The 9th chapter of Cikitsasthanam of Ashtanga Hridayam is named as Atisara Cikitsitam Adhyayah. This chapter deals with the explanation of ‘treatment of diarrhea’.
The topics covered in this chapter include –
- Langhana as first line of treatment for atisara
- Vamana (vomiting) in diarrhea
- Ama atisara cikitsa
- Upavasa in atisara
- Medicated water for atisara
- Laghu anna
- Ideal drinks
- Beneficial diet inclusions in atisara
- Peya Prayoga – use of gruels
- Use of Virecana and Peya
- Pakvatisara Cikitsa
- Pravahika Cikitsa – treatment of dysentery
- Aparajita Khala
- Treatment of Varcha Ksaya (depletion of feces) and Mukha Sosa (dryness of mouth)
- Treatment for obstruction of vata
- Treatment for vibaddha vata-varca (obstruction to flatus and feces)
- Musta Ksirapaka
- Pippali Marica Curna
- Treatment of Nirama condition
- Treatment of pain
- Appraisal of taila in atisara
- Gudabhramsa Cikitsa – treatment of rectal prolapsed
- Oil enema
- Lubricating enema
- Gophana Bandha for prolapse rectum
- Unduru (Musaka) Taila
- Pittatisara Cikitsa
- Pichcha Basti – Slimy enema
- Putapaka Rasa Yoga
- Raktatisara – treatment of bleeding diarrhea
- Kaphatisara Cikitsa
- Kapitthastaka Curna
- Dadimastaka Curna
- Vidangadi Khala
- Medicated ghee
- Pichcha Basti
- Anuvasana Basti
Pledge by the author(s)
अथातोऽतीसार चिकित्सितं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having offered prayers to the God, henceforth we are going to explain the chapter pertaining to the explanation of ‘treatment of diarrhea’. Thus say (pledge) Atreya and other sages.
Langhana as first line of treatment for atisara
अतीसारो हि भूयिष्ठं भवत्यामाशयान्वयः ।
हत्वाऽग्निं वातजेऽप्यस्मात्प्राक् तस्मिल्लङ्घनं हितम् ॥ १ ॥
Atisara (diarrhea) is born especially form the amasaya (stomach) first, destroying the digestive fire, hence langhana (fasting) is ideal (at the commencement of the disease,) even in the Vata type of Atisara.
Vamana (vomiting) in diarrhea
शूलानाहप्रसेकार्तं वामयेदतिसारिणम् ।
The patient of atisāra – diarrhea, śūla – who is suffering from pain in the abdomen, ānāha – flatulence and praseka – excess of salivation should be made to vomit (by Vamana Panchakarma treatment).
Ama Atisara Chikitsa
दोषाः सन्निचिता ये च विदग्धाहारमूर्छिताः ॥ २ ॥
अतीसाराय कल्पन्ते तेषूपेक्षैव भेषजम् ।
भृशोत्क्लेशप्रवृत्तेषु स्वयमेव चलात्मसु ॥ ३ ॥
न तु सङ्ग्रहणं योज्यं पूर्वमामातिसारिणि ।
Doshas which have increased greatly and associated with burnt out food (due to improper digestion), make for the onset of diarrhea, hence when the increased doshas are moving out of the body by their own accord, due to natural movement, then the treatment is to neglect them (allow to go out). The patient of amatisara (diarrhea when the doshas are not cooked/ transformed by heat) sangrahana (herbs or therapies which stop the loose stools) should not be administered in the beginning.
Ama Atisara Chikitsa
अपि च आध्मान गुरुता शूल स्तैमित्य कारिणि ॥ ४॥
प्राणदा प्राणदा दोषे विबद्धे सम्प्रवर्तिनी ।
When the doshas have given rise to flatulence, gurutā – heaviness, śūla – pain, staimitya kāriṇi – and loss of movement of the abdomen, then use of pranada (Terminalia chebula), restores life, by mobilizing and clearing out the obstructed doshas.
Ama Atisara Chikitsa
पिबेत्प्रक्वथितास्तोये मध्यदोषो विशोषयन् ॥ ५ ॥
भूतिकपिप्पलीशुण्ठीवचाधान्यहरीतकीः ।
अथवा बिल्वधनिकामुस्तनागरवालकम् ॥ ६ ॥
विडपाठावचापथ्याकृमिजिन्नागराणि वा ।
शुण्ठीघनवचामाद्रीबिल्ववत्सकहिङ्गु वा ॥ ७ ॥
The patient who has moderate increase of doshas, should resort to Langhana – light foods and drink the Pramathya decoction prepared from the bhūtika – Cymbopogon citratus / Carum capticom, pippalī – Piper longum, śuṇṭhī – Zingiber officinale, vacā – Acorus calamus, dhānya – Coriandrum sativum, harītakīḥ – Terminalia chebula or Pramathya prepared from bilva – Aegle marmelos, dhanikā – Coriandrum sativum, musta – Cyperus rotundus, nāgara – Zingiber officinale, vālakam – Vetiveria zizanioides / Pavonia odorata; viḍa – or of Vida salt, pāṭhā – Cissampelos pareira, vacā – Acorus calamus, pathyā – Terminalia chebula, kṛmijit – Embelia ribes, nāgara – Zingiber officinale or prepared from śuṇṭhī – Zingiber officinale, ghana – Cyperus rotundus, vacā – Acorus calamus, mādrī – Manilkara hexandra, bilva – Aegle marmelos, vatsaka – Holarrhena antidysenterica, hiṅgu – Ferula narthex.
Upavasa in atisara
शस्यते त्वल्पदोषाणामुपवासोऽतिसारिणाम् ।
When the doshas are slightly increased, fasting is best for patients of atisāra – diarrhoea.
Medicated water for atisara
वचाप्रतिविषाभ्यां वा मुस्तापर्पटकेन वा ॥ ८ ॥
ह्रीवेरनागराभ्यां वा विपक्वं पाययेज्जलम् ।
Water well cooked with vacā – Acorus calamus, Or prativiṣa – Aconitum heterophyllum, mustā – Cyperus rotundu or parpaṭakena vā –Fumaria parviflora, hrīvera – Pavonia odorata,or nāgara – with Zingiber officinale should be given (in plenty) to drink.
Laghu anna
युक्तेऽन्नकाले क्षुत्क्षामं लघ्वन्नप्रति भोजयेत् ॥ ९ ॥
तथा स शीघ्रं प्राप्नोति रुचिमग्निबलं बलम् ।
When at the time of food, when the person feels weak by hunger, he should be given light foods, in small quantity, at the proper time; that undergoes digestion quickly and bestows taste, digestion strength and body strength.
Ideal drinks
तक्रेणावन्तिसोमेन यवाग्वा तर्पणेन वा ॥ १० ॥
सुरया मधुना वाथ यथासात्म्यमुपाचरेत् ।
He should be served either with buttermilk, sour gruel, thin gruel, paste of flour added with ghee, sugar, milk etc. beer or madhu (fermented liquor prepared from honey) whichever he is accustomed to.
Beneficial diet for atisara
भोज्यानि कल्पयेदूर्ध्वं ग्राहिदीपनपाचनैः ॥ ११ ॥
बालबिल्वशठीधान्यहिङ्गुवृक्षाम्लदाडिमैः ।
पलाशहपुषाजाजीयवानीविडसैन्धवैः ॥ १२ ॥
लघुना पञ्चमूलेन पञ्चकोलेन पाठया ।
Next, foods should be prepared, with herbs havingwater absorbing, digestion kindling, digestive properties such as
bālabilva – tender fruits of Aegle marmelos, śaṭhī – Curcuma zedoaria, dhānya – Coriandrum sativum, hiṅgu – Ferula narthex, vṛkṣāmla – Garcinia indica, dāḍima – and Punica granatum, palāśa – or of Butea monosperma, hapuṣā – Juniperus communis, ajājī – Cuminum cyminum, yavānī – Trachyspermum ammi, vida salt and rock salt, or of lagupancamula; or of pancakola and pāṭhā – Cissampelos pareira should be given.
