Sushruta Samhita, volume 4: Cikitsasthana

by Kaviraj Kunja Lal Bhishagratna | 1911 | 123,229 words

This current book, the Chikitsa-sthana (english translation), deals with therapeutics, surgical emergencies, geriatrics, aphrodisiacs and various other subjects. The Sushruta Samhita is the most representative work of the Hindu system of medicine. It embraces all that can possibly appertain to the science of medicine. Susruta-samhita is recognized...

Chapter XXXI - The medicinal use of Sneha (oleaginous substances)

Now we shall discourse on the medicinal uses (both internal and external) of the Snehas[1], i.e., oleaginous substances (Snehaupayogika-Chikitsita). 1.

A Sneha or an oleaginous substance forms the essential factor of the physical organism, and the self- conscious animated element (which contributes directly to its vitality and makes life possible) abounds in oleaginous principles; both are consequently in constant want of a Sneha. Snehas or oleaginous substances are enjoined to be administered in food and drinks as well as in Anuvasana, Mastikya-shiro-vasti and Uttara-vasti (urethral or vaginal enemas), errhines (Nasya), ear-drops (Karna-purana) and unguents (Abhyanga). 2.

There are four kinds of Snehas which, however, are divided into two classes according to their origin: viz., vegetable and animal. Clarified butter prepared from cow’s milk is the best of the animal Snehas, while Sesamum oil is the best of the vegetable ones, 3.

Now we shall describe the ends for which the different vegetable oils should be used as well as the modes in which they should be prepared and employed. 4.

The expressed oils prepared from (the seeds of) Lodhra, Eranda, Koshamra, Danti, Dravanti, Saptala, Shanikhini, Palasha, Vishanika, Gavakshi, Kampillaka, Sampaka and of Nilini act as purgatives. The oils prepared from (the seeds of) Jimutaka, Kutaja, Kritave-dhana, Ikshvaku (bitter gourd), Dhamargava and of Madana act as emetics. The expressed oils prepared from (the seeds of) Vidanga, Khara manjari, Madhu-shigru, Surya-valli, Pilu, Siddharthaka and of Jyotishmati act as errhines (Shiro-virecana). 5.

The expressed oils prepared from (the seeds of) Karanja, Putika, Kritamala, Matulunga, lngudi and of Kirata-tikta are used in cases of Dushta-vrana (malignant ulcers). The expressed oils of Tuvaraka, Kapittha, Kampillaka, Bhallataka and of Patola are used in cases of Maha-vyadhi (Kushtha, etc.). The expressed oils of Trapusha, Ervaruka, Karkaruka, Tumbi and of Kushmanda are used in cases of Mutra-sanga (for diuretic purposes). The expressed oils of Kapota-vamka, Avalguja and of Haritaki are used in cases of Sharkara- shmari (gravels, stones, etc.). The expressed oils of Kusumbha, Sarshapa, Atasi, Pichu-marda, Atimuktaka Bhandi, Katu-tumbi and of Katabhi are used in cases of Prameha (urinary complaints). The expressed oils of the fruits of Tala, Narikela, Panasa, Moca, Piyala, Vilva, Madhuka, Shleshmataka and of Amrataka are used in diseases due to the deranged Vayu acting in concert with the deranged Pitta. The expressed oils of Vibhitaka, Bhallataka and of Pinditaka are used in Krishna-karma (blackening the cicatrix of a healed ulcer, etc.). The expressed oils of Shravana, Kanguka and of Tuntuka are used in imparting a yellow colour (to a cicatrix). The expressed oils of the pith of Shimshapa and of the Aguru are used in cases of Kushtha known as Dadru (ring-worm) and Kitima. 6-7.

The primary action of all kinds of Sneha (oil, clarified butter, etc.) is to subdue the aggravation of the deranged Vayu of the body, and the general virtues of all kinds of (vegetable) oil have been described above. 8.

