INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue X October 2025
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Efficacy of Bilvadi Kwath {DIVITYA}In The Governance of
Atisara{MILD}- A Case Study
Dr. Vikash Kaushik {1}, Dr. Amit Kataria{2}
Ph.D. Scholar at S.K.G.A.C., Kurukshetra. Assistant prof. in Kaumarbhritya dept. at G.B.A.C.,
Brahmanwas, Rohtak.{1}
Associate Prof. in Kaumarbhritya dept. at S.K.G.A.C., Kurukshetra, Haryana. {2}
DOI: https://doi.org/10.51244/IJRSI.2025.1210000123
Received: 20 August 2025; Accepted: 27 August 2025; Published: 07 Novenber 2025
ABSTRACT
Atisāra is one of the most commonly observed disorders in children, characterized by frequent passage of watery
stool. In Ayurveda, it is described as the result of vitiation of Doṣha’s, particularly Vāta, Pitta, and Kapha, leading
to abnormal movement of Apāna Vāyu. It is a critical condition in children (Bāla) due to their delicate Dhātus
and low immunity (Ojas). Management Principles of this diseases includes:1.General Chikitsā Sūtra: Langhana
(fasting/light diet) ,Pachana (digestives),Deepana (appetizers).2.Use of specific herbs like Bilva, Mustā,
Nāgakesara, Kutaja, etc.3. Important Classical Formulations: Bilvādi Chūrṇa ,Kutajarishta ,Mustādi
Sanjñāpanīya Gana (used for rehydration),Balachaturbhadra Chūrṇa for infants. 4. Basti (Enema):In chronic or
complicated cases with Vāta predominance, Yapan Basti may be used in older children. 5.Pediatric
Considerations (Kumāra Bhṛtya):According to Kāshyapa Samhitā, special attention should be paid to bāla-roga
(pediatric diseases), as the child’s body is still developing. Kṣīra-dosha (vitiated milk) and teething are common
causative factors in infants. Recent research and modern orrelation: Atisāra in children correlates with acute
gastroenteritis.WHO recommends ORS (Oral Rehydration Solution) and zinc therapy; similarly, Ayurveda
prescribes Sanjñāpanīya Gana and Ama Pachana herbs.Studies have shown that Bilvādi Kwātha and Kutaja
preparations effectively reduce stool frequency and improve gut health. This case study highlights the efficacy
of Bilvadi Kwath {Dvitiya} as mentioned in Charaka Samhita Chikitsa Sthana 19/78,and in Chakradatta to
governance Atisara with Ayurvedic principles.
INTRODUCTION:
Atisāra, the Ayurvedic correlate of acute diarrhoea, remains a significant pediatric health concern worldwide. In
Ayurveda, Atisāra is characterized by increased frequency, fluidity, and volume of stools, often accompanied by
associated features such as abdominal pain, tenesmus, and systemic signs like fever or dehydration. In children—
owing to their developing physiology—Atisāra poses a higher risk of rapid dehydration, electrolyte imbalance,
and consequent morbidity and mortality. Atisara is caused due to vitiation of Vata predominantly, and is often
associated with Agni-mandya (digestive weakness). According to Ayurveda, Bilva (Aegle marmelos) is a prime
herb in the management of Atisara due to its Grahi (absorbent), Deepana (digestive stimulant), and Sangrahaniya
properties. Bilvadi Kwath {Dvitiya} is a classical formulation that acts effectively in controlling excessive bowel
movements and restoring Agni.
Incidence and Mortality: Atisara {Diarrhoea} accounts for approximately 1.3 million deaths yearly among
children beyond the neonatal period, making Atisara, the second leading cause of post-neonatal childhood
mortality rate globally. The incidence of severe gastroenteritis is in peak level in the first two years of life,
concentrated in resource-limited settings, especially in parts of Africa and South-East Asia .
Hospitalization and Pathogen Distribution: In 2024 , India saw a notable increases in the reported cases of
acute diarrhoeal diseases, with 1.95 lakh cases recorded ,data collected from the Integrated diseases Surveillance
Programme and the state epidemiology department. The most common pathogen associated with
Atisara{Diarrhea}includes bacteria like E.coli and Salmonella,viruses like Rotavirus was the leading pathogen
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue X October 2025
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(33.3% attributable fraction), followed by Shigella (9.7%), Norovirus (6.5%), and Adenovirus 40/41 (5.5%) and
parasites like Entamoeba histolytica and Giardia lamblia. Sites with rotavirus vaccine introduction saw rotavirus-
attributable hospitalizations halved compared to non-vaccinated sites (20.8% vs. 42.1%).
Nidāna (Etiology):
According to Charaka Samhitā (Chikitsā Sthāna 19/4-5) and Kāshyapa Samhitā (Khilasthāna - Kumārabhṛtya):
Overeating, indigestion, unwholesome food, suppression of natural urges, infections, and teething are major
causes. Contaminated breast milk due to maternal Doṣha vitiation can cause Atisāra in infants. Host Factors : In
Ayurveda, factors such as Agnimandya (reduced digestive fire) and Avara-Satva (diminished systemic resilience)
are implicated in predisposition to Atisāra, correlating modern concepts of malnutrition and immunocompromise
condition.
