The Ayurveda Encyclopedia _ Natural Secrets to Healing, Prevention, and Longevity ( PDFDrive ) (1)

Section 4: Specific Illnesses and Diseases Chapter 15: Digestive System is very thoughtful, giddy, or lazy. of the rectum. Acquired Hemorrhoids Poor digestion, accumulation of sweat, urine, and feces can develop by eating too many heavy, Causes: sweet, cold foods and liquids that block the chan- General: Hemorrhoids are caused by excess ag- nels of circulation and cause burning sensations. gravation of the doßhas through improper diet and Also, eating mutually contradictory foods, eating lifestyle that weaken the digestive fire. They may before the last meal is digested, eating too small be caused by excess sex, riding, straining, sitting portions, junk food or stale food, animal products for long periods on uneven or hard seats, or on or excessive amounts of pastries can cause trou- one’s heels. Other causes include enema nozzles, ble. Other causes include dry or raw vegetables, rough surfaces, washing with very cold water, vinegar, garlic, pickles, heavy fruits, fermented straining during defecation, and suppression or wines, polluted water. External causes include ex- early release of gas, urine, or feces. Emaciation cessive oleation therapy, not eliminating toxins, caused by fever, abdominal tumors, diarrhea, ex- wrong use of enema therapy, lack of exercise, ex- cess áma, duodenal disorders, edema, anemia, cessive sexual acts, and day naps. and overexertion can also cause this disease. For women this disorder can be caused by abortion, When Apána Váyu is excessive, it pushes feces miscarriage, and abnormal fetus development. to the anal sphincter and aggravates it, developing This leads to an accumulation of undigested food hemorrhoids. Apána Váyu is deranged from sit- (toxin waste or áma). Feces become lodged in the ting on rough, hard, or uneven seats, bumpy rides, folds of the rectum, hardening and causing fric- excessive sexual intercourse, enema nozzles tion, thus developing hemorrhoids. improperly inserted, too much cold water, and scratching the anus. Other causes include strain- Premonitory Symptoms: Weak digestion, weak ing in life and in passing feces, suppressing the thighs, twisting pain in calves, dizziness, enfee- natural urges, miscarriage, pressure of the uterus blement of parts of the body, swelling of eyes, during pregnancy, and abnormal delivery. diarrhea or constipation, gas with lower abdomi- nal pain, cutting pain in the anus; feces are diffi- Váyu: Eating astringent, pungent, bitter, dry, cult to eliminate with accompanying noise. Other cold, and light food, eating too little food or fast- symptoms include intestinal gurgling, abdominal ing, drinking sharp alcohol, sex, living in too cold distention, emaciation, excess belching, excess an environment, hard exercise, grief, and expo- urine, and insufficient feces, not feeling the need sure to the wind. to defecate, hot fumes, acidity, pain in the head, back, and chest, exhaustion, skin discoloration, Pitta: Eating pungent, hot, salty, burning, and stupor, weakened sense organs, anger, and unhap- sharp foods (e.g., onions, garlic, cayenne), strain- piness. ing exercise, exposure to the sun and fire, living in very hot places, drinking alcohol, envy, anger, Development: and impatience. General: Downward moving air (Apána Váyu) moves upward because of obstructions of the rec- Kapha: Eating sweet, oily, cold, salty, sour, tum. This aggravates the other four forms of Váyu and heavy foods, eastern winds, living in cold cli- (Práò, Udán, Vyán, Samán) in the body, as well mates, mental lethargy. as the urine, feces, Pitta, Kapha, the tissues (dhá- tus), and their sites. Thus, digestion is weakened, Tridoßhic: Caused by combinations of foods and áma and feces accumulate and sit in the folds and life-styles mentioned above. Symptoms: General: Severe emaciation, lack of enthusi- asm, helplessness, a weakened, broken voice, 383

The Áyurveda Encyclopedia pale complexion, weakened tissues, and pain in (but painless to the touch), stiff, and rigid. Other the vital organs. Further symptoms include cough, symptoms include severe itching, cutting pain in thirst, bad taste in the mouth, difficult breathing, the anus, urinary bladder, and navel region. Fur- nasal mucus, exhaustion, faint body pains, vomit- ther developments include cough, difficult breath- ing, excessive sneezing, edema, fever, impotence, ing, nausea, salivation, anorexia with mucus, and deafness, and blindness. Persons may develop urinary disorders (e.g., dysuria, diabetes, stones, urinary gravel or stones, worry, spitting, loss of gravel). Persons may experience vomiting, exces- appetite, pains in all the bones, joints, heart, na- sive spitting, cough, cold, impotence, dull head vel, anus, and groin. Other symptoms include pain, and fever with shivering. Feces symptoms oozing from the rectum, hemorrhoids (either dry include straining to eliminate, containing mucus or bleeding—yellow, green, red, or slimy) may and excess elimination. The stool can be reddish, occur. white and sometimes with slimy discharge. The urine and stool are heavy, slimy, and white. Com- Váyu: Dry, tingling, shriveled, bluish-red, un- plexion becomes yellowish-white and greasy; even, coarse and hard, sharp, cracked, associated there is constant edema, and the organs feel as with pain, cramps and excessive itchiness, numb- though covered with sticky material. The mouth ness, and tingling sensations. Other symptoms has a sweet taste. Tuberculosis and poor diges- include severe pain in the head, ribs, shoulders, tion associated with acute diseases caused by waist, thighs and groin, sneezing, and belch- áma (undigested food toxins) can develop. This ing. Further disorders include food not moving is a chronic condition. Dry and hot things bring through the digestive tract, sudden heart pain, loss relief. of taste or appetite, cough or difficult breathing. Irregular digestion, ringing in the ears, dizziness, Tridoßha: Symptoms of all three doßhas will blackened skin, nails, feces, urine, eyes, and face appear simultaneously. may occur. Feces disorders include small quantity with noises and straining, or dysentery followed Blood: Hemorrhoids caused by blood aggrava- by painful release of frothy, slimy fluid. If this is tion have symptoms similar to Pitta and have the not healed, it will lead to abdominal tumors, en- look of Váyu. Feces are hard, and hemorrhoids largement of the spleen, abdomen, and prostate. may bleed suddenly. This bleeding can lead to a Oily and hot things relieve this condition. greenish or pale complexion and to other diseases associated with loss of blood, strength, enthusi- Pitta: Thin, soft, flabby hemorrhoids are blue, asm, and sensory abilities. red, yellow, blue, or black in complexion, exuding thin blood with a foul smell and burning sensa- The most serious secondary complication to tion in the body. Other symptoms include asthma, arise along with hemorrhoids is constipation. ulceration, fever, perspiration, excessive sweat- ing and discharge, thirst, fainting, and loss of The most serious forms of hemorrhoids occur taste and appetite. Further disorders are delusion, with cardiac and/or rib pain, limb pain, fainting, heavy stool, brown, green, yellow or deep yellow vomiting, thirst, and inflammation of the anus. complexion, eyes, and nails. The stool becomes Almost as serious are symptoms of hand, leg, yellow or red, and bloody, burning, and itching. face, navel, anal, or testicle edema. In these cases, Colic or pricking pain, yellow or green loose hemorrhoids can only be controlled, but they can- stools or diarrhea develops. Copious, yellow and not healed. Also in this category are hereditary malodorous urine and stool develop. Cold things symptoms due to tridoßhic causes, when found in bring relief. the internal anal sphincter. Kapha: Hemorrhoids are deeply rooted, large, If persons are strong and have good digestion, swollen, thick, hard, round, white, and bulging. their hemorrhoids can be healed. Hemorrhoids They may be oily, greasy, smooth, with dull pain may last for a long time when they are caused by the simultaneous imbalance of two doßhas, when 384

Section 4: Specific Illnesses and Diseases Chapter 15: Digestive System they are congenital, when they are tridoßhic, or used, mixing sesame oil, ghee, or warm water when they are found in the innermost folds of the with herbs until the mixture becomes a paste. rectum. However, they can be controlled if the The paste is smeared on the masses. Herbs used digestive fire is adequately strengthened. Those include pippalí, chitrak, turmeric, triphalá, and hemorrhoids caused by two doßhas found in the cane sugar. Ointments are specifically useful second rectal fold or those that have existed more when there is edema, stiffness, itching, and pain. than one year (chronic) are difficult to heal. Those caused by only one doßha, found in the outer folds Herbs that reduce the various doßha-caused and that are non-chronic, are easily healed. Some hemorrhoids are also used in the above thera- suggest surgery or cauterization with alkalis. pies (i.e., cold, bitter herbs for Pitta; warm, oily herbs for Váyu; bitter and warm herbs for Kapha). There are 3 additional places where piles may Bloodletting is administered (by qualified practi- occur: in the male organ (discussed later), at the tioners) when the above therapies do not work. navel (being slippery and soft), and on the skin as warts. Herbal powder mixtures (chúròas) are also ingested; the mixture depends on the prevailing Therapies doßha causing the hemorrhoids. Triphalá is a good General: Herbs of neem, triphalá, guæúchí, lic- general chúròa. Hot spices like ginger, pippalí, orice, chitrak, viæa´ga, and pittapapra are most and black pepper (t^ikatu) are used for Váyu and effective. Kapha conditions. These also help improve the Hemorrhoids are classified into 2 main cat- digestive power, improve appetite, stimulate the egories, dry and wet. Those caused by Váyu and downward movement of air (Apána Váyu), re- Kapha fall into the former category, those caused duce swelling, itching and pain, promote strength by Pitta and blood aggravation fall into the latter. and complexion. Barley, turmeric, triphalá, and Here blood is considered wet, and although Ka- viæa´ga are useful for Pitta conditions. pha hemorrhoids are oily, greasy, slimy, etc., they are considered dry. When the patient suffers from both hemor- Dry Symptoms and Therapies: With numb- rhoids and constipation, recipes include triphalá ness, edema, and painful lumps, the mass is first decoction, triphalá with yogurt-water (lassi), or smeared with triphalá, bilwa, or chitrak medi- just harítakí with lassi. Lassi (buttermilk) is con- cated oils. Afterwards, warm or oily compresses sidered the best medicine for healing hemorrhoids (fomentation) of barley, or sesame seed powder, caused by Váyu and Kapha (a teaspoon of ghee or lukewarm compresses of vachá powder, corn sesame oil may be added for Váyu conditions). flour with sesame oil or ghee, dry radish pulp are Depending upon the person’s strength and the sea- applied. son, they may take buttermilk (lassi) from 1 week Next, herbal water made from herbs of bilwa, to 1 month, gradually increasing and decreasing vásák, arka, and castor oil may be sprinkled on the number of glasses per day. [1 month example: the areas of the navel and anus. Persons may 1 lassi—first day. 2 lassis—second day...adding 1 take sitz baths with water decoctions made from lassi per day until 15 lassis on the 15th day. On triphalá, bilwa, yogurt-water, whey, or radish the 16th day—14 lassis, the 17th day—13 lassis... leaves. One prepares for the sitz bath by smearing reducing the amount by 1 each day until 1 lassi on warm triphalá oil or ghee on the hemorrhoids. the 30th day. Aromatherapy includes burning and inhal- ing arka root, viæa´ga, barley, a¤hwagandhá, If the person is weak, then lassi is given morn- or Pippalí mixed with ghee. Ointments are also ings and evenings. When persons are strong, they may mix fried barley flour with lassi for evening drinks. Rock salt (saindav namak), found in any Indian grocery store, may be added to the drink. Meals are eaten using foods that balance the per- son’s doßha. After meals lassi with ghee or oil, 385

The Áyurveda Encyclopedia mixed with basmati rice is taken. Signs of Váyu as a secondary cause—gray- There are 3 types of lassi: (one for each doßha), ish color, hard and dry stool, not releasing gas through the anus, blood from hemorrhoids is thin, Váyu’s lassi is made with whole milk. Pitta’s lassi reddish, and foamy, pain in lumbar, thighs, and is made with skim milk. Kapha’s lassi is made anus, great weakness. This is caused by drying with fat-free milk. Lassi cleanses the circulatory foods and life-styles. [Váyu predominance—de- channels, enabling the plasma (rasa) to reach and velops even in Pitta and Kapha excesses if bleed- nourish all 7 tissue layers (dhátus). It is said that ing is excessive.] hemorrhoids healed with lassi will not develop again. Therapies include oily and cold foods and life- styles. Other useful foods and drinks: Signs of Kapha as a secondary cause—stool is 1) Thin gruel (peyá)—rice flour, pippalí, chitrak, loose, yellow, white, dry, heavy and cold; blood bilwa, lassi, fried in ghee or oil for Váyu hemor- from hemorrhoids is dense, thready, pale yellow, rhoids. A peyá mix is 50 gms. (1.76 oz) basmati and slimy. There is sliminess and numbness in the rice cooked with 8 times as much water. region of the anus. This is caused by heavy and 2) Thick gruel (yavágú)—Basmati rice with dry foods and life-styles. pippalí, lassi, black pepper for Váyu and Kapha. A yavágú mix is 50 gms. basmati rice cooked Therapies include dry and warm foods and life- with 2 to 4 times as much water. styles. First, detoxifying or elimination therapies 3) Vegetable soup—boiled and dry paßhana (e.g., fasting, purgation, emesis) are recommend- bedha, dried radish, bilwa, lassi, any astringent ed, then herbs are taken. herbs (e.g., raspberry) for Pitta. 4) For hemorrhoids with constipation—drinks Hemostatic Therapies (stopping bleeding): consisting of cane sugar, ghee, barley, gokßhura, When toxic blood is exuded, continued bleeding and lassi are for all doßhas. is necessary to release the toxins. Should bleeding be stopped too soon, it can lead to various other Cane sugar, barley flour, pomegranate juice, diseases of Rakta Pitta. Examples include bleed- boiled water, and black salt for Váyu. ing from other parts of the body, fever, morbid thirst, weakening digestion, anorexia and, jaun- Barley, honey, pippalí, dry ginger, black pep- dice. Other disorders include edema, colic pain per, rock salt, and lassi for Kapha and Váyu. in the anus and pelvic areas, skin diseases in the lumbar region and thighs, anemia, retention of 5) Green leafy vegetables are especially good gas, urine, and stool, headache, and heaviness. for Pitta. Bitter drugs stimulate the digestion, metabolism, 6) Fresh white unsalted butter with sugar and and stoppage of bleeding. If Váyu is predominant sesame seeds also heals this disease if taken for a even after the toxins are eliminated, then oily liq- long time. uids, massage, and anuvásana enemas are sug- gested. If Pitta is the only cause of the illness, and Enemas: bleeding occurs in the summer, then hemostatic 1) For gastritis (upward moving air [Upána therapies are immediately given to stop the bleed- Váyu]—chitrak, pippalí, bilwa, licorice decoc- ing. tion). This is an anuvásana enema. 2) Medicated enema for Váyu—milk, decoction Hemostatic herbal decoctions: Kuþaj, ginger of da¤hmúl, castor oil, and black salt. This is a (coagulates blood), sandalwood, neem, musta, nirúha enema. bilwa, nágkehar, pittapapra, red lotus, white lo- Bleeding Hemorrhoid Therapy: Two types of tus, balá, and cinnamon. this therapy exist: when Pitta is predominant, and when Kapha or Váyu are secondarily aggravated. Recipes: Fried barley flour with any of the above 386

Section 4: Specific Illnesses and Diseases Chapter 15: Digestive System herbs, onions taken alone or with barley and sugar moisture in these channels, obstructing the move- (or with lassi, butter, and sesame seeds). ment of feces, gas, and urine. Sprinkling water, sitz baths, and ointments made Following this, severe pain develops in the low- from the above herbs also help stop bleeding. Wa- er abdomen, ribs, back, and heart area, along with ter decoctions include licorice, arjuna, neem, and gripping abdominal pain, nausea, cutting pain in vásák. Bath herbs include sandalwood and lico- the rectum, severe and constant pain in the urinary rice. Ointments include ghee with sandalwood bladder; cheeks may swell. Váyu moves upward. and neem oils. The next stage of symptoms includes vomiting, If rectum prolapse (determined by feeling a Pit- anorexia, fever, other Váyu diseases of the heart, ta/Váyu pulse) or burning or stickiness in the anus duodenum, and urine suppression. Other disorders occurs, then it is rubbed with sesame oil or ghee include dysentery, deafness, blindness, difficult and mañjißhþhá, licorice, sandalwood and neem, breathing, headache, cough, nasal mucus, mental honey, and ghee, red and white sandalwood. anxiety, worry or fear, thirst, bleeding, abdominal tumors, and enlarged abdomen. Being secondary Continuous Bleeding Therapy: Forehead paste complications, these diseases—when associated and soup made of dúrba (the best blood coagula- with hemorrhoids—are difficult to heal. There- tive), sandalwood, and ghee. Also, anuvásana en- fore, constipation is the main complication to heal emas with the luke-warm upper portion of ghee, before these other symptoms appear. dúrba, and sandalwood. Summary: Váyu uses oily, sour and sweet thera- Therapies: pies, Pitta uses bitter, dry and cool therapies, Ka- Triphalá—Váyu pha uses hot therapies. Castor oil—Pitta, Pitta/Váyu—2 teaspoons in a cup of hot water before bed. Rhubarb—for stron- Either hemorrhoids, diarrhea, and sprue (grah- ger measures Senna—the strongest therapy. aní—malabsorption, anemia, and gastrointestinal Therapies include oil massage (oleation) fol- disorders) can cause the development of the other lowed by sudation (sweating). Afterwards, ole- 2 diseases. They develop from poor digestion and ation and sudation herbal suppositories are given, are healed by strengthening the digestive power. made of pippalí, madanphal, charcoal ash, mus- Generally hemorrhoids are healed by eating fried tard, and jaggery. In difficult cases castor oil pur- vegetables, thick barley gruel, vegetable/ghee gation and nirúha basti (enema) (mainly using soup, milk, and lassi. castor oil) are used. Bloating Obesity Due to Hemorrhoids (Udávarta) Causes: Váyu is aggravated in the colon by eat- Causes: Generally, acceptable weight levels ing air-increasing foods and drinks, i.e., foods depend on cultural beliefs. Westerners aim at the that are bitter, astringent, and dry (e.g., broccoli, slim, Pitta form. More ancient cultures praise Ka- barley, apples, most beans, and dry cereals). pha forms (where physical activity is also more prevalent). Thus the definition of over-weight Developmental Symptoms: The accumulated may be determined by whether it causes health air then becomes aggravated, blocking the down- problems. ward movement of Váyu (Apána). This dries the Causes of overweight include overeating, exces- sive eating of heavy or cold things, and oversleep- 387

