Hemorrhage (Rakta Pitta)
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Introduction

 

Hemorrhage simply means bleeding. It is a pitta vitiation and therefore in Ayurveda it is termed as rakta pitta, where rakta means ‘blood’. Hemorrhage can be both internal as well as external. This article explains the common types of hemorrhages.

Definition of Hemorrhage (Rakta Pitta)

 

Hemorrhage is a medical term that is applied commonly to any type of bleeding. In the human body, blood flows through blood vessels; viz. the arteries, veins and the capillaries. If there is a rupture of any of these blood vessels due to some reason, then the blood flows out into the extra-vascular space. This is called as hemorrhage.

The flow of blood out of the blood vessels (or even out of the body itself) is called in Ayurveda as rakta pitta. This is a common term in Ayurveda to encompass all hemorrhagic blood losses. As the name suggests, rakta pitta is considered to be a pittaja disorder, i.e. it is caused due to the vitiation of the pitta dosha.

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Types of Hemorrhage (Rakta Pitta)

The human body generates up to two quarts of blood per week. Hence hemorrhage to a small extent does not cause any severe medical condition in the human body. But more blood loss can definitely be dangerous and even fatal. Depending on the volume of blood that is lost in the hemorrhage, it is divided into four classes as given below:-

Class 1 Hemorrhage

This is the hemorrhage in which there is less than 15% of the total blood of the body lost. This is not dangerous to the human body. There are no external symptoms (except, of course, the bleeding itself) and no transfusion is necessary.

Class 2 Hemorrhage

If there is between 15 and 30% of the blood lost, then it is termed as class 2 hemorrhage. This is a slightly serious medical condition. Here the following are observed:-

The rapidity of heartbeat increases.

The systolic and diastolic pressures come closer together.

The skin may lose its color and become cool to the touch.

In such cases, blood transfusion is not necessary, but the person needs to be put on saline.

Class 3 Hemorrhage

Blood loss of between 30 and 40% of the total volume in the body is classified as class 3 hemorrhage. This is a serious condition. The following symptoms are observed:-

The person loses his or her mental faculties.

The heartbeat becomes very rapid.

The blood pressure falls to drastic levels.

In this class of hemorrhage, both blood transfusion and volume enhancement of the blood through saline is needed.

Class 4 Hemorrhage

This is the worst kind of hemorrhage which is usually a cause for death. It occurs when more that 40% of blood from the total volume in the body is lost. When this happens, the person must be resuscitated quite aggressively to prevent from dying.

Apart from the above classes of hemorrhage, it is also classified on the basis of the region in the human body where it occurs. The following are the prominent types of hemorrhage found:-

(1) Cerebral Hemorrhage

This is the hemorrhage when bleeding occurs inside the brain. Depending on where precisely in the brain the bleeding occurs, this type of hemorrhage is classified into:-

  • Subarachnoid hemorrhage
  • Intercranial hemorrhage
  • Epidural hemorrhage
  • Subdural hemorrhage

Cerebral hemorrhage is most often fatal. It is a medical emergency and drastic measures need to be taken in order to resuscitate the patient. Subarachnoid hemorrhage is a type of cerebral hemorrhage

(2) Vitreous Hemorrhage

Vitreous hemorrhage covers all kinds of bleeding that can take place within the eye, mostly in the retina. The person suffering from vitreous hemorrhage will have impaired vision and will see spots in front of the eyes. Vitreous hemorrhage is a fairly common complication in people suffering from hypertension and diabetes.

(3) Postpartum Hemorrhage

Postpartum hemorrhage is the bleeding that occurs during childbirth. The bleeding occurs in both normal as well as cesarean deliveries, but if too much blood loss is involved, then there is a chance that the mother may die.

In the conventional definition, postpartum hemorrhage was stated as that in which there was more than 500 ml blood loss in a normal birth and more than 1 liter blood loss in a cesarean birth.

(4) Nasal Hemorrhage or Epistaxis

Nasal hemorrhage is bleeding from the nose. This is a much less serious condition than the ones mentioned above, but is very common. This is because the inner lining of the nose is quite delicate and is very vulnerable to slight pressure. Nasal hemorrhage can occur due to:-

  • Digging the nose
  • Injury to the nose
  • Sudden climatic changes, such as very cold weather
  • Pressure reduction, as is felt when flying in a plane

Nasal hemorrhage doesn’t complicate itself because there is very little blood loss. But nasal hemorrhage is a symptom of leukemia; hence if there is an unexplained loss of blood through the nose, it needs to be urgently checked by a doctor.

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Causes of Hemorrhage (Rakta Pitta)

Hemorrhage can occur due to both traumatic and underlying medical factors.

Traumatic factors of hemorrhage are those which occur due to an injury. The injury could be either blunt or penetrating. Blunt injuries, such as a punch or a hit with a club, can cause internal bleeding. The blood may not escape out because in such injuries generally the skin does not break. As the result, the extent of such injuries cannot be found out from the outside. Any organ within the body can bleed. The internal bleeding is sometimes observable as a dark clot under the skin, after the clotting process has occurred. Bleeding due to penetrating injuries is more apparent. These injuries can directly rupture the skin and cause the blood to flow out of the puncture.

There are some underlying factors that can cause internal bleeding. The most well-known of them is hemophilia. Hemophiliac people can bleed to death because they lack the factor necessary for blood clotting. Weakness of the blood vessels, i.e. aneurism, can also cause grievous blood loss.

