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Sushruta SamhitaAyurvedic Treatment of Alcoholism - Panatyaya Pratisedha - Sushrutasamhita Uttaratantra Chapter 47

Ayurvedic Treatment of Alcoholism – Panatyaya Pratisedha – Sushrutasamhita Uttaratantra Chapter 47

सप्तचत्वारिंशोऽध्यायः अथातः पानात्ययप्रतिषेधं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥

Now we shall discourse on the (symptoms and) medical treatment of alcoholism and its kindred maladies (Panatyaya-Pratisedha).

मद्यमुष्णं तथा तीक्ष्णं सूक्ष्मं विशदमेव च। रूक्षमाशुकरञ्चैव व्यवायि च विकाशि च ॥२॥ औष्ण्याच्छीतोपचारं तत् तैक्ष्ण्याद्धन्ति मनोगतिम् । विशत्यवयवान् सौक्ष्म्याद् वैशद्यात् कफशुक्रनुत् ॥ ३ ॥ कोपयेद्रौक्ष्यादाशुत्वादाशुकर्मकृत् । मारुतं हर्षदञ्च व्यवायित्वाद् विकाशित्वाद् विसर्पति ॥ ४ ॥ तदम्लं रसतः प्रोक्तं लघु रोचनदीपनम् । केचिल्लवणवर्ज्यास्तु रसानत्रादिशन्ति हि ॥५॥

Properties and action of Wine Wine is heat-making in its potency, keen or sharp in its properties, subtle in its essence, acts as a soaker or cleanser of moisture and albuminous matter (Visada), is dry, and instantaneous in its action (Asukara), stimulating or exhilarating in its effect (Vyavayi) and is diffusive (Vikasi). It destroys cold and shivering by virtue of its heat-making potency. It suspends all cognitive process (lit.-intellectual motions) on account of its keenness or sharpness, enters into every limb and members of the body organ by reason of its subtlety (Suksmatva), destroys Kapha (phlegm) and semen in virtue of its Vaisadya, enrages or aggravates the bodily Vayu on account of its dryness (Ruksatva), and is instantaneous in its action by reason of its Asukaritva. It is exhilarating on account of its Vyavayitva and diffusive (coursing swiftly all through the body) for its Vikasitva. Wine is acid in its taste, is light and appetising, and produces fresh relish for food. Others assume the presence of all the tastes except the saline one in it. 2-5.

स्निग्धैस्तदन्नैर्मांसैश्च भक्ष्यैश्च सह सेवितम् । भवेदायुःप्रकर्षाय बलायोपचयाय च ॥६॥ काम्यता मनसस्तुष्टिधैर्यं तेजोऽतिविक्रमः । विधिवत् सेव्यमाने तु मद्ये सन्निहिता गुणाः ॥७॥ तदेवानन्नमज्ञेन सेव्यमानममात्रया । कायाग्निना ह्यग्निसमं समेत्य कुरुते मदम् ॥ ८ ॥

Wine taken in combination with cooked meat and boiled rice, or any other articles of food profusely saturated with a Sneha (clarified butter etc.) adds to the longevity, muscular strength and corpulency of a person (using it in moderate quantities) and to the exhilarated state of mind accompanied with beauty, fortitude, vigour and valour and these benefits one may derive from the proper use of wine. This fiery liquid in combination with the aggravated bodily fire (Kaya-Agni) produces the symptoms of intoxication and unconciousness, etc. (Mada) in a foolish person taking it without food or in an empty stomach and in an inordinate quantity. 6-8.

मदेन करणानान्तु भावान्यत्वे कृते सति । निगूढमपि भावं स्वं प्रकाशीकुरुतेऽवशः ॥ ९ ॥

Evil effects of Drinking- Excessive drinking produces incidental nescience which gradually creeps into and clouds the senseperceptions, destroying all power of self control (control over the senseorgans) and giving publicity to the innermost thoughts (in the mind) of the intoxicated person. 9.

Three Stages of Alcoholic Intoxication

त्र्यवस्थश्च मदो ज्ञेयः पूर्वो मध्योऽथ पश्चिमः । पूर्वे वीर्यरतिप्रीति – हर्षभाष्यादिवर्द्धनम् ॥ १० ॥

प्रलापो मध्यमे मोहो युक्तायुक्तक्रियास्तथा । विसंज्ञः पश्चिमे शेते नष्टकर्मक्रियागुणः ॥ ११ ॥

Three stages of Alcoholic Intoxication – There are three stages of intoxicaton-viz., the first, the second or intermidate and the third or last. The first or preliminary stage (of intoxication) is marked by an exhilarated state of mind with increased valour, and conviviality as well as satisfaction and talkativeness, etc. The second or intermediate stage is indicated by incoherent speech, delusion and the performance of proper and improper acts. In the third or last stage the man lies down unconscious, bereft of all powers of action, of memory and of judging the ethic effects of his acts. 10-11.

