अथातो ग्रहणीदोषचिकित्सितं व्याख्यास्यामः । इतिह स्माहुरात्रेयादयो महर्षयः ॥ १ ॥
We will now expound the Grahanidosha chikitsa- treatment of duodenal disorder, thus said Atreya and other great sages. (1)
GRAHANIROGA CHIKITSA
ग्रहणीसमाश्रितं दोषमादावेव यथास्वमजीर्णानुसारतो मात्राशीतीयोक्तविधानेनोपक्रमेत ।
अथातीसारविधिनाच। आमपाचनार्थ पिबेन्मुस्तातिविषाविश्वभेषजक्वाथम् । तच्चूर्णवासुखोदकेन, तेन वाशुण्ठीम् ।
तद्वद्वचादिवर्गं ससैन्धवम् । वारुणीमण्डेन वा गुल्मविध्युक्तं त्रिलवणादि चूर्णम् || २ ||
Disease of the grahani (duodenum) should be treated first on the same lines as of ajirna (indigestion) described in the matrasitiya. (Chapter 11 of sutrasthana) appropriate to the doshas, and also similar to the treatment of atisara ( diarrhoea). Decoction of musta, ativisa, and visvabhesaja should be consumed for digesting the ama (undigested matter) or their powder licked with warm water; or (powder of) only sunthi (with warm water); similarly that of (powder of) drugs of vachadivarga (chapter 16 of sutrasthana) along with saindhava; or the trilavanadicurna (described in the treatment of gulma) (chapter 16 of cikisitasthana) mixed with the scum of varuni (kind of wine). ( 2 )
सप्रवाहे वा वर्चसि चूर्णीकृतान् बिडलवणयुक्तान् बिल्वमध्यनागरचित्रकान् दाडिमाम्भसा सकफे वा । अतिमात्र आमशूलेऽलसकोक्तं हिङ्ग्वादिमुष्णाम्भसा पिबेत् । छर्दिशूलानाहानुग्रन्थिषुतु मरिचाजाजिसौवर्चलाभयाः। सपित्तकफेचामेकटुकेन्द्रयवपाठापिप्पलीमूलवचाभयानागराणिक्वथितानि चूर्णितानिवा || ३ ||
If the faeces is coming out after straining or if mixed with kapha (mucus), then a powder of marrow of bilva fruit, nagara and chitraka mixed with powder of bida lavana should be administered with the juice of dadima. If the pain due to ama accumilation is severe, hingvadi curna described in alasaka ( chapter 11 of sutrashtana) should be consumed with hot water.
In case of vomiting, pain in the abdomen, flatulence and tumor in the lower abdomen, powder of maricha, ajaji, sauvarchala and abhaya (should be used).
If ama is associated with pitta and kapha, then a decoction or powder of katuka, indrayava, patha, pippalimula, vacha, abhaya and nagara (should be administered) . ( 3 )
भोजनकाले च पञ्चकोलपरिगृहीतं पटुलघुदीपनीयं पेयादिकमुपकल्पयेत् । पेयां वा
नागरातिविषाभ्यां तक्रदाडिमवृक्षाम्लाम्लाम् पाने च तक्रमस्त्वारनालमदिरारिष्टानतीसारनिर्दिष्टं चाम्बु । यवानीपथ्यामलकमरिचानि त्रिपलिकानि लवणपञ्चकं चपलांशकमेकतचूर्णयित्वा कंसे सद्योमथितस्यासुनुयात् । ततो व्यक्ताम्लकटुकं जातं पिबेत् । एष तक्रारिष्टः परमग्निदीपनोऽर्शोगुल्मजठरश्वयथुकृमिप्रमेहहरः ॥ ४ ॥
At the times of meals, peya etc (liquid foods) processed with panchakola made pungent, esily digestable and improving humger should be prepared (for use as food); peya (gruel) processed withnagara and ativisa; or takra (buttermilk) made sour by adding dadima, vrikshamla; or takra (buttermilk), mastu (whey), aranala (rice-wash), madira and aristas described in the treatment of atisara (chapter 11 of chikitsa sthana) should be used for drinking).
