षट्पञ्चाशत्तमोऽध्यायः अथातो विसूचिकाप्रतिषेधमध्यायं व्याख्यास्यामः , यथोवाच भगवान् धन्वन्तरिः ॥ १ ॥
Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of Visuchika type of cholera, etc. (Visuchika- Pratisedha). 1.
अजीर्णमामं विष्टब्धं विदग्धञ्च यदीरितम् । विसूच्यलसकौ तस्माद् भवेच्चापि विलम्बिका ॥ २ ॥
Visuchika Causes – Visuci, Alasaka and Vilambika are produced from the effects of the three kinds of indigestion spoken of before (in Sutra. Chapter XLVI), viz., Amajirna (indigestion properly so-called), Vistabbhajirna (indigestion with undigested food stuffed into the intestines in the form of undigested fecal matter) and vidagdhajirna (indigestion with acidity). 2.
सूचीभिरिव गात्राणि तुदन् सन्तिष्ठतेऽनिलः । यस्याजीर्णेन सा वैद्यैरुच्यते ( तु)ति विसूचिका ॥ ३ ॥ न तां परिमिताहारा लभन्ते विदितागमाः । मूढास्तामजितात्मानो लभन्ते कलुषाशयाः॥ ४॥
Definition – The disease in which the deranged and incarcerated bodily Vayu produces, owing to the presence of indigestion, a pricking pain in the limbs resembling that produced by the pricking of needles is called Visuchika by the physicians. Men well-versed in the (dietetic) principles and temperate in their diet, enjoy an almost absolute immunity from its attack, whereas fools who are greedy and intemperate and eat like gluttons, fall an easy victim to it. 3-4.
मूर्च्छातिसारौ वमथुः पिपासा शूलं भ्रमोद्वेष्टनजृम्भदाहाः । वैवर्ण्यकम्पौ हृदये रुजश्च भवन्ति तस्यां शिरसश्च भेदः ॥ ५ ॥
Symptoms — Fainting, diarrhoea ( loose motions), vomiting, thirst, pain, cramps, vertigo, yawning, burning sensation in the body, discolouring or paleness of complexion, pain (cramps) at the heart and a breaking pain in the head are the symptoms of Visuchika. 5.
कुक्षिरानह्यतेऽत्यर्थं प्रताम्यति विकूजति । निरुद्धो मारुतश्चापि कुक्षौ वि( 3 ) परिधावति ॥ ६ ॥ वातवर्चोनिरोधश्च कुक्षौ यस्य भृशं भवेत् । तस्यालसकमाचष्टे तृष्णोद्गारावरोधकौ ॥ ७ ॥
Alasaka- Excessive pain in and stiffness of the abdomen, rumbling noise ( in the intestines ) 1, and the upward coursing of the Vayu incarcerated in the abdomen making a croaking rumbling sound in its way upwards, absolute suppression of stool and flatus, hiccough² and eructations-a patient suffering from these symptoms is said to have an attack of Alasaka.6-7
दुष्टन्तु भुक्तं कफमारुताभ्यां प्रवर्तते नोर्ध्वमधश्च यस्य | विलम्बिकां तां भृशदुश्चिकित्स्यामाचक्षते शास्त्रविदः पुराणाः ॥ ८ ॥ यत्रस्थमामं विरुजेत् तमेव देशं विशेषेण विकारजातैः । दोषेण येनावततं स्वलिङ्गैस्तं स्वलिङ्गैस्तं लक्षयेदामससुद्भवैश्च ॥ ९ ॥
Vilambika- The person in whom the deranged and undigested food matter does not find any outlet either through the upper or lower channels of the body owing to the fact of its being obstructed in its course by the action of the deranged Vayu and Kapha, is said to be suffering from an attack of Vilambika by old medical experts and should be given up as incurable. In whatever part of the body the Ama (undigested food matter) is present, it produces its own characteristic symptoms in that very part and the vitiation of a particular Dosa in such cases should be diagnosed by the presence of the characteristic symptoms (e.g. distension, etc.) of Ama (indigestion). 8-9.
1. According to Srikantha the commentator on Madhava Nidana the patient himself makes in indistinct sound.
2. Madhava reads “thirst” in place of “hic-cough.”
यः श्यावदन्तौष्ठनखोऽल्पसंज्ञश्छर्घर्दितोऽभ्यन्तरयातनेत्रः । क्षामस्वरः सर्वविमुक्तसन्धिर्यायान्नरः सोऽपुनरागमाय ॥ १० ॥
Prognosis – A patient exhibiting such symptoms as blackish blue (syama) colour of teeth, nails and lips, diminished consciousness, vomiting, eyes sunk in their sockets, feeble voice and looseness of all the joints, should be regarded as not returning from his journey (to the eternal home). 10.
