अथातः श्वयथुचिकित्सितं व्याख्यास्यामः । इतिह स्माहुरात्रेयादयो महर्षयः ।।१॥
We will now expound the Svayathu chikitsa- treatment of swelling/oedema/oedema/ anasarca; thus said Atreya and other great sages. ( 1 )
SVAYATHU CHIKITSA – Treatment of Oedema – Sotha Chikitsa
श्वयथुषु दोषजेषु सर्वेशु सर्वसरेष्वामानुबद्धेषु लङ्घन पाचनशोधनान्यादौ योजयेत् । स्नेहजेषु विरूक्षणान्यौषधानि विरूक्षणोत्थेषु स्नेहनानि । तत्रामजेषु लङ्कितवतो लध्वन्नमशिनस्य भद्रदारुनागरमरिचप्रतिविषाविडङ्गेन्द्रयवानुष्णाम्बुना | नागरदेवदारुपथ्यावर्षाभ्वोवा । पञ्चकोलकाजाजीनिदिग्धिकामुस्तपाठारजनीर्वा | मूत्रवर्ति वा नवायसं वा । गुरुभिन्नपुरीषस्तु तक्रं सव्योषसौवर्चलक्षौद्रम् | गुडहरीतकीं वाशीलयेत् ॥ २ ॥
For oedema produced by the doshas, which are found all over the body, and which are associated with ama, therapies such as langhana (fasting and other thinning therapies), pacana (digestive) and sodhana (purificatory therapies like purgation, emesis etc) should be administered in the beginning itself. That (oedema) produced by the use of unctous substances (fatty foods etc) should be treated with drugs which are ruksa (non-unctous), that (oedema) produced by dry substances (non-fatty, moistureless foods etc) should be treated with drugs which are snehana (unctous). In that (oedema) produced by ama, the patient should be made to fast, allowed very light foods and drink warm water mixed with (powder of) bhadradaru, nagara, maricha, prativisa, vidanga and indrayava, or of nagara, devadaru, patha, varsabhu or of panchakola, ajaji, nidigdhika, musta, patha and rajani; or make use of mutravarti (described in the treatment of udararoga) or navayasa (described in the treatment of panduroga).
If the faeces is sound to be heavy ( and so containing ama) and broken (watery) he should use takra (buttermilk) mixed with vyosa, sauvarchala and ksaudra (honey) or make use of guda (jaggery) and haritaki mixed together. (2)
इतरस्त्रिवृत्त्र्भूषणकटुरोहिण्ययश्चूर्णानि त्रिफूलाक्वाथेन । व्योषयवक्षारायोरजांसि वा । बिभीतककल्कं वा तण्डुलाम्बुना । गुग्गुलुं वा गोमूत्रेण । हरीतकीं वा । तुल्यगुडां वा शुण्ठीं पुनर्नवकषायानुपानाम् । आर्द्रकं वा तुल्यगुडमर्धपलाभिवृद्धं पञ्चपलप्रकर्षंप्रयुञ्जीत | मासमयं प्रयोगः शोफशोषार्श: श्वासकासप्रसेकपीनसालसकाग्निसादगुल्मोदरप्रमेहपाण्डुकामलामनोविकारानपहरति । आर्द्रकरसं वा शालिक्षीराहारः पिबेत् || ३ ||
If otherwise, faeces being light and solid; powder of trivrit, trayusana, katurohini and ayas curna (iron filings) should be consumed along with decoction of triphala; or powder vyosa, yavakshara and ayoraja (iron filings); or make use of paste of vibhitaka along with rise-wash; or guggulu with cowsurine or haritaki (with cows urine) or equal parts of guda (jaggery) and suntthi followed by decoction of punarnava as after-drink.
Equal parts of ardraka and guda (jaggery) taken by increasing its dose by half pala each day, till a maximum of five pala is reached and continued for one month; this recipe, thus followed, cures oedema, consumption, piles, dyspnoea, cough, salivation, nasal catarrah, indigestion, weak digestion, abdominal tumor, enlargement of the abdomen, diabetes, anaemia, jaundice and disorders of the mind. (3)
निवृत्तामदोषः शृतानि पयांसि सपषिच । त्रिकटुकैरण्डश्यामामूलैः सिद्धं क्षीरम् । महौषधमुरुङ्गीमूलाभ्यां वा । वर्षाभूमयूरकपञ्चकोलैर्वा । कुम्भनिकुम्भव्योषाग्निकैर्वा करभीक्षीरवृत्तिर्वा स्यात् गोमूत्रं महिषीमूत्रं वा सक्षीरं क्षीराशनः पिबेत् ॥ ४ ॥
Drinking fresh juice of ardraka, keeping on a diet of rice and milk (is also beneficial).
