🔘 Chardi (Vomiting)

CHARDI (VOMITING) 

👉🏻 Introduction :-

- Chardi is also mentioned as ‘adhaaraneeya vega’, a natural urge expressed by the body. 

- This means to tell that we should not control or suppress vomiting because it is a process in which the body is trying to throw out the unnecessary contents, contaminants and toxins out of the body, which would otherwise prove to be harmful when left alone in the body. 

- Stomach identifies the incompatible foods and rejects them in the form of expulsion through vomiting. 

- Chardi as roga or disease – Chardi is a disease when the pathology is head by the vitiated doshas. 

- Even here too, if the patient is strong enough, the vomiting process should be allowed until the unwanted things have been ejected out of the system. 

- When comes to treating vomiting, the pathology should be addressed and treated only after the unnecessary things have been thrown out of the body.

👉🏻 Defination of Chardi:-

1. "छादयति मुखम् अर्दयति चाङ्गानीति छर्दिः।" (विजय रक्षित)

- Combination of Mukha achhadana and Ardana of anga is called as chardi.

2. "उर्ध्वातिदोषप्रवृत्त रुपा छर्दिरुच्यते।" (च.चि. 20/1 चक्रपाणि)

- When aggravated doshas expelled from urdhwa marga, it is called as Chhardi.

3. "छादयन्नाननं वेगैरर्दयनङ्गभञ्जनैः निरुच्यते छर्दिरिति।" (सु.उ.49/6)

- After achhadana of Mukha ashrita doshas and anga peedana when the doshas are removed, it is called as Chhardi.

👉🏻 Types of chardi :-

- दोषैः पृथक्त्रिप्रभवाश्चतस्रो  द्बिष्टार्थयोगादपि पञ्चमी स्यात्| 

(Cha.Chi.20/6)

1) Vataja Chardi – Vomiting caused by vitiated Vata.

2) Pittaja Chardi – Vomiting caused by vitiated Pitta.

3) Kaphaja Chardi – Vomiting caused by vitiated Kapha.

4) Sannipataja Chardi – Vomiting caused by vitiation of all 3 doshas

5) Drushtartha Samyogaja (Agantuja Chardi) – Vomiting caused due to consumption or sight or exposure to incompatible   foods and things.

👉🏻 Samanya Nidana (Causitive factors):-

- अतिद्रवैरतिस्निग्धैरहद्यैलवणरति ।

अकाले चातिमात्रैश्च तथाऽसात्म्यैश्च भोजनः ।

श्रमात् क्षयात्तथोद्वेगादजीर्णात् कृमिदोषतः ।

नार्याश्चापन्नसत्त्वायास्तथाऽतिद्रुतमश्नतः ।

अत्यन्तामपरीतस्य छर्देर्वे संभवो ध्रुवम ।

बीभत्सर्हेतुभिश्चान्यैर्दुतमुत्क्लेशितो बलात् ।।                                       (Su.U.49/3-5)

- Ati drava – excessive consumption of liquid foods or liquids.

- Ati snigdha– excessive consumption of unctuous or oily foods, fried foods.

- Ahrudhyaihi – excessive consumption of incompatible or unsuitable (unwholesome) foods.

- Ati lavana – excessive use of salt or salty foods.

- Akala bhojana – untimely intake of food.

- Ati matra bhojana – eating in excess.

- Asaatmya bhojana – incompatible foods

- Shramaat – exhaustion

- Bhayaat – fear, panic

- Udwega – high end emotions

- Ajeernaat – indigestion

- Krimi dosha – infection

- Naaryaha aapanna satva – pregnancy

- Ati drutam ashnataha – eating food in hurry.

- Beebhatsa hetu – anything which creates an awkward feel.

👉🏻 Vishesha Nidana:-

1) Vataja Chhardi:-

-व्यायामतीक्ष्णौषधशोकरोगभयोपवासाद्यतिकर्शितस्य ।                                               (Cha.Chi.20/7)

- Vyaayaama – excessive exercise.