Peya Prayoga: Use of gruels
शालिपर्णीबलाबिल्वैः पृश्निपर्ण्या च साधिता ॥ १३ ॥
दाडिमाम्ला हिता पेया कफपित्ते समुल्बणे ।
अभयापिप्पलीमूलबिल्वैर्वातानुलोमनी ॥ १४ ॥
Thin gruel processed with śāliparṇī – Desmodium gangeticum, balā – Sida cordifolia, bilva – Aegle marmelos, pṛśniparṇi – Uraria picta and juice of dāḍima āmlā – sour Punica granatum is beneficial when kapha and pitta are greatly increased that (peya) processed with abhayā – Terminalia chebula, pippalīmūla – roots of Piper longum, bilva – and Aegle marmelos promotes movement of Vata in normal direction.
Use of Virechana and Peya
विबद्धं दोषबहुलो दीप्ताग्निर्योऽतिसार्यते ।
कृष्णाविडङ्गत्रिफलाकषायैस्तं विरेचयेत् ॥ १५ ॥
पेयां युञ्ज्याद्विरिक्तस्य वातघ्नैर्दीपनैः कृताम् ।
He who has great increase of doshas, keen digestive fire, and eliminate hard feces in small quantities should be administered the decoction of kṛṣṇā – Piper longum, viḍaṅga – Embelia ribes, triphalā – Terminalia chebula, Terminalia bellirica and Emblica officinalis to produce purgation; After such purgation, he should be given thin gruel processed with herbs destroying vata and increasing hunger.
Pakvatisara Chikitsa
आमे परिणते यस्तु दीप्तेऽग्नावुपवेश्यते ॥ १६ ॥
सफेनपिच्छं सरुजं सविबन्धं पुनः पुनः ।
अल्पाल्पमल्पशमलं निर्विड्वा सप्रवाहिकम् ॥ १७ ॥
दधितैलघृतक्षीरैः स शुण्ठीं सगुडां पिबेत् ।
स्विन्नानि गुडतैलेन भक्षयेद्बदराणि वा ॥ १८ ॥
गाढविड्विहितैः शाकैर्बहुस्नेहैस्तथा रसैः ।
क्षुधितं भोजयेदेनं दधिदाडिमसाधितैः ॥ १९ ॥
शाल्योदनं तिलैर्माषैर्मुद्गैर्वा साधु साधितम् ।
शठ्या मूलकपोतायाः पाठायाः स्वस्तिकस्य वा ॥ २० ॥
सूषायवानीकर्कारुक्षीरिणीचिर्भटस्य वा ।
उपोदकाया जीवन्त्या बाकुच्या वास्तुकस्य वा ॥ २१ ॥
सुवर्चलायाश्चुञ्चोर्वा लोणिकाया रसैरपि ।
कूर्मवर्तकलोपाकशिखितित्तिरिकौक्कुटैः ॥ २२ ॥
When the ama (complex of undigested food and doshas) has been well digested, digestive activity is keen, the patient eliminating feces mixed with froth and slimy materials accompanied with pain and obstruction, again and again in little quantities, with little fecal matter or without it and with pravāhikā – straining at stools (tenesmus) he should drink either curds, oil, ghee or milk containing śuṇṭhī – Zingiber officinale, and jaggery, or eat badara – Ziziphus mauritiana fruits steam cooked and mixed with jaggery and sesame oil. When he develops hunger, he should be served with vegetables (or soup) gāḍhaviṭ vihitaiḥ – beneficial for relieving hard stools and cooked rice to eat along with meat soup processed withplenty of fats, curdsand juice of Punica granatum or properly processed with tila – Sesamum indicum, māṣa – Vigna mungo or mudga – Vigna radiata, śaṭhi – or with Curcuma zedoaria, mūlaka – Anethum graveolens, potā – Basella alba, pāṭhā – Cissampelos pareira, svastika – Marsilea quadrifolia; sūṣā – or with Cassia occidentalis(?), yavānī – Trachyspermum ammi, karkāru – Cucurbita pepo, kṣīrī – Manilkara hexandra, cirbhaṭa – Cucumis utilissimus; or with upodakā – Basella alba, jīvantī – Leptadenia reticulata, bākucī – Psoralea corylifolia and vāstuka – Chenopodium album; or with black salt cuñco: – Corchorus fascicularis, loṇikā – and Portulaca oleracea or with soup of meat of kūrma – tortoise, vartaka – quail, lopāka – jackal, śikhi – peacock, tittiri – partridge or kaukkuṭa – fowl.
Pakvatisara Chikitsa
बिल्वमुस्ताक्षिभैषज्यधातकीपुष्पनागरैः ।
पक्वातीसारजित्तक्रे यवागूर्दाधिकी तथा ॥ २३ ॥
कपित्थकच्छुराफञ्जीयूथिकावटशेलुजैः ।
दाडिमीशणकार्पासीशाल्मलीनां च पल्लवैः ॥ २४ ॥
Gruel prepared with buttermilk or curdprocessed with: bilva – Aegle marmelos, mustā – Cyperus rotundus, akṣibhaiṣajya – Symplocos racemosa, flowers of dhātakī – Woodfordia fruticosa, nāgara – and Zingiber officinale cures pakvatisara (diarrhea in which the doshas are ripe/ transformed by heat) so also that (yavagu) prepared with tender leaves of: kapittha – Limonia acidissima, kacchurā – Curcuma zedoaria, phañjī – Clerodendrum serratum, yūthikā – Jasminum auriculatum, vaṭa – Ficus benghalensis, śeluja – Cordia myxa, dāḍimī – Punica granatum, śaṇa – Crotalaria verrucosa, kārpāsī – Gossypium herbaceum and Bombax ceiba.
Pravahika Cikitsa: Treatment of dysentery
कल्को बिल्वशलाटूनां तिलकल्कश्च तत्समः ।
दध्नः सरोऽम्लः सस्नेहः खलो हन्ति प्रवाहिकाम् ॥ २५ ॥
Buttermilk boiled with spices added with paste of tender fruits of bilva – Aegle marmelos and equal quantity of paste of tila – Sesamum indicum, mixed with water of dadhi (curds), which is sour added with fat (oil or gruel) cures dysentery.
Aparajita Khala
मरिचं धनिकाऽजाजी तिन्तिडीकं शठी विडम् ।
दाडिमं धातकी पाठा त्रिफला पञ्चकोलकम् ॥२६॥
यावशूकं कपित्थाम्रजम्बूमध्यं सदीप्यकम् ।
पिष्टैः षड्गुणबिल्वैस्तैर्दध्नि मुद्गरसे गुडे ॥२७॥
स्नेहे च यमके सिद्धः खलोऽयमपराजितः ।
दीपनः पाचनो ग्राही रुच्यो बिम्बिशिनाशनः ॥ २८ ॥
Buttermilk boiled with spices prepared with the paste of (equal quantities of): marica – Piper nigrum, dhanikā – Coriandrum sativum, ajājī – Cuminum cyminum, tintiḍīkaṃ – Rhus parviflora, śaṭhī – Curcuma zedoaria, Vida salt, dāḍimaṃ – Punica granatum, dhātakī – Woodfordia fruticosa, pāṭhā – Cissampelos pareira, triphala, pancakola, yāvaśūkaṃ – straw of Hordeum vulgare, kapittha – Limonia acidissima, āmra – seed kernel of Mangifera indica, jambūmadhyaṃ – and Syzygium cumini, dīpyakam – Cuminum cyminum / Trachyspermum ammi – (all these forming one part) along with the paste of bilva – Aegle marmelos six times in quantity of the above paste, mixed with curds mudgarase – soup of Vigna radiata jaggery and yamaka-sneha (two fats, oil and ghee), is prepared into khala, this is known as aparajita khala is carminative, digestive, water-absorbent, enhances taste and cures dysentery.