The Áyurveda Encyclopedia ing and lack of exercise. Other causes include vegetables), avoidance of refined sugar, fewer hot hormone imbalance, emotional sentimentality, spices and more sweet digestives like cardamom, clinging, loss of love or low self-worth, insecu- coriander, bráhmí, jaóámáò¤hí, and a¤hwagandhá rity, and poor digestion. Weight-reducing and ap- calm the mind. Guggul helps cleanse and warm petite-suppressing drugs can weaken the diges- the body. tion and increase air (thereby aggravating Váyu). When overweight causes poor digestion, nutrients Pitta: Pitta-reducing foods, avoiding meat, fish, are not absorbed. Even after eating, the body does oily, greasy, or fried foods, sugars, and desserts. not receive the nutrients. So it sends a message to Raw salads, green herbs, and chlorophyll, diges- the brain to eat again. Even still, the digestive fire tive bitters and bitter laxatives are the best foods is unable to extract nutrients from the food. Thus, to reduce weight and counter sugar addiction. a vicious cycle of eating and overeating develops Herbs include aloe vera gel, kaóuká, turmeric, (absorbing little or no nutrition). bhúámalakí. Váyu: Sudden and fluctuating weight: (over, un- Kapha: Kapha-reducing foods, avoiding refined der, normal), variable hunger, eating lots of sugar sugars, salt, dairy, sweet fruit, bread, pastry, meat, to calm the nerves. Eating offers a feeling of se- fish, fruit juices, cold liquids, and oils. The best curity. foods for digestion are sprouts: their enzymatic properties help digestion. Meals are eaten after Váyu/Kapha: This constitution reflects a ner- 10:00 a.m. and before 6:00 p.m. Hot spices and vous mind and weak digestion. Pitta: Overeat- fasting (if one is strong) help raise the metabolism. ing is their main cause because appetite is strong. Spice teas, vegetable juices, steamed vegetables, There may be addiction to sugar and red meat. beans, and whole grains are also advised. Sugges- Weight develops muscle and flabbiness. tions include less sleep, no naps, and strong, aero- bic exercise. Hot digestive herbs like black pep- Kapha: This is the most common doßha that per, ginger, turmeric, and t^ikatu burn up fat and develops obesity, slow metabolism, easy weight raise the digestive fire. Bitter herbs reduce fat and gain, continuous appetite (addicted to eating), hy- dry water. Bitters include kaóuká, myrrh, triphalá, pothyroid or other hormonal conditions that cause and guggul. Gokßhura is a gentle diuretic. £hilájit retention of weight, mainly water and fat reten- helps the kidneys. bráhmí is a useful nervine to tion, weak pancreas and kidneys, low pulse and calm the mind. energy, flabbiness, pallor, moist complexion and skin, excess phlegm or saliva, subcutaneous fat Candida (Yeast) deposits and benign tumors may develop. Therapies: Cause: Usually starts in GI tract, then moves to General: A mild, long-term reducing plan is the blood and other organs. Candida is generally more natural than crash diets. Winter is not a good caused by weak digestion due to áma (toxin). It time to begin dieting because the cold can lower is usually due to high Váyu or Kapha, but it can one’s resistance and body heat. Reducing or light- also be caused by Pitta. Excessive use of sugars, ening therapy is needed, with a light diet, fasting, drugs, antibiotics, frequent colds and flu, weak digestive (spicy) herbs, mild laxatives, and tonics nervous system, worry, fear, grief, and anger can like guggul (1 gram 3 times daily) or ¤hilájit (1/2 also cause candida. gram twice daily). This reduces obesity in a few months. Bráhmí calms the mind for conditions of Symptoms: excessive eating. General: Chronic low energy, low-grade fevers, Váyu: Váyu-reducing herbs, diet, and lifestyle, variable digestion, poor immune functioning, and complex carbohydrates (whole grains and starchy food allergies. 388

Section 4: Specific Illnesses and Diseases Chapter 15: Digestive System Váyu: Insomnia, lower back pain, dry skin, ner- Ulcers vous, restless, light-headedness, ringing ears, de- pression, gas, bloating, constipation, and variable Inflamed ulcers are discussed in the next chapter. energy. Here stomach ulcers are reviewed. When the mu- cus lining of the stomach becomes inflamed, one Pitta: Fever, thirst, burning, hyperacidity, and experiences pain, burning sensation, and eventual infections. bleeding. The current Western view of ulcers is that they are caused by bacteria. Both viewpoints Kapha: Phlegm, frequent colds and flu, swollen are discussed below. glands, edema, heaviness, dullness, and excess sleeping. Bacterial Therapies: Áyurvedic therapies include antibacterial thera- Dual and Tridoßha: Symptoms of 2 or all 3 pies. doßhas. Váyu: Garlic, sandalwood, jasmine, turmeric. Therapies: Pitta: Chiráyatá, golden seal, aloe, sandalwood, General: This condition is treated similarly to jasmine, turmeric. parasites. The goal is to destroy the yeast and boost the immune system. This is achieved through re- Kapha: Garlic, golden seal, aloe, sandalwood, storing digestive and immune strength. turmeric. Refined sugars, white bread, yeast products, dairy, sweet fruit, raw foods, and cold drinks are Inflammation Therapies: avoided. Usually these conditions develop from mental Váyu: Antifungal herbs include asafoetida, stress, worry, overwork, nervous sensitivity, etc. garlic, ginger, pippalí, t^ikatu, triphalá, viæa´ga, Foods also can play a part in this condition: for musta. Viæa´ga and musta are antifungal but de- example, eating overly hot and spicy foods and plete the immune system, so they are best used for drinking excessive amounts of alcohol. only 1 or 2 weeks. Digestive herbs include carda- General: It is best to follow a bland food plan mom, cumin, ginger. Immune herbs include bráh- with easily digestible items. A milk fast is benefi- mí, guæúchí, balá, yogaraj guggul, and saffron. cial. Alcohol and smoking aggravates ulcers, as do Later, ¤hatávarí and a¤hwagandhá are taken. garlic, onions, pickles, vinegar, and salt. Bananas Pitta: Viæa´ga and musta are used as antifungal and the nightshade family of vegetables and fruit herbs. Digestives include coriander, fennel, and can also cause trouble. Therapies for hyperacidity turmeric. Immune herbs include bráhmí, guæúchí, are recommended here. Herbs to protect the mu- balá, kaißhore guggul, saffron, and neem. Later, cus lining of the stomach are useful, and include ¤hatávarí is used. aloe gel, ¤hatávarí, and licorice. Kapha: Viæa´ga and musta as antifungal herbs: Váyu: Symptoms include more pain than burn- cardamom, ginger, asafoetida, t^ikatu, and tripha- ing, feeling cold, light-headedness, anxiety, with lá as digestive herbs. Immune-boosting herbs in- insomnia, gas, constipation, abdominal disten- clude gokßhura, bráhmí, guæúchí, balá, saffron. tion, and palpitations. Heat applied to the stom- Also guggul and neem are used. ach brings relief. Excessive meals of dry and light Lyme disease has been helped by Pitta-type foods can dry up the mucus secretions causing an candida therapies and antibacterial herbs. We ulcer. Thus a Váyu-reducing diet is recommended. have found this therapy to be helpful in all lyme After a bland diet is followed for some time, spic- disease cases at our center. es can be safely used, such as hi´gwasták, lavaò bháskar chúròa, and t^ikatu (unless the tongue is dry, cracked or reddish). These herbs are taken with warm milk or ghee. 389

The Áyurveda Encyclopedia Pitta: Burning sensation is the predominant Ãma-Reducing Diet symptom. Anger and impatience are mental causes of Pitta ulcers. A Pitta-reduction diet is ad- Ãma Reducing Ãma Increasing vised, along with bitter herbs like aloe, barberry, Lemon, lime, grapefruit, Sweet fruits chiráyatá, kaóuká, and mahásudarßhan chúròa; pomegranate, cranberry also demulcents like ¤hatávarí. Steamed veggies (Váyu Potatoes, mush- and Kapha)/ Raw (Pitta). rooms, carrot juice Kapha: Ulcers are rare for this doßha. (pure or unmixed is Physical symptoms include white or clear Best sources: sprouts, phlegm, nausea, lack of appetite, dull pain, vegetable juices too sweet) and heaviness. Mental causes include greedi- Breads, pastries, ness, grief, or emotional attachment. Herbs Whole grains (oats and white flour prod- to digest mucus are recommended (e.g., wheat in moderation); ucts containing t^ikatu, pippalí, black pepper, and dry ginger). kicharí yeast Áma All other beans Múng beans (dal) Nuts and seeds Áma has been discussed throughout this book. Pumpkin seeds in mod- When áma (undigested food toxin) is present it Dairy can cause many diseases. Thus, one can follow a eration special áma-reducing diet that mainly decreases Acidophilus, yogurt wa- Pork, meat, fish, excess Kapha (because foods that increase Kapha poultry, eggs, lard increase áma). An anti-áma diet is depleting, so ter (shaken - Takra) the length of time persons should adhere to this --- Oils diet depends upon their physical strength. Kapha doßhas can stay on this plan for long periods of Ghee (moderation), mus- Sugars time. Pitta doßhas eventually need to introduce re- tard and flax oils Salt juvenation therapies. Váyu doßhas, the weakest of Raw homey the constitutions, are advised to stay on this diet Spices Cold liquids, coffee for only 1 week before adding rejuvenating herbs and foods. The chart below lists áma-reducing Warm liquids (eg., herb foods. Foods are chosen from the áma-reducing tea) column, according to one’s doßha. 390

Section 4: Specific Illnesses and Diseases Chapter 16: Infections/Wounds Thinking of sense objects causes attachment. From attachment arises longing and from longing anger is born [anger causes fever]. From anger arises delusion; from delusion, loss of memory is caused. From loss of memory, the discriminative faculty is ruined, and from the ruin of discrimination, one perishes. Bhagavad Gita Chapter 2; verse 62-63 It is desire, it is anger, born of Rajas Guòa (passion); of unappeasable craving and great sin; know this as the foe in the world. - Bhagavad Gita Chapter 3; verse 37 Chapter 16 Infections or Wounds Fever, Abscess, Sinus, Wounds, Inflamed Ulcers, Fractures/Dislocations ever (Jwara) Eight Fever Types ever, known as the lord of diseases, is said There are 8 major forms of fever: Váyu, Pitta, to be the most painful of all diseases. Its Kapha, Váyu/Pitta, Váyu/Kapha, Pitta/Kapha, heat destroys the ojas (life sap) and afflicts the Tridoßha (Sannipátika 13 types), and external body, senses and the mind. It was the first disease causes (five types). Both tridoßha fevers and ex- of humans and is the first illness to develop among ternal causes can be provoked by one or two pre- all diseases. Fevers afflict the entire mind and dominating doßhas, and the blockage of life sap body. It is considered the most powerful of all dis- (ojas). Five varieties of recurring fevers (vißham- eases because it produces various forms of death sa jwara) also exist (malaria-related). Fevers have and is also present during birth. three stages, which will be detailed later. The Vedic mythology of fever states that it orig- Cause and Development of Fever inated in Lord Rudra (£hiva—the destroyer of ig- norance) who unleashed his wrath on the asuras Improper or excessive use of oil, inflammation, (demons). In the process, the gods (elements of over fatigue, wasting, indigestion, intake of bad, nature) became afflicted with burning sensations toxic or poisonous substances, poor diet, sudden and pain, and all creatures became unconscious. change of diet or weather, poor conduct, grief, The gods propitiated £hiva who restored them to anger, passion, toxic fumes, malefic planets and health. He said that anger will take the form of stars at birth, spells, curses, or factors related to fever, afflicting people at birth, death, and when child birth (i.e., miscarriage, untimely delivery, they do not follow their prescribed Áyurvedic life- improper self-care after delivery or during the styles. In short, people living virtuously will not first accumulation of breast milk after delivery). suffer from fever. Fever causes emaciation, delu- sion, and heat discomfort, caused by unhealthy lifestyle habits and improper conduct. In conventional medicine (allopathic) fever is Development: The doßhas thus becoming viti- also the predominant and common symptom of ated and all illness. Fever is seen as the first warning the body gives in response to any imbalance or infec- 1. Enter the stomach and intestines (ámáßhaya) tion. [each respective doßha, Váyu, Pitta, Kapha, when entering the ámáßhaya will aggravate and develop 391

The Áyurveda Encyclopedia into its respective doßha fever] Causes of Fever 2. Mix with áma (undigested food toxins) 3. Lodge in the plasma or lymph chyle (rasa) mental/physical cold/heat due to their inherent heat. 4. Then, they mix with the plasma, obstructing internal/external seasonal/unseasonal the plasma (rasa), hemoglobin (rakta), muscle (máµsa) and sweat channels (sweda srotas). curable/incurable 5. Next, it pushes the agni digestive fire en- Either the mind or the body can be the cause of a zymes out of the GI tract. The agni then spreads fever. Mythologically, it is said that the Soma god throughout the body (i.e., into all of the tissues, causes cold fevers and the Agni god causes hot organs, etc.), pushing the heat to the skin. This fevers. Fevers occurring in their respective season raises the body’s temperature and stops perspira- are healed in their respective season. Fevers are tion. The parallel of this process in modern sci- easily healed, difficult to heal, or incurable. ence is known as the increase of metabolic activ- ity. This in turn increases body temperature. To learn all necessary information about fever, the Áyurvedic practitioner (vaidya) must analyze Incubatory or Premonitory the, Signs and Symptoms 1. Nature of the dis- 9. Symptoms and listless indifference sluggish ease signs heaviness lassitude fainting 2. Precipitating factors 10. Doßhas involved 3. Origin 11. Features low spirit distaste 4. Cause 12. Healing signs and no appetite teary eyes body aches 5. Premonitory or symptoms incubatory signs and tires easily indigestion low strength 13. Preventing relapse symptoms excess drooping great thirst 6. Location 14. Reasons for re- sleep lapse 7. Strength of the tingling calf pain forgetfulness disease 15. Healing the re- teeth lapse 8. Time of occurrence depression dark vision moody hair stands pale complex- excess yawning on end ion desire hot/ desire pungent, impatience for cold things sour, and salty good advice alternately tastes Further, the vaidya needs to have an un- strongly dislike sweets, music, children, cold derstanding of fever caused by alcohol, the water, shade and sun seven dhátus, knowledge of the first and later stages of fever and chronic fevers. 392

Section 4: Specific Illnesses and Diseases Chapter 16: Infections/Wounds Premonitory Doßha Symptoms sorrow dry skin indigestion drooping body Váyu constant yawning intermittent rambling parts temple pain speech Pitta burning eyes desiring hot Kapha loss of hunger things irregular tem- irregularity- shivering Tridoßha all symptoms irregularity perature acute/mild in onset and Dual-Doßha symptoms of both alleviation stiff jaw tingling teeth Causes Aggravating Air Fevers occuring after digestion in the afternoon, dawn, end of sum- mer (Váyu Jwara) The general words to describe Váyu fever symptoms are sharp, cutting, shifting pain, snuff assault fasting coldness, and dryness. anxiety grief excess exercise suppression of staying up late poor posture Causes Aggravating Pitta Fevers natural urges (Pitta Jwara) excess emesis, purgation or excess sex drying enemas irregular diet eating with exposure to indigestion hot sun and over-indulgence of oily, light, excess cold foods blood-letting fires exhaustion excessive hot, salty, sour, and pungent foods Symptoms of Air Caused Fevers Symptoms of Pitta Caused Fevers (Váyu Jwara) twisting calf loss of sensa- contracting (Pitta Jwara) pain tion and rigid- abdominal or ity of the feet shoulder pain dizzy fainting toxicity loose joints weak thighs ringing ears no elimina- sharp, cutting reddish face, diarrhea acidity great thirst tion of sweat, pain in upper eyes, nails, feces, or urine urine, throat, red skin burning rambling body patches sensations speech splitin back or lips, skin, bone (and rib) astringent or feces perspiration high fever bile in vomit pain, dry skin bad taste in loss of taste expectorating desiring cold malodorous chest pain mouth and lack of blood things breath headache anorexia dry cough or dizziness hunger delirium restlessness naps dry heaves hair stands on desiring sun hives giddiness intoxication end insomnia dry lips, occurs during occurs at night, midnight, mouth, throat digestion autumn pungent taste green/yellow liking cold skin, nails, things eyes, urine, stool 393

The Áyurveda Encyclopedia In short, the key words for Pitta fevers include, Again, these fevers have 12 subdivisions, when heat, sweat, red, yellow, or green, blood, bile, one, two or all three doßhas are predominant (e.g., Váyu/Pitta equal predominance, Váyu/Pitta with impatience. Váyu predominance, Váyu/Pitta/ Kapha with Pit- ta and Kapha predominance, etc.) Causes Aggravating Kapha Fevers Fevers of all three doßhas begin during their re- (Kapha Jwara) spective times of day (or night), season, and di- gestion (as discussed earlier). The rainy season lack of lack of naps (mid July- mid September) is most likely to cause discipline exercise Váyu fevers. The autumn season (mid September- mid November) is most likely to produce Pitta fe- excess intake of oily, heavy, sweet, slimy, cold, vers. The spring season (mid March- mid May) sour, and salty foods is when Kapha fevers are most likely to occur. When doßha fevers arise outside their respective Symptoms of Kapha Caused Fevers season they are more difficult to heal, unseasonal Váyu fevers are the most difficult. All Váyu fevers (Kapha Jwara) are usually difficult to heal. lassitude nausea mild fever During the seasonal fevers, food may be taken (i.e., fasting is not necessary). Fasting is advised sweet taste running nose heaviness when persons are strong and the Sun is weak (rainy, autumn and winter seasons). It is also nec- glassy/white cold swellings no hunger or essary for practitioners to remember that Váyu and eyes taste Pitta are weak at the beginning of spring. They are moderately strong in the middle of the season and drowsiness slight heat acid belching strong at the end of this time. Similarly, Kapha is weak at the beginning of autumn, moderate in the obstructed no obstructed middle and strong at the end of this season. Thus, channels assimilation feces, urine, the strength of the patient with fever is known at (srotas) these times. of foods sweat Other causes include combinations of these fac- goose bumps cough shivering tors, or due to, fainting stupor heart coating irregular diet fast poison intake improper oleation, fomentation, emesis, purga- slight limb increased cold skin tion, or enema; improper diet or lifestyle after pain salivation eruptions pañcha karma heavy chest vomiting poor digestion improper child deliver or poor diet after delivery difficult fever after desiring hot breathing eating things sudden change in diet, toxic fumes, or materials whitish skin, fever during desiring hot nails, mucus, spring, morn- things urine, stool ing, evening The key words for Kapha fevers are white, cold, slow minded. Causes of Multiple Doßha Fevers Four types of multiple fevers exist. 1. Váyu/Pitta Two Doßha Fevers (Dwandvaja Jwara) 2. Váyu/Kapha 3. Pitta/Kapha Fevers caused by two doßhas exhibit symptoms 4. Váyu/Pitta/Kapha of both doßhas. Váyu/Pitta fevers cause a desire 394

