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Ashtanga samgrahaPRAMEHA CHIKITSA - Treatment of Diabetes in Ayurveda - Ashtanga Samgraha Chikitsasthana...

PRAMEHA CHIKITSA – Treatment of Diabetes in Ayurveda – Ashtanga Samgraha Chikitsasthana Chapter 14

अथातः प्रमेहचिकित्सितं व्याख्यास्यामः । इतिह स्माहुरात्रेयादयोमहर्षयः ॥ १ ॥

We will now expound, Prameha chikitsa- treatment of diabetes; thus said Atreya and other great sages. (1)

Ayurvedic Treatment of Diabetes

प्रायेण हि प्रमेहिणोऽभिष्यण्णदेहत्वादुपहताग्नेर्भक्ष्यादिपञ्चविधमप्यन्नमुपयुक्तं मूत्राय मेदसे च विपरिणमते।तस्मादस्यतेजोधातुवृद्धये क्लेदमेदः प्रशमनाय च बलिनः संशोधनानिप्रयुञ्जीत । दुर्बलस्य तुसंशमनानि । सर्वस्यच बद्धमूत्राण्यमेदस्कराण्यबृंहणान्यग्निदीपनानिबलजननानि चान्नपानानि । बलं हिविधिनोपचितमशेषामयक्षयाय सम्प्रवर्तते ॥ २ ॥

Generally, patients of prameha (diabetes) have excess accumilation of water in their body and consequent diminition of digestive activity, though (they) partake the five kinds of foods such as bhaksya (solid foods) etc, all of them will be converted into urine and fat only. Hence, in order to enhance the tejodhatu (fire-like element) and to diminish moisture and fat in their body, the strong (among them) should be treated with sodhana (purificatory) therapies, and those who are weak with samana (palliative) therapies.

In all, foods and drinks should be such, which diminish the urine and fat, not cause stoutness of the body and which increase hunger and strength. Strength of the body itself, increased in a proper way, is sufficient for the complete cure of the disease. ( 2 )

अथ संशोधनार्हं प्रमेहिणमादावेव बिभीतकसर्षपेङ्गदीकरञ्जनिम्बनिकुम्भान्यतमतैलेन त्रिकण्टकादिना वा यथास्वं सिद्धेन स्नेहेन प्रियङ्वादिश्रुतेन वा हविषा स्नेहयित्वा कल्पविहितैः प्रयोगैर्वामयेद्विरेचयेच्च ॥ ३ ॥

ततो जातबलं मुस्तामरदारुनागरप्रतिवापेन सुरसादिकषायेणास्थापयेत् । पित्तोत्तरं तु न्यग्रोधादिकषायेण । ततश्च जाङ्गलरसैः क्रमेण सन्तर्पयेत् । अत्यपतर्पणेन हि प्रमेहिणो विशेषेण मूत्रकृच्छ्रबस्तिमेद्रशूलगुल्मातिकार्य भ्रमादीनां सम्भवः । ततोऽनुबन्धरक्षणार्थं शमनार्हस्य च शमनान्यवचारयेत् ॥ ४ ॥

The patient of diabetes who is fit to undergo purificatory therapies should first be given snehana (oleation therapy) with the oil prepared from either vibhitaka sarsapa, ingudi, karanja, nimba, nikumba or trikantaka, appropriate to the dosha; or with ghee prepared from the decoction of drugs of priyangvadi gana (chapter 16 of sutrasthana) next, vamana (emesis) and virecana (purgation) therapies should also be done with suitable recipes described in kalpasthana.

After he regains his strength, he should be administered asthapana (decoction enema) with the decoction of drugs of surasadigana (chapter 16 of the sutrasthana) added with the paste of musta, amaradaru and nagara, in case of predominance of pitta, decoction of drugs of nyagrodadhi gana (chapter 16 of sutrasthana) should be used.

Because of too much of reducing therapies (such as fasting, avoidance of sweet and nourishing foods etc) patients of diabetes especially become victims of mutrakrchra (dysuria), pain in the bladder and penis, abdominal tumor, severe emaciation, giddiness etc.

