Amlapitta: Acidity, Heartburn, Gastritis
The three doshas present in the humansm, namely, vata, pitta and kapha are situated in the grahani (duodenum) that is the seat of digestive fire or agni. Fasting, eating during indigestion derange the pachaka pitta and agni pachak pitta vitiates with its drava, tiksna, ushna property. This process is known as "amla pitta " and the symptoms in amla pitta resemble with the symptoms in hyperacidity and gastritis. Amla pitta is classified in two broad categories, namely :
• Adhoga Amplapitta (downward)
• Urdhwaga Amplapitta (upward)
• Amlapitta caused by Vata, Pitta & Kapha
Hetu (Causative factors)
• Consumption of food incompatible combination (viruddha anna)
• Contaminated food (Dushta anna)
• Sour (Amla) food
• Spicy food such as pickles, papad etc that cause burning sensation inside vidahi
• Similar food and drinks that cause increase in pitta
Symptoms of Urdhvaga (upward) Amla pitta
• Vomiting of green, yellow, blue, black, slightly red or of bright red color having sour material that resemble mutton wash, sticky, thin, followed by kapha.
• Vomiting occurring during digestion of food or due to empty stomach with bitter or sour taste occasionally.
• Belching of similar nature.
• Burning sensation in the throat, chest and upper abdomen.
• Burning sensation in the palms and soles.
• Feeling of great heat.
• Loss of appetite.
• Fever of kapha pittaja type.
• Appearance of rasnas.
• Circular itching studded with numerous small vesicles on the skin.
Symptoms of Adhoga (downward) Amlapitta
• Burning sensation
• Downward movement of different kinds of diarrhea
• Occasional oppression in the chest
• Rashes on the skin
• Poor digestion
• Yellowish skin
Symptoms of Amla pitta caused by Vata, Pitta & Kapha
Following are the symptoms of amla pitta caused by vata :
• Feeling of pins and needles
• Weakness of body parts
• Pain and darkness before the eyes
Following are the symptoms of amla pitta caused by pitta:
• Expectoration of thick phlegm
• Feeling of heaviness
• Loss of appetite
• Coating on the tongue
• Burning sensation
• Loss of strength
• Itching of the skin
• More sleep
Following are the symptoms of amla pitta caused by kapha and pitta both:
• Eructation having bitter
• Sour and pungent tastes
• Burning sensation in the chest upper abdomen and throat
• Loss of appetite
• Vomiting lassitude
• Sweet taste in the mouth
Medication recommended for Amlapitta (upward evacuation):
• Emesis with mild emetic drugs and downward evacuation with laxatives.
• After evacuation, purification of the body the patient should take snehapana (oleationtherapy) and shaman chikitsa ahara (pacificatory management) should be administered.
• Anuvasana basti (or enema prepared with unctuous substances and medicament).
• Samshodhan Chikitsa in which all the three doshas are vitiated in amla pitta samshodhan (evacuation).
Medication recommended for urdhvaga amlapitta (upward amlapitta):
• Vamana or emesis
• adhog amlapitta (downward amlapitta) virechana (or evacuation by purgatives and laxatives).
• For patients with dominance of kapha dosha, decoction of parval leaves, neem-leaves madanphala, honey and saindhav should be given for emesis or nishottar powder added with kwath should be given to a patient as a purgative.
• Edibles made of yava (barley) and godhuma (wheat) should be given to patients without salt, red chilli powder or sour and pungent in taste.
• Sugar and honey with Laja sattu should be regularly taken in diet.
Pathya-apathya (dos and don'ts)
1. Old rice (shali), yava, godhum, mudga, jangal, mamsarasa, bilwa, kapitha, parval, bitter gourd (kararela), vastukam dhatri (amalaki), dadima (pomegranate), mustha and all edibles bitter in taste are recommended in amla pitta.
Til (sesame) mash (black gram), kultha taila Avidugdha (milk of goats), Dhanyamla (vinegar), salty, pungent and spicy food, food item those are heavy (guru) for digestion (digest with difficulty), dadhi (curds) and alcohol immediately
Amavata (Rhumatoid Arthritis)
In terms of medicine ama refers to the events that follow and the factors that arise as a consequence of impaired functioning of 'kayagni' whereas in literal terms the word "Ama" means unripe, immature and undigested.
This diseased condition is not specifically mentioned in Charak Samhita, Sushrut Samhita or Vagbhata Samhita. But the signs and symptoms of sama tridosha are mentioned in different chapters.
According to Vagbhata (A .H. Su. 13/25) due to the hypo functioning of ushma (Agni), the first dhatu viz. the rasa or chyle, is not properly formed and the anna-rasa undergoes fermentation or putrefaction (dushta) being retained in the amashaya. This state of rasa is 'Ama' where the impaired vatadi doshas being mixed up with one another lead to the ama-dosha.
The disease 'amavata' is formed due to such vitiated ama-doshas. 'Madhav-nidana' explains this disease descriptively.
In Charak Samhita (Viman Sthana, Adhyaya 2), there is description of the causes of over-production of ama due to deficient and excessive consumption of food where Charak.
• Vata produces colic pain, body ache, distension of abdomen, dryness of mouth, fainting, giddiness, irregularity of digestion, stiffness of back and waist, constriction and spasm of blood vessels.
• Pitta produces fever, diarrhea, thirst, internal heat, giddiness and delirium.
• Kapha produces vomiting, anorexia, indigestion, fevers with cold, lassitude and heaviness in body.
Hetu- Etiological Factors
• Indulgence in incompatible foods and habits.
• Lack of physical activity after taking fatty foods.
• Those with poor digestive capacity, even normally, also produce ama (improperly digested food) in the body.
In this situation vata is predominant and pain is severe.
In this situation pitta is predominant and burning sensation, redness of the affected joints is present.
In this situation kapha is predominant and loss of movement and itching is seen
Roopa- Signs and Symptoms
• Pain all over the body.
• Loss of taste.
• Lack of enthusiasm.
• Swelling of body parts
Following are the lines of treatment:
• Langhana (fasting)
• Swedana (fomentation)
• Katu-tikta deepan- bitter medicines to promote digestive power
• Virechan (purgatives).
• Snehpana (ingestion of unctuous substances)
• Basti (enema).
• Dry fomentation-using sands like dry substances
• Upanaha (local application) of non-unctuous substances
• Langhanum (fasting)
• Swedanum (fomentation)- local hot fomentation using sand etc.
• Mild purgatives, which digest ama also such as eranda sneha, drugs like gandharva haritaki can be given.
• Enema or basti- Kshara basti such as vaitarana basti.
Pathya-apathya (dos and don'ts)
1. Yava (barley), kulattha (horse gram), raktashali (rice), vastuk, shigru (drum sticks), punarnava, karvellak (bitter gourd), parawar, ardrak (ginger), hot water, rasona or ginger (shodhit with takra), jangal mansa (meat).
2. Curd, fish, jaggery, milk, flour of mash (black gram), dushit jala (contaminated water), viruddha bhojan (incompatible food), asatmya food, control of natural urges (vegavrodh), visham bhojan, heavy, slimy foods (pischhil).
