Chapter XL - Description of medicated fumes, snuffs, errhines and gargles

Now we shall discourse on the treatment which consists in employing the (inhalation of) medicated fumes, snuffs, (errhines) and gargles (Dhuma- Nasya-Kavala-Graha-Chikitsita). 1.

Dhuma (fumes) may be divided into five groups^[1] viz., Prayogika (capable of being daily used), Snehana (soothing), Vairecana (expectorant),^[2] Kasaghna (anticough) and Vamaniya (emetic). 2.

Materials of different Dhuma-varti:—

The drugs of the Eladi group, excepting Kushtha and Tagara, should be pasted together. A space of eight fingers out of the entire length of a stem of Shara weed twelve fingers long should be covered-with a piece of silk cloth and plastered with the coat of the preceding paste. This stick should be burnt and used in the Prayogika Dhuma pana. The pith (pulp) of oleaginous fruits, wax and resin, Guggulu, etc., with the admixture of a Sneha (oil or clarified buttery should be used in the Snehana-Dhuma. The drugs included into Shiro- Virecana group should be used in Vairecana Dhuma. Vrihati, Kanta-karika, Trikatu, Kasa-marda, Hingu, lngudi-bark,^[3] Manah-shila, Guduci, and Karkata-shringi and such other drugs which allay cough should be used in the Kasaghna-Dhuma. Nerves, skin, horns, hoops, shells of a crab, dried fish, dry meat or worms, etc., and such other emetic drugs should be used in the Vama niya-Dhuma. 3.

Formation of the pipe used in Dhuma-Pana:—

The pipe to be used in respect of an inhaler should be made of one or other of the same substances^[4] of which the pipes of enema-syringes (Vasti-Netra) are made. The girth of such a pipe should be equal to that of the small finger at its mouth with an inner aperture or calibre as large as a Kalaya pulse, and its girth at the root or base should be equal to that of the thumb, while the girth of the inner aperture or near (at the root) should be sufficiently large to allow the Dhuma-Varti (made of Shara weed) to fit in. The length of the pipe should be forty-eight fingers^[5] in respect of a Prayogika, thirty-two fingers in respect of a Snehana, twenty-four fingers in respect of a Vairecana, sixteen fingers in respect of a Kasaghna (anti-cough) and Vamaniya (emetic) Dhuma. The girth of the aperture (channel) should be equal to that of a stone of the Kola fruit in respect of the tube to be used in the last two cases (Kasaghna and Vamaniya), The tube to be employed in fumigating an ulcer should be eight fingers in length and equal to a Kalaya pulse in outer girth, while the girth of the inner orifice should be sufficient to allow a Kulattha pulse to pass in. 4.

The medicinal stick (Varti) should be lubricated with a Sneha (clarified butter, etc). It should then be attached to one end of the pipe (Netra) and lighted. The patient should sit in an easy and comfortable posture, maintain a cheerful frame of mind and carefully inhale the medicinal fumes with his eyes cast down straight towards the ground. 5.

Metrical Texts:—

The fumes should be first inhaled through the mouth and then through the nostrils; whether inhaled through the mouth or the nostrils they should be invariably exhaled through the mouth. Inhaled through the mouth, they should not by any means be exhaled through the nostrils, as such a course (of exhaling through the nostrils) would act wrongly and impair the eye-sight. 6.

The fumes (Dhuma) should be specially inhaled through the nostrils, in connection with a Prayogika inhalation, while they may be inhaled both through the mouth and the nostrils in Snehana-Dhuma. They should be inhaled through the nostrils alone in an act of Vairecana inhalation and through the mouth only in the two remaining cases (Vamaniya and Kaphaghna). 7.

Mode of inhalation:—

In an act of Prayogika inhalation, the stick (Varti) should be dried in shady places protected from the wind. The stem of the Shara weed inside the Varti should then be removed. The Varti should then be lighted with a live charcoal and fixed to the end of the pipe (Netra) and then the patient should be asked to inhale the fumes. The same method should be followed in respect of Snehana and Vairecana ones. In the other cases of smoking (Kasaghna and Vamaniya) the fumigating drugs (Varti) should be placed over a bed of smokeless burning charcoal contained in an earthen saucer. Another saucer furnished with an aperture at its top or middle should be fitted over the former saucer and the inhaling pipe should be fitted into this aperture, and the fumes should be inhaled (through the mouth). On the subsidence of the fumes the remaining portion of the stick should be cast into the fire and the patient should continue to inhale the fumes till the complete elimination of the aggravated Doshas from his organism. This is the rule and means of inhalation (Dhuma-pana). 8.

