
sāṁsargyāṁ kriyamāṇāyāṁ śūlaṁ yadyanuvartatē| <br /><br />
srutadōṣasya taṁ śīghraṁ yathāvadanuvāsayēt||61|| <br /><br />
<br />
śatapuṣpāvarībhyāṁ ca payasā madhukēna ca| <br /><br />
tailapādaṁ ghr̥taṁ siddhaṁ sabilvamanuvāsanam||62|| <br /><br />
<br />
pittAtisAro dIpAgneH kShipraM samupashAmyati| <br /><br />
ajAkShIraprayogeNa balaM varNashca vardhate||57|| <br /><br />
<br />
bahudoShasya dIptAgneH saprANasya na tiShThati| <br /><br />
paittiko yadyatIsAraH payasA taM virecayet||58|| <br /><br />
<br />
palAshaphalaniryUhaM payasA saha pAyayet| <br /><br />
tato~anupAyayet koShNaM kShIrameva yathAbalam||59|| <br /><br />
<br />
pravAhite tena male prashAmyatyudarAmayaH| <br /><br />
palAshavat prayojyA vA trAyamANA vishodhinI||60|| <br /><br />
<br />
sAMsargyAM kriyamANAyAM shUlaM yadyanuvartate| <br /><br />
srutadoShasya taM shIghraM yathAvadanuvAsayet||61|| <br /><br />
<br />
shatapuShpAvarIbhyAM ca payasA madhukena ca| <br /><br />
tailapAdaM ghRutaM siddhaM sabilvamanuvAsanam||62||<br /><br />
</div></div><br />
<br />
*Goat-milk administered to a patient having strong power of digestion cures [[pitta]]ja atisara and promotes strength as well as complexion.<br />
*Due to excessive aggravation of [[dosha]], if the [[pitta]]ja atisara is not cured and if the patient has strong power of digestion and vitality, then laxative therapy with milk should be given. <br />
*Decoction of the fruit of ''palasha'' along with milk should be given. Later, depending upon the strength of the patient, lukewarm milk should be given. This will restore bowel movement and control the ''atisara''. Decoction of ''trayamana'' along with milk should be given. Later, depending upon the strength of the patient lukewarm milk should be given. This will restore bowel movement and control the ''atisara''.<br />
<br />
Anuvasana [[basti]] (medicated untuous enema):<br />
<br />
*During the course of ''sansarjana-krama'' (gradual administration of light food) after purification therapy if the colic pain persists, then anuvasana [[basti]] therapy should be administered immediately because morbid matter is already eliminated. <br />
<br />
''Satapushpadi'' ghee is advised for anuvasana [[basti]] [57-62].<br />
<br />
=== Piccha [[basti]] (slimy medicated enema) ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
कृतानुवासनस्यास्यकृतसंसर्जनस्यच | <br /><br />
वर्ततेयद्यतीसारःपिच्छाबस्तिरतःपरम् ||६३|| <br /><br />
<br />
परिवेष्ट्यकुशैरार्द्रैरार्द्रवृन्तानिशाल्मलेः | <br /><br />
कृष्णमृत्तिकयाऽऽलिप्यस्वेदयेद्गोमयाग्निना ||६४|| <br /><br />
<br />
सुशुष्कांमृत्तिकांज्ञात्वातानिवृन्तानिशाल्मलेः | <br /><br />
शृतेपयसिमृद्नीयादापोथ्योलूखलेततः ||६५|| <br /><br />
<br />
पिण्डंमुष्टिसमंप्रस्थेतत्पूतंतैलसर्पिषोः | <br /><br />
स्नेहितं[१]मात्रयायुक्तंकल्केनमधुकस्यच ||६६|| <br /><br />
<br />
बस्तिमभ्यक्तगात्रायदद्यात्प्रत्यागतेततः | <br /><br />
स्नात्वाभुञ्जीतपयसाजाङ्गलानांरसेनवा ||६७|| <br /><br />
<br />
पित्तातिसारज्वरशोथगुल्मजीर्णातिसारग्रहणीप्रदोषान् | <br /><br />
जयत्ययंशीघ्रमतिप्रवृद्धान्विरेचनास्थापनयोश्चबस्तिः[२] ||६८||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
kr̥tānuvāsanasyāsya kr̥tasaṁsarjanasya ca| <br /><br />
vartatē yadyatīsāraḥ picchābastirataḥ param||63|| <br /><br />
<br />
parivēṣṭya kuśairārdrairārdravr̥ntāni śālmalēḥ| <br /><br />
kr̥ṣṇamr̥ttikayā''lipya svēdayēdgōmayāgninā||64|| <br /><br />
<br />
suśuṣkāṁ mr̥ttikāṁ jñātvā tāni vr̥ntāni śālmalēḥ| <br /><br />
śr̥tē payasi mr̥dnīyādāpōthyōlūkhalē tataḥ||65|| <br /><br />
<br />
piṇḍaṁ muṣṭisamaṁ prasthē tat pūtaṁ tailasarpiṣōḥ| <br /><br />
snēhitaṁ [1] mātrayā yuktaṁ kalkēna madhukasya ca||66|| <br /><br />
<br />
bastimabhyaktagātrāya dadyāt pratyāgatē tataḥ| <br /><br />
snātvā bhuñjīta payasā jāṅgalānāṁ rasēna vā||67|| <br /><br />
<br />
pittātisārajvaraśōthagulmajīrṇātisāragrahaṇīpradōṣān| <br /><br />
jayatyayaṁ śīghramatipravr̥ddhān virēcanāsthāpanayōśca bastiḥ [2] ||68||<br /><br />
<br />
kRutAnuvAsanasyAsya kRutasaMsarjanasya ca| <br /><br />
vartate yadyatIsAraH picchAbastirataH param||63|| <br /><br />
<br />
pariveShTya kushairArdrairArdravRuntAni shAlmaleH| <br /><br />
kRuShNamRuttikayA~a~alipya svedayedgomayAgninA||64|| <br /><br />
<br />
sushuShkAM mRuttikAM j~jAtvA tAni vRuntAni shAlmaleH| <br /><br />
shRute payasi mRudnIyAdApothyolUkhale tataH||65|| <br /><br />
<br />
piNDaM muShTisamaM prasthe tat pUtaM tailasarpiShoH| <br /><br />
snehitaM [1] mAtrayA yuktaM kalkena madhukasya ca||66|| <br /><br />
<br />
bastimabhyaktagAtrAya dadyAt pratyAgate tataH| <br /><br />
snAtvA bhu~jjIta payasA jA~ggalAnAM rasena vA||67|| <br /><br />
<br />
pittAtisArajvarashothagulmajIrNAtisAragrahaNIpradoShAn| <br /><br />
jayatyayaM shIghramatipravRuddhAn virecanAsthApanayoshca bastiH [2] ||68|| <br /><br />
</div></div><br />
<br />
If diarrhea persists in spite of the administration of anuvasana [[basti]] and observing the ''samsarjana-krama'' (gradual administration of lighter to heavier food) then piccha [[basti]] (mucilaginous type of medicated enema) should be given.<br />
<br />
Green stalks of ''shalmali'' should be covered with green ''kusha'' and tied. This bundle is then smeared with the mud of black soil and placed over cow-dung fire. After the mud is dried up, the stalks of ''shalmali'' is removed. These stalks are then triturated in a pestle and mortar. One ''mushti'' (''pala'' or handful) of this paste should be mixed with one ''prastha'' of boiled milk and filtered. In this milk, oil, ghee and paste of ''madhuka'' are added in adequate quantity. This recipe is used for the medicated enema to be given to the patient after massaging the body with oil. When the nasty material comes out, the patient should take bath and thereafter take food along with either milk or the meat soup of the wild animals. This piccha-[[basti]] (mucilaginous enema) cures ''paittika'' type of diarrhea, fever, edema, ''gulma'' (abdominal lumps), chronic diarrhea, ''grahani'' (digestive disorders) and the acute complications of purgation as well as of asthapana [[basti]] [63-68]<br />
<br />
=== ''Raktatisara'' (bloody diarrhoea) ===<br />
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<br />
पित्तातिसारीयस्त्वेतांक्रियांमुक्त्वानिषेवते |<br /><br />
पित्तलान्यन्नपानानितस्यपित्तंमहाबलम् ||६९|| <br /><br />
<br />
कुर्याद्रक्तातिसारंतुरक्तमाशुप्रदूषयेत् | <br /><br />
तृष्णांशूलंविदाहंचगुदपाकंचदारुणम् ||७०||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
pittātisārī yastvētāṁ kriyāṁ muktvā niṣēvatē| <br /><br />
pittalānyannapānāni tasya pittaṁ mahābalam||69|| <br /><br />
<br />
kuryādraktātisāraṁ tu raktamāśu pradūṣayēt| <br /><br />
tr̥ṣṇāṁ śūlaṁ vidāhaṁ ca gudapākaṁ ca dāruṇam||70||<br /> <br />
<br />
pittAtisArI yastvetAM kriyAM muktvA niShevate| <br /><br />
pittalAnyannapAnAni tasya pittaM mahAbalam||69|| <br /><br />
<br />
kuryAdraktAtisAraM tu raktamAshu pradUShayet| <br /><br />
tRuShNAM shUlaM vidAhaM ca gudapAkaM ca dAruNam||70||<br /><br />
</div></div><br />
<br />
If a [[pitta]]ja atisara patient does not follow the therapeutic measures and resorts to such foods and drinks which cause aggravation of [[pitta]], then the excessively provoked [[pitta]] causes ''raktatisara'' and instantaneous vitiation of [[rakta]] (blood). This leads to serious complications like morbid thirst, colic pain, burning sensation and suppuration of the anus. It can also manifest itself directly on account of excessive aggravation of [[pitta]] and vitiation of blood [69-70]<br />
