Journal name: World Journal of Pharmaceutical Research
Original article title: A critical review of arsha
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Subtitle: an ayurvedic perspective
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Archana Singh and Neelam Gupta
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: A critical review of arsha
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
Doi: 10.20959/wjpr201811-12392
Copyright (license): WJPR: All rights reserved
Summary of article contents:
Introduction
Anorectal disorders, particularly Arsha (commonly known as piles or hemorrhoids), are significant medical conditions that manifest in the peri-anal and perineal regions. This article presents a comprehensive review of Arsha from an Ayurvedic perspective, detailing the various types of Arsha mentioned across ancient Ayurvedic texts. Notably, it highlights the criticality of this condition as described by ancient scholars, emphasizing its classification, symptoms, and prognostic significance.
Classification of Arsha
The classification of Arsha is diverse across various Ayurvedic texts, such as those of Charaka, Sushruta, Vagbhatta, Bhela, and Harita. These classifications take into account several factors, including the origin of the condition, its bleeding nature, and the predominance of Doshas (Vata, Pitta, Kapha). For instance, Arsha can be categorized based on its origin into 'Sahaja' (congenital) and 'Janmottarakalaja' (birth-related). Another classification includes the nature of bleeding, which can be either 'Shushka' (dry) or 'Sravi' (wet). The understanding of these classifications is crucial for determining the appropriate treatment and management of Arsha.
Symptoms of Arsha
The symptoms of Arsha are categorized into distinct forms based on various parameters, including the predominance of Doshas. For example, Vataja Arsha is associated with pain and changes in natural urges, while Pittaja Arsha presents with specific colorations and fluid characteristics. Additionally, symptoms are not only localized but can also affect the entire body, showcasing the condition's multifaceted nature. Premonitory symptoms, or 'Purva Rupa', manifest before the actual disease and provide valuable insights for diagnosis and treatment. This symptomatology underlines the need for a thorough examination to differentiate between various types of the disorder, ensuring a precise approach to management.
Upadrava (Complications of Arsha)
The concept of Upadrava refers to complications that arise during the course of Arsha. According to various ancient scholars like Acharya Charaka and Sushruta, conditions such as Baddha Gudodara (obstructed abdominal disorders) and Udavarta (abdominal distension) are significant complications associated with Arsha. Harita provides a more extensive list of complications, such as Tamaka Shwasa (asthma) and Atisara (diarrhea), indicating that the ramifications of Arsha extend beyond local symptoms to affect overall health. Understanding these complications is vital for effectively addressing both primary and secondary manifestations of the disease.
Conclusion
In conclusion, the exploration of Arsha through ancient Ayurvedic texts reveals a comprehensive understanding of this disorder, from its classification to its symptoms and possible complications. The rich tradition of Ayurvedic medicine offers valuable insights into the diagnosis and management of Arsha, integrating the concepts of Doshas, srotas (channels), and various bodily functions. These ancient teachings remain relevant today, emphasizing the importance of a holistic approach to healthcare that encompasses not just the physical aspects of disease, but also the underlying imbalances that contribute to conditions like Arsha.
FAQ section (important questions/answers):
What are anorectal disorders and where do they occur?
Anorectal disorders are medical issues that occur in the peri-anal and perineal region, where the snadyah pranahara marma is located.
How is Arsha classified in Ayurveda?
Arsha is classified based on origin, bleeding nature, dosha predominance, and prognosis. It can be categorized into Sadhya (curable), Yapya (palliative), and Asadhya (incurable).
What are the purva rupa of Arsha?
Purva Rupa refers to premonitory symptoms of Arsha that manifest before the disease fully appears. These symptoms vary across different srotas as described in ancient texts.
Which Acharyas discussed the symptoms of Arsha?
Acharya Charaka, Sushruta, Vagbhata, Bhela, Harita, and Madhav discussed symptoms of Arsha in their respective Ayurveda texts.
What are some specific symptoms of Vataja Arsha?
Specific symptoms include Angamarda, Guda shoola, Kati shoola, and varying pain in the body such as Hrud shoola or Parva bheda.
What is the conclusion about Arsha symptoms in Ayurveda?
