Introduction:

This is an acute disease (Aas`hukaaree). It spreads like forest fire. It should be treated immediately and carefully. When this disease changes the course (direction) it is indicative of incurability (Asaadhyatva). It is a serious disease (Mahaagada), having grave consequences. It afflicts the patient very fast. Mahaavega – greatly agitated). It is like fire and affects instantaneously (Agnivat S`heeghrakaaree)

 

Pitta is associated with Rakta; hence it has a natural tendency to vitiate. This vitiated Pitta combines with Rakta and contaminates it. Pitta and Rakta have comparable smell and colour. Owing to this relationship in this Vyaadhi Pitta is addressed as Rakta.

 

 

Saamanya Chikitsaa

 

Raktapitta is of three types

o Oordhvaga which is Kaphaanubandhee and is Saadhya

o Adhoga which is Vaataanubandhee and Yaapya

o Tiryak which is Asaadhya.

 

Note: – Pratimaarga (Viruddha) Maarga Haran`a (S`hodhana): Eliminating the causative, vitiated Dosha from the opposite direction of its manifestation is the key to management of Rakta Pitta.

(For Oordhvaga Raktapitta Kashaaya and Tikta Rasa are criteria for S`hamana Dravya and Madhura Rasa is for Adhoga Raktapitta.)

 

Oordhvaga Raktapitta: –

 

The causative attributes are Snigdha and Ushn`a which vitiate the combination of Kapha and Pitta resulting in Oordhvaga Rakta Pitta. To eliminate from the oppositeMaarga, Virechana is the modality of choice; which is the best S`hodhana for Pitta and for Kapha too. Hence Oordhvaga Rakta Pitta is Saadhya / Curable. Out of the three Rasa_s owing to Kapha involvement Madhura is contraindicated; which leaves Kashaaya and Tikta for S`hodhana which are abundantly available, thus the choice is wide, hence it is Saadhya.

 

Adhoga Raktapitta: –

 

Vamana is the modality of choice as per Pratimaarga Haran`atenet. The attributes are Rooks`ha and Ushn`a; which cause vitiation of Vaata and Pitta. The available taste for S`hodhana is only Madhura. The availability for Madhura Vamana dravya is limited as well as S`hamana with Madhura Rasa too is limited. Vamana is not a treatment of choice for Pitta as well as Vaata. This makes Adhoga Rakta Pitta Yaapya / incurable but controllable with diet and regimen.

 

Tiryak Raktapitta: –

 

When all three Dosha_s are simultaneously vitiated and are circulating in the blood stream, the manifestation is subcutaneous, which does not respond to eitherVamana or Virechana as the Dosha_s are in the S`haakha Maarga, owing to the amount of the Dosha_s it becomes impossible to bring them in the Kosht`ha for elimination. There is limited number of drugs available to manage this condition. The patient may be Durbala due vitiation of all the three Dosha_s and Rakta, all of them being Pran`aayatana_s. All these factors taken together render the condition incurable.

 

Aavasthika Chikitsaa

Flow of treatment

State of Upeks`haa (Na Aadau Stambhanam Arhati) initially ignore if the bleeding is not too much as arresting the bleed may lead to complications

S`hamanaarha (Garbhin`ee, Baala etc.)

o Langhana

o Oordhvaga Peyaa, Yavaagoo

o Adhoga Tarpan`a

S`hodhanaarha (Bahu Dosha, Balavaan Rugn`a etc.)

o Oordhvaga Virechana, Peyaa, Yavaagoo

o Adhoga Vamana, Tarpan`a

Oordhvaga Raktapitta:

Kan`t`hagata

o Pichchha + Grathita

o Kalpa

Naasaagata

o Astambhanaarha Upeks`haa

o Ati Raktasraava S`hamanaarha

o Stambhana Avapeed`a Nasya (S`heeta Dravya)

Adhoga Raktapitta:

Yonigata Pradaravat Chikitsaa

Mootra Maarga Gata + Rujaa Ksheerapaaka + Uttara Basti

Gudagata Kalpa + Basti Raktaatisaara Chikitsaa Raktaja Ars`ha Chikitsaa

Vaata Ulban`a Avasthaa Vibandha Maamsa Rasa Sevana

Description:

State of Upeks`haa

Since Raktapitta is a bleeding disorder initially in person who is not weak and if only vitiated Dosha_s are flowing out, then no attempt should be made to arrest the bleeding as untimely arrest invariably leads to complications like Paan`d`u (anemia), Grahan`ee (Intestinal motility disorder), Kusht`ha (Resistant skin diseases),Prameha (Urinary tract and system disorders), Gulma (Solitary lump in abdomen) and Jvara (Pyrexia / fever) etc.

