The 4th chapter of Chikitsasthana of Sushruta Samhita is known as as Vātavyādhi Cikitsitam Adhyaya. This chapter offers with Remedy of Neurological Ailments.
अथातोवातव्याधिचिकित्सितंव्याख्यास्यामः।।१।।
यथोवाचभगवान्धन्वन्तरिः।।२।।
We’ll now expound Vātavyādhi cikitsita – remedy of illnesses attributable to (aggravated) vāta (illnesses of the nervous system); as revealed by the venerable Dhanvantari.
Āśayagata vāta cikitsă
आमाशयगतेवातेच्छर्दयित्वायथाक्रमम्।।
देय :षड्धरणोयोगःसप्तरात्रंसुखाम्बुना।।३।।
चित्रकेन्द्रयवेपाठाकटुकाऽतिविषाऽभया।।
वातव्याधिप्रशमनोयोगःषड्धरणःस्मृतः।।४।।
Chardana – In Amashayagata Vata i.e. aggravated vata lodged within the abdomen – chardana / vamana – emesis remedy ought to be administered.
Shaddharana Yoga – After vamana, Shaddharana Yoga i.e. Shaddharana Churna ought to be given combined with lukewarm water for a interval of seven days. Alternatively heat decoction of Shaddharana Churna ought to be administered for a similar variety of days.
The formulation referred to as Shaddharana Yoga or Churna is helpful for mitigating vata vyadhis.
Preparation – This formulation is ready with the under talked about substances –
– Chitraka
– Indrayava
– Patha
– Katuka
– Ativisha
– Abhaya
Powder of every of the above stated substances ought to be taken in a dose of 1 dharana every (roughly 750mg in amount) and combined collectively. That is referred to as Shaddharana. It ought to be administered combined with lukewarm water for seven days or ought to be administered within the type of Kashaya – decoction.
Profit – This formulation is used to fight Vata issues and is taken into account to be one of the best one within the enterprise.
पक्वाशयगतेचापिदेयंस्नेहविरेचनम्।।
बस्तयःशोधनीयाश्चप्राशाश्चलवणोत्तराः।।५।।
कार्योबस्तिगतेचापिविधिर्बस्तिविशोधनः।।
श्रोत्रादिषुप्रकुपितेकार्यश्चानिलहाक्रमः।।६।।
Under talked about ought to be administered for treating Pakvashayagata Vata i.e. vata lodged in and affecting Pakvashaya (colon) –
– Sneha virechana – oily purgatives,
– Shodana Vasti – purificatory enemas and
– Lavanottara prasha – meals with predominant salt style
Even in case of Vastigata Vata i.e. vata lodged in and affecting Vasti / Basti (urinary bladder), Basti Shodhana Vasti i.e. bladder cleaning purificatory enemas ought to be administered.
Likewise, therapies prescribed for mitigating vata ought to be adopted in srotradigata vata i.e. vata affecting the ear and different sense organs.
Dhätugata väta cikitsa
स्नेहाभ्यङ्गोपनाहाश्चमर्दनालेपनानिच।।
त्वङूर्मासासृकूसिराप्राप्तेकुर्यात्चासग्विमोक्षणम्।।७।।
Under talked about therapies ought to be adopted when Vata is positioned in and impacts pores and skin, muscular tissues, blood, veins and arteries –
– Snehana – oleation,
– Abhyanga – natural oil therapeutic massage, oil tub,
– Upanaha – heat poultices,
– Mardana – massaging,
– Alepa – making use of medicinal pastes on the physique and
– Asrk mokshana – bloodletting
स्नेहोपनाहाग्निकर्मबन्धनोन्मर्दनानिच।।
स्नायुसन्ध्यस्थिसंप्राप्तेकुर्याद्वायावतन्द्रितः।।८।।
Under talked about therapies are useful in treating Vata positioned in and affecting the ligaments, joints and bones and ought to be finished with out laxity as and when wanted –
– Snehana – oleation
– Upanaha – heat poultices,
– Agnikarma – branding with hearth / hearth or thermal cautery
– Bandhana – bandaging,
– Unmardana – arduous therapeutic massage or therapeutic massage with stress, squeezing, kneading or trampling the physique elements
निरुद्धेऽस्थनिवावायौपाणिमन्थेनदारिते।।
नाडीदत्त्वाऽस्थनिभिषक्चूषयेत्पवनंबली।।९।।
शुक्रप्राप्तेऽनिलेकार्यंशुक्रदोषचिकित्सितम्।।
Obstruction of vata contained in the bones ought to be handled within the under talked about manner –
– The bone ought to be punctured with Panimantha – thick needle and
– Vata which has been obstructed in it ought to be sucked by a tube inserted into the hole portion of the bone by the puncture
Likewise, therapies talked about for purification of semen as defined in chapter 2 of Sarira Sthana part ought to be finished to deal with Sukragata Vata – the semen affected by vata.
