Chapter XLVIII - Symptoms and Treatment of thirst (Trishna)

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of thirst (Trishna-Pratishedha Adhyaya). 1.

He who is not satisfied even with the constant drinking of water but craves for more and more water should be regarded as afflicted with the disease known as thirst (morbid desire for water). 2.

Etiology:—

The Pitta and Vayu of the body become extremely aggravated by such factors as (excessive) exercise, grief (or any violent mental; agitation), fatigue, drinking, use of any extremely dry, acid, hot or pungent fares, or of those which cause a parched condition in the organism, or waste of any vital organic principle (Dhatu) of the body, fasting or exposure to the sun, and combinedly affect the watercarrying channels of the body (diminish the liquid portion of the bodily lymph-chyle). The water-carrying channels thus affected give rise to violent thirst. The disease is divided into seven types. 3.

Classification:—

The first three are due to the action of the deranged Doshas (Vayu, Pitta and Kapha). The fourth and fifth are respectively incidental to any ulcer and to the waste of any of its fundamental organic principles. The sixth is due to the presence of undigested fecal matter in the intestines (lit. mucus) and the seventh is due to errors in diet. Now hear me describe their specific symptoms and the therapeutic agents to be employed in curing them. 4.

Premonitory Symptoms:—

An extreme dryness of and a burning sensation in the palate, throat, lips and mouth, external heat, vertigo, loss of consciousness, and delirium are the general premonitory symptoms which usher in an attack of the disease. The specific symptoms are given below. 5.

Symptoms of Vataja, Pittaja and Kaphaja Thirst:—

Dryness of the mouth with a tingling sensation in the regions of the temples, and the head (D. R.—throat), obstruction of the (water-carrying) channels of the body and a bad taste in the mouth, are the symptoms which specifically mark a case of the Vataja type in which the drinking of cold water leads to a distinct aggravation of the disease (thirst). Loss of consciousness (epileptic fits), delirium, an aversion to food, dryness of the mouth, yellowness of the eyes, extreme burning sensation in the whole body, desire for coldness, a bitter taste in the mouth and a fumid sensation (in the throat) are the features which specifically mark the Pittaja type of the disease. The vapours produced by the fire of digestion being enveloped and obstructed in their course by the layer of accumulated Kapha, the heat (pent up in the body tends to dry up the moisture of its water-carrying channels and) produces a kind of thirst which is characterised by somnolence, a sense of heaviness in the limbs, a sweet taste in the mouth, extreme emaciation, cold-fever, vomiting, an aversion to food and suppuration in the skin are the symptoms of Kaphaja type. And where such symptoms are present, the patient has no excessive desire for drinking water. 6—8.

Kshataja and Kshayaja Thirsts:—

A case of thirst which is engendered in consequence of pain in or discharge of blood from, any cut in the body is the fourth type and is known as Kshataja thirst. The days of the patient in such a case pass with great uneasiness even if he drinks water. In the type due to the waste of the fundamental organic fluid (Rasa) which is known as Kshayaja thirst, the patient constantly drinks water in large quantity both in the day and in the night but still finds no relief. This type is attributed by several authorities to the concerted action of the three deranged Doshas and all the specifice symptoms due to the waste of the vital organic principle (Rasa) described before are expected there. 9—10.

Amaja and Annaja Thirst:—

The symptoms of all the three (aggravated) Doshas in addition to pain in the heart, spitting and a sense of lassitude in the limbs are present in the type which is due to indigestion (Amaja). The case of thirst which is produced by using extremely fatty and saline articles of fare, as well as those which are hard to digest is due to errors in diet (and is known as Annaja thirst). 11—12.

Prognosis:—

A patient who has become extremely weak and deaf in consequence of thirst and who suffers from a mental stupour and lies with his tongue protruded and hung down should not be taken charge of (by a physician) for treatment. 13.

General Treatment:—

Vomiting should be induced with a solution of powdered Pippali in a case of thirst in which the stomach of the patient becomes fully loaded (with water). A plaster composed of Dadhna, Amrataka and Matulunga is also beneficial. Drugs which are cooling in their virtue and potency should be applied in the three cases of thirst (due to the three Doshas). A gargle composed of a solution of powdered Amalaka with any acid drug (Matulunga, etc.) should be retained in the mouth for removing the bad taste in the mouth under the circumstances. Water made hot by immersing bits of heated gold, silver, etc, as well as pieces of heated stone or baked clay in it and taken in a tepid state, or cold water charged with sugar and honey, is possessed of the efficacy of allaying thirst. 14—16.

Specific Treatment:—

A patient suffering from Vataja thirst would find relief by taking lukewarm and in a little quantity at a time the water boiled with the drugs of any of^[1] the five Panca-mula groups or with the drugs of the first group (Vidari-gandhadi-gana). A decoction of the drugs of the Pitta-subduing groups^[2] subsequently cooled and taken with the addition of honey and sugar, or milk duly boiled with the admixture of the drugs of the Jivaniya group (Kakolyadi Gana) would allay a case of Pittaja thirst. Water duly boiled with Vilva, Adhaki, the drugs of the Kantaka-Panca-mula^[3] and Darbha allays a case of Kaphaja thirst. Vomiting induced with the help of a draught of the infusion of tender Nimba -Ieaves taken lukewarm would likewise prove curative in such a case. 17—19.

