The twenty first chapter of Uttaratantra of Sushruta Samhita is called as Karṇaroga Pratişedha Adhyaya. This chapter offers with the Therapy of Illnesses of the Ear.

अथातः कर्णगतरोगप्रतिषेधं व्याख्यास्यामः ।। ।।
यथोवाच भगवान् धन्वन्तरिः ।। ।। 

We’ll now expound Karnaroga pratişedha- remedy of illnesses of the ear; as revealed by the venerable Dhañvañtari.

Samanya cikitsä- normal remedy

सामान्यं कर्णरोगेषु घृतपानं रसायनम् ।।
अव्यायामोऽशिरः स्नानं ब्रह्मचर्यमकत्थनम् ।। ।।

Under talked about are the overall therapies for ear illnesses –

        Ingesting ghee / medicated ghee,

        Rasayana,

        Avoidance of bodily workouts and head bathtub,

        Sustaining celibacy and

        Not talking an excessive amount of

Vataja Karnasuladi cikitsa

कर्णशूले प्रणादे बाधिर्यक्ष्वेडयोरपि ।।
चतुर्णामपि रोगाणां सामान्यं भेषजं विदुः ||४||
स्निग्धं वातहरैः स्वेदैर्नरं स्नेहविरेचितम् |
नाडीस्वेदैरुपचरेत्पिण्डस्वेदैस्तथैव च ||५||

The remedy is identical for the beneath talked about 4 illnesses –

        Karnasula,

        Pranada,

        Badhirya and

        Karnaksveda

The affected person ought to firstly be administered with oily purgatives. Following this sudation must be given. It must be administered with vata mitigating herbs by both nadi sweda or pinda sweda strategies.

बिल्वैरण्डार्कवर्षाभूदधित्थोन्मत्तशिग्रुभिः |
बस्तगन्धाश्वगन्धाभ्यां तर्कारीयववेणुभिः ||६||
आरनालशृतैरेभिर्नाडीस्वेदः प्रयोजितः |
कफवातसमुत्थानं कर्णशूलं निरस्यति ||७||

Under talked about herbs are boiled in Aranala –

        Bilva,

        Eranda,

        Arka,

        Varsabhu,

        Dadhittha,

        Unmattha,

        Sigru,

        Bastagandha,

        Ashvagandha,

        Tarkari and

        Yavavenu

The fumes emanating from this are led by means of a pipe.

This Nadisveda relieves Karnasula – earache produced by aggravated kapha and vata.

मीनकुक्कुटलावानां मांसजैः पयसाऽपि वा |
पिण्डैः स्वेदं च कुर्वीत कर्णशूलनिवारणम् ||८||

Pinda sweda executed utilizing one of many blow talked about issues added with milk would relieve ear ache –

        Flesh of fish,

        Flesh of cock or

        Flesh of lava chook

अश्वत्थपत्रखल्लं वा विधाय बहुपत्रकम् |
तदङ्गारैः सुसम्पूर्णं निदध्याच्छ्रवणोपरि ||९||
यत्तैलं च्यवते तस्मात् खल्लादङ्गारतापितात् |
तत् प्राप्तं श्रवणस्रोतः सद्यो गृह्णाति वेदनाम् ||१०||

Leaves of Asvattha or Bahupatraka are heated on burning coal. The leaves are later stored on the ears, when they’re heat sufficient for the ear to tolerate.

Additionally, oil must be expressed from these cooked leaves. This oil must be put into the ear. This oil instantly subsides the ear ache.

क्षौमगुग्गुल्वगुरुभिः सघृतैर्धूपयेच्च तम् |
भक्तोपरि हितं सर्पिर्बस्तिकर्म च पूजितम् ||११||

Kshauma, Guggulu and Aguru must be burnt in fireplace together with ghee. Ear must be uncovered to the smoke coming from them.

Additionally, ingesting ghee and enema after meals is extremely praised.

