Manage Ulcerative Colitis

Treatment of Ulcerative Colitis

Modern Point of View

Treatment of Ulcerative Colitis

Treatment of Ulcerative colitis depends upon how often the symptoms of UC flare up and how severe is the condition of the patient.

Two Types of Treatment are Done so Patients get:

• Inducing remission (a period without symptoms)
• Maintain remission

Medicines that Can Be Used to Treat UC are as follows:

• Aminoacylates 
• Cortico- steroids
• Immunosuppressant 
• Biologic medicine
• Tofacitinib

Surgery (removal of colon that can be done either by an ileostomy or by creating ileoanal pouch i.e., J- pouch)

Treatment of Ulcerative colitis

Ayurvedic Point of View

Treatment of Ulcerative colitis (Pittaja Atisara Chikitsa)

CharakaSamhita Chikitsa Sthana. 19/ 50

पित्तातिसारं पुन र्निदानोपशया कृतिशभिरामान्वयमुपल यथा बलं लड्डन पाचनाभ्यामुपाचरेत्‌| 

तृष्यतस्तु मुस्तपर्पटकोशीर सारिवार्चन्दनकिराततिक्तकोदीच्यवारिभिरुपचार: । लङ्घितस्य चाहारकाले बलाति बला सूर्पपर्णी शालपर्णी पृश्निपर्णी बृहतीकण्टकारिकाशतावरीश्व दंष्ट्रा निर्युह संयुक्तेन यथासात्म्य॑ यवागूमण्डादिना तर्पणादिना वा क्रमेणोपचार: । मुदगमसूरहरेणुमकुष्ठकाढकीयूपैर्वा लावक पिंन्जलशश    हरिणैणकालपुच्छकरसैरीषदम्लैरनम्लैवा क्रमशो अग्नि सन्धुक्षयेत्‌ । अनुबंधे त्वस्य दीपनीया  पाचनीय उपशमनीय संग्रहणियां योगान संप्रयोजयेदिति।।  

• If Pittaja ATisara (diarrhea) the patient is associated with ama which can be determined by causative factors, Upasaya (homologation), signs and symptoms, then the patient should be given Langhana (fasting therapy) and Pacana (carminative therapy) appropriate to the strength of the patient.
• If the patient is thirsty, then such a patient should be given the decoction of musta, parpataka, sariva, candana, kirata-tiktaka, and udicya to drink.
• After the fasting therapy is administered, during meal time, the patient should be gradually given yavagu (thick gruel), manda (a type of thin gruel), and tarpan (roasted flour of cereals added with water) prepared with the niryuha (decoction prepared according to the procedure suggested for Sadanga- paniya- C. S. Chi. 3/ 145-146) of Bala, atibala, Surpa-parni (mudga-parni and masa-parni), sala-parni, prishan- parni, brihati, kantakari, Satavart, and svadamstra.
• Agni (power of digestion) should be stimulated gradually with the vegetable soup of mudga, masura, harenu, makustha, and adhaki or with the soup of the meat of lava, kapinjala, Sasa, harina, ena, and kalapuccha. These vegetable soups and meat soups may be slightly sour or may not be sour.
• If the Pittaja Atisara persists even after the administration of the above-mentioned measures, then the patient should be treated with recipes which are dipaniya (digestive stimulant), pachaniya (carminative), upasamaniya (dosa-alleviator) and sangrahaniya (constipating).

Management of Atisara (Diarrhea) Associated with Pain

Charaka Samhita Chikitsa Sthana. 19/ 30- 33

आमे परिणते यस्तु विबद्धमतिसार्यते ।

सशूलपिच्छमल्पाल्प॑ बहुश: सप्रवाहिकम्‌।। 

युषेण मूलकानां त॑ बदराणामथापि वा ।

उपोदिकाया: क्षीरिण्या यवान्या वास्तुकस्य वा।।

सुवर्चलायाश्वज्चोरवा शाकेनावल्गुजस्य वा। 

शट्या: कर्कारुकाणां वा जीवन्त्याश्व्र्भटस्य वा।। 

लोणिकाया:  सपाठाया: शुष्कशाकेन वा पुनः ।

दधिदाडिम सिद्धेन बहुस्नेहेन भोजयेत।।

After the maturity of ama (product of indigestion), if the patient voids loose motions along with scybalous faces associated with colic pain and mucus very frequently in small quantities, and if there is griping pain, then he should be given food along with the soup of mulaka, badara, upodika, ksirini, yavani, vastuka, suvarcala, cancu (nadica), leaves of avalguja, sati, karkaruka, Tivanti, cirbhata (karkat), lonika, patha or suska-saka (susa or kasamarda according to Cakrapani). These soups should be cooked along with curd (yogurt) and dadima and added with ghee (fat) in huge quantities.

Use of Medicated Dugdha (milk)

Charaka Samhita Chikitsa Sthana. 19/ 47- 49

विबद्धवातवर्चास्तु बहुशूलप्रवाहिक: ।

सरक्तपिच्छस्तृष्णार्तः क्षीरसौहित्यमति।। 

यमकस्वोपरि क्षीर॑ धारोष्ण॑ वा पिबेन्नर: ।

शृत मेरण्डमूलेन बालबिल्वेन वा पय: ।। 

एवं क्षीरप्रयोगेण रक्त पिच्छा शाम्यति ।

शूलं प्रवाहिका चैव विबन्धश्चोपशाम्यति।।    

• If the movement of the flatus and stool is blocked, if the patient suffers from various kinds of pain, if the patient voids blood and mucus, and if the patient is thirsty, then an adequate quantity of milk should be administered. Such a patient should be given yamaka (ghee and oil mixed, and thereafter, lukewarm milk collected directly from the udder (dharaushana) should be given.
• Milk boiled with the root of eranda or tender fruit of bilva may also be given in the above-mentioned condition.
• By the intake of the recipes of medicated ghee mentioned above, bleeding and mucus discharge from the anus stops. These recipes also cure colic pain, griping pain, and constipation.

Specific Recipes for Pittaja Atisara

Charaka Samhita Chikitsa Sthana. 19/ 51- 56

• The fruit and bark of vatsaka should be added with ativisha and honey. It should be taken along with rice water (tandula- udaka)

The following recipes should be taken along with honey and rice water (tandula- udaka).

• Powder of kirata-tiktaka, musta vatsaka and rasanjana.
• Powder of bilva, daru-haridra, tvak, hribera and duralabha
• Powder of candana, mrinala, nagara, lodhra and utpala
• Powder of tila, mocarasa, lodhra, samangã, kamala and utpala
• Powder of utpala, dhataki (flower), dadima, tvak and mahausadha
• Katphala, nagara, patha, seed-pulp of jambu and amra, and amralabha.

Once the above-mentioned recipes are digested, the patient should be given to eat a red variety of rice (Rakta Shali) harvested in earlier seasons, along with appropriately cooked meat soup added with constipating drugs.

Administration of Milk for Pittaja Atisara

Charaka Samhita Chikitsa Sthana. 19/ 57- 60

पित्तातिसारो दीप्ता अग्नि: क्षिप्रं समुपशाम्यति ।

अजाक्षीरप्रयोगेण बलं वर्णश्च वर्धते।। 

बहुदोषस्य दीप्ताग्ने: सप्राणस्य न तिष्ठति।

पैत्तिको यद्यतीसार: पयसा तं विरेचयेत्‌।। 

पलाशफल निर्युह पयसा सह पाययेत।

ततो अनुपाययेत्‌ कोष्णं क्षीरमेव यथाबलम्‌।। 

पलाशवत्‌ प्रयोज्या वा त्रायमाणा विशोधिनी। 

प्रवाहिते तेन मले प्रशाम्यत्युदरामय:।।

• Goat milk administration to the patient having strong power of digestion cures Pittaja Atisara and promotes strength as well as complexion.
• Due to excessive aggravation of dosas, the Pittaja Arisara is not cured and if the patient has a strong power of digestion and vitality, then laxative therapy with milk should be given.
• Decoction of the fruit of phalasa along with milk should be given. Later, depending upon the strength of the patient, lukewarm milk should be given. This will restore bowel movement and control the Atisara.
• Decoction of trayamana along with milk should be given. Later, depending upon the strength of the patient, lukewarm milk should be given. This will restore bowel movement and control the Atisara.