Section 4: Specific Illnesses and Diseases Chapter 16: Infections/Wounds for cold things (i.e., Pitta heat predominates). Grief is aggravated by Váyu. Its symptoms are Váyu/Kapha fevers cause a desire for hot things. excessive crying or heavy breathing. Tridoßha Fevers (Sannipáta Jwara) Lust is caused by excess Pitta, and produces loss of appetite, burning sensations, frequent breaths, Sannipáta Jwaras are caused by the same ac- absence of shame, sleep, intelligence and cour- tions described above for each doßha. Thus, fe- age. vers caused by all three doßhas exhibit symptoms of all three doßhas. Pollen, Dust causes fainting, headaches, vom- iting, intoxicating, wetness and sneezing, and is During dual or tridoßha fevers, one doßha is pre- caused by all doßhas. This is easily healed. dominant. Thus, the predominant doßha is mainly focused on when healing the illness. Poison symptoms include blackened face, burn- ing sensations, diarrhea, heart pain, disliking food, thirst, limb pain, extreme weakness, wetness, epi- lepsy, caused by all doßhas. This is easily healed with their antidotes. Difficult to Heal or Incurable Sannipáta Evil spirit’s symptoms include laughing or cry- Doßha obstruction or non-elimination, de- ing without reason, and are caused by all three stroyed agni enzymes, fully manifested signs and doßhas. These occur rarely, but are hard to heal. symptoms. 3. Curses (are caused by all three doßhas). Externally Caused Fevers (Ágantu) 4. Sorcery or Witchcraft (are caused by all three doßhas). Four types of externally caused fevers exist. 1. Trauma or Injuries are associated with Váyu The last two types of spells rarely occur. Their within vitiated blood (rakta) [and sometimes the symptoms include thirst and fainting, all signs other tissues (dhátus)]. Symptoms include pain, of tridoßhic fever and are hard to bear. The Áy- swelling and discoloration. According to modern urvedic practitioner (vaidya) determines these science, these symptoms are explained as inflam- last two fevers by, mations caused by infections or injuries. 1. Observing the deed 2. Hearing about the deed 2. Emotions, Infections (e.g., bacteria, virus, 3. Through inference poisons), Evil Spirits 4. By healing the fever Sometimes eternal fevers remain exogenous. Emotions are caused by vitiated Váyu and Pitta. Sometimes they later become associated with the They first occur in the mind, then fever develops doßhas. Its premonitory symptom is pain. Fever during the times and seasons of the respective may occur first, then the symptoms, or vice ver- doßhas. Modern Psychology calls these events sa. psychosomatic; the mind affects the health of the body. Anger is due to excess Pitta (and sometimes the other doßhas). Its symptoms include wrath, trem- ors, and headache. Fear is aggravated by Váyu. Its symptoms are delirium and apprehension. 395

The Áyurveda Encyclopedia External Fever Therapies Third Stage Fever Symptoms (Niráma) Spiritual therapies are used for externally reduced temperature appetite caused fevers. These therapies include rites, ritu- elimination of doßhas lightness als, good deeds, fasting, light meals, and herbal decoctions. and wastes These symptoms will generally appear by the eighth day Three Stages of Fever Three stages of a fever include, Recovery From Fever 1. Association with áma (undigested foods) 2. Metabolic transformation Healing from fevers is easy when persons are 3. Non-association with áma. strong, the doßha is mildly increased and there are no secondary complications (áma fevers). Symp- First Stage Fever Symptoms (with Ãma) toms of fevers with áma include excess urine, con- stipation or diarrhea, and loss of hunger. Fever, emaciation indigestion drowsiness thirst, delirium, difficult breathing, dizziness, and heart feels constant nausea are symptoms of fever with heated doßhas. body and impure/heavy Fevers that are long lasting, recurring after seven abdominal temperature days or appear after fasts are fevers without áma. heaviness salivation nausea Remittent/Intermittent Fevers laziness (Viähama Jwara) acute attack rigidity numbness Doßhas & Dhátus Fevers—Malarial Fevers no hunger/ tastelessness unformed heavy Fevers are generally caused by all three doßhas. excess urine stool stomach However, due to one’s doßha, the fevers may manifest as described above in the various tissues no elimination of wastes, (dhátus). After tridoßhic fevers subside a slight doßhas, sweat residue of the deranged doßhas and weakness exists. Through improper healing measures and During this stage, one is not to take naps, bath, mas- poor diet, Váyu becomes vitiated and re-aggra- sage, heavy foods, sexual intercourse, vated. Further, this can cause five fevers lodged in any or all of the five Kapha sites (stomach and anger, wind, exercise, or astringent tastes. intestines, the chest, throat, head, and joints). Second Stage Fever Symptoms Modern medicine sees remittent fevers as dif- (Pachyamána) ferent types of malarias caused by mosquitoes (various species of plasmodium). The mosquitoes excess fever/ mucus in difficult infect the blood and act upon the red blood cells. thirst feces breathing These blood infections affect the various support- ing elements of the tissues (dhátus). Malaria is delirium giddiness considered a parasitic infection, while typhoid is classified as a bacterial infection. Fevers of plasma, hemoglobin, muscle and fat 396

Section 4: Specific Illnesses and Diseases Chapter 16: Infections/Wounds are easy to heal. Bone and marrow fevers are more nant—sudden head pain, Váyu/Kapha predomi- difficult to heal. The six fevers are nate—sudden pain in the entire back, Kapha/Pitta predominant—sudden pain in the upper back or 1. Santata Jwara/Plasma (Rasa) Fevers: This lumbo-sacral joint). fever starts in the plasma (and sometimes in the other dhátus), quickly spreading to the three Symptoms include excess sweat, thirst, deliri- doßhas, seven dhátus, urine and feces. The fe- um, frequent vomiting, dislike of one’s own body ver is continuous and hard to tolerate. They are odor, wetness, anorexia. caused by rasa spreading the aggravated doßhas throughout the body and are difficult to bear. If 5. Chaturthaka Jwara/Marrow (Majjá), Bone purified, Váyu fevers last for 7 or 14 days, Pitta (Asthi) and Fat (Medas): When the doßhas are fevers last for 9 or 10 days and Kapha fevers last in the fat, marrow, and bones, fever occurs every for 11 or 12 days. This fever is continuous due to fourth day, manifesting either with Váyu excess the vitiated rasa spreading throughout the body. (beginning in the head), or Kapha excess (begin- For all fevers of plasma origin, fasting is the first ning in the calves). Some say only when doßhas healing therapy. Various forms of this fever dis- are in the marrow does fever occur every fourth appear for a day or two, then recur during their day. aggravating time of day and season. They last for Fevers caused by doßhas simultaneously in bone another seven or 14 days. Recurrence is caused by and marrow are called Viparyaya Jwara, which is improper convalescing and diet. of three kinds (one for each doßha). These fevers Symptoms include heaviness, misery, anxiety, last for 2 days, disappear for a day and then reap- prostration, vomiting, anorexia, malaise, and pear, continuing this cycle. yawning. Some authorities believe these three fevers are 2. Satata Jwara/Hemoglobin (Rakta) Fevers: caused by afflictions of the previous alternate Vitiated doßhas reside in the blood or hemoglo- dhátus (i.e., afflicted rakta dhátu causes any- bin, deranging the blood. These fevers are caused edyußhka (fat) jwara; muscle afflictions cause and develop according to the time of day or sea- t^itíyaka (bone fevers); doßhas in the fat (medas) son. They appear twice within 24 hours; they can tissue cause chaturthaka (marrow) fever. develop and become healed merely by the time of day or season, or by attending to the aggravated Symptoms of bone fevers include diarrhea and dhátu or one’s prak^iti (constitution) with ap- vomiting, bone pains, unusual sounds, and body propriate therapies. (Sometimes called Santataka spasms. Symptoms of marrow fever include hic- Jwara) cup, asthma, bronchitis, dark vision, vital organ pains, outer coldness, and internal burning. Symptoms include blood, pimples, thirst, burn- ing, discoloration, giddiness, intoxication, deliri- um. 6. Ojas Nirodhaja: The life sap or ojas tissue (¤hukra dhátu) may also be blocked by Váyu and 3. Anyeduähka Jwara/Muscle (Máåsa) Fevers: Pitta. Symptoms include shivering, numbness, One’s prak^iti, dhátus, the doßhas, or seasons unconsciousness, drowsiness, delirium, slight pain, and ejaculation. Váyu fevers appear every can cause the muscle channel (máåsavaha srota) 7 days, Pitta fevers arise every 10 days, Kapha obstructions. These fevers occur once a day. Symptoms include burning thirst, unconscious- excess fevers appear every 12 days. ness, wetness, diarrhea, foul smell, body spasms. 4. Trtíyaka Jwara/Fat (Medas) Fevers: These are Váyu-caused fevers, which manifest every other day. (Symptoms of Váyu/Pitta predomi- 397

The Áyurveda Encyclopedia Symptoms of Relief From Fever be used during the first stages of fevers. Accord- ing to the experience of some modern Áyurvedic When fevers begin to be relieved, the doßhas in doctors, sudarßhan chúròa works best for the ma- the dhátus (tissues) create abnormalities and be- larial (remittent) fevers; others prefer sitopaladi. come liquefied. Persons begin to breathe heavily, sweat profusely, moan, vomit, and shake. They Sitopaladi Chúròa become delirious, have unusual body movements, experience heat and cold, become angry, have For fevers associated with flus and respiratory noisy, malodorous diarrhea, become pale, and disorders, sitopaladi chúròa works best. It is up lose consciousness. Fevers may leave suddenly or to each modern practitioner to decide whether gradually. Certain fevers can produce anxiety, so sudarßhan or sitopaladi chúròa works better for persons must be treated with care. After the fever the client. A recipe for typhoid or malaria (re- is healed the person gradually returns to a normal curring fevers) is 1/2 tsp. sitopaladi chúròa with state of health. warm water—3 times daily for 8 weeks. The first 10 days one follows a liquid fast. Within 3 to 4 Fevers that heal suddenly are termed “healed days, persons should feel better. After the 8-week by crises” in modern medicine. When persons program the fever will not occur. take antibiotics to kill bacteria, viruses, etc., these pathogens are suddenly killed. When they die, Thus, regardless of the type of fever (i.e., Váyu, they release various toxins into the bodily sys- Pitta, remittent, etc.), sudarßhan and sitopaladi tems. The body reacts to this sudden release of chúròas are the only herbal therapies needed. De- toxins, and develops various disorders. (When pending on the doßha(s) causing the fever, per- fever is healed gradually the toxins are slowly re- sons are advised to follow the corresponding food leased into the body, giving it time to adapt and and lifestyle guidelines that balance and maintain excrete them). their health. Symptoms of Healed Fever Lightness, normal functioning of the mind and senses, normal sweating, appetite, itching head, absence of exhaustion, delusion and heat, mouth ulcers, and discomfort. Therapies Abscesses (Vidradhi) Remedy for All Fevers: Sudarßhan Chúròa Causes: Eating stale, very hot, and dry foods, The Áyurvedic seers have created this formula (causing burning during digestion); lying on an for all fevers (intermittent and other doßha and uneven bed, foods and life-styles that vitiate the dhátu fevers). This formula is a combination of 48 blood. The doßhas become aggravated and weak- herbs (the main herb used is chiráyatá). Sudarßhan en the skin, muscles, fat, bones, ligaments, blood, chúròa is taken with cold water. On the right in- and tendons, producing swelling in any one or dex finger of Lord Vißhnu resides a powerful dis- several of them. This occurs either inside the body cus that destroys all kinds of enemies. It is called (with severe pain) or on the outer body. Abscesses Sudarßhan Chakra. Because this herbal remedy are either round or wide. Six forms of abscess- destroys all kinds of fevers, it was named after es exist: Váyu, Pitta, Kapha, Tridoßha, blood, or this discus or chakra. Sudarßhan chúròa can even trauma caused. 398

Section 4: Specific Illnesses and Diseases Chapter 16: Infections/Wounds Symptoms: urinary bladder and those that have burst after External: Forming anywhere on the body, being maturing (either inside or outside), are unable to difficult to bear, they are hard and raised. be healed. Also, those that burst inside and expel Internal: More difficult to bear, deep seated, their contents, those arising in debilitated persons, hard, growing upwards (like an anthill), near the and those that have secondary complications can- navel, urinary bladder, liver, spleen, heart, abdo- not be healed. men, groin, kidneys, or rectum. It is very serious. Váyu: Severe pain, blackish-red, takes a long Abscess Complication time to grow, forming and discharging pus, irreg- ularly placed, unevenly shaped, painful, cutting, near navel hiccup rotating, spreading easily, gaseous, throbbing, in bladder difficulty eliminating/ and producing sounds. Pitta: Red, coppery or black, causing thirst, de- in liver foul smell lusion, fever, burning, quick to grow, form, and in spleen difficult breathing discharge pus. in pancreas difficult exhaling Kapha: White, itching, with nausea, cold, stiff- all over body ness of the body, excessive yawning, loss of taste, in heart thirst heaviness of the body, slow to grow, form, and sharp pain/rigidity discharge pus. on front/ great delusion, unconscious- Tridoßha: Symptoms of all the doßhas simulta- top of stomach ness, cough, friction/ neously. pain in the heart Blood: Surrounded by black eruptions, blue col- in groin pain/gurgling in upper abdo- ored, severe burning, pain, fever, and other symp- in kidneys men, pain in ribs toms of aggravated Pitta. It is external in all cases except those developing in the uterus. in rectum and shoulders Trauma: Váyu becomes aggravated from the stiff thighs force of assault, unsuitable foods or lifestyle. It displaces the heat at the trauma site, aggravating sharp pain in waist and back, Pitta, and causing symptoms of Pitta and blood. rib pain This causes the severest secondary complica- tions. obstruction of gas Depending upon the site of the abscess will de- termine the secondary symptoms. Therapies: These therapies are the same as for sinus (next section). Sinus (Náæí-Vraòa) If persons neglect abscesses or swellings sinus problems can develop. Five forms of náæí exist: Váyu, Pitta, Kapha, Tridoßha, and £halyaja. The early, middle, and advanced stages of ab- Causes and Symptoms: scess development are similar to inflammatory Váyu: Rough, short-mouthed size, aching pain edema. In the advanced stages of abscesses lo- within the sinus, secreting a frothy matter, in- calized above the navel, they expel pus or blood creasing by night with aching pain, thirst. through the mouth, and when present below the navel, discharges are through the rectum. The features of the doßhas and of that which Pitta: Lethargy, heat, piercing pain. Fever oc- is exuded is similar to ulcers (rather than from curs at the beginning and there are large amounts trauma). Tridoßhic abscesses in the heart, navel, of hot, yellow sinus secretions. Secretions devel- op more frequently during the night. 399

The Áyurveda Encyclopedia Kapha: The sinus is hard, itching, and slightly ghee, to 1 part herbs (all combined)] painful or numb. An excess of thick, shiny, white Kapha: First, antiseptics are used in a decoc- colored pus secretions exist, and is expelled more at night. tion form. Herbs include neem, guæúchí, mango leaves, and chitrak. Next, antibiotic therapy in- Dual and Tridoßha: Symptoms of two or three cludes barley flour, turmeric, and sesame paste doßhas. Tridoßhic symptoms are considered se- applied as a poultice. This purifies or balances vere. the doßhas. Finally, healing is achieved through a medicated oil of myrrh, chiráyatá, danti, black or £hlayaja: Foreign matter (e.g., dirt, bone, splin- sea salt, and triv^it. ter, etc.) becoming fixed in a body part and still visible, opens the skin and creates a form of a Tridoßha: Will not respond to therapies. sinus. Symptoms include constant pain, instant Shlayaja: First the foreign matter is removed, secretion of a sort of hot, bloody, frothy liquid then the sinus is cleansed and purified with a plas- matter. ter of sesame paste, raw honey, and ghee. Herbs are cooked into the oil (bilwa, musta, and other Therapies: herbs used in the above Pitta therapy). General: In each case the therapy is three-fold. First antiseptics are used to wash the wound, then Breast Abscess (Stana Vidradhi) antibiotics cleanse and balance the doßhas and fi- nally healing measures are applied. In the same manner as described above, the Váyu: Constantly wash the ulcer with an herbal doßhas enter the open channels of the female decoction of da¤hmúl (i.e., an antiseptic). Sesame breast during pregnancy or after delivery. They oil cooked with turmeric, kaóuká, balá, rock salt, produce a hard swelling in the breasts (having myrrh, and bilwa are used to purify the ulcer by features of external abscesses). This generally filling it with the medicated oil (i.e., antibiotic does not happen in young girls because the chan- and doßha balancing). The lesion is constantly nels in their breasts are still small. washed with a decoction of triphalá, amaltas, and milk. Finally oil cooked in neem, viæa´ga, chi- Therapies are treated like vraòa (ulcer), but trak, pippalí, vachá, and mustard are applied to without applying the warm poultice. Incision may promote healing. [Aßhþáñga H^idayam therapy] be applied by qualified persons, being careful not Charak first uses herb poultices including gar- to injure the milk ducts. lic, cloves, chitrak, and pañchmúla. Then the channels with pus are cut opened with a knife and Wounds (Vraòa) bandaged with sesame paste and turmeric. A poul- tice is then applied of licorice, sesame, salt, and devadaru, da¤hmúl, garlic, cloves, and chitrak. Pitta: According to Aßhóáñga, first the sinus Causes: Two types of wounds exist: internal and is washed with herbal decoction of mañjißhþhá, arjuna, mango, and licorice for antiseptic pur- poses. Then a poultice of guæúchí, licorice, and sesame paste is applied as an antibiotic and to heal the excess doßha. Finally, healing is effected by medicated ghee cooked in milk with herbs of mañjißhþhá, poppy seeds, vidárí kand, turmeric triphalá, and licorice. [16 parts milk, to 4 parts 400