Treatment of Varcha Kshaya (depletion of feces) and Mukha Sosa (dryness of mouth)
कोलानां बालबिल्वानां कल्कैः शालियवस्य च ।
मुद्गमाषतिलानां च धान्ययूषं प्रकल्पयेत् ॥ २९ ॥
ऐकध्यं यमके भृष्टं दधिदाडिमसारिकम् ।
वर्चःक्षये शुष्कमुखं शाल्यन्नं तेन भोजयेत् ॥ ३० ॥
दध्नः सरं वा यमके भृष्टं सगुडनागरम् ।
सुरां वा यमके भृष्टां व्यञ्जनार्थं प्रयोजयेत् ॥ ३१ ॥
फलाम्लं यमके भृष्टं यूषं गृञ्जनकस्य वा ।
भृष्टान्वा यमके सक्तून् खादेद्व्योषावचूर्णितान् ॥ ३२ ॥
माषान् सुसिद्धांस्तद्वद्वा घृतमण्डोपसेवनान् ।
रसं सुसिद्धपूतं वा छागमेषान्तराधिजम् ॥ ३३ ॥
पचेद्दाडिमसाराम्लं सधान्यस्नेहनागरम् ।
रक्तशाल्योदनं तेन भुञ्जानः प्रपिबंश्च तम् ॥ ३४ ॥
वर्चःक्षयकृतैराशु विकारैः परिमुच्यते ।
In case of depletion of feces,and dryness of the mouth, porridge of rice should be consumed with soup of pulsesprocessed with paste of: kola – Ziziphus jujuba, bālabilvānāṃ – tender fruits ofAegle marmelos, śāli – Oryza sativa, yava – and Hordeum vulgare, mudga – Vigna radiata, māṣa – Vigna mungo, and tilā – Sesamum indicum, any one separately fried in yamaka (two fats) mixed / processed with curds and Punica granatum, supernatant layer of curds fried in Yamaka (combination of two fats) and consumed mixed with jaggeryand nāgara – Zingiber officinale or alcohol,fried in mixture of two fats and mixed with condiment / sources; or sour fruit fried in mixture of two fats or soup of Daucus carota) fried in two fats or flour of cornfried in mixture of two fats mixed with powder of Trikatushould be consumed; or māṣā – Vigna mungo prepared, similarly mixed with supernatant layer of ghee should be consumed. Juice (soup) of intestines of goat or sheep well prepared, filtered, mixed / processed with juice of sour dāḍima – Punica granatum, dhānya – Coriander sativum, fats, nāgara – Zingiber officinale should be consumed along with mess of red rice and even drunk in more quantity by these the person gets relieved quickly of all disorders caused by loss of feces.
Treatment for obstruction of vata
बालबिल्वं गुडं तैलं पिप्पलीं विश्वभेषजम् ॥ ३५ ॥
लिह्याद्वाते प्रतिहते सशूलः सप्रवाहिकः ।
वल्कलं शाबरं पुष्पं धातक्या बदरीदलम् ॥ ३६ ॥
पिबेद्दधिसरक्षौद्रकपित्थखरसाप्लुतम् ।
In case of obstruction of flatus associated with pain and straining at stools (tenesmus) the patient should lick the (paste of), tender fruits of Aegle marmelos, jaggery, oil, Piper longum, and viśvabheṣajam – Zingiber officinale, Bark of śābaraṃ – Symplocos racemosa, flowers of dhātaki – Woodfordia fruiticosa, leaves of badarī -Ziziphus mauritiana, mixed with supernatant layer of curds, honey, and fresh juice of kapittha – Limonia acidissima should be consumed.
Treatment for vibaddha vata-varcha (obstruction to flatus and feces)
विबद्धवातवर्चास्तु बहुशूलप्रवाहिकः ॥ ३७ ॥
सरक्तपिच्छस्तृष्णार्तः क्षीरसौहित्यमर्हति ।
यमकस्योपरि क्षीरं धारोष्णं वा प्रयोजयेत् ॥३८॥
शृतमेरण्डमूलेन बालबिल्वेन वा पुनः ।
He who has obstruction to flatus and feces, associated with severe pain, watery stools, feces mixed with blood and sticky material, and is suffering from thirst, deserves comfort by milk (should drink more quantity of milk) or he should drink milk directly from the udder, which is warm. After drinking a mixture of two- fats or drinking milk boiled with roots of Ricinus communis or tender fruits of Aegle marmelos, often.
Musta Kshirapaka
पयस्युत्क्वाथ्य मुस्तानां विंशतिं त्रिगुणेऽम्भसि ॥ ३९ ॥
क्षीरावशिष्टं तत्पीतं हन्यादामं सवेदनम् ।
One part of milk, twenty parts of mustā – Cyperus rotundus, and three parts of water are mixed boiled reduced to the quantity of milk, and this is consumed; cures raw unripe/unprocessed feces associated with pain.
Pippali Maricha Churna
पिप्पल्याः पिबतः सूक्ष्मं रजो मरिचजन्म वा ॥ ४० ॥
चिरकालानुषक्तापि नश्यत्याशु प्रवाहिका ।
Fine powder of pippali – Piper longum and marica – Piper nigrum consumed with water, habitually, cures dysentery quickly though persisting for long time.
Treatment of Nirama condition
निरामरूपं शूलार्तं लङ्घनाद्यैश्च कर्षितम् ॥ ४१ ॥
रूक्षकोष्ठमपेक्ष्याग्निं सक्षारं पाययेद्घृतम् ।
He who has developed symptoms of absence of ama, suffers from pain, emaciated / debilitated by fasting etc. dryness of the alimentary tract should be made to drink ghee mixed with alkalies after considering the strength of his digestive fire.
Treatment of pain
सिद्धं दधिसुरामण्डे दशमूलस्य चाम्भसि ॥ ४२ ॥
सिन्धूत्थपञ्चकोलाभ्यां तैलं सद्योऽर्तिनाशनम् ।
Medicated oil prepared with curds and scum of sura, and decoction of dasamula and paste of rock salt and pancakola relieves the pain immediately.
Treatment of pain
षड्भिः शुण्ठ्याः पलैर्द्वाभ्यां द्वाभ्यां ग्रन्थ्यग्निसैन्धवात् ॥ ४३ ॥
तैलप्रस्थं पचेद्दध्ना निःसारकरुजापहम् ।
Medicated oil prepared with 288 g of śuṇṭhi – Zingiber officinale, 96 g of each of granthi – roots of Piper longum, agni – (Plumbago zeylanica) and rock salt, 768 ml of sesame oil and curds relieves the pain of saraka (dysentery).
Appraisal of taila in atisara
एकतो मांसदुग्धाज्यं पुरीषग्रहशूलजित् ॥ ४४ ॥
पानानुवासनाभ्यङ्गप्रयुक्तं तैलमेकतः ।
तद्धि वातजितामग्र्यं शूलं च विगुणोऽनिलः ॥ ४५ ॥
On the one hand, the use of meat, milk and ghee in the form of drink, lubricating enema and massage on the body cures obstruction of feces and pain, while on the other, medicated oil alone does so when used in the same manner; because it is the chief among these which mitigate vata and pain caused chiefly due to abnormality of vata.
