Charaka Kshatasheena Chikitsa 11th chapter

Kshataksheena refers to injury or excessive exertion such as swimming, running, wrestling for long hours, leading to respiratory symptoms and depletion of body tissues. Charaka Samhita explains this condition in the 11th chapter of Chikitsa Sthana. This condition is correlated by a few as phthisis and even with tuberculosis.

We shall now expound the chapter on the treatment of Kshata Ksheena (Phthsis)
Thus, said lord Atreya [1-2]
Kind and famous sage Atreya herewith started explaining about Kshataksheena.

Causes

Kshata Ksheena Nidana – causes:
1. Straining in excess with a bow. Injury due to continuous use of bow
2. Bhara – Lifting heavy weight.
3. Falling while walking over uneven place or from high altitudes
4. Fighting with stronger persons
5. Stopping an enraged bull, stallion or any other strong animals requiring control
6. Throwing heavy stone, wooden blocks or equipments made of stone
7. Killing powerful animals
8. Reciting scriptures, verses on a very high tone
9. Walking for long distances, walking too fast
10. Crossing a big river by swimming
11. Running along with a running horse
12. Sudden high and long jump
13. Practising violent dance for a long time and
14. Being excessively injured by other violent and cruel acts.
Kshataksheena is caused because of the above activities by a person who indulges too much in sexual activities, who takes dry food stuffs (causes Vata increase), who takes less food at irregular intervals.
These activities lead to exertion in such a person and leads to injury of chest and lungs. [4-8]

Pathogenesis

Kshata Ksheena Samprapti:

Pathogenesis
Because of the above mentioned causative factors,
The chest gets broken, punctured and cracked;
Sides of the chest get pressed and
Pravepana -emaciation with tremor in limbs.
Gradually it leads to
Veerya hani – loss of potency, loss of fertility
Balahani – loss of strength and immunity
Varnahani – loss of complexion
Ruchi hani – Loss of taste, anorexia
Agnihani – loss of digestion strength.

The person suffers with –
Jwara – fever,
Vyatha – worries
Manodainya – mental debility, depression
Vid bheda – diarrhoea, IBS
Agnivadha – lack of hunger, absence of digestion strength.

While coughing, the patient spits out phlegm which is Dushta (putrid), Shyava (gray coloured sputum), Durgandha (foul smelling), Peeta (yellow) and Vigrathita (knotty), in large quantities along with blood.
The person suffering from Kshatakseena becomes excessively emaciated due to further wastage of semen and Ojas (vital essence). [9- ½ 12].

Premonitory signs and symptoms

Kshataksheena Poorvaroopa:
Premonitory Signs and symptoms-
Less manifested symptoms constitute premonitory signs and symptoms in Kshataksheena.
If there is Kshata (Injury) patient exhibit below symptoms.
Uro ruk – Pain in the chest,
Shonita chardi – Blood- vomiting and
Kasa – Cough are specially manifested, and

If there is Ksaya (diminution of tissue elements), then
Sa rakta mutratva – Heamaturia and
Parshva Prstha kati graha – Stiffness of the sides of tissue elements, chest, back and lumbar region are specially manifested. [12 ½- 13]

Prognosis

Sadhya Asadhyatva – Prognosis:
If the signs and symptoms are manifested in lesser quantities, if the power of digestion (of the patient) is strong, if the patient has good strength and if the disease is new (freshly occurred), then it is curable.
If the disease lasts for more than a year, then it is Yapya (palliable – Cannot be completely cured).
If all the signs and symptoms of the disease are simultaneously manifested, then such a patient should not be treated, because the condition is incurable. [14]

Treatment

Treatment based on symptoms:
If there is fresh injury to the chest, the patient is given:
Laksha (lac – Laccifer lacca) along with milk and honey
After Laksha is digested, digested, he is given food along with milk and sugar.