Lakṣaṇa (Symptoms):
Mala-pravarti {Watery or semi-solid stools}
Udara shola {Abdominal pain}
Aam {Undigested food particles in stool}
Fever, vomiting, dehydration
Lethargy and weight loss in chronic cases
Types of Atisāra:
According to Charaka Samhitā and Bhāva Prakāśa, it is classified into:
Vātaja Atisāra: Thin, frothy, frequent stool, abdominal cramps
Pittaja Atisāra: Foul-smelling, yellowish stools, burning sensation
Kaphaja Atisāra: Mucus-laden, sticky, white stools
Sannipātaja and Amaja Atisāra are considered more severe types
Kṣīrabala Atisāra (in infants): Associated with improper breast milk
Supportive Measures: Ayurveda emphasizes Samśodhana (gentle cleansing), Santāpaṇa (cooling therapies),
and Uṣṇāpāna (warm fluid intake). Dietary management with BRAT-like regimens (rice gruel, boiled yams) and
avoidance of heavy, cold foods complement pharmacotherapy.
Modern Supportive Care Integration: Oral rehydration therapy (ORT) remains the cornerstone for preventing
dehydration-related mortality. Integration of Ayurvedic herbal adjuncts with ORT and zinc supplementation
could offer synergistic benefits, although robust clinical trials are needed to establish standardized combined
protocols.
Patient Information:
Age/Sex: 4yr
Occupation: nil
Chief Complaint: Loose motions 3–4 times/day, mild abdominal pain and mild dehydration since 2 days.
History: No history of chronic illness. Patient reported intake of stale food prior to onset.
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue X October 2025
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Clinical Findings:
Frequency /Bowel Movement: 3-4 times/day.
Swaroopa/consistency of stool: watery.
Pureesha Ganndha/smell in stool :Visra Gandha
Annavdesh/loss of appetite: Reduced
Varna/colour of stool:whitish-yellow.
Quantity of water intake :Mild increased.
Mutrapravarti/frequency of urine:4-7times/24hrs.
Other Symptoms: restless.
Tongue and oral mucosa : Dry
Pulse & BP: Normal
Lab.investigations :
C.B.C.-Hb:11.8gm%,TLC:7000/cumm, ESR:06
S.electrolyte : Na2+ 147mEq/L ,K+ 3 mEq/L ,chloride 102mEq/L
Diagnosis: Atisara {Mild}
Ayurvedic Assessment (Nidana Panchaka):
Nidana (Etiology): Consumption of contaminated/stale food
Purvarupa (Prodromal): Aruchi, Mandagni
Rupa (Symptoms): Drava Mala Pravritti, Shoola, Trishna
Samprapti: Vitiation of Vata and Kapha dosha leading to improper digestion and expulsion of undigested
material
Rogamarga: Kostha
Sadhyasadhyata: Sadhya (easily curable if treated early)
Treatment Administered:
Main Formulation:
Bilvadi Kwath {Divitya}
Reference: Chakradatta 64/35
Ingredients: Bilva, Amra, Laja, Sarkara.
Dosage: 10 ml twice daily before meals {30min}with warm water
Duration: 10 days
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI |Volume XII Issue X October 2025
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Anupana (Adjuvant):
Warm water
Pathya:
Laghu (light) diet: Yavagu, moong dal soup.
Apathya:
Avoid heavy, oily, spicy, or fermented food
Follow-up and Outcome:
Day 3: Frequency reduced to 4 times/day, less watery
Day 5: No abdominal pain, appetite improved
Day 7: Complete relief in bowel frequency (1–2/day), normal consistency
DISCUSSION
The convergence of classical Ayurvedic insights and modern epidemiological data underscores the multifactorial
nature of paediatric diarrhoea. While preliminary clinical studies demonstrate promise for formulations like
Bilvadi Kwath {Divitya} larger randomized controlled trials with standardized endpoints are warranted.
CONCLUSION:
Atisāra in children remains a global health challenge.It is a potentially serious condition in children that requires
timely intervention. Ayurveda emphasizes Doshic assessment, dietary correction, and use of age-appropriate
herbal formulations. Bilvadi Kwath {Dvitiya} is Grahi, Deepana, and Pachana, making it’s effective in the
Samprapti Vighatana of Atisara. The combination acts synergistically to improve digestion, absorb excess
intestinal fluids, and correct vitiated Vata and Kapha Dosha.
Integration of Ayurvedic and modern approaches especially in dehydration management can yield safe and
effective outcomes in pediatric care. Ayurveda offers a spectrum of classical formulations and individualized
approaches that, when validated through rigorous research and integrated appropriately with modern care, may
enhance therapeutic outcomes and reduce childhood morbidity and mortality. Bilvadi Kwath {Dvitiya} proved
effective in treating Atisara without any side effects. This case supports the traditional use of Bilvadi Kwath
(Divitya) and related herbs in the management of gastrointestinal disorders.
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