The third chapter of Nidanasthanam of Ashtanga Hridayam is known as as Raktapitta Kasa Nidanam Adhyaya. This chapter offers with the reason of ‘prognosis of bleeding problems and cough’.
The subjects lined on this chapter embrace –
– Causes and pathogenesis of bleeding problems
– Premonitory signs of bleeding problems
– Scientific options of bleeding problems
– Prognosis of bleeding problems
– Analysis of cough
– Premonitory signs of cough
– Pathogenesis of cough
– Options of cough of vata origin
– Options of cough of pitta origin
– Options of cough of kapha origin
– Options of cough on account of trauma to the lungs
– Cough on account of consumption, pulmonary tuberculosis
– Prognosis of various sorts of cough
Pledge by the writer(s)
अथातो रक्तपित्तकासनिदानं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having provided prayers to the God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘prognosis of bleeding problems and cough’. Thus say (pledge) atreya and different sages.
Raktapitta Nidana and Samprapti (causes and pathogenesis)
भृशोष्णतीक्ष्ण कट्वम्ललवणादिविदाहिभिः ।
कोद्रवोद्दालकैश्चान्नैस्तद्युक्तैरतिसेवितैः ॥ १ ॥
कुपितं पित्तलैः पित्तं द्रवं रक्तं च मूर्च्छितै: ।
तेमिथस्तुल्यरूपत्वमागम्य व्याप्नुतस्तनुम् ॥ २ ॥
पित्तं रक्तस्य विकृतेः संसर्गाद्दूषणादपि ।
गन्धवर्णानुवृत्तेश्च रक्तेन व्यपदिश्यते ॥ ३ ॥
प्रभवत्यसृजः स्थानात्प्लीहतोयकृतश्च तत् ।
Over-indulgence in meals and drinks which might be profoundly scorching (warmth producing), penetrating deep, pungent, bitter, salt and such others that trigger burning sensation throughout digestion, use of Kodrava (Paspalum Scrobiculatum), Uddalaka (millet and such others), in additional amount and different causes (actions) which enhance pitta. Pitta which is in liquid from and Rakta (blood) which possesses nearer affinity, will get vitiated, combined collectively, assume equivalent qualities, unfold all through the physique, (and produce the illness Raktapitta) pitta being the bye-product of Rakta (blood) due to their admixture (Samsargat) and property of vitiating one another (dushanat), and resemblance in odor and colour, Pitta is expressed and exhibited as Rakta (blood). The illness Raktapitta originates from the seat of Rakta (blood), that’s the Pliha (spleen) and Yakrit (liver).
Notes: Pitta and Rakta each being Agneya possess related properties and better affinity. Each get elevated by the identical trigger, on the similar time and provides rise to the disease-Raktapitta, characterised by bleeding from completely different components of the physique. Use of the phrases “Pitta in liquid type” is to point the Pacaka and Ranjaka Pitta, particularly the previous, current within the Amasaya (abdomen), Yakrt (liver) and Pliha (spleen), which change into the websites of origin of the ailments. The blood that comes out is vitiated particularly by Pitta, related to Kapha and Vata to slightly extent. It is going to be having elevated warmth, liquidity, foul odor, tendency to penetrate the partitions of the vessels and tissue cells, flows out constantly; the property of clotting being both diminished or misplaced. Identification of this illness in trendy parlance has not thus far been passable, ailments like polycythemia vera, purpura, hemophilia, and so forth. that are primarily hemorrhagic are among the probables, the primary one most certainly.
Purvarupa (premonitory signs)
शिरोगुरुत्वमरुचिःशीतेच्छाधूमकोऽम्लकः ॥ ४ ॥
छर्दिश्छर्दितबैभत्स्यंकासःश्वासोभ्रमःक्लमः ।
लोहलोहितमत्स्यामगन्धास्यत्वंस्वरक्षयः ॥ ५ ॥
रक्तहारिद्रहरितवर्णतानयनादिषु ।
नीललोहितपीतानांवर्णानामविवेचनम् ॥ ६ ॥
स्वप्नेतद्वर्णदर्शित्वंभवत्यस्मिन्भविष्यति ।
Feeling of heaviness of the top, lack of style (or urge for food), need for chilly, feeling of scorching fumes popping out (from the abdomen via the mouth), (elevated) acidity, vomiting, worry from vomiting (by the sight of the vomited supplies), cough, dyspnoea, dizziness, exhaustion, feeling of the odor of iron, blood and uncooked fish within the mouth, lack of voice, purple, turmeric (deep yellow) or inexperienced colour of the eyes and so forth. (pores and skin, tongue, nails, urine, feces), lack of ability to acknowledge blue, purple and yellow colours, seeing objects of the identical colour (purple, deep yellow or inexperienced) in goals – are the signs of the forthcoming illness.
