CLASSIFICATION OF CHARDI –

A. PRIMARY CHARDI – Here the vomiting is caused by the vitiation of doshas and the disease will have its own pathological process.

This type of Chardi again is of 5 sub-types, they are –

1. VATAJA CHARDI – Vomiting caused by vitiated Vata

2. PITTAJA CHARDI – Vomiting caused by vitiated Pitta

3. KAPHAJA CHARDI – Vomiting caused by vitiated Kapha

4. SANNIPATAJA CHARDI – Vomiting caused by vitiation of all 3 doshas

5. DRUSTARTHA SAMYOGAJA (AGANTUJA) CHARDI – Vomiting caused due to consumption or sight or exposure to incompatible foods and things

B. SECONDARY CHARDI – This type of Chardi is not manifested by itself. It is a part of yet another disease and is thus secondary to another primary disease.

1

CHARDI AS VEGA

Chardi as vega – Chardi is also mentioned as ‘adhaaraneeya vega’, a natural urge expressed by the body. This means to tell that we should not control or suppress vomiting because it is a process in which the body is trying to throw out the unnecessary contents, contaminants and toxins out of the body, which would otherwise prove to be harmful when left alone in the body. Stomach identifies the incompatible foods and rejects them in the form of expulsion through vomiting. Chardi as roga or disease – Chardi is a disease when the pathology is head by the vitiated doshas. Even here too, if the patient is strong enough, the vomiting process should be allowed until the unwanted things have been ejected out of the system. When comes to treating vomiting, the pathology should be addressed and treated only after the unnecessary things have been thrown out of the body.

2

CAUSATIVE FACTORS (NIDANA) OF CHARDI IN GENERAL –

Ati drava – excessive consumption of liquid foods or liquids

• Ati snigdhihi – excessive consumption of unctuous or oily foods, fried foods

• Ahrudhyaihi – excessive consumption of incompatible or unsuitable (unwholesome) foods

• Ati lavana – excessive use of salt or salty foods

• Akala bhojana – untimely intake of food

• Ati matra bhojana – eating in excess

• Asaatmya bhojana – incompatible foods

• Shramaat – exhaustion

• Bhayaat – fear, panic

• Udwega – high end emotions

• Ajeernaat – indigestion

• Krimi dosha – infection

• Naaryaha aapanna satva – pregnancy

• Ati drutam ashnataha – eating food in hurry

• Beebhatsa hetu – anything which creates an awkward feel

3

PATHOGENESIS (SAMPRAPTI OF CHARDI) OF VOMITING –

On getting provoked by the above said causative factors, the doshas get immediately vitiated. They quickly move upwards and fill up the mouth. In the process they cause serious discomfort, bends and twist the body parts. The condition in which there is quick movement of doshas towards the mouth is called Chardi.

Nidana sevana->kapha-vata dosha-> agnimandhay & amautpatti-> annavaha shrota dusti-> amashya utklesa-> anna ka vayu duara vimargamana-> chardi

4

SAMPRAPTI GHATAKA

DOSHA- vata-kapha

DUSHYA- anna ahara rasa

ADHISTHANA- amashaya

SHROTAS- annavaha

SVABHAVA-ashukari

SADHYAASADHYATA- sadhya

5

PREMONITORY SYMPTOMS OF CHARDI –

• Hrudaya utklesha – feeling of discomfort in the region of the heart, nausea (repeated)

• Kapha praseka / Hrillasa – filling of mouth with watery secretions, water brash, excessive salivation

• Ashana dwesha – aversion or lack of interest in food

• Udgara rodha – obstruction to belchings

• Tanu, lavana srava – thin salty secretions in the mouth

6

VATAJA CHARDI

VATAJA CHARDI (VOMITING CAUSED BY VITIATED VATA)

CAUSES:

• Vyaayaama – excessive exercise

• Teekshna aushadha – strong medicines

• Shoka – grief

• Jeerna roga – chronic diseases

• Bhaya – fear

• Upavasa – excessive fasting

PATHOGENESIS:

Due to the above said factors, the person becomes debilitated and emaciated. In the process, the vata gets severely aggravated in the maha srotas (passages of food; gut) and in turn provokes the other doshas and contaminants in the gut. The vitiated vata pushes these doshas in an upward direction. While throwing the doshas in an upward direction, vayu causes provocation and disturbance in the stomach. The whole set of process causes vomiting producing sever pain in the region of heart.