- Teekshna aushadha – strong medicines.

- Shoka – grief.

- Jeerna roga – chronic diseases.

- Bhaya – fear.

- Upavasa – excessive fasting.

 2) Pittaja Chhardi:-

- अजीर्णकट्वम्लविदाह्यशीतैरामाशये पित्तमुदीर्णवेगम्|                                             (Cha.Chi.20/10)

- Ajeerna bhojana – indigestion.

- Katu – excessive consumption of pungent foods.

- Amla – excessive consumption of sour foods.

- Vidahi – excessive consumption of corrosive foods.

- Ushna – excessive consumption of hot foods.

3) Kaphaja Chhardi:-

- स्निग्धातिगुर्वामविदाहिभोज्यैः स्वप्नादिभिश्चैव कफोऽतिवृद्धः|                                        (Cha.Chi.20/12)

- Snigdha – excessive consumption of unctuous, oily and fried foods.

- Guru – excessive consumption of heavy ‘to digest’ foods.

- Ama – excessive consumption of unprocessed and immature / improperly prepared (cooked) food components.

- Vidahi – excessive consumption of corrosive foods.

- Swapna – excessive sleeping, sedentary life, rest prone etc.

4) Sannipataja Chhardi:-

- समश्नतः सर्वरसान् प्रसक्तमामप्रदोषर्तुविपर्ययैश्च|

                                              (Cha.Chi.20/14)

- Constant indulgence in diet consisting of wholesome and unwholesome diet together, having all categories of taste together because of ama-dosha (ailments caused by improper digestion) and because of seasonal perversions.

 5) Dvistartha Samyogaja Chardi:-

- द्विष्टप्रतीपाशुचिपूत्यमेध्यबीभत्सगन्धाशनदर्शनैश्च|                                          (Cha.Chi.20/18)

√ Smells, food or things which are:

- Dwishta – repulsive to the mind

- Prateepa – against the need of mind.

- Ashuchi – untidy, clumsy, unwholesome, unclean.

- Puti – putrid, decayed,

- Amedhya – disturbs the mind.

- Beebhatsa – horrifying, scary.

👉🏻Samprapti (Pathogenesis):-

- वायुर्महास्रोतसि सम्प्रवृद्ध उत्क्लेश्य दोषांस्तत ऊर्ध्वमस्यन्|

आमाशयोत्क्लेशकृतां च मर्म प्रपीडयंश्छर्दिमुदीरयेत्तु|                                               (Cha.Chi.20/7)

- On getting provoked by the above said causative factors, the doshas get immediately vitiated.

- They quickly move upwards and fill up the mouth. In the process they cause serious discomfort, bends and twist the body parts. 

- The condition in which there is quick movement of doshas towards the mouth is called Chardi.

👉🏻 Poorvarupa :-

- तासां हृदुत्क्लेशकफप्रसेकौ द्वेषोऽशने चैव हि पूर्वरूपम्||                                            (Cha.Chi.20/6)

- Hrudaya utklesha – feeling of discomfort in the region of the heart, nausea (repeated).

- Kapha praseka / Hrillasa – filling of mouth with watery secretions, water brash, excessive salivation.

- Ashana dwesha – aversion or lack of interest in food.

- Udgara rodha – obstruction to belchings

Tanu, lavana srava – thin salty secretions in the mouth.