In shvayathu (shotha) chikitsa, Charaka described granthi (tumor), galaganda, apachi (scrofula) etc. while Sushruta as well as Madhava both described arbuda and mentioned similarity in the symptoms of their respective granthis and stated that granthi and arbuda are similar in site, etiology, characters, doshas and dushya.Following are the six types of arbuda:
Sushruta mentioned one more type of arbuda in kshudraroga called as 'sharkararbuda' (S.N. 13/25-27) and while describing prognosis (sadhyata) of arbuda, Sushruta mentioned two more states of this as -
According to Samprapti- (S. N. 11/ 13): Increasing doshas, invade the muscles and blood and produce round (vrittam), immovable (sthiram), slightly painful (manda ruja), big (mahan), deep-seated (unalpa moolam), slowly increasing (chira vruddhi), non-suppurating (apakam) tumors of muscular tissue are called arbuda.
Roopa (Signs and Symptoms)
• Vataja arbuda
Mass is black in color, soft, resembles a bladder (bas (basti), and when pricked exudes thin and pure blood. Patient feels different types of pain, such as - expanding, tearing, pricking, pulling, churning and cutting.
Mass is red or yellowish - red in color and exudes large amount of warm blood if pricked.
Patient feels severe burning sensation (dhoopyate), sucking pain (chushyate), excessive suppurating (papachyate) is there and feels as if burning with fire (prajwalativ).
Mass is cold in touch, not having any discoloration, very hard like stone, slow growth rate, and when pricked exudes thick white puss Patient feels mild pain with severe itching.
Mass will have increase or decrease in size in accordance to that of body, unctuous (snigdha). If pricked exudes thick fatty material resembling paste of sesame seeds or ghee.
Patient feels severe itching with no pain or mild pain.
Increased dosha invades the blood, compresses and constricts the blood vessels (sirastu sampidya- sankochya) gets suppurate and produces big sized muscular tumor; studded all over with sprouts developing quickly and discharging large quantity of blood constantly.
This makes the patient to suffer from pandu (anemia) and complications of loss of blood.
This is said to be more common in those who are fond of eating non-vegetarian food. Body assault, by the fist etc makes derangement in mansa and gives rise to shotha (swelling), which is painless, smooth, and same in color as of skin, non-supportive, hard like stone, and immovable.
One more arbuda developing after, the course of the earlier on, is known as adhyarbuda.
Another arbuda developing concurrently with the first one is known as Dvirarbuda.
Vata and kapha both make site in mansa, sira, snayu and meda and develops mass or tumor. When this mass bursts, it exudes like honey, ghrita and vasa; then vitiated vata of that place dries up mansa and produces crystals like sugar (sharkara).
• Upanaha should be applied mainly to those arbuda, which are made up of mansa (meat) and vesawar.
• Fomentation (nadi sweda) and blood letting by shringa (horn) should be done periodically.
• Milk and kanji is to be processed first with the decoction of vata-shamak drugs (drugs which alleviates vata, such as - devadaru). Then oil is processed from the milk-kanji-decoction, which is called shatpaki oil. The patient should drink this oil.
• Ghrita (ghee), oil and fat (vasa) processed with the above said vata-shamak dravya (drugs) decoction, milk and kanji should be drank • Pittaj arbuda -
• In this type of arbuda mild fomentation and upanaha (poultice) is preferred such as drava sweda.
• Poultice (upanaha) of drugs mentioned in kakolyadi gana triturate in milk and kanji should be applied in lukewarm state (not so hot).
• Same drugs are applied on (bandhana), kakolyadi gana, kshirakakoli, jivak, rushabhak, mudgaparni, mash-parni, meda, mahameda, amruta, karkatshrungi, tugashiri, padmak, prapaundarik, ruddhi, vruddhi, mridvika, jivanti and yashtimadhu.
• Mild purgatives should be used.
• Arbuda should be rubbed with the leaves of udumbara and gojivha, priyangu, rakta chandan, lodhra, anjan and yashtimadhu mixed with honey should be applied on it frequently.
• After blood letting local application of aragwadha, gojivha, kataphal and krishna nishoth should be done.
• Processed ghee made up of krishna nishoth, girivha, anjan, draksha rasa/ yavatikta juice, together with yashtimadhu kalka (paste) should be given to the patient to drink.
Pathya-apathya (dos and don'ts)
1. Puran ghrita (old ghee), shali rice, yava (barley), mudga (green gram), patol, rakta shigroo, karavellak, shalishak vetagra, dry and bitter dravya, all deepan (which improves digestion) dravyas, guggulu and shilajatu.
2. Milk, Ikshu and dugdha vikrutis (products made up of sugarcane and milk e.g. curd, jaggery etc), meat of aquatic animals, sweet, sour, heavy (guru) and products, which block channels (abhishyandi).
The excessive elimination of watery stools from guda (anus) is known as atisar. It is Aashukari, which means that it is not treated well in time it results in severe dehydration that may prove fatal.
• Drinking large quantity of water
• Eating emaciated & dry meat
• Unaccustomed foods
• Puddings of tila (sesame seeds)
• Sprouted grains
• Excess of wine
• Foods which are dry (non-fatty) & in large quantity
• From arshas (piles)
• Improper oleation therapy
• Suppression of urges
Poorvarupa (premonitory symptoms)
• Pricking pain in the region of heart
• Rectum & alimentary tract
• Weakness of the body
• Flatulence & indigestion.
Classification With respect to each Dosha separately:
• Kaphaja From all of the doshas together
• Tridoshaja, one each from Bhayaja (fear) & Shokaj(grief).
Rupa (clinical features)
Feces are watery, very less in quantity, expelled out with noise, severe pain & difficulty.
Feces are yellow, black turmeric like (deep yellow) or algae like (green) mixed with blood & foul smelling. Patient suffers from excessive thirst, fainting, perspiration, burning sensation, elimination of feces is accompanied with pain, burning sensation & ulceration of the rectum.
Feces are solid, slimy, white, fatty, uncooked, mixed with Kapha (mucus), frequent, heavy, foul smelling, accompanied with difficulty of elimination & followed by pain. Patient feels sleepy, lazy, dislikes food, has mild straining at stools (or tenesmus), horripilation, nausea, feeling of heaviness of urinary bladder, rectum & abdomen & feeling of non-elimination of feces though actually eliminated.
Has all the features simultaneously i.e. it is manifested with symptoms of all doshas.
Bhayaja & Shokaja Atisara
Vayu gets vitiated quickly by fear & anxiety. This diarrhea caused by fear and anxiety are psychic & exogenous. The mind disordered by fear causes increase of pitta & vayu which cause the feces to become liquid & produce diarrhea, elimination is quick, feces is warm, fluid like, floating (on water).
• Langhana (fasting) is ideal at the commencement (of the disease) even in that kind arising from vata (as well as in others).
• The patient of diarrhea, who is suffering from pain in the abdomen, flatulence and excess of salivation should be made to vomit (by using drugs).
• Purgation's and vomiting.