S`hamanaarha Avasthaa

If a person afflicted with bleeding disorder is exhibiting one or more of the following he should be subjected to palliative mode of treatment immediately without delay

• weakness (Ksheen`a Bala),
• wasting / reduced power of muscle tissue (Ksheen`a Maamsa),
• emaciated by grief (S`hoka Kars`hita),
• carrying heavy load (Bhaara Kars`hita), or
• walking for long time and distance (Adhva Kars`hita),
• Affected by exposure to heat of fire or Sun (Jvalana Santapta, Aatapa Santapta),
• emaciated by other debilitating or wasting diseases (Kshee`nam Aamayaih),
• Pregnant/ expectant woman (Garbhin`ee),
• Child under sixteen years (Baala),
• having habit of consuming dry food (Rooks`haanabhuk) or
• consume food in less quantity (Alpaas`hana) or
• taking food at less times (Pramitaas`hana),
• who is not suitable for Vamana or Virechana (S`hodhana Anarha )and
• who is suffering from S`hosha ( Tuberculosis or wasting disease leading to progressive weight loss)

Should be treated by S`hamana Therapy.

• S`hamana

o By examining Langhanaarha and Brimhan`aarha, Tikta and Kashaaya Rasa substances should be used for S`hamana Therapy in Oordhvaga Raktapitta.

 

o Langhanaaraha persons should be administered Tikta (Bitter) and Kashaaya (Astringent) substance while Brimhan`eeya persons should be administeredMadhura (Sweet) substances, in case sweet tasting substances is not available a substances having sweet post digestive taste (Madhura Vipaaka) should employed.

 

o Madhura Rasa substances should be used for Adhoga Raktapitta.

o Vaasaa is the S`hamana drug of choice in Rakta Pitta.

 

• State of Langhana in S`hamana

 

o The state of Upekshaa is assisted by Langhana (Fasting which could be complete fasting to restricted food intake in the form of Tarpan`a). By examining theDosha_s (Dominant Dosha), Avasthaa (Oordhvaga or Adhoga or Tiryak), Saatmya (homologation) and Anubandha (associated Dosha) fasting should be done by consuming Tarpan`a.

 

o If Raktapitta is Oordhvaga, fasting is assisted by consuming Tarpan`a and if it is Adhoga fasting is done with consuming Peyaa, Yavaagoo etc. to controlVaata.

 

o After adequate fasting Sus`hruta advises the person to consume Peyaa with a little rice.

 

o The Rasa and Yoosha prepared by using Aromatic drugs and Sneha (oil or Ghee) are also suggested.

 

o Tarpan`a, Paachana, Avaleha and medicated ghee are also advised as per the condition and indication.

 

o The monitoring and protection of the persons physical power and mental strength is emphasized by Vagbhat`a throughout the management.

 

• S`hodhanaarha Avasthaa

A person suffering from Raktapitta exhibits aggravated Dosha_s, good strength and power, without muscular wasting and whose condition has arisen out of Santarpan`a, who can withstand S`hodhana and is devoid of complications should always be treated by S`hodhana.

 

• S`hodhana Pas`hchaat Samsarjana Krama

In a strong person suffering from Oordhvaga Raktapitta after Purification the sequence of food should consuming Tarpan`a and in case of Adhoga Raktapitta it should consist of Peyaa, Yavagoo etc. to establish control over Vaata activity.

 

• Mandaagni + Amla Rasa Saatmya

If the person suffers from Mandaagni and likes sour things to eat he should be given Tarpan`a prepared with sour substance which is not only harmless but also beneficial to him.

 

• Trishn`aa

The S`hritas`heeta Jala medicated with Tikta (bitter) drugs as well as fruit juices are suggested for Trishn`aa. By examining Dosha_s, Bala (Physical capacity) andAahaara (food consumption) water can be given in small quantity and at small time intervals in Trishn`aa.

• Grathita Rakta Avasthaa: –

In this condition clotting of blood occurs. Due to intermittent bleeding clots are seen in excreted blood. Excreta of pigeon (Paaraavata S`hakrit) mixed with appropriateAnupaana is used as medicine.

o Ati Nihsrita Rakta / Ati Raktasraava: –

This condition can happen in any type of Raktapitta due to extremely aggravated intensity and heat of both Rakta and Pitta. In this condition medicine in the form of medicated Ghee as well as fresh blood with honey is advised to be taken internally.

