Chapter XLIX - Symptoms and Treatment of Vomiting (Chardi)

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of vomiting (Cardi-Pratishedha).

Causes and Nomenclature:—

The bodily Doshas are deranged and aggravated per force by the use of extremely liquid, emollient, unpalatable or oversalted food or of one taken at an improper time or in an inordinate quantity or which is incongenial to the physical temperament of its user, as well as by over-fatiguing physical exercise, fear, mental agitation, indigestion, presence of worms (in the intestines), or quick eating or owing to pregnancy or any disgusting or loathsome causes. Thus deranged, the Doshas rush up to the mouth and after covering the whole of it come out with great force and with an aching pain in the limbs. This is, therefore, called Vomiting (Cardi). 2.

The vital Vayu known as the Udana-Vayu coming in combination with the one known as the Vyana-Vayu in a man addicted to incompatible food and drink leads to the derangement of the bodily Doshas and rushes up to the upper part of his body (which causes vomiting). 3.

Premonitory Symptoms:—

Nausea, suppression of eructations, thin and saline water-brash and an aversion to food and drink are the premonitory symptoms of vomiting. 4.

Specific Symptoms:—

Scanty ejections of frothy matter of strong astringent taste accompanied with a loud sound and cramps at the back and the sides produce a sense of exhaustion or fatigue and increase after the digestion of a meal and this should be ascribed to the action of the deranged bodily Vayu. Vomiting of yellow, greenish or blood-streaked matter with an excessively acid, pungent or bitter taste in the mouth and attended with such complications as fever, dryness of mouth, fainting fits and burning and sucking (Chosha) sensations in the body, should be ascribed to the action of the deranged Pitta. Excessively cold, white, sweet, thick and mucous vomiting attended with horripilation, an aversion to food, heaviness of the limbs and lassitude should be ascribed to the Kaphaja type of vomiting. The specific features of all the three preceding types are present in the type due to the concerted action of all the three Doshas. 5—8.

Traumatic Cases:—

The five cases of vomit ing due to any disgusting or loathsome cause or to pregnancy, indigestion, presence of worms (in the bowels) or the taking of uncongenial food and drink, should be duly classified according to the Dosha aggravated in each case. The stomach is irritated in all types of vomiting. Fasting should, therefore, be the first remedy in these cases. Violent cramps and nausea as well as the symptoms of Krimija-Hridroga are the special characteristics of a case of vomiting due to the presence of worms in the bowels. 9—10.

Prognosis:—

A skilful physician shall not take in hand the medical treatment of a patient afflicted with vomiting, where the patient is emaciated and is distressed with the supervening symptoms,^[1] and in which the ejected matter is mixed with pus and blood, and resembles the variegated colour of a peacock’s plume and where vomiting is almost constant. 11.

General Treatment:—

In a case of vomiting marked by an excessive preponderance of any Dosha (or by the presence of all the three Doshas), emetics or purgatives should be administered with a due regard to the nature and intensity of the Dosha or Doshas involved. In cases due to the concerted action of any two of the deranged bodily Doshas the medical treatment should be determined according to their relative order of preponderance. Diet in these cases should consist of dry and light articles and what the patient is accustomed to. Febrifuge decoctions should be administered according to the nature and intensity of the deranged bodily Doshas involved in each case. 12.

Treatment of Vataja Type:—

Draught of clarified butter churned from milk,^[2] or the soup of Mudga and A malaka taken with clarified butter and Saindhava- salt, or gruels (Yavagu) prepared with the drugs of Panca-mula and taken with honey, would prove curative in the Vataja type of vomiting. The use of the essence of any bird of the Vishkira group (e.g. chicken, etc.) taken with a little quantity of salt and juice of acid-fruits would likewise prove efficacious. Lukewarm oily purgtives mixed with salt are also recommended in such cases 13.

Pittaja Type:—

Cold drinks and decoctions of Pitta-subduing virtue would relieve vomiting due to the derangement of Pitta. Emetics or purgatives composed of the drugs of the Madhura-drugs and mixed with the expressed juice of Draksha may likewise be employed in the present type. In violent attacks of vomiting the medicated clarified butter known as Tailvaka-ghrita should also be prescribed. 14.

Treatment of Kaphaja Type:—

A decoction of the drugs of the Aragvadhadi- group or of Dasha-mula should be given with honey in a case of vomiting due to the aggravation of Kapha. A cold infusion (Hima-Kashaya) of Guduci mixed with honey would prove an excellent remedy in all the three preceding types of vomiting. 15—16.

Vomiting due to (the use or sight of) any disgusting or loathsome thing should be treated with agreeable things, while that peculiar to pregnancy should be relieved by giving to the enceinte the things she longs for.

Traumatic Types:—

Vomiting due to the use of any unaccustomed or incongenial food should be relieved with fasting, vomiting or with the administration of habituated or congenial food. Vomiting due to the presence of worms in the bowels (Krimija) should be treated with remedies applicable in a case of Krimija Hrid-roga (heart-disease of parasitic origin). The measures and remedies prescribed before should be employed with a due regard to the nature and intensity of the deranged bodily Dosha or Doshas involved in each case. 17.

General Treatment:—

Vomiting is relieved by frequently licking a lambative made of Pippali, honey and the expressed juice of Kapittha- fruit. Madhurasa^[3] with the washings of rice and with honey may be likewise taken for the purpose. Tarpana (soothing) measure with the admixture of honey would be beneficial in all the three eases (due to the aggravation of the Doshas). A potion composed of powdered Atma-gupta- seeds and Yashti-madhu mixed with a copious quantity of rice-washing and with honey as well as gruels prepared with the admixture of Karanja- leaves should be administered. Kustumburu pasted and mixed with salt and acid would also be benificial. Kapittha should also be taken with Tri-katu and rice-washing. 18—A.

The excreta of flies should be licked with sugar, honey and sandal paste. A lizard should be immersed in hot milk and this milk, when cooled, should be given to the patient to drink. Powdered fried paddy mixed with honey and clarified butter should be given to drink or pulverised Pippali mixed with honey, sugar and clarified butter should be licked. Sandal-paste^[4] with the expressed juice of Amalaka or the decoction of the leaves of Mudga^[5] as well as a lambative composed of the marrow of Kola and Amalaka spiced with the Tri-sugandhi drugs (viz., Ela, Patra and Tvak) powdered together should be prescribed. Gruels of fried Shali paddy mixed with honey should also be prescribed. The use of perfumes which are agreeable both to the mind and to the organ of smell, is also rccomcnded. 18–B.

Diet:—

The meat of any Jangala animal and palatable cordials and victuals of various plates should be likewise taken with care in all cases. 18.

 

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

Footnotes and references:

[1]:

The supervening symptoms are:—Cough, asthma, fever, hiccough, thirst, mental dejection, heart-disease and Tamaka-Śvāsa.

[2]:

“kṣīraghṛtaṃ” been explained by some commentators as milk mixed with clarified butter. Chakradatta reads “kṣīrodakaṃ” milk and water in place of “kṣīradhṛtaṃ”.

[3]:

“Madhurasā” may mean (1) Drakshā (2) Gāmbhāri fruit (3) Murvā or (4) Yashti-madhu. The practice is to prescribe Drākshā.

[4]:

The practice is to take white Sandal in this case.

[5]:

Vāgbhata prescribes the decoction alone as a separate remedy.