he name itself suggests that the disease – Raktapitta is caused by vitiation of two body elements, namely

R a k t a a n d P i t t a together due to their Ashray – Ashrayee relationship. But it is a lso important to u n d e r s t a n d t h a t Raktapitta is different from the group of disorders caused due to vitiated Rakta or Pitta independently. It

is important to consider the similarity between Rakta and Pitta being together in pathogenesis of Raktapitta, identifying its types, its Ashray – Ashrayee relationship and also to consider the principle - '' jòebâ peerJe Fefle efmLeefle:~'' i.e. Rakta being the support of

the life while treating it.

The efforts are made to present the measures to take care of Rakta – the Pranayatan while treating vitiated Pitta in such condition, the causative factors of Raktapitta found in today's life style, preventive measures, the onset and progress of the disease and the principles of treatment and their practical application in front of you.

Though the our Granthas are the absolute source of knowledge, but information regarding the causative factors found these days which are not mentioned in Granthas, but should be considered at the time of treatment, which are the effective medicines in a particular condition and why, etc is discussed in ' Raktapitta Visheshank'.

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Vishay Pravesh

The main thing comes to mind when we observe the order of the topics described by Granthakaras is the importance of nomenclature. Granthakaras have described the chapter of “Raktapitta” immediately after describing a very important and serious disease “Jwara” at the beginning of Nidan Sthan.

It can be understood that the disease with severity almost same as that of Jwara is Raktapitta. If Rakta Dhatu which has been described as '' jòebâ peerJe Fefle efmLeefle:~'' flows out of

the body through any opening or outlet, it can certainly give rise to serious conditions. This might have been considered while discussing Raktapitta after the description of Jwara.

Also, when Jwara not treated well; the disturbed Agni which is nothing but Teja Mahabhoota is the factor responsible for Raktapitta.

``pJejmevleeheeled jòeâefheòecegoerÙe&les~`` The heat or burning sensation caused due to Jwara gives

rise to Raktapitta. The name of the disease is given after the names of Dooshya and Dosha involved in the occurrence of this disease.

Raktapitta Visheshank

October 2011

Raktapitta

T

necessary to differentiate it from the jòeâ_Ûe efheòe_Ûesefle jòeâefheòeefceefle~ - megßeglediseases like Raktarsh from treatment point efheòe ÙeLeeYetleb ueesefnle efheòeb Fefle meb%eeb ueYeles~ - Ûejkeâof view. Samanya Chikitsa of Pachan,

efheòesve og°b jòebâ jòeâefheòeefcelÙegÛÙeles~ - ceOegkeâes<e šerkeâe Stambhan according to the Avastha, Bala etc remain the same for all diseases with abnormal bleed, but as the disease – When the Pitta Dosha with increased Raktapitta differ from them due to its Ushna – Teekshna Gunas gets more different Hetu and Samprapti, it is important vitiated due to the excessive intake of the to study it separately. Hetus with similar Gunas; it vitiates the

Rakta Dhatu being its Ashray Sthan. This Charakacharya has described it in the

Pitta Dooshit Rakta Dhatu increases in chapter immediately after Jwara as it arises

amount due to the Ushna Guna of Pitta and due to the Santap caused as a result of

it starts flowing out of the body from different Jwara; whereas Sushrutacharya has

outlets – Upwards & downwards. This described it after discussing Pandu as they

condition is known as 'Raktapitta'.have common causative factors.

Though, the blood, expelling out of the body, is not Shuddha Jeeva Rakta, but due to the nature of the disease, Rakta - the Pranashray itself gets vitiated. Thus, this Ashukari (acute), Raktapradoshaj disease can be considered as one of the life threatening disorders.

Gananath Sen has described Raktapitta as “bleeding without any trauma or injury due to any external object'. Though this Vyadhi can be assumed as the Nija Hetujanya; but to some extent, it is

EditorialEditorial

'Rakta' is one of the 7 Dhatus of Shareer. The very first Dhatu of Pittadooshit Rakta and tries to get expel out of the body through Shareer – Rasa Dhatu gets converted into Rakta Dhatu with the one or more outlets. It can prove life threatening if the flow of blood action of Rakta Dhatvagni (Ranjakagni) on it. This Ranjakagni (Jeevaswaroop Rakta) continues for longer duration. Though its resides in Yakrut and Pleeha, thus they are known as the Moola the Pitta which gets expelled out; but due to the vitiated Rakta Sthan of Raktavaha Srotas. Dhatu increased in volume being site of Pitta, causes expulsion of

vitiated Doshas out of the body in the form of Rakta itself. Also, the fullness of blood vessels is the sign of Rakta Vruddhi. This certainly Being Pranashray and support of life, Rakta Dhatu is the most helps understanding the seriousness of the blood flowing out of the important amongst rest of the Dhatu. It provides nourishment to all body along with Dosha, due to increased volume of Pittadushta the constituents of body with the help of Vyana Vayu's action of Rakta resulting in rupture of blood vessels. Thus, it is important to Vikshepan. The Normal state of the Rakta Dhatu is also stop this bleeding after examining Bala (strength) etc and then responsible for the Varna (complexion), Mansapushti (muscle treating it according to causative factors. strength), Sukha (pleasure) and Sparsha Dnyan (touch