<br />
=== Treatment of ''raktatisara'' ===<br />
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<br />
तत्रच्छागंपयःशस्तंशीतंसमधुशर्करम् | <br /><br />
पानार्थंभोजनार्थंचगुदप्रक्षालनेतथा ||७१|| <br /><br />
<br />
ओदनंरक्तशालीनांपयसातेनभोजयेत् | <br /><br />
रसैःपारावतादीनांघृतभृष्टैःसशर्करैः ||७२|| <br /><br />
<br />
शशपक्षिमृगाणांचशीतानांधन्वचारिणाम् | <br /><br />
रसैरनम्लैःसघृतैर्भोजयेत्तंसशर्करैः ||७३|| <br /><br />
<br />
रुधिरंमार्गमाजंवाघृतभृष्टंप्रशस्यते | <br /><br />
काश्मर्यफलयूषोवाकिञ्चिदम्लःसशर्करः ||७४|| <br /><br />
<br />
नीलोत्पलंमोचरसंसमङ्गापद्मकेशरम् | <br /><br />
अजाक्षीरयुतंदद्याज्जीर्णेचपयसौदनम् ||७५|| <br /><br />
<br />
दुर्बलंपाययित्वावातस्यैवोपरिभोजयेत् | <br /><br />
प्राग्भक्तंनवनीतंवादद्यात्समधुशर्करम् ||७६||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
tatra cchāgaṁ payaḥ śastaṁ śītaṁ samadhuśarkaram| <br /><br />
pānārthaṁ bhōjanārthaṁ ca gudaprakṣālanē tathā||71|| <br /><br />
<br />
ōdanaṁ raktaśālīnāṁ payasā tēna bhōjayēt| <br /><br />
rasaiḥ pārāvatādīnāṁ ghr̥tabhr̥ṣṭaiḥ saśarkaraiḥ||72|| <br /><br />
<br />
śaśapakṣimr̥gāṇāṁ ca śītānāṁ dhanvacāriṇām| <br /><br />
rasairanamlaiḥ saghr̥tairbhōjayēttaṁ saśarkaraiḥ||73|| <br /><br />
<br />
rudhiraṁ mārgamājaṁ vā ghr̥tabhr̥ṣṭaṁ praśasyatē| <br /><br />
kāśmaryaphalayūṣō vā kiñcidamlaḥ saśarkaraḥ||74|| <br /><br />
<br />
nīlōtpalaṁ mōcarasaṁ samaṅgā padmakēśaram| <br /><br />
ajākṣīrayutaṁ dadyājjīrṇē ca payasaudanam||75|| <br /><br />
<br />
durbalaṁ pāyayitvā vā tasyaivōpari bhōjayēt| <br /><br />
prāgbhaktaṁ navanītaṁ vā dadyāt samadhuśarkaram||76|| <br /><br />
<br />
tatra cchAgaM payaH shastaM shItaM samadhusharkaram| <br /><br />
pAnArthaM bhojanArthaM ca gudaprakShAlane tathA||71|| <br /><br />
<br />
odanaM raktashAlInAM payasA tena bhojayet| <br /><br />
rasaiH pArAvatAdInAM ghRutabhRuShTaiH sasharkaraiH||72|| <br /><br />
<br />
shashapakShimRugANAM ca shItAnAM dhanvacAriNAm| <br /><br />
rasairanamlaiH saghRutairbhojayettaM sasharkaraiH||73||<br /><br />
<br />
rudhiraM mArgamAjaM vA ghRutabhRuShTaM prashasyate| <br /><br />
kAshmaryaphalayUSho vA ki~jcidamlaH sasharkaraH||74|| <br /><br />
<br />
nIlotpalaM mocarasaM sama~ggA padmakesharam| <br /><br />
ajAkShIrayutaM dadyAjjIrNe ca payasaudanam||75|| <br /><br />
<br />
durbalaM pAyayitvA vA tasyaivopari bhojayet| <br /><br />
prAgbhaktaM navanItaM vA dadyAt samadhusharkaram||76|| <br /><br />
</div></div><br />
<br />
For the treatment of ''raktatisara'', the following therapy should be administered:<br />
*Goat’s milk is very useful. It should be used, when cooled, with honey and sugar for drink, along with food, and for washing the anal region.<br />
*Goat’s milk along with the boiled rice of red variety of ''shali'' should be given.<br />
*The boiled rice may also be given along with the soup of the meat of ''paravata'', etc., sizzled with ghee and mixed with sugar. The soup of the meat having cooling effect like that of rabbits, birds and deer inhabiting deserts should be sizzled with ghee, mixed with sugar should be given. It may be ensured that these soups are free from any sour ingredients.<br />
*The blood of deer or goat, sizzled with ghee is also very useful.<br />
*The soup of the fruits of ''kashmarya'', made slightly sour and mixed with sugar should be given.<br />
*The powder of ''nilotpala, mocharasa, samanga'' and ''padmakeshara'' should be administered along with the goat’s milk. After the digestion of this potion, the patient should be given rice with milk. If the patient is weak, then food can be given to him even before the above mentioned potion is digested.<br />
*Butter along with honey and sugar may be given before meals [71-76].<br />
<br />
=== Measures to alleviate bleeding in ''raktatisara'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
प्राश्यक्षीरोत्थितंसर्पिःकपिञ्जलरसाशनः | <br /><br />
त्र्यहादारोग्यमाप्नोतिपयसाक्षीरभुक्तथा ||७७|| <br /><br />
<br />
पीत्वाशतावरीकल्कंपयसाक्षीरभुग्जयेत् | <br /><br />
रक्तातिसारंपीत्वावातयासिद्धंघृतंनरः ||७८|| <br /><br />
<br />
घृतंयवागूमण्डेनकुटजस्यफलैःशृतम् | <br /><br />
पेयंतस्यानुपातव्यापेयारक्तोपशान्तये ||७९||<br /><br />
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<br />
prāśya kṣīrōtthitaṁ sarpiḥ kapiñjalarasāśanaḥ| <br /><br />
tryahādārōgyamāpnōti payasā kṣīrabhuk tathā||77|| <br /><br />
<br />
pītvā śatāvarīkalkaṁ payasā kṣīrabhugjayēt| <br /><br />
raktātisāraṁ pītvā vā tayā siddhaṁ ghr̥taṁ naraḥ||78|| <br /><br />
<br />
ghr̥taṁ yavāgūmaṇḍēna kuṭajasya phalaiḥ śr̥tam| <br /><br />
pēyaṁ tasyānu pātavyā pēyā raktōpaśāntayē||79|| <br /><br />
<br />
prAshya kShIrotthitaM sarpiH kapi~jjalarasAshanaH| <br /><br />
tryahAdArogyamApnoti payasA kShIrabhuk tathA||77|| <br /><br />
<br />
pItvA shatAvarIkalkaM payasA kShIrabhugjayet| <br /><br />
raktAtisAraM pItvA vA tayA siddhaM ghRutaM naraH||78|| <br /><br />
<br />
ghRutaM yavAgUmaNDena kuTajasya phalaiH shRutam| <br /><br />
peyaM tasyAnu pAtavyA peyA raktopashAntaye||79|| <br /><br />
</div></div><br />
<br />
*After taking ghee collected from the cream of milk along with milk, the patient should take the meat soup of ''kapinjala''. During this therapy, he should take milk in adequate quantity. It cures ''raktatisara'' in three days.<br />
*While consuming milk as food (drink), the patient should take the paste of ''shatavari'' mixed with milk. He may also take ghee boiled with the paste of ''shatavari''. <br />
*Consumption of ghee cooked by adding the paste of fruits of ''kutaja'', along with the scum (upper part) of ''yavagu'', and followed by intake of ''peya'' (thin gruel) is advised [77-79].<br />
<br />
=== Treatment of ''sannipataja atisara'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
त्वक्चदारुहरिद्रायाःकुटजस्यफलानिच | <br /><br />
पिप्पलीशृङ्गवेरंचद्राक्षाकटुकरोहिणी ||८०|| <br /><br />
<br />
षड्भिरेतैर्घृतंसिद्धंपेयामण्डावचारितम् | <br /><br />
अतीसारंजयेच्छीघ्रंत्रिदोषमपिदारुणम् ||८१||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
tvak ca dāruharidrāyāḥ kuṭajasya phalāni ca| <br /><br />
pippalī śr̥ṅgavēraṁ ca drākṣā kaṭukarōhiṇī||80|| <br /><br />
<br />
ṣaḍbhirētairghr̥taṁ siddhaṁ pēyāmaṇḍāvacāritam| <br /><br />
atīsāraṁ jayēcchīghraṁ tridōṣamapi dāruṇam||81|| <br /><br />
<br />
tvak ca dAruharidrAyAH kuTajasya phalAni ca| <br /><br />
pippalI shRu~ggaveraM ca drAkShA kaTukarohiNI||80||<br /><br />
<br />
ShaDbhiretairghRutaM siddhaM peyAmaNDAvacAritam| <br /><br />
atIsAraM jayecchIghraM tridoShamapi dAruNam||81|| <br /><br />
</div></div><br />
<br />
Ghee should be cooked by adding the six drugs, viz., the bark of ''daru-haridra'', fruits of ''kutaja, pippali, shringavera, draksa'' and ''katukarohini''. Intake of ''peya'' (thin gruel) and ''manda'' (very thin gruel) along with this medicated ghee cures a serious type of diarrhea even if caused by ''sannipata'' (simultaneous aggravation of all the three [[dosha]]).[80-81]<br />
<br />
=== Hemostatic recipes ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
कृष्णमृन्मधुकंशङ्खंरुधिरंतण्डुलोदकम् | <br /><br />
पीतमेकत्रसक्षौद्रंरक्तसङ्ग्रहणंपरम् ||८२|| <br /><br />
<br />
पीतःप्रियङ्गुकाकल्कःसक्षौद्रस्तण्डुलाम्भसा | <br /><br />
रक्तस्रावंजयेच्छीघ्रंधन्वमांसरसाशिनः ||८३|| <br /><br />
<br />
