अथातोऽतीसारचिकित्सितं व्याख्यास्यामः ।
महर्षयः । इति ह स्माहुरात्रेयादयो
We shall now expound the chapter-Atisara chikitsa – treatment of diarrhoea; thus said Atreya and other great sages.
अतीसारो हि भूयिष्ठं भवत्यामाशयान्वयः।
हत्वाऽग्निं वातजेऽप्यस्मात्प्राक् तस्मिल्लङ्घनं हितम् ॥ १ ॥
Atisara (diarrhoea) is born especially from the amasaya (stomach) destroying the digestive fire, hence langhana ( fasting ) is ideal at the commencement (of the disease) even in that kind arising from vata ( as well as in others). 1.
शूलानाहप्रसेकार्तं
वामयेदतिसारिणम् ।
The patient of diarrhoea, who is suffering from pain in the abdomen, flatulence and excess of salivation should be made to vomit ( by using drugs). 2a.
Amatisara ciktisa
दोषाः सन्निचिता ये च विदग्धाहारमूच्छिताः ॥ २ ॥
अतीसाराय कल्पन्ते तेषूपेक्षैव भेषजम् । भृशोत्क्लेशप्रवृत्तेषु स्वयमेव चलात्मसु ॥ ३ ॥
न तु सग्रहणं योज्यं पूर्वमामातिसारिणि ।
Doshas which have increased greatly and associated ama (improperly digested food) make for the onset of rhoea, hence when the increased dosas are moving out the body by their own accord (by purgations and vomittingsthen the treatment is to neglect them (allow to go out).
The pateint of amatisara (diarrhoea when the dosas are not cooked/transformed by heat / and more in quantity) sangrahana (drugs or therapies which stop the purgations) should not be administered at the commencement. 2b-4a.
अपि चाध्मानगुरुताशूलस्तैमित्यकारिणि ॥ ४ ॥
प्राणदा प्राणदा दोषे विबद्धे सम्प्रवर्तिनी ।
अथवा पिबेत्प्रक्वथितास्तोये मध्यदोषो विशोषयन् ॥ ५ ॥
भूतीकपिप्पलीशुण्ठीवचाधान्यहरीतकीः बिल्वधनिकामुस्तनागरवालकम् ॥ ६ ॥
बिडपाठावचापथ्याकृमिजिन्नागराणि शुण्ठीघनवचामाद्रीबिल्ववत्सकहिङ्गु वा ॥७॥ वा ।
When the dosas have given rise to flatulence, heaviness, pain and loss of movement of the abdomen, then (the use of) pranada (haritaki), restore life, by clearing out the obstructed dosas, effectively. Increase of ) dosas, The patient who has moderate should abstain from (heavy) foods and drink the decoction prepared from the (paste of ) either of bhutika, pippali, sunthi, vaca, dhanya and haritaki; or of bilva, dhanika, musta, nagara, and valaka; or of bida, patha, vaca, pathya, krimijit and nagara or of sunthi, ghana, vaca, madri, bilva, vatsaka and hingu. 5b-7.
शस्यते त्वल्पदोषाणामुपवासोऽतिसारिणाम् ।
When the dosas are slightly increased, fasting is best for patients of diarrhoea. 8a.
वचाप्रतिविषाभ्यां वा मुस्तापर्पटकेन वा ॥ ८ ॥ हीबेरनागराभ्यां वा विपक्कं पाययेज्जलम् ।
Water well cooked with either vaca and prativisa, musta and parpata or hribera and nagara should be given (in plenty) to drink. 8b-9a.
युक्तेऽन्नकाले क्षुत्क्षामं लघ्वन्नंप्रति भोजयेत् ॥ ९ ॥ तथा स शीघ्रं प्राप्नोति रुचिमग्निबलं बलम् ।
When he feels weak by hunger, he should be given light foods, in little quantity, at the proper time; that undergoes digestion quickly and bestows taste, the strength of digestive fire and of the body. 9b-10a.
तक्रेणावन्तिसोमेन यवाग्वा तर्पणेन वा ॥ १० ॥ सुरया मधुना वाऽथ यथासात्म्यमुपाचरेत् ।
He should be served either takra (buttermilk), avantiisoma (sour gruel), yavagu (thin gruel), tarpana (paste of flour added with ghee, sugar, milk etc. ) , sura (beer) or madhu (fermented liquor prepared from honey) whichever is accustomed to. 10b-11a.
भोज्यानि कल्पयेदूर्ध्वं ग्राहिदीपनपाचनैः ॥ ११ ॥ ।
बालबिल्वशठीधान्यहिङ्गवृक्षाम्लदाडिमैः पलाशहपुषाजाजीयवानीबिडसैन्धवैः ॥१२॥
लघुना पञ्चमूलेन पञ्चकोलेन पाठया ।
Next, foods processed with possessing grahi (water absorbing), dipana (carminative) and pacana (digestive) properties such as tender fruits of bilva, sathi, dhanya, hingu, vrksamla and dadima; or of palasa, hapusa, ajaji, yavani, bida and saindhava; or laghu pancamula; or of pancakola and patha should be given. 11b-13a.
शालिपर्णोबलाबिल्वैः पृश्निपर्ण्या च साधिता ॥ १३ ॥
दाडिमाम्ला हिता पेया कफपित्ते समुल्बणे । अभयापिप्पलीमूलबिल्वैर्वातानुलोमनी ॥१४॥
Peya (thin gruel) processed with either saliparni, bala, bilva, prsni parni and dadimamla (juice of sour dadima), is beneficial when kapha and pitta are greatly increased that (peya) processed with abhaya, pippalimula and bilva is a laxative. 13b-14.
विबद्धं दोषबहुलो दीप्ताग्निर्योऽतिसार्यते । कृष्णाविडङ्गत्रिफलाकषायैस्तं विरेचयेत् ॥ १५ ॥
पेयां युञ्ज्याद्विरिक्तस्य वातघ्नैर्दीपनैः कृताम् ।
He, who has great increase of dosas, keen digestive fire, and eliminate hard faeces in small quantities often should be administered the decoction of krsna, vidanga and triphala to produce purgations; after such purgation he should be given peya (thin gruel) processed with drugs mitiating vata and increasing hunger. 15-16a.
