The sixth chapter of Chikitsasthana of Sushruta Samhita is called as Arśas Cikitsitam Adhyaya. This chapter offers with Therapy of Piles / Haemorrhoids.
अथातोऽर्शसांचिकित्सितंव्याख्यास्यामः।।१।।
यथोवाचभगवान्धन्वन्तरिः।।२।|
We’ll now expound Arsas cikitsita – therapy of piles / haemorrhoids; as revealed by the venerable Dhanvantari.
Arśas cikitsopāya – strategies of therapy
चतुर्विधोऽर्शसांसाधनोपायःतद्यथा – भेषजंक्षारोऽग्निःशस्त्रमिति।तत्र,अचिरकालजातान्यल्पदोषलिङ्गोपद्रवाणिभेषजसाध्यानि,मृदुप्रसृतावगाढान्युच्छूितानिक्षारेण,कर्कशस्थिरपृथुकठिनान्यग्निना,तनुमूलान्युच्छ्रितानिक्लेदवन्तिचशस्त्रेण।तत्रभेषजसाध्यानामर्शसामदृश्यानांचभेषजंभवति,क्षाराग्निशस्त्रसाध्यानांतुविधानमुच्यमानमुपधारय।।३।।
Arsas Cikitsopaya – Beneath talked about are the 4 essential strategies of treating piles –
- Bhesaja prayoga – use of medicines
- Ksarakarma – use of caustic alkalies,
- Agnikarma – use of fireplace / branding and
- Sastrakarma – use of sharp devices / surgical procedure
Bheshaja – Piles curable by medicines – Beneath talked about sorts of piles are treatable with medicines –
– these which aren’t power,
– these having gentle aggravation of doshas
– these having gentle signs and
– these having gentle / few problems
Kshara – Piles curable by alkali – Piles must be handled by software / administration of kshara – alkali (alkaline cautery) if they’re –
– tender,
– broad,
– deep seated and
– bulged up
Agni – Piles curable by fireplace – The piles with beneath talked about options qualifies to be handled with fireplace (branding / thermal cautery) –
– tough,
– immovable,
– huge and
– laborious
Shastra – Piles curable by surgical procedure – The piles with the beneath talked about options must be handled with sharp devices (i.e. by surgical procedure) –
– having skinny roots,
– are bulged up and
– exuding fluids
Bheshaja i.e. therapy by administration of medicines alone is enough for the piles –
– that are treatable with medicines and
– these that are invisible
After this, the therapy of piles that are treatable by use of kshara – alkali, agni – fireplace and shastra – sharp devices shall be described. Please hearken to the identical attentively.
Okayșāraprayoga – Alkali cauterisation
तत्रबलवन्तमातुरमर्शोभिरुपद्रुतमुपस्निग्धंपरिस्विन्नमनिलवेदनाभिवृद्धिप्रशमार्थस्निग्धमुष्णमल्पमन्नंद्रवपायंभुक्तवन्तमुपवेश्यसंवृतेशुचौदेशेसाधारणेव्यभ्रेकालेसमेफलकेशय्यायांवाप्रत्यादित्वगुदमन्यस्योत्सङ्गेनिषण्णपूर्वकायमुत्तानंकिञ्चिदुन्नतकटिकंवस्त्रकम्बलकोपविष्टंयन्त्रणशाटकेनपरिक्षिप्तग्रीवासक्थिपरिकर्मिभिःसुपरिगृहीतमस्पन्दनशरीरंकृत्वाततोऽस्मैघृताभ्यक्तगुदायघृताभ्यक्तंयन्त्रमृज्वनुमुखंपायौशनैःशनै : प्रवाहमाणस्यप्रणिधाय,प्रविष्टेचार्शोवीक्ष्य,शलाकयोत्पीड्य,पिचुवस्त्रयोरन्यतरेणप्रमृज्य,क्षारंपातयेत्पातयित्वाचपाणिनायन्त्रद्वारंपिधायवाक्च्छतमात्रमुपेक्षेत,ततःप्रमृज्यक्षारबलंव्याधिबलंचावेक्ष्यपुनरालेपयेत्,अथार्शःपक्वजाम्बवप्रतीकाशमवसन्नमीषन्न-तमभिसमीक्ष्योपावर्तयेत्,क्षारंप्रक्षालयेद्धान्याम्लेनदधिमस्तुशुक्तफलाम्लैर्वा,ततोयष्टीमधुकमिश्रेणसर्पिषानिर्वाप्ययन्त्रमपनीयोत्थाप्यातुरमुष्णोदकोपविष्टंशीताभिरद्भिःपरिषिञ्चेत्,अशीताभिरित्येके,ततोनिर्वातमागारंप्रवेश्याचारिकमादिशेत् ; सावशेषंपुनर्दहेत् ; एवंसप्तरात्रात्सप्तरात्रादेकैकमुपक्रमेत ; तत्रबहुषुपूर्वंदक्षिणंसाधयेत्,दक्षिणाद्वामं,वामात्पृष्ठजं,ततोऽग्रजमिति।।४।।
Snehana and Swedana – Oleation and sedation therapies are first administered to the sturdy affected person affected by piles throughout temperate season. It must be performed on the acceptable time of the day when the sky is obvious (not full of clouds).
