(ImTessjjondenqt RAKTA PITTYA" (BLOOD BILE) OP AYURVED

To the Editor o/The Indian Medical Gazette.

Sir,-With reference to Lieutenant-Colonel Sutherland's articlo on Ayurveda, I beg: to state that to understand the true import of "

llakta-Pittya" of Ayurved, by which is not meant haemorrhage but a chronic, diseased condition of the digestive system in which haemorrhage is the most

prominent symptom, we must turn to the causation of medicine in the indigenous system of medicine.

Diseases may be due to : (i) Derangement (exciteme .t or depression) of one or

more of the three " dothes" (6au, pit'ya and Jcaph) into which the vital foroe of the body bos been divided in

158 THE INDIAN MEDICAL. GAZETTE. [April, 1919.

Ayurved. Sucli a disease is as a rule functional and has an

acute course.

(ii) Primary derangement of one or more divisions of the vital force which secondarily affect one or more of the eight

" dhatus" (tissues) of the body. The " dhatus " are " rasa

"

(chvle), " rakla " (blood),

" mausa "

(muscular tissue), " medha

"

(fatty tissue), "asthi " (bone),

"

majjar "

(marrow), " sukra " (germinal fluid), and

" ojha " (nervous tissue).

A disease of this group is more complicated, has a chronic course and is accompanied by structural changes. " Blood-bile " is therefore a chronic, diseased condition in

which the particular division of the vital force known as

"pittya" is primarily affected, which, in its turn, affects the "dhatu" known as blood.

Though the derangement of any one of the divisions of vital force upsets the equilibrium we find in health and

may manifest in symptoms in any tissue or organ, yet the

derancement of "pittya" is mainly manifested on the

digestive system just as that of'' bau " on the nervous system

and of " kapha" on the secretory and excretory organs and tissues of the body. The derangement of " rakta" may manifest itself in

symptom on any organ or tissue of the body, but coupled with " pittya

" it manifests itself mainly as disease of the

digestive system. It may however be noted here that other

systems do not entirely escape in "

rakta-pittya" The change induced in the blood by the action of deranged

or excited (as opposed to depressed) " pittya" causes hse

morrhage, which is nature's mode of relieving congestion, the result of excited "pittya" Advantage is taken of this mode of relief of congestion by venesection. The object of treatment is to help nature, not to go against

it. Tn a case of " rakta-pittya

" deranged treatment should

be directed to remove the derangement, not to check the haemorrhage by which nature tries to remove deranged or

bad blood from the system, and by lowering the blood

pressure which is unduly raised by excited "

pittya," depress it and restore it to its normal condition. Thus it is that

Ayurved enjoins that haemorrhage if suddenly " checked at

the outset " is harmful and induces a number of diseases.

Tn " rakta-pittya" haemorrhage may come up from the upper digestive tract, e.g., haematemesis or go down from the lower digestive tract, e. g.. melsora or from the various

appendages of the alimentary canal, e. g., liver, as hemor-

rhagic piles. It may also come from local congestion from any tissue or organ unconnected with the digestive system, due to the increased blood-supply of a part and the resulting congestion due to excited "pittya," e.g., nose, larynx, brain, etc.

It does not require much stress of imagination to under- stand that laryngeal congestion, which is relieved by haemor- rhage at times, may cause

" loss of voice " if nature's mode of relief is suddenly checked ; a nasal congestion similarly may cause

" ozcena," a cerebral congestion may induce

"swooning," a congestion of the lower genito urinary tract may cause

" strangury," a persistent congestion of the liver mav cause haemorrhagic

" piles

" and later " fistnla-in-ano."

Modern medicine corroborates the well-known clinical fact of the association of haemorrhage with enlarged spleen. Bruptive and other fevers like typhoid all such conditions of disease being due to derangement of

" rakta and pittya." According to Ayurved again, the haemorrhage of

" rakta-

pittya" if suddenly "checked at the outset" may cause some skin diseases like leucoderma, leprosy, eryipelas, etc.. which are more or less associated with derangement of blood and " pittya."

In conclusion. I must state that our thanks are due to Lieutenant-Colonel Sutherland for devoting so much of his energy and valuable time to the study of Ayurved and for his increased sympathy towards it. We await with eagerness his next article on Ayurved, which we hope will illuminate

many a dark corner in the indigenous system of medicine and help its rejuvenation.

? A. T. KOY, L.M.S.

Hazaripagh :

February 1 \lh, 1919.