एकोनविंशोऽध्यायः । अथातो वृद्ध्युपदंशश्लीपद चिकित्सितं व्याख्यास्यामः, यथोवाच भगवान् धन्वन्तरिः । ॥ १ ॥
Now we shall discourse on the medical treatment of hernia, hydrocele, scrotal tumour, etc. (Vruddhi), diseases of the genital organ (Upadarnisa) and elephantiasis (Sipada). 1
अन्त्रवृद्धया विना षड्या वृद्धयस्तासु वर्जयेत् । अश्वादियानं व्यायामं मैथुनं वेगनिग्रहम् । अत्यासनं चङ्क्रमणमुपवासं गुरूणि च॥२॥
In the six types of Vruddhi other than the one known as the AntraVruddhi (Hernia), riding on horse back, etc., excessive physical labour, fastings, sitting in an unnatural posit constant walking, voluntary restraint of any natural urging (for stool and urine, etc.), sexual intercourse and eating food of difficult digestion should be avoided. 2
तत्रादितो वातवृद्धौ त्रैवृतस्निग्धमातुरम् । स्विन्नञ्चैनं यथान्यायं पाययेत विरेचनम् ।। ३ ।।
कोशाम्रतिल्वकैरण्ड-फलतैलानि वा नरम् । तैलमेरण्डसम्भवम् ॥ ४ ॥
सक्षीरं वा पिबेन्मासं ततः कालेऽनिलघ्नानां क्वाथैः कल्कैश्च बुद्धिमान् । निरूहयेन्निरूढञ्च भुक्तवन्तं यष्टीमधुकसिद्धेन ततस्तैलेन रसौदनम् ॥ ५ ॥ योजयेत् ।
स्नेहोपनाहौ कुर्याच्च वा सेवनीं भिन्द्यात् ततः प्रभिन्नायां तथोक्तं
प्रदेहांश्चानिलापहान् ॥ ६ ॥ परिवर्जयेत् । क्रममाचरेत् ॥ ७॥
Treatment of Vataja Vruddhi: In the Vataja type of Vruddhi, the patient should be first soothed (Snigdha) with the application of Traivrta Ghrita (vide, Chap. V. Chikitsa Sthana). He should then be duly fomented and subjected to a proper course of purgatives. As an alternative, he should be made to drink the expressed oil of the Kosamra, Tilvaka, or Eranda (castor) oil (as a purgative) with milk for a month. A decoction of the Vayu subduing drugs mixed with the powders of the same drugs should then be employed by an experienced physician at a proper time in the manner of a Niruha Basti. The patient should then be made to take a meal (of boiled rice) along with meat soup; and oil cooked with Yasti madhu should be applied (in the manner of an Anuvasana measure). Applications of Sneha (oil, etc.). poultices (Upanaha), and plasters (Pradeha) of the Vayu-subduing drugs should be applied to the affected part. If the tumour (Vruddhi) begins to suppurate, it should be made to do so fully. It should be then opened with an incision avoiding the median line (Sevani) of the perineum and the proper purifying (i.e., antiseptic and healing) measures should be resorted to in the usual way laid down (in the treatment of Dvi-vrana²). 3-7
पित्तजायामपक्वायां पित्तग्रन्थिक्रमो हितः । पक्वां वा भेदयेद् भिन्नां शोधयेत् क्षौद्रसर्पिषा ।
शुद्धायाञ्च भिषग् दद्यात् तैलं कल्कञ्च रोपणम् ।। ८ ।।
Treatment of Pittaja Vruddhi : A case of the non-suppurated state of Pittaja Vruddhi may be beneficially treated with the remedies laid down in connection with a case of the same type of glandular swelling (Pittaja Granthi). In the case of it being suppurated, the surgeon should open it with a knife and purify it with the application of honey and clarified butter. The incidental ulcer should then be
1. After a period of one week from the time of the application of purgatives and in case the patient is strong enough to undergo the Niruha basti measure.
