षड्विंशोऽध्यायः अथातः शिरोरोगप्रतिषेधं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥
Now we shall discourse on the chapter which deals with the therapeutics of the diseases of the head (Shiro-roga-Pratisedha). 1
Treatment of Vataja Shiroroga
वातव्याधिविधिः कार्य: शिरोरोगेऽनिलात्मके । पयोऽनुपानं सेवेत घृतं तैलमथापि वा ॥ २ ॥ मुद्गान् कुलत्थान् माषांश्च खादेच्च निशि केवलान् । कटूष्णांश्च ससर्पिष्कानुष्णञ्चानु पयः पिबेत् । पिबेद् वा पयसा तैलं तत्कल्कं वाऽपि मानवः ॥ ३ ॥ वातघ्नसिद्धैः क्षीरैश्च सुखोष्णैः सेकमादिशेत् । तत्सिद्धैः पायसैर्वाऽपि सुखोष्णैर्लेपयेच्छिरः ॥ ४ ॥ स्विन्नैर्वा मत्स्यपिशितैः कृशरैर्वा ससैन्धवैः । चन्दनोत्पलकुष्ठैर्वा सुश्लक्ष्णैर्मगधायुतैः ॥ ५॥
Treatment of Vataja-Shiroroga – Remedial measures described in connection with the treatment of Vata-Vyadhi should be empolyed in their entirety in the Vayu-origined types of the diseases of the head, and all medicinal compounds of oil or clarified butter should be followed by a potion of milk. Mudga, Kulattha, or Masa pulse, unmixed with any other thing, as well as pungent and heat-making articles, saturated with clarified butter and followed by potions of tepid milk should be taken in the night. Sesamum oil or the paste of sesamum may also be taken. Milk duly boiled with the Vayu-subduing drugs should be employed in a lukewarm state in washing the diseases of locality, and a plaster composed of the powders of the same drugs boiled with milk should be applied lukewarm to the scalp. In the altermative, the scalp may be plastered over with the boiled flesh of fish or with Krsara (preparation of rice and sesamum) saturated with Saindhava salt, or with (the paste of) Candana, Utpala, Kustha and Pippali, finely powdered together (all in a lukewarm state.) 2-5.
स्निग्धस्य तैलं नस्यं स्यात् कुलीररससाधितम् । वरुणादौ गुणे क्षुण्णे क्षीरमर्धोदकं पचेत् ॥ ६ ॥ क्षीरशेषञ्च तन्मध्यं शीतं सारमुपाहरेत् । ततो मधुरकैः सिद्धं नस्ये तत् पूजितं हविः । तस्मिन् विपक्के क्षीरे तु पेयं सर्पिः सशर्करम् ॥ ७॥ धूमञ्चास्य यथाकालं स्नैहिकं योजयेद् भिषक् । पानाभ्यञ्जननस्येषु बस्तिकर्मणि सेचने ॥ ८ ॥ विदध्यात् त्रैवृतं धीमान् बलातैलमथापि वा । भोजयेच्च रसैः स्निग्धैः पयोभिर्वा सुसंस्कृतैः ॥ ९ ॥
Oil duly prepared with Kulira (crabs) should be used for Nasya ( snuffing ) purposes subsequent to the employment of the (above) fomentation. A quantity of milk diluted with the addition of half as much of water should be duly boiled with the paste of the drugs of the Varunadi group and taken down from the fire when the water has evaporated. Butter should be skimmed out of it when cool and clarified butter prepared therefrom should be again duly cooked with the paste of the drugs of the Madhura group. The use of this Ghrita as a Nasya (Snuff) is highly efficacious in the type under discussion. Clarified butter duly cooked with the decoction of the preceding drugs (of the Varunadi group) and with milk should be taken with sugar. Snaihika Dhuma (Chikitsa, XL) should be administered in time when requried, and Traivrta Ghrita and Bala Taila should be prescribed as a draught and as an errhine, as well as for the purposes of anointing, sprinkling and Basti-karma. The food in the present type of the disease should be taken with milk cooked with Vayu subduing drugs and with soup saturated with Sneha (Clarified butter). 6-9.