If there is Parshva basti ruja (pain in the sides of the chest or in kidney region) and if there is Alpa Pitta, Agni [less of Pitta and digestion strength], then the patient is given
Laksha (lac) along with Sura (alcoholic Drink)

If there is diarrhoea, then patient is given
Laksha (lac) along with Musta (Cyperus rotundus), Tinisha, Patha (Cissampelos parriera) and Vatsaka (Wrightia antidysenterica).

If the patient has strong digestion strength, then he is given
Milk cooked with Laksha (Lac), ghee, bee’s wax, drugs belonging to Jeevaniya group, sugar and Tavakksiri.

For the healing of injury, the patient should take
Milk boiled with Ikshuvalika, Bisagranthi (lotus stalk knot), Padma Kesara (Lotus stamen) and Chandana (Sandalwood), by adding honey.

If there is fever and burning sensation in the body, then the patient is given
Barley powder cooked with milk and added with ghee

Alternatively, such a patient should take sugar, honey and Saktu (roasted corn- flour) mixed with milk.
If the patient is suffering from cough and pain in the sides of the chest as well as bones, then he should take
Linctus prepared of the powder of Madhuka– Licorice, Draksha – Raisin, Tavaksheeri, pippali – Piper nigrum and Bala – Country mallow (root) mixed with ghee and honey. [15-20]

Eladi Gutika

1/2 Aksha of each of
Ela – Elattaria cardamum,
Patra – Cinnamomum tamala Nees and Eberum
Tvak,
1/2 Pala of Pippali – Piper nigrum,
1 pala each of
Sita – white variety of Cynodon dactylon
Madhuka– Licorice – Glycyrrhiza glabra
Kharjura – Phoenix sylvestris and
Mrudvika – Vitis vinifera is made to a powder.
This powder is added with honey to make a paste.
From out of this paste, pills of 1 Aksa each are prepared. 1 such pill is taken every day.
It is indicated in –
Kasa – cough
Shwasa – Asthma
Jvara – fever
Hikka – hiccup
Chardi – vomiting
Murccham – fainting
Rakta nisthivanam – hemoptysis
Trushna – morbid thirst
Parshva shula – pain in the sides of the chest
Aruchi – anorexia
Sosha – consumption
Pliha – splenic enlargement
Adhyavata – Rheumatic disorders
Svara bhedam – hoarseness of voice
Ksata – Injury to the chest
Ksaya – diminution of tissue elements and
Raktapitta – condition characterised by bleeding from different parts of the body.
This pill is improves energy and acts as aphrodisiac. [21-24]

Treatment of Excessive Bleeding
If there is excessive bleeding (hemoptysis), then the patient should eat eggs of Daksha (wild hen) along with juice (vegetable soup) or water.
He may also take the soup of the eggs of sparrow or (preparations) of the blood of goat or wild animals (like deer, etc).
The patient having hemoptysis (blood spitting) should take the powder of Punarnava, red variety of Shali rice and sugar cooked along with grape juice, milk and ghee. [25-26]

Symptomatic treatment

Milk is boiled the paste of Madhuka– Licorice and madhuka – Madhuka longifolia. With this milk, Tanduliyaka is cooked – useful in hemoptysis – blood spitting from mouth.

If there is Mudhavata (muscle cramping), the patient should take the fat of goat fried with Sura type of alcohol and mixed with Saindhava – rock salt.

If the patient is weak, emaciated and has chest injury, sleeplessness and excessive aggravation of Vata, then he should take goat’s fat boiled with the cream of milk and added with honey, ghee and sugar.

If the patient is emaciated, having injury in the chest and diminution of body tissues, he is given sugar, barley, wheat, Jivaka – Malaxis acuminata, Rishabhaka – Manilkara hexandra and honey in a linctus form. This potion promotes muscle tissue and blood.

The patient having injury to the chest and diminution of semen, should eat Shali – rice mixed with ghee prepared with milk boiled with Nyagrodha (Ficus benghalensis), Udumbara (Ficus racemosa), Ashvattha(Ficus religiosa), Plaksa, Sala( Shorea robusta) Priyangu (Callicara macrophylla), Tuft of Tala, Bark of Jambu(Syzygium cumini), Priyala (Buchanania lanzan), Padmaka – Prunus cerasoides and Asvakarna.