श्लैष्मिकानल्पपित्तांश्च स्निग्धान् मात्रोपसेविन: । न बाधतेऽत्यर्थं विपरीतांस्तु बाधते ॥ १२ ॥ पानं निर्भक्तमेकान्तत एव मद्यं निषेव्यमाणं मनुजेन नित्यम् । उत्पादयेत् कष्टतमान् विकारानापादयेच्चापि शरीरभेदम् ॥ १३ ॥

A man who is in the habit of taking fatty food or in whom Slesma predominates, or in whose constitution, there is only a little of Pitta, is not so easily affected by the action of wine, which, however, proves distressing in a person of contarary nature, Wine, if taken daily without food by a man in an empty stomach, gives rise to many distressing and dangerous diseases in his organism and leads to the ultimate dissolution of his body. 12-13

क्रुद्धेन भीतेन पिपासितेन शोकाभितप्तेन वुभुक्षितेन । व्यायामभाराध्वपरिक्षतेन वेगावरोधाभिहतेन चापि ॥ १४ ॥ अत्यम्ल भक्ष्यावततोदरेण साजीर्णभुक्तेन तथाऽबलेन । उष्णाभितप्तेन च सेव्यमानं करोति मद्यं विविधान् विकारान् ॥ १५ ॥ पानात्ययं परमदं पानाजीर्णमथापि वा । पानविभ्रममुग्रञ्च तेषां वक्ष्यामि लक्षणम् ॥ १६ ॥

Cases where wine is prohibited- Wine should not be taken by a person under the influence of anger, grief, fright, thirst or hunger. The use of wine is prohibited immediately after a fatiguing journey, physical exercise or an act of load-carrying, or after the repressing of any physical urging, or after the use of excessively acid food, (D.R. excessive water and food) to the full, or before the proper digestion of food or by a weak person, or by one suffering from the effects of heat. In the above cases, wine undoubtedly proves a source of a host of bodily derangements such as Panatyaya, Paramada, Panajirna and the violent Panavibhrama the characterstic symptoms of which I shall presently describe. 14-16.

Specific symptoms of Panatyaya

स्तम्भाङ्गमर्दहृदयग्रहतोदकम्पाः स्वेदप्रलापमुखशोषणदाहमूर्च्छाः पानात्ययेऽनिलकृते शिरसो रुजश्च । पित्तात्मके वदनलोचनपीतता च । श्लेष्मात्मके वमथुशीतकफप्रसेकाः सर्वात्मके भवति सर्वविकारसम्पत् ॥१७॥

Specific symptoms of Panatyaya — The Vataja type of Panatyaya is marked by such symptoms as numbness and aching pain in the limbs, palpitation, a catching and pricking pain in the region of the heart and headache. Perspiration, delirium, dryness of the mouth, burning sensation and fainting fits (loss of consciousness) and yellowness of the face and eyes are the features which distinguish the Pittaja type (of Panatyaya). Vomiting, shivering and water-brash are the indications which mark the Kaphaja type. The symptoms of all the three preceeding types are exhibited in the one due to the concerted action of the three deranged bodily Dosas- Tri-Dosaja type of Panatyaya. 17.

Symptoms of Para mada

ऊष्माणमङ्गगुरुतां विरसाननत्वं श्लेष्माधिकत्वमरुचिं मलमूत्रसङ्गम् | लिङ्गं परस्य तु मदस्य वदन्ति तज्ज्ञास्तृष्णां रुजां शिरसि सन्धिषु चापि भेदम् ॥ १८ ॥

Symptoms of Para-mada — Heat and a snese of heaviness in the body, bad taste in the mouth, excessive accumulation of Slesma in the body, an aversion to food, supression of stool and urine, thirst, headache and a crushing pain in the joints are the symptoms which the learned physicians set down to para-mada (reactionary effects of the abuse of wine). 18

Panajirna and Pana vibhrama

आध्मानमुद्रिरणमम्लरसो विदाहोऽजीर्णस्य पानजनितस्य वदन्ति लिङ्गम् । ज्ञेयानि तत्र भिषजा सुविनिश्चितानि पित्तप्रकोपजनितानि च कारणानि ॥ १९ ॥ हृद्गात्रतोदवमथुज्वरकण्ठधूम-मूर्च्छाकफस्त्रवणमूर्धरुजो विदाहः । द्वेषः सुरान्नविकृतेषु च तेषु तेषु तं पानविभ्रममुशन्त्यखिलेन धीराः ॥ २० ॥

Panajirna and Pana-vibhrama – Distension of the abdomen (tympanites), acid or sour taste ( in the mouth ), vomiting, deficient gastric digestion are the symptoms which are exhibited in a Panajirna type (alcoholic indigestion). Aggravation of the deranged Pitta should be regared by a physicion as the exciting factor of the disease. The malady which exhibits such symptoms as pricking pain in the heart and limbs, vomiting, fever, a sensation of the rising of fumes into the throat, salivation, epileptic fits, headache, a burning sensation in the throat and an aversion to all sorts of food and wine (in connection with an abuse of wine) is called Pana-Vibhrama.19-20.

