अथातो रक्तपित्तचिकित्सितं व्याख्यास्यामः । इति ह स्माहुरात्रेयादयो महर्षयः ।
We shall now expound the chapter Raktapitta chikitsa treatment of raktapitta (bleeding disease); thus said Atreya and other great sages;
Raktapitta Sadhyasadhyata – prognosis of bleeding disorders
ऊर्ध्वगं बलिनोऽवेगमेकदोषानुगं नवम् । रक्तपित्तं सुखे काले साधयेन्निरुपद्रवम् ॥ १ ॥
अधोगं यापयेद्रक्तं यच्च दोषद्वयानुगम् । शान्तं शान्त पुनः कुप्यन्मार्गान्मार्गान्तरं च यत् ॥ २ ॥
अतिप्रवृत्तं मन्दाग्नेस्त्रिदोषं द्विपथं त्यजेत् ।
Raktapitta which is of upward direction (bleeding from the upper parts of the bocy such as nose, mouth, ears) seen in a strong person, of mild bouts (of bleeding), produced by any one dosa, of recent onset, appearing at a fovourable time and having no complications (secondary affections) should be treated.
Raktapitta which is of downward direction (bleeding from the urethra, rectum, and vagina), that produced by two dosas, recurring often after subsiding and changing from one channel (site) to the other ( often) should be controlled.
That which bleeds heavily, found in a person who has poor digestive power, produced by all the three dosas and that manifesting in both the direction should be rejected. 1-3a.
Raktapitta chikitsa krama – procedure of treatment
ज्ञात्वा निदानमयनं मलावनुबलौ बलम् ॥ ३ ।।
देशकालाद्यवस्थां च रक्तपित्ते प्रयोजयेत् । लङ्घनं बृंहणं वाऽऽदौ शोधनं शमनं तथा ॥ ४ ॥
Having (clearly) determined the cause, direction, the mala (cheif causative dosa), anubala (secondary dosas), the strength (of the patient and the diesease), the condition of the desa (habitat and the body of the patient vis a vis his constitution) and kala (season and the stage of the diseases), treatment of raktapitta should be commenced either with langhana (therapies to make the body thin) or brmhana (therapies to make the body stout) with either sodhana (purifactory therapies) or samana (palliative therapies). 3b-4.
सन्तर्पणोत्थं बलिनो बहुदोषस्य साधयेत् । ऊर्ध्वभागं विरेकेण वमनेन त्वधोगतम् ॥ ५ ॥
शमनैबृंहणैश्चान्यल्लङ्घ्यबृंह्यानवेक्ष्य च।
That (raktapitta) which is produced by santarpana (over nourishment) in a strong person, caused by many dosas should be treated by vireka (purgation therapy) if it is of upward direction and by vamana (emesis therapy) if it is of downward direction or by samana (palliative) and brmhana (stoutening, nourishing therapies) after finding out whether the patient is fit for langhana and brmhana therapies. 5-6a.
ऊर्ध्वं प्रवृत्ते शमनौ रसौ तिक्तकषायकौ ॥ ६ ॥
निःशुण्ठीषडङ्गोदकपायिनः । उपवासश्च
अधोगे रक्तपित्ते तु बृंहणो मधुरो रसः ॥ ७ ॥
When it is of upward direction, administration of drugs having samana (mitigating the dosas tastes, viz, bitter and astringent, fasting and drinking sadangodaka devoid of sunthi should be adhered to; in case of downward direction, it should be the use of sweet taste which is nourishing. 6b-7.
Notes Sadangodaka or shadanga paniya is drinking water prepared by boiling with six drugs viz, ghana (musta), candana, sunthi, ambu (valaka), parpata and usira. In this disease it should be prepared without sunthi.
ऊर्ध्वगे तर्पणं योज्यं प्राक् च पेया त्वधोगते ।
In case of upward direction, tarpana should be given first (as food) and in case of downward direction, peya should be given first. 8a.
Notes Tarpana’ is prepared with flour of corns mixed with cold water and added with ghee (and sugar) and made neither too thin nor too thick in constitence. It is a nourishing menu; ‘Peya’ is gruel prepared by boiling corns (especially broken rice) in water and allowing small quantity of precipitate to remain in it.
