Chapter X - The medical treatment of major cutaneous affections

Now we shall discourse on the medical treatment of major cutaneous affections (Maha-Kushtha).^[1] 1.

Metrical Text:—

An intelligent physician should have recourse to the following medicinal compounds in virulent types of Kushtha, urinary complaints (Meha), diseases due to the action of the deranged and aggravated Kapha and general edima of the body and also in respect of inordinately corpulent persons wishing to reduce their obesity. 2.

Mantha-Kalpas:—

Pounded barley-corn should be saturated with the urine of a cow and kept in a large bamboo basket (Kilinja) for the whole night; and should then bedried in the sun on the following day. This process should be continued for seven consecutive days. At the close of this period it should be fried in an earthen vessel (Kapala) and then ground to fine powder (Shaktu). The powder, thus prepared should be given every morning to a person afflicted with Kushtha (leprosy), or any urinary complaint (Prameha) through the medium of a decoction of the drugs included within the Shalasaradi group, or of the Kantaki (thorny)^[2] trees, and mixed with a pulverised compound of Bhallataka, Prapunnada, Avalguja, Arka, Citraka, Vidanga and Musta weighing a fourth part of the Shaktu. Barleycorn should, in the same manner, be soaked in a decoction of the drugs constituting the Shala-saradi or the Aragvadhadi groups, or barley-corn should be given to a cow to eat and the undigested barley-corn passed with the cow-dung should be collected. This barleycorn should then be fried and powdered in the form ofSShaktu. This powder should be mixed with a pulverised compound of Bhallataka, etc., mentioned above, and given to the patient through the medium of a decoction of any one of the Khadira, Asana, Nimba, Raja-Vriksha, Rohitaka and Guduci, sweetened with honey and sugar, and acidified with grapes, or the expressed juice of pomegranate and Anda-vetasa and then mixed with rock-salt. This is the method of preparing all kinds of Manthas. 3.

Articles of food made of barley-corn in the form of Dhana, Lunchaka, Kulmasha, Apupa, Purnakosa, Utkarika,^[3] Shashkulika, Kunari^[4] and Konali, etc., should be given as diet. Preparations of wheat and Venu-yava (seeds of bamboo) after the manner of barley preparations should also be recommended as a proper food. 4-5.

Medicated Arishtas:—

Now we shall describe the mode of preparing Arishtas (applicable in cases of Kushtha). Six Pala weight of each of the following drugs, viz., Putika, Cavya, Citraka, Deva-daru, Sariva, Danti and Trikatu, and one Kudava weight of Vadara and Triphala should be powdered. An earthen jar or pitcher, which formerly contained clarified butter, should be purified^[5] and plastered inside with a compound of honey, clarified butter and powdered Pippali. Then the pulverised compound, mentioned above, together with seven Kudava measures of water^[6] half a Kudava measure of iron-powder, and half a Tula weight of treacle, should be poured into the said jar which should then be tightly covered with a lid and placed under a heap of barley for seven days (for fermentation). After this period, it should be taken out and the patient should be made to take some of it (every day) according to his physical capacity. This Arishta (fermented liquor) cures Kushtha, obesity, urinary complaints (Meha), jaundice and edima. Arishtas may also be similarly perpared from the drugs included in the Shala-saradi, the Nyagrodhadi or the Aragvadhadi group. 6.

Medicated asavas:—

Now we shall describe the mode of preparing Asavas. The ashes of burnt Palasha should be dissolved in hot water and duly filtered. Three parts of this (alkaline) water, subsequently cooled, and two parts of Phanita (molasses) should be mixed together and fermented in the manner of preparing Arishta^[7]. Asavas may be similarly prepared with the alkali made of the ashes of sesamum plants (described in connection with the treatment of Ashmari —Chapter. VII), or with the drugs constituting the Shala- saradi the Nyagrodhadi, or the Aragvadhadi groups, or with cow’s urine as in the preceeding manner. 7.

Medicated Suras:—

Now we shall describe the process of preparing Suras (wines). A decoction should be duly made of Shimshpa and Khadira woods with Uttamarani, Brahmi and Koshataki boiled together should be likewise added to it.—Dallana.

in water^[8]. Then Sura-kinva (the drug which is used to cause the fermentation in the manufacture of spirits) should be mixed with the above decoction and the compound distilled in the usual officinial method. The liquor thus prepared is called Sara. Suras may be similarly prepared, from the drugs of the Shala-saradi, the Aragvadhadi, or the Nyagrodhadi groups. 8.

Medicated Avalehas:—

(lambatives) Now we shall describe (the method of preparing) medicated Avalehas (lambatives). A decoction should be prepared with the Sara (essential parts,) of Khadira, Asana, Nimba, Raja-vriksha and Shala.^[9] Fine powders of the same drugs should be mixed with the above (decoction) and boiled again. The compound should be removed from the fire neither thick nor thin. The patient should be made to lick a handful^[10] of the compound mixed with honey and be made to abstain from taking any meal in the morning. Similar preparations may be made (Avaleha) from the drugs of the Shala-saradi, the Aragvadhadi, or the Nyagrodhadi groups. 9.

