The milk for heavy bleeding

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Three-quarters of a litre, lukewarm, and the khārak boiled in the morning

Here is the household half of the heavy-flow rule, and it is the one instruction in this article that a patient can begin this evening without you.

Key teaching

Milk for heavy bleeding — the quantity, the temperature and the reason for both

If there is greater bleeding during the menses, then so that a deficiency of calcium does not come in the body, the woman should drink at least three-quarters of a litre of lukewarm milk.

But the milk should not be more hot, because from that the bleeding can increase further.

At night, put one khārak — a dried date — into a cup of milk and keep it in the fridge. In the morning boil that milk together with the khārak, and eating the khārak, drink the milk as well.

Four separate things are asked for, and a student who gives only the first has given about a quarter of the rule.

The quantity: at least three-quarters of a litre. Not a cup. Three-quarters of a litre is about three ordinary tumblers, and it is a quantity a household has to plan for, which is why you say the number out loud and let her do the arithmetic in front of you.

The stated purpose: so that a deficiency of calcium does not come in the body. That is the reason given, and it is the reason you give her. Note that it sits in the same country as the treatment you are giving on the mat — (4) Para and the 1,25 DCC formula are the calcium work, and the material says of 1,25 DCC that women who bleed very heavily in their menses because of calcium deficiency have their bleeding reduced or stopped by it. The rule at home and the rule on the mat are pointing the same way.

The temperature, and the reason it is a rule and not a preference. Lukewarm. Not more hot — because from that the bleeding can increase further. This is the sentence students drop, and it is the one with a consequence attached. Say it to her in her own kitchen's terms: warm enough to drink comfortably, not hot enough to make you blow on it. A mother-in-law who believes that hotter is better for a woman who is bleeding will need to hear the reason, not the rule.

The khārak. A procedure, performed the night before and finished in the morning.

THE METHOD, STEP BY STEP

The khārak in milk

At night, put one *khārak* — a dried date — into a cup of milk.

Keep it in the fridge overnight.

In the morning, boil that milk together with the khārak.

Eat the khārak, and drink the milk as well.

Both are taken; the date is not thrown away. The morning cup is part of the day's three-quarters of a litre, not additional to it — and the rest of that quantity is taken lukewarm, never hotter, for the reason given above.

Note the one place in this wiki where the refrigerator is instructed rather than warned against. The general drinking rule asks for water from an earthen pot and not from the fridge, because warming cold water inside the body wastes the body's energy — but that rule is about water being drunk cold. Here the milk is chilled overnight in order to be boiled in the morning, and nothing cold is swallowed. Two rules, two different things, no conflict.

THE WORDS WE USE

खारक — khārak

खारक (khārak), also written kharik and known in many households as chhuhārā, is the dried date — the date left on the palm to dry hard, sold by weight in every grocery in India, kept for months in a tin, and costing very little. It is not the soft, sticky khajūr eaten from the hand; it is the pale, wrinkled, stone-hard one that has to be soaked or boiled before it can be chewed, which is exactly why this instruction soaks it overnight and boils it in the morning.

In Indian households it has a settled place in the food given to a woman who is bleeding, who is newly delivered, or who is weak — usually boiled in milk, which is what this rule asks for. When you name it to a patient, name it in her own word: chhuhārā in the north, kharik in Maharashtra and Gujarat, and its own local names further south. She will know it under one of them.

TAKE CARE

When bleeding stops being a rule and becomes a referral

This therapy treats heavy bleeding and says so. It does not replace a look at the thing that is bleeding. Send the same day, and go on treating alongside, for any of these:

Bleeding after the menopause — any bleeding at all, however little, however long since the periods stopped.

Bleeding in pregnancy, at any stage.

Soaking through a pad within an hour, hour after hour, or passing very large clots, or bleeding with faintness, breathlessness or a racing heart.

Bleeding between periods, or after intercourse.

A cycle that has changed its pattern recently and has stayed changed.

None of those is a reason to stop the treatment you are giving. Give it and send. And say the reason for sending in a way that does not frighten her out of going: "This one needs somebody who can look, and I cannot look. I will keep treating you either way."

