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ashtanga hridayaSARPAVISA PRATISEDHA - Treatment of snake bite poison - Ashtanga Hridaya Chapter...

SARPAVISA PRATISEDHA – Treatment of snake bite poison – Ashtanga Hridaya Chapter 36

We will now expound the chapter Sarpa visa Pratisedha -treatment of snake poisoning; thus said Atreya and other great sages.

अथातः सर्पविषप्रतिषेधं व्याख्यास्यामः । इति ह स्माहुरात्रेयादयो महर्षयः ।

दर्वीकरा मण्डलिनो राजीमन्तश्च पन्नगाः। त्रिधा समासतो भौमाः, भिद्यन्ते ते त्वनेकधा ॥ १ ॥ व्यासतो योनिभेदेन नोच्यन्तेऽनुपयोगिनः ।

Snakes living on earth are, in brief, of three kinds viz. Darvikara (those having a hood) ; Mandalina (those having patches on their body) and Rajimanta (those having lines on their body); considered species-wise they are of many kinds, which are not described in detail here since it is not useful 1-2a. (for ayurveda).

विशेषाद्र्क्षकटुकमम्लोष्णं स्वादुशीतलम् ॥ २ ॥ विषं दर्वीकरादीनां क्रमाद्वातादिकोपनम् ।

Dry (non-unctuous, viscid) and pungent, sour and hot, sweet and cold are the qualities respectively, of poison especially of darvikara, etc. these cause aggravation of vata etc. 2b-3a. respectively.

Notes: The poison of hooded snake is dry, pungent and aggravates vata; that of the snake with patches is sour, hot in potency and aggravates pitta; that of the snake with stripes is sweet, cold in potency and aggravates kapha; these qualities have been inferred by the symptoms, appearing when they bite.

तारुण्यमध्यवृद्धत्वे वृष्टिशींतातपेषु च ॥ ३ ॥

विषोल्बणा भवन्त्येते व्यन्तरा ऋतुसन्धिषु ।

They (darvikara etc.) become loaded with more poison during their youth, middle age and old age, rainy, cold and summer seasons respectively, while the hybrid (cross breed) snakes during inter-seasonal period. 3b-4a.

Notes Darvikara snakes will be having more poison during their youth and rainy season, mandali snakes in their middle age and cold season, rajimanta snakes in their old age and summer season.

Darvikara sarpa laksana – features of snake with hood

रथाङ्गलाङ्गलच्छत्रस्वस्तिकाङ्कुशधारिणः ॥४॥

फणिनः शीघ्रगतयः सर्पा दर्वीकराः स्मृताः ।

Snakes which have the mark of either a wheel, plough, svastika, or hook / goad of the elephant; on their hood; which move very fast are known as Darvikara. 4b-5a.

ज्ञेया मण्डलिनोऽभोगा मण्डलैर्विविधैश्चिताः ॥ ५ ॥ प्रांशवो मन्दगमनाः

Snakes which have no hood, covered with patches of different sizes on their body, big in size, and slow in movement are known as Mandalina. 5b.

राजीमन्तस्तु राजिभिः | स्निग्धा विचित्रवर्णाभिस्तिर्यगृर्ध्वं च चित्रिताः ॥ ६ ॥

Snakes which have shining line, running sidewards and upwards of different colours on their body are known as Rajimanta. 6.

गोधासुतस्तु गौधेरो विषे दर्वीकरैः समः । चतुष्पाद्

The young one of godha (iguana lizard) is known as Gaudhera and is equal to the hooded snake in respect of its poison. It has four legs. 7a.

व्यन्तरान् विद्यादेतेषामेव सङ्करात् ॥ ७ ॥ वयामिश्रलक्षणास्ते हि सन्निपातप्रकोपनाः ।

Born from the mingling of these species (male of one species mating with female of the other) are born the snakes which are vyantara (cross breed, hybrid), they have mixed feature and cause aggravation of all the dosas. ‘7b-8a.

Notes: Darvikara snakes are the common cobra and the king cobra, these have the capacity to expand their neck on either side and thus produce the ‘hood’, whenever they are enraged, mirthful, at the time of striking its prey etc; the common cobra grows to a length of 5-6 feet, is usually brown in colour, the neck and back are often spackled with small golden spots. Head is of the same width as of the neck and pupils of the eye are circular. On the hood there is predominant mark resembling a double spectacle, scissors or single spectacle. It moves very fast and zigzag with the help of its belly (since it has no legs). The king cobra is usually jet black (krsna sarpa) grows to a length of 12 to 15 feet. It can also produce the hood but there will be no mark on it. Belly may be mottled or having bars, both these kinds lay eggs which hatch.

