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=== Abstract ===

=== Abstract ===

 

This second chapter of [[Nidana Sthana]] is about bleeding disorders (''raktapitta'') caused by an excess of ''pitta dosha'' in the body vitiating the ''rakta dhatu''. This vitiated ''rakta dhatu'' leads to tissue break-down, causing hemorrhages in the upper and lower parts of the gastrointestinal tract. Contributing factors that increase the probability of ''raktapitta'' include consumption of specific food and drug substances including consumption of incompatible food substances, consuming certain meats with alcohol, butter milk with meat of animals etc. These etiological factors are basically ''ushna'' (hot) –either in properties or in potency - which when regularly consumed by a person, vitiate ''pitta''. Vitiated ''pitta'' has the same color and smell as ''rakta'', and blends seamlessly with it to form ''raktapitta.''  Vitiated ''pitta'' and increased ''rakta'' circulate in the channels and the resultant increased volume of the blood overflows from the bodily orifices. During the pathogenesis of ''raktapitta'', if an excessive and vitiated ''kapha'' joins in the action, bleeding from upper orifices occurs while an excessive and vitiated ''vata'' leads to bleeding from the lower orifices. While the ''kapha'' condition is curable, the ''vata''-affliction is difficult to cure. Complications arise when both ''kapha'' and ''vata'' vitiations occur alongside ''raktapitta''. Such conditions are incurable. Therapeutic measures of emesis and purgation, along with useful medicinal formulations and attention may improve the condition of patients of hemorrhagic disorders in varying degrees. Prodromal symptoms and complications have been described in this chapter.  

This second chapter of [[Nidana Sthana]] is about bleeding disorders (''raktapitta'') caused by an excess of ''pitta dosha'' in the body vitiating the ''rakta dhatu''. This vitiated ''rakta dhatu'' leads to tissue break-down, causing hemorrhages in the upper and lower parts of the gastrointestinal tract. Contributing factors that increase the probability of ''raktapitta'' include consumption of specific food and drug substances including consumption of incompatible food substances, consuming certain meats with alcohol, butter milk with meat of animals etc. These etiological factors are basically ''ushna'' (hot) –either in properties or in potency - which when regularly consumed by a person, vitiate ''pitta''. Vitiated ''pitta'' has the same color and smell as ''rakta'', and blends seamlessly with it to form ''raktapitta.''  Vitiated ''pitta'' and increased ''rakta'' circulate in the channels and the resultant increased volume of the blood overflows from the bodily orifices. During the pathogenesis of ''raktapitta'', if an excessive and vitiated ''kapha'' joins in the action, bleeding from upper orifices occurs while an excessive and vitiated ''vata'' leads to bleeding from the lower orifices. While the ''kapha'' condition is curable, the ''vata''-affliction is difficult to cure. Complications arise when both ''kapha'' and ''vata'' vitiations occur alongside ''raktapitta''. Such conditions are incurable. Therapeutic measures of emesis and purgation, along with useful medicinal formulations and attention may improve the condition of patients of hemorrhagic disorders in varying degrees. Prodromal symptoms and complications have been described in this chapter.  

                

                

'''Keywords''': Etio-pathogenesis of ''raktapitta'', bleeding disorders, epistaxis, hemorrhage, hematemesis, rectal bleeding.

'''Keywords''': Etio-pathogenesis of ''raktapitta'', bleeding disorders, epistaxis, hemorrhage, hematemesis, rectal bleeding.

 

=== Introduction ===

=== Introduction ===

 

The second chapter of the [[Nidana Sthana]] focuses on ''rakta'', the second ''dhatu'', just as the first chapter on ''jwara'' focused on the first ''dhatu, rasa''. ''Pitta'' is the primary cause of ''jwara'' which causes elevated temperature, leading to ''raktapitta''. Thus it can be said that ''jwara'' is a cause of ''raktapitta'', and an aggravated ''pitta'' is the cause of both ''jwara'' and ''raktapitta''.  

The second chapter of the [[Nidana Sthana]] focuses on ''rakta'', the second ''dhatu'', just as the first chapter on ''jwara'' focused on the first ''dhatu, rasa''. ''Pitta'' is the primary cause of ''jwara'' which causes elevated temperature, leading to ''raktapitta''. Thus it can be said that ''jwara'' is a cause of ''raktapitta'', and an aggravated ''pitta'' is the cause of both ''jwara'' and ''raktapitta''.  

