Arshasam Chikitsitam Adhyaya (Remedies of haemorrhoids / piles)

The 8^th chapter of Cikitsasthanam of Ashtanga Hridayam is known as as Arsas Cikitsitam Adhyayah. This chapter offers with the reason of ‘remedy of hemorrhoids / piles.

The subjects lined on this chapter embody –

–   Sadagdha laksana – indicators of correct cauterization
–   Therapy of bladder ache in piles
–   Therapy of shakrt mutra pratighata (obstruction of feces and urine)
–   Bilwadi Taila
–   Kasisadi Taila
–   Arkadi Dhupa
–   Gudavarti
–   Lepa Yogah
–   Raktamokshana – bloodletting
–   Takra prayoga – use of buttermilk
–   Takrarista
–   Chitrakasiddha Takra
–   Medicated gruel, soup, ghee
–   Therapy for sufferers having unfastened and arduous stools
–   Use of Varuni
–   Use of herbs
–   Use of Pathya (Terminalia chebula)
–   Use of Ajasrngi and Vartaka
–   Use of Trivrt and Pathya
–   Use of Takra, Sidhu, Gauda and Sura
–   Vardhamana Pippali
–   Dusparshakadi kashayam
–   Abhayarishta
–   Dantyarista
–   Duralabharista
–   Ghrta Yogas
–   Ahara – weight loss program in piles
–   Anuvasana – oil for enema remedy
–   Niruha – decoction for enema remedy
–   Raktarsas Cikitsa – remedy of bleeding piles
–   Shodhana and Langhana
–   Tikta pachana and dipana
–   Snehana
–   Stambhana Cikitsa
–   Kashaya for Rajtaja Arsas related to Kapha
–   Kutajadi Curna
–   Kutajadi Leham
–   Lodhradi Yoga
–   Yastyahvadi Yoga
–   Lodhradi Yoga
–   Yavanyadi Curna
–   Sarkaradi Yoga
–   Good meals and wine for bleeding piles
–   Best issues for Vataja Raktarshas
–   Controlling Vata and bleeding in bleeding hemorrhoids
–   Indication of coolant measures
–   Tarpana and Avapeedaka
–   Pichcha Basti
–   Anuvasana Basti
–   Madhukadi Ghrta
–   Vyatyasa Chikitsa
–   Varti – suppository
–   Churna vinirdhamana
–   Kalyanaka Ksara
–   Therapy of gadavarca arshas
–   Putikaranjadi Yoga
–   Chukra Prayoga
–   Pilvadi Yoga
–   Dasamuladi Guda
–   Chitrakadi Leham
–   Vyoshadi Gutika
–   Use of Surana
–   Maricadi Guda
–   Suranadi Pindi   
–   Pathyadi Curna
–   Kalingadi Guda
–   Lavanottamadi Curna
–   Use of Bhallataka, Kutaja and Kalasheya
–   Rules for utilizing superb meals and drinks in piles
–   Significance of defending the digestive hearth in piles and different problems

Pledge by the writer (s)

अथातो रक्तपित्तचिकित्सितं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having provided prayers to God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘hemorrhoids / piles’. Thus say (pledge) atreya and different sages.

Kshara-Agnikarma: Cauterization with alkali and hearth

काले साधारणे व्यभ्रे नातिदुर्बलमर्शसम् ।
विशुद्धकोष्ठं लघ्वल्पमनुलोमनमाशितम् ॥ १ ॥
शुचिं कृतस्वस्त्ययनं मुक्तविण्मूत्रमव्यथम् ।
शयने फलके वाऽन्यनरोत्सङ्गे व्यपाश्रितम् ॥ २ ॥
पूर्वेण कायेनोत्तानं प्रत्यादित्यगुदं समम् ।
समुन्नतकटीदेशमथ यन्त्रणवाससा ॥ ३ ॥
सक्थ्नोः शिरोधरायां च परिक्षिप्तमृजु स्थितम् ।
आलम्बितं परिचरैः सर्पिषाऽभ्यक्तपायवे ॥ ४ ॥
ततोऽस्मै सर्पिषाऽभ्यक्तं निदध्यादृजु यन्त्रकम् ।
शनैरनुसुखं पायौ ततो दृष्ट्वा प्रवाहणात् ॥ ५ ॥
यन्त्रे प्रविष्टं दुर्नाम प्लोतगुण्ठितयाऽनु च ।
शलाकयोत्पीड्य भिषग्यथोक्तविधिना दहेत् ॥ ६ ॥
क्षारेणैवार्द्रमितरत् क्षारेण ज्वलनेन वा ।
महद्वा बलिनश्छित्त्वा वीतयन्त्रमथातुरम् ॥ ७ ॥
स्वभ्यक्तपायुजघनमवगाहे निधापयेत् ।
निर्वातमन्दिरस्थस्य ततोऽस्याचारमादिशेत् ॥ ८ ॥
एकैकमिति सप्ताहात् सप्ताहात् समुपाचरेत् ।
प्राग्दक्षिणं ततो वाममर्शः पृष्ठाग्रजं ततः ॥ ९ ॥
Throughout Sadharana Kala (average seasons resembling autumn and spring), on a cloudless day, the affected person of hemorrhoids, who just isn’t very weak, whose alimentary tract has been purified, who has consumed easily-digestible and laxative meals in little amount, who’s clear, who has carried out auspicious rites, who has eradicated the feces and urine, who’s free from worries, who’s sleeping both on a cot or plank, or different horizontal surfaces with the higher portion of the physique positioned a little bit excessive, the rectum dealing with the solar, the area of the waist raised up, the thighs and neck restrained, by tying them with material (made as rope), and positioned straight and held tightly, suspended by attendants. The rectum is bathed with ghee, then, the Yantra (Arso Yantra – rectal speculum) which is smeared with ghee is launched slowly straight into the rectum (following the passage of rectum) in a snug approach; then observing the pile mass stepping into the instrument (into the slit of the rectal speculum) after straining, it’s raised with the assistance of a probe which is roofed at its tip with cotton swab; then the doctor ought to cauterize it with caustic Alkali based on the technique defined provided that it (piles) is of the moist form (bleeding piles) and the opposite form (non-bleeding) with both caustic Alkali or hearth (touching a crimson sizzling metallic probe and so forth.) or excising (with sharp instrument) if the pile mass is large, particularly in sturdy sufferers. Afterwards, the instrument is eliminated, the rectum and pelvis smeared with fat (ghee or oil) and the affected person requested to take a seat in a bath (containing lukewarm or chilly water (processed with herbs) saved in a chamber devoid of breeze (for someday) after which instructed to stick to the procedures (vide verses 26 and 27 of chapter 16 of Sutrasthana). The pile lots, one after the other; must be handled week after week on this method, that located on the proper aspect handled first and subsequent, that located on the left, after which the highest on, when there are a number of lots.

Sadagdha lakshana: Indicators of correct cauterization

बह्वर्शसः सुदग्धस्य स्याद्वायोरनुलोमता ।
रुचिरन्नेऽग्निपटुता स्वास्थ्यं वर्णबलोदयः ॥ १० ॥
When the cauterization is correct, there’s downward motion of Vata, want for meals, keenness of digestive hearth, well being and improve of energy and colour /complexion.

Therapy of bladder ache in piles

बस्ति शूले त्वधो नाभेर्लेपयेच्छ्लक्ष्णकल्कितैः ।
वर्षाभूकुष्ठसुरभिमिशिलोहामराह्वयैः ॥ ११ ॥
If there’s ache within the area of the bladder, skinny paste of varṣābhū – Boerhavia diffusa, kuṣṭha – Saussurea lappa, surabhi – Ocimum sanctum / Pluchea lanceolata, miśi – Foeniculum vulgare, loha – Aquilaria agallocha, amarāhvayaiḥ tu – and Cedrus deodara must be utilized, under the umbilicus.

Therapy of shakrt mutra pratighata (obstruction of feces and urine)

शकृन्मूत्रप्रतीघाते परिषेकावगाहयोः ।
वरणालम्बुषैरण्डगोकण्टकपुनर्नवैः ॥ १२ ॥
सुषवीसुरभीभ्यां च क्वाथमुष्णं प्रयोजयेत् ।
सस्नेहमथवा क्षीरं तैलं वा वातनाशनम् ॥ १३ ॥
युञ्जीतान्नं शकृद्भेदि स्नेहान् वातघ्नदीपनान् ।
If there’s obstruction / problem for elimination of feces and urine, decoction of varaṇa – Crataeva nurvala, alambuṣa – Biophytum sensitivum / Sphaeranthus indicus, eraṇḍa – Ricinus communis, gokaṇṭaka – Tribulus terrestris, punarnava – Boerhavia diffusa, suṣavī – Carum carvi, surabhībhi – Ocimum sanctum must be made use of for pouring over the half (pelvis) and immersing in it, made heat and blended with fats (ghee); or milk or oil which mitigates Vata must be used (for pouring and immersing). The meals which is purgatory and fat (ghee) which mitigate Vata and are carminative must be administered.

Bilwadi Taila

अथाप्रयोज्यदाहस्य निर्गतान् कफवातजान् ॥ १४ ॥
सस्तम्भकण्डूरुक्शोफानभ्यज्य गुदकीलकान् ।
बिल्वमूलाग्निकक्षारकुष्ठैः सिद्धेन सेचयेत् ॥ १५ ॥
तैलेनाहिबिडालोष्ट्रवराहवसयाऽथवा।
Additional, these pile lots, that are unsuitable for cauterization and are of kapha or vata in origin, that are stiff / protruding, itching, painful and swollen must be massaged with (under talked about bilwadi oil) and must be bathed by pouring the oil boiled with bilvamūla – root of Aegle marmelos, agnika – Plumbago zeylanica, kṣāra – alkali, kuṣṭha – Saussurea lappa, or with the fats of snake, cat, camel or boar.

Bilwadi Taila

स्वेदयेदनु पिण्डेन द्रवस्वेदेन वा पुनः ॥ १६ ॥
सक्तूनां पिण्डिकाभिर्वा स्निग्धानां तैलसर्पिषा ।
रास्नाया हपुषाया वा पिण्डैर्वा कार्ष्ण्यगन्धिकैः ॥ १७ ॥
Subsequent, the pile lots must be given fomentation both with the bolus (of herbs) or liquids or with balls of flour blended with oil and ghee or with bolus of rāsnā – Pluchea lanceolata, hapuṣā – Juniperus communis, kārṣṇya gandhika – Moringa oleifera blended with oil and ghee.

