चतुःपञ्चाशत्तमोऽध्यायः अथात: क्रिमिरोगप्रतिषेधमध्यायं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥
Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of worms (Krimi Roga Pratisedha). 1.
अजीर्णाध्यशनासात्म्यविरुद्धमलिनाशनैः । अव्यायामदिवास्वप्न – गुर्वतिस्निग्धशीतलैः माषपिष्टान्नविदल-विसशालूकसेरुकैः पर्णशाकसुराशुक्त-दधिक्षीरगुडेक्षुभिः पललानूपपिशित-पिण्याकपृथुकादिभिः स्वाद्वम्लद्रवपानैश्च श्लेष्मा पित्तञ्च कुप्यति ॥ ४ ॥ क्रिमीन् बहुविधाकारान् करोति विविधाश्रयान् । आमपक्काशये तेषां कफविड्जन्मनां पुनः । धमन्यां रक्तजानाञ्च प्रसवः प्रायशः स्मृतः ॥५॥ ॥२॥ । ॥३॥
Causes The Pitta and Kapha of the body are aggravated by such causes as eating before the digestion of a previous meal, excessive use of any indigestible, uncongenial, incompatible or filthy articles of fare, sedentary habits, partaking of cold, heavy or fatty meals, sleeping in the day-time, excessive use of Masa, cakes, Vidala ( cereals), Visa ( lotus stems), Saluka (bulbous root of the lotus), Kaseruka, pot-herbs, Sura (wine) Sukta (a kind of fermented rice-gruel), curd, milk, treacle, sugar-cane, Palala ( dried plants of corn), flesh of anupa animals, Pinyaka (oil cakes), Prthuka (Cipitaka), and such other articles of fare as well as by the use of sweet, acid and liquid articles. They help the germination of parasites of various shapes in the different parts of the body, amasaya (stomach) and Pakvasaya ( intestines ) being their principal seats or location. 2-5.
Classification of Krimi Roga
विंशते: क्रिमिजातीनां त्रिविधः सम्भवः स्मृतः । पुरीषकफरक्तानि तासां वक्ष्यामि विस्तरम् ॥ ६ ॥
Classification – The worms or parasites (which are found to germinate and grow in a living human organism) are divided into twenty different species, and have their origin either in faeces, Kapha or blood’. Now I shall enumerate their names and characteristic features. 6.
Names and Symptoms of Purisaja Krimi
अजवा विजवाः किप्याश्चिप्या गण्डूपदास्तथा । चूरवो द्विमुखाश्चैव ज्ञेयाः सप्त पुरीषजाः ॥ ७ ॥ श्वेताः सूक्ष्मास्तुदन्त्येते गुदं प्रतिसरन्ति च । तेषामेवापरे पु पुच्छः पृथवश्च भवन्ति हि ॥ ८ ॥ शूलाग्निमान्द्यपाण्डुत्वविष्टम्भबलसंक्षयाः प्रसेकारुचिहृद्रोग-विड्भेदास्तु । पुरीषजैः ॥ ९ ॥ रक्ता गण्डूपदा दीर्घा गुदकण्डूनिपातिनः । शूलाटोपशकृद्भेद-पक्तिनाशकराश्च ते ॥ १० ॥
Names and Symptoms of Purisaja Krimi — The seven kinds of worms which are known as Ajava, Vijava, Kipya, Cipya, Gandupada, Curu and Dvi-mukha, originate from faeces (Purisaja). They are white and extremely attenuated in their size. They frequent the passage of the rectum and produce a pricking pain (therein). Several of them are thicker and have tails. Cramps ( sula), dulness of appetite, yellowness of complexion, distension of the abdomen, loss of strength, water-brash, aversion to food, heart-disease (Hrd-roga) and looseness of stool, are the symptoms whch mark the presence of worms (in the intestines), which originate in the faeces. Of these Gandu-pada worms are red and long in their shape producing such symptoms as cutting pain (Sula), rumbling sound in the intestines, looseness of stool, and indigestion and they come out of the anus with an itching sensation. 7-10.
1. Caraka speaks of another kind viz. Malaja (produced from the external filth of the body), over and above that kind of worms which are present in every organism from the very birth (Sahaja ).