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Symptoms of Hemorrhage (Rakta Pitta)

If the bleeding is externally apparent, then the symptoms are quite observable. The bleeding can be seen as a flow of blood from the injured region. Depending on the nature of the injury, the blood could flow as a small trickle, or as a stream, or in extremely adverse injuries, even gush out of the skin. The blood loss is accompanied by pain, which is due to the rupturing of the skin.

Internal hemorrhages are more difficult to understand. If the hemorrhage is close to the skin, then it can be made out from the outside as a darkened spot under the skin. When the blood clots, the darkening is more visible.

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Complications of Hemorrhage (Rakta Pitta)

Depending on the nature of the hemorrhage, there can be several complications. The following are some of the important complications:-

The major complication involves the loss of blood. Blood is the carrier of oxygen to all the vital organs of the body. Hence the loss of blood would mean a short supply of oxygen to all the vital organs. This would cause the vital organs to malfunction; which could lead to death of the person.

Minor hemorrhages also can make a difference to the person. The skin of the person may become pale due to the blood loss and the eyes may look dilated. The lips may look discolored and the person could become short of breath.

Hemorrhages cause the heart to pump blood faster. In a person with a chronic heart ailment, this could aggravate the condition of a myocardial infarction, i.e. a heart attack.

Hemorrhage is very dangerous in a person with hemophilia. Hemophilia is a hereditary disease in which the person is unable to clot blood. As a result, the person could even bleed away to death with a small injury.

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Transmission of Hemorrhage (Rakta Pitta)

Hemorrhage is a condition that occurs in the individual human body; hence there is no chance of it of getting transmitted from one person to another.

But at the same time it can be mentioned here that several dangerous microorganisms like the AIDS virus HIV and the hepatitis virus live in the blood of the person. A hemorrhage could make it very possible for these viruses to be transmitted from an infected person to a healthy person.

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Prevention and Basic Care during Hemorrhage (Rakta Pitta)

First aid is absolutely essential in minor hemorrhages. For hemorrhages caused due to small injuries, the following is the pattern of first aid:-

  • The area around the wound must be cleaned thoroughly by washing with water.
  • If the bleeding does not stop, then some direct pressure with the thumb can be applied to the region.
  • Use a bandage to tie around the wound. If the bandage consists of some disinfecting material within it, it is much ideal to prevent infections.

With serious hemorrhages, it is necessary to rush the person to a hospital. The doctors would check the airway of the person before beginning the resuscitation, in order to ensure that normal respiration can occur.

Any internal hemorrhage needs medical attention, and it must not be delayed.

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Diet for People with Hemorrhage (Rakta Pitta)

The following is a list of foods that is good for people with hemorrhage:-

  • A diet of old rice is advised.
  • Foods that contain vitamin C are very essential. Vitamin C contains collagen, which acts as a cementing material in blood clotting. All citrus foods such as oranges, lemons, amlaki and green leafy vegetables are good sources of vitamin C.
  • Foods that contain vitamin K are also needed. Vitamin K is necessary to synthesize prothrombin, which is another important ingredient for blood clotting. Leafy vegetables such as spinach, lettuce and cabbage and cauliflower are good sources of vitamin K. Also meats, cow’s milk, eggs and soy products contain good amounts of vitamin K.
  • Pulses such as Bengal gram and tur daal are helpful in regeneration of blood.

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Ayurvedic Treatment of Hemorrhage (Rakta Pitta)

The following are some beneficial herbs that can be taken in order to reduce blood losses through hemorrhages.

Ayurvedic Name of the Herb

Biological Name of the Herb

Common English Name of the Herb

Action on the Human Body

Adraka or Sunthi

Zingiber officinale

Ginger

Ginger is a beneficial herb in improving the process of blood clotting. Ginger can also increase the volume of blood and help in quick regeneration of lost blood.

Amlaki

Emblica officinalis

Indian Gooseberry

Amlaki is the richest source of vitamin C. the vitamin C in amlaki does not deteriorate even on heating or refrigeration. For this reason, a choorna (i.e. or powder) of amlaki, known commonly as aamchoor can be given to the person with hemorrhage.

Chandana

Santalum alba

Sandalwood

Sandalwood, especially red sandalwood, is good in arresting bleeding if applied externally. It is especially potent in stopping nosal hemorrhage.

Harad

Terminalia chebula

Chebulic Myroblan

The powdered fruit rind of the chebulic myroblan is an excellent remedy for bleeding. This is a component of the Ayurvedic mixture known as Triphala. For better effects, this choorna must be taken with honey or milk.

Mulethi or Yashtimadhu

Glycyrrhiza glabra

Licorice

Licorice can be used in a similar manner as red sandalwood in order to arrest bleeding.

The herbs mentioned above have been expertly mixed into preparations. These preparations contain just the right proportions of herbs so as not to produce major side effects. The following are some herbs that are effective in the treatment of hemorrhage:-

Type of Preparation

Name of Preparation

Asava/Arishta

Vasarishta

Bhasma/Kashaya

Pravala Bhasma, Mauktikha Bhasma

Choorna

Prithvika Choorna, Ghata Bhrashta Choorna

Ghrita

Shatavari Ghrita

Lehya

Vasava Lehya, Dadimdi Lehya, Kusmanda Lehya, Gulakanda

Rasa

Chandrakala Rasa, Pravala Panchamrita

Vati

Heamax, Eladi Gutika

It must be borne in mind that while taking any Ayurvedic preparation, the doctor must be consulted first. Most of the herbs do not have any side-effects (and are indeed a regular part of the diet), but some people may be allergic to certain herbs and may show adverse reactions.

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