Sushruta Samhita, volume 1: Sutrasthana

by Kaviraj Kunja Lal Bhishagratna | 1907 | 148,756 words

This current book, the Sutra-sthana (english translation), is the first part of this voluminous medical work. It contains a large summary of the knowledge envelopig the medical aspects of Ayurveda. Descriptions of diseases, various diets and drugs, the duties of a surgeon, surgical procedures, medical training; these are only some of the numerous s...

Chapter XLIV - Recipes of purgative drugs

Now we shall discourse on the Chapter, which treats of the choice of purgatives (Virecana-Dravya-Vikalpa-Vijnaniya-adhyaya.)

Metrical Texts:—

Of the purgative roots, the roots of reddish Trivrita should be deemed the most effective. The barks of Tilvaka and the fruit known as Haritaki are the most potent of all purgative barks and fruits. Similarly, the oil of castor seeds (Eranda-Taila), the expressed juice of Karavellika and the milky exudations of Sudha plant are the most effective of all such purgative oils, expressed juices and milky exudations of plants, etc. These drugs or substances form the principal purgative remedies (in our pharmacy), and we shall discuss the mode of their administration in successive order.

A purgative remedy consisting of the sound and matured roots of Trivrita, soaked in the expressed juice of the principal purgative drugs and subsequently pulverised and mixed with a considerable quantity of Saindhava salt and powdered Nagara, should be administered through the medium of curd or sour rice gruel, etc. to a patient, suffering from a disease due to the derangement of the bodily Vayu. The same powder mixed with modifications of sugarcane juice (such as treacle, sugar etc.), or with decoctions of drugs belonging to the Madhuradi group (Kakolyadi-gana), or with milk, should be prescribed for a patient laid up with Pittaja distemper.’ In diseases due to the deranged action of the Kapha the same powder should be administered with a decoction of Guduci, Arishta or Triphala, or with the addition of pulverised Vyosha and cow’s urine.

One part of the same powder (Trivrit), mixed with one part of old treacle and the drugs known as Trivarnaka, and Tryushana, should be administered for purgative purposes in a disease (due to the concerted action of the deranged Vayu and Kapha). As an alternative, a Prastha mea sure (four seers) cf the decoction of the Trivrit roots, mixed with a Kudava measure (half a seer) of their paste, and a Karsha (two tolas) weight of Saindhava salt and Nagara, and boiled together, and then formed into a condensed compound should be used; or one part of the paste of the same roots, mixed with half a part each of rock-salt and powdered Nagara, should be administered through the vehicle of cow’s urine. A compound consisting of one part of each of the following drugs viz., powdered Trivrita roots, Nagara and Haritaki, and a half part of each of such drugs as powdered Marica, Devadaru, Vidanga and ripe Puga nuts, mixed with rock-salt, and administered through the medium of cow’s urine, should be considered as an effective purgative (in diseases of whatsoever type).

Powders of purgative drugs taken in adequate measures and soaked in their own juice should be boiled with their roots and made into pills (Gutika) with clarified butter and administered as occasion would arise. As an alternative, powders of purgative drugs pasted with clarified butter boiled with their roots should be made into boluses, and the intelligent physician should administer them through the medium of clarified butter, prepared as above, whenever necessary. A quantity[1] of treacle should be kept boiling over an oven, and a (halt part) of the pulverised purgative roots should be cast into it, a little before it is completely boiled. Then the basin should be taken off the fire, and powders of aromatic drugs known as Trijata strewn over it, and the compound subsequently made into boluses (Gutika) of adequate size according to the requirements of the case under treatment.

One part of any of the pulverised purgative drugs (such as the Trivrit roots, etc.) should be boiled with four parts of their own decoction, and one part of powdered wheat steamed in the fumes of a separate quantity of a similar boiling decoction, should be pounded with a quantity of clarified butter boiled and prepared with the same decoction. Then having cooked a quantity of thin treacle in a separate utensil, powders of wheat and purgative drugs prepared as above, should be cast into it, immediately before being completely cooked, and the vessel should be taken down from the oven and allowed to cool. Then this confection (Modaka) should be perfumed with aromatic drugs and regarded as ready for use. In short, this purgative Modaka is good food as well.