Ancient Acharyas comprehensively described Arsha, addressing symptoms not only through dosha but also considering srotas, body parts, and natural urges.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “A critical review of arsha”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Arshas (Arsa, Arsas, Arsha):
Arsha refers to anorectal disorders in Ayurvedic medicine, a significant condition affecting the anal region. It is encompassed within the broader category of 'guda vikaras' highlighting its pathological relevance. The significance of this term lies in its implications for treatment approaches and understanding of symptoms related to anorectal health.
2) Harita:
Harita is one of the ancient Ayurvedic scholars who contributed to the understanding of various ailments, including conditions like Arsha. The relevance of Harita's work lies in the diverse diagnostic criteria and therapeutic recommendations provided in his texts, offering insights into Ayurvedic practices and treatment methodologies.
3) Vagbhata:
Vagbhata was an influential Ayurvedic practitioner known for his contributions to classical texts, providing clarity on the diagnosis and management of diseases. His input aids in expanding the understanding of conditions like Arsha, with classifications and treatment regimens that integrate holistic approaches common in Ayurvedic teachings.
4) Rakta:
Rakta signifies blood within Ayurvedic texts, and its vitiation is crucial in understanding various ailments, including Arsha. Conditions that manifest as Rakta-related disorders indicate bleeding symptoms or irritation, necessitating specific treatment strategies. The focus on Rakta helps practitioners diagnose and manage disorders effectively.
5) Upadrava:
Upadrava denotes complications arising from an initial disease. Understanding Upadrava is vital for Ayurvedic practitioners to manage secondary symptoms effectively that stem from primary disorders like Arsha. This term prompts a holistic view of patient health, considering all aspects of disease.
6) Disease:
In the context of Ayurveda, disease encompasses an array of dysfunctions in the body related to dosha imbalances. Understanding disease helps practitioners identify not just the symptoms but also the root causes and dosha interplay, facilitating more effective interventions and treatments.
7) Dosha (Dosa):
Dosha refers to the three fundamental energies (Vata, Pitta, Kapha) in Ayurveda that govern physiological processes. Analyzing an individual's dosha helps in determining imbalances that may lead to conditions such as Arsha, guiding personalized treatment approaches aimed at restoring balance.
8) Guda:
Guda is the term for the anal region in Ayurvedic literature. Its significance is heightened in disorders like Arsha, indicating the location of symptoms and guiding treatment approaches that address localized issues while considering the whole body’s health.
9) Srotas (Shrotas):
Srotas indicates the channels through which bodily fluids, energy, and nutrients flow in Ayurveda. Understanding Srotas is crucial for diagnosing and treating conditions like Arsha since they can influence the movement and absorption of doshas and thus affect overall health.
10) Udavarta:
Udavarta refers to a condition where there is upward movement of Vata, leading to various distressing symptoms. Recognizing Udavarta is pertinent for Ayurvedic practitioners managing Arsha, as it influences symptoms, treatments, and overall health enhancement strategies.
11) Surface:
Surface in this context often refers to conditions on the superficial levels of the body, including skin manifestations of diseases. In relation to Arsha, surface symptoms can help practitioners to identify severity and guide therapeutic decisions.
12) Nayana:
Nayana refers to the eyes in Ayurvedic texts. Understanding conditions of the Nayana can provide insights into systemic health, although not directly related to Arsha, highlighting the interconnectivity of bodily systems within Ayurveda.
13) Sahaja (Saha-ja):
Sahaja denotes congenital or innate conditions in Ayurvedic terms. In the context of Arsha, recognizing a Sahaja nature may influence treatment strategies, emphasizing the need for a deeper understanding of a patient's inherent dispositions toward certain disorders.
14) Nakha:
Nakha means nails in Ayurvedic literature. The health and appearance of Nakha can indicate internal health conditions. Assessing Nakha can guide practitioners in understanding systemic issues, albeit indirectly related to conditions like Arsha.
15) Ushna (Usna):
Ushna signifies heat within Ayurvedic concepts. The vitiation of Ushna can contribute to many diseases, including Arsha. Recognizing Ushna's role helps practitioners in tailoring treatments focused on cooling and balancing the body’s internal state.
16) Kandu (Kamdu):
Kandu refers to itching or irritation that often accompanies various conditions, including Arsha. Understanding Kandu assists practitioners in diagnosing and treating discomfort, focusing on symptomatic relief and underlying dosha balance.
17) Vali:
Vali refers to the folds or structures within the anal region. Recognition of Vali's anatomy is essential for diagnosing and treating conditions like Arsha, contributing to targeted therapeutic approaches in managing anorectal disorders.