👉🏻 Samanya Lakshana:-

- Vegapurvaka Anna pravrutti from mukha pradesha

- Angamarda (Bodyache)

- Mukha vairasya

👉🏻 Vishesha Lakshana:-

 1) Vataja Chhardi:-

- हृत्पार्श्वपीडामुखशोषमूर्धनाभ्यर्तिकासस्वरभेदतोदैः|

उद्गारशब्दप्रबलं सफेनं विच्छिन्नकृष्णं तनुकं कषायम्|

कृच्छ्रेण चाल्पं महता च वेगेनार्तोऽनिलाच्छर्दयतीह दुःखम्||                                                    (Cha.Chi.20/8-9)

- Hrit parshva peeda – Pain in the cardiac region and sides of the chest

- Mukha shosha – Dryness of the mouth

- Murdha nabhya arti – Pain in the head and umbilical region

- Kasa – Coughing

- Swara bheda -hoarseness of the voice 

- Toda – pricking pain

- Udgara shabda prabala – Eructation with loud noise

- Sa phena, vicchinna, krshna, tanu kashayam – Vomiting of material which is frothy, scattered, black in color, thin and astringent in taste.

- Krchrena alpam – The urge for vomiting is forceful, but the patient vomits only in small quantities with pain and The patient feels miserable.

 2) Pittaja Chhardi:-

- मूर्च्छापिपासामुखशोषमूर्धताल्वक्षिसन्तापतमोभ्रमार्तः|

पीतं भृशोष्णं हरितं सतिक्तं धूम्रं च पित्तेन वमेत् सदाहम्||                                             (Cha.Chi.20/11)

- Moorcha – Fainting

- Pipasa – Morbid thirst

- Mukha shosha – dryness of the mouth

- Santapa – Burning (or heating) sensation in the head, Palates and eyes

- Tamo pravesha- A feeling as if the entering into darkness

- Bhrama – Giddiness

- Pitam bhrsoshanam haritam satiktam dhumram-Vomiting of material which is yellow, excessively hot, green, bitter and smoky in appearance

- Sa daham – Vomiting takes place with burning sensation.

3) Kaphaja Chhardi:-

- तन्द्रास्यमाधुर्यकफप्रसेकसन्तोषनिद्रारुचिगौरवार्तः|

स्निग्धं घनं स्वादु कफाद्विशुद्धं सलोमहर्षोऽल्परुजं वमेत्तु|                                           (Cha.Chi.20/12-13)

- Tandra – Drowsiness

- Madhura aasya – sweet taste in the mouth

- Kapha praseka –  excessive salivation

- Santosha – Sense of satisfaction

- Nidra – sleep

- Aruchi – anorexia 

- Gauravam – heaviness of the body

- Vomiting of material which is Snigdha – unctuous, Ghana – thick, Svadu – sweet and free from any undesirable smell

- Loma harsha – Horripilation and Alpa ruja – less of pain

4) Sannipataja Chhardi:-

- शूलाविपाकारुचिदाहतृष्णाश्वासप्रमोहप्रबला प्रसक्तम्|

छर्दिस्त्रिदोषाल्लवणाम्लनीलसान्द्रोष्णरक्तं वमतां नृणांस्यात्|                                                (Cha.Chi.20/15)

- Shula – Colic pain

- Avipaka – indigestion

- Aruchi – Anorexia

- Daha – burning sensation

- Trishna – morbid thirst

- Shwasa – dyspnoea and fining which are of serious nature and persistent.

- Vomiting of material which is Lavana – saline, amla-sour, Anila – blue, Sandra -dense, Ushna -hot and Rakta – red (mixed with blood).

5) Dvistartha Samyogaja Chardi:- 

- शूलहल्लासबहला कृमिजा च विशेषतः ।

कृमिहद्रोगतुल्येन लक्षणेन च लक्षिता ।।                                   (Su.U.49/14)

- Udarashoola - Pain in abdomen

- Hrillasa Bahulata - Excessive nausea

- Similiar Lakshana of Krimija hridroga

👉🏻 Sadhyasadhyatva :-

- क्षीणस्य या छर्दिरतिप्रवृद्धा सोपद्रवा शोणितपूययुक्ता|

सचन्द्रिकां तां प्रवदन्त्यसाध्यां साध्यां चिकित्सेदनुपद्रवां च||                                             (Cha.Chi.20/19)

- Ksheena – person is emaciated or has tissue depletion.