Anuvasana Basti (Type of Medicated Enema)

Charaka Samhita Chikitsa Sthana. 19/ 61- 62

During samsarjana- krama (gradual administration of light to heavy food) after purification therapy if the colic pain persists, then Anuvasana Basti therapy should be administered immediately because the morbid matter is already eliminated. Satapuspadi ghee should be used for anuvasana basti.

Piccha-Basti (Mucilaginous Enema)

Charaka Samhita Chikitsa Sthana. 19/ 63- 68

If diarrhea persists even after the administration of Anuvasana Basti and samsarjana krama then piccha-basti should be given. It cures Pittaja Atisara, fever, edema, Gulma, chronic diarrhea, Grahan pradosa, and the acute complications of purgation as well as asthapana (a type of medicated enema containing decoctions, etc.) therapies.

Treatment of Ulcerative Colitis (Raktaja Atisara Chikitsa)

Charaka Samhita Chikitsa Sthaan. 19/ 69- 70

पित्तातिसारी यस्त्वेतां क्रियां मुक्त्वा निषेवते ।

पित्तलान्यन्नपानानि तस्य पित्त महाबलम।। 

कुर्याद्रक्तातिसारं तु रक्‍तमाशु प्रदूषयत्‌ ।

तृष्णां शूलं विदाहं च गुदपाकं च दारुणम्‌।। 

If a Pittaja Atisara patient does not follow the therapeutic measures and resorts to such foods and drinks which cause aggravation of pitta, then the exceedingly exacerbated pitta causes Rakta Atisara and instantaneous vitiation of Rakta (blood). This leads to serious complications like morbid thirst, colic pain, burning sensation, and suppuration of the anus. It can also manifest itself directly on account of excessive aggravation of pitta and vitiation of blood.

Charaka Samhita Chikitsa Sthaan. 19/ 71- 76

तत्र च्छागं पय: शस्त॑ शीत समधुशर्करम्‌ । पानार्थ भोजनार्थ च गुदप्रक्षालने तथा ।। 

ओदनं रक्तशालीनां पयसा तेनः भोजयेत्‌ । रसैः पारावतादीनां घृतभृष्टै: सशर्करै: ।। 

शयापक्षि मृगाणां च शीतानां धन्वचारिणाम्‌। रसैरनम्लै: सघृतैभोजयेतं सशर्करै: ।। 

रुधिरं मार्गमाजं वा घृतभृष्टं प्रशस्यते । काश्मर्यफलयूषो वा किंचिदम्ल: सशर्कर: ।। 

नीलोत्पलं मोचरसं समंगा पदमकेशरम्‌। अजाक्षीरयुतं दद्याज्जीर्ण च पयसौदनम्‌।।

दुर्बल॑ पाययित्वा वा तस्वैवोपरि भोजयेत्‌ । प्रा्भक्ते नवनीत॑ वा दद्यात्‌ समधुशर्करम्‌।। 

For the cure of Rakta Atisara, following therapy should be administered:

• Goat’s milk is very useful. It should be used, when cooled, with honey and sugar for drink, along with food, and for washing the anal region.
• Goat’s milk along with the boiled rice of red variety of sali should be given.
• The boiled rice may also be given along with the soup of the meat of paravata, etc., sizzled with ghee and mixed with sugar. The soup of the meat having a cooling effect like that of rabbits, birds, and deer inhabiting deserts should be sizzled with ghee, and mixed with sugar should be given. It may be ensured that these soups are free from any sour ingredients.
• The blood of deer or goat sizzled with ghee is also very useful.
• The soup of the fruits of kasmarya made slightly sour and mixed with sugar should be given.
• The powder of nilotpala, mocarasa, samanga, and padmakesara should be administered along with the goat’s milk. After the digestion of this potion, the patient should be given rice with milk. If the patient is weak, then food can be given to him even before the above-mentioned potion is digested.
• Butter along with honey and sugar may be given before meals.
• After taking ghee collected from the cream of milk along with milk, the patient should take the soup of kapinjala.
• During this therapy, he should take milk in adequate quantity. It heals in three days.
• While consuming milk as food (drink), the patient should take the paste of Shatavari mixed with milk. He may also take ghee boiled with the paste of Shatavari.
• Consumption of ghee is cooked by adding the paste of the fruits of kutaja, along with the scum (upper part) of yavagu and followed by intake of peya (thin gruel).  

Treatment of Anal Suppuration

Charaka Samhita Chikitsa Sthana. 19/ 87- 93     

गुदो बहुभिरुत्थानैयस्य पित्तेन पच्यते। 

सेचयेत्तं सुष्टि तेन पटोलमधुकाम्बुना ।। 

पंञ्च वल्कमधूकानां रसेरिक्षुर सै घ्रिस्ते: । 

छागैर्गव्यै: पयोभिर्वा शर्कराक्षौद्रसंयुतै: ।। 

Aggravated Pitta suppurates the anus due to frequent avoidance of stool. The anus of such a patient should be sprinkled and applied with the following recipes and these therapies stop bleeding and pacify suppuration and pain. 

• Exceedingly cold decoction of patola and madhuka. Decoction of Pancha- Valkala (barks of nyagrodha, udumbara, asvattha, parish, and plaksa) or sugarcane juice.
• Milk or ghee of goat or cow mixed with sugar and honey.
• The paste of drugs mentioned above for washing (sprinkling over) the anus may be mixed with ghee and applied over the suppurated anus.
• The powder of the above-mentioned drugs may also be used for pratisarana (dusting) over the suppurated anus.
• The powder of dhataki and lodhra, taken in equal quantities, may be used for dusting over the suppurated anus.
• If there is excessive bleeding (from the anus, the cold decoction of the above-mentioned drugs should be impregnated with ghee and sprinkled over the anal region, pelvic region, lumbar region, and thighs.
• Excessive bleeding should be controlled with a cotton pad should be soaked with Candanadya- taila (C.S Ci 3/ 258) or Satadhauta- Ghrita (ghee washed with cold water one hundred times), and the oil or ghee should be sprinkled by squeezing this pad over the anal and pelvic regions.

Treatment of Ulcerative Colitis (Shokaja Atisara)

Charaka Samhita Chikitsa Sthana. 19/ 12- 13

मारुतों भयशोकाभ्यां शीघ्र॑ हि परिकुप्यति ।

तयोः क्रिया वातहरी हर्षणाश्वासनानि च।। 

इत्युक्ताः षडतीसारा: साध्यानां साधनं त्वत: ।

The following therapies help to cure Agantuja/ Mansika/ exogenous Atisara:

• Both fear and grief cause aggravation of Vata instantaneously.
• Vata-alleviating drugs and therapies should be administered for the treatment of Agantuja/Manasa or exogenous Atisara.
• The patient suffering from diarrhea caused by fear (bhayaja) should be exhilarated
• The patient suffering from diarrhea caused by shoka (grief) should be consoled.

Treatment of Ulcerative Colitis (Pravahika)

Charaka Samhita Chikitsa Sthana. 19/ 34

कल्कः स्याद्वालबिल्वानां तिलकल्कश्च तत्सम: ।

दध्न: सरोम्लस्नेहा आढ्य: खडो हन्यात्‌ प्रवाहिकाम्‌।।

The following Khada (A sour appetizer) cures Pravahika (griping pain):

It is prepared by adding the paste of tender fruits of bilva, an equal quantity of the paste of tila, cream of sour curd, and a profuse quantity of ghee.  

Sushruta Samhita Uttara Tantra. 40/ 140- 141      

Pravahika (Dysentery) which does not subside by langhna etc. (fasting and other thinning methods) or gets increased by the use of Pacana (digestive medicines), becomes subsided quickly by the use of boiled milk, oil (of sesame), and piccha basti (slimy enema). 

Sushruta Samhita Uttara Tantra. 40/ 141- 143

Salmali vrinta (slimy mass inside Salmali fruit which is moist is enveloped with moist blades of Kusa grass and cooked by Putapaka method; after properly cooked, its juice is extracted, this is mixed with cooked milk, oil ghee, and paste of Yastimadhu stirred well and administered by physicians as enema slowly, in Pravähika and obstruction of urine and faces.

Sushruta Samhita Uttara Tantra. 40/ 143- 144

When the patient of Pravahika has pain predominantly, then a decoction enema prepared with a decoction of drugs of the two Panchamula (Mahat and Laghu) added with honey and milk is said to be the best. So also Anuvasana (Oil enema) prepared with the same drugs.