Kasisadi Taila

कासीसं सैन्धवं रास्ना शुण्ठी कुष्ठं च लाङ्गली ।
शिलाभ्रकाश्वमारं च जन्तुहृद्दन्तिचित्रकौ ॥ १६-१+ (१) ॥
हरितालं तथा स्वर्णक्षीरी तैश्च पचेत्समैः ।
तैलं सुधार्कपयसी गवां मूत्रे चतुर्गुणे ॥ १६-१+ (२) ॥
एतदभ्यङ्गतोऽर्शांसि क्षारवत्पातयेद्द्रुतम् ।
क्षारकर्मकरं ह्येतन्न च दूषयते वलीम् ॥ १६-१+ (३) ॥
Medicated oil is ready from decoction of equal portions of kāsīsaṃ – inexperienced vitriol, saindhavaṃ – rock salt, rāsnā – Pluchea lanceolata, śuṇṭhī – Zingiber officinale, kuṣṭhaṃ – Saussurea lappa, lāṅgalī – Gloriosa superba, śilā – Bitumen, abhraka – mica, aśvamāraṃ – Nerium oleander, jantuhṛt – Embelia ribes, danti – Baliospermum montanum, citraka – plumbago zeylanica, haritālaṃ – Arsenic trisulphide, svarṇakṣīrī – Argemone mexicana; milky sap of sudhā arka – Euphorbia neriifolia, Calotropis gigantea and cow’s urine. These must be taken 4 components every by anointing with this oil, the pile lots fall off as if touched by Alkali; it performs the actions of the Alkali and doesn’t hurt the folds of the rectum.

Arkadi Dhupa

अर्कमूलं शमीपत्रं नृकेशः सर्पकञ्चुकम् ।
मार्जारचर्म सर्पिश्च धूपनं हितमर्शसाम् ॥ १८ ॥
तथाऽश्वगन्धा सुरसा बृहती पिप्पली घृतम् ।
Fumigation with arkamūlaṃ – roots of Calotropis gigantea, śamīpatraṃ – Prosopis cineraria, nṛkeśaḥ – human hairs, sarpa kañcukam – snake peel, mārjāra carma – and pores and skin of cat, blended with ghee is sweet for piles. Equally, aśvagandhā – Withania somnifera, surasā – Ocimum sanctum, bṛhatī – Solanum indicum, pippalī – and Piper longum blended with ghee.

Gudavarti

धान्याम्लपिष्टैर्जीमूतबीजैस्तज्जालकं मृदु ॥ १९ ॥
लेपितं छायया शुष्कं वर्तिर्गुदजशातनी ।
सजालमूलजीमूतलेहे वा क्षारसंयुते ॥ २० ॥
गुञ्जासूरणकूष्माण्डबीजैर्वर्तिस्तथागुणा ।
Seeds of Luffa echinata and its Jalaka (web-like portion current inside Jimuta fruit) macerated with fermented gruel, made into a pleasant paste, is utilized over a reed and dried in shade. This wick (rectal suppository) destroys the piles. Equally the confection ready from the net and roots of Luffa echinata blended with Ksara (Yavakshara – alkali of entire plant of Hordeum vulgare) ; likewise the rectal suppository ready from guñjā – Abrus precatorius, sūraṇa – Amorphophallus campanulatus kūṣmāṇḍa bījai: – and seeds of Benincasa hispida possess comparable properties.

Lepa Yogah

स्नुक्क्षीरार्द्रनिशालेपस्तथा गोमूत्रकल्कितैः ॥ २१ ॥
कृकवाकुशकृत्कृष्णानिशागुञ्जाफलैस्तथा ।
स्नुक्क्षीरपिष्टैः षड्ग्रन्थाहलिनीवारणास्थिभिः ॥ २२ ॥
कुलीरशृङ्गीविजयाकुष्ठारुष्करतुत्थकैः ।
शिग्रुमूलकजैर्बीजैः पत्रैरश्वघ्ननिम्बजैः ॥ २३ ॥ १३७५
पीलुमूलेन बिल्वेन हिङ्गुना च समन्वितैः ।
कुष्ठं शिरीषबीजानि पिप्पल्यः सैन्धवं गुडः ॥ २४ ॥
अर्कक्षीरं सुधाक्षीरं त्रिफला च प्रलेपनम् ।
आर्कं पयः सुधाकाण्डं कटुकालाबुपल्लवाः ॥ २५ ॥
करञ्जो बस्तमूत्रं च लेपनं श्रेष्ठमर्शसाम् ।
Equally the appliance of paste of snukkṣīra – milk of Euphorbia neriifolia, ārdra niśā – and moist Curcuma longa or of excreta of the cock, kṛṣṇā – Piper longum, niśā – Curcuma longa, guñjāphalai: – Abrus precatorius macerated with cow urine. Paste of roots of ṣaḍgranthā – Piper longum, halinī – Gloriosa superba, bones of the elephant, kulīra śṛṅgī – Pistacia chinensis, vijayā – Terminalia chebula, kuṣṭha – Saussurea lappa, aruṣkara – Semecarpus anacardium, tutthaka – blue vitriol), seeds and roots of śigru – Moringa oleifera, leaves of aśvaghna – Nerium indicum, and nimbaja – Azadirachta indica, root of pīlu – Salvadora persica, bilva – and Aegle marmelos, macerated with the milky sap of snuk – Euphorbia neriifolia, hiṅgunā ca samanvitaiḥ – blended with Ferula narthex (utilized on the piles act equally). Utility of paste of kuṣṭhaṃ – Saussurea lappa, śirīṣa bījāni – seeds of Albizia lebbeck, pippali – Piper longum, saindhavaṃ – rock salt, guḍaḥ – jaggery, Latex of arka – Calotropis gigantea, sudhākṣīraṃ – Latex of Euphorbia neriifolia, triphalā – and Triphala (is useful). Utility of latex of ārka – Calotropis gigantea, sudhākāṇḍaṃ – stem of Euphorbia neriifolia, kaṭukālābu pallavāḥ – tender leaves of Lagenaria siceraria, and karañja – Pongamia pinnata and goat urine is finest for piles.

Lepa Yogah

आनुवासनिकैर्लेपः पिप्पल्याद्यैश्च पूजितः ॥ २६ ॥
एभिरेवौषधैः कुर्यात्तैलान्यभ्यञ्जनाय च ।
Utility of paste of herbs resembling Piper longum and so forth. meant for Anuvasana (oil enema) (vide verses 89 to 92) is taken into account finest; oil ready from these herbs is sweet for anointing on the piles.

Raktamokshana: Bloodletting

धूपनालेपनाभ्यङ्गैः प्रस्रवन्ति गुदाङ्कुराः ॥ २७ ॥
सञ्चितं दुष्टरुधिरं ततः सम्पद्यते सुखी ।
The pile lots eradicate the vitiated blood accrued inside them by the usage of fumigation, topical utility and anointing; after that the affected person obtains consolation.

Raktamokshana: Bloodletting

अवर्तमानमुच्छूनकठिनेभ्यो हरेदसृक् ॥ २८ ॥
अर्शोभ्यो जलजाशस्त्रसूचीकूर्चैः पुनः पुनः ।
शीतोष्णस्निग्धरूक्षैर्हि न व्याधिरुपशाम्यति ॥ २९ ॥
रक्ते दुष्टे भिषक् तस्माद्रक्तमेवावसेचयेत् ।
For the hemorrhoid pile lots that are coiled, swollen and arduous, blood must be eliminated many times by way of both leeches, knife or brush of needles. When the blood is vitiated, the illness (piles) doesn’t get relieved by remedies resembling cold and warm, unctuous and dry remedies. Therefore the doctor ought to take away the blood itself.

Takra prayoga: Use of buttermilk

यो जातो गोरसः क्षीराद्वह्निचूर्णावचूर्णितात् ॥ ३० ॥
पिबंस्तमेव तेनैव भुञ्जानो गुदजान् जयेत् ।
कोविदारस्य मूलानां मथितेन रजः पिबन् ॥ ३१ ॥
अश्नन् जीर्णे च पथ्यानि मुच्यते हतनामभिः ।
He who drinks milk boiled with the powder of Plumbago zeylanica and eats meals together with it solely, will get cured of piles. He who drinks buttermilk blended with / macerated with the powder of roots of Bauhinia variegata and eats appropriate meals solely after its digestion will get cured of piles.

Takra prayoga: Use of buttermilk

गुदश्वयथुशूलार्तो मन्दाग्निर्गौल्मिकान् पिबेत् ॥ ३२ ॥
हिङ्ग्वादीननुतक्रं वा खादेद्गुडहरीतकीम् ।
तक्रेण वा पिबेत्पथ्यावेल्लाग्निकुटजत्वचः ॥ ३३ ॥
कलिङ्गमगधाज्योतिःसूरणान् वांऽशवर्धितान् ।
कोष्णाम्बुना वा त्रिपटुव्योषहिङ्ग्वम्लवेतसम् ॥ ३४ ॥
He who has swelling and ache within the rectum, poor digestion and stomach tumor ought to eat Hingvadi Churna (chapter 14) with buttermilk as after-drink, eat jaggery and Terminalia chebula with buttermilk one ought to drink (powder of) pathyā – Terminalia chebula, vella – Embelia ribes, agni – Plumbago zeylanica, kuṭaja tvacaḥ – bark of Holarrhena antidysenterica; kaliṅga – or (powder of) Holarrhena antidysenterica, magadhā – Piper longum, jyotiḥ – Plumbago zeylanica, sūraṇān – Amorphophallus campanulatus every succeeding one elevated by one half than its previous must be consumed with heat water (or buttermilk) powder of the three salts, vyoṣa – Piper longum, Piper nigrum and Zingiber officinale, hiṅgu – Ferula narthex, amlavetasam – Garcinia pedunculata.

Takra prayoga: Use of buttermilk

युक्तं बिल्वकपित्थाभ्यां महौषधविडेन वा ।
अरुष्करैर्यवान्या वा प्रदद्यात्तक्रतर्पणम् ॥ ३५ ॥
दद्याद्वा हपुषाहिङ्गुचित्रकं तक्रसंयुतम् ।
मासं तक्रानुपानानि खादेत्पीलुफलानि वा ॥ ३६ ॥
पिबेदहरहस्तक्रं निरन्नो वा प्रकामतः ।
अत्यर्थं मन्दकायाग्नेस्तक्रमेवावचारयेत् ॥ ३७ ॥
Takra Tarpana (buttermilk blended with flour of barley (Hordeum vulgare) blended with bilva – Aegle marmelos, kapittha – Limonia acidissima, mahauṣadha – Zingiber officinale and Vida salt aruṣkara – Semecarpus anacardium, yavānyā vā – Trachyspermum ammi must be given to drink particularly; or butter milk blended with the hapuṣā – Juniperus communis, hiṅgu – Ferula narthex, citrakaṃ saṃyutam – and Plumbago zeylanica must be given (to drink); eat the fruits of Salvadora persica just for one month with buttermilk as an after-drink; or drink buttermilk solely, with none meals, commonly, as a lot as desired. For many who have very weak digestive energy, buttermilk solely must be given particularly (with out some other meals).

Takra prayoga: Use of buttermilk

सप्ताहं वा दशाहं वा मासार्धं मासमेव च ।
बलकालविकारज्ञो भिषक् तक्रं प्रयोजयेत् ॥ ३८ ॥
सायं वा लाजसक्तूनां दद्यात्तक्रावलेहिकाम् ।
जीर्णे तक्रे प्रदद्याद्वा तक्रपेयां ससैन्धवाम् ॥ ३९ ॥
तक्रानुपानं सस्नेहं तक्रौदनमतः परम् ।
यूषै रसैर्वा तक्राढ्यैः शालीन् भुञ्जीत मात्रया ॥ ४० ॥
The doctor who has understood the energy of the affected person, time, season and the character of the illness ought to administer buttermilk for seven or ten days, half a month or one month; or Lajasaktu (powder of fried paddy) made right into a paste with buttermilk may be given within the evenings. After the buttermilk will get digested, gruel blended with buttermilk added with rock salt must be given. Then, boiled rice blended with buttermilk, then added with ghee must be consumed adopted by buttermilk as an after drink; or boiled rice may be consumed in correct amount both with soup, meat soup blended with extra of buttermilk.