After the symptoms of amadosha have disappeared, he should drink boiled milk mixed with medicated ghee recipes, or drink milk boiled with trikatu, eranda mula and syama mula or with mahausadha and murangimula (murva mula); or with varsabhu, mayuraka; and panchamula; or with kumbha, nikumbha, vyosa and agnika. He should make use of camels milk habitually, or drink urine of either cow or buffalo mixed with milk and indulge in milk only as diet. ( 4 )
दाडिमयवानीयवानक धनिकापाठाम्लवेतसमरिचपञ्चकोलबिल्वफलयावशूकानक्षमात्रान् सलिलाढके विपाच्य तत्कषायेण घृतप्रस्थं साधयेच्छोफार्शोगुल्ममेहाग्निसादहरम् । अर्शोविहितविधिनाचित्रकदनोनवनीतमाददीत | तच्चित्रकमूलगर्भंसचित्रककल्कतक्रसिद्धं समानंपूर्वेण ॥५॥
One aksa each of dadima, yavani, yavanaka, dhanika, patha, amlavatasa, maricha, panchakola, bilvaphala and yavasuka- are boiled in one adhaka of water (and decoction reduced to a quarter); to this is added one prastha of ghrta (ghee) and medicated ghee prepared; this cures oedema, piles, abdominal tumors, diabetes, dyspepsia.
Butter should be prepared from the chitraka dadhi described in the treatment of arsas (chapter 10); this should be boiled with (decoction of) citramula, paste of citramula and takra (buttermilk) and medicated ghee prepared) this is similar to the earlier recipe (in action). (5)
यथादोषोच्छ्रयं चं धान्वन्तरं कल्याणकं पञ्चगव्यं तिक्तं महातिक्तमुदरोक्तानि वा तिल्वकचतुर्थानिघृतानिपाययेत् ॥६॥
Depending on the predominant dosha, medicated ghee such as dhanvantara (described in the treatment of prameha) kalyanaka (described in the treatment of unmada) panchagavya (in apasmara), tiktaka, mahatiktaka (as in kustha ), the four kinds of tilvaka ghrta described in the treatment of udara should be given to drink. (6) Dashamoola haritaki leha
दशमूलक्काथकंसे पथ्याशतं गुडतुलोन्मिश्रमधिश्रयेत् । लेहीभूते तत्र त्रिकटुकत्रिजातकयवक्षारचूर्ण प्रक्षिपेत् क्षौद्रार्धप्रस्थं च । एता दशमूलहरीतक्योऽतिप्रवृद्धमपि श्वयथुमुदरारोचकाविपाकपाण्डुरोगगुल्ममेहश्वासकासकार्यामवाताम्लपित्तमूत्रशुक्रदोषांश्चनिघ्नन्ति ॥७॥
One hundred (by count) of pathya is cooked in one kamsa of decoction of dashamoola, added with one tula of guda (jaggery); when the mass attains the consistence of a confection, powder of trikatu, trijataka and yavakshara and half a prastha of ksaudra (honey) are added (and taken out of the oven and preserved). This recipe – Dashamoola haritaki (leha) cures even greatly advanced oedema, enlargement of the abdomen, anorexia, indigestion, anaemia, abdominal tumor, diabetes, dyspnoea, cough, emaciation, rheumatism, amlapitta (hyperchlorhydria.gastritis) and disorders of urine and semen. (7)
शठीपुष्करमूलकारवीचित्रकाजाजीजीवन्तीबिल्वमध्ययवक्षारवृक्षाम्लैर्दशमूलेन च परिगृहीतानि घृततैलभृष्टानि पेयादीन्यन्नान्यल्पस्नेहलवणान्युपकल्पयेत् । स्वर्शसुखांश्चाभ्यङ्गप्रदेहसेकान् ॥ ८ ॥
Peya (thin gruel) and other kinds of diets should be processed with drugs such as sathi, puskaramula, karavi, chitraka, ajaji, jivanti, bilvamadhya, yavakshara, vrikshamla, dashamoola; they should be used with very little of fats and salt. Oil, massage, poultices and fomentations which are comfortable to touch should be adopted. (8)
शैलेयस्थौणेयक श्रीवेष्टकागरुदेवदारुहरेणुकाकुष्ठध्यामकपद्मकमांसीमागधिकावन्यधान्यतालीसपत्रक चतुर्जातकपलाशाम्बुदाम्बुप्रियङ्गुस्पृक्वानखैः शुक्ष्णपिष्टैस्तैलमभ्यङ्गं पचेत् । तैश्च प्रदेहं कुर्यात् । सर्षपसौवर्चलसैन्धवशाङ्गेष्टाभिश्च । केवलैर्वाक्षमज्जाभिः ।। ९ ।।
