The Diagnosis of Raktapitta (Bleeding Disorders)

Verse 1 (garuda.1.148.1)

धन्वन्तरिरुवाच । अथातो रक्तपित्तस्य निदानं प्रवदाम्यहम् । भृशोष्णतिक्तकट्वम्ललवणादिविदाहिभिः

dhanvantariruvāca athāto raktapittasya nidānaṁ pravadāmyaham bhṛśoṣṇatiktakaṭvamlalavaṇādividāhibhiḥ

Dhanvantari said: Now I shall declare the diagnosis of Raktapitta, the bleeding disorder in which Pitta and blood together become vitiated. By intensely hot, bitter, pungent, sour, salty, and similarly burning substances —

Verse 2 (garuda.1.148.2)

कोद्रवोद्दालकैश्चान्यैस्तदुक्तैरति सेवितैः । कुपितं पैत्तिकैः पित्तं द्रवं रक्तञ्च मूर्छति

kodravoddālakaiścānyaistaduktairati sevitaiḥ kupitaṁ paittikaiḥ pittaṁ dravaṁ raktañca mūrchati

and by kodrava grain, uddalaka, and other similarly named foods eaten to excess, Pitta becomes aggravated by pitta-provoking causes, and the liquid blood becomes deranged along with it.

Verse 3 (garuda.1.148.3)

तैर्मिथस्तुल्यरूपत्वमागम्य व्याप्नुवंस्तनुम् । पित्तरक्तस्य विकृतेः संसर्गाद्दषणादपि

tairmithastulyarūpatvamāgamya vyāpnuvaṁstanum pittaraktasya vikṛteḥ saṁsargāddaṣaṇādapi

Through these causes, the two, Pitta and blood, attain a mutual similarity of nature and pervade the body — through the mingling and mutual contamination of their derangement —

Verse 4 (garuda.1.148.4)

गन्धवर्णानुवृत्तेषु रक्तेन व्यपदिश्यते । प्रभवत्यसृजः स्थानात्प्लीहतो यकृतश्च सः

gandhavarṇānuvṛtteṣu raktena vyapadiśyate prabhavatyasṛjaḥ sthānātplīhato yakṛtaśca saḥ

and when the discharge's odor and color follow that of blood, the condition is designated Raktapitta. It arises from the seat of the blood, from the spleen, and from the liver.

Verse 5 (garuda.1.148.5)

शिरोगुरुत्वमरुचिः शीतेच्छा धूमकोऽम्लकः । छर्धितश्छर्दिबै भत्स्यं कासः श्वासो भ्रमः क्लमः

śirogurutvamaruciḥ śītecchā dhūmako'mlakaḥ chardhitaśchardibai bhatsyaṁ kāsaḥ śvāso bhramaḥ klamaḥ

Heaviness of the head, loss of appetite, craving for cold things, a sensation of smoke, sourness, and vomiting — the vomited matter being repulsive — cough, breathlessness, giddiness, and exhaustion —

Verse 6 (garuda.1.148.6)

लोहितो न हितो मत्स्यगन्धास्यात्वञ्च विज्वरे । रक्तहारिद्रहरितवर्णता नयनादिषु

lohito na hito matsyagandhāsyātvañca vijvare raktahāridraharitavarṇatā nayanādiṣu

an unwholesome redness, a fishy odor of the mouth even without fever, and a reddish, yellowish, or greenish discoloration in the eyes and other places —

Verse 7 (garuda.1.148.7)

नीललोहित पीतानां वर्णानामविवेचनम् । स्वप्ने इन्मादधर्मित्वं भवत्यस्मिन्भविष्यति

nīlalohita pītānāṁ varṇānāmavivecanam svapne inmādadharmitvaṁ bhavatyasminbhaviṣyati

an inability to distinguish blue, red, and yellow colors, and seeing inauspicious things in dreams — these signs appear before this disease is about to manifest.

Verse 8 (garuda.1.148.8)

उर्ध्वं नासाक्षिकर्णास्यैर्मेढ्रयोनिगुदैरधः । कुपितं रोमकूपैश्च समस्तैस्तत्प्रवर्तते

urdhvaṁ nāsākṣikarṇāsyairmeḍhrayonigudairadhaḥ kupitaṁ romakūpaiśca samastaistatpravartate

When aggravated, it manifests upward through the nose, eyes, ears, and mouth, and downward through the penis, vagina, and anus, and also through all the hair-follicles.