SYMPTOMS –

• Hridaya peeda – pain in the heart or cardiac region

• Parshwa peeda – pain in the flanks or sides of the chest

• Mukha shosha – dryness of the mouth

• Murdha arti (shira shula) – head ache

• Nabhi arti – pain in the navel region

• Kasa – cough

• Swara bheda – hoarseness of voice

• Toda – pricking pain (in the belly, tummy pain)

• Udgara shabda prabalam – severe sounds while vomiting (vomiting with sounds of expulsion of contents)

• Nature of vomitus – saphena (frothy), vichinna (content of vomiting is in the form of broken pieces), krushnam (blackish colour), tanukam (thin or less concentrated liquid in the content) and kashayam (gives an astringent taste in the mouth)

• Kruchra – vomiting occurs with much difficulty and distress

• Alpam – less quantity of vomitus

• Mahati vegam – comes in quick and forceful bouts

7

PITTAJA CHARDI

PITTAJA CHARDI (VOMITING CAUSED BY VITIATED PITTA)

CAUSES:

• Ajeerna bhojana – indigestion

• Katu – excessive consumption of pungent foods

• Amla – excessive consumption of sour foods

• Vidahi – excessive consumption of corrosive foods

• Ushna – excessive consumption of hot foods

PATHOGENESIS:

The pitta vitiated due to the above said factors accumulates in the amashaya (stomach and upper intestines). When the quantity of accumulation becomes excessive, the pitta gains enormous power and tends to move upwards. Due to the intense provocation, pitta enters the rasayanis (channels of nutrition, oesophagus here), moves upwards in a projectile and causes vomiting causing severe pain and discomfort in the heart.

SYMPTOMS:

• Murcha – fainting, loss of consciousness

• Pipasa – excessive thirst

• Mukha shosha – dryness of mouth

• Murdha santapa – feeling of excessive heat in the head

• Talu santapa – feeling of excessive heat in the palate

• Akshi santapa – feeling of excessive heat in the eyes

• Tama – feeling of darkness in front of the eyes

• Bhrama – giddiness

• Nature of vomitus – peeta (yellow), ushna (hot), haritam (green), tiktam (bitter in taste), dhumram (feeling of smoke or flames being eliminated from mouth) and daha yukta (burning sensation)

8

KAPHAJA CHARDI

KAPHAJA CHARDI (VOMITING CAUSED BY VITIATED OF KAPHA)

CAUSES:

• Snigdha – excessive consumption of unctuous, oily and fried foods

• Guru – excessive consumption of heavy ‘to digest’ foods

• Ama – excessive consumption of unprocessed and immature / improperly prepared (cooked) food components

• Vidahi – excessive consumption of corrosive foods

• Swapna – excessive sleeping, sedentary life, rest prone etc

PATHOGENESIS:

The kapha gets severely aggravated due to the above said causes and causes vomiting by filling up in the ura (chest), shira (head), rasaayani (channels of nutrition) and marma (heart). While causing vomiting, the vitiated kapha produces serious discomfort in the mentioned regions.

SYMPTOMS:

• Tandra – sleepiness, stupor

• Asya madhurya – sweetness in the mouth

• Kapha praseka – excessive filling of phlegm or watery secretions in the mouth

• Santosha – the person feels as if he has just consumed food i.e. feeling of saturation

• Nidra – sleep

• Aruchi – anorexia, tastelessness, aversion towards food

• Gourava – feeling of heaviness of the body

• Nature of vomitus – snigdha (oily, fatty), Ghana (thick, concentrated), swadu (sweet taste)

• Shuddha kapha – contains clear phlegm

• Loma harsha – horripulation

• Alpa rujam – vomiting occurs with minimum pain or discomfort

9

SANNIPATAJA CHARDI

SANNIPATAJA CHARDI (VOMITING CAUSED BY VITIATION OF ALL THE 3 DOSHAS)

CAUSES:

Samashnatam sarvarasaan – intake of all the rasas (foods having all the tastes – sweet, sour, salt, pungent, bitter and astringent) in an unbalanced way, not taking into consideration about good and bad food (suitable and unsuitable foods)

Prasakta ama – formation of ama in severe quantities in the body (ama is the immature essence formed after the digestion of the food and is in circulation, considered as unwanted toxin and intermediate product of metabolism, tends to clog the channels and cells in the body by the virtue of its sticky nature, leading to serious damage and disorders)

Rutu viparyaya – seasonal incompatibility, seasonal drift (one season encroaching the other and occurring in wrong time, example, severe rain in summer, severe heat in winter etc)

PATHOGENESIS:

Due to the above said causes, all the 3 doshas i.e. vata, pitta and kapha gets aggravated together and cause vomiting. This is called sannipataja or tridoshaja chardi.

Symptoms:

• Shula – colic, pain abdomen

• Avipaka – indigestion

• Aruchi – tastelessness, anorexia, aversion towards food

• Daha – burning sensation

• Trishna – thirst

• Shwasa – shortness of breath, dyspnoea

• Pramoha – delirium, loss of consciousness

• Prabala – severe vomiting with severe bouts

• Prasaktam – repeated or frequent vomiting

• Nature of vomitus – lavana (salty), amla (sour taste), neela (blue in colour), saandra (dense, concentrated), ushna (hot), raktam (mixed with blood)

ASADHYA SANNIPATAJA CHARDI (SANNIPATAJA CHARDI WITH BAD PROGNOSIS):

Sannipataja chardi is said to be having a bad prognosis (not possible to treat) when associated with below said complaints or symptoms –

• Vin mutrayoho tat – the materials or contents of vomiting will have the appearance, colour and smell of stools (faeces) and urine

• Prasakta trishna – repeated thirst

• Prasakta shwasa – repeated bouts of breathlessness or dyspnoea

• Prasakta hikka – repeated bouts of hiccoughs

• Ativega – severe bouts of projectile vomiting, comes in quick successions

• Dushta chardi – vomitus contains severe contaminated material

The person who has the above said symptoms of sannipataja chardi is said to die in a short period of time.