Sushruta Samhita Uttara Tantra. 40/ 144- 145

Oil boiled with drugs of the Vata mitigating group and Lavands (All salts) is beneficial for use along with foods and drinks. Lodhra, Bida lavana, and tender fruit of Bilva made as paste, added with more of Trikatu should be licked.

Sushruta Samhita Uttara Tantra. 40/ 150- 151

When there is severe pain and dysuria, the physician should administer a decoction enema prepared with Madhuka and Utpala mixed with milk, honey, and ghee, this enema mitigates bleeding, burning sensation, and fever.

Sushruta Samhita Uttara Tantra. 40/ 152- 153

Anuvasana (Oil enema) prepared with drugs of sweet taste given either during the day or night will be beneficial to the person suffering from pain. It mitigates Vata, when Vata gets mitigated Pravahika (Dysentery) also subsides; hence the physician should try to mitigate Vāta first in dysentery.

Sushruta Samhita Uttara Tantra. 40/ 154

Patha, Ajamoda, Kutaja, Utpala, Sunthi, and Magadhika are all equally made into a paste and consumed with warm water which mitigates the diseases or Medhyanda (Testicles of the goat) cooked with ghee or milk also mitigates it.

Sushruta Samhita Uttara Tantra. 40/ 155- 156

Sunthi and Ksavaka are cooked in ghee and oil (Mixed) and consumed quickly. Yavagu (Thick gruel) prepared with the juice of Gajasana (Sallaki), Kumbhika, and Dadima, added with oil, Ghee, Curds, and Bilva and consumed or drinking milk fresh from the under of the cow is ideal as the drink.

Complication (Updrava) of Ulcerative Colitis

• Perforated colon 
• Severe dehydration
• Bone loss
• Inflammation of eyes, skin, and joints
• Risk of colon cancer
• Risk of blood clotting  
• Primary sclerosing cholangitis        

Herbs Used for Ulcerative Colitis and their Classical Indication and Method of Use for Relieving Ulcerative Colitis Symptoms

Herbs that Can Be Used for Ulcerative Colitis {Pravahika (Dysentery)} are as follows:

• Ajamoda
• Bakuchi
• Bhringraj
• Kantaki Karanja
• Dugdhika
• Lakucha
• Lodhra
• Lonika
• Maricha
• Upodika
• Vastuka

Ajmoda:

• Milk mixed with ghee, honey, and the powder of sugar ajamoda, aralu, and madhuka should be taken for diarrhea associated with pain. (Sushruta Samhita Uttara Tantra. 40/ 79).
• The formulation consisting of patha, ajamoda, kutaja, utpala, sunthi, and pippali-all in equal quantities taken with tepid water controls the disease. (Sushruta Samhita Uttara Tantra. 40/ 154)

Bakuchi: Bakuchi Leaves of bakuchi cooked with curd and pomegranate and added with ample ghee are used as a vegetable. (Charaka Samhita Chikitsa Sthana. 19. 30-33)

Bhringraja: A pill made of bhringaraja with water alleviates dysentery with mucus, blood, and griping. (Vanga Sena. Atisara. 120)

Kantaki Karanja:  One should take the seed- kernel of kuberaksha with sour gruel in the morning. It alleviates dysentery with mucus, blood, and griping. (Vaidya Manorma. 6/ 6)

Dugdhika: Dugdhika steamed with cooked rice and taken with the same after adding oil checks dysentery with blood. (Vaidya Manorma. 6. 14)

Lakucha: Intake of the juice of lakuca fruit 40 ml mixed with goat milk in the morning checks dysentery with blood and mucus. (Vaidya Manorma. 6/ 11)

Lonika: Lonika should be cooked with curd and pomegranate and added with profuse ghee. It should be taken as a vegetable. (Charaka Samhita Chikitsa Sthana. 19/ 33, Ashtanga Hridya Chikitsa Sthana. 9/ 22).

Lodhra: Lodhra with curd is useful in dysentery. (Bhava Parkasha Chikitsa. 2/ 120)

Maricha:

• Maricadya Churna (Charaka Samhita Chikitsa Sthana.15. 108- 110)
• Intake of fine powder of pippali or Marica checks even chronic dysentery. (Ashtanga Hridya Chikitsa Sthana. 9. 40)
• One who takes the power of marica mixed with citraka and sauvarcala with buttermilk becomes free from grahani roga besides Udara, splenomegaly, deficient digestion, gulma, and piles. (Sharangdhara Samhita. 2. 6. 53)

Uppodika: In dysentery associated with pain and tenesmus due to retention of faces the leaves of uppodika cooked with curd and pomegranate seeds with ghee are used as a vegetable. (Charaka Samhita Chikitsa Sthana. 19. 31- 33)

Vastuka: Vegetables of vastuka prepared with curd and pomegranate and added with profuse ghee should be taken. (Charaka Samhita Chikitsa Sthana.19. 31- 33)

Herbs that Can Be Used for Karshya (Emaciation) – Symptoms of IBD are as follows:

• Ashwagandha
• Ikshu 

Ashwagandha: Excessive emaciation in cases of excessive emaciation ashwagandha etc. should be used. (Sushruta Samhita Sutra Sthana. 15/ 33)

Ikshu: Sugarcane, Sali rice, black gram, wheat, and the product of Jaggery remove emaciation and promote the development of the body. (Sushruta Samhita Sutra Sthana. 21/ 31- 33)

Eranda Draksha: In UC some time constipation is three as a symptom and  Eranda Draksha recommended. 

Herbs that Can Be Used for Vivandha (Constipation) – Symptoms of UC are as follows:

Eranda:

• Castor oil mixed with a double quantity of Triphala decoction or milk acts as a quick purgative. (Sharangdhara Samhita. 34/ 20)
• For purgation, castor oil is the best one. (Charaka Samhita Chikitsa Sthana 13/ 12)

Draksha: A person with a soft bowl is purgated by intake of the juice of grape or Pilu or hot water or fresh wine. (Charaka Samhita Sutra Sthana. 13/ 67)

Herbs that Can Be Used for Atisara (Pittaja, Raktaja, Shokaja) (Diarrhea) – Symptoms of Ulcerative colitis

• Atisara
• Ahiphena
• Ajamoda
• Amlika
• Amra
• Ankota
• Aralu
• Arjuna
• Ativisa
• Babbula
• Badari
• Bala
• Bhanga
• Bibhitaki
• Bilva
• Changeri
• Cavika
• Citraka
• Cukrika
• Dadima
• Dasamula
• Dhanyaka
• Dhataki
• Duralabha
• Eranda
• Gajapippali
• Hapusa
• Haritaki
• Hribera
• Jambu
• Jatiphala
• Jivanti
• Kancata
• Kapittha
• Karpasa
• Kasmarya
• Katphala
• Kesaraja
• Kutaja
• Laja
• Lonika
• Mallika
• Masura
• Mocarasa
• Mulaka
• Mustaka
• Nicula
• Palasha
• Laghu Panchmool
• Patola
• Pippali
• Rakta chandana
• Sallaki
• Salmali
• Sami
• Sati
• Simsapa
• Sunthi
• Syonaka
• Tila
• Tinduka
• TrayamanA
• Trikatu
• Udumbara
• Vacha
• Vandaka
• Vata
• Vetasa
• Virataru
• Yuthika 

Ahiphena: Ahiphena mixed with the bark of kupilu and honey checks all types of diarrhea. (Vaidya Manorma. 6. 3)

Ajamoda:

• Milk mixed with ghee, honey, and the powder of sugar, ajamoda, aralu, and madhuka should be taken for diarrhea associated with pain. (Sushruta Samhita Uttara Tantra. 40/ 79)
• The formulation consisting of patha, ajamoda, kutaja, utpala, Sunthi, and pippali-all in equal quantities taken with tepid water controls the disease. (Sushruta Samhita Uttara Tantra. 40/ 154)

Amlika: Covering of seeds, Sunthi, rock salt, and yavani are mixed and taken with fresh buttermilk. It checks diarrhea quickly. (Vaidya Manorma. 6/ 5)

Amra: 

