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Line 2,266: − In case of excessive bleeding, the arsha becomes vata dominant. Even if pitta and kapha are predominantly vitiated, then also predominance of vata shall be considered in excessive bleeding. [212]+ + + − Cooling Therapy: Line 2,276:
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→Diet in bleeding hemorrhoids
Bleeding stops if the patient takes freshly prepared ghee from butter, goat-meat, shashtika types of rice, freshly fermented sura (a type of alcoholic drink). [211]
Bleeding stops if the patient takes freshly prepared ghee from butter, goat-meat, shashtika types of rice, freshly fermented sura (a type of alcoholic drink). [211]
Predominance of vayu:
==== Predominance of vayu ====
प्रायेण वात बहुलान्यर्शांसि भवन्त्यतिस्रुते रक्ते|
प्रायेण वात बहुलान्यर्शांसि भवन्त्यतिस्रुते रक्ते|
दुष्टेऽपि च कफ पित्ते तस्मादनिलोऽधिको ज्ञेयः||२१२||
दुष्टेऽपि च कफ पित्ते तस्मादनिलोऽधिको ज्ञेयः||२१२||
prAyeNa vAtabahulAnyarshAMsi bhavantyatisrute rakte|
prAyeNa vAtabahulAnyarshAMsi bhavantyatisrute rakte|
duShTe~api ca kaphapitte tasmAdanilo~adhiko j~jeyaH||212||
duShTe~api ca kaphapitte tasmAdanilo~adhiko j~jeyaH||212||
In case of excessive bleeding, the arsha becomes vata dominant. Even if pitta and kapha are predominantly vitiated, then also predominance of vata shall be considered in excessive bleeding. [212]
==== Cooling Therapy ====
दृष्ट्वा तु रक्तपित्तं प्रबलं कफ वात लिङ्गमल्पं च|
दृष्ट्वा तु रक्तपित्तं प्रबलं कफ वात लिङ्गमल्पं च|
शीता क्रिया प्रयोज्या यथेरिता वक्ष्यते चान्या ||२१३||
शीता क्रिया प्रयोज्या यथेरिता वक्ष्यते चान्या ||२१३||
If there is predominance of rakta and pitta and there is less of the signs and symptoms of aggravated kapha and vayu, then the patient should be given cooling remedies which are already described and some of which are to be described later. [213]
If there is predominance of rakta and pitta and there is less of the signs and symptoms of aggravated kapha and vayu, then the patient should be given cooling remedies which are already described and some of which are to be described later. [213]
Sprinkling in bleeding hemorrhoids:
==== Sprinkling in bleeding hemorrhoids ====
मधुकं सपञ्चवल्कं बदरीत्वगुदुम्बरं धवपटोलम्|
मधुकं सपञ्चवल्कं बदरीत्वगुदुम्बरं धवपटोलम्|
परिषेचने विदध्याद्वृषककुम यवास निम्बांश्च||२१४||
परिषेचने विदध्याद्वृषककुम यवास निम्बांश्च||२१४||
pariShecane vidadhyAdvRuShakakumayavAsanimbAMshca||214||
pariShecane vidadhyAdvRuShakakumayavAsanimbAMshca||214||
To stop bleeding, hemorrhoids should be sprinkled with the decoctions of madhuka, panchavalka [barks of nyagrodha (ficus bengalensis), udumbara (ficus glomeruta), ashwatha (ficus religiosa), parisha (thespesia populnea) and plaksha (ficus lacor)], bark of badar, udumbara (ficus glomeruta), dhava (Anogeissus latifolia) and patola (Tricosanthes dioica) or vasa (Adhatoda vasika), kakubha,Yavasaka (Alhagi camelorum) and nimba (Azadiracta indica). [214]
==== Warm water sitz-bath in bleeding hemorrhoids ====
रक्तेऽतिवर्तमाने दाहे क्लेदेऽवगाहयेच्चापि|
रक्तेऽतिवर्तमाने दाहे क्लेदेऽवगाहयेच्चापि|
मधुक मृणाल पद्मक चन्दन कुश काश निष्क्वाथे||२१५||
मधुक मृणाल पद्मक चन्दन कुश काश निष्क्वाथे||२१५||