10

DWISHTA ARTHA SAMYOGAJA CHARDI

Dwishta artha samyogaja Chardi (Vomiting caused due to consumption, sight or exposure to incompatible, disturbing, repulsive or awkward foods and things)

CAUSES –

Smells, food or things which are:

• Dwishta – repulsive to the mind

• Prateepa – against the need of mind

• Ashuchi – untidy, clumsy, unwholesome, unclean

• Puti – putrid, decayed,

• Amedhya – disturbs the mind

• Beebhatsa – horrifying, scary

PATHOGENESIS –

Due to the above said factors, the mind becomes disturbed and causes vomiting

11

ASADHYA LAKSHANA

SYMPTOMS OF BAD PROGNOSIS (ASADHYA LAKSHANA) IN CHARDI –

Chardi is said to be difficult to cure (has bad prognosis) when the below said conditions prevail:

• Ksheena – person is emaciated or has tissue depletion

• Ati pravrudda vamana – severe vomiting occurring repeatedly

• Sa upadrava – vomiting associated with complications

• Shonita yukta – blood mixed vomitus

• Pooya yukta – pus mixed vomitus

• Sa chandrika – vomitus having shiny materials

12

SECONDARY CHARDI (DIFFERENTIAL DIAGNOSIS OF CHARDI)

Chardi is a part of some other disease. Below mentioned are different diseases in which Chardi appears as a symptom or premonitory symptom or complication.

AS PURVARUPA (PREMONITORY SYMPTOM) IN –

Urustambha – stiffness of thigh

Raktapitta – bleeding / haemorrhagic disorders

Rajayakshma – Tuberculosis, tissue depleting diseases, consumption

AS LAKSHANA (SYMPTOM) IN –

• Antarayama – type of tetanus

• Atisara – in kaphaja, pittaja and vataja types of atisara (diarrhoea)

• Amlapitta – gastritis, GERD (gastro intestinal reflux disease)

• Pureeshaja Aanaha – Flatulence or distension of abdomen caused due to improper or inadequate defecation

• Kaphaja arshas – piles caused due to morbid kapha

• Udavarta – upward movement of vitiated vata due to forcible suppression of puresha vega (urge to defecate), vata (urge to fart), mutra (urge to urinate)

• Kaphaja unmade – insanity caused by vitiated kapha

• Urustambha – stiffness of thigh

• Pittaja kasa – cough caused by vitiated pitta

• Kaphaja krimi – worm infestations caused by vitiated kapha

• Koshta shula (bala roga) – abdominal colic (paediatric disease)

• Kaphaja grahani – sprue or small bowel disease caused by vitiation of kapha

• Jwara – fever, pittaja jwara (caused by vitiated pitta), kaphaja jwara (caused by vitiated kapha), vata-pittaja (caused by vitiated vata and pitta), rasagata (seated in plasma or lymph), raktagata (seated in blood), medogata (seated in fat), asthigata (seated in bones), majjagata (seated in bone marrow) and aushadha gandhaja (due to smell of medicines)

• Talukantaka – disease of palate (paediatric)

• Kapha dushta stanya pana – due to consumption of breast milk contaminated by kapha (paediatric)

• Kaphaja parinamashula – duodenal (peptic) ulcer caused by vitiated kapha

• Sannipataja pandu – anaemia or liver disorders caused by vitiation of all the 3 doshas

• Panavibhrama – disease caused due to excessive consumption of alcohol

• Panajeerna – disease caused due to indigestion of consumed alcohol

• Parigarbhika – paediatric disease

• Pittavrita prana – pitta obstructing functions of prana vayu

• Bala graham – infective diseases or neurological, nutritional, abdominal or idiopathic disease occurring in infants and children

• Andhaputana, naigamesha, sheetaputana, skandapasmara – paediatric diseases

• Bhinnakoshta – tear or injury in visceral organs

• Kaphaja madatyaya – alcoholic intoxication caused by excessive vitiation of kapha

• Visha – poisoning – by the poison of dooshi visha (mixed poisons), pushpa (poisonous flowers), manduka (frog), mushika (rat), vishapana (intake of poisons), sthavara (plant poisons or chemical poisons), ksheeri visha (poisons of latex yielding poisons) etc

• Visarpa – herpes or erysipelas (agni, kaphaja, granthi and pittaja types)

