एकचत्वारिंशोऽध्यायः अथातः शोषप्रतिषेधं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥
Now we shall discourse on the (symptoms and medical treatment of Phthisis (Sosa-Pratisedha) 1. 1
अनेकरोगानुगतो बहुरोगपुरोगमः । दुर्विज्ञेयो दुर्निवारः शोषो व्याधिर्महाबलः ॥ २ ॥
संशोषणाद् रसादीनां शोष इत्यभिधीयते । क्रियाक्षयकरत्वाच्च क्षय इत्युच्यते पुनः ॥ ३॥
राज्ञश्चन्द्रमसो यस्मादभूदेष किलामयः । तस्मात् तं राजयक्ष्मेति केचिदाहुः पुनर्जनाः ॥ ४॥
Nomenclature- Wasting or a general emaciation of the frame marks the sequel of many diseases and comes in a premonitory symptom of organic diseases, which is difficult to be diagnosed and to be cured. Any cachetic condition of the body accompanied by a low lingering fever is called Ksaya. The disease is named as Sosa from the fact of its consuming or drying up (Sosa-withering) the vital principles of the body such as Rasa— serum, etc. It is called Ksaya (wasting ) since a wasting process is found to accompany all the functional activities of the body during its attack. Since the Moon-god, the king of the Brahmanas, was the first to fall a victim to its attack, so it is also called Raja-yaksma (king’s disease ) by some authorities. 2-4.
1. The mythological of Sosa (phthisis) is The Moon-god married 27 daughters of Daksa of whom he was attached to Rohini in the extreme. Thereupon the personated wrath of his father-in-law, Daksa entered the Moon-god in the shape of Phthisis, whereby the body of the Moon-god began to emaciate. The Moon-god became penitent and the wrath of his father-inlaw having been subdued at the intervention of the other gods, he managed to send down the personated Phthisis to earth to take possession of men indulging in any kind of excess and more particularly-Sexual excess. The Moon-god was then medically treated and radically cured by the celestial physicians, the twin Aswins.
स व्यस्तैर्जायते दोषैरिति केचिद् वदन्ति हि । एकादशानामेकस्मिन् सान्निध्यात् तत्रयुक्तितः । क्रियाणामविभागेन प्रागेकोत्पादनेन च॥५॥ एक एव मतः शोष: सन्निपातात्मको ह्यतः । उद्रेकात् तत्र लिङ्गानि दोषाणां निपतन्ति हि ॥ ६ ॥
Some say that the disease is produced by the separate action of the three fundamental Dosas of the body. It being usually found to be attended with all the eleven distressing symptoms which are manifested simultaneously with the ushering in of the disease, and being the only instance in the science of therapeutics in which the treatment does not vary according to the variation of sysmptoms. This disease, Sosa, is more properly said to originate in the simultaneous aggravation of all the three Dosas, and it is the symptoms of the most predominant Dosa only that are manifested. 5-6.
क्षयाद् वेगप्रतीघातादाघाताद् विषमाशनात् । जायते कुपितैर्दोषैर्व्याप्तदेहस्य देहिनः ॥ ७॥ रुद्धेषु रसवर्त्मसु । कफप्रधानैर्दोषैर्हि अतिव्यवायिनो वाऽपि क्षीणे रेतस्यनन्तरम् । क्षीयन्ते धातवः सर्वै ततः शुष्यति मानवः ॥ ८ ॥ भक्तद्वेषो ज्वरः श्वासः कासः शोणितदर्शनम् । स्वरभेदश्च जायन्ते षड्रूपे राजयक्ष्मणि ॥ ९ ॥
Etiology and general symptoms- The process of any wasting disease in the system, repression of any physical urging or trauma and irregular diet are the causes which, by aggravating the bodily Dosas and propelling them all over the organism, give rise to the disease. The aggravated Dosas with Kapha as the most predominant factor having obstructed the lymphatic channels, or the semen of a person having been exhausted by sexual excesses consequently produce a loss of the other Dosas or the principal elements of the organism, there by producing a cachectic condition of the body, and the following symptoms, viz., aversion to food, fever, asthma, cough, emission of blood, loss of voice, numbering six in all are found in cases of Rajayaksma. 7-9.
