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Sushruta SamhitaChikitsasthanaVata Vyadhi Chikitsa - Treatment of nervous disorders - Sushrutasamhita Chikitsasthana Chapter...

Vata Vyadhi Chikitsa – Treatment of nervous disorders – Sushrutasamhita Chikitsasthana Chapter 4

चतुर्थोऽध्यायः । अथातो वातव्याधिचिकित्सितं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥

Now we shall discourse on the medical treatment of nervous disorders (Vata-vyadhi). 1

आमाशयगते वाते च्छर्दयित्वा यथाक्रमम् । देयः षड्धरणो योगः सप्तरात्रं सुखाम्बुना ।। २ ।।

चित्रकेन्द्रयवे पाठा कटुकाऽतिविषाऽभया । वातव्याधिप्रशमनो योगः षड्धरणः स्मृतः ॥ ३ ॥

Metrical Texts : The patient having been made to vomit in the event of the deranged Vayu being incarcerated (lodged) in the Amasaya (stomach), a pulverised compound known as the Sad-Dharana-yoga (a compound of six Dharanas or twenty-four Masa weight) with tepid water should be administered to him for seven days. A compound made up of Citraka, Indra-yava, Patha, Katuka, Ativisa, Abhaya ( taken in equal parts) together is known as the Sad-Dharana-yoga and contains the properties of subduring an attack of Vata-vyadhi. 2-3

पक्वाशयगते चापि देयं स्नेहविरेचनम् । वस्तयः शोधनीयाश्च प्राशाश्च लवणोत्तराः ।। ४ ।।

कार्यो बस्तिगते चापि विधिर्बस्तिविशोधनः ।। ५ ।।

1. One Dharana is equal to four Masas.

श्रोत्रादिषु प्रकुपिते कार्यश्चानिलहा क्रमः । स्नेहाभ्यङ्गोपनाहाश्च मर्दनालेपनानि च।।६।।

त्वङ्मांसासृक्सिराप्राप्ते कुर्याच्चासग्विमोक्षणम् ।। ७

स्नेहोपनाहाग्निकर्म- बन्धनोन्मर्दनानि च । स्नायुसन्ध्यस्थिसम्प्राप्ते कुर्याद् वायावतन्द्रितः ।। ८ ।।

निरुद्धेऽस्थनि वा वायौ पाणिमन्थेन दारिते । नाडीं दत्त्वाऽस्थनि भिषक् चूषयेत् पवनं बली ।। ९ ।।

In the event of the aggravated Vayu being incarcerated in the Pakvasaya intestines ), purgatives of fatty matters (Sneha – Virecana, i.e., Tilvaka-Sarpi, etc.), and Sodhana-Basti of purifying drugs (with decoctions and Kalka of fatty matters) and diet (Prasa) abounding in salt or saline articles should be prescribed. In the case of the aggravated Vayu being incarcerated in the Basti (urinary bladder). diuretic (lit. bladder-cleansing) measures and remedial agents should be resorted to Anointing with medicated oils. Ghrtas.etc..application of poultices (Upanaha)compounded of Vayu-subduing drugs, massage, and plasters (Alepa) of similar properties are the remedies in cases where the aggravated Vayu is lodged in the internal ducts or channels such as the ears, etc., of the body, Blood-letting (venesection ) is the remedy where the aggravated Vayu would be found to be confined in the skin, flesh, blood or veins (Siras). Similarly, application of fatty matters (Sneha), actual cauterization, massage, application of poultices and binding of ligatures should be the remedies where the aggravated Vayu would be found to have become situated in the bone, the skin and flesh of that part of the body should be perforated with a proper surgical instrument (Ara-Sastra) and the underlying bone should be similarly treated with an awl. A tube open at both ends should be inserted into the aperture, thus made, and a strong physician should suck the aggravated Vayu from out of the affected bone by applying his mouth to the exterior open end of the tube. 4-9

शुक्रप्राप्तेऽनिले कार्यं शुक्रदोषचिकित्सितम् ।। १० ।।

अवगाहकुटीकर्पू- प्रस्तराभ्यङ्गबस्तिभिः । जयेत् सर्वाङ्गजं वातं सिरामोक्षैश्च बुद्धिमान् ।। ११ ।।

