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→Etiology and pathogenesis of acquired arsha (hemorrhoids)
The apana vayu aggravated by the above mentioned factors, brings down the accumulated waste products and so afflicts the anal sphincters and leads to acquired type of hemorrhoids. [9]
The apana vayu aggravated by the above mentioned factors, brings down the accumulated waste products and so afflicts the anal sphincters and leads to acquired type of hemorrhoids. [9]
====Shapes of the arsha (hemorrhoids)====
सर्षप मसूर माष मुद्गमकुष्ठ कयव कलाय पिण्डिटिण्टिकेर केबुक तिन्दुक कर्कन्धु काकणन्तिका बिम्बी बदर करीरोदुम्बर- खर्जूर जाम्बव गोस्तनाङ्गुष्ठ कशेरु शृङ्गाटक शृङ्गीदक्ष शिखि शुकतुण्ड जिह्वा पद्ममुकुलकर्णिका संस्थानानि सामान्याद्वात पित्त कफ प्रबलानि||१०||
sarṣapa masūra māṣa mudgamakuṣṭha kayava kalāya piṇḍiṭiṇṭikera kebuka tinduka karkandhu kākaṇantikā bimbī badara karīrodumbara- kharjūra jāmbava gostanāṅguṣṭha kaśeru śṛṅgāṭaka śṛṅgīdakṣa śikhi śukatuṇḍa jihvā padmamukulakarṇikā saṃsthānāni sāmānyādvāta pitta kapha prabalāni||10||
sarShapamasUramAShamudgamakuShThakayavakalAyapiNDiTiNTikerakebukatindukakarkandhukAkaNantikAbimbIbadarakarIrodumbara-kharjUrajAmbavagostanA~gguShThakasherushRu~ggATakashRu~ggIdakShashikhishukatuNDajihvApadmamukulakarNikAsaMsthAnAnisAmAnyAdvAtapittakaphaprabalAni||10||
Hemorrhoids have different shapes and resemble mustard, masura, masha, mudga, kushtaka (Saussurea lappa CB. Clarke), yava (barley), kalaya (green pea), pindi, tundikeri (fruit of karira), kebuka, tinduka, karkandhu, kakanantika, bimbi badara, karira, udumbara (Ficus racemosa Linn), kharjura (Phoenix dactylifera) jambu (Syzygium cuminii (Linn.)), gostana (cow's breast), thumb, kasheruka, shringataka, shringi, beaks or tongues of a fowl, a peacock or a parrot, and buds of lotus or karyika.
All above mentioned shapes are in general the characteristic shapes of hemorrhoids caused by excessive aggravation of vayu, pitta and kapha. [10]
====Signs and symptoms of vataja arsha ====
तेषामयं विशेषः- शुष्कम्लान कठिन परुष रूक्ष श्यावानि, तीक्ष्णाग्राणि, वक्राणि, स्फुटित मुखानि, विषम विसृतानि, शूलाक्षेपतोदस्फुरण चिमिचिमासंहर्ष परीतानि, स्निग्धोष्णोपशयानि, प्रवाहिका ध्मान शिश्न वृषण बस्ति वङ्क्षण हृद्ग्रहाङ्गमर्द हृदय द्रव प्रबलानि, प्रतत विबद्ध वात मूत्र वर्चांसि, ऊरु कटी पृष्ठ त्रिक पार्श्व कुक्षि बस्ति शूल शिरोऽभिताप क्षवथूद्गार प्रतिश्याय कासोदावर्तायाम शोष शोथ- मूर्च्छारोचक मुखवैरस्य तैमिर्य कण्डू नासा कर्ण शङ्ख शूल स्वरोपघातकराणि, श्यावारुण परुष नख नयन वदन त्वङ्मूत्र पुरीषस्य वातोल्बणान्यर्शांसीति विद्यात्||११||
teṣāmayaṃ viśeṣaḥ- śuṣkamlāna kaṭhina paruṣa rūkṣa śyāvāni, tīkṣṇāgrāṇi, vakrāṇi, sphuṭita mukhāni, viṣama visṛtāni, śūlākṣepatodasphuraṇa cimicimāsaṃharṣaparītāni, snigdhoṣṇopaśayāni, pravāhikā dhmāna śiśna vṛṣaṇa basti vaṅkṣaṇa hṛdgrahāṅgamarda hṛdaya drava prabalāni, pratata vibaddha vāta mūtra varcāṃsi, ūru kaṭī pṛṣṭha trika pārśva kukṣi basti śūla śiro’bhitāpa kṣavathūdgāra pratiśyāya kāsodāvartāyāma śoṣa śotha- mūrcchārocaka mukhavairasya taimirya kaṇḍū nāsā karṇa śaṅkha śūla svaropaghātakarāṇi, śyāvāruṇa paruṣa nakha nayana vadana tvaṅmūtra purīṣasya vātolbaṇānyarśāṃsīti vidyāt||11||