''Raktapitta'' from the upper orifices is curable, while that from the lower orifices is considered palliable. Manifestation of bleeding from both the tracts is said to be incurable. Charaka advocates that in order to avoid progression to this stage, prompt preventive action should be taken.

''Raktapitta'' from the upper orifices is curable, while that from the lower orifices is considered palliable. Manifestation of bleeding from both the tracts is said to be incurable. Charaka advocates that in order to avoid progression to this stage, prompt preventive action should be taken.

 

===Sanskrit Text, Transliteration and English Translation===

===Sanskrit Text, Transliteration and English Translation===

      

      

When a person consumes a diet or food consisting mostly of:

When a person consumes a diet or food consisting mostly of:

 

*Grains such as ''yavaka, uddalaka,'' and ''koradusha'', in excess quantities, along with other food items that are ''ushna'' (hot in potency) and ''tikshna'' ( sharply acting) such as  legumes of ''nishpaava'', black gram, horse gram and alkali, or with curd, whey, buttermilk, sour buttermilk or sour gruel

*Grains such as ''yavaka, uddalaka,'' and ''koradusha'', in excess quantities, along with other food items that are ''ushna'' (hot in potency) and ''tikshna'' ( sharply acting) such as  legumes of ''nishpaava'', black gram, horse gram and alkali, or with curd, whey, buttermilk, sour buttermilk or sour gruel

*Meat of pig, buffalo, sheep, fish and cow,  

*Meat of pig, buffalo, sheep, fish and cow,  

With such food articles, a person’s ''pitta'' gets vitiated and the quantity of blood in his body exceeds its normal quantity. Along with the increased quantity of vitiated blood in the system, vitiated ''pitta'' gets into the circulation and reaches ''raktavaha srotas'' and its organs like liver and spleen. Due to ''abhishyandi'' and guru qualities of ''rakta'', obstructions in the channels occur leading to morbidity in ''rakta''. [4]

With such food articles, a person’s ''pitta'' gets vitiated and the quantity of blood in his body exceeds its normal quantity. Along with the increased quantity of vitiated blood in the system, vitiated ''pitta'' gets into the circulation and reaches ''raktavaha srotas'' and its organs like liver and spleen. Due to ''abhishyandi'' and guru qualities of ''rakta'', obstructions in the channels occur leading to morbidity in ''rakta''. [4]

 

संसर्गाल्लोहितप्रदूषणाल्लोहितगन्धवर्णानुविधानाच्च पित्तं  लोहितपित्तमित्याचक्षते||५||

संसर्गाल्लोहितप्रदूषणाल्लोहितगन्धवर्णानुविधानाच्च पित्तं  लोहितपित्तमित्याचक्षते||५||

tasyemAni pUrvarUpANi bhavanti; tadyathA- anannAbhilAShaH, bhuktasya vidAhaH, shuktAmlagandharasa udgAraH, charderabhIkShNamAgamanaM, charditasyabIbhatsatA, svarabhedo, gAtrANAM sadanaM, paridAhaH, mukhAddhUmAgama iva, lohalohitamatsyAmagandhitvamiva cAsyasya,raktaharitahAridratvama~ggAvayavashakRunmUtrasvedalAlAsi~gghANakAsyakarNamalapiDakolikApiDakAnAm [14] , a~ggavedanA,lohitanIlapItashyAvAnAmarciShmatAM ca rUpANAM svapne darshanamabhIkShNamiti (lohitapittapUrvarUpANi [15] bhavanti)||6||  

tasyemAni pUrvarUpANi bhavanti; tadyathA- anannAbhilAShaH, bhuktasya vidAhaH, shuktAmlagandharasa udgAraH, charderabhIkShNamAgamanaM, charditasyabIbhatsatA, svarabhedo, gAtrANAM sadanaM, paridAhaH, mukhAddhUmAgama iva, lohalohitamatsyAmagandhitvamiva cAsyasya,raktaharitahAridratvama~ggAvayavashakRunmUtrasvedalAlAsi~gghANakAsyakarNamalapiDakolikApiDakAnAm [14] , a~ggavedanA,lohitanIlapItashyAvAnAmarciShmatAM ca rUpANAM svapne darshanamabhIkShNamiti (lohitapittapUrvarUpANi [15] bhavanti)||6||  

 