Names and Symptoms of Kaphaja Krimi
दर्भपुष्पा महापुष्पाः प्रलूनाश्चिपिटास्तथा । पिपीलिका दारुणाश्च कफकोपसमुद्भवाः ॥ ११॥ रोमशा रोममूर्धानः सपुच्छाः श्यावमण्डलाः । रूढधान्याङ्कुराकाराः शुक्लास्ते तनवस्तथा ॥ १२ ॥ नेत्रलेढारस्तालुश्रोत्रभुजस्तथा मज्जादा । ते ॥ १३ ॥ शिरोहृद्रोगवमथु-प्रतिश्यायकराश्च
Names and Symptoms of Kaphaja Krimi – Those known as Darbha-puspa, Mahapuspa, Praluna, Cipita, Pipilika and Daruna have their origin in the deranged Kapha. They are either hairy or have hairs only on their heads, or are marked with brown spots on their sides or are provided with tails. They are white and small-sized like fresh paddysprouts. They eat away the marrow and bore into the eye-balls, the palate and the ears and produce head-ache, cardiac trouble (Hrd-roga), vomiting and catarrh. 11-13.
Names and Symptoms of Raktaja Krimi
केशरोमनखादाश्च दन्तादाः किक्किशास्तथा । कुष्ठजाः सपरीसर्पा ज्ञेयाः शोणितसम्भवाः ॥ १४ ॥ ते सरक्ताश्च कृष्णाश्च स्निग्धाश्च पृथवस्तथा । रक्ताधिष्ठानजान् प्रायो विकारान् जनयन्ति ते ॥ १५ ॥
Names and Symptoms of Raktaja Krimi – The names of the worms originating from the vitiated blood are Kesada, Romada, Nakhada, Dantada, Kikkisa, Kusthaja and Parisarpal. They are either black or blood-coloured, glossy and thick and generally produce diseases which are peculiar to the vitiated state of the blood² in the body. 14-15.
1. The names of these worms have been derived from the nature of their actions on the different parts of the organism. 2. See Chapter XXIV-Sutra Sthana.
माषपिष्टान्नविदल- पर्णशाकैः मांसमाषगुडक्षीर-दधितैलैः पुरीषजाः । कफोद्भवाः । विरुद्धाजीर्णशाक द्यैः शोणितोत्था भवन्ति हि ॥ १६ ॥
Specific Causes-Worms which have their origin in the faces (accumulated in the bowels) are the results of the (excessive) use of such articles of fare as Masa-pulse, cakes and pot-herbs. The Kaphaja worms germinate in the system in consequence of eating flesh, Masapulse (D.R. fish), treacle, milk, curd and oil. Worms which originate from the contaminated blood of the body, are intimately connected with the use of pot-herbs and other indigestible and incompatible articles of fare. 16.
General Symptoms of Krimi Roga
ज्वरो विवर्णता शूलं हृद्रोगः सदनं भ्रमः । भक्तद्वेषोऽतिसारश्च सञ्जातक्रिमिलक्षणम् ॥१७॥
General Symptoms – Fever, paleness of complexion, Sula, cardiac troubles (Hrd – roga), lassitude, vertigo, aversion to food and diarrhoea (Atisara) are the complaints which mark the presence of worms of the system. 17.
दृश्यास्त्रयोदशाद्यास्तु क्रिमीणां परिकीर्तिताः । केशादाद्यास्त्वदृश्यास्ते द्वावाद्यौ परिवर्जयेत् ॥ १८ ॥
Prognosis of these the first thirteen kinds of worms may be seen with the naked eyes, while those beginning with Kesada (viz, the Raktaja worms) are not so visible and (of these latter) the first two (Viz., Kesada and Romada) kinds should be given up (as incurable). 18.
