The twelfth chapter of Cikitsasthanam of Ashtanga Hridayam is called as Prameha cikitsitam Adhyayah. This chapter offers with the reason of ‘therapy of diabetes’.
The subjects coated on this chapter embody –
– Sodhana – purificatory remedy
– Samana – palliative remedy
– Decoctions for Kaphaja Prameha
– Decoctions for Pittaja Prameha
– Pana anna – drinks and meals processed with herbs
– Consumption of Yava
– Treatments for Kapha-pittaja Prameha
– Trikantakadi taila and Ghrta
– Dhanvantara Ghrta
– Lodhrasava
– Ayaskrti
– Therapies and measures to mitigate kapha and medas
– Silajatu Rasayana
– Measures to be taken by poor affected person of prameha
– Remedy for skinny sufferers of prameha
– Prameha Pidaka Cikitsa
– Premonitory signs
– Drugs for ulcer therapeutic
– Drugs for ulcer therapeutic
– Appraisal of use of Shilajatu
Pledge by the creator(s)
अथातो प्रमेहचिकित्सितं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having supplied prayers to the God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘therapy of diabetes’. Thus say (pledge) Atreya and different sages.
Shodhana: Purifactory remedy
मेहिनो बलिनः कुर्यादादौ वमनरेचने ।
स्निग्धस्य सर्षपारिष्टनिकुम्भाक्षकरञ्जजैः ॥ १ ॥
तैलस्त्रिकण्टकाद्येन यथास्वं साधितेन वा ।
स्नेहेन मुस्तदेवाह्वनागरप्रतिवापवत् ॥ २ ॥
सुरसादिकषायेण दद्यादास्थापनं ततः ।
न्यग्रोधादेस्तु पित्तार्तं रसैः शुद्धं च तर्पयेत् ॥ ३ ॥
The affected person of diabetes who is robust must be initially administered emesis purgation therapies after giving oleation remedy by ingesting oil ready with sarṣapa – Brassica nigra, ariṣṭa – Azadirachta indica, nikumbha – Baliospermum montanum, Terminalia bellerica, karañja – and Pongamia pinnata. Or oil processed with herbs commencing with trikantaka (enumerated in verse 17-18) or with different applicable herbs (appropriate to the doshas).
Afterwards asthapana basti (decoction enema) must be administered utilizing the decoction of herbs of surasadigana (vide, chapter 15 of sutrasthana) added with the paste of musta – Cyperus rotundus, devāhva – Cedrus deodara, nāgara – and Zingiber officinale, with the decoction of herbs of nyagrodhadi gana. For pitta (decoction enema must be given) after these purifactory therapies. He must be nourished with meat soup.
Shamana: Palliative remedy
मूत्रग्रहरुजागुल्मक्षयाद्यास्त्वपतर्पणात् ।
ततोऽनुबन्धरक्षार्थं शमनानि प्रयोजयेत् ॥ ४ ॥
असंशोध्यस्य तान्येव सर्वमेहेषु पाययेत् ।
Mūtragraha – Retention of urine, rujā – ache, gulma – stomach tumour, kṣaya – depletion of tissues and so on. come up from apatarpana (beneath nourishment) as secondary ailments. Therefore as a way to defend the affected person from these, he must be administered therapies to mitigate the doshas. The identical must be administered to those that are unsuitable for purifactory remedy, in all kinds of diabetes.
Shamana: Palliative remedy
धात्रीरसप्लुतां प्राह्णे हरिद्रां माक्षिकान्विताम् ॥ ५ ॥
दार्वीसुराह्वत्रिफलामुस्ता वा क्वथिता जले ।
चित्रकत्रिफलादार्वीकलिङ्गान् वा समाक्षिकान् ॥ ६ ॥
मधुयुक्तं गुडूच्या वा रसमामलकस्य वा ॥ ७अब् ॥
Within the forenoon, the affected person ought to drink both (powder of) Curcuma longa put into the juice of Emblica officinalis and combined with honey; dārvī – or Berberis aristata, surāhva – Cedrus deodara, triphalā – Terminalia chebula, Terminalia bellirica and Emblica officinalis, and mustā vā – Cyperus rotundus boiled in water; or decoction of citraka – Plumbago zeylanica, triphalā – Terminalia chebula, Terminalia bellirica and Emblica officinalis, dārvī – Berberis aristata, kaliṅga – and Holarrhena antidysenterica added with honey or contemporary juice of Tinospora cordifolia or Emblica officinalis combined with honey.
