The 5th chapter of Chikitsasthana of Sushruta Samhita is named as Mahāvātavyādhi Cikitsitam Adhyaya. This chapter deals with Treatment of Special Nervous Diseases.

अथातोमहावातव्याधिचिकित्सितंव्याख्यास्यामः।।१।।
यथोवाचभगवान्धन्वन्तरिः।।२।|

We will now expound Mahāvātavyädhicikitsitam- treatment of special nervous diseases; as revealed by the venerable Dhanvantari.

1. Vatasonita (vātarakta) – Gout

द्विविधंवातशोणितमुत्तानमवगाढंचेत्येकेभाषन्ते;तत्तुनसम्यक्,तद्धिकुष्ठवदुत्तानंभूत्वाकालान्तरेणावगाढीभवति,तस्मान्नद्विविधम्।।३।।

According to some authorities, Vatasonita / Vatarakta is of two kinds –

1. Uttana Vatarakta – which is superficial
2. Gambhira Vatarakta – which is deep seated

But this is incorrect. Vatasonitha first develops as Uttana – superficially and in due course of time gets converted into Gambhira i.e. deep seated, just like Kustha – skin diseases. Hence, Vatasonita is not of two kinds.

Nidāna samprāpti – cause and pathogenesis

तत्रबलवद्विग्रहादिभिःप्रकुपितस्यवायोर्गुरूष्णाध्यशनशीलस्यप्रदुष्टंशोणितंमार्गमावृत्यवातेनसहैकीभूतंयुगपद्वातरक्तनिमित्तांवेदनांजनयतीतिवातरक्तम्।तत्तुपूर्वहस्तपादयोरवस्थानंकृत्वापश्चाद्देहंव्याप्नोति।तस्यपूर्वरूपाणितोददाहकण्डूशोफस्तम्भत्वक्पारुष्यसिरास्नायुधमनीस्पन्दनसक्थिदौर्बल्यानिश्यावारुणमण्डलोत्पत्तिश्चाकस्मात्पाणिपादतलाङ्गुलिगल्फमणिबन्धप्रभृतिषु,तत्राप्रतिकारिणोऽपचारिणश्चरोगोव्यक्ततरः,तस्यलक्षणमुक्तं;तत्राप्रतिकारिणोवैकल्यंभवति।।४।।

Etiological Factors –

Aggravation of Vata takes place when one indulges in combat – wrestling, restraining, fighting, etc. with persons or animals stronger than him.

Aggravation of Rakta – blood takes place in persons who are indulged in –

–        Foods and drinks which are heavy to digest,

–        Foods and drinks which are hot in potency,

–        Overeating

Pathogenesis –

In such persons the blood causes blockage of vata. Later, the blood combines with the same vata and causes pains and symptoms of both vata and rakta types simultaneously, at the same time.

Such a disease caused by simultaneous vitiation of vata and rakta is called Vatarakta. This disease vatarakta first appears (gets located) in the hands and feet. Later it spreads to the entire body.

Purvarüpa – premonitory symptoms

Below mentioned are the premonitory symptoms of Vatasonita –

–        Pricking pain

–        Burning sensation

–        Itching

–        Rigidity

–        Roughness of the skin

–        Throbbing of the veins, arteries and ligaments,

–        Debility in the thighs and legs

–        Bluish red coloured round patches develops in the palms, soles, fingers, ankle, wrist etc without any cause

The disease Vatasonita would become well manifested if the premonitory symptoms are not treated or if the person indulges in improper and incompatible foods, activities and other regimens.

Symptoms of Vatasonita have already been described in the first chapter of Nidana Sthana section. If this condition is not properly / promptly treated, it produces distortions / deformities.

भवतिचात्र

One verse here–

प्रायशःसुकुमाराणांमिथ्याहारविहारिणाम्।।
स्थूलानांसुखिनांचापिवातरक्तंप्रकुप्यति।।५।।

Vatarakta, generally becomes aggravated in persons

–        of tender constitution

–        who indulge in unhealthy foods and activities

–        who are obese and

–        who lead a luxurious life without indulging themselves in physical and mental activities

Cikitsā – treatment

तत्रप्राणमांसक्षयपिपासाज्वरमूश्विासकासस्तम्भारोचकाविपाकविसरणसंकोचनैरनुपपद्रुतंबलवन्तमात्मवन्तंमुपकरणवन्तंचोपक्रमेत्।।६।।

Below mentioned are the complications of Vatasonita –

–        loss of strength,

–        loss of muscles,

–        thirst,

–        fever,

–        fainting,

–        dyspnoea,

–        cough,

–        rigidity,

–        anorexia,

–        improper digestion,

–        dilation or contraction of fingers etc.

Vatasonita should be treated in patients –

–        who do not have complications,

–        who are strong,

–        follow discipline in relation to foods, activities etc. and

–        who is well equipped with all requirements for treatment i.e. attendants, money, medicines etc.

तत्र,आदावेवबहुवातरूक्षम्लानाङ्गादृतेमार्गावरणाहुष्टशोणितमसकृदल्पाल्पमवसिञ्चेद्वातकोपभयात्।ततोवमनादिभिरुपक्रमैरुपपाद्यप्रतिसंसृष्टभक्तंवातप्रबलेपुराणघृतंपाययेत्।अजाक्षीरंवाऽर्धतैलंमधुकाक्षययुक्तं,शृगालविन्नासिद्धंवाशर्करामधुमधुरं,शुण्ठीशृङ्गाटककशेरुकसिद्धंवा,श्यामारास्नासुषवीशृगालविन्नापीलुशतावरीश्वदंष्ट्राद्विपञ्चमूलीसिद्धंवा।द्विपञ्चमूलीक्वाथाष्टगुणसिद्धेनपयसामधुकमेषशृङ्गीश्वदंष्ट्रासरलभद्रदारुवचासुरभिकल्कप्रतीवापंतैलंपाचयित्वापानादिषूपयुञ्जीत,शतावरीमयूरककिणिजमोदामधुकक्षीरविदारीबलातिबलातृणपञ्चमूलीक्वाथसिद्धंवाकाकोल्यादिप्रतिवापंबलातैलंशतपाकंवेति।वातहरमूलसिद्धेनचपयसापरिषेचनमम्लैर्वाकुर्वीत।यवमधुकैरण्डतिलवर्षाभूभिर्वाप्रदेहःकार्यः।तत्रचूर्णितेषुयवगोधूमतिलमुद्गमाषेषुप्रत्येकशःकाकोलीक्षीरकाकोलीजीवकर्षभकबलातिबलाबिसमृणालशृगालविन्नामेषशृङ्गीप्रियालशर्कराकशेरुकसुरभिवचाकल्कमिश्रेषूपनाहार्थंसर्पिस्तैलवसामज्जदुग्धसिद्धाःपञ्चपायसाव्याख्याता:स्नैहिकफलसारोत्कारिकावा,चूर्णितेषुयवगोधूमतिलमुद्गमाषेषुमत्स्यपिशितवेशवारोवा,बिल्वपेशिकातगरदेवदारुसरलारास्नाहरेणुकुष्टशतपुष्पैलासुरादधिमस्तुयुक्तउपनाहः,मातुलुङ्गाम्लसैन्धवघृतमिश्रंमधुशिग्रुमूलमालेपस्तिलकल्कोवेतिवातप्रबले।।७।।

Bloodletting – The vitiated and obstructed blood should be let out many times in the beginning of the treatment itself. Bloodletting should be done in small quantities from the body. It should not be done from the areas of the body having severe symptoms of vata and which are dry / rough and shrivelled. This is because; if bloodletting is done in these conditions there is fear of further aggravation of vata. Vata gets aggravated if more blood is removed through bloodletting suddenly.

