The Sushruta Samhita — trans. Bhishagratna
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19.
Thus ends the tenth Chapter of Chikitsita Sthanam in the Sus'ruta
Samhitd which deals with the medical treatment of Maha-Kushtha.
CHAPTER XL
Now we shall discourse on the medical treatment of the diseases of the urinary tracts (Prameha). i.
This disease may be ascribed to two causes, such as the congenital (Sahaja) and that attributable to the use of injudicious diet. The first type (Sahaja) is due to a defect in the seeds of one's parents and the second is originated from the use of unwholesome food. The symptoms, which mark the first of these two types, are emaciation and a dryness (of the body), diminished capacity of eating, too much thirst and restlessness; while the symptoms, which usually attend the latter type of the disease, are obesity, voracity, gloss of the body, increased soporific tendency and inclination for lounging in bed or on cushions. A case of emaciation, etc., (viz., the first kind of Prameha) should be remedied with nutritious food and drink, etc., whereas Apatarpana, etc., (fasting, physical exercise, depletory measures etc.), should be adopted in cases of obesity viz., the second kind of (Prameha). 2.
Forbidden Articles of Food & Drink :
— All patients suffering from Prameha should forego the use of (the different species of wine and fermented liquor known as) Sauviraka, Tushodaka, Sukta, Maireya, Surd, and Asava, water, oil, clarified butter, milk, any modification of the expressed juice of sugarcane, cakes, milk-curd, acid, Pdnaka* the flesh of domestic and aquatic animals and of those which frequent swamps or marshy places 3.
* Made of sugar, lemon-juice, or fermented rice-gruel boiled together.
p. 373
Articles of diet:— The use of sufficiently old and matured, S'dli and Shashtika rice, barley, wheats Kodrava, Udddlaka, with the different preparations of Chanaka, Adhaki, Kulattha or Mtidga pulse is recommended ; or the meal should be taken with the S'dkas (potherbs) of bitter or astringent taste cooked with the oils of Nikmnbha, Ingudi, mustard or linseed oil ; or with the soup of the lean flesh of Jdngala animals which are possessed of anti-diuretic properties cooked without any clarified butter and unseasoned with any acid juice. 4.
Preliminary Treatment :— -The patient
4.
Preliminary Treatment :— -The patient
should be first anointed with any of the oils (of Nikumbha, Ingudi, Sarshapa, Atasi, etc.); or with the medicated clarified butter* cooked with the drugs of the Priyangvddi group and should also be treated with strong emetics and purgatives-f*. After the application of purgatives, an Asthapana measure with a decoction of the drugs of the Surasddi group, mixed with honey and Saindhava salt and with the powders of S'jinthi, Bhadraddru and Musta by way of an after-throw, should be resorted to. (On the eighth day) in a case attended with a burning sensation, a decoction of the Nyagrodhddi group without {i.e , mixed with a little quantity of) Sneha (oil or clarified butter) should be used (in the manner of an Asthapana).
The five Medicinal remedies :— After
cleansing the system, the expressed juicej of Amalaka mixed withZ/rtir^'^r^' (powder) and honey should t Emetics in cases of Kaphaja-meha and purgatives in those of Pittaja-melia, should be applied.
* The palient should be anointed with the medicated clarified butter in a case of Pittaja-meha.
X This is also found in Charaka and has been quoted by Chakradatta in his compilation.
p. 374
be administered. As an alternative, a decoction* of Triphald, Vis'dld, Deva-ddru and Musta or an Aksha (two Tola) measure of the Kalka (powders^-f- of S'dla, Kampillaka and Mushkaka i^both of them) sweetened with honey and the expressed juice of Amalaka should be taken ; or powders]: of the flowers of Kutaja .Kapittha^ Rohita^ Vibhitaka and Saptaparna (should be taken with honey, Haridrd and the expressed juice of Amalaka), or a decoction of the roots, leaves, barks, flowers and fruits of Nimba, Aragvadha^ Saptaparna, Murvd, Kutajay Soma-vriksha, P aids a should be given to the patient. All cases of Meha are often found to yield to the use of any of these five medicinal preparations. 5.
Specific Treatments :— Now we shall specifically describe the course of treatment to be adopted in each particular type of the disease (Prameha). A decoction of Pdrijdta should be given in a case of Udaka-meha ; a decoction of Vaijayanti in that of Ikshu-meha ; a decoction of Nimba in a case of Suraimeha ; a decoction of Chitraka in a case of S'ikataimeha; a decoction of Khadira in a case of S'anairmeha; a decoction of Pdthd and Aguru in a case of Lavana-melia ; a decoction of Haridrd t The third Yoga of the text is also quoted by Chakradatla but no addition of Haridra powder is prescribed there. Chakradatla is more generally followed in the case.
*This is quoted by Chakradalta but he reads «' ^j^f^j " in place of " ^ej^jj^" and does not mention the use of the expressed juice of Amalaka. The practice, however, is to follow the recipe of Chakradatla.
X The fourth Yoga of the text is found also in Charaka although wiih some variation. Charaka adds the flowers of Kampilla and S'ala in the list, but does rot recommend the use of Haridra powder nor of the expressed juice of Amalaki as the medium of taking the medicine. Charaka, however, is quoted verbatim by Chakradalta and is followed in practical use,
Chap. XI.] CHIKITSA STHANAM. 375
and Ddru'haridrd in a case of Pishta-meha ; a decoction of S'aptaparna in a case of Sandrameha ; a decoction o{ Du7'vdf S'aivdla^ Plava, Hathakaranja and Kas'eruka, or that of Kakubha and redsandal wood in a case of Sukra-meha ; and a decoction of Triphald, Aragvadha and Drdkshd mixed with honey in a case of a Phena-nieha. All decoctions, to be employed in the foregoing ten types of Kaphaja-meha, should be sweetened with honey (slightly sweetened with honey — D. R ).
Treatment of Pittaja Prameha : In
the Pittaja types of the disease, a decoction of the drugs of the S'dla-sdrddi group or that of As'vattha should be administered in a case of Nila-meha ; similarly a decoction of Rdja-vriksha should be given in a case of Haridrat-meha ; a decoction of the Nyagrodhddi group, mixed with honey, in a case of Amla-meha ; a decoction of Triphld in a case of Ksha'ra-meha ; a decoction of Manjishthd and (red) Chandana in a case of Manjishthai-meha ; and a decoction of Guduchi, seeds of Tinduka, Kds'marya and Kharjura^ mixed with honey, in a case of Sonita-meha*. 6.
Palliative IVIeaSUreS :— Now we shall describe the palliative measures to be adopted even in cases of incurable types of the disease. A Kalka compound of KushtJia^ Kutaja^Pdthd, Hingu diwd Katu-rohini should be taken with a decoction of Guduchi and Chitraka in a case of Sarpir-meha. A patient afflicted with an attack of Vasa(-meha should be made to drink a decoction of Agni-mantha or of S'ims'apd. Similarly a decoc-
• Honey should be added to all oi these decoctions prescribed in cases Pittaja-meha. — Dallana.
t Honey should also be added to these decoctions prescribed in cases of Valja Meha — Dallana.
376 THE SUSHRUTA SAMHITA. [Chap. XI.