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Sushruta SamhitaChikitsasthanaKustha Chikitsa - Skin Diseases Treatment - Sushrutasamhita Chikitsasthana Chapter 9

Kustha Chikitsa – Skin Diseases Treatment – Sushrutasamhita Chikitsasthana Chapter 9

नवमोऽध्यायः । अथात: कुष्ठचिकित्सितं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥ ः।।१।।

Now we shall discourse on the medical treatment of Skin Diseases in general (Kustha). 1

विरुद्धाध्यशनासात्म्यवेगविघातैः स्नेहादीनाञ्चायथारम्भैः पापक्रियया पुराकृतकर्मयोगाच्च त्वग्दोषा भवन्ति ।। २ ।।

A cutaneous disease (Twag-dosa) originates through injudicious conduct of life such as, partaking of large quantities of unwholesome food, or taking it before the previously eaten one is not digested (i.e., eating too often), indulgence in incompatible articles of diet, voluntary suppression of the natural urgings of the body, and improper application of medicated oil, clarified butter, or other lardacious articles. It is attributed even to the dynamics of sinful acts done by a man in this or in some prior existence. 2

तत्र त्वग्दोषी मांसवसादुग्धदधितैलकुलत्थमाषनिष्पावेक्षुपिष्टविकाराम्लविरुद्धाध्यशनाजीर्णविदाह्यभिष्यन्दीनि दिवास्वप्नं व्यवायञ्च परिहरेत् ।। ३ ।।

Conduct of diet and regimen : A person afflicted with any kind of skin disease should refrain from taking meat, lard, milk, curd, oil, Kulattha pulse, Masa pulse, Nispava, preparations and modifications of sugarcane juice, acid substances, incompatible food, meals taken before the complete digestion of the preceding one, unwholesome and indigestible food, or food causing a burning sensation and some kind of internal secretion, day-sleep and sexual intercourse. 3

ततः शालिषष्टिकयवगोधूमकोरदूषश्यामाकोद्दालकादीननवान् भुञ्जीत मुद्गाढक्योरन्यतरस्य यूषेण सूपेन वा निम्बपत्रारुष्करव्यामिश्रेण, मण्डूकपर्ण्यवल्गुजाटरूषकरूपिकापुष्पैः सर्पिः सिद्धैः सर्षपतैलसिद्धैर्वा, तिक्तवर्गेण वाऽभिहितेन । मांससात्म्याय वा जाङ्गलमांसममेदस्कं वितरेत्। तैलं वज्रकमभ्यङ्गा | आरग्वधादिकषायमुत्सादनार्थे । पानपरिषेकावगाहादिषु च खदिरकषायम्, इत्येष आहाराचारविभागः ।। ४ ।।

Regulation of diet and conduct: The old and matured grain of sali, Sastika, barley, wheat, Koradusa, Syamaka, Uddalaka, etc., boiled and taken along with the soup (Supa) or a decoction’ (Yusa) of either Mudga pulse or Adhaki pulse mixed with Nimba leaves and Aruskara are wholesome in a case of Kustha. Preparations of any of the aforesaid grains may be taken with Manduka-parni, Avalguja, Atarusaka and Rupika flowers cooked in mustard oil or clarified butter, or with the soup prepared of the articles of the Tikta-varga (bitter group, mentioned in the Sutra-sthana). The cooked flesh of Jangala animalas, devoid of all fatty matter, should be given to a patient, habituated to the use of meat diet. The medicated oil, knwon as the Vajraka-Taila should be used for anointing the body. A decoction of the drugs of the Aragvadhadi group should be used for rubbing (Utsadana) purposes. Decoctions of Khadira should be employed in drinks, baths, washes, etc. The preceding rules are intended to regulate the diet and regimen of one suffering from Kustha (Skin DIseases). 4

तत्र पूर्वरूपेषूभयतः संशोधनमासेवेत । तत्र त्वक्संप्राप्ते शोधनालेपनानि । शोणितप्राप्ते संशोधनालेपनकषायपानशोणितावसेचनानि । मांसप्राप्ते शोधनालेपनकषायपान-शोणितावसेचनारिष्टमन्थप्राशाः ।

1. An unsalted decoction of any substance not seasoned with any spices whatever is called Yusa, while the one salted and seasoned with spices is called Supa. In preparing the soup of any pulse, all husks should be carefully thrashed out and the grain should be slightly fried before boiling.

चतुर्थकर्मगुणप्राप्तं याप्यमात्मवतः संविधानवतश्च ।। ५ ।।

तत्र संशोधनाच्छोणितावसेचनाच्चोर्ध्वं भल्लातशिलाजतुधातुमाक्षीकगुग्गुल्वगुरुतुवरकखदिरासनायस्कृतिविधानमासेवेत । पञ्चमं नैवोपक्रमेत् ।। ६ ।।

Preliminary Treatment: In the premonitary stages of the disease the system should be cleansed by the application of both emetics and purgatives. When the disease is found to invade the Tvak¹ only, a plaster prepared of the purifying drugs should be applied to the affected parts; blood-letting and the use of medicinal decoctions and purifying and disinfecting plasters are the remedies to be employed when the desease would appear to infect the blood. The same remedies and Arista, Mantha, Prasa, etc., should be employed when the disease would be found to have invaded the principle of the Mansa (muscles). Palliation and temporary respite are the only cure that can be offered in a case of the sin-begotten type² of the disease which is the fourth (in order of enumeration) and that even is purely contingent on the willingness and capacity of the patient to conform to a strict regimen of diet, conduct and dress. Blood-letting and purifying measures (emetics and purgatives) should be resorted to in such a case and then the special medicinal remedies prepared from Bhallataka³, Silajatu, Guggulu, Aguru, Tuvaraka, Khadira, and Asana and the Ayaskrti should be used in accordance with the prescribed rules. The disease in its fifth form is found to invade the bones and should be given up as incurable. 5-6

तत्र प्रथममेव कुष्ठिनं स्नेहपानविधानेनोपपादयेत् । मेषशृङ्गीश्वदंष्ट्राशाङ्गेष्टा-गुडूचीद्विपञ्चमूलीसिद्धं तैलं घृतं वा वातकुष्ठिनां

1. Tvak here means Rasa or serum.

2. The type of Kustha affecting the principle of Medas (fat) is generally supposed to be sin-begotten.

3. Bhallataka-preparations have been described in the treatment of Arsas, preparations of Silajatu, Guggulu, Aguru and Tuvaraka in the treatment of Prameha-pidaka, and Khadira, Asana and Ayaskrti preparations in the treatment of Maha-kustha.

