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AIAPGET Points

–        There are five types of Arochaka. Vataja, Pittaja, Kaphaja, Sannipataja & Chinta Janya.

–        Hrt Shula is one of the features of Vataja Arochaka.

–        Hrd Daha-Chosha are the important features of Pittaja Arochaka.

–        Virasa ananam is a feature of Vataja Arochaka. Mukha Tiktata is a feature of Pittaja Arochaka. Madhura Asya is a feature of Kaphaja Arochaka.

–        Kashaya or Leha prepared with Mustadi Gana, Rajataru (Aragvadhadi Gana) and Dashanga (Dashamula) is used for treatment of Arochaka.

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The 57th chapter of Uttaratantra of Sushruta Samhita is named as Arocaka Pratiședha. This chapter deals with Treatment of Anorexia.

अथातोऽरोचकप्रतिषेधमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We will now expound Arocaka pratiṣedha – treatment of Anorexia (loss of taste) as revealed by the venerable Dhañvañtari.

Nidāna-samprāpti – Causes and Pathogenesis

दोषैः पृथक् सह च चित्तविपर्ययाच्च भक्तायनेषु हृदि चावतते प्रगाढम् |
नान्ने रुचिर्भवति तं भिषजो विकारं भक्तोपघातमिह पञ्चविधं वदन्ति ||३||

Arocaka manifests as five types – three types by each individual aggravated dosha, one type by aggravation of all the three doshas and the fifth type by disorders of the mind (too much of kama, soka, bhaya etc causative factors).

In this way the doshas get accumulated greatly and spread out in the seats of (channels of) food (taste) and the heart. In this condition, the person does not relish the food (present in his mouth). This disease is called by the physicians as Bhaktopaghata (arocaka), said to be of five kinds.

 Lakşana – Clinical features

हृच्छूलपीडनयुतं विरसाननत्वं वातात्मके भवति लिङ्गमरोचके तु |
हृद्दाहचोषबहुता मुखतिक्तता च मूर्च्छा सतृड् भवति पित्तकृते तथैव ||४||
कण्डूगुरुत्वकफसंस्रवसादतन्द्राः श्लेष्मात्मके मधुरमास्यमरोचके तु |
सर्वात्मके पवनपित्तकफा बहूनि रूपाण्यथास्य हृदये समुदीरयन्ति ||५||
संरागशोकभयविप्लुतचेतसस्तु चिन्ताकृतो भवति सोऽशुचिदर्शनाच्च |६|

Arochaka is also produced by the below mentioned factors –

–       Lust

–       Grief

–       Fear

–       Worry

–       Seeing dirty things like terrifying or disgusting things, obnoxious smell etc

Cikitsā – Treatment

वाते वचाम्बुवमनं कृतवान् पिबेच्च स्नेहैः सुराभिरथवोष्णजलेन चूर्णम् ||६||
कृष्णाविडङ्गयवभस्महरेणुभार्गीरास्नैलहिङ्गुलवणोत्तमनागराणाम् |७|

For vataja arochaka –

Vamana – emesis should be induced first by administering Kashaya – decoction of Vacha – Acorus calamus.

Next, the patient is given the powder of the below mentioned herbs mixed with either oil, sura – beer or warm water, for licking –

–       Krshna

–       Vidanga

–       Yava Bhasma

–       Harenu

–       Bharangi

–       Rasna

–       Ela

–       Hingu

–       Lavanottama

–       Nagara

पित्ते गुडाम्बुमधुरैर्वमनं प्रशस्तं स्नेहः ससैन्धवसितामधुसर्पिरिष्टः ||७||

For Pittaja Arochaka –

Vamana – emesis should be administered by making the patient drink jaggery water and sweet tasting herbs (Madhuka etc)

Later, Sneha – oils or ghee added with the below mentioned ingredients should be given –

–       Saindhava

–       Sita

–       Madhu

–       Sarpi

निम्बाम्बुवामितवतः कफजेऽनुपानं राजद्रुमाम्बु मधुना तु सदीप्यकं स्यात् |
चूर्णं यदुक्तमथवाऽनिलजे तदेव …सर्वैश्च सर्वकृतमेवमुपक्रमेत ||८||

In Kaphaja Arochaka –

Vamana – emesis should be induced by administering the decoction of Nimba – Azadirachta indica.

The patient is later given decoction of Rajadruma added with honey and Dipyaka for drinking.

Alternatively, the powder prescribed for Vataja Arochaka can be prescribed.

For Tridoshaja Arochaka, all the treatments should be appropriately adopted.

