अथातो धूमनस्यकवलग्रहचिकित्सितं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ।। १ ।।
Now we shall discourse on the treatment which consists in employing the (inhalation of) medicated fumes, snuffs, (errhines) and gargles (Dhuma-Nasya-Kavala-Graha-Chikitsa). 1
धूमः पञ्चविधो भवति; तद्यथा – प्रायोगिकः स्नैहिको वैरेचनिकः कासघ्नो वामनीयश्चेति ।। २ ।।
Dhuma (fumes ) may be divided into the five groups, viz., Prayogika (capable of being daily used). Snehana (soothing), Vairecana (expectorant), 2 Kasaghna (anti-cough) and Vamaniya (emetic ). 2
तत्रैलादिना कुष्ठतगरवर्ज्यन श्लक्ष्णपिष्टेन द्वादशाङ्गुलं शरकाण्डमङ्गुलिपरिणाहं क्षौमेणाष्टाङ्गुलं वेष्टयित्वा लेपयेत्, एषा वर्त्तिः प्रायोगिके । स्नेहफलसारमधूच्छिष्टसर्जरसगुग्गुलुप्रभृतिभिः स्नेहमिश्रैः स्नेहने । शिरोविरेचनद्रव्यैर्वैरेचने । बृहतीकण्टकारिकात्रिकटुकासमर्दहिङ्ग्विङ्गदीत्वङ्मनःशिलाच्छिन्नरुहाकर्कटशृङ्गीप्रभृतिभिः कासहरैश्च कासघ्ने । स्नायुचर्मखुरशृङ्गकर्कटकास्थिशुष्कमत्स्यवल्लूरक्रिमिप्रभृतिभिर्वामनीयैश्च वामनीये ।। ३।।
1. Charaka, however, divides Dhuma into three classes only–viz., Prayogika, Snaihika and Vairecanaka and includes the Kasa-hara into the Prayogika and Vamaniya into the Vairecana Dhuma.
The term Varecana here means Siro-Virechana by means of fumes.
Materials of different Dhuma-varti
Materials of different Dhuma-varti: The drugs of the Eladi group, excepting Kustha and Tagara, should be pasted together. A space of eight fingers out of the entire length of a stem of Sara weed twelve fingers long should be covered with a piece of silk cloth and plastered with the coat of the preceding paste. This stick should be burnt and used in the Prayogika Dhuma pana. The pith (pulp) of oleaginous fruits, wax and resin, Guggul, etc., with the admixture of a Sneha (oil or clarified butter) should be used in the Snehana-Dhuma. The drugs included into Siro-Verecana group should be used in Vairecana Dhuma. Brihati, Kanta-karika, Trkatu, Kasamarda, Hingu, Ingudi-bark, Manah-sila, Guduci and Karkata-srngi and such other drugs which allay cough should be used in the Kasaghna-Dhuma. Nerves, skin, horns, hoops, shells of a crab, dried fish, dry meat or worms, etc., and such other emetic drugs should be used in the Vamaniya-Dhuma. 3
Formation of the pipe used in Dhuma-Pana
तत्र बस्तिनेत्रद्रव्यैर्धूमनेत्रद्रव्याणि व्याख्यातानि भवन्ति । धूमनेत्रन्तु कनिष्ठिकापरिणाहमग्रे कलायमात्रस्त्रोतः, मूलेऽङ्गुष्ठपरिणाहं, धूमवर्त्तिप्रवेशस्त्रोतोऽङ्गुलान्यष्टचत्वारिंशत् प्रायोगिके, द्वात्रिंशत् स्नेहने, चतुर्विंशतिर्वैरेचने, षोडशाङ्गुलं कासघ्ने वामनीये च। एतेऽपि कोलास्थिमात्रच्छिद्रे भवतः । व्रणनेत्रमष्टाङ्गुलं व्रणधूपनार्थं कलायपरिमण्डलं कुलत्थवाहित्रोत इति । ॥ ४ ॥
Formation of the pipe used in Dhuma-Pana : The pipe to be used in respect of an inhaler should be made of one or other of the same substances of which the pipes of enema-syringes (Basti-netra) are made. The girth of such a pipe should be equal to that of the small finger at its mouth with an inner aperture or calibre as large as a Kalaya pulse, and its girth at the root or base should be equal to that of the thumb, while the girth of the inner aperture or near (at the root) should be sufficiently large to allow the Dhuma-Varti (made of Sara weed) to fit in. The length of the pipe should be forty-eight fingers² in respect of a Prayogika thirty-two fingers in respect of a Snehana, twenty-four fingers in respect of a Vairecana, sixteen fingers in respect of a Kasaghna (anti-cough) and Vamaniya (emetic) Dhuuma. The girth of the aperture (channel) should be equal to that of a stone of the Kola fruit in respect of the tube to be used in the last two cases (Kasaghana and Vamaniya). The tube to be employed in fumigation of an ulcer should be eight fingers in length and equal to a Kalaya pulse in outer girth, while the girth of the inner orifice should be sufficient to allow a Kulattha pulse to pass in. 4
1. Some commentators mean to explain “a” as Ingudi and cardamom instead of as Ingudi-bark. This seems to be better.
2. Charaka’s description of the pipes, (Chapter V, Slokasthana) corresponds closely to that of Susruta, except in the case of Prayogika pipe, where Charaka’s reading is somewhat ambiguous. There it may be consured to mean thirty-six as well as forty-eight fingers. Jatu-Karna, however, explicitly asserts forty
अथ सुखोपविष्टः सुमना ऋज्वधोदृष्टिरतन्द्रितः स्नेहाक्तदीप्ताग्रां वर्त्तिं नेत्रस्त्रोतसि प्रणिधाय धूमं पिबेत् ॥ ५॥
The medicinal stick (Varti) should be lubricated with a Sneha (clarified butter, etc.) It should then be attached to one end of the pipe (Netra) and lighted. The patient should sit in an easy and comfortable posture, maintain a cheerful frame of mind and carefully inhale the medicinal fumes with his eyes cast down straight towards the ground. 5
मुखेन तं पिबेत् पूर्वं नासिकाभ्यां ततः मुखपीतं मुखेनैवं वमेत् पीतञ्च मुखेन धूममादाय नासिकाभ्यां न तेन हि प्रतिलोमेन दृष्टिस्तत्र निहन्यते ॥ ७ ॥ पिबेत् । नासया ।। ६ ।। निर्हरेत् ।
Metrical Texts: The fumes should be first inhaled through the mouth and then through the nostrils; whether inhaled through the mouth or the nostrils the smoke should be invariably exhaled through the mouth. Inhaled through the mouth, the smoke should not by any means be exhaled through the nostrils, as such a course (of exhaling through the nostrils) would act wrongly and impair the eye-sight. 6-7
विशेषतस्तु प्रायोगिकं घ्राणेनाददीत, स्नैहिकं मुखनासाभ्यां, नासिकया वैरेचनिकं, मुखेनैवेतरौ ॥ ८ ॥
The fumes (Dhuma) should be specially inhaled through the nostrils, in connection with a Prayogika inhalation, while they may be inhaled both through the mouth and the nostrils in Snehana-Dhuma.
eight fingers to be the length of the pipe in question. Vrnda is in a fix, and solves the difficulties by explaining that in cases of an aggravation of Kapha and an abundance of Dosas, the length of the pipe should be thirty-six fingers.
