A case of Atisara (diarrhcea) would be said to be in the Ama (acute) state, if the stool of the patient suffering from any of the foregoing Doshas would be found to sink in water and to emit a very fetid smell and to pass in broken jets (D. R. - to be slimy). A contrariety of the preceding symptoms and a sense of lightness of the body and in the affected cavity would indicate that the disease has passed the acute stage and it is then called Pakva (chronic) Atisara. II.
Prognosis: - If the colour of the stool (in a case of Atisara) resembles that of clarified butter, fat, the washings of Ves'avara, oil, goat's milk, honey, Manjishtha, brain-matter, or Rasanjana, or if the stool is cold or hot to the touch, or if it is charged with a fleshy or fetid smell, or marked with lines or specks of variegated colours, or if it looks like pus or clay, or if just the opposite or reverse symptoms or other distressing symptoms would be exhibited, the case is likely to end fatally in case the patient be weak. A patient suffering from an attack of Atisara would be given up (as incurable) if he be weak, if the orifice of his anus become suppurated and cannot be closed, if there be distension of the abdomen (D. R. - if the patient be not self-restrained), if there be distressing symptoms and if the patient be found destitute of thermal heat. 12-13.
An attack of Atisara ushered in by whatsoever cause, is sure to be marked by the specific symptoms of the deranged bodily Dosha or Doshas complicated with it. All cases of Atisara whether due to the indigestion of any oleaginous food or drink (Ghrita, oil, etc.), whether with (or without) the symptoms of Pravahika and the accompanying colic, as well as those due to Visuchika or any "other kind of indigestion as also those due to the effect of any poison (affecting the digestive system), hcemorrhoids (Ars'as), or worms in the intestines, - all of them arc marked by the symptoms of the specific Dosha involved therein. The treatment of Atisara varies according to its acute or matured stage, the characteristic symptoms of those therefore are to be carefully observed and noted in each case under treatment. 14-15.
The patient should be kept without food as soon as the premonitory symptoms of Atisara would appear, and then the dietic gruels (Yavagu) prepared with the admixture of digestive drugs should be given in their proper order. In a case marked by colic and flatulent distension of the abdomen, fasting should be first advised. And then vomiting should be induced with draughts of water mixed with powdered Pippali and Saindhava salt. A light diet in the shape of a Khada-yusha, Yavagu, etc., prepared with the admixture of the drugs of the Pippalyadi group, should then be prescribed after the cessation of vomiting. A decoction of the drugs of the Haridradi, or Vachadi group, should be be taken in the morning where the preceding remedies would fail to relieve mucous accumulations in the intestines (Amaitisaira). No astringent or costive medicine in the acute or immature (Ama) stage of the disease should be administered in as much as by obstructing the passage of the Doshas it might bring on an attack of enlarged spleen, chlorosis, distension of the abdomen with suppression of stool and urine, Meha (urinary complaints), Kushtha (cutaneous affections), ascites, fever, cedematous swellings of the limbs, Gulma (abdominal gland, etc.,) diarrhoea, piles, colic, Alasaka and catching pain at the heart. 16-17.
Purging should be induced with Haritaki in a case marked by constant and scanty motions (of mucus and) attended with griping and pain (Sula) or by an incarceration of the deranged bodily Doshas (in the intestines). Emetics should be first exhibited and followed by fastings and digestive or assimilative (Pachana) remedies in a case marked by watery and copious motions. Powdered Haritaki and Pippali with tepid water should be administered for purgative purposes in a case marked by scanty emissions of stool at times attended with pain and colic (Sula). Fasting is the first remedy to be prescribed in cases of Ama (acute) Atisara, or in the alternative, digestive remedies should be prescribed. The recipes of digestive medicinal compounds which arc curative in the disease under discussion (Amatisara) arc described below. 18 - 19.