Causes Of Atisara - The excessive use of extremely heavy (hard to digest), oleaginous, dry, hot, cold, fluid, thick, and incompatible articles of food, eating irregularly and at improper time (or unaccustomed articles of fare), indigestion, eating before the digestion of the previous meal, excessive use or misuse of any lardacious substances, etc., (Sneha, Sveda, etc.), use of any poison, fright, grief, drinking impure water, the excessive drinking of liquor, change of season or physical contrarieties, indulgence in aquatic sports, voluntary repression of any natural urging (of the body) or germination of parasites in the intestines are the causes which bring on an attack of diarrhoea (Atisafra) the symptoms whereof will be dealt with presently. 2.
Pathology: - The liquid part (Ap-dhatu) of the body, if aggravated and carried downward by the bodily Vayu, impairs the fire in the stomach (fire of digestion) and mixing with the fecal matter, is painfully and constantly emitted through the anus. This dangerous disease is named Atisafra from the constant oozing out (Ati and Sarana) of the liquid fecal matter from the anus. It is usually classified into six different types, viz., those due to the predominance of the deranged bodily Doshas severally involved therein, that due to the concerted action of the three Doshas, one due to grief and that due to the indigested mucous accumulations (Ama) in the intestines. Some authorities hold that Atisara is of many kinds but the holy Dhanvantari, on the contrary, holds that it is not so but that the physical conditions of a diarrhceic patient undergo changes and become manifold. 3.
Piercing pain in the regions of the heart, umbilicus, rectum, abdomen and in the Kukshi (sides of the abdomen), a sense of numbness in the limbs, stoppage or suppression of flatus and of stool, distension of the abdomen, and indigestion are the premonitory symptoms of the disease. 4.
Vayu-origined type of the disease is marked by Sula (colic), suppression of urine, rumbling sound in the intestines, looseness (constant movement in the intestines) of the abdominal (Apana) wind, a gone feeling in the waist, in the thighs and in the legs, and frequent emissions with flatus of a scanty, frothy, dry (Ruksha) brown-coloured (yellowish black) stool. The specific features of the Pitta-origined type are that the stool is fetid, hot, yellow, blue or slightly red-coloured, or resembles the washings of meat, and is emitted with sharp or acute force and is accompanied by thirst, epileptic fits (fainting), burning sensation, perspiration, suppuration and inflamation (Paka) of the affected organs, and fever. In the Kapha-origined type of the disease the stool becomes loose and constant, gets mixed with the lump of mucus and looks white. The stool comes out without any sound. A sense of constant urging is complained of and each motion only creates the apprehension of a fresh one in the mind. The patient becomes drowsy or sleepy, and feels a sense of heaviness in the limbs, nausea, disrelish for food, horripalation and lassitude. The symptoms which mark a case of Tri-doshaja type (due to the concerted action of the three simultaneously deranged bodily Doshas) are drowsiness, swoon, lassitude, dryness of the mouth, thirst and a varied colour of the stools. A case of Tri-doshaja type, if attended with all the symptoms, is very hard to cure and if occurring in an infant, or an old person, is scarcely amenable to medical treatment. 5-8.
Atisara: - The suppressed tears of a bereaved person of sparing diet, on quenching the digestive fire, reach down into the Koshtha (intestines) and there freely mix with, and vitiate the local blood which becomes dark-red like Kakananti (Gunja). It then passes through the rectum, charged with a peculiar fetour imparted to it by the fecal matter in case of its combination with the latter or without any fetid smell, when passing out unmixed. Such an attack ushered in by the grief of bereavement of a person is accordingly considered very hard to cure. The local bodily Doshas in the Koshtha (abdomen) are aggravated and deranged when they come in contact with the Ama (unassimilated chyle), and are brought down into the Koshtha (bowels), where they are more agitated and emitted in combination with the undigested fecal matter in various ways, and are attended with pain and characterised by a variety of colour. This is the sixth type of Atisara. 9 - 10