4. Oil should be used in a case of Kapha-predominance, whereas clarified butter in that of Pitta-predominance. Others assert that clarified butter should be used for drinking purposes and oil for anointments.

पानाभ्यङ्गयोर्विदध्यात्। धवाश्वकर्णककुभपलाशपिचुमर्दपर्पटकमधुकरोघ्रसमङ्गासिद्धं सर्पिः पित्तकुष्ठिनाम् । प्रियालशालारग्वधनिम्बसप्तपर्णचित्रकमरिचवचाकुष्ठसिद्धं श्लेष्मकुष्ठिनाम् । भल्लातकाभयाविडङ्गसिद्धं वा, सर्व्वेषां तुवरकतैलं भल्लाकतैलं वेति ।। ७-८।।

Treatments of Dosaja Types: In the first stage of Kustha, the patient should be treated in accordance with the prescribed maxims (rules) of Sneha-pana. In a case of Vataja – Kustha, oil or clarified butter, cooked with (a decoction and Kalka of) Mesa-srngi, Swadamstra, Sarngsta, Guducei and the drugs included in the group of Dasamula should be used as drink and an ointment. In cases of the Pittaja type, the patient should be made to drink (a potion consisting of) clarified butter prepared with ( a decoction and Kalka of) Dhava, Asvakarna, Kakubha, Palasa, Picu-marda, Parpataka, Madhuka, Rodhra and Samanga. In the Kaphaja type, clarified butter cooked with (a decoction and Kalka of) Priyala, Sala, Aragvadha, Nimba, Saptaparna, Citraka, Marica, Vaca and Kustha should be prescribed. The clarified butter cooked with (a Kalka and a decoction of) Bhallataka, Abhaya and Vidanga, or (the medicinal oil known as) the Tuvaraka Taila and the Bhallataka Taila should be used in all types of Kustha. 7-8

सप्तपर्णारग्वधातिविषा-पाठा-कटुरोहिण्यमृतात्रिफलापटोलपिचुमर्द-पर्पटकदुरालभात्रायमाणामुस्ताचन्दन- पद्मक-हरिद्रोपकुल्याविशालामूर्वा-शतावरीसारिवेन्द्रयवाटरूषकषड्ग्रन्था-मधुक-भूनिम्बगृष्टिका इति समभाग: कल्क: स्यात्, कल्काच्चतुर्गुणं सर्पिः प्रक्षिप्य तद्विगुणो धात्रीफलरसस्तच्चतुर्गुणा आपस्तदैकध्यं समालोड्य विपचेत् । एतन्महातितकं नाम सर्पिः कुष्ठविषमज्वर रक्तपित्तहृद्रोगोन्मादापस्मारगुल्मपिडकासृग्दरगलगण्ड-गण्डमालाश्लीपदपाण्डुरोगविसर्पषाण्ढयकण्डूपामादींश्च शमयेदिति ।। ९ ।।

The Maha-tikta Ghrita: A paste or Kalka should be made by pounding equal parts of Saptaparna aragvadha, Ativisa, Patha, Katu-rohini, Amrta, Triphala, Patola, Picu-marda, Parpataka, Duralabha, Trayamana, Musta, Candana, Padmaka,_Haridra, Upakulya, Visala, Murva, Satavari, Sariva, Indra-yava, Atarusaka, Sadgrantha (vaca), Madhuka, Bhu- nimba and Grstika’. This paste

1. Cakradatta does not read Grstika” but reads “Usira’ instead. He also takes both the kinds of “Haridra’, of “Upakulya” (Pippali) and of “Sariva”. (Kalka) should be cooked with four times its own weight of clarified butter, with the juice of Amalaka, weighing twice as much as of the clarified butter and with water weighing four times the quantity of the Amalaka juice. It should be constantly stirred ( with a ladle), while being cooked. This medicated Ghrita is called the Maha- tikta Ghrita, which proves curative in Kustha, chronic fevers, haemorrhage, heartdisease, insanity, Apasmara, Gulma, postular eruptions, menorrhagia, goitre, scrofula, elephantiasis, anaemea, erysipelas, impotency, itches and Pamal, etc. 9

त्रिफलापटोलपिचुमर्दाटरूषककटुरोहिणीदुरालभात्रायमाणाः पर्पटकश्चैतेषां द्विपलिकान् भागान् जलद्रोणे प्रक्षिप्य पादावशेषं कषायमादाय कल्कपेष्याणीमानि भेषजान्यर्धपलिकानि त्रायमाणामुस्तेन्द्रयवचन्दनकिराततिक्तानि पिप्पल्यश्चैतानि घृतप्रस्थे समावाप्य विपचेत् । एतत् तिक्तकं नाम सर्पिः कुष्ठविषमज्वरगुल्मार्शोग्रहणीदोषशोफपाण्डुरोगविसर्पषाण्ढ्यशमनञ्चेति ।। १० ।।

The Tikta-Sarpih: Two Pala weight of each of the following drugs, viz.. Triphala, Patola, Picu-marda, Ataruslaka, Katu-rohini, Duralabha, Trayamana and Parpataka² should be taken and boiled together in a Drona measure of water. The boiling should be continued till it is reduced to one fourth of its original quantity. Then half a Pala weight of each of the following drugs, viz., Trayamana, Musta, Indrayava, (red) Candana, Kiratatikta and Pippali should be pasted together. This pasted Kalka and the decoction should be cooked with a Prastha measure of clarified butter. The medicated Ghrita thus prepaed is called the Tikta-Sarpih. Diseases such as Kustha, chronic fever, Gulma, Haemorrhoids, Grahani, oedema, anaemea, erysipelas and impotency readily yield to the curative efficacy of this Ghrita. 10