अवगाहकुटीकप्रस्तराभ्यङ्गबस्तिभिः।।१०।।
जयेत्सर्वाङ्गजंवातंसिरामोक्षैश्चबुद्धिमान्।।
एकाङ्गगंचमतिमाञ्छङ्गैश्चावस्थितंजयेत्।।११।।
In Sarvanga Vata i.e. vata affecting all the physique / all elements of the physique, the sensible doctor ought to administer the under talked about therapies –
– Avagaha – tub tub or immersion in medicated liquids,
– Sveda – sudation
– Kuti – chamber sudation / staying in heated room
– Karsu Sweda – mendacity on heated floor and
– Prastara Sweda – mendacity on heated corn, husk and so forth. which have been unfold on the bottom
– Abhyanga – therapeutic massage with medicated oils
– Basti / Vasti – medicated enemas and
– Siramoksa – bloodletting by venepuncture
Along with the above-mentioned therapies, an clever doctor ought to deal with Ekangavata – affection of anyone a part of the physique by aggravated vata – by utilizing Srnga – bloodletting utilizing sucking horns.
बलासपित्तरक्तैस्तुसंसृष्टमविरोधिभिः।।
सुप्तिवातेत्वसृङग्नोक्षंकुर्यात्तुबहुशोभिषक्।।१२।।
दिह्याच्चलवणागारधूमैस्तैलसमन्वितैः।।
Remedy ought to be given with respective therapies with out antagonizing each other in circumstances whereby vata is related to kapha, pitta and rakta.
A sensible doctor ought to do raktamokshana – bloodletting many instances in case of Suptivata – a situation attributable to vata whereby there may be lack of tactile sensation. Later the affected half ought to be smeared with paste of lavana – rock salt and agara dhuma – kitchen / chimney soot combined in oil.
Ahara-food
पञ्चमूलीशृतंक्षीरंफलाम्लोरसएवच।।१३।।
सुस्निग्धोधान्ययूषोवाहितोवातविकारिणाम्।।
Under talked about are useful as meals / dietary dietary supplements and ought to be served after including extra fats i.e. oil or ghee –
– Milk boiled with Pancamula
– Juice of bitter fruits
– Meat soup
– Horse gram soup and so forth.
Sālvaņa upanāha (poultice)
काकोल्यादिःसवातघ्नःसर्वाम्लद्रव्यसंयुतः।।१४।।
सानूपौदकमांसस्तुसर्वस्नेहसमन्वितः।।
सुखोष्णःस्पष्टलवण :साल्वणःपरिकीर्तितः।।१५।।
तेनोपनाहंकुर्वीतसर्वदावातरोगिणाम्।।
Under talked about are the principle substances of Salvana Upanaha –
– Herbs belonging to Kakolyadi Gana group
– All Vataghna – vata mitigating herbs,
– All Amla Dravya – all herbs and issues of bitter style,
– Anupa mamsa – meat of animals residing in marshy areas
– Audaka mamsa – meat of animals residing in water
– Sarva Sneha – all types of fat i.e. ghee, bone marrow, muscle fats and oil
– Spashta Lavana – added with lot of salt
All of the above stated substances are cooked collectively in order to type a smooth mass out of them and used heat to offer poultice. This is called Salvana Upanaha.