• When the doshas have given rise to flatulence, heaviness, pain and loss of movement of the abdomen, then (the use of) pranada (haritaki) restores life, by clearing out the obstructed doshas, effectively.
• When the doshas are slightly increased, fasting is indicated. Water well cooked with either vacha and prativisha, musta and parpata or hrida and nagara should be given (in plenty) to drink.
• When weak hunger is felt patient should be given light foods, in little quantity, at the proper time; that undergoes digestion quickly and bestows taste, strength of digestive fire (digestive juices & enzymes) and of the body.
It is the combination of two words namely, Chhad meaning to cover / enclose / fill and Ard means Pain / discomfort thus giving the whole term he meaning of discomfort due to vomiting. During vomiting, the vomitus covers / fills the mouth completely & causes immense discomfort to the body.
• Dwistharthaja (contact with digesting object)
• Utklesha - means nausea.
• Kapha praseko - excessive salivation.
• Dwesho ashaneya - aversion to food.
Atidrava - excessive intake of liquids
Atisnighda - excessive intake of unctuous food
Ahridya - something that does not suit one's taste
Atilavan - Excessive salty food
Atimatra - Untimely intake of food & over eating
Asatyma Bhojan- incompatible food / allergies to certain foods
Shrama - fatigue
Bhaya - fear
Shoka - grief
Udveg - anger
Ajeerna - Indigestion
Krimidoshata - worm infestation
Naaryascha Aapannasatva - vomiting of pregnancy
Atidrutamashnata - to gulp down food without chewing it properly
• Vibhistdarshana- contact with digesting object
Roopa (clinical features)
• Pain in cardiac region, head & navel
• Dryness of mouth
• Hoarseness of voice
• Priking pain
• Loud sound of eructation while vomiting
• Vomitus is frothy, broken up, black color, thin & astringent, little in quantity. Vomiting is with great difficulty but with severe impulse & great distress.
• Pittaja Chhardi
• Dryness of mouth
• Burning in head, palate & eyes
• Feeling of darkness & giddiness
• Vomitus is yellow, green, hot, bitter & smoky.
• Kaphaja Chhardi
• Sweetness in the mouth
• Excessive salivation
• Vomitus is unctuous, solid (concentrated), sweet & white & vomiting is accompanied by horripilation.
• Severe pain in abdomen
• Dyspnoea & fainting
• Vomitus is salty, sour, blue, viscous, hot & red.
• The person when stressed psychologically by factors, which inflict the psyche such as smell, vision, or eating, disgusting, antagonistic, unclean, putrefied objects vomits.
• Langhana (fasting) is indicated in the beginning itself, except in vomit caused by vata.
• For those who are strong, have great increase of doshas and who continue to vomit large quantities repeatedly a vamana (emesis) is to be administered.
• In vireka (purgation) wine, fruit juices or milk (as adjuvant to the purgative drug) should be used
• For those, who are dry and debilitated, samana ausadhas (drugs which mitigate the doshas) only should be administered.
• Ghee mixed with saindhava, made warm and drunk cures vomiting caused by vata especially, also cough and palpitation; or that (ghee) mixed with more of trikatu and trilavan or that prepared with the
• For vomiting arising from pitta, in order to produce purgation (powder of trivrit mixed with juice of drksha and iksu or tailvaka sarpi should be administered.
Hidhma or Hikka (Hiccup)
This disease has been given this name because the sound produced during this ailment is 'hic'. The causes, pre-symptoms, number of hidhma (hiccup) are the same as those of shwasa.
The ailment of hikka has been classified in the following categories:
• Annaja Hidhma
• Kshudra Hidhma
• Yamala Hidhma
• Mahati Hidhma
• Gambhira Hidhma
Roopa (clinical features)
Annaja Hikka Hiccups are produced by the consumption of foods and drinks that are tough, improper, dry and penetrating. All these types of food items aggravate Maruta (vata) that hiccups that are painless. If the hiccups are followed by sneezing and subsiding with the use of accustomed foods & drinks it is known as Annaja Hikka (hiccup produced by unaccustomed food).
The Hiccups starting from the root base of shoulders with mild and soft bouts caused due to increased exertion that consequently increases pavana (vata) produces Kshudra (minor).
As it comes in pairs, with force (vega) and during parinamkala (digestion) of food it is called vegini and parinamvati Hikka that commences after taking food & increases during period of digestion, coming up in pairs, causing tremors of head & neck, flatulence severe thirst, irrelevant talk, vomiting, diarrhea, unsteady eyes, & yawning.
This hikka arises from deep inside with great sound & forceful bouts. This hikka is manifested with rigidity (loss of movements) of the brows, eyes are red & full of tears, loss of movements of the body, speech, memory & general awareness, obstructing the passage of food, producing a feeling as though vital organs are being hit, bending of the body backwards, and emaciation.
This starts from either pakvashaya (large intestine) or nabhi (umbilicus) and has similar features as Maha Hikka like more yawning and a vibrating sound (of hiccup).
Snehan- Svedana (Oleation and Sudation)
1. Hidhma patients should have administered Sweda (Sudation) after anointing the body with oil mixed with salt. After sudation, the patient should be made to eat rice, dadhi (curds). Then, a mild emesis therapy should be given, especially for those who have cough, vomiting, catching pain in the region of the heart and diminution of voice, by using Pippali, Saindhava and honey, which is not opposed to Vata (which does not aggravate vata). Following method must be a purgative drug mixed with saindhava and any sour fruit followed by warm water should be administered to produce purgation. It is beneficial to clear the passage by administration of purifactory therapy of both the upper and lower parts of the body.
If by the above treatment the disease does not subside the Kapha dosha leaves of haridra, root of eranda, laksha, manashila, devadaru, ela, and mansi, are made into a paste and a cigarette prepared. It should be lubricated with ghee and smoked. Or smoke of yava mixed with ghee, or smoke of madhucchista, sarjarasa and mixed with ghee; or smoke of aguru or of chandana or of guggulu, of manohva or of resin of sala, sallaki, guggulu, aguru or padmaka-each one lubricated with ghee.
Swedana (sudation therapy) is essential for those who are fit for it and even those who are unfit, should be given sudation for a moment (short duration) either by pouring warm milk mixed with sugar, or oil; or by utkarika and upanaha (warm poultices) especially over the chest and throat.
• A mud pot smeared inside with ghee coated (inside) with the paste of pippli, pippalimula, pathya, jantughna and chitraka. After the paste dries up; the pot is filled with takra (buttermilk) and kept undisturbed for a month; this is carminative and cures dyspnoea, hidhma and cough.
• Jivanti, musta, surasa, tvak, eladvaya, pushkara, tamalaki, aguru bharangi, nagara, karkata, shathi, krishna, nagakeshara, are made into nice powder and mixed with sugar, double its quantity are used as when desired. It cures pain in the flanks, fever and cough and best to relieve hiccup and dyspnoea. Cough, dyspnoea, constipation, vomiting and hiccup should be treated with therapies indicated for one another.
The verbal root of word kaasa is 'Kasra - Kushabde' meaning that which produces abnormal sound. It is called so because of Yathoktagatimatvath i.e. specific movement & Uraprabruthishanthachha (painful effect on chest).