2. According to Gayadasa, the measures to be adopted should be those laid down in the Misraka chapter (Chap. XXV) healed up with oils and pastes of healing virtues. 8
रक्तजायां जलौकोभिः शोणितं निर्हरेद् भिषक् । पिबेद् विरेचनं वापि शर्कराक्षौद्रसंयुतम् ।
पित्तग्रन्थिक्रमं कुर्यादामे पक्वे च सर्वदा ।। ९ ।।
Treatment of Raktaja Vruddhi: In a case of Raktaja Vruddhi (originated through the vitiated condition of the blood), the (vitiated) blood should be drawn out by the application of leeches. As an alternative, purgatives should be administered through the medium of honey and sugar. Remedial measures described in connection with the Pittaja type of the disease should be employed both in the suppurated and the non-suppurated stages (of this type). 9
वृद्धिं कफात्मिकामुष्णैर्मूत्रपिष्टैः प्रलेपयेत् । पीतदारुकषायञ्च पिबेन्मूत्रेण संयुतम् ।
विम्लापनादृते वाऽपि श्लेष्मग्रन्थिक्रमो हितः ।। १० ।।
पक्वायाञ्च विभिन्नायां तैलं शोधनमिष्यते ।सुमनारुष्कराङ्कोठ-सप्तपर्णेषु साधितम् ।। ११ ।।
Treatment of Kaphaja Vruddhi: In a case of the Kaphaja type of the disease, poultices with the heat-making¹ drugs (i.e., Vacadi, Pippalyadi and Muskakadi groups, etc. ) pasted with cow’s urine should be applied. The patient should be made to drink a potion consisting of the decoction of Daru-Haridra mixed with the urine of a cow, and all the remedial measures with the exclusion of Vimlapana (resolution by pressure) laid down under the treatment of the Kaphaja Granthi should be employed. The tumour should be opened (with a knife) when suppurated and the oil cooked with Jati, Aruskara, Amkota and Sapta-parna should be used for the purification (disinfection) of the incidental ulcer. 10-11
मेदः समुत्थां संस्वेद्य लेपयेत् सुरसादिना । शिरोविरेकद्रव्यैर्वा सुखोष्णैर्मूत्रसंयुतैः ॥ १२ ॥
स्विन्नाञ्चावेष्टय पट्टेन समाश्वास्य तु मानवम् । रक्षन् फले सेवनीञ्च वृद्धिपत्रेण दारयेत् ॥ १३ ॥
1. Some say that the heat-producing drugs are those comprised in the Ajagandhadi group mentioned in the Misraka chapter, Sutra Sthana
मेदस्तत: समुद्धृत्य दद्यात् कासीससैन्धवे । बध्नीयाच्च यथोद्दिष्टं शुद्धे तैलञ्च दापयेत् । मनः शिलाललवणैः सिद्धमारुष्करेषु च ॥ १४ ॥
Treatment of Medoja Vruddhi : In a case of the Medoja (fatoriginated) type of the disease, the affected part should be (lightly ) fomented, and plasters composed of drugs (of the roots) of the Surasadi group or of the Siro-virecana group ( Ch. XXXIX. Sutra Sthana) pasted with the urine of a cow should be applied to it in a lukewarm state. The inflamed and swollen scrotal tumour, (lightly ) fomented as before, should be tightened round with a piece of cloth. Then having encouraged the patient, the surgeon should open the tumour with a Vruddhipatra (knife) carefully avoiding the two testes (lying within the scrotal sac) and the median line of the perineum (Sevani). Then having carefully removed all morbid products (Medas) from its inside Saindhava and sulphate of iron should be applied to the incised part, and the scrotum should be carefully bandaged (in the manner of a Gophana bandage). After the proper purification (disinfection) of the ulcer, its healing should be effected with the application of an oil cooked with Manahsila, Haritala (yellow oxide of arsenic), rock-salt and Bhallataka. 12-14
मूत्रजां स्वेदयित्वा तु वस्त्रपट्टेन वेष्टयेत् । सेवन्या: पार्वतोऽधस्ताद् विध्येद् व्रीहिमुखेन च ॥ १५ ॥
अथात्र द्विमुखां नाडीं दत्त्वा विस्रावयेद् भिषक् । मूत्रं, नाडीमथोद्धृत्य स्थगिकाबन्धमाचरेत् ।
शुद्धायां रोपणं दद्याद् वर्जयेदन्त्रहेतुकीम् ॥ १६ ॥
Treatment of Mutraja Vruddhi: In a case of an enlargement of the scrotum (hydrocele) due to the derangement of urine, it should be first fomented and then a piece of cloth should be tightened around it. A puncture should then be made in the bottom of the sac with a Vrihimukha instrument, on either side of the raphe of the perineum (Sevani ). A tube open at both ends should be introduced (into the puncture) and the accumulated (morbid ) fluid should be let out. The