Section 4: Specific Illnesses and Diseases Chapter 16: Infections/Wounds external. Internal wounds are caused by excesses with maggots, bone cracking, with foreign bod- of the doßhas. When Váyu, Pitta or Kapha be- ies, toxic, spreading, and scratches that produce comes excessed and move to the external passag- tearing. Other types include, skin friction, hair es, they cause innate wounds. When external friction, faulty bandage, over oiling, and emacia- wounds are not able to be healed and have internal tion from excess reduction therapy. Further types symptoms the same therapies as innate wounds are, indigestion, over eating, eating incompatible are applied. foods, unsuitable foods, grief, anger, naps, excess exercise, insufficient exercise, and sex. Symptoms: Examination falls into three categories, Váyu: These wounds cause stiffness, are hard Inspection: Noticing client’s age, complex- to the touch, slow to develop pus, have great and ion, body parts, sense organs, and touch. piercing pain, throbbing, and are black in color. Questions: Asking about the cause of wounds, Pitta: Thirst, confusion, fever, sweating, burn- development, pain, and digestive power. ing, impurity, tearing, malodorous, and pus- Touch: Noting softness/hardness and coldness/ filled. warmth. Kapha: Slimy, heavy, oily, wet, with mild pain, pale, with slight fluid, and chronic. Healing is possible if the wound is in the skin These two forms of wounds have 20 variet- or muscle when in an easy place to treat, when ies, incisable/unincisable, defective/undefective, young, without complications, due to a wise pa- in vital parts/not in vital parts, open/closed, se- tient, and if it is immediately tended to. Herbs in- vere/mild, oozing/non-oozing, poisoned/non-poi- clude licorice, tagar, red sandalwood, jaóámáòçhí, soned, even/uneven location, with/without pouch, turmeric, barberry, and kút. and raised/depressed. Therapies: Five variations of wounds exist: General: First, emesis, purgation, enema, and Defective wounds: Twelve types exist: white, surgery are used depending upon the doßhas in- narrow or depressed passages, very wide passag- volved and the strength of the person. Wounds es, grayish, blue, black, red, numerous boils, diffi- become quickly healed from these cleansing mea- cult to heal, bottleneck shaped, and malodorous. sures. Locations: Eight types, in the skin, blood ves- Thirty-six Measures: These measures include sels, flesh, fat, bone, ligaments, vital parts, and anti-swelling, six surgeries, pressing, cooling, viscera. uniting, fomenting, pacifying, probing, cleansing, Discharges: Fourteen types, lymph, water, pus, healing, detox paste, healing paste, cleaning oil, blood, yellow oozing, reddish, brownish, ochre, healing oil, leaves, bandages, diet, elevation/de- blue, green, oily, rough, black, and white. pression, cauterization, hard and soft aromas, hard Complications: Sixteen types, visarpa (erysip- and soft pastes, powders, colors, and healing. elas), paralysis, blood vessel blockages, tetanus, Inflammation—when seen as an initial sign, confusion, insanity, wound pain, fever, thirst, blood-letting prevents the wound from develop- lockjaw, cough, vomiting, diarrhea, hiccup, dif- ing. Toxins are cleansed first (except Váyu caused ficult breathing, and trembling. wounds, which one needs to eat ghee and Váyu- Defects: Twenty types, preventing healing, moist reducing decoctions) using the appropriate pa- ligaments, excess blood vessel fluid, deepness, ñcha karma therapy. Paste of ¤hatávarí, sandal- wood, parched barley flour mixed with ghee are useful to cool inflammations. If this is ineffective then the herbs are applied as a warm poultice (of 401

The Áyurveda Encyclopedia parched barley flour and ghee), that ripens the truded (and not very red) wounds are considered wound. When it is ripe, it is pierced. If one has a already clean and not in need of cleansing.] delicate condition, then instead of piercing, lin- seed oil and guggul are applied to the wound to Leaves & Bandages—arjuna, neem, and pippalí allow it to open on its own. leaves or sterile bandages are used to cover wounds. Operations—Six types of operations exist: in- cisions, puncturing, excision, scraping, scarifica- Depressed Wounds—galactogogues, vitaliz- tion, and suturing. Incisions are used for sinuses, ers, and bulk promoting herbs (e.g., ¤hatávarí, ripened inflammations, intestinal wounds or ob- a¤hwagandhá, and ¤hweta musali) are used to structions, swellings with foreign bodies inside. raise depressions. To depress raised wounds gug- Puncture is useful for ascites, ripe and blood tu- gul, triphalá, and castor oil are used. mors, blood disorders, boils. Excision is applied to protruded wounds with thick margins, raised Excess Hemorrhaging—(after excision) tumors, and hard, hemorrhoids. Scraping is done on leu- Kapha nodules, glands, stiffness and Váyu disor- koderma and other skin diseases. Scarification is ders, wounds with pus or lymph, deep and firm, performed on Váyu blood disorders, glands, pim- cauterization is needed. ples, urticarial rashes (i.e., burning, itching, sting- ing, smooth patches), red patches, skin diseases, Fractured Bones/Dislocated Joints—after injured parts, and swellings. Suturing is needed the bone or joint is set, herbs of aloe, guggul, for bowels, abdomen, and other deep or invasive and lodhra are applied as a paste and bandaged surgery. (dipped in ghee). Then the bone or joint is im- mobilized with splints, casts, etc. Pitta-reducing Pressing—any wound with a pouch or small foods are eaten. Other complications are also to opening is pressed with a paste of wheat flour and be tended to. peas. Herbs include onion, archu, turmeric, gug- gul, and licorice. Váyu (Dry, Pain, Stiff): Massage, fomentation, bolus, poultices, and ointments with ghee, milk, Cooling—balá paste or balá—water sprinkling and balá, guæúchí, and ¤hatávarí, sprinkling with is used when heat is present. For blood-related da¤hmúl, ingesting ghee and sesame oil. wounds, cold ghee or cold milk is applied. Váyu with Burning and Pain: Warm paste of lin- Long Wounds—paste of honey and ghee is seed and sesame oil, dipped in milk, roasted bar- evenly applied. Then mañjißhþhá, turmeric, neem, ley flour. Herbs used include mañjißhþhá, neem, tulsí (holy basil), harítakí bark, and guggul are and onion. placed over this. A bandage is then wrapped over the wound. Pitta: Oils, paste and water sprinkling using cold, sweet and bitter herbs (sandalwood, lico- Small Wounds, Much Oozing, Pouchy—(not rice, balá, viæa´ga, kuþaj, triphalá, musta, carda- within vital parts), soft or hard probing is advised. mom), sesame oil and ghee, ingesting ghee and Soft probes are soft plant stalks, hard probes are purgation. A Pitta-reduction diet (i.e., no salt, hot, iron rods. Deep muscle probing also needs hot sour, pungent, heavy or burning foods or drinks) iron rods for cauterization. and no sexual intercourse, in order to heal these disorders. Cool foods and drinks, naps, and rest Odorous, Discolored, Much Oozing & Pain— are also useful healers. These are said to be caused by uncleanliness. They need to be cleansed and kept clean with Kapha: Oil and water sprinkling with astrin- decoctions of triphalá, balá and neem. Paste of gent, pungent, hot, and rough herbs; emesis and sesame, salt, turmeric, and neem are also good other reduction therapies, digestive herbs. cleansers. [Black, pale, painful, raised, and pro- 402

Section 4: Specific Illnesses and Diseases Chapter 16: Infections/Wounds Inflamed Ulcers (Dvivraniya) ghee, fishy smell, spreads, hot, and blackish se- cretions. Causes: Ulcers fall under two categories, inter- nal and external. Kapha/Blood: Red, heavy, slimy, glossy, hard or callused, itching, or bloody yellow secretions. Internal: Causes may be due to excesses of blood, Váyu, Pitta, Kapha, or Tridoßha. Váyu/Pitta/Blood: Throbbing, pricking and burning pain, thin yellowish bloody secretions, External: Causes are due to bites from animals, with sensation, and feeling like fumes arise. accidents, and injuries, poisons, etc. Cooling ther- apies are immediately used to cool the expanding Váyu/Kapha/Blood: Itching, throbbing, tin- heat of the ulcer. This heat is Pitta related and may gling, thick, gray, and blood-streaked secretions. be pacified with a mixture of honey and ghee ap- plied directly on the wound for 1 week. After that, Pitta/Kapha/Blood: Redness, itching, pus form- the appropriate internal therapies are followed. ing, burning, thick, gray,1 and bloody secretions. Symptoms: Sixteen forms of ulcers exist. Pain Tridoßha: Various pains, secretions, and colors is associated with each, while specific symptoms associated with all three doßhas. vary from form to form. Váyu/Pitta/Kapha/Blood: Burning and pierc- Váyu: Brown or bright red, cold, thin, and slimy ing pains, throbbing, itching, complete loss of secretions, tension, throbbing, pricking, and pierc- sensation, redness, pus forming, various colors, ing pain inside the ulcer, and feeling of expan- pains, and secretions common to all doßhas and sion. the blood. Pitta: Bluish-yellow, grows quickly, burning, Shuddha-vrana: (clean ulcer) Ulcers that are oozing, redness, and surrounded by small yellow the same color as the back of the tongue, smooth, pustule eruptions. painless, soft, shiny, well shaped, and without se- cretions. Kapha: Gray, extended, raised around the cir- cumference, itching, thick, compact, covered by Therapies: Sixty therapies and surgical meth- vessels and membranes, slightly painful, hard, ods exist, including fasting and light meals, cold, thick, white, and slimy secretions. plastering, irrigation or spraying, anointing, fo- mentation, massage, large and small poultices, Blood: Looks like a lump of red coral, sur- inducing oozing, draining. Other therapies are rounded by black vesicles and pustules, malodor- internal intake of oils and ghee, emesis, and ous, painful, feels like fumes rise from it, bleed- purgatives. Surgical methods include excision, ing, and other Pitta symptoms. opening abscesses, bursting, scraping, extrac- tion, probing, vein puncturing, inducing dis- Váyu/Pitta: Red or bright red, pricking and charge, suturing adhesion, and pressing. burning pain, feels like fumes rise from it, bright red or bluish yellow secretions. Further methods include stopping bleeding, cooling, suturing, decoction washes, plugs, pastes, Váyu/Kapha: Itching, piercing pain, heavy, hard external ghee and oils, internal herbal use, dusting or callused, constant exuding of cold, slimy secre- and rubbing with herbs. Other methods are, grow- tions. ing hairs, fumigation, raisings, destroying, soften- ing, hardening, caustics, cauterization, blacken- Pitta/Kapha: Heavy, hot, yellow, burning, pale, ing, and healing with scars. Additional methods or yellow secretion. include burning (cauterization), enemas, urethral and vaginal injections, bandaging, leaf applica- Váyu/Blood: Dry, thin, piercing pain, loss of tion, vermifuges, rejuvenatives, disinfectants, and sensation, blood, or bright red secretions. ¤hiro virechana (nasal evacuation). Further thera- Pitta/Blood: The color of the surface cream of 403

The Áyurveda Encyclopedia pies are, snuff, gargling or holding herbs in the extension, flexibility, rotation, and painful when mouth, smoking, honey/ghee, yantras (physical moved or touched. therapy machines), nutrition, and protection from malicious spirits. Joint Friction: (utplißhtam) This is due to two joint extremities causing swelling on either side Discussed here are the more common internal of the joint. Various pains are felt at night. ulcers that inflame the stomach’s tissue lining. Usually they are Pitta disorders causing pain, Looseness: (vi¤hlißhtam) Symptoms include burning, or bleeding. They are most commonly slight swelling with constant pain, and poor func- caused by stress, worry, working too hard, spicy tioning of the joint. and sour foods, alcohol, and smoking. Lateral displacement: (vivartitam) Symptoms are pain and uneven joint setting. General: Bland diet, whole grains, digestible Dislodged Bone: (adha-kßhiptam) Excruciat- foods, milk fast (if one is strong). Nightshades ing pain, dislocated bone looseness, and hanging (e.g., tomatoes, eggplants, white potatoes), citrus from the joint can develop. fruit (lemons, limes and grapefruits), and bananas are avoided. Herbs to soothe the mucus lining in- Abnormal Projection: (ati-kßhiptam) The dislo- clude aloe gel, ¤hatávarí, and balá. Also useful is cated bone moves away from the joint and is very pravál pißhti, ¤ha´kh bhasma (conch shell ash), painful. and súktí bhasma (sea shell ash). Oblique Dislocation: (tiryak-kßhiptam) Projec- Váyu: Váyu-reducing foods, liquids, herbs and tion or displacement of bone on one side causes spices. unbearable pain. Pitta: Pitta-reducing foods, aloe, barberry, Fracture Symptoms: (Kánda-bhagnam) kaóuká, ámalakí, and chiráyatá. General: Symptoms include violent swelling around the seat of the fracture, throbbing, pulsa- Kapha: These conditions may be caused by tion, abnormal position of the fractured limb with emotional issues like sadness, greediness, or at- unbearable pain when touched. Other experiences tachment. Herbs include hot and pungents like include cracking sounds when pressure is applied, t^ikatu and cloves. looseness of limb, various pains, and discomfort in all positions. Bone Fractures and Joint Disloca- The most difficult to heal are impacted, droop- tions (Bhagnam and Sandhi Mukti) ing, severed, and shattered fractures. Also, dis- placement or looseness in children or in very old Causes: This is due to falling, or weak persons, those suffering from asthma, pressure, blow, violent jerking, or skin problems, or kßhata-kßhíòa (lung abscess or bites. Six forms of dislocations exist: injury) are difficult to heal. friction, looseness, abnormal pro- jection, lateral and oblique disloca- Symptoms that cannot be healed include pelvic tion. Twelve types of fractures exist. bone fracture or dislocation, compound fracture of thigh or skull flat bones. Other unhealable symp- toms include frontal bone fractures (into small pieces) or dislocation, simple breast bone, back bone, temporal and cranial bone fractures. Dislocation Symptoms: Bulging: (Karkatam) Pressing or bending the General: Persons experience loss of movement, fractured bone at its two joint extremities causes bulging at the middle of the fracture, resembling 404

Section 4: Specific Illnesses and Diseases Chapter 16: Infections/Wounds a knot. plied and properly bandaged. Bandages are made Upward Projection: (a¤hvakaròam) Symptoms neither too loose nor too tight. include an upward protrusion and looks like the Healing fractures or dislocations is difficult when ear of a horse. they occur in Váyu doßhas, in the over-indulging person and in one who eats too little. Fractures Shattered Fragments: (churnitam) Palpitations are also difficult to heal in those who have fever, and cracking sounds develop. abdominal distention, suppress urine or stool (and similar disorders). Fractures in young persons, Smashed Bones: (pichitam) Large swellings ap- those with only slight imbalances of the doßhas pear. or in the winter are easily healed within 1 month. Healing in mid-life takes 2 months, while elderly Splintered: (asthi-challitam) The bone covering people require 3 months to heal. or skin (periosteum) is splintered off. Salt, acidic, pungent and alkaline foods and Compound Fracture: (kánda-bhagnam) Bones spices need to be avoided. Rest, shade oily foods that are completely broken, broken in several and drinks, and other Váyu-decreasing foods and places, or several bones projecting through the habits need to be followed. Foods include rice, skin are these symptoms. ghee, or boiled milk. Herbs include mañjißhþhá, red sandalwood, ¤hatávarí, flaxseed, horsetail, Impacted Fracture: (majjánugatam) A fragment solomon’s seal, and comfrey, and may be taken or broken bone pierces the bone, digging out the internally (every morning with ghee) and used as marrow. an external plaster. Drooping: (ati-pátitam) The fractured bone Herbs of the nyagrodhádi group are used for ban- droops or hangs. daging and washing. Herbs in this group include lic- orice, lodhra, pípal tree, guggul (salai tree), Indian Arched: (vakram) The unloosened bone is bent, persimmon (tinduka/temru), mango, arjuna, and forming an arch. harítakí. The tree bark of each of these herbs is used. Severed: (chinnam) One joint extremity of the bone is severed. Holes: (pátitam) A slight fracture is pierced Washing: A cold decoction of the above herbs with many holes with excruciating pain. is used to wash the fractured part. When pain is great, da¤hmúl or mahánáráyan oil (oil is warmed Greenstick Fracture: (sphutitam) Cracked, in the winter) are applied to the fracture. If the swollen, pain, and prickliness develop. fracture has ulcerated complications, astringent herbs mixed with honey and ghee are also used Bending of gristle or cartilage is called a frac- (such as raspberry, ámalakí, arjuna, and musta). ture, long bones are usually severed, skull bones Crushed or dislocated joints are not shaken. Cold are generally cracked, teeth are usually splintered washes, plasters and oils are used. off. Ghee: Is first used on fractures and dislocations Therapies: before they are reset. All dislocations or fractures are manually ma- nipulated to replace bones in their proper position and then bandaged. Bandaging: Fractures are dressed and bandaged weekly during the winter, every fifth day during spring and autumn, and every fourth day in the summer. The affected area is first covered with a piece of linen soaked in ghee, then the splint is ap- 405

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Section 4: Specific Illnesses and Diseases Chapter 17: Respiratory System Modern science is based on the study of physical principles to conquer nature. Ãyurveda requires spiritual insight in order to live in harmony with natures. Swami Sadashiva Tirtha Chapter 17: Respiratory System Cough, Breathing Disorders, Asthma, Hiccup, TB, Cold Cough (Kása) hair standing on end; thick, sticky, white, or clear mucus is expelled. Introduction: here are 5 kinds of coughs: Váyu, Pitta, Lung Injury Cough: From trauma caused Kapha, those caused by lung injury, and by fighting, or strenuous activities. Váyu be- those caused by wasting (i.e., pulmo- comes increased, mixes with Pitta, and pro- duces coughs. Symptoms include large nary tuberculosis). amounts of yellow or black blood mixed with mucus. It is dry, nodular, and foul smelling. Premonitory Signs: Throat irritation, loss of taste or appetite, thorny feeling in the throat. Severe pain is present in the throat, chest (i.e., feeling like pricking needles), joints, and ribs. Development: When the downward movement Other symptoms include fever, difficult breathing, of Váyu (Apána) is obstructed, it begins to move thirst, hoarseness, tremors, and cooing sounds. upward to the chest and throat, and eventually to Strength or vigor steadily diminishes. One’s di- the head. This affects the eyes, back, chest, ribs, gestion and desire for eating is reduced, and poor and eventually comes out the mouth as a cough. complexion develops. Persons become emaci- ated, and there is blood in the urine, with sharp back and waist pains. Váyu Cough: As the accumulation of Váyu in- Wasting Cough: This is caused by all the doßhas, creases into aggravation, dryness is produced in but mainly Váyu. Mucus is putrefied, pus-like, the chest, throat, mouth, ribs, heart, and head. The yellow, foul smelling, and is green or red. The dry air also causes delusion, mental agitation, loss ribs and heart feel as though sliding and falling of voice, and results in a dry cough with violent down, and an unreasonable desire for hot or cold bouts, great pain, noise, and hair standing on end. comforts develops. Persons overeat but still lose A dry spit may be coughed out, which reduces the strength. The face is oily, yet has a pleasing ra- coughing fits. diant look and glittering eyes. Once this symp- tom appears, tuberculosis gradually begins to de- Pitta Cough: Yellow color in the eyes and mu- velop. If a person is emaciated, or if tuberculosis cus, a bitter taste in the mouth, fever, dizziness, (k¤hayaja) lingers for a long time, it is considered vomiting of bile and blood, thirst, hoarseness, harmful. If aggressively treated with all the ap- fumes emitted from the mouth, acidity, and con- propriate measures during the early stages, a per- tinuous coughing that makes persons stare up- son can be completely cured. wards. If one doßha is the cause of any of these 3 types Kapha Cough: Mild pain in the chest, head, and of coughs, the illness can be healed. If two doßhas heart region; heaviness, throat coating, debility, cause any of these coughs, the illness can be con- runny nose, vomiting, loss of appetite and taste, trolled. If unattended, doßha-caused coughs lead 407