perception). Charakacharya describes it as Mahagad (dreadful disease), Mahaveg (rapid onset) and Ashukari (acute). It should be treated

osnmÙe ®efOejb cetueb ®efOejsCewJe OeeÙe&les~ immediately as the onset, progress and its consequences rapidly lemceeod Ùelvesve mebj#Ùeb jòebâ peerJe Fefle efmLeefle: ~~ meg. met. 14 set in.

Hetu:Rakta Dhatu is the main factor in formation and maintenance of the Ahar - body, thus it should always be protected.

Rasa – Regular & excessive consumption of Lavan, Amla (exception – Avala, Pomegranate) and

Many seers have considered it as the forth Dosha due to its great Katu importance. But it is not acceptable as it does not posses the

Guna – Intake of Teekshna, Ushan, Vidahi, Kshar, properties of Prakruti Arambhakatva (it is not responsible for Prakruti) and Swatantra Dushti Kartrutva (independently it can not Viruddhaharvitiate the body substances). Though, the separate Adhyayas are Dravya – Intake of dry green vegitables, radish, mustard, found in Charak as well as Sushrut Samhita describing its

garlic, starchy foodimportance.

Vihar - Wondering in sunlight, working in atmosphere of high Raktapitta is one of the Raktapradoshaj Vyadhis. Vidhishonitiya

temperature for longer, especially near furnace, work or Adhay of Charak Samhita says that all the Raktapradoshaj Vyadhis exercise exceeding the limit of strength, exertionshould be treated like Raktapitta. It is also necessary to start

Virechan, Upwas and Raktamokshan along with it, as per the condition of the patient and stages of the disease. All the causative Manas - Anger, grief, frightfactors of Rakta Dushti mentioned in this Adhyay are similar to those vitiating Pitta Dosha. Vitiation of Pitta Dosha resulting in

Other - Excess of Virechanvitiation of Rakta Dhatu can be well understood after considering common aggravating factors due to their Ashray-Ashrayee Sambandh (One of them being the site of the other). These factors naturally aggravates the vitiation of Pitta and Vidaha

of Rakta being the site of Pitta as both of them are from same origin (Samayoni) i.e both of them have dominance of Agni Mahabhoota. Definition of Also, the Factors responsible for Rakta Vidaha are the same causing vitiation of Pitta along with Rakta Vidaha. mebmeiee&uueesefnleØeot<eCeeuueesefnleievOeJeCee&vegefJeOeeveeÛÛe efheòeb

ueesefnleefheòeefcelÙeeÛe#eles~ Ûe. efve. 2

mebÙeesieeod ot<eCeeleòeg meeceevÙeeod ievOeJeCe&Ùees:~jòeâmÙe efheòeceeKÙeeleb jòeâefheòeb ceveeref<eefYe: ~~ Ûe. efÛe. 4

As a result of Ashray Ashrayee relationship of Pitta Dosha & Rakta Dhatu, this vitiated Pitta?combines with Rakta (Lohit Sansarg)?contaminates Rakta (Lohit Pradushan)?Pitta having similar odor and color like Rakta (Lohitasaman

Gandh-Rasa- Varn) after vitiationOwing to this relationship, the Vyadhi, is addressed as Raktapitta.

Introduction:This is an acute (Ashukari) Raktapradoshaj Vyadhi. Doshas vitiated due to Nija Hetu circulates in the whole body along with the

Raktapitta

Kamadugha (with Mouktik)

?An excellent Pittashamak, Sheetal, Dahashamak, Trushnashamak, Raktastambhak, Raktaprasadak and Mootral Kalpa containing Praval, Mukta, Shuddha Suvarna Gairik, Guduchi sattva and Dravyas of Sudha Varga

?Extremely effective in all disorders caused due to vitiation of Pitta & Rakta

?Reduces the Amlata, Drava, Ushna and Teekshna Gunas of vitiated Pitta, thus effective in Raktapitta

?Also useful in Amlapitta, Jwara, Daha, Bhrama, Mootravikar

Dosage & Anupan - 1 to 2 tablets 2 – 3 times a day with Usheerasava, Chandanasava, Sheetasudha or plain water

Rakta itself. This Rakta Dhatu increased in volume circulates in the lewnxlegefYe: mecegeflkeäue°b efheòeb jòebâ ØeheodÙeles ~whole body with the help of Vikshepan of Vyan Vayu. Increased leÅeesefvelJeeled ØeheVeb Ûe JeOe&les leled Øeot<eÙesled ~~intra-vascular pressure causes rupture of blood vessels further

lemÙees<ceCee õJees Oeeleg: OeeleesOee&lees ØeefmeÛÙeles~ leading to Dooshit Raktasrav. efmJeoŸelemlesve mebJe=efæb YetÙemleoefOeieÛÚefle ~~ Ûe. efÛe. 4