1. Sneha Lavana and Kanda-Lavana, etc.

एकाङ्गगञ्च मतिमान् छृङ्गैश्चावस्थितं जयेत् ।। १२ ।।

In the case of the aggravated Vayu having contaminated the semen, measures and remedies for seminal disorders (Sukra-dosa)¹ should be employed. The intelligent (physician) would take recourse to measures, such as blood-letting, immersion or bath in a vessel (full of Vayu-subduing decoctions) fomentation with heated stones, as well as in the manner of Karsu-Sveda, vapour-bath in a closed chamber (Kuti sveda), anointment. Basti-Karmas, etc., in the event of the aggravated Vayu having extended throughout the whole organism; whereas bleeding by means of a born (cuffing) should be regarded as the remedy when the aggravated Dosa would be found to have been confined in any particular part of the body. 10-12

बलासपित्तरक्तैस्तु संसृष्टमविरोधिभिः ॥ १३ ॥ ।। ।।

सुप्तिवाते त्वसृमोक्षं कुर्यात् तु बहुशो भिषक् । दिह्याच्च लवणागार – धूमैस्तैलसमन्वितैः ॥ १४ ॥

पञ्चमूलीशृतं क्षीरं फलाम्लो रस एव च । सुस्निग्धो धान्ययूषो वा हितो वातविकारिणाम् ।। १५ ।।

In the event of the aggravated Vayu being connected either with the Pitta or the Kapha, such a course of treatment should be adopted as would not be hostile to the two other Dosas. Blood-letting (in small quantities) should be resorted to several times in a case of complete anesthesia (Supta-Vata) and the body should be anointed with oil mixed with salt and chamber-dust (agara-dhuma). Milk boiled with a decoction of the drugs of the Pancha-mula group, acid-fruits (Phalamla), meat-soup or soup of (well-cooked) corn (Dhanya) with clarified butter are beneficial in cases of Vata-roga. 13-15

काकोल्यादिः सवातघ्नः सर्वाम्लद्रव्यसंयुतः । सानूपौदकमांसस्तु सर्वस्नेहसमन्वितः ।। १६ ।।

1. Treatments, such as the purification of the semen, etc. and the use of medicines for making Aphrodisia (Baji-karana) and for the remedy of the disordered urinary organ (Mutra-dosa) should be adopted and employed.

2. It is to be understood that measures and remedies laid down under the head of Sarvanga-gata should be used when the Vayu would be found to be diffused throughout the whole organism instead of being confined to any specific part.

सुखोष्णः स्पष्टलवणः शाल्वणः परिकीर्त्तितः । तेनोपनाहं कुर्वीत सर्वदा वातरोगिणाम् ।। १७ ।।

कुञ्च्यमानं रुजार्तं वा गात्रं स्तब्धमथापि वा। गाढं पट्टैर्निबघ्नीयात् क्षौमकार्पासिकौर्णिकैः ।। १८ ।।

बिडालनकुलोन्द्राणां चर्मगोण्यां मृगस्य वा । प्रवेशयेद् वा स्वभ्यक्तं शाल्वणेनोपनाहितम् ।। १९ ।।

Salvana-Upanaha : A poultice composed of the drugs of the Kakolyadi group, the Vayu-sub-duing drugs (those of Bhadra-darvadi and Vidari-gandhadi groups), and all kinds of acid articles¹ (such as, Kanjika, Sauvira, fermented rice-gruel, ctc.), the flesh of animals which live in swamps (Arupa) or in water (Audaka)², oil clarified butter and all kinds of lardaceous substances, mixed together and saturated with a profuse quantity of salt and then slightly heated is known by the name of Salvana. A person suffering from any form of Vata ga should be always treated with such Salvana poultices (Upanaha). The poultice should be applied to such part of the body as is numbed, painful or contracted and the affected part should be firmly bandaged thereafter with a piece of Ksauma³ linen or woollen cloth. As an alternative, the affected part should be plastered (and well rubbed) with the ingredients of the Salvan-Upanaha and inserted into a bag made of cat or mongoose skin or that of a camel or deer hide. 16-19

स्कन्धवक्षस्त्रिकप्राप्तं वायुं मन्यागतं तथा । वमनं हन्ति नस्यञ्च कुशलेन प्रयोजितम् ।। २० ।।

शिरोगतं शिरोबस्तिर्हन्ति वाऽसृग्विमोक्षणम्। स्नेहं मात्रासहस्रन्तु धारयेत् तत्र योगतः ।। २१ । ।

सर्वाङ्गगतमेकाङ्ग-स्थितं वाऽपि समीरणम् । रुणद्धि केवलो बस्तिर्वायुवेगमिवाचलः ॥ २२ ॥

The aggravated Vayu, if located in the shoulders, the chest. the sacrum (Trika) or the Manya, should be subdued by emetics and