एषामन्यतमं ज्ञात्वा जिघांसुः स्निग्धमातुरम् । सुरसादिविपक्वेन सर्पिषा वान्तमादितः । विरेचयेत् तीक्ष्णतरैर्योगैरास्थापयेच्च तम् ॥ १९ ॥ यवकोलकुलत्थानां सुरसादेर्गणस्य च । विडङ्गस्नेहयुक्तेन क्वाथेन लवणेन च ॥ २० ॥ प्रत्यागते निरूहे तु नरं स्नातं सुखाम्बुना । युञ्यात् क्रिमिघ्नैरशनैस्ततः शीघ्रं भिषग्वरः ॥ २१ ॥ स्नेहेनोक्तेन चैनन्तु योजयेत् स्नेहबस्तिना । ततः शिरीषकिणिहीरसं क्षौद्रयुतं पिबेत् ॥ २२ ॥ केवूकस्वरसं वाऽपि पूर्ववत् तीक्ष्णभोजनः ॥ २३ ॥
A physician should first ascertain the nature of the worms and, with a view to destroy their colony in the body, should treat the patient by giving emetic with a Sneha (Clarified butter duly cooked with the drugs of the Surasadi group. He should then purge the patient with any strong purgative and treat him with an Asthapana-basti prepared with the decoction of Yava, Kola, Kulattha-pulse, and the drugs of the Surasadi group, charged with salt and with Sneha (clarified butter or oil) duly cooked with Vidanga. Just after the flowing out of the injected solution (through his anus) the patient should be bathed with lukewarm water and a meal prepared with vermifugal articles should be given to him. Anuvasana-basti should then be applied with the preceding Sneha (preapared with Vidanga). He should take a potion composed of the expressed juice of Sirisa and Kinihi (Apamarga) mixed together and sweetened with honey. The expressed juice of Kevuka may be similarly (mixed with and) administered with a meal prepared with the articles of strong (Tiksna) property. 19-23
पलाशबीजस्वरसं कल्कं वा तण्डुलाम्बुना। पारिभद्रकपत्राणां क्षौद्रेण स्वरसं पिबेत् ॥ २४ ॥ पत्तूरस्वरसं वाऽपि पिबेद् वा सुरसादिजम् । लिह्यादश्वशकृच्चूर्णं वैडङ्गं वा समाक्षिकम् ॥ २५ ॥ पत्रैर्मूषिकपर्ण्या वा सुपिष्टैः पिष्टमिश्रितः | खादेत् पूपलिकाः पक्का धान्याम्लञ्च पिबेदनु ॥ २६ ॥
A paste (or powder) of Palas-seeds or the expressed juice there of should be taken with the washings of rice. The expressed juice of Paribhadra-leaves should be taken with honey. The juice extracted from Pattura¹ or the drugs of the Surasadi group should (similarly) be taken, or the powders of dried horse dung or of Vidanga should be licked with honey. Pupulika-cakes prepared with (pasted Yava and) the pasted leaves of Musika-parni (a kind of Danti) should be taken by the patient followed by draughts of Dhanyamla (fermented paddygruels). 24-26.
1. Dalhana explains “Pattura” as Sephalika, but Sivadasa takes it to be Salinca.
सुरसादिगणे तैलं पक्कं वा पानमिष्यते । विडङ्गचूर्णयुक्तैर्वा पिष्टैर्भक्षांस्तु कारयेत् ।
तत्कषायप्रपीतानां तिलानां स्नेहमेव वा ॥ २७ ॥
Oil duly cooked with (the paste and decoction of) the drugs of the Surasadi group shuld be given to be drunk. Different kinds of cakes should be prepared for him with (Yava mixed with) powdered Vidanga. Sesamum-seeds should be duly soaked in the decoction of Vidanga (after the manner of Bhavana saturation) and oil should be then pressed out thereform (for his use). 27.
श्वाविधः शकृतश्चूर्णं सप्तकृत्वः सुभावितम् । विडङ्गानां कषायेण त्रैफलेन तथैव च ॥ २८ ॥ क्षौद्रेण लीढ्वाऽनुपिबेद्रसमामलकोद्भवम् । अक्षाभयारसं वाऽपि विधिरेषोऽयसामपि ॥ २९ ॥ पूतीकस्वरसं वाऽपि पिबेद् वा मधुना सह । पिबेद् वा पिप्पलीमूलमजामूत्रेण संयुतम् ॥ ३० ॥ सप्तरात्रं पिबेद् घृष्टं त्रपु वा दधिमस्तुना । पुरीषजान् कफोत्थांश्च हन्यादेवं क्रिमीन् भिषक् ॥ ३१ ॥
Powdered excreta of a Svavidh (porcupine) similarly pounded seven times in (each of) the decoctions of Tri-phala and of Vidanga should be licked with honey, followed by draughts of the expressed juice of Amalaka, Haritaki, and Aksa (Vibhitaka). Powders of any (dead) metal (Ayas)’ may also be prepared and taken in the preceding manner. In the alternative, the expressed juice of Putika should be taken with honey, or Pippali-roots should be administered through the vehicle of the urine of a she-goat. Trapu (killed lead) should be rubbed in the upper liquid part of curd (Mastu) and should be taken for a week. Worms which have their origin in the accumulated faeces or aggravated Kapha in the body should be destroyed with the help of the aforesaid medicinal remedies. 28-31.