1. The fomentation should be applied according to Sivadasa, with balls of cowdung, etc., slightly heated. It should be noted in this connection that strong fomentations should not, in any case, be applied to the testes tube should then be taken off and the scrotum should be tied up with a bandage of the Sthagika (stump bandage) pattern and the incidental ulcer should be purified and healed up with appropriate medicinal applications. 15-16
अप्राप्तफलकोषायां वातवृद्धिक्रमो हितः ॥ १७ ॥
तत्र या वङ्खणस्था तां दहेदर्धेन्दुवक्त्या | सम्यङ्मार्गावरोधार्थं कोषप्राप्तान्तु वर्जयेत् ।
त्वचं भित्त्वाऽङ्गुष्ठमध्ये दहेच्चाङ्गविपर्ययात् ।। १८ ।।
अनेनैव विधानेन वृद्धी वातकफात्मिके । प्रदहेत् प्रयत: किन्तु स्नायुच्छेदोऽधिकस्तयोः ।। १९ ।।
शङ्खोपरि च कर्णान्ते त्यक्त्वा यत्नेन सेवनीम् । व्यत्यासाद्वा सिरां विध्येदन्त्रवृद्धिनिवृत्तये ॥ २० ॥
Treatment of Antra – Vruddhi : A case of Antra – Vruddhi (hernia when strangulated) extending down to the scrotal sac (Kosa) should be given up as irremediable; but, in the case of its not being so extended, it should be treated as a case of Vataja-Vruddhi. If the colon be found to have descended down to inguinal region (Vamksana), it should be cauterized with a heated crescent-mouthedrod (Arddha-Candra Salaka) to prevent its descending down into the scrotal sac. A case of hernia that, in spite of all these precautions, descends down into the scrotal sac (Kosa), should be given up as irremediable. The first finger of the hand opposite¹ the affected part (i.e. the affected testes) should be incised at its middle and cauterized. In cases of hernia (Antra-Vruddhi) of the Vataja and of the Kaphaja type the affected part should be carefully cauterized in the above manner; but in these two cases, the Snayu (ligaments) should be cut off in addition (before cauterization). In a case of Antra-Vruddhi the veins (Sira) of the temples at the (upper) end of the ears on the opposite sides of the affection should be carefully opened avoiding the Sevani therein. 17-20
उपदंशेषु साध्येषु स्निग्धस्विन्नस्य देहिनः । सिरां विध्येन्मेद्रमध्ये पातयेद् वा जलौकसः ॥ २१ ॥
1. Incision and cauterization should be performed in the thumb of the right hand. if the left testis is affected, and in case the affection is in the right testis, incision and cauterization should be made in the thumb of the left hand.
Treatment of Upadamsa¹: In cases of the curable type of Upadamsa, Sneha (oleaginous substances) should be first applied, and the affected part should be fomented. Then the veins of the penis should be opened, or leeches should be applied (to the organ) for the elimination of the contaminated blood² (according as the affections are more or less severe). 21
हरेदुभयतश्चापि सद्योऽपहृतदोषस्य दोषानत्यर्थमुच्छ्रितान्। रुक्शोफावुपशाम्यतः ॥ २२ ॥
यदि वा दुर्बलो जन्तुर्न वा प्राप्तं विरेचनम्। निरूहेण हरेत् तस्य दोषानत्यर्थमुच्छ्रितान् ॥ २३ ॥
General Treatments : The system of the patient should be cleansed with both emetics and purgatives in the event of an excessive aggravation of the Dosas inasmuch as the local pain and swelling would subside simultaneously with the elimination of the aggravated Dosas from the system. Medicinal Bastis (enemas) should be injected (into the rectum) in the way of a Niruha-Basti for the elimination of the aggravated Dosas, where the weakness of the patient would prohibit the application of purgatives. 22-23
प्रपौण्डरीकयष्ट्याह्न-वर्षाभूकुष्ठदारुभिः । सरलागुरुरास्नाभिर्वातजं संप्रलेपयेत् ॥ २४ ॥
यवगोधूमशक्तवः। निचुलैरण्डबीजानि एतैश्च वातजं स्निग्धैः सुखोष्णैः सम्प्रलेपयेत् । प्रपौण्डरीकपूर्वैश्च द्रव्यैः सेकः प्रशस्यते ॥ २५ ॥
Treatment of Vataja Upadamsa : In a case of the Vataja type of the disease drugs such as Prapaundarika, Yasti-madhu, Varsabhu, Kustha, Deva-daru, Sarala, Aguru and Rasna, should be used as a plaster (over the affected organ). Similarly plasters composed of Nicula, castor-seeds, and pulverised wheat and barley grains pasted with Sneha (clarified butter, oil, etc.) should be applied lukewarm to the seat of the disease, which should also be affused with a decoction of the above-mentioned drugs, viz. Prapaundarika, etc. 24-25
