Charak Samhita - Sutrasthana - Chapter 24 (Vidhishonitiya Adhyaya)
Blood is essential to an individual's ability to remain alive. Because it transports vitiated dosha that causes disease, it additionally serves as the most significant element in the pathophysiology of every illness. This chapter discusses rakta dhatu, or blood tissue, outlining the qualities of pure blood and the variables that affect blood development. Suddha rakta, or pure blood, is created by eating appropriate foods. Thus, this chapter covers the qualities of pure blood, the causes of blood vitiation, dosha-specific properties of affected blood, their management, and the bloodletting process. A description of conditions like sanyasa (Coma), mada (Intoxication) and murchha (Syncope), along with their pathology, treatments, and the role of the mind in the development of certain types of these illnesses, have also been included because blood plays a significant role in the management of cerebrovascular diseases. So today we will discuss the Charaka Samhita Sutra sthana chapter twenty four Vidhishonitiya adhyaya in detail.
The previous sections of Yojana Chatushka, a tetrad on maintenance protocol, explained how to treat diseases brought on by the vitiation or unbalance of three doshas. The basics of managing illnesses resulting from vitiation of shonita, or blood, are further discussed in this chapter. Pure blood production is essential for survival since blood is necessary to support life. The body depends on blood for its genesis, growth, and survival. In this chapter, several etiological causes leading to rakta vitiation have been discussed. Numerous conditions, including stomatitis and eye redness, are brought on by vitiated rakta. When therapy with cold, hot, or harsh or unctuous dravyas is not working, the reason should be raktaja vikara (Blood condition). The therapy options for raktaja vikara are similar to those for raktapitta (Bleeding disorder), which includes bloodletting, fasting and purgation as suggested for vitiated pitta patients. Pure blood is said to have a golden hue, resembling red lotuses, fireflies, lakhsha, or the gunja fruit (Abrus precatorius). Variations from these might be attributed to vikaras or mental illnesses.
Synthesis Of Pure Blood
विधिना शोणितं जातं शुद्धं भवति देहिनाम्।
देशकालौकसात्म्यानां विधिर्यः सम्प्रकाशितः।। (3)
As previously said, pure blood is generated in accordance with time, location and adaptation.
Benefits Of Pure Blood
तद्विशुद्धं हि रुधिरं बलवर्णसुखायुषा।
युनक्ति प्राणिनं प्राणः शोणितं ह्यनुवर्तते।। (4)
The person gets their life, vigour, complexion, and happiness from such pure blood. Because blood is necessary for life to exist.
Blood Vitiation Causes
The following factors can produce vitiation of the blood
By regularly consuming rotten or inappropriate food or beverages, pungent or acidic liquor, and other comparable beverages, overeating, excessive salty, alkaline substances, pungent and sour food, masha (Phaseolus mungo), kulatha (Dolichos biflorus), tila taila (Sesamum indicum), nishpava (Dolichos lablab), pindalu (Randia uliginosa), radish and green leafy vegetables, meat of marshy and aquatic animals, excessive consumption of curd water, curd, vinegars and other fermented beverages, scavengers of birds and burrowing animals, intake decomposed, putrid food along with opposite characteristics, excessive daytime sleep particularly after consuming liquids, heavy and unctuous food, overexposure to the wind and sun, excessive anger, inhibition of the natural urges such as vomiting, avoiding bloodletting within the prescribed period, excessive exertion, heat, injury, indigestion, natural cycle in autumn season and intake of food during indigestion.