Pakvatisara chikitsa
आमे परिणते यस्तु दीप्तेऽग्नावुपवेश्यते ॥ १६ ॥
सफेनपिच्छं सरुजं सविबन्धं पुनः पुनः । अल्पाल्पमल्पशभलं निर्विड् वा सप्रवाहिकम् ॥ १७ ॥
दधितैलघृतक्षीरैः स शुण्ठीं सगुडां पिबेत् ।
स्विन्नानि गुडतैलेन भक्षयेद्वदराणि गाढविड्विहितैः शाकैर्बहुस्नेहैस्तथा रसैः । क्षुधितं दधिदाडिमसाधितैः ।। १९ ।।
भक्षयेद्वदराणि वा ॥ १८ ॥
भोजयेदेनं शाल्योदनं तिलैर्माषैर्मुद्गैर्वा साधु साधितम् । शठ्या मूलकपोतायाः पाठायाः स्वस्तिकस्य वा ॥ २० ॥
सूषायवानीकर्कारुक्षीरिणीचिर्भटस्य वा । उपोदकाया जीवन्त्या बाकुच्या वास्तुकस्य वा ॥ २१ ॥
सुवर्चलायाश्चञ्चोर्वा लोणिकाया कूर्मवर्तकलोपाकशिखितित्तिरिकौक्कुटैः रसैरपि । ॥ २२ ॥
When the ama (undigested food and dosas) has been well digested, digestive activity is keen, the patient eliminating faeces mixed with froth and slimy materials accomanied with pain and obstruction, again and again in little quantities, with little faecal matter or without it and with straining at stools (tenesmus ) he should drink either curds, oil, ghee or milk containing sunthi, and guda, or eat badara fruits steam cooked and mixed with guda and taila.
When he develops hunger, he should be given sali rice mess to eat, along with soup of vegetables, beneficial for relieving hard faeces mixed with more of fats (oil, ghee) well processed either with dadhi and dadima or with tila masa and mudga or with sathi, mulakapota, patha, and svastika; or with susa, yavani, karkaru, ksirini, and cirbhata; or with upodaka, jivanti, bakuci, and vastuka; or with suvarcala, cancu, and lonika or with soup of meat of the kurma (tortoise), vartaka ( quail), lopaka (jackal), sikhi (peacock), tittiri (partridge) or kukkuta (fowl). 16b-22.
बिल्वमुस्ताक्षिभैषज्यधातकीपुष्पनागरैः पक्कातीसारजित्तक्रे यवागूर्दाधिकी तथा ॥ २३ ॥
कपित्थकच्छुराफञ्जीयूथिकावटशेलुजैः दाडिमीशणकार्पासीशाल्मलीनां च पल्लवैः ॥ २४ ॥
Yavagu (gruel) prepared with dadhi or takra processed with bilva, musta, aksibhaisajya (rodhra), dhatakipuspa and nagara cures pakvatisara (diarrhoea in which the dosas have been ripened / transformed by heat / decreased); so also that (yavagu) prepared with tender leaves of kapittha, kacchura, phanji yuthika, vata, seluja, dadima, sana, karpasi and Salmali. 23-24.
Pravahika chikitsa – treatment of dysentery
कल्को बिल्वशलाटूनां तिलकल्कश्च तत्समः ।
दध्रः सरोऽम्लः सस्नेहः खलो हन्ति प्रवाहिकम् ॥ २५ ॥
Khala (buttermilk boiled with spices) added with paste of bilva salatu (tender fruits) and equal quantity of paste of tila, mixed with water of dadhi (curds) which is sour and fat ( oil or gruel) cures pravahika ( dysentery). 25.
Aparajita khala
मरिचं धनिकाऽजाजी तिन्तिडीकं शठी विडम् । दाडिमं धातकी पाठा त्रिफला पञ्चकोलकम् ॥ २६ ॥
यावशूकं कपित्थाम्रजम्बूमध्यं सदीप्यकम् | पिष्टैः षड्गुणबिल्वैस्तैर्दनि मुद्गरसे गुडे ॥२७॥
स्नेहे च यमके सिद्धः खलोऽयमपराजितः ।
दीपन: पाचनो ग्राही रुच्यो विम्बिशिनाशनः ॥ २८ ॥
Khala prepared with the paste of (equal quantities of) marica, dhanika, ajaji, tintidika, sathi, bida, dadima, dhataki, patha, triphala, pancakola, yavasuka, kapittha, seed kernel of amra and jambu phala and dipyaka (all these forming one part) along with the paste of bilva-six times in quantity of the above paste, mixed with dadhi, soup of mudga, guda and yamaka-sneha ( two fats, oil and ghee ), is prepared into khala; this known as Aparajita khala is carminative, digestive, water-absorbent, enhances taste and cures bimbisi (dysen
tery). 26-28.
कोलानां बालबिल्वानां कल्कैः शालियवस्य च । मुद्द्रमाषतिलानां च धान्ययूषं प्रकल्पयेत् ॥ २९ ॥
ऐकध्यं यमके भृष्टं दधिदाडिमसारिकम् । वर्च: क्षये शुष्कमुखं शाल्यन्नं तेन भोजयेत् ॥ ३० ॥
दध्रः सरं वा यमके भ्रष्टं सगुडनागरम् । सुरां वा यमके भृष्टां व्यञ्जनार्थं प्रयोजयेत् ॥ ३१ ॥
फलाम्लं यमके भृष्टं यूषं गृञ्जनकस्य वा। भृष्टान्वा यमके सक्तून् खादेह्योषावचूर्णितान् ॥ ३२ ॥
माषान् सुसिद्धांस्तद्वद्वा घृतमण्डोपसेवनान् । रसं सुसिद्धपूतं वा छागभेषान्तराधिजम् ॥ ३३ ॥
पचेद्दाडिमसाराम्लं सधान्यस्त्रेहनागरम् । रक्तशाल्योदनं तेन भुञ्जानः प्रपिबंश्च तम् ॥ ३४ ॥
वर्च:क्षयकृतैराशु विकारैः परिमुच्यते ।
In varcaksaya (loss/depletion of faeces) and dryness of the mouth, porridge of sali rice should be consumed with dhanya yusa (soup of pulses ) processed with paste of kola, bala bilva, sali, yava, mudga, masa and tila, any one seperately fried in yamaka (two fats) mixed with dadhi, and dadima; essence of dadhi, fried with two fats and mixed with guda and nagara or sura, fried in two fats may be given as condiment/souces; or sour fruits fried in two fats or soup of grnjanaka, fried in two fats or saktu (flour of corn) fried in two fats mixed with powder of vyosa should be consumed; or masa prepared similarly mixed with fluid of ghee should be consumed.