Purgative preparations of Mudga, etc.:—

The soup of Mudga pulse saturated with the decotion of a purgative drug, and taken with clarified butter and rock salt, acts as a good purgative as well. Similarly, soups of other pulses (such as the Musara, etc.) soaked in a decoction of any of the purgative drugs and drunk with the aforesaid adjuvants, exert purgative virtues. Drugs possessed of emetic properties may be used through the preceding media of pulse-soups as well.

A bit of sugar-cane should be longitudinally split, and then paste of Tribhandi should be placed in its middle; then it should be tied up (with the blades of Kusha grass), and plastered over with a coat of clay, and inserted in a gentle fire of dung cake. After that, it should be taken out of the fire, fully roasted; the juice squeezed out and cooled, would prove a good purgative to a patient laid up with a Pittaja distemper.

A compound consisting of equal parts of sugar and powdered Ajagandha, Tvakkshiri, Vidari and Trivrit and licked with honey and clarified butter, proves curative in a fever with thirst and a burning sensation of the body.

A compound consisting of one part of pulverised Trivrit and a quarter part each of the drugs known as Tvak, Patra and Marica, and administered with an adequate quantity of honey and sugar, should be regarded as a good purgative for delicate persons.

A Pala weight of sugar should be boiled with a half Kudava weight of honey, and Trivrita powders to the weight of a quarter part (of the combined weight of honey and sugar) should be added to the boiling compound at the later part of the cooking. The remedy should be administered cool, and looked upon as a good purger of Pitta.

A compound consisting of equal parts of powdered Trivrit, Shyama (Vriddha-Daraka), Yavakshara, Shunti and Pippali, and taken with honey, acts as one of the most effective purgatives in diseases due to the action of the deranged Kapha.

Over-ripe Pathya, Kashmari, Dhatri, Dadima and Kola fruit taken with their seeds or stones, should be boiled (with a quantity of water weighing sixteen times their combined weight). The decoction thus obtained should be boiled with (castor) oil, and the juice of Amlaphala etc. (to the weight of a quarter part thereof), should be added to it. The whole should be boiled together until reduced to a considerable consistence. The powders of the three aromatic drugs (Trisugandha) and Trivrit[2] should be then added to it, which should be administered to a patient as an electuary with honey. This remedy will prove a good purgative in respect of a delicate person of Kaphaja temperament.

A compound, consisting of one part of powdered Nili fruit, one part of powdered Tvak and Ela, and two parts of pulverised Trivrit, and mixed with an adequate quantity of sugar, and taken with honey and the juice of Amlaphala, should be regarded as a purgative remedy possessed of the virtue of destroying the concerted action of the three deranged humours of the body.

A compound, consisting of equal parts of powdered Trivrit, Shyama (Vriddhadaraka), Pippali and Triphala and made into a confection (Modaka) (with the addition of honey and sugar), should be regarded as one of the most potent cures (purgatives) for Sannipata (simultaneous derangement of the three vital humours), hemoptysis and fever.

A compound consisting of three parts of Trivrit, one part of Triphala, one of Yavakshara, one of Krishna (Pippali), and one of Vidanga, pounded together and used as an electuary with the addition of honey and clarified butter, or made into boluses (Gutika) with treacle, proves curative in cases of enlarged spleen, in Gulmas due to the action of the deranged Kapha and Vayu, in Halimaka (Chlorosis), as well as in cases of abdominal dropsy, etc. The present remedy (purgative) is one of the most harmless purgative compounds (of our pharmacopeia). A purgative compound consisting of Shyama (Vriddhadaraka), Trivrit, Nili, Katvi, Musta, Duralabha, Cavya, Indrayava and Triphala, administered through the vehicle of clarified butter, essence of meat, or water, is commended to persons of dry temperament.

Preparations of Purgative Asavas (Wines):—

All purgative drugs[3] should be duly boiled in water. Three parts of the decoction thus prepared should be mixed with two parts of cold powdered barley (Phanita) and again boiled over a fire. Then after boiling it, it should be taken down from the oven, cooled and poured into a pitcher previously coated inside with a special plaster.[4] Then according to the difference of the season (cold or hot), the pitcher should be kept buried in a heap of paddy for a month, or a fortnight. It should be taken out and understood to be ready for use as soon as it would emit a winy of fermented odour. Asavas (fermenting liquours) of animal urines and alkaline substances should be likewise prepared in the foregoing manner.