Next, to prevent the disease continuing for long periods, and for those who are fit for Samana (palliative) therapy only, samana therapy should be administered. (3-4)

प्रातः सर्वप्रमेहेषु हरिद्रांमधुना युक्तामामलकरसेन पिबेत् । अथवा सालसप्तपर्णकुटजकपित्थकम्पिल्लकबिभीतकऱोहतककुसुमानि तच्चूर्णं वा क्षौद्रेण लिह्यात् । हरीतकीचूर्णं वा । पिबेद्वा त्रिफलामुस्तादेवदारुहरिद्राक्वाथम्। असनचित्रकत्रिफलादार्वीकलिङ्गकानांवासक्षौद्रम् | तद्वद् गुडूच्या वास्वरसमामलकानांवा ॥ ५ ॥

In all varieties of diabetes, patients should drink the juice of amalaka mixed with (powder of) haridra and honey in the morning.

Or lick the paste or powder of flowers of Sala, saptaparna, kutaja, kapittha, karnpillaka, vibhitaka or rohitaka with honey; Or powder of haritaki (similarly); or drink the decoction of triphala, musta, devadaru and haridra (with honey); or the decoction of asana, chitraka, triphala, darvi and kalingaka mixed with honey; similarly the fresh juice of guduchi or of amalaka can be used. (5)

Kaphaja prameha chikitsa

विशेषतस्तु कफमेहेषु कट्फलमुस्तालोध्राभयानां समाक्षिकं कषायम् । तगरविडङ्गद्विहरिद्राणां वा।चन्दनागरुकुष्ठदेवदारूणांवा। पाठाग्निमन्थचविकात्रिफलानांवा। पित्तप्रमेहेषु तु लोध्रसेव्यार्जुनचन्दनानाम् । निम्बामृतामलकपटोलीनां वा । शिरीषसर्जार्जुनकेसराणां वा । फलिनीकमलोत्पलकिंशुकानांवा । कुटजोत्पलकटङ्कटेरीणांवा ॥६॥

In Kapha meha (diabetes caused by kapha predominantly) especially the following should be used.

Decoction of katphala, musta, lodhra, abhaya mixed with honey; or ( decoction ) or tagara, vidanga and the two haridra; or of chandana aguru, kustha and devadaru; or of patha, agnimantha, cavika and triphala.

Pittaja prameha chikitsa

In pitta meha (diabetes caused by predominance of pitta) the decoction of lodhra, sevya, arjuna and chandana; or of nimba, amrita amalaka and patoli; or of Sirisa, sarja, arjuna and (naga) kesara; or of phalini, kamala, utpala and kimsuka; or of kutaja, utpala and katarnkateri. (6)

तेष्वपि च विशेषेण पिबेदुदकमेहादिषु क्रमात् कषायं पारिजातस्य वैजयन्त्याः सप्तच्छदस्यारिष्टस्य निशायाः ककुभचन्दनयोश्चित्रकस्य पाठाजोङ्गकयोः खदिरस्य त्रिफलारग्वधयोश्चमधुयुतम् । पिबेच्च सिकतामेहे हिङ्गुप्रवालकैलालवणानि मद्येन मूत्रेण क्षारोदकेन वा । क्षारमेहादिषु त्रिफलाया असनादेः न्यग्रोधादेः शम्याकस्य चन्दनमञ्जिष्ठयोः गुडूचीतिन्दुकास्थिकाश्मर्यखर्जूराणांचमधुयुक्तम् । शोणितमेहे मदयन्तीपत्रकल्कं च सक्षौद्रं शीताम्बुना ॥ ७ ॥

Drinking the decoction mixed with honey of the following drugs is especially advocated, in each of the (kaphaja) prameha (diabetes) commencing with udakameha respectively.

Or parijata (in udaka meha); of vaijayanti, ( in iksumeha); of saptachada (in sandrameha), of arista (in surameha), of nisa (in pista meha), of kakubha and chandana (in suklameha), of chitraka (in sikata meha) of patha and jongaka (in sita meha); of khadira (in sanair meha) of triphala and aragvadha (ii. lala meha). In sikata meha, (powder of) hingu pravalaka, ela and lavanas along with wine, cows urine or a solution of kshara (such as yavakshara etc ).