Takra prayoga: Use of buttermilk

रूक्षमर्धोद्धृतस्नेहं यतश्चानुद्धृतं घृतम् ।
तक्रं दोषाग्निबलवित्त्रिविधं तत्प्रयोज्येत् ॥ ४१ ॥
Buttermilk may be administered in three kinds: dry (fatless), eliminated of half of fats, and never eliminated of fats in any respect, relying on the situation of the Doshas and energy of the digestive hearth.

Takra prayoga: Use of buttermilk

न विरोहन्ति गुदजाः पुनस्तक्रसमाहताः ।
निषिक्तं तद्धि दहति भूमावपि तृणोलुपम् ॥ ४२ ॥
Pile lots don’t develop once more, which have been rooted out by way of buttermilk, as a result of it (buttermilk) burns away (destroys) even the grass when poured on the bottom.

Takra prayoga: Use of buttermilk

स्रोतःसु तक्रशुद्धेषु रसो धातूनुपैति यः ।
तेन पुष्टिर्बलं वर्णः परं तुष्टिश्च जायते ॥ ४३ ॥
वातश्लेष्मविकाराणां शतं च विनिवर्तते ।
मथितं भाजने क्षुद्रबृहतीफललेपिते ॥ ४४ ॥
निशां पर्युषितं पेयमिच्छद्भिर्गुदजक्षयम् ।
Rasa Dhatu transferring via the channels purified by buttermilk simply reaches all of the tissues; by this nourishment, energy, complexion, and better of satiation are produced, and tons of of ailments attributable to Vata and Sleshman (Kapha) get cured. Buttermilk saved in a single day in a pot smeared inside with the paste of fruits of Solanum indicum and nicely churned the following morning must be consumed by those that want to get cured of hemorrhoids.

Takrarista

धान्योपकुञ्चिकाजाजीहपुषापिप्पलीद्वयैः ॥ ४५ ॥
कारवीग्रन्थिकशठीयवान्यग्नियवानकैः ।
चूर्णितैर्घृतपात्रस्थं नात्यम्लं तक्रमासुतम् ॥ ४६ ॥
तक्रारिष्टं पिबेज्जातं व्यक्ताम्लकटु कामतः ।
दीपनं रोचनं वर्ण्यं कफवातानुलोमनम् ॥ ४७ ॥
गुदश्वयथुकण्ड्वर्तिनाशनं बलवर्धनम् ।
Buttermilk fermented in a pot smeared inside with the ghee, is blended with (powder of) dhānya – Coriandrum sativum, upakuñcika – Nigella sativa, ajājī – Cuminum cyminum, hapuṣā – Juniperus communis, pippalīdvayaiḥ – Piper longum and Scindapsus officinalis, kāravī – Carum carvi, granthika – Piper longum, śaṭhī – Curcuma zedoaria, yavāni – Trachyspermum ammi, agni – Plumbago zeylanica, yavānaka – Apium graveolens – is allowed to ferment. When it turns into not very sourbut of perceptible bitter and will get pungent tastes, it must be consumed as a lot as desired. This recipe referred to as Takrarista is carminative, appetizer, bestows colour / complexion, results in downward motion of Kapha and Vata, cures the swelling, itching and cures ache of the rectum and will increase energy.

Chitrakasiddha Takra

त्वचं चित्रकमूलस्य पिष्ट्वा कुम्भं प्रलेपयेत् ॥ ४८ ॥
तक्रं वा दधि वा तत्र जातमर्शोहरं पिबेत् ।
भार्ग्यास्फोतामृतापञ्चकोलेष्वप्येष संविधिः ॥ ४९ ॥
A pot must be smeared inside with the paste of bark of citraka – Plumbago zeylanica buttermilk or dadhi vā – curds put into it and saved in a single day; it must be consumed for the remedy of piles. Equally, these ready with (paste of) bhārgī – Clerodendrum serratum, asphota – Vallaris solanacea, amṛtā – Tinospora cordifolia and Panchakola.

Medicated gruel, soup, ghee

पिष्टैर्गजकणापाठाकारवीपञ्चकोलकैः ।
तुम्बुर्वजाजीधनिकाबिल्वमध्यैश्च कल्पयेत् ॥ ५० ॥
फलाम्लान् यमकस्नेहान् पेयायूषरसादिकान् ।
एभिरेवौषधैः साध्यं वारि सर्पिश्च दीपनम् ॥ ५१ ॥
Paste of gajakaṇā – Scindapsus officinalis, pāṭhā – Cissampelos pariera, kāravī – Carum carvi, Panchakola, tumbu: – Zanthoxylum alatum, ajājī – Cuminum cyminum, dhanikā – Coriandrum sativum, and marrow of bilva – Aegle marmelos is to be made use of to arrange bitter syrup of fruits, combination of two fat, skinny gruel, soup or meat-soup, consuming water and medicated ghee ready by these herbs are carminatives.

क्रमोऽयं भिन्नशकृतां वक्ष्यते गाढवर्चसाम् ।
These remedies are meant for individuals who’ve unfastened feces; additional on, will probably be described to these of arduous feces.

Use of Varuni

स्नेहाढ्यैः सक्तुभिर्युक्तां लवणां वारुणीं पिबेत् ॥ ५२ ॥
लवणा एव वा तक्रसीधुधान्याम्लवारुणीः ।
Varuni (a form of wine) must be consumed by mixing it with extra fat, corn-flour and salt; or buttermilk, Sidhu, Dhanyamla; or Varuni added with salt solely.

Anulomana Saktu

प्राग्भक्तान् यमके भृष्टान् सक्तुभिश्चावचूर्णितान् ॥ ५३ ॥
करञ्जपल्लवान् खादेद्वातवर्चोऽनुलोमनान् ।
karañja pallavān – Tender leaves of Pongamia pinnata fried in a mix of two fat (oil and ghee) added with powdered flour must be consumed earlier than the primary meal; it strikes the flatus and faeces downward.

Use of herbs

सगुडं नागरं पाठां गुडक्षारघृतानि वा ॥ ५४ ॥
गोमूत्राध्युषितामद्यात् सगुडां वा हरीतकीम् ।
nāgaraṃ – Zingiber officinale, pāṭhāṃ – Cissampelos pareira added with jaggery or jaggery with alkali and Ghrta (ghee), harītakīm – or Terminalia chebula soaked in cow urine must be consumed first with jaggery.

Use of Pathya (Terminalia chebula)

पथ्याशतद्वयान् मूत्रद्रोणेनामूत्रसङ्क्षयात् ॥ ५५ ॥
पक्वात् खादेत्समधुनी द्वे द्वे हन्ति कफोद्भवान् ।
दुर्नामकुष्ठश्वयथुगुल्ममेहोदरकृमीन् ॥ ५६ ॥
ग्रन्थ्यर्बुदापचीस्थौल्यपाण्डुरोगाढ्यमारुतान् ।
pathyā – Terminalia chebula – 200 in quantity, is cooked in 12.288 liters of cow urine until the urine will get evaporated. Two such cooked Pathya blended with honey consumed at every time cures piles attributable to kapha, kuṣṭha – pores and skin ailments, śvayathu – dropsy, gulma – stomach tumor, meha – diabetes, udara – enlargement of the stomach, kṛmi – intestinal worms, granthi – tumors, arbuda – malignant tumors, apacī – goiter, sthaulya – weight problems, pāṇḍuroga – anaemia, āḍhyamārutān – and rigidity of the thighs arising fom Kapha. 

Use of Ajashringi and Vartaka

अजशृङ्गीजटाकल्कमजामूत्रेण यः पिबेत् ॥ ५७ ॥
गुडवार्ताकभुक् तस्य नश्यन्त्याशु गुदाङ्कुराः ।
Piles of the one who drinks goat urine blended with the paste of root of Gymnema sylvestre and consuming jaggery and Solanum indicum as meals, will get cured rapidly.

Use of Trivrit and Pathya

श्रेष्ठारसेन त्रिवृतां पथ्यां तक्रेण वा सह ॥ ५८ ॥
पथ्यां वा पिप्पलीयुक्तां घृतभृष्टां गुडान्विताम् ।
अथवा सत्रिवृद्दन्तीं भक्षयेदनुलोमनीम् ॥ ५९ ॥
हते गुदाश्रये दोषे गुदजा यान्ति सङ्क्षयम् ।
trivṛtāṃ – Operculina turpethum consumed with decoction of Triphala, Terminalia chebula with buttermilk; or Pathya (Terminalia chebula) fried in ghee together with Pippali (Piper longum) and blended with Guda (jaggery) or Terminalia chebula blended with – trivṛt – Operculina turpethum, dantīṃ – Baliospermum montanum must be consumed acts as an laxative; when the doshas localized within the rectum are mitigated, the rectal sprouts additionally get subsided.

Use of Takra, Sidhu, Gauda and Sura

दाडिमस्वरसाजाजीयवानीगुडनागरैः ॥ ६० ॥|
पाठया वा युतं तक्रं वातवर्चोऽनुलोमनम् ।
सीधुं वा गौडमथवा सचित्रकमहौषधम् ॥ ६१ ॥
पिबेत् सुरां वा हपुषापाठासौवर्चलान्विताम् ।
Buttermilk, blended with juice of dāḍima – Punica granatum, ajājī – Cuminum cyminum, yavānī – Trachyspermum ammi, guḍa – jaggery, nāgara – and Zingiber officinale, or pāṭhaā – Cissampelos pareira, vāta varco anulomanam – strikes the flatus and faeces downwards. Equally, Sidhu or Gauda (sorts of liquor) blended with citraka – Plumbago zeylanica, mahauṣadham – Zingiber officinale; or Sura (beer) must be consumed blended with hapuṣā – Juniperus communis, pāṭhā – Cissampelos pareira and black salt.

Vardhamana Pippali

दशादिदशकैर्वृद्धाः पिप्पलीर्द्विपिचुं तिलान् ॥ ६२ ॥
पीत्वा क्षीरेण लभते बलं देहहुताशयोः ।
Commencing with ten, elevated by ten every day, pippalī: – Piper longum blended with two Pichu (2 Karsha – 24 grams) of Sesamum indicum boiled in milk and consumed; by this the particular person attains energy of the physique and of the digestive hearth.

Dusparshakadi Kashayam

दुःस्पर्शकेन बिल्वेन यवान्या नागरेण वा ॥ ६३ ॥
एकैकेनापि संयुक्ता पाठा हन्त्यर्शसां रुजम् ।
pāṭhā – Cissampelos pareira consumed together with duḥsparśaka – Alhagi camelorum, bilva – Aegle marmelos, yavāni – Trachyspermum ammi, nāgara – or Zingiber officinale each individually (or all collectively) cures the ache of the piles.