1. According to others it means all kinds of acid-fruits, etc.

2. Cakradatta reads सानूपमांस: सुखिन:’ (well-cooked with the flesh of ‘‘anupa’animals) in place of सानूपौदकमांसस्तु ।

3. Some read it as Valka, i.e., made up bark.

errhines judiciously employed. Siro-Basti should be applied to the head of the patient as long as it would take one to utter a thousand Matras (a short vowel sound), more or less, as the case may require, where the aggravated Vayu would be found to have located itself in the head, (if necessary) blood-letting should be resorted to. As a mountain is capable of obstructing the passage of the wind, so the Sneha-Basti (oily enema) is alone capable of resisting the action of the aggravated Vayu whether it extends throughout the whole system or is confined to a single part. 20-22

स्नेहस्वेदस्तथाऽभ्यङ्गो बस्तिः स्नेहविरेचनम् । शिरोबस्तिः शिर: स्नेहो धूमः स्नैहिक एव च ।। २३ ||

सुखोष्णः स्नेहगण्डूषो नस्यं स्नैहिकमेव च । रसा: क्षीराणि मांसानि स्नेहा: स्नेहान्वितञ्च यत् ॥ २४ ॥

भोजनानि फलाम्लानि स्निग्धानि लवणानि च । सुखोष्णाश्च परीषेकास्तथा संवाहनानि च ॥

कुङ्कमागुरुपत्राणि कुष्ठैलातगराणि च। कौशेयौर्णिकरौमाणि कार्पासानि गुरूणि च ॥ २६ ॥ २५ ॥ ॥

निवातातपयुक्तानि तथा गर्भगृहाणि च। मृद्वी शय्याऽग्निसन्तापो ब्रह्मचर्यं तथैव च । समासेनैवमादीनि योज्यान्यनिलरोगिषु ॥ २७ ॥

Measures beneficial to Vata-Vyadhi: An application of Sneha. fomentations, anointment of the body, Basti, oily purgatives, Sirobasti, the rubbing of oils on the head, oily fumigation, gargling with tepid oil, oily errhines, the use of meat-soup, milk, meat, clarified butter, oil and other lardaceous articles (of food), all kinds of acid fruits, salt, lukewarm washes, gentle massage, the use of saffron, Agura, Patra, Kustha, Ela, Tagara, the wearing of woollen silken, cotton or any other thick kind of garments, living in a warm room or in one not exposed to the wind or in an inner chamber, the use of a soft bed, baking in the glare of fire, entire sexual abstinence, these and such like other things should be generally adopted by a patient suffering from Vata-roga. 23-27.

त्रिवृद्दन्तीसुवर्णक्षीरीसप्तलाशङ्खिनीत्रिफलाविडङ्गानामक्षसमाः भागाः, विल्वमात्रः कल्कस्तिल्वकमूलकम्पिल्लकयोः, त्रिफलारसदधिपात्रे द्वे द्वे, घृतपात्रमेकं, तदैकध्यं संसृज्य विपचेत; तिल्वकसर्पिरतत् स्नेहविरेचनमुपदिशन्ति वातरोगिषु । तिल्वकविधिरेवाशोकरम्यकयोर्द्रष्टव्यः ॥२८॥

The Tilvaka-Ghrta : A paste (Kalka) of the following drugs, viz.. Trivrt, Danti, Suvarna-ksiri, Saptala, Sankhini, Triphala and Vidanga, each weighing an Aksa (two tolas), and Tilvaka-roots and Kampillaka, each weighing a Bilva ( eight tolas), a decoction of Triphala and curd, each weighing two Patras ) ( thirty-two seers) and clarified butter, weighing sixteen seers, should be duly cooked together. Medical authorities recommend this Tilvaka Ghrta as an oily purgative in cases of Vata-roga. Asoka-Ghrta and Ramyaka-Ghyta are prepared in the same manner. (viz.. by substituting Asoka and Ramyaka respectively for Tilvaka). 28

तिलपरिपीडनोपकरणकाष्ठान्याहृत्यानल्पकालं तैलपरिपीतान्यणूनि खण्डश: कल्पयित्वाऽवक्षुद्य महति कटाहे पानीयेन आभिप्लाव्य क्वाथयेत्, ततः स्नेहमम्बुपृष्ठाद् यदुदेति तत् सरकपाण्योरन्यतरेणादाय वातघ्नौषध- प्रतिवापञ्च स्नेहपाककल्पेन विपचेत्, एतदणुतैलमुपदिशन्ति वातरोगिषु । अणुभ्यस्तैलद्रव्येभ्यो निष्पाद्यत इत्यणुतैलम् ॥ २९ ॥