 

o Udeern`a Raktapitta: –

This is an acute disease and affects instantaneously like fire in terms of spread, causing damage and acuteness. The decoction of Rakta Stambhaka drugs should be used to treat Udeern`a Raktapitta.

 

Note: – The above given conditions can occur irrespective of the type and Dosha Praadhaanya. The following are the conditions which occur in any of the type ofRaktapitta.

 

Oordhvaga Raktapitta:

Oordhvaga Raktapitta is Saadhya type of Raktapitta. It is Kaphaanubandhi.

 

Oordhvaga Raktapitta:

• Kan`t`hagata

Kaphaanubandha + Sapichchha + Grathita Rakta: –

In this condition bleeding occurs from throat. The expectorated blood is found to be sticky due to mucous strands (Sa Pichchha), and along with clots (Grathita Rakta).Ks`haara is used in this condition though they are normally contraindicated. Ks`haara of Kamalanaala is used in this condition.

 

• Naasaagata

Avapeed`a Nasya of Raktapitta Naas`haka drugs is the procedure of choice. This is given only when vitiated Dosha_s are excreted.

To combat the effects of excessive bleeding use of fresh blood internally is advised as well as fresh goats liver is also advised to be consumed. Cold and Sweet substances should be used to treat Naasaagata Raktapitta.

 

Threat in treating Naasaagata Raktapitta

If bleeding is arrested when blood is still vitiated it produces Dusht`a Pratis`hyaaya, S`hiroroga, the smell of blood coming out from the nose resembles Pus or foul smell, power of smelling gets diminished / perception of smell is affected and Dusht`a Krimi appears in nose / the nose may exhibit presence of worm infestation in the later stages.

 

Guidelines for Oordhvaga Raktapitta (which doesnt get pacified):

Even after improved Agni, annihilation of Kapha, if bleeding persists then it is considered to be due to Vaata. Hence the management should aim at establishing normal flow of Vaata along its channels (Vaataanulomana).Vaataghna treatment should be done and Ksheerapaaka is the drug of choice for such condition.

 

Adhoga Raktapitta: –

This is Yaapya (remains controlled as long as the treatment is going on palliative) type of Raktapitta. In this Vaata is Anubandhi / associated Dosha. In this type bleeding occurs from Mootra Maarga (Urethra), Guda (per rectum), and Yoni (per vaginum) in females.

This should be differentiated from Raktaatisaara, Raktaja Ars`ha, Rakta Pradara like disorders resembling Adhoga Raktapitta.

 

• Vaatolban`a Raktapitta
  • Vibandha Avasthaa

Vibandha is a condition found in Vaata Pradhaana Raktapitta in which MaamsaRasa is the medicine of choice.

 

• Mootra Maargagata
  • Rujaa

Ks`heerapaaka is the drug of choice according to Charaka and Vaagbhat`a. Sus`hruta suggests Uttarabasti for managing this condition.

• Gudagata

Since the sign and symptoms are similar to Raktaatisaara and Raktaja Ars`ha, their treatment also shows similarity. According to Sus`hruta it should be treated by the medicines used in Raktaatisaara. In Raktasraavee Ars`ha treatment of Raktapitta can be used and vise versa.

Vaagbhat`a adds Basti as the procedure of choice for this condition

Similar Chikitsaa: –

• In Raktapitta, treatment of Pittaja Jvara is advised. Along with this Sarpigud`a from Ks`hataks`heen`a Chikitsaa are also suggested.

 

• Similarly in Adhoga Raktapitta, treatment of Raktaatisaara, Raktasraavee Ars`ha and Rakta Pradara is advised.

 

Wholesome things for the person suffering from Raktapitta: –

All Kashaaya and substances which are cold to touch and in potency are useful for treating Raktapitta in both ways i.e., internal as well as external.

 

Aahaara for Raktapitta (Pathya): –

 

• In Kaphaanuga Raktapitta Yoosha, S`haaka can be given as wholesome food.
• In Vaataanuga Raktapitta Maamsarasa, Yavaagoo can be given as wholesome food.

 

Vihaara (Life style): –

 

• All the cold and things favorable / conformable to the mind (Mana Anukoola) are advised in Raktapitta.
• For Basti Ksheera and Ghrita (plain as well as medicated) is indicated for Aasthaapana Basti.