• Vishuchika – cholera

• Vishpota – eruptive disorder, boils, blisters (kaphaja, kapha-pittaja and sannipataja types)

• Sheetapitta – urticaria, allergic disorders

• Amaja shula – colic caused by excessive ama (metabolic endo-toxins)

• Kaphaja shotha – inflammation or oedema caused by vitiated kapha

AS UPADRAVA (COMPLICATION) IN –

• Ajeerna – indigestion

• Atisara – diarrhoea

• Arshas – piles

• Ashmari – urinary stones (calculi)

• Amavata – rheumatoid arthritis

• Kaphaja prameha – urinary disorders or diabetes caused by vitiated kapha

• Madatyaya – alcoholic intoxication

• Raktapitta – bleeding disorders

• Visarpa – herpes

• Vrana – ulcers, wounds

AS ASADHYA LAKSHANA (SIGN OF BAD PROGNOSIS) IN –

• Atisaara – diarrhoea

• Apache – lymphadenitis

• Arshas – piles

• Alasaka – lazy stomach

• Akhu visha – rat poison

• Udavarta – upward movement of vitiated vayu

• Kamala – jaundice

• Kumbhakamala – complicated stage of jaundice

• Gandamala – cervical lymphadenopathy

• Gulma – abdominal tumours

• Grahani – sprue, irritable bowel disease, inflammatory bowel disease, small bowel disease

• Trishna – thirst

• Pandu – liver disorders, anaemia

• Madatyaya – alcoholic intoxication

• Raktapitta – haemorrhagic disorders

• Antar vidradhi – internal abscess

• Vishuchika – cholera

• Kshata ksheena – emaciation due to chest injury (bleeding within the chest organs)

13

CHARDITA DRAVYA LAKSHANA (SIGNS AND SYMPTOMS ON OBSERVING THE NATURE OF VOMITUS)

APPEARANCE:

• Alpa drava (less in quantity) – in Vataja chardi

• Arakta (reddish colour or blood mixed) – in urdhwagata raktapitta (haemorrhagic disorders, bleeding in upward direction or through mouth), tridoshaja chardi (vomiting caused by vitiation of all 3 doshas), rakta purna koshta (blood filled viscera), kamala (sign of bad prognosis in jaundice), raktapitta (sign of bad prognosis of bleeding disorders), ura kshata (chest injury) and akhu visha (rat poisoning)

• Krishna varna (blackish blue colour) – vataja chardi (vomiting caused by vitiated vata)

• Chandrika yukta (with shining particles) – chardi asadhya lakshana (sign of bad prognosis of vomiting)

• Dhumra varna (smoky or dusky appearance) – pittaja chardi (vomiting caused by vitiated pitta)

• Nila varna (blue colour) – in urdhwaga amlapitta (gastritis having upper course) and tridoshaja chardi (vomiting caused by vitiation of all 3 doshas)

• Peeta varna (yellow colour) – in urdhwaga amlapitta (gastritis having upper course), pittaja kasa (cough caused by vitiated pitta) and pittaja chardi (vomiting caused by vitiated pitta)

• Phena yukta (frothy appearance) – in Vataja chardi (vomiting caused by vitiated vata), balagraha samanya lakshana (common symptom of paediatric idiopathic diseases), skandapasmara (epilepsy caused by infection in children and infants) and vataja apasmara (epilepsy or memory related disorders caused by vitiated vata)

• Mamsa udakabha (meat washed water) – in urdhwaga amlapitta (gastritis having upper course)

• Vichchinna (split into pieces) – vataja chardi (vomiting caused by vitiated vata)

• Vit varna (faecal appearance) – chardi asadhya lakshana (sign of bad prognosis in vomiting)

• Snigdha (unctuous, fatty) – kaphaja chardi (in vomiting caused by vitiated kapha)

• Harita (green) – in urdhwaga amlapitta (gastritis having upper course) and pittaja chardi (vomiting caused by vitiated pitta)

• Ghana (dense, concentrated, having more solid) – kaphaja chardi (vomiting caused by vitiated kapha)

• Tanu (light, thin, diluted) – vataja chardi (vomiting caused by vitiated vata)

• Vishuddha (clean, clear) – kaphaja chardi (vomiting caused by vitiated kapha)

• Shakrut chardi (faecal vomitus) – in pureeshaja anaha (flatulence caused by obstruction of stools) and udavarta asadhya lakshana (bad prognosis of vata moving upwards)

• Sandra (viscous) – kaphaja chardi (vomiting caused by vitiated kapha)

• Shonita puya yukta (mixed with blood and pus) – chardi asadhya lakshana (bad prognosis of vomiting)

FEEL:

Ati pichchila (too sticky) – urdhwaga amlapitta (gastritis having upward course)

Ushna (hot) – in pittaja and tridoshaja (vomiting caused by vitiated pitta and vitiation of all 3 doshas)