The Anu – Taila (oil) : The log of a long-standing wooden oilmill should be cut into small chips and then thrashed and boiled in water in a large cauldron. The globules of oil that will be found floatingg on the surface of the boiling water should be skimmed off either with the hand or with a saucer. The oil thus collected should then be cooked with the Kalka of Vayu-subduing drugs as in the preparation of a medicated oil. This oil is known as the Anu-Taila. The use of this oil has been advised by medical authorities in cases of Vata-roga. This oil is so named from the fact of its being pressed out of small chips of oily wood (as described above). 29

अथ महापञ्चमूलकाष्ठैर्बहुभिरवदह्यावनिप्रदेशमसितमुषितमेकरात्रमुपशान्तेऽग्नावपोह्य भस्म निवृत्तां भूमिं विदारीगन्धादिसिद्धेन तैलघटशतेन

1. Patra means 64 Palas i.e., 8 seers, but in cases of liquids the weight should be doubled.

तुल्यपयसाऽभिषिच्यैकरात्रमवस्थाप्य ततो यावती मृत्तिका स्निग्धा स्यात् तामादायोष्णोदकेन महति कटाहेऽभ्यासिञ्चेत्, तत्र यत् तैलमुत्तिष्ठेत् तत् पाणिभ्यां पर्यादाय स्वनुगुप्तं निदध्यात्; ततस्तैलं वातहरौषधक्वाथमांसरसक्षीराम्लभागसहस्रेण सहस्त्रपाकं विपचेद् यावता कालेन शक्नुयात् पक्तुम्; प्रतिवापश्चात्र हैमवता दक्षिणापथगाश्च गन्धा वातघ्नानि च तस्मिन् सिध्यति शङ्खानाध्मापयेद्, दुन्दुभि नाघातयेच्छत्रं धारयेद् बालव्यजनैश्च वीजयेद् ब्राह्मणसहस्त्रं भोजयेत्, तत् साधुसिद्धमवतार्य सौवर्णे राजते मृन्मये वा पात्रे स्वनुगुप्तं निदध्यात् । तदेतत् सहस्रपाकमप्रतिवारवीर्यं राजाईं तैलम्; एवं भागशतविपक्वं शतपाकम् ॥ ३० ॥ }

The Sahasra-paka-Taila : The wood of drugs belonging to the group of Maha-paica-mula should be collected in large quantities and burnt on a plot of land, so as to make the soil black. The fire shold be kept burning one whole night; on the following morning on the extinction of the fire the ashes should be removed and the ground. when cool, should be soaked with one hundred Ghatas (six thousand and four hundred seers) of oil cooked with the drugs of the Vidarigandhadi group and with the same quantity of milk and kept in that condition for one night more. On the next morning the earth should be dug up, down to the stratum found to have been soaked with the oil and the soil should then be dissolved in warm water in large cauldron for the purpose. The oil that will be found floating on the surface of the water should be skimmed off with both hands and kept in a safe basin. Then the decoction of the Vayu-subduing drugs (the Bhadra-darvadi group), meat-juice, milk, fermented rice-gruel (each taken in a quantity measuring a quarter part of that oil) should be taken one thousand times and each time should be boiled with the oil. Vayu-subduring and aromatic drugs and spices in the northern (trans-Himalaya) and southern (Deccan) countries, should be thrown into it and boiled with the oil. The boiling should be completed within the period during which it could be properly done. While the oil is being cooked, conchshells should be blown, Dundubhis should be sounded, umbrellas should be held open, chowries should be blown into it and a thousand Brahmins should be treated with repasts. The oil so properly prepared should be stored carefully in golden, silver or earthen pitchers. This oil is called the Sahasrapaka-Taila and is of irresistible potency and fit even for the use of kings. Satapaka-Taila is also prepared in the above manner (with the aforesaid ingredients) by cooking it one hundred times only. 30

गन्धर्वहस्तमुष्ककनक्तमालाटरूषकपूतीकारग्वध-चित्रकादीनां पत्राण्यार्द्राणि लवणेन सहोदूखलेऽवक्षुद्य स्नेहघटे प्रक्षिप्यावलिप्य गोशकृद्भिर्दाहयेत्; एतत् पत्रलवणमुपदिशन्ति वातरोगेषु । ( पत्रलवणम्) ॥३१॥