Appraisal of taila in atisara
धात्वन्तरोपमर्देद्धश्चलो व्यापी स्वधामगः ।
तैलं मन्दानलस्यापि युक्त्या शर्मकरं परम् ॥ ४६ ॥
वाय्वाशये सतैले हि बिम्बिशिर्नावतिष्ठते ॥ ४६ऊअब् ॥
Cala (vata) aggravated by the disorders of the other dhatus (doshas, pitta and kapha) though spreading all over the body, moves specifically towards its own residence (large intestine); Sesame oil should beused skillfullyin case of presence of low digestive power,which is best for balance of dhatus.When the residence of Vata is treated with taila (medicated oil administrated orally or rectally)then dysentery does not stay there at all.
Appraisal of taila in atisara
क्षीणे मले स्वायतनच्युतेषु दोषान्तरेष्वीरण एकवीरे ।
को निष्टनन्प्राणिति कोष्ठशूली नान्तर्बहिस्तैलपरो यदि स्यात् ॥ ४७ ॥
When there is depletion of feces, the other doshas (pitta and kapha) getting displaced from their respective channels cause affliction of vata, and becomes the sole leader. The patient of diarrhea, will have to strain at stools with abdominal pain, if he is not devoted to the use of medicated oil both internally and externally.
Gudabhramsa Chikitsa: Treatment of rectal prolapse
गुदरुग्भ्रंशयोर्युञ्ज्यात् सक्षीरं साधितं हविः ॥ ४८ab॥
रसे कोलाम्लचाङ्गेर्योर्दध्नि पिष्टे च नागरे ।
When there is pain and prolapse of rectum, medicated ghee prepared with: juice of sour kola – Ziziphus mauritiana, cāṅgeri – and Oxalis corniculata. Curd, paste of Zingiber officinale should be administered with milk.
Gudabhramsa Chikitsa: Treatment of rectal prolapse
तैरेव चाम्लैः संयोज्य सिद्धं सुश्लक्ष्णकल्कितैः ॥४९||
धान्योषणविडाजाजीपञ्चकोलकदाडिमैः ।
Medicated ghee prepared with the same sour (amla, kola, cangeri and curd) and fine paste of dhānya – Coriandrum sativum, ūṣaṇa – Piper nigrum, Vida salt, ajājī – Cuminum cyminum, pancakola, dāḍima – Punica granatum (may also be administered).
Oil enema
योजयेत् स्नेहवस्तिं वा दशमूलेन साधितम् ॥ ५० ॥
शठीशताह्वाकुष्ठैर्वा वचया चित्रकेण वा ।
Oil enema should be given with oil processed with either group of 10 roots, or śaṭhī – Curcuma zedoaria, śatāhvā – Anethum graveolens, kuṣṭha – and Saussurea lappa or vaca – Acorus calamus, citraka – withPlumbago zeylanica.
Lubricating enema
प्रवाहणे गुदभ्रंशे मूत्राघाते कटीग्रहे ॥ ५१ ॥
मधुराम्लैः शृतं तैलं घृतं वाऽप्यनुवासनम् ।
pravāhaṇe – When there is straining at stools, gudabhraṃśe – prolapse of the rectum, mūtrāghāte – retention of urine, kaṭīgrahe – and catching pain in the waist, a lubricating enema with either oil or ghee prepared with sweet and sour herbs should be administered.
Gophana Bandha for rectal prolapse
प्रवेशयेद्गुदं ध्वस्तमभ्यक्तं स्वेदितं मृदु ॥ ५२ ॥
कुर्याच्च गोफणाबन्धं मध्यच्छिद्रेण चर्मणा ।
The prolapsed rectum should be anointed with fats, fomented mildly, pushed inside, and a gophana bandha (“i” bandage) should be applied using leather strap having a hole in the centre.
Unduru (mushaka) Taila
पञ्चमूलस्य महतः क्वाथं क्षीरे विपाचयेत् ॥ ५३॥
उन्दुरुं चान्त्ररहितं तेन वातघ्नकल्कवत् ।
तैलं पचेद्गुदभ्रंशं पानाभ्यङ्गेन तज्जयेत् ॥ ५४ ॥
Medicated oil is prepared with the decoction of mahat pancamula and milk, boiled with rats devoid of their intestines and paste of herbs which mitigate vata; used both for drinking and anointing on the prolapsed rectum and then placed back in situ. This cures rectal prolapse.
Pitta Atisara Chikitsa
पैत्ते तु सामे तीक्ष्णोष्णवर्ज्यं प्रागिव लङ्घनम् ।
तृड्वान् पिबेत् षडङ्गाम्बु सभूनिम्बं ससारिवम् ॥ ५५ ॥
पेयादि क्षुधितस्यान्नमग्निसन्धुक्षणं हितम् ।
बृहत्यादिगणाभीरुद्विबलाशूर्पपर्णिभिः ॥ ५६ ॥
In diarrhoea arising from pitta and having ama, penetrating and hot things (foods, herbs etc.) should be avoided and fasting is administered, in the beginning itself. If thirsty, he should drink sadanga paniya (chapter 1 of cikistsasthana) added with Andrographis paniculata along with Hemidesmus indicus. When hungry, it is beneficial to consume foods such as peya (gruel) etc., processed with herbs of brithatyadi gana (vide chapter 15 of sutrasthana), ābhīru – Asparagus racemosus, dvibalā – two kinds of bala (Sida cordifolia and Abutilon indicum), śūrpaparṇibhiḥ – and the two surpaparni (Desmodium gangeticum and Uraria picta), which kindle the digestive fire is good to take.
Pitta Atisara Chikitsa
पाययेदनुबन्धे तु सक्षौद्रं तण्डुलाम्भसा ।
कुटजस्य फलं पिष्टं सवल्कं सघुणप्रियम् ॥ ५७ ॥
पाठावत्सकबीजत्वग्दार्वीग्रन्थिकशुण्ठि वा ।
क्वाथं वाऽऽतिविषाबिल्ववत्सकोदीच्यमुस्तजम् ॥५८॥
अथवाऽतिविषामूर्वानिशेन्द्रयवतार्क्ष्यजम् ।
समध्वतिविषाशुण्ठीमुस्तेन्द्रयवकट्फलम् ॥ ५९ ॥
Still, if diarrhea persists, one should drink rice-washed water mixed with either a paste of fruit and bark of kuṭaja – Holarrhena antidysenterica, ghuṇapriyam – Aconitum heterophyllum with honey or of pāṭhā – Cissampelos pareira, seeds of vatsaka – Holarrhena antidysenterica, bark of dārvī – Berberis aristata, granthika – roots of Piper longum and śuṇṭhi – Zingiber officinale; Or a decoction of: ativiṣā – Aconitum heterophyllum, bilva – Aegle marmelos, vatsaka – Holarrhena antidysenterica, udīcya – Pavonia odorata, mustajam – Cyperus rotundus; or of ativiṣā – Aconitum heterophyllum, mūrvā – Marsdenia tenacissima, niśā – Curcuma longa, indrayava – seeds of Holarrhena antidysenterica and tārkṣyaja – extract of Berberis aristate, ativiṣā – or of Aconitum heterophyllum, śuṇṭhī – Zingiber officinale, mustā – Cyperus rotundus, indrayava – seeds of Holarrhena antidysenterica, kaṭphalam – and Myrica nagi mixed with honey.
