एकविंशोऽध्यायः । अथातः शूकदोषचिकित्सितं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥ :।।१।।
Now we shall discourse on the medical treatment of the Sores on the penis produced by the Suka, a kind of poisonous insect (SukaDosa). 1
संलिख्य सर्षपीं सम्यक् कषायैरवचूर्णयेत् । कषायेष्वेव तैलञ्च कुर्वीत अष्ठीलिकां जलौकोभिग्रहयेच्च पुनः पुनः । व्रणरोपणम् ॥२॥ कफग्रन्थिवदुद्धरेत्।।३।। तथा चानुपशाम्यन्तीं स्वेदयेद् ग्रथितं शश्वन्नाड़ीस्वेदेन बुद्धिमान् । सुखोष्णैरुपनाहैश्च सुस्निग्धैरुपनाहयेत्।।४॥
Treatment of Sarsapi, etc. : In a case of the Sarsapi type of the disease, the affected (ulcerated) part should be scarified and dusted with the (powdered) drugs of an astringent taste (as described in the Misraka chapter), and an oil, cooked with (the Kalka and decoction of) the same drugs, should be applied for healing purposes. In a case of the Asthilika type of the disease, the repeated application of leeches should be done to the seat of affection. In case the swelling does not still subside, it should be removed and treated as a Kaphaja Granthi (glandular swelling). A Granthi type of the disease should be constantly fomented in the manner of Nadi-Sveda, and should be poulticed with a lukewarm medicinal compound mixed with a profuse quantity of Sneha (oil). 2-4
कुम्भीकां पाकमापन्नां भिन्द्याच्छुद्धान्तु रोपयेत् । तैलेन त्रिफलालोध्र-तिन्दुकाम्रातकेन तु ॥५॥
ग्राहयित्वा जलौकोभिरलजीं सेचयेत् ततः । कषायैस्तेषु सिद्धञ्च तैल रोपणमिष्यते ।।६।।
Treatment of Kumbhika, etc.: An incision should be made into the suppurated seat of affection in a case of the Kumbhika type of the disease, and the incidental ulcer should be purified (disinfected) and healed up with the application of the oil, cooked with Triphala, Lodhra, Tinduka and Amrataka. In the Alaji type of the disease, the affected part should be bled by applying leeches to it and should then be affused with a decoction of the astringent drugs. An oil cooked with the decoction of the same drugs, should be used to heal up the (incidental) ulcer. 5-6
बलातैलेन कोष्णेन मुदितं परिषेचयेत् मधुरैः सर्पिषा स्निग्धैः सुखोष्णैरुपनाहयेत् ।।७।।
संमूढपिडकां क्षिप्रं जलौकोभिरुपाचरेत् । भित्त्वा पर्यागताञ्चापि लेपयेत् क्षौद्रसर्पिषा ।।८
अवमन्थे गते पाकं भिन्ने तैलं विधीयते । धवाश्वकर्णपत्तङ्ग-सल्लकीतिन्दुकीकृतम् ।।९।।
Treatment of Mrdita, etc. : In the Mrdita type of the disease, the affected part should be affused with tepid Bala oil and poulticed with alukewarm plaster (Upanaha) of the drugs of the Madhura (Kakolyadi) group, pasted and mixed with clarified butter. Leeches should be speedily applied to the condylomatous growths (Pidaka) in a case of Sammudha-Pidaka. In cases of suppuration, they should be opened and plastered with honey and clarified butter. In a case of Avamantha, the growths (Pidaka) should be opened, when suppurated, and healed up with the application of an oil, cooked with Dhava, Asva – Karna,Pattanga, Sallaki and Tinduka. 7-9
1. Siva-dasa in his commentary on Cakra-datta quotes this couplet from Susruta, but there he reads आम्रकृतेन in place of आम्रातकेन; that is to say, he says that Amra should be used in place of Amrataka. He further adds that the stones of Amra and Tinduka fruits should be taken.