They should be inhaled through the nostrils alone in an act of Vairecana inhalation and through the mouth only in the two remaining cases (Vamaniya and Kasaghna). 8
Mode of inhalation
तत्र प्रायोगिके वर्तिं व्यपगतशरकाण्डां निवातातपशुष्कामङ्गारेष्ववदीप्य नेत्रमूलस्त्रोतसि प्रयुज्य धूममाहरेति ब्रूयात् । एवं स्नेहनं वैरेचनिकञ्च कुर्यादिति । इतरयोर्व्यपेतधूमोद्गारे स्थिरे समाहिते शरावे प्रक्षिप्य वर्तिं मूलच्छिद्रेणान्येन शरावेण पिधाय तस्मिंश्छिद्रे नेत्रमूलं संयोज्य धूममासेवेत । प्रशान्ते धूमे वर्तिमवशिष्टां प्रक्षिप्य पुनरपि धूमं पाययेदादोषविशुद्धेः । एष धूमपानोपायविधिः ।। ९ ।।
Mode of inhalation: In an act of Prayogika inhalation, the stick (Varti) should be dried in shaddy places protected from the wind. The stem of the Sara weed inside the Varti should then be removed. The Varti should then be lighted with a live charcoal and fixed to the end of the pipe (Netra) and then the patient should be asked to inhale the fumes. The same method should be followed in respect of Snehana and Vairecana ones. In the other cases of smoking (Kasaghna and Vamaniya) the fumigating drugs (Varti) should be paled over a bed of smokeless burning charcoal contained in an earthern saucer. Another saucer furnished with an aperture at its top or middle should be fitted over the former saucer and the inhaling pipe should be fitted into this aperture, and the fumes should be inhaled (through the mouth). On the subsidence of the fumes the remaining portion of the stick should be cast into the fire and the patient should continue to inhale the fumes till the complete elimination of the aggravated Dosas from his organism. This is the rule and means of inhalation (Dhuma-pana). 9
तत्र शोकश्रमभयामर्षीष्ण्यविषरक्तपित्तमदमूर्च्छादाहपिपासापाण्डुरोगतालुशोषच्छर्दिशिरोऽभिघातोद्गारापतर्पिततिमिरप्रमेहोदराध्मानोर्ध्ववातार्ता बालवृद्धदुर्बलविरिक्तास्थापितजागरितगर्भिणीरुक्षक्षीणक्षतोरस्कमधुघृतदधिदुग्धमत्स्यमद्ययवागूपीताल्पकफाश्च न धूममासेवेरन् ।। १० ।।
Prohibitive Cases : Any kind of smoking (Dhuma-pana) is forbidden to a person afflicted with anger, fear, bereavement, fatigue, and in a heated state of the body and after fasting. It is also forbidden in cases of poisoning, haemorrhage (Rakta-pitta), alcoholism, swooning, burning sensation of the body, thirst, anaemia, dryness of the palate, vomiting, head-disease, eructation, effects of prolonged fast Timira’, urinary complaints (Prameha), abdominal enlargement with dropsy (Udara ), distension of the abdomen and Urddha-vata, and in respect of infants, old and enfeebled persons, as well as of those treated with purgatives and Asthapana-basti. It is also forbidden to enciente women, those suffering from insomnia or a parched condition of the body as well as to those suffering from any kind of cachexia or from Urah-Ksata. An act of inhaling ( smoke ) is also prohibited after taking a potion of honey, clarified butter, curd, and milk, fish, wine or gruel (Yavagu) as well as during the continuance of a small quantity of Kapha in the organism. 10
अकालपीतः कुरुते भ्रममूर्च्छाशिरोरुजः । घ्राणश्रोत्राक्षिजिह्वानामुपघातञ्च दारुणम् ।। ११ ।।
Metrical Text: Medicated fumes inhaled in an improper season (viz., in the above-mentioned prohibited cases) bring on vertigo, fainting fits, diseases of the head and serious injury to the eyes, ears, nose and the tongues. 11
Time of Smoking
आद्यास्तु त्रयो धूमा द्वादशसु कालेषूपादेयाः । तद्यथा – क्षुतदन्तप्रक्षालननस्यस्नानभोजनदिवास्वप्नमैथुनच्छर्दिमूत्रोच्चार – हसितरुषितशस्त्र – कर्मान्तेष्विति। तत्र विभागो मूत्रोच्चारक्षवथुहसितरुषितमैथुनान्तेषु स्नैहिकः, स्नानच्छर्दनदिवास्वप्नान्तेषु वैरेचनिकः, दन्तप्रक्षालननस्यस्नानभोजनशस्त्रकर्मान्तेषु प्रायोगिक इति ।। १२ ।।
Time of Smoking: The first three kinds of inhalations should be resorted to at the close of the following twelve physical functions and acts, viz. sneezing, cleansing the teeth, snuffing, bathing, eating, sleeping in the day, coition, vomiting, micturition, passing stools, fits of anger and surgical operations. A Snehana-Dhuma should be smoked after sneezing, cleansing the teeth, snuffing, bathing, eating. sleeping in the day, coition, vomiting, micturition, passing stools. laughing, fits of anger and surgical operations. A Snehana-Dhuma should be smoked after sneezing, micturition, passing stools, coition or after a fit of anger. Similarly, a Varecana-Dhuma should be smoked after bathing, vomiting and sleeping in the day time. While a PrayogikaDhuma should be smoked after cleansing the teeth, snuffing, bathing, eating and after a surgical operation. 12
The therapeutic effects of Dhuma pana
तत्र स्नैहिको वातं शमयति, स्नेहादुपलेपाच्च । वैरेचनः श्लेष्माणमुत्क्लेश्यापकर्षति, रौक्ष्यात् तैक्ष्ण्यादौष्ण्याद् वैशद्याच्च । प्रायोगिकः श्लेष्माणमुत्क्लेशयति, उत्क्लिष्टञ्चापकर्षति शमयति वातं साधारणत्वात् पूर्वाभ्यामिति ।। १३ ।।