Kaasa has the following five types:
• Three coughs caused by the three Doshas (Vata, Pitta & Kapha)
• The fourth type of cough (Kshataj) caused by chest wound
• Fifth type of cough is (Kshayaj) i.e. consumption.
Poorvaroopa (Prodominal Symptoms)
• ShookPurna Galaasyata (throat & mouth as if covered with thorns).
• Kanthe Kandushcha- i.e. itching in throat.
• Bhojyanam Avarodh- i.e Aruchi (anorexia) or difficulty in intake of food.
• Intake of coarse
• Little & deficient food
• Excessive indulgence in sex
• Suppression of urges and exertion
Roopa (clinical features)
• Dry cough
• Intense pain in cardiac region, sides, chest & head
• Hoarseness of voice
• Dryness of chest, throat & mouth
• Feeling of darkness
• Sound like that of conch or clouds
• Anxious expression
Hetu & Roopa of Pittaja Kaasa
• Excessive intake of pungent, hot, burning, sour & alkaline substances
• Heat of fire
• Sun causes
Roopa (clinical features)
• Yellowness of sputum & eyes
• Bitter taste in mouth
• Disorder of voice
• Fuming in chest
• Burning sensation
• While coughing the patient constantly sees as if stars & expectorates phlegm mixed with Pitta.
Hetu & Roopa of Kaphaja Kaasa
• Excessive intake of heavy, slimy, sweet & unctuous foods & drinks
• Sedentary habit
Roopa (clinical features)
• Loss of appetite
• Sweetness in mouth
• On expectoration profuse, sweet, unctuous & viscous phlegm without pain is coughed out.
Hetu & Roopa of Kshataja Kaasa
• Excessive sexual indulgence
• Weight lifting
• Combat with horses and elephants (i.e. Physical exertion disproportionate to one's strength) in a person who is already suffering from Urahkshata (chest wound).
Roopa (clinical features)
• Initially dry cough
• Later on expulsion of sputum with blood
• Intense pain in throat
• Piercing pain in chest
• Pain in joints
• Abnormal voice
• Cooing sound like pigeon during bouts of cough
Hetu & Roopa of Kshayaj Kaasa
• Irregular meals (untimely)
• Intake of incompatible food
• Excessive sexual intercourse
• Suppression of urges in a person already affected with disgust & anxiety consequent loss of digestive power
Roopa (clinical features)
• Expectoration of sputum, which is fetid, green, red & pus like.
• While coughing a feeling, as if heart has fallen down from its normal place feeling hot & cold.
• Inspite of good intake of food the patient is weak & emaciated.
• Complexion & skin of face is unctuous & clean.
• Eyes are pretty and sole of hands and feet are smooth.
• Envious & disgusting.
• Hoarseness of voice without an apparent cause.
Treatment of Vatika Kaasa
• In rough (undernourished) patients the Vatika Kaasa with unctuous applications such as Ghurtas, Enemas, Gruels, Vegetable, soups, milk, meat soup.
• In case of retention of stool and flatus enemas are indicated.
• In case of dryness of upper parts administration of Ghruta before meals and excess of Pitta and Kapha by unctuous purgation is advised.
• Ghee 640 gm. cooked with 1.2 liter's decoction of each Kantakari and Guduci alleviates Vatika Kaasa and promotes digestion.
• Ghee 640 gm. should be cooked in decoction of Dashamula 2.56l with the paste of Pippali, Pippalimula, Chavya. Chitraka, Sunthi, Dhanyaka, Pathya, Vacha, Raasna, Madhuyasthi, Yavakshara and Hingu each 5gm should be taken in the dose of 40gm followed by gruel scum.
• To alleviate cough, fever, gulma, anorexia, spleen enlargement, pain in head, heart and sides, jaundice, piles, vatasthila, urahkhshata (chest wound), phthisis and wasting, Ghee 640gms should be cooked in four times milk. To the milk add the paste of Trikatu, Triphala, Draksha, Kashmarya, Parushaka, two types of Pathya, Devadaru, Riddhi, Atmagupta, Chitraka, Shati, Vyaghri, Tamalaki, Meda, Kakanasa, Shatavari, Gokhshura and Vidari each 10 gm. This Ghruta is known as Tryusanadya Ghruta.
Treatment of Pittaj Kaasa
• In Paitika cough with profuse phlegm, emesis with ghee or decoction of Madana, Kashmarya and Madhuka or paste (or powder) of Madhuyashthi and Madana mixed with the juice of Vidari and sugarcane is beneficial.
• One should adopt unctuous-cold and rough-cold regimens in conditions of thin and thick phlegm respectively. The regimens with edibles, unctuous substances and linctus preparations are as follows:
1. Srngataka, lotus seeds, Nili and Gajapippali.
2. Pippali, Musta, Madhuyashthi, Draksha, Murva and Shunthi.
3. Parched paddy, Amalaki, Draksha, Vanshlochan, Pippali and sugar.
4. Pippali, Padmaka, Draksha, juice of Bruhati fruits
5. Kharjura (dates), Pippali, Vanshalochana and Gokhshura
6. These five formulations added with ghee and honey and used as linctus are beneficial for those suffering from Paittika cough.
• In case of association of Kapha, Musta and Maricha and in that of Vata, ghee should be added to the above. Dried grapes 50(in number), Pippali 30(in number) and sugar 40gm all together mixed with honey should be taken as linctus.
• The linctus prepared of, Rasna, Amalaki fruits and Vibhitaka added with sugar, honey and ghee alleviates cough, dyspnoea, hiccup, wasting and heart disease.
• Pippali, Amalaka, Draksha, Lac, parched paddy and sugarcandy - these should be boiled in milk till it is thickened. When cooled, Twak, Ela, Trikatu, Mrdwika, Pippalimula, Pushkaramula parched paddy, Musta, salt honey in one-eight quantity should be added. Juice of Vidari, sugarcane and lotus stalk mixed with milk, sugarcandy and honey should be taken.
• Ghee cooked with milk of buffalo, goat, sheep and cow and juice of Amalaki all in equal quantity should be taken to alleviate Paittika cough.
Treatment of Kaphaja Kaasa
• The patient should take light food with vegetable soup of Kulattha (horse gram) and radish containing alkali of Pippali or with oils of sesamum, mustard and bilva followed by drink of pure honey, sour, hot water, buttermilk or wine.
• Water dipped with Pushkaramula, Aragvadha root and Patola for the night should be mixed with honey in three times of meal (before, middle and after).
• Shunthi, Ativisha, Musta and Karkatasrngi, Haritaki and Shati should be taken after adding asafetida and rock salt. Or one should take the paste of Pippali 10gm.
• Powder of Sauvarchala, Haritaki, Amalaki, Alkali of Pippali and Shunthi taken with ghee to alleviate cough caused by Vata & Kapha.