A CASE FROM PRACTICE

The woman who bled for eleven days and was on a treatment that was making it worse

A composite, written to teach the menstrual rules and the heparin bar.

Rukmini Parab · 41 · sorts and packs dried fish · Ratnagiri · came with numbness in both hands at night, and "so much bleeding"

What she came with. "Raatri hātānā mungyā yetāt. Ani pāḷī khūp jāte — akrā divas." At night ants come in my hands. And the bleeding is very much — eleven days. She had been given, at a different centre, a course for the hands that had helped them considerably, and she had continued it right through her periods because — as she said, entirely reasonably — "tyānni thāmbāyla sāngitla nāhi." Nobody told me to stop.

What was observed and palpated. Pale inner eyelids and pale nail beds. Tenderness at Mu°, four plus, and at 'Acid'; no tenderness at Liv°. Both wrists tender over the carpal region. A soft, loose abdomen. She was giddy standing up from the mat and said she had been for months, worst in the two or three days after a period ended.

Which reports mattered. She had none. A haemoglobin was asked for and it mattered enormously — it came back at 7.8, and she was sent that week to a doctor with the number written on a slip, and treated alongside. An ultrasound was asked for by that doctor, not by the therapist, and found a fibroid; the therapist's plan did not change because of it, but the therapist's honesty did — she was told plainly that there was a thing in her womb that a doctor was now watching, and that nothing in this room would be presented to her as a cure for it. A thyroid report from two years earlier changed nothing; a fresh one was taken because of the pattern of her cycle.

What was wrong with the treatment she was already having. The course she had been given for her hands was a heparin formula, given for the carpal tunnel — a correct and ordinary indication.

What was changed, and in what order. Two things only. First: the heparin course stops the moment the flow begins and resumes when it has finished — and this was written on her card as a line, not left in anyone's memory. Second: for the heavy flow itself, during the menses, (4) Para. Her cramps were real, so the 1,25 DCC formula was given with it. At home: three-quarters of a litre of lukewarm milk daily — not hot, and she was told why not hot, in front of her sister-in-law who prepared it — and the khārak soaked overnight and boiled in the morning, both eaten and drunk.

What followed, cycle by cycle. The first period after the change ran nine days instead of eleven, which she reported flatly and without excitement. The second ran six. The third ran five and she noticed, without being asked, that she was not giddy on the fourth day. Her hands, off the heparin work for one week in four, took longer than they would otherwise have taken, and she was told that in advance and accepted it without argument once the reason was given. Her haemoglobin, followed by her doctor, came up over four months.

Where it went wrong, and what was withheld. In the fifth month she missed a period entirely and did not mention it. She was found out in the ordinary way — asked to say when her last three had begun, from a calendar on the wall — and the gap was plain. She had not mentioned it because she had assumed it was the treatment working. It was not; she was sent to be seen, and it turned out to be nothing that needed anything done about it. But the lesson was recorded on the card in eight words: a period that does not come is also a finding.

What this case teaches

A standing course does not run through a heavy period. Nobody told her to stop, so she did not stop, and the treatment helping her hands was doubling her bleeding.

Write the bar on the card as a line, not as a memory. Heparin — stop while bleeding heavy.

Ask for the haemoglobin. A woman losing that much blood is not "a bit weak"; she is short of the thing that carries her oxygen, and the number is cheap and quick.

A finding that a doctor must look at does not stop the treatment and does not get hidden from the patient. She was told about the fibroid in plain words, and nothing in the room was offered as a cure for it.

Too little is a finding as much as too much. She thought a missed period was a success and it was a question.

From the moment pregnancy is a possibility, an entire group of treatments closes. Learn the closed list first, because it is short and because the cost of forgetting it is not borne by your patient.

Key teaching

What is blocked in pregnancy, and why

Blocked: Thymus, Th + Ch, Ton 'P'.

Thymus or Th + Ch are not to be given, because from them the child begins to kick hard and to move about, which is an indication that it is having some trouble.

And in general no treatment of any kind is to be given from which the child may have trouble.

It is thought that Ton (P) and Ton (T) have some relation with infertility. Therefore they are not given.