Oil for external application and bath should be prepared with nice paste of saileya, sthauneyaka, Srivestaka, aguru, devadaru, harenuka, kustha, dhyamaka, padmaka, mamsi, magadhika, vanyadhanya, talisapatraka, caturjataka, palasa, ambuda, ambu, priyangu, sprikka and nakha; warm paste/poultice prepared from these drugs can also be applied; or those prepared from sarsapa, sauvarchala, saindhava and sarngestha or that prepared with only the marrow of aksa ( can also be applied). (9)
विशेषतश्चैकाङ्गजेषु पुनर्नवहिंस्त्राकोशातकीकरवीरकिंशुकातिविषर्धिवृद्धिमूषिकपर्णीहस्तिकर्णनलिकानाकुलीस्थूलकाकादनीसालत्रिफलादेवदारुलोध्रतालपर्णीदशपत्रिकाजयन्तीभिः प्रलेपः ॥ १० ॥
Especially, if the oedema ( swelling ) is confined to any one part of the body, application of a paste of punarnava, himsra, kosataki, karavira, kimsuka, ativisa rddhi, vruddhi, musakaparni, hastikarna, nalika, nakuli, sthulakakadani, sala, triphala, devadaru, lodhra, talaparni, dasapatrika, jivanti (is especially beneficial). (10)
मूलकतोयेन कवोष्णेन वृक्षकार्कनक्तमालनिम्बवर्षाभूक्काथेन वास्नानम् ॥ ११ ॥
The patient should take bath in warm water boiled with mulaka, or with the decoction of viksaka, arka, naktamala, nimba or varsabhu. ( 11 )
Vataja sotha chikitsa
अथानिलजे श्वयथौ त्रिवृतमेरण्डतैलं वार्धमासं मासं वा पिबेत् । एरण्डतैलमेव च विड्वातसङ्गे प्राग्भक्तं पयसा रसैर्वा । वातहराभ्यङ्गस्वेदोपनाहांश्च कुर्यात् । विशेषेण चैकाङ्गगे मातुलुङ्गाग्निमन्थशुण्ठीदेवदारुहिंस्त्राप्रलेपः ॥ १२ ॥
In oedema produced by vata, the patient should drink trivrit (quatha) or eranda taila for either half-a-month or one month; if there is obstruction to movement of faeces or flatus, only eranda taila along with either milk or meat juice should be taken before food; oil massage, sudation and warm poultices, which subdue vata, should be adopted; if the oedema is confined to any one part only, then (warm) application of paste of matulunga, agnimantha, sunthi, devadaru and himsra should be done. (12)
Pittaja sotha chikitsa
पित्तजेन्यग्रोधादिसिद्धं सर्पिः पिबेत् | तिक्तकं वा । मूर्छारतितृड्दाहेषु क्षीरम् । तदेव तुस्रंसनार्थी मूत्रयुक्तम् । अभयामरदारुमधुककटुकादन्तीचन्दननिचुलपटोलमूर्वादार्वीत्रायमाणोपकुल्याविशालाक्वाथ: ससर्पिरुपयुक्तः श्वयथुविषवीसर्पज्वरदाहपिपासान्तः सन्तापसन्निपातानुपशमयति । घृतक्षीरक्षीरिवृक्षवेतसमञ्जिष्ठामृणालचन्दनादिभिः शीतवीर्यैः कल्पयेदभ्यङ्गादीन् ॥१३॥
In oedema produced by pitta, the patient should drink ghee medicated with drugs of nyagrodhadi gana (chapter 16 of sutrasthana) or drink tiktaka ghrta; if there is fainting, restlessness, thirst and burning sensation, he should drink only milk; in order to get the soft movement of faeces, it (milk) should be used mixed with cows urine, decoction of abhaya, patola, murva, darvi, trayamana, upakulya and visala, added with ghee, relieves oedema, poison, herpes, fever, burning sensation, thirst, internal exhaustion and toxicity caused by combination of all the doshas; oil for massage etc should be prepared with substances of cold potency such as ghee, milk, ksirivriksha (trees yeilding milky sap) vetasa, manjista, mrunala, chandana etc. ( 13 )
Kaphaja sotha chikitsa
कफोत्थे त्वारग्वधादिसाधितं तैलं पिबेत् । क्षारमूत्रतक्रासवारिष्टांश्च । भल्लातकचित्रकव्योष
विडङ्गबृहतीफलानि पृथक् प्रस्थांशान्यच्छधान्याम्लद्रोणे गोमयाग्निना त्रिभागशेषमवतारयेत् । तत्पूतशीतं मस्तुकलशेन सितोपलातुलया च युक्तमग्निकमागधिकाकल्कलिप्ते दृढे भाण्डे समावाप्य वैहायसे सुगुप्तं स्थापयेत् । ततो दशाहस्थितोऽयमुपयुक्तो भल्लातकारिष्टः शोफोदरार्शोभगन्दरग्रहणीकृमिकुष्ठमेहकार्श्यकिक्सान्सत्वरमपनयति ।।१४।।
In oedema produced by kapha, the patient should drink oil medicated with drugs of aragvadhadi gana (chapter 16 of sutrasthana) and solution of) alkalies, cows urine, buttermilk, fermented infusions and decoctions.
