द्वाविंशोऽध्यायः । अथातो मुखरोगचिकित्सितं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः।।१।।
Now we shall discourse on the medical treatment of the affections of the mouth (Mukha- Roga). 1
Treatment of Vataja Ostha-kopa
चतुर्विधेन स्नेहेन मधूच्छिष्टयुतेन च। वातजेऽभ्यञ्जनं कुर्यान्नाडीस्वेदञ्च बुद्धिमान् ॥२॥
विदध्यादोष्ठकोपे तु शाल्वणञ्चोपनाहने । मस्तिष्के चैव नस्ये च तैलं वातहरं हितम् ॥ ३ ॥
श्रीवेष्टकं सर्जरसं सुरदारु सुगुग्गुलु । यष्टीमधुकचूर्णन्तु विदध्यात् प्रतिसारणम् ॥४॥
Treatment of Vataja Ostha-kopa: In a case of inflammation of the lips (Ostha Kopa) due to the action of the deranged Vayu, the affected part should be rubbed with (an ointment composed of) the four kinds of lardacious (Sneha ) substances mixed with wax. Fomentations in the manner of Nadi-sveda should also be resorted to by an intelligent physician. Applications of the Salvana poultices and those of the medicated oils, possessed of the virtue of subduing the deranged Vayu, as errhines and Mastiskya (Siro-vasti) are also recommended. The lips should be treated with the powder composed of Sri-vestaka, Sarjarasa, Sura-daru, Guggulu and Yasti madhu. 2-4
Treatment of Pittaja Ostha-kopa
1. Vagbhata reads “मधुच्छिष्ट” i.e, wax, in place of श्रीवेष्टकम् ।
पित्तरक्ताभिघातोत्थं जलौकोभिरुपाचरेत् । पित्तविद्रधिवच्चापि क्रियां कुर्यादशेषतः ।।५।।
Treatment of Pittaja Ostha-kopa, etc. : In a case of Ostha kopa of traumatic origin, (Abhighataja) or one due to the deranged action of the blood (Raktaja) or of the Pitta bleeding of the affected part should be effected by the application of leeches and all the measures and remedies (Samsodhana and Samsamana) mentioned in connection with the treatment of the Pitta-Vidradhi should be likewise employed. 5
Treatment of Kaphaja Osthakopa
शिरोविरेचनं धूमः स्वेदः कवल एव च। हृते रक्ते प्रयोक्तव्यमोष्ठकोपे कफात्मके ॥ ६॥
त्र्यूषणं स्वर्जिकाक्षारो यवक्षारो विडं तथा । क्षौद्रयुक्तं विधातव्यमेतच्च प्रतिसारणम्।।७।।
Treatment of Kaphaja Osthakopa: The use of medicated Sirovirecana (errhines), fumigations, (Vairecanika Dhuma), fomentation and (Sveda) Kavala (gurgles), prepared from the Kapha-subduing drugs should be recommended after blood-letting in the Kaphaja type of Ostha-kopa. The swollen and inflamed lips should be treated (Pratisarana) with a compound consisting of Trikatu, Sarjika-kshara, YavaKshara and Vid-lavana (black-salt)¹ pounded together and made into a thin paste with the admixture of honey. 6-7
मेदोजे स्वेदिते भिन्ने शोधिते ज्वलनो हितः । प्रियङ्गुत्रिफलालोध्रं सक्षौद्रं प्रतिसारणम् ।
एतदोष्ठप्रकोपानां साध्यानां कर्म कीर्त्तितम् ।।७-८।।
Treatment of Medoja Ostha-kopa : In a case of the fatty type of Ostha-kopa, the affected part should be fomented and opened (when suppurated); and should then be purified and cauterised with fire. A paste compound of Priyangu, Triphala, Lodhra and honey should be rubbed cver the affected part (Prati-sarana). These are the remedies for the curable types of Ostha-kopa. 7-8
Treatment of the Diseases of Danta-Mula
दन्तमूलगतानान्तु रोगाणां कर्म वक्ष्यते ।। ९ ।। शीतादे हृतरक्ते तु तोये नागरसर्षपान् ।