निरन्नो निशि तत्सर्पिः पीत्वोपरि पिबेत् पयः |
मूर्धबस्तिषु नस्ये च मस्तिष्के परिषेचने ||१२||
शतपाकं बलातैलं प्रशस्तं चापि भोजने |

Ghee must be consumed by the affected person on an empty abdomen at evening. After this, he must drink milk.

Satapaka Bala Taila is alleged to be greatest for utilization and must be used within the beneath talked about varieties –

        Sirobasti,

        Nasya,

        Mastiska Parisecana (pouring medicated liquids on the top) and

        Together with meals

कण्टकारीमजाक्षीरे पक्त्वा क्षीरेण तेन च ||१३||
विपचेत् कुक्कुटवसां कर्णयोस्तत्प्रपूरणम् |

Kantakari must be cooked in goat’s milk and muscle fats of cock boiled on this milk i.e. goat’s milk. That is used for ear-filling.

तण्डुलीयकमूलानि फलमङ्कोलजं तथा ||१४||
अहिंस्राकेन्दुकान्मूलं सरलं देवदारु च |
लशुनं शृङ्गवेरं च तथा वंशावलेखनम् ||१५||
कल्कैरेषां तम्लैश्च पचेत् स्नेहं चतुर्विधम् ।। 
वेदनायाः प्रशान्त्यर्थं हितं तत्कर्णपूरणम् ।।१६।

Decoction and paste of the beneath talked about are ready –

        Roots of Tanduliyaka,

        Fruits of Ankola,

        Roots of Ahimsra and Kenduka,

        Sarala,

        Devadaru,

        Lasuna,

        Srngavera and

        Bark of Vamsa

Then, it’s added with bitter issues (fermented gruels) and all 4 varieties of fat i.e. oil, ghee, muscle fats and bone marrow. They’re all cooked collectively and medicated fats must be ready. This must be stuffed into the ear for reduction of ache.

लशुनार्द्रकशिग्रूणां मुरङ्गया मूलकस्य ।।
कदल्याः स्वरसः श्रेष्ठः कदुष्णः कर्णपूरणे ।। १७
शृङ्गवेररसः क्षौद्रं सैन्धवं तैलमेव ।।
कदुष्णं कर्णयोर्देयमेतद्वा वेदनापहम् ।।१८।।

Contemporary juice of the beneath talked about elements must be made lukewarm and stuffed within the ear –

        Lasuna,

        Ardraka,

        Sigru,

        Murangi,

        Mulaka and

        Kadali

Under talked about elements must be made lukewarm and instilled into the ear relieves ache –

        Juice of Srngavera,

        Honey,

        Saindhava Lavana and

        Oil

वंशावलेखनायुक्ते मूत्रे चाजाविके भिषक् ।।
सर्पिः पचेत्तेन कर्णं पूरयेत् कर्णशूलिनः ।।१९।।

Under talked about elements are cooked collectively –

        Urine of goat or sheep

        Bark of Vamsa and

        Ghee

This ghee shall be used for filling within the ear by the doctor to remedy ear ache.

Dīpikā taila

महतः पञ्चमूलस्य काण्डमष्टादशाङ्गुलम् ।।
क्षौमेणावेष्ट्य संसिच्य तैलेनादीपयेत्ततः ।।२०।।
यत्तैलं च्यवते तेभ्यो घृतेभ्यो भाजनोपरि ।।
ज्ञेयं तद्दीपिकातैलं सद्यो गृह्णाति वेदनाम् ।।२१।।
कुर्यादेवं भद्रकाष्ठे कुष्ठे काष्ठे सारले ।।
मतिमान् दीपिकातैलं कर्णशूलनिबर्हणम् ।। २२।।

Shoots of herbs belonging to Mahat Pancamula must be lower to a size of eighteen angula – 36 cm. They’re wrapped in material, soaked in oil and fireplace is ready. The oil drops coming from burning it are collected in a vessel. This oil is called Dipika Taila. When put into ears, it instantly cures earaches.

Equally, oil must be ready from Bhadrakastha, Kustha and Sarala must be ready by an clever doctor. This oil must be used for curing earache.