Preparations of purgative rice Sura (Wines) etc.:—

Quantities of Masha pulse and Shali rice should be respectively first soaked and washed in a decoction of purgative roots. Then they should be dried and pounded together and made into balls, which should be subsequently dried in the sun and again pulverised.[5] After that a separate quantity of Shali rice steamed in the vapours of the aforesaid decoction, and kept apart, should be made into cakes. Then three parts of these cakes should be mixed with one part of the aforesaid powdered ball. The compound thus obtained should be soaked in an adequate quantity of that purgative decoction previously kept apart in an earthen pitcher of the plastered type, described before. The Sura should be deemed ready for use, as soon as it would emit the peculiar honey-like smell. Suras of emetic drugs should be likewise made in the same manner.

Preparations of purgative Sauvirakas (Barley Wines):—

Trivrit roots and drugs belonging to the groups of Vidarigandha and major Pancamula, as well as Murva, Sharngashta, Sudha, Haimavati, Triphala, Ativisha and Vaca should be mixed together and then set apart in two equal parts. A decoction should be made of one of them, while the other should be reduced to a state of powder. After that, a quantity of well thrashed and huskless barley should be soaked in the aforesaid decoction for seven days, and should be subsequently dried and fried a little. Then three parts of the latter and one part of the aforesaid powder (powdered Trivrita roots etc.) should be mixed together and soaked in the aforesaid cold decoction of those drugs. The mixture should be then kept into an earthen pitcher of the foregoing type and administered in adequate doses as soon as the characteristic winy smell of the mixture (Jatarasa) would be detected. The preparation is called the purgative Sauviraka.

Preparations of purgative Tushodaka
(fermented liquors of barley with husks):—

The drugs enumerated in connection with the foregoing preparation should be mixed together and divided in halves and kept in two separate vessels. One half of the mixture should be well-thrashed and tied up in a piece of clean linen with a quantity of unthrashed barley in husks and should be boiled with a decoction of Ajashringi in a separate basin. Then barley in husks should be separated from the rest of the components of the mixture after it has been thoroughly cooked. Then three parts of these barley grains subsequently thrashed should be again soaked in their decoction, and a fourth part of the aforesaid pulverised drugs such as the roots of Trivrit, etc.) should be added to it, and the entire mixture should be kept in an earthen pitcher of the before mentioned type. This preparation is called Tushodaka (lit: Washings of husks), and should be used as soon as the characteristic smell of fermentation (Jatarasa) would be emitted from the pitcher. The processes of preparing Sauviraka and Tushodaka have been described. They should be used after the expity of six or seven nights from the date of their being in the pitcher.

The rules and processes regarding the preparation of Trivrit compounds hold good in cases of similar preparations made of the rest of purgative drugs (such as, Danti, Dravanti, etc.)

The roots of Danti and Dravanti should be first pulled up and collected, after which they should be dried in the sun. After that, they should be mixed with honey and pasted Pippali and placed in a box of Kusha grass firmly tied up and plastered with a layer of clay. The box should be put into a fire of dried cowdung cakes. The compound inside the plastered grass box should be cooked according to the process of Putapaka, and should be taken out and used in diseases due to the action of the deranged Kapha and Pitta and in combination and through vehicles described in connection with the purgative compounds of Trivrit.

Pastes (Kalkas) and decoctions of Danti and Dravanti should be boiled with clarified butter, and Chakra Tailam (sesamum oil pressed in an oil mill). The clarified butter, thus cooked and prepared, would prove curative in cases of Erysipelas, Kaksha, burning sensation of the body and Alaji, while cases of Meha, Gulma, retention of flatus, (kapha) and obstruction of the bowels would prove amenable to the oil above described. Diseases due to the retention of urine, semen and Vayu or fecal matter readily yield to one of the four oily substances (Catuh-sneha, oil, clarified butter, lard and marrow) cooked and prepared with the paste and decoction of Danti and Dravanti.

A compound consisting of Danti, Dravanti, Marica, Kanakahvaya, Yavasaka, Vishva-veshaja, Mridvika, and Citraka powdered together and successively soaked in cow’s urine for seven days, should be administered for purgative purposes, through the medium of clarified butter. A diet of powdered barley, stirred in honey, should be given to the patient after the assimilation of the abovesaid medicine. Diseases such as indigestion, pain at the sides, jaundice, enlargement of the spleen as well as those due to the combined action of the deranged Kapha and Pitta readily yield to the curative efficacy of this purgative remedy.

