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 XXXII - Description of Sveda (fomentation, calorification, etc.)

Now we shall discourse on the medical treatment by measures of fomentations, diaphoretic measures, etc. (Sveda-vacaranìya). 1.

Sveda[1] (calorification, fomentation, diaphoretic measures, etc.) may be divided into four groups such as, the application of direct heat (Tapa-sveda), fomentation (Ushma-sveda), poulticing (Upanaha sveda) and the application of heated fluids (Drava-sveda). All kinds of diaphoretic measures (Sveda) belong to one or the other of these groups. 2.


Of these the Tapa-sveda consists in repeatedly applying heat to (any affected part of the body of) a patient made to lie down (on a bed) with the help of the palm of the hand, a piece of brass, an Indian saucer, a piece of baked clay or sand, or a piece of cloth after heating them over a fire of Khadira wood, etc. 3.


A piece of stone, brick, iron, or baked clay should be made red-hot and sprinkled over with water or with sour gruel (Kanjika). The affected part of the body should be covered with (cotton plugs soaked in) Alaktaka[2] and then fomented with the above-named (heated) articles. As an alternative, a metal saucer containing milk, curd, Dhanyamla, meat- soup and a decoction of the tender leaves of the Vayu- subduing plants (jointly or separately) should be heated over a fire. The mouth of the saucer should be covered (with a piece of blanket or such other cloth)[3] and the affected part of the body should be fomented with the vapours rising therefrom. As an alternative, another pitcher should be placed with its mouth downward over the mouth of the above pitcher (containing the above- named heated articles). Then an aperture should be made in the side of the upper pitcher and a pipe to the shape of an elephant’s trunk should be inserted into it. The affected part of the body should then be fomented with the vapour escaping through that pipe. 4.

Metrical Texts:—

The mode of applying heat to a patient suffering from any disease or affection of the bodily Vayu (disease of the nervous system, etc.,) is as follows:—He should be first anointed with oil, etc.,) and wrapped up in a thick cloth. He should then be made to sit in an easy posture. Heat should then be applied through a pipe shaped as an elephant’s trunk. The advantage of this mode of fomentation is that the entire body of the patient may be easily fomented without causing him any serious trouble. The pipe should be made half a Vyama[4] in length with three bends or turns[5] in its body to resemble the trunk of an elephant.[6] The use of a pipe made of the materials (such as Kusha, Kasha, etc.) used in the making of a Kilinji (basket) and resembling the trunk of an elephant in shape is only recommended for the purposes of Sveda (heat-application). 5.

A plot of ground commensurate with the length of the patient’s body should be dug and heated with fire of Khadira wood and then sprinkled over with milk, water and Dhanyamla. The heated ground should be then covered with a layer of leaves (of the Vayu-subduing plants) and the patient should be made to lie down full stretched upon the (bed of) leaves and thereby fomented.[7] As an alternative, a stone slab should be heated and the fomentation (Sveda) should be applied similarly to the patient by making him lie down upon it after the ashes and cinders have been removed[8]. As an alternative, the patient should be seated inside a chamber with four doors (one on each side) and fomented by lighting up a good blazing fire (of Khadira wood) at all the doors (simultaneously[9]. Another alternative is that the patient should be laid on a mattress (made of Kusha, Kasha, etc.) or on a similar bed as before and fomented with the fumes of duly boiled paddy (and Masha- pulse, etc.) kept under the same mattress. In the same manner, Sveda (fomentation) might be applied with the help of heated cow-dung, ashes, husks of paddy, weeds, etc. 7.

Upanaha-Sveda (Poulticing):—

The roots of the Vayu-subduing drugs should be pasted together with Amla (Kanjika) and mixed with an abundant quantity of rock-salt and of Sneha (clarified butter, etc.). The paste should be heated and applied lukewarm to the affected part. The pastes of the drugs included within the Kakolyadi, the Eladi or the Surasadi groups as well as a paste of mustard seed, sesamum or linseed, or Krishara, Payasa (porridge) Utkarika, or Veshavara, or the drugs of Shalvana[10] (as described under the treatment of Vata-Vyadhi) should be similarly applied (lukewarm to the affected locality) folded in a piece of thin linen. This is what is called the Upanaha-Sveda. 8.

Drava-Sveda (Diaphoresis with fluids):—A jar or a cauldron should be filled with a lukewarm decoction of any of the Vayu-subduing drugs and the patient should be immersed therein. In the same way, the patient might be immersed in a tubful of warm milk, meat-soup, soup (of Mudga or Masha pulse), oil, Dhanyamla (fermented or sour gruel), clarified butter, lard, cow’s urine, etc.[11] The patient may also be sprinkled over or washed with a tepid decoction (of the above-mentioned drugs).[12] This is what is called the Drava-Sveda. 9.

Of the four forms of Sveda described above those known as the Tapa-Sveda and Ushma-Sveda pre-eminently destroy the deranged Kapha, while the Upanaha- Sveda subdues the deranged Vayu of the body; the Drava-Sveda, however, is beneficial in cases due to the concerted action of the deranged Pitta with either of the other two Doshas (viz., Vayu and Kapha). 10 -A.

The patient should be diaphorised by making him put on warm clothing or exposing himself to the sun or by becoming fatigued after a long walk, or by wrestling, or some other physical exercise, load-carrying, etc., or by arousing his anger in a case where the deranged Vayu would be found to be subcharged with the deranged fat or Kapha, 10.