1. Ayas- lit. iron, is also used for all the metals generally.
पृथग्विधान् । साधयेत् ॥ ३२ ॥ शकृद्द्रसं तुरङ्गस्य सुशुष्कं भावयेदति । निष्काथेन विडङ्गानां चूर्ण प्रधमनन्तु तत् ॥ ३३ ॥ अयश्चर्णान्यनेनैव विधिना योजयेद् भिषक् । सकांस्यनीलं तैलञ्च नस्यं स्यात् सुरसादिके ॥ ३४ ॥ शिरोहृद्भ्राणकर्णाक्षि-संश्रितांश्च विशेषेणाञ्जनैर्नस्यैरवपीडैश्च
Medicinal Anjanas, Nasyas and Avapidas should be particularly employed in destroying the different classes of vermins which infest the regions of head, heart, ears, eyes and the nostrils. The liquid expressed out of horse-dung should be dried and then successively pounded several times in the decoction of Vidanga. The preperation should be blown into the nostrils (Pradhamana). Powders of killed metal (Ayas, etc. 1) may also be applied in the same manner. Oil duly cooked with the drugs of the Surasadi Gana should be used in snuffing with the blue part 2 of India bellmetal. 32-34.
इन्द्रलुप्तविधिश्चापि विधेयो रोमभोजिषु | दन्तादानां समुद्दिष्टं विधानं मुखरोगिकम् । रक्तजानां प्रतीकारं कुर्यात् कुष्ठचिकित्सिते । सुरसादिन्तु सर्वेषु सर्वथैवोपयोजयेत् ॥ ३५ ॥
Measures and remedies mentioned in connection with the treatment of alopecia (Indra-lupta) should be employed in cases of Romada worms (viz. where the worms would be found to have invaded the hairs of the body). Medicines enumerated in connection with the treatment of the diseases of the mouth should be prescribed in cases of Dantada worms (viz. where the vermins would be found to have taken lodgment in the teeth). Cases where the worms would be found to have their origin in the vitiated condition of the blood should be treated as cases of Kustha to all intents and purposes. The drugs of the Surasadi Gana, however, may be used in any shapel in any case (of Krimi). 35.
1. Avas — as in para 15 may mean any metal.
2. Oil duly cooked with the drugs of the Surasadi Gana should be placed in a pot of Indian bell-metal. When the inner surface of the pot would become blue by being oxidised, the oil should be well stirred and mixed with that blue and used as an errhine.
प्रव्यक्ततिक्तकटुकं भोजनञ्च हितं भवेत् । कुलत्थक्षारसंसृष्टं क्षारपानञ्च पूजितम् ॥३६॥ क्षीराणि मांसानि घृतानि चैव दधीनि शाकानि च पर्णवन्ति । समासतोऽम्लान् मधुरान् हिमांश्च क्रिमीन् जिघांसुः परिवर्जयेत् तु ॥ ३७ ॥
Diet Meals composed of the articles of bitter and pungent taste as well as draughts of Ksar (Alkali) mixed with the Ksar of Kulattha-pulse are recommended. A person suffering from any complaint due to the presence of worms (Krimi of whatever kind) and seeking their destruction, should refrain from using milk, cooked meat, clrified butter, curd, pot-herb ( edible leaves), things of acid or sweet tastes as well as cold things in general. 36-37.
इति सुश्रुत संहितायामुत्तरतन्त्रे क्रिमिप्रतिषेधव्याख्यानाम चतुःपञ्चाशत्तमोऽध्यायः ॥ ५४॥ –
Thus ends the fifty-fourth chapter in the Uttara-Tantra of the Susruta Samhita which deals with the ( symptoms and) treatment of Krimi-Roga.
1. Both internally and externally e.g. as a drink or bath.