Abhayarishta

सलिलस्य वहे पक्त्वा प्रस्थार्धमभयात्वचाम् ॥ ६४ ॥
प्रस्थं धात्र्या दशपलं कपित्थानां ततोऽर्धतः ।
विशालां लोध्रमरिचकृष्णावेल्लैलवालुकम् ॥ ६५ ॥
द्विपलांशं पृथक् पादशेषे पूते गुडात्तुले ।
दत्त्वा प्रस्थं च धातक्याः स्थापयेद्घृतभाजने ॥ ६६ ॥
पक्षात् स शीलितोऽरिष्टः करोत्यग्निं निहन्ति च ।
गुदजग्रहणीपाण्डुकुष्ठोदरगरज्वरान् ॥ ६७ ॥
श्वयथुप्लीहहृद्रोगगुल्मयक्ष्मवमिकृमीन् ।
Half Prastha (384 grams) of fruit pores and skin of Terminalia chebula, one Prastha (768 grams) of Emblica officinalis ten Pala (480 grams) of Limonia acidissima, half of it of Citrullus colocynthis, lodhra – Symplocos racemosa, marica – Piper nigrum, kṛṣṇā – Piper longum, vella – Embelia ribes, elavālukam – Prunus cerasus every two Pala (96 grams) are boiled in two Vaha (4 Drona – 48.9 Litres) of water, decoction lowered to 1 / 4, filtered and blended with one Tula (4.8 Kg) of jaggery and one Prastha (768 grams) of Woodfordia fruticose. It’s then stuffed right into a pot smeared inside with ghee and saved undisturbed for a fortnight. This Arista consumed every day, will increase digestive energy and cures gudaja – piles, grahaṇī – duodenal ailments, pāṇḍu – anaemia, kuṣṭha – pores and skin ailments, udara – ascites, gara – synthetic poison, jvara – fever, śvayathu – dropsy, plīha – splenic problems, hṛdroga – coronary heart ailments, gulma – stomach tumour, yakṣma – tuberculosis, vami – vomiting, kṛmi – and worms.

Dantyarista

जलद्रोणे पचेद्दन्तीदशमूलवराग्निकान् ॥ ६८ ॥
पालिकान् पादशेषे तु क्षिपेद्गुडतुलां परम् ।
पूर्ववत्सर्वमस्य स्यादानुलोमितरस्त्वयम् ॥ ६९ ॥
dantī – Baliospermum montanum, daśamūla – Dashamula, varā – Terminalia chebula, Terminalia bellirica and Emblica officinalis, agnika – Plumbago zeylanica each Pala (48 g) are boiled in a single Drona (12 Litres 228 ml) of water and decoction lowered to 1 / 4; after filtering, one Tula (4.8 Kg) of jaggery and all of the herbs enumerated earlier (in Abhayarista) are added, and saved undisturbed for a fortnight after which used acts as laxative.

Duralabharista

पचेद्दुरालभाप्रस्थं द्रोणेऽपां प्रासृतैः सह ।
दन्तीपाठाग्निविजयावासामलकनागरैः ॥ ७० ॥
तस्मिन् सिताशतं दद्यात् पादस्थेऽन्यच्च पूर्ववत् ।
लिम्पेत्कुम्भं तु फलिनीकृष्णाचव्याज्यमाक्षिकैः ॥ ७१ ॥
One Prastha (768 grams) of Fagonia cretica, together with one Prasrta (768 grams), every of – dantī – Baliospermum montanum, pāṭhā – Cissampelos pareira, agni – Plumbago zeylanica, Vijayā – Terminalia chebula, vāsā – Adhatoda vasica, āmalaka – Emblica officinalis, Nāgara – Zingiber officinale are boiled in a single Drona (120 Litres 228 ml) of water and decoction lowered to 1 / 4; to that is added 100 Pala (4.8 Kg) of sugar and different herbs as enumerated beforehand and poured right into a pot smeared inside with a paste phalinī – Lagenaria sicerania / Callicarpa macrophylla, kṛṣṇā – Piper longum, cavya – Piper retrofractum, ājya – ghee, mākṣika – and honey; this recipe acts equally.      

Ghrita Yogas

प्राग्भक्तमानुलोम्याय फलाम्लं वा पिबेद्घृतम् ।
चव्यचित्रकसिद्धं वा यवक्षारगुडान्वितम् ॥ ७२ ॥
पिप्पलीमूलसिद्धं वा सगुडक्षारनागरम् || ७७ ॥
Medicated ghee must be consumed processed with bitter fruits earlier than meals with the intention to trigger downward motion; or that (ghee) ready with: cavya – Piper retrofractum, and citraka – Plumbago zeylanica, yavakṣāra – alkali of entire plant of Hordeum vulgare, guḍa – and jaggery; pippalīmūla – or that (ghee) ready with roots of Piper longum, added with jaggery, alkali of entire plant of Hordeum vulgare, nāgaram – Zingiber officinale.

Ghrita Yogas

पिप्पलीपिप्पलीमूलधानकादाडिमैर्घृतम् ॥ ७३ ॥
दध्ना च साधितं वातशकृन्मूत्रविबन्धनुत् ।
Medicated ghee ready with (decoction of): pippalī – Piper longum, pippalīmūla – Piper longum roots, dhānakā – Coriandrum sativum, dāḍima – Punica granatum, dadhnā ca – and blended with curds; flatus, faeces, urine.and if consumed, relieves the obstruction of above three (flatus, faeceas and urine)

Ghrita Yogas

पलाशक्षारतोयेन त्रिगुणेन पचेद्घृतम् ॥ ७४ ॥
वत्सकादिप्रतीवापमर्शोघ्नं दीपनं परम् ।
Medicated ghee ready from three components of answer of ash of Butea monosperma and powder of herbs of Vastakadi Gana (chapter 15 of Sutrasthana) destroys piles and is a finest carminative.

Ghrita Yogas

पञ्चकोलाभयाक्षारयवानीविडसैन्धवैः ॥ ७५ ॥
सपाठाधान्यमरिचैः सबिल्वैर्दधिमत् घृतम् ।
साधयेत्तज्जयत्याशु गुदवङ्क्षणवेदनाम् ॥ ७६ ॥
प्रवाहिकां गुदभ्रंशं मूत्रकृच्छ्रं परिस्रवम् ।
Medicated ghee must be ready with (decoction of): pañcakola – herbs of Panchakola, abhayā – Terminalia chebula, kṣāra – alkali, yavānī – Trachyspermum ammi, viḍa – Vida salt, saindhava – rock salt, pāṭhā – Cissampelos pareira, dhānya – Coriandrum sativum, maricaiḥ – Piper nigrum, bilva – and Aegle marmelos added with curds / yoghurt; this rapidly cures the ache of the rectum and groins, pravāhikāṃ – dysentery, gudabhraṃśaṃ – prolapse of the rectum, mūtrakṛcchraṃ – dysuria, parisravam – and slimy discharge from the rectum.  

Ghrita Yogas

पाठाजमोदधनिकाश्वदंष्ट्रापञ्चकोलकैः ॥ ७७ ॥
सबिल्वैर्दध्नि चाङ्गेरीस्वरसे च चतुर्गुणे ।
हन्त्याज्यं सिद्धमानाहं मूत्रकृच्छ्रं प्रवाहिकाम् ॥ ७८ ॥
गुदभ्रंशार्तिगुदजग्रहणीगदमारुतान् ।
Medicated ghee ready with (decoction of): pāṭhā – Cissampelos pareira, ajamoda – Apium graveolens, dhanikā – Coriandrum sativum, śvadaṃṣṭrā – Tribulus terrestris, pañcakolakaiḥ – herbs of Panchakola, bilva – and Aegle marmelos added with 4 components of dadhni – curd, svarase and juice of cāṅgerī – Oxalis corniculate – hanti ānāhaṃ – cures flatulence, mūtrakṛcchraṃ – dysuria, pravāhikām – dysentery; gudabhraṃśa arti – prolapse of the rectum and ache, gudaja – haemorrhoids, grahaṇī gada – duodenal illness, mārutān – and improve of Vata.

Ahara: Weight loss program in piles

शिखितित्तिरिलावानां रसानम्लान् सुसंस्कृतान् ॥ ७९ ॥
दक्षाणां वर्तकानां वा दद्याद्विड्वातसङ्ग्रहे ।
When there’s obstruction of faeces and flatus juice (soup) of meat of Śikhi – peacock, tittiri – black partridge, lāva – widespread quail, dakṣāṇāṃ – cock, vartakānāṃ vā – or button quail processed with sours must be administered.

Ahara: Weight loss program in piles

वास्तुकाग्नित्रिवृद्दन्तीपाठाम्लीकादिपल्लवान् ॥ ८० ॥
अन्यच्च कफवातघ्नं शाकं च लघु भेदि च ।
सहिङ्गु यमके भृष्टं सिद्धं दधिसरैः सह ॥ ८१ ॥
धनिकापञ्चकोलाभ्यां पिष्टाभ्यां दाडिमाम्बुना ।
आर्द्रिकायाः किसलयैः शकलैरार्द्रकस्य च ॥ ८२ ॥
युक्तमङ्गारधूपेन हृद्येन सुरभीकृतम् ।
सजीरकं समरिचं विडसौवर्चलोत्कटम् ॥ ८३ ॥
वातोत्तरस्य रूक्षस्य मन्दाग्नेर्बद्धवर्चसः ।
कल्पयेद्रक्तशाल्यन्नव्यञ्जनं शाकवद्रसान् ॥ ८४ ॥
गोगोधाछगलोष्ट्राणां विशेषात् क्रव्यभोजिनाम् ।
Tender leaves of vāstuka – Chenopodium album, agni – Plumbago zeylanica, trivṛt – Operculina turpethum, dantī – Baliospermum montanum, pāṭhā – Cissampelos pareira, and amlīka – Tamarindus indica / Emblica officinalis and different greens which mitigate Kapha and Vata, that are simply digestable and purgative in motion, must be given, fried in two fat, blended with Ferula narthex, cheese from curds blended with paste of Coriandrum sativum herbs of Panchakola macerated with juice of Punica granatum, tender leaves of (Dhanyaka) Coriandrum sativum items of Zingiber officinale made aromatic by the fumes of fireside which is enjoyable, added with jīrakaṃ – Cuminum cyminum, maricaṃ – Pepper nigrum, and little extra of Bida and black salt must be given as adjuvants to staple meals, to individuals of Vata predominance, who’re dry, have weak digestive energy and constipation, to be consumed together with mess of crimson rice, equally soup processed with greens (talked about above) ready from the meat, of the go – cow, godhā – lizard, chagala – iguana, uṣṭra – camel or particularly of carnivorous animals.