Memorable Verses:—

The four forms of Sveda mentioned above may be employed in two ways, viz.:—either to the whole body or to any particular part of it. Sveda should be first employed in cases of patients fit to be treated with errhines (Nasya), purgatives, emetics or with Vasti-measures. It should be applied to the enciente in cases of obstructed fetus (Mudha-garbha) unattended with any other supervening distresses (ie., excessive discharge of blood, etc.) after the extraction of the Shalya (the obstructed fetus) from the womb, and after parturition, and in cases where pregnancy runs to its full and natural term. Sveda should similarly be applied both before and after the surgical operation in cases of fistula-in-ano and stones, gravel, etc., (in the bladder) and of hemorrhoids. Specific modes of applying Sveda in other diseases should be duly described under their respective heads, 11.

Men conversant with the rules of Sveda (fomentations, etc.) should, under no circumstances, employ it before rubbing or softening the body or the limb with a Sneha (oil, etc.) inasmuch as a piece of wood is found to break or burst immediately under the application of heat if not previously rubbed with a Sneha. 12–A.

Effects of Sveda:—

Improved digestive capacity (Agni-dipti), softness of the limbs, smoothness and clearness of the skin, relish for food, clearness of the bodily ducts or channels, absence of somnolence and drowsiness and restored functions (free movements) of the numbed bone-joints are the benefits which result from an application of Sveda. The Doshas (morbific principles) having been moistened with a Sneha and lying inherent in the root principles (Dhatus) of the body or imbedded in its ducts or channels or located in their specific seats within the system, become liquefied and carried down into the bowels (Koshtha) by and after an application of Sveda and are eventually totally eliminated from the system (by means of correcting measures—D. R.). 12-B.

A perfect or satisfactory application of Sveda is marked by a copious flow of perspiration, an abatement or amelioration of the disease, a lightness of the body and a desire for cool things and the softening of the patient’s limbs, while the contrary effects result from an imperfect or unsatisfactory application of the same. An excessive application of Sveda would produce pain in the joints, and a burning sensation (in the body). It produces blisters, an aggravation of the Pitta, an excited condition of the blood, epileptic fits, vertigo, thirst, and fatigue. In such a case the evils should be speedily remedied with cooling measures. 12.

Prohibited cases of Sveda:—

Applications of Sveda should not be resorted to in cases of persons suffering from jaundice, urinary complaints, hemorrhage, pulmonary consumption (Kshaya), emaciation, indigestion, ascites (Udara),[13] thirst, vomiting , dysentery, and from diseases due to the effects of poison. It is also prohibited in respect of pregnant women and intoxicated persons, inasmuch as an application of Sveda proves fatal in these cases or tends to impart an incurable character to the disease (inflicting an irreparable injury to the whole organism). 13.

Mild Sveda may be applied (and that only in cases of emergency) to the aforesaid persons suffering from diseases amenable only to an application of Sveda, as well as to the regions of the eyes, the heart (Hridaya) and the scrotum. 14

Sveda should be applied unto a patient in a covered and windless place and after the complete digestion of his ingested food, and after having anointed his body with a Sneha. During the application of Sveda (to the eyes and to the heart) the eyes of the patient should be (first) covered with something cold (e g., lotus leaves, etc.) and the heart should be constantly touched with something cold (e.g., cold palms of the hand, etc.) 15.

After a full and complete application of Sveda, the (body of the) patient should be well rubbed with a Sneha (oil, etc.) and a hot bath should be prescribed. The patient should then be made to keep his body well covered (with warm clothes) and be removed to a windless chamber (immediately afterwards). The diet should consist of such articles as would not produce any internal secretion (in the channels of the system) and he should observe, if necessary, the ether rules of Conduct (enjoined in such cases). 16.


Thus ends the Thirty-second Chapter in the Chikitsita Sthana of the Sushruta Samhita which treats of the applications of Sveda.

Footnotes and references:


The Sanskrit term “Sveda” is not properly rendered by the terms fomentations, diaphoretic measures or any other such word or phrase. Sveda is used to mean the application of heat in any possible way—it may be to cause or not to cause perspiration. Vapour baths, hot water baths, applications of warm poultices, etc., are also included in the meaning of the term Sveda. We have, however, for convenience sake, used the term fomentation as a synonym of Sveda in general.


Jejjata reads “tairardrairalaktakapariveṣṭitaṃ” instead of “tairardralaktakapariveṣṭitaṃ” and explains that the cotton plug soaked in Alaktaka should be made wet and placed over the affected part before applying the fomentation.



The mouth of the pitcher should be covered only to mitigate and regulate the heat.


A Vyama is the length measured by the outstretched hands of a man.


The reasons for bending the tube are to make the fomentation delightful, in consequence of the vapour not passing in a straight course.


This is called the “Nadi-sveda”.


This is called the “Karshu-sveda”.


This is called the “Ashma-ghana-sveda”.


This is called the “Kuti-Sveda”.


Drugs of the Kakolyadi group should be used in cases of the dominant deranged Pitta acting in cencert with the deranged Vayu; those of Eladi group in cases of the dominant deranged Kapha acting in concert with the deranegd Vayu and the Shalvana, or sesamum, linseed, etc., in cases of a simple or complicated deranged Vayu.


This is called the Avagaha-Sveda.


This is called the “Parisheka-Sveda


Vrinda evidently quotes this verse from Sushruta Samhita but by a little change in the versification he excludes cases of vomiting and poisoning from the list and mentions only the cases of Dakodara (instead of Udara in general) as unfit for Sveda and this is consistent with the treatment prescribed by Sushruta himself in Chapter XIV, Chikitsita Sthana.

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