Rog'a : — The affected part should be rubbed with powdered salts* in a case of Sarva-sara Mukha-roga (invading the entire cavity of the mouth) due to the aggravated Vaiya. Oil cooked with the (decoction and the pastes of) Vayu-subduing drugs (such as, the Bhadra- darvddi group, etc.) and used as errhines (Nasya) and gurgles (Kavala) is efficacious in this disease. After the application of this oil, the patient should be treated with the Snaihika form of fumigation (Dhuma) in the follow- ing manner. Juntuka leaves smeared with honey should be plastered with a compound of the Sdra of S'dla, Piydla and castor wood, the marrow of In^udi and Madhuka, Guggulu, Dhydmaka CGandhatrina), Mdmsi, Kdldnu-sdrivd^ S'ri (Lavanga), Sarja-rasa, S'dileya and wax pounded together and mixed with an adequate quantity of clarified butter or oil. It should then be burnt, and the patient made to inhale the fumes. This medicinal fumigation (Dhuma) proves remedial in the disease. It destroys the deranged Va(yu and Kapha, and proves curative in all affections of the mouth. In the Pittaja type of the Sarva sara Mukha-roga, all the morbific principles (Doshas) should be eliminated from the patient^s body (with emetics and purgatives),
* Dallana and Nis'chala explain the term "^^'^^igf^*/' as the powders of the five officinal kinds of salt. S'iva-dasa, however, holds that powdered Saindhava salt only should bs used. Vrinda reads *' ^^^j^ :" and the commentator S'ri-kantha Datta explains it to mean either the powders of '^^f^qj]'', i.^., Jyotishmati or those of '%^f!j", i.e., the five officinal kinds qf salt.— Ed,
Chtp. XXII.] CHIKITSA STHANAM. 473
and all kinds of- sweet, soothing and Pitta-subduing
drugs should be administered. Medicated gurgles
(Gandusha), fumigation (Dhuma), Pratisdrana (rubbings)
and purifying (S'odhana) measures as well as the
Kapha-subduing remedies should be employed in the
Kaphaja type of the Sarva-sara-Mukha-roga, and the
patient should be made to take one Dharana measure
(Twenty-four Ratis) of powdered Ati-vishd, Pdihd,
Musta, Devaddru, Katuka and Kutaja seeds, with an
adequate quantity of cow's urine. This medicine acts
as a potent remedy for all the Kaphaja disorders of the
body. Gurgles (Kavala) with milk, sugarcane juice,
cow's urine, curd-cream, Kdnjika, oil, or clarified
butter (Sneha) should be prescribed according to the
nature of the aggravated Doshas involved in each case
(of the Sarva-sara-Mukha-roga). We have described
above the medical treatment of the affections of mouth
which yield to medical remedies. 43-45.
incurable Types : — Now we shall enumerate
the different incurable types of mouth-diseases. Of
the types of Oshtha-p^ka, those due to the vitiated
condition of the flesh, or of blood, and those due
to the concerted action of the aggravated Doshas
(Sannipdta) should be deemed as incurable. Of the
diseases peculiar to the roots of the teeth, the affections
known as the Sdnnipjitika Danta-ns^di (Sinus in the
gums) and the Sdnnip^tika ^aushira (Mah^-Saushira)
should be also deemed as incurable. Of the affec-
tions of the teeth, those known as the Syi^va-dantaka,
Ds^lana and Bhanjana, and of the diseases which
restrict themselves to the tongue, the one known as the
Alstsa should be looked upon as incurable. Similarly,
of the affections of the palate, the Arvuda should be
deemed as incurable. Of those of the throat, the Svara-
474 THE SUSHRUTA SAMHITA. [Chap. XXII
ghna, Valaya, Brinda, Bals^sa, Bid^riks^, Galaugha,
Miimsa-tsina, Sataghni and Rohini should be regarded
as beyond the pale of medicine. The nineteen kinds of
the disease mentioned above are incurable, and the
medical treatment of these diseases should be taken in
hand without holding out any definite hope of
recovery. 46—49.
Thus ends the Twenty-second Chapter of the Chikitsita-Sthdnam in the I Sui'ruU Samhit^ which deals with the medical treatment of the diseases of the mouth.
CHAPTER XXm.
Now we shall discourse on the (symptoms and) medical treatment of swellings (Sopha). i.
The six kinds of swelling (Sopha) appearing in the particular parts of the body have already been described* with the variations in their symptoms and the medical treatment to be pursued in each case. But the swelling known as the Sarva-sara bopha (general Anasarca) may be divided into five subheads. They are as follows, namely, the Vs^taja, Pittaja, Kapahja San- nip^itaja and Vishaja {t.e., the one due to the introduc- tion of any extraneous poison into the system). 2.