Juice (soup) of intestines of goat or sheep well prepared, filtered, mixed with juice of sour dadima, dhanya (ka), fats and nagara should be consumed along with mess of red rice and even drunk in more quantity; by these the person gets relieved quickly of all disorders caused by loss of faeces.
बालबिल्वं गुडं तैलं पिप्पलीं विश्वभेषजम् ॥ ३५ ॥
लिह्याद्वाते प्रतिहते सशूल: सप्रवाहिकः । वल्कलं शावरं पुष्पं धातक्या बदरीदलम् ॥ ३६॥
पिबेद्दधिसरक्षौद्रकपित्थस्वरसाप्लुतम् ।
In case of obstruction of vata (flatus) associated with pain and straining at stools (tenesmus) the patient should lick the (paste of ) balabilva, guda, taila, pippali and visvabhesaja.
Bark of Sabara, flowers of dhataki, leaves of badari, mixed with dadhisara, ksaudra and fresh juice of kapittha should be consumed. 35b-37a.
विबद्धवातवर्चास्तु बहुशूलप्रवाहिकः ॥ ३७॥
सरक्तपिच्छस्तृष्णार्तः क्षीरसौहित्यमर्हति । यमकस्योपरि क्षीरं धारोष्णं वा प्रयोजयेत् ॥ ३८ ॥
शृतमेरण्डमूलेन बालबिल्वेन वा पुनः ।
He who has obstruction to vata (flatus) and varca (faeces), severe pain, staining at stools, faeces mixed with blood slimy material, and is suffering from thirst, deserves comfort by milk (should drink more quantity of milk) or he shoud drink warm milk ( direct from the udder) after drinking a mixture of two-fats or drink milk boiled with roots of eranda or bala-bilva often. 37b-39a.
पयस्युत्क्वाथ्य मुस्तानां विंशतिं त्रिगुणेऽम्भसि ॥ ३९ क्षीरावशिष्टं तत्पीतं हन्यादामं सवेदनम् ।॥
One part of milk, twenty ( pala) of musta and three parts of water are mixed, boiled and reduced to the quantity of milk. This consumed cures ama ( raw unripe / unprocessed faeces) associated with pain. 39b-40a.
पिप्पल्याः पिबत: सूक्ष्मं रजो मरिचजन्म वा ॥ ४० ॥ चिरकालानुषक्ताऽपि नश्यत्याशु प्रवाहिका ।
Powder of pippali or marica consumed (with water) cures pravahika (dysentery) though persisting for a long time. 40b-41a.
निरामरूपं शूलार्तं लङ्घनाद्यैश्च कर्षितम् ॥ ४१ ॥ रूक्षकोष्ठमपेक्ष्याग्निं सक्षारं पाययेद् घृतम् ।
He who has developed symptoms of absence of ama suffers from pain, emaciated / debilitated by fasting etc., has dryness of the alimentary tract should be given ghrta (ghee) mixed with ksara (alkalies) to drink after considering the strength of his digestive fire. 41b-42a.
सिद्धं दधिसुरामण्डे दशमूलस्य चाम्भसि ॥ ४२ ॥ सिन्धूत्थपञ्चकोलाभ्यां तैलं सद्योर्तिनाशनम् ।
Medicated oil prepared with dadhi and scum of sura, decoction of dasamula and paste of sindhuttha (saindhava) and pancakola relieves the pain immediately. 42b-43a.
षड्भि: शुण्ठ्या पलैर्द्वाभ्यां द्वाभ्यां ग्रन्थ्यग्निसैन्धवात् ॥ ४३ ॥
तैलप्रस्थं पचेद्दवा निःसारकरुजापहम् ।
Medicated oil prepared with six pala of sunthi, two pala each of granthi (pippalimula), agni (citraka) and saindhava, one prastha of taila (oil of sesame) and dadhi (curds) relieves the pain of nihsaraka (dysentery). 43b-44a.
एकतो मांसदुग्धाज्यं पुरीषग्रहशूलजित् ॥४४॥
पानानुवासनाभ्यङ्गप्रयुक्तं तैलमेकतः । तद्धि वातजितामग्रयं शूलं च विगुणोऽनिलः ॥ ४५ ॥
On the one hand, the use of meat, milk and ghee in the form of drink, lubricating enema and massage on the body cures obstruction of faeces and pain, while on the other taila (medicated oil) alone does so when used in the same manner; because it (oil) is the cheif among those which mitigate vata and pain is chiefly due to abnormality of vata. 44b-45.
धात्वन्तरोपमर्देद्धश्चलो व्यापी स्वधामगः |
तैलं मन्दानलस्यापि युक्त्या शर्मकरं परम् ॥ ४६ ॥ वाय्वाशये सतैले हि बिम्बिसी नावतिष्ठते ।
Cala (vata) aggravated by the disorders of the other dhatus (dosas, pitta and kapha) though spreading all over the body, move especially towards its own residence (pakvasaya) (large intestine); when the residence of vayu (vata) is having taila (medicated oil administered orally or rectally) then bimbisi ( dysentery ) does not stay there at all. 46-47a.