Prognosis of Alcoholism

हीनोत्तरोष्ठमतिशीतममन्ददाहं तैलप्रभास्यमतिपानहतं विजह्यात् । जिह्वौष्ठदन्तमसितं त्वथवाऽपि नीलं पीते च यस्य नयने रुधिरप्रभे च ।

हिक्काज्वरौ वमथुवेपथुपार्श्वशूलाः कासभ्रमावपि च पानहतं भजन्ते ॥२१॥

Prognosis – A patient suffering from the effects of excessive drinking and exhibiting such symptoms as atrophied upper lip, excessive shivering or burning sensation and oily hue of the face, black or blue colour of the tongue, lips and teeth, yellowness or blood-colour of the eyes should be givin up as incurable. Hiccough, fever, vomiting, shivering, tremor, cramp of the sides, cough and vertigo are the supervening symptoms (Upadrava) which are found in all forms of Panatyaya (alcoholism). 21.

Treatment of Vataja types

तेषां निवारणमिदं हि मयोच्यमानं व्यक्ताभिधानमखिलेन विधिं निबोध ॥ २२ ॥ मद्यन्तु चुक्रमरिचार्द्रकदीप्यकुष्ठ- सौवर्चलायुतमलं पवनस्य शान्त्यै | पृथ्वीकदीप्यकमहौषधहिङ्गभिर्वा सौवर्चलेन च युतं वितरेत् सुखाय ॥ २३ ॥ आम्रातकाम्रफलदाडिममातुलुङ्गैः कुर्याच्छुभान्यपि च षाडवपानकानि । सेवेत वा फलरसोपहितान् रसादीनानूपवर्गपिशितान्यपि गन्धवन्ति ॥ २४ ॥

Treatment of Vataja types — Now hear me describing the medicinal remedies for all the above said maladies. Wine saturated with the mixture of pulverised Cukra, Marica, Adraka, Dipya (Yamani), Kustha and Souvarcala should be given for the relief of the Vataja type of Panatyaya, or one mixed with Prthvika, Dipyaka, Mahousadhi and Hingu or with Souvarcala should be taken for comfort. Sadavas or cordials made of Amrataka, Amra-fruits, Dadima and Matulunga should be given for relief. In the alternative, the cooked flesh of an animal of Anupa group i.i. tortoise, etc. should be seasoned with the expressed juice of above fruits should be taken. 22-24.

Treatment of Pittaja type

पित्तात्मके मधुरवर्गकषायमिश्रं मद्यं हितं समधुशर्करमिष्टगन्धम् । पीत्वा च मद्यमपि चेक्षुरसप्रगाढं निःशेषतः क्षणमवस्थितमुल्लिखेच्च ॥ २५ ॥ पिबेदनम्लान् लावैणतित्तिरिरसांश्च मौगान सुखाय सघृतान् ससितांश्च यूषान् ॥ २६ ॥

Treatment of Pittaja type – In the Pittaja- type of Panatyaya, wine mixed with the decoction of the drugs of the Madhura group and saturated and flavoured with the admixtue of sugar and scented drugs should be taken, or wine profusely mixed with the expressed juice of sugar-cane should be taken and fully vomited out, a short while thereafter Meat – juice (Rasa) of Lava, Ena and Tittira unmixed with any acid, or Mudga soup should be taken with sugar and clarified butter. 25-26.

Treatment of Kaphaja and TriDosaja type

पानात्यये कफकृते कफमुल्लिखेच्च मद्येन बिम्बिविदुलोदकसंयुतेन । सेवेत तिक्तकटुकांश्च रसानुदारान् यूषांश्च तिक्तकटुकोपहितान् हिताय ॥ २७ ॥ पथ्यं यवान्नविकृतान्यपि जाङ्गलानि श्लेष्मघ्नमन्यदपि यच्च निरत्ययं स्यात् ॥ २८ ॥ कुर्याच्च सर्वमथ सर्वभवे विधानं

द्वन्द्वोद्भवे द्वयमवेक्ष्य यथाप्रधानम् ॥ २९ ॥

Treatment of Kaphaja and Tri – Dosaja type, etc.— In the Kaphaja type of Panatyaya, the mucous should be eliminated by taking a potion of wine mixed with the expressed juice or decoction of Bimibi and Vidula (Vetasa) Meat-juice of any fatty Jangala animal mixed with bitter and pungent articles or also the Mudga-soup made bitter and pungent should be taken as beneficial tothe patient. The diet should consist of preparations of barley, flesh of Jangala animals and also the Kapha-subduing articles, as well as those calculated as remedial to the present type of Panatyaya. The above kinds of medicines and diet should be combinedly applied in the one due to the concerted action of the three Dosas of the body (Tri-Dosaja type), while in the Dvi-Dosaja types, the treatment should be according to the nature of the predominant Dosas. 27-29.