TASTE:

• Amla rasa (sour taste) – in urdhwaga amlapitta (gastritis with upper course) and tridoshaja chardi (vomiting caused by vitiation of all 3 doshas)

• Katu rasa (pungent taste) – pittaja kasa (cough caused by vitiated pitta)

• Kashaya rasa (astringent taste) – vataja chardi (vomiting caused by vitiated vata)

• Tikta rasa (bitter taste) – vataja chardi (vomiting caused by vitiated vata)

• Madhura rasa (sweet taste) – kaphaja chardi (vomiting caused by vitiated kapha)

• Lavana rasa (salty taste) – tridoshaja chardi (vomiting caused by vitiation of all 3 doshas)

SMELL:

Mutra gandha (smell of urine) – chardi asadhya lakshana (bad prognosis of vomiting)

Vit gandha (faecal smelling) – chardi asadhya lakshana (bad prognosis of vomiting)

14

CHARDI CHIKITSA SUTRA – LINE OF TREATMENT

LANGHANA THERAPY – All except Vatika chardi (Because the Doshas are vitiated by the agitation of Doshas in the stomach)

SAMSHODHANA THERAPY – Kapha and Pitta chardi (Because the Doshas are aggravated in excess)

Along with honey, the powder of Abhaya – Terminalia chebula is given in a linctus form for the purpose of purgation. Such other purgative drugs which are cardio- tonics may also be given appropriately along with alcohol or milk. These recipes cause downward movement of the aggravated Doshas having the tendency to move upwards.

Such patients may also be given Vamana therapy, with the recipes containing Valli-Phala etc.

If the patient is weak, then he is treated with Shamana or alleviation therapy for which delicious soups and light as well as dry food is given for eating along with different types of drinks. [20-22]

15

VATAJA CHARDI CHIKITSA

TREATMENT OF VATAJA CHARDI:

The following cure Vataja type of Chardi (vomiting):

1. The well sizzled soup of the meat of Tittiri, Barhi and Lava

2. Vegetable soup of Kola, Kulattha, Dhanya, Bilva – Aegle marmelos (Shyonaka – Oroxylum indicum, Gambhari – Gmelina arborea, Patali – Stereospermum sauveolens, Ganikarika – Clerodendrum phlomidis), Mulamla (sour drink prepared of radish) and yava;

3. Ghee with rock- salt (cooked with rock salt). This recipe is given to the patient of Vatika Chardi, associated with the palpitation of the heart.

4. Ghee cooked with Dhanyaka –Coriandrum sativum , Nagara – Zingiber officinale, Yogurt and the juice of Dadima – Pomegranate – Punica granatum and

5. Ghee added with the powder of Sunthi – Zingiber officinale, Pippali – Long pepper fruit – Piper longum ,Maricha – Black pepper fruit – piper nigrum and Saindhava, Sauvarchala and Vida type of salt;

The patient of Vataja Chardi is given food which is unctuous and pleasing to the heart along with meat- soup, vegetable- soup, yogurt and sour pomegranate. [23-25]

16

PITTAJA CHARDI CHIKITSA

Treatment of Paittaja type of Chardi, the patient is given the powder of Trivrt – Operculina turpethum along with the juice of Draksha – Raisin – Vitis vinifera, Vidari (Ipomoea paniculata / Pueraria tuberosa) and sugarcane for causing Anulomana or downward movement of the morbid matter, i.e purgation. When Pitta is over- aggravated in chest (in the region above the abode of kapha- stomach), then (emetic therapy with the help of) drugs having sweet taste is administered.

After the body is cleansed from the morbid matter, the patient is given during meal- time the Laja-mantha (flour of popped- rice, Diluted in water) or Laja-Peya (thin gruel made of popped- rice) along with honey and sugar. The patient may also be given boiled Shali- rice along with the soup of Mudga – Vigna radiata or the soup of the meat of animals inhabiting an arid zone.

Kulmasha (the paste of boiled green gram, Masura (red lentil) etc.,) Laja (popped paddy), Yava – Barley (Hordeum vulgare) – Saku (flour of roasted barley), Grnja (boiled barley along with its scum), or the pulp of Kharjura – Phoenix dactyliera, Coconut, Draksha – Raisin – Vitis vinifera or Kola is made to a linctus by adding Sitopala (sugar having big crystals), honey and Pippali – Long pepper fruit – Piper longum. These recipes are given to the patient suffering from Paittika type of vomiting.

The powder of Srotonjana Laja (popped paddy), Utpala (Nymphaea alba), the seed- pulp of Kola (ber fruit) and Abhaya – Terminalia chebula is made to a linctus by adding honey, and given to the patient. Similarly the seed- pulp of Kola, Anjana, and stool of fly, Laja (popped paddy), sugar and grains of Pippali – Piper longum mixed with honey may be given to the patient.

The patient may drink cooled juice of Draksha – Raisin – Vitis vinifera or the leaves of jambu –Syzygium cumini and Amra by adding honey (after the decoction is cooled).