The patient should be given warm water sitz bath with the decoction of madhuka, nifnala, padmaka, chandana (Santalum album), kusha (Desmospachya bipinnata) and kasha (Saccharum spontaneum) in cases suffering from bleeding, burning sensation and stickiness. [215]
The patient should be given warm water sitz bath with the decoction of madhuka, nifnala, padmaka, chandana (Santalum album), kusha (Desmospachya bipinnata) and kasha (Saccharum spontaneum) in cases suffering from bleeding, burning sensation and stickiness. [215]
Cold water sitz-bath in bleeding hemorrhoids:
==== Cold water sitz-bath in bleeding hemorrhoids ====
इक्षुरस मधुक वेतस निर्यूहे शीतले पयसि वा तम्|
इक्षुरस मधुक वेतस निर्यूहे शीतले पयसि वा तम्|
अवगाहयेत् प्रदिग्धं पूर्वं शिशिरेण तैलेन||२१६||
अवगाहयेत् प्रदिग्धं पूर्वं शिशिरेण तैलेन||२१६||
The peri-anal area of the patient should be first anointed with cold oil and then sitz bath should be given with sugar-cane juice and the decoctions of madhuka and vetasa mixed with cold water in excessive bleeding. [216]
The peri-anal area of the patient should be first anointed with cold oil and then sitz bath should be given with sugar-cane juice and the decoctions of madhuka and vetasa mixed with cold water in excessive bleeding. [216]
Hemostatic douche:
==== Hemostatic douche ====
दत्त्वा घृतं सशर्करमुपस्थदेशे गुदे त्रिकदेशे च|
दत्त्वा घृतं सशर्करमुपस्थदेशे गुदे त्रिकदेशे च|
शिशिर जल स्पर्श सुखा धारा प्रस्तम्भनी योज्या||२१७||
शिशिर जल स्पर्श सुखा धारा प्रस्तम्भनी योज्या||२१७||
To stop bleeding in hemorrhoids the genitals, anus and lumber region should be smeared with ghee and sugar then douche of cold water should be applied to stop bleeding. [217]
To stop bleeding in hemorrhoids the genitals, anus and lumber region should be smeared with ghee and sugar then douche of cold water should be applied to stop bleeding. [217]
External application of cold leaves:
==== External application of cold leaves ====
कदलीदलैरभिनवैः पुष्करपत्रैश्च शीतजलसिक्तैः|
कदलीदलैरभिनवैः पुष्करपत्रैश्च शीतजलसिक्तैः|
प्रच्छादनं मुहुर्मुहुरिष्टं पद्मोत्पलदलैश्च||२१८||
प्रच्छादनं मुहुर्मुहुरिष्टं पद्मोत्पलदलैश्च||२१८||
Hemorrhoid mass should be covered with the leaves of banana, and puskara sprinkled with cold water. Similarly, covering these masses with the leaves of padma (Nelumbo nucifera) and utpala is useful. [218]
Hemorrhoid mass should be covered with the leaves of banana, and puskara sprinkled with cold water. Similarly, covering these masses with the leaves of padma (Nelumbo nucifera) and utpala is useful. [218]
Soothing Ointment:
==== Soothing Ointment ====
दुर्वाघृतप्रदेहः शतधौतसहस्रधौतमपि सर्पिः|
दुर्वाघृतप्रदेहः शतधौतसहस्रधौतमपि सर्पिः|
व्यजनपवनः सुशीतो रक्तस्रावं जयत्याशु||२१९||
व्यजनपवनः सुशीतो रक्तस्रावं जयत्याशु||२१९||
External application of durvaghrita, shatadhauta ghrita and sahasradhauta ghrita, and fanning of cold air stops bleeding. [219]
External application of durvaghrita, shatadhauta ghrita and sahasradhauta ghrita, and fanning of cold air stops bleeding. [219]
Topical application or rubbing:
==== Topical application or rubbing ====
समङ्गा मधुकाभ्यां तिल मधुकाभ्यां रसाञ्जनवृताभ्याम्|
समङ्गा मधुकाभ्यां तिल मधुकाभ्यां रसाञ्जनवृताभ्याम्|
सर्जरस घृताभ्यां वा निम्बघृताभ्यां मधुघृताभ्यां वा||२२०||
सर्जरस घृताभ्यां वा निम्बघृताभ्यां मधुघृताभ्यां वा||२२०||
8. Chandana (Santalum album) and rakta-chandana
