Sushruta Samhita Chikitsasthana Chapter 4 Vātavyādhi Cikitsitam (Treatment of Neurological Diseases)

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The 4th bankruptcy of Chikitsasthana of Sushruta Samhita is known as as Vātavyādhi Cikitsitam Adhyaya. This bankruptcy offers with Treatment of Neurological Diseases.

अथातोवातव्याधिचिकित्सितंव्याख्यास्यामः।।१।।
यथोवाचभगवान्धन्वन्तरिः।।२।।

We will now expound Vātavyādhi cikitsita – remedy of sicknesses brought about via (irritated) vāta (sicknesses of the anxious machine); as printed via the venerable Dhanvantari.

Āśayagata vāta cikitsă

आमाशयगतेवातेच्छर्दयित्वायथाक्रमम्।।
देय :षड्धरणोयोगःसप्तरात्रंसुखाम्बुना।।३।।
चित्रकेन्द्रयवेपाठाकटुकाऽतिविषाऽभया।।
वातव्याधिप्रशमनोयोगःषड्धरणःस्मृतः।।४।।

Chardana – In Amashayagata Vata i.e. irritated vata lodged within the abdomen – chardana / vamana – emesis remedy will have to be administered.

Shaddharana Yoga – After vamana, Shaddharana Yoga i.e. Shaddharana Churna will have to be given combined with lukewarm water for a length of 7 days. Alternatively heat decoction of Shaddharana Churna will have to be administered for a similar choice of days.

The formula referred to as Shaddharana Yoga or Churna is really helpful for mitigating vata vyadhis.

Preparation – This formula is ready with the beneath stated substances –

– Chitraka

– Indrayava

– Patha

– Katuka

– Ativisha

– Abhaya

Powder of each and every of the above stated substances will have to be taken in a dose of 1 dharana each and every (roughly 750mg in amount) and combined in combination. This is known as Shaddharana. It will have to be administered combined with lukewarm water for seven days or will have to be administered within the type of Kashaya – decoction.

Benefit – This formula is used to struggle Vata issues and is regarded as to be the most productive one within the trade.

पक्वाशयगतेचापिदेयंस्नेहविरेचनम्।।
बस्तयःशोधनीयाश्चप्राशाश्चलवणोत्तराः।।५।।
कार्योबस्तिगतेचापिविधिर्बस्तिविशोधनः।।
श्रोत्रादिषुप्रकुपितेकार्यश्चानिलहाक्रमः।।६।।

Below stated will have to be administered for treating Pakvashayagata Vata i.e. vata lodged in and affecting Pakvashaya (colon) –

– Sneha virechana – oily purgatives,

– Shodana Vasti – purificatory enemas and

– Lavanottara prasha – meals with most important salt style

Even in case of Vastigata Vata i.e. vata lodged in and affecting Vasti / Basti (urinary bladder), Basti Shodhana Vasti i.e. bladder cleaning purificatory enemas will have to be administered.

Likewise, therapies prescribed for mitigating vata will have to be followed in srotradigata vata i.e. vata affecting the ear and different sense organs.

Dhätugata väta cikitsa

स्नेहाभ्यङ्गोपनाहाश्चमर्दनालेपनानिच।।
त्वङूर्मासासृकूसिराप्राप्तेकुर्यात्चासग्विमोक्षणम्।।७।।

Below stated remedies will have to be followed when Vata is situated in and impacts pores and skin, muscle mass, blood, veins and arteries –

– Snehana – oleation,

– Abhyanga – natural oil therapeutic massage, oil bathtub,

– Upanaha – heat poultices,

– Mardana – massaging,

– Alepa – making use of medicinal pastes at the frame and

– Asrk mokshana – bloodletting

स्नेहोपनाहाग्निकर्मबन्धनोन्मर्दनानिच।।
स्नायुसन्ध्यस्थिसंप्राप्तेकुर्याद्वायावतन्द्रितः।।८।।

Below stated remedies are really helpful in treating Vata situated in and affecting the ligaments, joints and bones and will have to be carried out with out laxity as and when wanted –