2. Mandali (spotted with patches) are the vipers and pythons; two kinds of vipers are found in India, (1) the pit viper-this has a pit or depression on either side of the head between the eye and the nostril. (2) the pitless viper-this has no pit or depression in the sides of the head. The head of vipers is broad and lozenge shaped, the neck is narrow and tail short. The pupils of the eyes are vertical slits. These snakes cannot make the hood. Two species of pitless vipers found in India are-(a) Russel’s viper grows to a length of 4-5 feet, of light brown colour head is flat, traingular and heavy and has a V shaped mark. Body is whitish with dark circular, or semicircular patches in three rows. It make a terrible hissing sound during the attack. (b) Saw scaled viper-is a small snake growing to a length of 1½ to 2½ feet brown or grey in colour, usually inhabiting sandy regions. Head is triangular with a white mark resembling an arrow, a wavy line on each flank, the back covered with rough scales which produce sound when the animal moves.

3. Rajimanta-(snake with stripes) are known as Kraits; two species commonly found in India are-(a) Common krait-grows to a length of 35 feet, has a shining grey colour, the back has single or double white or brown coloured stripes across, the belly is creamy white in colour. It a cannot make the hood. (b) Branded krait-grows to a length of 5-6 feet it has alternate black and yellow bands across the back. It also cannot make the hood.

4. Vyantara-snake of mixed breeds (cross breed).

Sankes are also classified as 1. poisonous and 2. non-poisonous. Cobra, king cobra, krait and the two vipers are poisonous. Among the non-poisonous are the python (ajagara sarpa), tree snakes, water sankes and coral snakes etc.

Dasana karana-(reasons for biting)— आहारार्थं भयात् पादस्पर्शादतिविषात् क्रुधः ॥ ८ ॥ पापवृत्तितया वैराद्देवर्षियमचोदनात् । दशन्ति सर्पास्तेषूक्तं विषाधिक्यं यथोत्तरम् ॥ ९ ॥ Snakes bite man for the snake of food, out of fear when touched by the foot, by more (accumulation) of poison, by anger, to those who indulge in sinful acts, by hatredness and from instigation by gods, sages and the Lord of death. Among these, effect of poison is greater in the successive order. 8b-9.

आदिष्टात् कारणं ज्ञात्वा प्रतिकुर्याद्यथायथम् ।

Ascertaining the reason by inviting the snake (by the power of mantra-magical rites) appropriate treatment should be done. 10a.

व्यन्तरः पापशीलत्वान्मार्गमाश्रित्य तिष्ठति ॥ १० ॥

Hybrid snakes, being sinful by nature, dwell near the roads (awaiting men). 10b.

Dasana bheda – kinds of bite

यत्र लालापरिक्लेदमात्रं गात्रे प्रदृश्यते । न तु दंष्ट्राकृतं दंशं तत्तुण्डाहतमादिशेत् ॥ ११ ॥

एकं दंष्ट्रापदं द्वे वा व्यालीढाख्यमशोणितम् । दंष्टापदे सरक्ते द्वे व्यालुप्तं, त्रीणि तानि तु ॥ १२ ॥

मांसच्छेदादविच्छिन्नरक्तवाहीनि दष्टकम् । दंष्ट्रापदानि चत्वारि तद्वद्दष्टनिपिडितम् ॥ १३ ॥ निर्विषं द्वयमत्राद्यमसाध्यं पश्चिमं वदेत् ।

If only deposit of saliva (of the snake) is seen at the site of the body, then it is not caused by biting by the teeth but only rubbed by its mouth; this is known as Tundahata. If one or two marks of bite by the teeth are seen but there is no bleeding, it is to be known as Vyalidha damsa. Two such biting marks accompanied with bleeding is Vyalipta damsa; three such marks accompanied with tearing away of the muscle and blood vessels is Dastaka damsa; four biting marks with the same features is Dastanipidita damsa. Out of these the first two (tundahata and vyalidha) are not having poison in them (so is curable); the last two (dastaka and dastakanipidita), are incurable (the middle one-vyalipta is curable with difficulty). 11-14a.

Notes Snakes bite marks Cobras, kraits two lacerated puncture marks about ½ inch deep, many times marks ma be invisible to the naked eye.

Vipers

Non-poisonous snakes

two puncture marks about 1 inch deep. Several shallow marks may be seen.

विषं नाहेयमप्राप्य रक्तं दूषयत वपुः ॥ १४॥ रक्तमण्वपि तु प्राप्तं वर्धते तैलमम्बुवत् ।

Poisons do not vitiate the body without reaching the blood, mixing with blood even on atom of it spreads like oil on water (to all places quickly). 14b-15a.

भीरोस्तु सर्पसंस्पर्शाद्भयेन कुपितोऽनिलः ॥ १५॥ कदाचित्कुरुते शोफं सर्पाङ्गाभिहतं तु तत् ।

In those who are very frieghtful, vata getting aggravated by the fear of touch of snakes, gives rise to a swelling (at the place of contact ) ; this condition is known as Sarpangabhihata. 15b-16a.

दुर्गान्धकारे विद्धस्य केनचिद्दष्टशङ्कया ॥ १६ ॥

विषोद्वेगो ज्वरश्छर्दिर्मूर्च्छा दाहोऽपि वा भवेत् । ग्लानिर्मोहोऽतिसारो वा तच्छङ्काविषमुच्यते ॥ १७ ॥

Bitten by any other animal (other than snake) during profound darkness, the person suspects it to be snake only and develop symptoms of poisoning, such as fever, vomiting, fainting, burning sensation or exhaustion, delusion and diarrhoea. This condition is known as Sankavisa. 16b-17.