This paste shall be utilized as upanaha – heat poultice at all times to these sufferers affected by vata illnesses and sudation given.
Remedy of contracted, painful or stiffened physique half
कुञ्यमानंरुजार्तंवागात्रंस्तब्धमथापिवा।।१६।।
गाढंपट्टैर्निबध्नीयात्क्षौमकार्पासिकौर्णिकैः।।
बिडालनकुलोन्द्राणांचर्मगोण्यांमृगस्यवा।।१७।।
प्रवेशयेद्वास्वभ्यक्तंसाल्वणेनोपनाहितम्।।
Any a part of the physique which has been contracted is painful and static (stiff, inflexible) ought to be subjected to abhyanga – therapeutic massage or anointing with oil and utilized with Salvana Upanaha. After this, that half ought to be bandaged tightly with bands of linen, cotton or wool or that a part of the physique ought to be inserted right into a sling (sac) constituted of the pores and skin of a cat, mongoose, otter or deer.
Remedy of vata affliction in shoulders, chest, higher again and nape of the neck
स्कन्धवक्षस्त्रिकप्राप्तंवायुमन्यागतंतथा।।१८।।
वमनंहन्तिनस्यचकुशलेनप्रयोजितम्।।
शिरोगतंशिरोबस्तिर्हन्तिवाऽग्विमोक्षणम्।।१९।।
स्नेहंमात्रासहस्रंतुधारयेत्तत्रयोगतः।।
An clever doctor ought to administer vamana – emesis and nasya – nasal remedy to treatment the shoulders, chest, higher again or nape of the neck which has been affected by aggravated vata.
Shirovasti – pooling of oil on the top or Raktamokshana – bloodletting ought to be administered to treatment shirogata vata i.e. aggravated vata positioned in and affecting the top. Whereas doing Shirovasti, oil ought to be retained on the top for one thousand matrakala. Matrakala is the time period required to utter a vowel.
Remedy of Sarvanga Vata and Ekanga Vata
सर्वाङ्गगतमेकाङ्गस्थितंवाऽपिसमीरणम्।।२०।।
रुणद्धिकेवलोबस्तिर्वायुवेगमिवाचलः।।
Basti / Vasti i.e. medicated enema alone is sufficient to management vata when it’s localized in both the entire physique or anyone a part of the physique, identical to the mountain which controls the bouts of wind.
Vāta sämāñya cikitsa – normal therapies for vata
स्नेहस्वेदस्तथाऽभ्यङ्गोबस्तिःस्नेहविरेचनम्।।२१।।
शिरोबस्तिःशिरःस्नेहोधूमःस्नैहिकएवच।।
सुखोष्णःस्नेहगण्डूषोनस्यंस्नैहिकमेवच।।२२।।
रसाःक्षीराणिमांसानिस्नेहा :स्नेहान्वितंचयत्।।
भोजनानिफलाम्लानिस्निग्धानिलवणानिच।।२३।।
सुखोष्णाश्चपरीषेकास्तथासंवाहनानिच।।
कुङ्कुमागुरुपत्राणिकुष्ठैलातगराणिच।।२४।।
कौशेयौर्णिकरौमाणिकार्पासानिगुरूणिच।।
निवातातपयुक्तानितथागर्भगृहाणिच।।२५।।
मृद्वीशय्याऽग्निसंतापोब्रह्मचर्यंतथैवच।।
समासेनैवमादीनियोज्यान्यनिलरोगिषु।।२६।।
Under talked about are included within the normal line of remedy of aggravated Vata –
Therapies – under talked about therapies ought to be finished heat –
– Sneha – oleation or lubricating therapies
– Sweda – sudation
– Abhyanga – natural oil therapeutic massage, oil tub
– Basti / Vasti – medicated enema
– Sneha virechana – oily/ unctuous purgatives
– Sirovasti / Shirobasti – oil pooling over the top
– Shiro Sneha – oiling the top,
– Snaihika dhuma – lubricating smoke inhalation,
– Sneha gandusha – unctuous mouth gargles
– Snaihika nasya – unctuous oily drops instilled within the nostril
Meals together with –
– meat soup,
– milk,
– meat added with oil or ghee,
– juice of bitter fruits
– fatty meals
– salty meals
Different inclusions within the remedy –
– pouring comfortably heat liquids on the physique,
– masking the physique with thick material product of leaves of vegetation together with kumkuma, aguru, kustha, ela and tagara,
– garments – product of silk, wool or thick cotton garments shall be used,
– staying contained in the deep inside or underground chambers devoid of breeze and with little little bit of daylight / solar warmth,
– sleeping on smooth beds,
– publicity to the warmth of the solar, and
– sustaining celibacy (avoiding copulation)
All of the above stated therapies and measures in short shall be adhered to in treating all of the illnesses attributable to vata.