The prodromal symptoms of ''raktapitta'' include aversion to food, hot eructation just after meal, belches with smell and aftertaste of sour gruel, frequent vomiting, ugliness of vomitus, hoarseness of voice, malaise, radiating burning sensation, emittance of smoke from the mouth, smell of metal, blood, or fish , mucus in the mouth, appearance of red, green or yellow spots in body parts, feces, urine, sweat, saliva, nose-secretion, excreta from mouth and ear and boils, bodyache, and frequent vision of red, blue, yellow, blackish and brilliant objects in dreams. [6]

The prodromal symptoms of ''raktapitta'' include aversion to food, hot eructation just after meal, belches with smell and aftertaste of sour gruel, frequent vomiting, ugliness of vomitus, hoarseness of voice, malaise, radiating burning sensation, emittance of smoke from the mouth, smell of metal, blood, or fish , mucus in the mouth, appearance of red, green or yellow spots in body parts, feces, urine, sweat, saliva, nose-secretion, excreta from mouth and ear and boils, bodyache, and frequent vision of red, blue, yellow, blackish and brilliant objects in dreams. [6]

 

==== Complications ====  

==== Complications ====  

mArgau punarasya dvau UrdhvaM, cAdhashca|  

mArgau punarasya dvau UrdhvaM, cAdhashca|  

tadbahushleShmaNi sharIre shleShmasaMsargAdUrdhvaM pratipadyamAnaM karNanAsikAnetrAsyebhyaH pracyavate, bahuvAte tu sharIre vAtasaMsargAdadhaHpratipadyamAnaM mUtrapurIShamArgAbhyAM pracyavate, bahushleShmavAte tu sharIre shleShmavAtasaMsargAddvAvapi mArgau pratipadyate, tau mArgaupratipadyamAnaM sarvebhya eva yathoktebhyaH khebhyaH pracyavate sharIrasya||8||  

tadbahushleShmaNi sharIre shleShmasaMsargAdUrdhvaM pratipadyamAnaM karNanAsikAnetrAsyebhyaH pracyavate, bahuvAte tu sharIre vAtasaMsargAdadhaHpratipadyamAnaM mUtrapurIShamArgAbhyAM pracyavate, bahushleShmavAte tu sharIre shleShmavAtasaMsargAddvAvapi mArgau pratipadyate, tau mArgaupratipadyamAnaM sarvebhya eva yathoktebhyaH khebhyaH pracyavate sharIrasya||8||  

 

There are two routes of the manifestation of ''raktapitta'' -  upwards and downwards. In persons having an abundance of ''kapha'', vitiated ''rakta'' goes up and bleeding occurs from ear, nose, eyes and mouth. In those having an excess of ''vata, rakta'' flows downwards along with ''vata'' and patients bleed through the urinary tract and rectum. Finally, in those having abundance of both ''kapha'' and ''vata'', ''rakta'' comes out from the body with both the routes and thus bleeds through all the aforesaid orifices. [8]

There are two routes of the manifestation of ''raktapitta'' -  upwards and downwards. In persons having an abundance of ''kapha'', vitiated ''rakta'' goes up and bleeding occurs from ear, nose, eyes and mouth. In those having an excess of ''vata, rakta'' flows downwards along with ''vata'' and patients bleed through the urinary tract and rectum. Finally, in those having abundance of both ''kapha'' and ''vata'', ''rakta'' comes out from the body with both the routes and thus bleeds through all the aforesaid orifices. [8]

 

==== Prognosis ====

==== Prognosis ====

tatra yadūrdhvabhāgaṁ tat sādhyaṁ, virēcanōpakramaṇīyatvādbahvauṣadhatvācca; yadadhōbhāgaṁ tadyāpyaṁ, vamanōpakramaṇīyatvādalpauṣadhatvācca;yadubhayabhāgaṁ tadasādhyaṁ, vamanavirēcanāyōgitvādanauṣadhatvāccēti||9||  

tatra yadūrdhvabhāgaṁ tat sādhyaṁ, virēcanōpakramaṇīyatvādbahvauṣadhatvācca; yadadhōbhāgaṁ tadyāpyaṁ, vamanōpakramaṇīyatvādalpauṣadhatvācca;yadubhayabhāgaṁ tadasādhyaṁ, vamanavirēcanāyōgitvādanauṣadhatvāccēti||9||  

tatra yadUrdhvabhAgaM tat sAdhyaM, virecanopakramaNIyatvAdbahvauShadhatvAcca; yadadhobhAgaM tadyApyaM, vamanopakramaNIyatvAdalpauShadhatvAcca;yadubhayabhAgaM tadasAdhyaM, vamanavirecanAyogitvAdanauShadhatvAcceti||9||  

tatra yadUrdhvabhAgaM tat sAdhyaM, virecanopakramaNIyatvAdbahvauShadhatvAcca; yadadhobhAgaM tadyApyaM, vamanopakramaNIyatvAdalpauShadhatvAcca;yadubhayabhAgaM tadasAdhyaM, vamanavirecanAyogitvAdanauShadhatvAcceti||9||  

