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Ashtanga samgrahaPANDUROGA CHIKITSA - Treatment of Anaemia - Ashtanga Samgraha Chikitsasthana Chapter 18

PANDUROGA CHIKITSA – Treatment of Anaemia – Ashtanga Samgraha Chikitsasthana Chapter 18

अथातः पाण्डुरोगचिकित्सितं व्याख्यास्यामः । इति ह स्माहुरात्रेयादयो महर्षयः ॥ १ ॥

We will now expound Panduroga chikitsa- treatment of morbid pallor / anaemia; thus said atreya and other great sages. (1)

PANDUROGA CHIKITSA – Treatment of Anaemia

पाण्ड्वामयिनमादौ कल्याणकपञ्चगव्यतिक्तकानामन्यतमं सर्पिः पाययेत् । दाडिमसारतः कुडवं धान्यकार्धकुडवं पिप्पल्यष्टमिकां शुण्ठीचित्रकयोश्च पलं पलमेकतः कल्कीकृत्य तोयाढके विंशतिपलं घृतस्य सिद्धं हृत्पाण्डुरोगगुल्मप्लीहार्शःश्वासकासमूढवातवातकफार्तिहरमग्निदीपनं वन्ध्यानां सम्मतंदुःखप्रसवनीनांच ॥ २ ॥

The patient of panduroga should be made to drink either kalyanaka, panchagavya or tiktaka sarpi or any other medicated ghee in the beginning itself.

Medicated ghee prepared with one kudava of dadimasara (juice of dadima), half kudava of dhanyaka, one astamika (half-pala) of pippali, one pala each of sunthi and chitraka made into a paste, one adhaka of water and twenty pala of ghrta (ghee); this recipe cures disease of the heart, anaemia, abdominal tumor, disease of the spleen, piles, dyspnoea cough, inactive vata, disorders of vata and kapha, promotes digestive activities and beneficial barren women and who experience difficulty during delivery. (2)

दुरालभाचन्दनपटोलत्रायमाणागुडूचीकिराततिक्तरोहिणीघननिशाद्वयेन्द्रयवदेवदारुपर्पटकाजमोदै: कार्षिकैः क्षीराढके घृतपस्थं साधयेत् । पाण्डुरोगकामलारक्तपित्तज्वरदाहासृग्दरविस्फोटश्वयथुभगन्दराशघ्नम् ।।३।।

Medicated ghee prepared with one karsa each of duralabha chandana, patola, trayamana, devadaru, parpata and ajamoda, one adhaka of kshira (milk) and one prastha of ghrta (ghee). This cures anaemia, jaundice, bleeding disease, fever, burning sensation, menorrhagia, visphota (small-pox) dropsy, rectal fistula and harmorrhoids. (3)

स्निग्धं चैनं तीक्ष्णैर्वामयेत् । पुनश्च स्निग्धं मूत्रयुक्तं गव्यं माहिषं वार्धमासं पयः पाययेत् । मागधिकाशृतं वा । मूत्रसिद्धां वा त्रिफलाम् । सप्ताहं मूत्रेण वा हरीतकीः कल्किताः । स्वर्णक्षीरीभद्रद्रारुनागरश्यामात्रिवृन्मूलानि तेनैव वा क्वथितानि । एभिर्वा शृतं पयः ॥४॥

After (administering) oleation therapy, he should be made to vomit by using strong emetics. Once again he should be administered oleation therapy and then prescribed drinking of either cows milk or buffalos milk mixed with cows urine for a period of half a-month; it (milk) may be boiled along with magadhika; or he may be administered triphala boiled in (cows) urine or paste of haritaki along with (cows) urine for a period of seven days; or svarnaksiri, bhadradaru, nagara, root of syama and trivrit boiled in cows urine; or milk boiled with these drugs may be consumed. (4)

वत्सकबीजविशालाकुष्ठकटुकादारुमुस्तानांसमा भागाः मूर्वाभागद्वयमतविषाभागार्धंचचूर्णितं सुखाम्बुना पीत्वा क्षौद्रमनुलिह्यात् । एतत् पाण्डुकामलाज्वरारुचिगुल्मानाहामवातरक्तपित्तकासश्वासानपोहति ॥ ५ ॥