1. Cf. Scrofula which is now known as the “Kings’s disease.”
Specific Symptoms of Sosa
स्वरभेदोऽनिलाच्छूलं संकोचश्चांसपार्श्वयोः । ज्वरो दाहोऽतिसारश्च पित्ताद्रक्तस्य चागमः ॥१०॥ शिरसः परिपूर्णत्वमभक्तच्छन्द एव च। कासः कण्ठस्य चोद्ध्वंसो विज्ञेयः कफकोपतः ॥ ११ ॥
Specific Symptoms – The symptoms which mark the action of the deranged bodily Vayu in the disease are loss of voice (hoarseness), aching pain (in the chest), contraction of the sides and stoop at the shoulders (Amsa), while those which are exhibited through the action of the derangd Pitta are fever, burning sensation, Atisara and expectoration of blood, and the features which indicate the action of the deranged Kapha in the disease are a sense of fullness in the head, aversion to food, cough and a sense of the presence of lump or plug in the throat (as if something in rising up ). 10-11.
Prognosis of Phthisis
॥१२॥ एकादशभिरेतैर्वा षड्भिर्वाऽपि समन्वितम् । कासातीसारपार्श्वार्ति-स्वभेदारुचिज्वरैः त्रिभिर्वा पीडितं लिङ्गैर्ज्वरकासासृगामयैः । जह्याच्छोषार्दितं जन्तुमिच्छन् सुविपुलं यशः ॥ १३॥
Prognosis – A physician having an eye to his professional reputation or good name should not take in hand the treatment of a case of Sosa (Phthisis) whether marked by all the preceding eleven kinds of symptoms or attended with six of them viz. cough, Atisara, pain at the sides, loss of voice, aversion to food and fever, or accompanied by only three symptoms, Viz. fever, cough and bloodspitting. 12-13.
Other causes of Sosa and their symptoms
व्यवायशोकस्थाविर्य – व्यायामाध्वोपवासतः व्रणोरः क्षतपीडाभ्यां शोषानन्ये वदन्ति हि ॥ १४ ॥ शुक्रस्य क्षयलिङ्गैरुपद्रुतः । व्यवायशोषी पाण्डुदेहो यथापूर्वं क्षीयन्ते चास्य धातवः ॥ १५ ॥ प्रध्यानशीलः स्त्रस्ताङ्गः शोकशोष्यपि तादृशः । विना शुक्रक्षयकृतैर्विकारैरभिलक्षितः जराशोषी कृशो श्वसनोऽरुचिमान् ॥ १६ ॥ मन्द – वीर्यबुद्धिबलेन्द्रियः । भिन्न- कांस्यपात्रहतस्वरः ॥ १७ ॥ ष्ठीवति श्लेष्मणा हीनं तथैवारतिपीडितः । `सम्प्रस्त्रुतास्यनासाक्षः सुप्त – ( शुष्क ) रूक्षमलच्छविः ॥ १८ ॥
Other causes of Sosa and their symptoms – Sexual excess, grief, old age, overfatiguing physical exercise, toils of journey, fasting, ulcers and injury of the Urah (lungs) are included by certain authorities within the exciting factors of this disease (Sosha). A case of Sosa due to sexual excess is attended with all the symptoms due to loss of semen and is marked by pallor or yellowness of the complexion, the vital organic principles beginning with semen being wasted up in succession in their inverse order of enumeration. Constant brooding over the departed person, looseness of the limbs and allthe symptoms of sexual excess other than the actual discharge of semen mark a case due to grief. A general cachectic condition of the body accompanied by imbecility of the mind, diminution of bodily strength, impaired functions of the sense-organs, laboured or difficult breathing (D.R. shivering of the limbs), aversion to food, a gong-like voice, expectorations marked by the absence of mucus (A.R. heaviness of the limbs), a general apathy to the concerns of life and (constant mucus ) secretions from the nose, eyes and mouth are the symptoms which indicate the origin of the disease in the natural and spontaneous waste of an extreme old age. 14-18.
