Diarrhea (Atísára) and
Dysentery (Praváhika)
Cause: There are 6 forms of diarrhea: Váyu, Pitta,
Kapha, Tridoßha, fear and grief, and undigested food
(áma). Causes include drinking excessive amounts
of water, eating very hot, dry, fatty, hard, cold, or
unaccustomed foods, puddings, sesame seeds,
sprouted grains, excess wines, overeating, eating before
the last meal is digested, and eating at unusual
times. Further causes include improper oleation
therapy, drinking bad water, excessive use of alcohol,
overdoing water sports, suppression of natural
urges, hemorrhoids, intestinal parasites, changes in
lifestyle, and seasonal changes. As accumulating
Váyu becomes aggravated, it causes the Kapha (watery
element) to move downward, dampening the digestive
fire before entering the alimentary canal. This
causes the feces to become watery and produce diarrhea.
There are 5 types of dysentery: Váyu, Pitta,
Kapha, Tridoßha, and blood (raktapitta).
Premonitory Signs: Prickling pain in the heart region,
rectum, and alimentary tract; weak body, constipation,
gas, and indigestion.
Symptoms:
Váyu: Watery feces, small quantity, expelled with
noise, severe pain, and difficulty. It may be dry, frothy,
thin, rough, or scaly, slightly brown and frequently
expelled. Alternatively, it may seem gooey, burnt, and
slimy. One may experience a dry mouth, prolapsed
rectum, hair standing on end, and straining to expel
stools.
Pitta: Yellow, black, algae green, blue, red, or deep
yellow color, mixed with blood and foul smelling;
thirst, fainting, perspiration, burning sensation, painful
elimination, burning and ulcerated rectum.
Kapha: Solid, slimy, thready, white, mucus, fatty,
frequent, heavy, foul smelling, difficult elimination
followed by pain, sleepiness, laziness, dislike of food,
mild straining to eliminate stools or frequent and
urgent need to eliminate.
Tridoßha: Symptoms of all three doßhas simultaneously.
Fear/Grief: This situation can cause persons to
eat very little. The heat of tears and secretions of the
nose, mouth, and throat can increase and move to the
alimentary tract to weaken digestion and blood tissue
(rakta dhátu). Vitiated blood is then expelled, mixed
with feces or by itself. It is very difficult to heal.
Emotional causes increase Pitta and Váyu, causing
liquid feces and diarrhea; feces are quick, warm, fluid,
and float on water. Symptoms are the same as Váyu.
Undigested Food (Áma): Diarrhea is of two types:
1) with áma and without áma, and 2) mixed with
blood and without blood. With áma, stools sink in
the water, have a foul smell, are associated with
intestinal gurgling; undigested food remains in the
stomach, abdominal pain, excess salivation.
Symptoms of “without áma” feces have the opposite
qualities.
When food is not properly digested (áma), doßhas
combine with áma and become excessed. They then
travel in the wrong channels, weakening tissues
(dhátus), waste products (malas), and cause frequent,
multicolored feces and abdominal pain.
If diarrhea is allowed to continue without being
healed, it develops the disorders of the duodenum.
This is discussed later.
Therapies:
General: Diarrhea caused by excess doßhas (due
to undigested food) needs to be eliminated. Initially,
astringent herbs and foods are not used to stop
diarrhea with áma (toxins) until the toxins are expelled
with the stool. If the diarrhea is prematurely halted
while áma is still in the body, it may cause various
diseases (e.g., hemorrhoids, edema, anemia, tumors,
fever, etc.). Rather, it is advised to allow initial áma
diarrhea to come out, and even to induce it by taking
harítakí. It is a part of the body’s defense mechanism
to expel toxins (áma). Thus, stopping diarrhea when
it is still toxic goes against the body’s natural healing
process.
Persons with a moderate doßha excess take
decoctions to stimulate the appetite and strengthen
the digestion. If doßhas are greatly excessed, then
lightening therapy (i.e., pañcha karma, etc.) is
advised.
General: Herbs include pippalí, ginger, coriander,
harítakí, calamus, gokßhura, bilwa, fennel.
Váyu: (the same as Kapha) balá, gokßhura, bilwa,
ginger, coriander, calamus, pippalí, chitrak, sour
pomegranate, da¤hmúl, ámalakí, ghee, and rock salt
are taken with foods and drinks to strengthen the
digestion and the constitution.
Pain, gas retention, and the desire to pass urine or
stool (but cannot): Are healed with bilwa, pippalí,
ginger, cane sugar, and sesame oil.
Diarrhea with a dry mouth (dehydration): Basmati
rice, barley soup, green lentils, sesame seeds, bilwa,
kuþaj, í¤habgol fried in ghee, and sesame oil/added
with yogurt and pomegranate, cane sugar, ginger.
When Kapha is diminished, excessed Váyu
presents serious problems; therefore, this condition
must be immediately healed.
Váyu/Pitta: Enemas.