The therapeutic effects of Dhuma-pana: Smoking the SnehanaDhuma subdues the deranged and aggravated Vayu of the body owing to the existence of the Sneha with which it is charged, as well as to a consequent sticky coating being deposited in the organism. The Vairecana-Dhuma facilitates the loosening and flowing out of the mucus (Kapha) owing to its dryness non-viscidness (Vaisadya), keenness and heat-making potency. While the Prayogika-Dhuma tends to loosen the accumulation of the mucus (Kapha) and helps its expulsion from the system by virtue of its being possessed of common therapeutic properties with both of the two preceding kinds (of Dhuma). 13
भवति चात्रनरो धूमोपयोगाच्च प्रसन्नेन्द्रियवाङ्मनाः । दृढकेशद्विजश्मश्रुः सुगन्धिविशदाननः ॥ १४ ॥
Memorable Verse: Inhalation of (medicated) fumes removes the cloudening of the faculties of the organs of sense-perception and imparts distinctness of the speech and firmness to the teeth, hair of the head and beard. It cleanses the mouth and fills it with an aroma. 14
तथा कासश्वासारोचकास्योपलेप-स्वरभेदमुखास्राववमथुक्षवथु – क्रथतन्द्रानिद्राहनुमन्यास्तम्भाः पीनसशिरोरोग-कर्णाक्षिशूला-वातकफनिमित्ताश्चास्य मुखरोगा न भवन्ति ।। १५ ।।
The inhalation of medicated fumes guards against an attack of cough, asthma, an aversion to food and clumsy sensation in the mouth. hoarseness, excessive salivation, sneezing, vomiting, drowsiness, somnolence, sleep, numbness of the jaws and of the nerves (Snayu) on the back of the neck (Manya), chronic catarrh, diseases of the head, earache, inflammation of the eyes, and any affection of the mouth due to an aggravation of the deranged Vayu and Kapha. 15
तस्य योगायोगातियोगा विज्ञातव्याः । तत्र योगो रोगप्रशमनः, अयोगो रोगाप्रशमनः । तालुगलशोषपरिदाहपिपासामूर्च्छाभ्रममदकर्णक्ष्वेडदृष्टिनासारोगदौर्बल्यान्यतियोगो जनयति । । १६ ।।
It behoves a physician to be fully acquainted with the effects of adequate, inadequate and excessive smoking (Dhuma-pana). Properly administered is followed by a distinct alleviation of the disease under treatment; does not cure, while its excessive use is followed by a positive aggravation of the disease and is likely to produce a dryness of the palate and the throat, a burning sensation in the body, thirst, fainting fits, vertigo, delirium, alcoholism, affection of the ears, nose and eyes, impairment of vision, and weakness of the body. 16
Mode of Smoking
प्रायोगिकं त्रींस्त्रीनुच्छ्वासानाददीत मुखनासिकाभ्याञ्च पर्यायांस्त्रींश्चतुरो वेति, स्नैहिकं यावदश्रुप्रवृत्तिः, वैरेचनिकमादोषदर्शनात्, तिलतण्डुलयवागूपीतेन पातव्यो वामनीयः, ग्रासान्तरेषु कासघ्न इति । व्रणधूमं शरावसम्पुटोपनीतेन नेत्रेण व्रणमानयेत्, धूपनाद् वेदनोपशमो व्रणवैशद्यमास्त्रावोपशमश्च भवति ।। १७ ।।
Mode of Smoking: The Prayogika-Dhuma should be smoked thrice at a time either through the mouth or through the nostrils and may be repeated thrice or four times (according to the strength of the patient and the itensity of the Dosa). The Snaihika-Dhuma should be inhaled until the appearance of tears in the eyes. While the VairecanikaDhuma should be smoked till the beginning of the elimination of the Dosas from the system. The Vamaniya-Dhuma should be smoked by a patient after he has taken a gruel of huskless sesamum (TilaTandula), and the Kasaghna-Dhuma should be inhaled between morsels of food.2 Fumigation of an ulcer should be made by means of a tube attached to (the orifice of) a covered saucer. Fumigation alleviates the pain in an ulcer, arrests its discharge and makes it clean and non-viscid. 17
1. According to Vrnda’s commentator we have here Sneezing and a sudden obstruction of breath as an additional text.
2. Dalhana quotes a different reading which would mean that the Kasaghna
विधिरेष समासेन धूमस्याभिहितो मया । नस्यास्यातः प्रवक्ष्यामि विधिं निरवशेषतः ।। १८ ।।
Metrical Text: The processes of inhalation and fumigation have been briefly described above. Now I shall fully describe the processes of using medicinal snuffs ( Nasya). 18
Snuffs and Errhines
– औषधमौषधसिद्धो वा स्नेहो नासिकाभ्यां दीयत इति नस्यम् । तद् द्विविधम् – शिरोविरेचनं स्नेहनञ्च । तद् द्विविधमपि पञ्चधा । तद्यथानस्यं, शिरोविरेचनं, प्रतिमर्श: अवपीडः, प्रधमनञ्च । तेषु नस्यं प्रधानं शिरोविरेचनञ्च, नस्यविकल्पः प्रतिमर्शः, शिरोविरेचनविकल्पोऽवपीडः प्रधमनञ्च । ततो नस्यशब्दः पञ्चधा नियमितः ।। १९-अ ।।
Snuffs and Errhines : The term “Nasya” (snuff) is so called from the fact of its being composed of the powders of any drugs or of any Sneha (oleaginous substance) cooked with such drug or drugs, to be snuffed into the nostrils. It may be broadly divided into two kinds, viz. Siro-Virechana (errhines) and Snehana (contributor of oleaginous principles); and may, however, be further grouped under five specific heads, viz. Nasya, Siro-Virechana, Pratimarsa (a medicated Sneha poured into the nostrils to be discharged into the mouth), Avapida (the expressed juice of any drug put into the nostrils in drops by pressing it with the palms then there) and Pradhamana (a medicinal snuff blown into the nostrils with the help of a blow pipe). Of these, the Nasya (snuff) and Siro-Virechana (errhines) are pre-eminently the most effective. Pratimarsha is a Nasya while Avapida and Pradhamana are Siro – Virechana (errhines). Thus it is that the term Nasya is employed in the above five senses. 19-A