Pitta Atisara Chikitsa
पलं वत्सकबीजस्य श्रपयित्वा रसं पिबेत् ।
यो रसाशी जयेच्छीघ्रं स पैत्तं जठरामयम् ॥६०॥
मुस्ताकषायमेवं वा पिबेन्मधुसमायुतम् ।
सक्षौद्रं शाल्मलीवृन्तकषायं वा हिमाह्वयम् ॥६१॥
48 grams of vatsaka bīja – seeds of Holarrhena antidysenterica is boiled in water and consumed by the person who partakes meat-soup (as food) quickly gets cured of disease of the stomach (diarrhoea) of pitta origin; Similarly either the decoction of mustā – Cyperus rotundus should be consumed mixed with equal quantity of honey or the cold infusion of śālmalīvṛnta – Bombax ceiba with honey can be made use of.
Pittatisara Chikitsa
किराततिक्तकं मुस्तं वत्सकं सरसाञ्जनम् ।
कटङ्कटेरी ह्रीवेरं बिल्वमध्यं दुरालभा ॥ ६२ ॥
तिला मोचरसं लोध्रं समङ्गा कमलोत्पलम् ।
नागरं धातकीपुष्पं दाडिमस्य त्वगुत्पलम् ॥ ६३॥
अर्धश्लोकैः स्मृता योगाः सक्षौद्रास्तण्डुलाम्बुना ।
The formulations (powders) of herbs mentioned in each of the following half verses consumed along with honey and rice-washed water are beneficial. kirātatiktakaṃ – Swertia chirata, mustaṃ – Cyperus rotundus, vatsakaṃ – vatsaka madhya (pulp of Holarrhena antidysenterica) and aqueous extract of sarasāñjanam – Berberis aristate, kaṭaṅkaṭerī – Berberis atistata, hrīveraṃ – Pavonia odorata, Bilva madhyaṃ – pulp of Aegle marmelos, durālabhā – and Fagonia cretica, tilā – Sesamum indicum, mocarasaṃ – Salmalia malabarica, lodhraṃ – Symplocos racemosa, samaṅgā – Rubia cordifolia, kamala – Nelumbo nucifera, utpalam – and Nymphaea stellata, nāgaraṃ – Zingiber officinale, dhātakī puṣpaṃ – flowers of Woodfordia fruticosa, dāḍimasya tvak – bark of Punica granatum, utpalam – and Nymphaea stellata.
Pittatisara Chikitsa
निशेन्द्रयवलोध्रैलाक्वाथः पक्वातिसारजित् ॥ ६४ ॥
लोध्राम्बष्ठाप्रियङ्ग्वादिगणांस्तद्वत् पृथक् पिबेत् ।
Decoction of: niśā – Curcuma longa, indrayava – seeds of Holarrhena antidysenterica, lodhra – Symplocos racemosa, elā – and Elettaria cardamomum pakva atisārajit – cures pakvatisara. Similarly, the below medicines may be consumed separately. The decoction of herbs of rodhradigana, ambasthadigana and priyagvadi gana (chapter 15 of sutrasthana)
Pitta Atisara Chikitsa
कट्वङ्गवल्कयष्ट्याह्वफलिनीदाडिमाङ्कुरैः ॥ ६५ ॥
पेयाविलेपीखलकान् कुर्यात् सदधिदाडिमान् ।
तद्वद्दधित्थबिल्वाम्रजम्बूमध्यैः प्रकल्पयेत् ॥ ६६ ॥
Peya, vilepi, and khala (all these are liquid) foods, prepared with kaṭvaṅga valka – bark of Oroxylum indicum, yaṣṭyāhva – Glycyrrhiza glabra, phalinī – Callicarpa macrophylla, and dāḍima aṅkura – tender sprouts of Punica granatum mixed with curds and juice of dāḍimān – Punica granatum is beneficial.
Similarly, those prepared with kernel of dadhittha – Feronia elephantum, bilva – Aegle marmelos, āmra – Mangifera indica and jambū – Syzygium cumini.
Pittatisara Chikitsa
अजापयः प्रयोक्तव्यं निरामे तेन चेच्छमः ।
दोषाधिक्यान्न जायेत बलिनं तं विरेचयेत् ॥ ६७ ॥
When there is no ama, goat milk should be administered, if it does not subside because of great increase of the doshas and if the person is strong, he should be given a purgation therapy.
Pittatisara Cikitsa
व्यत्यासेन शकृद्रक्तमुपवेश्येत योऽपि वा ।
पलाशफलनिर्यूहं युक्तं वा पयसा पिबेत् ॥ ६८ ॥
ततोऽनु कोष्णं पातव्यं क्षीरमेव यथाबलम् ।
प्रवाहिते तेन मले प्रशाम्यत्युदरामयः ॥ ६९ ॥
He who is excreting feces and blood alternately, should drink milk along with decoction of palāśa phala – fruits of Butea monosperma followed by drinking of warm milk only (as food), according to his strength. With discharge (voiding) of the feces the stomach disorder (diarrhea) gets relieved.
Pittatisara Chikitsa
पलाशवत्प्रयोज्या वा त्रायमाणा विशोधनी ।
Just like palāśa – Butea monoseprma, trāyamāṇā – Gentiana kurroo should be used in the same way. It acts as a purifier (purgative).
Pittatisara Cikitsa
संसर्ग्यां क्रियमाणायां शूलं यद्यनुवर्तते ॥ ७० ॥
स्रुतदोषस्य तं शीघ्रं यथावह्न्यनुवासयेत् ।
शतपुष्पावरीभ्यां च बिल्वेन मधुकेन च ॥ ७१ ॥
तैलपादं पयोयुक्तं पक्वमन्वासनं घृतम् ।
During the course of samsargi kriya (regimen of liquid food such as peya, vilepi etc), if pain in the abdomen persists, due to over-elimination of the doshas, then the patient should be quickly given anuvasana (oil-enema therapy), depending on the strength of the digestive fire. Medicated ghee prepared with śatapuṣpā – Anethum graveolens, varī – Asparagus racemosus, bilva – Aegle marmelos, and madhuka – Glycyrrhiza glabra, oil one-fourth part, with milk is best for anuvasana – fat enema.
Pichcha Basti: Slimy enema
अशान्तावित्यतीसारे पिच्छावस्तिः परं हितः ॥ ७२ ॥
परिवेष्ट्य कुशैरार्द्रैरार्द्रवृन्तानि शाल्मलेः ।
कृष्णमृत्तिकयाऽऽलिप्य स्वेदयेद्गोमयाग्निना ॥ ७३ ॥
मृच्छोषे तानि सङ्क्षुद्य तत्पिण्डं मुष्टिसम्मितम् ।
मर्दयेत्पयसः प्रस्थे पूतेनास्थापयेत्ततः ॥ ७४ ॥
नतयष्ट्याह्वकल्काज्यक्षौद्रतैलवतानु च ।
स्नातो भुञ्जीत पयसा जाङ्गलेन रसेन वा ॥ ७५ ॥
पित्तातिसारज्वरशोफगुल्मसमीरणास्रग्रहणीविकारान् ।
जयत्ययं शीघ्रमतिप्रवृत्तिं विरेचनास्थापनयोश्च वस्तिः ॥ ७६ ॥
In diarrhoea, if itdoes not subside by the above treatment, administrering piccha basti is best suited. Moist flower stalks of śālmai – Bombax ceiba are tied with kuśai: ārdrai: – green Desmostachya bipinnata grass given a coating of black mud and made into a ball, and burnt in the heat of cow dung cakes, when the mud plaster gets dried, it should be broken. One musti (48 grams) of this bolus of paste is macerated with 768 ml of milk and filtered. nata – Valeriana wallichii, yaṣṭyāhva – and Glycyrrhiza glabra paste of above two medicines should be added to above-mentioned liquid, along with ghee, honey and oil, this should be administered as an enema afterwards. The patient should take bath and eat his food along with either milk or soup of meat of desert-like regions. This kind of enema quickly cures –
pittātisāra – diarrhea of pitta origin, jvara – fever, śopha – dropsy, gulma – abdominal tumour, samīraṇa asra – gout, grahaṇī vikārān – disorders of the duodenum, excess bouts of purgation and decoction enema therapies.