1. See note, Chapter XII., Nidana Sthana.
2. Jejjata holds that leeches should be applied in a case of superficial Upadamsa.
गैरिकाञ्जनयष्ट्याह्व-सारिवोशीर पद्मकैः सचन्दनोत्पलैः स्निग्धैः पैत्तिकं सम्प्रलेपयेत् ॥ २६ ॥
पद्मोत्पलमृणालैश्च ससर्जार्जुनवेतसैः । सर्पिः स्निग्धैः समधुकैः पैत्तिकं सम्प्रलेपयेत् ॥ २७ ॥
घृतक्षीर-शर्करेक्षुमधूदकैः । सेचयेच्च अथवाऽपि सुशीतेन कषायेण वटादिना ॥ २८ ॥
1 Treatment of Pittaja Upadamsa : In a case of the Pittaja type of the disease, a plaster composed of Gairika, Anjana, Yasti-madhu, Sariva, Usira, Padmaka, (red) Candana and Utpala mixed with a Sneha (clarified butter), or that composed of Padma, Mrnala, Sarja, Arjuna, Vetasa and Yasti-madhu mixed with clarified butter should be applied to the affected organ which should be sprinkled with a solution of milk, clarified butter, sugar, sugar cane juice and honey, or with a cold decoction of the drugs of Vata, etc. 26-28
शालाश्वकर्णाजकर्ण-धवत्वग्भिः कफोत्थितम् । सुरापिष्टाभिरुष्णाभिः सतैलाभिः प्रलेपयेत् ॥ २९ ॥
रजन्यतिविषामुस्ता- सरलासुरदारुभिः सपत्रपाठापत्तूरैरथ वा सम्प्रलेपयेत् । सुरसारग्वधाद्योश्च क्वाथाभ्यां परिषेचयेत् ॥ ३० ॥
Treatment of Kaphaja Upadamsa : In a case of the Kaphaja type of the disease, a plaster composed of the barks of Sala, Asvakarna, Aja-karna and Dhava pasted with Sura and mixed with oil, should be applied hot to the affected part. As an alternative, the drugs such as, Haridra, Ativisa, Musta, Sarala, Deva-daru, Patra, Patha, and Pattura should be used for similar purposes and the affected organ should be affused with a decoction of the drugs of the Surasadi and Aragvadhadi groups. 29-30
एवं संशोधनालेप-सेकशोणितमोक्षणैः । प्रतिकुर्यात् क्रियायोगैः प्राक्स्थानोक्तैर्हितैरपि ॥ ३१ ॥