Ahara: Weight loss program in piles

मदिरां शार्करं गौडं सीधुं तक्रं तुषोदकम् ॥ ८५ ॥
अरिष्टं मस्तु पानीयं पानीयं वाऽल्पकं शृतम् ।
धान्येन धान्यशुण्ठीभ्यां कण्टकारिकयाऽथवा ॥ ८६ ॥
अन्ते भक्तस्य मध्ये वा वातवर्चोऽनुलोमनम् ।
Madira (wine) ready with Sharkara or Guda, Sidhu (wine ready from sugarcane juice), Takra (buttermilk), Tusodaka (fermented water soaked with husk of grains), fermented decoction or whey must be used for consuming or consuming water boiled barely with dhānya – Coriandrum sativum or Coriandrum sativum together with and śuṇṭhī – Zingiber officinale, kaṇṭakāri – Solanum xanthocarpum must be drunk both on the finish or center of the meals; this helps downward motion of flatus and faeces.

Ahara: Weight loss program in piles

विड्वातकफपित्तानामानुलोम्ये हि निर्मले ॥ ८७ ॥
गुदे शाम्यन्ति गुदजाः पावकश्चाभिवर्धते ।
When the rectum turns into freed from faeces, Vata, Kapha and Pitta by the downward motion, piles subside and digestive energy turns into elevated.

Anuvasana: Oil for enema remedy

उदावर्तपरीता ये ये चात्यर्थं विरूक्षिताः ॥ ८८ ॥
विलोमवाताः शूलार्तास्तेष्विष्टमनुवासनम् ।
For many who are having Udavarta (upward motion), who’re tremendously dried, who’ve upward motion of Vata accompanied with ache, Anuvasana (oil enema) is fascinating.

Anuvasana: Oil for enema remedy

पिप्पलीं मदनं बिल्वं शताह्वां मधुकं वचाम् ॥ ८९ ॥|
कुष्ठं शठीं पुष्कराख्यं चित्रकं देवदारु च ।
पिष्ट्वा तैलं विपक्तव्यं द्विगुणक्षीरसंयुतम् ॥ ९० ॥
अर्शसां मूढवातानां तच्छ्रेष्ठमनुवासनम् ।
गुदनिःसरणं शूलं मूत्रकृच्छ्रं प्रवाहिकाम् ॥ ९१ ॥
कट्यूरुपृष्ठदौर्बल्यमानाहं वङ्क्षणाश्रयम् ।
पिच्छास्रावं गुदे शोफं वातवर्चोविनिग्रहम् ॥ ९२ ॥
उत्थानं बहुशो यच्च जयेत् तच्चानुवासनात् ।
Medicated oil must be ready with the paste of pippalīṃ – Piper longum, madanaṃ – Randia dumetorum, bilvaṃ – Aegle marmelos, śatāhvāṃ – Anethum graveolens, madhukaṃ – Glycyrrhiza glabra, vacām – Acorus calamus, kuṣṭhaṃ – Saussurea lappa, śaṭhīṃ – Curcuma zedoaria, puṣkarākhyaṃ – Inula racemosa, citrakaṃ – Plumbago zeylanica, and devadāru – Cedrus deodara are added and made paste with two components of milk. This oil is finest for oil enema remedy arśasāṃ – in piles, mūḍhavātānāṃ – inactivity of Vata, guda niḥsaraṇaṃ – prolapsed of the rectum, śūlaṃ – ache of the stomach, mūtrakṛcchraṃ – dysuria, pravāhikām – dysentery, kaṭi ūru pṛṣṭha daurbalyaṃ – weak spot of the waist, thighs, and again; ānāhaṃ – stomach distention, vaṅkṣaṇa āśrayam – localized within the groins, picchāsrāvaṃ – slimy discharge from the rectum, gude śophaṃ – swelling of the rectum, vātavarco vinigraham – obstruction of flatus and feaces and frequent elimination of faeces get cured by this oil used for oil enema remedy.

Niruha: Decoction for enema remedy

 निरूहं वा प्रयुञ्जीत सक्षीरं पाञ्चमूलिकम् ॥ ९३ ॥
समूत्रस्नेहलवणं कल्कैर्युक्तं फलादिभिः ।
Even a decoction enema could also be administered, ready with milk decoction of Panchamula, with cow urine, fats (oil), salt and paste of Randia dumetorum and so forth.

Raktarshas Chikitsa: Therapy of bleeding piles

अथ रक्तार्शसां वीक्ष्य मारुतस्य कफस्य वा ॥ ९४ ॥
अनुबन्धं ततः स्निग्धं रूक्षं वा योजयेद्धिमम् ।
Discovering the presence of Raktarsas (piles arising from vitiation of blood) having Vata or Kapha because the secondary Doshas, therapies (herbs, weight loss program and so forth.) that are unctuous or dry (for Vata and Kapha respectively) however chilly (in efficiency/ nature/ impact) must be administered.

Raktarshas Chikitsa: Therapy of bleeding piles

शकृच्छ्यावं खरं रूक्षमधो निर्याति नानिलः ॥ ९५ ॥
कट्यूरुगुदशूलं च हेतुर्यदि च रूक्षणम् ।
तत्रानुबन्धो वातस्य श्लेष्मणो यदि विट् श्लथा ॥ ९६ ॥
श्वेता पीता गुरुः स्निग्धा सपिच्छः स्तिमितो गुदः ।
हेतुः स्निग्धगुरुर्विद्याद्यथास्वं चास्रलक्षणात् ॥ ९७ ॥
If the feces are black, arduous and dry, flatus doesn’t come down, there’s ache within the waist, thighs and rectum when there’s trigger for dryness (through the use of dry issues as meals) then Vata is the secondary Dosha; if the faeces is unfastened, white or yellow, heavy unctuous, blended with slimy materials, the rectum is static (with out motion), when there’s trigger for unctuousness and heaviness (through the use of meals of those properties) then Kapha is the secondary Dosha, related to the signs of vitiated blood.

Shodhana and Langhana

दुष्टेऽस्रे शोधनं कार्यं लङ्घनं च यथाबलम् ।
यावच्च दोषैः कालुष्यं स्रुतेस्तावदुपेक्षणम् ॥ ९८ ॥
When the blood is vitiated, purifactory remedy and likewise fasting and different thinning therapies must be finished relying on the energy of the particular person. Discharge of blood (from the piles) must be uncared for (not stopped) until it has indicators of vitiation by the Doshas.

Tikta pachana and dipana

दोषाणां पाचनार्थं च वह्निसन्धुक्षणाय च ।
सङ्ग्रहाय च रक्तस्य परं तिक्तैरुपाचरेत् ॥ ९९ ॥
Afterwards the particular person must be handled with herbs that are bitter, with the intention to cook dinner / ripen the Dosas, increase the digestive hearth and management bleeding.

Snehana

यत्तु प्रक्षीणदोषस्य रक्तं वातोल्बणस्य वा ।
स्नेहैस्तत् साधयेत् युक्तैः पानाभ्यञ्जनबस्ति षु ॥ १०० ॥
Discharge of blood in an individual who has nice lower/depletion of the Doshas, or who has nice aggravation of Vata, must be handled with fat, (medicated ghee or oil) used within the type of consuming, anointing and enema.

Stambhana Chikitsa

यत्तु पित्तोल्बणं रक्तं घर्मकाले प्रवर्तते ।
स्तम्भनीयं तदेकान्तान्न चेद्वातकफानुगम् ॥ १०१ ॥
When Pitta is aggravated together with Rakta flows in Greeshma Ritu (summer time season), then Stambhana remedy (blocking remedy) must be adopted. Nonetheless, this rule just isn’t relevant if there’s affiliation of Vata and Kapha.

Kashaya for Raktaja Arshas related to Kapha

सकफेऽस्रे पिबेत् पाक्यं शुण्ठीकुटजवल्कलम् ।
किराततिक्तकं शुण्ठीं धन्वयासं कुचन्दनम् ॥ १०२ ॥
दार्वीत्वङ्निम्बसेव्यानि त्वचं वा दाडिमोद्भवाम् ।
When Raktaja Arshas is related to Kapha Dosha, then decoction ready with Zingiber officinale, bark of Holarrhena antidysenterica must be consumed kirātatiktakaṃ – Swertia chirata, śuṇṭhīṃ – Zingiber officinale, dhanvayāsaṃ – Alhagi camelorum, kucandanam – number of Santalum album – sappan, log-wood, dārvī tvak – or decoction ready with bark of Berberis aristata, nimba – Azadirachta indica, sevya – Vetiveria zizanioides or decoction ready from tvacaṃ vā dāḍima – fruit pores and skin of Punica granatum

Kutajadi Churna

कुटजत्वक्फलं तार्क्ष्यं माक्षिकं घुणवल्लभाम् ॥ १०३ ॥
पिबेत्तण्डुलतोयेन कल्कितं वा मयूरकम् ।
Powder of bark of Holarrhena antidysenterica, fruit, tārkṣyaṃ – Daru Haridra – Berberis aristata, mākṣikaṃ – honey, ghuṇavallabhām – Aconitum heterophyllum is consumed together with rice washed water or powder of Achyranthes aspera is consumed together with rice washed water.

Kutajadi Leham

तुलां दिव्याम्भसि पचेदार्द्रायाः कुटजत्वचः ॥ १०४ ॥
नीरसायां त्वचि क्वाथे दद्यात् सूक्ष्मरजीकृतान् ।
समङ्गाफलिनीमोचरसान् मुष्ट्यंशकान् समान् ॥ १०५ ॥
तैश्च शक्रयवान् पूते ततो दर्वीप्रलेपनम् ।
पक्त्वाऽवलेहं लीढ्वा च तं यथाग्निबलं पिबेत् ॥ १०६ ॥
पेयां मण्डं पयश्छागं गव्यं वा छागदुग्धभुक् ।
लेहोऽयं शमयत्याशु रक्तातीसारपायुजान् ॥ १०७ ॥
बलवद्रक्तपित्तं च स्रवदूर्ध्वमधोऽपि वा ।
1 tula – 100 pala = 4.8 kg of ārdrāyāḥ kuṭajatvacaḥ – moist bark of Holarrhena antidysenterica is cooked with rain water, until the bark of Holarrhena antidysenterica loses its style and is filtered. Until the Kutaja loses its style – It’s added with 1 Mushti (1 Pala – 48 grams) of superb powders of samaṅgā – Manjishta – Rubia cordifolia, phalinī – Lagenaria siceraria / Callicarpa macrophylla, mocarasān – and Salmalia malabarica. Indrayava (Seeds of Kutaja – holarrhena antidysenterica) is added equal to the powders of the above three, heating is sustained until the content material turns into semi strong and sticks to the ladle (Darvi Pralepa). As soon as confection is ready, it’s consumed, as per digestion energy after its consumption, Peya, Manda, goat milk or cow milk, or the particular person ought to have meals together with goat milk. This Avaleha pacifies rapidly bleeding diarrhea bleeding piles. It’s helpful in sturdy bleeding related to Urdhvaga and Adhoga Raktapitta.