Equal parts of vatsaka bija, visala, kustha, katuka, daru and musta (together making one part), two parts of murva and half part of ativisa are all converted into a powder and consumed (in suitable doses) with warm water and followed with licking of honey; this recipe cures anaemia, jaundice, fever, anorexia, abdominal tumor, flatulence, rheumatism, bleeding disease, cough and dyspnoea. (5)

त्रिकटुककालतिललोहैर्वा माक्षिकधातुतुल्यैर्माक्षिकेणवटकान् कृत्वा तक्रानुपानान् पाण्डुरोगी भक्षयेत् । त्रिफलाव्योषकाग्निविडङ्गभागा नव नव चायसचूर्णभागा मधुघृताभ्यां तक्रेणीष्णोदकेनवोपयुक्ताहृत्पाण्डुरोगकामलाकुष्ठार्शःशोफोदरप्लीहमेहहराः ।।६।।

The patient of panduroga (anaemia) should consume pills prepared from (equal quantities of) trikatu, kalatila and loha or maksika dhatu ( iron pyrites) and maksika (honey); he should consume buttermilk as after-drink.

Navayasa loha

Triphala, vyosa, agni and vidanga- together making nine parts and nine parts of powder of ayas (iron) are powdered together and used (in appropriate dose) along with either honey and ghee or buttermilk or warm water. This cures heart disease, anaemia, jaundice, leprosy ( and other skin diseases), piles, dropsy, enlargement of abdomen, splenic disorders and diabetes. (6)

Mandura vataka

माक्षिकधातुचविकादारुदावत्वग्ग्रन्थिकान् त्रिफलादीनि च नव विचूर्ण्य चूर्णाद्विगुणं च सुश्रूक्ष्णं पृथड्मण्डूरं ततो गोमूत्रं सर्वतोऽष्टगुणं पक्त्वा तस्मिंस्तत् क्षिपेत् । अनन्तरं च वटकान् कुर्यात् । ते तक्रानुपानमभ्यस्ताः परमौषधं पाण्ड्वामयिनां शोफार्शः कुष्ठकामलामेहप्लीहाढ्य – वातकफार्तानांच ॥७॥

Maksika dhatu, cavika, daru, darvitvak, granthika and triphala and others (enumerated in the previous recipe) together making nine parts should be powdered, and added with fine powder of mandura (iron slag) double the quantity (of the powder of drugs) all are boiled in cows urine eight times their (total) quantity and rolled into pills (powder of drugs should be added at the terminal stages of boiling). These pills consumed habitually, followed by buttermilk as after drink acts as the best medicine for patients of anaemia and also for those suffering from dropsy, piles, leprosy ( and other skin disease), jaundice, diabetes, adhyavata ( stiffness of the legs) and diseases of kapha. (7)

Yogaraja

शिलाजतुताप्यरूप्यायोमलाः पृथक् पञ्चपलिकास्त्रिफलादयश्च विगतघनाः पलांशाः शुक्ष्णरजसः सितोपलापलाष्टकयुक्ताः क्षौद्रद्रुता योजराजः । कुलत्थादियूषाशिना यथाग्न्यभ्यवहृतः समान: पूर्वेण । यक्ष्मविषविषज्वरकासश्वासापस्मारहरश्च ।। ८ ।।

Five pala each of Silajatu, tapya, rupya and ayormala (mandura) one pala each of triphala and other drugs (enumerated in earlier recipe- navayasa loha) devoid of ghana are converted into nice powder along with honey, in appropriate doses in relation to digestive capacity, followed by soup of kulattha, as an after- drink is similar (in action) to the previous recipes and cures tuberculosis, poison, fever due to the poison, cough, dyspnoea and epilepsy. (8)

Vajra vataka

त्रिफलाकुटजफलघनपटोलपिचुमन्दमहौषधकषायैर्मासमर्धमासं वा भावितान्यष्टौ शिलाह्वयपलानि समसितान्युपकुल्यातुगाक्षीरीधात्रीफलकर्कटकशृङ्गयः पृथक् पलांशाः निदिग्धिकाफलमूलयोः पलं त्रिजातकत्रिकर्षं च क्षौद्रत्रिपलयुक्तान् वटकान् वर्तयेत् । ते दाडिमाम्बुक्षीररस – सलिलसुरासवान्यतमानुपाना वज्राभिधाना वज्रमिवानन्तरोक्तान् रोगान् दारयन्ति । हृद्रोगगलरोगगरोदरासुन्दरभगन्दरगुत्मवर्ष्मशुक्रमूत्रदोषांश्च ।।९ ॥