Treatment of Pittaja and Raktaja Shiro roga
। ॥११॥ पित्तरक्तसमुत्थानौ शिरोरोगौ निवारयेत् । शिरोलेपैः ससर्पिष्कैः परिषेकैश्च शीतलैः ॥ १० ॥ क्षीरेक्षुरसधान्याम्ल-मस्तुक्षौद्रसिताजलैः नलवञ्जुलकह्लार- चन्दनोत्पलपद्मकैः शङ्खशैवलयष्ट्याह्व-मुस्ताम्भोरुहसंयुतैः । शिरः प्रलेपः सघृतैर्वेसर्पैश्च तथाविधैः ॥ १२ ॥ मधुरैश्च मुखालेपैर्नस्यकर्मभिरेव च। आस्थापनैर्विरेकैश्च पथ्यैश्च स्नेहबस्तिभिः ॥ १३ ॥ क्षीरसर्पिर्हितं नस्यं वसा वा जाङ्गला शुभा । उत्पलादिविपक्क्रेन क्षीरेणास्थापनं हितम् ॥ १४ ॥ भोजनं जाङ्गलरसैः सर्पिषा चानुवासनम् । मधुरैः क्षीरसर्पिस्तु स्नेहने च सशर्करम् । पित्तरक्तघ्नमुद्दिष्टं यच्चान्यदपि तद्धितम् ॥१५॥
Treatment of Pittaja and Raktaja Shiro-roga -Cooling plasters saturated with clarified butter should be applied to the scalp and cooling head-washes should be prescribed in the Pittaja and Raktaja types of Shiro-roga. Milk, the expressed juice of sugarcane, fermented rice-gruel (Dhanyamla), Curd (Mastu), honey and sugar mixed in water— these should be used for sprinkling purposes. Plaster for the head should be prepared with Nala, Vetasa, Kalhara ( red lotus ), Candana, Utpala, Sarmkha (Conch-shell), Saivala, Yasti-madhu, Musta and Lotus teken together and mixed with clarified butter, and the plasters described in connection with the treatment of Pittaja and Raktaja Visarpa (Erysipelas) should also be used. The drugs of the Madhura group should be used in a tepid state as plasters and the Sneha (oil or clarified butter) duly cooked with the same drugs should be used as an errhine, and appropriate medicines should be used as purgatives as well as Asthapana and Sneha-Basti measures, Clarified butter skimmed from milk, and fresh Vasa (lard)¹ of Jangala animals should be used as errhines, and, cooked with the drugs of the Utpaladi group, should be used in the manner of Asthapana-basti. Food should be taken with meat-soup of Jangala animals, and clarified butter should be used in the manner of an Anuvasana Basti. Clarified butter skimmed from milk and duly cooked with the drugs of the Madhura group and mixed with sugar should be used for emulsive purposes (Snehana), and all measures and remedies which are remedial to the deranged blood and Pitta may be likewise employed with profit in these cases. 10-15.