Takrarista
Three pala each of yavani, pathya, amalaka and maricha, and one pala of lavana paficaka, or converted into a powder and mixed with one kamsa (one hundred and twenty eight pala) of freshly churned buttermilk and allowed to ferment. After it becomes sour and pungent, it should be used for drinking. This, known as Takrarista – is very good to increase hunger and cure haemorrhoids, abdominal tumor, enlargement of abdomen, dropsy, parasites and diabetes. (4)
अपि च
ग्रहणीदोषिणां तक्रं दीपनग्राहिलाघवात् । पथ्यं मधुरपाकित्वान्न च पित्तप्रदूषणम् ॥५॥ कषायोष्णविकाशित्वाद्र्क्षत्वाच्च कफे हितम् । वाते स्वाद्वम्लसान्द्रत्वात् सद्यस्कमविदाहितत् ॥ ६ ॥ तस्मात्तक्रप्रयोगाये जठराणां तथार्शसाम् । विहिता ग्रहणीदोषे सर्वशस्तान् प्रयोजयेत् ॥ ७ ॥
Further for patients of grahani (duodena 1 disease) takra (buttermilk ) is idealy suited to increase hunger and stop purgations due to its easy digestability and attaining sweetness at the end of digestion, it does not vitiate (increase) pitta, it is good for kapha because of its astringent, hot potency, vikasi ( dilating the pores) and non-unctous properties, it is good even for vata due to its sweet and sour tastes semisolid (thick liquid) consistence and not causing burning sensation during digestion. Hence the use of different kinds of takra (buttermilk) prescribed in the treatment of enlargement of the abdomen and haemorrhoids are also good for disorders of grahani (duodenum); hence they should be administered. ( 5-7)
दाडिमकपित्थवृक्षाम्लाम्लीकानां पृथक् पृथक् कुडवं लवणपञ्चककुडवं त्र्यूषणत्रिपलं शर्करापलाष्टकं चैकध्यं चूर्णितमन्नपाने प्रणीतमजीर्णांरुचिश्वासकासप्लीहगुल्मग्रहणीहृत्पाण्डुरोगघ्नम् । परिपक्कामं च मारुतग्रहणीरोगिणमग्निसन्धुक्षणार्थं सर्पिः पाययेत् । द्विपञ्चमूलपञ्च कोलसरलसुरदारुसुरभिगजपिप्पलीशणबीजयवकोलकुलत्थान्मस्तुनारनालेन वा पाचयेत् । तेन पादावशेषेण पञ्चलवणद्विक्षाराम्लबदरयुक्तं सर्पिर्विपक्कमथवा सैन्धवव्योषक्षारद्वयपञ्चमूलाभयारास्त्राजाजीग्रन्थिकशठीविडङ्गगर्भमार्द्रकमातुलुङ्गकोलाम्लीकादाडिमस्वरसशुष्कमूलकक्काथमस्तुतक्रशुक्तप्रसन्नासौवीरकतुषोदकारनालोपेतं परमग्निदीपनमग्निघृताख्यम् ॥८॥
One kudava each of dadima, kapittha, vrikshamla and amlika, one kudava of lavana panchaka, three pala of tryusana, eight pala of sugar-all are made into nice powder and used mixed with food and drinks; this cures indigestion, anorexia, dyspnoea, cough, splenic enlargement, abdominal tumor, duodenal disorder, diseases of the heart and anaemia.
