सप्तपञ्चाशत्तमोऽध्यायः अथातोऽरोचकप्रतिषेधमध्यायं व्याख्यास्यामः, धन्वन्तरिः ॥ १ ॥ यथोवाच भगवान्
Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of aversion to food (Arochaka Pratisedha). 1.
Etiology of Arochaka
दोषैः पृथक् सह च चित्तविपर्य्ययाच्च भक्तायनेषु हृदि चावतते प्रगाढम् । नान्ने रुचिर्भवति तं भिषजो विकारं भक्तोपघातमिह पञ्चविधं वदन्ति ॥ २ ॥
Etiology – The derangement of the Dosas either separately or combined or an apathetic state of the mind (through grief etc.) tends to block the food-carrying channels viz., the esophagus, etc., as well as the region of the heart causing aversion to all sorts of food, which is designated as Bhaktopaghata (lit. aversion to food-popularly known as Arochaka) by the physicans and it is divided into five distinct types (according to the different nature of its exciting factor). 2.
Arochaka Specific Symptoms
हृच्छूलपीडनयुतं विरसाननत्वं वातात्मके भवति लिङ्गमरोचके तु ॥ ३ ॥ हृद्दाहचोषबहुता मुखतिक्तता च मूर्च्छा सतृड् भवति पित्तकृते तथैव ॥ ४॥ कण्डूगुरुत्वकफसंत्रवसादतन्द्राः श्लेष्मात्मके मधुरमास्यमरोचके तु ॥५॥ सर्वात्मके पवनपित्तकफा बहूनि रुपाण्यथास्य हृदये समुदीरयन्ति ॥ ६ ॥ संरागशोकभयविप्लुतचेतसस्तु चिन्ताकृतो भवति सोऽशुचिदर्शनाच्च ॥ ७ ॥
Specific Symptoms – Pain and cramps at the heart and a vapid taste in the mouth are the symptoms which mark the Vataja type of Arochaka. Excessive burning sensation (in the region) of the heart, sucking pain (in the locality), a bitter taste in the mouth, thirst and fainting fits are the features which mark the Pittaja type of the disease. Itching sensation, heaviness of the body, water-brash, lassitude, drowsiness and a sweet taste in the mouth are the indications whch characterise the Kaphaja type. The Tri-dosaja type is characterised by a good many symptoms which severally mark the three Dosas. Indulgence in fear and grief, or the sight of any impure article, or of anything that tends to disturb the mental (Manasa) equilibrium, may also usher in an attack of Arochaka. 3-7.
Vataja Arochaka Treatment
कृष्णाविडङ्गयवभस्महरेणुभार्गीरास्नैलहिङ्गलवणोत्तमनागराणाम् ॥ ८ ॥ पित्ते गुडाम्बुमधुरैर्वमनं प्रशस्तं स्नेहः ससैन्धवसितामधुसर्पिरिष्टः॥ ९ ॥ निम्बाम्बुवामितवतः कफजेऽनुपानं राजद्रुमाम्बु मधुना तु सदीप्यकं स्यात् । चूर्णं यदुक्तमथवानिलजे तदेव सर्वेश्च सर्वकृतमेवमुपक्रमेत ॥ १०- ११॥
Treatment In the case of the Vataja type, the patient should be first made to vomit with the help of decoction of Vaca and then be given a pulverised compound of Krsna, Vidanga, Yava-Kshara, Harenu, Bhargi, Rasna Ela’, Hingu, Saindhava and Nagara through the medium of any Sneha or wine or hot water. Vomiting should be induced with emetics sweetened² with the solution of treacle in the Pittaja type of the disease. The use of a lambative prepared with Saindhava, Sita (sugar), honey and clarified butter would also be efficacious. In the Kaphaja type, vomiting should be induced with the decoction of Nimba and the powders of Yamani should then (after the taking of the meal) be administered with the decoction of Aragvadha mixed with honey. The pulverised compound mentioned in connection with the treatment of the Vataja type may also be administered (in this case). All the preceding measures should be employed in the Tri-dosaja type of Arochaka, 8-11.
1. Ela-Dalhana says that some take Ela in the sense of Ela-valuka (a part used for the whole). Sivadasa, however, refutes this and asserts, on the authority of Vagbhata, that “Ela” should mean Ela.
2. According to some, the emetic used should be Madana fruit; while, according to other, it should be the drugs of the Madhura (Kakolyadi) group- the word ‘Madhura’ indicating the same. Some, however, read ‘Madhuka’ (Yasti-madhu) for ‘Madhura’.
द्राक्षापटोलबिडवेत्रकरीरनिम्बमूर्वाभयाक्षबदरामलकेन्द्रवृक्षैः बीजैः करञ्जनृपवृक्षभवैश्च पिष्टैर्लेहं पचेत् सुरभिमूत्रयुतं यथावत् ॥ १२ ॥ मुस्तां वचां त्रिकटुकं रजनीद्वयञ्च भार्गीञ्च कुष्ठमथ निर्दहनीञ्च पिष्वा । मूत्रेऽविजे द्विरदमूत्रयुते पचेद् वा पाठां तुगामतिविषां रजनीञ्च मुख्याम् ॥ १३ ॥ मण्डूकिमर्कममृताञ्च सलाङ्गलाख्यां मूत्रे पचेत् तु महिषस्य विधानविद् वा । एतान् न सन्ति चतुरो लिहतस्तु लेहान् गुल्मारुचिश्वसनकण्ठहृदामयाश्च ॥ १४ ॥
Four Specific Lambatives — (1) Draksa, Patola, Vit-salt, Vetra, Karira (bamboo sprouts), Nimba, Murva, Abhaya, Aksa, Badara, Amalaka, (barks of) Kutaja and seeds of Karanja and of Aragvadha should be (powdered and) duly cooked with the urine of a cow in the form of a lambative. (2) A similar preparation should be made of Musta, Vaca, Tri-katu, the two kinds of Rajani, Bhargi, Kustha and Nirdahani and cooked with the urine of an ewe. (3) Similarly Patha. Vamsalocana,Ativisa and Rajani should be boiled together with the urine of a she-elephat. (4) Manduki, Arka, Amrta and Langala should be similarly boiled by an experienced and practical physician with the urine of a she-buffalo. Whoever licks up any 2 of the four preceding lambatives gets rid of Gulma, aversion to food, asthma and diseases affecting the heart and the larynx. 12-14.