Now we shall describe the process of preparing drug- decoctions and of medicating oils (therewith). According to several authorities, the bark, roots and leaves, etc., of the drugs to ba used should be boiled with water weighing four times their combined weight, and should be taken down with three-founhs of the original water evaporated by boiling. This is the rule of preparing drug-decoctions (Kashaya). Six Prasrita (one Prasrita being equal to sixteen Tolas) weight of oil, twenty-four Prasrita weights of the liquid (decoction prepared before) and four Aksha measures (one Aksha being equal two to Tolas) of pasted drugs (as Kalka) are the proportions to be observed in cooking a medicated oil. But this is not correct. Why? Because it is not in conformity with the injunctions of the Scriptures (officinal standard). We shall now proceed to explain the different measures of Pala, Kudava, etc. 9-10.

Measures of Drugs:—

The weight of twelve middle-sized Dhanya-mashas (corns of paddy) make one Suvarna-mashaka. Sixteen Suvarna-mashakas make one Suvarna. The weight of nineteen middle-sized Nishpavas (pulse) make one Dharana. Three Dharanas and a half make one Karsha. Four Karshas make one Kudava. Four Kudavas make one Prastha[2] Four Prasthas make one Adhaka. Four adhakas make one Drona. Hundred Palas make one Tula. Twenty Tulas make one Bhara. This is the measure in respect of dried substances. The quantity should be doubled in cases of fresh vegetables and fluids.[3] 11.

The Kashaya-Paka Kalpa:—

The bark, roots and leaves, etc., of medicinal drugs should be dried in the sun and taken in any of the aforesaid measures, should be cut in small pieces, or pounded, as the case may be, and soaked in a quantity of water[4] weighing eight or sixteen times their combined weight. They should then be boiled over a fire and the decoction should be taken down from the oven with only a quarter part of the water left. This is the general rule for preparing a decoction (Kashaya). 12.

The Sneha-Paka Kalpa:—

One part of the Sneha (oil, clarified butter, etc.), four parts of (any one or more) liquid[5] substances, a fourth part of the medicinal pastes (Kalka) should be boiled together. This is the general rule for the preparation of a medicated Sneha (oil, clarified butter, etc.). 13.

Alternative Methods:—

As an alternative, a Tula measure of the bark, roots and leaves, etc. (as the case may be) of the drugs to be decocted, should be boiled with a Drona measure of water. The water in the preparation should be boiled down to a quarter part of its original quantity and then considered as cooked and prepared. A Kudava measure of oil should be boiled and cooked with four times as much of the liquid and a Pala measure of pasted drugs (Kalka). This is another process of cooking medicated Snehas (oil, etc.), 14.

Memorable Verses:—

The foregoing rules should be adopted where no measures would be found to have been specifically given of the Sneha, the liquid and of the drugs, whereas in cases of specification, the specific quantities should be taken. Water should be used as the liquid, where no other liquid would be mentioned by name (in connection with medicating a Sneha, viz., oil, clarified butter, etc, by cooking). Both for the decoction and paste (Kalka\ the drugs mentioned in the respective list should be used in preparing a medicated Sneha in the absence of any explicit and specific injunction to that effect. 15.

Now we shall discuss the degrees of medically cooking a Sneha (oil or Ghrita). Mild (Mridu), middling or intermediate (Madhyama) and hard (Khara) are the three degrees which the boiling process undergoes in medically cooking a Sneha. A cooking is said to be mild (Mridu-Paka) when the oil is found to drop off entirely from its drug-paste (Kalka) leaving it dry and sapless; whereas in an act of middle-cooking (Madhyama- Paka) the paste would be found to have become pellucid and non-sticky like wax; a cooking done until the paste (in the Sneha) assumes a little clear, glossy, frothless, black colour is termed strong (Khara- Paka). A Sneha cooked beyond the last-named degree is called a burnt Sneha. A Sneha should, therefore, be properly cooked. A mildly cooked Sneha should be administered in food and drinks. A middling-cooked one for the purposes of errhines and anointments, while a strongly cooked one should be used for the purposes of Vasti-Karma and as ear-drops[6] 16.

