We will now expound the chapter called Dhumapana Vidhi – procedure of inhalation of (medicinal) smoke, thus said atreya and other great sages. (1)
अथातो धूमपानविधिं नामाध्यायं व्याख्यास्यामः । इति हस्माद्दुरात्रेयाद्यो महर्षयः ॥१॥
Dhumapana prayojana – usefulness of inhalation of smoke
धूमो हि शिरोऽक्षिकर्णशूलाभिष्यन्दगौरवार्धावभेदकपीनसकासश्वासास्यवैरस्यप्रसेकवैस्वर्यपूति घ्राणमुखहिष्मागलरोगदन्तशूलदौर्बल्यारुचिहनुमन्याग्रहक्रिमिकण्डूपाण्डुत्वक्केशदोषक्षवथुनाशबाहुल्यतन्द्रातिनिद्राक्रथनादिजत्रूर्ध्वगतवातकफव्याधिप्रशमाय प्रयुज्यते । तथा शिरःकपालेन्द्रियमनोबृंहणप्रसादनाय च ॥२॥
Inhalation of smoke is indicated for the treatment of diseases such as pains of the head, eyes and ears, ophthalmia and heaviness of the eyes, hemicrania, rhinities, cough, dyspnoea, bad taste in the mouth, excess salivation, disorder of voice, bad smell from the nose and mouth, hiccup, diseases of the throat, toothache, looseness of teeth, loss of appetite, loss of movement of the neck and lower jaw, worms, itching, anaemia, disorders of the skin and hairs, absence of sneezing or excessive sneezing, stupor, excess sleep, asphyxia, and diseases of vata and kapha origin affecting the parts of the body above the shoulders. It is also used to strengthen and purification of the head, scalp, sense organs and the mind. ( 2 )
Dhuma Prakara – Types of Inhalation of smoke
शीतद्रव्यनिर्वृत्तोऽप्यग्निसंयोगादुष्णतया पित्तरक्तविरुद्धः । स त्रिविधो भवति । शमनो बृंहणः शोधनश्च । तथा कासघ्नो वामनो व्रणधूपनश्च । तत्र शमनः प्रायोगिको मध्यम इति पर्यायः । बृंहणः स्नेहनो मृदुरिति । शोधनो विरेचनस्तीक्ष्ण इति च ॥३॥
Though the smoke is derived from drugs which are cold in potency, yet with the contact of fire, it becomes hot in potency and so is antagonistic to pitta and rakta (aggravates the disorders of pitta and rakta).
It is of three kinds Samana (mitigating), Brimhana ( strengthening) and Shodhana (purificatory); and also as Kasaghna (anti-tussive), Vamana (emetic) and Vrana Dhupana (fumigation to ulcers).
Samana (mitigating) has two synonyms prayogika and madhyama.
Brimhana (strengthening) has also two synonyms – snehana and mrdu.