Regimen of Diet in Arochaka
सात्म्यान् स्व ( स ) देशरचितान् विविधांश्च भक्ष्यान्पा नानि मूलफलषाडवरागयोगान् । अद्याद् रसांश्च विविधान विविधैः प्रकारै र्भुञ्जीत वाऽपि लघुरुक्षमनःसुखानि ॥ १५ ॥
Regimen of Diet – The patient should partake of fruits, edible roots, etc. which grow in his country and take cordials,— Sadavas Ragas and other palatable dishes which are congenial to his physical temperament and which he is accustomed to. He should also be made to take (articles of) different Rasas¹ in different ways and his food should be at the same time light, Ruksa and agreeabe to his taste. 15.
1. Nirdahani, according to some means Chitraka, but, according to others, it means Yamani. The former sense is the most general one.
2. According to Dalhana the four Lambatives should be used in cases of Vataja, Pittaja, Kaphaja and Tri-dosaja types of Arochaka respectively. 3. “Sadava”— It is prepared with a variety of articles of sweet, acid and saline tastes.
4. “Raga” — It is a preparation of a cordial with sugar, Souvarcala-salt, Saindhava, turmeric, Parusaka, black-berry and mustard, etc.
आस्थापनं विधिवदत्र विरेचनञ्च कुर्यान्मृदूनि शिरसश्च विरेचनानि । त्रीण्यूषणानि रजनीत्रिफलायुतानि चूर्णीकृतानि यवशूकविमिश्रितानि । क्षौद्रायुतानि वितरेन्मुखबोधनार्थमन्यानि तिक्तकटुकानि च भेषजानि ॥ १६ ॥
The due applications of Asthapana-Basti, purgatives and of light head-purgatves (errhines) are efficacious in the disease under discussion. The drugs known as Tryusana, Rajani (D.R. – the two kinds of Rajani) and Tri-phala pounded together and mixed with powdered Yava-Kshara and honey, should be used as a tooth-powder in washing the mouth. Any other drugs of bitter and pungent taste may be likewise prescribed for the purpose. 16.
मुस्तादि-राजतरुवर्गदशाङ्गसिद्धैः क्वाथैर्जयेन्मधुयुतैर्विविधैश्च लेहैः ॥ १७ ॥ मूत्रासवैर्गुडकृतैश्च तथा त्वरिष्टैः क्षारासवैश्व मधुमाधवतुल्यगन्धैः ॥ १८ ॥ स्यादेष एव कफवातहते विधिश्च शान्तिं गते हुतभुजि प्रशमाय तस्य ॥ १९ ॥
Use of Decoction, Arista and Asava—Decoctions of the drugs of the Mustadi and Aragvadhadi or Dasa-mula groups as well as the different lambatives with honey, the different Asavas prepared with any officinal urine and with treacle as well as the different Aristas and the different Asavas prepared from any Kshara and rsembling in scent, the wine prepared from honey, should be used in conquering an attack of Arochaka. The aforesaid measures should also be employed for the purpose of re-kindling the digestive fire (appetite) impaired through the action of deranged Vayu and Kapha. 17-19.
इच्छाभिघातभयशोकहतेऽन्तरग्रौ भावान् भवाय वितरेत् खलु शक्यरूपान् । अर्थेषु चाप्यपचितेषु पुनर्भवाय पौराणिकैः श्रुतिशतैरनुमानयेत् तम् । दैन्यं गते मनसि बोधनमत्र शस्तं यद्यत् प्रियं तदुपसेव्यमरोचके तु ॥ २० ॥ Treatment of Manasa Arochaka- In a case of impaired digestion due to the effects of any ungratified desire, fear, grief, etc., the lost longing for food should be restored in the patient by holding out to him the near prospect of its realisation and by consoling him with the prospects of fresh joy and safety. In a case due to the loss of a splendid fortune, the bitter apathy and loathsomeness of the patient towards taking any food should be removed by infusing fresh hopes into his heart and by narrating to him the balmy stories of the Puranas. A case due to dejection or despondency should be conquered by sincere sympathy and cheering up. In short any impairment of appetite due to any disturbed or agitated state of the mind should be remedied with discourses gratifying to the patient under the circumstances. 20.
1. Dalhana interprets “Rasa” by meat soap but we are inclined to take it in the sense of articles of different tastes (Rasa).
इति सुश्रुत संहितायामुत्तरतन्त्रे अरोचकप्रतिषेधव्याख्यानाम सप्तपञ्चाशत्तमोऽध्यायः ॥ ५७ ॥
Thus ends the fifty seventh chapter in the Uttara-Tantra of the Susruta Samhita which deals with the symptoms and treatment of Arochaka.