अध्वप्रशोषी त्रस्ताङ्गः संभृष्टपरुषच्छविः । प्रसुप्तगात्रावयवः शुष्कक्लोमगलाननः॥१९॥
व्यायामशोषी भूयिष्ठमेभिरेव समन्वितः । उरः क्षतकृतैर्लिङ्गैः संयुक्तश्च क्षताद् विना ॥ २० ॥
A case due to the toils of journey or travel develops such symptoms as looseness of the limbs, flabbiness of the muscles, scorched or burntness of complexion, a haggard and cadaverous look, agonyfeeling in the limbs, the absence of natural gloss of the body and dryness of the mouth, throat and of the Kloma. These symptoms in addition to those of the injured lungs (Urah-Ksata) without actual injury, characterise the type due to over-fatiguing physical exercise. 19-20.
रक्तक्षयाद् वेदनाभिस्तथैवाहारयन्त्रणात् । व्रणितस्य भवेच्छोषः स चासाध्यतमः स्मृतः ॥ २१ ॥ व्यायामभाराध्ययनैरभिघातातिमैथुनैः 1 कर्मणा चाप्युरस्येन वक्षो यस्य विदारितम् ॥ २२ ॥ तस्योरसि क्षते रक्तं पूयः श्लेष्मा च गच्छति । कासमानश्छर्दयेच्च पीतरक्तासितारुणम् ॥ २३ ॥ सन्तप्तवक्षाः सोऽत्यर्थं दूयनात् परिताम्यति । दुर्गन्धवदनोच्छ्वासो भिन्नवर्णस्वरो नरः ॥ २४ ॥ केषाञ्चिदेवं शोषो हि कारणैर्भेदमागतः । न तत्र दोषलिङ्गानां समस्तानां निपातनम् ॥ २५ ॥ क्षया एव हि ते ज्ञेयाः प्रत्येकं धातुसंज्ञिताः । चिकित्सितन्तु तेषांहि प्रागुक्ते धातुसंक्षये ॥ २६ ॥
If a case of ulcer is attended by loss of blood, pain and difficulty in eating, it is turned to a case of Sosa and is pre-eminently the most incurable type of the desease. Rupture or ulceration in the lungs (Urahksata) is caused by physical exercises, lifting up heavy loads, excessive and loud reading, a hurt or a blow, or excessive sexual intercourse and such other acts as require the active co-operation and entail excessive straining of the chest (Urah). They ultimately discharge blood and pusy secretions. Yellowish, black or purple coloured blood is expectorated or hawked out by coughing. A burning sensation is felt inside the region of the chest. A fetid smell is felt in the mouth and in the breath. The complexion of the body and the tone of the voice is changed and the patient becomes senseless from the excessive pain. In certain cases the symptoms vary according to the varied natures of their exciting factors, and all the specific symptoms are not fully exhibited. Nevertheless these diseases also go under the denomination of Ksaya (consumption) owing to the fundamental vital principles of the body being equally cossumed or withered up in them, and the specific mode of their treatment has already been explained before (chapter XV, Sutra-Sthana). 21-26.