Food regimen – The affected person is allowed to eat a small amount of liquid meals which is unctuous and heat in order to mitigate ache attributable to aggravated vata.
Positioning of affected person for therapy – The affected person is now made to lie down together with his face up, on a cot or plank / desk positioned at a coated and clear place such that his anal orifice / rectum faces daylight. His higher a part of the physique must be resting on the desk. His waist must be barely raised by putting fabric pads or blankets beneath his waist. His knees must be folded and stored erect and the thighs tied tightly with binding ropes and held in place by attendants in such a method that the affected person can not make any actions.
Now, the anal opening and anus of the affected person is lubricated with ghee. Arshoyantra i.e. anal speculum can also be smeared with the ghee in order that it’s straightforward for it to be launched into the anus. The instrument is now pushed into the anus slowly, progressively and straight whereas the affected person bears down (straining). After the instrument has entered into the anus, the doctor ought to observe the pile mass and it shall be raised by a rod like instrument. The pile mass is now massaged with sterile cotton swab or fabric (gauze). Following this, Kshara is positioned / utilized on the pile mass.
The doctor ought to hold the mouth (exterior opening) of the arshoyantra (speculum) closed by his hand for a interval of 100 matra kala, after making use of the alkali over the pile mass. One Matra kala is the time required for announcing a vowel.
Afterwards the pile mass is kneaded with a sterile fabric. Following this, kshara is as soon as once more utilized on the pile mass after having thought of the energy of the kshara and the illness.
When to cease making use of the Kshara?
The doctor ought to cease making use of kshara on the pile mass when –
– the pile mass seems bluish black in colour, resembling a ripe fruit of Jambu,
– is uninteresting in look and
– drooping barely
Elimination of Kshara – Subsequent, the kshara is cleansed utilizing one of many beneath talked about issues –
– dhanyamla – fermented gruel,
– dadhi mastu – whey of curd,
– sukta – vinegar or
– phalāmla – juice of bitter fruits
Later, the pile mass must be bathed with ghee combined with Yashtimadhuka – licorice. Following this, the speculum is slowly eliminated.
Postoperative procedures
The affected person must be allowed to take a seat in a bathtub full of heat water for some time. Alternatively chilly water must be sprinkled over the affected person’s anus / rectum. In keeping with some students, the water used for sprinkling over the anus shouldn’t be very chilly. Due to this fact, lukewarm water must be used for a similar.
Subsequent, the affected person is shifted to a room devoid of breeze. He’s additionally given directions concerning his meals and actions that he ought to comply with.
On this method, every pile mass is individually handled, every at a interval of seven days.
Order of treating piles in presence of a number of pile plenty – When many pile plenty are current, they shall be handled within the beneath talked about order –
– the mass on the fitting aspect must be handled first
– subsequent, the pile mass on the left aspect must be handled
– the pile mass on the again i.e. deep inside must be handled subsequent and at last the mass current within the entrance must be handled
तत्रवातश्लेष्मनिमित्तान्यनिक्षाराभ्यांसाधयेत्,क्षारेणैवमृदुनापित्तरक्तनिमित्तानि।।५।।
Agni i.e. thermal cautery must be used to deal with piles that are attributable to aggravated vata and kapha.
Piles produced by pitta and rakta must be handled with milk alkalis.
Okayșāra dagdha laksana – Options of burning by alkalies
तत्रवातानुलोम्यमन्नरुचिरग्निदीप्तिाघवंबलवर्णोत्पत्तिर्मनस्तुष्टिरितिसम्यग्दग्ध-लिङ्गानि,अतिदग्धेतुगुदावदरणंदाहोमूर्छाज्वरःपिपासाशोणितातिप्रवृत्तिस्त -निमित्ताश्चोपद्रवाभवन्ति,ध्यामाल्पव्रणताकण्डूरनिलवैगुण्यमिन्द्रियाणामप्रसादोविकारस्यचाशान्तिहीनदग्धे।।६।।
Samyak dagdha lakshana – Beneath talked about are the signs of correct burning by alkali –
– downward motion of flatus,
– want for meals,
– improve of starvation,
– feeling of lightness,
– restoration of energy and color (of the physique) and contentment in thoughts
Ati dagdha Lakshana – Beneath talked about are the signs of over burning by alkali –
– tears within the anus,
– burning sensation,
– fainting,
– fever,
– thirst,
– heavy bleeding and problems consequent to it
Hina dagdha Lakshanas – Beneath talked about are the signs of insufficient burning by alkali –
– pile mass turns into black, growing a small wound,
– itching,
– irregularity of vāta,
– absence of calmness within the sense organs and
– non-mitigation of the illness
Agni karma & sastra karma – thermal cautery and surgical procedure
महान्तिचप्राणवतश्छित्त्वादहेत्,निर्गतानिचात्यर्थंदोषपूर्णानियन्त्राद्विनास्वेदाभ्यङ्गस्नेहावगाहोपनाहवित्रावणालेपक्षाराग्निशस्त्रैरुपाचरेत्प्रवृत्तरक्तानिचरक्तपित्तविधानेन,भिन्नपुरीषाणिचातीसारविधानेन,बद्धवर्चासिस्नेहपानविधानेनोदावर्तविधानेनवा ; एषसर्वस्थानगतानामर्शसांदहनकल्पः।।७।।
The pile plenty must be excised (minimize) and later the world must be burnt with fireplace if they’re huge in measurement and the affected person is robust. Placing it brief, each surgical procedure and fireplace cautery must be performed collectively.