Prohibitive Cases:—

Any kind of smoking (Dhuma-pana) is forbidden to a person afflicted with anger, fear, bereavement, fatigue, and in a heated state of the body and after fasting. It is also forbidden in cases of poisoning, hemorrhage (Rakta-pitta), alcoholism, swooning, burning sensation of the body, thirst, jaundice, dryness of the palate, vomiting, head- disease, eructation, Timira, urinary complaints (Prameha), abdominal enlargement with dropsy (Udara), inflation of the abdomen and Urddha-vata, and in respect of infants, old and enfeebled persons, as well as of those treated with purgatives and asthapana-vasti. It is also forbidden to enciente women, those suffering from insomnia or a parched condition of the body as well as to those suffering from any kind of cachexia or from Urah-kshata. An act of inhaling (smoke) is also prohibited after taking a potion of honey, clarified butter, curd, and milk, fish, wine or gruel (Yavagu) as well as during the continuance of a small quantity of Kapha in the organism. 9.

Metrical Text:—

Medicated fumes inhaled in an improper season (viz., in the above-mentioned prohibited cases) bring on vertigo, fainting fits, diseases of the head and serious injury to the eyes, ears, nose and the tongue. 10.

Time of Smoking:—

The first three kinds of inhalations should be resorted to at the close of the following twelve physical functions and acts, viz. sneezing, cleansing the teeth, snuffing, bathing, eating, sleeping in the day, coition, vomiting, micturition, passing stools, fits of anger and surgical operations. A Snehana-Dhuma should be smoked after sneezing, micturition, passing stools, coition or after a fit of anger. Similarly, a Vairecana-Dhuma should be smoked after bathing, vomiting and sleeping in the day time, while a Prayogika-Dhuma should be smoked after cleansing the teeth, snuffing, bathing, eating and after a surgical operation. 11.

The therapeutic effects of Dhuma- pana:—

Smoking the Snehana-Dhuma subdues the deranged and aggravated Vayu of the body owing to the existence of the Sneha with which it is charged, as well as to a consequent sticky coating being deposited in the organism. The Vairecana-Dhuma facilitates the loosening and flowing out of the mucus (Kapha) owing to its dryness, non-viscidness (Vaishadya), keenness and heat-making potency. While the Prayogika-Dhuma tends to loosen the accumulation of mucus (Kapha) and helps its expulsion from the system by virtue of its being possessed of common therapeutic properties with both of the two preceding kinds (of Dhuma). 12.

Memorable Verse:—

Inhalation of (medicated) fumes removes the cloudening of the faculties of the organs of sense-perception and imparts distinctness of the speech and firmness to the teeth, hair of the head and to beard. It cleanses the mouth and fills it with an aroma. 13.

The inhalation of medicated fumes guards against an attack of cough, asthma, an aversion to food and clumsy sensation in the mouth, hoarseness, excessive salivation, nausea,^[6] somnolence, sleep, numbness of the jaws and of the nerves (Snayu) on the back of the neck (Manya), catarrh, diseases of the head, ear-ache, inflammation of the eyes, and any affection of the mouth due to an aggravation of the deranged Vayu and Kapha. 14.

It behoves a physician to be fully acquainted with the effects of satisfactory and excessive smoking (Dhuma-pana). Properly administered, it is followed by a distinct alleviation of the disease (under treatment); while its excessive use is followed by a positive aggravation or non-amelioration of the disease and is likely to produce a dryness of the palate and the throat, a burning sensation in the body, thirst, fainting fits, vertigo, delirium, alcoholism, affection of the ears, nose and eyes, impairment of vision, and weakness of the body. 15.

Mode of Smoking:—

The Prayogika-Dhuma should be smoked thrice at a time either through the mouth or through the nostrils and may be repeated thrice or four times (according to the strength of the patient and the itensity of the Dosha). The Snaihika-Dhuma should be inhaled until the appearance of tears in the eyes. While the Vairechanika-Dhuma should be smoked till the beginning of the elimination of the Doshas from the system. The Vamaniya-Dhuma should be smoked by a patient after he has taken a gruel of huskless sesamum (Tila-Tandula), and the Kasaghna-Dhuma should be inhaled between morsels of food.^[7] Fumigation of an ulcer should be made by means of a tube attached to (the orifice of) a covered saucer. Fumigation alleviates the pain in an ulcer, arrests its discharge and makes it clean and non-viscid. 16.