Premonitory Symptoms of sosa
। श्वासाङ्गसादकफसंसस्त्रवतालुशोषच्छर्दयग्निसादमदपीनसकासनिद्राः शोषे भविष्यति भवन्ति स चापि जन्तुः शुक्लेक्षणो भवति मांसपरो रिरंसुः ॥ २७ ॥ स्वप्नेषु काकशुकशल्लकिनीलकण्ठ- गृध्रास्तथैव कपयः कृकलासकाश्च । तं वाहयन्ति स नदीर्विजलाश्च पश्येच्छुष्कांस्तरून् पवनधूमदवार्दितांश्च ॥ २८ ॥
Premonitory Symptoms – Laboured or difficult breathing, agony-feeling in the limbs and a sense of physical lassitude, secretion of mucus, dryness of the palate, vomiting, dulness of digestive fire, vertigo or fainting fits, nasal catarrh, cough, somnolence, whiteness of the eye, desire for meat and increased sexual propensities are the symptoms which mark the advent of the dreadful disease- Sosa. The patient dreams that he has been borne on the wings of a crow or a parrot or a vulture or a pea-cock or has been riding a porcupine or a lizard or a monkey or sees in dreams river-beds dried up and trees dried up or fanned by gales of wind or surrounded by flames or fumes of fire. 27-28.
महाशनं क्षीयमाणमतीसारनिपीडितम् । शूनमुष्कोदरञ्चैव यक्ष्मिणं परिवर्जयेत् ॥ २९ ॥ उपाचरेदात्मवन्तं दीप्ताग्निमकृशं नवम् ॥ ३० ॥
Prognosis- A gradual wasting of the body inspite of sufficient food, presence of Atisara (diarrhoea) and swelling of the abdomen and scrotum are the symptoms of a comsumptive patient who should be given up. The treatment, however, of a patient temperate in his habits and strictly conforming to the instructions of the physician and possessed of a good digestive fire and not much reduced in body may be taken in hand provided the disease be an acute one. 29-30.
स्थिरादिवर्गसिद्धेन घृतेनाजाविकेन च । स्त्रिग्धस्य मृदु कर्तव्यमूर्द्धञ्चाधश्च शोधनम् ॥ ३१ ॥ आस्थापनं तथा कार्यं शिरसश्च विरेचनम् । यवगोधूमशालींश्च रसैर्भुञ्जीत शोधितः । दृढेऽग्नौ बृंहयेच्चापि निवृत्तोपद्रवं नरम् ॥ ३२ ॥ व्यवायशोषिणं प्रायो भजन्ते वातजा गदाः । बृंहणीयो विधिस्तस्मै हितः स्निग्धोऽनिलापहः ॥ ३३ ॥
Treatment The patient should be made first to use the medicated clarified butter prepared from the milk of a ewe or a shegoat and duly cooked with the drugs of the Sthiradi (Vidari-gandhadi) group and then mild emetics and purgatives should be given for cleaning the alimentary canal. Intestinal injections after the maner of an Asthapana Basti should follow the preceding medicinal measures and head-prugative (Siro-vireka) should be applied. The diet should then be given consisting of (cooked) wheat, barley Sali-rice together with meat-soup. Constructive tonics or tissue-builders (Brmhana) should be given to a patient with a good digestion and relieved of all distressing symptoms of concomitants. Complications peculiar to the action of the deranged bodily Vayu generally mark a case due to sexual excess, wherein constructive tonics and remedial agents of Vayu-subduing virtue would be found to be extremely efficacious. 31-33.
काकानुलूकान् नकुलान् बिडालान् गण्डूपदान् व्यालविलेशयाखून् । गृध्रांश्च दद्याद् विविधैः प्रवादैः ससैन्धवान् सर्षपतैलभृष्टान् ॥ ३४ ॥ देयानि मांसानि च जाङ्गलानि मुद्गाढकीसूपरसाश्च हृद्याः । खरोष्ट्रनागाश्वतराश्वजानि देयानि मांसानि सुकल्पितानि । मांसोपदंशांश्च पिबेदरिष्टान् माकयुक्तान् मदिराश्च सेव्याः ॥ ३५ ॥
Diet-meat, etc— The flesh of a crow or an owl or a mungoose or a cat or a Gandupada (earth-worm) or beast of prey ( Vyala) or of any animal of the Bilesaya rats or vultures should be given fried in mustard oil mixed with saindhava salt naming them with various eatable flesh, or flash of Jangala class mixed prescribed in various ways for a patient laid up with Phthisis. The diet may also consist of Mudga-soup or of adhaki-soup or of the flesh of an ass, camel, elephant, mule or horse variously prepared and well cooked. Meat in combination with any Arista as well as wine mixed with Madhvika may also be given. 34-35.