अर्काङ्कुरानम्लपिष्टांस्तैलाक्तान् लवणान्वितान् ।।
सन्निदध्यात् स्नुहीकाण्डे कोरिते तच्छदावृते ।।२३।।
पुटपाकक्रमस्विन्नान् पीडयेदारसागमात् ।।
सुखोष्णं तसं कर्णे दापयेच्छूलशान्तये ।।२४।।
कपित्थमातुलुङ्गलशृङ्गरः शुभैः ।।
सुखोष्णी: पूरयेत् कर्णं तच्दूलविनिवृत्तये ।। २५।।
कर्ण कोष्णोन चुक्रेण पूरयेत् कर्मशूलिनः ।।
समुद्रफेनचूर्णेन युक्त्या चाप्यवचूर्णयेत् ।।२६।।

Leaf buds of Arka are taken and added with sesame oil and rock salt. They’re macerated in a bitter liquid and made right into a ball. That is stored inside a hole made within the stem of Snuhi and coated by its bark itself. That is now cooked within the putapaka methodology. It’s later eliminated and the contents are squeezed. The juice thus extracted must be put into the ear, comfortably heat. This cures earache.

Alternatively, juice of the beneath talked about made comfortably heat must be put into the ear –

        Kapittha,

        Matulunga and

        Srngavera

Lukewarm Cukra – vinegar added with powder of Samudraphena must be stuffed within the ear for the remedy of earache.

अष्टानामिह मूत्राणां मूत्रेणान्यतमेन तु ।।
कोष्णेन पूरयेत् कर्णं कर्णशूलोपशान्तये ।। २७।।
मूत्रेष्वप्लेषु वातघ्ने गणे कथिते भिषक् ।।
पचेच्चतुर्विधं स्नेहं पूरणं तच्च कर्णयोः ।। २८ ।।

For reduction of ache, lukewarm urine of any one of many eight sorts of urine talked about in chapter 45 of Sutra Sthana or some other urine shall be made use of (put into the ear for ache reduction).

Herbs belonging to the Vata mitigating group, like Vidarigandhadi Gana must be boiled and processed in urine, any bitter liquid and all 4 sorts of fat – oil, ghee, muscle-fat and bone marrow. This medicated fats must be used for filling into the ears.

Pittaja karna sula cikitsă

एता एव क्रियाः कुर्यात् पित्तघ्नैः पित्तसंयुते ।।
काकोल्यादौ दशक्षीरं तिक्तं चात्र हितं हविः ।। २९ ।।
क्षीरवृक्षप्रवालेषु मधुके चन्दने तथा ।।
कल्कक्काथे परं पक्कं शर्करामधुकैः सरैः ||३० ।।

In pittaja karnasula, the identical strategies defined above shall be executed. Ghee, oil and many others must be ready with pitta mitigating medicine and instilled into the ears for the reduction of ache. Additionally, paste of medicine of Kakolyadi gana must be processed with ten instances (amount) of milk or ghee shall be ready (processed) with paste and decoction of tiktavarga group of medicine and the ready medicines must be used as lukewarm drops into the ears.

Ghee ready with decoction and paste of the beneath talked about is alleged to be useful when used as ear drops –

        Tender leaves of ksiri vrksa,

        Two sorts of Madhuka,

        Two varieties of Candana,

        Sarkara,

        Madhuka and

        Laxative herbs

Kaphaja karnasula cikitsa 

इङ्गुदीसर्षपस्नेहौ सकफे पूरणे हितौ ।।
तिक्तौषधानां यूषाश्च स्वेदाश्च कफनाशनाः ।। ३१ ।।
सुरसादौ कृतं तैलं पञ्चमूले महत्यपि ।।
मातुलुङ्गरसः शुक्तं लशुनाईकयो रसः || ३२ ||
एकैकः पूरणे पथ्यस्तैलं तेष्वपि वा कृतम् ||
तीक्ष्णा मूर्धविरेकाश्च कवलाश्चात्र पूजिताः ।।३३ ।। 

In case of ear ache as a consequence of kapha origin, oil of Ingudi and Sarsapa is alleged to be the perfect for ear filling. Additionally, soup ready from bitter tasting herbs must be given for ingesting and sudation for mitigating kapha also needs to be executed.