1. Vrnda and Cakrapani do not read Vid-lavana.
निष्क्वाथ्य त्रिफलामुस्तं गण्डूषः सरसाञ्जनः ।। १० ।।
प्रियङ्गवश्च मुस्तञ्च त्रिफला च प्रलेपनम् । नस्यञ्च त्रिफलासिद्धं मधुकोत्पलपद्मकैः ।। ११ ।।
दन्तपुप्पुटके कार्यं तरुणे रक्तमोक्षणम्। सपञ्चलवणः क्षार: सक्षौद्रः प्रतिसारणम् ।
हितः शिरोविरेकश्च नस्यं स्निग्धञ्च भोजनम् ॥ १२ ॥
Treatment of the Diseases of Danta-Mula: Now we shall describe the treatment of the affection of the roots of the teeth (Gingivitis). In a case of the Sitada (spongy gums) type of the disease, the gums should be first bled and a decoction of Sarsapa, Nagara, Triphala and Musta¹ mixed with Rasanjana should then be used as gargles. The gums should be plastered (Pralepa) with Priyangu, Musta and Triphala and (clarified butter, cooked with) the decoction of Triphala, Madhuka, Utpala and Padmaka should be used as an errhine. In an acute case of Danta Pupputaka (Gum boil), the gums should be first bled and then rubbed (Prati-sarana) with the five officinal kinds of salt and Yava-Kshara mixed with honey. The use of errhines (Siro-virecana). medicated snuffs (Nasya) and demulcent food is recommended. 9-12
Treatment of Danta – Vesta
।।१३।। विस्त्राविते दन्तवेष्टे व्रणांस्तु प्रतिसारयेत् । रोध्रपत्तङ्गयष्ट्याह्व-लाक्षाचूर्णैर्मधूत्तरैः गण्डूषे क्षीरिणो योज्या सक्षौद्रघृतशर्कराः । काकोल्यादौ दशक्षीर-सिद्धं सर्पिश्च नस्यतः ॥ १४ ॥ शौषिरे हृतरक्ते तु रोध्रमुस्तरसाञ्जनैः । सक्षौद्रः शस्यते लेपो गण्डूषे क्षीरिणो हिताः ॥ १५ ॥ सारिवोत्पलयष्ट्याह्व-सावरागुरुचन्दनैः क्षीरे दशगुणे सिद्धं सर्पिर्नस्ये च पूजितम् ।। १६ ।।
Treatment of Danta – Vesta, etc. : In a case of Danta – Vesta (Pyorrhoea), the swelling should be first bled and then rubbed with a pulverised compound of Rodhra, Pattanga, Yasti madhu and Laksa mixed with a profuse quantity of honey. A decoction of (the bark of)the Ksiri trees, mixed with sugar, honey and clarified butter (as an after-throw) should be used as gargles (Gandusa). Clarified butter, cooked with the drugs of the Kakolyadi group and milk ten-times of Ghrita should be used as snuff (Nasya). In a case of Sausira, the affected parts, after being properly bled, should be plastered (Lepa) with Lodhra, Musta and Rasanjana, pounded together and mixed with honey. A decoction of the Ksiri trees should be used as gargles (Gandusa), and clarified butter cooked with the paste-compound of Sariva, Utpala, Yasti-madhu, Savara (Lodhra), Aguru, (red) Candana and ten times its own weight of milk should be recommended as an errhine. 13-16
1. Vrnda and Cakra datta do not read Musta, nor Rasanjana.
Treatment of Pari-dara
।। १८ ।। क्रियां परिदरे कुर्याच्छीतादोक्तां विचक्षणः ॥१७॥ संशोध्योभयतः कार्यं शिरश्चोपकुशे तथा । काकोदुम्बरिकागोजी-पत्रैर्विस्त्रावयेदसूक् क्षौद्रयुक्तैश्च लवणैः सव्योषैः प्रतिसारयेत् । पिप्पली: सर्षपाञ् श्वेतान् नागरं नैचुलं फलम् ।। १९ ।। सुखोदकेन संसृष्टं कवलञ्चापि धारयेत् । घृतं मधुरकैः सिद्धं हितं कवल नस्ययोः ॥ २० ॥
Treatment of Pari-dara, etc. : In a case of Pari-dara (bleeding gums) the treatment should consist of the remedies described in connection with Sitada. In a case of Upa kusa (suppurative gingivitis) as well, the system of the patient should be cleansed both ways (by means of emetics and purgatives), and his head should be cleansed with Siro-virecana. The affected part (in a case of Upa-kusa) should, in addition, be bled (by rubbling it over) with the leaves of the Kakodumbarika, or of the Goji, or with the application of a medicinal compound composed of the five officinal kinds of salt and Trikatu mixed with honey. Tepid watery solutions² of Pippali, (white) Sarsapa. Nagara, and Nicula fruits should also be used as gargles (Kavala). The use of clarified butter cooked with the drugs of the Madhura (Kakolyadi) group as errhine (Nasya) and gargle (Kavala) is also recommended. 17-20
1. This shows that cleansing the system by means of emetics and purgatives, as well as with Siro-virecana should be resorted to in a case of Pari-dara as well. 2. The solution may be prepared with the drugs taken together or separately.