Their causes :— The Doshas (morbific prin-
ciples) become aggravated and give rise to swellings
(Sopha) of the body, by such causes, as by undertaking
a journey immediately after a meal, or by the use of
Harita-sdkas (potherbs\ cakes and salts in inordinate
quantities, or by the excessive use of acids by weak
and emaciated persons, or by the use of clay, baked or
unbaked, of lime-stones, or of the flesh of aquatic
animals, or of those frequenting swampy places, exces-
sive sexual intercourse, use of fares consisting of incom-
patible articles and lastly by the joltings when riding
on elephants, horses, camels, in vehicles, etc., or on
persons on the part of dyspeptic patients. 3.
Specific Symptoms :— A swelling (^opha)
of the Va^tajsi type is vermilion or black-coloured and
is attended with softness and a pricking pain in the •
swelling which disappears at intervals. A swelling of
the Pittaja type assumes a blood-red or yellow colour,
swiftly expands and is attended with a burning and
* See Stttca-sthJim, Cbaptei XVIL
4^6 THE SUSHRUTA SAMHITA. tChap. XXIII.
drawing pain (Chosha). A swelling of the Kaphaja
type assumes a white or greyish colour, becomes hard,
cold to the touch and glossy, is slow in its growth, and
is attended with itching, pain, etc. A swelling of the
Sstnnipsitika type (due to the concerted action of all the
three Doshas of the body) exhibits all the symptoms
which specifically belong to each of the three above-
said types. 4-7.
Symptoms of Vishaja-^opha : -A
swelling (Sopha) which results from the contact or
introduction of a (weakened) chemical poison (Gara) with
or into the body, or from the use of polluted water,
or by bathing in a foul and stagnant pool or tank, or by
dusting the body with the powders of substances
poisoned by any poisonous animal, or from the contact
with weeds and plants, which have become poisoned
by the urine, fcecal matter, or semen of poisonous
animals, is called a Vishaja swelling. The swelling
is soft, pendent and persistent, expands rapidly and
moves gradually (from one part of the body to the
other) and is attended with a burning sensation and
suppuration. 8.
Memorable Verse : —The aggravated Doshas of the body confined in the stomach (Amdsaya) give rise to a swelling in the upper part of the body. Confined in the intestines (Pakvasaya), they give rise to a swelling in the middle part of the body. If they are confined in the receptacle of the foeces (Malasaya), the lower part of the body becomes swollen. The swelling extends all over the body in the event of their (Doshas) being diffused throughout the organism. 9.
Prognosis : — An oedematous swdling (Sopha)
occurring in the middle part (trunk) of the body or
extending all over it may be cured with difficulty as
Chap. XXIIL] CHIKITSA STHANAM. 477
well as the one which first occurs at either (the upper or
lower) half of the body and tends to extend upward.
A case of swelling attended with dyspnoea, thirst,
weakness, fever, vomiting, hiccough, dysentery, colic
(S'ula), and a want of relish for food is extremely hard
to cure and soon proves fatal. lo-ii.
We shall now proceed to describe their general and specific remedies. The use of acids, salts, milk, curd, treacle, lard, water, oil, clarified butter, cakes and all kinds of heavy (in digestion) edibles should be refrained from in all the types of oedema (S'opha). 12-13.
The Special Treatment of ^opha :—
Traivrita (Ghrita) or castor oil should be administered
for a month or a fortnight to the patient suffering from
the Vsitaja type of oedema (Sopha). Clarified butter
cooked with the decoction of the drugs of the Nydgfo-
dhddi and the Aragvadhddi groups should be respec-
tively prescribed in the Pittaja and Kaphaja types.
In the Sannipattaja type, the patient should be made
to drink a potion of clarified butter cooked
with a Pdtra* measure of the milky exudation of the
Snuhi plant and twelve Pitra measures of fermented
rice gruel (Kdnjika) with an adequate quantity of
Danti as a Kalka. The remedy in regard to a swelling
due to the action of poison (Vishaja) imbibed into the
system will be duly described in the Kalpa Sthdnam. 14.