Pichcha Basti: Slimy enema
फाणितं कुटजोत्थं च सर्वातीसारनाशनम् ।
वत्सकादिसमायुक्तं साम्बष्ठादि समाक्षिकम् ॥ ७७ ॥
Inspissated juice of sugarcane and seeds of kuṭaja – Holarrhena antidysenterica added with herbs of vatsakadi group and ambasthadi gana (chapter 15 of sutrasthana) mixed with honey cures all types of diarrhoea.
Putapaka Rasa Yoga
नीरुङ्निरामं दीप्ताग्नेरपि सास्रं चिरोत्थितम् ।
नानावर्णमतीसारं पुटपाकैरुपाचरेत् ॥ ७८ ॥
The patient of diarrhea who is not having painand also no ama,whoeliminates feces mixed with bloodfor long time,and of any coloursand having good digestive powershould be treated withputapaka (explained further).
Putapaka Rasa Yoga
त्वक्पिण्डाद्दीर्घवृन्तस्य श्रीपर्णीपत्रसंवृतात् ।
मृल्लिप्तादग्निना स्विन्नाद्रसं निष्पीडितं हिमम् ॥ ७९ ॥
अतीसारी पिबेद्युक्तं मधुना सितयाऽथवा ।
Paste of tvak dīrghavṛntasya – bark of dirghavrnta (Bombax ceiba) is made into a ball, covered with leaves of śrīparṇī – Gmelina arborea and given a coating of mud, slightly dried, put into fire and taken out when it becomes red, after cooling, the paste is taken out and juice extracted the patient of diarrhoea should drink this juice, made cold and added with either honey or sugar.
Putapaka Rasa Yoga
एवं क्षीरिद्रुमत्वग्भिस्तत्प्ररोहैश्च कल्पयेत् ॥८०॥
कट्वङ्गत्वग्घृतयुता स्वेदिता सलिलोष्मणा ।
Similarly, the juice extracted from the barks and sprouts of trees having milky sap or bark of kaṭvaṅga – Oroxylum indicum, added with ghee and warmed on hot water and mixed with honey. These cure diarrohea quickly even if severe.
Raktatisara: Treatment of bleeding diarrhea
पित्तातीसारी सेवेत पित्तलान्येव यः पुनः ।
रक्तातीसारं कुरुते तस्य पित्तं सतृड्ज्वरम् ॥ ८२ ॥
दारुणं गुदपाकं च तत्र छागं पयो हितम् ।
पद्मोत्पलसमङ्गाभिः शृतं मोचरसेन च ॥ ८३ ॥
शारिवायष्टिलोध्रैर्वा प्रसवैर्वा वटादिजैः ।
सक्षौद्रशर्करं पाने भोजने गुदसेचने ॥ ८४ ॥
The patient of pittatisara (diarrhea caused by pitta), who again indulges in things (food etc) which increase pitta; His pitta further increased, produces raktatisara (diarrhoea with bleeding) along with thirst and fever, and ulcerations of the rectum. For this, goat’s milk boiled with padma – Prunus cerasoides, utpala – Nymphaea stellata, samaṅga – Rubia cordifolia, mocarasa – and Salmalia malabarica, śārivā – or with Hemidesmus indicus, yaṣṭi – Glycyrrhiza glabra, lodhra – and Symplocos racemosa, with sprouts of vaṭādija – Ficus benghalensis etc., mixed with honey and sugar is beneficial for use for drinking and as food for bathing the rectum.
Raktatisara: Treatment of bleeding diarrhea
तद्वद्रसादयोऽनम्लाः साज्याः पानान्नयोर्हिताः ।
काश्मर्यफलयूषश्च किञ्चिदम्लः सशर्करः ॥ ८५ ॥
Similarly meat soup etc., which are not sour and mixed with ghee used for drinking and along with food is beneficial. Soup prepared with kāśmaryaphala – fruits of Gmelina arborea made slightly sour and mixed with honey and sugar is also beneficial.
Raktatisara: Treatment of bleeding diarrhea
पयस्यर्धोदके छागे ह्रीवेरोत्पलनागरैः ।
पेया रक्तातिसारघ्नी पृश्निपर्णीरसान्विता ॥ ८६ ॥
प्राग्भक्तं नवनीतं वा लिह्यान्मधुसितायुतम् ।
Goat’s milk dded with half its quantity of water mixed with powders of hrīvera – Pavonia odorata, utpala – Nymphaea stellata, nāgara – Zingiber officinale, and juice of pṛśniparṇī – Uraria picta, made into a peya (thin gruel) cures bleeding diarrhoea. Butter mixed with honey and sugar should be licked every day before (midday) meal.
Raktatisara: Treatment of bleeding diarrhea
बलिन्यस्रेऽस्रमेवाजं मार्गं वा घृतभर्जितम् ॥८७॥
क्षीरानुपानं क्षीराशी त्र्यहं क्षीरोद्भवं घृतम् ।
कपिञ्जलरसाशी वा लिहन्नारोग्यमश्नुते ॥ ८८ ॥
When there is large amount of bleeding, then the blood of either a goat or deer, fried with ghee should be given to drink followed with milk as an after-drink. The patient should drink milk only as food for three days or consume ghee obtained from milk or soup of meat of kapinjala bird should be licked. By this he regains health.
Raktatisara: Treatment of bleeding diarrhea
पीत्वा शतावरीकल्कं क्षीरेण क्षीरभोजनः ।
रक्तातीसारं हन्त्याशु तया वा साधितं घृतम् ॥८९॥
Paste of śatāvarī – Asparagus racemosus mixed with milk and consumed by the peson who takes milk only as food,this cures bleeding diarrhoea quickly, so also the medicated ghee prepared from it (satavari – Asparagus racemosus)
Raktatisara: Treatment of bleeding diarrhea
लाक्षानागरवैदेहीकटुकादार्विवल्कलैः ।
सर्पिः सेन्द्रयवैः सिद्धं पेयामण्डावचारितम् ॥९०॥
अतीसारं जयेच्छीघ्रं त्रिदोषमपि दारुणम् |
Medicated ghee prepared lākṣā – with Laccifer lacca, nāgara – Zingiber officinale, vaidehī – Piper longum, kaṭukā – Picrorhiza kurroa, dārvi valkalaiḥ – bark of Berberis aristate and indrayava – seeds of Holarrhena antidysenterica consumed, mixed with peya or manda (thin gruel) quickly cures severe diarrohea arising from the three doshas.
Raktatisara: Treatment of bleeding diarrhea
कृष्णमृच्छङ्खयष्ट्याह्वक्षौद्रासृक्तण्डुलोदकम् ॥९१॥
जयत्यस्रं प्रियङ्गुश्च तण्डुलाम्बुमधुप्लुता ।
Black soil, conch, yaṣṭyāhva – Glycyrrhiza glabra, honey and blood of goat or deer mixed with rice-washed water cures bleeding diarrhoea; So also, priyaṅgu: – Callicarpa macrophylla mixed rice-wash water and honey.
Raktatisara: Treatment of bleeding diarrhea
कल्कस्तिलानां कृष्णानां शर्करापाञ्चभागिकः॥९२॥ आजेन पयसा पीतः सद्यो रक्तं नियच्छति ।
Paste of tilānāṃ kṛṣṇānāṃ – krsnatila (Sesamum indicum) added with one-fifth part of sugar, mixed with goat’s milk and consumed stops the bleeding immediately.
