अथातः प्रमेहचिकित्सितं व्याख्यास्यामः । इति ह स्माहुरात्रेयादयो महर्षयः ।
We shall now expound the chapter – Prameha chikitsa treatment of polyuria/diabetes; thus said Atreya and other great sages.
Sodhana in prameha – Panchkarma in diabetes
मेहिनो बलिनः कुर्यादादौ वमनरेचने । स्निग्धस्य सर्षपारिष्टनिकुम्भाक्षकरञ्जजैः ॥ १ ॥
तैलैस्त्रिकण्टकाद्येन यथास्वं साधितेन वा । स्नेहेन सुरसादिकषायेण दद्यादास्थापनं ततः।
न्यग्रोधादेस्तु पित्तार्तं रसैः शुद्धं च तर्पयेत् ॥ ३ ॥
The patient of diabetes who is strong should be administered vamana (emesis ) and virechana (purgation) therapies after giving oleation therapy by drinking oil prepared with sarsapa, arista, nikurmbha, aksa and karanja or with drugs commencing with trikantaka (enumerated in verse 17-18) or with other appropriate drugs (suitable to the dosas).
Afterwards asthapana basti (decoction enama) should be administered using the decoction of drugs of surasadigana (vide, chapter 15 of sutrasthana) added with the paste of musta, devahva and nagara, with the decoction of drugs of nyagrodhadigana (vide chapter 15 of sutrasthana) for the person suffering from (increase of) pitta.
मुस्तदेवाह्वनागरप्रतिवापवत् ॥ २ ॥
After these purificatory therapies, the person should be nourished with juice ( soup) of meat. Samana ( palliative therapy 1-3.
मूत्रग्रहरुजागुल्मक्षयाद्यास्त्वपतर्पणात् ततोऽनुबन्धरक्षार्थं शमनानि प्रयोजयेत् ॥ ४ ॥
असंशोध्यस्य तान्येव सर्वमेहेषु पाययेत् ।
Mutragraha (retention of urine), pain, abdominal tumor, ksaya (consumption depletion of tissues) etc. arise from apatarpana (under nourishment) as secondary diseases; hence in order to protect the patient from these, he should be administered samana (therapy to mitigate the dosas). The same should be administered to those who are unsuitable for purifactory therapy, in all types of diabetes.
धात्रीरसप्लुतां प्राहे हरिद्रां माक्षिकान्विताम् ॥ ५॥
दार्वीसुराह्वत्रिफलामुस्ता वा क्वथिता जले | चित्रकत्रिफलादार्वीकलिङ्गान् वा समाक्षिकान् ॥ ६ ॥
मधुयुक्तं गुडूच्या वा रसमामलकस्य वा ।
In the forenoon, the patient should drink either (powder of) haridra put into the juice of dhatri and mixed with honey; or darvi, surahva, triphala and musta boiled in water; or decoction of citraka, triphala, darvi and kalinga added with honey; or fresh juice of guduci or amalaka mixed with honey.
रोध्राभयातोयदकट्फलानां पाठाविडङ्गार्जुनधन्वनानाम् । गायत्रिदार्वीकृमिहृद्धवानां कफे त्रयः क्षौद्रयुताः कषायाः ॥७॥
The following three decoction mixed with honey should be consumed in case of increase of kapha; either of rodhra, abhaya, toyada, and katphala; of patha, vidanga, arjuna and dhanvana; or of gayatri, darvi, krimihrt and dhava. 7.
उशीररोध्रार्जुनचन्दनानां पटोलनिम्बामलकामृतानाम् । रोध्राम्बुकालीयकधातकीनां पित्ते त्रयः क्षौद्रयुताः कषायाः ॥ ८ ॥
The following three decoctions mixed with honey should be consumed when pitta is increased; either of usira, rodhra, arjuna and candana; of patola, nimba, amalaka and amrta; or of rodhra, ambu, kaliyaka and dhataki. 8.
यथास्वमेभिः पानानं यवगोधूमभावनाः ॥ ९ ॥ वातोल्वणेषु स्नेहांश्च प्रमेहेषु प्रकल्पयेत् ।
Foods and drinks should be prepared from either yava or godhuma which have been soaked in the decoction of the above drugs. For treating diabetes arising from increase of vata, sneha (medicated fats-oil, ghee etc.) should also be prepared by these drugs.