1. In place of ‘वसा’ (lard) some read ‘रसा’ which means meat-soup.
Treatment of Kaphaja Shiro roga
॥ १६॥ कफोत्थितं शिरोरोगं जयेत् कफनिवारणैः । शिरोविरेकैर्वमनैस्तीक्ष्णैर्गण्डूषधारणैः अच्छञ्च पाययेत् सर्पिः स्वेदयेच्चाप्यभीक्ष्णशः । शिरो मधूकसारेण स्त्रिग्धञ्चापि विरेचयेत् ॥ १७ ॥ इङ्गुदस्य त्वचा वाऽपि मेषशृङ्ख्या च वा भिषक् । आभ्यामेव कृतां वर्तिं धूमपाने प्रयोजयेत् । प्रेयं कट्फलचूर्णञ्च कवलाश्च कफापहाः ॥ १८ ॥ सरलाकुष्ठशाङ्गेष्टा-देवकाष्ठैः सरोहिषैः । क्षारपिष्टै: सलवणैः सुखोष्णैर्लेपयेच्छिरः ॥ १९ ॥ यवषष्टिकयोश्चान्नं व्योषक्षारसमायुतम् । भोजयेद्रसैः ॥ २० ॥ पटोलमुद्द्रकौलत्थैर्मात्रावद्
Treatment of Kaphaja Shiro-roga – In a case of KaphajaShiroroga, the Kapha-subduing measures, such as strong emetics, headpurgatives (Shirovireka) and gargling should be resorted to. The transparent upper part of clarified butter¹ should be given to drink, and fomentation should then be frequenty applied to the head. Headpurgatives should then be administered with the pith of Madhuka wood, or with Mesa-srngi or Ingudi bark. Vartis ( sticks) made of Mesa-srngi and Ingudi barks should be used in smoking, snuffs of powdered Katphala should be taken,and gargles with Kapha-subduing drugs should be used. Plasters prepared with Sarala, Kustha, Sarngesta, Deva – daru and Rohisa pasted together with the alkaline water and mixed with Saindhava salt should be applied lukewarm to the head. The diet should consists of cooked barley or Sastika rice, which should be judiciously taken with Yava-ksara and powdered Tri-katu and with the soup of Mudga, Patola and Kulattha pulse. 16-20.
1. According to a variant matured clarified butter should be used in this case.
Treatment of Tridosaja and Khsayaja Shiroroga
शिरोरोगे त्रिदोषोत्थे त्रिदोषघ्नो विधिर्हितः । सर्पिः पानं विशेषेण पुराणं वा दिशन्ति हि ॥ २१ ॥
क्षयजे क्षयमासाद्य कर्तव्यो बृंहणो विधिः । पाने नस्ये च सर्पिः स्याद् वातघ्नमधुरैः शृतम् ।
क्षयकासापहञ्चात्र सर्पिः पथ्यतमं विदुः ॥ २२ ॥
Treatment of Tridosaja and Khsayaja Shiroroga- The Measures which are severally remedial to the three deranged Dosas of the body should be employed in case of Shiroroga marked by the concerted action of the three Dosas (Tri-dosaja) and draughts of old and matured clarified butter are said to be specially efficacious in such instances. Employment of untritive (Brimhana) measures and remedies is recommended in cases of the diseases of the head due to any waste or atrophy of the local fat, etc. ( Ksayaja Shiroroga). Clarified butter duly cooked with the admixture of the durgs of the Vayu-subduing and the Madhura grouos’ should be given as drinks and errhines. Any medicated Ghrita which acts as a remedy in cases of consumptive cough would be found most efficacious in the present (Ksayaja) type. 21-22.
Treatment of Krimija Shiroroga
कृमिभिर्भक्ष्यमाणस्य वक्ष्यते शिरसः क्रिया । नस्ये हि शोणितं दद्यात् तेन मूर्च्छन्ति जन्तवः ॥ २३ ॥ मत्ताः शोणितगन्धेन समायान्ति यतस्ततः । तेषां निर्हरणं कार्यं ततो मूर्धविरेचनैः ॥ २४ ॥ हस्वशिग्रुकबीजैर्वा कांस्यनीलीसमायुतैः । कृमिघ्नैरवपीडैश्च मूत्रपिष्टैरुपाचरेत् ॥ २५ ॥ पूतिमत्स्ययुतान् धूमान् कृमिघ्नांश्च प्रयोजयेत् । भोजनानि कृमिघ्नानि पानानि विविधानि च ॥ २६॥
Treatment of Krimija Shiroroga— In a case of head -disease (head-ache ?) due to the germination of parasites ( Krmi) in the head, the patient should be made to snuff in a quantity of animal blood. The worms or parasites lured with the smell of the blood, would greedily come down (into the passages of the nostrils) when they should be carefully extracted (by means of tongs, etc.). Head-purgatives composed of the pulverised seeds of Hraswa (Small) Sigru mixed with Kansya ( dead brass) and Nili (indigo) pounded together should then be used, if necessary, or any vermifuge drug (Vidanga, etc.) pasted with the urine of a cow should be snuffed into the nostrils in the manner of an Avapida Nasya. Fumigations should be applied into the nostrils with the fumes of burnt sordid fishes and vermifuge foods and drinks of various kind should be given. 23-26.