Kutajadi Leham

कुटजत्वक्तुलां द्रोणे पचेदष्टांशशेषितम् ॥ १०८ ॥
कल्कीकृत्य क्षिपेत्तत्र तार्क्ष्यशैलं कटुत्रयम् ।
लोध्रद्वयं मोचरसं बलां दाडिमजं त्वचम् ॥ १०९ ॥
बिल्वकर्कटिकां मुस्तं समङ्गां धातकीफलम् ।
पलोन्मितं दशपलं कुटजस्यैव च त्वचः ॥ ११० ॥
त्रिंशत्पलानि गुडतो घृतात् पूते च विंशतिः ।
तत् पक्वं लेहतां यातं धान्ये पक्षस्थितं लिहन् ॥ १११ ॥
सर्वार्शोग्रहणीदोषश्वासकासान्नियच्छति ।
1 Tula – 4.8 kg of Bark of Kutaja (Holarrhena antidysenterica) is cooked with 1 Drona (12.288 ml) of water, lowered to 1/8^th amount of water and filtered. It’s added with 1 pala – 48 grams of every of paste of tārkṣya – Berberis aristata, kaṭutrayam – Piper longum, Piper nigrum and Zingiber officinale lodhra dvayaṃ – two sorts of Symplocos racemosa, mocarasaṃ – Salmalia malabarica, balā – Sida cordifolia, dāḍimajaṃ tvacam – fruit bark of Punica granatum, bilva – Aegle marmelos, karkaṭikāṃ – Cucumis sativus / Pistacia chinensis, mustaṃ – Cyperus rotundus, samaṅgāṃ – Rubia cordifolia, dhātakīphalam – fruits of Woodfordia fruticosa, kuṭajasyaiva ca tvacaḥ – bark of Holarrhena antidysenterica is added in amount of 10 pala (480 grams) 30 pala (1.44 Kg) of jaggery is added and ghee is added 20 pala (960 grams) amount as soon as confection is ready, it’s saved within the heap of grains for 1 paksha (15 days). It’s consumed for sarva arśo – the remedy of all sorts of hemorrhoids, grahaṇīdoṣa – problems of duodenum, śvāsa – dyspnea, kāsa – and cough.

Lodhradi Yoga

लोध्रं तिलान् मोचरसं समङ्गां चन्दनोत्पलम् ॥ ११२ ॥
पाययित्वाऽजदुग्धेन शालींस्तेनैव भोजयेत् ।
lodhrā – Symplocos racemoasa, tila – Sesamum indicum, mocarasaṃ – Salmalia malabarica, samaṅga – Rubia cordifolia, candana- Santalum album, utpalam – Nymphaea stellata are administered together with goat milk and for meals, the affected person is given cooked rice alongside goat milk.

Yastyahvadi Yoga

यष्ट्याह्वपद्मकानन्तापयस्याक्षीरमोरटम् ॥ ११३ ॥
ससितामधु पातव्यं शीततोयेन तेन वा ।
yaṣṭyāhva – Glycyrrhiza glabra, padmaka – Prunus cerasoides, anantā – Hemidesmus indicus, payasyā – Impomoea paniculata, kṣīramoraṭam – Marsdenia tenacissima goat’s milk together with sugar sweet, honey is run with chilly water.

Lodhradi Yoga

लोध्रकट्वङ्गकुटजसमङ्गाशाल्मलीत्वचम् ॥ ११४ ॥
हिमकेसरयष्ट्याह्वसेव्यं वा तण्डुलाम्बुना ।
lodhra – Symplocos racemosa, kaṭvaṅga – Oroxylum indicum / Ailanthus excela, kuṭaja – Holarrhena antidysenterica, samaṅgā – Mimosa pudica / Rubia cordifolia, śālmalītvacam – bark of Butea monosperma, hima – Santalum album, kesara – Messua ferrea, yaṣṭyāhva – Glycyrrhiza glabra, sevyaṃ vā – Vetiveria zizanioides are administered together with rice washed water.

Yavanyadi Churna

यवानीन्द्रयवाः पाठा बिल्वं शुण्ठी रसाञ्जनम् ॥ ११५ ॥
चूर्णश्चले हितः शूले प्रवृत्ते चाति शोणिते ।
दुग्धिकाकण्टकारीभ्यां सिद्धं सर्पिः प्रशस्यते ॥ ११६ ॥
अथवा धातकीलोध्रकुटजत्वक्फलोत्पलैः ।
सकेसरैर्यवक्षारदाडिमस्वरसेन वा ॥ ११७ ॥
Powder of: yavānī – Trachyspermum ammi, indrayavāḥ – Holarrhena antidysenterica, pāṭhā – Cissampelos pareira, bilvaṃ – Aegle marmelos, śuṇṭhī – Zingiber officinale, rasāñjanam – extract of Berberis aristata is sweet to take with water to deal with ache and extra bleeding, or ghee ready with dugdhikā – Euphorbia prostrate, kaṇṭakārībhyāṃ – Solanum xanthocarpum is beneficial for a similar objective or ghee ready with dhātakī – Woodfordia fruticosa, lodhra – Symplocos racemosa, kuṭajatvak phala – bark and fruits of Holarrhena antidysenterica, utpalaiḥ – Nymphaea stellata sakesarai: – or ghee ready with Mesua ferrea, alkali of Hordeum vulgare, juice of dāḍima –  Punica granatum.

Sharkaradi Yoga

शर्कराम्भोजकिञ्जल्कसहितं सह वा तिलैः ।
अभ्यस्तं रक्तगुदजान् नवनीतं नियच्छति ॥ ११८ ॥
śarkara – sugar, ambhoja kiñjalka – stamen of lotus taken with butter in meals, as a apply relieves bleeding hemorrhoids, additionally Sesamum indicum together with butter in meals.  

Good meals and wine for bleeding piles

छागानि नवनीताज्यक्षीरमांसानि जाङ्गलः ।
अनम्लो वा कदम्ल वा सवास्तुकरसो रसः ॥ ११९ ॥
रक्तशालिः सरो दध्नः षष्टिकस्तरुणी सुरा ।
तरुणश्च सुरामण्डः शोणितस्यौषधं परम् ॥ १२० ॥

Butter, ghee, milk of Goat meat from animals of dry land are finest for bleeding hemorrhoids not bitter or barely bitter, meat soup of animals of dry land together with juice extract of Chenopodium album raktaśāliḥ – crimson number of Oryza sativa, supernatant layer of curd, rice harvested in 60 days, candy wine higher layer of contemporary wine is sweet for bleeding hemorrhoids.

Best issues for Vataja Raktarshas

पेयायूषरसाद्येषु पलाण्डुः केवलोऽपि वा ।
स जयत्युल्बणं रक्तं मारुतं च प्रयोजितः ॥ १२१ ॥
Drink, skinny gruel, soup, meat soup and so forth. Allium cepa (onion) or the above ones ready simply with onion when administered. It cures aggravated hemorrhoids related to vitiated blood troubled by vata dosha.

Controlling Vata and bleeding in bleeding hemorrhoids

वातोल्बणानि प्रायेण भवन्त्यस्रेऽतिनिःसृते ।
अर्शांसि तस्मादधिकं तज्जये यत्नमाचरेत् ॥ १२२ ॥
When there’s extreme bleeding in haemorrhoids, it could result in Vata aggravation. Therefore, in case of bleeding hemorrhoids, particular efforts must be put to manage bleeding and Vata Dosha.

Indication of coolant measures

दृष्ट्वाऽस्रपित्तं प्रबलमबलौ च कफानिलौ ।
शीतोपचारः कर्तव्यः सर्वथा तत्प्रशान्तये ॥ १२३ ॥
After observing extreme bleeding problems and weak Kapha and Vata, one ought to resort to coolant measures at all times to pacify that situation.

Tarpana and Avapeedaka

न चेदेवं शमस्तस्य स्निग्धोष्णैस्तर्पयेत्ततः ।
रसैः कोष्णैश्च सर्पिर्भिरवपीडकयोजितैः ॥ १२४ ॥
सेचयेत्तं कवोष्णैश्च कामं तैलपयोघृतैः ।
When the bleeding hemorrhoids don’t heal, nourishing remedy must be finished utilizing unctuous and sizzling meat soups luke-warm ghee must be utilized in avapeedaka method (in most dose on the finish of digestion of meal of each the mid-day and night time) sechana (pouring / showering) must be finished based on the requirement with lukewarm oil, milk or ghee.

Pichcha Basti

यवासकुशकाशानां मूलं पुष्पं च शाल्मलेः ॥ १२५ ॥
न्यग्रोधोदुम्बराश्वत्थशुङ्गाश्च द्विपलोन्मिताः ।
त्रिप्रस्थे सलिलस्यैतत्क्षीरप्रस्थे च साधयेत् ॥ १२६ ॥
क्षीरशेषे कषाये च तस्मिन् पूते विमिश्रयेत् ।
कल्कीकृतं मोचरसं समङ्गां चन्दनोत्पलम् ॥ १२७ ॥
प्रियङ्गुं कौटजं बीजं कमलस्य च केसरम् ।
पिच्छाबस्ति रयं सिद्धः सघृतक्षौद्रशर्करः ॥ १२८ ॥
प्रवाहिकागुदभ्रंशरक्तस्रावज्वरापहः ।
kuśa – Desmostachya bipinnata, kāśa – Saccharum spontaneum, root and flower of śālmaleḥ Bombax ceiba śuṅgāśca – and tender shoots of nyagrodha – Ficus benghalensis, udumbara – Ficus racemosa, aśvattha – Ficus religiosa, are cooked with 3 prastha (2.304 liters) of water and 1 prastha (768 ml) of milk, when solely the milk stays whereas heating, it’s filtered, and blended with paste of 3-12 grams of mocarasaṃ – Salmalia malabarica, samaṅgāṃ – Rubia cordifolia, candana – Santalum album, utpalam – Nymphaea stellata, priyaṅguṃ – Callicarpa macrophylla, seeds of Holarrhena antidysenterica and stamen of lotus, blended with ghee, honey and sugar, this preparation Picchabasti (slimy enema) pravāhikā – cures dysentery, gudabhraṃśa – rectal prolapse, raktasrāva – rectal bleeding and jvarā – fever.

Anuvasana Basti

यष्ट्याह्वपुण्डरीकेण तथा मोचरसादिभिः ॥ १२९ ॥
क्षीरद्विगुणितः पक्वो देयः स्नेहोऽनुवासनम् ।
yaṣṭyāhva – Glycyrrhiza glabra, puṇḍarīkeṇa – Nelumbo nucifera Salmalia malabarica and different herbs (talked about in verse 127) made into paste, cooked with double the amount of cow’s milk is used for oil enema.