Eight pala of silahvaya, is soaked and macerated for one month or half-a-month in the decoctions of triphala, kutajaphala, ghana, patola, picumanda and mahausadha, in each seperately; it is then mixed with equal quantity of sita (sugar) and one pala each of tugaksiri, dhatriphala and karkatasrngi, one pala each of fruits of roots of nidigdhika, three karsa of trijataka and three pala of ksaudra (honey) and made into pills. This recipe known as Vajra vataka consumed either with the juice of dadima, milk, meat, juice, water, sura (beer) or asava (fermented infusion) destroys like a thunderbolt, the diseases mentioned earlier and also disease of the heart and throat, artificial poison, enlargement of the abdomen, menorrhogia, rectal fistula, abdominal tumor, enlargement of the scrotum and disorders of semen and urine. (9)

Draksaleha

द्राक्षापिप्पलीप्रस्थद्वयं शर्करार्धतुलां तवक्षीरीनागरमधुकानि च द्विपलिकानि चूर्णयित्वामलकरसद्रोणे प्रक्षिप्य मृद्वग्निना पचेत् । लेहीभूते शीते च तस्मिन् मधुप्रस्थमावपेत् । त्रिसुगन्धिकस्य कर्षत्रयं च चूर्णीकृत्य दर्व्या परिघट्य जातीपुष्पादिवासिते मृद्भाण्डे निदध्यात् । अयं द्राक्षालेह उपयुज्यमानः पाण्ड्वामयहृद्रोगकामलाहलीमकज्वरगुल्मोदरशोफोदावर्तादीनपरानपिविरेकसाध्यान् व्याधीन्प्रसह्यवायुरिवाभ्राण्यपहरति ।।१०।।

Two prastha of draksa and pippali (one prastha each), half tula of sugar, powder of two pala each of tavksiri, nagara and madhuka are added to one drona of juice of amalaka and cooked over mild fire into a confection. After it cools, one prastha of honey and three karsa of powdered trisugandha are added, stirred well with a laddle and preserved in a mud pot, made fragrant with flowers of jati, etc; this recipe – Draksaleha, used habitually, cures anaemia, heart disease, jaundice, chlorosis, fever, abdominal tumor, enlargement of the abdomen, dropsy, upward movement of vata, other diseases curable by purgative therapy, acting like the wind dispersing the clouds in the sky. (10)

भोजनं तु सात्म्यतः शालियवगोधूममुद्गजाङ्गलमांसानि पयो घृतं वृषपटोलवेत्रपर्पटशाकं द्राक्षादाडिमखर्जूरामलकरसानि। पानमनुपञ्चमूलसिद्धंवारिवाताधिके। घनहीबेरशुण्ठीसाधितं पित्तोत्तरे | श्रेष्मण्यरिष्टसीधुमाकासवाः । सर्वत्र वातक्रम् ॥॥११॥

The diet should consist of accustomed foods such as rice, barley, wheat, green gram, juice of meat of animals of desert-like regions, milk, ghee, leaves of vrsa, patola, vetra and parpata; juice of draksa, dadima, kharjura, amalaka, as after drinks; drinking water processed with panchamula should be used in case of predominance of vata; processed with ghana, hribera and sunthi in case of predominance of pitta; and in case of kapha, arista (fermented decoction), sidhu (fermented liquor), mardvika (liquor prepared with grapes) and asavas (fermented infusions); takra (buttermilk ) being used in all conditions. (11)