Water is added with the powder of mudga – Vigna radiate, Pippali – Long pepper fruit – Piper longum, Ushira – Vetiver – Vetiveria zizanioides and Dhanya – Coriandrum sativum and kept overnight. In the morning the powder is strained out and the filtered water is taken by the patient. Similarly the water added with the powder of chanaka (Bengal gram) or Gavedhuka- root or Guduchi – Tinospora cordifolia and kept to overnight can be given to the patient.

The patient may be given sugarcane juice or milk to drink.

RECIPES WHICH ARE USEFUL FOR CURING TRISHNA (EXCESS THIRST) AND CHARDI:

1. The powder of Sevya and Balaka along with rice- water (tandulodaka) and honey);

2. Powder of Kancana- Gairika and Balaka along with rice- water and honey and

3. The paste of white variety of Chandana – Santalum album mixed with the juice of Amalaki – Emblica officinalis along with honey.

The following recipes also cure Paittika type of vomiting:

1. The paste of Chandana – Santalum album, Chavya – Piper retrofractum, Mamsi – Nardostachys jatamamsi, Draksha – Raisin – Vitis vinifera of good quantity,

2. Powder of Gairika and Shali along with cold water and honey

3. Powder of Murva – Marsedenia tenacissima along with rice- water (Tandulodaka) and honey.

17

KAPHAJA CHARDI CHIKITSA

TREATMENT OF KAPHAJA CHARDI:

In Kaphaja type of Chardi (vomiting), emetic therapy gives the best results. For this purpose, the patient is given the decoction of Pippali – Long pepper fruit – Piper longum, Sarsapa – Brassica campestris and Nimba – Neem (Azadirachta indica) added with the powder of Pinditaka (Madana-Phala – Randia dumetorum) and rock salt. This cleanses (eliminates) Kapha from Amashaya (stomach).

The patient is given wheat, rice and barley which are old (more than 6 months old after harvesting) as food. Along with this food, he is given the following side –dishes and drinks

1. Vegetables soup of Patola – Trichosanthes dioica, Amrta and Chitraka – Leadword – Plumbago zeylanica

2. Butter-milk cooked by adding Sunthi – Zingiber officinale, Pippali – Long pepper fruit – Piper longum, and Maricha – Black pepper fruit – piper nigrum

3. Butter- milk cooked by adding Nimba – Neem (Azadirachta indica)

4. Soup of sour fruits along with pungent drugs

5. Soup of the meat of animals inhabiting arid zone (Jangala). The spit-roasted meat these animals may also be given along with food.

6. Old honey, Sidhu (alcohol prepared of sugar-cane- juice) and Arishta (a type of alcoholic drink) and

7. Raga (condiments), sasava (pickles) and Panaka (syrup) prepared of Draksha – Vitis vinfera, Kapittha (Feronia limonia) and Phala- Puraka (bija-Puraka) – Citrus medica.

THE FOLLOWING RECIPES ARE USEFUL FOR THE PATIENT SUFFERING FROM KAPHAJA TYPE OF VOMITING:

1. Linctus prepared with the powder of the roasted Mudga – green gram, Masura – Lens esculenta (red lentil), Chanaka (bengal gram) and kalaya (peanut) mixed with the powder of Sunthi – Zingiber officinale and honey.

2. Linctus prepared of the powder of Haritaki – Terminalia chebula, Bibhitaka – Terminalia bellerica, Amalaki – Emblica officinialis and Vidanga – Embelia ribes mixed with the powder of Sunthi – Zingiber officinale and honey.

3. Linctus prepared of the powder of Vidanga – Embelia ribes and Plava (Kaivarta mustaka) mixed with the powder of sunthi and honey.

4. Powder of Jambu (Jamun seed) and sour fruits of Badara – Zizyphus jujuba mixed with honey

5. Powder of Musta (Cyperus rotundus) and Karkata- srngi – Rhus succedanea mixed with honey and

6. Powder (or juice) of Duralabha – Fagonia cretica mixed with honey.

18

SANNIPATIKA CHARDI CHIKITSA

Various types of treatment suggested by me (by Atreya) for the treatment of different types of Chardi,(Viz, Vatika,pattika and Kaphaja Chardi) is appropriately and judiciously combined, and given by the physician to the patient suffering from Sannipatika type of Chardi. The physician well versed in ayurvedic scriptures is (specially) vigilant (with regard to the Sannipatika type of Chardi) keeping in view the relative preponderance of the Doshas involved, the season when the disease has occurred, the stage of the disease and the power of digestion of the patient [40]

19

DVISTARTHA SAMYOGAJA CHARDI CHIKITSA

For the treatment of vomiting caused by the mental disgust or affliction of the mind (Manobhighata), the following steps are taken:

• Mano anukula – The patient is made to hear pleasing talks

• Ashvasana – He is consoled and encouraged.