18) Vata:
Vata is one of the three doshas and represents the elements of air and space. Its imbalance can lead to various disorders, including those affecting the anal region. Identifying Vata's role in diseases like Arsha assists practitioners in creating balanced treatment plans.
19) Purvarupa (Purva-rupa):
Purva-rupa refers to the premonitory symptoms that manifest before a disease fully develops. Identifying Purva-rupa in conditions such as Arsha is crucial for early intervention and effective management of health issues.
20) Bleeding:
Bleeding, in the context of Arsha, highlights one of the primary symptoms of this condition. Its recognition is essential since it guides diagnosis, severity assessment, and treatment strategies focusing on both symptom control and root cause correction.
21) Asadhya:
Asadhya refers to conditions considered incurable in Ayurvedic terms. Identifying Arsha as Asadhya indicates a need for focused treatment aimed at symptom management rather than complete curing, influencing a practitioner’s approach toward patient care.
22) Dasana (Dashana, Dashan-na):
Dashana means teeth in Ayurvedic context, often considered indicators of overall health. Though not directly connected to Arsha, the state of Dashana can provide insights into a patient’s nutritional status and systemic health.
23) Raktaja:
Raktaja refers to conditions related to blood. In the context of Arsha, identifying Raktaja characteristics promotes an understanding of the bleeding nature of some symptoms, guiding differential diagnoses and treatment plans focusing on blood-related issues.
24) Pittaja (Pitta-ja):
Pittaja signifies conditions associated with the Pitta dosha, often leading to inflammation or heat-related symptoms. Recognizing Pitta's role in Arsha assists practitioners in formulating treatments that pacify heat and balance bodily systems.
25) Vadana:
Vadana translates to face in Ayurvedic texts. While not implicated directly in Arsha, understanding facial health provides insights into overall wellness, reflecting the integrative approach of Ayurveda to assess health comprehensively.
26) Vataja (Vata-ja):
Vataja represents conditions arising from an imbalance of the Vata dosha. Recognizing Vataja characteristics in Arsha aids practitioners in implementing specific therapies aimed at rectifying Vata-related disturbances.
27) Mukha:
Mukha denotes the mouth or lips in Ayurvedic literature. Although its direct connection to Arsha may be limited, alterations in Mukha can reveal systemic health insights, emphasizing the holistic nature of Ayurvedic practice.
28) Graha:
Graha refers to the concept of grasp or hold in Ayurvedic terms, often tied to understanding diseases' complex natures. Its application fosters a deeper comprehension of how different factors affect disease manifestation.
29) Varna:
Varna means color and is integral in Ayurvedic diagnosis. Observing Varna of different body parts, including lesions or symptoms, provides practitioners with essential clues for identifying and managing disorders like Arsha.
30) Purva:
Purva translates to 'pre-' in Ayurvedic contexts, implicating earlier phases of disease development. Understanding Purva symptoms offers the potential for early intervention, thereby reducing the severity of conditions like Arsha.
31) Roga:
Roga refers to disease or illness in Ayurveda, encompassing all health-related issues. Examining Roga allows practitioners to understand the complexities of patient symptoms, identify dosha imbalances, and devise holistic treatment plans.
32) Anna:
Anna pertains to food in Ayurvedic philosophy, essential for sustaining health. Its relationship to Arsha stems from dietary influences on digestion and bowel health, directly impacting the state of the anal region.
33) Rupa:
Rupa means form or appearance, reflecting how conditions like Arsha manifest visually. Analyzing Rupa helps practitioners to understand disease severity and implement targeted treatment strategies based on symptom expressions.
34) Shalyatantra (Salyatantra, Shalya-tantra, Shalyatamtra):
Shalya-tantra is a specialized field in Ayurveda centered on surgery and invasive procedures. Its relevance emerges when managing advanced or complicated cases of Arsha, determining the appropriateness of surgical interventions in treatment.
35) Vishtambha (Vistambha):
Vishtambha refers to constipation or the difficulty in bowel movements, a common symptom associated with anorectal conditions like Arsha. Understanding Vishtambha assists practitioners in creating effective treatment strategies focused on easing digestive transit.
36) Udararoga (Udara-roga):
Udara-roga refers to abdominal diseases in Ayurveda. The correlation of Udara-roga with Arsha signifies the interplay of digestive health impacting anorectal conditions, emphasizing a holistic treatment perspective.
