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<big>'''Abstract'''</big>

<big>'''Abstract'''</big>

<div style="text-align:justify;">This chapter deals with diagnosis of bleeding disorders (raktapitta) caused by an excess of pitta dosha vitiating blood (rakta dhatu) in the body. This leads to capillary break-down causing hemorrhage from external openings like mouth, per rectum, nose, eyes, ears, urethra. Contributing factors that increase the probability of raktapitta include consumption of incompatible food substances, consuming certain meats with alcohol, butter milk with meat of animals etc. The regular exposure to dietary and lifestyle factors with hot (ushna) properties vitiates pitta. This pitta has the same color and smell as rakta, and blends seamlessly with it. Vitiated pitta and increased rakta circulate in the channels and the resultant increased volume of the blood overflows from the bodily orifices. The pathogenesis, if associated with vitiated kapha, leads to bleeding from upper orifices, whereas if it is associated with vitiated vata, leads to bleeding from the lower orifices. The first condition is curable, and later is difficult to cure. If both kapha and vata are involved in the pathogenesis, then the complications arise and such conditions are incurable. Avoiding etiological factors enlisted in this chapter can delay the progression of hemorrhagic disorders. Therapeutic measures of emesis and purgation, along with useful medicinal formulations and attention can improve the condition of patients of hemorrhagic disorders in varying degrees. Prodromal symptoms and complications have been described in this chapter. </div>

<div style="text-align:justify;">This chapter deals with diagnosis of bleeding disorders ([[raktapitta]]) caused by an excess of [[pitta dosha]] vitiating blood tissue ([[rakta dhatu]]) in the body. This leads to capillary break-down causing hemorrhage from external openings like mouth, per rectum, nose, eyes, ears, urethra. Contributing factors that increase the probability of [[raktapitta]] include consumption of incompatible food substances, consuming certain meats with alcohol, butter milk with meat of animals etc. The regular exposure to dietary and lifestyle factors with hot (ushna) properties vitiates [[pitta dosha]]. This [[pitta dosha]] has the same color and smell as [[rakta dhatu]], and blends seamlessly with it. Vitiated [[pitta dosha]] and increased [[rakta dhatu]] circulate in the channels and the resultant increased volume of the blood overflows from the bodily orifices. The pathogenesis, if associated with vitiated [[kapha dosha]], leads to bleeding from upper orifices; whereas if it is associated with vitiated [[vata dosha]], leads to bleeding from the lower orifices. The first condition is curable, and later is difficult to cure. If both [[kapha]] and [[Vata dosha|vata]] are involved in the pathogenesis, then the complications arise and such conditions are incurable. Avoiding etiological factors enlisted in this chapter can delay the progression of hemorrhagic disorders. Therapeutic measures of [[emesis]] and [[purgation]], along with useful medicinal formulations and attention can improve the condition of patients of hemorrhagic disorders in varying degrees. Prodromal symptoms and complications have been described in this chapter. </div>

'''Keywords''': Etio-pathogenesis of ''raktapitta'', bleeding disorders, epistaxis, hemorrhage, hematemesis, rectal bleeding.

'''Keywords''': Etiopathogenesis of [[raktapitta]], bleeding disorders, epistaxis, hemorrhage, hematemesis, rectal bleeding.

== Introduction ==

== Introduction ==

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The second chapter of the [[Nidana Sthana]] 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 [[Nidana Sthana]] focuses on [[Rakta dhatu|rakta]] , the second [[dhatu]], just as the first chapter on [[jwara]] focused on the first [[dhatu]], [[Rasa dhatu|rasa]]. [[Pitta dosha|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 dosha|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 disorders of [[vata dosha]] affecting vessles (siragata vata).

''Raktapitta'' manifests through two broadly divided routes that correlate with the flow of ''dosha'' energies in the body: the upper tract and the lower tract. The upper tract includes the orifices of eyes, ear, nose, and mouth/throat and is the route taken by the flow of blood when the person has an abundance of body ''kapha'' besides ''rakta'' and ''pitta''. When there is an abundance of body ''vata'' with an interplay of ''rakta'' and ''pitta'', ''raktapitta'' manifests through the lower tract using urine via hematuria and feces via occult blood. When bleeding manifests through both the routes, it indicates the involvement of both the ''doshas, vata'' and ''kapha''.  

[[Raktapitta]] manifests through two broadly divided routes that correlate with the flow of [[dosha]] energies in the body: the upper tract and the lower tract. The upper tract includes the orifices of eyes, ear, nose, and mouth/throat. It is the route taken by the flow of blood when the person has an abundance of [[Kapha dosha|kapha]] besides [[Rakta dhatu|rakta]] and [[Pitta dosha|pitta]]. When there is an abundance of body [[Vata dosha|vata]] with an interplay of [[Rakta dhatu|rakta]] and [[Pitta dosha|pitta]], [[raktapitta]] manifests through the lower tract as in hematuria and per rectal bleeding. When bleeding manifests through both the routes, it indicates the involvement of both the [[dosha]], [[Vata dosha|vata]] and [[Kapha dosha|kapha]].  

''Raktapitta'' from the upper orifices is curable, while that from the lower orifices is considered palliable. Manifestation of bleeding from both the tracts is said to be incurable. Charak advocates that in order to avoid progression to this stage, prompt preventive action should be taken.

[[Raktapitta]] from the upper orifices is curable, while that from the lower orifices is considered palliable. Manifestation of bleeding from both the tracts is said to be incurable. Prompt preventive action is advocated to avoid progression to incurable stage.

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==Sanskrit Text, Transliteration and English Translation==

==Sanskrit Text, Transliteration and English Translation==

Now we shall expound the chapter "Raktapitta Nidana" (Diagnosis and etiopathogenesis of Bleeding Disorders). Thus said Lord Atreya.[1-2]

Now we shall expound the chapter "Raktapitta Nidana" (Diagnosis and etiopathogenesis of Bleeding Disorders). Thus said Lord Atreya.[1-2]

=== Synonym of ''raktapitta'' ===

=== Synonym of [[raktapitta]] ===

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Also explained would be the origin of ''lohitapitta'' as an alternate name for ''pitta''. [3]  

We shall also expoutd how [[Pitta dosha]] gets the term 'Lohitapitta'. [3]  

=== Etiopathogenesis ===

=== Etiopathogenesis ===