तुद्यते सविषो दंशः कण्डूशोफरुजान्वितः ।

दह्यते ग्रथितः किञ्चिद्विपरीतस्तु निर्विषः ॥ १८ ॥

Bite containing poison has pricking pain, itching, swelling, pain, burning sensation and knotted (at the site); opposite of these are the feature of the bite not containing poison. 18.

Darvikara visa vega – stage of poisoning from bite by hooded

पूर्वे दर्वीकृतां वेगे दुष्टं श्यावीभवत्यसृक् । श्यावता तेन वक्त्रादौ सर्पन्तीव च कीटकाः ॥ १९ ॥

द्वितीये ग्रन्थयो वेगे, तृतीयो मूर्ध्नि गौरवम् । दृग्रोधो दंशविक्लेदश्चतुर्थे ष्ठीवनं वमिः ॥ २० ॥

सन्धिविश्लेषणं तन्द्रा पञ्चमे पर्वभेदनम् । दाहो हिध्मा च षष्ठे तु हृत्पीडा गात्रगौरवम् ॥ २१ ॥

मूर्च्छा विपाकोऽतीसारः, प्राप्य शुक्रं तु सप्तमे | स्कन्थपृष्ठकटीभङ्गः सर्वचेष्टानिवर्तनम् ॥ २२ ॥

In the first stage of darvikara visa, the blood becomes blue; because of that, there is blue colour of the mouth etc. and the person feels as though insects are crawling on his body.

In the second stage there is appearance of enlarged glands; in the third, feeling of heaviness of the head, obstruction of vision, moistness at the site of bite; in the fourth stage there is expectoration, vomiting, looseness of joints and stupor. In the fifth stage, cutting pain in the joints, burning sensation and hiccup. In the sixth stage pain in the region of the heart, heaviness of the body, fainting, indigestion and diarrhoea; in the seventh stage, the poison reaches the semen produces distortions of the shoulders, back and waist and loss of all activities (death). 19-22. Mandali visavega-(stages of poisoning from bite by snakes with

patches)

अथ मण्डलिदष्टस्य दुष्टं पीतीभवत्यसृक् । तेन पीताङ्गता दाहो, द्वितीये श्वयथूद्भवः ॥ २३ ॥

तृतीये दंशविक्लेदः स्वेदस्तृष्णा च जायते । चतुर्थे ज्वर्यते, दाहः पञ्चमे सर्वगात्रगः ॥ २४ ॥

Bitten by mandali, the blood becomes yellow first and from that the body also becomes yellow and has burning sensation, in the first stage. In the second stage, appearance of swelling; in the third, there is moistness at the site of the bite, sweating and thirst; in the fourth there is fever and in the fifth there is burning sensation all over the body. 23-24. Rajimanta visa vega-(stages of poisoning from bite by snake with stripes

दष्टस्य राजिलैर्दुष्टं पाण्डुतां याति शोणितम् ।

पाण्डुता तेन गात्राणां, द्वितीये गुरुताऽति च ॥ २५ ॥

तृतीये दंशविक्लेदो नासिकाक्षिमुखस्त्रवाः । चतुर्थे गरिमा मूर्ध्नो मन्यास्तम्भश्च, पञ्चमे ॥ २६ ॥

गात्रभङ्गो ज्वरः शीतः शेषयोः पूर्ववद्वदेत् ।

Bitten by rajila, in the first stage the blood becomes pale yellow, by that the body also becomes pale in the second stage, there is feeling of too much of heaviness of the body; in the third, there is moistness at the site of the bite, exudation from the nose, eyes and mouth; in the fourth there is feeling of heaviness of the head and stiffness of the neck; in the fifth stage distortions of the body, fever and cold; in the remaining (sixth and seventh stages) features are same as of the earlier (darvikara). 25-27a.

कुर्यात्पञ्चसु वेगेषु चिकित्सां, न ततः परम् ॥ २७॥

Treatment should be done in the first five stages but not in the next (since these are incurable). 27b.

Notes Symptoms of poisoning from the bite of cobras and kraitsImmediate local burning or tingling pain, redness, swelling, after an interval ranging from 15 minutes to 1 or 2 hours, giddiness, muscular weakness, intoxication, nausea and vomiting develop; paralysis of the lower limbs, then of the trunk and next the head, muscles of the lips, tongue and throat also get paralysed; speech and swallowing become difficult, saliva collects at the mouth, breathing becomes slow and laboured and finally stops; heart continues to beat for some time. Consciousness is retained till the end. In case of bite from krait there may be violent abdominal pain and convulsions which precede death. Symptoms of poisoning fram bite of vipers

Local symptoms are severe pain, swelling, discolouration and oozing of bloody serum from the punctures of bite, within fifteen minutes, nausea, vomiting and signs of collapse, cold and clammy skin, thready pulse, dilated pupils insensible to light etc. develop; this is followed by complete unconsciouness. If the patient recovers from these, haemorrahages occur from the rectum and other orifices or the body. Extensive local suppuration, sloughing, gangrene, malignant oedema or tetanus may supervene or death may occur from septicaemia.