• Loka prasiddha sruta – He is made to hear reputed folk tales including mythological stories

• He is attended to by congenial companions and he should resort to amorous and wholesome regimes (games)

• He is made to smell various types of pleasing perfumes emanating from the earth, flowers, Sukta (vinegar) and Sour fruits

• He is given to eat well prepared vegetables, eatables, syrups, Shadavas (Pickles), raga (condiments) and Lehas (preparations in the form of linctus or jam).

• Eatables like vegetable- soup, meat- soups, Kambalika (sour curry of fish and meat), Khada (sour drinks prepared of fruits), meat preparations, popped cereals, different food preparations, fruits and roots having pleasing smell, color and taste cure vomiting caused by mental disgust and

• In general, whatever smell, taste, touch, sound or vision is pleasing to such patients is administered even though some of these might be unwholesome, because the aliments caused by such unwholesome contacts can be treated easily. [41-44]

20

THE FOLLOWING RECIPES SUBSIDE THE FORCEFULLY GENERATED URGE FOR VOMITING:

Powder of (purified) Manahsila with the juice of Bija-Puraka – Citrus medica, Honey and powder of Maricha – Black pepper fruit – piper nigrum and

Powder of Pippali – Long pepper fruit – Piper longum mixed with the juice of Kapittha (Feronia limonia), honey and the powder of Maricha – Black pepper fruit – piper nigrum. [34-39]

21

UPADRAVA CHIKITSA

Treatment of Complications:

Complications associated with the disease (vomiting) are treated on the lines suggested in respect of each of these ailments. If there is excess of vomiting, then the therapeutic measures to be suggested in Siddhi 6: 52- 56 is administered to the patient. [45]

22

MANAGEMENT OF CHRONIC CHARDI

If vomiting persists continuously for a long time, then because of the diminution of tissue elements (Dhatus), the Vata Dosha certainly gets aggravated. Therefore, if the vomiting has become chronic, then therapeutic measures which are upastambhana (anti- emetic) and Brmhana (nourishing) is administered.

Recipes like Sarpirguda (vide Chikitsa 11: 50- 77), Ksheera-Vidhi (milk boiled by adding Vata balancing herbs), Kalyanaka Ghrita (vide Chikitsa 9: 33-42), Tryushana- Ghrita (vide Chikitsa 18: 39- 42), Jivaniya –ghrita (vide Chikitsa 29: 55- 57), meat- soup and different types of linctus cure chronic type of Chardi (vomiting). [46-47]

Pathya(DO):

Purana java,godhuma,shali rice,munga,chana,harit saka,godugdha,dhana lava,titter-bater mamsa,nimbu,anar,ela,lavanga,jeeraka,sounf

Vaman,virechana,snana,

Apathya(DON’T):

Seb(apple),bimbiphala,mahua,chitrak mula,sarso,kunduru,dravya pradarth

A. BILWADI KASHAYAM

Bilwa (Aegle marmelos)

Coriander (Coriandrum sativum )

Bala (Sida cordifolia )

Ginger (Zingiber officinale)

Laja (Parched grains )

Green gram (Vigna radiate)

The decoction prepared with these ingredients should be served fresh mixed with sugar

use-Vomiting caused by vata, pitta and kapha

B. LAJADI KASHAYAM

Laja Parched grains

Bilwa (Aegle marmelos )

Ginger (Zingiber officinale)

The decoction prepared with these ingredients should be served fresh

use-Vomiting

C. JAMBVADI KASHAYAM

Tender leaves of Jambu (Syzygium cumini )

Tender leaves / sprouts of mango (Mangifera indica)

Musta (Cyperus rotundus )

Hrivera (Pavonia odorata)

Ushira (Vetiveria zizanioides)

Ginger (Zingiber officinale)

The decoction prepared with these ingredients should be served fresh with honey

use-1.Vomiting 2.Bleeding

2. DRAKSHADI KASHAYAM (VATA-PITTA JWARAHARA KASHAYAM)

Ref – Sahasrayogam, Kashaya Prakaranam, 6

Draksha (Vitis vinifera)

Madhooka (Madhuca longifolia)

Madhuka (Glycyrrhiza glabra)

Lodhra (Symplocos racemosa)

Kashmarya (Gmelina arborea)

Sariva (Hemidesmus indicus)

Musta (Cyperus rotundus)

Amalaki (Emblica oficinalis)

Hrivera (Pavonia odorata)

Padmakesara (Filament of lotus)

Padmaka (Prunus cerasoides)

Mrinala (Nelumbium speciosum)

Sandalwood (Santalum album)

Ushira (Vetiveria zizanioides)

Nilotpala (Nymphaea stellata)

Parushaka (Grewia asiatica)

The decoction prepared with these ingredients should be served with honey, sugar and powder of parched grains.