Beneath talked about therapies must be performed for the pile mass which protrudes out tremendously and is full of elevated doshas taking care that the speculum is just not used –
– sudation,
– anointing with oils
– oleation
– tub-bath
– heat poultices
– bloodletting
– topical software of medicines
– use of alkali
– use of fireplace / thermal cautery and
– surgical procedure
Arshas in which there’s bleeding must be handled on strains of treating raktapitta.
If there’s elimination of liquid faeces together with arshas, it must be handled on the strains of treating atisara – diarrhoea.
If constipation is current in a affected person of arshas, he must be handled both with oleation remedy or on the strains of therapy of Udavarta – upward motion of vata / reverse peristalsis.
Thus, the strategies of burning / cauterization by each kshara and agni as relevant for arshas positioned in all of the locations has been defined.
आसाद्यचदर्वीकूर्चकशलाकानामन्यतमेनक्षारंपातयेत्।भ्रष्टगुदस्यतुविनायन्त्रेणक्षारादिकर्मप्रयुञ्जीत।
Kshara – caustic alkali must be utilized over the pile mass which is incurable. The pile mass is burnt utilizing alkali. It must be utilized with a deal with of a ladle or related such devices which is broad and may maintain extra amount of kshara.
Kshara must be utilized utilizing anal speculum in case of Bhrasta Guda – prolapse of rectum.
Hita ahara – appropriate meals
सर्वेषुचशालिषष्टिकयवगोधूमान्नंसर्पिःस्निग्धमुपसेवेतपयसानिम्बयूषेणपटोलयूषेणवा,यथादोषंशाकैर्वास्तूकतण्डुलीयकजीवन्त्युपोदिकाश्वबलाबालमूल -कपालयसनचिल्लीचुच्चूकलायवल्लीभिरन्यैर्वा।यच्चान्यदपिस्निग्धमग्निदीपनमर्शोघ्नंसृष्टमूत्रपुरीषंचतदुपसेवेत।।८।।
Meals ready from śāli, șaștika, yava or godhūma added with ghee must be consumed (by sufferers) in every kind of arshas. This meals must be consumed with one of many beneath talked about –
– milk or
– soup of nimba – Azadirachta indica (neem) or patola – Trichosanthes dioica, pointed gourd
– greens acceptable to mitigate the dosha concerned, like – vāstuka, tandulīyaka, jīvañtī, upodikā, aśvabalā, tender mülaka, palañkya, asana, cilli, cuccū, kalāyavallī or related others
Some other meals which have the beneath talked about properties shall be used –
– these that are unctuous,
– these which kindle digestive fireplace (improve capability of digestion),
– these which may remedy piles and
– these which assist in straightforward elimination of urine and faeces
दग्धेषुचार्श: स्वभ्यक्तोऽनलसन्धुक्षणार्थमनिलप्रकोपसंरक्षणार्थंसामान्यतःक्रियापथमुपसेवेत।विशेषतस्तुवातार्श : सुसीषिचवातहरदीपनीयसिद्धानिहिङ्ग्वादिभिश्शूर्णैःप्रतिसंसृज्यपिबेत्,पित्ताश : सुपृथक्पादीनांकषायेणदीपनीयप्रतीवापचस्नेहादीनांसर्पिः,शोणितार्श : सुमञ्जिष्ठामुरुङ्गयादीनांकषायेपाचयेत्,श्लेष्मार्श : सुसुरसादीनांकषाये।उपद्रवांश्चयथास्वमुपाचरेत्।।९।।
Common therapies like snehana – oleation and so on. must be adopted and adhered to in arshas which have been subjected to cauterization (by kshara or agni) and even in other forms of arshas. The intention is to kindle the agni and to mitigate aggravation of vata.
Piles produced by vata – In piles produced by vata, medicated ghee ready with vatahara – vata mitigating and dipaniya – digestive fireplace / starvation enhancing herbs added with Hingvadi Curna and so on. must be particularly administered.