Alpavisa sarpa – snakes with little quantity of poison

जलाप्लुता रतिक्षीणा भीता नकुलनिर्जिताः । शीतवातातपव्याधिक्षुत्तृष्णाश्रमपीडिताः 113611 तूर्णं देशान्तरायाता विमुक्तविषकञ्चकाः । कुशौषधीकण्टकवद्ये चरन्ति च काननम् ॥ २९ ॥ avia freyfuci Aufzascufaut Hall: 1

Snakes which are drenched in water, debilitated by mating, frieghtened, vanquished by mungoose, suffering from cold breeze, sunlight, disease, hunger, thirst and exertion, just arrived from a foreign land, cast off its poison and peel (skin), move in forests full kusa, medicinal plants and thorny plants, which dwell in places where gods reside-are known to possess very little ( quantity ) of poison. 28-30a.

Tyajya dansa – rejectable bites

श्मशानचितियैत्यादौ अष्टमीनवमीसन्ध्यामध्यरात्रिदिनेषु याम्याग्नेयमघाश्लेषाविशाखापूर्वनैरृते

नैरृताख्ये मुहूर्ते च दष्टं मर्मसु च त्यजेत् । पञ्चमीपक्षसन्धिषु ॥ ३० ॥ च । ॥३१॥

Bite happening at the burial ground, place of fire sacrifice, sacred tree, on the fifth day, full moon and new moon days, eighth and ninth days. during evenings. midnight and middays, during the constellation of yamya (bharani), agneyi (krttika), magha, aslesa visakha and purvaniruta (mula) and niruta muhurta (the time of commencement of the evening), should be rejected. Tyajyarogi- (rejectable patient) 30b-32a.

दष्टमात्रः सितास्यक्षः शीर्यमाणशिरोरुहः ॥ ३२ ॥ स्तब्धजिह्वो मुहुर्मूर्च्छन् शीतोच्छ्वासो न जीवति ।

The person bitten (by snakes) who has white coloured face and the eyes, hairs falling off, loss of movement of the tongue, faints again and again and cold expiration does not survive. 32b-33a.

हिध्मा श्वासो वमिः कासो दष्टमात्रस्य देहिनः ॥ ३३ ॥

जायन्ते युगपद्यस्य स हृच्छूली न जीवति । He who develops hiccup, dyspnoea, vomiting and cough all these simultaneously and also pain in heart, does not survive. 33b-34a.

फेनं वमति नि:संज्ञः श्यावपादकराननः ॥ ३४ ॥

नासावसादो भङ्गोऽङ्गे विभेदः श्लथसन्धिता । विषपीतस्य दष्टस्य दिग्धेनाभिहतस्य च ॥ ३५ ॥

भवन्त्येतांनि रूपाणि सम्प्राप्ते जीवितक्षये।

Vomiting of froth, unconsciousness, blue colour of the feet, hands and face; pinched nose, distortion of body parts, diarrhoea, looseness of joints are the symptoms manifesting just before death in persons who have consumed poison by mouth, bitten by snakes or injured by poisoned arrow. 34b-36a.

न नस्यैश्चेतना तीक्ष्णैर्न क्षतात् क्षतजागमः ॥ ३६॥ दण्डाहतस्य नो राजि: प्रयातस्य यमान्तिकम् ।

He who does not regain consciousness by strong nasal medication, who does not bleed from the wound (specially made) and who does not develop linear marks when hit by 36b-37. the baton are all going near the Lord of death.

Sarpadasta chikitsa – treatment of the person bitten by snake

अतोऽन्यथा तु त्वरया प्रदीप्तागारवद्भिषक् ॥ ३७ ॥ रक्षन् कण्ठगतान् प्राणान् विषमाशु शमं नयेत् ।

The remaining kinds of persons should be treated expeditiously by the physician, just as saving a house on fire, protecting the life raching the throat, by all efforts and miti37b-38a. gating the poison.

मात्राशतं विषं स्थित्वा दंशे दष्टस्य देहिनः ॥ ३८ ॥

देहं प्रक्रमते धातून् रुधिरादीन् प्रदूषयत् । एतस्मिन्नन्तरे कर्म दंशस्योत्कर्तनादिकम् ॥ ३९ ॥

कुर्याच्छीघ्रं यथा देहे विषवल्ली न रोहति ।

The poison remain for a period of one hundred matra only at the site of the bite and the spread throughout the body vitiating the blood and other tissues. Within this period itself, incising the site of the bite and other treatments should be done, quickly so that the creeper of poison does 38b-40a. not grow in the body.

दष्टमात्रो दशेदाशु तमेव पवनाशिनम् ॥ ४० ॥

लोष्टं महीं वा दशनैश्छित्त्वा चानु ससम्भ्रमम् । निष्ठीवेन समालिम्पेद्दशं कर्णमलेन वा ॥ ४१ ॥

The person bitten should immediately bite the same snake or a stone or ball of mud by his teeth and smear the dribbling saliva (spittle) over the site of the bite or smear it with the excretion of the ears ( cerumen, earwax). 40b-41.