Oil must be ready with the beneath talked about elements both individually or all collectively –

        Surasadi Gana group of herbs or

        Mahat / Brhat Pancamula group of herbs,

        Juice of Matulunga,

        Sukta,

        Juice of Lasuna and

        Ardraka

This oil is useful for relieving ache. Sturdy purgatives to the top and mouth gargles are additionally advisable on this situation.

Raktaja karṇaśūla cikitsa 

कर्णशूलविधिः कृत्स्नः पित्तघ्नः शोणितावृते ।। 

In karna sula i.e. ear ache produced by rakta (vitiated blood), therapies indicated for pittaja karna sula must be executed.

Bādhirya cikitsā – remedy of deafness 

शूलप्रणादबाधिर्यक्ष्वेडानां तु प्रकीर्तितम् ।।३४ ।।
सामान्यतो , विशेषेण बाधियें पूरणं शृणु ।।
गवां मूत्रेण बिल्वानि पिष्ट्वा तैलं विपाचयेत् ।। ३५ ।।
सजलं सदुग्धं बाधिर्ये कर्णपूरणम् ।। 

Till now, the overall therapies for Karnasula, Pranada, Badhirya and Karna Ksveda had been described. From right here, the particular therapies for Badhirya shall be described, take heed to the identical.

All of the elements of Bilva tree i.e. roots, bark, leaves and fruits are taken and are macerated in cow’s urine. Oil, water and milk are added to this and processed in order to arrange their medicated oil. This oil shall be put into the ear to remedy deafness.

सितामधुकबिम्बीभिः सिद्धं वाऽऽजे पयस्यपि ।। ३६ ।।
बिम्बीक्काथे विमथ्योष्णं शीतीभूतं तदुद्धृतम् ।।
पुनः पचेद्दशक्षीरं सितामधुकचन्दनैः ।। ३७ ।।
बिल्वाम्बुगाढं तत्तैलं बाधिर्ये कर्णपूरणम् ।।
वक्ष्यते यः प्रतिश्याये विधिः सोऽप्यत्र पूजितः ।।३८ ।।
वातव्याधिषु यश्चोक्तो विधिः हितो भवेत् ।। 

Alternatively, medicated oil is ready with sugar, Madhuka and Bimbi and goat’s milk. That is churned with heat decoction of Bimbi. After the oil cools down, it’s taken out individually and cooked as soon as once more by including ten elements of milk and paste of Sita, Madhuka, Candana and decoction of Bilva. In situations of deafness, this oil must be stuffed into the ear.

On this illness, therapies indicated for Pratisyaya are additionally useful. Equally, the therapies indicated in Vata Vyadhi are additionally useful and therefore must be adopted.

Karna srāvādi cikitsă 

कर्णस्त्रावे पूतिकर्णे तथैव कृमिकर्णके ।। ।।
समानं कर्म कुर्वीत योगान् वैशेषिकानपि ।।
शिरोविरेचनं चैव धूपनं पूरणं तथा ।।४० ।।
प्रमार्जनं धावनं वीक्ष्य वीक्ष्यावचारयेत् ।।
राजवृक्षादितोयेन सुरसादिगणेन वा ।। ४१ ।।
कर्णप्रक्षालनं कार्यं चूर्णैरेषां पूरणम् ।। 

Each normal and particular therapies must be executed in Karnasrava, Putikarna and Krimikarna illnesses.

Contemplating the situation of the dosha, the beneath talked about therapies must be executed –

        Sirovirecana – purgation to the top,

        Dhupana – fumigation to the ear,

        Purana – filling the ear with medicines,

        Pramarjana – washing and

        Dhavana – cleansing

This must be executed utilizing the decoction of herbs belonging to both Rajavrksadi Gana or Surasadi Gana herbs.

Ear filling must be executed utilizing the powders of the identical herbs.

