Chapter LVIII - Symptoms and Treatment of suppression of Urine (Mutra-ghata)

Now we shall discourse on the chapter which deals with the (symptoms and) medical treatment of the suppression of urine (Mutra-ghata Pratishedha). 1.

The disease is of twelve kinds^[1], viz.,

1. Vata-kundalika,
2. Ashthila,
3. Vata-vasti,
4. Mutratita,
5. (Mutra-) Jathara,
6. Mutrotsanga,
7. (Mutra-) Kshaya,
8. Mutra-granthī,
9. Mutra-shukra,
10. Ushna-vata
11. Kaphaja-Mutraukasada,
12. and Pittaja-Mutraukasada. 2.

Symptoms of Vata-kundalika:—

The bodily Vayu deranged and aggravated through an extremely parched condition or through the voluntary repression of an urging towards micturition affects and retains the urine in the bladder, causing it to revolve in eddies within the cavity of that organ. It allows the urine to pass in small quantity or (even) to dribble out in drops with pain. This disease is known as Vata-kundalika and is of a violent type. 3.

Vatashthila:—

The deranged and aggravated bodily Vayu incarcerated or lodged in the region lying between the bladder and the anus gives rise to a thick lumpy tumour like a pebble (Ashthila), which is hard and non-shifting in its character, producing suppression of stool, urine and flatus, distension of the abdomen and pain in the bladder. It is known as Vatashthila. 4.

Vata-vasti:—

The bodily Vayu in the locality, aggravated by a voluntary repression of a propulsion to urination enters into the bladder of the ignorant person doing the same and also obstructs the orifice of that organ causing retention of urine with an oppressive pain in the bladder and loins. The disease is known as Vata-vasti and is extremely hard to cure. 5.

Mutratita:—

The urine of a person voluntarily suppressing it does not flow out at all or only dribbles out in drops or in scanty jets with slight pain, when he strains. The disease is called Mutratita. 6.

Mutra-jathara:—

The vital Apana Vayu is deranged and aggravated by the Udavarta produced by a checked desire for urination and completely fills up and distends, with an excruciating pain in the abdomen below the umbilicus. The disease is called Mutra-jathara and the lower orifices^[2] (viz. the anus and the urethra) are obstructed in this disease. 7.

Mutrotsanga:—

The disease in which the stream of urine gliding along the bladder and urethra is gradually emitted in scanty jets or runs down the exterior surface of the glan penis with blood, whether with or without pain, is called Mutrotsanga (lit. gliding urination) and is an outcome of the deranged and aggravated action of the bodily Vayu. 8.

Mutra-kshaya and Mutra-granthi:—

The deranged and aggravated Pitta and Vayu in the bladder of an extremely fatigued person already suffering from an extreme parchedness of organism, finds lodgement in the bladder producing, in concert, a sensation of local burning and pain attended with a scanty accumulation of urine in the cavity of the organ (lit. absence of micturition). The disease which can be made to yeild only to the virtue of therapeutic agents with the greatest difficulty is called Mutra-kshaya. A small round painful fixed Granthi suddenly occurring on the interior side (of the orifice) of the bladder and exhibiting by its characteristic pain, etc., all the symptoms of the presence of gravels (urinary calculii) in that organ, and which stands completely obstructing its orifice without letting out a single drop of urine, or admits only of its being dribbled out in scanty jets, is called Mutra-granthi. 9–10.

Mutra-Shukra and Ushna-vata:—

person visiting a woman in the presence of a strong urging towards urination and by voluntarily repressing the same is found to pass urine highly charged with semen which is sometimes seen to precede or follow the discharge of urine. The urine in this case resembles the washing or solution of ashes in colour. The disease is called Mutra-Shukra (lit. semen-charged urine). The disease in which the Pitta of a person deranged by such factors as over-fatiguing physical exercise, exposure to the sun, or arduous pedestrian journey, gets into his bladder completely wrapped in the deranged Vayu of his body, and produces an intense burning sensation in his bladder, penis and the anus, setting up a painful flow of a dark yellow or blood-streaked urine or of blood alone through the urethra in its stead, is designated as Ushna-vata. 11–12.