Piles produced by pitta – In piles produced by pitta, medicated ghee ready with decoction of Prthakparni added with Dipaniya herbs (herbs which kindle digestive fireplace) must be particularly administered.
Piles produced by rakta – In piles produced by aggravated rakta – blood, medicated ghee processed with decoction of Manjistha, Murungi and so on. must be administered.
Piles produced by kapha – In piles produced by kapha, medicated ghee ready with decoction of Surasadi Gana group of herbs must be particularly administered.
Issues of Arshas must be handled appropriately.
Nirdesana – warning
परंचयत्नमास्थायगुदेक्षाराग्निशस्त्राण्यवचारयेत्,तद्विभ्रमाद्धिपाण्ड्यशोफदाहमदमूर्छाटोपानाहातीसारप्रवाहणानिभवन्तिमरणंवा।।१०।।
The doctor or surgeon ought to apply kshara – caustic alkali, agni – fireplace and shastra – sharp devices into the anus with utmost care and talent.
When these therapies are inappropriately performed, they’d produce the beneath talked about signs / problems –
– impotence,
– swelling,
– burning sensation,
– toxicity,
– fainting,
– gurgling noises within the stomach,
– flatulence,
– diarrhoea,
– tenesmus or
– even demise
Arso yantra – rectal speculum
अतऊर्ध्वंयन्त्रप्रमाणमुपदेक्ष्यामः – तत्रयन्त्रंलौहंदान्तंशार्ङ्गवाक्षंवागोस्तनाकारंचतुरङ्गुलायतंपञ्चाङ्गुलपरिणाहंपुंसां,षडङ्गुलपरिणाहंनारीणांतलायतं ; तद्द्विच्छिद्रंदर्शनार्थम्,एकछिद्रंतुकर्मणि ; एकद्वारेहिशस्त्रक्षा-राग्नीनामतिक्रमोनभवति;छिद्रप्रमाणंतुत्र्युङ्गलायतमङ्गुष्ठोदरपरिणाहं,यदङ्गुलमवशिष्टंतस्यार्धाङ्गलादधस्तादर्धाङ्गुलोच्छ्रितोपरिवृत्तकर्णिकम् ; एषयन्त्राकृतिसमासः।।११।।
Now, the measurements of Arsho Yantra i.e. rectal speculum shall be described.
Supplies used – Arso Yantra must be ready with any one of many beneath talked about –
– steel (iron),
– tusk (ivory) or
– horn of animals or
– tree (wooden)
Form – The form of the Arso Yantra must be within the form of a cow’s nipple.
Dimensions –
– for utilization in males – 4 angula (8cm) in size and 5 angula (10 cm) in circumference
– for utilization in ladies – 6 angula (12 cm) in circumference and size of palm (4 angula – 8 cm roughly).
Kinds of Arso Yantra – Arso Yantra is of two sorts –
- that having two slits for inspection and
- that having just one slit for doing therapy i.e. for software of kshara and shastra
Improper software of shastra, kshara or agni won’t occur if the instrument having one slit is used.
Measurement of the slit –
– 3 angula (6cm) in size
– measurement of center of the thumb – in circumference
– about ½ angula (1 cm) – within the remaining portion of the instrument
A spherical elevated karnika i.e. ridge of about ½ angula (1 sm) in peak must be made beneath the entrance orifice / opening of the instrument. It will restrict the instrument from getting deep into the rectum when it’s inserted.
Thus, the measurement of arso yantra – anal speculum instrument has been defined briefly.
Alepa – software of medicinal pastes on pile plenty
अतऊर्ध्वमर्शसामालेपान्वक्ष्यामः – स्नुहीक्षीरयुक्तंहरिद्राचूर्णमालेपःप्रथमः,कुक्कुटपुरीषगुञ्जाहरिद्रापिप्पलीचूर्णमितिगोमूत्रपित्तपिष्टोद्वितीयः,दन्तीचित्रकसुवर्चिकालागलीकल्कोवागोपित्तपिष्टस्तृतीयः,पिप्पलीसैन्धवकुष्ठशिरीषफलकल्कःस्नुहीक्षीरपिष्टोऽर्कक्षीरपिष्टोवाचतुर्थः,कासीसहरितालसैन्धवाश्वमारकविडङ्गपूतीककृतवेधनजम्ब्वर्कोत्तमारणीदन्तीचित्रकालर्कस्नुहीपयःसुतैलंविपक्वमभ्यञ्जनेनार्शःशातयति।।१२।।
Now, the usage of completely different Alepa – exterior software for use for piles shall be described –
– 1st Recipe – Powder of Haridra – Curcuma longa (turmeric) combined with milk / latex of Snuhi – Euphorbia neriifolia
– 2nd Recipe – Kukkuta Purisa (faeces of cock), Gunja – Abrus precatorius, Haridra – Curcuma longa and Pippali – Piper longum, all macerated with urine of cow
– third Recipe – Paste of Danti – Baliospermum montanum, Citraka – Plumbago zeylanica, Suvarcica – Saltpetre / Tribulus terrestris (?) and Langali – Gloriosa superba or Go-Pitta / Go-Rochana (oc gall)
– 4th Recipe – Pippali – Piper longum, Saindhava – rock salt, Kustha – Saussurea lappa and Sirisa phala – fruit of Albizia lebbeck macerated with latex of Snuhi – Euphorbia neriifolia or Arka – Calotropis gigantea
Medicated oil is ready with decoction of beneath talked about components cooked within the standard method –
– kāsīsa – inexperienced vitriol
– haritāla – orpiment
– saindhava – rock salt
– aśvamäraka – Nerium indicum
– vidanga – Embelia ribes
– pūtikā – Holoptelea integrifolia
– krtavedhana – Luffa acutangula
– jambū – Syzygium cumini
– arka – Calotropis gigantea
– uttamāraṇī – Achyranthes aspera
– danti – Baliospermum montanum
– citraka – Plumbago zeylanica
– alarka – Solanum trilobatum
– snuhikșira – latex of Euphorbia neriifolia and
– taila – oil
When the pile mass is anointed with this oil, it falls off.