• Seed-kernel of jambu, Amra, bilva, kapittha, and sunthi- these should be taken with liquid gruel in case of diarrhea. (Charaka Samhita Chikitsa Sthana. 8. 127) 
• Decoction of bilva and seed- the kernel of Amra mixed with honey and sugar checks vomiting and diarrhea. (Vaidya Manorma. 3. 30)
• Tender leaves of Amra and kapittha fruit are pounded together and taken with rice water in case of diarrhea. (Vanga Sena. Atisara. 61)
• The bark of sallaki, badari, jambu, priyala, amra, and arjuna mixed with honey and taken with milk checks hemorrhage (in diarrhea). (Vaidya Manorma. 3/ 41)
• Decoction of the seed-kernel of amra and bilva is added with honey and sugar. It controls severe vomiting and diarrhea. (Bhava Parkasha Chikitsa. 2. 107)
• A juice of amra bark extracted by putapaka (closed heating) is added with oil and taken. It alleviates diarrhea with blood and mucus. (Vaidya Manorma. 6/ 7)

Ankota:

• The root bark of ankota taken with buffalo’s buttermilk is an efficacious remedy for diarrhea. Similar is the leaf of Patha. (Vanga Sena. Atisara. 171)
• The intake of the root bark of ankota 5 gm pounded with rice- water checks severe diarrhea and disorder of grahani. (Chakra Dutta. 3. 54)
• Ankota – vataka consisting of ankota root (bark) 40 gm and an equal quantity of patha and daruharidrà pounded with rice water and dried in shade is administered with rice water in all types of diarrhea. (Bhava Parkasha Chikitsa. 2/ 96- 98, Chakra Dutta. 3. 58- 60)

Aralu: 

• Susruta has been prescribed dirghavrnta (aralu) putapaka for diarrhea. (Sushruta Samhita Uttara Tantra. 40/ 81- 83, Vaidya Manorma. 3. 49- 51)
• The bark of aralu smeared with ghee is heated on steam. It is crushed and mixed with honey. It checks for severe diarrhea. (Ashtanga Hridya Chikitsa Sthana. 9/ 80)
• Putapaka of aralu is an appetizer. If mixed with honey and mocarasa, it checks all types of diarrhea. (Sharangdhara Samhita. 2. 1. 29)
• The bark of aralu pounded and mixed with sunthi should be taken with rice water. It checks mature diarrhea. (Vanga Sena Atisara. 59)

Arjuna: In diarrhea associated with blood, arjuna bark mixed with honey should be taken with milk. It checks hemorrhage. (Vaidya Manorma. 3. 41)

Ativisha: 

• Ativisa Avaleha containing ativisa along with bilva, mocarasa, lodhra, dhataki-puspa, and mango-seed, checks severe diarrhea. (Bhava Parkasha Chikitsa. 2. 148)
• Liquid gruel processed with ativisa, sours, and sunthi is as efficacious as amatisara. (Charaka Samhita Sutra Sthana. 2. 22)

Babbula: 

• Paste of tender leaves of babbula checks diarrhea. (Chakra Dutta. 3/ 53)
• Babbula Arista. (Sharangdhara Samhita. 2. 10. 66- 68)

Badari:

• The patient should be fed on the soup of radish or badara fruits cooked with curd and pomegranate and have ample ghee. (Charaka Samhita Chikitsa Sthana. 19/ 31-33)
• Decoctions of the bark of badari, arjuna, jambu, amra, Sallaki, and vetasa mixed with sugar and honey check diarrhea. (Sushruta Samhita Uttara Tantra. 40/ 96)
• Badara fruits boiled and mixed with jaggery and oil should be taken. (Sushruta Samhita Uttara Tantra. 40/ 133, Ashtanga Hridya Chikitsa Sthana. 9. 18)
• Simply, badari root should be taken with honey. (Sushruta Samhita Uttara Tantra. 40/ 96)

Bala: In case of dehydration, if digestion is good, the patient should be treated with milk cooked with Bala and sunthi followed by intake of jaggery mixed with oil in the morning. (Bhava Parkasha Chikitsa. 2. 111)

Bhanga: 

• Bhanga and jatiphala in equal parts mixed with indrayava in double quantity are made into a linctus. It checks all types of diarrhea. (Bhava Parkasha Chikitsa. 2. 147)
• Bhanga mixed with the latex of udumbara is made into pills. It checks for diarrhea. (Siddha Bhaishjya Manni Mala. 4. 166)
• Arka distilled from bhanga and yavani promotes digestive fire. (Siddha Bhaishjya Manni Mala. 4/ 264)

Bibhitaki: Burnt fruit of bibhitaki mixed with salt checks diarrhea even if severe. (Vanga Sena Atisara. 173)

Bilva: 

• One gets rid of abdominal disorder (diarrhea) after taking pippali with honey or buttermilk with citraka or tender fruits of bilva. (Charaka Samhita Chikitsa Sthana. 19/ 113)

• In case of diarrhea with blood, tender fruits of bilva mixed with liquid jaggery, honey and oil should be taken. It checks the disease immediately. (Sushruta Samhita Uttara Tantra. 40. 119)
• The dietary preparation (khada) is made of tender bilva fruits, an equal quantity of sesamum paste, the supernatant layer of curd, and added sour and ghee checks dysentery. (Charaka Samhita Chikitsa Sthana.19/ 34)
• Fruit-pulp of bilva and madhuka mixed with sugar and honey and taken with rice-water checks diarrhea caused by pitta and rakta. (Sushruta Samhita Uttara Tantra. 40/ 127)
• Badara fruits are steamed with bilva fruits and when cooled are taken with jaggery and oil to check for diarrhea. (Sushruta Samhita Uttara Tantra. 40/ 133)
• Intake of bilva with jaggery checks diarrhea with blood removes pain due to ama and constipation and alleviates disorders of the bowels. (Vaidya Manorma.3. 40, Vaidya Jeevana. 2/ 15, Bhava Parkasha Chikitsa. 2/ 57)
• Tender fruits of bilva, jaggery, oil, pippali, and sunthi- all these together should be taken in the condition of obstructed Vata, pain, and tenesmus. (Vaidya Manorma. 3/ 66)

Changeri: 

• Changerighrita. (Charaka Samhita Chikitsa Sthana. 19/ 42- 43)
• Khada (a dietary preparation) made of changeri, cukrika, and dugdhika added with a fatty layer of curd, ghee, and pomegranate seeds should be used. (Sushruta Samhita Chikitsa Sthana. 8/ 131)

Chavika: 

• Cavyadi ghrta. (Charaka Samhita Chikitsa Sthana. 19. 44)
• Tender leaves of cavika, Svetamula (Sveta) and ksiri vrksa should be pounded and given with oil. (Vaidya Manorma. 6/ 2)

Chitraka: After taking pippali with honey, citraka with buttermilk, or only tender fruits of bilva one is freed from diarrhea. (Charaka Samhita Chikitsa Sthana. 19/ 113)

Chukrika: In case of diarrhea, khada made of cangeri, cukrika, and dugdhika added with a fatty layer of curd, ghee, and pomegranate seeds should be given. (Charaka Samhita Chikitsa Sthana. 8/ 131)

Dadima: 

• Decoction of the bark of dadima and kutaja mixed with honey checks severe diarrhea with blood immediately. (Vaidya Manorma. 3/ 39, Vaidya Jeevana. 2. 13)
• Dadimastaka churna. (Ashtanga Hridya Chikitsa Sthana. 9. 112- 113)
• In case of dysentery, the patient should take a diet consisting of vegetables prescribed for constipation, meat soups with profuse fat, and processed with curd and pomegranates, and shali rice cooked with sesamum, black gram, or green gram. (Ashtanga Hridya Chikitsa Sthana. 9/ 19)
• The ripe fruit of dadima should be cooked under close heating. The juice so extracted checks all types of diarrhea. (Sharangdhara Samhita. 2.1. 31)
• Paste of the flower bud of dadima mixed with honey checks diarrhea immediately. (Siddha Bhaishjya Manni Mala. 4. 147)

Dashmula: In diarrhea with pain and tenesmus non-unctuous enema the decoction of dasamula added with honey and milk is an excellent remedy. (Sushruta Samhita Uttara Tantra. 40/ 143)

Dhanyaka: 