Vamana etc. therapies – Next, the patient should be administered with Vamana and other purificatory therapies. After this, foods should be gradually given in a stipulated and graduated way i.e. samsarjana krama should be done commencing with peya, vilepi, yusa etc.

Ghee and milk recipes – Later, the patient is given with old ghee or goat’s milk added with half its quantity of oil and 1 aksa – 10 grams of Madhuka.

Alternatively, he should be given with milk boiled and prepared with

–        Sunthi, Srngataka and Kaseruka or

–        with Syama, Rasna, Susavi, Srgalavinna, Pilu, Satavari, Svadamstra and two Pancamulas

Dwipancamuladi Taila – Medicated oil should be prepared with the below mentioned ingredients and be administered along with foods and drinks –

–        Both Pancamulas – Brihat and Laghu Pancamula – the ten roots which constitute Dasamula

–        Eight parts of milk and

–        Paste of – Madhuka, Mesasringi, Svadamstra, Sarala, Bhadradaru, Vaca and Surabhi

Satavaryadi Taila – Oil prepared with the below mentioned herbs should be used internally –

1. Decoction of the below mentioned –

–        Satavari,

–        Mayuraka / Apamarga,

–        Kinihi

–        Ajamoda

–        Madhuka

–        Ksiravidari

–        Bala

–        Atibala and

–        Herbs belonging to Trina Pancamula group of herbs

1. Paste of herbs of Kakolyadi Gana group of herbs.

Satapaka Bala Taila – Alternatively, Satapaka Bala Taila should be used internally.

Parisecana (pouring / showering medicated liquids on the body) should be done with –

–        milk boiled with roots of vata mitigating herbs or

–        milk boiled with sour liquids like fermented gruel etc.

Pradeha (application of medicinal pastes or warm poultices with medicinal pastes)

1. Yavadi Pradeha – is prepared from –

–        Yava,

–        Madhuka,

–        Eranda,

–        Tila and

–        Varsabhu

1. Yava Godhumadi Pradeha – is prepared from

–        Separate flours of Yava, Godhuma, Tila, Mudga and Masa added with

–        Paste of – Kakoli, Ksirakakoli, Jivaka, Rshabhaka, Bala, Atibala, Bisa, Mrnala, Srgalavinna, Mesasringi, Priyala, Sarkara, Kaseruka, Surabhi and Vaca added with

–        Ghee, oil, muscle-fat, bone marrow and milk

These five Payasa (preparations of milk or milk puddings) may be used.

Other Pradehas – Pradeha can be done with one of the below mentioned recipes when vata is predominant –

–        Utkarika (pan cake) prepared from Tila, Eranda, Atasi etc oil yielding seeds

–        Flour of Yava, Godhuma, Tila, Mudga and Masa added with Vesavara (meat broth) of fish

–        Bilvapesika (tender fruits of Aegle marmelos), Tagara, Devadaru, Sarala, Rasna, Harenu, Kustha, Satapushpa, Ela, Sura and Dadhimastu (whey of curd) or

–        Mastulungamla, Saindhava, Ghrta and paste of root of Sigru or

–        Paste of Tila – sesame seeds

पित्तप्र्बलेद्राक्षारेवतकदूफलपस्यामधुकचन्दनकाश्मर्यकषयंशर्करामधुमधुरंपाययेत्,शतावरीमधुकपटोलत्रिफालाकटुरोहिणीकषायं,गुडूचीकषायं वा,पित्तज्वरहरंवा  चन्दनादिकषायंशर्करामधुमधुरं,मधुरतिक्तकषायसिद्धंवा;सर्पिःबिसमृणालभद्रश्रियपाककषायेणार्धक्षीरेणपरिषेकः,क्षीरेक्षुरसैर्मधुकशर्करातण्डुलोदकैर्वाद्राक्षेक्षुकषायमित्रैर्वामस्तुमद्यधान्याम्लैः;जीवनीयसिद्धेनवासर्पिषाऽभ्यङ्गः,शतधौतघृतेनवा,काकोल्यादिकल्ककषायविपक्वेनवासर्पिषा;शालिषष्टिकनलवझूलतालीसशृङ्गाटकगलोड्यगौरीगैरिकशैवलपद्मकपद्मपत्रप्रभृतिर्धान्याम्लपिष्टैःप्रदेहोघृतमिश्रः,वातप्रबलेऽप्येषसुखोष्णःप्रदेहकार्यः।।८।।

Below mentioned measures should be adopted when pitta is predominant –

Drakshadi Kwatha – Decoction of the below mentioned herbs should be served after adding sugar, honey and other sweet substances for drinking –

–        Draksha

–        Arevata

–        Katphala

–        Payasya

–        Madhuka

–        Candana and

–        Kasmarya

Satavaryadi Kwatha – Decoction of the below mentioned herbs shall be given –

–        Satavari

–        Madhuka

–        Patola

–        Triphala and

–        Katurohini

Below mentioned Kashaya / decoctions too shall be given –

–        Decoction of Guduchi or

–        Decoctions which cure fever of pitta origin Ex. Candanadi Kashaya

Ghrta – Medicated ghee prepared with herbs belonging to the below mentioned groups should be taken internally –

–        Madhura – sweet tasting herbs

–        Tikta – bitter tasting herbs and

–        Kashaya – astringent tasting herbs

Pariseka – pouring of medicated liquids on the body or parts of the body

1. Bisadi Kwatha – Pariseka should be done with the decoction of the below mentioned herbs –

–        Bisa

–        Mrnala

–        Bhadrasriya (Candana)

–        Padmaka

Before pouring, ghee – half the quantity of decoction should be added to the decoction.