Yapana yoga – recipes for steady use
अतऊर्ध्वंभेषजसाध्येष्वदृश्येष्वर्श :सुयोगान्यापनार्थंवक्ष्यामः – प्रातःप्रातर्गुडहरीतकीमासेवेत,ब्रह्मचारीगोमूत्रद्रोणसिद्धंवाहरीतकीशतंप्रातःप्रातर्यथाबलंक्षौद्रेण,अपामार्गमूलंवातण्डुलोदकेनसक्षौद्रमहरहः,शतावरीमूलकल्कंवाक्षीरेण,चित्रकचूर्णयुक्तंवासीधुंपरायं,भल्लातचूर्णयुक्तंवासक्तुमन्थमलवणंतक्रेण,कलशेवाऽन्तश्चित्रकमूलकल्कावलिप्तेनिषिक्तंतक्रमालमनम्लंवापानभोजनेषूपयुञ्जीत,एषएवभार्यास्फोतायवान्यामलकगुडूचीषुतक्रकल्पः,पिप्पलीपिप्पलीमूलचव्यचित्रकविडङ्गशुण्ठीहरीतकीषुचपूर्ववदेव,निरन्नोवातक्रमहरहासमुपसेवेत,शृङ्गवेरपुनर्नवाचित्रककषायसिद्धंवापयः,कुटजमूलत्वक्फाणितांवापिप्पल्यादिप्रतीवापंक्षौद्रेण,महावातव्याध्युक्तंहिङ्ग्वादिचूर्णमुपसेवेततक्राहारःक्षीराहारोवा,क्षारलवणांश्चित्रकमूलक्षारोदकसिद्धान्वाकुल्माषान्भक्षयेत्,चित्रकमूलक्षारोदकसिद्धंवापयःपलाशतरुक्षारसिद्धवापलाशतरुक्षारसिद्धान्वाकुल्माषान्,पाटलापा -मार्गबृहतीपलाशक्षारंवापरिस्त्रुतमहरहघृतसंसृष्टं,कुटजबन्दाकमूलकल्कंवतक्रेण,चित्रकपूतीकनागरकल्कंवापूतीकक्षारेण,क्षारोदकसिद्धंवासर्पिःपिप्पल्यादिप्रतीवापं,कृष्णतिलप्रसृतंप्रकुञ्चंवाप्रातःप्रातरुपसेवेतशीतोदकानुपानम् ; एभिरभिवर्धतेऽग्निरांसिचोपशाम्यन्ति।।१३।।
Additional, recipes which can be utilized for longer intervals of time for piles that are curable by medicines and likewise these that are invisible (and therefore curable by medicines) might be described –
– Guda Haritaki – a mixture of jaggery and Terminalia chebula, must be consumed within the morning, daily.
– 100 Haritaki – Terminalia chebula cooked in a single drona amount of cow’s milk must be consumed each morning by the affected person who’s sustaining celibacy (avoids copulation). Honey must be combined within the recipe. The affected person ought to devour this recipe contemplating his energy (digestion capability) or
– Roots of Apamarga – Achyranthes aspera must be macerated and brought combined in rice wash daily, after including milk to it or
– Paste of roots of Shatavari – Asparagus racemosus must be consumed combined with milk or
– Powder of Citraka – Plumbago zeylanica combined in half its amount of sīdhu; or
– Powder of Bhallataka – Semecarpus anacardium must be consumed combined with sakthu mañtha (groats) together with buttermilk devoid of salt; or
– Paste of Chitrakamula i.e. roots of Plumbago zeylanica must be smeared to the within of a pot. Bitter or unsoured buttermilk must be positioned on this pot and left in place. The affected person ought to use this buttermilk for consuming. Alternatively it shall be consumed with meals.