Raktapitta Pravrutti (Gati or Path):All Granthakaras have explained almost the same Samprapti. But Raktapitta Samprapti is thoroughly discussed in Charak Samhita

efheòeb efJeoiOeb mJeiegCew: efJeonlÙeeMeg MeesefCeleced~which helps in easy understanding of Samprapti Shrunkhala.

lele: ØeJele&les jòeâcetOJeË ÛeeOees efÉOeeÓefhe Jee~~ meg. G. 45Regular consumption of the causative factors stated above vitiates Pitta Dosha resulting in the increase in its Teekshna - Ushna Gunas TOJeË veemeeef#ekeâCee&mÙew: ces{^Ùeesefveiegow: DeOe: ~as well as its quantity. The Rakta Dhatu also gets increased in

kegâefheleb jescekegâhew§e mecemlew: leled ØeJele&les~~ cee. efve.volume and vitiated as it has properties similar to those of Pitta. The raised Ushma (temperature) of Pitta causes Swedan of rest of other Swidyaman Dhatus (with Apyansh/ Jaleeyansh or fluid The Granthakaras have described Urdhva, Adha and Dwidha content). As a results this, water content from these Dhatu – (Ubhay) Gati of Raktapitta. The Rakta vitiated by Pitta tries to get Apyansh gets extracted (OeeleesOee&lees: ØeefmeÛÙeles) and then accumulated in out of the body through the nearest outlet due to raised intra-

vascular pressure. When the Raktapitta is associated with Kapha (Kapha-Anubandha), upper part of the body being the main site of Kapha, these Doshas get expelled out from Amashay in upward direction. When it is associated with Vata Dosha (Vata-Anubandha); lower part being its main site, Doshas tries to get out of the body from Pakvashay in downward direction. Rakta along with vitiated Doshas also gets expelled out in downward direction through urethral, anal and vaginal opening in case of females. These are Urdhva and Adha Gati of Raktapitta respectively. The stimulation of Udan and Apan Vayu in these Gatis is an obvious thing as per their sites. Same way, Ubhay Gati is observed when there is association of both the Doshas – namely Kapha & Vata.

Urdhvag Raktapitta expels out through external openings of the upper body part – 7 Bahirmukh Srotas – namely Mukh, Nasa (2), Karna (2) and Akshi (2); whereas Adhog Raktapitta flows out through the openings found in lower body part – 2 Bahirmukh Srotas – namely Guda, Mootra (and Yoni in case of female). Ubhayag Raktapitta follows all the paths.

Apart from this, Asankhyeya (Antiki) Gati has been described in the Charak Samhita, Chikitsa Sthan – 4; in which Dhoshas also get expelled through the Loma Koopa (the openings of the sweat glands/ skin pores). This condition shou ld be cons idered as l i fe threatening. This condition can be compa red w i t h subcu taneous haemorrhage (like Purpura, Patechae) described in Modern medicine.

It can be assumed that during the Gati of Raktapitta, Sthanik Vigunata (Kha-Vaigunya) along with Snigdha-Ushna Hetu, Kapha-Vata Anubandha, Amashay-Pakvashay Sthan respectively is responsible for its urdhva or Adha Gati.

Raktapitta Poorvaroop:

meoveb MeerlekeâeefcelJeb keâC"OetceeÙeveb Jeefce: ~ueesnieefvOe§e efve:Õeemees YeJelÙeefmceved YeefJe<Ùeefle~~ meg. G. 45 / cee. efve.

Before the onset of Raktapitta, i. e. the direct flow of Pitta Dooshit

Rakta Sansarg Rakta Pradooshan

Rakta Pradooshak

Ushna, Teekshna, Amla, Drava

Gandha Varna same as Rakta

Raktaswaroop Pitta

Swedan due to Ushna Guna

Rakta; following signs and symptoms are seen. Sadan, Raktapitta – Urdhvag as well as Adhog. Thus, no separate path is Sheetakamita, Kanthadhoomayana, Vaman, Lohagandhi mentioned for Pittaj Raktapitta. Nishwas, Anannabhilasha, Swarabhed, Bhuktavidah, Raktapitta Upadrava:Shuktamlagandharasa Udgar, Satat Chhardi, Chhardit Ghruna, Swarabhed, Paridah, Mukha Gandha like Loha, Rakta, Matsya, Following diseases in the form of complications arising in Aam, red, yellow, green discoloration of the body, stool, urine, Raktapitta are discussed in Bruhad Trayi. It can lead to miserable sweat, saliva, Khamal, Dreams with different colors, Shirogaurav, disorders when not treated on time. Kasa, Shwas, Bhram, Klam etc