The general remedies:— Now we shall
describe the general remedies (which are applicable in
cases of Sotha). Any of the four Ghritas ending with
the Tilvaka Ghrita which have already been mentioned
under the treatment of Udara would prove remedial
in a case of S'vayathu (CEdematous Swelling). The
use of (the officinal) urine and the applications of the
* A Piitra measure is equal to eight seers
4/8 THE SUSHRUTA SAMHITA. CChap. XIII
(medicated) Vartis are likewise recommended. The
patient should be made to take every day the
medicine known as the Nava^yasa* through the
medium of honey. He should be made to take a
Dharana weight of the compound of powdered
Vidanga, Ativishd, Kutaja-(tu\t, Bhadra-ddru, Ndgara
and Markka in tepid water. Trikatu, Yava-kshdra
and powdered iron should be mixed together and
administered through the medium of the decoction
of Triphald ; or, cow's milk and cow^s urine, in
equal proportions should b2 taken. As an alternative,
treacle and Haritaki mixed in equal proportions should
be administered. Deva-ddru and S'unthi\ may be given ;
or Guggulu* dissolved in cow^s urine or in the
decoction of Varshdhhu. Equal parts of treacle
and S^ringavera § may as well be prescribed ; or the
roots of the Varshdbhu pasted with the decoction of the
same drug and mixed .vith powdered S'unthi dissolved
in milk should be given to the patient every day for a
month. He should take Mudga pulse fried with the
clarified butter prepared by cooking it with the decoc-
tion of Trikatu and Varshdbhu. Milk boiled with
Pippali, Pippali-roots^ Chavya^ Chitraka^ Mayura (Apd-
mirga) and Varshdbhu, or with Sunthi and Surangi-
roots, or with Trikatu, Eranda-roots and Sydrnd-rootSj
or with Varshdbhu, S'unthi, Sahd and Deva-ddru
should be given to the patient. A paste of Aldvu and
• See Chapter XXII, para. lo, Chikitsita*sthdnam.
t Some commentators explain that the compound of Deva*d4ru and S'unthi also should be taken ihrough the medium of cow's urine or the decoction of Varshdbhu.
X According to Ohakradatta's reading, Deva-daru, S'unfhi and Guggulu should be taken together with cow's urine.
5 The S'iringavera in this compound may be either fresh oi dried.— Ed.
chap. XXIII ] CHIKITSA STHANAM. 4/9
Vibhitaka dissolved in the washings of rice, should likewise be administered. 15.
The diet of the patient should consist of cooked
barley or wheat saturated with the unsalted soup of
-Mudga pulse, cooked with Yava-kshdra, Pippali,
Maricha. and S^ringavem, and prepared with only a
small quantity of oil or clarified butter. A decoction
of Vrikshaka, Arka, Naktatndla^ Nimba and Varshdhhu
should be used in effusing (Parish eka) the affected part.
It should be plastered with a compound consisting of
Sarshapa^ Suvarchald^ Saindhava and S^drngashtd,
pasted together. Strong purgatives, Asthdpana
measures and applications of Sneha, Sveda and
IJpansnia should be constantly employed according to
the nature and instensity of the aggravated Doshas
involved in the case. In a case of Sotha, other than
what is the outcome or supervening symptom (Upadrava)
of any other disease, the patient should be frequently
bled by opening a vein of the locality. 16.
Memorable Verse :— A patient wishing to
get rid of an attack of Sopha (oedematous swelling) should refrain from taking all sorts of cakes, acid sub- stances, liquor, clay, salts, oil, clarified butter,* water, heavy and indigestible articles of food, sleep in the day time, the flesh of animals other than that of the animals of the Jdngala group and from visiting the bed of any woman. 17.
Thus ends the Twenty-third Chapter in the Chikitsita Sthinam of the Suslruta Samhitil which deals with the medical treatment of S'opha.
* Some read «' ^^," «•<?•. treacle in place of " ^TW," ''^m clarified hutter. This reading seems to be the correct one, inasmuch as it is supported by all other authoritative works on Ayurveda. — Ed,
CHAPTEE XXIV.
Now we shall discourse on the rules of hygiene and the prophilactic measures in general (Atlctg^at^*-
vstdha-Prati-shedhaniya). i.
Metrical Texts :— Now we shall describe the
rules of conduct to be daily observed by an intelligent
man (after leaving his bed) seeking perfect health and a
sound body. 2.
Tooth-brushing :— A man should leave his
bed early in the morning and brush his teeth. The
tooth-brush (Danta-Kishtha) should be made of a
fresh twig of a tree or a plant grown on a commendable
tract and it should be straight, not worm-eaten, devoid
of any knot or at most with one knot only (on one side),
and should be twelve fingers in length and like the
small finger in girth. The potency and taste of the
twig (tooth-brush) should be determined by or vary
according to the season of the year and the preponder-
ance of any particular Dosha in the physical tempera-
ment of its user.* The twig of a plant possessed of any
of the four tastes as sweet, bitter, astringent and pungent
should be alone collected and used. Nimha is the
best of all the bitter trees ; Khadira of the astringent
ones ; Madhuka of the sweet ; and Karanja of the
pungent ones. 3