37) Sannibha (Samnibha):
Sannibha indicates resemblance or similarity in form. In the context of Arsha, recognizing Sannibha characteristics aids in differential diagnosis, enhancing understanding of various disease expressions and tailored treatment approaches.
38) Mandagni (Manda-agni, Mamdagni):
Mandagni refers to weak digestive capacities in Ayurveda, which can exacerbate symptoms like those seen in Arsha. It's essential to identify Mandagni to develop strategies that strengthen digestion and overall health.
39) Rudhira:
Rudhira translates as blood in Ayurvedic terms. Understanding its vitiation is essential in diagnosing conditions like Arsha, where bleeding may be a critical symptom that guides treatment decisions.
40) Atisara:
Atisara denotes severe diarrhea in Ayurveda. Its connection to Arsha may arise in cases where acute exacerbation of symptoms occurs, necessitating integrated management approaches that address both conditions.
41) Shushka (Suska):
Shushka means dry, often used to describe types of conditions or symptoms in Ayurvedic pathology. Recognizing Shushka characteristics assists practitioners in understanding hydration balance in relation to conditions like Arsha.
42) Grahani:
Grahani represents a disorder of the gut related to absorption, often leading to digestive issues. Understanding Grahani is relevant for Ayurvedic management of conditions like Arsha, focusing on improving nutrient absorption and digestion.
43) Kaphaja:
Kaphaja refers to conditions caused by the Kappa dosha, leading to heavy, stagnant qualities. Recognizing Kaphaja in Arsha assists practitioners in formulating therapies that balance this dosha’s impact on digestion and elimination.
44) Praroha:
Praroha indicates growth or budding, often used in the context of tumors or abnormal tissue formation. Its association with Arsha assists in understanding various manifestations of growths, informing treatment strategies.
45) Tantra (Tamtra, Tantrism):
Tantra refers to systems or practices in Ayurveda encompassing various knowledge aspects. Understanding Tantra fosters a comprehensive approach to diagnosis and treatment, enriching the management of conditions like Arsha.
46) Vikara:
Vikaras denotes disorders or pathologies across Ayurveda, cumulatively informing understanding of complex presentations. Understanding Vikaras assists practitioners in comprehensive patient evaluations and targeted treatment formulations.
47) Sadhya:
Sadhya denotes conditions that are curable. Identifying Arsha as Sadhya allows Ayurvedic practitioners to devise effective therapeutic strategies aimed at complete recovery, emphasizing the dynamic nature of Ayurvedic healing.
48) Ruksha (Ruksa):
Ruksha indicates dryness in Ayurvedic terminology, often associated with a particular dosha's qualities. Recognizing Ruksha helps practitioners in understanding the nature of symptoms present in conditions like Arsha for appropriate treatments.
49) Sahasa:
Sahasa refers to sudden or acute conditions in Ayurveda. The understanding of Sahasa patterns assists practitioners in assessing and managing Arsha during acute flare-ups, ensuring timely interventions.
50) Shalya (Salya):
Shalya translates to surgical instruments in Ayurveda, indicating procedures that may be necessary for severe cases of Arsha. Its emphasis on surgical therapy within Ayurveda represents the duality of treatment approaches in managing such disorders.
51) Guruta:
Guruta refers to heaviness, often categorized as a symptom among various conditions, including Arsha. Understanding Guruta assists in assessing the severity of complaints and guides tailored therapeutic pathways.
52) Baddha:
Baddha translates to 'bound' or 'restricted.' In Ayurvedic discussions about Arsha, recognizing Baddha implications helps identify the constrictive symptoms that might accompany anal disorders.
53) Udgara:
Udgara denotes the act of belching or expulsion of gas from the stomach. Understanding Udgara's relation to Arsha assists practitioners in identifying broader digestive issues impacting anorectal health.
54) Analpa:
Analpa means insufficient or inadequate in Ayurvedic texts. This term's relevance lies in diagnosing conditions that may present with insufficient clinical representations, informing practitioners on nuanced case representations.
55) Medhra:
Medhra refers to the male reproductive organs in Ayurveda, implicating their interconnectedness to anorectal health. Understanding Medhra's contributions aids practitioners in evaluating Arsha from a comprehensive health perspective.