In kshara meha and others (pittaja prameha) respectively-drinking the decoction mixed with honey of the following drugs is especially advocated; of triphala (in kshara meha); of asanadi gana (in kala meha); of nyagrodhadi gana (in nilameha); of Samyaka (in haridra meha); of chandana and manjista (in manjista meha); of guduchi, tinduka asthi (seeds of tinduka), kasmarya and kharjura (in rakta meha); in sonita meha the paste of leaves of madayanti mixed with honey can be consumed with cold water. (7)

Vataja prameha chikitsa

वातजेष्वपियापनार्थं कफपित्तोल्बणेषु पिबेत् कषायम् । तत्र वसामेहेऽग्निमन्थस्य | मज्जमेहेऽमृताचित्रकयोः । कुष्ठकुटजपाठाकटुरोहिणीकल्कमिश्रम् हस्तिमेहे हस्तिसूकरखरोष्ट्रास्थिक्षारम् । मधुमेहेकदरखदिरपुरकषायम् ॥ ८ ॥

Even in pramehas (diabetes) caused by vata also having the aggravation of kapha and pitta, in order to maintain the patient for a long time, drinking the decoction of the following drugs is beneficial; decoction of agnimantha in vasameha; of amrita and chitraka in majja meha; paste of kustha, kutaja, patha and katukarohini mixed with ash of bones of elephant, boar, ass and or camel in hastimeha; decoction of kadara, khadira and pura in madhumeha. (8)

कफानुगतेषु तु वसादिमेहेषु यथास्वकषायेण साधितानि तैलानि । पित्तानुगतेषु च घृतानि यमकंवाप्रयुञ्जीत ॥ ९ ॥

If kapha is the secondary dosha, in vasameha and other (vataja prameha), medicated oil prepared from the decoction of the respective drugs should be used; in case of pitta being the secondary dosha, use of medicated ghee or yamaka (mixture of oil and ghee) prepared from the decoction of respective drugs should be used. (9)

एतेन शेषेष्वपि मेहेषुस्नेहविकल्प उक्तोवेदितव्यः ॥ १० ॥

By this, the use of different kinds of medicated fats in the remaining kinds of prameha is to be inferred. (10)

तथा कषायसम्पृक्तैः स्त्रेहैः कफपित्तमूत्रमेदसामनिलस्य चोपशमो भवति ।।११ ॥ By the use of medicated fats mixed with decoctions, kapha, pitta, mutra (urine), meda (fat) and also anila (vata) will be mitigated. (11)

त्रिकण्टकातिविषा भल्लातकलोध्रवचापिचुमन्दघननिशाजमोदार्जुनाश्मन्तकपटोलसोमवल्कमञ्जिष्ठपद्मकचन्दनागरुभिश्चस्त्रेहो- विपक्वः सर्वमेहघ्नः ॥ १२ ॥

Medicated fats (oil or ghee) prepared from (the decoction of ) trikantaka, ativisa, bhallataka, lodhra, vacha, picumanda, ghana, nisa, ajamoda, arjuna, asmantaka, patola, somavalka, manjistha, padmaka, chandana and aguru-cures all varieties of meha (diabetes) (12)

Dhanvantara ghrita

दशमूलहरीतकीदेवदारुकरञ्जद्वयद्विवर्षाभूदन्तीभूकदम्बभल्लातकशठीपुष्करमूलार्कमूलस्नुहीमूलवरणभूलपिप्पलीमूलानि प्रत्येकशो दशपलोन्मितानि यवकोलकुलत्थप्रस्थत्रयं चाष्टगुणेऽम्भसि साधयित्वा पादशेषं कषायमवतारयेत् । तेन वचाविडङ्गकम्पिल्लकभल्लातकभारोहिषचविकापिप्पलीद्वयत्रिवृन्निचुलविश्वभेषजप्रतीवापं घृतप्रस्थं विपचेत् । एतद्धान्वन्तरं सर्पिः सर्वमेहपिटकाकुष्ठविषशोफार्शोगुल्मविद्रधिप्लीहजठरश्वासकासवर्ध्मपाण्डुरोगवातशोणितोन्मादापस्मारहरम् ।।१३।।