सामान्यमन्यदपि यच्च समग्रमग्रयं वक्ष्यामि यच्च मनसो मदकृत् सुखञ्च ॥ ३० ॥ शुक्ष्णैरजाजिमरिचैश्च कृतं समांशैः । पानात्ययेषु विधिवत् स्स्रुतमम्बरान्ते ॥ ३१ ॥ पुष्पैः प्रलिप्य करवीरजलोद्भवैश्च । पिष्टैः सपद्मकयुतैरपि सारिवाद्यैः सेकं जलैश्च वितरेदमलैः सुशीतैः ॥ ३२॥ त्वङ्नागपुष्पमगधैलमधूकधान्यः पानं कपित्थरसवारिपरूषकाढ्यं ह्रीवेरपद्मपरिपेलवसंप्रयुक्तैः

Now I shall describe the medicianl compounds which tend to relieve the delirious state of mind and may be employed for the relief of all forms of Panatyaya in general. The fine powder of Naga-puspa, Magadhika, Ela, Madhuka, Dhanya, Ajaji and Marica taken in equal parts mixed copiously with the expressed juice of Kapittha, water and Parusaka should be duly taken in all forms of Panatyaya after the mixture is strained through a piece of cloth. The body of the patient should be anointed with a paste of Hribera, Padma, Paripelava, Karavira, Padmaka, drugs of the Sarivadi group and acquatic flower pasted together, and clear and cold water should be sprinkled over the body of the patient in a case of Madatyaya. 30-32.

Panaka

त्वक्पत्रचोचमरिचैलभुजङ्गपुष्प- श्लेष्मातकप्रसवकल्क गुडैरुपेतम् । द्राक्षायुतं हृतमलं मदिरामयार्तैस्तत्पानकं शुचि सुगन्धि नरैर्निषेव्यम् ॥ ३३ ॥ पिष्वा पिबेच्च मधुकं कटुरोहिणीञ्च द्राक्षाञ्च मूलमसकृत् त्रपुषीभवं यत् । कार्पासिनीमथ च नागबलाञ्च तुल्यां पीत्वा सुखी भवति साधु सुवर्चलाञ्च ॥ ३४ ॥

Panaka – A Panak prepared with Tvak, Patra, Coca, Marica, Ela, Naga-puspa and flowers of Slesmataka ground together into a paste and mixed with treacle and Draksa, should be filtered and perfumed and given to a person suffering from an attack of Panatyaya. The patient would find relief by the frequent use of of Panaka (draughts) composed of Yasti-madhu, Katurohini, Draksa and Trapusa-roots or of Karpasa-roots Naga-bala and Suvarcala (Surjavarta ) all taken in equal parts. 33-34.

Treatment of Para-mada

काश्मर्यदारुविडदाडिमपिप्पलीषु द्राक्षान्वितासु कृतमम्बुनि पानकं यत् । तद् बीजपूरकरसायुतमाशु पीतं शान्तिं परां मदगदेष्वचिरात् करोति ॥ ३५ ॥ द्राक्षासितामधुकजीरकधान्यकृष्णास्वेवं कृतं त्रिवृतया च पिबेत् तथैव | सौवर्चलायुतमुदाररसं फलाम्लं भार्गीभृतेन च जलेन हितोऽवसेकः ॥ ३६॥

Treatment of Para-mada – A Panaka (cordial) made of the fruits of Kasmarya, Daru, Dadima, Vit, Pippali, Draksa pasted together and disolved in water and taken in combination with the expressed juice of Bijapuraka, instantly gives relief in discomforts due to an abuse of wine (Para-mada). Panakas made of sugar, Draksa, Madhuka, Jiraka, Dhanya, Krsna (Pippali) and Trivrit, or of Sauvarcala, the meatspup (Rasa) of any fatty Jangala animal and Phalamla should be taken. Cold infusion of Bhargi would be found beneficial in sprinkling. 35-36.

Treatment of Panajirna

इक्ष्वाकुधामार्गववृक्षकाणि काकाइयोदुम्बरिकाश्च दुग्धे । विपाच्य तस्याञ्जलिना वमेद्धि मद्यं पिबेदह्नि गते त्वजीर्णे ॥ ३७ ॥ त्वपिप्पलीभुजगपुष्पविडैरुपेतं सेवेत हिङ्गुमरिचैलयुतं फलाम्लम्। उष्णाम्बुसैन्धवयुतास्त्वथवा विडत्वक्चव्यैलहिङ्गुमगधाफलमूलशुण्ठीः ॥ ३८ ॥ भोजनमत्र खडैरपि शस्तम् ॥ ३९ ॥ हृद्यैः

Treatment of Panajirna — Vomiting should be induced with an Anjali measure of milk duly cooked with the admixture of Iksvaku, Dhamargava, Vrksaka and two kinds of Udumbarika after which the patient should be advised to take wine in the evening in a case of indigestion due to an abuse of wine (Panajirna) Phalamla in combination with Tvak, Pippali, Naga-puspa, Vid, Hingu, Marica and Ela or a compound consisting of Saindhava, Vid, Tvak, Cavya, Hingu, Pippali, Pippali-roots and Sunthi pounded and desolved in warm water should be taken. The food of the patient should be made palatable with the admixture of Khada-yusa’ in the present instance. 37-39.