Agni ghrita
Patients of duodenal disease of vata origin who have ama well digested, should be made to drink ghee in order to enhance their digestive activity; the two panchatnula, panchakola, sarala, suradaru, surabhi, gajapippali, sanabija, yava, kola, kulattha, are boiled in either mastu (whey) or aranala (rice-wash) and reduced to a quarter; to it are added, the panchalavana, the two kshara, amlabadara and ghee and medicated ghee prepared (and used); or medicated ghee prepared with paste of saindhava, vyosa, the two kshara, panchamula, abhaya, rasna, ajaji, granthika, ſathi and vidanga, fresh juice of ardraka, matulunga, kola, amalika and dadima, added with decoction of dry mulaka, mastu, takra, sukta, prasanna, sauviraka, tusodaka and aranala (any one).. This recipe known as Agnighrta is best to enhance digestive activity. (8)
Agastya ghrita
अथवा चव्यचित्रकपाठातेजोवतीपिप्पलीमूलानि कुडवोन्मितानि मुस्तद्विकुडवमास्फोतजातीनिम्बसप्तच्छदाश्वमारककर्कोटकपटोलपल्लवानां च मुष्टिं मुष्टिमन्तर्नखमुदकद्रोणे पक्त्वापादावशेषमवतारयेत् । अर्धपलोन्मितां चात्र कल्कितां दद्यादतिविषां कृष्णासारिवाभद्राश्च द्विपलांशं सैन्धवं बिडं यवक्षारंच मागधिकायाश्चतुष्पलं पात्रं चघृतस्य एतदगस्त्यनिर्मितमलमनलजननम् ।।९ ।।
One kudava each of chavya, chitraka, patha, tejovati and pippali mula, two kudava of musta, one musti ( quantity that can held in the first ) each of tender sprouts of asphota, jati, nimba, saptachada asvamaraka, karkotaka and patola are boiled in one drona of water, decoction reduced to quarter; to this are added the paste of half pala each of ativisa, krsna, sariva and bhadra (krsnasariva), two pala each of saindhava, bida and yavakshara, four pala of magadhika and one patra (adhaka) of ghee and medicated ghee prepared. This recipe formulated by (sage) Agastya is enough for generating digestive activity. (9)
उद्दीपिते तु किञ्चिदनले विबद्धमलमास्थापयेत् । ततो जिते मातरिश्वनि स्त्रस्तदोषमेरण्डतैलेन तिल्वकसर्पिषा वा क्षारवता मिश्रकस्त्रेहेन वा विरेचयेत् । कृतसंसर्गक्रमं च बद्धवर्चसमनुवासयेद्वातहरदीपनीयाम्लद्रव्यसिद्धेन तैलेन । ततः पुनरपि लघ्वन्नभोजन: सर्पिरेव यथाग्निबलमल्पशोऽव चारयेत्। अग्निघृतंचछर्दिविबन्धशूलश्वासकासिनः सबीजपूरकरसम्। अभ्यङ्गार्थंच तैलमग्नि-घृतौषधैः साधयेत् । अनिलकफसंसर्गेतु चूर्णमेषामौषधानामुष्णोदकेनपिबेत् ॥ १० ॥
When digestive activity is slightly increased, if there is obstruction to faeces, the patient should be given decoction enema, when the matarasvi (vata) is subdued by this and the dosha become weak, he should be given a purgative therapy using either erannda taila, tilvaka ghrta or misrakasneha added with kshara. After he undergoes the regimen of diet and if he has obstruction of faeces he should be administered, oil enema with medicated oil prepared from drugs which subdue vata, promote hunger and possess sour taste.
Then again (after enema therapies) he should take foods which are easily digestable or only ghee should be partaken in small quantity depending on the strength of digestion.
Those who have vomiting, constipation, pain in the abdomen, dyspnoea, and cough should consume agnighrta mixed with the juice of bijapura. The oil for massaging should be prepared from the drugs mentioned in agnighrta. In case of association of anila (vata) and kapha, the powder of the same drugs should be consumed with hot water. (10)
Pitta grahani chikitsa
पित्तदुष्टायां तु ग्रहण्यां स्वस्थानगतमुत्क्लिष्टं द्रवमनलनिर्वापणं पित्तमास्थापनेन वमनेन वा निर्हरेत् । तिक्तलघुद्रव्यैश्च कृतसंसर्जनस्य दोषशेषशमनार्थं मधुनावलेह्यमुष्णाम्बुना वा पातुं प्रणयेत् । मूर्वाकिरातततिक्तपर्पटकवचाचन्दनमुस्तत्रिकटुकत्रायमाणायवानीकलिङ्गत्वक्फलकटुरोहिणीदेवदारुदार्वीत्वक्पद्मकोशीरारिष्टपटोलपत्रातिविषासौराष्ट्रीत्वगेलामधु शिग्रुबीजचूर्णम् । अयं हि ग्रहणीदोषशूलातिसारपाण्डुहृद्रोगगुल्मज्वरप्रमेहकामलामुखरोगारोचकनिबर्हणः ॥ ११ ॥
In grahani caused by pitta, that pitta which is localised in its own seat, slightly increased, watery in consistence and so diminished in it digestive power, should be brought out either by asthapana (decoction enema) or vamana ( emesis ). After he undergoes dietary regimen a confection prepared from drugs possessing bitter taste and easily digestable properties, mixed with honey should be taken along with hot water, in order to mitigate the remnants of the doshas.
