Atisaara

References:
C.Chi.19, S.U.40, A.H.Ni.8

Introduction:
Atisaara is a condition in which liquid stool is passed in excess quantity. The movement of the Pureesha gets increased. It is serious disease.

Mythological origin:

1. In Kritayuga (Aadikaala) animals were brought near for sacrificial rite / ceremony but they were not sacrificed / killed.
2. At the time after the sacrificial rites were carried out by Daksha (in Daksha Yadnya / Kratu), the sons of Manu also carried out Kratu.
3. The sons of Manu were Narishyat, Aabhaaga, Ikshvaaku, Nriga, S`haryaati.
4. In the sacrificial rites (Kratu) of the sons of Manu, animals allowed themselves to be sacrificed. So they are sacrificed with proper prayers / rituals. ( Prokshan`a Vidhipoorvakam Maaran`am)
5. It has been said in the Veda that one who sacrifices and one who gets sacrificed both become liable for moral and religious merits (Pun`ya)
6. That is the reason why animals allowed themselves to get sacrificed.
7. In the descendent time Prishadhra, son of Manu organized another sacrificial rite for a very long period.
8. He was unable to get the animals for the sacrifice. So, he sacrificed cows instead of animals.
9. Cow is a religious and respected animal in Indian customs and traditions. Hence when cows were sacrificed, living beings were afflicted by sadness as cows were never sacrificed before this. They were sacrificed for the first time in the sacrificial rite of Prishadhra.
10. Meat of these ritually sacrificed cows were eaten by people (as Purod`aas`ha).
11. Being heavy (Guru), hot (Ushn`a), unwholesome (Asaatmya), ineffable, and unwished (As`hasta Upayogaat) the capacity of digestive fire was reduced (Agni Upahanana) and caused destruction of minds (Mano Upahanana)
12. These led to Atisaara in the Kratu of Prishadhra.
13. This story suggests that causative factors of Atisaara are Mano Upaghaata and consumption of unwholesome diet having attributes like Guru etc.

Nirukti:
Atisaran`am Atisaarah | S. U. 40/2 D`alhan`a
Saamam S`hakrit Niraamam Vaa Jeern`e Yena Atisaaryate |
So Atisaarah Ateesaran`aad Aas`hukaaree Svabhaavatah || A.H.Ni.8/16,17
Atisaran`aad Atisaara iti Uchyate | A. H. Ni. 8/16 Arun`adatta
Atih Atyathavachane, Saratih Gatikarman`i |
Tasmaad Atyanta Saran`aad Atisaarah || S. U. 40/2 D`alhan`a
Apaam Dhaatuh Ati iva Adhah Sarati Yasmaad Tam Ghoram Vyaadhim Atisaaram Aahuh | S.U.40/6.
Gudena Bahu Drava Saran`am Atiarah | M. Ni. 3/4 Madhukos`ha.
Passage of watery stool is cardinal sign of this disease.

Types according to various texts

Charaka	Vaagbhat`a	Sus`hruta	Maadhava
Vaataja	Vaataja	Vaataja	Vaataja
Pittaja	Pittaja	Pittaja	Pittaja
Kaphaja	Kaphaja	Kaphaja	Kaphaja
Tridoshaja	Tridoshaja	Tridoshaja	Tridoshaja
Bhayaja (Aagantu)	Bhayaja (Aagantu)	–	–
S`hokaja (Aagantu)	S`hokaja (Aagantu)	S`hokaja	S`hokaja
–	–	Aamaja	Aamaja

Other types (mentioned by Asht`aanga Hridaya) are Sarakta and Nirakta

There are no Dvandvaja Atisaara (Vyaadhisvabhaavaat) described. However, Haarita have quoted Dvandvaja types of Atisaara, moreover in Chikitsaa suchtypes are described. But they are not supported by Sus`hruta. According toD`alhan`a in Doshaja Atisaara, there is association of another Dosha; hence it creates a picture of Dvandvaja type. But it can be considered as a specific condition in Atisaara (Avasthaa).

Sampraapti

1. Causative factors hamper Agni also cause Aapa Dhaatu Dusht`ee.
2. Body fluids (Apaam Dhaatuh Kaaya Drava) further lower digestive capacity and gets mixed with the Pureesha.
3. Aggravated Vaayu moves down the body fluid (Abdhaatu) causing Atisaara.

Description of each type:

Vaataja Atisaara

1. Vaayu gets aggravated in a person who is of Vaataja constitution, and who indulges in Vaata aggravating diet and behavior.
2. It hampers the capacity to digest (Paktaa Upahanyate)
3. The Sweat and Urine both are brought into the Pakvaas`haya (Pureeshaas`haya), which lead to increase in liquidity of stools (Pureesham Draveekritya)
4. These liquefied stools pass through Guda, which is termed as Vaataja Atisaara.