विकृतिर्हिता ॥ १० ॥ वेणुजन्मनाम् । तृणधान्यानि मुद्राद्याः शालिर्जीर्ण: सषष्टिकः ॥ ११ ॥
श्रीकुक्कुटोऽम्लः खलकस्तिलसर्षपकिट्टजः । कपित्थं तिन्दुकं जम्बूस्तत्कृता रागषाडवाः ॥ १२॥
तिक्तं शाकं मधु श्रेष्ठा भक्ष्याः शुष्काः ससक्तवः। धन्वमांसानि शूल्यानि परिशुष्काण्ययस्कृतिः ॥ १३ ॥
मध्वरिष्टासवा जीर्णाः सीधुः पक्वरसोद्भवः । तथाऽसनादिसाराम्बु दर्भाम्भो माक्षिकोदकम् ॥ १४ ॥
अपूपसक्तुवाट्यादिर्यवानां गजाश्वगुदमुक्तानामथवा
Apupa (cake of rice and black gram baked in steam), saktu (cornflour mixed with milk sugar and ghee ), vatya (paste of pulses fried in oil) prepared from either yava (barley) which has come out of the rectum of an elephant or horse (which have been fed sumptously with barley earlier) or venuyava (seeds of bamboo tree), are suitable; similary the trnadhanya (corns produced by grass like plants), mudga etc. (pulses), old rice and sastika rice, beverage known as srikukkuta-the sour buttermilk processed with the residue of tila and sarsapa (after taking out the oil), kapittha, tinduka and jambu fruits and raga ( sweet drink) and sadava (powder of sour, sweets, spices, salts etc.) prepared from them, bitter vegetables, honey, eatables ( snacks) and paste of cornflour which are dry (non- fatty ), meat of animals of desert-like regions roasted on a rod or which is well dried in sun, ayaskriti (described further on), madhvarista and madhvasava which are old, sidhu prepared from cooking sugarcane juice, drinking water prepared from drugs of asanadigana (vide chapter 15 of sutrasthana), darbha; or honey water, all are suitable for patients of diabetes. 10b-14.
वासितेषु वराक्वाथे शर्वरीं शोषितेष्वहः । यवेषु सुकृतान् सक्तून् सक्षौद्रान् सीधुना पिबेत् ॥ १५ ॥
Yava (barley) is soaked in the decoction of vara (triphala) for the night and dried in the day. Saktu (paste of flour) prepared from this yava should be consumed along with sidhu and added with honey.
शालसप्ताह्नकम्पिल्लवृक्षकाक्षकपित्थजम् रोहीतकं च कुसुमं मधुनाऽद्यात्सुचूर्णितम् ॥ १६ ॥
कफपित्तप्रमेहेषु पिबेद्धात्रीरसेन वा ।
Flower of sala, saptahva, kampilla, vrksaka, aksa, kapittha, and rohitaka, powdered nicely should be licked with honey. It can be consumed with the juice of dhatri in diabtes arising from kaphapitta. 16-17a.
त्रिकण्टकनिशारोधसोमवल्कवचार्जुनैः ॥१७॥
पद्मकाश्मन्तकारिष्टचन्दनागुरुदीप्यकैः पटोलमुस्तमञ्जिष्ठामाद्रीभल्लातकैः तैलं वातकफे पित्ते घृतं मिश्रेषु मिश्रकम् । पचेत् ॥ १८ ॥
Trikantaka, nisa, rodhra, somavalka, vaca, arjuna, padmaka, asmantaka, arista, candana, aguru, dipyaka, patola, musta, manjistha, madri, and bhallataka-should be made use of for preparing medicated oil for use in diabetes of vata kapha origin, misarka (combination of two fats) by mixture of both (oil and ghee) for use in diabetes arising from mixture of dosas. 17b-19a.
Dhanvantara ghrta
द्विपुनर्नवम् ॥ १९ ॥ दशमूलशठीदन्तीसुराहं मूलं स्नुगर्कयोः पथ्यां भूकदम्बमरुष्करम् ।
करौ वरुणान्मूलं पिप्पल्याः पौष्करं च यत् ॥ २० ॥
पृथग् दशपलं प्रस्थान् यवकोलकुलत्थतः । त्रींश्चाष्टगुणिते तोये विपचेत्पादवर्तिना ॥ २१ ॥
तेन द्विपिप्पलीचव्यवचानिचुलरोहिषैः । साधयेत् ॥ २२ ॥
त्रिवृद्धिडङ्गकम्पिल्लभार्गीविश्वैश्च प्रस्थं घृताज्जयेत्सर्वांस्तन्मेहान् पिटिका विषम् ।
पाण्डुविद्रधिगुल्मार्श: शोषशोफगरोदरम् ॥ २३ ॥
श्वासं कासं वमिं वृद्धिं प्लीहानं वातशोणितम् । कुष्ठोन्मादावपस्मारं धान्वन्तरमिदं घृतम् ॥ २४ ॥
Ten pala each of dasamula, sathi, danti, surahva, punarnava, roots of snuk and arka, pathya, kadamba, aruskara, the two karanja, roots of varuna, pippali the two bhu and puskra, one prastha each of yava, kola, and kulattha-are boiled in eight times their quantity of water and decoction reduced to a quarter. To it are added the paste of the two pippali, cavya, vaca, nicula, rohisa, trivrt, vidanga, kampilla, bharngi and visva and one prastha of ghrta (ghee) and medicated ghee prepared. This formula known as Dhanvantara ghrta cures all varieties of diabetes, eruptions arising from them, poision, anaemia, abscess, abdominal tumour, haemorrhoids, consumption, dropsy, homicidal poison, enalargement of the abdomen, dyspnoea cough, vomitting, scrotal enlargement ( hernia), disease of the spleen, gout; leprosy, insanity and epilepsy. 19b-24.