दंशस्योपरि बध्नीयादरिष्टां चतुरङ्गुले । क्षौमादिभिर्वेणिकया सिद्धेर्मन्त्रैश्च मन्त्रवित् ॥ ४२ ॥

अम्बुवत् सेतुबन्धेन बन्धेन स्तभ्यते विषम् । न वहन्ति सिराश्चास्य विषं वन्धाभिपीडिताः ॥ ४३ ॥

Arista (tourniquet) should be tied four angula (fingers ) breadth) above the bite, with the rope of flax etc. and then fortified by potent hymns by those skilled in it. By this (turniquet) the poison stops spreading just as the flow of water by the dam; blood vessels do not transport the poison, being subjected to pressure by the binding. 42-43.

निष्पीड्यानूद्धरेद्दंशं मर्मसन्ध्यगतं तथा ।

न जायते विषाद्वेगो बीजनाशादिवाङ्कुरः ॥ ४४ ॥

Next, the site of the bite should be massaged and the teeth (fangs of the snake) removed from places other than the vital spots. By so doing further stages by poisoning do not develop just as the sprout (does not develop) from the destruction of the seed. 44.

दंशं मलिनां मुक्त्वा पित्तलत्वादथापरम् । प्रततैर्हेमलोहाद्यैर्ददाशूल्मुकेन करोति भस्मसात्सद्यो वह्निः किं नाम वा ॥ ४५ ॥

Except in the bite of mandali snakes because of they possessing quanlities of pitta, in the bites of all others the site of the bite should be burnt with heated rods of gold, iron etc. or even by burning charcoal. Fire turns every thing into ash, what to say of a wound; (even that is burnt away along with poison). 45-46a.

आचूषेत् पूर्णवक्त्रो वा मृद्भस्मागदगोमयः ॥ ४६॥ प्रच्छायान्तररिष्टायां मांसलं तु विशेषतः ।

अङ्गं सहैव सहैव दंशेन दंशेन लेपयेदगदैर्मुहुः ॥ ४७ ॥ चन्दनोशीरयुक्तेन सलिलेन च सेचयेत् ।

Or (in case of predominance of pitta) incision should be made in between two tourniquets (bindings) and blood sucked through the mouth filled earlier with mud, ash, antipoisonous drugs or cowdung; this should be done specially in fleshy parts; the bitten part should be applied with paste of antipoisonous drugs again and again and bathed with water added with candana and usira. 46b-48a.

विषे प्रविसृते विध्येत्सिरां सा परमा क्रिया ॥ ४८ ॥ रक्ते निर्हियमाणे हि कृत्स्नं निर्हियते विषम् । तु क्षतम् ।

When the poison has spread in the body, the vein should be cut ( and blood let out ). This is the best treatment, when the vitiated blood is taken out the poison also comes 48b-49a. out.

दुर्गन्धं सविषं रक्तमग्नौ चटचटायते ॥ ४९ ॥ यथादोषं विशुद्धं च पूर्ववलक्षयेदसृक् ।

Blood containing poison is foul smelling and makes crackling noise when thrown on fire; the pure blood has features as described previously (chapter 27 of sutrasthana). 49b-50a.

सिरास्वदृश्यमानासु योज्याः शृङ्गजलौकसः ॥ ५० ॥

When the veins are invisible (for venesection) then blood should be taken out by using a sucking horn or a leech. 50b.

शोणितं स्त्रुतशेषं च प्रविलीनं विषोष्मणा । लेपसेकै: सुबहुश: स्तम्भयेद्भृशशीतलैः ॥ ५१ ॥

The blood containing poison which has remained inside (even after venesection) undergoing dissolution by the heat of the poison, should be prevented from spreading by frequent cold applications and bathings. 51.

अस्कन्ने विषवेगाद्धि मूर्च्छायमदहृद्रवाः ।

भवन्ति तान् जयेच्छीतै वजेच्चारोमहर्षतः ॥ ५२ ॥

If the blood has not clotted (at the site of the bite) due to the effect of poison, fainting, toxicity pain and palpitation in the heart occur; these should be controlled by cold therapies, he should be fanned (exposed to cold air) till he deve lops horripilations. 52.

स्कन्ने तु रुधिरे सद्यो विषवेग:

If the blood clots the effects of poison subsides immediately. 53a.

Hrdayavarana – protecting the heart

विषं कर्षति तीक्ष्णत्वाद हृदयं तस्थ गुप्तये ॥ ५३

पिबेद्धृतं घृतक्षौद्रमगदं वा घृताप्लुतम् । हृदयावरणे चास्य श्लेष्मा हृद्युपचीयते ॥ ५४ ॥

Because of penetrating action, poison weakens the heart; in order to protect it, the patient should drink either

ghee, mixture of ghee honey or antipoisonous recipe mixed with ghee; by this Hrdayavarana, slesma (kapha) gets increased in the heart. 53b-54.

