Oils pressed out of black sesamum and Bhalldtaka, clarified butter, the expressed juice of Amalaka and the decoction of the drugs of the S'dla-sdrddi group, each weighing a Drona measure, and a Pala weight of each of the following drugs, viz., Triphald^ Trikatu, the pith or marrow of Parusha fruit, Vidanga seed, Chitraka, Arka, Avalguja, Haridrdy Ddru-haridrd^ Trivrit, Danti^ Indra-yava, Yashti-madhu, Ativishd, Rasdnjana and Priyangu, should be boiled together in the manner of cooking medicated oil, etc. (Sneha- pdka Vidh^na). When well cooked, this medicated com- pound should be strained (through a piece of clean linen) and carefully preserved (in an earthen pitcher with its mouth well closed with a lid). The system of the patient should be well cleansed (with appropriate emetics and purgatives) and a Pala weight of this preparation, mixed with honey, should be given to him every morning. After the digestion of this medicine, he should be made to take a light meal of rice well cooked with a decoction of the Khadira-wood and mixed with clarified butter, and the soup (Yusha) of Amalaka or Mudga unseasoned with salt. A Drona measure (of this compound), gradually taken in the aforesaid manner by a patient taking a (light) decoction* of Khadira (instead of water), would ensure a speedy recovery from all types of Kushtha and enable the patient to witness a hundred summers (on earth) in the full enjoyment of sound health and intellect. 18.
* The decoction of Khadira-wood for drink should be prepared afteir the manner of Shadanga-paniya preparation.— Ed.
Chap. X.] CHIKITSA STHANAM. 37I
Memorable Verse :— An intelligent physi-
cian may prepare a thousand varieties of medicated
remedies, such as Surds, Asavas, Arishtas, Lehas
(lambatives), powders and Ayaskritis (metal-prepara-
tions) with the aforesaid drugs and in the manner
described above. 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 unwhole- some 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.
Chap. XL] CHIKITSA STHANAM. 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 recom-
mended ; 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
should be first anointed with any of the oils (of Nikum-
bha, Ingudi, Sarshapa, Atasi, etc.); or with the medi-
cated 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 pur-
gatives, an Asthapana measure with a decoction of the
drugs of the Surasddi group, mixed with honey and Sain-
dhava 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 burn-
ing 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
* The palient should be anointed with the medicated clarified butter in a case of Pittaja-meha.
t Emetics in cases of Kaphaja-meha and purgatives in those of Pittaja-melia, should be applied.
X This is also found in Charaka and has been quoted by Chakradatta in his compilation.
374 THE SUSHRUTA SAMHITA. [Chap. XL
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 speci-
fically 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 Surai-
meha ; a decoction of Chitraka in a case of S'ikatai-
meha; a decoction of Khadira in a case of S'anair-
meha; a decoction of Pdthd and Aguru in a
case of Lavana-melia ; a decoction of Haridrd
*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.
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.
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 Sandra-
meha ; a decoction o{ Du7'vdf S'aivdla^ Plava, Hatha-
karanja and Kas'eruka, or that of Kakubha and red-
sandal 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 em-
ployed 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 de-
coction 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 decoc-
tion of Triphld in a case of Ksha'ra-meha ; a decoc-
tion 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 de-
scribe 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 decoc-
tion 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.
tion o{ Khadira, Kadara and Kramuka should be given
in a case of Kshaudra-meha ; a decoction of Tinduka,
Kapittha, S'irisha, Palds'a^ Pdthd^ Murvd^ and Dus-
parsd (Duraiabh^) mixed with honey * or the Kshara,
(alkaline water) prepared from the ashes of the bones of
an elephant, horse, hog, ass or camel, in a case of
Hasti-meha. A gruel (Yav^gu prepared in the manner
of Shadanga-kalpa) with a decoction of aquatic bulbs
and sweetened with milk and the juice of sugarcane
should be prescribed in a case attended with a burning
sensation. 7.