The Áyurveda Encyclopedia to lung injury resulting in TB. formula. Foods and liquids are oily and cold, in- cluding barley, green dal, and ghee. Herbs include Therapies: lotus seeds, pippalí, musta, licorice, fresh gin- Váyu: When persons are undernourished, ex- ger, dry ginger, ámalakí, sandalwood, bibhítakí, cess Váyu is reduced with ghee, oil enemas, a vaå¤ha lochana, gokßhura, mixed with ghee, wholesome diet including basmati rice, whole sugar cane, and honey. wheat, barley gruel (with bilwa, ginger, da¤hmúl, chitrak, jaggery, and black salt), warm and moist Thick phlegm: Bitter herbs and vegetables vegetables, and sesame oil. Persons should drink are mixed with emesis formula. Dry and cold boiled milk, lassi (1/2 yogurt to 1/2 water), or foods and drinks are recommended. Neem and sour fruit juices—all mixed with sugar cane. raw honey are added to the above herbs. Grape Ghee should be mixed with Váyu-reducing juice mixed with sugar cane, sugar cane water, herbs including a¤hwagandhá, ginger, pippalí, and milk, should be drunk. licorice, calamus, viæa´ga, black salt, chitrak, da¤hmúl, kapikachhú, balá, guæúchí, triphalá, Chest Wound and Wasting Cough with burning t^ikatu, gokßhura, and ¤hatávarí. These herbs and fever: Boiled milk with ¤hatávarí, balá, and promote digestion and reduce coughs. Raw honey licorice. and cane sugar can also be mixed with the herbs and barley. [Traditional texts speak of barley as Chest Wound, Wasting: Ghee with boiled milk, reducing Váyu; however, modern experience in- ¤hatávarí, cane sugar, pippalí, vaå¤ha lochana, dicates most Váyu doßhas find that barley causes black pepper, turmeric, karkata ¤hringi, and chab- gas. If needed white basmati rice is an easily di- chini. gested and nutritious substitute.] Other therapies include massage, water sprin- Kapha: First, administer an emetic (if per- kling, oil fomentations, snuff, and smoking Váyu- sons are strong) with barley and pungent herbs and Kapha-reducing herbs. For constipation and like pippalí; then, a castor oil purgation. Foods gas retention, enemas should be administered. should be light, including vegetable soup, radish, Ghee should be taken before meals if there is up- and pippalí, and a little ghee, sesame oil, mus- per body dryness. tard oil, and bilwa fruit. After eating, drink raw Smoking (Herbs): Relieves coughs that cannot honey, sour drinks (e.g., ámalakí juice), hot water, be helped by ingesting herbs and foods. Herbal or lassi (1/4 yogurt to 3/4 water). Herbs should smoke includes musta, balá, black pepper, car- include sugar cane, sandalwood, vásák, tulsí, damom, vaå¤ha lochana, ginger, a¤hwagandhá, apámárga, ámalakí, musta, harítakí, calamus, and harítakí. This also relieves Kapha-caused balá, t^ikatu, viæa´ga, chitrak, punarnavá, ámla- coughs. vetasa, gokßhura, ginger, and black pepper mixed with raw honey. Another recipe includes 10 gms. (.35 oz.) of pippalí fried in canola oil mixed with cane sugar or rock candy. Váyu with phlegm: Viæa´ga, ginger, pippalí, Smoking: Herbs are the same as forVáyu (musta, asafoetida, black salt, barley powder, with ghee. balá, black pepper, cardamom, vaå¤ha lochana, ginger, a¤hwagandhá, harítakí, chakramarda). Pitta: Castor oil purgation is useful. Pitta with phlegm: Emesis with ghee, licorice, Kapha/Váyu: Pippalí, ginger, musta, harítakí, and sugar cane. After the doßhas are cleansed and ámalakí, and rock candy, made with honey and balanced, one takes Pitta-reducing foods and liq- ghee. (Sesame oil can be used for Pitta cough.) uids (cold and sweet properties). Dry and oily foods and drinks are used for wet Thin phlegm: Sugar cane is mixed with emesis and dry symptoms, respectively, to balance these conditions. 408

Section 4: Specific Illnesses and Diseases Chapter 17: Respiratory System Kapha/Pitta: Pitta-reducing herbs (i.e., bitters) widely used in India for rapid healing. Iron ash and vásák, turmeric, vaå¤ha lochana, cardamom, (loha bhasma) is suggested to regain strength and honey are recommended. from wasting and emaciation quickly. Abhrak, pravál and mukta bhasmas are also useful. Chest Wounds: Sweet and vitalizing herbs such as ¤hatávarí and sugar cane. Also pippalí, boiled As with all diseases, therapy depends upon the milk, barley and wheat flours, ámalakí, sesame aggravating doßha. oil, ghee, and honey are helpful. Therapies for chest wounds generally follow the Pitta-pacifying Difficult Breathing (£hvása) regime. [including asthma] If physical pain from Váyu and Pitta exists, ghee Causes: Difficult breathing arises from many massage is useful. The chest is warmed with a hot, factors, from increases of cough, doßha aggrava- dry cloth, and massaged with medicated oil. tion, diarrhea owing to indigestion, vomiting, poi- sons, anemia, fever, allergies, smoke, breeze, in- Should Váyu cause the spitting of blood with jury to vital organs, and drinking very cold or ice burning sensation, along with heart or side pain, water. There are five types of difficult breathing. ghee, mixed with rejuvenatives (e.g., ¤hatávarí), vásák, and dúrba, is recommended. For any Development: When movement of Váyu is ob- bleeding complications, ghee is ingested and used structed by Kapha, it spreads in all directions and as nasal oil (Tuberculosis is usually accompanied vitiates the channels of respiration (práòa), water by bleeding.). (udaka), and food (anna). The obstruction rises from the stomach (i.e., the origin site of Kapha) When the wound is healed but Kapha remains into the chest, causing difficult breathing. in the chest and head, causing coughing fits, one smokes a¤hwagandhá, balá, and ginger with sug- Premonitory Signs: Pain in the heart and ribs, ar cane juice. upward respiratory movement (of práòa), gas, splitting temple pain, heaviness in the throat and Emaciation: Wholesome, restorative foods (e.g., chest, astringent taste in the mouth, and abdomi- basmati rice gruel) and herbs include triphalá, nal rumbling. chitrak, pippalí, ginger, guæúchí, calamus, ¤ha- távarí, with black salt, and ghee. Grape juice is also advised. Herbs like cardamom are also used to strengthen digestion. When one is strong, but still has excesses of the doßhas, mild oil purgation is useful (triphalá and ghee, or castor oil). Other recipes: Ghee cooked in grape juice Symptoms of the Five Types: with harítakí, musta, ginger, black pepper, and 1. Exertion (kestrel ¤hvása): Caused by exer- pippalí; ghee and ámalakí boiled in milk, and tion or overeating. It is not serious, subsiding after pomegranate juice with cane sugar. rest or digestion. 2. Bronchial Asthma (tamaka ¤hvása): Aggra- For thirst, boiled milk is given. With dimin- vated Váyu begins to move upwards in the respi- ished Pitta and Kapha, ghee, boiled milk, and ratory channel (Práòavaha srotas), aggravating balá are used. For dysuria or urine discoloration, Kapha, making it difficult to breathe. Sharp pains boiled milk with ghee, vidárí kand, and gokßhura in the head, neck, chest, and ribs appear. Coughs are used. For pain and swelling in the penis, anus, may be experienced with cracking sounds, de- hip, and groin, oil enemas with a little ghee are lusion, loss of taste or appetite, runny nose, and used. thirst. Heaviness or forced breathing may devel- The ashes of metals and gems (bhasmas) are 409

The Áyurveda Encyclopedia op, causing distress and loss of consciousness. air. Attacks happen mainly at noon or midnight. Expectorants bring temporary comfort, but there Kapha: Wheezing and coughing with excess is difficulty breathing when lying down (or sit- ting). Eyes are wide and gaze upward, sweating clear or white phlegm, lung fluid, rattling sounds. develops on the forehead, and the mouth becomes Attacks mainly develop in the morning and eve- dry. Persons desire hot things, and develop trem- ning. ors or shivering. Breathing becomes more dif- ficult on cloudy days, after drinking cold water, Therapies: from cold breezes or direct wind, when eating General: Bronchodilators, such as lobelia and Kapha-increasing foods. (Another form of this ephedra, quickly open breathing passages. Long- asthma is associated with fever and fainting. It is term use can be depleting for Pitta and Kapha, resolved by cold foods, drinks, and air.) Overall, and immediately weakening for Váyu. Tridoßhic bronchial asthma may be healed if treated when it herbs include harítakí, balá, and saffron. Each first arises, otherwise it is only controllable. person must follow their appropriate doßha diet. After attacks, the lungs must be strengthened The latter 3 types may also be healed if treated with tonics like chyavan prá¤h, balá, ahwagand- in the early stages há, harítakí, and bráhmí. Rebuilding the lungs in this way can help prevent future attacks. 3. Cheyne-stokes (chinna ¤hvása): When in- For difficult breathing associated with terrupted breathing with sharp pain develops (i.e., Váyu: Ghee and pippalí, vaå¤ha lochana, and extreme pain similar to the pain of injury to vi- guggul; lemon or lime juice. tal points (marma), vital organ pain occurs along Váyu/Pitta: Milk, ghee, rice water, bibhítakí, with sweating, fainting, gas, burning sensations, vásák, and t^ikatu. and urinary stones. Eyes gaze downward, are un- Pitta: Ghee, vásák, vaå¤ha lochana, ginger, steady and teary; one eye is red. Coma, dry mouth, pippalí, bráhmí, and kaißhore guggul. erratic speech, feeling of helplessness, and loss of Pitta/Kapha: Vásák, pippalí, guggul, kaißhore complexion can also develop. guggul, and honey. Kapha: Vásák, pippalí, a¤hwagandhá, guggul, 4. Mahá ¤hvása: Heavy breathing, feel- and honey. Apply a mustard paste to the chest. ing helpless, breathing noises, continuous high- Kapha/Váyu: Emesis and purgation, including pitched sounds, loss of common sense and intel- herbs that reduce these doßhas. ligence, unsteady eyes and face, constricted chest, blocked urine and stool, broken voice, dry throat, frequent delusions, severe pain in ears, temples, and head. 5. Úrdhva ¤hvása: Prolonged exhalations with Hiccup (Hikká) inability to inhale, mucus lines the mouth and There are 5 kinds of hiccup. Their causes, pre- throat, eyes gaze upward, rolling and terrified, se- vere pain, inability to speak (owing to the pain in monitory symptoms, kinds, and development are the vital organ). the same as diseases of difficult breathing. Specific Doßha Symptoms Type 1. Food-caused (annajá hikká): Váyu be- Váyu: Dry cough, wheezing, dry skin, dry comes aggravated by eating too quickly and im- properly, or eating and drinking dry, penetrating, mouth, thirst, constipation, desiring warm liquids, rough, and unaccustomed foods. This produces anxiety. Attacks happen mainly at dawn or dusk. a painless hiccup. It is quiet, then followed by sneezing. It ceases when foods and drinks that Pitta: Wheezing and coughing with yellow one may be accustomed to are ingested. phlegm, sweating, irritability, fever, desiring cold Type 2. Exertion-caused (kähudrá hikká): 410

Section 4: Specific Illnesses and Diseases Chapter 17: Respiratory System Váyu becomes mildly increased from exertion. erly. Should there be any remaining Kapha, tur- This causes a slight hiccup from the base of the meric and barley grain are mixed with ghee and shoulders. It ceases after eating food. smoked. Type 3. Indigestion-caused (yamalá ki- When either of these illnesses are associated hhá): This type arises when one hasn’t eat- with a weak voice, diarrhea, internal bleeding, or en for many hours or when digestion is not burning, one eats foods that are sweet, oily, and working properly. These hiccups come in cold. pairs, causing tremors in the head and neck, gas, severe thirst, nonsensical speech, vomiting, Short periods of fomentation are applied to the diarrhea, unsteady eyes, and yawning. chest and throat. Warm oil is mixed with cane sugar, or poultices are made with sesame and Type 4. (mahatí hikká): Rigidity develops in the whole wheat, Váyu-reducing herbs, foods, sour eyebrows and sides of neck, eyes become red and herbs (e.g., ámalakí), and milk are ingested. Oth- teary, there is loss of body movements, speech, er herbs include da¤hmúl, pippalí, t^ikatu, balá, memory, and awareness. Food is obstructed from chitrak, dry ginger, gokßhura, guæúchí, black salt; moving, causing the vital organs to feel like they along with yogurt, ghee, dry radish, ghee, rice, have been hit. The body bends backwards and and barley. Da¤hmúl also removes complications emaciation develops. These types of hiccups arise of thirst. from deep inside the body, forcefully, with great sounds. A general herbal recipe includes bilwa, gokßhu- ra, guæúchí, balá, t^ikatu, chitrak, pippalí, gin- Type 5 (gambhírá hikká): This hiccup begins ei- ger decoction with ghee, black pepper, and black ther in the colon or in the navel region. Symptoms salt. are similar to Type 4, but with more yawning, body expansion, and vibrating sounds. If a strong fever with toxins (áma) develops, reduction therapy (la´gana) is used (i.e., pañcha Hiccups caused by food and exertion are most karma, exercise, sun bathing, etc.). Emesis with easily healed. Severe hiccups should be taken se- salt water is especially useful. riously. Should these therapies cause a Váyu excess, Therapies: balanced can be regained through Váyu-reducing For both difficult breathing and hiccup oil and foods and warm massage. sweat (náæí, bolus or steam tent—see Chapter 7) are required. First, persons undergo an oil mas- If gas, distention, and constipation develop ow- sage with black salt (with Pitta constitution) When ing to Váyu, foods with black salt, ámlavetasa, or there are Pitta problems, such as burning, exces- hi´gwasták are recommended. sive bleeding or sweating, weakness and tissue depletion, or pregnancy, black salt should not be Hiccup is predominated by Kapha, and is healed used. Oil loosens and dissolves the thick phlegm through emesis, purgation, a wholesome diet, and blocking the breathing channels, softening them, pacification therapy, using herbal smoking (for and rebalancing Váyu. strong persons only). Afterwards, a light diet of basmati rice and ghee or sesame oil is taken to increase Kapha. When weak children or elderly persons develop Then one is ready for emesis with pippalí, rock excess Váyu, oil therapies are used to reduce ex- salt, and honey (reducing Kapha and Váyu). After cess air. It is important not to use laxatives when emesis releases the excess Kapha, the channels there is not an excess of Kapha. To do so may dry are cleared, and the Váyu begins to flow prop- up the vital organs and threaten the person. See difficult breathing section (page 409) for specific doßha therapies. 411

The Áyurveda Encyclopedia For hiccup, ghee mixed with triphalá, or cas- Váyu overwhelms the chest, deranging Kapha and tor oil quickly stops the situation. Suddenly sprin- Pitta. This vitiated Váyu then spreads throughout kling cold water on persons with hiccups is help- the body to all the body joints, veins, and plasma ful. Slowly drinking water nonstop for 30 seconds channels. These increases spread in all directions or until the hiccups cease is another option. Other (i.e., up, down, sideways), excessively constrict- therapies include frightening or causing surprise, ing or dilating their channels. Thus, disease is cre- anger, exhilaration, or separation from loved ated. ones. 1) Váyu in the joints causes yawning, malaise, All foods and herbs should simultaneously re- and fever. Váyu in the stomach and small intestine duce excess Kapha and Váyu. Ghee is used in all produce anorexia, palpitations, cardiac pain, and situations. other chest disorders. When Váyu aggravates the throat, irritations and hoarseness develop. When Pulmonary Tuberculosis the channels through which vital air flows through (Rájá-yakßhmá) are affected, breathing is difficult and persons feel [and other wasting diseases] cold. When the head is affected, head disorders develop. Constant coughing causes chest injury, Mythology: Chandra, the moon, was married irregular Váyu movement, and throat irritation. If to the 28 daughters of Dakßha Prajapati, but he coughing continues, the chest can be further in- favored only one of the daughters, Rohiní. Hav- jured. This weakens the person even more. These ing exhausted and emaciated himself by depleting complications cause emaciation, developing his ojas (life sap) through sensual pleasures with weight loss, wasting of muscles, loss of appetite, this one woman, he had no strength to satisfy the and debility. remaining ladies. Their father, Dakßha became angry and caused the moon to develop tuberculo- 2) By suppressing natural urges of gas, urine, sis. The moon soon apologized and was forgiven and feces (owing to bashfulness, disgust, or fear), by Dakßha, who sent the two celestial physicians Váyu becomes superabundant, and while mixed (Ashwins) to heal him with soma nectar (restoring with Pitta and Kapha, move in all directions. As his ojas). Váyu moves to the bones, stomach, etc. (as de- scribed above), it causes many disorders. Tri- Causes: The Sanskrit word, Rájá yakßhmádi, doßhic symptoms include coryza, cough, frequent means king of the diseases. There are four causes vomiting and diarrhea, dry stool, rib and shoulder of Rájá yakßhmádi: pain, anorexia, panting, head disorders, coughing, difficult breathing, fever, hoarseness, and colds. 1) sudden or excessive exertion or chest These develop emaciation that leads to weight wound, loss, wasting of muscles, loss of appetite, and de- bility. 2) suppression of any of the 13 natural urges (e.g., urine, feces, flatulence, etc.), 3) Excessive weight loss can be caused by great grief and worry, envy, terror, jealousy, anxiety, 3) excessive loss of semen (¤hukra), life sap/ fear anger, excessive sexual intercourse, excess tissue essence (ojas), or tissue lubrication (sneha) oily diet when emaciated, fasting, or insufficient [pratilomak diabetes—depletion of dhátus] sizes of meals when weak. 4) improper nutrition [anulomak diabetes— Should one continue having sexual intercourse depletion of dhátus]. All forms of TB are caused after the depletion of semen, Váyu then enters by the simultaneous excess of all three doßhas. the blood vessels and is ejaculated. This causes loose, dry joints, and further excesses Váyu and Development: Owing to any of the above causes, weakens the body. This deranged Váyu spreads 412