Yastvahvadi Ghrita

Ghee is cooked with equal quantity of milk, decoction of Madhuyasti (licorice) and Nagabala [4 times of ghee in total of ghee]. This medicated ghee is useful in the treatment of Kshata (injury to the chest).

Koladi Ghrita

Similarly, ghee is cooked with the decoction of Kola (ber fruit) and Laksha[4 times in total of ghee], 8 times of milk, and the paste of the bark of Katvanga, bark of Darvi, bark of Kutaja – Connessi (Holarrhena antidysenterica Wall.) and fruit of Kutaja – Connessi (Holarrhena antidysenterica Wall.) 1/4th fourth in total of ghee This medicated ghee is useful in the treatment of Kshata (injury to the chest) [27-34]

Amruta Prasha Ghrita

2 Prasthas of ghee is cooked with 2 Prasthas each of
Juice of Dhatri
Juice of Vidari (Ipomoea paniculata / Pueraria tuberosa),
Sugarcane juice
Soup of the meat of the goat
Milk and
1 Karsha each of the paste of
Jivaka – Malaxis acuminata,
Rishabhaka – Manilkara hexandra,
Veera – Desmodium gangeticum
Jivanti – Leptadenia reticulata,
Nagara – Zingiber officinale
Shati – Hedychium spicatum
Shalaparni – Desmodium gangeticum
Prishniparni – Uraria picta
Mashaparni – Teramnus labialis
Mudgaparni – Vigna trilobata
Meda – Polygonatum cirrhifolium
Mahameda – Polygonatum cirrhifolium
Kakoli – Fritillaria roylei
Ksheerakakoli – Lilium polyphyllum
Kantakari – Solanum xanthocarpum
Brihati – Solanum indicum
Sveta Punarnava – Boerhavia diffusa
Rakta punarnava — Boerhavia diffusa
Madhuka– Licorice – Glycyrrhiza glabra
Atmagupta – Mucuna pruriens
Shatavari – Asparagus racemosus
Riddhi – Habenaria intermedia
Parushaka – Grewia asiatica
Bharngi – Clerodendrum serratum
Mrudvika – Vitis vinifera
Brhati – Solanum indicum
Shringataka – Trapa natans
Tamalaki – Bhui amla
Payasya (Ksheera vidari)
Pippali – Long pepper fruit – Piper longum,
Badara – Zizyphus jujube,
Akshota – Juglans regia
Kharjura – Phoenix sylvestris
Vatama,
Abhisuka (Pishta) and
Such other fruits (which are alleviators of Vata and Pitta)
After cooking, when the recipe is cooled,
1 Prastha (768 ml) of honey,
1/2 Tula (2.4 kg) of Sugar, and
The powder [2 karsha each] of
Patra – Cinnamomum tamala Nees and Eberum
Ela (Elettaria cardamomum Maton)
Hema (Mesua ferrea)
Tvak – Cinnamon and
Maricha – Black pepper is added to it.
This medicated ghee is taken by a person in appropriate dose regularly.

This is called ‘Amruta Prasa ghritam’ and it is like ambrosia for human beings. This linctus is like Sudha (ambrosia worth the consumption of wordily creatures) and Amruta (nectar worth the consumption of the gods).
It is taken along with milk and meat soup.
It promotes
Nourishment of persons who had meat soup
Nourishment of persons, who had wasted semen
Who are suffering from phthisis
Who are weak
Who are emaciated because of chronic diseases
Who are cachectic and
Who have lost their complexion and voice
It cures
Kasa – cough
Hikka – hiccup
Jwara – fever
Svasa – Asthma
Daha – burning sensation
Trushna – morbid thirst
Rakta pitta – an ailment characterised by bleeding from different parts of the body
Chardi – vomiting,
Bhrama – fainting, and
Hrudi vyadhi – diseases of the heart,
Female genital tract and urinary tract
It helps in the procreation of a male child. [35-43]