2. Ksiradi Pariseka – Pariseka should be done with mixture of –

–        Ksira,

–        Iksurasa

–        Madhuka

–        Sarkara and

–        Tandulodaka

3. Draksadi Pariseka – Pariseka shall also be done with mixture of the below mentioned –

–        Decoction of Draksa and Iksu

–        Mastu – whey

–        Madya – wine and

–        Dhanyamla – sour gruel

Abhyanga – massage or anointing with oil or ghee

Abhyanga should be done with one of the below mentioned medicated ghee –

–        Ghee prepared with herbs of Jivaniya Gana group or

–        Satadhauta Ghrta or

–        Ghee prepared with herbs of Kakolyadi Gana group

Pradeha – applying medicinal pastes / warm poultice

Pradeha should be prepared with the below mentioned herbs macerated with dhanyamla and added with ghee –

–        Sali

–        Swastika

–        Nala

–        Vanjula

–        Talisa

–        Srngataka

–        Galodya

–        Gauri

–        Gairika

–        Saivala

–        Padmaka

–        Padmapatra

–        and such other herbs

These pradeha shall be used comfortably warm, even in predominance of vata.

रक्तप्रबलेऽप्येवं,बहुशश्चशोणितमवसेचयेत्,शीततमाश्चप्रदेहाःकार्याइति।।९।।

The same treatment is also applicable in case of predominance of Rakta (blood). Bloodletting should be done many times. Cold poultices should be applied.

श्लेष्मप्रबलेत्वामलकहरिद्राकषायंमधुमधुरंपाययेत्,त्रिफलाकषायंवा;मधुकथङ्गवेरहरीतकीतिक्तरोहिणीकल्कंवासक्षौद्रं,मूत्रतोययोरन्यतरेणगुडहरीतकीवाभक्षयेत्;तैलमूत्रक्षारोदकसुराशुक्तकफघ्नौषधनिःक्वाथैश्चपरिषेकः,आरग्वधादिकषायैर्वोष्णैः;मस्तुमूत्रसुराशुक्तमधुकसारिवापाकसिद्धवाघृतमभ्यङ्गः;तिलसर्षपातसीयवचूर्णानिश्लेष्मातककपित्थमधुशिमिश्राणिक्षारमूत्रपिष्टानिप्रदेहः;श्वेतसर्षपकल्कः,तिलाश्वगन्धाकल्कःप्रियालसेलुकपित्थकल्कः,मधुशिग्रुपुनर्नवालकल्कः,व्योषतिक्तापृथपर्णीवहतीकल्कइत्येतेषांपक्षप्रदेहाःसुखोष्णा:क्षारोदकपिष्टाः,शालिपर्णीपृश्निपर्णीबृहत्यौवाक्षीरपिष्टास्तर्पणमिश्राः।।१०।।

Below mentioned recipes are beneficial in case of kapha predominance –

Amalakyadi Kashaya – Decoction of Amalaka – Emblica officinalis and Haridra – Curcuma longa should be honey or other sweets and should be served for drinking

Triphala Kashaya may be given after adding honey to it.

Paste of the below mentioned shall be given, mixed in honey –

–        Madhuka

–        Srngavera

–        Haritaki and

–        Tiktarohini

Guda Haritaki should be administered with any one of the below mentioned –

–        Cow’s urine

–        Water or

–        Any other liquids

Pariseka – The below mentioned liquids should be poured / showered

–        Oil

–        Cow urine

–        Alkali solution

–        Beer

–        Vinegar

–        Decoction prepared with kapha mitigating herbs,

–        Warm decoction of Aragwadhadi Gana

Abhyanga – Massage should be done with one of the below mentioned –

–        Mastu

–        Matra

–        Sura

–        Sukta or

–        Ghee processed with Madhuka, Sariva and Padmaka

Pradeha – application of medicinal paste or poultice

Tiladi Pradeha – Pradeha prepared with below mentioned herbs macerated with alkali solution and urine –

–        Tila

–        Sarsapa

–        Atasi

–        Flour of Yava

–        Sleshmataka

–        Kapittha and

–        Madhusigru

Other Pradehas

Below mentioned five kinds of poultices should be used by macerating with alkali solution –

–        Sveta Sarsapa Pradeha – Paste prepared with Sveta Sarsapa – black mustard

–        Tiladi Pradeha – Paste of Tila – sesame and Asvagandha – Withania somnifera

–        Priyalvadi Pradeha – Paste of Priyala, Selu and Kapittha

–        Madhusigrvadi Pradeha – Paste of Madhusigru and Punarnava

–        Vyoshadi Pradeha – Paste of Vyosa, Tikta, Prthakparni and Brhati

Saliparnyadi Pradeha – Paste of the below mentioned macerated with milk and added with Tarpana (flour of Yava) should be applied warm –

–        Saliparni

–        Prsniparni and

–        Two types of Brhati

संसर्गेसन्निपातेचक्रियापथमुक्तंमिश्रंकुर्यात्।।११।।

The treatments described so far for individual dosha predominance / aggravation may be administered mixed together appropriately in conditions wherein there is predominance of combination of two or three doshas.

Vardhamānapippalī yoga

सर्वेषुचगुडहरीतकीमासेवेत;पिप्पलीक्षीरपिष्टावारिपिष्टावापञ्चाभिवृद्ध्यादशाभिवृद्ध्यावापिबेत्क्षीरौदनाहारोदशरात्रं,भूयश्चापकर्षयेत्,एवंयावत्पञ्चदशवेति;तदेतत्पिप्पलीवर्धमानकंवातशोणितविषमज्वरारोचकपाण्डुरोगप्लीहोदरार्श:कासश्वासशोफशोषाग्निसादहृदोगोदराण्यपहन्ति;जीवनीयप्रतीवापंसर्पिःपयसापाचयित्वाऽभ्यज्यात्;सहासहदेवाचन्दनमूर्वामुस्ताप्रियालशतावरीकशेरुपाकमधुकशतपुष्पाविदारीकुष्ठानिक्षीरपिष्टःप्रदेहोघृतमण्डयुक्तः,सैरेयकाटरूषकबलातिबलाजीवन्तीसुषवीकल्कोवाच्छागक्षीरपिष्टः,गोक्षीरपिष्टःकाश्मर्यमधुकतर्पणकल्कोवा;मधूच्छिष्टमञ्जिष्ठासर्जरसारिवाक्षीरसिद्धंपिण्डतैलमभ्यङ्गः;सर्वेषुचपुराणघृतमामलकरसविपक्वंवापानार्थे;जीवनीयसिद्धंपरिषेकार्थे,काकोल्यादिक्वाथकल्कसिद्धंवा;सुषवीक्वाथकल्कसिद्धंवा,कारवेल्लकक्वाथमात्रसिद्धंवा;बलातैलंवापरिषेकावगाहबस्तिभोजनेषु;शालिषष्टिकयवगोधूमान्नमनवंभुञ्जीतपयसाजाङ्गलरसेनवामुद्गयूषेणवाऽनम्लेन;शोणितमोक्षंचाभीक्ष्णंकुर्वीत;उच्छ्रितदोषेचवमनविरेचनास्थापनानुवासनकर्मकर्तव्यम्।।१२।।

Gudaharitaki should be regularly consumed in all varieties of this disease. Or pippali macerated with either milk or water may be used increasing either by five or ten pippali every succeeding day. One should take a diet predominant in milk and rice while consuming this recipe. After taking pippali in ascending dose for a time duration of ten days, the number of pippali should be gradually decreased by five or ten pippalis each day (in the same manner). The number of Pippali should be increased until it reaches fifty (in number). This recipe is popularly known by the name Vardhamana Pippali Yoga.

