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ashtanga hridayaSHIROROGA Shirashoola PRATISEDHA - Treatment of diseases of the head - Ashtanga...

SHIROROGA Shirashoola PRATISEDHA – Treatment of diseases of the head – Ashtanga hridaya Chapter 24

अथातः शिरोरोगप्रतिषेधं व्याख्यास्यामः ।

इति ह स्माहुरात्रेयादयो महर्षयः । We shall now expound the chapter called Shiroroga pratisedha-treatment of diseases of the head; thus said Atreya and other great gages.

Vataja shirashoola chikitsa

शिरोभितापेऽनिलजे घृतमक्तशिरा रात्रौ माषान् कुलत्थान् मुद्गान् वा तद्वत्खादेद्धृतान्वितान् ।

तैलं तिलानां कल्कं वा क्षीरेण सह पाययेत् ॥ २ ॥

पिण्डोपनाहस्वेदाश्च मांसधान्यकृता हिताः । सेचनम् ॥ ३॥

वातघ्नदशमूलादि सिद्धक्षीरेण स्निग्धं नस्यं तथा धूमः शिरः श्रवणतर्पणम् । चरेत् । पिबेदुष्णपयोनुपः ॥ १ ॥ वातव्याधिविधिं

In Shirobhitapa caused by anila (vata) treatments advocated

for vatavyadhi (diseases caused by aggravated vata) should be adopted.

The head should be anointed and ghee should be consumed at night followed by drinking warm water. Masa, kulattha or mudga may be consumed, added with ghee, or oil or paste of tila may be consumed with milk, application of poultice or fomentation with balls of meat and corns (well cooked) are beneficial; pouring warm milk boiled with dasamula and other drugs mitigating vata should be done: lubricating nasal drops and inhalation recipes are also to be done. 1-4a.

वरणादौ गणे क्षुण्णे क्षीरमर्धोदकं पचेत् ॥ ४ ॥

क्षीरावशिष्टं तच्छीतं मथित्वा सारमाहरेत् । ततो मधुरकैः सिद्धं नस्य तत् पूजितं हविः ॥ ५ ॥

Drugs of varanadi gana (chapter 15 of sutrasthana) are boiled in milk added with half its quantity of water, till only milk remains. Then its essence (butter ) is taken out by churning and that butter is cooked with drugs of sweet taste. This ghee is ideal to be used for nasal medication. 4b-5.

वर्गेऽत्र पक्कं क्षीरे च पेयं सर्पिः सशर्करम् ।

Medicated ghee prepared with drugs of this group itself (varanadigana) added with milk and consumed along with sugar is beneficial. 6a.

कार्पासमज्जा त्वङ्मुस्ता सुमनः कोरकाणि च ॥ ६ ॥ सर्वमूर्धरुजापहम्। नस्यमुष्णाम्बुपिष्टानि

Karpasamajja, tvak, musta and buds sumana, macerated in hot water and instilled to the nose cures headaches of all types.

शर्कराकुङ्कुमशृतं घृतं पित्तासृगन्वये ॥ ७ ॥

प्रलेपः सघृतैः वातोद्रेकभाद्र कुष्ठकुटिलोत्पलचन्दनैः । चास्मिन्नवसेचयेत् ॥ ८ न

इत्यशान्तौ चले दाहः कफे चेष्टो यथोदितः।

In shirassula (caused by vata) associated with pitta and asra (blood) ghee boiled with a sarkara and kumkuma is beneficial. Application of paste of kustha, kutila, utpala and candana added with ghee is suitable. Blood letting should not be done in these kinds for the fear of aggravation of vata. If the disease does not subside by these, then burning by fire (thermal cautery) as prescribed for vata and kapha are desirable. 7b-9a.

Ardhavabheda chikitsa

अर्धावभेदकेऽप्येषा तथा दोषान्वयात्क्रिया ॥ ९ ॥

शिरीषाबीजापामार्गमूलं नस्यं बिडान्वितम् । स्थिरारसो वा, ले तु प्रपुन्नाटोऽम्लकल्कितः ॥ १०॥

Even for ardhavabheda the same treatment together with those relevent to the increased dosa should be done.