Svadamshtradi Ghrita

1 Pala of each of
Svadamstra – Tribulus terrestris
Ushira – Vetiver – Vetiveria zizanioides
Manjistha – Rubia cordifolia
Bala – Country mallow (root) – Sida cordifolia
Kashmarya -Gmelina arborea
Katruna – Cymbopogon schoenanthus
The root of Darbha – Demostachya bipinnata
Pruthak Parni
Palasa – Butea monosperma
Rishabhaka – Manilkara hexandra and
Sthira – Desmodium gangeticum is made to decoction.
2 Prasthas of ghee is mixed with the above mentioned decoction
8 Prasthas of milk, and the paste of
Svagupta – Mucuna pruriens
Jivanti – Leptadenia reticulata
Meda – Polygonatum cirrhifolium
Rishabhaka – Manilkara hexandra
Jivaka – Malaxis acuminata
Shatavari – Asparagus racemosus
Riddhi
Mrdvika – Vitis vinfera
Sarkara – unrefined sugar
Shravani and
Bisa (lotus Stalk) [1/2 Prastha in total] and cooked
This medicated ghee cures:
Hruddrava (Palpitation of heart) caused by Vayu and Pitta
Hrudaya Shoola (pain in cardiac region) caused by Vata and Pitta
Mutrakrucchra (dysuria), piles, bronchitis, consumption and phthisis
It promotes strength and muscle tissues of persons emaciated because of indulgence in archery, women, alcoholic, caring heavy weight and walking a long distance. [44-47]

Samasaktu Ghrita

2 Prasthas of ghee is cooked by adding the decoction of
8 Palas Madhuka– Licorice – Glycyrrhiza glabra and
1 Prastha Draksha – Raisin – Vitis vinifera and
8 Palas of paste of Pippali – Long pepper fruit – Piper longum
After it is cooked and cooled, 8 Palas of each of honey and sugar is added and mixed well
This medicated ghee is administered by adding Saktu (roasted barely flour) in equal quantity.
It is useful in the treatment of-
Ksataksina (Phthisis) and
Rakta Gulma (Phantom tutor in ladies resembling pregnancy). [48-49]

Sarpirguda (First recipe)

Ingredients to be cooked: 2 Prasthas of ghee is added with
2 Prasthas each of
Juice of Amalaki – Phyllanthus emblica
Vidari (Ipomoea paniculata / Pueraria tuberosa) and
Iksu – Sugar cane
Decoction of drugs belonging to Jivaniya group
Goat milk
Cow milk
After the cooking is over and the recipe is cooled
1 Prastha (768 g) of sugar and 2 prasthas of honey is added and mixed well.
This medicated ghee is useful in the treatment of
Tuberculosis,
Epilepsy,
Raktapitta (an ailment characterised by bleeding from different parts of the body),
Prameha (obstinate urinary disorders including diabetes) and
Kshaya (consumption)
It prevents
Ageing,
Promotes longevity and
Endows the person with muscle tissue, semen as well as strength
If the diseases are caused by excess of pitta, then this recipe is used as linctus.
If however, the diseases are caused by the excess of Vayu, then it should be taken as a drink.
When this medicated ghee is used (licked) in the form of a linctus, it alleviates Pitta. Since it is in small quantity, it however, doesn’t suppress the Agni (power of digestion).
When it is used in the form of a drink, at alleviated Vata and obstructs heat.
This and such others medicated ghee is made to a thick paste by adding the powder of Tvakksiri, sugar and Laja (fried paddy) which is then be given to persons who are tired, weak and emaciated.
This and such other recipes of Sapirguda [recipes of medicated ghee in which sugar, honey etc, are added] is added with honey (which is equal in quantity with the powder of Tvakksiri, etc) and taken. Thereafter, the patient should drink milk. This instantaneously promotes semen, potency, strength and nourishment. [50-55]