Murva, kirata, tikta, parpataka, vacha, chandana, musta, trikatuka, trayamana, yavani, kalingatvak, phala, katurohini devadaru, darvitvak, padmaka, usira, arista, patolapatra, ativisa, saurastri, tvak, ela, and seeds of madhusigru (each equal in quantity) are made into a powder. This recipe cures disorder of the duodenum, pain in the abdomen, diarrhoea, anaemia, heart disease, abdominal tumor, fever, diabetes, jaundice, diseases of the mouth and loss of taste. (11)
भूनिम्बत्रिकटुककटुकामुस्तेन्द्रयवाः समाश्चित्रक भागौ द्वौ कुटजत्वग्भागाश्चषोडश सर्वमेकत्र चूर्णितं सगुडशीतोदकं पीतं समानं पूर्वेण । नागररसाञ्जनातिविषाधातकीघनपाठाकलिङ्गत्वग्बीजबिल्वकटुका: सक्षौद्रास्तण्डुलाम्बुपीताः पित्तग्रहणीविकारं रक्तातिसारमशसि सप्रवाहिकं गुदशूलं च व्यपोहन्ति । ततश्चैवं शमितपित्तोद्रेकस्याग्नेः स्थिरीकरणाय सर्पि: पूर्वोक्तमूर्वादिक्वाथेन सारिवास्फोतसप्तपर्णाटरूषकेन्द्रयववीराभूनिम्बधान्यन्यग्रोधाश्वत्थोदुम्बरप्लक्षोपकुल्यानीलोत्पलगर्भसिद्धं पानाय प्रयुञ्जीत कुष्ठोक्तं वातिक्तकम् ॥ १२ ॥
Equal quantities of bhunimba, trikatu, katuka, musta and indrayava (together forming one part), two parts of chitraka, sixteen parts of kutaja tvak- are all powdered nicely and consumed along with guda (jaggery) and cold water; it acts in the same way as the earlier.
Nagara, rasanjana, ativisa, dhataki, ghana, patha, kalinga, tvak, and (kalinga) bija, bilva and katuka, nicely powdered and consumed with honey followed by ricewash as an after-drink cures duodenal disorder caused by pitta, bleeding diarrhoea, haemorrhoids and pain in the rectum associated with tenesmus.
Next, after the increased pitta is mitigated, in order to maintain the steadiness of digestive activity, medicated ghee prepared with drugs mentioned earlier, commencing with murva, made into decoction added with the paste of sariva asphota, saptaparna, atarusaka, indrayava, vira, bhunimba, dhanya, nyagrodha, asvattha, udumbara, plaksa, upakulya and nilotpala, (along with ghee); or the Tiktaka ghrta described in the treatment of kustha (chapter 21) should be consumed. (12)
Kaphaja grahani chikitsa
लेष्मदुष्टायां पुनर्ग्रहण्यां मागधिकसिद्धार्थकल्कतीक्ष्णेन मदनफलकषायेणपुनः पुनर्वामयेत् । अब्धातुर्हि प्रवृद्धस्तेजो निर्वापयति । ततः कृतपेयादिक्रमस्य लवणक्षाराम्लकटुकोत्कटैर्यथोक्तैरन्नपानौषधैरनलमुत्तेजयेत् । मञ्जिष्ठाचित्रकारुष्करकृमिघ्नमधूकपुष्पाणि क्रमाद् द्विकुडवार्धाढकाढकाधंद्रोणद्रोणांशान्यपां द्रोणत्रये क्वाथयेत् । द्रोणशेषश्च पूतशीतः स निर्यूहो मधुद्विप्रस्थवांश्चन्दनोशीरसूक्ष्मैलागरुरूषितं जतुसृतं घृतकुम्भमध्युषितो मासमासवः । सर्वदोषघ्नो ऽग्निजननो बृंहणः शोषकुष्ठकिलासप्रमेहानाहगुल्मपाण्डुहृद्रोगजिच्च ॥१३॥
In grahani caused by vitiation (increase) of slesma ( kapha), the patient should be made to vomit, repeatedly by administering strong decoction of madana phala mixed with paste of magadhika and siddharthaka; apdhatu (body water) getting increased is mainly responsible for diminition of tejas (body heat, digestive function).