Section 4: Specific Illnesses and Diseases Chapter 17: Respiratory System throughout the body and further deranges Kapha Symptoms: Symptoms of tuberculosis include and Pitta (i.e., reduces them). heaviness of the head, coughing, difficult breath- ing, hoarseness, vomiting phlegm, spitting blood, Other symptoms include reduction of muscle rib pain, shoulder pain, fever, diarrhea, loss tissue and blood, rib pain, grinding shoulder pain, of appetite and taste, coughing up mucus with throat irritation, head congestion (owing to exces- sticky, thick odorous, green, white, or yellowish sive Váyu vitiating Kapha), malaise, anorexia, phlegm. and indigestion. These symptoms can develop into fever, cough, difficult breathing, hoarseness, Vághbhata (Aßhþáñga H^idayam) states that, and excess mucus. This can lead to consumption depending where in the body the doßhas are that will develop into TB if not corrected. found, different symptoms will manifest. 4) From poor eating habits, the three doßhas Pulmonary TB can become imbalanced and spread throughout the body, obstructing the entrances of the circula- Location Symptoms tory channels. This results in most foods becoming converted into feces and urine instead of tissue el- Upper body nasal mucus, difficult ements. Persons become depleted and emaciated. breathing, cough, pain, Váyu causes colic, malaise, throat irritations and in shoulders and head, hoarseness, rib and shoulder pain, and excessive hoarseness, loss of appe- mucus. Pitta causes fever, diarrhea, and burning. Kapha causes excessive mucus, anorexia, cough- tite and taste ing, and heaviness of the head. Excessive cough- ing injures the lungs, resulting in spitting blood, Lower body diarrhea or constipation. which further weakens the person. This develops Digestive tract vomiting into TB. Sides of the body rib pain Premonitory Signs: Nasal mucus, excessive sneezing, salivation, sweet taste in the mouth, poor Joints fever digestion, physical weakness, imagining objects (e.g., dirt, flies, grass, hairs) in food and drinks, The signs and symptoms vary according to the nausea and vomiting (even during meals), loss site of development of tuberculosis (e.g., pulmo- of appetite or taste, weakness or tiredness when nary, intestinal, bone, kidney, adrenals, etc.). Main eating, fault finding, staring at hands, swelling of symptoms according to modern medicine include the feet and face, excessive showing of the whites weight loss (despite proper diet, low-grade fever, of the eyes, denying one’s emaciation, imagining and pain. one’s looks are disgusting, excessive desire for sexual intercourse, wine and meat; miserliness, Secondary diseases include chest pain, excess excessive passion, cruelty, covering the head with yawning, body aches, expectoration of mucus, clothes, nails and hair grows at an unusually rap- weak digestion, bad breath, and throat problems. id rate, unusual dreams (e.g., being defeated by small animals and insects, climbing on piles of Váyu causes pain in the head and ribs, shoul- hair, bones, and ash; visions of deserted villages, der and body aches, hoarseness and other throat empty places, dry wells, stars, and mountains fall- problems. ing, trees burning). Pitta causes burning sensations on the soles, shoulders and palms, diarrhea, vomiting blood, bad breath, fever, and toxins. Kapha produces loss of taste and appetite, vomiting, cough, heaviness of head and body, excess salivation, mucus, difficult breathing, weak voice, poor digestion. When Kapha is pre- dominant, the digestive fire is weakened owing to excessive coating of the plasma channel (rasa 413

The Áyurveda Encyclopedia dhátu). This causes the channel to become ob- If the person is strong, emesis and purgation structed, preventing plasma from going into other are advised. They are given with ghee or oil to tissues (dhátus). Blood is forced upward and ex- prevent drying and debilitation. pectorated with mucus. Further, the undigested food, which becomes toxic (áma), does not al- Cough, difficult breathing, hoarseness, head, low for proper absorption of nutrients, preventing side, and shoulder pain: After stool evacuation, a the nourishment of the other tissues. As a result, snuff is made with ghee, balá, vidárí kanda, and weakness occurs. If one is strong and not emaci- mixed with rock salt. Frequent ingesting of ghee, ated, therapy is recommended. Tuberculosis can balá, da¤hmúl, and milk after meals (and/or balá be healed in persons who are still strong or who and ghee during the middle of the meal) alleviates have regained strength. these symptoms. Therapies: Fever, difficult breathing, cough, hoarseness: Pacificatory Therapies: Eating ghee mixed with dates, cane sugar, raw Coryza: Sudation, massage, smoking, pastes, honey, and pippalí heals these conditions. Thera- pies for other symptoms are discussed in their re- sprinkling, whole baths. Ingesting barley, rock spective chapters. salt, sour, pungent herbs, and foods mixed with ghee or oil. Herbs include pippalí, ginger, and Wasting and emaciation: Váyu-reducing herbs ámalakí. Foods include pomegranates, radish and foods. Other therapies include abhyañga fol- sour, wheat, rice, tea of da¤hmúl, coriander, gin- lowed by bathing in oil and milk. This removes ger, or bhúámalakí. the blocks in the channels (srotas) and heals the person. After bathing, the person receives another The throat, sides, chest, and head are fomented abhyañga. using a bolus (see Chapter 7). The head is sprin- kled with a lukewarm water decoction of balá and Ingredients for this abhyañga include ¤ha- guæúchí. Náæí sweda (tube steam) can also be ap- távarí, mañjißhóhá, punarnavá, a¤hwagandhá, plied to these areas. Steam water is mixed with apámárga, balá, vidárí kanda, kuähthá, rice, lin- Váyu-reducing herbs. seed, sesame, and yeast, barley powder in a mix- ture of 3 to 1 with the preceding ingredients is add- Headaches and pain in the sides and shoulders ed, then, honey and yogurt. This mixture anointed receive poultices of balá, vachá, vidárí-kanda, on the body promotes nourishment, complexion, ghee, and sesame oil. A paste of kußhóa, tagara, and strength. and sandalwood mixed with ghee also relieve these symptoms. Next, persons dress in special clothes offered in worship and place essential oils on themselves. A When these symptoms include secondary wholesome diet according to their doßha is taken, doßha complications, balá, cedar, sandalwood, including light whole grains. Meditation music, nágkeçhar, punarnavá, vidárí kanda, ¤hatávarí, celibacy, pleasant company, company of elders, sesame oil, and ghee are used according to the meditation, prayer, ethics, and nonviolence are doßhas they reduce (as an external ointment). other aspects required to restore good health. Toxic blood may require blood-letting. Abhya- ñga with sandalwood oil or ghee is helpful. Snuff and smoke are also useful. Sprinkling milk or san- dalwood decoction is also advised (see Chapter 7 for various therapies). 414

Section 4: Specific Illnesses and Diseases Chapter 17: Respiratory System Cold (Pratißhyáya) Causes: Sweat therapy is advised, using diaphoretic anti-cough and expectorant herbs prepared as a When the head or nasal passages are filled tea (e.g., cinnamon. ginger, pippalí, tulsí, licorice, with excess Kapha or Pitta they may move to- sitopaladi mix). Steam tents or sleeping under wards the Váyu location in the head (prati). This many blankets to promote sweat are also useful. causes a serious form of cold (coryza) and devel- ops emaciation of the body. Pitta: (Yellow or green mucus, high fever, sore throat, flushed face) Gokßhura, punarnavá, co- Signs and symptoms are headaches, stuffy riander, fennel, spearmint, and other cooling nose, cough, mucus, nausea, hoarseness, heavi- diaphoretics used for Pitta doßha. Sitopaladi or ness, fever, fatigue, anorexia, and poor mind/body sudarähan mixture is especially useful for fever. coordination. This develops into tuberculosis. Therapies: Váyu: (Little mucus, dry cough, hoarseness, Kapha: If mucus is abundant, white, or clear, take insomnia) For a dry nose, 3 drops of sesame oil Kapha- and áma-reducing foods and herbs. Light, can be placed in each nostril. Warming diaphoret- warm, simple foods. Dairy, sweets, fried foods, ics used for Kapha are mixed with a smaller dose herbal tonics, and breads (with yeast) must be of demulcent herbs like a¤hwagandhá, ¤hatávarí, avoided because they increase Kapha. If a person and licorice. Here, too, sitopaladi is an excellent is strong, a short fast is useful. Tea with lemon mixture, and can be mixed into warm milk. juice, fresh ginger, and raw honey reduces Ka- pha. 415

The Áyurveda Encyclopedia 416

Section 4: Specific Illnesses and Diseases Chapter 18: Urinary System Nothing in this universe is non-medicinal; all substances can be used for various healing purposes. Aßhóáñga H^idayam Sú. Ch. 9: ver. 10 Chapter 18 Urinary System Urinary Diseases, Gravel, Obstructions, Diabetes Urinary Diseases (Mútrá-gháta) Váyu: Oleation and sudation are applied, es- pecially on the lower abdomen. Medicated oil efinition and Causes:Although the bladder is made of ghee, cooked with da¤hmúl, castor is full, urine will not pass. The area in- oil, barley, ¤hatávarí, punarnavá, and rock salt; volved includes the urinary bladder, mixed in equal parts. One tsp. of the medicated oil ureters (which connect the kidneys with the blad- is taken internally. Also, da¤hmúl with sesame oil, der), and urethral passage. Urine is secreted into vinegar, and ghee can be used in equal amounts— the urinary bladder through minute channels. Ex- 1 tsp. total cessed doßhas enter the bladder through these channels to produce 20 variations of urinary dis- Pitta: Cooling measures are used to alleviate eases. Pitta. A decoction of ¤hatávarí, gokßhura, vidárí kand; with honey and sugar (equal amounts to Dysuria (Mútrá-k^ichra) make 1 tsp.) Also, the seeds of cucumber, lico- Difficult or painful urination rice, and turmeric; with grape juice and rice water can be taken (equal amounts—4 gms. or .14 oz. There are 4 types of dysuria: Váyu, Pitta, Ka- per dose). pha, and Tridoßha. [It’s symptoms can be early signs of urinary stones—see below] Kapha : Emesis, sudation, an anti-Kapha diet, and lassi are advised. The powder of small car- Váyu: Pain in the bladder, groin, and urethral damom with the juice of ámalakí is also recom- passage; small quantities of urine are frequently mended. Another remedy includes gokßhura, emitted. small cardamom, and t^ikatu with honey. Lastly, pravál pißhti with rice water is useful. Pitta: Yellow urine is discharged with burning sensation, or blood may be voided. Tridoßha: The above therapies are used depend- ing upon the predominant doßha. Kapha: Heaviness, edema of the bladder, and Urinary Stones (Mútrá-Áßhmarí) urethral passage; disrupted flow, slimy urine. Causes: Váyu covers the mouth of the bladder, Tridoßha: Symptoms of all three doßhas are drying up the urine inside. The urine then mix- present. es with Pitta, Kapha, or semen, causing stones. Three types of this disorder develop: Váyu, Pitta, Therapies: and Kapha. General: For all urinary retention disorders lic- orice, harítakí, and cedar are taken as powder in milk or water. 417

The Áyurveda Encyclopedia Premonitory Signs: Urinary bladder distention, Urine Retention (Mútrá-ghátádi) severe pain in and around the stone, urine smells like a goat, difficult elimination of urine, fever, or All the therapies mentioned above are useful loss of appetite. for urine retention. Purgations, basti, and uttara basti (urinary bladder enema) are also suggested Symptoms: if needed. General: Pain in the navel area, and in the seam and head of the bladder; urine flow is in- Seminal Stones (£hukrá-¤hmarí) terrupted when stones obstruct the path/easy flow when there is no obstruction, clear, golden-yel- Causes: low urine, pain if straining to pass urine, blood in These stones occur in adults due to preventing urine if stones cause internal wounds. ejaculation of the semen, once leaving its origin Váyu: Severe pain causes persons to grind site. By withholding the semen, it becomes dried teeth, shiver, squeezing penis, rub the navel, cry by Váyu inside the scrotum. constantly, passing feces with gas, frequent urina- tion, and in drops; stones are black, rough, and Symptoms: thorny. Bladder, pelvis, or genital pain; difficult urina- Pitta: Burning sensation in the bladder, the tion, scrotum swelling, stiffness or pain; semen color of the stones are red, yellow, or black. begins to flow but stops in the middle, coming out Kapha: Pricking pain in the bladder, and feel- only when squeezed; urine mixed with semen. ing cold and heavy; stones are big, smooth, gold- en, or white. Therapies: Strong enemas, especially urinary blad- Therapies: General: This is considered a serious disease der enemas (uttara basti) are taken to purify the that can even lead to death if it is not healed. semen receptacle. Aphrodisiac herbs are then At the early stages, herbal therapy can heal the taken (e.g., ¤hatávarí, a¤hwagandhá). condition. However, at later stages, surgery is re- quired. The best herb for all urinary disorders is Urinary Gravel (Mútrá-¤harkará) gokßhura. Causes: Váyu: Gokßhura ghee, or gokßhura taken Urinary gravel is a collection of small sand- alone or with lassi, also produces good results. like urinary stones caused by Váyu. According to modern science, urinary gravel combines to form Pitta: Medicated ghee prepared with a decoc- urinary stones. Both systems are saying the same tion of gokßhura, ku¤há, vidárí kand, red and thing in different ways. The gravel is expelled with white punarnavá. £hilájit is also useful. the urine when Váyu is moving downward, and it is obstructed when Váyu is moving upward. Kapha: Medicated ghee made with a decoction Today, modern science breaks the urinary stones of gokßhura, elá, guggul, black pepper, chitrak, with lithotripsy (a sonic vibration), turning them hi´g, myrrh, and rock salt. £hilájit is also useful. into gravel. Then, they are expelled through the urinary system. 418

Section 4: Specific Illnesses and Diseases Chapter 18: Urinary System Therapies: Mútrá-títa - Powder of gokßhura taken with water and cane sugar expels gravel. Tumburu, apámárga, and Obstruction Due to Slow Elimination barley are good for both stones and gravel. When trying to expel urine after suppressing the urge for a long time, it fails to come out or flows with mild pain. 13 Urine Obstruction Disorders Mútro-tsa´ga - Obstruction Due to Nar- (Mútragháta) row Urethral Duct Below are discussed various other urinary ob- Either urethral blockages or aggravated Váyu structions. In all cases the therapy involves basti can cause some urine to remain in the bladder, and urethra basti. urethra, or urethral passage. Urine thus becomes obstructed, flowing slowly (without pain). The re- Vátabasti - Obstruction Due to Sup- maining urine produces heaviness in the urethral pressing the Urine Urge passage. Habitual suppression of the urge to urinate ag- Mútrá-granthi - gravates Váyu and Pitta. This causes the urine to Obstruction Due to Bladder Tumor dry up and block the mouth of the urinary bladder. Thus, red or yellow urine is passed with pain, irri- Pain similar to that of a urinary stone is expe- tation, and may distend the bladder. This can also rienced from round, immovable, hard, and small cause burning, throbbing, twisting, urine expelled tumors that may suddenly develop inside the cav- in drops, or in a continuous flow if the bladder ity of the urinary bladder. Blood affected by Váyu is pressed. There are 2 forms of Vátabasti: diffi- and Kapha cause the hard nodular mass at the uri- cult and very difficult (to bear and to heal). These nary bladder opening. symptoms are similar to benign hypertrophy of the prostate (BPH). Váta Kundaliká - Radiating Bladder Mútrá-¤hukra - Pain Obstruction Due to Semen Due to urine retention, Apána Váyu (upward Performing sexual intercourse when there is a moving air) becomes excessed. Aggravated Váyu, strong urge to urinate causes the displacement of moving circularly in the bladder, causes severe, semen, and is obstructed. Semen will then be ex- radiating bladder pain, circular moving of urine pelled just before or after urination. in the bladder, obstructed flow, heaviness, urine is released little by little, accompanied with ex- Viægháta - pelling feces. One may also experience stiffness, Obstruction Due to Impacted Feces in heaviness, and cramps. Rectum (Fistula in between urinary bladder and rectum) Persons who are excessively dry, thin, and de- bilitated may experience Váyu moving upwards, 419

The Áyurveda Encyclopedia bringing a small amount of feces into the urinary Vátáßhþhílá - Obstruction Due to En- bladder and urethra. This results in urination with larged Prostate (or prostate tumor) the odor of feces. When aggravated Váyu becomes trapped be- Ußhòa-Váta - Obstruction Due to Blad- tween the rectum and urinary bladder, it results in der Inflammation or Cystitis (Hematu- an enlarged prostate, or a hard, elevated, immov- ria-blood in the urine) able tumor. It causes abdominal distention and blockages of urine, feces, and gas. Aggravated Pitta, due to excess exercise, hot, penetrating foods, long distance walking, and ex- Bladder cessive sun-bathing, overflows into the bladder Prostate because of aggravated Váyu. This causes pain, burning, or inflammation in the bladder and ure- Rectum thral passage (cystitis), and yellow urine. It may Urethra be mixed with blood, or only blood flowing alone; urine is warm or comes out repeatedly with dif- The prostate is situated below the bladder and in front of the rectum. ficulty. The urethra tube runs from the bladder to the penis or vulva. Mútrá-saåkßhaya - Healthy Prostate Due to Diminished Urine Urinary Dry, debilitated persons may experience Váyu Bladder and Pitta depositing into the urinary bladder, di- minishing urine, causing pain, and burning. Prostate Gland Mútrá-sáda - Obstruction Due to Blad- der Inflammation or Cystitis Urethra If Váyu aggravates Pitta and Kapha (alone or Prostate and Ureter together), difficult urination is produced. Urine is yellow, red, white (or all colors mixed), thick, ac- companied with pain, and is dry. Therapies: Kapha- and Pitta-reducing measures are used to heal this condition, in addition to the common therapies for all these 13 urinary conditions. 420

Section 4: Specific Illnesses and Diseases Chapter 18: Urinary System Swollen Prostate Enlarged One can experience stiffening, cramping, and dis- tress. It is a severe condition. Urinary Ureter - Bladder urine backs up Pitta: One feels burning, pain, and abnormal into Kidneys urine color. Enlarged Bladder Kapha: Persons experience heaviness, swelling Prostate Compressed and oiliness; whitish and precipitant urine. Pitta and Kapha forms can only be controlled but not healed. Urethra Obstinate Urinary Diseases (Prameha) Compressed (Excessive Urination, Diabetes, etc.) An enlarged prostate compresses the lower ureter, obstructing the pas- Causes: There are 24 forms of this disease: 4 sage of urine. This dilates the bladder and thus weakens it. are due to Váyu, 6 result from Pitta, and 10 are caused by Kapha. The main causes of these dis- The backed-up urine in the bladder enlarges and weakens the upper eases are fat, urine, and Kapha buildups due to; ureters that run to the kidneys. The kidney pelvis becomes damaged. Continued pressure on the kidneys causes damage to kidney tissue. 1) Foods (e.g., sweets, sours, salts, hard to di- gest, slimy, cold, raw grain; marsh, domesticated, Therapies for this disorder are covered under and aquatic animal meats). cancer and tumors, Chapter 22 page 501. 2) Liquids (e.g., beer, sugarcane juice, molas- Mútrá Jaþhara - ses, and milk). Obstruction Due to Enlarged Bladder 3) Life-styles (e.g., sedentary, sleeping while Habitual suppression of urine causes Váyu to sitting). become obstructed and move upward. A full blad- 4) Other things causing an increase of Kapha, der results in abdominal distention below the na- fat and urine. vel, severe pain, indigestion, and accumulation of feces. Therapy: Development Diuretics (e.g., gokßhura) are used to heal this condition (in addition to the common therapies Kapha prameha: Excessed Kapha overflows for all these 13 urinary conditions). into the body channels and becomes mixed with the dhátus (i.e., tissues of fat (medas), plasma/ Basti Kuòæala - Obstruction Due to lymph (rasa), muscle (máåsa), and sweat (Ka- Bladder Displacement pha mala). This situation weakens the dhátus and brings them into the urinary system, causing the This condition is similar to Vátabasti. 10 types of Kapha prameha. Váyu: Due to fast travel, jumping, exertion, in- jury, or pressure on the urinary bladder it may Pitta prameha: Aggravated Pitta and blood also shift out of place and remain expanded. This will can vitiate the urinary bladder when the watery tis- cause pain, shaking, and burning. Urine will pass sues are depleted. If fat (medas), muscle (máåsa), in drops, or if pressed, will come out in a stream. and plasma (rasa) are already weak or depleted, then this Pitta excess in the blood produces the 6 types of Pitta prameha. 421