द्राक्षाकपित्थफलदाडिमपानकंयत् तत् पानविभ्रमहरं मधुशर्कराढ्यमाम्रातकोलरसपानकमेव चापि ॥ ४० ॥ खर्जूरवेत्रकरीरपरूषकेषु द्राक्षात्रिवृत्सु च कृतं ससितं हिमं वा । श्रीपर्णीयुक्तमथवा तु पिबेदिमानि यष्ट्याह्वयोत्पलहिमाम्बुविमिश्रितानि ॥ ४१ ॥

1. Dalhana in his commentatory says that some read “मद्यै: ” in place of “हृद्यै” and other read “फलैः” in place of “खडै”.

Treatment of Pana-vibhrama

। ॥४२॥ क्षीरिप्रवालबिसजीरकनागपुष्प-पत्रैलवालुसितसारिवपद्मकानि आम्रातभव्यकरमर्दकपित्थकोल-वृक्षाम्लवेत्रफलजीरकदाडिमानि सेवेत वा मरिचजीरकनागपुष्पत्वक्पत्रविश्वचविकैलरसान् समग्रान् । सूक्ष्माम्बरस्त्रुतहिमांश्च सुगन्धिगन्धान् पानोद्भवान् नुदति सप्तगदानशेषान् ॥ ४३ ॥

Treatment of Pana-vibhrama – A Panaka composed of Draksa, Kapittha, Phala (Matulunga etc.) and Dadima sweetened with profuse quantity of sugar and honey, as well as the one made with the expressed juice, of Kola and Amrataka sweetened in the same manner would prove curative in a case of Pana-vibhrama. A compound consisting of Kharjura, Vetra, Karira, Parusaka, Draksa and Trivrit pounded together and disolved in cold water should be taken, sweetened with sugar, or the same should be taken in combination with Sri-parni. In the alternative, the tender sprouts of Ksiri – trees, Visa ( Mrnala), Jiraka, Nagapuspa, Patra, Elavalu, Sita-sariva, Padmaka, Amrataka, Bhavya, Karamarda, Kapittha, Kola, Vrksamla, Vetra-fruit, Jiraka, Dadima, Yasti-madhu and Utpala, all pounded together and mixed with the cold infusion of such drugs as Marica, Jiraka, Naga-puspa, Tvak, patra, Visva, Cavika and Ela filtered through a piece of thin linen duly perfumed with the addition of scented drugs would be found curative in the seven types of distempers which have their origin in drinking excesses. 40-43.

पञ्चेन्द्रियार्थविषया मृदुपानयोगा हृद्याः सुखाश्च मनसः सततं निषेव्याः । पानात्ययेषु विकटोरुनितम्बवत्यः पीनोन्नतस्तनभरानतमध्यदेशाः ॥ ४४ ॥ प्रौढा स्त्रियोऽभिनवयौवनपीनगात्र्यः सेव्याश्च पञ्चविषयातिशयस्वभावाः ॥ ४५ ॥

Objects which are pleasing to the five sense-organs of man and gratifying to the mind and heart, as well as light wine should be always prescribed in a case of Panatyaya and the patient should be enlivened with the embrace of handsome and youthful damsels exceedingly attached to the gratification of the senses with splendid hips and thighs with their slender waists drooping under the weight of the exuberance of their breasts. 44-45.

पिबेद्रसं पुष्पफलोद्भवं वा सितामधूकत्रिसुगन्धियुक्तम् । सञ्चूर्ण्य संयोज्य च नागपुष्पैरजाजिकृष्णामरिचैश्च तुल्यैः ॥ ४६ ॥वर्षाभूयष्ट्याह्वमधूकलाक्षा- त्वक्कर्बुदाराङ्कुरजीरकाणि । द्राक्षाञ्च कृष्णामथ केशरञ्च क्षीरे समालोड्य पिबेत् सुखेप्सुः ॥ ४७ ॥

Potions prepared with powders of Naga-puspa, Ajaji, Krsna and Marica taken in equal parts mixed with sugar, Madhuka and Trisugandhi and then disolved in the expressed juice of Kusmanda fruits, should be taken. The drugs known as Varsabhu, Yastyahva, Madhuka, Laksa, Tvak, tender sprouts of Karbudara, Jiraka, Draksa, Krsna and Kesara should be given mixed with tepid milk. 46-47.

यथा नरेन्द्रोपहतस्य कस्यचिद् भवेत् प्रसादस्तत एव नान्यतः । ध्रुवं तथा मद्यहतस्य देहिनो भवेत् प्रसादस्तत एव नान्यतः ॥ ४८ ॥ विच्छिन्नमद्यः सहसा योऽतिमद्यं निषेवते । तस्य पानात्ययोद्दिष्टा विकाराः सम्भवन्ति हि ॥ ४९ ॥

A person afflicted with diseases due to the excess of Sura, Asava, etc. should be treated with the same wines ( Sura, asava, etc.) duly administered otherwise he will be ruined in the same manner as a person who has incurred the king’s displeasure, should be saved by courting the royal favour. An inveterate drunkard giving up his habit of drinking is afflicted with the symptoms of Panatyaya if he suddenly revert to his former pernicious habit. 48-49.