Ten pala each of dashamoola, haritaki, devadaru, the two karanja, the two varsabhu, danti, bhukadamba, bhallataka, sathi, puskaramula, arkamula, snuhimula, varanamula and pippalimula; three prastha of yava, kola and kulattha (one prastha each), are boiled in eight times their quantity of water and decoction reduced to one-fourth the quantity. To this are added one prastha of ghee and the paste powder of vacha, vidanga, kampillaka, bhallataka, bharangi, rohisa, cavika, the two pippala, trivrit, nicula and visvabhesaja and medicated ghee prepared. This recipe known as Dhanvantara sarpi (ghrta) cures all varieties of diabetes, carbuncles, leprosy, poisons, dropsy, harmorrhoids, abdominal, tumors, abscess, splenic disease, enlargement of the abdomen, dyspnoea, cough enlargement of the scrotum, anemia, gout, insanity and epilepsy. (13)

आहारंच यवविकृतिप्रायं मध्वामलकोपेतमाहारयेत् । यथायथं प्रमेहघ्नौषधनियूहै: सुबहुशो यवान् भावयित्वा सक्तुमन्थापूपधानालाजवाट्यादीन् विविधांश्च लघून् भक्ष्यानुपकल्पयेत् । तद्वच्च गोधूमान् । गवाश्वखरजठरस्थितैश्च यवैर्वंशयवैर्वा । यवो हि हि बद्धमूत्रो मेदः पित्तकफहर: स्थैर्यकरश्च । तथा शालिषष्टिकतृणधान्यानि मुद्गादयस्तिक्तानि शाकानि जाङ्गलानि च पिशितानि शूल्यानि परिशुष्काणि प्रदिग्धानि भृष्टचणकोपदंशानि विविधासवानुपानान्युपयुञ्जीत ।।१४।।

Regarding food, patients should partake foods consisting chiefly of preparations of yava (barley) along with honey and amalaka. Yava ( barley) should be soaked in the decoction of the anti-diabetic drugs, for many times, and from such barley different types of saktu, mantha, apupa, dhana, laja, vatya and such other easily digestable dishes prepared. Similarly from godhuma (wheat) may also be made used of or from yava (barley) or vamsayava (seeds of bamboo tree) which have remained (for some time) in the stomach of either a cow, horse or donkey. Yava ( barley ) possesses properties of reducing the urine, mitigating fat, pitta and kapha and bestowing stability (strength).

Similarly, also the use of sali (rice), Sastika rice, trna dhanya ( grains from grass type plants), mudga and others (pulses) bitter vegetables, meat of animals of desert-like regions which is roasted, dried or fried; condiments prepared from fried canaka should be adopted; different kinds of asavas (fermented infusions ) can be used as afterdrinks. (14)

Lodhrasava

लोध्रमूर्वाशठीविडङ्गत्रिफलापुष्करमूलचातुर्जातकक्रमुकचविकायवानीश्यामाभाङ्गद्विविशालाभूनिम्बतगरचित्रकपिप्पलीमूलकटुरोहिणीकुष्ठपाठेन्द्रयवातिविषाप्लवनखमरिचानि कर्षांशान्यपां कलशेऽधिशृत्य तुर्यशेषे रसे पूते जतुशृतपुराणघृतभाजनस्थेऽर्धभागेन मधु निधाय पक्षमुपेक्षितोऽयं लोध्रासवः सर्वप्रमेहकुष्ठकिलासस्थौल्यारोचककृमिपाण्डुशोफार्शोग्रहणीदोषान्निहन्ति ।। १५ ।।

