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Ars`ha

References:
C.Chi.14, S. Ni 2, A.H.Ni.7, M.Ni.5,

Synonyms:
Durnaama, Maamsa Praroha, Maamsa Ankura, Maamsa Keelaka, Maamsa Kareera, Gudakeela, Gudaankura, Guda Rooha, Gudaja, Hatanaama

Svaroopa:
Ars`ha are hemorrhoids or piles. It is excessive and unnatural growth of the Maamsa Dhaatu. These are caused in Guda (anal canal) in folds or sphincters(Valee).

Nirukti:

  1. Arivat Praan`ino Maamsa Keelakaa Vis`hasanti Yat |
    Ars`haamsi Tasmaad Uchyante || A. H. Ni. 7.1
  2. Arivat Praan`aan S`hrin`aati Hinasti iti Ars`hah | M. Ni. 5.1
    (Patient having Maamsa Keelaka (Ars`ha) suffers severely as if one is suffering from an enemy (Arivat). Hence the disease is called Ars`ha.)

Anatomical aspect of Guda (anal canal)
This area has three Valee (folds) those divide the canal into three parts. Each Valee measures one and half Angula. These folds are constituted by Maamsa. This part of the colon, which is four and half Angula in length includes anal opening, which is half Angula (figure) in length. Ars`ha is manifested in this area.

Types of Ars`ha:
Types of Ars`ha according to various texts:

CharakaSus`rutaAsht`aanga HridayaMaadhava Nidaana
SahajaSahajaSahaja
VaatajaVaatajaVaatajaVaataja
PittajaPittajaPittajaPittaja
KaphajaKaphajaKaphajaKaphaja
DvandvajaDvandvaja
SaannipaatikaSaannipaatajaSaannipaatikaSaannipaatika
S`hon`itajaRaktajaRaktaja

Sahaja Ars`ha
According to Charaka and Sus`ruta Ars`ha could be congenital in nature. They are termed as Sahaja Ars`ha. (Saha Jaataani S`hareeren`a).

Sahaja Ars`ha: Sampraapti:
1.    Unwholesome dietary and behavioral regimes (also sinful acts of past life) of mother and father leads to impaired part of Beeja (S`hukra and S`hon`ita), which is responsible for Gudavalee formation.
2.    This leads to deformity in anal region to manifest congenital piles (Sahaja Ars`ha)
These reasons are applicable not only to the Ars`ha but to all the other diseases also, which are caused by the Beeja Dusht`i.
Other types are based on Dosha dominance and are important for treatment decisions.
1.                                                       S`hushka Ars`ha = Vaata and Kapha Dominance
2.                                                       Sraavee Ars`ha = Rakta and Pitta Dominance

Related Sampraapti factors
Generally, this disease is caused by vitiation of Maamsa Dhaatu (Adhi Maamsa Vikaara) with vitiation of three Dosha. (i.e. it is Tridoshaja Vikaara). Meda and Tvak are other involved factors in the all types of Ars`ha.

This growth (Ars`ha) appears in various sizes and shapes as long, short, round, irregularly spread, matted together etc. Their characteristic colours are according the involved Dosha.

Ars`ha Sampraapti:
1.    Apaana Vaayu gets aggravated due to causative factors. (Person having Mandaagni is prone to Ars`ha.)
2.    The aggravated Apaana Vaayu brings down the accumulated waste products (Upachita Mala).
3.    This aggravation of Dosha and Rakta takes place.
4.    These aggravated Dosha (all three Dosha) move along with the course of Pradhaana Dhamanee (Pureeshavaahee) in the downward direction.
5.    These Dosha get located in Guda and vitiate Guda valee producing the muscular growth or piles (Maamsapraroha).
6.    Apaana Vaayu gets obstructed by the growth of Maamsa Dhaatu in the anal canal. Due to this obstruction Apaana Vaayu moves upwards and aggravates SamaanaVyaanaPraan`a and Udaana Vaayu.
7.    All the aggravated five types of VaayuPitta and Kapha are responsible for the disease like Ars`ha.
8.    A person with Ars`ha gets all the diseases caused by Vaayu (Vaata VikaaraPitta and Kapha Vikaara are also manifested as there is aggravation of Pitta and Kapha also.

Clinical presentation (Lakshan`a) of Ars`ha:

        Presence of piles or hemorrhoids is cardinal sign of Ars`ha.
        The prodromal symptoms of Ars`ha may mislead a physician with the diseases like UdaraGrahan`ee, Paan`d`u.
        The signs and symptoms of Ars`ha get manifested in accordance with the dominance of the Dosha.
        Other signs include:Patient is becomes lean, thin, pale and emaciated.
Patient gets irregular bowel habits with changing stool consistency (i.e. hard, loose), sometimes it is normal and sometimes it is Saama or Niraama.
Patient passes stool, flatus, and urine in excessive quantity and sometimes having constipation. Also patient passes various coloured stained stools. viz. white, pale yellow, green, yellowish, red, reddish, having different consistencies i.e. slimy, thin, dense with offensive smell like dead body.
Patient get other diseases as complications as:
        Udaavarta is the main complication.
        Gravels and stone in the urinary tract.
        Sharp shooting /cutting pain at umbilicus and around urinary bladder and pelvis, anal pain.
        Pravaahikaa, Pariharsha, Prameha, Visht`ambha (constipation), Antrakoojana (hyper peristaltic sound), Hridaya Upalepa, Indriya Upalepa.
        At times he gets excessive belching associated with bitter and sour taste.
        Excessive generalized weakness with depleted digestive power.
        Depleted state of S`hukra Dhaatu (semen)
        These patients are agitated and are difficult to treat.
        Other symptoms include: Kaasa, S`hvaasa, Tamaka S`hvaasa, Trishn`aa, Hrillaasa, Chhardee, Arochaka, Avipaaka, Peenasa, Kshavathu, malaise, Jvara (fever),oedema on hands, feet, face and Akshikoot`a, Paars`hva, Kukshi, Hridaya, Prisht`ha, Trika
        Taimirika: patient feels as if he is entering into darkness and suffers from headache.
        Voice becomes Kshaama (weak), Bhinna (broken), Sanna (low pitched voice), Sakta (impeded) and Jarjara (hoarse)
        Patient develops frequent Karn`a Roga. (ear complainants)