तत्र यः स्नेहनार्थं शून्यशिरसां ग्रीवास्कन्धोरसाञ्च बलजननार्थं दृष्टिप्रसादजननार्थं वा स्नेहो विधीयते तस्मिन् वैशेषिको नस्यशब्दः । तत् तु देयं वाताभिभूते शिरसि दन्तकेशश्मश्रुप्रपातदारुणकर्णशूलकर्णक्ष्वेडतिमिरस्वरोपघातनासारोगास्यशोषावबाहुकाकालजवलिपलितप्रादुर्भावदारुणप्रबोधेषु वातपैत्तिकेषु मुखरोगेष्वन्येषु च वातपित्तहरद्रव्यसिद्धेन स्नेहेनेति ।। १९ ।।
Dhuma should be inhaled after taking meals. The term Nasya in the specific sense, is particularly used with reference to the snuffing of any Sneha (oleaginous substance) with a view to make up the deficient oily matter in the brain in the case of patient complaining of a sense of void or emptiness in the head or to impart tone to the nerves and muscles of the neck, shoulders and chest, or to invigorate the eye-sight. This should be prepared with a Sneha (oleaginous substance) cooked with the drugs possessed of the virtue of subduing the deranged Vayu and Pitta and should be snuffed in by a patient affected in the head through the overwhelming preponderance of the deranged Vayu and in cases of the falling off of the teeth and hair of the head and beard, in Karna-Ksveda, acute ear-ache, Timira (cataract), loss of voice, disease of the nose, dryness of the mouth, Avabahuka, premature greyness of the hair and wrinkling of the skin and other dangerous complications due to the deranged Vayu and Pitta as well as similar other affections of the mouth. 19
शिरोविरेचनं श्लेष्मणाऽभिव्याप्ततालुकण्ठशिरसामरोचकशिरोगौरवशूलपीनसार्धावभेदककृमिप्रतिश्यायापस्मारगन्धाज्ञानेष्वन्येषु चोर्ध्वजत्रुगतेषु कफजेषु विकारेषु शिरोविरेचनद्रव्यैस्तत्सिद्धेन वा स्नेहेनेति ।। २० ।।
Siro-Virechana : Powders of the Siro-Virechana drugs¹ or any Sneha cooked with those drugs² should be employed in the event of there being an accumulation of Kapha (mucus) in the region of the palate, throat, or head of a patient, as well as in cases of an aversion to food, head-ache, heaviness of the head, Pinasa (coryza), Ardhavabhedaka (haemicranial), neuralgia worms, Pratisyaya (cattarrh), loss of the faculty of smell, hysteric convulsion (Apasmara) and in similar other diseases of the super-clavicular regions due to the action of the deranged Kapha. 20
तत्रैतद् द्विविधमप्यभुक्तवतोऽन्नकाले, पूर्वाहे श्लेष्मरोगिणाम्, मध्याह्ने पित्तरोगिणाम् अपराह्ने वातरोगिणाम् ।। २१ ।।
1. The Siro-Virechana drugs are Pippali, Vidanga, Sigru, Siddharthaka, Apamarga, etc. See Sutrasthana, Chapter XXXIX.
2. Srikantha Datta, commentator of Vrnda, says that Gayi reads forfaterceffere etc., from which it is evident that he prescribed only the Sneha cooked with the Siro-Virechana drugs as Siro-Virechana Nasya.
These two kinds of Nasya (snuffs) should be administered before meals. To a patient affected with diseases of Kaphaja origin they should be administered in the morning, while one suffering from any Pittaja complaint should use them at noon and one afflicted with any distemper of the deranged Vayu should use them in the afternoon.¹ 21
अथ पुरुषाय शिरोविरेचनीयाय त्यक्तमूत्रपुरीषाय भुक्तवते व्यभ्रे काले दन्तकाष्ठधूमपानाभ्यां विशुद्धवक्तस्त्रोतसे पाणितापपरिस्विन्नमृदितगलकपोलललाटप्रदेशाय वातातपरजोहीनवेश्मन्युत्तानशायिने प्रसारितकरचरणाय किञ्चित् प्रविलम्बितशिरसे वस्त्राच्छादितनेत्राय वामहस्तप्रदेशिन्यग्रोन्नामितनासाग्राय विशुद्धस्त्रोतसि दक्षिणहस्तेन स्नेहमुष्णाम्बुनाप्रतप्तं रजतसुवर्णताम्रमृत्पात्रशुक्तीनामन्यतमस्थं शुक्त्या पिचुना वा सुखोष्णं स्नेहमद्रुतमासिञ्चेदव्यवच्छिन्नधारं यथा नेत्रे न प्राप्नोति ।। २२ ।।
Before the application of a Siro-Virechana (errhine) the patient should be asked to pass stool and urine and take some food (before receiving the snuff treatment. The appropriate time for the Nasya is when the sky is clear of the clouds. The person to whom head cleanning-errhines are to be administered should clean his mouth and nasal panages with a tooth twig and by inhaling fumigation. Then the regions of the neck, cheek and forehead should be fomented and softened with the application of heated palms, the patient himself being laid on his back in a dustless chamber not exposed to the sun and the wind. His head should be kept a little hung back with his arms and legs fully stretched out and expanded and a cloth should be tied over the eyes. Then the physician should lift up with the fore-finger of his left hand the tip of the nose of the patient and slowly drop with his right hand a continuous jet of (medicated) Sneha into the cleansed channels of the (patient’s) nostrils. The oil to be so used should be made lukewarm (D. R. — made lukewarm in the sun ) and kept in a golden, silver, copper, or earthen receptacle or in an oyster shell and poured down into the nostrils of the patient by means of an oyester shell (D.R.–pipe) or (by presting) a cotton plug ( soaked in that oil). Care should be taken that the oil does not get into the eyes (while being poured into the nostrils ). 2 22
1. In respect of healthy patients, the Nasya should be administered at noon in winter, in the morning in spring and autumn, and in the afternoon in summer. while in the rainy season, they should be administered at a time when the sun would be visible in the sky. –Vrddha-Vagbhata.
