त्रयोदशोऽध्यायः । अथातो मधुमेहचिकित्सितं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ।।१।।
Now we shall discourse on the medical treatment of Diabetes (Madhu-Meha). As it was stated by Lord Dhanvantari. 1
मधुमेहित्वमापन्नं भिषग्भिः परिवर्जितम् । योगेनानेन मतिमान् प्रमेहिणमुपाचरेत् ।। २॥
Metrical Text: The intelligent physician should adopt the following course of treatment in the case of a Madhu-Meha-patient abandoned as incurable by other physicians. 2
मासे शुक्रे शुचौ चैव शैला: सूर्यांशुतापिताः । जतुप्रकाशं स्वरसं शिलाभ्यः प्रस्रवन्ति हि ।
शिलाजत्विति विख्यातं सर्वव्याधिविनाशनम् ।। ३ ।।
Silajatu, its origin and properties : A kind of gelatinous substance is secreted from the sides of the mountains when they are heated by the rays of the sun in the months of Jyaistha and Asadha. This substance is known as the Silajatu and it cures all distempers of the body. 3
त्रप्वादीनान्तु लोहानां षण्णामन्यतमान्वयम् । ज्ञेयं स्वगन्धतश्चापि षड्योनिप्रथितं क्षितौ ॥ ४ ॥
लोहाद् भवति तद् यस्माच्छिलाजतु जतुप्रभम् । तस्य लोहस्य तद्द्वीर्यं रसञ्चापि विभर्ति तत् ॥ ५ ॥
त्रपुसीसायसादीनि प्रधानान्युत्तरोत्तरम् । यथा तथा प्रयोगेऽपि श्रेष्ठे श्रेष्ठगुणाः स्मृताः ॥ ६ ॥
तत् सर्वं तिक्तकटुकं कषायानुरसं सरम् । कटुपाक्युष्णवीर्यञ्च शोषणं छेदनं तथा ।। ७ ।।
तेषु यत् कृष्णमलघु स्निग्धं निःशर्करञ्च यत् । गोमूत्रगन्धि यच्चापि तत् प्रधानं प्रचक्षते ।। ८ ।।
The presence of the six kinds of metal, such as tin, lead, copper, silver, gold and black-iron, in their essential form in the substance (Silajatu), may be detected by their respective smell and hence it is known to the people by the name of Sad-Yoni (lit.–having six different origins). The taste of this shellac-coloured substance has the same taste (Rasa) and potency ( Virya) as the metal to whose essence it owes its origin. It should be understood that as tin, lead and iron, etc., are progressively more and more efficacious, so the different varieties of Silajatu, originated from the essence of tin. lead. iron, etc.. are progressively more efficacious in their application.
All kinds of Silajatu have a bitter and pungent taste with an astringent after-taste (Anu-rasa), are laxative, pungent in their digestive reaction, heat-making in their poteney and possessed of absorbing and Dosa removing (Chedana) properties. Of these which looks black and glossy, is heavy and devoid of sandy particles, as well as which smells like the urine of a cow, should be considered as the best. 4-8
तद्भावितं सारगणैर्हतदोषो दिनोदये। पिबेत् सारोदकेनैव श्लक्ष्णपिष्टं यथाबलम् । जाङ्गलेन रसेनान्नं तस्मिन् जीर्णे तु भोजयेत् ।। ९ ।।
This best kind of Silajatu should be infused with the decoction of the drugs of the Sala-saradi group in the manner of Bhavana saturation (for ten, twenty, or thirty days). Then after cleansing the body (by the application of emetics and purgatives), it should be taken every morning (by the patient in adequate doses), well pasted with Sarodaka.’ He should further be made to take a meal of boiled rice mixed with the soup of the flesh of animals of the Jangala group after the medicine had been fully digested. 9
तुलामेवं गिरिजादमृतोपमात् । मधुमेहविवर्जितः । पूर्णमजरोऽमरसन्निभः ।। १० ।।
उपयुज्य वपुर्वर्णबलोपेतो जीवेद् वर्षशतं शतं शतं तुलायान्तु सहस्त्रं दशतौलिके । भल्लातकविधानेन परिहारविधिः स्मृतः ॥ ११ ॥
मेहं कुष्ठमपस्मारमुन्मादं श्लीपदं गरम् । शोषं शोफार्शसी गुल्मं पाण्डुतां विषमज्वरम् ॥ १२ ॥
अपोहत्यचिरात् कालाच्छिलाजतु निषेवितम् । न सोऽस्ति रोगो यञ्चापि निहन्यान्न शिलाजतु ॥ १३ ॥
शर्करां चिरसम्भूतां भिनत्ति च तथाऽश्मरीम् । भावनालोडने चास्य कर्तव्ये भेषजैर्हितैः ।।१४।।
A Tula measure of this hill-begotten panacea (Silajatu), when gradually taken, (in adequade doses) tends to improve the strength and complexion of the body, cures an attack of Madhu-Meha and enables the user to witness a hundred summers on earth, free from disease and decay like the unmortals. Each Tula weight of this medicine, taken successively, adds a century to the duration of human life, while ten Tula measures extend it to a thousand years. The regimen of diet and conduct during the period of its use should be identical with that described in connection with the use of the Bhallataka compounds. Cases of Meha, Kustha, epilepsy (Apasmara), insanity, elephantiasis, poison-begotten distempers, phthisis, oedema, haemorrhoids, Gulma (internal tumours), anaemia and irregular fever, provereadily amenable to the curative efficacy of Silajatu. Indeed there is no such bodily distemper which does not yield to its highly curative virtues. It acts as a potent solvent in cases of long-standing Sarkara (gravel) in the bladder as well as of stone. Silajatu should be treated (soaked and dried) with appropriate medicinal drugs by stirring it up with the same. 10-14
1. It is evident from the reading of Cakradatta that “Sarodaka” means a decoction of the drugs of the Sala-saradi group. But Dalhana explains it as “Pancha-sarodaka” which is quite unintelligible. In practice, also, Cakradatta. is followed.
