Various factors cause vitiation of pitta dosha which in turn afflicts the blood and brings it out either through the upper routes i.e. the nose, mouth or ears etc. or through the lower routes i.e. the urethra, vagina, anus etc. or generalized from the hair pores of the skin. The disorder is called as Rakta-pitta. Aetiopathogenesis:
- Overexposure to Sun
- Excessive physical exercise
- Travelling long distances on foot
- Sexual Intercourse
- Excessive use of sharp, hot, alkaline, saltish, acidic and pungent substances which vitiate the pitta.
Vitiated pitta, due to its inherent properties quickly affects the blood; thereafter, the blood is sometimes passed through the upper passages, sometimes by the lower passages and sometimes by both. The upper routes are the nose, the eyes, the ears and the mouth; and the penis, the vagina and the anus are the lower routes. When there is a generalized vitiation of blood, it may also come out through all the pores of the hair of the skin. Prodromal Features:
- Desire for cold
- A feeling as if fumes are present in the throat.
- A metallic odour in the breath are the prodromal symptoms of rakta pitta.
General Clinical features:
- Kaphaj Hemorrhagic Disorder: A viscid, somewhat pale, oleaginous and mucoid blood material indicates the kaphaj type of haemorrhagic disorder.
- Vaataj Hemorrhagic Disorder: Grey, reddish, frothy, thin and arid sanguineous material is due to vaat.
- Pittaj Hemorrhagic Disorder: The haemorrhagic fluid due to pitta may resemble the decoctions of astringent drugs, may be black or stimulate the urine of a cow.
- Rakta pitta due to combined vitiation of doshas: With the simultaneous dual or triple vitiation of doshas, the appropriate combined features of the respective two or three involved doshas appear clinically.
Secondary involvement of the doshas in the hemorrhagic disorders: Bleeding occurs from the upper passages is mixed with mucus (kaphaj), that from the lower passages is associated with vaat and the one coming from the both of the routes is combines with both kapha and vaat. Prognosis according to the routes of bleeding: Bleeding from the upper passages is curable, that from the lower channels is difficult to cure, while simultaneous bleeding from both the routes is incurable. Favourable prognostic features: The haemorrhagic disorders manifesting through one channel only are considered as curable in an otherwise healthy person, especially if it is not severe, is of recent onset, has occurred in a favourable season and is uncomplicated. Complications:
- Weakness, dyspnoea, cough, fever and vomiting.
- A burning sensation
- Severe heartburn on taking food
- Lack of self confidence
- Persistent intolerable precordial pain
- Loose motions
- Purulent expectoration
- Aversion to food
Fatal Signs of incurability: A case of hemorrhagic disorder proves fatal who vomits blood many times, who has bloodshot eyes and who has blood appearing even in the water brash.