Chapter IV - The medical treatment of nervous disorders

Now we shall diseourse on the medical treatment of nervous disorders (Vata-vyadhi). 1.

Metrical Texts:—

The patient having been made to vomit in the event of the deranged Vayu being incarcerated (lodged) in the amashaya (stomach), a pulverised compound known as the Shad-Dharana-yoga (a compound of six Dharanas or twenty-four Masha weight) with tepid water should be administered to him for seven days. A compound made up of Citraka, Indra-yava, Patha, Katuka, Ativisha, Abhaya (taken in equal parts) together is known as the Shad- Dharana-yoga^[1] and contains the properties of subduing an attack of Vata-vyadhi. 2-3.

In the event of the aggravated Vayu being incarcerated in the Pakvashaya (intestines), purgatives of fatty matters (Sneha-Virecana, i.e., Tilvaka-Sarpih, etc.), and Sodhana- Vasti of purifying drugs (with decoctions and Kalka of fatty matters) and diet (Prasha) abounding in salt^[2] or saline articles should be prescribed. In the case of the aggravated Vayu being incarcerated in the Vasti (urinary bladder), diuretic (lit. bladder-cleansing) measures and remedial agents should be resorted to. Anointing with medicated oils, Ghritas, etc., application of poultices (Upanaha) compounded of Vayu-subduing drugs, massage, and plasters (Alepa) of similar properties are the remedies in cases where the aggravated Vayu is lodged in the internal ducts or channels such as the ears, etc,, of the body. Blood-letting (venesection) is the remedy where the aggravated Vayu would be found to be confined in the skin, flesh, blood or veins (Shiras). Similarly, application of fatty matters (Sneha), actual cauterization, massage, application of poultices and binding of ligatures should be the remedies where the aggravated Vayu would be found to have become involved in the Snayu (ligaments), joints and bones Where the aggravated Vayu would be found to have become situated in the bone, the skin and flesh of that part of the body should be perforated with a proper surgical instrument (Ara-Shastra) and the underlying bone should be similarly treated with an awl. A tube open at both ends should be inserted into the aperture, thus made, and a strong physician should suck the aggravated Vayu from out of the affected bone by applying his mouth to the exterior open end of the tube. 4–9.

In the case of the aggravatd Vayu having contaminated the semen, measures and remedies for seminal disorders (Shukra-dosha)^[3] should be employed. The intelligent (physician) would take recourse to measures, such as blood-letting, immersion or bath in a vessel (full of Vayu- subduing decoctions), fomentation with heated stones, as well as in the manner of Karshu-Sveda, vapour-bath in a closed chamber (Kuti sveda), anointment, Vasti- Karmas, etc., in the event of the aggravated Vayu having extended throughout the whole organism; whereas bleeding by means of a horn (cuffing) should be regarded as the remedy when the aggravated Dosha would be found to have been confined in any particular part of the body.^[4] 10–12.

In the event of the aggravated Vayu being connected either with the Pitta or the Kapha, such a course of treatment should be adopted as would not be hostile to the two other Doshas. Blood-letting (in small quantities) should be resorted to several times in a case of complete enesthesia (Supta-Vata) and the body should be anointed with oil mixed with salt and chamber-dust (Agara-dhuma) Milk bailed with a decoction of the drugs of the Panca-mula group, acid-fruits (Phalamla), meat-soup or soup of (well-cooked) corn (Dhanya) with clarified butter are beneficial in cases of Vata- roga. 13-15.

Shalvana-Upanaha:—

A poultice composed of the drugs of the Kakolyadi group, the Vayu-subduing drugs (those of Bhadra-darvadi and Vidari- gandhadi groups), and ail kinds of acid articles^[5] (such as, Kanjika, Sauvira, fermented rice-gruel, etc.), the flesh of animals which live in swamps (Anupa) or in water (Audaka)^[6], oil, clarified butter and all kinds of lardaceous substances, mixed together and saturated with a profuse quantity of salt and then slightly heated is known by the name of Shalvana. A person suffering from any form of Vata roga should be always treated with such Shalvana poultices (Upanaha). The poultice should be applied to such part of the body as is numbed, painful or contracted and the affected part should be firmly bandaged thereafter with a piece of Kshauma^[7] linen or woollen cloth. As an alternative, the affected part should be plastered (and well rubbed) with the ingredients of the Shalvana-Upanaha and inserted into a bag made of cat or mungoose skin or that of a camel or deer hide. 16.