एवञ्च माक्षिकं धातुं तापीजममृतोपमम्। मधुरं काञ्चनाभासमम्लं वा रजतप्रभम् ॥ १५ ॥
पिबन् हन्ति जराकुष्ठ-मेहपाण्ड्वामयक्षयान् । तद्भावितः कपोतांश्च कुलत्थांश्च विवर्जयेत् ।। १६ ।।
The Maksika Kalpa : The metal known as Maksika ( ironpyrites), which grows in the river Tapi and which copes with the divine ambrosia in its highly therapeutic properties, may be also used in the same way and under the same sort of preparation. The metal is divided into two classes according to its colour, as Svarna-Maksika (goldcoloured) and Rajata-Maksika (silver-coloured). Of these the first has a sweet taste while the second is acid. Both of them prove efficacious in cases of decrepitude, Kustha, Meha, anaemia and consumption. A person using Silajatu and Maksika (in the manner prescribed above) should refrain from taking pigeon-flesh and Kulattha pulse (during his life-time). 15-16
पञ्चकर्मगुणातीतं श्रद्धावन्तं जिजीविषुम् । योगेनानेन मतिमान् साधयेदपि कुष्ठिनम् ।। ७ ।।
The following measures should be adopted by an experienced physician in the case of a patient suffering from (Meha and) Kustha and who has a firm faith in medicines and is desirous of existence (life) and in whose case the curative efficacy of Pancha-karma’ has been baffled. 17
वृक्षास्तुवरका ये स्युः पश्चिमार्णवभूमिषु । वीचीतरङ्गविक्षेप-मारुतोद्धूतपल्लवाः फलानि तेषां गृह्णीयात् सुपक्वान्यम्बुदागमे । मज्जां तेभ्योऽपि संहृत्य शोषयित्वा विचूर्ण्य च । तिलवत् पीडयेद् द्रोण्यां स्रावयेद् वा कुसुम्भवत् ।। १९ ।। तत्तैलं संहृतं पचेदातोयसंक्षयात् । भूयः अवतार्य करीषे पक्षमात्रं निधापयेत् ।। २० ।। ।। १८ ।।
1. Some take the term in its ordinary sense to mean the five measures of emetics, purgatives, etc.; but Dalhana did explain it as the measures adopted in the treatment of the Kustha affecting the bone which is the fifth Dhatu in the system.
स्निग्धः स्विन्नो हृतमल: पक्षादूर्ध्वं प्रयत्नवान् । चतुर्थभक्तान्तरितः मन्त्रपूतस्य तैलस्य तत्र मन्त्रं प्रवक्ष्यामि मज्जसार महावीर्य सर्वान् धातून् विशोधय । शङ्खचक्रगदापाणिस्त्वामाज्ञापयतेऽच्युतः शुक्लादौ शुक्लादौ दिवसे दिवसे शुभे ।। २१ ।। पिबेन्मात्रां यथाबलम् । येनेदमभिमन्त्रयते ।। २२ । । ।। २३ ।।
The Tuvaraka Kalpa: The Tuvaraka plants which grow on the shores of the Western Sea (Arabian Sea) are constantly tossed about by the winds raised by the waves of the sea. The pith or marrow of the seeds (lit.–fruits) of these plants should be carefully collected in the rainy season while they ripen and should be subsequently dried and pounded. The oil should be either pressed out of these seeds in a mill in the manner of preparing sesamum oil, or squeezed out (of a press bag) like that used in the case of Kusumbha flowers. The oil should be boiled over a fire so as to have its inherent watery particles completely evaporated. Then it should be taken down from the fire and kept in a pitcher and then buried for a fortnight in a heap of well dried cowdung. The patient (in the meantime) should be duly anointed, fomented and treated with cleansing remedies (i.e., emetics and purgatives).¹ He should wait a fortnight (after the administration of the aforesaid measures) and wait for a period of fourth missed meals² (caturthabhaktarita) (i.e., two days) more; and on the next morning he should drink a portion of the oil in adequate dose (two Tolas) according to his own strength under the auspices of favourable astral combinations in the lighted fortnight of the month. He should be made to recite, at the time of his taking the dose, a Mantra which runs as follows: 0 Thou potent essence of seed-marrow, cleanse all the essential principles of (my) vital organism. The deity krsna who knows no decay and suffers no
1. The Kapha should be first reduced with emetics; and after a fortnight, the Pitta with purgatives. A fortnight after the use of purgatives, a potion of the Tuvarka oil should be administered in as much as it is a Samsodhaka (cleansing) remedy.