 

 

Counter references: –

Ch. Chi.11/50 -77 Kshataksheen`a Chikitsaa Sarpigud`a.

Ch. Chi. 19/93 -94 Raktaatisaara Chikitsaa.

A.H.8/98 -101,107,123 Rakta Sraavee Ars`ha Chikitsaa.

 

Pathya –

Rasa –Kashaaya

Dhaanya – Jeern`a Shasht`ika S`haalee, Priyangu, Neevaara, Yava, Godhuma

S`himbee – Mudga, Masoora, Chan`aka, Aad`hakee, Makusht`a, Koradoosha, S`hyaamaaka

Maamsa – Ajaa, Matsya, Pakshee Maamsa Rasa, Hareen`a, Kukkut`a

Dugdha – Godugdha, Ghrita, Maahisha Ghrita, Ajaa Dugdha, Santaanikaa

Drava – S`heeta Jala, Naarikela Jala, Vaarun`ee, Audbhid Jala, Shritas`heeta Jala, Madhu + Jala, Shad`angodaka, Laghu Panchamoola Siddha Jala,

Phala – Panasa, Kadalee, Taalaphala, Daad`ima, Kharjoora, Aamalakee, Naarikela, Kapittha, Draaksha, Ikshu, Pakva Aamra Phala

Kritaanna – Utpalaadi Siddha Ksheera, Tarpan`a, Peyaa, Yoosha, Yavaagoo, Maamsa Rasa

Other – Mis`hreyaa, Laajaa, Saktu, Madhu, S`hrakaraa, Priyangu, Gajapippalee

Apathya –

Rasa – Kat`u, Amla, Lavan`a

Gun`a – Vidaahee

S`haaka – Rasona, Vaarataaka

S`himbee – Tila, Maasha, Sarshapa, Kulattha

Dugdha – Dadhi

Drava – Kaupa Jala, Madya

Other – Gud`a, Taambula, Viruddhaanna, Lavan`a, Vyaayaama, Pravaasa, Aatapa Sevana, Teekshn`a S`hodhana, Kshobha, Mala Mootraadi Vegadhaaran`a, Svedana, Raktamokshan`a, Dhoomapaana, Maithuna, Krodha, Kshaara

 

Synonyms:

• S`hosha -This is a disease in which a person gets wasted, dried out.
• Yakshmaa-A disease with many complications like S`hvaasa, Kaasa, etc. (It is a disease which needs continuous monitoring and attention like a deity.)
• Kshaya it lowers down the physical and mental activities.

 

Raajayakshmaa is a disease having:

1. Many diseases as prodromal signs.
2. It is very difficult to assess a disease as per the quality and quantity of vitiation of Dosha_s (Ams`hams`ha Kalpanaa)
3. It is very difficult to cure, it is Krichhrasaadhya
4. The strength of disease itself is more as it dominates over the strength of a patient.

 

Note: – As the disease progresses the Dhaatu are substantively depleted and their wastes increase proportionately. The solid food the fecal matter controls the Agni andVaayu activity in the body and it is also responsible for physical power to a certain extent, hence the sages advice protection of Pureesha in all the stages of management of Raajayakshamaa.

 

Saamanya Chikitsaa:

• The guideline for management of Raajayakshamaa is to assess the strength of the patient, his Dosha_s and his Agni, then decide upon the course of treatment.
• One, who has good self-control, has good digestive capacity with no emaciation and the disease of recent origin should be taken up for treatment.
• After purification therapies, when the digestive power is restored and the complications are allayed, the patient should be given bulk promoting diet.

 

Avasthika Chikitsaa:

Peenasa:

• Svedana
• Abhyanga
• Dhooma
• Lepa
• Parisheka
• S`hamana

S`hiras`hoola and Parsh`va Shoola:

• Pralepa
• Abhyanga
• Parisheka
• S`hamana
• Raktamoksh`ana by

• Sh`ringa
• Alaabu
• Jalauka
• Vyadhana

Bahudosha Avastha:

Snehana

Svedana

Vamana

Virechana

The recipes should contain Sneha (ghee) and should not be Karshan`a (depleting) in nature.

The recipes should be in accordance with the strength of the patient.

After the Kosht`ha has been cleansed the S`hamana therapy should be adopted.

 

Ati Kapha Praseka:

As Vaata Dosha is the main culprit behind it should be treated with Snigdha (unctuous) and Ushn`a (hot) remedies.