Medicinal Churnas:—

Now we shall describe the process of preparing pulverised compounds. A Prashtha measure of the powdered Sara of the trees belonging to the Shala-saradi group should be many times (i.e., seven days) saturated with the decoction of the drugs of the Aragvadhadi group (and dried). Then the prepared compound should be taken with the vehicle of the decoction of the drugs of the said Shala- saradi group. A pulverised compound (Churna) may be as well prepared in the above manner from the fruits of the Nyagrodadhi group or from the flowers of the Aragvadhadi group, io.

Medicinal Ayaskriti:—

Now we shall describe the process of preparing an Ayaskriti (iron compound). Thin leaves of steel should be plastered with the (five officinal kinds of) salts and heated in fire a of dried cow-dung. When red-hot, they should be immersed in a decoction of Triphala and the drugs of the Shala-saradi group. The above process should be repeated sixteen times in succession after which they should be heated and burnt in a fire of Khadira wood. When cooled down, the iron foils should be pounded into fine powder and passed through a piece of thick linen. The patient should be made to take this powder with honey and clarified butter in an adequate dose suiting his capacity. Af:er the digestion of the medicine, he should take such a meal as is not hostile to his particular disease and is devoid of salt and acid articles. The use of a Tula measure of this medicinal iron preparation in the above manner leads to the recovery of Kushtha, Meha (urinary complaints), obesity, edima, jaundice, insanity and epilepsy and makes the patient live for one hundred years. The use of each additional Tula weight of the preparation adds a century to the duration of the user’s life. This is the mode of medically preparing all kinds of Loha (zinc, copper, lead and gold). 11-12.

Aushadha Ayaskriti:—

A bail of iron (weighing fifty Palas) heated and made red-hot in a fire of Khadira wood should be cooled by immersing it in a cauldran (Droni), made of (green) Palasha wood and containing (five-hundred Palas of) Svarasa (expressed juice^[11]; of Trivit, Shyama, Agnimantha, Samkhini, Kevuka, Lodhra, Triphala, Palasha and Shimshapa. The iron mass should be thus heated and cooled twenty one times in succession; finally the iron ball should be immersed and boiled in the expressed juice of the foregoing drugs over a fire of cow-dungs. It should be removed from the fire when only a quarter part of the liquid would remain. It should now be filtered and the mass of iron should be again heated in the fire mixed with the same liquid and boiled again; when the cooking is nearly complete, (it should be removed from the fire and) a pulverised compound of the drugs included in the Pippalyadi group together with honey and clarified butter each weighing double the quantity of the iron mass or ball should be mixed with the same. When cooled down, this preparation should be preserved in a well-sealed iron-pitcher. The medicine, thus prepared, should be given to the patient according to his capacity but not less than a Shukti (half a Pala) or a Prakuncha measure (one Pala). After the digestion of this medicine, a diet should be given to the patient determined by the nature of his disease. This is called the Aushadha Ayaskriti and it cures even the incurable types of Kushtha and urinary complaints (Meha), reduces obesity, impairs edima and improves the impaired digestive functions. It is specially efficacious in cases of phthisis (Raja-Yakshma). A proper and regular use of this remedy increases the duration of life to a hundred years. 13.

Mahaushadha-Ayaskriti:—

A decoction of the drugs of the Shala-saradi group should be poured in a Droni (vessel) made of Palasha wood. Sheets of iron should be made red-hot and cooled down (twenty one times) by immersing them into the said decoction of the drugs of the Shala-saradi group. The interior part of an earthen pitcher should be disinfected (with fumigation). Then the iron foils and the powder of the drugs of the Pippalyadi group together with treacle and honey should be added and preserved in the earthen pitcher with its mouth well-covered with a lid for a period of one month (in winter) or a fortnight (in summer). This preparation is called the Mahaushadha-Ayaskriti and an adequate quantity of it should be given to the patient after the lapse of the said period. Similar preparations of (iron) may be made with a decoction of the drugs of the Nyagro - dhadi or Arevatadi (Aragvadhadi) group. 14.

The Khadira Vidhana:—

Now we shall describe the Khadira preparations. The earth around the central root of a middle-aged Khadira tree, grown in a commendable soil and not worm-eaten, should be dug out and the central and principal root of the tree should be cut open. An iron pitcher should be placed under the tree so that the secreted juice may collect into it through the main root. The outer surface of the tree should be completely plastered with a paste of clay and cow-dung (mixed together). It should then be treated with a fire fed with faggots mixed with cow-dung so that the glutinous secretions of the Khadira tree would naturally settle down into the pitcher (through the principal root). When the pitcher is filled up, the juice should be collected and filtered and then kept in another vessel with its lid carefully closed and sealed. The extract so preserved should be taken in proper doses with honey, clarified butter and the expressed juice of Amalaka. The patient should be made to take such diet and observe such regimen of conduct, as has been prescribed in connection with the use of Bhallataka compounds, after the digestion of the medicine. A Prastha measure of this remedy gradually taken by a man enables him to live a hundred summers. 15.