– Snehana – oleation

– Upanaha – heat poultices,

– Agnikarma – branding with hearth / hearth or thermal cautery

– Bandhana – bandaging,

– Unmardana – exhausting therapeutic massage or therapeutic massage with drive, squeezing, kneading or trampling the frame portions

निरुद्धेऽस्थनिवावायौपाणिमन्थेनदारिते।।
नाडीदत्त्वाऽस्थनिभिषक्चूषयेत्पवनंबली।।९।।
शुक्रप्राप्तेऽनिलेकार्यंशुक्रदोषचिकित्सितम्।।

Obstruction of vata throughout the bones will have to be handled within the beneath stated means –

– The bone will have to be punctured with Panimantha – thick needle and

– Vata which has been obstructed in it will have to be sucked via a tube inserted into the hole portion of the bone throughout the puncture

Likewise, therapies stated for purification of semen as defined in bankruptcy 2 of Sarira Sthana phase will have to be carried out to regard Sukragata Vata – the semen suffering from vata.

अवगाहकुटीकप्रस्तराभ्यङ्गबस्तिभिः।।१०।।
जयेत्सर्वाङ्गजंवातंसिरामोक्षैश्चबुद्धिमान्।।
एकाङ्गगंचमतिमाञ्छङ्गैश्चावस्थितंजयेत्।।११।।

In Sarvanga Vata i.e. vata affecting all of the frame / all portions of the frame, the sensible doctor will have to administer the beneath stated remedies –

– Avagaha – bath bathtub or immersion in medicated liquids,

– Sveda – sudation

– Kuti – chamber sudation / staying in heated room

– Karsu Sweda – mendacity on heated flooring and

– Prastara Sweda – mendacity on heated corn, husk and so on. that have been unfold at the flooring

– Abhyanga – therapeutic massage with medicated oils

– Basti / Vasti – medicated enemas and

– Siramoksa – bloodletting via venepuncture

In addition to the above-mentioned remedies, an clever doctor will have to deal with Ekangavata – affection of anybody a part of the frame via irritated vata – via the usage of Srnga – bloodletting the usage of sucking horns.

बलासपित्तरक्तैस्तुसंसृष्टमविरोधिभिः।।
सुप्तिवातेत्वसृङग्नोक्षंकुर्यात्तुबहुशोभिषक्।।१२।।
दिह्याच्चलवणागारधूमैस्तैलसमन्वितैः।।

Treatment will have to be given with respective remedies with out antagonizing one some other in stipulations by which vata is related to kapha, pitta and rakta.

A sensible doctor will have to do raktamokshana – bloodletting repeatedly in case of Suptivata – a situation brought about via vata by which there’s lack of tactile sensation. Later the affected section will have to be smeared with paste of lavana – rock salt and agara dhuma – kitchen / chimney soot jumbled together oil.

Ahara-food

पञ्चमूलीशृतंक्षीरंफलाम्लोरसएवच।।१३।।
सुस्निग्धोधान्ययूषोवाहितोवातविकारिणाम्।।

Below stated are really helpful as meals / nutritional dietary supplements and will have to be served after including extra fats i.e. oil or ghee –

– Milk boiled with Pancamula

– Juice of bitter culmination

– Meat soup

– Horse gram soup and so on.

Sālvaņa upanāha (poultice)

काकोल्यादिःसवातघ्नःसर्वाम्लद्रव्यसंयुतः।।१४।।
सानूपौदकमांसस्तुसर्वस्नेहसमन्वितः।।
सुखोष्णःस्पष्टलवण :साल्वणःपरिकीर्तितः।।१५।।
तेनोपनाहंकुर्वीतसर्वदावातरोगिणाम्।।

Below stated are the principle substances of Salvana Upanaha –

– Herbs belonging to Kakolyadi Gana team

– All Vataghna – vata mitigating herbs,

– All Amla Dravya – all herbs and issues of bitter style,

– Anupa mamsa – meat of animals dwelling in marshy areas

– Audaka mamsa – meat of animals dwelling in water

– Sarva Sneha – a wide variety of fat i.e. ghee, bone marrow, muscle fats and oil

– Spashta Lavana – added with lot of salt

All the above stated substances are cooked in combination so that you can shape a comfortable mass out of them and used heat to offer poultice. This is referred to as Salvana Upanaha.