Sarpirguda (Second recipe)

1 Pala of each of these drugs is made to a decoction:
Bala – Country mallow (root) – Sida cordifolia
Vidari (Ipomoea paniculata / Pueraria tuberosa)
Hrsva Panchamula (Shalaparni, Prishnaparni – Uraria picta, Brihati – Solanum indicum, Kavtakari and Goksura – Tribulus terrestris)
Punarnava – Boerhavia diffusa
And the Sungas (terminal buds) of five Ksirivrksha (Nyagarodha – Ficus bengalensis, Udumbara – Ficus racemosa, Asvatha – Ficus religiosa, Madhuka– Licorice – Glycyrrhiza glabra and Plaksa)
To this
2 parts milk
1 part juice of Vidari (Ipomoea paniculata / Pueraria tuberosa),
1 part soup of goat meat,
2 Adhakas ghee [in the text, actually 1 Adhaka is mentioned. But in practice, it is to be taken double the quantity according to the general rule (Praibhasa)], and
1 Aksa each of paste of drugs belonging to Jivaniya group is added and cooked.
When it is well cooked and cooled 32 Palas of Sugar is added
Thereafter, 1 Kudava of each of the powder of
Godhuma – wheat – Triticum sativum
Pippali – Long pepper fruit – Piper longum
Vamsa Locana,
Srngataka and
Honey is added
All of them are stirred with the help of a stirrer (Khaja)
When it becomes dense, cakes (Sarpirgudas) is prepared and each of them is wrapped with Bhurjapatra (thin barks of Bhuja tree)
Having taken this cake 1 Pala in weight, the patient should take milk or alcohol as post- prandial drink.
These are useful in the treatment phthisis.
These are also useful for persons who are
Emaciated because of excessive exertion,
Over – indulgence in sex and
Exhaustion by lifting excessive weight
These cakes are efficacious in the treatment of
Rakta-Nisthivana — Hemoptysis
Daha -Burning sensation
Pinasa – chronic rhinitis having residual infection in the chest
Parshva shoola — pain in the sides of the chest
Shira shoola – headache
Svara bheda – hoarseness of voice and
Varna nasha – loss of complexion [56-61]

Sarpirgudah (Third recipe)

1 Pala of each of
Tavaksheeri
Sravani (Muditika) – sphaeranthus indicus
Draksha – Raisin – Vitis vinifera
Murva – Marsedenia tenacissima
Rishabhaka
Jivaka – Malaxis acuminata
Vira kanda (Vidari (Ipomoea paniculata / Pueraria tuberosa)
Riddhi
Ksheerakakoli – Lilium polyphyllum
Brihati – Solanum indicum
Kapikacchu – Mucuna pruriens
Fruit of kharjura – Phoenix sylvestris and
Meda is made to a paste by triturating with milk.
To this paste 2 prasthas of each of these are cooked together:
Juice of Dhatri
Juice of Vidari (Ipomoea paniculata / Pueraria tuberosa)
Sugarcane juice and
Ghee
After the ghee is well cooked and cooled:
1/2 Tula of sugar and
1 Prastha of honey is added, out of which cakes (Sarpirgudas) is prepared.
These cakes cure
Kasa — cough
Hikka – hiccup
Jwara – fever
Yakshma – tuberculosis
Shvasa – bronchial asthma
Rakta Pitta – an ailment characterised by bleeding from different parts of the body
Halimaka – a serious type of jaundice
Shukra Ksaya – diminution of semen, oligospermia
Nidranasa-Insomnia
Trushna – morbid thirst
Karshya – emaciation and
Kamala – Jaundice [in translation, liquids, ghee and honey are taken double the prescribed quantity according rules (Paribhasa),] [62-65]

Sarpirguda (Fourth recipe)