Rupa (scientific options)
ऊर्ध्वं नासाक्षिकर्णास्यैर्मेढ्रयोनिगुदैरधः॥७॥
कुपितं रोमकूपैश्च समस्तैस्तत्प्रवर्तते।
It (vitiated blood) comes out from the higher components via the nostril, eyes, ears and mouth; from the decrease components via the penis (urethra), Yoni (vagina and genital tract) and rectum; from all of the channels, the hair follicles (within the pores and skin) and all different websites (of each higher and decrease areas).
Notes: – The illness is of three types-viz, Urdhvagata-bleeding in upward route, Adhogata-bleeding in downward route and Ubhaya marga gata or Tiryaggata-bleeding from upward, downward and all instructions concurrently. Pitta is the first causative Dosha for all the categories, however the secondary or affiliate Dosha is completely different, Kapha for the upward kind, Vata for the downward kind and all of the three for the third kind.
Sadhyasadhyata (Prognosis)
ऊर्ध्वं साध्यं कफाद्यस्मात्तद्विरेचन साधनम्॥८॥
बह्वौषधं च पित्तस्यविरेको हि वरौषधम् ।
अनुबन्धीकफोयश्चतत्रतस्यापिशुद्धिकृत् ॥ ९ ॥
कषायाः स्वादवोऽप्यस्यविशुद्धश्लेष्मणोहिताः ।
किमुतिक्ताःकषायावा ये निसर्गात्कफापहाः ॥ १० ॥
Urdhavaga (upward route) is sadhya (curable) due to Kapha (being the affiliate Dosha); for this (the illness) purgation is the best technique of therapy, of availability of enormous variety of medicine; for mitigating Pitta, purgation is the very best remedy, and it additionally clears (mitigates) Kapha, the affiliate Dosha Kashayas (recipes/medicinal varieties akin to contemporary juice, infusion, decoction, powder and so forth.) although candy are appropriate for the one who has been free of Kapha; then what to say of these recipes that are bitter or astringent, that are by nature mitigates of Kapha.
Notes: – Pratimargaharana – conquering the illness via the wrong way – is likely one of the strategies of therapy which is relevant to this illness. Illnesses having upward and downward instructions are managed by creating motion within the reverse instructions respectively, eg. Extreme vomiting is managed by producing purgation and extreme diarrhea by producing vomiting. Equally, for management of bleeding of upward route, purgative remedy and of downward route, emesis remedy are mentioned to be perfect.
Sadhyasadhyata (Prognosis)
अधोयाप्यं चलाद्यस्मात्तत्प्रच्छर्दनसाधनम् ।
अल्पौषधं च पित्तस्यवमनंनवरौषधम् ॥ ११ ॥
अनुबन्धीचलोयश्चशान्तयेऽपिनतस्य तत् ।
कषायाश्चहितास्तस्यमधुरा एव केवलम् ॥ १२ ॥
Adhoga (downward kind) is Yapya (incurable, controllable) due to Chala (Vata being the affiliate Dosha), for it (the illness) emesis is the means and perfect technique of therapy and of availability of a smaller variety of herbs. For mitigating Pitta, emesis is just not the best remedy; Chala (Vata) being the affiliate Dosha, the recipes that are astringent or bitter or incapable to mitigate the very best ones on this situation are solely the recipes which have candy style.
Sadhyasadhyata (Prognosis)
कफमारुतसंसृष्टमसाध्यमुभयायनम् ।
अशक्यप्रातिलोम्यत्वादभावादौषधस्य च ॥ १३ ॥
न हि संशोधनं किञ्चिदस्त्यस्यप्रतिलोमगम् ।
शोधनंप्रतिलोमं च रक्तपित्तेभिषग्जितम् ॥ १४ ॥
एवमेवोपशमनंसर्वशोनास्यविद्यते ।
संसृष्टेषु हि दोषेषुसर्वजिच्छमनं हितम् ॥ १५ ॥
Ubhayayana (each instructions concurrently) kind is Asadhya (incurable) due to, Kapha and Vata are the affiliate Doshas. It’s unimaginable additionally due to administering therapies reverse of the instructions (of bleeding) and of non-availability of medicine (in adequate quantity). There isn’t any purificatory remedy which is reverse of each the instructions, however for Raktapitta, the best therapy is purifactory remedy reverse to the route (of bleeding). Equally there isn’t a palliative technique for all of the Doshas; and when all of the Doshas are combined collectively, simultaneous mitigation of all them is most fitted
Sadhyasadhyata (Prognosis)
तत्रदोषानुगमनं सिरास्रैवलक्षयेत् ।
उपद्रवांश्च विकृतिज्ञानतस्तेषु चाधिकम् ॥ १६ ॥
आशुकारीयतः कासस्तमेवातः प्रवक्ष्यति ।
It this illness, (Raktapitta) recognition of the (vitiating) Dosha is just like that described in venesection (chapter 27 of Sutrasthana). Its Upadrava (secondary ailments, issues) are these enumerated in) Vikriti Vijnaniya (chapter 5 of Sarira Sthana). Amongst them Kasa (cough) goes to kill the individual quickly, therefore its description additional on.