1. According to Videha the clarified butter in this case should be cooked with the decoction of the Vayu-subduing drugs and with the Kalka of the Madhura drugs.
Treatment of Suryavarta and Ardhavabhedaka
सूर्यावर्ते विधातव्यं नस्यकर्मादि भेषजम् । भोजनं जाङ्गलप्रायं क्षीरान्नविकृतिर्घृतम् ॥ २७ ॥ तथाऽर्धभेदके व्याधौ प्राप्तमन्यच्च यद् भवेत् । शिरीषमूलकफलैरवपीडोऽनयोर्हितः वंशमूलककर्पूरैरवपीडं ॥ २८ ॥ प्रयोजयेत् । अवपीडो हितश्चात्र वचामागधिकायुतः ॥ २९ ॥ मधुकेनावपीडो वा मधुना सह संयुतः । मनः शिलावपीडो वा मधुना चन्दनेन वा । तेषामन्ते हितं नस्यं सर्पिर्मधुरसान्वितम् ॥ ३० ॥ •सारिवोत्पलकुष्ठानि मधुकञ्चाम्लपेषितम् । सर्पिस्तैलयुतो लेपो द्वयोरपि सुखावहः ॥ ३१ ॥ एष एव प्रयोक्तव्यः शिरोरोगे कफात्मके ॥ ३२ ॥
Treatment of Suryavarta and Ardhavabhedaka – Errhines etc. (plaster, gargle, etc.) should be prescribed in cases of the Suryavarta type of Shiroroga. The diet should principally consist of boiled rice and milk with clarified butter and the essence or extract of the meat of Jangala animals. These and similar other suitable remedial agents should be employed in cases of the Ardhavabhedaka type of Shiroroga. Sirisa¹ and Mulaka seeds or bamboo-roots camphor, or Vaca and Magadhi, or Yasti-madhu and honey or Manah sila, pasted with honey or (pasted) Candana should be snuffed into the nostrils in the manner of an Avapida Nasya in a case of the Suryavarta type of Shiroroga as well as in a case of Ardhavabhedaka headache. After the use of the above, the patient should be made to snuff in the medicated clarified butter cooked with the drugs of the Madhura ‘ ( Kakolyadi) group, in both the above cases. Plasters composed of Sariva, Utpala Kustha and Yasti-madhu pasted with Kanjika (acid gruel) and surcharged with oil and clarified butter are to be found efficacious in both the cases, if applied to the affected region. This may be employed with equal success in the cases of the Kaphaja type 2 of Shiroroga. 27-32.
1. Sripati Datta, the commentar ot of Vnda, prescribes the bark and Sivadasa Sen, the commentator of Cakrapani, prescribes the seeds of Sirisa.
Treatment of Ananta vata
अनन्तवाते कर्तव्यः सूर्यावर्तहिरो विधिः । सिराव्यधश्च कर्तव्योऽनन्तवातप्रशान्तये ॥ ३३ ॥
आहारश्च विधातव्यो वातपित्तविनाशनः । मधुमस्तकसंयाव-घृतपूरैश्च भोजनम् ॥ ३४ ॥
Treatment of Ananta-vata – Cases of Ananta-vata Shiroroga should be treated like those of Suryavarta. Moreover blood-letting should be effected (by opening a local vein) and the diet should be such as to subdue the Vayu and the Pitta and should cossist of Madhumastaka, Sanyava and Ghrita-pura (different Kinds of confectionery made of wheat, sugar, milk, clarified butter, etc.) 33-34.