One karsa each of lodhra murva, sathi, vidanga, triphala, puskaramula, caturjataka, kramuka (pattika lodhra), cavika, yavani, syama, bharigi, the two visala, bhunimba, tagara, chitraka, pippalimula katurohini, kustha, patha, indrayava, ativisa, plava, nakha and maricha are boiled in one kalasa of water, decoction reduced to a quarter and filtered. It is then poured into a earthen pot which has been smeared inside with ghee and added with honey half the quantity (of the decoction) (pot sealed) and kept undisturbed for a fortnight. This recipe known as Lodhrasava cures all varities of diabetes, leprosy, leucoderina, obesity, anorexia, worms, anaemia, dropsy, haemorrhoids, duodenal disease. (15)

Dashamoolarista

दशमूलदन्तीत्रिवृच्छ्यामाश्रेयसीचित्रकपुनर्नवसुधाधवैकैषिकागण्डीरगुडूचीनांपृथक् पञ्चविंशतिपलान् भागांस्त्रिफलाढकं च सलिलद्रोणैर्दशभिः पादशेषं निर्यूहमवतारयेत् । तस्मिन् पूतशीते गोमूत्राढकमयोरजोर्धाढकं मागधिकाप्रस्थं कुटजार्जुनकुष्ठकृमिघ्नवचाचित्रकपलानि च द्वादश प्रतीवापं दत्वा मासं स्थापयेत् । एष दशमूलारिष्टः समानः पूर्वेण ।। १६ ।। शुचिभाजनस्थेपुराणगुडतुलाद्वयं

Twenty five pala each of dasmula, danti. trivrit, syama, sreyasi, chitraka, punarnava, sudha, dhavaka, ekaisika, gandira and guduchi; one adhaka of triphala are boiled in ten drona of water, decoction reduced to a quarter, filtered and poured into a clean vessel. Two tula of old jaggery, one adhaka of cows urine, half adhaka of iron filings, one prastha of magadhika and the twelve pala of powder of kutaja, arjuna, kustha, krimighna, vacha and chitraka, are all added to the decoction, (pot sealed) and kept undisturbed for one month. This recipe Dashamoolarista is similar (in properties) to the earlier one. (16)

Loharista

असनादिद्रव्याणि पृथग्विंशतिपलान्यम्भसांघटाष्टकेन क्वाथयेत् । चतुर्थस्थितं च परिस्स्रुतं सुशीतं गुडपलशतद्वयेन मध्वर्धाढकेन शुक्ष्णपिष्टेन च पृथक् पलांशेन वत्सकादिना संयोज्य सक्षौद्रेण पिप्पलीचूर्णेनान्तः प्रलिप्ते जतुसृते घृतकुम्भे आवाप्य यवपल्लेनिधापयेत् । तत्र चतनूनि खदिराङ्गारप्रतप्तानि तीक्ष्णलोहपत्राणि बहुशो निमज्जयेदालोहविलयनात् त्रींश्चतुरो वा मासानयं विधृतो लोहारिष्टः पूर्वस्मादधिकगुणः ।।१७।।

Twenty pala each of the drugs of asanadi gana (chapter 16 of sutrasthana) are boiled in eight ghata (drona) of water, decoction reduced to one-fourth, filtered and cooled. To this, are added, two hundred pala of jaggery, half adhaka of honey and the nice paste of one pala each of drugs of vatsakadigana (chapter 16 of sutrasthana ). A non-porous earthen pot, smeared inside with ghee, dried and again smeared with a paste of pippali powder and honey is filled with this decoction and kept inside a heap of barley, thin sheets of tiksna loha (magnetic iron) heated with burning coal of khadira wood should be immersed many times it till the iron dissolves in the liquid; (then the pot is sealed) and kept undisturbed for three or four months. This recipe- Loharista is more efficacious than the earlier ones. (17)

शीधुमधुमाधवानपि च निगदान् पिबेत् । निवृत्तमद्यस्तु सारोदकं दर्भाम्भो मधुकपित्थतिन्दुकमरिचानुविद्धानि पानकानि रागषाडवांश्च सार्षपिकान्यनुपानानि च तद्विधानि | उष्ट्राश्वतरखरपुरीषचूर्णानुविद्धं चास्मै दद्यादशनम् ।।१८।।