Kasa Nidana (prognosis of cough)
पञ्चकासाः स्मृता वातपित्तश्लेष्मक्षतक्षयैः॥१७॥
क्षयायोपेक्षिताः सर्वे बलिनश्चोत्तरोत्तरम्।
Kasa (cough) is alleged to be of 5 sorts (one every) from Vata, Pitta, Shleshman (Kapha); from Kshata (damage to the chest (lungs) and Kshaya (consumption). All of them lead on to Kshaya if uncared for and are sturdy within the succeeding order (succeeding type stronger than its previous type).
Purvarupa (premonitory signs)
तेषां भविष्यतां रूपं कण्ठे कण्डूररोचकः॥१८॥
शूकपूर्णाभकण्ठत्वं
Their premonitory options are – irritation within the throat, lack of style/urge for food, feeling as if the throat is filled with thorns.
Samprapti (pathogenesis)
तत्राधोविहतोऽनिलः।
ऊर्ध्वं प्रवृत्तः प्राप्योरस्तस्मिन्कण्ठे च संसजन्॥१९॥
शिरः स्रोतांसि सम्पूर्य ततोऽङ्गान्युत्क्षिपन्निव।
क्षिपन्निवाक्षिणीपृष्ठमुरः पार्श्वे च पीडयन्॥२०॥
प्रवर्तते सवक्त्रेण भिन्नकांस्योपमध्वनिः।
हेतुभेदात्प्रतीघात भेदोवायोः सरंहसः॥२१॥
यद्रुजा शब्दवैषम्यं कासानां जायते ततः।
tatrādhovihato’nilaḥ |
Anila (Vata) obstructed in its downward motion, begins to maneuver upwards, reaching the chest, invades the throat after which filling the channels of the top, makes for violent upward motion of the physique, the eyes, again and chest; ache within the flanks, and comes out of the mouth producing noise resembling the sound of a damaged bell-metal. From the distinction within the causes (causative Dosha) there’s distinction within the nature of obstruction of the forceful Vata. Therefore there happens variations within the ache (signs) and the sound of cough.
Vataja Kasa – (options of cough of Vata origin)
कुपितो वातलैर्वातः शुष्कोरः कण्ठवक्त्रताम्॥२२॥
हृत्पार्श्वोरः शिरःशूलं मोहक्षोभस्वरक्षयान्।
करोति शुष्कं कासं च महावेगरुजास्वनम्॥२३॥
सोऽङ्गहर्षी कफं शुष्कं कृच्छ्रान्मुक्त्वाल्पतां व्रजेत्।
Vata present process aggravation (enhance) from aggravating causes, produces dryness of the chest, throat and mouth, ache within the (area of) coronary heart, flanks and head; delusion, agitation of the thoughts, lack of voice, offers rise to dry cough accompanied with violent bouts, extreme ache and nice noise, and horripilation. The individual brings out dry sputum with problem and after that it (cough) will get decreased.
Pittaja Kasa (options of cough of Pitta origin)
पित्तात्पीताक्षिकफता तिक्तास्यत्वं ज्वरोभ्रमः॥२४॥
पित्तासृग्वमनं तृष्णा वैस्वर्यं धूमकोऽम्लकः।
प्रततं कासवेगेन ज्योतिषामिवदर्शनम्॥२५॥
From Pitta, there’s yellow coloration of the eyes and sputum, bitter style within the mouth, fever, dizziness, vomiting of Pitta and Asrk (blood), thirst, hoarseness, feeling of scorching fumes popping out via the mouth, (elevated) acidity, steady cough retaining the affected person gazing on the stars, sitting up together with his face turned upward.
Kaphaja Kasa (options of cough of Kapha origin)
कफादुरोऽल्परुङ्मूर्धहृदयं स्तिमितं गुरु।
कण्ठोपलेपः सदनं पीनसच्छर्द्यरोचकाः॥२६॥
रोमहर्षो घनस्निग्धश्वेतश्लेष्मप्रवर्तनम्।
From Kapha, there’s delicate ache within the chest, head and (area of) the guts, little or no motion (of the chest) and feeling of heaviness, coating of the throat, debility, working within the nostril, vomiting, lack of style/urge for food, horripilation; thick, sticky, white sputum is expelled out.
