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=== Abstract ===

=== Abstract ===

The second chapter of Nidanasthana 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.   

 

The second chapter of the Nidaanasthaana 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 Nidaanasthaana 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.  

Bleeding disorders also include conditions where bleeding is not apparent. Hemorrhagic strokes, vessel diseases, and heart attacks cause internal bleeding and do not erupt through the skin or orifices. These are typically due to vascular and other events and not caused due to raktapitta. These disorders should be classified under avarana and shiragata vata.

Bleeding disorders also include conditions where bleeding is not apparent. Hemorrhagic strokes, vessel diseases, and heart attacks cause internal bleeding and do not erupt through the skin or orifices. These are typically due to vascular and other events and not caused due to raktapitta. These disorders should be classified under avarana and shiragata vata.