Treatment of Danta-Vaidarbha
शस्त्रेण दन्तवैदर्भे दन्तमूलानि शोधयेत् । ततः क्षारं प्रयुञ्जीत क्रियाः सर्व्वाश्च शीतलाः ॥ २१ ॥
उद्धृत्याधिकदन्तन्तु ततोऽग्निमवचारयेत् । कृमिदन्तकवच्चापि विधिः कार्यो विजानता ॥ २२ ॥
Treatment of Danta-Vaidarbha, etc. : In a case of DantaVaidarbha (Traumatic Periodontitis), the regions about the roots of the teeth should be cleansed by opening them with a (Mandalagra) instrument and subsequently treated with alkaline applications. Cooling measures should also be resorted to (during the treatment of this disease). In a case of Adhika-danta (extra tooth), the additional tooth should be uprooted and removed; then (in order to arrest the bleeding, if any), the part should be cauterised with fire, and then an experienced physician should apply the remedies mentioned under the head of worm-eaten teeth (Krmi-danta). 21-22
Treatment of Adhi-mamsa
छित्त्वाऽधिमांसं वचातेजोवतीपाठा-स्वर्जिकायावशूकजैः क्षौद्रद्वितीयाः पिप्पल्यः कवलश्चात्र कीर्त्तितः । पटोलत्रिफलानिम्ब – कषायश्चात्र धावने । हितः शिरोविरेकश्च धूमो वैरेचनश्च यः ॥ २४ ॥ सक्षौद्रैरेभिश्चूर्णैरुपाचरेत् । ॥ २३ ॥
Treatment of Adhi-mamsa: Ina case of Adhi-mainsa (impacted tooth). the additional flesh growth about the roots of a tooth should be removed (with a knife ) and treated with a compound of Vaca, Tejovati, Patha. Sarjika and Yava-kshara; pasted together with honey. Powdered Pippali, mixed with honey, should be used as a gargle (Kavala); and a decoction of Patola, Triphala and Nimba for washing the affected part. Errhines (Siro-virecana) and inhalation of Vairecana smoke, (that lead of the secretion of mucus from the head), would likewise prove efficacious in such cases. 23-24
Treatment of Danta – Nadi
सामान्यं कर्म नाडीनां विशेषञ्चात्र मे शृणु ॥ २५ ॥ नाडीव्रणहरं कर्म दन्तनाडीषु कारयेत ।। यं दन्तमभिजायेत नाडी तं दन्तमुद्धरेत् । छित्त्वा मांसानि शस्त्रेण यदि नोपरिजो भवेत् । शोधयित्वा दहेच्चापि क्षारेण ज्वलनेन वा ॥ २६ ॥ 35
गतिध्रुवम् । भग्नमस्थिरम् ॥ २७ ॥ भिनत्त्युपेक्षिते दन्ते हनुकास्थि समूलं दशनं तस्मादुद्धरेद् उद्धृते तूत्तरे दन्ते समूले रक्तातियोगात् पूर्वोक्ता रोगा घोरा काण: सञ्जायते जन्तुरर्द्दितञ्चास्य जायते । चलमप्युत्तरं दन्तमतो नापहरेद् भिषक् ॥ २९ ॥ स्थिरबन्धने । भवन्ति हि ॥ २८ ॥
Treatment of Danta – Nadi: In a case of Danta – Nadi (Dental sinus) the treatment of Nadi (Sinus) about the teeth is identical with that of sinus in general. Procedures for curing the sinus track should be carried out in a case of Danta – Nadi. The specific remedial measure, however, is that the gum of the affected tooth should be incised, and the tooth should be extracted, if it be not in the upper jaw. The affected part should then be purified and cauterised with an alkali or fire. Hence in a case of Sinus (Nadi), a complete extraction of any fragment of the broken bone, or tooth, is essentially necessary (for its cure), inasmuch as, if left unextracted, it may cause the sinus to affect ( run below) the jaw-bone. If the affected tooth be in the upper jaw, and if it be found to be firm and steady at its roots, though attended with tooth-ache. it should not be extracted, inasmuch as it might produce an excessive haemorrhage from its roots, and usher in blindness, facial paralysis, or other dangerous affections (such as convulsion, etc.) due to the excessive loss of blood. Hence in the case of a looseness of such a tooth in the upper jaw, it should not be extracted. 25-29
जातिमदन- स्वादुकण्टकखादिरम् । जातिमदन-कदुकस्वादुकण्टकैः यष्टचाह्वरोध्रमञ्जिष्ठाखदिरैश्चापि यत् कृतम् । धावने कषायं ॥ ३०॥
1. Both Vrnda and Chakradatta quote this passage from the text, but both of them read “शोणितं सम्प्रसिच्यते” (excessive bleeding takes place) in place of “सशूले स्थिरबन्धने” (if it be found to be firm and steady at its roots, though attended with tooth-ache). Sri-kuntha Datta again, in his commentary quotes another reading “सपूलेऽस्थिरबन्धने” (if it be loose in its sockets and be extracted with its roots ). In our humble opinion, however, the current reading of the text seems to be the correct one, inasmuch as both the readings quoted above seem to be redundant in the presence of the two following sentences “रक्तातियोगात्…” and “चलमप्युत्तरं दन्तं ‘