uses-1.Vomiting 2.Fever of vata-pitta origin 3.Alcoholic intoxication, fainting, giddiness, burning sensation 4. Fatigue, thirst, bleeding from upper passages 5. Thirst, jaundice

3. AMRUTASHTAKA KASHAYAM

Ref – Sahasrayogam, Parishishta Prakaranam, 9

Giloy (Tinospora cordifolia)

Neem (Azadirachta indica)

Katuka (Picrorhiza kurrooa)

Musta (Cyperus rotundus)

Indrayava Seeds of Holarrhena antidysenterica

Ginger (Zingiber officinale)

Patola (Trichosanthes dioica)

Sandalwood (Santalum album)

The decoction prepared with these ingredients should be served fresh with powder of long pepper

uses-1.Vomiting 2.Fever of Pitta-Kapha origin 3.Nausea 4.Burning sensation 5.Thirst

4. PANAL VERADI KASHAYAM

Ref – Sahasrayogam, Parishishta Prakarana, 27

Patha (Cissampelos pareira )

Ikshu mula Roots of (Saccharum officinarum)

Bilwa mula Roots of (Aegle marmelos)

Laja (Parched grain)

Ginger (Zingiber officinale)

The decoction prepared with these ingredients should be served fresh, admixed with powder of Cuminum cyminum

uses-1. Dyspnea / asthma 2. Vomiting

5. MUDGADI KASHAYAM

Ref – Sahasrayogam, Parishishta Prakaranam, 35

Fried green gram( Vigna radiata)

The decoction should be served with parched grains, honey and sugar

uses-1.Vomiting 2.Diarrhea 3.Burning sensation 4.Fever

6. PARPATAKA KASHAYAM

Ref – Sahasrayogam, Parishishta Prakaranam, 35

Parpataka (Fumaria officinalis)

The decoction should be cooled, mixed with honey and administered for oral consumption

uses-1.Vomiting caused by vitiated pitta 2.Raised heat in the head 3.Burning sensation in the eyes

7. BILWADI KASHAYAM

Ref – Sahasrayogam, Parishishta Prakaranam, 37

Bilwa mula Roots of (Aegle marmelos)

The decoction prepared with Aegle marmelos should be added with ¼ quantity milk, boiled, reduced to half. With this, gruel should be prepared by adding powder of cumin seeds and parched grains.

uses-1.Cures vomiting

Water

8. TRAYANTYADI KASHAYAM

RASODHI/BHASMA/PISTI-(120-250MG WITH MADHU/USHNODAKA)

- Chardiripu rasa-(parad,gandhak,naga,vanga,loha,abhrak bhasma)

- Vamankuthar rasa-(gandhak,sheelajitu,tankan,shringbhasma)

- Sutsekhar rasa-(parad,gandhak,tankan,swarna,visa,tamra bhasma,sankh bhasma)

- Mayur Piccha Bhasma-(mayur pankh)

- Mansheeladi yoga-(mansheela,pippali,marich)

- Rasendra yoga-(syaha jeera,dhaniya,choti pippali,parad,gandhak,trikatu)

- Vrish dhuaj rasa-(parad,gandhak,loha,mulethi,svetchandana,tankan)

VATI-(250-500MG WITH USHNA JALA)

- Eladi vati-(ela,vanga,maricha,pippali)

- Lavangadi vati-(lavang,sunthi,kali marich,apamarga,chitrak,tankan)

CURNA-(3-6GM WITH MADHU/USHNODAKA)

- Eladi curna-(chaturjata,lavanga,ela,draksha,mulethi)

- Vidangadi curna-(vidang,triphala,sunth)

- Lajadi curna-(dhana lava,kainth,pipper,marich)

- Avipattikar curna-(triphala,trikatu,vidanga,mustak,nisoth,lavang,mishri)

KVATHA-(20-30ML WITH JALA)

- Jambvadi kvatha-(jamuna,amrapallav,khas,haubera)

- Guduchyadi kvatha-(guduchi,triphala,nimbachal,patol patra)

- Parpatak kvatha-(pittapapda, madhu)

- Chandanadi kvatha-(svetchandan,khas,gandhbala sunthi,vasa,amla,dhan ka lava)

- Dhatriyapanak kvatha-(dhatri,draksha,mishri)

GHRITA/TAILA-(15-20ML WITH USNA JALA/MILK)

- Pandmakadya ghrita-(padmakatha,guduchi,neem,dhaniya,chandana,ghrita)

- Triyshan ghrita-(triphala,trikatu,ghrita)

- Kalyan ghrita-(triphala,daruharidra,devdaru,anantmula,sariva)

- Jeevaniya ghrita-(jevak,rishbhak,meda,dasamula,amlaki,ikshurasa,aja mamsa)

AVLEHA/PAKA(20GM WITH DUGHDHA)

- Jatyadi leha-(amla,kapithya,pippali,marich)

- Jatyadi leha-(amla,kapithya,pippali,marich)

- Chandan kalka leha-(chandan,amlaki,khas,sonth)