Pitta: Kuóaj, chiráyatá, kaóuká, bilwa, sandalwood,
lotus seeds, ginger, pomegranate, sesame seeds,
mango (taken with raw honey), ghee, and rice water.
If the appetite is good and digestion strong, goats’
milk will heal Pitta diarrhea.
If pain recurs after cleansing, oil enemas should
be administered immediately, using ghee to 1/4 the
amount of sesame oil, with ¤hatávarí, bilwa, and milk.
If diarrhea continues, one receives a massage. Then,
a pichá basti followed by bath is taken [the soft bark
of silk cotton tree and pawdar mixed with oil and
ghee]. Next, persons have meals of boiled milk and
Pitta-reducing foods. If one eats Pitta-increasing foods
in this condition, it may lead to bloody diarrhea and
thirst, pain, burning, and rectal inflammation. Should
this occur, boiled goats’ milk with raw honey and
cane sugar is ingested and used to wash the anus.
Foods include boiled rice with this milk decoction,
and ghee. If the person is strong, food (e.g., rice)
should be eaten after milk is digested. Weak persons
eat food just after the milk. Alternately, fresh butter
mixed with honey and sugar is eaten before meals.
The rice is soaked in water overnight, and crushed
and rubbed the next morning. When the water from
this rice is drunk, it heals bloody diarrhea.
Áma: Purgation is advised (i.e., see lightening
therapies in pañcha karma chapter) if the person is
strong. After lightening therapy, meals are to include
barley gruel with balá, ¤hatávarí, and gokßhura.
Green lentils improve digestion. If diarrhea continues,
digestives like t^ikatu, and astringents like comfrey,
gentian, lotus seeds, red raspberry, and yellow dock
may be used.
Thirst: Boiled water with musta and sandalwood.
Dysentery: One takes bilwa, sesame paste,
yogurt, ámalakí, and ghee.
Amoebic dysentery: Kuóaj along with immuneboosting
herbs (e.g., guæúchí). £ha´k bhasma (shell
ash) reduces acid indigestion if present.
Bacillary Dysentery: See therapies for Pitta
diarrhea.
Bleeding diarrhea: A diet of ¤hatávarí or ghee
cooked with milk (before or after passing stools) heals
this disorder. Alternately, one may eat sandalwood
mixed with sugar and honey, followed by rice water.
For frequent movements with small amounts of blood,
and associated with pain and Váyu (i.e., difficulty in
passing stools), pichá basti, or oil enema with ghee
and the above mentioned herbs.
Upper/lower channel bleeding: If Pitta-increasing
foods are continually eaten, severe rectal
inflammation can develop, and is fatal. Herbs include
lotus seeds, dúrba, and nágke¤har.
Chronic diarrhea: This causes a weak anus.
Frequent, local application of ghee or oil can heal
this condition.
Inflamed anus: This is caused by frequent
movements. It is healed either by sprinkling a cold
decoction of sugar cane, ghee, milk, and raw honey,
or by applying the mixture as a paste on the
inflammation. Ghee may also be applied first before
sprinkling with ghee, neem oil, or sandalwood oil.
Kapha: Emesis (i.e., lightening therapy) and
improved digestion are the first concerns. Ginger,
coriander, bilwa, musta, harítakí, calamus, pippalí,
chitrak, nutmeg, and sour pomegranate are used to
strengthen the digestion. Later, balá, gokßhura, bilwa,
viæa´ga, and rock salt are combined with foods and
drinks to strengthen the constitution. One part yogurt
mixed with 3 parts water (lassi) also promotes
digestion. Alternately, either a mixture of pippalí with
honey or a mixture of chitrak with lassi heals this
condition.
When áma is digested persons may still suffer from
diarrhea with small amounts of stool retention, pain,
mucus, and the urge to pass stool or urine (but cannot).
Therapy includes radish soup with bákuchí, yogurt,
pomegranate, and ghee. (Other diuretic vegetables
may be used.)
Should the above condition also have
complications of passing blood and mucus with thirst,
boiled milk with ghee, bilwa, or castor oil is used.
If rectum prolapse with pain exists after eliminating
áma, first the inner rectum is oiled and fomented to
soften it. Then herbs are taken including ámalakí,
ghee, or oil enema (with da¤hmúl and bilwa), or ghee
cooked with dry ginger, sour yogurt, triphalá, and
¤hatávarí.
Váyu/Kapha: (or excessive diarrhea caused by
Kapha or dysentery with pain), pichá basti is applied,
followed by an enema with pippalí, bilwa, calamus,
and black salt. Afterwards, one bathes, and then one
eats. In the evening, one receives an oil enema made
from the same herbs mixed in sesame oil.
Tridoßhic: Herbs from each category are used. If
all three are equally unbalanced, the order of healing
is Váyu first, Pitta second, and Kapha third.
Otherwise, whichever is most unbalanced is treated
first.
Fear/Grief: Váyu-reducing therapies,
psychotherapeutic measures that produce exhilaration
and consolation.