तैलं संशोधनं तद्धि हन्याद् दन्तगतां गतिम् ॥ ३१ ॥ कीर्त्तिता दन्तमूले तु क्रिया दन्तेषु वक्ष्यते ।। ३२ ।।
A decoction of Jati, Madana, Svadu-Kantaka and Khadira should be used to wash the mouth. An oil cooked with Jati, Madana, Katuka, Svadu-Kantaka, Yasti-madhu, Rodhra, Manjistha and Khadira should be used to cleanse and heal a sinus invading the roots of a tooth. The re-medical measures to be employed in the diseases affecting the roots of the teeth have thus been described above. We shall now proceed to describe the medicinal remedies to be employed in the diseases which confine themselves exclusively to the teeth. 30-32
Treatment of the diseases of Tooth proper
स्नेहानां कवलाः कोष्णा: सर्पिषस्त्रैवृतस्य वा । निर्यूहाश्चानिलघ्नानां दन्तहर्षप्रमर्दनाः ।। ३३ । स्नैहिकश्च हितो धूमो नस्यं स्निग्धञ्च भोजनम् । रसो रसयवाग्वश्च क्षीरं सन्तानिका घृतम् । शिरोबस्तिर्हितश्चापि क्रमो यश्चानिलापहः ।। ३४ ॥
Treatment of the diseases of Tooth proper : A case of Dantaharsa yields to the use of any lukewarm Sneha, or the Traivrta-Ghrita (mentioned in Chapter V), or of the decoction of the Vayu-subduing drugs as gargles (Kavala). An application of Snaihika Dhuma (emulsive fumes) and the use of snuff (Nasya), emulsive articles of food, meat soups, gruel prepared with meat (Rasa-Yavagu), milk. milk-cream, clarified butter, Siro-vasti and the other Vayu-subduing ineasures generally prove efficacious. 33-34
Danta Sarkara Chikitsa
अहिंसन् दन्तमूलानि शर्करामुद्धरेद् भिषक् । लाक्षाचूर्णैर्मधुयुतैस्ततस्ताः प्रतिसारयेत् । कुर्यान्निरवशेषतः ॥ ३५ ॥ दन्तहर्षक्रियां वापि
case of Danta Sarkara (Tartar-calcareous deposits on the teeth), the deposit should be removed in such a way as not to hurt the roots of the tooth, after which the part should be dusted (Prati-sarana) 1. According to Srikantha and Sivadasu, it appears that the application of this decoction as a wash is not to be found in all editions of the Susruta Samhita, but they say that it is found only in Jejjatas reading and explanation seem to be correct and have been followed by us in the transiation. –Ed. 2. All the four kinds of Sneha should be used separately or combinedly with powdered Laksa with honey. All the remedies mentioned in connection with the treatment of Danta-harsa (Dental Hyperaesthesis) may as well be employed in this disease. 35
Treatment of Kapalika
कपालिका कृच्छ्रतमा तत्राप्येषा क्रिया हिता ॥ ३६ ॥ जयेद् विस्त्रावणैः स्विन्नमचलं क्रिमिदन्तकम् । तथाऽवपीडैर्वातघ्नैः स्नेहगण्डूषधारणैः । स्निग्धैश्च भोजनैः ॥ ३७॥ भद्रदार्वादिवर्षाभू-लेपैः चलमुद्धृत्य च स्थानं विदहेच्छुषिरस्य च। ततो विदारीयष्टचाह्व-शृङ्गाटककशेरुकैः । तैलं दशगुणे क्षीरे सिद्धं नस्ये हितं भवेत् ॥ ३८ ॥ हनुमोक्षे समुद्दिष्टां कुर्याच्चार्दितवत् क्रियाम् ।। ३९।।
Treatment of Kapalika, etc.: These remedies are also efficacious in a case of Kapalika (caries of the tooth) which is extremely hard to cure. In a case of Krmi-Danta (worm-eaten tooth) found to be firm and unloosed (in its socket), the affected tooth should be fomented, and the accumulation (i.e., the pus, blood, etc.) should be removed. It should then be treated with some Vayu-subduing errhines of the Ava-pidana form and with emollient gargles ( Gandiusa), as well as with plasters, prepared with Varsabhu and the drugs of the Bhadra-Darvadi group and with a diet of emulsive articles of food. In the case, however, where the tooth is found to be loose (in the socket), the loose tooth should be extracted, and the cavity cauterised with fire or an alkali (for the purpose of arresting the bleeding). An oil cooked with the pastes (Kalka) of Vidari, Yasti-madhu, Srngataka, and Kaseruka and with ten times of milk of its own weight should be administered as an errhine (in such cases). The course of treatment in a case of Hanumoksa (dislocation of the Jaw) is the same as in one of facial paralysis. 36-39