कल्कस्तिलानांकृष्णानांशर्करापञ्चभागिकः | <br /><br />
आजेनपयसापीतःसद्योरक्तंनियच्छति ||८४||<br /><br />
<br />
पलंवत्सकबीजस्यश्रपयित्वारसंपिबेत् | <br /><br />
योरसाशीजयेच्छीघ्रंसपैत्तंजठरामयम् ||८५|| <br /><br />
<br />
पीत्वासशर्कराक्षौद्रंचन्दनंतण्डुलाम्भसा | <br /><br />
दाहतृष्णाप्रमेहेभ्योरक्तस्रावाच्चमुच्यते ||८६||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
kr̥ṣṇamr̥nmadhukaṁ śaṅkhaṁ rudhiraṁ taṇḍulōdakam| <br /><br />
pītamēkatra sakṣaudraṁ raktasaṅgrahaṇaṁ param||82|| <br /><br />
<br />
pītaḥ priyaṅgukākalkaḥ sakṣaudrastaṇḍulāmbhasā| <br /><br />
raktasrāvaṁ jayēcchīghraṁ dhanvamāṁsarasāśinaḥ||83|| <br /><br />
<br />
kalkastilānāṁ kr̥ṣṇānāṁ śarkarāpañcabhāgikaḥ| <br /><br />
ājēna payasā pītaḥ sadyō raktaṁ niyacchati||84|| <br /><br />
<br />
palaṁ vatsakabījasya śrapayitvā rasaṁ pibēt| <br /><br />
yō rasāśī jayēcchīghraṁ sa paittaṁ jaṭharāmayam||85|| <br /><br />
<br />
pītvā saśarkarākṣaudraṁ candanaṁ taṇḍulāmbhasā| <br /><br />
dāhatr̥ṣṇāpramēhēbhyō raktasrāvācca mucyatē||86|| <br /><br />
<br />
kRuShNamRunmadhukaM sha~gkhaM rudhiraM taNDulodakam| <br /><br />
pItamekatra sakShaudraM raktasa~ggrahaNaM param||82|| <br /><br />
<br />
pItaH priya~ggukAkalkaH sakShaudrastaNDulAmbhasA| <br /><br />
raktasrAvaM jayecchIghraM dhanvamAMsarasAshinaH||83|| <br /><br />
<br />
kalkastilAnAM kRuShNAnAM sharkarApa~jcabhAgikaH| <br /><br />
Ajena payasA pItaH sadyo raktaM niyacchati||84|| <br /><br />
<br />
palaM vatsakabIjasya shrapayitvA rasaM pibet| <br /><br />
yo rasAshI jayecchIghraM sa paittaM jaTharAmayam||85|| <br /><br />
<br />
pItvA sasharkarAkShaudraM candanaM taNDulAmbhasA| <br /><br />
dAhatRuShNApramehebhyo raktasrAvAcca mucyate||86|| <br /><br />
</div></div><br />
<br />
*Intake of ''krishnamrita'' (black earth), ''madhuka, shankha, rudhira'' (blood or ''kesara'') and rice-water, mixed with honey controls bleeding instantaneously.<br />
*The paste of ''priyangu'' should be added with rice-water (''tandulambu''). Intake of this, while taking the soup of the meat of animals inhabiting arid zone, in food, controls bleeding instantaneously.<br />
*One part of the paste of the black variety of ''tila'' should be added with four parts of sugar. Intake of this potion along with the goat’s milk checks bleeding instantaneously. <br />
*Intake of the decoction of the seeds of ''vatsaka'', while taking meat-soup as food, cures [[pitta]]ja disorders of abdomen (''jathara'').<br />
*Intake of ''chandana'' along with rice-water, mixed with sugar and honey cures burning sensation, morbid thirst, ''prameha'' and bleeding [82-86].<br />
<br />
=== Treatment of anal suppuration ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
गुदोबहुभिरुत्थानैर्यस्यपित्तेनपच्यते | <br /><br />
सेचयेत्तंसुशीतेनपटोलमधुकाम्बुना ||८७|| <br /><br />
<br />
पञ्चवल्कमधूकानांरसैरिक्षुरसैर्घृतैः | <br /><br />
छागैर्गव्यैःपयोभिर्वाशर्कराक्षौद्रसंयुतैः ||८८||<br /><br />
<br />
प्रक्षालनानांकल्कैर्वाससर्पिष्कैःप्रलेपयेत् | <br /><br />
एषांवासुकृतैश्चूर्णैस्तंगुदंप्रतिसारयेत् ||८९|| <br /><br />
<br />
धातकीलोध्रचूर्णैर्वासमांशैःप्रतिसारयेत् | <br /><br />
तथास्रवतिनोरक्तंगुदंतैःप्रतिसारितम् ||९०|| <br /><br />
<br />
पक्वताप्रशमंयातिवेदनाचोपशाम्यति | <br /><br />
यथोक्तैःसेचनैःशीतैःशोणितेऽतिस्रवत्यपि ||९१|| <br /><br />
<br />
गुदवङ्क्षणकट्यूरुसेचयेद्घृतभावितम् | <br /><br />
चन्दनाद्येनतैलेनशतधौतेनसर्पिषा ||९२|| <br /><br />
<br />
कार्पाससङ्गृहीतेनसेचयेद्गुदवङ्क्षणम् |९३| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
gudō bahubhirutthānairyasya pittēna pacyatē| <br /><br />
sēcayēttaṁ suśītēna paṭōlamadhukāmbunā||87|| <br /><br />
<br />
pañcavalkamadhūkānāṁ rasairikṣurasairghr̥taiḥ| <br /><br />
chāgairgavyaiḥ payōbhirvā śarkarākṣaudrasaṁyutaiḥ||88|| <br /> <br />
<br />
prakṣālanānāṁ kalkairvā sasarpiṣkaiḥ pralēpayēt| <br /><br />
ēṣāṁ vā sukr̥taiścūrṇaistaṁ gudaṁ prAtisārayēt||89|| <br /><br />
<br />
dhātakīlōdhracūrṇairvā samāṁśaiḥ prAtisārayēt| <br /><br />
tathā sravati nō raktaṁ gudaṁ taiḥ pratisāritam||90||<br /><br />
<br />
pakvatā praśamaṁ yāti vēdanā cōpaśāmyati| <br /><br />
yathōktaiḥ sēcanaiḥ śītaiḥ śōṇitē'tisravatyapi||91|| <br /><br />
<br />
gudavaṅkṣaṇakaṭyūru sēcayēdghr̥tabhāvitam| <br /><br />
candanādyēna tailēna śatadhautēna sarpiṣā||92|| <br /><br />
<br />
kārpāsasaṅgr̥hītēna sēcayēdgudavaṅkṣaṇam|93| <br /><br />
<br />
gudo bahubhirutthAnairyasya pittena pacyate| <br /><br />
secayettaM sushItena paTolamadhukAmbunA||87|| <br /><br />
<br />
pa~jcavalkamadhUkAnAM rasairikShurasairghRutaiH| <br /><br />
chAgairgavyaiH payobhirvA sharkarAkShaudrasaMyutaiH||88|| <br /><br />
<br />
prakShAlanAnAM kalkairvA sasarpiShkaiH pralepayet| <br /><br />
eShAM vA sukRutaishcUrNaistaM gudaM pratisArayet||89|| <br /><br />
<br />
dhAtakIlodhracUrNairvA samAMshaiH pratisArayet| <br /><br />
tathA sravati no raktaM gudaM taiH pratisAritam||90|| <br /><br />
<br />
pakvatA prashamaM yAti vedanA copashAmyati| <br /><br />
yathoktaiH secanaiH shItaiH shoNite~atisravatyapi||91|| <br /><br />
<br />
gudava~gkShaNakaTyUru secayedghRutabhAvitam| <br /><br />
candanAdyena tailena shatadhautena sarpiShA||92|| <br /><br />
<br />
kArpAsasa~ggRuhItena secayedgudava~gkShaNam|93| <br /><br />
</div></div><br />
<br />
Aggravated [[pitta]] suppurates the anus due to frequent evacuation of stool. The anus of such a patient should be sprinkled and applied with the following recipes which stops bleeding and pacifies suppuration and pain.<br />
*Exceedingly cold decoction of ''patola'' and ''madhuka''<br />
*Decoction of ''pancha-valkala'' (barks of ''nyagrodha, udumbara, ashvattha, parisa'' and ''plaksha'') or sugar-cane juice. Milk or ghee of goat or cow mixed with sugar and honey. The paste of drugs mentioned above for washing (sprinkling over) the anus may be mixed with ghee and applied over the suppurated anus. The powder of the above mentioned drugs may also be used for ''pratisarana'' (dusting) over the suppurated anus.<br />
*The powder of ''dhataki'' and ''lodhra'', taken in equal quantities, may be used for dusting over the suppurated anus.<br />
*If there is excessive bleeding (from the anus), the cold decoction of the above mentioned drugs should be impregnated with ghee, and sprinkled over the anal region, pelvic region, lumbar region and thighs. <br />
*Excessive bleeding should be controlled with a cotton pad soaked with ''chandanadya-taila''[Cha.Sa. [[Chikitsa Sthana]] 3-258] or ''satadhauta-ghrita'' (ghee washed with cold water for one hundred times), and the oil or ghee; squeeze this pad over the anal and pelvic regions [87-92 ½]<br />
<br />
=== Pichcha-[[basti]](mucilaginous enema) for dysentery ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
अल्पाल्पंबहुशोरक्तंसशूलमुपवेश्यते ||९३|| <br /><br />
<br />
यदावायुर्विबद्धश्चकृच्छ्रंचरतिवानवा | <br /><br />
पिञ्छाबस्तिंतदातस्ययथोक्तमुपकल्पयेत् ||९४|| <br /><br />
<br />
प्रपौण्डरीकसिद्धेनसर्पिषाचानुवासयेत् | <br /><br />
प्रायशोदुर्बलगुदाश्चिरकालातिसारिणः ||९५|| <br /><br />
<br />
तस्मादभीक्ष्णशस्तेषांगुदेस्नेहंप्रयोजयेत् |९६| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
alpālpaṁ bahuśō raktaṁ saśūlamupavēśyatē||93|| <br /><br />
<br />
yadā vāyurvibaddhaśca kr̥cchraṁ carati vā na vā| <br /><br />
picchābastiṁ tadā tasya yathōktamupakalpayēt||94|| <br /><br />
<br />
prapauṇḍarīkasiddhēna sarpiṣā cānuvāsayēt| <br /><br />
prāyaśō durbalagudāścirakālātisāriṇaḥ||95|| <br /><br />