Metrical Text:—

The processes of inhalation and fumigation have been briefly described above. Now I shall fully describe the processes of using medicinal snuffs (Nasya). 17.

On Snuffs and Errhines:—

The term “Nasya” (Snuff) is so called from the fact of its being composed of the powders of any drugs or of any Sneha (oleaginous substance) cooked with such drug or drugs, to be stuffed into the nostrils. It may be broadly divided into two kinds, viz.:—Shiro-Virecana (errhines) and Snehana (contributor of oleaginous principles); and may, however, be further grouped under five specific heads, viz.:—Nasya, Shiro-Virecana, Pratimarsha (a medicated Sneha poured into the nostrils to be discharged into the mouth), Avapida (the expressed juice of any drug put into the nostrils in drops by pressing it with the palms then and there) and Pradhamana (a medicinal snuff blown into the nostrils with the help of a blowpipe). Of these, the Nasya (snuff) Shiro-Virecana (errhines) are pre-eminently the most effective. Pratimarsha is a Nasya while Avapida and Pradhamana are Shiro-Virecana (errhines). Thus it is that the term Nasya is employed in the above five senses. The term Nasya, in the specific sense, is particularly used with reference to the snuffing of any Sneha (oleaginous substance) with a view to make up the deficient oily matter in the brain in the case of a patient complaining of a sense of void or emptiness in the head or to impart tone to the nerves and muscles of the neck, shoulders and chest, or to invigorate the eye-sight. This should be prepared with a Sneha (oleaginous substance) cooked with the drugs possessed of the virtue of subduing the deranged Vayu and Pitta and should be snuffed in by a patient affected in the head through the overwhelming preponderance of the deranged Vayu and in cases of the falling off of the teeth and hair of the head and beard, in Karna- Kshveda, acute ear-ache, Timira (cataract), loss of voice, disease of the nose, dryness of the mouth, Ava- Vahuka, premature greyness of the hair and wrinkling of the skin and other dangerous complications due to the deranged Vayu and Pitta as well as in similar other affections of the mouth. 18.

Shiro-Virecana:—

Powders of the Shiro-Virecana drugs^[8] or any Sneha cooked with those drugs^[9] should be employed in the event of there being an accumulation of Kapha (mucus) in the region of the palate, throat, or head of a patient, as well as in cases of an aversion to food, head-ache, heaviness of the head, Pinasa (coryza), Ardhavabhedaka (hemicrania), worms, Pratishyaya (catarrh), loss of the faculty of smell, hysteric convulsion (Apasmara) and in similar other diseases of the super-clavicular regions due to the action of the deranged Kapha. 19.

These two kinds of Nasya (snuffs) should be administered before meals. To a patient affected with diseases of Kaphaja origin they should be administered in the morning, while one suffering from any Pittaja complaint should use them at noon and one afflicted with any distemper of the deranged Vayu should use them in the afternoon.^[10] 20.

Before the application of a Shiro-Virecana (errhine) the patient should be asked to cleanse his mouth with a tooth-twig and by smoking. Then the regions of the neck, cheek and forehead should be fomented and softened with the application of heated palms, the patient himself being laid on his back in a dustless chamber not exposed to the sun and the wind. His head should be kept a little hung back with his arms and legs fully stretched out and expanded and a compress should be tied over the eyes. Then the physician should lift up with the fore-finger of his left hand the tip of the nose of the patient and slowly drop with his right hand a continuous jet of (medicated) Sneha into the cleansed channels of the (patient’s) nostrils. The oil to be so used should be made lukewarm (D. R. —made lukewarm in the sun) and kept in a golden, silver, copper, or earthen receptacle or in an oyster shell and poured down into the nostrils of the patient by means of an oyster shell (D. R.—pipe) or (by pressing) a cotton plug (soaked in that oil). Care should be taken that the oil does not get into the eyes (while being poured into the nostrils).^[11] 21.

Metrical Texts:—

The patient should refrain from shaking his head or indulging in a fit of anger or speaking, sneezing or laughing at the time of any oily snuff (Sneha-Nasya) being administered unto him, as it may otherwise badly interfere with its reaching down to the desired spot or may bring on an attack of cough or coryza (catarrh) or any affection of the head or of the eyes. 22.