teShAmayaM visheShaH- shuShkamlAnakaThinaparuSharUkShashyAvAni, tIkShNAgrANi, vakrANi, sphuTitamukhAni,viShamavisRutAni, shUlAkShepatodasphuraNacimicimAsaMharShaparItAni, snigdhoShNopashayAni,pravAhikAdhmAnashishnavRuShaNabastiva~gkShaNahRudgrahA~ggamardahRudayadravaprabalAni,pratatavibaddhavAtamUtravarcAMsi,UrukaTIpRuShThatrikapArshvakukShibastishUlashiro~abhitApakShavathUdgArapratishyAyakAsodAvartAyAmashoShashotha-mUrcchArocakamukhavairasyataimiryakaNDUnAsAkarNasha~gkhashUlasvaropaghAtakarANi,shyAvAruNaparuShanakhanayanavadanatva~gmUtrapurIShasya vAtolbaNAnyarshAMsIti vidyAt||11||
Hemorrhoids caused by the predominance of aggravated vata:
#The mass of hemorrhoids is dry, wrinkled, hard, rough, ununctuous and greyish in color; these masses have sharp tips; these are curved and with cracks on the surface; and these are spread irregularly.
#The mass of hemorrhoids is associated with pain, cramps toda (piercing pain), itching, numbness and tingling sensa¬tion in excess.
#Unctuous and hot things give relief in this condition.
#The patient suffers from dysentery, abdominal disten¬sion and stiffness of genitals, testicles, urinary bladder, pelvis and cardiac region; he also suffers from malaise and palpitation in excess.
#His flatus, urine and stool are constantly obstructed.
#He suffers from pain in thighs, lumber region, back, trika (sacral region), parshva (sides of the chest), kukshi (sides of the abdomen ) and in basti (urinary bladder)
#He gets heat sensation in the head and suffers from, sneezing, eructation, coryza, cough, udavarta (mis-peristalsis), lethargy, edema, fainting, anorexia, distaste in mouth, timira (impairment of vision) it¬ching, pain in the nose, ears and temporal region, and impairment of the voice.
#Greyish, reddishness and roughness of nails, eyes, face, skin, urine and stool. [11]
====Etiology of vataja arsha hemorrhoids====
भवतश्चात्र-
कषाय कटु तिक्तानि रूक्ष शीत लघूनि च|
प्रमिताल्पाशनं तीक्ष्ण मद्य मैथुन सेवनम्||१२||
लङ्घनं देशकालौ च शीतौ व्यायामकर्म च|
शोको वातातपस्पर्शो हेतुर्वातार्शसां मतः||१३||
bhavataścātra-
kaṣāya kaṭu tiktāni rūkṣa śīta laghūni ca|
pramitālpāśanaṃ tīkṣṇa madya maithuna sevanam||12||
laṅghanaṃ deśakālau ca śītau vyāyāmakarma ca|
śoko vātātapasparśo heturvātārśasāṃ mataḥ||13||
bhavatashcAtra-
kaShAyakaTutiktAni rUkShashItalaghUni ca|
pramitAlpAshanaM tIkShNamadyamaithunasevanam||12||
la~gghanaM deshakAlau ca shItau vyAyAmakarma ca|
shoko vAtAtapasparsho heturvAtArshasAM mataH||13||
The causes of vataja arsha are as follow.
#Habitual intake of astringent, pungent, bitter, ununctuous, cold and light food;
#Habitual intake of pramitashana ( food measured in extremely small quantities), intake of less quantity of food, intake of excess alcoho¬lic drinks and indulgence in sexual acts.