This paste will likely be carried out as upanaha – heat poultice at all times to these sufferers affected by vata sicknesses and sudation given.

Treatment of shriveled, painful or stiffened frame section

कुञ्यमानंरुजार्तंवागात्रंस्तब्धमथापिवा।।१६।।
गाढंपट्टैर्निबध्नीयात्क्षौमकार्पासिकौर्णिकैः।।
बिडालनकुलोन्द्राणांचर्मगोण्यांमृगस्यवा।।१७।।
प्रवेशयेद्वास्वभ्यक्तंसाल्वणेनोपनाहितम्।।

Any a part of the frame which has been shriveled is painful and static (stiff, inflexible) will have to be subjected to abhyanga – therapeutic massage or anointing with oil and carried out with Salvana Upanaha. After this, that section will have to be bandaged tightly with bands of linen, cotton or wool or that a part of the frame will have to be inserted right into a sling (sac) comprised of the surface of a cat, mongoose, otter or deer.

Treatment of vata affliction in shoulders, chest, higher again and nape of the neck

स्कन्धवक्षस्त्रिकप्राप्तंवायुमन्यागतंतथा।।१८।।
वमनंहन्तिनस्यचकुशलेनप्रयोजितम्।।
शिरोगतंशिरोबस्तिर्हन्तिवाऽग्विमोक्षणम्।।१९।।
स्नेहंमात्रासहस्रंतुधारयेत्तत्रयोगतः।।

An clever doctor will have to administer vamana – emesis and nasya – nasal drugs to remedy the shoulders, chest, higher again or nape of the neck which has been suffering from irritated vata.

Shirovasti – pooling of oil at the head or Raktamokshana – bloodletting will have to be administered to remedy shirogata vata i.e. irritated vata situated in and affecting the pinnacle. While doing Shirovasti, oil will have to be retained at the head for a thousand matrakala. Matrakala is the time frame required to utter a vowel.

Treatment of Sarvanga Vata and Ekanga Vata

सर्वाङ्गगतमेकाङ्गस्थितंवाऽपिसमीरणम्।।२०।।
रुणद्धिकेवलोबस्तिर्वायुवेगमिवाचलः।।

Basti / Vasti i.e. medicated enema on my own is sufficient to keep an eye on vata when it’s localized in both the entire frame or anybody a part of the frame, similar to the mountain which controls the bouts of wind.

Vāta sämāñya cikitsa – basic therapies for vata

स्नेहस्वेदस्तथाऽभ्यङ्गोबस्तिःस्नेहविरेचनम्।।२१।।
शिरोबस्तिःशिरःस्नेहोधूमःस्नैहिकएवच।।
सुखोष्णःस्नेहगण्डूषोनस्यंस्नैहिकमेवच।।२२।।
रसाःक्षीराणिमांसानिस्नेहा :स्नेहान्वितंचयत्।।
भोजनानिफलाम्लानिस्निग्धानिलवणानिच।।२३।।
सुखोष्णाश्चपरीषेकास्तथासंवाहनानिच।।
कुङ्कुमागुरुपत्राणिकुष्ठैलातगराणिच।।२४।।
कौशेयौर्णिकरौमाणिकार्पासानिगुरूणिच।।
निवातातपयुक्तानितथागर्भगृहाणिच।।२५।।
मृद्वीशय्याऽग्निसंतापोब्रह्मचर्यंतथैवच।।
समासेनैवमादीनियोज्यान्यनिलरोगिषु।।२६।।