स्नेहेऽवसिच्यमाने तु शिरो नैव प्रकम्पयेत् ।
न कुप्येन्न प्रभाषेच्च न क्षुयान्न हसेत् तथा ।। २३ ।। एतैर्हि विहतः स्नेहो न सम्यक् प्रतिपद्यते ।
ततः कासप्रतिश्याय – शिरोऽक्षिगदसम्भवः ।। २४ ॥
Metrical Texts : The patient should refrain from shaking his head or indulging in a fit of a anger or speaking, sneezing or laughing at the time of any oily snuff (Sneha-Nasya) being administered unto him, as it may otherwise badly interfere with its reaching down to the desired spot or may bring on an attack of cough or coryza (catarrh) or any affection of the head or of the eyes. 23-24
Doses of a Sneha Nasya
तस्य प्रमाणमष्टौ विन्दवः प्रदेशिनीपर्वद्वयनि:सृताः प्रथमा मात्रा, द्वितीया शुक्तिः, तृतीया पाणिशुक्तिः, इत्येतास्तिस्त्रो मात्रा यथाबलं प्रयोज्याः ।। २५ ।॥
Doses of a Sneha-Nasya : Eight drops of oil trickling down the two upper phalanges of the fore-fingers should be regarded as the proper quantity for the smallest (lit. –first ) dose. A Sukti measure (thirty-two drops ) is the intermediate (lit. –second) dose and a Pani – Sukti measure (sixty-four drops) is the highest (lit.–third) dose. These are the three doses (of Sneha-Nasya) which should be determined in proportion to the strength of the patient and of the disease under treatment. 25
स्नेहनस्यं नोपगिलेत् कथञ्चिदपि बुद्धिमान् । शृङ्गाटकमभिप्लाव्य निरेति वदनाद् यथा ।
कफोत्क्लेशभयाच्चैनं निष्ठीवेदविधारयन् ।। २६ ।।
Metrical Text: An oily snuff should never be swallowed. An oily snuff (Sneha-Nasya) should be hawked in so as to flow along the girths (Sringataka) of the nostrils and immediately spit out (by the patient), without retaining it in the mouth for a moment, as it may otherwise (irritate the mucous membrances of the throat, etc., and) aggravate the local Kapha. 26
1. The commentator of Vrnda adds two more conditions –viz., the patient should be made to pass stools and urine before the application of the Nasya and that the Nasya should be applied at a time the sky would be free from clouds.
दत्ते च पुनरपि संस्वेद्य गलकपोलादीन् धूममासेवेत । भोजयेच्चैनभभिष्यन्दि, ततोऽस्याचारिकमादिशेत्, रजोधूमस्नेहातपमद्यद्रवपानशिरः स्नानातियानक्रोधदीनि च परिहरेत् ।। २७ ।।
The region of the neck and the cheeks, etc., of the patient should be fomented again after the use of the oily snuff (Sneha-Nasya) and the patient should be made to smoke, and partake of a meal composed of any phlegmogenic articles (bhisyandi). He should then be advised as to regimen of conduct, etc. (to be subsequently observed). Washing the head, exposure to the sun, dust and smoke, the use of any intoxicating liquor or of any other liquid or oleaginous substance, indulgence in a fit of anger and excessive driving, etc., are strictly prohibited (after the application of Sneha-Nasya). 27
तस्य योगातियोगायोगानामिदं विज्ञानं भवति । लाघवं शिरसो योगे सुखस्वप्नप्रबोधनम् । विकारोपशम: शुद्धिरिन्द्रियाणां मनः सुखम् ।। २८ ।। कफप्रसेकः शिरसो गुरुतेन्द्रियविभ्रमः । लक्षणं मूर्ध्यतिस्निग्धे रुक्षं तत्रावचारयेत् ।। २९ ।। अयोगे वातवैगुण्यमिन्द्रियाणाञ्च रुक्षता । रोगाशन्तिश्च तत्रेष्टं भूयो नस्यं प्रयोजयेत् ।। ३० ।।
Effects of proper, excessive, or deficient application of a Sneha-Nasya (M.T.) : The effects of proper excessive and deficient applications of (oily) snuffs will now be described. Lightness of the head, sound and refreshing sleep, the state of being easily awakened, alleviation of the disease, hilarity of the mind and a gladsome activity of the sense-organs in performing their respective functions, are the symptoms which attend a proper and satisfactory application (of an oleaginous medicinal snuff). Salivation, heaviness of the head, and dulness of the sense organs are the symptoms which result from an excessive application of a Sneha (Nasya) and the remedy in such cases consists in employing the parching measures of medicines. A case of deficinet application (of a Sneha-Nasya) is marked by the functional derangements of the sense-organs¹ and a dryness (Ruksata) of the system without any indication of the amelioration of the disease. The remedy, in such cases, consists in a fresh application of the (oleaginous ) snuff. 28-30
चत्वारो बिन्दवः षड्वा तथाऽष्टौ वा यथाबलम् । शिरोविरेकस्नेहस्य प्रमाणमभिनिर्दिशेत् ।। ३१ ।।
The proper doses of an oleaginous errhine (Siro-Vireka) should be four, six or eight drops in accordance with strength (of the disease and of the patient under treatment). 31
नस्ये त्रीण्युपदिष्टानि लक्षणानि प्रयोगतः । शुद्धहीनातिसंज्ञानि विशेषाच्छास्त्रचिन्तकैः ।। ३२ ।।
व्याधिनिर्जयः । लाघवं शिरसः शुद्धिः स्रोतसां चित्तेन्द्रियप्रसादश्च शिरसः शुद्धिलक्षणम् ।। ३३ ।।
कण्डूपदेहौ गुरुता स्त्रोतसां कफसंस्त्रवः । मूर्छिन हीनविशुद्धे तु लक्षणं मस्तुलुङ्गागमो परिकीर्तितम् ॥ ३४ ॥
वात-वृद्धिरिन्द्रियविभ्रमः । शून्यता शिरसश्चापि मूर्टिन गाढविरेचिते।। ३५।।
The framers of the Ayurveda have particularly classified the effects of the application (of a Sneha-Nasya) into three classes, viz., proper or satisfactory, deficient and excessive. The head being satisfactorily cleared (by the satisfactory application (of an oleaginous errhine) is marked by a sense of lightness in the head, clearness of the channels (of the mouth, throat, nostrils, etc.), an amelioration of the disease under treatment, healthy and vigorous workings of the senseorgans and an exhilarating sensation of the body and of the mind. Itching, clumsiness of the mouth, heaviness, saturation of the local channels (of the mouth, throat, etc.) with mucous coatings are the symptoms which mark the deficient action of (an oleaginous) errhine. A discharge through the nostrils of Mastulunga (the brain-matter), an aggravation of the Vayu, dulness of the sense-organs and a sense of void or emptiness in the head are the indications which mark an excessive application of an (oleaginous) errhine. 32-35
1. Gayi’s reading, according to Dalhana, as well Srikantha’s reading is “वातवैगुण्यम्” which means the functional derangement of the local Vayu.