क्षीणे मले स्वायतनच्युतेषु दोषान्तरेष्वीरण एकवीरे । को निष्टनन्प्राणिति कोष्ठशूली नान्तर्बहिस्तैलपरो यदि स्यात् ॥ ४७ ॥
When there is loss/depletion of faeces, the other dosas ( pitta and kapha) getting displaced from their own/respective channels cause aggravation of vata, which becomes the sole leader; which patient of diarrhoea, having straining at stools and pain in the abdomen survives, if he is not devoted to (the use of ) taila (medicated oil) both internally and externally? 47b.
Gudabhramsa chikitsa – treatment of prolapse of the rectum
गुदरुग्भ्रंशयोर्युञ्यात्क्षीरं साधितं हविः ॥ ४८ ॥ रसे कोलाम्लचाङ्गेर्दनि पिष्टे च नागरे ।
When there is pain and prolapse of the rectum, medicated ghee prepared with milk, ghee, juice of kolamla, and cangeri, dadhi, and paste of nagara should be administered.
तैरेव चाम्लैः संयोज्य सिद्धं सुश्लक्ष्णकल्कितैः ॥ ४९ ॥ धान्योषणबिडाजाजीपञ्चकोलकदाडिमै: ।
Medicated ghee prepared with the same sours (kolamla cangeri and dadhi ) and nice paste of dhanya, usana, bida, ajaji, pancakola and dadima (may also be administered).
योजयेत्स्नेहबस्तिं वा दशमूलेन साधितम् ॥ ५० ॥ शठीशताह्वाकुष्ठैर्वा वचया चित्रकेण वा । 49b-50a.
Oil-enema should be given with oil processed with either dasamula, or sathi, satahva and kustha; or vaca and citraka. 50b-51a.
प्रवाहणे गुदभ्रंशे मूत्राघाते कटिग्रहे ॥ ५१ ॥ मधुराम्लैः शृतं तैलं घृतं वाऽप्यनुवासनम् ।
When there is straining at stools, polapse of the rectum, retention of urine and catching pain in the waist, a lubricating enema with either oil or ghee boiled with drugs of sweet and sour tastes should be administered. 51b-52a.
प्रवेशयेद्गुदं ध्वस्तमभ्यक्तं स्वेदितं मृदु ॥ ५२ ॥ कुर्याच्च गोः फणाबन्धं मध्यच्छिद्रेण चर्मणा ।
The prolapsed rectum should be anointed with fats, fomented mildly, pushed inside, and a gophana bandha (“T” bandage) applied using leather strap having a hole in the centre). 52b-53a.
Unduru – musaka taila
पञ्चमूलस्य महतः काथं क्षीरे विपाचयेत् ॥ ५३ ॥ उन्दुरुं चान्त्ररहितं तेन वातघ्नकल्कवत् ।
तैलं पचेद्गुदभ्रंशं पानाभ्यङ्गेन तज्जयेत् ॥ ५४ ॥
Medicated oil is prepared with the decoction of mahat pancamula, ksira and unduru (rats) devoid of their intestines and paste of drugs which mitigate vata. Used both for drinking and nointing (the rectum), this cures rectal prolapse.
Pittatisara chikitsa
पैत्ते तु सामे तीक्ष्णोष्णवर्ज्यं प्रागिव लङ्घनम्। तृडवान् पिबेत् षडङ्गाम्बु सभूनिम्बं ससारिवम् ॥ ५५ ॥
पेयादि क्षुधितस्यान्नमग्निसन्धुक्षणं हितम् । बृहत्यादिगणाभीरुद्विबलाशूर्पपर्णिभिः ॥५६॥
In diarrhoea arising from pitta and having ama, penetrating and hot things (foods, drugs etc.) should be avoided and fasting resorted to, in the beginning itself.
If thirsty, he should drink sadanga paniya (chapter 1 of chikitsasthana) added with bhunimba and sariva, when hungry, it is beneficial to consume foods such as peya (gruel) etc. processed with drugs of brihatyadigana (vide chapter 15 of sutrasthana), abhiru, the two bala and two surpaparni, which kindle the digestive fire. 55-56.
पाययेदनुबन्धे तु सक्षौद्रं तण्डुलाम्भसा | कुटजस्य फलं पिष्टं सवल्कं सघुणप्रियम् ॥ ५७ ॥
पाठावत्सकबीजत्वग्दावग्रन्थिकशुण्ठि वा । क्वाथं वाऽतिविषाबिल्ववत्सकोदीच्यमुस्तजम् ॥ ५८ ॥
अथवाऽतिविषामूर्वानिशेन्द्रयवतार्क्ष्यजम् समध्वतिविषाशुण्ठीमुस्तेन्द्रयवकट्फलम् । ॥५९॥
Still, if diarrhoea persists, rice-wash mixed with either a paste of fruit and bark of kutaja and ghunapriya or of patha, vatsakabija, darvitvak, granthika and sunthi, should be given to drink; or a decoction of ativisa, bilva, vatsaka, udicya and musta; or of ativisa, murva, nisa, indrayava and tarksya; or of ativisa, sunthi, musta, indrayava and katphala mixed with honey. 57-59.
पलं वत्सकबीजस्य श्रपयित्वा रसं पिबेत् ।
यो रसाशी जयेच्छीघ्रं स पैत्तं जठरामयम् ॥ ६० ॥
मुस्ताकषायमेवं वा पिबेन्मधुसमायुतम् । सक्षौद्रं शाल्मलीवृन्तकषायं वा हिमाह्वयम् ॥ ६१ ॥
One pala of vatsaka bija is boiled in water and consumed by the person who partakes meat-soup ( as food) quickly gets cured of disease of the stomach (diarrhoea) of pitta origin; similarly either the decoction of musta mixed with equal quantity of honey or the cold infusion of salmali vrnta mixed with honey can be made use of. 60-61.
