Chapter LVI - Symptoms and Treatment of Cholera (Visuchika)

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of Vishuchika type of cholera, etc. (Visuchika-Pratishedha). 1.

Causes:—

Yisuchi, Alasaka and Vilambika are produced from the effects of the three kinds of indigestion spoken of before (in Sutra, chapter XLVI), viz, Amajirna (indigestion properly so-called), Vidagdha-jirna (indigestion with acidity) and Vishtabdhajirna (indigestion with undigested food stuffed into the intestines in the form of undigested fecal matter). 2.

Definition:—

The disease in which the deranged and incarcerated bodily Vayu produces, owing to the presence of indigestion, a pricking pain in the limbs resembling that produced by the pricking of needles is called Visuchika by the physicians. Men well-versed in the (dietetic) principles and temperate in their diet, enjoy an almost absolute immunity from its attack, whereas fools who are greedy and intemperate and eat like gluttons, fall an easy victim to it. 3.

Symptoms:—

Fainting, diarrhea (loose motions), vomiting, thirst, pain, cramps, vertigo, yawning, burning sensation in the body, discolouring or paleness of complexion, pain (cramps) at the heart and a breaking pain in the head are the symptoms of Visuchika. 4.

Alasaka:—

Excessive pain in and stuffedness of the abdomen, rumbling noise (in the intestines),^[1] and the upward coursing of the Vayu incarcerated in the abdomen making a croaking rumbling sound in its way upwards, absolute suppression of stool and flatus, hic-cough^[2] and eructations—a patient suffering from these symptoms is said have an attack of Alasaka. 5.

Vilambika:—

The person in whom the deranged and undigested food matter does not find any outlet either through the upper or lower channels of the body owing to the fact of its being obstructed in its course by the action of the deranged Vayu and Kapha, is said to be suffering from an attack of Vilambika by old medical experts and should be given up as incurable. In whatever part of the body the Ama (undigested food matter) is present, it produces its!own characteristic symptoms in that very part and the vitiation of a particular Dosha in such cases should be diagnosed by the presence of the characteristic symptoms (e.g. distension, etc.,) of Ama (indigestion). 6—7.

Prognosis:—

A patient exhibiting such symptoms as blackish blue (Shyama) colour of teeth, nails and lips, diminished consciousness, vomiting, eyes sunk in their sockets, feeble voice and looseness of all the joints, should be regarded as not returning from his journey (to the eternal home). 8.

General Treatment:—

In the curable types, cauterization of the regions of Parshni (heels), dry fomentation, exhibition of strong emetics and such like measures are recommended. Fasting should be observed at (the time of) the digestion of the food. Digestive (Pacana) remedies as well as purgatives should also be prescribed. The patient gets instantaneous relief in cases of fainting, diarrhea, etc., on the cleansing of his body with the medicinal (emetic or purgative) remedies. Intestinal injections after the manner of an Ashthapana Vasti may be likewise applied in all cases of the present disease. Now hear me describe the recipes of other medicinal compounds which may be employed in the aforesaid diseases in addition to those already mentioned. 9—10.

A pulverised compound of Pathya, Vaca, Hingu, Kalinga (Indra-yava), Grinja (a variety of garlic), Sauvarchala and Ativisha taken with tepid water instantaneously relieves an attack of indigestion, colic, Visuchika and an aversion to food. The medicine known as Kshara-gada (Kalpa—chapter VII) or Vit -salt, or mustard-seeds and a profuse quantity of treacle, should be taken (with tepid water). Saindhava, Hingu, Vija-pura, (D. R. seeds of Shaka), clarified butter and the two Tri-vargas (Tri-phala and Tri-katu) in combination with any fermented gruel (Kanjika), or Tri-katu and Saindhava- salt mixed together with the milky exudation of Snuhi, should be taken (with Kanjika). In the alternative, the medicated salt known as Kalyana-Lavana described before under the treatment of Vata-vyadhi should be taken (with Kanjika). Pippali, Yamani and Apamarga, or Pippali and Danti in equal parts should be similarly taken. Pippali mixed with Danti should also be used with the expressed juice of Koshavati (Ghosha). Pippali and Shunthi should also be taken with hot water. 11.

