Changes

*For ''kaphaja chhardi chikitsa'', as the ''doshas'' are situated in ''kaphashaya'' (''amashaya / ura'') the nearest and ideal route is ''vamana''. The choice of ''dravyas'' for ''vamana'' should be ''kaphahara'' 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.  

*For ''kaphaja chhardi chikitsa'', as the ''doshas'' are situated in ''kaphashaya'' (''amashaya / ura'') the nearest and ideal route is ''vamana''. The choice of ''dravyas'' for ''vamana'' should be ''kaphahara'' 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.  

*Various types of ''yusha, ragashadava, panaka'' ([[Sutra Sthana]] 27/279-281) are ''kaphahara, madhura-amlarasatmaka'' (sweet & sour), ''deepaneeya-pachaneeya'' (appetizer & digestant) in nature.  

*Various types of ''yusha, ragashadava, panaka'' ([[Sutra Sthana]] 27/279-281) are ''kaphahara, madhura-amlarasatmaka'' (sweet & sour), ''deepaneeya-pachaneeya'' (appetizer & digestant) in nature.  

*For chhardinigrahana (anti-emetic group), the drugs should be kashaya rasatmaka (astringent taste), sheetaveerya (cool potency) and kaphaghna (kapha alleviators) in nature. The manahshiladi yoga (a formulation) is considered to be vyadhiviparitarthakari (anti-disease) measures.

*For ''chhardinigrahana'' (anti-emetic group), the drugs should be ''kashaya rasatmaka'' (astringent taste), ''sheetaveerya'' (cool potency) and ''kaphaghna'' (''kapha'' alleviators) in nature. The ''manahshiladi yoga'' (a formulation) is considered to be ''vyadhiviparitarthakari'' (anti-disease) measures.

*In case of dvistarthayoga chhardi (vomiting due to hate/ aversion) The treatment includes ashvāshana (assurance), vārtālāpa (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.   

*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.   

*The vegakalina or chronic chhardi, whether mild or severe,  involves constant irritation of involved body parts/systems which leads to poor nourishment of dhatus resulting in dhatuksheenata. Such a long term dhatukshaya (loss of dhatus) increases vata in the body. The management should be purely vatashamaka treatment especially stambhana (which restricts the vamana vega) in combination with brimhana (nourishment to dhatus).  

*The ''vegakalina'' or chronic ''chhardi'', whether mild or severe,  involves constant irritation of involved body parts/systems which leads to poor nourishment of ''dhatus'' resulting in ''dhatuksheenata''. Such a long term ''dhatukshaya'' (loss of ''dhatus'') increases ''vata'' in the body. The management should be purely ''vatashamaka'' treatment especially ''stambhana'' (which restricts the ''vamana vega'') in combination with ''brimhana'' (nourishment to ''dhatus'').  

The selection of drugs plays very important role here. Most of the dravyas mentioned here are vichitrapratyarabhadha (extraordinary) in nature which achieve stambhana but won’t 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.

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.

==== Current clinical practice for management of chhardi (referred from Chikitsa Pradeep page 25) ====

==== Current clinical practice for management of chhardi (referred from Chikitsa Pradeep page 25) ====