• Ghee 640gm. should be cooked in 2.56 liter's of the decoction of Kantakari (with root, fruit & leaves) with the paste of Bala, Trikatu, Vidanga, Shati, Chitraka, Sauvarcala, Yavakshara, Pippalimula, Pushkaramula, Bruhati, Haritaki, Yavani, Dadima, Riddhi, Draksha, Punarnava, Chavya, Duralabha, Amlavetasa, Srngi, Tamalaki, Bhargi, Raasna and Gokhshura.
Treatment of Kshataja Kaasa
• Paste of Pippali and Madhuka and sugarcandy - each 10gms, cow's milk, goat's milk, sugarcane juice - each 640ml., flour of barley and wheat, Mrdvika, Amalaka juice and (tila) oil - each 80ml should be mixed together and cooked on mild fire. When cooled, ghee and honey should be added.
Treatment of Kshayaja Kaasa
• If the disease is newly arisen, treatment should be started after declaring its difficult nature. One should administer the measures promoting body- weight and digestive power. If the patient has plenty of impurity, he should be given unctuous and mild purgation.
• Evacuative Ghruta cooked with Aragvadha, Trivrta, grape juice, decoction of Tilvaka and juice of Vidari (in such condition, protection of his body and strength is desirable) should be taken by such a patient.
• When Pitta and Kapha are diminished and Dhatus are wasted, one should take ghee cooked with Karkatasrngi, milk and two types of Bala.
• Ghee should be cooked in decoction of two Panchamulas (Dashamula), Triphala, Chavika, Bharangi, Chitraka, Kulattha, Pippalimula, Pathya, Kola and Yava, with the paste of Shunthi, Duralabha, Pippali, pushkarmula and Karkatasrngi must be divided in equal parts. When it is prepared, powder of two alkalis (Yavakshara and Svarjikshara) and five salts should be added and taken in proper dose by the patient of cough caused by wasting.
• Ghee mixed with Amalaka fruits boiled in milk should be cooked in double quantity of pomegranate juice along with Trikatu. It should be taken after meals.
• Yavakshara-Ghruta (ghee processed with Yavakshara) or ghee cooked in goat's milk with pippali and jaggery is administered. These Ghrutas are administered to those suffering from cough caused by wasting in order to improve the Agni and for cleansing in case of sticking of Dosha (impurity) in channels of belly and chest.
According to Charaka over lean (karshya) persons are described under eight despicable persons (ashtau-ninditiya) along with over obese (medasvi) person. Charaka mentioned the definition of swastha purusha, in which he described how the ideal proportion should look like i.e. any person who has balanced proportion of muscles (sama-mansa pramana), compactness (sama samhanana), firmness of organs (drudhendriya vikaranam) does not fall prey to the prowess of a disorders. An over lean person has dried up buttocks, abdomen, neck (shushka-sphic, udar, greeva), prominent vascular network (dhamanijal santataha), remnant of skin and bone (twagasthi shesho, ati krusha) and thick nodes (sthool parva). According to Sushruta, lean and fattiness of body depends upon rasa-dhatu.
Hetu (etiological factors)
• Indulgence in rough food and drinks (rukshanna pana seva)
• Fasting (langhana)
• Little diet (pramitashana) or diet that aggravates vata (dry, astringent etc)
• Excessive subjection to evacuative therapy (kriyatiyoga)
• Grief (shoka), worries, fear, excess study
• Suppression of natural urges, such as - sleep (vega- nidravi- nigrah), thirst and hunger
• Excessive exercise, sexual intercourse, excess bath
• Excess non - unctuous anointing to the persons (ruksha udvartan)
• Indulgence in bath (snana abhyasa)
• Constitution (prakruti), heredity (beej dosha)
• Old age (jara)
• Continued disorder (vikar-anushaya)
• Anger (krodha)
Roopa (the signs and symptoms)
• The over lean does not tolerate physical exercise, over saturation (vyayamum atisauhityam), hunger, thirst, disease, drugs (kshutpipasamay-aushadham).
• Too much of cold, heat and sexual intercourse (ati-shitoshna-maithunam).
• The over lean often becomes a victim of spleen enlargement (pleeha).
• Cough- kasa.
• Wasting- kshaya
• Dyspnoea- Shwasa
• Gascious tumour- gulma
• Piles- arsha
• Abdominal diseases- udara, Raktapitta
• Disorders of vata
• As person is weak in nature (low immunity), all disease that he suffers is difficult to treat (sampoorna roga balwan).
Following are the conducts that must be followed in order to cure this ailment:
• Day sleep (diva-swapna)
• Exhilaration (harsha)
• Comfortable bed (sukha shayya) for sleep
• Relaxation of mind (manaso nivrutti)
• Keeping away from mental work, sexual intercourse and physical exercise.
• To live amongst the people and the environment one likes
• Tailabhyanga (daily oil massage)
• Snigdha udvartan (unctuous anointing)
• Snana (bath)
• Gandha-mala-neshevanam (using perfumery and garlands)
• Shukla vasa (wearing white dress)
• Sweet and unctuous food
• New cereals, fresh wine, meat soup
• Meat soup of domestic, marshy and aquatic animals
• Well-cooked meat
• Curd, ghee, milk, sugarcane, rice, black gram, wheat
• Products of jaggery
One desirous of giving up the leanness should follow these:
• Smadhur basti (use of unctuous and sweet enema)
• Yatha-kala dosha-vasechana (timely drainage of dosha)
• Regular use of rasayana (bulk promoting) and vajikarana (aphrodisiac) formulations.
The person is called obese when due to excessive increase of fat and muscles and has pendulous buttocks and abdomen. He also suffers from deficient metabolism and energy. Charakha included obese persons among the eight persons who are despicable. This medoroga comes under diseases caused by over saturation i.e. under santarpanaja vikar.
Hetu (etiological factors)
• Absence of physical activity (avyayamad).
• Day sleep (divaswapna).
• Over consumption of foods that increase kapha viz sweet, heavy, slimy substances (pichchhil), new cereals, fresh wine, meat of marshy and aquatic animals, milk and its derivatives, jaggery and flour preparations.
• Lack of mental work.
• Genetic defects.
Roopa (the signs and symptoms)
• Fat accumulation in large quantity in the body makes the person incapable of all physical activities.
• Makes breathing difficult even on slight exertion.
• Excess thirst.
• Excess sleep.
• Sudden catching of breathe, exhaustion even after doing lighter work.
• Excessive hunger.
• Bad smell of the body.
• Poor physical and sexual capacity gradually develops.
Charaka Mentioned Following Treatment for Obesity :
• Physical exercise
• Use of abhayaprasha with honey
• Rough food grains
• Use of guduchi, devdaru, musta, triphala, takrarishta and honey, are recommended for reducing the over obesity.
• Vidanga, shunthi, yavakshara, and ash-powder of black iron mixed with honey, is used for obesity.
• Barley and amalaki powder, in combination, is an excellent formulation for the same.
Pathya-Apathya (dos and don'ts)
1. Worries, excessive physical exercise, sexual- intercourse, sprinkling and rubbing of various medicinal powders over body, fasting, sunbath, brisk walking. Taking panchakarma treatment like vamana (emesis) and virechana (laxatives and purgatives), old rice, yava (barley), kulattha, masoor, mudga, chana, honey, pungent and bitter edible things, trifala, trikatu, leafy vegetables, hot water or taking excessive water before meals.