Medicinal Arishtas, Asavas, Yava-
gUSy etc. : — Likewise Arishtas, Ayaskritis, lamba- tives and Asavas should be prepared (in the manner hereinbefore described) with Priyangu, A7tantd, Yuthikd, Padmd (Bhargi), Trdyantikd, Lohitikd, Amhashthd, bark of pomegranate, S' dla-parni, (D.R. — Tala-parni), Padma (lotus), Tu7iga, Kes'ura, Dhdtaki, Vakula, S'alntali, S' ri'Ves htaka and Mocharasa, should be administered to the patient. As an alternative, similar preparations made of S'ringdtaka, Gilodya^, Mrindla, Kas'eruka, Madhuka, A'mra^ fainbu^ Asana, Tinis'a, Arjuna, Kat- vanga^ Lodhra^ Bhalldtaka, Charmi-vriksha, Giri-karnikdy S'ita-s'iva, Nichula^ Dddima, Aja-karna, Hari-vriksha, Rdjddana,Gopaghontd diwd. Vikamkata should be prescrib- ed. Different preparations of Yavagu, etc. should be given to the patient as diet. A gruel (Yavagu) cooked with the decoction of the preceding medcinal drugs or (only these) decoctions should be given to the patient as drinks. Potions of any of the aforesaid Asavas thickened with an admixture of powdered Pdthd, Chitraka and Haritaki and sweetened with a liberal quantity of honey
* Jejjata interprets it as grape-wine, but Gayadasa does not support this view.
Chap. XL] CHIKITSA STHANAM. 377
should be prescribed for a rich or royal patient of
injudicious conduct and refusing to take medicines ;
or he should be made to drink frequent potions of
Mddhvika liquors (prepared from honey) * with meat
roasted on gridiron over a charcoal fire. Food and drinks
mixed with honey, Kapittha and pepper should be
prescribed for him. 8.
The powdered dung of a camel, a mule, or an ass
should be administered to him in food ; he should take
his meal with soups saturated with a compound of
asafoetida and Saindhava salt or with mustard prepara-
tions (Raga). * His food and drink should be fragrant
and well flavoured Iwith ingredient not incompatible
with the nature of the disease. 9-10.
The practice of regular physical exercise, wrestling,
active sports, riding on a horse or an elephant, long
walks, pedestrial journeys, practising archery, casting
of javelines, etc., should be resorted to in a case where
the disease has made a decided advance. 11.
A poor and friendless patient should live on alms,
lead a life of perfect continence like an ascetic, forego
the use of shoes and umbrella and walk a hundred
Yojanasf or more on foot without staying for more than
one night at a single village. A rich man (suffering
from Prameha) should live on S'ydmaka, Kapittha,
Tinduka and As'mantaka and live among the deer.
He should constantly follow the tracks of cows and take
their dung and urine (for food and drink). A Brahman
patient should live on the grain, spontaneously fallen
from plants, constantly study the Vedas and draw
* Some read "liT#:" i e. potherb ( of mustard ) in place of t A Yojana is ecjual to eight miles.
373 TttE SUSHRUTA SAMHITA. CChap. XI,
chariots occupied by Brahmanas. * A patient belong-
ing to the lower orders of society i^Sudras, etc.) should be
made to sink wells (under such circumstances) and the
strength of a weak or emaciated patient should be pre-
served vwith nutritive diets, etc.). 12.
IVIemorable Verse :— A poor patient, carefully
following these directions of his medical advisers
without the least demur or delay, should be able to get
rid of the disease (Prameha) in the course of a year or
even in less than that time. 13.
Thus ends the eleventh Chapter of the Chikitsifa Sthanam in the Sus'ruta Samhita which deals with the medical treatment of Prameha,
* Some explain the phrase "^HT^q^^Urf" to mean that he should retain in his memory (the teachings of) the Vedas.. —Dallana.