Bijakashara arista

बीजकसारप्रस्थम् । वरायाः पलानि पञ्चविंशतिः । पञ्च द्राक्षाया बलाया: सप्त जलद्रोणे पक्त्वा पादशेषं तेभ्यो रसमादाय पूतशीतेऽस्मिन् शर्करातुलां मधुप्रस्थं कर्षांशानि च चूर्णितानि व्योषव्याघ्रनखोशी रक्रमुकैलावालुककुष्ठमधुकानि निक्षिप्य घृतभाजने सर्वमैकध्यं यवपल्ले ग्रीष्मे दशरात्रं विंशतिरात्रं शीते स्थापयेत् । अयं बीजकसारारिष्टः पाण्डुकामलामेहहृद्रोगवातशोणितविषमज्दरारोचककासश्वासान्निबर्हति ।। १२ ।।

One prastha of bijakashara (asana), twentyfive pala of vara (triphala), five (pala) of draksa, seven of bala, are boiled in one drona of water, decoction reduced to one-fourth and allowed to cool; It is then added with one tula of sugar, one prastha of honey and powder of one karsa each of vyosa, vyaghranakha, usira, kramuka (pattika lodhra), elavaluka, kustha and madhuka- are added stirred well, poured into a mud pot smeared inside with ghee, (its mouth sealed) and kept inside a heap of barley for ten days during summer or for twenty days during winter (and used later). This recipe known as Bijakasharaarista-cures anaemia, jaundice, diabetes, heart disease, gout, irregular fevers, anorexia, cough and dyspnoea. (12)

Gandirarista

गण्डीरतरो: समूलपुष्पशाखस्य तुलामाहरेत् । अर्धतुलां दशमूलस्य त्रिफलायाः पृथगर्धप्रस्थ कुटजत्वचश्च। कुडवांशान् मुस्तारुष्करकृमिघ्नेन्द्रयवान् । पालिकान् पाठादन्तीमधुरसारास्त्राशठीचित्रकान् । मृद्वीकार्धप्रस्थं च षोडशगुणे पादशेषमम्भसि विपाच्य रसमाददीत | तं पूतशीतं सितोपलातुलाद्वयेन लोहचूर्णप्रस्थेनचयुक्तंमागधिकार्धप्रस्थेन शुक्ष्णपिष्टेनग्रन्थिकपलेनार्धपलिकैश्च मरिचविडङ्गैलवालुकैः प्रलिप्ते घृतकुम्भे निधापयेत् । मासमात्रं स्थितोऽयं गण्डोरारिष्टोऽधिकगुणः पूर्वस्मात् । ग्रन्थ्यर्बुदकृमिहरा ॥१३॥

One tula of roots, flowers, branches of gandira tree, half tula of dashamoola, half prastha of each of triphala and also of kutaja tvak, one kudava each of musta, aruskara, krimighna, and indrayava, one pala each of patha, danti, madhurasa rasna, sathi and chitraka and half prastha of mrdvika- all these are boiled in water, sixteen times their total quantity, decoction reduced to one-fourth and allowed to cool. After it cools, two tula of sitopala (sugar candy) and one prastha of lohacurna (iron filings) are added, filled into mud pot smeared inside with ghee and given a coating of nice paste of half prastha of magadhika, one pala of vidanga and elavaluka, the pot kept undisturbed for one month. This recipe known as Gandirarista is more effective than the earlier ones, and also cures tumors, malignant tumors, worms, (bacteria, parasites etc ). (13)

Mastvarista

अथवा चव्यकुष्ठचित्रकप्रलिप्ते भाजने मस्तुद्रोणं गुडतुलां पिप्पली प्रस्थत्रयं त्रिफलाप्रस्थत्रयं विडङ्गप्रस्थत्रयं कुडवांशांश्च मरिचपरूषकद्राक्षाकाश्मर्यफलेन्द्रयवान् द्विपलिकानि च दन्तीचित्रकभल्लातकानि चूर्णितानि प्रक्षिपेत् । ततो यवपल्लस्थं पक्षमुपेक्ष्य यथाबलं पिबेत् । एष मस्त्वरिष्टः पाण्डुरोगमेहस्थौल्यमेदोर्शोग्रहणीप्लीहशोफोदरभगन्दरहरः । परमंचाग्निदीपनइति ॥ १४ ॥