Rodhrasava
रोध्रमुर्वाशठीवेल्लभार्गीनतनखप्लवान् कलिङ्गकुष्ठक्रमुकप्रियङग्वतिविषाग्निकान् द्वे विशाले चतुर्जातं भूनिम्बं कटुरोहिणीम् ।
यवानीं पौष्करं पाठां ग्रन्थिं चव्यं फलत्रयम् ॥ २६ ॥
कर्षांशमम्बुकलशे पादशेषे स्रुते हिमे । द्वौ प्रस्थौ माक्षिकात्क्षिप्त्वा रक्षेत्पक्षमुपेक्षया ॥ २७ ॥
रोध्रासवोऽयं मेहार्शः श्वित्रकुष्ठारुचिकृमीन् । ॥ २५ ॥
पाण्डुत्वं ग्रहणीदोषं स्थूलतां च नियच्छति ॥ २८ ॥
One karsa each of rodhra, murva, sathi, vella, bharngi, nata, nakha, plava, kalinga, kustha, kramuka, priyangu, ativisa, agnika, the two visala, caturjata, bhunimba, katuhorhini, yavani, puskaramula patha granthi cavya and phalatraya, are boiled in one kalasa (drona) of water and decoction reduced to a quarter, filtered, and cooled. To this is added two prastha of honey and kept undisturbed for a fortnight, this Rodhrasava cures diabetes, haemorrhoids, leucoderma, leprosy, anorexia, intestinal worms, anaemia, disorders of the duodenum and obesity. 25-28.
Ayaskrti
साधयेदसनादीनां पलानां विंशतिं पृथक् । द्विवहेऽपां क्षिपेत्तत्र पादस्थे द्वे शते गुडात् ॥ २९ ॥
क्षौद्राढकार्धं पलिकं वत्सकादिं च कल्कितम् । तत्क्षौद्रपिप्पलीचूर्णप्रदिग्धे घृतभाजने ॥ ३० ॥
स्थितं दृढे जतुसृते यवराशौ निधापयेत् । खदिराङ्गारतप्तानि बहुशोऽत्र निमज्जयेत् ॥ ३१ ॥
तनूनि तीक्ष्णलोहस्य पत्राण्यालोहसङ्क्षयात् ।
अयस्कृतिः स्थिता पीता पूर्वस्मादधिका गुणैः ॥ ३२ ॥
Twenty pala each of the drugs of asanadigana (vide chapter 15 of sutrasthana) are boiled in two vaha ( drona) of water, and decoction reduced to its quarter. Two hundred pala of guda (molasses) half adhaka of honey and paste of the drugs of vatsakadigana (vide chapter 15 sutrasthana), each one pala are added to it and poured into a pot smeared inside with ghee, honey and powder of pippali, the pot is then given a thick coating of jatu (lac) outside and placed inside a heap of yava (barley). Thin sheets of tiksna loha (magnetic iron) are made red hot with the embers of khadira wood and immersed in the liquid several times till the iron gets depleted completely in the liquid. (then the mouth of the pot is sealed and kept undisturbed for a fortnight). This formula known as Ayaskrti, consumed daily provides qualities (effects) greater than the previous one (rodhrasava). 29-32.
रूक्षमुद्वर्तनं गाढं व्यायामो निशि जागरः ।
यच्चान्यच्छेष्ममेदोघ्नं बहिरन्तश्च तद्धितम् ॥ ३३ ॥
Hard, dry massage, physical exercise, keeping awake at night and all such other activities both external and internal which mitigate slesman (kapha) and medas (fat) are beneficial (to a patient of diabetes). 33.