The Áyurveda Encyclopedia Váyu prameha: Váyu may also weaken the blad- Analysis Cautions der by drawing the depleted tissues into the blad- 1) If the urine is yellowish or expelling blood der. Váyu diabetes is due to vitiated ojas, marrow, without the aforesaid premonitory signs of and lymph. When Kapha and Pitta doßhas become prameha, a person is not to be said to have decreased Váyu becomes excessed, bringing fat prameha, but rather a disease of Rakta Pitta. Since (medas), muscle (máåsa), marrow (Majjá), and the signs and symptoms of these two diseases are life sap (ojas) to the urinary system. This produc- similar, being sure of the disease is important. es 4 types of Váyu prameha. 2) If persons with prameha expel sweet, slimy, and honey-like urine, it is caused by the depletion Kapha prameha involves rasa, máåsa, and me- of doßhas (a Váyu-caused disease), or from over das. They are similar in nature. Thus, the herbs nourishment (a Kapha disease). to heal this prameha will not imbalance the other doßhas. Pitta prameha involves plasma (rasa), If Váyu, Pitta, or Kapha prameha is left untreat- muscle (máåsa), and fat (medas) dhátus that are ed after their premonitory signs and symptoms, opposite in nature to Pitta-reducing herbs (i.e., they are not able to be healed. Generally, Pitta Pitta reducing herbs are cool). These herbs will prameha is controllable. If the adipose tissue (fat/ increase plasma, muscle, and fat tissues. Still, Pit- medas) is not depleted, then Pitta prameha can ta diabetes (prameha) can be helped with special be healed. Kapha prameha is usually able to be herbs (e.g., ¤hilájit and guæmar) if dhátu deple- healed. tion is not extensive. Symptoms: On the other hand, when Váyu prameha involves General: Common to all forms of diabetes is muscle (máåsa) and fat (medas) dhátus, it is very the increased quantity and turbidity of the urine. difficult to treat because all the therapies for re- Kapha: Excess Kapha weakens the body fluids, ducing Váyu will further increase the already ex- muscle, and fat; and are drawn into the urinary cessed fat and muscle tissues. In this case, Váyu bladder and kidneys. This results in 10 forms of becomes aggravated either due to depletion of the Kapha prameha. reproductive (¤hukra) and life sap (ojas) tissues (dhátus), or from obstruction of the channels due to excess fat (medas) and muscle (máåsa) tissue. Premonitory Signs: 1) Udaka—large quantities of clear urine, white, cold, odorless, watery, sometimes slightly murky Common to all forms of diabetes is an excess of and slimy. perspiration, body odor, looseness of body parts, desiring rest, thickening heart, eyes, tongue, and 2) Ikßhumeha—urine is sweet, cold, slightly ears; stoutness of body, fast growth of hair and salty, and muddy. nails, wanting cold things, dry throat and palate, always having a sweet taste in the mouth, numb- 3) Sándra—urine becomes thick when kept ness and burning of the hands and feet (and other overnight. organs), sweet urine, matted hair, sticky excreta from orifices, ants and insects attracted to the 4) Surá—urine looks like beer (clear on top and body and urine, abnormalities of the urine, urine thick on the bottom) when kept overnight. smells of raw flesh. 5) Pißhta—hair stands on end, urine is thick and white. 6) £hukra—urine looks like semen or is mixed with semen. 422

Section 4: Specific Illnesses and Diseases Chapter 18: Urinary System 7) Sikatá—urine has dirty particles, like sand, Váyu: These 4 forms of diabetes immediately frequently cold, sweet urination. become aggravated due to; 8) £hítá—urine contains small hard things (be- a) Overeating of astringent, pungent, bitter, cause the weakened doßhas pass through). rough, light, and cold things. 9) £hanair—urine passes very slowly, with lit- b) Over indulgence in sexual acts and exercise. tle force. c) Over use of emesis, purgation, dry enemas, head evacuation. 10) Lála—urine is thready (like saliva) and d) Suppressing natural urges, fasting, physical slimy. accident, excess sun, anxiety, grief, blood-letting, staying up late at night, poor posture. Pitta: Aggravation of fire is caused by The excessed Váyu then overflows, along with a) Excess of hot, sour, salty, alkaline, and pun- muscle fat (vásá) and enters the channels (srotas) gent food. with urine, causing the development of fat in the urine (lipuria). It may also carry marrow to the b) Eating before the previous meal is digested. urinary bladder (via the mútravaha srota), de- c) Exposure to sun, fire, physical exertion, ranging the marrow (majjá) as myelouria. Mar- row may be expelled with urine as Váyu pushes and anger. the marrow out. d) Eating mutually contradictory foods (e.g., Should there be an excess of lymph entering the bladder (due to deficient insulin), large amounts fish and milk, hot and cold things; see page 551). of urine are produced, with a need for constant urination (without pressure). Váyu converts the Manifestation of Pitta forms of diabetes is sweetness of life sap (ojas) into an astringent taste quicker than that of those caused by Kapha. The and brings it to the bladder. This causes rough- 6 Pitta forms are only able to be controlled be- ness, which develops Diabetes mellitus [Either (a) cause it is a different element (fire) than the wa- an insufficient production of insulin that causes tery elements. Bitter and pungent herbs heal Ka- abnormal metabolism of carbohydrates, fats and pha. Bitters help Pitta, but the pungents will cause proteins. Sugar levels are increased in the blood aggravation. The stomach, small intestine, fat, and urine causing great thirst, frequent urination, and the abdominal wall membrane (which con- wasting, and acidity. nects the stomach with the other abdominal or- This can occur in childhood or early adoles- gans) are involved here. The 6 forms are; cence, or (b) A mild form appears in adulthood ag- gravated by obesity and an inactive lifestyle. Few 1) Kßhára—urine smells, looks tastes and feels symptoms exist, and insulin may not be needed]. salty. The 4 Váyu-caused diseases are serious because 2) Níla—urine is blue. of the risk of secondary diseases developing due 3) Kála—urine is ink black. to the loss of all the tissues. Váyu-diabetic urine is 4) Háridra—urine is pungent or bitter, yellow- grayish, reddish, and painful. ish, and burns when expelled. 5) Mañjißhþhá—urine smells like raw flesh and 1) Vasá—urine is expelled with muscle fat or fat has a slight red color. may be passed alone and frequently (fat-lipid-like 6) Rakta—urine smells bad, is hot, slightly salty urine). and reddish. 2) Majjá—urine is frequently expelled with marrow, or marrow may be passed alone (mar- row-like urine). 423

The Áyurveda Encyclopedia 3) Hasti—urine passes continuously and with- they remain on the proper herbs and diet. out force, mixed with lymph, and without diffi- The 7 types of diabetic carbuncles (skin or sub- culty (urinary incontinence/diabetes tuniflues). cutaneous tissue bacterial infections that exude 4) Madhu—sweet and astringent urine, which pus) require surgery. is pale and oily (diabetes mellitus). Diabetes involves the imbalance of carbohydrate This is caused either by aggravated Váyu deplet- metabolism that is controlled by the insulin secre- ing the tissues, or by obstructing the movement tion of pancreas. The blood level of sugar/glucose of the doßhas covering it. In the latter case, Váyu rises beyond the normal limits in the system that shows signs of the doßha covering it, washout any is excreted by the urinary system. other reason, occasionally, and thus the bladder is sometimes empty, sometimes full. These diseases General Therapies: cannot be healed. There are 2 general categories of urinary diseas- es: persons who are strong and obese, and those Any form of diabetes not tended to eventually who are weak and emaciated. The former catego- develops into Madhu (honey-like) diabetes. All the ry of people use elimination therapies, while the sweet forms of diabetes (i.e., sweet-tasting urine latter follows nourishing therapies. After oleation, and sweet-smelling body) are called Madhu. the strong and obese person follows Kapha-reduc- ing therapies to eliminate the excesses through the Sweet, slimy urine may be confused as being upward and downward channels. caused by either Kapha (excess nutrition) or Váyu Once the toxins are eliminated (and digestive (malnutrition). Should Kapha and Pitta forms be power is strong) one follows refreshing therapy experienced with all the premonitory signs (and (stearopten) [e.g., barley with honey] instead of Váyu forms, after lasting for a long time) can- fasting. Fasting immediately after elimination not be healed. The 4 Váyu types are unable to be may cause cystic tumors; wasting, kidney, urinary healed because they afflict the deepest tissue lay- bladder, and genital disorders. Alleviation therapy ers (marrow and semen). The Pitta forms which is used for people not strong enough for elimina- last for a long time are controllable. Forms where tion therapy. the fat tissue is not greatly excessed are healable. Secondary Complications: Diet: The most important herbs for all doßhas Kapha Forms: Poor digestion, anorexia, vomit- are ¤hilájit, guæmar, turmeric, neem, ámalakí, gug- ing, excess sleep, cough, nasal mucus. gul, and arjuna. Turmeric with aloe vera gel (1 to Pitta Forms: Pricking pain in the bladder and 3 gms./.035 to .1 oz) is best used during the early passage, oozing from the scrotum, fever, burning, stages of diabetes for regulating pancreas and liver and loose stools. functions. Other therapies include roasted or fried Váyu Forms (upward moving air): Tremors, barley, corn flour, light, bitter vegetables, barley sharp abdominal pain, insomnia, dry mouth and porridge, ghee, rice, and herbs like gokßhura, throat, cough, difficult breathing. guæmar, triphalá, musta, cardamom, fenugreek, or coriander, mixed with honey. Triphalá with Hereditary and genetic diabetes (like all he- ámalakí juice can also be used to heal prameha. reditary and genetic-caused diseases) cannot be Barley is the main food to heal urinary diseases. completely healed due to the dysfunctional genes. Other methods to heal prameha include strenuous However, these forms of diabetes can be con- exercises, oil massage, steam, sitz or waist bath, trolled; persons can live symptom-free as long as and sprinkling of water and ointment. Herbs of dry ginger, cardamom, and sandalwood are used 424

Section 4: Specific Illnesses and Diseases Chapter 18: Urinary System in baths, and taken orally. Guæmar is the best herb 3) For Váyu secondary excess with Kapha for digesting sugar in the pancreas. Guæmar and prameha, medicated oil (canola or mustard) is ¤hilájit are an excellent herbal combination used used with the same herbs to reduce Kapha. by modern Áyurvedic practitioners. 4) For Tridoßhic symptoms, both the ghee and Simultaneously, the foods and life habits that oils are used with the same herbs. caused the disease are avoided. Diabetic Ulcer, Pimple, Pustule, etc. (Prameha Piæaká) Kapha Therapies: Causes: 1) Emesis and fasting. If madhumeha (diabetes mellitus) is not treated, 2) Food: Barley soaked in a triphalá decoction 10 forms of eruptions can develop on the joints, overnight, then mixed with honey and eaten sev- vital spots, and muscular areas during diabetes. eral times a day (cane sugar may also be used). All three doßhas are aggravated. 3) Herbs: Include decoctions of triphalá, fenu- Symptoms: greek, musta, arjuna, sandalwood, lodhra, ajwan, 1) £hará-viká: Raised edges, depressed centers, gokßhura, viæa´ga, guæúchí, harítakí, and chitrak. black, oozing, painful, saucer-sized and shaped. These may be taken with a small amount of ghee. 2) Kacha-piká: Deep continuous or intermit- Guæmar and ¤hilájit are excellent. tent pain, extending over large areas, smooth, and tortoise shell-like. Pitta Therapies: 3) Jáliní: Stable, vein networks, oily, oozing, Only when muscle tissue (medas dhátu) is ex- with a large inner cavity, severe, intermittent pain, cessively aggravated is Pitta prameha unable to minute openings. be healed. 4) Vinatá: Large, found on the back or abdomen, 1) Purgation is the best therapy for healing. blue, deep pain, oozing, bending downwards. 2) Herbal decoctions include sandalwood, mus- 5) Alají: Burning, raised, hard to bear, spread- ta, ámalakí, neem, kuþaj, turmeric, blue lotus, and ing, reddish-black, severe thirst, boils, delusion, arjuna. These are taken with ghee or sesame oil. fever. Guæmar and ¤hilájit are excellent. Váyu Therapies: 1) Guæmar and ¤hilájit, triphalá, fenugreek, musta, turmeric, harítakí, and ámalakí mixed with raw honey and ámalakí juice. They may be added to a drink of roasted corn flour mixed with raw honey. 2) Medicated oils and ghees. Pitta/Kapha Therapies: 1) For either Pitta or Kapha urinary diseases, herbs of gokßhura, bibhítakí, and kuþaj are mixed in ámalakí juice. After digesting this drink rice and soup (with ghee) may be taken. 2) For Váyu secondary excess with Pitta prameha, medicated ghee and Pitta-reducing herbs. 425

The Áyurveda Encyclopedia 6) Masú-riká: Lentil sized and shaped. guggul. 7) Sarßha-piká: The size and shape of a mustard Liquids and foods include herbs of kaóuká, black seed, severe pain, surrounded by similar erup- tions. pepper, cardamom, vachá, hi´g, and viæa´ga. 8) Putriòí: A large eruption surrounded by many smaller eruptions. Charak suggests surgical procedures. 9) Vidá-riká: Round and hard shaped. 10) Vidhradi: Abscesses (discussed in the next Incontinence section). Useful herbs are cardamom, bákuchí, yogaraj The first 3 ulcers are caused by fat and are dif- guggul, nutmeg, skullcap, cinnamon. ficult to bear and heal. The rest are bearable and easy to heal. Aggravated symptoms of these erup- Renal Failure: tions are similar to diabetes. These symptoms may occur even without diabetes as they are caused by Punarnavá is the recommended herb to use un- vitiated fat tissue. til the kidneys begin to function again. Symptoms of deep yellow or red urine, without experiencing any premonitory signs of diabetes, are classified under bleeding disorders (Rakta Pit- ta—Chapter 14) and require the same therapies. Piæaká Therapies: Urinary System General: Early stages of all 10 eruptions (piæaká) Adrenals use inflammatory edema ¤hotha) therapies (Chap- ter 25). Advanced stages of eruptions use thera- pies according to ulcers (Chapter 16). Small eruptions that appear only on the skin, are soft to the touch, slightly painful, easily form pus and then burst, and develop on persons who are strong and can be healed. When symptoms in- clude eruptions in the rectum, heart region, head, shoulders, back vital parts, and joints; associated with complications; and who have poor digestion; no therapy is available. Medicated oil herbs for ulcers include carda- Kidneys Urinary mom (elá), saffron or safflower, sandalwood, and Bladder kaißhore guggul. Massage herbs include neem, guæúchí, bhúá- malakí, and paóola. Sprinkling (parißheka) water requires herbs of kaóuká, neem, viæa´ga, mañjißhóhá, guæmar, and 426

Section 4: Specific Illnesses and Diseases Chapter 19: Ear, Nose, Throat, (Eyes, Mouth) Pouring warm water over the body bestows strength, but the same over the head, makes for loss of strength of hair and eyes. Aßhóáñga H^idayam - Sú. Ch. 2: ver. 17 Chapter 19 Ears, Nose, Throat, Catarrh, Hoarse Throat, Eyes, Mouth Diseases of the Ear Secretion (karòa-sráva): Caused by excess (Karòagata-Roga-Vijnániya) Váyu in the ear cavity, resulting from head in- jury, remaining underwater for a long time, or a wenty-eight different types of ear disor- spontaneous formation and bursting of an inner ders exist: ear (karna) diseases, earache ear abscess. (karna-ßhula), ringing/noise (pranáda), Itching (Karòa Kaòæú): Excess itching from lo- deafness (vádhirya), windpipe sounds (karnakßh- cal Kapha. veda), secretions (karna-sráva), itching (karna- kandu), karna-guntha, parasites (krimi-karna), Excess Ear Wax (Karòa Gúthaka): Accumulat- prati-náha, two forms of local abscess (vidradhi), ed mucus in the ear dries and is hardened by local boil/pus formation (karna-páka), pus and mal- Pitta heat. odor (puti-karna), four kinds of cysts, seven forms of tumor, four types of swelling (¤hopha). Inner Ear Fistula (karòa-prati-náha): When dried ear accumulations caused by secretions be- Causes and Symptoms: come liquefied and seep from the nose (and/or the Earache (karòa-¤hula): Great aching pain in the mouth) and head, diseases (and certain forms of ear region and inside the middle ear (tympanum) headaches) may develop. from local Váyu excess that becomes aggravated and obstructed by the other imbalanced doßhas. Parasites (krimi-karòa): These vermin, collect- Ringing/noise (karòa-náda): Ringing and other ing in the ear impair the hearing. sounds resulting from excess local Váyu entering the ear the wrong way and becoming blocked in Abscesses (karòa-vidradhi): These are caused the sound channels. by ear ulcer, external injury to the ear, or other Deafness (vádhirya): When excess Váyu re- unknown causes. Symptoms include choking and mains in the sound channels along with Kapha burning sensations, piercing and sucking pain, imbalances and is not healed or balanced. yellow, red, or bloody secretions. Wind-Pipe Sounds (karòa-kßhveæa): Results from cold object or exposure to nasal purgatives Pus-Boil- Ulcer Formation (karòa-páka): When for the head, or continual derangement of Váyu in pus forms in the boils of the ear from excess Pitta, the sound channel and aggravated by excess work, a blockage and consequent malodor in the pas- any wasting process in the system, or by ingesting sageway of the ear occurs. astringent or dry items. The sound is caused by excess of Pitta, Kapha, and blood. Pus and Malodor (puti-karòa): When the pus, with or without accumulation of mucus in the ear passage is secreted after being heated by excess Pitta, it may cause swelling (¤hopha—Chapter 25), tumors (arbuda—Chapter 22) and multiple growths (polypoid—ar¤has—Chapter 15). 427