Decoctions for Kaphaja Prameha
लोध्राभयातोयदकट्फलानां पाठाविडङ्गार्जुनधन्वनानाम् |
गायत्रिदार्वीकृमिहृद्धवानां कफे त्रयः क्षौद्रयुताः कषायाः ॥ ७ ॥
The next three decoctions combined with honey must be consumed in case of improve of kapha;
1. lodhrā – both of Symplocos racemosa, abhayā – Terminalia chebula, toyada – Cyperus rotundus, kaṭphalānāṃ – and Myrica nagi;
2. pāṭhā – Cissampelos pareira, viḍaṅga – Embelia ribes, arjuna – Terminalia chebula, dhanvanānām – and Grewia tiliaefolia; or of
3. gāyatri – Acacia catechu, dārvī – Berberis aristata, kṛmihṛt – Embelia ribes, and dhava – Anogeissus latifolia.
Decoctions for Pittaja Prameha
उशीरलोध्रार्जुनचन्दनानां पटोलनिम्बामलकामृतानाम् ।
लोध्राम्बुकालीयकधातकीनां पित्ते त्रयः क्षौद्रयुताः कषायाः ॥ ८ ॥
The next three decoctions combined with honey must be consumed when pitta is elevated,
1. uśīra – both of Vetiveria zizanioides, lodhra – Symplocos racemosa, arjuna – Terminalia arjuna, candanānāṃ – and Santalum album;
2. paṭola – of Trichosanthes dioica, nimba – Azadirachta indica, āmalaka – Emblica officinalis, and amṛta – Tinospora cordifoli
3. lodhra – or of Symplocos racemosa, ambu – Cyperus rotundus, kālīyaka – Coscinium fenestratum and dhātakī – Woodfordia fruticosa.
Pana anna: Drinks and meals processed with herbs
यथास्वमेभिः पानान्नं यवगोधूमभावनाः ॥ ९ ॥
वातोल्बणेषु स्नेहांश्च प्रमेहेषु प्रकल्पयेत् ।
Drinks and meals must be ready from yava – Hordeum vulgare, godhūma – or Triticum aestivum which have been soaked within the decoction of the above herbs for consuming. In diabetes arising from improve of Vata, sneha (medicated fats-oil, ghee and so on) also needs to be ready with these herbs.
Pana anna: Drinks and meals processed with herbs
अपूपसक्तुवाट्यादिर्यवानां विकृतिर्हिता ॥ १० ॥
गजाश्वगुदमुक्तानामथवा वेणुजन्मनाम् ।
तृणधान्यानि मुद्गाद्याः शालिर्जीर्णः सषष्टिकः ॥ ११ ॥
श्रीकुक्कुटोऽम्लः खलकस्तिलसर्षपकिट्टजः ।
कपित्थं तिन्दुकं जम्बूस्तत्कृता रागषाडवाः ॥ १२ ॥
तिक्तं शाकं मधु श्रेष्ठा भक्ष्याः शुष्काः ससक्तवः ।
धन्वमांसानि शूल्यानि परिशुष्काण्ययस्कृतिः ॥ १३ ॥
मध्वरिष्टासवा जीर्णाः सीधुः पक्वरसोद्भवः ।
तथाऽसनादिसाराम्बु दर्भाम्भो माक्षिकोदकम्॥१४॥
Cake of rice and black gram baked in steam, corn flour combined with milk sugar and ghee, paste of pulses fried in oil ready from Hordeum vulgare which has come out of rectum of an elephant or horse (which have been fed sumptuously with barley earlier) or seeds of bamboo tree are appropriate. Equally, the corns produced by grass like vegetation mudga – Vigna radiata and so on. (pulses), previous rice and sastika rice, beverage often called srikukkuta- the bitter buttermilk processed with the residue of Sesamum indicum and Brassica nigra (after taking out the oil), kapitthaṃ – Feronia linonia, tindukaṃ – Diospyros malabarica, and jambū: – Syzygium cumini fruits and candy drink powder of bitter, sweets, spices, salts and so on. ready from them, bitter greens, honey, eatables (snacks) and paste of corn flour that are dry (non-fatty), meat of animals of desert-like areas inserted right into a rod and roasted or which is properly dried in solar, ayaskriti (described additional on), madhvarista and madhvasava that are previous, sidhu ready from cooking sugarcane juice, ingesting water ready from herbs of asandi gana (vide chapter 15 of sutrasthana), or from – Desmostachya bipinnata or honey water, (all are appropriate for sufferers of diabetes.)