हीनातिशुद्धे शिरसि कफवातघ्नमाचरेत् । सम्यग्विशुद्धे शिरसि सर्पिर्नस्यं निषेचयेत् एकान्तरं द्वयन्तरं वा सप्ताहं वा पुनः पुनः एकविंशतिरात्रं वा यावद् वा साधु मन्यते ।। ३७ ।। मारुतेनाभिभूतस्य वाऽत्यन्तं यस्य देहिनः । द्विकालञ्चापि दातव्यं नस्यं तस्य विजानता ।। ३८ ।।
Measures and remedies possessed of the virtue of subduing the deranged Kapha and Vayu should be (respectively) employed in cases of excessive and deficient applications of (an oleaginous) errhine (Nasya), while in the case of a proper and satisfactory application the patient should be made to snuff in a proper quantity of clarified butter on each alternate day or at an interval of two days for one, two or three weeks in succession or for any longer period as considered proper according to the exigency of the case. In a case of an overwhelming aggravation of the Vayu, the patient may be made to use the snuff (of clarified butter) even twice a day. 36-38
अवपीडस्तु शिरोविरेचनवदभिष्यण्णसर्पदष्टविसंज्ञेभ्यो दद्याच्छिरोविरेचनद्रव्याणामन्यतममवपिष्यावपीडच च, शर्करेक्षुरसक्षीरघृतमांसरसानामन्यतमं क्षीणानां शेणितपित्ते च विदध्यात् ।। ३९ ।।
Avapida-Nasya : The Avapida-Nasya, like the Siro-Virechana Nasya, should be administered to a person bitten by a snake, or lying in a comatose or unconscious state or suffering from a disease of the head due to its being oppressed with an accumulation of fat and mucus (Ahisyanda ). An Avapida-Nasya should be administered to a patient by pasting any of the (fresh) Siro-Virechana drugs and putting a few drops therefrom into the nostrils of the patient. In cases of a distraction of the mind or of a disease of a parasitic origin or of patients suffering from the effects of poisoning the fine powder (of the Siro-Virechana drugs) should (by means of a pipe) be blown into the nostrils of the patient. Sugar, the expressed juice of the sugar-cane, milk, clarified butter or an extract of meat should be (similarly) administered in the case of a weak patient or of one suffering from an attack of RaktaPitta. 39
योषिताम् । कृशदुर्बलभीरूणां सुकुमारस्य शृताः स्नेहाः शिरः शुद्धयै कल्कस्तेभ्यो यथा हितः । ॥ ४० ॥
Metrical Texts : A Sneha (oil or clarified butter) cooked with the pasted drugs (of the Siro-Virechana group) would be as beneficial as the powder (Kalka) of those drugs for the purpose of an errhine in respect of a weak, emaciated, timid, delicate or female patient. 40
चेतोविकारकृमिविषाभिपन्नानां चूर्णं प्रथमेत् ।। ४१ ।।
Pradhamana Nasya : The Powder (of drugs used for purification of the head) should be administered (through the nostils) by the pradhamana technique in the psychotic and in those suffering from worm infestations and poisoning. 41
नस्येन परिहर्तवे भुक्तवानपतर्पितोऽत्यर्थतरुणप्रतिश्यायी गर्भिणी पीतस्नेहोदकमद्यद्रवोऽजीर्णी दत्तबस्तिः क्रुद्धो गरार्तस्तृषितः शोकाभिभूतः श्रान्तो बालो वृद्धो वेगावरोधितः शिरः स्नातुकामश्चेति, अनार्तवे चाभ्रे नस्यधूमौ परिहरेत् ।। ४२-अ।।
Forbidden Cases: A fasting person, or one who has just taken his meal, or one suffering from an acute catarrh or coryza of a virulent type, an enciente woman, a man found to be still under the influence of an intoxicating liquor or who has taken a Sneha (oleaginous substance), water or any other liquid, or one suffering from indigestion or who has been treated with an enema (Basti), one in an angry and excited state of mind or afflicted with thirst or who is suffering from the effects of any slow chemical poison (Gara) or fatigued or overwhelmed with grief as well as an infant, an old man, one who has voluntarily repressed any natural urging of the body or one about to take a full bath (Sira-Snana) should be regarded unfit for treatment with (any kind of medicinal) snuff (Nasya). Snuffing and smoke inhalation should not be resorted to in the event of the sky being (unseasonably) overcast with clouds at a time when such phenomena do not usually or ordinarily happen. 42-A
तत्र हीनातिमात्रातिशीतोष्णसहसाप्रदानादतिप्रविलम्बितशिरस उच्छिङ्गतो विचलतोऽभ्यवहरतो वा प्रतिषिद्धप्रदानाच्च व्यापदो भवन्ति तृष्णोद्गारादयो दोषनिमित्ताः क्षयजाश्च ।। ४२ ।।
A deficient or an excessive application of snuffs (at one time), or its extreme heat or coldness, a sudden or delayed application of the same (into the nostrils), drooping posture of the head or its movements during the application, the fact of its being used while the patient would be taking his meals, or its application in any forbidden case may produce such distressing symptoms as thirst eructations, etc., due to the action of the aggravated or decreased Dosas of the body. 42
नस्ये शिरोविरेके च व्यापदो द्विविधाः स्मृताः । दोषोत्क्लेशात् क्षयाच्चैव विज्ञेयास्ता यथाक्रमम् ॥ ४३ ॥ दोषात्क्लेशनिमित्तास्तु जयेच्छमनशोधनैः । अथ क्षयनिमित्तास्तु यथास्वं बृंहणं हितम् ॥ ४४ ।।
Metrical Texts: The evils which are usually found to attend an abuse of medicinal snuffs ( Nasya) or errhines ( Siro-vireka) may be grouped into two classes– those incidental to the aggravation (Utklesa ) of the Dosas or to the loss or waste (Ksaya) of the same. The distempers due to an aggravation of the Dosas should be remedied with soothing (Samana ) and corrective (Sodhana) measures and remedies, while those resulting from the loss or waste of the Dosas should be remedied with such drugs and remedies as would make up the decreased Dosas (of the system ). 43-44
Pratimarsa Nasya when to be used
प्रतिमर्शश्चतुर्दशसु कालेषूपादेयः । तद्यथा– तल्पोत्थितेन, प्रक्षालितदन्तेन, गृहान्निर्गच्छता, व्यायामव्यवायाध्वपरिश्रान्तेन, मूत्रोच्चारकवलाञ्जनान्ते, भुक्तवता, छर्दितवता, दिवास्वप्नोत्थितेन, सायञ्चेति ।। ४५ । ।
Pratimarsa Nasya when to be used : The Pratimarsa form of snuff should be resorted to on any of the following fourteen different occasions, viz. after quitting the bed in the morning, after cleansing the teeth, on the occasion of going out of the house, after having been fatigued with physical exercise, after sexual intercourse and a journey. after defecation and urination, after the use of gargles (Kavala) and collyrium (Afnjana), in an empty stomach, after vomiting. just after a day-sleep and in the evening. 45