The Patra-Lavana (Salt) : The green leaves of the Eranda plants and those of the trees known as MUskaka, Naktamala, Atarusaka, Putika, Aragvadha and Citraka should be thrashed with (salt of equal quantity) in an Udukhala (a hand thrashing mill) and placed in an earthen pitcher, saturated with oil or clarified butter. Having covered the mouth of the pitcher with a lid, it should be plastered and burnt in fire of cow-dung. The medicine thus prepared (with the help of internal heat) is called the Patra-Lavana. Medical experts advise the application of this medicine in cases of Vatu-roga. 31

एवं स्नुहीकाण्डवार्ताकुशिगुलवणानि संक्षुद्य घटं पूरयित्वा सर्पिस्तैलवसामज्जभिः प्रक्षिप्यावलिप्य गोशकृद्भिर्दाहयेत्; ऐतत् स्नेहलवणमुपदिशन्ति वातरोगेषु (काण्डलवणम्)॥३२॥

The Kanda-Lavana : Similarly, Snuhi twigs, Brinjal(Vartaku), and Sigru-bark (taken in equal parts) and rock-salt (of equal weight as the entire drugs) should be thrashed and kept in a pitcher. Oil, clarified butter, lard and marrow should be added to it equal in weight with salt and then having covered the mouth of the pitcher with a lid, it should be plastered and burnt in a fire of cow-dung (as before). The use of this medicated salt which is called the Kanda-Lavana or Sneha-Lavana is recommended by experts in Vata-roga. 32

गण्डीरपलाशकुटजबिल्वार्कस्नुह्यपामार्गपाटलापारिभद्रकनादेयीकृष्णगन्धानीप-निम्बनिर्दहन्यटरूषक-नक्तमालक-पृतीकबहती-कण्टकारिकाभल्लातकेङ्गदीवैजयन्तीकदली- वाष्पद्वयेक्षुरकेन्द्रवारुणी- श्वेतमोक्षकाशोका इत्येवं वर्ग समूलपत्रशाखमार्द्रमाहत्य लवणेन सह संसृष्टं पूर्ववद् दग्ध्वा क्षारकल्पेन परित्राव्य विपचेत्, प्रतिवापश्चात्र हिङ्ग्वादिभिः पिप्पल्या दिभिर्वा । इत्येतत् कल्याणकलवणं वातरोगेषु गुल्मप्लीहाग्निषङ्गाजीर्णार्शोऽरोचकार्तानां कासादिभिः क्रिमिभिरुपद्रुतानाञ्चोपदिशन्ति पानभोजनेष्वपिति (कल्याणकलवणम्) ॥३३॥

The Kalyanaka-Lavana : The follwing drugs with their roots, leaves and twigs, viz., Gandira, Palasa, Kutaja, Bilva, Arka, Snuhi, Apamarga, Patala, Paribhadra, Nadeyi, Krsnagandha Nipa, Nimba, Nirdahani, Atarusaka, Nakta-malaka, Putika, Brihati, Kantakari, Bhallataka, Ingudi, Vaijayanti (Arani). Kadali (bananas), Varsabhu, Hrivera, Iksuraka, Indra-varui, Svetamoksaka and Asoka should be gathered in a green condition and mixed with (as large a quantity of) rock-salf and having thrashed them in an Udukhala should be burnt in a hermetically sealed pitcher as above, after which it should be filtered (twenty times) and boiled in the manner of alkaline preparations. At the close of the boiling, powders of the drugs of the Hingvadi or Pippalyadi group should be mixed with it. This medicine is called the Kalaynaka-Lavana and is specially efficacious in all cases of Vataroga and is applicable both in food and drink in cases of Gulma, enlarged spleen. impaired digestion. indigestion. haemorrhoids. intestinal worins, aversion to food and cough. 33

भवति चात्र |

विष्यन्दनादुष्णभावाद् दोषाणाञ्च विपाचनात् । संस्कारपाचनाच्चेदं वातरोगेषु शस्यते ।। ३४ ।।

Memorable Verse: The remedy proves efficacious in Vataroga through its heat-making potency, power of solubility and digesting the deranged Dosas and because of its special mode of preparation.34

इति सुश्रुतसंहितायां चिकित्सितस्थाने वातव्याधिचिकित्सितं नाम चतुर्थोऽध्यायः॥४॥

Thus ends the fourth Chapter of the Chikitsa Sihana in the Susruta Samhita which deals with the treatment of Vata-Vyadhi.

1. The total weight of these powders should be one-fourth of the weight of the rock-salt taken in the course of the preparation.


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