The patients may also drink sidhu, madhu ( wine) madhava ( different kind of liquors) which are unspoilt. Persons who do not consume liquors, can make use of sarodaka (water boiled with pith of khadira and other trees), darbhambu (water boiled with darbha grass)., panaka (syrups), raga and sadava (sweet beverages) containing honey, kapittha, tinduka, maricha or those containing sarsapa; such persons should be given foods prepared from flour of grains recovered from the dung of camel, mare or donkey. (18)

मुस्तामृतागण्डीरद्विहरिद्राद्विसारिवाद्विदर्भवर्षाभूत्रिकण्टकव्योषफल्गुरोहिषपल्लवश्यामासुरदारुकालाविडङ्गपाठाकम्पिल्लकभार्ङ्गनिदिग्धिकादन्तीचित्रककटुकैरण्डमूलानि समांशान्यैकध्यं चूर्णयित्वा तच्चूर्णादयश्चूर्णं द्विगुणं शुक्ष्णमावाप्य मद्यानुपानं मधुनावलिह्यात् पिबेद्वा सुखोदकेन त्रिफलाम्भसा वा। तेन मेहप्लीहहलीमकपाण्डुरोगश्वयथुदुर्नामगुल्मोदराणि शीघ्रमुपशाम्यन्ति । द्विविधोपक्रमणीयोक्तांश्चातिस्थौल्यादिगदयोगांश्च शीलयेत् । प्रवृद्धमेदाः प्रगाढव्यायामोद्वर्तनस्त्रानविलेपनानि चरूक्षाभिरौषधीभिः ॥ १९ ॥ –

Equal quantity of each of musta, gandira, the two haridra, two sariva, the two darbha, varsabhu, trikantaka, vyosa, phalgu, sprouts of rohisa, syama (pippali) suradaru, kala (nilini), vidanga, patha, karmpillaka, bharangi, nidigdhika, danti, chitraka, katuka (maricha) and roots of eranda, are powdered nicely and mixed with double its quantity of nice powder of iron. This powder licked with honey followed by wine as after-drink, or consumed with warm water, or decoction of triphala, quickly alliviates diabetes, disease of the spleen, halimaka (severe formjaundice), anaemia, dropsy, piles, abdominal tumors and enlargement of the abdomen.

The remedial methods which are prescribed for the treatment of the very obese persons in Dvividhopakramaniya (chapter 24 of sutrasthana) should be followed here also.

Those having profound increase of fat should resort to strenous exercises, massage, bath and unguents with drugs which are dry (or create dryness). (19)

अधनस्तु छत्रपादत्रविरहितो मुनिवृत्तिर्योजनशतमधिकं वा गच्छेत् । श्यामाकनीवारामतिन्दुककपित्थाश्मज्ञकफलमूलाहारो वा मृगैः सह वसेत् । गोभिर्वा सह तन्मूत्रशकृवृत्तिः परिभ्रमेत् । तडागानि वाखनेत्। कृशंत्वविरुद्धैबृंहयेत् ॥ २० ॥

Those (patients of diabetes) who are poor, should undertake a journey on foot of more than a hundred yojana (one yojana=four miles) without using umbrella or foot wear, adopting the mode of life of an ascetic, eat only syamaka, nivara, unripe fruits of tinduka, kapittha, and asmantaka or only tubers; or should dwell along with animals, wander along with cows partaking their urine and dung; or dig a pond.

Those who are emaciated, should be made stout by measures which are not contrary (to diabetes). (20)

Prameha pidaka chikitsa- treatment of diabetic ulcers

शराविकाद्यास्तु अपक्वाः शोफवदुपाचरेत् । पक्वाश्च व्रणवत् । पूर्वरूपेष्वेव तु तासां पाने वनस्पतिकषायं बस्तमूत्रं चोपदिशन्ति । तीक्ष्णं च संशोधनं । दुर्विरेच्या हि मेहिनो भवन्ति मेदोभिव्याप्तदेहत्वात्। तैलं च व्रणरोपणार्थमेलादौ कुर्वीत। आरग्वधादेः कषायमुद्वर्तने । असनादेः परिषेचने। वत्सकादेः पानभोजनेषु ॥ २१ ॥

Saravika and others pidakas (carbuncles) which are unripe should be treated just like a swelling, and those which are ripe just like a wound. Some authorities prescribe the use of decoction of vanaspatis (tress which bear fruit without flowers) with goats urine and strong purifactory therapies in their prodromal stage itself. It is very difficult to make patients of diabetes to purge because of accumulation of fat in their body entirely.