क्रियां पुष्करिकायान्तु शीतां सर्वां प्रयोजयेत् । जलौकोभिर्हरेच्चासृक् सर्पिषा चावसेचयेत् ।। १० ।।
स्पर्शहान्यां हरेद्रक्तं सेचयेच्च प्रदिह्यान्मधुरैरपि । सुशीतलैः ।।११।।
क्षीरेक्षुरससर्पिर्भिः पिडकामुत्तमाख्याञ्च बडिशेनोद्धरेद् भिषक् । कषायैरवचूर्णयेत्॥१२॥ उद्धृत्य मधुसंयुक्तैः
Treatment of Puskarika, etc. : In a case of Puskarika, all kinds of cooling measures should be applied and the vitiated blood should be extracted by applying leeches. The affected part should be subsequently affused with clarified butter. In a case of the Sparsa-hani type of the disease, blood should be let out and plasters (Pradeha) of Madhura (Kakolyadi) drugs should be applied. The affected part should be affused with a very cold compound of milk, clarified butter and the expressed juice of sugar cane. In the type of the disease known as Uttama the Pidakas (condylomatous growths) should be removed with the help of a Badisa instrument, and powders of astringent drugs with honey should be applied to the seat of affection. 10-12
रसक्रिया विधातव्या लिखिते शतपोनके । तैलमनन्तरम् ।।१३।।
पृथक्पर्ण्यादिसिद्धञ्च देयं क्रियां कुर्याद् भिषक् प्राज्ञस्त्वक्पाकस्य विसर्पवत् । रक्तविद्रधिवच्चापि क्रिया शोणितजेऽर्बुदे ।।१४।।
Treatment of Sata-ponaka, etc. : In a case of the Sata-ponaka type of the disease, the affected part should be scarified and the measures laid down in connection with Rasa-Kriya should be resorted to. After this, an oil, cooked with the Prthak-parnyadi drugs’ should be likewise applied to the seat of the disease. The medicinal treatment, in a case of Tvak-paka, should be the same as described in connection with Erysipelas (Visarpa). The remedial measures, laid down under the head of Rakta-vidradhi, should be employed in a case of the Sonitarbuda type of the disease. 13-14
1. For Rasa-kriya and the Prthak-par nyadi drugs, see Chapter XXXVI–Sutrasthana.
कषायकल्कसपषि तैलं चूर्णं रसक्रियाम्। शोधनं रोपणञ्चैव वीक्ष्य वीक्ष्यावचारयेत् ।। १५ ।।
हितं च सर्पिषः पानं पथ्यञ्चापि विरेचनम् । हितः शोणितमोक्षश्च यच्चापि लघु भोजनम् ॥ १६ ॥
General Treatment : Remedies such as medicinal decoctions, pastes (Kalka), medicated clarified butter, oils, powders, Rasa-Kriya, etc., and the measures for purifying and healing (incidental sores or ulcers), should be employed with due consideration to the nature and intensity of the aggravated Dosas involved in the case. The application of specifically prepared medicated clarified butter, purgatives, bloodletting and light diet should be similarly prescribed beneficially. 15-16
अर्बुदं मांसपाकञ्च विद्रधिं विद्रधिं तिलकालकम् । प्रत्याख्याय प्रकुर्वीत भिषक् सम्यक् प्रतिक्रियाम् ॥१७॥
Prognosis: The medical treatment of the patient affected with any one of the following types of the disease, viz., Arbuda, Mamsapaka, Vidradhi and Tila-Kalaka should be undertaken without holding out any definite prospect of recovery. 17
इति सुश्रुत संहितायां चिकित्सितस्थाने शूकदोषचिकित्सितं नामैकविंशोऽध्यायः ।। २१ ।।
Thus ends the twenty-first Chapter of the Chikitsa Sthana in the Susruta Samhita which deals with the treatment of Suka-Dosa.
