The eighth chapter of Nidanasthanam of Ashtanga Hridayam is known as as Atisara Grahani Dosa Nidanam Adhyayah. This chapter offers with the reason of ‘prognosis of diarrhea and duodenal problems’.
The subjects lined on this chapter embrace –
– Atisara Bheda – sorts of diarrhea
– Nidana-Samprapti – causes and pathogenesis
– Purvarupa – premonitory signs
– Rupa – medical options of diarrhea
– Vataja, pittaja, kaphaja, tridoshaja, bhayaja and shokaja atisara
signs
– Sama and Nirama atisara
– Grahani Dosha Nidanam – prognosis of duodenal problems
– Grahani Dosha bheda – sorts of duodenal problems
– Purvarupa – premonitory signs of diarrhea
– Rupa – medical options of diarrhea
– Vataja, pittaja, kaphaja, tridoshaja grahani signs
– Ashta maharogas – eight nice illnesses
Pledge by the writer(s)
अथातोऽतीसार ग्रहणीदोषनिदानं व्याख्यास्याम ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having supplied prayers to the God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘prognosis of diarrhea and duodenal problems’. Thus say (pledge) Atreya and different sages.
Atisara Bheda (sorts of diarrhea)
दोषै: व्यस्तैः समस्तैश्च भयात् शोकात् च षड्विधः ।
अतीसारः
Atisara (diarrhea) is of six varieties; viz. from every Dosha individually, from all of them collectively, one every from concern and grief.
Nidana Samprapti (causes and pathogenesis)
सुतरां जायतेऽत्यम्बुपानतः ॥ १ ॥
कृशशुष्कामिषासात्म्यतिलपिष्टविरूढकैः ।
मद्यरूक्षातिमात्रान्नैरर्शोभिः स्नेहविभ्रमात् ॥ २ ॥
कृमिभ्यो वेगरोधाच्च तद्विधैः कुपितोऽनिलः ।
विस्रंसयत्यधोऽब्धातुं हत्वा तेनैव चानलम् ॥ ३ ॥
व्यापद्यानुशकृत् कोष्ठं पुरीषं द्रवतां नयन् ।
प्रकल्पतेऽतिसाराय
It mainly arises from consuming giant amount of water, consuming meat which is emaciated and dry, unaccustomed meals, puddings, of Tila – Sesamum indicum (sesame seeds), sprouted grains, extra of wine, meals that are dry (non-fatty) and in giant amount; from Arsas (piles), improper oleation remedy, worms (intestinal parasites), suppression of urges and such others. Anila (Vata) getting aggravated, makes the Apdhatu (watery tissues) to maneuver downwards; destroying the Anala (digestive fireplace), invades the Kostha (alimentary tract), makes the faeces watery and produces atisara (diarrhea).
Purvarupa (premonitory signs)
लक्षणं तस्य भाविनः ॥ ४ ॥
तोदो हृद्गुदकोष्ठेषु गात्रसादो मलग्रहः ।
आध्मानमविपाकश्च
Its premonitory signs are pricking ache within the area of the center, rectum and alimentary tract; weak spot of the physique, constipation, flatulence and indigestion.
Rupa (medical options)
Vataja Atisara
तत्र वातेन विड्जलम् ॥ ५ ॥
अल्पाल्पं शब्दशूलाढ्यं विबद्धमुपवेश्यते।
रूक्षं सफेनमच्छं च ग्रथितं वा मुहुर्मुहुः ॥ ६ ॥
तथा दग्धगुडाभासं सपिच्छापरिकर्तिकम् ।
शुष्कास्यो भ्रष्टपायुश्च हृष्टरोमा विनिष्टनन् ॥ ७ ॥
In diarrhea brought on by Vata, the faeces is watery, very much less in amount, expelled out with noise, extreme ache and problem; it might be dry, combined with froth, skinny or scabelous and expelled typically; or it might resemble over-burnt jaggery and combined with slimy materials; slicing ache within the anal area, the particular person has dryness of the mouth, prolapsed of the rectum, horripilation and straining at stools.
Pittaja Atisara
पित्तेन पीतमसितं हारिद्रं शाद्वलप्रभम् ।
सरक्तमतिदुर्गन्धं तृण्मूर्छास्वेददाहवान् ॥ ८ ॥
सशूलं पायुसन्तापपाकवाञ्
In that brought on by Pitta, the faeces is yellow, black, turmeric like (deep yellow) or algae like (inexperienced); combined with blood and foul smelling, the particular person has thirst, fainting, perspiration, burning sensation; elimination is accompanied with ache, burning sensation and ulceration of the rectum.
