अष्टचत्वारिंशोऽध्यायः अथातस्तृष्णाप्रतिषेधमध्यायं व्याख्यास्यामः, धन्वन्तरिः ॥ १ ॥ यथोवाच भगवान्
Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of thirst ( Trishna- Pratisedha Adhyaya). 1
सततं यः पिबेद् वारि न तृप्तिमधिगच्छति । पुनः काङ्क्षति तोयञ्च तं तृष्णार्दितमादिशेत् ॥ २ ॥
He who is not satisfied even with the constant drinking of water but craves for more and more water should be regarded as afflicted with the disease known as thirst ( morbid desire for water ). 2
Etiology of Thrist
संक्षोभशोकश्रममद्यपानाद्रूक्षाम्लशुष्कोष्णकटूपयोगात् । धातुक्षयाल्लङ्घनसूर्यतापात् पित्तञ्च वातश्च भृशं प्रवृद्धौ ॥ ३ ॥ स्रोतांसि संदूषयतः समेतौ यान्यम्बुवाहीनि शरीरिणां हि । स्रोतःस्वपांवाहिषु दूषितेषु जायेत तृष्णाऽतिबला ततस्तु ॥ ४ ॥
Etiology – The Pitta and Vayu of the body become extremely aggravated by such factors as (excessive) exercise, grief (or any violent mental agitation), fatigue, drinking, use of any extremely dry, acid, hot or pungent fares, or of those which cause a parched condition in the organism, or waste of any vital organic principle (Dhatu) of the body, fasting or exposure to the sun, and combinedly affect the water carrying channels of the body (diminish the liquid portion of the bodily lymph-chyle). The water-carrying channels thus affected give rise to violent thirst. The disease is divided into seven types. 3-4.
Classification of Trishna
तिस्त्रः स्मृतास्ताः क्षतजा चतुर्थी क्षयात् तथाऽन्याऽऽमसमुद्भवा च । स्यात् सप्तमी भक्तनिमित्तजा च निबोध लिङ्गान्यनुपूर्वशस्तु ॥ ५॥
Classification – The first three are due to the actions of the deranged Dosas ( Vayu, Pitta and Kapha ). The fourth and fifth are respectively incidental to any injury and to the waste of any of its fundamental organic principles. The sixth is due to the presence of undigested eatable matter in the intestines (lit, mucus) and the seventh is due to errors in diet. Now hear me describing their specific symptoms and the therapeutic agents to be employed in curing them. 5.
ताल्वोष्ठकण्ठास्यविशोषदाहाः सन्तापमोहभ्रमविप्रलापाः । पूर्वाणि रूपाणि भवन्ति तासामुत्पत्तिकालेषु विशेषतो हि ॥ ६ ॥
Premonitory Symptoms – An extreme dryness and a burning sensation in the palate, throat, lips and mouth, external heat, vertigo, loss of consciousness, and delirium are the general premonitory symtoms which usher in an attack of the disease. The specific symptoms are given below. 6.
Symptoms of Vataja, Pittaja and Kaphaja Thirst
शुष्कास्यता मारुतसम्भवायां तोदस्तथा शङ्खशिरःसु चापि । स्त्रोतोनिरोधो विरसञ्च वक्त्रं शीताभिरद्भिश्च विवृद्धिमेति ॥ ७ ॥ पीतेक्षणत्वं पीतेक्षणत्वं प्रततश्च दाहः । मूर्च्छाप्रलापारुचिवक्त्रशोषाः शीताभिकाङ्क्षा मुखतिक्तता च पित्तात्मिकायां परिधूपनञ्च ॥ ८ ॥ कफावृताभ्यामनिलानलाभ्यां कफोऽपि शुष्कः प्रकरोति तृष्णाम् । निद्रा गुरुत्वं मधुरास्यता च तयार्दितः शुष्यति चातिमात्रम् ॥ ९॥ कण्ठोपलेपो मुखपिच्छिलत्वं शीतज्वरच्छर्दिररोचकश्च । कफात्मिकायां एतानि रूपाणि गुरुगात्रता च शाखासु शोफस्त्वविपाक एव । भवन्ति तस्यां तयार्दितः काङ्क्षति नाति चाम्भः ॥ १० ॥
Symptoms of Vataja, Pittaja and Kaphaja Thirst — Dryness of the mouth with a tingling sensation in the regions of the temples, and the head (D.R.-throat), obstruction of the (water-carrying) channels of the body and a bad taste in the mouth, are the symptoms which specificaHy mark a case of the Vataja type in which the drinking of cold water leads to a distinct aggravation of the disease (thirst). Loss of consciousness (epileptic fits), delirium, an aversion to food, dryness of the mouth, yellowness of the eyes, extreme burning sensation in the whole body, desire for coldness, a bitter taste in the mouth and a fumid sensation (in the throat) are the features which specifically mark the Pittaja type of the disease. The vapours produced by the fire of digestion being enveloped and obstructed in their course by the layer of accumulated Kapha, the heat (sent up in the body tends to dry up the moisture of its water-carrying channels and) produces a kind of thirst which is characterised by somnolence, a sense of heaviness in the limbs, a sweet taste in the mouth, extreme emaciation, cold-fever, vomiting, an aversion to food, sliminess in mouth, Oedema in limbs and indigestion are the symptoms of Kaphaja type. And where such symptoms are present, the patient has no excessive desire for drinking water. 7-10.