Doses of a Sneha-Nasya:—

Eight drops of oil trickling down the two upper phalanges of the forefingers should be regarded as the proper quantity for the smallest (lit.—firsts dose. A Sukti measure (thirty- two drops) is the intermediate (lit.—second) dose and a Pani-Shukti measure (sixty-four drops) is the highest (lit.—third) dose. These are the three doses (of Sneha- Nasya) which should be determined in proportion to the strength of the patient and of the disease under treatment. An oily snuff should never be swallowed. 23.

Metrical Text:—

An oily snuff (Sneha-Nasya) should be hawked in so as to flow along the girths (Shringataka) of the nostrils and immediately spit out (by the patient), without retaining it in the mouth for a moment, as it may otherwise (irritate the mucous membranes of the throat, etc., and) aggravate the local Kapha. 24.

The region of the neck and the cheeks, etc., of the patient should be fomented again after the use of the oily snuff (Sneha-Nasya) and the patient should be made to smoke, and partake of a meal not composed of any phlegmagogic articles (Anabhishyandi). He should then be advised as to regimen of conduct, etc. (to be subsequently observed). Washing the head, exposure to the sun, dust and smoke, the use of any intoxicating liquor or of any other liquid or oleaginous substance, indulgence in a fit of anger and excessive driving, etc., are strictly prohibited (after the application of Sneha-Nasya). 25.

Effects of proper, excessive, or deficient application of a Sneha-Nasya (M.—T.):—

The effects of proper and excessive applications of (oily) snuffs will now be described. Lightness of the head, sound and refreshing sleep, the state of being easily awakened, alleviation of the disease, hilarity of the mind and a gladsome activity of the sense-organs in performing their respective functions, are the symptoms which attend a proper and satisfactory application (of an oleaginous medicinal snuff). Salivation, heaviness of the head, and dulness of the sense-organs are the symptoms which result from an excessive application of a Sneha (Nasya) and the remedy in such cases consists in employing the parching measures or medicines. A case of deficient application (of a Sneha-Nasya) is marked by the functional derangements of the sense-organs^[12] and a dryness (Rukshata) of the system without any indication of the amelioration of the disease. The remedy, in such cases, consists in a fresh application of the (oleaginous) snuff. 26.

The proper doses of an oleaginous errhine (Shiro- Vireka) should be four, six or eight drops in accordance with the strength (of the disease and of the patient under treatment). 27.

The framers of the Ayurveda have particularly classified the effects of the application (of a Sneha-Nasya) into three classes, viz., proper or satisfactory, deficient and excessive. The head being satisfactorily cleared (by the satisfactory application (of an oleaginous errhine) is marked by a sense of lightness in the head, clearness of the channels (of the mouth, throat, nostrils, etc.), an amelioration of the disease under treatment, healthy and vigorous workings of the sense-organs and an exhilarating sensation of the body and of the mind. Itching, clumsiness (of the mouth), heaviness, saturation of the local channels (of the mouth, throat, etc.) with mucous coatings are the symptoms which mark the deficient action of (an oleaginous) errhine. A discharge through the nostrils of Mastulunga (the brain matter), an aggravation of the Vayu, dulness of the sense-organs and a sense of void or emptiness in the head are the indications which mark an excessive application of an (oleaginous) errhine. 28.

Measures and remedies possessed of the virtue of subduing the deranged Kapha and Vayu should be (respectively) employed in cases of excessive and deficient applications of (an oleaginous) errhine (Nasya), while in the case of a proper and satisfactory application the patient should be made to snuff in a quantity of clarified butter on each alternate day or at an interval of two days for one, two or three weeks in succession or for any longer period as considered proper according to the exigency of the case. In a case of an overwhelming aggravation of the Vayu, the patient may be made to use the snuff (of clarified butter) even twice a day. 29.