Silajatu rasayana
सुभावितां सारजलैस्तुलां पीत्वा शिलोद्भवात् । साराम्बुनैव भुञ्जानः शालीन् जाङ्गलजै रसैः ॥ ३४ ॥
सर्वानभिभवेन्मेहान् सुबहूपद्रवानपि । गण्डमालार्बुदग्रन्थिस्थौल्यकुष्ठ भगन्दरान् ॥ ३५ ॥
कृमिश्लीपदशोफांश्च परं चैतद्रसायनम् ।
One tula of silodbhava (Silajatu) is soaked and macerated well in the decoction of sara ( drugs of asanadigana). He who consumers this (daily in appropriate dose) and eats boiled rice with the same decoction and soup of meat of animals of desert-like regions, gets cured of all the varieties of diabetes; though having many complications/secondary disease and also scrofula, malignant tumour, benign tumour, obesity, leprosy ( and other skin disease), rectal fistula, worms filariasis and swelling (dropsy). It is a best rejuvinator also.
अधनश्छत्रपादत्ररहितो मुनिवर्तनः ॥ ३६ ॥
योजनानां शतं यायात्खनेद्वा सलिलाशयान् । गोशकृन्मूत्रवृत्तिर्वा गोभिरेव सह भ्रमेत् ॥ ३७ ॥
The patient of diabetes who has no money (to provide for this treatment) should go on walk (by foot) of one hundred yojana (800-900 miles approx.), without making use of an umbrella and foot-wear, adhering to the way of life of an ascetic (disciplined and hard life) or dig a reservoir of water by himself or wander along with a herd of cows substing on the dung, urine etc. of the cows. 36-37.
बृंहयेदौषधाहारैरमेदोमूत्रलैः कृशम् ।
The patient of diabetes who is emaciated should be stoutened/nourished well with drugs and foods which do not increase fat and urine. 38a.
Premeha pidaka chikitsa
शराविकाद्याः पिटिकाः शोफवत्समुपाचरेत् ॥ ३८ ॥ अपक्वा व्रणवत्पक्वाः
Saravika and other pitaka (diabetic eruptions) which are unripe should be treated just as a sopha (inflammatory oedema) and those which are ripe; just as treating an ulcer. 38b-39a.
तासां प्राग्रूप एव च।
क्षीरिवृक्षाम्बु पानाय बस्तमूत्रं च शस्यते ॥ ३९ ॥ तीक्ष्णं च शोधनं, प्रायो दुर्विरेच्या हि मेहिनः ।
In their prodromal stage itself, it is benficial to drink the decoction of bark of trees yielding milky sap and goat’s urine; resort to strong purificatory therapies since generally, patients of diabetes are hard in respect of purgation therapy.
तैलमेलादिना कुर्याद्गणेन व्रणरोपणम् ॥ ४० ॥
उद्वर्तने कषायं तु वर्गणारग्वधादिना । परिषेकोऽसनाद्येन पानान्ने वत्सकादिना ॥ ४१ ॥
Oil for healing the ulcers should be prepared from drugs of eladigana (chapter 15 of sutrasthana) decoction for massaging prepared from drugs of aragvadhadi gana (chapter 15 of sutrasthana), water for pouring over the body from drugs of asanadigana (chapter 15 of sutrasthana ), drinking water and food processed with drugs of vatsakadi gana (chapter 15 of sutrasthana).
पाठाचित्रकशाङ्गेष्टासारिवाकण्टकारिकाः । सप्ताहं कौटजं मूलं सोमवल्कं नृपद्रुमम् ॥ ४२ ॥
सञ्चूर्ण्य मधुना लिह्यात्तद्वच्चूर्णं नवायसम् ।
Patha, citraka, sarngesta, sariva, kantakarika, saptahva, root of kutaja, somavalka and nrpadruma, should be powdered nicely and licked with honey (daily). similarly Navayasana curna (chapter 16/14 of chikitsa sthana) may be licked. 42-43.
मधुमेहित्वमापन्नो भिषग्भिः परिवर्जितः ॥ ४३ ॥ शिलाजतुतुलामद्यात्प्रमेहार्तः पुनर्नवः ॥ ४३५ ॥
That patient of diabetes who has been rejected (refused treatment) by the physician, should consume one tula of silajatu in suitable daily doses to become a new man again.
इति श्री वैद्यपतिसिंहगुप्तसूनुश्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां चतुर्थे चिकित्सितस्थाने प्रमेहचिकित्सितं नाम
द्वादशोऽध्यायः ॥ १२ ॥
Thus ends the chapter Prameha chikitsa-the twelvth in chikitsa sthana of Astangahrdaya samhita, composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