• Decoction of dhanyaka, Sunthi, balaka, and bilva alleviates ama, pain, and constipation, and is a digestive and appetizer. (Vaidya Manorma. 3/ 21)
• Ghee processed with four times water and dhanyaka paste should be given for diarrhea caused by pitta and associated with pain. It is also an appetizer and digestive. (Vanga Sena. Atisara. 91)
• Water processed with dhanyaka and balaka should be given to those suffering from thirst, burning sensation, and diarrhea. (Bhava Parkasha Chikitsa. 2. 14)

Dhataki: 

• For the child, modaka (sweet bolus) prepared of dhataki flowers, Sarkara, and parched paddy should be given in diarrhea. (Ashtanga Hridya Uttara Tantra.1. 40)
• One suffering from dysentery should take dhataki, badari leaves, kapittha juice, honey, and lodhra- all together with curd. (Bhava Parkasha Chikitsa. 2. 120)
• Liquid gruel processed with dhätaki decoction and Sunthi and added with sour pomegranate seeds is useful in fever, diarrhea, and abdominal pain. (Vanga Sena. Atisara. 318)

Durlabha: A paste of duralabha root of the size of udumbara fruit should be taken along with the diet of milk processed with the same (duralabha root). (Sushruta Samhita Uttara Tantra. 40. 74,110)

Eranda:

• Milk cooked with eranda root or tender fruits of bilva is efficacious. (Charaka Samhita Chikitsa Sthana.19/ 48) 
• The patient should be given only milk cooked with eranda. Moreover, gruels processed with Vata-alleviating and appetizing drugs should be served. (Sushruta Samhita Uttara Tantra. 40/ 131)
• Ghee and oil mixture should be given followed by warm milk or cooked with eranda root or tender fruits of bilva. (Ashtanga Hridya Chikitsa Sthana. 9/ 38)

Gajja Pippali: In diarrhea with blood and mucus gajapippali sweetened with honey and sugar should be given. (Ashtanga Sangreha Chikitsa Sthana. 11/ 4)

Hapusha: It is one of the members of Shalaparnyadi gana which acts as an appetizer and digestive. (Charaka Samhita Chikitsa Sthana.19. 27)

Haritaki:

• In difficult elimination of impurity, haritaki should be given to expel it. (Charaka Samhita Chikitsa Sthana. 19. 17, Sushruta Samhita Uttara Tantra. 40/ 31, Ashtanga Hridya Chikitsa Sthana. 9/ 5)
• If stool comes out in small quantities and with obstruction and pain, the patient should be purgated with the warm paste of haritaki and pippali. (Sushruta Samhita Uttara Tantra. 40/ 33)
• Powder of haritaki, rock salt, and sunthi should be taken with honey and sugar in case of diarrhea caused by Kapha. (Ashtanga Sangreha Chikitsa Sthana.11/ 27)
• Gruel prepared with haritaki, pippali mula, and bilva acts as carminative. (Ashtanga Hridya Chikitsa Sthana. 91/ 14)
• Haritaki, sunthi, mustaka, and jaggery-these four mixed in equal quantities are made into pills known as ‘catuhsama modaka’. It checks all types of diarrhea. (Bhava Parkasha Chikitsa. 2/ 88)
• In boiled goat’s milk powder of haritaki should be put. The curd so formed should be given in case of dysentery. (Vaidya Manorma. 6/ 13)

Hribera: Water processed with hribera and sunthï should be given to drink. (Charaka Samhita Chikitsa Sthana. 19. 22)

Jambu: 

• Seed-kernel of jambu and amra, bilva, kapittha, and sunthi- this formulation should be taken with liquid gruel. It checks for diarrhea. (Charaka Samhita Chikitsa Sthana. 8/ 127)
• Tender bilva fruit is cooked while being wrapped with the leaves of jambu, dadima, Sringata, patha, and kancata. It should be kept overnight and then taken with jaggery and sunthi. It checks all types of diarrhea and alleviates severe grahani. (Chakra Dutta. 4. 12)

Jati Phala:

• Jatiphala with Sunthi rubbed in cold water is given to check diarrhea and make stool formed. (Siddha Bhaishjya Mannimala. 4. 141)
• The paste of jatiphala is applied to the navel. It checks for diarrhea. (Bhaishjya Ratnavali. Atisara. 30)
• A lavangacatuhsama-This formulation consisting of jatiphala, Lavagna, jiraka, and tankana and mixed with honey and sugar destroys, by intake, all types of diarrhea associated with ama. (Bhaishjya Ratnavalli. Atisara. 30)

Jivanti:

• Vegetables of any of Sati, karkaruka, jivanti, and cirbhata or dried vegetables of lonikä and Patha cooked with curd and pomegranate with ample ghee should be given to eat. (Charaka Samhita Chikitsa Sthana. 19. 32- 33)
• Putapaka (Juice extracted by closed heating) of jivanti, meshasrnga, etc. should be administered. (Sushruta Samhita Uttara Tantra. 40/ 84)

Kancata: 

• Leaves of kancata, jambu, dadima, Singtaka, bilva, hribera,m musta, and sunthi- decoction of these (known as kancatadi kvatha) check even severe diarrhea. (Chakra Dutta. 3/ 38)
• One should take boiled kancata and tender bilva fruit mixed with butter in case of diarrhea with blood and griping and also in grahani disorder. (Vanga Sena Atisara. 116)

Kapittha:

• One becomes free from diarrhea if he takes a fruit pulp of kapittha mixed with trikatu, honey, and sugar or katphala with honey. (Charaka Samhita Chikitsa Sthana. 19/ 112, Ashtanga Hridya Chikitsa Sthana. 9. 106)
• Kapittha, salmali, phanji, Vata, karpas, dadima, yuthika, kacchura (duralabha), slesmataka, Sana, and cancu-these processed with curd are useful in diarrhea. (Sushruta Samhita Uttara Tantra. 40/ 113).
• One suffering from dysentery should take dhAtaki, badari leaves, and kapittha mixed with curd. (Bhava Parkasha Chikitsa. 2. 120)

Karpas: The juice of karpas and plaksa added with honey is useful. (Vaidya Manorma. 3.3 8)

Kashmarya: The soup of käsmarya fruits added with sugar and a bit soured is beneficial. (Charaka Samhita Chikitsa Sthana. 19/ 74, Ashtanga Hriya Chikitsa Sthana. 9/ 84)

Katphala: One becomes free from abdominal disorders (diarrhea) after taking kapittha (fruit pulp) mixed with trikatu, honey, and sugar or only katphala with honey. (Charaka Samhita Chikitsa Sthana.19/ 112)

Kesaraja: A pill made of kesaraja with water checks for diarrhea associated with mucus, pain, and blood. (Vanga Sena. Atisara.120)

Kutaja:

• Kutaja is the best drug for diarrhea. (Ashtanga Hridya Uttara Tantra. 40/ 49)
• To check blood coming with stool one should take ghee cooked with indrayava with barley scum followed by intake of liquid gruel. (Charaka Samhita Chikitsa Sthana. 19/ 79)
• Ativisa and Kutaja were taken with rice water. It checks diarrhea caused by pitta (Charaka Samhita Chikitsa Sthana.19/ 51)
• One who takes indrayava 40 gm decocted in the water keeping on a diet of meat soup overcomes diarrhea caused by pitta. (Charaka Samhita Chikitsa Sthana. 19/ 85, Vrinda Madhava. 3/ 27)
• The linctus of kutaja mixed with drugs of ambasthadi and pippalyadi groups and honey destroys chronic diarrhea having profuse mucus, blood, and atony. (Sushruta Samhita Uttara Tantra. 40/ 89- 90, Ashtanga Hridya Chikitsa Sthana. 9/ 76)
• Kutaja seeds alone are capable of checking diarrhea. (Ashtanga Sangreha Chikitsa Sthana. 11/ 17)
• Linctus of kutaja bark checks matures diarrhea. (Chakradutta. 130, Bhava Parkasha Chikitsa. 2/ 94- 95)

• Linctus prepared from the decoction of kutaja bark and mixed with ativisa alleviates all types of diarrheas. (Vrinda Madhava. 3/ 36)
• Decoction of kutaja bark and seeds and musta added with sugar and honey checks diarrhea. (Vrinda Madhava. 3/ 29, Vanga Sena. atisara. 173)
• Kutaja- putapaka. (Vrinda Madhava. 3/ 46- 48, Bhava Parkasha Chikitsa. 2/ 90- 93)
• Kutaja, ativisha, bilva, balaka, and musta-decoction are useful in even chronic diarrhea having severe pain and blood. (Vrinda Madhava. 3/ 43, Sushruta Samhita Uttara Tantra. 40/ 66)
• Decoction of indrayava, dhanyaka, and patola mixed with honey and sugar should be used in all types of diarrhea. Similarly acts that of bilva and amra (seed-kernel). (Sharangdhara Samhita. 2. 2. 75)
• Decoction of Syonaka and kutaja bark alleviates all types of diarrhea. (Sharangdhara Samhita. 2. 1. 12)
• Kutajarista (Sharangdhara Samhita. 2. 10. 44- 46)
• Kutaja-ksira. (B. P. Chi. 2. 59-60)

Laja: Laja Pieces of kosakara, a type of sugarcane, fried in ghee and laja powder mixed with sugar and honey should be taken. It checks diarrhea with pain and blood. (Sushruta Samhita Uttara Tantra. 40. 126)

Lonika: Lonika should be cooked with curd and pomegranate and added with profuse ghee. It should be taken as a vegetable. (Charaka Samhita Chikitsa Sthana 19/ 33, Ashtanga Hridya Chikitsa Sthana. 9/ 22).