नयाति च यथा पाकं प्रयतेत तथा भिषक् ।
1. According to Sivadasa the Sneha to be used in the plaster should be clarified butter washed a hundred times.
विदग्धैस्तु सिरास्नायु – त्वङमांसैः क्षीयते ध्वजः ॥ ३२ ॥
शस्त्रेणोपचरेच्चापि पाकमागतमाशु वै। तदाऽपोह्य तिलैः सर्पि:-क्षौद्रयुक्तैः प्रलेपयेत् ॥ ३३ ॥
जात्यारग्वधयोस्तथा । वैजयन्त्यर्कयोस्तथा ॥ ३४ ॥ करवीरस्य पत्राणि प्रक्षालने प्रयोज्यानि
The aboveremedial measures, viz., plasters, sprinkling (Pariseka), blood-letting and Sansodhana (i.e, application of purgatives, enetics, etc.) as well as those described in the Sutra Sthana (and the first Chapter of the Chikitsa Sthana), should be resorted to in a case of (non suppurated) Upadamsa. The physician should try his best to arrest the setting in of suppuration (in a case of Upadamsa) inasmuch as suppuration in (and consequent putrefaction of ) the (local) veins, ligaments, skin and flesh would lead to the destruction of the organ (Dhvaja). An incision should be made as soon as suppuration would set in, and the pus and other putrid matters being drawn out, the incised part should be plastered with the paste of sesamum mixed with honey and clarified butter. The incidental uicer should be washed with a decoction¹ of the leaves of Karavira, Jati and Aragvadha, or of Vaijayanti and Arka. 31-34
सौराष्ट्रीं गैरिकं तुत्थं पुष्पकासीससैन्धवम् । रोध्रं रसाञ्जनं दाव हरितालं मनःशिलाम् ॥ ३५ ॥
हरेणुकैले च तथा सूक्ष्मचूर्णानि कारयेत् । तच्चूर्णं क्षौद्रसंयुक्तमुपदंशेषु पूजितम् ॥ ३६ ।।
The use of a medical plaster composed of the fine powders of Saurastra-mrttika, Gairika, Tuttha, Puspa Kasisa, Saindhava, Rodhra, Rasanjana, Daru-Haridra, Haritala, Manahsila, Harenuka and Ela, mixed with honey is highly recommended in all cases of Upadamsa. 35-36
जम्ब्वाम्रसुमनानिम्ब – श्वेतकाम्बोजिपल्लवा: शल्लकीबदरीबिल्व-पलाशतिनिशत्वचः । ॥३७॥
क्षीरिणाञ्च त्वचो योज्याः क्वाथे त्रिफलया सह । तेन क्वाथेन नियतं व्रणं प्रक्षालयेद् भिषक् ॥ ३८ ॥
1. According to Cakradatta the five kinds of leaves should be separately used in the preparations of the decoctions for washing.
अस्मिन्नेव कषाये तु तैलं धीरो विपाचयेत् । सर्वगन्धैश्च गोजीविडङ्गयष्टीभिः एतत् सर्वोपदंशेषु संयुतम् । रोपणमिष्यते ।। ३९।।
श्रेष्ठं स्वर्जिका तुत्थकासीसं शैलेयञ्च रसाञ्जनम्। मनःशिलासमैश्चूर्णं व्रणवीसर्पनाशनम् ॥ ४० ॥
गुन्द्रां दग्ध्वा कृतं भस्म हरितालं मनः शिला । उपदंशविसर्पाणामेतच्छान्तिकरं मार्कवस्त्रिफला उपदंशं निहन्त्येष दन्ती परम् ॥ ४१ ॥
ताम्रचूर्णमयोरजः । वृक्षमिन्द्राशनिर्यथा ॥ ४२ ॥
A decoction of the tender leaves of Jambu, Amra, Sumana, Nimba, Sveta and of Kamboji and the barks of Sallaki, Badara, Bilva, Palasa, Tinisa and of the Ksiri trees, as well as Triphala should be used by the physician for constantly washing the ulcer. Oil cooked with the preceding decoction, with the Kalkas of Goji, Vidanga and Yasti-madhu, as well as with the different spices ( Eladi group) should be used as the best remedy for the purpose of the healing up (Ropana) of an Upadamsa-ulcer of whatsoever type. The use of a pulverised compound composed of Svarjika, Tuttha, Kasisa, Saileya, Rasanjana and Manahsila taken in a equal parts arrests the extension of an ulcer and Visarpa. Cases of Upadamsa and Visarpa readily yield to the application of a pulverised compound of the ashes of Gundra, Haritala and Manahsila. An ( external) application of Bhrngaraja, Triphala and Danti mixed with the powders of copper and iron, destroys Upadamsa just as the thunder bolt of Indra (completely) destroys a tree. 37-42
उपदंशद्वयेऽप्येतां प्रत्याख्यायाचरेत् क्रियाम् । तयोरेव च या योग्या वीक्ष्य दोषबलाबलम् ॥ ४३ ॥
उपदंशे विशेषेण शृणु भूयस्त्रिदोषजे । दुष्टव्रणविधिं कुर्यात् कुथितं मेहनं त्यजेत् ॥ ४४ ॥
जम्ब्वोष्ठेनाग्निवर्णेन पश्चाच्छेषं दहेद् भिषक् । सम्यग्दग्धञ्च विज्ञाय मधुसर्पिः प्रयोजयेत् ।
शुद्धे च रोपणं दद्यात् कल्कं तैलं हितञ्च यत् ॥ ४५ ॥