Consumption of Yava
वासितेषु वराक्वाथे शर्वरीं शोषितेष्वहः ।
यवेषु सुकृतान् सक्तून् सक्षौद्रान् सीधुना पिबेत् ॥ १५ ॥
yava – Hordeum vulgare is soaked within the decoction of Terminalia chebula, Terminalia bellirica and Emblica officinalis for the evening and dried within the day. Paste of flour ready from this yavasaktu must be consumed together with sidhu added with honey.
Treatments for Kapha: Pittaja Prameha
शालसप्ताह्वकम्पिल्लवृक्षकाक्षकपित्थजम् ।
रोहीतकं च कुसुमं मधुनाद्यात् सुचूर्णितम् ॥ १६ ॥
कफपित्तप्रमेहेषु पिबेद्धात्रीरसेन वा ।
Flowers of śāla – Shorea robusta, saptāhva – Alstonia scholaris, kampilla – Mallotus philippinensis, vṛkṣaka – Holarrhena antidysenterica, akṣa – Terminalia bellirica, kapitthajam – Limonia acidissima and rohītakaṃ – Tecomella undulata powdered properly must be licked with honey. It may be consumed with the juice of dhātrī – Emblica officinalis in diabetes arising from kapha and Pitta.
Trikantakadi taila and ghrita
त्रिकण्टकनिशालोध्रसोमवल्कवचार्जुनैः ॥ १७ ॥
पद्मकाश्मन्तकारिष्टचन्दनागुरुदीप्यकैः ।
पटोलमुस्तमञ्जिष्ठामाद्रीभल्लातकैः पचेत् ॥ १८ ॥
तैलं वातकफे पित्ते घृतं मिश्रेषु मिश्रकम् ।
trikaṇṭaka – Tribulus terrestris, niśā – Curcuma longa, lodhra – Symplocos racemosa, somavalka – Acacia polycantha, vaca – Acorus calamus, arjuna – Terminalia arjuna, padmaka – Prunus cerasoides, aśmantaka – Bauhinia vahlii / Ficus rumphii, ariṣṭa – Azadirachta indica, candana – Santalum album, aguru – Aquilaria agallocha, dīpyaka – Trachyspermum ammi / Cuminum cyminum, paṭola – Trichosanthes dioica,musta – Cyperus rotundus, mañjiṣṭhā – Rubia cordifolia, mādrī – Gliricidia sepium (?), bhallātaka – Semecarpus anacardium must be made use of for making ready medicated oil to be used in diabetes of vata-kapha origin, medicated ghee for that of pitta origin, mishraka (mixture of two fat) for combination of doshas.