Dourbalya, Shwas, Kasa, Jwara, Vamathu, Mada, Tandra, Daah, Moorchha, Bhuktanna Vidah, Adhruti, Hrudpida, Trushna, Types of Raktapitta & their sign - symptoms:Kanthabhed, Shirastap, Pootinishtivan, Bhaktadwesh, Aruchi, Avipak, Atisar, Shoka, Shosha, Pandu, Swarabhed

The types of Raktapitta stated above are according to its Marga/ Gati. Apart from these types, Sushrutacharya has mentioned 7

Raktapitta Arishta: -Doshaj Bhed as per the predominance of the Dosha; whereas in Charak Samhita, Chikitsa Sthan, 4 as well as in Madhav Nidan, following 3 types are mentioned according to the predominance of In Indriya Sthan, chapter 5 of Charak Samhita; following Arishta the Dosha. Lakshanas of Raktapitta are mentioned which certainly lead to

death. Vatik - Shyav, Arun, Saphen, Tanu, Ruksha Paittik - Kashayabh, Krushna, Gomootrasannibh, Red colored sky in one's dreams, wearing garland of red flowers,

Mechakagar, Dhoomabh, Anjanabh Rakta red colored dress, red discoloration of the body, constant laughing Kaphanvit - Sandra, Pandu, Sasneha, Pichchhil Rakta without any reason etc

Though the disease – Raktapitta is Pitta Dosha Pradhan Vyadhi, Also, Raktapitta with Durgandhit, Ativegavan, Ati Raktasrava along along with solitary Pitta, Vata and Kapha Doshas also get involved with Pandu, Jwara, Chhardi, Kasa, Shopha and Atisar are called as in the development of the Raktapitta; which can explain the Arishta Soochak classification mentioned above. (Indicating the

Arishta) in the Shareer Sthan According to Madhukoshakar, these types as per Dosha Sansarg o f A s h t a n g should be considered different than those mentioned earlier as per Hruday. Marga Sambandh. He says that the Dosha Sansarg and Marga

Sambandh are separate things. Signs and symptoms of either of the Doshas or all Doshas are observed in case of every Gati of

Akeek Pashti?Extremely effective in Raktapitta; mainly in

Urdhwag Raktapitta being Balya for Hruday, Pittashamak

?Can be effectively used in Raktapradar, Urahkshat; being Sheeta & Raktastambhak

?Pacifies Teekshna – Ushna qualities of Pitta, thus proves useful in Pittaj Vikar like Daha, Jwara, Moorchha etc

?Also useful in Netrarog, Mootrarog, Mastishkavikar

Dosage & Anupan - 125 to 250 mg 2 - 3 times a day along with honey, butter or cow milk

Chandanasava?An excellent Pittashamak, Dahashamak,

Sheeta, Kashay Rasatmak, the most cooling Asava

?Contents like Shalmali, Usheer, Chandan being Stambhak, effective in Raktapitta with Daha, mainly in Adhog Raktapitta

?Also useful in Prameha, Pooyameha, Mootrakruchhra, Mootraghata, Shwetapradar, Amlapitta, Trushna, Sheetapitta, Twak Vikar

Dosage & Anupan - 2 to 4 tsf (10 to 20 ml) 2 times a day with equal quantity of lukewarm water

Bheda Urdhwag Adhog Tiryag / Ubhayaga

Hetu Snigdha, Ushna Rooksha, Ushna Both

Dosha Kapha Vata Tridosha

Sthan Amashay Pakvashay Sarvang

Marg 7 – Mukha, Nasa 2, 2 – Guda, Loma Koopa Karna 2, Akshi 2 Mootra (Asankhyey)

Sadhyatva Sukhasadhya Yapya Asadhya

Shodhan Virechan Vaman Vaman Virechan Anarha Chikitsa (Good for Pitta, (Not bad for Pitta, (Vaman cannot suit Vata

But not so good for But contra-indicated & Virechan cannot be Kapha) for Vata) given for Kapha)

Shaman Kashay, Tikta Madhur -Chikitsa (Rasa pacifying one

Dosha vitiates the other & vice versa)

Apunarbhav Kapha Samanya Vata Samanya Vata – Kapha Samanya Upakrama Upakrama Upakrama Chikitsa

Sadhya – Asadhyata (Prognosis) When stopped, these vitiated Doshas lead to complications like Galagraha, Pootinasya, Moorchha, Aruchi, Gulma, Pleeha, Anah, The two principles – '' jòebâ j#esled ØeÙelvele:'' and '' ØeefleceeieË Ûe njCeb jòeâefheòes Pandu, Grahani, Kushta, Jwara etc.efJeOeerÙeles '' have been considered while describing prognosis of the

disease. It can be considered that in case of (weak) patients with less Bala, Stambhan can be given for Pranaraksha (life saving).