Memorable Verses:—

The cooking of a Ghrita should be considered medically complete as soon as the froth and the sound would vanish and the peculiar smell, colour and taste of preparation would be manifest. The medically cooking of an oil resembles in all respects that of a Ghrita with this exception that an abundance of froth appears on the surface of the oil at the completion of the cooking. 17.

The process of taking a Sneha internally:—

Now we shall describe the process of taking a Sneha internally. A man with an empty stomach should be made to take a draught of a medicinal or medicated oil or Ghrita, just as the god of day (sun) would appear on the summit of the hill at dawn and lighten up the horizon with the first shoots of his vermilion- tinted golden rays. Rites of benediction should be first done unto the patient before administering to him the oil or the Ghrita in an adequate dose. After that he should wash his mouth with warm water and quietly stroll about with his shoes on. 18.

Metrical Texts:—

The use of a potion of a (medicated) Ghrita is recommended to patients suffering from an extremely parched or dry condition of the organism, or from ulcers, or from the effects of a poison, or from those due to the actions of the deranged Vayu and Pitta, as well as to persons of weak memory and intellect. Potions of (medicated) oils should be prescribed in aggravations of the Kapha and of fat, as well as in cases of worms (in the intestines) and incarcerated flatus (wind in the abdomen), or when the patient is found to be habituated to the internal use of any oil, or seeks the firmness of his body (muscles). The use of lard is recommended to persons emaciated with over-fatiguing physical labour, or to persons whose blood and semen are greatly diminished or to those suffering from an attack of Maha-vyadhi (due to the vitiated condition of the blood), or to persons of a voracious appetite (Mahagni), or of Vataja (nervous) temperament, as well as to those possessed of great physical strength. The use of marrow or of medicated Ghritas mixed with appropriate drugs is beneficial to men of strong digestive capacity (Dipta- vahni), or to those afflicted with a deranged Vayu, or to those whose bowels are not easily moved, or who are capable of undergoing a large amount of physical hardship. Clarified butter, without any other thing added thereto, should be administered in the affections of the deranged Pitta; whereas it should be mixed with salt before use in the diseases due to the action of the deranged Vayu and with the admixture of Yava-kshara and powdered Trikatu in the affections of the aggravated and deranged Kapha. Oil or clarified butter should be administered through the medium of one, two or more of the sixty three different combinations[7] of the (six different) Rasas (flavour) according to the nature and intensity of the aggravated Dosha or Doshas involved in each case. 19-A.

Clear (filtered) oil, clarified butter, etc., should be taken by a man habituated to its use and capable of undergoing physical hardships during the months of the year which are neither too hot nor too cold[8] inasmuch as the use of clear or transparent oil or Ghrita is above being commendable. A Sneha should be taken in the morning (lit. day-time) during the cold months of the year and in case of the joint aggravation of the bodily Vayu and Kapha; whereas it should be taken in the evening (lit. night) during summer and in cases of the joint aggravation of the bodily Vayu and Pitta. Potions of oil or clarified butter taken in summer by a person suffering from an aggravation of the bodily Vayu and Pitta may bring on thirst, epileptic fits and insanity. In the same manner draughts of oil or clarified butter taken in winter by a person suffering from an aggravation of the bodily Vayu or Kapha may be followed by a heaviness of the limbs, aversion to food and colic (Shula). If a patient feels thirsty after taking a Sneha, he should take warm water, and be made to vomit the Sneha with (further) draughts of hot water in the event of the thirst still not subsiding. Cooling plasters should be applied to his head and a cold water bath should be prescribed. 19-B.