Below stated are integrated within the basic line of remedy of irritated Vata –

Therapies – beneath stated remedies will have to be carried out heat –

– Sneha – oleation or lubricating remedies

– Sweda – sudation

– Abhyanga – natural oil therapeutic massage, oil bathtub

– Basti / Vasti – medicated enema

– Sneha virechana – oily/ unctuous purgatives

– Sirovasti / Shirobasti – oil pooling over the pinnacle

– Shiro Sneha – oiling the pinnacle,

– Snaihika dhuma – lubricating smoke inhalation,

– Sneha gandusha – unctuous mouth gargles

– Snaihika nasya – unctuous oily drops instilled within the nostril

Foods together with –

– meat soup,

– milk,

– meat added with oil or ghee,

– juice of bitter culmination

– fatty meals

– salty meals

Other inclusions within the remedy –

– pouring conveniently heat liquids at the frame,

– overlaying the frame with thick material product of leaves of crops together with kumkuma, aguru, kustha, ela and tagara,

– garments – product of silk, wool or thick cotton garments will likely be used,

– staying throughout the deep inside or underground chambers devoid of breeze and with little little bit of daylight / solar warmth,

– napping on comfortable beds,

– publicity to the warmth of the solar, and

– keeping up celibacy (averting copulation)

All the above stated therapies and measures in short will likely be adhered to in treating the entire sicknesses brought about via vata.

Tilvaka ghrta

त्रिवृद्दन्तीसुवर्णक्षीरीसप्तलाशङ्खिनीत्रिफलाविडङ्गानापक्षसमाःभागाः,कल्कस्तिल्वकमूलकम्पिल्लकयोः,त्रिफलारसदधिपात्रेद्वेद्वे,घृतपात्रमेकं,तदैकयसंयुज्यविपचेत्;तिल्वकसर्पिरेतत्स्नेहविरेचनमुपदिशन्तिवातरोगिषु।तिल्वकविधिरेवाशोकरण्यकयोर्द्रष्टव्यः।।२७।।

One aksa / karsa (10-12 grams roughly) each and every of –

– Trivrt

– Danti

– Suvarnaksiri

– Saptala

– Sankhini

– Triphala and

– Vidanga

One bilva (40 grams) each and every of –

– Tilvaka

– Mulaka and

– Kampillaka

2 adhaka (adhaka = 5.12 kg) each and every of –

– Triphala Rasa – decoction of Triphala and

– Dadhi – curds

One patra (2.56 kg) – ghrta – ghee

All the above-mentioned substances will have to be cooked in combination and medicated ghee ready. This ghee is referred to as Tilvaka Sarpi / Ghrta. It is used as an unctuous purgative in a wide variety of Vata issues. Similarly, medicated ghee ready with Asoka and Ramyaka additionally will likely be used for a similar goal.

Anu taila

तिलपरिपीडनोपकरणकाष्ठान्याहृत्यानल्पकालंतैलपरिपीतान्यनिखण्डश :कल्पयित्वाऽवक्षुद्यमहतिकटाहेपानीयेनाभिप्लाव्यक्वाथयेत्,ततःस्नेहमम्बुपृष्ठाद्यदुदेतितत्सरकपाण्योरन्यतरेणादायवातघ्नौषधप्रतीवापंस्नेहपाककल्पेनविपचेत्,एतदणुतैलमुपदिशन्तिवातरोगिषु;अणुभ्यस्तैलद्रव्येभ्योनिष्पाद्यतइत्यणुतैलम्।।२८।।

A wood pestle of an oil mill i.e. sesame is received. This will have to were in utilization for a very long time. Now this pestle will have to be lower into small items, nearly to powder-like minuteness. This piece / powder is put into a large iron cauldron. The cauldron is now full of water and is boiled. The layer of oil that rises to the outside of the water after it’s been boiled for a while is separated with a sieve and brought out. Vata mitigating herbs are added to the oil and medicated oil is ready. This is referred to as Anu Taila. It is really helpful for utilization in the entire Vata Rogas. It is known as Anu Taila as a result of it’s ready from minute items (anu = minute) of the oily subject material.