Ùeled GOJe&Yeeieb leled meeOÙeb efJejsÛeveeshe›eâceCeerÙelJeeled ye£ew<eOelJeeÛÛe,Ùeled DeOeesYeeieb leled ÙeehÙeb Jeceveeshe›eâceCeerÙelJeeled Deuheew<eOelJeeled Ûe,

According to the Sootra, '' keâeue Øeleer#ee ve menles leled DeelÙeefÙekeâced '' and '' Ùeod GYeÙeYeeieb leled DemeeOÙeb, JeceveefJejsÛeveeÙeesefielJeeled Deveew<eOelJeeÛÛesefle~~ Ûe.efve.2 jòebâ j#esled ØeÙelvele: '' the condition of the Doshas and Sama-Nirama

stages should be examined while trying to arrest this bleed. Factors responsible for Sadhyata – Virechan is advised for Though, the type - Tiryaga Raktapitta is described as incurable, Raktapitta flowing out through outlets of upper body and there are results can be obtained if the predromal symptoms are observed plenty of medicines available to take care of it. It is called as carefully and treated immediately at this stage. curable. Because, Virechan is the best Shodhan Chikitsa for Pitta and not so bad for Kapha being the Anubandha Dosha. Medicines 2) Langhanwith Tikta – Kashay Rasa as well as Madhur Rasa are effective in Urdhvaga Raktapitta. Thus, it is known as Sadhya.

ØeeÙessCe efn mecegeflkeäue°ceeceoes<eeÛÚjerefjCeeced~Je=efæb ØeÙeeefle efheòeeme=kedâ lemceeòeue*dIÙeceeefole: ~~ Ûe. efÛe. 4Factors responsible for Yapyata – Adhoga Raktapitta is called as

Yapya, as Vaman is not so effective in it and very few medicines are available for its treatment. Vaman is not advisable for First of all, fasting should be advised to the patient as discussed in Pittashaman. Though the medicines with Kashay and Tikta Rasa Charak Samhita. pacify Pitta, but they are unable to take care of vitiated Vata. Thus, He has also mentioned, Adhoga Raktapitta is called as Yapya.

ceeieezb oes<eevegyevOeb Ûe efveoeveb Øemeceer#Ùe Ûe~Factors responsible for Asadhyata – Ubhayag Raktapitta (following ue*dIeveb jòeâefheòeeoew lehe&Ce Jee ØeÙeespeÙesled~~ Ûe. efÛe. 4both the paths) are called as Asadhya, as discussed earlier. In Raktapitta, Shodhan for Doshas should be performed through

After considering path of the disease, predominance of Dosha and outlets at opposite side (Virechan for Urdhvaga and Vaman for

causative factors of Raktapitta, examining the factors like Desha, Adhoga). Thus, there is no opposite exit for Doshas in case of

Kala etc of the patient, Langhan (Apatarpan) or Tarpan (Santarpan) Ubhayag Raktapitta. Same way, there is no Shaman Chikitsa for

should be given to the patient. Langhan (Fasting) can only be Doshas expelling out from both the paths. Generally a combination

advisable for Balavan patients. of treatment for all 3 Doshas should be given in such condition.

3) BrumhanApart from this, Sushrutacharya has advised to start Peya, Tarpan, Pachan, - Raktapitta with involvement of single Dosha, slow onset, Avaleha, Yoosha, Mansaras etc after Langhan for the purpose of recently developed, in season with good strength, without Bruhan which indicate Doshapachan, Vatashaman and any complications is called curable.Agnivardhan.

- Raktapitta with involvement of 2 Doshas, changing its path, with recurrence is known as difficult to cure.

Line of treatment for Balavan patients should be Langhan, Tarpan - Tridoshaj Raktapitta involving both paths, skin pores, etc; whereas Durbala patients should be given Kharjuradi Tarpan, acute onset, Rakta with foul smell, dark black in color, Laja Tarpan in case of Doshas getting expelled out through Urdhva Kaphavataj, with obstruction in throat, in case of fasting Marg and Peya in case of Adhog Raktapitta. patient, suffering from other diseases is called as

incurable.4) Shodhan/ ShamanShodhan should be given to the patient with good strength and with Sushrutacharya says that, Sadhya Raktapitta can get converted excess of Doshas; but only Shaman should be given to weak into Yapya and Yapya in Asadhya when not treated on time. Thus, patients with less Doshas. proper treatment should always be given on right time.

Shodhan Chikitsa:Raktapitta Chikitsa -

Øeefleceeie&b Ûe njCeb jòeâefheòes efJeOeerÙeles~ Ûe. efve. 2Rakta Dhatu being a Pranayatan and support of life, the disease

De#eerCeyeueceebmemÙe ÙemÙe mevlehe&CeeseflLeleced~Raktapitta should be treated immediately. yengoes<eb yeueJelees jòeâefheòeb MejerefjCe: ~~keâeues mebMeesOeveen&mÙe leæjsefVe®heõJeced ~1) veeoew mlecYevecen&efle~ Ûe. efÛe. 4efJejsÛevesveesOJe&YeeieceOeesieb Jecevesve Ûe ~~ Ûe. efÛe. 4

Charakacharya has suggested that initially no attempts should be made to arrest this bleeding through which vitiated Doshas are In Nidan Sthan, Charakacharya has explained that in Raktapitta, getting expelled out of the body, in case of patients with good increased vitiated Doshas must be removed out the body through musculature and strength (Balamansopachit) having proper diet. outlets at an opposite direction with the help of Shodhan Chikitsa.