1. Avoid rasayana aushadhi, rejuvenating therapies etc. Avoid shashtishali (rice), wheat, urad, all milk products, sugarcane products, sweets, oily food, fat (specially hydrogenated fat like vanaspati ghee) etc.
Pandu -rog (Anaemia)
Predominantly caused by pitta, the disease pandu roga is because of the prominence of pallor in skin called 'Pandu'. 'Pandu' is said to be 'Piitapradhana' indicating that in all types, pitta is the root cause. Based on the causative factor Panduroga is classified into five following types: caused by Vata, Pitta, Kapha, Sannipata & Mritbhakshana (earth eating.)
• Excessive intake of alkaline, sour, salty, too hot, incompatible & unsuitable food
• Excessive use of nispava, black gram, tila oil
• Sexual intercourse during indigestion
• Faulty management of evacuative measures
• Suppression of natural urges particularly in persons inflicted with sexual desire, anxiety, fear, anger & grief.
Poorvarupa (premonitory symptoms)
• Palpitation of heart
• Dryness of skin
• Loss of taste / appetite
• Yellow colored urine
• Absence of sweating
• Poor digestive activity
• Weakness & exertion
Roopa (clinical features)
• body becomes flabby & has a feeling of being squeezed
• Felling of limbs kneaded, pressed or churned
• Heart rate increases
• Swelling of the eye sockets & area surrounding the eyes
• Expectoration of sputum
• Diminution in speech results
• Hatred towards food & cold things
• Falling of skin hair
• Loss of luster
• Exertion on climbing (stairs etc)
• Cramps in shanks
• Pain in waist, thighs, legs & lassitude.
Vataja Panduroga (clinical features)
• Body aches
• Piercing pain & tremors
• Discoloration of veins, nails, feces, urine & eyes
• Astringent taste in the mouth
• Dryness of feces
• Pain in flanks & head.
Pittaja Panduroga (clinical features)
• Green / yellowish color in the veins etc
• Desire for cold things
• Bad smell (of the body, mouth etc)
• Bitter taste
• Loose bowels
• Burning sensation.
Kaphaja Panduroga (clinical features)
• White color of the veins etc
• Salty taste in the mouth
• Loss of voice
Sannipataja (clinical features)
There is a mixture of symptoms & the disease is difficult to bear.
Mritbhakshanaja (earth -eating) (clinical features)
In persons who eat mud (habitually for a long time) astringent mud aggravates Vata, alkaline mud aggravates Pitta, sweet mud aggravates Kapha. Mud vitiates rasa & other tissues by its dryness & produces dryness in the channels of the tissues & without undergoing digestion it fills & blocks them & produces pandu roga as before. The person develops swelling of the umbilicus, feet, face & genitals, expels feces containing worms, not well formed mixed with blood & kapha (mucus).
Oleation Therapy 1. Medicated ghee prepared with decoction of dadima and of dhanyaka boiled in one water and paste of chitraka and shringabera, pippali and ghrita cures diseases of the heart, anemia, abdominal tumor, hemorrhoids, disease of the spleen, pain (diseases) arising from vata and kapha. It is best suited for women who have difficulty in delivery and the sterile women.
2. After oleation therapy, administered strong emesis therapy. There after he should be administered strong purgative therapy, using fatty (oil / ghee) purgatives added with milk and cows urine or milk only.
3. Ayoraja (iron filings) soaked either in cow's urine or milk for seven days should be consumed.
4. Decoction of vaasa, guduchi, triphala, bhunimba, and nimba consumed with honey cures anaemia, bleeding disease and jaundice.
1. Equal quantities of guda, nagara, mandura (iron slag) and tila, and pippali double the quantity (of all the other put together) made into pills should be administered to patients of anaemia. Tapya, darvi tvak, cavya, granthika, devadaru, are converted into nice powder. Mandura, resembling anjana (antimony sulphide) double the quantity (of the powder) is boiled in cows urine, when it become suitable to prepare pills, the powder is mixed with it and rolled into pills dried in shade and consumed, the patient taking buttermilk as food. These mandura vataka bestows life to patients of anemia, they also cure leprosy, poor digestion, dropsy, stiffness of the thighs, loss of taste/appetite, hemorrhoids, jaundice, diabetes and diseases of the spleen.
2. That arising from kapha with those which are predominantly pungent, dry and hot; and that arising from the combination of all the doshas by combination of drugs (or treatments). Mud should be expelled out from the body (in anaemia caused by eating mud habitually) first, by strong sansodhana (purifactory therapies); when the alimentary tract becomes purified, medicated ghee recipes which bestow strength should be administered.
3. Medicated ghee prepared with decoction of vyosha, bilva, the two rajani, triphala, the two punarnava, musta, ayoraja, pathya, vidanga, devadaru, vrscikali, and bharngi, added with equal quantity of milk and (quarter part of) ghrita (ghee). This recipe mitigates all the disorders produced by mud quickly.
Rajayakshma (Pulmonary Tuberculosis, Koch's Infection)
It is an old age disease making the patient suffer all throughout. Ayurvedic classics have expounded Tuberculosis as well as it's treatment. The Bruhat trayee (Charak Sanhita, Sushrut Sanhita & Ashtang Hridaya) have expounded the above in great details.
Following are the synonyms of this ailment:
• It leads to depletion of Dhatus (body tissues) to such an extent where by the Aushad (medicines) used to treat the disease, are depleted i.e. it is Kruchha Sadhya (difficult to treat).
• It leads to drying & diminution of body tissues & thus emaciation.
• It is the king of Yakshmas (disease syndromes).
• King of diseases since it reigns (overpowers, subdues) over them. Just as the king is accompanied by his soldiers Tuberculosis is accompanied by a hoard of premonitory signs, signs & symptoms & a host of complications.
Rajyakshma Lakshan (symptoms)The symptoms for tuberculosis are classified on the basis of different stages of the progress of the disease, as follows:
Trirupa Rajyakshma (first stage of the disease)
• Pain in shoulder & ribs (scapular region), flanks
• Burning of palms of hands and soles of feet
• Fever (pyrexia).
Shadarupa Rajyakshma (second stage of progress of disease)
• Hoarseness of voice
Ekadash Rupa Rajyakshma (third stage of progress of disease)
• Pain in shoulders (scapular region) & in flanks
• Hoarseness of voice
Rajyakshma Chikitsa (treatment of Rajyakshma)
• In Rajyakshma all food in the gastro-intestinal tract is converted to Malas & a little is utilized for Ojas. Hence the stool in patient of Rajyakshma should be cared for particularly because in the state of wasting of all seven Dhatus as the strength of the stool supports the body.
• Emesis & purgation should be administered with substance, which will not exert debilitating effect on the patient.
• In patients having abundance of Doshas, emesis & purgation should be carried out with great care.
• The patients who are emaciated should be given well-prepared meats of carnivorous animals, which are particularly built- promoting.
dysnopea is afatal disease as loss of life is very much possible inthis ailment. It is not necessary that this disease arises from its root cause in any person but can also arise as a compkication side effect of some other ailment.
