Drying (Ruksha) measures should be employed in a case due to the excessive use of any oily or emulsive food and emulsive (Snigdha) measures should be adopted in a case brought on through an excessive use of any dry (Ruksha) article. The cause of terror should be first removed in a case due to fright, while the mind should be calmed or consoled in the case due to any grief or bereavement. The treatment in cases (of Atisara) due to piles or worms (in the intestines) as well as in those due to the effect of poison (introduced into the system) consits in employing therapeutic agents which are simultaneously remedial both to the disease and to its exciting factors. Complications or distressing concomitants such as vomiting, thirst, fainting fits, etc., should be removed with drugs which arc not incompatible with the main treatment of the disease, and which do not aggravate the exciting factors. In a case of fever or Atisara marked by the simultaneous aggravation of the deranged bodily Doshas, the deranged Pitta should be first remedied, while in all other affections, it is the deranged bodily Vayu which should be first curbed down or corrected. 95 - 96.
Non-emission of stool at the time of urination and the free emission of flatus (Vayu), as well as the rousing of the appetite, and the lightness of the abdominal cavity (Koshtha) arc the indications of cure in a case of Udaramaya (Diarrhoea, etc.). * 97.
* The printed edition of Dallana's commentary says that these are the symptoms of cases of aggravated Atisira.
Some diseases are due to the dynamics of Karmas (deeds done by a man in the present or any prior existence), and some are due to the effects of deranged bodily Doshas, while there may be others which have their origin both in the dynamics of Karma and the necessary physiological (Doshaja) causes. Of these a Karma-origined disease may come on without any apparent exciting factor and it disappears with the extinction of its (Karma's) result effected by means of any remedial measure (e. g. penance, etc.) other than medical treatment, whereas as a Dosha-origined disease is conquered as soon as the involved deranged Doshas of the body are restored to their normal condition. Cases due to a slight derangement of the bodily Doshas but attended with a good deal of troubles as well as those due to the excessive aggravation of the Doshas but attended with only slight troubles should be attributed both to the physiological causes and to the dynamics of Karma, and these arc cured only when both of these causes viz., Karma and aggravated Doshas are removed. 98.
Grahani: - The Grahani (lit. the uppermost extremity or the receiving ducts of the intestines) is affected by the causes which produce dulness of appetite. The digestive fire of a patient is again deranged, even after * the subsidence of an attack of Atisara, if, with the dulness of appetite, he be still intemperate and injudicious in matters of food and drink. Hence the regimen of diet and conduct in a case of Atisara should be as laid down in connection with the sequel of any purgative course (Virechana), until the deranged Doshas of the body would be completely restored to their normal condition, bringing in the natural health and strength in their train. The sixth Kala which has been described as the Pitta-dhara Kala (Pitta-containing sheath) is situated between Pakvas'aya and Amas'aya (duodenum?) is called Grahani. The strength of the organ of Grahani is dependent on the digestive fire (Agni) and the latter is situate in the former. Hence anything that impairs the digestive fire (Agni) necessarily affects the Grahani. 99-102.
* The use of in the text shows, say the commentators, that(Irahani is possible even without a previous attack of Atisdra.
The aggravation of one or all the bodily Doshas leads to the derangement of the Grahani into which the food taken is passed off in the shape of undigested fecal matter, or if it is digested, it sometimes produces constipation of the bowels and sometimes liquid motions accompanied (in both cases) by pain and fetid smell. The disease is called Grahani (chronic diarrhoea ?) by experienced Physicians. 103.
Incomplete digestion, lassitude or a sense of physical langour, laziness, thirst, a sense of exhaustion, weakness, aversion to food, cough, ringing in the ears (Karna-Kheda) and rumbling sound in the intestines are the symptoms which mark the premonitory stage of the disease. 104.
Symptoms: - Swelling or oedema of the hands and of the feet, emaciation, pain at the joints, greediness, thirst, vomiting, fever, aversion to food, burning sensation, eructations of bitter, acid or fermented taste, or of those smelling of blood or smoke, water-brash, bad taste in the mouth and non-relish for food, as well an attack of Tamaka-Svasa (variety of asthma) are the indications of the developed stage of the disease (Grahani). 105.