Twenty pulverised Pathyas mixed with the powders of Danti and Citraka roots, each weighing a Pala in weight, as well as with two tola weights each of powdered Pippali and Trivrit, should be cooked with eight pala weights of treacle. The compound thus prepared should be made into ten large balls of confection (Modaka), each of which should be taken on every tenth day. Warm water should be used for drinking and bathing purposes while using the medicine, which does not entail any strict regimen of conduct (as non-exposure to cold wind, etc.). It proves curative in dysentery, jaundice, pile and cutaneous affections and subdues the three deranged humours of the body.

Trivridashtaka:—

The nine following drugs, viz. Trikatu, Trijata, Musta, Vidanga and Amalaka taken in equal parts, and eight parts of Trivit, and two parts of Danti roots should be separately pulverised and sieved through a piece of thin linen. The powders thus prepared should be pounded together and mixed with six parts of sugar and a little quantity of honey and rock salt.[6] Cold water should be given to the patient after he had taken the medicine, which proves curative in colic pain in the bladder (Vasti-Shula), thirst, fever, vomiting, anasarca (Shotha), chlorosis and vertigo. It does not entail any strict regimen of conduct like other purgatives and acts as a good eliminator of poison. The compound is called the Trivridashtaka and is specially recommended in Pittaja affections. Persons, suffering from diseases due to the action of the deranged Pitta and Kapha, should take the medicine through the vehicle of milk. The medicine should be prescribed for rich persons, owing to its dietetic character.

Purgative barks:—

The external skin of the Lodhra bark, to the exclusion of its inner lining, should be taken and pulverised. The powder, thus prepared, should be divided into three equal parts, two of which should be soaked in a decoction of the same (Lodhra) bark and filtered twenty-one times according to the process laid down in connection with the preparation of alkalis. The remaining third part of the powders should be soaked in the aforesaid filtered decoction and subsequently dried in the sun, and again soaked in a decoction of the drugs, which collectively go by the name of Dashamula. The medicine should be prescribed in forms (wines, electuaries, etc.) previously described in connection with the Trivrit compounds.

The mode of preparing and administering purgative medicines out of barks endued with similar virtues has been described. We shall presently deal with those made with purgative fruits.

Fruit Purgatives:—

Sound and stoneless Haritakis administered in the way of Trivrit compounds prove curative in all forms of disease and in malignant sores and internal abscesses. They are the best of elixirs and improve the intellectual faculties. Haritaki and Vidanga, as well as rock salt, Nagara, Trivrit and Marica mixed in equal parts and taken with cow’s urine, act as good purgatives. Similarly, powders of Haritaki, Bhadra-daru, Kushtha, Puga-phala, Saindhava salt and Shringaveram taken through the medium of cow’s urine, act as good purgative. For purgative purposes, a man should lick a compound consisting of the powders of Nilini fruits, Nagara, Abhaya and treacle and subsequently drink a good draught of warm water. A compound composed of Haritakis pasted with a decoction of the drugs constituting the group of Pippalyadi and a bit of Saindhava salt, exerts an instantaneous purgative action.

Haritakis eaten with Nagara or treacle and with a bit of rock salt added to it, is an excellent stomachic. The specific virtue of Haritaki consists in restoring the normal condition of the bodily Vayu (laxative), in rejuvenating an used up or exhausted frame, and in soothingly invigorating the sense organs. Haritaki destroys all diseases, which are due to the use of sweet or richly cooked dishes (Santarpana) such as, thirst, etc. amalaka is cooling, and refrigerent; it subdues Pitta and Kapha and is antifat in its virtues. Vibhitaka is cooling; it subdues Pitta and Kapha. The group of medicinal fruits known as the Triphala consists of Haritaki, Amalaka and Vibhitaka, which are collectively marked by an acid-astringent taste with a shade of bitter and sweet. Powdered Triphala regularly taken with clarified butter of a three quarter part of its own weight acts as a regular panacea and is endued with a rejuvenating virtue.

All fruits possessed of purgative properties, should be used in the manner described in connection with Haritaki with the exception of Caturangulas. The Caturangula fruit should be collected in the proper season, and then kept buried for a week in a bed of sand. After that, they should be unearthed and dried in the sun, and their stones or seeds (lit. marrow) should be taken out. Then the essential oil of the seeds should be extracted by pressing them in an oil-mill like the seeds of sesamum, or by boiling them with water (hot expression). The oil is a good purgative for a child up to its twelfth year.