Karna srāva cikitsa 

क्वाथं पञ्चकषायं तु कपित्थरसयोजितम् ।।४२ ।।
कर्णस्त्रावे प्रशंसन्ति पूरणं मधुना सह ।।
सर्जत्वक्चूर्णसंयुक्तः कार्पासीफलजो रसः ।। ४३ ।।
योजितो मधुना वाऽपि कर्णस्त्रावे प्रशस्यते ।।
लाक्षा रसाञ्जनं सर्जश्चूर्णितं कर्णपूरणम् ।।४४ ।।
सशैवलं महावृक्षजम्ब्वाम्रप्रसवायुतम् ।।
कुलीरक्षौद्रमण्डूकीसिद्धं तैलं पूजितम् ।। ४५ ।।

Decoction of 5 herbs is ready as enumerated in forty sixth verse. It’s added with Kapittha juice and honey. This recipe is used for filling the ear in Karna Srava illness.

Recipe ready by combining the beneath talked about elements is used for fillingn the ears in Karna Srava illness –

        Juice of Karpasa fruits,

        Powder of bark of Sarja and

        Honey

Powder of the beneath talked about must be stuffed into the ear –

        Laksa,

        Rasanjana and

        Bark of Sarja

One other recipe – Decoction of Saivala, Mahavrksa, Jambu, Amra pallava (leaf buds of amra) is ready. It’s added with pastes of Kulira (Karkatasrngi), Ksaudra (honey) and Manduki (Madhukaparni). Oil is ready from this and this recipe is taken into account to be the perfect one to be stuffed within the ear.

तिन्दुकान्यभया रोध्रं समङ्गाऽऽमलकं मधु |पूरणं चात्र पथ्यं स्यात्कपित्थरसयोजितम् ||४६||


Decoction must be ready with the beneath talked about elements –

        Tinduka,

        Abhaya,

        Rodhra,

        Samanga and

        Amalaka

This decoction is blended with honey and Kapittha juice.

This preparation is useful for filling into the ear.

रसमाम्रकपित्थानां मधूकधवशालजम् |
पूरणार्थं प्रशंसन्ति तैलं वा तैर्विपाचितम् ||४७||
प्रियङ्गुमधुकाम्बष्ठाधातकीशिलपर्णिभिः |
मञ्जिष्ठालोध्रलाक्षाभिः कपित्थस्य रसेन वा ||४८||
पचेत्तैलं तदास्रावमवगृह्णाति पूरणात् |

Juice of tender leaves of the beneath talked about herbs, both individually or all collectively is used for filling the ears –

        Amyangera,

        Kapittha,

        Madhuka,

        Dhava and

        Sala

It’s praised as a greatest recipe on this situation. Additionally, oil boiled and ready with the identical elements shall be used for ear filling and can also be useful.

Medicated oil is ready with the decoction of beneath talked about elements added with juice of tender leaves of Kapittha –

        Priyangu,

        Madhuka,

        Ambastha,

        Dhataki,

        Manassila,

        Salaparni,

        Manjistha,

        Lodhra and

        Laksa

This oil cures Karna Srava when used for ear filling.

Putikarna Cikitsa

घृतं रसाञ्जनं नार्याः क्षीरेण मधुसंयुतम् ||४९||
तत्प्रशस्तं चिरोत्थेऽपि सास्रावे पूतिकर्णके |
निर्गुण्डीस्वरसस्तैलं सिन्धुर्धूमरजो गुडः ||५०||
पूरणः पूतिकर्णस्य शमनो मधुसंयुतः |५१|

In putikarna with exudation, rasanjana macerated with girl’s milk and added with honey must be stuffed within the ear. It’s stated to be a extremely praised recipe on this situation. It can be utilized in power situations of putikarna.                                                                                                                                                                                                                                                                                                                                                                 

Recipe ready with beneath talked about elements relieves Putikarna when it’s stuffed within the affected ear –