द्राक्षापटोलविडवेत्रकरीरनिम्बमूर्वाभयाक्षबदरामलकेन्द्रवृक्षैः |
बीजैः करञ्जनृपवृक्षभवैश्च पिष्टैर्लेहं पचेत् सुरभिमूत्रयुतं यथावत् ||९||
मुस्तां वचां त्रिकटुकं रजनीद्वयं च भार्गीं च कुष्ठमथ निर्दहनीं च पिष्ट्वा |
मूत्रेऽविजे द्विरदमूत्रयुते पचेद्वा पाठां तुगामतिविषां रजनीं च मुख्याम् ||१०||
मण्डूकिमर्कममृतां च सलाङ्गलाख्यां मूत्रे पचेत्तु महिषस्य विधानविद्वा |
एतान्न सन्ति चतुरो लिहतस्तु लेहान् गुल्मारुचिश्वसनकण्ठहृदामयाश्च ||११||

Drakshadi Leha –

The paste of the below mentioned herbs added with cow’s urine and cooked to prepare confection and administered –

–       Drākşā,

–       Patola

–       Bida

–       Vetrakarira

–       Nimba

–       Murva

–       Abhaya

–       Aksa

–       Badara

–       Amalaka

–       Indravrksha

–       Seeds of Karanja

–       Nrpavrksha

Mustadi Leha

The paste of the below mentioned ingredients are added with sheep’s urine and made into confection and administered –

–       Musta

–       Vacha

–       Trikatuka

–       Haridra

–       Daruharidra

–       Bharngi

–       Kustha

–       Nirdahani (Chitraka)

Pathadi Leha

Powder of the below mentioned ingredients are boiled and cooked with elephant’s urine to form a confection and administered –

–       Patha

–       Tuga

–       Ativisha and

–       Rajani

Mandukaparnyadi Leha

Paste of the below mentioned ingredients should be cooked with buffalo’s urine, confection prepared and administered –

–       Mandukaparni

–       Arka

–       Amrta

–       Langalaka

Any person who consumes one of the above explained confections will get relieved from the below mentioned diseases –

–       Abdominal tumours

–       Anorexia

–       Dyspnoea

–       Diseases of the throat

–       Diseases of the heart

सात्म्यान् स्वदेशरचितान् विविधांश्च भक्ष्यान् पानानि मूलफलषाडवरागयोगान् |
अद्याद्रसांश्च विविधान् विविधैः प्रकारैर्भुञ्जीत चापि लघुरूक्षमनःसुखानि ||१२||
आस्थापनं विधिवदत्र विरेचनं च कुर्यान्मृदूनि शिरसश्च विरेचनानि |१३|

Below mentioned are the methods of taking foods in case of Arochaka –

–       Consumption of different kinds of accustomed eatables, drinks, condiments and salads

–       Foods prepared in his own country from roots and fruits

–       Consumption of meat soup along with

–       Different kinds of easily digestible foods

–       Foods which are dry and pleasing to the mind

In this disease the below mentioned therapies are also beneficial and should be administered in a mild way –

–       Decoction enema

–       Purgation

–       Head purging 

त्रीण्यूषणानि रजनीत्रिफलायुतानि चूर्णीकृतानि यवशूकविमिश्रितानि ||१३||
क्षौद्रायुतानि वितरेन्मुखबोधनार्थ मन्यानि तिक्तकटुकानि च भेषजानि |

Powder of the below mentioned should be licked along with honey to stimulate the tongue –

–       Tryusana – Trikatu – Pippali, Maricha and Shunti

–       Rajani

–       Triphala – Haritaki, Bibhitaki and Amalaki

–       Yavasuka / Yavaksara

Similarly, bitter or pungent tasting herbs should be made into powder and given for licking with honey.

मुस्तादिराजतरुवर्गदशाङ्गसिद्धैः क्वाथैर्जयेन्मधुयुतैर्विविधैश्च लेहैः ||१४||
मूत्रासवैर्गुडकृतैश्च तथा त्वरिष्टैः क्षारासवैश्च मधुमाधवतुल्यगन्धैः |१५|

This disease shall be treated by using the below mentioned, mixed with honey or confections prepared and administered

–       decoction of herbs of mustādi gana,

–       rājataru (āragvadhadi gana) and

–       daśāñga (dasamūla)

The below mentioned also should be administered –

–       fermented infusions prepared using urines or jaggery

–       fermented decoctions and infusions prepared from alkalis fermented infusions made from urines or guda (jaggery) possessing the smell of honey or wine

स्यादेषएवकफवातहतेविधिश्चशान्तिंगतेहुतभुजिप्रशमायतस्य।।१५।।

Kapha and Vata get mitigated by the administration of these therapies. Following this, treatments should be done to enhance the digestive fire.

इच्छाभिघातभयशोकहतेऽन्तरग्नौ भावान् भवाय वितरेत् खलु शक्यरूपान् |
अर्थेषु चाप्यपचितेषु पुनर्भवाय पौराणिकैः श्रुतिशतैरनुमानयेत्तम् ||१६||
दैन्यं गते मनसि बोधनमत्र शस्तं यद्यत् प्रियं तदुपसेव्यमरोचके तु ||१७||

Many times, arochaka is caused because of not getting the things one desires and also due to fear or grief. All these causes would result in loss of digestive fire and power. For these patients, substitutes for those desired things shall be given. Alternatively, when such substitutes cannot be procured, the patient should be consoled by narrating him the stories from mythology. Once the mind of the patient becomes calm by the above-mentioned methods, the patient should be encouraged to make use of other things as per his wish.

इति श्री सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रेऽरोचकप्रतिषेधो नाम (एकोनविंशोऽध्यायः, आदितः) सप्तपञ्चाशत्तमोऽध्यायः।।५७।।

Thus ends the fifty-seventh chapter by name Arocaka pratiședha in Uttara sthana of Suśruta Samhita.