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Thus ends the fourth chapter on the treatment of hemorrhagic disorder in [[Chikitsa Sthana]] in the treatise composed by Agnivesha and redacted by Charaka. (4)
Thus ends the fourth chapter on the treatment of hemorrhagic disorder in [[Chikitsa Sthana]] in the treatise composed by Agnivesha and redacted by Charaka. (4)
=== Tattva Vimarsha ===
=== ''Tattva Vimarsha'' ===
*The causes of ''raktapitta'' include excess consumption of food with hot potency and ingredients with sharp, sour, pungent and salty taste, exposure to the sun and foods that cause burning sensations.
*''Pitta dosha'' and ''rakta'' have similar properties in terms of vitiation, odor, color and origin. Therefore, anything affecting ''pitta'' will affect ''rakta'' and vice versa.
*The ''pitta'' and ''rakta'' (blood) including blood vessels originate from spleen and liver.
*Affliction by ''kapha'' in ''rakta'' can be observed by appearance of viscous, pale, unctuous and slimy blood (in blood coming out).
*Blackish, reddish, frothy, thin and roughness in blood indicates affliction by ''vata''.
*Blood having ochre-like, black, cow-urine-like, shining black, smoky and collyrium-like color indicates ''pitta'' affliction. Due to combination of two ''doshas'' the symptoms of both manifest. ''Raktapitta'' caused by ''sannipata'' has symptoms of all the three ''doshas''.
*The prognosis and treatment of ''raktapitta'' depend upon movement of vitiated ''rakta'', direction of its flow, origin, severity of disease, strength of patient.
*''Raktapitta'' is caused by food having predominantly unctuous-hot and rough-hot properties. The former often gives rise to the upward movement and the latter to the downward movement of ''raktapitta''.
*The upward movement in ''raktapitta'' is associated with ''kapha'', the downward one with ''vata'' and that from both the passages is associated with both ''kapha'' and ''vata''.
*''Stambhana'' (styptic therapy) should not be given at first in hemorrhagic disorders having excessive impurities, aggravated ''doshas'', over-nourished and in a person who is not emaciated and weak.
*Mostly the ''raktapitta'' is aggravated by ''amadosha'', hence patient should be managed with ''langhana'' (lightening measures). In the beginning stage of ''raktapitta'', lightening or nourishing measure according to passage, association of ''dosha'' and etiology shall be applied.
*''Raktapitta'', due to excess nutrition in a strong patient with aggravated ''doshas'', who don’t have emaciation, debility and complications, should be treated with purification therapy by purgation in upward type and emesis in lower movement of ''raktapitta''.
*After purification, in the case of upward type, the dietetic regimen starts with saturating drinks. In that of downward type, it starts with gruel subjected to the condition that ''vata'' is not dominant.
*All types of sweet, bitter, astringent medicines with cold potency are indicated in diet and medicinal management. In lifestyle management, the cold measures and avoiding exposure to excess heat are applied in treatment of hemorrhagic disorders.
=== Vidhi Vimarsha ===
=== Vidhi Vimarsha ===