Kaphaja Atisara
छ्लेष्मणा घनम् ।
पिच्छिलं तन्तुमच्छ्वेतं स्निग्धमामं कफान्वितम् ॥ ९ ॥
अभीक्ष्णं गुरु दुर्गन्धं विबद्धं अनुबद्धरुक् ।
निद्रालुरलसोऽन्नद्विड् अल्पाल्पं सप्रवाहिकम् ॥ १० ॥
सरोमहर्षं सोत्क्लेशो गुरुवस्तिगुदोदरः ।
In that attributable to Slesma (Kapha) the faeces is stable, slimy, thready, white, fatty, raw, combined with Kapha (mucus), frequent, heavy foul-smelling, accompanied with problem of elimination and adopted by ache; the particular person is all the time sleepy, lazy, dislikes meals, has slight (gentle) straining at stools (or tenesmus) all the time; horripilation, nausea, feeling of heaviness of the urinary bladder, rectum and stomach and feeling of non-elimination (of feaces) although really eradicated.
Tridoshaja Atisara
सर्वात्मा सर्वलक्षणः॥११॥
That brought on by all of the Doshas can have all of the options (concurrently).
Bhayaja and Shokaja Atisara
भयेन क्षोभिते चित्ते सपित्तो द्रावयेच्छकृत् ।
वायुस्ततोऽतिसार्येत क्षिप्रमुष्णं द्रवं प्लवम् ॥ १२ ॥
वातपित्तसमं लिङ्गैराहुस्तद्वच्च शोकतः ।
The thoughts getting disordered by concern, makes for improve of Pitta and Vayu (Vata) which trigger the faeces to change into liquid, and produce diarrhea. Elimination is fast, faeces is heat, fluid and floating (on water); the particular person having signs brought on by Vata and Pitta; that (diarrhea) brought on by grief can be related.
Sama and Nirama kinds of Atisara
अतीसारः समासेन द्विधा सामो निरामकः ॥ १३ ॥
सासृङ् निरस्रस्तत्राद्ये गौरवादप्सु मज्जति ।
शकृद्दुर्गन्धमाटोपविष्टम्भार्तिप्रसेकिनः ॥ १४ ॥
विपरीतो निरामस्तु कफात्पक्वोऽपि मज्जति ।
In short, diarrhea is of two varieties viz, Sama (related to Ama) and Nirama (unassociated with Ama) and Sasra combined with blood and Nirasra not combined with blood. Within the first (Sama) the faeces is heavy and so sinks in water, has foul odor, accompanied with intestinal gurgling, stasis of undigested meals within the abdomen, ache within the stomach and extra salivation; Nirama (which isn’t having Ama) has reverse options; feces containing extra of Kapha additionally sink although it’s ripe.
Grahani Dosha Nidanam (prognosis of duodenal problems)
अतीसारेषु यो नातियत्नवान् ग्रहणीगदः ॥ १५ ॥
तस्य स्यादग्निविध्वंसकरैरन्यस्य सेवितैः ।
The affected person of diarrhea who doesn’t attempt a lot (to get cured of it) turns into affected by problems of Grahani (duodenum); so additionally even others who bask in issues (meals and actions) which destroy the Agni (digestive exercise).
Grahani Dosha Nidanam (prognosis of duodenal problems)
सामं शकृन्निरामं वा जीर्णे येनातिसार्यते ॥ १६ ॥
सोऽतीसारोऽतिसरणादाशुकारी स्वभावतः ।
सामं सान्नमजीर्णेऽन्ने जीर्णे पक्वं तु नैव वा ॥ १७ ॥
अकस्माद्वा मुहुर्बद्धमकस्माच्छिथिलं मुहुः ।
चिरकृद्ग्रहणीदोषः सञ्चयाच्चोपवेशयेत् ॥ १८ ॥
Too many elimination of feces with or with out admixture of Ama, after the digestion of meals is Atisara (diarrhea) which by nature, goes to trigger dying quickly; whereas in Grahani Dosha (dysfunction of duodenum) the faeces is combined with Ama and meals, eradicated both when the meals is undigested, throughout digestion or after digestion; or there could also be no eliminations (of faeces) in any respect; the faeces is typically eradicated stable and another instances unfastened (liquid) with out every other purpose; elimination happens solely after accumulation (within the giant gut); this illness inflicting dying after a very long time.
Grahani Dosha Bheda (sorts of duodenal problems)
स चतुर्धा पृथग्दोषैः सन्निपाताच्च जायते ।
It’s of 4 varieties; (one) from every Dosha individually and from all of them collectively.
Purvarupa (premonitory signs)
प्राग्रूपं तस्य सदनं चिरात्पचनमम्लकः ॥ १९ ॥
प्रसेको वक्त्रवैरस्यमरुचिस्तृट् क्लमो भ्रमः ।
आनद्धोदरता छर्दिः कर्णक्ष्वेडोऽन्त्रकूजनम् ॥ २० ॥
Its premonitory signs are-weakness, digestion after a very long time, sourness (elevated acidity), salivation, dangerous style within the mouth, lack of style/urge for food, thirst, exhaustion, dizziness, distension of the stomach, vomiting, noise within the ears and intestinal gurgling
Rupa (medical options)
सामान्यं लक्षणं कार्श्यं धूमकस्तमको ज्वरः ।
मूर्छा शिरोरुग्विष्टम्भः श्वयथुः करपादयोः ॥ २१ ॥
Its basic signs are emaciation, feeling of sizzling fumes popping out from the mouth Tamaka (dyspnoea), fever, fainting, headache, stasis of undigested meals within the abdomen and swelling of the palms and toes.