– Equally, buttermilk processed with bhārñgī – Clerodendrum serratum, āsphoța – Jasminum angustifolium / Clitoria ternatea, yavāni – Trachyspermum ammi, āmalaka – Emblica officinalis and guducī – Tinospora cordifolia; or with pippali – Piper longum, pippalīmūla – roots of Piper longum, cavya – Piper retrofractum, citraka – Plumbago zeylanica, vidanga – Embelia ribes, suņțhī – Zingiber officinale and harītaki – Terminalia chebula could also be used or
– The affected person must be suggested to devour solely buttermilk with out taking some other meals for a interval of 1 month, or
– Milk boiled with śrñgavera – Zingiber officinale, punarnavā – Boerhavia diffusa, citraka – Plumbago zeylanica must be consumed; or
– Phāṇita (mollases) ready with roots and bark of kutaja – Holarrhena antidysenterica added with powder of herbs belonging to pippalyādigana group of herbs combined with honey must be consumed; or
– Hiñgvādi cūrna described within the therapy of vātavyadhi must be used every day whereas consuming buttermilk or milk predominantly as meals or
– Kulmasa i.e. pulses cooked with alkali resolution and added with Kshara – Yava Kshara (alkali obtained from complete plant of barley), Lavana – Saindhava Lavana / rock salt and Chitraka Mula – roots of Plumbago zeylanica must be consumed or
– Milk boiled with ash of Palasha tree – Butea monosperma must be used for consuming or
– Okayulmāsa pulses cooked with ash of palāśa – Butea monosperma; alkali (ash) of pāțalā – Stereospermum suaveolens, apāmārga – Achyranthes aspera, brịhati – Sonanum indicum and palāśa – Butea monosperma properly filtered many occasions and combined with ghee must be consumed on a regular basis;
– Paste of kutaja – Holarrhena antidysenterica and roots of vañdāka – Dendrophthoe falcata combined with buttermilk must be consumed or
– Paste of citraka – Plumbago zeylanica, pūtīka – Holoptelea integrifolia and nagara – Zingiber officinale must be consumed together with resolution of ash of Putika – Holoptelea integrifolia or
– Ghee must be ready with resolution of yavakṣāra – alkali obtained from the entire plant of barley, added with powder of herbs belonging to Pippalyādi Gaṇa group of herbs whereas cooking and consumed or
– Paste of Krsna Tila – black sesame seeds must be consumed in a dose of 1 prastha – 80 grams or 1 prakunca – 40 grams dose. This recipe must be taken each morning adopted by consuming chilly water.
These recipes would improve agni – digestive fireplace and mitigate / remedy arshas – piles.
Dvipañcamūladi āsava
द्विपञ्चमूलीदन्तीचित्रकपथ्यानांतुलामाहृत्यजलचतुर्दोणेविपाचयेत्,ततःपादावशिष्टंकषायमादायसुशीतंगुडतुलयासहोन्मिश्यघृतभाजनेनिक्षिप्यमासमुपेक्षेतयवपल्ले,ततःप्रातःप्रातर्मात्रांपाययेत,तेनाग्रहणीदोषपाण्डुरोगोदावर्तारोचकानभवन्तिदीप्तश्चाग्निर्भवति।।१४।।
One tula – 4kg every of the beneath talked about herbs must be collected –
– Two Pancamulas – Brhat and Laghu Pancamulas (each collectively constituting Dasamula)
– Danti – Baliospermum montanum,
– Chitraka – Plumbago zeylanica and
– Pathya – Terminalia chebula
These herbs must be boiled in 4 drona – 40.94 kg of water and decreased to 1 / 4 in order to organize its Kashaya – decoction.
This Kasaya must be allowed to chill down. To the cooled Kashaya, 1 tula – 4kg Guda – jaggery is added and is poured right into a pot whose inside has been smeared with ghee.
Now, the pot is stored hidden in a heap of barley for a interval of 1 month.
Later, after one month, it’s taken out and the medication consumed daily, within the morning in appropriate doses.
Piles, ailments of the duodenum, anaemia, upward motion of vata (reverse peristalsis), and anorexia and so on. ailments won’t develop when this drugs is consumed. The digestive fireplace can even get augmented.
Dhātryārişta
पिप्पलीमरिचविडङ्गैलवालुकलोध्राणांद्वेद्वेपले,इन्द्रवारुण्याःपञ्चपलानि,कपित्थमध्यस्यदश,पथ्याफलानामधप्रस्थःप्रस्थोधात्रीफलानां,एतदैकथ्यंजलचतुर्दोणेविपाच्य,पादावशेषंपरिस्राव्य,सुशीतंगुडतुलाद्वयेनोन्मिश्य,घृतभाजनेनिःक्षिप्य,पक्षमुपेक्षेतयवपल्ले ; ततःप्रातःप्रातर्यथाबलमुपयुञ्जीत।एषखल्वरिष्टःप्लीहाग्निसङ्गार्थोग्रहणीहृत्पाण्डुरोगशोफकुष्ठगुल्मोदरकृमिहरोबलवर्णकरश्चेति।।१५।।
Elements –
– 2 pala (40 grams) every of – Pippali – Piper longum, Maricha – Piper nigrum (black pepper), Vidanga – Embelia ribes and Elavaluka – Prunus cerasus
– 5 pala (200 grams) – Iñdravāruni,
– 10 pala (400 grams) – Kapittha madhya – pulp of Limonia acidissima,
– ½ Prastha (320 grams) – Pathya phala / Haritaki – Terminalia chebula and
– 1 Prastha (640 grams) – Dhatri phala / Amalaki – Emblica officinalis
The above mentioned components must be boiled in 4 drona (40.96 kg) of water and decreased to 1 quarter in order to organize its Kashaya – decoction.