 

Chhardi:

Similar Chikitsaa as Sleshmaati Praseka; added to that all such diet and drinks which are Hridya and which alleviate Vaata Dosha should be adopted.

 

Atisaara:

Agni Deepana

Vaktra S`huddikara

Atisaara Nigrahan`a

Aruchi Chikitsaa

Jvara:

Raajayakshmaa associated with fever and burning sensation should be given the formulations described for Jvara (fever) along with ghee.

 

Importance of Maamsa in Raajayakshmaa:

The meat should be suitably selected and prepared as per the patients requirements.

• They are nourishing
• To promote the muscle tissues.
• Meat of carnivorous animals is Teeksh`na, Ushn`a and Laghu.

 

Baahya Chikitsaa:

A patient should take tub bath containing warm Sneha (oil, ghee), milk, and water. These baths help to open the obstructed channels and promote strength. This should be followed by gentle massage after smearing his/her body with Sneha.

 

Similar Chikitsaa:

All the complications such as hoarseness of voice etc. should be treated as per their respective treatment schedule and in accordance with the context as described in the classics

 

Vyavaayaja Shosha:

• Generally Vaataja disorders afflict the person suffering from Vyavaayaja S`hosha, hence Promotive measures which are unctuous and Vaata alleviating should be adopted.
• If one uses regularly faeces, urine, milk, ghee, blood, meat, and the patient should spend his days with a herd of goats etc. definitely gets rid of the disease-Raajayakshma.

 

Regime:

One suffering from this ailment should

• Abstain from:

o Grief

o Sex

o Anger

o Jealousy

Should:

o Entertain noble ideas.

o Worship physicians, Braahman`a, Gods, elders and teachers

o Listen to holy incantations from Braahman`a.

 

Pathya-

Rasa- Madhura

Dhaanya- Godhuma, Rakta S`haalee, Shasht`ika S`haalee, Yava

S`haaka- S`higru Phala

S`himbee- Mudga, Chan`aka

Maamsa- Ajaa Maamsa, Kravyaada Maamsa, Jaangala Maamsa Rasa, Harin`a

Dugdha- Ajaa Navaneeta, Dugdha, Ghrita, Goghrita, Maahisha Ghrita

Drava- Madya, Kaambalika

Phala- Bakula Phala, Badara Phala, Pakva Kadalee, Panasa, Aamra, Aamalakee, Kharjoora, Naarikela, Taad`a Phala, Draaksha

Kritaanna- Raaga, Khand`ava, Ves`havaara, S`hikharin`ee

Other- Mis`hreyaa, Pushkaramoola, Saindhava, Vaasaa, Khan`a S`harkaraa, Karpoora, Kasturee, Chandana

Apathya-

Rasa- Amla, Tikta, Kashaaya, Kat`u

Gun`a- Rooksha, Vidaahee

S`haaka- Karkot`aka, Kaaravellaka, Parn`a S`haaka, Vetraagra, Hingu, Vaartaaka, Sarshapa

S`himbee- Kulattha, Maasha, Rasona

Phala- Kalingad`am, Badara, Phala

Other- Kshaara, Virechana, Mala Mootraadi Vega Dhaaran`a, Svedana, Anjana, Jaagaran`a, Vishamaas`hana, Taambula

 

Introduction:

Prameha Chikitsaa generally divided into two categories.

1. S`hodhana
2. S`hamana

Generally, in Prameha Santarpan`a is always indicated.

 

Initially in the management of Prameha, a person has to be given Snehana and then appropriate preparation that is suited for the condition to induce S`hodhana. After adequate S`hodhana by Oordhva and Adhah Maarga he should be maintained on Santarpan`a.

 

Saamaanya Chikitsaa:

1. Kaphaghna
2. Medoghna
3. Kledahara
4. Hetuvipareeta
5. Various types of Apatarpan`a

 

Indications of S`hodhana:

Balavaan Rugn`a

Sthoola Rugn`a

Balavaan Dosha

S`hodhana Dravya:

Generally Pramehee Rugn`a should be advised Teekshn`a S`hodhana.

S`hodhana Dravya should be Snigdha e.g. Sarshapa, Kusumbha, Priyangvaadi Gan`a Siddha Taila or Ghrita etc. should be used for Snehana.