घृतेन अर्कामृताक्षारजलोषितेभ्यः कृत्वा यवेभ्यो विविधांश्च भक्ष्यान् । खादेत् पिबेत् सर्पिरजाविकं वा कृशो यवाग्वा सह भक्तकाले ॥ ३६॥ सर्पिर्मधुभ्यां त्रिकटु प्रलिह्याच्चव्याविडङ्गोपहितं क्षयातः । मांसादमांसेषु घृतञ्च सिद्धं शोषापहं क्षौद्रकणासमेतम् ॥ ३७॥ द्राक्षासितामागधिकावलेहः सक्षौद्रतैलः क्षयरोगघाती । तुरङ्गगन्धातिलमाषचूर्णम् ॥ ३८ ॥ घृतक्षौद्रयुतं प्रलिह्यात् । चाजेन समाक्षिकेण सिताश्वगन्धामगधोद्भवानां चूर्णं क्षीरं पिबेद् वाप्यथ वाजिगन्धा – विपक्कमेवं लभते च पुष्टिम् । तदुत्थितं क्षीरघृतं सिताढ्यं प्रातः पिबेद् वाऽपि पयोऽनुपानम् ॥ ३९ ॥
Various articles of food made of barley-grains previously soaked in the alkaline water duly prepared with Arka and Amrta may likewise be prescribed. Clarified butter skimmed off from the milk of a ewe or a she-goat, may be given with gruel at the meal-time to an extremely emaciated patient. A compound consisting of Tri-katu, Cavya and Vidanga made into a paste with honey and clarified butter should be given to be licked up by a patient suffering from phthisis. The use of a medicated clarified butter duly cooked with the essence of the flesh of any carnivorous animal and mixed with Pippali and honey as an afterthrow proves remedial in a case of Phthisis. A lambative consisting of Draksa, sugar and Magadhika pasted together with honey and oil proves efficacious as a cure for Phthisis. A case of Phthisis would yield to the use of a lambative consisting of Tila, Masa-pulse and Asvgandha ground to a fine paste with the addition of honey and clarified butter skimmed out of the milk of a she-goat, or of sugar, Asvagandha and Pippali pounded together and made into a fine paste with the addition of honey and clarified butter. Milk duly cooked with the admixture of Asvagandha may be prescribed as a constructive tonic. Butter skimmed out of the preceding preparation of milk and mixed with copious quantity of sugar should be taken, as an alternative, every morning and this should be then followed by a draught of milk. 36-39.
उत्सादने चापि तुरङ्गगन्धा योज्या यवाश्चैव पुनर्नवे च ॥ ४० ॥ कृत्स्ने वृषे तत्कुसुमैश्च सिद्धं सर्पिः पिबेत् क्षौद्रयुतं हिताशी । यक्ष्माणमेतत् प्रबलञ्च कासं श्वासञ्च हन्यादपि पाण्डुताञ्च ॥ ४१ ।।
Asvagandha, Punarnava and Yava should be used in rubbing (Utsadana) the body of the patient. Clarified butter duly cooked with (the decoction of) the whole of a Vasaka tree (viz.its roots, leaves, branches and barks) and with its flower (as Kalka) and mixed with an adequate quantity of honey¹ should be taken by a consumptive patient strictly conforming to the regimen of diet. Thus a virulent attack of Phthisis accompanied with cough, asthma and chlorosis would be speedily conquered. 40-41.