The aggravated Vayu, if located in the shoulders, the chest, the sacrum (Trika) or the Manya, should be subdued by emetics and errhines judiciously employed. Shiro-Vasti should be applied to the head of the patient as long as it would take one to utter a thousand Matras (a short vowel sound), more or less, as the case may require, where the aggravated Vayu would be found to have located itsellf in the head, (if necessary) blood-letting should be resorted to. As a mountain is capable of obstructing the passage of the wind, so the Sneha-Vasti (oily enema) is alone capable of resisting the action of the aggravated Vayu whether it extends throughout the whole system or is confined to a single part. 17–19

Measures beneficial to Vata-Vyadhi:—

An application of Sneha, fomentations, anointment of the body, Vasti, oily purgatives, Shiro-vasti, the rubbing of oils on the head, oily fumigation, gargling with tepid oil, oily errhines, the use of meat-soup, milk, meat, clarified butter, oil and other lardaceous articles (of food), all kinds of acid fruits, salt, lukewarm washes, gentle massage, the use of saffron, Agura, Patra, Kushtha, Ela, Tagara, the wearing of woollen, silken, cotton or any other thick kind of garments, living in a warm room or in one not exposed to the wind or in an inner chamber, the use of a soft bed, basking in the glare of fire, entire sexual abstinence, these and such like other things should be generally adopted by a patient suffering from Vata-roga 20.

The Tilvaka-Ghrita:—

A paste (Kalka) of the following drugs, viz, Trivrit, Danti, Suvarna-kshiri, Saptala, Samkhini, Triphala and Vidanga, each weighing an Aksha (two tolas), and Tilvaka -roots and Kanipillaka, each weighing a Vilva (eight tolas), a decoction of Triphala and curd, each weighing two Patras^[8] (thirty-two seers) and clarified butter, weighing sixteen seers, should be duly cooked together. Medical authorities recommend this Tilvaka Ghrita as an oily purgative in cases of Vata-roga. Ashoka-Ghrita and Ramyaka-Ghrita are prepared in the same manner, (viz., by substituting Ashoka and Ramyaka respectively for Tilvaka). 21.

The Anu-Taila:—

The log of a long-standing wooden oil-mill should be cut into small chips and then thrashed and boiled in water in a large cauldron. The globules of oil that will be found floating on the surface of the boiling water should be skimmed off either with the hand or with a saucer. The oil thus collected should then be cooked with the Kalka of Vayu-subduing drugs as in the preparation of a medicated oil. This oil is known as the Anu-Taila The use of this oil has been advised by medical authorities in cases of Vata- roga. This oil is so named from the fact of its being pressed out of small chips of oily wood (as described above). 22.

The Sahasra-paka-Taila:—

The wood of drugs belonging to the group of Maha-panca-mula should be collected in large quantities and burnt on a plot of land, so as to make the soil black. The fire should be kept burning one whole night; on the following morning on the extinction of the fire the ashes should be removed and the ground, when cool, should be soaked with one hundred Ghatas (six thousand and four hundred seers) of oil cooked with the drugs of the Vidari-gandhadi group and with the same quantity of milk and kept in that condition for one night more. On the next morning the earth should be dug up, down to the stratum found to have been soaked with the oil and the soil should then be dissolved in warm water in large cauldrons for the purpose. The oil that will be found floating on the surface of the water should be skimmed off with both hands and kept in a safe basin. Then the decoction of the Vayu-subduing drugs (the Bhadra-darvadi group), meat-juice, milk, fermented rice- gruel (each taken in a quantity measuring a quarter part of that oil) should be taken one thousand times and each time should be boiled with the oil. Vayu- subduing and aromatic drugs and spices, in the northern (trans-Himalaya) and southern (Deccan) countries, should be thrown into it and boiled with the oil. The boiling should be completed within the period during which it could be properly done. Then after the completion of the cooking, conch-shells should be blown, Dundubhis should be sounded, umbrellas should be held open, chowries should be blown into it and a thousand Brahmins should be treated with repasts. The oil so sacredly prepared should be stored carefully in golden, silver or earthen pitchers. This oil is called the Sahasrapaka-Taila and is of irresistible potency and fit even for the use of kings. Satapaka-Taila is also prepared in the above manner (with the aforesaid ingredients) by cooking it one hundred times only. 23.

