An English Translation of the Sushruta Samhita (Bhishagratna ed.)

* Here a line is not found in the printed edition of the Sus'ruta Samhitd, which is evident from Dallana's commentary and supported by S'rikantha Datta in his commentary on Vrinda. The line is as follows : —

650 THE SUSHRUTA SAMHITA. [Chap. XXXIX.

articles of sweet and bitter tastes. Dry (Ruksha) and
demulcent food should be enjoined in succession in the
course of a meal. The meals of a healthy person should
then be prescribed. 12.

Light diet should be given for a week after the
internal use of a Sneha and after the exhibition of
emetics. A patient should observe a proper regimen
of recoupment of his health, after having been subjected
to a course of blood letting or treated with a course of
S'odhana remedy (purgative). Intervals of three days
should be allowed between two successive applications
of a Vasti and the period of the third interval thus
allowed, should be determined according to the require-
ments of each case.* 13.

A patient suffering from an ulcer (Vrana) or recently
treated with emulsive measures (Sneha-karma) or cleans-
ing (emetics or purgatives) measures, or afflicted with
any affection of the eyes or with fever attended with
dysentery (Jvaratisara) resembles a vessel of unbaked
clay fitted with oil, i.e.^ such a patient is greatly liable
to the derangement of the Doshas. 14.

An irascible mood or fit of anger (in such a person)
agitates his Pitta and produces Pitta origined distem-
pers jf physical labour and grief cause a distracted
state of the mind ; and gratification of sexual desires
(in such a state) brings on such dangerous diseases as
convulsions, epileptic fits, paralysis, aching pain in the
limbs, swelling about the anus, cough, hiccup and

* Some commentators explain this verse to mean that the patient should observe the rules of diet and conduct (prescribed hereafter) for a period of three days after each application of a Vasti, but after the third application the rules of diet and conduct should be determined according to requirements.

t The Pitta-origined distempers are thirst, burning sensation, etc.

Chap. XXXIX.J CHIKITSA STHANAM. 6$!

emission of blood-streaked semen and haemorrhage from the vagina. 15- A.

Day-sleep under the circumstances, gives rise to the
affections of the deranged Kapha, viz., enlargement of
the spleen (Plihodara), catarrh, jaundice, edema, fever,
loss of consciousness, a sense of physical langour, in-
digestion, an aversion to food, and causes the patient to
become overwhelmed with the quality of Tamas which
produces in him a desire for sleep. 15-B.

Talking in a loud voice aggravates the Vdyu and is attended with such grave consequences as pain in the head, blindness, inertness, loss of the faculty of smell, dumbness, deafness, dislocation of the jaw-bones (Hanu- moksha), Adhi-mantha, facial paralysis, paralysis of the eye-balls (Netra-stambha), thirst, cough, insomnia, shak- ing of the teeth and similar other distempers (due to an aggravation of the Vdyu). 15C.

Riding (on horse-back, etc.) under the circumstances may cause vomitings, swoons, vertigo, a sense of fatigue, stiffness of limbs, and the serious functional derangements of the sense organs. A long continuance in a sitting posture or bathing may give rise to pain in the region of the pelvis ; while, on the contrary, excess- ive walking under the circumstances aggravates the Vayu and is attended with pain in the knee-joints, atro- phy of the thighs, edematous swellings of the localities, or the form of disease known as Pdda-harsha (sensitive- ness in the feet). 1 5-D.

The use of cold water and other cold things* (such as
paste of Sandal, etc.) under the circumstances tends to
aggravate the bodily Vayu and brings on an aching

* In place of "^cIWt<l<ll<<i'Tt" Gayadasa reads] "^cn^^T^t^TTTf' which means the use of cold food an^ drink. This jreading seems to ^e |jetter.— ^^.

652 THE SUSHRUTA SAMHITA. [Chap. XXXIX.

pain in the limbs, Sula (gastralgia), stuffedness of the
injested food in the stomach (Vishtambha) and infla-
tion of the abdomen (Adhmana) and shivering. An
undue exposure to the sun and wind produces fever
and discoloration of the complexion. The use of any-
unwholesome and incompatible diet as well as food taken
before the complete digestion of the previous meal
tends to produce serious distempers and may ulti-
mately result in death. The use of incongenial fare
undoubtedly leads to the deterioration of the strength
and complexion of the body. A man of irregular and
" intemperate habits, who eats voraciously like an animal,
suffers from indigestion which is the cause (source)
of a number of physical distempers. 15.

In all these instances the real cause of the distress
should be first ascertained, which should be then remedied
with proper antidotal measures and remedies. 16.