तत्र तल्पोत्थितेनासेवितः प्रतिमर्शो रात्रावुपचितं नासास्त्रोतोगतं मलमुपहन्ति मनःप्रसादञ्च करोति । प्रक्षालितदन्तेनोसवितो दन्तानां दृढतां वदनसौगन्ध्यञ्चापादयति । गृहान्निर्गच्छता सेवितो नासास्त्रोतसः क्लिन्नतया रजो धूमो वा न बाधते । व्यायाममैथुनाध्वपरिश्रान्तेनासेवितः श्रममुपहन्ति । मूत्रोच्चारान्ते वा सेवितो दृष्टेर्गुरुत्वमपनयति । कवलाञ्जनान्ते सेवितो दृष्टि प्रसादयति । भुक्तवतासेवितः स्त्रोतसां विशुद्धिं लघुताञ्चापादयति । वान्तेनासेवितः स्त्रोतोविलग्नं श्लेष्माणमपोह्य भक्ताकाङ्क्षामापदयति । दिवास्वप्नोत्थितेनासेवितो निद्राशेषं गुरुत्वं मलञ्चापोह्य चित्तैकाग्रचं जनयति । सायञ्चासेवितः सुखिनिद्राप्रबोधञ्चेति ।। ४६ ।।
Their Effects: A Pratimarsa snuff used by a person just after rising from his bed tends to remove the waxy mucous (Mala) accumulated in the nostrils during the night and brings on a cheerful state of the mind, when used after having cleansed the teeth, it imparts a sweet aroma to the mouth and makes the teeth steady and firm (in their sockets). When used by a man on the occasion of his going out of the house, it acts as a safeguard against the troubles of smoke and dust (assailing him on the road) owing to the consequent moist mucous secretion in the nostrils. When used after the exertion of physical exercise, coition or a journey, it serves to remove the sense of consequent fatigue, and when used after micturition or defecation it tends to remove the dulness or heaviness of vision. When applied after gargling or after an application of collyrium (along the eyelids) it serves to invigorate the eye-sight. When applied after taking meals, it cleanses the internal channels of the body and imparts a lightness to it. Taken after an act of emesis it tends to cleanse the mucous (Slesma) deposit on the beds of the internal ducts of the body and thus brings on a fresh appetite for food. When taken after a day-sleep it tends to remove the sense of drowsiness and physical heaviness and purges the filthy accumulations (in the nose, etc.) thus bringing about a concentrated state of the mind. When taken in the evening it brings on a good sleep and an easy awakening. 46
ईषदुच्छिङ्घतः स्नेहो यावद् वक्तुं प्रपद्यते । नस्ये निषिक्तं तं विद्यात् प्रतिमर्शं प्रमाणतः।। ४७।।
नस्येन रोगाः शाम्यन्ति नराणामूर्ध्वजत्रुजाः । इन्द्रियाणाञ्च वैमल्यं कुर्यादास्यं सुगन्धि च ।। ४८ ॥
हनुदन्तशिरोग्रीवा – त्रिकबाद्दूरसां बलम् । वलीपलितखालित्य-व्यङ्गानाञ्चाप्यसम्भवम् ।। ४९।।
Metrical Texts : The quantity of Sneha which, being lightly snuffed in, reaches down into the cavity of the mouth should be deemed adequate for a dose of the Pratimarsa (kind of snuff¹). The benefit of using a snuff may be perceived in a variety of ways, as it tends to cure the disease peculiar to the super-clavicular regions of the body, removes the cloudening or dulness of the sense-organs, imparts a sweet aroma to the mouth, and strength to the teeth, jaw bones, head, neck, Trika, arms and the chest, and guards against an attack of baldness, Vyanga, premature greyness of the hair and the premature apperance of wrinkles or furrows. 47-49
Specific use of Sneha Nasya
तैलं कफे सवाते स्यात् केवलं पवने वसाम् । दद्यात् सर्पिः सदा पित्ते मज्जानञ्च समारुते ।। ५० ।।
चतुर्विधस्य स्नेहस्य विधिरेवं प्रकीर्तितः । श्लेष्मस्थानाविरोधित्वात् तेषु तैलं विधीयते ।। ५१ ।।
Specific use of Sneha-Nasya : This snuff should consist of oil in a case marked by (the concerted actions of the deranged) Kapha and Vayu, while it should consist of Vasa (lard) in a case involving the action of the Vayu alone. Similarly clarified butter should be used as a snuff in a case of a Pittaja disorder, while the snuff should consist of Majja (marrow) in a case marked by (the concerted actions of the deranged) Vayu and Pitta. The four different modes of using snuff have thus been described in all of which oil may be used as not being hostile in its action as regards the seats of Kapha within the organism. 50-51
अतः परं प्रवक्ष्यामि कवलग्रहणे विधिम् । चतुर्धा कवलः स्नेही प्रसादो शोधिरोपणौ ।। ५२ ।।
1. One drop or two, or the quantity necessary to bring about a disruption of the Dosas, is the dose of a Pratimarsa Nasya according to Vrddha-Vagabhata. The four forms of Nasya-Karma (medicinal) snuff should be prescribed for patients above seven years of age. Pratimarsa is recommended in Gulma. — Krsnatreya.
स्निग्धोष्णैः स्नेहिको वाते, स्वादुशीतैः प्रसादनः । पित्ते, कट्वम्ललवणै रुक्षोष्णैः शोधनः कफे ॥ ५३॥
कषायतिक्तमधुरैः कटूष्णै रोपणो व्रणे । चतुर्विधस्य चैवास्य विशेषोऽयं प्रकीर्तितः ॥ ५४॥
Kavala-graha : Now we shall describe the process of using medicinal gargles ( Kavala) which may be divided into four kinds, viz. : The Snehi (oleaginous), Prasadi (soothing), Sodhi (purifying) and the Ropana (healing ). The oleaginous (Snehi) gargle should be surcharged with any oleaginous substance and should be prescribed tepid in a case marked by the action of the deranged Vayu, while cold and sweet articles should be employed in preparing a soothing (Prasadi) gargle and should be prescribed in cases of the deranged Pitta. The purifying (Sodhana) gargles should be composed of acid, pungent and saline drugs which are parching and heat-making’ in their potency and should be employed lukewarm (for corrective purposes) in diseases due to the action of the deranged Kapha. The healing (Ropana) gargles should be composed of bitter astringent, sweet, pungent and heat-making2 articles should be employed in cases of ulceration (of the mouth). The therapeutic virtues and applications of the four different kinds of gargle (Kavala) have thus been described ( above). 52-54
तत्र त्रिकटुकवचासर्षपहरीतकीकल्कमालोड्य तैलशुक्तसुरामूत्रक्षारमधूनामन्यतमेन प्रदेशो धारयेत् ।। ५५ ।। सलवणमभिप्रतप्तमुपस्विन्नमृदितगलकपोलललाट
The neck, cheeks and the forehead of the patient to be treated with gargles should be (first) fomented and softened and he should be made to take (into his mouth) Trikatu, Vacha, mustard seeds, Haritaki and rock-salt pasted together and dissolved in any of the following articles. viz. : oil, Sukta, Sura alkali (cow’s ) urine or honey and made lukewarm (before use as a gargle). 55
1. Vrnda does not include parching’ while Chakradatta does not include heatmaking’ as the conditions of this kind of Kavala in their respective collections. 2. Chakradatta does not include pungency’ and ‘heat-making potency’ as conditions of this kind of Kavala.