Madhukadi Ghrita

मधुकोत्पललोध्राम्बु समङ्गा बिल्वचन्दनम् ॥ १३० ॥
चविकातिविषा मुस्तं पाठा क्षारो यवाग्रजः ।
दार्वीत्वङ्नागरं मांसी चित्रको देवदारु च ॥ १३१ ॥
चाङ्गेरीस्वरसे सर्पिः साधितं तैस्त्रिदोषजित् ।
अर्शोऽतीसारग्रहणीपाण्डुरोगज्वरारुचौ ॥ १३२ ॥
मूत्रकृच्छ्रे गुदभ्रंशे वस्त्यानाहे प्रवाहणे ।
पिच्छास्रावेऽर्शसां शूले देयं तत्परमौषधम् ॥ १३३ ॥
madhuka – Glycyrrhiza glabra, utpala – Nymphaea stellata, lodhra – Symplocos racemosa, ambu – Pavonia odorata, Acorus calamus, samaṅgā – Rubia cordifolia, Mimosa pudica, bilva – Aegle marmelos, candanam – Santalum album, cavikā – Piper retrofractum, ativiṣā – Aconitum heterophyllum, mustaṃ – Cyperus rotundus, pāṭhā – Cissampelos pareira, kṣāro yavāgrajaḥ – alkali of entire plant of Hordeum vulgare, dārvītvak – bark of Berberis aristata, Zingiber officinale, māṃsī – Nardostachys jatamansi, citraka – Plumbago zeylanica, devadāru – Cedrus deodara, juice of cāṅgerī – Oxalis corniculata, ghee ready with the above components destroys all three doshas, it’s the finest drugs for arśa – haemorrhoids, atīsāra – diarrhea / dysentery, grahaṇī – duodenal problems, pāṇḍuroga – anemia, jvara – fever, arucau – anorexia, mūtrakṛccha – dysuria, gudabhraṃśa – rectal prolapse, asti – urinary bladder dysfunction, ānāhe – bloating, pravāhaṇe – dysentery, picchāsrāve – slimy discharges, arśasāṃ – hemorrhoids, śūla – ache (colic) in these situations it must be given, it’s the finest drugs.

Vyatyasa Chikitsa

व्यत्यासान्मधुराम्लानि शीतोष्णानि च योजयेत् ।
नित्यमग्निबलापेक्षी जयत्यर्शःकृतान् गदान् ॥ १३४ ॥
In sufferers in search of enchancment of digestion energy, must be administered every day with candy and bitter herbs, cold and warm herbs alternatively this helps to win in opposition to haemorrhoids and (haemorrhoids) associated ailments.

Varti: Suppository

उदावर्तार्तमभ्यज्य तैलैः शीतज्वरापहैः ।
सुस्निग्धैः स्वेदयेत्पिण्डैर्वर्तिमस्मै गुदे ततः ॥ १३५ ॥
अभ्यक्तां तत्कराङ्गुष्ठसन्निभामनुलोमनीम् ।
दद्याच्छ्यामात्रिवृद्दन्तीपिप्पलीनीलिनीफलैः ॥ १३६ ॥
विचूर्णितैर्द्विलवणैर्गुडगोमूत्रसंयुतैः ।
तद्वन्मागधिकाराठगृहधूमैः ससर्षपैः ॥ १३७ ॥
For the particular person struggling with Udavarta, therapeutic massage must be finished with oil which is used to deal with Sheetajvara. To the particular person given with correct oleation (unctuousness remedy, therapeutic massage) Pinda Sweda (bolus fomentation / sudation) is given. After this, the anal area is given therapeutic massage and Varti (suppository) is ready much like the finger (measurement of the thumb), and is run. The varti must be ready with laxative herbs resembling: śyāmā – Ipomoea turpethum, trivṛt – Operculina turpethum, dantī – Baliospermum montanum, pippalī – Piper longum, nīlinī phalaiḥ – Indigofera tinctoria, powdered rock salt and black salt guḍa – jaggery and urine of cow, equally varti (suppository) ready with māgadhikā – Piper longum, rāṭha – Randia dumetorum, gṛhadhūma – Gruhadhuma (soot), sasarṣa – Brassica alba

Churna vinirdhamana

एतेषामेव वा चूर्णं गुदे नाड्या विनिर्धमेत् ।
Or, the identical herbs are made into powder and blown via a pipe into anal area.

Churna vinirdhamana

तद्विघाते सुतीक्ष्णं तु वस्तिं स्निग्धं प्रपीडयेत् ॥ १३८ ॥
ऋजूकुर्याद्गुदसिराविण्मूत्रमरुतोऽस्य सः ।
भूयोऽनुबन्धे वातघ्नैर्विरेच्यः स्नेहरेचनैः ॥ १३९ ॥
अनुवास्यश्च रौक्ष्याद्धि सङ्गो मारुतवर्चसोः ।
If administration of powder fails, then Teekshna basti (sturdy enema) with Sneha (fat) must be administered. This releases Vata Dosha obstructed in veins of anal area, feces and urine. Sneha virechana or virechana with Vata balancing herbs, as soon as once more adopted by Anuvasana Basti is run. As a result of dryness, there will probably be obstruction of flatus and feces.

Kalyanaka Kshara

त्रिपटुत्रिकटुश्रेष्ठादन्त्यरुष्करचित्रकम् ॥ १४० ॥
जर्जरं स्नेहमूत्राक्तमन्तर्धूमं विपाचयेत् ।
शरावसन्धौ मृल्लिप्ते क्षारः कल्याणकाह्वयः ॥ १४१ ॥
स पीतः सर्पिषा युक्तो भक्ते वा स्निग्धभोजिना ।
उदावर्तविबन्धार्शोगुल्मपाण्डूदरकृमीन् ॥ १४२ ॥
मूत्रसङ्गाश्मरीशोफहृद्रोगग्रहणीगदान् ।
मेहप्लीहरुजानाहश्वासकासांश्च नाशयेत् ॥ १४३ ॥
Three sorts of salt i.e. rock salt, black salt and bida salt, trikaṭu – Piper longum, Piper nigrum and Zingiber officinale, śreṣṭhā – Aquilaria agallocha, dantī – Baliospermum montanum, aruṣkara – Semecarpus anacardium, citrakam – Plumbago zeylanica, are floor collectively, blended with equal portions of: fats (ghee or oil) and urine of cow, taken in a pan (mud crucible) and lined with different pan and the junction of pans sealed with mud, is subjected to warmth by hid heating (technique), thus obtained alkali is known as Kalyanaka Ksara, when it’s consumed together with ghee or when it’s consumed together with unctuous meal, udāvarta – bloating, vibandha – constipation, arśo – haemorrhoids, gulma – stomach tumor, pāṇḍu – anemia, udara – ascites, kṛmi – intestinal worm infestation, mūtrasaṅga – problem in urination, aśmarī – urinary calculi,  śopha – irritation, hṛdroga – cardiac problems, grahaṇīgada – duodenal problems (irritable bowel syndrome, sprue), meha – diabetes, plīha – splenic problems, ruja – colic, ānāha – gaseous distension of stomach, śvāsa – problem in respiration (dyspnea), kāsa – and cough destroys (cures) all these ailments

Therapy of gadha varcha arshas

सर्वं च कुर्याद् यत् प्रोक्तमर्शसां गाढवर्चसाम् ॥ १४४अब् ॥
All of the measures instructed to deal with Hemorrhoids related to arduous feces, all these measures must be adopted right here.

Putikaranjadi Yoga

द्रोणेऽपां पूतिवल्कद्वितुलमथ पचेत्पादशेषे च तस्मिन् ॥ १४४च् ॥
देयाऽशीतिर्गुडस्य प्रतनुकरजसो व्योषतोऽष्टौ पलानि ॥ १४४द् ॥
एतन्मासेन जातं जनयति परमामूष्मणः पक्तिशक्तिं ॥ १४४ए ॥
शुक्तं कृत्वाऽऽनुलोम्यं प्रजयति गुदजप्लीहगुल्मोदराणि ॥ १४४f ॥
In a single drona (12.288 liters) of water atha pacet – is cooked with 2 tula (9.6kg) of Caesalpinia bonduc, as soon as the amount of water is lowered to 1 / 4 (one fourth), 80 pala (3.840 kg) of jaggery is added to it 8 pala (384 grams) of Piper longum, Piper nigrum and Zingiber officinale is added to it, in superb powder kind. This undergoes a form of acidic fermentation in a single month and generates superb warmth and digestion energy restores downward motion of Vata within the intestine, gudaja – wins over hemorrhoids, plīha – splenomegaly, gulma – stomach tumour and udara – ascites.

Chukra Prayoga

पचेत्तुलां पूतिकरञ्जवल्काद्द्वे मूलतश्चित्रककण्टकार्योः ।
द्रोणत्रयेऽपि चरणावशेषे पूते शतं तत्र गुडस्य दद्यात् ॥ १४५ ॥
पलिकं च सुचूर्णितं त्रिजातत्रिकटुग्रन्थिकदाडिमाश्मभेदम् ।
पुरपुष्करमूलधान्यचव्यं हपुषामार्द्रकमम्लवेतसं च ॥ १४६ ॥
शीतीभूतं क्षौद्रविंशत्युपेतमार्द्रद्राक्षाबीजपूरार्द्रकैश्च ।
युक्तं कामं गण्डिकाभिस्तथेक्षोः सर्पिःपात्रे मासमात्रेण जातम् ॥ १४७ ॥
चुक्रं क्रकचमिवेदं दुर्नाम्नां वह्निदीपनं परमम् ।
पाण्डुगरोदरगुल्मप्लीहानाहाश्मकृच्छ्रघ्नम् ॥ १४८ ॥
1 Tula (4.8 Kg) of Caesalpinia bonduc 2 tula (9.6 Kg) of roots of citraka – Plumbago zeylanica, kaṇṭakāri – Solanum xanthocarpum are cooked 3 Drona (36.864 liters) of water, is cooked until the water amount reduces to 1 / 4, it filtered and added with 100 pala (4.8 kg) of Jaggery. It’s additional added with superb powders of 1 pala (48 grams) of every of: trijāta – Cinnamomum zeylanicum, Cinnamomum tamala and Elettaria cardamomum, trikaṭu – Piper longum, Piper nigrum and Zingiber officinale, granthika – root of Piper longum, dāḍima – Punica granatum, aśmabhedam – Bergenia ligulata, pura – Commiphora mukul, puṣkaramūla – Inula racemosa, dhānya – Coriandrum sativum, cavyaṃ – Piper retrofractum, hapuṣāṃ – Juniperus communis, ārdrakaṃ – Zingiber officinale, amlavetasaṃ ca – and Garcinia pedunculata, As soon as it cools down, honey is added in 20 pala (960 grams) amount. It’s additional added with contemporary Vitis vinifera, bījapūra – Citrus medica, ārdraka – and Zingiber officinale, gaṇḍikābhi: tathekṣoḥ – Ikshu Gandika (knots on Saccharum officinarum), that is taken in a vessel coated with ghee, it’s saved sealed for a month to arrange a fermented product known as Chukra, which is rather like a noticed for haemorrhoids. It tremendously improves digestive hearth, cures pāṇḍu – cures anemia, gara – continual poisoning, udara – ascites, gulma – stomach tumor, plīha – splenomegaly, ānāha – distension of stomach, aśma – urinary calculi and कृच्छ्रघ्नम् – kṛcchraghnam – dysuria.