A pot coated inside with (the paste of) chavya, kustha, and citrak is filled with one drona of mastu (whey), one tula of guda (jaggery), three prastha of pippali, three prastha of triphala, three prastha of vidanga, one kudava each of maricha, parusaka, draksa, kasmaryaphala and indrayava, two pala each of danti, chitraka and bhallataka- all well powdered are added to the liquid. The pot is then (sealed) and kept hidden in a heap of barley for a fortnight and used later, in accordance with the strength (of the body). This recipe Mastvarista cures anaemia, diabetes, obesity, enlargement of the abdomen, piles, disease of the duodenum and spleen, dropsy and rectal fistula, and is an efficient promotor of digestive activity. ( 14 )

Some verses here

भवति चात्र

पाण्डुरोगप्रशान्त्यर्थं विहितंयच्चिकित्सितम् । विकल्प्यमेतद्विदुषापृथग्दोषबलंप्रति ।।१५ ।।

The wise physician should plan out the methods of treatment (so far described) for panduroga, appropriate to the strength of the individual dosha (causing the diseases ) . ( 15 )

स्नेहप्रायंपवनजे तिक्तशीतं तुपैत्तिके । शैष्मिके कटुरूक्षोष्णं विमिश्रंसान्निपातिके ॥ १६ ॥

In that type caused by vata, the treatment should be with more use of drugs possessing sneha (unctousness); in that type caused by pitta with more of drugs of bitter taste, of cold potency; in the type caused by kapha with more of pungent, dry and hot potency; and in the type caused by all the three doshas by the combination of the therapies and drugs. (16)

मृदं निर्घातयेत् कायात्तीक्ष्णैः संशोधनैः पुरः । बलाधानानि सर्पीषिशुद्धे कोष्टेतु योजयेत् ।।१७।।

(In that variety of pandu caused by the habit of eating mud) the mud should first be removed out by administering strong purificatory therapy (purgations, emesis, enema etc) and after the alimentary tract becomes clear, medicated ghee which give strength should be administered. (17)

व्योषबिल्वद्विरजनीत्रिफलाद्विपुनर्नवम् । मुस्तान्ययोरजः पाठाविडङ्गंदेवदारु च ।। १८ ।।

वृश्चिकाली च भार्ङ्ग च सक्षीरैस्तैः शृतंघृतम् । सर्वान् प्रशमयत्याशु विकारान् मृत्तिकाकृतान् ।।

तद्वत्केसरयष्ट्याह्वपिप्पलीक्षीरशाद्वलैः ।।१९।।

Medicated ghee prepared with vyosa, bilva, the two rajani, triphala, the two punarnava, musta, ayoraja ( iron filings), patha, vidanga, devadaru, vrscikali, bharangi kshira (milk) and ghrta ( ghee) quickly relieves all the abnormalities caused by the mud. Similarly also, the ghee prepared with kesara, yasti, pippali, kshira (milk ) and sadvala. (18-19)

मृद्वेषणाय तल्लयैल्ये वितरेद्भावितांमृदम् । विडङ्गेनातिविषया पाठया निम्बपल्लवैः ।।२०।।

If the patient is very fond of eating mud, in order to create aversion to it, he should be given such mud which is processed with (mixed with) drugs such as vidanga, ativisa, patha, tender leaves of nimba, vartaka, katurohini, kautaja (kutaja bija) or murva. The drugs should be suitable to the dosha which has undergone increase by different kinds of mud. (20)

Kamala chikitsa – treatment of jaundice

वार्ताकैः कटुरोहिण्या कौटजैर्मूर्वयाथवा | मृद्धेदभिन्नदोषानुगमाद्योज्यं च भेषजम् । ॥ २१ ॥

कामलायां तु पित्तघ्नं पाण्डुरोगाविरोधियत् । पथ्याशतरसे पथ्यावृन्तार्धशतकल्कितः ।।

प्रस्थ: सिद्धोघृताद्गुल्मकामलापाण्डुरोगजित् ।।२२।।

For kamala (jaundice), the treatment should be that which subdues pitta and not contrary to panduroga.