Raktatisara: Treatment of bleeding diarrhea
पीत्वा सशर्कराक्षौद्रं चन्दनं तण्डुलाम्बुना ॥९३॥
दाहतृष्णाप्रमोहेभ्यो रक्तस्रावाच्च मुच्यते ।
गुदस्य दाहे पाके वा सेकलेपा हिता हिमाः ॥९४॥
Paste of candanaṃ – Santalum album, added with sugar, honey mixed with rice wash and consumed cures burning sensation, thirst, delusion and bleeding. If there is burning sensation and ulceration of the rectum, bathing the part or topical application with cold thing is beneficial.
Raktatisara: Treatment of bleeding diarrhea
अल्पाल्पं बहुशो रक्तं सशूलमुपवेश्यते ।
यदा विबद्धो वायुश्च कृच्छ्राच्चरति वा न वा ॥ ९५ ।
पिच्छावस्तिं तदा तस्य पूर्वोक्तमुपकल्पयेत् ।
When the patient eliminates little quantities of blood, many times accompanied with pain or vayu (flatus) getting obstructed, comes out with difficulty or does not come out at all, then he should be given (sticky enema) as described earlier.
Raktatisara: Treatment of bleeding diarrhea
पल्लवान् जर्जरीकृत्य शिंशिपाकोविदारयोः ॥९६॥
पचेद्यवांश्च स क्वाथे घृतक्षीरसमन्वितः ।
पिच्छास्रुतौ गुदभ्रंशे प्रवाहणरुजासु वा ॥ ९७ ॥
पिच्छावस्तिः प्रयोक्तव्यः क्षतक्षीणबलावहः ।
Tender leaves of śiṃśipāko – Dalbergia sissoo, vidārayoḥ – Bauhinia variegata are crushed and cooked, mixing it with Hordeum vulgare. This decoction added with ghee and milk, administered as a picchabasti is useful for rectal exudation, rectal prolapse, straining and pain. A person debilitated from injury to the chest will get strength.
Raktatisara: Treatment of bleeding diarrhea
प्रपौण्डरीकसिद्धेन सर्पिषा चानुवासनम् ॥ ९८ ॥
Anuvasana (oil enema) should be given with ghee prepared with Nelumbo nucifera.
Raktatisara: Treatment of bleeding diarrhea
रक्तं विट्सहितं पूर्वं पश्चाद्वा योऽतिसार्यते ।
शतावरीघृतं तस्य लेहार्थमुपकल्पयेत् ॥ ९९ ॥
For the patient who eliminates blood mixed with feces, either earlier to or after elimination of feces, satavari Ghrta should be given to him for licking.
Raktatisara: Treatment of bleeding diarrhea
शर्करार्धांशकं लीढं नवनीतं नवोद्धृतम् ।
क्षौद्रपादं जयेच्छीघ्रं तं विकारं हिताशिनः ॥ १०० ॥
Butter obtained fresh, mixed with sugar half of its quantity and honey, quarter of its quantity. This remedy,licked daily followed by partaking suitable food cures the above diseases quickly.
Raktatisara: Treatment of bleeding diarrhea
न्यग्रोधोदुम्बराश्वत्थशुङ्गानापोथ्य वासयेत् ।
अहोरात्रं जले तप्ते घृतं तेनाम्भसा पचेत् ॥१०१॥
तदर्धशर्करायुक्तं लेहयेत्क्षौद्रपादिकम् ।
अधो वा यदि वाऽप्यूर्ध्वं यस्य रक्तं प्रवर्तते ॥१०२॥
Sprouts of nyagrodha – Ficus benghalensis, udumbara – Ficus racemosa, aśvattha – and Ficus religiosa, āpothya – are slightly crushed, soaked in hot water and kept undisturbed for a day and night. Ghee should be cooked in this water, mixed with half its quantity of sugar and one-fouth quantity of honey and made into a confection. Thus, should be licked daily by one who hasbleeding either in the downward or upward directions.
Kaphatisara Chikitsa
श्लेष्मातीसारे वातोक्तं विशेषादामपाचनम् ।
कर्तव्यमनुबन्धेऽस्य पिबेत्पक्त्वाऽग्निदीपनम् ॥ १०३ ॥
बिल्वकर्कटिकामुस्तप्राणदाविश्वभेषजम् ।
वचाविडङ्गभूतीकधानकामरदारु वा ॥ १०४ ॥
अथवा पिप्पलीमूलपिप्पलीद्वयचित्रकम् ।
In diarrhoea of kapha origin, the treatment prescribed for that of vata origin itself should be done, especially so, those which cook the ama. If the diarrhoea persists, the treatment should be done which includes drinking of decoction prepared with bilva – Aegle marmelos, karkaṭikā – Cucumis sativus, musta – Cyperus rotundus, prāṇadā – Terminalia chebula, viśvabheṣajam – Zingiber officinale, vacā – Acorus calamus, viḍaṅga – Embelia ribes, bhūtīka – Cybopogon citrates, dhānakā – Coriandrum sativum, amaradāru vā – and Cedrus deodara or of pippalīmūla – roots of Piper longum, pippalīdvaya – Piper longum and Scindapsus officinalis, citrakam – Plumbago zeylanica, which enhance digestive fire.
Kaphatisara Chikitsa
पाठाग्निवत्सकग्रन्थितिक्ताशुण्ठीवचाभयाः ॥१०५॥
क्वथिता यदि वा पिष्टाः श्लेष्मातीसारभेषजम् ।
pāṭhā – Cissampelos pareira, agni – Plumbago zeylanica, vatsaka – Hollarhena antidysenterica, granthi – roots of Piper longum, tiktā – Swertia chirata, śuṇṭhī – Zingiber officinale, vaca – Acorus calamus, abhayā – and Terminalia chebula made into a decocton or paste is the best medicine for diarrhea of kapha origin.
Kaphatisara Chikitsa
सौवर्चलवचाव्योषहिङ्गुप्रतिविषाभयाः ॥ १०६ ॥
पिबेच्छ्लेष्मातिसारार्तश्चूर्णिताः कोष्णवारिणा ।
मध्यं लीढ्वा कपित्थस्य सव्योषक्षौद्रशर्करम् ॥ १०७ ॥
कट्फलं मधुयुक्तं वा मुच्यते जठरामयात् ।
The person suffering from diarrhoea arising from kapha should consume the powder of Black salt, vacā – Acorus calamus, vyoṣa – Piper longum, Piper nigrum and Zingiber officinale, hiṅgu – Ferula narthex, prativiṣa – Aconitum heterophyllum, abhayā – and Terminalia chebula mixed with warm water. He who licks the marrow of kapittha Feronia limonia, mixed with powder of Piper longum, Piper nigrum and Zingiber officinale, honey, sugar; kaṭphalaṃ – or Myrica nagi madhuyuktaṃ vā – mixed with honey, gets cured of diseases of the stomach (diarrhea).
Kaphatisara Chikitsa
कणां मधुयुक्तां लीढ्वा तक्रं पीत्वा सचित्रकम्॥१०८॥
भुक्त्वा वा बालबिल्वानि व्यपोहत्युदरामयम्।
Licking the (powder of) kanam – Piper longum with honey, drinking buttermilk mixed with chitrakam – Plumbago zeylanica or eating tender fruits of Aegle marmelos cures diseases of the stomach (diarrhoea).