Two kinds of Mutraukasada:—

A non-slimy and thick flow of yellow-coloured urine attended with a burning sensation, and leaving a sediment like powdered Rocana when dried, is called (Pittaja) Mutraukasada. The wise ascribe the origin of this disease to the action of the deranged Pitta. The type in which a pale sediment resembling the powders of conch-shell is deposited when the urine is dried and in which the flow is painful and the urine is slimy, thick and white, should be attributed to the action of the deranged Kapha. It is but another variety of the disease described immediately before. 13.

General Treatment:—

Medicinal decoctions, Kalkas, (medicated) Ghritas, (various kinds of) foods, lambatives, preparations of milk, alkalis, honey, Asavas, fomentation and Uttara-vasti should be employed according to their indications in coping with an attack of any of the aforesaid ailments. An intelligent physician shall resort, in these cases, to measures which are efficacious in cases of Ashmari, or shall employ in their entirely the medicinal compounds which have been described as curative under the treatment of urinary Udavarta. 14.

A case of Mutra-kricchra would be relieved by the use of pasted Ervaru- seeds and Saindhava weighing an Aksha and taken with the fermented paddy-boilings. A person afflicted with Mutra-kricchra should take wine (prepared from Pishta or pasted rice,) in combination with Sauvarchala- salt, or he should take wine prepared from honey by biting meat at intervals, or take any wine made from treacle. In the alternative, a Karsha measure of Kumkuma should be kept saturated with honey and water during the night and this should be taken in the morning, whereby the patient would be relieved of the trouble (of Mutra-kricchra). Py taking the principal wine (viz., that prepared from Pishta or pasted rice) with salt, powdered Ela, Jiraka and Nagara and saturated with the acid juice of pomegranade one would get rid of Mutra-kricchra. 15—16.

Half a Prastha measure of water with four times as much of milk together with the drugs of the Prithak-Pamyadi (Vidari-gandhadi) group and Gokshura-roots should be kept boiling till all the water is evaporated. A person suffering from an attack of Mutra-ghata due to the concerted action of deranged Vayu and Pitta should use this medicated milk, when cooled, with sugar and honey. The dung of an ass or of a horse should he squeezed through a piece of linen and a Kudava measure of this expressed liquid should be taken for the cure of an attack of painful urination. 17—18.

An Aksha measure of the compound made by pasting Musta, Abhaya, Deva-daru, Murva and Yashti-madku, should be taken with the decoction of Draksha. Abhaya, Amalaka and Aksha (Vibhitaka) together weighing a Vadara measure should be taken with salt and water for getting relief in cases of painful urination. An Udumbara measure of Draksha should be kept saturated in water for the whole night and this cold infusion should be taken (in the morning) for getting relief in cases of painful urination. A Kudava measure of the expressed juice of Nidigdhika or the Kalka of the same should be taken with honey as a relief from the urinary complaints. 19.

By taking a Kudava measure of the expressed juice of Amalaka, a person suffering from uninary complaints would get rid of his troubles. In the alternative, the patient should drink a potion consisting of powdered small Ela, dissolved in the expressed juice of Amalaka (and mixed with honey), or he should take a paste of the tender roots of Tala (palm) with cold ricewashing. The expressed juice of Trapusha and white Karkataka should also be prescribed to be taken with milk in the morning. In the alternative a person should take a potion consisting of milk duly boiled with the drugs of the Madhura group saturated with clarified butter as the compound is possessed of excellent diuretic properties and tends to remove the seminal troubles (e.g., Mutra-shukra) as well. 20.

A compound consisting of Vala, Shvadamshtra, seeds of lotus (Krauncha)^[3], Tandula (i.e., seeds) of Kokilaksha^[4], roots of Shata-parvan^[5], Devadaru, Citraka and stone of Aksha, pasted together and dissolved in wine should be taken by a person under the circumstances inasmuch as it removes the defects of urine and eliminates the gravels from the bladder. 21.

The ashes of burnt Patala wood, which are efficacious in relieving all sorts of urinary troubles, should be strained seven times in succession (after the manner of Kshara preparation) and taken with a small quantity of oil. In a similar way a paste of Nala, Ikshu, Darbha, Ashma-bheda and the seeds of Trapusha and Ervaruka, should be duly washed in milk and filtered and taken in combination with clarified butter. Powders of Tvak, Ela and Tri-katu should be taken by the intelligent one in combination with the alkaline solution of the ashes of Patala, Yava-kshara, Paribhadra and Tila. Lambatives made of the powders of the above-mentioned drugs should be separately licked with treacle. 22—24.