Oil for healing of wounds (of diabetes) should be prepared from drugs of eladigana (chapter 16 of sutrasthana); the (thick) decoction of drugs of aragvadhadi gana (chapter 16 of sutrasthana) should be used for massaging; decoction of drugs of asanadigana (chapter 16 of sutrasthana) for bathing, and that of vatsakadigana for drinking and cooking food. (21)

पाठाचित्रकशाङ्गेष्टाक्षुद्रबृहतीसारिवासोमवल्कसप्तपर्णारग्वधकुटजमूलचूर्णंमधुनालिह्यान्नवायसं वा । असनादिवर्गस्य कषायं पादशेषं परिगृह्य परिस्राव्य च पुनः प्रियङ्ग्वामलकलोध्रदन्तीकृष्णायस्ताम्रचूर्णावापं दर्वीप्रलेपिनमवतारयेत् तं यथाबलममवलिह्यात् । यथास्वं च प्रमेहघ्नौषधनिर्यूहैर्भावितशिलाजतुतुलोपयुक्ता सर्वमेहान्सपिटकानपकर्षतीति ॥ २२ ॥

Powder of patha, chitraka, sarngesta, ksudrabrihati sariva, somavalka, saptaparna, aragvadha, kutajamula- should be licked with honey or navayasa yoga (vide Panduroga chikitsa- chapter 18 of chikitsasthana).

Drugs of asnadigana ( 16 of sutrasthana) are boiled in water, decoction reduced to a quarter and filtered; to this is added the powder of priyangu, amalaka, lodhra, danti and krsna ayas (iron), cooked into a confection and removed from the oven when the material begins to adhere to the laddel. This confection is consumed according to ones strength. Similarly the use of one tula of silajatu, soaked and macerated in the decoction of anti-diabete drugs is going to cure all varieties of diabetes and also corbuncle. (22)

Some verses more:

भवति चात्र

मागधीमधुकं लोध्रं कुष्ठमेलाहरेणवः । समङ्गाधातकीपुष्पं सारिवारजनीद्वयम् ॥ २३ ॥

प्रियङ्गवः सर्जरसः पद्मकं पद्मकेसरम् । मातुलुङ्गस्य पत्राणि मधूच्छिष्टंससैन्धवम् ।।२४ ॥

तैस्तैलं सिद्धमभ्यङ्गाच्छोधयेद्रोपयेत च । दुष्टारु: पिटकागण्डगण्डमालाभगन्दरान् ॥ २५

Medicated oil prepared from magadhi, madhuka, lodhra, kustha, ela, harenu, samanga, dhatakipushpa, sariva, the two rajani, priyangu, sarjarasa, padmaka, padmakesara, leaves of matulunga, madhucista (bees wax) and saindhava- by anointing, cleans and also heels the foul ulcers, papules, nodules, glandular enlargements, scrofula and fistula-inano. (23-25)

पिटका: साधयेच्छीघ्रं ता ह्यसून्घ्नन्ति मेहिनः । अनुशेषानपि भिषग्यथाबलमुपद्रवान् ।।२६ ।।

The physician should treat carbuncles first, for they quickly kill the patients of diabetes; the rest of the complications (secondary diseases) can be treated later, depending on their strength. (26)

सर्वजत्वान्महामर्मसंश्रयादनुषङ्गतः । सुबहूपद्रवत्वाच्चप्रमेहोदारुणो गदः ।। २७ ।।

Because of arising from all three doshas, of being localised in the most vital organ, of persisting for a long time and of being accompanied with many complications (secondary diseases), diabetes is a dreadful disease. (27)

।। इति चतुर्दशोऽध्यायः ॥

Thus ends the Fourteenth chapter.

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