All these drugs is made to powders: 10 palas of each of
Freshly collected and dried Amalaki – Phyllanthus emblica
Draksha – Raisin – Vitis vinifera
Atmagupta – Mucuna pruriens
Punarnava – Boerhavia diffusa
Shatavari – Asparagus racemosus
Vidari – Ipomoea paniculata / Pueraria tuberosa
Samanga – Rubia cordifolia
Pippali – Long pepper fruit – Piper longum
8 Palas of Nagara – Zingiber officinale
1 Pala of Madhuyasti – Licorice
1 Pala sauvarcala
And
2 Palas of Maricha – Black pepper fruit – piper nigrum
2 Adhakas each of
Milk
Tila Taila – sesame oil
Ghee and
100 Palas of Sugar is cooked together.
Thereafter, the above mentioned powders is added be prepared.
These cakes are taken by persons suffering from phthisis and consumption.
Intake of these cakes instantaneously promotes tissue elements like Rasa (Chyle) etc, as a result of which the individual gets nourished. [66-69]

Sarpir modakah (Fifth recipe)

1 Adhaka of Cow’s milk
2 Prasthas ghee
2 Adhakas Sugarcane Juice
2 Prasthas Juice of Vidari and
2 Prasthas soup of the meat of Tittiri is cooked together
During the final stage of cooking
1 Kudava each of
Paste of Madhuka– Licorice – Glycyrrhiza glabra Puspa
Priyala (Buchanania lanzan)
½ kudava Tugaksiri
20 fruits of kharjura
20 fruits bibhitaki
1 pala Pippali – Long pepper fruit – Piper longum
30 Palas Sugar
1 Karsa Madhuka– Licorice – Glycyrrhiza glabra and
1/2 Pala Drugs belonging to Jivaniya group each is added.
The above mentioned drugs are made to a paste by triturating with sugar cane juice before adding to the recipe.
After the recipe is fully cooked and cooled, 2 kudavas of honey is added.
From out of this, Modakas 1 Pala of the powder of Maricha – Black pepper fruit and Ajaji (cumin) are sprinkled.
These Modakas cures
Vatasruk (gout)
Diseases caused by Pitta
Phthisis
Cough and
Kshaya – body tissue depletion.

These are useful for persons suffering from emaciation, who are reduced of semen, whose blood is locked up in the chest, who are thin, weak and old, and also for those desires of having nourishment, complexion and strength.
These Modakas are also useful for ladies suffering from exudations through the vitiated genital tract, who ring from exudations through the vitiated genital tract, who desire conception and who suffer from miscarriages and death of the fetus in womb. By the use of these pills, ladies are endowed with auspiciousness strength and wholesomeness. These are promoters of Shukra (sperm) and Shonita (ovum) [70-77]

Recipes

In persons indulging in women, [vitiated] Vata afflicts Bestrides (Pelvic region). To such patients, recipes which are alleviators of Vayu, prompters of nourishment and aphrodisiacs are to be administered.
Sugar, powder of Pippali – Long pepper fruit – Piper longum, ghee and or honey is added to milk and given to patient to drink for the cure of cough and fever.
These ingredients can be added to milk after or before boiling, appropriately. Whenever honey is to be used, it is added to the milk when it is boiled and cooled.

Phalamla is fried in ghee and boiled with the juice of Vidari (Ipomoea paniculata / Pueraria tuberosa) and sugarcane.
The vegetable soup, thus prepared, is useful for a patient who is emaciated because of the excessive indulgence in women this is an excellent recipe for the promotion of longevity and nourishment.

Roasted barley flour is sieved through a cloth, and Mantha (thin gruel) is prepared out of it. This gruel is added with honey and ghee, and given to a patient suffering from phthisis, provided that he is accustomed to taken barley as one of the ingredients of the food and if he has strong of digestion.