Now I shall describe the measures which are beneficial in Mutra-dosha (urinary defects). Purgatives should be administered to a patient after the due application of Sneha and Sveda. Uttara-vastis should be injected after he has been duly purged. 25.

Sexual intercourse should be refrained from by a person afflicted with a discharge of blood from the urethra owing to sexual excesses, and he should be treated with remedies which are constructive tonics (e. g., meat-soup, milk, clarified butter,^[6] etc,). Uttara-vastis should be applied into the urethra, under the circumstances, with cock’s lard and with oil, the process of applying which has already been elaborately described. (See Chikitsa, XXVII). 26–27.

Half a Patra measure of honey, one Patra measure of clarified butter churned from milk (Kshira-sarpis)^[7] and equal parts of sugar, and powdered Draksha, Atmagupta- seed, Ikshuraka and Pippali, together weighing one half part (i.e., half of half a Patra) should be thoroughly mixed by stirring the compound with a laddie. A Pani-tala (two Tolas) measure of this compound should be licked, followed by draughts of milk. By using this Ghrita, a man is relieved of all injurious principles of his body, and gets rid of distressing and dreadful urinary troubles which cannot otherwise be easily cured by any other remedy. It acts as an excellent blood-purifier, and, by using it, even a barren woman may get rid of her sterility and of all other vaginal and uterine complaints which usually obstruct or retard conception in females. 28.

Equal parts of Vala, stones of Kola -fruits, Yashti-madhu, Shvadamshtra (Gokshura), Shatavari, Mrinala (lotus-stem), Kasheru, seeds of Ikshuraka, Sahasra-virya (Durba), Amshumati (Sala-parni), Payasya (Vidari), Kala, Shrigalavinna( Prishniparni), Ati-vala and the drugs of the Vrimhaniya (Kakolyadi) group should be duly boiled with four times of water of their combined weight and a Tula masure of treacle. When only a Drona measure of water would remain, it should be taken down and strained through a piece of linen. It should then be duly cooked with an Adhaka measure of clarified butter. The medicated Ghrita (thus prepared) with a Prastha measure of honey added to it (when cooled) should be kept in an earthen pitcher. By using this medicated Ghrita, one would be cured of all urinary troubles.^[8] 29.

 

Thus ends the fifty-eighth chapter in the Uttara-Tantra of the Sushruta Samhita which deals with the (symptoms and) treatment of the suppression of urine (Mutraghata).

Footnotes and references:

[1]:

Mādhava reads thirteen different kinds of this disease. He reads only one kind of Mutra-sāda and adds Vid-vighāta and Vasti-kundala.

[2]:

Some read “adhovastinirodhakam” the lower part viz., the neck of the bladder is obstructed.

[3]:

Dallana explains Krauncāsthi as bones of a Krouncha bird, but we are not inclined to accept this explanation.

[4]:

Some explain “Kokilākshaka-tandula” as meaning Kokilāksha and Tandula (rice) which meaning may also be accepted.

[5]:

“Śata-parvan” may mean Durbā-grass or bamboo.

[6]:

Dallana says that Kārtika does not read this, in as much as this would increase the number originally mentioned, as also because this case has already been mentioned in Prameha. But according to Jejjata, this is mentioned here to make the case more clear.

[7]:

Dallana’s reading here evidently is ‘Kshira-sarpishah’, but according to a variant the reading would be “Kshira-sarpish?u” i.e., milk and clarified butter (taken together). The latter reading has the support of Cakrapāni and Vrinda who, however, read these lines in a different way and prescribe the drugs in somewhat different proportions. The former reading ‘Kshira-sarpishah’ with the sixth case-ending is, however, more grammatical.

[8]:

Additional Text:—Powders of Tugā-kshiri and sugar should be mixed together with honey and licked in an auspicious day according to the digesting capacity of the patient and a draught of milk should then be taken. By its use the patient would be able to conquer all seminal troubles if he observes a perfect continence. One whose semen has been wasted by sexual excesses would get instantaneous relief; and a man who is possessed of vigour (Ojas) and strength would be refreshed and cheerful.