Articles of Diet:— A diet consisting of
cooked Shashti grain (Tandula) or matured S'dli rice,
Mudga pulse as well as (the soup of the flesh of; an
Ena, Ldva, hare, peacock, Tittiri, or deer, and such
other light food should be given to a patient after the
exhibition of emetics and purgatives. 17.

Thus' ends the Thirty-ninth Chapter of the Chikitsita Sthanam in the Sus'ruta Samhitd which deals with the treatment of distressing symptoms which are manifested in a patient.

CHAPTER XL.

Now we shall discourse on the treatment which
consists in employing the (inhalation of) medicated
fumes, snuffs, (errhines) and gargles (DhUITia-

Nasya-Kavala-Graha-Chikitsita). i.

Dhuma (fumes) may be divided into five groups*
viz., Prayogika (capable of being daily used), Snehana
(soothing), Vairechana (expectorant),*}* Kasaghna (anti-
cough) and Vamaniya (emetic). 2.

Materials of different Dhuma-varti :

— The drugs of the Elddi group, excepting Kushtha and TagarUy should be pasted together. A space of eight fingers out of the entire length of a stem of S'ara weed twelve fingers long should be covered- with a piece of silk cloth and plastered with the coat of the preced- ing paste. This stick should be burnt and used in the Prs^yogika Dhuma pdna. The pith (pulp) of oleaginous fruits, wax and resin, Guggulu, etc., with the admix- ture of a Sneha (oil or clarified butter; should be used in the Snehana-Dhuma. The drugs included into Siro- Virechana group should be used in Vairechana Dhuma. Vrihati, Kanta-kdrikct, Trikatu, Kasa-marda, Hingu, lngudi'bark,\ Manah-s'ild, Guduchi, and Karkata-s* ringi and such other drugs which allay cough should be used in the Katsaghna-Dhuma. Nerves, skin, horns, hoops, shells of a crab, dried fish, dry meat or worms, etc., and

* Charaka, however, divides Dhuma into three classes only—t^zz,, Prayogika, Snaihika and Vairechanaka, and includes the Kasa-hara into the Prayogika, and Vdmaniya into the Vairechana Dhuma.

t The term Vairechana here means S'iro-Virechana by means of fumes.

% Some commentators mean to explain "f^^t^^" as Ingudi and cardamom instead of as Ingudi-bark. This seems to be bettef,

654 THE SUSHRUTA SAMHITA. [Chap. XL.

such other emetic drugs should be used in the Vima- niya-Dhuma. 3.

Formation of the pipe used in

Dhuma-Pana :— The pipe to be used in respect of an inhaler should ba made of one or other of the same substances* of which the pipes of enema-syringes (Vasti-Netra) are made. The girth of such a pipe should be equal to that of the small finger at its mouth with an inner aperture or calibre as large as a Kaldya pulse, and its girth at the root or base should be equal to that of the thumb, while the girth of the inner apertureor near (at the root) should be sufficiently large to allow the Dhuma-Varti (made of S'ara weed) to fit in. The length of the pipe should be forty-eight fingers*!* in respect of a Prdyogika, thirty-two fingers in respect of a Snehana, twenty-four fingers in respect of a Vairechana, sixteen fingers in respect of a Kdsaghna (anti-cough) and Vamaniya (emetic) Dhuma. The girth of the aperture (channel) should be equal to that of a stone of the Kola fruit in respect of the tube to be used in the last two cases (Kasaghna and Vdmaniya), The tube to be employed in fumigating an ulcer should be eight fingers in length and equal to a Kaldya pulse in outer girth, while the girth of the inner orifice should be sufficient to allow a Kulattha pulse to pass in. 4. The medicinal stick (Varti) should be lubricated

* See Chapter XXXV, Para. 7, Chikitsita Sthana.

t Charaka's description of the pipes, (Chapter V, S'lokasthana) cor- responds closely to that of Sus'ruta, except in the case of Prdyogika pipe, where Charaka's reading is somewhat ambiguous. There it may be construed to mean thirty-six as well as forty-eight fingers. Jatu-karna, however, explicitly asserts forty-eight fingers to be the length of the pipe in question. Vrinda is in a fix, and solves the difficulties by explaining that in cases of an aggravation of Kapha and an abundance of Doshas, the length of the pipe should be thirty-six fingers.

Chap. XL] CHIKITSA STHANAM. 655

with a Sneha (clarified butter, etc). It should then be
attached to one end of the pipe (Netra) and lighted.
The patient should sit in an easy and comfortable
posture, maintain a cheerful frame of mind and carefully
inhale the medicinal fumes with his eyes cast down
straight towards the ground. 5.