Sodhana has also two virechana and tiksna. ( 3 )
Dhuma Ayogya – persons unsuitable for inhalation
अधूमार्हास्तु विरिक्तदत्तबस्तिरात्रिजागरिताभिहतशिरोमधुदधिदुग्धमद्यस्नेहयवागूविषपयः पीतमत्स्या शितपाण्डुरोगप्रमेहोदराध्मानोर्ध्ववाततिमिररोहिणिकारक्तपित्तिनोऽत्युष्णेऽन्येपि च । एषां हि भ्रमज्वरशिरोऽभितापेन्द्रियोपघाततालुशोषपाकधूमायनच्छर्दिमूर्छारक्तपित्तार्दितानि मृत्युं वा धूमो जनयति । अतिमात्रश्चान्येषामपि ॥४॥ –
The following persons are inelligible for dhuma therapy – those who have undergone purgation therapy, who have been administered an enema, who have kept awake at night, who are injured in the head, who have drunk honey, curds, milk, wine, gruel mixed with fatty material, poison and (large quantities of) water, who have eaten fish as food, those suffering from anaemia, diabetes, enlargement of abdomen, flatulence, upward movement of vata inside the abdomen (reverse peristalisis), blindness, rohinika (a disease of the throat), bleeding diseases, and all others during very hot season. Administration of smoke to the above categories of persons will produce giddiness, fever, headache, difficulty in sensory perception, dryness and ulceration of the palate, feeling as though hot fumes are coming from the throat, vomitting, fainting, bleeding diseases, facial paralysis and even death. Even in others also, these diseases will be produced if used in excess. ( 4 )
तत्र वातकफान्यतरसंसृष्टं पित्तमुपलक्ष्य यथास्वं सर्पिः कषायपाननस्यास्यालेपनाञ्जनपरिषेकान् स्निग्धरुक्षशीतान् प्रयुञ्जीत। एतेन सर्वधूमोपघातप्रतिकारा व्याख्याताः ॥ ५ ॥
In all the diseases enumerated above, it is pitta either alone or in combination with vata and kapha that gets increased. So keeping this in mind, use of ghee, decoctions, nasal medication, application of paste into the mouth, eye-salve, pouring medicated water over the body and others which are mixed with fatty materials or not mixed with them and cold (in nature and feeling) should be used. By this, the treatment for all the complications of inhalation of smoke are described. (5)
विशेषतस्तु सर्वस्त्रोतोगते धूमे भवन्त्यूषाध्मान नेत्ररोगश्वासकासपीनसाङ्गस्वरसादाम्लकाः । तत्र घृतक्षीरेक्षुरसद्राक्षाशर्करोपयोगस्ताद्विधैरेव वमनम् । कटुतिक्तैरपि च नस्यगण्डूषाः॥६॥
Especially the smoke entering to all the channels produces severe pain, flatulence, redness of the eyes, dyspnoea, cough, nasal catarrh and sourness in the alimentary tract. In such conditions use of ghee, milk, sugarcane juice, grapes and sugar; producing vomiting by similar drugs, nasal medications and mouth gargles with drugs of pungent and bitter tastes should be adopted. (6)
Dhuma kala – time of administration
पानकालास्त्वष्टौ प्रायोगिकस्य निशामूत्रशकृद्दन्तधावनस्वेदनस्याहारशस्त्रकर्मान्ताः । एकादश: मृदो: क्षुतव्यवायहसितचिरासिततिजृम्भितमूत्रशकृद्दन्तधावन तर्पणपुटपाकशस्त्रकर्मान्ताः । पञ्च तीक्ष्णस्य नस्याञ्जनछर्दितस्त्रानाहस्स्वप्नान्ताः । एषु हि कालेषु वातकफोत्क्लेशा भवति ॥ ७ ॥
Prayogika dhuma is administered at eight periods of time such as at the end of 1. the night 2. elimination of urine and 3. feces 4. cleaning of the teeth, 5. of sudation therapy 6. nasal medication 7. taking of food and 8. surgical operation.
at the end of 1. Mrdu dhuma has eleven such periods of administration sneezing 2. sexual intercourse 3. laughing 4. sitting for long periods 5. yawning 6. elimination of urine and 7. feces 8. washing of teeth 9. tarpana (soaking the eyes in oil or ghee) 10. putapaka (instilling decoction and juice into the eye) and 11. surgical operation.
Tiksna dhuma has five such periods; at the end of 1. nasal medication 2. anjana (collyrium to the eyes) 3. vomitting 4. bath and 5. day sleep.