Medicated ghee prepared with juice (decoction) of one hundred (by count) of pathya (haritakii), paste of half of hundred tender leaves of pathya, and one prastha of ghrta ( ghee), cures abdominal tumors, jaundice and anaemia. (21-22 )

दन्तीचतुष्पलरसे पिष्टैर्दन्तीशलाटुभिः । घृतप्रस्थः शृतस्तद्वत्प्लीहाश्वयथुजिच्चसः ॥ २३ ॥

One prastha of purana sarpi (old ghee) and half prastha of draksa made into medicated ghee cures jaundice, abdominal tumor, fever and enlargement of the abdomen. (23)

पुराणसर्पिषः प्रस्थोद्राक्ष र्धप्रस्थसाधितः । कामलागुल्मपाण्ड्वर्तिज्वरमेहोदरापहः ॥ २४ ॥

Likewise, that prepared with four pala of decoction of danti and paste of unripe fruit of danti, and one prastha of ghrta ( ghee) cures disease of the spleen and dropsy. ( 24 )

हरिद्रात्रिफलानिम्बबलामधुकसाधितम् ।। सक्षीरंमाहिषं सर्पिः कामलाहरमुत्तमम् ।। १५ ।।

गोमूत्रे द्विगुणे दार्वीकल्कार्धपलसाधितः । दार्वीपञ्चपलक्काथे कल्के कालीयके परः ॥ २६ ॥

माहिषात्सर्पिष: प्रस्थ: पूर्व: पूर्वे परः परे । सिद्धं कालीयकक्वाथे सनिशं चोत्तरे हितम् ॥ २७ ॥

आरग्वधं र सेनेक्षोर्विदार्यामलकस्य वा | सत्र्यूषणं बिल्वमात्रं पाययेत् कामलापहम् ॥ २८ ॥

Medicated ghee prepared with one prastha of buffalos ghee, along with twice its quantity of cows urine and half pala of paste of darvi; or with one prastha of buffalos ghee along with decoction of five pala of darvi and paste of kaliyaka; the former (ghee) is best for the earlier diseases (panduroga), and the later ( ghee) for the latter (disease-kamala). That medicatd ghee prepared from decoction of kaliyaka and paste of nisa is also beneficial to the latter (kamala). (25-28)

पिबेन्निकुम्भकल्कं वा द्विगुडं शीतवारिणा | कुम्भस्य चूर्ण सक्षौद्रं त्रैफलेन रसेन वा ।।

सशर्करां त्रिभाण्डीं वागवाक्षीं वा प्रयोजयेत् ।।२९ ॥

Aragvadha, one bilva (pala) in quantity should be given to drink along with juice of either iksu, vidari or amalaka and mixed with tryusana for the cure of kamala (jaundice); or drink the paste of nikumbha, with twice its quantity of guda (jaggery) mixed with cold water; or powder of kumbha along with honey and decoction of triphala, or powder of tribhandi or gavaksi mixed with sugar can also be used. (29)

त्रिफलायागुडूच्या वादार्व्या निम्बस्य वा रसम् । प्रातः प्रातर्मधुयुतं कामलार्ताय योजयेत् ॥ ३० ॥

For the patient suffering from kamala (jaundice), the juice (or decoction) of triphala, guduchi, darvi or nimba should be administered in the morning daily mixed with honey. (30)

तिलपिष्टनिभं यस्तु कामलावान्सृजेन्मलम् । कफरुद्धपथं तस्य पित्तं कफहरैर्जयेत् ॥ ३१ ॥

The patient of kamala, who voids faeces resembling the paste of tila (sesamum), due to the obstruction of the passages (of pitta) by kapha; hence his (increased) pitta should be subdued by administering treatment which subdues kapha. (31)

रूक्षशीतगुरुस्वादुव्यायामचलनिग्रहै: कफसम्मूर्छितो वायुर्यदापित्तंबहिः क्षिपेत् ॥ ३२ ॥

हारिद्रनेत्रमूत्रत्वक्श्वेतवर्चास्तदानरः । भवेत्साटोपविष्टम्भो गुरुणाहृदयेन च ||३३ ॥

दौर्बल्याल्पाग्निपार्श्वार्तिहिध्माश्वासारुचिज्वरैः । क्रमेणाल्पेऽनुषज्येत पित्तेशाखा ॥३४॥