 

Due to untimely or excess Apatarpan`a following Vyaadhi can occur as complications:

Mootragraha

Rujaa

Gulma

Ks`haya

 

Pramehahara Vihaara:

Vihaara of Prameha aims at:

Kaphakshaya (eradicating Kapha substantively, qualitatively and / or functionally)

Medakshaya (depleting fat tissue and control adipose metabolism)

Rookshan`a ( creating dryness in the internal environment and controlling unctuousness and excess fluidity)

 

Following Vihaara are indicated in Prameha:

Rooksha Udvartana

S`hatayojana / Dviyojana / Treeyojana Bhraman`a [1 Yojana = 2.5 miles (M.W.)]

Raatri Jaagaran`a

Gos`hakrit-Mootra Vritti: (Pramehee should live with cows, use grains of cow-dung as food.)

Vedaadi Adhyayana (For Paapakrit Prameha, according to D`alhan`a)

 

Vyaayaama:

Heavy physical exercises are indicated in Prameha, e.g. Koopa khanana, S`hatayojana Chankraman`a; however Rugn`abala and Prameha type etc should be considered.Kris`ha Rugn`a should be advised light exercises.

 

Bhishagvarjita Madhumeha Chikitsaa:

Madhumehee Rugn`a, who is untreatable, should consume following drugs:

1. S`hilajaatu
2. Tuvaraka
3. Maakshika Dhaatu

A person suffering from Prameha on being subjected to the purificatory measures still does not respond to therapeutic management should, as a last resort should consume these drugs according to Sus`hruta.

 

S`hilaajatu Prayoga:

1 Tulaa (400 Tolaa = 5 Kg) S`hilajaatu (Asanaadi Kvatha Bhaavita)

 

Maakshikadhaatu Prayoga:

Tuvaraka Prayoga:

In Vaataja Prameha if there is association of Kapha dosha than Snehakalpana made from Kaphaghna Kashaaya should be used.

In Vaataja Prameha if there is association of Pitta Dosha than Snehakalpana made from Pittahara Kashaaya should be used.

Pathya-

Rasa- Tikta, Kashaaya

Gun`a- Rooksha, Laghu

Dhaanya- Koradoosha, S`hyaamaaka, Godhuma, S`haalee, Yava, Shasht`ika S`haalee, Uddaalaka, Trin`a Dhaanya

S`haaka- S`higru, Pat`ola, Punarnavaa, Kaarvellaka, Nirmalee Beeja, Kan`t`akaaree, Rasona, Gokshura, Mandaara, Nimba, Karchoora, Kamalakanda, Khaira, Laangalee, S`hun`t`hee, Maricha, Pippalee, Sarshapa, Atasee, Grinjanaka

S`himbee- Bharjita Chan`aka, Mudga, Kulattha, Makusht`a, Tila

Maamsa- Harin`a, Laavaa, Jaangala Maamsa, S`hushka Maamsa

Dugdha- Takra

Drava- Puraan`a Madya, Madya, Mantha, Khara Mootra, Maahisha Mootra, Seedhu, Madhu, Madhooka, Sarshapa Siddha Kaanjika, Vaat`ya Madya,

Phala- Udumbara, Puraan`a Kadalee, Kapittha, Jamboo, Kharjoora, Aamalakee, Tindooka, Amlikaa

Kritaanna- Yava- Godhuma Kritaa Padaartha, Yavaudana, Aapoopa, Kulmaasha, Utkaarikaa, S`hashkulikaa, Madhu+Khadeera+Maricha, Mudga, Kulattha, Aad`hakee, Chan`aka Yoosha, Vanachat`aka Maamsarasa

Other- Laajaa, Langhana, Deepana, S`hamana, Vamana, Virechana

Apathya-

Rasa-Madhura, Amla, Lavan`a

Gun`a- Abhishyandi

S`himbee- Nishpaava

Maamsa- Aanoopa Maamsa

Dugdha- Dadhi, Ghrita, Dugdha

Drava- Ikshu Rasa, Kaanjika, Nava Madya, Taila

Phala- Taad`a, Kushmaan`d`a

Other- Nava Anna, Paisht`ika Padaartha, Ikshu, Gud`a, Mootraavarodha, Dhoomapaana, Sveda, Raktamokshan`a, Divaasvaapa, Maithuna

 

Saamaanya Chikitsaa

• Snehana
• Svedana
• Dadhi Sevana
• Raktamokshan`a:

o Pleehaa Vriddhi: Siraa (Vein) from Vaama Baahumadhye (Left Elbow Joint)

o Yakrit Vriddhi: Siraa (Vein) from Dakshin`a Baahumadhye (Right Elbow Joint)

o Kshaara Karma:- Siraa (Vein) from Vaama Angusht`ha (Left Wrist Joint)