Next, after the patient has undergone peyadikrama (regimen of liquid foods), his digestive capacity should be increased by use of foods drinks and drugs described earlier, made more salty, alkaline, sour and pungent in tastes Manjista chitraka, aruskara, krimighna and madhuka pushpa each two kudava, half adhaka, one adhaka, half drona and one drona respectively, are boiled in three drona of water and decoction reduced to one drona and filtered (through cloth ). After it cools, two prastha of honey is added and poured into a pot smeared inside with ghee and applied with the paste of chandana, usira, suksma ela and aguru ( the pot is sealed) and kept (undisturbed) for a month for fermentation. This asava (fermented decoction) subdues all the doshas, generates digestive activity, produces stoutness and cures consumption, leprosy, leucoderma, diabetes, distention of abdomen, abdominal tumors, anaemia and heart diseases. ( 13 )
मधूकपुष्पाणां स्वरसोऽर्धावशेषक्कथितः क्षौद्रपादयुक्तः सर्वथा समान: पूर्वेण । अनेन द्राक्षेक्षुकाश्मर्यफलस्वरसासवा व्याख्याताः ॥१४॥
Juice of madhukapushpa boiled, reduced to half its quantity, mixed with quarter part of honey and used, is similar in all respects with the earlier one. By this (method) the asavas prepared from juice of draksa, iksu and kasmarya phala, are all also described (be made and used). (14)
Dashamoolasava
दशमूलवीरारजनीत्रिफलाजीवकर्षभकाणां पृथक् पृथक् पञ्चपलान् भागानपां वहे पक्त्वा पादशेषे रसे शीतीभूते गुडतुलाद्वयं दद्यादर्धकुडवं च माक्षिकात्तत्प्रमाणांश्च चूर्णितान् मुस्तप्रियङ्गमञ्जिष्ठामधुकविडङ्गप्लवशाबरलोध्रान् एषोऽर्धमासस्थितो मूलासवोऽयं समानः पूर्वेण । महावृक्षकाण्डचतुष्पलं द्विगुणार्ककाण्डं लवणत्रयत्रिपलं पक्कवार्ताककुडवं चित्रकमूलपलद्वयं चान्तर्धूमं दग्ध्वा वार्ताकरसेन गुटिकाः कुर्यात् । ता भोजनोत्तरं भक्षिता ग्रहणीदुर्नामविषूचिकालसककासश्वासपीनसप्लीहपाण्डुश्वयथुमेहारोचकगुल्महराः ॥ १५ ॥
Five pala each of dashamoola, vira, rajani, triphala, jivaka and rsbhaka are boiled in one vaha (two thousand four hundred and eighty pala) of water, decoction reduced to a quarter; after it cools, two tulas (two hundred pala) of guda (jaggery), half kudava of honey and the same quantity of powder of musta, priyangu, manjista, madhuka, vidanga, plava and sabara lodhra are added and kept for half-a-month; this recipe – Mulasava by name (dashamoolasava to be more appropriate ) is similar to the earlier one (in action).