#Fasting, living in cold country and cold season, physical exercise, grief and exposure to sun and wind. [12-13]
====Signs and symptoms of pittaja arsha====
मृदु शिथिल सुकुमाराण्य स्पर्शसहानि, रक्त पीत नील कृष्णानि, स्वेदोपक्लेद बहुलानि, विस्र गन्धि तनु पीत रक्त स्रावीणि, रुधिरवहानि, दाह कण्डू शूल निस्तोद पाकवन्ति, शीतोपशयानि, सम्भिन्नपीत हरित वर्चांसि, पीत विस्रगन्धि प्रचुर विण्मूत्राणि, पिपासा ज्वर तमक सम्मोह भोजन द्वेषकराणि पीत नख नयन त्वङ्मूत्र पुरीषस्य पित्तोल्बणान्यर्शांसीति विद्यात्||१४||
mṛdu śithila sukumārāṇya sparśasahāni, rakta pīta nīla kṛṣṇāni, svedopakleda bahulāni, visra gandhi tanu pīta rakta srāvīṇi, rudhiravahāni, dāha kaṇḍū śūla nistoda pākavanti, śītopaśayāni, sambhinnapīta harita varcāṃsi, pīta visragandhi pracura viṇmūtrāṇi, pipāsā jvara tamaka sammoha bhojana dveṣakarāṇi pīta nakha nayana tvaṅmūtra purīṣasya pittolbaṇānyarśāṃsīti vidyāt||14||
mRudushithilasukumArANyasparshasahAni, raktapItanIlakRuShNAni, svedopakledabahulAni,visragandhitanupItaraktasrAvINi [1] , rudhiravahAni, dAhakaNDUshUlanistodapAkavanti, shItopashayAni,sambhinnapItaharitavarcAMsi, pItavisragandhipracuraviNmUtrANi,pipAsAjvaratamakasammohabhojanadveShakarANi pItanakhanayanatva~gmUtrapurIShasyapittolbaNAnyarshAMsIti vidyAt||14||
The following are the signs and symptoms of Pittaja Arshas:
#The pile mass is soft, flabby, delicate and tender to touch
#The color of hemorrhoids is red, yellow, blue or black
#The hemorrhoids is associated with excessive swea¬ting and sticky discharge
#The discharge from the hemorrhoids mass is visra (smelling like raw-meat), thin, yellow or red
#There is bleeding from the hemorrhoids
#The hemorrhoids are associated with burning sensa¬tion, itching, pain, pricking pain and suppura¬tion.
#Cold things relief the symptoms
#The stool of the patient is loose, yellow or green
#The urine and stool are voided in large quantities, yellow in colour and the smell is like raw meat.
#The patient suffers from morbid thirst, fever, asthma, fainting and disliking for foods
#The nails, eyes, skin, urine and stool become yellow in color. [14]
====Etiology of pittaja arsha====
भवतश्चात्र-
कटूष्ण लवण क्षार व्यायामाग्न्यातप प्रभाः |
देश कालावशिशिरौ क्रोधो मद्यमसूयनम्||१५||
विदाहि तीक्ष्णमुष्णं च सर्वं पानान्नभेषजम्|
पित्तोल्बणानां विज्ञेयः प्रकोपे हेतुरर्शसाम्||१६||
bhavataścātra-
kaṭūṣṇa lavaṇa kṣāra vyāyāmāgnyātapa prabhāḥ |
deśa kālāvaśiśirau krodho madyamasūyanam||15||
vidāhi tīkṣṇamuṣṇaṃ ca sarvaṃ pānānnabheṣajam|
pittolbaṇānāṃ vijñeyaḥ prakope heturarśasām||16||
bhavatashcAtra-
kaTUShNalavaNakShAravyAyAmAgnyAtapaprabhAH [2] |
deshakAlAvashishirau krodho madyamasUyanam||15||
vidAhi tIkShNamuShNaM ca sarvaM pAnAnnabheShajam|
pittolbaNAnAM vij~jeyaH prakope heturarshasAm||16||
The causes of pittaja arsha are as follow:
#Intake of pungent, hot, salty and alkaline food,
#excess exercise and exposure to the heat of fire and Sun
#Living in a place and season which are not cold, intake of alcohol and envy;
#Intake of drinks, food and drugs having vidahi (causing burning sensation), sharp and hot properties. [15-16]
=== ''Tattva Vimarsha'' ===
=== ''Tattva Vimarsha'' ===