Ksataja and Ksayaja Thirst
क्षतस्य रुक्शोणितनिर्गमाभ्यां तृष्णा चतुर्थी क्षतजा मता तु । तयाऽभिभूतस्य निशादिनानि गच्छन्ति दुःखं पिबतोऽपि तोयम् ॥ ११ ॥ रसक्षयाद् या क्षयजा मता सा तयाऽर्दितः शुष्यति दह्यते च । अत्यर्थमाकाङ्क्षति चापि तोयं तां सन्निपातादिति केचिदाहुः ॥ १२ ॥ रसक्षयोक्तानि च लक्षणानि तस्यामशेषेण भिषग् व्यवस्येत् ॥ १३ ॥
Ksataja and Ksayaja Thirst — A case of thirst which is engendered in consequence of pain or discharge of blood from any cut in the body is the fourth type and is known as Ksataja thirst. The days of the patient in such a case pass with great uneasiness even if he drinks water. In the type due to the waste of the fundamental organic fluid (Rasa) which is known as Ksayaja thirst, the patient constantly drinks water in large quantity both in the day and in the night but still finds no relief. This type is attributed by several authorities to the concerted action of the three deranged Dosas and all the specific symptoms due to the waste of the vital organic principle (Rasa) described before are exhibited there. 11-13.
Amaja and Annaja Thirst
त्रिदोषलिङ्गाऽऽमसमुद्भवा च हृच्छूलनिष्ठीवनसादयुक्ता ॥ १४ ॥ स्निग्धं तथाऽम्लं लवणञ्च भुक्तं गुर्वन्नमेवाति तृषां करोति ॥ १५ ॥
Amaja and Annaja Thirst – The symptoms of all the three (aggravated) Dosas in addition to pain in the heart, spitting and a sense of lassitude in the limbs are present in the type which is due to indigestion (Amaja). The case of thirst which is produced by using extremely fatty and saline articles of fare, as well as those which are hard to digest or due to errors in diet (and is known as Annaja thirst).14-15.
Prognosis of Trishna
क्षीणं विचित्तं बधिरं तृषार्तं विवर्जयेन्निर्गतजिह्वमाशु ॥ १६ ॥
Prognosis – A patient who has become extremely weak and deaf in consequence of thirst and who suffers from a mental stupour and lies with his tongue protruded and hung down should not be taken into charge of (by a physicaian) treatment. 16.
General Treatment of Trishna
तृष्णाभिवृद्धावुदरे च पूर्णे तं वामयेत् मागधिकोदकेन । विलोभनञ्चात्र हितं विधेयं स्याद् दाडिमाम्रातकमातुलुङ्गैः ॥ १७ ॥ तिस्त्रः प्रयोगैरिह सन्निवार्याः शीतैश्च सम्यग्रसवीर्यजातैः ॥ १८ ॥ गण्डूषमम्लैर्विरसे च वक्त्रे कुर्याच्छुभैरामलकस्य चूर्णैः ॥ १९ ॥ सुवर्णरूप्यादिभिरग्निष् कृतं वा सिकतादिभिर्वा । जलं सुखोष्णं शमयेत्तु तृष्णां सशर्करं क्षौद्रयुतं हिमं वा ॥ २० ॥
General Treatment – Vomiting should be induced with solution of powdered Pippali in a case of thirst in which the stomach of the patient becomes fully loaded (with water). A plaster composed of Dadima, Amrataka and Matulunga is also beneficial. Drugs which are cooling in their virtue and potency should be applied in the thre cases of thirst (due to the three Dosas). A gargle composed of a solution of powdered Amalaka with any acid drug (Matulunga etc.) should be retained in the mouth for removing the bad taste in the mouth under the circumstances. Water made hot by immersing bits of heated gold, silver, etc. as well as pieces of heated stone or baked clay in it and taken in a tepid state, or cold water charged with sugar and honey, is possessed of the efficacy of allaying thirst. 17-20.