प्रवृत्तगौरवोत्क्लेशहृल्लासं वामयेत्ततः । ॥ ५५ ॥

द्रवैः काञ्जिककौलत्थतैलमद्यादिवर्जितैः वमनैर्विषहद्भिश्च नैव व्याप्नोति तद्वपुः ।

When feeling of heaviness, salivation, nausea, ( excess of) appear, he should be made to vomit using liquid emitics avoiding kanjika (fermented gruel); kulatthayusa (soup of horse gram), taila ( oil), madya (wine) and which are antipoisonous. By this, the poison does not speread all over the body. 55-56a.

भुजङ्गदोषप्रकृतिस्थानवेगविशेषतः सुसूक्ष्मं सम्यगालोच्य विशिष्टां चाचरेत्क्रियाम् । ॥ ५६ ॥

After carefully considering the dosa predominance, constitution (nature) place of dwelling ( and of biting) stage of poisoning etc. minutely, special treatments should be adopted. 56b-57a.

सिन्दुवारितमूलानि श्वेता च गिरिकर्णिका ॥ ५७ ॥ पानं दर्वीकरैर्दष्टे नस्यं मधु सपाकलम् |

(Fresh juice of ) roots of sinduvarita and svetagirikarnika should be consumed in case of bite by hooded snake and pakala (kustha) mixed with honey should be used as nasal drops. 57b-58a.

कृष्णसर्पण दष्टस्य लिम्पेद्दंशं हृतेऽसृजि ॥ ५८ ॥ चारटीनाकुलीभ्यां वा तीक्ष्णमूलविषेण वा ।

पानं च क्षोद्रमञ्जिष्ठागृहधूमयुतं घृतम् ॥ ५९॥

If bitten by a black snake, blood should be removed (from the site) and smeared with the paste of either carati and nakuli or of any strong/powerful poisonous root and made to drink ghee mixed with honey, manjistha and grhadhuma. 58b-59.

तन्दुलीयककाश्मर्यकिणिहीगिरिकर्णिकाः । मातुलुङ्गी सिता शेलुः पाननस्याञ्जनैर्हितः ॥ ६० ॥

अगदः फणिनां घोरे विषे राजीमतामपि ।

Tanduliyaka, kasmarya, kinihi, girikarnika matulungi, sita and selu — these used for drinking, nasal drops and collyrium is an agada (anitpoisonous remedy) for powerful poisons of darvikara snakes and also for rajimata snakes. 60-61a.

समाः सुगन्धामृद्वीकाश्वेताख्यागजदन्तिकाः ॥ ६१॥

अर्धाशं सौरसं पत्रं कपित्थं बिल्वदाडिमम् । सक्षौद्रो मण्डलिविषे विशेषादगदो हितः ॥ ६२ ॥

Equal parts each of sugandha, mrdvika, sveta and gajadantika, half part each of leaves of surasa, kapittha, bilva and dadima made into a paste and used, mixed with honey is an agada (anti-poisonous remedy ) especially for poison of mandali snakes. 61b-62.

Himavan agada

पञ्चवल्करायष्टीनागपुष्पैलवालुकम् जीवकर्षभकौ शीतं सिता पद्मकमुत्पलम् ॥ ६३ ॥

सक्षौद्रो हिमवान्नाम हन्ति मण्डलिनां विषम् । लेपाच्छ्यथुवीसर्पविस्फोटज्वरदाहहा ॥ ६४॥

Pancavalkala, vara, yasti, nagapuspa, elavaluka, jivaka, rsabhaka, sita, sita, padmaka and utpala-made into a paste and used internally mixed with honey, known as Himavan agada it cures poison of mandali snake. Applied externally it cures swelling, herpes, vescicles, fever and burning sensation. 63-64.

काश्मर्यं वटशुङ्गानि जीवकर्षभकौ सिता ।

मञ्जिष्ठा मधुकं चेति दष्टो मण्डलिना पिबेत् ॥ ६५ ॥

The person bitten by mandali snake should drink the (decoction of) kasmarya, vatasunga, jivaka, rsabhaka, sita, manjistha and madhuka. 65.

Astanga agada

वंशत्वग्बीजकटुकापाटलीबीजनागरम्

शिरीषबीजातिविषे मूलं गावेधुकं वचा ॥ ६६ ॥

पिष्टो गोवारिणाऽष्टाङ्गो हन्ति गोनसजं विषम् ।

Bark and seeds of vansa, katuka, seeds of patali, nagara, seeds of sirisa, ativisa, root of gavedhuka and vaca—macerated cow’s urine ( and consumed internally); this known as Astanga agada, cures the poison of gonasa (a kind of cross breed snake). 66-67a.

कटुकातिविषाकुष्ठगृहधूमहरेणुकाः ॥६७॥

सक्षौद्रव्योषतगरा घ्नन्ति राजीमतां विषम् ।

Katuka, ativisa, kustha, grhadhuma, harenuka, vyosa and tagara-made into paste and consumed mixed with honey destroys the poison of rajimata snakes. 67b-68a.