Dhanvantara Ghrita
दशमूलशठीदन्तीसुराह्वं द्विपुनर्नवम् ॥ १९ ॥
मूलं स्नुगर्कयोः पथ्यां भूकदम्बमरुष्करम् ।
करञ्जौ वरुणान् मूलं पिप्पल्याः पौष्करं च यत्॥२०॥
पृथग्दशपलं प्रस्थान् यवकोलकुलत्थतः ।
त्रींश्चाष्टगुणिते तोये विपचेत् पादवर्तिना ॥ २१ ॥
तेन द्विपिप्पलीचव्यवचानिचुलरोहिषैः ।
त्रिवृद्विडङ्गकम्पिल्लभार्गीविश्वैश्च साधयेत् ॥ २२ ॥
प्रस्थं घृताज्जयेत्सर्वांस्तन्मेहान्पिटिका विषम् ।
पाण्डुविद्रधिगुल्मार्शःशोषशोफगरोदरम् ॥ २३ ॥
श्वासं कासं वमिं वृद्धिं प्लीहानं वातशोणितम् ।
कुष्ठोन्मादावपस्मारं धान्वन्तरमिदं घृतम् ॥ २४ ॥
Ten pala (480 grams) every of daśamūla – group of ten herbs, śaṭhī – Curcuma zedoaria, dantī – Baliospermum montanum, surāhvaṃ – Cedrus deodara, dvi punarnavam – the 2 punarnava (Boerhavia diffusa) roots of snuk – Euphorbia nerifolia, arka – Calotropis gigantean, pathyāṃ – Terminalia chebula, bhūkadambaṃ – Sphaeranthus senegalensis, aruṣkaram – Semecarpus anacardium, karañjau – the 2 Pongamia pinnata, varuṇān mūlaṃ – roots of Crataeva nurvala, pippalyāḥ – Piper longum, and pauṣkara – Inula racemosa, one prastha (768 grams) every of yava – Hordeum vulgare, kola – Ziziphus jujuba, kulattha – and Dolichos biflorus all three of them are boiled in eight occasions their amount of water and decoction decreased to 1 quarter. To it are added the paste of dvi pippalī – the 2 pippali (Piper longum fruit and root), cavya – Piper retrofractum, vacā – Acorus calamus, nicula – Salix tetrasperma / Barringtonia acutangula, rohiṣaiḥ – Cymbopogon martini, trivṛt – Operculina turpethum, viḍaṅga – Embelia ribes, kampilla – Mallotus phillipensis, bhārgī – Clerodendrum serratum, viśvai: – and Zingiber officinale and one prastha (768 grams) of ghee and medicated ghee ready. This system often called dhanvantra ghrta cures all styles of diabetes, diabetic ulcers, viṣam – poisons, pāṇḍu – anemia, vidradhi – abscess, gulma – stomach tumour, arśaḥ – haemorrhoids, śoṣa – consumption, śopha – dropsy, gara – homicidal poison, udaram – enlargement of stomach, śvāsaṃ – dyspnea, kāsaṃ – cough, vami – vomiting, vṛddhiṃ plīhānaṃ – illness of the spleen, vātaśoṇitam – gout, kuṣṭha – pores and skin ailments, unmāda – madness, and apasmāraṃ – epilepsy.
Lodhrasava
लोध्रमूर्वाशठीवेल्लभार्गीनतनखप्लवान् ।
कलिङ्गकुष्ठक्रमुकप्रियङ्ग्वतिविषाग्निकान् ॥ २५ ॥
द्वे विशाले चतुर्जातं भूनिम्बं कटुरोहिणीम् ।
यवानीं पौष्करं पाठां ग्रन्थिं चव्यं फलत्रयम् ॥ २६ ॥
कर्षांशमम्बुकलशे पादशेषे स्रुते हिमे ।
द्वौ प्रस्थौ माक्षिकात्क्षिप्त्वा रक्षेत्पक्षमुपेक्षया ॥ २७ ॥
लोध्रासवोऽयं मेहार्शःश्वित्रकुष्ठारुचिकृमीन् ।
पाण्डुत्वं ग्रहणीदोषं स्थूलतां च नियच्छति ॥२८॥
One karsha (12 grams) every of lodhra – Symplocos racemosa, mūrvā – Marsdenia tenacissima, śaṭhī – Curcuma zedoaria, vella – Embelia ribes, bhārṅgī – Clerodendum serratum, nata – Oroxylum indicum / Caesalpinia bonduc, nakha – Martynia annua, plava – Cyperus scariosus, kaliṅga – Hollarhena antidysenterica, kuṣṭha – Saussurea lappa, kramukha – Areca catechu, priyaṅgu – Callicarpa macrophylla, ativiṣā – Aconitum heterophyllum, agnika – Plumbago zeylanica, dve viśāle – the 2 visala (Citrullus colocynthis), caturjātaṃ – Cinnamomum zeylanica, Elettaria cardamomum, Cinnamomum tamala and Messua ferrea, bhūnimbaṃ – Andrographis paniculata, kaṭurohiṇī – Picrorrhiza kurroa, yavānī – Trachyspermum ammi, pauṣkara – Inula racemosa, pāṭhāṃ – Cissampelos pareira, granthi – Cynodon dactylon, cavyaṃ – Piper retrofractum, phalatrayam – triphala (Terminalia chebula, Terminalia bellirica and Emblica officinalis) are boiled in a single kalasa (49 litres 152 ml) of waterand decoction decreased to 1 / 4, filtered and cooled. To that is added two prastha (1536 grams) of honey and saved undisturbed for a fortnight. This system often called lodhrasava; cures meha – diabetes, arśa: – haemorrhoids, śvitra – leucoderma, kuṣṭha – pores and skin ailments, aruci – anorexia, kṛmi – intestinal worms, pāṇḍutva – anaemia, grahaṇī doṣa – issues of the duodenum, sthūlatāṃ – and weight problems.