Treatment of Tridosaja and Raktaja Upadamsa : The medical treatment of the two kinds of Upadamsa due to the concerted action of the three Dosas as well as that due to the vitiated blood (Raktaja) should be taken in hand without holding out any definite hope of recovery. The above-mentioned medicines specific to the different Dosas should be combinedly applied in these cases in consideration of the nature and intensity of the Dosas specifically involved in them. Now hear my discourse on the special treatment of Tridosaja Upadamsa. It should be the same as in the case of a malignant ulcer (Dusta-Vrana). The putrid portion of the male organ should be cut off and the remaining portion should be fully cauterized (in the incised part) with a Jambvostha instrument, made red-hot in fire. Honey and clarified butter should then be applied to the cauterized part, and medicinal plasters and oils possessed of healing properties should be applied to the incidental ulcer when it would be cleansed (disinfected). 43-45
स्नेहस्वेदोपपन्ने तु श्लीपदेऽनिलजे भिषक् । कृत्वा गुल्फोपरि सिरां विध्येत् तु चतुरङ्गुले ॥ ४६ ।।
समाप्यायितदेहञ्च बस्तिभिः समुपाचरेत् । मासमेरण्डजं तैलं पिबेन्मूत्रेण संयुतम् ॥ ४७॥
पयसौदनमश्नीयान्नागरक्वथितेन च। त्रैवृतञ्चोपयुञ्जीत शस्तो दाहस्तथाऽग्निना ॥ ४८ ॥
Treatment of Stipada: In a case of Elephantiasis (Slipada) due to the action of the deranged and aggravated Vayu, the vein (Sira) at a distance of four fingers above the instep (Gulpha) should be opened after an application of Sneha and Sveda¹ to the patient. Bastis should be employed when the patient has been (soothed and) restored to his former condition (with appropriate and nutritious diet, etc.). He should be made to take continuously for a month, a potion consisting of castor-oil mixed with (an adequate quantity of cow’s) urine. The patient should take rice as his diet with milk duly cooked with Sunthi. The use of the Traivrta Ghrita as well as cauterization of the affected part with fire is also recommended in such a case. 46-48
1. Cakradatta reads “” in place of “” meaning thereby that such Sveda and Upanaha should be applied before the incision of the vein. Gayadasa also supports this reading as is evident from Dalhana’s commentary. –Ed.
गुल्फस्याधः सिरां विध्येत् श्लीपदे पित्तसम्भवे । पित्तघ्नीञ्च क्रियां कुर्यात् पित्तार्बुदविसर्पवत् ॥ ४९ ॥
Treatment of Pittaja Slipada : In a case of Pittaja type of Elephantiasis, the vein (Sira) below the instep (Gulpha) should be opened. Medicinal remedies mentioned in connection with the treatment of the Pittaja type of tumours (Arbuda) and of Erysipelas (Visarpa) as well as other Pitta-subduing remedies and measures should be employed.¹ 49
सिरां सुविदितां विध्येदङ्गुष्ठे श्लैष्मिके भिषक् । मधुयुक्तानि चाभीक्ष्णं कषायाणि पिबेन्नरः । पिबेद् वाऽप्यभयाकल्कं मूत्रेणान्यतमेन च ॥५०॥ कटुकाममृतां शुण्ठीं विडङ्गं दारु चित्रकम् । हितं वा लेपने नित्यं भद्रदारु सचित्रकम् ॥५१॥ विडङ्गमरिचार्केषु नागरे चित्रकेऽथवा । भद्रदार्वेलुकाख्ये च सर्वेषु लवणेषु च । तैलं पक्वं पिबेद् वाऽपि यवान्नञ्च हितं सदा ॥ ५२ ॥
Treatment of Kaphaja Slipada : In a case of the Kaphaja type of elephantiasis the principal vein (Sira) of the first toe should be opened by an experienced surgeon and the patient should be made to take at intervals the decoction (of the Kapha-subduing drugs) with honey. As an alternative, the patient should be advised to take the powders (Kalka) of Abhaya mixed with any officinal kind of urine. The affected locality should be constantly plastered with the paste of Katuka, Amrta, Sunthi, Vidanga, Deva daru and Citraka, or with Citraka and Deva-daru. An oil cooked with Vidanga, Marica, Arka, Sunthi, Citraka, Deva-daru, Elaka and all the five officinal kinds of salt should be given him as a potion. Cooked barley is specially recommended as diet in the present case. 50-52
पिबेत् सर्षपतैलं वा श्लीपदानां निवृत्तये । पूतिकरञ्जपत्राणां रसं वापि यथाबलम्॥५३॥