निखनेत्काण्डचित्राया दंशं यामद्वयं भुवि ॥ ६८ ॥

उद्धृत्य प्रच्छितं सर्पिर्धान्यमृद्धयां प्रलेपयेत् । पिबेत्पुराणं च घृतं वराचूर्णावचूर्णितम् ॥ ६९ ॥

जीर्णे विरिक्तो भुञ्जीत यवान्नं सूपसंस्कृतम् ।

The part bitten by kandacitra (a kind of snake) should be buried for two yama (six hours) in the ground, afterwards it is taken out, incised (to cause bleeding) and then given a coating of ghee and soil in which grains are grown; drinking old ghee mixed with the powder of vara, after it is digested and after taking a purgative he should partake food prepared from yava (barley) processed with soups. 68b-70a.

Sarvakarmika agada

करवीरार्ककुसुममूललाङ्गलिकाकणाः ॥ ७० ॥

कल्कयेदारनालेन पाठामरिचसंयुताः । एष व्यन्तरदष्टानामगदः सार्वकार्मिकः ॥ ७१ ॥

Flowers and roots of karavira, arka, langali and kakanika along with patha and marica are made into a paste with fermented rice wash and consumed. This Sarvakarmika agada is best for bites of vyantara ( cross breed) snakes. 70b-71.

शिरीषपुष्पस्वरसे सप्ताहं मरिचं सितम्। भावितं सर्पदष्टानां पाननस्याञ्जने हितम् ॥ ७२ ॥

Sitamarica (svetamarica or sigrubija) soaked and macerated in the juice of flowers of sirisa for seven days is beneficial for drinking, nasal drops and collyrium for persons bitten by snake. 72.

अपि नतकुष्ठाभ्यां घृतक्षौद्रं चतुष्पलम् । तक्षकदष्टानां पानमेतत्सुखप्रदम् ॥ ७३ ॥ Two pala of nata and kustha and four pala of ghee and honey consumed internally bestows happiness even if bitten by Taksaka (mythical serpent). 73.

द्विपलं

Darvikara visa chikitsa

अथ दर्वीकृतां वेगे पूर्वे विस्त्राव्य शोणितम् । अगदं मधुसर्पिर्भ्यां संयुक्तं त्वरितं पिबेत् ॥ ७४ ॥

द्वितीये वमनं कृत्वा तद्वदेवागदं पिबेत् । विषापहे प्रयुञ्जीत तृतीयेऽञ्जननावने ॥ ७५ ॥

पिबेच्चतुर्थे पूर्वोक्तां यवागूं वमने कृते । षष्ठपञ्चमयोः शीतैर्दिग्धं सिक्तमभीक्ष्णशः ॥ ७६ ॥

पाययेद्वमनं तीक्ष्णं यवागूं च विषापहैः । अगदं सप्तमे तीक्ष्णं युञ्ज्यादञ्जननस्ययोः ॥ ७७ ॥

कृत्वाऽवगाढं शस्त्रेण मूर्ध्नि काकपदं ततः । मांसं सरुधिरं तस्य चर्म वा तत्र निक्षिपेत् ॥ ७८ ॥

In the first stage of poisoning from bite of darvikara snake, blood should be let out (by incising near the site) and then agada (antipoisonous recipe) mixed with honey and ghee should be given to drink immediately.

In the second stage, emesis therapy should be administered and use of antipoisonous recipes as before. In the third stage, application of anti-poisonous collyriums and nasal medications should be adopted.

In the fourth stage, emsis should be adiministered and yavagu (thin gruel) described earlier consumed as food.

In the fifth and sixth stages, he should be sprinkled and bathed with cold water, administered a strong emetic and made to drink yavagu (gruel) prepared with antipoisnous drugs.

In the seventh stage, strong agada (antipoisonous recipe) should be used, so also collyrium and nasal medication, a deep incisoin should be made on the head (scalp ) and a piece of muscle or skin (of any animal) containing blood should be placed over the wound. 74-78.

Mandati visa chikitsa

तृतीये वमितः पेयां वेगे मण्डलिनां पिबेत् । अतीक्ष्णमगदं षष्ठे गणं वा पद्मकादिकम् ॥ ७९ ॥

In the third stage of poisoning of mandali snake peya (thin gruel) should be consumed after vomiting.

In the sixth stage, a mild agada (antipoisonous recipe ) or (decoction of drugs of) padmakadi gana ( vide chapter 15 of sutrasthana) may be made use of. 79.

Rajimanta visa chikitsa

आद्येऽवगाढं प्रच्छाय वेगे दष्टस्य राजिलैः । अलाबुना हरेद्रक्तं पूर्ववच्चागदं पिबेत् ॥ ८० ॥

In the person bitten by rajimanta snake, in the first stage, blood should be let out either by a deep incision or by the use of a sucking gourd and agada (antidote) consumed.

षष्ठेऽञ्जनं तीक्ष्णतममवपीडं च योजयेत् ।

In the sixth stage strong collyrium and very strong avapida (nasal drops) should be resorted to. 81a.

अनुक्तेषु च वेगेषु क्रियां दर्वीकरोदिताम् ॥ ८१ ॥

The treatments of those stages not described, is same as prescribed for darvikara visa 81b.