Illnesses Brought On By Blood Vitiation
The dietary practices and lifestyle choices stated above lead to a number of illnesses which should be classified as blood disorders, like eye redness, gulma (Lump abdomen), foul smell from mouth and nose, stomatitis, upakusha (Inflamed gums results in teeth falling), bleeding disorder, abscess, erysipelas, sleepiness, menorrhagia, skin discoloration, hematuria, vatarakta (Gout), thirst, pyrexia, body heaviness, weakness of digestive power, anorexia, extreme debility, headache, sour and bitter eructation, after-meal burning feeling, mental and physical exhaustion, confused state, foetid odour from body, excessive anger, sweating, salty flavour in the tongue, tremors, drowsiness, narcosis, decreased voice, darkness feeling and excessive sleep, pustules, boils, itching, patches, thick skin, leprosy, etc. The illnesses should be regarded as (Impure) blood-related as they are treatable but do not improve with any of these six treatments (Unctuous-rough, cold-hot, etc.).
Management Of Illnesses Related To Blood Vitiation
कुर्याच्छोणितरोगेषु रक्तपित्तहरीं क्रियाम्।
विरेकमुपवासं च स्रावणं शोणितस्य च।। (18)
Blood disorders are treated according to raktapitta, which includes therapeutic purgation, bloodletting and fasting.
Caution For Bloodletting
बलदोषप्रमाणाद्वा विशुद्ध्या रुधिरस्य वा।
रुधिरं स्रावयेज्जन्तोराशयं प्रसमीक्ष्य वा।। (19)
It is recommended to do bloodletting based on the patient's dosha, strength, and ailment location, and to continue until only pure blood is dripping out.
Dosha-Specific Characteristics Of Vitiated Blood
अरुणाभं भवेद्वाताद्विशदं फेनिलं तनु।
पित्तात् पीतासितं रक्तं स्त्यायत्यौष्ण्याच्चिरेण च।। (20)
ईषत्पाण्डु कफाद्दुष्टं पिच्छिलं तन्तुमद्घनम्।
संसृष्टलिङ्गं संसर्गात्त्रिलिङ्गं।। (21)
Blood becomes reddish (Arunabham), non-slimy, foamy, and thin as a result of vitiated vata. It turns blackish or yellow due to vitiated pitta, and heat causes the coagulation to happen more slowly. It is more viscous, fibrous, slimy, and a bit pale as a result of vitiated kapha. When two or more doshas are combined, the result is a mixture of traits and, in the case of sannipata, all three dosha symptoms.
Properties Of Pure Blood
गुञ्जाफलसवर्णं च विशुद्धं विद्धि शोणितम्।। (22)
When the hue of blood resembles fireflies, red-gold, red lotuses, gunja fruit (Abrus precatorius) and laksha (Lac-resinous substance), it is considered pure.
Diet After Bloodletting
नात्युष्णशीतं लघु दीपनीयं रक्तेऽपनीते हितमन्नपानम्।
तदा शरीरं ह्यनवस्थितासृगग्निर्विशेषेण च रक्षितव्यः।। (23)
It is recommended to follow up with a food that is light (Easy to digest), appetizing, and neither too cold nor hot. The body is susceptible to relapses of other blood-related disorders at this time, thus caution should be used to protect the agni (Digestive power).
Qualities Of An Individual With Pure Blood
सुखान्वितं तु(पु)ष्टिबलोपपन्नं विशुद्धरक्तं पुरुषं वदन्ति।। (24)
A person is said to have pure blood if his skin is radiant, his sense organs are in good working order, and he is delighted. An individual with unvitiated blood is joyful, blessed with saturation and vigour, and has proper digestion and unrestricted natural urges.
Causative Factors And Pathogenesis Of Intoxication, Syncope And Coma
A person's sensorium becomes confused and has tamas and rajas traits when they engage in bad habits and ruined food. The pathways that carry rasa (Plasma), rakta, as well as consciousness get clogged by the vitiated doshas, either separately or in combination. Diseases like intoxication (Mada), syncope (Murchcha), and coma (Sanyasa) result from this, and they develop in their etiology, symptoms, and treatments. Further degradation of awareness is caused by altered sensorium and distressing mental states brought on by vitiated dosha.