At the above periods of time, there will be mild increase of vata and kapha (hence ideal time for inhalation of smoke). (7)
Dhuma netra – smoke pipe
नेत्रं तु बस्तिनेत्रद्रव्यभवं गोपुच्छाकारमग्रमूलयोः कनिष्ठिकाङ्गुष्ठपरिणाहं राजमाष वाहिधूमवर्तिप्रवेशच्छिद्रमृजु त्रिकोशं श्लक्ष्णं शिथिलशलाका गर्भं शमनादिषु क्रमादातुराङ्गुलमानेन चत्वारिंशद्वात्रिंशच्चतुर्विंशत्यङ्गलं कुर्यात् । कासघ्ने वमने च दशाङ्गुलम् । लम्कलायपरिमण्डलं कुलत्थवाहि स्रोत इति । एवं हि धूमो दूरात् प्रवृत्तो नेत्रस्य पर्वच्छेदादूर्ध्वं तनुतया च शनैः श्लिष्यन्नबाधको भवति ॥८॥
The nozzle or pipe for inhaling the smoke is prepared from any one of the materials mentioned for preparing the enema nozzle. It should resemble the tail of the cow with a circumference of (size of) the little finger and the thumb at its lower and upper ends respectively, the lower and upper orifices permitting a rajamasa and the smoke wick respectivly; straight, having three compartments, smooth and having a slender rod inside, it should be of the length of fourty, thirty-two and twenty-four angulis of the patients hand; for Samana, Brimhana and Shodhana kinds of dhuma respectively; of ten angulis for Kasaghna and vamana; eight angulis for Vrana dhupana having the size of a pea and the orifice permitting a horsegram to move freely.
The smoke coming from a distance, passing through the chamber of the pipe, rising up in thin column, reaching the inside of the body will be harmless. ( 8 )
कासघ्नादिषु तु नेत्राभावे नलवंशैरण्डादीनामन्यतमा नाड़ीं योजयेत् ॥९॥
In kasaghna and other kinds of smoke therapy the physician can make use of the hollow reeds of nala, vamsa and eranda in the absence of the metal nozzle. (9)
Dhumapana vidhi – procedure of inhalation
यथास्वं च धूमद्रव्याणां कल्केन श्लक्ष्णेनाक्षमात्रेण द्वादशाङ्गुलामिषीकामम्भस्यहोरात्रोषितां कृत्वालेपयेत् । तत्र च नवाङ्गुलगर्भा पञ्चप्रलेपामङ्गुष्ठस्थूलां यवमध्यां छायाशुष्कां वर्तिं कृत्वा विगतेषीकां च स्नेहाक्ताङ्गारेषु प्रदीप्य नेत्रमूलच्छिद्रे च निधाय यथार्हं पानायोपनयेत् ।।१०।।
The drugs which are appropriate to the doshas or diseases are converted into fine paste by grinding.
A smooth, hallow reed of twelve angulis (fingers breadth) in length, is soaked in water for one day and night.
Next day it is taken out and one aksa (about 12 gms) of the thin paste of drugs is smeared over it for a length of nine angulis and allowed to dry. After drying one more coating of the paste is made over the previous coating, thus making five coatings in total; reaching the thickness of the thumb and of the size of barley within. It should be slightly dried in shade, then the reed removed and smeared with little quantity of ghee or oil. It (layers of paste of drugs) should then be kept inside the pipe from the upper orifice and set fire, to emit thin column of smoke at its lower orifice. (10)
अथ धूमार्हः सुमना, ऋजूपविष्टः प्राक्कृतोच्छ्वासनिश्वासो विवृतौष्ठदशनो नेत्राग्रनिविष्टदृष्टिः पर्यायेणैकैकं नासापुटं पिधायेतरेणाक्षिप्य मुखेनोत्सृजेत् । मुखेन तु मुखेनैव । न नासयादृग्विघातभयात् ।।११ ।।
The eligible person should be made to sit straight, with a calm mind, taking deep expiration and inspiration, keeping his lips and teeth open, gazing the tip of the nozzle which is held very close to his nostrils. He should be asked to inhale the smoke from one nostril at a time, keeping the other one closed. He should inhale from the nostrils alternatively and emit out the smoke through the mouth. The smoke that has been inhaled through the mouth should be emitted only through the mouth but not through the nose because of the risk of disorders of vision. (11)
तत्र प्रायोगिकं द्वौ द्वौ त्रींस्त्रीन् वाऽऽपानां स्त्रींश्च पर्यायान् । कण्ठादूर्ध्वमुत्क्लिष्टे दोषे पूर्वं नासया ततो मुखेन । कण्ठे तु पूर्वमास्येन । परं चाहोरात्रस्य द्विः पिबेत् ॥ १२ ॥
In case of presence of increased doshas above the level of the throat, prayogika dhuma should be done in pairs of two or three alternatively; each time first from the nose and then from the mouth;
in case of presence of increased doshas in the throat, first from the mouth and next from the nose. Inhalation is done twice, once during day and once at night.