- Ati pravrudda vamana – severe vomiting occurring repeatedly

- Sa upadrava – vomiting associated with complications.

- Shonita yukta – blood mixed vomitus.

- Pooya yukta – pus mixed vomitus.

- Sa chandrika – vomitus having shiny materials.

These type of Chhardi is Asadhya.

- The chhardi without above mentioned symptoms are Sadhya.

👉🏻 Complications:-

- Kasa:- Cough

- Shwasa:- Dyspnoea

- Jwara:- Fever

- Hikka:- Hiccough

- Trishna:- Polydypsia

- Vaichitya:- Restlessness

- Hridroga:- Cardiac disorders

- Tama:- Darkness infront of eyes

👉🏻 Chikitsa Sutra:-

- आमाशयोत्क्लेशभवा हि सर्वाश्छर्द्यो मता लङ्घनमेव तस्मात्|

प्राक्कारयेन्मारुतजां विमुच्य संशोधनं वा कफपित्तहारि||                                                 (Cha.Chi.20/20)

- As all the types of vomiting are considered originating from the agitations of the doshas in the stomach, fasting therapy should first be prescribed or purificatory procedure curative of kapha and pitta should be administered except in cases of vata dominance.

- Patient may also be given emetic therapy prepared of the drugs of the valliphala (group of cucurbitaceous fruits), etc. or if the patient is weak, then he should be treated with pacification therapy through delicious soups and light as well as dry food articles for diet along with various kinds of drinks.

👉🏻 Vataja Chardi chikitsa:-

- The well sizzled soup of the meat of Tittiri, Barhi and Lava.

- Vegetable soup of Kola, Kulattha, Dhanya, Bilva (Shyonaka, Gambhari, Patala), Mulamla (sour drink prepared of radish) and yava.

- Ghee with rock- salt (cooked with rock salt). This recipe is given to the patient of Vatika Chardi, associated with the palpitation of the heart.

- Ghee cooked with Dhanyaka Nagara, Yogurt and the juice of Dadima 

- Ghee added with the powder of Sunthi, Pippali,  Maricha and Saindhava, Sauvarchala and Vida type of salt.

- The patient of Vataja Chardi is given food which is unctuous and pleasing to the heart along with meat- soup, vegetable- soup, yogurt and sour pomegranate.

👉🏻 Pittaja Chhardi Chikitsa:-

- The powder of Trivruta along with the juice of Draksha, Vidari and sugarcane for causing Anulomana or downward movement of the morbid matter, i.e purgation. 

- When Pitta is over- aggravated in chest (in the region above the abode of kapha- stomach), then (emetic therapy with the help of) drugs having sweet taste is administered.

- After the body is cleansed from the morbid matter, the patient is given during meal- time the Laja-mantha (flour of popped- rice, Diluted in water) or Laja-Peya (thin gruel made of popped- rice) along with honey and sugar. 

- The patient may also be given boiled Shali- rice along with the soup of Mudga or the soup of the meat of animals inhabiting an arid zone.

- Kulmasha, Masura,  Laja, Yava, Saktu, Grnja (boiled barley along with its scum), or the pulp of Kharjura,  Coconut, Draksha or Kola is made to a linctus by adding Sitopala (sugar having big crystals), honey and Pippali.

- These recipes are given to the patient suffering from Paittika type of vomiting.

- The powder of Srotonjana Laja (popped paddy), Utpala and Abhaya is made to a linctus by adding honey, and given to the patient. 

- Similarly the seed- pulp of Kola, Anjana, and stool of fly, Laja (popped paddy), sugar and grains of Pippali mixed with honey may be given to the patient.

- The patient may drink cooled juice of Draksha or the leaves of jambu and Amra by adding honey (after the decoction is cooled).

- Water is added with the powder of mudga, Pippali, Ushira and Dhanya and kept overnight. In the morning the powder is strained out and the filtered water is taken by the patient. 

- Similarly the water added with the powder of chanaka or Gavedhuka- root or Guduchi and kept to overnight can be given to the patient.