Tilvaka ghrta
त्रिवृद्दन्तीसुवर्णक्षीरीसप्तलाशङ्खिनीत्रिफलाविडङ्गानापक्षसमाःभागाः,कल्कस्तिल्वकमूलकम्पिल्लकयोः,त्रिफलारसदधिपात्रेद्वेद्वे,घृतपात्रमेकं,तदैकयसंयुज्यविपचेत्;तिल्वकसर्पिरेतत्स्नेहविरेचनमुपदिशन्तिवातरोगिषु।तिल्वकविधिरेवाशोकरण्यकयोर्द्रष्टव्यः।।२७।।
One aksa / karsa (10-12 grams roughly) every of –
– Trivrt
– Danti
– Suvarnaksiri
– Saptala
– Sankhini
– Triphala and
– Vidanga
One bilva (40 grams) every of –
– Tilvaka
– Mulaka and
– Kampillaka
2 adhaka (adhaka = 5.12 kg) every of –
– Triphala Rasa – decoction of Triphala and
– Dadhi – curds
One patra (2.56 kg) – ghrta – ghee
All of the above-mentioned substances ought to be cooked collectively and medicated ghee ready. This ghee is called Tilvaka Sarpi / Ghrta. It’s used as an unctuous purgative in all types of Vata issues. Equally, medicated ghee ready with Asoka and Ramyaka additionally shall be used for a similar objective.
Anu taila
तिलपरिपीडनोपकरणकाष्ठान्याहृत्यानल्पकालंतैलपरिपीतान्यनिखण्डश :कल्पयित्वाऽवक्षुद्यमहतिकटाहेपानीयेनाभिप्लाव्यक्वाथयेत्,ततःस्नेहमम्बुपृष्ठाद्यदुदेतितत्सरकपाण्योरन्यतरेणादायवातघ्नौषधप्रतीवापंस्नेहपाककल्पेनविपचेत्,एतदणुतैलमुपदिशन्तिवातरोगिषु;अणुभ्यस्तैलद्रव्येभ्योनिष्पाद्यतइत्यणुतैलम्।।२८।।
A wood pestle of an oil mill i.e. sesame is obtained. This could have been in utilization for a very long time. Now this pestle ought to be lower into small items, nearly to powder-like minuteness. This piece / powder is put into a giant iron cauldron. The cauldron is now crammed with water and is boiled. The layer of oil that rises to the floor of the water after it has been boiled for a while is separated with a sieve and brought out. Vata mitigating herbs are added to the oil and medicated oil is ready. This is called Anu Taila. It’s useful for utilization in all of the Vata Rogas. It’s referred to as Anu Taila as a result of it’s ready from minute items (anu = minute) of the oily materials.