Kaphatisara Chikitsa
पाठामोचरसाम्भोदधातकीबिल्वनागरम् ॥१०९॥
सुकृच्छ्रमप्यतीसारं गुडतक्रेण नाशयेत् ।
pāṭhā – (Powder of) Cissampelos pareira, Salmalia malabarica, Cyperus rotundus, Woodfordia fruticosa, Aegle marmelos and Zingiber officinale consumed mixed with jaggery and buttermilk destroys diarrhoea even ifvery severe.
Kapitthastaka Churna
यवानीपिप्पलीमूलचातुर्जातकनागरैः ॥ ११० ॥
मरिचाग्निजलाजाजीधान्यसौवर्चलैः समैः ।
वृषाम्लधातकीकृष्णाबिल्वदाडिमदीप्यकैः ॥१११॥
त्रिगुणैः षड्गुणसितैः कपित्थाष्टगुणैः कृतः ।
चूर्णोऽतीसारग्रहणीक्षयगुल्मगलामयान् ॥ ११२ ॥
कासश्वासाग्निसादार्शःपीनसारोचकाञ्जयेत् ।
Equal parts each of yavānī – Trachyspermum ammi, pippalīmūla – root of Piper longum, cāturjātaka – Cinnamomum zeylanicum, Cinnamomum tamala, Elettaria cardamom, Messua ferrea, Zingiber officinale, maricā – Piper nigrum, agni – Plumbago zeylanica, jala – Pavonia odorata, ajājī – Cuminum cyminum, dhānya – Coriandrum sativum, sauvarcalaiḥ – Black salt together making one part, triguṇaiḥ – together making three parts, by equal parts of vṛṣksamla – Garcinia indica, dhātakī – Woodfordia fruticosa, kṛṣṇā – Piper longum, bilva – Aegle marmelos, dāḍima – Punica granatum, dīpyakaiḥ – and Cuminum cyminum, sita – sugar, six parts, kapitthā – and Feronia linonia eight parts kṛtaḥ cūrṇo – are all converted into a nice powder. Consumed in appropriate dose, this cures atīsāra – diarrhoea, grahaṇī – duodenal disease, kṣaya – consumption, gulma – abdominal tumour, gala āmayān – diseases of throat, kāsa – cough, śvāsa – dyspnoea, agnisāda – weak digestion, arśaḥ – piles, pīnasa – chronic nasal catarrah, ārocaka – and loss of taste / appetite.
Dadimastaka Churna
कर्षोन्मिता तवक्षीरी चातुर्जातं द्विकार्षिकम् ॥११३॥
यवानीधान्यकाजाजीग्रन्थिव्योषं पलांशकम् ।
पलानि दाडिमादष्टौ सितायाश्चैकतः कृतः ॥ ११४ ॥
गुणैः कपित्थाष्टकवच्चूर्णोऽयं दाडिमाष्टकः ।
भोज्यो वातातिसारोक्तैर्यथावस्थं खलादिभिः ॥११५॥
12 grams of tavakṣīrī – Bambusa bambos, cāturjātaṃ – Cinnamomum zeylanica, Cinnamomum tamala, Elettaria cardamom and Messua ferrea in 24 g quantity, pala aṃśakam – one pala (48 grams) each of: yavānī – Trachyspermum ammi, dhānyaka – Coriandrum sativum, ajājī – Cuminum cyminum, granthi – root of Piper longum, vyoṣaṃ – and Piper longum, Piper nigrum and Zingiber officinale, eight pala (384 grams) each of dāḍima – Punica granatum and sugar – all are made into a nice powder. This dadimastaka churna is similar to the earlier kapitthastaka curna in qualities and should be consumed along with khala etc., described in the stage-wise treatement in diarrhoea of vata origin.
Vidangadi Khala
सविडङ्गः समरिचः सकपित्थः सनागरः ।
चाङ्गेरीतक्रकोलाम्लः खलः श्लेष्मातिसारजित् ॥११६॥
Khala prepared with viḍaṅga – Embelia ribes, marica – Piper nigrum, kapittha – Feronia linonia, nāgara – Zingiber officinale and cāṅgerī – Oxalis corniculata mixed with buttermilk kola amlaḥ – sour fruit of Ziziphus jujuba cures diarrhoea of kapha origin.
Medicated ghee
क्षीणे श्लेष्मणि पूर्वोक्तमम्लं लाक्षादि षट्पलम् ।
पुराणं वा घृतं दद्याद्यवागूमण्डमिश्रितम् ॥ ११७ ॥
If kapha is decreased, medicated ghee described earlier such as amla ghrita (verse 48) laksadi ghrita (verse 90) satpalaghrta (chapter 5/22) or even old ghee should be given or mixed with yavagu and thin gruel may be consumed.
Pichcha Basti
वातश्लेष्मविबन्धे वा स्रवत्यति कफेऽपि वा।
शूले प्रवाहिकायां वा पिच्छावस्तिः प्रशस्यते॥११८॥
वचाबिल्वकणाकुष्ठशताह्वालवणान्वितः।
If there is obstruction of vata and kapha or if kapha only is being eliminated greatly, or when these is pain and straining at stools, picchabasti (slimy enema) containing vacā – Acorus calamus, bilva – Aegle marmelos, kaṇā – Piper longum, kuṣṭha – Saussurea lappa, śatāhvā – Anethum graveolens and salt is best suited.
Anuvasana Basti
बिल्वतैलेन तैलेन वचाद्यैः साधितेन वा ॥ ११९ ॥
बहुशः कफवातार्ते कोष्णेनान्वासनं हितम् ।
Oil obtained from the marrow of bilva – Aegle marmelos fruits or oil processed with vacā – Acorus calamus etc., (enumerated above) made warm and used for anuvasana (oil of enema), many times is beneficial for the person suffering from (increase of) kapha and vata.
Pichcha Basti
क्षीणे कफे गुदे दीर्घकालातीसारदुर्बले ॥ १२० ॥
अनिलः प्रबलोऽवश्यं स्वस्थानस्थः प्रजायते ।
स बली सहसा हन्यात्तस्मात्तं त्वरया जयेत् ॥ १२१ ॥
वायोरनन्तरं पित्तं पित्तस्यानन्तरं कफम् ।
जयेत्पूर्वं त्रयाणां वा भवेद्यो बलवत्तमः ॥ १२२ ॥
When kapha is decreased, the rectum becomes weak due to long continued atīsāra – diarrhoea; the vata residing in is its own seat (the rectum) definetly becomes very powerful. This powerful Vata kills the person suddenly. Hence it should be won immediately. After winning vata, pitta should be won after winning pitta, kapha should be won. Or among three whichever is most predominant, should be won first.
Pichcha Basti
भीशोकाभ्यामपि चलः शीघ्रं कुप्यत्यतस्तयोः ।
कार्या क्रिया वातहरा हर्षणाश्वासनानि च ॥ १२३ ॥
Vata gets aggravated soon, even by fear and grief, hence even for the diarrhoea caused by these (fear and grief) treatment which mitigates vata and also treatment which provides happiness and courage of the patient should be resorted to.
Pichcha Basti
यस्योच्चाराद्विना मूत्रं पवनो वा प्रवर्तते ।
दीप्ताग्नेर्लघुकोष्ठस्य शान्तस्तस्योदरामयः ॥ १२४ ॥
The disease of the stomach (diarrhoea)is to be considered as cured when the person is able to eliminate urine or flatus without the elimination of feces,when his digestive fire is increased and alimentary tract is light.
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां चतुर्थे चिकित्सितस्थानेऽतीसारचिकित्सितं नाम नवमोऽध्याय: ॥९॥
Thus, ends the chapteratisara cikitsa the ninth in cikitsita sthana of astangahrdayasamhita, composed by Srimadvagbhata, son of Sri Vaidyapati Simhagupta.