It cures the below mentioned diseases –

–        Vatarakta – gout, peripheral vascular diseases

–        Visama Jwara – irregular fevers

–        Arochaka – tastelessness, anorexia

–        Pandu Roga – anaemia, liver disorders

–        Plihodara – enlargement of spleen / Splenomegaly

–        Arshas – piles

–        Kasa – cough

–        Sopha – swelling, oedema

–        Sosha – consumption, emaciation due to tissue destruction

–        Agnisada – weak digestive fire and weak digestion capacity

–        Hrdroga – Heart diseases and

–        Udara – Abdominal diseases

For Abhyanga – ghee prepared with herbs belonging to the Jivaniya Gana group of herbs and milk should be used.

For Pradeha (warm poultices) – Below mentioned herbs macerated with milk and added with ghee scum shall be used –

–        Saha,

–        Sahadevā,

–        Cañdana,

–        Mūrvā,

–        Mustā, Priyāla,

–        Satāvarī,

–        Kaseru,

–        Padmaka,

–        Madhuka,

–        Satapuspa,

–        Vidārī,and

–        Kuştha

Other Pradeha

Saireyakadi Pradeha – Pradeha prepared by macerating the below mentioned herbs with goat’s milk –

–        Saireyaka,

–        Ațarūşaka,

–        Balā,

–        Atibalā,

–        Jīvañtī and

–        Suşavī

Kasmaryadi Lepa – Paste of the below mentioned macerated with cow’s milk is used for applying pradeha – poultice –

–        Kāşmarya,

–        Madhuka and

–        Tarpaņa (flour of yava)

For Abhyanga (massage), Pinda Taila is used. This oil is prepared with the below mentioned ingredients –

–        Madhūcehişta,

–        Manjista,

–        Sarjarasa and

–        Sariva and

–        Milk

Recipes for all types of Vatarakta –

For drinking purposes – old ghee prepared with juice or decoction of Amalaka should be used.

For Parisheka (pouring or showering on the body parts) –

–        old ghee prepared with Jivaniya Gana group of herbs should be used or

–        old ghee prepared with decoction of Kakolyadi Gana group of herbs

–        old ghee prepared with decoction and paste of Susavi or

–        old ghee prepared with decoction of Karavellaka

–        Bala Taila

Bala Taila – Apart from Parisheka, Bala Taila is used for Avagaha – tub bath, Basti – administering enema and Bhojana – to be used along with food.

For preparing food – old sali rice, swastika rice, yava – barley and godhuma – wheat should be used. The prepared food should be taken along with any one of the below mentioned –

–        milk

–        soup of meat of animals living in arid lands without adding sour substances or

–        soup of mudga – green gram, without adding sour substances

Bloodletting – is the best treatment for Vatarakta and should be done often.

Therapies for severe aggravation of doshas – If there is severe aggravation of doshas in the disease, the below mentioned therapies should be administered as and when required –

–        vamana – emesis

–        virechana – purgation

–        asthapana – decoction enema and

–        anuvasana – oil enema

पटोलत्रिफलाभीरुगुडूचीकटुकाकृतम्।।
क्वाथंपीत्वाजयत्याशुवातशोणितजांरुजम्।।१३।।

Patoladi Kashayam – The decoction of the below mentioned herbs, when consumed, cures pain associated with vatarakta –

–        Patola

–        Triphala

–        Abhiru

–        Guduchi and

–        Katuka

भवन्तिचात्र

Some verses here

एवमाद्यैःक्रियायोगैरचिरोत्पतितंसुखम्।।
वातासृक्साध्यतेवैद्यैर्याप्यतेतुचिरोत्थितम्।।१४।।

Vatarakta of recent origin / onset can be cured by the physician by administering these therapies mentioned above. Chronic conditions of Vatarakta cannot be cured but can only be controlled by administering these therapies.

Pathyāpathya — do and don’ts

उपनाहपरीषेकप्रदेहाभ्यञ्जनानिच।।
शरणान्यप्रवातानिमनोज्ञानिमहान्तिच।।१५।।
मृदुगण्डोपधानानिशयनानिसुखानिच।।
वातरक्तेप्रशस्यन्तेमृदुसंवाहनानिच।।१६।।
व्यायाममैथुनंकोपमुष्णाम्ललवणाशनम्।।
दिवास्वप्नमभिष्यन्दिगुरुचान्नंविवर्जयेत्।।१७।।

The below mentioned types of therapies are highly beneficial in the treatment of Vatarakta –

–        Upanaha – application of warm poultices

–        Parisheka – pouring or showering medicinal liquids over the body or body parts

–        Pradeha – warm application of medicinal pastes over the body or affected body parts

–        Abhyanjana – massage with medicated oils 

–        Sharanani – apravatani manojnani mahantani – staying in room / chamber which is devoid of heavy breeze, pleasing to the mind and is also large

–        Mrdu gandopadhanani shayanani sukhani cha – use of soft pillows and comfortable bedding

–        Mrdu Samvahanani – mild massaging / kneading

Vatarakta patient should avoid the below mentioned –

–        Vyayyama – excessive exercise

–        Maithuna – excessive sex / copulation

–        Kopa – anger

–        Ushna, Amla Lavana Ashana – foods which are hot in potence and predominant in sour and salt tastes

–        Divaswapna – sleeping during day time

–        Abhishyandi anna – consumption of foods which create more moisture inside the body