Metrical Texts :— The fumes should be first
inhaled through the mouth and then through the nostrils;
whether inhaled through the mouth or the nostrils they
should be invariably exhaled through the mouth. In-
haled through the mouth, they should not by any means
be exhaled through the nostrils, as such a course (of
exhaling through the nostrils) would act wrongly and
impair the eye-sight. 6.

The fumes (Dhuma) should be specially inhaled
through the nostrils, in connection with a Praiyogika
inhalation, while they may be inhaled both through the
mouth and the nostrils in Snehana-Dhuma. They
should be inhaled through the nostrils alone in an act
of Vairechana inhalation and through the mouth only in
the two remaining cases (Vaiinaniya and Kaphaghna). 7.

Mode of inhalation :— In an act of Pra'yo-

gika inhalation, the stick (Varti) should be dried in shady places protected from the wind. The stem of the S'ara weed inside the Varti should then be removed. The Varti should then be lighted with a live charcoal and fixed to the end of the pipe (Netra) and then the patient should be asked to inhale the fumes. The same method should be followed in respect of Snehana and Vairechana ones. In the other cases of smoking (Ka^saghna and Va^maniya) the fumigating drugs (Varti) should be placed over a bed of smokeless burning charcoal contained in an earthen saucer. Another saucer furnished with an aperture at its top or middle should be fitted over the former saucer

656 THE SUSHRUTA SAMHiTA. [Chap. XL.

and the inhaling pipe should be fitted into this aperture, and the fumes should be inhaled (through the mouth). On the subsidence of the fumes the remaining portion of the stick should be cast into the fire and the patient should continue to inhale the fumes till the complete elimina- tion of the aggravated Doshas from his organism. This is the rule and means of inhalation (Dhuma-pana). 8.

Prohibitive Cases : — Any kind of smok- ing (Dhuma-pana) is forbidden to a person afflicted with anger, fear, bereavement, fatigue, and in a heated state of the boJy and after fasting. It is also forbidden in cases of poisoning, haemorrhage (Rakta-pitta), alcoholism, swooning, burning sensation of the body, thirst, jaundice, dryness of the palate, vomiting, head- disease, eructation, Timira, urinary complaints (Pra- meha), abdominal enlargement with dropsy (Udara), inflation of the abdomen and Urddha-vata, and in respect of infants, old and enfeebled persons, as well as of those treated with purgatives and Asthdpana-vasti. It is also forbidden to enciente women, those suffering from in- somnia or a parched condition of the body as well as to those suffering from any kind of cachexia or from Urah kshata. An act of inhaling (smoke) is also pro- hibited after taking a potion of honey, clarified butter, curd, and milk, fish, wine or gruel (Yavagu) as well as during the continuance of a small quantity of Kapha in the organism. 9.

Metrical Text :— Medicated fumes inhaled in
an improper season {viz.^ in the above-mentioned prohi-
bited cases) bring on vertigo, fainting fits, diseases of the
head and serious injury to the eyes, ears, nose and the
tongue. 10.

Time of Smoking :— The first three kinds of inhalations should be resorted to at the close of the

Chap. XL.] CHIKITSA STHANAM. 657

following twelve physical functions and acts, viz.
sneezing, cleansing the teeth, snuffing, bathing, eating,
sleeping in the day, coition, vomiting, micturition,
passing stools, fits of anger and surgical operations.
A Snehana-Dhuma should be smoked after sneezing,
micturition, passing stools, coition or after a fit of
anger. Similarly, a Vairechana-Dhuma should be
smoked after bathing, vomiting and sleeping in the day
time, while a Praiyogika-Dhuma should be smoked
after cleansing the teeth, snuffing, bathing, eating and
after a surgical operation. 11.

The therapeutic effects of Dhuma-
pctna : —Smoking the Snehana-Dhuma subdues the
deranged and aggravated Vdyu of the body owing to
the existence of the Sneha with which it is charged,
as well as to a consequent sticky coating being
deposited in the organism. The Vairechana-Dhuma
facilitates the loosening and flowing out of the mucus
(Kapha) owing to its dryness, non-viscidness (Vais'adya),
keenness and heat-making potency. While the
Pra^yogika-Dhuma tends to loosen the accumulation of
mucus (Kapha) and helps its expulsion from the system
by virtue of its being possessed of common therapeutic
properties with both of the two preceding kinds (of
Dhuma). 12.

Memorable Verse : -Inhalation of (medi-
cated) fumes removes the cloudening of the faculties of
the organs of sense-perception and imparts distinctness
of the speech and firmness to the teeth, hair of the head
and to beard. It cleanses the mouth and fills it with
an aroma. 13.

The inhalation of medicated fumes guards against an
attack of cough, asthma, an aversion to food and clumsy
sensation in the mouth, hoarseness, excessive salivation