In short, for Along with this, Granthakaras have also advised to follow the line of Urdhvag Raktapitta – Virechan should be given (using Nishottar, treatment mentioned for Urahkshat and Kshay Vyadhi.

Haritaki, Aragvadh, Indrayan etc.) Adhoga Raktapitta – Vaman should be done (using Indrayav, Adhoga -

Musta, Madan, Yashti etc.) In Adhoga Raktapitta, Doshas get expelled out of the body through the Guda, Mootra Marg and Yoni. In this condition, following Shaman Chikitsa proves effective when given immediately in case Shaman Chikitsa -of Stambhanarha patients and after Shodhan in case of In all patients with Raktapitta, Sheeta - Upachar by all means are Shodhanarha patients. advised in Granthas. Mootra Margagat – Gokshur, Shatavari or Chatushparni In case of patients eligible for Shaman; Stambhan, Langhan and (Shaliparni, Prushniparni, Mudgaparni, Mashaparni) Siddha Brumhan should be followed by oral medication as well as Dugdha are effective.medicine for local application mentioned below.Guda Margagat – Mocharas, Vata Praroha / Shung, Shunthi, Usheer, Kamal Siddha Dugdha + Raktatisar and Raktarsh Chikitsa

Internal - Diet should be soft, sweet, cold, bitter & astringent Aushadhi Yog - Bolabaddha Rasa, Kamadugha Rasa,

Administration of Basti:Chandrakala Rasa etc.Sushrutacharya has mentioned Shaman Basti for Adhoga External - Abhyang, Lep, Parishechan, Sek, Avagah, Sheeta Raktapitta. Ghrut etc. all Sheeta UpacharIn case of Guda Margagata Raktapitta – Anuvasan Basti like Vidarigandhadi, Yashti Ghrut and Asthapan Basti can be used;

Chikitsa according to the Marg (Path) of the disease: whereas in case of Mootra Margagata Raktapitta, Uttar Basti with Urdhvag - same medicines can be given. At the initial stage of Nasagat Raktapitta, the flow of Raktapitta should be neglected and should not be arrested. But once the

Shaman Yoga - Shuddha Rakta starts flowing out of the body through nasal cavity, Palash Ghrut, Kshiri Ghrut, Vasa Ghrut, Vasavaleha etc.different Shaman Nasyas (nasal drops) described in Granthas

should be given.

In case of Pravruddha Raktapitta, Kwath of Mudga, Laja, Yav, Pippali, Usheer, Musta, Bala can be given. Usheeradi Peya is In case of Urdhvag Raktapitta flowing out through either of the useful to arrest the excessive bleeding in Raktapitta.paths – Mukha, Nasa, Karna or Akshi; following Avapeed Nasyas

prove effective when administered along with other oral medicines of Raktapitta. Sushrutacharya has advised to use fresh blood of goat with honey

to avoid ill effects of excessive blood loss and has asked to have ` veemee efn efMejmees Éejced ̀ fresh liver of goat along with its gall bladder to combat the blood

loss. But practically, liver of goat can be consumed in minced or According to the Sootra, the medicines used instantly pacifies the soup form. Sthanik Doshas with the help of their Sheeta Veerya and Stambhan

Karma. Thus, the life of patient is saved by arresting this excessive Use of Kshar in Raktapitta -bleed. In Urdhvag Raktapitta, when the blood gets clotted as a result of Kapha Sansarga and gets obstructed at the level of throat; Kshar Avapida Nasya of Raktapitta Nashak drugs is the procedure of of Kamal Nal along with Madhu and Ghrut can be given in such choice using either of following Dravya - Stanya, Godugdha, condition. Same way, though the dried excreta of pigeon can be Ikshurasa, Draksha, Ghrut, Trapusmoola Rasa, Sharkara Jal, used with Madhu as advised in Charak Samhita, Chikitsa Sthan, Dadimpushpa, Amrapatra, Doorva, Palandumoola Rasa, Adhyay – 4, it has not been observed in practice. Yavasamoola Rasa.