When the Kashaya will get cooled, 2 tula (4kg) guda – jaggery is added to it and all these are actually poured right into a pot whose inside has been smeared with ghee. This pot is hid in a heap of barley for a fortnight.
Later, the pot is faraway from the heap. The drugs is able to be consumed and is named Dhatryarishta. This drugs must be consumed each morning in an appropriate dose, as suited to 1’s capacity.
This Dhatryarishta cures the beneath talked about circumstances –
– enlargement of spleen
– dyspepsia
– piles
– ailments of the duodenum
– anaemia
– dropsy
– leprosy / pores and skin ailments
– stomach tumors
– enlargement of stomach and
– intestinal worms
It additionally bestows energy and color / complexion.
तत्र,वातप्रायेषुस्नेहस्वेदवमनविरेचनास्थापनानुवासनमप्रतिषिद्धं,पित्तजेषुविरेचनम्,एवंरक्तजेषुसंशमनं,कफजेषुशृङ्गवेरकुलत्थोपयोगः,सर्वदोषहरंयथोक्तंसर्वजेषु,यथास्वौषधिसिद्धंचपयःसर्वेष्विति।।१६।।
Vataja Arshas – In piles brought about because of predominant aggravation of vata, the beneath talked about therapies are usually not prohibited i.e. they are often performed –
– oleation
– sudation
– emesis
– purgation
– decoction enema and
– oil / unctuous enema
Pittaja Arshas – In piles brought about because of predominant aggravation of pitta, virechana – purgation has not been prohibited i.e. it may be readily thought of and performed.
Raktaja Arshas – In piles brought about because of predominant aggravation of rakta – blood, Samshamana Chikitsa – palliative therapies must be performed.
Kaphaja Arshas – In piles attributable to predominant aggravation of kapha, Srngavera – Zingiber officinale (ginger) and Kulattha – horse gram must be used.
Sarvaja / Tridoshaja Arshas – In piles attributable to aggravation of all three doshas, all therapies (to fight the aggravated tridoshas) must be performed.
Additionally, in every kind of arshas, one ought to devour milk boiled with acceptable herbs.
Bhallātaka prayoga – Use of Bhallataka (Semecarpus anacardium)
अतऊर्ध्वंभल्लातकविधानमुपदेक्ष्यामः – भल्लातकानिपरिपक्वान्यनुपहतान्याहृत्यततएकमादायद्विधात्रिधाचतुर्धावाछेदयित्वाकषायकल्पेनविपाच्यतस्यकषायस्यशुक्तिमनुष्णांघृताभ्यक्ततालुजिह्वौष्ठःप्रातःप्रातरुपसेवेत,ततोऽपराणेक्षीरंसर्पिरोदनइत्याहारः,एवमेकैकंवर्धयेद्यावत्पञ्चति,ततःपञ्चपञ्चाभिवर्धयेद्यावत्सप्ततिरिति,प्राप्यचसप्ततिभपकर्षयेद्भूयःपञ्चपञ्चयावत्पञ्चेति,पञ्चभ्यस्त्वेकैकंयावदेकमिति।एवंभल्लातकसहस्रमुपयुज्यसर्वकुष्ठार्शोभिर्विमुक्तोबलवानरोगःशतायुर्भवति।।१७।।
Additional, the tactic of utilizing Bhallataka – Semecarpus anacardium within the therapy of Arshas – piles might be described.
Firstly, properly ripened Bhallātaka fruits which aren’t spoiled must be collected. Every Bhallataka fruit is then minimize into two, three or 4 items. These items are boiled in water following the process of making ready Kashaya – decoction.
The affected person ought to drink this decoction each morning in a dose of 1 sukti (20 grams). The decoction must be chilly on the time of consuming. Care must be taken that the affected person ought to smear ghee over his palate, tongue and lips earlier than consuming the decoction.
As a weight-reduction plan, the affected person ought to take milk and cooked rice, added with ghee within the afternoon.
Whereas taking on this method, the variety of Bhallataka must be elevated by one fruit daily till it turns into fifty. After this, the quantity must be elevated by 5 Bhallataka fruits daily until it turns into seventy. Later, the reverse sample must be adopted and the variety of Bhallataka fruits must be progressively tapered.