• Increase of cough
• Diarrhoea due to indigestion
• Exposure to dust, smoke, breeze
• Injury to vital organs
• Drinking of very cold water
Following are the types of this disease
Purvaroopa (premonitory signs)
• Pain in region of heart & flanks
• Upward movement of prana (respiration)
• Splitting pain in the temples (sides of the forehead)
Roopa (clinical Features)
• When Maruta (Vata) on being aggravated by exertion & overeating, produces Kshudra Shwasa which subsides by itself (without any medication) i.e. heavy breathing on exertion, passes of soon by rest & is thus not very troublesome.
• Pain in head, neck, chest & flanks, cough accompanied with cracking sound
• Loss of taste, appetite
• Running nose
• Thirst Forceful bouts of respiration
• Feeling of going into darkness (i.e.losing conciouseness of the surrounding) momentary comfort after expectoration
• Inability to breathe on lying
• Comfortable on sitting
• Eyes wide open
• Perspiration on forehead
• Dry mouth
• Desire for hot comforts
• Patient breathes with interruptions
• Cutting pain in the vital organs
• Burning sensation
• Obstruction in the urinary bladder
• Eyes are unsteady ( full of tears)
• Delusion (or coma)
• One eye is angry - (red in colour)
• Dryness of mouth
• Irrelevant talks
• Feeling of helplessness (inability to do anything)
• Loss of chhaya (complexion)
Loss of conciousness
• Heavy breathing
• Helplessness (unable to withstand the trouble)
• Respiration is accompanied with sounds resembling those of high pitch sounds from the nose, resembling that of a bull in heat
• Common sense & intelligence are lost
• Eyes & face are unsteady
• Chest constricted
• Obstruction of urine & feces
• Broken voice
• Dryness of throat
• Frequent delusions
• Severe pain in ears, temples & head
• Prolonged upward breathings (expiration) but difficult respiration
• Obstructed movement of vata
• An upward gaze
• Rolling eye balls
• Terrified look
• Severe pain as though his vital organs are being cut
• Speech choked.
Snehan - Svedana (Oleation and Sudation)
• Snehan (Sudation) anointing the body with oil mixed with salt.
• After sudation, the patient should be made to eat ricemess, mixed with ghee or with dadhi (curds). Then, a mild emesis therapy should be given, especially for those who have cough, vomiting, catching pain in the region of the heart and diminution of voice, by using Pippali, Saindhava and honey, which is not opposed to Vata (which does not aggravate vata).
• Rice-mess mixed with matulunga, amlavetasa, hingu, pilu and bida should be consumed, this acts as anulomana (laxative).
• Next, a purgative drug mixed with saindhava and any sour fruit followed by warm water should be administered to produce purgation.
• It is advisable to have administration of purifactory therapy of both the upper and lower parts of the body.
• If by the treatment the disease does not subside, the kapha dosha adherent deep inside should be removed out by inhalation of smoke (of drugs) after purifying the patient by emesis and puragation therapies.
• Leaves of haridra, root of eranda, laksha, manasshila, devadaru, elaa, and mansi , are made into a paste and a cigarette prepared. It should be lubricated with ghee and smoked; or smoke of yava mixed with ghee; or smoke of madhucchista, sarjarasa and mixed with ghee; or smoke of aguru or of chandana or guggulu, of manohva or of resin of sala, sallaki, guggulu, aguru or padmaka-each one lubricated with ghee.
Svedana (Sudation Therapy)
• This is essential for those who are fit for it and even those who are unfit, should be given sudation for a short duration either by pouring warm milk mixed with sugar, or oil; or by utkarika and upanaha (warm poultices) especially over the chest and throat.
• Decoction of dashamula, shathi, raasana, bharangi, bilva, riddhi, pushkara, tamalaki, amruta and nagara should be consumed; after it is digested peya (thin gruel) processed by the same drugs should be partaken.
• A mud pot smeared inside with ghee should be coated (inside) with the paste of pippali, pippalimula, pathya, jantughna and chitraka. After the paste dries up; the pot is filled with takra (buttermilk) and kept undisturbed for a month; this is carminative and cures dyspnoea and coughs.
• Jivanti, musta, surasa, tvak, eladvaya, pushkara, tamalaki, aguru, bharangi, nagara, karkata, shathi, krishna, nagakeshara, are made into nice powder and mixed with sugar, double its quantity.
Sheet Pitta ( urticaria)
According to madhukosha commentary, udarda and sheetapitta do have similar system of origin (samana sansthana), they are defined as per dominance of dosha.
Purva-roopa (prodromal signs)
• Feeling of heaviness in the body
• Redness of the eyes
Roopa (the signs and symptoms)
• Swelling (elevated patches) resembles to wasp sting (varatidashtasansthanah shothah).
• Severe itching
• Pricking pain (sakandustoda-bahul)
• Feeling of burning sensation (chhardi-jwara-vidahawan).
• Patches (mandal) with highly itching, red in colour.
• Innumerable rashes
Hetu (etiological features)
• Improper administration of emetics (asamyakvaman)
• Suppression of aggravated pitta, kapha and anna
• Excessive consumption of kanji (fermented gruel), shukti, aasuri-lavana (bid-lavan).
• Massage (abhyanga) with sarshapa oil
• Hot water fomentation
• Immediate emesis should be done with the help of decoction of patol leaves, nimba twak and arishtaka
• Purgation (virechana) should be done using decoction of triphala, pippali and guggul.
• Rakta- mokshana (blood - letting) should be done after using mahatikta ghrita, which is mentioned in kushtha chikitsa.
• Krumighna (antihelmentic) and dadru har treatement first.
• Unction (snehan) and swedana (fomentation followed by sanshodhan (evacuative measures) like emesis, purgatives etc. should be done afterwards.
• Kushtha (skin disease) chikitsa.
Pathya - apathya (dos and don'ts)
Rice of shalidhan, mudga, kullatha, karavellaka, poi shak, vetagra, hot water, vaman (emesis), virechana (purgatives), pralepa (local applications), rakta mokshana (blood letting), dadim (pomegranate), triphala, sarshapa oil. All bitter, pungent and astringent products are advisable in this disease.
Bath, sun bath (atap seva), heavy food, dugdha and ikshu vikar (products which are made up of milk and sugar cane), fish, day sleep, exposure to east wind and south wind, viruddha bhojan, slimy (pichchhil), sweet, sour and salty food should be avoided.
This ailment expounded by Ayurveda, VataRakta is a combination of two words Vata & Rakta. In Charak Sanhita, Ashtang Hridaya & Madhav Nidan VataRakta has been elaborated in great details.
Khuda means small joints. Since in this disease, the small joints are inflicted it is called as Khuda Vata
Adhaya means the rich class of people & those who are delicate. Since this class of people is generally inflicted with the disease, it is also called as Adhayavata.
The aggravated vata having been obstructed in its passage by aggravated blood, affects the entire blood.