–        Guru anna – foods which are heavy and difficult to digest

2. Apatānaka – Tetanus

अपतानकिनमस्रस्ताक्षमवक्रभुवमस्तब्धमेढ़मस्वेदनमवेपनमप्रलापिनमखट्वापातिनमबहिरायामिनंचोपक्रमेत्।तत्रप्रागेवस्नेहाभ्यक्तंस्विन्नशरीरमवपीडनेनतीक्ष्णेनोपक्रमेतशिरःशुद्ध्यर्थं;अनन्तरंविदारिगन्धादिक्वाथमांसरसक्षीरदधिपक्वंसर्पिरच्छंपाययेत्,तथाहिनातिमात्रंवायुःप्रसरति;ततोभद्रदादिवातघ्नगणमाहृत्यसयवकोलकुलत्थंसानूपौदकमांसंपञ्चवर्गमेकतःप्रक्वाथ्यतमादायकषायमम्लक्षीरैःसहोन्मियसर्पिस्तैलवसामज्जभिःसहविपचेन्मधुरकप्रीतवापं,तदेतत्रैवृतमपतानकिनांपरिषेकावगाहाभ्यङ्गपानभोजनानुवासननस्येषुविदध्यात्;यथोक्तैश्चस्वेदविधानैःस्वेदयेत्,बलीयसिवातेसुखोष्णतुषबुसकरीषपूर्णेकूपेनिदध्यादामुखात्,तप्तायांवारथकारचुल्ल्यांतप्तायांवाशिलायांसुरापरिषिक्तायांपलाशदलच्छन्नायांवाशिलायांसुरापरिषिक्तायांपलाशदलच्छन्नायांकृशरावेशवारपायसैस्वेदयेत्।मूलकोरुबूस्फूर्जार्जकार्कसप्तलाशङ्खिनीस्वरससिद्धंतैलमपतानकिनांपरिषेकादिषूपयोज्यम्।अभुक्तवतापीतमम्लंदधिमरिचवचायुक्तमपतानकंहन्ति;तैलसर्पिर्वसाक्षौद्राणिवा।एतच्छुद्धवातापतानकविधानमुक्तं,संसृष्टेसंसृष्टंकर्तव्यम्।वेगान्तरेषुचावपीडंदद्यात्;ताम्रचूडकर्कटकृष्णमत्स्यशिशुमारवराहवसाश्चासेवेत,क्षीराणिवावातहरसिद्धानि,यवकोलकुलत्थमूलकदधिघृततैलसिद्धायवागूः;स्नेहविरेचनास्थापनानुवासनैश्चैनंदशरात्राहृतवेगमुपकमेत;वातव्याधिचिकित्सितंचावेक्षेत;रक्षाकर्मचकुर्यादिति।।१८।।

Below mentioned are the conditions favorable for treating the patient of Apatanaka (i.e. the patient of Apatanaka – tetanus shall be treated only in the presence of the below mentioned features / conditions) –

–        eyes of the patient should not have been dropped down too much,

–        his eyebrows should not be irregular,

–        his penis should not be rigid,

–        he should not be heavily sweating,

–        his body should not be bent too much,

–        he should not be talking irrelevantly,

–        he should not be falling down from his cot and

–        he should not be having bahirayama i.e. his body should not be bending backwards (not be having opisthotonus)

Cikitsă – treatment

Below mentioned therapies should be done at the commencement of treatment itself so as to purify / cleanse the head of its doshas –

–        Sneha Abhyanga – anointing the body with oil,

–        Swedana – sudation

–        Tikshna Avapidana Nasya – strong nasal drops

After this, Achchapana i.e. drinking ghee in one greater dose should be administered with ghee prepared from decoction of Vidarigandhadi Gana group of herbs, meat juice, milk and curds. By doing so, the aggravated doshas do not spread greatly and would not affect many parts of the body.

Traivrta sñeha

Next, decoction is prepared using the below mentioned ingredients –

–        herbs belonging to the Bhadradarvadi Gana group of herbs,

–        Yava – barley

–        kola – jujube

–        kulattha – horse gram and

–        meat of animals living in marshy regions and water and also

–        meat of other five groups (külacara, plava, kośastha, pādina and matsya)

This decoction is added with sours and milk and the ghee, oil, muscle fat and marrow and cooked by adding the paste of herbs belonging to Madhuraka group of herbs i.e. sweet tasting herbs such as Kakolyadi Gana group of herbs and sneha i.e. medicated fat prepared. This formulation is called Traivrta Sneha.

This Traivrta Sneha is used in treating Apatanaka patients in below mentioned forms / for below mentioned purposes –

–        pouring on the body

–        tub bath

–        anointing the body

–        drinking

–        mixing with food

–        unctuous enema and

–        nasal drops

Swedana i.e. ‘sudation therapy’ is also administered as indicated.

Below mentioned treatments should be given to the patient having severe aggravation of vata –

–        he should be buried in warm heap of ash or husk, muck etc. neck deep

–        he should be made to lie near a hearth of a metalsmith,

–        he should be made to lie on a stone slab which has been heated and then sprinkled with sura – beer and later spread over with palasha leaves or

–        he should be provided with sudation by using krśara (boiled rice), palāśa (milk pudding) or vesavāra (mutton broth)

For pouring or showering over the body and for other purposes, the medicated oil prepared from fresh juice of the below mentioned herbs should be used –

–        Mulaka

–        Urubaka

–        Sphurja

–        Arjaka

–        Arka

–        Saptala and

–        Sankhini

The below mentioned recipes consumed on empty stomach cures Apatanaka (tetanus) –

–        sour curds mixed with powder of Marica – black pepper and Vaca – Acorus calamus or

–        mixture of oil, ghee, muscle fat and honey mixed with powder of pepper and Acorus calamus

Thus, the treatment of Apatanaka produced by Vata not associated with other aggravated doshas i.e. Shuddha Vata has been explained above. The therapies for different doshas should be combined and administered in cases of Apatanaka wherein other doshas are associated or combined with Vata.

Measures to be done in between the bouts of convulsions of Apatanaka –

–        Avapida Nasya – strong nasal medicinal drops should be administered

–        Consumption of muscle fat of cock, crab, black fish, dolphin or boar or

–        Consumption of milk boiled with herbs which mitigate vata or

–        Consumption of yavagu i.e. thick gruel prepared with yava – barley, kola – jujube fruit, kulattha – horse gram and mulaka – radish added with curds, ghee and oil

The patient should be administered with the below mentioned therapies for ten days or till the bouts of convulsions of apatanaka get reduced or stop –

–        oil purgatives

–        decoction enema and

–        oil enema

The other treatments described in the context of chapter on Vatavyadhi i.e. previous chapter of the same section should also be considered. Raksha Karma i.e. protective rites should also be performed.

3. Paksāghāta — Hemiplegia

पक्षाघातोपद्रुतमम्लानगात्रंसरुजमात्मवन्तमुपकरणवन्तंचोपक्रमेत्।तत्रप्रागेवस्नेहस्वेदोपपन्नमृदुनाशोधनेनसंशोध्यानुवास्यास्थाप्यचयथाकालमाक्षेपकविधानेनोपचरेत्;वैशेषिकश्चामस्तिष्क्यःशिरोबस्तिः,अणुतैलमभ्यङ्गार्थे,साल्वणमुपनाहार्थे,बलातैलमनुवासनार्थे;एवमतन्दितस्त्रींश्चतुरोवामासान्क्रियापथमुपसेवेत।।१९।।

Below mentioned are the conditions for treating the patient of Pakshaghata –

–        the body of the patient should not be emaciated

–        he should be having pain (pakshaghata should be associated with pain)

–        the patient should be self controlled and

–        he should be well equipped with essential herbs, money for treatment, attendants and caretakers etc

Only snehana – oleation and swedana – sudation should be administered in the beginning. Following this, mild purificatory therapies i.e. emesis and purgation should be administered. Later, oil enema and decoction enema shall be administered at proper time. Then, the treatments prescribed for Akshepaka i.e. convulsions should be administered.