Seeds of sirisa root of apamarga added with bida should be used for nasal medication or the juice (or decoction) of sthira may be used; prapunnata macerated with any sour liquid should be applied over the head. Suryavarta chikitsa 9b-10.

सूर्यावर्तेऽपि तस्मिंस्तु सिरयाऽपहरेदसृक् ।

Even in suryavarta the same treaments should be done and blood should be let out from the veins. 1la.

Pitta shirashoola chikitsa

शिरोभितापे पित्तोत्थे स्निग्धस्य व्यधयेत्सिराम् ॥ ११ ॥ शीताः शिरोमुखालेपसेकशोधनबस्तयः । क्षीरसर्पिषी जीवनीयशृते पाननस्ययोः॥१२॥

In shirobhitapa caused by pitta, oleation be done and then venesection; cold applications on the face, bathing the head and purificatory enema therapies should be resorted to; milk and ghee boiled with drugs of jivaniya gana (chapter 15 of sutrasthana ) are suitable for internal consumption and nasal medication. 11b-12.

Raktaja shirashoola and Sankhaka chikitsa

कर्तव्यं रक्तजेऽप्येतत् प्रत्याख्याय च शङ्खके।

Even in shirassula caused by rakta (blood) the treatment is the same; so also in sankhaka, its incurability being intimated before commencing treatment. 13a.

Kaphaja shirashoola chikitsa

श्लेष्माभितापे जीर्णाज्यस्नेहितः कटुकैर्वमेत् ॥ १३ ॥ स्वेदप्रलेपनस्याद्या रूक्षतीक्ष्णोष्णभेषजैः । शस्तन्ते चोपवासोऽत्र

In shirobhitapa due to kapha, the patient should be given oleation therapy by drinking of old ghee and then administered emesis therapy using drugs of pungent taste; fomentation, external application of paste, nasal medication etc. by drugs having properities such as dry, penetrating and hot, and avoidance of food is ideal. 13-14a.

निचये मिश्रमाचरेत् ॥ १४ ॥

In that caused by all the dosas, combined treatment should be done. 14b.

Krimija shirashoola chikitsa

कृमिजे शोणितं नस्यं तेन मूर्च्छन्ति जन्तवः । मत्ताः शोणितगन्धेन निर्यान्ति घ्राणवक्त्रयोः ।। १५ ।।

सुतीक्ष्णनस्यधूमाभ्यां कुर्यान्निर्हरणं ततः ।

In sirssula caused by krmi (worm, bacteria) blood (of animals) should be put into the nose, the worms intoxicated by the smell of the blood come out of the nose and mouth, then they should be removed by strong nasal medication and inhalation of smoke. 15-16a.

विडङ्गस्वर्जिकादन्तीहिङ्गुगोमूत्रसाधितम् ॥१६॥ कटुनिम्बेङ्गुदीपीलुतैलं नस्यं पृथक् पृथक् ।

Katu taila, nimba taila, ingudi taila or pilu taila each seperately boiled with vidanga, svarjika, danti, hingu and gomutra (cow’ urine) should be used for nasal medication. 16b-17a.

अजामूत्रद्रुतं नस्यं कृमिजित् कृमिजित्परम् ॥ १७॥

Krimijit boiled in ajamutra ( goat ‘s urine ) and used as nasal drops is best to remove worms. 17b.

पूतिमत्स्ययुतैः कुर्याद् धूमं नावनभेषजैः । कृमिभिः पीतरक्तत्वाद्रक्तमत्र न निर्हरेत् ॥ १८ ॥

Smoke of bad smelling fish and drugs meant for nasal medication should be inhaled.

In this variety, blood should not be taken out since the worms will have consumed the blood. 18.