<br />
tasmādabhīkṣṇaśastēṣāṁ gudē snēhaṁ prayōjayēt|96| <br /><br />
<br />
alpAlpaM bahusho raktaM sashUlamupaveshyate||93|| <br /><br />
<br />
yadA vAyurvibaddhashca kRucchraM carati vA na vA| <br /><br />
picchAbastiM tadA tasya yathoktamupakalpayet||94|| <br /><br />
<br />
prapauNDarIkasiddhena sarpiShA cAnuvAsayet| <br /><br />
prAyasho durbalagudAshcirakAlAtisAriNaH||95|| <br /><br />
<br />
tasmAdabhIkShNashasteShAM gude snehaM prayojayet|96| <br /><br />
</div></div><br />
<br />
When the movement of the aggravated vata (flatus) gets obstructed or moves with difficulty or seizing of [[vata]] inside the abdomen, then the patient voids blood frequently in small quantities which is associated with pain. Piccha-[[basti]] should be administered to such patients. This type of patient may also be managed by anuvasana [[basti]] given with medicated ghee prepared with ''prapaundarika''. Because of chronic diarrhea, the anus of the patient generally becomes weak. Therefore cotton soaked in medicated ghee should be inserted into the anus frequently or anuvasana [[basti]] with medicated ghee is given [93-95½ ].<br />
<br />
=== Medicated enema and recipes of linctus ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
पवनोऽतिप्रवृत्तोहिस्वेस्थानेलभतेऽधिकम् ||९६|| <br /><br />
<br />
बलंतस्यसपित्तस्यजयार्थेबस्तिरुत्तमः | <br /><br />
रक्तंविट्सहितंपूर्वंपश्चाद्वायोऽतिसार्यते ||९७|| <br /><br />
<br />
शतावरीघृतंतस्यलेहार्थमुपकल्पयेत् | <br /><br />
शर्करार्धांशिकंलीढंनवनीतंनवोद्धृतम् ||९८|| <br /><br />
<br />
क्षौद्रपादंजयेच्छीघ्रंतंविकारंहिताशिनः | <br /><br />
न्यग्रोधोदुम्बराश्वत्थशुङ्गानापोथ्यवासयेत् ||९९|| <br /><br />
<br />
अहोरात्रंजलेतप्तेघृतंतेनाम्भसापचेत् | <br /><br />
तदर्धशर्करायुक्तंलिह्यात्सक्षौद्रपादिकम् ||१००|| <br /><br />
<br />
अधोवायदिवाऽप्यूर्ध्वंयस्यरक्तंप्रवर्तते |१०१| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
pavanō'tipravr̥ttō hi svē sthānē labhatē'dhikam||96|| <br /><br />
<br />
balaṁ tasya sapittasya jayārthē bastiruttamaḥ| <br /><br />
raktaṁ viṭsahitaṁ pūrvaṁ paścādvā yō'tisāryatē||97|| <br /><br />
<br />
śatāvarīghr̥taṁ tasya lēhārthamupakalpayēt| <br /><br />
śarkarārdhāṁśikaṁ līḍhaṁ navanītaṁ navōddhr̥tam||98|| <br /><br />
<br />
kṣaudrapādaṁ jayēcchīghraṁ taṁ vikāraṁ hitāśinaḥ| <br /><br />
nyagrōdhōdumbarāśvatthaśuṅgānāpōthya vāsayēt||99|| <br /><br />
<br />
ahōrātraṁ jalē taptē ghr̥taṁ tēnāmbhasā pacēt| <br /><br />
tadardhaśarkarāyuktaṁ lihyāt sakṣaudrapādikam||100|| <br /><br />
<br />
adhō vā yadi vā'pyūrdhvaṁ yasya raktaṁ pravartatē|101| <br /><br />
<br />
pavano~atipravRutto hi sve sthAne labhate~adhikam||96|| <br /><br />
<br />
balaM tasya sapittasya jayArthe bastiruttamaH| <br /><br />
raktaM viTsahitaM pUrvaM pashcAdvA yo~atisAryate||97|| <br /><br />
<br />
shatAvarIghRutaM tasya lehArthamupakalpayet| <br /><br />
sharkarArdhAMshikaM lIDhaM navanItaM navoddhRutam||98|| <br /><br />
<br />
kShaudrapAdaM jayecchIghraM taM vikAraM hitAshinaH| <br /><br />
nyagrodhodumbarAshvatthashu~ggAnApothya vAsayet||99|| <br /><br />
<br />
ahorAtraM jale tapte ghRutaM tenAmbhasA pacet| <br /><br />
tadardhasharkarAyuktaM lihyAt sakShaudrapAdikam||100|| <br /><br />
<br />
adho vA yadi vA~apyUrdhvaM yasya raktaM pravartate|101| <br /><br />
</div></div><br />
<br />
*The aggravated vata becomes stronger in its own site in ''atisara'' patients. For the pacification of aggravated [[vata]] associated with [[pitta]] (which takes place in bloody diarrhea), [[basti]] (both the ''anuvasana'' and ''niruha'' types) is the best therapy.<br />
*If bleeding takes place before evacuating the stool or after evacuation of stool (i.e., a case of ''raktatisara''), then ''shatavari-ghrita'' [Cha.Sa. [[Chikitsa Sthana]] 30/64-69] in the form of linctus should be given.<br />
*Intake of freshly collected butter along with half the quantity of sugar and one fourth quantity of honey cures the above mentioned ailments. While taking this potion, the patient should take wholesome food. Adventitious roots of ''nyagrodha, udumbara'' and ''ashvattha'' should be crushed and kept soaked in hot water for twenty four hours. Ghee should be cooked along with this water. This medicated ghee should be added with half the quantity of sugar and one fourth in quantity of honey, and taken in the form of linctus. It cures ''raktatisara'', associated with bleeding either before or after the passing of stool [96-100½]<br />
<br />
=== Suppuration of anal sphincters ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
यस्त्वेवंदुर्बलोमोहात्पित्तलान्येवसेवते ||१०१|| <br /><br />
<br />
दारुणंसवलीपाकंप्राप्यशीघ्रंविपद्यते |१०२|<br /><br />
<div class="mw-collapsible-content"><br />
<br />
yastvēvaṁ durbalō mōhāt pittalānyēva sēvatē||101|| <br /><br />
<br />
dāruṇaṁ sa valīpākaṁ prāpya śīghraṁ vipadyatē|102| <br /><br />
<br />
yastvevaM durbalo mohAt pittalAnyeva sevate||101|| <br /><br />
<br />
dAruNaM sa valIpAkaM prApya shIghraM vipadyate|102| <br /><br />
</div></div><br />
<br />
A patient who has become weak because of ''raktatisara'', if indulges in [[pitta]]-aggravating ingredients out of ignorance, then the anal sphincters gets suppurated. This is a serious condition leading to instantaneous death [101½].<br />
<br />
=== Treatment of [[kapha]]ja atisara ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
श्लेष्मातिसारेप्रथमंहितंलङ्घनपाचनम् ||१०२|| <br /><br />
<br />
योज्यश्चामातिसारघ्नोयथोक्तोदीपनोगणः | <br /><br />
लङ्घितस्यानुपूर्व्यांचकृतायांननिवर्तते ||१०३|| <br /><br />
<br />
कफजोयद्यतीसारःकफघ्नैस्तमुपाचरेत् | <br /> <br />
बिल्वंकर्कटिकामुस्तमभयाविश्वभेषजम् ||१०४|| <br /><br />
<br />
वचाविडङ्गंभूतीकंधान्यकंदेवदारुच | <br /><br />
कुष्ठंसातिविषापाठाचव्यंकटुकरोहिणी ||१०५|| <br /><br />
<br />
पिप्पलीपिप्पलीमूलंचित्रकंहस्तिपिप्पली | <br /><br />
योगाञ्छ्लोकार्धविहितांश्चतुरस्तान्प्रयोजयेत् ||१०६|| <br /><br />
<br />
शृताञ्छ्लेष्मातिसारेषुकायाग्निबलवर्धनान् | <br /><br />
अजाजीमसितांपाठांनागरंमरिचानिच ||१०७|| <br /><br />
<br />
धातकीद्विगुणंदद्यान्मातुलुङ्गरसाप्लुतम् | <br /><br />
रसाञ्जनंसातिविषंकुटजस्यफलानिच ||१०८|| <br /><br />
<br />
धातकीद्विगुणंदद्यात्पातुंसक्षौद्रनागरम् | <br /><br />
धातकीनागरंबिल्वंलोध्रंपद्मस्यकेशरम् ||१०९|| <br /><br />
<br />
जम्बूत्वङ्नागरंधान्यंपाठामोचरसोबला | <br /><br />
समङ्गाधातकीबिल्वमध्यंजम्ब्वाम्रयोस्त्वचः ||११०|| <br /><br />
<br />
कपित्थानिविडङ्गानिनागरंमरिचानिच | <br /><br />
चाङ्गेरीकोलतक्राम्लांश्चतुरस्तान्कफोत्तरे ||१११|| <br /><br />
<br />
श्लोकार्धविहितान्दद्यात्सस्नेहलवणान्खडान् | <br /><br />
कपित्थमध्यंलीढ्वातुसव्योषक्षौद्रशर्करम् ||११२|| <br /><br />
<br />
कट्फलंमधुयुक्तंवामुच्यतेजठरामयात् |११३| <br /><br />
<div class="mw-collapsible-content"><br />
<br />
ślēṣmātisārē prathamaṁ hitaṁ laṅghanapācanam||102|| <br /><br />
<br />
yōjyaścāmātisāraghnō yathōktō dīpanō gaṇaḥ| <br /><br />
laṅghitasyānupūrvyāṁ ca kr̥tāyāṁ na nivartatē||103|| <br /><br />
<br />
kaphajō yadyatīsāraḥ kaphaghnaistamupācarēt <br /><br />
bilvaṁ karkaṭikā mustamabhayā viśvabhēṣajam||104|| <br /><br />
<br />
vacā viḍaṅgaṁ bhūtīkaṁ dhānyakaṁ dēvadāru ca| <br /><br />
kuṣṭhaṁ sātiviṣā pāṭhā cavyaṁ kaṭukarōhiṇī||105|| <br /><br />
<br />
pippalī pippalīmūlaṁ citrakaṁ hastipippalī| <br /><br />
yōgāñchlōkārdhavihitāṁścaturastān prayōjayēt||106|| <br /><br />
<br />
śr̥tāñchlēṣmātisārēṣu kāyāgnibalavardhanān| <br /><br />