Bhallatakarista
One prastha each of bhallataka, chitraka, vyosa, vidanga and brihati phala are put into one drona of clear (filtered) dhanyamla (gruel prepared from grains and fermented), cooked over fire of (dry) cowdung, and taken out when the quantity gets reduced to onethird. It is then mixed with one kalasa (drona) of mastu (whey), one tula of sitopala (sugar candy) and the entire mixture filled into a strong mud pot which has been coated in its interior with a paste of agnika and magadhika. The pot is kept in an open space and used after tendays.This recipe Bhallatakarista – quickly cures oedema, abdominal enlargement, rectal fistula, duodenal disease, parasites, leprosy ( and other skin disease) diabetes, emaciation and kikkasa (stretching of the skin). (14)
Astasatarista
त्रिफलामरिचद्राक्षापिप्पलीकाश्मर्यफलानां प्रत्येकं शतं गुडतुलामुदकद्रोणं च मधुलिप्तभाजनस्थं सप्ताहमुष्णे काले द्विसप्ताहं शीते धारयेत् । अयमष्टशतारिष्ट: समान: पूर्वेण । पुराणपिण्याककृष्णाशिग्रुत्वगतसीसिकता मूत्रपिष्टाः सुखोष्णाः प्रलेपे दद्यात् । एकाङ्गगे तु कालासरलाजशृङ्गयजगन्धाश्वगन्धैकैषिकाः । शुण्ठीकुलत्थतर्कारीकुष्ठार्जकचित्रकजलमूत्राणि स्नाने । चण्डागरुणीविलेपने ॥ १५ ॥
One hundred pala each of triphala, maricha, draksa, pippali, and kasmaryaphala made into decoction and added with one tula of guda (jaggery), mixed with one drona of water, filled into a jar smeared in its interior with honey and kept undisturbed for seven days in hot season, and for fifteen days in cold season, and then made use of. This formula Astasatarista- is similar ( in action) with the earlier (recipe).
The body should be given a warm coating with the paste of old pinyaka (oil cake), bark of krsna sigru, atasi, and sikata macerated with cows urine.
In case the swelling is in any one part, the paste should be of kala, sarala, ajasrngi, ajagandha, ashwagandha and ekaisika; sunthi, kulattha, tarkari, kustha, arjaka, chitraka and cows urine (should be used for preparing the water for bath), powder of canda and aguru used for vilepana (anointing). (15)
संसर्गसन्निपातयोर्यथादोषोदयमिदमेव साधनम् । एकदेशाश्रये च श्वयथौ यथासन्नं वमनादीनि रक्तावसेचनं च कुर्वीतेति । भवति चात्र ॥ १६ ॥
For oedema arising from the combination of two dosha and from all the three the treatment should be as suitable to the predominant dosha.
In case the oedema is confined to any one part, emesis and other therapies and blood letting should be done (to eliminate the doshas from the nearest route). (16)
प्रायोऽभिघातादनिलः सरक्तः शोफं सरागं प्रकरोति तत्र । विसर्पनुन्मारुतरक्तनुच्चार्यं विषघ्नं विषजेच कर्म ॥१७॥
Generally, in trauma, vata associated with rakta (blood) produces swelling of red colour. This should be treated with therapies which mitigate visarpa (herpes), vata and rakta. In case of swelling due to poison, antipoisonous therapies should be administered. (17)
ग्राम्याब्जानूपंपिशितमबलं शुष्कशाकं तिलान्नं | गौडं पिष्टान्नं दधिसलवणं पिच्छिलं मद्यमम्लम् ।। धाना वल्लूरं समशनमथो गुर्वात्म्यं विदाहि | स्वप्नं चारात्रौ श्वयथुगदवान् वर्जयेन्मैथुनं च ।। १८ ।।
The patient suffering from oedema, should abstain from, meat of domestic and aquatic animals, of those living in marshy regions, and of those which are debilitated; dry vegetables, mess prepared from tila, guda ( jaggery) and pista (flour); curds, salts, food which are slimy, alcoholic drinks which are sour, dhana (fried barley), vallura (dry meat ) samasana (foods which is a mixture of both suitable and unsuitable things) foods which are hard to digest, unaccustomed and which cause burning sensation inside during digestion; sleep other then at nights and sexual intercourse. (18)
।। इतिएकोनविंशोऽध्यायः ॥
Thus ends the Ninteenth chapter.