Treatment of Samkhaka
क्षीरसर्पिः प्रशंसन्ति नस्ये पाने च शङ्खके। जाङ्गलानां रसैः स्निग्धैराहारश्चात्र शस्यते ॥ ३५ ॥ शतावरीं तिलान् कृष्णान् मधुकं नीलमुत्पलम् । दूर्वां पुनर्नवाञ्चैव पुनर्नवाञ्चैव लेपे साध्ववचारयेत् ॥ ३६॥ महासुगन्धामथवा पालिन्दीञ्चाम्लपेषिताम् । शीतांश्चात्र परीषेकान् प्रदेहानत्र योजयेत् । अवपीडश्च देयोऽत्र सूयावर्तनिवारणः ॥ ३७॥
Treatment of Samkhaka — Clarified butter churned from milk should be given for a drink and used as an errhine in a case of Samkhaka and the diet should consist of (boiled rice mixed with) clarified butter and the essence of the meat of jangala animals. Plasters composed of Satavari, black sesamum, Yasti-madhu, Nilotpala, Durva and Punarnava pasted together, or of Maha-sugandha (Utpala-sariva) of Palindi pasted with Kanjika should be applied to the affected locality. Cooling washes and plasters as well as different Avapida Nasyas prescribed in cases of Suryavarta should also be prescribed for this diseases (Samkhaka). 35-37.
1. Some take ” मधुरसा” to mean ” मूर्वा” । 2. In Place of Kaphaja type some read the Ksayaja type. But it is not accepted by Jejjata. Ot hers again read “Anilatmake” i.e. in the Vataja type.
कृमिक्षयकृतौ हित्वा शिरोरोगेषु बुद्धिमान् । मधुतैलसमायुक्तैः शिरांस्यतिविरेचयेत् । पश्चात् सर्षपतैलेन ततो नस्यं प्रयोजयेत् ॥ ३८ ॥ न चेच्छान्तिं व्रजन्त्येवं स्निग्धस्विन्नांस्ततो भिषक् । पश्चादुपाचरेत् सम्यक् सिराणामथ मोक्षणैः ॥ ३९ ॥
Strong head-purgatives ( errhines) composed of oil and honey should be first administered in cases of Shiroroga with the exception of the Krmija and the Ksayaja types. Then the patient should be made to snuff in drops of mustard oil. In cases where the preceding remedies would fail to produce any relief, the patient should be treated with Sneha and Sveda and bleeding should then be effected by opening a local vein. 38-39.
षट्सप्ततिर्नेत्ररोगा दशाष्टादश कर्णजा: । एकत्रिंशद् घ्राणगताः शिरस्येकादशेह तु ॥ ४० ॥ इति विस्तरतो दू (दि)ष्टाः सलक्षणचिकित्सिताः । संहितायामभिहिताः सप्तषष्टिर्मुखामयाः ॥ ४१ ॥ गदाः । एतावन्तो यथास्थूलमुत्तमाङ्गगता अस्मिन् शास्त्रे निगदिताः सङ्ख्यारूपचिकित्सितैः ॥ ४२ ॥
The Conclusion-The casuses, symptoms and the therapeutics of the seventy-six kinds of ocular affection, of the twenty-eight kinds of the disease of the ear, of the thirty-one kinds of nasal disease, of the eleven kinds of the disease of the head as well as of sixty-seven (sixty-five) kinds of the affection of the mouth have been described in detail in other treatises (e.g. those of Videha, etc. dealing with this special subject the diseases of the over-clavicular region). The number, symptoms and therapeutics of these diseases of the overclavicular region are here briefly described in accordance therewith. 40-42.
– इति सश्रुत संहितायामुत्तरतन्त्रे शिरारोगप्रतिषेधोनाम षड्विंशोऽध्यायः ॥ २६ ॥
Thus ends the twenty-sixth chapter of the Uttara-Tantra in the Susruta Samhita which deals with the treatment of the disease of the head.
Here ends Salakya Tantra (Surgery Minor).