The drugs known as Vyosha (Tri-katu), Karanja- fruits (seeds), the two kinds of Haridra^[3] and the root of Matu-lunga taken in equal parts should be pounded together, made into Gutikas (or pills) and dried in the shade. The application of these pills as an eye-salve (Anjana) along the eye-lids proves curative in cases of Visuchika.^[4] 12.

Diet:—

Digestive and appetising Peya, etc., should be given to the patient when he experiences a good hunger after he had been fully treated with a course of emetic or purgative or kept fasting for a proper period. 13.

Causes and Symptoms of Anaha:—

The disease in which Ama (undigested food) or fecal matter, gradually incarcerated (in the stomach) through the action of the deranged and aggravated local Vayu fails to find its natural outlet, or is not spontaneously evacuated is called Anaha (Enteritis?).

A case of Anaha due to the accumulation of undigested food (in the stomach) exhibits such symptoms as thirst, cattarrh, burning in the head, a sense of heaviness and cramps in the stomach, nausea (D. R.—heaviness of the heart) and suppression of eructations. While a case of Anaha in the Pakvashaya (intestines) is marked by a sense of stuffedness in the back and waist, suppression of stool and urine, colic, epileptic or fainting fits, vomiting of feces, laboured and difficult respiration (D. R.—swelling), as well as the symptoms mentioned under the head of Alasaka. 14.

Treatment:—

In a case of Anaha due to the presense of Ama, the patient should be treated with emetics and then with digestive medicines and diet according to the prescribed order. The Ama (undigested food) in a case not marked by any vomiting of feces should be treated with fomentation and therapeutic agents of digestive efficacy. Vartis (suppositories) made by pasting the purgative drugs mentioned in connection with the medical treatment of Visuchika together with the urine of a she-buffalo, or of a she-goat or of a ewe or of a she-elephant, or of a cow, should be used. The body of the patient should be first fomented and then the powders of the drugs used in preparing the afore-said Vartis should be blown (into his intestines) through a pipe inserted into his rectum. Decoction should be duly prepared by boiling the drugs of emetic and purgative virtue in cow’s urine. Nirudha Vasti^[5] should soon be applied with the above decoction mixed with half as much of cow’s urine^[6] and with honey and adding also the powders of Trivrit and salt weighing a Prakuncha (Pala). The procedure laid down in respect of the exhibition of purgatives should be adopted here. Oil duly cooked and boiled with the foregoing drugs should also be injected into the rectum, if necessary, after the manner of an Aunvasana Vasti. 15—16.

 

Thus ends the fifty-sixth chapter in the Uttara-Tantra of the Sushruta Samhita which deals with the (symptoms and) treatment of Visuchika.

Footnotes and references:

[1]:

According to Śrikantha the commentator on Mādhava’s Nidāna—the patient himself makes an indistinct sound.

[2]:

Mādhava reads “thirst” in place of “hic-cough.”

[3]:

Cakrapāni reads Haridrā in the singular number.

[4]:

Some here read the following two compounds as an additional text:—Kushtha, Aguru, Patra, Rāsnā, Śigru, Vacā and Tvak should be mixed together and pasted with Kānjika. This would be the best remedy, for rubbing over the body of the patient, in a case of Visucikā.

Oil should be duly cooked with Citraka, Yuthi-flower, oil-cakes (of sesamum), Bhallātaka, the two Kshāras, Saindhava and two parts of Kushtha. This should be prescribed by an expert to be rubbed, or used as a plaster over the body of the patient.

[5]:

The application of this Nirudha Vasti should be prescribed only in the “pakva” stage of Ānāha and never in its stage.

[6]:

Kārtika Kundu does not include “urine” in this list. He reads “mātrārddhayuktena” (added in half dose) in place of “mutrārddhayuktena”.