 

Amongst these, that which comes out of the upper orifices is curable and is treatable by purgation due to availability of plenty of drugs for the purpose. That coming out from the lower orifices is palliable because of being amenable to emesis and availability of lesser number of drugs for the purpose. That coming out from both the routes is incurable because of non-applicability of both emesis and purgation and in want of suitable drugs. (9)

Amongst these, that which comes out of the upper orifices is curable and is treatable by purgation due to availability of plenty of drugs for the purpose. That coming out from the lower orifices is palliable because of being amenable to emesis and availability of lesser number of drugs for the purpose. That coming out from both the routes is incurable because of non-applicability of both emesis and purgation and in want of suitable drugs. (9)

 

==== Origin of ''raktapitta'' ====

==== Origin of ''raktapitta'' ====

tasyAshukAriNo dAvAgnerivApatitasyAtyayikasyAshu prashAntyai prayatitavyaM mAtrAM deshaM kAlaM cAbhisamIkShya santarpaNenApatarpaNena vAmRudumadhurashishiratiktakaShAyairabhyavahAryaiH pradehapariShekAvagAhasaMsparshanairvamanAdyairvA tatrAvahiteneti||11||  

tasyAshukAriNo dAvAgnerivApatitasyAtyayikasyAshu prashAntyai prayatitavyaM mAtrAM deshaM kAlaM cAbhisamIkShya santarpaNenApatarpaNena vAmRudumadhurashishiratiktakaShAyairabhyavahAryaiH pradehapariShekAvagAhasaMsparshanairvamanAdyairvA tatrAvahiteneti||11||  

 

The disease is acute in nature and becomes critical very quickly, spreading like bush fire. Hence its treatment should be done immediately with saturating or de-saturating soft, sweet, cold, bitter and astringent diet and pastes, baths, emesis etc. after due consideration of dose, place and time. [11]

The disease is acute in nature and becomes critical very quickly, spreading like bush fire. Hence its treatment should be done immediately with saturating or de-saturating soft, sweet, cold, bitter and astringent diet and pastes, baths, emesis etc. after due consideration of dose, place and time. [11]

 

भवन्ति  चात्र- साध्यं लोहितपित्तं तद्यदूर्ध्वं प्रतिपद्यते|  

भवन्ति  चात्र- साध्यं लोहितपित्तं तद्यदूर्ध्वं प्रतिपद्यते|  

विरेचनस्य योगित्वाद्बहुत्वाद्भेषजस्य  च||१२||

विरेचनस्य योगित्वाद्बहुत्वाद्भेषजस्य  च||१२||

bhavedyogAvahaM tatra madhuraM [18] caiva bheShajam|  

bhavedyogAvahaM tatra madhuraM [18] caiva bheShajam|  

tasmAt sAdhyaM mataM raktaM yadUrdhvaM pratipadyate||14||

tasmAt sAdhyaM mataM raktaM yadUrdhvaM pratipadyate||14||

 

The “upward” variety of ''raktapitta'' is curable because of applicability of purgation and abundance of useful drugs. Purgation is the best remedy for alleviation of ''pitta'' and ambivalence to ''kapha''. Sweet drugs are also applicable in this case. Hence, bleeding from the upper part is curable. [12-14]  

The “upward” variety of ''raktapitta'' is curable because of applicability of purgation and abundance of useful drugs. Purgation is the best remedy for alleviation of ''pitta'' and ambivalence to ''kapha''. Sweet drugs are also applicable in this case. Hence, bleeding from the upper part is curable. [12-14]  

 

रक्तं  तु यदधोभागं तद्याप्यमिति  निश्चितम्|  

रक्तं  तु यदधोभागं तद्याप्यमिति  निश्चितम्|  

वमनस्याल्पयोगित्वादल्पत्वाद्भेषजस्य च||१५||

वमनस्याल्पयोगित्वादल्पत्वाद्भेषजस्य च||१५||

taccAyogAvahaM [22] tatra kaShAyaM tiktakAni ca|  

taccAyogAvahaM [22] tatra kaShAyaM tiktakAni ca|  

tasmAdyApyaM samAkhyAtaM yaduktamanulomagam [23] ||17||

tasmAdyApyaM samAkhyAtaM yaduktamanulomagam [23] ||17||

 

