Chapter LIX - Symptoms and Treatment of the defects of Urine (Mutra-dosha)

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of the defects of urine (Mutra-dosha-Pratishedha).^[1] 1.

Classification:—

The disease known as Mutropaghata is divided into eight different types according as an attack is induced by the deranged action of the bodily Vayu. Pitta and Kapha separately, or is due to the concerted action of all of them, or to the effects of an external blow or hurt (on the locality), or to the pressure of the feces incarcerated (in the intestine),—i.e. to the constipation of the bowels—or to the presence of any stone (Ashmari in the bladder). The eighth is the one due to the presence of gravels (Sarkara in the bladder). This disease is one of the most painful and distressing ailments which assail the human body. 2.

Specific Symptoms:—

A scanty flow of urine coming out in drops and producing an oppressive and bursting pain in the scrotum, penis and bladder, is the specific feature of the Vataja type of the disease. The Pittaja type is characterised by the emission of bloody or high-coloured (lit. dark yellow) and (very) warm urine which produces a burning sensation in the scrotum, bladder and penis being burnt by fire, as it were. A sense of weight or heaviness in the scrotum, penis ani bladder, an appearance of goose-flesh (on the skin) and the emission of cold, white and glossy (oily) urine, are the features which mark the Kaphaja type. Burning sensation (in the urethra, etc.), shivering (of the body), frequent emission of urine of varied colours, painful micturition and loss of consciousness are the indications which point to the Sannipatika origin of the disease which is very hard to cure. 3-6.

The presence of any ulcer in or an injury to the urethra, by any external object gives rise to an extremely distressing stricture in the case of which the characteristic symptoms of Vata-vasti manifest themselves. The suppression of the feces leads to the aggravation of the local Vayu which, in its turn, produces a distension of the abdomen and a suppression of urine accompanied with cramps (in the bladder). 7–8.

Asmarija and Sharkaraja:—

Mutra-ghata (obstructed urination) due to the presence of Ashmari (stone) has been already mentioned (in the Nidana Sthana). Stones and gravels are of similar origin and exhibit similar symptoms. Now hear me describe the symptoms which are the distinguishing traits of a case of Sarkara (gravel or urinary calculus in the bladder). Flakes or particles of deranged and condensed Kapha when baked (dried?) by the action of the deranged and aggravated Pitta and severed in pieces by the deranged bodily Vayu, are called Sarkara (gravels) giving rise to such symptoms as cardiac troubles (pain in the heart, etc.), shivering, cramps in the loins, great diminution of the digestive fire, fainting fits and painful and obstructed urination. The pain, however, subsides with the subsidence of the desire for micturition (full evacuation of the bladder), the relief from the pain continuing until the orifice of the organ (urethra) is not again obstructed by the presence of other calculii. These are the symptoms which characterise a case of Mutraghata (obstructed urination) due to the presence of gravels in the bladder. 9.

General Treatment:—

Now I shall describe the mode of medical treatment and active therapeutic agents to be employed in the eight cases of Mutraghata. Medical measures and remedies mentioned in connection with the treatment of Ashmari (stone) should also^[2] be employed in the present instance in due succession—commencing with the application of Sneha, etc.—with proper regard to the Dosha or Dhosas involved in each case. 10.

Treatment of Vataja Type:—

Oil, clarified butter and lard mixed together should be duly cooked with Shva-damshtra, Ashmobheda, Kumbhi (a kind of moss), Hapusha, Kantakari, Bala, Shatavari, Rasna, Varuna, Giri-karnika and the drugs of the Vidari - gandhadi group. Oil or clarified butter alone may also be similarly cooked and prepared with the above drugs. The above preparations should be internally administered, or injected into the intestines after the manner of an Anuvasana-vasti, or into the urethra as an Uttara-vasti for giving relief in cases of Vataja Mutra-kricchra. 11–12.

Pittaja and Kaphaja Types:—

The internal use of the clarified butter duly cooked with the drugs of the Trina-panca-mula, Utpaladi, Kakolyadi and Nyagrodhadi groups, would give an instantaneous relief in a case of Pittaja Mutra-Kricchra. The use of this Ghrita as an Uttara-vasti would also similarly give relief in a case of the present type. Any Sneha duly cooked with the preceding drugs should be similarly used after the manner of any of the three Vasti-applications. Purging with milk and the expressed juice of Ikshu and of Draksha is also beneficial. Oils and Yavagus duly cooked with the drugs of the Surasadi, Ushakadi, Mustadi and the Varunadi groups would prove curative in a case of Kaphaja Mutra-kricchra. 13 —14.

Tri-doshaja Type:—

The foregoing measures and remedies should be employed in the Tri-doshaja type of Mutra-kricchra according to the nature and intensity of the predominance of the Doshas involved. Pulverised compound of Phalgu (Kakodumbara), Vrishchika (white Punarnava), Darbha and Ashma-sara (dead iron) taken with water, potions of Sura (wine), the expressed juice of Ikshu, and the decoction of Darbha would relieve pain in a case of Mutra-kricchra. 15.

Medicines and medicinal measures mentioned in the chapter on the treatment of Sadyo-vrana should be employed in a case of stricture due to any hurt (Abhighata) to the urethra. Vayu-subduing remedies should be constantly used, and baths, fomentations, unguents, applications of Vasti and powders should be employed in a case of Purishaja Mutra-kricchra. The treatment of the last two kinds (viz. Ashmari-ja and Sharkara-ja) has already been described. 16–17.

 

Thus ends the fifty-ninth chapter of the Uttara-Tantra in the Sushruta Samhita which deals with the (symptoms and) medical treatment of Mutra-dosha.

Here ends the Kaya-Chikitsa.

Footnotes and references:

[1]:

Dallana’s reading evidently is Mutra-kricchra (Strangury), for he says that the variant here in some Mss. is Mutra-dosha. He says further that some do not read this chapter at all on the ground that the matter in this chapter is included in the chapters on Aśmari, Mutrāghāta and Udāvarta, etc. But, according to him, it must be read here for treatment’s sake as well as on the ground of its being separately treated in other authoritative works. Mādhava, Chakra-pāni, Vrinda and other compilers have read this as Mutra-kricchra in a separate chapter as here.

[2]:

Dallana says that the presence of the particle “ca” (meaning also) indicates that the mode of medical treatment prescribed in Cases of Mutrāghāta should also be applied in this case.