Dosha-specific Characteristics Of Mada (Intoxication)
If the person speaks too quickly, moves uncontrollably, and has a rough, blackish or reddish face, they should be considered to have vatika mada. It is recognized that someone with paittika mada has a red, black and yellow face, is irritable and harsh-tongued, and is prone to violent altercations. Kaphaja mada patients have less coherent speech, appear sleepy and sluggish, are pale, and experience constant anxiety. These characteristics are all present in combination in sannipataja mada. Like alcoholic narcosis, sannipataja mada is a form of narcosis that appears and goes away fast. All forms of narcosis are brought on by blood vitiation, poisoning, or alcoholic beverages. We may thus determine that the dosha vitiation of vata, pitta, and kapha, is the only factor contributing to all forms of narcosis.
Dosha-specific Characteristics Of Murchcha (Syncope)
When a patient experiences vatika murchcha, they see the sky like blue, reddish or black and rapidly lose consciousness. Additional signs and symptoms include shaking, bodily aches, severe pain around the heart, malnourishment, and a reddish-black lustre. Sweating is a sign of recovery in pattika murchcha. Unconsciousness occurs when the sky appears red, yellow or green. Additional symptoms include loose motion, yellowish pallor, yellow or red troubled eyes, pyrexia and thirst. When the patient sees a cloud-covered or completely black sky, they become unconscious and need a while to recover from this state of unconsciousness. His body feels heavy and covered with wet hide most of the time. He also experiences nausea and excessive salivation. All the aforementioned forms of murchchas are present in Sannipataja murchchas, and the patient has paroxysmal episodes resembling epilepsy; however, in this type of murchcha, the person falls unconscious without exhibiting violent or repulsive motions.
After the vitiated doshas pass on, mada and murchcha go away on their own. But without medical care, the coma (Sanyasa) does not lessen. Coma develops in weak people when unbalanced doshas enter a critical organ (Such as heart and brain) and begin to impair speech, movement, and mental faculties. A person in a coma looks to be dead or in a vegetative condition. If timely and efficient therapy is not received, death could occur. The doctor should tend to a comatose patient in the same manner as an intelligent individual would quickly retrieve a utensil that is floating in deep water before it hits the bottom. Colyriums, smokes, drops, needling, burning, blowing, put the patient on a nail bed by causing pain, hair removal from the patient's head and body, bite the patient, and rub with the hairy Atmagupta fruits (Mucuna prurita) are all suggested and thought to be useful methods for helping someone come out of a coma. In addition, a patient with syncope should be given a variety of potent alcoholic beverages that have been combined with a lot of pungent flavours. Similarly, to aid in someone's regaining consciousness, a mixture of sauvarchala (Black salt), dried ginger, wine, hingu (Ferula foetida), and vinegar or sour juice should be given.
After regaining consciousness, the patient should be provided a light food and kept occupied with captivating tales, memoirs, engaging discussions, enchanting songs, live music, and vibrant surroundings. In addition, he ought to be given emesis, purgation, gargles, exercise, collyriums, bloodletting, and body rubs. His mind has to be adequately shielded from anything that might be upsetting or confusing.
Different Methods Of Treating Mada And Murchcha
Patients with mada and murchcha should undergo five evacuative techniques based on their dosha and illness severity, after appropriate oleation and sudation. Similarly, it's advised to provide paniya-kalyana, tiktashatpala, or mahatikta ghrita. Other useful remedies include chitraka (Plumbago zeylanica) or pippali (Piper longum) with milk, triphala with sugar, ghrita, and honey, rasayana, kaumbha (Ten-year-old) ghrita, shilajatu and milk. Bloodletting, as well as continually reciting stories from the texts and surrounding the sick with noble and knowledgeable people, are effective ways to relieve mada and murchcha.
The features of non vitiated and non-vitiated blood, their causes, blood diseases and how they are treated, as well as the causes, symptoms, and management of mada, murchcha, and sanyasa, have all been covered in the section on Vidhishonitiya adhyaya. This chapter has covered diseases that cause varying states of awareness, from disorientation to coma.