Shiro Basti is beneficial for the head and is a special treatment for this disease.

Below mentioned are specific indications –

–        Anutaila – for anointing and bathing purpose

–        Salvana Upanaha – for fomentation

–        Bala Taila – for oil enema

Without any laxity, these treatments should be continued for three or four months.

4. Mañyāsthambha – Wry neck

मन्यास्तम्भेऽप्येतदेवविधानं,विशेषतोवातश्लेष्महरैर्नस्यैरूक्षस्वेदैश्चोपचरेत्।।२०।।

The same treatments are also useful in treating Manyastambha – stiff neck. Below mentioned are special treatments for this condition –

–        Nasya – nasal drops which mitigate vata and kapha and

–        Ruksha Sweda – dry sudation

5. Apatañtraka – Tetanus

अपतन्त्रकातुरंनापतर्पयेत्,वमनानुवासनास्थापनानिननिषेवेत,वातश्लेष्मोपरुद्धोच्छ्वासंतीक्ष्णैःप्रध्यापनैर्मोक्षयेत्,तुम्बुरुपुष्कराह्वहिङ्ग्वम्लवेतसपथ्यालवणत्रयंयवक्वाथेनपातुंप्रयच्छेत्,पथ्याशतार्धेसौवर्चलद्विपलेचतुर्गुणेपयसिसर्पिःप्रस्थंसिद्धं;वातश्लेष्मापनुच्चकर्मकुर्यात्।।२१।।

The patient of Apatantraka should not be allowed to become malnourished and weak.

Below mentioned therapies should not be administered –

–        emesis

–        oil enema

–        decoction enema

Tikshna Pradhamana – Strong nasal insufflations should be administered to relieve obstruction of breathing caused by aggravated vata and kapha.

Powder of the below mentioned ingredients should be mixed in decoction of Yava – barley and given to the patient for drinking –

–        tumburu,

–        puskarāhvaya,

–        hingu,

–        amlavetasa,

–        pathyā and

–        lavanatraya – three salts – saindhava, sauvaracala and bida

Medicated ghee prepared with below mentioned ingredients should be given for drinking –

–        decoction of pathyā – Terminalia chebula – fifty in number,

–        sauvarcala salt – two pala i.e. 80 grams in quantity,

–        milk – four times the quantity and

–        ghrta – one prastha i.e. 640 ml

Other treatments which are meant to mitigate väta and kapha should also be administered. 

6. Ardita – Facial paralysis

अर्दितातुरंबलवन्तमात्मवन्तमुपकरणवन्तंचवातव्याधिविधानेनोपचरेत्,वैशेषिकैश्चमस्तिष्क्यशिरोबस्तिनस्यधूमोपनाहस्नेहनाडीस्वेदादिभिः;ततःसतृणंमहापञ्चमूलंअर्दितातुरंबलवन्तमात्मवन्तमुपकरणवन्तंचवातव्याधिविधानेनोपचरेत्,काकोल्यादिविदारिगन्धादिमौदकानूमांसंतथैवौदककन्दांश्चाहृत्यद्विगुणोदकेक्षीरद्रोणेनिःक्वाथ्यशीतीभूतमभिमशीयात्,तत्रयःस्नेहउत्तिष्ठेत्तमादायमधुरौषधसहाक्षीरयुक्तंविपचेत्,एतत्क्षीरावशिष्टमवतार्यपरिस्राव्यतैलप्रस्थेनोन्मियपुनरग्नावधिश्रयेत्,ततस्तैलंक्षीरानुगतमवतार्यक्षीरतैलमर्दितातुराणांपानाभ्यङ्गादिषूपयोज्यं;तैलहीनंवाक्षीरसर्पिरक्षितर्पणमिति।।२२।।

The patient of Ardita shall be treated with the same therapies indicated for treating Vatavyadhi (general line of treatment of Vatavyadhi). Below mentioned are the conditions for treating Ardita –

–        the patient should be strong

–        he should be self controlled

–        he should be well equipped (have all equipments needed for treatment)

Below mentioned are the special treatments for Ardita –

–        Shirobasti – oil pooling over the head

–        Nasya – nasal medication

–        Dhuma – smoke inhalation

–        Upanaha – warm poultice

–        Snehana – oleation

–        Nadi Sweda – tube fomentation / sudation

Kșīra taila

Ingredients –

–        Herbs belonging to Trnapancamula, Mahatpancamula, Kakolyadi gana and Vidarigandhadi gana group of herbs

–        Meat of animals living in water

–        Meat of animals living in marshy regions

–        Water – double the quantity of the above ingredients

–        Milk – 1 drona i.e. 10.24 kg approximately in quantity

Method of preparation – All the above mentioned ingredients are boiled together until only milk remains and then filtered. To this, Taila – sesame oil is added in 1 prastha (640gm) quantity and cooked on fire until the oil gets thoroughly mixed with the milk. When this happens, it is removed from the fire. After it cools, it should be churned well.

The resultant oil is taken out separately and cooked once again along with herbs having a sweet taste (Kakolyadi Gana group of herbs) and milk. This preparation is called Kshira Taila.

Benefits – Kshira Taila should be used for treating patients suffering from Ardita and shall be administered for purposes of drinking, anointing etc.

Just like Kshira Taila, Kshira Sarpi shall be prepared using ghee instead of oil and used for Netra Tarpana – pooling the ghee around the eyes.