साध्यासु पायर्दहनं प्रशस्तमग्निप्रतापो वमनञ्च तीक्ष्णम् । पक्के ततोऽन्ने तु विलङ्घनं स्यात् सम्पाचनञ्चापि विरेचनञ्च ॥ ११ ॥ विशुद्धदेहस्य हि सद्य एव मूर्च्छातिसारादिरुपैति शान्तिम् । आस्थापनञ्चापि वदन्ति पथ्यं सर्वासु योगानपरान् निबोध ॥ १२ ॥
General Treatment – In the curable types, cauterization of the regions of Parsni ( heels), dry fomentation, exhibition of strong emetics and such like measures are recommended. Fasting should be observed at (the time of) the digestion of the food. Digestive (Pacana) remedies as well as purgatives should also be prescribed. The patient gets instantaneous relief in cases of fainting, diarrhoea, etc. on the cleansing of his body with the medicinal (emetic or purgative) remedies. Intestinal injections in the manner of an Asthapana Basti may be likewise applied in all cases of the present disease. Now hear me describing the recipes of other medicinal compounds which may be employed in the aforesaid diseases in addition to those already mentioned. 11-12.
पथ्यावचाहिङ्गकलिङ्गगृञ्ज – सौवर्चलैः सातिविषैश्च चूर्णम् । । सुखाम्बुपीतं विनिहन्त्यजीर्णं शूलं विसूचीमरुचिञ्च सद्यः ॥ १३ ॥ क्षारागदं वा लवणं विडं वा गुडप्रगाढानथ सर्षपान् वा । अम्लेन वा सैन्धवहिङ्गयुक्तौ सबीजपूरौ सघृतौ त्रिवर्गौ ॥ १४ ॥ कटुत्रिकं वा लवर्णैरुपेतं पिबेत् स्नुहीक्षीरविमिश्रितन्तु । कल्याणकं वा लवणं पिबेत् तु यदुक्तमादावनिलामयेषु ॥ १५ ॥ कृष्णाजमोदक्षवकाणि वाऽपि तुल्यौ पिबेद् वा मगधानिकुम्भौ । दन्तीयुतं वा मगधोद्भवानां कल्कं पिबेत् कोषवतीरसेन ॥ १६ ॥ उष्णाभिरद्भिर्मगधोद्भवानां कल्कं पिबेन्नागरकल्कयुक्तम् ॥ १७ ॥
A pulverised compound of Pathya, Vaca, Hingu, Kalinga (Indrayava), Grnja (a variety of garlic), Souvarcala and Ativisa taken with tepid water instantaneously relieves an attack of indigestion, colic, Visuchika and an aversion to food. The medicine known as Kshara-gada (Kalpa-chapter VII) or Vit-salt, or mustard-seeds and a profuse quantity of treacle, should be taken (with tepid water). Saindhava, Hingu, Bijapura (D.R. seeds of Saka), clarified butter and the two Tri-vargas (Tri-phala and Tri-katu) in combination with any fermented gruel (Kanjika), or Tri-katu and Saindhava-salt mixed to gether with the milky exudation of Snuhi, should be taken (with Kanjika). In the alternative, the medicated salt known as Kalyana-Lavana described before under the treatment of Vata-vyadhi should be taken (with Kanjika). Pippali, Yavani and Apamarga or Pippali and Danti in equal parts should be similarly taken. Pippali mixed with Danti should also be used with the expressed juice of Kosavati (Ghosa). Pippali and Sunthi should also be taken with hot water. 13-17.
व्योषं करञ्जस्य फलं हरिद्रे मूलं समं वाप्यथ मातुलुङ्गयाः । छायाविशुष्का गुटिकाः कृतास्ता हन्युर्विसूचीं नयनाञ्जनेन ॥ १८ ॥
The drugs known as Vyosa (Tri-katu), Karanja-fruits (seeds), the two kinds of Haridra¹ and the root of Matulunga taken in equal parts should be pounded together, made into Gutikaas (or pills) and dried in the shade. The application of these pills as an eye-salve (Anjana) along the eye-lids proves curative in cases of Visuchika². 18. Oil should be duly cooked wih Chitraka, Yuthi-flower, off-eakes (of sesamam), Bhallataka, the two Ksharas, Saindhava and two parts of Kuyt This should be prescribed by a expert to be rubbed, or used as a plaster over the body of the patient.
1. Cakrapani reads Haridra in the singular number.
2. Some here read the following two compounds as an additional text- Kustha, Aguru, Patra, Rasna, Sigru, Vaca and Tvak should be mixed together and pasted with Kanjika. This would be the best remedy, for rubbing over the body of the patient in a case of Visuchika.