Four pala of stem of mahavriksha (snuhi), stem of arka-twice that quantity, three pala of the three lavanas ( together ), one kudava of ripe fruit of vartaka, two pala of chitrakamula- are all converted into ash in the closed method; the ash is then mixed with the juice of vartaka and rolled into pills. Consumed after food, it cures duodenal disorders, piles, visucika (gastro enteritis), alasaka (severe indigestion), cough, dyspnoea, nasal catarrah, splenic disease anaemia, dropsy, diabetes, anorexia and abdominal tumors. (15)
दशमूलार्कमूलदन्तीत्रिवृच्चित्रकास्फोतपाठारास्त्रास्नुहीकाण्डानांपृथग्दशपलान्भागान् कपालोदरे दग्ध्वा क्षारमुदकद्रोणैश्चतुर्भिः क्वाथयेत् । पादवशेषं च पूतं पुनः पादावशेषमेव क्वधितावतारितं गुडपलशतोन्मिश्रमधिश्रयेत् । घनीभवति च तस्मिन् सुश्रूक्ष्णरजसां वृश्चिकालीद्वययावशूकानांत्रिंशत् पलान्यावपेत् । त्रिंशदेव वचाभयाव्योषचित्रकाणाम्। द्विपलं च पृथक् पृथक् हिङ्ग्वम्लवेतसयोः । ततोऽक्षमात्रागुटिकाः कृत्वायथाबलमुपयुक्ताः समानाः पूर्वाभिरधिकावा । अर्शोविहितांश्च क्षारतक्रारिष्टन् घृतान्यन्नपानं च सेवेत । षट्पलं भल्लातकघृतं धान्वतरंच । सन्निपाते तु पञ्च कर्माणि कुर्याद्यथावस्थं वा ग्रहणीचिकित्सितमिति । भवतिचा || १६ ||
Ten pala each of dashamoola, arkamula, danti ( mula), trivrit, chitraka, asphota, patha, rasna and snuhikanda- are converted into ash inside a pot. The ash obtained is boiled in four drona of water, reduced to a quarter and filtered (through cloth), then this solution is boiled again, reduced to a quarter, mixed with two hundred pala of guda (jaggery) and boiled; just prior to becoming solid, nice powder of thirty pala of the two vrscikali and yavasuka, thirty pala of vacha, abhaya, vyosa and chitraka, two pala each of hingu and amalavetasa are added, the mass rolled into pills of one aksa each; used according to the strength (of the patient) it is equal to others (recipes) mentioned earlier or even more effective.
The patient should use the alkalies, takrarista, medicated ghee (recipes), foods and drinks prescribed for piles (in chapter 10 of cikistitasthana) or use satpalaghrta, bhallataka ghrta (described in kapha gulma), (chapter 16of chikitsasthana) and dhanvantara ghrta (described in prameha, chapter 14 of chikitsasthana).
Sannipata grahani chikitsa
In grahani (duodenal diseases) caused by sannipata, panchakarmas (the five purifactory therapies) should be done depending upon the stage (of doshas and the disease). (16) Some verses more
प्रसेके शैष्मिकेऽल्पाग्नेर्दीपनं रूक्षतिक्तकम्। योज्यं कृशस्य व्यत्यासात् स्त्रिग्धरूक्षं कफोदये ॥१७॥
If there is slight elimination of kapha and poor digestive activity, then drugs to enhance digestion, which are dry and bitter should be prescribed for strong persons; for increase of kapha in the weak, it should be in reverse, first with drugs possessing snigdha (unctousness) and next with those possessing ruksa (non-unctous properties ) . ( 17 )
क्षीणक्षामशरीरस्य दीपनं स्नेहसंयुतम् । दीपनं बहुपित्तस्य तिक्तं मधुरकैर्युतम् ॥१८ ।।
स्नेहोऽम्ललवणैर्युक्तो बहुवातस्य शस्यते । स्नेहमेव परविद्यादुर्बलानलदीपनम् ॥ १९ ॥
नालं स्नेहसमिद्धस्य शमायानं सुगुर्वपि । मलमामं कफे क्षीणे मन्दाग्निर्योऽतिसार्यते ॥ २० ॥
स पिबेत् सर्पिषो मात्रां दीपनीयौषधैर्युताम् । प्रसन्नो मार्गमापन्नः स्वं समानोऽनिलस्तया || अग्नेः समीपचारित्वादाशुप्रकुरुते बलम् ॥ २१ ॥
For those who are weak and wasted, improvement of digestion should be done by drugs mixed with fatty materials; for those having predominance of pitta, improvement of digestion should be by drugs which are bitter combined with those of sweet taste. For those who have predominance of vata, fatty materials combined with drugs having sour and salt tastes are ideal.
Fats (ghee or oil) are the best to enhance the strength of poor digestive fire, foods however heavy (hard to digest) they may be, are not enough (capable) to reduce the strength of the digestive fire which is nourished by the fuel of fats.
When the faeces has signs of ama, kapha is diminished, digestion is weak, and diarrhoea is present, the patient should drink, in the usual dose, ghee processed with drugs which enhance hunger.
