148 - Diseases 

Dhanvantari said:

1-2. I shall explain the pathology of Raktapitta (Bilious Haemorrhage). The deranged pitta contaminates the blood. The cause of derangement is the excessive intake of such articles of food as are bile-provoking in character e.g. the grains of Kodrava and Uddalaka. Too hot, bitter, pungent, sour, saline and thirst-inducing foodstuffs also have the similar effect. 

3-4. This mixture of bile and blood has the colour, smell etc of the blood. Hence, in Ayurvedic parlance it is known as Rakta. It comes out of blood vessels, spleen and liver. 

5-7. The onset of this haemorrhage is indicated by various symptoms --Heaviness of the head, non-relish for food, desire to cat cold things, a smoky vision, sour vomiting, nausea, hiccough, gasping for breath, vertigo, fatigue, allergy to red colour, fishy smell in the mouth when the fever abates, reddish, yellow and green colour in the eyes, inability to distinguish the colours of blue, red and yellow and dreams of madness. 

8. The deranged and contaminated blood comes out through nose, eyes, mouth and ears when it flows up or through penis, vagina or anus when it flows down. It comes out of the roots of hair also all over the body. 

9. The egress of bilious blood when it flows up can be cured by means of purgatives. In the case of pitta also it is better to purge it out rather than arrest it with medication. 

10. Purging cleans the system where Kapha persists. Astringent, sweet and Kapha producing drugs can be used in cleansing the system. 

11-12. Or drugs of pungent, bitter and astringent nature naturally generating phlegm can be used. If the haemorrhage takes a downward course and the patient appears to die, emetics are to be used. If the patient is given a little medicine to curb the pitta and then the emetics are applied he will have strength regained. 

13. Astringent and sweet things are alone good for him. If there is concerted action of both Kapha and Vayu on the deranged pitta it is incurable. 

14. If the flow of blood is upward (regressing) it is unbearable and medication is ineffective. Purging then becomes impossible in his case. 

15. In Raktapitta cases of Pratiloma type (upward flow), purging and emetic are the only remedies. 

16-17. But when all the humours are deranged emetic alone is advisable. It should be known that like Shiva's dart the disease is fatal since many unfavourable symptoms and disorders are observed from the beginning. If cure is effected it is good.