ajājīmasitāṁ pāṭhāṁ nāgaraṁ maricāni ca||107|| <br /><br />
<br />
dhātakīdviguṇaṁ dadyānmātuluṅgarasāplutam| <br /><br />
rasāñjanaṁ sātiviṣaṁ kuṭajasya phalāni ca||108|| <br /><br />
<br />
dhātakīdviguṇaṁ dadyāt pātuṁ sakṣaudranāgaram| <br /><br />
dhātakī nāgaraṁ bilvaṁ lōdhraṁ padmasya kēśaram||109|| <br /><br />
<br />
jambūtvaṅnāgaraṁ dhānyaṁ pāṭhā mōcarasō balā| <br /><br />
samaṅgā dhātakī bilvamadhyaṁ jambvāmrayōstvacaḥ||110|| <br /><br />
<br />
kapitthāni viḍaṅgāni nāgaraṁ maricāni ca| <br /><br />
cāṅgērīkōlatakrāmlāṁścaturastān kaphōttarē||111|| <br /><br />
<br />
ślōkārdhavihitān dadyāt sasnēhalavaṇān khaḍān| <br /><br />
kapitthamadhyaṁ līḍhvā tu savyōṣakṣaudraśarkaram||112|| <br /><br />
<br />
kaṭphalaṁ madhuyuktaṁ vā mucyatē jaṭharāmayāt|113| <br /><br />
<br />
shleShmAtisAre prathamaM hitaM la~gghanapAcanam||102|| <br /><br />
<br />
yojyashcAmAtisAraghno yathokto dIpano gaNaH| <br /><br />
la~gghitasyAnupUrvyAM ca kRutAyAM na nivartate||103|| <br /><br />
<br />
kaphajo yadyatIsAraH kaphaghnaistamupAcaret|104| <br /><br />
<br />
bilvaM karkaTikA mustamabhayA vishvabheShajam||104|| <br /><br />
<br />
vacA viDa~ggaM bhUtIkaM dhAnyakaM devadAru ca| <br /><br />
kuShThaM sAtiviShA pAThA cavyaM kaTukarohiNI||105|| <br /><br />
<br />
pippalI pippalImUlaM citrakaM hastipippalI| <br /><br />
yogA~jchlokArdhavihitAMshcaturastAn prayojayet||106|| <br /><br />
<br />
shRutA~jchleShmAtisAreShu kAyAgnibalavardhanAn| <br /><br />
ajAjImasitAM pAThAM nAgaraM maricAni ca||107|| <br /><br />
<br />
dhAtakIdviguNaM dadyAnmAtulu~ggarasAplutam| <br /><br />
rasA~jjanaM sAtiviShaM kuTajasya phalAni ca||108|| <br /><br />
<br />
dhAtakIdviguNaM dadyAt pAtuM sakShaudranAgaram| <br /><br />
dhAtakI nAgaraM bilvaM lodhraM padmasya kesharam||109|| <br /><br />
<br />
jambUtva~gnAgaraM dhAnyaM pAThA mocaraso balA| <br /><br />
sama~ggA dhAtakI bilvamadhyaM jambvAmrayostvacaH||110|| <br /><br />
<br />
kapitthAni viDa~ggAni nAgaraM maricAni ca| <br /><br />
cA~ggerIkolatakrAmlAMshcaturastAn kaphottare||111|| <br /><br />
<br />
shlokArdhavihitAn dadyAt sasnehalavaNAn khaDAn| <br /><br />
kapitthamadhyaM lIDhvA tu savyoShakShaudrasharkaram||112|| <br /><br />
<br />
kaTphalaM madhuyuktaM vA mucyate jaTharAmayAt|113| <br /><br />
</div></div><br />
<br />
For the cure of [[kapha]]ja atisara, following therapy and recipes should be administered:<br />
*Fasting ([[langhana]]) and carminative ([[pachana]]) therapies should be administered in the beginning. <br />
*The group of drugs which stimulates the power of digestion ([[dipana]]-gana) which is prescribed for the treatment of ''ama-atisara'' should be given.<br />
*If the [[kapha]]ja atisara persists even after the administration of the above mentioned measures, then the patient should be given [[kapha]] alleviating therapies.<br />
*The following four decoctions cure [[kapha]]ja atisara as well as promotes ''kayagni'' (power of digestion and metabolism)<br />
**Decoction of ''bilva, karkatika, musta, abhaya'' and ''vishva-bheshaja''(''shunthi'')<br />
**Decoction of ''vacha, vidanga, bhutika, dhanyaka'' and ''devadaru''<br />
**Decoction of ''kushtha, ativisha, pātha, chavya'' and ''katukarohini''<br />
**Decoction of ''pippali, pippali-mula, chitraka'' and ''gajapippali''<br />
*Administration of the recipe containing one part each of black variety of ''ajaji, pachana, nagara'' and ''maricha'' and two parts of ''dhataki'' along with profuse quantity of lime juice.<br />
*One part each of ''rasanjana, ativisha'' and fruits of ''kutaja'', and two parts of ''dhataki'' should be added with honey and ginger. This potion should be given to drink.<br />
*For the treatment of [[kapha]]ja atisara, the following four recipes should be given in the form of ''khada'' (a type of sour drink which stimulates the power of digestion). ''Dhataki, nagara, bilva, lodhra'' and ''padmakesara''; bark of ''jambu, nagara, dhanya, patha, mocha-rasa'' and ''bala''; ''samanga, dhataki,'' pulp of ''bilva'' and the bark of ''jambu'' and ''amra''; and ''kapittha, vidanga, nagara'' and ''maricha''.<br />
<br />
The above mentioned recipes should be added with the sour juice of ''changeri'' and ''kola'' and butter-milk and given to the patient after adding ghee and salt.<br />
<br />
*Intake of the pulp of ''kapittha'' along with ''shunthi, pippali, maricha,'' honey and sugar, or ''katphala'' along with honey cures diseases of digestive system (''jathara'').<br />
*Intake of ''pippali'' along with honey, or butter-milk added with the powder of ''chitraka'' or the powder of the tender fruits of ''bilva'' cures diseases of digestive system [102-112½].<br />
<br />
=== Management of complications of ''atisara'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
कणांमधुयुतांपीत्वातक्रंपीत्वासचित्रकम् ||११३|| <br /><br />
<br />
जग्ध्वावाबालबिल्वानिमुच्यतेजठरामयात् | <br /><br />
बालबिल्वंगुडंतैलंपिप्पलींविश्वभेषजम् | <br /><br />
लिह्याद्वातेप्रतिहतेसशूलःसप्रवाहिकः ||११४|| <br /><br />
<br />
भोज्यंमूलकषायेणवातघ्नैश्चोपसेवनैः | <br /><br />
वातातिसारविहितैर्यूषैर्मांसरसैःखडैः ||११५|| <br /><br />
<br />
पूर्वोक्तमम्लसर्पिर्वाषट्पलंवायथाबलम् | <br /><br />
पुराणंवाघृतंदद्याद्यवागूमण्डमिश्रितम् ||११६||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
kaṇāṁ madhuyutāṁ pītvā takraṁ pītvā sacitrakam||113|| <br /><br />
<br />
jagdhvā vā bālabilvāni mucyatē jaṭharāmayāt| <br /><br />
bālabilvaṁ guḍaṁ tailaṁ pippalīṁ viśvabhēṣajam| <br /><br />
lihyādvātē pratihatē saśūlaḥ sapravāhikaḥ||114|| <br /><br />
<br />
bhōjyaṁ mūlakaṣāyēṇa vātaghnaiścōpasēvanaiḥ| <br /><br />
vātātisāravihitairyūṣairmāṁsarasaiḥ khaḍaiḥ||115|| <br /><br />
<br />
pūrvōktamamlasarpirvā ṣaṭpalaṁ vā yathābalam| <br /><br />
purāṇaṁ vā ghr̥taṁ dadyādyavāgūmaṇḍamiśritam||116|| <br /><br />
<br />
kaNAM madhuyutAM pItvA takraM pItvA sacitrakam||113|| <br /><br />
<br />
jagdhvA vA bAlabilvAni mucyate jaTharAmayAt| <br /><br />
bAlabilvaM guDaM tailaM pippalIM vishvabheShajam| <br /><br />
lihyAdvAte pratihate sashUlaH sapravAhikaH||114|| <br /><br />
<br />
bhojyaM mUlakaShAyeNa vAtaghnaishcopasevanaiH| <br /><br />
vAtAtisAravihitairyUShairmAMsarasaiH khaDaiH||115|| <br /><br />
<br />
pUrvoktamamlasarpirvA ShaTpalaM vA yathAbalam| <br /><br />
purANaM vA ghRutaM dadyAdyavAgUmaNDamishritam||116|| <br /><br />
</div></div><br />
<br />
*If the movement of vata (flatus) is obstructed resulting in colic pain and dysentery, then the patient should be given tender fruits of ''bilva'', jaggery, oil, ''pippali'' and ''shunthi''.<br />
*Diet prepared with [[vata]] alleviating ingredients along with the vegetable soup, meat soup and ''khada'' (a type of sour drink) described under [[vata]]ja atisara should be given. <br />
*Sour medicated ghee like ''changeri ghrita'' or ''shatpala ghrita'' [Cha.Sa. [[Chikitsa Sthana]] 5/ 147-148 ] or (ten years) old ghee mixed with ''yavagu'' (thick gruel) and ''manda'' (thin gruel) should be given [113-116].<br />
<br />
=== Piccha-[[basti]] and anuvasana-[[basti]] ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
वातश्लेष्मविबन्धेवाकफेवाऽतिस्रवत्यपि | <br /><br />
शूलेप्रवाहिकायांवापिच्छाबस्तिंप्रयोजयेत् ||११७|| <br /><br />
<br />
पिप्पलीबिल्वकुष्ठानांशताह्वावचयोरपि | <br /><br />
कल्कैःसलवणैर्युक्तंपूर्वोक्तंसन्निधापयेत् ||११८|| <br /><br />
<br />
प्रत्यागतेसुखंस्नातंकृताहारंदिनात्यये | <br /><br />