अश्वतो बलिनोऽशुद्धं न धार्यं तद्धि रोगकृत् ॥ ८ ॥
धारयेदन्यथा शीघ्रमग्निवच्छीघ्रकारि तत् ।
If the patient is eating well and strong, the impure blood (that is flowing out) should not be stopped; if done so, it is going to produce diseases. If otherwise, (patient not eating well and is weak ) it (bleeding) should be stopped soon, as it is going to kill the patient, quickly. 8b-9a.
Virecana yoga in Raktapitta – purgative recipes
त्रिवृच्छ्यामाकषायेण कल्केन च सशर्करम् ॥ ९ ।।
साधयेद्विधिवल्लेहं लिह्यात्पाणितलं ततः । त्रिवृता त्रिफला श्यामा पिप्पली शर्करा मधु ॥ १० ॥
मोदकः सन्निपातोर्ध्वरक्तशोफज्वरापहः । त्रिवृत्समसिता तद्वत् पिप्पलीपादसंयुता ॥ ११ ॥
A lehya (confection) should be prepared as per procedure with the decoction and paste of trivrit and syama and sugar. It should be licked one panitala ( karsa) per dose.
A modaka (bolus) prepared from trivrt, triphala, syama, pippali, along with sarkara (sugar) and madhu (honey) cures raktapitta caused by all the dosas, of the upward direction, dropsy and fever. Similarly the bolus prepared with equal quantities of trivrt, and sita (sugar) and one fourth part of the pippali. 9b-11.
Vamana yoga – emetic recipes
वमनं फलसंयुक्तं तर्पणं ससितामधु । ससितं वा जलं क्षौद्रयुक्तं वा मधुकोदकम् ॥ १२ ॥ क्षीरं वा रसमिक्षोर्वा
Tarpana mixed with (powder of ) phala (madana) and added with sita ( sugar ) and madhu ( honey) should be used for vamana (emesis ) followed by drinking either sugar water, honey water, water boiled with madhuka, milk or sugarcane juice. 12-13a.
शुद्धस्यानन्तरो विधिः ।
यथास्वं मन्थपेयादिः प्रयोज्यो रक्षता बलम् ॥ १३ ॥
After purificatory therapies, the other regimen of these therapies, such as drinking mantha, peya etc. (liquids foods) should be adhered to, protecting the strength (of the body constantly). 13a-b.
Notes : Mantha is thin watery beverage containing corn flour, milk, sugar etc., churned well. It also means a cold infusion of drugs well churned and then sweetened.
मन्थो ज्वरोक्तो द्राक्षादिः, पित्तघ्नैर्वा फलैः कृतः ।
Draksadi mantha mentioned in the treatment of fever (vide, chapter1 / 55-58 ) or that prepared from fruits which mitigate pitta ( should be used). 14a.
मधुखर्जूरमृद्वीकापरूषकसिताम्भसा ॥१४॥
मन्थो वा पञ्चसारेण सघृतैर्लाजसक्तुभिः । दाडिमामलकाम्लो वा मन्दाग्न्यम्लाभिलाषिणाम् ॥ १५ ॥
Mantha or pancasara (sweet syrup) prepared from madhu (honey), kharjura, mrdvika, parusaka, sita (sugar) and water, added with ghrta ( ghee ) and laja saktu ( flour of fried paddy) may be used; for those who have poor digestion and desire sour taste, mantha prepared from dadima and amalaka. 14b-15.
कमलोत्पलकिञ्जल्कपृश्निपर्णीप्रियङ्गुकाः ।
उशीरं शाबरं रोधं शृङ्गबेरं कुचन्दनम् ॥ १६ ॥
हीबेरं धातकीपुष्पं बिल्वमध्यं दुरालभा । अर्धाधैर्विहिताः पेया वक्ष्यन्ते पादयौगिकाः ॥ १७ ॥
भूनिम्बसेव्यजलदा मसूराः पृश्निपर्ण्यपि | विदारिगन्धा मुद्राश्च बला सर्पिर्हरेणुकाः ॥ १८ ॥
Peya prepared from drugs in the following (three half verses and next, (four) in quarter-verses, should be made of (in adhoga raktapitta-downward bleeding)-viz. 14 A.H.II
1. Kamala, utpala kinjalka, prsniparni and
priyangu, 2. Usira, sabararodhra, Srngavera and kucandana, 3. Hreebera, dhatakipuspa bilvamadhya ( majja ) and duralabha,