मद्यस्याग्नेयवायव्यौ गुणावम्बुवहानि च । स्त्रोतांसि शोषयेयातां तेन तृष्णोपजायते ॥ ५० ॥ पाटलोत्पलकन्देषु मुद्द्रपर्ण्याञ्च साधितम् । पिबेन्मागधिकोन्मिश्रं तत्राम्भो हिमशीतलम् ॥ ५१ ॥ सर्पिस्तैलवसामज्ज-दधिभृङ्गरसैर्युतम् 1 क्वाथेन बिल्वयवयोः सर्वगन्धैश्च पेषितैः । पक्कमभ्यञ्जने श्रेष्ठं सेके क्वाथश्च शीतलः ॥ ५२ ॥ रसवन्ति च भोज्यानि यथास्वमवचारयेत् । पानकानि सुशीतानि हृद्यानि सुरभीणि च ॥५३॥

The Agneya and Vayaviya virtues of wine tend to produce a dryness in the water carrying channels of the body, hence thirst is experienced by a drunkard person. A cold infusion of Patola, flowers and bulbs of Utpala and Mudga-parni mixed with Magadhika should be taken under the circumstances (reactionary thirst), or oil, clarified butter, Vasa (lard) and marrow (D.R. – milk ) should be duly cooked with curd (four times), expressed juice of Bhrnga-raja (four times), and the decoction of Bilva and Yava (four times with the Kalkas of the drugs known as the Sarva-gandha should be applied as an Abhyanga. The body should be sprinkled (Seka) with the cold decoction¹. Palatable foods and cold, pleasing and scented cordials should be prescribed according to the nature and intensity of the deranged bodily Dosas underlying the disease. 50-53.

त्वचं प्राप्तस्तु पानोष्मा पित्तरक्ताभिमूर्च्छितः । दाहं प्रकुरुते घोरं पित्तवत् तत्र भेषजम् ॥ ५४॥

The heat generated by drinking being aggravated by bodily Pitta and blood of an intoxicated person, escapes through the surface of the skin and causes a feeling of intense burning (Daha) which should be remedied with measures and therapeutic agents prescribed in connection with the aggravation of Pitta. 54.

शीतं विधानमत ऊर्ध्वमहं प्रवक्ष्ये दाहप्रशान्तिकरमृद्धिमतां नराणाम् । तत्रादितो मलयजेन हितः प्रदेहश्चन्द्रांशुहारतुहिनोदकशीतलेन ॥ ५५ ॥ शीताम्बुशीतलतरैश्च शयानमेनं हारैर्मृणालवलयैरबलाः स्पृशेयुः । भिन्नोत्पलोज्वलहिमे शयने शयीत पत्रेषु वा सजलबिन्दुषु पद्मिनीनाम् । आसादयन् पवनमाहृतमङ्गनाभिः कह्लारपद्मदलशैवलसञ्चयेषु । कान्तैर्वनान्तपवनैः परिमृश्यमानः शक्तश्चरेद् भवनकाननदीर्घिकासु ॥५६॥ दाहाभिभूतमथवा परिषेचयेत् तु लामज्जकाम्बुरुह- चन्दन-तोयतोयैः । विस्रावितां हृतमलां नववारिपूर्णां पद्मोत्पलाकुलजलामधिवासिताम्बुम् । वापीं भजेत हरिचन्दनभूषिताङ्गः कान्ताकरस्पृशनकर्कशरोमकूपः ॥ ५७ ॥ तत्रैनमम्बुरुहपत्रसमः स्पृशन्त्यः शीतैः करोरुवदनैः कठिनः स्तनैश्च । तोयावगाहकुशला मधुरस्वभावाः संहर्षयेयुरबलाः सुकलैः प्रलापैः ॥ ५८ ॥ Remedies for Daha-Now I shall describe the cooling measures

which should be employed for alleviating the burning sensaton (Daha) in the case of a rich patient. The body of such a patient under the circumstances should be smeared at the outest with Candana (white sandal wood) pastes made cooler by the contact of cold beams of the moon, pearl-necklaces and the water produced from melted icc. He should try to alleviate the burning feeling by strolling on the banks of a tank in a garden in the soft, cool and sweet breeze bearing on its wings the soft perfume of Kalhara (red) lotus and water-moss dancing in the adjoining tank. Water cooled and charged with Usira, Balaka and (white) sandal paste should be sprinkled over his body, or he should be made to sport in a cleansed tank filled with freshly collected water embalmed with full-blown red and blue lotus-flowers and scents (e.g. sandal pastes) after being smeared with sandal paste and with the hairs of his body standing on their roots with the magnetic touch of beloved female hands. Here he should take his bath with young, gay and beautiful damsels skilful in aquatic sports refreshing him with the lotus-like touch of their cold hands, thighs and mouth and hard (i.e., full-grown) breasts and with their sweet words. 55-58.