अतोऽन्यतमेन घृतेन स्निग्धस्विन्नस्यैकां द्वे तिस्त्रश्चतस्त्रः पञ्च वा सिरा विध्येत् ; मण्डलानि चोत्सन्नान्यवलिखेदभीक्ष्णं प्रच्छयेद् वा । समुद्रफेनशाक-गोजीकाकोदुम्बरिकापत्रैर्वाऽवघृष्यालेपयेल्लाक्षासर्जरसरसाञ्जनप्रपुन्नाडावल्गुजतेजोवत्यश्वमारकार्ककुटजारेवतमूलकल्कैर्मूत्रपिष्टैः पित्तपिष्टैर्वा, स्वर्जिकातुत्थ-कासीस-विडङ्गागारधूम

1. A variety of eczema and moniliasis.

2. Cakradatta reads Nisa” in addition to the above drugs.

चित्रक-कटुकसुधा-हरिद्रासैन्धवकल्कैर्वा, एतान्येवावाप्य क्षारकल्पेन निःसृते पालाशे क्षारे ततो विपाच्य फाणितमिव सञ्जातमवतार्य लेपयेत् । ज्योतिष्कफललाक्षामरिचपिप्पलीसुमनः पत्रैर्वा, हरितालमन:शिलार्कक्षीरतिलशिग्रुमरिचकल्कैर्वा, स्वर्जिकाकुष्ठतुत्थकुटजचित्रकविडङ्गमरिचरोध्रमनः शिलाकल्कैर्वा, हरीतकीकरञ्जिकाविडङ्गसिद्धार्थकलवणरोचनावल्गुजहरिद्राकल्कैर्वा ।। ११ ।।

Medicinal Plasters for Kustha: Having first soothed the patient with any of the preceding medicated clarified butters and having his body fomented, the surgeon should have recourse to the venisection. One, two, three, four, or five siras (veins) of the patient may be opened (according to the circumstances). The raised or elevated patches on the skin should be scraped off, or should be kept constantly covered with a medicinal plaster. As an alternative, the characteristic patches of the disease should be first rubbed with the substance known as the Samudra-phena or with the leaves of Saka, Goji, or Kakodumbara and a plaster (Lepa) composed of Laksa, Sarja-rasa. Rasanjana, Prapunnada, Avalguja, Tejovati and the roots of Asva-maraka, Arka, Kutaja, and Arevata, pasted with the urine or bile of a cow, should be applied to them; or Svarjika, sulphate of copper, sulphate of iron. Vidanga, Agara-dhuma, Citraka, Katuka, Sudha, turmeric and Saindhava pounded together with the urine or bile of a cow should be applied to the diseased localities.

As an alternative, the alkali, prepared from the ashes of Palasa wood in the prescribed manner, should be boiled with the powders of the preceding drugs; it should be removed from the oven after reducing it to the thickness or consistency of a Phanita and used in plastering the diseased patches; or a plaster composed of Jyotiska fruits, Laksa, Marica, Pippali and the leaves of the Jafi flower pasted together; or a plaster composed of yellow orpiment, Manah-sila, the milky juice of Arka, sesamu, Sigru and Marica, pasted together; or a plaster composed of Svarjika, Kustha, sulphate of copper, Kutaja, citraka, Vidanga, Marica, Rodhra and Manah-sila pasted together; or a plaster of Haritaki, Karanjika, Vidanga, white mustard seeds, rock-salt, Gorocana, Somaraji and Haridra pasted together should be applied to the diseased localities. 11

सर्वे कुष्ठापहाः सिद्धा लेपाः सप्त प्रकीर्तिताः । ददुश्वित्रेषु मे वैशेषिकानतस्तूर्ध्वं मे शृणु ।। १२ ।।

Metrical Text: The preceding seven medicinal plasters are possessed of the virtue of the destroying or curing Kustha in general. Now hear me dealing with the remedies to be specifically employed in cases of ringworm infection (Dadru) and leucoderma (Svitra). 12

लाक्षा कुष्ठं सर्षपा: श्रीनिकेतं रात्रियोषं चक्रमर्दस्य बीजम् । कृत्वैकस्थं तक्रपिष्टः प्रलेपो दद्रुषूक्तो मूलकाद् बीजयुक्तः ।। १३ ।। सिन्धूद्भूतं चक्रमर्दस्य बीजमिक्षूद्भूतं केशरं तार्क्ष्यशैलम् । पिष्टो लेपोऽयं कपित्थाद्रसेन ददूस्तूर्णं नाशयत्येष योगः ॥ १४॥ हेमक्षीरी व्याधिघातः शिरीषो निम्बः सर्जो वत्सकः साजकर्णः । शीघ्रं तीव्रा नाशयन्तीह दद्रूः स्नानालेपोद्यर्षणेषूपयुक्ताः ।। १५ ।।

Treatment of Dadru: A plaster composed of Kustha, mustard seeds, Sri-niketa, Haridra, Trikatu and the seeds of Cakra-marda and of Mulaka pasted together with Takra (butter milk) should be applied to the ringworm infection. The disease is found to readily yield to the curative efficacy of a medicinal plaster, composed of Saindhava, Cakra-marda seeds, treacle, Kesara (Vakula), and Tarkasay-saila (Rasanjana) pasted together with expressed Kapittha juice. Preparations of Hema-ksiri Vyadhi ghata (aragvadha) Sirisa, Nimba, Sarja. Vatsaka and Aja-karna (a species of Sarja) should be used in cases of ringworm infection of a virulent type for baths (D. R. Drinks).’ plasters and rubbing. 13-15

भद्रासंज्ञोदुम्बरीमूलतुल्यं दत्त्वा मूलं क्षोदयित्वा मलप्वाः । सिद्धंतोयंपीतमुष्णे सुखोष्णं स्फोटा श्वित्रे पुण्डरीके च कुर्यात् ।। १६ ।।

द्वैपं दग्धं चर्म मातङ्गजं वा भिन्ने स्फोटे तैलयुक्तं प्रलेपः । पूति: कीटो राजवृक्षोद्भवेन क्षारेणाक्तः श्वित्रमेको निहन्ति ॥ १७ ॥

Treatment of Svitra – Leucoderma Ayurvedic Treatment

Treatment of Svitra : In cases of Svitra (Leucoderma) and Pundarika: the patient should be made to drink a lukewarm decoction prepared with equal parts of the roots of Bhadra (Udumbara) and Malapu. The use of this potion would produce blisters on the patches.