Chandrakala Rasa?Potent Raktaprasadak, Sthambhak and Pittashamak

Rasakalpa with ingredients having Sheeta Veerya and Tikta Rasa

?Extremely useful in all types of Raktapitta, being pacifier of Ushna, Teekshna Guna

?Acts as Dahashamak?Recommended for persons w i th

Pittaprakruti, especially in Greeshma and Sharad Rhutu for maintenance of health

?A l s o e f f e c t i v e i n R a k t a p r a d a r, Shwetapradar, Kamala, Jwara with Daha, Mootradaha, Mootrakruchhra, Peptic ulcer, Chhardi

Dosage & Anupan - 1 to 2 tablets 3 times a day with Usheerasava, Sheetasudha, milk or water

Raktastambhak?An excellent Haemostatic medicine for various Bleeding

disorders?Nagakeshar being a well known Dravya for Raktagata Pitta

Pachan, Shuddha Laksha, Mocharasa, Shuddha Gairik being Raktastambhak and Doorva being Pittashamak help to stop blood loss

?Being a combination of Raktaprasadak Dravyas, helpful in Urdhvag as well as Adhog Raktapitta by minimizing bleeding tendency

?Also useful in Raktarsha, RaktapradarDosage & Anupan - 2 to 3 tablets 2 – 3 times

a day with Usheerasava, Chandanasava, Sheetasudha, cow's milk or honey

Raktapitta and High Blood Pressure

Rakta Dhatu gets vitiated as a result of vitiation of Pitta Dosha which further causes Vidaha of Rakta. The excessive heat in Rakta Dhatu absorbs fluid content from rest of the Dhatus increasing its own volume. This increases the pressure on the wall of blood vessels. This condition is known as 'High Blood Pressure' in modern science. Symptoms like bleeding nose (Epistaxis) are seen due to increased intra-vascular pressure. This condition of high blood pressure if not treated immediately can cause rupture of nasal capillaries and can even give rise to conditions like Paralysis as a result of ruptured cerebral blood vessels. The conditions developed due to acute cerebral haemorrhage are very serious. The patient can also land into comatous conditon. The prognosis depends on the part of brain involved in haemorrhage. This cerebral haemorrhage can be a stage of Raktapitta. Dominance of Vata Dosha and lack of Kapha Dosha as well as Sneha (unctuous part) is found in old age. In such condition, elasticity of blood vessels reduces resulting in rigidity just like other body elements. Thus, the chances of raised blood volume causing rupture of blood vessels are high in old persons due to the lack of elasticity in vessels. The brain (Mastishka) is one of the Sadya Pranahar Marmas (vital organ) situated in skull. Thus, haemorrhage in this part is dangerous enough to land in an emergency, especially in old aged patients. The line of treatment described for Raktapitta like Virechan and Raktamokshan can help preventing such emergency situations. Patients with cerebral haemorrhage can be well treated with medicines which pacifies Pitta and help Rakta Prasadan. Medicinal preparations like Tapyadi Loha can give excellent results in preventing recurrence.

LakshaBeing Kashay (astringent) in nature, Laksha act as Pittashamak, Raktaprasadak and helps in absorbing the excessive fluid.

It also helps to constricts the blood vessels and strengthens them.

Nagakeshar

veeieheg<heb keâ<eeÙees<Ceb ®#eb ueIJeeceheeÛeveced ~ YeeJeØekeâeMe

Being Ushna Veeryatmak, Nagakeshar helps in Pachan of Rasagat Pitta Dosha.It also reduces the excess of fluid and arrests bleeding, being Kashay, Ruksha and Laghu.

GairikBeing Madhur, Kashay and

Sheeta, it pacifies Pitta.It helps to stop bleeding by reducing Ushna and Teekshna Gunas raised in the Rakta.It is also effectively reduces the excess of fluid content of Rakta.

Mocharasa

ceesÛeeœeeJees efncees «eener efmveiOees Je=<Ùe: keâ<eeÙekeâ: ~

ØeJeeefnkeâeeflemeejecekeâHeâefheòeeœeoenvegled ~~ YeeJeØekeâeMeBeing Kashay Rasatmak and S h e e t a V e e r y a t m a k , Mocharasa arrests the bleeding b y p a c i f y i n g P i t t a a n d constricting blood vessels.

Vasa

JeemeeÙeeb efJeÅeceeveeÙeeb DeeMeeÙeebpeerefJelemÙe Ûe ~

jòeâefheòeer#eÙeerkeâemeer efkeâceLe&ceJemeeroefle ~~ Je=b.cee.Being Tikta-Kashay Rasatmak and Sheeta Veeryatmak, Vasa pacifies Raktagata Pitta and arrests bleeding; thus known as the best remedy for Raktapitta Vyadhi.Reduces Drava and Vidahi Gunas of Pitta with the help of Tikta-Kashay Rasa.

Doorva -Being Kashay Rasa, Madhur Vipak and Sheeta Veerya, pacifies

Pitta and reduces burning sensation.Immediately reduces Ushna-Teekshna Gunas of Pitta.Use of Doorva Swaras is an excellent medicine for arresting nasal bleeding.Internal use of Doorva Swaras effectively stops bleeding and burning sensation.

Praval (coral) from Sudha Varga as well as Mouktik (pearl) from Ratna Varga (gems) also have excellent results in Raktapitta like other Vanaspati Dravya (herbs).