Intake of diet consisting of an excess of sour, pungent, alkaline, fatty, hot & uncooked articles, moist or dried things, meat of aquatic & marshy animals, oil-cakes, radish, horse gram, black gram, nishpava and other leguminous. Vegetables, seasum paste, sugar cane, curd, sour gruel, sauvira, shukta (vinegars), butter milk, sura are asava also the causative factors
• Incompatible food
• Eating during indigestion
Poorvarupa (Premonitory symptoms)
1. Swedo Atyartham Na Vaa- Excess or absence of perspiration.
2. Karshnya- Blackness
3. Sparshaagyatvam- Anaesthesia
4. Shate Atiruk- Severe pain on injury
5. Sandhi Shaithilyam- Laxity in joints
6. Aalasyam- Lassitude
7. Sadanam- Malaise
8. Pidakodgam- Appearance of boils
9. Janujangha Uru Katayam Sa hastapada and Sandhishu Nistoda Sfurnam
10. Bhedo Gurutvam Supti Kandu - piercing pain, quivering, tearing, heaviness
Numbness & itching in knee, shanks, thigh, waist, shoulder, hands,, feet & joints of body.
11. Sandhishu Rug Bhutva- unstable pain in joints.
12. Vaivarnam & Mandalotpatt- abnormal complexion & appearance of patients.
Classification & Rupa (clinical features)
Based on the seat (root) / location
This is located in the twak (skin) & mamsa (muscle).
This is located in the deeper dhatus.
According to the Doshas involved (predominance)
Predominance of Vata (Vatadhika)
Sira aayam shul Sfuran Todanam Shothasya Karshnyam. Raukshyam Shyavata Vruddhi haanaya meaning:
• Dilatation of vessels
• Quivering & piercing pain
• Aggravation & diminution
Dhamanya anguli Sandhinam Sankocha Anggraho Atiruk
• Contraction in Dhamanis (arteries), fingers & joints
• Stiffness in body parts
• Intense pain
Kunchan Stambhane Sheeta Pradvesha
• Contracture & stiffness
• Aversion to cold
Predominance of Rakta (Raktadhika)
Shwayatu Brusha Ruka Toda Tamrashcha Chim Chimayate
• Swelling with severe distress
• Pierceing pain
• Coppering with pricking sensation
Snigdha Rukshaiya Shaman Na ati Kandu Kledanvito
• Not subsiding by either unctuous or rough applications & associated with itching & moistening.
Predominance of Pitta (Paitika)
Vidaho Vedana Murchha Swed Trshna Mada Bhrama
• Burning after meals
Raga Pakashcha Bhedascha Shoshashcha
Predominance of Kapha
Steymityam Gauravam Sneha Supti Manda Ruk
• Feeling of wetness
• Numbness & mild pain
There are certain upadrava (complications) that musty be kept in mind while treating this ailment, which are a follows:
• Asvapna- Sleeplessness
• Arochaka- Anorexia
• Swasa- Dyspnoea
• Mansa kotha- Gangrene
• Shiro graha- Stiffness in head
• Murchhaya- Fainting
• Mada- Narcosis
• Ruk- Distress
• Trushna- Thirst
• Jwara- Fever
• Moha- Mental confusion
• Pravapaka- Trembling
• Hikka- Hiccup
• Pangulya- Lameness
• Visarpa- Erysipalas
• Paka- Inflamation
• Toda- Piercing pain
• Angulivakrata- Crookedness in fuigen
• Sfota- Blisters
• Daha- Burning Sensation
• Marmagraha- Stiffness in Vital parts
• Arbuda- tumour
• Etaivupadrava Vaivarjyam Mohen Ekan Vaa Api Yata - Even on complication, mental confusion is enough to make the disease incurable
• Samprastavi Vivarnam Cha Stabhdham Arbuda Kruchcha Varjayet Cha Eva Sankoch Karmendriya Tapanam
• Akrutsna Upadravam Yapyam Sadhyam Syat Niru padravam - The one having less than all symptoms i.e. least no of symptoms is pallative & that which is free from complications is curable.
The blood of the patient of Vata Rakta (gout) should be let out, in small quantities, at many times after oleation therapy
Protecting him from (aggravation of) vata
Bloodletting beingappropriate to the dosha
When pain, redness, pricking pain and burning sensation are present, blood should be got sucked by jalauka (leeches).
When tingling sensation, itching, pain and burning sensation are present, the use of srnga-alabu (sucking horn or gourd) is indicated.
When the disease / lesion is found spreading from place to place, either pracchana (scratching the skin) or siravyadha (venesection) is recommended.
Blood should not be let out when there is debility of the body, dryness and predominance of vata; vata getting aggravated (increased) by loss of blood (from blood-letting) produces profound swelling, stiffness, tremors, diseases of tendons, and veins, debility and many other disorders of vata origin.
Purgation therapy should be given oleation therapy first and then administered purgative drugs mixed with fats (medicated ghee / oil).
In Vatarakta (gout) having predominance of vata, the patient should be made to drink old ghee. Ghrta prepared with decoction of Draksha and
Madhuka, added with Sitopala (sugar candy) should be consumed; or milk boiled with addition of fresh juice of Guduchi; or drink the mixture of taila (oil), milk and sarkara (sugar) boiled together.
In Vatarakta caused by pitta, decoction of vari, tikta, patola, triphala and amrta should be consumed. Also ghee or milk boiled with drugs of sweet and bitter tastes (be consumed)
Eranda taila should be consumed mixed with milk to produce purgations in the patient who has great increase of dosha; after it gets digested (and after purgations) he should eat boiled rice along with milk.
The malas (doshas) may also be removed by kshirabasti (milk enema) added with grtha (ghee).
There is nothing equal to basti (enema therapy) in the treatment of vatarakta (gout), especially for those who have pain in the rectum, flanks, thighs, joints, bones and abdomen.
When kapha is predominant, the decoction of musta, dhatri and haridra or of triphala or of guduchi, whichever is suitable, should be consumed mixed with kshaudra (honey)
After administering the appropriate sneha (fat) to drink, he should be given mild vamana (emetic) drugs and then rukshana (therapy creating dryness inside).
Decoction of kokilaksha consumed followed by partaking its leaves only as food, cures gout just like the practice of compassion cures anger.
Medicated oil prepared with madhu ucchista (bee's vax), manjishta, sarjarasa and sariva-known as pinda taila-used for abhyanga (anointing and massage) relieves the pain of vatrakta.
The Uttana kind of vatrakta (gout) should be treated with lepana (application of pastes), abhyanga (anointing with fats) parisheka (pouring liquids on the body) and avagaha (immersing the body in liquids), the gambhira kind of gout by vireka
(Purgation), Asthapana (decoction enema) and snehapana (drinking of fats).
When vata and kapha are predominant, warm applications of pastes etc. are beneficial; if cold applications are made, burning sensation, swelling, pain and itching will increase, due to rigidity (caused by cold).
In gout, when there is predominance of pitta and rakta cold application are beneficial, plosha (blisters, blebs) osha (localised burning sensation) pain, redness, sweating and avadarana (laceration, abrasion) will develop by heat (of warm applications).