Avapida-Nasya:—

The Avapida-Nasya, like the Shiro-Virecana Nasya, should be administered to a person bitten by a snake, or lying in a comatose or unconscious stat- or suffering from a disease of the head due to its being oppressed with an accumulation of fat and mucus (Abhisyanda). An Avpida-Nasya should be administered to a patient by pasting any of the (fresh) Siro-Virecana drugs and putting a few drops therefrom into the nostrils of the patient. In cases of a distraction of the mind or of a disease of a parasitic origin or of patients suffering from the effects of poisoning the fine powder (of the Shiro-Virecana drugs) should (by means of a pipe) be blown into the nostrils of the patient. Sugar, the expressed juice of the sugar-cane, milk, clarified butter or an extract of meat should be (similarly) administered in the case of a weak patient or of one suffering from an attack of Rakta-Pitta. 30.

Metrical Texts:—

A Sneha (oil or clarified butter) cooked with the pasted drugs (of the Shiro-Virecana group) would be as beneficial as the powder (Kalka) of those drugs for the purpose of an errhine in respect of a weak, emaciated, timid, delicate or female patient. 31.

Forbidden Cases:—

A fasting person, or one who has just taken his meal, or one suffering from an acute catarrh or coryza of a virulent type, an enciente woman, a man found to be still under the influence of an intoxicating liquor or who has taken a Sneha (oleaginous substance), water or any other liquid, or one suffering from indigestion or who has been treated with an enema (Vasti), one in an angry and excited state of mind or afflicted with thirst or who is suffering from the effects of any slow chemical poison (Gara) or fatigued or overwhelmed with grief as well as an infant, an old man, one who has voluntarily repressed any natural urging of the body or one about to take a full bath (Sirah-Snana) should be regarded unfit for treatment with iany kind of medicinal) snuffs (Nasya). Snuffing and smoke inhalation should not be resorted to in the event of the sky being (unseasonably) overcast with clouds at a time when such phenomena do not usually or ordinarily happen. 32-A.

A deficient or an excessive application of snuffs (at one time), or its extreme heat or coldness, a sudden or delayed application of the same (into the nostrils), drooping posture of the head or its movements during the application, the fact of its being used while the patient would be taking his meals, or its application in any forbidden case may produce such distressing symptoms as thirst eructations, etc., due to the action of the aggravated or decreased Doshas of the body. 32.

Metrical Texts:—

The evils which are usually found to attend an abuse of medicinal snuffs (Nasya) or errhines (Shiro-vireka) may be grouped into two classes —those incidental to the aggravation (Utklesha) of the Doshas or to the loss or waste (Kshaya) of the same. The distempers due to an aggravation of the Doshas should he remedied with soothing (Shamana)and corrective ^S'odhana) measures and remedies, while those resulting from the loss or waste of the Doshas should be remedied with such drugs and remedies as would make up the decreased Doshas (of the system). 33.

Pratimarsha Nasya when to be used:—

The Pratimarsha form of snuff should be resorted to on any of the following fourteen different occasions, viz.:—after quitting the bed in the morning, after cleansing the teeth, on the occasion of going out of the house, after having been fatigued with physical exercise, after sexual intercourse and a journey, after defecation and urination, after the use of gargles (Kavala) and collyrium (Anjana), in an empty stomach, after vomiting, just after a day-sleep and in the evening. 34,

Their Effects:—

A Pratimarsha snuff used by a person just after rising from his bed tends to remove the waxy mucus (Mala) accumulated in the nostrils during the night and brings on a cheerful state of the mind, when used after having cleansed the teeth, it imparts a sweet aroma to the mouth and makes the teeth steady and firm (in their sockets). When used by a man on the occasion of his going out of the house, it acts as a safeguard against the troubles of smoke and dust (assailing him on the road) owing to the consequent moist mucous secretion in the nostrils. When used after the exertion of physical exercise, coition or a journey, it serves to remove the sense of consequent fatigue, and when used after micturition or defecation it tends to remove the dulness or heaviness of vision. When applied after gargling or after an application of collyrium (along the eyelids) it serves to invigorate the eye-sight. When applied on an empty stomach, it cleanses the internal channels of the body and imparts a lightness to it. Taken after an act of emesis it tends to cleanse the mucous (Shleshma) deposit on the beds of the internal ducts of the body and thus brings on a fresh appetite for food. When taken after a day-sleep it tends to remove the sense of drowsiness and physical heaviness and purges the filthy accumulations (in the nose, etc.) thus bringing about a concentrated state of the mind. When taken in the evening it brings on a good sleep and an easy awakening. 35.

