Grahani/Sprue/Malabsorption disease

Grahani is the seat of Agni and is called so because of holding up the food. It is situated above umbulicus and is strengthened by the power of agni. Normally, it holds up the food(till it is digested)and releases it from the side after it is digested but when it is derranged due to weak digestive fire it releases the ingested material even in unripe condition.

Vataj Grahani-

Causative factors: Following factors envelop the agni and thus makes it sluggish. 

  • Intake of pungent, bitter, astringent, too rough and cold food articles,
  • little or no food,
  • too much travelling on foot,
  • suppression of urges,
  • sexual intercourse

Sign and Symtoms:

  1. Food is digested with difficulty
  2. Hyperacidity
  3. Coarsness in body, dryness in throat and mouth
  4. Hunger, thirst
  5. Blurred vision
  6. tinnitus
  7. frequent pain in sides-thigh-groin-neck
  8. Visuchika(peircing pain in abdomen)
  9. Cardiac pain
  10. emaciation
  11. debility
  12. abnormal taste in mouth
  13. cutting pain in abdomen
  14. greed for every food item, lassitude
  15. tympanitis during and after digestion subsiding after meal
  16. suspicion of vata-gulma, heart disease or splenimegaly arise
  17. patient passes stool as liquid, dried, thin, undigested with sound and frothy frequently and with difficulty after a long time
  18. He suffers from cough and dyspnoea

Kaphaj Grahani- 

Causative factor: Following factors extinguishes the fire:

  • Intake of heavy, unctous, cold food
  • over-eating and sleeping just after meals

Sign and Symptoms:

  1. digest the food with difficulty
  2. nausea, vomitting, anorexia
  3. sliminess
  4. sweetness in mouth
  5. cough, spitting and coryza
  6. He feels his heart as stretched, abdomen as still and heavy
  7. has foul, sweet eructations, malaise
  8. loss of libido
  9. He passes stool as broken mixed with Ama and mucus and heavy
  10. though not emaciated he has debility and lassitude

Pittaj Grahani-

Causative factor:Pitta gets aggrevated and extinguishes the fire by flooding like hot water.

  • Intake of pungent, uncooked, burning, sour, alkaline food

Sign and Symptoms:

  1. Patient gets yellowish luster
  2. passes frequently undigested bluish or yellowish liquid stool associated with foetid and sour eructations, burning in cardiac region and throat,
  3. anorexia
  4. thirst 

Treatment Principle:

  • When the morbidity is situated in Grahani and is flared up with the half burnt food and if one observes it as associated with the symptoms of Ama such as distension, salivatin, discomfort, burning, anorexia and heaviness, it shoud be eliminated by administering warm water or decoction of madanphala or pippali and sarshapa.
  • Even if the Ama is hidden or situated in Pakvasha(intestine) it should be discharged by administering purgations mixed with appetisers.
  • If rasa associated with ama has circulated in the whole body, lightening and digestive measures be adopted.
  • When the stomach is cleaned, the patient should be given light diet like liquid gruel etc. followed by appetising formulations.

Vataj Grahani treatment:

  • When the Ama is known as digested fully in the Grahani disorder caused by Vata, the physician should presribe ghee mixed with appetizers.
  • When the agni is stimulated slightly but there is retention of stool, urine and flatus the patient should be uncted for two or three days, fomented and massaged and then subjected to non-unctous enema.
  • When the vaayu is pacified and impurity is loosened the patient should be purged with castor oil
  • When the patient is free from impurity, has rough viscera and is constipated, unctous enema with oil prepared with appetisers, sours and Vata-allevating drugs should be administered to him in proper dose.
  • Ghrut useful in Vataj Grahani:
  1. Dashmulaady Ghrut
  2. Trushnaady Ghrut
  3. Panchmulaady Ghrut
  • Tablets useful in Vataj Grahani:
  1. Chitrakadya Gutika/tablet
  • Powder useful in Vataj Grahani:
  1. Marichadya churna/powder

Buttermilk is efficacious in grahani disorder due to appetising nature, astringeny and lightness. Because of sweet vipaka, it does not vitiate pitta, is wholesome in kapha due to astringent, hot, vikaasi(depressant) and rough properties and in Vata due to sweet, sour and viscous nature(thus it is useful in all the three doshas). Buttermilk, if fresh, does not produce burning(or acidity). Hence the use of buttermilk prescribed earlier in abdominal disorders and piles are all applicable in grahani disorder and should be applied in all ways.

Pittaj Grahani treatment:

  • Pitta which is situated in its own place, agitated and extinguishing the fire should eliminate it either by purgation or emesis. Thereafter the agni should be stimulated by administering non-burning light food added with bitters, meat soup of wild animals, soups and khadas(a type of dietary preparation) of green gram etc. soured with pomegranate, added with ghee, appetisers and astringent powders and ghees of bitter drugs.
  • Ghrut useful in Pittaj Grahani:
  1. Chandanaadya Ghrut
  • Churna useful in Pittaj Grahani:
  1. Naagaradya churna
  2. Bhunimaadya churna
  3. Kiraatadya churna

Kaphaj Grahani Treatment:

  • In Grahani affected by Kapha, after administering emesis according to prescribed method, one should stimulate the agni with pungent, sour, saline, alkaline and bitter drugs.
  • Palash, chitrak, chavya, matulunga, haritaki, pippali, pippalimula, patha, shunthi and dhanyaka-10gm each should be boiled together in 640ml water reduced to one fourth. This should be used for drinking purposes and for preparing gruel. The patient should be given light cereals with the soup of dried radish or horse gram added with pungent and sour substances, alkali and salt. After taking meals he should drink sour buttermilk, takrarisht, madhvaarisht or undamaged sidhu.
  • Aasav/Arisht useful in Kaphaj Ghrahani:
  1. Madhukaaasav
  2. Duralabhasav
  3. Mulaasav
  4. Pindaasav
  5. Madhvarisht
  • Ghrut useful in Kaphaj Grahani:
  1. Ksharghrut
  • Tablet useful in Kaphaj Grahani:
  1. Ksharguduka
  2. Chaturth Kshar
  3. Pancham Kshar

DIETARY RULE FOR PREVENTIVE PURPOSE:

Even on indigestion of the day-meal is not disturbing. During day, heart is blossomed like lotus and because of this all channels remain clear. Moreover, due to physical exertion, movements and mental activities the dhatus do not get moistened during day. So, on contrary, during night heart is faded, channels are covered and belly is obstructed and as such the dhatus get moistened. Another food added while the undigested material is moistened gets affected like hot milk added to the damaged milk. Hence the wise person in order to protect his strength and life-span should never eat anything if the food taken in noight is tsill undigested.