The Compendium of Caraka 2.2

English (machine translation) 2.2

Language: English

2.2.1

Now we shall explain the etiology of bleeding disorders (raktapitta).

2.2.3

How pitta in reality acquires the designation 'lohitapitta' [blood-bile], that we shall explain.

When a person mostly eats grains such as wild barley, uddālaka, and koradūṣa, or other food that is intensely hot and sharp, accompanied by alkaline preparations and soups of flat beans, black gram, and horse gram; or moistened with curd, curd water, buttermilk, whey, or sour kāñjika; or meat of wild boar, buffalo, sheep, fish, or cattle, served with oil-cake, piṇḍālu, and dried leafy greens; or side-dishes of radish, mustard, garlic, karañja, moringa, red moringa, sour buttermilk soup, ginger-grass, sumukha, basil, kuṭheraka, gaṇḍīra, kālamālaka, parṇāsa, kṣavaka, and phaṇijjaka; or with after-drinks mostly consisting of surā, sauvīraka, tuṣodaka, maireya, medaka, madhūlaka, vinegar, and sour preparations of jujube or small jujube; or eats excessively of flour-based pastries; or, oppressed by heat, drinks unboiled milk in excessive amounts or out of season; or consumes along with milk the flesh of rauhiṇīka or a one-eyed pigeon cooked in mustard oil and alkali; or, oppressed by heat, drinks milk together with horse gram, oil-cake, rose-apple, monkey-jack cooked preparations, or vinegars—as he behaves in this manner, his pitta becomes provoked, and his blood exceeds its own normal measure.

2.2.4_1

When that [blood] exceeds its normal measure, the provoked pitta, spreading throughout the body, reaches the orifices of the blood-carrying channels that arise from the liver and spleen—which are heavy due to the congestion of blood—blocks them, and corrupts that very blood.

2.2.5

Because of contact [with blood], because of corrupting blood, and because of taking on the smell and colour of blood, pitta is called lohitapitta [blood-bile].

2.2.6

Its premonitory symptoms are these: namely—aversion to food; digestive combustion of what has been eaten; eructations having the smell and taste of vinegar-sourness; frequent emergence of vomiting; disgusting appearance of what has been vomited; hoarseness of voice; lassitude of the limbs; burning sensation all over; a feeling as if smoke were issuing from the mouth; a smell of iron, blood, or raw fish in the mouth; redness, greenness, or yellowness of the limbs, body parts, feces, urine, sweat, saliva, nasal mucus, and the excretions of the mouth and ears, as well as eruptions and boils; aching in the limbs; and frequent seeing in dreams of objects that are red, blue, yellow, or greyish-black and radiating light—[these are the premonitory symptoms of lohitapitta].

2.2.7

Its complications indeed are: debility, anorexia, indigestion, dyspnea, cough, fever, diarrhea, swelling, consumption, jaundice, and hoarseness of voice.

2.2.8

Moreover, its pathways are two: the upward and the downward.

2.2.8_1

In a body abounding in phlegm, moving upward owing to its association with phlegm, it flows out from the ears, nose, eyes, and mouth; but in a body abounding in wind, moving downward owing to its association with wind, it flows out from the pathways of urine and feces; and in a body abounding in both phlegm and wind, owing to its association with phlegm and wind, it takes to both pathways, and taking to those two pathways, it flows out from all the aforesaid orifices of the body.

2.2.9

Among these, that which takes the upward path is curable, because it can be treated by purgation and because of the abundance of medicines [available for it]; that which takes the downward path is manageable, because it can be treated by emesis and because of the scarcity of medicines; that which takes both paths is incurable, because emesis and purgation are not applicable and because no medicines can be employed.

2.2.10

The provocation of raktapitta indeed arose in ancient times upon the destruction of Dakṣa's sacrifice, following fever, in living beings whose bodies and vital breaths were pervaded by the fire of Rudra's wrath and fury.

2.2.11

For the swift pacification of this fast-acting, urgent affliction that has fallen like a forest fire, an attentive [physician] must make an effort, having considered the dosage, the habitat, and the season, by means of nourishing therapy or reducing therapy, with articles of food and drink that are mild, sweet, cooling, bitter, and astringent, or with poultices, sprinklings, immersion baths, tactile applications, or emesis and the like.

2.2.12

And here are [the verses]:

2.2.12_1

That lohitapitta is curable which moves upward,
because purgation is applicable and because medicines are plentiful.

2.2.13

Purgation is the supreme medicine for conquering pitta,
and for the phlegm that is associated with it there, it is traditionally regarded as not inferior.

2.2.14

Sweet medicine would also be suitable in that condition;
therefore, the blood that moves upward is considered curable.

2.2.15

The blood, however, that moves downward is determined to be manageable,
because emesis has limited applicability and because medicines are scarce.

2.2.16

For emesis is not declared to be best in expelling pitta,
and for the pacification of the wind that is associated with it there, it is traditionally regarded as inferior.

2.2.17

Astringent and bitter [medicines] are also unsuitable in that condition;
therefore, that which moves downwards is declared to be manageable.

2.2.18

The raktapitta, however, that takes to both pathways
should be known as incurable, precisely for the reason stated earlier.

2.2.19

For there is no purification whatsoever that acts counter to its path,
and elimination in the direction opposite to the path is prescribed in raktapitta.

2.2.20

Likewise, no pacification is found that works in every way,
and when doshas are combined, a pacifying treatment is thought to be one that conquers all.

2.2.21

Thus has blood[-bile] of three kinds of outcome been described according to the difference in pathways;
but for the following reasons a curable condition may fail to be cured:

2.2.22

Due to absence of attendants and equipment, wicked conduct [of the patient], error of the physician,
or lack of proper treatment, a disease transgresses its curability.

2.2.23

In that matter, [one form of] incurability would arise from the transition out of curability and manageability;
this diagnostic knowledge of raktapitta is taught for it:

2.2.24

That which is black or blue, or resembles a rainbow,
and that raktapitta which stains cloth, is incurable;

2.2.25

and that which is intensely foul-smelling, excessive, accompanied by all complications,
and occurs during loss of strength and muscle tissue—that blood is incurable.

2.2.26

And a man afflicted with raktapitta who sees
visible objects and the sky as red—that is incurable without a doubt.

2.2.27

Among these, the incurable should be rejected; the manageable, one should sustain with effort;
and the curable, the attentive physician should cure with proven remedies.

2.2.28

Here are the two concluding verses:

2.2.28_1

The cause, the derivation of the name, the premonitory symptoms, the complications,
the two pathways, the secondary association of doshas, and curability or non-curability with reasons—

2.2.29

Punarvasu, free from delusion, passion, faults, greed, pride, intoxication, and longing,
has proclaimed in this etiology of raktapitta.

2.2.29_1

Thus ends the second chapter, titled 'The Etiology of Bleeding Disorders (Raktapitta)', in the Section on Etiology (Nidānasthāna) of the treatise composed by Agniveśa and redacted by Caraka. //2

Commentaries (1)

Jalpakalpataru — Gaṅgādhara Kaviratna 1860, Sanskrit

Linked texts (1)

Carakasaṃhitā — Agniveśa (Āyurveda) & Caraka, Sanskrit