An English Translation of the Sushruta Samhita, Vol. III: Uttara-tantra — trans. Kaviraj Kunja Lal Bhishagratna (1916)

sequel of any purgative course (Virechana), until the deranged Doshas of the body would be completely restored to their normal condition, bringing in the natural health and strength in their train. The sixth KalA which has been described as the Pitta-dhard Kal& (Pittacontaining sheath) is situated between Pakvâsaya and Amis'aya (duodenum ?) is called Graham. The strength of the organ of Grahani is dependent on the digestive fire (Agni) and the latter is situate in the former. Hence anything that impairs the digestive fire (Agni) necessarily affects the Grahani. 99-102.

The aggravation of one or all the bodily Doshas leads to the derangement of the Grahani into which the food taken is passed off in the shape of undigested fecal matter, or if it is digested, it sometimes produces constipation of the bowels and sometimes liquid motions accompained (in both cases) by pain and fetid smell. The disease is called Grahani (chronic diarrhoea ?) by experienced Physicians. 103.

Premonitory Symptoms s— incomplete digestion, lassitude or a sense of physical langour, laziness, thirst, a sense of exhaustion, weakness, aversion to food, cough, ringing in the ears (Karna-Kheda) and rumbling sound in the intestines are the symptoms which mark the premonitory stage of the disease. 104.

Symptoms : — Swelling or oedema of the hands and of the feet, emaciation, pain at the joints, greediness, thirst, vomiting, fever, aversion to food, burning sensation, eructations of bitter, acid or fermented taste, or of those smelling of blood or smoke, water-brash, bad taste in the mouth and non-relish for food, as well an attack of Tamaka-S>vAsa (variety of asthma) are the indications of the developed stage of the disease (Grahani), 105,

Chap. XL.] UTTARA-TANTRA. 2^

Specific Symptoms of Grahani A

case of the Vrftaja type is accompained by a severe aching pain at the anus, thorax (Hridaya), sides, abdomen and the head. A case of the Pittaja type is marked by a burning sensation in the body, while the one of Kaphaja origin is characterised by a sense of heaviness in the limbs. A case of Tri-Doshaja Grahani exhibits symptoms belonging to all the symptoms of the three cases (Vâtaja, Pittaja and Kaphaja types). The deranged bodily Dosha involved in a case imparts its characteristic colour to the finger-nails, eyes, face and excreta (stool and urine) of the patient. Thus it furnishes a satisfactory clue to the diagnosis of the disease, which, if neglected or unchecked at the outset, may usher in an attack of Hrid-roga (disease of the heart), Pdndu (chlorosis), Udara (ascites, etc.), Gulma, piles and enlargement of spleen. 106.

Treatment and Diet -.—Appropriate emetics and purgatives should be exhibted (for cleansing the upper and lower parts of the body) in accordance with the aggravation of the Dosha or Doshas involved, and Peyâs (gruels) and other articles of diet duly prepared with appetising drugs should then he prescribed in their due order. Therapeutic agents possessed of digestive, astringent and appetising virtue should then be employed through the vehicles of Sura, Arishta (wine), Sneha (oil or clarified butter), cow's urine, tepid water, or Takra. The use of Takra in the morning is in itself an excellent cure for the disease (Grahani). Remedies mentioned in connection with the treatment of worms in the intestines, Gulma, ascites or piles may also be adopted with benefit in the disease uuder ditecussion. The compound known as the Hingvddi • chunta , or the medicated clarified butter described as

23 6 THE SUSHRUTA SAMHlfX. [Chap. XL.

remedial in a case of enlarged spleen, or the one duly cooked with the expressed juice of Chdngeri and with the drugs of the Mdgadhddi (Pippalyidi) group as Kalka may be likewise prescribed with beneficial results. Clarified butter duly cooked with four times as much curd (Dadhi) may also be used with benefit Whatever is appetising (medicines, drugs and diet, etc.) would be beneficial in cases of Grahani. Complications (Upadrava) such as fever, etc. should be subdued with drugs not incomptible wdth the main treatment of nor in any way aggravative of the main disease. 107

Thus ends the fortieth chapter of the Uttara-Tantra in the Sus'ruta SamhiU which deals with the (symptoms) and medical treatment of Atisdra*

CHAPTER XLI.

Now we shall discourse on the (symptoms and) medical treatment of Phthisis (Siosha-Pratiâhedha). I.

Nomenclature : — Wasting or a general emaciation of the frame marks the sequel of and comes in as a premonitory symptom of an organic disease. Any cachectic condition of the body accompanied by a low lingering fever is called Kshaya. A correct diagnosis and a radical cure of the disease under discussion has baffled many a skilful physician. The disease is nameds Sosha from the fact of its consuming or drying up (Sosha — withering) the vital principles of the body such as Rasa — serum, etc. It is called Kshaya (wasting) since a wasting process is found to accompany all the functional activities of the body during its attack. Since the Moon-god, the king of the Brâhmanas, was the first to fall a victim to its attack, it is also called Rija-yakshmd (king’s disease) f by some authorities. 2.

Some say that the disease is produced by the separate action of the three fundamental Doshas of the body. It being usually found to be attended with all