Metrical Texts:—

The quantity of Sneha which, being lightly snuffed in, reaches down into the cavity of the mouth, should be deemed adequate for a dose of the Pratimarsha (kind of snuff^[13]). The benefit of using a snuff may be perceived in a variety of ways, as it tends to cure the diseases peculiar to the super- clavicular regions of the body, removes the cloudening or dulness of the sense-organs, imparts a sweet aroma to the mouth, and strength to the teeth, jaw bones, head, neck, Trika, arms and the chest, and guards against an attack of baldness, Vyanga, premature greyness of the hair and the premature appearance of wrinkles or furrows. 36-37.

Specific use of Sneha-Nasya:—

This snuff should consist of oil in a case marked by (the concerted actions of the deranged) Kapha and Vayu, while it should consist of Vasa (lard) in a case involving the action of the Vayu alone. Similarly clarified butter should be used as a snuff in a case of a Pittaja disorder, while the snuff should consist of Majja (marrow) in a case marked by (the concerted actions of the deranged) Vayu and Pitta. The four different modes of using snuff have thus been described in all of which oil may be used as not being hostile in its action as regards the seats of Kapha within the organism. 38.

Kavala-graha:—

Now we shall describe the process of using medicinal gargles (Kavala) which may be divided into four kinds, viz.:—The Snehi (oleaginous), Prasadi (soothing), Sodhi (purifying) and the Ropana (healing). The oleaginous (Snehi) gargle should be surcharged with any oleaginous substance and should be prescribed tepid in a case marked by the action of the deranged Vayu, while cold and sweet articles should be employed in preparing a soothing (Prasadi) gargle and should be prescribed in cases of the deranged Pitta. The purifying (Shodhana) gargles should be composed of acid, pungent and saline drugs which are parching and heat-making^[14] in their potency and should be employed lukewarm (for corrective purposes) in diseases due to the action of the deranged Kapha. The healing (Ropana) gargles should be composed of bitter, astringent, sweet, pungent heat-making^[15] articles and should be employed in cases of ulceration (of the mouth). The therapeutic virtues and applications of the four different kinds of gargle (Kavala) have thus been described (above). 39-40.

The neck, cheeks and the forehead of the patient to be treated with gargles should be (first) fomented and softened and he should be made to take (into his mouth) Trikatu, Vaca, mustard-seeds, Haritaki and rock-salt pasted together and dissolved in any of the following articles, viz:—oil, Shukta, Sura, alkali, (cow’s) urine or honey, and made lukewarm (before use as a gargle). 41.

Kavala and Gandusha—distinguished (M. T.):—

The quantity which can be easily and conveniently rolled out in the mouth is the proper dose in respect of a Kavala, whereas the one which cannot be so (easily and conveniently) rolled out in the mouth is called a Gandusha. 42.

Kavala—how long it should be retained:—

A gargle (Kavala) should be so long held^[16] in the mouth by a patient till the aggravated Dosha^[17] would accumulate in the regions of the cheeks^[19] and would secrete copiously through the nostrils and the eyes, after which the gargle (Kavala) should be every time removed and fresh ones should be taken and kept (similarly) in the mouth. The patient should during the use of a Kavala sit in an erect posture without allowing the mind to be in the least distracted. 43.

Metrical Texts:—

Gargles (Kavala) should be similarly prepared with Sneha, milk, honey, curd, urine, meat-juice or Amla (Kanjika) mixed with the decoction (of any drug) or hot water prescribed according to the nature and intensity of the bodily Dosha or Doshas involved in the case. An amelioration of the disease, a sense of lightness and of purity in the mouth, a cheerful frame of mind and an exhilarating vigour in the organs of sense are the features which mark an act of perfect or satisfactory gargling (Kavala), whereas a sense of physical lassitude, salivation and a (consequent) defect in the sense of taste are the traits which mark deficient gargling. Thirst, an aversion to food, dryness of the mouth, a sense of fatigue and an inflammation of the mouth are the symptoms which attend an act of excessive gargling. These symptoms undoubtedly arise in due proportion to the nature and intensity of the corrective drugs used. 44-45.

Sesamum, Nilotpala, clarified butter, sugar, milk and honey^[20] used as a gargle (Gandusha) alleviates the (consequent) burning sensation of a burn inside the mouth. 46.

The process of using medicinal gargles (Kavala) in general have thus been briefly described.