- The patient may be given sugarcane juice or milk to drink.

👉🏻 Kaphaja Chhardi Chikitsa:-

- The patient is given the decoction of Pippali, Sarsapa and Nimba  added with the powder of Pinditaka and rock salt. This cleanses (eliminates) Kapha from Amashaya (stomach).

- The patient is given wheat, rice and barley which are old (more than 6 months old after harvesting) as food. 

√ Along with this food, he is given the following side –dishes and drinks:-

- Vegetables soup of Patola, Amrta and Chitraka.

- Butter-milk cooked by adding Sunthi, Pippali and Maricha.

- Butter- milk cooked by adding Nimba.

- Soup of sour fruits along with pungent drugs

- Soup of the meat of animals inhabiting arid zone (Jangala). The spit-roasted meat these animals may also be given along with food.

- Old honey, Sidhu (alcohol prepared of sugar-cane- juice) and Arishta (a type of alcoholic drink) and

- Raga (condiments), sasava (pickles) and Panaka (syrup) prepared of Draksha, Kapittha and Phala- Puraka (bija-Purakaa)

👉🏻 Sannipataja Chhardi Chikitsa:-

- Various types of treatment suggested by me (by Atreya) for the treatment of different types of Chardi,(Viz, Vatika,pattika and Kaphaja Chardi) is appropriately and judiciously combined, and given by the physician to the patient suffering from Sannipatika type of Chardi. 

- The physician well versed in ayurvedic scriptures is (specially) vigilant (with regard to the Sannipatika type of Chardi) keeping in view the relative preponderance of the Doshas involved, the season when the disease has occurred, the stage of the disease and the power of digestion of the patient.

👉🏻 Dvistartha Samyogaja Chardi Chikitsa:-

- For the treatment of vomiting caused by the mental disgust or affliction of the mind (Manobhighata), the following steps are taken:-

• Mano anukula – The patient is made to hear pleasing talks.

• Ashvasana – He is consoled and encouraged.

• Loka prasiddha sruta – He is made to hear reputed folk tales including mythological stories.

• He is attended to by congenial companions and he should resort to amorous and wholesome regimes (games).

• He is made to smell various types of pleasing perfumes emanating from the earth, flowers, Sukta (vinegar) and Sour fruits.

• He is given to eat well prepared vegetables, eatables, syrups, Shadavas (Pickles), raga (condiments) and Lehas (preparations in the form of linctus or jam).

• Eatables like vegetable- soup, meat- soups, Kambalika (sour curry of fish and meat), Khada (sour drinks prepared of fruits), meat preparations, popped cereals, different food preparations, fruits and roots having pleasing smell, color and taste cure vomiting caused by mental disgust.

• In general, whatever smell, taste, touch, sound or vision is pleasing to such patients is administered even though some of these might be unwholesome, because the aliments caused by such unwholesome contacts can be treated easily.

👉🏻 Treatment of Chronic Chhardi:-

- In persistent vomiting vata invariably gets aggravated because of loss of tissue elements. 

- Therefore, in case of chronic vomiting medications that are bulk promoting, vata pacifying, upastambhana (astringents) and brimhana (nutritive) should be administered.

√ The following recipes are useful in chronic type of vomiting.

- Sarpirguda 

- Kshira-vidhi 

- Kalyanaka Ghrita

- Tryushana Ghrita

- Jeevaniya Ghrita

- Vrishya recipes

- Mansarasa.

- Lehya like chyavanprasha

 

👉🏻Upadrava Chikitsa (Management of complication) :-

- छर्द्युत्थितानां च चिकित्सितात् स्वाच्चिकित्सितं कार्यमुपद्रवाणाम्|

अतिप्रवृत्तासु विरेचनस्य कर्मातियोगे विहितं विधेयम्||                                       (Cha.Chi.20/45)

- Complications associated with the disease (vomiting) are treated on the lines suggested in respect of each of these ailments. 