बिल्वतैलेनमतिमान्सुखोष्णेनानुवासयेत् ||११९|| <br /><br />
<br />
वचान्तैरथवाकल्कैस्तैलंपक्त्वाऽनुवासयेत् | <br /><br />
बहुशःकफवातार्तस्तथासलभतेसुखम् ||१२०||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
vātaślēṣmavibandhē vā kaphē vā'tisravatyapi| <br /><br />
śūlē pravāhikāyāṁ vā picchābastiṁ prayōjayēt||117|| <br /><br />
<br />
pippalībilvakuṣṭhānāṁ śatāhvāvacayōrapi| <br /><br />
kalkaiḥ salavaṇairyuktaṁ pūrvōktaṁ sannidhāpayēt||118|| <br /><br />
<br />
pratyāgatē sukhaṁ snātaṁ kr̥tāhāraṁ dinātyayē| <br /><br />
bilvatailēna matimānsukhōṣṇēnānuvāsayēt||119|| <br /><br />
<br />
vacāntairathavā kalkaistailaṁ paktvā'nuvāsayēt| <br /><br />
bahuśaḥ kaphavātārtastathā sa labhatē sukham||120||<br /><br />
<br />
vAtashleShmavibandhe vA kaphe vA~atisravatyapi| <br /><br />
shUle pravAhikAyAM vA picchAbastiM prayojayet||117|| <br /><br />
<br />
pippalIbilvakuShThAnAM shatAhvAvacayorapi| <br /><br />
kalkaiH salavaNairyuktaM pUrvoktaM sannidhApayet||118|| <br /><br />
<br />
pratyAgate sukhaM snAtaM kRutAhAraM dinAtyaye| <br /><br />
bilvatailena matimAnsukhoShNenAnuvAsayet||119|| <br /><br />
<br />
vacAntairathavA kalkaistailaM paktvA~anuvAsayet| <br /><br />
bahushaH kaphavAtArtastathA sa labhate sukham||120|| <br /><br />
</div></div><br />
<br />
For the cure of [[kapha]]ja and [[vata]]ja-predominant ''atisara'', the following therapy and recipes should be administered:<br />
*If [[vata]] and [[kapha]] are obstructed in the ''mahasrotas'', if there is excessive evacuation of [[kapha]] (mucus) and if there is colic pain as well as dysentery, then piccha-[[basti]] (mucilaginous enema) should be administered. <br />
*Piccha-[[basti]] should be prepared of the paste of ''pippali, bilva, kustha, shatahva'' and ''vacha'' by adding salt.<br />
*Patient feels comfortable after the ingredients of pichcha-[[basti]] come out of the rectum and then patient should be advised to take bath followed by intake of food. Anuvasana [[basti]] with lukewarm oil of ''bilva'' [Cha.Sa.[[Siddhi Sthana]] 4/ 4-7] should be given in the afternoon.The anuvasana [[basti]] can also be given frequently with the oil cooked with the paste of ''pippali, bilva, kushtha, shatahva'' and ''vacha'' [117-120].<br />
<br />
=== Need for immediate control of [[vata]] ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
स्वेस्थानेमारुतोऽवश्यंवर्धतेकफसङ्क्षये | <br /><br />
सवृद्धःसहसाहन्यात्तस्मात्तंत्वरयाजयेत् ||१२१||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
svē sthānē mārutō'vaśyaṁ vardhatē kaphasaṅkṣayē| <br /><br />
sa vr̥ddhaḥ sahasā hanyāttasmāttaṁ tvarayā jayēt||121||<br /><br />
<br />
sve sthAne mAruto~avashyaM vardhate kaphasa~gkShaye| <br /><br />
sa vRuddhaH sahasA hanyAttasmAttaM tvarayA jayet||121|| <br /><br />
</div></div><br />
<br />
When [[kapha]] gets reduced because of the above mentioned therapeutic measures, the [[vata]] undoubtedly gets aggravated in its own location (colon). This aggravated [[vata]] may cause instantaneous death and hence should be controlled without delay [121]<br />
<br />
=== Principle of treatment of ''sannipataja atisara'' ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
वातस्यानुजयेत्पित्तं, पित्तस्यानुजयेत्कफम् | <br /><br />
त्रयाणांवाजयेत्पूर्वंयोभवेद्बलवत्तमः ||१२२||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
vātasyānu jayēt pittaṁ, pittasyānu jayēt kapham| <br /><br />
trayāṇāṁ vā jayēt pūrvaṁ yō bhavēdbalavattamaḥ||122|| <br /><br />
<br />
vAtasyAnu jayet pittaM, pittasyAnu jayet kapham| <br /><br />
trayANAM vA jayet pUrvaM yo bhavedbalavattamaH||122|| <br /><br />
</div></div><br />
<br />
For the cure of ''sannipataja atisara,'' following therapy and recipes should be administered: <br />
*The aggravated [[vata]] should be pacified first followed by the alleviation of the aggravated [[pitta]] followed by alleviation of [[kapha]].<br />
*Alternatively, the most aggravated one should be controlled first followed by the treatment of the remaining two [[dosha]] [122].<br />
<br />
=== Summary ===<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
तत्रश्लोकः- <br />
<br />
प्रागुत्पत्तिनिमित्तानिलक्षणंसाध्यतानच | <br /><br />
क्रियाचावस्थिकीसिद्धानिर्दिष्टाह्यतिसारिणाम् ||१२३||<br /><br />
<div class="mw-collapsible-content"><br />
<br />
tatra ślōkaḥ- <br />
<br />
prāgutpattinimittāni lakṣaṇaṁ sādhyatā na ca| <br /><br />
kriyā cāvasthikī siddhā nirdiṣṭā hyatisāriṇām||123||<br /><br />
<br />
tatra shlokaH- <br />
<br />
prAgutpattinimittAni lakShaNaM sAdhyatA na ca| <br /><br />
kriyA cAvasthikI siddhA nirdiShTA hyatisAriNAm||123||<br /><br />
</div></div><br />
<br />
In this chapter, the following topics in respect of the patient suffering from ''atisara'' (diarrhea) are described:<br />
*Historical origin of ''atisara''<br />
*Etiology of different types of ''atisara''<br />
*Signs and symptoms of ''atisara''<br />
*Curability and incurability of ''atisara''<br />
*Effective treatment for different stages of ''atisara'' [123].<br />
<div class="mw-collapsible mw-collapsed"><br />
<br />
इत्यग्निवेशकृतेतन्त्रेचरकप्रतिसंस्कृतेचिकित्सास्थानेऽतिसारचिकित्सितंनामैकोनविंशोऽध्यायः ||१९||<br />
<div class="mw-collapsible-content"><br />
<br />
ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē cikitsāsthānē'tisāracikitsitaṁ nāmaikōnaviṁśō'dhyāyaḥ||19|| <br />
</div></div><br />
<br />
Thus, ends the nineteenth chapter of [[Chikitsa Sthana]] (section on the treatment of diseases) dealing with the treatment of ''atisara'' (diarrhea) in the work of Agnivesha as redacted by Charak [19]<br />
<br />
== Tattva Vimarsha (Fundamental Principles) ==<br />
<br />
*''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''. <br />
*There are five categories of etio-pathological factors for ''atisara'':<br />
#Reduced [[agni]], <br />
#Vitiated [[vata]] and its sub types ''samana'' and ''apana''. <br />
#Vitiated body fluids. <br />
#Vitiated ''purishavaha srotas'' (lower gastro-intestinal tract) and organs of excretion. <br />
#Fear and grief (mental).<br />
*Interaction of [[Prakriti]] (basic constitution) and the diet and lifestyle of similar properties (as that of [[dosha]] [[Prakriti]]) makes the person susceptible for ''atisara''. <br />
*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.<br />
*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 ''purishavaha srotas'' to excretes these large waste products, frequently. <br />
*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''. <br />
*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. <br />
*The endogenous ''atisara'' shall be treated after proper assessment of dominant [[dosha]], causative factors and pacifying factors, <br />
*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]], [[stambhana]] is given and care should taken to keep [[vata]] balanced.<br />
*In case of prolapse of rectum, medicated ghee processed with sour herbs or ''anuvasana'' (unctuous enema) is prescribed. <br />
*Various states of ''atisara'' like that mixed with mucous, blood, associated with colic pain shall be treated with pichcha [[basti]] (mucilaginous enema). <br />
*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.<br />
*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]].<br />
<br />
== Vidhi Vimarsha (Applied Inferences ) ==<br />
<br />