8. Chandana (Santalum album) and rakta-chandana
9. Utpala (Nelumbo nucifera) and ghee
9. Utpala (Nelumbo nucifera) and ghee
Topical application in continuous bleeding:
==== Topical application in continuous bleeding ====
आभिः क्रियाभिरथवा शीताभिर्यस्य तिष्ठति न रक्तम्|
आभिः क्रियाभिरथवा शीताभिर्यस्य तिष्ठति न रक्तम्|
तं काले स्निग्धोष्णैर्मांसरसैस्तर्पयेन्मतिमान्||२२२||
तं काले स्निग्धोष्णैर्मांसरसैस्तर्पयेन्मतिमान्||२२२||
Patient should be given medicated ghee which is administered, prior to taking food. His anus should be massaged with luke warm ghee or oil, or the hemorrhoid mass should be fomented with luke-warm milk, ghee or oil. These remedies should be administered quickly.
Patient should be given medicated ghee which is administered, prior to taking food. His anus should be massaged with luke warm ghee or oil, or the hemorrhoid mass should be fomented with luke-warm milk, ghee or oil. These remedies should be administered quickly.
If bleeding doesn't stop and there is aggravation of vayu then the patient should be given anuvsana type of enema with the help of luke-warm ghritamanda (upper portion of the ghee). He should be given the effective piccha basti (recipe of which is described below) at the appropriate time. [222-224]
If bleeding doesn't stop and there is aggravation of vayu then the patient should be given anuvsana type of enema with the help of luke-warm ghritamanda (upper portion of the ghee). He should be given the effective piccha basti (recipe of which is described below) at the appropriate time. [222-224]
Piccha basti:
==== Piccha basti ====
यवास कुश काशानं मूलं पुष्पं च शाल्मलम्|
यवास कुश काशानं मूलं पुष्पं च शाल्मलम्|
न्यग्रोधोदुम्बराश्वत्थ शुङ्गाश्च द्विपलोन्मिताः||२२५||
न्यग्रोधोदुम्बराश्वत्थ शुङ्गाश्च द्विपलोन्मिताः||२२५||
Anuvasana basti in bleeding hemorrhoids
Anuvasana basti in bleeding hemorrhoids
Prapaundarika and madhuka along with the drugs described in piccha basti should be made to a paste. This paste should be added to oil and double the quantity of milk, and cooked. [This medicated oil should be used for anuvasana type of medicated enema for the patients suffering from hemorrhoids. [229]
Prapaundarika and madhuka along with the drugs described in piccha basti should be made to a paste. This paste should be added to oil and double the quantity of milk, and cooked. [This medicated oil should be used for anuvasana type of medicated enema for the patients suffering from hemorrhoids. [229]
Hriveradi Ghrita:
==== Hriveradi Ghrita ====
ह्रीवेरमुत्पलं लोध्रं समङ्गा चव्य चन्दनम्|
ह्रीवेरमुत्पलं लोध्रं समङ्गा चव्य चन्दनम्|
पाठा सातिविषा बिल्वं धातकी देवदारु च||२३०||
पाठा सातिविषा बिल्वं धातकी देवदारु च||२३०||
The paste of ingredients like hribera, utpala, lodhra, majitha, chavya chandana, patha, atisa, bilva, dhataki, devadaru, bark of daruharidra, nagaramotha, jatamamsi, musta, yavakshara and chitraka should be made then added 4 times juice of changeri and cooked with ghee as per ghrita siddha. It is an excel¬lent remedy for hemorrhoids, diarrhea grahani, pandu (anemia), fever, anorexia, dysuria, prolapsed rectum, distension in the region of urinary bladder, dysentery, voiding of slimy material and pain in the hemorrhoids. It alleviates all the three aggravated doshas. [230-233]