- If there is excess of vomiting, then the therapeutic measures to be suggested in Siddhi 6 is administered to the patient.

👉🏻 Yoga for chardi :

1) Samshodhana Chikitsa:-

- *Vamana* :- Madanaphala or other Vamana drugs

- *Virechana* :- Haritaki + Madhu churna

2) Samshamana chikitsa:-

a) Rasa / Bhasma / Pishti:-

- Chardi Ripu rasa

- Sutasekhar rasa

- Mayurpichha bhasma

- Rasendra yoga

- Manashiladi yoga

- Vamanakuthara rasa

b) Vati:-

-  Eladi Vati

- Lavangadi Vati

c) Churna:-

- Eladi Churna

- Vidangadi churna

- Lajadi churna

- Avipattikara churna

d) Kwatha:-

- Jamvadi kwatha

- Guduchyadi Kwatha

- Parpataka kwatha

- Chandanadi kwatha

e) Ghrita:-

- Padmakadi Ghrita

- Sarpiguda

- Jeevaniya Ghrita

- Kalyanaka Ghrita

f) Paka / Avleha:-

- Jatyadi leha

- Kolamajjadi leha

- Haritaki churna leha

👉🏻 Pathya-Apathya: 

1) Pathya:-

√ Ahara:-

- Purana tava. Godhuma, shali, mudga, chanaka, green vegetables, godugdha, nimbu, mansa rasa of lava, tittira and bater, jeeraka, sunthi etc.

√ Vihara:-

- Vamana, Virechana, Snana, Sharira Shuddhi, lepa prayoga, agnikarma above nabhi etc.

2) Apathya:-

√ Ahara:- 

- Viruddha ahara, bimbi phala, Sarshapa, drava padartha etc 

√ Vihara:-

- Vyayama, Nasya, Basti, Swedana, snehapana, dushita jala, bibhatsa Darshana, raktamokshana, bhaya, udwega etc 

👉🏻MODERN CORRELATION:- VOMITING

- In modern on the basis of symptoms Chhardi is known as 'Vomiting'.

✓ Defination:-

- Vomiting, or throwing up, is a forceful discharge of stomach contents.

✓ Causes of Vomiting:-

- Vomiting is common. 

- Eating too much food or drinking too much alcohol can make a person throw up.

- This generally isn’t a cause for concern. 

- Vomiting itself is not a condition. It’s a symptom of other conditions. Some of these conditions include:

• food poisoning

• indigestion

• infections (associated with bacterial and viral illnesses)

• motion sickness

• pregnancy-related morning sickness

• headaches

• prescription medications

• anesthesia

• chemotherapy

• Crohn’s disease

- This condition can cause vomiting episodes several times throughout the year when left untreated. 

- It can also have serious complications that include:

• dehydration

• tooth decay

• esophagitis

• a tear in the esophagus

✓ Complications:-

- Dehydration is the most common complication related to vomiting. 

- Vomiting causes your stomach to expel not only food but fluids, too. Dehydration can cause:

• dry mouth

• fatigue

• dark urine

• decreased urination

• headache

• confusion

- Dehydration is especially serious in infants and young children who vomit. 

- Younger children have smaller body mass and thus have less fluid to sustain themselves. 

- Parents whose children show symptoms of dehydration should talk to their family pediatrician immediately.

- Malnutrition is another complication of vomiting. 

- Failure to keep down solid foods causes your body to lose nutrients. 

- If you’re experiencing excessive fatigue and weakness related to frequent vomiting, seek medical attention.

✓ Management:-

- To treat the main cause first like Gastritis, Hyperacidity, Poisoning etc.

- Antacids

- Anti emetic drugs

- Patient should be advised to take light food.

Avoid Tea, Coffee, Alcohol & Cigarrete smoking.

- Avoid overeating & lying down for 3 hour's after eating.

- Maintain Fluid/Electrolyte balance of body.