1. Decoction of the drugs of Madhura-gana and of the drugs of cold virtues.

धारागृहे प्रगलितोदकदुर्दिनाभे क्लान्तः शयीत सलिलानिलशीतकुक्षौ । गन्धोदकैः सकुसुमैरुपसिक्तभूमौ जात्युत्पलप्रियक केशरपुण्डरीके तस्मिन् गृहे कमलरेण्वरुणे शयीत म्लानं प्रतान्तमनसं मनसोऽनुकूला: पीनस्तनोरुजघना हरिचन्दनाङ्ग्यः । ता एनमार्द्रवसनाः सह संविशेयुः श्लिष्ट्वाऽबलाः शिथिलमेखलहारयष्ट्यः ॥ ६१ ॥ हर्षयेयुर्नरं नार्यः स्वगुणै रहसि स्थिताः । पत्राम्बुचन्दनरसैरुपलिप्तकुड्ये ॥ ५९॥ पुन्नागनागकरवीरकृतोपचारे । यत्राहृतानिलविकम्पितपुष्पदाम्नि ॥ ६० ॥ ता: शैत्याच्छमयेयुश्च पित्तपानात्ययान्तरम् ॥ ६२ ॥

He should lie down, when tired, in a cool chamber cooled with watery breeze, fitted with fountains and made dusky with the misty jets vapours, of water. The floor of the chamber should be sprinkled over with scented water and flowers and the walls thickly coated with pastes of sandal wood, Teja-patra and Balaka. The chamber should be scented and decorated with Mansi, Tamala, Musta, Kunkuma, Padmaleaves, Jati flower, Utpala (Blue-lotus ), Priyangu, Kesara (Bakula), and Pundarika (red – lotus ), Punnaga, Naga-Kesara, and Karavira and there in the room with garlands of flowers gently swinging in the sweet and lazy wind, the patient should lie down and listen to the sweet discourses about the Hemanta, the Vindhya the Malaya or the Himalaya mountains as well as about cold water, leaves of Kadali or of any other evergreen tree or plant and about the receptacles of full-blown blue or red lotus, as well as about topics of moon-rise, or any other subject which may be calculated to be agreeable to his mind under the circumstances. Young and beautiful damsels with their full and thickset breasts and thighs anointed with sandal pastes, being clad in wet splendid contours of their limbs, etc.) and with their necklaces and girdles loosely sliding down their bosoms and slender waists should lie there with him in their firm embrace. These damsels should refresh him with their secret charms in that lonely chamber and by means of their bodily coolness would be able to alleviate the burning sensation of aggravated Pitta due to overdrinking. 59-62.

तृड्दाहरक्तपित्तेषु कार्योऽयं भेषजक्रमः । सामान्यतो विशेषन्तु शृणु दाहेष्वशेषतः ॥ ६३ ॥

These are the measures in general which should be employed also in the cases of burning sensation due to the aggravated condition of blood, Pitta and thirst. Now hear my discourse on the measures which are to be specifically employed in the case of a burning sensation in the body under different circumstances. 63.

Symptoms of Raktaja Daha

कृत्सदेहानुगं रक्तमुद्रिक्तं दहति ह्यति । सञ्ञ्जूष्यते दह्यते च ताम्राभस्ताम्रलोचनः ॥६४ ॥ लोहगन्धाङ्गवदनो वह्निनेवावकीर्यते ॥ ६५ ॥

Symptoms of Raktaja Daha — The blood coursing through the whole body when aggravated by any cause whatsoever becomes heated and imparts a copper colour to the skin, complexion and the eye-balls of the patient. It produces a bloody smell in the mouth and the body, and the patient feels a burning and contracting sensation as if he is surrounded by fire. 64-65.

तं विलय विधानेन संसृष्टाहारमाचरेत् ॥ ६६ ॥ अप्रशाम्यति दाहे च रसैस्तृप्तस्य जाङ्गलैः | शाखाश्रया यथान्यायं रोहिणीर्व्यधयेच्छिराः ॥ ६७ ॥ पित्तज्वरसमः पित्तात् स चाप्यस्य विधिर्हितः ॥ ६८ ॥

Treatment Fasting should be prescribed at the outset in such a case and then the diet should be regulated conformably to the nature and intensity of the deranged bodily Dosa involved therein. If such burning sensation (in the body) be still unrelieved, the patient should be treated with a diet largely composed of the soup of Jangala animal flesh and venesecton in the extremeties should then be resorted to duly in conformity with the rules (prescribed in Chapter VIII-Sarira Sthana). Cases of burning sensation due to the aggravation of Pitta would produce the symptoms of Pittaja fever and remedies for Pittaja fever should in such cases be resorted to. 66-68.