Specific complications (Upadrava) of Ars`ha:

Ars`ha typeVaatajaPittajaKaphajaRaktaja
UpadravaGulma Jvara S`hophaAakshepaka
 PleehaaDaaha S`heeta Jvara
 Asht`heelaaPipaasaa Arochaka
  Moorchchhaa Avipaaka
    S`hirogaurava

Ars`ha is to be treated immediately. Otherwise they produce Baddha Gudodara (obstruction to anal canal.)
Other sites of Ars`ha
Though the term Ars`hameans piles or hemorrhoids, various muscular growths like polyps are also described as Ars`ha due to similarity in pathogenesis. Ars`ha might occur at several other locations like S`hisna (penis), Apatya Patha (female genital tract), Gala (throat), Taalu (palate), Mukha (mouth), Naasaa (nose), Karn`a (ears), Akshi Vartma (eyelids), Tvak (skin) etc. Each type is described as follows:

        Med`hra Ars`ha
Aggravated Dosha vitiate Maamsa and S`hon`ita of penis. It causes itching. The wound is formed due to scratching. In this wound, the vitiated Maamsa grow out on the glans penis, which lead to the deformity in the penis and causes Pumstva Upaghaata (impotency).

        Yoni Ars`ha
Aggravated Dosha produce muscular growths in the vagina which destruct Aartava and normal functioning of vagina and anal related structures.

        Naabhi Ars`ha
Aggravated Dosha produce muscular growths in the umbilical region.

        Karn`a Ars`ha
Aggravated Dosha tend to develop Ars`ha in the ear causing deafness, pain and suppuration in ear. (For details, please refer Karn`a Roga)

        Netra Ars`ha
Ars`ha formed on the eyelid cause difficulty in movements of eyelid, manifests symptoms like pain, lacrimation . It may hamper vision also.

        Naasaa Ars`ha
It develops internal cavity of nose, causes Pratis`hyaaya, sneezing, difficulty in exhalation, Pootinasya, nasal voice (Anunaasika Vaakya), headache. (For details, please refer Naasaa Roga)

        Mukha Ars`ha
It causes Gadgad Vaak (obstructed and deep voice ), Rasa Adnyaana (tastelessness) and diseases of mouth.

        Charmakeela
The aggravated Vyaana Vaayu with Kapha produces stable muscular growth like Keela (nail) on the surface of the skin. In Charmakeela there is pricking pain and dryness due to Vaayu. It looks blackish red due to Pitta. It is oily and glandular due to Kapha. (For details, please refer Kshudra Roga)

Saadhya – Asaadhyatva:
Ars`ha is difficult to cure. Patient suffers a lot from this disease. In complications, other organs are also involved.

Ars`ha: Comparative study of subtypes and Sampraapti factors

Sampra apti factorsArs`haSahajaJaatottarajaVaatajaPittajaKaphajaTridoshajaRaktaja
DoshaVaata PrakopaPitta PrakopaKapha Prakopa Praan`a, Udaana, Apaana, Samaana, Vyaana PrakopaApaana PrakopaApaana RodhaSamaana PrakopaVyaana PrakopaPraan`a PrakopaUdaana PrakopaPitta PrakopaKapha PrakopaApaana PrakopaVaata PrakopaPitta PrakopaKapha PrakopaTridosha PrakopaPitta Prakopa
DoshaGun`a(Rasa   RookshaS`heetaLaghuKharaSookshmaTeekshn`aUshn`a (Kat`uLavan`a) Snigdha, S`heetaGuruMandaS`hlakshan`aSthira  
DhaatuMedas, MaamsaAlpa S`hukra, Ksheen`a Retas,Dhaatu Kshobha   S`hukra Naas`ha,Klaibya  
UpadhaatuTvak       
MalaAti Nichita MalaPrachura Vibaddha, Vaata Mootra, Pureesha Saama, Pureesha Mootra Kshobha,Pureesha RodhaUpachita MalaPratata Vibaddha Vaata Mootra Varchas,Samhata PureeshaBhinna Varchas Prachura Vit`, MootraSarakta PureeshaSas`hleshma Pureesha Avagaad`ha Pureesha, Gaad`ha Vit`,Sarakta Pureesha

Ars`ha: Comparative study of subtypes and Sampraapti factors

 Ars`haSahajaJaatottarajaVaatajaPittajaKaphajaTridoshajaRaktaja
SrotasMedovaha,Maamsavaha       
IndriyaIndriya DaurbalyaIndriya Upalepa     Kalusha Indriya
AgniAgni SaadaDurbala Agni, Alpa Agni,Agni Manda   Agni Maardava  
Ojas       Hata Ojus

Last updated on May 26th, 2021 at 11:29 am

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