फलान्यम्लानि शीताम्बु रूक्षान्नं दन्तधावनम् । तथाऽतिकठिनान् भक्ष्यान् दन्तरोगी विवर्जयेत् ॥ ४० ॥ साध्यानां दन्तरोगाणां चिकित्सितमुदीरितम् । जिह्वागतानां साध्यानां कर्म वक्ष्यामि सिद्धये ॥४१॥
A person suffering from any affection of the teeth should refrain from taking acid fruits, cold water dry ( Ruksa) food, excessively hard articles of food and from brushing his teeth (with a twig). The treatment of the curable types of tooth-diseases has been thus described above, we shall now (proceed to) describe the treatment of the curable types of tongue-diseases. 40-41
Treatment of Tongue-diseases
ओष्ठप्रकोपेऽनिलजे यदुक्तं प्राक् चिकित्सितम् । कण्टकेष्वनिलोत्थेषु तत् कार्यं भिषजा भवेत् ॥ ४२ ॥ पित्तजेषु विघृष्टेषु निःसृते दुष्टशोणिते। प्रतिसारणगण्डूषं नस्यञ्च मधुरं हितम् ॥ ४३ ॥ कण्टकेषु कफोत्थेषु लिखितेष्वसृजः क्षये। पिप्पल्यादिर्मधुयुतः गृह्णीयात् कार्यस्तु प्रतिसारणे ॥४४॥ गौरसर्षपसैन्धवैः । भोजयेत् ॥ ४५ ॥ कवलांश्चापि पटोलनिम्बवार्त्ताकु-क्षारयूषैश्च
Treatment of Tongue-diseases : In the Vataja type of Jihvakantaka (Papilla), the treatment should be the same as in the case of Vataja Ostha-kopa. In the Pittaja type (of Jihva kantaka), the vitiated blood should be made to secrete from the affected organ by rubbing it with any article of rough surface (such as the leaves of Sakhotaka, etc.) and the drugs of the Madhura (Kakolyadi) group should be used for gargles and errhines, as well as for being rubbed over (Prati-sarana) the affected organ. In the Kaphaja type (of Jihva-kantaka), the organ should be bled by scarifying it (with a Mandala patra and such other instrument); it should then be rubbed with the powders of the drugs of the Pippalyadi group mixed with honey. A compound of powdered white mustard-seed and Saindhava should be administered as gargles (Kavala), and the patient should be made to take his food with the soup of Patola, Nimba, and Vartaku mixed with (a liberal quantity of) YavaKshara. 42-45
Treatment of Upa-jihva
उपजिह्वान्तु संलिख्य क्षारेण प्रतिसारयेत् । शिरोविरेकगण्डूष-धूमैश्चैनमुपाचरेत् ॥ ४६॥ जिह्वागतानां कर्मोक्तं तालव्यानां प्रवक्ष्यते ॥ ४७ ॥
Treatment of Upa-jihva : In a case of Upa-jihva (Ranula), the affected part should be scarified and rubbed with an alkali, and the patient should be treated with errhines (Siro-vireka). gargles (Guidusa) and inhalations of smokes (Dhuma). The treatment of the tongue diseases has been thus described above. We shall now describe the medical treatment of the affections of the palate (Talu-gata Roga). 46-47
Treatment of the Talu-gata diseases
गलशुण्डिकाम् । अङ्गुष्ठाङ्गुलिसन्दंशेनाकृष्य छेदयेन्मण्डलाग्रेण जिह्वोपरि तु संस्थिताम् ।। ४८ ।।
नोत्कृष्टञ्चैव हीनञ्च त्रिभागं छेदयेद् भिषक् ।
अत्यादानात् त्रवेद्रक्तं तन्निमित्तं म्रियेत च। हीनच्छेदाद्भवेच्छोफो लाला निद्रा भ्रमस्तमः ।। ४९ ।।
तस्माद् वैद्यः प्रयत्नेन दृष्टकर्मा विशारदः । गलशुण्डीन्तु संच्छिद्य कुर्यात् प्राप्तमिमं क्रमम् ।। ५० ।।
Treatment of the Talu-gata diseases : In a case of GalaSundika the Sundika (protuberance) should be drawn out along the tongue with the help of the thumb and the second finger of the hand, or with a Samdamsa (forceps) and then cut off with a Mandalagra¹ instrument. But it should be severed neither more nor less than threequarters of the appendage, inasmuch as profuse haemorrhage might follow an excessive incision, and death might result therefrom: whereas, a case of lesser severance is usually found to be attended with swelling. excessive salivation, somnolence, vertigo darkness of vision, etc. Hence a surgeon, well-versed in the science of surgery and well-skilled in practical operations, should carefully operate a Galasundika (with a knife) and subsequently adopt the following measures. 48-50
मरिचातिविषापाठा वचाकुष्ठकुटन्नटैः । प्रतिसारयेत् ॥५१॥
क्षौद्रयुक्तैः सलवणैस्ततस्तां वचामतिविषां पाठां रास्नां कटुकरोहिणीम् । निष्क्वाथ्य पिचुमर्दञ्च कवलं तत्र योजयेत् ॥ ५२ ॥ इङ्गुदीकिणिहीदन्ती-सरलासुरदारुभिः । पञ्चाङ्गीं कारयेत् पिष्टैवर्त्तिं गन्धोत्तरां शुभाम् ॥ ५३॥