Ayaskriti
साधयेदसनादीनां पलानां विंशतिं पृथक् ।
द्विवहेऽपां क्षिपेत्तत्र पादस्थे द्वे शते गुडात् ॥ २९ ॥
क्षौद्राढकार्धं पलिकं वत्सकादिं च कल्कितम् ।
तत्क्षौद्रपिप्पलीचूर्णप्रदिग्धे घृतभाजने ॥ ३० ॥
स्थितं दृढे जतुसृते यवराशौ निधापयेत् ।
खदिराङ्गारतप्तानि बहुशोऽत्र निमज्जयेत् ॥ ३१ ॥
तनूनि तीक्ष्णलोहस्य पत्राण्यालोहसङ्क्षयात् ।
अयस्कृतिः स्थिता पीता पूर्वस्मादधिका गुणैः ॥ ३२ ॥
Twenty pala (960 grams) every of the herbs of asanadi gana (vide chapter 15 of sutrasthana) are boiled in two vaha (24 litres 456 ml) of water, and decoction decreased to its quarter. 200 pala (9.6 Kg) of molasses half adhaka (1536 grams) of honey and paste of the herbs of vatsakadigana (vide chapter 15 of sutrasthana), every one pala are added to itand poured right into a pot smeared inside with ghee, honey and powder of Piper longum. The pot is then given a thick coating of jatu (lac) exterior and positioned inside a heap of yava – Hordeum vulgare. Skinny sheets of magnetic iron are made purple sizzling with the embers of khadira – Acacia catechu wooden and immersed within the liquid a number of occasions until the iron will get depleted fully within the liquid. (then the mouth of the pot is sealed and saved undisturbed for a fortnight) This formulation often called Ayaskrti, consumed each day supplies qualities (results) larger than the earlier one (Rodhrasava).
Therapies and measures to mitigate kapha and medas
रूक्षमुद्वर्तनं गाढं व्यायामो निशि जागरः ।
यच्चान्यच्छ्लेष्ममेदोघ्नं बहिरन्तश्च तद्धितम्॥३३॥
Deep, dry therapeutic massage, bodily train, protecting awake at nights and all such different actions each exterior and inside which mitigate slesman (kapha) and medas (fats) (to a affected person of diabetes).
Shilajatu Rasayana
सुभावितां सारजलैस्तुलां पीत्वा शिलोद्भवात् ।
साराम्बुनैव भुञ्जानः शालीञ्जाङ्गलजै रसैः ॥ ३४ ॥
सर्वानभिभवेन्मेहान्सुबहूपद्रवानपि ।
गण्डमालार्बुदग्रन्थिस्थौल्यकुष्ठभगन्दरान् ॥ ३५ ॥
कृमिश्लीपदशोफांश्च परं चैतद्रसायनम् ।
One tula (4.8 Kg) of asphaltum is soaked and incarcerated properly within the decoction of sara (herbs of asanadigana). He who consumes this (each day in applicable dose) and eats boiled rice with the identical decoction and soup of meat of animals of desert-like areas, will get cured of all of the styles of diabetes, although having many problems /secondary ailments gaṇḍamāla – and in addition scrofula, arbuda – malignant tumour, granthi – cysts, sthaulya – weight problems, kuṣṭha – pores and skin ailments, bhagandarān – rectal fistula, kṛmi – worms, ślīpada – filariasis, śophāṃśca – and swelling (dropsy). It’s the finest rejuvenator too.
