A disorder in which the absorption of nutrients from the diet by the small intestine (malabsorption) is impaired resulting in malnutrition is known as sprue syndrome. It is also called as malabsorption syndrome. Two forms of sprue exist: tropical sprue, which occurs mainly in tropical regions; and celiac sprue, which occurs more widely and is due to sensitivity to the wheat protein gluten.
This disease is characterized by diarrhea with frothy stools, indigestion, sore mouth, loss of weight and anaemia. The stool is accompanied by mucus. The patient usually passes a large quantity of stool in the morning after he gets up from the bed.
In ayurveda, this condition is called as grahani roga. Like dysentery, at times, it is associated with a griping pain in the stomach. The small intestine beginning from intestine upto colon is known as grahani in ayurveda. Organism donot play any significant role in the causation of this disease. It is caused by the impairment of functioning of the inner wall of the small intestine. The large intestine is also involved at times.
Causative Factors
According to ayurveda persons having paittika type of physical constituent and psychic temperament are more prone to get this disease. Anger, worry, anxiety and other types of emotional stresses and strains are primarily responsible for the causation of this disease. Irregularity in intake of food also precipitate the attack of this disease. Impairment of digestion and absorption of food articles result in malnutrition. The tissue element in the body doesnot get proper nourishment. The patient becomes emaciated and anaemic. Even the best of nourishing food doesnot help in this condition.
Treatment
This is very chronic condition and the patient has to be tackled very carefully. Rasa paparti is the drug of choice for the treatment of this condition. The ingredients of this medicine are mercury and sulphur. In ayurveda these arenot used unless they are purified by a special process of purification. Both these ingredients have toxic effect on the body. Therefore, they are processed through a special pharmaceutical method to make them non-toxic and useful for the body. Elaborate method of sodhana of both these ingredients are described in ayurveda texts on pharmaceutics. Sulphur is taken in an iron spoon mixed with ghee. Then it is heated over an oven. The sulphur thus melts. This is then poured through a clean cloth into a vessel containing milk. Cow’s milk is considered to be better than buffalo milk for correcting the toxic effect of sulphur. After this, the solidified sulphur is collected from the vessel and washed with hot water. Then it is dried and made to a fine powder. The processing of mercury is very different. There are various eight different steps which are followed by the ayurveda pharmacists to make mercury non-toxic and useful.
Then both the powder of sulphur and the mercury are mixed together and titrated together in a stone pestle and mortar. When rubbed for sufficient period, the yellow colour of sulphur and white colour of mercury disappears and black colour emerges. Trituration should be done for sufficiently long period. The glaze of the mercury particles should completely vanish from the powder. Mercury, when combined with sulphur, even as a physical mixture is considered to become free from toxicity. The powder, thus obtained, is further processed to make it in the form of parpati ( a scale preparation).
This parpati is administered to the patient in a gradually increased dose. It is to be started with two grains and increased by one grains each day till ten grains. At this stage the dose is maintained for ten days and then gradually reduced by one grain till it reaches two grains again, after which the therapy is to be discontinued. This particular way of giving medicine is called parpati kalpa.
Diet during parpati kalpa
The patient is strictly prohibited from taking salt or water when given this therapy. He is to be given only milk or butter milk. Sugar can be added to this. In the beginning the patient may feel a little uncomfortable in taking milk alone. Subsequently, he gets habituated to this and soesnot experience any difficulty. He develops the power to digest large quantity of milk. It is seen that the patient who were unable to digest 250 ml of milk per day, manage to digest after this therapy about ten to fifteen litres of milk per day. This serves as a rejuvenation therapy for the patient. Along with the improvement of in this condition of the functioning of the inner wall of intestine, more and more food ingredients gets digested and he picks up weight.
The anaemia and emaciated condition of the patient slowly disappears and he develops good health. Since, this involves many diet restrictions it is always advisable to administer this therapy under the supervision of an expert ayurvedic physician.
Other medicines
Jati phala or nut-meg is the other medicine of choice in this condition. The kernel of the fruit is used in medicine. Five grains of this powder may be given three or four times a day depending upo the number of motions. There is ayurveda preparation called jatiphala churna in which nut-meg is added as an important ingredient. One teaspoonful of this powder is given to the patient two or three times a day.
Diet
Fried, oily and spicy food ingredients are strictly contraindicated in this condition. The patient should be given butter-milk in profuse quantity. Keeping the patient on butter-milk alone expedites recovery from this disease. Fried cumin seed in the form of powder and rock-salt can be added to this butter milk according to the taste of the patient. Butter-milk mixed with the rice and little salt forms a good food for the patient. The patient can be given orange juice, ripe banana and dry grapes. Other dry food are not normally indicated for the patient. Meat and fish are also contra-indicated. Among vegetables, the patient can take green banana, drum-stick, patola(Trichosanthes dioica), karavella(bitter gourd), tomato and white variety of pumpkin. Yellow variety of pumpkin, colocasia, potato, lady-finger and leafy vegetables are not indicated in this condition.
Other regimen
Even though the patient suffers from diarrhea at times gets constipation also. In some case diarrhea and constipation follow one after the other. The husk of isafgul(Plantago ovate) may be given to the patient in a dose of one to two teaspoonfuls at bed time mixed with butter milk. The patient should be given sufficient rest. He is advised to sleep for one hour during the day. Efforts should be made so that the patient gets good sleep at night. Light exercise or morning walk is very useful in this condition. Over-exertion, mental worry, anxiety, anger .etc. should be avoided. The patient should not fast for prolonged period.