The Dosage:—

The Dosage of a Sneha which requires the quarter part of a day (i.e., three hours) to be digested, should be deemed appetising and beneficial in slight aggravations of the bodily Doshas; that which requires half a day to be digested should be regarded as invigorating, spermatopoietic, constructive and beneficial in moderate aggravations of the bodily Doshas. The dosage of a Sneha which takes three-quarter parts of a day to be digested, acts as a bodily emollient and should be prescribed in cases of extreme aggravation of the bodily Doshas, while the quantity which can only be digested in the course of an entire day (twelve hours) should be considered efficacious in all affections of the body and does not produce physical lassitude, fainting fits and delirious conditions. The measure or quantity of a Sneha which takes a whole day and night to be digested without undergoing any kind of vitiation (reactionary acidity) in the stomach, proves curative even in cases of Kushtha (cutaneous affections), insanity, poisoning (effects of poison) and Apasmara (hysteric convulsions), ascribed to the baneful influences of the malignant stars. 19-C.

The evil effects of Over-dosage:—

A patient should be made to take as much of the Sneha as he would be able to easily digest inasmuch as an excessive over-dose may prove fatal. The patient should be made to vomit with draughts of hot water in a case of over dose or abuse of a Sneha and in the event of its continuing in an undigested or partially digested state in the stomach. In cases of doubtful digestion, similar potions of hot water should be administered which would produce good eructations and bring on a fresh relish for food. 19-D.

When the Sneha begins to be digested, it is attended with thirst, vertigo, lassitude, weariness, a disturbed state of the mind and a burning sensation. When the Sneha appears to have been fully digested the patient should be affused with hot water. A gruel prepared with only a small quantity of rice should be given lukewarm to the patient (at this stage). As an alternative, a well-aromated soup (of Mudga, etc.) or meat-juice cooked without the addition of any Sneha (oil or Ghrita) or with only a small admixture of clarified butter should be given, or he may take Yavagu (pure and simple). 19-E.

A Sneha should be taken three, four, five or six days consecutively; used (continually) for more than a week it becomes habituated to the user. A Sneha should be taken with food (at the time of mid-day meal) by a weak, or an old man or an infant, or a thirsty person, or one of a delicate constitution, or one averse to its use in summer. 19-F.

Sadyah-Snehana:—

The administration of a potion composed of powdered Pippali and (Saindhava) salt mixed with curd-cream and the four kinds of oleaginous substances (Sneha) constitute what is known as the Sadyah-Snehana (i.e., it produces the effects of the Sneha within a very short time). The use of a Yavagu well-cooked[9] with the soup of half- fried meat (instead of water) and a Sneha (clarified butter), and mixed with honey acts as a Sadyah- snehana. A Yavagu prepared with milk[11] and a small quantity of rice and taken lukewarm with clarified butter produces the same result. The use of cow’s milk milched into a pot containing clarified butter and sugar produces an instantaneous emulsive effect (Sadyah-snehana), if taken by a man with a parched state of the organism. Clarified butter cooked with three parts of the decoction of Yava, Kola and Kulattha pulse (taken together) and one part each of milk, curd, wine and clarified butter churned from milk acts as an instantaneous demulcent (Sadyah-snehana) and is hence recommended to kings and king like personages. This potent emulsive measure (Sadyah- snehana) should be prescribed for the old, the imbecile, to females and to persons of sluggish appetite, as well as to sensitive persons and in diseases due to a slight aggravation of the bodily Doshas. 19-G.

Forbidden cases of Sneha-pana:—

The internal use of a Sneha is forbidden to persons suffering from ascites, fever, delirium, alcoholism, aversion to food and vomiting, as well as to weak, corpulent, thirsty, fatigued, or intoxicated persons. It is forbidden on a cloudy day, in an improper season of the year, after the application of Vasti-measures, purgatives and emetics and after premature parturition. The internal use of a Sneha (oil or Ghrita) gives rise to a host of maladies in the foregoing cases, or the diseases become more serious or may even become incurable. In cases of premature parturition, there remains a quantity of mucus and vitiated lochia in the womb; therefore, stomachic (Pacana) and parching (Ruksha) drugs should be administered to females after child-birth. After a period of ten days, however, draughts of oil or clarified butter should be given according to requirements. 19.