Hot water taken after having licked a compound consisting of Castor oil saturated with powdered Kushtha and Trikatus, acts as a good purgative. Castor oil taken with a decoction of Triphalas, double its own measure, or with milk or extract of meat, acts as a good purgative, which should be prescribed for infants, old men, or persons debilitated from the effects of ulcer cachexia, or of delicate constitution.

I have finished describing the preparation and application of fruit purgatives. Now hear me, O Sushruta, discourse on similar milky exudations of plants and trees, etc. which are possessed of purgative properties. The milky juice of a Sudha plant is the strongest of all purgatives, which being imprudently used by a medical ignoramus, may be attended with dangerous consequences, while the same in the hands of a judicious physician proves strong enough to disintegrate a mighty accumulation of deranged humours and to successfully combat many an irremediable distemper.

One part of the decoction of each of the drugs constituting the group of major Pancamula and Vrihati, etc. should be mixed with one part of the milky juice of a Sudha plant (thus forming an eighth part of the whole compound). After having boiled it over a charcoal fire, the compound should be taken with two Tola (kola) weights of any acid liquid (such as wine, sour rice gruel, cream of curd, etc.) in the manner of Trivrit compounds. A gruel made of rice saturated with the milky exudation of a Mahavriksha, or a sweetened, porridge-like preparation of the same substance (Utkarika) made with treacle, should be deemed as possessed of purgative properties. As an alternative, an electuary composed of sugar, clarified butter and the milky juice of a Snuhi plant, should be used for purgative purposes.

Powders of Pippali soaked in the milky juice of the same plant should be used with rock salt for moving the bowels. Powdered Kampillaka made into boluses with Snuhi juice may be as well prescribed for the same end. Powders of Saptala, Shankhini, Danti, Trivrit and kernel of Aragvadham, should be saturated with cow’s urine and then soaked in the milky juice of a Snuhi plant successively for seven consecutive days.[7] A smell of the powder thus prepared and strewn over the flower-garlands, and clothes worn by a man whose bowels are easily moved, acts as a mild purgative.

The use and preparation of purgative remedies concocted with roots, barks and milky exudations of plants, etc. have been described, which should be prescribed after carefully considering the nature of the case under treatment and according to their specific indications.

A compound consisting of three Shana weights (one tola and a half) of powdered Trivrit, three Shana weights of powdered Triphala pulp, and three Shana weights of powdered Vidanga, Pippali and Yavakshara, mixed and pounded together, should be licked with honey and clarified butter, or they should be made into a confection with treacle for purgative purposes. The medicine does not entail any strict regimen of diet and conduct. It is one of the most effective remedies (of our pharmacopoeia) and proves curative in Gulmas, enlargement of the spleen, cough,. Halimaka (chlorosis), non-relish for food and in diseases due to the action of the deranged Kapha and Vayu. A wise and intelligent physician should administer purgative medicines through the vehicles of clarified butter, oil, milk, Madya (wine) cow’s urine, meat essence, or through the expressed juice of drugs, or through articles of food, or in forms of electuary. The six kinds of purgatives are the milky exudations, expressed juices, pastes, decoctions, cold infusions and powders of medicinal drugs or herbs, and each of these preceding factors should be deemed stronger than the one immediately following it in the order of enumeration.

 

Thus ends the forty-fourth Chapter of the Sutrasthana in the Sushruta Samhita, which treats of the choice of purgatives.

Footnotes and references:

1.

The quantity of old treacle should be equal to the aggregate weight of the other drugs in the compound under similar circumstances.

2.

The weight of honey and pulverised Trivrit should be equal to a fourth part of the entire quantity of medicine taken at a time.

3.

Several authorities exclude the plant known as Sudha (Manasa), while others stick to Trivrita alone in exclusion of all other drugs.

4.

A new earthen pitcher is first washed with water and dried in the shade. Then its inside is coated with a plaster of honey and powdered Pippali and is fumigated with the fumes of Aguru (Eagle wood).

5.

For imparting to it the necessary Enzyme,

6.

The term little (Ishat) in the present instance stands for a quarter part.

7.

The mode of preparing the porridge is as follows:—First the wheat should be saturated with the milky juice of a Maha-Vriksha and then macerated. The powder should be then cooked with milk and treacle and made into a thick porridge.

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