1. Bhunimba, sevya and jalada,
2. Masura and prsniparni,
3. Vidarigandha and mudga,
4. Bala, sarpis ( ghrta ) and harenuka.
जाङ्गलानि न मांसानि शीतवीर्याणि साधयेत् । पृथक्पृथग्जले तेषां यवागूः कल्पयेद्रसे ॥ १९ ॥
शीताः सशर्कराक्षौद्रास्तद्वन्मांसरसानपि । ईषदम्लाननम्लान् वा घृतभृष्टान् सशर्करान् ॥ २० ॥
Meat of animals of desert-like region which are cold in potency should be processed seperately in water with of drugs mentioned above and from that (cold infusion) juice (meat soup) yavagu (gruel) should be prepared). It should be cooled and added with sugar and honey (and used) or meat juice (soup) with slight sour taste or not having sour taste, fried in ghee and added with sugar ( may be used). 19-20.
शूकशिम्बीभवं धान्यं रक्ते शाकं च शस्यते ।
अन्नस्वरूपविज्ञाने यदुक्तं लघु शीतलम् ॥ २१॥
Grains with spike, legumes (pulses) and vegetables which are easily digestable and cold (in potency) mentioned in annasvarupa vijnana (chapter 6 of sutrasthana) are best suited for raktapitta (bleeding disease). 21.
पूर्वोक्तमम्बु पानीयं पञ्चमूलेन वा शृतम् । लघुना शृतशीतं वा मध्वम्भो वा फलाम्बु वा ॥ २२ ॥
Water mentioned earlier (sadanga paniya without sunthi), water boiled and cooled, honey water or syrup of fruits (Any one of these) should be used for drinking. 22.
शशः सवास्तुकः शस्तो विबन्धे तित्तिरिः पुनः । उदुम्बरस्य निर्यूहे साधितो मारुतेऽधिके ॥ २३ ॥
प्लक्षस्य बर्हिणस्तद्वन्यग्रोधस्य च कुक्कुटः ।
(Meat of rabbit along with vastuka (saka) is beneficial when there is constipation, (meat of ) tittiri (black partridge) boiled with the decoction of udumbara is beneficial when there is predominance of maruta (vata ). Similarly the (meat of) peacock boiled in the decoction of plaksa and the (meat of) fowl/poultry boiled in the decoction of nyagrodha. 23-24a.
यत्किञ्चिद्रक्तपित्तस्य निदानं तच्च वर्जयेत् ॥ २४ ॥
Any cause which gives rise to raktapitta (bleeding disease) should be avoided. 24b.
Vasakalpa
वासारसेन फलिनीमृद्रोधाञ्जनमाक्षिकम् ।
पित्तासृक् शमयेत्पीतं, निर्यासो वाऽटरूषकात् ॥ २५ ॥
शर्करामधुसंयुक्तः केवलो वा, शृतोऽपि वा ।
वृष: सद्यो जयत्यस्त्रं, स ह्यस्य परमौषधम् ॥ २६ ॥
Fresh juice of vasa mixed powder of phalini, mrt (saurastri), rodhra, anjana (rasanjana) and maksika (honey) alleviates bleeding disease; or fresh juice of atarusaka either mixed with sugar and honey or alone, or decoction of it (atarusa) cures raktapitta immediately. It ( vasa) is its ( of raktapitta) best medicine. 25-26.
Anya Kalpa – other recipes
पटोलमालतीनिम्बचन्दनद्वयपद्मकम् रोध्रो वृषस्तन्दुलीयः कृष्णा मृन्मदयन्तिका ॥ २७ ॥
शतावरी गोपकन्या काकोल्यौ मधुयष्टिका । रक्तपित्तहराः क्वाथास्त्रयः समधुशर्कराः ॥ २८ ॥
The following three decoctions of drugs added with honey and sugar cure bleeding disease,
1. Patola, malati, nimba, the two candana and pad-maka,
2. rodhra, vrsa, tanduliya, krsnamrt, and madayantika,
3. satavari, gopakanya, the two kakoli and madhu-yastika,.