Pratisarana:—

A Pratisarana remedy may be of four kinds, viz., that prepared with a Kalka (paste), Rasa-kriya, honey and with powders. Prepared with the appropriate drugs, such a compound should be rubbed gently with the tip of a finger in a case of an affection of the mouth. An intelligent Physician may exercise his discretion in selecting the drugs to be used in the preparation of such a remedy. The symptoms of a satisfactory or unsatisfactory Pratisarana should be respectively identical with those of a Kavala. The ranges of therapeutic applications are also co-extensive in both the cases. In other words the diseases of the mouth which yield to the use of medicinal gargles, equally prove amenable to that of Pratisarana remedies. The diet in both the cases should be composed of light and non- phlegmagogic articles of food. 47.

 

Thus ends the Fortieth Chapter of the Chikitsita Sthana in the Susruta Samhita which deals with the inhalation of medicinal fumes, snuffs, and gargles.

Here ends the Chikitsita Sthana

Footnotes and references:

[1]:

Charaka, however, divides Dhuma into three classes only—viz,, Prayogika, Snaihika and Vairecanaka, and includes the Kasa-hara into the Prayogika, and Vamaniya into the Vairecana Dhuma.

[2]:

The term Vairecana here means Shiro-Virecana by means of fumes.

[3]:

Some commentators mean to explain “iṅgudītvak” as lngudi and cardamom instead of as Ingudi-bark. This seems to be better.

[4]:

See Chapter XXXV, Para. 7, Chikitsita Sthana.

[5]:

Charaka’s description of the pipes, (Chapter V, Shlokasthana) corresponds closely to that of Sushruta, except in the case of Prayogika pipe, where Charaka’s reading is somewhat ambiguous. There it may be construed to mean thirty-six as well as forty-eight fingers. Jatu-karna, however, explicitly asserts forty-eight fingers to be the length of the pipe in question. Vrinda is in a fix, and solves the difficulties by explaining that in cases of an aggravation of Kapha and an abundance of Doshas, the length of the pipe should be thirty-six fingers.

[6]:

According to Vrinda’s commentator we have here “Sneezing and a sudden obstruction of breath” as an additional text.

[7]:

Dallana quotes a different reading which would mean that the Kasaghna-Dhuma should he inhaled after taking meals.

[8]:

The Shiro-Virecana drugs are Pippali, Vidanga, Shigru, Siddharthaka, Apamarga, etc. See Sutrashana, Chapter XXXIX.

[9]:

Shrikantha Datta, commentator of Vrinda, says that Gayi reads “shirovirecanadravyasiddhena snehenaiva” (?) etc., from which it is evident that he prescribed only the Sneha cooked with the Shiro-Virecana drugs as Shiro- Virecana Nasya.

[10]:

In respect of healthy patients, the Nasya should be administered at noon in winter, in the morning in spring and autumn, and in the afternoon in summer, while in the rainy season, they should be administered at a time when the sun would be visible in the sky.—Vriddha-Vagbhata.

[11]:

The commentator of Vrinda adds two more conditions—viz., the patient should be made to pass stools and urine before the application of the Nasya and that the Nasya should be applied at a time when the sky would be free from clouds.

[12]:

Gayi’s reading, according to Dallana, as well Shrikantha’s reading is which means the functional derangement of the local Vayu.

[13]:

One drop or two, or the quantity necessary to bring about a disruption of the Doshas, is the dose of a Pratimarsha Nasya according to Vriddha-Vagabhata.

The four forms of Nasya-Karma (medicinal) snuffs, should be prescribed for patients above seven years of age. Pratimarsha is recommended in Gulma.—Krishnatreya.

[14]:

Vrinda does not include ‘parching’ while Chakradatta does not include ‘heat-making’ as the conditions of this kind of Kavala in their respective collections.

[15]:

Chakradatta does not include ‘pungency’ and ‘heat-making potency’ as conditions of this kind of Kavala.

[16]:

Vrinda here reads “sañcarayitavyashca”, i.e., ‘and should be rolled out (in the mouth)’.

[17]:

“Dosha” here means ‘Kapha’.

[18]:

Vrinda here reads “sañcarayitavyaśca”, i.e., ‘and should be rolled out (in the mouth)’.

[19]:

Vrinda reads “yavaddoṣaparipūrṇagalakopalatvam” which means till the Dosha accumulates in the regions of the throat and the cheeks.

[20]:

Commentators, on the authority of Videha, hold that gargles should be used with these articles either collectively or separately in cases of burning in the mouth by an excessive use of an alkali or such other articles.