Alternatively, meat of animals of arid zone (Jangala) is boiled with drugs belonging to Jivaniya group. The meat soup, thus prepared, should be sizzled with ghee, added, with sugar and used as a dish (Vyanjana) for a patient suffering from phthisis.
Boiled barley is given to a patient suffering from phthisis along with milk of she- buffalo, mare, she – elephant and she -goat or with meat soup or with vegetable soup or with Phalamla sizzled with ghee.
The above mentioned recipes are given to patient having strong power of digestion. If power of digestion is suppressed, then the patient should given recipes which are stimulants of digestion (Dipana) and carminative (Pacana). If there is Diarrhoea in a patient suffering from phthisis, then the bowel binding recipes prescribed for the treatment of tuberculosis (Chapter 8) is used. [78-84]\

Saindhavadi Churna

1 Pala each of Saindhava and sunthi
2 Palas of Sauvarchala
1 Kudava of Vrksamla (Dadima – Pomegranate)
1 Kuduva of leaf of Arjaka
1 Pala of Maricha – Black pepper fruit
1 Pala of Ajaji – cumin
2 Palas of Dhanyaka – coriander and
12 Palas of sugar is made to powders and mixed together.
In appropriate quantity, this powder is added to food and drinks.
It is appetizer, stimulant of digestion and promoter of strength; it cures pain in the sides of the chest, asthma and cough. [85-87]

Shadava

Powders of
1 Pala Dhanyaka
2 Pala Ajaji
2 Pala of Ajamoda
4 Palas of Dadima – Pomegranate – Punica granatum
1 Pala of Sauvarchala (Black salt)
1 karsa of Sunti – Zingiber offcinale
5 Palas of pulp of Kapittha (Feronia limonia) and
16 Palas of sugar is mixed together.
Like the earlier recipe, the present Sadava [delicious recipe having sweet and sour tastes] is administered along with food and drinks for the treatment of mandanala (suppression of the powder of digestion) and diarrhoea
It promoted the promotes the digestive power of patients suffering from tuberculosis [88-90]

Nagabala Kalpa

1/2 Karsha of the root (bark) of Nagabala (Grewia populifolia, Sida spinosa, Urena lobata, Grewia hirsuta) is boiled with milk and given to the patient on the first day.
Thereafter, the powder of Nagabala- root- (bark) is increased by 1/2 Karsha every day, and given by boiling with milk.
On 8th day, the quantity of Nagabala- root will be 1 Pala (48 g).
Thereafter, the patient should continue to take this drug in the dose of 1 Pala for 1 month.
While taking this drug boiled milk, the patient should refrain from taking any cereals. Whenever he feels hungry, he should take only milk.
The recipe is excellent for the promotion of nourishment, longevity, strength and immunity to diseases.
In the above mentioned manner, Mandukaparni, Sunthi (ginger) and Madhuka– Licorice is administered for therapeutic effects described above. [91-92]

Diet and drink

Food and drinks which are nourishing, cooling, Vidahi (which do not cause burning sensation), wholesome and light, is used by the patient suffering from phthisis and who is desirous of regaining health.
With due regard to the Agni (digestion strength), nature of disease, wholesomeness and strength, the patient of Phthisis should resort to wholesome diet, and regimens prescribed for tuberculosis, Kasa (cough) and Raktapitta (a disease for characterised by bleeding from different parts of the body ). [93-94]

Need for Prompt Attention

If the patient suffering from phthisis is not given appropriate treatment on time, then this may lead to Rajayakshma – tuberculosis. Therefore before the arrival of this ailment (attack of tuberculosis), the phthisis should be treated, subdued (Cured). [95]

In this chapter, on the treatment of phthisis, Lord Punarvasu who is conversant with Truth and is free from Rajas (1 of the 3 attributer representing fickle mindedness including passion) and Tamas (1 of the 3 attributes representing slackness including ignorance) imparted instincts to the senior disciple on the following points:
1. Etiology of Phthisis;
2. Signs and symptoms of phthisis in general and of each variety
3. Incurability, Pliability and curability of phthisis and
4. Successful treatment of curable variety of phthisis. [ 96-97]

Thus, ends the 11th chapter dealing with the treatment of Phthisis (Kshata Ksheena) in the section on therapeutics of Agnivesa’s work as redacted by Charaka and not being available, restored by Drdhabala.