By indulgence in foods which are dry, cold, heavy, of sweet taste, physical exercise and control of chala (vata), in other words, suppression of natural urges of the body, and other activities, when vata gets aggravated (increased) associated with kapha and expels the pitta to the exrerior (the dhatus [ tissues ]) man develops ( abnormal) colouration resembling haridra (termuric), (deep yellow), in his eyes, urine and skin, eliminates white coloured faeces, gurgling noise in the abdomen, stasis of food inside the alimentary tract for a long time, (feeling of) heaviness of the heart, debility, poor digestive activity, pain in the flanks, hiccup, dyspnoea, anorexia, fever, gradually develops when the pitta becomes decreased (in the alimentary tract), and gets lodged in the sakhas (dhatus or tissues) (32-34)

रसैस्तं रूक्षकट्वम्लैः शिखितित्तिरिदक्षजैः । शुष्कमूलकजैर्यूषैः कुलत्थोत्यैश्च भोजयेत् ॥ ३५ ॥

भृशाम्लतीक्ष्णकटुकलवणोष्णं चशस्यते । सबीजपूरकरसंलिह्याद्व्योषं तथाशयम् ||३६ ।।

स्वं पित्तमेति तेनास्य शकृदप्यनुरज्यते । वायुश्चयाति प्रशमं सहाटोपाद्युपद्रवैः ।। निवृत्तोपद्रवस्यास्य कार्यः कामलिको विधिः ॥३७॥

He should be treated with juice of meat of Sikhi (peacock ), tittiri, ( partridge) and daksa (cock), and which is dry (without addition of fats) pungent and sour. He should take food with soups of dried mulaka and kulattha, these being made very sour, penetrating, pungent, salty and hot (heat producing).

Vyosa should be licked along with the juice of bijapura; by this, the pitta (lodged in the tissues), returns to its own seats (in the alimentary tract), then his faeces also regains its (normal) colour, vata gets mitigated, along with intestinal gurgling and other troubles. After the patient thus gets relieved of such distresses, other treatment stipulated for kamala should be administered. (35-37)

गोमूत्रेणपिबेत्कुम्भकामलायांशिलाजतु | मासंमाक्षिकधातुंवाकिट्टंवाथ हिरण्यजम् ॥ ३८ ॥ For kumbha kamala (advanced stage of jaundice with abdomen enlarged like a pot), the patient should be made to drink silajatu mixed with cows urine for one month; or maksika dhatu (iron pyrates) or hiranya kitta (waste gold) mixed with cows urine can also be used for drink. (38)

गुडूचीस्वरसक्षीरसाधितेन हलीमकी । महिषीहविषा स्निग्धः पिबेद्धात्रीरसेनतु ॥ ३९ ॥

त्रिवृतांतद्विरिक्तोऽद्यात् स्वादुपित्तानिलापहम् । द्राक्षालेहंचपूर्वोक्तं सर्पीषिमधुराणिच ॥४०॥

यापनान् क्षीरबस्तींश्चशीलयेत्सानुवासनान् । मार्द्वीकारिष्टयोगांश्चपिबेद्युक्त्याग्निवृद्धये ॥४१ ॥

कासिकंचाभयालेहं पिप्पली मधुकं बलाम् । पयसा च प्रयुञ्जीत यथादोषं यथाबलम् ।।

पाण्डुरोगेषु कुशलः शोफोक्तं चक्रियाक्रमम् ।।४२ ||

The patient of halimaka should drink medicated ghee prepared with fresh juice of guduchi, buffalos and cows milk or ghee; after undergoing oleation therapy with this ghee, he should drink the juice of dhatri mixed with trivrit in order to get purgations; eat foods which are sweet and which mitigate pitta and vata; then consume draksaleha described earlier and other medicated ghee which are sweet and which subdue pitta and vata. He should also be administered yapana and kshira basti (enemas containing ruilk which can be continued for many days without inturruptions) and anuvasana (oil enema); the patient should drink judiciously arista (fermented decoctions) prepared from mardvika for the increase of his digestive activity, make use of abhayaleha described in the treatment of kasa (cough) (chapter 5 of chikitsasthana); pippali, madhuka, bala along with milk should be administered in accordance with the dosha and the strength. The wise physician should also adopt the treatment prescribed for sopha (dropsy) in treating panduroga (anaemia). (39-42)

।। इति अष्टादशोऽध्यायः ॥ Thus ends the Eighteenth chapter.

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