गृध्रसीविश्वाचीक्रोष्ट्रकशिरःखञ्जपङ्गुलवातकण्टकपाददाहपादर्षावबाहुकबाधिर्यधमनीगतवातरोगेषुयथोक्तंयथोद्देशंचसिराव्यधंकुर्यात्,अन्यत्रावबाहुकात्;वातव्याधिचिकित्सितंचावेक्षेत।।२३।।

Siravedha / Siravyadha i.e. bloodletting through venipuncture should be done as indicated in the below mentioned conditions / diseases with the exception of Avabahuka. Other treatments prescribed for vātavyadhi in general should also be adopted –

–        Grdhrasi – sciatica

–        Visvaci – painful condition of the arm along with loss of functions

–        Krostukasirsa – inflammatory swelling of the knee joint

–        Khanja – limp

–        Pangu – lameness

–        Vatakantaka – ankle sprain

–        Padadaha – burning feet

–        Padaharsa – tingling or tender feet

–        Avabahuka – painful arm

–        Badhirya – deafness

–        Dhamanigata Vata – disorders caused by vata getting lodged in blood vessels / arteries and

–        Such other conditions

7. Karņaśüla – Earaches

कर्णशूलेतुशृङ्गवेररसंतैलमधुसंसृष्टंसैन्धवोपहितंसुखोष्णंकर्णेदद्यात्,अजामूत्रमधुतैलानिवा,मातुलुङ्गदाडिमतिन्तिडीकस्वरसमूत्रसिद्धंतैलं,शुक्तसुरातक्रमूत्रलवणसिद्धंवा;नाडीस्वेदैश्चस्वेदयेत्,वातव्याधिचिकित्सांचावेक्षेत;भूयश्चोत्तरेवक्ष्यामः।।२४।।

Below mentioned recipes are highly beneficial for those suffering from Karna Sula (earache) –

–        Fresh juice of Srngavera (ginger) mixed with oil, honey and rock salt should be instilled into the ear, made comfortably warm or

–        Goat’s urine and honey can be used in similar method or

–        Oil cooked with Matulunga, Dadima and Tintidika and goat’s urine may be used for the same purpose in similar method

–        Likewise, oil prepared by processing with sukta – vinegar, sura – beer, takra – buttermilk, mutra – urine and lavana – rock salt may be used

Fomentation to the ears should be given by Nadi Sweda – tubular sudation method. Treatments prescribed for Vata Vyadhi may also be administered. Further details shall be furnished in the Uttara Sthana section of the text (Sushruta Samhita).

8. Tuni-Pratituni – Pain of bladder

तूनीप्रतून्योःस्नेहलवणमुष्णोदकेनपाययेत्,पिप्पल्यादिचूर्णवा,हिङ्गुयवक्षारप्रगाढंवासर्पिः,बस्तिभिश्चैनमुपक्रमेत्।

Tūnī and pratituni are conditions which present with pain in the urinary bladder or region of urinary bladder. In this condition, warm water added with oil and rock salt shall be given for drinking. Alternatively, warm water mixed with powder of Pippalyadi Gana group of herbs may be given for drinking.

Ghee mixed with more quantity of Hingu – asafoetida and Yava Kshara – alkali prepared from barley plant should be given for the same purpose.

Enema therapies will also be helpful in this condition.

9. Adhmāna – Flatulence

आध्मानेत्वपतर्पणपाणितापदीपनचूर्णफलवर्तिक्रियापाचनीयदीपनीयबस्तिभिरुपाचरेत्;लङ्घनानन्तरंचान्नकालेधान्यकजीरकादिदीपनसिद्धान्यन्नानि।प्रत्याध्मानेछर्दनापतर्पणदीपनानिकुर्यात्।।२६।।

Below mentioned measures / treatments shall be adopted for treating Adhmana (flatulence) –

–        Apatarpana – fasting

–        Panitapa – providing heat / fomentation with palm

–        Dipana Churna – carminative powders / herbal powders which enhance digestive capacity

–        Phalavarti – suppositories

–        Pachana, Deepana Kriya – digestive and carminative therapies

–        Vasti – enemas

Foods prepared with carminative herbs like Dhanyaka – coriandrum, Jiraka – cumin seeds etc should be consumed after observing a period of fasting.

Chardana – emesis, Apatarpana – fasting and Dipana – carminatives should be administered for treating Pratyadhmana.

10. Asthila and pratyasthila: Enlargement of prostate

अष्ठीलाप्रत्यष्ठीलयोर्गुल्माभ्यन्तरविद्रधिवत्क्रियाविभागइति।।२७।।

The treatments described for Gulma – abdominal tumors and Abhyantara Vidradhi – internal abscess should be adopted for treating Asthila and Pratyasthila (prostate enlargement).

Hingvādi guţika-

हिङ्गत्रिकटुवचाजमोदाघान्याजगन्धादाडिमतिन्तिडीकपाठाचित्रकयवक्षारसैन्धवबिडसौर्वचलस्वर्जिकापिप्पलीमूलाम्लवेतसशटीपुष्करमूलहपुषाचव्याजाजीपथ्याचूर्णयित्वामातुलङ्गामोनबहुश:परिभाव्याक्षमात्रागुटिका:कारयेत्,ततःप्रातरेकैकांवातविकारीभक्षयेत्,एषयोगकासश्वासगुल्मोदरारोचकहद्रोगाध्मानपार्थोदरबस्तिशूलानाहमूत्रकृच्छ्प्लीहार्शस्तूनीपतूनीरपहन्ति।।२८॥

Powder of the below mentioned ingredients taken in equal proportions is prepared –

–        Hingu,

–        Trikatu,

–        Vaca,

–        Ajamoda,

–        Dhānyaka,

–        Ajagandha,

–        Dadima,

–        Tintidika,

–        Patha,

–        Citraka,

–        Yava ksāra,

–        Saindhava,

–        Bida,

–        Sauvarcala,

–        Svarjikā,

–        Pippalīmüla,

–        Amlavetasa,

–        Sati,

–        Puskaramula,

–        Hapusa,

–        Cavya,

–        Ajaji and

–        Pathya

This powder is soaked in Matulunga juice many times. Later, pills of one aksa i.e. 10 grams each is prepared with the paste obtained by soaking the above mentioned powder in juice of Matulunga.

Patients suffering from Vata diseases should consume one prepared pill every morning.

Other benefits – Apart from curing vata diseases, this pill also cures the below mentioned conditions –

–        cough

–        dyspnoea,

–        abdominal tumour

–        abdominal enlargement

–        anorexia

–        heart disease

–        flatulence,

–        pain in flanks, abdomen and urinary bladder,

–        tympanitis,

–        dysuria,

–        spleen enlargement,

–        haemorrhoids and

–        bladder pain

भवन्तिचात्र

Some verses here

केवलोदोषयुक्तोवाधातुभिर्वाऽऽवृतोऽनिलः।।
विज्ञेयोलक्षणोहाभ्यांचिकित्स्यश्चाविरोधतः।।२९।।

One should understand Kevala Dosha / aggravated Vata or Avruta Vata i.e. Vata being enveloped and blocked by other dhatus on the basis of the symptoms produced by these conditions. They can also be understood by inference. After diagnosing these conditions, treatments which are not mutually opposing in nature shall be adopted.

रुजावन्तंघनंशीतंशोफंमेदोयुतोऽनिलः।।
करोतियस्यतंवैद्यःशोथवत्समुपाचरेत्।।३०।।

The physician should treat the sopha i.e. swelling which is painful, hard and cold produced by vata and medas (fat) together on the lines of treating sotha (edema).