The Áyurveda Encyclopedia Therapies: Pus/Malodor (Puti-kaòna), General: Therapy includes ingesting ghee after Secretion (Kaòna-sráva) and meals, rejuvenative herbs such as ¤hatávarí and Parasites (Krimi-karòa): balá, refraining from exercise and sex, avoiding wetting the ear, and less talking. General therapies: These include ear-drop Váyu: For all Váyu-related ear diseases (earache, therapy as discussed above, nasal therapy, smoke, ringing, wind sounds, and deafness), oil is first medicated washing herbs (see below). used internally and externally (in the ear too) in addition to emulsive purgatives (e.g., licorice/ Secretion (karòa-sráva): Ear drops made from viæa´ga). Then the ear is fomented with Váyu-re- cane sugar, licorice, and bilwa (Bilwadi Tail) are ducing herbs by means of steam (náæí sveda) that made into a paste and mixed with goat’s milk and is applied to the ear through a tube. Ringing in the sesame oil. ear is helped by placing three drops of clove oil in the ear. Pus/Malodor (puti-karòa): Ear drops made Váyu/Kapha earache: These are helped by from milk, honey and herbs of licorice, ámalakí, smoke fomentation. Herbs include bilwa, castor patta, dhátakí, mañjißhþhá, lodhra, and príya´gu. oil root, a¤hwagandhá, barley, and vaµ¤ha locha- The herbs are boiled in milk and sesame oil, and na, boiled in fermented rice, It is applied via tube are either dropped into the ear or ingested. fomentation (náæí sveda). Warm oil (mahánáráy- an, da¤hmúl, sesame, guggul-ghee) is dropped Parasites (krimi-karòa): This includes viæa´ga, into the ear for instant relief (one or two drops). kuóaj, musta, guggul taken internally, and mixed Ingesting ghee after meals and ¤hiro basti are also with warmed mustard oil to be applied to the ear useful. Rice should not be eaten at the dinner time canal. Smoke of guggul destroys the odor. Emet- meal, but replaced with milk and ghee. The same ics and gargling are also useful. herbal oils can also be used as nasal therapies, sprinkling and ingested. Three drops of garlic oil Wind Pipe Sounds (karòa-kßhveæa): Mustard may be placed in the ear for V/K earaches. oil ear drops are useful (3 drops per ear). Váyu earache: Three drops of warm garlic oil are applied to the ear. Abscess (karòa-vidrahi) is the same as ordinary Pitta earache: Ghee cooked with licorice, mus- abscesses. The ear is fomented after being filled ta, mañjißhþhá, sandalwood and milk, used as ear with oil (to soften the deposit). Discharges can drops (three drops per ear). then be removed with a probe. Kapha earache: Three drops of mustard or gar- lic oil are placed in each ear. Strong nasal evacua- Inner Ear Fistula (karòa-pratináha): Therapies tives and gargling with guggul, pippalí and ginger include oil and sweat, followed by nasal evacua- are also useful. tives. Diet and lifestyle changes that reduce the Blood earache: Pitta therapies are followed. imbalance causing this disease are recommend- Deafness (vádhirya): Sesame oil cooked with ed. milk, water, bilwa, licorice, mahánáráyan, and da¤hmúl oils is applied (3 drops per ear). Ear Inflammation - pus - boils (karòa-páka): Itching (karòa kaòæú): Local steam (náæí swe- Therapies include lightening (see pañcha kar- da) to the ear; herbal emetics, smoke, and head ma: Chapter 7), vomiting, and bitter herbs (e.g., purgatives may also be taken. chiráyatá, kuóki, neem, aloe vera, gentian, bar- berry). Bloodletting and purgation are also em- ployed. Dirt, parasites, or other foreign objects stuck in the ear cavity should be removed with a probe. 428

Section 4: Specific Illnesses and Diseases Chapter 19: Ear, Nose, Throat, (Eyes, Mouth) Ear Lobes (Karnapálí Rog) Traumatic Swelling (Utpáta): Mañjißhþhá, ses- ame oil, licorice, ¤hatávarí, musta, turmeric, and There are 5 main diseases of the ear lobes mango are cooked together and applied to the Inflammatory Swelling (Paripota): The lobe is lobe. suddenly pulled and held for a long time in this position, it becomes numb, painful, swollen, Piercing or pulling (Unmantha): A medicated blackish-red, and may spontaneously burst or oil of bákuchí, guggul, mañjißhþhá, viæa´ga, tur- crack as a result of excess Váyu. meric, musta, and ginger is applied to the lobe. Traumatic Swelling (Utpáta): This condition results from friction and the weight of earrings. Ulceration (Duhka-vardhana): Ghee and sesame Painful swelling, burning, and pus develops in the oil are mixed with milk (10 times the weight of the ear lobe and may be brown or red-colored,owing ghee and oil) and are cooked with a¤hwagandhá to toxic blood and Pitta. and apámárga. The finished recipe is then filtered Piercing/Pulling (Unmantha): Pulling the ear- before application to the ear lobe. Constant ap- lobes creates excess Váyu and Kapha at this site, plication and fomentation helps the regrowth of causing painful swelling, itching. The color of the the lobe, making it soft, healthy, smooth, painless, lobe depends upon which doßha is present in ex- evenly developed, and able to bear the weight of cess. earrings. Ulceration (Duhka-vardhana): Swollen, pain- ful, burning, itching lobes result from being pulled Pustules (Parilehi): The lobe is oiled with warm and lengthened, leading to pus formation. ghee, sesame or sunflower, cooked with bákuchí, Pustules (Parilehi): Small oozing pimples, guggul, mañjißhþhá, viæa´ga, ginger, and turmer- painful, burning, and itching may cover the lobes. ic. A powder of these herbs is also dusted on the These result from toxic blood, excess Kapha, or lobe. The use of medicated oil on ear lobes pre- parasites. This disease quickly spreads. Inflam- serves their health. mation and fever may develop. The lobe may be destroyed. Diseases of the Nose (Násá-gata-roga-Vijñániya) Ear Lobe Therapy: General: These five diseases are considered very There are 31 forms of nasal (násá) diseases: ob- dangerous and may eventually destroy the lobe if struction (apínasa); malodor (púti-násá); inflam- not quickly attended to. The first line of therapy mation/pus pimples (násá-páka); bloody pus in the includes a wholesome diet of foods, drinks, and nose (puya-rakta); hemorrhage (¤honita-pitta); lifestyle habits. Oils and sweat, ointments, wash- sneezing (kßhavathu); mucus sneezes (bhramßha- es, plasters, poultices, and blood-letting are used thu); vapors (dípta); stuffiness (násá pratináha); for all five disorders. Váyu does best with oils, cold/ mucus/coryza (násá-parisráva); dryness poultices, and enemas. Pitta does best with purga- (násá- ßhoßha); four types of arßhas (nasal hem- tives. Kapha does best with emetics. orrhoids); four forms of swelling (¤hopha); seven Inflammatory Swelling (Pari-potaka): Licorice, types of tumors; and five forms of prati-¤hyáya. apámárga, devadaru, bákuchí, and mañjißhþhá are pasted together and cooked with milk, ghee, Causes, Symptoms, and Therapies sesame oil, and are applied to the lobe. 1. Obstruction—Wasting or Atrophic Rhinitis (apínasa)—excesses of Váyu and Kapha cause symptoms of choked and burning nostrils with dryness and dirty and slimy mucus in the passage. This deadens the faculty of smell and taste. [This 429

The Áyurveda Encyclopedia is identical to the type of mucus (pratißhyáya) kút, kuþaj, and tulsí seed). After the blood and pus block discussed in the next section.] are reduced, purifying herbs are used. Therapies include applying oil and steam to 5. Hemorrhage (¤honita-pitta or nasá púyara- the nasal passage, emetics, and purgation, taking kta) decoctions and snuffs are discussed under light and moderate meals, drinking boiled water, bleeding (Raktapitta) in Chapter 14. and nasal inhalation of the smoke from viæa´ga, pippalí, and apámárga. Nasal oil is made from 6. Excessive Sneezing (kßhavathu)—the nasal mustard oil and herbs of t^ikatu, hi´gwasták, cal- marma results from doßha imbalance or trauma, amus, ku¤hþha, viæa´ga, and applied daily. causing Váyu and Kapha to flow from the nose while sneezing. If something touches the nose 2. Malodor (púti-násá)—Excess Váyu mixed hairs, a trickling sensation develops. This sen- with other doßhas in the throat and palate roof sation can also develop from eating or smelling causes a malodorous smell in the nostrils and any pungent aromas or from looking at the sun. mouth. The same therapies are used as described Therapies include evacuative herb nose drops, for obstructions. such as pippalí, kayphal, dry ginger, kút, viæa´ga, bilwa, munuka (dry grapes), and ginger. Inhaling 3. Inflammation/Pus/Pimples (násá-páka)—Ex- smoke is also advised. The head is fomented with cess Pitta causes sliminess, malodorous ulceration Váyu reducing herbs (e.g., ahwagandhá, balá), inside the nose, secretion, putrefication. Internal and oily snuff, including turmeric, balá, kaóuká, and external Pitta-reducing therapies are required. and bilwa. Ghee is mixed with ámalakí, guæúchí, dúrba, elá, and dhátakí flowers. This is applied as a wash and 7. Mucus Sneezes (bhramßhathu)—Excess a plaster in the nasal passages after bleeding. thick and salty Kapha accumulations in the head become liquefied from the heat of Pitta and are 4. Bloody Pus/Ulcers (púya-rakta)—resulting expelled through sneezing. The same therapies from trauma to the head. Pitta and Kapha be- used for sneezing may also be used here. come very heated, causing a discharge of blood 8. Burning Sensation/Vapor (dípta)—Vapor or blood-streaked pus. For Pitta reduction, a por- breaths of Váyu emit from the nostrils with a ridge made of milk, ghee, dúrba, mañjißhþhá, and great burning sensation. Pitta-reducing therapies nágke¤har is used as a poultice. Then the sinus are used to heal dípta. is cut open with a knife and a plaster of licorice, dúrba, nágke¤har, mañjißhþhá, turmeric, and kuþaj 9. Stuffiness/Deviated Septum (násá-prat-in- is applied. Neem and turmeric are used to wash áha)—Upward moving Váyu (Udán) becomes the ulcer daily. Medicated ghee of triphalá, tur- excessive as a result of Kapha and blocks the na- meric, kuþaj, dúrba, nágke¤har, and balá are used sal passages. Therapies include applying blow- to lubricate the sinus. For Kapha reduction, poul- ing powders of viæa´ga, millet seed, vachá, kút, tices of white mustard seeds, dúrba, nágke¤har, kayphal, frankincense, sage, and tulsí to the nose. and mañjißhþhá are used daily until softened. Talisadi chúròa with honey or ¤h^i´gyádi chúròa may be taken internally. Váyu-reducing herbs such The sinus is then cut open with a knife and plas- as a¤hwagandhá, bilwa bark, gokßhura, kaòókárí, tered with neem, dúrba, nágke¤har, mañjißhþhá, punarnavá will provide relief. Balá or Náráyan and sesame paste. A decoction of neem, guæúchí, oil is also useful. and mañjißhþhá is used to wash the ulcer. Sesame oil is cooked with myrrh, chitrak, neem, guæúchí, 10. Cold and Mucus/Coryza (násá-paris- and mañjißhþhá, can be applied to the ulcer. Nasal ráva)—Constant clear or white watery secretion therapy using a few drops of herb juice or medi- of Kapha will emit from the nostrils (especially cated oil is also useful. Another useful therapy at night). Therapies include powdered herbs of is smoke inhalation of £hadbindú oil (endrojo, musta, kuóki, pippalí, turmeric, chitrak, rock salt, pippalí, black pepper, dry ginger, calamus (vachá), and kayphal inhaled through the nose. Fresh herb 430

Section 4: Specific Illnesses and Diseases Chapter 19: Ear, Nose, Throat, (Eyes, Mouth) juice poured in the nose is also useful. Inhaling General Symptoms: Intense pain and distress aromas of chitrak and cedar may also be taken. occurring in all three doßhas. 11. Dryness (násá-parißhoßha)—Excess Váyu Early Symptoms: Heaviness of the head, no and Pitta causes difficult breathing owing to dry- ap petite, discharge of thin fluid from the nose, ing, hardening, and accumulation of the mucus feeble voice, and frequent expectoration of mucus (Kapha). Therapies include ghee and sesame oil and saliva. used as a nasal lubricant. Advanced Symptoms (Pakva): Mucus becomes * Excess Mucus (Násá-sráva)—Váyu and Ka- thicker, staying in the nasal passages; voice re- pha block the passages of respiration (similar to turns, mucus returns to its normal color. If this pratináha). Consequently, a continuous discharge condition is neglected, it can develop deafness, of yellow or white fluid runs from the nose. Váyu/ blindness, loss of smell, eye diseases, body swell- Kapha therapies are used. ings, poor digestion, and cough. * Dry Frontal Sinus (Srotaà ¤h^i´gáóa-¤hoßha)— Pínasa Therapies: Nose oil drops of aòu taila [sesame oil, goat’s (also see next section—Hoarse Voice) milk, madhuka, da¤hmúl decoction and rock salt] When symptoms of one doßha dominates, the may be used. following therapies are used. Váyu: Unction followed by non-unctuous en- The four nasal hemorrhoids or polyps (arßhas ema. A light, Váyu-reducing diet using, oily, sour, —Chapter 15) [Guggul, triphalá and pippalí are and hot foods. Hot water is also used for drinking used.] and four swellings (¤hophas—Chapter 25) and bathing. Homes should be draft-free. Anxiety, result from the three deranged doßhas, either sep- exertion, excessive talking, and sexual intercourse arately or in combination. Therapies are the same should be avoided. as those discussed in their respective chapters. Pitta: Ghee should be taken with bitter herbs and milk boiled with ginger to help dispel the tox- Seven different nasal tumors (arbuda) exist, ins. This is followed by nasal evacuatives, such as (Váyu, Pitta, Kapha, Váyu/Pitta, Váyu/Kapha, viæa´ga, apámárga, and pippalí (with turmeric). Pitta/Kapha, Tridoßha). Pitta-reducing foods and liquids can also be tak- en. General Therapies: Triphalá, antiseptic and germicidal herbs are taken internally, as snuff and oil drops. Váyu: Comfrey, ginger, licorice, sandalwood, Kapha: Lightening therapy (emesis) is used with turmeric, asafoetida, bh^i´garáj, bráhmí. symptoms of heaviness or anorexia. To improve digestion, ghee is applied to the head, followed by Pitta: Barberry, dandelion, sandalwood, tur- fomentation and water sprinkling (parißheka). meric, jasmine, mañjißhóhá, neem, bh^i´garáj, bráhmí. Sesame seed paste is eaten, followed by emetic and pungent herbs (e.g., garlic, kuähtha, vachá, Kapha: Barberry, dandelion, sandalwood, pippalí), with green gram powder, rock salt, and turmeric, jasmine, mañjißhóhá, neem, asafoetida, ghee boiled in milk. This drink causes emesis. The bh^i´garáj, bráhmí. herbs can also be made into a medicated mustard oil and applied to the nasal passages. Kapha-re- Rhinitis (Pínasa) ducing foods and liquids are taken. It is caused by all doßhas. Two stages of rhi- For all nose and head disorders, ¤hadbindu, nitis can occur: early and advanced. bilwa and Náráyan oils are useful. 431

The Áyurveda Encyclopedia Catarrh sumption. Chronic coryza symptoms are difficult to heal. Inhaling smoke of roasted gram flour and Inflamed Mucus Membranes of the Nose ghee is advised. and Throat (Prati¤hyáya-Prati¤hedha) Causes: Therapies: Overindulgence in sexual intercourse, heating General: Ghee emetics and fomentation are use- of the head, inhaling dust or smoke through the ful except during the beginning and acute stages nose, excessive heat or cold, suppression of stool of catarrh. Fresh herb juice (according to doßha) is and urine, eating raw foods, or excessive talk- applied as nasal drops (for blood conditions such ing can instantly cause nasal catarrh. Excesses of as bloody secretions from the nose) add sugar Váyu, Pitta, Kapha, Tridoßha or blood may cause cane and milk). Acidic foods should be lukewarm catarrh (prati¤hyáya). and taken with ginger, fresh or dried. Sugar cane juice and pungent tastes may help thicken mucus Premonitory Signs: secretions. Heavy head, sneezing, aching limbs, goose When mucus is too thick, it can be loosened and secreted by using nasal head purgatives, non oily bumps. enemas, inhaling warm aroma smoke, and me- dicinal gargles. Symptoms: Persons should rest in draftless rooms, with Váyu: Hoarseness, stuffiness, thin mucus secre- their heads covered to protect them from the tem- tions, dry throat, palate and lips, pricking and perature. White basmati rice, harítakí and other piercing pain in the temples, excessive sneezing, herbs related to the excessed doßha are eaten. bad taste in the mouth. Wine, cold liquids and baths, sexual intercourse, Pitta: Hot, yellow, hot smoky mucus secretions, anxiety, grief, suppression of stool and urine, and heated skin, thirst, emaciation, yellow skin. eating very dry foods should be avoided. Fasting (if one is strong) or light meals with Kapha: Constant runny nose, cold, white or digestive and appetite-increasing herbs are used clear mucus, swollen eyes, heavy head, tickling when catarrh is accompanied by vomiting, ach- and itching in the head, throat, lips and palate. ing, heavy limbs, fever, lack of hunger, apathy, Tridoßha: Spontaneous appearance or disappear- and diarrhea. Adults with a Váyu/Kapha-caused ance of symptoms of all three doßhas. illness should drink a large quantity of liquids and Blood: Bloody secretions from the nose, red eyes, them vomit. bruised pain in chest, bad breath and smell, loss of smell, small white or black worms in the nose. Chronic Coryza (dußhóha prati¤hyáya): Neglect Váyu: Ghee cooked with vidárí-kand, balá, of coryza and poor eating habits, causes this con- vásák, licorice, triphalá, t^ikatu, chitrak, and rock dition to worsen. Serious conditions are noted by salt. Snuff of warm and moist herbs and oils may constant alternation between dry and slimy nos- also be used. trils, and between contracted and expanded nos- trils, foul smell and loss of smell. Nasal diseases Pitta and Blood: Ghee cooked with bitter herbs previously discussed can also develop. Other is ingested. Decoctions of bitter herbs are used to symptoms include ear, eye, head disorders, gray- wash and plaster the affected area. Red sandal- ing or baldness, whitening of body hairs, thirst, wood, guæúchí, licorice, ¤hatávarí, triphalá, hon- difficult breathing, cough, fever, intestinal bleed- ey, and cane sugar are boiled in milk and/or oil ing, swellings (¤hopha), hoarse voice, and con- and used as a gargle and nasal purgative. 432