Anila (vata) which is pure (not associated with other doshas) moving freely in this channels, remaining within its quantity and moving near the digestive fire, soon enhances its strength. (17-21)
पुरीषं यस्तु कृच्छ्रेणकठिनत्वाद्विमुञ्चति । सघृतं लवणैर्युक्तं नरोऽन्नावग्रहं पिबेत् ॥ २२ ॥
रौक्ष्यान्मन्देऽनले सर्पिस्तैलं वा दीपनैः पिबेत् । क्षारचूर्णासवारिष्टान् मन्दे स्नेहातिपानतः ॥ २३ ॥
He, who voids faeces with dificulty and which is hard, should drink ghee mixed with salt, before food. In case the digestive fire is weak, because of dryness, the patient should drink ghee or oil processed with drugs which enhance digestion. In case of weakness (of digestive fire) due to drinking more quantity of fats (ghee or oil) he should make use of alkalies, powders, asavas (fermentedinfusion) andaristas (fermented decoctions).(22-23)
उदावर्तात्तुयोक्तव्यानिरूहस्त्रेहबस्तयः । दोषातिवृध्या मन्देऽसौ संशुद्धोऽन्नविधिं चरेत् ॥ २४ ॥
व्याधिमुक्तस्य मन्देऽग्नौ सर्पिरेव तु दीपनम् । अध्वोपवासक्षामत्वैर्यवाग्वापाययेत् घृतम् ॥ अन्नावपीडितं बल्यं दीपनं बृंहणं च तत् ॥ २५ ॥
He who is having udavarta (upward movement of vata) should be given both niruha basti (decoction enema) and sneha basti (oil enema) therapy; in case of weakness of digestive fire due to increase of the doshas purifactory therapies and regimen of diet should be adopted.
In case of weakness of digestion after the relief from diseases, drinking of ghee, is the best to increase digestion. If weakness is due to walking long distance and fasting, the person should drink yavagu (gruel) mixed with ghee, which combining with foods enhances strength, digestion and stoutness of the body. (24-25)
दीर्घकालप्रसङ्गात्तु क्षामक्षीणकृशान् नरान् । प्रसहानां रसैः साम्लैर्भोजयेत् पिशिताशिनाम् ।।२६।।
लघूष्णकटुशोधित्वैर्दीपयन्त्याशु तेऽनलम् । मांसोपचितमांसत्वात्परंच बलवर्धनाः ॥२७॥
Persons who are debilitated, wasted and emaciated due to long continued illness, and if they are accustomed to meat eating, they should partake food mixed with juice of meat of carnivorous animals (or birds) made slightly sour; such meat being easily digestable, hot in potency, pungent and purificatory, quickly improves the strength of the digestive fire. Such meat having been nourished by meat itself is very best to improve the strength (of the patient). (26-27)
स्नेहासवसुरारिष्टचूर्णक्वाथ हिताशनैः । सम्यक्प्रयुक्तैर्देहस्य बलमग्नेश्चवर्धते ॥ २८ ॥
दीप्तो यथैव स्थास्त्रुश्च बाह्योऽग्निः सारदारुभिः | सस्त्रेहैर्जायते तद्वदाहारैः कोष्ठगोऽनलः ।।२९ ।।
The best strength of the body and of the digestive fire will increase by the appropriate use of fats ( ghee or oil), asava (fermented infusion ) sura ( beer) arista (fermented decoction), powders and decoction of drugs and suitable foods. Just as the external fire, fed by faggots containing the essence (pith of the tree) burns bright and remains constant, similarly also the fire present in the alimentary tract by the effect of fats and foods. (28-29)
नाभोजनेन कायाग्निर्दीप्यते नातिभोजनात् । यथानिरिन्धनो वह्निरल्पो वातीन्धनावृतः ॥ ३० ॥
The digestive fire increases neither by fasting nor by over-eating, just as the (external) fire becomes diminished when not fed by any fuel or when covered (overfed) by too much of fuel. (30)
Atyagni chikitsa
यदा क्षीणे कफे पित्तं स्वे स्थाने पवनानुगम् । प्रवृद्धं वर्धयत्यग्निं तदासौ सानिलोऽनलः ॥ ३१ ॥
पक्त्वान्नमाशु धातूंश्च सर्वानोजश्च सङ्क्षिपन् । मारयेत् स्यात्स ना स्वस्थो भुक्ते जीर्णे तु ताम्यति ।।
तृट्कासदाहमूर्च्छाद्या व्याधयोऽत्यग्निसम्भवाः || ३२ ।।
तमत्यग्निं गुरुस्निग्धमन्दसान्द्रहिमस्थिरैः । अन्नपानैर्नयेच्छान्तिं दीप्तमग्निमिवाम्बुभिः ॥ ३३ ॥
मुहुर्मुहुरजीर्णेऽपि भोज्यान्यस्योपहारयेत् । निरिन्धनोऽन्तरं लब्ध्वा यथैनं न विपादयेत् ।।३४ ।।
When kapha diminishes, pitta in association with vata undergoes increase in its own seat, cause increase of digestive activity, then both vata and anala (pitta) together digest both the food and all the dhatus (tissues) quickly, bring about decrease of ojas (essence of dhatus) and kill the person. Such a person remains well, if he takes food but gets into distress when the food gets digested; thirst, cough, burning sensation, fainting and such other diseases are produced by atyagni (hyperactive digestive function).