Vataja Grahani
तत्रानिलात्तालुशोषस्तिमिरं कर्णयोः स्वनः ।
पार्श्वोरुवङ्क्षणग्रीवारुजाभीक्ष्णं विषूचिका ॥ २२ ॥
रसेषु गृद्धिः सर्वेषु क्षुत्तृष्णा परिकर्तिका ।
जीर्णे जीर्यति चाध्मानं भुक्ते स्वास्थ्यं समश्नुते ॥ २३ ॥
वातहृद्रोगगुल्मार्शःप्लीहपाण्डुत्वशङ्कितः ।
चिराद्दुःखं द्रवं शुष्कं तन्वामं शब्दफेनवत् ॥ २४ ॥
पुनः पुनः सृजेद्वर्चः पायुरुक्श्वासकासवान् ।
In that brought on by Anila (Vata), there’s dryness of the palate, feeling of blindness, noise within the ears; fixed ache within the flanks, thighs, groins and neck, Visucika (vomiting and diarrhea concurrently), want for (issues of all of the tastes, elevated starvation and thirst, slicing ache within the rectum, flatulence after and through digestion, feels comfy by taking meals; results in suspicion of illness of the center, belly tumor, piles, illness of the spleen and anemia – all of Vata origin; affected person eliminates faeces alter lengthy intervals, with problem; faeces is liquid, dry (non-unctuous), skinny, raw, frothy, and elevated frequency, accompanied with ache within the rectum, dyspnea and cough.
Pittaja Grahani
पित्तेन नीलपीताभं पीताभः सृजति द्रवम् ॥ २५ ॥
पूत्यम्लोद्गारहृत्कण्ठदाहारुचितृडर्दितः ।
In that brought on by Pitta, the feces is bluish-yellow or yellow, and liquid; the particular person has dangerous smelling, bitter belching, burning sensation within the area of the center and throat, lack of style/urge for food and thirst.
Kaphaja Grahani
श्लेष्मणा पच्यते दुःखमन्नं छर्दिररोचकः ॥ २६ ॥
आस्योपदेहनिष्ठीवकासहृल्लासपीनसाः ।
हृदयं मन्यते स्त्यानमुदरं स्तिमितं गुरु ॥ २७ ॥
उद्गारो दुष्टमधुरः सदनं स्त्रीष्वहर्षणम् ।
भिन्नामश्लेष्मसंसृष्टगुरुवर्चःप्रवर्तनम् ॥ २८ ॥
अकृशस्यापि दौर्बल्यं
In that brought on by Slesma (Kapha), the meals is digested with problem, there’s vomiting, lack of style/urge for food, coating of the mouth, expectoration, cough, nausea, nasal catarrh, the particular person feels his throat / coronary heart as stable (heavy) and stomach as static (motion much less), damp and heavy; impure belching (with dangerous odor) and candy; debility, lack of want for ladies (intercourse), elimination of faeces which is damaged, raw, combined with mucus, and heavy or giant in amount, and feeling of weak spot despite the fact that not emaciated.
Tridoshaja Grahani
सर्वजे सर्वसङ्करः ।
विभागेऽङ्गस्य ये चोक्ता विषमाद्यास्त्रयोऽग्नयः ॥ २९ ॥
तेऽपि स्युर्ग्रहणीदोषाः समस्तु स्वास्थ्यकारणम् ॥ ३०अब् ॥
In that attributable to all of the Doshas, all of the signs are current. Even Visamagni and different kinds of Agnis (sorts of digestive actions) described in Angavibhava (chapter 3 of Sarirasthana) are additionally Grahani Dosha (problems of the duodenum); the Samagni (regular digestive company) solely is the trigger for well being.
Ashta Maharogas: Eight nice illnesses
वातव्याध्यश्मरीकुष्ठमेहोदरभगन्दराः ॥ ३०- ॥
अर्शांसि ग्रहणीत्यष्टौ महारोगाः सुदुस्तराः ॥ ३०- ॥
Vatavyadhi (nervous illness), Ashmari (urinary calculus), Kustha (leprosy), Meha (diabetes) udara (enlargement of the stomach), Bhagandara (fistula-in-ano), Arshas (piles, haemorrhoids) and Grahani (duodenal illness) these eight Maharogas (nice illnesses) are tough to deal with.
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहिताया तृतीये निदानस्थानेऽतीसारग्रहणिदोषनिदानं नामाष्टमोऽध्याय: ।।१॥
Thus ends the chapter Atisara-Grahani Nidana – the eighth in Nidanasthana of AstangaHrdaya Samhita, composed by Srimad Vagbhata, son of Sri VaidyapatiSimhagupta.