पलाशवल्कक्वाथो वा सुशीतः शर्करान्वितः । लिह्याद्वा मधुसर्पिर्भ्यां गवाश्वशकृतो रसम् ॥ २९ ॥
Decoction of bark of palasa, cooled and added with sugar should be consumed or the juice of (fresh) dung of either a cow or a horse may be licked after making it thick (by boiling) adding honey and ghee. 29.
सक्षौद्रं ग्रथिते रक्ते लिह्यात्पारावताच्छकृत् ।
If the blood (coming out ) is found clotted, the excreta of pigeon may be licked, mixing it with honey. 30a.
अतिनि: स्त्रतरक्तश्च क्षौद्रेण रुधिरं पिबेत् ॥ ३० ॥ जाङ्गलं, भक्षयेद्वाऽऽजमामं पित्तयुतं यकृत् ।
If there is too much of bleeding, then the blood of animals of desert like regions or the uncooked liver along with the bile of a goat may be eaten. 30b-31a.
चन्दनोशीरजलदलाजमुद्गकणायवैः बलाजले पर्युषितैः कषायो रक्तपित्तहा ॥ ३१ ॥
(Powder of) candana, usira, jalada, laja, mudga, kana and yava soaked in the decoction of bala (kept overnight) and used, cures bleeding disease. 31b-32a.
प्रसादश्चन्दनाम्भोजसेव्यमृद्धृष्टलोष्टजः सुशीत: ससिताक्षौद्रः शोणितातिप्रवृत्तिजित् । ॥३२॥
Essence (supernatant fluid of a solution) of candana, ambhoja, sevya, mrt and heated potsherd (dipped in water), cooled and mixed with sugar and honey controls profuse bleeding. 32b-33a.
आपोथ्य वा नवे कुम्भे प्लावयेदिक्षुगण्डिकाः ॥ ३३॥
स्थितं तद्गुप्तमाकाशे रात्रिं प्रातः स्रुतं जलम् । मधुमद्विकचाम्भोकृतोत्तंसं च तद्गुणम् ॥ ३४ ॥
Pieces of sugar-cane are crushed a little and put into water kept in a new pot, which is kept protected (from insects, flies etc.) in the open air for a night. Next morning, the water is stirred well, mixed with honey, made fragrant with the well bloomed flower of lotus and consumed; it acts likewise (stops heavy bleeding ) 33b-34.
ये च पित्तज्वरे चोक्ताः कषायास्तांश्च योजयेत् ।
Those decoctions described in pittajvara may also be used (in this disease). treatment of 35a.
Ksira prayoga – recipes of milk in raktapitta
कषायैर्विविधैरेभिर्दीसेऽग्रौ वि कफे ॥ ३५ ॥
रक्तपित्तं न चेच्छाम्येत्तत्र वावणे पयः । युञ्ज्याच्छागं शृतं, तद्वद्रव्यं गुणेऽम्भसि ॥ ३६॥
पञ्चमूलेन लघुना शृतं ससितामधु । जीवकर्षभकद्राक्षाबलागो गरैः ॥३७॥
पृथक्पृथक्शृतं क्षीरं रसितयाऽथवा ।
decoctions the digesminant and bleeding is not When by the use of these tive power gets increased / p* mitigated, then goat’s milk cows milk should be boiled with five times its quantity nal quantity) should cons drugs of laghu pancamu or milk boiled with jiva and nagara-each one may be consumed. ater (and reduced to its origid or cow’s milk boiled with the id mixed with sugar and honey rsabhaka, draksa, bala, goksura, rately mixed with ghee or sugar 35b-38a.
गोकण्टका तं पर्णिनीभिस्तथा पयः ॥ ३८ ॥
सरुजं विशेषान्मूत्रमार्गगम् । हन्त्याशु . शेषेण हितं मोचरसेन तु ॥ ३९ ॥
वटङ्गैर्वा शुण्ठ्यदीच्योत्पलैरपि। विण्मार्ग
4 gokantaka and of abhiru, or with the Milk boiley relieves the bleeding associated with (four) parnis, cinary passage. Milk boiled with mocarasa pain, especiallial in bleeding from the rectum; or milk is especially and tender leaves of vata or that boiled boiled with _ya and utpala. 38b-40a. with sunthi
तसारदुर्नामचिकित्सां चात्र कल्पयेत् ॥ ४० ॥
bleedin nent prescribed for bleeding diarrhoea and The, may also be adopted in this diseases. 40b.
