Pathogenesis of Chhardi
Increased Dosha are expelled out in upward direction through mouth it is called as Chhardi (Vomiting or Sickness). It is an acute condition and if neglected can lead to acute dehydration and further complications.
Types of Chhardi
Chhardi is of five types.
o Dauhridajaa due to insult of likings of pregnant woman
o Aamajaa in diseases like Visoochikaa
o Saatmyaprakopajaa (Saatmya Tyaagaat) suddenly giving up the Saatmya.
o Krimijaa due to worms
All types of Chaardi have the same cause, the irritation of Aamaas`haya. As it Aas`haya of Aama, its irritation is treated by treating Aama. Langhana (Fasting with light food or without food) is the best remedy for treating Aama. Also regime like Saatmya Annapaana, S`huska Phala Sevana, and Application of aromatic powders, follow by bath should be given. In addition, mouth should be washed with cold water.
If the person suffering from Chhardi is Balavaan (having capacity / strength to tolerate
effects of disease as well as treatment), should be treated by Kapha – Pittaghna S`hodhana i.e. Vamana and Virechana. Vaata gets aggravated by Vamana or Virechanahence in Vaataja Chhardi both the procedures should be avoided.
Durbala (weak) patient should be treated by S`hamana and Langhana.
Drugs and diet should have following properties:
Manodnya (liked / favorite)
Laghu (easy to digest)
Saatmya (wholesome / habitual)
Sugandhi (flavored / aromatic)
After having food sprinkling of cold water on face is also suggested. These all things are advised for pacification of Dosha and Chhardi increasing the strength. Laajaa is the best S`hamana Dravya for Chhardi.
S`hodhana is contraindicated in Vaataja Chhardi, if administered likely complications are chest pain or Hridaya Drava etc. Hence, only S`hamana is the choice to treat.Ghrita is the drug of choice in this condition. It is used with Saindhava (rock salt) or medicated Ghrita are used.
Sneha Virechana (Virechana by unctuous medicines or medicines along with ghee or oils like Eran`d`a Taila) is also advised by Sus`hruta Samhitaa. Ghrita added withKat`u and Lavan`a Dravya is indicated for drink so as to pacify Vaata Dosha.
Kashaaya indicated in Vaataja Jvara should be used to treat Vaataja Chhardi.
Pittaja Chhardi should be treated by Virechana as it is best S`hodhana therapy of Pitta. Pratimaarga (in opposite direction) S`hodhana helps in Vaataanulomana and ultimately pacification of Chhardi. Mridu Virechaka Dravya like Draakshaa, Ikshurasa, Tilvaka Ghrita should be used.
If Pitta is more aggravated in Kapha Sthaana, it should be alleviated by Vamana because it is the nearest way of letting Dosha out from Kaphaas`haya. For this Madhura(sweet) and Tikta (Bitter) medicines are used.
For Kaphaja Chhardi, Vamana is the treatment of choice as it is the best S`hodhana therapy for Kapha Dosha. If the person suffering from Chhardi is weak, he is treated by S`hamana Kalpa, which is supported by Kaphaghna and Hridya Aahaara.
Tridoshaja Chhardi is treated by combinations of the medicines used in Vaataja, Pittaja and Kaphaja Chhardi respectively after carefully assessing the Dosha dominance, season in which the disease has occurred, Rogabala (intensity / state of disease – Saadhya / Asaadhya) and Agnibala etc.
As other Saannipaatika diseases Chhardi too exhibits bizarre signs and symptoms hence the physician has to be innovative it its management. All possible permutations and combinations of medicines, procedures etc. have to be employed depending upon the apparent Dosha dominance along with due consideration to the season of onset, physical power of the person and his digestive capacity as well as the strength of the diseases with its prognosis.
This type of Chhardi is also called as Manobhighaataja Chhardi. The first step of treatment is to avoid / refrain from the causative factors. This is supported by indulgence in favourite food, fragrance of flowers, soil (wet soil), sour fruits etc. Aas`hvaasana and Harshan`a (counseling) are also equally important to divert the persons attention from the cause.
Sus`hruta Samhitaa advocates treatment for specific type:
Aamaja Chhardi Langhana, Vamana
Asaatmyaja Chhardi Saatmya Aahaara, Vihaara
Bibhatsaja Chhardi Hridya Aahaara, Vihaara
Dauhrid Avamaanaja Chhardi completing the demand
Krimija Chhardi Treat as per Krimija Hridroga
Charaka Samhitaa specifies it as the route of causative factor is the best way of using medicine for the disease e. g. if Chhardi is caused by Asaatmya Gandha it should be treated by Saatmya Gandha.
Saatmya is homologous stimulus response; some substances are homologous from birth due to the Prakriti while others become homologous by repeated consumption / habit forming. Sudden deviation from usual, homologous behaviour is a cause for diseases like Chhardi. Hence the principle of management is to restore the homologation that is disturbed and allay the condition. The various ways it could be done are described above.
Prasakta Chhardi (chronic / persistent vomiting):
Excessive Chhardi causes Dhaatukshaya (dehydration, loss of fluid content first and finally the unctuous content too, resulting in depletion of the volume of Dhaatu), resulting in Vaata Prakopa which creates further complications. Stambhana and Brimhan`a treatment advised in Vamana Karma Atiyoga should be given in this condition.
Sarpigud`a, Maamsarasa, Ghrita (Medicated as Kalyaan`aka, Tryooshan`a, Jeevaneeya) as well as Pathya Leha are also used to treat Prasakta Chhardi
Gun`a / Karma – Laghu, S`hushka, Saatmya
Dhaanya – Bharjita Yava, Jeern`a Shasht`ika S`haalee, Godhuma, Bharjita Godhuma, Tand`ula
S`himbee – Sateena, Maasha, Bharjita Mudga, Chan`aka
Maamsa – S`has`ha, Mayoora, Tittira, Laavaa, Jaangala Maamsa, S`hushka Maamsa
Phala – Naarikela, Nimbuka, Aamalakee, Badara, Draakshaa, Kapittha, Haritakee, Daad`ima, Maatulunga, Aamara, Mridvikaa
Kritaanna – Laajaa Mand`a, Yoosha, Raaga, Khaand`ava, Paanaka, Avaleha, Khad`a
Other – Madhu (Pushpottha), Gomootra, Kambalika, Madya, Suraa, Jaatiphala, Us`heera, Nimba, Vaasaa, S`harkaraa, Mis`hreyaa, Naagakes`hara, Vetrragra, Dhaanyaka, Virechana, Vamana, Langhana, Hridya Padaartha, Kasturee, Chandana, Priya Peya
Gun`a/ Karma – Snigdha, Ushn`a, Vidaahee, Drava
S`haaka – Alaaboo, Bimbee, Kaaravellaka, Chitraka, Meda, Sarshapa