Verse 9 (garuda.1.148.9)

ऊर्ध्वं साध्यं कफाद्यस्मात्तद्विरेचनसाधितम् । बह्वौषधानि पित्तस्य विरेको हि वरौषधम्

ūrdhvaṁ sādhyaṁ kaphādyasmāttadvirecanasādhitam bahvauṣadhāni pittasya vireko hi varauṣadham

The upward-flowing form, being associated with kapha, is curable and is treated by purgation. Many medicines exist for Pitta, but purgation is indeed the best of them.

Verse 10 (garuda.1.148.10)

अनुबन्धी कफो यत्र तत्र तस्यापि शुद्धिकृत् । कषायाः स्वादवो यस्य विशुद्धौ श्लेष्मला हिताः

anubandhī kapho yatra tatra tasyāpi śuddhikṛt kaṣāyāḥ svādavo yasya viśuddhau śleṣmalā hitāḥ

Where kapha is also a concomitant factor, it too should be purified. Astringent and sweet substances are beneficial in its purification, being effective against kapha —

Verse 11 (garuda.1.148.11)

कटुतिक्तकषाया वा ये निसर्गात्कफावहाः । अधो याप्यञ्च नायुष्मांस्तत्प्रच्छर्दनसाधकम्

kaṭutiktakaṣāyā vā ye nisargātkaphāvahāḥ adho yāpyañca nāyuṣmāṁstatpracchardanasādhakam

or pungent, bitter, and astringent substances that by nature counteract kapha. The downward-flowing form is only palliable, not curable, and for one lacking vitality, emesis is the treatment for it.

Verse 12 (garuda.1.148.12)

अल्पौषधञ्च पित्तस्य वमनं नावमौषधम् । अनुबन्धि बलं यस्य शान्तपित्तनरस्य च

alpauṣadhañca pittasya vamanaṁ nāvamauṣadham anubandhi balaṁ yasya śāntapittanarasya ca

For Pitta, medicine should be given in small measure, and a weak medicine should not be used for emesis. For a person whose Pitta has subsided while some residual strength remains —

Verse 13 (garuda.1.148.13)

कषायश्च हितस्तस्य मधुरा एव केवलम् । कफमारुतसंस्पृष्टमसाध्यमुपनामनम्

kaṣāyaśca hitastasya madhurā eva kevalam kaphamārutasaṁspṛṣṭamasādhyamupanāmanam

astringent remedies are beneficial, and sweet substances alone are suitable. The condition touched by both kapha and vata together is incurable and tends to relapse repeatedly.

Verse 14 (garuda.1.148.14)

असह्यं प्रतिलोमत्वादसाध्यादौषधस्य च । न हि संशोधनं किञ्चिदस्य च प्रतिलोमिनः

asahyaṁ pratilomatvādasādhyādauṣadhasya ca na hi saṁśodhanaṁ kiñcidasya ca pratilominaḥ

It is unbearable, owing to its contrary course, and remains incurable even with medicine; no purificatory treatment at all works for this contrary variety.

Verse 15 (garuda.1.148.15)

शोधनं प्रतिलोमञ्च रक्तपित्तेऽभिसर्जितम् । एवमेवोपशमनं संशोधनमिहेष्यते

śodhanaṁ pratilomañca raktapitte'bhisarjitam evamevopaśamanaṁ saṁśodhanamiheṣyate

In this contrary form of Raktapitta, purificatory treatment is contraindicated; hence only palliative treatment, not purification, is called for here.

Verse 16 (garuda.1.148.16)

संसृष्टेषु हि दोषेषु सर्वथा छर्दनं हितम् । तत्र दोषोऽत्र गमनं शिवास्त्र इव लक्ष्यते

saṁsṛṣṭeṣu hi doṣeṣu sarvathā chardanaṁ hitam tatra doṣo'tra gamanaṁ śivāstra iva lakṣyate

When the humors are commingled, emesis is in every case beneficial. There, the movement of the humor under treatment is observed to be swift and decisive.

Verse 17 (garuda.1.148.17)

उपद्रवाश्च विकृतिं फलतस्तेषु साधितम्

upadravāśca vikṛtiṁ phalatasteṣu sādhitam

And the complications that arise as a consequence of this disorder should likewise be treated according to their respective kinds.