1. Round head knife.
2. Srikantha Dutta. in his commentary on Vynda’s compilation quotes this passage from the text, but does not include somnolence’ therein. He reads “लालास्रावी भ्रमस्तमः” in place of “लाला निद्रा भ्रमस्तमः” ।
ततो धूमं पिबेज्जन्तुर्द्विरह्नः कफनाशनम् । क्षारसिद्धेषु मुद्गेषु यूषश्चाप्यशने हितः ॥ ५४॥
तुण्डिकेर्यध्रुषे कूर्मे सङ्घाते तालुपुप्पुटे । एष एव विधिः कार्यो विशेष: शस्त्रकर्मणि ॥ ५५ ॥
The incidental ulcer should be treated with the pulverised compound of Marica, Ati visa, Patha. Vaca, Kustha and Kutannata, mixed with honey and rock salt. A decoction of Vaca, Ati-visa, Patha, Rasna, Katuka-rohini and Picu-marda should be used as gargle (Kavala). The five drugs viz.. lngudi, Apamarga, Danti, Sarala and Deva-daru should be pasted together and made into Vartis (sticks), well flavoured by the addition of perfuming drugs. Twice every day (once in the morning and again in the evening), the patient should be made to inhale the fumes of these burning Vartis (sticks) which have the property of subduing the (deranged) Kapha, and should be made to take the soup of Mudga boiled in alkaline water. In cases of Tundikeri Adhrusa, Kurma, Mansa Sanghata and Talu pupputa, the preceding measures should be adopted, but the surgical operation should vary with the nature of the particular disease under treatment. 51-55
Treatment of Talu-paka
तालुपाके तु कर्त्तव्यं विधानं पित्तनाशनम् ॥ ५६ ॥ स्नेहस्वेदौ तालुशोषे विधिश्चानिलनाशनः । कीर्त्तितं तालुजानान्तु कण्ठ्यानां कर्म वक्ष्यते ॥ ५७ ॥
Treatment of Talu-paka, etc. : Remedies which destroy the deranged Pitta should be employed in Talu-paka (suppuration of the palate); while applications of Sneha (oil, etc.) and Sveda (fomentations), as well as Vayu-subduing measures should be the remedies in a case of a Talu-Sopha (swelling of the palate). The remedies to be employed in the diseases affecting the palate have been thus described above. Now hear me discoursing on the remedial measures in Kantha-Roga ( diseases of the throat). 56-57
1. The alkaline water to be used in the Mudga-soup should be prepared from Yava-kshara according to Dulhana. But according to Siva-dasa, alkaline water prepared from the ashes of Muskaka, Apamarga, etc. should be used.