56) Shosha (Sosa):
Shosha means emaciation or dryness. Recognizing Shosha is essential for identifying possible nutritional deficiencies or chronic conditions that can exacerbate symptoms associated with Arsha.
57) Nature:
Nature in the Ayurvedic context refers to the innate characteristics of individuals, including dosha profiles. Understanding Nature helps practitioners devise personalized treatment plans for conditions like Arsha, focusing on individual health needs.
58) Udara:
Udara pertains to the abdomen and its disorders in Ayurveda. Recognizing links between Udara disorders and Arsha emphasizes the interconnected nature of abdominal health and anorectal conditions.
59) Marma:
Marma refers to vital points in the body considered essential for healing practices in Ayurveda. Their relevance in relation to Arsha highlights the importance of targeted therapies aimed at restoring health through these critical points.
60) Gulma:
Gulma indicates masses or swellings in Ayurveda, often tied to blockages or disturbances. Identifying Gulma helps practitioners address underlying obstructions contributing to Arsha symptoms, focusing on restoring normalcy.
61) Mamsa (Mamsha):
Mamsa signifies flesh or muscle in Ayurvedic texts, associated with tissue health. Its examination is relevant in understanding the structural health surrounding the anal region in conditions like Arsha.
62) Drava:
Drava refers to liquid or fluid. Recognizing Drava characteristics in relation to conditions like Arsha impacts understanding of various bodily fluids' balance, guiding hydration-focused treatment methodologies.
63) Basti:
Basti indicates a therapeutic procedure involving the administration of medicated oils or fluids in the rectal area. It’s a vital treatment modality for managing conditions like Arsha effectively.
64) India:
As the birthplace of Ayurveda, India holds profound significance for the study and practice of traditional healing methods. Its cultural understandings influence contemporary applications of Ayurvedic principles in managing disorders like Arsha.
65) Bheda:
Bheda refers to differentiation, often utilized in diagnosis to determine distinct disease features. In studying Arsha, Bheda helps delineate between dosha imbalances that may present with similar symptoms.
66) Nila:
Neela translates to blue or dark, often used to describe discolouration associated with various diseases. Understanding Neela in relation to Arsha assists practitioners in recognizing and diagnosing systemic imbalances.
67) Ruja:
Ruja signifies pain, which is central to many clinical presentations of Arsha. Recognizing Ruja aids practitioners in addressing discomfort, tailoring treatments towards alleviating pain associated with anorectal disorders.
68) Kati:
Kati refers to the waist or lower back region in Ayurvedic texts. Its examination aids practitioners in correlating lower body issues that may impact conditions such as Arsha, emphasizing treatable links in therapy.
69) Kasa (Kasha):
Kasa means cough, prevalent in respiratory conditions. Although not directly connected to Arsha, understanding the nuances of Kasa can assist in diagnosing and treating multifaceted health issues.
70) Vaha:
Vaha denotes channels or pathways for bodily functions, integral in understanding how doshas influence health. Recognizing Vaha's role in managing conditions like Arsha aids in providing holistic treatments.
71) Daha:
Daha refers to burning sensations that often accompany various dosha imbalances. Recognizing Daha features in Arsha helps practitioners identify discomfort levels, guiding appropriate cooling therapies.
72) Pain:
Pain is a significant symptom in conditions like Arsha, influencing diagnosis and treatment strategies. Understanding pain characteristics is paramount for practitioners to develop comprehensive management approaches directing patient care.
73) New Delhi:
New Delhi, as a capital city, embodies a blend of traditional and modern healing practices, emphasizing the ongoing relevance of Ayurveda in contemporary healthcare environments, including significant health conditions such as Arsha.
74) Udgarabahulya (Udgara-bahulya):
Udgara-bahulya refers to excessive belching or gas expulsion. Understanding this symptom aids practitioners by linking gastrointestinal disturbances with anorectal health, fostering integrated treatment strategies.
75) Mamsapraroha (Mamsa-praroha):
Mamsa-praroha denotes the growth of flesh or tissue, reflecting development in the context of conditions like Arsha. Identifying its characteristics allows practitioners to tailor treatment plans for growth management.
[Note: The above list is limited to 75. Total glossary definitions available: 177]
Other Science Concepts:
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Yapya, Sadhya, Purvarupa, Asadhya, Upadrava, Gudavikara, Astamahagada, Vataja Arsha, Pittaja Arsha, Sadyah pranahara marma.