Shirahkampa chikitsa

वाताभितापविहितः कम्पे दाहाद्विना क्रमः ।

For sirahkampa, all treatment except burning by fire (thermal cautery) prescribed for sirobhitapa caused by vata should be adopted. 19a.

Upasirsaka chikitsa

नवे जन्मोत्तरं जाते योजयेदुपशीर्षके ॥ १९॥ वातव्याधिक्रियां, पक्के कर्म विद्रधिचोदितम् ।

In Upasirsaka which is new and developed after birth, treatments prescribed for vatavyadhi should be administered; after ripening, the treatments prescribed for vidradhi should be done. 19b-20a.

आमपक्के यथायोग्यं विद्रधीपिटिकार्बुदे ॥ २० ॥ In vidradhi, pitaka and arbuda appropriate treatments should be done determining their ama (unripe) or pakva ( ripe ) stages. 20b.

Arumsika chikitsa

अरुंषिका जलौकोभिर्हतास्त्रा निम्बवारिणा । सिक्ता प्रभूतलवणैर्लिम्पेदश्वशकृद्रसैः ॥ २१ ॥

पटोलनिम्बपत्रैर्वा सहरिद्रैः सुकल्कितैः । गोमूत्रजीर्णपिण्याककृकवाकुमलैरपि ॥ २२ ॥

In arumsika blood should be removed by using the leech, then washad with the decoction of nimba and covered with plenty of salt macerated in juice of fresh horse dung or with the paste patola; leaves of nimba and haridra with cow’s urine or old pinyaka (oil cake of tila) and excreta of krkavaku (cock) made with cow’s urine. 21-22.

कपालभृष्टं कुष्ठं वा चूर्णितं तैलसंयुतम् । रूंषिकालेपनं कण्डूक्लेददाहार्तिनाशनम् ॥ २३ ॥

Powder of kustha fried on a pan, mixed with oil and applied to arumsika cures itching, exudation, burning sensation and pain. 23.

मालती चित्रकाश्वघ्ननक्तमालप्रसाधितम् । चाचारूंषिकयोस्तैलमभ्यङ्गः क्षुरघृष्टयोः॥२४॥

Oil medicated with malati, citraka, asvaghna and naktamala is beneficial for anointing the head in caca ( indralupta) and arumsika, which have been scraped a razor.24.

If the disease does not subside, then attempts should be made to purify the haed by emesis and other therapies. 25a.

Darunaka chikitsa

विध्येच्छिरां दारुणके लालाट्यां, शीलयेन्मृजाम् ॥ २५ ॥

नावनं मूर्द्धबस्ति च लेपयेच्च समाक्षिकैः ।

प्रियालबीजमधुककुष्ठमाषैः लाक्षाशम्याकपत्रैडगजधात्रीफलैस्तथा कोरदूषतृणक्षारवारिप्रक्षालनं ससर्षपैः॥२६॥ । हितम् ॥ २७ ॥

In darunaka, the vein in the forehead should be cut, observe cleanliness, adopt nasal therapy and sirobasti (making oil to stand on the head for sometime-vide chapter 22 of sutrasthana), apply the paste of seeds of priyala; madhuka, kustha, masa and sarsapa added with honey; washing the head with water in which ash of reeds of koradusa is dissolved will be beneficial. 25b-27a.

Indralupta chikitsa

इन्द्रलुप्ते यथासन्नं सिरां विध्वा प्रलेपयेत् । प्रच्छाय गाढं कासीसमनोह्वातुत्थकोषणैः ॥ २८ ॥

वन्यामरतरुभ्यां वा गुञ्जामूलफलैस्तथा । तथा लाङ्गलिकामूलैः करवीररसेन वा ॥ २९ ॥

सक्षौद्रक्षुद्रवार्ताकस्वरसेन रसेन वा । धत्तूरकस्य पत्राणां भल्लातकरसेन वा ॥ ३० ॥ अथवा माक्षिकहविस्तिलपुष्पत्रिकण्टकैः ।

In Indralupta the vein nearest to the site should be cut, the patch should be scratched well and then covered with the paste of kasisa, manohva, tutthaka, usana or of vanya, amarataru; or root or fruits of gunja or root of langali or juice of karavira added with honey; or juice of ksudravartaka or of leaves of dhattura or juice of bhallataka added with honey; or of honey, ghee, flowers of tila and trikantaka. 28-31a.