The paste of ingredients like hribera, utpala, lodhra, majitha, chavya chandana, patha, atisa, bilva, dhataki, devadaru, bark of daruharidra, nagaramotha, jatamamsi, musta, yavakshara and chitraka should be made then added 4 times juice of changeri and cooked with ghee as per ghrita siddha. It is an excel¬lent remedy for hemorrhoids, diarrhea grahani, pandu (anemia), fever, anorexia, dysuria, prolapsed rectum, distension in the region of urinary bladder, dysentery, voiding of slimy material and pain in the hemorrhoids. It alleviates all the three aggravated doshas. [230-233]
Sunnishannak changeri ghrita:
==== Sunnishannak changeri ghrita ====
अवाक्पुष्पी बला दार्वी पृश्निपर्णी त्रिकण्टकः|
अवाक्पुष्पी बला दार्वी पृश्निपर्णी त्रिकण्टकः|
न्यग्रोधोदुम्बराश्वत्थशुङ्गाश्च द्विपलोन्मिताः||२३४||
न्यग्रोधोदुम्बराश्वत्थशुङ्गाश्च द्विपलोन्मिताः||२३४||
The juice of changari in the above recipe should be added four times the quan¬tity of ghee because this portion does not contain any other liquid sunishanyaka changeri ghrita.
The juice of changari in the above recipe should be added four times the quan¬tity of ghee because this portion does not contain any other liquid sunishanyaka changeri ghrita.
The above mentioned decoction and paste should be added with the juice of sunijannaka and changeri, two prasthas of each and one prastha of ghee, and cooked. This medicated ghee cures hemorrhoids, diarrhea, bleeding caused by the aggravation of all the three doshas, dysentery, voiding of different types of slimy material, prolapsed rectum, urge for motion, edema and pain in anal region, suppression and anorexia. This medicated ghee helps in the promotion of strength, complexion and digestive power. This medicated ghee is harmless, and it can be administered alone or along with different types of food for digestion and strength. [235-242]
The above mentioned decoction and paste should be added with the juice of sunijannaka and changeri, two prasthas of each and one prastha of ghee, and cooked. This medicated ghee cures hemorrhoids, diarrhea, bleeding caused by the aggravation of all the three doshas, dysentery, voiding of different types of slimy material, prolapsed rectum, urge for motion, edema and pain in anal region, suppression and anorexia. This medicated ghee helps in the promotion of strength, complexion and digestive power. This medicated ghee is harmless, and it can be administered alone or along with different types of food for digestion and strength. [235-242]
Different foods in arsha:
==== Different foods in arsha ====
भवन्ति चात्र-
भवन्ति चात्र-
व्यत्यासान्मधुराम्लानि शीतोष्णानि च योजयेत्|
व्यत्यासान्मधुराम्लानि शीतोष्णानि च योजयेत्|
Thus it is said, depending upon the power of digestion, the patients of hemorrhoids should be given some time cold article and sometimes hot articles sometimes sweet or sour taste drugs or food should be given having opposite characters to keep digestive power normal. [243]
Thus it is said, depending upon the power of digestion, the patients of hemorrhoids should be given some time cold article and sometimes hot articles sometimes sweet or sour taste drugs or food should be given having opposite characters to keep digestive power normal. [243]
Interdependence of diseases and protection of agni in hemorrhoids:
==== Interdependence of diseases and protection of agni in hemorrhoids ====
त्रयो विकाराः प्रायेण ये परस्परहेतवः|
त्रयो विकाराः प्रायेण ये परस्परहेतवः|
अर्शांसि चातिसारश्च ग्रहणीदोष एव च||२४४||
अर्शांसि चातिसारश्च ग्रहणीदोष एव च||२४४||
Hemorrhoids, diarrhea and grahani these three diseases are interdependent. In all patients of above three diseases if the digestive power is low then disease gets aggravated and if digestive power is strong then relief occurs. So, the digestion power should be maintained in these three diseases to overcome them. [244-245]
Hemorrhoids, diarrhea and grahani these three diseases are interdependent. In all patients of above three diseases if the digestive power is low then disease gets aggravated and if digestive power is strong then relief occurs. So, the digestion power should be maintained in these three diseases to overcome them. [244-245]
Treatment in General:
==== Treatment in General ====
भृष्टैः शाकै र्यवागूभिर्यूषैर्मांसरसैः खडैः|
भृष्टैः शाकै र्यवागूभिर्यूषैर्मांसरसैः खडैः|
क्षीर तक्र प्रयोगैश्च विविधैर्गुदजाञ्जयेत्||२४६||
क्षीर तक्र प्रयोगैश्च विविधैर्गुदजाञ्जयेत्||२४६||
kShIratakraprayogaishca vividhairgudajA~jjayet||246||
kShIratakraprayogaishca vividhairgudajA~jjayet||246||
The physician should overcome hemorrhoids by the use of diffe¬rent types of fried vegetables, thick gruel, vegetable soup, meat soup, khada (a sour preparation), milk and curd. [246]
The physician should overcome hemorrhoids by the use of diffe¬rent types of fried vegetables, thick gruel, vegetable soup, meat soup, khada (a sour preparation), milk and curd. [246]
Pathya (diet regimen) in hemorrhoids:
==== Pathya (diet regimen) in hemorrhoids ====
यद्वायोरानुलोम्याय यदग्निबलवृद्धये|
यद्वायोरानुलोम्याय यदग्निबलवृद्धये|
अन्नपानौषधद्रव्यं तत् सेव्यं नित्यमर्शसैः||२४७||
अन्नपानौषधद्रव्यं तत् सेव्यं नित्यमर्शसैः||२४७||
gudajAbhiparItena tat sevyaM na kadAcana||248||
gudajAbhiparItena tat sevyaM na kadAcana||248||
The foods that lead to downward movement of vayu and promote digestive power should be daily consumed by patients of hemorrhoids. Those foods having opposite properties and those described in the etiology of hemorrhoids should never be used by the patient suffering from this disease. [247-248]
The foods that lead to downward movement of vayu and promote digestive power should be daily consumed by patients of hemorrhoids. Those foods having opposite properties and those described in the etiology of hemorrhoids should never be used by the patient suffering from this disease. [247-248]
Summary of the chapter:
==== Summary of the chapter ====
तत्र श्लोकाः-
तत्र श्लोकाः-
अर्शसां द्विविधं जन्म पृथगायतनानि च|
अर्शसां द्विविधं जन्म पृथगायतनानि च|
19. Many recipes for washing or local cleaning of perianal region, sitz bath, ointment and sprinkling on hemorrhoids.
19. Many recipes for washing or local cleaning of perianal region, sitz bath, ointment and sprinkling on hemorrhoids.
20. The remedies in cases of excessive bleeding in hemorrhoids. [249-255]
20. The remedies in cases of excessive bleeding in hemorrhoids. [249-255]
Colophon:
==== Colophon ====
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते
चिकित्सास्थानेऽर्शश्चिकित्सितं नाम चतुर्दशोऽध्यायः||१४||
चिकित्सास्थानेऽर्शश्चिकित्सितं नाम चतुर्दशोऽध्यायः||१४||