Such atyagni (hyperactive digestive fire) should be controlled by use of foods and drinks which are heavy (not easily digestable), fatty slow, solid, cold and rough, just as the external fire is controlled by water. Such a patient should be given food frequently though it might cause indigestion; lest (otherwise) like digestive fire, not getting its fuel in the interval, not kill the person himself. (33-34)
कृसरांपायसंस्निग्धंपैष्टिकं गुडवैकृतम् । अश्श्रीयादौदकानूपपिशितानि भृतानि च ॥ ३५ ॥
मत्स्यान्विशेषतः शुक्ष्णान्स्थिरतोयचराश्चये । आविकं सुभृतं मांसमद्यादत्यग्निवारणम् ||३६ ||
पयः सहमधूच्छिष्टंघृतं वा तृषितः पिबेत् । गोधूमचूर्णं पयसा बहुसर्पिः प्लुतं पिबेत् ॥३७॥
आनूपरसयुक्तान् वा स्नेहांस्तैलविवर्जितान् | श्यामात्रिवृद्विपक्कं वा पयो दद्याद्विरेचनम् ॥ ३८ ॥
असकृत् पित्तहरणंपयसाप्रतिभोजनम् । यत्किञ्चिद्गुरु मेध्यं च श्रेष्मकारिच भोजनम् ।।
सर्वं तदत्यग्निहितं भुक्त्वाच स्वपनं दिवा ॥ ३९ ॥
Krsara (rice boiled with sesame or other pulses), payasa (sweet pudding prepared from milk) mixed with fats, foods prepared from flour, bye-products of guda (jaggery), meat of animals living in water and marshy regions or of domestic animals, fish especially those which are smooth and which live in stagnant water, should be partaken. Meat of sheep which is well nourished at home should be eaten to reduce huperactive digestive fire; when thirsty, the person should drink milk mixed with bees wax; or mixed with wheat flour and plenty of ghee; or the juice of meat of animals of marshy regions mixed with fats other than the oil. Milk boiled with syama trivrit should be used to produce purgations, which subdues pitta immediately; after purgations, he should eat food along with milk. All those foods which are hard to digest, fatty and increase kapha are good for hyperactive digestive fire; so also sleeping during day time. (35-39)
आहारमग्निः पचति दोषानाहारवर्जितः । धातून् क्षीणेषु दोषेषु जीवितं धातुसङ्क्षये ॥४० ।।
अग्निमूलं बलं पुंसां बलमूलं हि जीवितम् । एष सारश्चिकित्साया यदग्नेः परिरक्षणम् ।।४१ ।।
The ( digestive) fire digests the food, in the absence of food it digests the doshas, when the doshas get diminished it digests the dhatus (tissues) and when the dhatus get diminished it digests life itself.
The (digestive) fire is the source of strength of men, strength is the source for living (life); hence protection of the (digestive) fire is the essence of treatment. (40-41)
।। इतिद्वादशोऽध्यायः ॥
Thus ends the Twelvth chapter.