Read the middle sentence twice, because it is the one that does the most work and the one a student is likeliest to skip past. No treatment of any kind is to be given from which the child may have trouble. That is not a list; it is a standing instruction, and it means that the named bars are examples of a principle and not the whole of it. Where you do not know, you do not give. That is the whole of the rule and it needs no elaboration. (Figure 40.3)

The reason given for the thymus bar is an observation, and it is an unusually concrete one: after giving this, the babies begin to move about vigorously, from which it may be judged that the baby must be experiencing discomfort. Nobody is claiming to know what the child feels. Something was watched, it was read as distress, and the treatment was withdrawn. Teach it in exactly that shape.

Key teaching

What is directed in pregnancy

If the child's head is not in the correct place, then Liver or WD may be given to correct it.

If the mother has high BP, hypothyroidism, a deficiency of folic acid, or any genetic disease, then she is to be set right by giving the appropriate treatment.

So pregnancy is not a season in which a woman is untreatable. It is a season in which the list narrows and the purpose sharpens. Four maternal conditions are named by name and the instruction about them is positive: set her right.

Each of those four has its own article, and this is where they meet.

High BP in pregnancy is taken seriously in this material and for a stated reason: if during pregnancy a woman gets high BP, then arterial spasm occurs in her kidneys, brain and liver — a kind of tightening comes into the arteries so that they cannot contract properly, and this same effect will certainly fall on the child's organs too.

Hypothyroidism — see also → The Front of the Body II for Thrd, and note the cycle sign in Table 1 above.

A deficiency of folic acid — see also → Vitamin and Gene Formulas, "The Missing Links", which owns the folic acid work whole, and which carries the reasoning that during pregnancy women often have a deficiency of it.

Any genetic disease — see also → Vitamin and Gene Formulas again, for Pure Genes, New Genes and Mild Genes.

Key teaching

Nausea and vomiting — and the one modification of technique

For nausea, and to stop vomiting, Gas Only is immediately helpful — especially in pregnant women; but if they have back pain, it is better to give the treatment with the hands rather than the feet.

Two instructions in one sentence, and the second is a modification of technique, not of the point. The point is the same; the tool changes.

Why the hands? The material gives the condition — if they have back pain — and does not spell the mechanism out. What it plainly asks for is less load, more control, and a tool you can modulate under your own eye. A hand can feel what it is doing on a body that is already carrying a load it did not carry last year; a sole is a blunter instrument. Treat it as it is written: back pain present, hands rather than feet. Supine

DID YOU KNOW?

What a heavy period takes away

Blood is where most of the body's iron is kept, and a woman who bleeds heavily month after month is losing iron faster than an ordinary diet puts it back. That is why heavy periods are the commonest reason for a woman of childbearing age to run short of it — and why the tiredness, the breathlessness on a staircase and the giddiness she describes are often about the carrying capacity of her blood rather than about her strength.

Two practical consequences follow. The measurement is a simple one — a haemoglobin, which any laboratory does for a few rupees, and which tells you in a day something you cannot palpate. And the iron in dal, greens and millet is absorbed far better when something sour is eaten in the same meal — the lemon, the tomato, the āmlā. Keep that in mind before you remove several sour things at once from a woman who is already bleeding heavily.

FROM AYURVEDA AND YOGA

The three days a woman was given

Long before anybody counted a tablet, the classical household order set aside the first three days of a woman's cycle as days of rest. She was excused heavy work and long journeys; she bathed and ate simply; she was not expected to lift, to churn, or to be up before everyone else. The old texts describe her as needing to be left alone rather than needing to be treated — and they describe the fourth day, with the bath, as the day on which ordinary life resumes.

Set that beside the rule on this page and the instinct is identical: four days in which nothing is done to her, and then the course goes on. The two traditions disagree about very little except the counting. And both of them, read carefully, are saying the same thing to a household — that this is not an illness, and that the right response to it is not medicine but room.

Language

The milk for heavy bleeding

Watch

Milk for heavy bleeding — the quantity, the temperature and the reason for both

What is blocked in pregnancy, and why

What is directed in pregnancy

Nausea and vomiting — and the one modification of technique

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