गर्भिणीबालवृद्धेषु मृदुं, विध्येत्सिरां न च ।

In case the persons bitten are the pregnant lady, children and old men, only mild treatments should be given, venesection should not be done. 82a.

Vajra churna agada

त्वङ्मनोह्वा निशे वक्रं रसः शार्दूलजो नखः ॥ ८२ ॥

तमाल: केसरं शीतं पीतं तन्दुलवारिणा । हन्ति सर्वविषाण्येतद्वज्रं वज्रमिवासुरान् ॥ ८३ ।।

Tvak, manohva, the two nisa, vakra rasa, nails of a sardula (tiger), tamala, kesara and sita (made into nice powder) and consumed with rice wash; this Vajra (curna agada) destroys all kinds of poisons, just as the vajra (weapons of Indra) destroys all the asuras. 82b-83.

Bilvadi gutika

बिल्वस्य मूलं सुरसस्य पुष्पं करञ्जस्य नतं सुराह्वम्। फलत्रिकं व्योषनिशाद्वयं च बस्तस्य मूत्रेण सुसूक्ष्मपिष्टम् ॥ ८४ ॥

भुजङ्गलूतोन्दुरवृश्चिकाद्यैर्विसूचिकाजीर्णगरज्वरैश्च । आर्तान्नरान् भूतविधर्षितांश्च स्वस्थीकरोत्यञ्जनपाननस्यैः ॥ ८५ ॥

Roots of bilva; flowers of surasa, fruits of karanja, nata, surahvam, phalatrika, vyosa, the two nisa— all macerated in goat’s urine and made into a nice paste. Used as collyrium, internal potion, and nasal medication, this medicine cures the poison of bites of snake, spider, mice, scorpion, etc. visucika, (simultaneous vomiting and diarrhoea), indigestion, artificial poison and fevers, makes the persons suffering from possession of evil spirits healthy again. 84-85.

प्रलेपाद्यैश्च निःशेषं दंशादप्युद्धरेद्विषम् ।

भूयो वेगाय जायेत शेषं दूषीविषाय वा ॥ ८६ ॥

The poison should be removed completely without leaving any residue from the site of bite, because such a residue either increases again and produces stages of poison or becomes a dusivisa ( slow acting poison). 86.

विषापायेऽनिलं क्रुद्धं स्नेहादिभिरुपाचरेत् । तैलमद्यकुलत्थाम्लवर्यैः पित्तं पित्तज्वरहरैः पवननाशनैः॥ ८७॥

कषायस्नेहबस्तिभिः । समाक्षिकेण वर्गेण कफमारग्वधादिना ॥ ८८ ॥

After the elimination of poison, vata that gets aggravated should be treated with oleation and other vata mitigating therapies but avoiding the use of oil, wine, kulattha and sours; pitta that gets aggravated by treatments which cure pitta jvara by use of decoctions and oil enema; kapha should be treated by decoction of drugs of aragvadhadi gana (vide chapter 15 of sutrasthana) mixed with honey. 87-88.

सिता वैगन्धिको द्राक्षा पयस्या मधुकं मधु । पानं समन्त्रपूताम्बु प्रोक्षणं सान्त्वहर्षणम् ॥ ८९ ॥

सर्पाङ्गाभिहते युञ्ज्यात्तथा सङ्काविषार्दिते ।

Sita, vaigandhika, draksa, payasya, madhuka and madhu (honey) should be consumed (internally) sprinkling with water sanctified by holy hymns, assurances and creating 24 A.H.

pleasure these treatments should be administered to person suffering from sarpangabhihata (touched by the snake)sankavisa (fear of bite as that of a snake). 89-90a

कर्केतनं मरकतं वज्रं वारणमौक्तिकम् ॥ १० ॥

वैडूर्यं गर्दभमणिं पिचुकं विषमूषिकाम् | हिमवगिरिसम्भूतां सोमराजीं पुनर्नवाम् ॥ ९१ ॥

तथा द्रोणां महाद्रोणां मानसीं सर्पजं मणिम् । विषाणि विषशान्त्यर्थं वीर्यवन्ति च धारयेत् ॥ ९२ ॥

Karketana, marakata, vajra, varana, mauktika, vaidurya, gardabha mani, picuka, visamusika, himavadgiri, sambhuta, somaraji, punarnava, drona, mahadrona, manasi, sarpamanithese powerful poisons should be worn on the body (as amulets) to mitigate the effects of poison. 90-92.

छत्री झर्झरपाणिश्च चरेद्रात्रौ विशेषतः । तच्छायाशब्दवित्रस्ताः प्रणश्यन्ति भुजङ्गमाः ॥ ९३ ॥

The person should move out at night holding an umbrella and a drum (rattle); frieghtened by their shade and sound, the snakes get destroyed (run away). 93.

इति श्रीवैद्यपतिसिंहगुप्तसूनुश्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने सर्पविषप्रतिषेधो नाम षट्त्रिंशोऽध्यायः ॥ ३६ ॥ Thus ends the chapter Sarpavisa pratisedha—the thirtysixth in Uttarasthana of Astanga hrdaya samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.

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