Praval -Being Madhur and Sheeta ,effectively reduces Ushna-Teekshna Gunas of Pitta with the help of Pittaprasadan and Dahaprashaman properties.Mouktik-Being Madhur, Sheeta and Pruthvi-Jala Mahabhoota predominance, immediately reduces Vidah of Pitta. It prevents bleeding as well as provides strength to the blood vessels.

Pathya -Ahar -Rasa - KashayDhanya - Jeerna Shashtika Shali, Priyangu, Nivara, Yava,

GodhumShimbi - Mudga, Masoora, Chanaka, Adhaki, Makusht,

Koradoosha, ShyamakaMansa - Aja, Pakshi, Harin, KukkutDugdha - Godugdha, Ksheeranavaneet, Ghrita, Aja Dugdha,

SantanikaDrava - Sheeta Jala, Narikel Jala, Varuni, Audbhid Jala,

Shrutasheeta Jala, Madhu + Jala, Shadangodak, Laghu Panchamoola Siddha Jala,

Phala - Kadali, Talaphala, Dadima, Amalaki, Narikela, Kapittha, Draksha, Ikshu, Pakva Amra Phala, Shrungataka, Kamalgadda, Gambhari, Kharjur, Panas, Mocharas, Karkati, Taruni, Vidarikanda, Shatavari, Kasheruk, Shrungatak, etc

Krutanna - Utpaladi Siddha Ksheera, Tarpan, Peya, Yoosha, Yavagu, Mansa Rasa

Other - Mishreya, Laja, Saktu, Madhu, Shrakara, Gajapippal, Guda, Vasa-Meda-Majja

Apathya -Ahar - Rasa - Katu, Amla, LavanGuna - VidahiShaka Varga - Rasona, VartakaShuka Varga - Samo riceShimbi - Tila, Masha, Sarshapa, Kulattha, ground nutDugdha - Curd, LassiDrava - Kaupa Jala, MadyaOther - Guda, Tambula, Viruddhanna, Matsya, Kshar,

Lavan, Tapioca, fried food, fermented food like Idli, asafoetida, mustard seeds, red chilly, green chilly, fenugreek, ginger, starchy food, bangoli sweets

Vihar -Excessive Exercise, traveling, sunlight, excess of Shodhan, irritation, curbing of natural urges l ike defecation, urination, Fomentation, Raktamokshan, smoking, intercourse, anger

Is it not necessary to think?

Usually it is considered that patients with the disease Raktapitta are rarely seen. But is it really true? A number of patients are seen with diseases where blood leaves its normal path from large blood vessels or even capillaries and gets accumulated at a particular site in various ways. In such conditions, these diseases are known with different names as they differ from each other due to their sites and manifestations or due to different nomenclature used in other medical sciences, for e. g. subconjunctival haematoma or conditions like facial palsy, paralysis etc caused as a result of cerebral haemorrhage.

Considering this etiology, is it not necessary for us to think about the aggravating factors of Raktapitta for the benefit of patient? Is it not necessary to use Raktaprasadak medicinal preparations when only anti-hypertensives cannot prove effective as a complete treatment. Is it not necessary to practically apply one of the principles described in our medical science named as “ Vishuddha Chikitsa” ? Now a days, instead of using so called “Life saving Drugs” very often for treatment, can't we physicians use our own Ayurvedic preparations properly which are proved effective all the time irrespective of the era and without any unexpected ill-effects? When the whole world is looking respectfully and optimistically at Ayurved; is it not our duty to practice our Ayurvedic preparations based on Ayurvedic principles of treatment and to set more and more examples of successful as well as Vishuddha Chikitsa in front of the world? Is it not necessary to think deeply and seriously about this context?

Bolabaddha Rasa?An effective Raktasthambhak Khalvi Rasayan with main

ingredient 'Raktabola' useful in Adhog Raktapitta, especially Yonigata Raktapitta

?Helps in controlling excessive bleeding in Atyartav and Raktapradar

?It tones up the uterine muscles?Acts as Vranaropak in healing the cervical

erosion and ulcers in vagina?Also proves effective in Shwetapradar,

Raktarsha, Mootravikar, Prameha, Makkalshoola, Sootikavastha

Dosage & Anupan -2 to 3 tablets 2 – 3 times a day with Ashokarishta, Usheerasava, milk, butter or hone

Usheerasava?An Asava mainly containing Kashay, Sheeta, Raktastambhak

and Mootral Dravyas like 'Usheer' useful for reducing vitiation and Vidagdhata of Pitta

?Being an excellent Dahashamak, Pittashamak and Raktaprasadak, effective in all types of Raktapitta, mainly in Adhog Raktapitta

?Recommended in Greeshma and Sharad Rhutu for persons with Pittaprakruti who has tendency of bleeding

?Also useful in Raktarsha, Raktapradar, Shwetapradar, Mootrakruchhra, Mootradaha, Daha, Trushna

Dosage & Anupan - 2 to 4 tsf (10 to 20 ml) 2 – 3 times a day with equal quantity of lukewarm water

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