Though Aama and Pakva types are subtypes of Vaataja Atisaara, all types of Atisaara in their prior stage may have Aamaavasthaa and in later stage Pakvaavasthaa.
Pakva Atisaara (Anugrathita) thickened (Grathita) stools are passed.
Aama Atisaara dry (Rooksha) and liquid (Drava) stools are passed.
        

Pittaja Atisaara

1. Pitta gets aggravated in a person who is of Pittaja constitution, and who indulges in Pitta aggravating diet and behaviour.
2. This aggravated Pitta with its liquidity (Drava attribute) lowers the capacity of digestive fire to digest and enters into the Pakvaas`haya (Pureeshaas`haya Visritam).
3. Due to its Sara and Drava attribute it shatters (Bhinna) and liquefies the stools, which pass through anus causing Pittaja Atisaara.

 Kaphaja Atisaara

1. Kapha gets aggravated in a person who is of Kapha constitution, indulges in Kapha aggravating diet and behaviour.
2. Due to its attributes like Guru, S`heeta, Madhura, Snigdha, it lowers the capacity of the digestive fire.
3. With its cold attribute it affects Pureesha in Pureeshaas`haya.
4. It moistens the Pureesha, which passes through anus causing Kaphaja Atisaara.

 Tridoshaja Atisaara

1. In a person whose digestive capacity is reduced and who indulges in causative factors aggravating all the three Dosha, digestive capacity gets reduced totally.
2. These aggravated Dosha enter into the Pakvaas`haya, which manifests in Atisaara with symptoms and signs of all the three Dosha.
3. Saannipaatika Atisaara is Krichchhrasaadhya and Asaadhya in children and old persons.
4. Sudden cure from Saannipaatika Atisaara is one of its Asaadhya Lakshan`a.

  Aagantu Atisaara (Bhayaja and S`hokaja)

1. Due to Bhaya (Fear) and S`hoka (Sorrow) Vaayu gets aggravated.
2. This aggravated Vaayu causes Atisaara.

S`hokaja Atisaara

1. Sorrow or grief and hunger reduce digestive capacity of the person.
2. Rakta Dhaatu gets irritated. (Kshobha)
3. Then with difficulty Pureesha passes through Guda with difficulty.
4. Pureesha resembles red colour of Gunjaa

Bhayaja Atisaara

1. When mind is irritated by fear, Vaayu with Pitta increases liquidity in Pureesha.
2. This Vaayu expels out the Pureesha causing Bhayaja Atisaara.

Aamaja Atisaara

1. In a person having Aamaajeern`a, vitiated Dosha irritate Koshth`a.
2. These Dosha pass out through anus manifesting different coloured Pureesha and with undigested food material causing Aamaja Atisaara.

 Aama Atisaara
When Pureesha is associated with Dosha, it sinks into the water, it has excessive bad odour, it does not pass at one time completely (Alpa Alpa Pravartakam) and when it is excessively sticky (Pichchhila) the diagnosis is AamaAtisaara.
 PakvaAtisaara
When all the signs and symptoms are opposite to Aama Atisaara, it is said to be Pakva Atisaara.
 Raktaatisaara
A person suffering form Pittaja Atisaara, if persistently consumes Pitta aggravating diet then RaktaAtisaara gets manifested.

Upadrava of Atisaara
S`hopha
S`hoola
Jvara
Trishn`aa
S`hvaasa
Kaasa
Arochaka
Chhardi
Hikkaa
Moorchchhaa

When Atisaara due to no reason violates signs and symptoms of Dosha, probable causes are:
        Snehaajeern`a nimittaja
        Visoochikaa nimittaja
        Visha nimittaja
        Ars`ha nimittaja
        Krimi nimittaja

Difference between Atisaara and Grahan`ee

Differentiating factor	Atisaara	Grahan`ee
Svabhaava	Aas`hukaaree	Chirakaaree
Aahaara Avasthaa	Pureesha is expelled out when Aahaara is Jeern`a	Pureesha is expelled out when Aahaara may be Jeern`a (Pakva) or it may be Ajeern`a (Saama)
Pureesha Nihsaran`a	Pureesha is expelled out excessively (Atee)	Pureesha is not expelled out excessively
Dosha Avasthaa	There is no Dosha sanchaya	It manifests due to Dosha Sanchaya

1. When urine and Vaayu (Adhovaata – D`alhan`a) pass without Pureesha
2. When digestive capacity gets increased
3. When Kosht`ha becomes Laghu (Without heaviness)

If these signs are present, one can say that Atisaara is cured.

Atisaara Nivritti Lakshan`a: (Signs of cure after Atisaara)

Last updated on February 5th, 2021 at 11:55 am