Kshataja Kasa (options of cough on account of trauma to lungs)
युद्धाद्यैः साहसैस्तैस्तैः सेवितैरयथाबलम्॥२७॥
उरस्यन्तः क्षतेवायुः पित्तेनानुगतोबली।
कुपितः कुरुते कासं कफं तेन सशोणितम्॥२८॥
पीतं श्यावं चशुष्कं च ग्रथितं कुथितं बहु।
ष्ठीवेत्कण्ठेन रुजता विभिन्नेनेव चोरसा॥२९॥
सूचीभिरिव तीक्ष्णाभिस्तुद्यमानेन शूलिना।
पर्वभेदज्वरश्वास तृष्णावैस्वर्य कम्पवान्॥३०॥
पारावत इवाकूजन्पार्श्वशूली ततोऽस्य च।
क्रमाद्वीर्यं रुचिः पक्ता बलं वर्णश्च हीयते॥३१॥
क्षीणस्य सासृङ्मूत्रत्वं स्याच्च पृष्ठकटीग्रहः।
By indulgence in preventing in battle, adventurous actions and so forth., in extra of 1’s power, there happens a wound contained in the chest, (lungs); Vayu getting elevated and associating with the Pitta, produces cough. By these, the affected person brings out sputum combined with blood, yellow or black in colour, dry (non-unctuous), nodular, foul smelling and huge in amount; extreme ache within the throat, ache within the chest as if pricked by sharp needles, ache within the joints, fever, dyspnea, thirst, hoarseness, tremors; cooing sound like that of a pigeon comes out of the throat, ache within the flanks additionally seem; vigour, need for meals, digestion, power and colour (complexion) get diminished steadily, emaciation, urine is combined with blood and catching ache within the again and waist develop.
Kshayaja Kasa (cough on account of consumption, pulmonary tuberculosis)
वायुप्रधानाः कुपिताधातवोराजयक्ष्मिणः ॥ ३२ ॥
कुर्वन्तियक्ष्मायतनैः कासं ष्ठीवेत्कफं ततः ।
पूतिपूयोपमं पीतं विस्रं हरितलोहितम् ॥ ३३ ॥
लुच्येतेइवपार्श्वे च हृदयं पततीव च ।
अकस्मादुष्णशीतेच्छाबह्वाशित्वं बलक्षयः ॥ ३४ ॥
स्निग्धप्रसन्नवक्त्रत्वं श्रीमद्दर्शननेत्रता ।
ततोऽ स्यक्षयरूपाणिसर्वाण्याविर्भवन्ति च ॥ ३५ ॥
All of the Dhatus (Doshas) with the predominance of Vata, produce cough in sufferers of Rajayakshma (pulmonary tuberculosis). The affected person brings out sputum which is putrefied, resembling pus, yellow, foul smelling, inexperienced or purple. The affected person feels as if his flanks are sliding down, coronary heart falling down, develops need for warm or chilly comforts with none (obvious) motive, consumes an excessive amount of of meals however nonetheless loses power; the face seems unctuous, pleasing to take a look at, has radiant look and glittering eyes; thereafter, all of the signs of consumption, start to manifest regularly.
Prognosis of various sorts of cough
इत्येषक्षयजः कासः क्षीणानां देहनाशनः ।
याप्योवाबलिनां तद्वत्क्षतजोऽ भिनवौ तु तौ ॥ ३६ ॥
सिध्येतामपि सानाथ्यात्साध्यादोषैः पृथक्त्रयः ।
मिश्रायाप्याद्वयात्सर्वेजरसास्थविरस्य च ॥ ३७ ॥
Thus, this Kshayaja Kasa goes to destroy the physique of those that are emaciated, or it persists for lengthy within the sturdy; equally the Kshataja Kasa additionally, each could change into curable if they’re of latest onset and endowed with richness (excellence) of all of the 4 limbs of therapy. The three sorts, arising from one Dosha individually are curable, these from combination of two Doshas are incurable, however controllable, and likewise that arising from previous age within the aged.
Prognosis of various sorts of cough
कासाच्छ्वासक्षयच्छर्दि स्वरसादादयो गदाः।
भवन्त्युपेक्षया यस्मात्तस्मात्तं त्वरयाजयेत्॥३८॥
By neglecting cough, ailments like dyspnea, consumption (tuberculosis), vomiting lack of voice and so forth. will happen. Therefore it needs to be received (handled successfully) rapidly.
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहिताया तृतीये निदानस्थाने रक्तपित्तकासनिदानं नाम तृतीयोऽध्याय: ।।१॥
Thus ends the chapter – Raktapitta and Kasa Nidana – the third in Nidanasthana of Astangahrdaya Samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