Sahasrapāka taila

अथमहापञ्चमूलकाष्ठैर्बहुभिरवदह्यावनिप्रदेशमसितमुषितमेकरात्रमुपशान्तेऽग्नावपोहभस्मनिवृत्तांभूमिविदारिगन्धादिसिद्धेनतैलघटशतेनतुल्यपयसाऽभिषिच्यैकरात्रमवस्थाप्यततोयावतीमृत्तिकास्निग्धास्यात्तामादायोष्णोदकेनमहतिकाटहेऽभ्यासिञ्चेत्,तत्रयत्तैलमुत्तिष्ठेत्तत्पाणिभ्यांपर्यादायस्वनुगुप्तंनिदध्यात्;ततस्तैलंवातहरौषधक्वाथमांसरसक्षीराम्लभागसहस्त्रेणसहस्रपाकंविपचेद्यावताकालेनशक्नुयात्पक्तुं,प्रतिवापश्चात्रहैमवतादक्षिणापथगाश्चगन्धावातघ्नानिच,तस्मिन्सिध्यतिशङ्खानाध्यापयेहन्दुभीनाघातयेच्छत्रंधारयेद्वालव्यजनैश्चवीजयेबाह्मणसहस्रंभोजयेत्,तत्साधुसिद्धमवतार्यसौवर्णेराजतेमृन्मयेवापात्रेस्वनुगुप्तंनिदध्यात्,तदेतत्सहस्रपाकमप्रतिवारवीर्यंराजाहतैलम्;एवंभागशतविपक्वंशतपाकम्।।२९।।

A plot of flooring with black soil is chosen. On this flooring, the items of picket of Mahat (Brihat) Panchamula are positioned and the picket is about on hearth.

One hundred ghata (drona – 10.24 kg) of sesame oil will have to be taken. Next day, the plot of black soil on which the woods of Pancamula have been burnt is sopping wet with this sesame oil and allowed for at some point. Before this, the sesame oil will have to were boiled and ready with herbs belonging to Vidarigandhadi Gana team of herbs and equivalent amount of milk.

Once the soil turns into very unctuous because of the oil poured on it, it will have to be taken out and put into a large pot. This pot is now full of scorching water.

After a while, the oil starts to drift on water. The floating oil is amassed at the hands one by one and saved. Next, it’s added with decoction of vata mitigating herbs, meat soup and milk and amla kanjika, each and every 4 occasions the amount of oil. Now the oil is cooked.

Pastes of aromatic herbs amassed from Himalayan areas and in addition from Daksinapatha – south India are added and medicated oil is cooked. Vata mitigating herbs also are added whilst cooking. The oil is cooked for a thousand occasions in as many days as required.

When the oil is cooked neatly, it will have to be paraded with recognize. Parading of oil will have to be carried out via blowing conches, beating kettle drums and maintaining an umbrella. It will have to be fanned with fly whisks. One hundred Brahmanas will have to be fed with foods. The ready oil is later saved in golden, silver or dust vessels and safely preserved. This is known as Sahasrapaka Taila – oil cooked for 1000 occasions. It is an excessively efficacious medication and is definitely suited to kings. This oil, when cooked for 100 occasions, is understood via the identify Satapaka Taila.

Patra lavana

गन्धर्वहस्तमुष्ककनक्तमालाटरूषकपूतीकारग्वधचित्रकादीनांलवणेनसहोदूखलेऽवक्षुधस्नेहघटेप्रक्षिप्यावलिप्यगोशनिहियेत्,एतत्पत्रलवणमुपदिशन्तिपत्राण्यााणिवातरोगेषु।।३0 ।।

Moist leaves of the beneath stated herbs will likely be amassed –

– Gandharvahasta

– Muskaka,

– Naktamala,

– Atarusa,

– Putika,

– Aragvadha,

– Citraka and so on

These herbs are lower into items. Equal amount of saindhava – rock salt is added to it and pounded neatly within the mortar. This paste is now put right into a pot whose within has been smeared with fats (oil). It is now cooked with the hearth of cow-dung lots. This is referred to as Patra Lavana. This may be very helpful in the entire Vatarogas. it will likely be used both in conjunction with meals or as poultice.