The disease ''atisara'' resembles the clinical condition of diarrhea and is defined as the passage of frequent, liquid stools (usually of more than 200 g of stool) daily. In the most severe instances of ''atisara'', incontinence is a commonly observed symptom. Diarrhea, among adults, could broadly be categorized as sudden onset(acute), or chronic diarrhea that could last for 14 days or more.<br />
<br />
=== Acute (sudden onset) diarrhea ===<br />
<br />
This is most common variant and in over 90% of cases is infectious, caused due to ingestion of contaminated food or water. Other causes may include drug induced especially antibiotics, diverticulitis, ischemia, radiation enterocholitis, food allergies or initial presentation of various gastrointestinal diseases.<br />
<br />
=== Chronic (or relapsing) diarrhea <ref>Patient Education: Chronic Diarrhea among adults, UptoDate<br />
(https://www.uptodate.com/contents/chronic-diarrhea-in-adults-beyond-the-basics?topicRef=4021&source=see_link)<br />
</ref> === <br />
Defined as loose stools (occurring three or more times a day) that last for weeks. A most common variant is the Irritable Bowel Syndrome (IBS). Chronic diarrhea could be a symptom of an inflammatory bowel disease like Crohn's Disease, ulcerative colitis, malabsorption syndrome, metabolic or endocrine disorders, food allergies, laxative abuse, neoplasm, or reaction to certain medications.<br />
<br />
Careful assessment of the patient's medical history, physical examination, CBC, electrolytes, stool and urine examination are initial tests advised to help assess the underlying causes. Further specialised investigations may be needed depending upon the condition of patient.<br />
<br />
=== Pathophysiological factors of endogenous diarrhea ===<br />
<br />
* [[Dosha]]: [[Vata]] dominant three [[dosha]] <br />
* [[Dhatu]] (vitiated factors): Udaka (body fluid), [[Rasa dhatu]] <br />
* [[Mala]] kriya affected: [[Purisha]] (defecation) <br />
* Status of [[agni]]: Manda (poor) <br />
* Origin of disease: Pakwashaya (large intestine) <br />
* Sites of vitiation: large intestine <br />
* Sites of clinical presentation: rectum and anus <br />
* Srotasa involved: Purishavaha srotasa and udakavaha srotasa <br />
* Type of samprapti: atipravritti (excess discharge)<br />
<br />
=== Management protocol of endogenous diarrhea ===<br />
<br />
==== Assessment of strength of patient ====<br />
<br />
Excess dehydration in case of diarrhea can lead to serious complications. Hence the strength of the patient should be assessed first for severity of dehydration. This helps to design treatment protocol. Vital parameters including pulse rate, its volume, blood pressure, heart rate shall be examined. <br />
<br />
==== Subjective and objective parameters ====<br />
<br />
Frequency of bowel more than three times a day with stool weight less than 200 grams with more watery content are considered as diarrhea. The quantity is less in [[vata]] dominance, medium in [[pitta]] dominance and more in [[kapha]] dominant. Frequency is more in [[vata]] dominance, medium in [[pitta]] dominance and less in [[kapha]] dominance. The consistency of stool also differs according to [[dosha]] dominance as described in the text.[[Purisha]] pariksha (stool examination) is researched further in view of frequency, consistency, smell, its specific gravity in water to determine the ''ama'' and ''nirama'' status of [[purisha]].<br />
[[File:Atisara.png]]<br />
<br />
=== Prevention of ''atisara'' ===<br />
==== ''Atisara'' can be prevented by following measures ====<br />
#Avoiding causative factors <br />
#Strengthening [[agni]] (digestive processes) by following dietary rules<br />
#Observing body purification treatments as per [[Prakriti]] and season<br />
<br />
==== Current clinical management in [[Ayurveda]] practice ====<br />
*'''Principles of treatment''': [[deepana]], grahi, [[pachana]], buttermilk <br />
*'''Main drugs''': ''kutaja, ahiphena, bhanga, bhallataka, bilva''<br />
<br />
{| class="wikitable"<br />
|-<br />
! scope="col"| Type<br />
! scope="col"| Formulation<br />
! scope="col"| Dose<br />
! scope="col"| Time<br />
! scope="col"| ''Anupana''<br />
|-<br />
| rowspan="2"|[[Vata]] and [[kapha]] dominant<br />
| ''Jatiphaladi–bhallataka guti'' <br />
| 60-120 mg<br />
| Before meals, two times<br />
| Buttermilk<br />
|-<br />
| ''Sanjivani vati'' <br />
| 60-250 mg<br />
| Before meals<br />
| Buttermilk<br />
|-<br />
|[[Pitta]] and [[kapha]] dominant<br />
| ''Kutaja kalpa'' <br />
| 60-120 mg<br />
| Before meals, two times<br />
| Ricewater with Buttermilk<br />
|-<br />
|[[Rakta]]ja<br />
| ''Shatavaryadi kwatha'' <br />
| 25-40 ml<br />
| Empty stomach<br />
| ''-''<br />
|-<br />
|rowspan = "3"|''Pravahika''(dysentry)<br />
| ''Isabgola'' seeds (cold effusion with sugar) <br />
| 5-10 ml<br />
| Morning and night, two times<br />
| ''-''<br />
|-<br />
| ''Ahiphena kalpa'' <br />
| 125-250 mg<br />
| Morning and night, two times<br />
| ''kutajavaleha''<br />
|-<br />
| ''Kutaja parpati'' <br />
| 250-1000 mg<br />
| Empty stomach<br />
| Honey<br />
|-<br />
|rowspan = "3"|Chronic<br />
| ''Dhanya panchaka churna'' <br />
| 10-25 mg<br />
| Between meals<br />
| ''Bilvavaleha''<br />
|-<br />
| ''Shatpala ghee'' <br />
| 10-25 ml<br />
| Before meals<br />
| Buttermilk or hot water<br />
|-<br />
| ''Bilwadi tailam'' <br />
| 10-25 grams<br />
| Before meals<br />
| Buttermilk<br />
|}<br />
<br />
==== Researches on ''atisara'' and medicines ====<br />
A combination of ''musta'' (cyperus rotundus), ''ativisha'' (aconitum heterophyllum), ''kutaja'' (holarrhena antidysenterica), ''chitraka'' (plumbago zeylanica) and ''bilva'' (Aegle marmelos) was found effective in management of ''atisara''.<ref>Sridhar B.N., Gopakumar K., Jaya N. Mustadi yoga-A new preparation for treatment of atisara. Aryavaidyan,10(4).May-July 1997;222-225. </ref> <br />
<br />
''Kutaja'' is widely used and first preferred drug in management of ''atisara''. It is mainly indicated in conditions of vitiated [[kapha]]-[[pitta]] and as a ''sangrahi'' (styptic) and ''shoshana'' (absorbent)(Charak sutra 25/40). In an in-vitro study, sterile double dilution aqueous extract of ''kutaja'' was found effective to inhibit growth of E. coli, staphylococcus aureus, salmonella Typhi.<ref>Shrivastava Niraj, Saxena Varsha. Antibacterial activity of Kutaja(Holarrhena antidysenterica Linn.) in childhood diarrhea:-In vitro study. The Pharma Innovation Journal 2015;4(4):97-99 .</ref> Thus ''kutaja'' can be used for all purpose in management of ''atisara''. <br />
<br />
Nitin Salve and Debendranath Mishra studied the botanical identification of plants described in text Madhava chikitsa for the treatment of diarrhea.<ref>Nitin Salve, Debendranath Mishra. Botanical identification of plants described in text Madhava chikitsa for the treatment of diarrhoea. Anc Sci Life.2016 Apr-Jun:35(4):195-200 </ref> <br />
<br />
The conditions like ulcerative colitis, irritable bowel syndrome, acute diarrhea are considered under the umbrella of ''atisara''.<br />
<br />
In a study on 43 patients of ulcerative colitis, Patel M.V.et.al observed 80% reduction in signs and symptoms of ulcerative colitis by Ayurvedic treatment. The treatment included ''udumbara kwatha'' combination of ''lodhra, musta, nagakeshara,mukta panchamrita rasa, kutaja ghana vati'' and udumbara kwatha [[basti]]. It also highlighted disease modifying effect and reduction in use of steroidal drugs in the patients. <ref>Patel M.V.,Patel K.B., Gupta S.N. Effects of Ayurvedic treatment on forty three patients of ulcerative colitis. AYU,Oct-Dec 2010,31(4), 478-481.</ref> <br />