तैलाक्ता हस्तिदन्तस्य मषी चाचौषधं परम् ॥ ३१ ॥

शुक्लरोमोद्गमे तद्वन्मषी मेषविषाणजा । वर्जयेद्वारिणा सेकं यावद्रोमसमुद्भवः ॥ ३२ ॥

Ash of tooth of an elephant mixed with oil and applied is the best medicine for indralupta. In case of white hair emerging the ash of horn of a ram used similarly is beneficial. pouring ( warm ) water on the head should be avoided till the hair grow. 31b-32.

Khalitya – Palitya chikitsa

खलतौ पलिते वल्यां हरिल्लोम्नि च शोधितम् । नस्यवक्त्रशिरोभ्यङ्गप्रदेहैः समुपाचरेत् ॥ ३३॥

In khalati, palita, vali (wrinkles on the scalp) and haritaloma (brown hair) prifactory therapies followed by nasal medication, anointing the face and head and application of paste of drugs should be resorted to. 33.

सिद्धं तैलं बृहत्याद्यर्जीवनीयैश्च नावनम् । मासं वा निम्बजं तैलं क्षीरभुङ्नावयेद्यतिः ॥ ३४ ॥

Medicated oil prepared with drugs of brhatyadi (hrsva pancamula) and jivaniya gana (chapter 15 of sutrasthana) should be used for nasal medication; or nimba taila be used as nasal medication, for one month; the patient should drink only milk and lead the life of an ascetic. 34.

नीलीशिरीषकोरण्टभृङ्गस्वरसभावितम् शेल्वक्षतिलरामाणां बीजं काकाण्डकीसमम् ॥ ३५ ॥ पिष्टाऽजपयसा लोहाल्लिप्तादर्कांशुतापितात् । तैलं स्त्र्तं क्षीरभुजो नावनात् पलितान्तकृत् ॥ ३६ ॥

Seeds of selu, vaksa, tila and rama, saoked and macerated in the juice of nili, sirisa, koranta and bhrnga and again with goat’s milk is taken in the quantity equal to kakandaka (egg of a crow) and pasted on an iron plate and exposed to sunlight. The oil that exudes from it used as nasal drops by the person who takes only milk as food; cures palita. 35-36.

क्षीरात्साहचराद् भृङ्गरजस: सौरसाद्रसात् । प्रस्थैस्तैलस्य कुडवः सिद्धो यष्टीपलान्वितः ॥ ३७ ॥

नस्यं शैलासने भाण्डे शृङ्गे मेषस्य वा स्थितः ।

Medicated oil prepared with one prastha each of milk, juice of sahacara, bhrngaraja and surasa, one kudava of oil, and one pala of yasti and preserved either in vessel of stone, or horn of a ram, should be used for nasal medication.

क्षीरेण श्लक्ष्णपिष्टौ वा दुग्धिकाकरवीरकौ ॥ ३८ ॥ उत्पाट्य पलितं देयावाशये पलितापहौ ।

Nice paste of dugdhika or karaviraka made with milk, applied to the scalp after plucking the grey hair cures palita.

क्षीरं प्रियालं यष्ट्याह्वं जीवनीयो गणस्तिलाः ॥ ३९ ॥ कृष्णा: प्रलेपो वक्त्रस्य हरिल्लोमवलीहितः ।

Paste of priyala, yastyahva, drugs of jivaniya gana (chapter 15 of sutrasthana) and krsna tila made into a paste with milk and applied on the face cures brown hair and wrinkles. 39b-40a.