1. In drinks or baths, a decoction should be used and in plasters and rubbings the ingredients should be pasted with Takra and the expressed juice of Kapittha.

These blisters should be treated, after their bursting, with a plaster (Pralepa) composed of the ashes of the burnt skin of leopard and elephant and made into a thin paste with (mustard) oil. A plaster composed of the insect known as the Puti and the Kshara (alkali) of Aragvadha should be found to be the best remedy for Svitra. 16-17

कृष्णस्य सर्पस्य मसी सुदग्धा वैभीतकं तैलमथ द्वितीयम् । एतत् समस्तं मृदितं प्रलेपाच्छ्वित्राणि सर्वाण्यपहन्ति शीघ्रम् ।। १८ ।। अध्यर्धतोये सुमतिनुतस्य क्षारस्य कल्पेन तु सप्तकृत्वः । तैलं शृतं तेन चतुर्गुणेन श्वित्रायहं म्रक्षणमेतदग्रयम् ।। १९ ।।

All kinds of Svitra are found to readily yield to the application of a medicinal plaster made of the black ashes of a well-burnt cobra (Krsna-Sarpa) pasted with the oil of Vibhitaka. The white ashes of the said cobra mixed with one and a half time of its own weight of water should be filtered seven times in the manner of preparing an alkali. Mustard oil should be cooked with this alkaline water weighing four times of the oil. An application of this oil proves best curative in cases of Svitra. 18-19

घृतेन युक्तं प्रपुनाडबीजं कुष्ठञ्च यष्टीमधुकश्च पिष्ट्वा । श्वेताय दद्याद् गृहकुक्कुटाय चतुर्थभक्ताय बुभुक्षिताय ।। २० ।। तस्योपसंगृह्य च तत् पुरीषमुत्पाचितं सर्वत एव लिम्पेत् । अभ्यन्तरं मासमिमं प्रयोगं प्रयोजयेच्छ्वित्रमथो निहन्ति ।। २१ । ।

The Prapunnada seeds Kustha and Yasti-madhu should be pasted together with clarified butter. The plaster thus prepared should be given to a domestic white cock, purposely kept without food for a day and a half when it would evince any sign of hunger after the period. The facces of the said cock should then be collected after a full digestion of the said medicated drug and applied as plasters on the affected patches for a month. It would bring about the cure (even) of internal2 Svitras. 20-21

क्षारे सुदग्धे गजलेण्डजे च गजस्य मूत्रेण बहुस्रुते च । द्रोणप्रमाणे दशभागयुक्तं दत्त्वा पचेद् बीजमवल्गुजस्य || २२ ||

1. This is the best medicine for curing Svitra.

2. The internal Svitras are those under the blisters produced by the application of the remedy mentioned first in the list.

एतद् यदा चिक्कणतामुपैति तदा समस्तं गुटिका विदध्यात् । शिवत्रं प्रलिम्पेदथ सम्प्रघृष्य तया व्रजेदाशु सवर्णभावम् || २३ ।।

Well burnt ashes of the drug Jalpippali¹, mixed with elephant’s urine, should be filtered several times (twenty-one times or seven times) after the manner of an alkaline preparation. A Drona measure of this alkaline solution should be boiled with the seeds of the Somaraji weighing a tenth part thereof. This compound should be taken down from the oven as soon as it assumes a glossy hue and should then be made into boluses. Having rubbed the diseased patches of Svitra, a plaster of these boluses should be applied to them which would soon assume a healthy and natural complexion. 22-23

कषायकल्पेन सुभावितान्तु दलत्वचं चूतहरीतकीनाम्। तां ताम्रदीये प्रणिधाय धीमान् वर्ति वटक्षीरसुभावितान्तु ॥ २४ ॥ आदीप्य तज्जातमसीं गृहीत्वा तांचापि पथ्याऽम्भसि भावयित्वा । संप्रच्छितं तद् बहुश: किलासं तैलेन सिक्तं कटुना प्रयाति ॥ २५ ॥

The leaves and bark (Dala-tvaca) of the Amra (mango) and the Haritaki² should be well soaked in a decoction of the same drugs (after the manner of a Bhavana-saturation) and made into Vartis (i.e., plugs). These Vartis should again be well soaked in the milky exudation of the Vata tree and lighted (with mustard oil) in a cooper vessel used as an Indian lamp. The lamp black, thus produced, should be collected and well soaked in a decoction of Haritaki. Kilasa (a particular kind of Kustha) is destroyed, if rubbed with this preparation for several times after having been lubricated with mustard oil.³ 24-25

1. Sivadasa, the commentator of Cakradatt says that some read नलगन्डने in place of in which case it would mean “Samatha.”

2. According to some, both the leaves and bark of the “Amra” and of the “Haritaki” should be taken.

3. The leaves and bark respectively of the Amra and the Harilaki should be taken in the preparation. The whole stanza seems to be of faulty construction. Dalhana, in his commentary, says that some read the fourth line as “f a dura¶aoyafa fy||”This seems to be a better reading. It removes the difficulty in the construction, but it omits also the word “Kilusa” from the text. This, however, is also an improvement, inasmuch as this preparation seems to be a remedy for Svitra (which is only a variety of Kilusa) like the preceding and the following ones; and it seems unlikely that Susruta would introduce a remedy for Kilasa in general in the special treatment of Svitra.