        Contemporary juice of leaves of Nirgundi,

        Tila,

        Saindhava Lavana,

        Powder of dhuma (grha dhuma – kitchen soot),

        Jaggery and

        Honey

Krimikarna cikitsa

कृमिकर्णकनाशार्थं कृमिघ्नं योजयेद्विधिम् ||५१||
वार्ताकुधूमश्च हितः सार्षपस्नेह एव च |५२|

Therapies which might kill the krimis (worms, micro organism, microorganisms and many others) must be administered for the remedy of Krimikarna illness. Under talked about recipes are additionally useful –

        Fumigation to the ear with smoke of Vartaka,

        Filling the ear with Sarsapa Taila

Karna daurgandhya cikitsa

कृमिघ्नं हरितालेन गवां मूत्रयुतेन च ||५२||
गुग्गुलोः कर्णदौर्गन्ध्ये धूपनं श्रेष्ठमुच्यते |
छर्दनं धूमपानं च कवलस्य च धारणम् ||५३||

Therapy rules for Karna Daurgandhya –

        For filling within the ear- the powder of Vidanga and Haritala added with Gomutra must be used.

        Fumigation with smoke of guggulu is taken into account as greatest for karna daurgandhya.

        Other than these, emesis (initiation of vomiting), inhalation of smoke and mouth gargles are additionally to be executed.

Karna Ksveda and Karna Vidradhi Cikitsa

कर्णक्ष्वेडे हितं तैलं सार्षपं चैव पूरणम् |
विद्रधौ चापि कुर्वीत विद्रध्युक्तं चिकित्सितम् ||५४||

In karnaksveda, it’s useful to fill the ears with lukewarm Sarsapa taila.

In karna Vidradhi, therapies prescribed for vidradhi (abscess) must be adopted.

Karnavit Cikitsa

प्रक्लेद्य धीमांस्तैलेन स्वेदेन प्रविलाय्य च |
शोधयेत्कर्णविट्कं तु भिषक् सम्यक् शलाकया ||५५||

The clever doctor ought to lubricate the ear with oil, then give fomentation and take away the ear-wax with the assistance of a rod formed instrument.

Karnakandu cikitsa

नाडीस्वेदोऽथ वमनं धूमो मूर्धविरेचनम् |
विधिश्च कफहृत्सर्वः कर्णकण्डूमपोहति ||५६||

Karna Kandu must be handled with the beneath talked about measures –

        Nadi Sweda – tubular sudation,

        Emesis,

        Medicated smoke inhalation,

        Purgation to the top and

        All types of Kapha mitigating therapies

Karna pratinaha cikitsa

अथ कर्णप्रतीनाहे स्नेहस्वेदौ प्रयोजयेत् |
ततो विरिक्तशिरसः क्रियां प्राप्तां समाचरेत् ||५७||

Ideas of treating Karna Pratinaha – Karna Pratinaha must be handled with the beneath talked about measures –

        Oleation,

        Sudation,

        Purgation to the top

        Different measures and medicines helpful and indicated within the remedy of complications

Karnapaka cikitsa

कर्णपाकस्य भैषज्यं कुर्यात्पित्तविसर्पवत् |

Karnapaka must be handled on the traces of treating Pittaja Visarpa (Chikitsa Sthana, Chapter 17).

Karnakita

कर्णच्छिद्रे वर्तमानं कीटं क्लेदमलादि वा ||५८||
शृङ्गेणापहरेद्धीमानथवाऽपि शलाकया |
शेषाणां तु विकाराणां प्राक् चिकित्सितमीरितम् ||५९||

An clever doctor ought to use both a horn (sucking horn) or rod like instrument to take away the bugs, fluids, wax and many others current within the ear orifices.

The remedy for different ear illnesses has been described earlier within the involved chapters of Cikitsa Sthana part of the treatise.

इति श्रीसुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते शालाक्यतन्त्रे कर्णगतरोगप्रतिषेधो नामैकविंशोऽध्यायः ।।२१।।
Thus ends the twenty-first chapter by title Karnaroga  Pratisedha in Uttara Sthana of Susruta Samhita.