तिला: सामलकाः पद्मकिञ्जल्को मधुकं मधु ॥ ४० ॥

बृंहयेद्रञ्जयेच्चैतत् केशान् केशान् मूर्द्धप्रलेपनात् ।

Paste made from tila, amalaka, padmakinjalka, madhuka and honey applied on the head nourishes the hair and gives them (black) colour. 40b-41a.

मांसी कुष्ठं तिलाः कृष्णाः सारिवा नीलमुत्पलम् ॥ ४१ ॥ क्षौद्रं च क्षीरपिष्टानि केशसंवर्धनं परम् ।

Mamsi, kustha, krsnatila, sariva and nilotpala made into a paste with milk added with honey and applied to the head is best to promote growth of hair. 41b-42a.

अयोरजो भृङ्गरजस्त्रिफला कृष्णमृत्तिका ॥ ४२ ॥ स्थितमिक्षुरसे मासं समूलं पलितं रजेत् ।

Ayoraja (iron filings), powder of bhrngaraja, triphala and krsnamrttika (black mud) kept soaked in sugarcane juice for one month, applied to the head cures palita (imparts black colour to the hair). 42b-43a.

माषकोद्रवधान्याम्लैर्यवागूस्त्रिदिनोषिता

लोहशुक्लोत्कटा पिष्टा बलाकामपि रञ्जयेत् । ॥ ४३॥

Yavagu (thick gruel) fermented for three days with the addition of masa kodrava and dhanyamla and made pre dominant with loha, suklotkata-imparts colour even to the crane (which is white). 43b-44a.

प्रपौण्डरीकमधुकपिप्पलीचन्दनोत्पलैः ॥ ४४ ॥

सिद्धं धात्रीरसे तैलं नस्येनाभ्यञ्जनेन च। सर्वान् मूर्धगदान् हन्ति पलितानि च शीलितम् ॥ ४५ ॥

Medicated oil prepared with prapaundarika, madhuka, pippali, candana and utpala and juice of dhatri, used for nasal medication and anointing daily cures all the diesases of the head and also palita. 44b-45.

वरीजीवन्तिनिर्यासपयोभिर्यमकं पचेत् ।

जीवनीयैश्च तन्नस्यं सर्वजत्रूर्ध्वरोगजित् ॥ ४६ ॥

Yamaka sneha ( two fats, oil and ghee) are cooked with vari, decoction of jivanti, milk and drugs of jivaniya gana (chapter 15 of sutrasthana); this used for nasal medication cures all the diseases arising above the shoulders. 46.

Mayura ghrita

मयूरं पक्षपित्तान्त्रपादवितुण्डवर्जितम् ।

दशमूलबलारास्त्रामधुकैस्त्रिपलैर्युतम् जले पक्त्वा घृतप्रस्थं तस्मिन् क्षीरसमं पचेत् ।

कल्कितैर्मधुरद्रव्यैः तदभ्यासीकृतं ॥४७॥ सर्वजत्रूर्ध्वरोगजित् ॥ ४८ ॥ पानबस्त्यभ्यञ्जननावनैः ।

Mayura (peacock) devoid of its feather, bile, intestines, legs, excreta and beak (only the flesh) is cooked along with three pala each of dasamula, bala, rasna and madhuka in water, one prstha of ghee and equal quantity of milk and paste of drugs of sweet taste are added and medicated ghee prepared. Consumed habitually in the form of internal potion, enema, anointing the body and nasal medication, it cures all the diseases of the parts above the shoulders.