Measures to be taken by poor affected person of prameha
अधनश्छत्रपादत्ररहितो मुनिवर्तनः ॥ ३६ ॥
चन्दनमुत्पलं द्राक्षा उशीरं च पुनर्नवा ।
यष्टीमधुकश्रीखण्डं त्रिफलोत्पलशारिवा ॥ ३६१+१ ॥
The affected person of diabetes who has no cash (to supply for his therapy), ought to go on stroll (by foot) for 100 yojana (800-900 miles approx), with out making use of an umbrella and with out footwear adhering to the lifestyle of an ascetic (disciplined and onerous life) or dig a reservoir of water by himself or wander together with a herd of cow uncovered to the dung, urine and so on. of the cows.
Remedy for skinny sufferers of prameha
बृंहयेदौषधाहारैरमेदोमूत्रलैः कृशम् ।
The affected person of diabetes who’s emaciated must be stoutened / nourished properly with herbs and meals which don’t improve fats and urine.
Prameha Pidaka Chikitsa
शराविकाद्याः पिटिकाः शोफवत्समुपाचरेत् ॥ ३८ ॥
अपक्वा व्रणवत्पक्वास्तासां
Saravika and different pitaka (diabetic eruptions) that are unripe must be handled simply as an inflammatory oedema. These that are ripe; simply as treating an ulcer.
Premonitory signs
प्राग्रूपमेवच।
क्षीरिवृक्षाम्बु पानाय बस्तमूत्रं च शस्यते ॥ ३९ ॥
तीक्ष्णं च शोधनं प्रायो दुर्विरेच्या हि मेहिनः ।
Of their prodromal stage itself, it’s useful to drink the decoction of bark of bushes yielding milky sap and goats urine, resort to robust purifactory therapies, since usually sufferers of diabetes are onerous in respect of purgation remedy.
Drugs for ulcer therapeutic
तैलमेलादिना कुर्याद्गणेन व्रणरोपणम् ॥ ४० ॥
उद्वर्तने कषायं तु वर्गेणारग्वधादिना ।
परिषेकोऽसनाद्येन पानान्ने वत्सकादिना ॥ ४१ ॥
Oil for therapeutic the ulcers must be ready from herbs of eladi gana (chapter 15 of sutrasthana) decoction for massaging ready from herbs of aragvadhadi gana (chapter 15 of sutrasthana), water for pouring over the physique from herbs of asanadi gana (chapter 15 of sutrasthana), ingesting water and meals proceeded with herbs of vatsakadi gana (chapter 15 of sutrasthana).
Drugs for ulcer therapeutic
पाठाचित्रकशार्ङ्गष्टाशारिवाकण्टकारिकाः ।
सप्ताह्वं कौटजं मूलं सोमवल्कं नृपद्रुमम् ॥ ४२ ॥
सञ्चूर्ण्य मधुना लिह्यात् तद्वच्चूर्णं नवायसम् ।
pāṭhā – Cissampelos pareira, citraka – Plumbago zeylanica, śārṅgaṣṭā – Clerodendrum serratum, śārivā – Hemidesmus indicus, kaṇṭakārikā – Solanum xanthocarpum, saptāhvaṃ – Alstonia scholaris, kauṭajaṃ mūlaṃ – root of Holarrhena antidysenterica, somavalkaṃ – Acacia catechu, nṛpadrumam – Cedrus deodara, must be powdered properly and licked with honey (each day). Equally, navayasa curna (chapter 16/14 of cikistsa sthana) could also be licked.
Appraisal of use of Shilajatu
मधुमेहित्वमापन्नो भिषग्भिः परिवर्जितः ॥ ४३ ॥
शिलाजतुतुलामद्यात्प्रमेहार्तः पुनर्नवः ॥ ४३ऊअब् ॥
That affected person of diabetes who has been rejected (refused therapy) by the doctor, ought to devour one tula (4.8 Kg) of silajatu in appropriate each day doses to grow to be a brand new man once more.
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां चतुर्थे चिकित्सितस्थाने प्रमेहचिकित्सितं नाम द्वादशोऽध्याय: ॥ १२॥
Thus ends the chapter- prameha cikitsita- the twelvth in cikitsita sthana of Astanga hrdaya samhita composed by Srimadvagbhata, son of Sri Vaidyapati Simhagupta.