1. The particle “च” in the text shows that Kapha-subduing remedies and measures should also be used in all these cases.
अनेनैव विधानेन पुत्रजीवकजं रसम् । प्रयुञ्जीत भिषक् प्राज्ञः कालसात्म्यविभागवित् ॥ ५४॥
केवुकाकन्दनिर्यासं लवणन्त्वथ पाकिमम् । रसं दत्त्वाथ पूर्वोक्तं पेयमेतद् भिषग्जितम् ॥ ५५ ॥
As an alternative, the patient should be made to drink a potion of mustard oil¹ or of the expressed juice of the leaves of Puti-Karanja according to his capacity for the cure of Slipada. In the same way² the juice of Putranjivaka should be prescribed by a physician after a due consideration as to the strength of the patient and of the time. The same juice (i.e., of Putrafijivaka) should be taken along with the juice of the bulbs of Kevuka with Pakima (vid) salt 53-55
काकादनीं काकजङ्घां बृहतीं कण्टकारिकाम् । कदम्बपुष्पीं मन्दारीं लम्बां शुकनसां तथा ॥ ५६ ॥
दग्ध्वा मूत्रेण तद् भस्म स्त्रावयेत् क्षारकल्पवत् । तत्र दद्यात् प्रतीवापं काकोदुम्बरिकारसम्॥५७॥
मदनाच्च फलात् क्वाथं शुकाख्यस्वरसं तथा । एष क्षारस्तु पानीयः श्लीपदं हन्ति सेवितः ॥ ५८ ॥
अपचीं गलगण्डञ्च ग्रहणीदोषमेव च। भक्तस्यानशनञ्चैव हन्यात् सर्वविषाणि च ॥ ५९॥
एष्येव तैलं संसिद्धं नस्याभ्यङ्गेषु पूजितम् । एतानेवामयान् हन्ति ये च दुष्टव्रणा नृणाम् ॥ ६० ॥
The Alkaline Remedies : An alkali should be prepared from the ashes of Kakadani, Kaka-jangha, Vrhati, Kantakarika, Kadamba puspa, Mandari, Lamba, Sukanasa in the usual way by filtering them (twenty one times) after dissolving them incow’s urine. Theexpressed juice of Kakodumbarika, Sukanasa and the decoction of Madana fruit should be mixed with the above alkaline preparation (and duly cooked in the manner of Kshara-paka). Diseases, such as supada (Elephantiasis), Apaci (Scrofula, Gala-ganda (Goitre), Grahani (chronic diarrhoea), aversion to food and the affections of all kinds of poison, yield to the internal use of this alkaline preparation. An oil cooked with the aforesaid drugs, if used as errhines and anointments, will cure all the foregoing maladies as well as malignant ulcers (Dusta-vrana). 56-60
1. Chakradatta reads “पिबेत् सर्षप तैलेन” in place of “पिबेत् सर्षप तैलं वा” which shows that the expressed juice of Puti-Karanja leaves should be taken with mustard oil and not separately. Dalhana evidently supports this in his commentary, that Cakradatta’s reading is the correct one is also evident from the next copulet which says that the expressed juice of Putranjivaka should be taken in the preceding manner. This “preceding manner” evidently means with mustard oi!”, and unless we accept Cakradatta’s reading the expression would be unmeaning.
2. It evidently means that the expressed juice of Putranjivaka should be taken with mustard oil–see last note. –Ed.
द्रवन्तीं त्रिवृतां दन्तीं नीलीं श्यामां तथैव च । सप्तलां शङ्खनीञ्चैव दग्ध्वा मूत्रेण गालयेत् ।। ६१ ।।
दद्याच्च त्रिफलाक्वाथमेष क्षारस्तु साधितः । अधो गच्छति पीतस्तु पूर्वेश्चाप्याशिषः समाः ।। ६२ ।।
The ashes of the Dravanti, Trivit, Danti, Nili, Syama, Saptala and Samkhini should be filtered in the way of preparing alkalies after dissolving them in cow’s urine. The solution, thus prepared, should be boiled with a decoction of Triphala. Taken internally it tends to act in the lower part of the body (i.c., it moves the bowels). The medicine produces the same effect as the prcceding ones. 61-62
इति सुश्रुत संहितायां चिकित्सितस्थाने वृद्धयुपदंशश्लीपदचिकित्सितं नामैकोनविंशोऽध्यायः ।। १९ ।।
Thus ends the nineteenth Chapter of the Chikitsa Sthana in the Susruta Samhita which deals with the medical treatment of Vruddhi, Upadamsa and Slipada.