शकृद्रसा गोऽश्वगजाव्यजानां क्काथा मिताश्चापि तथैव भागैः । मूर्वाहरिद्राखदिरद्रुमाणां क्षीरस्य भागस्त्वपरो घृतस्य ॥ ४२ ॥ भागान् दशैतान् विपचेद् विधिज्ञो दत्त्वा त्रिवर्गं मधुरञ्च कृत्स्नम् । कटुत्रिकञ्चैव सभद्रदारू घृतोत्तमं यक्ष्मनिवारणाय ॥ ४३ ॥
A wise physician should take equal parts of clarified butter, milk, decoctions of Murva, Haridra and of Khadira and the expressed liquid of the dungs of a cow, a horse, an elephant, a she-goat and an ewe. Ten equal parts of the above ten articles should be duly boiled and cooked together with the Kalka of powdered Tri-katu, Tri-phala, Devadaru and the drugs of the sweet (Kakolyadi) group. This medicated clarified butter would be found highly beneficial in the cure of Phthisis (Yaksma). 42-43.
द्वे पञ्चमूल्यौ वरुणं करचं भल्लातकं बिल्वपुनर्नवे च । यवान् कुलत्थान् बदराणि भार्गी पाठां हुताशं समहीकदम्बम् ॥ ४४ ॥
1. This preparation is also found in the Caraka Samhita though in different language under the treatment of Rakta-pitta.
कृत्वां कषायं विपचेद्धि तस्य षड्भिर्हि पात्रैर्घृतपात्रमेकम् । व्योषं महावृक्षपयोऽभयाञ्च चव्यं सुराख्यं लवणोत्तमञ्च ॥ ४५ ॥ एतद्धि शोषं जठराणि चैव हन्यात् प्रमेहांश्च सहानिलेन ॥ ४६ ॥ गोऽश्वाव्यजेभैणखरोष्ट्रजातैः शकृद्रसक्षीररसक्षतोत्थैः । द्राक्षाश्वगन्धामगधासिताभिः सिद्धं घृतं यक्ष्मविकारहारि ॥४७॥
Six Patra measures of the duly prapared decoction of Dasamula, Varuna Karanja, Bhallataka, Bilva the two kinds of Punarnava, Yava, Kulattha, Badara, Bhargi, Patha, Citraka and Mahi-kadamba should be cooked with a Patra measure of clarified butter and with (the Kalka of) Vyosa ( Tri-katu ), the milk of Maha-vrksa (Snuhi), Abhaya, Cavya, Devadaru and Saindhava salt (D.R. Pippali). The medicated clarified butter thus prepared proves efficacious in cases of Phthisis, Ascites and Vataja-Prameha. Clarified butter duly cooked with the milk, blood, meat-soup and the expressed liquid of the dungs of a cow, a mare, an ewe, a she-goat, a cow elephant, a hind, a sheass and a she-camel and with the Kalka of Draksa, Asvagandha, Magadha and sugar proves extremely beneficial in cases of Phthisis. 44-47.
एलाजमोदामलकाभयाक्ष-गायत्र्यरिष्टासनशालसारान् । विडङ्गभल्लातकचित्रकोग्रा-कटुत्रिकाम्भोदसुराष्ट्रजांश्च ॥४८॥ पक्त्वा जले तेन पचेद्धि सर्पिस्तस्मिन् सुसिद्धे त्ववतारिते च । त्रिंशत्पलान्यत्र सितोपलाया दत्त्वा तुगाक्षीरिपलानि षट् च ॥ ४९ ॥ प्रस्थे घृतस्य द्विगुणञ्च दद्यात् क्षौद्रं ततो मन्थहतं विदध्यात् । पलं पलं प्रातरतः प्रलिह्यात् पश्चात् पिबेत् क्षीरमतन्द्रितश्च ॥ ५० ॥ एतद्धि मेध्यं परमं पवित्रं चक्षुष्यमायुष्यमथो यशस्यम् । यक्ष्माणमाशु व्यपहन्ति चैतत् पाण्ड्वामयञ्चैव भगन्दरञ्च ॥ ५१ ॥ श्वासञ्च हन्ति स्वरभेदकासहृत्प्लीहगुल्मग्रहणीगदांश्च । न चात्र किञ्चित् परिवर्जनीयं रसायनञ्चैतदुपास्यमानम् ॥ ५२ ॥
