Chapter XXXVIII - Treatment of the diseases of the female organ of generation

Now we shall discourse on the chapter which deals with (the symptoms and) the therapeutics of the diseases of the female^[1] organ of generation (Yoni-vyapat-Pratishedha). 1.

Causes:—

The bodily (as well as the local) Vayu of a girl of tender years, weakly constitution or build and dry organic temperament, is deranged and aggravated in consequence of her excessive indulgence with a man of abnormally developed reproductive organ, and on getting into her organ of generation (yoni) gives rise to different local vaginal diseases which become manifest through the presence of the symptoms of the aggravation of the three specific Doshas. 2.

In the chapter on the enumeration of diseases, the diseases which affect the female organ of generation (yoni) have been classified into twenty different kinds^[2]. The injudicious conduct of life which is usually found in females, menstrual disorders, the diseased or defective nature of the seed (of the parents of the girl), or any accidental cause may be fairly set down as causes of these female diseases. Now hear them discussed separately. 3.

Enumeration and Classification:—

Udavarta (dysmenorrhea), Bandhya (sterility), Vipluta (introversion of the uterus), Paripluta (retroversion or retroflexion of the uterus) and Vatala are the five kinds of Vataja vaginal diseases. Rudhirakshara (menorrhea), Vamini, Sramsini, Puttraghni and Pittala are the Pittaja ones. Atyananda (nymphomania), Karnini, the two kinds of Charana and Shlaishmiki find their origin in Kapha, and Shandi, Phalini, Mahati, Suchivaktra and Sarvaja are said to be due to the aggravation of the three Doshas. 4.

Symptoms of the Vataja types:—

An Udavarta yoni discharges painful and frothy menses and a Bandhya yoni is marked by the absence or suppression of the catamenial flow. A local pain is always complained of in a Vipluta yoni and in a Paripluta yoni an excessive local pain is experienced at the time of sexual congress. A Vatala yoni is marked by an aching and piercing pain in the organ which seems rough and numbed. The peculiar pain due to the derangement of the Vayu is also felt in the first four types of the series. 5.

Symptoms of the Pittaja types:—

Discharge of the menses with a burning sensation in the passage is the characteristic symptom of Lohita-kshara or Rudhira-kashra yoni. The yoni from which the semen charged with the menstrual blood, is ejected with Vayu (sound) is called Vamini; the coming out (prolapsus) of the organ (uterus) when disturbed and a difficult or painful parturition are the symptoms of a Prasramsini yoni. The yoni in the case of repeated abortions due to the excessive discharge of catamenial blood during the period of gestation is called Puttraghni. An extremely burning sensation and suppuration in the organ attended with fever are the symptoms which mark a Pittala yoni. The four previous vaginal diseases are also marked by the specific symptoms of the aggravated Pitta. 6.

Symptoms of the Kaphaja types:—

An Atyananda yoni knows no satisfaction in matters of sexual pleasures. Hemorrhoid growths or polypii due to the aggravation of Kapha and vitiated blood appear on the living membrane of the organ in a Karnini yoni. In an Acaraua yoni a greater quantity of ovum is secreted before the completion of sexual act, and in the other i.e., in an Aticharana yoni the semen is not retained in consequence of over-indulgence. A Shleshmala yoni is very cold and slimy and has a local itching sensation. The first four kinds of this series of vaginal disease (lit. diseased vagina) are also characterised by the actions of the deranged and aggravated Kapha in the locality. 7.

Symptoms of the Tri-doshaja types:—

The yoni of a woman marked by the non-appearance of the menses, non-development of her breasts and the roughness of the vagina (vaginal canal) which is felt at the time of coition is called a Shandhi. A woman of tender years, who has just passed her girlhood, when ravished by a man with an abnormally developed genital organ, offers the illustration of a Phalini yoni. An extremely dilated vagina is called Mahayoni, while an extremely constricted one is called a Suchivaktra (lit. a vagina with a needle-eyed vulva). The yoni marked with the symptoms of the aggravation of all the three Doshas is said to be a Sarvaja yoni. The four preceding kinds of vaginal malformations or diseases are also due to the concerted action of the three deranged Doshas in the locality and these last (five) kinds of Tridoshaja vaginal diseases are incurable. 8.

Medical Treatment:—

The medical treatment of the curable types of vaginal diseases should begin with the administration of a Sneha according to the Dosha involved in each case and applications of properly charged vaginal enemas (Uttara-vasti) should be particularly resorted to. In cases where the yoni (vagina) would feel cold, rough, numbed and be marked by diminished sensibility of its mucous membrane during sexual action it should be fomented, in the manner of Kumbhi-sveda, with the flesh of aquatic and Anupa animals; and drugs of the Madhura group mixed with Veshavara (all described before) should be applied (in the form of poultice) to the part, and plugs of oil-soaked cotton should be constantly retained in the yoni (vagina). Proper vaginal lotions and washes as well as the measures of Purana i e. medical injection (prepared with the Vayu-subduing drugs) should also be employed; cooling measures should be adopted in the cases marked by dryness and sucking pain (Osha and Chosa) in the affected locality. The vagina should be filled up with the powders of the five officinal kinds of drug (Panca-kashaya) in a case, marked by fetour and slimy mucous secretion, and the decoction of the drugs of Rajavrikshadi group should be used in washing. Pindas (balls) of disinfectant (Shodhona, lit. purifying) drugs pasted with cow’s urine and saturated with salt, should be inserted into the vagina marked by the discharge of pus. 9–12.

A yoni (vagina) marked by an itch and impaired sensibility should be fumigated with the vapour of Vrihati and the two kinds of Haridra taken together, which should be as well inserted and retained in the vagina (in the shape of a plug). A plug or stick composed of a paste of disinfectant (or Shodhana) drugs should be inserted into and retained in a Karnini yoni; and a prolapsing (Prasramsini) yoni should be fomented with hot milk and rubbed with clarified butter. It should then be restored to its proper place and, being pasted with Veshavara, should be duly bandaged 13–14.

Diet:—

Sura, Asava, Arishta, (wines of medicinal drugs) should be prescribed according to the Dosha involved in each case and the patient should be made to take the expressed juice of garlic (Lashuna) every morning and her diet should consist mainly of milk, meat-soup, etc. 15.

We have already described the nature of the medical treatment and the remedial agents to be respectively pursued in and prescribed for diseases of the semen, menstrual complaints, affections of the mammae, impotency, cases of false presentation of child and diseases during the period of pregnancy and motherhood, and all those may be employed with equal benefit in these diseases peculiar to the female sex. Other diseases (such as fever etc.) which may arise from immature delivery should be treated in the manner described in the respective treatment of those diseases in the Uttara Tantra. 16.

 

Thus ends the thirty-eighth chapter of the Uttara Tantra in the Sushruta Samhita which deals with the therapeutics of the female organ of generation.

Here ends the Kaumarabhritya Tantra.

Footnotes and references:

[1]:

The term “yoni” is here used in a very comprehensive sense and means the whole female organ of generation, i.e., Uterus, Vagina, etc.

[2]:

These three lines correspond verbatim with three lines in the Charaka Samhitā (vide Charaka Samhitā, Chapter XXX, Chikitsita-sthāna).