Mallika: Khada (a dietary preparation) of the tender leaves of kasmarya, madayanti, and yuthika should be made with fat, sour, and salt. It is a good checking remedy. (Charaka Samhita Chikitsa Sthana. 3/ 129- 30)

Masura: Masura- Ghrita. (Sharangdhara Samhita. 2. 9. 25- 26)

Mochrasa: Tila, mocarasa, lodhra, samanga, Kamala, and utpala-all combined should be mixed with honey and taken with rice water. It is useful in diarrhea caused by pitta. (Charaka Samhita Chikitsa Sthana. 19. 53- 55)

Mulaka: Soup of mulaka is efficacious in diarrhea. (Charaka Samhita Chikitsa Sthana. 19/ 31- 33)

Mustaka

• Decoction of musta alone should be mixed with honey. (Sushruta Samhita Uttara Tantra. 40/ 72)
• Musta rhizomes twenty (in number) should be boiled in milk with three times water reduced to milk. Its intake checks mucus and pain. (Sushruta Samhita Uttara Tantra. 40/ 47, Ashtanga Hridya Chikitsa Sthana. 9. 39,60, Chakra Dutta.130)
• The patient should be given to drink water processed with vaca and prativisha or musta and parpata or Haridra and sunthi. (Charaka Samhita Chikitsa Sthana. 19/ 22)
• Mustaka is crushed and boiled in equal milk, reduced to one-fourth, when cooled it is mixed with honey and taken. It checks diarrhea with mucus and blood. (Vaidya Manorma. 6/ 9)
• Crushed mustaka 2 kg. is cooked in 640 ml milk. Add sufficient water till only milk remains. The remaining portions of mustaka are removed and the milk is curdled. Curd so obtained alleviates diarrhea and other abdominal disorders. (Vaidya Manorma. 6. 19)

Nicula (Hijjala): Intake of the juice of hijjala leaf mixed with honey alleviates amatisara (diarrhea with mucus). Similarly acts the decoction of kutaja bark. (Vaidya Manorma. 3/ 35)

Palasha: Decoction of palasha fruit (seeds) mixed with milk should be given followed by intake of warm milk according to strength. By this, impurity is eliminated and thus diarrhea is checked. (Charaka Samhita Chikitsa Sthana. 19/ 59- 60, Ashtanga Hridya Chikitsa Sthana. 9/ 68)

Laghu pancha mula: 

• In case of aggravation of Vata, liquid gruel should be processed with panchamula. (Charaka Samhita Sutra Sthana. 2. 19)
• Besides laghu panchamula, it should be cooked with panchakola or patha. (Ashtanga Hridya Chikitsa Sthana. 9/ 13)
• Patola: Decoction of patola, indrayava, and dhanyaka should be taken, cooled, and added with sugar and honey. It checks for vomiting and diarrhea. (Vaidya Moanorma. 3/ 32)

Pippali: 

• By taking pippali with honey, buttermilk with chitraka, and by eating tender fruits of bilva one becomes free from bowel disorders (diarrhea). (Charaka Samhita Chikitsa Sthana. 19/ 113, Ashtanga Hridya Chikitsa Sthana. 9/ 107)
• By using a fine powder of pippali or marica dysentery, even if it is chronic, is destroyed. (Ashtanga Hridya Chikitsa Sthana. 9/ 40, Vaidya Manorma. 3/ 67)

Rakt Chandan: Daruharidra, duralabha, bilva, balaka, and rakta chandana check diarrhea caused by pitta. (Sushruta Samhita Uttara Tantra. 40. 63- 65)

Shallaki: 

• Decoction of the barks of badari, arjuna, jambu, amra, Sallaki, and vetasa mixed with sugar and honey checks diarrhea. (Sushruta Samhita Uttara Tantra. 40/ 96).
• Barks of priyala, salmali, plaksa, Sallaki, and tinisa are pressed in milk and added to honey. It checks diarrhea with blood. (Sushruta Samhita Uttara Tantra. 40. 119, Vaidya Manorma. 3/ 4)

Shami: Leaves of aralu, tinduka, dadima, kutaja and shami- these digest ama and as such are useful in amatisara. (Sushruta Samhita Uttara Tantra. 40/ 41)

Shati: The diet should contain a soup of Sati. (Ashtanga Hridya Chikitsa Sthana. 9/ 20-21)

Simsapa: Decoction made of the crushed tender leaves of Simsapa and kovidara along with barley and mixed with ghee and milk should be given as a slimy enema in the discharge of mucus, tenesmus, and prolapse-rectum. (Ashtanga Hridya Chikitsa Sthana. 9/ 95- 96)

Shunthi:

• One should take water processed with Vacha and ativisa, musta and parpata, and hribera and sunthi for improving appetite and digestion. (Charaka Samhita Chikitsa Sthana.19/ 22)
• In diarrhea caused by Kapha and associated with ama, the paste of sunthi alone should be taken with tepid water. (K. K. 9/ 94)
• One who defecates frequently with or without a stool or with tenesmus should take Sunthi with Jaggery mixed with curd, oil, ghee, and milk. (Ashtanga Hridya Chikitsa. 9. 17)
• Powder of Sunthi smeared with ghee is wrapped within eranda leaves and cooked in putapaka (closed heating) on a mild fire. The powder is then taken out and mixed with an equal quantity of sugar. It is taken in the morning and thus pacifies all sorts of pain due to amatisara. (Sharangdhara Samhita. 2. 1. 38- 39)
• Fried and unfried sunthi mixed and pounded with eranda juice alleviates pain due to amatisara and stimulates digestion and appetite. (Bhava Parasha Chikitsa. 2/ 22)

Shyonaka: The juice of Syonaka obtained by closed heating is useful in diarrhea. (Chakra Dutta. 3. 84- 85)

Tila: 

• The paste of tila and mudga and also the soup of the latter is wholesome. (Sushruta Samhita Uttara Tantra. 40/ 115)
• Paste of black sesamum mixed with 1/5 sugar and taken with goat’s milk checks blood immediately. (Charaka Samhita Chikitsa Sthana. 19/ 34)

Tinduk: The bark of tinduka is wrapped with käsmari leaves, covered with a paste of earth, and cooked in a mild fire. The juice so extracted is mixed with honey and taken. It destroys all types of diarrhea. (Harita Samhita. 3. 36- 37)

Trayamana: Trayamana, like palasa, should be used in diarrhea to expel the impurity. (Charaka Samhita Chikitsa Sthana. 19/ 60, Ashtanga Hridya Chikitsa Sthana. 9/ 69)

Trikatu: In the case of griping, the patient should be given a diet with milk boiled with trikatu and salaparni. (Sushruta Samhita Uttara Tantra. 40. 146)

Udumbara: 

• The tender leaves of Vata, udumbara, asvattha, plaksa, lotus, etc. are astringent, checking, and cold and as such useful in diarrhea caused by pitta. 
• Leaf buds of Vata, udumbara, and asvattha are pounded and then kept in hot water for 24 hours. With this infusion, ghee is cooked and taken after mixing 1/2 sugar and 1/4 honey. It checks hemorrhage be it upwards or downwards. (Charaka Samhita Chikitsa Sthana. 19. 99- 100)