आवल्गुजं बीजमग्रचं नदीजं काकाह्वानोदुम्बरी या च लाक्षा | लौहं चूर्णं मागधी तार्क्ष्यशैलं तुल्याः कार्याः कृष्णवर्णास्तिलाश्च ॥ २६ ॥

वर्तिं कृत्वा तां गवां पित्तपिष्टां लेपः कार्यः श्वित्रिणां श्वित्रहारी । लेपात् पित्तं शैखिनं श्वित्रहारि हीबेरं वा दग्धमेतेन युक्तम् ॥ २७ ॥

A case of leucoderma would (undoubtedly) yield to the curative virtue of a medicinal plaster composed of Somaraji seeds, Maksika, Kakodumbara, Laksa, powdered iron, Pippali and Rasanjana, taken in equal parts and black sesamum equal to their combined weight. pasted with the bile of a cow and applied to the diseased patches. Similarly, a case of Svitra would prove amenable to the application of peacock’s bile, or of burnt Hrivera mixed with the said bile. 26-27

तुत्थालकटुकाव्योष-सिंहार्कहयमारकाः कुष्ठावल्गुजभल्लात-क्षीरिणीसर्षपाः i स्नुही ॥ २८ ॥

तिल्वकारिष्टपीलूनां वा। बीजं विडङ्गाश्वहंत्रोर्हरिद्रे बृहतीद्वयम् । आभ्यां शिवत्राणि योगाभ्यां लेपान्नश्यन्त्यशेषतः ।। २९ ।।


Various types of Svitra are cured with the application of either of the two following medicinal plasters. The first consists of Tuttha ( sulphate of copper), Haritala ( yellow oxide of arsenic ). Katuka, Trikatu, Sinha (Rakta-sobhafijana),Arka, Karavira, Kustha, Avalguja, Bhallataka, Ksirini, mustard seeds and Snuhi; and the seeds of the Vidanga, Karavira, Haridra, Daru-haridra, Vrhati and Kantakari 28-29

वायसीफल्गुतिक्तानां शतं दत्त्वा पृथक् पृथक् । द्वे लोहरजसः प्रस्थे त्रिफलात्र्याढकं तथा ॥ ३० ॥

द्विद्रोणेऽपां पचेद् यावद् भागौ द्वावसनादपि । शिष्टञ्च विपचेद् भूय एतैः श्लक्ष्णप्रपेषितैः ।। ३१ ।।

कल्कैरिन्द्रयवव्योषत्वग्दारुचतुरङ्गलैः पारावतपदीदन्तीबाकुचीकेशराह्वयैः । कण्टकार्या च तत् पक्वं घृतं कुष्ठिषु योजयेत् ।। ३२ ।।

दोषधात्वाश्रितं पानादभ्यङ्गात् त्वग्गतं तथा । अप्यसाध्यं नृणां कुष्ठं नाम्ना नीलं नियच्छति ॥ ३३ ॥

Nila-Ghrita : Vayasi, Phalgu and Tikta each weighing one hundred Palas, two Prastha measures of powdered iron, three Adhaka (eight seers) measures of Triphala and two Adhaka measures of Asana should be boiled together with two Drona measures of water. This decoction should be taken down when reduced to one quarter of its original measure and cooked again with a quantity of clarified butter (weighing a quarter part of the former (decoction) and with a Kalka consisting of Indra-yava, Trikatu, Tvak, Deva – daru, Aragvadha, Para-vata-padi, Danti, Vakuci, Kesarahva (Valuka) and Kantakari. The patient should be made to drink this medicated clarified butter when the disease would be found to have attacked the Dhatus (fundamental principles of the organism), or to have become involved in the aggravated Dosas of the system. The diseased patches should be rubbed with it, in the event of the affection being found to be confined to the Tvak (skin) alone. Even the type of Kustha, commonly held to be incurable, has been found to prove amenable to the use of this medicated clarified butter, which is known as the Nila-Ghrita.30-33

त्रिफलात्वक् त्रिकटुकं सुरसा मदयन्तिका । वायस्यारग्वधाश्चैषां तुलां कुर्यात् पृथक् पृथक् ॥ ३४ ॥

काकमाच्यर्कवरुण-दन्तीकुटजचित्रकात् दार्वीनिदिग्धिकाभ्यान्तु पृथग्दशपलं तथा ।। ३५ ॥

त्रिद्रोणेऽपां पचेद् यावत् षट्प्रस्थं परिशेषितम् । शकृद्रसदधिक्षीर-मूत्राणां पृथगाढकम् ।। ३६ ।

तद्वद् घृतस्य तत् साध्यं भूनिम्बव्योषचित्रकैः करञ्जफलनीलिकाश्यामावल्गुजपीलुभिः नीलिनीनिम्बकुसुमैः सिद्धं कुष्ठापहं घृतम् ॥ ३७॥

म्रक्षणादङ्गसावर्ण्य शिवत्रिणां जनयेन्नृणाम् । भगन्दरं कृमीनर्शो महानीलं नियच्छति ।। ३८ ॥

Maha-Nila-Ghrita : A Tula weight of the drugs known as Triphala Tvak (Triphala bark), Trikatu, Surasa, Madayantika, Vayasi and Aragvadha and ten Pala weight of each of the drugs known as Kakamaci, Arka, Varuna, Danti, Kutaja, Citraka, Daru-haridra and 1. A Tula is equal to a hundred Palas or twelve seers and a half of our modern measure.