किराततिक्तकं मुस्तं वत्सकं सरसाञ्जनम् । कटङ्कटेरी हीबेरं बिल्वमध्यं दुरालभा ॥ ६२ ॥
तिला मोचरसं रोधं समङ्गा कमलोत्पलम् । नागरं धातकीपुष्प दाडिमस्य त्वगुत्पलम् ॥ ६३ ॥
अर्धश्लोकैः स्मृता योगा: सक्षौद्रास्तण्डुलाम्बुना।
The powder of drugs mentioned in each of the following half verses consumed along with rice wash are beneficial
1. Kiratatika, musta, vatsaka and rasanjana,
2. Katankateri, hribera, bilva madhya and duralabha,
3. tila, mocarasa, rodhra, samanga, kamala and utpala,
4. nagara dhatakipuspa, dadima tvak and utpala. 62-64a.
निशेन्द्रयवरोधैलाक्काथ: पक्वातिसारजित् ॥ ६४॥
रोध्राम्बष्ठाप्रियङ्ग्वादिगणांस्तद्वत्
पृथक् पिबेत् ।
Decoction of nisa, indrayava, rodhra and ela cures pakvatisara; similarly the decoction of drugs of rodhradigana, ambasthadigana and priyarngvadi gana ( chapter 15 of sutrasthana) seperately may be consumed. 64b-65a.
कट्वङ्गवल्कयष्ट्याह्वफलिनीदाडिमाङ्कुरैः पेयाविलेपीखलकान् कुर्यात्सदधिदाडिमान् ।
तद्वद्दधित्थबिल्वाम्रजम्बुमध्यैः ॥६५॥ प्रकल्पयेत् ॥ ६६ ॥
Peya, vilepi, and khala ( all these are liquids foods) prepared with bark of katvanga, yasthyahva, phalini, and tender sprouts of dadima mixed with dadhi and juice of dadima is beneficial. Similarly those prepared with kernel of dadhittha, bilva, amra and jambu. 65b-66.
अजापयः प्रयोक्तव्यं निरामे, तेन चेच्छमः ।
दोषाधिक्यान्न जायेत बलिनं तं विरेचयेत् ॥ ६७ ॥
When there is ama, goat’s milk should be administered, if it does not subside because of great increase of the dosas and if the person is strong, he should be given a purgative therapy. 67.
व्यत्यासेन शकृद्रक्तमुपवेश्येत् योऽपि वा । पलाशफलनिर्यूहं युक्तं वा पयसा पिबेत् ॥ ६८ ॥
ततोऽनु कोष्णं पातव्यं क्षीरमेव यथाबलम् । प्रवाहिते तेन मले प्रशाम्यत्युदरामयः ॥ ६९ ॥
He who is eliminating faeces and blood alternately should drink milk along with decoction of fruits of palasa followed by drinking warm milk only (as food) depending on his capability. By this straining at the stools subsides and the disease of the stomach gets relieved. 68-69.
पलाशवत्प्रयोज्या वा त्रायमाणा विशोधिनी ।
Similarly the use of trayamana in the same way as palasa acts as a purifier (purgative).
संसर्ग्या क्रियमाणायां शूलं यद्यनुवर्तते ॥ ७० ॥
स्रुतदोषस्य तं शीघ्रं यथावह्व्यनुवासयेत् । शतपुष्पावरीभ्यां च बिल्वेन मधुकेन च ॥ ७१ ॥
तैलपादं पयोयुक्तं पक्कमन्वासनं घृतम् ।
During the course of samsarjana kriya (regimen of liquid foods such as peya, vilepi etc. ) if the pain in the abdomen persists, due to over-elimination of the dosas, then the patient should be given anuvasana (oil-enema therapy) depending on the strength of the digestive fire. Medicated ghee prepared with satapuspa, vari, bilva and madhuka, taila one quarter, along with milk is best for anuvasana (fat enema). 70b-72a.
Piccha basti – slimy enema
अशान्तावित्यतीसारे पिच्छाबस्तिः परं हितः ॥ ७२ ॥ परिवेष्ट्य कुशैराद्रैराद्रवृन्तानि शाल्मलेः ।
कृष्णमृत्तिकयाऽऽलिप्य स्वेदयेद्गोमयाग्निना ।। ७३ ।।
मृच्छोषेतानि सद्भुद्य तत्पिण्डं मुष्टिसम्मितम् । मर्दयेत्पयसः प्रस्थे प्रस्थे पूतेनास्थापयेत्ततः॥७४॥
नतयष्ट्याह्नकल्काज्यक्षौद्रतैलवताऽनु च। स्नातो भुञ्जीत पयसा जाङ्गलेन रसेन वा ॥ ७५ ॥
पित्तातिसारज्वरशोफगुल्मसमीरणास्त्रग्रहणीविकारान् । जयत्ययं शीघ्रमतिप्रवृत्तिं विरेचनास्थापनयोश्च बस्तिः ॥७६ ॥
If diarrhoea does not subside by the above treatment administering picchabasti is best suited. Moist flower stalks of salmali are tied with green kusa grass, made into a ball, given a coating of mud and burnt in the heat of cow dung cakes. When the mud plaster gets dried, it is removed, the cooked stalks are made into a paste. One musti ( pala) of this paste is macerated with one prastha of milk and filtered. To this liquid is added, a paste of nata and yasti, and ghee, honey and oil, and administered as an enema.
Afterwards, the patient should take a bath and eat his food along with either milk or soup of meat of desert-like region. This kind of enema quickly cures diarrhoea of pitta origin, fever, dropsy, abdominal tumour, gout, disorders of the duodenum, excess bouts of purgation and decoction enema therapies. 72b-76.
फाणितं कुटजोत्थं च सर्वातीसारनाशनम् । वत्सकादिसमायुक्तं साम्बष्ठादि समाक्षिकम् ॥ ७७ ॥
Phanita and kutaja bija added with drugs of vatsakadi and ambasthidi gana (chapter 15 of sutrasthana) mixed with maksika (honey) cures all types of diarrhoea. 77.