Kavala and Gandusa
सुखं सञ्चार्यते या तु मात्रा सा कवले स्मृता ।
असञ्चार्या तु या मात्रा गण्डूषः स प्रकीर्त्तितः ।। ५६ ।।
Kavala and Gandusa–distinguished (M.T. : The quantity which can be easily and conveniently rolled out in the mouth is the proper dose in respect of a Kavala, whereas the one which cannot be so (easily and coveniently) rolled out in the mouth is called a Gandusa. 56
तावच्च धारयितव्योऽनन्यमनसोन्नतदेहेन यावद्दोषपरिपूर्णकपोलत्वं नासास्त्रोतोनयनपरिप्लावश्च भवति तदा विमोक्तव्यः, पुनश्चान्यो ग्रहीतव्य इति ।। ५७॥
Kavala– How long it should be retained ? A gargle (Kavala) should be so long held¹ in the mouth by a patient till the aggravated Dosa² would accumulate in the regions of the cheeks³ and would secrete copiously through the nostrils and the eyes, after which the gargle (Kavala) should be every time removed and fresh ones should be taken and kept (similarly) in the mouth. The patient should during the use of a Kavala sit in an erect posture without allowing the mind to be in the least distracted condition. 57
एवं स्नेहपयः क्षौद्र-रसमूत्राम्लसंभृताः । कषायोष्णोदकाभ्याञ्च कवला दोषतो हिताः ।। ५८ ।।
व्याधेरपचयस्तुष्टिर्वैशद्यं वक्तलाघवम् । शुद्धिलक्षणम् ।। ५९ ।।
इन्द्रियाणां प्रसादश्च कवले हीने जाडचकफोत्क्लेशावरसज्ञानमेव च। अतियोगान्मुखे पाकः शोषतृष्णारुचिक्लमाः । शोधनीये विशेषेण भवन्त्येव न संशयः ।। ६० ।।
Metrical Texts: Gargles (Kavala) should be similarly prepared with Sneha, milk, honey, urine, meat-juice or Amla (Kanjika) mixed with the decoction (of any drug) or hot water prescribed according to the nature and intensity of the bodily Dosa or Dosas involved in the case. An amelioration of the disease, a sense of lightness and of purity in the mouth, a cheerful frame of mind and an exhilarating vigour in the organs of sense are the features which mark an act of perfect or satisfactory gargling (Kavala), whereas a sense of physical lassitude, salivation and a (consequent) defect in the sense of taste are the traits which mark deficient gargling. Thirst, an aversion to food, dryness of the mouth, a sense of fatigue and an inflammation of the mouth are the symptoms which attend an act of excessive gargling. These symptoms undoubtedly arise in due proportion to the nature and intensity of the corrective drugs used. 58-60
1. Vinda here reads “सञ्चारयितव्यश्च”, i.e., ‘and should be rolled out (in the mouth)’. 2. “Dosa” here means ‘Kapha’.
3. Vrnda reads “यावद्दीषपरिपूर्णगलकपोलत्वम्” which means till the Dosa accumulates in the regions of the throat and the cheeks.
तिला नीलोत्पलं सर्पिः शर्करा क्षीरमेव च । सक्षौद्रो दग्धवक्तूस्य गण्डूषो दाहनाशनः । कवलस्य विधिह्येष समासेन प्रकीर्तितः ।। ६१ ।।
Sesamum, Nilotpala, clarified butter, sugar, milk and honey¹ should be used as a gargle (Gandusa) alleviates the ( consequent) burning sensation of a burn inside the mouth. The process of using medicinal gargles (Kavala) in general have thus been briefly described. 61
विभज्य भेषजं बुद्धया कुर्वीत प्रतिसारणम् । कल्को रसक्रिया क्षौद्रं चूर्णञ्चेति चतुर्विधम् । अङ्गुल्यग्रप्रणीतन्तु यथास्वं मुखरोगिणाम् ।। ६२ ।। तस्मिन् योगमयोगञ्च कवलोक्तं विभावयेत् । तानेव शमयेद् व्याधीन् कवलो यानपोहति । दोषघ्नमनभिष्यन्दि भोजयेच्च तथा नरम् ।। ६३ ।।
Pratisarana : A Pratisarana remedy may be of four kinds, viz., that prepared with a Kalka (paste), Rasa-kriya, honey and with powders. Prepared with the appropriate drugs, such a compound should be rubbed gently with the tip of a finger in a case of an affection of the mouth. An intelligent Physician may exercise his descretion in selecting the drugs to be used in the preparation of such a remedy. The symptoms of a satisfactory or unsatisfactory Pratisarana should be respectively identical with those of a Kavala. The ranges of therapeutic applications are also co-extensive in both the cases. In other words the diseases of the mouth which yield to the use of medicinal gargles, equally prove amenable to that of Pratisarana remedies. The diet in both the case should be composed of light and non-phlegmogenic articles of food. 62-63
1. Commentators, on the authority of Videha, hold that gargles should be used with these articles either collectively or separately in cases of burning in the mouth by an excessive use of an alkali or such other articles.
इति सुश्रुत संहितायां चिकित्सिस्थाने धूमनस्यकवलग्रहचिकित्सितं नाम चत्वारिंशोऽध्यायः ।। ४० ।।
Thus ends the Fortieth Chapter of the Chikitsa Sthana in the Susruta Samhita which deals with the inhalation of medicinal fumes, snuffs, and gargles.
समाप्तमिदं चिकित्सितस्थानम् ।।
Here ends the Chikitsa Sthana.