Pathyaapathya: Same as Udara

Pathya –

• Rasa-Kat`u, Amla, Lavan`a

• Gun`a-Laghu, Deepaneeya
• Dhaanya-Yava, Shasht`ika S`haalee, Godhooma, Neevaara, Rakta S`haalee
• S`haaka-Pat`ola, Punarnavaa, Kaaravellaka, S`higru Phala, Hareetakee, Aardraka, Saindhava, Taamboola, Yavakshaara, Las`hoona, Nis`hottara, Elaa, Braahmee,Vaastuka, S`harapunkhaa, Man`d`ookaparn`ee, Kaalas`haaka.
• S`himbee- Mudga, Maasha, Kulattha
• Dugdha-GoDugdha, Ajaa Dugdha,Usht`ra Dugdha, Maahisha Dugdha
• Drava- Go Mootra, Ajaa Mootra,Usht`ra Mootra, Maahisha Mootra, Madhu, Madhura Takra, Eran`d`a Taila, Seedhu, Suraa, Aasava, Arisht`a, Madhookajanita Madya
• Phala-Badara, Draakshaa, Mridveekaa, Ikshu, Kola
• Kritaanna-JaangalaMaamsarasayukta Peyaa, Amla and Lavan`a Rasyukta Yoosha,Maamsa Rasa, Panchamoolasiddha Aahaara

Apathya-

• Rasa-Lavan`a, Amla

• Veerya- S`heeta
• Gun`a/Karma-Guru, Abhishyandee, Vidaahee,Ushn`a, Rooksha, Atisnigdha, Pichchhila, Kshaara
• S`hooka- Dvidala Dhaanya, Tila
• S`haaka- S`haaka, Gud`a and Taila Yukta S`haaka
• Maamsa-Aanoopa Maamsa
• Dugdha-Dugdha, Dahi (In Prabhoota Matraa)
• Drava-Jalapaana, Mahendra Parvatajanya Saritaa Jala

Other-Paisht`ika Bhakshya, Lavan`a, Divaasvaapa, Vyaayaama, Sneha, Dhoomapaana, Siraavyadha, Vamana, Maargakraman`a.

 

Introduction:

This disease is of Aagantuka type. This disease is called so because occurrence of this disease is more in Phiranaga Des`ha. It is also known as Gandha Roga.

 

Types:

This disease is mainly of three types

• Baahya
• Aabhyantara
• Bahirntarbhava

 

Saamaanya Chikitsaa:

• Baahya
  • Dhooma Paana
  • Seka
• Abhyantara
  • S`hamana

Upadrava:

• Kaars`hya
• Bala Kshaya
• Naasaabhanga
• Agnimaandya
• Asthis`hosha
• Asthivakrataa

 

Precautions:

Lavan`a, Amla Rasa_s, Shrama, Aatapa Sevana, Adhva, Maithuna should be avoided.

Chikitsaa Description:

The disease in which colour of the skin becomes Paan`d`u Varn`a i.e Ketaki Dhoola Sannibha (Yellowish white) is called as Paan`d`uroga.

It is of five types as below-

o Vaataja

o Pittaja

o Kaphaja

o Sannipaataja

o Mridbhakshan`ajanya

Synonyms: – Kaamalaa , Apaanakee, Laagharaka, Alasakhya, Kumbhaahvyaa.

Saamanya Chikitsaa:

S`hodhana

o Vamana + Virechana

S`hamana

o Kalpa + S`hopha Adhikaarokta Kalpa

Vaataja à Sneha Pradhaana

Pittaja à Tikta + S`heeta

Kaphaja à Kat`u + Tikta + Rooksha + Ushn`a

Mridbhakshan`ajanya à Teekshn`a S`hodhana

Sannipaataja à Mis`hra

Description of Saamaanya Chikitsaa:

The basic treatment of Paan`d`uroga is as below.

o Vamana and Virechana (S`hodhana) should be given after proper Snehana (oleation therapy) with the help of Teekshn`a Dravya. For the same ghee medicated with S`hodhana Dravya can be used.

o For Snehana Kalyaan`aka Ghrita, Panchagavya Ghrita ,Daadhika ghrita, Kat`vara Ghrita.Aaragvadhaadi Gan`a Siddha Ghrita should be used.