The Pitta-subduing remedies and measures should, in the alternative, be applied in all types of thirst which cannot otherwise be allayed. The expressed juice or a decoction of ripe Udumvara should be taken with sugar under the circumstances. A thirst-afflicted patient should likewise drink the water duly boiled with the drugs of the Sarivadi group sufficiently cooled down for the purpose. 20—21.

Water duly boiled with Kasheru, Shringataka, Padma, Moca (plantain-flower) and Visha is efficacious in allaying thirst incidental to hurt (Kshataja). Water containing Nilotpala, Ushira and red Chandana should be kept in an open space during the night and a physician should give this well-scented water mixed with sugar and honey and with a large quantity of Draksha to the thirst-afflicted patients on the following morning for their benefit. Cold infusions of the drugs of any of the Trina-panca-mula, Utpaladi and Madhura (D. R. the first group i.e., Vidarigandhadi) groups mixed with the drugs of the Sarivadi group as well as that of the drugs of the Madhuka-pushpadi groups should be prepared in the preceding manner and prescribed. The six kinds of cordials (Panaka) separately prepared (in the preceding manner) with the (four kinds of) Rajadana, Kshiri or Kapitana are also beneficial in such cases. Fruits of Tundikeri (wild Karpasa) and of Karpasa pasted together (and dissolved in water) and taken internally would prove beneficial. A case of thirst incidental to any ulcer (Kshataja) is allayed with the stoppage or removal of the pain or by taking meat-soup or the blood (of deer, goat, etc.). 22—26.

A case of thirst due to the waste (Kshayaja) of any fundamental organic fluid (Rasa) is removed by taking draughts of clarified butter churned from milk,^[4] as well as those of meat-soup and infusion of Yashti-madhu. Thirst which is incidental to the presence of mucus and undigested fecal matter in the intestines (Amaja) should be remedied with the decoction of Vilva, Vaca and the drugs of the Dipaniya (Pippalyadi) group or with the decoction of the drugs of the Dipaniya group mixed with Amrataka, Bhallataka and Vala. The type which has its origin in the use of heavy and indigestible fares or due to errors in diet as well as all other types of thirst with the exception of the one which is incidental to the waste of any fundamental organic principle should be cured by inducing vomiting. 27—28.

Solution of common treacle or Mantha or meat-soup is efficacious in allaying thirst which is due to physical fatigue. Warm Yavagus or cold Manthas^[5] would alleviate a thirst caused by the obstruction of the participated meal. A man should drink warm water in cases of thirst due to an excessive taking of any fatty substance (Sneha). The thirst of a habitual drunkard which is due to the reactionary effects of wine is allayed by draughts of half-diluted wine. Thirst due to heat, may be allayed with draughts of cold water surcharged with sugar or with the expressed juice of suger-cane. 29—33.

General Treatment:—

Vomiting should be induced in these cases with the decoction of such drugs as are remedial to the deranged bodily Doshas involved in each case and the digestive (Pacana) remedies as prescribed in cases of fever should also be prescribed in these cases. Use of cooling plasters and of cold baths and spray, residence in cold chambers, exhibition of emetics and purgatives, use of milk, meat-essence, clarified butter and sweet and cooling lambatives would be likewise prescribed in all cases of thirst. 34—35.

 

Thus ends the forty-eighth chapter of the Uttara-Tantra in the Sushruta Samhita which deals with the (symptoms and) treatment of thirst.

Footnotes and references:

[1]:

The five Panca-mula groups are

1. The major Panca-mula,
2. The minor Panca-mula,
3. The Valli Panca-mula,
4. The Kantaka-Panca-mula,
5. The Trina-Panca-mula .

See Chap. XXXVIII, Sutra sthāna.

[2]:

The Pitta-subduing groups are Utpalādi, Sārivādi and Kākolyādi groups.

[3]:

In Place of “kaṇṭakapañcamūlī” etc.”, some read “kaṇṭakapañcakola” etc., i.e. Kantaka (Gokshura) and the drugs included in the group known as “pañcakola,” viz. Pippali, Pippali-mula, Cavya, Citraka and Nāgara. The commentator Kārtika Kundu supports this:—Dallana. For Kantaka—Panca-mula, see Chap, XXXVIII—Sutra-Sthāna.

[4]:

In places of “kṣīraghṛtaṃ” and “madhukodakaṃ” some read “kṣīracalaṃ” (milk mixed with water), “māṣodakaṃ” (soup of Māsha pulse) and “madhūdakaṃ” (honey mixed with water) respectively.

[5]:

Warm Yavāgu should be prescribed in cases where Vāyu pre-ponderates and cold Mantha in cases where Pitta preponderates.