Putapaka rasa yoga
नीरुड्निरामं दीप्ताग्नेरपि सास्त्रं चिरोत्थितम् । नानावर्णमतीसारं पुटपाकैरुपाचरेत् ॥ ७८ ॥
The patient of diarrhoea who is not having pain and ama, eliminates faeces mixed with blood for long time, and of many colours and has good digestive power should be treated with putapaka ( such as the following). 78.
त्वपिण्डाद्दीर्घवृन्तस्य श्रीपर्णीपत्रसंवृतात् | मुल्लितादग्निना स्विन्नाद्रसं निष्पीडितं हिमम् ॥ ७९ ॥
अतीसारी पिबेद्युक्तं मधुना सितयाऽथवा |
Paste of bark dirghavrnta (salmali) is made into a ball, covered with leaves of sriparni (kasmari) and given a coating of mud, slightly dried, put into fire and taken out when it becomes red. After cooling, the paste is taken out and juice extracted. The patient of diarrhoea should drink this juice, made cold and added with either honey or sugar. 79-80a.
एवं क्षीरिद्रुमत्वग्भिस्तत्प्ररोहैश्च कल्पयेत् ॥ ८० ॥
कट्वङ्गत्वग्घृतयुता स्वेदिता सलिलोष्मणा । सक्षौद्रा हन्त्यतीसारं बलवन्तमपि द्रुतम् ॥ ८१ ।।
Similarly, the juice taken out from the barks and sprouts of trees having milky sap or bark katvanga, added with ghee and warmed in hot water and mixed with honey. These cure diarrhoea quickly even though severe. 80b-81.
Raktatisara chikitsa – treatment of bleeding diarrhoea
पित्तातिसारी सेवेत पित्तलान्येव यः पुनः । रक्तातिसारं कुरुते तस्य पित्तं सतृड्ज्वरम् ॥ ८२ ॥
दारुणं गुदपाकं च तत्र छागं पयो हितम् । पद्मोत्पलसमङ्गाभिः शृतं मोचरसेन च ॥८३ ॥
सारिवायष्टिरोधैर्वा प्रसवैर्वा वटादिजैः । सक्षौद्रशर्करं पाने भोजने गुदसेचने ॥ ८४ ॥
The patient of pittatisara (diarrhoea caused by pitta) who again indulges in things (food etc.) which increase pitta, the pitta getting further increased produces raktatisara (diarrhoea with bleeding ) and ulcerations of the rectum. For this, goats milk boiled with padma, utpala, samanga and mocarasa, or with sariva, yasthi and rodhra; or with sprouts of vata etc.-mixed with honey and sugar is beneficial for use for drinking, as food and for bathing the rectum. 82-84.
तद्वद्रसादयोऽनम्लाः साज्याः पानान्नयोर्हिताः। काश्मर्यफलयूषश्च किञ्चिदम्लः सशर्करः ॥ ८५ ॥
Similarly meat soup etc. which are not sour and mixed with ghee used for drinking and along with food is beneficial. Soup prepared with fruits of kasmarya made slightly sour and mixed with honey and sugar is also beneficial. 85.
पयस्यर्धोदके छागे हीबेरोत्पलनागरैः। पेया रक्तातिसारघ्नी पृश्चिपर्णीरसान्विता ॥ ८६ ॥
प्राग्भक्तं नवनीतं वा लिह्यान्मधुसितायुतम् ।
Goat’s milk added with half its quantity of water, (powder of) hribera, utpala and nagara and juice of prsniparni, made into a peya ( thin gruel) cures bleeding diarrhoea. Butter mixed with honey and sugar should be licked every day before (midday) meal. 86-87a.
बलिन्यस्त्रेऽस्त्रमेवाजं मार्गं वा घृतभर्जितम् ॥ ८७ ॥
क्षीरानुपानं क्षीराशी त्र्यहं क्षीरोद्भवं घृतम् । कपिञ्जलरसाशी वा लिहन्नारोग्यमश्रुते ॥ ८८ ॥
When there is large amount of bleeding then the blood of either a goat or deer itself fried with ghee should be given to drink followed with milk as an after-drink, the patient should drink milk only as food for three days or consume butter obtained from milk or soup of meat of kapinjala bird. By this he regains health. 87b-88.
पीत्वा शतावरीकल्कं क्षीरेण क्षीरभोजनः ।
रक्तातिसारं हन्त्याशु तया वा साधितं घृतम् ॥ ८९ ॥
Paste of satavari mixed with milk should be consumed by the person who takes milk only as food, this cures bleeding diarrhoea soon. So also the medicated ghee prepared from it (Satavari). 89.
लाक्षानागरवैदेहीकटुकादार्विवल्कलैः सर्पिः सेन्द्रयवैः सिद्धं पेयामण्डावचारितम् ॥ ९० ॥ अतीसारं जयेच्छीघ्रं त्रिदोषमपि दारुणम् ।
Medicated ghee prepared with laksa, nagara, vaidehi, katuka, bark of darvi and indrayava consumed mixed with peya or manda (thin gruel) cures even severe diarrhoea arising from the three dosas. 90-91a.
कृष्णमृच्छङ्खयष्ट्याह्वक्षौद्रासृक्तण्डुलोदकम् ॥ ९१ ॥
जयत्यस्त्रं प्रियङ्गुश्च तण्डुलाम्बुमधुप्लुता ।
Krsnamrt, sankha, yastyahva, ksaudra (honey) and asrk (blood of goat or deer) mixed with rice-wash and consumed cures bleeding diarrhoea, so also priyangu mixed with rice wash and honey. 91b-92a.
कल्कस्तिलानां कृष्णानां शर्करापाञ्चभागिकः ॥ ९२ ।।
आजेन पयसा पीतः सद्यो रक्तं नियच्छति ।
Paste of krsnatila added with one-fifth part of sugar, mixed with goat’s milk and consumed stops the bleeding immediately. 92b-93a.