<br />
A study found that a combination of ''nagarmotha'' (Cyperus rotundus L.), ''indrayava'' (Holarrhena antidysenterica (L.) Wall.), ''nagakeshara'' (Mesua ferrea L.), ''madhuyashti'' (Glycyrrhiza glabra L.), and ''amalaki'' (Emblica officinalis Gaertn.) powders, along with ''dadimashtaka choorna, shankha bhasma, mustarista'' and ''dhanyapanchaka kvatha'' showed significant response in case of ''pravahika'' (irritable bowel syndrome). <ref>Pooja BA, Bhatted S. Ayurvedic management of Pravahika – A case report. Ayu 2015;36:410-2. </ref> <br />
<br />
In another study, ''bilwadileha'' showed significant relief in management of irritable bowel syndrome. <ref>Tiwari R, Pandya DH, Baghel MS. Clinical evaluation of Bilvadileha in the management of irritable bowel syndrome. AYU [serial online] 2013 [cited 2018 Jun 12];34:368-72. Available from: http://www.ayujournal.org/text.asp?2013/34/4/368/127717</ref> <br />
<br />
In a study, ''vatasakadi'' syrup was observed 70 % effective in treatment of ''atisara'' in children as compared to ''bala-chaturbhadra'' syrup.<ref>Shah Kiran. A Comparative Study of Vatsakadi Syrup & Balachaturbhadra Syrup in Management Balatisara with reference to Diarrhea, Int. J. Ayu. Alt. Med., 2014; 2(1):28-33.</ref><br />
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=== Management of exogenous diarrhea/''atisara'' ===<br />
<br />
#Diarrhea due to mental factors: These patients need counseling along with therapeutic management of diarrhea as discussed above.<br />
#Infectious diarrhea or bacterial food poisoning: The practitioner/physician should proceed with the treatment of the disease with information obtained from the history, stool examination, and evaluation of dehydration severity.<br />
#Watery diarrhea usually indicates a defect in water absorption. However, there are other categories of watery diarrhea caused due to the dysregulation of intestinal function, endocrine dysfunction (including hypothyroidism), tumors (by obstructing bowel). Another category of watery diarrhea is idiopathic secretory diarrhea. These categories largely are termed chronic inflammatory diarrhea. Based on the result of examining the patient’s history thoroughly, the physician should prescribe a course of treatment as well as dietary regimen.<ref>Schiller Lawrence, Sellin Joseph, Pardi Darrell, Chronic Diarrhea:Diagnosis and Management, Clinical Gastroenterology and Hepatology, 2017, 15:182-193</ref> <br />
#Fatty diarrhea, like watery diarrhea, indicates poor absorption of fat and other nutrients<br />
#Dysentery (passage of bloody stools) or fever (>37.8°C) should be treated with antibacterial drugs<br />
#Vomiting, minimal diarrhea should be treated with Bismuth subsalicylate. <br />
#Diarrhea in infants (<2 years old) should be treated with fluids and electrolytes (oral rehydration solution, pedialyte, lytren); continue feeding, especially with breast milk; seek medical attention for moderate dehydration, fever lasting >24 h, bloody stools, or diarrhea lasting more than several days.<br />
<br />
'''Note'''<br />
<br />
Loperamide should not be used by patients with fever or dysentery because its use may prolong diarrhea in patients with infection due to Shigella or other invasive organisms.<br />
<br />
=== Important guidelines and precautions for diarrhea management ===<br />
<br />
The World Health Organization , beginning 2002, recommended a “reduced osmolarity/reduced-salt” Oral Rehydration Solution (ORS) to adequately rehydrate the patient, which is key to treating any case of diarrhea.<ref>WHO Press Release, 8 May 2002, http://www.who.int/mediacentre/news/releases/release35/en/</ref> The Centers for Disease Control and Prevention (CDC) considers rehydration as “the cornerstone of treatment of cholera”.<ref>https://www.cdc.gov/cholera/treatment/rehydration-therapy.html</ref> CDC also recommends other treatment alternatives, based on recent studies in Bangladesh and other areas affected by cholera, such as zinc treatment.<ref>https://www.cdc.gov/cholera/treatment/zinc-treatment.html</ref> Severe cases need to take a recourse of antibiotics, though there are instances of resistance to tetracycline and other antimicrobial agents .<ref> https://www.cdc.gov/cholera/treatment/antibiotic-treatment.html</ref><br />
<br />
=== List of research on review of ''atisara'' ===<br />
<br />
#Uikey R, Kar AC. A review on Purisha Pariksha in [[Ayurveda]]. AYU [serial online] 2015 [cited 2018 Jun 12];36:125-9. Available from: http://www.ayujournal.org/text.asp?2015/36/2/125/175536<br />
#Patil Dhiraj, Babel Sadhana, Chitte Sanjay. Atisaar (Diarrhea): A Review based on [[Ayurveda]] and modern perspective. WJPMR, 2017,3(7), 227-229 available from http://www.wjpmr.com/ downloaded on 12/06/2018 <br />
#S Durgalakshmi, Pious Uthara Anu, Ajantha. An Overview on Nidana Panchaka of Atisara (Diarrhea). IAMJ: Volume 3(8); August. 2015 available from http://www.iamj.in/current_issue/images/upload/2419_2425.pdf downloaded on 12/06/2018<br />
<br />
=== Research Areas ===<br />
<br />
*Though there are many anti-diarrheal and ant-dysentery medicines are available in conventional systems of medicine, the immediate stoppage of diarrhoea may lead to complications as mentioned in the text. Therefore a survey study is needed to examine the prevalence of such complications caused by stoppage of diarrhea.<br />
*The rehydrating effect of ''pramathya'' (decoctions), ''peya'' (liquid gruel), sour processing media like ''dadima, changeri,'' buttermilk used in the treatment of ''atisara'' need to be investigated further. <br />
*More researches are needed to study effect of [[Ayurveda]] medicines in chronic diarrhea and psycho somatic disease like irritable bowel syndrome.<br />
<br />
<br />
=== Further reading ===<br />
<br />
#Charak Samhita (700 BC) with English Translation and Critical exposition (Volume IV). Sharma R.K. and Dash B., Chaukhambha Sanskrit Series Office, Varanasi.pages-202-242<br />
#Valiathan, M.S. (2009): Legacy of Charak, Sushruta, Vagbhata, Orient Longman, Chennai.<br />
#Sushruta. Sushruta Samhita. Volume III, Uttarasthana, translated by Prof. K.R. Srikatha Murthy, Varanasi, Chaukhambha Orientalia; 2005.p.223-250.<br />
#Parameswarappa’s ĀyurvedÍya Vikriti Vijñāna and Roga Vijñāna by Dr. P.S. Byadgi. Volume II, pages-431-446<br />
#Davidson’s Principles of practice of medicine, 21th Ed. (2007) Ed. by Nicholas A. Boon., Nicki R. College, Brain R. Walker, Pub. Churchill Livingstone Elsevier, London Elsevier. Pages-302-304<br />
#Harrison’s principles of internal medicine 17th Ed. (2008) Ed. by Fauci Kasper D.L., A.S., Longo D.L., Braunwal Eugene, Hauser S.J., Jameson J.L.. Joseph Loscalzo., Pub. MacGraw-Hill USA, Chapter 128. Acute Infectious Diarrheal Diseases and Bacterial Food Poisoning <br />
#Harrison’s principles of internal medicine 17th Ed. (2008) Ed. by Fauci Kasper D.L., A.S., Longo D.L., Braunwal Eugene, Hauser S.J., Jameson J.L.. Joseph Loscalzo., Pub. MacGraw-Hill USA, Vol.-2, Chapter 338.<br />
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