A dry or parched condition of the organism should be inferred from a general dryness of the body, the hard and knotty character of the fecal matter (stools), a sluggish digestion with a burning sensation on the epigastrium (Uras) and an upward coursing of the Vayu from the abdomen (Koshtha) as well as from the weakness and discoloration of the body. Lassitude, a sense of heaviness in the limbs, the oozing out of the Sneha through the lower orifices of the body and an aversion to any kind of oleaginous substance are the indications which mark the satisfactory action of an emulsive remedy in a human organism, while its abrupt excess or abuse is followed by aversion to food, salivation, a burning sensation about the anus, dysentery and diarrhea and such like symptoms. A condition of dryness in the organism should be remedied with a Sneha, while an excess of the latter should be corrected with meals of Shyamaka or Kora- dusha grains, as well as with milk-curd (Takra), levigated sesamum paste (Pinyaka) and powdered barley (Shaktu). 20-23.

The good effects of Sneha-pana:—

The blessings which attend a person who has duly taken a Sneha are improved digestive capacity, regular and satisfactory motions of the bowels, a growth of all the vital principles of the body, strength and firmness of the organs, improvement of complexion, a delayed old age and the enjoyment of a hundred summers on earth. The application of a Sneha is potent enough to increase the strength and the digestive capacity of a weak person suffering from impaired digestion, and a person having his health and digestive capacity recouped (by the use of a Sneha) does not yield to the evil effects of errors of diet. 54-55.

 

Thus ends the Thirty-first Chapter in the Chikitsita Sthana of the Sushruta Samhita which deals with the treatment of the diseases where oleaginous medicines are useful.

Footnotes and references:

[1]:

The Sneha is of four kinds, viz., clarified butter, oil, lard and marrow, of which clarified butter and oil are generally used.

[2]:

Thirty-two Palas make one Prastha in respect of water j but in respect of non-oily substances a Prastha is equal to twenty Palas, whereas in respect of fresh drugs it is equal to only sixteen Palas.

[3]:

Some drugs, viz.:—Vasa, Kutaja, Kushmanda, Prasarani Vala, Amrita and Nimba, etc., are invariably employed in their fresh state and the practice is not to take them in double measures in spite of their freshness. Two different kinds of measure have been adopted ip the Ayurvedic Pharmacopoeia. One is called the Kalinga and the other the Magadha measure. Maharshi Charaka has adopted the first, but that adopted by Sushruta is the second one.

[4]:

Water weighing four times as much as the drugs when the drugs are of a soft consistency and eight times as much when they are hard and sixteen times as much when they are very hard.

[5]:

When there are more liquids to be used than one, the general rule is that the total weight of all the liquids would be four times that of the Sneha, if not otherwise directed. All this liquid part should, however, be boiled away and the Sneha part should be left before the Sneha is removed from the fire and before it can be fit for use. It should be noted that the cooking of a Sneha should not be completed in one day.—Ed.

[6]:

Charaka, on the contrary, holds that a Khara (strongly cooked) Sneha should be used in anointing the body, a middling-cooked one for the purposes of drinks and Vasti-karma and a mildly cooked (Mridu) one for the purposes of errhines.

[7]:

Vide Uttara-Tantra, Chapter LXIII.

[8]:

Both Vrinda and Chakrapani read this but with little difference. Both of them read “kale ca shītale”, i.e., in the cold season. But their commentators accept the reading “kale natyuṣṇashītale”, as in the text, to be a variant. We have the authority of Charaka, however, to accept the reading of the text.

[9]:

In place of “sūpakalpita” (well-cooked), Chakradatta reads ‘svalpataṇdula’ (prepared with a small quantity of rice).

[10]:

Both Vrinda and Chakrapani read this but with little difference. Both of them read “kale ca śītale”, i.e., in the cold season. But their commentators accept the reading “kale natyuṣṇaśītale”, as in the text, to be a variant. We have the authority of Charaka, however, to accept the reading of the text.

[11]:

In place of “payaḥsiddha” (prepared with milk), Chakradatta reads “bahutila” (prepared with an abundance of sesamum which, according to Shivadasa, would constitute three parts with only one part of rice).

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