पीत्वा सशर्कराक्षौद्रं चन्दनं तण्डुलाम्बुना ।। ९३ ।।
दाहतृष्णाप्रमोहेभ्यो रक्तस्त्रावाच्च मुच्यते । गुदस्य दाहे पाके वा सेकलेपा हिता हिमाः ॥ ९४॥
Paste of chandana, added with sugar and honey mixed with rice-wash and consumed cures burning sensation, thirst, delusion (coma) and bleeding.
In such case of burning sensation and ulceration of the rectum, bathing the part or topical application with cold things is beneficial. 93b-94.
अल्पाल्पं बहुशो रक्तं सशूलमुपवेश्यते । यदा विबद्धो वायुश्च कृच्छ्राच्चरति वा न वा ॥ ९५ ॥
पिच्छाबस्तिं तदा तस्य पूर्वोक्तमुपकल्पयेत् ।
When the patient eliminates little quantities of blood, many times accompanied with pain or vayu (flatus) getting obstructed comes out with difficulty or does not come out at all, then he should be given a picchabasti (slimy enema) as described earlier. 95-96a.
पल्लवान् जर्जरीकृत्य शिंशिपाकोविदारयोः ॥ ९६ ॥
पचेद्यवांश्च स क्वाथो घृतक्षीरसमन्वितः । पिच्छास्त्रुतौ गुदभ्रंशे प्रवाहणरुजासु च ॥ ९७ ॥
पिच्छाबस्तिः प्रयोक्तव्यः क्षतक्षीणबलावहः ।
Tender leaves of simsipa and kovidara are crushed and cooked mixing it with yava, this decoction added with ghee and milk, administered as a picchabasti ( slimy enema ) is useful for rectal exudation, prolapse, straining and pain. It gives strength to persons debilitated from injury to the chest. 96b-98a.
प्रपौण्डरीकसिद्धेन सर्पिषा चानुवासनम् ॥ ९८ ॥
Anuvasana (oil enema) should be given with ghee prepared with prapoundarika. 98b.
रक्तं विट्सहितं पूर्वं पश्चाद्वा योऽतिसार्यते । शतावरीघृतं तस्य लेहार्थमुपकल्पयेत् ॥ ९९ ॥
For the patient who eliminates blood mixed with faeces, either earlier to or after the elimination of faeces, satavari should be given to lick. 99.
शर्करार्धांशकं लीढं नवनीतं नवोद्धृतम् ।
क्षौद्रपादं जयेच्छीघ्रं तं विकारं हिताशिनः ॥ १०० ॥
Butter obtained fresh, mixed with sugar half of its quantity and honey quarter of its quantity licked daily followed by partaking suitable food cures the above disease quickly. 100.
न्यग्रोधोदुम्बराश्वत्थशुङ्गानापोथ्य वासयेत् । अहोरात्रं जले तप्ते घृतं तेनाम्भसा पचेत् ॥ १०१ ॥
तदर्धशर्करायुक्तं लेहयेत्क्षौद्रपादिकम् । अधो वा यदि वाऽप्यूर्ध्वं यस्य रक्तं प्रवर्तते ॥ १०२ ॥
Sprouts of nyagrodha (Banyan tree), udumbara and asvattha (Pipal) are slightly crushed, soaked in hot water and kept undisturbed for a day and night. Ghee should be cooked in this water, mixed with half its quantity of sugar and one-fourth quantity of honey and made into a confection. This, licked daily cures bleeding either of the downward or upward directions. 101-102.
Kaphatisara chikitsa
श्लेष्मातिसारे वातोक्तं विशेषादामपाचनम् । कर्तव्यमनुबन्धेऽस्य पिबेत्पक्त्वाऽग्निदीपनम् ॥ १०३ ।।
बिल्वकर्कटिकामुस्तप्राणदाविश्वभेषजम् । वचाविडङ्गभूतीकधानकामरदारु वा ॥ १०४ ॥ अथवा पिप्पलीमूलपिप्पलीद्वयचित्रकम् ।
In slesmatisara (diarrhoea of kapha origin) the treatment prescribed for that of vata origin itself should be done, especially so, those which cook the ama; if the diarrhoea persists the decoction of bilva, karkatika, musta, pranada, visvabhesaja, vaca, vidanga, bhutika, dhanaka, and amaradaru or of pippalimula, the two pippali and citraka. 103-105a.
पाठाग्निवत्सकग्रन्थितिक्ताशुण्ठीवचाभयाः । १०५ ।।
क्वथिता यदि वा पिष्टाः श्लेष्मातीसारभेषजम् ।
Patha, agni, vatsaka, granthi, tikta, sunthi, vaca, and abhaya-made into a decoction or paste-is the best medicine for diarrhoea of kapha origin. 105b-106a.
॥ १०६ ॥ सौवर्चलवचाव्योषहिङ्गप्रतिविषाभयाः पिबेच्छ्लेष्मातिसारार्तचूर्णिताः कोष्णवारिणा ।
मध्यं लीढ्वा कपित्थस्य सव्योषक्षौद्रशर्करम् ॥ १०७॥ कट्फलं मधुयुक्तं वा मुच्यते जठरामयात् ।
The person suffering from diarrhoea arising from kapha should consume the powder of souvarcala, vaca, vyosa, hingu, prativisa and abhaya mixed with warm water. He who eats the marrow of kapittha mixed with (powder of vyosa, ksoudra and sarkara, or katphala mixed with honey gets cured of diseases of the stomach ( diarrhoea). 106b-108a.
कणां मधुयुतां लीढा तक्रं पीत्वा सचित्रकम् ॥ १०८ ॥ भुक्त्वा वा बालबिल्वानि व्यपोहत्युदरामयम् ।
Licking the (powder of) kana with madhu, drinking takra (buttermilk) mixed with citraka, or eating tender fruits of bilva cures diseases of the stomach ( diarrhoea).
पाठामोचरसाम्भोदधातकीबिल्वनागरम् ॥ १०९ ।। सुकृच्छ्रमप्यतीसारं गुडतक्रेण नाशयेत् । 108b-109a.