As soon as the variety of Bhallataka fruits attain seventy numbers, the variety of Bhallataka fruits must be decreased by 5 fruits daily till it turns into fifty. Then onwards, the consumption of Bhallataka fruits must be decreased by one fruit daily until the quantity reaches just one fruit (as was began).
On this method, in your entire circle of accelerating and lowering the consumption of Bhallataka fruits, one would have consumed a complete of 1 thousand Bhallataka fruits. By this, he would get cured of every kind of kustha – pores and skin problems / leprosy and arshas – piles. He would additionally turn out to be sturdy and stay for a complete span of 100 years, i.e. it promotes longevity.
द्विवणीयोक्तेनविधानेनभल्लातकनिश्च्युतितंस्नेहमादायंप्रातःप्रातःशुक्तिमात्रमुपयुञ्जीत,जीर्णेपूर्ववदाहारःफलप्रकर्षश्च।भल्लातकमज्जभ्योवास्नेहमादायापकृष्टदोषःप्रतिसंसृष्टभक्तोनिवातमागारंप्रविश्ययथाबलंप्रसृतिंप्रकुञ्चंवोपयुञ्जीत,तस्मिञ्जीर्णेक्षीरंसर्पिरोदनइत्याहारः,एवंमासमुपयुज्यमासत्रयमादिष्टाहरोरक्षेदात्मानं; ततःसर्वोपतापानपहृत्यवर्णवान्बलवान्श्रवणग्रहणधारणशक्तिसंपन्नोवर्षशतायुर्भवति,मासेमासेचप्रयोगेवर्षशतंवर्षशतमायुषोऽभिवृद्धिर्भवति,एवंदशमासानुपयुज्यवर्षसहस्रायुर्भवति।।१८।।
Oil of Bhallataka – Oil is extracted and obtained from fruits of Bhallataka within the methodology described within the first chapter of Chikitsa Sthana – Dvivraniya Cikitsa. This oil is consumed in a dose of 1 sukti (20 grams) each morning. As soon as the oil will get digested, meals described earlier must be consumed with extra portions of fruits.
Oil obtained from Bhallataka fruit marrow could also be consumed within the dose of 1 prastha (80 grams) or 1 prakunca (40 grams) by the particular person –
– who has been cleared of the doshas i.e. the doshas have been expelled from the physique,
– who’s following correct weight-reduction plan routine and
– resides in a home / room devoid of breeze
As soon as this drugs will get digested, he ought to devour milk and boiled rice added with ghee.
On this method Bhallataka must be used for one month whereas following the dietetic routine for 3 months. Additionally, one ought to shield oneself from anger and so on.
Advantages – By doing so, one would –
– do away with all ailments,
– attain good complexion / color,
– acquire good energy and
– acquire capability for good listening to (sound notion), comprehension and reminiscence and
– stay for 100 years (promotes longevity)
Consumption of this recipe for one month would improve the life span by 100 years. Like this, for each month consumption of this recipe, the lifespan would improve by 100 years. If the particular person consumes this recipe for a time interval of ten months, one can be bestowed with a lifespan of 1 thousand years.
भवन्तिचात्र –
Some verse right here –
यथासार्वाणिकुष्ठानिहतःखदिरबीजको।।
तथैवाासिसर्वाणिवृक्षकारुष्करौहतः।।१९।।
हरिद्रायाःप्रयोगेणप्रमेहाइवषोडश।।
क्षारागीनातिवर्तन्तेतथादृश्यागुदोद्भवाः।।२०।।
घृतानिदीपनीयानिलेहायस्कृतयःसुरा।।
आसवश्चप्रयोक्तव्यावीक्ष्यदोषसमुच्छ्रितिम्।।२१।।
वेगावरोधस्त्रीपृष्ठयानान्युत्कुटुकासनम्।।
यथास्वंदोषलंचान्नमर्श :सुपरिवर्जयेत्।।२२।।
All of the styles of Kustha – pores and skin problems / leprosy would get cured by use of Khadira and Bijaka. Equally, every kind of Arshas – piles would get cured by use of Aruskara – Bhallataka.
All styles of Arshas – piles would get cured by use of Kshara – alkali and Agni – fireplace, similar to sixteen sorts of Prameha – diabetes would get cured by use of Haridra – turmeric.
In keeping with the aggravation of doshas in Arshas, the beneath talked about can be introduced into use –
– medicated ghee,
– confections,
– recipes of ayas – iron, corresponding to lohasava
Beneath talked about must be prevented by sufferers of Arshas –
– suppression of urges,
– copulation,
– driving animals,
– sitting on heels and
– use of meals that irritate the doshas
इतिसुश्रुतसंहितायांचिकित्सास्थानेऽर्शश्चिकित्सितंऽध्यायःनामषष्ठो।।६।।
Thus ends the Sixth chapter by title Arśas Cikitsita in Cikitsā Sthäna of Susruta Samhita.