Kantkari should be boiled together with three Drona measures of water. This decoction, boiled down or reduced to six Prastha measure, should be again boiled with the watery secretion of cowdung, cow’s urine, milk, curd and clarified butter, each weighing an Adhaka, and with the Kalka (weighing one-fourth as much of clarified butter) of Bhu-nimba, Trikatu, Citraka, Karanja-fruit, Nilika, Syama, Avalguja, Pilu, Nilini and Nimba-flowers. It is a curative for Kustha. The rubbing of the diseased patches with this Ghrita imparts a healthy and natural colour to the skin in cases of Svitra or white Psoriasis. It also cures diseases like fistula-in-ano, worms in the intestines and Arsas. It is known as the Maha- Nila Ghrita. 34-38

मूत्रं गव्यं चित्रकव्योषयुक्तं सर्पिः कुम्भे क्षौद्रयुक्तं स्थितं हि । पक्षादृर्ध्वंश्वित्रिभिः पेयमेतत् कुर्याच्चास्मिन् कुष्ठदिष्टंविधानम् ।। ३९ ।।

पूतीकार्कस्नुङ्नरेन्द्रमाणां मूत्रै: पिष्टाः पल्लवा: सौमनाश्च । लेपः श्वित्रं हन्ति दद्रुद्रव्रणांश्च दुष्टान्यर्शास्येष नाडीव्रणांश्च ।। ४० ।।

A compound consisting of cow’s urine, Citraka, Trikatu and honey should be kept for a fortnight in a closed earthen pitcher which formerly contained clarified butter. A Svitra-patient would do well to take this medicine after this period. He should also observe the rules of diet and regimen of a Kustha-patient. The application of a Lepa (medicinal plaster), prepared by pasting the tender twigs of the Putika, Arka, Snuhi, aragvadha and of the Jati flower with cow’s urine, would prove curative in cases of Svitra, ringworm infection, ulcer, bad types of haemorrhoids and sinus. 39-40

अस्मादूर्ध्वं निःस्रुते दुष्टरक्ते जातप्राणं सर्पिषा स्नेहयित्वा । तीक्ष्णैर्योगैश्छर्दयित्वा प्रगाढं पश्चाद् दोषं निर्हरच्चाप्रमत्तः ।। ४१ ।।

दुर्वान्तो वा दुर्विरिक्तोऽपि वा स्यात् कुष्ठी दोषैरुद्धतैर्व्याप्तदेहः । निःसन्दिग्धं यात्यसाध्यत्वमाशु तस्मात् कृत्स्त्रान् निर्हरेत् तस्य दोषान् ॥ ४२ ॥

In case the foregoing medicinal remedies prove ineffective, the patient should be duly bled for the purpose of letting out the vitiated blood from the system, and after sufficiently recouping his strength

1. Dalhana, in his commentary, says that the two Ghytas (Nila and Maha- Nila) seem to be spurious (Anarsa). But he has included them in his commentary as Jejjata and Gayasa have read and explained them before him.

Nila-Ghrita : Vayasi Phalgu and Tikta each weighing one hundred Palas, two Prastha measures of powdered iron, three Adhaka (eight seers) measures of Triphala and two Adhaka measures of Asana should be boiled together with two Drona measures of water. This decoction should be taken down when reduced to one quarter of its original measure and cooked again with a quantity of clarified butter (weighing a quarter part of the former (decoction) and with a Kalka consisting of Indra-yava, Trikatu, Tvak, Deva-daru, aragvadha, Para-vata-padi, Danti, Vakuci, Kesarahva (Valuka) and Kantakari. The patient should be made to drink this medicated clarified butter when the disease would be found to have attacked the Dhatus (fundamental principles of the organism), or to have become involved in the aggravated Dosas of the system. The diseased patches should be rubbed with it, in the event of the affection being found to be confined to the Tvak (skin) alone. Even the type of Kustha, comn mmonly held to be incurable, has been found to prove amenable to the use of this medicated clarified butter, which is known as the Nila-Ghrita.30-33

त्रिफलात्वक् त्रिकटुकं सुरसा मदयन्तिका । वायस्यारग्वधाश्चैषां तुलां कुर्यात् पृथक् पृथक् ।। ३४ ।।

काकमाच्यर्कवरुण-दन्तीकुटजचित्रकात् दार्वीनिदिग्धिकाभ्यान्तु पृथग्दशपलं तथा ।। ३५ ।।

त्रिद्रोणेऽपां पचेद् यावत् षट्प्रस्थं परिशेषितम् । शकृद्रसदधिक्षीर-मूत्राणां पृथगाढकम् ।। ३६ । ।

तद्वद् घृतस्य तत् साध्यं भूनिम्बव्योषचित्रकैः ।

करञ्जफलनीलिकाश्यामावल्गुजपीलुभिः नीलिनीनिम्बकुसुमैः सिद्धं कुष्ठापहं घृतम् ॥ ३७॥

म्रक्षणादङ्गसावर्ण्यं शिवत्रिणां जनयेन्नृणाम् । भगन्दरं कृमीनर्शो महानीलं नियच्छति ।। ३८ ॥

Maha-Nila-Ghrita : A Tula weight of the drugs known as Triphala Tvak (Triphala bark), Trikatu, Surasa, Madayantika, Vayasi and Aragvadha and ten Pala weight of each of the drugs known as Kakamaci, Arka, Varuna, Danti, Kutaja, Citraka, Daru-haridra and 1. A Tula is equal to a hundred Palas or twelve seers and a half of our modern measure. (after bloood-letting) his body should be anointed with clarified butter and copious vomitings should be induced with the help of strong emetics and the patient should be treated subsequently with a judicious administration of purgatives (so as to remove the aggravated Dosas from the system). The aggravated Dosas of the body, not being fully expelled from the organism of a Kustha-patient by means of the preceding emetic and purgative measures, ter to extend all over the organism and the disease in consequence thereof is sure to lapse into one of an incurable type. Hence the aggravated Dosas should be fully eliminated from the organism. 41-42 ·

पक्षात् पक्षाच्छर्दनान्यभ्युपेयान्मासान्मासात् स्रंसनञ्चापि देयम् । स्त्राव्यं रक्तं वत्सरे हि द्विरल्पं नस्यं दद्याच्च त्रिरात्रात् त्रिरात्रात् ॥ ४३ ॥

Emetics should be administered to a Kustha-patient once a fortnight and Sramsana (purgatives) once a month. He should be bled twice a year though not profusely and medicated snuffs should be administered to him every fourth day. 43′