Treatment of Throat-diseases
साध्यानां रोहिणीनान्तु हितं छर्दनं धूमपानञ्च गण्डूषो वातिकीन्तु हृते रक्ते लवणैः सुखोष्णान् स्नेहगण्डूषान् पत्तङ्गशर्करराक्षौद्रैः पैत्तिकीं
द्राक्षापरूषकक्वाथौ आगारधूमकटुकैः हितौ श्लैष्मिकीं श्वेताविडङ्गदन्तीषु तैलं सिद्धं नस्यकर्मणि योक्तव्यं तथा च॥ ५८ ॥
शोणितमोक्षणम् । नस्यकर्म प्रतिसारयेत् । धारयेच्चाप्यभीक्ष्णशः ॥ ५९॥
प्रतिसारयेत् । कवलग्रहे ।। ६० ।। च प्रतिसारयेत् । ससैन्धवम् ॥ ६१ ॥ रक्तसम्भवाम् ॥ ६२॥ कवलधारणे ।
पित्तवत् साधयेद् वैद्यो रोहिणीं
Treatment of Throat-diseases: In a curable type of Rohini (Diphtheria) blood letting and the applications of emetics, gargles. inhalations (of medicated fumes) and errhines (Nasya) are efficacious. In cases of Vataja Rohini, blood letting should be first effected, and the affected part should then be rubbed with salts. Gargles (Gandusa) of tepid Sneha (oil, clarified butter, etc.) should be frequently resorted to. In cases of the Pittaja Rohini, the powdered Pattangu, honey and sugar should be rubbed (Prati-sarana) over (the affected part), and the decoctions of Draksa and Parusaka, should be used as gargles (Kavala). In the Kaphaja type of Rohini, the affected part should be rubbed with Katuka and Agara-dhuma (soot of a house–chimneysoot). An oil properly cooked with Sveta Vidanga, Danti and Saindhava should be employed as (Nasya) and employed as gargles (Kavala). In a case of Raktaja Rohini, a physician shall employ the same measures of treatment as in the Pittaja type of the disease. 58-62
Treatment of Kantha-Saluka
वित्राव्य कण्ठशालूकं साधयेत् तुण्डिकेरिवत् । एककालं यवान्नञ्च भुञ्जीत स्निग्धमल्पशः ॥ ६३ ।।
उपजिह्विकवच्चापि साधयेदधिजिह्विकाम् ॥ ६४ ॥ एकवृन्दन्तु विस्त्राव्य विधिं शोधनमाचरेत् ॥ ६५ ॥
गिलायुश्चापि यो व्याधिस्तञ्च शस्त्रेण साधयेत् ॥ ६५ ।। अमर्मस्थं सुपक्वञ्च भेदयेद् गलविद्रधिम् ।। ६६ ।।
1. According to Cakra-pani, Draksa and Parusuku should be combinedly used in preparing the decoction.
Treatment of Kantha-Saluka, etc. In a case of Kantha-Saluka, : it should be bled and treated as a case of Tundikeri, and the patient should be enjoined to take a single meal in the day consisting only of a small quantity of Yavanna (barley-rice) with clarified butter. The treatment of a case of Adhi-jihvika should be the same as that of Upajihvika. In a case of Eka-vynda, blood-letting of the affected part should be resorted to (by the application of leeches), and Sodhana¹ (purifying) remedies should be employed. The medical treatment of a case of Gilayu (Silayu D.R.) consists of a surgical operation ( on the seat of the disease). Incision should be made into a Gala-Vidradhi (throat-abscess) in its suppurated stage and appearing at a part other than a Marma (vulnerable part). 63-67
Treatment of Sarva-sara Mukha-Roga
वातात् सर्वस चूर्णैर्लवणैः प्रतिसारयेत् । तैलं वातहरैः सिद्धं हितं कवलनस्ययोः ।। ६८ ।।
ततोऽस्मै स्नैहिकं धूममिमं दद्याद् विचक्षणः । शालराजादनैरण्ड- सारैङ्गदमधूकजाः ।। ६९।।
मज्जानो गुग्गुलुध्याम मांसीकालानुसारिवाः । श्रीसर्जरसशैलेय-मधूच्छिष्टानि चाहरेत् ।। ७० ।। लेपयेत् ।। ७१ ।।
तत् सर्वं सुकृतं चूर्णं स्नेहेनालोडच युक्तितः । टिण्टूकवृन्तं सक्षौद्रं मतिमांस्तेन एष सर्वसरे धूमः प्रशस्तः स्नैहिको मतः । कफघ्नो मारुतघ्नश्च मुखरोगविनाशनः ।। ७२।।
Treatment of Sarva-sara Mukha-Roga : The affected `part should be rubbed with powdered salts in a case of Sarva-sara Mukharoga (invading the entire cavity of the mouth) due to the aggravated Vayu. Oil cooked with the (decoction and the pastes of) Vayusubduing drugs (such as, the Bhadra-darvadi group, etc.) and used as errhines (Nasya) and gargles ( Kavala) is efficacious in this disease.
1. The ‘purifying remedies” here means Stro-virecung, fumigation, plasters and applications of alkali, etc.. for purifying the Dosas in the throat.
Dalhana and Niscala explain the term “चूर्णेलंवणै:” as the powders of the five officinal kinds of salt. Siva-dasa, howevere holds that powdered Saindhava salt only should be used. Vinda reads “चूर्णेर्लावणे” and the commentator Srikantha Datta explains it to mean either the powders of “लवणा”, i.e. Jyotismati or those of “लवण” i.e. the five officinal kinds of salt.