Hemorrhage from the lower parts is decidedly palliable because emesis has limited efficacy here and effective drugs are also a few. Emesis is not so efficacious for elimination of pitta and it is also ineffective in alleviation of ''vata'' responsible for the downward flow. Moreover, astringents and bitter drugs are not applicable there. Hence hemorrhage from the lower parts is considered palliable. (15-17)   

Hemorrhage from the lower parts is decidedly palliable because emesis has limited efficacy here and effective drugs are also a few. Emesis is not so efficacious for elimination of pitta and it is also ineffective in alleviation of ''vata'' responsible for the downward flow. Moreover, astringents and bitter drugs are not applicable there. Hence hemorrhage from the lower parts is considered palliable. (15-17)   

 

रक्तपित्तं तु यन्मार्गौ द्वावपि  प्रतिपद्यते|  

रक्तपित्तं तु यन्मार्गौ द्वावपि  प्रतिपद्यते|  

असाध्यमिति तज्ज्ञेयं पूर्वोक्तादेव कारणात्||१८||

असाध्यमिति तज्ज्ञेयं पूर्वोक्तादेव कारणात्||१८||

saMsRuShTeShu ca doSheShu sarvajicchamanaM matam [25] ||20||  

saMsRuShTeShu ca doSheShu sarvajicchamanaM matam [25] ||20||  

ityuktaM trividhodarkaM raktaM mArgavisheShataH|21|  

ityuktaM trividhodarkaM raktaM mArgavisheShataH|21|  

 

In cases where blood comes out from both the routes, ''raktapitta'' is incurable because no effective evacuative measure is applicable. In ''raktapitta'', elimination of ''dosha'' from the opposite route is recommended. Thus, the three types (on the basis of the routes taken by ''rakta'') of ''raktapitta'' progression (''udarka'') have been described. [18-20]

In cases where blood comes out from both the routes, ''raktapitta'' is incurable because no effective evacuative measure is applicable. In ''raktapitta'', elimination of ''dosha'' from the opposite route is recommended. Thus, the three types (on the basis of the routes taken by ''rakta'') of ''raktapitta'' progression (''udarka'') have been described. [18-20]

 

एभ्यस्तु खलु हेतुभ्यः किञ्चित्साध्यं न सिध्यति||२१||

एभ्यस्तु खलु हेतुभ्यः किञ्चित्साध्यं न सिध्यति||२१||

yena copahato raktaM raktapittena mAnavaH|  

yena copahato raktaM raktapittena mAnavaH|  

pashyeddRushyaM viyaccApi taccAsAdhyaM na saMshayaH||26||

pashyeddRushyaM viyaccApi taccAsAdhyaM na saMshayaH||26||

 

Now described are types of ''raktapitta'', identified (by their physical appearance). ''Raktapitta'' which is black, blue or of rainbow color and stains clothes is incurable. Bleeding which is of excessively fetid smell, in large quantities, and which is associated with all the complications particularly in weak and emaciated patients is incurable. A patient, if sees things around him and the sky red, is certainly suffering from an incurable variant of the disease. [23-26]

Now described are types of ''raktapitta'', identified (by their physical appearance). ''Raktapitta'' which is black, blue or of rainbow color and stains clothes is incurable. Bleeding which is of excessively fetid smell, in large quantities, and which is associated with all the complications particularly in weak and emaciated patients is incurable. A patient, if sees things around him and the sky red, is certainly suffering from an incurable variant of the disease. [23-26]

 

तत्रासाध्यं परित्याज्यं, याप्यं यत्नेन यापयेत्|  

तत्रासाध्यं परित्याज्यं, याप्यं यत्नेन यापयेत्|  

साध्यं चावहितः सिद्धैर्भेषजैः साधयेद्भिषक्||२७|

साध्यं चावहितः सिद्धैर्भेषजैः साधयेद्भिषक्||२७|

Now summarizing the chapter–  

Now summarizing the chapter–  

 

Etiology, etymology of the disease, prodroma, complications, routes, association of ''doshas'', curability (or otherwise), with reasoning – all this has been addressed in the chapter on diagnosis of ''raktapitta'' by Punarvasu who has shed off ''tamas'' and ''rajas, doshas,'' greed, conceit and pride. [28-29]