Vacha: One suffering from diarrhea should take water boiled with Vacha and prativisha or musta and parpata or Haridra and sunthi. (Charaka Samhita Chikitsa Sthana. 19. 22, Ashtanga Hridya Chikitsa Sthana. 9/ 8, Ashtanga Sangreha Chikitsa Sthana. 11/ 5)

Vandana: Vandaka is one of the drugs used for the digestion of Ama. (Sushruta Samhita Uttara Tantra. 40. 41- 45)

Vata: 

• Leaf buds of nyagrodha, udumbara, and asyattha should be crushed and kept in hot water day and night. With this watery extract, ghee should be cooked and mixed with half the sugar and one-fourth honey. It checks blood coming out upwards or downwards. (Charaka Samhita Chikitsa Sthana.19. 100- 101)
• Hanging root of nyagrodha pounded with cow’s buttermilk should be taken. It checks acute diarrhea. (Chakra Dutta. 3. 51, Raja Amrittanda. 14. 1)

Vetasa: Khada (a dietary preparation) should be prepared with vetasa leaves added with ghee, sours, and salt. It checks for diarrhea. (Charaka Samhita Chikitsa Sthana. 8.  129- 130)

Virtaru:  In diarrhea with ama, vandaka, virataru, brhati, kantakari, mudgaparni and masaparni should be given in decoction form. (Sushruta Samhita Uttara Tantra. 40. 41)

Khada (a dietary preparation) should be made of the tender leaves of vetasa etc including yuthika added with ghee, sour, and salt. It acts as an excellent checking remedy. (Charaka Samhita Chikitsa Sthana. 8. 129- 30)

Yuthika: Kapittha, salmali, phanji, Vata, karpas, dadima, yuthika, duralabha, slesmataka, Sana, and cancu cooked with curd should be taken. (Sushruta Samhita Uttara Tantra. 40. 113)

Herbs that Can Be Used for Pandu (Anaemia) – Symptoms of Ulcerative Colitis are as follows:

• Amalaki
• Asana
• Chitraka
• Dadima
• Danti
• Daruharidra
• Dasamula
• Draksa
• Haridra
• Haritaki
• Iksu
• Kakadani
• Kasmarya
• Katuka
• Madhuka
• Matulunga
• Mulaka
• Punarnava
• Shala
• Shali
• Svarnaksiri (kankusthaprabhava)
• Triphala
• Trivit
• Yava

Amalaki: 

• The juice of amalaka and sugarcane in the form of mantha (churned drink) is beneficial in case of anemia. (Sushuruta Samhita Uttara Tantra. 44. 8)
• One should take the powder of Amalaka with honey. (Sushruta Samhita Uttara Tantra. 44. 27)

Bijaka (Asana): Bijaka Arista is prescribed in anemia. (Ashtanga Sangreha Chikitsa Sthana. 18/ 13)

Chitraka: One suffering from anemia, should take roots of Bala and chitraka 10 gm with warm water or seeds of shigru mixed with equal salt keeping on a milk diet. (Sushruta Samhita Uttara Tantra. 44/ 26)

Dadima: Dadimadya ghrita. (Charaka Samhita Chikitsa Sthana. 16/ 45- 46)

Danti: 

• Dantighrta. (Charaka Samhita Chikitsa Sthana. 16/ 51)
• Danti 20 gm, should be boiled in buffalo’s urine sixteen times remaining to 80 ml. It should be given as purgative. (Sushruta Samhita Uttara Tantra. 44/ 16)

Darvi (Daru Haridra)

• Darvighrita. (Charaka Samhita Chikitsa Sthana. 16/ 54)
• One suffering from jaundice should take in morning cooled decoction of Triphala, guduci, darvi, or Nimba mixed with honey. (Charaka Samhita Chikitsa Sthana. 16/ 63)

Dashmula: In anemia caused by Kapha, the decoction of dasamula mixed with sunthi should be taken. It is also useful in fever, diarrhea, edema, grahani, asthma, anorexia, and disorders of the throat and heart. (Vaidya Manorma. 8. 4)

Draksha: 

• Draksa ghrita. (Charaka Samhita Chikitsa Sthana. 16/ 52)
• For patients of anemia and jaundice, water processed with laghu pancamula or juice of draksa and amalaka is useful in food and drink. (Charaka Samhita Chikitsa Sthana. 16/ 114, Ashtanga Hridya Chikitsa Sthana. 16/ 32)

Haridra: One should take haridra mixed with Triphala, ghee, and honey. (Sushruta Samhita Uttara Tantra. 44/ 17)

Haritaki:

• Patients of kaphaja pandu should take haritaki impregnated with and suspended in cow’s urine. (Charaka Samhita Chikitsa Sthana. 16/ 58, 68)
• Haritaki is the chief ingredient in pathyaghrta. (Charaka Samhita Chikitsa Sthana. 16/ 50)
• Haritaki pounded with urine or Triphala cooked in cow’s urine should be taken. (Ashtanga Hridya Chikitsa Sthana. 16/ 7)
• After evacuation from both ways, one should take haritaki mixed with profuse honey and ghee. (Ashtanga Hridya Chikitsa Sthana. 16/ 10, Vrinda Madhava. 8/ 1)

Ikshu: 

• One suffering from anemia should take a churned drink prepared with the juice of amalaka or sugarcane mixed with honey. (Sushruta Samhita Uttara Tantra. 44/ 18)
• Sakralata is one of the ingredients of dasas varas-ghrta. (SY. P 312)

Kashmarya: In the tepid decoction of danti 40 gm kasmarya (fruit) or draksha 160 gm is dipped and then pressed. The juice extracted should be taken in anemia. (Ashtanga Hridya Chikitsa Sthana. 16/ 6)

Katuki:

• Katukadya ghrita. (Charaka Samhita Chikitsa Sthana. 16. 47- 49)
• Katuka 10 gm. with sugar, juice of dronapushpi applied as collyrium, and snuffing with powder of devadali- each one of them alleviates anemia. (Siddha Bhaishjya Mannimala. 4/ 282)

Madhuka: One should take a decoction of madhuka or powder of the same with honey. (Sushruta Samhita Uttara Tantra. 44/ 20, Gada Nigreha. 2. 7. 33)

Matulunga:

• Buds of matulunga should be burnt and then dipped into urine. Intake of this liquid alleviates anemia with edema. (Charaka Samhita Chikitsa Sthana. 16/ 65)
• One should take the juice of matulunga mixed with honey, pippali, marica, and sunthi. Thus, pitta comes back to its site. (Charaka Samhita chikitsa Sthana. 16/ 29)

Mulaka: Juice of tender radish 40 ml added with sugar alleviates anemia shortly. (Siddha Bhaishjya Mannimala. 4. 287)

Punarnava:

• Punarnava Mandura. (Charaka Samhita Chikitsa Sthana. 16. 93- 96)
• Punarnavastaka. (Vaidya Manorma. 38. 3)

Shala:  Powder of the heartwood of shala etc. or amalaka fruit should be taken with honey. (Sushruta Samhita Uttara tantra. 44. 24)

Shali: One suffering from anemia should use shali rice and barley regularly. (Sushruta Samhita Uttara Tantra. 44/ 37)

Svarna Kshiri: One suffering from anemia should take svarnaksiri, trivet, Syama, devadaru, and Sunthi pounded in cow-urine 160 ml or decocted in the same. (Charaka Samhita Chikitsa Sthana. 16/ 66)

Triphala: 

• The patient should take the decoction of Triphala mixed with cow’s urine for a week. (Charaka Samhita Chikitsa Sthana. 16/ 65)
• Navayasa churna. (Charaka Samhita Chikitsa Sthana 16/ 70- 71)
• Triphala mixed with lauha bhasma should be taken with cow urine for a long time. (Sushruta Samhita Uttara Tantra. 44/ 21)
• Vasadi (phalatrikadi) kvatha. (Ashtanga Hridya Chikitsa Sthana. 16. 13, Vrindha Madhava. 8. 5)
• One suffering from jaundice should take the cooled decoction of Triphala, guduci, Daru Haridra, or Nimba mixed with honey in the morning. (Charaka Samhita Chikitsa Sthana. 16. 63, Vrinda Madhava. 8/ 11, Sharangdhara Samhita. 2. 1. 9, Bhava Parkasha Chikitsa. 3. 39)