After the application of this oil, the patient should be treated with the Snaihika form of fumigation (Dhuma) in the following manner. Tintuka leaves smeared with honey should be plastered with a compound of the Sara of Sala, Priyala and castor wood, the marrow of Ingudi and Madhuka, Guggulu, Dhyamaka (Gandha trna), Mansi, Kalanu sariva, Sri (Lavanga), Sarja-rasa, Saileya and wax pounded together and mixed with an adequate quantity of clarified butter or oil. It should then be burnt, and the patient should be made to inhale the fumes. This medicinal fumigation (Dhuma) proves remedial in the disease. It destroys the deranged Vayu and Kapha and proves curative in all affections of the mouth. 68-72
पित्तात्मके सर्वसरे शुद्धकायस्य शुद्धकायस्य देहिनः । सर्वः पित्तहर: कार्यो विधिर्मधुरशीतलः । प्रतिसारणगण्डूषौ धूमः संशोधनानि कफात्मके सर्वसरे विधिं कुर्यात् कफापहम् । पिबेदतिविषां पाठां मुस्तञ्च सुरदारु सुरदारु रोहिणीं कटुकाख्याञ्च कुटजस्य फलानि च। मूत्रेण मनुजो भागैर्धरणसम्मितैः । गवां एष सर्वान् कफकृतान् रोगान् योगोऽपकर्षति ।। ७५ ।। क्षीरेक्षुरसगोमूत्र-दधिमस्त्वम्लकाञ्जिकैः च ।। ७३ ।। च ।।७४॥ । विदध्यात् कवलान् वीक्ष्य दोषं तैलघृतैरपि । रोगाणां मुखजातानां, साध्यानां कर्म कीर्त्तितम् ॥ ७६ ॥
In the Pittaja type of the Sarva-sara-Mukha-roga, all the morbific principles (Dosas) should be eliminated from the patient’s body (with emetics and purgatives), and all kinds of sweet, soothing and Pittasubduing drugs should be administered. Medicated gargles (Gandusa). fumigation (Dhuma), Pratisarana (rubbings) and purifying (Sodhana) measures as well as the Kapha-subduing remedies should be employed in the Kaphaja type of the Sarva-sara-Mukha-roga, and the patient should be made to take one Dharana measure (Twenty-four Ratis) of powdered Ati-visa, Patha, Musta, Deva daru, Rohini, Katuka and Kutaja seeds with an adequate quantity of cow’s urine. This medicine acts as a potent remedy for all the Kaphaja disorders of the body. Gargles (Kavala) with milk, sugarcane juice, cow’s urine, curd-cream, Kanjika, oil, or clarified butter (Sneha) should be prescribed according to the nature of the aggravated Dosas involved in each case (of the Sarva-sara-Mukha-roga). We have described above the medical treatment of the affections of mouth which yield to medical remedies. 73-76
असाध्या अपि वक्ष्यन्ते रोगा ये यत्र कीर्त्तिताः ॥ ७७ ॥ ओष्ठप्रकोपा वर्ज्याः स्युर्मांसरक्तत्रिदोषजाः । दन्तमूलेषु वर्ज्यो तु त्रिलिङ्गगतिशौषिरौ ॥ ७८ ॥ दन्तेषु च न सिध्यन्ति श्यावदालनभञ्जनाः।। ७९।। जिह्वागतेष्वलासस्तु तालव्येष्वर्बुदं तथा । स्वरघ्नो वलयो वृन्दो विदार्यलस एव च। गलौघो मांसतानश्च शतघ्नी रोहिणी च या ॥ ८० ॥ असाध्याः कीर्त्तिता होते रोगा नव दशैव च। तेषाञ्चापि क्रियां वैद्यः प्रत्याख्याय समाचरेत् ।। ८१ ।।
Incurable Types: Now we shall enumerate the different incurable types of inouth-diseases. Of the types of Ostha-paka, those due to the vitiated condition of the flesh, or of blood, and those due to the concerted action of the aggravated Dosas (Sannipata) should be deemed as incurable. Of the diseases similar to the roots of the teeth, the affections known as the Sunnipatika Danta-nadi (Sinus in the gums) and the Sannipatika Sausira (Maha- Sausira) should be also deemed as incurable. Of the affections of the teeth, those known as the Syava-dantaka, Dalana and Bhanjana and of the diseases which restrict themselves to the tongue, the one known as the Alasa should be looked upon as incurable. Similarly, of the affections of the palate, the Arbuda should be deemed as incurable. Of those of the throat, the Svara-ghna, Valaya, Vrnda, Vidari, Alasa, Galaugha, Mamsa-tana, Sataghni and Rohini should be regarded as beyond the pale of medicine. The nineteen kinds of the disease mentioned above are incurable, and the medical treatment of these diseases should be taken in hand without holding out any definite hope of recovery. 77-81
इति सुश्रुत-संहितायां चिकित्सितस्थाने मुखरोगचिकित्सितं नाम द्वाविंशोऽध्यायः ।। २२ ।।
Thus ends the Twenty-second Chapter of the Chikitsa-Sthana in the Susruta Samhita which deals with the medical treatment of the diseases of the mouth.