Pilvadi Yoga

द्रोणं पीलुरसस्य वस्त्रगलितं न्यस्तं हविर्भाजने ॥ १४९अ ॥
युञ्जीत द्विपलैर्मदामधुफलाखर्जूरधात्रीफलैः ॥ १४९ब् ॥
पाठामाद्रिदुरालभाम्लविदुलव्योषत्वगेलोल्लकैः ॥ १४९च् ॥
स्पृक्काकोललवङ्गवेल्लचपलामूलाग्निकैः पालिकैः ॥ १४९द् ॥
गुडपलशतयोजितं निवाते निहितमिदं प्रपिबंश्च पक्षमात्रात् ।
निशमयति गुदाङ्कुरान् सगुल्मान् अनलबलं प्रबलं करोति चाशु ॥ १५० ॥
The fruit juice of Salvadora persica filtered via material, is taken in 1 Drona (12.288 liters) amount put in a vessel smeared with ghee. It’s added with 2 pala (96 grams) of every of madā – Woodfordia fruticosa, madhuphalā – Vitis vinifera, kharjūra – Phoenix dactylifera, dhātrīphala – Emblica officinalis, pāṭhā – 1 pala (48 grams) every of Cissampelos pareira, mādri – Vitex agnus-castus, durālabhā – Fagonia cretica, amlavidula – Garcinia pedunculata, vyoṣa – Piper longum, Piper nigrum and Zingiber officinale, tvak – Cinnamomum zeylanica, ela – Elettaria cardamomum, ullaka – Picrorhiza kurroa, spṛkkā – Anisomeles malabarica, kola – Ziziphus jujube, lavaṅga – Syzygium aromaticum, vella – Embelia ribes, capalāmūla – roots of Piper longum, agnika – Plumbago zeylanica, pālika – Linum usitatissimum, jaggery is taken in 100 pala amount (4.8 Kg). This combine is saved in a spot devoid of motion of air and this must be consumed after 15 days. It’s helpful in treating gudāṅkurān – haemorrhoids, gulma – stomach tumors, strengthens digestion energy in a short time.

Dashamuladi Guda

एकैकशो दशपले दशमूलकुम्भपाठाद्वयार्कघुणवल्लभकट्फलानाम् ।
दग्धे स्रुतेऽनु कलशेन जलेन पक्वे पादस्थिते गुडतुलां पलपञ्चकं च ॥ १५१ ॥
दद्यात् प्रत्येकं व्योषचव्याभयानां वह्नेर्मुष्टी द्वे यवक्षारतश्च ।
दर्वीमालिम्पन् हन्ति लीढो गुडोऽयं गुल्मप्लीहार्शःकुष्ठमेहाग्निसादान् ॥ १५२ ॥
10 pala (480 grams) every of, daśamūla – group of 10 roots, kumbha – Baliospermum montanum, pāṭhā dvaya – Patha and Raja Patha (Cissampelos pareira and Cyclea peltata), arka – Calotropis gigantea, ghuṇavallabha – Operculina turpethum, kaṭphalānām – Myrica nagi, the above are burnt in open air and filtered. It’s boiled in 1 Drona (12.288 liters) of water, lowered to 1 / 4 and added with 1 tula (4.8 Kg) of jaggery, 5 pala (240 grams) every of: must be given individually vyoṣa – Piper longum, Piper nigrum and Zingiber officinale, cavya – Piper retrofractum, abhaya – Terminalia chebula, 2 pala (96 grams) of Plumbago zeylanica and a pair of pala (96 grams) of alkali of Hordeum vulgare, a semisolid preparation which adheres to the ladle, this jaggery preparation when licked, destroys gulma – stomach tumor, plīha – splenomegaly, arśaḥ – haemorrhoids, kuṣṭha – pores and skin ailments, meha – urinary tract ailments / diabetes, agnisāda – and weak digestion energy,

Chitrakadi Leham

तोयद्रोणे चित्रकमूलतुलार्धं साध्यं यावत्पाददलस्थमथेदम् ।
अष्टौ दत्त्वा जीर्णगुडस्य पलानि क्वाथ्यं भूयः सान्द्रतया सममेतत् ॥ १५३ ॥
त्रिकटुकमिशिपथ्याकुष्ठमुस्तावराङ्गकृमिरिपुदहनैलाचूर्णकीर्णोऽवलेहः ।
जयति गुदजकुष्ठप्लीहगुल्मोदराणि प्रबलयति हुताशं शश्वदभ्यस्यमानः ॥ १५४ ॥
1 drona (12.288 liters) of water is heated together with half tula (2.4 Kg) of citraka – Plumbago zeylanica, until the water amount reduces to 1 / 4. It’s added with 8 pala (384 grams) of previous jaggery. It’s heated until it good points a semisolid consistency. It’s added with a complete of 192 grams of trikaṭuka – Piper longum, Piper nigrum and Zingiber officinale, miśi – Foeniculum vulgare, pathyā – Terminalia chebula, kuṣṭha – Saussurea lappa, mustā – Cyperus rotundus, varāṅga – Cinnamomum zeylanicum, kṛmiripu – Embelia ribes, dahana – Plumbago zeylanica, powder of elā – Elettaria cardamom and the resultant confection cures gudaja – hemorrhoids, kuṣṭha – pores and skin ailments, plīha – splenomegaly, gulma – stomach tumor, udara – ascites and improves digestion, when consumed by apply commonly

Vyoshadi Gutika

गुडव्योषवरावेल्लतिलारुष्करचित्रकैः ।
अर्शांसि हन्ति गुटिका त्वग्विकारं च शीलिता ॥ १५५ ॥
A pill ready with: jaggery, vyoṣa – Piper longum, Piper nigrum and Zingiber officinale, varā – Terminalia chebula, Terminalia bellirica and Emblica officinalis, vella – Embelia ribes, tila – Sesamum indicum, aruṣkara – Semecarpus anacardium, citrakaiḥ – Plumbago zeylanica, if used commonly, it cures: arśāṃsi – haemorrhoids tvak vikāraṃ ca – and pores and skin ailments.

Use of Surana

मृल्लिप्तं सौरणं कन्दं पक्त्वाऽग्नौ पुटपाकवत् ।
अद्यात् सतैललवणं दुर्नामविनिवृत्तये ॥ १५६ ॥
Tuber of Amorphophallus campanulatus is coated with mud, and is heated on hearth much like putapaka (hid heating in crucible), blended with sesame oil and rock salt, and used within the remedy of continual haemorrhoids.

Marichadi Guda       

मरिचपिप्पलिनागरचित्रकान् क्रमविवर्धितभागसमाहृतान् ।
शिखिचतुर्गुणसूरणयोजितान् कुरु गुडेन गुडान् गुदजच्छिदः ॥ १५७ ॥
marica – Piper nigrum, pippali – Piper longum, nāgara – Zingiber officinale, citrakān – and Plumbago zeylanica are taken in growing components, 4 occasions of śikhi – Plumbago zeylanica i.e. 16 components is Amorphophallus campanulatus, is added with 16 occasions jaggery and tablets ready, that is helpful in haemorrhoids.

Suranadi Pindi          

चूर्णीकृताः षोडश सूरणस्य भागास्ततोऽर्धेन च चित्रकस्य ।
महौषधाद्द्वौ मरिचस्य चैको गुडेन दुर्नामजयाय पिण्डी ॥ १५८ ॥
16 components of superb powder of sūraṇa – Amorphophallus campanulatus, 8 components of citrakas – Plumbago zeylanica, 2 components of mahauṣadhāt – Zingiber officinale, 1 a part of marica – Piper nigrum are added with jaggery and enormous tablets are ready, it’s helpful in curing continual durnām – haemorrhoids

Pathyadi Churna

पथ्यानागरकृष्णाकरञ्जवेल्लाग्निभिः सितातुल्यैः ।
वडवामुख इव जरयति बहुगुर्वपि भोजनं चूर्णः ॥ १५९ ॥
pathyā – Terminalia chebula, nāgara – Zingiber officinale, kṛṣṇā – Piper longum, karañja – Pongamia pinnata, vella – Embelia ribes, agni – Plumbago zeylanica are taken in 1 half every, sugar is taken equal to the powders (and blended), this powder (formulation) similar to the forest hearth (consumes the whole forest), digests even very heavy-to-digest meals.

Kalingadi Guda

कलिङ्गलाङ्गलीकृष्णावह्न्यपामार्गतण्डुलैः ।
भूनिम्बसैन्धवगुडैर्गुडा गुदजनाशनाः ॥ १६० ॥
kaliṅga – Holarrhena antidysenterica, lāṅgalī – Gloriosa superba, kṛṣṇā – Piper longum, vahni – Plumbago zeylanica, apāmārga taṇḍula – seeds of Achyranthes aspera, bhūnimba – Andrographis paniculata, saindhava – rock salt, superb powder of the above is blended with jaggery and tablets are ready, this formulation cures gudaja – hemorrhoids.

Lavanottamadi Churna

लवणोत्तमवह्निकलिङ्गयवांश्चिरिबिल्वमहापिचुमन्दयुतान् ।
पिब सप्तदिनं मथितालुडितान् यदि मर्दितुमिच्छसि पायुरुहान् ॥ १६१ ॥
lavaṇa uttama – rock salt, vahni – Plumbago zeylanica, kaliṅga – Holarrhena antidysenterica, yava – Hordeum vulgare, ciribilva – Holoptelea integrifolia, mahāpicumanda – Melia Azadirachta. It’s consumed for seven days, blended with luḍitān – buttermilk who want to eliminate pāyuruha – hemorrhoids.

Use of Bhallataka, Kutaja and Kalasheya

शुष्केषु भल्लातकमग्र्यमुक्तं भैषज्यमार्द्रेषु तु वत्सकत्वक् ।
सर्वेषु सर्वर्तुषु कालशेयमर्शःसु बल्यं च मलापहं च ॥ १६२ ॥
In case of Shushka Arsha (dry haemorrhoids), bhallātakaṃ – Semecarpus anacardium is taken into account finest herb. Within the case of Ardra Arsha (moist haemorrhoids), one of the best herb is vatsaka tvak – bark of Holarrhena antidysenterica. In all sorts of haemorrhoids, in all seasons, quite a lot of buttermilk, ready with out including water, and devoid of cream – is finest which improves energy and eases bowel motion.

Rules for utilizing superb meals and drinks in piles

भित्त्वा विबन्धाननुलोमनाय यन्मारुतस्याग्निबलाय यच्च ।
तदन्नपानौषधमर्शसेन सेव्यं विवर्ज्यं विपरीतमस्मात् ॥ १६३ ॥
The meals and drinks that assist to interrupt down the fecal matter and Maruta Anulomana – normalizes Vata motion, which strengthens digestive hearth, such meals, drinks and medicines must be consumed in case of haemorrhoids. The meals, drinks and medicines reverse to the above capabilities must be averted.

Significance of defending the digestive hearth in piles and different problems

अर्शोऽतिसारग्रहणीविकाराः प्रायेण चान्योऽन्यनिदानभूताः ।
सन्नेऽनले सन्ति न सन्ति दीप्ते रक्षेदतस्तेषु विशेषतोऽग्निम् ॥ १६४ ॥
arśa – In case of hemorrhoids, atisāra – diarrhea, grahaṇī vikārāḥ ca – duodenal problems and such different ailments are most likely brought on because of depleted digestive hearth, ailments is not going to manifest when the digestive hearth is robust. Therefore, agni must be protected in such situations with particular effort

इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां चतुर्थे चिकित्सितस्थानेऽर्शचिकित्सितं नामाष्टमोऽध्याय: ॥ ८॥
Thus, ends the chapter, arshacikitsita – the eighth in cikitsita sthana in astanga hrdaya samhita, composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.