11. Urusthambha: Rigidity of the leg

कफमेदोवृतोवायुर्यदोरूप्रतिपद्यते।।
तटाऽङ्गमर्दस्तैमित्यरोमहर्षरुजाज्वरैः।।३१।।
निद्रयाचार्दितौस्तब्धौशीतलावप्रचेतनौ।।
गुरुकावस्थिरावूरूनस्वाविवचमन्यते।।३।।
तमूरुस्तम्भमित्याहुराढ्यवातपथापरे।।

Pathogenesis – Kapha and Medas (fat) cause Avarana (envelope or obstructs) of Vata. Such Vata obstructed by kapha and fat gets localized in the thigh and causes the below mentioned symptoms.

Symptoms –

–        body aches

–        feeling of the leg / thigh covered with a wet cloth / loss of movements,

–        horripilations,

–        pain,

–        fever,

–        the person feels as if his thigh is asleep (not having movements), painful, rigid, cold and unconscious and immovable

–        the person feels as if the leg is heavy, unsteady and does not belong to him i.e. a feeling as if his leg / thigh has been replaced by someone else’s leg

The disease presenting with the above said symptoms is called Urusthambha. Others also call it Adhyavata.

स्नेहवर्जंपिबेत्तत्रचूर्णंषड्धरणंनरः।।३३ ||
हितमुष्णाम्बुनातद्वत्पिप्पल्यादिगणैःकृतम्।।
लिह्याद्वात्रैफलंचूर्णंक्षौद्रेणकटुकान्चितम्।।३४11
मूत्रैर्वागुग्गुलंश्रेष्ठंपिबेद्वाऽपिशिलाजतु।।
ततोहन्तिकफाक्रान्तंसमेदस्कंप्रभञ्जनम्।।३५।।
हृद्रोगमरुचिंगुल्मंतथाऽभ्यन्तरविद्रथिम्।।

In this condition, ShadDharana Churna should be given mixed with warm water without adding fats like ghee or oil, to the patient.

Likewise, the below mentioned formulations can also be given –

–        Pippalyadi Gana – powder of Pippalyadi Gana group of herbs or

–        Triphala powder and Katuka mixed with honey should be given for licking or

–        Guggulu – good quality Commiphora mukul with cow’s urine

–        Shilajatu – with cow’s urine

Benefits – The above mentioned recipes cure Vata mixed with or obstructed by kapha and medas, as in Urustambha. It is also used to cure heart diseases, anorexia, abdominal tumour and internal abscess.

सक्षारमूत्रस्वेदांश्चरूक्षाण्युत्सादनानिच।।३६।।
कुर्याद्दिह्याच्चमूत्राढ्यैःकरञ्जफलसर्षपैः।।
भोज्या:पुराणश्यामाककोद्रवोद्दालशालयः।।३७।।
शुष्कमूलकयूषेणपटोलस्यरसेनवा।।
जाङ्गलैरघृतैर्मासैःशाकैश्चालवणैर्हितैः।।३८।।
यदास्यातांपरिक्षीणेभूयिष्ठेकफमेदसी।।
तदास्नेहादिकंकर्मपुनरत्रावचारयेत्।।३९।।

Below mentioned recipes are also useful –

–        Cow’s urine added and mixed with Yava Kshara

–        Dry sudation / fomentation and massage and

–        Application of paste of Karanja – Pongamia pinnata fruits and Sarsapa – mustard – mixed with more of cow’s urine

Diet – Foods should be prepared using old syamaka, kodrava, uddala and sali rice. It should be consumed along with soup of dry mulaka – radish or patola – pointed gourd.

Meat of animals living in desert-like lands should be consumed without adding fats and vegetables shall be consumed without adding salt.

Oleation and other therapies shall be administered after observing that kapha and medas have been significantly decreased.

Guggulu Prayoga

सुगन्धिःसुलघुःसूक्ष्मस्तीक्ष्णोष्णःकटुकोरसे।।
कटुपाकःसरोहृद्योगुग्गुल:स्निग्धपिच्छिलः।।४0।।
सनवोबृहणोवृष्यपुराणस्त्वपकर्षणः।।
तैक्ष्ण्यौष्ण्यात्कफवातघ्नःसरत्वान्मलपित्तनुत्।।४१।।
सौगन्ध्यात्पूतिकोष्ठनःसौम्याच्चानलदीपनः।।
तंप्रातस्त्रिफलादापिटोलकुशवारिभिः।।४२।।
पिबेदावाप्यवामूत्रैःक्षारैरुष्णोदकेनवा।।
जीर्णेयूषरसैःक्षीरैर्भुञ्जानोहन्तिमासतः।।४३।।
गुल्मंमेहमुदावर्तमुदरंसभगन्दरम्।।
कृमिकण्ड्वरुचिश्वित्राण्यर्बुदग्रन्थिमेवच।।४४।।
नाड्यान्यवातश्वयथून्कुष्ठदुष्टव्रणांश्चसः।।
कोष्ठसन्ध्यस्थिगंवायुंवृक्षमिन्द्राशनिर्यथा।।४५।।

Properties / qualities of Guggulu – Commiphora mukul –

–        has pleasant odour,

–        very light,

–        subtle,

–        penetrating,

–        hot in potency,

–        pungent / bitter in taste,

–        pungent after digestion,

–        laxative,

–        good for the heart,

–        unctuous and

–        slimy

Fresh Guggulu is stoutening and aphrodisiac.

Old Guggulu causes thinning of the body.

Guggulu mitigates kapha and vata owing to its penetrating quality and hot potency.

It eliminates faeces and mitigates pitta due to its laxative property.

It relieves the bad smell of the visceral spaces / abdomen due to its pleasant odor.

It kindles the digestive fire by its subtle quality.

Method of consumption of Guggulu – Guggulu should be consumed in the morning. It should be taken mixed with decoction of Triphala, Darvi – Berberis aristata, Patola – pointed gourd or Kusa grass. Alternatively it shall be taken well soaked in cow’s urine, added with alkalis or along with warm water. The patient should take food with corn soup, meat soup or milk once Guggulu gets digested.

Benefits – If Guggulu is consumed in the above said manner for a period of one month, it cures the below mentioned diseases –

–        abdominal tumour,

–        diabetes,

–        upward movement of vata / upward peristalsis

–        abdominal enlargement

–        fistula-in-ano

–        intestinal worms,

–        itching

–        ulcers

–        leukoderma

–        malignant tumors

–        benign ulcers

–        rigidity in the thighs

–        swellings

–        leprosy / skin disorders

–        septic ulcers

–        vata localized in the abdominal viscera, bones and joints

Analogy – Guggulu destroys the above said diseases just like the  thunderbolt destroys a tree.

इतिश्रीसुश्रुतसंहितायांचिकित्सास्थानेमहावातव्याधिचिकित्सितंनामपञ्चमोऽध्यायः।।५।।

Thus ends the fifth chapter by name Mahāvātavyādhi Cikitsita in Cikitsa Sthāna of Suśruta Samhita.