पथ्या व्योषं सेक्षुजातं सतैलं लीद्वा शीघ्रं मुच्यते कुष्ठरोगात् ।

धात्रीपथ्याक्षोपकुल्याविडङ्गान् क्षौद्राज्याभ्यामेकतो वाऽवलिह्यात् ।। ४४ ॥

पीत्वा मासं वा पलांशां हरिद्रां मूत्रेणान्तं पापरोगस्य गच्छेत् । एवं पेयश्चित्रकः श्लक्ष्णपिष्टः पिप्पल्यो वा पूर्ववन्मूत्रयुक्ताः ॥ ४५ ॥

तद्वत् तार्क्ष्यं मासमात्रञ्च पेयं, तेनाजस्त्रं देहमालेपयेच्च ॥ ४६ ॥

Haritaki, Trikatu and treacle (prepared from the juice of the sugarcane) mixed with oil if licked would lead to the early recovery of a case of Kustha. an alternative, he should use a lambative medicinal compound of Amalaka, Haritaki, Aksa, Pippali and Vidanga mixed with honey and clarified butter. Or he should take a Pala weight of Haridra with an adequate quantity of cow’s urine every day for a month in order to get free from Kustha; or the same quantity of the fine powder of Pippali or of Citraka should be given to him through the same vehicle and for the same period which would cure him of Kustha. The same quantity of the fine powder of Rasanjana should be given through the said vehicle and in the same manner for a period of one months and the same should also be repeatedly applied externally. 44-46

अरिष्टत्वक् साप्तपर्णी च तुल्या लाक्षा मुस्तं पञ्चमूल्यौ हरिद्रे | मञ्जिष्ठाक्षौ वासको देवदारु पथ्यावह्नी व्योषधात्री विडङ्गम् ॥ ४७ ॥

सामान्यांशं योजयित्वा विडङ्गैश्चूर्णं कृत्वा तत्पलोन्मानमश्नन्। कुष्ठाज्जन्तुर्मुच्यते त्रैफलं वा सर्पिर्द्रोणं व्योषयुक्तञ्च युञ्जन् ।।४८ ॥ गोमूत्राम्बुद्रोणसिद्धेऽक्षपीडे सिद्धं सर्पिर्नाशयेच्चापि कुष्ठम् ।

Drugs such as Rodhra, Nimba, Padma-kastha, Rakta-candana, Sapta-parni, Aksa, Vrksaka and Bijaka should be used in the bath of the patient in the event of there being any burning sensation; or a potion consisting of honey and paste Tribhandi (Trivrt) should be given to him. Old and matured Mudga, boiled in the decoction² of Nimba and mixed with oil, should be given to the patient as drink, where sloughing would be detected in the diseased localities. A decoction of Nimba or that of Arka, Alarka and Sapta-cchada should be given to him if there be any worms in the diseased locality. The affected part of the body should be plastered over with the roots of the Asva-mara and Vidanga, pasted with cow’s urine, in the event of its being eaten away by the worms. cow’s urine should be sprinkled over the diseased locality and all food (of the patient) should be given with the powder of Vidanga. 50-52

कारचं वा सार्षपं वा क्षतेषु क्षेप्यं तैलं शिशुकोशाम्रयोर्वा | पक्वं सर्वैर्वा कटूष्णैः सतितैः शेषञ्च स्यादुष्टवत् संविधानम् ।। ५३ ।।

As an alternative, the affected parts should be rubbed with the oil of Karanja, mustard, Sigru, or Kosamra, or with an oil (any one of the preceding oils) cooked with (a decoction of) pungent, bitter and heatproducing substances. Measures laid down under the head of DustaVrana (malignant ulcer) should be resorted to in a case where the aforesaid remedies would fail to produce any beneficial effect. 53

सप्तपर्णकरञ्जार्क-मालतीकरवीरजम् चित्रकास्फोतयोरपि ।। ५४ ।।

विषलाङ्गलवज्राख्य-कासीसालमनः शिलाः । करञ्जबीजं त्रिकटु त्रिफलां रजनीद्वयम् ॥ ५५ ।।

सिद्धार्थकान् विडङ्गानि प्रपुन्नाडञ्च संहरेत् । मूत्रपिष्टैः पचेदेतैस्तैलं कुष्ठविनाशनम् ।

एतद् स्नुहीशिरीषयोर्मूलं वज्रकमभ्यङ्गान्नाडीदुष्टव्रणापहम् ।। ५६।।

Vajraka-Taila : The roots of Sapta-parna, Karanja, Arka, Malati, Karavira, Snuhi, Sirisa, Citraka and asphota as well as of Visa (aconite root), Langala, Vajrakhya (mica), sulphate of iron,

1. The drugs are to be boiled in water in which the patient should take his bath. 2. The decoction should be prepared in the manner of “Sadanga-kalpa’.

Haritala, Manah-sila, Karanja-seeds, Trikatu, Triphala, the two kinds of Haridra, white mustard seeds, Vidainga and Prapunnada should be pasted together with the urine of a cow. The paste thus prepared should be cooked in an adequate quantity of oil.¹ This oil known as the Vajraka-Taila, used as unguents, proves remedial to Kustha etc., sinus and malignant ulcers in general 54-56

सिद्धार्थकः करौ द्वौ द्वे हरिद्रे रसाञ्जनम् ।


प्रयुन्नाड – सप्तपण

मृगादनी ॥ ५७ ॥

लाक्षा सर्जरसोऽर्कश्च सास्फोतारग्वधौ स्नुही ।

कुटजारुष्करौ शिरीषस्तुवराख्यस्तु

वचा ।। ५८ ॥

कुष्ठं कृमिघ्नं मञ्जिष्ठा लाङ्गली चित्रकं तथा । मालती कटुतुम्बी च गन्धाह्वा मूलकं तथा ॥ ५९ ॥ सैन्धवं करवीरश्च गृहधूमं विषं तथा । कम्पिल्लकं ससिन्दूरं तेजोह्वातुत्थकाह्वये । समभागानि सर्वाणि कल्कपेष्याणि कारयेत् ।। ६० ।। गोमूत्रं द्विगुणं दद्यात् तिलतैलाच्चतुर्गुणम् । कारचं वा महावीर्यं सार्षपं वा महागुणम् ।। ६१ ।। अभ्यङ्गात् सर्वकुष्ठानि गण्डमालाभगन्दरान् । नाडीदुष्टव्रणान् घोरान् नाशयेन्नात्र संशयः । महावज्रकमित्येतन्नाम्ना तैलं महागुणम् ।। ६२ ।

