Changes

=== Introduction ===

=== Introduction ===

This chapter is followed by udara roga because the causative factors for both the diseases are similar like vitiation of tridosha. Both the diseases are related to the same system i.e. gastrointestinal tract. Further, arsha is one of the causative factors of udara roga (Boddhagudedara- intestinal obstruction) Therefore the chapter dealing with arshas (hemorrhoids) follows the chapter on the treatment of udara (obstinate abdominal disorders).

This chapter is followed by ''udara roga'' because the causative factors for both the diseases are similar like vitiation of ''tridosha''. Both the diseases are related to the same system i.e. gastrointestinal tract. Further, ''arsha'' is one of the causative factors of ''udara roga'' (''Boddhagudedara''- intestinal obstruction) Therefore the chapter dealing with ''arshas'' (hemorrhoids) follows the chapter on the treatment of ''udara'' (obstinate abdominal disorders).

The chapter describes types of arsha (such as congenital or acquired), sites of manifestation other than the ano-rectal region, doshic signs & symptoms, etio-pathogenosis, etiology of the doshaja arsha, and prognosis along with the symptoms of curable and incurable hemorrhoids. Hemorrhoids can be shushka (dry or non-bleeding) and sravi (wet or bleeding) with different modes of treatment for each of these. In the bleeding type hemostatic management is essential while in non- bleeding type hemostatic treatment is not needed.  

The chapter describes types of ''arsha'' (such as congenital or acquired), sites of manifestation other than the ano-rectal region, ''doshic'' signs and symptoms, etio-pathogenosis, etiology of the ''doshaja arsha'', and prognosis along with the symptoms of curable and incurable hemorrhoids. Hemorrhoids can be ''shushka'' (dry or non-bleeding) and ''sravi'' (wet or bleeding) with different modes of treatment for each of these. In the bleeding type hemostatic management is essential while in non- bleeding type hemostatic treatment is not needed.  

The dry hemorrhoids can be correlated with the external hemorrhoids where protrusion of mucosal folds occur, without bleeding. Local treatment includes, fomentation, sitz bath, sprinkling, smearing and fumigation and topical medicament. The need of proper hygiene of the peri-anal area is important. Raktamokshan (bloodletting) was advised as one of the para-surgical procedure and in cases of vitiation of rakta and predominance of pitta dosha. Oral intake of the herbal powders, takraarishta, abhayaarishta, dantyaarishta, phalaarishta are described along with their method of preparation. In pathya the recipes like thick gruel, curd, buttermilk, leafy vegetables for vegetarian and meat as well as meat soup for non-vegetarian was advised in cases of constipated bowel. It proves that along with the other causative factors constipation is an important cause. The role of haritaki with jaggery is one of the requirements for deepana and pachana because the cause of arsha is depressed digestive power. The other recipes like ghrita, preparations like pippalyadi ghrita, chavyadi ghrita, nagaradi ghrita in constipated patients. The anuvasan basti is advisable with medicated taila in the management of dry or external hemorrhoids.

 

The wet hemorrhoids have the predominance of kapha along with vata and can be correlated with internal hemorrhoids which are usually bleeding in nature. The line of treatment as per predominance of vata or kapha has been described. In initial stage the bleeding should not be stopped as the vitiated blood should be let out. Later on kutajadi rasakriya for hemostatis, thick and thin gruel remedies were explained. Cooling therapy, sprinkling therapy with different herbal preparations, warm and cold water sitz bath was advised in the cases of bleeding. Recipes of curds and rice in the diet are also recommended. For local treatment external application of cold leaves, soothing ointment, rubbing recipes and topical application in the bleeding hemorrhoids are described.    

The dry hemorrhoids can be correlated with the external hemorrhoids where protrusion of mucosal folds occur, without bleeding. Local treatment includes, fomentation, sitz bath, sprinkling, smearing and fumigation and topical medicament. The need of proper hygiene of the peri-anal area is important. ''Raktamokshana'' (bloodletting) was advised as one of the para-surgical procedure and in cases of vitiation of ''rakta'' and predominance of ''pitta dosha''. Oral intake of the herbal powders, ''takraarishta, abhayaarishta, dantyaarishta, phalaarishta'' are described along with their method of preparation. In ''pathya'' the recipes like thick gruel, curd, buttermilk, leafy vegetables for vegetarian and meat as well as meat soup for non-vegetarian was advised in cases of constipated bowel. It proves that along with the other causative factors constipation is an important cause. The role of ''haritaki'' with jaggery is one of the requirements for ''deepana'' and ''pachana'' because the cause of ''arsha'' is depressed digestive power. The other recipes like ''ghrita,'' preparations like ''pippalyadi ghrita, chavyadi ghrita, nagaradi ghrita'' in constipated patients. The ''anuvasana basti'' is advisable with medicated ''taila'' in the management of dry or external hemorrhoids.

 

The wet hemorrhoids have the predominance of ''kapha'' along with ''vata'' and can be correlated with internal hemorrhoids which are usually bleeding in nature. The line of treatment as per predominance of ''vata'' or ''kapha'' has been described. In initial stage the bleeding should not be stopped as the vitiated blood should be let out. Later on ''kutajadi rasakriya'' for hemostatis, thick and thin gruel remedies were explained. Cooling therapy, sprinkling therapy with different herbal preparations, warm and cold water sitz bath was advised in the cases of bleeding. Recipes of curds and rice in the diet are also recommended. For local treatment external application of cold leaves, soothing ointment, rubbing recipes and topical application in the bleeding hemorrhoids are described.

===Sanskrit text, Transliteration and English Translation===

===Sanskrit text, Transliteration and English Translation===