(Powder of) patha, mocarasa, ambhoda, dhataki, bilva and nagara consumed mixed with guda and takra destroys diarrhoea though very severe. 109b-110a.
Kapitthastaka curna
यवानीपिप्पलीमूलचातुर्जातकनागरैः ॥ ११०॥
मरिचाग्निजलाजाजीधान्यसौवर्चलैः समैः । वृषाम्लधातकीकृष्णाबिल्वदाडिमदीप्यकैः ॥ १११ ॥
त्रिगुणैः पडगुणसितैः कपित्थाष्टगुणैः कृतः। चूर्णोऽतीसारग्रहणीक्षयगुल्मगलामयान् ॥ ११२ ॥
कासश्वासाग्निसादार्श:पीनसारोचकान् जयेत् ।
Equal quantities of yavani, pippalimula, caturjataka, nagara, marica, agni, jala, ajaji, dhanya and souvarcala together making one part, equal parts of vrksamla, dhataki, krsna, bilva, dadima and dipyaka together three parts, sugar six parts and kapittha-eight parts are all converted into a nice powder; (consumed in appropriate dose ) this cures diarrhoea, duodenal disease, consumption, abdominal tumor, diseases of the throat, cough, dyspnoea, weak digestion, piles, chronic nasal catarrah and loss of taste / appetite. 110b-113a.
Dadimastaka curna
कर्षोन्मिता तवक्षीरी चातुर्जातं द्विकार्षिकम् ॥ ११३ ॥
यवानीधान्यकाजाजीग्रन्थिव्योषं पलांशकम् । पलानि दाडिमादष्टौ सितायाश्चैकतः कृतः ॥ ११४ ॥
गुणैः कपित्थाष्टकवच्चूर्णोऽयं दाडिमाष्टकः । भोज्यो वातातिसारोक्तैर्यथावस्थं खलादिभिः ॥ ११५ ॥
One karsa of tavaksiri, two karsa of caturjata, one pala each of yavani, dhanyaka, ajaji, granthi, and vyosa, eight pala each of dadima and sita (sugar) all are made into a nice powder.
This Dadimastaka is made similar to the earlier kapitthastaka curna in action and should be consumed along with khala etc. described in the stage-wise treatment in diarrhoea of vata origin. 113b-115.
सविडङ्गः समरिचः सकपित्थः सनागरः । चाङ्गेरीतक्रकोलाम्लः खलः श्लेष्मातिसारजित् ॥ ११६ ॥
Khala prepared with vidanga, marica, kapittha, nagara and cangeri, mixed with takra and kolamla cures diarrhoea of kapha origin. 116.
क्षीणे श्लेष्मणि पूर्वोक्तमम्लं लाक्षादि षट्पलम् ।
पुराणं वा घृतं दद्याद्यवागूमण्डमिश्रितम् ॥ ११७ ।।
If slesma (kapha) has undergone decrease, medicated ghee described earlier such as amla ghrita ( verses 48 ) laksadi ghrita (verse 90 ) satpala ghrta ( chapter 5-22) or even old ghee or yavagu (thin gruel) may be consumed. 117.
वातश्लेष्मविबन्धे वा स्रवत्यति कफेऽपि वा । शूले प्रवाहिकायां वा पिच्छाबस्तिः प्रशस्यते ॥ ११८ ॥
वचाबिल्वकणाकुष्ठशताह्वालवणान्वितः ।
If there is obsturction to elimination of vata and slesma (kapha) or if kapha only is being eliminated greatly, or when there is pain and straining at stools, picchabasti (slimy enema) containing vaca, bilva, kana, kustha, ssatahva and lavana-is best suited.
बिल्वतैलेन तैलेन वचाद्यैः साधितेन वा ॥ ११९ ॥
बहुश: कफवातार्ते कोष्णेनान्वासनं हितम् ।
Bilva taila (oil obtained from the marrow of bilva fruits) or oil processed with vaca etc. (enemerated above) made warm and used for anuvasana (oil of enema), many times is beneficial for the person suffering from (increase of) kapha and vata. 119b-120a.
क्षीणे कफे गुदे दीर्घकालातीसारदुर्बले ॥ १२० ॥
अनिलः प्रबलोऽवश्यं स्वस्थानस्थः प्रजायते । स बली सहसा हन्यात्तस्मात्तं त्वरया जयेत् ॥ १२१ ॥
वायोरनन्तरं पित्तं पित्तस्यानन्तरं कफम् । जयेत्पूर्वं त्रयाणां वा भवेद्यो बलवत्तमः ॥ १२२॥
When kapha undergoes decrease, the rectum becomes weak due to long continued diarrhoea; the anila (vata) residing in its own seat ( the rectum) definitely becomes very powerful. This powerful vata kills the person suddenly hence it should be won ( mitigated) urgently. After winning vata, pitta should be won and kapha after winning pitta, or among three whichever is most predominant should be won first. 120b-122.
भीशोकाभ्यामपि चलः शीघ्रं कुप्यत्यतस्तयोः |
कार्या क्रिया वातहरा हर्षणाश्वासनानि च ॥ १२३ ॥
Cala (vata) gets aggravated soon, even by fear and grief, hence even for the diarrhoea caused by these (fear and grief) treatment which mitigate vata and also providing pleasure and courage to the patient should be resorted to. 123.
यस्योच्चाराद्विना मूत्रं पवनो वा प्रवर्तते ।
दीप्ताग्नेर्लघुकोष्ठस्य शान्तस्तस्योदरामयः ॥ १२४ ॥
The disease of the stomach ( diarrhoea) is to be considered as cured when the person is able to eliminate urine or flatus without the elimination of faeces, when his digestive fire is increased and alimentary tract is light. 124.
इति श्री वैद्यपतिसिंहगुप्तसूनुश्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां चतुर्थे चिकित्सितस्थानेऽतीसारचिकित्सितं नाम
नवमोऽध्यायः॥९॥
Thus ends the chapter-Atisara chikitsa-the ninth in chikitsa sthana of Astangahrdaya samhita, composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
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