Specific Treatment of Trishna
पञ्चाङ्गिकाः पञ्चगणा च उक्तास्तेष्वम्बु सिद्धं प्रथमे गणे वा । पिबेत् सुखोष्णं मनुजोऽचिरेण तृषो विमुच्येत हि वातजायाः ॥ २१ ॥पित्तघ्नवर्गैस्तु कृतः कषायः सशर्कर: क्षौद्रयुतः सुशीतः । पीतस्तृषां पित्तकृतां निहन्ति क्षीरं शृतं वाऽप्यथ जीवनीयैः ॥ २२ ॥ बिल्वाढकीकन्यकपञ्चमूली-दर्भेषु सिद्धं कफजां निहन्ति । हितं भवेच्छर्दनमेव चात्र तप्तेन निम्बप्रसवोदकेन ॥ २३ ॥
Specific Treatment – A patient suffering from Vataja thirst would find relief quickly by taking lukewarm decoction boiled with the drugs of any of the Panca-mula groups or with the drugs of the first group (Vidari-gandhadi-gana ). A decoction of the drugs of the Pitta-subduing groups² subsequently cooled and taken with the addition of honey and sugar or milk duly boiled with the admixture of the drugs of the Jivaniya group (Kakolyadi Gana) would allay a case of Pittaja thirst. Water duly boiled with Bilva, Adhaki the drugs of the KantakaPanca-mula³ and Darbha allays a case of Kaphaja thirst. Vomiting induced with the help of the decoction of tender Nimba-leaves taken lukewarm would likewise prove curative in such a case. 21-23.
सर्वासु तृष्णास्वथवाऽपि पैत्तं कुर्याद् विधिं तेन हि ता न सन्ति ॥ २४ ॥ पर्यागतोदुम्बरजो रसस्तु सशर्करस्तत्वथितोदकं वा । वर्गस्य सिद्धस्य च सारिवादेः पातव्यमम्भः शिशिरं तृषार्तैः ॥ २५ ॥
The Pitta-subduing remedies and measures should, in the alternative, be applied in all types of thirst which cannot otherwise be allayed. The expressed juice or a decoction of ripe Udumbara should be taken with sugar under the circumstances. A thirst-afflicted patient should likewise drink the water duly boiled with the drugs of the Sarivadi group sufficiently cooled down for the purpose. 24-25.
कशेरुशृङ्गाटकपद्ममोच-विसेक्षु सिद्धं क्षतजां निहन्ति ॥ २६ ॥
1. The five Panca-mula groups are (I) The major Panca-mula, (2) The minor Pancamula, (3) The Valli Panca-mula (4) The Kantaka-Panca-mula, (5) The Trna Paricamula. See Chap. XXXVIII, Sutra Sthana.
2. The Pitta-subduing groups are Utpaladi, Sarivadi and Kakolyadi groups. 3. In place of ‘‘कण्टकपञ्चमूली, etc.” some read “कण्टकपञ्चकील” etc. i.e. Kantaka (Goksura) and the drugs included in the group known as “पञ्चकील”, viz Pippali, Pippali-mula, Cavya, Citraku and Nagara. The commentator Kartika Kundu supports this— Dalhana for kantaka Panca-mula, see Chap. XXXVIII-Sutra-Sthana.
लाजोत्पलोशीरकुचन्दनानि दत्त्वा प्रवाते निशि वासयेत्तु ॥ २७ ॥ तदुत्तमं तोयमुदारगन्धि सितायुतं क्षौद्रयुतं वदन्ति । द्राक्षाप्रगाढञ्च हिताय वैद्यस्तृष्णार्दितेभ्यो वितरेन्नरेभ्यः ॥ २८ ॥ ससारिवादौ तृणपञ्चमूले तथोत्पलादौ प्रथमे गणे च । कुर्यात् कषायञ्च यथेरितेन मधूकपुष्पादिषु चापरेषु ॥ २९ ॥ राजादनक्षीरिकपीतनेषु षट् पानकान्यत्र हितानि च स्युः ॥ ३० ॥ सतुण्डिकेरीण्यथवा पिबेत्तु पिष्टानि कार्पाससमुद्भवानि । क्षतोद्भवां रुग्विनिवारणेन जयेद्रसानामसृजश्च पानैः ॥ ३१ ॥
Water duly boiled with Kaseru, Srngataka, Padma, Moca (plantain-flower), Visa and sugar cane is efficacious in allaying thirst incidental to hurt (Ksataja). Water containing parched paddy, Nilotpala, Usira and red Candana should be kept in an open space during the night and a physician should give this well-scented water mixed with sugar and honey and with a large quantity of Draksa to the thirst afflicted patients on the following morning for their benefit. Cold infusions of the drugs of any of the Trnapanca-mula, Utpaladi and Madhura (D. R. the first group i.e., Vidarigandhadi) groups mixed with the drugs of the Sarivadi group as well as that of the drugs of the Madhuka-puspadi group should be prepared in the preceding manner and prescribed. The six kinds of cordials (Panaka) separately prepared (in the preceding manner) with the (four kinds of ) Rajadana, Ksiri or Kapitana are also beneficial in such cases. Fruits of Tundikeri (wild Karpasa) and of Karpasa pasted together (and dissolved in water) and taken internally would prove beneficial. A case of thirst incidental to any ulcer (Ksataja) is allayed with the stoppage or removal of the pain or by taking meatsoup or the blood (of deer, goat, etc.) 26-31.