Mahamayura ghrita

एतेनैव कषायेण घृतप्रस्थं विपाचयेत् ॥ ४९ ॥ चतुर्गुणेन पयसा कल्कैरेभिश्च कार्षिकैः ।

जीवन्तीत्रिफलामेदामृद्वीकर्द्धिषरूषकैः ॥५०॥

समङ्गाचविकाभार्गीकाश्मरीकर्कटाह्वयैः आत्मगुप्तामहामेदातालखर्जूरमस्तकः

मृणालबिसखर्जूरयष्टीमधुकजीवकैः ॥५१॥

शतावरीविदारीक्षुबृहतींसारिवायुगैः ॥ ५२ ॥

मूर्वाश्वदंष्टृर्षभकशृङ्गाटककसेरुकैः रास्त्रास्थिरातामलकीसूक्ष्मैलाशठिपौष्करैः ॥ ५३॥

पुनर्नवातवक्षीरीकाकोलीधन्वयासकैः । मधूकाक्षोटवाताममुञ्जाताभिषुकैरपि महामायूरमित्येतन्मायूरादधिकं

धात्विन्द्रियस्वरभ्रंशश्वासकासार्दितापहम् ॥५४॥ गुणैः । ॥५५॥ योन्यसृक्शुक्रदोषेषु शस्तं वन्ध्यासुतप्रदम् ।

From this dicoction itself (of peacock’s flesh etc.) one prastha of ghee should be cooked adding four times of milk and paste of one karsa each of jivanti, triphala, meda, mrdvika, the two parusaka, samanga, cavika, bharngi, kasmari karkatahvaya atmagupta mahameda talamastaka, kharjuramastak, mrnala, bisa; kharjura, yastimadhuka, jivaka, satavari vidari, iksu, brhati, the two sariva, murva, svadamstra, rsabhaka, Srngataka, kaseruka, rasna, sthira, tamalaki, suksamaila sathi, pauskara, tavaksiri, kakoli, dhanvayasaka, madhuka, aksota, vatama, munjata and abhisuka. This known Mahamayura ghrta is more effective than mayuraghrta, cures loss of tissues, sense organs and voice, dyspnoea, cough, facial palsy, best in diseases of the vaginal tract, menstrual blood, semen and bestows sons to the barren women. 49b-56a.

जत्रूर्ध्वजानां परस्परमसङ्कीर्णं आखुभिः कुक्कुटैर्हसैः शशैश्चेति प्रकल्पयेत् ॥ ५६ ॥

This kind of medicated ghee may be prepared from (meat of) the mouse, cock, swan or rabbit. 56b.

व्याधीनामेकत्रिंशच्छतद्वयम् । विस्तरेण प्रकाशितम् ॥५७ ॥

Thus were described in detail two hundred thirtyone diseases, not mixed with one another, affacting the parts of the body above the shoulders. 57.

Notes This total number is formed in the following mannerNetraroga (diseases of the eyes ) 94, karnaroga ( diseases of the ears) 25, nasaroga ( diseases of the nose) 18, mukha roga ( diseases of the mouth etc.) 75, siroroga ( diseases of the head) 19. total 231.

ऊर्ध्वमूलमधःशाखमृषयः पुरुषं विदुः । मूलप्रहारिणस्तस्माद् रोगान् शीघ्रतरं जयेत् ॥ ५८ ॥

The sages describe the human being as “having the roots on the top and branches below” so by striking at the roots the diseases can be cured very quick. 58.

सर्वेन्द्रियाणि येनास्मिन् प्राणा येन च संश्रिताः ।

तेन तस्योत्तमाङ्गस्य रक्षायामादृतो भवेत् ॥ ५९ ॥ That in which all the sense organs are located, that in which prana ( life ) resides, such a chief organ, the head — should be protected with great effort. 59.

इति श्रीवैद्यपतिसिंहगुप्तसूनुश्रीमद्वाग्भटविरचितायामष्टाङ्गहृदय संहितायां

षष्ठे उत्तरस्थाने शिरोरोगप्रतिषेधो नाम चतुर्विंशोऽध्यायः ॥ २४ ॥

Thus ends the chapter Siro roga pratisedha-the twenty fourth in Uttarasthana of Astanga hrdaya samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.

इति शालाक्यं नाम चतुर्थमूर्ध्वाङ्गमङ्गं सम्पूर्णम् ।

Thus ends Urdhvanga chikitsa (Salakyatantra-treatment of diseases of organs above the shoulders) the fourth branch of Ayurveda.

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