Eladi-mantha- A Prastha measure of clarified butter should be duly cooked with the decoction of Ela, Ajamoda, Amalaka, Abhaya, Aksa, Gayatri, Arista, Asana, Salasara, Vidanga, Bhallataka, Citraka, Ugra’, Tri-katu, Ambhada and Surastraja-earth. When duly cooked it should be taken down from the oven and thirty Pala weight of candied sugar, six-Pala-weight of Tuga-ksira (Vamsa-locana) and two-Prastha measure of honey should be added to it and stirred with laddle. A Pala weight of this preparation followed by a draught of milk should be given to be licked every morning to a Phthisical patient. The present elixir is possessed of ambrosial sanctity. The extent of its therapeutic application cures such diseases of the body as Phthisis, chlorosis, fistulain-ano, asthma, loss of voice, cough, troubles of the heart, enlarged spleen, Gulma and chronic diarrhoea or indigestion. It imparts longevity to a person using it, leads to the expansion of his intellectual faculities and tends to invigorate his eye-sight. It is the best of all rejuvenating preparations of our pharmacopea and no strict regimen of diet and conduct is required to be followed while it is used. 48-52.
प्लीहोदरोक्तं विहितञ्च सर्पिस्त्रीण्येव चान्यानि हितानि चात्र ॥ ५३ ॥ उपद्रवांश्च स्वरवैकृतादीन् जयेद् यथास्वं प्रसमीक्ष्य शास्त्रम् ॥ ५४॥ प्रतिसेवमानः । अजाशकृन्मूत्रपयोघृतासृङ्गमांसालयानि स्नानादिनानाविधिना जहाति मासादशेषं नियमेन शोषम् ॥ ५५ ॥ रसोनयोगं विधिवत् क्षयार्तः क्षीरेण वा नागबलाप्रयोगम् । सेवेत वा मागधिकाविधानं तथोपयोगं जतुनोऽश्मजस्य ॥५६॥
The medicated clarified butter mentioned under the treatment of Plihodara (dropsy of the abdomen owing to the enlargement of spleen Chapter XIII, Chikitsasthana) as well as the three others mentioned in that connection may be also used with advantage in the disease under discussion. The accompanying symptoms or complications such as hoarseness of voice, etc. should be remedied with appropriate medicines presented for those diseases in the Sastra. The patient should be made to use regularly the milk, butter, urine, blood, meat and the (expressed liquid of the) dung of a she goat as his bath or in any other way possible (e.g., in drinking) and to live in a goat-shed (in the company of goats) whereby he would be cured of his Phthisis in a month. A Phthisical patient should likewise be made to take Rasona (garlic) or Naga-bala or Magadhika or Silajatu with milk, in the prescribed manner (laid down in connection with the medical treatment of Maha-vata-Vyadhi). 53-56.
1. Cakradatta does not read Ugra in the list.
शोंकं स्त्रियं क्रोधमसूयनञ्च त्यजेदुदारान् विषयान् भजेत् । वैद्यान् द्विजातींस्त्रिदशान् गुरूंश्च वाचश्च पुण्याः शृणुयाद् द्विजेभ्यः ॥ ५७॥
Rules of conduct- He should not allow any grief, anger or jealousy to disturb the equilibrium of his mind, should lead a life of strict continence, deal in the discussion of sublime subjects and conform to the injunctions of his medical advisers or physicians. He should pay respects to the gods, superiors and Brahmanas and listen to the discussions of the spiritual truths from the lips of Brahmans. 57.
इति सश्रुत-संहितायामुत्तरतन्त्रे शोधप्रतिषेधव्याख्यानामैक चत्वारिंशोऽध्यायः ॥ ४१ ॥
Thus ends of the forty-first chapter of the Uttara Tantra in the Susruta Samhita which deals with the (symptoms and) treatment of Phthisis.