The Patra-Lavana:—

The green leaves of the Eranda plants and those of the trees known as Mushkaka, Naktamala, Atarushaka, Putika, Aragvadha and Citraka should be thrashed with (salt of equal quantity) in an Udukhala (a hand thrashing mill) and placed in an earthen pitcher, saturated with oil or clarified butter. Having covered the mouth of the pitcher with a lid, it should be plastered and burnt in fire of cow-dung. The medicine thus prepared (with the help of internal heat) is called the Patra-Lavana. Medical experts advise the application of this medicine in cases of Vata-roga. 24.

The Kanda-Lavana:—

Similarly, Snuhi- twigs, Brinjal (Vartaku), and Shigru- bark (taken in equal parts) and rock-salt (of equal weight as the entire drugs) should be thrashed and kept in a pitcher. Oil, clarified butter, lard and marrow should be added to it equal in weight with salt and then having covered the mouth of the pitcher with a lid, it should be plastered and burnt in a fire of cow-dung (as before). The use of this medicated salt which is called the Kanda- Lavana or Sneha-Lavana is recommended by experts in Vata-roga. 25.

The Kalyanaka-Lavana:—

The following drugs with their roots, leaves and twigs, viz Gandira, Palasa, Kutaja, Vilva, Arka, Snuhi, Apa- marga, Patala, Paribhadra, Nadeyi, Krishnagandha Nipa, Nimba, Nirdahani, Atarushaka, Nakta-malaka, Putika, Vrihati, Kantikari, Bhallataka, Ingudi, Baijayanti, Kadali, Varshabhu, Hrivera, Kshuraka, Indra- varunì, Svetamokshaka and Asoka should be gathered in a green condition and mixed with (as large a quantity of) rock-salt and having thrashed them in an Udukhala should be burnt in a hermetically sealed pitcher as above, after which it should be filtered (twenty times) and boiled in the manner of alkaline preparations At the close of the boiling, powders^[9] of the drugs of the Hingvadi or Pippalyadi group should be mixed with it. This medicine is called the Kalaynaka-Lavana and is specially efficacious in all cases of Vata-roga and is applicable both in food and drink in cases of Gulma, enlarged spleen, impaired digestion, indigestion, hemor rhoids, intestinal worms, aversion to food and cough. 2 6.

Memorable Verse:—

The remedy proves efficacious in Vata-roga through its heat-making potency, power of liquifying and secreting the deranged Doshas and of restoring and correcting them as well. 27.

 

Thus ends the fourth Chapter of the Chikitsita Sthana in the Sushruta Samhita which deals with the treatment of Vata-Ayadhi.

Footnotes and references:

[1]:

One Dharana is equal to four Mashas.

[2]:

Sneha-Lavana and Kanda-Lavana, etc.

[3]:

Treatments, such as, the purification of the semen, etc., and the use of medicines for making Aphrodisia (Vaji-karana) and for the remedy of the disordered urinary organ (Mutra-dosha) should be adopted and employed.

[4]:

It is to be understood that measures and remedies laid down under the head of Sarvanga-gata should be used when the Vayu would be found to be diffused throughout the whole organism instead of being confined to any specific part.

[5]:

According to others it means all kinds of acid-fruits, etc.

[6]:

Chakradatta reads “sanūpamaṃsaḥ susvinnaḥ” (well-cooked with the flesh of “Anupa” animals) in place of sanūpaudakamaṃsastu |

[7]:

Some lead it as Valka, i.e., made up bark.

[8]:

Patra means 64 Palas, i e., 8 Seers, but in cases of liquids the weight should be doubled.

[9]:

The total weight of these powders should be one-fourth of the weight of the rock-salt taken in the course of the preparation.—Dallana.