o Though Vamana is contraindicated in Paan`d`u Vamana should be administered with Mridu Dravyaa_s should be used according to Des`ha Kaala Prakriti etc are used.(D`alhan`a T`eekaa S.U.44 )

o Pathyakara Aahaara should be given after proper S`hodhana.

o S`hamana Kalpaa_s should be given after S`hodhana.

o Ayas i. e. iron is the best S`hamana Medicine for Paan`d`uroga. Therefore, various Loha formulations should be used e.g. Navaayas Loha, Taapyaadi Loha etc. according to Dosha domination.

o The formulations used for treating S`hotha are also useful in treating Paan`d`uroga.( A. H. Chi. 16/57)

o Laghu Panchamoola Siddha Jala (Decoction of Laghu Panchamoola)or Juice of Aamalkee is used for Dietary regime and to drink.

 

Precaution to be taken: – In Paan`d`u, S`hodhana should be done multiple times to expel Dosha Situated in Srotas Dhaatu and Aas`haya completely, as the residualDosha may cause edema.

Vaataja Paan`d`u:

S`hodhana as mentioned above.

The S`hamana medicine should be predominantly Siddha Ghrita (medicated ghee preparations)

Pittaja Paan`d`u:

S`hodhana as mentioned above.

S`hamana Dravya should be Tikta (bitter) and S`heeta (cold) medicines.

Kaphaja Paan`d`u

S`hodhana as mentioned above

S`hamana Kalpa should be Tikta (bitter), Kat`u (pungent), Rooksha (dry) and Ushn`a (hot). Haritakee soaked in cows urine should be used for Virechana.

Sannipaataja Paan`d`u:

S`hodhana as mentioned above.

S`hamana Kalpa should be selected examining the dominance of Dosha at the respected time.

Mridbhakshan`ajanya Paan`d`u:

S`hodhana as mentioned above. Teekshn`a S`hodhana Dravyaa_s should be used by examining Vyaadhi Bala (stage of disease) and Rugn`a Bala (condition and strength of suffering person).

After S`hodhana, medicated ghee should be used to improve strength.

For withdrawal / elimination of the addiction of eating soil, the soil medicated with Krimighna and Tikta (bitter) medicines is used.

 

Counter references if any

Goudarisht`a i.e. Abhayarisht`a , Madhvaasava , S`harkaraasava, Mootraasava from Kusht`ha Chikitsaa ,Kshaarakrita Aasava from S`hleepada should be used. In addition, diet that is suitable and wholesome should be administered.

 

Pathya:

Rasa- Kashaaya

Gun`a- Snigdha, Anulomaka

Dhaanya- Jeern`a Yava, Godhuma, Bhakta, S`haalee

S`haaka- Pat`ola, Jeevantee, Kshaara, Matsyaakshee, Gud`oochee, Tan`d`uleeyaka, Punarnavaa, Dron`apushpee, Palaand`u, Moolaka, Rasona, Hareetakee, Haridraa, Naagakes`hara, Chandana, Bimbee

S`himbee- Kulattha, Tila, Aad`hakee

Maamsa- S`hringee Matsya, Kukkut`a

Dugdha- Maahisha Ghrita, Godugdha, Ghrita, Takra, Navaneeta

Drava- Taila, Sauveeraka, Tushodaka, Gomootra, Laghu Panchamoola Siddha Jala

Phala- Jeern`a Kushmaand`a, Kadalee(Apakava), Aamara, Aamalakee, Draaksha

Kritaanna- Mudga, Aad`hakee, Masoora Yoosha, S`higru Beeja + Saindhava, Jaangala Maamsa Rasa

Other- Chhardi, Virechana, Yavakshaara, Loha Bhasma, S`hunt`hee, Mand`oora

Apathya:

Rasa- Alma, Lavan`a

Gun`a- Ati Ushn`a, Vidaahee, Kshaara, Viruddha, Asaatmya, Teekshn`a

S`haaka- Patras`haaka, Sarshapa

S`himbee- S`himbee Dhaanya, Maasha, Nishpaava, Tila

Drava- Ambupaana, Dusht`a Jala Sevana, Madya

Other- Hingu, Yava, Pin`yaaka, Dhoomapaana, Chhardi, Mala Mootra Vega Dhaaran`a, Svedana, Maithuna, Pin`yaaka, Taambula, Mrittikaa Bhakshan`a, Divaasvaapa