( त्वा कषायान् पयसा भुञ्जीत् पयसैव च । कषाययोगैरेभिर्वा विपक्कं पाययेद्धृतम् ॥ ४१ ॥
After drinking decoction mixed with milk, the patient should eat his foo,ith milk only. He should drink ghee cooked with the dru mentioned for preparing decoctions.
Vasa ghrta
समूलमस्तकं णं वृषमष्टगुणेऽम्भसि । पक्त्वाऽष्टांशाव- घृतं तेन विपाचयेत् ॥ ४२ ॥
तत्पुष्पगर्भं तच्छी पक्षौद्रं पित्तशोणितम्। पित्तगुल्मज्वरश्वासवाद्भोगकामला: तिमिरभ्रमवीसर्पस्वरस् श्व ॥ ४३ ॥ नाशयेत् ।
The vrsa plant with its r pieces is boiled in eight parts c ‘ and head (leaves) cut into ter and decoction reduced to one-eighth part, medicated हु is prepared from it using its own flowers as paste. After co with honey. This cures bleeding g, it is consumed mixed Pease, abdominal tumor casued by pitta, fever, dyspnoea, ch, heart disease, jaundice, blindness, visarpa (herpes voice). d svarasada (feeble 42-44a.
Palasa ghrita – Trayamana ghrta
पलाशवृन्तस्वरसे तद्गर्भं च रक्तघ्नं, तथैव त्रा ६चेत् ॥ ४४ ॥
सक्षौद्रं तच्च या ।
juice of stalks of Medicated ghee prepared with the flowers of palasa and paste of the sal honey it cures bleeding disease; similarayonsumed with from trayamana. that prepared 44b-45a.
रक्ते सपिच्छे सकफे ग्रथिते कण्ठमा लिह्यान्माक्षिकसर्पिर्भ्यां क्षारमुत्पलनाल ॥
पृथक्पृथक् तथाऽम्भोजरेणुश्यामामधूकजम्
In case of bleeding from the throat, the slimy, mixed with kapha or solidified. then thed being prepared from the stalks of utpala, ambojarealkali) kesara or filaments of lotus flowers) syama (padma(flowers of) madhuka-each one seperately should) or mixed with honey and ghee. 46.
गुदागमे विशेषेण शोणिते बस्तिरिष्यते ।
If the bleeding is from the rectum, enema therapy is especially suitable. 47a.
घ्राणगे रुधिरे शुद्धे नावनं चानुषेचयेत् ॥ ४७ ॥
कषाययोगान् पूर्वोक्तान् क्षीरेक्ष्वादिरसाप्लुतान् । क्षीरादीन्ससितांस्तोयं केवल वा जलं हितम् ॥ ४८ ॥
रसो दाडिमपुष्पाणामाम्रास्थ्नः शाद्वलस्य वा ।
In case of bleeding from the nose and the blood is unvitiated, then nasal drops with the drugs mentioned for decoctions earlier, prepared either with milk or juice of sugarcane etc. may be put into the nose, or milk etc. mixed with sugar or cold water alone is beneficial; so also the juice of flowers of dadima, stone of mango fruit (the kernal inside the stone) or juice of Sadvala (durva). 47b-49a.
कल्पयेच्छीतवर्गं च प्रदेहाभ्यञ्जनादिषु ॥ ४९ ॥
The drugs belonging to the cold group (possessing cold potency) should be made use of for application over the body, oil massage, bath etc. 49b.
यच्च पित्तज्वरे प्रोक्तं बहिरन्तश्च भेषजम् । रक्तपित्ते हितं तच्च क्षतक्षीणे हितं च यत् ॥ ५० ॥
The external and internal medicines described in the treatment of pittajvara (fever of pitta origin) are beneficial in bleeding disease also; similarly also those precribed in Ksataksina (consumption due to injury to chest). 50.
इति श्री वैद्यपतिसिंहगुप्तसूनुश्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां चतुर्थे चिकित्सितस्थाने रक्तपित्तचिकित्सितं नाम द्वितीयोऽध्यायः ॥
Thus ends the chapter Raktapitta chikitsa-the second in ChikitsaSthana of Astangahrdaya samhita, composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