Trivrit: 

• Trivit powder mixed with double sugar in the dose of 20 gm should be taken in the predominance of pitta. (Charaka Samhita Chikitsa Sthana. 16. 57, Vrinda Madhava. 8. 3)
• Trivrit mixed with sugar, Indravaruni or Sunthi mixed with jaggery are useful in jaundice. (Sushruta Samhita Uttara Tantra. 4/ 30, Vrinda Madhava. 8/ 14)
• One suffering from jaundice should take trivrit with the decoction of Triphala. (Charaka Samhita Chikitsa Sthana. 16/ 60)
• Sugarcane is bifurcated longitudinally, and the inner surface is pasted with trivrit, then it is tied with rope and cooked by closed heating. When cooled it is taken by one suffering from the disorder of pitta (jaundice). (Chakra Dutta. 71/ 5)

Yava: One suffering from anemia should use the formulation mentioned for edema, particularly a diet of sali rice and barley. (Sushruta Samhita Uttara Tantra. 44. 37)

Few Classical Formulations with Ingredients that can be Used in Ulcerative Colitis

Bhaishjya Ratnavalli, 7/ 68- 70

Kutaja Leha

Ingredients: Barks of kutaja tree, suvarchala salt, black salt, yavakshara, rock salt, pepper, dhatakti flowers, indrayava, and white cumin seeds.

Dose and Anupana: 6-12 gm. with honey.

Bhaishjya Ratnavalli, 7/ 71- 76

Kutajastaka Avaleha

Ingredients: Fresh barks of the plant kutaja, water, dhataki flowers, pulp of unripe bilva fruit, mustaka, ativisa, any one of the herbs mocarasa, patha, samanga, manjistha, and varahakranta.

Dose and Anupana: 12 g to 50 g with cold water.

Bhaishjya Ratnavalli, 7/ 77

Punarnavadi Kvatha

Ingredients: Punarnava, indrayava, patha, the pulp of bilva fruit, ativisa, and mustaka.

Dose and Anupana: 30-50 ml. with water

Bhaishjya Ratnavalli, 7/ 78

Vidangadi Kvatha 

Ingredients: Vidanga, ativisa, mustaka, devadaru, patha, and indrayava.

Dose and Anupana: 30-50 ml. along with 2 gm. of fine black pepper powder.

Bhaishjya Ratnavalli, 7/ 101- 102

Rasanianadi Churnam 

Ingredients: Rasanjana, ativisa, indrayava, the bark of kutaja, dhataki flowers, and dried ginger.

Dose and Anupana: 3 gm. to 6 gm. with the rice-washing (tandulodaka) and honey.

Bhaishjya Ratnavalli, 7/ 103- 106

Narayana Curnam 

Ingredients: Guduchi, seeds of purified vrddhadaraka, indravava, the pulp of the unripe bilva fruit, ativisa, bhringaraja, dried ginger, purified Vijay, and bark of the kutaja.

Dose and Anupana: 2 gm. to 4 gm. with unrefined sugar.

Bhaishjya Ratnavalli, 7/ 112

Patoladi Kvatha 

Ingredients: Patola, yava and dhanyaka, sugar, and honey.

Dose and Anupana: 50 ml. with honey and jaggery.

Bhaishjya Ratnavalli, 7/ 113

Priyangvadi Churnam

Ingredients: Priyangu, anjana and musta.

Dose and Anupana: 2 gm. to 4 gm. with honey and rice-washing.

Bilvadi Leha

Ingredients: Fruit pulp of unripe bilva, raw sugar, oil of sesame, pepper, and dried ginger.

Dose and Anupana: 3 gm. to 6 gm. with honey.

Bhaishjya Ratnavalli, 7/ 130- 131

Jatiphaladi Vati

Ingredients: Jatiphala, date fruits, opium, and juice of betel leaves.

Dose and Anupana: 375 mg. with buttermilk. 

Bhaishjya Ratnavalli, 7/ 132- 135

Purnacandrodaya Rasa 

Ingredients: Purified haratala, bhasmas of lauha and abhraka, purified camphor, purified mercury, purified sulphur, jatikosa, mura, cassia leaves, salt, talisapatradi, nagakesara, dried ginger, marica, pepper, cinnamon bark, pippali mula, and clove.

Dose and Anupana: 125 to 250 mg. with water.

Bhaishjya Ratnavalli, 7/ 141- 143

Lokanatha Rasa 

Ingredients: Parada bhasma or Rasasindura, gandhaka, purified Varatika (counch shells), and borax along with honey.

Dose and Anupana: 125 to 250 mg. with honey.

Bhaishjya Ratnavalli, 7/ 144- 148

Chintamani Rasa

Ingredients: Purified mercury, purified sulphur, Tamra bhasma, vatsanabha visa, the pulp of the tamarind seeds, juice of jambira lemon, powder of marica, and tamarind pulp.

Dose and Anupana: 125- 250 mg. with water.

Bhaishjya Ratnavalli, 7/ 149- 150

Bhuvanesvara Rasa 

Ingredients: Rock salt, Triphala herbs, caraway seeds, the dried pulp of the unripe bilva fruit, and smoke-ashes of the kitchen.

Dose and Anupana: 125- 250 mg. with water.

Bhaishjya Ratnavalli, 7/ 151- 156

Jatiphala Rasa 

Ingredients: Purified mercury, purified mica powder, rasa sindura, purified sulphur, jatiphala, indrayava, purified seeds of dhattura, purified tankana, dried ginger, marica, pepper, musta, Harada, the pulp of the seed of the mango fruit, dried pulp of the unripe bilva fruit, seeds of the sala tree, bark of the pomegranate fruit, cumin seeds, and juice of Vijaya leaves.

Dose and Anupana: 125- 250 mg. with water.

Bhaishjya Ratnavalli, 7/ 157- 160

Abhayanrsinha Rasa 

Ingredients: Purified hingula, powders of purified vatsanabha visa, dried ginger, marica, pippali, white cumin seeds, purified tankana, purified gandhaka, abhraka bhasma, purified Parada, and lemon juice.

Dose and Anupana: 125- 250 mg with water.

Bhaishjya Ratnavalli, 7/ 161- 163

Ananda Bhairava Rasa

Ingredients: Hingula, marica, visa, vyosa, tankana, and Magadhi.

Dose and Anupana: 125 mg with honey.

Bhaishjya Ratnavalli, 7/ 164- 165

Karpura Rasa

Ingredients: Purified hingula, purified opium, powders of mustaka, indrayava, jatiphala, camphor, and water.

Dose and Anupana: 125- 250 mg. with water.

Bhaishjya Ratnavalli, 7/ 167- 168

Kanadi Lauham 

Ingredients: Pippali, dried ginger, patha, haritaki, vibhitaka, Amalaki, marica, pippali, cavanidasva, mustaka, roots of citraka, the dried inner pulp of the stones of mango, billa roots, white sandalwood, netrabala, lauha bhasma, and water.

Dose and Anupana: 125- 250 mg.

Bhaishjya Ratnavalli, 7/ 169- 170

Sadanga Ghritam

Ingredients: Indrayava, the bark of Daru Haridra, pippali, dried ginger, laksa, katuki, ghrita, and water.

Dose and Anupana: 6 gm. to 12 gm. with water.

Bhaishjya Ratnavalli, 7/ 171- 173

Babbulyadya Arista

Ingredients: Bark of babbula tree, raw sugar, dhataki flowers, pepper powder, jatiphala, kankola, cinnamon bark, smaller cardamom, cassia leaves, nagakesara, clove, and marica.

Dose and Anupana: 30- 50 ml. after meals along with water in equal quantity.

Bhaishjya Ratnavalli, 7/ 174- 177

Kutajadya Arista

Ingredients: Fresh bark of the kutaja, raisin, fruits of plant madhuka, the bark of plant Gambari, dhataki flowers, and raw sugar.

Dose and Anupana: 30- 50 ml. after meals along with water in equal quantity.

Bhaishjya Ratnavalli, 7/ 178- 180

Ahiphena Asava

Ingredients: Flowers of madhuka, purified opium, mustaka, jatiphala, indrayava, and smaller cardamom.

Dose and Anupana: 10 to 20 drops of this drug are to be taken along with water.