Etiology, etymology of the disease, prodroma, complications, routes, association of ''doshas'', curability (or otherwise), with reasoning – all this has been addressed in the chapter on diagnosis of ''raktapitta'' by Punarvasu who has shed off ''tamas'' and ''rajas, doshas,'' greed, conceit and pride. [28-29]

 

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते| निदानस्थाने रक्तपित्तनिदानं नाम  द्वितीयोऽध्यायः||२||

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते| निदानस्थाने रक्तपित्तनिदानं नाम  द्वितीयोऽध्यायः||२||

=== ''Tattva Vimarsha'' ===

=== ''Tattva Vimarsha'' ===

 

*''Rakta'' and ''pitta'' have a cause-and-effect relationship because of their common origin, and this fact is important in the pathogenesis and manifestation of ''raktapitta''.

*''Rakta'' and ''pitta'' have a cause-and-effect relationship because of their common origin, and this fact is important in the pathogenesis and manifestation of ''raktapitta''.

*The ''amla'' (sour), ''lavana'' (salty), ''katu'' (pungent) food articles with ''ushna'' (hot potency), ''tikshna'' (sharply acting) lead to vitiation of ''pitta dosha'' and blood. This causes ''abhishyanda'' (excess discharge leading to increase in volume of fluid) and ''guru'' (heaviness) in blood. This results in obstruction of ''raktavaha srotasa'' rooted in ''yakrita''(liver)-''pleeha'' (spleen) and ''raktapitta'' (hemorrhage).   

*The ''amla'' (sour), ''lavana'' (salty), ''katu'' (pungent) food articles with ''ushna'' (hot potency), ''tikshna'' (sharply acting) lead to vitiation of ''pitta dosha'' and blood. This causes ''abhishyanda'' (excess discharge leading to increase in volume of fluid) and ''guru'' (heaviness) in blood. This results in obstruction of ''raktavaha srotasa'' rooted in ''yakrita''(liver)-''pleeha'' (spleen) and ''raktapitta'' (hemorrhage).   

Internal hemorrhage/hemorrhagic disorders of conventional medicine are well described in Ayurvedic texts in the form of ''raktapitta'' disorders, and the pathogenesis of ''raktapitta'' diseases forms the basis of this chapter. ''Raktapitta'' bleeding occurs through bodily orifices (mouth, rectum, urethra, nose, eye, ear, vagina, as well as hair-roots), per [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. The parallels between the description of bleeding disorders in conventional medicine and [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] are quite apparent in this regard. An important aspect of the discussion on ''raktapitta'' disorders is the fact that some disorders are curable, some palliable and some are incurable – and that all these variants are dependent on ''doshic'' imbalances beyond just the ''pitta'' vitiation. It is important to note here that if proper attention is not paid, even curable disorders can soon aggravate to incurable variants. Avoidance of known causative factors is certainly one of the best measures to overcome this disease. Attempts need to be made to collect data on the effect of these factors (known to [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]) and establish an empirical, evidence-based relationship between food articles (some of the primary etiological factors) and bleeding disorders.   

Internal hemorrhage/hemorrhagic disorders of conventional medicine are well described in Ayurvedic texts in the form of ''raktapitta'' disorders, and the pathogenesis of ''raktapitta'' diseases forms the basis of this chapter. ''Raktapitta'' bleeding occurs through bodily orifices (mouth, rectum, urethra, nose, eye, ear, vagina, as well as hair-roots), per [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]. The parallels between the description of bleeding disorders in conventional medicine and [https://en.wikipedia.org/wiki/Ayurveda Ayurveda] are quite apparent in this regard. An important aspect of the discussion on ''raktapitta'' disorders is the fact that some disorders are curable, some palliable and some are incurable – and that all these variants are dependent on ''doshic'' imbalances beyond just the ''pitta'' vitiation. It is important to note here that if proper attention is not paid, even curable disorders can soon aggravate to incurable variants. Avoidance of known causative factors is certainly one of the best measures to overcome this disease. Attempts need to be made to collect data on the effect of these factors (known to [https://en.wikipedia.org/wiki/Ayurveda Ayurveda]) and establish an empirical, evidence-based relationship between food articles (some of the primary etiological factors) and bleeding disorders.   

 

=== Glossary of Technical terms ===

=== Glossary of Technical terms ===