2. On the sixteenth day after the administration of the cleansing measures, as well as on the morning of the seventeenth day, the patient should take his meals as usual. On the evening of the seventeenth day no meal should be taken. On the following morning the oil should be taken. change and who weilds a discus, a maca and a conch-shell in his arms, commands thee to do so.” 18-23
तेनास्योर्ध्वमधश्चापि दोषा यान्त्यसकृत् ततः । अस्नेहलवणां सायं यवागूं शीतलां पिबेत् ॥ २४ ॥
पञ्चाहं प्रपिबेत् तैलमनेन विधिना नरः । पक्षं परिहरेच्चापि मुद्द्रयूषौदनाशनः । सर्वकुष्ठैर्विमुच्यते ॥ २५ ॥ पञ्चभिर्दिवसैरेवं
The Dosas in both the upper and the lower parts of a patients body are eliminated again and again with the help of this oil (which should be given to the patient in the morning); while a cold gruel, unseasoned¹ with salt and not mixed with any emollient substance (oil or clarified butter) should be given to him in the evening. The use of this oil should be repeated in the same manner for five days in succession and the patient should avoid anger, etc., and live on Mudga soup ( Yusa) and boiled rice for a fortnight. A five days use of this oil would ensure the cure of every types of Kustha ( and Madhu-meha). 24-25
तदेव खदिरक्वाथे त्रिगुणे साधु साधितम् । निहितं पूर्ववत् पक्षात् पिबेन्मासमतन्द्रितः ।। २६ ।।
तेनाभ्यक्तशरीरश्च कुर्वीताहारमीरितम् । भिन्नस्वरं रक्तनेत्रं विशीर्णं क्रिमिभक्षितम् ।
अनेनाशु प्रयोगेण साधयेत् कुष्ठिनं नरम् ।। २७ ।।
सर्पिर्मधुयुतं पीतं तदेव खदिराम्बुना | पक्षिमांसरसाहारं करोति द्विशतायुषम् ॥ २८ ॥
तदेव नस्ये पञ्चाशद्दिवसानुपयोजितम् । वपुष्मन्तं श्रुतिधरं करोति त्रिशतायुषम् ।। २९ ।।
शोधयन्ति नरं पीता मज्जानस्तस्य मात्रया | महावीर्यस्तुवरकः कुष्ठमेहापहः परः ।। ३० ।।
The foregoing (Tuvaraka) oil should be boiled and prepared with a decoction of Khadira weighing three times the quantity of the oil and kept (in cow dung) as before for a fortnight should be taken diligently for a month for the same purpose. The patient should anoint his body
1. A little quantity of salt and of oil or clarified butter may be given. with the same and then take his meals in the prescribed form. A Kustha-patient (as well as a Meha-patient) suffering from hoarseness, redness of eyes and with worm-eaten and emaciated limbs should be speedily treated with this oil as an anointment and a drink. Regular potions of the above medicinal (Tuvaraka) oil taken with honey, clarified butter and a decoction of Khadira and a diet consisting of the soups of bird’s flesh (during its course) would enable the user to live for a period of two hundred years. A use of this oil as errhines (Nasya) for a period of fifty consecutive days would enable the user to witness three hundred years on earth, in the full enjoyment of bodily vigour and a youthful glow of complexion, as well as with a very powerful retentive memory.
A regular use (in an adequate dose) of the pith of Tuvaraka cleanses the system of the patient and is a most potent remedy in cases of Kustha and Meha. 26-30
सान्तर्धूमस्तस्य मज्जा तु दग्धः क्षिप्तस्तैले सैन्धवञ्चाञ्जनञ्च | ऐर्म्यं हन्यादर्म्मनक्तान्ध्यकाचान् नीलीरोगं तैमिरञ्चाञ्जनेन ।। ३१ । ।
The pith (inner pulp of the seeds of the Tuvaraka burnt in a closed vessel (Antar-dhuma) should be mixed with Saindhava-salt, Anjana¹ and Tuvaraka oil. This prepared compound, used as a collyrium, is efficacious in cases of eye-diseases, such as night-blindness, Arman, Nili, Kaca-roga (dimness of sight) and Timira. 31
Thus ends the Thirteenth Chapter of the Chikitsa Sthana in the Susruta Samhita which deals with the treatment of Madhu-Meha.