Khadira-Sara-Kalpa:—

A decoction made by boiling a Tula weight of the essential part (Sara) of the Khadira tree with a Drona measure of water and boiled down to a sixteenth part of its original quantity should be kept in a vessel with its mouth tightly closed. An adequate quantity of this decoction should be taken every day with honey, clarified butter and the expressed juice of Amalaka. The present method should be adopted with the extract from the essential parts (Sara) of all other medicinal trees. 16.

Every morning the patient should be made to take an adequate dose of the powders of Khadira-sara, or its decoction, until a Tula weight is consumed, or he should be made to take a potion of the clarified butter churned from the milk of a ewe and cooked in a decoction of Khadira-sara. As an alternative the expressed juice or a decoction of Amrita-valli, or clarified butter cooked with that juice or decoction, should be taken every morning. The patient should every afternoon take a meal of boiled rice with clarified butter and Amalaka-soup. A constant use of this remedy and a conformity to the foregoing diet for a month would lead to a radical cure of any type of Kushtha. 17.

Oils pressed out of black sesamum and Bhallataka, clarified butter, the expressed juice of Amalaka and the decoction of the drugs of the Shala-saradi group, each weighing a Drona measure, and a Pala weight of each of the following drugs, viz., Triphala, Trikatu, the pith or marrow of Parusha fruit, Vidanga seed, Citraka, Arka, Avalguja, Haridra, Daru-haridra, Trivrit, Danti, lndra-yava, Yashti-madhu, Ativisha, Rasanjana and Priyangu, should be boiled together in the manner of cooking medicated oil, etc. (Sneha- paka Vidhana). When well cooked, this medicated compound should be strained (through a piece of clean linen) and carefully preserved (in an earthen pitcher with its mouth well closed with a lid). The system of the patient should be well cleansed (with appropriate emetics and purgatives) and a Pala weight of this preparation, mixed with honey, should be given to him every morning. After the digestion of this medicine, he should be made to take a light meal of rice well cooked with a decoction of the Khadira-wood and mixed with clarified butter, and the soup (Yusha) of Amalaka or Mudga unseasoned with salt. A Drona measure (of this compound), gradually taken in the aforesaid manner by a patient taking a (light) decoction^[12] of Khadira (instead of water), would ensure a speedy recovery from all types of Kushtha and enable the patient to witness a hundred summers (on earth) in the full enjoyment of sound health and intellect. 18.

Memorable Verse:—

An intelligent physician may prepare a thousand varieties of medicated remedies, such as Suras, Asavas, Arishtas, Lehas (lambatives), powders and Ayaskritis (metal-preparations) with the aforesaid drugs and in the manner described above. 19.

 

Thus ends the tenth Chapter of Chikitsita Sthana in the Sushruta Samhita which deals with the medical treatment of Maha-Kushtha.

Footnotes and references:

[1]:

Kushtha which affects the deeper tissues and fundamental principles of the body is called Maha-Kushtha.

Gayi interprets the term “Maha-Kushtha” as signifying those seven types of Kushtha which cannot be attributed to any detectable cause,

[2]:

Vadara, Khadira, Arimeda, Snuhi, etc.

[3]:

Gayadasa reads Citra (a kind of soup) before “Utkarika”

[4]:

Dallana does not read “Konali” but says that some read “Konalika’ in place of “Kunari” both of which are synonyms. We have, however, both the terms in our text.

[5]:

The jar should be purified or disinfected by fumigation with the medicinal drugs such as Nimba-leaves, Guggulu, etc.

[6]:

Jejjata recommends twenty-eight Pala weight of water, but Gayadasa does not support this.

[7]:

Powders of Putika, Citraka, etc., mentioned in connection with the preparation of Arishtas

[8]:

One part of Shimshapa, one of Khadira and a third of Uttamarani, Brahmi and Koshataki should be taken. Tula weight of the drugs and four Drona measures of water should be boiled and reduced to one Drona.—Dallana.

[9]:

Gayalasa does not read “Shala” in the list.

[10]:

Though the word “Panitala” means a “Karsha” i.e., two Tolas, yet as there is the word “Purna” inserted after it, so a handful should be understood here by this term.—Dallana. It should be observed, however, that the difference in the two interpretations is ultimately immaterial.—Ed.

[11]:

Old and experienced physicians explain “Svarasa” to be the decoction as well. Gayadasa says that a decoction of one Drona weight of the drugs, boiled in four Drona weight of water and reduced to its quarter part should be taken. Dallana says that if the expressed juice of the drugs be not available, then a cold infusion of one Adhaka weight of the powdered drugs should be taken.

[12]:

The decoction of Khadira-wood for drink should be prepared after the manner of Shadanga-paniya preparation.—Ed.