Sneha lavana – kändalavana

एवंस्तुहीकाण्डवार्ताकुशिलवणानिसंक्षुधघटेपूरयित्वासर्पिस्तैलवसामज्जभिःप्रक्षिप्यावलिप्यगॊशाकृद्रिर्दाहयेत्ःएतत्स्नेहलवणमुपदिशान्तिवातरोगेषु।।(हतिकाण्डलवणम्)।।३१।।

Below stated are amassed –

– Snuhikanda

– Vartaka

– Sigru and

– Lavana

They are all pounded and installed a pot. To this, ghee, oil, muscle fats and marrow are added. These substances are cooked with the hearth of cow dung lots. This Sneha Lavana (Kanda Lavana) is indicated in all Vata Rogas.

Kalyanaka lavana

गण्डीरपलाशकुटजबिल्वार्कस्नुह्यपामार्गपाटलापारिभद्रकनादेयीकृष्णगन्धानीप-नियनिर्दहन्याटरूषकनक्तमालकपूतिकबृहतीकण्टकारिकाभल्लातकेङ्गुदीवैजयन्ती-कदलीबाष्पद्वयेश्चरकेन्द्रयारुणीश्वेतमोक्षकाशोकाइत्येवंवर्गसमूलपत्रशाखमामाहृत्यलवणेनसहसंसृज्यपूर्ववन्ध्याक्षारकल्पेनपरित्राव्यविपचेत्,प्रतिवापश्चात्रहिङ्ग्वादिभिःपिप्पल्यादिभिर्वा।इत्येतत्कल्याणकलवणंवातरोगगुल्मप्लीहाग्निषङ्गाजीर्णार्थोऽरोचकार्तानांकासादिभिःकृमिभिरुपद्वतानाचोपदिशन्तिपानभोजनेष्वपीति।।३२।।

भवतिचात्र –

विष्यन्दनादुष्णभावाहोषाणांचविपाचनात्।।
संस्कारपाचनाच्चेदंवातरोगेषुशस्यते।।३३।।

Moist roots, leaves and branches (twigs) of the beneath stated herbs are amassed –

– Gandira,

– Palasa,

– Kutaja,

– Bilva,

– Arka,

– Snuhi,

– Apamarga,

– Patala,

– Paribhadraka,

– Nadeyi (jalajambu),

– Krshnagandha,

– Nipa,

– Nimba,

– Nidrahani (morata),

– Atarusaka,

– Naktamalaka,

– Putika,

– Brhati,

– Kantakarika,

– Bhallataka,

– Ingudi,

– Vaijayanti,

– Kadali,

– Baspadvaya (2 varieties of Baspika),

– Iksuraka,

– Indravaruni,

– Sveta moksaka and

– Asoka

They are combined with Saindhava lavana – rock salt, equivalent in amount and cooked in a similar fashion as ahead of.

The ash of the similar is amassed. It is blended with water after which filtered. To this, powder of herbs of Hingvadi Gana or Pippalyadi Gana team of herbs could also be added. All those are cooked in combination within the approach of making ready ksara – alkalis. This is referred to as Kalyanaka Lavana.

Indications – Kalyanaka Lavana is used within the beneath stated stipulations –

– In remedy of a wide variety of Vataroga – in conjunction with foods and drinks,

– Abdominal tumours

– Diseases of spleen,

– Dyspepsia,

– Indigestion,

– Piles,

– Anorexia,

– Cough,

– Intestinal worms

It is really helpful in the entire Vatarogas because it produces moisture throughout the frame, is of scorching efficiency, reasons ripening of doshas and is cooked with different herbs.

इतिश्रीसुश्रुतसंहितायांचिकित्सास्थानेवातव्याधिचिकित्सितंनामचतुर्थोऽध्यायः।।४।।

Thus ends the fourth bankruptcy via identify Vātaroga Cikitsita in Cikitsā Sthāna of Suśruta Samhita.

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