Sahasrapāka taila
अथमहापञ्चमूलकाष्ठैर्बहुभिरवदह्यावनिप्रदेशमसितमुषितमेकरात्रमुपशान्तेऽग्नावपोहभस्मनिवृत्तांभूमिविदारिगन्धादिसिद्धेनतैलघटशतेनतुल्यपयसाऽभिषिच्यैकरात्रमवस्थाप्यततोयावतीमृत्तिकास्निग्धास्यात्तामादायोष्णोदकेनमहतिकाटहेऽभ्यासिञ्चेत्,तत्रयत्तैलमुत्तिष्ठेत्तत्पाणिभ्यांपर्यादायस्वनुगुप्तंनिदध्यात्;ततस्तैलंवातहरौषधक्वाथमांसरसक्षीराम्लभागसहस्त्रेणसहस्रपाकंविपचेद्यावताकालेनशक्नुयात्पक्तुं,प्रतिवापश्चात्रहैमवतादक्षिणापथगाश्चगन्धावातघ्नानिच,तस्मिन्सिध्यतिशङ्खानाध्यापयेहन्दुभीनाघातयेच्छत्रंधारयेद्वालव्यजनैश्चवीजयेबाह्मणसहस्रंभोजयेत्,तत्साधुसिद्धमवतार्यसौवर्णेराजतेमृन्मयेवापात्रेस्वनुगुप्तंनिदध्यात्,तदेतत्सहस्रपाकमप्रतिवारवीर्यंराजाहतैलम्;एवंभागशतविपक्वंशतपाकम्।।२९।।
A plot of floor with black soil is chosen. On this floor, the items of wooden of Mahat (Brihat) Panchamula are positioned and the wooden is ready on hearth.
100 ghata (drona – 10.24 kg) of sesame oil ought to be taken. Subsequent day, the plot of black soil on which the woods of Pancamula had been burnt is drenched with this sesame oil and allowed for in the future. Earlier than this, the sesame oil ought to have been boiled and ready with herbs belonging to Vidarigandhadi Gana group of herbs and equal amount of milk.
As soon as the soil turns into very unctuous because of the oil poured on it, it ought to be taken out and put into a giant pot. This pot is now crammed with scorching water.
After a while, the oil begins to drift on water. The floating oil is collected by the fingers individually and stored. Subsequent, it’s added with decoction of vata mitigating herbs, meat soup and milk and amla kanjika, every 4 instances the amount of oil. Now the oil is cooked.
Pastes of aromatic herbs collected from Himalayan areas and likewise from Daksinapatha – south India are added and medicated oil is cooked. Vata mitigating herbs are additionally added whereas cooking. The oil is cooked for one thousand instances in as many days as required.
When the oil is cooked effectively, it ought to be paraded with respect. Parading of oil ought to be finished by blowing conches, beating kettle drums and holding an umbrella. It ought to be fanned with fly whisks. 100 Brahmanas ought to be fed with meals. The ready oil is later saved in golden, silver or mud vessels and safely preserved. That is referred to as Sahasrapaka Taila – oil cooked for a thousand instances. It’s a very efficacious medication and is effectively fitted to kings. This oil, when cooked for 100 instances, is understood by the identify Satapaka Taila.
Patra lavana
गन्धर्वहस्तमुष्ककनक्तमालाटरूषकपूतीकारग्वधचित्रकादीनांलवणेनसहोदूखलेऽवक्षुधस्नेहघटेप्रक्षिप्यावलिप्यगोशनिहियेत्,एतत्पत्रलवणमुपदिशन्तिपत्राण्यााणिवातरोगेषु।।३0 ।।
Moist leaves of the under talked about herbs shall be collected –
– Gandharvahasta
– Muskaka,
– Naktamala,
– Atarusa,
– Putika,
– Aragvadha,
– Citraka and so forth
These herbs are lower into items. Equal amount of saindhava – rock salt is added to it and pounded effectively within the mortar. This paste is now put right into a pot whose inside has been smeared with fats (oil). It’s now cooked with the fireplace of cow-dung heaps. This is called Patra Lavana. That is very helpful in all of the Vatarogas. it shall be used both together with meals or as poultice.