Maha-Vajraka Taila: The drugs and substances known as white mustard-seeds (Siddharthaka), the two kinds of Karanja, the two kinds of Haridra, Rasanjana, Kutaja, Prapunnada, Sapta-parna, Mrgadani Laksa, Sarja-rasa, Arka, Asphota, Aragvadha, Snuhi, Sirisa, Tuvara, Kutaja, Aruskara, Vaca, Kustha, Vidanga, Manjistha, Langali, Citraka, Malati, Katu-tumbi, Gandhahva, Mulaka, Saindhava, Karavira, Grha-dhuma, Visa (aconite), Kampillaka, Sindura (mercuric oxide), Tejohva and sulphate of copper should be taken in equal parts and made into a paste. This paste (Kalka) should be cooked with either Karanja-oil or mustard-oil2, both of which have great curative potency,

1. Sivadasa, the commentator on Cakradatta, asserts, on the authority of Vagbhata, that the oil should be sesamum-oil and it should be boiled with cow’s urine. According to Gayadasa mustard-oil should be used. with double quantity of cow’s urine. It may also be prepared with sesamum-oil, but in this case four times of cow’s urine should be taken. As an anointment it is undoubtedly efficacious in a case of Kustha or whatsoever type as well as in cases of scrofula, fistula-inano, sinus and malignant ulcers. This oil is known by the name of Maha-Vajraka oil and possessed of supreme and unquestionable efficacy. 57-62

पित्तावापैर्मूत्रपिष्टैस्तैलं लाक्षादिकैः कृतम् । सप्ताहं कटुकालाब्वां निदधीत चिकित्सकः ।। ६३ ।।

पीतवन्तं ततो मात्रां तेनाभ्यक्तञ्च मानवम् । शाययेदातपे तस्य दोषा गच्छन्ति सर्वशः ॥ ६४ ॥

स्रुतदोषं समुत्थाप्य स्नातं खदिरवारिणा । यवागूं पाययेदेनं साधितां खदिराम्बुना ।। ६५ ।॥

एवं संशोधने वर्गे कुष्ठघ्नेष्वौषधेषु च। कुर्यात् तैलानि सर्पोंषि प्रदेहोद्धर्षणानि च ।। ६६ ।।

प्रातः प्रातश्च सेवेत योगान् वैरेचनान् शुभान् । पञ्च षट् सप्त चाष्टौ वा यैरुत्थानं न गच्छति ॥ ६७ ॥

कारभं वा पिबेन्मूत्रं जीर्णे तत्क्षीरभोजनम् । जातसत्त्वानि कुष्ठानि मासै: षड्भिरपोहति ।। ६८ ।।

The drugs which constitute the Laksadi group should be pasted with an adequate quantity of cow’s urine and cooked’ with sesamumoil and mixed with Pitta cow’s bile). The oil, thus prepared, should be preserved for a week inside the body of a Katukalavu. The oil should be taken out (after this period) and the patient should use it both internally and externally (in an adequate quantity ). After doing this, he should expose himself to the heat of the sun whereby all the Dosas would be eliminated from his organism. After the complete elimination of the Dosas from the system, the patient should be removed from the sun and bathed with a decoction² of Khadira, and a gruel, prepared with the decoction of Khadira, should be given to him as diet.

1. In cooking the oil, cow’s urine weighing four times of oil should be taken.-Dalhana.

2. The decoction of Khadira in the bath as well as in the preparation of the gruel should be prepared according to the manner of Sadanga Kalpa. –Dathana.

Similarly, oil or clarified butter boiled and prepared with the drugs constituting the Sansodhana group (mentioned in chap. xxxix, Sutra.) or with the drugs possessing anti-Kustha properties should be used as hot plasters and rubbings (in the diseased localities). Purgatives should be administered every morning with good results. The preceding remedies should be taken and continued for five, six, seven, or eight days, or till the Dosas of the system producing the disease are not perfectly fully digested, so that there may not be provocation of Dosas again. As an alternative, camel’s urine and after its full digestion, camel’s milk should be taken. Even parasitic types of Kustha are sure to disappear withinsix months (under thecourse of this treatment ). 63-68

दिदृक्षुरन्तं कुष्ठस्य खदिरं कुष्ठपीडितः । सर्वथैव प्रयुञ्जीत स्नानपानाशनादिषु ।। ६९ ।।

यथा हन्ति प्रवृद्धत्वात् कुष्ठमातुरमोजसा। तथा हन्त्युपयुक्तस्तु खदिर: कुष्ठमोजसा ।। ७० ।।

A Kustha-patient desirous of being perfectly cured should constantly use preparations of Khadira in his drinks, food, bath, etc. As kustha in advanced stages kills the patient due to its severity. similarly the use of khadir cures the Kustha due to its potency 69-70

नीचरोमनखः श्रान्तो हिताश्यौषधतत्परः । योषिन्मांससुरावर्जी कुष्ठी कुष्ठमपोहति ।। ७१ ।।

The paring of the nails and shaving the hair off, light physical exercise, the use of wholesome food, regularity in using medicines, abstinence from wine, women and meat-diet are the rules of conduct which should be strictly observed by a patient affected with Kustha, with the strict observance of the above rules a Kustha-patient may be expected to recover. 71

इति सुश्रुत संहितायां चिकित्सितस्थाने कुष्ठचिकित्सितं नाम नवमोऽध्याय: ।। ९ ।।

Thus ends the ninth Chapter of the Chikitsa Sthana in the Susruta Samhita which deals with the medical treatment of Kustha.


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