Symptoms and treatment of Daha due to thirst

तृष्णानिरोधादब्धातौ क्षीणे तेजः समुद्धतम् । सबाह्याभ्यन्तरं देहं दहेद् वै मन्दचेतसः ॥ ६९ ॥ संशुष्कगलताल्वोष्ठो जिह्वां निष्कृष्य चेष्टते ॥ ७० ॥ तत्रोपशमयेत् तेजस्त्वब्धातुञ्च विवर्द्धयेत् । पाययेत् काममम्भश्च शर्कराढ्यं पयोऽपि वा । शीतमिक्षुरसं मन्थं वितरेच्चेरितं विधिम् ॥ ७९ ॥

Symptoms and treatment of Daha due to thirst — The watery part is dried up in the event of an unslaked thirst, thus generating a heat in the organism. This produces an extreme dryness of the lip, throat and palate and a burning sensation (Daha) both in the skin and inside the organism of the patient followed by the coming out of the tongue and the trembling of the whole body. The medical treatment under such circumstances consists in alleviating the heat and adding to the watery component of the body. A large draught of cold water or cooled milk saturated with a copious quantity of sugar, or of the expressed juice of sugar-cane or of Mantha should be given to the patient to his satiety under the circumstances. 69-71.

असृजा पूर्णकोष्ठस्य दाहो भवति दुःसहः । विधिः सद्योव्रणीयोक्तस्तस्य लक्षणमेव च ॥ ७२ ॥ धातुक्षयोक्तो यो दाहस्तेन मूर्च्छातृषान्वितः | क्षामस्वरः क्रियाहीनः भृशं सीदति पीडितः । रक्तपित्तविधिस्तस्य हितः स्निग्धोऽनिलापहः ॥ ७३ ॥

An intense burning sensation in the body is caused by the presence of accumulated blood in the abdomen (Kostha), the symptoms and therapeutics of which are those mentioned in the chapter on Sadyovrana (Chap II—Chikitsa-Sthana ). A burning sensation of the body incidental to the waste (Ksaya) of any of its fundamental organic principles (Dhatus) brings on thirst, fainting fits, feebleness of voice, suspension of physical and mental faculties or functions, weakness and lassitude in its train which should be remedied with measures laid down under Rakta-pitta. Emulsive and Vayu-subduing remedies are likewise applicable there in. 72-73.

क्षतजेनाश्नतश्चान्यः शोचतो वाऽप्यनेकधा । तेनान्तर्दह्यतेऽत्यर्थं तमिष्टविषयोपेतं क्षीरमांसरसाहारं विधिनोक्तेन साधयेत् ॥ ७५ ॥ मर्माभिघातजोऽप्यस्ति स चासाध्यतमः स्मृतः । सर्व एव च वर्ज्याः स्युः शीतगात्रेषु देहिषु ॥ ७६ ॥ ( एवंविधो भवेद् यस्तु मदिरामयपीडितः ) प्रशान्तोपद्रवे चापि शोधनं प्राप्तमाचरेत् ॥ ७७ ॥ तृष्णामूर्च्छाप्रलापवान् ॥ ७४ ॥ सुहृद्भिरभिसंवृतम्।

A severe internal burning sensation in the body may also be produced by (the aggravation of) blood due to (the breach of the rules of) diet and to grief of any kind. The symptoms in such cases are thirst, fainting fits and delirium. The remedy should consist in giving the patient the wished-for objects, and the diet under the circumstances should largely consist of milk and meatsoup to be partaken of in company with friends in the manner described before. A burning sensation in the body incidental to a hurt or to a blow on any of its vulnerable or tender parts (Marma) is the severest of its kind and should be deemed as incurable. All kinds of burning sensation in the body with a coolness of its surface are incurable. Emetics and prugatives should be exhibited according to the Dosa involved even after the subsidence of the supervening symptoms of excess in wine. 74-77.

सजीरकाण्याद्रक शृङ्गवेरसौवर्चलान्यर्धजलप्लुतानि मद्यानि हृद्यान्यथ गन्धवन्ति पीतानि सद्यः शमयन्ति तृष्णाम् ॥ ७८ ॥जलप्लुतश्चन्दनभूषिताङ्गः स्रग्वी सभक्तां पिशितोपदंशाम् । पिबन् सुरां नैव लभेत रोगान् मनोनुविघ्नञ्च मदं न याति ॥ ७९ ॥

Wine mixed with half its quantity of water and scented with Jiraka, Sauvarcala, Ardraka and Sunthi becomes palatable and immediately allays thirst. Wine, taken with meal and with cooked meat by a person besmeared with sandal paste and wearing wet clothes and garlands of flowers, does not produce any of its bad after-effects nor brings on intoxication which in its turn would throw the mind and mental faculties of their balance. 78-79.

इति सुश्रुत संहितायामुत्तरतन्त्रे पानात्ययप्रतिषेधव्याख्यानाम सप्तचत्वारिंशोऽध्यायः ॥ ४७ ॥

Thus ends the forty-seventh chapter of the Uttara-Tantra in the Susruta Samhita which deals with the (symptoms and) medical treatment of alcoholism.

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