स्नैहिकं त्रींस्त्रींश्चतुरश्चतुरो वाऽऽपानान् यावद्वात्रप्रवृत्तिस्तथा सकृदहोरात्रस्य ॥१३॥
Snaihika dhuma should be done in bouts of three or four inhalations at a time and continued till all the channels start exuding fluid. It should be taken only once in a day and night. (13)
तीक्ष्णं नासाभ्यामेव चतुरश्चतुरश्चाऽऽपानान् यावद्वा स्त्रोतोलाघवम् । तथा त्रिश्चतुर्वाहोरात्रस्य। तत्राक्षेपविसर्गावापानमित्याहुः ॥१४॥
Tiksna dhuma should be inhaled only through the nose, in bouts of four each time or till the person feels lightness of the channels. It should be taken three or four times in one day and night.
The terms Aksepa (inhaling, sucking) and Visarga (exhaling, expelling out) are together known as Apana (one inhalation) in this context. (14)
कासघ्नं तु चूर्णं गुटिकां वा निर्धूमदीप्तस्थिराङ्गारपूर्णे सुसंस्थिते शरावे प्रक्षिप्यान्येन मूर्ध्नि प्रवृत्तच्छिद्रेण शरावेणापिधाय निधाय च तत्त्रोतसि नेत्रं कृत्वा मुखेनैव धूमं पिबेत् । उरः प्राप्तं च मुखेनैवोद्वमेत् । प्रशान्ते च धूमे पुनः क्षिपेत् । पिबेच्चादोषशुद्धेर्लाघवाद्वा ॥१५॥
Kasaghna (antitussive) dhuma is administered in the following way: burning coal devoid of smoke is placed in an earthen saucer and fine powder or pills of the drugs are put on the burning coal. Another saucer with a hole in its centre is kept inverted over the first one, so as to allow the smoke only through its hole, to which the smoking tube is attached. The patient is asked to take in the smoke through the mouth only; when his chest is filled up completely, he should let it out through the mouth itself. When the drugs are burnt off, some more powder is placed on the fire. The inhalation should be continued till all the doshas are expelled out or till the patient feels lightness of the organs. (15)
तद्वद्वामनमपि कृसरामनतिघनां पीत्वा पिबेत् । तद्वच्च व्रणमपि घूपयेद्वैशद्याय क्लेदवेदनोपशमनाय च ॥१६॥
Vamana dhuma (emetic smoke) is done in the same manner but after the patient has taken the drink of thin krisara ( porridge).
Even Vrana dhuma (fumigation of ulcers) is done similarly, to cleanse the wound of its exudations and relief from pain. ( 16 )
धूमस्यायोगे दोषोत्क्लेशाद्रोगवृद्धिः । अतियोगे प्रागुक्तमिति ॥१७॥
The inadequacy of inhalation therapy is indicated by exacerbation of the disease, by the increase of the doshas. Excess therapy has been described earlier (in para 4). (17)
हृत्कण्ठेन्द्रियसंशुद्धिः शिरसो लाघवं शमः । यथेरितानां रोगाणां सम्यक्पीतस्य लक्षणम् ॥१८॥
Further, some verses more :
Inhalation of smoke therapy properly done, will clear the impurities from the heart, throat and sense organs, produce lightness of the head and mitigation of the doshas and diseases produced by them. (18)
शमनो वातकफयोः संसग्रे स्वस्थकर्मणि । बृंहणो मारुते शस्तो धूमः संशोधनः कफे ॥१९॥
Samana dhuma is indicated to mitigate vata and kapha individually or their combination and also for the healthy. Brimhana is ideal for (mitigating) vata and Sodhana (virechana) for mitigating kapha. (19)
॥ इति त्रिंशोऽध्यायः ॥
Thus ends the thirtieth chapter.