Sneha lavana – kändalavana
एवंस्तुहीकाण्डवार्ताकुशिलवणानिसंक्षुधघटेपूरयित्वासर्पिस्तैलवसामज्जभिःप्रक्षिप्यावलिप्यगॊशाकृद्रिर्दाहयेत्ःएतत्स्नेहलवणमुपदिशान्तिवातरोगेषु।।(हतिकाण्डलवणम्)।।३१।।
Under talked about are collected –
– Snuhikanda
– Vartaka
– Sigru and
– Lavana
They’re all pounded and put in a pot. To this, ghee, oil, muscle fats and marrow are added. These substances are cooked with the fireplace of cow dung heaps. This Sneha Lavana (Kanda Lavana) is indicated in all Vata Rogas.
Kalyanaka lavana
गण्डीरपलाशकुटजबिल्वार्कस्नुह्यपामार्गपाटलापारिभद्रकनादेयीकृष्णगन्धानीप-नियनिर्दहन्याटरूषकनक्तमालकपूतिकबृहतीकण्टकारिकाभल्लातकेङ्गुदीवैजयन्ती-कदलीबाष्पद्वयेश्चरकेन्द्रयारुणीश्वेतमोक्षकाशोकाइत्येवंवर्गसमूलपत्रशाखमामाहृत्यलवणेनसहसंसृज्यपूर्ववन्ध्याक्षारकल्पेनपरित्राव्यविपचेत्,प्रतिवापश्चात्रहिङ्ग्वादिभिःपिप्पल्यादिभिर्वा।इत्येतत्कल्याणकलवणंवातरोगगुल्मप्लीहाग्निषङ्गाजीर्णार्थोऽरोचकार्तानांकासादिभिःकृमिभिरुपद्वतानाचोपदिशन्तिपानभोजनेष्वपीति।।३२।।
भवतिचात्र –
विष्यन्दनादुष्णभावाहोषाणांचविपाचनात्।।
संस्कारपाचनाच्चेदंवातरोगेषुशस्यते।।३३।।
Moist roots, leaves and branches (twigs) of the under talked about herbs are collected –
– Gandira,
– Palasa,
– Kutaja,
– Bilva,
– Arka,
– Snuhi,
– Apamarga,
– Patala,
– Paribhadraka,
– Nadeyi (jalajambu),
– Krshnagandha,
– Nipa,
– Nimba,
– Nidrahani (morata),
– Atarusaka,
– Naktamalaka,
– Putika,
– Brhati,
– Kantakarika,
– Bhallataka,
– Ingudi,
– Vaijayanti,
– Kadali,
– Baspadvaya (2 sorts of Baspika),
– Iksuraka,
– Indravaruni,
– Sveta moksaka and
– Asoka
They’re combined with Saindhava lavana – rock salt, equal in amount and cooked in an identical manner as earlier than.
The ash of the identical is collected. It’s combined with water after which filtered. To this, powder of herbs of Hingvadi Gana or Pippalyadi Gana group of herbs can be added. All these are cooked collectively within the methodology of getting ready ksara – alkalis. This is called Kalyanaka Lavana.
Indications – Kalyanaka Lavana is used within the under talked about circumstances –
– In remedy of all types of Vataroga – together with meals and drinks,
– Belly tumours
– Ailments of spleen,
– Dyspepsia,
– Indigestion,
– Piles,
– Anorexia,
– Cough,
– Intestinal worms
It’s useful in all of the Vatarogas because it produces moisture contained in the physique, is of scorching efficiency, causes ripening of doshas and is cooked with different herbs.
इतिश्रीसुश्रुतसंहितायांचिकित्सास्थानेवातव्याधिचिकित्सितंनामचतुर्थोऽध्यायः।।४।।
Thus ends the fourth chapter by identify Vātaroga Cikitsita in Cikitsā Sthāna of Suśruta Samhita.