सुवामितं साधु विरेचितं वा सुलङ्गितं वा मनुजं विदित्वा । पेयादिभिर्दीपनपाचनीयैः सम्यक्क्षुधार्तं समुपक्रमेत ॥ १९ ॥
Diet – Digestive and appetising Peya etc. should be given to the patient when he experiences a good hunger after he had been fully treated with a course of emetic or purgative or kept fasting for a proper period. 19.
Causes and Symptoms of Anaha
आसं शकृद् वा निचितं क्रमेण भूयो विबद्धं विगुणानिलेन । प्रवर्तमानं न यथास्वमेनं विकारमानाहमुदाहरन्ति ॥ २० ॥ तस्मिन् भवन्त्यामसमुद्भवे तु तृष्णाप्रतिश्यायशिरोविदाहाः । आमाशये शूलमथो गुरुत्वं हृल्लास उद्गारविघातनञ्च ॥ २१ ॥ स्तम्भः कटीपृष्ठपुरीषमूत्रे शूलोऽथ मूर्च्छा स शकृद् वमेच्च । श्वासश्च पक्काशयजे भवन्ति लिङ्गानि चात्रालसकोद्भवानि ॥ २२ ॥
Causes and Symptoms of Anaha – The disease in which Ama (undigested food) or fecal matter, gradually incarcerated (in the stomach) through the action of the deranged and aggravated local Vayu fails to find its natural outlet, or is not spontaneously evacuated is called anaha (Enteritis)?
A case of Anaha due to the accumulation of undigested food (in the stomach) exhibits such symptoms as thirst, cattarrh, burning in the head, a sense of heaviness and cramps in the stomach, nausea (D.R.— heaviness of the heart) and suppression of eructations. While a case of Anaha in the Pakvasaya (intestines) is marked by a sense of stuffeness in the back and waist, suppression of stool and urine, colic, epileptic or fainting fits, vomiting of feces, laboured and difficult respiration (D.R.—swelling), as well as the symptoms mentioned under the head of Alasaka. 20-22.
आमोद्भवे वान्तमुपक्रमेत संसर्गभक्तक्रमदीपनीयैः । अथेतरं यो न शकृद् वमेत् तमामं जयेत् स्वेदनपाचनैश्च ॥ २३ ॥ विसूचिकायां परिकीर्तितानि द्रव्याणि वैरेचनिकानि यानि । तान्येव वर्तीर्विरचेद् विचूर्ण्य महिष्यजावीभ-गवान्तु मूत्रैः ॥ २४ ॥ स्विन्नस्य पायौ विनिवेश्य ताश्च चूर्णानि चैषां प्रधमेत् तु नाड्या | मूत्रेषु संसाध्य यथाविधानं द्रव्याणि यान्यूर्ध्वमधश्च यान्ति ॥ २५ ॥ क्वाथेन तेनाशु निरूहयेच्च मूत्रार्ध्वयुक्तेन समाक्षिकेण । विरिक्तक्रममाचरेच्च । त्रिभण्डियुक्तं लवणप्रकुञ्चं दत्त्वा एष्वेव तैलेन च साधितेन प्राप्तं यदि स्यादनुवासयेच्च ॥ २६ ॥
Treatment In a case of Anaha due to the presense of Ama, the patient should be treated with emetics and then with digestive medicines and diet according to the prescribed order. The Ama (undigested food) in a case not marked by vomiting of faeces should be treated with fomentation and therapeutic agents of digestive efficacy. Vartis (suppositories) made by pasting the purgative drugs mentioned in connection with the medical treatment of Visuchika together with the urine of a she-buffalo, or of a she-goat or of an ewe or of a she-elephant, or of a cow, should be used. The body of the patient should be first fomented and then the powders of the drugs used in preparing the afore-said Vartis should be blown (into his intestines) through a pipe inserted into his rectum. Decoction should be duly prepared by boiling the drugs of emetic and purgative virtue in cow’s urine. Niruha Basti¹ should soon be applied with the above decoction mixed with half as much of cow’s urine² and with honey and adding also the powders of Trivrit and salt weighing a Prakunca (pala). The procedure laid down in respect of the exhibition of purgatives should be adopted here. Oil duly cooked and boiled with the foregoing drugs should also be injected into the rectum, if necessary, in the manner of an Aunvasana Basti. 23-26.
इति सुश्रुत संहितायामुत्तरतन्त्रे विसूचिकाप्रतिषेधव्याख्यानाम षट्पञ्चाशत्तमोऽध्यायः ॥ ५६ ॥ –
Thus ends the fifty-sixth chapter in the Uttara-Tantra of the Susruta Samhita which deals with the (symptoms and) treatment of Visuchika.