क्षयोत्थितां क्षीरघृतं निहन्यान्मांसोदकं वा मधुकोदकं वा ॥ ३२ ॥ आमोद्भवां बिल्ववचायुतैस्तु जयेत् कषायैरथ दीपनीयैः । आम्रातभल्लातबलायुतानि पिबेत् कषायाण्यथ दीपनानि ॥ ३३ ॥ गुर्वन्नजातां वमनैर्जयेच्च क्षयादृते सर्वकृताञ्च तृष्णाम् ॥ ३४ ॥
A case of thirst due to the waste (Ksayaja) of any fundamental organic fluid (Rasa) is removed by taking draughts of clarified butter churned from milk’, as well as those of meat-soup and infusion of Yasti-madhu. Thirst which is incidental to the presence of mucus and undigested fecal matter in the intestines (Amaja) should be remedied with the decoction of Bilva, Vaca and the drugs of the Dipaniya (Pippalyadi) group or with the decoction of the drugs of the Dipaniya group mixed with Amrataka, Bhallataka and Bala. The type which has its origin in the use of heavy and indigestible fares or due to errors in diet as well as all other types of thirst with the exception of the one which is incidental to the waste of any fundamental organic principle should be cured by inducing vomiting. 32-34.
श्रमोद्भवां मांसरसो निहन्ति गुडोदकं वाऽप्यथवाऽपि मन्थः ॥ ३५ ॥ भक्तोपरोधात् तृषितो यवागूमुष्णां पिबेन्मन्थमथो हिमञ्च ॥ ३६ ॥ या स्नेहपीतस्य भवेच्च तृष्णा तत्रोष्णमम्भः प्रपिबेन्मनुष्यः | मद्योद्भवामर्धजलं निहन्ति मद्यं तृषां याऽपि च मद्यपस्य ॥ ३७॥ उ – ( तृ )ष्णोद्भवां हन्ति जलं सुशीतं सशर्करं सेक्षुरसं तथाऽम्भः ॥ ३८ ॥
Solution of common treacle or Mantha or meatsoup are efficacious in allaying thirst which is due to physical fatigue. Warm Yavagus or cold Manthas² would alleviate a thirst caused by the obstruction of the participated meal. A man should drink warm water in cases of thirst due to an excessive taking of any fatty substance (Sneha). The thirst of a habitual drunkard is removed by taking halfdiluted wine. Thirst due to heat, may be allayed with draughts of cold water surcharged with sugar or with the expressed juice of sugarcane. 35-38.
स्वैः स्वैः कषायैर्वमनानि तासां तथा ज्वरोक्तानि च पाचनानि ॥ ३९ ॥ लेपावगाहौ परिषेचनानि कुर्यात् तथा शीतगृहाणि चाऽपि । संशोधनं क्षीररसौ घृतानि सर्वासु लेहान् मधुरान् हिमांश्च ॥ ४० ॥
1. In places of ‘‘ क्षौरघृतं” “मांसोदक” and “मधुकीदकं” some read ‘क्षौरजलं” (milk mixed with water), “माषीदकं” (soup of Masa pulse) and मधूदकं ( honey mixed with water) respectively.
1. Warm Yava should be prescribed in cases where Vayu preponderates and cold Mantha in cases where Pitta preponderates.
General Treatment – Vomiting should be induced in these cases with the decoction of such drugs as are remedial to the deranged bodily Dosas involved in each case and the digestive (Pacana) remedies as prescribed in cases of fever should also be prescribed in these cases. Use of cooling plasters and of cold baths and spray, residence in cold chambers, exhibition of emetics and purgatives, use of milk, meatessence, clarified butter and sweet and cooling lambatives would be likewise prescribed in all cases of thirst. 39-40.
इति सुश्रुत संहितायामुत्तरतन्त्रे तृष्णाप्रतिषेधव्याख्यानामाष्टचत्वारिंशोऽध्यायः ॥ ४८ ॥
Thus ends the forty-eight chapter of the Uttra-Tantra in the Susruta Samhita which deals with the (symptoms and) treatment of thirst.